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HomeMy WebLinkAbout0060 SHERYLES WAY J � ._.�—__-. .. _�.___�.d.�•:n,w- �� �,r:�ur�se��:3eac�c v........., .. ...a:.wr.:,..v- ^--•-_ ��s�� ae.J�xa:�;a.��.. ..�,�: _yN*^rn.'y�*Ay"— _— — ....s.Y�.,�_a— ____ 51, Town, of Barnstable � -Permit b 1 -�o( YCf� EXpReguRstory Services rTQS ntI DI ¢tP a JILCNSraBLE, o ERIT Thomas F.Geiler,Director - A 2 3 2010 Build tr-m Divisi®n C(/ Tom Perry,CBO, Building Commissioner 0 TOWN OF BARNSTABLE 200 Main Street,Hyannis,MA 02601 www.towri.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERINUT APPLICATION - RkSlDEITTAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number _15_- ' L Property Address /00 Y PPI/��S h)Q v �l//�.�!0 S �l AS (Residential Value of Work y700, Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /l i? dltd t as a6we Contractor's Name /(,d up Clj h k Telephone Number 509 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Worlonan's Compensation Insurance Check one: ❑ I am a sole proprietor 91 am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles).All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) [a/Re-side #of doors ElReplacement W itidows/doors/sliders.U-Value (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is,. required. : a j t SIGNAT C_\Users\decollik\AppData\i Deal osofl\ endows\Tim porary intemet Ftles\Content 0utlook4STGUSQO�Ex$RESS:doc Revised090809 s ; S t, f it Town of Barnstable Regulatory Services MASSw� " Thomas F.Geiler,Director 39. 6 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 JOB LOCATION: t� W/P—V S GU,CV /Q�I��IS '////S //j/ ' number L,, , /� street p // q ,/ village ..HOMEOWNER": /� ��dx L1 U GyC��j 50 -7- �'ZIT d name home phone# work phone# CURRENT MAILING ADDRESS: as 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.ASection 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 andrequirements and that he/she will comply with said procedures and requirements. Signature of Het-7- o eowner Approval of Building Official Note: Tbree-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." Io 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 hives 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. I C:\Users\decollik\AppData\Local\1vlicrosoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 o� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street c Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizationflndivi dual):/, A9/ p Q S Address: ,/v e Sn oz_L � S W!`��I - D Zfp City/State/ZipW&X-S' D-/V9 MIA Phone #: t5_6 41ZF-- 7,1 Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I eiiiployeds-(full and/of part-time). * - have hired the sub-contractors._ 6• New construction ❑ 2.❑ I am a sole proprietor-or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition No workers' comp. insurance comp. insurance.$ equired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. ,1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other �e — S t rl comp. insurance required.] •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.M 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. 1 do hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Si atur . Date: - a Phone#: Official use only. Do not write in this area, to be completed by city or town officiaL I City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M "a i Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as "an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,_or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state'or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic•work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out.the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone numbers)along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a.reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"lob Site Address" the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i,e.a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's'address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 i I Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.inass.gov/dia FF r TOWN OF BARNSTABLE Permit No. .g0. .95.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash p.� HYANNIS,MASS.02601 Bond. .6. CERTIFICATE OF USE AND OCCUPANCY Issued to Richard Rogers Address Lot #7, 60 Kialod Drive Marstons 14ills, class. USE GROUP FIRE GRADING OCCUPANCY LOAD I ' 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. i�uqust 11, 19 87 ............... ......... .. ....