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Home My WebLink About0100 LOOMIS LANE Tr �� i;t. i_y� -. ...r.r � `�:,.y ', .. '..� .•:' � -. .. .!,F.- .,.. __ __ p�. !I� i ty4. :. ,ky�t J'{I!? ,�� 1 � F7,�4 ,:u,W .r. :- 'k! .k,.1': �t ,•.i" .. ..,+t .. i) ''. '.`',..� -: K 'E w {•. /tTli. f� Y"�� '13� _ .. ,.:.T jjt q�::,iG -q.,. } a.M ...:. - fib.v....; r:'tl,. , �• 2 n,�, , � ��! '� �"'7 ''u_�� ,t•s ';t' Y� t.'�+�' �•;.;. .p < ,yb.�*F .. �• }i,. .. L". dx. ."ti. lti A:'Fi:�'.�. F L- r c...:r. ��... < ...1'.,�:.., -.;rt'F�' �. 4E ,.}rl K a i.. q� FI•+,aF R_� 1! .,., .. -. . - ,. •. �!' '•,;.. � '' - '"h�V a �YJ �' 1 4 � S:f ..t�.�r `! u�,��3i�� tf��C 'Yt�� k 3��q � r � �.t! � �v�, _�rt � qks��. �x�x`� ^� i�;ui% ik['';u'h A $ .°7`!�, "�•R'w..1 t{it ,y: a P r y. v �eiq, i L v Y; p L F h -: .., '. ,. .. ` .'.: ., _.- '' ,. a •.','. e y 5 « Application number... �^ I� Fee . '1 D ......................................... Building Inspectors Initials...... ............................ sue. •'� JI;L 08 ?hjo DateIssued:........... .................................................... f OWN 0HARNS'FA LE Map/Parcel...................o ................................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Z4A/01//S NUMBER ET VILLAGE Owner's Name: /10 Z? /��Md Phone Number oe,673 l-73 �'326 Email Address: 4LZ C Cell Phone Number Project cost$ G �ed . 'Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date:- TYPE OF WORK �Sid g Windo IJ�J s no e han e # �❑ Insulation/Weatherization ( _ headg ) ❑ Doors(no header change)# Commercial Doors_ require an inspector's review ElRoof(not applying more than 1.layer ofshingles) / Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# l ZS (attach copy) Y Construction�Supervisor's License# �S / ` 6,2l (aftach.copy) Email of Contractor ' /'� yy Phone number �� Y� ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS/N A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER r *For Tents Only* y - a, Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If ye;please aitach`floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit,is required.` If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date - ` APPLIC 'S GNATURE Signature Date 4 All permit ap lications are subject to a building official's approval prior to issuance. 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): r ' Address: City/State/Zip: Phone#: 0 Are you an employer?Check the appropriate box: Type of project(required): l.❑ I am a to er with 4. ❑ I am a general contractor and I P Y 6. []New construction . e oyees(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. working for me in any capacity. employees and have workers' 9. ❑Building addition, [No workers'comp.insurance comp.insurance.$ required.] 15. ❑ We are a corporation and its 10.❑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 pea 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 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: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a frte 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 certify u r ains and penalties of perjury th 'formation provided above is true and correct. Si ature: Date: t/ l Phone# Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: c r � i 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." Y ; 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 4 , Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#61.7-727-4900*ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia MICHAEL SILVA 82 WA LTO N AV. HYANNIS MA. 02601 508 245 2906 H.I.0 175708 C.S 106219 Caroline McKeon 100 Loomis RD. Centerville Mass Description : Repairs all rotten T 11 on walls exterior Plywood only .Then Install 5 new Harvey windows on rear of house . Then install new corners board on all of house . All trim will 'be P.V.0 material . Then Install new rake board trim on Gables of house and garage . Install new trim around garage door and build new door out'of bead board . Replace all rotten trim around all windows and doors .Then install white cedar shingles on all sides of house and t„ garage . White cedar R@R Clear B . Remove all rubbish from grounds and clean . Michael~ will retain all building permits -z9-' Total Materials & Labor $24,000 .00 `$8000.00 order window$8000.00 when% done rest when done . Mi ` 'el Sil Car 'ne M eon t � � -074 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR f ttt TXePE:Individual Real ' 4n Expiration Q� O6/03/2021 I � MICHAEL SILV/k�� MICHAEL D.Si r I L 1 82 WALTON AVE f it ` Yj HYANNNIS;MA 02601, - i Undersecretary , + Commonwealth.of:.Massachusetts. Division of Professional Licensure Board of Building Regulations and Standards ConstructiopS111rj,1 2 Family 0�pires: 06/28/202.1 CSFA.