HomeMy WebLinkAbout0031 TRACEY ROAD 3� ��� �
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_ Town of Barnstable Bull
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rn>xivn t Post This Card So That it is.Visible From the Street Approved Plans Must be Retained on Job and this Cafd Must be Kept
Posted Until,Final,Inspection-Has Been Made. A P t
i Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a.Fnal Inspection has been made `'
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Permit No. B-19-3551 Applicant Name: Stephen Dickinson Approvals
Date Issued: 05/04/2020 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/04/2020 Foundation:
Location: 31 TRACEY ROAD COTUIT _Map/Lot, 005-059 Zoning District: RF Sheathing:
- a - w
Owner on.Record:. AMES, NANCY B& RODNEY W Contractor Name:' STEPHEN T DICKINSON Framing: 1
Address: 31 TRACEY RD I` Contractor License: CS=081843 2
COTUIT, MA 02635 r.."`- - Est. Project Cost: $6,671.00 Chimney:
Description: same for dame no structural changes replacing windows F, Permit Fee: $35.00
Insulation:
Project Review Req: GLAZING REPLACED IN HAZARDOUS LOCATIONS AS DEFINED Fee Pal d;f $35.00 ,
IN 780 CMR MUST BE TEMPERED OR EQUAL. Date: : 5/4/2020 Final
Plumbing/Gas
i Rough.Plumbing:
Bijilrfing Official,
This permit shall be deemed abandoned and invalid unless the work authorized by this permit isacommenced within six months after_issuance. Final Plumbing: .
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 structure's 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 Work4l, 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.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"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:
C
Town of Bar
nsabl
�,, 1R"4STa_BLE
Op1HE Tp�, O� RegulatoryU�ces
.. I Thomas F.Geiler,DirecYor2o PH 12: 5
* BARNSTABLE,
MASS, Building Division
039.
Tom Perry,Building' o ssione
- 200 Main Street, Hyannis,M+lWNW
www.town.barnstable.ma.us
- ' Fax: 508- - 2 Office: 508 862 4038 ,�,�t• 790 6 30
y/0 'ey
PERMIT# FEE: $
SHED REGISTRATION
120 square feet or less
Location of shed(address) Village
Property owAer4s name Telephone number
40-r dQ
Size of Shed Map/Parcel#
Signature Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction? /✓�
Conservation Commission(signature is required)
PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A
PLOT PLAN
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BIKE Town of Barnstable *Permit#2615•0`7(0G1,1
Expires 6 nonths from issue date
Regulatory Services Fee
snxxs'rasc.E,
r 1� Richard V.Scali,Director ® t
--- ' P � -----
. . . .
--- --— —
Tom Perry,CBO,Building Commissioner! NOV`Q 9 2015
200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
n Not Valid without Red X-Press Imprint
Map/parcel Number
Pro erty Address e
]1 Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address /I/ /►�G� e of ie Q A neS
�I T�-aJceG,
Contractor's Name t'ci�� �'rk��i.l\ Telephone Number 7��—a-��—��d�3
Home Improvement Contractor License#(if applicable) • l p Zg 57 Email: eA([Ccl42,Qr0g CQiNC�$7 ALd'
Construction Supervisor's License#(if applicable) /0-3 oq
❑Work_man's Compensation Insurance
Check one:
❑ v,,amasole proprietor {
❑ am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Re est(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)
❑ Re-side - s
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#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 Contractors License&Construction Supervisors License is
required.
t
SIGNATURE:
Q:\WPFILES\FORMS\building permit forms\E)PRESS.doC
Revised 040215
�•
Tlie Commorrfrealtle of-Vassrecltusetts
Depra hment o,f I'nrlustrial Accidents
00ke oflmwstigadons
600 Washington Street
,-Boston,M-4 0211
4
n5YP-,.m+fm,,gov1,dlla
'Workers' Campensat on Insurance Affidavit:Btdlders/ContractnrsJEIectricians/Plumbers
Applicant Information Please Print Legibly
Name(Bmiiaem Organindionffndcvi&u 1): � m&4:�(9.O1
Address: �er�,8 rA t�1u
ci f ta& : Phoncluk
Myou an employer?Check the appropriate box,: Type pf project(required}:
1. I am a employer urith 1 4. ❑I am a general contractor and I
employees(frill andfor part-time).
