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0072 ANCHOR LANE
�' V �� F i 1 � � �• �I F•.A�^:.i ;BAH •i!�ryR�/^ yiJ�,_ :� ,..i...1 '�_�. ....r•;.. r. .., ..,,.�:. � .,, .�..e ..�.. _ • ... BUILDING DE T sb UN 01 2020 �`*�OWN OF BARNSt4LE JL 0 {�'.�_•��4 •�' -Y.��. •- +�3 y . . .' 6..E+37- •', � `��-, :. �'�. -. - �- �•- VIA Aw �,. i'4�( � _ ..t•�l..Y .y .�, i .: t:� w :::WWM'rrr••• _ :. •�'re!' '�� ���'�,ia�• ,�.. '"r• �� ., t +�,�+�, �.-•r•e_ s�..�=" s' � T ''t ^ ,.,� .� "ems i r, ��► •` '►�•r'•S:' '.�_ Or �� ►, E' '• r 4 ....... ...... .... ........ .......... . Application Number..........�. I..... BARN�� MAS& Permit Fee................/.....................Other Fee........................ 039. -/4V q 7-OWA/OF 9 4?6p Is TOWN OFBARNSTABLE Total Fee Paid......... ............ ...... &%V Permit Approval by.................................On........................... BUILDING PERMIT Map........ ..............P=el..........)O.t................. APPLICATION Section 1 — Owner's Information and Project Location Project Address /Qr)C, kov- a V,-z— Villag e / V 6 a 0^./0'k",Owners Name V,0 C&wmers-Legal Addfess 10,11 to zip ,Cell#�QWiers o4 65 L ONU—s A gi�", J .04S e.ction of Structure St Use Group_ El "orumercial Structure over 35,000 cubic feet mmercial Structure under 35,000 cubic feet ;Single/Two Family Dwelling 1*,&Aon 3 --Type of Permit F] New Construction ❑ Move/Relocate [:] Accessory Structure ❑ Change of use D Demo/(entire�structure) El Finish Basement 0 Family/Amnesty ❑ Fire Alarm Rebuild El Deck Apartment El Sprinkler System g'Addition E] Retaining wall. Solar Renovation ❑ Pool El Insulatibn Other—Specify Section 4 - Work'Descripti A cu 4 0 LW 4 se -eill /c/ Ax?V en ftzpm 0--b-c-e— V-000VN2- Last updated. 11/15/2018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction 60 CIU&? Square Footage of Project L/ . Age of Structure / Dig Safe Number # Of Bedrooms Existing 4— Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring f ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing Gas ❑ Fire Suppression �t ❑ Heating System Masop*Chimney ❑ Add/relocate bedroom Water Supply ❑ Public 1 ❑ Private Sewage Disposal ❑ Municipal `i � ❑ On Site Historic District ❑ Hyannis Historic bistrict 0 Old Kings Highway Debris Disposal Facility: I am u�si ag'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 Yazd Required Proposed Rear Yazd Required Proposed Side Yazd Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/152018 Town of Barnstable Building Department Services Brian Florence, CBO 5! '� Building Commissioner lnl� STABLE "a5, 1 200 Main Street H annis MA 02601 ` `' ' �"��' 39-201`4 ' .:. Knsoxs�m�srosr[anuc•war ! 'Hyannis, 1639-2019 J www.town.barnstable.ma.us Office: 508-862-4038 i> Fax:,50.8-790=62- 0= 10/17/19 Evgeniy Bronov 72 Anchor Lane Cotuit, MA 02635 Please be advised that Building Permit Application B-19-305 is now an expired permit due to more than 180 days passing without any further submittals of additional construction documents for continued review (R105.3.2). If you wish to proceed with this project anew Building Permit Application is required. You will have seven days to stop by the Building Department to pick-up the contents of the application or it will be discarded. Feel free to contact me with any concerns regarding this notice. Respectfully, ' l Jeff Carter Local Inspector 508 862-4035 Carter, Jeff From: Carter,Jeff Sent: Tuesday, February 05, 2019 11:20 AM To: 'bronusa@gmail.com' Subject: Permit/Application:TB-19-305 at 72 ANCHOR LANE, COTUIT for Building - Addition/Alteration - Residential Good morning, Please be advised that we are currently your permit request for 72 Anchor Lane, Cotuit. We have to deny your permit request at this time until further information is provided. The submitted plans with the current grade of the existing structure, in my determination, would make the addition a third story which is not allowable in the RF zoning district(240-14)where the parcel is located. Please provide the following additional information: 1) Provide calculations from a registered design professional that the structure with the proposed addition will be 2 %stories or less as defined by town of Barnstable zoning regulation.These calculations can be either how the structure complies in its current state or how the final grade of the project will comply. If more than 50%of the basement is exposed then the basement is considered a story. The basement calculation is based from the area of the basement that could potentially/or currently be used as habitable space not the footprint of the first floor where areas such as the garage slab that does not have any potential to have habitable space below. And, if aggrieved by this notice and order,you may file an appeal with the Town Clerk of Barnstable, specifying the ground thereof within thirty(30) days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). Feel free to contact me at any time regarding this request. Thank you, Jeff Carter Local Inspector- Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508 862-4035 1 1 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 I 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 Section 11 —Home Owners License Exemption Home Owners Name: �J2o�v�t/ Telephone Number �F�� /O( Cell or Work NumberJ6�5 I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building C9de. I understand the construction inspection procedures,specific inspections and documentation required by 78 d the wn of Barnstable. Signature' Date APPLICANT SIGNATURE Signature Date //a8/ /9 print Name Telephone Number (64006Y-S Gi/D 6 -nail permit to: l'� On/j�W Last updated: 11/152018 .. .. Section 12—Department Sign-Offs -• Health Department ❑ Zoning Board(if required) ❑ i Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval 6 Section 13 — Owner's Authorization I 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) f Signature of Owner date Print Name Last updated: 11/15/2018 oF,NE Town ofBarnstable RARNSTARLE. • Regulatory Services MASS .a,9 6 Building Division pff0 MA'S . 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection 4� S � L 19- C7° Permit Number Location 72 4!V c f ����� i Owner 412kh(1'M Builder � C One notice to remain on job site,one notice on file in Building Department. , i I' The following items need correcting: 3 G G d UC t I/en/s�z?'S Y i d Please call: 508-862-40H fe eet are. Inspected by Date 7ILL /�6 ,f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ter, -Map '� 2 Parcel Application Health Division Date Issued 5s- Conservation Division Application Fe Planning Dept. Permit Fe Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 7ol nG ✓ �a ..2_ Village Owner e/o riot/ 050k4L Address Telephone IS 6�`J — �/ 6 Permit Request a ] Fron 4- oo�— •, vdo� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total ne%, Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes )l No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 3 Historic House: ❑Yes $(No On Old King's Highway: ❑Yes *o Basement Type: ❑ Full ❑ Crawl XWalkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 2 existing _new Total Room Count (not including baths): existing -3 new First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes t.NO Fireplaces: Existing__ __New Existing wood/coal stove: ❑Yes KNo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: &existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: j Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes A No ' If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION-- - (BUILDER OR HOMEOWNER) Name Telephone Number -6F,5-- 1/� 6 v Address _V, ,&, ,, A 64� License # 0 a3S- - Home Improvement Contractor# Email b on%_ksa Coy'^ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO YG1'i'W SIGNATURE DATE Y'-����c� r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE �. OWNER DATE OF INSPECTION: FOUNDATION FRAME j u1��l e INSULATION a FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: _ ROUGH FINAL. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. AWC Guide to Wood Construction in High Hrind Areas: 110 niph H17nd Zone Massachusetts Checklist for Compliance(7so cimR5301.2.1.1)r. Loadbearing Wall Connections Lateral(no.of 16d common nails).._......._...._.:.......(fables Z).........__.-------------_---__..._.....__ Non--:oadbearing Wall Connections Lateral(no.of 16d common nails)..__.._..._......._._.(fable 8)._...___..._...__...._....._............ _- r Load Bearing Wall Openings(n ord largest opening but check all openings for corApflance to Table 9) Header Spans ..... 9).......:..._....._.._...._..._It in.s 11' Sid Plate Spans _..._.__---------_...........__......_.(Table 9)_............_....._..........._ft_in.s 11' Full Height Studs (no.of"studs)......._...._... ......(Table 9)..........._._.._.__...__._...._...._..__ ) Non-toad Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9 Header Spans.:..................... (Table 9)......._.._....._._._..._..._ft_m.s 12' Sill Plate Spans...._._.._.-........._........._._..:».._.___.(Table 9)...-..__:............._-._..._ft_in.s Full Height Studs(no.of studs). _....._......._.___... .(fable 9)......._....... _..._.....__........... . .. .. . .... ....... Exterior Wall Sheathing to Resist Upfitt and Shear Simultaneously4. Minimum Budding*Dimension,W Nominal Height of Tallest OpeningZ ...................................................... :..._.__._..._.. SheathingType_......_......._.._.._.--.............(note 4):,..........................._.-__....__ • . Edge Nail Spading............ ._.. ..........(Table 10 or note 4 if less). _--------__.... In. Feld Nail Spacing._.....—...' 10)........ ....._........__.......