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0013 JOHNNY CAKE ROAD
Z!, III ,f IIII -DIVA tIIIIMY now MAW AMTOVA"Aly Mao00 e tIIIItIIIl05=1"Stamm,"tIII &vow Yke*110 I itym Iq.ygmaway Ono owmyho tIM- ,JE llI,I--Apo KA V"Qmv g: @NN I Ell IIAPIA 4W I13 iv -MUM, _vP"%vg MMIRAMN l.......... I4 Iquo IDo!............... Oil IIwoo R; I"Mom ti1,040 oust,wassimAly A NUMMIN My md" fT%WK&I NAVA II WTI%ZAP ,mils gum ii4 our P IittIitIhow, IItWit, IIIitI0 W`KKA%0-0 moo ^ . Town of Barnstable _ a,� �. �� � Building a Post This"Card So That it is Visible from"the Street .Approvetl Plans Must be'Retamed on Job and this Ca,�d Mustbe Kept t HABWIABLE t MARK Posted"Until final Inspection Has Been Made. Permit ere a Certificate Hof Occuanc is Required,such Buildm shall Not 1. 1 llll a. t ° Wh p y g be Occupied until a Final"Inspection has been made Permit No. B-19-3978 Applicant Name: William McCluskey Approvals Date Issued: 11/25/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 05/25/2020 Foundation: Location: 13 JOHNNY CAKE ROAD,CENTERVILLE Map/Lot: 210-046 Zoning District: RD-1 Sheathing: Owner on Record: HARTMANN, ROBERT J&aLOWE,JENNIFER , Contractor Name:�g William J McCluskley Framing: 1 s , n :. Address: 300 NOTTINGHAM DRIVE Contractor License: 102776 2 CENTERVILLE, MA 02632 ": ` _,. "' ,Est. Project Cost: $4,900.00, Chimney: Description: Add R-38 fiberglass, R-37 cellulose,and R-10 rigid insulation to the Permit Fee: $85.00 i attic.Add R-10 rigid insulation to the crawispace.Air seal the attic Insulation: i Fee Paid:: $8 5.00 lane and cr wls ace with expanding foam. General Final: 4 Dater Date: Z weatherization. - Project Review Req: _ Plumbing/Gas Rough Plumbing: g . Buildin Official , g Final'Plumbing: r<" uance.i m nths afte ss ?h rued b this permit is within sx o h work aut o This permit shall be deemed abandoned and invalid unless the E, by'.this p 1 All work authorized by this permit shall conform to the approved application and the approved construction documentsfor which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shalFbe in compliance with the local zoning by-laws'ancl codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road�and shall be'maintained open for,p6blic inspection for the entire duration of the 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 thispermit. Service: Minimum of Five Call Inspections Required for All Construction Work:j Y 1.Foundation or Footing rts Rough: 2.Sheathing Inspection g 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Cape Save Inc. 318b1SN8y8 JO tvM01 7-D Huntington Avenue - Me f Z 83� South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 ld3Q �N�a7��8 1/3/20 Brian Florence CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit 19-3978 Dear Mr. Florence: ` This affidavit is to certify that all work completed for 13 Johnny Cake Road, Centerville has been inspected by a third party Certified Building Performance Institute (BPI)Inspector. - All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey I Town of Barnstable *Permit# b/ %E0P Expires 6 non is from issue date Regulatory Services Fee RAMMBM MAC Richard V. Scali,Director ,r�e3� Aq 13 2015 ®F CD�A'�+ /I pp Building Division WNSTABLETom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us -, Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Is �.LA a 1 �, i✓ �G.Q U /� 2(Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address (�Ob;&Q-i V-� -T tA" ICI Contractor's Name Q_L.j i=_IL kLe,(,4s Telephone Number-Sp g; �70 9 q b C{n Home Improvement Contractor License#(if applicable)_ Email: Construction Supervisor's License#(if applicable) "( %( ( ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 0-I have Worker's Compensation Insurance Insurance Company Name t& d/14 J5�t t Cam/ Workman's Comp.Policy# -696Z 11j2 E 90/3 7 Copy of Insurance Compliance liance Certificate must accompany each permit. Permit Requ t(check box) �Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ,,¢,PtiIOtJ � � I ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ 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. SIGNAT Ee Q:\WPFILES\FORMS\building permit forms EXPRESS.doc Revised 040215 r 6 a 7U Conitrronrveafth of Massachusetts Department of Industfial Accidents O,jjRce of Invesfigadons a 600 Washington Street Boston,MA 02111 www.mas.gov/d`a `a Workers' Compensation Insurance Affidavit: Buliders/Contractors/Electrtctaus/Plumbers