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0011 CORNWALL COURT
1 Coin�Q�1 CAAI(+ _YYTown of Barnstable _� Building , - .� - _ - - s�x�sc+e� s Post This Card So That it is Visible From the Street.-'Approved Plans Must be Retained on Job and this Card Must be Kept AM Posted Until Final Inspection Has Been Made. , ^ � „ucc• ,Where a Certificate of Occupancy is Required,such Building shall-Not be Occupied until a Final Inspection has been made. Permit Permit No. B-18-3355 Applicant Name: Megan Joseph Approvals Date Issued: 10/30/2018 Current Use: Structure Permit Type: Building-Fence Over 6'-Residential Expiration Date: 04/30/2019 Foundation: Location: 11 CORNWALL COURT,COTUIT Map/Lot: 056-012 Zoning District: RF Sheathing: Owner on Record: JOSEPH, BRIAN C&MEGAN M Contractor.Name: Framing: 1 Address: 11 CORNWALL COURT Contractor License: 2 COTUIT, MA 02635 r Est. Project Cost: $480.00 Chimney: Description: We installed a 6 foot privacy fence along our back yard property Permit Fee: $85.00 line;and we want to add two feet of lattice to the top of the fence, Fee Paid: $85.00 Insulation: as strangers walking behind our home on the dirt road that abuts Date: 10/30/2018 Final: our property are still visible from our living room,over the fence. We have had issues with people stopping to peer in our windows;it �!� C is very intrusive. (We hired a surveyor to confirm the original plot Plumbing/Gas pan on file with the town.Also,since the fence abuts the Cordwood Rough Plumbing: Road walking path,and there is a fire hydrant in the easement area, Building Official we asked the Fire Chief come out to confirm that our staked line Final Plumbing: will not interfere with the hydrant. Chief Rhude said.thatahe fence Rough Gas: location was fine.The fence was also approved by our HOA.) Final Gas: Project Review Req: - Electrical Service: Rough: Final: Low Voltage Rough: Low Voltage Final: Health Final: Fire Department Final: �'L I -Commonwealth of Massachusetts � 2117115 o - Sheet Metal Permit Map Parcel D/ Date: 3 r— PRESS IT Permit ��� I Estimated Job.Cost: 4FEB 13 2015 Permit.Fee: $ C�� Plans Submitted: YES NJO W N OF BA R N S1 ILleviewed: YES NO Business License Applicant License# Y Business Information: Property Owner.kJob Location Information: Name: L-u �' Name: � � Street: 2 cn J`'���i� S� �/rL�- Z Street: (_orV► W �a � �(,, ,,n City/Town: � ��� t�+ 0-R - �"V\1 City/Town: t' J- MA. Telephoner o' 6 6�8 3�10 Telephone: O a - L Photo I.D. required/Copy of Photo I.D. attached: YES NO staff Initial i J-1/M-1-unrestncted.license I J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft./2-stories or less Residential: 1-2 family Multi-fanvly Condo/Townhouses Other. Commercial: Office Retail Industrial Educational Fire]Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft ?�' over 10,000 sq.ft. Number of Stories: Sheet metal work to be completed: New Work: Renovation: HVAC Metal Watershed Roofing. Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: '{'oven l 1> S f � INSURANCE COVERAGE: 1 have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes❑ No ❑ , i If you have checked yg& indicate the type of coverage by checking the appropriate box below: A liability insurance policy ( Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives tl�is requirement Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑,1 hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of'my knowledge and that all sheet metal work and installations performed under the permit issued for this.application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments' Final Inspection Date Comments I Type of License: 3y ❑ Master ritle El Master-Restricted , 'ityfrown ❑Joumeyperso'n . Signature of Licensee permit# L/ El License Number:. (( � =ee$ El Check at www,mass.dov/dnl l nspector Signature of Permit Approval 1( �t Town of Barnstable Regulatory Services aeartaresu. MASS �, Thomas F.Geiler,Director Mn+' 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 r, �c I,t--� �_ D.�y-, ,as Owner of the subject property hereby authorize L- � 4 r to act on my behalf; in all matters relative to work authorized by this building petrait 1 b/-IdIAJa,lI (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. Se ature of Owner Signature of Applicant 2c i o'y >C>s �. Y-- Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS T[w Commonnwv *afMassachusezf& [alto Of fnveAzafians 600 W47shingfon Wreet Basta 02M wK-m inassgat4/dia Workers' Compensaf a-atInsurance Affidavit]Bi3ilders/Confirm:ctorsMechicianMumbers Applicant Inferm,ation Please Pant Leeibly Name(Busmeasl�tion/tudividual): j Address- '2, c, A-A-C( t sS!L 7 e City/State/Zip: E„ Phone O ~- L p A.re you an employer?ChecIL the appropriate ba= Type of project(requ�d�: I_❑ I am a employer with 4- ❑ I gm a g�tal conf ractor and I 6- ❑New construcfioa employees(full and/or part-time)-* have mrect the su 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7_ WRemodeling shift and have no employees These sub--contractors have g- ❑Demolitioa -w for mein an capacity emplaY�and have wor3cers' �� Y� {S _ � p- ❑Building addition ff- 0workers' clamp_imsmance comp_insurance Wired] 5- We are a corporation and its 10_El Electrical repairs or additions officers have em-rcised their I1� Plumbing airs or additions 3.❑ I am a homeowner doing all ward g reP , myself [No worlms'O=P_ right of a mmption per MGL 12-0 Roof repairs 1_ 52, (-[and 1 a we/issue no i ns7xx„re requirz>d l l c employees- o wolloers' 13_ Q.tbes —Q- comp_Insurance required-] 'Amy sagti Graf that checks boa fl must also fM our the section below stewing alas woikus'co vemsa oa porky dnfunpitias t Homtwners orlro s�amit this afnr3sdff incurY ace tiering a1T ZrtaiC anal then hoe odC couttactnrs rffiSY Snit s iFP s�dsrii ia3icsx sucB_ ZCbntmcmrs tbst check this box must attached M addidauo sheet showrng tine nsme of&e sat--mmrscbx-s=d stela irhether cent 8ase Mies fizm ampIvyees_ If the mb-comamctam h3-m employees,they must provide t eir wnskea'comp.policy aur2nr_ l atrt arz etrrpLryer thatisgratz tt or ern'competzsalion inrttrruxcs for ttly'emgtayeea Belotr is f3tega&cy arzd job sirs in formatLwL Insurance CompanyName: Policy fr or Self ins Lic-#: Expiration Date. Ioh Site Address: cityl"5tate/T-P; Attach a copy of the workers'compensation policy-declaration page(showing the policy number and expiration date). Failure to secure cm-crage as regniredunder Section 25A of MGL c. 152 can lead to the imposition of criminal Penalties of a fine up to$1,500.Oa and/or one year impri as weal as civil penalties m the fog of a STOP WORK ORDER and a fins of up to$250.00 a.day against the violator_ Be advised that a copy of this stdE=t may be forwarded to the OL=ice of Investigations of the DIA far fim rance coverage verificadion- lyder hcrrebjr e erttfy under th pains ttrtripenattiss afger tuy f#tatfhe ttej-ornzatian provide-J above is.bars and correct PZj 3/ Sit?nature: Bate- pbom 9: 3 3 ©�fj r i4rd use only. Do trot twits in this arez,to be cawpleW by city or town of}4'ciaL C itv or Town- PermitUcense# Issuing Au-thority(dreIe one): L Board of Health 2.BmIdin g Depar[meut I CitVTIawn Clerk 4,Electrical Enspector S.Plumbing Inspector 6.Othex Cogrtsct Person Phone-9: 6 �d ri Information and Instruetions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute, an employee is defined as"...every person in the service of another under any contact 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 