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0121 TROTTERS LANE
.. r _ � - -- oP"E. Town of Barnstable Building t BTABLE. Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept • BA&v 1M^� Posted Until Final Inspection Has Been Made. Permit esa .� . �t° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-2227 Applicant Name: Stephen Dickinson Approvals Date Issued: 07/12/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 01/12/2020 Foundation: Location: 121 TROTTERS LANE, MARSTONS MILLS Map/Lot: 032-016 ^ _ Zoning District: RF Sheathing: Owner on Record: WAN,AARON Contractor Name:`-,SSTEPHEN T DICKINSON Framing: 1 Address: 121 TROTTERS LANE Contractor License: CS=081843 2 MARSTONS MILLS, MA 02648 `� Est. Project Cost: $ 2,589.00 Chimney: Description: Same for same, replacing 1 double sliding door u factor 0.28 Permit Fee: $35.00 rl � Insulation: Project Review Req: f Fee Paid::t $35.00 Date- ,f 7/12/2019 Final: Plumbing/Gas f Rough Plumbing: - -- -------—._ ``tBuilding Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withir'six months after`issuance. All work authorized by this permit shall conform to the approved application and thesapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the work until the completion of the same. - -•--�-- � Electrical � The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection --~- 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site � ��' Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 6pz �-1 j i Town of Barnstable THE Tqy� Regulatory Services TO OFRfSTp�LE Thomas F.Geiler,Director MASS. � Building Division 1013 NOV �� �'f; ■naxseA BLE. + E1639. a` Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Q1V1S10 -"-® Office: 508-862-4038 Fax: 508-790-6230 PERMIT# 20/,3 Q Fa 5 S FEE: $ t SHED REGISTRATION1� r RESIDENTIAL ONLY 200 square feet or less 121 -T/ZO TTE2 S L.A-1\16- MA-RSTONs IW lZ-Z .s Location of shed(address) Village AARON YVAA/ 917 -- 5/- 9z13 Property owner's name Telephone number �'eef 6y 8 f e et 0 3 2- Size of Shed Map/Parcel# VJ 1 Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) 'Sign off hours for Conservation 8:00-9:30_&3:30_4:30. PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN -Q-forms-shedreg REV:052813 ,r. `1"�'iF`I b"fy �• r .. •�' •.. 'fit•.M.. `�, ♦ .��•�., it r ,, '. .. t - •�' � i~: .ak rt „�:,i` ).Lrf•^t l`. .. r• .t :" ' ' ' , - r r fr _ t ' ' ji.n:� 1 i `x - ..v• .. • , •' .. . ref:' -:, Loff-• „L'' . � / J r r e. � 'i. •te ... r i` VA / 7 s 'w,w, 1 ', �.•, ♦ ., }n. 3 �"•",� 1, (v� '' ( .l .i br� r+ ._l {t q^:,I^ .• � LAk— M! 1 .4 1 '�^� a..J �(, ' $.r!✓ ~/may l •i' I t RMERT Ip r �,SY•4` r» .•' is .r l � E�.�$ � �4• � CERTIFIED PLOT PLAM q•Et ''•'CONSTRUC.TION - 014LY"^= 4 ` 0; 0P.'-'FOUNDATION I .3. FFcr ty atJV,E-. 4OVY POINT 'OF' ADJACENT � f..--9��J] ��1mIl� 1, •ROAD..' m e SCALE= "_ ¢C� DATE 917h LE- DREDGE; ENGINEERING CO. CLIENT D/O nr I CERTIFY THAT THE �oy'Np�}*/OA/ EIG .ERED REOFSTE�3ED - SHOWN ON THIS PLAN IS LOCATED, JOB NO. �7= ON THE GROUND AS IMDICATED Af3® i_ LAND CONFORMS TO THE �OfJin LMS �.EER SURVEYOR DR. BY= �� OF BARNST L , fJ7S. MIAIN ST +•712 MAIN ST. CH, BY: t' _ { C7, ARP.70UTN, MASS. HYANNIS, MASS. / �' ^_2� r SHE OF / ' DATE RES. LAND SURVI?YOn M ) TUPPER CONSTRUCTION CO_LLC 79B MID-TECH DRIVE,WEST YARMOUTH,MA 02573 PHONE- 505-77M111 FAX 508-77"010 VMW.Ul PPERQ,Q.CCM Date: ho Town of Barnstable 0y'c)(- Thomas Perry CBO 200 Main Street Hyannis, Ma 02601 (508) 790.-6230 fax Re: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for permit application # 0 01 �o Issued on -5 has been inspected by a certified Building Performance Institute (BPI) inspector. All work performed meets or exceeds Federal and State requirements. Tupper yo Rliard -69 058 i . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map; Parcel TOWN OF BARSTAppcation # Health Division Date�lssued 2013 AJv 29 AN i.� � � Conservation Division Application FA66 Planning Dept. Permit Fee - m Date Definitive Plan Approved by Planning Board DIVIS -0 I �(� Historic - OKH Preservation / Hyannis Project Street Address Village HA19tEr0fJt LLS Owner AA 400 WA Address 2 T?�a LAtJE Telephone Permit Request 1"r1—�GR12Anm� I fj 5 UtAa t 6) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 21500 °a Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 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: ❑ 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 Telephone Number P5eA - 176 - © it Address 1�9 oQi�ST l�GTE 0 6� License # (:�,D - 0cog f, I D `Ect4 . Home Improvement Contractor# A DZ(P-7 Jam' Worker's Compensation # 1yCC Sown-rig 301 20I 2 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL;BE TAKEN TO I�I7PI•.IZ2a I.)3 ipw �190 In/I I , _DcH _A91101 )T 4 . PA SIGNATURE DATE I� FOR OFFICIAL USE ONLY, APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ; OWNER - DATE OF INSPECTION: FOUNDATION. �f > FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' 4: t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL k FINAL BUILDING DATE CLOSED OUT {... - j ASSOCIATION PLAN NO.- e f i OWNER AUTHORIZATION FORM 1, .��1-�oN I�✓�4J�1 , (Owner's Name) owner of the property located at jalro °rS Lase. (Property Address) (Property Address) hereby authorize , (SubcontrVE r an authorized subcontractor for Engineering, to act on my behalf to obtain a.building permit and to perform work on my property. Owner's Signature _ Date 13iJIlJ�,AfGi l��Cit}tt3tNAhdi.'t li�K!ll U Ttr,t1�C t Mass' chuset#s DepaKmert'of Pubirc Safety, 107 Heffnes Road,Sifte 10 4 a ' ;u Baard'`of Buit fing,i2egulat�onS.and.Standards MM.NY 12{}20 g �' (;i,n,Fru�nFin Sti{��r�ii+ii t8771274.1274 ' www, com ; Lfcetise Cs4-68050. bti . RICHARD`S TUYIR - 79 B i41{D-TEGI DR .. '.Y. . 1 . WEST YARMOtYfH 73' Richi�rd TUpr BPI 100:6046ss0 ;1. .?� .. EXplCdtiOn (sEEitEV f&SW FOR MkAAROASuiD.E%�ltngrotufESi ; ComrntSSibner. 