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HomeMy WebLinkAbout0042 TANBARK ROAD � T���� �� _ _ � _ _ _ 'aJ TOWN OF BARNSTABLE BUILDING'PERMIT APPLICATION Map Parcel Application # Health Division Date Issued Conservation Division Application'Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address a Village JAaf-+M S Owner Address 6,aM e- Telephone �J - ( 14 Permit Request Cofvl. u cl+ X i- l i ad&tim (0- -n o of e:e-Ma. on. C- 24.5 � � 5 - Aop i 11 `4 6*4 Square feet: 1 st floor: existing proposed ., 2nd floor: existing proposed Total new Zoning District RES Flood Plain Groundwater Overlay Project Valuation 3'Construction Type L 008 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 34o On.Old_King's Highway: ❑Yes ❑ No Basement Type: NFull ❑ Crawl ❑Walkout ❑ Other n a') rV7 n� V � J Basement Finished Area (sq.ft.) Basement UnfinisJhed Area (soft IIII� D �Number of Baths: Full: existing new Half: :xisting IJ Y Number of Bedrooms: existing _new I 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 AppealZo orization ❑ Appeal # Recorded ❑ Commercial ❑Yes If es site Ian review # Y p Current Use. "Res Proposed Use Re6l . APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 'Bp`D 608+-" IOC KeZ Inc• Telephone Number -774-9 - 135� Address 70 - 330k Z( License #. CS "7&332 6&COs bWe-, N A 0 ��0�' Home Improvement Contractor# Email u`e-g 1 h @- LA�� _CD Cie GOVY) Worker's Compensation # 0 I a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TKO SIGNATUR DATE �R FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED- MAP/ PARCEL NO. ADDRESS VILLAGE 4 OWNER DATE OF INSPECTION:'k FOUNDATION _ .. FRAME I 'INSULATION L FIREPLACE ELECTRICAL: ROUGH FINAL '. PLUMBING: ROUGH FINAL II GAS:. ROUGH FINAL ` FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I - 7Tie CommloyMealtk of-Massachusetts Deparli feat of rndks&ia1Accide7av _ Offrre 0frn1WStigai!i07Zs 600 Washington Street y Boston,CIA 02111 >; mitmassgovldia Markers' Campensatian Insurance Affidavit:Bmlde>-slCantracterslE•Iect icians/Ph=bers Applicant InfGi-maf an Please PrintLeeillly N3YDe(BtrS�EES�'�Fg3IIffitlanllnr�ccrtrina7} Ad&ess i•D ."9N 2-1 r � Cifftatel S Pliaae en — — 15-7 Are you an employer?Check the appropriate b Type of project(required): 1.❑ I am a employer with I am a general contractor and I employees(full andtoc part-time).* have hired the sub-contractors6. New consfmctioa �.❑ I am a sole proprietor or partner- listed onthe attached sheet, ?. ❑Remodeling slip and have no employees . These sob-contractors have g- ❑Demolition woriring fame in any capacil:r employees andhave workers' q Building addition [Na wodmrs,' comp.+*���ce comp.insurant�l ❑ g regnired_j 5. E] We are a corpomfion and its 10:❑Electrical repairs or additions 3.❑ I am.a homeowner doing all work officers have exercised their 11.❑Plumbingrepairs ar additions my-self,[No workers'comp- right of exemption per MGL c.152,§1(4Xandwehaveno ME]Roofrepairs insurance required-]�i • employees.[No workers' 13.❑Other comp_insurance required-) 'Amy WfficsuCfat checlrsbox Pl umst also fiII cutthe sectioabeIowshassing their wolkeze campemsatiaapenry infomraamL I Hameowneu who submit rims affid2vii indkitnt they axe doing Ruwa t and then laze o+c Mdecontractorsamst submits new affidavit indicz�saidL TCantxactorsthatchecYthf box mast attached aradditional sheet aow!ngtheauneofthesub-contructo-xs-sadstatewhathesornotthoseentitkshave emp9oyees-I€thesub-cmttactvrshave employes,theymustpra-A their workers,-romp.policy number- lain an eutplo}�rr fltrrt is prat�dnrg tt�orkers'canrperisrcfi'arr insurance for err}*enrploy�ees $eIaty is f)te paticy rcrzd job s ile information. Insurance Company Name: Pokey 4-ar Self-i13IS.Lic.9 ExpirationDate: Job Site Aadre= tan b�l� M.2�,CsIONs r�lt 6_ 4/StaWzio-.3___ r4 Attach a copy of the workers'compensationpolicy decI2ra4ion page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c 152 can lead to-the imposition of criminal penalties of a fine up to$1,500:OU anWGr one-yearimprisonn—f as well as civil peualties.in the form of a STOP WORK ORDE1Zand a fine of up to$250-00 a day against the violator. Be ad`dsed that a copy of this statement maybe forwarded to the Office of lmrest gations of the DIA for insurance coverage veriEcation. I do hereby ca fy n r the pacts and penialties ofpedai3}diatilte inforniatimlproi-v a o rns E and[arrest Simature: Bate: 2-1 A6P Phone 7 — Official use an£y: Do)tot avrke in tltis.area;tax be winpteted by city ortoirir o fjrcieL City or T•omu: Permff cease# Issuing A utltorfty(tirde one): 1.Board of Health Building Department 3.City/rotrn Cleric 4.Electrical Inspector S.Plumbing Inspector 6.Other CoYl-tact Person: Phone#: Information and Instructions Uassachusetts GeYreral Laws chapter 152 requires all employers to provide workers'compensation for their employees. p -to this Side,an enp&yee is defined as."