repay work on such dwelling house or on the grounds or building appurtenant thereto sliallnot because of such employment be deemed to be as 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 arty 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 peformance of public work until acceptable evidence of compliance v6th the insurance requirements of this chapter have been presented to the contracting authority--' Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their ce tificaice(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 insura ce Coverage. Also be sure to sign and date the affidavit Uie 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 ad-di tica. an applicant that must submit multiple permitlhcense applitations in any given year,need only submit one affidavit indicadag current policy information (if necessary) and under"Job Site Address"the applicant should write"all locations is (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be.provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call_ The Department's address,telephone and fax number_ A no Coram<c alth of Massachusetts Department of Industrial Acci�d=ts OffiCe of J.avestzgatiGuS 600 Washington Stet Boston,IAA G2111 74. A 617'127-49GU W 406 or I-97-7-MASSAFE Revised 4-2 -07 Fax#617-727-7 7749 Www_rnass,gov1dia r e Tlpnw�, . � :COMM.ONWEAUH OF.MA. SA `HUSETTS- OF ISSUES THE FOLLOWING Ll£ENSE Ra A MASTER UKRESTRICTED Q i t 1,11K£ S CYR G -.30 MELISS�i G YARt�OUTH �tA` 02673 14I;3 4z4 .06°/z$/l5 30684 : Timothy Gray Building & Remodeling, Inc. "We'll restore the very old...or start from scratch...to fashion your dreams from timber' November 18, 2014 Town of Barnstable / Building Department Attention: Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 Regarding: 11 Cornwall Court, Cotuit Permit#20141779 My contract with the owner's for this project was a "weather tight shell. At this time my part in this project is complete. Jeff Lauzon came out and did final inspection and signed off. The owner's have wired smokes and other without a permit. (you can speak to Jeff regarding this, he is aware) Please be sure this permit is closed out and remove my license and insurance on this job. do not want to be responsible for owner's work or other tradesmen he may have hired. Thank you, Timothy Gray Owner Timothy Gray Building & Remodeling, Inc CC: Jeffrey Lauzon; Inspector 68K Nicoletta's Way * Mashpee MA 02649 (508)477-3364 office(508) 539-3714 www.Tii-nothyaraybuilding.com/TimothyGray(a�comcast.net Lic 046234 * State Registered#102634 * Insured TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel YO';IN OF BARNSTABLE Application 63 6 Health DivisionU'!1 �,�4, -, 4 Date Issued . Pi f 2: ? ,�.a Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board DIVISION Historic - OKH _ Preservation/ Hyannis Fa ject Street Address ` � ��Whu_ C&&T ge O ner G` dJ Address U-1 LOT= Telephone 30� LiH agQ5 I �rmit quest Vn " &12 at 4) 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 supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new 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 0 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) Name � � G- � �Pti� Telephone Number ( Add1 ress _ CLicense#a,o ^ WailZT% Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGINATU DATE Lou\— —a U t r FOR OFFICIAL USE ONLY AP?LICATION# DATE ISSUED = MAP/PARCEL NO. ADDRESS VILLAGE " OWNER j DATE OF INSPECTION: 1 •r• i FOUNDATION € FRAME l 2�Llo r i Y INSULATION 1 " ":I y 1 - - FIREPLACE ' ELECTRICAL: ` ROUGH i FINAL . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDING } DATE CLOSED OUT Y Y ASSOCIATION PLAN NO. Me C,rzrsmomt ofMLasachrzsr- ���r�f��trrr114cr�e�s r.,Z v office rrt orrs 60 WmhhVfoYr Street ffosfcnr Ai 02M wesnu massgavAr]rux Worke& Cum-pe sa5u In urzmce -ffidaFit BufldersfC�ani-acters/Efectrici &=lumbers F� afau Pease Fri IihIy Add , f�tatp= PhDnt--M A /Are you an exaploy'er?Check dm aplNupriate bax; T ctf a'eLt F El -ama employerwith . 4- ❑ I�a goal ccntiactur and I n e pw.3 {Find)- 6_ Ides won employees{€tell andforpa t-1 * bav�hire&ffie� ❑ 2_❑ I am a sole grogiie#Qr orparfner- listed on the aftacfied sheer 7. R exnadcl sbip and have no employees Theme sab-oogtractors have g- ❑DemiIifian woddng frrf M-in any cap2-ed5r employees tnd have woi�eers' 4_ Build-mg addifion [96-wo,&Zm, carp_in-Vxance comp_mcnrwrr,�-I I 5. ❑ We are a corpoiaiianand its IO-E]Eleeaical repair;or additions am a hnm doing au v a� have e�rcised their 11.O Piumbiag repairs or additions o s� O6=' � e-�, F �s �� F oomg c-15 6f I and hati�o 12❑Hof Q11�d I. § -I 13_0 Other �oy�-moo ' comp-inswance &T �� �1CPEf&3rt chadLs b=tl=!talso ffi ontthee section brJvarsinwnig tbeI"wodm'CO=umatLOII AoJ"iCfaafi fr� FFo-meowneis airs tin t his s d�:u M r aj;may.MM damg=II s^�^A ti=h�*e DM±M&- sarh tcantsaastmtrhwIrthisbax must sttsrbe3aIIdditiCMWsaeushvc�gthet1a�eofthesub n sandsmtevrbetherticnaLfrrnseemshova _ t�tioyees. Tf the svb-caut�aas 1�re emnTay�s,tiieg�rst piavfle the w�1s�s'camp.p oiic�m�bes: ram•art atatpZmyer fhrtis prov&Lmg'tt�orkers'coapgnsrrfion inm4raace for M errP£ayecs. DeZotr is Ste po&cy raid job szts Z7ifOt?CtQ'ftL?iL .. J. _ . T wrance CiotnpMYNl the PORCy#or Se-ins-7 zc#- Expiration-Date: Job�r .Addiess_ COIS`a"-": Attach a copy of the tsvrkers'compensatim palicg declaratiou page(shoNving the politer number aad•expiration date}: Failure to secure-coverage as reToiredander Sectioa SA of MUL c. 152 can lead to the impasitioa ofrriminal pesiallies of a flue up to$1,500.0a and/or one yeavimpris�m well as cimil peaaifiss in ffie form of a STOP WORK ORDER-and a tine of up.to S-250.00 a dtry against the violator. Be advised that a copy of this sb&tement maybe forwarded to the Ofnire of InvieuEgations of the DIA fbr v�cavefage vedfic adon_ T do IaEcre rc t€r pains attdpsnal{ies tr�pedtay f3iatfhe iatforrizct am prcndd.d above Ls fats and cvrrect Sig6ag - Bate E zciarL use emu£} Da trot-wribr its tf&area,ta ba catttpleted by city or taws rif cinZ City or Town.: Permiu ;cense# LBwn:dof$ealtf[ 2.$-uMingDepartmtmt I Cif�d Fawn Qcrk 4_EIectricalI2sgeckor S.PhwabtngIasxctor 6.Other Ca>z�ct I't rsttn: Pita ue,k hrjassachuse_s Viral Laws clapte<r 152 requires aR employers to provide workers'compensa ion for their employees Pmsu�to f ais statote,an niployee is defined as C__evezy person in the sea-vice of oaother uaiea any confact oflibm, ' express or izaplied, oral or written-" v An enpXayer is defined as"an individual,partaershm,association, corporation or other legal.matity, or any two or more of the,tpregomg engaged in aJoint enterprise,and includingtire legal represmtetives of a deceased employer,-or the receiver or trast z of an individiial,partzaesshrp,association or othez legal emery,employing employees. -However the owner of a dwelIiag'house having not more than firree apartments and who resides therein,or the occupant of the - dwelling horse of anothez'who employs persons to do maintenance,con&;t=tion or repair work on such dwelling house or on the grounds or building appuitenard 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 airy applirant who has not preduced acceptable evidence of cowpliance with the insurance.coverage required.