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HomeMy WebLinkAbout0024 JUSTICE DOUGLAS WAY ., .. y a, 1 ��_ . � i nw F-.. c � .t.: yrr �4�r-. � .. .. et .ill � fits' — �_ .a.� '� ...... Fy .{ � e .. � � ti 1F r � .. ��: �.., .. u - c. .w., .. y.. .:. . - �I . � � � .. .. �, . t ,.. i .. . -: �.. ,. S From: Tom Caruso tcaruso@yahoo.com Subject: Fw:License Transfer. <' Date: April 3,2021 at 12:10 PM To: linnellent@gmail.com ----- Forwarded Message----- f From:Tom Caruso<tcaruso@yahoo.com> To: Linnell@gmail.com <linnell@gmail.com> Sent: Saturday, April 3, 2021, 12:01:42 PM EDT Subject: License Transfer. 24 Justice Douglas Way, Centerville MA. 02632 Town of Barnstable Building division As the homeowner of the property located at 24 Justice Douglas Way, I give approval to Dave Linnell to transfer building permit, B-20-3235 from the current contractor Teixeira Construction to Linnell Enterprises. Please feel free to contact me at (508)439-1879 with any questions or if you require additional information. Best Regards, _ i Tom Caruso 24 Justice-Douglas Way ' Centerville MA, 02632 g :w- I _ _ _ " own of Barnstable Building �s uiwxrnaan.�=fJ Past'it'tlstard So S`hat it(s Uts�hlt#rortsdkto Sheet /4pprair�t i+Parss MlrSt tFe Ratiirted-aO kobandf llhls Gird flllusC be ltcpt t+.'W - ui til Pirol fnspeetten Has®cea�f►tado a:x z p '} c` aZZ;! WhsreatcAiBrateaftbem�rancy�itc�uircd surhlu�dlrtgshalilat6ntkaupicdunUBmFinalttespectt becnmada s P1.rmii i s fmli No. B-20.3235 A,ppSkantNwn.c: •damienteweira , A "- teasued: Yt/UIWzO 61rrcnt ifte: Structure II !"at.type: Building•Addition/Alteration.Residential Upir:160%[bale: as'V'k 021 foundation: xiion: ZA YUSUCE 001.101AS WAY,CONE`AVI1Lt 6lapd tat„I%k V 2 $enins isttiw A ihcathir mar on Necerd: CAIt1190,t`HOMAS&NANCY A LursP�ctar e�1'k19taR`�COH3YFiUefiON INC, raining_ F. 'O idrw,: 201AtsIh11E.E'i AD CmrttaacYerficer>±d tii$€JG I a � 'EsLizrnlecttimt: $.dC;93k Lhirnne�T sa4pt�= guild pr,;ga . �sutatian� )Jett N;n wRcG: ,Wdif[edat>buittvirviymg, irebcfcireframa � FepParel:,� SYE3.�4 `' lei c 5}SpJ3tixo /ircel � . � k f� �/,i/ r �ea plumtringfGas l r k Rh prumbinip / "" ^y'tfsmldirfgUHiniud finaOiumbirg: r I.ttr;mat s}Wbr W-+3imravd-uaku is snlnmesxed Issuance, , sVa�6caurdzt:tlCy+hN.pai�rrssfallur,orrntasfiespprarJapplratisndndcnnapproiedcciatitfln�nc-uinsioftvh> thispo-rs'iti5as�tccn; aaipd.: �hGas: - - aliisaru:t(On,.i16¢ra^,.Nsns and Gtctn((k4i*R uSe�t any tfuikJ3.y?snd:svuACJiat#Fesllain ctan5[i' sM.di�thdfnral iating t+.4nwst=and�entlfst.,.' - s vemslt stu�Y be dispti- in a k+c.M'an ttegd ++sibk IGamarcris staeel a[�oeand st�I16e�sintainat €irul teas: yd g . _ - cpentor�rtlkhFspes+scnfortheentirrd�ruanct _ . .��� ;.. �rccrk.untilihr,amp�thrlcfthrsnmc:. _tt :� p - „^� �.` •�. ticarlical zt;prltKar!asr;.o�upircyaiinei.ha.,s.±sad v3ilal3a�,r#itatid;s'gaGirosls+,�dtwdtailtlii si�ilF:raef,'littalsu prd d4di50 this isOrMA, i,,,,;r„Ut�iYeCallfn:pect�nawetried€arnllac�nstrs_alioniticsk . , ,e aumirti�ao-arEDOUng " h: 11 3ar{� .. x f r SINE t Town of Barnstable Building Department Services. s +iszAsu, Brian Florence,CBO k $nilding,Commissioner :# 200 Main.Street,Hyannis;MA 02601 www:town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 • . t NOTICE TO THE BUILDING DIVISION OF' LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Construction Supervisor License hereby certify thatI have assumed responsibility for the project under ` construction, as authorized by building permit# -3� .. ,:issued to (property address) y J IC-4 �Q0419 l AS" . Q ,1 on 201 The following documents are attached: copy of my Massachusetts State Construction,Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration.(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) .07 LICENS HOLDER DATE q*ms/newcontrb rev:003/17 Town of Barnstable Building W - as�. ,,,; � .. at ,,' �•� X .. ..... � .< .•..ram. " Post This3Gard SoThat it; s Visible From the��StreetA _ rovedPlans�Musi beRetamedocrJob and�this Car'dsMust'be Ke't enxxxewea e P Pp , MASK. Posted UntllFinal Inspe'ctl9n,Flas°Been Made � � ,����-- � ``' � ��"• ,� � t �' _ � � �,,, � �x�� ° ;639 Permit R Where a Cert�ficateof�O,cc.0 anc. is;Re. uired,vsach,Buildin shall Not be Occu ied^untilraFinahlns ection'has been,made Permit No. B-18-764 Applicant Name: TIMOTHY CABRAL Approvals Date Issued: 04/06/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 10/06/2018 Foundation: Location: 24 JUSTICE DOUGLAS WAY,CENTERVILLE P Map/Lot 191-192 Zoning District: RC Sheathing: Owner on Record: CARUSO THOMAS&NANCY A Contractor Name ALTERNATIVE WEATHERIZATION, Framing: 1 I �� k � INC. Address: 28 TAM MIE ROADS 2 ContraCtor;License 1756.83 HOPEDALE, MA 01747 Chimney: Est Project Cost: $3,777.00 Description: INSULATION/WEATHERIZATION ,. ( Insulation: Permit Fee: $85.00 Project Review Req: � _ Fee Paid: $85.00 Final: Date: 4/6/2018 _..... ___. Plumbing/Gas Rough Plumbing: , 1.:...�....... "...._ Building Official -AFinal Plumbing:Rough Gas: This permit shall be deemed abandoned and invalid unless the work aathonze&by this permit is commenced within six onthsaafter issuance. Final Gas: All work authorized by this permit shall conform to the approved application,and the approved construction documents for which this permit has been granted. � , All construction,alterations and changes of use of any building and structures shall be in compliance with the local zonng,by lawsarid codes. This permit shall be displayed in a location clearly visible from access street or.road and shall be°maintained open for pukihc inspection for the entire duration of the Electrical work until the completion of the same. 4 Service: The Certificate of Occupancy will not be issued until all applicable signatures Dy the lsuqding and Fire ff cials a(e provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work:' ' - 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations: Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: 9` Building plans are to be available on site \ ��, All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT r273T7Y�747 ... ........ .. :..... . SAIMBU _YABILI FemiftFte........ ............OhwFee..................... TOtd Fac Md.................... . TOWN OF BARNSTABIX PmmftApp¢aveiby !'" ...,....On b 6. BUff.DING PERMIT f APPLICATION Map........I.. ....1. ............J..4.._....a��.. Section 1--Owners Worivatian,`azfd P-ioiert Location PrciectAddressiO cl Owners Narie A, Zt owners Legal Address _ R star f�'Jf 1. / - zip 9YT owners Cell#`J -T19 77 F mz o Sect ioa 2-Structural Ilse J� Single I Two F=ily Dwwling ❑ Commercial Striae over 35,000 cubic feet _ 'Commercial Structure under 35,000 Ncubic feed Section 3-1`ype of Peh nit ❑ New Constm edon ❑.Move I Relocate ❑ Accessary Structure, ❑`Change'of use " ❑ Demo/ entire strums , { ) ❑ FirushBeserueat ❑ FamlylAmnesty, ❑ -Fire Alarm. Rebuild ❑ Deck Apartment ❑..Sprinkler System— _ ❑ Addition Retaining wall, ❑ Solar Renovation "` Pool 'Insulation" oar—Sgeczfy - Section 4—Detail Cost of ProposedconstrmcdoJ7 Square Foa W of P -ect d� Age of Structure Safe Number #Of$edrooms Existing Total#Ofi droonis(prow y 110 NTH Wmd.Zone Compliance Method MA Checklist WFCM Quest MAR_15 20 1 TOWN OV- \si _10 III • , -Section S :Work Description Section 6—Project Specifics, , ❑ Wning ❑ oil Tank Storage. Smoke Detectors Plumbing ❑ Gas ❑ Firs:Suppression ❑Heating Systems. ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ .On Site Historic District ❑ Hyannis Mstoiic District ❑ Old Kings Aighway Debris Disposal'Facility- I am using a crane C Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjace t to a wetland,coastal bank? Yes ❑ No ❑ Section S—Zoning Information F-- Zoniag District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #'of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required 'Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board iu the past? ❑`Yes El No Lost updsb&iinmv 'Section 9—Construction.Supervisor Name % .. Ze Number h?l' :2_ Addreas , ve/s m� Z License Number/O�� License Type Vl Pxpirsfian Date concrorsm `-L�' 'Li HtG� Cell# I odd my r b;}iriesj tdu rnd d regndaz=for UcemsedCnstrucd=SVWViS=is accordance with 790 CMR the Ifimm huselts BucicTmg Code caus�xnctic n hupecticm Pam, c b2Vac ims said docmma mdm of 3e'Attach a&W of your if cemse• Section 10—Home Improvement Contractor x N SW&4_Zip Reg�Number/ E*radon Date I mulasbmd my reapaasc•Hclities mnder the nudes aced reguldkm for$ome Improvement ccvbmci is accardaace with 780 CMR the Massachusetts Bauldirtg Code, canstruc d=iaspecdm p meedmes, c i tiora and documentation 0 CMR T of a AAttacb a copy ofyoaa FUc-. Sigmttae Date Section 11—Home Owners License Exemption Home owners Name; Telephone Number Cell or Work Number I=decstand my rwponmIat' s=da the rules and ragaWicros far Licensed Cambuct m SVWVisor is ac 0mli ce with 780 CMR the Massachusetts State Bmld=g Coda. I mod,the c mutrucd=inspex ticm pmcedmes,SPecific bVecdow and docama=xd=requhed by 780 CMR and the Town afBamstablm Stgnaf�tre Date PLIC IGNATURE see , 8 Print Name rA.� Telephone Number E-mail p=nit to: _ : _ L,e� •ddrnzod� ' l f Section 12—Department Sign-Offs Health Department ❑ Zoning Board.C¢requir4 Historic District ❑ Site plea Review{if rem Fire Department ❑ Conservation ❑ For coymnerdat wo?*pkae take y0rrrp1ma y to thew dgx*ne►st jor app vvd Section 13-Owner's Authorization ; as Owner of the subject property hereby authorize to,act on my behai4 n all matters relative to work authorized by this building permit application for. (Address of job) Signature of Owner date Print Name Ust updab41IM2017 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERNUTTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC. Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): L[R]I am a employer with 16 employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $. ❑Remodeling any capacity.[No workers'comp.insurance re4uired.] 9. ❑Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole 11:❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.0 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.❑✓ Other INSULATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. +Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors 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:STAR INSURANCE COMPANY Policy#or Self-ins.Lic.#:0849257 00 Expiration Date:4/4/18 Job Site Addres Q _ [ City/State/Zip>� ( �I�l Attach a copy of the workers'compensation p - y dectaratio age(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up 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$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify unM' _ an ralfies p rjury that the information provided above is true and correct Si ature: Date: 1 S Phone#:508-567-42 Official use only. Do not write in this area,to be completed by city or town official .City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ram,...