_.every person in the service of another under any contract ofbire, express or implied,oral or wrinru_" An erpproyer is defined as"an individual,partnership,association,corporation or other legal eu�iiy,or any two or more of the foregoing engaged is a Joint enterprise,and including the legal r epmseatatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other Iegal entity,employing employees. However the owner of a dwelling house bavmg not more than three apartments and who resides therein,or the occupant of the. - dweIIing house of another who employs persons to do make,construction or reps wmic on such dwelling house or on the grounds or building appurtrnantthemto sbOnotbecanse of sash employmmtbe deemed to be an employer." MGL chapter 152,§25C(6)also stairs that"et cry state or local Iicensmg agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for ray applicant Who has notproduced acceptable evidence of compliance Wn the h sur'auce-coverage required." Additionally,MGL chapter 152,§25C(7)states-Neither the commonwealth nor airy of its political subdivisions shall enter into any contract for the,pmfomance ofpublic wont maul acceptable evidence of compliance with the insm-anc6. regL iremeafs of this chapter have been presenfEd t,the confractiag andhOzity-" Appiiratrts . Please 01 oil the worker'compensation affidavit completely,by checking&e boxes that apply to your sitnation and,if necessary,supply sub-contrar-tor(s)name(s), addresses)and phonD n=ber(s) along with their certificate(s)of D s l ance. Liraitrd Liability Companies CLLC)or Limited LiabilityParinerships CLEF)with no employees other than the ' members or partners,are not rbquimd to carry workers' compensation insurance. If an LLC'or LLP does have employees,a policy is required. BeadvisedthatthisafEidayhmaybesubmithtdtotireDeparfantntofIndustrial Accidemts for conf rmaE0n of msm ance coverage. Alm be sure to sign and date;.he afadavit The affidavit should be retuned to the city or town that the application fur tine permit or license is being requested,not the Department of ludug>zLl Accidents. Should you have any questions regardmg the law or if you are required to obtain a workers' compensation policy,please call the Department at the nunnbe:r lisi-,d beIow. Self-insured companies should enter their s elf-insurance;license number on the appropriate line. City or Town Officials t - Please be sure that:the affidavit is complete and pried legiilnly. The Department has provided a space at the bottom of the affidavit for you to fill oil in the event the Office of Investigations has to contact You regarding the applicant Please be sure to fill in the pen�ait(license number which will be used as a refe rence number. In addition,an applicant that must submit mvl4le permibUcense applications is any given year,need only submit one affidavit indicating current Policy infomatiom(if necessary)and under"lob Site Ad 1drms"tie applicant should write"all locations in (GEy or town)."A copy of the-affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for fatal permits or licenses_ A new affidavit must be filled oirt each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial 7bMtMe Cie. a.dog license or permit to bun leaves etr.)said person is NOT required to complefie this affidavit The Office of Investigations would lake to thank you in advance for your cooperation and should YOU have any questions, please do not hesitate to give us a call The Department's address,telephone and fax n7mmber. Tit CGMMMlwean of MMchn Depadmmt cif IndugtElal Accidents Once of)hVaSagatio-A ���asbin�Qn Stece� ' 8�an,IvfA E�111 - TfL 4 617. 