The URL can be used to link to this page

Home My WebLink About0066 STONEY CLIFF ROAD Ir d yr ` T q. �, �w ww��t,.�...z t',an'.,t�q" Ye y.;f'C $ -��" � �,. .. � - •n•,.; 2'. � -,r "'•tr� - k ,�. �•� } �i'r' 6�.._:�`•'�,h',� '�..��,- 2 b. .:N, c. ,� �� : � u�b r ,'� .gyp. sY n yr, a � a tl �� •�,.. �� ^ • "S ' _ • a .Cry' :- tiv�-jZ4 .F `k'• rE� x._ - ' s r .24ry � ,sl;/.?1�' � - t6 } � -. 'C ?$, .r• �-} 'tyrf�, .� •,9y d„ i� ...� v�,� �' �` W. � fir_ �rtr i '-s,. _.,per c- .K l•�i u '- '� '- ti,-c _M t•y �,`r,,•.•c.-F ,n.Y mg - arc: •�. u' .. - w 41, A" Y � � � �.. �.,. �..Ay:�,, _ r , n G 9 -aEi-�' '�� .,E`•G�,.,m .. ..',y -''i'.`ca y o'�' ;t r!. H 5 � �y - v. • L yv3 f ,, .�,�x� , .': '.`�t...f •a, '- �,,r:, :. -, ,y}, Ed'� s: n '� �- a. .,a. �h R S' .. .s''�L `sh�" �� ; 'gym ��"� �•�" 'La � � Q .. - - h "� ,•a- � 'ram n -.er� x-q",pµ � g yp�-{'�''� _, , .. , g� ''�- �� .. -. .. •e, v 1r �,� r s�is�� L[j. +9 1"v �' 1 .:fc. � n a PA q,�• � .. � - y rip « •3 ,y5-„ vk7 .r .,�v- fill �" .3 .�,.�• •q phi , �w ti tr� ;�':r j€,r, n 9$F'c+ 'x:; i �� :nn�,� „ at"" u• '�+d: �.�. Vie.::» •.. �„�,s "^�.. ., �.. . ,, a,,, a q;.:.g�y 3.�.�;€`� .y..��4 �:`.� ,,.s� ' '•d>n ,a s4, - �' � '4 ,�'y x ',.�� .. 'µ '�a:ti y.a• -t: �� 'ST ,.t°-; 4� .'•' -P P, _�:� ''ir;, �-s� i `n n�q <. � �:�' .. . v r,-. s_w.A y R'-+;.. ,y.:'n°`''u.:..,r �^' '�1.E w.,}.}+ e•:y 't p., _. �^,� • n § ry=.. p a� x c �,_ •aS' �.• .•. ..:;}� :if,�•x`r.''�&r`�.::T�`:. �'.. a-sv� _ {�sc 'h.'�,. .. .. tv ,��, � �'�;,p ^ 7.4 Ys'•i_wP `�.[ �" :+�, ¢6'�F�• ,p , k +,r ei y� r.. e� w an...,e. '..:,, �.. i•-=v ,atpt G .;;� ''�: .,. 9' -.� .� .x •�,. p .�_9 .�.� `1',. k � �, ,'�l ,;a ✓_ •fy.�,;..- *.;' 4 w'7., 'Q,zx::` °' -;+T`e,`,;, �3°s."'�•. p� ,� _.� •�,�Ye' r M 9', p _- �•s L s` '..i.. ,.. N� a ,�, �.. cA 6 t1 _��.#�a.ifv._-$r?H.. ^�• s aa�� ,x�.. B�E�av �.��o.sF si�.n ❑� t U � - .r - � � .. k ' ��.. �� y q?v;Yl�-: �•r otr.: .a �'� a'��i a ;off. ��r� � ��' � � ° E, .. �•. J c. . N Or : ' c ,5i•. '. H4 . 'v„t•3, ..,n, t "a6 a e !kt�.. s p,. "' _ X!, .+x,..T s ,ty .Y - o a' ,_ P .;.. a x .r, ta'n ',��' ate. y �.•n. ,�1. � It:<. ,�,� t4 '�, `�' ._,,��. a ".,�,...S» .,. ..^ ..y i;•R�t• ...., r 4�..� ;. :.. u.:. • ,.y, 'q. .�-a'y _ �' - �$t - - ,rY' S��.r s , . deg,;o SzPr��3 ;: ;��..; a t,'� ��;''' '.�I; f e' .. •£�. :sj� �r - - y ��..�' - ., ., G ,.. �'. ;4�" .::.�, ,. �.: ,.� .. k.} .. �.t .. �}n. ....i_ ,`R .w d:w A "•�•-d� ,}:. .. I siYi ,Y M'�:•.I'... xi�, a .4'g� ��.h., � :•yi ��,. a''�xa,. ;�n�� z dr�.il.�>. . •o � .. __ ,. „s -• _. '.� .. ,. cst-s, � .s}x.4 :..e,� A v a � [n. �x,. a� tad* 4� �•� �. s� e s, - %fie •G- _ .9 Y e. q. !' q ti ` .� � q..... •.�,` i x%.' ��p Alt .�' � ,'� F' ��M `;�,.F .w',. .1, �.. •��S . ..i-�� q.'v*. $ y � ��U _:� �,-�E. ' ,w-„ �'' ? •r�?_*i+�yy.a: i< �,.ak a r "; ,:d. � �.a. a• 'f rt �• r'.°� a .a yP � 'N',. �.sr1 w,. �. .° @>•47, ._' f{F:;^ *.. r v '.� p 'Y ,,. { n g ":.A r _ 3 n �� r�� :. _ - .. ,.. . i :. .. u �. t _ . .. � _ ,. � ,, � ,� _ - ti _, � . _ � - . _ �. ;. . �_ , _ �.. ., ,.� �� d ,� _ �- ;> • _ .: ,. . . .. �, �,�. � , .. ..,< e _. .. _ .. _ , - ,„ p _ _ � _ ,. _ � a : �- � r. ,; ._ �. i x• .� ., _, .0 ..w �. u w ... - � � �- ' i .. .� �� r. ., ., �:-- �- � � - - - a ',�-� - y { � C p Y ' G S r . � .n y, .. 4 t� Y n .. e i� t - C f .. .. t � '4 .... t � '._- . � � ... i t .. 1 � .. *I' � _ :r: `c ,. w r c •, r _ . R ., r �. � N n . r� t' ., x:r .. qv. .,.. � L r *,. .=, F,a _ ,y. - � � °- � .