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HomeMy WebLinkAbout0003 HALYARD WAY �: �.1� � �. �:. ., f, .. .. .0 w i o �, A; � �� a e � � a e a �. ° N:. ._ ... �. w F. �......:. st��__ ,�.. _y ,P,� cam. l6/.1�� _lit _ ��J� —�/��/3 c,�C!_m_ _rl�� � 62��d�Y�'I� T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 6 Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee C Date Definitive Plan Approved by Planning Board �y/Z9 LJ Historic - OKH _ Preservation / Hyannis TsProject'Street. dA dress -3 to I VG y-A IAk,j Owner 4r)i I() % Yeir� � v�I i Address "Ct Te_lepho�neQ `Permit Reguest'1 �n�,f o S� a.r�-�. t n ��S-es�ne�'�' f-v� ���eSS v✓t �6)(i'male- st'2e- it A e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new i Zoning District Q Flood Plain Groundwater Overlay Project-Valuation ._ Construction Type R �'i�5 - 6,1veAl«+aj 60S - 1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family )H Two Family ❑ Multi-Family (# :nits) Age of Existing Struct&`'f} I 7`J Historic House: ❑Yes WNo On Old King's Highway: ❑Yes *No Basement Type: ❑ Full ❑ Crawl *alkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) 8340 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 3 existing Onew Total Room Count (not including bathe): existing IS7 new _First Floor Room Count 3 Heat Type and Fuel: )4"'G as ElOil ❑ Electric ❑ Other �* e " Central Air: ❑Yes "'N'o Fireplaces: Existing New Existing wood/coal stove: ❑Yes-J4/No Detac arage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size Attached garage(existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: A .. Z Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' Commercial ❑Yes to If yes, site plan review# ON. Current Use SL1�Ip ,�wkil� Proposed Use ` �uvv►�� £" © r- APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name h� C� QvC� irAc� CTelephone_Number­ 7 Address ` C�✓Ci �u� License # 04 VkryM e_f 1Q3�, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTINGff FROM THIS PROJECT WILL BE TAKEN TO �rGc�S 1u6 S fe,V, Sf `l.0 r—SIGNATURE�_ DATEu`i ` — FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE I ' OWNER a DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL ? E FINAL BUILDING F DATE CLOSED OUT ASSOCIATION PLAN NO. t The Commonwealth pfMassachusetts Department of Industrial Accidents Office of Investigations .600 Washington Street Boston,MA 02111 UV _ www.massgov/diu Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information i Please Print Ledbly Name(BR�^m s/orgmization/Individuat): �n 1 b c �2�i✓Np AddresY s w' 11i r-e�- l� CA-4 `City/State-"%Z p t e_ IM i� Phone-#: .�.___�- Are you an employer? Check the appropriate box: 'Type of project"(required): 1.❑ I am a employer with • 4. I.am a general contractor and I : 6. ❑New construction . employees(full and/or part timel.* have hired the sub-contractors 2.❑ I am a-sole proprietor or partner- listed on the-atta.ched sheet 7. .$emodeling ship and have no employees - These sub-contractors have 'g. Demolition t I working for me in an ca aci employees and have workers'. g Y' p tY� -9. ❑Building addition. [No workers' comp.insurance comp.insurance. required-] 5. .0 We are a corporation and°its 10.❑Electrical repairs.or additions officers have exercised their . . 11. Plumbin repairs or additions . '3. _ I�a homeowner doing all work 0 g p myself [No workers' comp. right exemption per IYIGL, 12.Q Roof repairs insurance required]t c. 152;§1(4),and we have no employees..[No workers' 13.F Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew at`tidavit 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-contactors have employees,they must provide their workers'comp.policy nu nbcr. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: ITI Policy#or Self-ins.Lic.#: Expiration Date ' } ��� Ml Job Site Address: r City/State/Zip: . Attach a copy of the workers' compensation policy.declaration page'(showiug 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be.advised that a copy of this statement may be forwarded to the Office of Investigations of the D or insurance coverage verification I do hereby cerkyy un k th pains•and penalties of perjury that the information provided above is true and correct. Date'` y e8-7 Phone-# Official use only. Do not write in this area,to be completed by city or town vffctab, City or Town: Permit/License#. Issuing Authority(circle one): 1.Board of Health 2.Building Department,3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other, Contact Person: Phone#. . ; SHE r � Town of Barnstable �} o� Regulatory Services BARNSTABLE, Thomas F.Geiler,Director Mass. �`� 1639• .