Loading...
HomeMy WebLinkAbout0313 COTUIT BAY DRIVE ��.3 G'oryr i3 y 7�� ��. :.. ,- ti r �. �3:1"� ' .� .,, Town of Barnstable Building t 1XIMMIM Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MAE& Posted Until Final Inspection Has Been Made. Permit 19- Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-20-1397 Applicant Name: DONNA WILSON Approvals Date Issued: 06/03/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 12/03/2020 Foundation: Location: 313 COTUIT BAY DRIVE,COTUIT Map/Lot: 055-008 Zoning District: RF Sheathing: Owner on Record: KELLEY, DAVID B&JANE A TRS Contractor Name' INDOW NATION LLC Framing: 1 Address: 65 COCHRANE STREET Contractor License: 119..7968 2 MELROSE, MA 02176 Est. Project Cost: $4,320.00 Chimney: Description: INSTALL( 6) REPLACEMENT WINDOWS NOSTRUCTURAL Permit Fee: $35.00 Insulation: Project Review Req: GLAZING REPLACED IN HAZARDOUS LOCATIONS AS DEFINED Fee Paid:' $35.00 - IN 780 CMR MUST BE TEMPERED OR EQUAL. - - Date:/� 6/3/2020 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. i � The Certificate of Occupancy will not be issued until all applicable signatures by the Building—and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT �� ,� Final: ; " /Uo7`�n Plan TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,,ll Map-o;t' Parcel Application o 13 U 3/ Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation /HyannisQ Project Street Address �— Village ' Owner ' Address Telephone ��1:7 - 9 Permit Request --t-en, 1-,)t,/1� �)zc6 c IThe Al2U Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0010 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U,/ Two Family ❑ Multi-Family units) Age of Existing Structure Historic House: ❑Yes d No On Old King's Highway: ❑Yes UlTo 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 CD Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove]Yes; ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ Jisting dew sizeCD 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�,.�� ��(�`� " �� (11 — Telephone Number 0+ Address ; d "-' License #— C — & 14A- O c232 z Home Improvement Contractor# (� Worker's Compensation #-M W C 0 �L ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ( (77/aj. SIGNATURE p /GYJ (�✓�� c.G—.�� DATE 2, I�A � y FOR OFFICIAL USE ONLY , APPLICATION# DATE ISSUED MAR/PARCEL NO. ADDRESS VILLAGE ; OWNER ' DATE OF INSPECTION: FOUNDATION �1erlmS oW 2a s2 FRAME 464k INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING IS• x DATE CLOSED OUT ASSOCIATION PLAN NO`) , L • l r T6w.n- of B ar'pstable . -�2egulatory 5ervzces - r � r ` Thomas F. Getler,Director ui m., a6 h wilding Division ; EO TiLomas Perry,•CB O,Building Cc)i migsii oner 200 main Stint, Hyannis,MA D260I' Fywsp.town barnstablauta.us •Offi= 508-8524038 Fax: 508-790- M- PLAN REVEW P_ © 1 Z o 31 .3 Z Owner• Map/P.arecl' 1\ - Projmt Address 3l 3 CorW RIVE Builder- ru-s c) CIT- The follow%ng items were noted.on reYie•Wing: yu t N i vLt U-M o f- • ( 1 ya' .G N 'Z'�ate. " Ys. • G • rip.<i•• • -� �/� NE-ccJ �ooi2 S ,R � � 'Z,H �•o F . �•���bc:�� • . .. l Reviewed by: . Date: 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): . tv., oM 1 �,'. C2Q2 ` Address: City/State/Zip:' NW-Y, P-A- Phone.#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction . 2.❑ I am a sole proprietor or partner- listed on the-attached sheet: 7. ❑Remodeling ship and have no employees These sub-contractors have '8. ❑Demolition working for me in any capacity: employees and have workers' [No workers' comp.insurance co insurance. $ 9. ❑Building addition required.] 5. e are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.El am a homeowner doing all work 11.El Plumbing repairs or additions . . myself. [No workers'comp. right of exemption per MGL . 12.❑Roof repairs insurance required.)t c. 152,§1(4),and we have no employees. [No workers' 13.Rther (De(! 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 certi under the pains•and penalties of perjury that the information provided above is true and correct Si afore: c* ti/O,G �� Date: Phone#: ^ 3 ,00 - F� !uu, ial use only. Do not write in this area, to be completed.by city or town official- or Town: Permit/License# ng Authority(circle one): ard of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Oher Contact,Per-son• Phone#• . Information and Instructions ' Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment.be-deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C( )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 comp�h.ance 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-conti-actor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department-at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line.. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the'Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A co_py 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 io any business or commercial venture (i.e. a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,- please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Intve stiptimis 600 Washington Street B.ostQn, MA 02111 Tel.#617-727-4400 ext 406 or 1-877-MASSAFB Revised 11-22-06 Fax#61 7-727-7749 www.mas&gav/din t .. ✓1 Consumer rcurea`l/ °sines Regulation License or registration valid for individul use only i.. Office of Cousumer Affairs&B s�uess Regulahon f _ — HOME IMPROVEMENT CONTRACTOR i before the expiration date. If found return to: i Office of Consumer Affairs and Business Regulation Registration: 168610 Type: 10 Park Plaza-Suite 5170 Expiration: 3/.8/2013 Corporation !. Boston,MA 021.16 - -_ IM ESSIONS BU.I.LDING CO.RPQRATION EDWARD WILLIAfVISON� 4 GARFIELD STREET; ,.;., FRANKLIN,MA 02038 :' „' Undersecretary Not valid without signature Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor I & 2 Family License: CSFA-057445 EDWARD A V .LIAMSON 4 GARFIELMST FRANKLIN jVIA 02038•_ y .11 `It\n Expiration •' Commissioner 01/17/2014 �TME' Town of Barnstable • Regulatory Services 1 96 Thomas F.Geiler,Director 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, as Owner of the subject property hereby:authorize to act on my behalf in all matters relative to work authorized by this building permit. (Address�ofob) Pool fences and alarms are the responsibilityof the e 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 ignature of Applicant Print Narne Print Name Date Q:FORM&OWNERPER OSIONPOOLS c THE . Town of Barnstable j Regulatory Services Thomas F.Geiler,Director NABS. �A16.19. s9•�.