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Home My WebLink About0013 VALLEY AVENUE t P , f J•� }`7i t �r x x., rL''}t f; iy iq9'' �,;j �, , s: a:� . .;)'_ r .. r ,.. > � •.'ex f, '-:{' :.c ` '. '.t• •s nt. M 'k. as +.,r, i �. 4i. .Nr yY�'�. ' - �f .!.:.:••.A.,:. t., ,;.i '.,:. . r, , _.A � ..a. }.'.rk .'; �� lV� 5,, r{": i•L +°2,: bn `A P FN .S:`, ;y 77 ,, Nk z .+ r r a y. x x, a, ry + r •' , r e : Y F r ° • r , d c • el P t Town, of Barnstable *Permit# Regulatory Services fee 6 monthsjrom issue date Richard V.Scali,Director ., r I i639. . Building Division DEC . � DE 1 fly' Paul Roma,Building Commissioge �' �� 200 Main Street,Hyannis,MA 02"o i Ilk www.town.bamstable.ma.us 508-862-4038 f! fL'b'Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Prope Address v4ftgy A V EV\U e I A Residential Value of Work$ zt e Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address AKIM IVY 1r. G'nA AS OA 13 VAu-e� A-J9� -VMkJ`U4;r V� Contractor's Name__ �;,,oV�s\7 vIAAS-'� Y Telephone Number 5'08 p4Z3- AZ� Home Improvement Contractor License#(if applicable) C 1 Email: ! A Pw A 5- — ZO N,Mt-T— Construction Supervisor's License#(if applicable). 0 56 776 ❑Workman's Co ensation Insurance Che ne: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Reque check box) , Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to S4P Dw ►G" RIj� of(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 ome improvement Contractors License&Construction Supervisors License is require SIGNATURE: Q:\WPFILES\FO mg permit forms\EXPRESS.doc 06/20/16 { k 0. ?he Comrnomwakh ofMa&wdiusetts ' DepaFtamit oflndustrid Accidents Owe afbnWS69ativns _ 600 washfjwwt street Boston,MA.02LI iPPvi-v- ma3xgoPMli N%TQrIcersa Cumpe1]SafiaIIIusurauce avit:EcildeTS/Contra ursMectriCLins/P tubers APPU=iELtInfmmntiGu PleasePxin r2, ��s � ��L' J 1 c�/stag �1V. & -M4 6W Phono~r 5� -2)9'41,5-aZ6 a Are you an employer?:Qreclr the appropriate bom T of project r I.❑ I a 1 vd& 4 ❑I ant a general contmctcr and I E ew (required): ogees(andfor part-fiime)* Ewe hired the sub-coaftz tm 6. ❑l�e�construction. 2. I am a sole -etor or _ listed on the attached sheet,- ?- ❑Remodeling l i?a � These sub-contractors have , ship and have as employeesb h _ , 8. ❑Demolition wanting far me in any capacity: employees and have wodors' 9. .❑Build addition JN¢wodoe&coup-fimxanre comp,insaraa l required-] 5. ❑ we are a corporatiaa and its M EI Electrical repairs or additions 3_❑ I am a homeowner doing all wont officers have emm-ised their 1 L❑Plumbing repairs or additions TiOL of ffion per MW— ffiysf1f[No�r�'Ioers'comp-. . c.'152, §I{ d a have rro 1�❑�afrepairs , insaZ acer�';r'd-�i 1.3-0 Other employees-[No Ivor]tux camp-iusaraace Vie-) #Any gVBc=&zt dbed&sbox#1 mast also ffioutthe secticabdowsbawiag&eirwor&ere a=penud=po&eyinf m=%dno_ I Ekmeoarners wbo sabmd flits affidavit indkzting dey axe&zg a]lwea&and Bien him outside comM :Mrs Vst submit a new affidaidt mdiatina Mc i ICagtraetoes V=check t ds box 7m=altad1 as.addili®al sheet stowing the--of the and state whether or mat 9we entities employees.I€tbesdb-� I=e employees,theynntstgxu[ide then wodteW vomp.pol9U atanbm I am an euip r Pleat is prm irlitcg itrarrkers'compensalian i rmaraxce for my enipralwM Serow is file pa cy ard job she „ irnformadon Insurance Company i�ame: ' "Porky 4t'or Self-ins-lic-4: Expi€ationDate_ Job Sate Addles CdylStat�el p: AEt2ch a-copy of the warkere compensatienpolicp declaration page(showing the policy member and expiration date). Failure to secure coverage as required under Section 25A of MC L m 1:57-caa lead to the imposition of criminal penfllti of a fine up to$UOa OD im d.For as W&. as rind penalties im$ie fo=of a STOP WORTL ORDER and a fie of up-to$73U_tlil a dag the ' Be adi ised fimt a copy of this statement:maybe fkwarded to the Office of Imvestcgations of'14 veriffm iam- I ara ifere.by ;t#s ' s