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HomeMy WebLinkAbout0040 BAY ROAD �o � _ �' � . �, . ��.,� ... .:.. �.' e.A,1'r '!x • _.;�.n - a �, ...� ff �T v 1 k � � I :c r A F r � Y f E z> © J 43 .. i op a f , t J _ r t oFIKKE Town of Barnstable *Permit# OExpires 6 months f om issue date Regulatory Services FeeO • ,Lzmsrwar.8 • Mnes Thomas F. Geiler,Director 16y9. 1m • AtFO MAy� Building Division < - 'RESS PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 O C T 2 4' 2011 www.town.barnstable.ma.us A Office: 508-862-4038 0MINJII O F c"� b{ -�c7�0= 30 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number oQa 7 Property Address Residential Value of Work 8 QQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �Srr n4�l Contractor's Name Telephone Number 2✓j Home Improvement Contractor License#(if applicable) _ Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor 19 I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to— Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. ;IGNATURE: �:1WPFILESTORMSIbuilding permit forms RESS.doc .evised 070110 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street• Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 4 43/7 UV Address: 7 �O UI ® 7 City/State/Zip: Z p2:4�;,?,�_Phone k 03 Are you an employer? Check the appropriate box: p y 4. I am a general contractor and I ElI am a emto er with Type of project(required): [2. .employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g• Demolition working for me in any capacity. employees and have workers' [No workers' comp, insurance comp.insurance.$ 9. ❑Building addition j required.] 5. We are a corporation and its 10.[]Electrical repairs or additions 3.X I am a homeowner doing all work officers have exercised their 11.[I Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL insurance required.]t c. 152, §1(4), and we have no 12. Roof repairs employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t e pains and nalties of perjury that the information provided above is true d correct Signature: - Date: /0 Phone#: �(�3 7 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#: �THE'�wti Town of Barnstable Regulatory Services aAwsTAB�, t r3' Ms. Thomas F. Geiler,Director 16Jg6 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 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 petmit. (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name ' Date Q:FORMS:O WNERPERMIS SIONPOOLS DIME T Town of Barnstable Regulatory Services • BAIWWAELE, Thomas F. Geller,Director y MASS. 16.39. .39. a � 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 Please Print DATE: /o Z JOB LOCATION: number et T village "HOMEOWNER": v o A/t Z,1*1e 319 573, name home phone# work phone# CURRENT MAILING ADDRESS: Z.9 a S C✓C! �� _�i( AS Jrn Aid 950(z city/town state zip code The current exemption for"homeowners"was extended to include owner-occullied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official.on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures an equirements and that he/she will comply with said procedures and requirements. Signature o omeowner 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. iQ:forms:homeexempt �*,?Jt" a1d:S 8 ,.y�y .ac-ysi7.•;:J,.;.,r-�...:.{'.c�u4r�.P'y. F^}'• ...-_,.•. •. •.^kz: . „ .+ � r►'+^ �ey,+.r--,- . Town of Barnstable ' Regulatory Services BARNSTABLE. MAS&,.�. Building Division RFD MP' 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 f ' Inspection Correction Notice Type of Inspection / 7` Location �= Permit Num er f Owner Builder One notice to remain on job site, one notice on file in Building Department. The folio g items need correcting: r + C all 3 I r. �J e: Please X: 508-862-4©:3:8,.for re=inspection. Inspected by Date Ila A g. 11 TOWN OF BARNSTABLE_BUILDING PERMIT_APPLICATION Map Parcel — Application # v �� .• (00 Health'Division 2.6a *l- �s'/ Date Issued Conservation,Division Application F ' —06 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address (/ Village LfAtm Owner 35in.A L AA. Address 1/0 �Gw Telephone b 03 -SS 7 2q,6-3 Permit Request C rPA, 1U!'Gt2� G►GJ'A-�I e� o� OYJP,/���✓�Ci (�G �C 79 on G"IP, eA d W / -hr(A5s CCDt- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach upporAgg documentation. Dwelling Type: Single*Family ❑ Two Family ❑ Multi-Family (# units) � a � Age of Existing Structure Historic House: ❑Yes XNo On Old KZ 's Higl}way: Yes $(No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(s .ft) s ae. Number of Baths: Full: existing new Half: existing Wnevfz 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 • A , APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name OIAn� 4, 001C.