+ :, ,. ., a _ ,. ,.r ti � , . . ,. �. � �. �- w _ .• y� ., ., '. 4 „' . } ,y . > ,� ;.. �> ._ ._ _ _ -. � � _ .. � 7 ., _ , _ . C � .. r �: _c +�� . r .:. . ,, � y � i ,. � � �. ... � ., n. � � - e' s i e:. ,. e. . „n. .'R "ie.' I. .. -t, - -..! r � .� r c ;. .:. .. .. a ,i t' a �.. �. ,� - !i -_. .3 < s ." ..q„ 's o- 'y -„ -� ,. _ a ry .-.. � :. � - r � - r . � �. ti � - -mot , :. •' �- �., .< . ,: � ..- � ,. �,. ,. _, -'t:: `k. .;. ,. c . `.'eta ,.� �' , �. . _ _ .. .. a .� ' 4 c � � �b L j .. ' i. 1! , ` .�. �. - _ ,� t �. - a ' Y �., Town of Barnstable 3r� Building. Post This Card-So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MASS Posted Until Final Inspection Has Been Made. � eri111t Wherera Certificate of Occupancy is Required,such Building hall Not be Occupied until a Final Inspection has been made. Permit No. B-19-2588 Applicant Name: . Matthew Russell Approvals Date Issued: 09/13/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/13/2020 Foundation: Location: 66 STONEY CLIFF ROAD,CENTERVILLE Map/Lot: '190-042 Zoning District: RC Sheathing: Owner on Record: DYER,THOMAS F&'BRIDGET Contractor Name: Matthew Russell Framing: 1 Address: 66 STONEY CLIFF RD Contractor License 195309 2 CENTERVILLE,MA 02632 Est. Project Cost: $6,770.00 Chimney: Description: Insulation;see contract - Permit Fee: $85.00 . n' Insulation: Project Review Req: <' Fee Paid: $85.00 bate: 9/13/2019 Final: f` Lds��crn Plumbing/Gas Rough Plumbing: Building Official � Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six monthsnafter issuance. All work authorized by this permit shall conform to the approved application and the tapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the 'Final Gas: work until the completion of the same. rv� Electrical The Certificate of Occupancy will not be issued until all applicable signatures by1he Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:1',` Service: 1.foundation or Footing 2.Sheathing Inspection " Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 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 C�)o �oFr►u row Town of Barnstable *Permit# 2 RegulatoiY Services LFeee rr�/ jrtw�isOerlgre g,ARVSrABLE, OAS. . Thomas F. Geiler, Director Building DivisionCie) 1�a Tom Perry, CBO,. Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax:_508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nnl Valid rPiliroal Red X-Press Inrprinl Map/parcelNunber Property Address Ir Residential Value of Work �;�; Minimum fee ofS35,00 for Work under$6000.00 Owner's Name & Address 17 eo,,,,a �� 4A // GL� Contractor's Narne ,N,�� Telephone Number Home Improvement Contractor License #(if applicable)�� 'ZCyo �}`3L!♦ J Construction Supervisor's License#(ifapplicable) 2L/`? 6, PWorkman's Compensation Insurance M S , MI Check one: ❑ I am a sole proprietor NOV ❑ I am the Homeowner. 0 I have Worker's Compensation Insurance TOWN OF BARNSTABL Insurance Company Name Workman's Cornp. Policy# 4,063627 /.2r 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 1 P-W--t � C ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of root) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Valu #of doors e (maximum .35)# of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations, i:e. Ftistoric,Conservation,etc. ***,Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors.Lice required. rise & Construction Supervisors License is SIGNATURE: Q:TWPrILESTPORMSTbailding permit forinSTXPRESS.doC " Revised 072110 They Cam7norrivealtll of!'klrnssachusetts. --r-- ---- Departlrmerzt of 1'rldzrstrial.4cciderzts Office oflrrvestigntior-is. 600 Wasltarlgto7r Street B,ostorr, M4 02111 31•':ii,m rnass g0v1dh7 'Workers' Compeusabou Insar-ince-A ffi:da-,,-it:'Builder:s/Cr)nti-actors/El:ectriciins/Plumbers Applicant Information Please hint Legibh' Nance (Birsines&rOrgacuzotionrindividrral). aW10-1w Xy Ad&e-s°s: 8 City/state/zip:k/.k /f' ; 11;Z-17 Rhorie 4:�p�—a►cj,s' �S'?