�� Building Division . Argo n��" Tom Perry,Building Commissioner ,200 Main Street, Hyannis,MA 02601 www.town.barnstableafia.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print l—DATE: JO number street. village "H OMEOWNER : l «a i O V Ora - t r1�1C` f� � l UP— name home phone# work phone# CURRENT MAILING ADDRESS: 4 c.'l, yyt - lea 3 u.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 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 undersign "homeowner"certifies that he/she understands the Town of Barnstable Building Department Cminimum ins ecn n procedures and requirements and that he/she will comply with said procedures and, req ents. C—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 Y 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:forms:homeexempt °FTHE t°,,, - Town of Barnstable ti Regulatory Services BMWSTABLE9MASS. ' ` Thomas F.Geiler,Director q'ArFc �A`m Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: .508-790-6230 Property Owner Must, Complete and Sign This Section ' If Using A Builder' r' J� 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: fA ,f (Address of Job) �a ,f **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. A bl� s Signature of Owner l.' Signature of Applicant IV Print Name / Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 6/2012 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Map Q Parcel V�c� Application # J w3 Health Division Date Issued Conservation Division Application Fee S Planning Dept. Permit Fee 3S� Date Definitive Plan Approved by Planning Board �5 Historic - OKH _ Preservation/ Hyannis Em1�IL S�`T' Project Street Address n 14CLt Ll6 WnA=i Village L o n�p f y t 1 Owner D anAo b Address 3 WaQCM "e4A ,C&14e U I(Lo , AMA Telephone -n Cam- Q")ya Permit Request '3(_A.00A +U_-O dori n2dl Q-) (-R- took Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation (o 1 2�4 S Construction Type Lot Size • 3y Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure SO q.aC& Historic House: ❑Yes �*No On Old King's Highway: ❑Yes (3�No Basement Type: W Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) D8 AyG • Basement Unfinished Area (sq.ft) C1 3(a Number of Baths: Full: existing new Half: existing new Number of Bedrooms: xistin _new Total Room Count (not including baths): existing ) new First Floor Room Count Heat Type and Fuel: 0 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: 0 existing 0-new size_ Attached garage:A 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 w '. APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name SC) i b1L.l.P 00 'Telephone Number 1n1 Address IC11 9 ReA- nnS�"Ld_-D(e- Q4A License# C'. S -b O (o 16 cnij C) I Home Improvement Contractor# Email Worker's Compensation # �t^�C�IDb1Oo�i9ti��-D\�A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -77SIA.+r1 SIGNATURE DATE a ch�\LO 'L FOR OFFICIAL USE ONLY APPLICATION# . DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ,s DATE OF INSPECTION: i FOUNDATION FRAME INSULATION FIREPLACE 3 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ti FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. • J N. The Commonwealth of Massachusetts Department of Industrial Accidents d 1 Congress Street,Suite 100 Boston,MA 02114 2017 a� y www.nwss.gov.1ia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO.BE FILED WITH THE PERMITTINGGAUTHORITY. Applicant Information Please Print Le¢ibly Name(Business/Organizarion/Individual):SPRINKLE HOME IMPROVEMENT, INC: Address: 199 Barnstable Rd. . City/State/Zip: Hyannis,:MA 02601 Phon e#:508 77571778 A're you an employer?Check the appropriate boa Type Of project(required): 10 1'.Q I am a'employer with 7. 0 New.construction employees(fulland/or part-time).'. 