__.. in. Shear Connection(no.of 16d common nails)(fable 10)... ........................................... Percent Full-Height Sheathing.-_._:_-.-.....:_.(Table 10)..............................................._% 5%Additional Sheathing for Wall with Opening>5W(Design Concepts)....._............. Maximum Budding Dimension,L Nominal Height of Tallest Openingz....._.............................................................._ SheathingType_._...._...._._.........._.._._...(note 4)..................._.___._._....__.__...._ Edge Nail Spacing.............._.._......:....._.__-(fable i 1 or note 4 if less)..............._...... in. Feld Nadi Spading...._........_...__.._..-._._,(fable 11)........._... . ............_.._.. ...... in. Shear Connection(no.of 16d common nails)(Table 11)........................._._.. ._................. 1/0 Pen�nt Full-Height Sheathing..._.;_�.__._(Table 11)..._.._._..._......__...._...:..._._.__ 5%Additional Sheathing for Wall writh'Opening>6'8'(Design Concepts)_.........._...:.. Wall Cladding Ratedfor Wind Speed?....... _.._..:.___...._...._......... ....._........__.... �_.__..._._.:....__._ 5.1 (ZOOFS Roof framing member spans chedced7._......_:...__._..(For Ratters use AWC Span Tool,see BBRS Website) . Roof Overhang ...............................................(Figure 19)............ ft s smaller of 2'-or U3 Truss or Rafter Connections at Loadbearing Wads Proprietary Connectors Uplift...._..._._........_........_ •--_..(fable 12)...................... ................U= plf Lateral........................... ..._............._....._....._.........(fable ....... ptf Shear.--'._.._....._............_._--.._.(Table 12)...... S= .PIf. Ridge Strap Connections,if collar ties not)used per page 21... (fable 13)...._._................ aller of 2'or L12 ' Truss or Ratter Connections at Non-Loadbearing Walls' Proprietary Connectors Uplift__..._......................_._.._..-.(Table 14)....._..........._...._...-.........__U= lb. Lateral(no.of 16d common nab)_.(Table 14)....................................._L= kb. Roof Sheathing Type......_._._.:.._._...._._._..__M.(per 780 CMR Chapters 58 and 59)...........: Roof Sheathing Thickness. ........... ..... ...........---........................_In.z 7116'WSP Roof Sheathing Fastening._........._..__--------.._......._:(Table 2)_.............__.;.................... ........_.._ Notes: 1: , This dumkW shall be met In its entirety,excluding the specific exception noted In 2,to comply with the requirements of 7B0 CMR-530121.1 Item 1.If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 2b Gage Straps per Figure 11 m Upfrft Straps per Figure 14 d. Al Straps per Figure 17 m Comer Stud Hold Downs per Figure 1 Ba and Figure 18b 2 'Fxaeption:Opening heights of up to 8 ft.shall be permitted when 5%Is added to the percent fuMelght sheathing - 'requirer eats shown In Tables 10 and 11. 3. The bottom sic plate In exterior wads shall be a minimum 2 in.nominal thickness pressure treated#2-grade. ATYC-Guide to' food Construedorr iu High Wind Areas:110,wph Mind Zone Massachusetts Checklist for Compliance(7so cn-rRsw:2.i.i)' - . Compliance 1.1 SCOPE WindSpeed(3-sm gust)__......_._.................._...__..._..___.._..._._._...._._..._-.---......... .110 mph WindExpam a Caisgory...._._._.»...._..._...._..»_._........_............».__»...._...._._.................:.._..........._...e Wind Exposure Category................Engineering Required For Entire Project.......................................0 12 APPWCABiLITY Number of Stories(a roof which exceeds B In 12 slope shall be considered a story) stories 5 2 stories Roof Pitch.-.-..--. (Fig 2) .._..._ .......................... 512:12 Mean Roof Height._......._......_._._.__...._...._._......._._.....(Fig 2)_...._............»__.............._._._—ft 5'33' BuildingWidth,W.............._.._..._._......._..._..__._....._r..(Fig 3)_.._......:.._..:.................__:._._ft 50'8 Building Length,L , Building Aspect Ratio - Nominal Height of Tallest Opening2 ............. _». 4)...._.-...__................_........ _. 1.3 FRAMING CONNECTIONS General compliance with framirig connections._...__._.... .(Table 2).......__................................_.........._.... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 , Concrete...................................................:........................:............................ .................... Concttb Mason - 22 ANCHORAGE TO FOUNDATION1'3 5/8'Anchor Bol sdmbedded or 5/B'Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general...................................-_:.(Table 4).....................................___ in. Bolt Spacing from endfjoint of plate....._....._....--_-_.»(Fig 5)....._..._._..:..:.............. in.5 6'-12'. Bolt Embedment-concrete.........._.........__....__.._...(Fig 5)....;.__.._..---.__.._.:._.._......_.. In.z r Bolt Embedment-masonry............._........_»._......_(Fig 5).....:.._.t_:......._............_.... in.t 15' PlateWasher..:....._........_.......__.._._._...__._._...._...(Flg 5).._..._..__.__......_...__...._......z 3'x 3'x Y.' 3.1 FLOORS Floorframing member spans checked ...__...-........._._...._.(per 780 CMR Chapter 55)........ Maximum Floor Opening]Dimension (Fig 6)...___.»:_....................__........... fts 12' Fun Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)..:.............. Mi1ximrim Floor Joist Setbacks Suppoiting Loadbearing Wailk or Shearwall...._........_ r ft 5 d Maximum Cantilevered Floor Joists_ M T Supporting Loadbearing Walls or Shearwall...._...»._(Fig 8)___...._......_............._...._.......... _ft 5 d FloorBracing at Errdwafls.._.._..».........._.._._....__......... (Fig 9) .._.__.._...........�...............__.._. _...._. Floor Sheathing Type .._....__.........._...:_..._........_.._..:.._(per 780 CMR Chapter 55)......_.........._:.._.._..._ Floor Sheathing Thickness.........._._.._..._.._......_...._:.....(per 780 CMR Chapter 55)....................... In. Floor Sheathing Fasts ing__.........................................:.(Table 2)_ d nails at in edge/ in field 4.1 WALLS Wan Height Loadbearing walls._.».._.........__......_._.................._.(Fig 10 and Table 5)_........ ft 510' Non-Loadbeadng walls.._..._..:._..._. »._._.(Fig 10 and Table 5)......................... ft'5 20' Wall Stud Spacing .....__......_.............--..._..»._......_(Fig 10 and Table 5).................. in.-<24'a.c. Wall Story Offsets .(Flgs 7&8) ............ 42 1:DMMOR WALLS Wood Studs Loadbearing*all$........................................_--.. (Table b)........_................._.mac_-_ft—in. Non4Loa0eanng coatis ......._...._.:(fable 5)._..._...:;.........._._..2x • Gable End Wall Bracing' ._._.__............._.._. — — •— Full Height Endwall Studs.._»....»..._.........._._......_...(Fg 10)_.................................. ......__..:._:...._ WSP-Atiic Floor Length.____..:.: ft kW/3 'Gypsum Ceiling Length(If WSP not used)....:._......._.:(Fig 11)..:_.................-..............:...—ft z 0.9W and 2 x 4 Continuous Lateral Brace @ 6 ft.mm_(Fig 11�_..:.........................._......____....._,.._ . or 1 x 3 ceiling furring strips @ I S'spacing min.with 2 x 4 biocldng @ 4 ft spacing In end Joist or truss bays Double Top Plate - Splice.Length .._.._....:_:._.._»..._._...._.....___..(Fig 13 and Table 6)................. _ft Splice Connection (no.of 16d common naI1s).._..........(Table 6),..._._......................... AWC Guide to Wood Construction in High Wind Areas: 110 mph lend Zone Massachusetts Checklist for Compliance(78o CIAR 5301.2.1:1)' 4. a. From Tables 10 and 11 and location of wall sheathing and Buldtng Aspect Ratio,determine Percent Full-Height Sheathing and Nall Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16 and be installed as follows: L . Panels shall be Installed Wifh strength adds parallel to studs. H. Ali horizontal joints shall occur over and be naled to framing. 111. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. . Iv. On two story construction, upper panels shall be attached to the top'member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nall spacing at'double top plates,band joists,and girders shall be a double row of tad staggered 9t 3 Inches on center per figures below:Vertical and Horimntal Nailing for Panel Attachment S. Glazing protection:a)new house or horizontal addition—required if project Is 1 mile or closer to shore(generally,south of Rte.26 or north of Rte.6) b)vertical addition—not required unless there is extensive renovation to the first'fioor c) replacement Wbidows—needs energy conservation compliance only(chap 93) 6.Wood Frame Construction Manual(WFCM)for 110 MPH, Exposure B maybe obtained from the American Wood Council (AWC)website. YV!tHrTM EDGERWrs orr Fi3AAmiG USEad Naas ATG-= • rr r r it t • ii it i, r � i ii it I Fa r Itit r� lov. f 1 ii go li v d . It u r PRAL G LQMG0qSr EDM W�TE t r L' L tl9 -�+ ;E r 46 JA K DW OZ r-axE STAB NM,SP_ MALL PAT16iAi _ � PIING PAWL EDCMDo-B<ENALEDGESPACM DUAL See Dotal on Next Page ' Detall Vertical and Horizonlal Nailing Vertical End Horizontal Nailing • for Panel Attachment for Panel Attachment f. _ • -- ' - -- - - 'i .t�•� i :r� i • '� 4 I - � - �*• De� 'ofl�d rrida►rf�c . ' Offl,=o.f1AVffQgaY0nS 500 WashhVtun Strut Boston,MA 0 M . WWW-M 9uv/tea Worh s' Compensation Insurance Affidavit:Bmlders/Confracbrs)Mecb emns/phmabers A-puRcautInformation plmse pit Lep-bly• , •Name - ✓ror'tJ�1/ 702 Avic/ o� Are you an employer?Check the appropriate bo:c Type of prof ect(req ; .1.❑ I am g empIoper with 4- ❑I am a general and I employees(frill and/or pert toner). * have hired the 6. El New constractim 2.