-' _ Additionally, MGL chapter 152, §2SC(7)staffs"Neithez the commonwealth nor any of its.political subdivisions shall enter into any contract for the perfomance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.' A-pplicants Please fill out the woikers'compensation affidavit completely,by checking the boxes that apply to year situation and,if necessary, supply sub-contiactor(s)name(s), addresses)and phone number(s)along with their ceruicaie'(s) of inSLrrance. Limited Liability Companies(LLC)or Lia t Liability Partnerships(LLP)with Do employees other than the members or partners,are not required to carry workers' compensation ineun-ance. If an LLC or LLP does have employees;a policy is required Be advised that this affidavit maybe submitt--d to the Depar (-,nt o_`Industrial Accidents for confirmation ofia=ance Coverage. Also be sure to sign and date the affidavit The affidavit should be retrained to the city or town that the application for the pemit or license is being requested,not the Department of Industrial•Accidents. Should you have any questions regarding,the law or if you art,required to obtain a vrorkers' compensation policy,please call the Depaiment at the number listed below. Self-insured companies should enter then self-insurance license number on the appropriate line. City or Town.Officials Please be su fii re at' he affidayit_is complete andprirated legibly. The Department has provided a space at the hot m. of the affidavit for you in fill out in the event the Office of Investigations has to wntabt you regarding the applicant ' Please be sure.to fill in the pean.it/liecnse number which vr,M be used'as a reference number. In addition,an applicant that must submit multiple peffiit/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 madced by the city or town may be provided to the applicant as proof that a valid a$davit is on file for future permits or licenses. Anew affidavit must be glen 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 fhis affidavit The Office of Investigations would lake to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give n§a call. The Department's address,Wr_phone and fax number ` Thy C�omm�aaWaTth of Ma&sach Delrazfin�t c�-f 7n.�u�tr-Ia�.f��c%dtinf�• • - • of.Txz� t�o-xL� $-fin.=MA G211 I T--L A 617 727-4905 Q_Xt 4-6 M I-fir hLA-&%AFE . . Fa,# 617-727-774.1� Revised 4-24-07 T4 F go�dia Town of Barnstable Regulatory Services �oFTHE TOYyti Richard V.Scali,Director Building Division saxt�szas Tom Perry,Building Commissioner �$ 9-- ��� 200 Main Street, Hyannis,MA 02601 RFD www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 l ��a� 3 HOMEOWNER LICENSE EXEMPTION DATE: f r C 1 H Please Print JOB LOCATION: )) LeWuaL�_ �/] COS f2 p number street village ��xol�owriz✓R°°: Zo3) LA name home hone# work phone# CURRENT WJLrNG ADDRESS: Sill 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,rules and/regumltions.The undersigned owner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection p oce es�reents and that he/she will comply with said procedures and requirements. of Homeo er f' I. J 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 r 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:IWPFILESIFORMS\building permit forms\EXPRESS.doc Revised 061313 � E T Town of Barnstable �. ' Regulatory Services 9snx�v S. E'g Richard V.Scali,Director i639• �0 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 Com lete and Si n This Section J '` P g 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. Pool`s" - 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&O WNERPERMISSIONPOOLS F Town of Barnstable r Regulatory Services ♦ ya► MASS, ♦ Richard V. Scali,Director i63�9' ,m�' 1639. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-190-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner of property located at o17 hereby certify that llmow< � �( is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# 6 0 0 , issued on 201 I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. J ` l ROP[Tykry OWNER DATr q/forms/newcontr reference R-5 780 CMR rev:040414 t `OFtHE TO,�� Town of Barnstable ',-, RA+R�c�=XSTi/Ay�RoLE. Regulatory Services MASS. .b,q. Building Division prF p��a• 200 Main Street,Hyannis, MA 02601 e, Office: 508-862-4038 Fax: 508=790-6230 Q Inspection Correction Notice I Type of Inspection �I�-A 0) Location,-* I-.1 e ORWA L L Permit Number Builder One notice,to remain on job site, one notice on file in Building Department. o The following items need correcting: 0 U)IkZz JG Ayo'F Co M PI-£`T N 6r nJ.sPEc n Ie t41M 1= N67- 1!2-6 t CAsE> 6 ,PU a-r I�ej n✓ �.i�G F \ S� F_xP s J i or paow\ �s AiJD R C=,r3S PCC-7' RE40 5 Please call: 508-862-4038 for re-inspection. Inspected by J Date D o VW I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 �Map ��� Parcel �1� • - � � � Application / d Health Division Date Issued ���J }' Conservation Division � Application Fee Planning Dept. Permit Fee C) Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address C� �✓lo�'e�-d/ Village OwnerJarm"'?v -z;aXC,�d r Address Z_':0 Telephone 3 0-3 Ll A/2, Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing 140 proposed �a Total new e01 Zoning District Flood Plain Groundwater Overlay I Project Valuation Construction Type Ae,041 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure % dam Historic House: ❑Yes A,No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing A net Number of Bedrooms: existing _new o n 'n Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: L7 Uas ❑ Oil ❑ Electric ❑ Other c�s� ---+ Central Air: 84es ❑ No Fireplaces: Existing New Existing wood/coal stove:~9I Yes?❑ No �/ .c 0 Detached garage: 2! existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ ngw size_ y 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/ r � Proposed Use �� APPLICANT INFORMATION (BUILDER OR HOMEOWNER) r/ p s Name ��''1�� �J'd''�J Tele hone Number r Address j�&t ZZ/G 014'f! A410'9 License # OA�W y h Me eV Home Improvement Contractor# Email2 i;7 a/�y o (�=reay��(O�C i ��GJ Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `���� t, FOR OFFICIAL USE ONLY 1- APPLICATION# DATIf ISSUED 1 MAP/PARCEL NO. _ ADDRESS VILLAGE OWNER k DATE OF INSPECTION: FOUNDATION ' FRAME 0`r Voka t INSULATION t' f FIREPLACE ELECTRICAL: ROUGH FINAL t , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING , DATE CLOSED OUT) , ASSOCIATION.PLAN NO. Id Town of Barnstable Regulatory Services Richard V. Scali,Director • Building Division BARNSTABI,E MMMSTAB MASS. $ wa sn nius�rn�iwiii[ seiaai+eu 1639, .• Thomas Perry, CBO 639-3014 �FDN1°�6 Building Commissioner �Dg 200 Main Street, Hyannis, MA 02601 www.town.ba rnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 June 2, 2014 Timothy Gray 68K Nicoletta's Way Mashpee, MA. 02649 RE: 11 Cornwall Court, Cotuit, Map: 056 Parcel: 012 Dear Mr. Gray, This letter.is in response to application number 201403070 submitted to add to the above referenced property. Unfortunately,the application can not be approved at this time for the following reasons: 1) The construction documents submitted do not match the description of the work proposed on the application. 2) The construction documents submitted are incomplete and do not show compliance with 780 CMR. ' Please do not hesitate to contact this office with any questions. Respectfully, L. Lauzon Local Inspector jeffrey.lauzon(c town.bamstable.ma.us (508) 862-4034 i the Corn; umveaM of Mirssachrrsetts ,r DVarhumt o•f Industrial Accidm& Office of Investigations 600 Washingtan Street Boston,31A a2111 wwmmassgovldia Workers' Compensation Insurance davit Builder slContract rslEiect ieians/Phunbers Applicant Information Please Print Lezibiv Name(Busine niraf;ondadividnao:�1r/d%'/y Ad&ess: UO�-A �fc�j i7 1 a.y CitytStaielZip: `i e-e eze-/ Phone :- Are you an employer?Cheer the appropriate box: Type of project r 4. I ama general contractor and I � p ] ( ���'= . 