Loading...
HomeMy WebLinkAbout0071 ANCHOR LANE � ���� �/ �/� f� F '^�.Z ..:;,rye. .t e^� _ _ .... - �+-:�.���4'�..,t��o-U.:_. "n� I. ...� ""J�' tiL01~i�,.i..�.t��r'�1A;;�i -�..,.,r'"" r�.. .. , "I "a Town of Barnstable Building aAmmmAffia Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept ; AS& `� Posted Until Final Inspection Has Been Made. Permit s9. Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-2866 Applicant Name: Approvals Date Issued: 09/18/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 03/18/2020 Foundation: Residential Map/Lot: 024-107 Zoning District: RF Sheathing: Location: 71 ANCHOR LANE,COTUIT ,. Contractor Name: Framing: 1 Owner on Record: WHALEN,STEPHEN M&ALLISON B TRS Contractor License: 2 Address: PO BOX 1936 Est. Project Cost: $ 1,000.00 COTUIT, MA 02635 Permit Fee $85.00 : Chimney: Description: Remove wall between kitchen and living room new kitchen to be Fee Paid: $85.00 Insulation: installed Date: 9/18/2019 Final: Project Review Req: /J 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,4ix months afte��issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. 1.__ 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: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: 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. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site V Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 5 BUILDING, I. Application Number...... r • 7( * sARN6PA8LE, U ab� SEp 04 2019 Permit Fee.......................................Other Fee:....................... 39- Fo�" TOVvry Or u„a;1-43 l LE .. TotalFee Paid................................,:.............................. ...... TOWN OF BARNSTABLE Permit Approval by.................................On........................... BUILDING PERMIT f.01 Map.........6-A....................Parcel........ ............................ APPLICATION Section 1 — Owner's Information and Project Location - Project Address �-7/ p Village �L, Owners Name_ -57' V exl "Ie,X< Owners Legal Address '71 ��� C .,- City L-�7`v� State 141-4, Zip �Z�3 Owners Cell X 737 E-mail -t5-1V V�g/per Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet R�S�imngiewo Family Dwelling Section 3 —Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description ` 7r—o /e T e +....A.+.A• i t/11CMR1 0 r Application Number.................................................... Section 5—Detail Cost of Proposed Construction /DOy Square Footage of Project Age of Structure 19d 2' Dig Safe Number # Of Bedrooms Existing ,� Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics a Wiring ❑ Oil Tank Storage Smoke Detectors Plumbing 1z Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom i Water Supply Public ❑ Private Sewage Disposal ❑ Municipal W—On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: bw6&-6�96le- I am using a crane ❑ Yes W No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No i Section 8—Zoning Information Zoning District /'D/O 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 a Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Last undated: 11/15/2018 The Commonwealth of Massachusetts Department of IndustridAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly I / 1 Name(Business/Organization/Individual): Address: '7 City/State/Zip: �e71v/�T��. e2- 33- Phone#: d-D �73 Are you an employer?Check the appropriate box: 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• WRemodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity.acitY• employees and have workers' 9. ❑Building addition [No workers' comp.irorrance comp'insurance.: 10. Electrical Sus or additions required.] 5. ❑ We are a corporation and its ❑ rep 31 I am a homeowner doing all work officers have exercised their I L❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance ram]t C. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. r I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$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 it>.surance coverage verification. I do hereby certify under the pains and penaties of perjury that the information provided above is true and correct Signstore: ` Date: �^ Phone#: �73� Official use only. Do not write in this area,to be completed by city or town oftiaL 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 Commonwealth of Massachusetts' Department of Industrial Accidents O►fce of Investigations 600 Washington Street Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 wwwv maw.gov/dia s � � , cep ,'.v �-o►__s�" L.�s.