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Home My WebLink About0006 HARRINGTON WAY 6 /�A��iti� r��v Gva� �� I 1�3 J i, 3 �b2 y�/Y/N1N1�•1Q� Z CIO m OW N �. r r 0 0' z Town of Barnstable Building Postthis Card So That it is U�sible�From theStreet Approved Plans Mustzbe,ltetamed on Job and�this Card Must be Kept, � �=- hnM r Permit Pot We Permit No. B-18-781 Applicant Name: MATTHEW M BOROWSKI Approvals Date Issued: 03/19/2018 Current Use: . Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 09/19/2018 Foundation: Location: 6 HARRINGTON WAY, HYANNIS Map/Lot: 288-048 Zoning District: RB Sheathing: Owner on Record: MCGINNIS,JOHNSR&MARY C Contractor:Nam6,.'-MATTHEW M BOROWSKI Framing: 1 Address: 6 HARRINGTON WAY Cbhtractor*•License-. 128017 2 HYANNIS, MA 02601 Est Project Cost: $6,500.00 Chimney: Description: remove existing chimney, rebuild to same dimensions A' Permit Fee: $85.00 Insulation: Project Review Req: REBUILT TO FIREBOX.THROAT INSPECTION REQUIRED. Fee Paid $85.00 Date 3/19/2018 Final: Plumbing/Gas u Rough Plumbing: 3 Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized b�yths permit is commenced within sixmonths after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Final 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,46ad and shall be maintained open for public nspection for the entire duration of the work until the completion of the same. Electrical 3� A Service: The Certificate of Occupancy will not be issued until all applicable signatures,by the Buildmgand Fire Officials arerprowded on this permit. Minimum of Five Call Inspections Required for Ali Construction Work: Y ' Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Pefsons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT -t-j6a, 1h -.t AnS Applicadon Number.......................................I.................... .00 Peimit Fee . .........................Other Fee........................ MABEL .'s ....... 165 TotalFee Paid................................................................ ..... 8UILDING � �� li�� Permit�PrDval by......... ....... ........On....S TO" OF BARNSTABLE .......... ... ... AR BUILDING PERMIT ...........................I APPLICATION Section I owner's information and Project Location Project Address— A145-k—� Village- owners Name Owners Legal Address Zb� State zip 6P 2,6,0 C Owners Cell 7&jk- _E-mail Section 2—Use of Structure Use Group_ ❑ Commercial Structure over 35,000cubic feet Commercial Structure under 35,000 cubic feet Single Two Family Dwelling Section 3—Type of Permit E] New Construction ❑ Move/Relocate E] Accessory Structure 0 Change'of use ❑ Demo/(entire structure) F-1 Finish Basement ❑ Family/Amnesty 0 Fire Alarm Rebuild ❑ "Deck Apartment Sprinkler System Fj Addition ❑ Retaining wall ❑ Solar El Renovation 11 Pool 0 Insulation Other—Spec Section 4 -Work Description ca T.Rd Tmdafed:2/9/2019 Application Number.. .. ........................ Section 5—Detail Cost of Proposed Construction G SOD Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method 0 MA Checklist WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing Gas ❑ Fire Suppression ❑ HeatingSystem ice" Maso Chimney ❑Add/relocate bedroom Y m5' Y Water Supply 0 Public ❑ Private Sewage Disposal 0 Municipal ❑ On Site HEstoric District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone,Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed >=as this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated:2/9/2019 ~" Application Number........................................... Section 9—.Construction Supervisor Name 0`a*stk Telephone Number 56b 3,0 I'(:,39 Address uOsAL City ��a P:Zi_ State m-A Zip License Number CS 0"2 y 469- License Type Expiration Date Z. I Contractors Email rAA4 Mo vy s PL. ,c.om Cell# SS$ 36q 7697 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by7 0 CMR e Town of Barnstable.Attach a copy of your license. Signature Date- -31/�-118" Section-10 —Home Improvement Contractor Name QVZ"SYY - • 5�4.3 %39 Telephone Number .6�1 Address 71S Wde- City L�gf?a w� � � State 10A ' Tip 02�7s Registration Number 12% 17 Expiration Date 419 I undeastand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation requ,/ired by780 C�1MR an e T wn of Barnstable.Attach