HomeMy WebLinkAbout0014 POWDERHORN WAY ;? � � - r.y �_ � � «I j �, ✓ � of .Y
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enxnsrneMr 'Post This Card SoThat it is Visible From the Street-Approved Plans Must be Retained on Job and this_ Card Must be Kept
6 Posted Until Final Inspection Has Been Mede. er Jl
aWhere a Certificate of occupancy is Required,such Building shall Not be Occupied.until a Final Inspection has been made
Permit No. B-20-1252 Applicant Name: rick sullivan Approvals
Date Issued: 07/16/2020 Current Use: Structure
Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/16/2021 Foundation`-
Location: 14 POWDERHORN WAY,CENTERVILLE - Map/Lot: 190-010 Zoning District: RC Sheathing:
Owner on Record: SULLIVAN, RICHARD AND Contractor Name: Framing: 1
Contractor License:
Address: 14 POWDERHORN WAY 2
CENTERVILLE, MA 02632 Est. Project Cost: $ 10,000.00
Chimney:
Description: alteration/remodel 1.demo inside/new layout of area framing new Permit Fee: $ 101.00.
walls relocating doors and windows(same windows) 2.adding a Fee Paid: S 101.00 Insulation:
bathroom 3.relocating basement stairs 4.building new front steps Final:
5.finish basement Date: 7/16/2020
Note: Basement to remain unfinished. �'� Plumbing/Gas
Rough Plumbing:
Project Review Req: n. 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 work 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 All Construction Work: Service:
1.Foundation or Footing
2.Sheathing Inspection Rough:
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 Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
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.
"Persons contracting with unregistered contractors do not have access to the guaranty fund"{as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
A7
ry. Application numb . ... . ..- .............. ....
.
Fee....................................... l............ ......
MAR 5 2019 Building Inspectors Initials. ... ...............................
,, ,t•� � � B_AMSTABLE Date Issued...... T�'
Map/Parcel.............:.... .... /
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: f bLx—d e-r d ryl &J�- p o t
ER STREET VILLAGE
Owner's Name: �c( �V i �<<!k/--\ Phone Number 191 7
CCAA � •br Z-
Email Address: Cl CGS qQ � �� L0 o-�cl/l� Cell Phond Number
Project cost$ Check one Residential Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application for a building permit in a ordance with 780 CMR
Owner Signature: Date: —7 -
TYPE OF WORK
in 0 Windows(no header change)# Insulation/Weatherization
o — Commercial Doors require ors (no header change)# . re an inspector's review
� 4
Roof(not applying more than 1 layer of shingle /
Construction Debris will be going oin to
II
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable)# (attach copy)
Construction Supervisor's License# (attach copy)
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN
A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER............................................................
*For Tents Only*
P 1
Date Tent(s)will be erected Removed on number of tents total
Does the tent have side's? Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X 9 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.
I ood is being served at our event lease obtain a Health Department approval between the hours
.ff g y P eP PP
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 -7 7 Cell or Work number
f
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, s ecific inspections and documentation required by 780
CMR and the n f Barn ab .
Signature Date
APPLICANT'S SIGNATURE
Signature
Alt permit applications 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
II
Name(Business/OrganizatiowlndividuaI): rv,
. Address:
City/State/Zip: -6cr,./ Phone#: 04 7,�— -7 ( ( 7 I-L 3
Are you an employer?Check the appropriate box: Type of project(required):
1.El am a employer with 4. I am a general contractor.and I
employees(hill and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling
ship and have no employees These sub-contractors have g. Demolition a
working for me in any capacity, employees and have workers'
$ 9. ❑Building addition
[No workers'comp.insurance comp.insurance. 10.❑Electrical re airs or additions
r d] 5. [] We are a corporation and its P
•3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
m sel£ o workers' right of exemption per MGL
Y � comp. 12.❑-Roof 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#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 isproviding workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine 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 certi nder the p d pe . ties of pe)lury that the information provided above is true and correct
Sign afore: Date:
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.EIectrical 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.