---- GrJ�Y�� (3�-i��i R�h�o v�� �0. _/�•a v'�:, ��,so '- O 14 i Barnstable Bldg. Dept. 4 r� Permit 04 yf' cQ1�_ fry' � /•- c� 0 i c Q � U 1 i � I�V c� ®Boise Cascade Double 1-3/4" x 9-1/2"VERSA-LAM@ 2.0 3100 SP PASSED FB01 (Floor Beam) BC CALC®Member Report Dry I 1 span I No cant. August 20,2019 14:55:53 Build 7295 Job name: File name: Address: Description: City,State,Zip: Specifier: Customer: Designer: Brian flagg Code reports: ESR-1040 Company: 1 i 12-00-00 B7 B2 Total Horizontal Product Length=12-07-00 Reaction Summary(Down/Uplift) (Ibs) Bearing Live Dead Snow Wind Roof Live B1,3-1/2" 2265/0 816/0 B2,3-1/2" 2265/0 816/0 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 12-07-00 Top 10 00-00-00 1 Attic Loading Unf.Area(lb/ft2) L 00-00-00 12-07-00 Top 30 10 12-00-00 Controls Summary Value %Allowable Duration Case Location Pos.Moment 8998 ft-Ibs 64.5% 100% 1 06-03-08 End Shear 2550 Ibs 40.4% 100% 1 01-01-00 Total Load Deflection U306(0.476") 78.5% Me 1 06-03-08 Live Load Deflection U416(0.35") 86.6% n\a 2 06-03-08 Max Defl. 0.476" 47.6% n\a 1 06-03-08 Span/Depth 15.3 %Allow %Allow Bearing Supports Dim.(LxW) Value Support Member Material B1 Column 3-1/2"x 3-1/2" 3081 Ibs n\a 33.5% Unspecified B2 Column 3-1/2"x 3-1/2" 3081 Ibs n\a 33.5% Unspecified Notes Design meets Code minimum(U240)Total load deflection criteria. Design meets Code minimum(U360)Live load deflection criteria. Design meets arbitrary(1")Maximum Total load deflection criteria. Calculations assume member is fully braced. BC CALC®analysis is based on IBC 2009. Design based on Dry Service Condition. Connection Diagram: Full Length of Member a C e I. Page 1 of 2 ®Boise Cascade Double 1-3/4" x 9-1/2" VERSA-LAMO2.0 3100 SP PASSED FB01 (Floor Beam) BC CALC@ Member Report Dry 11 span I No cant. August 20,2019 14:55:53 Build 7295 Job name: File name: Address: Description: City,State,Zip: Specter: Customer: Designer: Brian flagg Code reports: ESR-1040 Company: Connection Diagram: Full Length of Member a minimum=1-1/2" c=6-1/2" b minimum=4" d=24" e minimum=1" Install screws with screw heads in the loaded ply. Connectors are:SDS 1/4 x 3-1/2 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 CALC@,BC FRAMER@,AJSTm, ALLJOIST@,BC RIM BOARD-,BCI@, BOISE GLULAMTM-,BC FloorValue@, VERSA-LAM@,VERSA-RIM PLUS@, Page 2 of 2 Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # 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.Attach a copy of your license. Signature Date Section 10 —Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand 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 required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Q F Section 11 —Home Owners License Exemption Home Owners Name: Telephone Numberif-09--2L —6 7 37 Cell or Work Number �gm� 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. l Signature Date APPLICANT SIGNATURE Signature Date L Print Name�'� �r Telephone Number E-mail permit to: .Syyl���jg��i(� ,Z 2 �/��e , C©&,-7 Last undated: 11/15/2018 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 I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name i _ 1 I i ' J 1 1• i ! 1 Last updated: 11/15/2018 E i Application number ^ 9 Fee ...................: D...............V ' SEP 1 Building Inspectors Initials.... ra����� E)F �� Date Issued.:.....1......�.. .'. . HNS 1ABLE Map/Parcel...... ........... rr 11 U .. ..v ............... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/S IDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: '7I Nan Ayp v- Lm e NUM]BER STREET VILLAGE Owner's Name: ",,�n W kZ4eA Phone Number_ 6015-73-7-747 7 Email Address: at i s0 n W 1 aA c Cell Phone Number Project cost$ 3,000 o Check one Residential_ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: ,TYPE OF WORK 0 Siding )A Windows(no header change)#�_D Insulation/Weatherization Doors(no header change)# e2- Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# _ (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. Pr ti APPLICATION.NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No____, if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: —, wkd,-V�� Telephone Number -5 CK-2 37-2 q-7 7 Cell or Work number.5Q4y\.L 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- 1 J �'1 l.�J Date, 01 l& h 9 APPLICANT'S SIGNATURE Signatures Date All permit applications are subject to a building official's approval prior to issuance. f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): (\ Address: -7 1 Ah"i-1 0 City/State/Zip: 0,a - 01'V,35 Phone#: 5 cy�<`-7-3 -7'C- Are you an employer?Check the appropriate box: 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 workingfor me in an capacity. employees and have workers' Y P h'• t 9. ❑Building addition (No workers' comp. insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I I.❑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.[1 Other comp. insurance required.] 