�S Z Are you an employer?Cliecic the 1ppropriate boa.; Type of project(required): et3): I...k I rim a employer with dA14 - `l. ❑ I am a general contractor and I ' * Have hired the sub-contractors 6 ❑Netu c:onstnrctiou erz�ployees(full and/or part-time). - .2..❑ f am a sole proprietor or partner- listed on.the attached sheet_ .,7. 0`Remodeling slup-and have no employees These gib-contractors have 8. O,Demolition working :far the in any capacity. employees and have workers' [No workers' comp.insairarice comp-insurance..1 9: 0.Building adii tiou required.] 5- 0 We are.a corporation and its 10.0 Electricalrepairs or additions 3.❑ .1 am a.homeowner doing.all work afficers have exercised their 11.0 Plumbing repairs or additions rmyself. [No ivorkers'comp. right of exemption per NMGL 12.&rRoof repairs insurance required.] T c. 152, §1(4), and we have no employees. o workers' 13.0 Other comp.:insurance required-] #Any applicant that checks box#1.must also fill out the section belour shriving their workers'conapelasa:tion policy inforiwiiarL Y Homeowners who submit this.affidavit indkatiug they are doing all worst and then Hire autsidc•contrucinrs must submit.a uew affidavit indicating such- !Cawractors that check this:box inirst sttacbed an additional:sheet showing the:nim<e oithe sub-contracmrs su.d state whether or not those entities have employees. Ifthe Rib-c.ontractorshave employees,they.must provide their workers'comp.polio number. I a1n nn eN►plotrlr that is pronid rrg ilro k�rs'conrpPrrsalYan icrsrrrrirrce for lir) erirpla�e es. BelotT is the policy an.d job city informal o7L Insurance Company Name: e0_`1 ��r.e�•s� -�•�..,<,cb *�� ,�� /9,�v�o�, .�wi Policy#or.Self-ins.Lc.#: re36 7 zDdz e E:xpiration Date: Al/q Jots Site Address- �u_ CL, QP� City/StAteZ�D.-��-1�1��4� :lbtacla a copy of th e ii of leers' compensation policy declaration page(shooing the policy number and expiration:iia.te). Failure to secure coverage as required under Sectiou.25A of MGL c.. 152 can lead to the imposition of er.iizsinal pamilties of a fine up to$1.,500.00 and/or one-year imprisonment,as well as civil penalties in the fortis of a STOP WORK ORDER and a fine of up to$250-00 a clay against the violator. Be advised that a cop),of this gtatemmeut may be-forwarded to the Office of Investigations of the D.IA for insurance coverage verification. I do 1 omkv certify under tho pains and penalfi'es nfperywy that the hl fortini io'-n proiRded above is true and correct.. Signature' &-n,t,�C� �, Date Phone#: c 5,zr— 2t�/S' c577 5Z L Li.Bo.xrd nse a►tly• Do not tirite tat flris.rrrea,to be completed by cifti or tora�ir:ociai Town: Permit/License# A u th Dli ty(cdi-cle o ne) of Health 2.Building Department 3. C1ty/I"o-%im Clerk d:Electrical Inspector 5.Plumbing Inspector • wi Person: Phone#. '' �p THE rp� y � r w BARNSTABLE, i6Sq Town of Barnstable • �� rFD MAC p Regulatory Services Thomas F. Geiler, Director Building Division . Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 509-862-4038 Fax: 509-790-6230 Property-Owner Must Complete. and Sign This-S`ectiori If•UJ ing A Builder -- I, - *DyEfzt. � _ as Owner of the subject property- hereby authorize i�krG i -� / to act on my behalf, in all matters relative to work authorized by this building permit application for: , EY dL ffJr, ap, �EfI-:-QV II-4 (Address`of Job) 9 tl Signature,of Owner ate 7-TIRVI - Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption.Form on the reverse side. Q;\WHILESIFORMSIbuilding permit forms\EXPRESS.doc Revi.cPfl072110 :r+ , P�0 HE Town of Barnstable Regulatory Services " g�jiSSS. /HA . Geiler, Director toss. $ , a° ,vAN ing Divisio uilding Co missioner t, Hya is, MA 02601 n.ba stable.ma.us Office: 518-862-4038Fax: 508-790-6230 LICENSE EXEMPTIONease PrintDATE: /`JOB LOCATION:_ 11 �p � numb street village .�0 o p/ "HOMEOWNER" �i6 U'1�}'g §'C)+,Ne 7, O _l�t�! name ��ll home phone# work phone# CURRENT MAILNG ADDRESS: Vn . e i own state zip code The current exemption for"hom owners" extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an indi dual for hire does not possess a license, provided that the owner acts as supervisor. EFINIT/ON OF FIOMEOWNER Person(s) who owns a par of land on which he/she ides or intends to reside, on which there is, or is intended to be, a one or two- family dwelling,attached o detached structures accessory such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowne Such "homeowner"shall submit.to the Building Official on a form acceptable to the Buildin Official, that he/she shall be res onsible all such work performed under the building permit. (Section 109.1.1) The undersigned"ho eowner"assumes responsibility for compliance with the to Building Code and other applicable codes, bylaws, rules and re tlations. The undersigned" omeowner"certifies that he/she understands the Town of Barnstable Building Department'minimum inspection procedures and re uirements and that he/she will comply with said procedures and requirements, a Pco Signature of Homeo ner Approval of BuilVThreamily Note: dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section.127.0ontrol. HOMEOWNER'S EXEMPTION The Code stales 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 oflen 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(lie 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 I amend and acopt such a form/certification for use in your community. Q",WPFILESIFORMSIbuilding permit formslEXPRESS.doc Revised 072110 • r "Massachusetts- De'liartment of Public Safety Board of Building;Rel,Tulations and Standards Construction.Supervisor License License: CS'.24720 " Resfricted,to 00 s • , D0NAL��*KAHRMAN is t 87 BLACKMORfPOND RD { P W WAREHAM; MA 02576 !=z�� Expiration: 1 211 5/201 1, Coniniissioncr' 'a - Tr#: 10190. Offi e ofiner Cons� i fr.rs I _ l HOME IMPROVEMENT CONTRAell GTC;R' Registrations 19802 y 1 Expiration 8/31/2011 ' TYPe;` fhdividual Tr# 28717 •DONALD A Kq`F{�Rif/IAN�� w f DONALD KAHRMA'N ' ' { 87 BLACKMORE{PD RD ' 1� ,a WARHAM, MA�02576 Y/%f e r UndCrsecret:Iiy Massachusetts- Deliartmcnt of Public Safety ' Board of Building Rc<=ulati G Constr'iiction S ' �' ons and StandArds upervisor..License License: CS 24720 ` Restricted to: 00 r e.. bONALGf , s A.KAHRMAN . - BLACKMORE FOND RD WWWMEHAUi MA`Q576 Expiration: 42/15/2011 Commis§ionet d z. r#: 10190- � DATE"M/DD/YYY) CERTIFICATE OF LIABILITY INSURANCE 10/19/2010 THISCERTIFICATE 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 G H'Dunn Insurance Agency Inc NAME: PHONE FAX 2201 Cranberry Highway � (A/C. No. Ext): -(A/C. No ') _ . E-NAIL PO Box'"9 9 ADDRESS: PRODUCER • _ ..._ .. .. West,,Wareham, MA 02576, CUSTOMER IDM. . INSUREDS) AFFORDING COVERAGE "'' 'NAIL y INSURED INSURER A, A.I.M. Mutual Insurance Co Donald Kahrman INSURER B: 87 Blackmore Pond Rd INSURER C: West Wareham, MA 02576 INSURER D: INSURER E: INSURER P. 