12/31/2014 —7-7777�usr`e' sY,»' '4 •v r< � x^s t Ail uzff 0 Build a S sTM - t3ffec of Consna�xn Affairs&Baes+s Aegntation: ' tGeople Wetprng P_eopte afer World ®� t � t m10, NOME IMPROVEMENT CONTRACTOR 4NfERNATIONAt � � COOECOUNCi�3. � s ? c z EksitetiOn IA (ntlN�U81 MEMBERR. Rl ARI V ru" s hRichardTuppeerrs �� � `, RICHARD`TUf?pF_R k �TupperConstructionr� �� � r> r 29 Robedla. O e x it Budding Safety Profess onai ��� ��� VY YARMOUTH ,AAA 02613_ tFddeiaecretary: d r xMember�#�858119Exp 4/30J:2014 �� �R .;. •�+'k:.x ..:s., «..�att`r�'s' '.z� h.:..- b,gyp ,.,.P n, ,�{v .<,'�a'�"ate•,• ,. Dec. 10. 2412 4:37PM No, 8524 P. 1/2 A4uKUTM CERTIFICATE OF LIABILITY INSURANCE 1 D 12/19/19/2012012/ ) 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 pollcy(les)must be endorsed. if SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCERCONTACT NAME: Lora Lowe Southeastern Insurance Agency, Inc. ruc°NcE : C508)997-6061 wcNo: (508)990-2731 439 State Rd. E-MAIL ADDRESS: P.O. Box 79398 PRODUCER CUSTOMER I00: _ N. Dartmouth, MA 02747 INSURER(S)AFFORDING COVERAGE NAICI INSURED INSURER A: Arbella Protection Insurance Tupper Construction Co LLC INSURERB: AEIC wsuaeac: CNA Surety 27 Roberta Drive INSURER D: West Yarmouth, MA 02673 INSURERE: _ INSURER F: COVERAGES CERTIFICATE NUMBER: 12/13-2 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER MWDD MIDD LIMITS GENERALUABILITY I 950000874311/0112012 11/0112013 EACH000URRENCE $ 1,000,00 X ;COMMERCIAL GENERAL LIABILITY � I?RE,MISES E a occur $ 100,OOO _.�_..------'�----...--------_..._-_..._....._..--........_. CLAWS-MADE I A I OCCUR I !t&C EXP(Any One person) $ 5,000 A I PERSONAL 8 ADV INJURY $ 1,000,000 I GENERAL AGGREGATE $ 2,000,000 Nial 'LAGGREGATELIMITAPPLIES PER: PRODUCTS-COMP;OF AGG $ 2,OOO,OOO POLICY jEa LOC $ AUTOMOBILE LIABILITY 5666240000 12/01/2012 12/01/2013 COMBINED SINGLE LIMIT $ (Ea accrdas) 1,000,000 ANY AUTO BODILY iNJI;RY(Psi person) $ i ALL OWNED AUTOS BODILY 1.r4JURY(Pe;occident) $ A X !SCHEDULED AUTOS PROPERTY DAMAGE X I HIREDAUTOS (Per accident) $ INC X (NMOWNED AUTOS I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAINSMPDE AGGREGATE _� $ DEDUCTiBLE $ RETENTION S WORKERS COMPENSATION i WCC500559301200 10/03/2012 1010312013 X wcS'ATu- X °H-i !AND EMPLOYERS'LIABILITY YIN i T RY L MITS ER _ ;ANY PROPRIETOWRARTNEWE(ECUTIVE l ;wra RICHARD TUPPER I EL.FACriACCIDEM is �500,00 B i OFFICERIMENIBER EXCLUDED? , I(Mandatory In NH) I LUDED FOR WC COVERAGE EL DISEASE-EAEMPLOYE�-$ 500,000 i[!loss.describe under i CRIPTION OF OPERATIONS Oelrnr E.L DISEASE-POLICY LIMIT $ 500,000 Pond or theft of money & or 71069913 02/28/2012 02/28/2013 Limit of $10,000 C property. DESCRIPTIO OF OPERATIONS r LOCATIONS r VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) ill.ju�io@csgrp.com CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE 141TH THE POLICY PROVISIONS. Conservation Services Group Attn: Bill Julio AUTHORIZED REPRESENTATIVE 50 Washington Street We tborough, MA OIS81 Lora Lowe O 1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization/individual): Tupper Construction Co. , LLC Address: 79B Mid Tech Drive City/State/Zip: West Yarmouth, MA 02673 Phone#: 508-778-0111 Are you an employer?Check the appropriate box: Type of project(required): 1.❑X 1 am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. t 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 10.❑Electrical)repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.[]Plumbing repairs or additions myself. [No workers'comp. c. 152,§](4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.0 Other comp, insurance required.] *Any applicant that checks box it 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: AE I C -- Policy#or Self-ins. Lic.#: WCC 5005593012012 Expiration Date: 10/03/2013 Job Site Address: 121 Trotters Lane City/State/Zip: Marstons Mills, MA 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 under the pains and penalties of perjury that the information provided above is true and correct. Si-nature: Date: 8/2 3/2 013 Phone#: 508-778-0111 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#: TOWN OF BARNSTABLE Permit No. --------_—------ 1 »STAX Building Inspector .... Cash _..----------- OCCUPANCY PERMIT Bond rz "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. , ...................................................... 19... .w _........_.. ....._... ... Building Inspector j� d, U , o 5, G n M t� F�a R' `OERT G` .t• r � i'� BUNI;tt9 � ' ao N.n.8420 e �e013TEK•`/ \4 '� QQ' h Y a Y CERTIFIED PLOT PLAN NEW CONSTRUCTION ONLY : TOP OF FOUNDATION IS �' . 1 FEET IN ABOVE LOW POINT OF ADJACENT .0AJ1 BSIAS1J4,WASSo ROAD. SCALE: -4. 0 DATE = IA-DREDGE' ENGINEERING CO. lN' `J D`� f ✓c' 1 CERTIFY THAT THEoyN�R���i -; _CLIE.NT SH ON THIS PLAN IS LOCATED EGISTERED REGISTERED J65 No.�'- � � ��" ON-- 'WE GROUND AiCtNDICATED AND CIVIL I LAND � �{� ENGINEER SURVEYOR DR. BY; r CONFS TO THE ZONING LAWS OF B _ STABLE , MAX 712 MAIN ST. CH. BY: �G �G fG -r 1p1 HYANNIS,- MASS. SHEET�OFL DATE • REG. LAND SURVEYOR - ssessar's map and lot numb c,. ......-....� ......: D /� �C f -� g-3 �P�OfTNEt0�1 Sewage Permit number . ....... ...::V� .�............................. �� SNouyi1�,13b1 �f, GN Yy 3O I /JOJ iN31�/Y N O • STADLE. House number .... � �........................................................ C 9 3"1112 H1UV6 'oo M & \0� .• 3:)NMdWO:) NI 43-I1br1 pMAYh. TOWN OF BARNSTASEMAs :)11d3S BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... f?L:.... s 5'1A)(C ,�,.., / C\ /,) ,.,/ ..... TYPE OF CONSTRUCTION vv.��` �''"""e- ................ ......................................................................................................... ...........2.......!.........`�...........19.F0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: w A�l� �� ss Location ........ is................................................`.......................................................................... / n/ ( i-� Proposed Use .......S� e......