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HomeMy WebLinkAbout0017 COPPER LANE ® . u e � S C e O r. c , u r . co Town of Barnstable *Permit# I F THE t O �{y Expires 6 mon�hs rom issue date °s Building Department Services t�'ee 9sniiws$ Brian Florence,CBO �A 1639. Building Commissioner ( ► .� (/ tEo.rr►Pl�' 200 Main Street,Hyannis,MA 02601at}J� . www.town.barnstable.ma.us Office: 508-862-4038 '® ®Cj0 5 6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL 4 p Not Valid without Red X-Press Imprint Map/parcel Number _ Property Address /7 64a,2gz L ae e, Cel4p 1 f/�, IVA D,) 3 o2 Residential Value of Work$ S Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ghorle 8'/�La'/IC'.L/ T� ehe✓' 12 eo Z.Q ce;? Zk Contractor's Name Telephone Number�F U & Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) . O D O (2 Z ❑Workman's Compensation Insurance Check one: I am a sole proprietor I 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 Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Y11,AJ44a1A ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) �Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows t #of doors: *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. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 08/16/17 Tlie Commomvea&h ot -Maysac7rusetts . Depart wivit o,f rndus&ial Accidimts O,fce of Loma igatie= 600 Washbigton Street - Basion,MA 0211I mvRumass gtw/dia Workers' CampensafnQn Insurance Affidavit:Buildexs(Cantractr&Tlecfrir i slPhu nbers E£a Rt IIIfQrM3ti U Please Print Naze ,R 14Addre Clty1'Stef Phone ` I Are you an ernplayer. Che&the'appropriate box: ' Tyke of project(required): 1.❑ I am a employer Uith. 4. ❑I am a general contractor and I 6. ,❑New construction employees(hill and/or part-time)-* have hired the sub-contractors 2.i I am a sale proprietor orparhmr- listed on- the attached sheet 7. Retuodeligg ship and have no.exmplasyees These smb-cmtractors have g.,0 Demolition working for me is any capacity: employees and have workers' [NO g'comp_msur-nre Comp.cn urany t 9. ❑Building addition ret 5. .We are a corporation and its 10❑Electrical repairs or addztitsas 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself[Trio workers'oomp- sight of exemption per MGL ir 12_❑Roof ans insurance required-]F c.152,§1(4)6 aadwehaveno employees.[No wodms' 13,❑Other comp insurance required-) •ttwfspplfcmtdmtcbedmbosinamsialsofMoatthasectioahelowsha►�agtfieirzaodceis'compeasatiaapaTuyiafarn iaa fi ga'IDea9YnetS Who SIIb®dt i�1ls afiidaS$indg they axe dales all�Cak and then hIIE outside r'+T���*�2ffist submit a neW affidaest ind'�SLiCh. fCauhactots Slat eheck this b=must attached sn addi6amsil sheet dumiag tbensme of flie sub-cauftWA T gad stye whetha m not those ei ddubaee eupimes.Iftbesmb-ccmRactaeshmempIvfee%tfiey'mouipiv mkdeir trackers'comp palicgnumber- I am an ernpiaper that,ispro iding workers'compensdie n insrtrance for nzy emplayem Below is the policy and jolt s*e information. Insurance Company Name: , Policy 9 or Self-ins.l ic. _ Fxpiratiaa Date: , Job ate Address-- CitylState!Zip: Attach a copy of the workers'coaapensation 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$1,50a 00 and for one-year imprison meat,as well as civil penalties in the farm of a STOP WORK ORDER and a time 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 IrrvesEigations ofthe DIA for mi surance coverage vacation. Tito henib ' T uatder thepains penafties perjatry thatthe nfor=a#iair prmzded abmv is bare and correct Date: Phone ik OoWai we only._Do not write in this Brea,to be campleted by city ortown ofjiiciet City or Town: PerrmitUcense i€ Issuing Authority(drde one): 1.Board of Health 2.Buildiing_Department 3.CitptTown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#- lbi farm aeon and Instractloias Massachusetts Ge=al Laws aVtEx 152 reqUires all employees to provide wozicras'compensation for fheir empIoyees. P0rSUanfyn this sty,an enq7Iayw is defiaed as.