�.. ...... Building Inspector ��..� '•.w TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING NAM HYANNIS, MASS. 02601 MEMO TO: Town Clerk 1 FROM: Building Department DATE: An 'Occupancy Permit has been issued for the building authorized by BuildingPerm' `S�r ..................................................................._...................... .. ._......_ . ... _ . M issued to ......(..�.......... ...�...._ . h............. _............. Please release the performance bond. WN OF BARN;TABLE, MASSACHUSETTS y BUILDING A.045-0 15 4•t r� $Y : DATE �)n�,,•n;{,,•+ 1t1� 19 Kam_ PERMIT �.Mo1$15 • APPLICANT R-+r•11:rrri W,,o,.+ri': ~- ADDRESS r i -•� .. `� 'jw)-an o • (NO.) (STREET) (CONTR'S LICENSE) NUMBER OF ' PERMIT TO Build Dweli-�ily /Garz f`l_) STORY J11lfde Fr'-mil`; i)Wci Llilh DWELLING UNITS (TYPE OF IMPROVEMENT) NO:. - (PROPOSED USE) .w • �'� ZONING ` 'AT (LOCATION) LOL Or`7j 60 Lialda Drive, tr�i(11;:; �i111:; � DISTRICT k1' (NO.) (STREET) �, ( BETWEEN AND (CROSS STREET) (CROSS. STREET) LT SUBDIVISION LOT BLOCK SIZE'S i BUILDING IS TO BE FT. WIDE BY FT. LONG.By FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALL OR FOUNDATION (TYPE) REMARKS: Suwa)r_e 1;&6--1014 / bond AREA OFf• .121214 sq, it. / f' nr VOLUME. JU,t)VI✓.OU PERMIT /•j��5 ESTIMATED OST $ FEE_ � `' (CUBIC/SQUARE FEET) QWNER Eichard Rogers y -BUILDING DEPT, a ., 33U Wi1lur,a';ltic �l ive a:.r ;:.,).1:. L:: �Y.� 9 �A ;� + ADDRESS - BY /1 ' �' .. / � . THIS PERMIT CONVEYS NO RIGHT TO OCCUPY. ANY STREET,'ALLEY OR SI)DEWALK',O'R`A!jJY PART THEREOF. EITM E' TEMPORARILY OR PERMANENTLY. ENCROACHMENTS\ON PUBLIC PRO E• PERTY, NOT SPECIFICALLY PRkTTED',,UNDER THE' BUILDING ODE, MUST BE AP- PROVED BY .THE JURISDICTIONI. STREET OR ALLEY GRADES AS WELL' AS. DEPTH AND;LOCATION OF PUBLIC-SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY 'APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF- THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECT_IONd REQUIRED FOR PERMITS ARE REQUIRED FOR ALC _c-ONSTgt:S)TIOiv WOJ3K __ CARD KEPT-POSTED UNTIL FINAL INSPECTION HAS BEEN_ ELECTRICAL, PLUMBING AND f`r OUNOATIONS OR FOOTINGS. MADE. WF1 RE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSr4LT:.TtO'NS= =_ 2. PRIOR TO COVERING STRUCTURAL QUIRED,SL H BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION' TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. •3. FINAL INSPECTION' BEFORE 'OCCUPANCY. POST THIS CARD SO IT IS- VISIBLE FROM STREET BUILDING PECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 40 v t , Ty 3i •,- fy 0:•" ', HEATING INSPECTION APPROVALS GINEER DEPARTMENT OTHER 2 /� nc� ^ ^ r ( BOARD OF HEALTH �/ , VC W"(/�V Fes• ) I •' . / PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION • { .WORK SHALL NOT PROCEED UNTIL THE INSPEC- Ir ,� INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF PERMIT ISOT 'START kN�T[D IN ON�THS OF DATE THE ARRANGED RRAN ED FOR BY TELEPHONER WRITTEN' 1. . 1 c � z -75' 3'1 - ct . � 0 k / li P�1� rl ,ta s Er i� qRD G s 1 0 11{ KELLEY / fJ No. 26100 IST dAL i CERTI FI ED PLOT PLAN c 6 LOCATION '33 ...... c.'s /1ilGs� SCALE . ..�i�: 40 �... DATE PLAN REFERENCE . "6 7'IC.. 407- I CERTIFY THAT THESHOWN ON THIS PLAN IS LOCATED ON THE GROUND dSi9ivG' AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF ,WHEN CONSTRUCTED. DATE __ ,�;!�;!�.�•r� ;?�GC� �- .PC777/D�t/G� ER L C Sle�� Assessor's office,(1st floor): / 0F1NETo Assessor's map and lot number .......®� ..Q�� c$, Board of Health Ord floor): 3 f�✓S�• �� 101.'� � {'JG� u SAW Sewage Permit number .:......:................................................ I ' SF G STABLE, :L 1N COM Engineering Department (3rd floor): ')77 �^ ;. INSTA L Opi63q• ♦� Housenumber ................................ ...........................;....... E APPLICATIONS PROCESSED 8:30-9:30 A.M. and' 1:00-2:00 P.M. only: AL CODE ENVIRONMENT LATIONS TOWN OF '. BARN SITTIft BUILDING`' INSPECTO APPLICATION FOR PERMIT TO .................................... .....................S/ ... .... � '«,TYPE OF CONSTRUCTION ...� ......................................................................................... F ............ ................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: u� Location ..... .\ k02.... ��. ....................Z. ..........5.................5............. (1. .......... .................................... ProposedUse ......�eS.l. lr!' .............................................................................................................. . ...................... � ....................................Fire District .C .