•.., ALTEWEA-01 SNERONHA ,q►cc�► zlc�° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIODIYYYY) 0512612017 THIS CERTIFICATE IS ISSUED AS A.MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES I BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A'CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(i")must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION 1S WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rl hts to the certificate holder in lieu of such endomemen s. PRODUCER2WCT Christlne Costa . Mason&Mason insurance Agency,Inc. �i�Ext):(781)623-0067 1(AIICC,No): 458 South Ave. A ccosta@masoninsure.com Whitman,MA 02382 INSURE S AFFORDING COVERAGE NAIC# ±INSURER A:Evanston Insurance Co. `3537$ INSURED oisuRERB:Safety Insurance Company _ 39454 Alternative Weatherization,Inc. I.INSURER Insurance Company1$023 2 Lark Street INSURER D: _. Fall River,MA 02721 INSURER E: INSURER F: 3. �OVERAGES CERTIFICATE NUMB ER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDiTIO� OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN_P f IADOL SUBR� PaIJCY NUMBER , POLICY EFF 1 PauCY EXP I LIMITS TYPE OF INSURANCE i A XX COMMERCIAL GENERAL LIABILITY � i ? �EACH OCCURRENCE S 1,000,000 CLAIMS-MADE I X OCCUR i DAMAGE TO RENTED j 10fl,00fl � � � �3CA2088 �06107/2017;OS1I;1713fl18 J�p I��iEa,rw,rr«,cra s j 6,000 I j i I i MED EXP(Any Ora oerWn) IS PERSONAL&AOV INJURY I s 7,fl00,fl00 2,000,000 s GEN'L AGGREGATE LIMIT APPLIES PER: 3 y ' ±GENERAL AGGREGATE 15 77 I POLICY P 2,0flfl,0flfl T LOC 3 i PRODUCTS-COMPJOPAGG i S OTHER: s B AUTOMOBILE LIABILITY i CON.iSINED SINGLE LIMIT 's 1,W0,000 I tI _ ANY AUTO j6237702 fld1081201710410812018 BODILY INJURY(Par yerscn) 3 !OWNED iX SCHEDULED 1 60DILY INJURY(Per accident) S AUTOS ONLY _ AUTOS I � -- YX '1i EE 1 X yyN p ± j {PPe�atedent?AMAGE S AARS ONLY AUUOTO OILY i 1 I I A ? UMBRELLA LIAR X OCCUR I I i EACH OCCURRENCE s 1,©fl0,0fl0 I X j EXCESS UAB CLAIMS-MADE; IXOBW6619616 0610712fl17I fl6/fl712fl18 I AGGREGATE 's 1,000,000 1 DED RETENTION s � I C I WOR►(ERS COMPENSATION j I X 1 SUARTUTE 1 10RTH I AND EMPLOYERS'LIABILITY I I YIN C 0849257 0fl ' 0d10412017 04IM2018 500,000 ;AhN PROPRIETOERIPARTNER1ExECUTIVE �'?I i �•' i E.L.EACH ACCIDENT jAAo lACdaEi�oryrMl NH;EXCLUDED? N 1 A I _ ' 500 Ofl0 E,L.D±SEASE-EA EMP?DYEEi 3 I ISS —_- 600,000, I YCRIPTlIOsOOPERATIONS below E.L.D -POLICYT I I I I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may tw attached If more space is required) !Action Inc.and National Grid USA,its direct and indirect parents,subsidiaries and affiliates shall be named as additional insureds on Commercial General Liability policy per terms and conditions of forms CG2010 and CG2037 and Commercial Auto Liability policy per terms and conditions of farm SCA 005(02 116).Forms Available Upon Request. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN � National Grid I ACCORDANCE WITH THE POLICY PROVISIONS, j 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENTATIVE I ACORD 25(2016/03) C 1088-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ,9 5 3Mjy JS = ,SFlM��'. �'s, i✓ lr Eias #�r n, U- -so :rt y Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Ma.