1.P-I am a employer with ❑ g 6- ❑New construction employees(fun andforpart.-time).* have kued.the'sab-contracors 2.❑ I am a sole proprietor orpartner- listed on.the attached sheet. 7-JRemodeling ship and have no employees These sub-contractors ha<<e &. P51)emolition woAing for the in any capacity.• employees and have wotdmrs' 9. ❑Building addition worloers'comp.insurance comp-insurance-1 required] 5. ❑ We are a corporation and its 10-❑Electrical repairs or additions officers have exercised their I Plumbing airs or additioms 3_❑ I am a bomeovvner doing all work -❑ g rep myself [No workers'comp- right of exemption per MGL 12-0 Roof repairs insurance required-]1 c. 152,§1(4X and we have no employees.[No workers' 13-❑Outer comp.insurance required-1 !Amy aoplicasst Beat checks box--1 also fill outthe:section below showingtheir,woskere,compeusatim policy infhamnion. t Smmeoamm who submit this.affidavit indicatiug they axe doing all watic and thum hue outside contractors must snbait a new affidavit ituhcating sorb =Cantractoss That check this box mast attached an sdditioml street showing the 71 of the sub-coutrritors and statearhether ornat those entities have employees.Ifthesub-canta aorshave employees,they must pmvide their workers'camp.policy number. lain an etriplarer that isprntdding tvarkers'compensation irmirance for my employees. Below is the paltry and job site information. Insurance Company Name a ,�—� '//%�9�`�9 Policy#or Self-ins-Lic.#: peg&, ',PV d Expiration Date. Job Site Address: // efdrA4WI Crz Gt-3" City/state/zip: e'y.%;C//,7T -02,&'3J— Aktach a,copy of the workers'compensationpolicy declaration page(showing the policy number and elation 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 andlor 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 uZolator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ida Hereby certify ruder the pxuns a d penahYes ofpedirty thatthe information prmdded abMw is true and correct Sienatar�-- �. e: Bate: Phone#: �i~��-��7,"'3 j Official use onky. Do not owtite in this,area,to be completed by city or town qfficiaL City or Tom : PermitUcense# Issuing l-Ithority(tdreIe one): I.Board of Health 2.Budding Department 3.Cityllown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone 0: RV CERTIFICATE OF LIABILITY INSURANCE -ATE(MMIDDIYYYY) 05/14/2014- HIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS tCERTIFICATEE 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 Mark Sylvia Insurance Agency,LLC NAME: Kris E Ko�reski PHONE r No):508-957-2781_ . 404 Main Street PHON n,txU (508)957-2125 E-MAIL - aopRtss:m ark(c�marksylviainsurance,com _ Centerville,MA OZ632 INSURER(31 AFFORDING COVERAGE NAIC 8 - 1 INSURER A:Farm Family Casualty Insurance INSURED "- - - — Timothy Gray Building and Remodeling Inc INSURER 11; - -_ 68 K Nicoletta's Way INSURER C:_ Mashpee,MA 02649 INSURER D; INSURER E: INS ER 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 TI•IE 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, INGRkig Mn TYPE OF INSURANCE UeR POLICY E POLICY EXP "— imnPOLICY NUMBER MM bDNYYY1 -IMMIDDIYYYYI LIMITS A X COMMERCIAL GENERAL LIABILITY 20OIX0540 2/26/2014 2/2612D15 EACH OCCURRENCE $ 1.000,000 CLAIMS-MADE Fi-1 OCCUR DAMAGE 10 R NTED - S1Ee oceunenco $ _ 100,000 MEo EXP Any one person) s 5,000 - •• _ PERSONAL B ADV INJURY $ 1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGq_'M $ 2,000,000 N POLIC,Y I1 PEA E I LOC PRODUCTS-C,DMPIOP AGG $ 2,000,D00 ` OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED I - - AUTOS AUTOS BODILY INJURY(Por accidano $ HIRED AUTOS NON-OWNED WNED PROPERTY DAMAGE $ Per d I UMBRELLA LIAB OCCIJR EACH OCCURRENCE S _ EXCESS LIAR CLAIMS-MAOF- AGGREGATE IS DED RETENTION$ $ A WORKERS COMPENSATION 2001 W6340 10/15/2013 10115/20 4 _ PER OTH- AND EMPLOYERS'LIABILDY Y 1 N SjAjUTE ER ANY PROPRIETORJPARTNERrEXECUTIVE E,L.EACH ACCIDENT S ' 1,OI10,000 OFFICERIMEM9ER EXCLUDED? N NIA -•• ... (Mandatory In NMI Ir yes,tl'W'be under E.L.DISEASE-EA EMPLOYE g 1,000,000 DESCRIPTION OF OPERATIONS be)ow E.L.DISEASE•POLICY LIMIT E 1.000.000 _� ZE DESCRIPTION OF OPERATIONS I LOCATIONS I VBNICLES(ACORD 101•AOAIUonol Remarks Schodulo,may t1a attached If more opoco is roqulrod) r Carpentry C> Timothy Gray is covered by the workers compensation policy. CERTIFICATE HOLDER CANCELLATION . 1 • (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Building Department ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r t BARNSTABM ,e� Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,"MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must. Complete and Sign This Section If Using A Builder E_L*_rq'GG—A N m S C--P H -, as Owner of the subject property hereby authorizeW / ��o�� ��' � to act on my behalf, in all matters relative to work authorized by this building permit application for: P (Address of Job) �Signa e o Owner Date G� vvv �C�S ' f Punt Name ,° i If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit formAsmokecarbondetectors.doc. Revised 050412 'Town of Barnstable Regulatory Services Richard V. Scali, Director Building Division * swuvsr.+ar� t Tom Perry,Building Commissioner MAM ,d$ 200 Main Street, Hyannis,MA 02601 prED � www.town.barnstable.ma.us Office: 508-862-4038 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 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 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 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. Massachusetts -Department of Public Safety � Re ulations and Standards Board of Building 9 , Fumily ,_ Construction SUP': i`Oi 1 & . License: CSFA-046234'' ,FUA91 RY GRAY 68K SICOLETT W S MASHpEE MA 6L649 0 Expiration �J.�' �Jf %• J V3012014 Commissioner -- ell,�a»zaicaini et��l/o�C�1R ulation Off-tee of Consumer Affairs&Business � =y: ME IMPROVEMENT CONT Type `- registration: 1.02634 private Corporati_`. — . Xpiration: 712I - TIMOTHY GRAY BUILDING&REMODELING Timothy Gray 6BK NICOLETTAS WAY Mashpee, MA 02649 Unders�cret?r . i Andrejs R. Strikis Architect 85 River View Lane Centerville, MA 02632 (508) 790-0920 astrikis@amail.com June 29, 2013 Mr. Jefferey Lauzon Building Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 RE: 11 Cornwall Court, Cotuit Verification of grade levels at existing building Dear Mr. Lauzon, A review of existing grade levels shows the following: The grade level at the building front, on average, is about 24"below the plane of the first floor. The grade levels drop at the sides of the building, and continue to drop around the rear, until, for a distance of nearly 40 feet in the area below the main living room, and rear deck,the grade drops to a few inches below the basement floor plane, creating a"walk-out" section. The entire perimeter of the basement (not including the garage, which is slab-on-grade), is measured at 200'-6". The"walk-out" section of the basement, therefore, constitutes less than 20% of the entire building perimeter. Therefore, the basement does not qualify as a"story" as defined by IBC 2009, Section 502, as 80%of the floor is below the grade plane. Sub tted by, Andrejs . Strikis Architect cc: Brian Joseph Andrejs R. StrikiMWN OF BARNSTABLE