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0302 WAKEBY ROAD
rs , 1m: „ ,....__ r. �. .� ,. .ram, � � _:� V..r- y .,n aj. �,,V•„�„��... f'''' 1 w� , I i I 2,( � . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel C�"f Applications (�3 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 o. Village Owner Address Telephone Permit Request cPV \),._30 % T 100 S/D S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total ew Zorn' District Flood Plain Groundwater Overlay "� Valu o � Project n Construction Type rn Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Fami ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ kout ❑ 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 w /coal stove: ❑Yes ❑ No I Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ ex ing ❑ 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 AHZ-RTCAN T,;N 7- /Al342_�- Telephone Number Sol? -44 ?_D Address T OX 3 License # NARSTDA)3 N:i-LS "A Home Improvement Contractor# Worker's Compensation # V-D2b1Z S— 20J3/1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /V/ 4 SIGNATURE DATE E r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. 3f3 i , ' -ADDRESS f VILLAGE OWNER- DATE OF INSPECTION: FOUNDATION FRAME - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL E GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 2. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Inves4aflons 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electrickns/Plumbers Aunlicant Information .�/ Please Print Lea_ibly Name(Businesstorgdaization/individual): Oq Address: .469 Y_ /� VF City/StaWZip: fl,44S?P VS *1 .1—S t7A 6 hone#: V?—f cA® c)c-/S Are you an employer?Check the appropriate boa: T of ' 1.DPI am a employer with 4. ❑ I am a general contractor and I � project(requite: employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' coin insurance; 9. ❑Building addition [No workers'comp.instance P• required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[I 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 13.�theri{4 / S employees.(No workers' 1� ) comp.insurance required.] •My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homoowners 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 attachod an additional sheet showing the name of the sub 46ntraCtors and swe whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that isproviding workers'compensation insurance for my employeeL Below is thepoliey andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#:A io e—--yoo— 7o a.( /.9g -a aD 13 A Expiration Date: i Job Site Address:—3 � -/ - City/State/Zip-XA7`/Y '7 U /T Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).z'./,,� 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 OfiSee of' Investigations of the DIA for insurance coverage verification. I do hereby under the pain and enalSes of perjury that the information provided above is true and correct Si e: Date: Z51� 2 Phone#: Official use only. Do not write in this area,to be completed by city or town offild L 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#: AC R& CERTIF DATE � ICATE OF LIABILITY INSURANCE """°°""m 04/11/IN73 THIS CERTIFICATE DOES NOT CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ANb CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS W THIS AFFRMATIVEI-Y OR N EGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED BY THE POLICES BELOW. THIS CERTFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:It the certificate holder is an AUDDfUXMAL INSURED,fhe Poicy("must be endorsed. If SUBROGATION IS WAIVED,subject to the terns and conditions of the policy,certain y require an endorsement A statement on this certilieate does not confer rights to the oerbfieate holder in lieu of such endorsement(s). r PRODUCER 08082-001 cr 60 DIPS � Ave.Group,Inc. N,, (617)478-600 ($17)4784761 Suite 3 Milton,MA 021N !` GE S LIH6UR® A.I.M.Mutual Insurance Company 337SS Amorfean Tent&Table Inc ' P 0 Box 1348 Marstons Miss,MA 02M COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: INDICATED. IS TO CERTIFY TMT THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED LAMED ABOVE FOR THE POLICY PERIOD CERTIITED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH REJECT TO VM�ICH THIS CERT119CATE 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 CI.AIMS. TYPE OF INSURANCE POLICY NUMBER LIMITSGENERAL UABN1rY w CeMw8zaAl GENERAL uAetuTY EACH OCCURRENCE i'I CLAIMS-MADE OCCUR L s MED EXP(Nry are paw) $ PERSONAL a ADV INJURY S I GENERAL AGGREGATE $ HNI AGGREGATE UMRAPPUESPER: I PRODUCTS-COMPIOPAGG $ CY AUTOMOBILE UABILrrY --' ANY AUTO ALL OV*JED SCHEDULED Ir BODILY INJIARY(Pbr petaon)AUrOS i--- AUTOSI7YY BODILY INJURY(Flan aeeidw4 S HHll�AUi08 AUTOS IjDAMAGE i i UMBRBJA LJAB OCCUR EACH OCCURRENCE i EXCEESUAB CLAIMSMADE AGGREGATE S Ow REgTppE��NnopN S i �'I AtO BPLAYERS LJI1BLrrY YIN x WWI ER A U MIA AWC�7026128-2013A 4/5/2013 41512014 EL EACH ACCIDEN r i 100,000 (Mmdalny in MN) EL OISFA4E-EA EMPLOYEE S 100,000 Ukafts%ERATIONS below 1EI DISEASE-POLCY LI l S 500,000 is I� DeacRPnoN of OPERATIONS/tACAT10NS vBtICLffi(Attaell ACORD 101. 'a motwl Remarks Sdmdule.I mate space Is tequked) F 1 1 CERTIFICATE HOLDER I CANCELLATION SHOULD ANY OF THE AW4E DESCRIB®POLICES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE OBJVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHOR®REPRESS TATNE N It 0 INI;-=10 ACORD WWORATIDN.AO rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD } 1 y � _ f" e �� �1. .. f��a��� 7 �":.t... ^M� t ica e ® ar�eKesis `ancePAGE: 1 ^tea Date Manufactured AZTEC TENTS �~ 2665 COLUMBIA ST INV NUMBER: 0184178 �. 12/17/2010 TORRANCE,CA 90503 ;`1Y P.O. NUMBER: <? (800) 228-3687 CUSTOMER NO: AMER026 :�•': This is to certify that the materials described below have been flame retardant g�:tk treated or are inherently flame retardant). " AMERICAN TENT&TABLE INC. °"'" "°'" F F-222,0e ;;.' P.O. y Caldavnia czf0. 1pinrc*12.N.le•leas ?.e19.01 ='.'.1y'y -•'t o, 'O• BOA 1348 atlO Fatnq aear vnyr loga72°ga F•5]o.0) .!"�1,, Marstons Mills, MA 02648 °�"^+IcaDAF 1. EcOu:iv!Y Ew MI. . FHrdM1 Wsysa:ten lAner F-e N.01 k;� aa9narunl sot aa,g1 .�"i ea aA osamnva�ns 2oi F•a.a,m Yeti;;` • ,� nnnnos rer0lea M.Yrei UAH ae0p.q �_>.• �i T FYC Tttn, Deco c..f Wa .SM.01 •+'�'''" s^roar wt9[ners°aA F•1a0,01 •wy(cj•w�.h Tn VarneOt 1r°nit SenerNla F•208.0! r', s? Certification is hereby made that the articles described below hereof are made Y Tri Vantage keoo lOD f-i from aflame-retardant fabric or material registered and a y w9T* F•121.1° y 9 approved b the t"lan aqa vanqub'V v9°Cn F069A1 "S,xy California State Fire Marshal for such use.The fabric has been tested and n rn Vanlego weelan/Co>s°sne passes NFPA 701 Large Scale. See chart to right for trade name of vHFe9ap ouasunmer�,elsls F.,D.o1 c_. flame-resistant fabric or material used and additionally referenced on the label ; :z Y of the fabric panel. a THE FLAME RETARDANT PROCESS USED WILL NOT BE REMOVED BY WASHING David Bradley,�•rF;, Y General Manager-Manufacturing .. a Name of Applicator or Production Superintendent Title of Applicator or Production Superintendent + 4y r `��j{d1,a '��"•� ,yy' i s �y� 'Yy)'y s r'S� ���` ay'�..ZE,�rF -•* r k�f •.( 'We X'"CYt����'r��+�", �.�S$t�>�2\��rlri .1" a ♦ a�zc'£fir 3 ell _> ex"}. .^d ix" •2e ' aE�r _'d yt ITEMS MANUFACTURED TYPE PRODUCED 30x30 2pc Std Top Only UW S 2 ATC Style Clasp 20x20 2pc Std Top Only UW S 2 ATC Style Clasp Stock #'s 6957,6958 20x7.0 1pc Top Only UW S 2 Stock #'s 6947,6948 20x10 Std Middle Top Only UW S 3 ATC Style Clasp Stock#'s 6502.6503, 6504 30x10 Std Middle Top Only UW S 3 ATC Style Clasp 15x15 2pc Std Top Only UW S 1 ATC Style Clasp 15x15 Std Middle Top Only UW S 1 ATC Style Clasp 10x10 2pc Std Top Only UW S 2 ATC Style Clasp 10x10 Std Middle Top Only UW S 2 ATC Style Clasp 3000 2pc Series 1200 Top UW S 1 w/New Plates& #2 Grommets I Town of Barnstable Regulatory Services HAMST"IZ Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner I' 200 Main Street,Hyannis,MA 02601 i www.town.barnstable.ma.us i Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using n¢ A Builder 1 �5� ,as Owner of the subject property hereby authorize act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) -Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QYORMS:OWNERPERMISSION r-_/_ ______ _ 1 I�, G L°3'Te� /o � V i � ' �� ,� � � _ vt ___-- � c 00 0 0 0 0 0 0 0 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �3 Parcel 011-iCa Application #c2eJ16 66W7 Health Division Date Issued Z C� Conservation Division Application Fee Planning Dept. Permit Fee a� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address 3aa W a[4 8 V Rd Village MQr S-b n S m l l IS