11 *My applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$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 pains and penalties ofperjury that the information provided above is true and correct. Si afore: Date: ID ,_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#: r - � 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 cant'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 line. 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 Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington,Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia f Town of Barnstable g P ��E r Boildin Department Services ° Brian Florence, CBO TOWN OF BARNSTABLE Building Commissioner m Zfl�� ��4`� 200 Main Street, Hyannis,MA 02601 �_P 13 AN 9: 18 www.town.barnstable ma.us Office: 508-862-4038 ' •Fag:5QQW-6230 PERA/fcr# - I Q r $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less Location of shed(address) Village 3-7-'-74-7 -7 Property owner's name Telephone number 1.o x l z 0a y L0 7 Size of Shed Map/Parcel# OLUD Q C 9 Signature Date Hyam is Main Street Waterfront Historic District.? Old King's Highway Historic District Commission jurisdiction? You must file with Old TCng's Highway Conservation Commission(signature is required) Sign off bom-s for Conservation 9:00-9:30&3:304:30 PLEASE NOTE: IF YOU ARE WrDIIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT'PLAN Q forms-sbe dreg REV:08/6/17 „o•'"» TOWN OF BARNSTABLE permit No. L. Y � Building Inspector n„n Cash -- — , wa q ,eyo• � I OCCUPANCY PERMIT Bona _. X 11 J No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector.” Issued to 7h::o ConaLnuction Curp: Address FoutY :'—mr,=uth lot i.-ft3 71 kr_chor i. m—,, CoLuit Wiring Inspector Inspection date /�� Plumbing Inspector Inspection date Vri Gas Inspector / Inspection date /Engineering Department ,�;�� ,�' , / Inspection date ,It). � ) THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building Inspector V ,GaT 87 .GoT NO. 88 o ,c oT 73 0 �vIVDI'977/6, o C.u.N�a .�3Y. . T.�J�'rJ Co.�/57�2 • Go��? , _, -' , A`_ TO 4Y /97-9 ! F;E!2FC?Y CC• %Y TFi;1? Tt!; �J FOUNDI?;;Q LliCn:TF.'v Cr,. . ��• f` r'?K.viAf+ � � OOidcOPP.13 TO 'i ii):'!1V OF Get J-MAN � K gA Q.iaT�soB[E U Zo ° r,'ri�_GULA.' 0p43 REGAROIN; SETgr',CKS ST Et_T.LIKS AflD.LOT.LINES: \\ A A4s .­;;ors map and lot,number 2.�l........ 40 2 ... ...... ..... Sewage Perniit number ......................3 7f- ................................. i I SEPTIC SYSTEM MUS ........................... UWAUSEED IN COMPLI ST&BLI, House number .............. jt ........... t639- Q. %VM TITLE 5 #KFLAL CODE A TOWN :OF BARN TRGULATIONS BUILDING IMS P EC T 0 R ab- ..B.0 ............. APPLICATION FOR PERMIT TO . .............. ................................................................................................ TYPE OF CONSTRUCTION ........106hd... ji!/ . . .................................................... I........ ...........6. V......................19...V TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... . ...../o.i4of-V.......(' A........................... ProposedUse ... . el/ f V.......................................................................................................................... ..................... Zoning District ....... .......................................................Fire District ...... ................................................. Name of Owner Address I$029e& ...................................... I Jz" Name of Builders-SXI-d....... . .........Address .Sr....... .4�. Z �lw................................... Nameof Architect...................................................................Address .................................................................................... .......................... Number of Rooms ..........S .............................................Foundation .!./...... ... .... Exterior ..........Roofing V....a, .....................Aa.&..V � Floors ...oupe-.1-1 ................ .....................................Interior .....D. .......................................... Heating ...t/y 45.�gd........................Plumbing .... .......... ............ Fireplace .............oetw..........................................................Approximate Cost ............ ................... ............. Definitive Plan Approved by Planning Board -------19-M. Area .106-W. ....... Diagram of Lot and Building with Dimensions Fee ...AW........ SUBJECT TO APPROVAL OF BOARD OF HEALTH qc ' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Na m e .................................. �14 Theo Const. Corp- a .44.7.$..... Permit for ......single..f=4Y.- dwelling ...................................................................... Location ......lQt...M8.....7.1-Ancher...La............ .................catuit................................................. Owner ....Theo..Comst car.p.......................... Type of Construction ...........frame..................... 