�� 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: 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. 7 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 Constriction 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/ber responsibilities,many communities require,as part of the permit application, that the homeowner certify that helshe 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:forms:homeexempt l � III Il l i 1� / r' i i` i • i i I , f s -- ------ - -— ---- - .. _.... mil• 4�5:t ��� Z .i.}1'o ._ G 6�Z T t F�( T N A T T N ou j J n I^-T"! r: 5�30���1 t�L_l�.►J R:�F c�Z c�.1 G ' $Eon-1 GoN�PI �S WITN- 15 s A:ua SET$AcK QE4U�c�eVF-WTS of T► e ti „ ati W V Op:, V4T.E `�! -)t' �� ILLti r r ^ el '�'� r � ;?Ia� ti ti� Bl�.XTE�Z `. W`(F IWC-- REGtSCC-�ZcD 1.ALlp' 5Uw�Yo2S T'N I'S �R L A�--I I S t.l oT BAS.E� v�.► j°N os-Tezv%L-Lal o' MaSS. i'�JSTQuEtJT 5vczveYTi4F o�G'S�TS yy�wsn APP�-�GA.f�lT. .. "i _ , q--M '....�...+n_.v�.c.ro- m+�._�1•.__ • �T AYr � .�"'�'�..er,r9�v.a,e..as�+��.. ' M� e�+LI i N f ® tA JAL t..-�•�,....T.. ...:4..a.w..-.6.x...:..�rr. � ��...�t....._� � i�..��-..n+y.-.w.,..� C.�.. ..sra.� ,...��y..»:i,+�+•...-1.�a...-._�>..a_tat-+-...��. y..��...,.-. 1 r T7I 7tt­f-t I _ N v F-4" IL -� O r h L z C N i � ^ � _ An T—Q { sv =� s _ � J s s V -6 ID 1 S ' c4 LA 00 � i I LLJ co C3 L x �= n! < cx: co e r� t F _ `pF,ME Tp� Town of Barnstable BARNSTABLE. Regulatory Services 9 MASS. 0 i639 a.�0 Building Division prED MP' � . 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location�l� e0 7` iT Permit Number Owner Builder ` One notice to remain on job site, one notice on file in Building Department. 4 The following items need correcting: /% L Sc R erlu S IN 4(us Please call: 508-862-41B-3?8 for re-inspection. Inspected by v Date 7 2- �_r w1+'•- -D''3�--w•wl,i,,,4a-r„Itij..,7t,�J•'%"`.ia-.-...4/.I^1'ti-"�2 • ..�.� � ...,�s^..fw•w.'''2Y�'ti`f .re•'r �..�'.�i�Ynr.f7r._.�..•-«...•..r-...-.` i Town of Barnstable ,y q�pF THE y7 �p BARNSTABLE. Regulatory Services 9 MASS. 0 039. e, Building Division pfFD MAC 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location 3 13 C� f /�� G?, Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: i 10—N 1 �19At:�-Wb ALG O7.1/ c/ Dr /tom ��s / /7/2rIZay'2 C. 4-1 P 4 7- • Please call: 508-862-41@-M for re-inspection. } Inspected by ✓� /� G , .: Date w 112, � y i TOXIN O,c BARNSTABLE 10i3 R I. S E Division of Thielsch Engineering,Inc. P'A Y 10 AM 11: 19 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island 02910 DIV TS p� May 1, 2013 Thomas Perry, CBO Town of Barnstable , ^' Building Division 6 200 Main Street lJ Hyannis, MA 02601 Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 313 Cotuit Bay Drive has been inspected by a Building Performance Institute (BPI) certified Professional. All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 401-784-3700 •800-422-5365 •Fax 401-784-3710 111257. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map y✓ Parcel- 00O ) Application # Z.�S CD1 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee �J Date Definitive Plan Approved by Planning Board Historic ,- OKH Preservation/ Hyannis Project Street Address 313 Cotuit Bay Road Village Cotuit Owner David B Kelley Address 65 Cochrane 4t;PMe1 9,se, MA��02176 Telephone 617-686-2533 Permit Request air sealing, insulate attic, weatherstrip attic door BY- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3340 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: 0 Yes 0 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 ❑ 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 0 No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 Address 1341 Elmwood Avenue, Cranston, RI License# 100459 Home Improvement Contractor# 120979 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE J , 4 FOR OFFICIAL USE ONLY f l APPLICATION# DATE ISSUED MAP•%PARCEL N0: ADDRESS VILLAGE OWNER DATE OF INSPECTION: a- F f 7•: 'f.OUNDATIONA:- .; l ..;•r � FRAME INSULATION.:. -: FIREPLACE ELECTRICAL: ROUGH FINAL ; y PLUMBING: ROUGH FINAL rA GAS: � , ROUGH FINAL .z DATE CLOSED OUT } ASSOCIATION PLAN NO.. f i RISE ENGINEERING Federal ID#05-WS629 RI Contractor Registration No 8186 A division of Thielsch Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 (401)784,3700 FAX(401)784-3710 CONTRACT RISE Page ' THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE Client B David B Kelley (617)686-2533 07/08/2010 111257 SERVICE STREET BILLING STREET 313 Cottut-bay Road 65 Cochrane St SERVICE CITY,STATE,21P BILLING CTry,STATE,ZIP Cotait,MA 02635 Melrose,MA 02176 I* JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakag . This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be....with exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 20 man hours. $1,320.00 RISE Engineering will provide labor and materials to install a I V layer of R-38 Class I Cellulose added to 1600 square feet of open attic space. $1,920.00 RISE Engineering will provide labor and materials to insulate the back of the attic door with I"rigid foam board and seal the door edge with weatherstripping to restrict air leakage. $100.