Owner �ITQ1�4_ Woo 5 ` Address Telephoner� '��J Permit Request G6 w i C(d r0 00 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family -:.,El 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: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -�- _w ire Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION -(BUILDER OR HOMEOWNER) Name VV I ` l 1 Q ron�_- w 9 I Telephone Number Address aOa-- wa k2 & R( License # M Ct Y s4b n S (Y) I S Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P I� SIGNATURE(, DATE h? J ��U '1 y 8 FOR OFFICIAL USE ONLY c ' 4 APJLICATION# DATE ISSUED; MAP/PARCEL NO. ADDRESS VILLAGE l OWNER DATE OF INSPECTION: FOUNDATION?: _..FRAME 07 rC /Ldt�r�L INSULATION �� FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH FINAL ROUGH ; ,:: FINAL .:FINAL BUILDING;' R'-'- " 0 t t 6 1(14� ., .DATE CLOSED OUT . ASSOCIATION PLAN NO. The Commonwealth of Massachusetts c i Department of Industrial Accidents ~� c Office of Investigations 600 Washington Street Boston, MA 02111 ' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information I II '' , 11 Iw Please Print Legibly W Name (Business/Organization/Individual): l t l(OM - (t,15• , Address: 7j01?' W CL k2 City/State/ZipACLY-MgMS i 1{`��S LA- Phone #: 4A-9 LJ 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 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 LJ 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.❑ 1 am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp. insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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 certifylIuAAnder the pains 'an1d penalties of perjury that the information provided above is true and correct. Sienature: � �IJU 1 ►�/W Date: 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 M i 't 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'corrimonwealth 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. Anew 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 Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass..gov/dia i . " f pf THE Town of Barnstable Tp� , Regulatory Services t BARNSTAHLE, Thomas F. Geiler, Director q MASS. 039. ,m Building Division ff0 �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 m,wNy.tovvn.barnstable.ma.us Office: 508-862-4038 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: I f ( � I/0 JOB LOCATION: ?L>a WCI,IC$JV M /'tay,Y 1 U»S / '/ICI Ks number rr e street village HOMEOWNER": I�j_!l Tom, I0als� name home phone# work phone# CURRENT MAILING ADDRESS: �O e5 o X :3 o o - n�►-S-f�S lh�`l�S V1�1 t4- rs�� �8` 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 bome 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. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such 'work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supenrisor(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. �yoff If-HErOy C Town of Barnstable ti Regulatory Services `• BAWSTABLE, v Mass. $ Thomas K Geiler,Director E16,199. a '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 Property Owner Must Complete and Sign This Section. y rf Using A Builder as Owner of the subject property here 6y authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date i. Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISS10N f y C44" SXed Vgemg,,- 17- 4, f i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �Y� Application#r)003�� 1 Health Division Conservation Division Permit# Tax Collector Date Issued ;? 1 a Treasurer Application Fee Planning Dept. ; Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis r . Project Street Address Village A4� � & ,/A Owner ll j.4,, Address Telephone 1 Permit Request _ b� Z &SC_,W:e _ -»; Square feet: 1 st floor:existing proposed 2nd floor:existing proposed X Tc W new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 01` Lot Size�3 Sr Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) A' of Existing Structure Historic House: ❑Yes WNo On Old King's Highway: ❑Yes C/N. Basement Type: ❑Full ❑Crawl 0Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing ' / new Half:existing new J Number of Bedrooms: existing `7 new J Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: R/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: I Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes E(No If yes, site plan review# Current Use / Proposed Use / BUILDER INFORMATIONC,� Name / `'J Telephone Number �"v /5- Address l License# Home Improvement Contractor#A) Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A' e "SIGNATURE DATE e rye FOR OFFICIAL USE ONLY PERMIT NO. 00 DATE ISSUED MAP/PARCEL NO. ADDRESS, 1 VILLAGE ! y OWNER x (' ` { DATE OF INSPECTION: != FOUNDATION Ate-- ' i,• FRAME f�-- 1Z,0210 � - INSULATION .� FIREPLACE 1 ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ►u- C- Acd DATE CLOSED OUT ' ASSOCIATION PLAN NO. ' _ ' f BOARD OF BUILDING-•REOULATIONS License. CONSTRUCTION SUPERVISOR j ` Numbet 048502 : , 1 rres'0 W /24 7 Tr.no: 15068 Res.`r cte EUG.ENE P FRIEkif to PO BOX 1063 I MARSTONS MILLS �INAfi 8~ Commissioner 7fie V�am�izaizcueai a� aae�ivaet� _-------• SM Board of Building Regulations and Standards 09 License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Regi to: 109482V IC/ Board of Building Regulations and Standards REX_RitdOR 0/16F2008 One Ashburton Place Rm 1301 i� =Jndb7 Boston,Ma.02108,. idual .NE P.FRIEv• .NE FRIER ` IVER RD TONS MILLS,MA 02648 ` Deputy Administrator Not valid wi out signatu e I i �` 1/LG �V//LI/�VIS I►GMi•/• V, Ju wuuw....--.....-.. . \ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA OZIII www mass.gov/dia Workers' Comp ensation•Insurance Affida-vit: Builders/Contractors/EIectricians/Pluxubers Applicant Information Please Print Legibly Name (Business/Or nization/lndividual): �-C p ✓ �� '1 Address: A City/State/Zip: Phone#: Are ou an employer? Check the-appropriate bog: Type of project(required): 1.ZI 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.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7. Remodeling ship and have no employees These sub-contractors have & ❑ 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 11•❑ Plumbing repairs or additions myself.[No workers' comp, c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t . employees. [No workers' 13.❑ Other . comp,instance required.] *Any applicant that cbecks box#1 must also fill out the section below showing their workers'compensation policy inforrnation ' f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a mew affidavit indicating such 1contractors_that.dmcTcthis room must attached sn additional sheet showing the name of the sub-contractors and their workers'comp,policy info znetion. I am an employer that is providing workers'compensation insurance for.my employees. Below is the policy and job site Information. Insurance Company Name:,// / C �� Policy#or Self-ins.Lie.#: I & 6 / 22—00 Expiration Date:�Z �l' )6 Job Site Address:- , �G`'' ' e�`- �QG Ai, /5�i City/State2ip- 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 o�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 ofperjury that the information provided above is true and correct Si ature Date: /(J —T l/� : 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.Bo;d of Eealth 2.Building Department I 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 lobe 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 commonwwealth 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 die contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to y=situation and,if necessary, supply sub-contractor(s)name(s),address(es)and phone mmiber(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orpartners,are notrequired to carry workers' compensation insurance. If an I:LC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Dep artment 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 Depar iinent 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 cnterr 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 ih 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 thatirng 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. Anew 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 orpermit 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 member: 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-S77-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/ilia I FTME Tp Town of Barnstable Regulatory Services • EARNSTABLE, 9 'MASS. g, Thomas F.Geiler,Director �A s6;y. �0 tE&639. i 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 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: Estimated Cost Address of Work: ��z C'/��/z� C� , r Owner's Name: / cs Date of Application: �-3O,�5 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: r /v fsz Da e Contractor Signature Registration No. OR Date Owner's Signature Q:wpfil es.forms:homeaf day Rev: 060606 Town of Barnstable °* Regulatory Services 9 XASS Thomas F.Geiler,Director Building Division, Toin Perry, Building Commissioner 200 Main Street, Iiyannis,MA b2601 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 I, ! � ,as Owner of the subject property hereby authorize iz- to act on my behalf, in all matters relative to work authorized by this building permit application for. S6 (Address offob) Signature dFOViner Date Print Name Q TORMS:O WNERPERMISSION I I 1 _ _ V I �/ I X24-1 ) h �5 im— L — — — - - - - - - - - - - - .