- e=y person in the service of another under any contact ofhire, express or implies,oral or wrh=." An,employer is defined as"an jad dual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged m a joint entezp:i=,and inclndmg the legal representatives of a deceased employer,or the receiver or trustee,of an individual,partnership,association or other Iegal entity,employing employees. However fhe owner of a dweIImg house having not more than three apartments and who resides therein,or the occupant of the - dwel n house of another who employs persons to do maintmance,cons(xaction or repair work on such dwelling house or on the grotmds or building appm�thesefo shaIlnotbmanse of such employmenfbe deemedto be an employer." MGL chapter 152,§25C(S)also sues 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 buzgdings in the commonwealth for any applicant who has not produced acceptable evidence of cdmplzance with the insurance covexage required." Additionally,MGL chapter 152, §25C(7)slates'Neither the cammmvealfh nor any of its political subdivisions shalt enter fntn any contact for the performance 0fpubho woik until acceptable evidence of compliance with the fnsurance. regtm-ements of this chapter have been presented in the confrar}n,c aufhouty.-" Applicants Please fill oht the workers'compensation affidavit completely,by chmlang fie boxes that apply to your situation and,if necessary,supply sob-contracfar(s)name(s), address(es)and phone n— m(s)along with their certificate(s)of immn ante. Limited Liability Companies(LLC)or Limited Liability Pm taersbips(LLP)wiihno =:ipIoyees other than the members or partners,are not regim-ed to cant'workers'compensation msorance- If an LLC or LLP does have employees,a policy is required. Be advised that this affidayif maybe submitted to the Department of Industrial Accidents for confirmation of msurance coverage. Also be sure to sign and date the affidavit The affidavit should be retvmed to the city or town that the application for the permit or license is being requested,not the Department:of Indusfiial Accidents. Shouldyou have any questions regarding the law or ifyou are regrrhed to obtain a workers' compensation policy,please call fhe Deparfinenf at the number listed below. Self-minced companies should enter their self-insormce license number on the appropriate line. City or Town Officials r • Please be saga that the affidavit is complete and prirdrt.legibly. The Department has provided a space at the bottom of the affidavit for you to fJI.out in the event the Office ofInvestigations has to coz¢actyou regarding the applicant Please be sure tb fill m the pennit/licrose mnaber which will be used as a reference number. In addition,an applicant that must sabmit multiple pennWlicense appli-cations in any given.year,need only submit one affidavit indicating cu rzt: 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 beea officially s anpe d or ma0ced by the city or gown maybe provided to the ' applicant as proof that a valid affidavit is on file for fotnre'permrts or licenses A new affidavrtmust be filled oft each year.There a home owner or citizen is obtaining a license or permit not rmhtl e d in any bn h3=or commercial 4&atl0 (Le. a dog license or permit to bum Ieaves etc.)said person is NOT reqired to complete fads affidavit The Office of Investigations would lake to thank you m adv-�mce for your coopw. an and should you have any questions, please do not hesitate to give us a call The Deparimmfs a tress,telephone and fax number= Thy ConnnM *of M ssachnsetfs , D�epa invent of Iii&mtdd Awideatst amce Of lnvestiotiol= �Q�C�ashin�n S Bostwi MA 0�111 TfI-L#617' -4-900 I=t 4-06 or I-977-MAS F, Fax 617'27'749 Revised 4-24-07 Wdia . Town of Barnstable Building Department Services NAM Brian Florence,CBO 039. ►``� 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 et Qrlle5 /YC�/�C�c/ G,iT ,as Owner of the subject property Ply hereby authorize d LY?, /A '' to act on iriy behal f in all matters relative to work authorized by this building permit application for:. /7 eopperL C'��rfery�//� �l oa��07 (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and°all final inspections are performed and accepted. Signatuile of Owner Signature of Applicant /Va/loz FQG4e/' Print Name r P t Name Ae Date t Q:FORM&OWNERPERMLSSIONPOOI S Rev:09/16/17 Town of Barnstable Building Department Services Brian Florence,CBO r ' � Bwldurg Commissioner N 200 MamStreet,'Hyannis,MA 02601 �srr►ara. : ►,n f , . 4 tom. www.town bariistable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCAnom number street village "H01IEOWNE : �l 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 sup4 isor. 