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year.includes all of the air sealing costs -$2,835.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Five Hundred Five&001100 Dollars $505.00 UPON FINAL INSPECTION APPROV R18E ENGINEERING.CUSTOMER AOREES.TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER YB.8 FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES A TORE•RISE ENGINEERING ER ACCEPTANCE IS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE ` ( / ACCEPTANCE OF CONTRACT•THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE r , _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street U. Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RISE Engineering a division of Thiel ch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-800-422-5365 Are you an employer? Check the appropriate box: Type of project(required): 1. (@ I am an employer with 4. 0 I am a general contractor and I 6. O New construction employees(full and/or part time).* have hired the sub-contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7• D Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance. $ 9. 0 Building addition required] 5.0 We are a corporation and its 10. D Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their myself [No workers' comp. right of exemption perm MGL 11. ❑Plumbing repairs or additions insurance required] t c. 152,§ 1(4),and we have no 12. 0 Roof repairs employees. [no workers' 13. N Other Insulate comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contactors that check this box must attach sin 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 isproviding workers'compensation insurance for my employees.Below is thepolicy and job site information. Insurance Company Name: The_Preston Agency Policy#or Self-ins.Lic.#: 3730961-00 Expiration Date: 1/1/11 Job Site Address: ✓ City/State/Zip:_ 0 ,L L Attach a copy of the workers' compensation polic declaration page(showing the policy number and expiration (date). Failure to secure coverage as required under Section 25a of MGL 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 $250.00 a.day against violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the 151A for coverage verification. I do herby certi and the ins enalties ofperjury that the information provided above is true and.correct. Si nature: � Date: Print Name: Erik Nerstheimer Phone#:(401)784-3700 or 1 800 422 5365 x t '3 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 Heath 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: i ACORD, CERTIFICATE OF LIABILITY- INSURANCE OPID 47 DATE(MMIDONYYY) THIEL-1 09/13/10 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency InC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-88571700 INSURERS AFFORDING COVERAGE NAIC INSURED INSURERA: Zurich-American Ins Co. Thielsch Engineering, InC INSURER 8, cVa Ar.r.lc.n rant.• i L1.b11Y ty Thielsch Group Inc.Hi Tech Realty Inc. INSURERC: North American Capacity __ 19S Frances Avenue INSURER 0: Hartford Insurance Company -Cranston RI 02910 INSURER E' COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSLRED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUMEPrT WITH.RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT•TOALL THE TERMS.EXCLUSI.ONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I LTR I,NSDR TIPE OF INSURANCE POLICY NUMBER DATE(MWODlYY) DATE( IIYYY) LIMITS TX GENERAL LIABILITY EACH OCCURRENCE s 1,000,000 COMMERCIAL GENERAL LIABILITY 3730962-00 04/01/10 01/01/11 PREMI�3EsU(EaRoccurence) s300,000 CLAIMS MODE- �OCCUR. MED EXP(Any.one person) s 10,000 PERSONAL 3 ADV INJURY Y 1,000,000 GENERAL AGGREGATE a 2,000,000 GEML AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG 8 2,0 0 0,0 0 0 POLICY X JEGT LOC ETnp Ben. 1,000,000 AUTOMOBILE LIABILITY , COMBINED'SINGLELIMIT = 2,000,000it X ANY AUTO 37309'63-00 04/01/10 01/0l/11 (Ea accident) ALL OWNED AUTOS BODILY INJURY SC}-DIAED AUTOS (Per person) s HIRED AUTOS NCRr•OVAJEDAUT'OS BODILY INJURY $ - (Per ecc,daril) PROPERTY DAMAGE ; (Per accibenl) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC 5 ' AUTO.CNiLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE S 10,000,000 B X OCCUR CLAIMS MADE UMB 9 2 6 3 6 3 7—0 0 0 4/01/10 O T/O 1/11 AGGREGATE i 10,000,000 4 DEDUCTIBLE X RETENTION $10,0 0 0 y WORKERS COMPENSATION AND X I TORY LWITS P. EMPLOYERS•'LIABIL ITY A AN)'PROPRIETOPJPARTNEPJEXECUTIVE 3'730961-00 04/01/10 01./01/11. E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? E.L.DISEASE•EAEMPLOYEE 5 1,000,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-PC+LICY LIMIT s 1,000,000 OTHER C Professional Liab DVL0000-26.800 04/01/10 -04/01/11 Prof Liab 2,000,000 DlLeased/Rented Eqp 02ULTNTD5678 04/01/10 04/01/11 Equipment 100,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 O:.YS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY HINO UPON THE INSURER.ITS AGENTS OR REPRESENTATIVES. AUTHO IAD REPRESE V ACORD 25(2001/08) @ACORD CORPORATION 1988 r r . .,4��y� ei"ir-.... ..� 1.�� �•S'1,a .i�,(F!.c-�--y�;:tv:y°:nf{f t ):`.�`.J..yI i :^h'7ri:;t(`! !F. � lit;'rt a .i,%.�tk t1;1'ai�t �.' a�.-i G -1i>, :!ctii„ca„�°:l.,r..;#� I,>,°�':=�r bci�;, .•-'LYSF'.Jw•L •JitJ4'�'.n .., ?,:�•, �f,l� :� ••��<�W1�pl�,,g�tbit..,e.l �:'.1'HIlr'I.1-`1, t"'r 'fit. ;PAGE..'2�"-. of ..�PJ4p •;:Jx°- it��r•: ai..�-'?, �wi. �Y�i � ��,:i.,I'lY F t �+ �u� fir<.(i�..7 r.. •.r. �.: r^}w��i ' � 'f� tN� i"�t^.�I•�i;�>'�!`1f.•�•.. 1}!� .�.-!I iV�•�# �:��� r� ., :..,F�_,i'-h�`.� � i '`ID `2; `� ;DA- � 04� 1•r2 �0�, ,."tea� W ��.d'qI�1;,.,a=A. �• tata. �, n i�w�, J`Szl rt�,f�, :e9 . .:�,�L�StIirL:.>.. ..,aa�� .._yr�.M`�..,la�.,V'>fr'a��S'.�,... ..,.......... ..'�i�:�;.