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Town of Barnstable Building
Post This"Card So That it is Visible From the Street-'Approvetl Plans;IVlust,be'Retamed.on Jo'b and this Card Must be Kept
KAS& Posted Until Final Inspection Hash' een Made e erg�lt lli 11
a Where.a-Certificate"of Occupancy:is Required,such Building shall Not_be Occupied until a Final Inspeection has been macJe
Permit NO. B-18-3720 Applicant Name: KIERAN T WHELAN f - Approvals
Date Issued: 12/10/2018 Current Use: Structure
P
Permit Type: Building-Deck
Expiration Date: 06/10/2019 Foundation: SeNsS v Iz�7� &
Location: 25 KALMIA WAY,.CENTERVILLE Map/Lot: 188 118-006 Zoning District: RD-1 Sheathing:
Owner on Record: MCATEER, Keith W Sheila D Contractor Name'' JK CONTRACTING INC. Framing: 1
Address: 25 KALMIA WAY Contractor=License: 171393 2
CENTERVILLE, MA 02632 Est Project Cost: $21,537.00 Chimney:
Description: BACK DECK-REMOVE DECKING AND RAILINGS, INSTALL NEW PVC t .Permit Fee: $170.00
DECKING AND NEW TRANSFORM RAIL SYSTEM G Insulation:
$ 170.00
SIDE DECK-DEMO EXISTING DECK AND STAIRS AND FRAME Fee Paid:.
ENLARGED DECK AS SHOWN ON PLAN 13'OUT FROM HOUSE AND ,, _ "
Date. ,�b 12/10/2018 Final-
14'.LONG. DECKING AND RAILINGS TO MATCH BACK.`FRAME TO BED
2X10 PT,4X4 PT VERTICAL POSTES RESTING ON"SO,NOTUBES Plumbing/Gas
Rough Plumbing:
Project Review Req: ,n , Building Official Final Plumbing:
i
Rough Gas:
Final Gas:
Electrical
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.
All work authorized by this permit shall conform to the approved application and the.approved construction documents for which this permit has been granted. Service:
All construction,alterations and changes of use of any building and structuresshall be`in`compliance with the-local zoning by-laws and codes.
This permit shall be displayed in a location clearly visible from access street or,road and shall Ibe„maintained open for public inspection for the entire duration of the Rough:
work until the completion of the same. Final:
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Low Voltage Rough:
Minimum of Five Call Inspections Required for All Construction Work:
1.Foundation or Footing Low Voltage Final:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Health
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.P;,or to Covering Structural Members(Frame Inspection) Final-
6.Insulation Fire Department
7.Final,Inspection before Occupancy
Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction.
DE
,,,, ,-�► OV 9 2018 ZFe
............. .... .. o Fcx.............
NF BARNS , a Pia............. . .... _ .. .. .......
TOWN 0
oa:. 12�1a l�
TOWN Off'BARNSTABLE per. �b..... ....... ...... � ....... ..... ®'0�
BUILDING PEPJVHT
. ., . . . .. .......
.........(
APPLICATION ��► s '
Section 1 -- Owner's Information and Project Location
o'ect Address WRY V�e ..�-r�. 2-y l �
Owners Name
Owners Legal Address
Cirty
Pr-r 1'�v� State S C Zin
� '
ll n F"� i
Owners Ce
Section 2—Use of Structure
Use Graup L2_- ❑ Commercial Structure over 35;000.cubic feet
❑ Commercial Strexture under 35,000 cubic feet
Single 1 Two Fami.Iy Dwelling
Section 3-- Type of Permit
New Construction ❑ .Move/Relocate C1 .
Accessory Structure ❑ Change of:use
[] Demo/(entire structure) ❑ Finish Basement ❑ 1,amily/Amnesty ❑ Fire AJ.arm
Rebuild
Deck Ls� Apartment Sprinkler System
EJ
Addition ❑ Retaining wall ❑ Solar
❑ Renovation ❑ Pool ❑ Insulation
Other--Specify
Section 4 -Work Description
i5 ��C't— t' � �l� iti1 '�
U 6., 4_V
J Q+
U `�" SS
I
Application Number. .... . ..................................
_ Section 5�-Detail
Cost of Proposed Construction 111 5 131-�" Square Footage of Project
Age of Structure R et 0 PP"' X Dig Safe Number 1,.r o t � t�-- _� Q S 4
# Of Bedrooms Existing Total Of Bedrooms(proposed) N
11:0_MPH Wind Zone Compliance Method M M:A Checklist Q WFCM Checklist Q Design
Section 6--:Project Specifies
[� Wiring [] Oil Tank Storage Smoke Detectors
(� Phunbing `
[] Fire Suppression �..---
Heating System F1 Masonry Chimney Add/relocate bedroom
Water Supply 0 Private
SewageDisposal F"l Municipal: `❑ On Site
elf} :
Historic District El Hyannis Historic District Old Kings Highway
Debris Disposal Facility: l am using a crane ED Yes ® No
Section 7—,Flood Zone
Flood.Zone Designation
Within or adjacent to a wetland, coastal bank? Yes ❑. No
Section 8--Zoning Information
('ps
Zonis District
g Proposed Use Lot Area Sc}.Ft.�' .�.. ..
Total Frontage. Percentage of Lot Coverage #of Dwelling Units(on site) `
Setbacks Front Yard. Required_ Lt' () Proposed N t
Rear Yard R, 0
csluared _ Proposed. k'J
Side Yard Required 't ti Proposed _ 3
I
I Has this prcpeTtY.had relief from the Zoning Board in the past? ❑ Yes IT No
Last uDdst�:2/92018
Application Number............ .......................... .
:�P
58GtlilYl 9- .Constrnction Supervisor
Name KX 61t,41n1 l�G Telephone Number- kn
Addxess 'l 1 (-k clA m,a,Np k city e,'yv rtk state zip 0_2"RV
License Nmnber_ b� License Type�-rptTf Expiration Dam
Contractors Email i oy�, Cell`# ka 4'" - 1-
I understand my responsibilities under the rules and regulations for-Licensed Construction Supervisor m acco dance with 780
CUR the Massachusem State Building Code. I understand the.constrac on znspecdon.procedoxes,specific inspections_;and
docm=tafion required by 780 CMR and the Town of Barnstable.Attach a copy of your license.
