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Home My WebLink About0031 DANA COURTr.3, dar • Application number. 7t ...-..� tt ' Fee, .......... ..........S.J....(............ ............. DARW MM&x8rt. ` AUG 0 9 2' � Building Inspectors Initials...... .................... Q19 MAt� 6AHNS Date Issued.'.,............ � y IABLt 04 Map/Parcel............................/............................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: A �,o--�— �n u i NUMBER STREET VILLAGE Owner's Name: �� M e �eq-Qc,�- Phone Number Email Address: Cell Phone Number Project cost$ / 8 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: f Date: TYPE OF WORK D Siding 0 Windows (no header change) # El Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review �oof(not applying more than 1 layer of shingles) , Construction Debris will be going to Aa m CONTRACTOR'S INFORMATION Contractor's name AVM Home Improvement Contractors Registration(if applicable)# �(�;'/ � _(attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number 6-d2)—3(0 ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTYES IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. I APPLICATION NUMBER...................................................... �,.... *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach 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 201bs. 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 Homeowners 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 an a Town of Barnstable. Signature —Z J Date APPLICANT'S SIGNATURE Signature��"- �`�- Date 0'//'?//2 All permit applications are subject to a building official's approval prior to issuance. , 1 The Commonwealth of Massachusetts . Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AL4.02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Mt' ( C i`i' Address: /l 4y.55� City/State/Zip: LJ l if, Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I - * have hired the sub-contractors' 6. ❑New construction employees(full.and/or part-time). - 2.S-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 tY• 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.❑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: 7✓-r4•✓Ie%d Policy#or Self-ins,Lic.#: tie -Z.06.AJ 3( Expiration Date: Z v Job Site Address: 31 DAv-.)A- (��-�- City/State/Zip: 0—eAU 1'4 1'NLL 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 certifyunderlthe pains Aand penalties of perjury that the information provided above is true and correct. Signature:t�-_In' V y �f Date: (J 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#: 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-contractor(s)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 0211.1 Tel.#617-727-4900 ext 406 or 1-977-NIASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gav/dia - R [Type here] MID CAPE ROOFING 312 Skunknet Road Centerville, MA 02632 508-385-8801/508-360-8097 Barry Merrill&Paul Merrill [Type here] Job Site Address Mailing Address Name: Aj& ►,gt, IAMA Name: Street: Street: City: o jam,, -� V.4,A City: Telephone: Telephone: We hereby propose to furnish all the materials and all the labor necessary for the completion of: roof replacement of the dwelling at the above address. Mid Cape Roofing proposed to remove and dispose of the existing roof. The roof will be replaced with CertainTeed Landmark shingles. Aluminum drip edge will be installed along the gutter line. Ice&Water Shield installed on bottom edges to protect ice back-up. 15 pound felt paper will also be applied. The shingles will be installed using 6 roofing nails (1% inch). New pipe vent collars will be installed. Ridge vent will be installed along the ridgeline of the roof to provide proper venting of the,attic space. Mid Cape Roofing guarantees the workmanship. for a period of 10 years. All walls and landscaping will be protected from damage; the property will be raked and cleaned of all debris. All material is guaranteed to be as specified and the above work is to be performed in accordance with specifications submitted for above work;and completed in a substantial workmanlike manner for the sum of: /6 Y —All discounts have been applied. Payment made as follows: Deposit of: ��the day job is started and remainder paid on completion. Any alteratio or deviation from the above specifications involving extra costs will become an additional charge over and above the estimate and will be discussed with the homeowner., Respectively Submitted by Mid Cape Roofing NOTE: This proposal may be withdrawn by Mid.Cape Roofing if not accepted within 30 days. Acceptance of Proposal The.above prices, specifications and conditions are satisfactory and are hereby accepted. Mid Cape Roofing is hereby authorized to perform work as specified with payments made as outlined above. G Accepted: c, PA�6 1'v j+6-e, .� .✓fie [�imirroieu�cou2 a�✓r�p,J7acJulilell. Office of Consumer Affairs&Business Reguldlion HOME IMPROVEMENT CONTRACTOR, TYPE:Individual Reaistration Expiration 12/01/2020 r BARRY MERRR.L` qqv � PARRY MERRILL 312 SKUNKNET ROAD CENTERVILLE,MA 02i32' U.ndersedreta Registration valid for individual use only before the expiration date. If found return to:.