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0058 TREELINE DRIVE
J�' i O ��-. ,.. �...',' :-�.+..�_.....,.-_:..----. _.- '..G..�,l�.yyt'�4^'ti.� r•.TS*..w.'CA"!e'w' �^4�«'w/wr_ _ *' .r.►_..+.-- '?"` '.-'^��� /.' .- a. e ... � .. � _. .. "'w .:ram"�'. �� r 0 a _ .,. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ;. Z3 . Map Parcel Application o Health Division Z Date Issued Conservation Division Application Fee , � Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis ' Project Street Add ressR�,f L Villag ` VYA AR,S�J ).JS Owner a /j 1 4? V G E ram_ PS E,r%- Address 5 Il Zech/)t✓ -Y?a- C i ul) YA Telephone Permit Request ��(� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning.District Flood Plain Groundwater Overlay 4P y roject Valuation 5-0!T�, Construction TypeCA C o ' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sGp orting 4umeyEltation.; Dwelling Type: Single Family' ► Two Family ❑ Multi-Family (# units) `' `� o Age of Existing-Structure 19 Historic House: ❑Yes ❑ No On Old King's f ighway:"-b Yes ❑ No Basement Type: ZIFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) r d 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: 41(,/-as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes V�o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) • Name 6 a Telephone Number,T,bp— _Address .S P /�ZG'��/ /� License # Co %'-, / Z 09 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �.� FOR OFFICIAL USE ONLY g 1 . APPLICATION# DATE ISSUED MAP/PARCEL NO. ` w ADDRESS VILLAGE_ OWNER _ DATE OF INSPECTION: 1 F0UNDATI0Ni o_,, F o�.<� FRAME INSULATION. t FIREPLACE ELECTRICAL: r. ROUGH FINAL f PLUMBING: ROUGH . FINAL GAS: ROUGH FINAL FINAL BUILDING' .._A1Al oK ��Y��./�GfiLIL DATE CLOSED OUT ASSOC IATIOWPLAN NO. r Town of Barnstable Regulato,g Services BAIL'W"B' Thomas.F.Giiler,Director Buildingbivision Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office,: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW APP# z-o 130 YC" 3L Owner: � Map/Parcel: 0 4110/2- X 2 3 Project Address WN ��� Builder: cR#-/tLc The following items were noted on reviewing: r � ?G 1x6- 4as-r 7' I Reviewed by: G Date: l �3 i I I Q:Forms:Plnrvw I ►' The Commonwealth of Massachusetts viDepartment 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 �p n Name(Business/Organization/Individual):0 Q 1)rj] e o� Address: 5 C' Yi (— City/State/Zip: C -1 Phone#3 6 e C/l 9 3 Are you an employer?Check the appropriate box: Type of project(required): 1.El 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.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• t 9. ❑Building addition [No workers' comp. insurance comp. insurance. 10. Electrical repairs or additions required.] 5. ❑ We are a corporation and its ❑ P 9 3. I am a homeowner doing all work officers have exercised their l l.❑ 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.❑ 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. XContractors 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$1,50.0.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties of perjury that the information provided above ' true and correct Si atur Date: �71 "3 Phone#: 0 43 ) Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(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 permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related 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 Tel, #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia Town of Barnstable Regulatory Services s"u7SM Thomas F.Geiler,Director 19- 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 A� Please Print `DATE: 3 _ JOB LOCA ON: S� &e// n(> u l/� U t q,` number street village "HOMEOWNER"�G/��/C' 7 647 foie-4 CGi6 _3—Ucs '//� J/ /1C name home phone# work phone# CURRENT MAILING ADDRESS: a-4:I / Gil 3 5� city/town testate 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 e' and r"certifies that he/she understands the Town of Barnstable Building Department minimum inspection ocedures and re th he/she will comply with said procedures and requirements. ignature o Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. I C:\Users\dewllik\AppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRFSS.doc Revised 053012 Town of Barnstable Regulatory Services sn MASS.is Thomas F.Geiler,Director 0 9 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subje property hereby authorize t act on my-behalf, in all matt relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the r o sibility of the applicant. Pools are not to be filled or utilized before f is installed and all final inspections are performed and acc ted. Signature of Owner Signature of Applicant Print Name Print Name Da Q:FORM&OWNERPERMISSIONPOOLS 6/2012 LOT 18 LOT 21 97.21' LOT 22 LOT 23 60,470 sq.ft.f � ?gg r- �Q i R = 722.00' C� ! ryo L = 20.00' v N- 0 59 k 0 N N N X Q4,j `L9 V� 15a R 150.00' �J y L 42.36' O -i J 181.59 vS� / I THIS PLAN IS NEITHER INTENDED 1 s/s/92 INITIAL ISSUE ELK FOR, NOR SHALL IT BE USED FOR ND DATE DESCRIPTION BY MORTGAGE LOAN PURPOSES. AS—BUILT FOUNDATION PLAN—LOT 23 TREELINE DRIVE MASHPEE, MASSACHUSETTS FOR THEO CONSTRUCTION .CO. I CERTIFY THAT THE FOUNDATION PAULA. c�� SCALE: 1" = 60'1 JOB NO. 1583 SHOWN ON THIS PLAN IS LOCATED o LEVY 0 so 12q ON .THE G I AS. IND(CA NO. 10617 LEVY ELDREDGE & WAGNER ASSOCIATES INC. DATE R GIST RED LAND S U R VE YO '� ' ENCRO LANDSCAPE ARCHITECTS PLANNERS LAND SURVEYORS 889 WEST MAIN RTRF.FT Lo 4ti. r: 2rl3 tq x ' r Y- pD� = ---^ � w !jllj!!jj i Ph L jo _ _ ' R I: live 14 y � / . a - r � � Iz ram: tp. �.. ,�' }• - *j. , �' .. - t � '� f : .fir ;. i. 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I, i I t • _..,«. ` 1,7t ..+," �xd�' 1 ~� y ri t�• w '"t t VA _"�".' +••�,_ � ^!ff f ��;. �r�({�,1` _! .R �; � 1 J"r'r I JS""S j i. �,t r lr ! +`wy,�,� f.� �.7+ �� !"I,I � r" ��'�°'t'� ".i' r+�� `�. i t�}r.';F _ i j ,�. `I.aR1� j' r G/'.}.t,�' �� �'u�,�'•I.