�1 ...© �/�..... Zoning District ....................... Name of Owner ... 44`4ZV.......... ......... ............................Address ... 11 Name of Builder .. eG`� .,........................Address 2 Nameof Architect ............VW4.........................................Address :............................Q......................................................... ..... .....................Foundation ..... . QWl�/.1...(fQ.4.ct i�........................... Number of Rooms .e..`._ ` 1 •..,.�................. I Exterior ... �....•�"�:�`.c.WJ..�.. ��i„.f?.Q.2"'.'.........Roofing ........ '... S. .. Z. .. ............................................ Floors w�L' C✓ ..............................Interior ...... ....... .... ... .... .................c... .r�- -...... _ .......................1. ........ rieating {.. _W `� 4................................Plumbing .... .. ....1.. ..-.:C?�..2. _ ............�.......... gA Fireplace ...... ..............................................Approximate Cost ........... t ............. .............. Definitive Plan Approved by Planning Board ________________________________19________ - Area .....7..................... Diagram of Lot and Building with Dimensions Fee ���.+.... .... ...... .. ........... SUBJECLIA�IPRA OARD OF HEALTH !, >.2231 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .... ..... /' ... - :� . ...�............... Construction Supervisor's License .... .. .s4�... .. � 20GERS, RICHARD DWELL VG /GARAGE No Permit for .................................... ...........S i ncr le Family Dwelling , Location Lot #7 , 60 al4a-LIx-i-ve ........................................................ Marstons Mills ............................................................................... Owner .......Richard...R.....og...e...r..s....................... .. Type Of Construction Fr.ame............. ....... ......... .......... ............. ....................................................... Plot ............................. Lot ................................ Permit Granted November 18..................................... 19 86 Date of Inspection 1 91 Date Corn 'let d ..........1-9 7, a .• — + TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel d 119TALLEW111 ? r�.�':�IIAf� hermit# Health Division /d WITH i i T LI- 5 Date Issued 3O ENVIROfV:1,?EN4 / L'OODE AND Conservation Division "7 2-1 (-- TCW°78\1 RFC","! ``,- N' Fee Tax Collector Treasurer dWE q I __�L4 -i Planning Dept. " Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis .Project Street Address !0o �g P/t►/lL'S �L)a V l`la�sns lyills Village - n ' Owner lCl eb OILS 1PD oeQS Address Telephone Permit Request deci C skvch'm Square feet: 1 st floor:existing - proposed - 2nd floor:existing proposed - Total new Estimated Project Cost Zoning District ems Flood Plaines Groundwater Overlay Construction Type Lot Size 117) 191 sF Grandfathered: ❑Yes ; ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure RIB Historic House: ❑Yes ANo On Old King's Highway: ❑Yes ANo Basement Type: PrFull ❑Crawl ❑eW/alkout . ❑Other Basement Finished Area(sq.ft.) /y0- Basement Unfinished Area(sq.ft) Number of Baths: Full:existing o? new Half:existing new Number of Bedrooms: existing 1A new Total Room Count(not including baths): existing `5 new - First Floor Room Count Heat Type and Fuel: Pd Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes kNo Fireplaces: Existing 4 A-a New & Existing wood/coal stove: ❑Yes KNo Detached garage: existing ❑new sized 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 O(No If yes,site plan review# //►�- Current Use Proposed Use how BUILDER INFORMATION Name Telephone Number Address �o� Peu�Ps• & V License# (W 096 /Q 2Sk/ZS t////-S d o260 YO Home Improvement Contractor# fag T Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE _ 10 P91 IP 9 9 FOR OFFICIAL USE ONLY g , PERMIT NO. DATE ISSUED . - MAP/PARCEL NO. ADDRESS ' -VILLAGE OWNER. DATE OF INSPECTION FOUNDATION- F - FRAME INSULATION FIREPLACE ELECTRICAL:.. ROUGH FINAL PLUMBING: ROUGH FINAL y GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. a f i i f 1 'TOP OF FOUNDATION CONCRETE COVER { CONCRETE COVERS 6 •- 4 CAST IRON 12n Mrisn;7�AX. ,ins • OR SCHEDULE 40 12"MAX. P.V.C. PIPE 4"SCHEDULE 40 P.V.C.(0KLY) t • • PITCH 1/4"PER. PIPE - MIN. f- 3t EACH PITCH 1/4"PER.FT -- PIT PRECAST I ?'o i e'' INVERT a LEACHING I '0 EL••!!!