an atfha inflBnnaff=pnnri&d abm'e is trarpp$��and correct Signature: Date- Phone t3fi%rial use anff: Do not grits in this area,to be evinipleted by city artown ojoWat CkF or Town.: Permftlf;sense;9 Lwaing Aaflorety(t-rde tine): L Board of$ealth r.Ong t 3.Qt�Town Clerk 4.Electrical Imspector S.Pl=bh g Inspector "b.Other C'om#act Person: Fhow 9- 6 ormation and las efions M� each ace fs C-,--�Laws chVbW M regohes an Wg3la ess'Eo provide wort=''eoraPMSE iou fortbeg emgIo3'ees- p to this statafa,an�Iayr�is dafined as;every person in$ne scdvi ce of an Yffi=under any contract ofl*t;, empress or implie L oral ate wziffz� An t�Ivyei'is,deemed as ran fijTWidma.I,partnership,associ an,corporation or other legal entity,or any two or more of the foregoing=gaged is a3oint enterprise,anal including the legal rcpres��+yes of a dEceased eanployer,or the recei4Pa or tmstee of an indivi&A P iP,associafion or ofherle gal entity,employing empIoyees. However the owner of a.dwelling house having not more than#bree apartments and who resides there,or the occ ul=d ofthe - dw Mug house of ano$er who employs perscros to do mahtenmce,construction or repair work on such dWrlMng house �ffieaeto sbaHnotbecanse of sash employmentbe deemedfn be an euzploy�-" or oz1 the grounds or bui7dmg appurEen MCI,chapter 152,§25C(6)also sib that"every siafe or loc2l Iiceusing agency shaII withhold the issuance or renewal of a license or permit to operate a business or to contract b�u7diugs in the commorrevealth for any applicanj-Who has notproduced acceptable evidence of c6mpr=cn with tine ftm wan ce.coverage regIIired" Additionally.MQ,chapter I52,§25C(7)states-Neither the c=Tn awcahh nor nay ofifs political subdivisions shaIl enfpr info any contract for the perla rmance ofpublic work u:61 acceptable evidence of compliancewith the nasurance. req=-eMets of this chapter have been presented to the confrari>ag aofhoiziy-" Applies ' PIease fM oirt the v,*orlcers' compensation aftdavit completely,by checking the bones that apply to your situation and,if necessary,sopply sab-contractar(s)name(s), addresses)and phaw nornber(s) along withthr r cat (s) of nasorance. Limited Liability Companies(ILC)or Limited Liab11iLTPazinesships(LLP)Wjfhno employees other than the members or partners,are not regzmed to cagy worke&compensaiiaa insetice_ If an LLC or LLP does have employees,a policy is ruquizad- Be advised that ibis a$daykmaybe sahmiited to the Department of Industrial Accidents for confnmafM of insurance coverage Also be sure to sign and date the affidavit The affidavit should be rDtar ned to the city of town that fhe appHcation for thapermit or license is being requested,not the Department of Tn�l A czi m-L-_ Shnnld you have any questions regarding tine law or ifyon=regoaed to obtain a workers' compe: satic .policy,please call tho Deparba ent at the number listed below. Self-fimued'companies should enter their self-insm7an a license number as the appmpdadc line. City or Town Officials f Please be sore that the affidavit is complete and pridrdlegibly. Toe Depart neuthas provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to c oOA ct you.regmTag the applicant_ Please be sure to fill in the pe=WHcense manber which wM be used as a mf=nce number- In addition,sit applicant fbat must submit muht pk peunWHce<ose applications in aay even year,need only submit one affidavit indicating cat and under`Job Site Addrress"the applicant should wafe'all locations in (city or policy information Cif necessary) town)_"A copy of the-affidavit that has bea officially stamped or madCed by tie city or town may be provided to the applicant as proofthat a valid affidavit is on file for fature permits-or licenses_ A new affidavitmlrst be f.I1ed out each year.Where a home owner or citizen is obtaining a license or permit not=aired tU any business or commercial Vdnt3ro (i.e_a dog license orpermrt to burn leaves etc_)said.person is NOTregairxA complete this affidavit The:Office ofIn •�*+ wouldhlmt�o fhankyouina&mm foryour coapw anand sfiD. dyon.have any questions. please do not hest to give us a ca1L The Dej air menfs address,inlephone and fax number: face @f��fto� R MA Oil11 2`f,-L 4 617727-49W=t 4-06 or I-V--MA S A Fax#617 727-7749 Reviser1424-07 -T1dk W ToWnn of Barnstable Regulatory Services ' MASS Richard V.ScaIi,Director. &6s¢ qua` Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabie.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Ic ASC1 , as Owner of the subject property herebyauthrize o to act on my behalf, in ail matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. - S 114Y e of Owner Signs e of Applicant IjZ t', A AS c-t /a "Jul Print ame Date QYORMS:OWNERPERMISSIONPOOLS Town of Barnstable -- BuiRding DARNWASM ; 'Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept Posted MAC 'Until Final Inspection Has Been Made. Permit® 9� ♦ ' 6 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-16-2807 Applicant Name: DAVID P SHASTANY _ Approvals Date Issued: 09/28/2016 Current Use: Structure Permit Type: Building-Deck Expiration Date: „ 03/28/2017 Foundation: Location: 3 VALLEY AVE,CENTERVILLE -- M�-ap/Lot�'226-066 � Zoning District: CBDCV` Sheathing: Owner on Record: MATTHIJSSEN,JUDITH E i Contractor N e: DAVID P SHASTANY Framing: 1 . a Address: 8 SKINNER TRAIL M - _ Contractor License:`r CS-058376 2 CHESTER, NJ 07930 Est. Project Cost: $4,200.00 Chimney: Description: repair rot on decking and sidewalls Permit Fee: $ 110.00 Insulation: Project Review Req: repair rot on decking and sidewalls Fee Paid: $ 110.00 _ - 6 Final: Date: , 9/28/2016 9 / Plumbing/Gas i Rough Plumbing: ti. \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work'authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which�,this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local'zoning by-laws and codes. Final Gas: 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 work until the completion of the same. �• Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on.this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: / 1.Foundation or Footing . " Rough: 2.Sheathing Inspection — r 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 r � J N« = r o n v>� ay � ,// M D U1ae�prhnmoazc[eal o�UlGCX60C/c1LtUJCy - - - nl _ Wo M O Office of Consumer Affairs&Business Regulation License or registration valid for individual use only .3 I n D o • W c before the expiration date. If found return to: rn c N 0 e_ m HOME IMPROVEMENT CONTRACTOR -i Office of Consumer Affairs and Business Regulation T. �`` z c b ° y Registration U 108901 Type: -��; C to C) 10 Park Plaza-Suite 5170 Expiration�8/27[20,18 Private Corporation Boston,MA 02116. f REVISIONS, INC. ? Wj' - ° C ; David Shastany % ( '� m o k /f �. 12 VISTA CIR MASHPEE, MA 02649 a Undersecretary Not valid without sign re rn a a 00x (n - 0) 0. m cn N °; . o_ a) o O d m i a,< Town of Barnstable � � of t loiy Permit# Expires 6 months from issue date Regulatory Services Fee MAM 9�p 1 `�� Thomas F..Geiler,Director �0�6�!l � off.\ Building Division ti Tom Perry,CBO, Building Commissioner Pam: 200.Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us f�(- Office: 508-862-4038 7-0VIA �,,�� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTL` . TABLE Not Valid without Red X-Press Imprint Map/parcel Number - Property Address 4-1 dip4 �1 i� Residential Value of Work 1 %5�O0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&AddressC Contractor's Name Telephone Number .7S ,P !J Home Improvement Contractor License#(if applicable) 3 Construction Supervisor's License#(if applicable) 1 50 'k t4 _D a ❑Workman's Compensation Insurance •ra Check one: I am a sole proprietor [T I am the Homeowner ❑ I have Workers Compensation Insurance 0�., Insurance Company Name L4 Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box). ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side, #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#.of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'N e: Property Owner must sign Property Owner Letter of Permission. A copy f me Improvement Contractors.License& Construction Supervisors License is e ui SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 070110 m The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ® ( Please Print Legibly Name (Business/Organization/Individual): �° 1 \� Q Address: � �L) IL City/State/Zip: '��C( > !_ Phone #: 03 Are you an employer? Check the appropriate box: 1.❑ I am a employer with 4.F ❑ I am a general contractor and I Type of project(required): employees (fall and/or part-time).* have hired the sub-contractors 6• ❑New construction 2 am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' o comp. # 9• ❑Building addition[N workers' comp.insurance p.insurance. required.} 5, ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152,§1(4),and we have no employees. [No'workers' 13.❑ 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 a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp:policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: _ Expiration Date: Job Site Address:. 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 Section 25A of MGL c. 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 P2SQ,00 a day against the violator. Be.advised that a copy of this statement may be forwarded to the Office of InvestigAtionsX the D for insurance coverage verification. I do here certi n r e ns and penalties of perjury that the information provided above is true and correct Si ature: Date: b-el I Phone Official use only. Do not write in this area,to be completed by city or town official 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#: From: Sandy<smascia123@aol.com> Subject: permit Date: September 27,2011 8:49:56 PM EDT To: pkelly@cape.com ► 1 Attachment,225 KB Hi Peter, Here's the signed permit. I will put the deposit in the mail tomorrow. Reminder,we are not doing the azek. Tony 1 /%TME y Town of Barnstable Rcgulatory Services �•i:�HAHNSTABt E, •; noes Thomas F.Geiler,Director \ J9- Building Division Tom Perry,tiuitding Commissioner 200 Main Strc4 Hyawu s,-M- A 02601 wwwt•.towu.barnstable.ma.us Of nee. SOS-S62 438 A8-790-6 0 r max: Property Owner Must Complete and Sign This Sectio.ni If Usin r ABuilder ( wt:(:r of the subject p_ouc .ic_eb ,t.L�o fl Z � _— to 6c c1c= a taOr2-�G nv_;$17i:11� -+^?ae.'T'Z. (Addre of job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence i5 installed and pools are not to be utilized until all final inspections are perforn.-ied and accepted. �is�-z •�_�of�Jwrez S-ignan:re of Appkane — / A - I V fW Office of Consumer Affairs a'id ffusiness Regulation j 10 Park Plaza - :liuite 5170 Boston, Massachusetts 02116 Home Improvement Con ractor Registration ..,Registration: 106328 _ Type: Indly dud Expiration: 7/1b.72001 Tr# 205535 PETER E. KELLY Peter Kelly 50 RUSTIC AVE. HYANNIS, MA 02601 - Update Addness and return card.i YArk reason for change. ' ❑ Address .Renewal Em*yment [],Lost Card IS-CAI is 50M-04/04-G101216 ✓fte TOom/IYtom"u�eaGUi �/l�Ca06ac�u[6e�1`b Office of Consumer Affairs&Bdsiuess Regulation License`or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: ;103928 Type: Office of Consumer Affairs and Business Regulation Expiration: <711:012012 Individual 10 Park Plaza-Suite 5170 2i oston, A 02116 P R E. KELLYJ; c�= . Peter Kelly 2\ t= 50 RUSTIC AVE. HYANNIS, MA 02601': s Undersecretary Not valid without signature -nomw Nlassaehusetts Depa►-tment of Public Safety Board of Building Regulations and Standards Construction Supervisor License License: CS 15044 PETER E KELLY 50 RUSTIC,LANE HYANNISPORT MA 02647 Expiration: 8/15/2013 ('ununissiuner Tr#: 1601