❑ I an a sole proprietor or pmt a=- Bated on the affacbed sheet 7. ❑RemodcB3g sbip and bane no employees These moors bane S. n Demoh`tion, wrnicing for me:in'my capacity. eoagloyexs rind have worlxrs [No worl= CM33P. msiam>= gyp,insan,m t 9- ❑BmZd ng addition 5. We are a corporation and its 10-❑Electrical.repairs or additions 3.Liu,I am a hamww=doing an work officers have==dsed their IL❑Pknbingrepa*s or additions M3ySdf [No wads'cam. ri&of exeart mperMGL �❑Roofop insonince required.]t o.L52,§1(4),and we have non / aim mploy=[No waai�s' 13.[ Otbea•�oo d r k3,6 ccmp-insoranmminirmil ��Y aPpIiemmt Smf r3e+dc�box�l mat also§II ontSu sutina below shaw�gSieawo�'eaaopea�on poIny infn�tiom. t Hameoq�ess wbn salmm�Sus affidavit mdi�a' g Sup so daiog�II Wod�®L thin Lae ode eta Est tabu$amw�davrt mdicdmg sn�h_ �CSoat�a�ebeckSus boot ommst albrched�edditiemdl sbrLtsbowfi�gSu name of Su tab-cm�haelnts�d staff whdfia or not�nsa des have eazPlo3'ees•ff Sie snb-�c�a hrn e�layces.�cP nab Pam'ide 6u��vodas'cow,Po�a-Y�b�s - . I am ax ea�loyer•that is prrtvidusg7parkers'mrr�enration uzrru-rmre for my empla3'ee� Belay it the pa&ry and job site . v formation, Inso rmam Compaay Name: Policy#or Self-ins,Lim#: BcpiratirmDatr_ Job Site Address: ( y : AtfnA a copy of the workers'compensation policy a eclaration page(showing the policy number and=pka ion date)- Failam to s=mc caverage as required Roder Se c ion25A ofMGL c.152 can lmd to the imposition of crminal penalties of a fine np to$I,500.00 and/or me-yezr iaprisam a nt as well as civil penalties in fbe f arra of a STOP WORK ORDER and a fie of up to$250.00 a day against the violator. Be advised chat a copy of this stataoz may be f xwmdcd to the Office of hTym igations of the DIA fur ins®nce velcation. I do hereby certify under the erratties ofPerjmy that the h fm=fion per nUed above it loon-and correct S' Dam �/�3 Phan#: j_ �046 l ff=' l use only. Do notWr&e in this arra,to be completed by city or fmm o�rr%T! - City or Town: Perm:.rt •� �p ssnmrg Authority(oar rIe one): L Board of Health.2.BmZdmgDepariment 3.CitpfTowa Clerk 4,Mcctrirallnspednr EPbmmbingInspector 6 Orther Cantact Person: Phone#: - Information and Instructions,' Mkscachllse ft Gemmel Laws chapter M regoxs all enpbyes to provide worker'campeosatiM fOr their eMPIopees- Pm otio this staff,an employee is de5ned as=.every person m the service of Bawd r mnder auy-mart of hoe, express or implied,oral or wriffei-" An deed as"air indivi Taal,pmIncrship,assoc dim,corporation or other legal easy,or EMY two m more of the foregoing egged in a join and incladmg 11a legal represcutefives of a.deceased employer,or the receiver or t ustee of an kdfividnal,partacobip,association or ad=legal entity,employing employecs• However the owner of a dwelling house baving not more than three apartments and who resides fhece n,or the occapauxt of fhe - dweMag house of mmiber who employs pecans to do insirtmmur,canstroctian or repair work-on.such dwelling house or on the grounds or bmVmg a;iiintensait theclo shall not because of such moployment be deemed to be an employer." MM chapter IA§25C(6)also sines that"every state or local licensing agency,shall witkhold ffie issuance or renewal of a license or permit to operate a business or to construct bmMags-in the commonwealth fur any applicantw•ho has not produced acceptable evidence of c6mpMmce with the i osm-anca coverage requi e&" Additionally,MGL chapter 152, §25C(7)slates"Neifhcr the m=anwean nar imy of its poIitical subdivisions shall ear rain any contract for the perform ofpablic wmk until acceptable evidenm of campligam with the ium mm requir fs of this chapterbzm been presemtcd to the couf mcti ng au lhorifyy." A ppIi=is Please fill out fe worms'compensation affidavit camglebety,by checking 13m boxes fhat apply to yopr situation and,if necessary,supply sub-contractors)name(s), address(es)and phone mmn es(s)along with their cetificate(s)of insurance. Lmmited Liability Companies(LLC),or Lmmitad Liabfiity Paxtaecships(I I P)with no employees ofher than the members or partners,ate not required to cony worms'compensaticn.insmmmce. If an LLC or LLP does have employees,a policy is regard. Be advised that this affidayhmaybe submitted to the Depadment of Indashial A.ccidems for confnmatim ofromance wveaagm Also be sure to sign and date the affidavit The affidavit should be reEnmed to-66 city or town that the application for the permit or license is being rrgaested,not the Department of dal Ac ' mfS Should you have any questions regarding the law or if you are required to obtain a wori=' ce¢rPeasaiion pDJiCN please call the Depareneni at the nmmbe r listed below. Self-insured campm i,es should enter their self-insurance license number au.the appropriate line. City or Town Officials r Please be sore$fat the affidavit is cnmr Ietn and pdafed.legibly. The Depsatmmxt has provided a space at&c boI of the affidavit for you to fill out in the event the Office of li vestigatiams has to confect you regarding the applicant Please be sure m fill in the pen�it/liccnse m7m er wbich will be used as a reference number. In addition,an applicant that must sabmrt multiple pem Mic=se applications in ffiry given year;need only submit one affidavit indicating currant policy fi fbimation Ciif u=cwzry)cud mnder-Job Site Address"the applicmt should write"all locations in (city or town)."A copy of me affidavit Brat has becn officially stamped or m 3md by the city or town maybe provided to the applicant as proof that a valid affidavit is on file firfirimre permits or licenses A new affidavit must be filled out each year.Wheat a home at or citizen is obtaining a lk==or permit not irldcd to any business or commercial venture (i_e. a dog license or permit to burn leaves etc.)said person is NOT reqahed to complete this affidavit The Office of Investigations would Ifice to thank you in advance fur your cooperation and should yea have any questions, please do not hesitate to give us a call. The Deppilia mt's address,tc lephoa a and f-number. • • . Tl�e C��1tIr of 1�as�hi�lfs - - . Depazfinmt of 17;dTqMal Accd®ts Office of Xnvestigafio= 6UQ wadbom Sfted Bmtom,IY &o�11I Tel.#617-M-49W cat 4€16 or 1-M-MASSAFE xevised¢2a-o7 Fax#617 72'-'7� WW muggUTARa 'i rqy Town of Barnstable Regulatory Services MASS. $, Richard V.Scali,IXrector Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date . QTORMS:O WNERPERMIS SIONPOOLS Town of Barnstable Regulatory Services oFViE Totf y Richard V.Scali,Director , Building Division r BARNS Tom Perry,Building Commissioner MASS 200 Main"Street, Hyannis,MA 02601 QED a www towu.barnstable.mn us Office: 508-862-4038 Fax: 508-790-6230 ' HONIIAWNER LICEI�ERENffTlON 3�l�-7� Please Print DATE: � W� r� JOB IOCATiow- / ��e h IJ A . number village ygn n home phone# work phone# CURRENT MAMING ADDRESS: /O� 47�`C k<�,Y- 7�') cityhown staff rip 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. DEFINMON OR 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`.`ho eowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules Tr�pqd oils. _ The undersi es that he/she understands the Town ofBamsfable Buil ' De artment minimum' ection � P msPprocedures that he/she will comply with said procedures and requirements. Signatum o eowncr 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 EREN=ON The Code states that: "Any homeowner performing work for which a building permit is required shaIl be exempt from the provisions of this section(Section 109.11-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 8s 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 r6quir'e,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iast 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. i i Q.\WPFII_ESTORMS\bugdmg permit founs\ M]KESS.doc Revised 061313 . -Y - - P` r� •mac.—�., --�,��-=.�.-----�—'-L��.=--' iom I •� � �i 1� � I to TAd a iQ- F i'Yl r ii '�,a �''.L ,�_y,:.�.y�M� v. s••.-�r���',`Sa„r, ^.`�? �rL �`.�` -+"-icy - 1" ��' ``.�C .. +A"�~ !�[ � 3..L'' "r s".` +�..p.a�-��kw{(.�"r,_7la�i "�.� 'sec w s '�wf� "•C+a � 4,f». - a. P�'.Jt� �-.� �M'A"?•• dy,�n..e��'�}� ,�rx�,l�r ���r''�"`.�yi•tpll�r�""`� 5+y+-�... ��.�i"t�"L. L" �� �{�'r�. � {� .. 4 ., ••,C•a,Y�,. «'Sq',,... 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S i �,�,� �4 :� r� C j •'i �• ,,, � "' �.< �� � ��• .7 .. } �� .f'� � •� •4i. � .�- ",u.xe«+y.wu.�.,.waoimvr�.uo,..w,..�.,�«.�.,,r.:�au �vwog.s,..�.�..�.�,a.a....,�.a....�..,......,a......�.....,.«,....M......�.,.>,a.uvex.un...� �1 1 L Ili. i, �. �p 1J -r� ^7- c�'��� � � � �tr) �� � �,�" �� � o v 1 ir7 � .7a �=� >.:. �,,,, t,.r n.�.�ze.,�,.�..,..,.�...,«�,�.�,;..�..�,.,.,,,�.,�.,�,..,..�,.�,,..�,�,..�,.�,.�aa....,.�..�_...... ,.,..._�..�.�.... �.i 1• A J nr� +� r h Z � o o o ° a a o, -- � oe Q 3 Q � ^n O � 3 0 O Q S. ° fee ' go 0 ti MA M 22 ft AW qw, S c,` , of i� N Weatherization & Insulation 410 Grove St.Fall River,Ma 02723 Insuaatezov"et September 30, 2014 Town of Barnstable j Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 RE: 72 Anchor Lane Dear Mr. perry, This Affidavit is to certify that all work completed at 72 Anchor Lane has been i aspected by a certified BPI Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, Roland Langeyin_ Insulate 2 Save, Inc President CSL 103861 HIC 166311 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division .. Date Issued l `� Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address �� AnA0.Q� Village iul Owner i Ly ►_ Address `7� �n��- r�r �✓. Telephone S_OS' - �ermit Request 1 g O�oi c1n �� c ,� w�Lc) 62c= AIA1 rie CeA�JoSe ;2n L44-C7 oPr)tit-i��t'�`or� ©��" Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new I Zoning District Flood Plain Groundwater Overlay Project Valuation '2 J. Construction Type /W�aTn�r� Zct4'do'-? Lot Size Grandfathered: ❑Yes ❑ No If yes, aJKiN-g porting�,�-ocurrntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Olighway: ❑ s ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area ( q.ft) E5 Number of Baths: Full: existing new . Half: existing sewn A(t Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑ Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name20) 0 i Telephone Number Off' 70 - e2o 6 Address 4110 Err nu n sh2clol► License # SIC Jl i U cl IY74 d Home Improvement Contractor# (n h Email i2x-Ar)4 c cc,lo�e Qs.