�chusetts 02116 Horne lrnprovemebiCoh' tractor Registration p Type: Corporation 'h Registration: 175683 ALTERNATIVE WEATHERIZATION, INC Expiration: 05/2812019 2 LARKST FALL RIVER,MA 02721 g Update Address and return card. Mark reason for change, _. #w=1 Renewal Office of Consumer Affairs&Business Regulation ?; HOME IMPROVEMENT CONTRACTOR Registration Valid for individual use only z TYPE:Comoraticri before the expiration date. If found return to: Reg, atian imIll+ Office of Consumer Affairs and Suslnass Regulation 05M/2019 10 Park Plaza-Suite 5170 ALTERNATIVE WEA?ijER17ATJON,INC. n,MA 02116 �r TIMOTHY CABRAL 2 LARK ST FALL RIVER,MA 02721 Undersecretary Ot v O si mute DocuSign Envelope ID:73362D3E-8EE5-4E87-A6B7-50D48243BF20 of IH E ro Town of Barnstable Regulatory Services e BAIN TABLE, Richard V. Scali,Director I MASS. ° �639. p , Building Division A�FD Paul Roma 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 A A I, NANCY C RUSO , as Owner of the subject property hereby ��authorize �1 �'�{, � �. to act on my behalf, in all matters relative to work authorized by this building permit application for: 24 Justice Douglas Way Centerville,MA 02632 (Address of Job) rDocuSignetl by: - - uruso- 11/3/2017 1 8:06 AM EDT - �—hFE1R31fC6CJL,23T;... Signature of Owner Date TOM CARUSO Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:\Users\decollikWppData\Local\Microsoft\Windows\INetCache\Content.OutlookMU69LF2\EXPRESS(2).doc 01/25/17 ALTERNATIVE .07 WEATHERIZATION 3� 8Date ca Ni Town of Barnstable co w 200 Main St. r .csa Hyannis,MA 02601 Re: Permit _. The insulation work at has been completed in accordance with;7GN)R Agency work performed for ' Timothy Cabral President CSL-105454 58 DICKINSON STREET FALL RIVER,MA 02721 (508) 567-4240 ALTERNATNEWEATHERIZATIONOGMAIL.COM r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION L Map Parcel � � Application D iSU Health Division Date Issued IS Conservation Division Application Fe qq� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project-5treet_Addre s 1 � g r �� Village VI /e, =Owner_-1 2K,�?,e-tz� Address 7J us GTelephone Permit-Re uesti 't7 �" Y ��j� ;,.� �� ,fir' 0 4 n AF eat Square feet: 1 st floor: existing/ Yproposed zyrz 2nd floor: existing proposed --Total new—/5//3�7 Zoning District Flood Plain Groundwater Overlay Project-Valuation o o Construction Type Lot Size Grandfathered: ❑Yes. ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) r Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's;Highway: ,0 Yes-. ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other r F� Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) CIO C- Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new ;z= w:r Total Rohm Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name _ s Telephone Number Address 5 WO'License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO =SIGNATURE �' � �� FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED d MAP%PARCEL NO. T . t AbDRESS VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION N) SbKb5 CO 1) OS FRAME `�kY r4T f3 11 1/(.1l s 1 181 ^ INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL FINAL BUILDING ���/�t r DATE CLOSED OUT ASSOCIATION PLAN NO. Town of Barnstable , oFtHE r Regulatory Services �F' c Richard V. Scali,Director * Building Division 1AMSTABLE, BASTABLE MASS. xuex 14U Mm IU-mnm�W-3 39 Thomas Perry, CBO 1639- 1�1 . �� 2014 AlEO ti"0�a Building Commissioner 573 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us a Office: 508-862-4038 Fax: 508-790-6230 June 1, 2015 Thomas Caruso 24 Justice Douglas Way Centerville,MA. 02632 RE: 24 Justice Douglas Way, Centerville, Map: 191 Parcel: 192 Dear Mr. Caruso, This letter is in response to application number 201502274 submitted to build a porch at the above referenced address. Unfortunately, the application can not be