Loading...
HomeMy WebLinkAbout0077 HELMSMAN DRIVE r7,7Y �� tY1 I"1'1�.K1 1r- h , r - - , �7 Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 7/11/17 t } Ci3 Thomas Perry CBO a Town of Barnstable 01 Building Division - 200 Main.St. Hyannis,MA 02601 RE: Insulation Permit 17-1788 Dear Mr. Perry This affidavit is to certify that all work completed for 77 Helmsman Drive, Centerville has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCloskey f Town of Barnstable r a" 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-174788 Date Recieved: 6/7/2017 Job Location: 77 HELMSMAN DRIVE,CENTERVILLE Permit For: Building-Insulation-Residential - Contractor's Name: WILLIAM J MCCLUSKEY State Lic. No; CSSL-102776 . Address: West Yarmouth, MA 02673 Applicant Phone: (508) 398-0398 (Home)Owner's Name: FRIEDMAN,ROY M&HELEN K Phone: (508)362-3856 (Home)Owner's Address: 77 HELMSMAN DR, CENTERVILLE,MA 02632 Work Description: Add R-40 cellulose to the attic.Air seal the attic plane with expanding foam. Total Value Of Work To Be Performed: $5,000.00 AJ Structure Size: 0.00 0.00 0.00E Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. " Signed: William McCluskey 6/7/2017 (508)398-0398 . Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $5,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 6i7i2017 $85.00 __. - -)0M-� Credit Card .... 0299 .... ........ .. ... Total Permit Fee Paid: k $85.00 f� �zMME r Town of Barnstable *Permit# : �OR/i� ' ~O Expires 6 month�frorn issue date Regulatory Services Fee _ B Thomas F.Geiler,Director �b,,rfDa. PERMIT Building Division Tom Perry,CBO, Building Commissioner AR 1 0 2008 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.townbarmtable.ma.us � Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number '/ Property Address -2 11 �L" ey /41X/V c e �J. Residential Value of Work ri -0&✓� Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name_���c�-e� _�r�or�r'� /�P�r�,,d �t G r14 Z4 C Telephone Number 5"o 3 zo Z 6-`r Home Improvement Contractor License#(if applicable)_ 5 3> ❑Workman's Compensation Insurance Check one: [j I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. . A copy of the Home Improvement Contractors License is required. SIGNATURE: ✓>,. G% Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 rs The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' a 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name(Business/Organization/Individual): Address: i¢a (d t�3� Phone.#: 63 9 �)City/State/Zip: � 3' � Are you an employer? Check the appropriate box. Type of project(required): 1.❑ I am a employer with . 614. 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction .2 I am a sole proprietor or:partner- listed on the attached sheet. 7...❑ Remodeling ship and have no employees These sub-contractors have 8.. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• � 9. ❑Building addition [No workers'comp.-insurance comp. insurance. 10. Electrical repairs or additions required.) 5. ❑ We are a corporation and its ❑ P 3.❑ 1 am a homeowner doing all work, officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers', 13.0 Other k 5U �. comp. insurance required.] "Any applicant_that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,-they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ' Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u der the pains and enalties ofperjury that the information provided above is true and correct Sijznafore: Date: �.6 Phone#: Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): - 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in.the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-cont>actor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in -_(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. ..The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street, Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-774 Revised 11-22-06 www.mass.gov/dia `1 - �O Town of Barnstable * anxtvsTnsi.E, • ��� Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I O 4, as Owner of the subject'property. herebyauthorize K oke.14-t o rj r/re , yd a 'vim s`L�,c to act on my behalf, in all matters relative to work authorized by this building permit application for: ' (Address of Job) A^a' 0� ` L00 Sigptature of Owner Date '/jay /'p�M �r,M - Pdnt Name QAWPHLESTORMS\building permit forms\EXPRESS.doc Revise020108 " IHE Town of Barnstable Regulatory Services Thomas F.Geiler,Director MAes. 1639. Building Division ArED Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print a DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC <ae �anvnuYres.reall�i a�✓ Za sac�u�aeCla BOARD OF BUILDING REGULATIONS ;License: CONSTRUCTION SUPERVISOR Number:-CS O49205 '�� �?