A21DUcant Information Pleas_ a Print Legibly r-, Name(Business/orp&,atioWbufivi&W): Yc,- J e) Address: u�.V r, Ci /State/Zi : f�� Phone#: .5i3 F,'tr yt�-an emptoyu?Check the appropriate box: ama employer with 4. ❑ I am a general contractor and IType°fpr°Ject(required):employees(furl and/or partarttim )e .' have hired the subcontractors f'• ❑New construction . I am a sole proprietor or partner listed on the attached sheet, 7. []Remodeling ship and have no employees These sub-contractors have working for me in any capacity. employees and have workers' 8' Demolition (No workers'comp. insurance comp insurance.: 9. ❑Building addition 3.Qrequired:) 5. Q We are a corporation and its 10.0 Electrical repairs or additions I am a homeowner doing all work - officers have exercised their t 1.0 Plumbin repairs myself.[No workers'comp. right of exemption MOL g or additions insurance required.]t c. 152,§1(4),and we have no 12 Q Roof repairs 3a.❑ I am a homeowner acting as a employees.[No workers' 13.❑Other . general contractor(refer to#4) ' comp.insurance regnired.j fAnY appucat that checks box#1 alter also fill out the section below showing their workers,compmatiodtaliy Homeowners who submit this stigdsvlt indicating they are doing as work and then hire outside contractors must sub davit tContnwtats that check this box must attached an additional sheet showing the name indicating suchof the employees. If the�have employees,they must provide their wo 'comp.PoUcy number sue-convactm sad state whether titets or not those entities have I for an employer that providfirg worlters'conrpensodon Jirsrrrance for my employees Below is the pommy and job able Jnfoniradon. Insurance Company Name: Ct:. f Policy#or Self-ins. Lic. 6z Expiration Date:s- 2J t Job Site Address- Attach a copy of the workers'compensation policy declaration page(showiu the "�9-m�Z4 Failure to secure coverage as g policy number and expiratko date). g Wider Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance4oveMP verification. 1 do hen ce +knder the pate and 1 of perjury 1"the infonerolJox provided above is trace and correct Phone O,0'kial we only. Do not write in thi�a"a,to be completed by city or Iowa q,(lcld City or Town: ` ' Permit/License# Issuing Authority(circle one): i.Board of Health L Building Department 3.City/Town Clerk 4. Electrical inspector S. Plumbing Inspector Contact Contact Person: Phone#: a Massachusetts Department of Public.S•afety Board of Building Regulations and Standards 'a License: CSSL-099167 Construction Supervisor Specialty . OLIVER M KELLY°4 8 RHINE ROAD YARMPUTH PORT M 3 -� lA Expiration: . Commissioner 09/28/4017 40, :1 2P r j Office of Consumer Affairs and Business Regulation 10 Park Plaza -.Suite 5170 Boston,-Massachusetts 02116 Home Improvement Contractor Registration Registration: 128957 - - Type: Individual -"" Expiration: 6/14/2017 Tril: 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd - Yarmouthport, MA 02675 _ Update Address and return card.Mark reason for change. scAi u 2ora-05/11 Address RenewalI Employment Lost Card ____ !�J/e`ft»>o»r•�ru�cnl/�n�"illr�ryc�i��ef/.i `----- ------�.—.__�..___-_. -• Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTORjj'Abefore the expiration date If found return ta: registration: _•j_28957 Type: Office of Consumer Affairs and Business Regulation " Expiration 6/1.4/2017; Individual ' 10 Park Plaza-Suite 5170 --- - Boston,MA 02116 Oliver Kelly = Oliver Kelly 8 Rhine Rd. _ Yarmouthport,MA 02675 Undersecretary Not valid without signature ACG;e' CERTIFICATE OF LIABILITY INSURANCE 461� f1ffimn5- THIS CERTIFICATEi19 MIMED AS A MATTER OF INFQRMATiW OAFS'AND OMFEIR&NO RlOM&UPON INE CERTIFiC-ATE HOLCE3I.THIS CERTIMATE DOES NOT AFF RMTWELti OR NEGATIVELY AMEND? UTEND ON ALTER THE.COVERMkE AFRMDEO BrY THE !