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HomeMy WebLinkAbout0010 MICAH HAMLIN ROAD n � w. rA '� t a z� �; o ti 3 ��� �� ."• � ., r. _ ��, '�. ,rr� r :� ° �� � r �, „F, r y •k 9 F rs N � r 4 .D., t..°b' ,=F � �' .r4, + :ik - �•�,. •y .. 'v ',:" n .t 9 �.. �' .. `-., , U u c v e '.. a ..o" -:;. �., .. .. � �.. n „_^rv'• e i -. � 7 J i m < • c a. Y 4 + T f M • w a e(r. : CI - � Y , a u,• .b _ �.-,�' '�r,- , � 1. -r c,. d fin`^ ' r �,y. •• s 1 � a. iA.' !y, a,y k,, t u.N `� ' a ,.'Al .a,,, µ. n • ..`tr :b ;A„ + ,d�.y i.-`i' d _.4., �'. *'r 14 r. . n- ew J w v 'i n c a r. c r ' r. < : » z • r J: A • r „ 0 , r S it t ¢ , i V L n I n 3 ' r - ; r w , ns n c Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept M"S&1619, Posted Until Final Inspection Has Been,Made. el j s g shall Not:be Occupied until a Final Inspection has been made' W Mat here a Certificate of.Occupancy Is Re wired such Buildin Permit No. B-19-1423 Applicant Name: Gabriel Panaite DBA G&R Home Improvement Approvals Date Issued: 05/20/2019 Current Use: Structure Permit Type: Building- Deck Expiration Date: 11/20/2019 Foundation: Location: 10 MICAH•HAMLIN ROAD,CENTERVILLE _ Map/Lott 170-174 Zoning District: RC Sheathing: u Owner on Record: KILEY, EVELYN C Contractor NameGABRIEL I PANAITE Framing: 1 Address: 10 MICAH HAMLIN RD Contractor License: CS--112592 2 CENTERVILLE, MA 02632 .F _, Est Project Cost: $9,500.00 Chimney: Description: new front covered deck Permit Fee` $ 110.00 .- - Insulation: Project Review Req: Fee Paid:.'f $ 110.00 Date: a 5/20/2019 Final Plumbing/Gas Rough Plumbing: -.: Building Official ' Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after:issuance. All wo'r'k authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall 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 be maintained.open for.public inspection for the entire duration of the Final Gas: 'work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this,-permit. Minimum of Five Call Inspections Required for Ali Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection RP Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to CoveringStructural Members Frame Inspection)( p ) Low Voltage Rough: 6.Insulation g g 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: -. -- - - ----- - ... _. ... -.-... . -. I , p Application Number...... .................................... BARMAEL'E' BUILDING E//��TT MASS. $ M-t Fee............. . v.............Other Fee........................ 163 APR 6 Zp 19 TOW/►OF ggRNs A Total Fee Paid............................................................... :..... BA TOWN OF BARNSTABLE PerL Approval by..... .: ...............on.. / /i ... BUILDING PERMIT � �....C..7... ........................ �............`?D............. APPLICATION Section I — Owner's Information and Project Location Project Address_ /d �lC'� �/�iY,�Z//y R)d Village Owners Name 15 klZ�L YI-1 Owners Legal Address l© /Y`�ff l� f �e%3z- � City G" '7r � G� /� State 4'A Zip Owners Cell # -� Z// 1(6l E-mail Section 2-Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet ❑ Single/Two Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other-Specify Section 4 - Work Description YEW volw 6`'� f Application Number.................................................... �. Section 5—Detail Cost of Proposed Construction 9 A-0 Square Footage of Project P2 Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas - ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes No Section 7 Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning 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 in the past? ❑ Yes ❑ No T act nnriatPA- i i/i i/7ni 2 Application Number............................................ Section 9- Construction Supervisor �/QG �G P/�// Telephone NumberName 6 Address �� CryA WI(017Z State Zip ��ul` License Number rs License Type Expiration Date Qs o2 oz z Contractors Email �/ �//' G ��� �/Le 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 0 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor n , Name �IC l�� ������� Telephone Number _� 6 c'6 6 Address gity ff�i�G� Iall State /75�'-Zip 6126154 Registration Number Expiration Date Oc? 0!