.Signature Date $ cg
Section,10—Home Improvement Contractor
Name k`t tT 40-,Q IdN C� I PYV Telephone Number la I'1
Address 3 I (�i c tt N b w 0 -k"City C; y'rl,0%/T'W state Zip' Q 2-i
Registration Number 1*11-3 9 24, Expiration Date 0 1 Zr 2 p z.o
I under stand my responsibilities under the rules and regulations for$ome improvement Contractors is accordance with 780
CMR the Massachusetts State Building Code. I undwstand the cbnstr w on inspection procedures,specific inspections,and
documentation required by/78`0 CMR and the Town of Barnstable.Attach a copy of your RI.C...
Signatuae Date.
Section it -Home Owners License Exemption
Home Owners Name: A to
Telephone Number ,,.--�''"^ Cell or Work Number
I Mde7stand MY responsibilities under:the rules and regulations for.Licensed Cbustiuction'Supervisor in accordance with 780
CMR the Massachusetxs State Building Code. I undQ^"tand the construction,inspection procedures,specific inspections and
documentation required by 780 CNM and the.Town of Barnstable.
Signature Date
APPLICANT SIGNATURE
Signature Date i I V ! p
Print Name �,t H QV t r9�J Telephone Number �, i`� - g L,-la J
v
E-mail permit to: 1:' � � R+( >^+ K c_J rJ 1 K+g e`7-Q tq- � o �
I
Section L? --Department Sign-Offs
Health Department ❑ Zoning Board(if ) ❑
Historic District ❑ Site Play Review(if`reguir4 ❑
Fire Department ❑
Conservation ❑
For commercial work,please take your plans directly to the;fire deparmad for approval..
Section 13 - Owner's Authorization
f J r-I Trsa�L4%.$ri--
I as Ownerbf the-subject property hereby
J v
authorize'", kl to act on mybeMa in all.
matters relative to work authorized by this building Permit application.for:
(Address of jo
lie
S gnalure of{Owner. date
Print Name
i.esz wdamh n1201 s
JK Contracting Inc.
4 High Street, Suite 108 Proposal - Exhibit B
North Andover, MA 01845
617-592-6775 (Kieran)
781-254-2862 (Judy) Proposal Date: 9/6/2018
Proposal#: 203-274
Project: McAteer-25 Kal...
Bill To: Ship To -
Maffei Landscape Contractors, LLC 25 Kalmia Way
28 Nicoletta's Way Centerville„MA 02632
Mashpee, MA 02649
Description Rate _.Total
Maffei Landscape Contractors, LLC:McAteer-25 Kalmia Way,
Centerville, Ma-
Side Deck
Pour;6, concrete 10 inch sonotubes 4.ff below grade minimum. Pour 14,780.00 ' 14,780:00>
one concrete footing for resting of stringers.[Extend 12 inches past
bottom riser.
Cut shingles and apply lead step flashing where necessary fro new
deck.
'Frame new deck per plan using 2x10 PT Joists and 4x4 vertical
posts. Stringers to be 2x12 stock. =
All railings, post sleeves, post caps post trim to be Transform,
Resalite railing system in White.
All decking'to be 7/8"x5.5"Trex Select, pebble Grey, grooved with
hidden fasteners on main deck, solid around perimeter, screwed and
plugged.
All trim to be white, Colonnade PVC.
Extend.heating supply and return vets beyond new decking.
Clean up and removal of all construction debris from site:
No electrical, no painting, no latticework.
Permit fee [if same permit as back deck.].
Decking-For side deck area-Additional material cost for Wolf 1,233.21 1,233.21
Silver Teak decking instead of Trex Select Grey(originally quoted).
Estimate for your review and approval .
y
Total $16,013.21
Approved: (Initials)
SIGNATURE
ra
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4.
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131 IL
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�:._..� t!_•._-.. - � --'� a � � F s ems. E � � � c A -..� �
Contracting Inc.
4 H Proposal - Exhibit B
4 High Street, Suite 108
North Andover, MA 01845
617-592-6775 (Kieran)
781-254-2862 (Judy) Proposal Date: 9/6/2018
Proposal#: 203-273
Project: McAteer-25 Kal...
Bill To: Ship To
Maffei Landscape Contractors, LLC 25 Kalmia Way
28 Nicoletta's Way Centerville„MA 02632
Mashpee, MA 02649
.Description Rate Total
Maffei Landscape Contractors, LLC:McAteer-25 Kalmia Way-
Back Deck
Selectively remove, repair and replace approx.2 rows of shingles at 5,300.00 w5,300.00
base of house after decking is removed. Remove decking and
railings from existing deck, leaving frame, stringers, and 4x4 posts.
Frame new bottom landing and steps to new patio using PT framing
stock.All new decking to be 7/8"x5.5"Trex Select, grooved with
hidden fasteners, solid around perimeter , screwed and plugged.
[Pebble Grey].All trim to be white, Collonade PVC.Install lead reglet
where new landing is to be installed. Provide access panel for
condenser, matching vertical lattice. No electrical, no painting.
Clean-up and removal of debris from site. permit fee included
[provided permit will be for both decks,side and back].
Decking -For steps and landing -additional material cost for Wolf. _ 224.22 "224 22'
Silver Teak decking instead of Trex Select Pebbly Grey(originally
quoted)
0.00. .. .� 0.00
Estimate for your review and approval .
Total $5,524.22
Approved: (initials)
SIGNATURE
ka ,
ik
McAteer Residence
2`5 Kalmia way
Centerville, MA 62632
Decks,
Permit Acquisition
11/8/18
Specs: '
1. 2 x 10 P:7,'s to be used for Framing
1. Framing 16#OC
3. Double rim joists at perimeter
4. 12"Sonotubes 4' below grade
5. . Top,of 5onotubes 8"above grade
6.. Set 4"x 4":metal plates in Sonotubes to accept P.T.4 x 4"s
7. Decking to be 5/4"x b" P.v:C..
8. 4 x 4 posts.no more thai�8' aparf
S. Resalite Transform Rail.-Sy-stem
' The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information \ \ Please Print Legibly
Name(Business/Organization/Individual): (o
Address:
p��yS
City/State/Zip: _�m V ef.4 rti A- Phone#:.
Are you an employer?Check the appropriate box: Type of project(required):
1.[9 I am a employer with 3 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling
ship and have no employees These sub-contractors have g, ❑Demolition
workingfor me in an capacity. employees and have workers'
Y P t3'• 9. ❑Building addition
[No workers' comp.irmn-and comp.insurance.$
required] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their 11.❑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
equir ] employees.[No workers' 13.[ Other
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.
$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: C) V 5 V`r O�h G 2. �C)v"�(�tkY, r
Policy#or Self-ins.Lic.#: 5`5_7 \�Z Expiration Date:_ \yt\��
Job Site Address: 9\5 ��th �A CU \�J Vi- City/State/Zip: e-eh�,CN
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 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 the DIA for insurance coverage verification.