�,t�e:'�.... ....... Also for RISE Engineering, a division .of Th"ielBch Engineering, Inc. Gaskell Associates.; a division of Thielsch Engineering, Inc. BAL Labo.ra.tory; .a division of Thielsch Engineering, Inc. ESS Laboratory, a division of Thielsch Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering; Inc. Water Management' Services, a division of Thielsch Engineering, Inc. 9/t e Oi messceo onsumer y a nus e on 10 Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improve ontractor Registration Registration: 120979 Type: Supplement Card Expiration: 3/25/2012 THIELSCH ENGINEERING M ERIK NERSTHEIMER 1341 ELMWOOD AVE. CRANSTON, RI 02910 A �Q � w mac. `0 Update Address and return card.Mark reason for change. Address Renewal ❑ Employment ❑ Lost Card DPS-CA1 Co 50M-04/04-G101216 �!e -�onr��cor;cve lv a/.� a�..�2ax /emu/acue�sQ' . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation Registration79 Type: 10 Park Plaza-Suite 5170 Expira 12 Supplement Card Boston,MA 02116 THIELSCH ENG10 10000, ERIK NERSTH 1341 ELMWOOD CRANSTON; RI 029 �- Undersecretary Not valid without signature f r dge 1 oI 1 ;i The Official VVebsite of the Executive Office of Public Safety and Security (EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License tf 100459 Restrictibn WS,IC Name Erik Nerstheimer City, State, Zip North Scituate, RI, 02857 Expiration Date 3/28/2012 Status Current No complaints found for this Licensee. Back To Search fie. .. .,_ ✓17�. VLL,�YL97LCyflL�P�ch 6�✓vGQ'Q :i _ _ _. Board of 73iiildino Regulations and Sta� ! �f:�-�:..:."'„"'• �...._.._..;.._. . L''i.eense or registration valid for individiil use only •i HOME IMP R VEMENT COfVT CTOR I, j „1 before the expiration date. If found return to: Registratipii:: 0979 Board of Building Regulations and Standards Ezpratii:o:n=3j 5/20 I One Ashburton Place Rm ]301 =- r. meet Card _ P^{'sten,Ala. 021 08 ELSCH ENGINEEK.KNI K NERSTHEIfv1ER= 1 ELMWOOD.AV,E =3 aNSTON, RI 02910� Adm isti: r Not valid without signztyre hrtp://db.state.ma.us/dps/llcdetalls-asp?tXtSearchLN=CRT.i nna.So y � r -a, z 4Y NAT-24531 - 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map" Q_�S Parcel { [�� SC _ Permit# �^� � i %lam L,r�C�.,1J I�Wi�� Health Division I ( ° 7,7—1 i6 Date Issued S �z 6V ' Conservation Division V lam. Avy 1,10 V 16 } 11' 33 Application Fee Tax Collector Permit Fee (,go Treasurer / Planning Dept. EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO lt,_#OF BEDROOMS I Historic-OKH Preservation/Hyannis Project Street Address _ 313 Ca7-0/T &?-y 11goW 'Df.1 q Village Ca ilk Owner 1��91�i1� ke,LLey Address CC�Amoe- Telephone 53-3 Permit Request �Li Id / Z X ,S'G�e�.�/c?� %�v✓r-4 can lie late 8 �� aws �� ►�,-�, U�' �a vs� . G �o / >,, Square feet: 1 st floor: existing I`i aC) proposed I H OO 2nd floor: existing NO proposed Total new _ Zoning District Flood Plain Groundwater Overlay Project Valuation 3CQ, 67)D Construction Type 'Nw7 Pic 4v✓tC Lot Size Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family JV Two Family Cl Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes k No On Old King's Highway: ❑Yes Flo Basement Type: gFull ❑Crawl Walkout ❑Other Basement Finished Area(sq.ft.) 1,2- c7 a Basement Unfinished Area(sq.ft) ZOa Number of Baths: Full: existing new Half:existing new / Number of Bedrooms: existing / new Total Room Count(not including baths): existing new 0 First Floor Room Count «!o Heat Type and Fuel: ❑Gas 9I Oil ❑ Electric ❑Other Central Air: $Yes ❑No Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes 4 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 BUILDER INFORMATION -y� Name Telephone Number �� Address P6 3K License# l� yzwmt A- Home Improvement Contractor# Worker's Compensation# ?M:t/R 2M)�tTg ALL CONSTRUCTION DEBRIS R LTING F ' M THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. ; DATE ISSUED - MAP/PARCEL NO. ADDRESS • , . ; VILLAGE. OWNER DATE OF INSPECTION: FOUNDATION FRAME 06610r O Qd �S INSULATIONG�iy�oS ( FIREPLACE ELECTRICAL: ROUGH n —FINAL ' PLUMBING: ROUGH FINAL, GAS: ROUGH FINAL Er FINAL BUILDING t,j 0 A o d , DATE CLOSED OUT O ASSOCIATION PLAN NO. �' ;: The Commonwealth of Massachusetts ::-- Department of Industrial Accidents _ Its B1/mssd®sv�s 600 JYashin;ton Street V�7 Boston,Mass. 02111 workers, Com ensatio a Insurance Affidavit-General Businesses acne, ' address: �� P� 117, state: Zi : hone# ci work site location full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) I ea to er with Q ] ees(full& art time). ❑Other //./'///j/�/%/////%/// //y/%//// %/ VD2%%%// I am an employer pro ' '_g-workers' compensation for my.employees working on this job. coati any name: :, address: :'�i''... '•• + .>.r '� • .•:,.• .':, •• hone#•:. '. cityc oiiey.WIN, #-.. :/ c. ie•1•... I;i. rinstirance.cb:r:'.:' / / '.. /// •• // ///// /// //// % / . / •••: /,,• ///% �] I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: com en name. dddress: ; hone .7777777777 insurance co. ev - WIN / /// / / ///// // %7RIP///7/%///////,/.- •t• .:a a•..: :?I.y •. com aria Deriie •a: r; hone#d insurance:eo.:+: ./.�/ / //%%% y/d%///%�` // / 1' .., ••• �' / i Failure to secure coverage s9 required under section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or: one years'imprisonment as well as civil penalties is the f o a STO 'R'ORK ORDER and a fine of 5100.00 a day against me. I understand that copy of this statement maybe forwarded to the Off of Investigatio of the DIAfor coverage verification. I do hereby certify ursder th pains and enalties o0 ry th a Inform ation provided above is true and correct � Date 1` Signature Phone# Print name � r official use only do not write in this area to be completed by city or town official permittlicense# ❑Building Department city or town. ❑Licensing Board .. ❑selectmen's Office ❑check if immediate response is required ❑Health Department , contact person: phone#; ❑Other (Tevaed Sept 2003) J t _ 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 contract I lied, ora or written. of hire, express or� l ►• � � - 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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. • �/�//jai/�/iai/�/����������/�/��a�a�i��//�yi//�/�a��/i���/.