5........................................................................ Plot ............................ Lot ................................ Permit Granted ...........July... �1q...........19 79 Date of Inspection ....................................19 /�? � Date Completed ...... .....19 -7 PERMIT REFUSED ........... ..... .................................. 19 ........... . ...... . ............................................ . ............................................ ............................................ z, *........... -4...................—.......*............... M < Approved.......... .................................... 19 ................................................................................ ............... ...................................... ....................... 474 Assessor's map and 16t *number .......... ........ ............. ... Q�oFTHE d ,lSewage Permit number .......... ...................... BARNSTABLE, House number .................. r7 ..................................... MAM 1639- Up,,j A,. TOWN -OF BARNSTABLE 14 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...�.RAMU.................................................................................................... TYPE OF CONSTRUCTION ........ ...... ...... �4......................19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... ......Qz�Z4✓..... ........ ........ala- ......................... ProposedUse ...1 ................................................................................................................................................. ZoningDistrict ....... ..................................................Fire District ...... ................................................. f Name of Owner ..................40.-.Address ........ . .................. ............................................. ................................... I ---­ Name of Builder"..... f t�......Address ........S..... 00 Name of Architect ................. Address ..................................................................................... Number of Rooms .......NS�Q.............................................Foundation e ............ /L........................... Exterior ........... ..... ......................... f .................Roofing ... ..............Floors .... ......... ........................................Interior. ...... ............... Heating j ...A.) ........................Plumbing . .......... .... . aX..... ..... .......... Fireplace ..............A_�...........................................................Approximate Cost .............. .................... Definitive Plan Approved by Planning Board /__ _9 A4�r--- -------19 Area .................. Diagram of Lot and Building with Dimensions Fee .... ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ....................... Theo, Const. Corp. w� A=24-107 No 21478....... Permit for &ingle••!Eamiiy......•• ...........................dwe.Ll.ing.................................. Location .......1-at..#s8.....71..Anchar--L,: ......... Cotuit ............................................................................... Owner ....................Theo)...EoTmt•:••ICcsrp.......... Type of Construction .... ........frame.................. .............. . .................... .................................. Plot ............................ Lot .. ......................... Ju Permit Granted ...... ..........18..................19 79 Date of Inspectn ....................................19 Date Completed ......19 PERMIT REFUSED ........................ .................................... 19 f ............................ 0 .... .......... ............... ............................................ ............................................................................... Approved ........................................... ............................................................................... ............................................................................... ACCESS COVERS MUST BE WITHIN INSPECTION 9' MINIMUM. 6' OF FINISH GRADE r PORT 3 ' MAXIMUM COVER FIRST 2 " TO BE L EVEL 4- DIAM PIP_ - T- CLEAN SAND BACKF,'L " o h0O. /00.2 TI ! AROUND AND 2- OVER CHAMBER cas J/ r 99. 9! I j 9AFFLE 1 3 Ol';LEi` 10 HIGH CAPACITY INFILTRATOR EXISTING CHAMBERS IN TRENCH FORMATION D-BOX WOO GAL SEPTIC TANK Z 6. CRUSHED STONE OR COMPACTED BASE PROF I L- E NOT TO SCALE o 88 20. 6u7' S. F. s '� �o N o o F 1 - 9M. CORNER OF 9ULKH£A9 / EL-IOJ.JB- rt My O T' P V ExlsrING 5£P T I C TANK ^ V PJCO (/ CB/DH FND 1 1 c 9 D-BOX o� v syF'0 b I u'o p P*2 o j U.1)O TPrI I O� i CB/DH FND jc 10 rrlGH CAPACI TY v4 CJ i NF I L TRA i 0R ChAMBERS iA TRENCH FORMATION I O'p t� I � Qay 9~ z�x vi I C8/0H FND � 2 t 2 / ^ vy w 11Y/1 .f1 O� << - ­j 0 ���n\`0 h ,,"