�.......... ...........?..,GcJ2... ...................................................................................... Zoning District .................... c ....f S...........Fire District ....... ......................................... . ............................. Name of Owner .....�? :......................Addresses,/ . �2G'S �occ / � f.................. ............................................ .............. 0 I/ Nameof Builder ......................................... '^e..............Address .................................................................................... Name of Architect -� ..........................Address Number of Rooms `S ....... .. ...`�.`(...�''��./� G l Aec e-UvL C/1? ,,�� .. Foundation ....�...................................—l..e......................... Exterior ..........�-!, ..�� -:U..........................................Roofing ......��-.49.!" 1...(......Sf�..G` . !. ........................ Floors r / C•�. .............................................................Interior ......�5�?..�2C1................................................... ;6i'eC- � f Heating ......:............ ........................................................Plumbing ....... ..3.:5....... ......:.f�/t'. .................................. --------------- Fireplace ................................................................................A, roximate Cost .....;�.s F..awo.................................... ... .... Definitive Plan Approved by Planning Board -----------_______ Area ....,l.Q.� .. ....°....... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH -IQNo I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .........71", . `................../...................... ....... Mop(,-ATq HOMES No .... Permit for One.....S...t.....or...y .. ..................Si.n..cl.e. F.a-T.n .l..v. Dwe.l...l..i...n..c.j .............. Location ..Lot........#15 121 Trotters Land........ .............................................. Marstons Mills ............................................................................... Owner .... ...Homes ................................ ....... .. Type'of Construction ....Frame ...................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .... 19 November 6, 1911-10 .................................... Date of Inspection ................&Av/..I 9,ce '0/' Date Completed ............. 19&:2- PERMIT REFUSED ......... ... .... r................................... 19 .................................. ....... ........... ... .. ............................. ............•....... ............................................... ri .............................P,............................................... Approved ................:,*.................................... 19 ............................. ss y tom d 00 essor's map antl lot number ......... -••••••••••-••-••••••••••• >y? fy SEPTIC SYSTEM MUST BE r" `r _ 'L��J�i INSTALLED IN COMPLIANCE ,.+ Sewage,,Permit'number!k " 2.G �' .......... WITH ARTICLE 1.1 STATE ' NEt " SANITARY CODE AND TOWN TOWN OF BAR, ��ABLE 11 GBAR39TAZDX 9a 16 9• `� � •� -� BUILDING INSPECTOR .e�D NO a`. ; tom' APPLICAIO FOR, PERMllf-YO,t, . ,., y 7........................................... TN tl ! i �. TYPE OF CONSTRUCTION .. j .. ..................................................................................................... . ........i g...77 I{ rr,[, j vorLc. ,`BUILDINGS:fit . .-a- ,.,...�. :,. .:u .�, .�A , � .�s4:..._ . •... ..:w ,: - The undersigned hereby applies for a permit according, to the following information: Location ... ........%S.-....... � .............................................. r Proposed/Use f�4.C,d4� /1 ...�? q.... J......t.................................................................................. i 2 Zoning District .... .. .+rl..:...............................................Fire District ..�.... r Name of Owner '•t �,�-�o'.... . .. .. :.............Address ..��� s�•�(.a....�if-���y�s�xr�����.�� Nameof Builder .... !...............................:...........Address .........deze ...r.......................................................... Name of Architect ...X14�6.eiz .............................Address `�./��1..•1�,.-��. /i%�"'sr+•.I Number of Rooms ...... ................................................Foundation � '�.a2� ............................ ExieriorL� ; Q-r,��•/ � - �,/ Roofing Floors ry.. �/� t Interior .mac. �,. .. .4. .,�t . ' e ............6012 ............................................ r-;',a F. .....�./:..'."... Plum frig' 'e �' z e...................... . _ I ,, ......................................... Fireplace ...%, ......... r..........................Approximate Cost ........... ,,, ..`............................ e. Definitive Plan Approved by Planning Board -----------_______-----------19________. Area .... ��..-�;,�!..�'/a.... Diagram of Lot and Building with Dimensions Fee L/ 0 U �..1. ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH i R I hereby-agree to conform to all the Rules-and Regulations of the Town of Barnstable regarding the above construction. Name il.Y•. 7t. 1f4 J I _ rj ' f r 19650 /Dwelling No ......Aq...... Permit for .. ................................. ,$t ..........1 .. . s LoaY..' ........................ a 77 Lot 15 1Trdtters Lane )1 Location ............... .........................��..... . ... ` ll . . .... 1'Ii113........ . .......... .... Owner , Bu-lders........... . � r Typ7,jf Frame....... `�. Construction . . ... _ ......:•••... .�.� �;_•. .-........................................ ............................... f . A 32 16 ......................... Lot ................................ �q Permit Granted Oct 5 1977 Date of Inspection %A10 Date Completed ......................................19 z PERMIT REFUSED t. " ................................................................ 