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'�t�ET TOWN OF BARNSTABLE Building
201203897
BARNSTABLE, Issue Date: 09/06/12 Permit
y MASS.
1639• A� Applicant: LEARY,MICHAEL P Permit Number: B 20122168
FD MA'I
Proposed Use: SINGLE FAMILY HOME Expiration Date: 03/06/13
Location 284 SCHOOL STREET Zoning District RF Permit Type: RESIDENTIAL ADDITION/ALTERATIO
Map Parcel 020059 Permit Fee$ 35.00 Contractor LEARY,MICHAEL P
Village COTUIT App Fee$ 50.00 License Num 080386
Est Construction Cost$ 3,500
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
RAMP TO FRONT DOOR 176 SQ.FT. THIS CARD MUST BE KEPT POSTED UNTIL FINAL
j INSPECTION HAS BEEN MADE. WHERE A
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH
Owner on Record: NICKERSON,JUDITH M @'1 BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: 284 SCHOOL ST \ INSPECTION HAS BEEN MADE.
COTUIT,MA 02635 1 /
Application Entered by: RM Building Permit Issued By:
THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY.OR:SIDEWALK 11 OR ANY PART THEREOF7717ER TEMPORARILY OR,PERMANENTLY ;ENCROACHMENTS ON PUBLICPROPERTY.,N0,
SPECIFICALLY PERMITTED UNDERTHE.BUILDING CODE,MUST BE APPROVED BY.THE JURISDICTION. STREET OR ALLEY.GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE
OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.-THE ISSUANCE OFTHIS PERMIT DOES NOTRELEASETHE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE-SUBDIVISION'
RESTRICTIONS
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION.
4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH).
5.INSULATION.
6. FINAL INSPECTION BEFORE OCCUPANCY.
WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS.
WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PERMIT IS ISSUED AS NOTED ABOVE.
PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A).
0
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
1 1 1
2 2 2
3 1 Heating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 20 Parcel Application
Health Division i� Date Issued Z--
Conservation Division Application Fee
Planning Dept. Permite� 6c3�
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project St r!��,
ress
Village
Owner VV l e., Address Z?q � � S
Telephone
Permit Request
Square feet: 1 st floor: existing /Y�Zproposed 2nd floor: existing proposed Total new <>
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type ?'��
Lot Size ®� ��� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family �1 Owl- Two Family ❑ Multi-Family (# units)
Age of Existing Structure u� Historic House: ❑Yes YNo On Old King's Highway: ❑Yes b No
Basement Type: V<ull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) r Basement Unfinished Area (sq.ft) l 39
Number of Baths: Full: existing , new Half: existing c new
Number of Bedrooms: f existing L9 new
Total Room Count (not including 7cri
s): existing new First Floor Room Count
eat
H T n F I: G s ❑ ❑Electric Other
Type and Fuel: ❑ a
�A
Central Air: ❑Yes No Fireplaces: Existing New (9 Existing wood/cbaPstove: CNYes No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: di existing ❑ new size _Shed: ❑ existing ❑ new size _ Other
4
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review# �,
-Current Use Proposed Use-
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
((
Name M_lam- (20A5 ��vc:I i� o ��L Telephone Number
Address 2li x— License # Yb3
`C a 76 Home Improvement Contractor# 13 _
Worker's Compensation # wcV(9/00! /0-
ALL CONSTRU TION PPqRIS RESUL NG IE�PM THIS EqJECT WILL BE TAKEN TO
SIGNATURE I DATE �� /
f" FOR OFFICIAL USE ONLY
APPLICATION#
6
DATE ISSUED
MAP/PARCEL NO. `
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
r
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
` ASSOCIATION PLAN NO.
k
{
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e ammarrweaFtlz of h�rrssa�useti=s
r, D arlment o fit
y eF f Lrirrt ccadei%ts
' ' - D•�ce of Fnvesfigati�trs - -
.600 Washuc R gtan S�xeet•
Basfvrt-AM 02M
.. Www.M=gavldia `
Workers' Compensation Builders/CoutractorsMectridmis/Pl 4ip3ers
ficant llaformatioa Please Print L
•Address: / V fie•� � _ -
ciiy/state/ip: `
Phone,#
Are you an employer? Check the appropriate bay
1.1-1 1 am a employer with 4. [] l am a�emT ccqractor and I �`9Pe of project(requQ ed):
employees(fnIl and/or park thmeI.' have hired the sub=cmt_,,z s 6. El New coastrncfzan
2 ❑ I am a•sole proprietor•Orparfner. �dcm fhe-athached sheet 7. []R emodehng
ship and have no employees These sub-cairlractors have g, []Demolition
working for me�any capa�y, mmpjoye6s-and have wtskers'
INC) ' ccmp.,instsanoe cimmp..: ne.$ 9: []Big addition
mq d J 5, We are a coiPaiaiim and its ID-0 Electrical mpain ar adxd=
`3.❑ I am a homeowner doing in-work officers have exercised f
rIIysel£ jNo workers' come right 6f e XCMption perQ, I I.[]Pltmmbing repairs.ar moons
m r�P mgni ed_j t a. 152, §I(4), and Ym have no 12•[(ItnQfrepaas
employees. [No woil e , .'13-❑ Other
' :camp.ins�mce requ¢•ed.] `. • - _
*Any appH-mt�checks b=#I nest aSso f Il out fhe secficn below showing fmii wrizcs'oQmpecsafion puficy atfnrmafien '.