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 responsible for all such work u&fdrmed,6der 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 Buildin, Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature ofHomeowner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:WJPFILESIFORMS\building permit fo=VDTRESS.doc 08/16/17 daclW PAO ay C%v gulati n j Office o[JConsnOmer Affairs&Bn mess Re�lafion riOME jMp-,tOVEMENT CONTRACTOy e: e istratio ,`�1,36003 R ns g Individual Expir3tiarg= ON 1 �f018. BRUCE'P.MILLS „�_ "•: � ``. BRUC E MILLS ec, ;o CROOKED PONDd - ^r;'s Undersecretary HYANNIS,MA 02601 I Massachusetts Department lnsf Public and Standardsty Board of Building Reg License: CS-078687 Construction Supervisor BRUCE P MILLS 16 CROOKED POND ROAD HYANNIS MA 02601 ^M Expiration: t Commissioner 0612912018 E _ • t " Construction Supervisor } Restricted to: f Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. r Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW,MASS.GOVIDPS � �� e 14.1 e vc � ` �a,.a .�s� Co-cJ � A,1 tee/ ��— i BIKE ram, Town.of Barnstable *Permit# �P� ~O Expires 6 months from issue date Regulatory Services Fees, t RARNSfASLE MASS.AlED MAC Richard V.Scali,Director A . � s� r����� ' Building Division . Tom Perry;CBO,Building Commissioner SEP 0 2 2014 . : 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.tow a.n.barnstable.mus Off ce: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number _ Property Address r �e r ✓� [Residential Value of Work$ a OU 0., 6� Minimum fee of$35.00 for work under$6000.00 ---. _ ............ ......- _. -- - - . Owner's Name&Address No r ks ogadP Contractor's Name �` tL, Telephone Number Sri) 7.32•V7� Home Improvement Contractor License#(if applicable) ��. Email: De4 DBE�r/ �/ ,p j�/GDY-j Construction Supervisor's License#(if applicable) C — 14)L 3 7 S ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor WI am the Homeowner have Worker's Compensation Insurance Insurance Company Name LA)C /8�Z7 46'. CU, Workman's Comp.Policy# ' cc-— d S a 3 L —dZOI y A Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side [Replacement Windows/doors/sliders.U-Value I d� (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 Contractors License&Construction Supervisors License is required. SIGNATURE: t. Q:\WPFlLES\F0RMS\bu ilding fo rmsEXPRESS. o e R v"sed 061313 i - DeparhaentaffrdjuftirlAccidexrws - - - Office to_&VC Ms . fire Wayh ngton eet . $ostarr,,MA02 � rvr4�lv.i�uss.go�ftlitr - _ Warke"' Compensation Ins -ance.4flidavit Bidldeis/Con"cturs/Mecfricians/Numbers ApWkant Infarm Pion P1e3se hint,Le?_ibIy Name akisfi�Oizanizafiouffi0i-,�O: City/state/zip: Ph..47- .56 1', 7 37 - q71 Are yo-a an employer?check t�apprapriate bo= Type of of ect r - - --- - - pa.J { cored ._.-_ 1_V'I am a employer with d_ ❑ I am a goal confractcr and employees(full agdlor part-time)_ * havehitt dthe sub�antracfors. _ 0 rY7r,ctr,rc#on 7 El I am a sole psopriietor or partner- listed on the attached sht et y- ❑Remodeling ship and hen e no employees empTheloyees ees a d have have $_ Demolifroa w for mein an cs r_ � and have workers' or�ng y cape � $ 4_ ❑Building addition PTO Norker8'comp,ine�trance comp_tnsniant� 5- We are a corporation and ifs i{1_❑EL-%tri:cal repairs or additions 3_❑ I am t a homeowner doing a wor, of ms Kati"exercised their I1_EI Plumbing repairs or additions myself[No warlrErs' right ofe-2�mption per MGL 12 0 Roof repairs in mn- ce mired-]1 c-152,§1(Z%and we have aD employees-[Na workers 13_0 Oiler comp_insurance required,] 'Any spprbo th at at cheer s boa#1 mast also fill out the section below shDvring their woeicets�eompensatiag pnii�i�tmaEitm_ Snmeowners who submit this affidavh i—;rrat r K they are doing sli wark and tfiea hie Outa&e contERCw s mast subs a neg affjdsrit inrT5rgtm sorb Z antsaciors thst check this box mat wed as additions)sheet showing the nmme of file 5ab--ca¢h2cba mfl ststE whetter ornzxt these esrities fiave ampluyees. Ifthe mib-contcactam bXM empIUYees,they must Pmvide their Markers'romp-polacy number- -Tam urz ermployeF tfirct fsprm�iciitr n�orkers'cant risalin.n frtsurrutce�`or rt3lK earpl�yees fieIaar is the paEcy and job site an�`ornfirctian '1 Insurance Gompaayl`Fame: f S c. � � �n-� v Y Pahcy; orself ias-I.i,_4�7 wcc-rb z) -5-6 1 3 Y6 7"J,6AI A Expiation Date: 616 d-0 S Job Site