►. , TYP 5/e" RODS V-0" Ai — — — I ► t' •* im I yh IIII � I Q I I I I -Jul I •, I � " Y I IIII_ � • I ►, i sT� I — IHI— 1X10'e 6 16" OZ, I I , IIII I (above) , i I• , ' I I '► I � , IIII; I I I - 1X10'e 9 WtO.C. I ' I (above) IIII I IIII I o IIII m 0 O I '► I ,7, IIII. Q �� � � I I I �I`III x � p Q I ► I �_ ml �� r I J ►, L — — — - - — — — — — — — — — — — - - -Illy - LLLL • ► I � zz I _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _1 1110 � 00 I .� I '►' 1 N I I I I x 1 ►' 1 1 N I I ` I I BASEMENT 1 I I I I I 4" THICK o CONC.SLAB rl I I + I - 1 '► I � I Q 41-0 I ► I / 1 ' I � (A1 N I I A I N DROP WALL 18" 1cla , ►. I �y I I - 1 (Y I I I I ►' I Q p 1 in , o' DROP 24" Q - - — — — — — — — — — — — — — — — — — — — I �► - — - — — — — — r — — — — — M — I — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — — 6'-0" 8'-0° 24'-0" . 14'-0" i - NOU CE NOTICE TO TO EMPLOYEES EWLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 -http://www.state.ma.us/dia As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to our injured employees under the above-mentioned chapter by insuring with: Insurance Company: Atlantic Charter Insurance Company Policy Number: WCV00697200 Effective Dates: 12/9/2005 TO 12/9/2006 Insurance Agent: President Insurance Agency 151 Bay State Drive Braintree MA 02184 Employer: Eugene Frieh PO Box 1063 Marston Mills, MA 02648 Workplace: Eugene Frieh 465 River Road Marston Mills, MA 02648 MEDICAL TREATMENT The above named insurer.is required:in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatm.ent is necessary and reasonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS TO.BE POSTED BY EMPLOYER `pp IME Tp The Town of Barnstable BARE. Department of Health Safety and Environmental Services MASS. t65q. �0 MPS° Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location JO Z 61)19-�cWc, AS Permit Number o �� r7 q Owner Builder (&5W6 7—iel'571pl One notice to remain on job site,one notice on file in Building Department. Th wing items need correcting: {tJoT t�-n1�1 74 kr=V4Sc-- G-30 Or- 10Lj4 Al ch& 4 7- .a. �z emu- us 4 f vE u f�CL�sS 4afLW-I C)qO6 C 1, ;P6 PAP-(eP-5; 7-,p &,A-r 6 4 b V L- V n57r - ours D� COc CT- � S�,u R-O Ft,A T �C I L I�r1— Wk11 L cJoi�Z' �o SoL/p 18LOGK#k)G — w> le�� or—� �vL &T4 `Cric'J" — CAp /5 r Nfl-EeT/NG Please call: 508-862-4@3*for re-inspection. Inspected by J "^'`7 �/ . *W4 Date fa 0/060 V �� I � � I o �% ��� -,� ��'" C-�.. � �'� � o ��� � � ��� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map X Parcel I Permit# S969V Health Division _ ,r, . - � /s�s Date Issued A A�o Conservation Division Fee # 2,9_0, 00 Tax Collector / Application Fee () Treasurer c Planning Dept. Checked in By J Date Definitive Plan Approved by Planning Board Approved By Historic-OKH /- Preservation/Hyannis Project Street Address. 302 v,,;ke b v Village � � /ice ,"zxs Owner e, Address AW Telephone 2,7 j Permit Request ` Square feet: 1 st floor: existing.&;?4 proposed 6 3 2nd floor: existing L% proposed 69 Total new c?L (7AF-VadIdation-_� Zoning District Flood Plain Groundwater Overlay Construction Type " e' Lot Size A-�e6 2 Grandfathered: ❑Yes XNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes J21"No On Old King's Highway: ❑Yes .l3 No Basement Type: 0full ❑Crawl ❑Walkout ❑Other f Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /0a/ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing, new Total Room Count(not including baths): existing new 2— First Floor Room Count t � •ry Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other _�- i Central Air: ❑Yes TM No Fireplaces: Existing 1 New 0 Existing wood/coal stove: ❑ s W Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size --' Attached garage:]existing Rrnew size Z"Z Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes WNo If yes, site plan review# Current Use Proposed Use /9 BUILDER INFORMATION Name Telephone Number �Z zD Z2 2� Address License# OS0 z CALL `�r :.�,� �•�� Home Improvement Contractor# �� Worker's Compensation# ONSTTRRUCTIONDEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO TURE DATE FOR OFFICIAL USE ONLY r H PERMIT NO. DATE ISSUFD MAP/PARCELLNO. ADDRES' VILLAGE OWNERj,;°fit Vil DATE OF RSPECTION: FOUNDATION CO)Z FRAME ..` ` 7za���� � INSULATION(5Z7/o7�04�2xCA-- FIREPLACE ELECTRICAL: ROUGH FINAL 1 PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL , FINALBUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - . . ,�. Town of Barnstable Regulatory Services t Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 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. AWEstimated Cost Zc �i G Type.ofWork: "� ` ,, Address of Work �/oa vv :4:LA e�� �� Al` Owner's Name:—/4& Date of Application: I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law Fl7ob Under$1,000 []Building not owner-occupied FlOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH.UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: L,� ! Z5 Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav i RESIDENTIAL BUILDING PERAM FEES APPLICATION FEE _ New Buildings $100.0.0 Residential Addition $50.00 r Alterations/Renovations $50.00 Change of contractor/Builder $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE Gf a y . square feet x$96/sq.foot,� � / � x.0041= p us'frombelow(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041- plus frombelow(if applicable) . QARAGES'(attached&lehed) square feet x$32/sq.$.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 . >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= �Vr (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost �. e Town of Barnstable Regulatory Services $ Thomas F.Geiler,Director o ,�► Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-403 8 Fax: 508-790-6230 Property Omer Must Complete and Sign This Section If Using A Builder I, \0 J LLB 4M WA L-SH ,as Owner of the subject property hereby authorize C yG E'Y1 e. P -f-p-j kk to act on my beh4 in all matters relative to work authorized by this building permit application for: Vuake i2d, AQws-Nf')s (AdAtess of Job) A,/ am, Signature of Owner Date W i Llr( A- Pr E L S�} Print Name Q:FOWS:OWNEMRMIS SION `pp SHf►0� The-Town of Barnstable - -- BARN ABLE. M ASS , Department of Health Safety and Environmental Services 639 `0m p'E�►^p'° Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: Wa I5 h Map/Parcel: (.y 3 O yCo Project Address: 362- W.� ,e b y /�� Builder: )�—r' 1�� The following items were noted on reviewing: 5l,e-d C'C_k. C "I e W / �2�i K r cW-rc k f Id �1D f � . e r` ,k h l \ e0. Reviewed by: AAL Date: o[O E-G PRtE. E08a2a297e 01-210a T5,02un P w?.. Pema Number Mc'heck Cumrtlkance Certificate Chedcl ByDeto 2000 we RESdwk Soff s Version 3.6 Release 2 Uaa film-c C:1Pm9an FIIeetCheek%REScheek173204 Fndt Const. PROJECT TITLE:New Custom Additicn PITY:Mntons xlilla STATE:Slessaohudm HUD:6137 CONSTRUCTION TYPE:Single Fmnily WD:DOW I WALL 3ATIO:0A DATE:U102M6 DATE OF PLANS:M-29-05 �OIEC-T-DE.SCLTTION: 4il W h.Residence� 3C2'\Yal-vby ld77 rMarstone::\til7s,:4fab`2676 DESIGNER,'CONTR ACTOR: F P.Fneh Cooetneetien P.U.Box iD63 MMtons Mills,Ma 02648 PROJECT NOTES: Ma Check By Cqe Cod Iosclaion COMPLIANCE:Pau. M.imtun UA=365 Z Homo UA z 294 6.9%Sew Than^ode(UP.) Cams amins AM or C.mnry Cone cr Doer Par. LL-Y:= R-l'alne M.E=,31A Ceiling l:MA Cdliog os Scissor Tress 900 ?1.0 0.0 28 Ceiling 2:Catba g Ceiling(no epic) 450 30.0 0.0 15 We11 1:`Rood Frame,16"o.a 76;0 13.0 om 115 ' Wirdo l:Wood Fly ,:Deublc Pone I"Low•13 169 0,3.30 56 Oonr 1:So1:d 20 0.340 9 Ooar 2:CJ:ttsa 20 0.330 '1 Floor 1:All-Wood JoistJTms:Ovc,Ummnditioned Space 1194 19.0 00 56 Boiler 1:'Iter.(E.