* have hired.the sub-comrtaactaas 6. ❑New construction
2.ElI din a sole proprietor or partner-
listed on the attached sheet. 7. ❑Remodeling
ship and haze no employees., These sub•-contractors have g_ ❑Demolition
workingforme in any �c itT employees and have workers'
9. ❑Building addition
[No worlmrs'comp.insurance comp-msuran ce.l
required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeoKmer doing all work officers have es,escised their 1L❑Plumbing repairs or additions
myself.[No workers'cramp_ riglst of exemption per MGL 12.❑Roof repairs
inm ance required_]i c.152,§1(4h and we have no
employees.[No workers' 13.❑Other
camp.insurance required.]
'Any W icsntdhatchecksbox 91 mnst also fillootthe sectioabeiowshmaing dmirwakere campensationporiicyinfarmad=
I RomwvnmK who submit this dfidaru mficaUng they am:domg all wodt and;dim hire outsi&contractors amct submit a new affidavit indicating mcb-
=Canitactorsthat chew this box must attached an addWonal sheet s'haumg the name of the sub-cantxuctm and state whether or not those entities have
employees.I€thesuh-caatactotshave employees,theyzansrprovide their workers'comp.palicg number.
I ant air entplg,er fliat ispranading markers'compensafiart in arance for my employees Below is flee policy arrd job site
information.
Insurance Company Name:
Policy 4 or Self-ins:Lic.# E�Tiratio'nDate:
Job Site Address: CitylgtzwzJ p:
Attach a copy of the workers'coampensationpolicy declaration page(shoving the policy number and expiration date).
Failure to secure coverage as required.under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500OD andror one-year imprisoutuent,as welt as ci 1 penabies.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 maybe fkwarded to the Office of
Investigations of-the DIA for insurmce coverage verifxca#ion.
Ida Hereby cerfify ander the pRns and penabYes ofpeduty that the in;f bnuafion pm i&d abmw is hue mid carrect
Sitmature: - Date:
Phone ik
official arse oPity. Da not aware in tltis area,to be cainpleted by city or toorn official
City or Town-. PermitMicense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.QtylTown Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions `f
Massachusetts G&aeral Laws chapter 152 recces all employers to provide workers'compensation for their employees.
Pm: IZattD.this stye,an.elrrPlayee is defined as."-.every person in the service of another under any contract of hire, 'f
express or implied oral or written_"
An e sprayer is defined as"aa individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a Joint a tmprise,and including the legal representatives of a deceased employer,or the
receiver&trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more tha a three apartments and who resides therein,or the occupant oft he -
dwelling house of another who employs persons to do maintenance,construction or repair work-on such dwelling house
or on the grounds or balding appirhaarLt thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25g6)also skates 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 nay
applicant who has not produced acceptable evidence of compliance with the in:s ice_coverage required-"
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of ifs political subdivisions shall
enter into any contract for the perfonn.ance ofpubhc work until acceptable evidence of compliance with the fimnan ce..
requirPanents of this chapter have Been presented tin 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 numbers)along with their certificate(s)of
mmarance. Limited Liability Companies(LLC)or Limited Liability Partnerships CLEF)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 regaired. $e advised that this affidavit maybe submitted to the Department of Industrial
Accidents for conf]u'mation of ins mace coverage. Also be sure to sign and date the affidavit The affidavit should
be returned to the city or town that the application fur the permit or license is being requested,not the Department of
ludasfrial 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
cense number on the line.
self-m��ce h aPProFn�
City or Town Offici2k
t
has vided a ace at the bottom
Please be sun e that the affidavit is complete and printed legibly- The Departmentpro space
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 pen iainceme number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/hmusa applications is any given year,need only submit one affidavit mdicaimg current
p olicy infb=ation(if necessary)and under"Job Site Address"the applicant should unite"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 proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be tiIIed oiA each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
NOT to complete this affidavit
e or ermit to bon leaves etc. said erson is ITT regmced mp
(i_e_ a dog livens p , ) P
The Office of Investigations would hke to th an k 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 C:GMMMWmj- E of Massachus:ttts
Dapaxbnent of l idmtdal Accident!