Address_t C o Ajee Cif5,/StateI2sp: Co Well AtUch ae ropy of the wGrkers'compensation policy dechrstiou page(showing the pEcy number and ration(late). Failure to secure coverage as regtxircd under Section 25A of NML c. 152 can Iead to the imposition of criminal penalties of a fine up to S1,500_0D ancVor ow-year i3p=_ as we11 as civil peena% m the form of a STOP WORK ORDER-and a fine ofup.to$250-00 a day against the violator- Be advised that:a copy of this sUdemeut maybe forwarded to the Office of Investigations of ffie DIA for insurance coverage vacation_ I do hereby c under tkspruxis aI'd e' W.'rs VfP tdUt}'thatfhe in,jbrmid an prmidgdr ubtn a is bus and correct A Simatute: Date dt 6 l Phone 9� (WEC&l use on[. ,1ka not twits fa tl&ureq,tic be camplet6d by did at town of cia City-or Town: Ptnmitucense# Issuing AuthGr4{tdrde one}: ".1:Board of Ifealth 2.Building Department 3.OitySTown Clerk 4.Ele-c r cal Inspector S.Piutmii g rm-slrector &.ether information and Tnstructiolols Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees- Pursuantto this statute, an anployee 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 Iocal 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 afridavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)mme(s), address(es)and phone number(s)along with their ceiiincate(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 maybe submitted to the Department of Industrial Accidents for confirmation ofinsurance,coverage- Also be sure to sign and date the affidavit The affidavit should be retomed 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_ Seli imsured companies should enter their 'self-insurance license number on the appropriate line_ City or Town Officials PIease be are 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 additioD,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 ilZ (city or town)_"A copy of the affidavit that has been officially stamped of 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 bum leaves etc_)said person is NOT required to complete this affidavit The Office of Investigations would bike 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 Con naoawmalth of Massachusetts Department of Industdat AacxO: Qffiee Of favestiotiGILS 64�l�askl��tan Street . Rostma,MA G21II Tel_A 617-727-4900-W4-06 or I-& MASW Revised 4-24-07 Fax#617-727-7149 w-mam2ov/dia 1 - WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company 54 Third Avenue, Burlington, Massachusetts 01803-0970 (800) 876-2765 NCCI NO 40959 POLICY NO. WCC-500-5013469-2014A PRIOR NO. NEW ITEM 1. The Insured: Dennis O'Reilly DBA: Mailing address: 11 Cotuit Cove Rd FEIN:**-***2038 Cotuit, MA 02635 Legal Entity Type: Sole Proprietor Other workplaces not shown above: 2. The policy period is from 06/08/2014 to 06/08/2015 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers' Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of liability under Part Two are: Bodily Injury by Accident $ 100,000 each accident Bodily Injury by Disease $ 500,006 policy limit Bodily Injury by Disease $ 100,000 each employee C. Other States Insurance: Coverage Replaced by Endorsement WC 20 03 06 B D. This Policy includes these Endorsements and Schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Code Estimated Per$100 Estimated No., Total Annual Of Annual Remuneration Remuneration Premium INTRA 0972030 INTER SEE CLASS CODE SCHEDULE Minimum Premium $500 Total Estimated Annual Premium $2,701 IGOV GOV Deposit Premium $695 STATE ICLASS MA 15645 MA Assessment Chg. $2,354.00 x 3.4000%. $80 This policy, including all endorsements is hereby countersigned b �� P Y� g Y 9 Y 06/09/2014 Authorized Signature Date Service Office: Rogers&Gray Insurance Agency Inc 54 Third Avenue 434 Route 134 Burlington MA 01803 South Dennis, MA 02660 WC 00 00 01 A(7-11) Includes copyrighted material of the National Council on Compensation Insurance, used with Its permission. O'REILLY & ASSOCIATES Builders — Developers — Woodworkers 11 Cotuit Cove Road, Cotuit, MA 02635 "Serving Southeastern Mass and Cape Cod" 508-737-4711 617-699-8055 www.OREILLYBUILDER.com DenOReilly@hotmail.com Work Authorization Form I, 94outs -8&&—H—&Lhereby authorize Dennis O'Reilly of O'Reilly Associates Building and Remodeling to represent me and perform work at the following address: l 1 Co (L (.,6 , C15r)1ty-2V1QLC-, /r `,(`3Z� zZ lL/ LDA -�--� •� �r Homeowner _ r f 1 V lZB IQO�I79/I/L6'l2[G'BCcltl2 6�C-/I�GCCdJCLC�I/QBJ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return p:egistration: 166842 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 kV xpiration:_8/46/204fi.; DBA Boston,MA 02116 O'REILLY&ASSOCIATES BUILDERSfDEVELOPERS DENNIS O'REILLY - aa 11 COTUIT COVE RD O l/ COTUIT, MA 02635 Undersecretary Not valid without signatu v Unrestricted=Buildings of anyuse —='- contain less group Which than 35,000 cubic feet(991M )of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for "revocation of this license: For DPS Licensing information visit: www.Mass.Gov/DPS i Mass achusetts Department of Board of Building.Re public Safety Construction Su gulations and Standards License: CS-104375 r MNiS T.p 11 CoY ` „, fait Cove R� ,. Cotuit MA 0263 Commissioner Expiration 05/15/2016 - A=248-039 JosFPH D. DALUZ / rELBPHONEt 775.1120 Building Commissioner EXT: 107 TOWN OF BARNSTABLE BUILDING INSPECTOR TOWN OFFICE BUILDING HYANNIS, MASS. 02601 August 11, 1988 Mr. Arnold Cummings 183 Lake Shore Drive Marstons Mills, MA 02648 RE: 17 Copper Lane, Centerville A=248-039 Dear Mr. Cummings: This office is in receipt of a complaint alleging that there are two living units in your dwelling located at 17 Copper Lane, Centerville. Please contact. this office immediately re the above matter. Peace, oseph D.iDLuz Building Commissioner JDD/gr Mr . Joseph Daluz Inspectors Department 367 Main Street Hyannis-, Massachusetts RE: ZONING VIOLATION -PROPERTY, OWNED BY ARNOLD CUMMINGS ET UX 17 COPPER LANE, CENTERVILLE, MASSACHUSETTS 02632..- x Dear Mr.: Daluz, It has been alleged to me by my neighbor that the above mentioned property, 'has two illegal kitchens. They claim that they saga one (1) in the basement, one (1) on -the first floor -and one , (1) on the second floor . ; Please investigate this matter on My behalf. The title for said property is Bo6k•.4407 Page 115 and Assessors e Map 248 Lot '039. Thank you for your attention to this matter. Paul t-Zagnant G 16 Kay Ave. , a f' Centerville, MA 02632 ' ,.. J. Assessor's p and,lot number ./...�1.................................... f CF THE t0 Sew g Permit number '......�2 .r SPTIC SYSTEM y` *J A•LED IN CO • House number WITH TITL •ENVIRONMENTAL C i6 9 0� tNEEGULATION TOWN OF BARNSTAh BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....lvo v z.......��4 ce- ...4o ' !lEw....L 0 e1..7..1 O..... ....... ... 14 S-S TYPE OF CONSTRUCTION ..................................................... ....................................................... :. ................................................19........ TO THE,INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..�.7.........cv e..e...........X./ ./1..Q,r......... G'./1. !°f.C..t✓.1...�1..�..�..: �-�: ...................... ProposedUse ...... r�tv�.e..:.......................................................................................................................... Zoning District led° ...Fire District d Name of Owner 1 1C O..U.la....� ...?9 Address ..1..7 . r4 Cum -n i pl\s Nameof Builder .............................. ........... .......................Address .................................................................................... Nameof Architect .............. .f................................Address .................................................................................... Number of Rooms ........../.....................................................Foundation ....�� . ..4?. .......Cd�?.C.� fie,—. Ex•ierior .....C.&O.�.c,-�........ kn�,.......................Roofing ........... .......................................... FloorFloors 4� 7� .."` s ...... .... ........... .......:..................................... � Heating _/ n .. ........................Plumbing •...... ....................................... Fireplace ............ .......................................:..................Approximate Cost , !2..0........................... ... Definitive Plan Approved by Planning Board __________________0----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee 7.c.�.` .