I do hereby .y nder the a' d penalties of perjury that the information provided above\is true and correct
N Signature: uza �6 Date:
Phone#• U\ " `ot.`J
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-contractors)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
Revised 4-24-07 Fax#617-727-7749
www.M=.gov/dia
----1 JKCON-1 oP ID:eD
.4C0►R 0)"` DATE ttI w6orYYYS"I
.., CERTWIC-ATE OF LIABILITY INSURANCE 012412,91 .
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS.NO RIGHTS UPON THE CERTIFIGATE'HOLOfR, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND; EXTEND OR ALTER THE COVERAGE AFFORDED BY THE.POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.A CONTRACT BETWEEN THE ISSUING INSURER($), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on.this certificate does not confer rights to the
certificate holder in lieu of such endorsements.
PROOUCEfl :.. -- -CONTACT - ...
DeSanctis Insurance Agcy,Inc. PRONE
.......r.M
100 Unicorn Park Drive SeY -t' 1ae Stp_935 €t480� - o Nn.781-g'33 S&45
Woburn,MA 01801 EaDR s's+
INSURER{st Arf O ,R!NG c. ERAG M { NAIC1
,NsuREI?A Star insurance Compa.n�r _ 0 2245 f4�
WSUREn JK Contracting,Inc. INSURER Seteciive Insurance Company
4 High Street Suite 108 i IwsuREric _ _ '
4 North Andover, MA 01845
L'lSDREFi D l
IkSURE4$
COVERAGES CERTIFICATE Nt1MBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POL CiES OF INSURANCE LlSTEO BELOW HAVE-BEEN ISSUED TO THE INSURED NAMED.ABPYt,FOR T!4E POLICY PERIOD
INDICATED. NO—iWITHSTANDING ANY REQUIRE:MCNIT. TERM OR CONDITION OF A:VY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO,WHICH-THIS
CERTIFICATE MAY BE ISSUED OR PIAAY PERTAIN, TH4 1NISURANICC'AFFORDED BY THE POLICIES DESOR18EQ HEREIN AS SUBacCT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF'SUCH PCLICIES�L{MtTS SHOWN MAY.HAVE BEEN REDUCED BY PAID`CLAIMS.
4YSR1 A21`b��-F�Et�„_ .._....._ ._.__.,. ..i:_i�t31-(C'�!'�'�,_.nsPO��Y
L'TR: TYPE OF INSURANCE } POLICY NUMBER I M3A}Dilt'Y f.YY S MMfDD1YY 1. titMPrB:�-
B i X{COMMERCIAL GENERAL LtAatLrrY I 1
I I i I_EAC�HYO;CURRENCE s 1,000,00 -
i `X` sS2205113 0211 Dt2O1811 02/10/2019`D SA�' It' 31 rsr l
R CLAW MADE i o CUR i I 5D0 00
P € 5 b C a,si65 t*ctsslw '% ,00
r MAD ExP w,r ono P ~r s __ 15,00
I PERSONAL a Aov INJURY_t� 1 000,00D_
` X t I G£!cR/LAGREGdTE - a - 3,00.0_,0_.
00GEN AGGREGATEI,MIT APPtES:PER
POLICY LOf ae OPAuG 3 000 00 S
AUTOMOBILE LIABILITY S - t { GfSL+Blr.rO SsNGLELIMIT l5
ANY AUTO x ( flCO4t Y lyJt;RY -
ALL 0114NED SCHEDULED I "
i AUTOS _ „,,AUTOS 1 - '> L 1 �34Dit 1€+JSl1AY tPcx acsa'cieaRi i B .-. ,.,...,...
''S)REO AUTOS f�I�TOD'v�so i s # Osd RT T Dal Ao= s
r !uwBRElw LIAR, I OCCUfi
•- E1'a'..i 1 .I H OCCURIiENL;E ) .
{ I
EXCESS LIAB- 4 C,ftF95-IviA'J,E i1 AGGR_GA7E... $ .I DED i..._., R':•TeNT10N. ._ i (....v:..,.....,.,, .�, ..-....,_..... ^!S. ew..
I WORKER&COMPENSATION Id yt:l
iAND EMPLOYERS'LIABILITY YIN
l I i I 3}TUTE.l
A: IA,vYP;tOPRIETOiVPruRTNERrxEGUTtYc t WC08537C,2 02/17tZ018)0211T12018 I L ACIIACCIOFNT $ '10_0 0_0
C>~PICrWMEWEREXCLUDED? 7tofA t I' i- .- I _
!(Mandatory In NN) i 1 WA # }.� �E L.G€5ER5E-FA EMPLPYEE'{S 100,00
10,yy N -._-•-r .. '.r _.._.._..tee-, -.�.
e DESCkIP`I"fDN 6P UPFftATiDNS bM .: F F _ i £ D TERSE-r FOLiCY L:X�1tT.E 5 3500,000_
"DESCRIPTION Or OPERATIONS YLOCATIOMSI VEHICLES (ACORD 101,Addl6onal.Romarka Schedule,r4y.be anathed it more Fpaca:4 r.QW-,d)
Evidence of coverage.
CER.TIFIGATE'HOLOER CANCELLATION
TO WHOM
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
TO WHOM 1T MAY CONCERN THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED. 'SENTATfVC
0 1988 201'4 ACORO CORPORATION. Affrights reserved.
ACORD 28.(2014101) The ACORD name and logo are,registered marks of ACORD
�;:t,fi''+��*5arr erect n.W�t7.ECf�r��Zdf kn.%f,•[�V�F }a.
Otfiaa a _ConadrrierAffa{xs 8 t3ufreass i§eguEatfQn
HC�Mt'try,RAQVEMFNxtoOt4.rl=ACTOR
TYP5..Cbrwatfian
R�gt�tr'��tl�n �. �cjttrton
tit i x 'S4=20
:iK GON'fFifC Pt�}Cx t �.,'�
ur1d feJC�C.SE�.te1'1 04
#` �rrsritcac+ Kre l a3 Safi assaCtstx.s EF�s
Okit;dii af Psct�ss�ur�at�ic����ru
farc1 of a�es, ,�� isrtz lrsctartls
'L vrtwout±mo� s �, � `
y ,
Lauzon, Jeffrey
From: Lauzon,Jeffrey
Sent: Tuesday, December 04, 2018 9:55 AM '
To: 'KIERAN@JKCONTRACTOR.COM'
Cc: Lauzon,Jeffrey
Subject: ViewPermit, Permit No:TB-18-3720
Applicant,
Please be advised that the above application has been reviewed and the following is noted:
1) No property owner authorization has been submitted.