=nt Ga.Fird Steam)•84 AFUE ' j/ ARAI • :.Y �C"NUmbe QT4 NSTRUC poW. � PO gNF,P no, 1506 r' M'q'RS 8 �8 �. . o' er . � �lze elrnmzoouueal� Board of Building Regulations and Standards License or registration valid for individul use only HOME IM:i4s �VEMENT CONTRACTOR before the expiration date. If found return to: Re istwa n. 09482 Board of Building Regulations and Standards "ira JO — /2006 One Ashburton Place Rm 1301 i idual Boston,Ma.02108 EUGENE P.FRI EUGENE FRIEH " Pb Box 1063/465 RI MARSTONS MILLS, MA 02648 _� Administrator of valid wi ho t signature J[� ; EUGENE FRIEH 5084202576 01/09/06 12:39am P. 004 notes, Double 1-3/4" x 9-1/2" VERSA-LAMI&2.0 3100 SP Roof BeamI11601 BC CALL®9.2 Design Report-US 1 span(No cantilevers 0/12 slope Thursday,December 15,2005 10:57 Build 141 File Name: BC CALC Project Job Name: Walsh Res. Description:RS01 Address: 302 Wakeby Rd. Specifier: Botello Lumber City,State,Zip:Marston's Mills,Me. Designer. J.B.Designs Customer. Gene Frieh Company: Code reports: ESR-1040 Misc: 12 i I i 1 t �T' a Y fi f)f f 1,r . '+FI'�� �, s t+ r✓r �- k3Y it a s r• ,e may. s4Hl`. Li•aM�t�'�. ,'a i 3. .'1. N' 1 .} � - R)fryF ZL 3 ih L .:`�5 }iY C i St ".'4,Y.+i, r �_4..Snit DTI t `t 1540-00 BO,3-1tr 91,3-1/r U.188 lbs LL 188 lbs DL 1495 lbs OL 1495 Ibs SL 1500 bs SL 1500lbs Total Horizontal Product Leno=15-00-00 Load gurnmary Live Dead Snow Wind Roof Live TTa _Description Load Type Ref. Start End 100% 90% 116% 1339E 125% Trib, 1. Standard Load Unf.Area Left 00-00-00 15-00-00 15 psf 25 psf 08-0&00 2 layover roof load Unf. Lin. Left 00-00-00 15-00-00 D pfl 60 plf n/a 3 ceiling load. Unf.Area Left 00-00-00 15-00-00 25 psf 10 psf 01-00-00 Controls Summary value %Allowable Duration Load Case Span Location Disclosure Pos.Moment 11217 ft-lbs 69.9% 115% 2 1 -Intemal Completeness and accuracy of input must End Shear 2723 Ibs 37.5% 115% 2 1-Left be verified by anyone who would rely on Total Load Defl. -U204(0.854") 88.1% 2 1 output as evidence of suitability for particular application.Output here based on Live Load Defl. U386(0,453") 62.3% 2 1 building code-accepted design properties Max Defl. 0.854" 85.4% 2 1 and analysis methods.Instagation of BOISE Span/Depth 18.4 n/a 1 engineered wood products must be in accordance with current installation Guide Yo Allow %Allow and applicable burllding codes.To obtain Bearing Supports Dim.(L x iM Value Support Member Material Installation Guide or ask questions,piease BO Post 3-1/2"x 3-1/2" 3183 lbs n/a 34.6% Unspecified call(800)232-0788 before Inslafiation. B1 Post 3-1 2"x 3-1/2" 3183 Ibs n/a 34.6% Unspecified BC CALCO,BC FRAMERS,AJS- ALLJOISTM,BC RIM BOARD-,BCM, Cautions SYSTEMS, GLULAM^' SIMPLE FRAMING SYSTEMS,VERSA-LAMC,VERSA-RIM Column at Bearing BO analyzed for bearing only,column analysis has not been performed. PLUS®,VERSA-RIMS, Column at Bearing B1 analyzed for bearing only,column analysis has not been performed. VERSA-STRAND",VERSA-STUDO are trademarks of Boise Wood Products. Notes L.L.C. Design meets Code minimum(U180)Total load deflection criteria. Design meets Code minimum(U240)Live load deflection criteria. Design meets arbitrary(1")Maximum load deflection criteria. Member Slope=0,consider drainage. Page 1 of 2 ` EUGENE FRIEH S084202978 01 08/OS 12:99am P. 002 Double 1-314" x 9-112" VERSA-LAM® 2.0 3100 SP Roof Beam1RB01 BC CALCb 9.2 Design Report-US 1 span No cantilevers 10/12 slope Thursday,December 15,200510:57 Build 141 File Name: BC CALC Project Job Name: Walsh Res. Description:RB01 Address: 302 Walceby Rd. Specifier Sotello Lumber City,State,Zip:Marston's Mills, Ma. Designer. J.B.Designs Customer: Gene Frieh Company: Code reports: ESR-1040 Misc: Connection Diagram a ; a minimum=1-12"c=&1/2" b minimum=4" d=24" e minimum= 1" Member has no side loads. connectors are:SDS 114 x 3412 r EUGENE FR[EH S084202S78 01/03/OE 12:ssam P. oes ® Double 1-3/4" x 11-7/8" VERSA-LAW 2.0 3100 SP Roof Beam1RS02 BC cx-co 9.2 Design Report-US 1 span t No cantilevers 10112 slope Thursday,(December 15,2005 10:57 duiid 141 File Name: BC CALC Project Job Name: Walsh fees. Description:R802 Address: 302 Waiceby Rd, Specfer. Botello umber City,State,Zip:Marston's Mills,Ala. Designer: J.8,Designs Customer: Gene Frieh Company: Code reports: ESR-1 D40 Misc: _ _ �._ 1 z �_. T.r.._. �t._�..._ -�._• -- v b _} 'o _._�s._.t I i--- I �.. L �.._7 j } �_T-. JY T_�.S=T ! 1` YL.� f >L .Jr � _1 L.S • .�. .i�L_R-�+i Q' •��d.y, K.�i�Y 9!Wl & 80,312" 81,3.1/2' 175 LL 175� LL 832 Ibs OL I&V lbs DL t fAs SL 210D Ibs SL 2100 01}Ibs Total Horizontal Produci Lengths 14,DDa Load Summary Live Dead snow iNtrtd Rod Live T�Desetiation Load Type Ref. Start End 1o0% 80%s 91596 133� 12E9S Tvtfb 1 Standard Load Unf.Area Leff 00-00-M 14-00600 15 psf 25 psf 12-00-00 2 layover roof load. Unf.Lin. Left WOO-00 14-WDO 0 pif 60 pll Iva 3 ceiling load Urf.Area Left 00-00-00 14-00-00 25 psf 10 psi 01-00-00 Corttrola Summary value _ %allowable Duration Load Case �l I"" Disclosure Pos.Moment 13448 ft-ibs_ 55.0% 116% 2 1-Internet completeness and accuracy of inpi.rt must End Shear 3355 tbs 36.9% f 15% 2 i-Left be verified by anyone who would rely on ouWTotal Load Defl. L/358 0.454 50.3% panic as applkWde li of suitabnity for { � 2 1 pariioular appl}catlon,f?ul}uA here based on Live Load Deft. 1-1846(0.252') 37.2% 2 1 building code-accepted design properlfee Max Defl. GAW 45.4L%, 2 1 and aria"rnettrodti.tnstaf don of BOISE t engineered wood products must be in $pan 1 Depth 13.7 accordance with current Irtstallation Guide 'b Allow 9'o Allowand appomWe building codes.To of taln !.maltation Guide or ask questions,please seBfritlg PAo Rim,(!x 1Fl8 Value Support_ Member Malarial ran(800)232-0768 before installation.80 Post 3-112"x 3-1/2" 4107 Ibs n1a 44.7% Unspecified B1 Post 3.112"x3.1/2' 4107lbs n1a 44. % Unspecified ���CO BFRAMER*, MMER*,�°�10 BOISE GLULAM-,SIMPLE F"NG cautione _. SYSTEM®,VERSA-LAM*,VERSA-RIM Column at Bearing HO analyzed for bearing only,column analysis has not been performed. PLUS*,VERSA-RIMCD, Column at Bearing 31 analyzed for bearing only,column analysis has not been performed. ��mAk4RA �o-s �are - P� Design meets Code minimum(U180)Total load deflection criteria. Design meets Code minimum(U240).Live load defieclion criteria. Design meets arbitrary(I I Maximum load deflection criteria. Membor Slope W 0,wnsider drainage. I EUGENE FRIEH 608420297e 01/03/06 12:39am P. 006 trouble 1-314"x 11-718" VERSA-LAM@ 2.0 3100 SW Roof BeamIRBO: BC CALCA)8.2 Degigrl Report-US i span No cantilevers 10/12 slope Thursday,December 15.2005 10:51 Build 141 File Name: BC CALC ProjW Jab Name: Walsh Res. Description:RB02 Address: 302 Wakeeby Rd. Specifier: BoteBo Lumbar City,State,Zip,Marsto6s Mills,Ma. Designer: J.B.Designs Customer: Gene Frieh Company: Code reports: ESR-1040 Misc: Connection Diagram __ T—� i n I C a minimum=1-112'c=8-7/8" b minimum=4" d=24" .a Onimum= 1" Membei has no side bads. Connectors are:SDS 1/4 x 3-1/2 I EUGENE r R f EH G"1,GW/eE 11.:24pm P. e0a Vk. 6PS Mr,Q Crg Daniel E. Braimam P.L. 189 Harbor Point Rd. Cumttmagwd, .WA 026?7.0361 'Desm , or- ;Z� iaL®c,rz l'sT� 1 70 i• (L / 2. Co,e•e"C6Z.t� c...c:.=d�,C� AtL�� r 2cb���. tea 0-10 e4 , fit' `fs DANIEL E.BRAMAN G o 4 STRUCTURAL 44 m L���N+rPsf I• NO. SIDRAt .a txa>o 4; m fin) m n■ i �.■. — =:�]_a�e e� � ., .. .. - - - - -_ :�...,. . -- — .IL.r.__,I� _.I�rr!-'...._„--•.,•_-- --- ��11; ■ �■■i =-_- ............. � - - - •-fin■n ___�. _ _ _:iillllll�lllllllll IIIIIIII " � - - a____I-------•---._._.,I���I _-_�_ �=�I■n�■■■ = - All ---= r MOM --- =� a-■ um \ ; ..a mill--------------- --------------- .. .. ::: :.. n u■,; - ll --_ - - _ _ ■■■: - = __ in - _ _= IIIII ■_ _ �IIII n ' � u= _ -J �I oil III u■� T ■■ - Y Jim as — rr,• ----- _ _ --- _ - - - - - - _ -_ -_-_ -_ -_ _ ill -- , I Exm814 1 EXTERIOR oFGK' I I fd' . Dn.nYf• E7SCID14 "mEI BAItl _ 1. r:Aaeoe EXI@IM4 E7L1 �� ran CIMtEsm r elA�g,emkcH : IEXMIM EA= Wulff, :=am r ; op Ytl ---------- - LKW4 , ftl C4i7 Lv'L'.ABOVE - Ye. • b ...�murex, S NFW AND FX15TNG FIRST FLOOR PLAN ? T N`.n va. • .r.u•iwecaoeai.viu. a .ewa __.-____-_� ie..uArayry i DARE 4 T GARAGE =fw• rr� b s _ ----------- ----------- DRAWN BY p,AkE SCALE B r1 : JOB ADDRESS' MAGGIE WALSH QFS'" ENLARGE EXISTING KITLHEN ADD NEW GARAGE,BEDROOM AND BATH. 10-7BB005 .s ,s�s V_r-0• ✓B Designs ROAD MARSTONSARSTONS ROAD MA, i�ueeaw�s�✓<�.,^�"°N'�ea '°^ � NOTE: eov mx ro. . EXI8r01G--------------------- -----------------r________________ aroa-F AREA BarthOA. BFDa00M S - Ex181NG gig. r N� t+^.. Ex%T _ BEDROOM EXIBF � eEoaoon ----- NEd F �) V - 9 3 'A e 9 k 3 9 -------------------- DRAWN By PAGE ``ZaALE. Designs QFSKN s w_ro• x�B ADORFSS MAGGIE WALSH ENLARGE EXISTING KITCHEN ADD NEW GARAGE. AND BATH. p-78-�05 0 •IB 1E-- _ .vo.omx. ewirea.a -L,2m 307 WAKEBT ROAD uwrn,m o..ucouun•°°'°1°' • MARSTON$MILLS MA. ��i 'O•uyO:°�.n.•« � � y p1.w1OfJ:v'ero +'.,u�ia m�ra• p1O°•r"1O'r' ' 1°"yre�w�w.