_6CIE3 SELOW. THIS CERTfIsiCAIM OF INSURANCE DOER NOT CONSTITUTE A CONTRACT:BETWEEN THE ISSMIND INSUREF4.9h AI/M REME'SENFATIL"E OR PROGMER,AND THECE11TIFICATE HMMER. IWORTANT-, If dw,eft0li aata hal&t h an.ADDITIONAL INSMElD,Ilia pi ffeyYifestl inilil;to andaiai& Ill SUBROCATIM 1$WAWED*Ubjl a tb ibs is is and eetsdidwA al the F4110"ea,iein paflei&w fft*07 iayulia aft eado t*ownt A 04fiixiigm ea iieis eaiflea daris.tii eanlaf ifOM is the CmWfllleala ieefdtie In o au eA sudh sndaa r<z-tufi A �iifSla,a f2ii�itas DOMING&O'NEIL INSURANCE.AG13 Y p' ��os)��s� ► - 271 fr'ANNOUQH RD. _scafTiw acae r�i�c c�fa is 3 we, HYANNIS MA OHM i1tmsi:iac ACE AMERIt Afd:IhSAJRQNC*CO 2ffiii7 imatPEa ti i*tk,it 1 KELLY ROOFING INC w—*kqr �tluacn� , bRMEROAD fib Hi COVERAMS CETf:'4MA.TE NUIBETR: 2185 REVISION NUVABE Q "is"YS TD€eATIPY'Ttiel`THE PCUClft CP IMSUApAM!L13*01'St.LINO MOM®L"CN IMM- D'M IME 142JAEU fAMaD AM&POt'aM VOUCY Pulco LmAr fto A�i'tPA?'sfs7rth'CItA:.Al3YY Ia:'tlU1S:1.SYNC,1`F1RSi1 FA!CER%9lfICtJ Oi"M2Y`C•oNnwrr G'ii.I3ilts:it�OCIGLIAPNT rM7H 394SS'EGf'7tl YA41h71 7tir"i . CINT"hCA7L'MAY HL ISSUED at,MAY MUM*3Flt:INSUBANMC .ATF,01-WED BY 7tt_MICICS DEWMIlEll MOMN Is Sulmmcr to ALL Till!gi!xws . - _ _. . GlGLLL•11$�S.A)ID{CiTi�IT40t�S tlf"SICM i'LUGIES 4M7.:571DS131 KYIY"'.'L4lLMYPN 11PI5LiCCtJ OY RPIn-C1AtM1S. eaifllCCR'vA'1.fr�i6uL.LLitfi7£d "�/I'uCf9l�fi�liliL 7y_. - CLAiAtSi%ii£ - `Ad�`1 - HG�Sfit�,N..AG'BitiBiitY L - �S'i'FLf1C�YrP3'�41yC ivY7T�P1�6'9R&R=.-' r.. - _ G6If�.1L,..4'udffe�'fiM7ffi: 30 r PeaIL"d 1.._.I i-'T EL4i.' .,M.dh.11le tdlTdf�iiii6Llatiii6Y �aN[�roeq..._�.r..,_. �yA�?FLA•r�JfD�. �C{ le0li3,'a'iiiiic�l p=(�a+vsf T - l1JTa5. iu TES. LL`• �,A � {G54;iY[6tlii fYV psi'e¢iliT{1 i_ - II iMUJAJM& ummEliid,UAA$ `` u': iR Cht'N�°'iCEiiCI&.ti.6,,_,., i t'ucE3,9dfdPi i. A. ` Tis „ �.� -GEG Ib-T61lN.i-itLS' 1� NaiisTEmC9aPili"Ti5H _ _ _.Uk _... 8g351iVLasifcYktlii[:Yfi� -. . L.iTd6i1•,.,,.- - .s.......,_-,:. - kEFF�T �k7iP,: t. iGiiPi.� - - GL EiviN.K �rt -t�506 Ct " A I fPi�iuEie66itEzCxkiiTw'Ix s►► au 5�.e21@2>w'i019Fi14 ii5i�18fl15, ft2Di4 stet at r65r .•G#�v�itfv� s,5dtIJ0i1El 540.005 im% t � - iiGti�Y�l4iiu'S+S��19'air+'i�taT�IciiflTiitAi��f�i,:'�.•.--'Wt�ss-6iieiy+ir`.a,eu�iersas�la•B��+tiiccfarsp/rrsi 'A'*ik(,, `C&_-WsitWofi tumi"4n7 Na p6d ra Mhsa siamu i65i,01yaii18i .Pwf ubtl W Eiai2.,emff"!'A'C 0,03 M 8,na awi3tc& ,e3 µriff fu pity e'iafl-d Paitl)a:iGau lG wA;A&,Y4&t.ii sh'Aw 0iltas'iian i,iai fiat Itus am 1f'diib fftadtsiid Nad,0441;11 fifad thola aw04Qi's au".d,WAitgi aakl_ 'Brig aiiiAvIda l of aiw&Qn%,,ho"ihwi,i,Nity Wtt`t a i lia dma iitdlPli ewbRAU also its d tu,lim fi`a k iiFm dua af,dt&ihi,ird pafiW pi"Ww III& MIA daia aPdig bittli ka aPw,t i6ir3p') 11ta tiYei�.ai'ttia eaa�➢�ja el9fi kia n'»i,lir4>ti d73i by aaeattiind iha PIYir,f a1" , 0i-�iaiatla kYiffira�5n. Swat Easelaivv,i�rrt�yae�r�1t$f��n� CERTIFICATE HOL&k _ _.- CANCELLATION SnBULD AM Grn¢wnn#EE 6L5CFtMMWp Juii,Q3 CZ CANCELUDS17CM 'H►+l.'' m1pi"Twu DATE TtiEsw , *OTs2 WXA. BE BE AT".0, IN < ACCOMMICEW"THEVOUCY t`P895I01M. Robert,CadiRl3 " 6UTaei�SnFktCi�i'CATtili. Saii3f+JaiiiKiitii; la[e dY28B4 04idllld ilzAltiy,CFCL&Vito Pi,"re-Ratiai"MA9,AM-iViCRIBKM 0 i:S1-2014 ACORD COMORATION. All Rills mam 1. ACCHD 25(01if" Tho AGORD a2m aatd"a we raSlslaraO:Ina*s aMDORD i } KELLY ROOFING MA GSL #99167 PH 508 509'4640 6 RHINE ROAD. ;k MA HIC #128957' YARMOUTHPORT MA 02675 kellyro®fing@icloud,com' September 14' 2015 � 6k� ` Proposal submitted to Hartmann of 13 Johnny`Cake Road Centerville MA We propose to supply all materials and labor.necessary to remove and replace the existing roof.at the address above.,.,,, r , -All debris to be removed to town transfer. 8" White aluminum drip edge to be installed on all'eaves, retain existing vented drip` ~ edge where installed. Ice and water damage protection membrane to be installed on the first three feet:of eaves,in all valley areas and around all protrusions. Remainder of deck to be covered with #15 Felt Paper. t Lifetime limited warranty Architect style shingle to be"installed, (color to be specified) All shingles to be storm nailed. (6) g .. Bathroom vent pipe boots to be replaced with new. Install Shingle Vent 11 Ridge vent on all ridges with Hand Nailed Caps. ' Protect all wails, windows, decks,-plants, shrubs,;etc.Pduring roof strip: . , Replace existing rubber membrane roof on house rear, replacing existing skylight with , new velux venting model.' ( $1600 and $950 respectively) Complete cleanup of area during and after procedure including all nails and cleaning of gutters. Obtaining of Town Permit. F 4 At a Total Cost of $7650 (Includes pricing for Rubber roof and Skylight) Payment schedule;50% at Project Start, balance upon completion: Respectfully Submitted, Oliver Kelly. y Proposal accepted by; �►`�%�Y� Date' ® / f� q /2015 If acceptable please sign and remit one copy to the address above, keeping a copy for Your records, this proposal is valid for 45 days from date above,.please call to verify