The application is denied pending the submission of the above required document. And, if aggrieved by this notice;you
may file a Notice of Appeal (specifying the grounds thereof)with the State Building Appeals Board within forty-five (45)
days of the receipt of this notice.
Respectfully,
Jeffrey Lauzon
Chief Local Inspector
(508) 862-4034
ieffrey.lauzon(a town.barnstable.ma.us
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Town of f Barnstable Building
!P,�hstee.r"%de aU Cnte�l;Fi�f ricaalt�eln ospf e�Ocgctciounp aHnacsy<B'seweRne qMua;. t.�b
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BARN#rA Ps& o
s W Occp,��e d eY/, F •�
Permit
until a Final InspectEon haabeen made
Permit No. B-18-291 Applicant Name: Stephen Dickinson Approvals
Date Issued: 01/31/2018 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 07/31/2018 Foundation:
Location: 25 KALMIA WAY,CENTERVILLE Map/Lot 188-118-006 Zoning District: RD-1 Sheathing:
Owner on Record: MCATEER,.KEITH W&SHEILA D fi` Contractor Name ` STEPHEN T DICKINSON Framing: 1
Address: 25 KALMIA WAY *
;Contractor License:=CS-081843 2
CENTERVILLE, MA 02632 a L N_ EstS Project Cost: $3,859.00 Chimney:
Description: Windows r Permit Fee: $35.00
x Insulation:
Project Review Req:
g Fee Paid $35.00
�M_ � Daie 3 1/31/2018 Final:
zAl Plumbing/Gas
" Rough Plumbing:
BuildingOfficial
„t Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authors ed by this permit is commenced within six months after issuance. Rough 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 structuresshall ni
be in with the local zong by laws and codes. Final Gas:
l" s �. :
This permit shall be displayed in a location clearly visible from access street orroadand shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. a Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by,tFretBuilding and Fire Officials are`provided on this permit.
Service:
Minimum of Five Call Inspections Required for All Construction Work: lv
a
1.Foundation or Footing Rough:
A ,-.,:. ' �� .
2.Sheathing Inspection
Final:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation
Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Final:
'Ifersons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Building plans are to be available on site Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
Town of Barnstable
KAM 200 Main Street, Hyannis MA 02601 . 508-862-4038
•63 ,
Application for Building Permit
'c
Application No: TB-18-291 Date Recieved: 1/30/2018 t I
Job Location: 25 KALMIA WAY,CENTERVILLE
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: STEPHEN T DICKINSON State Lic: No: CS-081843
Address: , Plymouth, MA 02360 Applicant Phone: (508) 676-6820
(Home)Owner's Name: MCATEER, KEITH W& SHEILA D Phone: (508)360-5567
(Home)Owner's Address: 25 KALMIA WAY , CENTERVILLE,MA 02632
Work Description: Windows
o
o
Total Value Of Work To Be Performed: $3,859.00 —077
oAai
Structure Size: 0.00 0.00 PJ 0 r—
e M
Width Depth Total Area
I hereby swear and attest that I wiI I 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).
1 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: Stephen Dickinson 1/30/2018 (508)676-6820
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $3,859.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $35.00
1/30/2018 ? $35.00 Credit Card
7597
Total Permit Fee Paid: $35.00
TIIS IS NOT A PERMIT
Town of Barnstable � � ►.
Regulatory Services
` Richard V.Scali,Interim Director
'ARPM& ' Building Division � P,N
ia39
�► Tom Perry,Building Commissioner flF 8N
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma:us ;
Office: 508-862-4038 G Fax: 508-790-6230
PERMIT# Lo FEE: $_ �
SHED REGISTRATION
RESIDENTIAL ONLY
200 square feet or less ,
rz.s 1 v� w� Ce'o ire v V I 1
Location of shed(address) Village
S�•C- 1 g 01:4 kt.,-T-L. plc..—Tw-4! . ` SCE �3 `7 3-7 3 2C6Z•
Property owner's name Telephone number
Size of Shed _ Map/Parcel#
Si true Date ,
Hyannis Main Street Waterfront Historic District? '
Old King's Highway Historic District Commission jurisdiction? a .
If over 120 square feet,you must file with Old King's Highway
Conservation Commission(signature is required)
Sign off hours for Conservation 8:00 9:30&3:30-4:30.
.PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE
' ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION
FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
. THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
¢forms-shedreg ,
REV:110413 s
1
i
. _ 1
,
b�
r'
7-7
CIM
ER
VALM i 1,
I•c� 7-1-IA 7- 7-1.1,C--`�av�tl�AT/vn1 •CaC.4T/�,t/ '
'WN yE�EO.C/. 0O�'1f?L'YS C6�V TE�LV�G.LE .
SC-A L.C 1
' .A447 /s NOT' E�E.vc�
,4TEp lyi�-y/.v_7-.5i�c .c�.Loar�,oG4/y LOT' G
o �
9 .
�FT`S;syvy�ysr�v�.z� osr-E.2�/�!�•a
, a a�0
Town of Barnstable RcEIPl'
3BA' " 200.Main Street, Hyannis MA 02601 . 508-862-4038
Application for Building Permit
Application No: TB-18-612' Date Recieved: 2/28/2018
Job Location: 25 KALMIA WAY,CENTERVILLE
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: JAMES.P CURLEY State Lic. No: CSSL-099138
Address: Centerville, MA 02632 Applicant Phone: (508) 790-4508
(Home)Owner's Name: MCATEER,KEITH W& SHEILA D Phone: (508)790-4516
(Home)Owner's Address: 25 KALMIA WAY, CENTERVILLE,MA 02632 .
Work Description: Strip and re-roof approximately 20 square of asphalt roof shingles.
Ca C�
Total Value Of Work To Be Performed: $10,000.00 COw
ca n
Structure Size: 0.00 0.00 0.0(� �
Width Depth Total Area r-
••,t
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 ' 6 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: James Curley 2/28/2018' (508)790-4508
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $10,000.00 Date Paid Amount Paid Check or CC# j Pay Type
Total Permit Fee: $51.00 2/28/2018 $5100 Xaoc-3000c mac- Credit Card
( 5483 .
............................................................................