%J e,k1 c4- Worker's Compensation # I k lit/ C 3 i 1 y 3/ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i W n I Iv �G P � c:rJ0 c.JY1 12�24 SIGNATURE �%G� 12�� DATE _9 "/O -I q FOR OFFICIAL USE ONLY APPLICATION# DATEISSUED MAP%PARCEL NO. -E ADDRESS VILLAGE '.' ti l •• OWNER a DATE-OF INSPECTION: FOUNDATION 9 FRAME r INSULATION FIREPLACE s ELECTRICAL: ROUGH FINAL k PLUMBING: ROUGH FINAL. GAS: ROUGH• FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ,`a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Insulate 2 Save, Inc Address:410 Grove St City/State/Zip: Fall River, MA 02720 Phone#: 508-567-6706 Are you an employer? Check the appropriate box: Type of project(required): 1.❑■ 1 am a employer with 18 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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' y9. ❑ Building addition [No workers' comp. insurance comp. insurance.2 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 Insulation/weatherization employees. [No workers' 13.X Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Fiomeowners 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:Guard Insurance Group Policy#or Self-ins.. Lic. #:INWC311431 Expiration Date: 12/10/2014 Job Site Address: City/State/Zip:Cn ,,+, /)9W 020r 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under �t/h�e pains and penalties of perjury that the information provided above is true and correct. Sianature: //�� �i�"'—" Date: q7_1 0 Plone#: 5085676706 Official use only. Do not write in this area, to be completed by city or town official. :City or Town: Permit/License # :Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector `6.Other :Contact Person: Phone#: ,aco o CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDaYYYY) �.i 6/12/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the.policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to. the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Anthony . Cordeiro Insurance PHONE FAx y • (508) 677-04.07 Al No; (508) 677-0409 JAMR(XENti171 Pleasant Street ADDRE SS:SS: lbrizido@cordeiroinsurance.com Fall River, MA 02721 INSURE S)AFFORDING COVERAGE NAIC q INSURER A:Atlantic Casualty Ins. Co. INSURED INSURER B:Torus Specialty Ins. Co. Insulate 2 Save, Inc. IN$URERC:Great American Ins. 410 Grove St. INSURERD:Guard Insurance Group Fall River, MA 02720 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 AOD SUER POLCY EFF_'—POLICY EX155I LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MMIDDN MMIDDIYYYY I LINTS A GENERALLIABILITY Y Y M081000174-2 6/12/14 6/12/15 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE E,S_(E14CCufiC OB_=uia 0.Ce)_ $ 100 000 , CLAIMS-MADE OCCUR ME0EXP(Aryonoperson) $ 5 000 PERSONAL&ADV INJURY $ 1,.000,QOO GENERAL AGGREGATE $ 2,000,000 G�EN'LAGGREGATE LIMIT APPLIES PER PRODUCTS-OOMP/OPAGG $ 2,.000,000 X I POLICY 71 XCT PRO- LOC $ AUTOMOBILE LIABILITY COMBINE,'d'D$I L- IMI Ea ac t $ ANYAUTO BODILY INJURY(Per person) $ ALLOWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPE D E $ HIRED AUTOS _AUTOS {Poaacc ent B }{ UMBRELLA LIAR X OCCUR Y Y 78264D142ALI 6/12/14 6/12/15 EACH OCCURRENCE $ 1,000,000 EXCESS LIAR CLAIMS-MADE AGGREGATE $ 10,000 DED RETENTION$ $ D WORKERS COMPENSATION INWC414038 12/10/13 12/10/14 X WC STATU- OTH- AND EMPLOYERS'LIABILITY TDRY-LIMI.T.S — Y _ER_ ANY PROPRIETOR/PARTNERIEXECUTIVE � NIA E.L EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yyes describe under SddescribeESCDRIPTIONOF OPERATIONS below E,L.DISEASE-POLICY LIMIT 1$ 500,000 C Equipment Floater IMP375-99-76-02 6/12/14 6/12/15 Shop Storage 75,350 Veh Storage 76,250 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Addldonal Remarks Schedule,If more space Isregtired) Proof of Ins. Residential Insulation contractor, 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. 200 Main St. Hyannis, MA 02601 AUTHORIZEDREPRESENTp �r ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: 42 Office of Consuaier Affairs and BLIS11"IeSS RegulationAV 1.0 Park Plaza - SLIItC' 5170 Boston, 02- 116 Home Improvement Contractor Registration Registration: 166311 Type: DBA Expiration: 5111/2016 Tr# 251248 E INSULATE 2 SAW, NOLAND LANGEVIN 410 GROVE STREET FALL RIVER, MA 02720 Update Address,and return card.`lark reason for change. ."'dcjruSs Renewal Employment host Card 4. Office of Consumer Affairs& Business Regolatioll -Aid for individul use only I.Jc.�:nsc or reoists ifion before the expiration date. If found return to: OME IMPROVEMENT CONTRACTOR "Registration: 166311 Type: Office of Consmw-r Affairs and Business Regulation 10 Park Play- -Suite 5170 xpiration: 51111+120.15 DBA 110.'Unn.i*%IA 02116 INSULATE 2 SAVE ROL.AN6 LANGEVIN 536-EAS.TERN AVE. FALL RIVER,MA 02723 Undersecretury Not valid without sioniture sa, e"" Sy. Pol ('i,ii,tructwn Su I)v rN r CS-103861 13\01-Ais'T) LzAANGEYUN 536 EXTI'EWN A%fY,. FuJj}'liver NIA 02-723 08 `15 1241 20 .... ...... r OWNER AUTHORIZATION FORM ( ner's Name) owner of the property located at A C C, ry— ko rr (Property Address) (P operty Address) 11 hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. ZZ - �Own •`ignature ,VK� Date Town of Barnstable OF THE rq� Regulatory Services gyp' o Richard V. Scali, Director » anlwsrnal E ' Building Division BARNSTABLE y MAS3. Qj 1639. Thomas Perry, CBO 1639-2014 �ED1AA�� Building Commissioner 575 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 September 2, 2014 Evgeniy Bronov 72 Anchor Lane Cotuit, MA. 02635 RE: 72 Anchor Lane, Cotuit, Map: 024 Parcel: 108 Dear Property Owner, This letter is to inquire on the status of building permit application number 201305999. To date, this office has not been contacted by you in regards to any inspections. Please contact this office immediately with an explanation and/or arrange for inspection. Failure to contact this office will result in the expiration of said permit. Thank you for your anticipated cooperation in this matter. Respectfully, L. L Local Inspector jeffrey.lauzon@town.barnstable.ma.us (508) 862-4034 TOWN OF BARNSTABLE 21479 r ` yO Permit No. -------•---------=- s� 1 Building Inspector ,��''r'� Cash a VAN OCCUPANCY PERMIT Bond X 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 Cedar Acres Realty ` rust Address South Yarmouth Wiring Inspector x111' � Inspection date1flf Plumbing Inspector Inspection date Gas Inspector , �* �� + f Inspection date 7 3 F h• tea` ►�Engineering Department Inspection dater fl 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. BuiIdin'* Inspector r �i f R .CaT 96 LoT c. (99 TL o o . gt -o - N Sa—b /Y ,3'4LL- v r . 13o•oa A�NOD i laU/VD. T/D-/ QuJJE/� .t3Y = ��ET;A� 1 .HEREBY C PT;FY T;i7;;"N S'COUNOAT;ON. iS PtORMA"N `-- _ _LOGAT'f,� G'.;. t1SF LO'i t`S.ShlpWcv AND <4 'a i;Ord=O!:�:Z.TO .,1: T•,3Wt4 OF QAR/VJ7)gAV,E v GROssmA i:ONS. Rc",rA.(?fah iG:SE`tTrrtri .� 127' 1't3QF! :�7RcET IfAEb O'D LGi. lf"aCS, a _ ss-Ssors map and lot nu'y}r .../: { . .............. ..� �' h oFTNeTo� Sewage Permit nu be v d� SEPTIC SYSTEM o ......................... ............................. INSTALLED IN CO • {i AflH4TADLE, i House number WITH TITL MAM ��''' ENVIRONMENTAL TOWN OF -B AIR N S T A ft"EGULATI BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......... wd..4�:�D............................................................................................ TYPE OF CONSTRUCTION ....(! D....�� E.....cs�� UE 44 k............................................ • ...................................19..� F TO THE—INSPECTOR-OF-BUILDINGS: - - - - The undersigned hereby applies for a permit according to the following information: Location ....../""Y.. ... ......... 1� k......1�9W................. 0 2 ....... .......................... ... ProposedUse ...,[./..W.16.4- ../G ..................................................................................................................................... ZoningDistrict ......... .................................................Fire District ..........:.................................................................... �.. ..JRAfkdclre JName of Owner i�,../.�l.;K�i.. .. ss .....6r.. vGO.....4�................................. Name of Builde ...A&.11ardV................Address .... f ................................... Nameof Architect ..................................................................Address ...............................:.................................................... Number of Rooms ....... .. ......................... Foundation ..... ..........,...................... ��-L-�C-..... ' '11J��/ ................. Exterior -". .. E.....4,..CL,14l .��? .�.... . .........Roofing .. / R-4,77 7 #)dr ............. ���... . Onto , lq� Floors ..... ��, ......................................................Interior ......�.1. . ....!�!.1 o............ Mccwrig--45�t ..4��IKe...&. m . /...__._ Plbig 9F ,k... ... .. � .......................... Fireplace .........Vi/.I.......................................................Approximate Cost ... .. //>> �........................ ............... Definitive Plan Approved by Planning Board�! -------19-— Area .../s . ......................... O Diagram of Lot and Building with Dimensions Fee �5 SUBJECT TO APPROVAL OF BOARD OF HEALTH 2- . I hereby agree to conform to all the Rules and Regulations of the Tow f Barnstable regarding the above construction. Name `e. . .. . Cedar Acres Realty Trust Ito ... 4.72... Permit for ..B2ftgle••.family..... .....................dwelling. ....................................... Location ...lat..#k881....72...Anchor. ..................Cotui.t................................................ a Owner .......Cedar.. Acres••�ea+ty..Trus..r...... Type of Construction ........... game. .................. 9 i ....................................................................... I Plot` Lot ................................ Permit Granted July 18 1979 .............................. Date of Inspection ....................................19 CIA Date Completed 19 PERMIT REFUSED ................................................................ 19 a.......00.�.......z....................................................... Ci •`nz.•ni................................................ ` ' . ............................................... ApPr�ov d' � .................................. 19 = . ... i....................................................... . . ............................................................................... Assessor's map and lot number ... ��/„ +. 6.. r ""i' FTNE 4Sewage 'Permit number ............ ................... Z P MA"STAD E L I House number / .+�'` ..-..... ...... 9 PAS& ...r..... ... :! ... ............................. 00 i639, D YPY a` TOWN OF BARN�STABLE BUILDING. " INSPECTOR APPLICATION FOR PERMIT TO ........� ). .1)........................................................................................... TYPE OF CONSTRUCTION ... J/ ... /` .........,'.:k ..iq& 1............................................ ...........��—.....................19. TO THE--INSPECTOR--OF---BUILDINGS: The undersigned hereby applies for a permit according to the following information: A. 7� � Location ....... ....... . ' .............../. 7! .. � .1._/�;�. ....... 4 ................ ��. /. ...:............ ... ProposedUse ... 1.(J .� .119/.x.................................................................................................................................... Zoning District ......... ......................................................Fire District q � • r ,� r�" �, �r�t�✓n®u�" ..Name of Owner !"�.•!t. ?R........ .1..:• ....:..,... ..�.....a(Address .....c < .... ... . ........................... t �5, '�r� �P�� r .A.4................. Name of Builder .......:.. ,.................... ............. .. Address .................... Nameof Architect ..................................................................Address .................................................................................... Number,olf/.`R`oomilsj ................. ..............C.................`...............Foundation ................... .............................,.. -......... Exterior !'/��.l ...... (U(" ��.�,.:.?. / (,,091........Roofing ...19 A.09`.:77...�, zod.,LkEf.................. Floors .....C Ptc 7.S........:.............................................Interior ...... /N ......... Heating !� ....!!`'1 'F. 1 .... ......................._ Plumbing dm..aq.. ../ .......................... Fireplace ........ONE...................................:.........................Approximate Cost ...........1 .........t...................... Definitive Plan Approved by Planning Board ����:;!!�___ _--___19 A0. Area /.� ,............................. Diagri0r, LoPand' Building with Dime'ions Fee �,:.<?,�..... SUBJECT TO APPROVAL OF BOARD OF HEALTH AN it � _PW JIl - w I hereby agree to conform to all the Rules and Regulations of the Townof Barnstable regarding the above construction. ,. Name , 7. " ;. �'�%:��^s+�•�G"e::'.... �r �4- �: . Cedar Acres Realty Trust / A=24-108 No 21479.••••• Permit for .�;iugle..IamiLy...... .................. we ii i.ng............................................ c Location .....1Qt...#89.....7.2..A-nchor..La............. ....................C-otuf t............................................ Owner ..Cedar..Acres...Raalty...Mrust........... "Type of Construction ........Lf-ramee................... ...........................................•................................... Plot ............................ Lot ............................... �. July 18 79 Permit Granted ........................................19 Date of Inspection/...................................19 Date Completed ....:: .A..........................19 PE IT REFUSED .................... 7.............................. 19 - �,. d ..�.. _ ..A / . •G................. ........................ ................................................. ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... 1Town of Barnstable oFVE, Regulatory Services Richard V. Scali, Director SZAB . ; Building Division B ARN LE MAss. g iegq Thomas Perry, CBOa Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 December 23, 2014 Evgeniy Bronov 72 Anchor Ln. Cotuit, MA. 02635 RE: 72 Anchor Ln., Cotuit, Map: 024 Parcel: 108 Dear Property Owner, This letter is in response to application number 201408279 submitted to obtain a building permit for the above referenced address. Unfortunately, the application can not be approved at this time because of the following: 1) Incomplete construction documents. 2) The property is the subject of open building permit application number 201305999 with no inspections. Additionally, electric work has been done in basement without the benefit of a permit or inspections. Please do not hesitate to contact this office with any questions. Respectfully, Vefio—nuzon Local Inspector jeffrey.lauzon@town.bamstable.ma.us (508) 862-4034 A ' -7/30/1 �IMHE Tp� Town of Barnstable Regulatory Services • iARNSTABIM KAss. Richard V. Scali,Director � 1639 A�0 �ED MA'S Building Division Tom Perry, CBO,Building Commissioner 200 Main'Street, Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 Building Permit Procedure for Residential Addition Or Remodel Or Dock ❑ Determine map and parcel number and enter it on application. ❑ Historic District Commission,200 Main Street, approval required prior to construction/demolition for any properties located in a Historic District: • Old Kings Highway Historic District(north of the Mid Cape Highway) • Hyannis Main Street Waterfront Historic District(See map for boundaries) • Historic Preservation(if applicable). ❑ If ZBA relief(Special Permit or Variance is required for Project): ❑Copy of ZBA decision _ _. _ _... .... . ❑Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date ❑. Approvals from the-following departments are required,and can.be obtained at 200 Main St.: ❑Health-Department— ` (8:00--9 30 AM=&3:30—4:30 PM {as of Mz rch 2"a,--2005} ❑Conservation Department (8:OOg=9:30 AM&3c30=4:30'PM)- `-w-===� ❑Tax Collector {can be obtained from Building Department) ❑Treasurer {can be obtained from Building Department} ❑ Permit must contain complete owner information, full description of project, correct square footage of project,valuation of project(do not include hvac),building detail for Assessor's Office, complete builders information, including signature and date of application. ❑ 5 sets of reduced house plans measuring 11"x 17",scaled 1/4"=1' & fully dimensionalized are required. Plans must include a foundation, cross section, framing schedule, insulation detail & floor plan showing location of smoke detectors(located with-a Red `S'.) ****** IF USING ENGINEERED LUMBER AND/OR STRUCTURAL STEEL,ENGINEERING DATA MUST BE PROVIDED****** ❑ Plot plan or mortgage survey required for any addition. ❑ Workers Compensation Insurance Affidavit form must be submitted for any workers hired. In the event the homeowner takes out the permit, subcontractors hired must supply this. Copy of Insurance Compliance Certificate must be submitted. ❑ Mass Compliance Checklist ❑ Construction Supervisors License &Home Improvement Contractor's License -OR ❑ Homeowner License Exemption Form must be submitted if homeowner is acting as general contractor'or builder for the project. ❑ Property owner must sign Property Owner Letter of Permission. ❑. A NON-REFUNDABLE Application Fee must be paid upon receipt of application number. All checks should be made out to the Town of Barnstable ❑ CEOTANEYS: Need Home Improvement License,no plot plan required ❑ PIERS AND DOCKS:Need Construction Super License AND Home Improvement License. OWNER CANNOT PULL OWN PERMIT. ❑ Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel - �cat�on Health Division - Date Issued Conservation Division � Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address -7a n C4-,Ay- J Village �Z L4 Owner �� �✓�n/oJLo P 0 C-1�14-�O Address W,4 n G ko, rLe 64tf .4 Telephone Permit Request C Ati�I Square feet: 1 st floor: existing IbW proposed 2nd floor: existing proposed ' Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio ' f �� Construction Type Y' Ac Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) , -=i Age of Existing Structure 3 Historic House: ❑Yes 4No On Old King's�iighway: C]Ye_s�_n' No Basement Type: ❑ Full ❑ Crawl Walkout ❑ Other o o Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft s v�Number of Baths: Full: existing new Half: existing new _O b A Number of Bedrooms: 2' existing _new t..� u; Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: �Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ANo Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 4 No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) \\ ,, Name E. Q�oc� Telephone Number i��J 4'jd6 Address 701 - C/n A,- /J-1 License # ('0 V'V+-'1 /9 6' _,� J— Home Improvement Contractor# A11A Email _0/1) L`Sq Q' / co Worker's Compensation # AJIA- ALL CONSTRUCTION D RIS RES rING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE ZZId.