27-4900=t 406 or I 477 MA-S AF E Fax 9 617 727 7749 x evised 4-24-07 w vi mas gavldia r Town of Barnstable : of Regulatory Services F AAA-r.331Z E g� %rA.CM `$ Richard P.SSA Director a BuRd.h1g Division Tom Perry,Bmlding Comndssioner 200 Main Street Hyannis,MA 02601 www townlarnstabk-ma_us Office: 508-862A-038 Fa= 508-790-6230 PropeiC r OwnerWst Complete and Sign This Section If Us" A Builder a\ ,as Owner of the subjectP1OPMtY lWMbY=Thorize 22 D Q JST A-Y� �lA CZ 6ff jt4C to art on mybehA is all matters relative to work and onzed bydus bmZdmg percent application for. . (Address of job) *'Poolfences and clams are the responslilttyof tb.e applicant Pools are not to be fMed or uilized before fence is installed and all final ' inspections.are pedon ed.and.accepted. S4aature of Owner tl Sie4af nm of App ' Priur Name Prim Name Q:Fox�:owi��a�ssmr�oors . To evn of Barnstable =' - RegQlatory Services Mchard V.Scafi,Director , $old mg bivision. f = Tom Perry,Bur7dmg Conunksioner _$ MA.MM �a 200 Mkim Strcat Hyanus,MA 02601 wwW_to pmhams ahk ma us ' Office: 508-862-4038 - Fax: 508-790-6230 - HOnM WNW LTCENO IXEMMON UAL• . roB I.00ATIOK- t � nn�a• '�OfvIFOWl�: - h®eph®c#- wo�cpbone ( •names - , . 7 CURRENT MA ngi,— eDDRPSS- _ up code The em=ent exemption for"hom.eowne&,was extended to include owner-0ccRpied dweIIm2s of sic twits or Iess and to aIIoW ELOmeovrners to.mgage an individual for HT-Who notpossess a license,uiuyided tbattbe owner ads as s�ervzsor_ D7TFIIMON ORHOMEOWNEB ,Fermn(s)who owns a parcel of land on which he/she resides or bfr-nds to reside,on which.the is,or is intended to ba,a one or two- fmay dwelling, attacbed or detaarhed stactores acxessoryto such use and/or fa=structrn:es. A person who constructs more than one bflme in a.two-ycar period shall notbe consiri,=ri,ahnmeowner Such`$omwwnee.Shan submitto$1e BmZding Of$cial on a farm acceptable to the BurZdmg OffiLial,tbatbc-lsbc Shallbe rmponsrbls for ail sucliworkperfnrmed tirebma pC (Section ID9.L1) - The undersigned`homeownrx•as sames responsIffi y for compliance wifh.tbe Staff Bu7lding CodL and ofI=applicable codes, bylaws,ralms and s o 1-d:i ns- - �dexsig>�d`homeownee-ryes that he/she understands$be Town ofBarmfable BuMling Depart m=t miIIiiomtr inspection pm=dn=andrequi=emants andtiAbrlsbewMwmplywilh said procehacs andreqiremeofs. S ofHnmeasen= ApptvPal ofB Iffimg0frydal • Note: Zhree Zy dwellings canfaining 35,000 ovbic feet or lager wMbe re gab a tcI comply wifhtho State,Building Code Section f27.0 Canslxnc(ion CantmL .Hp�oWI�R.•S F�IIOId The Code states that:'69 try homeowner performing workfor which a building permit is required shall be exempt from the provisions of this section(Sec$On I09_Ll-Lirr�of consiradion Supervisors);provided that if the homeowner engages a person(;)for Time to do such work,that such Homeowner shall act as supervisor." Many homeowners Who use ffiis exemption are unaware thatthey are assuming the respousiihi]l ies of a Supervisor (see App—iT Q� �8c R egmIations for n•..�it,g ConsErucfion Supervisors,Section Zl� This lark of awareness oftrrr results in serious problems,pardcular'ly when the homeowner hires unlicensed persons.`• case,our Board cannot I Proceed against the unlicensed person as if would with a ficeased Supervisor_ The homeowner acing as Supervisor is uItimatrlp respoasr-ble. To eusire that the hommwnrr is Emily aware of his/her respousibes,many ilif eommunifres reggae,as part of ffie permit applirati=6 that the homeowner crrtify f athefshe understands the responMbMt es of a Supervisor. On the last page of fEb issae is a form rm rrem$y used by several t owus. YOU may case t amend and adopt such a for=[cerfiiZ--^n for use in your camsaunitp. pr.�ft�s1F�FBFSS.dco RzRised 06 U 13 . Massachusetts Department of Public S ifety _. ` Board of Building Regulations and'Stan aids License: CS-076332 Construction Supervisor ti KEVIN BOYAR PO BOX•21 ` WEST BARNSTABLE MA��-,2i3• 68 = Expiration; Cornrhis.sioner 09106120117 'I/1sa`f>wnunrr oicroccl��c�'C/ffa�uclrt',�e ` .. rq Office of Consumer affairs&Business Regulattop License or regis'ration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 162150 Type: Office of Consu er Affairs:and Business Regulation v4 Expiration: :A126/2017 -Private Corporatioi! 