- l/4l S �hG Telephone Number Address 7 License # S Ny AfA- 2S'3(O Home Improvement Contra or# J 3 IS Worker's Compensation # 2 h 5-F6 sa 28 ALL CONSTR TION DEBRIS R SULTING FROM THIS PROJECT WILL BE TAKENio �C� �� SIGNATUR DATE �/ 3 r FOR OFFICIAL USE ONLY r APPLICATION# DATE ISSUED , MAP/PARCEL NO. t -ADDRESS VILLAGE 4 OWNER j ` DATE OF INSPECTION: FOUNDATION I r FRAME (5Z /h zloS 'INSULATION FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL - � , FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. s APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 G U Tele hone Number 7�� �GS-7 113 3 �I 1 V1. c� i lk ZiAL. p 6 Address �l w u License # C S 6 c� Home Improvement Contractor# Worker's Compensation # (JG 2 31 5 3,�-XKX-: ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CL��G�PA�.thv3 SIGNATURE ✓L- DATE Fro MAY, 23. 2008 9: 24AM HART INSURANCE N0. 012 P. 1 ACORD,v CERTIFICATE OF LIABILITY INSURANCE DATE(MMMD/YYM 05/23/2008 OOUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION HART INSURANCE AGENCY, INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 243 MAIN STREET HOLDER. THUS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 700 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. BUZZARDS BAY, MA 02632-0700 INSURERS AFFORDING COVERAGE NAIL# INSURED BUZZARDS Home Builders Inc INSURER A: PROVIDENCE MUTUAL FIRE INS CO 15p40 570 Teaticket Hwy INSURER B; LIBERTY MUTUAL INSURANCE CO 23043 Teaticket,MA 02536 INSURER 0- INSURER D: IN COVERAGES SURER E: 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD LTR I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERALLIABILIri CPPOO63567 03/01/08 03/01/09 EACH OCCURRENCE S 10000 00 COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMI Ea oeeurenrm $ 50 OOO CLAIMS MADE OCCUR MED EXP(Any one person) S 5.000 PERSONAL&ADV INJURY 5 1 0OO 000 GENERAL AGGREGATE S 2.O00 000 GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS•COMP/OP AQG S 2,000,000 POLICY PRO. LOC AUTOMOBILE UA81LITy COMBINED SINGLE LIMIT ANY AUTO (Ea accident) S 1 ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY (Per person) 1 c —•. HIRED AUTOS tt BODILY INJURY 1 NON-OWNED AUTOS (Per ecadant)�?I -n PR4ER Z (P -> GARAGE LIABILITY AUANY AUTO OTEAACCIAUAGG EXCMfUMBRELLA LIABILITY EACH OCCURRE E M OCCUR CLAIMS MADE AGGREGATE $ 3 DEDUCTIBLE RETENTION S $ JS�FE RKERS COMPENSATION AND WC231S358615028 03/07/08 03/07/09 WC STATLI• o RLOYERS'LUt81L17YPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENTOO OOO CER/MEMBER EXCLUDED?,deauihc under E.L,01SEASE-EA EMPLOYEE 9 50O 000 CIAL PROVISIONS below IOTHER E.L.DISEASE.POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDPD BY ENDORSEMENT I SPECIAL PROVISIONS OPERATIONS PERFORMED BY NAMED INSURED AS PROVIDED BY TERMS &CONDITIONS IN THE POLICY Faxed to 508-790-6230 CERTIFICATE HOLDER CANCELLATION 'SHOULD ANY OF THE ABOVA DESCRIBED POLf.CIES BE CANCELLED BEFORE THE EXpIRAT16N Town Of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TD MAIL 30 DAYS wRTTT'EN Building Dept NOTICE TO THE CERTIFICATE,HOLDER NAMED TO THE LEST,BUT FAeJURE TO DO SO SHALL 367 Main Street IMPOSE NO OBLIGATION OR LIABII_nY OF ANY KIND UPON THE INSURER,IT$AGENTS OR Hyannis, MA 02601 REPRESENTATIVE$. AUTHORIZED REPRESENTATIVE ACORD 25(2001/08) ®AC eff CORPORATION 1988 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street BOStOJY, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Bug ders/Contractors/EIectricians/P.lumbers Applicant Information / /_f Q Please Print Le>ri61Y Name(Business/Orgmi7ation/IndividuaI): SOL, �`-f0 Wl-Q� Y V`^i tGU�S ►h Address: 570 City/State/Zip: � O2s Phone.#: SOS Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction have hired the sub-contractors employees(full and/or part-time).* 2.El I am a•sole proprietor or partner- listed on the attached sheet 7. Remodeling These sub-contractors have g, ❑Demolition ship and have no employees - working foi me m any capacity. employees and have workers' 9 ❑Building addition [No workers' comp..insuraucc COMP-insuance.