- J / /� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING D'ATI &CLOSED OUT AS_#QCKTION PLAN NO. �;; "N, `TOW-N,�,PF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Vt (cation V00C;i� Health Division Date Issued Conservation Division �k � Application Fee S Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board s { Historic - OKH _ Preservation/.Hyannis€ � I J ' Project Street Address _ -7� r` o� 44 rye Village Owner I30Gh K.O Address 702 n G lG>nR Telephone Permit Request � c+ q Lv , on 4 e��v -! duo f e a O p vv, (A Y1 l n S kecV, Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain E Groundwater Overlay Project Valuation Construction Type r Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ' Two Family ❑ Multi-Family(#,units)---• Age of Existing Structure 3 - -Historic,House:❑Yes V1..No• On Old King's Highway: ❑Yes 4No 1 Basement Type: ❑ Full ❑ Crawl aWalkout„ ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)' Number of Baths: Full: existing new Half: existing j new <J? Number of Bedrooms: 2- existing _new :-r•a Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: $Gas ❑ Oil ❑ Electric ❑ Other . Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes AI,No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing 0 new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ I'. Commercial ❑Yes 4 No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Telephone'cNumber Address 7oZ �r)� ✓ 1� ; License # v//� Home Improvement Contractor# AJIA ` .'Email ✓on vSa o Cove, ' Workers Compensation # VIA �ALL CONSTRUCTION D RIS RE ING FROM THIS PROJECT WILL BE TAKEN TO g ll .� A SIGNATURE-- DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. �o i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. r The Comlr oymmI&of Massachusefa Deparhuent oaf fidm3fti4dAccidents Q ce of Investigtdians 600 M shington Street Boston,MA 02111 wwv.mass.goWdira Workers' CampensationInsaranceAffidavit Bllders/Contractors/FJectricianMumbers AmAkant Information Please Print-Lergibly Name(>Jrrsmessl ft dzati 0: & ro�o� LO I )SoC h Address �- A rc'`.o`- )y\ City/State/Zip: 64, d- �02 Phone 4-7 _ .._.. .. ._.Are yonan.employerl aecls.theapp:ropriatebox: _. ._---.-•__---_ -.-.-_- . ._.r of o'ect r ype pr 9 . (� =.. .. - 1.❑ I am a employer with 4. ❑ I arrx a con5ractor and I 6- ❑New consfructmn employees{fall and/or part-time)-* ha°ehirect the vi ces 2:❑ I am a sole proprie-tor or partner- listed on the attached sheet 7_ KRem, &-h g ship and have no employees These sub-contractors have g- ❑Demolitioa wodcing for me in any capaciti, employees and have vror$ess' y ❑Building addition [go workers'comp.insurance comp.msuranc 1 5_❑ We are a corporatic and its 10❑Electrical repairs or additions 3M I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself[No workers'comp- right of eimmpfioa per MGL 12-0 Roof repair ;t,c�ura„re regIIllEd.]l c-154§1(4} and we hati e no 13�other [No woriaers' comp.insurance regi ire�:j *Amy applicant that chedss bar-91 im st also fiU out the section below shooing&&wadess'compensation pnlirp iuiitttaa[iat� T Snmeawneis who submit this affidavit indicating[trey are doing all%, and dLea hae outside con=sctnms IIIDSI submit a new affidavit mdi-tgnC such_ tContoarmrs that check this box mmt sttsrhed an additional sheet shoteate the name of&E sub--0311r2cbDis sad state vrhather onnot thaw enter have Employees- If the anti-contnctuts haee empIoyees,they—I provide their workers'comp.police number_ I am an employer That is ptmdhtrg trorke-rs'conTeruyLtion insurance for rrtl^*LnWloyees Behr[.is the policy arrd job site information. Insurance CompanyName: Policy#or self-ins-Uc-4- Expiration Date: Job Site Address:- City/'State/zip: Attach a copy of the workers'compensation policy declaration page(shavving the policy number And e3cpsation date). Failure to secure coverage as mquireduuder Section 25A o€MGL c. 152 can lead to the imposititm of`criminal penalties of a fine up to S 1,500.00 and/or one-year imprint,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against a violator_ Be advised that a copy of this statement maybe forwarded to the Office of Jn>:eshgations of the DIA � - e coverage verification- I do hereby certify ur s 'ns art ena o�f`perjury that the information protaded above is true and correct Sit=_natttrre: Bate: Pl,one 9: 6 6S-Li/0g O,ff-rciud use ondy. Da not tvrite in fdtis area,to be completed by city a.•r town ofi'ciat_ City or Town:. Pert7mitUcetnse# Essaing Authority(circle one).: 1.Board of Health 2.Bnd'ding Department 3.Cit flown Cleric 4.Electrical Fnspector 5.Plumbing In-Tector 6.Other Contact Person: Phone 9- 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an m ployee is defined as"...every person in the service of mother 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 appurtenarit thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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 nunnber(s)along with their certincate(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 Indusrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit shoo-ld be returned to the city or town that the application for the permit or license is being requested,not the Deparmenf 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. Sells 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 is 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 additioD,an applicant that must submit multiple pmnit/limnse 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 lrlce 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 nurmber. The Commmw ffi of Massachusetts Dspartmeat of Ridustrial Accidents office Oflravesfigatims 600 Wasbingtan Sttieet Roston;IAA 02111 TeI.A 617-727-49-QO ext 406 or 1-7 MASSATE Revised 4-24-07 Fax#617-727-�49 �w.mas�go�ldia _ ATTAC Guide to Wood Caristruc ou in Higfi M d Areas: IIO arph Knd Zone MassachusetP ChecktiA for COMPRAnce (790 CIMRS301.Z.1-1)i Loadbearing Wa1I Connections - Lateral(no-of 16d common nails) _..... -._.- .. Non-Loadbearing Waff-CDnnecthns Lateral(no_of 16d common nails)--------(Table —�___—_.----__-_- L oad Bearing Wag-Openings(rec ord largest opening but check all openings for compliance to Table 9) Header Spans -----____. __-__---.-__.Crab)e9)_-__----------.._ft_m.511' Sig Plate Spans :---...__-_;_-------__(Table 9j--_____--------------ft—in 511' Full Height Studs (no.of studs)-----—_---(TableNon-Load Bearing Wall Openings(rEmrd largest opening bill check all openings for compffance to Table 9) Header Spans- -- - -_ --------- (Table 9)-.__------------ft—h 52`1 Sig Plate Spans:__. 9)-----------___-•—it—irL 512' Fug Height Skids(no_of studs)_' __(Table 9)______-__--_------__-_--- Exterior Wafl Sheathing to Resist Upfdit and Shear Simul aneousv Kuumum•Bidding Dimension,W - Nominal Height of Tallest Openine ----------------- 5 E Er Sheathing Type—— ------- (note 4)_-------- -----------• -Edge Nail Spacing_-y--------- ---(Table 1 D or note?.4 if less)_--_.----- in- Field Dail Spacing.-__..__--_y_ --._--.(Table 1D)__-- --------_- in. Shear CDnneGtiDn(nD.of 16d common nails)(Table 10):_-._.___�_- Percent FuIFHeight Shaatfiing.____-------(Tab[e 1l))=-_- .�_---------__-- ° . 5%Addi-5'on2l Sheathing for Wall witif Opening>6'8-(Design Concepts) Maximum Building Dimension, L Nominal Height of Tallest DpenfngZ--------------------------------------------------------------------—5 6 g- Sheathing Type -- —- ------ -(note 4)------- Edge:Nail Spacing----.---_.--_-----__-_--{Table 11 Dr note 4 if in. Field Nag Spacing.-------_.-.__..__w..____.(Table 11)-- :------------__—•-- ui Shear Connection(no. of 16d common nails)(Table 11)----------:-.-_____.-__--__._-_- — Percent Full-Height Sheathing_-- —_--.(Table 11)____•--_-_---__----__--__-_°� 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)_----- Waft(--fadding Rated for Wind SPA?----- ------- - ---_ ------ - ----- 5-1 ROOFS Roof framing member spans checked?._._ .__For Rafters use AWC Span Tool,see aBRS Websfte) Roof Dverhang _-------------------_._•---------____-.(Figure 19) ____:-__-_A-<smaller of 2'or Lf3 Truss or RaJter ConneotiDns at L-Dadbearing Walls Proprietary Connectors Uprrft_.—_:___...---___ (Table 1Z)__---__ ----•_-----_.-:—U= plf plf Shear--------_---------__--(Table 12)__----___.__------ Ridge Strap Connections,if cDJlarties not used per page 21._. (Table Gable Rake DUd0Dker--•----------_:--_--_----------(Fyui�2D) -------------_ft_<smaller of 2' Dr U2 ' Truss or Rafter Conn-BDns at Non4 Dadbearing Walls Proprietary Connectors Uprin------ ------- _:(Table 14)--------------U-_ lb. Lateral(no.of 16d common nails)-(Table 14)______________________________________1_._ . lb. Roof Sheathing Type---•-_-:•-- -- (per TSD.CMR Chapters 53 and 59)............ Roof Sheathing Thickness__-._.._- -_ —_--- - —in_?71167 WSP Roof Sheathing Fastening_---_-----_.___-.--.(Table 2)----�, _— _---------.— f. _' This chacWtsf shag be met in is entirely,excluding tJte sperzTic.e.=.:ption noted in 2, to comply vffh the requirements of 7BD CMR-5301-121.1 Item 1. tf the checldist is met in its entirety then the fDODvrmg metal straps and hold downs are not requfred per the WFCM 110 mph G'Ude: a. Steel Straps per Figure'S b. 2b Gage straps per Figure 11 Uptdt Straps per Figure 14 d_ All Straps per Figure 17 e Comer Stud Hold Downs per Figure 1Ba and Figure 19b. Exception:Opening heights of up iD 8 ft;shag be permitted when 5%is added to the percent ful-height sheathing - requina'rierds shown in Tables 10 and 11. The bottom st11 plate in exterior wails shall be a minimrun 2 in.nominal thlclfii ss pressure tread##Z-grade: AFCC.Guide to Flood Corrsirnrtiorr ur ffi�lr WndAreas.