�u ove°enunrd oo,+n'iar•�'��a,. xFm FQMDAl10N mALlOY tl/./ _ . Fxllf® s B FOOTIUG nFTA B' ONGRFTE WAL o/ w EE _____________________ -----------------vvvvcavevevve orr •� � � � j I 1 11� � • 1 f 1�1 1 • I I� ra • I 1 1� i a td • I I 1� � y� • • • • / / 1 1 1 1 1 /� ed --- x'd ---------------------------- HEMPmy e •e•.�1 F. yy rtl Lb �pp.p b y8 FOl nAiION PLAN I •l BA501M 1 o•e.n 6 tla. wa Qp���' FLOOR FRAMING PLAN DATE REVISION DRAWN BY PAGE �� ✓B Desgns AUn R: ,gB ADDRESS' MAGGiE WALSN OFS'GN ENLARGE EXISTING KITGNEN ADD NEW GARAGE.BEDROOM AND BATH, 10-W-2005 .B V4_f-0' 302WAKEBY ROAD MARSTONS MILLS MA. NOTE: nmu.e�marowuerov 5n'755 IIi _ L GASeGE °i nr•<w..neao.• SDEWLL • .om r°clue TTVEK OR EOSAL ____________• N PLY.OWATNWG OWY 0 --------------------------- 1 - 61®WLES 6TARhR Q GE02 5ECDON IAI COARSE ��. MSP.T.SWL ` N SS1SEALER H TOPR—f WAR VMIY ANQIDR BOLTS G ti OG. U 4111 DETARS e.r°xae•oc. _ - �+ev.e cam' I Hues E' •� •eou•[a - 1 on ✓a+• .ua°oum °uP.�sHaL•iYu�m.rAd ci wc uwnl<m j,��IjBQp'�C_ ® � P BH6NA.NSFLRTfuG�ELP AEEBASDDHE�PB o♦ED F 1VR�9nGAE'tCNAn YTL.E I MD.DGRVFR EERD GEqA7TU LT D ROOF FReMMG P,rI d MN .e f fR095 gEG TION IBI DATE QEYI$10y DRAWN BY PAGE ALE JOB ADDRESS: MAGGIE WALSH DEW C-H ENLARGE EXISTING KITCHEN ADD NEW GARAGE,BEDROOM AND BATH. 10-3B-1005 a WW �SoF S V4_r-0• ✓B Designs 302WAKEBY ROAD MARSTONS MLLS MA. •'�"'"�Q1°a"��"'�'°�10de ��• a�wppptlmwfOEean�"•�m�°w°F°Oieo:av ky i : TO N OF BARNSTABLE BUILDING PERMIT APPLICATION Map © ''1. Parcel Ll T13'7N 1i z''.'?',33TAELE Application# Health Division aD- f A /�,pi hP..R 18 PFi t;: ! � Conservation Division Permit# �` 7 Tax Collector -� -�` � ' :�.{j`� Date Issued ��z ;v; Treasurer L' Application Fee lip 6- t �d Planning Dept. Permit Fee r �� Date Definitive Plan Approved by Planning Board EXISTING SEPTIC SYSTEM Historic-OKH Preservation/Hyannis LIMITED TO�_#OF BEDROOMS Project Street Address Village iP) I Owner (Y'd Q Q i-0, W Q J� Address Telephone Lt a B Permit Request 'Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation D��� 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: O Yes ❑No On Old King's Highway: O Yes ❑No V Basement Type: ❑Full ❑Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new 1-1 Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count 2 Heat Type and Fuel: ❑Gas ❑Oil 0 Electric O Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: 0 Yes 0 No Detached garage:O existing 0 new size Pool:O existing ❑new size Barn:Cl existing ❑new size Attached garage:Cl existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes O No If yes, site plan review# Current Use --- -- - Proposed Use ii-- BUILDER INFORMATION i Name a/1 CQ�'�'G��'1CJ Telephone Number � � ( � - "3 Address License# 65 0?g311S Home Improvement Contractor# Worker's Compensation# � ��� C- ?J 0-5- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. r DATE ISSUED : 4 MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: le 4 FOUNDATION FRAME INSULATION //yy FIREPLACE l� d (, �� OGAAck ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL YYY fie GAS: ROUGH N t- FINAL FINAL BUILDING 0 o O 0 O DATE CLOSED OUT ASSOCIATION PLAN NO. I� Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,M4 02111 f www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/organization/individual): Is e4A Address: �� ��� L'e% `Ql W 4 C1�1( So� City/State/Zip: hone#: `��U� �C7�,`�cS�S`�' Are ou an employer? Check the-appropriate box: Type of project(required): 1.7I 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.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. workers' comp.insurance. g, ❑ 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 l L[1 Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12,❑ Roof r airs insurance required.] t . employees. [No workers' 13.❑ Other�V<« &'n1 at comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and,yab site information. tt II Insurance Company Name: `Z V � 1 Policy#or Self-ins.Lic. #: 'Z_Z',)b(D1? �. c I [?4:� CS- Expiration Date: ?10 Job Site Address: � f'`��' City/State/Zip:' All Attach a copy of the workers' compensatilon policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under the pains andpenalties ofperjury that the information provided /above is true and correct Signature: Date: Phone#: 4? IS'S �� ���" Za C Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# i 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-contractors)name(s),address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLQ 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 punted 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 pernmit/license number which will be used as a reference number. In addition,an applicant that crust 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 F 617-727-7749 Revised 5-26-05 wwtiv.m2ss.gov/din °F"ET� Town of Barnstable Regulatory Services 9BKAMMUiSTABLKg" Thomas F.Geiler,Director 039. ►a. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 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: s��. Estimated Cost (Di ©. O c� Address of Work: Owner's Name: a,qUZ_ lr✓C Date of Application: CP I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Ll Ll Date Contractor Name Registration No. OR Date Owner's Name Q:fomu:homeaffidav ®> TME r Town of Barnstable Regulatory Services MASS. Thomas F.Geiler,Director A,E 639. 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 Property ®wirer lust Complete and Sign This Section If Using A Builder -- c I, 1 ►�� ,as Owner of the subject property hereby authorize e.av- IVY • C ou ko to act on my behalf, in all matters relative to work authorized by this building permit application for: (Ad ss of Job) Signature o Owner Date �KAC=C rE e . w A-f-s H Print Name Q:FORMS:OwNERPERMISSION Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR ! I LExpiration 11/18/2007 6 s;-- i Yt?:?"sbBA ( SEAN CO dY'A SEAN COUTINH'O'� = 21 PC KEREL WAY (ORESTDALE,MA 02644 � - Administrator ??// lipp.:....... -•e .s.,-��//+,. - ti-•r.:a7:`t•r'�'y�:��. -.i ✓JtC •C)O�I!7/I)t0021lIC2GLIL O� ��,,// // �,�3 ;?• ✓UGIrddQ�Lll }}y BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR Number`: 079315 _xp'rees: 06X06%2007 Tr.no: 14467 esirisfe:d:t --A=; t I SEAN M COUTINHO- l i 21 PICKEREL WAY44;- = FORESTDALE, MA 026`44''4 Commissioner • o Mi �� I —�I�,ul■ ,won'Ron_;gG = - j' - - i u:11111 �� EN LKER r. n.;...1.....fm r: F _:,�e ee ee 1{�� — _- ..._ _-_-- -- _�ul Il ---Jul 7..: — — — — II IIII - ._.- hIIIII _ ..II -'I - _ I III P - _- III ' .I _J = _ III� � - _ I = _ � r own = ° inns l pol man ■_■�i —3 _ _ _ _ .■■ — / .long_. - = _- I ■■ go.II w....m. .' mloNo- _logoL�'�� . : — - _ I I �.......— _ _ � — —_— _�:x• I _Clog I EX19>�i I EXTFR oa oFGK I i I --------------------- y Emma CLOM 9ATN E I 1 •' ^ ~ - IIF l' ' � n ' GeBAGE �� KRCxNA2�A I rA '� PORGN 4� EA= 'I - �snni ---- UYltl4, r• r+• �I ra ' e'�SVY LVL�ABOVE,;S C� N1O1f«, rmu � y b NEW AhD EXIONG FIRST FLOOR P AN b �• rM• fG BTEP rar . Aewr ren'wmcaoe ontiu� y __________� �sautsrwaao. BAIH ' GARAGE `''w• / t Fx1eT.Err.eA re ' � 9EQBGPII cvAT,MI ;yp ,mod b Fb IXT.OALLB i unn MT nut 1 a __________I aye. DAIS REVISION DRAWN BY PAGE SfAIF ✓BDeelgns 10B eDDRE55' MAGGIE WALSH � ENLARGE EXISTING KITCHEN ADD NEW GARAGE,BEDROOM AND BATH. 10-20-7005 0 JB �'.ocS 1/4%1.0, 307 WAKEBY ROAD _ MARSTONS MILLS MA. NQTE� "� ocm�vmao e+inu�e a�oorauo,,,.c�' o �r�� �r�p 1°um ee"wniw�ronmuew Meaeoa.um ' e _________________LU nT Ref_ EXIBT. D00TN0 , _. 04M BEDROOM ExIMMWD EXIBTWG rm� NEW wuanr ExamG - BEDROOM E,,*WG BEDROOM � ------------- ------------------------------------------------- L� ------------------- HER �XISTI'.� ND FLOOR P dN b GTea Y Y z • b a �� RHEy�s14y DRAWN BY PAGE Pf eL F ✓B Desgns JOB ADDRESS' MAGGIE WALSH " QE ENLARGE EXISTING KITCHEN ADD NEW GARAGE.BEDROOM AND BATH. 10.7E-TO05 D JB S V4.r-O' 8�n DFR; 307 WAKEBY ROAD " Dun usaoccv'ma.u+.vw<wm'oomn+ "D'^°""'' �� � MARSTONS MILLS MA. an'�mo'�ewevcw+u'exwanaA" '4'° ti= m.wu rnoo ua ovmiuv..eoaeu�.r w'u�mn ,rn'cmnwcmooac'wvwrooa+mxiacu ewoecx. raon�cw ax.ne m>vene'.neoe omen caiemzmx 22 JxML EQgdQAJNM WAI I A ' ux�AGtmounlul .d..m �� ••� pw�`f•b.M Flo. D EOOTINC•DFTAII A'rQdrg TF NAI I m • ��w e. ____________________________ o � � ve euoe "U' ------------------ a EXISIWG .0 n•m.uu FXT-DECK DETdII BAN�r _ _1._ - 1 1 1 l l avvvavavvvvve _ __ • • • I 1 1 / ! 1 I !� ' Xo• ' re Te • __________' ' ' •rw • o ' 1 l I l l 1 1 I' Xc u 1 f 1 ! ! 11---------------- 1 n ------------------------------- mat - - - . c� FOUNDATION PI eN I -e.ar N•_ I. 'L-------- 0 ------ ------p ----- .