thereafter. CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT DEPARTMENT,OF FIRE-RESCUE&EMERGENCY SERVICES 1875 Route 28•Centerville, MA 02632-3117 1926 508-790-2375 x1 • FAX: 508-790-2385 John M.Farrington,Chief Martin O'L.MacNeely, Fire Prevention Officer Craig E.Whiteley,Deputy Chief Michael G.Grossman,Fire Prevention Officer June 24,2010 TO: Tom Perry, Building Commissioner Building Department Town of Barnstable 200 Main.Street Hyannis, MA. 02601 In accordance with MGL 148, Section 28A, the Centerville-Osterville- Marstons Mills Fire/Rescue Department brings to your attention the following potential violation(s).of 780 CMR: Massachusetts State Building Code for your review and/or interpretation of same. NAME/BUSINESS: Residence ADDRESS: 13 JohnnyCak Roa"dCe to en it e' .V OBSERVANCE: Ladder being used as stairway between 1st floor.and basement. Inadequate primary egress from finished basement. Michael Grossman Fire Prevention Officer C.O.M.M. Fire District CC: Jeff Lauzon, Building Inspector "Commitment to Our Community" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Ma Parcel Permit# C� (.n p �s Health Division F 1 '/D y 7 Date Issued JD Conservation Division OBI Application Fee Tax Collector ' _ Permit Fee Treasurer L._� Planning Dept. M''STA►LLEC IN CON'i L@ANC'P VWTDate Definitive Plan Approved by Planning Board 'TBT�E 0 Esc��! into DENTAL CO "' Historic-OKH Preservation/Hyannis TOWN REO �7 E0 v."I Project Street Address �SDtwpY -C: Village Cs Y �Ji t,, �L r� t KO, Owner Ikk) 1 u Address Telephone Permit Request Square feet: 1st floor: existing• '� t_"1% sed 2nd floor: existing proposed Total new. U ,r Zoning District Flood Plain Groundwater Overlay Project Valuation c 15M Construction Type Lot Size ikf Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. , Dwelling Type: Single Family ' Two Family Cl Multi-Family(#units) �. Age of Existing Structure L4 4 Ut-8�g Historic House: ❑Yes '�I?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 -Z, new Half: existing new Number of Bedrooms: existing__ new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: A Gas ❑Oil Cl Electric ❑Other Central Air: ❑Yes ?Q 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 ;'N No If yes,site plan review# Current Use Q W EI L r�&7 Proposed Use. BUILDER INFORMATION Name.. ZvNN ILC_ Telephone Number oc ©. . 1 Address 06 (U License# AA C=_T c�� f �C - Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0�_5 r-��=('�f2AIL— lfll SIGNATURE DATE 1 "`1 - FOR OFFICIAL USE ONLY L PERMIT NO. _ DATE ISSUED MAP/PARCEL NO. _ ADDRESS VILLAGE ? OWNER + t � r DATE OF INSPECTION: M . . FOUNDATION FRAME INSULATION ` } FIREPLACE R t 'ELECTRICAL: ROUGH FINAL ,r ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING 1 DATE CLOSED OUT ` ASSOCIATION PLAN NO. - t � rnaii - ��" The Commonwealth of Massachusetts Department of Industrial Accidents F 600 Washington Street . Boston,Mass. 02111 Workers'Comensation Insurance Affidavit-General Businesses name: address city (, Aim f,�.G� state 1 c zip• 12 L(r� vhone# wok site location full address): I am a sole proprietor and have no one Business Type: 0 Retail Restaurant/Bar/Eating Establishment working in any capacity- ❑Office❑Sales(including Real Estate,Antos etc.) ❑I am an em to er with em l ees(full& art time). ❑Other % /%/%/%%�%%%/%%%%�%�//%/%/%��%�%%//// I am an employer providing-workers' compensation for my employees working on this job. company IIame: address: city: insurance.cb:- I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: company address: city:. phoiie#; insurance co. .='` lic":# : . company name: address cif-:.. `: .• • , ::,. ... vhone#c .. . .. - . - surencs so: `o7icv#: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby eWmain:s and penalties of perjury that the information provided above is true and correct Signature Date Z Print name Phone# ?1 0 offiOTC ial use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑Bu➢dmg Department check if immediate response is required ❑Licensing Board ' ❑ p q ❑Se]ectmen a Office ❑Health Department contact person: phone#; ❑Other (mired aegL 2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers'compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract .. of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity, or any two or more of j 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 section 25 also states that every state or local licensing age.