10 Park Plaza- uite 5.170 Boston,MA 02.1-6 B&D CUSTOM BUILDERS;INC; KEVIN BOYAR 1050 MAIN STREET WEST BARNSTABLE,MA 02668 Undersecretary ofwtild without nature 2 Town of Barnstable *Permit# °. Regulatory Services Fee Expires 6,ru ntnths from issue date M �' Richard V.Scali Director �011 . Building Division IMP Tom Perry,CBO,Building Commissio eA y 04 ZQ�� Q 200 Main Street,Hyannis, ' 2 0 www.town barnstable.ma uss Office: 508-862-4038 QFg�0iVSTq,& 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number i Property Address 4z Tanba� [Residential Value of Work$ -� 00 a • Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address AnAreas. 42 lwi kzr� Rd f`nar dM5 11{s Contractor's Name Telephone Number_]_'l4 _q � �� Home Improvement Contractor License#(if applicable) (D 21 S'O Email: keV*1()Le_Map cod,,,ro Construction Supervisor's License#(if applicable) Tc 33 2 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor . ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 59E ftrh-jj� Copy of Insurance Compliance Certificate must accompany each permit.' Permit Request(check box) . ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Ln Re-side []'Replacement Windows/doors/sliders.U-Value n 2S (maximum.32)#of windows—*.- #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. ` A co y of the Home Improvement Contractors License&Construction Supervisors License is re fired. SIGNATURE: Q:\WPFIIM\FORMS\build' g permit forms\EYY .doc Revised 040215 a 37m Commomveah*ref sadrrrse&s spa�r6treMt oflrubzs&ia ACdd-d7d5 . O�ie of gafions y 600 WashhWlon S`ireet -- Boston,MA 02112 tvrvr,masmgavldia warlcers' CompensatsanInsurance Af5&vif_ Btibier$(C�ntr actors MechicianslPluibers A13phicant Infttrnnatian, Fletase Prin ley Named esm: 21 Cily7'Staxel �!o Ph,Qae QED Are you au employer?Check the appropriate b � = of project r L❑ I am a employer fib. 4_ [v�I am a general coafrsctur and I' F ] ( red}: Io fall * have hiredthe subr contractor 6. ❑New construction emg yeas( as�`or parWime�. 2.❑ I am a sole proprietor orpartaer- listed on the attached sheet 7.,❑ResrnodeEng slip and have no employees These sVb-contractors have $. ❑Demnlifion wad-ing forme in any capacity_ employees aadhave xvad='� 9._❑Budcimg addition [No wodmrs'comp_izQnce comp-msma, requked] 5. ❑ We are a corporatism and its 10L❑Electrical repairs cr ad&ions 3.❑ I am a homeovmer doing all walk officers have exercised their 1 L❑Plumbingrepairs or additions myself[No workers'camp- rigu of emunpfion per MGL 1--7❑Roof repairs imwanne required]Y c`152, §I(4k andwe have no employees.[No woros' 13-❑Other 0d04,4? s camp_in amre required_) . 5 d a Wa -f- 'Aay eppFres�dhat chetksboa c1 muQ aL.n ffiootfhe secfiaabeIows�dag theirwodsecs'compersaticapa�yin�cmati� #&nmevnraerswba submit tlzis affidaau=&—timg tbep ar &im;sIF wcA and&mbim autsidecrntactatsmnst subnmanew atndai&imdi=in--sma TCanzcectuxsrtiMt cbeclt this b=mmt atmcbed as additi"o dbeet snowing thensm-of the sub-cons-t a end statewhether arnutthose mfitiesha� emp3uyees.Iftbe ab_C=t Ctnz3 2 a emPIcY-6 t5e}'rmssiprnT ihev wwken'immp.policy number I am an e1lnpLay�ar snatis prouidunb workers'eourfercrafiart isns�rannte far�empIo}'ee� Beto►v is tlta policy and jab sits infarrarrrtion Insurance campanyNaune: Pa&cy,or Sel€-ins_Lic_;�: Expindiun Date: Job Site Address` cifp/Stawzip:�/a A.C#ach a copy of the workers'compensationpoEcy declaration page,(showing the policy number and expiration date). Failure to secam eoveFage as regtziredunder Section 25A o€MGL c 157 can lead to the imposition of criminal penalties of a fine up to$l,SOa OO andror one yearimprisonmeuf,as we11 as civil penalties.in the form of a STOP WGRI£ORDERand a fine of up to$254_Qfl a day against the violator. Be advised tlraf a copy of this statement snay be forwarded to the Office of InvvesEigations of the DIA for insurance coverage verifrtatim Ida hereby cl ass a pains and pennaNes a.Fer crJ']%at391e infonm�prnt&d abmw is byre all correct Phone iF O aI use asnIy. Da scat ow to in tads area,tar be campleted by tiny ortetrn official City or Town: Permiff I ease 9 Issuing Autlgarliy tcu cle onel: L Board of Health'2.RurTcl4ng Department 3.CitylTo n,Clerk 4.E3ectrical bnpector S.Phtmbing Inspector 6.Other Contact Person phone;ff- 6 formation and InstractiOUS 1sz