� �,1,, ''� , � S 4:� ` _� r , �'��� r r G��u�' � � ' �,�j i�''t�af /t�i,i+- :�: « ,��" —,I ��••/h�_�,K..r � f�� � � r• �tK'� � �' 1 ; S` r i A�'�' r�r � ! � ��,� •�14,r"`�/ rr,A f` �' '.4�'�, # \ � ' r� .�.? r!"A� � 11f! +�f �,' �S � �`�t t - •ri r Ali I � � y`� f �,� ) "+,. ".w�M1•'. �r'�' c. r} .� ¢' > r, V jw,,,:Y .,.Y-l f �. ryl� r t �Oj t, ; M• f. _ ` « 't ` T if / {/r 'f ter ;! .' I �r,r r ah ✓ s ;vl •� �.• r �''J; +! 'rl �,;`.+q�i` ' 7 *i _, )i +r., S r,' if r' ,ww'l. `S„E TF' .�„4 4•,1'♦. . l: h G � tt� � Zj � x lr t y}7 'K�ti r a•f �,4 � i��`�* k ,J� `,'+^,'e+' � � 1.. I r �'"x +/l r T� .i`i llirit ice`••�fil/ �' '�y ,\�{�rM1 «..F*4,w..s.,.' �` ; 'ti 'v««.. , t+! {j If �, 1 l'fiP:S« T� "`.'tti.`.� .,\vim f s•� 1,j� d t L•' ��.F�:fit - 1�_ o yxv Pad �aiao S7 ? oFVU A Town of Barnstable *Permit# Expires 6 mo VJro is ue dat • • Regulatory Seirvices Fee , • • • BARNSPABLE, • 1 '_ - Thomas F.Geiler,Director Building Division Tom Perry,CBO, Buildink Commissioner 200 Main Street,Hyannis;'MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-623 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint _.... Map/parcel Number 6 L{J D 0 X a 3 Property Address 'Residential Value of Work 0-0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address C L9 t.c ke �- Contractor's Name Telephone Number 4"-6 F Home Improvement Contractor License#(if applicable) 1 y 3 G Construction Supervisor's License#(if applicable) �� �° X.P®ES S PERMIT ER SIIT EAorkman's Compensation Insurance Check one: S E P 2 7 2012 ❑ I am a sole proprietor ❑ I am the Homeowner pI have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name `LL' lam. ✓ti �a Workman's Comp.Policy# W C �-- 1 5 -77 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ,R!�ke-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Ho a Improvement Contractors License&Construction Supervisors License is equi d. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 053012 e e onzrrrofi4e oHa—isa-chusetts Deparhnent of Indarstria1 Acczderay —0-,j)ice.-of_Investigations-._ - - a - , ,t Boston;.MA 02111 . `�.—Y wmv.mass govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Busines$/Or=animtionffndividuai): ---- Address:. .- e 1._ " (Q_-- i„- �G�lic-//.c - City/State/Zip: Phone#: Are you an employer:'Check the appropriate box: Type of project(required): 4. I am a general contractor and I 1�am a employer urith g 6. ❑New construction employees(full and/or part-time).* have hired the stub-contractors 2.❑ I am a sole proprietor or-partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors heave g- ❑Demolition working for mein any capacity. employees and have wodoers' 9. ❑Building addition [No workers' comp.insurance comp. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeoumer doing all work officers have exercised their 11-❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]' c. 152, §1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] 'Any apphcant that checks box#1 must also fill out the section below showing their workers'compensation policy information- 1 Homeownen who submit ibis affidavit indicating they are doing all wove and then hire outside contractors must submit a am af&dnit indicating such tConiractors that check this box mast attached m additianal sheet showing the came of the sub-contractors and state whether or not those entities have. employees. If the sub-contractors have employees,they must pravide their workers'comp.policy number. I am an employer that is proiuling workers'compensation insurance for my employees. Below is the police andlob site information. Insurance Company Name: L Policy#or Self-ins.Lic.#: 315 7 S yo Expiration.Date: Job Site Address: �,X_2 11,L, CityfState zip: G 0Y Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required unties Section.25A of MGL c, 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 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 ad that a copy of this statement may be forwarded to the(Office of Investigations of the DIA for mi saran overage tatitm I do hereby certify under the 'is d pert s ofpeti+jnuy that to informationprovidM above ' hue and correct S C Date: Phone M —' Official use only. Do not write in this area,to be completed by cii}r or town official. City or Tomm: PermitUcense 9 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Toxim Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: L l'1 V v• .-.�• r..v�.- v a a ....� .u. . ..v..., v• v v v . .w.. ....v a . v� I A v— � CERTIFICATE OF LIABILITY INSURANCE DATE(MWDOrYYYY) � . THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the temis and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER FRANK L HORGAN INS AGENCY INC CONrACTNAME: 44 BARNSTABLE ROAD PHONE INC,W Ext):(-508)775-5830 FAX(A/C Mo): (508)775-6688 HYANNIS, MA 02601 E-MAIL ADDRESS: INSURERS)AFFORDING COVERAGE NAIC A INSURERA: LIBERTY MUTUAL INSURANCE INSURED INSURER B: —— CAPE & ISLANDS CONSTRUCTION COMPANY INC -- PO BOX 210 INSURERC' CENTERVILLE MA 02632 INSURER0: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 13095795 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISPED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NJTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSI(M AND CAT)NDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE ----AD INSA SUBS POLICY NUMBER Q Y nnv oa�rY LIMITS GENERAL UABIUTY EACH00CURRENCE $ -- (XIMMERUALGENERALUABILI Y oaxrreloel $ (XAW MADE I—�O(n A MED EXP one-Berson) $ ----- PERSONAL&ADV INUURY $ GENERALAGGREGATE — $ — CZNL AGGREGATE LIMIT APPLIES PER: PRODUCTS.CCIVIPIOP AGG $ IaGucY ---- PRo --- Lnc —$ --- _— AUTOMOBILE UA9IUIV Wy—lllyop NULJ= $ ANY AlfrO BODILY INJURY(rat Netscn) $ —. ALLOMMED X�HEDIJL® -- — BODILY INJURY(Pet atxi ierY) $ _ AIJTCIi lfr(1S _ - FAUTOS ON CJNMEDa acd i $HREDAI-JrCXi — $ UMBRELLA LIAB 000 EACH OOCURRENCE $ — EXCESS LIAB (-.LAIM_S_MADE AGGREGATE $ _ DED RETENTICN$ $ _ --- ------------------------- $ A WORKERS COWENSAnoN WC5-31 S-377540-012 5/7/2012 5/7/2013 I-J AND ENPLOYERSLIABILITY Y/N ✓ T LMT lcm- ANY E-.L.EACH-A C-ODEN-T -- ---$- 100-.0._0_0 OrrICCMr a N/A , (Mandatory in NH) E.L.DLSEASE-EA av1PLOYE $a _100000 II es,cfet7llr.a ti — ' c Rlrmcrl OF OPFRATIM S I4mv E.L.DISEASE-POLICY UMTT $ 500006 I f DESCRIPTION OF OPERATIONS!LOCATIONS/VOiCLES{Attach ACORD 101,Additional Remarks e,If more space Js required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. CERTIFICATE"OLOER CANCELLATION SHOULD ANY OFTHE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF BARNSTABLE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 MAIN STREET ACCORDANCE WITH THE POLICY PROVISIONS_ HYANNIS MA 02601 AUTHORIZED REPRESENTATIVE Jeff Eldridge 46,1� — (1,1L' c(;`tc- 0 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD ,'.4:C tay.: 1.'