ice ofve�figtio
�t�4�asbingtQn Sir+�t
Boston,MA 02111
`pf,-L 4 617 727-4900 Qxt 4-06 or 1-477-MASSAFE
Fax 617-727 774
Revised 4244D7 .m gavIdia-
�IKE
r •
• r
• RARMABL4 •
M019.ASS. -Town of Barnstable - -
ArEO
-Regina-tQrx-Ser1ce - ----------
Richard V.Scali,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, , 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)
Sigmtute of Owner Date -
Print Name `
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
Q:\WPFILES\FORMS\building permit forms0TRESS.doc
Revised 040215
Town of Barnstable
Regulatory Services
W
�o`rTt+�rgrir Richard V.Scali,Director
Building Division
RMWSrnBM Tom Perry,Building Commissioner
v� 039.MASS. `��' 200 Main Street, Hyannis,MA 02601
ArEo �A www.town.barnstable.ma.us
Office: 508462-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"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
Person(s)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 resRonsible 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 cannot
proceed against the unlicensed person as 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 amend and adopt such a form/certification for use in
your community.
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 040215
/ >
ALL
Name- nancy&rodney ames Job address 31 tracey rd .
Date- 508-428-5620 cotuit MA 02635
• Phone- Home address- t
Cell-
Email- y P.O.box-
Office
All material and work is guaranteed to be as specified and'all work will be comp) ted in a
substantial workmanlike manner for a total sum of. - $ 990T10 100,00
with payments made as outlined. Deposit 1/2 44499-Q8$_7Sd®.
Remainder due immediately upon completion!
Please make check payable to Richard Sullivan -
If paying by credit card please note that there will be an additional cost of 2.15%in addition to any APR that
you may already be incurring. ,
If you would like different payment options please=ask. +
All workmanship is guaranteed. Factory warranties apply to all materials used and we.
Standby the products we use and also our customers. In the event of a problem with any product used we
Pledge to stand behind our customers to resolve the issue.
Any alteration or deviation from the above specifications involving extra costs will be executed only
upon written order, and will become an extra charge over and above the estimate.--
This proposal may be.withdrawn by us if not accepted within 14 days.
'Any issue of mold in the building will not be our responsibility during or after the project.
Si nature C /n, ate of acceptance
Acceptahca 00, PrOPIDin Z The above prices,specifications and conditions are satisfactory and are hereby accepted.
I as the owner of the property hereby authorize you to do the work as specified.
Payments will be made as outlined above.
- Home Improvement Contractor registration#164857
Call the office at:781-217-8123' Construction Supervisor license#103265
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/ALL .'TA►/�
Name- Nancy&rodney ames Job address- 31 tracey rd • '
Date- 04/27/15 cotuit MA 02635
Phone- ' 508-776-1687 Home address-
Cell- 508-428-5620
Email- P.O. box
-
Job description: new roof (will be stripping off old roof) 21
e hereby propose to perform the following services in a neat professional manner in accordance with
manufacturers specifications and local building code.
1.Supply and install Certainteed brand/Landmark line(limited lifetime warranty ten year surestart protection
10 year warranty algea resistance 130 MPH wind resistance warranty)These shingles are heavy weight
self sealing multi-layered fiberglass reinforced architectural style shingles featering copper-ceramic stones.
2.Supply and install Certainteed Winterguard ice and water shield at all eves walls roof vents skylites valleys
and roof penatrations
3.Supply and install Diamond Deck synthetic water proof under-layrrient to entire roof deck
4.Supply and install new stink pipe flashings` `
5.Supply and install 8"white drip edge along all fascias A =300.00
6.Supply and install vent along the ridge if requested ivyV
1�S
In addition to the above work we will also clean and remove debris from e work area daily, re-nail roof deck
as needed, and clean all gutters.
F
« e
replace all rakes boards with pcv trim $1,800.00 '
replace all comer boards with pvc trim $2,200.00
replace louvered attic vents with pvc replacements $340.00
replace fascia board and gutter and downspout over garage door ( $46�900
pick and choose what you can afford to do and call to discuss scheduling .