^.cy 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the perrrit/license number which will 6e used as a reference number. The affidavits may be returned to the Department by mail qr FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents emm of lmsugamns 600 Washington Street Boston,Ma. 02111 fag#: (617)727-7749 phone#: (617) 7274900 ext.406 E►o Town of Barnstable Regulatory Services BO NSUBi Thomas F. Geiler,Director Building Division lfD Mp't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT - HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: ae)9 yr f 0 Estimated Cost Address of Work: �3 F14 ��`�ib% cero Ic�rL.VtLA-C' Owner's Name' Date of Application: ' 1 _ (D I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law []Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICA$LE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the a ent of the owner: —4ft—iL, Date Contractor Name Registration No. OR Date Owner's Name Tja CMR Agpa.Lh 1 Table d5.2.1b(c3nthaU4 fretted With Foull Fuel; p�-cerlptive P:ekjgd for 0-A,snd Twa'F=11y Rrsideatial EAizdtags M1M1mug Heating/Coeling h1AXtMUM Cxng Will Floor S:scrnca dc� Equipment EMci=cy' Gia�sg Arcs'VA) U-value R-value R-yaiue� R-Yalucs R�=c A y aluar Fa�85c 5701 tc 6500 Hesting Degrse Daya� Normal 6 0.40 38 13 I9 10 8 Nernst Q 1Z'/0 0.57 30 19 19 10 B E5 AFUE 0.50 38 13 19 10 NIA Norrual 15'/. 036 33 13 25 NIA 6 NOMW I3'/. 0.44 78 19 19 t0 15 AFM U 13 Z5 NIA N/A 15 AFVE 15% 0.44 31< 6 P 19 19 1Q Normal 1S'/. O.sZ 3Q NIA W ZS NIA 19% 0.3Z 33 I3 NIA No X rmal I91/4 0.42 3s 19 Z5 NIA 8 90 AFUE Y 19% 0.4Z 3s 13 19 10 ti g0.AFU1~ x 19 19 10 13% 0.50 30 1. ADDRESS OF PROPERTY: �- SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: (#3 DNIDED BY#2): 4, 9A GLAZING AREA 5, SELECT PACKAGE i;Q--AA-see chart above): O'1HERMORE IrNOLVED METHODS OF DETBP&JNVrJ ENERGY REQ�EMFNTS NOTE ARE AVAILABLE, ASK US FOR THIS INFORMATION, BUILDING INSPECTOR APPROVAL; N0; YES; q-forms-980303a RESIDENTIAL BUILDING PEMUT FEE APPLICATION FEE New Buildings,Additions $50.00 So Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE �_square feet x$96/sq.foot o x.0031= plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE ti 0 square feet x$64%sq.foot= 4 �%o0 x.0031= y�fn,L plus from below(if applicable) 23 `� � 4Z GARAGES(attached&detached)- square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming;Pool $25.00 Relocation/Moving $150,00 (plus above if applicable) Permit Fee 7 projcost i I I I i I WToOrJ �+►a �tc� -F �;��L,11��,. _(—1 _I _ 1 -L- - ! ILLr � 11J.5 i7 s2 �G I ( x �S6 0 I -Cow+;+ -CoN�%; Li � 4 1`LhLx �� — a t � _ i W i l I 1 t i , `OftME ram, Town of Barnstable , Regulatory Services Thomas F.Geiler,Director MAM • s�sivsreste, � f ,e$ Building Division lEDr� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ice: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: d — b — .JOB LOCATIOM. �� A tV Y (f- �Lc P��_.( Ulu\ E k)\ number n ' street village "HOMEOWNER": At, 1A1 ( l 1 name liome phone# w rk phone# CURRENT MAILING ADbRESS: `t _r fcfl y c © 2(-` '- 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-aparcel of land on which he/sbe 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•Buildhig Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under'the building permit.jSection 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.., mdnimum inspection procedures and requirements and that he/she will comply with said procedures and re !� Sigaa0e o wner . r 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. i oFt r Towit of Barnstable Regulatory Services " • awxxsrasLe. nnss. g Thomas.F. Geiler,Director 1639. °r Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax:. 5087790-6230 RE: 13 JOHNNY- CAKE RD CENTERVILLE .ry OUR RECORDS THE' FOLLOWING ELECTRICAL PERMITS DOES NOT HAVE A FINAL INSPECTION #75150 ELECTRICAL PERMIT EXPIRED FOR WIRING OF "THE KITCHEN, a. LIVING ROOM AREA b�PyOFTNET���n TOWN 1V O BAR NSTABLE 33MUST"LE, i 9 BUILDING INSPECTOR o ,. a• APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following llowing information: Location . 1.... �f.l!N�!.....4.N./{� .�a.�e.. ....�. ...... ..... ....................................................... ProposedUse ...5O...Q.. ......... z.:. ?...................................................................................................................................... ZoningDistrict ........................................................................Fire District .........,.................................................................... Name of Owner .