�Z 2�2 I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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.Attach a copy of your H.I.C... Signature Date ®� ��• 2� ;i Section 11 —Home Owners License Exemption Home Owners 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 P: APPLICANT SIGNATURE Signature Date Print Name Telephone Number �� � 2c�� n 'o' E-mail permit to: � �_ � " � Section 12—Department Sign-Offs ' i Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ { Fire Department ❑ I �9L i ConservationcY(1, For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization i i I, , 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) Signature of Owner date Print Name ESr1T. _. . . . . . . . . . . ju i•¢S.57i \ r� 6Z Ni -o z L.-7- to Mai ,,ks v -- � ;. Fit.1 _ . 1 CERTIFIED PLOT PLAN LOCATION C&jTCRVt LL.C-: , MASS• CERTIFY THAT THE F00IQDATIoN HOWN HEREON COMPLYS WITH SCALE I 't S-6 DATE I- ?- - a HE SIDELINE AND SETBACK PLAN REFERENCE ;EQUIREMENTS OF THE TOWN OF )ARN ST ASt_C AND IS NOT .00ATED WITHIN THE FLOODPLAIN. CcNTfc�CZJI(--tL- HIGHLANDS )ATE ' 1 -2 -87 L, R BAXTER e NYE, INC. 'HIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS NSTRUMENT SURVEY AND THE OSTERVILLE^- MASS. OFFSETS SHOWN SHOULD NOT BE JSED TO DETERMINE LOT LINES. APPLICANT �1 �+�] SMALLi TNT ' :r mo Pill yMr am.=_ I ' s I Rl 7IF; `:.Cx ..Y 'ice• ...' Y4 4 '-.. +' ,. , 'd"� � �' "'..,"�� n} � � -' �.. FROM IK r gg q!pp�� ,,fi�gg r• 5. q V� ^`F 5C b �I - 1 ..; �-..'S" �.SF..' \tom ��.�¢- ET�k�#+ ���� � t ' 'v'�1 �-. ;�4.. a .'.�€�s '. � •wj. � � n�.a � ' +TT z• ��:� a.. -., .� -_.y.+ ' '. ec'a' ,. . �'`' �•":�."�7��d3.�c�Y��^>� 'F.i�.'.i�1S;✓dr�'q'' :�. ..`���,�+yc.,,� :� .±.�y!�#. ON f��a. •yy�!� } � ,.g���+ y�,��l... 1C�' � �'�{� ,S,l��li i7 .�.� �_�' �y'-` u o ! !"A�' ��a� i.?;V,I.'�F�•�1T��:2.A^.' '�� '...�.T "....��.\TG� .°?�� ^:'� _ ._ ,1` 3.ti... ._ �' fi� Lauzon Jeffrey From: Lauzon,Jeffrey Sent: Monday, May 20, 2019 9:41 AM' To: panaitegabriel@g Mai l.com' Cc: Lauzon,Jeffrey G Subject: ViewPermit, Permit No:TB-1971423 Applicant, . Please be advised that the above application has been reviewed and the following,is noted: 1) No plot plan demonstrating compliance with setback requirements submitted. The application is denied pending the submission of the required documents:And, if aggrieved by this notice;you may fila a Notice of Appeal (specifying the grounds thereof) with the State Building Appeals Board within-forty-five (45) days of the receipt of thisnotice. Respectfully, Jeffrey Lauzon Chief Local Inspector (508) 862-4034 jeffrey.lauzon(c)town.barnstable.ma:us !, This form satisfies all basic requirements of the state's Home Improvement Contractor Law(MGL chapter 142A),but does not include standard language to protect homeowners. Seek legal advice if necessary. Any person planning home improvements should fast obtain a copy of"a Massachusetts consumer guide to home improvement"before agreeing to any work on your residence.You may obtain a free copy by calling the Office of Consumer Affairs and Business Regulation's Consumer Information Hotline at 617-973-8787 or 1-888-283-3757. Homeowner Information Contractor Information Name^ ( Company N e - Street Address(do not use a Post Office Box ad ess) Contractor/Salesperson/Owner N - t L11Y� Udr�i r - City own Stare ip o e Business Address(must include a street address) L g 32 &24:�1Y Daytime hone Evening Phone - City/Town State Zip Code " Mp iYy i1 y Mailing Address(It different from above) Business Ph Due Federal Employer M or S.S.Number r.m.rtgrmestLetmoctLomeme- Home C.Reg.Nmober Exp-t-date ptu�mmt w�-ectors Lace e C�LdammbQ IG17 25tJ The Contractor agrees to do the following work for the Homeowner. (Describe in detail the work to completed,specifying the type,brand,and grade of mat 'als to be used,use additional sheets if necessary.) - Iry x' M /Y Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be gecured by the contractor as the homeowner's agent, be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be , excluded from the Guaranty Fund provisions of Date when contractor will begin contracted work MGL chapter 142A.) Date when contracted work will be substantially completed. Total Contract Price and Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: Payments will be made according to the following schedule: O upon signing contract(not to exceed 1/3 of t4f total contract price or the cost of special order items,whichever is greater) $ ry vr��jby "r /<�9 or upon completion of $ C ( C/by_l l or upon completion of $ 2 FAO upon completion of the contract. (Law forbids demanding full payment until contract is completed to both parry's satisfaction) The following material/equipment must be special $ to be paid for ordered before the contracted work begins in order $ to be paid for to meet the completion schedule.