•a 4 i FLOOR F12d MINC.Pt eu DATE RFVI4ION DRAWN BY PAGE SCAyE JOB ADDRESS MAGGIE WALSH Q 5'" ENLARGE EXISTING KITCHEN ADD NEW GARAGE.BEDROOM AND BATH. W-25.2005 $ hoc S V4_�-0' ✓B Desgns 302 WAKEBY ROAD MARSTONS MILLS MA. NOTE, ' ��� o�iacun.evu���•n�o"r����oern< ma�w vNnus RD BtoRAE RFa Temn ' ir I I I �aAa'•RY'OLr J 4dRAGE B e^OiD -BmEItALL ' F�ti•° TYVEK OR FOIUL / WKY.B ARBNG V ' I "Gus STARTER V G.R0555FGNONLI COARSE a y }XBP.T.BLL VDc6 BS.L SEALER r_ TI5 TOP RBG f CLEAR VMO'ANCHOR BOLTS NIP SLL 1 im it ABPNALT"GLE8 rr Ye�Ruo ® 50 ASPHALT PAPER V/PLT.SI�ATHOL6 1Bo 8ALLwAL S1WROpO 'j ————I . ..o. I eery I I V 17 DRE•EOG - 9'ANM.CORER ® enema eR•HMOBetttn _ _ _ _ _ _ _ _ _ _ _ ttt, _ w RM eu�cwmnm D(B FAp4 t �� ROOF FRdMINC•PLdN r�.xu aeirm BED MID. { B 6 FREE t D FAVF DFTAA 5 l GR099 9F[TION�1 / AI QAIE REVISION DRAWN BY P9GE IAI F • JOB ADDRE59+ MAGGIE WAL9N QE@1GN ENLARGE EX15TIWG KITCHEN ADD NEW GARAGE.BEDROOM AND BATH. 10-)g-2DO5 0 „g ISOF S V4_ro• ✓B Designs 302 WAKEBY ROAD •+ MAR STONS MILL5 MA. NOTE; Bm rwem�eT a Bn.lena.» x..eme b � ^^TIN�DETA B' -ONGRFIE WALL � �' Barr ------------------------ ------------------------------ ---------------- ________, e e e v e e e e e e ee_ _ • / / l / l l l /' v w H 3(,c to. . � l l .e+•..ne ec -- ---- ------ a ' — -------------- � � T n _ -------------- I rb Q�q��` BOOR ERdMINC•P�eN DATE RFVYSION DRAWN BY SAGE SCALEJOB ✓B Desgns ADOR 5 � ENLARGE EXISTING KITCHEN ADD NEW GARAGE.BEDROOM AND BATH. 10-26-1009, JB e¢OE V4_I.4' MA SToNS ROAD wa mnti.eev�em�s� e,,,..e�,¢�nuu�ra.asrz eooMm euu nrtw mwm�v.m�oam ' MARSTONS MILLS MA. H07E: �� ,,,, 'eew'�o m�e'^c'�� °Bcow�Oimeror Tx�a I �J gW-cu.a of I I --------------------- r.• E�9➢tlG BAQl ' „ aow•u , i i , c eaecE E�6»d4 rd eM�Qv(LVL••ABOVEn•1 i wd<X« wda _ b �( "AND XISTM-FIRST FLOOR PLAN . ®® op nn A rO, QIEP R / ffG r e. .. .�.....,.. G e(�' fq k� LP� �I a '�----� e ! � 2 fd• 3 � Y J � ���,� I N K � o I •s I 1 ---_-- -=--- ` da.• ' EXPT FM tl.�Q i O IgQI Mi.NALLB 'i . ed Oa' Td ya. DAIS -Ey�$fQj{ DWN BT 2AC£ lYAI F ✓B Designs hB ADDR MAGGIE WALSH DESIGN ENLARGE EXISTING KrTCWEN ADD NEW GARAGE.BEDROOM AND BATH. q-ffi-2005 RA JB �1 S U4�P-0� �I DFR� 302 WAKEBT ROAD MARSTONS MILLS MA. �g 'a A� m�caov wo rc�m Rsµ - _= 0-31 III�,,..... ' - Lin nee - — m Ey .■i lunl,■.! mill It __-____;_ „i _=:=__= ■u;m _- „1�■„�L,,,i,t�r — — — — u�pi IluilT lull ::r_ti?��IIIIIIiIIIIIIIIIIIIIIIIIIIIIIIIIIIIII ' J " � ` 1, _..__.._I:.: r:a_ __:•I,,���II-----_:ra:�zl„�,,�,�I:c ._�i ?MM. gnu IN ✓ �I—i�"1�r' ■■■ e,■ .�Wit, __._ _ MR -- ! ne- if am's I I= - - — — — — — - -- mill am I. in I I _ _ _ _ _ _ _ : _ _ _ - : _ _ r c •r r - n _ _ _ Assessor's map and lot number ... .... ... ...": .... ............ SEPTIC SYSTEM MUST BE INSTALLED I WITH N COMPLIANCE Sewage Permit num'ber ....................:..................................... ARTICLE li STATE Qy0f111Er��♦ N TOWN OF BARNSTABL TOWN BARX� 6 9 A33L w BUILDING INSPECTOR MA41 • fr APPLICATION FOR PERMIT TO .... ... .....C�t . . ... .. ....................................... TYPE OF CONSTRUCTION .......11/ .. .................................................................................. UU I TO THE INSPECTOR OF BUILDINGS: -?n The undersigned hereby applies for as permit according to the following information: y� Location ....... ..aA,,�........4.z/ ......./ .�........... .. . .<!�C{I�fd�� .. �X.......... ProposedUse .......iYr.?lr�... .. . ...... ................................................................................................................................... ZoningDistrict ........ ....fie ..............................................Fire District .............................. .......................................... Name of Owner ... .... . ....:44neL&.................Address ..... . ' //; .e................................. v Name of Builder .....all'InA.. ... . . . . . .t.....&�r,,/.. ddress ...... .....�.... . Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........... . . ..............................................Foundation .......4l -&... ..j rly� Exterior ..........LN.a,... .....................................Roofing ........ Floors .......... ...............................................................Interior .......,,61 . . ................................................ Heating ...... ..................................................Plumbing ......../_41_1 ............................................................. J/ va Fireplace ........... .1'1. ........................................................Approximate Cost .....t �'/. Q. .!..................... Definitive Plan Approved by Planning Board ------------__-------------19_______. Area 1........................�.`�oz..�..5'e Diagram of Lot and Building with Dimensions Fee © 7P ..................................... SUBJECT TO APPROVAL OF BQARD OF HEALTH -Pak 49. U�jh t5- zry I d� I� 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ... /4 ................... Small, Donald ,j No ......2..........0018 . Permit for ..">40.1~1Mr-t3ag......../ one 1/2 story..st> &l.gt..fmmi.ly...dw«........ Location N;2 41WA'...RoAd.......���.... I�tars tong.. . .l.et....................................... Owner ....DPAAWA!IAIl............................. Type of Construction ...wood..:Erame................. ................................................................................ Plot ............................ Lot 1.22A..................... Permit Granted ...M1`KOX.15......�.ii.............19 78 11 Date of Inspection �!. � 7f/...............19 Date Completed .. �.... . . .....19 0.10 B,P3 I? PERMIT REFUSED ................................................................ 19 ............................................................................... L. :.' ..... s.......... .................... ........................................... ........................... ✓. ':'.....: ?...:::........................................ Approved ................................................ 19 ............................................................................... ............................................................................... Assessor's map and lot number ...........................^............. Sewage Permit number .......................................................... THETO�y TOWN OF BARNSTABLE l EA"STADLE, i "b BUILDING INSPECTOR O•E�YPY tr APPLICATION FOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ......................................:.............................................................................................. ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder .......... .........................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board _______________________________19________ . Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Small, Donald M-43-46 k 1 20018 No ................. Permit for eonAX.rmcting........... one l/$..story sing h.. smllp::dw_....... �. . ................... ..... } 302 gkeb Location ......................Y...did................................. ................ .........:.:.................... s 1 Owner ...Donald Sm .,l..................................... Type of Construction wnjad.. ................................................. Plot ............................ Lot .... Y22A.................. e . 7 Permit Granted Mar ..1A .......1978 Date of Inspection ....................................19 Date Completed ......................................19 j PERMIT REFUSED .............................................. ............ 19 i r ......................... .,......... ... ... .......... i ....................... ...................................................... . ..................... Approved ......................................................... E .................... ..................................... ....... l ,Assessor's Office.(Ist floor) 'Map " Parcel CAL t# Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 5 1 l 3 K& ate Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) Fee _ 71 S Engineering Dept. (3rd floor) House# t �� lie Planning Dept.(1st floor/School Admin. Bldg.) ' BARNSTABLE. Defini ' e A ved by Planning Board 19 ;,�fo,'u�+'•� TOWN OF BARNSTABLE , Building Permit Application Proje St ddress 2 2 2 A- Village N mac.S Owner CL , ,"., Address ,gip Z. ��y Telephone y o?7Y3 ,Permit Request .P.Gbr TYST_ f GnPll1//l/dgV_&1A -,-n 1i';•f Rog DLA&; First Floor square feet Second Floor square feet w Estimated Project Cost $ C 22 ,moo Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use a1f704&1,-- Construction Type &&d22Z,� Tp rYJj�jZ� �Zj T/n/G Commercial Residential Dwelling Type: Single Family V111- Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House 1U0 Unfinished Old King's Highway Itie Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached 7" Other Detached Structures:. Pool Attached — Barn None Sheds Other Builder Information Name /�.4�1i22/r✓� Telephone Number !f2 Address le,y6—AJZw Jar uD License# D,5 7 O 3 Z �Zz/ Home Improvement Contractor# le4 70 O 17 T/���ilir; Worker's Compensation# D 8 U•1E/3 w e?Yg NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO of SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ci�/ • FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r- MAP/PARCEL NO. - ADDRESS r VILLAGE OWNER DATE OF INSPECTION: ' FOUNDATION FRAME -Zp. 