•'30•• INVERT `INVERT � e•; PIT ORSEPTIC TANK ,/o yy DIST. //o.ssw : EQUIV.INVERT ... . . :. . . . 80X EL. .... _ . GAL. INVERT `•EL..!!�`�.9 //07/ INVERTv° °: :;i, 3A"T0II/2� EL........ w w I • e EL!/o.,�o �: WASHED ED R e w STONE 1 D ( I NovE PROFI LE OF I GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : ( DATE , i9BG TIME. !O:'3o•A!ti • T�/oro�s r7cle,"N BOARD OF HEALTH TEST HOLE I TEST HOLE 2 ENGINEER ELEV. . !/f 30. . . ELEV. .l�.s io. . . I . Woo�DLoQs wed s:OE81 G N DATA 11 461 Ez.•ri to j NUMBER OF;BEDROOMS � Coih2d6 s,4+�� I SA„�p WirN 4.4ye7zs TOTAL ESTIMATED FLOW 33o GALLONS/DAY wry L9ye�s of G2AVEZ I BOTTOM LEACHING AREA /5 3 9 oF'6,eaue-L . . ... S0.FT. /PIT le'.RP. SIDE LEACHING AREA SO.FT./ PITI3.s/, 9C,Pv GARBAGE DISPOSAL (50% AREA INCREASE) 29.4 b TOTAL LEACHING AREA SO.FT PERCOLATION RATE 7AI41v. Tom'?. MIN/INCH LEACHING AREA PER PERCOLATION RATE 3 B SO.FT./e?,P ! .P./.'. .WATER ENCOUNTERED j NUMBER OF LEACHING PITS ovr- PST win! I APPROVED . .. . . . . . . . . BOARD OF HEALTH '�°`'�• � T. .oF -S�INC o.✓ /�G� 5/DO'S DATE. i AGENT OR INSPECTOR Of ` ZoT ,d7 1 z r 26100 ! • •t., �.��,�;yTiR .1� I ` STEP I :�./ SToNS /GLS. G \h;��•r;C l.f'= ,�dC E S4S,AS►* ncY�r10R'E'R _ ,�iGf�A/�D 2o06;C-"Tz'S „l�'"`'c.,,.,�-�•v" � !'"�a�y;�,�q�,�• e I, f ��� wt� .' L� - -- - .^.�...m..-._ ......-.�—•-t.n.. ter, ippv Xp��y.' co Lj — 1N �• �� mod^�`4 aye Y 4 ; d ............... �,� _ .; � -- --- -------mow t I 1, ,, ;� • \14 all CA ^' 3He-T /o,c Z Sf/EZTS 37� ' 1 • � ,, 1 � � N a 1 1 IV 1 � j k4�4A N� I o / ', 1 1 No. 26100 n�CISTtl� LcT tJ � h I -5,9 7 /J`'! sq,FT. � I � I � � .S/TE l�Li9•n,.. .... 10. 1 f I I LOCATION �4�J"���7z?BLE (i�1A/rs7ta�vs,�.�tLs} �' SCALE �3 ' DATE -S = !7, 1 . .. ..... .. PLAN REFERENCE . ..&IA'/G•, Lor410 I ' I I CERTIFY THAT THE .. ... .. . . . . . .. :. SIIOWN ON THIS PLAN IS LOCATED ON THE GROUND. . . . AS SHOWN HEREON' DATE . .. . RFECOSTERED LAND SURV 0%° The Commonwealth of Massachusetts —j Department of Industrial Accidents office of/otresmat/oos 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name location l� �I�e�eyles rr// city hone ll.,�DB 7079 I am a homeowner performing all work myself. ❑ I am a sole prophietor and have no one worlds m any capacity Providing workers' co ensaiion for my employees working on this job.:::: w an v n aware .....:.. .... lion CI cV insurance ..::::: :::: :�::::;..::. :::.::.:::.;...�.,::.;::: ❑ I am a sole praprieto ,general contractor;or homeowner(circle one)and have hired the contractors listed below who have polices: win workers comp P ............... . :.::<.::<.;:.; :..::.;:.;:.,.:.:;;>::.:::.:.:•.;;:.;;::.:::::::.::.::.;;:;.::>:.;:.::.;::.:::.;:::;;:.;}:.;};:;.:._:.;:;.:::.::.;:.::.}:.:}}>::.:::.;;:;:: :>:::.;:::: the following .. ..........:::::..:::::.::..:...:.:.... :::.::::::.:.....::. ::.:. .::.:::.::::::;:::::::::::::::::::::::.::::::.:.:::::... <>;:< com anvname: :..::.:.......:.... :.;>;:. 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Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of crlaninal penalties of a fine nil to 51,500.00 and/or one years,imprisonment as well as dva penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the OtSce of Investigations of the DIA for overage veziflcatlon. 1 do hereby certify under die pains and penalties of perjury that the information provided abaye is trw.and correct Signature Date - - Phone#- 50� yam- Print e oftidai use only do not write in this area to be completed by city or town ofR¢ial permit/llcense# ❑Building Department city or town: ❑Licensing Board is required ❑Selectmen's Ofitce ❑checkitimmediate response ❑Health Department contact person: phone#; - ❑Other. 15552,15511 (rcwsed 9195 PJA) Information and Instructions r• 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 contr..;: 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' 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 c 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 renew 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-Depwtuient 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 tl 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 permidUcense number which will be used as a reference number. The affidavits may be reatrned to the Department by mail 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. The Department's address,telephone and fax number- The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investlgadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 • .r .I e ° 9 M � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commission: 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: deck amstoc.h617 Estimated Cost a K Address of work: �cl steep //��1 S. o Owner's Name: 1 / Q2d Aaeks Date of Application: ch/y ow I hereby certify that: Registration is not required for the following reason(s): Work excluded by law OJob 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 PERJURY. I hereby apply for a permit as the agent of the owner. Dat' Contractor Name Registration No. OR Date Owner's Name q:fomis:Affidav .