-106219 MICHAEL SIL-*A 82 WALTON MENUS C HYANNIS Me�26041 Commissioner "�-- Town of Barnstable *Permit �gZ # Expires 6 months froI issue date Regulatory Services FEe Thomas F.Geller,Director / Building.Division @bI o1Z?1.a 8 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstab le.ma.us Office: 508-862-4038 Fax: 508-790-6230` EXPRESS PERMIT APPLICATION - R.ESXDENTIAL ONLY Not V,71id without Red X-Press Imprint Map/parcel Number Property Address [Residential .Value of Work -1,Y 00 . y " Minimum fee of$25,00 for wo rk k under$6000.00 Owner's Name&Address 1 J V ,� Contractor's Name tJ� — �J�1 ( Telephone Number -7q 0 (�j P 1 Home Improvement Contractor License#(if applicable) I d J Construction Supervisor's License#(if applicable) II I ✓ . ❑Workman's Compensation Insurance Chn<one: am a sole proprietor -PRESS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensationlnsurance O C T 2 .0 2008 - Insurance Company Name TOWN OF BAR NSTABL Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) VRe-roof(stripping old shingles) All construction debris will be taken to 0AA off( 6 U, [] Re-roof(not stripping. Going over existing layers Of roof) [] Re-side El Replacement Windows/doors/sliders. U-Value (maximum.44) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Hi ttvanu etch, ,,.. :***Note: Property wr r roperty Owner Letter of Permission. opy of /e Ho Imp ement Contractors License is required. SIGNATURE: 0C :I I Wv R 1?0 BIN, Q:Fomis:expmtrg Rey' se061306 The Commonwealth ofMassachusetis Department of.Industrial accidents Office of Investigations 600 Washington Street Boston,AM 02111 ' www.mass.gov/dia Workers" Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual):. _jy .S Address: 0 x. 43 City/State/Zip: Gll�os � Q(�� , r04hone.#: 1�10 Are you an employer? Check the appropriate box: Type of project(required):, 1.❑ 1 a employer with 4. ❑ I am a general contractor and T loyees (full and/orparttime).* have hired the sub-contractors 6• ❑New construction a'sole pioprietor or partner- listed on the'attached sheet. 7..❑Remodeling ship and have no employees Zhesa sub-contractors have g, ❑Demolition working forme in any capacity. employees and have workers' [No workers'comp,insurance comp.insurance,# 9: ❑Building addition required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions '3.❑ I am a homeowner doing all work officers have exercised their , g 11.❑ umbing repairs or additions anyselL [No workers' comp, right of exemption per MGL 12. oof 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 must also fill out the section below showing their warkcrs'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and thin hire outside contractors must submit a new affidavit indicating such. IContractm that chicle this box must attached an additionalshect showing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors gave employees,they must pravidb their workers'comp.policy number. lam an employer that isprovlding workers'compensation insurance for my employees Below!s.thepolicy and job site Information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Data: Job Site Address: City/State/Zip- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),; Failure,to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 Inv ations of the CIA for' Prance coVera e verification• I do here :rude the in -and naltles,ofperjury that the information provided ovg ' true and correct Signature: Date: JP Phone #: O' r ial use only. Do not write in this area,Yb be completed by city or town affclaL or Town: Permit/License# ng Authority(circle one);ard of Health 2.BuiIdingDepartment 3. Cify/Town Clerk 4.Electrical Inspector S.Plumbing Inspector heract Person: Phone#: 1HE 7, o Town of Barnstable. Regulatory Services i s�x�vsreeM, �9 � Thomas F. Geller,Director BUilding DI-vision Tom Perry, B m Building Comissioner' 200 Main Street, Hyannis,MA 02601 vm w.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508'-790-6230 Propeity Owner Must Complete and Sign This Section If Using A Builder Av,,\v) O'CT-o as Cwner of the subject property herebyauthorize CkAkU to act on my behalf, in all matters relative to work authorized by building permit application for: (Address oJob) gnatiue of Owner Date Print Name Q10RMS:OWNERPERMISS ION Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Regtstratton 1.24310 One Ashburton Place Rm 1301 Expiration 6(112009 Tr# 130873 Boston,Ma.02108 TYPQ dividua15, James Curley _ 7EF James Curley 287 Fuller Rd. Centerville,MA 02632 Administrator Not valid without re Massachusetts- Department of Public SafetN � Board of.Buildin�g Regulations and Standards; Construction Supervisor Specialty License License: CS SL 99138 ' Restricted.to:. .RFAS.. JAMES CURLEY 287 FULLER ROAD.. � CENTERVILLE,.MA 02632 j I Expiration: 1/28/2012 {'unmisiuner Tr#: 99138