Architect 85 River View L� �q JUL pB 40 Centerville, MA 0262 (508) 790-0920 astrikis@gmail.com July 1, 2014 • DIVISIgN Mr. Jefferey Lauzon Building Inspector Town of Barnstable 200 Main Street ,Hyannis, MA 02601 RE: 11 Cornwall Court, Cotuit Verification of grade levels at existing building for zoning compliance Dear Mr. Lauzon, A review of existing grade levels shows the following, with respect to zoning compliance. The specified height limit in a Residence F zone is 2 '/2 stories, or 30 feet measured from the average grade plane to the roof plane, also defined as the highest roof ridge. The existing building is a two-story building, with a basement. The basement is a walk-out basement, but 80% of its perimeter lies below grade, therefore it may not qualify as a story. The building height varies from front to back, as the grade slopes down to the rear of the building. For the building front, and partially at both sides,the height from grade to the top ridge is 25 feet,more or less.At the rear, for a section of about 40 feet,the grade drops to a level 32 feet below the top ridge.Averaging out the building height as taken at various key points around the building, the average becomes a fraction less than 27 feet, therefore, within zoning compliance. Please note also that the proposed work will not increase the height or expand the footprint of the existing and previously approved building. The work will only involve improvements to an already existing attic,space. I hope the above information will be helpful. Sincerely, 4AndrejjsjStrikis cc: Brian Joseph Architect f` Andrejs R. TOM- OF BARNSTABLE Architect 85 River VieTV. I I AM 11: S6 Centerville, 32 (508) 790-0920 astrikisQgmail.com DIVISION July 9, 2014 Mr. Jefferey Lauzon Building Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 RE: 11 Cornwall Court, Cotuit Verification of basement wall percentage below grade plane Dear Mr. Lauzon, Enclosed please find my most recent review of the grade levels at 11 Cornwall Court. The area of the basement wall appears to be closely divided between the portion above the grade plane (852 square feet, or 49% of the total basement wall surface) and the portion below the grade plane (886 square feet, or 51% of the total surface). Also enclosed please find my computation sheet, and some photographs illustrating my areas of measurement. I hope the above information will be helpful. Sincerely, Andrejs . Strikis Archite cc: Brian Joseph O to T 2-115 ISO '9Z ��• ... roll'A - Wh" Arun1738 S1�- �I Z$1S 7.5� i OF is co P .��_.._- _._._.._-_...__.•-_ _ _. _ :- WR L.L AV ;A,, M30v5 4kADE Pl.4JkS Lx d A 59' x 1.�` _. {y 5.7 �.r 11- x 34 36.0 �,F F. ..' //T��- 940C ill r`. I� ..o . 1 56.0 /e F. t .M � 1 a. I t)T FL a, e SIDE r 1 ST ( WALE Fib ARC{} C NOT CoLloleq) •� Aga l./ I 4� j SI D�5 WRLV- • OUT AREA 1tI Y �..._���� �� �-••."gip.-r�^� t, I I Al R�kR,- NOT eovolreP i �. .., A rAK- TOWN .OF BKRNSTABL39 permit No. -------220116 i �,�n..� Building Inspector cash9. 4 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." Issued to Paul SU;llix&n Address l nt- L►.. 1.1. f,`�r_rnr.�'1.i. (',rn�xi-: f''citz}�i t- t �, ���7- � Wiring Inspector � �,.r J, �'""""'� - �J � Inspecdon"date Plumbing Easpe�toi r�fer..l.f l � �s 1`'7 `-Inspecti n•date Gas. Inspector � �E Inspection date f .Engineering Department Inspection date � 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. -~ sp Building ect In . sx :fit o T 9'- as � ~ � oT , I PL.A A/ 26 �. 4 GEORGE 1 � =.raj T/.ON /J '1 GEC 14 S SHOYI/n/ q v COn.FO /y v1iiTHI SE T(�:JC-4C- T�Ec�U/t�E MF,v'7 y,�, ��1...,.. �' i7i- TNT T'Ovt/,1/ Of ��.)I:d�i',��,'�C�•?" i'_ . 7:,-'---yZ1- B Z-OW 5.OW ST. Y!a/?MO!✓T1/�� 'T_ Jq:_� ,Assessor's map and lot number ��..... .................... - _:, _.. .... ©© Sewage Permit number C7.Q. SEp'RC SIPSTEM MUST BE .�. .� .0 Q�/Q• Aj NBTALLED IN COMPLIANCE CFSNETD / 6 TOWN° OF BAR. 61TO 00EAND Tt1tr ', ,!. rr-f- .1`.,.1%T1 9f $ i BAHH9TSDLB, i 90 M6 9. M BUILDING IN'SPECTp,R..,.,.. � A�a �I"�.��e�.M.pa -�VAT';Cr Construct OP���n w=4 APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION .....WOOCd rAm.Q,...;51ngle...Famply.:.Dwelling........................... ..... /2 5/80 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....Lo.t 94 Cornwall Court, Cotuits „Mass.,,,,,,,,,,,,,,,,,,,,,,,,,, ..... ..... ........................................................ Proposed Use .......... ..... Dwellg.................................. in ................................................................................................................ ...... ZoningDistrict ........................................................................Fire District ......�r.A.:Qotat.......................................................... Name of Owner .....PaU1 Su11iV.. ..a.n ........... Address ...ri74R a�.Ja.., �.d.G'JaS...1�3nE~,...QS.teSVills Name of Builder David Tellegen Address ..Box 1620� Cotuit ''' ......................................................... .......................................... Name of Architect .. David Tellegen ........Address .,BOX 1620� COtult .......................................... ....................................... Number of Rooms $ ............................Foundation 1011 P.oured. ...concrete. . . ........................ .. ....... ..... ....... .... .. .... . Shingle or Clapboard ...Roofing 335 lbs. asphalt Exierior ................................................................................. .................................................................... Pine 2" Sheetrock Floors ..............................................................Interior .................................................................................... Heating Electric Plumbing .......,CO� er/PVC ................ ............................................................. 2 Masonr �„ Approximate Cost I+O�OOQ t 0�Fireplace .............. ...........x............. :...... ....................... . Definitive Plan Approved by Plannin Board __________________________19_______. Area �C�Q ...J�.... ' Plane Boo _-�92i Page 6 .C� Diagram of Lot and Building with Dimensions Fee /.. d�:......... """"' ' ""See attached sheet SUBJECT TO APPROVAL OF BOARD OF HEALTH �Iva 1 . d I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. i Name . .. ....444......... G� 1 SULLIVAN, PAUL f No .22.B 6... Permit for Q....... .... ~ . .........Family...dke u.i,n g. .... .......... Location Lot...01-11..CarmWall..Cpurt - ...............Co.twit........................... - • . Owner .....P.aul..S.iAlivaa... ....................... - � - - ; Type of Construction ..Frame........................... ~ Plot ............... ............ Lot ................................ Permit Granted April l..•„..•...„.•19 80 Date of Inspection {....... ............. ........19 t t Date Co pleted ......... I .......v19 S/ aw PERMIT REFUSED - = 44 ...... �..�..0.............. ....{./. .......... �• 1 i '� J ~' ` + S Appro .. ....... 19 -; 1 i t 41 ......... . ..... . : ....... �i C. , .................. .. .... .. ................. ...... 