-0`J:•!):. Nuk it�a:i)..9r SIIS/2012 8:59:01)AM Page 1 of 1 'ilea ::eLCifi.=,.� i.:SncaL•; ,;i:l —1,rsc[ks ALL I:ceviuusly issued certifieates. I _ '" Z Aug 2 17`201 s x: x R Cape & Islands Construction Co. a * f Y Y Po Box 210 d t, a �� � r e •s y `t� � � , Centerville Ma. 02632 508.775.7663 x • Connie Fagerberg (508)419-6355 58 Treeline Dr. Coyuit MA United States ID � • .- . . CERTAINTEED Certainteed Shingle Roof 8,114.40 2%Discount$165.60, Regular$8,280.00 Strip existing shingles from roof. Secure any loose sheathing. Install Hicks brand vented aluminum drip edge. Install Wip brand Ice&Water Shield to all eves, rakes, valleys and all protrusions. Install Surround brand Synthetic Felt Underlayment. Install Certainteed Quick Start starter shingles to all rakes&eves. Install Certainteed LIFETIME architectural shingles. Storm nail all shingles. (State building code requires 4 nails, we use 6) Re-flash all vent pipes with new boots. Install Rigid Vent II ridge venting. Remove and dispose of all job related waste. leave your property looking like we were never there! Provide all manufactures warranties and 15 year labor warranty, it's the longest in the business. Please note our wind warranty is also the best And longest available ANYWHERE! Total(0) $8,114.40 Signature Payments $0.00 Balance $8,114,40 Page 1 ._-•• Itt q.I T.IL IIII,ILI t•1 - "cilata t1IIV,,t M r t1 I?I IL .Jd I CIS ,. - ..+.. Board ot• Buildin!- Re-ulations anti Standards ✓/e r°arr��nwouuealt/ o�//ifaaaa�/,,caelt Construction Supervisor License Office of Consumer.Affairs&Busmess Regulation _ . R.OME IMPROVEMENT CONTRACTOR License: CS 74660 }` Registration:'. },65936 Type:.% . +t t, k Expiration 4/972014 Private Corporation JOSHUA X KOURI �t• CAPE-'&•ISLAND ddNST hJCThONCCO INC. PO BOX 210 CENTERVILLE, MA 02632 JOSHUA.KOURI N`� 55 ELM A. HYANNIS,MA 02601"� ,�:' Expiration: 2/12/2013 Undersecretary ('unuuissiuner Tr#i: 12106ij I I i i i i I Licenses registration-valid foe-individul:use only,.: I' bfore°the expiratton=.d'ate I•f found return to: r' Offi¢eriofkConsumer Affairs and Business Regulation e 10 P:arlc Plaza;=Surte 5170, Boston;MA 02'P16 -ai thout_gnature i t i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION q Map �y, Parcel 01A Application #1 l 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 5 Rp /W F AR Village ` Owner UIJMI� Address St- TR �t_NN6_ MWE Telephone 9_0�r- Permit Request ` Ow,9 T TWA- ok d P, �9MA3 i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Ng Flood Plain Groundwater Overlay Project Valuation �,O'90, Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family I Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing never Number of Bedrooms: existing _news a ;; 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: 0 Yes ;d No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ ne size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name NAI�K VOUAR Telephone Number Address po` X 6 q License # C:S y Te61� camrr, mP,, OoIL35- Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE V DATE J1�`11a f 1 = w FOR OFFICIAL USE ONLY APPLICATION# ` DATE ISSUED '1- s MAP/PARCEL N0: i ADDRESS VILLAGE OWNER ? DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL h FINAL BUILDING ® 7A. c� DATE CLOSED OUT` - ASSOCIATION PLAN NO,— - y� S ' } 4 _ .:: �Tke�ammortwealtli of hTassac3iu�et� . ' .. ' Deparftenf of fisdustrial Acc derzts Office of ficvesfigafiotrs -600 Washinktan Street. Boston,MA 02M -• www.mass:gIn Id& ' Workers' Compensation Iusu nnce Affidavit Buiiders/Contractors/Blee' ricians/Pliunbers 4pphcmt Information y� Please Print L eabiy Name(Bnsmess/prgani Uo ' Address: !' City/stateJzip o0�35 Phane.# Are you an employer? Check the appropriate box: 1.❑ 4ammn a 4. I am a F�7. yRzrm&hng ject(requ red):: employer with ❑ general contractor and Iopees(foIl and/or part-trine).* have hied the sub=cnrtractnrsconstruction 2. I am a'sole grrietor arpartner- listed ane'atlached sheet ship andhave no employees These sub-cofactors have li- don wanking far me i"any capacity. �loyees-and have workers'[No warkea' camp.ins�ce cb=p...ins�ce•#' g additron requited j 5. [] We are a carpo=ation and ocal repay or adcriti= 3.❑ I am a homeowner doing BM-work Officer;have exercised they 11 El ping repairs.or addIn.ons myself [No wariz:s' cOulp. right of exempticM per MQ, 12❑Rflaf repaas Insurance required.]t F. 152, §1(4), and we have no . employees. rgb workers' 13.❑ Other comp,insurance recpiited j Any applicant tbat checks btu:#1 must a190 M out the secfian bdow showing t�worksrs'coapensafion policy infnrmatitm Hnmeownets who submit this afdavit inFcafirng they are doing all work and thou hoe outside add caabmL=.must submit anew affidavitindicafi�g such Couhactrns that check this box mast attached an ificnial shoat showing the name of the sub�onttmtors and state whether ornot those entities have -Vloyf. IF fle sub� havo=3playcrz,ftmY=Stpmvidb feir wo>i sta'camp,policynumber. -ram an employer thy*is providing yporkers'compensation insurance for my employees. Be-Tow is the policy and job site information. Insurance Company Name: Policy#or Self ins.Lie.