��a����������/����i��i��/�ia��� .. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Deparment 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 Deparment at the number listedbelow. /lmo%�////�///��%%%///%������///%%�l///%/�/�%%%��%///////��%//%%%���%����%%%///iii 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 permrrit/license number which will be used as a reference number: The affidavits.maybe returned to the Department by nail or FAX unless other arrangements have been made. The Office of Investigations would.hlce to thank ybu in.advance for you 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 WIN of lmstigatlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 oF�HE►a,, Town of Barnstable Regulatory Services ' BARNSM LE, " Thomas F.Geiler,Director MAn 039..E p Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW ! SUPPLEMENT TO PERMIT APPLICATION I ' 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: J�� Estimated Cost 0zV Address of Work: 6 !T Owner's Name: Date of Application:T I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building 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 PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIE PE Y I hereby apply for a permit as the agent of the owner: at ontractor ame Registration No. OR Date Owner's Name Q:focros:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 :�O _ Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) ©no GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) O Permit Fee r) c Projcost Rev:063004 op THErp� Town of Barnstable tips ' Regulatory Services . �►ssMASS _ Thomas F.Geller,Director f16 p`0� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign TWs Section If Using A Builder as Owner of the subject property hereby authorize. !�`�� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) ignature o Owner ate Print Name n•rn-0MQ•nW1JRRPF.R W-,gT0N r t A -A .� W t'Tz1 f�Ae�LJE �t t.1�tt - �{ys L'7J►li-%( trLA^A/ c I lb SST t G T Au4w. - 4ct S c tcX> -74 Z 6,41- U;1� 11500 Gay T;N UY-- �8 , v%sPCYSAL. P"VT v;E 4.4 1 Z F X Z.S �' 4-1 V G 'P' GAQ SoTToAA AREA- la S F 00 'mod` TOTA t_ U1rSSt 6t�1 5 Q f y ISQ'� �LLSv 41 PpQCiOL4 tc>w 12ATc t� i w 2 Auu oe Lr*S. ��x too°kGxw r u � /- Z S"-78 •TIST Tor Fop = too' �t'tR'C� M ��PG• 'I, ZZ,#) 4 wv :a wu = g1 U s:.E Sub //P4 Dt�jT lH1/ L*A.L.so-A Goo tNv `I(,•a tug. �,�,,� ,.• GAL. �L,� •.' MELk� t.EAGt•a '.V. Pi T ti WtTLl �;. S O.N p WASM9D 6tU 416 cj� Q C VRX T I F t Qa pt.-O-r PL-AA-4 Lot-a7,C) .l /Z Llo Sce��rs SGL�Lt= LI uoTe-D t CrMi i F-r T4.4AT -r"v 1'`CC it`. ;7V.1 l u U� Shown PL.A.1-1 t-1ts2E.o!J GOMP�-Y S W t TH T4��. �l�EL1 1.1� �G—t-• AwD SETBACK V_MQt>jZr-_ME"-rJ5 OF TWF-- Tbvat..l OF T?.p,�%_�.. l �v!!L _ (�� L:..1.1 �u.x'.�1� 7r1z DATE14.20 jj 1 SZ6�tSTQ TZEl> L&A in �ZV&WV_r, T4NS PLAW IS UOT BASED OU M AU lQ4TQoEUT OSTEQ�/tLL�• AAJLCoS• 5ue%/Mf 4 TNG R orSt� D T; e,"00L' LAOT ISE. USEI> To �ETElemi"6. \.oT Ltl.(I,i. gppLtGAuT..' � £ T �'.� ILf-f=7�.1 - I o :h_ -- ... , -- I 7/. 1� I NSTR UGTION�S UPERVtSOk N;umbeI'C^ 009013 I 6 Tr.no: 25776 j GREGORaY3(yI :CA r UV YA'RMO;UTH, MA'- ;,- �,`'•°� G'� �, Commissioner 67' - ✓/ee�omma�uvea�/� ���r��oeQ2 Board of'Building.Regulati ns and Standards s HOME IMPROVEMENT CONTRACTOR Regist tidq` 106395 Ex ai1 23/2006 idual GREGORY M.dA Gregory Cauley LL I 33 A Baxter Avenu`c` � III W.Yarmouth,MA 026' 'y0 Administrator. c = - i o y i � r •• o F Y a 9 L 1 I m N ncl a o � W i S 3 1 i I� 0 II 1� N 1 N v CD r 1 M t k g s n` rt o � S x Y �co S r lC a m g -0� n n v f I =z NA' ' 1 N Q � � S � m1 C ` r � z i � F s r - Y N Y G = QO 4 W5 y �� g= pt �� R 3r 'I r p � ♦ s ��f sae II 3 3 0 v Ij s 5g F m E w= 6 s C� �t o u5 BUILDER INFORMATION p, ' Name ` � C Telephone Number �3 r Address License# b C� �S Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `� E TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION +� O O 'Maps Parcel Lc�� � 7G � -� D ss�' Permit# 1 //0 46 g `7 Health Division 5 �' �D 2- 1?- 126 Date Issued Conservation Division l� Application Fee mod. dG Tax Collector - �� Permit Fee Treasurer C/- / - p SEPTIC SYSTEM MUST BE INRALLED W COMPLIANCE Planning Dept. Y=T=a Date Definitive Plan Approved by Planning Board MMO AL CODE ANL T©VVN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address 3C�9 Village C C9 uz.t Owner � L c= n Address 1- D 13 n, 2—G 4f Telephone +� ,e oq.- K G a zJ cf 2 l 4 Permit Request . r ;:4� = Square feet: 1 st floor: existing I y 3 o proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ject Valuation Construction Type Lot Size �� L Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Y Two Family ❑ Multi-Family(#units)) // r Age of Existing Structure .2 Historic House: ❑Yes �"No On Old King's Highway: ❑Yes 166o Basement Type: ❑Full ❑Crawl UlWalkout ❑Other Basement Finished Area(sq.ft.) �� Basement Unfinished Area(sq.ft) Number of Baths: Full: existing -3 new Half: existing new Number of Bedrooms: existing_ new Total Room Count(not including baths): existing /O new First Floor Room Count "St CX) Heat Type and Fuel: ❑Gas vralil ❑ Electric ❑Other # cr Central Air: rQ YeS ❑ No Fireplaces: Existing New Existing wood/coaLsto ❑Yes [@1qo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing Tae_ sizal CrY Attached garage:g(existing ❑new size Shed:❑existing ❑new size Other: rn Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial" ❑-Yes—O-No- If yes,site plan review# Current Use Proposed Use s BUILDER INFORMATION Name Telephone Number C)_ 1 �� Address d v A ( License# ___C O 4 y Home Improvement Contractor# Wor ' om # ALL CONSTRUCTION DEBRIS RESULTIN�M T-f•S-PR-JECT E TAKEN JSIGNATURE DATE 9 FOR OFFICIAL USE ONLY P%RMIT NO. f DATE ISSUED s C MAP/PARCEL NO. 4 e ADDRESS VILLAGE ' OWNER DATE,OF INSPECTION:.' ` FOUNDATION Y; r FRAME INSULATION FIREPLACE r ELECTRICAL: ROUGH FINAL !9 PLUMBING: ROUGH FINAL GAS: ROUGHS A a FINAL FINAL—BUILDING zz D DATE-CLOSED OUT ASSOCIATION PLAN NO. + , The Commonwealth of Massachusetts , _ = Department of Industrial•Accidents Olfee of/nvest 92ff9ns r =600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit ---- name: 1 � ocahon ` `, DR � � ��.,. � .. -' -- hone#:--- -- ---- -- -- ❑ I am a homeowner perfo g all work myself. ®'I am a sole rc or and have no one workin in ca acity din workers' co ensation for my employees working on this job.:::::?