(**) - NOTES:(*)Including all-finance charges(**)Law requires that,any deposit or down-payment required'by the contractor before work begins may not exceed the greater of.(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty belna Provided by the contractor? No Yes (all terms or the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for . materials and labor under this ameement Contract Acceptance-Upon signing,this document becomes a binding contract under law.Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. * Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration: You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance?Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document- . Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. You may cancel this agreement if it has been signed at aplace other than the contractor's normal place of business,provided you notify the contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the third business day following the signing of this agreement. Seethe attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! Two identical copies of the contract rmru be completed and signed.One copy should go to the homeowner.The other copy should be kept by the contractor. Homeowner's Si6fiature Contractor's Signature Date Date E Office of Consumer Affairs and Business.Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 4 Home Improvement Contractor Registration 'Type: Individual Registration: 192964 - e9 _ GABRIEL PANAITE Expiration: 08/30/2020 D/B/A G&R HOME IMPROVEMENT 862 QUEEN ANNE RD - a HARWICH,MA 02645 ':('•�. ��=Sao.,•, y +�:f. - Update Address and Return Card. SCA 1 is 20M-05/17 JM7e rreieur¢�llo ✓Gm:1a ��elly office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Reoistration_ Expiration Office of Consumer Affairs and Business Regulation .=19296 08/30/2020 1000 Washington Street-Suite 710 — GABRIEL PANA } Boston,MA 02 ITE�_�,�s�� , D/B/A G&R HOMEIMPROVlEMENT GABRIEL PANAITE / 862 QUEEN ANNE RD' U , HARWICH,MA 02645 Ot valid v7ftout signature Undersecretary.; — usetts �°f Massach `k Comm°n,Nealth icensuredards s rotessional d Stan. pivision°f P R9ufations an ago. of.Building y� ,�• rvis°r Board n_ Constr� �ires 0110512022 5g2 CS_112 j ANAITEff GABRIE EN A NE ROAD �C $ ss2 QUE aZsg5 ri ,�� 4 HARWICH MA �VOI4S3�Q «•''c V Com►rissioner The Commonwealth of Massachusetts Department of IndustKal Accidents Office of Invadgations 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 organizationandividual):^ IS 9 tf®/`,F 4/< OtIVKW7 Address: 96.2 LT V5�QY I�N&57 VOW A/ 4�t W City/State/Zip: Phone#• �j �' �2 Are you an employer?Check the appropriate box: Type of project r uire 4. I arli a general contractor and I p ] ( e4:� � L❑ I am a employer with g 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.5ZI am a sole proprietor or partner- wed on the attached sheet. . 7. ❑Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition workingfor me in an capacity. employees and have workers' Y aP tY• ' $ 9. ❑Building addition [No workers'comp.insurance comp.insurance. r am•] S. � 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 per MGL 12.❑Roof repairs insurance required.]t c.152,§1(4),and we have no 13.E]Other '� � 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors most submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. p Insurance Company Name: . Policy#or Self-ins.Lie.