Home Improvement Contractor registration#164857
Call the office at:781-217-8123 Construction Supervisor License#103265
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Client#:44947 2ALLST1
ACORD. CERTIFICATE OF LIABILITY INSURANCE- DATE(MM!°°"Y"
3/26/2015
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(les)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 endorsements. �''
PRODUCER - ACT
Dowling&O'Neil "AONE
c No Ext;568 775-1620
Insurance Agency s-MAa Arc No: 5087781218
973 lyannough Rd., PO Box 1990 ADDRESS:
Hyannis,MA,0260) INSURERS AFFORDING COVERAGE NAIC iy
INSURER A;Acadia insurance
INSURED, All Star Renovations,LLC. INSURERS:Associated Employers Insurance
' �;•�
P.O.Box 775
INSURER C:
Sagamore,MA 02561•-. INSURER°;
INSURER E:
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.
1 ADDLSUER
LTR TYPE OF INSURANCE POLICY NUMBER MM DY EFF MMIDO LIMITS
A GENERAL LIAeaITY BOA507775912 1/02/2015 01/02/2016 EACH OCCURRENCE S 1 000 000
X COMMERCIAL GENERAL LIABILITY RIWMAIG E E RENTED
Ea occurrence $50000
CLAIMS-MADE 5�OCCUR i MED EXP(Any one arson) $5 OOO
PERSONAL&ADV INJURY $1 00O 0O0
GENERAL AGGREGATE s2000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AOG s2,000,000
POLICY PRO.j9CTLOC '
$
AUTOMOBILE LIABILITY COMBINED SING E LIMIT
Me accident)ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per person) $
AUTOS AUTOS BODILY INJURY(Per accident) $
HIRED AUTOS NON-OWNED PROPERTY OAMAGE AUTOS P r accide t $
S
UMBRELLA LIA& OCCUR EACH OCCURRENCE $
EXCESS LIAB CLAIMS-MADE AGGREGATE
S
DED RETENTION$ TF
B WORKERS COMPENSATION PP N
$
AND EMPLOYERS'LIABILITY WCC50050116252015A 1/0212015 01102/201 X WCSTATU- OTH-
OFFICERIMEMBER EXCLUDED?ECUTIVE7 N/A E.L.EACH ACCIDENT $500 000
if yandatory In NH)
ea,describe under E.L.DISEASE-EA EMPLOYEE $500 000
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500 000
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required)
Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements.
Nothing contained In the certificate of insurance shall be deemed to have altered,waived,or extended the
coverage provided by the policy provisions.
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORIZED REPRESENTATIVE
01988-2010 ACORD CORPORATION.All rights reserved,
ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD
dlC4dAAAR(M4d77R9 _,
C�//ye Tpo�rnnno�uuea�i a�6>�acfu�aetla
Office of Consumer Affairs&Bustness Regulation
OME IMPROVEMENT CONTRACTOR
egistration: .'J%Q57 Type:
expiration:,,.k �� DBA
ALL STAR RENOVATI S;;
RICHARD SULLIVAN� y
3 CRESCENT AVE.
PLYMOUTH,MA 02360 Undersecretary I
Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-103265
Construction Supervisor
RICHARD P SULLLVAN,
r
14 POWDERHORN V s
CENTERVILLE NJA 020 V'
Expiration:
Commissioner 08/31/2017
License or registration valid for individul use only
before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
10 Park Plaza-Suite 5170
t
Boston,MA 02116 y
• a
Not valid without signature I
Construction Supervisor
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of enclosed
space. -
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
DIPS Licensing information visit: WWW.MASS.GOV/DPS
Town of Barnstable
� -- R�E�CEi P�T
MASS 200 Main Street, Hyannis MA 02601 508-862-4038
A
"rkP� Applicatipn for Building Permit
Application No: B-17-3514 Date Recieved: 10/11/2017
Job Location: 31 TRACEY ROAD, COTUIT
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: STEPHEN T DICKINSON State Lic. No: CS-081843
Address: MERRIMAC, MA 01860 Applicant Phone: (508)_676-6820
(Home)Owner's Name: AMES,NANCY B&RODNEY W Phone: (508)737-0407
(Home)Owner's Address: 31 TRACEY RID, COTUIT,MA 02635
Work Description: Windows
i
Total Value Of Work To Be Performed: $4,275.00
Structure Size: 0.00 0.00 V00 w
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept Coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Stephen Dickinson 10/11/2017 (508)676-6820
Applicant Date f Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $4,275.06 Date Paid l Amount Paid Check#or CC# Pay Type
Total Permit Fee: $35.00 10/11/2017 $35.00. i XXXX-XXXX-XXXX-1 Credit Card
' 7597
Total Permit Fee Paid: $35.00
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Asse'ssor's map'and lot number ....