'INSULATION FIREPLACE • ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH -FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. , he Town of Barnstable t, . T �h . x"& $ Department of Health Safety and Environmental Services i Building Division 367 Main Strzek Hyattais MA 02601 Ralph Crosson Off= Sob-79o-6227 Building C,ommissione: F= 508-775-3344 For office use only Permit no Date AFFIDAVIT HOME 1WROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERwr APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair;modaai=tion,won' improvement,,re:mo%al, demolition. or construction of an addition to'any pre-aast na t building containing at least one but not more:than four dwdUng units or to to such residence or building be done by registered oonuact M with certain ecoeptions, along with other =quirt r== hip s 7-1'V4 7 gt�e- o ✓07?' q Type of Work: %Z�X 2 G Est Cost �— a-O a Address of Work: 302- 2r> Owmer.Name- Date of Permit Application: I hereby c=%ify that: Registration is not required for the following reason(s): _Work excluded by law ob under SI,000 Building not 0w=-occupied Qmra pulling awn Paz* Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT E G DO NOE��S TO THE FOR APPLICABLE HOME WORK ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. I42A SIGNED UNDER PENALTIES -. PEP-MY I hereby apply for a permit as the agent of the owner-. Date /� nu zne Registration No. OR Owner's name , A. Y . i eo T 1 r., 7ntbc,iv;":- .... ...:. . ,...v _..."a..�:.....: �`.� ..�, 3 .��..m...�..rY ;.,,rr ..�„+».'-•.nv ri:`An't+n+.-+si PLOT PLAN FOR LOT .# Indicate location of garage or accessory building Additions with dashed lines -------------- ---- Sewerage disposal (cesspool) Well jg I (lot.... .... . . .. .. ..ft: rear) .Abuttor's ( Abuttor's Name Name Lot # Lot # REAR YARD If this is a �r f If. this i corner lot, . . . . ... . . .ft• corner lc write in name write in of street. _ name of 04 other v ) street. ro b • lee SIDE YARD • SIDE YARD FT. HOUSE � • �J-- - � FT� • • L2 r • �s' • 3 SET BACK (lot..... ....... ......ft. frontage) j .tea z �Aic�3 y (NAME OF STREET) Information Supplied by MARK NORTH POINT • J . r.v � `�"3�A t�0 ,�.� . L •� ''"""` t' � '_ .L6 �0911/1IL071�G%�E:..w.IV O� 2'nl�;(/C(r(.(I r I I Ysrx .u4;{L HOME IMPROVEMENT CONTRACTORS REGISTRATION 1,<yt r . oard of Building Regulations and Standards One Ashburton Place - Room .1301 I 'Boston, Massachusetts :021.08 �Z {Sh'' , •HOME`'IMPROVEMENT •Co r _ ax • NTRACTOR I --------------------------------- � Registitation 100740 Expiration 06/23/96 X k; r, 'PRIVATE CO RPORATION M. Type yr..l�..o(. HOME INMVEMENT CONTAACTOR...,• ,. .Capizzi Home -Improvement ,rovement Inc . P t Typo ---PRIVATE CORPORATION- Thomas •Capizzi , sr . tIV •Eipltatlon 06/22/96 1 -}; 1645 Newton Rd . t Cotuit MA 02636.., i C�pii:l Role Itt r p ove eolo Its t ,x i:<s �A Tho�ee CePlztl, Ir. . •Cotull NA 01636 DEPARTMENT 2 1 � G ONE ASHBUtt i DOSTUN, AUCTCON{iSUPERVISOR LICENSE Expires: . • y r �.4 fn ,POUIVAL• ,b art•.;: { IRKS ABLE:• ,tA "'02660 4 t F p ) } Y --- , .The Commonwealth ofMassaehusetts • . a,,� _ -.:__ 3'e Department of Industrial Accidents •� •� OJylceil/orest/Oi�fiis , 600 Washington Street Boston, Mass. OZlll Workers' Compensation Insurance Affidavit 3 ohonc 0 1 am a homeowner performine all work myself. I am a sole proprietor anJ ha%e no one %%orkine in any capacirV - I am an employer pro�idine workers compensation for m} employees working on this job. m an • name: address: city: / nhone a: Insurance , nolicvy�777 -� _ • 1 am a sole proprietor. general contractor _. or homeowner(circle one) and have hired the contractors listed below who have the following workers- compensation polices: m an name: address: i ' ohong a: insurance co. nnlicva corrivanyt addre55` --- nhone a: policy a Failure to secure coverage as required uoderiSection 25A of MGL 152 can lead to the imposition of criminal penalties of a bee up to 51-00.00 and/or one years'imprisonment as well as civil penalties in,the form of a STOP WORK ORDER and a nae of S199.00 a day against me- I naderstaad that a copy of this statement may be forwsrded to the Ofrice of Investigations of the DIA for coverage verificaooe. t do hereby cerrify undeAts and penalties perjury that the inforrrwrion provided above is true and correct Signature at One Print name ofrieial use�only do not write in this area to he completed by city or town official jD city or town• _ _ permitAicense a nBuildC)Ucencheek if immediate response is required QSclecoHealt`<' ecnLaet x r: phone a' — I-10theu 5 4C�i.'C�'•"�tf�Sri•.�Si.�'.: ..... ._.-. :�'.k?^e". r:�sjX: .. .... .. •. ..:�^". . `QF1HE Tpy The Town of Barnstable BARar Department of Health Safety and Environmental Services ` _ MASS. P 039. Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice a Type of Inspections Location Z Y�Q Permit Number �� 3 Owner I\1 t _� �..� L�-�- Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 2� h n -�P A.n — �1 -e A V b C' k t'� �t l��-. FrC� Please call: 508-790-6227 for reeinspection. Inspected by ►�--. �n Date �� U9 t TOWN OF BARNSTABLE Permit No. ' Building Inspector i ,u„T,u • Cash -- -- ----------------- rua - ee ,eio. \re OCCUPANCY PERMIT Bond ---- "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 Donal-d Small. Address Dennis, MIc 10t Mill.: Wiring Inspector �,' f �'/ Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department sni.��l� `.,� i.i��i>!-�/, d_-. 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. .....................................................1 19......... .................................................................................................................. Building Inspector �F Town of Barnstable h Regulatory Services 3 seamLL ' Thomas F.Gefler,Director 1679. ��� Building Division �pTED Mpi�' Tom Perry, Building Commissioner 200 Main street, Hyannis,MA 02601 office: 508-8624038 Fax: 508 790-6230 Property Owner Must Complete and Sign,This Section If Using A Builder the.subject propexty hereby authorizemy.. ._.._...__ .: - - :. act on .behalf,. - ��-- _ ... Jam-- - . • • .to' my. in all matters relative to work authoiized•by this building.permit-applicationtfor: (Address of job) 3-Lt^n� Signature otNwnex Date Print Name • I Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number. Select Search type: G AND r OR Search Search Results' Reg. No. Applicant Street City State Zip Name Title Expiration PO Box EUGENE . 10 5 109482 46 MARSTONS FRIER GENERAL 9/16/2004 RIVER P. FRIEH MILLS MA 02648 EUGENE CONTRACTOR RD Total of 1 Records matched. ' ' Back to Home Page BBRS Privacy Statement http://db.state.ma.us/bbrs/hic.pl 3/5/2004 r P.O. Box 326 302 Wakeby Road Marstons Mills, MA.02648 September 29, 1996 Mr. Alfred E. Martin Building Inspector 367 Main Street Barnstable, MA 02160 Re: Garage/Breezeway addition 302 Wakeby Road, Marstons Mills, MA Dear Mr. Martin: As requested here is my statement regarding finishing the second floor of our garage addition and closing in the breezeway. It is not my intention to finish the second floor of the new garage addition or enclose the now open breezeway without first contacting the Barnstable Building Department and advising them of my intention to do so. It is my understanding that should I decide to enclose the breezeway and finish the second floor of the garage a fire wall will be required on the house wall contained inside the breezeway roof system. If you have any questions regarding my above statement or find that it does not meet your need at this time please contact me at 508-428-2743. Thank you. Sincerely, j William E. Walsh s01L LOG , • '„''Jlt'�..��/�.1:'i.•.Lc�_Sc..��f�.1.i��.._!ay_•�'.�y.d _— _ �fJeoD 1.2..vEes3N1 9 flLl iz 4A• IMF �pZ.Z I ( 411C.1. ' I I I DIST. 1' ��'. . � ° `',�•r i 11 U Box 1; 12 •° ° I , °+ Ct4y' 1 I �I z0•NON• 1000— GAL. GAL. I•'0 i • PRECAST OR I 7c�[c. + SEPTIC i 6,t° e• ° BLOCK TANK 1;'•.'. e e SEEPAGE PIT n , h I ' S T 20' MINIMUM. °'°, •° — — — — — o ;� 1 - ` FOUNDATION I � 9a• I /: WASHED STONE �/a up.+'l.TA. ^/O j e,-d at; l ..,. -- I o' --; P RC. RATS ��.c:� _t*. y['• ELEVATION. SKETCH - — I TEST EL-?-�.i�i.T�/�GAi�/../.,.iVrt rdax�� SCALE: 1's' 4' TOWN INSPE OR: _.