Total Permit Fee Paid: $51.00
L
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map i 0q `6 Parcel Application a v -7
Health Division Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fees
Date Definitive Plan Approved by Planning Board 36
Historic - OKH _Preservation/ Hyannis
Project Street Address �L VYLtG� fJ�
Village 4&p 1
Owner Address 2� 7t.Gtl f�fi' 1
Telephone - 1'—5Z 07,
Permit Request ett1--78 l
t141, " .b —Zi 4�-7 4v a i � Conk
k f eOt-4c4t r
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation i,56d- 6rb Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sf)
Number of Baths: Full: existing new Half: existing newv
s°)I Coa
Number of Bedrooms: existing —new = ram '
Total Room Count (not including baths): existing new First Floor Room Cou j
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other G?
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal sWe: 07'es ❑ 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 Au horization ❑ Appeal # Recorded ❑
Commercial ❑Y Nc If es site Ian review#
y p
Current Use Proposed Use
APPLICANT INFORMATION
/��J�DEER' OR HOMEOWNER)
Name Telephone Number �w 1 Zi
Address = License #
Home Improvement Contractor#
Worker's Compensation # k16fi_e0A5,J
ALL CONSTRUCTION DEBRIS RESULTING FPPM THIS PROJECT ILL BE TAKEN TO
SIGNATURE DATE 2 Z
E
)
FOR OFFICIAL USE ONLY
APPLICATION# '
} DATE ISSUED
\ '
/ MAP PARCEL NO \
.. �
ADDRESS/ VILLAGE
ƒ OWNER' \
\ . ,
§ '
DATE OF INSPECTION: _
FOUNDATION
ƒ FRAME
}
} INSULATION
} FIREPLACE
.4
ƒ ELECTRICAL: ROUGH FINAL .
\ , -
\ PLUMBING: ROUGH FINAL . .
GAS: ROUGH FINAL `
FINAL BUILDING
} • . . .
\
\ � . ` • , � .
) DATE CLOSED OUT
{ '
{ ASSOCIATION PLAN NO. •
} ' • .
:
±
OWNER AUTHORIZATION FORM
,j(/) �/rJ'nA Ate"[♦yQ.Q� t , .. .. .. �' :.
,
(Owner's Name)
owner of the property located at
�s 6LUICA
•(Property )Address
.. • • ,� .. •4 .: . - .n
(Property Address) ,
hereby authorize CAP 3 rr -
(Subcon or) !
an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building
permit and to perform work on my property. , =
71
Owrjees Signature
.Date
NO
f
6 'ice/
I:I 10 Park Plaza -'St"t 5170
Boston Massachus&ts 021.16 `
I-lo►ne Improvement Cwitactor Rebistration ;
Registration: •153567 t
l ype: Privii4e Corporation
Expiration,. .12/.15/2012 Tr# 206433
CAPE" COD INSULATION, INC
HENRY CASSIDY
455 YARMOUTH RD.
HYANNIS, MA 02601 4
-
..
Update Addi us iind return card, MI Wk rt.ason liir cliau�c
�. L) ;�'ddresa �_.I Ruiewal ,I I Employment I. 11usICard
lil�i , r�[ uuier all, ii, , tiu,,y,icr/, ltegul uiva LIU111C tii registration�aiid fur i ir►c I :.W ..!
Homr&tP 6Qtjfllt fkACT(� ccici�rrC(t belore,ilii.expiration date. It found r•etiu n to:
Registration: 153557 Type: _ 0ftice of Consunier Affairs and Business Regulation
l Expiration: 12/15/2012 Private Corporation. 10'Park Plaza-Suite 1170 .
'Boston,N'1A 02116 .
COD INSULA I ON, INC
("A"."S.I D y
ANdaJUIII RU.
+a "
INij,MA 0201 Uudersecretar }
Y t a11d Ith t Si till l'
t -
'- IVIa.JJachu,ctts Dcli;u un�nt.ul Public S;lic,tl +
I3ourd of Builtlin.,; I�r:;ulatiuils antl.lt,ln(lar(Lc -
Construction Supervisor License
License: Cs 100988 ,.
HENRY CASSIDY a
8 SHED ROW ''' # •� :'
WEST'YARMOUTH,•MA 02673
y
Expiration: 1 1 11 1/201 3 "
(lniuuisiaurW f �. ¢
to
Client#:4597 CCINSUL
ACORD. .. CERTIFICATE OF LIABILITY'INSURANCE - �T2/02/20,Ei,m2'0YYYY)
-- 2
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 `
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER,
IMPORTANT:It e certificate holder Is an AUUITIONAL INSURED,the.policy(ies)must be endorsed.It
su hec o
the terns and conditions of the policy, certain policies may require an endorsement.A'statement on this certificate does not confer rights to the'
certificate holder in lieu of such endorsement(s). r.
PRODUCER .. . . . _ _.- -
• NAME: `Margaret Young- ,
Rogers&Gray Ins. -So. Dennis f PHONE FAX
INo5O8- 60-4602C434 Route 134 No):.877=.816-2156. „.'.
P.O-Box 1601 ADDRESS:youngma.@rogersgray,com..
PRODUCEK
South Dennis,MA 02660-1601 y ' ... CUSTOMER to a: '
INSURER(S)AFFORDING COVERAGE NAIC#
INSUREDINSURER A:Peerless Insurance 18333
Cape Cod Insulation Inc INSURER B:Ohio Casualty Insurance Company
455 Yarmouth Road .... _. . _... -
INSURER c:Atlantic Charter Insurance ;
Hyannis,MA 02601 INSURER D:Commerce Insurance Company 34754
r
INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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 CONDITION 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.
NSR ADDL SUBR POLICY EFF POLICY EXP
_...
A GENERAL LIABILITY CBP8263063 '` 04/01/2011,'04/01/2012EACH000URRENCE $1,000,000
DAMAGE TO RENTED X.COMMERCIAL GENERAL LIABILITY '• - - PREMISES,(Ea occurrence) $100,000
m
^_ CLAMS-MADE X OCCUR MED EXP(Any one person) $5,OOOO
PERSONAL&ADV INJURY $1,000,000
A GENERAL AGGREGATE $2,000,000
GENT AGGREGATE LIMIT APPLIES PER: '+ PRODUCTS COMP/OP AGG $2,000,000 "
PRO-
_
D AUTOMOBILELIABILIY 11MMBCKVMK. U4/O1/2011 04/01/2012 COMBINED SINGLE LIMIT $
ANY AUTO (Ea acatlent) 1 OOQ,000.