19 t ............................................................................. r ............................................................................... iLM ............................................................................... ............................................................................... p f - Approved ................................................ 19 [` ............................................................................... ti t t is. T�. , yea•7.♦ .. i �>relh I`:'t.r. yjy,J A•�5 t K ., . .+ r ' 'f,t "k'e !' '.. +7 r.�.0 i t!. )I a • i: .ir , •" ! •+. t f. ,f"L �`f'A! A�1' P'St " '�,• '•NrYt,i�i t, + ;• :. ter,.. • ;' • ..n4 iytrt !. 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MAIN ST •712 MAIN ST. CH-,BY' �d r A,RA�IOUTh, MASS. HYANNISI MASS., SHEET°L OF J I " r; DATE REG. LANE► SURVEYOR Town of Barnstable *Permit# Regulatory Services Expires 6 m sfrdfil issue date g Y l �� 0 Thomas F. Geiler,Director k5TA LE Building Division Tom Perry,CBO, Building Commissioner Y" 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number --�?- P y Property Address 01 Otkr5 L WC MA-"-P/V S /t'1/(-L-5 r M A O 4 V O ❑Residential Value of Work 'S-G O Minimum fee of.$35.00 for work under$6000.00 Owner's Name&Address &Z-'Z&w 14. '5W 0 G 6-- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(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 1 3 2 (maximum.35)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is requi SIGNATURE: C:\Users\decollikAAppDa ocalVviicrosoft\Windows\Temp rary lntemet Files\Content Oudook\DDV87AAZ\EXPRESS.doc Revised 072110 �. �. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 c=� www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information f Please Print Legibly Name(Business/Organization/Individual): �( A'1 `'t/,,, frd 21 �� Address: , City/State/Zip: j/�./ �7J-f /t'IILLS Phone #: .1-120 3�j Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet S �• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. g• ❑ Building addition [No workers' comp. insurance . 5. ❑ We are a corporation and its .�required.] officers have exercised their I0.❑ Electrical repairs or additions 3. am a homeowner doing all work 'right of exemption per MGL I LEJ Plumbing repairs or additions yself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' 13 Other comp.insurance required.] 1 P *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-contactors 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: Policy#or Self-ins. Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi `� under a pains d penalties of perjury that the information provided above its true and correct: e2 Signature: Date: 11 S� Phone#: 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 of 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 addre'ssrtelephone 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 1-9.77-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia Town of Barnstable p41NE t Regulatory Services BARNSMAt3LE,/ Thomas F. Geiler,Director i g./� Building Division �rFeA Tom Perry, g Buildin Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: IL JOB LOCATION: I I-( 1jo-( number `, A ( street village Jal "HOMEOWNER": 3r�(^n g3ej SDg L/2.0 2-2 62-0- name 'C '_ home phone N work phone# CURRENT MAILING ADDRESS: I nI Ja l �X/�I 4:,54 / LA MA 0A�ff city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persori(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require me Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTIONN' 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:forms:homeexempt 4 A WE Town of Barnstable pF ip� Regulatory Services BARNSTABLE. T MASS. $ E #*, "1 039 A, Building Division prED MAC '�;r. , 200 Main Street;,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 f * Inspection Correction Notice Type.of Inspection Location 0 Tr--? Permit Number Owner 7 — 1 < C G'�� Builder — e One notice to remain on job site, one notice on file in Building Department. •The.f owing items need correcting: "•.t Of or- O-C6 MC- W A<. ,- -Fv (fLA'r C " L,( �j G ..*. r y i Please call: 508-862-4038 for re-inspec on. k I; Inspected by Date l TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 03 a Parcel IApplication Health Division _ Date Issued l l O Conservation Division Application Fee Planning.Dept. Permit Fee l y Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 're 0- aEgR Village Mi", S'-iNS MILL-5 If, Nli4 ` Owner B ANS -1 L�"���'-L- Address /a 4/00 Telephone��o`9) Y10 _ 2,2,33 Permit Request ova x 18 Add,i fo s vk &X ra4c h owc f y j&e iiged ArJziS h he toe&I /e 0, I roONI, Ekyb�)- h�c1� Square feet: 1 st floor: existing 1909proposed 2nd floor: existing proposed Total new j- `0 Zoning District Flood Plain Groundwater Overlay Project Valuation l «� � Construction Type Lot Size i Grandfathered:-. D Yes No If yes, attach supporting documentation. Dwelling Type: Single Family : Two Family ❑ Multi-Family (# units) Age of Existing Structure rs Historic House: ❑Yes No On Old King's Highway: ❑Yes *No* II Basement Type: Full Crawl ❑Walkout ❑ Other 4f+ cra(till Basement Finished Area(sq.ft.) ��/A Basement Unfinished Area(sq.ft) /001 4d 13460�4 Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing S new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑ Other t&)+ .k4_ . Central Air: ❑Yes �No Fireplaces: Existing New Existing wood/coal stove: ❑Yes i No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: k existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ . �i o Commercial ❑Yes ❑ No If yes, site plan review# (n -a C3 o Current Use Proposed Use n APPLICANT INFORMATION w (BUILDER OR HOMEOWNER) s Name Telephone Number �ttm) 33 Address lot 1 TAOTMZS ZAW45' License # MAP-MOS 'MILLS /Avi- Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l 3 FOR OFFICIAL USE ONLY /.APPLICATION# DATE ISSUED ' 'K MAP/PARCEL NO. 6 < F a�. ADDRESS VILLAGE l` t : . OWNER - DATE OF INSPECTION: FOUNDATION FRAME, G tt