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HomeMy WebLinkAbout0135 OAK HILL ROAD 711 mod' i To wn of Barnstable Building � ,� t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained.on Job and this Card Must be Kept MAIN- �' Posted Until.Final In Has Been Made rt ° Where,a Certificate of Oc:upancy.is Required,such,Buildrng shall Not`be Occupied until a Final Inspection has:,been+made Permit Permit No. B-20-1983 Applicant Name: Henry Cassidy Approvals Date Issued: 07/29/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/29/2021 Foundation: Location: 135 OAK HILL ROAD,HYANNIS Map/Lot: 248-_067-001 Zoning District: RB Sheathing: Owner on Record: KENNY,JAMES&ROBIN Contractor Name`-.HENRY E CASSIDY Framing: 1 Address: 6019 E CROCUS DRIVE Contractor License.: CS`-�100988 2 SCOTTSDALE,AZ 85254 Est. Project Cost: $6,400.00 Chimney: Description: Weatherizationq Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid.?, $85.00 Date: 7/29/2020 Final: 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 months afterissuance. 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 st uctures shall b incompliance with the local zo ing by-laws anc�codes. This permit shall be displayed in a location clearly visible from access street or road a d shall be maintained open fo bublic inspection for the entire duration of the Final Gas: 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. Minimum of Five Call Inspections Required for All Construction Work: r' Service: 1.Foundation or Footing Rough: 2.Sheathing Inspections - 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: i 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: 1, 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: EInhrz 56AJ7" E'E E HEATLOK SP Company Name -- Phone NumberC% - Applicator Name Installation Date A-Si'de Lot #'s Jobsite Address t r Permit Number WA- B-Side Lot #'s C Ll Walls " �" 0 to A11��i www.Service-Part.ners.com 318VISMO dU Wl SE RV/i C E www.Demilec.com partners DEM1 c Town of Barnstable_ Building PostThis Card So'That itis,V�s�ble From,the-Street ,ApprovBM ed Plans Must be Retained ori;,Job,andithis Card Mu''st�be,Ke t„ „ ;:4 "r" PosteBAMSTA dsUnt�l Final Ins ect�on Has Been MadeIV— , a 1639 1 ri- p... to .,; .. i, ,! a .,. • Where a Certifieate of..Qccu anc as Re ulred uch,Bu ld,mg•shall Not be Occupied until a�F Ina lant ection has,;been made Permit -a .. ,. ::.". .< .. .: .....:: pm,a.<..Y. ...��..aq ....,�.:.: s.,� :.. .._' .:• •,., ,>... :r. Ys• ,. ... „p..- a.v ..,.. Permit No. B-19-349 Applicant Name: IHS Building and Remodeling Inc. Approvals Date Issued: 02/12/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/12/2019 Foundation: Residential Map/Lot 248-067 001 Zoning District: RB Sheathing: Location: 135 OAK HILL ROAD, HYANNIS ,k Co tractorName: IHS Building and Remodeling Inc. Framing: 1 Owner on Record: KENNY JAMES& ROBIN Contra&brpL cerise 190612 2 Address: 6019 E CROCUS DRIVE 3 Est Project Cost: $ 12,000.00 Chimney: SCOTTSDALE,AZ 85254 PermitFee: $ 111.20 Insulatio Description: remodel kitchen and 3 bathrooms. remove wall�,WAheen kitchen& / t Fee Paid:. $111.20 —� sittling room,install 3x2x8x11 header. remove eslsp' cellmgs in e f Final: family rm.frame, insulate and install catherdral celling'Remove Date 2/12/2019 L %L and replace kitchen window. ' /) Plumbing/Gas Project Review Req: � Rough Plumbing: BuildingOfficial Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within i months aftef issuance. All work authorized by this permit shall conform to the approved application}andhe approved construction documents#for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and struetures�shall be in compliance with the local zoning bylaws and codes. This permit shall be displayed in a location clearly visible from access street oitroad rid shall be maintained open for pubs spection for the entire duration of the Final Gas: work until the completion of the same. " r Electrical The Certificate of Occupancy will not be issued until all applicable signaturesby th Bu ding and Fire Offic a s afire provided on this it. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing '� s 2.Sheathing Inspection T, ., N Rough: 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 Final: 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 ting 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ccn, - ------- ------ ---- -------- ---------- -- - VRE O Application Number.......... ....... ........................................ EL4RNSTAE= 2 MAS& Permit Fee..............40.,; 1639. . . ........Other Fee........................ RFD MA'S TotalFee Paid................................................................. ...... /Z TOWN OF BARNSTABLE Permit Approval by... .........on...... ....... ... BUILDING PERMIT 0 �� APPLICATION' Map........... ............Parcel..... .. Section 1 — Owner's Information and Project Location Project Address- i IT Oak +U11 kd. Village HqO-Pr) i's Owners Name. -Jam es e, kob lk- kepmy I Owners Legal Address 6 01 q E Cro cons Dr. State A 7-City zip 8S-2-5L4 Owners Cell# 602--?>?-8 -010-o E-mail peldol-0-dob-01clohl- sr. Section 2 -Use of Structure Use Group_ R Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet RI/Single Two Family Dwelling Section 3 - Type of Permit E] New Construction F] Move/Relocate [:] Accessory Structure ❑ Change of use ❑ Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm Rebuild El Deck Apartment Sprinkler System:pT. ❑ Addition ❑ Retaining wall E] Solar Renovation ❑ Pool El Insulation Other-Specify. n5 ta,NFI Section 4 - Work Description RQ-,rh0(AZJ k-J'&0kZ14-o-,d 3 batkroom-% Rerncwc wc61 6dwev, Remove eKit�tihq ;j.- Fa!r�i Jraorr? OE-,ev"'p- in uittt a,,d Last updated: 11/15/2018 fl Application Number................................................... Section 5—Detail i Oc p Cost of Proposed Construction j-:9e;d®o Square Footage of Project 5100 Age of Structure S 9 �v�3 Dig Safe Number # Of Bedrooms Existing � Total#Of Bedrooms (proposed) i 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics 0 Wiring ❑ Oil Tank Storage ❑ Smoke Detectors [� Plumbing ❑ Gas ❑ Fire Suppression 0 Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: S � co . P--ew++-c s I am using a crane I ( Yes Section 7—Flood Zone 1 Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoningbistrict 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 Has this property had'relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 Pill kd. I Family Room Patio _ 4 ig'XiW 119x18' — Mud 15'x9' _� Room 101X9' � Sitting Master Bedroom end ; ----- �� Room o Bedroom Master j 10'X12' ✓—' 14'x11' 12 X10 Bedroom rj'x4' 12'X14' ' �/x w 1 - -� x4 Breakfast -- � � �) MAI s Garage 1 Garage Nook - 14,X231 13'X23' Living 1 1 13 x16 Dining -- Room ra o e ROOM ` 19,X14/ o Q Kitchen �;` , ► {: Foyer 12 X12 < F 1'AIQ "h lid -SMok� ALARM �' ®3� 6lU1 �R p- % AC ^1 40RAW r n 135 Oak Hill Rd. Hyannis Kitchen Remodel Kitchen/Sitting Room Existing Wall ,5 8 , o 3 y� A4 ... � •fit '��% ..Fey � � If 1 , v $ stark _a -s •• • •• rvy�' a Sian. �;. w " `� (�)Boi'eCastade Quadruple 1-3/4" x 7-1/4" VERSA-LAND 2.0 3100 SP PASSED FB01 (Floor Beam) BC CALCO Member Report Dry 11 span I No cant. February 12,2019 14:29:10 Build 7082 Job name: 135 Oak Hill Rd File name: Address: 135 Oak Hill Rd Description: City, State,Zip: Hyannis, MA,02601 Specifier: Builder: Richard Peckman Designer: William Campbell Code reports: ESR-1040 Company: Shepleys 2 0 1 1-00-00 61 62 Total Horizontal Product Length=11-00-00 Reaction Summary (Down / Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B1, 3-1/2" 2063/0 1800/0 B2, 3-1/2" 2062/0 1800/0 Load Summary Live Dead Snow Wind Roof Tributary Live Tag Description Load Type Ref. Start End Loc. 100% 90% 115% 160% 125% 0 Self-Weight Unf. Lin. (lb/ft) L 00-00-00 11-00-00 Top 15 00-00-00 1 ceiling Unf.Area(lb/ft2) L 00-00-00 11-00-00 Top 0 10 12-06-00 2 roof Unf.Area(lb/ft2) L 00-00-00 11-00-00 Top 30 15 12-06-00 Controls Summary Value %Allowable Duration Case Location Pos. Moment 9754 ft-Ibs 58.2% 100% 1 05-06-00 End Shear 3233 Ibs 33.5% 100% 1 00-10-12 Total Load Deflection U288(0.439") 83.3% n\a 1 05-06-00 Live Load Deflection U540(0.234") 66.7% n\a 2 05-06-00 Max Defl. 0.439" 43.9% n\a 1 05-06-00 Span/Depth 17.4 %Allow %Allow Bearing Supports Dim.