- 110 Fnph kYadZone' Massachusetts Checkff�f for COM" pPance(78o aFlz-3ot2_r_r)r - Check 1.1 .SCOPE Wind Speed(3-sec. gust)_______ mph Wind Exposure Category_..__.____-__, ___.___--=---.-_--------_---------•---•-_-.^_B Wind Exposure Category................Engineering Required For Entire Project-----.---------__-•:---•-•- ---.0 j 1.2 APPLICABILITY Number of SDries(a roof which exceeds B in 12 slope&hail be'considered a slimy) stories _<2 stories Roof Pifzh___. _ _ _ _ �(Fig 2} .,_....__ _ � _ 5 12:12 ` Mean RDDf Height'---------------------- (Fig -__----.......--- - -- ft <_33• Butting Width,W --:-(F9 3)--_ ---�-- - --__-._ft 5 av Buil ding Length, L ------- __ --- --------(F9 3)------ -=--- ---�. _ft 5 80` Budding Aspect Ratio(L/1 (Fg 4)_---_-------_.__--_- <_3.1 Nominal Height of TaAest DpeningZ ._-�_--__-- __(1=t9 4)-.-------•-•-- 5 6 B' 1-3 FRAMING CONNECTIdNS General compliance with framing co-nnec6Dns_.._---.---.(Tabfe2)--_--------_-------------_�_._-----..-_. 2.1 FDUNDATiDN Foundafion Walls meeting naquiremenis Df 78D CMR 54D4.1 --•------- .----- Cancreta Masonry- ------------- - -- ---- --- -- - -= 22 ANCHORAGE TO FOUNDAbDN1'' S/a'AnchDr Boftsvimbedded or 5/8'Proprietary Mechanic il-AnchDrs as an'alternative in Carlcrete only BDIt Spacing-generai................................ ---.(Table 4)_-_ ___.._.� - ---- - in. Bo ft Spacing from end(Dint of plate-------•--,-------•(Fg.5)- _----- -_------_---- -12'. Bolt Embedment-Concrete-------------------_-(Fiq,�•-_-•------- ----_--- in-y 7" Boff Embedment-masanry..__.__._____::_.----_.____----(Fig 5)-= -=-------------------_ in_>15' Plate Wisher_.;_-:----- -------- -- -(Fig 5) ---- ------- -''-3.x 3`x Y.- 3.1 FLDDRS - Floorfrarning member spans checked - -_._ -_(per 7BD CMR Chapter 55)__----•___-- - Maximum Floor Opening' mensiDti_-. (F9 s)----------- _ _ft<-12' Futl Di Height Wall Studs at Floor Openings less f}ran 21 from Exterior Wag(Fig 6)-------------------------__ Mbmnum Floor Joist Setbacks Suppor-dng Loadbearing Waffs or Shearwalt-.___-(Fig Maximum Cantilevered 11DDrJDists_ -T Supporfng LDadbearing Walls or 5hearwag....__..-(Fig B)--------_--_-------_-__:_.._ft 5 d FloorBracing at Er►dwalls_---------- ---•---- -.---(Fi9 9)_.---------------..-----------•---- FToar Sheathing Type FIDor Sheathing Wckness -------------_--- ---(per78D GMR api r 55j: T-_w in_ Floor Sheathing Fasting_-•_-------_--•---•.----; (Table 2)__d nails at in edge I_in field 4.1 WALLS• Wag Height Lnadbearing wads.;--------- -._ (Fig 10 and Table 5)-.----- ft 51 D' NDn-Lo adbearing walls..---__._---- (Fig 10 and Table 5)------_-----•----_ft's 20' Wall Stud Spar_ing ----------.._.�-----_-___(Fg 10 and Table 5)-------____ Wag Story Offsets- -------------_�._(Figs 7 B)— ft c d ' 4.2 LXTEPJ C)R WALLS' WDDd Studs • Laadbearingv�alls�-------•----_.._------- (Tal?le�-}--:-------------__.2x -_iT_in. Non 1_Dar�ering wafts.-•-•- --- -- - - --.(fable 5)-- ----- - - -_ft_in- Gable End Wag Bracing t v Fuft Height Endwall Suds- (Fig ID)__:------_z-----------------� 1h'SP•Atfic FIDar Length___ _`.-___ ._• (Fig i t) ft�W/3. 'Gypsum Ceiling Length (rf WSP not used)_. _-�-ff ig 11).------------_-_--_ _ft 0.9W _ aid 2 x 4 CbntinuDus Lateral Brace @ E3 ft D_c._(Fig 11�.......................•--•----- __-- br 1 x 3 cetfing furring ships @ I S'spacing min.wif h 2 x 4 blDCidng @ 4 fL spacin in end joist ar truss bays DDuble Top Pfzr& Splice Length ----- -r------------(Fi9 13 and Table 6)-------=-------.._._ft _ SpGce DDnnecn"Dn (no.of 16d cDmmDn nark)-.-•_--.(Table 5)_�_-_______-_---•--_ __-- r AWC Gtdde to Wood C-ortstrucfiort III Hi,;k IfirndAreas_ IZO uylt H,irldZan- '�' Massachusett� Checklist for Compliance (790 cn-T'RS- of r:i)I 4. a. , From Tables-10 and 1 i and location of wall sheathing and 6uldmg Aspect Rafio,determine Perc&nt Full-Height Sheathing and Ptah Spacing requirements b. Wood Struchlral Panels shall be minimum thickness of 7116`and be installed as fDHDws: i_ Panels shall be installed with strength ands parallel to studs. I All horizontal joints shall occur over and be nailed to framing. uL On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shalt be attached to the tDp member of the upper double top plate and to band joist at bottom of panel-Upper attachment of lowerpanO shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. HDFLMntal nail spacing at double top plates, band joists,and girders shall be a double row of ad staggered at 3 inches on center per figures below:Vertical and HorizontaPNail-tng for Panel Attachment S. .Glazing prob�tcbon:a)new house.or horizontal addition-required if project is 1 mile,or closer to shone(generally,south of Rte;28 or north of-Rte.6) b)vertical addition-not requited unless there is extensive renDVa6Dn to the first floor c)replacement vriridows-needs energy conservation compliance only(chap 93) - 6.Wood Frame Construction Manual(WFCM)for 1 i o MPH,Exposure H may be obtained from the American Wood Council (AWC)websits. - l njsle�r�srsau - _r usEsa w�.s ATE nt tI !1 1 II C3 c - !K H t II Jl t 1 Q L I L I t`{- 4 1 [ o r it it e' ...t i ; o• �i L i G 1 t r a tl! a ! E [[[! I, rI ti < I ? I ` I !- 1 U [ ! d is 1 ht �t 41 I CL 1 1 111 I IL 1 r t i It ! I 1 I�L4TIdA�ii.l.�+RB�tS - - 1 1 l • ED&EAr WC1Z� _ 1,I L/ _ 11 l F9 t • tL LtIt u itt Ilk 11 tl r l t [ t rl SCRG93ERED 3`hdY t 1 i NAA-MTEF" PANEL • - '•-� PA1�_�:E � QC?IIIDE6tdsIL�lC4E5pRQ9CCETAL - See Defag on Next Page Vertical and Horizontal NaTng VSrIit I andOHotizonia!Nair mg far Panel Atfachm�t for Panel Attachment , I . Town of Barnstable Regulatory Services rRARNSTAELF,� Richard V.Scali,Director 16 yq. � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date I Q:FO RM S:O W NERP ERMIS S IONP 00 LS Town of Barnstable Regulatory Services �oFTHE rotyy Richard V_Scali,Director -Building Division � f Tom Perry,Building Commissioner brass. i639• ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1� l 7 ^7l I l Please Print DATE: p� `� JOB LOCATION: ( � number p Street village "HOMEOWNER..: E Q1JOV o I AO�L�,O syol-m/v 6 nadc U 7-�J �� , home phonc# work pbone# 7� CURRENT MAILING ADDRESS: _ h C "'�' I r MIA city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeownee' 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 and igned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proced e and require ents and f he/she will comply with said procedures and requirements. Si re o 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 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee J Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address - n C4,p r I a v\ Village Owner E./�v [Sroivov 0 lqa �och ko Address 72 A nG1t0V' 1r - 6:41,%� Telephone Permit Request fOw� U,v\ vim: W0 I 0%_ Se �`� a n.%s1�ed baSer�er -t f.✓,' h �J '�� ✓o ,Dr►n ��y.,�;� �� rmy, 4ew'10%! ohI _ Square feet: 1 st floor: exis ing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �0� Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure r Historic House: ❑Yes I(No On Old King's Highway: ❑Yes 1 No Basement Type: ❑ Full 0 Crawl Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing 1 new :- Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing new First Floor Room COLRR Heat Type and Fuel: �6 Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes *No Fireplaces: Existing New Existing wood/coal stove: L(es 6(No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: LU existing- rip size_ Attached garage: 4existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ephone,Numbe 6.95- 1//0G� 'Address ITI I " License # CA�`^ ► o 2 6 3 Home Improvement Contractor# /11 Worker's Compensation # ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BE TAKEN TO 'SIGNATURE. DATE 45� /i711 IA' FOR OFFICIAL USE ONLY APPLICATION# t DATE ISSUED MAP/.PARCEL NO. ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s FINAL BUILDING E DATE CLOSED OUT ASSOCIATION PLAN NO: ��s ►`Y °" r . S - 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 NilIle(Business/Organization/Individual): �y � �y 6 VO AJ D I/ 9 Address: 7c 2 -,&%C, City/State/Zip: (�0-�4 t /�1'4 02b 3SP` phone - S___DdJ 6V, - 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 ! employees(full and/or part-time).* have-hired the sub-contractors 6. ❑New construction 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' insurance.t 9. ❑Building addition [No workers comp.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 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.n Otlier A vn �Sk bGS&-,e-i comp. i surance 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. XContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors 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 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 D for' c overage verification. I do hereby certify un r e p and penalises of perjury that the information provided above is true and correct Signature:— Date: / / 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#: IF- 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-contractor(s)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 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Ile 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 1-977-MASSAFE Revised 4-24-07 Fax 4 617-727-7749 www,mass_gov/dia ��►+�>�,,� Town of Barnstable 1. Regulatory Services MASS.s"S Thomas F.Geiler,Director 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 DATE: ?