}::::?:Y}:i}:•}ti.<._:::.;?:?:<;.>„ti,,.,:,,.;,.:: : :a:: :::, an e l r :::: :::::::::?::::::;:::;::;;:;;::tt:::::<:;::::;:;:fi2::::::;::;;::.':Si::}}:.:;;{{.::.YY:•}}:.Y;;.:•:•::.::.�:::.:..�:::.:................... }}ti`:::;: ::;.ry:!ii::i'}::i::i:::.....:ri.....::'?:; ::j}iiiyi:`vji?'�i:::?"t i sii:}�:;+:•ii:i`:ii'r: f':i::`:::::uv::vi:::::i:i;;::::Ci;i}i?):J:i ii:4i i<:iiiiiii:v{iii:i:`v}:?.S}::•}::J.:}i:^S:vS:•Ys:?.:}Y{.5....,.:;•}is4}}:•i}5................::.....::.v::::•.v:... .............. ion v� gig ,;v::..::.{:.::NY..:::.:y.}SN::':.'.�::.'::::::::::.F::::nv...::.:vv:n::.i:•i}}}S}Y:v::�.....•....:..�:..•...:.v.v......:..:::.�:::n•..v.�..:,.•.:v:.•::•,.;,:.�:.•.�:.vv.•..v::.•5��:•S}:{y:;:�}Y:?^:C:!�};�S};::{::�Si�i:'tiJ;SSS}:;':j:S:Cj.S:Yi}..y:.vv::•:.};:.;. 1}$:�}isYri:'•':<+:i'ii:';?ii�:Y'}L�{'�ii::>:ii:;�;:''':� '?'?:,yiii}�:;{:�:v:i:.?::rf:y:.'>ti! .iii ..... ... ..:: ........ --------------------------- ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' .e..n...s..a..t.i..on o...h...c..e..s..:....::::::::::::.:.................:.... :. ............ ........................... ...........XX co - :.: ..:.......:....n... r i{O •S:•i^:•^S}:^Y:ti^:?•i}.:::. •:w:::n}.;i......'i S::::4i:•i:•Si:; r:::v:{;v:.{:y4i:::::.; ::::::::.i:w::::.5'::::{{{:i::{?tti•S:tL:'•.::j;Si:ti:v:iii�nw:n•:i:i::i::::::.:�:;:::J%2:J.•.v:::............::n::;::;:;S:;S:; ................................::::::::::::::::::.::.}ii}:•SSS}i}:4i:tv:•i}}:::ry}}S;Li}i}}}}:•}}:•}}S:?.}:{•} ......................::::::.::.:.::::::.v::::vii:?4YYiY}::YY;}:,;..v:.v:•:::;::::.::::r::?;i�vYY^';:iYSY}:'•i:•>}'ii:::Y.:�Li}}:::nv::.,:iYS::Sv-:•i:.;:4i:;::.^:?ii::;::{jj?j} ...................:...................:::.....................::::...................:::::::w::•:::•:::{•:is,.:w::}n......Y.:•.vF:n....v... -�r.v:::»v.v.:,....,• .. <r}nvn+•:. ..... .n. .... .............:::::::::::.....v.....v.l.:•:::- .:::{•ii:w;,..........t:•::::::::::::i::::.v:{•i}::;::}.n........v:::.v.y,•}}::•i::•ii t••i:�::y.p:•;.. ...v....,. .v.,........ v.,.r{5....{.....r.............. .::.,..vr:. .. ,,.. .,...r.::.,,..... ................ ...:Oi}}:'r.:»:.:::•:::•sn.n:.u.x," ,.v..nS'?!{?4:.1'n}:^"{L•:wi:j.4Y}Ci{:l k:tiv:�:::':C :4.:W.........nY.t•i....:........re,{:.....,.. ...n+:::.............n..n...•...........v...W.r...}•:r v.......... ,.q`S}:•S}:N�.. .... •.r:. .r.......... .......4..... .....r...... .................... ............... ..v::::::::::::::::::• ........:::v.v:::i:i4:{•}; ...n., ,............. ,:?;�::n':•Y...v...t.......r.:::C....n..v, {»,} ........ .n..r.. ......... ..r........ ...........: :.............. w.y:::::w.v:::.vnx::..:•:n•:.vv'??v::}i:;•S:vv::::.•:•v;:y•:n};n:::.,t. ..vt........ .......nr... r..•r..r......... ,:, ....... May Y.....,::ry;::n:{{v;....... .n ../..»r.. ...:.... ........« ..n..,w:::.:•...n:.r...... .:......:... ...:::i::t•SSS::::.,�::. On�. .'i::.:::.:...::::..... ..a.n .............. .................... .. :......:5}iSi: �}}:}:?J;{4i:{•}:•}}i:�i}ii)i:::'r'4i`;:i}i:iiY.:•::•:•5::...........•v::•:.v:•:...;.....:...:}:v..... :.nw::::.'• :.. .............::::.}}:'v:,:::•:x:v.v.Y:{•}::isiS:}:}jiii>+::::::.'...............:....................n:.............. n•................is i'r?ilv +;.:. .... .... .... .......................::::::n:v.v:::-.v:::r?•ii:v:;{4i}}:t•}t::4:v4}Y}Yii}i:.•iii:w.i v;;:::::.::: /!ii:::::{:n�i. a•r. sS.a.•<< ao.. .................::::::::}}}'• }.....::nv:::}...:::?•:'i::J:•i?}::rS:::::::{•i}::::::::::::::}:^!,^.;\??:':}:i::::$i:?;'.:j:;S:,v,.riU:SS:::L:Sii:.. v::::.:::::•::;::::.. :is:k:�:::::�:•::.:.}:•:::..}:::: }: {{c}N .....................................................................................................................:...................:::v.:w::::::x'}tiiii:L:ij:::;:i>riii{iiir•`;'��:i::?4}}:Y:::�:•ii :tK{•ii}i:..:...;•}S};:.}:::•:::..:..{{v...............s v:n:.�:.:::..........r:::::..nv,vv.:v:v:.,..:.:v.v.'.y}:::•n:;............................... .............. ........:...w::::::::::��•. v}:triS}v:•:::: ...r. {r... ...:,,:.: ....::::.,�:::: .......,.,n.::.... .... ..... :.r:•...r•::......::::.}:.YscL}}:.}:.:;:?:ist•}Y;:.:;}:�}}�.::�:;:}:{:}•.}}:.:.,............ .,•}?{•Y}:•YYY:.?:..,m..�•...,.;.}••.. r ti is iYfi........ ....::: ::i>i+ ::ii:,vivf<v.Ji>4iiiiiiiiiiiii::?i}iiii:?iiiii:<ti ii?:vi:i^�}Y:j4:•S:{{r:. .yi::�v::......:::}::?n:.}}}:?^:YiS:•S}:?v:mow:^.::v::::n.....,........ .name..... .....:•r.::.,..r::.,..w.,.n...:,..:::::•:�{',».:r.:.,•::i..':.;• ;..t an . :.... .... ........ ........................................ ..........................................,5:?t^:v::::::::::::�w:x'::}......H'r}v:<i;O.;F,.wnJ.,t.}:.t.?ii:::•: :der?'eX. .......:...... �f .....................::::::nv:::::::n...•:::::::::i:.w:.v::::nv::•i?is{•iiij;:}'ri<i:�ii$:{.: 'ii`iti�:�r•:}:i:;:iii�'�iS:•Y.v:::....•}:�N:::::x:?:v. .................:.,..w:w::w:::.:::::::.5}}}:•}':{:r:.}v:^S:4}}::•}:i<�j:•Sii:i:•}:;}:v::�ti.L:ii::'i{}iw{:is nv v... .:};.::;C ii:;?:i::S:;•.;vn ....... ...r 7� y....::::. �:::.