a copy of your H.LC... Signature /// �'�/ Date Section 11—Home Owners License Exemption afll/ �f; f Home Owners Name: APR Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 R CMR the Massachusetts State Building Code. I understand the construction inspection procedures,-specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature r Date w APPLICANT SIGNATURE Signature Date 3//F i8, Print Name Nla#ku3 t�=ol Telephone Number 36'-►96b � E-mail permit to: rn 4 ✓ D ) Oj AQ L (b vy�_. r...e....i aa.mmmnio I Section 12 —Department Sign-Offs Health Department- ❑ Zoning Board(if required) Historic District ❑ Site Plan Review(if required) Fire Department ❑ ' Conservation 0 For commercial work please take your plans directly to the fire department for approval: Section.13-Owner's Authorization as Owner of the-subject property hereby authorize {11 a !� to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) ell i Signature o Owner, 9 Print Name . r — . a All n y, Last undated 2/92018 ,a►co CERTIFICATE OF LIABILITY INSURANCE °ATE`MM/°°"""' 11/08/2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate'does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Joanne Bretton SOUTHEASTERN INSURANCE AGENCY INC A/CO No Ext: (508)997-6061 A/C No: E-MAIL ADDRESS: jbretton@southeasternins.com P O BOX 79398 INSURER(S)AFFORDING COVERAGE NAIC# NO.DARTMOUTH MA 02747 INSURERA: LM INS CORP 33600 INSURED INSURER B: MATTHEW BOROWSKI INSURERC: DBA CREATIVE CONSTRUCTI ON INSURERD: 73 WEIR RD INSURERE: YARMOUTH PORT MA 02675 INSURER F COVERAGES CERTIFICATE NUMBER: 210768 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. ILTR ADDLSUBRTYPE OF INSURANCE INSD WVD POLICYNUMBER MMIDDPOLICY/YYYY MM/DDIIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE PREMIDAMA OCCUR ES(RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO- JECT F LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ - Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED —PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAB - OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE EORH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 A OFFICER/MEMBER EXCLUDED? I NIA1 NIA NIA WC531S318294037 06/23/2017 06/23/2018 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 =N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensationi investigations/. Sole proprietor has not elected coverage. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Yarmouth ACCORDANCE WITH THE POLICY PROVISIONS. 1146 Route 28 AUTHORIZED REPRESENTATIVE South Yarmouth MA 02664 Daniel M:Crq*y,CPCU,Vice.President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD i 61.0Z/L0/Z0 JauolsslwwoO � _. .,�. -" 099Z0 VW SINN30 H1f10S ELL LX08Od IISM02108 W M31-111vw � tr. •��`®Z uoi one suo ® �osin�adnS l 3 o 699VLO-SO :asuaOl spaepuejS pue suoijeln6aa 6uiplin8;o pjeoij `Y �e d S I Q d 1 0 u �I W d��a a �l n o;uaw eda s asn Besse �1/06 s � ��c �rlrrrircancu�cr�/�-r�n"LC... l - Office of Consumer Affairs&Business Regulation 11 Registration va id or to a use on y HOME IMPR OVEMENT CONTRACTOR before the expiration date. If found return to: `.:. TYPE:Individual Office at Consumer Affairs and Business Regulation 1 rk Plaza.:!-Suite 5 S 70 z Registration Expiration n MA 02116 " 128017 02/10/2019 MATTHEW M B6R0INSKI MATTHEW BOROWSKI l j 73 Weir Rd Yarmouthport,MA 02s75 L-'�_ Not valid,.., o Jt signature Undersecretary. ' The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street - Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Orgazuzation/Indi-tidual): 111A1"Y IQ1�� Address: S�v b' City/State/Zip: ]�`/A� u�o2� 1�'A cRb'1S Phone#: S Are you an employer?Check the appropriate bow Type of project(required): 1.® I am a employer with 4. ❑I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.$ required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' repairs or additions 3.❑ I am a homeowner doing all work ❑ � p myself,[No workers' comp. right of exemption per MOL 12.❑Roof repairs insurance required] t c.152,§1(4),and we have no ed. employees.[No workers' 13.�r]Other�+ y�P��D comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating spch. Contractors that check this box must attached an additional sheet showing the name of the sub-rDn ractors and state Nybether 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.