lc�y S1'fr�( O D p7 la�rhh — u a r lDf� INSULATION (4-&kc, - FIREPLACE ELECTRICAL: ROUGH FINAL `= PLUMBING; ROUGH FINAL GAS: ROUGH FINAL , l 1 F FINAL BUILDING -A-Ij2s31,10 DATE CLOSED OUT ASSOCIATION PLAN NO. - it Town- of Barnstable Regulatory Services Y,IA?t9TA$LE, •• , Thomas F. Geiler, Director Pr 6)F q..;�10� Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b a rnsta b 1 e.in a.us 'Office( 508-862-4038 Fax: 508-790-6230 Owner: y�' L�Is�L- Map/Parcel: 03 2- 0 Project Address /02/ K07rcer ��, Builder: S'1tz�'YI6 The following items were noted-on reviewing: Cry _A [/Q EfYt G=A)T ro XI Reviewed by: Date: // �-T Q:Fornis:Plnrvw The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 y� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Indivi dual):/ �CW6,6z-- Address: TO.DTIMS L I) City/State/Zip: 1paS A1Q,5 026Y9 Phone #: S9 42D - aa3 Are you an employer? Check the appropriate ox: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and 1 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance��' required.] 5. ❑ We are a corporation and its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] 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' 13.0 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. -tContracto--�s-tkat-check=this.boxmust_attached-an-additional-sheet-showing-the-name of,thc sub-contractors and state whether-or n6t-those cntiiies hav—c-1 -employee fls ue ss b-contractors=have-employees;they_mustprovide=themworkers'-comp policy number. 1 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. Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up_to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. .1 do hereby certi& under the pains and penalties of perjury that the information provided above is tree and correc4 Si natur— Date. -_D `T 12,162 Phone#• Sa 16 L4 2 22 1� 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, constriction of 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, arenot 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`ooverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen-nit 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 Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia F - I A6YC Crcide to Hood Colish"Ictioll hi High hYind Areas:JI0 mph 611irrd"Lone N/fassaclit.tsetts Checklist for C0111 limice(780 C5.1.I1 5301:2.1.1)' Check Compliance 1.1 SCOPE ' WindSpeed(3-sec.gust)..................................................................................................................110 mph — Wind Exposure Category ............................................I..............................B — Wind Exposure Category................Engineering Required For Entire Project.......................................0 — 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) / stories 5 2 stories — RoofPilch..............................:............................................(Fig 2) .......................................... � - — MeanRoof Height .....................................................:........(Fig 2)................................................I ft _<33' — BuildingWidth,W ...............................................................(Fig 3)......................................... •..f ft -<80, — (Fig 3. fl 5 :1 — Building Length,L ..............................................................( 9 )................................,� <3:1 Building Aspect Ratio(L/W) ...............................................(Fig 4)................................ . �.�... - t.5 6'8" Nominal Height of Tallest Opening .............................:.....(Fig 4)................................................(�_ — 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)............................................................... — 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 .............. — ConcreteMasonry.............................................:........................................................ .......... ........ — 2.2 ANCHORAGE TO FOUNDATION�'�, Rtonclef .. 5/8'Anchor Bolts imbedded or 5/8"Proprietary Mechanical An as an alle e.in #6 - Boll Spacing-general.........................:..............:'(Table 4).................1:........I........... ...... in. — Bolt Spacing from end(oint of plate...............:. (Fig 5)..................:................. in.- .12 Bolt Embedment-concrete.........................................(Fig 5).....................................:........... in.?7" — Bolt Embedment-mason (Fig 5 in.z 15" — masonry.........................................( 9 )........ r................................z 3"x 3"x Y." — PlateWasher................................................................(Fig 5).......................................... 3.1 FLOORS Floor framing member spans checked ..:........:::.................(per 780 CMR Chapter 55).............................12 Maximum Floor Floor Opening Dimension....:..............................(Fig 6)...................;.......:............ ...... ft512' — Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6).............................. ........ — Mbximum Floor Joist Setbacks Supporting Loadbearing Wails or Sheanvall................(Fig.7)........................................ ..�P•._ft .5d — Maximum Cantilevered Floor Joists i N.l.b._ft 5 d Supporting Loadbearing Walls or Shearwall................(Fig 8)..........:........................;. — Floor.Bracing at Endwalls..............:.....................................(Fig 0)................................................................... Floor Sheathing Type ..:.....................................................(per 780 CMR-Chapter 55)....................... —........... Floor Sheathing Thickness ...........................................:.....(per 780 CMR Chapter 55 ..:.,...............3 in. — Floor Sheathing Fastening.............:....................................