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Sewage Permit number � — / G ................:. Q�k- /��A�
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House number .........:........ . .! :INSTALLED IN COMPLIANC
..... .................................
WITH TITLE S GM a`
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= R S6 (HDE AND
TOWN O FB A
TOWN REGULATIONS .
BUILDING INSPECTOR
}w 'APPLICATION -FOR PERMIT TO' ............................. ...... ..................................... ...
.... ...
m
TYPE OF CONSTRUCTION ..............................•........ . .....................................................
1. ............19..
TO THE INSPECTOR OF BUILDINGS:
The' undersigned hereby applies fora permit according to the followingininformation:
Location ................ Q.7..'... ` 0.......�..Ac ... ................Ou�!.�.�.'... :.. (o .��.......................
Proposed Use .........5! ! !s ....> ?l../Y...... ./�,, /.1 G� ................. .....................
Zoning District .............`'�...'.K7..................................................Fire District ....07'14 . ..................................................
Name of Owner ...fit?. 5� . .. .?...... 1 ......Address ..En.-Box........3.00......�-v.�. .4. j. ....
Nameof Builder ...... ................f/. ................................Address ...................................//...........................................
Nameof Architect ..................................................................Address .....................................................................................
............................Foundation ......Number of Rooms .................. .�:�.. .. n-........[......f.........................................................
Exierior ......1../.19 !��Ic.�...�J........................................Roofing ......1� �!?!ql.. ......................................................
Floors �� . .................................'......:.::...Interior .... .k. lx—,, c). ............................................
Heating .... . 1.�C 1��� ............................................Plumbing .....001 ... ..1'.YS.1..................................
Fireplace .........a:&tOik....................................................Approximate Cost ......�dP.60.................................
1 l
Definitive Plan Approved by Planning Board -----------_-------------------19_______. Area ........... ...........
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
a .
A 01 k
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. /,
�Z�
Name ..... ....... Yv .... ...... .
dd
Construction Supervisor's License .... 6/P..7......
AMES, RODNEY W.
o .25 3 01... Permit for .Two S tory...........
Single Family Dwelling c
Location' .,Lot 20 , 31 Tracey Road
COtuit ! ti
..............Rodney.. .:...Ames....................... - +�
Owner .................................................. _ - '
Type Hof Constructions Frame
Plot ot ................................
^ ` Permit Granted .......J111 ...7.: q.. ...........19 83
b Date of Inspectior i'f.�.ko............... .19
Date1 Completed .. �.'.! � 9.
TOWN OF BARNSTABLE
Permit No. --------------
Building Inspector
{ Cash AIL
•"7a
KIN
OCCUPANCY PERMIT Bona
Issued to Cxiney W. A*s Address
Inf :117b1 33, T;-a,�oy Rona, Cot-kilt
Wiring Inspector f Inspection date
Plumbing Inspector "f- Inspection date
--
Gas Inspector f Inspection date
Engineering Department f 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.
r.
............................... 19......._ ..r:.. � : :c� ' ._..............
Building Inspector ��
, ...a ..FROM -TOWN, OF BARNSTAB E
BUILDING DEPARTMENT
Mr. Francis Lahteine � � �s� . �.�� r , ��467,MAIN STREET HYANNIS, MA 02601
Town Clerk, �. �• w Phone: 775-1120
SUBJECT:
FOLD HERE
DATE -
April 12- 198.4._ _ MESSAGE
F° Work has bee� tn camp=tq .u ,er� e�rmit� # 2r3< (.Relne � .A Ames),.