$ i re a corporation and its 10.❑Electrical repairs or additions required.] 5. We a 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself- [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurancerequired]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant that chccla box 91 must also fill out the section below showing their workers'corrprnsation policy infarmation. t Homeowners who submit this affidavit indicating they am doing all work and than hire outside contractors must submit n new affidavit indicating such. _tContractors that check this box must attached an additional sheet showing the name of the sub-cantraetors and state wbether or not those entities have employees. If the sub-conhwtors have employees,they must providb their work='comp.policy number. I am an employer that is providing workers'compensation insurance for my employees: Below Ls the policy and jab site information. 4 Insurance Company Name: S &A , Q /, o Policy#or Self-ins. Lic.#: WC 2.��, S 35-RL 1 S02O Expiration Date: Q 3—V�— O 1 Job Site Address: V lxl �• City/State/Zip: C-0-61 T� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to soctrte coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip 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 insurancc coverage verification. Ida hereby cerf r the pains-and penalties of perjury that the information provided above is true and correct Signature C� Date: 5 2 3— Phone#- Soft — / S- Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/Licease# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of'hire, express or implied, oral or written." An employer is defined as"an individual, partnership, association,corporation or other-legal.entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other Iegal 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 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 comroriwealth 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, i.f necessary,supply sub-contractors)name(s), addresses) and phone numbcr(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 insuranc6. 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 OfI`'icials 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 referonce 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 aff davit 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 (Le. a dog license or permit to born leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would hke 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 Investigatians 600 Washington Street Boston, MA 02111 TO. # 617-727-4.90.0 ext 406 or 1-977-MASSAFE Rev isad 11-22-06 Fax# 617-727-7749 www.mass.gov/dia I __ _ � .:a.;r:. ✓/�->°�"ry' t�D1NG REGU VISOR.: � t .4 .BOARD S-TpOP g UCTION SUPER t� f ! ._icense S-. p835p Number C 119�9 g65.0.• m;� has t p8113 ;<1l.a, -fr. to �p8 1200_. KEVINEENo ORES R02536=f' comm. -""'- 3,3 GR. OUTH, .. Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR ?, Registration 153415 ' ` Exp(rat(on 11/28/2008 Tr# 251461 Type rPrivate Corporation '. ,� '• t SOUND HOME BUILDERS INC KEVIN HOWARD 570 TEATICKET HWY TEATICKET, MA 02536 Administrator I )0-35,000 cf enclosed space — 1 `(MQL'C.112 S:801.) IA-Maaonry only .1'G-1&;2 Family Homes r railure4to possess a current edition of the Massachusetts State Building Code s cause for revocation of this license. i DIG SAFE.CALL CENTER: (888)344-7233 - t• ~ � it istration valid for indi re urn use License or'regiration date. If found ulations and Standards before the exp Reg. Board of Bu►ldrng m g301. One"Ashburton Place R , _1 ( Boston,Ma.02108 y— nature sr ithout sig C, No nature w 9 -- — $t .fie c k t�' T.. * Y G 1 9 '3 of �A ?f l • Town of Barnstable Regulatory Services • MUwszeai.e, y n AS& �,, Thomas F. Geiler,Director o 9. +"�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, J D n C�_6t,✓1 e- , as Owner of the subject property hereby authorize .S t//'I !�f P. J (�/1/ �i�'S to act on my behalf, in all matters relative to work authorized by this building permit application for: YO r va f��T dac�3 ddress of Job) 7AZ S /3 /,0& Signatur of Owner Date Print Name If Property Owner is applying for permit please complete the.Homeowners License Exemption Form on the reverse side. i oF1HE r Town of Barnstable *Permit# ra 003 0 Expires 6 hs from issue date o r Regulatory Services Fee Thomas F. Geiler,Director t .