#: < r°�i J5-00 501��,�2� a9 Expiration Date: 12. Job Site Address: (4#ffL? '�� City/State zip: e G� 1//�l� / ,w a. _ 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 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 certify uDda tyre pains and penattks of perjury that the information provided above it true and correct: S S Date: .4 © o ®!t. Phone#: OfjFckd use only. Do not write in this area,to be completed by city or town ofj`icial' City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2:Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: _ t Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pur-suant 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 jo�,and including the legal repres r' es of a deceased employer,or the receiver or trustee of an individual,pa . -ship,association or other legal ,employing employees. However the owner of a dwelling house having not re than three apartments and who ides therein,or the occupant of the dwelling house of another who employs to do maintenance, on or repair work on such dwelling house or on the grounds or building appurtenant shall not because of 'employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"ev state or local lice agency shall withhhold the issuance or renewal of a license or permit to operate a b ess or to constrict dings in the commonwealth for any applicant who has not produced acceptable evide ce of complian the insurance coverage required." Additionally,MCrL chapter 152, §25C(7)states"Ne' er the common eatth nor any of its political subdivisions shall enter into any contract for the performance of public w k until le evidence of compliance with the insurance requirements of this chapter have been presented to the ntractirmg ority." Applicants Please fill out the workers' compensation affidavit completely; checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and p e numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Li ih Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'comp n insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affida may b''submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be re to and date the affidavit. The affidavit should be returned to the city or town that the application for the p ' or li e is being requested,not the Department of Industrial Accidents. Should you have any questions re the law or`;,you are required to obtain a workers' compensation policy,please call the Department at the ber listed below.`Self-insured companies should enter their self-insurance license number on the lime. City or Town Officials Please be sure that the affidavit is complete and prly legibly. The Department has rovided a space at the bottom of the affidavit for you to fill out in the event the Investigations has to co ou regarding the applicant. Please be sure to fill in the permit/license number ill be used as a reference nun . In addition,an applicant that must submit multiple permit/license applicati given year,need only submit o e affidavit indicating current policy information(if necessary)and under"Job Sress"the applicant should write" locations in (city or town)."A copy of the affidavit that has been officmped or marked by the ci or town ay be provided to the applicant as proof that a valid affidavit is on file fpermits or licenses. A n affidavit ust be filled out each year.Where a home owner or citizen is obtaining a e or permit not related to y business o crnmercial venture (i.e.a dog license or permit to burn leaves etc.)said :erson is NOT required to complete this affida The Office of Investigations would like to thank you in advance for your cooperation and should you ve any questions, please do not hesitate to give us a call. The Department's address,telephone and fax rum The Comm v�ealth of Ma whusetts Deparlm of Industrial Aeaidents Offic of I;nvestigadom 6f}Q ashinon Street _ 13o MA 02111 Tel.#617-727-4900 A 446 of 1-877-MASSAFE , Revised 42407 Fax# 7-727-7749 Www: .aov/dia Ir 'Ile • o v ��b Lie Al - - 6 - E ET r i. 4x4 R - Q zx 5 e(3U ;X pc�, y S�Ms IL At� DI 3l8bjgNabB j0 NM01 Barnstable Bldg.Dept. �����oF Massq�yGs Approved b �E 6l OZ 9 Y cobix1 -�N �d b Permit#: �" 2,3 o s�a��j i�a 1d3a 9Nlalm8 A REGISI� SS10% 1 3 l � t "1 ?viICHELE CLDILC P.E. � d�— i Consulting Structurai. cn inee- i ?23 Cottonwood Lane, Centerville, �dossachusetts 0263 D _ Drawn By: i�C late: f �`(/ V 1 U ►! li 1S,,Ie: ! 1 C/ Vluuii U"V� A� iVOTppt� ! Rev. v yJ — tie '�om�:6t�— No �[ r � r y . 512 + ��� goo E j Eliit t 14 'Eli I F e {f f 7*1 cLrx rot ks ---ij L-1 - t Town of Barnstable *Permit 47,—)0/C�),QV?Yo .