},�, --- '••_ •'� lee �o��inwvuuea/,lJ�•` ,illaarac/zurvtl I . OEPARTMEMT OF PUBLIC SAFETY I . z CONSTRUCTIOM-SUPERVISOR LICENSE = y Mu6er = Y Expires: Restrcfed':To:== A1 RICHARO%:06AV 68 SHEWES'WAY y MARSTONS MILLS' MA 02648 �e�Cnatioaorrcaa�DE.c�✓�aaaadeu�eQa ' HOME IMPROVEMENT"CONTRACTOR Registration t25194 , Type - INDIVIDUAL Expiration 03/04/00 I RICHARD ROGERS �. 6HERYLE'S WAY ' ' ADMINMTRAMR MILLS MA 42648 i j A"ssessor's office (1st?floor): -/ F THE T Assessors ('map an4 lot number W...........O./Z...... �1 . ........... �bBoa d.of Health(3rd-1floor)� o Sewage Perm'it number .........................................::............ 2 BARNSTABLE. Z Engineering Department (3rd floor): G Q L' 9°o Mb e• House number ................................. .............................., 0�aMA a' APPLICATIONS 'PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNS"' TABLE BUILDING INSPECTOR APPLICATIONFOR `PERMIT TO ............................................................................................................................. d TYPE OF CONSTRUCTION ....�a....�......`..:..Z....... ........................................................................................... ; TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: I,JL �Zv �t (Lt ,-Q �2 4 2 � Location �....�.....'..........�................................................�................�............. ... ..............,/...................................... ProposedUse ..:... f'S.l. .............................................................................................................. Zoning District ............Fire District ........... Qt(,'l�t 0 6i 1�� ..................... ........... . ...... .. ..........!........................................................ r If Name of Owner Gad30 C 1�....1 .:.. ...:.. Address Name of Builder ... .��...2v ........o... ! ......:..............Address � ................................................................ Nameof Architect ............. ................................:...............Address .................................................................................,.. Number of Rooms ...............��.....................:...........................Foundation ....�f3,u`.!�...�U1''C.��..`:5............................ C. fJ Exterior ....1 ..l..... t` ..................Roofing ......... 4z 1�.... .... .\.... ...... .... .. FloorsV�� �t�.........................................Interior ......�....................dC...............................................................\.".......i . \- 0 h� ® t � Rdumbin � Heating .......................................v.................................... g ............. .. Fireplace ��,,....�Sa.v.���!t...............................................Approximate Cost ............(.J.�;....�Q.........�........:..f.............. ............... l/ Definitive Plan Approved by Planning Board -------------------------- .-�49�.`... ------19-------- . Area ......... Diagram of Lot and Building with Dimensions Fee ..gz �� • i SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. F � ' s Name . i-��-4.... . .... ."....................................... Construction Supervisor's License ® ` �...... ...................... ....... ROGERS, RICHARD No Permit for ...Dwelling.../Ga.rage ....... .. .... .. A .. .... Sing�!E�J:�pily Dwelling .................. ..... .... ....... ........... 60 Location Lot #.7.......... .Ki=aloa Drive ............................. ...............ma.r.qt.ons...Mills........................... Owner ........Richard....Rogers .......... Type of Construction ..Frame ........... ........... .... ....... ................................................................................ Plot ......................... Lot ................................ Permit Granted .....��9 ..vbmbbr-, 18 ....19 86 ............ ........... . Date of Inspection .....................................19. Date Completed ............... 19 6 L/7