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. POLICY NUMBER POLICY EFF POLICY EXP - LIMITS ucr TYPE OF INSURANCE (M/DD/YYYY) IRx/nn/xzzz) GENERAL LIABILITY EACH OCCURANCE $ ❑COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ ❑❑CLAIMS MADE ❑OCCUR PREMISES(Ea.occurrence) MED EXP (Any one Person) $ F] PERSONAL R ADV INJURY $ F] GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES ER: PRODUCTS - COMP/OP AGG $ ,❑POLICY ❑PROJECT ❑LOC ' AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT r. ,; "- w __ (ea accident) ..$ ❑ANY AUTO.nw _ .. .. - BODILY INJURY (Per Person) $'� �- -1 El .ALL OWNED AUTOS '" . v a e ... ... ._...... ..... _ _ .. Y �, ,. ,_ __ ... ....___ d SCHEDULED AUTOS- BODILY INJUR (per dent) _ $�(-.,RJ ❑ PROPERTY DAMAGE cl _... $ _.. ❑HIRED AUTOS 1 A - .+ (Per acciaeatl .. ❑NON-OWNID AUTOS _ _•. . __ _. .. $t El ❑UMERELLA LIAR ❑ OCCUR EACH OCCURRENCE uuR Sa.o "Q ❑EXCESS LI- ❑ CLAIMS MADE AGGREGATE A $ ❑DEDUCTIBLE ❑RETENTION $ WORKERS COMPENSATION ® we rATu- y ore- } AND EMPLOYEES LIABILITY Toax Lxxxxe ER THE PROPRIETOR/PARTNERS/ E.L. EACH ACCIDENT $ 100,000 A EXECUTIVE OFFICERS AREY - incl ® excl 6003677012010 02/22/2010 02/22/2011 E.L. DISEASE - EA EMPLOYEE $ a 500,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 COMMENTS DESCRIPTION OF OPERATIONS OR LOCATIONS: - DONALD KAHRMAN IS NOT COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE BUILDING DEFT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE _ POLICY PROVISIONS. 200 MAIN STREET HYANNIS, MA 02601 AUTHORIZED REPRESENTATIVE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION' Map Parcel Permit# Health Division Date Issued Conservation Division Fees Tax Collector Treasurer lal Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address aZ-t F F- )2J , Village 6�.i L/Itt-E Owner lam 4 /0 /'3 .1DYe;�e_ Address _5)WA4,C,-_y' c°G-i�f= Telephone Permit Request �}A _C� kAn�A�- 'E.O. a Square feet: 1 st floor:existing « roposed 2nd floor:existing proposed Total new Estimated Project Cost �� Zoning District -Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Q___' Two Family ❑ Multi-Family(#units) Age of Existing Structure I Sq Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: Q' ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) -'500 Number of Baths: Full: existing ' r new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 15 new First Floor Room Count 5 Heat Type and Fuel: 26as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:O existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes E o If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 4>li�r/ �iGJ — Telephone Number 1-900'— Address G K11 License# /�Gd�" 454q Wm?F Home Improvement Contractor# W Worker's Compensation# wd 3 o 25 4/. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO aLof, SIGNATUR DATE FOR OFFICIAL USE ONLY PERMIT NO. . 