� Expires 6 moat rom lsue date Regulatory Services -Fee 1AMSTABIE MAS& Thomas F.Geiler,Director Building Division Cos b ))j)jj_JA Tom Perry,CBO, Building Commissioner 200 Main-Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 ' Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address ,4# _i1u [� f/ C I� Po FJI/�-e 2 Residential "( s�Value of Work I Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Lc7,4 H/ 6A-lei Contr ( �}tor's Name Zi-f d � ,V/IAK OWY� ZNf- Telephone Number Home Improvement Contractor License#(if applicable) . Construction Supervisor's License#(if applicable) d Se 04 PY31 Y.D R C e S P e R®_�T [ Vorkman's Compensation Insurance Check one: A U G - 9 2012 ❑ I am a sole proprietor ❑ I&M the Homeowner E3Ahave Worker's Compensation Insurance TOWN ^ f /L //0 qej I��[JfZ44ff� OF.BARNSTABLE Insurance Company Name H sf do i,7 e Workman's Comp.Policy# �•�i � Q,�.y�d vz Q�� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof), Pws4-/dye Re-side 'i5wgI .poeve #of doors [7�Replacement Window doors/ liders.U-Value ` 36 (maximum.35)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner.must sign Property Owner Letter of Permission. ractors License&Construction Supervisors License is A copy of the.Home Improvement Cont required SIGNATURE: C:\Users\decolliikk\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0utlook\DDV87AAZ\EXPRESS.doc Revised 072110 . .. ` 4 Capizzi Home Improvement Inc. Page 7 of 7 Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT , OWN THE PROPERTY LOCATED AT IN � `"° , MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A BUILDING PE IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING E. SIGNATURE OF OWNER: OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: The Commonwealth of Massachusetts �v 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 Leiribly Name(Business/Organization/Individual): C ��/ZZ>r �d Afif h7��d11� Fly" �yG Address: fi Aledl-16 II WO City/State/Zip: Ca-ki.# M, OZ635 Phone Are u an employer?Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1. I am a employer with © '� ❑ g 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 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. 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 11 ❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Vof repairs insurance required.]t c. 152, §1(4),and we have no 13. Other employees. [No workers' comp.insurance required.] . *Any applicant that checks box#t 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. t ontractors 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: /T.�fOCI �c� ���df���0 ✓�'.®!d/�� Ce Policy#or Self-ins.Lic.#: Wc-L-®/e-f V 701 ;U2�I Expiration Date: . IA`la rl2 ea — Job Site Address. r,c r� 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 Investigations of the DIA for insurance coverage verification. I do hereby certify under a pains and enalties of peryu that the information provided abov4e i Qtrue and correct Signature: Date: �o r 20,2— Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Purnit/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#: Client#:47298 " CAPIHOM DATE(MMIDD/YYYY) ACORDTM CERTIFICATE OF LIABILITY INSURANCE 6/08/2012 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: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 endorsement(s). PRODUCER - CONTACT Karen Walther NAME: Rogers 8r Gray Ins.-So.Dennis PHONE FAX 877-816-2156 A/C No Ext: A/C No 434 Route 134 E-MAIL _ ADDRESS:. South Dennis,MA 02660-1601 INSURER(S)AFFORDING COVERAGE NAIC# 508 398-7980 INSURER A:National Grange Insurance Co. INSURED - INSURER B;Associated Employers Insurance Capizzi Home Improvement,Inc. - INSURER C: Capizzi Enterprises,Inc. 1645 Newtown Road INSURER D: INSURER E: Cotuit,MA 02635 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 CONTRACTOR 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP - LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MMIDD A GENERAL LIABILITY MPB1075H 6/08/2012 06/08/2013 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occcur ence $500 000 CLAIMS-MADE. F x1 OCCUR. MED EXP(Any one person) $10 000 PERSONAL&ADVINJURY $1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $2,000,000 POLICY PRO- LOC $ JECT- A AUTOMOBILE LIABILITY M1 M28O44 `i 6/08/2012 06/08/201 COMBINED SINGLE LIMIT - Ea accident 500,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED Ix SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOSX HIREDAUTOSNON-OWNED PROPERTY DAMAGE. $ AUTOS Per accident X rive Oth Car $ A X UMBRELLA LIAB OCCUR CUB1076H 6/08/2012 06/08/2013 EACH OCCURRENCE