regm�an employees to P�de �etEon frs their employees. Cer 7y�c�ar]rttcettS alLaws p"'r cantiact ofh P==MMttD this , is deed as.6_-eveay person M$ze service of another under �or implied,oral or writtna." a is defmtd a'"an anfvidn�•al,parfnctship,association,carPoratzen or other leg e'ty,or two or more AIL m a joint eoterprise>andinclndmg legal repzese�ves of a deceased employes,or$ic .. of the fnrego>ng � association or otherIegal entity,employing�P�9�- However the r=eiv=or trustee of an ant 6dnaL P��� or the o oftbc owner of a dwelling house having not mare thaw three apaxtrnents and who resides therein, _ dwan,n.g house of am ier who employs persons to do Mahe,ca str•uch_on or report wosic on such dweIhng house 1 be deemIedtn be as employed" or an the grounds or bmldmg apgoa�therefn shaIlnotbexanse of such emp csymeat also states that¢every state or local riceasmg agency shall withhold the LSSaanCe or M(sL chapter Ifi2,§25C(� m the co�non:eQealih for any renewal of a Tr-- e-or permit to oPerafs a business or to cons tract t b�dings �cover r ,� applrcantw•ho has notproduced acceptable-evidence of cumpltanre�� p ge e�'� M(H,chapter 152, §25Cp)states"Neither the coffin of its political sabEvfsions shall Additionally, evidence of compliaacewhh ffie insaz' .- enter fatn any contract for the per�ce ofpablic work=E acceptable ralairemenfs of oafs chapter have been presented to the canfr'actmg auhorly-a AFPIi ensation affidavit completely.by chug the boxes ffi ±apply to your won�if Please fiIl o� the wod�s'comp enumber(s) alongwrththen-cent heaters)of necessary,supply sob- �s)neme(s), address( ) Piton other than th msaranc-. Limited Lfab1�*Comp, �C)or UnitedL��y'P�eashrps(LLP)with no eanp gees members or partams,are not rimed to carry Wo33ce& compensation fnsmanm If an LZC or I 7 P does have en3ployees,apolicy is re . Be advisedthatffifs affzdaY>tmaybe snbmitft-,d to the Department of Industrial Accideat for confirmation of fi sa=ce coverage. Also be sure to sign and date the affidavit The affidavit should o t the Department=of n be retcomed to the city or town that the appficatim for the permit or liceose is being requested,-ed toobtain a wogs' jS l A r1-i� Shauld you bane my question g the law or¢you are requir olnpensaiionpofiey,p DeP leasecaIlthe' artmentatthennmberlistedbelow~ Self-in,,,dcorapaniesshouldentertheir c self-fnsai'ance license number as the appiopr iads line. City or Town Officials Please be su c that the affidavit is compldo andpritdmd le&ly. The- I has o cootthas provided a space h faze applicant of the affidavit for you tO fill out in the event the Office ofInv ��* has to cordactyouregeZdingthe applicant Please bestoretofill m ¢/thepcu censernrmberwhichwMbeusedasaIefe=cenumber In addition,enappIicant at most submit maulfiple P=WHcrose apPlitations is any given year',need m'sobmrt one affidavit indicaf mg cmz mt th policy information(if nay)and under"lob�e Mdrm&'the applicant should e�dte`°sII locations �in the ar •town)"A copy of the-affidavit ffiat has been.officially st moped or maimed b3'the�y or iDvm may P applicant as proof that a yaIid affidavit is on file for fie k - or licenses- A new affidavitmust be filled Dirt eiarh year.Where a home owner or citizen is obtair i ag a Iiceasa or peTrt not=at rd to awry business or commca'C ial-Y&M C . (ie_ a dug license orpemik to bum IeaYes etc.)saidpersou is NOT r� to Mete Ihis affidavit The Office of Iuvesligaians would like to flank you ja advanca for your coopmafion and should you have any gnestr , please do not hesitate to give us a call. The Departmenfs address,telephone and fax nn Ober. T a canmnwwealth of MassaZEUSCM - Dement of Iz but zal Amid-tuts Qffice of I-aveg#gatio= • t�.4�ash�tQn . & YEA 02111 Tel.4 617- -4900 ext 4-06 4r 1-977-MAA�� Fax 6 617 727-7749 Revised 4-24-07 as, oFtt+e tq� . • MASS 639 Town of Barnstable 9Q' i . `erg' pTED MA't� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us I Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section VUsing A Builder as Owner of the subject p=operty hereby authorize ,RIIO GCIS'Tll'M 2ZLY4 to act on my bebA in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the' reverse side. Q:\WPMESTORNObuilding permit forms\E)TRES5.doc Revised 040215 Town of Barnstable Regulatory