approved as submitted because of the following: 1) Construction documents are incomplete and contain conflicting information. Please submit the revised documents demonstrating compliance with 780 CMR(State . Building Code). Do not hesitate to contact this office with any questions. Respectfully, _ �auzon Local Inspector jeffrey.lauzon@town.barnstable.md.us (508) 862-4034 , W the c:onwwnweaan ojmussacnuseus Depm tYnent of Industrial Acciden& 1 Office of bwestigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Buiilders/Contractors/EIectriciam/Plmnbers Applicant Information / 9 Please Print Lepibly Name(BnsinesslOrganirafiorr/fndivi ? (ice GAddmss7-) City/St1W_4iP6f 42Y qzk t Phone#: © � Y3 5 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(felt and/or gait one). * have hired the sob-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 working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance corny.insurance$ ❑ We are a corporation oration and its ME]Electrical repairs or additions co 3.[ I am.a homeowner doing all work officers have exercised their 1L0 Plumbing repass 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.❑Other comp.insurance required-] *Any applicant that checks box#1 most also fill out the section below showing their workers'compensation policy information_ fi Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sh=t showing the name of the sub-contractors and stet:whether or not those entities have, cmploycm If the sub-conhactors have cmployees,they mustprovide their workers'camp,policy number. I am an employer that is providmg 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/Stata/ZiD_ ' 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 mimmal penalties of a fine up 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 fat,DIA for insurance coverage verification. I do hereby ce 1 thep�=p " of'peltay that the information pravided aboye is hAe and correct Phone#__z�, OjTcW use only. Do not write in this area to be completed by city or town olJ7cial City or Town: PermitlLicense# 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,partammhip,association,corporation or other legal entity,or any two or more of the foregoing engaged m'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.acceptmble 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 ofpublic 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-contractors)name(s),addresses)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partaers,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is requirrA 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-insdrmce 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. Ia addition,an applicant that must subra f multiple permitllicense 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 co of the affidavit that has been officially stain ed or marked b the c' or town be provided to the i ) PY Y P Y �3' �Y applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filldd out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or Gommercial venture (Le. a dog license or permit to bum leaves et:c)said person is NOT required t D complete this affidavit The Office of Investigations would hke to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a ca1L The Departmenf s address,telephone and fax number: The Commonialth of Massachusetts Department of Industrial Accidents office of lavestigatious. 