1F1.1 am a sole proprietor or.partnership and have naemployees working:for me in 8 0 Remodeling any capacity.[No workers'-comp.insurance required], 9. .E Demolition . 3.M I am a homeowner.doing all.work.myself.[No workers comp.msurance.required.]t 10 O Building addition 4:[:]I am a homeowner and will be hiring:contractors to conduct all work on my property. I will ensure that all contractors either have.workers'compensation insurance or are sole 11.0 Electrical repairs or.additions proprietors with no employees:: 12:[]Plumbing repairs or additions . 5:Q 3 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13:a p Roof repairs These sub-contractors have employees and have workers'comp:insurance.t. 6,a We.are a corporation and its officers have.exercised their right,of exemption per MGL c 14:❑Other. I 152,§1(4),and we have no employees:.[No workers'comp:insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information: t Homeowners who submit this affidavit indicating they are.doing all work and then hire.outside contractors must submit a new affidavit indicating such =Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not.those'entities have employees. If the sub-contractors have employees,they must provide their workers'comp:policy number. I am an employer that is providing workers'compensation insurance for my e»iployees: Below is the policy and job:site information. Insurance Company Name: A.I.M.Mutual Policy#or Self-ins I:ic:#:AWC40070049432016A. Expiration Date:: 1/1/2017 Job Site Address .3 ('( I� �t L.1� City/State/Zip: , Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under.MGL,c..152,.§25A is a.criminaT 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$250.00 a day against the violator..Ncopy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certi er e s and penalties of perjury that the information provided above is true and correct Signature: Date.'. . Phone#: 508 775=1778 :Official use only., Do not write in this area,to be completed by city or town official. City or Town:' 'Permit%L.icense# Issuing Authority(circle one):., 1.Board.of Health 2.Building Department KCity/Town.Clerk: 4.Electrical Inspector`.5.Plumbing Inspector 6.Other Contact Person: Phone#• SPRIN-1 OP ID: DS ACORO" DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE F01/08/2016 4P 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(ies)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 endorsement(s). PRODUCER CONTACT Bryden&Sullivan Ins Agency NAME: Kelley A.Sullivan 88 Falmouth Road AICONN Ext:508-775-6060 FAX Noy 508-790-1414 Hyannis,MA 02601 E-MAIL Kelley A.Sullivan INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Associated Industries of MA INSURED Sprinkle Home Improvement Inc. INSURERB: 199 Barnstable Rd Hyannis,MA 02601 INSURER C: INSURER D: 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 CONTRACT OR 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. I EXP �7R TYPE OF INSURANCE INSD WVD POLICY NUMBER MMIDIDY/YYYY MM DD EFF Y/YYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DA E PNTED REMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ - GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PRO- JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident) $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS APer accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE YIN AWC40070049432016A 01/01/2016 01/01/2017 E.L.EACH ACCIDENT $ 600,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sprinkle Home Improvement,Inc ACCORDANCE WITH THE POLICY PROVISIONS. Margo Mack 199 Barnstable Rd. .REPRESENTATIVE Kelley A Hyannis,MA 02601 Kelley A.Sullivan ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD SPRIN-1 OP ID: DS CERTIFICATE OF LIABILITY INSURANCE DA07/101201 Y) 07/10/2015 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(ies) 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 endorsement(s). PRODUCER CONTACT Donna M.Souza Bryden&Sullivan Ins Agency NAME: 88 Falmouth Road PHHcON o Ext;508-775-6060 ac Ne;508-790-1414 Hyannis,MA 02601 E-MAIL Kelley A.Sullivan ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:ASSOCIated International Ins INSURED Sprinkle Home Improvement Inc. INSURERB:Western World 199 Barnstable Rd INSURER C:Commerce Insurance Company 34754 Hyannis,MA 02601 p INSURER D: . 