(LxW) Value Support Member Material B1 Wall/Plate 3-1/2"x 7" 3862 Ibs n\a 21.0% Unspecified B2 Wall/Plate 3-1/2"x 7" 3862 Ibs n\a 21.0% Unspecified Notes Design meets Code minimum(L/240)Total load deflection criteria. Design meets Code minimum(L/360)Live load deflection criteria. Design meets arbitrary(1")Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALCO analysis is based on IBC 2015, Design based on Dry Service Condition. Beams 7 inches wide will be assumed to be either top-loaded only, or equally loaded from each side. Install screws from both sides, staggering screws by half of the spacing to avoid splitting. Member has no side loads. Page 1 of 2 Boise Caseade Quadruple 1-3/4" x 7-1/4" VERSA-LAM® 2.0 3100 SP FB01 (Floor Beam) BC CALL®Member Report Dry 1 span No cant. February 12,2019 14:29:10 Build 7082 Job name: 135 Oak Hill Rd File name: Address: 135 Oak Hill Rd Description: City, State,Zip: Hyannis, MA, 02601 Specifier: Builder: Richard Peckman Designer: William Campbell Code reports: ESR-1040 Company: Shepleys Connection Diagram: Full Length of Member b d —. e a minimum= 1-1/2" c=4-1/4" b minimum=4" d= 12" e minimum = 1" Beams 7 inches wide will be assumed to be either top-loaded only, or equally loaded from each side. Install screws from both sides, staggering screws by half of the spacing to avoid splitting. Member has no side loads. Connectors are: SDS 1/4 x 6 Disclosure Use of the Boise Cascade Software is subject to the terms of the End User License Agreement(EULA). Completeness and accuracy of input must be reviewed and verified by a qualified engineer or other appropriate expert to assure its adequacy,prior to anyone relying on such output as evidence of suitability for a particular application.The output here is based on building code-accepted design properties and analysis methods. Installation of Boise Cascade engineered wood products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call(800)232-0788 before installation. BC CALCO,BC FRAMER®,AJST- ALLJOISTO,BC RIM BOARDT"',BCIO, BOISE GLULAMTM,BC FloorValue@, VERSA-LAM@,VERSA-RIM PLUS@, Page 2 of 2 i C��e lParnirreareeuealt�o G���tz:uuc�uoeftt Office of Consumer Affairs t8usiness Regulation HOME IMPROVEMENT CONTRACTOR TYPE:.Corporation Registration Expiration 1906-1 02/09/2020 IHS BUILDING AND REMODELING,INC.' RICHARD J.PECKKA.M 32 BUCKWOOD DR C J HYANNIS,MA 02601 Undersecretary Commonwealth of Massachusetts Division of Prof essional'Licensure Board of Building Regulations and Standards Constru-etion' SSpervisor CS-094193 ni E�ires: 07/29/2019 t ^ - RICHARD J PECKHAM 32 BUCKWOOD HYANNIS MA 02601 a� r1OIS�'T_ti��', e •, t Construction Supervisor Unrestricted-Buildings of any use group which contain less than 3500 cubic feet(991 cubic meters)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license /�- Call(617)727-3200 or visit www•mass.gov/dpl r f IRS Building and Remodeling,Inc bwtil:Richard@ihsbuilding.com 32 Puckwdod Drive Website: www.ihsbuilding.com Hyannis MA 02601 .. Phone: (774) 836-6654 Building? Remodeling Construction Contract This agreement is made by IHS Building and Remodeling, Inc (Contractor)and Jim Kenny and Robin Kenny (Owners)on the date written beside our signatures. Contractor IRS Building and Remodeling, Inc 32 Buckwood Drive Hyannis, Massachusetts 02601 Daytime Phone Number: 774-836-6654 Evening Phone Number: 774-836-6654 Email Address: richard@ihsbuilding.com Federal Employer ID 82-3954399 Massachusetts Home Improvement Contractor Registration Number: 190612 Registration expires on 2/9/2020. 1HS Building and Remodeling, Inc is incorporated in the state of Massachusetts. IHS Building and Remodeling, Inc will be referred to as Contractor throughout this agreement. Owners Jim Kenny and Robin Kenny 135 Oak Hill rd. Hyannis, MA 02601 Cell Phone Number: 602-328-0900 Email Address:jkenny@eldoradoholdings.net Jim Kenny and Robin Kenny will be referred to as Owners throughout this agreement. The Construction Site 135 Oak Hill Rd. Hyannis, MA 02601 1. Project Description A: For a price identified below,Contractor agrees to complete for Owners the Work identified in this agreement as the Project. The Project is described as follows: -Obtain necessary permits FRAMING: -Remove the wall between dining room and kitchen and install supporting beam -Remove wall between kitchen and fireplace area and install supporting beam -Remove the door to the garage from the kitchen and close in the opening. HVAC: FIRST FLOOR Install central air conditioning for first floor as follows: -Provide and install a York 3-ton air handler with ECM motor in basement and matching 3-ton 17 seer condenser. -Install air handler with new line set and connect to existing duct work. A new plenum and return box will be installed. -New sheet metal duct work will be run for new floor registers. -Standard grilles will be provided and installed. Signatures The signatures that follow constitute confirmation by those signing that they have examined and understand the Contract Documents and agree to be bound by the terms of these documents. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! This agreement is entered into as of the date written below. Jim Kenny and Robin Kenny, Owners Si na' re� ( g ) (Date) (Printed Name) (Signature) (Date) Anted Name) IHS BuiM=1 Inc, Contractor 01/15/2019 (Signature (Date) Richard Peckham, President (Printed Name and Title) • Page 19 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations IV 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): �4'I�a tt.,1 Idi t't ou.J P-ZrucOC U1rk- Address: 32 Dr. City/State/Zip: flya I yc/S AM 0260/ Phone#: 77 k-8 3 6--66511 Are you an employer?Check the appropriate box: Type of project(required): 1 [Q•I am a employer with.3 4. 0 I am a general contractor and 1 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 8. Demolition working for me in any capacity.ca aci • employees and have workers' t 9. ❑Building addition [No workers' comp.insurance comp•insurance' required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all 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.[]Oilier comp.insurance required.] `Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t♦,.H,�omeowners 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: /W • Ate� — Policy#or Self-ins.Lie.#: A k)C Lw,0703,6 t1 3 8ZQ 1 o0 A Expiration Date: 5161 Z-01 f _ Job Site Address: BE- Oak-�_il/ �• City/State/Zip: 11-l1-f S �/i1 OLbn 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 certify under the p ' and,p aloes ofpe 'u at the information provided above is true and correct Si ature• Date: 02'C/—/g Phone#• 7-7L/ - 836 -66SL 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#• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6 also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The GommennwWth of Mas.sachusefts Department of Industrial Aecidents Office of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-n7-4400 ext 406 or 1-877-MASSAFE R 5 h Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia i Act CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY1) 1 1 10/29/2018 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(les)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: Toni Davies GH DUNN INSURANCE IPAIC N Ext: (508)295-0005 A No): E-MAIL allusers@ghdunn.com @9hdunn.com P O BOX 99 INSURERS AFFORDING COVERAGE NAIC# W.WAREHAM MA 02576 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER B: IHS BUILDING & REMODELING INC INSURERC: INSURER D: 32 BUCKWOOD DR INSURER E: HYANNIS MA 02601 INSURERF: COVERAGES CERTIFICATE NUMBER: 331186 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR 1 POLICY NUMBER MM/DD MM/DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE TO 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 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) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION /� STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICERIMEMBEREXCLUDED? NIA NIA NIA AWC40070364382018A 05/06/2018 05/06/2019 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500.000 NIA DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,maybe 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.govnwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 367 main St AUTHORIZED REPRESENTATIVE TH Hyannis MA 02601 `- j C a�Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Application Number........................................... Section 9- Construction Supervisor Name_ Ptc .a.r c/ FecUa m J-P Telephone Number 77u-836-66S f Address 3Z Btd-c vno(2� P�" City 4ya,tw's State "A Zip 07-67 License Number 04 L//9 3 License Type e Expiration Date 07/Z ?f Z,o t q Contractors Email rr'G/,�ctv /`�u36cu'l�ihq�, Goy Cell # 77C/-8"36-665L/ 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 by 780 C d th own of Barnstable.Attach a copy of your license. Signature Date OZ-of—19 Section 10-Home Improvement Contractor Name P-I S BWu 1d1 Re140c6d;k Telephone Number -774-836 665�f Address 32 &WIU)6001 a, City a4ra�S State P4 Zip Re ' on Number I906 lD(/��glstrati /� Expiration Date ®a- I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I derstand the construction inspection procedures,specific inspections and documentation required by 780 CMR d the own of Barnstable.Attach a copy of your H.I.C... Signature DateZ 3I Section 11 —Home Owners License Exemption Home Owners Name: j Telephone Number Cell or Work Number 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 by 780 CMR and the Town of Barnstable. Signature Date APPLIC/ANT SIGNATURE Signature Date ©2--01-1`l Print Name 2ah Jc�` lave Telephone Number '774/436- 665L/ E-mail permit to: r iac tczrol / hS btt-j Last updated. 