��/.a?T..Q.j ............Address ... .......C, kt Y Name of Builder r..�. �.!.l J.' ..��...FA.7-. ..........Address ..Z. ....,:L.6.. ./►./..)i!..�t.....�.1.�..�<. ......,��v.f�d... Name of Architect Z o 11.�f. / �. �/V.. Address ...�3... ..� : l�lv�l!......C-A A.-........--F41 4.. Numberof Rooms ...... ...........................................................Foundation ..� d�✓ .......................................................... Exterior !r.. . ... ............................................... 4�Q.O.c� 1�....��%r.;il/ ................................. .............Roofing . ... �.�Z`... Floors ;rd�.�.W�.�.. Interior ., /-/./t(�-.�/V../..S`��-.�.................................. Heating AN .Ib' .................................................................Plumbing ... ..... Fireplace .../✓ .....L..................................................................Approximate Cost .. /-�..�b .................................................. Difinitive Plan Approved by Planning Board ________________________________19 Diagram of Lot and Building with Dimensions l00 N ,ems I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..��'ll•.� .......d�.�..`- . .............. Eaton, William L. i 12005 t No ................. Permit for .........Qoa.,..Shsd......... t ............................................................................... Location .....13..Johnr y Cake Road................ r :w. Centerville ............................................................................... I William L. Eaton r Owner .................................................................. Type of Construction frame 1 Plot ............................ Lot ................................ e � Permit Granted October 10 . 19 68 Date of Inspection Date Completed 1..............19 i PERMIT REFUSED i ................................................................ 19 ............................................................................... ................................................... ........................ i N ............................................................................... ............................................................................... , Approved ................................................ 19 g i r ............................................................................... QyoiTHE to�y TOWN OF BARNSTABLE Z BAflBSTADLE, i 9� o163 p BUILDING INSPECTOR s. APPLICATION FOR PERMIT TO �q� �e ' � TYPE OF CONSTRUCTION :..... .. ....... . . �. 4�. ....19..;7...a TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a. .permit according to the following information: Location .V.... ProposedUse ....................................................................... V ZoningDistrict ..................... .................................................Fire District .............................................................................. , Name of Owner I C..�.l.��•�1.,�.�,/... .... ..........Add ress�:.1 Nameof Builder .... . .....................................Address ......................... ...................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..` 42 ............................................Foundation 1�- _/...✓...................... Exterior .. ... .......................Roofing . Floors ..... .. .. .. .........................................................Interior ......G ............................... .. Heating .. '. �C� Plumbing e Fireplace ........ ...4 .....................................................Approximate Cost ... ..t:S ..Q...... Difinitive Plan Approved by Planning Board ___________ 19________ . Diagram of Lot and Bui i i �NFi,X$" ® - T IE PRO.p A F ,UP.P�Y __ a O � ` f ANI�ARAIN�� lS �k� AR ABLE, / 0 rtR© Qv NUT I � b <) �,taa i qb / 5� — -- --- --- — --_- ---- -- L 1 ® 01 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above i construction. Name .. .. i?11�Ci .... �� i/�- ............... Eaton, �hiliam tYAcP-r Cc-G)6 0P-0 3 119 7 No .....13.2Z0 Permit for .......4Ch1A9....s1n91.e. ................... ........................... 7W Location ........13..10.b mly...Qako...Road.............. .............. 7A .............................. Owner ..........V41liam Eaton ........................................................ 