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 CONTRACT OR 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. I`TR A001TYPE OF INSURANCE POLICY NUMBER SUBK POLICY MM OM YY LIMITS B X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ . 1,000,00 CLAIMS-MADE OCCUR NPP1403909 07/01/2016 07/01/2016 DAMAGE TO PREMISES RENT occurrence) $ A IVIED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ X POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: Emp Ben. $ none. AUTOMOBILE LIABILITY COMBINED a B SINGLE LIMIT(Ea $ 11000,00 C ANY AUTO BDYYVG 07/27/2015 07/27/2016 BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 11000,00 A ExcESS LIAS CLAIMS-MADE CUBW5992215 07/01/2015 07/01/2016 AGGREGATE $ 1,000,00 DED X I RETENTION$ 10000 $ WORKERS COMPENSATION PER OTH- ANDEMPLOYERS'LIABILITY y I N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N I A E.L.EACH ACCIDENT $ (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached It more space Is required) Operations performed by the named insured as provided for by the terms and conditions in the policy. CERTIFICATE HOLDER CANCELLATION SPRNKHO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Sprinkle Home Improvement, Inc ACCORDANCE WITH.THE POLICY PROVISIONS. 199 Barnstable Rd. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE Kelley A.Suilivan ©.1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD , � n ` Massachusetts'Department of Public'Safety Board.of Building Regulations-and Standards. License,CS-006643 Construction.Supervisor BRAD K SPRINKLE: 189 BARNSTABLE R HYANNIS MA 02501w - "ten Expiration` Commissioner. 10/08/2017 �RI ofCons FWAIINSIM Ps ftdrie it otailon -»�� EFRCQN�'RAE'fOR ris. �G3757 Ttpe: . - �rlIN0�1: 7t6 Prt+rate Gbrporago' _ • tioM Jh71RFf�5 Ei lENTONC. ..'Brad Sprime 1HB Sarrsata01 Rd. Hp nnls.MA Om . Underaecre4ly 7 Unrestricted-Buildings of any use group winch contain less than 35,000 cubic feet(991M )of enclosed space. Failure to possess a anent edition of the Massachusetts State Building Code is Cause for revocation of this license. For DPS Ucauft information visit: www.Mass.Gov/DPS LJOWNRPq*W4ftM,,FW111W w�.r.�•� Lrr.r a.,.,� M Pole Pbm-sidle 508 11118fts.BRA Ut 16 �`alY�s sr�ee • . .09.2016 15:12 5087751350 Sprinkle #5394 P.001 /001 r HONEQu1Pin0� OWM 1946 _ 'mop'%- 199 Barnstabic!toad Hyannis,MA 02601 (508)775-1778 Fax(508)775-1350 rmai)—sprink@cownstnet Website address: www.snrinklcbomc.com Danilo Delima 3 Halyard Way Centerville, MA 02632 508-776-2702 Dlima210)-yahoo.com October 31 , 2015 ` . Re:. Dormers & Roof CONTRACT Dormers . • Cut openings as need to install two dog house dormers to second floor bedroom approximately 50" — 60" in width. Shed or "A" style will be determined as approved by Historical: • Doghouse dormers will be weather tight and include all exterior finish.. n ; • Windows will be provided by owner. • All interior finish will be done by home owner. ' • Does not include any electrical, plumbing;;.or heat. w Roofing • Strip and dispose of all roof,shingles from home'and'garage. • Apply CertainTeed Winter Guard Ice Dam protection to leading edge of roof as.. well as all suspect areas (valleys, chimney etc.). • Apply CertainTeed Roofers Select Fiberglass Shingle Underlayment over existing plywood.` • Supply and install CertainTeed Landmark roof-shingles. Color: Pewterwood •o Cut in and install Air Vent Shingle Vent II ridge venting 'andfcap with Hip and` Ridge.. • Install all new drip edge and vent boots. o All shingles will be applied using the Hurricane Fastening,system with six fasteners per shingle. • Includes all taxes, permits and clean up fees. Contract ## 1.3,564 A warranties for product supplied by the Contractor under this Agreement shall be those given by the manufacturers of such product,which shall be and hereby passed directly to the Owner. Such manufacturer's warranties,the Owner may be required to register or mail in a warranty card or other evidence of ownership and use of such product in order to activate such warranties. The Owner's failure to send in or register such documentation,which failure voids that manufacturer's warranty, shall not create any responsibility for the Contractor to warranty such product. Note: Any changes in the contract during the duration of the project which results in additional monies due will be paid in full to the contractor at the time of the change. Sprinkle Home Improvement to act on my behalf in all matters relative to the work to be on this job(i.e. permits,applications etc.)13T H eow a nature bate Contractor Sign ure Date Registration number. 