#k Bxpa-d on Date: Tob Site Address: My/Stawzip: Attach a copy of the workers' compensation policy declarafmu page-(showiug the policy number and expiration date). Fai hare.to.secme coverage as required under Section25A ofM(H,c 152 can lead to a ' ' ] fine up $1,500.00 and/or one-year ngpusamment,as.,vmn as civil penalties in the form offaa STOP WORORDER ands of m of up to $250.00 a day against the viohdnr. Be advised that a copy of this statemezk maybe farw�ded Office of Inve ins of the DIA for insmanne covara ver fication. I do hereby certify under the and d penaTfivo afpe�y that the in form�x provided above is faze acid correct SienairQe: ���S� � � Dam: �/AV Phone ✓ �oZ�'jW FM3 only. Do not write in thir area, to be completed by city or town official orwn: PerniiVLicense# hority(circle one): Health 2.Bmldiizg Department 3.Ciig/Tov�n Clerk 4.Ilectricai Inspector 5,plumhiag Inspector son: Phone#: Y T Town of Barnstable By BAYNSTARM Regulatory Services Thomas F_Geiler,Director Ft659, Building Division Toni Perry, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder T, (�-O a4l C as Owner of the subject.property hereby authorize VaLL/gCK to act on my behalf, in all matters relative to work authorized by this building permit application for. (.Address of job) �all Signature of Owne Date J Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. pf Th4E ra Town of Barnstable y� 0 Regulatory Services > izxszwsLF- Thomas F. Geiler,Director " �P ' ASS Building Division rEo t,w� Tom Perry,Building Commissioner 200 Maid Street, Hyannis,MA 026.01 www.town.barnstable.ma.us Office: 509-862-4038 Fax: S08-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village --""HOMEOWNER': name home phone# work_pbone# 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 ht:lmeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DERNMON OF BOMEOWNER Persons)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 bomeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109,1.1) The undersigned"homeowner'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that-he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the Saate Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION .The Code states that "Any homeowner performing work for which a building perTrdt is required shall be exempt from the provisions of this scclion.(Scction 109.1.1 -Licensing of construction Supervisors);provided that if the homcowna cngagcs a pc son(s)for hire to do such work.,that such Homeowner-shall act as supervisor." Many hofncownm who use this exemption arc 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 Superyisor is ultimately responsible. To ensure that the homeownef is fully await of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the r•csponnbilitics 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 forrn/ccrtification for use in your community. Q:forms:homccxcmpt I ✓t/e .01'er A'tI , • L License or•re istration valid for individul use only Office o ousuger arrs' rl3u��uess e u ith4 g before the expiration date. If found return to:.. �' --- HOME IMPROVEMENTCONT ,I G!:. p t Officir.of Consumer•Affairs and Business Regulation. -Registration - 10955$. ,Expiration: 9i2g12 Individual. 10 P:%rk,Plaza-.Suite 5170 ��� Boston;MA VOLLMER(I 02]16' .. MARK VOLLMER� I r1 1 55 SANTUIT NEB h COTUIT, MA 02635 `� r ;,;1 Unacrseret�.�y Not valid without signature Massachusetts- Department Of Puhlic S;1tee Board Of Building Regulations and St:111( ds Construction Supervisor License License: CS 47667 PHILLIP M VOLLMER - PO BOX 64 COTUIT, MA 02635 c— ��_ Expiration: 9/1/2013 ('unnuisviuncr Tr#: 598 i • uN A . b M ARSTOYS M I(LS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map © Parcel d l X C=3 Application# Heal6Division 0!6 2V�L—14 w 5 C e -ry) YYl Q", Gy Conservation Division 010 6 e- Permit# I �® Tax Collector Date Issued 'lw'7`� Treasurer- Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address s$ ln� 1� � Yz(✓� a ' Village c Owner Mrs Address %1'Z" 111>lue rat, Telephone Permit Request c�tJ�'1 /'� Y" 5,e_ . a?-7 A Square feet: 1 st floor:existing proposed a 2nd floor:existing sed Total new 3�y 1 Zoning District Flood Plain >' Groundwater Overlay ! ' Project Valuation ���Construction Type k)CCT Lot Size , 3d Grandfathered: ❑Yes #No If yes, attach supporting:--documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age,of Existing Structure Historic House: ❑Yes Flo On Old King's Highway: Q Yes to a, Basement T e.yp II ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) _ Basement Unfinished Area(sq.ft) Number of Baths: Full:existing oZ new t Half:existi Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new First Floor Room Count �C Heat Type and Fuel:pg�Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes '14o Fireplaces: Existing New Existing wood/coal stove: ❑Yes . >4e- Detached garage:❑existing ❑new size---"Pool:❑existing ❑new size Barn:❑existing ❑new size '--- Attached garage?Vxisting ❑new size---- Shed:PIxisting ❑new size— Other: Zoning Board of Appeals Authorization ❑- Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# Current.,Use__.. -Proposed Use _ BUILDER INFORMATION Name &J Telephone Number 5DS' Li Z23- qa. Z q Address Z 1 S 'A` ''11 License# ��� t A4 Ou A Home Improvement Contractor# WTO t Worker's Compensation# ALL CONSTRUCTION DEf IS RESULTING FROM HIS PROJECT WILL BETAKEN TO S�1"W�G�� CAS et--A SIGNATURE DATE *tll-� ` d ©� FOR OFFICIAL USE ONLY 2 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE 4 q OWNER DATE OF INSPECTION: FOUNDATION FRAME l l yYl A4rPl6me � �S w'tlto� INSULATION _R,rA FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ��'�� Ok-- l!o�s, RGn� li•IF7tJ�l it.fts,�rS`t _ a DATE CLOSED OUT ASSOCIATION PLAN NO. I� 1 °FtT Town of Barnstable regulatory Services 9R&MSTABLF, Thomas F.Geller,Director 039. 0. BuRding Division. Tom Perry, Building Commissioner 200 Main Sheet, Hyannis,MA 02601 ww mtown.