(Table 2)..f Q d nails at 1-in edge/41 in rield ( i 4.1 WALLS �l Wall Height ! Loadbearing walls..........:.............................................(Fig 10 and Table 5)......................... J ft ....:..........�ft ' — Non-Loadbearing walls......:.........:...............................(Fig 10 and Table 5;........ 5 20 " in,s 24".o:c. Wall Stud Spacing (Fig 10 and Table 5 ................... f ' WallStory Offsets ...I............................:.......................(Figs 7&8)........................................N A 4.2 EXTERIOR.WALLS t ' I Wood Studs Loadbearing walls..........................................................(Table 5)..........,...................2x� �ft�in. Table 6 ...................:..........2x li h in. 4 Non-Loadbearing walls.................................................( ) _T -l} .7 Gable End Wall Bracing 1 Full Height Endwall Studs.............................................(Fig 10)....................:................�.............. tW/3 WSPAttic Floor Lehgth......:..........:..............................(Fig 11).........................I.....:...... f . _ — sum Ceiling Len th if WSP not used fi z O.gW Gyp9 9 ( )....:..............(Fig 11).........................................ti and 2.x 4 Continuous Lateral Brace.@ 6 ft.o.c...(Fig 11)....................................... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays— Double Top Plate (Fig 13 and Table 6 ff — SpliceLength ........................................................( 9 )............•........................_ Solice Connection(no.of 16d common nails)...............(Table 6)........:.............................................. i(WC Guide to 11%od Construction in Hi,111 1•Yindf(reas: 110 nrph. bYirul Zorlc IVI:lSSf:1CIIIlSCttS.ClIC'C.ICIiSt COI- C0I111)II?IICC (790 CiVlR530I.z.l.,)' Loadbearing Wall Connections Lateral(no.of 16d common nails).................................(Tables 7)...................................................... _ Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)........................................................ _ Load Bearing Wall Openings(record largest opening but check all openings for compliance/to Table 9) HeaderSpans . ........................................:...............(Table 9).................................. 6 it in.s 11, Sill.Plate Spans ........................................................(Table 9).................................. ft in,-1 1 —. Full Height Studs (no.of s(uds)....................................(Table 9)............................,........................ Non-Load Bearing Wall Openings(record largest opening but check all openings for compligpze to Table 9) Header Spans.............................................................(Table 9).................................. ft in.5 12' — Sill Plate Spans...........................................................(Table 9)................................... ftaIn.S 12" Full Height Studs(no.of studs)....................................(Table 9)....................................................... — Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously° Minimum Building DimensNb� s f fl Nominal Height o'�Tallest Opening2 .......................................................................... 6'8" Sheathing Type..............................................(note 4)................................................Yi _ Edge Nail Spacing........:................................(Table 10 or note 4 if less)................... _ Field Nail Spacing...........................::.............(Table 10)............................................ _ Shear Connection(no:of 16d common nails)(Table 10)............................................ _ Percent Full-Height Sheathing.......................(Table 10)............................................. 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts).................... Maximum Building Dimension,L Nominal Height of Tallest Openingz........................................................................._5 6V Sheathing ftpe......... ..................................(note 4)....:............ 711. Edge Nail Sp�`ci'v%,. h4 ..........................(Table 11 or note 4 If less)........................ in. Field Nail Spacing.................. ... ............:..(Table 11)............................,.....................�in. Shear Connection(no,of 16d c on nails)(Table i i)....................................I.................. Percent Full-Height Sheathing ..... Table 11 5%Additional Sheathing for Wall with'Opening>6'8"(Design Concepts).................:.. _ Wall Cladding Ratedfor Wind Speed?.......:.................................:..:................................................................................ 5A ROOFS Roof framing member spans checked?.......:................(For Rafters use AWC pan Tool,see BBRS Website) _ Roof Overhang ................................:..................(Figure 19)............. ft 5 smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls Proprietary.Connectors Uplift.................................................(Table 12)......:.....................................U= ��plf Lateral.............................................(Table 12)........................ pIf Shear............................:'..................(Table I2).......................... S— f — Ridge Strap Connections,if collar ties not used per page 21...(Table 13)...............................T=_pff _ Gable Rake.Outlooker................... ....(Figure 20):/IIA...._ft 5 smaller of 2'or U2 _ Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors , Uplift.......................:........................(Table 14)............................................U=.!h4 Ib. _ Lateral(no.of 16d common nails)...(Table 14)........ ..............................L= . Ib. _ Roof Sheathing Type................:.:................................(per 780 CMR Chapters 58 and 59)..