Services dry toy, Richard V.Scab,Director ` yam Building Division L►axsresr.E, Tom Perry;Building Commissioner MAM , ��� 200 Main Street, Hyannis,MA 02601 0EO www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street vrllage . "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. DEFINPTION 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 ear period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval ofBurlding 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 ExF2yn nON The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this.exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible- To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q.\WPFR.RS\FORNMbuilding permit forms\EXPRESS.doc Revised 040215 j . viassachuset's Department of,Public'S 06ty 'Board of Building Regulations and Standards License: CS-076332 Construction Supervisor • is a':- � .: KEVIN BOYAR PO BOX 21 WEST BARNSTABLE-M-•.02 8 y 1..� - Expir Lion: Cohirnissioner 09106 017 r. _... ............. _.._ __._....,_,.._ _ ... Office of Consumer Affairs&Business Regulation License or regi ration valid for individul use only �a E IMPROVEMENT CONTRACTOR i before the expiation date If found return to: i3 ...: }t egistration: 162150 Type: i Office of Consu I er Affairs and.'BusinessRegulation Expiration < 1/26/2017 Private Corporatioi? YO Y;tikPlaaa-' uite 5170 Boston,IVIA,02.1 6 B.&D CUSTOM BUILDERS;:-INCi;}';:' KEVIN BOYAR 1050 MAIN STREET WEST BARNSTABLE,MA 02668 Undersecretary of valid without ` nature J I r y���►�logy Town of Barnstable "`Permit l ©G 6(c Gvpires G iimulhs fi o n u.rue date ttt.Rrernmr. : Regulatory Services Fee MASS, e� _ t ,nas F.Ceiler,Director �AlFotrw�'' -PRESS �,�,�-FZ,1r1� Ildxng Division O C T 17 2007 Tom Perry,CBO, Building Conunissioner 200 Main Street, Hyannis, MA 02601 N Di BARNSTABylr-town.barnstable.ma.us Office: 508_862 038' Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RENDF,NTIAI-, ONLY .Not Valid without Ked X-Pras Imprint. Map/parcel Number ff! S . - Property Address h 1;�Rcsidential Value of Work Miuintum'fcc of$25.00 for work under$6000.00 Owner's Name&Address an ha rk M C7 (22 62 Contractor's Name ID0,0 at_zea I Telephone Number Home Improvement Contractor Licdnse It(if applicablc) / -7 Construction Supervisor's License 11(if applicable) Workman's Compensation Insurance Check one: ❑ I am a sole proprietor 1 am the Homeowner. 1 have Worker's Compensation Insurance Insurance Company Name (� (� P —71 7­1�S Workman's Comp.Policy g t ' � Co r �� Copy of Insurance Compliance Certificate must be on file.. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to Q ryy-)-.(DL,,,j ❑ Re-roof.(not stripping. Going over existing layers of root•) ❑ Ike-side ❑ Replacement Windows. U-Value (mitximum.44) ' •Whcrc 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. iomc Improve ent,Cotitractors L' ense is required. SIGNATURE:- Q:Forms:cxpmtrg Revisc071405 OThe Commonwealth of Massachusetts Page 10 of 10 Department of Industrial Accidents w Office of Investigations. 600 Washington Street Xq f Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): PA U L— S C2 Z e Q U l+ E S O n S (�p 047 AJ Address: I c 3 i M a l Yl s� City/State/Zip: ©5 T g r y I I �e Yh A02(o G S Phone#: So F- 2-6 - 11 -1-7 Are you an employer?Check the appropriate box: Type of project(required): I Z I am a employer with [2 4. ❑ I am a general contractor.and 1 6. ❑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.t ?• El Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.], officers have exercised their lU.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL I I.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.14 Roof repairs insurance required.]t employees.[No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: t ii'�'(�il,�il"� Z)S Policy#or Self-ins.Lic.