600 wa.shingtan fit. ' Bo&tan,MA 02111 Tel,#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07. Fax#617-727-7749- Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division + RSRNCI'ART_R. « Tom Perry,Building Commissioner 9- ��� 200 Main Street, Hyannis,MA 02601 �Ea FAA't a www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION CDATE"4 3 •-� Please Print � JOB ATION: 1 / G 6�4 eew? 9==n M- [ street , _p._ 2 ./^.- "HOMEOWNER" C� � C �7��� J ��/l S� ��>�`���� ho,.mye�-phone# '-� -- �,a... work phone# CURRENT MAILING ADDRESS 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 proved requiremen d that he/she will comply with said procedures and requirements. cSignature_of-Homeownei - 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 persou(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 2.1S) 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 formlcertification for use in your community. Q:\WPFILES\FORMS\building permit foims\EXPRESS.doc Revised 061313 ' �oyti Town of Barnstable Regulatory Services RAJWSLWI�' ` Richard V.Scali,Director '�Eo�a�• Building Division Tom Perry,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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&O WNERPERMISSIONPOOLS R�� NEY, MORAN 3c T(VNAN !1-110RTCIAGE INSPECTION r PLAN �ZEGI Ti�R S -RED LAN SURVEYORS NAME NANCY A. AND T 75 ►-�AMMOND STREET — FL — MA 30R 2 CARUSO WORCESTER. MA 01610-1723 LOCATION 24 JUSTICE OOUGLAS WAY PHONE: 508—752—888•'; FAX: HSTGROJP.NET CEN_/ILLE MA RMT®IiSTCROUP.NET A Division of H. S. & T. Croup, Inc. SCALE 1 " .= 30 ' _., DATE 07--23—T 3 ! REGISTRY BARNSTABI•E � 3 c avow oCcuMnsAT!o,t mmvm a RwlArem wsm- �4 Duo mm/rAw 24160/23 f NDrr4 WM MAR Or THE FNWAK AM aslral0(� -�•• -. ON]HS MOR'TM M miggl pe 01 IN=AM ALl `ea (H�! tepS BOOK/RAN 272 rJ ` !SiliA fJ1Ep/[wwlS AR[SND11N AIp flIDR AR[ NO S 8 OF ZOO*R 1 MOtAT10w� +�' �^ � ` PLAw / C Ln+t oIiSETs (NPtSS OINK 1+oTW dd ORAtlgly POP ly 7 �` �,�NIFi_ S \�' A` Conn 0A M1111 N111 O Q U J cP T"* BSI ARC NOT WMM 7w 1�`' ... 7apmrom Pt�MiO�►i TR m 047mimw StgYltt�tp c . TiVNAhl ��.I SP[CIM �tAOD MATAIm YIGI 5tE R1M W. SNftM LA6At M a vtANr io 40 7 1$ oTo 0 coMvu,wcc 4 Locr znNlwo ro t�SMM v mNow o 8 19-85 QWREQU LO Is► OR R cL IM�ylp�py°"0 't oifsEt ��. nom►*Z"mg NAs amm ocm m m NY scAt[AWa UNOm SM mmm Iwo c cw�wa�i. i"' 13 NET►�ftY AOCUPJX on TTmAlpy[ctRnnWpg An �.`R1m M FEWoumm PLAN=ARC' NFORAWOU MAO[►Irtw T!m PROVISOpw TiN1 ' ••; Aw/af A�vERflG�AMC PMUA y-ACCURATE AND IWT THE P cwft SLa1f v is PROP�A7YU�LJ►RS + W TLIY IDC�s�N MAMN Tp i:i PMW ELCVATIO G CANWr K p 3St k s V E A. ` i t f;•'d E�Mze- . sx`+ t if ofr F,x s� t•o is v at^ .,' rz rt r � Yas e $ 90, $ cri sai. ; Ui V'+ O : � � ,� �, � 3 �� ^� Y° '►gig`°4� c, � � uv a�- � e� µ� m f�f k u I 4 New /�'x la' L SSB 9g � 3 �EA FIOMW k . TlC�WR87S1a Orr-r, 4FORD FIEDERA>L :^,4MNg_SQUR97'�Q 4Y: S 0 !:CAN .iS50C L17tCP1 ftwm arn:ass iLU tiM cr � k k K 12) LO EE rya i � � Z a T,Z o — ° a 0. � 4 } z � h I% x a I L_ _!M Ale � Jd Bxp r -Ld sxr J �}w I�I -W sxr i� - -ts •1d�XC(L° I � f r ��3 IDS I 3S ,3 LOT 26 16,298f SF NOTE: SEPTIC TANK AND TRENCH LOCATIONS FROM INSTALLERS CARD DATED r0 2-12-1997 '01 ✓UsricE S o ,?0' 0 0 DOUGLAS (Nr\ 32.0' EXIST. o LO WAY j' DWELL. Tp 3 / Q S > Oiy0 0 T Tp ,J'>2' n 39 71 77 9 - rn g 32 c' BUILDING PLOT PLAN ( SHOWING AS BUILT SONO TUBE LOCATIONS ) PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE 24 JUSTICE DOUGLAS WAY LOCATION CENTERVILLE, MASS. PREPARED FOR: SCALE : 1" = 30' DATE : JULY 27, 2015 TOM CARUSO REFERENCE ASSESS. MAP 191 PCL. 192 _j�A°FMAss I HEREBY CERTIFY THAT THE STRUCTURE o SHOWN ON THIS PLAN IS LOCATED ON THE NIEL �� DAA s� GROUND AS SHOWN HEREON. A. OJALAN off Nb,40980 fox 506 362-6601 A v down cape engineering, inc. V . t� CIIAL ENGINEERS / V LAND SURVEYORS 939 Main Street — YARMOUTHPORT, MASS DATE REG. LAND SURVEYOR �106 _Assessor's map an u C� BE d lot number ... ..... ............