� Building Division D 200$ Tom Perry,CBO, Building Commissioner 8'1 T0�/N pF 6q 200 Main Street,Hyannis, MA 02601 . RtVSTASLE www.town.bamstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �)(� Not Valid without Red X-Press Imprint Map/parcel Number Property Address 9.0 I !1-1 1Ui (—,0+-,,a Residential Value of Work y V '' Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 10 r—d+ �k Contractor's Name �<.Q�1 t„rG..�j Telephone Number Home Improvement Contractor 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 be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side J6,� LIUD .l��7 Replacement Windows/doors/sliders. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: Q:\WPFILESTORMS\building.permit forms\EXPRESS.doc Revise020108 , Q i .Board ot'Buildin '` g Regulations and Standards: .(IWJ HOMEIMPRpj �CVE MENT CONTRACTOR Registrat n~ Expira on 15415 . 11F2872008 t IR 1 —!:!b Tr# 253461 : Ype o�Pri_v'ate.Corporation SOUND HOME B ' KEVIN UILDERS i HOWARD cw 570 TEATICKET HW TEATICKET, MA 02536 � ( - ...__ Administrator a f { �Y S . P e :its I N t t. 1 License t °r registr d before the ation valid Bo eXPirati for individul on °fBuildingRe date. ound ret use only If f to Bostons] rtonPlace,mt02108 L�,3°0 and Standards^ (t + Not valid Witl of ut si� ur gat. _ f ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letribly Name(Business/Organi�rion/Individuan: q11A `^,4 Address: S 7 y City/State/Zip: Phone.#: Are you an employer? Check the appropriate boa: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I 6. ❑New constriction . employees(full and/or part-time).* have hired the sbb-contractors 2.El am a'sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition wo,�,,^� for me is employees and have workers' ��"'b , any��• inctttance,x 9• ❑Bu11d1IIg additlOII [No workers comp.•ingln'-d a comp required.] 5119LY�a are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEI Plumbing repairs or additions myself:[No workers' comp. right 6f exemption per MGL 12❑Roof-repairs insturance regnrred.]t c. 152, §1(4),and we have no 13.❑Other employees. [No workers' comp•inmrance required_] Any applicant that ebwla box#1 must also 51l out the section below showing their workers'eotnpcnsation policy inf=mtimL t Horneowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new afdavit indicating such %Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not$rose entities have employees. If the subcontractors have employees,they must provide their workers'camp.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: S — Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: V City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to socuae coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fins tip to S 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 Investi lions of the MA for insurance cov verification. I do hereby certify under a pains-and pen of perjury that the information provided above is true and correct, Si e: Date: t�/-7 l/41 — Phone# d 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 M 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 builduigs 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 compliznce 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)namc(s),address(cs)and phone number(s).along with their ceatificate(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. Bp 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 retuned 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 fo any business or commercial venture (i.e. a dog license or permit to brim leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate ti give us a call The Department's address,telephone-and fax number. The G6mmonwmlth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 TO. #617-727-4900 ext 406 or 1-V7-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/ilia r �oFTHElp � Town of Barnstable Regulatory Services BARMNSTAB MASS.iE ` Thomas F.Geiler,Director Eo;9. 16 - . 