Loading...
HomeMy WebLinkAbout0094 VALLEY BROOK ROAD �{ �a.,l �� ��o�k �t c!, � . o e Wo o ,. A .. ., o �.' w. ... e 4c .. " � '- � ,� e ,. � - ji�i � .. i �„ - .. �. - � _ o ' f .� o a P - a V, � .. .� .. � � � n � � _ ,. o w ,., n , , m Town of'Barnstable *Permit# � �� 1 ` r r 6 month from issue date SS PERM Illegulatory Services Ezp - s�atvsr�ais. » ^' MAW JUL 0 9 2013 Thomas.F.Geiler,Director s6Sq. �� tFp MA'S� Building'DiviAon �FL- 'STATom Perry,CBO, Building Commissioner 1'O N ® Bt4RN0 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 0 Not Valid without Red X-Press Imprint Map/parcel Number Property Address 142 Residential Value of Work$ t Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Am Contractor's Name Telephone Number 8 " ,?7� Home Improvement C. tractor Licen #(if applicable) .i b29 Email: A 4 Construction Supervisor's License#(if applicable) 6 —&6 1 &Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ am the Homeowner have Worker's Compensation Insurance Insurance Company Namejo Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accomp y each permit. Permit Request(check box)❑ Xn� Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to- J 71 e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/.Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. 1 A co y of the Home Impr ment C tractors License&Construction Supervisors License is /reLi IOGNATURE: Q:\WPFILES\FORMS\buil in ermit s SS.doc / Revised 061313 The Commamvealth o,f manack"Setts D4mwhnmt o,f In ustriai Accide n& Office o}',ww1igations 600 Washington,Street Boston,MA(72111 wwmmas&.gov1dia Worlmrs' Compensation Insurance Affidavit:BmidersiContractorsl'Flectncians/Ph mbers Appix li,cant Information i Please Print b Name(Buduess0gmii: Address: r g Cityls Zip: phone## Are yy6 an employer?Check t4e appropriate box: Type of project(required): 1.VI am a employer with 4. ❑ I am general contractor and I have hired.the Mors 6. ❑New coast i.ction employees(full andloi -hme}. 2.❑ I am.a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling s and have no l These subs-contractors have ship employees 8. ❑Demolition woddng for mein any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.1 9. ❑Building addition required.] 5. ❑ We.are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work office have exercised their 11.❑Plumbing repairs or additions myself[No worbm.'camp. rigbt 2of we have no exemption per MGL 12.:❑Roof repairs insurance Required.]T � (� employees (No workers' 13.❑Other camp.insoranm required.] ''Any appbc=r that checks too#1 mast also fill out the secdan below showing their woakere compensation policy inf irmatiob Homeowners who submit this affidavit idcatzig they are doing all wodt wA ties bare outside combo im Est submit a new affidavit indicating such f Contractaas imat check this boa must attached as additional sheet stowing the name of the sab-a rcnoas and state orb :oraot ffiase entities haves employees. If the sub-contmctars lion empkyses,finey most provide Their workers'camp.policy number. I am an employer that is pror eg error etx'colt wnsaffon hwarance f sty emplcyees. Below is the policy w d job.site information. Insurance:Company Name.- Policy#or Self-ins.Lic_#: Expiration Date: Job Site Address: City/StatetZip: en 'on policy declaration page(s the policy number and expiration date). Attach a copy of the wtrkers."compFailure to secure coverage as rjequired. 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 tine 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 insurance coverage verification. I do hereby certify u rQatiorp►mRded abo�is hdcorrect.the s and # Si Date: Phone#: O,oicial use anlyr. Do root rfte in this m bs wed bf caiy or town o, icgat City or?own: PermitlLicense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.drown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 oFTME la,, Town of Barnstable Regulatory Services y� MASS. g Thomas F.Geiler,Director prED1AA'la Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us .. Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property a ` - hereby a4thorize q to act on my behalf, • in all matters relative to work authorized by this building permit. (A, dress 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. 9 � .�ignt) e of Owner Sign e o Applicant Ll�t-5�- 1AJ z�5' L/&K w, Print Name Print ame . Date Q Q:FORM&OWNERPERMISSIONPOOLS 6/2012 t ,. �ZFIE Town of Barnstable Regulatory Services Thomas F.Geiler,Director � �` g Buildin Division Fc Nay Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The 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 procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\D2RESS.doc Revised 053012 Client#:10798 2RILEYCJ ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 05/06/2013 'HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS .ERTIFIOATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES IELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED '3RESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. NT:If the certificate holder Is an ADDITIONAL INSURED,the pollcy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to �e and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the ertlficate holder In lieu of such endorsement(s). ,DUCER Wling&O'Neil NAMPC PHONE, urance Agency Lo Ell:508 775-1620 A/C N,: 5087781218 r-MI