/l 7I Q/-3 �^ L Please Print JOB LOCATION: �� n hG�✓ I h w�� C. number street village "flof'F.OWNER": /� `a♦ L�trO� / (509) &W5--L/1 76 name U `-] /) I home phone# work phone# CURRENT MAILING ADDRESS: cZ h Nl c, /a✓1 e 60-�L4 ,� HA 02655 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) - The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, /andations. Theundeo er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedur nts and th he/she will comply with said procedures and requirements. Signature f er Approval MBuilding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decolli7r\AppData\Loca]\Microsoftiwmdows\Temponuy Internet Fdes\ContentOutlook\QRE6ZUBN\EXPR.ESS.doc Revised 053012 • • t o�TMF r°wy . Town of Barnstable ° Regulatory Services MASS.I Thomas F.Geiler,Director s6;9. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma,us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as 045er of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize b building permit ( dress of Job **Pool fences and alarms re the respons ility of the applicant. Pools are not to be filled or utilized before fence is stalled and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QFORM&OWNERPERMMSIONPOOLS 62012 1 fl2635' /"� C�i�► Deck l•ft Oft Kitchen Bath Bedroom Family Room 1 Car Attache -- [Area:308 ftj First Floor N [Area: 1060 ft2] Porch Bedroom Living Half Bath 1ft Entrance 36ft C� rN C 1` V J 72-. 4, A1C,1-1L?R z- lfl Z,o Tt4 / SQL P��h �4 v s` 2-4Vq- I / 3 6P �2- e ,r �� ?C .`+ r hklcl-loo L I� T-� U_ bay o,�eo� : a P W 1� e�dY. box i L R� Town.of Barnstable *Permit# a 0 ° ' Expires 6 months from issue date PERMIT Regulatory Services Fe Ve--7 MASS.16 Richard V.Scali,Director y. �0 rr gg J QED a i'e1� C J s't / Building Division . Tom Perry,CBO,Building Commissioner .-JJ TM OFLE 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number (� 'l Not Valid without Red X-Press Imprint - � 1, l.y Property Address 702 Ac ko/— G.,?,-LX , C1✓�� 6� A 6-3 5 .Residential . Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address G V i ✓0X,'0l1 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re st(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Xi r�__Ou X 4 ,DU ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) F?"Re-side / 2 Replacement Windows/doors/sliders.U-Value (maximum .35)#of windows� #of doors: ? ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property O must sign Property Owner Letter of Permission. A co a Home Improvement Contractors License&Construction Supervisors License is red SIGNATURE: QAWPFILESTO ding permi rms\EE RESS.doc Revised 0613 T 7e Comlmarrytk--�of 3asSaf:}iusd& D'eptw&nmt orudrmstr.iid Accidents f Two of rnves6gafians 600 Wa;issttuigfon Street. Boston,MA 02HI wmi min-,mgaVdua Workef-s' Compensa{IoalnmranceAffidavit:BuildersfConte:Etors/EieecfricianslPlumbers Apthcant Information Please Print Legibly. Na=(BusiiEes310rgauiratianF ividnal): V'O N O A.&ess: -7c2 Al C A-oe- / -,uR �y>f t&zip:tom�� ,r4 " a2G 3 Phone 4-7 Are you an employer?Check the appropriate box: Twe of o'ec 4_ I a et�ral cimtractor and I Pr It ts t�oired}: L❑ I am a employer with ❑ am � ❑ employees(fiill and/or part-fime}* have hire&the sub-conbacfots. 6_ New cons scfi�on . listed on the attached sheet. 7- ❑Remodeling 7_El I am a sole proprietor of partner-ship and have, These�����have no employees 8- ❑Demolition wort ng for me in any capacity. emplo}-�and have workers' g_ ❑Building addition Wb� wo+$ers.' comp:insurance comp-msuragm 1 5_❑ We are a corporationaad its 10_�Electrical repairs or additions orxss aven exercised Thei r 1i�_�❑Plumbing airs or additions I �1.=Tn hom�vner doinD all wort f(i h g mP , myself [No workers,comp- right.of eiemptionper MGL 12-0 Roof repairs incixance required]l c_ 152,§1(4',and we ljas a no emplayees_[No v;Ddoms' 13-❑O.tber comp_insurance req6red.1 ,:Any eapUcant dixt checks boa r1 Yrm also fill oit the section below s o ;o&inea woffme compemssdon policy iurbmz6cn- i Hnmecwnf-s ww s abrmit this a-Sdsaff i.,mr dmg Mey am dung al-cauk ad then him oarnide cootzacmrs—st snbal2 a aE=zffidlvh in"'�s�rli t�bntc.cmrs the ch,k this box mast stiadud au aAditi nsI sweet sh whet ec ocmt Ihnse Mmtifies have rsminyees_ �t�sna-conTiactais h-Te empIo�ee..s,cfieg must pmviae tT�r-workers'comp.policy n>aahes I am an emp�rhrrtisgrm idi�g t.vorl a-rs'c-ompensrtivn irirttrruice far tn�errriv£�ye� �e.Lots is fhz pa&c}and}ob srl>� inf-orftral�o-L 1nsm-ance Company Name: Polly O Or Self-ins-Uc-A— Expiration Date:: Job Srf£address 7� 14 �Y�C ,K/y- /7 e CLfvfsta z: Eittacbt a copy of the workers'compensation policy-declaration page(sh-owang the policy number and expiration date). Failure to secure coverage as ref juired-under Section 25_4 of MGL c 152 can lead to the imposition ofclin inal penalties of a fine up to$1,500.Oa andlor one-year impri'EOn==t,as well as civil penalties in the fb=of a STOP WORK ORDER.and a fine of up.to$250.00 a.day against dL tar_ Be advised that a copy of tbis statement maybe fGrwarded to the Office of Investigations of the D ceZKmge verifittiort I dri hereby c r ndpenauhrs ofpedw y th tthe itzfprmatian preni&d a&we is hwe and correct S.itma Bate: Phone#: Offl,411L use wi[y. Da trot tvrite in th&area,to be completed by city ar town offic&L City-or Town: PtrmitUcense# Issuing Authority(circle one): 1.Board of Health Budding Department I GitF-,Tovm Cleric 4.EIectrical Enspec#or S-Plumbing rector 6.Other Contact Person: Phone#: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. P ursuantto 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-- Am 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 Iegal 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 Iocal Licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings is the commonwealth for an.y 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-MIL 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 aunrber(s)along with their ceriificatc-(s) of insurance. Limited Liability Compam;es(LLC) or Limited Liability Pa1-tverslips(J LP)with no employees other than the members or partners, are not requi-red to carry workers' compensation insurance_ if an LLC or LLP does have employees, a policy is required- Be.advised that this affidavit may be snbmi«ed to the Department of industrial Accidents for confirmation ofinsu—azce cnverage- Also be sure to sign and date the a fdav t '112e affida,,dt sLou1_d 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 lhe Department of the number listed below. Seli insured companies should enter their self-insurance license number oa the appropriate line. Cityor 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 Ell out in ibe event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permi`ALcense number which will be used as a reference r_umber. In add tics, an applicant that must submit multiple pernit/license applications in any given year,need only submit one alffidavit indicating,current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations m. (city or town)."A copy of the affidavit moat has been officially stamped or marked by i re city or town may be provided to the applicant as proof that a valid affiLvit is oa file for future permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizea is obtaining a license or permit not related to any business or commercial venture (Le.a dog license or permit to burn leaves etc.)said person is NOT required to complete this aifidaNdt 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 f*number: Tt,-Commonwealth of Massachu_cett De aztment cif Industrial Acclde. t Mee of kvestigatimxi 600 Washingtan Sft�t Tel.A 617 727-49-Q0 W 406 or 1-977-MA S1FE Revised 4-24-07 Fax-#617-727-774,91 Town of Barnstable Regulatory Services �oFViE roily Richard V.Scali,Director Building Division Tom Perry,Building Commissioner MASS. 1639. ��� 200 Main Street, Hyannis,MA 02601 CEO µAI s www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print JOB LOCATION: number street village "HOMEOWNER": �� 7/ /�-�'' E�/C/O!/ l 0< n `home phone# work phone# CURRENT MAILING ADDRESS: 7.2— cityhown 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 r;02`ZUwner" _ The undersigne ce es that he/she understands the Town of Barnstable Building Department minimum inspection procedure r ments - that he/she will comply with said procedures and requirements. f Homcowne 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 persons)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,RuIes &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. i 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. QAWPF=\.FORMS\building permit formsEXPRESS.doc Revised 061313 �'ME, � Town of Barnstable t r Regulatory Services MENMASS.$I'E� Richard V.Scali,Director i63¢ �0 039. & 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 Property Owner Must Complete and Sign This Section If Using A Builder ' 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) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name ' Date Q:FORM S:O WNERPERMISSIONPOOLS Town of Barnstable GF 1NE Tp� Regulatory Services Richard V. Scali, Director MEN9TABM ; Building Division BARNSTABLE p OI.ANSi6lE•QM[PKLLF•CONfI•M4v'.IS MAn 0 IIPPSiG\5 YtU5.OaZFPVILLL•d.3t&Y55P1AIf 1639. ♦0 Thomas Perry, CBO 1639-2014 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 September 2, 2014 Evgeniy Bronov 72 Anchor Lane Cotuit, MA. 02635 RE: 72 Anchor Lane, Cotuit, Map: 024 Parcel: 108 Dear Property Owner, This letter is to inquire on the status of building permit application number 201305999. To date, this office has not been contacted by you in regards to any inspections. Please contact this office immediately with an explanation and/or arrange for inspection. Failure to contact this office will result in the expiration of said permit. Thank you for your anticipated cooperation in this matter. Respectfully, L. Lauzon Local Inspector jeffrey.lauzon@town.barnstable.ma.us (508) 862-4034