BODILY INJURY (Per person) $
ALL OWNED AUTOS. BODILY INJURY(Per accident) $
X.SCHEDULED AUTOS » PROPERTY DAMAGE '
a X HIRED AUTOS - " - (Per accident) $
X NON-OWNED AUTOS f - .$
$
B UMBRELLA LIAB 'X _OCCUR 0001254514645 04/01/2011 04101/2012 EACH OCCURRENCE $1,000,000
EXCESS LIAB CLAIMS-MADE , AGGREGATE $1,000,000Y' ;
--- ---. m
DEDUCTIBLE 7
X RETENTION $ 10000 € t $
C WORKERS COMPENSATION WCA00525902 06/3O/2011 WC STATU- OTH
AND EMPLOYERS'LIABILITY YIN O6/30/2012-.X ..TORY LIMITS. .ER
ANY PROPRIETOR/PARTNER/EXECUTIVE� ��� + E.L:EACH ACCIDENT, $500,000
OFFICERIMEMBER EXCLUDED? I NJ NIA
y
(Mandatory in NH) E.L_,DISEASE--EA EMPLOYEE s,500,000
If yes,describe under - - r - O O -
Af
-
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if r[iore space is required) "
Workers Comp Information Included Officers or Proprietors
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES:BE CANCELLED BEFORE THE
I EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN'
ACCORDANCE WITH THE POLICY PROVISIONS.
AUTHORIZED REPRESENTATIVE
01988-2009 ACORD CORPORATION.All rights reserved.
r - v
ACORD 25(2009109) 1 of 1 The ACORD name and logo are registered marks of ACORD
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ToVj1j 01�: BARNI ABLE
C C® T;
I N S U LAT 10 NNI? AFI 3 ; L `
e IIBE941A55 E:,MLE59 SPEAY T4AM SUSPpNDEO -- "':Y "
-DATTS ^v uli ERS INSULATION CEILINGS i k
1-6� -696-6611 DIVIST T3.
,
I'own of
Regulatory Services
Building Division
Address - ,
Address 2 -
Date: y//ill
Dear Building/Inspector
Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed&
completed the insulation and we'atherizationwork'at the.property`listed below. Cape Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected by a certified Building Performance Institute
(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements.
Property Owner Property Address ; Village
Insulation Installed: Fiberglass Cellulose R-Value Restricted .Unrestricted
Ceilings
Slopes
Floors
Walls
j4 1 ca cv7Arr
Sincerely
He .ry L sidy r, resident
7 . .. -
t.
C pe Co nsu ion, Inc.. ,.a
Town of Barnstable
pTHE Tgy�o Regulatory Services
Thomas F.Geiler,Director
BmtNHABLE,
MASS. Building Division
i639'
ATFD MP'1 A Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
PERMIT# (9 S FEE: $ ��
SHED REGISTRATION
120 square feet or less
aA
Location of shed(address) Village.
� ,. car. a S4.E�\a ��,��2e� CSo�S�
Property owner's name Telephone number
g , CD
j Size of Shed Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required) q1/3 os
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
Q-forms-shedreg
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A.vd�C�TEI�
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BASE"O dN,4i{/ ,eEG/STE,eE� �SEp.7-p
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Parcel /l-� D o ( Permit# ?0
Conservation Office(4th floo (8:30-9: 0/1:00 2:00)' yL ��� 1� Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00- :45)
Engineering Dept. (3rd floor) House# nro p aud
"
RARNSTABLE.
19
MASS
- -- -.3 �
TOWN OF BARNSTABLE
Building Permit Application
Projec ., dress IS *AA c }` (/UA4
Village
,y
Owner K rE i T74 16 SWSU /y CA—F`251, 1, Address 2 S k" (4- W1
Telephone S - `f 3 Y
Permit Request w isyw CT- Altr Av A", Dr- CKS 4 Pcv-, C44
_ t
~First Floor square feet
Second Floor square feet
Estimated Project Cost $ 3�-o o o r'
Zoning District Flood Plain • Water Protection
Lot Size Z 3 i Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use S I I ry lF_ F✓W I L,-J R& T 1,06�E Proposed Use
Construction Type IAJ o O D r_A °
Commercial Residential
Dwelling Type: Single Family ✓ Two Family Multi-Family
• Age of Existing Structure (o y 'S Basement Type: Finished
Historic House A10 Unfinished
Old King's Highway N 0
Number of Baths 2, No.of Bedrooms 3
Total Room Count(not including baths) First Floor
Heat Type and Fuel GA'$ FOA Central Air YE S Fireplaces
Garage: Detached Other Detached Structures: Pool A) ��-
Attached Barn f
None Sheds
Other
K"I AJ 651�1 Builder Information
Name Ol/FS1_ e*Ae 1V4 ! GO�iC iVG Telephone Number VV- J-Yb 'b L3 3
Address P. O. �0 X 6 License# 2 3 2 l '�-
1 Home Improvement Contractor# 100017
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
WUVS"7A L-�
SIGNATURE DATE
BUILDING PERMI D IED FOR THE FOLLOWING REASON(S)
6
- FOR OFFICIAL USE ONLY
RMIT NO.
D ISSUED
is
a
M P/PARCEL NO
AJ DRESS VILLAGE l
O NER
DATE OF INSPECTION:
✓a f S Y. W 1Y l ��� � r sl _ ." • - ' F ` t a� • a {
FOUNDATION
FRAME 4,
INSULATION
FIREPLACE
s .
ELECTRICAL: ROUGH FINAL -
PLUMBING: ROUGH FINAL —
GAS: ROUGH -FINAL,,-
FINAL BUILDING ,
r t -
r ;
DATE CLOSED OUT 1 �'
f ,
ASSOCIATION PLAN NO. f # +
r ii ,
`OFINE►O The Town of Barnstable
BA S MA M.A S.BLE.p Department of Health Safety and Environmental Services
0
0
�F039."� Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection �_
�Location i � � tf)e- V,.�Y-k4 Permit Number
Owner , �C �° L Builder U, L
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
6CA f)(,-C VkqocV rLOT42'
Please call: 508-790-6227 for reeinspection.
r
Inspected by ,
Date A ,
The Town of Barnstable
Department of Health Safety and Environmental Services
Building Division
367 Maier Strut,Hyamus MA 02601
Ralph CtizsSCu
Office: 508 790-6227
Building Commissio
Fax~ 308 773-3344
For office use only
Permit no.
Date
AFFIDAVIT
SOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A rewires that the"reconstruction,alterations,renovation,repair,modernization,conversion'
improvement,.rnno%al, demolition, or construction of an addition to any pre-existing owner ooupied
building containing at least one but not more than four dwelling units or to stracnues which are adja=t
to such residence or building be done by registered contractors,with certain exceptions, along with other
requirements
7 �
Type of Work: �U(l�if Est,Cost vU ,
ZAddms of Work: Z K/-ACM &L4-Y
I
ner.Name: ('�( °JA CA ��`�
r✓ Date of Permit Application:
I hereby certify that:
Registration is not required for the following reason(s):
Work ccciuded by law
_
_ob under S1,000
Building not owner-occupied
Owa Piing own permit
Notice is hereby given that: CONTRACTORS
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGI
FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVVEE ACCESS TO THE
ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of oc owner.