�.. ...... I� I ;SMLLED Im C0 i'L1AI`6 WFITIA �' TIu;_� II S Sewage Permit number ................ � TAGE .. ......:............... ar ® SAI`�ITARY CODE .. y F THE roe �Q TOWN OF BAR.I®1•S ABLE i BARNSTABLE. "6 ,e0� BUILDING INSPECTOR a YPY Ar yp APPLICATION FOR PERMIT TO ....:........ ......r........................................................................................................ TYPEOF CONSTRUCTION ..... +' .......:................:........................................................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby a E plies for a�permit acc 'ng to the following information: .. Location .............. .. ..t y'. ....... �e ............ j.:........... Proposed osed Use .. �.. ' . . .. Zoning District ..... ` ...... .. .......,...... ... ... ..Fire District ........ .. ....... .... .... D5� ................................Name of Owner . ......................Address .................................................................. ................. Name of Builder ...' .......................................~............................Address .................................................................................... Nameof Architect ..................................................................Address .................................................. ................................ Number of Roo ............ .. ..........................................Foundation �....... Exterior .. .... .. ............... .....................................................Roofing ...... . .. ... . .. ... . .................................................... Floors Interior ..... .. . ..... HeatingPlumbing ................ ................ ............ .-:...... . .. ........... . .......................... Fireplace .. ......... ............ ..............................Approximate Cost .... �.A::anp..'h........................ Definitive Plan Approved by Pla ' g Board -------------------___--_ / ------19--------. Area ....F..I..................... .......... X ® Diagram of Lot and Building with Dimensions Fee .........�� -.................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding a above construction. Name ,,. Small, Alan E. 16868 one story ANo ................. Permit for .................................... singl® family d�rell.. ................. Location a Justice Douglas Way Centerville ............................................................................... Owner Alan E. Small: Type of Construction ..............frame............................ , i ........ .................................................................... t r Plot ............................ Lot ...............�6.......... I L / )� Permit Granted ...(........... ..../..................19/// � - fi Date of Inspection _ i! ..19 Date Completed" ..7.. ..:/ /7(; e19 PERMIT REFUSED ' ................................................................ 19 Y _ . ................................................................ ............................................................................... 1 ............................................................................... j Approved ................................................ 19 ............................................................................... ............................................................................... a y® �J 0 � J toSrcc,rt— �000&.K