11/152018 Section 12—Department Sign-Offs Health Department Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ 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 to act on m I. Y behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name 9 1 i n 1 Last updated: 11/15/2018 Town of Barnstable '"Fermi pn Expires 6 months om issue dat Regulatory Services Fee a s + RA MABLK • 9q� MAC' 9' Thomas F.Geiler,Director i63 �� rEp Mp'l� Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number , e—]) —lG CXO Property Address Residential Value of.Work // Minimum fee of$3355.00 for work under.$6000.00 Owner's Name&Address 6_b c,4�_ 17 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) +� Construction Supervisor's License#(if applicable). �1 ■ ❑Workman's Compensation Insurance Check one: 2��2 ❑ I am a sole proprietor �AY I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name T®Wti OF BAR Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Ile Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ti ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is quired. SIGNATURE: Q4PFILESIFORN[Mbuilding p rinit formslEXPRESS.doc . Revised 051811 S. The Commoniveahh of Massachusetts s Department o,f ludustrial Accidents Office of Imest gadotts 600 Washington,Street _ Bosun,MA 02111 www m ,gav1dia Workers' Compensation Insurance Affi&vit:BmldersiContrractorsfFlectric ans/Ptumbers Applicant Information Please Print 'b , Nan (Eusmese►70rgauizationllndiQianaq: RA e 77 Ci /State! la ��1� /�// Phone#J49 7 Iro Are Y� li an emplo6rir? eckthe appropriate boa: Type of project{required}: I.❑ I am a employer with 4_ ❑ I am a.general contractor and I employees(full and/or part-fime)- * have hired the sub-conhctors 6. ❑New construction 2.❑ I am a sole prapriet or or partner- listed on the attached sheet. 7- ❑Remodeling These sub-contractors have ship and have no employees. 8_ ❑Demolition working for me in any capacity_ employees and have workers' ' [No workers'comp.insurance comp.insuraum, 9. ❑Bung addition mod] .5- We are a corporation and its M❑Electrical repairs or additions work 3� I am a home officers have exercised thhomeowner doing all. 11.❑Plumbing repairs or.additions myself[No workers'comp. right of exemption per IMIGL insurance d_]i c. 152,§1(4),and we have no 13 13.❑Otheoof r pairs employees.[No workers' .❑Other comp.insurance required] ;Any applicant fat checks boa#1 mast also fill out the section below showing their womkere canipensatixm poricy infnrmetion- Homeowners who submit this af{dsvir indicating dwy are-doing all work and th.ea hue outside contractors nmst submit a new affidavit indicating sncIL IContractms that cberk this box in=attached an additional sheet showing the name of the sub-camuscon and stare Whether armot those entities ham employees. Ifthe:sub-wntntctorsbm employee%they must provide their workers'comp.policy number. I our an empZgjw that is prauiaiinrg workers'compensaion:hwarenrce for any empLayeas. Below is the policy oned job.rite information. Insurance Company Name: Policy#or self-ins.Lic.#: Expiration Date: Job Site Address: City/State)Zip: i Attach a copy of the workers'coampensation.policy declaratimi 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 farm of a STOP WORK ORDER and a Ene of up to$250-P0 a day against the Violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations ofthe DIA for insurance cmerage verification. Ida hereby catYi th paints and ury at the innformatim ptmided above fs bue and correct �ture: �Date:.-.....-•- ���� gfficial ruse only. Do not write in this area,to be completed by do or town official City or Town: PermitlLicense# Issuing Authority(circle one):: 1.Board of Health 2.Building Department 3.City/Town Clerk d.,Electrical Inspector $.Plumbing Inspector .6.Other Contact Person: Phone th 6 �t r Town of Barnstable Regulatory Services yKAM $; Thomas F. Geiler,Director 039. 