000
pate Con name Registration No.
7
OR
�w dFa
• �``nn" Tile Coninionwealth of Massachusetts
- .h: _... ;_..�•�� Department of Industrial Accidents
i _ . Iffleeof/ByeszVolloos
=i•;a, 61/tl If-mv of ton Street
Ba-min.Muss. 02111
Workers' Compensation Insurance.AlMdavit
ARttlica�ant
nformatio'n�
Ipc•�tion• /
city phone#
❑ 1 am a homeowner performing all work myself.
❑ 1 am a sole proprietor and have no one working in any capacity
❑ 1 am an employer providing workers' compensation for my employees working on this job.
company name• -
address• .
.•ir.•• phone#•
inut ance co .uy#
I am a sole propriet ,gene 1 contracto or homeowner(circle one)and have hired the contractors listed below who have
the following workers' compensation polices: 1<,IAJ6
company nw e: W6Si
:/ address: 41 IVY —
/"- • � (�ii/Ill � `v . .. :..
•• r'i d /�^f'J L phone#� I
lB,s WC Co. �/ V I �) ! .�neiicv# C V/
o`er 1 76
6
�lSinlliiBs'name. IYy V ,a Yam. " WLY
�ddress- 12/�
msumnce en. ae e�
Atiach additioeal'sheet if rieeessary :•�* - sj :mot"'-•�"r" r ''��+`'" '`
Fuilurc to secure coverage as required under Section 25A of MGL 152 an lad to the imposition of criminal penalties of a fine up to S1.500.00 and/or
une •ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day apaiast me. 1 understand that a
copy of this statement may be forwarded to the Once of Investigations of the D1A for coverage verification.
I do herebr cerrif}' r r lire p * S r� d penalties of perjwy that the infornrmion prm ded above is trae and correct
Signature ate 2 U:�, �
Print name �one#,�— o —;J—l 2 62�J 3
official use oniv do not write in this area to be completed by city or town official
city or town: permit/license i/ nBuilding Department
(31.1censing Board
0 check if immediate response is required (3Selectmen's Office
C)tlaitb Department
contact person: phone l/; Mother
(mised 3•175 PJA)
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", an empinree is defined as every person in the service of another under any
contract of hire, express or implied. oral or written.
An einpinrer is defined as an individual. partnership,association. corporation or otlier ;4al cntigy,1�i•any two or more of
the fore�soing 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
dwcliin;; 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 1'52 section 25 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 commonvi•calth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. 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 havf
been presented to the contracting authority.
!�!.e•+�!.!�I!!-•• i.n.. a a.: a �:.. Dom•.^ GIs '►¢.J". ��...w.l.+�........�_
�737
.. .. .. �/i•..- '.N.w.tl�dl.i� f4 is �:_.d.•.
Applicants
Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and
supplying-company names. address and phone numbers as all affidavits 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.
t...:.� a..... .+'...... ...:•.. .. ........ :•'%•• 7-
City or Towns
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. The affidavits may be returned to
the Department by mail or FAX unless other arrangements have been made. •.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions,
please do not hesitate to give us a call.
..1�!l � _ � '. ..:... •:.. Dn•..a.� Y.^.Y. ••wt:'...f4�•wrf.�J. w��R �R��..'.
i.r.4►..� _�� is .. `., .:1.. :'.R'
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
fax#: (617) 727-7749 -.
phone #: (617) 7274900 eat. 406, 409 or 375
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TOWN OF BARNSTABLE .Permit No. .,33458. .
BUILDING DEPARTMENT
..............TOWN OFFICE BUILDING Cash
r � D
679.
HYANNIS,MASS.02601 Bond ............ i
� r ,
CERTIFICATE OF USEIAND OCCUPANCY
Issued to Bayside Building- Co.-
Address Lot #6, 25 Kalmia Ways
Centerville, ,MasS. .,
USE GROUP FIRE GRADING OCCUPANCY LOAD 1
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.
May 18, 19 9 0 !�t'......................... ... :..;f✓.. -L-.
`� Building Inspector
�'fy �•'. * TOWN OF BARNSTABLE
BUILDING -DEPARTMENT
2 Reaaer TOWN OFFICE BUILDING
rua
HYANNIS, MASS. 02601 -
F
MEMO TO: Town Clerk
FROM: Building Department
DATE:
}
An Occupancy Permit has b�ee/n' issued for the building authorized by
Building Permit $k. ... ................�... !,�f _.. ......_:........-. ...._. ... ........�. ......._ _.
issuedto .......... _........._... .... ............................................ ..........._.........
�_ ..
Please release the performance bond.
r
STABLE, MASSACHUSETTS BUILDING PER'M11
-1i;c3
DATE
__._. ,_..F.. _ 19 _�I•i PFRMIT NO ��r)""'a/('••
APPLICANT A'DRESS ___._ ...• `.r ) I[_
(NO.) (STREET! (CONTH'S EICE NSEI
NUMBER OF
PERMIT TO ISU:. 1_k I i..%'S+.r'�..:.i..._ (_) STORY _' _ - DWEL1_ING UNITS
(TYPE OF IMPROVEMENT) NO. If'N O1`Ir SI Il it^,!I
AT (LOCATION) - '-"��- ' <' + C ZONING
(NO.) (STREET) DISTRICT
BETWEEN
AND
(CROSS STREET) (CROSS STREET)
SUBDIVISION LOT
LOT_ BLOCK SIZE
BUILDING IS TO BE FT, WIDE BY _ FT. LONG BY ___FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCT I,
TO TYPE USE GROUP BASEMENT WALLS ON FOUNDATION
(TYPE)
REMARKS:
AREA OR -
VOLUME `j.,e1) " t• -• ESTIMATED COST "' ..I, "" FEEMIT s
(CUBIC/SQUARE FEET) "
OWNER
ADDRESS BUILDING DEFT
" `J'-� r 1— i.
BY ? �;
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY c
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE A
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINF
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOI
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR RETAINED ON JOB AND THIS APPROVED PLANS MUST BE R WHERE APPLICABLE SEPARATE ALL CONSTRUCTION;WORK: CARD KEPT POSTED UNTIL FINAL.INSPECTION HAS BEEN PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND
I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE— MECHANICAL INSTALLATIONS.
2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
MINAL INSPECTION
TI TO BEFORE
FINAL INSPECTION HAS BEEN MADE.