�Birtlidate:�07/1�4"!;1}955 Expires:;07/14/2008 Tr.no: 28923 Restrctids °tG . MICHAEL J AUPPERLEE: 169 SANDALWOOD DR COTUIT, MA 02635 Commissioner ,, J� �anv;7zc�v.�sead� a�✓'�,�w�ar�'uraa.,l�s Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only Registration: 153.440 before the expiration date. If found return to: - Expiration 'Tti172008 Tr# 253486 Board of Building Regulations and Standards Type: Individual One Ashburton Place Rm 1301 Boston,Nla.02108 MICHAEL AUPPERLEE,REN.OVATIO.NS MICHAEL AUPPERLEE 169 SANDALWOOD DR Q• _ COTUIT, MA 02635 Administrator �`' Not valid without siga, re /9y.. Assessor's map and lot number ................... ..:.:;.... .,...... THE Sewage Permit number .......... .... 7�:�� ��. ...... . 218H39T11116 i House` number I `. iL6 9 9 �O 39• 9 # k. 0 MPY AP 71 TOWN OF BARNSTABLE '9 BUILDING INSPECTOR r , APPLICATION.FOR PERMIT TO ................................ ...mil ........................................ TYPE OF CONSTRUCTION ... A 'l .................................................... .......................19.0 TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies ,�for a permit according to the following information: Location ............c•` ...:j.........:.:...... :.................. � ........................ ProposedUse I.................................................................................................. ..............�........ Fire District � �C�-1�Zoning District ......... ... •C� .�... � ................................ .......... ........ ........... ......... ..,............................. Name of Owner ...... ..�.....,.. ..:...� .. .,t.... ...... .........Address ....... .......� !.,!!�._.,.��%��.`.:�-,-J Name of Builder_,.�! ��yYd ...Address �// �.1/3 !1 /� -�%�.�--�..........r...,1 J.. ........ d................. ............�. _ ................................................ Nameof Architect!.................................................................Address .................................................................................... 94-45. Number of Rooms ...................................................................Foundation ... ,.,.A.'1..(. ........ ` Exterior ....t:� he 1 ( I d�..... , r. S. ........Roofing .�'Q .. . ! C..e ?............ .� .•....... ... ........r...,.... Y10,�1 -r� ,,.... ............................ Interior 11, /�t.1 �.1 Floors �....... .(.: .... Heating t� .�-Ol!�zz--:.......l�...:!C %'..................Plumbing /a' .................................. ........:................................................................... ,� � � Fireplace % . `,''...........................................Approximate. Cost ......................y............................................. Definitive Plan Approved by Planning Board ---------/�------19 Area .......................................... Diagram of Lot and Building with Dimensions Fee . SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY;PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ......... ............................................. aConstruction Supervisor's License ....................... 4 SMITH, JAMES K. A=194-87 28616 One VDr�i�yee No ................. Permit for ............. .. Single Family Dwell' ........................................................ .. Location ,. Lot #4, 77 Helms Centerville ..................:............................................................ Owner James K. Smith .................................................................. Type of Construction ......Frame .................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ...October.;.31..............19 85 Date of Inspection ....................................19 Date Completed ......................................19 t of- o ° TOWN OF BARNSTABLE� Permit No. _______28616 t . _ Building Inspector , Cash ---------—- — °'"' OCCUPANCY PERMIT Bona Issued to .Tames K. Smith Address lot #4 77 Helmsman Drives Centerville Wiring Inspector ✓E � Inspection date _ Plumbing Inspector � � ^ Inspection date Gas Inspector { Inspection date r� L- 2 ¢G�,ca owl Engineering Department Inspection date a, ! -.I.r; ?�/ /i l�.y°/.r✓.'.Y9�.ie ar'. t 6 r,lf .. Board of Health Ty fY\ fl/1 ,.w4,q Inspection date `I,V_ THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS.AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ve"e...... 19 ...;,... ``� Building Inspector -y ,'�-, ; ....