t Hameown¢s who-b"tfbis endaviEmdcafmg$royan deazg a]I work and then bin oufside coIIhscivzs.must submit anew affidavitindic± g such
ont<aclaca ftrat cbeck$us hox�dtaiached ea addifianal street showing flee name of the sub-=t__irns.and state whether ornotfhase entities ha=
employe= if flu sob-c�trac�s have emp- eS, -P mmtprmdt fheir wcrk 'c e
�;p bcyaomh¢. ..
I am¢tt employer that is provirTzrzg ,orkers'eompensatfan imrrran a f
lnfarmado& or my employees. Belaw is the paficy.and jab site
Iamm=e Cr9nPEEny Name:
,q � (
PQliay#or Sett im,Lac.# �. 6-0/ Date:
Job�Address: Z Bd f
� ZHP:
AffaCh a copy of the workers' cam:pe=afron pokey-deciai of an page-.(shuwiag the PQ3icY member and ezpiraiion crate).
Faz�re•tn-secm-e coverage as req=od mim Secdim 25A❑fMGL c• 152 can lea[I to$ie ' Q
fine lip in$1,500-DO and/or one-year=P=S Ofp srtvm of crinIInal penaldm of.a
of to & 5D.DD a d ` penalties m the form of a STOP WORg ORDER Emd a fine
� day gaiust$ie violator, Be advJsed chat a copy of this-sfaatemeut map be forwarded�the Office of _
F� ons of the'D ;rIA far zzme coveia verificafion
I iio her c
�3' fy under r°h p¢uzs-and en afFY that the information provided above is true and correct
. - . Dam: � � �:�- •
Phone L/ 0 _
F
Do not write in;this Gregtb be completed by city ar.fawn on;
harity(cicle one}:Health2.Bm'I gDeparfiner<t"3.CifytTown'Clwk 4.IIectricaI Inspector 5 Pltr�m nsg
Contact Person: Phone#.
_ ,
� .
_�'� 1
057�3/2012 10:00 FAX 6174886501 UNDERWRITING 1a004/004
p 5/22/2012
[IMPORTANT.
HIS CERTIFICATE 13 ISSUED AS A MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER,THIS CERTIFICATE DOES NOT
FFIRMATIVELY 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 INSURENS),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
If the cord leats holder M an ADDITIONAL INSURED,the pal' Lea) be endorssd. If SUBROGATION IS WAIVED,subjedto the terms and condtions
of the policy,cerWn pollclm may require en endorsemat A slatemant an fhls glaft does not canter rights to ft c*rditaf holder In lieu of such sndomme s(sl.
PROOUCm CONTACT
ONE
Risk Strategies Company (AM,NO UI (781)961-0303 FAX No.:)
15 Pacella Park Drive E-MAIL Da:
Randolph,MA 02368 PRnnjIr1rR
INSURERS AFFORDING COVERAGE NAIC 0
INSURED INSURER A Atlantic Charter Insurmicc Company VDAC 29211
ML Construction Co.,Inc. INSURER F:
INSURER C:
651 River Road DISURER o:
Marstons Mills,MA 02648 INSURER I::
INSURER P
COVERAGES: CERTIFICATE NUMBER: REVISION NUMBER:
THIS S TO CERTIFY THAT THE POLICIES OF INSURANCE LSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WINCH THIS
CERTIFICATE MAYBE ISSUED OR MAY PERTAIN,THE WSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUNUECT TO ALL THE TERNS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
MR TYPE OF INSURANCE AWL swill POLICY Numum POLICY EFFECTIVE POLICY EXPIRATION LIMITS
LTA BAR wV0 DATE(MMIDWYY) DATE(MMlDDM (in Thamand)
GENERAL UARILnY FACH OCCURRENCE ;
C��� Da�UR ❑❑ PREMISS ;
AM EiP W9r on YmrtaN �
'ERMNALL ADV INJURY ;
' accR�ATe s
006.AGEMOATE LIMITAPPLM FEEL NtOOMTS-CX)WMP AM s
POLICY ❑PROJECT 1 I I=
AUTOMOBILE L1ABftM LJ COMMNED BMOLE LIAT f
ANY AUTO (Ea A600q
ALL OW►1lMAllT�OS DOGILY INJURY
(Per m"16
SCHEDULEDMITOS EIF BODILY INJURY ;
�Aeampip
HIRED AUTOS
PROPERTY DAMAGE ;
NOWNW OED AUTOS (Ed AGW2M)
amnia e ❑ OCCUR
mmny EACH OCCURRENCE $
E XCEBS LMS CLAM MADE AGGREGATE ;
El�
DEoucnBLE S
;
REMMION a
i
A RV LIA PLOYE Llry°NAND WC'VOI001900 03tl9/2012 3/19/2013 X Su1firrLrrCRY WHER
ANY PROPRLETOR+PAMTNI;RJDTNQUT VE YIN
0FFKVVME&jMEXCLUMM N "IA Policy Coverage State:MA EACH ACCIDENT s 100,000
McAtlekar N Nri
my"ues®mawa.aPEaALPRrnnBioNsaaaw mae4p-PDuCY"MIT ; 500,000
DISEASE.EAG14 EMPLOYEE s 100,000
OTNEIt ❑❑
OESOMPTIaM DF OPENATH MB UMMONMEHICLEe(AearA Ar:oLLn 14 AddAW 11 ft I Sdwdu1%a aww wP�tr mgWmdl
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Town of Barnstable EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