1 ttt j - ti L i - oF� Town of Barnstable *Permit# �8aa � Expires 6 months froin issue date BARNSPABtE. : Regulatory Services Fee y MASS. 0 9. Thomas F.Geiler,Director p�FD""°rA Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION 11 Not Valid without Red X-Press Imprint Map/parcel Number 0 1 d1 c Property Address ' ( (�pr'jr,�(,t9�,( ( CC9-iNr�— C04 � [/esidential OR ❑ Commercial Value of Work Ci l0 y�y e A 9 Owner's Name&Address ��V( j j L tjw0-(1 Cy�vr C541 - 0a 635� Contractor's Name&,awl a-'�jJ //4101 A§CL--,a T� Telephone Number ZS 0 — Home Improvement Contractor License#(if applicable)__ Construction Supervisor's License#(if applicable) �Workman's Compensation Insurance ©PRESS PERMIT Check one: MAY 13 2008 ❑ I am a sole proprietor Lam the Homeowner TOWN OF BARNSTABLE I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy#_ O 10 Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) c ❑ Re- ide <4 Replacement ��Value 0. 3 (maximum.44 ) . 1 CZ. ❑ Other(specify) "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature ezpmtrg i GTE �� � // �✓r License or registration valid.for individul use only Board of Building Regulations and Standards before the expiration date.•If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards One Ashburton Place Rm 1301 Registration: 119535 Boston,Ma.02108 Expiratioh: 7/24/2009 Tr# 130185 Type: Private Corporation MOON ASSOC INC JAMES MOON 1137 PARK EAST DR. Not valid ithout signature WOONSOCKET,RI 02895 Administrator i Board of Building Regula ions and Standards One Ashburton Place' Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 119535 Type: Private Corporation Expiration: 7/24/2009 TrrE 130185 MOON ASSOC INC JAMES MOON 1137 PARK EAST DR. WOONSOCKET, RI 02895 =,r•••: Update Address and return card.Mark reason for change. DPS-CAI 0 50M-05/06-PC8490 O Address Renewal ❑ Employment ❑ Lost Cari 1 � CM WINDOWS-DOORS eFa RC Andersen® Frenchwood®Hinged Inswing National Fenestration Patio Door Rating Council Fiberglass To Wood Frame Dual-Pane Low-E Glazing with Argon RES97 ENERGY PERFORMANCE RATINGS U-Factor(U.S./I-P) Solar Heat Gain Coefficient 033 027 - ADDITIONAL PERFORMANCE RATINGS Visible Transmittance OA1 7sPp"edrcl: stipulates that these ratings conform to applicable NFRC procedures for determining whole rmance.NFRC ratings are determined for a fixed set of environmental conditions and a size.Consult manufacturer's literature for other product performance information. www.nfrc.org ENERGY STAR®Qualified in All 50 States lE'711'JL'yilll „> --D DESIGN PRESSURE(PSF Single OP60 HGO-R60 3rx96" MONDow AND D00R NAMWAMURS ASSOM,x1N 2 Panel OP40 HGO-R40 72"•x 96' www.wdma.com 2 Panel Upgrade OP40 HGO-R40 10T x 96' Frenchwood®Hinged Inswing Patio Ooor Tested to ANSUAAMA/NWWOA 101A.S2.91 or raaFs o2 Manulacturerstiputates cordormance to the applicable standards Meets or exceeds M.E.C.,CI.C.,&I.E.C.C.Air Infiltration Requirements WOMA Hallmark Certification Program ilf Pe 4/03 Porto4rson4 _ .Sd 1 ne t,ommonwearrn uJ lnua•.•acnuawcay Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/]Electricians/Pluinlbers Applicant Information Please Print Legibly AName (Business/organization/Individual): So C11 S C . Address` fa Ci /State/Zi be?rSar � t3' p 13��OS Phone#: Are you.an employer? Check the appropriate box: Type of project(required): 1.P I am a employer with I O 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 t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. workers' comp. insurance. g, ❑ Building addition (No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.[ Other���fto l�oa� Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'camp,policy information. ram an employer that is providing workers'compensation insurance for my employees. Below is the policy and ob site information. "" Insurance Company Name: �6 m Policy#or Self-ins.Lie. #: d� g Expiration Date: O D ` L Job Site Address: I I (0 f N tom., �6U(J °1 City/State/Zip: 0` 6 f 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.$256.00 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 ee u r t pat a d en tie erj that the information provided above is true and correct. e 6 Si afore: � Date: O Phone#: .JbD �� — 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/—jown Clerk s.Electrical Inspector. S.Plumbing lnsp c-ciur � 6. Other Contact Person: Phone r: From:Shaunna Robinson,Hunter Insurance At:Hunter Insurance,Inc. FaxID: To:Denise Date:9/17107 12:56 PM Page:2 of 3 OP ID .5d DATE(MMIDDAY") -ACORD. CERTIFICATE OF LIABILITY INSURANCE, t4q0NA-j 1 09/17/07 PRODUCER THIS'CERTIFICATE* IS ISSUED AS A*MATTER OF INFORMATION ONLY ILD AND.CONFERS S UPON tHE CERTIFICATE inter Insurance, Inc. HOLDER:: IERi THIS E'DOEO NOT AMEND,EXTEND OR ., -�,,sq old River Road, P.O. BOX I ALTER. , W COVERAGE FORDED BY THE POLICIES BELOW. t4anville RI 02838-0001 Phone- 401-769-9500 Lrax:4-01-769-9SO2 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National In--C. Moon Associates Inc. WSURERBI in...... Co. DBA GlltteX Helmet INSURER C: DBA ReneWal by Andersen of RI 1137 Park Eas ElitiVe INSURER 0: Woonsocket RI 0289S INSURER E: COVERAGES FW-POLICIES OF INSURANCE LISTED BELOW HAVE BEEN'SSUED To THE INSURED NAMED ASOvEFOF;fTHE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REGIJIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWIHICH 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 NAVE BEEN REDUCED By PAID CLAIMS. TOIJCY EFFEC 0CVEXPIRAnuN LIMITS ImiH 9DD`E -poucy Nu DATE(MWDDfYY) DATE(MMIDDIYY) I- NSRC TYPE OF INSURANCE EACH OCCURRENCE s 1000000 GENERAL LIABILITY rA X. COMMERCIAL GENERAL LIABILITY 14PS26619 09/16/07 09/16/08 'PRE1,11 S ESu(E`atmN1c`umuv rx 0) $500000 CLAJI.,IS MADE rx—]OCCUR I&D EXP(Any one pwson) 1; 10000 PERSONAL&ADV INJURY $ 1000000 GENERAL AGGREGATE s2000000 PRooucTs-comptop,AGO $2000000 GENt AGGREGATE LIMIT APPLIES PER: PRO- POLICY lr-'�..., F-1 LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1000000 A X MY AUTO BIS26619 09/16/07 09/16/08 (Es*cjdant) ALL OVOED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY (Per.accidwrl) NON.OWNED AUTOS PROPERTY DRAAGE $ (P4 accldwt) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S PMI AUTO OW ry EA ACC 6 AGG $ EACH OCCURRENCE $1000000 EXCESSPJMBRELLA LIABILITY X OCCUR cLAjKs MADE CUS26619 09/16/07 09/16/08 AGGREGATE r $ DEDUCTIBLE 7X RETENTION 10:000 1w;A u. I I 7 WORKERS COMPENSATION AND LIMITS I — R B rMPLOYER9 LIABILITY 28586 10/01/07 10 0 1 0 8 EL EACH ACCIDENT $ 500000 ANY PROPRIETOR/PARTNER/EXECUTIVE $500000 OFFICER/MEMBER EXCLUDED? EL DISEASE-EA EMFLOYEE --- 11 yes,dosenbe under E.L.DISEASE-POLICY LIMIT 1$500000 SPECIAL PROVISIONS Wow OTHER 1 771 I ---- - DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY CNDORSEMENT I SPECtALPROVISIONS CERTIFICATE HOLDER CANCELLATION MOOMASS SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED I BEFORE THE EXPIRATION Moon Associates, Inc DATE THEREOF,THE ISSUING INSURERWILL ENDEAVORTO MAIL 10 DAYS WRITTEN dba outter ttelmi .et NOTICE To THE CERtTFIC ATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL dba Renewal by,Andersen IMPOSE NO OBLIGATION OR LIABILITY OF AM KIND UPON THE INSURER,ITS AGENTS OR 1137 Lark Cast EfriVe Woonsocket RI 0:�695 :'A D'REPRESREMW�"G-ENTATIVE ACORD 25(2001108) (D ACORD CORPORATION 1988 t " iI�W • a i c — { _ *e re. - at ^ l BY ANDERSEN' • �r e J g H; __ '� window r<placrment t Pg.k of 1,A� t t B r b, 50 �2-V—�Z�,L Year home was built Customer Name Phone•Home en U19dlorder# Address L Phone:-Work - i Cot State Zip �t Qty. Width Height Style Type Specifications,Poom,Color,Screens,Grilles Price IF r; x x ro Xi d6l x seiB 1" x qa- Z tEY 2 ' 7 x d� x C ( N x x Renewal by Andersen'Proposal All of the above replacement windnwi and doors w be provided for s total of the amount stated in This