-r ,,y,'.y; k� �. .r':.. ra-°r.. �.. ,•r :, ,;:f-`''q? .�:!�'R x�... � „ ��P..�` 'O•�e� ,TOWN OF BARNSTABLE BUILDING DEPARTMENT 1 = DA"ST'L TOWN OFFICE BUILDING " HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Departmen !'rr^"'' DATE: � An Occupancy Permit has been issued` for the building-authorized by Building Permit #............... f` issued to ¢Z e_< �' AA , .��.. �_j��.. ���!...." L Please release the performance bond: . S�t�IC---LE �AMiLY - 3 6Cul2ool�-( N o C-A RLiA&S GV.t iJ D C-f2.._ DAILY FLovJ l O X. 3 = 330 P. D. S E P T'1 e- -FAIN K : 3 3 o x 15070 -- 4qs G.P.D . -'"� � +y� �� ~M` USC IQOQ . +1_..rAiJ� _ gr D IS Por.AL P►T V SE I CCO G-AL. ISO 5-F Y, Z . S 375" G, P. D BoT r,o 1`1 A RJE A, = So 6-F. X. •o Sa G, P• L7. `TorAL Vc51& K) = 4zS G P. D. tEIZCoIA.I IIo N RAC ; 1 'w; 2 Mitt. of- L ss 4G PETER r,r F TEST•/,�Ot-E j�3J-�Cp - lz- 3 •g-� 82 ICAE1�5f�� /U G G /r/ z /coo /.V✓. < ,AL-.: r. Box t.t AC, _.A o• P,7 .o TAI1//G //Vv.. 8a-I ec,J G'.E.2T/F/EO PG OT ,o�a�✓ � � . w•�SHCD .• 14 PRO 1=I L t= VA !JO SCALE / GE.er/,Cy Tf/QT THE you�o,�rta.�l S.yaw.v LOTs yE.L�EO.c/ COMPS-YES W/Tf/Th�E'.S/.o��,/�iE B�fXT�.2 ��t/YE /.tiG. ,4it/O.SETI�/�G` .e�4U/.�ENI�ivTS d� Th'� �2EGi.Sr�,2c=IJ.G4ici0.s!/.eriEya,� i ToWiV Oi�'�►J,c5�,p�-�=. �1.V1> /S NoT T//Gr A4/ 7- I3.4SE0 Gn/,4A/ S�GYit/f�E,E'Ed�c/.5.4/�!/GlJ yaT!�c_ USEv: y { r .t i �- i 1 1 � 09 ;y10 �. SGot 1"—40' �0-T oy�`�;�_. R'ichA►� LLF i S A. v� �� Su LI'v'A Y i -BAXTER y �tF� fro. 29733 � 1o.24048 t�P►'l.t C ) t'� 9 1 t� -nr rE1`�±' ,r,:•' YR`1 ' 0 ♦ t tit 's Assessor's map and lot ./..9..y.�. S7n. THE - SEPTIC SYSTEM MUSS 4 ; of ro�4 Sewage Permit number ` INSTALLED IN COMPLIA House number �7 �S �� BasMAS& E, WITH TITLE 5 = ............................................... F�,ANVIROIl9RgENTAL CODE 039.a T ,a . „r % ,. nwar TOWN OF BARNSTABLE ., B UILDIHG INSPECTOR APPLICATION FOR PERMIT TO .............. f ..... .. . .............................:.......... TYPEOF CONSTRUCTION ........................ f..`........... . . ....... . ...... ................................................. f...�.. �.......................19. TO THE INSPECTOR OF BUILDINGS: The undersigned here y applies for a p it ccofding o the foll i g information: Location ........... 6.........:1........ .. :. ..... ........... ........................ ProposedUse ., . i7 ................................................................................................. ......................... . . . . ............... .. Zoning District ......... .. . . ............. .........Fire District ...d"4, . ... . ............... Name of Owner ...... .... 1...... .........Address ....... . Name of Build ... ... . .. .... .................Address ........ .......................... Nameof Archite ..................................................................Address .................................................................................... ' Number of Rooms ......... . ...................................................Foundation ... ........ ......... . ...... ....... .... . . ............ t Exterior ..... 1 ..�. ...Roofing ............. ............ yy Floors .............................Interior ................ ... ...... ..... . ................................... Heating :..... ..................Plumbing ..............Gr..........� ' ................................... Fireplace Approximate. Cost .............. G �.......................... . ..................................... .. Definitive Plan Approved by Planning Board A------------____1__�______19 a Area ...... .... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Y 4r OCCUPANCrPERMITS REQUIRED FOR NEW DWELLINGS � 37 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. i Name .. ..................... ........ Construction Supervisor's License ..�J..�O.............. t ff�H, JAMES K. `* Na ... ... -Perrni4 for ....Q me...5.t ox.y............. j -4 Single Family Dwelling .............................................................................. Location ..... ...... ....................Centerville.............. .................... Owner .....James...K.....Smith......................................... Type of Construction ..........................................: ................................................................................. Plot ............................. Lot ................................ ""� ' October 31,Permit.Granted 19 85Date of Inspection,...;—.., .....19 Date Completed .... ., 2...........