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 ✓a✓r%�Lk / QV 1 / _to act on my behalf, in all.matters relative to work authorized by this building permit application for: 0 84d CA&A �3S (Address of Job) Signa of Owner D We Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of Barnstable �OFTHE Tp�� Regulatory Services ` Thomas F.Geiler,Director • BARNsrwat e, M ss. Building Division PlEo �a Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 i wvm.town.b arnsiabl e.ma.us Office: S68-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER , Person(s)who owns a parcel of land on'which he/she resides or intends to reside; on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a iv✓o-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be.required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section ia1..1-Ucensing 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 aie 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. Assessor's Office(1st floor) Map 0 Parcel U Permit# Conservation'Office(4th floor)(8:30- 9:30/1:00- 2:00) /Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:49) 02.6 Engineering Dept.(3rd floor) House# `�0 SEPTIC SYs UST BE Planning Dept.(1st floor/School Admin. Bldg.) INSTAUE� NCE Definitive tAov'ed by Planning Board 19 ENVIRONM E AND TOWN RIE ORE TOWN OF BARNSTABLE�� Building Permit ApplicationProject S e 40 ,� t� {y l Village --7./i ► Owner / —/�/� 1 ��� Address /�/© Telephone 6_1Zv— `4�'2 Permit Request /D /x Z �i �d �!-� -51-e7�0 02 � �D� ,�fv_�2i✓�'T ��Jyv�� -- �ay��t�t�ST/i✓L� �csJZa'� First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name � Telephone Number/, Address (o License# LZ Home Improvement Contractor# f eO 7V O ��r i=vim Worker's Compensation# 19 1x/�JV 93y� NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 2 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. C DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: - . FOUNDATION f ' FRAME INSULATION - FIREPLACE ' ELECTRICAL: ROUGH FINAL s,3 rI PLUMBING: # RQUGe FINAL GAS: 2JUC� FINAL S _ FINAL BUILDIj © m ca a r , DATE CLOSED ASSOCIATIOW f. fN I .cj F ITT t The Town of Barnstable ,P Department of Health Safety and Environmental Services Building Division Ma 367 Main Street,Hyamais MA 02601 Ralph Crosses Off= 508-790-6227 Budding Commissions- F= 508 775-3344 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,.mmoval, demolition, or construction of an addition to-any precdsting owner adjacentoccnpied building containing at least one but not more than four dwelling units or to sauc�uzs which are to such residence or building be done by registered contractors,with certain exceptions, along with other raluircm1ents. Type of Work: O Est.Cost Address of Work: ov� Oaaer.Name: Z2L 1 adG� Date of Permit Application: c,2- I hereby certify that: Registration is not required for the following reason(s): _Work excluded by law Job under SI,000 Building not cwner-occupied Owner pulling own permit Notice is hereby green that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGI� FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcmby apply for a permit as the agent of the owner. Date Contractor e ��� Registration No. OR n�.P Owner's name The Commonwealth of Massachusetts Department of Industrial Accidents �_ a 0I11C001/eYOSI/Of�I/t 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit Applicant_information: Z�Y d m - / location cif.. e 7. Z phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity �m an employer pro%iding workers' compensation for my employees working on this job. comam• name.-- address: -- city phone#• insurance co �7 /��J�� � policy# [�g (.C�t�.E3� 9 3 I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below %vho have the following %vorkzr' compensation polices: company name: address: city phone#• - insurance co policy# -- m a y name: address: phone##• insurance co +^•�Y# MHEIL-AdMON-0 Failure to secure coverage as required under Section 25A of MGL 152 can lad to the imposition of criminal penalties of a fine up to S1,500.00 and/or one vears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. t do-hereby certify and th ns artd pe tes ojpe 'ury that the information provided above is true and eorrecL Signature Print name �if�ilZ� ��e/� Phone# official use only —do not write in this area to be completed by city or town oMcial city or town•_ _ permittlicense# rlBuilding Department ClUcensing Board check if immediate response is required .. ❑Selectmen's Office Health Department contact person: phone#;_ (SU8) Other (revised 3;9e P)AI I &�� o� ; HOME IMPROVEMENT CONTRACTORS REGISTRATION oard of Building Regulations and Standards I One Ashburton Place — Room .1301 I Boston, Massachusetts :021.08 I I . HOME IMPROVEMENT CONTRACTOR :1------------------------------------ -Registration 100740 Expiration 06/23/96 .