#: QC' �/S 3 fQJ'a o 37 Expiration Date:-.,(a!/Z3It 8' Job Site Address: l0 City/State/Zip: J-k 4 1.1,1,f 1 k 5 - —T 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$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,cgrwly nder the p ' andpenaldes ofperjury that the information provided above is true and correct: Si ture �\� \ � Date: 3I t 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#: Assessor's Office 0st floor) Map a `Lot `4, a Permit#_ 1 Conservation Office(4th floor) Date Issued 9 5� XBoard of Health(3rd floor) engineering Dept. (3rd floor) House# t. 0st floor%School Admin. Bldg.): - 1 �' n YYARN87A8lJ, _ Definitive Plan.Approved by Planning Board 19 SE�� UST BE (Abplications processed 8:30-9:30 a.m & 1 00-2.00 p.m) l�V�`T�LLE (.., , %gITH TITLE 5 M TOWN -OF BARNSTABLE ' _ � Building Permit Application r Pro'ect Street Address 77A) Ct-r'4� 4> WAS-5 Village Fire District (hvner`�pG [OY)i��f Al�1 aG�Ln l Al'+� Address Telcphonc �(�5 7� <c3 /o Permit Rc uest: ^Z tr7aa c eA(—z eijl> 411 s Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of ApMls Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure I—AX L'S Basement type (;ULL Historic House Finished ✓ Old King's Highway Unfinished Number of Baths No.of Bedrooms ,Total Room Count(not including baths) LP tMs ' First Floor Heat Type and Fuel CQi' Central Air Fireplaces l Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name 1�{r % i;(2 Telephone number Address License# Home Im rovement Contractor Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0OLk Proiect Cost af y� c� Fee s—/�, C X j SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T i 4/12/9 5 8 FOR OFFICE USE ONLY 288.048 ~ ADDRESS 6. Harrington Way VILLAGE Hyannis Mary C. McGinnis ' OWNER DATE OF INSPECTION: ` } FOUNDATION j FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING: } DATE CLOSED OUT: F ASSOCIATE PLAN NO. . s TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION --------------------------- Please print. DATE JOB. LOCATION Number Street address Section of town "HOMEOWNER" P�y M& fAIKA3 72 15 .37 0 7 / rq.S.l Name Home phone Work phone PRESENT MAILING ADDRESS 24Z y WNLCe la W(S VGA [`E�4cZ�C.o��cJ (�Q,1,4 f S 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 Officia on a form acceptable to the Building Official, that he/she shall be res onsibl for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes .responsibility for compliance with the Sta Building Code and other applicable codes, by-laws, 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. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet,. or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are ,unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This. lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "dwner� actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner 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. • s%sxsrA1= • The. Town of Barnstable MASS. �e� Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601;; -Office: 508-790-6227 Ralph Crossen Fax: 508-775,3344 Building Commissioner For office use only... Permit no. Date AFFMAVIT HOME E%IPROVEMENT 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 p e-e;dsting 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:(!'1 lit C&41-t Est.Cosy Address of Work: dk,,E ("(212-Mkv $ Owner Name:_01)JLy Pt I.G Ce(u P l.S - Date of Permit Application: I herebv certifi,that: Registration is not required for the following reason(s): Work 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 APPLICABLE 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 agent of the owner: Daf� Contractor name Registration No. OR q,I(I[q t ' Date �1�er's name 11;02'94 17:02 V6177277122 DEPT IND ACCID ZOO: w- Cotjunon.iuea It o WalJaclittJetfi ' elJaparfineicf o�J'•�triaal:�ccicien� 600 f/V uhzV1on Slur, l James J.Campbell &ton, ///aMacLuad o2 f f Commissioner Workers' Compensation 'Ittsurance Affidavit (aoeaseeJpmaaree) with a principal place of business at: (Mylstna/zip) do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation ponies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Polity Number I am a homeowner performing all the work myself. 