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner,must Complete and Sign This Section If Using A•Builder as Owner of the subject property hereby authorize �alll,l to act on my behalf, in all matters relative to work authorized by this boil g permit application for. (Address of Job) Signature o£'Owner Dfte Print Name Q:FORMS:OWNERPERMLSSION Town of Barnstable Regulatory Services miNs-rAimMAM Thomas F. Geiler,Director Building Division Thomas Perry,CBO,Building.Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: ic/E Map/Parcel: ' o f 0 Z Project Address �8 ��1GIlU der: /9L-5 Iv The following items were noted on reviewing: rlo1J V '��irJlc 96 G &EL .Reviewed by: Date: 1,11 0i Q:Forms:Plnrvw n.;. U QWW Rl EO O = SIIIOOMS"; :: .. ^r M:. 1 aches State uildin Co e: D� > 11 en echo L :2'3:1 w The Massachusetts State Building Code(780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency' standards. This supplemental .CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, consfiucting/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to,an existing house (780.CMR; Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration,orientation,form*of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design donsiderations that .a homeowner may 'wish to consider before actually constructinglinstalIing a"sunroom".It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential-.energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading - • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealingand'gasketing materials/.seal durability and/or weather tightness of the sunroom • Adequate ventilation-Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.123.1,..requires that the actual vroverty owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes'"sunroom" additions to an-existing residential building. In accordance with is ment, the undersigned hereby acknowledges that she/he has read the information in this doc en erniiig.sunroom comfort and ergy conservation. 6 ture of A uild' Owner Date Print Name Address of Permitted Project Owner Address(if different than project location) Owner's telephone number i I LOT 18 LOT 21 97.21' LOT 22 LOT 23 60,470 sq.ft.f 299 ss, r- Q- O oI R = 722.00' 00 a. o O g9 p Lo (v �O R = 150.00' �� Y L 42.36' 0 O 181.59' THIS PLAN IS NEITHER INTENDED 1 6 6 92 INITIAL ISSUE ELK FOR, NOR SHALL IT BE USED FOR NO. DATE DESCRIPTION MORTGAGE LOAN PURPOSES. AS—BUILT FOUNDATION PLAN—LOT 23Y TREELINE DRIVE MASHPEE, MASSACHUSETTS p'.(H or Ike vP FOR I CERTIFY THAT THE FOUNDATION THEO CONSTRUCTION CO. °� PAUL q, 9c�c SCALE: 1" = 60' JOB NO. 1583 SHOWN ON THIS PLAN IS LOCATED ON .THE G LEVY 0 60 120 � T AS. INDICA No. 10617 y DATE R GIST RED AND SURVEYO F �� ENGINM' ELgDsEVE�H WAnM GNER UyD SUREYOiS ,`p`�� 889 WEST MAIN °F�► , Town of Barnstable Regulatory Services anxx S. Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-8624038 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: rLocy� Estimated.Cos ,N Address of Work: Owner's Name: '1\/t�-- Date of Application: A ®(-� 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 F PERJURY I hereb apply for a permit as the agent of the owner: D7 Contract ame Registration No. OR Date Owner's Name Q:fonns:homeaffidav SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C LLSYSTEM INFORMATION (continued) Property Address: 5-�Tre�11 V►C. Owner: j�}( Lf SGZ Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM: include ties to at least two permanent references landmarks or benchmarks locate all wells within 100' (Locate where public water supply comes into house) I off r V 4V \ , I sery.C� 3o>L ear ) 1 I (revised 04/25/97) Page 9 of 10 I I i REV, JONS + TRM-ion y� i BOARD OF BUILDP P RECillIJ1TIONS . License: CONSTRUCTION SUPERVISOR NumberS� 058376 is Birttt49I1959 I � '. 7 Tr.no: 318.0 •0 81.1:9 Rts�, tr. DAVID P SHASTANN:.�y. 7 12 VISTA CIR «;•.. �;. � MASHPEE, MA 02fi48,s,;:= Commisslorier , r ,per TAe V�ovivnzaruoea/!/a o� aaocu/u�aeQ2 Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration-*.._108901 Ezplratlon=g/27l2006 rivate Corporation REVIS!ONS,INC.""... David Shastany 12 VISTA CIR MASHPEE,MA 02649 Administrator 12 Vista Circle Mashpee,MA 02649 (508)428-9929 CONE.RIDGE VENT TWIU1 ROOT OONS!RURION 2%10 RIDGE B D ITYP.) r ASPHALT ROOT SHINGLES AVER , , it P.T 2 JI. MER'80.DI' L_-- , APPROVED SHINGLE BAC%MG OVER I%8 COLIAR TIES O 18.O.C. ----- 1/2•WM.PLYWOOD(HR)OVER ` ROOF RNTERS(TYPICAL) __- 2%8's O Ia,O.C. V.]IS GE I' 2 Ppporol L E)BsTT NGG7 �—` 4Fe__ UC�SIBSQS 8� C. 'I - ��:RLAS�� N W] R.T.2% 05 D EA4 _- R. %6'S O C.(CEILING J05T5) / I - __ \fir E NEW - Q 'I P. 2%B'S opD BEA. I!i /I 3 SEASON it I _ _ 3 SUNROOM ,-; ,. r,\ tl h 3/4•T k G PLYW000 SUBROOR O I ii P..2 10 ISTS __ ______ __ I i ri -�SCNEEn_ __ ______ __ I� e c __ NEW 3 SEASON - SUNROOM _ 8•0 CONC.FIILLO SONMBE M1 ry e ON'81GFOpT•BASE ON CONC.TILLED SO--0- \ ON•B ELO G BASE 4'-0' 0 MIN.BELOW GRApE(TYPCAL) 4'-10• 8•-4' 4'-10• U B'-10, W-10, BUILDING SECTION IV-0, w 0 FOUNDATION PLAN FIRST FLOOR PLAN J I■]SHINGLE STOP WER 0 RA%E BOARD(TP.) 0 J 12 (n ASPHALT OR F.G.ROOF SHINGLES 7I LIJ ASP 0 HALT CR F.G.ROOF SHIN- a RIGHT ELEVATION REAR ELEVATION U LEFT ELEVATION (A LL.; 0 I�I SCALE: DATE: PRO,), �: J L t' L \`� I PLANS, SECTION & ELEVATIONS '�4r—' —0 's—Auc—zooz 1666 �i NEW CUSTOM HOME SHEET #: JEFFREY A. BARNABY C LIVING DESIGNS 2002 CERTIFIED PROFESSIONAL BUILDING DESIGNER Shasta Construction ,BE6E z 127 PINKHAINKHAM ROAD, EAST SAN➢VICH, MA. 0-2537 Sandwich, Ma mecNRucO°�`m.o EDaRi6r'"``p`TEL. 508-888-2747 • . Puxs AE ro'.Xo a E TMLE M jl=o 1 IMVG OE6N.'V6 PR :HE START OF AC2[ QF t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map (/ / Parcel V Apples s icy#- / 0) Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis `Project`Street Address �f f-� /N /G Villae�� 9 Owner -TAW V I IV Addr�,___P ��Y; �- Square feet: 1 st floor:existing proposed 2nd floor:existing proposed TotaLnew m Zoning District Flood Plain Groundwater Overlay `r ` - ' Project Valuati � Construction Type x , Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting docu entation Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Cl 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 _ U'` ILDER-INFORMATION Nab mew^: OIDP f tM. ��.