103757 Homeowner Signature Date ` 4 �' 1�F. r• 1 t i '� P y P -CSC'$ -2ff� �i�*iG� �. �J�� '� r�i�"} �4 n T ti � k: �: C►x � y.,.�S�4� . 147 *AA � . �" 0 t -- j fi LM t tbxr a 4aaid j y. f r r- u • A i # - � k e ,y ?Sl�� .y �.� �AL,^JF 1,�"`"q � !�' i�r�` � �,t,�• s� ���"'�"�' .,0+;. �uv - u t � o "gip�a r `«`W-`r i" a a f ti fit.: '%rC �,*• �s. JC,Wnd drivewa ProJc e4 JJ Gcy kr" Ile- 4 0�63a q p�� Q.n a µ 'tv� 9 Lv�d cats wt�G ,or � ri9�►�� .' Slam Q�, e����� � asP�AW� cr"OtAflj_ wi r. 0 03 E.XCISE R:d55 1 _- V JJ= J 19 11Htt2H r / Lynch and Annette M..Hailer L A ti • J .... CD `t and deed, before me L" \c•wry Public�J �, M�"�T •��y,� r� .�. N4Y commiss4on wilt' ?�" �M ICES/ 1 G/V � 7/ ,7 S1,MGL.:E A44flG.Y ! /VO GA2.e445E //,0 X 3 = 330 -- CD t OE.S/G.S/ PE,2COL.4T/a�V.2.4T� ,.. It OF MgsS � �N Of 45 q yG o RiCHAPiD 1;:: _ h. f. r r #, i i PETER s �� :A 1. , .! � �-� f �'�' l o SULLIVA_N. �. +.tl j. BAXTER j.. �' +3, F 1 , 'j� t �- 'I V h V Na 240�8 I, No. 29733 ,Z 1e ! r 4 7 I ADO Q�c sI�4. S,Y,�r �� � I f FSS1 pNA l f +LE 4-f TES!"f/o�•E # 3��0 0 - #-{' T ' �'t.. 114.E FG• = I l Z, z �- Isom CIO A/V BSo,� l s<" O/sr l�.�E�s� /ODO .;. •. 6.aL, /.Y✓ BOX //D. I o . dkl.A y l�Aty •• /rV✓. /Nr/ .. EO . K�►� •� sr�swE. _. _ �_... ,. _ �.E,2T/F/EO PLOT: PL.4�t/ ' SAIJI� • �a _ ti 0' LoG.GT/O.V CC,�I�7Z31W l r /� �71 14' C'L.too.*' :i -t �q. �r l f•f-�Y i� rr ' i? No watt PL % GE2T/.0 f/E 7 o,J yEQEUN COM�GY.S h//P/l T;v,=—S/OEL,/�t/E Tox�.v ,B.ge2•t157 �3 0V1. T'7 r .2t�i�::- ®. ;Oe Loc•�rE.v y✓/rH�isi T.�./E �LGd�PG.4/it/, , 7- L77 g S T//lt�t..Qiv /s iS/oT l�,4sE0!�N.4 fN/iYSr,2 Sh102W-t/17'-eA Ta ESTG/S.� LaT L/NEs; r , ;t i •; i TOWN OF BARNSTABLE Permit No. -_2R444______________ Building Inspector Cash -------------- men —- — (f/ OCCUPANCY PERMIT Bond — �_ Qb Issued to James K. Smith � Address Lot 44/ 3 l4a1zimr8 T"-q�r Wiring Inspector m` E ,� �t�-�, Inspection date Plumbing Inspector j � ) Inspection date Gas Inspector I ^ ' ;' ' Inspection date jr ;Engineering Departure t` { � Inspection date ff� yam.. Board of Health � `��"`� .n Inspection date THIS PERMIT WILL NOT BE VALID, ND 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. ` BuildingxInspector TOWN OF BARNSTABLE BUILDING DEPARTMENT ���a°T TOWN OFFICE BUILDING rua i6J9• HYANNIS, MASS. 02601 Rto rnr�� MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit . ..... ... .. ........ ..........„................... ........ _...:.... .. ».................._ .._ issued' to ............�� ..... ' � .�. v....... .... ._. Please release the performance bond.. I r DATE: Dec 6,2012 TO: Building File FROM: R. Anderson RE: Report of Overcrowding LOCUS: 3 Halyard Way, Centerville Reported to site with Paul Roma on this date. Complaint from BPD—Officer Matt Blondin. Found two vehicles in the front yard(on the lawn)and two in the rear. The rear access is off the power lines and the lower level of the house is a walk out. It is reported that this is a three bedroom home. A male finally answered the door. He stated he is not the owner and advised that 5 people live here. He is a long time friend of the family. I was informed that the owner.is at work and will return on Sat. His wife is working in Boston.. I left my card and told him to get a hold of the owner or otherwise he would be issued citations. Later that afternoon,the owner Danilo DeLima called me. He works on Nantucket. English is not his primary language and he was difficult to understand over the phone. Ultimately, he will be in Monday morning and will meet me at 8:30 to discuss in the person the situation. I called Officer Blondin and asked him to run the vehicles that are there overnight and provide