'r DATE ISSUED MAP/PARCEL NO. i ti ADDRESS VILLAGE E r OWNERI • ' �� ` , , oil DATE OF INSPECTIO FOUNDATION ? FRAME ` E = INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL } , GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT f s ASSOCIATION PLAN NO. ` r =__x• Department of Industrial Accidents = == OfBcE afJJW8Stfgalf0A7S 600 Washington Street M. Boston,Mass. 02111 Workers' Com isation Insurance davit a -j .V,o--MM a4 P °d. f name: location: Vz� city �tw� 7 I am a homeowner performing all work mysei£ 71 I am a sole proprietor and have no one woridnz in anv ac //%//%%/%/O%%/%////%I/////D/////////O// l'��i� // //%//,r/%//%///%i �/ / ir ////O/ �Z�r//✓/. .. � "�//�%%/!%///O//%d//////,;;: ensarion for my emplo9ees working on this job. :::: .:::. :::. ::,... .. ..... .:::;.. I vrorkusy am.an employer providing. :.::.:::?::::::COS?:::.......:....:.:::::::::::- ..,.::::. :;:»::<: » n vn a to . addre ss, :: ,.....:.: .: .....: _...: ape city insurance co. ��/��ii/ below who I am a sole proprietor,general contractor, r homeowner circle one)and have hired the contractors listed workers nap ........ . ..... the following .............:.:.�::..._.::. . :..;:.::::....:.�..: n ... .....k•>:.:>:;::;::::�:::;:•;;:;::•;:•:,:.?.,.::.::;:Y::;'?:::?!!.'.:::•.`:`:`::•`::;`:>:;:::;:s;:::5 ti:�:::::>k:::<:;::?:>x;;:fi•;>ar;:�>'isy:•::.;:;<:::':r';s:-�;;;;;:.;:. . .::.:...... ?' :...:...:: eddre _:.::::::::. .... .. .... ....... „...DO .... ..:....:..::::::?v:.:.......::�:.�::::.:v.vx;v:::::::::::.iii:� +...;:.... ;;:•..�.::n. .:.:•T.•i}i:•}ii:•. :. :?•.... .. ... ...�.iii:...:...............�:. ::. ........... ......................:::..... '.�:•.:iiiii:iiiiii�iiii:::ti'ii::S::i'::n:..:.' :n..::::::;v.;. •::::};: :nv::?'.^};?.:. 1. " ` insurance ca ►�"':�,'s$M0 ><:w:....... 0111 comr2nv .......::. :::...::::.�::...... ..�:::::::,..:..:.........:::.....::..:.....,.... ............................ ....._.�.,�..;:.; ::..:..........::••.. _: ....::.._............... dress' :: .......:.. i:•isi::�ii:•iiii:r:;i.':y:j$>:i?ri;::4:.;:j>i::: . ..,,. ..... .............. .. '..:� ::: ..:..::::::.::::�}:::::::::;;:::?�i:�i:Jii�4:{w:nwi::::::::::..................a.:.»••-.:.vi:•i}:i'ri}?iiiiiii:j.:....••.,., .#....�:::::.�:?.. insDrance Co. m<der Section 25A of MGL 152 can lead to the imposition of c imtoal penalties of a Sae I to S1r,Kouo and/or Failure to secure coverage as req�sd that s one Y can'imprisonment as well as civa penalties in the form of a STOP WOE ORDER pad CBnee�tiob00 a day a;mast tne. I tmderstatd copy of this statement may be foctnrded to the office of Investigations of the DIA for covers[ 1 do here certi der e p ens that the information provided above is trtr mid corned ate � � �Z0 � nt name o lgcial use only do not write in this area to be completed by city or town ofHcisl perndi icense it ❑Btdtdlnt Department city or town: ❑Licensing Board ❑Selectmen's offte ' ❑ check if immediate response is required C3]ladth Department a — ❑Othee---- phone contact person: ,.t-vuea 9;9 5 F;A i • - . :1.:1 . . :• • .1• ... 1 t �I.el• . :a . . . . - . �l •I•II•�1• .1I •1• . •- :Mitt . . . Y• . el•. II 1 % . / .i1.11�. 1 N t!• •. /1 a . 1. .i1 U.:.1 .1. a • title 0 4. i-11 • / / •- • 1�• I It . 61 .t• • • •1.• :/t • • • • 11 LI.1 . .1•• 1 . 11 • U •K • ti•1✓..e . .:.�ti i• wH/. . el 11 be . .• II a ..:./ • 1. •« ... ill woo 3.•1.1 v.I I!LLD I • .tell• • ip rer"t- to • - .• •• 1 II • 1 • I• • okiss • . r .I•:•t1I. .1.. • flea .+Y • �. 11 .