200 Green Street 12 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFr.
Hyannis,MA 02601 BUT FAILURE 0 80 SHALL IMPOS O OBLIGATION OR LIABILITY
OF ANY 10 N THE INS F-M OR REPRESENTATIVES
A
ACORD 25(7044M) I9 ACO CORPORATIOIL All rlphte murvsd
Page 4 of I CERTIFICATE HOLDER COPY
Town of Barnstable
W-11 NISMARM Regnlatory el-vices
+ .
Thomas F.Geiler,Director
Building Division
Tom Perry,Pailding Commissioner
200 Main Street Hyannis,MA 02601
WW ADwn.barnstable.ma.us
Office: 508-862-4038
Fax: 508=790-6230
Property Owner Must
Complete and Sigel This section
If Using 1A.Builder
as Owner of the subject property
hereb authorize J�uG I c?+'1 Cd 9 �/IC to act on m b
y. eh4l
in all matters.telatrve to work authorized by this building pertnit
�Gh® te e
(Address of Job)
Pool fences'and alarms are the responsibility-of the applicant.pP . Pools
are not to be filled before fence is installed and.pools are not to be
utilized until all final inspections are performed and accepted.
iLto
rG
iSt=e
of Owner Signature of Applicant
Print Name Print Name
Da
Q:F0RMS:0 WNERPERMISSI0NP00LS
:
VE Tom! of Barnstable c
Regulatory Services
MASS t Thomas F.Geller,Director
p$A 1639 �•� Building Division'
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601`
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number, street
i
. nt}age-
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state- zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as
supervisor. � � .
DEFINITION OF HOMEOWNER
Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner: Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building-Official,that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
Signature of Homeowner.
Approval of Building Official
Note: Three-family dwellings,containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions .
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cartnotproceed against the unlicensed persona's it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amgnd and adopt such a fomt/certification for use in your community.
Q:foms:homeexempt
sue, Mass;►chusctts Dr�r.�rtincnt Of Public S;lfeiN
Board of Buildinl�Regulations and Standards
Construction Supervisor License a
License: Cs 80386 ,
MICHAEL P LEARY
I 651 RIVER RD.
I MARSTONS MILLS,MA 02648`
' - f! y
A
Expiration:• 7/17/2013
• "' ('unuiiisiuncr
Tr#• .17447
ti x'.
Office of Consumer Affairs&Bus iSesula�tion I•T'
OME IMPROVEMENT CO 'License or registration valid for individul use only'
e egistration 135592 RACTOR before the expiration date. If found return to: 4
xpiration 4/22/2014 ��// Type' Office of Consumer Affairs and Business Regulation.
' Private Corporatun 10 Park Plaza
•
_ M.L. ONSTRUCTION CO, INC ,``
Suite 5170 "
� Boston,MA 02116
MICH AEL LEARY, � -
x
651 RIVER RD. a
MARSTONMILLS, MA 0264
Undersecretary
Not valid ithout signat re
•
- � Qe�rorol Notae•. � .
,
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{ - - Me romp will loop Ilk ad ragh dlr edloro
$ 4
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, �f'X 8' plafforr� 8'x Pomp fo qround 4 _
4.
' x8 PT Jalsts - - - '
r 4x4 is to be Lag
` hotted and nand to • - Deck ig to•-he con5lrucled with PJ lumber,
i x8 framing
Q 10 c oofitgs"',deep oncrefe ca5/in place f x� •de
r
_ jo�4i�.frorl de i corms ele"5 to be made wilh
and 1 /fs ,
A Post to -" - Z /Z 60
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- • concrete . • �� '' � � �ailing5.5halL be xG hand rail wilh ZxZ dalusler5, , � _
connection to .
be SABU44Z
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tw Gon/inuou5 handrail al a cor�forfable heigf�t for Mrs,'
10'x4'
•. • •• - Nickerson, •
deep J`
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- - - - ,
_ � "4� � ' ♦� .L.CONSTRUCTION COMPANY,
51 RiverRoad c
. � etstons Mills,Meseachusetts 02648
X 4, 08-428-3380phone, a
008-428-42"875 ll ���
_ NAcker5ori Pomp `
y - ' Poflp .r.
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