me with a list of names. I will cross reference that with the list of names I intend to obtain from the owner on Monday. Officer Blondin provided me the following names&vehicles found at the site on the evening of 12/6/2012: Danilo De Lima 2006 Ford Explorer Brown Danilo De Lima 1995 Ford Lgtcon PU Blue Paulo Pontes Chacon 2003 Ford Windst white Francisco Vaz Lira 2002 Mazd Millen Sedan Green Expired 2134 Main St Rear,MM Izaias C DeSouza 1996 Mazd 626 Sedan Green Sergio M Figueiredo 2001 Chevy Suburb SUV Gray Albete F Barroso 2003 Dodge Caravav Van Blue 34b Depot St,Dennisport See page 2 below DATE: Dec 10,2012 TO: Building File - FROM: R. Anderson RE: Report of Overcrowding LOCUS: 3 Halyard Way, Centerville Met with property owner, Danilo this morning. He provided me with a written list of occupants upon my request as follows: Danilo&Vera—husband and wife—property owners Isaias—last name unknown Sergio Gigeuro Felipe Parreiro Paul Chacon Antionio—last name unknown He stated that Paulo and Antonio were here on vacation and preparing to return to Brazil in a month. I told him that I was disturbed to hear that he does not know the names of the people living with him,people he identified as friends. I advised him that friends know the last names of their friends and people on vacation do not register cars to their friend's address. We reviewed the septic capacity with Health and determined that is limited to 3 original bedrooms and is located in a zone that prohibits adding more bedrooms. Danilo admitted he has three bedrooms and an office which he uses as a bedroom. He denied having an apartment in the basement. We discussed that parking on the front lawn is unattractive and the neighbors are less likely to complain if the property looks well kept. I recommended that parking be limited to the proper driveway and checked the septic area to insure that no one is parking over the septic system and incurring a risk. He stated that septic is in the rear of the property and he checked with Health. He knew this but was still unaware of what the proper number of bedrooms is. Advised he could have 1 roommate and recommended he re-arrange parking. He must schedule an inspection within 30 days(1/11/2013). I gave him my card. k DATE: Dec 6, 2012 TO: Building File FROM: R. Anderson RE: Report of Overcrowding LOCUS: 3 Halyard Way, Centerville Reported to site with Paul Roma on this date. Complaint from BPD—Officer Matt Blondin. Found two vehicles in the front yard(on the lawn)and two in the rear. The rear access is off the power lines and the lower level of the house is a walk out. It is reported that this is a three bedroom home. A male finally answered the door. He stated he is not the owner and advised that 5 people live here. He is a long time friend of the family. I was informed that the owner is at work and will return on Sat. His wife is working in Boston. I left my card and told him to get a hold of the owner or otherwise he would be issued citations. Later that afternoon,the owner Danilo DeLima called me. He works on Nantucket. English is not his primary language and he was difficult to understand over the phone. Ultimately,he will be in Monday morning and will meet me at 8:30 to discuss in the person the situation. I called Officer Blondin and asked him to run the vehicles that are there overnight and provide me with a list of names. I will cross reference that with the list of names I'intend to obtain from the owner on Monday. I Edson, Linda From: Perry, Michael Sent: Wednesday, February 20, 2008 8:44 AM To: Edson, Linda Subject: Over crowded house in my neighborhood Hi Linda I talked to you about a house in my neighborhood Sunday at stop and shop the address is#3 Halyard way Centerville there is at least 8-9 cars in this yard every night that's when you will have to witness it because they all work and by the way they are there at 3am I don't know what you can do, but this is a problem that is going to grow This neighborhood used to be mainly elderly but now they are disappearing and this is what is replacing them if you know what mean they are quiet but the surrounding neighbors are concerned and do not know who to turn to. If you could check this out for me I would appreciate it Thanks Mike Perry 1 . .. ....... . � � . Assessor's map and lot number ... , �pF 7N E TOE Sewage Permit number ........ J.! ?T�..ti.'_ .............. .... 1 EASBSTADLE, i House number .................. ...= ..............'....................... 90 MA86 O 039• \0� f _ �0 MPY a' TOWN OF BARNSTAB KSTEM MUSTBE ALLED IN COMPLIANCE BUILDING INSPECT 'WITH TITLE 5 ONMENTAL CODE AND Construct dwelling TOWN REGULATIONS APPLICATIONFOR PERMIT TO ................................................................................................................................ TYPE OF CONSTRUCTION Wood frame .... .. ......................................................................................................... September 10 85 II ..................................19........ TO THE INSPECTOR OF BUILDINGS. The undersigned hereby applies for a permit according to the following information: Location ..................Lo.t..4.44...Halyard..Way.,...f-nte.rv.i..1.1a...............................:.............................................................. Proposed Use Single family ............................................................................................................................................................................. Zoning District .....Residential . - Centerville-Osterville ....................................... . .......................Fire District .......... .............................. .............. ........ James K. Smith Address Barnstable Nameof Owner ..................................................................... s .................................................................................... Name of Builder games K. Smith Barnstable ..................................................Address .................................................................................... Nameof Architect ..............................................:...................Address .................................................................................... Number of Rooms .......:.....five......................................................Foundation ....p.....oured...........co....n.......crete............................................. clapboard & w.c.s. asphalt shingles Exlerior ...................................................................................Roofing. .................................................................................... Floors hardwood dr wall ........Interior <..............y.............................................................................. .................................................................... -- -gas-warm air 2 baths Heating ..................................................................................Plumbing ...... - ....................... ................:........................ Fireplace ...........................One..................................................Approximate Cost .......$60,000..0.0............................. ..... cif Definitive Plan Approved by Planning Board 12/19 ___________19__83_. Area � a—�.. . ................ Diagram of Lot and Building with Dimensions Fee ....../.... .. SUBJECT TO APPROVAL OF BOARD OF HEALTH 9-1 26- x 36 6 x 24 garage 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. E Name ......... ` '"" .. ... .... Construction Su ervisor's License SMITH, JAMES K. . b'No ....28444. .' 11 Story . ...... Permit for .................................... Sin le Family Dwelling .......................................................... Location Lot 44, 3 Halyard Way ................................................................ Centerville ............................. Owner .. -:James K. Smith ..............:.................................................. Frame Type of Construction .......................................... . ............. ........ .......... ................................ Plot ............................ Lot ................................ September 19, 85 Permit Granted ..........................................19 Date of Inspection.....................................19 Date Completed ........19 ... ........... fp 2 ;11 141 /✓ ��......./ /...