3. FINAL INSPECTION BEFORE
OCCUPANCY.
POST THIS CARD SO IT IS VISIBLE FROM STREET _
BUILDING IN ECTION APPROVALS �Q PLUMBING INSPECTION APPROVALS L-I_ECTHICAL INSPECTION APPROVALS
vp
2
f 2
17- m ga_cr p
3 S HI.AIIN(;INti I1,(:1 HN AI'I'IMVAI:; I,NGINLI:RING OLI'AR 1 N it I
OTHER —..-�-------------
1 •7^ I'7 q,q.o b HIIAHI, c)I IIIAI-I11 ----- -
_lplxcc o, Q 1
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT '"v!LL BECOME NULL AND VOID IF CONSTRUCTION
TOR HAS APPROVED THE VARIODU ARRANC11 S STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPE(GED INDICATED ON THIS CARD CAN
CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. FOR BY TELEPHONE OR WRITT
NOTIFICATION.
BUILDING PERMIT NO. 33 D zT' ��Jt� ✓ - � / j(7
ASSESSORS PARCEL NO.
CONTINUATION OF ROAD BOND
The undersigned owner/contractor hereby agrae to maintain their road bond in
force until the following work, items are ceWDletad to the satisfaction or the
E ngineer=:g Section of the Department of Public wor::s:
loa= and seed shoulders as soon as
weather pewits:
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g ...... cm�F�. I J Cr.0�� w. .tlt t?v�s� S BJHdSTADLE. i
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APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M.. only
'OWN . ®]F IDLP AAlt
1vTAL"E
BUILDING, 0 ��'��t; E
.. '
APPLICATION FOR PERMIT TO ....
.... X... 1p
TYPE OF CONSTRUCTION .............. .:. G/ + .:............. ..;.........,..................;..........:.. .:...
TO THE INSPECTOR, OF BUILDINGS: L.
The undersigned .hereby `applies for a permit ,according to the -following information:
Location .... -• %......�......... .� ..'.... �Y C FX 1° 12l :...:..
Proposed. Use ..........................:..........................................................
Zoning District .................._..............................: .............:.....Fire District ...... ..........
Y_ ��4?J7�QJ91�� /r��jial / ,f�tg"" L .. ...........................
Name of Owner J. . ............. ... ......C:�.................Address .... .... �� ( L��Zef
Name of Builder .....:.........._!5dAt.......................... ........Address ......... y���
Name of-Architect /....r..... t'(. ... :........ ......Address ......... ........ ., .....................................
Number of Rooms ..........:....?.................. .................. . ......Foundation' � ......... ......... ...:.
Exlerior 4A....�' .�'.. ................... .. ......Roofing . .... ......• .
1""�iloo.-�
Floors ' Z," ..1. .....y. .�nG -�.. .. ........Interior y . {./d6L✓�
Heating !✓ .....................0 .. ......-..... ........ .....:..Plumbing ` ...!C...c� ..... �2
Fireplace , `... .......:.........Approximate Cost .... .... ...
Area
Diagram of Lot 'and Building with Dimensions Fee
. .....::.. if ...........
11„ '
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` ....�/ :/' .. ...� .......
Construction Supervisor's license ......� � yS........
4:
1BPf:YSIDE BUILDING CO.
N 33458 Two Stor .
z .................. Permit for y.........
x - - -
Single..Familv...Dwellinq.........:. ;.
Location ...Lot•••#6, 25 Kalmia Way -
Centerville................. ......... K_.
Owner .....Bays•ide Building...gq,...... '
Type o'f`._Construction .....Frame........................ r
t , .................... ................. 1. ♦ • -
1 Plot ..... ................ Lot ................................ ,.
Permit Granted �......Janua.ry....1.6.......19 90 `.
Date of Inspection ...:� . q. ......19 '
Date Completed > _" .... .................19
tj
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Assessor's office (1st floor):
CF THE TO
Assessor's map- and lot number ..�.�......N.........................�`�`��
Board of Health (3rd floor): r` e�Q ♦�
Sewage Permit number �..rr
.........................�.............�............. Z BABd9TODLE, i
Engineering Department (3rd floor): oo 1639. 0�
�} �� �-� �,ems
House number ....................... ....�?..5..... ..^............... 1 CFO MAI d`
Definitive Plan Approved by Planning.Board ---------19________ -
APPLICATIONS PROCESSED 8:30-9:30 A.M. Land 1:00-2:00 P.M. only
t
TOWN OF ' BARNSTABLE
RUDL lul I N G O C T 0 R
APPLICATIONFOR PERMIT TO ........................................................................... .......... .......-...............................................
TYPE OF CONSTRUCTION ��oy`�......................!..........................................................................................
................................ - r7
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby
/applies
//for a permit according to the following information:
Location ....L 07 Lo k4L114 IN �J9�f CCU 70E..X J/ �.�
...................................................................................................................................................................................
ProposedUse .............................................................................................................................................................................
Zoning District a -�— /;l/YJ
............................................Fire District ..... .
Name of Owner l � ...l2CG�i ( /.�
...........�. . ...�........./...................Address ....................................................................................
Name of Builder ..............:��' .....................................Address
....................................................................................
� :1111�
Name of Architect ............... ...........................Address .......................................................
Number of Rooms ............... .7.......vc........... ........................Foundation
.......... ................................................................
E x l e i l a r .6� !!Z+l.... '. g ...............................................
............. ................Roofin ................,:�.. .
.......... ftTis���', � .�P rJy ,/� ........Interior ....!LC c�t,P...,f..... t �� -�/1
Floors .................................................... ..... . '............................
91
Heating ...............................'C.">` -Z...........................Plumbing ..... ....'"............. ../.a............................ ..............
Fireplace w' ls?; 7 ' '/n pP 1.......................................
r............... ..................:� .......................A roximate Cost ......... . ti:.trr ✓
Area ..........................................
Diagram of Lot and Building with Dimensions Fee .............................................
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 .... -� �/`�f!!..................�.G......... !
Construction Supervisor's License e,4if..............................
BAYSIDE BUILDING CO.
inn c
No ..33458 Two Story
............... Permit for ....................................
Single Family Dwelling
. ........................................................
Location .Lot #6 , 25 Kalmia Way
Centerville
...............................................................................
Owner ...Bayside Buildin5 Co.
Type of Construction ...Frame
................................
...............................................................................
Plot ............................ Lot ................................
January 16 90
Permit Granted ........................................
Date of Inspection ....................................19
Date Completed ......................................19
• • • JOB
West Barnstable Builders, Inc: SHEET NO. _ OF
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