- Type — PRIVATE CORPORATION I HOME IMPROVEMENT CONTRACTOR. I s."utrotioo 400140 •Cap i zz i Home -Improvement, Inc . i Trpe - PRIVATE CORPORATION• Thomas -Capizzi , Sr . i -ENplrltlon - •-06/23/96 1645 .Newton Rd. Cotuit MA 02635.., i CIPlitl Rome IRprovenell, Inc I ThoN1e Coplul, Sr. ' -W 05 d1 A NeNton Tad. I I -Cotult MA 02635 Restricted to: 10 DEPARTMENT I OEPARINENI or PUBLIC WEIT ONE ASHBUR COASIRUCIION SUPERVISOR LICENSE I 10 - Role DOWON, hiber: . Expires: If - 1 12 fuily Rolls ONS rRUCT'ION SUPERVISOR LICENSE Restricted Is: 00 umber: Expires: - S •0.57042 09/26/1997 0AVI8 N NEBO estr.Lcted Tu: UU c: COSAMMSge�n I00 PEON NOlLON RO E FALOQUIN, RA 02SH /a,4 OCIAL'.SECURITY ::. ;= • . • • f" 10 ^� NOMAS.'•X ' CAPIZZI JR 80 PERCIVAL DR 4 BARNSTABL_E, MA 02668 : 1 1 I i i - I RIDGE VENT TYPICAL TYPICAL ROOF CONSTRUCTION: ASPHALT ROOF SHINGLES: 15/ FELT PAPER; 1/2' CDX PLYWOOD SHEATHING; YX r RAFTERS AT IB' O.C. 1 EXISTING HOUSE t Cx C TREATED POSTS Yx 4 HEADER J FRONT ELEVATION FLOOR SCALE:1/$=1' Yx IIF ® 11F O.C. - $x 8' TREATED POSTS y-8• 10' GRADE 4 2 4' 10' SONOTURE 5 PLACES s CROSS SECTION SCALE:1/4"=1' 81 c GAPome IZZI Improvement 1645 Newtown Rd Cotuit. MA 02635 12' FLOOR PLAN (508) 428-8518 Fax (508) 428-1647 1-800-262-5080 SCALE:1/4"=1' 24' PORCH ADDITION FOR POOL, COTUIT JOB NO: REV.DATE: 7 Assessor's map and lot number .... SEPTIC sysTEM' t THE INSTALLED IN COP,,A:-,,, Sewage Permit number ........................... A WITH TITLE, 33ARESTABLE, ENMONMENTAL • MAG& House number ..... ................................................ ........ I",............ 039. TOWN RFGU� -f*- 0 Mix EE ITOWN OF BARNSTABp 'EE ®�,SE �AY, � A m,9 f BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......51A-.��...... .................. TYPEOF CONSTRUCTION ....................................................................................................................................1. ...............ole.T............I.........I 9AW. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for as permit according to the following information: Location ........ ..................A ..... ............................................................................ ProposedUse .......Te� ...............................................................................................................I......................... Zoning District ........................................................................Fire District ...................................... ......................................... Name of Owner J ?&PROV--).........POCK,.B.............Address ..edp.cw�.... ..................................... ti. - :me of Builder ..........Address ....... ...... ........ ................................. Na\m, of Architect Number' Rooms ..Av...KAOA....................Foundation ..... .....1.0... 4,.R............................ Exlerior -23 .......... ....................................Roofing ......A.jL,&4....................................................... Floors ....... ...........................................................Interior ........................................... Heating ...........Plumbing .... ......................................... Fireplace ..........................................................Approximate Cost ..... ............................................... Definitive Plan Approved by Planning Board ------------------------------19 .... --------- Area ......... Diagram of Lot and Building with Dimensions Fee ............... ........................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I? C X6 C/ ti I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. NaCeZf............................... ' POOLE, BRADFORD 23865 One Story No ...........Y.I.. Permit for .................................... .........Sin le Family Dwellin.g............ ............................................7.""' Lot #23A 40Ba Ro d Location ............. .........................Y.......A............ Cotuit .................. ............................................................ Bradford Poole Owner ..... ........................................................... Frame Type of Construction ........................