�i M�: elep one Number 7 �l - 7')�- n 'da[I $'(soh' Address, c Imo, -r License# 06 Z T p la MA A Home Improvement Contractor# / 2 d '7 / 2 Worker's Compensation# ALL-CONSTRUCTION'DEBAIS'RESULTING'FROM THIS"PROJECT"WILL BE-TAKEN_TO O SIGNATURE C__DAT-E_--'7 D J t FOR OFFICIAL USE ONLY 1 _ PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE, �1 OWNER, ./' DATE OF INSPECTION: I`.. -FOUNDATION i FRAME INSULATION = FIREPLACE ELECTRICAL: ROUGH FINAL - 1 1 'PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING , . 't DATE'CLOSED OUT t ASSOCIATION PLAN NO: ,r , ," < ^x _ +'. - v /�.. yli•1YY!! .�•Y' ' ys: '..ey..a1 _N n:r-vt�•vM'ec'R.S♦ IH?s".r.. _4VCtf.', Vi-3 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . -Map / Parcel V Application# . � Health Division Conservation Division Permit# , Tax Collector Date Issued J - � �' Treasurer Application Fee�g� l I Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ty Historic-OKH Preservation/Hyannis Project Street Address 7-yL'� A I N G /,� 1G / �I 1 I G Village Pj f� IU !-) , F' ,►� Owner 1`- on . )7 4 ! N -r-_ Address n 17, F_ I' Telephone r r � I Permit Request Al , � � 1�1� � � -r R k, �t •e J o 0),a y � f {I,. I I ( '(�_" , 0,h (_Ul A fo Square feet: 1 st floor:existing proposed `2nd floor:existing proposed Total new • Zoning District Flood Plain Groundwater Overlay ` u -r Project Valuation ` 0 0 Construction Type I Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation r; Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑,Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No QL 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� I`ye site p review Current Use Proposed Use rr , BUILDER INFORMATION Name _ 0 P"I VV u� V Q(� SQW 5 �C° �T r < Telephone Number �1 I� r • 1, 0 bid 2 Qrg & 0t7 Address ')7 q ��I A � M ry�+a !� �. �r License# 7 n w MA YA Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTINGFROM THIS PROJECT WILL BE TAKEN TO ► I '� ' ~`fir` � •:'�•mil. i 1 �— t i!/ lj t . SIGNATURE V "� ` DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. r j ADDRESS VILLAGE 4- OWNER i DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.. I The Commonwealth of Massachusetts ( ,; Department of Industrial Accidents �� 1 Office of Investigations Ili 1 a 600 Washington Street Boston, M4 02111 �11 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly N am(Business/Organization/Individual): �jP�'? � foQ U ) AeR �!� Ye Addresl s� p C,ity/State/Zip ,�T���L Phone#: c t 6 97 N � - Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4t❑'I am g_ 1_csntfactor andh 6. ❑New construction employees(full and/or part-time).* _ - ^ haze hired thewsub;contractor� 2. I am a sole proprietor or partner- Clisted on the attached sfieeCt �• ®Remodeling ship and have no employees —These sub=cQntractors'have� 8. ❑ Demolition �-- working for me in any capacity. , er 'comprance; 9. Building addition [No workers' comp. insurance 5. JFZetne��R ��6rtonand_l ts required.] officers have exercised their 10.❑Electrical repairs or additions 3 I am a homeowner doing all-work right of exemption per MGL 11.❑Plumbing repairs 6r additions . myself.`[Nowoikers'—comp: c. 152, §1(4),andwe have no 12.[]Roof repairs �msuranc_em equir�ed:]-t-1 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. tContractors 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 employei that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a . fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify d the pains and Penalties of perjury that the information provided above is true and correct ate Phone#: Of use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificates).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"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum 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 lavestigations 600 Washbgton Street Boston,UA Q2111- Teal. #617-727-4900 ext 406 or 1-8.7-7-MASSAFB Fax.#i 617-727-7749 Revised 5-26-05 wwwanass.gov/dia r E p 1 V TV11 V1 LLLK JLLOL"LFAWL+ Regulatory Services �xxsr�tE.$ Thomas F,Geiler,Director UAss. 9�p,ED u,,►�� Building Division Tom.Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Face: 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 v ith other requirements. # - - �Tl9yyrg O iU �QeA Estimated Cost T-ype-of VJork:� /?� � fi'Dcz) ° Address ofWorlc: Lit--e Owner's Name: 4 A d— i Aw► C Date pplicat on - - CS I hereby certify that: Registration is not required for the following reason(s): Work excluded by law .Job Under S 1,000 []Building_not owner occupied �QOwner 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 o Date Contractor. Signature Registration No. OR ate Owner's Signature Q.wPM.s.forms: eaffidav ` r� Rev: 060606 i ��t ►°,,� Town of Barnstable Regulatory Services vWXNSTABLE� Thomas F.Geiler,Director Building Division �fD MA'S Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 i Office: 508-862-4038 Fax: 508-790-6230 _ NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY I, , Construction Supervisor License. # , hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit# �v / , issued to (property address)!i: T�..r7 on L , 2000. The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form(if applicable) copy of my Home Improvement Contractor registration (if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LICENSE HOLDER DATE q/forms/newcontrb 74,, V/dl7tgYLO-U/ a� ,I Board of Building Regulation.and Standards ~ Construction Supervisor License { Lice2e. CS 64492 �.. Birthda_ 14/1952 A; Expiration=tit°l1 2008 �. Restnchorr-0.: ROBERT M DEVIrIt 729 OLD RANDOLA - ABINGTON,MA 0235 - g> Commissioner J �/xe.