��
Please re a'se -Rand':. » r. z +t P `«.h t srY <r-w r w sr nt s•
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- SIGNED.
1
DATE _ -
REPLY
SIGNED - - I
N87-RMI RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY
• - PRINTED IN U.S.A.
SENDER:'SNAP OUT YELLOW COPY ONLY..SEND WHITE AND PINK COPIES WITH CARBON INTACT.
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Sewage Permit number ............`.? .................................
Z SAUSTAELL i
House number ........................... .................................. ' rasa
�p 1639. ♦�
�om a\
TOWN OF BARNSTABLE
BUILDING - INSPECTOR
APPLICATION FOR PERMIT TO ............................. .. .................................................................................:..
TYPEOF CONSTRUCTION ............................... ... Yvr .,..-,....................................................................
................................................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location Location ............. C?7`... ....... i9 1/.... :................5.... .............................................................
ProposedUse ..................... e:.......r- X/..... ., =..........................................................................
Zoning District ........... .................................................Fire District .... la,/,GI/
...............................................................
Name of Owner ... ??: +3�1 ,��. .. ...... -��......Address .. Q . ...�.......................i.........t..... ��1A....
// y
Nameof Builder ....................................................................Address ......................................................................... ......
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms .................e�FOC . ............................Foundation ..............................................................................
Exterior ..... / 1• !xi! ............................................Roofing ...... ' .0�)A+'#,1.�......................................................
/ .� Lc3®dam .Interior ....�>��h ?. etQC
Floors .....................�...........................
Heating .... �(..->............................................Plumbing ..... y ..A.Vf...................................
Fireplace ...... ���. ....................................................Approximate. Cost ....... >` .....................................
Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ...........f..Y ...................
Diagram of Lot and Building with Dimensions Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH ,[
a2 � �
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
.e1� 4,2ca . ��
Name ......................... ) ...................�� .............
�l
Construction Supervisor's License ....!ft '0�.-�........
AMPS, RODNEY W. A=5-59
25301
. Permit for ...Two Story
Single Family Dwelling
...............................................................................
Location „Lot 20, 31 Tracey Road
............................................
Cotuit
...............................................................................
Owner ....Rodney. ...W.....Ames.................................... .... ... . ..........
Type of Construction' Fr.ame
.... .................................
................................................................................
Plot ............................ Lot ................................
Permit Granted .....,TULY...11.,,..............19 g 3
Date of Inspection
Date Completed ......................................19
(oo�f�
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
V � TOWN � BARNI.STABLE
ll"9
p
Ma U� Parcel App lication # .
Health Division ' l ! 1 "'i tt0 Date Issued
Conservation Division Application Fee
Planning Dept. Permit Fee
DIVISION
Date Definitive Plan Approved by Planning Board (
Historic - OKH _ Preservation / Hyannis IJ
Project Street Address i � ' '—cz
�
Village C k�
Owner -VrC\1h1, 2--A A&N Address
Telephone � `� ZC-73
Permit Request 64r,._(k Z �5 I-��c��s� Ms - E i c�.► d i'� d
rT i M , - 6 Zti S f3igk r)a 62 1 A )aL
,Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 1 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single.Family>( Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing —new
Total Room Count (not including bath,): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
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 Telephone Number
Addres License #
Home Improvement Contractor#
Worker's Compensation #
ALL CO TRUCTION D �bR�EIULTINGFROMTHP-PFRJECTWIL E TAKEN TO
SIGNATURE DATE 1
t
FOR OFFICIAL USE ONLY
APPLICATION#
` DATE ISSUED
MAP/FPARCEL NO.
r
' ADDRESS VILLAGE
y
OWNER
t
t
DATE OF INSPECTION:
..-,.FOUNDATION .-
t FRAME
INSULATION
FIREPLACE
F- ELECTRICAL: ROUGH FINAL
r
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE.CLOSED OUT
ASSOCIATION PLAN NO.
ti
t
t
k
�ie vo7rinw�zur� a�,.l�aaaac�zuael�a
Office of Consumer Affairs&Business Regulation
—�1F HOME IMPROVEMENT CONTRACTOR
i1 - r Registration: 180816 Type:
Expiration: 1/13120 1 7 LLC
BU -DING_ PERFORMANCECONTRACTING-
NAUSET INSULATION,LLC.