agteement. Labor&Materials This proposal will remain valid for 30 ��� D QX �R�O Sales Tax C Dan Renewal by Sala ReprrrentanveS�wn 1 Work Permit Cost y��g� Customer Acceptance Total Amount of Agreement l o You arc hereby authorized to furnish all replacement windows and doors required to complete this agreement for �"D3S ,�• which the undersigned agrees to pay the amount mentioned in this agreement and according to the terms hereof. CC ❑Finance❑ Deposit Required You,the buyer,may cancel this transaction at 1 n time prior to midnight of the third business day after the dat of th's tr s on.Please see attached Balance Due on.Completion notice of collation fo for plat' of 's right. -� �. !j Cost of Unforeseen Repairs Dan „ . Cruromn prow! anarvrr Any painting,training or wallpapering which may be needed it not included in- !his agreement unless specifically noted above. Renewal by Andersen'Acceptance Please note that we art unable to bid on repairing any unseen damage.However, if any unseen damage is discovered during installation.we will complete and Darr Reaewd by And—err Mmrager Sipunum charge you fur the repairs upon your approval At the end of the job all construction debrit will be removed and we will clean your new windows and NOT BINDING ON RENEWAL BY ANDERSEN•WITHOUT MANAGEMENT ACCEPTANCE. the mstallation area Form Distribution:White-Renewal by Andersen,Yellow-Installation.Pink-Cuaomer r° A R7gtnde- r) Map Parcel Permit#A House# I Date Issued Co (O q I( Board of Health(3rd floor)(8:15=9:30/1:00- Fee d, y Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Planning Dept. (1st floor/School Admin. Bldg.) BIKE 1p;� Definitive Plan Approved by Planning Board 19 BARNSTABLE. MASS. p TOWN OF BARNSTABLE° 'F°"'°�'�E� Building Permit Application Project Street Address Village Owner . �iC�-'� I t� `C D Address 15A t- Telephone s�- Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 7y Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished'Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.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 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) �❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ' Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use f`0 bC �'% TYIL)L Builder Information Name 7-1�/L.70 U- i'—C O F / Telephone Number T V Address 31 (3",'—I �4 r lt'M. <` License# C l CPO (' I !O J Home Improvement Contractor# 0 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE' -z _ OWNER - DATE OF INSPECTION: _ FOUNDATION - FRAME -,INSULATION FIREPLACE ! ELECTRICAL: ROUGH ' FINAL PLUMBING: ROUGH FINAL + -y GAS: ROUGH FINAL FINAL°BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. f i t ir+EP, ble _ _ The Town of Barnstable 9$ � Department of Health Safety and Environmental Services BuiIding Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 509-790-6227 BuiIding Commissioae Fax: 508-790-6230 For office use only Permit no. j Date AFFIDAVIT 1 HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization. - conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: �i - I—Al~ t.Cost 1, 1"'19 Address of Work. Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. BuiIding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROG:ZAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner- let - ► i'�� RD66-J-T c, Date Contracto Names ✓ J �� Registration No. ...E-.� OR Date Owner's Name The, Commonwealth of Massachusetts Department of Industrial Accidents VJffC8 911,9F9SZfg,9ffVJ75 600 Washington Street ...... Boston,Mass. 02111 11 Workers' Co InsuranceASridavit 190nMaiM p name: L 0 1 e- Ad location: 1 40 P r 0/ A. 09 (,,-6-5 phone# city -E?fr=a homeowner performing all Work mvscif am a sole ropnetor and have no one working in any capacity Lin anemployer providing workers ..compensation for my employees working on this job. company name: address: cityphone insurance cn. am a sole proprietor, general contractor. or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: . .......... comrany name: addrevs- .. phone .. . ......... insurance co. coniviany address- phone dtV.- . .... . ........... .......... . .................... ...... VoJfCV a ffisuranc-ca E "1 0 0 1 z/10/11/0/000K, ............0,000, S1.500.00 and/or Failure to secure coverage as required Under Section 25A of 1%4GL 152 can lead to the imposition of criminal penalties of a e UP to a As civil penalties in the form of a STOP WORK ORDER and a fine o(3100.00 a day against me. I understand that 2 one vein'impri"nmrnt as we Copy Of MIX statement may be forwarded to the Office of Investigations of the DIA for coverage verification. provided above is try.-and sorted f that the in I do h crekv certify under the pains and penalties of p erim ry jot G G si <7 gnattire Date ---------- L/ V q Print name 6,6 0 6E&T Pholle# in I M!........... Official use only do not write in this area to be completed by city or town official permit/license is OBuilding Department city or town: LiLicensing Board chnkif immediate response is required ❑QSelectmen's Office E3Heaitb Department phone#-. _0Other. contact person: iteaam 9,95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another_ under any contrz 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 o the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receives 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 building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renei of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who h. not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and j 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 yot are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns 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 peraut/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. i The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Depaitment's address,telephone and fax number: The Commonwealth Of Massachusetts • ' !� 'x; ' a Department of Industrial Accidents Ottici of in'Vistluadons } �� 600 Washington Street Boston,Ma. 02111 z fax#: (617) 727-7749 q. phone#: (617) 727-4900 eat. 406, 409 or 375 y�. L. . . t . ,per -. - --. - - ..... � . . . .�__ ... ._ . .. _,• ._.,_ - ... . ✓� V�LLY►�'/,Yh�'Lf,(lE'�2%GLIZ O�ii���GUC,2GCQP.� � . HOME IMPROVEMENT CONTRACTORS REGISTRATION j oard of Building Regulations and Standards !j One Ashburton Place — Room 1301 C Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR 4 Registration 116064 Expiration 05/15/00 , Type. — DBA : ,{<< HOME IMPROVEMENT CONTRACTOR Registration 116064 y. -5 TYNDALL ROOFING I _' Type - DBA ROBERT F . TYNDALL o Expiration 05/15/00 --> 37 BRIAR PATCH RD OSTERVILLE MA 02655 TYNDALL ROOFINfi ROBERT.F. TYNDALL fie- WRIAR PATCH RD ` ADMINISTRATOR OSTERVILLE MA 02655 Assessor's map and lot number .... � 'L.... .............. Sewage Permit number /Q THE r��♦ TOWN OF BARNSTABLE Z BARNSTABLE, i q ,•W BUILDING INSPECTOR APPLICATION FOR PERMIT TO Co.n.struct. ... .. .... ....... .................................................................................................... TYPE OF CONSTRUCTION ......Vc.-00....FrAmp, Si_r r7a Fxinilu roll inn .............. / 5/so................