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 HOMEOWNER LICENSE EXEMPTION J� Please Print �DATE:- % / of ._._...:d—mot JOB-LOCATION:, �/ T y.1 Rol ct :Z number street Village / "HOMEOWNER": d 6e� � 17x— C S' Oa= 71`� C—,,,...,- name home phone# work phone# CURRENT•MAILFNG ADDRESS:._ /'i1'•ci dr��J' ity/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"c es that he/she understands the Town of Barnstable Building Department minimum inspection pro the/pe will comply with said procedures and requirements. Sign eofHomeowner 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. Q:\WPFILES\FORMS\building permit formS\EXPRESS.doc Revised 051811 "y JL4 9r-4B14 MASS. ,0r 'Town of Barnstable rEo Mvr°i 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: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building perrnit application for: (Address of Job) s Signature of Owner Date Print Name If Property Owner is applying for permit,-please complete the Homeowners License Exemption Form on the reverse side. QAWH ILESTORWbuilding permit formsT)TRESS.doC Revised 051811 Assessor's map and lot number � SEP1"IC SYSTEM MUW BE INSTALLED IN COMPLIANCE Sewage Permit number ho........ WITH ARTICLE 11 STATE SANITARY CODE AND TOWN Q�Of I E.Tp�y T OWN OF by A R N ii • i BAENSTOBLE. i 9�p N & RUIL I G INSPECTOR APPLICATION FOR PERMIT TO .......e............................................................ TYPE OF CONSTRUCTION .................... "" " , 7.E......................................................................................... .,, .. ....................19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for according to the following information: Location ......... d......� ......1''� .E. �...! 'd :......................................................:................................................... Proposed Use ...... ........................................................................................................................... /.11.'�........... .. ...... ZoningDistrict .........(11 ...................................................Fire District .............................................................................. Name of Owner ...Address Name of Builder ` . ..... ...........Address ..... l.......... .... .......................��:••••'•. Name of Architect .. .. :. .....Address . V:� `.»..... ,,. .�. .1.... .�.��!!.�e-�i Numberof Rooms . . ....®. .....................................................Foundation .. ��'�....fJy ...... ................ Exteriors t. `��"'8 Roofing ....................................... ........ ...... . Floors ..... .Af, .................................................Interior ....�=��Z��Z� "' ....................,. ................ Heating ........... ..................................Plumbing .................................................................................. Fireplace ..................................................:.:.............................Approximate Cost ........ J........... '":............................. Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area ....pez ..................... Diagram of Lot and Building with Dimensions Fee �'............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I � J �� I hereby agree to conform to all the Rules and Regulations,of the Town of Barnstable regarding the above construction. Name4........... ......... .................. ...... Doane. Howard C. 114'74.. Permit for add to single No ............... .................................... ..........a ...y dwelling..................................... i �`5'. Oak Hill Road Location v"..... . .............................................. ........................�Y.j n ....................................... , r Owner ...........Howard C. Doane ....................................................... , Type of Construction ....................frame ................................................................................ r i Plot ............................ Lot ................................ f I August 6 73 Permit Granted ....19 Date of Inspection ......................... .........19 Date Completed ... ..,1.. .... ..3....19 1 PERMIT REFUSED ................................................................ 19 ............................................................................... ...:............................................................................. ............................................................................... .......................:....................................................... 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