#: yrJ��"J S rJ( / (� Expiration Date: FC 14101 O Job Site Address: `:21a 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 nder the pains and penalties of p rjury that the information provided above is true and correct. Signature,-Q Date: Phone#: Official use only. Do not write in this area,to be completed by city or town offiiciaL 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#: R 0 0 _ F I N G 1031 Main Street Osterville, MA 02655 www.cazeault.com 22 Giddiah Hill Road Ms. Tina Cormier 42 Tanbark Rd. . DATE A 02648 Marstons Mills, M 8/13/2007 Phone# 508-280-2525 Description of work to be perfromed Remove existing shingle roof.. Re-nail any loose boarding. Install ,032 aluminum heavy drip edge. Install WeatherWatch or Stormguard ice and water shield on bottom edge in valleys, around penetrations. Install 15 lb. underlayment felt. Install GAF brand Timberline 30 year architectural style shingles. All shingles to be storm nailed. Vent pipes to receive new flashing. Cut open and install Cobra ridge vent. All roofing related rubbish to be removed. All workmanship guaranteed for five years. COST 1/3 due with signed contract, 1/3 due when job is half done, 1/3 due TOtal Customer Signature The above prices,specifications,and conditions are 1 satisfactory,and hereby accepted. You are authorized to do Date of Acceptance l v ` a I0 the work as specified.Payment to be made as outlined above. Quote val In addition to the above,if Customer fails to make payment set forth above,then Customer agrees to pay Paul J.Cazcault reasonable costs and fees(including but not limited to Attorney's fees)incurred in collecting payment from Customer. Toll-free in MA: (800) 698-5569 Osterville: (508) 428-1177 a Orleans: (508) 255-5569 Falmouth: (508) 457-1141 Fax: (501 3� �ear<Q[; ii r ` 42 Tanbark Rd ' Marstons Mills MA 02648-1500 US T ' Notes: Tina Cormier 280-2525 j u �.. :MQPQUEST,;' �, p 600m Ln tons Mills - LIB+ 3 Dag Ip� �---�-�� Dy 'Q 20W MapQue•st Inc. palfQ�u P;13g afa t i�, �'7%\vT G1 or fe{eAl.: All rights reserved. Use Subject to License/Copyright This map is informational only. No representation is made or warranty given as to its content. User assumes all risk of use. MapQuest and its suppliers assume no responsibility for any loss or delay resulting from such use. http://www.mapquest.com/maps/print.adp?mapdata=jpKi8QRYVIpNy2deBGfB 5Z%252... 10/15/2007 Property Owner Must Complete & Sign This Form if Using a Roofer I Builder. as Owner / Agent I (print) oJ f the subject property hereby authorizes Paul J. Cazeault & Sons Roofing Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for Address of Job t Signature of Owner Mailing Address of Owner Telephone# D ate Please return this form to Ca roofing along with your signed contract; tthank you)fax#508-420-4555in the building permit required by your town, to complete your roofing project, Board of Building Regulati ns and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 103714 Type: Private Corporation PAUL J. CAZEAULT & SONS', INC. Expiration: 7/9/2008 Paul Cazeault 1031 MAIN ST OSTERVILLE, MA 02658 Updalc Address and return card. 111:u Ic reason for c11:111', -s-CAI a soon-o5/o6-Pco490 � L...I Address .�...I Renewal I � ISmploymcnt Lost Carl ✓lee 0�✓ ,pcce�u�4e(.�a . Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date, If fount) return to: Registration: 103714 Board of Building Regulations and Standards Expiration: 7/9/2008 One Ashburton Place Rnt 1301 Type: Private Corporation Boston,Ma.02108 DAUL J.CAZEAULT'A SONS,..INC. 'aul Cazeault ..a; 1031 MAIN ST JSTERVILLE, MA 02658 D iti Deputy Administrator Not valid without si nature gk13tT6Vruieg_4ula0V/bns4an ards One Ashburton Place - Room 1301 Boston.,Massachusetts 02108 Construction Supervisor License License CS: 26325 Restriction: 00 Birthdale: 10/20/1959 Expiration: 10/20/2009 Tr# 6311 PAUL J CAZEAULT 1031 MAIN ST OSTERVILLE, MA 02655 — Update Address and return card.Mark resson for change. BPS-CAI c, 50M o7/o7-pcai4so [I Address Renewal .Lost Card fie f7ammzanu t 5 �i, I �t ?Board of ling Rcgulatim► and Standards Construction Supervisor License License, CS 26325 i Birthdate:.