*................... A .............................................;.................................. Plot ............................. Lot ................................ Permit Granted ..M rch 11. ..........19 82 .... ...................... Date of Inspectio& .. ....................................19 Date Co le ed ... ... . ..... .....................19 m p: ? 17, 7 6, PERMIT REFUSED ........................................................ ...... 19 ........ ..... ............ ....9. .......................... .......... .. ................ . ..... . . .. ....... ... . ... ......... . .. .. ...... ......... ... .. ... ... .. .. ................. Approved ..................... 19 . ..................... ........Ko 1, A Assessor's map and lot number .a1�.. IN E Sewage Permit number' �,WQ ♦� ,/� Z BABBSTADLE, i House number .....,:... ...... y Maea C� i639. 0 9 TOWN 'OF BARNSTABLE - r BUILDING INS'PE=CTOR APPLICATION -FOR PERMIT TO rL.t,).Kr?T,PQi:Gr........7J. (9.4 ,•,,I�A�A�(t,? VW(3(,utt TYPE OF CONSTRUCTION ..........:.......................... ................................................................................................. . q ...............0.L°..T..:..........{.......... 19..��?�. TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location ........ .....23. ........ 1�`r .....��` ......... n v.l T-..................................... ................................... ProposedUse ...... CGiIpg .......................................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner E1?AT?'f. X2 ).........PO4-A3.............Address .. �. r,.✓.,<�........��ca.;.� ..��..................................... Name of Builder T ...........Address ......9..5.... .in_,l. ., a .r.... .. 1. .Q....... '�..???......... Name of Architect. . rt I�, oA.A. tea. .-..... !, .......................... .<4!?..s-1<A.eaa...?. .�,.. ,_...... ..•.:,. .,,. ..Address .. ,... Number of Rooms ........1rV./. ....'}'.: Foundation ...,.A.,a.:r.n...,....... ? ...+:.,?. ...:............................ Exterior ............... le,....................................Roofing ......�.._ �.c._..0�...................................................... Floors .......4:,.1..sr......�..............................................................Interior ..:.....C°..,.,r.e�!.......... ................................................... 4gD Heatingf ..!'�.-;...:............................................................Plumbing ..... ���nu :............�I/ ",.:............................ Fireplace .�. t .........................................................Approximate Cost ..... .............................................../1I ..... Definitive Plan Approved by Planning Board ---------------____------------19_______. Area ........./..,/.......��..J�...�.......... Diagram of Lot and Building with Dimensions Fee ......................../ _�----- ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 0I41) _ ��— ✓,� C/ �--mot. 10 .5/?1 ,,Vr i I hereby agree to conform to all -the Rules and Regulations of the Town of Barnstable regarding the above construction. Name !!. •°;1 /1........................................................ POOLE, BRADFORD A=7-40 Yo No .................23865'- Permit rmit for ...... ....One........ ..S tRr..y........ . Single Family Dwelling........... ................................................................. Location ..Lo.t...#.2.3.A......4.0...Bay...Road...... Cotuit ............................................................................... Owner ....B.ra.d.f o.r.d...Poole. ................ . ... .. .... .. .... .. .. .. .... .... Type of Construction ....FrAme................................. .. .... ................................................................................ Plot ............................. Lot ................................ March 11,Permit Granted .........................................19 82 Date of.,Inspection ....................................19 Date Completed ........19 PERMIT REFUSED ...........................i........ 19 .............................. ........................................................................ ............................................................................... ............................................................................... 'Approved ................................................. 