4.Z 71 Type of Construction ...............frame........................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .........August...11...........19 70 ............. .... Date of Inspection .........19 "7 Date Completed ....... ............19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ti ............................................................................... Approved ................................................. 19 ..........................I .................................................... ............................................................................... Assessor's' map_ant"lot number .... .... �......... THE t�1` r Sewage Permit, number .---27,-Q... ^ � �•':�• r� � • s Z BAHBSTADLE, i House number' ..,1.: ....;:!1�?. ......................... a SEPTIC SYSTEM MU o L!9• e� _ INSTALLED IN COMP a� " TOWN- A ;OF BARN-8 5 fit $=� TTITLE AL CODE AND T, Tdv' N*REGULATIONS RUILDIHG INSPECTOR APPLICATION FOR 'PERMIT TO .. :... N..l�?...L.. !S�/..C1. . .....OL.i).:Q.LL/./.1). ................ TYPE OF CONSTRUCTION .It CZ /.!:(fJ.ed a�'1 .. :.. .G?.� ............................ .... .......19Zz.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accordin to. the following information: Location ..4... ....... r..!i...< <. t C ... ... .... - ..................... Proposed Use ./,Q..e.C1. Y :. .. Q Th 0 d .........,.�......1.?'?.............. ...............................................................,............. ........ — r 2S1 /� Zoning District 4� �.. ./.:r.c..,/ ..Fire District Name of Owne(11i/. /.t��,:y......!.� ..i.!�.(:.�. .... Lf: ...Address °... ..1:. ...�..�. �'....<. Nameof Builder ...............................................................Address .................................................................................... Nameof Architect .....:.............................................................Address ........... ........................................................................ i Number of Rooms ...................................Foundation./ ).Q...l:...Ce—e. ,r.................................. Exterior :.1:.7.6.ir11).9. . ....................................................Roofing k5.P-)):G.1T...................................................... J r^ Floors ..........................................:....:...................Interior . Heating (�..C. $.-....�LCJ. ../CJL .... ..............................Plumbing ... f. .........V ?.7&......................................... Fireplace ... .............................................................................Approximate/Cost /.....0.(-}..Q................. ... • Definitive Plan Approved by Planning Board _______________________________19________. Area �`..Q .. .......... Diagram of Lot and Building with Dimensions Fee ........... .. SUBJECT TO APPROVAL OF BOARD OF HEALTH • � C�E�S�JL'C•�-•J`` O f �Uy o ' i . hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction: Name ................. EATONj WILLIAM & NANCY 23424 ADDITION No ................. Permit for .................................... Single Family Dwelling ...........;:.................................................................. Loc tio13 Johnny Cake Road ....................�n .. .......................................... Centerville .........................................................1........... William & Nancy •'Eaton Owner .................................................................. Type of Construction. ....Frame...................................... . ................................................................................. Plot .. Lot,.. .................;...... ............................ Permit Granted ...... ...19 81 Date off Inspection ....................................1.9 Date Completed ..... ..........I PERMIT REFUSED ..................................... .......................... '19 ............ ... ..................... .. .......... ................. ...................... ......................................... V, ....................................... ...................... Approved ,.;,.`.!. ....................... 19 ...............:............................................................... ................ ............................................................ Assessor's mpp aria lot number ' ......... .... ........................ gyp%TH E Sewage Permit number ti MAR3STADLE, i House number ..../3....../." ......................................... ...... qo PA & YpY. 0 U� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..................... .......TA... . ..... .................... TYPE OF CONSTRUCTION .,.��,i.r'1. .rc�. �.r ..... ?�... .C�.0 ........................................•.......................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location ,j... ?,.....�Q. ..G. ....C�,rl e....16n. f..<.rl.........t.-2Tc'...r.V...../ ................................... Proposed Use ` Zoning District ... ...............................Fire District �y.e .TQ ��.../.�.C''.-..' .•, ,!•P.., U•..1�.. : Name of Owne(-4.)/././4.q.,.... ?� ..!. . .✓...f:.�r1: ..? �.�.�►�. .Address Y.n?;'u—1...ra.a Name of Builder C r?:?....?�. 4..�`-�.. ........................ .Address .................... .... .............. .. ...............................:... Nameof Architect ..................:.......................................�.....:.Address ........ .::........................................................................ Number of Rooms ...... A ........................................................Foundation. .! / 0*.z.... /zo, ...................................... Exterior ��.1.r.J.�..I '> . Roofing 1.T...................................................... Floors .....�.�11.. ...................................................................4lnterior . 5 ?2 ?.1......l.o-C:.J ........................................... Heating (��..r.:S.'.... ..A;.L..........................'....... Plumbing ...j.... ..IS ;.......<..J .t!r..........!.........`...................... Fireplace ...J........................................................................:.:Approximate Cost .,.... ?.C?.. .............................................. Definitive Plan Approved by Planning Board -----------_----------°---------19--------. Area ......�..�< ........................ Diagram of Lot and Building with Dimensions Fee .. . ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH a � � r✓�F�s pnGGS t . Lail I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �� Cat�� r~ .:.. ..�.� �.. 1 _ 23424 ADDITION -----.. Permkfor ------------ � . � Siu le I�a�ilv , ll ' z� ------���-----.-~—���—..�znJ --. ' . , ^ ` Location l].. ..C��e.. d_____. _ � Centerville ------�-------------------- Owner ......VViIliaoz..�". ..II.�t��_.. .. .. — ���� ������`�....................... ` | Type Of Construction ---.����P��------ ' . � --------.-----------------' ` . .. Plot ' Lot ' ---------' ----------'' ( . - - ~ S _~ ^ Permit Granted. ' ~ � Date of 19 - , - 4 Date Completed � � ` � / . . PERMIT REFUSED ' --------.--|---------.. lA ' - ' ------.. .. /.^.----------.----- � . � ....................... ........................................................ . . ........ ~---.—....----------.— ' . ........................... Approved — --------------' lV / ^ ---------------^----^--^—~—' � -------.,--,--~----.----.---.- ` Certified Plot Plan in Centerville, MA. Prepared For Ran S. Hill Assessor's Map : 210 Parcel : 46 Baxter, Nye & Holmgren, Inc. Community Panel Number : 250001 0005 C Registered Professional F.I.R.M. Map Zone : C Engineers and land Surveyors Plan Reference : Plan .Book 126 Page 103 812 Main Street Deed Reference : Deed Book 11,562 Page 22 O , MA., 02655 Phone — (508) 428-91 lle9131 For — (508)-428-3750 Owner : Ryan S. Hill Job Number. 2003-091 Scale : 1" = 20' Date : 11/13/03 CB SEAL FND 64 O W Q 4 O 30 ac .30. '� a ® ` A 4• 30y A8 j?e A 8 8j LOT 52 . 4Y PLAN BOOK 126 PAGE 103 N/F VENTER 2yr 9, rye. 19.11 01) ?49, e F1'` -v CB SEAL FND 00 �N� � No '30we`4\ r8?. w000 OFCk 13s 34. � LOT 53 .h TOTAL PARCEL AREA 78 4' �'� LOT 54 9,102:k SQ. FT. PLAN BOOK 126 PAGE 103 0.21 f ACRES N/F OWEN N s� �0 S , 9 ,3 . 4 TO yF0 CO 1 NOTES: N/F PAKSTYS 781,>O, ZONING DISTRICT: RD-1 FRONT SETBACK: 30' SIDE & REAR SETBACKS: 10' FRONTAGE: 20' MINIMUM WIDTH: 125 OVERLAY DISTRICTS: RPOD: RESOURCE PROTECTION OVERLAY DISTRICT AP: AQUIFER PROTECTION I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE EXISTING STRUCTURES SHOWN HEREON ARE LOCATED IN RELATION TO THE MONUMENTS SHOWN t Of AND ARE NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA. ` THIS PLAN IS NOT TO BE RECORDED NOR IS IT TO BE USED, TO ESTABLISH PROPERTY-LINES. . i1b n/� PISTE � & _ fl - IDS- 'Loo3 � REG TEREO ROFESSIONAL LAND SURVEYOR DATE