}..........' .,.,r., ... ,v.Y.::S';•YSS}:{{viii.'?�iii::::}:•ii:i{•S:bin•;:::{.S'.:.::YS.:•.:::::•:•{.:::::::::............... X. .. .. FaSm a to secure coverage a,required under Section 25A of MGL 152 can lead to the imposition of criminal penaltin of a Sue -to s1,500 00 and/or one year,+imprisonment a+weII a,dvfi penalties in the form of a STOP WORK ORDER and a Sne of$100.00 a day against me. I understand that e copy of thb statement any be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby c ifpains and penalties of perjury that the information provided above is truo and correct Date q I IG signature Print name Phone# official use only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: ❑Licensing Board i're Aired ❑Selectmen's Office ❑checkif immediate responseq ❑H.ealth Department phone#; - ❑Other contact person: ' (rAW 9/95 PIA) _ Information and Instructions section 25 requires all employers to provide workers' compensation for their Massachusetts General Laws chapter 152 s quu employees. As quoted from the"law", 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 section 25 also states that every state or local licensing agency shall withhold the issuance or*renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 incmance as all affidavits 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. 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 pe��rmif/license number which will be used as a reference number. The affidavits may be rehimed in- the Department by or FAX unless other arrangements have been made. 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. i The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lovestigailons + 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 P�oFAHE,o Town of Barnstable Regulatory Services BaxxsrAB . ' Thomas F.Geiler,Director mass. 1 MP+a�O� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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,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:`'fie Cjtl A,n G r`�/' vy� l ��"` Estimated Cost OQ Address of Work: I '1�0 C, �v1 � ' /�• � 0( Owner's Name: 0 1 1 ,` r C Date of Application: G.I d 3 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law Job Under$1,000 Building 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 PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF P Y I hereby apply for a permit as the agent of the owner: (� o � i � � �� tg�o3 � L1 �. Date—� Contractor Name Registration No. OR /)� i v t Dati Owner's Name Q:forms:homeaffidav RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,eta) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS _�.x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ Q:fomis:dkcost ' eff:082301 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 31-3 Co luz:,tA 4 vb i number J sireet village "HOMEOWNER': C-n4 , 412+ name home phoned# wcfrk phone# CURRENT MAILING ADDRESS: Ikl�t 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 Barn table Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ature 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. O:FORMS:EXEMPTN i Z 3 0 o � It Aw M U mac,. v w � oc � � � w � � C GIN i i S R7 - FA)©0 r FIUDS Dt I)E L 1/V C &)/rrf. l ,,4C- SC�t�C CJS os i S (�1 x 7 ©;C, dac- 11; o - Q-u c v 4 x + s ►h u s-+--- U s-e 1000 psi L = 1.,300,UUU 1)si l yl�ic<.il values 1'01• SOLIOIe1,11 Yellow 1'ii�e #2 (I'resstirc; .'a'reatecl L•;xtel=ior use (e.�. decks) Joist Size is spac;iiit i 2x6 2A (ED 2x.1.2 1 -G I I :14-3 17-4 7-4 10-0 = 12- .15-0 20 6-7 8-Ti - 13_5 24 6_0 12-3 b)HEIV IST .r ,3c JpIST f�i4NGE2S �j-cC�UtI�CL`'� 4 yk i L0 TOWN OF BARNSTABLE Permit No. ------20404------------ 1 �,..n.u. : Building Inspector Cash $6Aq- } 8�78 .(1n----(hldr, OCCUPANCY PERMIT -Bond ----------P F.Q -fVP x i5d, No building nor structure shall be erected, and no land, building or structure shall be °,%q`j 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 Kathryn H. Kloss Address 70 Huntington Ave,,Scarsdale, N.` . lot #75 313 Cotuit Bay Drive, Cotuit Wiring Inspector Inspection date Plumbing Inspector 1171 ! Inspection date Gas Inspector Inspection date r Engineering Department �� �.�/ Inspection date 11_ 1 2 r 7 9 tom. 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. ),�-/5— 19?.h— (�). /,, • Building Inspector +s � 1 P�+If�'l d � �� S ►L�i4e�s�TEI�lP3f�f�T" ��'• INSTALLED IN COMPLIANCE %T RT IC„ AS TE Y TO Wdap 2 IRN I INI Er°�° TOWN OF BAR.NSTABLE BAHBSTADLS, i ° PASS 0�ON BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....construc. ... ... t a dw.ellin. . . g .... .. ..... .. . .. ........................................................................... TYPE OF CONSTRUCTION ...,single family frame dwelling for residence ............................................ ........................... ......... a.rch...?0..................19..7.8. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......Lot 75 Cotuit Bad Driver CotuitI Mass . Proposed Use .....singl. ... e fam. ily residence ... .. .. ................................................................................................................................................... Zoning District .......RF............................................................Fire District .....COtuit......................................................... Name of Owner ...Kathryn H. Kloss Address70 Huntington Ave. Scarsdale N.Y. ...................... ............................................ Name of BuilderA & THOMEBLDRS. INC. Address RFDBox....150...Mashpee� Ma 02649 ........ .. Name of Architect R.L......SEABERG ASSOC.INC. Address ., 341 Washington St.Norwell,Ma- 02061 ................................................................. Number of Rooms 8................................................Foundation poured concrete .................. ............. ....... Exterior ...Wood frame.:.cedar shingles ....Roofin asphalt shingles g .................................................................................... Floors carpet over plyscord drwall/skim coat plaster .....................:.............................................Interior .......y.................. ........................................................... Heating oil fired ho. ... t water. . .........................,.Plumbing ..,.per BarnstabtI6 code . ..... .. .. ....... .. Fireplace ........ ........................................................................Approximate Cost ...... $89 ,000 ..... ...................................................... Definitive Plan Approved by Planning Board __Jan. 6 _ 1975 . � 7& Diagram of Lot and Building with Dimensions — -- -- --- -.- -._ - - SUBJECT TO APPROVAL OF BOARD OF HEALTH (�4�� 4S�•�7 s. �IC6 ' , 5 n" i LOT AREA : 1.08 acres I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A & T HOME BLDRS , INC. Name ..... /.....' ............................... Alfred Tokar-z, Pres. i Kloss, Kathryn H. 20404 one story -*t4o,v................. Permit for .................................... single family dwelling ............ .................:....................................... 313 Cotuit Bay Drive Location .......................!........................................ Cotuit ................................................................................ Owner ..............Kath.r.ya..H.....M.s.s.................... ......... . .... .. . .... . . Type of Construction ..................frame........................ ................................................................................ Plot ............................ Lot ................................ July 20 78 Permit Granted ................................ 19 ...Date of Inspection .. . ........19 Date Completed ..... ...717: ...19 �7g PERMIT '.KEFUSED 19.... .. .......... ......................... /G/ ^'w .. ...... ........ ... ... ............................... .... ...... ......... ... ... .. ... ...... ............ ................... ............... .............. ............................................................................... Approved .................................................... 19 ............................................................................... ............................................................................... L IOL } r y. n �• t y r r J)I L-IT 14:11, TO M Lo -�S -4, • d�s.ov �0(0.Cj�j b►t�p 4A, f*CHARii' ;1`�► s CE2TtF1ED pLC>-r PL.h.V�l +cdep toGATIOV $UR''" �GAI�� rim bATEE �I23�j�d G6RTIFY T"AT THE r, ouNDpT-1VtJ St itt. t �-IEQEt��I GOW�PL�(S wtTN Tta1= 5tU'E.UWIF-- AW > SETP$AC-4 RC-QUi�E �►�TS OP TNT DATEz r X ti ' n.�_� B A.XTC j2 . 1J`(E 1 r.JG REG1S"rC-=LtD L WC> SU2Vc`fo'`S a 0�..1 AtiJ OSTEi�V�L� o MASS. tD L A►..1 I S LJ OT BAD,E 1WStQc1a►��►.iT '.AjZvrs--i' L oF�S�rS SNcww APPtr1GA," 2Mt To Dt=TG �C Scwa�e (e✓%ktIr IA0 r rA- �y, SEPI IC SYSTEM . 4 OF BA SAL 1ST1� e B SANITARY CODE AND TOWN MABEL AEG NOBUILDIN/G/ IBM' tr• APPLICATION FOR:PERMIT TO construct a dwelling ......................................................................................................................... TYPE OF CONSTRUCTION ._..single family frame dwelling for residence ...:................ ............................................................................................... ......... a.r ch...2 0..................19..�.8. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: .Location ......Lot 75 Cotuit BaV Drive Cotuit Mass . .............................................. ..................I....................i........................................................................................... Proposed Use .•. singl. ... e family residence .... .. ...................................................................................................................................................... w Zoning District .......RF...........................................................Fire District .....Cotuit......................................................... Name of Owner ...Kathryn H.- Kloss .,_•.........Address7.0 Huntington Ave. Scarsdale N.Y. . .................... . ......................................................... Name of BuilderA & T HOME BLDRS. INC. ••Address RFD Box 150 Mashpee� Ma 02649 Name of Architect R•L• SEABERG ASS0.0 INC. 341 Washington St.Norwe11 Ma 02061 ................................Address .................................................................................... Number of Rooms 8................................................Foundation poured concrete Exterior :..Wood frame :cedar s hingles Roofing .,•asphalt shingles Floors carpet over plyscord drywall/skim coat plaster .....................................................................................Interior Heating .....oil fired hot water. ......_.Plumbing .••.Per Barnstable code Fireplace ....... ........................................................... ............Approximate Cost ...........8.. ,000 Definitive Plan Approved by Planning Board _Jan. 6 _ _______1975 _ �6�� 47 ' Diagram of Lot and Building with Dimensions ---= SUBJECT TO APPROVAL OF BOARD OF HEALTH daa qs 7 GA @_ a t�r I,r'I�1 ♦ 7• •-I 411 �> >^ LOT AREA : 1.08 acres t • i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A & T .HOME BLDRS, INC. Name .... ...................... ..................................... Alfrcd Tokar_ z , Pres . I ' Kloss, Kathryn H. / t-55-8 No" 20404 Permit for one s ttry single family dwelling Laation 313 Cotuit Bay Drive Cotuit �- r Owner Kathryn H. Kloss Type of Construction frame Permit Granted my 20, 1978