�'1.." f7NEr Assessor's map and lot number 0 Sewage Permit number ........ s'"' �.. z.='.f .... :..... .. 1 BAHd9TABLE, i House number .................J,.. :;.....................:.........'..... ' rasa t639. \0� TOWN OF BARNSTABLE BUILDING ASPECTOR Construct dwelling APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION Wood frame ..................................................................................................................................... September 10 85 ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..................I.ot..#44... ............................................................................................... Single family ProposedUse ............................................................................................................................................................................. Residential Centerville-Osterville ZoningDistrict ........................................................................Fire District .............................................................................. James K. Smith Barnstable Nameof Owner .....................................................................Address .................................................................................... James K. Smith Bartrtstabl e Nameof Builder ...................................................................Address ..................................................................................... Nameof Architect ..................................................................Address .................................................................................... five poured concrete Numberof Rooms .................................................................Foundation .............................................................................. clapboard & w.c.s. asphalt shingles Exierior ....................................................................................Roofing .................................................................................... hardwood drywall �. Floors ..............................................Interior .................................................................................... as warm air 2 baths Heating .................................................................................Plumbing ............................................................. Fireplace One Approximate. Cost $6Mo0.00 ............................................. Definitive Plan Approved by Planning Board ______12/19 ........19__83_. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 26x36 16 x 24 ,garage 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. Name ..... :................................ Construction Supervisor's License ........'S.... ���. ......... SMITH, JAMES K. A=194-82 No for .....111...St ry 1 -t. .. ......1.7 .. .............. le FamilyDwe li ..........Sin.................. ....... .... . .................... ia/var' d Way Location ...... Ljft-A..xAK�.A4.Y......... ........................Centerville............I.................... Owner ........James K. Smith ................................................... ...... Type of Construction ....Frame...................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ......Se....p.tem.b.e.r.......19.., 85........19 85 Date of Inspection .......................... .........)9 �7 Date Completed .....................................ZJ 9 > • 17 TMINI OF BARNSTABLE CA" IVISION LI _ 4 - 0 1 — .I , —L.\ c. t 1 ..r l l,�- �_Lr� — .k��n. N•„,� _ - i:�.^`,.R?yau'„rc��� 'f'� :,i..�' .. '� r ��Yeyt,,�a - - •• r . • ——li � — L L 1 �, — ._.terr�-1_I, - — t f 1 ��� � a` R7 '� t' '`>•::;,:„ - laa s:�7K'S74 � Y Yar . _ � w W I G, f II yy� i Ut }j P \ yi '2(( (� inn, V ' io Ic cn S -h D ro - S Z) 71 � c � c X . �•s i { I a I��_; _r. I I i ( I � ;! I f I � ! I I I I I I ! � , �• � y, lp I ' `- 'I f'\) ..... EII IF •Y a v�x,�.�«� �. (I �lll.J �� ! II !!1� I �� !�.I !, i � I ifI 111�f -� I , I I ! 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