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH C- �ti > - N for La TA l;L 4 PL-AIV /30o11� of 1 , f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ,,f m��/....; ........... N�.I MINGS, ARNOLD & THARINE 22649 'KOVE GA. GF.......No �............. Permit for ............. ... i Accessory to Dwe1 ............... 17 Co per Lane Location .................�_........................................... - Centerville - Owner Arnold & Kathar re,,.r ummin'gs Type of Construction Frame Plot ....................:....... Lot ................................ f r Permit Granted ......NQv©mber••46•;••••.19 80 , Date of Inspection ........19 r Date ;Completed ....:. ..... .. .........19 t PERMIT REFUSED ......................................... ................. 19 rn ...... ..0......>..F:.................................................. ..... .................................................. ....-.11.1.0-J!.fn..v ................ .............................:. Appn0's ... ;. ................................. 19 .. ....................................................... .......... ........................................................ __ r _ t C� Assessor'sAerm' it 'i and lot number h,� .. �''' `" `" f 4' �r p ............................. . •• -� �oF toffy THE Sewa number ('..............,...,., 11v House number J/ 9 MUa �p 1639 6� �OF MPY I TOWN OF BARNSTABLE i BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....&6� cde�2 C- � uc � �J k_.cls-sch�,-v ........................ ... .. ...................................TYPE OF CONSTRUCTION ................. .. . . ........7F?.....:A.:' ! ...:. .!... .... ?......... ....... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. ........ .: �..... �`"......... • ..t'a...?..�'.-.... .... .�'.:�?. ;:.f!..?.:.�..........!? ......... ... .. ..:................. ProposedUse ............................... ..................................................................................................... ................... .? y�, ,J. ZoningDistrict .......... ...........................................................Fire District .........f:i........ .. .................................................. Name of Owner,: .!.....:. .: .....yc...`!.... ,?.t'........."..:....f: Address L .........: �...............:....f....:�: `............::.: V. Nameof Builder ....................................................................Address .................................................................................... Nameof Architect `` ..............................Address.................................... .................................................................................... Number of Rooms .....................................................Foundation ,-� t",. t' /.....:.....I., , jv ``. -7 �. ..f,.. .................... .................................. Exterior ......... �.: ....r.a. ..1. ........Roofing a%, ., / ....... .�. `� �. ..................................................... Floors / . � r :<,,... . ':: .:..............Interior .........................1:........................................................ ... ............................................. Heating -::.:...........................Plumbing ...................?...................-............................................. Fireplace pp..............:r''::^...........................................................Approximate Cost ........ .................................... Definitive Plan Approved by Planning Board _______________________________19--------. Area ..." ' 04 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH f 'C '^ I NN ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........................................................ 6 .K' . . � . . . . . . . 22649 CA RAG E , Accessory to Dwell ' Location 1.7...C.!DD.e��..La]n.e............................ Centerville ---------------'---~------''' "== ``-=` = s � , - '/r- of Construction— ........................................(...................................... � ^ ' ncx � ` . Permit Granted ....�November)6., O ' Date of Inspection Date Completed ..... .X_�......................19 PERMIT REFUSED PER IT REII ---. lA � ^ ` � ^ ---. . -----.. | 7 — ' —'--'[��—^^'—l''---' ^^'—'~----' -----^^--'----'^'—^'' --'~—^--^^ ' .—..-------.-.~....,---./—...~..--.. . . - _ Approved ---------------.. lA ` * -------.------..---.-----..—.... ^ - -------'------.------~...—~.— * ^ � ^ ` ^