s5,000,000 EXCESS LIAB HCLAIMS-MADE - _ AGGREGATE $5 00O 000 DED I X RETENTION$10000 $ B WORKERS COMPENSATION WCC5010547012011 12/25/2011 12/25/201 X wcsrATU- OTH. AND EMPLOYERS'LIABILITY TORY LIMITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE Ni E.L.EACH ACCIDENT $1 000 000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $1 000 000 If DESCes RI scribe under PTION OF OPERATIONS below - - E.L.DISEASE-POLICY LIMIT $1,000 000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Workers Comp Information Included Officers or Proprietors CERTIFICATE HOLDER CANCELLATION Town Of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©198 -2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S82889/M82857 TLH. Vhe rPom�meo�eitreea���i aclicdl& fr.ce of.Consumer;Aff.i.&Business Regulation {.:'. License or registration valid for,individul use only ME IMPROVEMENT CONTRACTOR. before the expiration date. If found return to: egistration i0b740 Office of Consumer Affairs_and'Business Regulation Type: 10 Park•Plaza-Suite 5170, j Expiration 6%23/2l}l4Supplement Card Boston,MA 02116` CAPIZZI HOME.IMPROVEMENT,INC = y ` ROBERT ELLSWORTH 1645 Newton Rd. Cotuit,MA 02635 — ' � � . Undersecretary "� Not valid without signature >. .77777-7 Massachusetts-,,Department of Public Safety Board.of Building Regulations-and Standards Construction Superiisor License: CS-061438 J. ROBERT T.ElAiV012TH LL '¢9 PALMERAD' 3 w ,MASBPEE `. °J-..4;+•. t''��►a Expiration Corrimissioner 10/15/2013 E. a2; r OF THE rO+ TOWN OF BARNSTABLE Permit No. .3.0669...... BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING .. �J °�enurR� HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Alan E. Small Address Lot #C 9 , 10 Micah Hamblin Roa.c? Centerville . Massaehii etts USE GROUP FIRE GRADING OCCUPANCY LOAD 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. j ...Apr 3 0 r.. 19...F3 7......... `� Building Inspector �-r TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 ssHaSTt : TOWN OFFICE BUILDING °b 1639• �� HYANNIS, MASS. 02601 b ' MEMO TO: Town Clerk FROM: Building Department DATE: a . An Occupancy Permit has"been issued for the-building authorized�by ' s BuildingPermit # ........ !0. ... __......................................................................................... t ....._............................. .. 4� issuedto ._........... ..._..........................................................................._.......... . . __._...... ...._..... . Please release the performance bond. ZO. FT_ Dr AiN , 148.57 - Ni m z 179S9 s.r � Mm 3s 2° Low T v' �)�;, • �, CERTIFIED PLOT PL A N LOCATION CEkjTL--Z-VI LLB , MAe,S I C ERT I F Y THAT THE FovN DATI oN SHOWN HEREON COMPLYS WITH SCALE � = Soy DATE THE SIDELINE AND SETBACK PLAN REFERENCE REQUIREMENTS OF THE TOWN OF bARN STA'a LC AND is NoT L c, LOCATED WITHIN THE FLOODPLAIN. C1=NT�CZ-\111_tc-- HIGHLANDS DATE : 1 -2 -87 ro � BAXTER e NYE, INC. THIS PLAN IS NOT BASED ON AN REGISTERED LAND SURVEYORS INSTRUMENT SURVEY AND THE OSTERVILLE^- MASS. OFFSETS SHOWN SHOULD NOT BE USED TO DETERMINE LOT LINES, APPLI C ANT ALtiN SM/� L�-� TIC • - ' YAor's offioe.(1st floor)r hv) �v" e,7 t at?` �arw a SINE Assessor's map.-and lot numbe'r. .......,. ............. J Board''of Health (3rd b`7 floor):' b 4 INSTALLED IN CO PLI Sewage Permit number Q •WITH TITLE 5 i ENVIE ONMElffAL CO®E B 39L;� En ineenn Department (3rd floor): l� ��/S House n'umber•-umber, .............. .. ..... ..... ` , ° TOWN REGULATION g F' �. cr YP APPLICATIONS PROCESSED 8:30-:_9:30 A.M. and 1:00-2:00-P.M.Fonlyj TOWN O�F B�A�RNSTA_ BLE HG -INSPECTOR BVILDI APPLICATION` FOR .PERMIT TO ..'. - ....... - ..................................... .............. ........................... ` TYPE OF CONSTRUCTION 4�-- �!-*- ......:.... ............................... .................... f...�---- .................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:: Location ..: .. .��C............ ...... .....1.'. :..:...................................... ..... ProposedUse ..... .......................... .................... .:... ........................................ :..... Zoning District - .Fire District-...:....................:. ..... ......... CL)�%wCX� %(Jl�. Name of Owner ........................:.. ... ..... .:......Address ... ...