�por, uuea�t� � aaac/uaell '. use -Board of Building Regulations and Standards Li fore the expiration date:If foundn,'Aid for treturn to only be HOME IMgROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration',1.20712 j One Ashburton Place Rm 1,301 _Ezpir`a`tlon:-2 25 2008 Boston,Ma.02108 -TY D A SEA-SIDE CONSTRUCTI;QN i �_ ROBERT DEVINE 7 - --- ---- 729 OLD Rp,NDOLPYd?S«r "' Not valid without signature ' ABINGTON,MA 02351 Deputy Administrator I Town of Barnstable Regulatory Services i BARNSfAKX, • 9 MASS. Thomas F.Geller,Director �'AlfD MAC A )Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 w w-town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Own er of the subject property hereby authorize dl �. 1� �J�u to act on my behalf, in all matters relative to.work authorized by this building permit application for: . dim (Address of Job Signa of Owner Date ANC S. � v Print Name Q FO R.M&OwNE"ERM IS S ION �114E,, � TOWN OF BARNSTABLE Building0 PPA lication Ref: 91509 BASTASLE, Issue Date: 09/18/07 Permit RN 9 MASS Q�Ar16 3�a� Applicant: Permit Number: B 20072256 Proposed Use: SINGLE FAMILY HOME Expiration Date: 03/17/08 Location 58 TREELINE DRIVE Zoning District RF Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 041012X23 Permit Fee$ 25.00 Contractor DEVINE,ROBERT Village LS App Fee$ 25.00 License Num 64492 C Est Construction Cost$ 40,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 18X18 3 SEASON SUN ROOM THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DEVINE, JANIS M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 58 TREELINE DR INSPECTION HAS BEEN MADE. COTUIT, MA 02635 G Application Entered by: PC Building Permit Issued By: `G �G�A-�/`� / THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY 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 FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). o I E BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health Town of Barnstable Regulatory Services sat MASS,t.E Thomas F.Geller,Director Mass. o a+"�0� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR owner of property located at i i l.Ol lay.. ��hereby certify that is no longer Construction Supervisor listed on the application for the project under onstruction as authorized by , -- building permit# q(t) , issued on 200� I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. PERTY OWNER DATE q/forms/newcontr reference R-5 780 CMR rev:080102 TOWN OF BARNSTABLE' Permit No. . 35110 BUILDINGDEPARTMENT I s.a,n I TOWN O FICE BUILDING Cash HYANNIS.MASS.02601 . Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Theo Construction Co. . . Address Lot #23, 58 Treeline Drive Marstons Mills, Mass. USE GROUP FIRE GRADING OCCUPANCY LOAD 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. g .ui August 5 92 Bulding nspector 4 17,OWN OF BARNSTABLE; Ii ,6SACHUSETTS BUILDING. PERMI' g$ ' A=041--012-23 i ® QQ j� 041-012-14 ;-. DATE juitle Vie 9 19 92 PERMIT NO. z P'U !) ' APPLICANT (?Saner ' ADDRESS Listed Below #019609 't s (NO.) (STREET) E t Jq (: (CONTR'S LICENSE) PERMIT TO Aulld Dwell- _ " (1 ) STORY Sin Family DwelllnQNUMBER OF (TYPE OF IMPRQ EMENT) - NO. DWELLING UNITS (PROPOSED USE) AT (COCATION) Lot `#23t 58' Treeline •,rive, Marstons Mills ZONING RF (STREET) DISTRICT . ') BETWEEN ` 5 AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE I ' BUILDING IS,TO BE FT.,WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI TO TYPE USE GROUP' BASEMENT WALLS OR FOUNDATION Sewage #92-145 (TYPE) REMARKS: f Bond i iAREA-E• 1,388 sq ft-:w' EIS,000'. OO FEE PERMIT $ 69.50 k t ESTIMATED COST$ (CUB.IC/SQUARE FEET). _ , �S OWNER ' Thew Cunutruction .Co. I ADDRESS 24 Great Pond- Drive, Jo. Yi:1ra1out:II BUILDING DEPT. ! By Y' THIS PERMIT•CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY < ► PERMA EfTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT CODE, MUST BE A PROVE '�q••yy THE JURISDICTION. STREET OR ALLEY GRADES AS SPECIFICALLY PERMITTED UNDER THE BUILDING WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE FROM Tr1AEPARTMENT OF PUBLIC WORKS.-THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIO: OF ANY.A4 LICABLE SUBDIVISION RESTRICTIONS. MINIMUM THREE CALL I.NSPEC -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION REQUIRED FOR WORKS CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN' PERMITS ARE REQUIRED FOR V. FOUNDATIONS OR FOOTINGS. ELECTRICAL, PLUMBING AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS., 2. PRIOR TO•COVER(NG STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL ME AL I`NSRECTI .TO EFOR,E FINAL INSPECTION HAS BEEN MADE. 3. FINAL kJSPE�CTION BEFORE OCCUPANCY: '� •A" POST THIS CARD SO IT IS VISIBLE FROM STREET BUI�C IING(INSPECTION APPROV S PLUMBING INSPECTION APPROVALS. ELECTRICAL INSPECTION APPROVALS 2 z�I. / !� ��l� 3 HEATING INSPECTION APPROVALS ENGINEERW DEPARTMENT Z OF HEALTH 'OTHER , orf SITE PLAN REVIEW APPROVAL -1 r3oaa pf- WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION :TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED W)THIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY TELEPHONE OR WRITT NOTIFICATION. LOT 18 LOT 21 97.21' LOT 22 LOT 23 60,470 sq.ft.f �? 2 9g S6' Q Z R = 722.00' i. ryo' L = 20.00' tea. 0 O Q Q 1h$ co L = 42.36' J � v 181.59 1 6/6 92 1 INITIAL ISSUE ELK THIS PLAN IS NEITHER INTENDED NO.1 DATE I DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR AS—BUILT FOUNDATION PLAN—LOT 23 MORTGAGE LOAN PURPOSES. TREELINE DRIVE IN MASHPEE, MASSACHUSETTS FOR �Pti�N°r'�'� THEO CONSTRUCTION CO. � 'cy SCALE: 1" = 60' JOB NO. 1583 I CERTIFY THAT THE FOUNDATION PAUL A. e+ SHOWN ON THIS PLAN IS LOCATED LEVY 4 . 0 ` 60 120 ON THE G AS INDICA -I\ No. 1G517 �— =- LEVY, ELDREDGE & WAGNER ASSOCIATES INC. DATE R GIST RED AND SURVEY ENGINEERS LANDSCAPE ARCHITECTS PLANNERS LAND SURVEYORS 889 WEST MAIN STREET CENTERVILLE, MA 02632 r Afsq9sor's map and lot number o y�• o/a2 • /� sl�f� �� G/a `''� i t �0 THE Sewage Permit number ..... .. ........ . ............�14 ...... SEP77C sysTEM Sb' INSTALLED IN COM E. House number V!/171'I I........................ (, TITLE ° i639.a���° ENVIRONNIE AL CO® ' aY TOWN OF BA' `RNSTAf GULATIONS -/y 1LDING INSPECTOR APPLICATION FOR PERMIT TO ...:Go/V,57. R. 1.�,�7...... ....