+ ti•1 pas-1 II • 11. .111 • •1 • • t 11 • I. /• • • I• il•/1• • r�.l el• • •feD 10-i 11 1 e 1 M• •11 .1 qbq-.e.it •' •I.. ell I 1 I • t 1. • Polb •1 •11 11 ••.. • • /• tobel a I difoki§1 II v,1 • 1 k I Igg. •14•1 wW. • 0.11 e a11111 • I.-#I e . -.n/l �# 1• • .11 ../11• e •�/ • . i1 a •11 • Y.11w 11 .1 1 1 / V I I ' ' :�1 1 ( 1 1 1 1 1 1 1 Y' 1 . . { 1 • 11 1 1 1 • 1 1 1 1 YI 1 . I Y I II 1 1 J. 1 el 1 11 11 1 1 1 1 1 1 1 I 1 1 • . e I 1 1 1 1 1 1 11 • 1 1 1 1 1 I Y- 1 :.1 11 �/ • 1 le •11 I • I �//.ti Ie ' is// ..•I• �': I 1• .11 a Il .• 1• 1✓, 1 •. • Y ell 1 �./IIti 1111• .11 • 1+•111. « le .1 •�/ 1.1.11 .11 •I • 1 • ••el.. •Y. • - - •:.1• •1 Y•1/.1. .11 ,'Plot II 11 1164r.I• Y �. 111 ..•1�11•. •I 111 MI a Iti 1 •�•-•1 I .+•11-. • II Y•I.1■ jajjj��jjjjjjj��jj/��jjjj///j��/j��j��j��j�j��/��j�j��jjj�� • 1 .1 • •• "'/ •'•I1/1•-o `..I■ 911 .. e 1 Y•I/11 If'-*11 I 6 10.1011111 It.1. • 1• a 11 YI•I .1• •11 .t.r •• •• •It11•• • I .111 • . • �'/. ./1 • I •1 11 11 .t1 Y I ■. . Il .1 e ••/ 1• �• • •1 , :•/ e11�.11 •1 1 111 •. « .well 1.1 .'•111U.•l .1• •II el 11 1.•:1/ r 1'• •wr •/ 1 1 II 11 Y :41 • 1 • . MITT.... I 1 ( / • 1Its r -?s&1v of�*rAcolk11 MI • el /. •' t /I .1 t1 .11 . KI• •11 1.1 11 1.A.1111 el Yw. • -•. • �. M �• 1 1 11 I - • .1 eM1 �.11 •I 1 .11 .• . « .wHw YI e 1 . • 1 1 . .11 . 1 ..� . •11 :.•Y.. U11 I/ - e1 �• �• FAVO t /1 I •+.✓•1 .11 .•.0 J /1 IU111I.•.1 1-6 e • j/jjjjj/jj��/��j��j�j��jjj��jjjjjj�jjj��jj� I 1 1 • I .1 .1 1• Y•11111 �. .1 ��}1 ./ . I off e .111/�. ��.•1 • 1 �• .1 .11 tilt 1 II . 1 . �. • Y .1 /1 . . • •1.• • n• •y • • .II • 11 It 11 ..•1 1. , .e • 1 1 1 •I:1■ •Il • 1• Y.111 Y. M • e 1 If..•Y.1 loll1 • 11 .11 . •••111 �• • • igloos •1 ..H.I111 V.wl 11111. .�•1 ' 1 1 I • �• .•1�. �'. •' .11111 ... I/ .1.• I Il 11 . •1�•e�• •/ , • .••:/•1 e ' II .I 111 • 11�1 .1• .11 • ..•1..+IIw I . ��•/ 11✓. . • i� • 1 � • %;1• •1. '• 1 • e II .t1 • 1 / I • .11 v •1 • 1 •• •� .le •11 .11. 1 • 1 • • 1 .11 • 1:� ..• SEEN E///�jjjj/jj/j/jjjjj��/j��jjjjjjjjjjjjjjjjjj�j��j��j��j�j��jjj�j/��jj • ..•:/.I •• .� r • 1 •11 m a K•. I111.1 •Li 1 ' . . •11 ' 1 I AM. • I I I 1 M ' 1 1 1 i t 1 1 I 1 . 1 1 1 1 1 ' III .• I I I I 1 TMe r� The. Town of Barnstable � �a Department of Health Safety. and Environmental Services- �059. � Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date y ®� AFFIDAVIT HOME IWROVEMENT 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: �e ; Alf i1.®vxe _ Estimated Cost 5 Address of Work: l(�V CWe,�� '" (�( 32 Owner's Name: "- Date of Application. 7-0 - 0 0 I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied - 00wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IIVWROVEMENT 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 agent of the owner. Date Contractor Name Registration No. O Date wner's Name g1orms:Affidav The Town. of -Barnstable F1HE r Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 uuss. 9 i639. Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: ?rO OC1 Q �y JOB LOCATION: CO ,q/F-y 6L4_�� number - street village "HOMEOWNER": �&M q7Vo /�i�/Q �y�'� � •�� 5�6 name home phone# work phone# CURRENT MAILING ADDRESS: �S ��_��0 ` lob S�iroY 3 a 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-toAhe,Building Official-on.a form acceptable to the Building Official,that he/she slia ff be responsible-foi all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes;bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said proceAum an uirements. Sign LHomeowneP 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN Assessor's map and lot umber ..L.../.. ....................... 