`~ 1 Office of Consumer Affairs and:Business Regulation' 1000 Washington Street-Suite 710 Boston,MA 02118 - Not slid without signature . Comm,mwealth of Massachusetts y sional Licensure, Division of PReyulations and Stanrards ,! BQard of Building ryisor G const`d( s .1Pires:05/2112020 CS-054428 4- Itoo x r• ILL � ' '�`� � i- �'�1' Bq RY B 312 SKUNNK6V R.02 CENTERVILLE Nl® w �S IV61, ►30 Commissioner . �,.•,�� TOWN OF BARNSIABLE Permit No. _.._---------__ Building Inspector ti s.urr Cash -- -- ---------- -- OCCUPANCY PERMIT Bond ----__ ----- � zl Issued to Address Wiring Inspector Inspection date 3 :4 - — Plumbing Inspector ' _'' \ �' Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date 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. Buflding Inspector �'S y FROM TOWN OF BARNSTA13LE t s. Eleanor DeNunno'.: BUILDING DEPARTMENT 534 Cotuit Bay Drive, 367 MAIN STREET HYANNIS, MA 02W1 Cotuit VA ' 02635 Phone; 775-1120 SUBJECT:FOLD HERE 00WA". M3f`Tf 16t #61 31 Dana Wirtz Cod t Build.xng em" #24614 ' DATE ,. .._ .. July 25, 1198.3 MESSAGE Enclosed please find a copy."'of ywr Occupancy Permit as' per yo= request. A copy has a3o been milerto you attorney. Mr. Pto 't 1onah e. SIGNED- DATE REPLY N 87•RM1 RECIPIENT:RETAIN WHITE COPY,.RETURN PINK,COPY ' PRINTED IN U.S.Ar SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE.AND PINK COPIES WITH CARBON INTACT. r. _ ... •i-r / »..�` tw ,fir,.. .�.� 1 �i to '.i .. 1. .. .. ., fp „�"I O '.. ...C.`/i U Tzt, 10, N i Ar 0 •� ` 1.o't'° --- \ ; T. BAX a TS PLOT En--.A.W "+ LOCATI OV-4 Co T U ►T I I '.. 4. 1 8 Z. 1 I� G6RTtF1� 't'i-lAT �TNG. FOUN'UAZIa�Suowu NElt�ow Co PL�lS %V ITN TN6 51,VE.Lt►aC-- L o -T 61 AND SET$AC4 QEQUIRENtENTs OF THE IS SAoT c o.T u tT LnGATS >' WITNIW FLoO PLAN B,lS.XTCtiZ DATA I l ®2. RE G I S'1 CJZ j THIS t4-Aw IS WOT Eb►5E'O Val A�J OSTEQ�/1t_L�z o 11X/LSS. J 0wy-MOAO%F *P4e OF9=5r--TS g �140WI- APPLI CA.tJ'T SI LYtAt S11-V I N 4 tJGT PCs u5to Ts✓ fle:rCz AZMj%4 LET Ltw`S essor's map and lot'number ......... ... �ig THE TO Sewage Permit numb ?-2 "_'�1�� Yd � w5 m �P.. er aa ! ' "TITLE 5 i ARNSTABLE, i ii n,� �, House number .......... ..t.. j(✓........ ............... ....... ``'p /�y��,qS �� p+ p� v� a r t n �p YFY a\ TOWN OF L"B � � s � � y . ASTABLE. BUILDING I(NSPECI'OR . t • APPLICATION FOR PERMIT TO ..( G. .f �liGl.....` ................ ./.......................... ..... ... TYPE OF' CONSTRUCTION ,GN.��L�!' :...... ! ,ll�f :.................:: TO THE INSPECTOR OF BUILDINGS: ` ;a The undersigned hereby applies for a permit according to the following information: LocationQ.U�QI...................C. �4/.1;77........................................................................... Proposed Use .S./..i11. .�C�... �T�'t/l. ........ G�1 4i4� .c.1-.........:............................................................................. Zoning District ..- Fire District nn }'— '... . ...6��lJ.cil.l.............................................. Name of Owner :`C—,�.�<?�� ....04,N.V.�ll,` ......Address Z y....��?.1. /� .....�3�`�.J........... Qs�/lJ� /,4 ....!� f....(J........P°................... cf' Name of Builder' //!.....��IO�:.....Address .......J r.....:... '✓ 'QG!� . lov Nameof Architect ..........................:........ .............................Address ..................................................................................... Number of Rooms .....r�.....................:................. ...Foundation J G?fZ .!9.........��..'QyG ............. Exterior .. .......................... Roofing ../� ��,/4. . Floors r✓ ./�. .. ........................:......................................Interior � '.y..�. s?�✓.._ ..................................... l 1.,�. ......... ��.�............................ Heating ..<................Plumbing ....... .�. Fireplace .......p .........................................................................Approximate Cost ... .c.. v-.v........................ Definitive Plan Approved by Planning Board _____I_________________________19________ . ea •�x'T--�..:... �'eq�c .......... .......... .. Diagram of Lot and Building. with Dimensions Fee �a /... ................................ SUBJECT TO APPROVAL OF BOARD OF.HEALTH d �� i� ;4. -s OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of. Barnstable re rding the above. construction. Nam . . ........ & UNNO, ELEANOR 1 . 24614 One Story 0 ................. Permit for ................ ....... ......... Sing-le Family Dwellin ............................................................. ... ............. Location Lot #61, 31 Dand ourt ................................................................ .................................Cotuit.............................................. -Eleanor Denunno'. Owner ................................................................ Type of Construction Frame ........ ................................ . .......................................... .. .................:.................... Plot ............................. Lot ................................ December 6 , 82 Permit Granted .......:.......................:........19 Date of Irow/MosIZ 75W......................19 Date Completed ......7:../:7 .... .....19