19 ........................................... ................................... ..................................................................... ......... TOWN OF BARNSTABLE Permit No. 2386� , �.• e r � f BuildaJnspector- s.un.ut :- Cash OCCUPANCY PERMIT "Bond - "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.",/ Alf-*�✓ , Issued to Bradford Poole ` Address lot #M 40 Bay Road; Cotliit .Wiring Inspector Inspection date Plumbing Inspector, ' y Inspection date Gas Inspector Inspection date X Engineering Department z �u i' �1�/�l Inspection date Al" THIS PERMIT WILL NOT BE VALID, AND THEJBUILDING SHALL NOT BE OCCUPIED .UNTIL SIGNED BY THE BUILDING INSPECTOR-UPON SATISFACTORY COMPLIANCE WITH TOWN r REQUIREMENTS. r j ..../� ..............................._......., .�d......Building..,Lfspeetor Y •s- GARAGE HEADER by Weyerhaeuser 2 Pcs of 1 3/4" x 9 1/2" 1.9E Microllam@ LVL -' TJ-BeamO6.30 Serial Number. User..1 5/27/2008 7:55:20 AM THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN Pagel Engine Version:6.30.14 CONTROLS FOR THE APPLICATION AND LOADS LISTED 3 a, .a b 16r 3" Product Diagram is Conceptual. LOADS: Analysis is for a Header(Flush Beam)Member. Tributary Load Width: 1' Primary Load Group-Residential-Living Areas(psf):40.0 Live at 100%duration, 12.0 Dead Vertical Loads: Type Class Live Dead Location Application Comment Uniform(plf) Floor(1.00) 0.0 80.0 0 To 16'3" Adds To wall Uniform(plf) Snow(1.15) 30.0 -15.0 0 To 16'3" Adds To roof SUPPORTS: Input Bearing Vertical Reactions(lbs) Detail Other Width Length Live/Dead/Uplift/Total T Stud wall 1.50"- T.50" 569/944/-0/1-513 A1: Blocking 1 Ply 1 1/4"x 9 1/2"0.8E TJ-Strand Rim Board® 2 Stud wall 1.50" 1.50" 569/944/0/1513 Al: Blocking 1 Ply 1 1/4"x 9 1/2"0.8E TJ-Strand Rim Board® -See iLevel@.Specifier's/Builder's.Guide.for detail(s):Al: Blocking DESIGN CONTROLS: " Maximum Design Control Result Location Shear(lbs)- 1513 -1342 7265 Passed(18%) Rt.end Span 1 under Snow loading Moment(Ft-Lbs) 6146 6146 13541 Passed(45%) MID Span 1 under Snow loading Live Load Defl(in) 0.240 0.406 Passed(U814) MID Span 1 under Snow loading Total Load Defl(in) ' 0.637 0.813 Passed(U306) MID Span 1 under Snow loading -Deflection Criteria:STAN DARD(LL:U480,TL:U240). -Bracing(Lu):All compression edges(top and bottom)must be braced at 16'3"o/c unless detailed otherwise. Proper attachment and positioning of, lateral bracing is required to achieve member stability. ADDITIONAL NOTES: -IMPORTANT! The analysis presented is output from software developed by iLevel@. iLevel@ warrants the sizing of its products by this software will be accomplished in accordance with iLevel@ product design criteria and code accepted design values. The specific product application,input design loads,and stated dimensions have been provided by the software user. This output has not been reviewed by an iLevel@ Associate. -Not all products are readily available. Check with your supplier or iLevel@ technical representative for product availability. -THIS ANALYSIS FOR iLevel@ PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS. -Allowable Stress Design methodology was used for Building Code BOCA analyzing the iLevel@ Distribution product listed above. -Note:See iLevel@ Specifier's/Builder's Guide for multiple ply connection. PROJECT INFORMATION: OPERATOR INFORMATION: 40 BAY ROAD David McLean COTUIT,MA Falmouth Lumber / 670 Teaticket Hwy East Falmouth,MA 02536 Phone:5085486868 Fax :5084570649 davem@falmouthlumber.com Copyright O 2007 by iLevel@, Federal Way, WA. Microllam® is a registered trademark of iLevel®. , J , t - C'" , ,D • , - l I ' J .. • - — _- f- _. .. .'il� ee . .t � .. .+ t. _ i T .1 ,E _ !. _, y ..-y , _ ._ 1 _ ' , w w . t. , , , • r 1 t � D ! 1 II } 5 . r f V L i . - - I -r -I- 1 4 _ S -- k i i . y _ Bt C t F t - - I ., , f - - r � ........... .... -- - - Al A eS N -_ - _ p� �-- UK •, z~fz- 13<} { OF f a � 1 AZ 7'c move � � s 3f,.. TAB _ �. t EL= =��:8 'L•- dOAA o17 of BA1,4 o fir' RAti r r 4 � • C,7 r.• 1 {, 4.o�,r >�,..+5 w' rt+- �,,�vt��r,;�. Av S ` i u1b �. &,rl To cr kc �, Ud L rwui =l+v 3 �S +ate 21•( -t t�4 L = ?'L[�V% r. CaCa4J Cfll ti USE qc 'L'Zi.• 5= `xoS c.?U o-rro'� _ ` G -4d - sr ► Lva It r EP-M C I Z- 32.2' ��� t►11� _" Li~.>• d 7z,,14- 28.0 .tya, ��I+J Ito I ,� _. _ �• oq Lags i 4 LC Ac&4Virg j 3 f Per I f c T 1. tAo j _-- _EL.2