4 SEPTIC SYSTEM MUST BE INSTALL ED IN COIMPLIANCE Sewage Permit number ...........rf °.................................... WITH A',TICLE I! STATE SANITARY CODE AND TONKI,-f 1Er TOWN OF B -IR-NIS°TTABLE i DAR3 ABLE, i 0�9�. BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......�....... ....�/............................. . 1 I ...................................... TYPEOF CONSTRUCTION ........... .... .. ............................................................................................................ ...:..........19. � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby, applies for a permit according to the following information: -� v Location ......... ..................................................... .................... ........................................................... ProposedUse .................................................................................. Zoning District, Fire District ........ Nameof Owner ........................ ...........................................Address .....................................................................,............... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Room ...... .......................................................Foundation ....... ....................................:............................. Exierior ... ..............................Roofing ......... ...... ...................... ................1............... ................................................................Interior .........Floors ..................... ...t../..��...'. . I ................................. Heating ,j.. ....................................Plumbing /-...:.......................... ...... ..... .......................................... Fireplace G,,�'.i .. ............ ...............................................Approximate Cost .........G� .�.�... ...................................... Definitive Plan Approved by Planning Board ---------------____-----------19________ . Area .../J....LiZ....�1................ Diagram of Lot and Building with Dimensions Fee ... ?.�F..V...V...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arding the above construction. Name .................................................................................. � Alan Small ` | No -1828.9— Permit for — ............... } Location | —~~—~ .... ----- | Centerville ----^^---------------'~----'' � Owner --'f�lan'.Sma-1l.................................... � Type of Construction ----..�Jms°&'�Fr-sme—'' \ | ^ -------------------------- Plot 1.90.------.. Lot __. ........... / � } Permit G,on/a6 6. 76 / Dote of Inspection ( -' . / Date Completed ----.lA } / ( ^�'\ PERMIT REFUSED ^ -----_—.------------_.. 19 � / . ' ! � / --------..--.----.----------. ` ` / . ----'~—'—',^------------------ \ �^ \ '`^—'^'---'—~~-----..,.—.....---.,— � . . , \ ._____,_.^_.____,____________. ' � . . � � � Approved ................................................ 19 � ' -------''-----------`—^—^'^--'' -------~---^---------'---'-- ^ ! 4S " d4 t ' Sa , l u 15,o2.S SF / 3/ x I Q � y 6 �a 4,1 MN OF RICHARt7 �� C EtZTI Fi C�� -ROTS A. r So' 31I 61-ho / c'E Tim y T;L/A r Lc r tv"nv r'N aviuG L.�.v.5 a � TUwl,) 94,e )vw,e zx-s �c.,r►�: �+c. 272 � 50 .U.4 TE 3 /8 7( �t\X VEL loc Gt�>' zG,(. l.Av� �,z✓ SSG► 4 .�/ST�'�� l.,q,c.�.� ..Sc��✓�-�c�� o�T��.✓t pus p n�f,� �5 t�ETIT10