� COX Roof Sheathing Thickness.....................................:...................................................�In. 7/16"WSP Roof Sheathing Fastening............................................(Table 2)..................I—:.................$r ..6 Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,'to comply with the requirements of 780 CMR.5301:2.1.1 Item 1.If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing. -'requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade.. ' I i I ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: 84'y4N ���� � Site Address: !2 J /A017 U Lnl print Town: MAIMS Applicant Phone: Tog 410 — L133 Applicant Signature: Date of Application: NEW CONSTRUCTIO choose ONE of the following two--options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab QOption 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-3 8 R-19 R=19 R-10 4 ft. 1987 as amended,minimums or realer as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energ cY odes.gov/rescheck/ ADDITIONS OR ALTERATIONS,TO EXISTING BUILDINGS.OVERS YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (10000 x b = a) 9/y SF 100 x g l q 7,(,6% of glazing (b) Glazing area equals 79 AI SF b a If glazing s:<40%.use the chart below. If glazing is> 40 % rpceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration Ceiling and Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value n Value R-Value and Depth .39 R-37 a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120T) oFtt,E r� Town of Barnstable o Regulatory Services anxNsrnsLe Thomas F. Geiler,Director 69. Building Division i �m ? A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ` Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: I ` JOB LOCATION: number street pvillage "HOMEOWNER": name l home phone# work phone# CURRENT MAILING ADDRESS: I C-I 1 RO TTU7-S Mid its MIu-S M 14 6 -6Lf? city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signat&AAf Homeow er Approval of Building Official Note: Three-family dwelling's 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. Q:\WPFILES\FOPMS\bomeexempt.DOC THE Tp� Town of Barnstable Regulatory Services S^R AB& Thomas V. Geiler,Director �E039..t A Building Division Tom Perry,Building Commis 'oner 200 Main Street,Hyannis, 02601 www.town.barnsta e.ma.us Office: 508-862-4038 Fax: 508-790-6230 Pro erty Owner Must Compl te' and Sign This Section . If Usina A Builder i as Owner of the subject property hereby authorize to act on my behalf, in all matters relati to work authorized b building permit application for. (Address -of Job) Signature of Owner Date Print Name I If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the rem, ye se Q:FORMS:OWNERPERMISSION Barnstable Building Application 20900905232 Location:121 Trotters Lane, Marstons Mills, MA Home Owner/Contractor: Bryan Schlegel Cell Phone: 508-237-8267 Box 4 requirement(Supply sub-contractor information) Foundation Reich Lawrence F Foundations 48 Almy Ave, Sandwich, MA 02563 (508) - 833-123 Excavation Charlie Merium(508) 737-2830 Using these sub-contractors depends on their availability and pricing. I have not secured them yet with a firm date, but I have spoken with them and reviewed plans. I plan to do all other work other than the foundation and excavation. If these contractors are unavailable and can not supply the paper work when I need them I will contact the following foundation sub-contractors for the job. No 1 Foundation 1141 Old Stage Rd, Centerville, MA (508)428-1389 Bay Colony Concrete Form Inc 99 High St Cotuit,MA 02635 (508)428-5144 All Square Concrete Foundations Inc 78 Beldan Lane Centerville, MA (508)775-6043 I would like to secure them to do and complete the work the week of November 15th so I can get going before the ground freezes. Once I've gotten preliminary approval from the building department I'll line them up and supply the necessary documentation so I can begin. Thank you, - Bryan ..'^'1 �•I+, s •• � .• � ' 4J •lit. r 2.P: j rn r'tr fff�iii'"' alh Nn- L'>n,-'Vr 9 t� �. '`r'•. , � + I-its SAN Qoo It am .{•,. k {. .. ,fir�. ., „� �e v ! . y it t a i ar .re .;r , r •. �. v I r (ll te'Ir � � 'Ili ` Jj ^.+ft•�� t r ' -�� �-'----�-�„""i'_-" --w'_----f _— - 'c^ . 14 L , .ht,G� cut �: 4 �. :r n t. •,�,I., � � C.� � ( rS .':v:'.'. fS� �...,4 �al�- ylc'•y':,•, wbi,.7P ^ t { 1. .. 4 j.- M., � �I �' " 4" t , rT r !!'.,' ..,. jjjj 11 g I Y ' t i an �p T'Y 'Y"'_ �4`.... ���V^. D � 1 � "- •. , I f' b: �*ce rj � �, .; A A.. 1 .a -y ^:.._.-..tom_t...•_.^-•�.•---- ..:......: ..._ '� ` _ I � 'I IN Vill �}{�+y,, /�/,,•,�'�J� 7 /..lam-^ q�/}{� � // �y i��qv 1 • I1 S°!�� ',i(� ' r` _ ,\ T:6 _ .T� �•,�i \ e/ �"''`• ` �p��.• •4e^\. 1 '1-•r1't�,1. �> l t t-•Y Pj F��, r� Ii t V LLB% `•• t ° O`� R00ERT t goo? 412'i..+ 0 i.. .r .,�° •F'' r `� P... �GR , r 'e'er'._"_". "'-`- �' �i qAY' a •.> .,i:.� , � � ,: - ^ _ � ..h i �.• :�i CERTI�IE® P v° LOT' N � 0td'STRUC,7I®P9 ,r i LO r, /S` 7 o T ;s �. i I 11/19/2009 23:02 5088880550 ALMEIDA AND CARLSON PAGE 01/02 AdORD. CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) ma) 11/2012009 PALMEIDARODUCER Phone: SO ass-5257 INSURANCE SBB NC TH1S CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION P.O.BOX 8.CARLSON INSURANCE AGENCY INC. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE P.O.BOX H HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR SANDWICH MA 02563 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED MARK O HARNEY INSURER A: ARBELLA PROTECTION INSURANCE DBA HARNEY CONCRETE FORMS INSURER 6: AIM MUTUAL 161 WHITE MOSS DRIVE INSURER C: MARSTON MILLS MA 02648 INSURER D; E.'COVERAGESS INSURER E THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMPLTR TYPE OF INSURANCE List INSR POLICY NUMBER o LICYlFFEc7svE PDucY EXPIRATION LIMITS GENERAL LIABILITY DATE 8500043148 05/19/09 05/19/10 EACHOCCURRENCE S 500,000 X COMMERCIAL GENERAL LIABILITY DAMAae To RQJTeD CLAIMS MADE PREMIaGe daurende) $ 50,000 a OCCUR MED.EXP(Arty one A P°'80n) $ 5,000 PER80NALBADVINJURY S 500,000 GENT AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE $ 110001001 X POLICY F1 PROOUCTS�OMP/OP AGG, JECTPRO LOC $ 1,000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT (Es aeeldem) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS NON-OWNED AUTOS BODILY INJURY (Per 0 1denl) $ PROPERTYOAMAGE S GARACE UABIUTY Per exld0m ANY AUTO 7 AUTO ONLY-EA ACCIDENT $ OTHER THAN EAACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR �CLAIMS MADE AGGREGATE g DEDUCTIBLE $ RETENTION$ $ WORKERS COMPENSATION AND $ EMPLOYERS•LIABILITY AWC7016521012009 06/06109 08/06/10 WC TO RV ,yam, oT�R LIMm3 .VV OFFANY CEPWEMBRAEXC%VD r1?xeCVrne E.I-EACH ACCIDENT' oPr'ICElubserARERF,ce4tlpEb7 $ :� I ,000 M yen.deeOAbe u dv E.L.DISEASE-EA'EMPLOYEE $ -�. v 0,000 SPECIAL PROYNIONS below OTHER; E.L.DISEASE-POLICY LIMIT $ ,= 0,000 1 O _c DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS tip JOB: 121 TROTTERS LANE,MARSTONS MILLS MA CONCRETE FORMS CO CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION.DATE THEREOF, THE ISS UING INSURER WILL ENDEAVOR TO MAIL t0 GAYS TOWN OF BARNSTABLE WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 30 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY IQND UPON THE INSURER, ATT•BLDG INSPECTOR 367 MAIN STREET MS AGENTS OR REPRESENTATIVES, HYANNIS, MA 02601 AUTHORIZED REPRESENTATIVE ��tt77 Attention: 508-79OA230 �� iY• /' � ACORD 26 2001/08 Maureen A.Raymond Certificate# 7075 ®ACORD CORPORATION Igoe Assessor's map and lot number ........�� ....:......../. ......:rTNE To` Sewage Permit number WP o a Z BABB9T!►DLE. i o House number ....1..1°z./................ ....................................... qO NA66 O i639. `00 MAY a' �j TOWN `OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....v6?e:......... : "�......S��`9�� / /G� cvY je'r+`/� ! y TYPE OF CONSTRUCTION ............vY�.C/... vc°'"-"-e-..................................I.......................................... e ...... 6...........19.F0 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit accor"ding to the following information: Location l/f S....... ..-......................�.:.-� .....�:....-- ...... ..` �c c............1�......... .............................................. le- _/ n/ r/ ProposedUse ................. .*. ......�.................�.............�p.....�•.... ..................................................................................... Zoning District ................... ... ............... .....................Fire District ............................ .......................................................... 19(l Name of Owner �'�- "• Address ................................................/ a2 G �ou �•�ck', %�/G i J ............................................................ ;...................................... Nameof Builder ...................... �...........� 2..............Address .............................................:::.................................... Nameof Architect Address. .. ..// `` ....................................................................................... Number of Rooms �� �jr. is /Z.......Foundation ....... �uiiF'`-..... .`'.�P.`c:........................ ...........................�.../ / /_.,G 1�?Exterior .........L" 12 hQGZ.L_ C! ...Roofing Q f��Q .../,,...5��k .sA ....,C r / Floors (�✓C•�JP / Interior• ......:2AoC� ! OC! ........................... .....i. ................................................................ Heating (F C................G .....Plumbing ...Ci1.� . ........................... `. .................................. Fireplace ................................................Approximate Cost ..... � �Definitive Plan Approved by Planning Board ______________ _ __ _ 19, _, Area .....!.j, ......:�.:.......... Diagram of Lot and Building with Dimensions Fee ........ �..................................-f�• SUBJECT TO APPROVAL OF BOARD OF HEALTH CA I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........ ................. .................................. MORG'P'N HOMES-1 V No' :.Z�A59... Permit for .One... t.O.r y.......... Sin4-le Family Dwellinq ..................:5........................................................... Lot"'�#15 121 Tr'otters Lane Location ................................................................ Marstons mills ......................................;........................................ Owner ......MorganHomes.......................................... Type of Construction .. Lot /.Fram .......... ............................ .............................................. ................................. Plot ............................ ................................ November 6 , 80 Permit Granted ..... ..................................19 Date of Inspectio ....................... ... .....19 ........................ Date Completed . .......19 PERMIT REFUSED ......... . ..... .. ...... ..... ............................. 19 ,D .. .............. ........... ....... ......................................... ......... . .. . ... I...... ............. ......... ........................... ..... ................... ..........I..................1. Approved .............. ... .... 19 ....................... ................... .............................. ........................................................... �'l h�l o3aJ° �� 4 a� a 5 �t IMPORTANT ANY CONSTRUCTION THAT INCREASES LIVING SPACE BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS. NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. G (�3 5/11-"prTE4 C7 l5f h�G 46 I 100 SI oc . V eJ S CAL-11;t DFFICE Copy . 4 i - 07 \ VS' Ati� r x V 14V( CL M� �,►cam \b• _ l . Qo Jot, 1e �, 4t to .......... ___.___._._. ---- - I Mrus �L Cyleyr#06 4tOOW s'_o" W-0'xWrSD i N �7 G LO 1 vJ O N N CV) K -77� ci 0 R k N v � a A-------- 4'-7" 4'-5" 4-6" 4'--6" do 1�0 00