lyannough Rd., PO Box 1990 ADDRESS: Innis, MA 02601 INSURER(S)AFFORDING COVERAGE NAIL RED INSURER A:National Grange Mutual Insuranc C.J. Riley Builder, Inc. INSURER B: P.0. BOX 382 INSURER C: Osterville, MA 02655 INSURER D: INSURER E: INSURER F 'ERAGES CERTIFICATE NUMBER: REVISION NUMBER: IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD )ICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS RTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, CLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ADDL UB POLICY EFF POLICY EXP INSR WVD POLICY NUMBER MMMD/YYYY MMIDD/YY LIMITS GENERAL LIABILITYMP059664 DW0212013 05/02/201 EACH OCCURRENCE a OECTCURRENCE $1 OOO MnO X COMMERCIAL GENERAL LIABILITY PREMISES E o TErrDence $5OO OOO CLAIMS-MADE a OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 OOO OOO GENERAL AGGREGATE $2,000 OOO 3EN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2,000,000 POLICY El PRO LOC UT^MOBILE LIABILITY M9059664 5/02/2013 05/02/201 COMBINED SINGLE LIMIT UTO Ea accident 1,000,000 _ AUTOS AUTOS X SCHEDULED BODILY INJURY(Per person) $ BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per acciderd $ X UMBREEXCESS UI LIAB X OCCUR BINDER 69107 5/02/2013 05002,201 EACH OCCURRENCE s3,000,000 EXCESS LIAR CLAIMS-MADE s3000,000 AGGREGATE DED RETENTION$ ORKERS COMPENSATION $ W EMPLOYERS'LIABmm YIN WC059664 5MSM13 05/05/201 X WC STATU- OTH- :FICIY ERMIEMBER EXCLUDED?ECllTIVE� N/A E.L EACH ACCIDENT $500 000 ,aslan In-d E.L DISEASE-EA EMPLOYEE $500 000 yes,describe under .SCRIPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $50O 000 'TION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,It more space Is required) Inca coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. ig contained in the certificate of Insurance shall be deemed to have altered,waived,or extended the tge provided by the policy provisions. 'ICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ZOO Mein Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. annis, MA 02601 AUTHORIZED REPRESENTATIVE ©1988.2010 ACORD CORPORATION.All rights res d. 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD J� t 1/ 1110879/M110878 LS1 7 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supers isor ; License: C.S466147 iCRAIG J RILEY PO BOX 382 - OSTERVELLE W* •; .r • Expiration Convnissioner 02/05/2015 WOlnee of Consumer 4_ Rega� License or registration valid for ind'rvtdol use only HOME IMPROVEMENT CONTRACTOR before the expiration-date. If found return to: Registration: 125799 Type: ice of Consumer Afrairs and Business Regulation Explration: 1/30/2014 Private Corporatim 10 Park Plaza-Suite 5170 C. ILMEY BUILDER SIC Boston,MA 02116 CRAIG RILEY �7 10 B WIANNO AVE. _ OSTERVILLE,MA 02655 UndersecreZy N a' out signs r � ✓ s p....... Z Asses"rsor's map and lot number 0 6k`3 (�i/�e� FTHE t � IL ~r a Itl 9l •vP O f Sewage Permit number ............... r -. a.��. ......... pS E ius - M� �.... °. INST� LED IN COl'lltlPLI .7 q •` k.,,a - • , i '=BgH�TSTLDLE House number .....••!.!. .......................... ..............:... ....... WITH TITLE. 5 90 rb a �� ENVIRONMENTAL CODE ' �aY a� TOWN` OF BARNS � �T��Ns BUILDING INS"PECTOR APPLICATION FOR PERMIT TO ...... ...:. ... ................................................................. TYPEOF CONSTRUCTION .........!LR.)'� .......................................................................................................... - .............. ....................19 r TO THE INSPECTOR OF BUILDINGS: f The undersigned hereby,applies for a permit according to the following information: rL- Location .................. ... ... . .... ............ ................................... ................................... ProposedUse .....................................�W .. i...... 4..................................... .+.......................... ............. Zoning District ................................... .................................Fire .District .... �.. Name of Owner Q..�, ... .... ..•..Address .....��...............................l........�....:"..:°,�.11� ... . ....... I.�.....................':�.... ................................... Name of Builder' :. ............................:Address Name of Architect .......t............ ...............................................Address ................ ............................................... Number of Rooms ............1.7............ Foundation ............................ .......... .0.......................................................... Exterior ... ? ..c.. �.. �-..................................Roofing .... ..Gl!► .................................................. �r Floors .....................Interior ...... ..........................�:.................... ......... .... .�..t fi`.... .� Heating ..... ��. y°�"5 `.rv� �^-9 64 Wl, ;. Plumbing .........�"............-...... ... r?:R�. .-'... Fireplace ..... ..................... ......... ......... . ........ ..................Approximate Cost .......... ......:............ Definitive Plan Approved by Planning Board ----________------ ___:_ Area ....JZ.�J © 'Diagram of Lot and Building with Dimensions Fee 1-51 ................... ......................... SUBJECT TO APPROVAL.OF BOARD-OF HEALTH �7 0 .. ..4 e^-- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Tow /BarnVIreging the above construction. Naa ......... ........................ ................ 41 1:4s►+,DELANEY, .JOHN _ � . 24179 One Story $!o Permit for Single Family• Dwellin t ... � . . Location Lot #23 94...Valle. . X...Broo. . k Rd. �' `' .... ..... .... .. .. .... i Centerville -- Owner ..John Delaney ` Type of Construction Frame , ti .......................................................................... .. iPlot ............................ Lot 1 Permit Granted ....June..................................3.. 9 8 2 } Date of I W Date Completed ........c�? Lam......r.........1911�3 Assessor's map and lot number � � �..... ,.!, . ,.,.. �' '/ rs- l,..................... a" J�Z THE• %/ �pF TOE ♦/ s^ ?�� Sewage Permit number ...............r-q �.�.>:a....:........ � Z MAR39TADLE. i House number 51 9� M66 p MPY a�9 TOWN OF BARNSTABLE �F BUILDING INSPECTOR APPLICATION, FOR PERMIT TO ...................._.p:....................................................................................................... TYPE OF CONSTRUCTION .........I..k„}�ti`!�)`?........ .fits- -_........................................................................... ................................................. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / -� ?� {'� ({I -t is t�tJ dam' _ C��✓� ' Location .............L-3 ..................................................... j...............t.%...�. ........................... Proposed Use ....�..............'.`.. .. .�`...i t,..4.1 ...........................................................:..... .............. ...................................... .. ... ..... Zoning District ...........................................�.............................Fire District :.................................... Name of Owner �.... ..�. �`.?`��'...,. .............Address .. .. 3............ ................................0 � � %�1 ............................ Nameof Builder. ....................................................................Address .................................................................................... Name of Architect ,�j 0 � i�Q v j 2- .................................................................Address .................................................................................... !r Numberof Rooms .............'?.................................................Foundation ..... ..... .............................................................. Exterior ...� ``rt�a. ...� Lit v�aC:'.���......................................Roofing ... .` T Floors �')� ...........................................................' Interior �� li � fp�.. .C.0 ..J........ ............. g 1 . I- A4" \.-3 cHeatin ................................. ..............Plumbing ..................................................... L . ........r Fireplace ......................................Approximate Cost ........... .................................... ..... .........`........................ ............................................ ........ �i' Definitive Plan Approved by Planning Board 19&. Area r�............................... .......... Diagram of Lot and Building with Dimensions Fee ............'................................... SUBJECT TO APPROVAL OF BOARD OF HEALTHX J �— tt e"( z z -� -- ---- - OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town'of Barnstable regarding the above construction. / // ,/r / Name .// ,. iff�..../. /J.n :..!I................ DELANtY, JOHN A=188-4 24179 One Story No ................. Permit for .................................../ .......Single. . Fami.jYA.pwp.jjjXj9/....... .... .... .. .................. .. ",g/****"* Location ..L...o...t.......#..2.....3...... 94 V / ..B . ok Rd. ................Cente ........... .......... .. Owner ....John lelanpy ........................... ............................... Type of Construction Flamd....................... .............................I......................I..... ................Plot .................... ...... Lot ................ Permit Granted. . ...... ............19 82 Date of Inspection ................. .................19 Date Completed .................. .................19 c 2 Z - • �� 17. 1 . 1 l 4 x� r !_s �.? '?, r_ C6�'"CI_r IEl7 pl.�`T" LocATIa -J CEW7E'Ly.t c.nti 1'�40 �Tt✓ f LGRTIt=�( Tt4AT Tt-1C-. �uQ�ArC4 5"0%"Q ;FAQ 1Ztr'Et;E►.1ca t-l�C?C c�t.l Go+vIPL�(S W ITtA TIAG 51 DC.I.I►-�E: Z j auv SETVACV �cQut�EM�NTs ot= TNic zawU of .I��� �,c. n.�to is Dort- �A�n Cvv�T 3SScL� LoGATC WITt-it coo PLA( l uY� ,> ( B Q XTE-Q- bA`l'i✓ 7. C(�lL '� �._ t2t:lI�� tct��t� t_.e.I.tt7 5vev�Yo►; T1-ll5 l�t_AN tom, t IC�T }SASE o 04-4 /*.tJ ca,'rc.R.utt_t_L v AXaSS• 'i' 'i Q 0AAll1.! I- �jU v fit':.. . 1 I t_,___--.c- -^ t . i • TOWN OF`BARNSTABLE Permit No. ?'?' ----------.- Building Irspector Cash w. 1 OCCUPANCY PERMIT Bond Issued to Jobe Delaney Address lot :ff23 Va1-1_Pv -Rrook. Ron-ri; J Wiring Inspector - � '— Inspection date w- Plumbing Inspector Inspection date Gas Inspector � ` Inspection date'xQ i /Engineering Department* ,/ / Inspection date: �5 r Inspection date f � ;/Board of Health f f` THIS PERMIT iI'ILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE" BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .�..................................;,4 �� ............ Ise :%- !,1-� Building In`s'pector "�`'""