JOSH EMOND
8 KINNIKINNICK RD
TRUTO,MA 02666 Undersecretary
License or registration valid for individul use only
before the expiration date. If found return to: I
Office of Consumer Affairs and Business Regulation
10 Park Plaza-Suite 5170 i
Boston,MA 02116
!
Not valid withou signature
Massachusetts-Department of Public Safety
Board cf Building Regulations and Standards
clop tr}}ii 0ii ia�Jcii'i3i)y " *
License: CS-078815
JOSH EMOND = ;
PO BOX 633 ' 'V.
� s
Truro MA 026667 -
r �+'
• Expiration
Commissioner 03/25/2017
rM
. Tow. of Barxistable
RegWatory•5ervices
Z Richard V.ScaY'i Dirwtor.
sb�.awe
$milts ng Divisioh
Tom Perry,Buflding;Commissioner
2W Mein Sheet,Hyan ai%- qA 02601
wwwAuWn.bamt2b1e u us
arfie: .508-862-4038 Fax:.5087790-6230
Property.Owner Must
Complete:and:S This Section
If Us. -.ABuildeir
as OvMer of:the.stbject P'nleny
henbywhorize got
Ulm - to act;ou:i. behalf,
in ail mau=relative to work.xuthorized by this buTding pemmt application.for.
{A,ddres's-:o.go ):
``"Poal fences and alarms are the resp0=11ility Of tk appk=t P.061S
.are lzat.to be fflled prutizedbeforefeacc s_ius.i: k€and allfinai
inspections are performed and Accept3ed..
a t
Y-+
Signature of' er S*uat=.of Ap0c=t
P&t Namk Print Name
D ,
Q:PORK&oWxF. EPJAMSIONPooLx
4 E
y;
.+ Y
The Common
wealth of Massachusetts
Department of Industrial Accidents
a I Congress Street,Suite 100
s
Boston,MA.02114-2017
." www mass.gov/dia
Workers,Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers!. ,
Applicant Information TO BE FILED WITH THE PERMITTING AUTHORITY.
Name (Business/Organization/Individ Please Print 'Legibly
ual): '� _� � ! :
Address:
City/State ip: Phone#: �
Are you an employer?Check the appropriate box:
t. 1 am a employer with Type of project(required):
—��employees(full and/or part-time).*
2.❑I am a sole proprietor or partnership and have no employees working for me in 7' ❑New construction'I
any capacity.[No workers'comp.insurance required.] g•. Remodeling
3.[DI am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition
4•❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 0 Building additiol]i
ensure that all contractors either have workers'compensation insurance or are sole
proprietors with no employees. 11.0 Electrical repair:;6r additions
12. Plumbing repairs or additions
5.❑I am a general contractor and I have hued the sub-contractors listed on the attached sheet.
These sub-contractors have employees and have workers'comp.insurance) 13.❑Roof repairs
6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14\7gOther
152,§1(4),and we have no employees.
[No workers'comp.insurance required.)
*Any applicant that checks box#I 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.
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 providing4'workers'compensation insurance for W employees Below is the policy an�fob site
information.
Insurance Company Name: . ; %1 hr
�— _
Policy#or Self-ins.Lic.#: r �)a -�, �'� _qfi c y Expiration Date: \ t j
Job Site Address: I V-C.— p� City/State/Zip: G�U
Attach a copy of the workers' compensation policy d ration page(showing the policy number and expi ati'.on date).
Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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 1050.00 a
day against the violator. opy of this statement may be ded to the Office of Investigations of the DIA for insurance
coverage verifrcatio
TPhone
reby certi under t e pains and penalties f perju that the information provided above irue a d corre<:t
re: 00 0,
Date:
#: 1 (d l (�
F
ly. Do not write in this area,to be completed by city or town ofcial
Permit/License#
rity(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Pers6nc _ — Phone
-
08/:0 2016 00,52` 9787178415 PAGE 01
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CERTIFICATE NOLDE CANCELLATION I
TOttn Of Baret,�table SHOULD"ANY OF THE ABOVE OESCRIBED"POLICIES B(EICANCELLEO BEFORE
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