1 undersund that a copy of dlis sltement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure overage as rec ired under Section 25A of MGL 152 can lead to the Imposition of criminal penalties eonsisdric of a fine of up to s1,500.00 an for en years' imprisonr„ent as well as civil penalties in the for of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this (� day of )Qpyi t, , 19 �( S zc Ucensee/Pefinittee Building Department Licensing Board Selettmens Office Health Department 3 7 TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 Town of Barnstable Building Post ThHARNSTAMA is Card SoThat it is VisibleFrom the Street Approved Plans Mus#be Retained on Job andahis Card Must lie Kept MAM Posted Until Final Inspection Has:Been Made � ` s Permit ° W K CertificateYof Occupancyas Required,such Building shall Not be�Occupied until a Final Inspection has'been made Permit No. B-17-4350 Applicant Name: ANDREW SWEET Approvals Date Issued: 12/19/2017 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 06/19/2018 Foundation: Location: 6 HARRINGTON WAY,HYANNIS Map/Lot 288 048 Zoning District: RB Sheathing: � , Owner on Record: MCGINNIS,JOHN SR&MARY C � Contractor:Name:`,-:.HOME DEPOT USA INC Framing: 1 Address: 6 HARRINGTON WAY Contractor;License 112785 2 HYANNIS, MA 02601 Est Project Cost: $921.00 Chimney : Description: INSTALL( 1) REPLACEMENT EXTERIOR DOOR NO STRUCTURAL e: $35.00 Insulation: Project Review Req: Fee Paid: $35.00 rDate: 12/19/2017 Final: Plumbing/Gas x M Rough Plumbing: Building Official � Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed�by this permit is commenced within six'months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and�the;approved construction documents"for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall lie incompliance with the local zoning by laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical f° Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire�Offcials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:; F� Rough: 1.Foundation or Footing _. .._ „_,. ,., 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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 R Building plans are to be available on site Final: ��A All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable r REc�iPT 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-4350 Date Recieved: 12/18/2017 Job Location: 6 HARRINGTON WAY,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: HOME DEPOT USA INC State Lic. No: 112785 Address: 2466 PACES FERRY RD C-11 HSC, Applicant Phone: (401) 714-6399 ATLANTA, GA 30339 (Home)Owner's Name: MCGINNIS,JOHN SR& MARY C Phone: (508)335-4214 (Home)Owner's Address: 6 HARRINGTON WAY, HYANNIS, MA 02601 Work Description: INSTALL( 1 ) REPLACEMENT EXTERIOR DOOR NO STRUCTURAL Total Value Of Work To Be Performed: $921.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: ANDREW SWEET 12/18/2017 (401)714-6399 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $921.00 Date Paid Amount Paid ' Check#or CC# Pay Type Total Permit Fee: $35.00 12/18/2017 $35.00 i XXXX XXXX-XXXX- Credit Card 1 7716 Total Permit Fee Paid: $35.00 TIN Is IS T APE R I I'T „ ._ wig.. , Town of Barnstable REc�EiPT 200 Main Street, Hyannis MA 02601 508-862-4038 a Application for Building Permit Application No: TB-17-4350 Date Recieved: 12/18/2017 Job Location: 6 HARRINGTON WAY,HYANNIS Permit For: Building-Siding/Windows/Roof/Doors Contractor's Name: HOME DEPOT USA INC State Lic. No: 112785 Address: 2455 PACES FERRY RD C-11 HSC, Applicant Phone: (401) 714-6399 ATLANTA, GA 30339 (Home)Owner's Name: MCGINNIS,JOHN SR& MARY C Phone: (508)335-4214 (Home)Owner's Address: 6 HARRINGTON WAY, HYANNIS, MA 02601 Work Description: INSTALL( 1 ) REPLACEMENT EXTERIOR DOOR NO STRUCTURAL say Total Value Of Work To Be Performed: $921.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the.best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: ANDREW SWEET 12/18/2017 (401) 714-6399 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $921.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $35.00 12n8i2o17 $35.00 x0ooc xx3ooc XX}O� Credit Card 7716 Total Permit Fee Paid: $35.00 THIS IS NOTA PERMIT