&M—g........................................................ TYPE OF CONSTRUCTION ...FA ..&Y....6�..r. W..... ...... ........................... �.�1/.........19..9v�, TO THE INSPECTOR OF BUILDINGS:' The undersigned hereby applies for a permit according to the following information: Location co-- ? Z-141E d,�. l�'�.•./fl ALL Proposed Use 1�.1 G .E.......fi9/!'�1.4.y......6, EGC,//Lf!r........J..IQ N..G ........a�.�f Zoning District .......��.5..!.ZlEM..T..?�.�,..../.. ............................ District .............................................................................. Name of Owner .�fi�4�d... !V.S.T1 GT/.�!v..cd .........Address .. .`1...... tJ.li,lta..... 1........ a.,.... . Nameof Builder ....................... Ct'J.6.............................Address ..................... ...........:.................................................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .....................�-rT..........:.............................Foundation ....... ....../..C/.......X..za . Css9fb Exterior-4J4,' lt. ..' ... ✓N./T ` !!C...�S!�!!!!�TSRoofing .................................................................................... /r Floors CA!IP ....... GL.....^L�!!!r7L El i1...............Interior ...�rY ',SL!s''1........................... . ........... Heating1 ......."7? .......... r.!S.,.............................Plumbing .... ...�............ '/4T y.......................................... Fireplace ......................................Approximate. Cost ...... O�O, A� Definitive Plan Approved by Planning Board _______ __`____ ______19 Area ..0't—MT......................... Diagram of Lot and Building with Dimensions' ' Fee .................9-DSO .................................. 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. Name ............................ ... .................................. ..... Construction Supervisor's License ......................... !THEO CONSTRUCTION CO. .35110 permit f On Story ,� Fn ........ ... ................ Sin91e Fam: D ling Lot 2 58 eeline Drive Location ...... Marston 11 Owner THEO C RU TION,CO.......... Type✓of Construction ... Frame ....................................... ... ........................ f sj Plot ....................... Lot ................................ Permit Granted ..,,,June 9 , 19 92 Date of Inspection��7.), -y - —.............19 Date om tedy/7o�..................19 ,, ,. s 1 • 3 �1, �1 G14 1 MNEY -77 I I W o cm 'dEG K L., - II SHINC, LE<j -i I I 'I-•• i t I , I � , I - . I ._.i-. ..1 - GoT a 3 F-L.EV�-TION MAtYf1-OWEP 1;FANC+j SGA.LE- I/fir = I -c) �.p. '/--', TIf 12�'x 1of., 12 10 8ra2oori �EaRool-t 9 x-7 0."•orz- N I �-O Op, 'F�T .N MAYfLOWV;1 .NCH -�a 20' MINIMUM OR AS INDICATED ON PLAN NOTES: 10' MIN. 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.Q.E. MASONRY EXTENSION TO 12" BELOW GRADE TITLE 5 ; THE TOWN OF ----- RULES AND TOP OF FOUNDATION BACKFILL WITH �T s` MIN. ��.© 7.o CLEAN SAND REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE; 6 �,-- -- GRADE MASONRY EXTENSION To 12' AND THE REQUIREMENTS OF THIS PLAN. ~ 2. ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO l WITHIN 12 OF FINISHED GRADE. MI SCH, H PVC PIPE -3. ALL MASONRY UNITS USED TO BRING COVERS TO GRADE x MIN. PITCH 1/8" PER FT. a �.�, ..., 2' LAYER OF SHALL BE MORTARED IN PLACE. Locu�a ' 4 PeR EE urlE TO 4. ALL COMPONENTS OF THE SANITARY SYSTEM 'SHALL BE CAPABLE - 10" TEE J WASHED STONE :0 3- MIN. 2•_0- -- i OF WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR 2- MIN. LEVEL G`'110N WITHIN '10 FT. ' OF DRIVES OR -PARKING AREAS. H-20 LOADING w LEACH 4'-0�z, g MIN. 6�. 2 PIT SHALL BE USED UNDER OR WITHIN 10 FT. OF DRIVES OR LIQUID DISTRIBUTION G2.0 U WASHED STONE PARKING. LEVELBox S It TION HAS BEEN MADE AS TO COMPLIANCE WITH DEED RESTRICT ONS OR ZONING REGULATIONS. OWNER/APPLICANT SHALL OBTAIN SUCH :DETERMINATION FROM THE APPROPRIATE AUTHORITY. LOCATION MAP GALLON SEPTIC TANK i 6. HORIZONTAL AND VERTICAL CONTROL, SEE LEVY, ELDREDGE & WAGNER FIELD NOTEBOOK 'c © ASSESSORS MAP #--- L-_ PARCEL LIQUID DEPTH IN SEPTIC TANK DEPTH OF OUTLET TEE BELOW FLOW LINE BOTTOM OF TEST HOLE 4 FEET 14 INCHES 50a5 l s FEET 19 INCHES OR USGS PROBABLE HIGH WATER LEVEL } 6 FEET 24 INCHES 4 Y CURRENT ZONING INTERPRETATION: DESIGN CALCULATIONS SEWAGE DISPOSAL SYSTEM PROFILE i MIN. FRONT SETBACK = FEET NUMBER OF BEDROOMS 3 NOT TO SCALE GARBAGE DISPOSAL UNIT I MIN. SIDE SETBACK r� FEET -L'� d TOTAL ESTIMATED FLOW MIN, REAR SETBACK L FEET (irk GAL./BR./DAY X .� BR.) ?� GAL. /DAY REQUIRED -SEPTIC TANK CAPACITY 45tS GAL. " , ACTUAL SIZE OF SEPTIC TANK 00 GAL. PERCOLATION SOIL TEST P_ '26 7 "/ LEACHING AREA REQUIREMENTS SIDEWALL AREA ,2,5 GPD./S:F. BOTTOM AREA 40 GPD:/S.F. f%c DATE OF SOIL ' TEST 7 Je- SIDEWALL 27T( /0 /2)( ! )SF x GPD/SF = 47/ GAL/DAY TEST BY 1 �, BOTTOM 7T ( /o '/2)2 SF x GPD/SF = 79 GAL/DAY WITNESSED BY PERCOLATION RATE 7-U)c MIN./INCH SF GAL/DAY EST PIT #1 TEST,. PIT #2 BREAKOUT CALCULA h'ON: '\ ELEV.= ��+�.c ELEV.- �.. �. 0.00 0.00 \ &p1 • 70 <rI LEGEND : , EXISTING SPOT ELEVATION OOXO EXISTING CONTOUR-------00----- ` FINAL SPOT ELEVATION 00.0 FINAL CONTOUR TP BOTTOM OF TEST HOLE BOTTOM OF TEST HOLE SOIL TEST PIT LOCATION O r OR WATER ELEV. ' OR WATER ELEV. TOWN WATER W W y SEPTIC TANKIle o 0 DISTRIBUTION BOX 0 WATER LEVEL ADJUSTMENT: PRIMARY LEACHING PIT `' ... , ✓ ,, I, RESERVE LEACHING PIT101, TEST DATE WATER LEVEL INDEX WELL ,�... -- `— -- •'� .,� ..- ,,�� WATER LEVEL RANGE ZONE 4 �, yZ r 5 / / INITIAL ISSUE S l \ __.._-.--•-p�- ,�,, ✓' DEPTH TO WATER LEVEL FOR INDEX WELL NO. DATE t} DESCRIPTION BY FOR MONTH OF: `o WATER LEVEL ADJUSTMENT J r= ! Lo-r 23 1k'L c t_1A/E a ZlV e DEPTH TO HIGH WATER 7H6'0 C0Aj.`5T"rc'UC770lV CC, _rAlG, APPROVED. BOARD OF HEALTH sTEPHE s. ALLYN wlLso No 30 16 ' SCALE:��t / '-!o JOB N0. 44.5=r3-3 h p ISTS SITE PLAN DATE AGENT LEVY, ELDREDGE & WAGNER ASSOCIATES .INC. ;PERMIT BNGMM- LAWAPI ARCHIT= PLANNERS LAND SURVBI'ORS' 889 S _ WE T MAIN STREET... CENTERVILLE`MA 02632