� . .......................................................................... • u Nameof Builder .........................................................:..............Address� ........'.'........................................................................... •Name of Architect .............:....................'................................Address ..........................:............. ,.................:........................ . ' Number of'Rooms {.........................................:..........Foundation ., . .......... Exterior' ...................................................Roofing .... ....... Floors ..`.. ............................................................:Interior' .....�..... ......................... Heating . .....L.........................................:..........:............Plumbing, .... :....P'?p.G%.. ......',.. ............................... p . ......Approximate Cost z!�,,,•„••„•, , Fireplace ..... Definitive Plan Approved by Winning Board _ ________ ______19 _ . Area T�� .........a............... f ' . Diagram of Lot and Building with Dimensions Fee / '.........1.. ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS' I hereby agree to conform to all the Rules and Regu lotions 1of-the Town of Barnstable regardingthe above - construction. ' ' y l _ Name ................ .......................................... Construction Supervisor's License ............................ ....... .P-MLL, ALAN E. - � 5 30669...'Pe�mit for .One StorX... Sin le FamilY Dwelling .............. ........ . ..................... Location ..,Lot #J689.1,......10_ ljica`l Harn !in Rd. - 41 �- t Centerville , t ; ...........E�..... ............ � . . � .• ` .,. -. u {� Owner'~ Alean:.EF:...Small......... .................. � YV _ Frame � � ., .. ir`' �~r � • TYPe'of Construction `.. _ ........ ... . .. ... ... .. .......... M . Plot'..'' .............. Lot .................. ' ......... Permit' Granted µ ..April... �.'.. ... ..19 87 .Date of inspection ...... ....... .. ....... ..19 Date Completed ! :'1 I } Y 17 ., tIop z '�.a '/ �'y 1•i �'a ',. . I f f r •..:• � - /r � ' • t � ,�{; • Ne ' .SERIES 500 Dual Glazed' - - Polypropylene TO "/ JX- ; 2—panel Slider __ —� National Fenestration Esr GY PERF 11MANCE RATINGS F ' r(U S A-P). -.Soiar Heat Gain Coefficient'° " I ADDITION �L PfcRFQRMANCE RATINGS L,k Vies ble Transm II, U .60 Q> L�•I r 1lanufacturer stipulates that these ratings conform to applicable NFRC procedures for determtnin whole a 3 ® product pertormance NFRC ratings are determined for a fixed,set of environmental conditions-and a specific produ�t sizec NFRC does not recommend any product and:does not warrant' e Suitability of;any 111 r product for an s fit use Consult mahVfacturer s Irterature for other produeY perfo. ante information. i g+ _ 1 / CM x> lsT ion. 7 .� ARR Windows 1415 , f a" .: j Series 40 Umyl Single Hung CipoR j / p I Nationaifenestration vin I Sash Vm I Frame rr - l `d' iw rz��c� ; ` 314"IG LOW= PP,G,$un stet 00 y f 7 y ,, Rating Council 5 rvA f L17. Energy savings will depend on your specific climate, 46se and lifestyle = E •For more information,call 1-336-667-5976 or viMIFRC's web site at I vill www.nfrc:or LvA L am.e I_. , r Solar Heat Gain Utsible U—Factor �3;g Coefficient .72 Transmittance 176 ......m....._"y—.�.._._...�_.,r-....u._.__._...___..,..._...�...-.._...awn..._._._.........._•.-..:... _..I..,...m...,.._.-^-�^....._. _ _ .. f 1 ���1 �. � � I . .. . .76 ` — / i i` �� � �'���•✓ Menufacfurer stipulates that these ratings conform to applicable.NFRC procetlrires for determininc whole product energy performance. NFRC ratings are determined for a.fixed set of environmental 1 � /c, S ,d conditions and specific product sizes. S`I mr bvJ o� k b i _ SMOKE DETECTORS REVIEWED P>PORTANT — UPGRADE REQUiRED STATE BUILDING CODE FEtIt11RES THE UPGRADING OF S!,AOKE DETECTORS FOR THE ENTIRE DWEWNG WHEN BARN ABLE BUILDING DEPT. DATE ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. ' � r C s 'T C, ®A k Sr NOTE A Srf'ARATEPERMIT f5 REQUIRED FOR THE FIRE DEPARTMENT DATE INSTALLATION OF SMOKE DETECTORS—THE ELECTRICAL , 0 6/ PERMIT QDE SATISFY THIS REQUIREMENT. BOTH "iGNAT_!'tFS.ARE REQUIRED FOR PERMITTING J . JM .> } ---_ ... ............. ___ R 13 ROOM -174,1 YI j d _ i j • I - C _ ' 1 , j r c OAI I= L oaf j 1 1 i _ aoz 3-- 4 oo