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....Lo cu. t 94 Cornwall Crt. Cotait. Masse ............................................................................................................................................................ a . ProposedUse 'L'cZllri? .................................................................................................. ZoningDistrict ........................................................................Fire District ....co.tult.......................................................... Name of Owner ....Paul aulliva�? Address etr�rtrill Name of Builder .... DSVid...Te.11e. en..........................Address „BOY. 1620, COtuit ............................................................... Name of Architect Dati�id Tellegen.........................Address ..Bo.X 1620a COtuit ........................ ............................................................... Number of Rooms ...........Foundation Ort poured concrei e ....................................................... .............................................................................. Shln,cle or Cla.oboard 335 lbs. asphalt Exterior ....................................................................................Roofing .................................................................................... Am �" Shc etrock Floors ................................................................Interior .................................................................................... ,t - oer/Y1rC Heating ..........................Plumbing.............. ........................................ .................................................................................. Fireplace .. ' L1a:nI'..: Approximate Cost 1 9.1000«00 ........................................................ Definitive Plan Approved by_Planning Board ---------------____-----------19________. Area .......................................... _'�a�, 29,e9 a;;e 26 Diagram of Lot and Building with Dimensions Fee .j^e -ittached sheet SUBJECT TO APPROVAL OF BOARD OF HEALTH ,1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....:1..'£: .............................°............:............. A�5 6—12 SULLIVAN, PAUL4 No 2 2 0 8 6.... Permit for ....5iP.gle................. ............F.ami.ly...VWPV.11ix1.g........................... Location ..Lo.-t...4.9.4...11...Cjarxiuia.11--jCcLurt ..................catuit.............................................. Owner .... ............. Type of Construction ......Frame...................... .................................................................. ............. Plot ............................ Lot Permit Granted .....A@',til...1..........:.....19 80 Date of Inspection ...........................19 Date Completed ...L..' 19 ............... PERMIT RiFISED ...................................... ......... 19 . .... ................................. ............................................................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... _ S:G" I 18�G I .... �F— RDDL '^Q•'1�"n0� /J- . 6 a , LOT 94 A rxrcrr n�rrr �Cq—:6EOtL'QOr7[ �g39.71Y 22.627 S.F.t _ :.WOfCK�..5.7UDY-UREA 0 �•^'• as ' o ® ?1�_ LOT 95 cd� _ .. LOT 93c V. — ' ,r.• 62 CORNWALL •� � 'gin QESS 1'N�_ -f6T COURT i � LILn-�t•w..,WmVOWS'-y�TH - �.. • T1C13IlN'G-6ELOW• --_A2UL/.KNEE SPPLE 30-0• .�ST.iffG==1Q-.REMAIN. � ... .: .. NAM.). AHOERSEN M09EL4 NOTES r Z�4 K 4-.14 'fW Z441o' LoW rPIR 2ro.4'lo 2=Tw Zloglo LawF,u•0.31' _ L!�. • -ILA'..._.—.. _ MUM W W tUj W J U = pr =V - r. �■Jpr EL ~ O ~ ' Si►��T.O_. AS'f..1:lET1T._::I Ito U dr U 0 V.Ef tL_==� .__. _;I Se:. BGs61v1E.NS.�VIJO.Gt�1.P16V_...6KSEYS_' Z C7 W W _ _ __=F9R-4iG�.E.._31p7M1C_o M-:UEi6w 5 W WLL �Lr4D�1.,_Yl lfd'_GLiEGT_1,:4�EiS T � -- LIVIN4..R 001A N O. BY I jWW JN WOoC Z Expanded Attic pc 'UZ ' � 11 Cornwall Court, Cotuit, MA 02635 W WN '-o Ci 2 M_ n W_ RN4-W 3ATR 9r3_ 013 OO C3 { . � ,�:�T��49altatrU+rn+hr,�. ED O. 2897 'pt �? CEN.TERVILLE A _ 5T1kaY OdL`Y na ss. eW - -U — - TEL SMOKE DETECTORS REV = ,; r,' U General Notes: \ / sr'�=�:.,,c.c►s;.- 7/S� 1.All work to be performed in accordance with Massachusetts Stine Building Code 760 CMR / , , / A T EBUILDING DEPT. DATE Eighth Edition,WC 1009,and applicable codes included by reference.loaning to be in / accordance with the American wood Council Wood rn m,Construction Manual,110 MPH — Zone.All work to be as approved or directed by local authorities having jurisdiction. 2.Contractor to secure all permits,and to )V drejs R.StrikiS artange for inspections by local authorities having Architect FIRE DEPARTMENT DATE jurisdiction,as may be required. h_ \�-••.� '� 83 River View Lore,Centervnle,MA 02632.Telephone:(S08)790-0920 BOTH SIGNATURES ARE REQUIRED FOR PERMITTING 3.Work to be reR in clean condition,ready for use and occupancy.All debris to be disposed off Floor Plans site in a legal manner_ A 1 Expanded Attic I I Cornwall CouA,Cotuit MA 02635- __ 0.'S NOt:D II l7�13 •�' ' I —ATSSt_8El3,OYASt:o N:�`I/:¢6131➢_ttlD[�6'-._. ..3O•_�O____...__— II1 tWj-Aru�.j.._ I =EEIImir-D _ _ 6 SHILL c_h1ASG" Starr—D�s���_ 4 • I t _ -NSV1_4161.1.'_ "_EY15Tl94-DO RACK - ... . ILLULA w - � 1 -3.7CPAilDED A1'IIC..._..-so'o' .. EiTDFAIIE��7Y1C -30'_O+..._ ..., 'SNii4L-_:Tom'=c1msE::4hr .-I . ' =QL•tpt-Rt04l-'.?O.::NLATCD • ��1rQr71:31i�3DVfE�- I :EIfS.T.fFl�]:T.-'_1t�O'113fi�-EYUwO _. .' -:S13L_-e4'�"�D. . i _ I EL ._NE14-612LL ® ® \ �� 1011SE-6£YONO mow, .. _ ---____ - \ _.E%Iti1N G7.916l11 M' EQN�1�tt ttt►Wy',110j/p�� sk ----- — I 2.897 N' s - CENTERVILLEV. C MASS. % '' T ..._ e1l0f1Y11N ``� An drejs R.Stri is Amhitect 85 Riau View LaM Centcrvi0e.MA 02632.Telephone:(308)7%-0920 Elevations' Expanded Attic. A2 I 1 Cornwell CowtCotuit,b1A 02635 _. .--- ��s•ILO 11 C JS ARf 9 12:0" (V.I.F) d-o" V.I•P.) . � I _- -.ZIp4E-•(p.E%lfSlfl4- � r „ 1.. =-T3Z7S5-BR40 N Grrr --.. .— ---- - - . l - ._B_IIIQF_319.CL�.--____ 1.iJ'G`.4"!: I _ :__.BtD4J<•_.. . __.�tURBCLA'13S ZIR:AY-TO, �7T 4-y'Ots.T._ � :.31UKRI CAN6_.S.TRnP.=A7_`_ --UT-rsL7-5TUA_LLµI fiCTI O:N,=T'(i. F %T-0(f051TE-EAV E� .YLVL5SG07f[ -aEWRI-B:OII1= -Ettr�crca'c-eFv9)�2.--.-_'. 1 96R►UE25:% ' I'F�ATZtiFTGft /..__�-_.iz \ \ .i Ac1�PC ` I371r1GRooF_'.REk1O CE1Z= \ \ L 1- MuMmm>aIJ -m1w I.ur cv->`Zt1't7-..FI}fli-s:H:FQ...% \ \ / . j \ \. _... _ ....... _ i £:• QvnvEr-\ I> si-sln�F-447r ALrIL-PLOO.R__FQLC I:OGWG. _F21[LIENt�=j00.Pf . ,. .. �vr•:Ga'.':_.R6G'a:'::7::,_-.. -2'¢i�-ecrnur.-JaISTf�.,�p :_._ FImm.-FLO .I> --_- - - -- - - — i ' n I;•,.. iP1111(ttf rF '� ED eet No 2897 H C'ENTERVILLE MASS. a e r !-- ------ �(� �Tf�•OFF ' - = 1 Andrejs R.Strikis Architect 85 Rlw View lane.CcMa%llk•MA 02632-T I pbm:(508)790-0920 1 _Section and.Details r 1 C Expanded Attic-- A3 om,v 1ell Cu Coluit,Iv1A 1 /4`04- 5 to 7- 3 �- o 1 `.q��� TAy T c.T` -.*' ASSvn-►Erb .,�'2 43,0 P2 on. D 6- G.O lir�.t / 1 m/sr LEAcr/ t Ar5E =J SSc. �z aCx FrT owNr Pr/dE �_ ,�ESERWL- ''i ad V n!D lSTr.I ... 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S/ fi 2 �,/�' , -X'7 G T.4NX t'7r�T.2 BLOT/ON �30X -_ - - r . CS. OUT4-ETS) AND LE�IGN/�G P/T" CkArG TO BE OF ,�E/�/F0.2CEZ7 CO.vC;2GTE R %4OR�ro ' CONCRETE. ST,2�,v(57;y 3000 xts/ M/N. nA t/1/� A 7T,: Z- . G� " :u° 2/4894 w STEEL " �� 20000 •, ,• /O LOA Drn/G /VE WAY n/oT 7-0 eL LOCA;ED `Y A � �,��' �j• )� 'D 0V4e 5y57 E;M CJN1-�-= 55 )Y 00 / Z7�S/GA/ LOAD//vim /S USED. I CE eT/FY 7NE•` FbUAYYt% -10" `/ 51-/OWAJ CAJ µ or T/-/iS F7Z_,4N /S 7agOPOSE27 ON Tf-/E. (3000A.ID A5 5<-/CINAl AND •/7- DOES C O,A'IT'Ly Gll/TN - TqF .5U/L0/,v6 SE TF,-AC,� ��pU/�t�-�/��/T5 ' LOW,18• OF 7--/E_ TO>-WAI OF BA /z,v T :4 11-:5 4-�-c A4 9 DA TE 1/E..4 L_774 A GE✓v T DATE T�i/ 20o,1790 s{/RV <t.PF;,420VAL-