•.10/20/1959 i. :c.: a: ;�;; Explratfoni10/20/2009 Tr# 6311 Restriction _00. PAUL.J CAZEAULT:': 1031 MAIN ST OSTERVILLE,MA 02655 Commissioner •RightFaX H1-2 PaQe� 003•� u 8/24/2007 1 ;21;48 PM PAGE 003/003 Fax Server ACORD. CERTIFICATE OF INSURANCE PRODUCER DATE(MM16D\YY) 08-24-07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION DOWLING&O'NEIL INS ACC ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 973 TYANNOUGH ROAD 2ND FL HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO BOX 1990 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW HYANNIS,MA.02601 COMPANIES AFFORDING COVERAGE 22LGR COMPANY INSURED A TRAVELERS DIRECT ASSIGNMCNT COMPANY PAUL J CAZSAULT&SONS INC. 9 1031 MAIN STREET COMPANY OSTERVILLE.MA 02655 C COMPANY p COVERAGE THIS IS TO.CERTII'Y THAT THE POUC16g OP INSURANCI3 USTED BROW RAVE 8ESN ISSUED TO THE INSURED NAM®ABOVE ppR TIiB POLICY PERIOD INOtCATED,NOTWITTeTANDINO ANY AFFORDED BY THE POLICIES CONDITION E EIN CONTRACT OR OTHER DOCUMENT WITH RMPEOTTO WWC ArAS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIEg DESCRIBED HEREIN IS SU13JECi TO ALLTHETERMB,EXCLUSIONS AND CONDITIONS OP SUCH POUOIEB. SE le S ED O MAY HAVE SEEN HE UCEDINSUR BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER DATE(MM►DDOLICY F DATE(MMIDDP GENERAL LIABILITY LIMIT$ COMMERCIAL OENERAL LIABILITY GENERAL AGGREGATE 3 CLAIMS MADE • OCCUR. PRODUCTS-COMP/OP AGO, a OWNER'S a8 CONTRACTOR'S PROT. PERSONAL&&AOV.INJURY i EACH OCCURRENCE y FIRE DAMAGE(Any one firs) S AUTOMOBILE LIABILITY ANY AUTO MEM EXPENSE(Any one Peron) $ ' ALL OWNED AUTOS. , COMBINED SINGLE LIMIT = SCHEDULE AUTOS BODILY INJURY(Par Pamon) b HIRED AUTOS BODILY INJURY(Par Acudenl) g NON-OWNED ALTOS PROPERTY DAMAGE g GARAGE LIABILITY ANY AUTOS AUTO ONLY-EA ACCIDENT g O'rHER THAN AUTO ONLY. EACH ACCIDENT S EXCESS LIABILITY AGREGATE $ UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE g WORKER'S COMPENSATION AND AGGREGATE g A EMPOLYER'S LIABILITY UB-0095864A-07 08.10.07 08-10-08 THE PROPRIETOR/ STATUTORY LIMITS X PARTNERSIEXECUTIVE X •INCL EACH ACCIDENT 4 100,000 OFFICERS ARE: EXCL DISEASE-POLICY LIMIT 5 500.000 OTHER DISEASE-EACH EMPLOYEE S 100,000 DESCRIPTION OF IS OPERAT1oNsILOCATIONSNEHICLBSIRESTRICT10NS1sPGClAt ITEMS TH REPLACES ANY P3ti0ACF1LTEICASE[SgTIED TOT'BL•CEAnFICArE HOLDER AbFECTn40 WOAKEkSCOb2 COVERAGE. CERTIFICATE HOLDER CANCELLATION -— —_ --� SHOULD ANY OF THE ABOVH DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TOMAX to DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L WT.WT PALURfi TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY WND UPON THE COMPANY,ITSAGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Charles J Clark i 12 UNHEATED ATTIC 11 I ASPHALT OR FIBERGLASS ROOF SHINGLES OVER APPROVED SHINGLE BACKING OVER 1 I EXTERIOR PLYWOOD EXISTING 2x8 I CEILING JOISTS CONTINUOUS RIDGE VENT @16"O.C. NEW 2x8 RIDGE BOARD EXISTING BEDROOM 2x6 RAFTERS@16"O.C. NEW 2-2x10s FLUSH WOOD ' ,�� � HEADER ABOVE w/JOIST II / 3/4"PLYWOOD SUBFLOOR HANGERS CLEARSPAN 6'-0'" EXISTING,2x10 JOISTS @ 16"O.0 NEW 12"R-38 I I . NEW 2-2x10s / NEW 2x6 EXTERIOR WALLS HEADER w/JOISTI INSULATED w/5 "R-21 F.G. HANGERS// INSUL. w 1- EXISTIN�2x4 EXT. 6 io WALL SECTION - NEW 1836 DH 0 GO NEW 1836 DH REMOV D @NEW / WINDOW C WINDOW PLYWOOD SUBFLOOR TO ENTRY -J MATCH EXISTING OVER 2x10 I / — P.T.JOISTS @ 16"O.C.w/ 3-6 2 X 4 BEARING W NEW 2x6 EXTERIOR WALLS JOIST HANGERS - NEW 3'0"MIN.P.C. w/R-21 INSUL EXI$TIfdB LPtjING ROOM STOOP w/STEP(S) 5 1/2"R-21 ��-- / EXISTING TO GRADE 3-2x8 P.T.WOOD BEAM w/ BEAM ANCHORS 2 X 10s @ 16"O.C. 12,6" 0„ 12 6„ "EXT.PLY.&TERMITE SHIELD _ ' 32'0" /i FLOOR PLAN I ; I , EXISTING BASEMENT 12"0 CONC.FILLED I SONOTUBE TO MIN.4'-0„ BELOW GRADE,ON 24" BIGFOOT FOOTING — — _ ._. . _ _ _.. .. -::: .. APOR MlL.;PO POLY VAPOR :.. �,-6 L . BARRIER 2'8 X 2' "X NON-ORGANIC EARTI/i .. M " :. N. :. " ; _..., .,: .:r. _.__,r ,_ . ,:.,:,.. s _... ............ : BUILDING SECTION w .T.» _ .......................... . . . : ... .......- .... :.. .. _. .. ..... ". . _ . ...-. . . .. ..:.. . . _ ._._. ., 1X8-RAKE..:..... ,. ..._ . .. .... - 80ARD :1 _ ".. >SHINGL€STOR ........... ._......- .....-. ..-. .. ..-.. ......... ....... _._. .... ... - r: ...... C . - - ❑❑o❑ ❑o ❑❑ ❑❑❑❑ - .......... ❑❑ ❑❑ w- _ - �..�: LNEW CEDAR CLAPBOARD P.T.STOOP @ 4"T.W.TO MATCH w/STEPS TO EXISTING GRADE ; NEW 3'-6"x T-0"FOYER FRONT ELEVATION i I PLANS FOR FOYER ADDITION R E YW'N G DESIGN DATE: APRIL?_0 2016 PROJECT: ADDITIONS&RENOVATIONS BOYAR RESIDENCE , 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH, MA 02537 SCALE: 1/4"_ 1'-0" 42 TANBARK ROAD MARSTONS MILLS < - ©2016 Greywing Design 508 888-0886 ` .9 reywl n g.co m (508) $$8-0886' All rights reserved.No copies may be made by any means without express,written permission. ---- _ - --- : - _ "" J PROJECT NO: G160414 SHEET A 1 OF 3