" hire
Pursuant to this statute,an employee is defined as ...every person in the service of another under any contract of ,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other leg�l�tity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of alloceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,emplfiying employees. However the
owner of a dwelling house having not more than three apartments and who residesthiereum,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction 4 repair work on such dwelling house
or on the grounds or bull appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6) o states that"every state or local licensing agency shall withhold the issna ce or
renewal of a license or permi to operate a business or to construct boil mgs m the commonwealth f any
applicant who has not produce-acceptable evidence of compliance with the insurance coverage re uired:'
of its political su visions shall
Additionally,MGL chapter 152,,§25C(7)states"Neither the comnonwea lh nor any
enter into any contract for the performance of public work until acceptab a evidence of compliance th the insurance
requirements of this chapter have be presented to the contracting auths6rity"
Applicants
k� •
Please fill out the workers' compensatiol\ davit completely,by checking the boxes apply to-your situation and,if
necessary,supply sub-contractor(s)name(eaddress(es)and phonnumber(s)along their certificates)of
insurance. Limited Liability Companies(I. ' or Limited Liabibty Partnerships )with no employees other than the
members or partners,are not required to canyVorkers' compensation insurance, an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitte o the Department of Industrial
Accidents for confirmation of insurance coveralk Also be suie to sign and ate the affidavit. The affidavit should
be returned to the city or town that the application' or the pemitt or license" eing requested,not the Department of
r a.. « i ti��;�o„+c .cl,�..,ld vrna_have_ans auestio mean "•fig the law or' you are requ fired to obtain a workers'
compensation policy,please-call the Department ax s numl3er listed be w. Self-insured companies shouia enter:near .
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed `e ly. e Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office,of gations has to contact you regarding the applicant.
Please be sure to fill in the permitllicense number which used as a reference number. In addition, an applicant
that must submit multiple permit/license applications I an g` year,need only submit one affidavit indicating current
policy information(if necessary)and under' Sitel�A ess'� applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officiary pedtor ked by the city or town may be provided to the
applicant as proof that a'valid affidavit is on file forty, e e permits licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining tense or permit of related to any business or commercial venture
(i.e.a dog license or permit to bum leaves etc.)s d person is NOT re ed to complete this affidavit.
The Office of Investigations would hike to tank ;ou.in advance for$your ooperation and should you have any questions,
please do not hesitate to give us a call,
The Department's address,telephone aria fax n ber:
i
,.E The GammonQvealfh of Massa ch efts .
D of Iadustdal Auden
ee of Investigati
600 Washington 5 1
Boston,MA 02111
Tel.#617-727-4900 ext 406 or 1-877-"SAFF,
Fax# 6.17-727-7749 ;
Revised 4-24-07
wwwmasis..gov/dim `� .
����()
Town of Barnstable *Permit
Expires 6 ro .issue e
Regulatory Services
* aaxtvsrABM
Richard V.Scali,Interim Director
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
�fffei 508-862-4038 t Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
l&1D d 0 Not Valid without Red X-Premiss Imprint
Map/parcel Number
Property Address `C rO�,�Gi eV f✓� N fh l y
[]Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00
(bwner's Name&Address L (w U1 Vol
Contractor's Name Telephone Number 777 -Zl1 -3JZI
Home Improvement Contractor License# if applicable) 7
3Z Email: raM -a4 'dERMIT
f r1J �StS%r�C J c9s��c�� Cc.s?
Construction Supervisor's License#(if applicable) 0231/0 X-PRESS P
11w,"orkman's Compensation Insurance +
Check one: JAN 31 2014
❑ I am a sole proprietor
❑ dam the Homeowner
9"I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name �� YY
Workman's Comp.Policy#
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 DU 1-1
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side F
['Replacement Windows/doors/sliders.U-Value : 3 q ` (maximum.35)#of windows /
#of doors: --
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractojrs-L>icen a Construction Supervisors License is
required/}
SIGNATURE: r 1 N
TAKEVIN_D\Building Ch:..:gesTXP PERM-AEXPRESS.doc
Revised 061313 �'
s+►ttxsrwst.s,
639. Town of Barnstable
Regulatory Services
g rY
Richard V.Scali,Interim Director
Building Division
Thomas Perry,CBO
Building Commissioner.
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section ,
If Using A Builder
I, bt-1 y(A ,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:
k1111
(Address of Job)
Signature of Dale
ner .
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
TAKEVIN D\Building Changes\EXPRESS PERNTIEXPRESS.doc
Revised 061313
IN
10 Atlantic Ave.
South Yarmouth. MA 02664
774-212-3321
WORK ORDER
LEAH SULLIVAI�
14 POWDERHORN WAY
CENTERVILLE, MA 02632 '
REMOVE THE EXISTING KITCHEN CABINETS AND FLOORING. INSTALL
NEW HARDWOOD FLOORING AND CABINETS.
INSTALL A NEW ANDERSON DOUBLE HUNG WINDOW AND SIDING
AROUND THE WINDOW ON THE EXTERIOR.
ELECTRICAL AND PLUMBING DONE BY OTHERS Y'
' f