�•otr.s."60A�01Y.. BACKI!0E OPERAT R _—� �. ��L���--•-_—...._ TEST MADE ON - /✓off._/1.2.22 rd 10 a � ICE • - �-V s \ .A ' �".C.+cT.,,c•� Sho..�•�� NraR �,.v � IOL �I'1I� SJr V.R GN p.,.L:• re�4Fer..S%t.. T�.-� yr.-,':'C 'Vf../ • ...» '\ I � O E� "�^K�\\ \�\\' '�L b • /f.t'i9 I 00 1, r V tel � s IaC jai itXslo, s . Z 3 6. l . '-'._._.�---0 0 �i oft F• ri•, .%�I,:'t ��� / ,aexsl w.�.��•6y x z9 U h1�'r'r"�� 7Y 6.J"r r•J rti� ELEVATION SCHEDUL PROPOSED SITE PLAN I. INV. AT FOUNDATION /OJ,0 SEWAGE •SYSTEM. DESIGN 2. I•NV. INTO SEPT.IC TANK' IN 3. 1 NV. OUT OF SEPTIC. TANK • = 9 � . 1oT a'Z� w� .t:��� �a••+, �v41G3lo�s H+EGG s,Awoo*S 4 IN+ :%TO ' DISTRIBUTION Box = 9`� SCALE : I"=$'O !✓�-0 197-P C-mod � ' 5 INV OUT. OF DISTRIBUTION BOX = � ^6 INV-- INTO. SEEPAGE PIT CAPE COD SURVEY CONSULTANTS ROUTE 132 T. " BOTTOM OF PIT - 13. o0• HYANNIS,MASS. ' ,{ A OIVIt10N SOfTON sunny CONSULfANtD, INC. 8_BOTTOM OF STONE LAYER = 93•DO V. . f I I I I I I I INI OPEN BREEZEWAY Hill FACE ELEVATION SIDE ELEVATION SCALE:1/4''=1' SCALE:1/4'=1 ' .. Z.41 r Home Improvement �c. 1645 Newtown Rd Cotuit, MA 02635 (508) 428-9518 Fax (508) 428-1547 1-800-262-5060 GARAGE & BREEZEWAY ADDITI❑N FOR WALSH, MARST❑NS MILLS PAGE 3 of 3 JOB NO: REV.DATEr 05-06-96 RIDGE VENT 7'x 6" COLLAR TIES 10 PITCH 39.81' TYPICAL ROOF CONSTRUCTION: ASPHALT ROOF SHINGLES; 15# FELT PAPER; 1/2" CDX PLYWOOD SHEATHING; Z"X 10" RAFTERS AT i6" O.C. 2"x 10" ® 1e O.C. VENTED SOFIT OR DRIP EDGE TYPICAL EXTERIOR WALL CONSTRUCTION: WHITE CEDAR SHINGLES AT 5 TO WEATHER 7'-8 1/2' SIDES & END ELEVATIONS; "TYVEICOR EQUAL BUILDING PAPER; 1/2" PLYWOOD SHEATHING; Yx 4 STUDS AT 16" O.C. 5" CONCRETE SLAB REBAR & WIRE MESH 6'+ 8' - 2 x 6 TREATED SILL GRADING 4' 8" CONCRETE WALL 16" x B" CONT. CONC. FOOTING 5 - CROSS -SECTION _-SCALE:1/4"=1' P olm.e zl Improvement J Inc. 1645 Newtown Rd Cotuit, MA 02635 (508) 428-9516 Fax (508) 428-1547 1-800-262-5060 GARAGE & 'BREEZEWAY ADDITION FOR WALSH, MARST❑NS MILLS PAGE 2 of 3 JOB NO: REV-DATE: 05-06-96 10, EXISTING i EXISTING DECK COVERED. BREEZEWAY GARAGE ADDITI❑N 26 ADDITI❑N EXISTING 2 PLACES 12 HOUSE 2'-6' 2 PLACES 1' i 61-8s 71 81 71 EXISTING �� Z 2 PLACES _ 2 PLACES 2 PLACES 1 Home Improvement ` 22 Inc. 1645 Newtown Rd Cotuit, ILA 02635 (508) 428-9518 (508 428-1547 FLOOR PLAN - GARAGE & BREEZEWAY-:ADDITI❑N FOR SCALE 1/4 1° WALSH, MARST❑NS MILLS PAGE 1 of 3 JOB NO: REV-DATE: 05-06-96 f 1l { $ OIL LOG . A sA,-4 L1l1 cx.•:�f..c,y�i+:_"_r i . x 4aeo �OZ.7 2"PEDSiONE � �04N 9 -ILL 12 MA, /Or.Z 4 C.I. �( 01 S T. BOX h Z_� � ro u N � 1000 -I, az,'MIN J1 1000- GAL. ., �i y I 7 GAL. to a' PRECAST OR I d ✓ I SEPTIC 6 1, a o BLOCK TANK e° SEEPAGE PIT 0 � + Ip. no p I 0 0 ° P 0 , 20' MINIMUM — 10,,. �0 0 1 ` FOUNDATION + 90.7 I I /z ' WASHED STONE —' ^/p wre7ar.C. -"-- ELEVATION SKETCH --- 10, 1 P6RC. RATa SCALE I 4' i TEST B+ c�-r.�elr��r� INiGK�.xaow TOWN INSPECYTOR: �.•2M v,cPt�el�' BACKHOE OPERATOR —1,_ZX�_ TEST MADE ON 972 ly „ Qp !y \ a .P I R r ' tip DD -. 10 \ � o r ; 1° ® A�b k�^c�FCR..AS i r.;�'�Ti Zcr.a�c 3y•f AW9 \. C. OFT Tbwr.t r'�fAKwsTA(�(� it s9. 1t 9 \X 00 40 so, 1 1a L 77 / pp � _ / �,oi�1�' �tH GF M Q / RENWICY. N I z B. rr' CHAPMAN y I�1 1Li0,0 Z� aac` . 1 �00 � p�G^ 2./654�Q��� 2,9 U N D•Tr AI� Td w'Rr w�'� ELEVATION SCHEDULE `} , PROPOSED SITE PLAN I INV. AT FOUNDATION = /Oo"O - SEWAGE SYSTEM DESIGN 2. 1 NV. INTO SEPTIC TANK' _ S'9.75 • IN. , 3. 1 NV. 0uT OF SEPTIC TANK = 99• SSA �'-��T ���f �^'�'� '�� *�`A-�+� 4 1li INTO DISTRIBUTION Box = 17. SCALE: 111=�O ° /✓0 d 1977 boa 5 + NV OUT OF DISTRIBUTION BOX 99 C- ,�0 •• '6 INV. INTO SEEPAGE PIT _ _ .77.0o CAPE COD SURVEY CONSULTANTS ROUTE ' 132 _ 7. BOTTOM OF PIT 713, 0Dn HYANNIS, MASS. ,,-, A DIVISION BOSTON SURVEY CONSULTANTS, INC. 8 BOTTOM OF STONE LAYER 73,00 r a E o • F PROFILE : SYSTEM 'DATUM . ALE , .r N T T S . . 0 0 0 N 1 9 r LOCUS VERTICAL DATUM: ASSUMED a BENCH MARK USED. TOP OF FOUNDATION W A y ELEVATION 102.34 kE8 � �... LOVELLS LN. ' 3 EXISTING TOP OF FOUNDATION NEW TOP OF FOUNDATION » La -- RAISE COVERS TO WITHIN 6 OF FINISH GRADE z r ELEV. 102.34 V 1 4 ELEV. . ALTERNATE 'TWO CHAMBER RISER (S) C.FLOOR C.FLOOR A 'FINISH GRADE FINISH GRADE RAISE TO WITHIN 6" FINISH GRADE 4 IN 95.34 95 3 FINISH GRAD OF FINISH 'GRADE ELEV. 95.0 ELEV. 95.0 : ELEV. 92.0 S E V. 5 . CLEAN OUT/ q /,��q q ELEV. 90. GROUND ELEVATION 90.0 10/ CLEAN OUT/ //G� //� 0 SWEEP o GRADE ..+ SWEEP TO GRAD 'x4l� 14i MlN.-3 MAX. COVER NORTH ELEV. 88- .09 34 Q�S 0.16 05 0.0 60 4�S 0 , TOP EL V 88.0812 �50.02E 15 TO BREAKOUT MlN.» » » EAST ELEV. 90 4 PVC 'SCH 40 c� O 0 ' O O O O 2 MIN 1 8 -1 4 DOUBLE WASHED PEA'STONE z � / MI M x 0 0 0 O � 28 SCH 40 SCH 40 INV.= „ , , c, _ SOUTHEAST ELEV. 88 _ " _ O 0 O O O 0 M _ - S.i 10 TEES i4 TEE INV.-87.92 �: © „ - N� V. 93.8 NI V. 93.6 8 2 { ) O O .�.._...._..._. p O N , O O O O. O O t 3 4 DOUBLE WASHED STONE ZI �O O c c O O - O O O O O c•�rGAS BAFFLE OUTLET4 -6 1// 87.33/2 .- n ,4 i LIQUID LEVEL „ -BOX S.A.S. (12.83 x 42.0 ) LOCUS MAP4 -4 -$7.68 INV,=87.51 {W/4' OF -STONE -AROUND CHAMBERS) NOT TO SCALE; ,r » r� t'J ELEV FOUR 4 10"x8 6 x2 9 CHAMBERS Q- w 85.33 83.58 'd a e a • e o ; 6" BASE OF CRUSHED STONE OR MECHANICALLY COMPACTED IRON PIPE TEST PIT. #2 ELEV 78.9 NO GROUNDWATER ENCOUNTERED D.T.H,' 1 D.T.H. 2 1,500 GALLON FOUND DATE; 9 9/05 DATE: 9/9/05 / PRECAST CONCRETE I . GROUND ELEV 92.9 GROUND ELEV 90.9 T NO GROUNDWATER NO GROUNDWATER SEPTIC TANK 0 NO 'MOTTLES NO MOTTLES 4 ,F SYSTEM DESIGN OEA OEA LOAMY SANG LOAMY SAND - 6S � , 10YR 3/2 10YR 3/2 9 3 BEDROOMS PER ACRE 'ALLOWED (WP/ ZONE ,II) , 10YR 5 1 10YR 5/1 / » 18 84637S.F. / 3 PER 43560S.F. 5.8 BEDROOMS ALLOWED 4 4 l hr• 8 B DESIGN FLOW LOAMY -SAND LOAMY SAND `5, BEDROOMS `AT 110 -GP8 D IW. GPD. 1 � 6 I; / 10YR 5/6 0 5/ _ 24" 24" 5 BEDROOM PROVIDED < 5.8 BEDROOM ALLOWED N. ELEV = '90.9 ELEV 88.9 REQUIRED SEPTIC TANK z 550 x 2 1100 GAL. . SEPTIC TANK PROVIDED _ _GAL, C » C » 66 60 181,2 5% GRAVEL 5% GRAVEL ^;l COARSE SAND COARSE SAND Y 4 2,5Y 7/4 2 5 7j " " F LEACHING FACILITY REQUIRED 1 4 144 SIZE 0 LE C ING 4 ELEV = 80.9 ELEV = 78.9 DESIGN PERC RATE '. ___...:_MIN. INCH B.O.H. ONG TERM APPL. RATE 0,74 'GPD° S.F. B.O.H. � / ON D MARAIS DON DESMARAIS D ES SOIL EVALUATOR. SOIL EVALUATOR SIZE OF LEACHING SYSTEM PROVIDED. -ED. STONE ED. STONE - r r ..._. r 744 BACKNOE OPERATOR. 1 !' ._--- ... ._ ... _ ` 550 0.74 SF GPD -_S.F. MIN. REQUIRED GENE FRIEH % m to , 1 _ 1 I I \ 1 I ,�- \ :- 4 R �' AR USING AM 1MTH 4 ON ND ra 1 � SI CHAMBERS S STONE AROUND - ' SOIL TYPE: 1 __ / �, 1 T 1 \ N M NG I O TLI _ ..,- . .PER INC _ . . - 1 1 ..-- 2 _ 1 rP A - �.RC R _ .-TE _ ` i 1 �- t \ 5 r N PING \ �. O WEE } ...� i A F I _� I 4 G L S N } _ _ .. ,O 7 /� ' +4`�,. .- ..- 5I WALL 2 12.83 2.0 x .2 19.3S.F. LOADING RATE. '► I l DE 2 I ,1 L \ r �- r _ T _1 x 4 , BOTTOM 2.$3 2.0 538.8S,F. 1 t ... I r ...... I T T HI AR} TOTAL LEAC NG AREA 758S.F , EXISTING � I �- � \ � 1 .9 F 4 1 St 758S, x 0.7 56 GPDDRIVEWAYIN I ATES DC dNDlCATES DEEP H 6011 P R R/ ! �,-� - - \ \ �, � '�, 561 GPD PROVIDED > 550 GPD .:REQUIRED G D 'RESERVE 4 PERC TEST ! EXIST. / \ \ \ \ P 1 4 �. '� � '� DTH 1 T E ti. L \ \ �, TES HOLE ' GA R �. �. \ \ � NO GARBAGE DISPOSAL GRINDER ALLOWED ON 1�10 \ �. 302 REMOVE EXISTING 1000 GALLON EXISTING TANK, D BOX AND LEACHING DWELLING \ r, 8 PIT IN ACCORDANCE WITH TOF' 102.3 ;#2, •, `1 TITLE 5. ,� fr r ` ` 1 f 8 7.2 ; q ` � 0 30 as so 90 1 5o a ... 15, : r GENERAL DOTES. g XI STING ! b , 1. ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. Z SING GRAPHIC SCALE, 1 INCH -- 30 FEET i,, DRIVEWAY / Pp6PO� TITLE V AND THE TOWN OF BARNSTABLE RULES AND REGULATIONS {--''" y FOR SUBSURFACE DISPOSAL OF SEWERAGE. rc'f�i 2. AT LEAST ONE ACCESS POINT OVER TANK TEES SHALL BE .g „ ya +y P ACCESSIBLE WITHIN 6 OF FINISH GRADE, NTH ANY REMAINING „ -- -e9- BEDROOM COUNT ACCESS PORTS BROUGHT TO WITHIN 12 OF FINISH GRADE. ' WE LL 3. ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE 9 g -'' EXISTING FINISHED BASEMENT I BEDROOM CAPABLE OF WITHSTANDING H-10 LOADING UNLESS THEY ARE g / ..87-- THEY EXISTING SECOND FLOOR 3 BEDROOMS UNDER` OR `WITHIN 10 OF DRIVES OR PARKING AREAS E g� / PROPOSED ADDITION 1 BEDROOM MUST WITHSTAND `H--20 LOADING. �, m �'' 4. THE EXCAVATION CONTRACTOR SHALL VERIFY THE LOCATION ., w , f TOTAL 5 BEDROOMS OF ALL 11LITI S PRIOR TO ANY EXCAVATION. U E a i 5. `ANY MASONRY UNITS USED TO BRING COVERS TO GRADE _ a" �' S TE AND SEWAGE PLAN (43 45) 2 „ OR WITHIN 6" OF GRADE SHALL BE MORTARED IN PLACE. 318 FINISH GRADE SHALL HAVE A MINIMUM OF 0.02 FEET PER / - 6. GR s ,,� � REF'All� � UPGRADE ,, ' FOOT OVER THE S.A.S. AND DISTRIBUTION BOX. f ' 7. SEPTIC TANK SANITARY TIrE S SHALL BE CONSTRUCTED OF l0 302 WAKEBY ROAD» ABOVE ► rh ` :SCHEDULE 40 PVC AND SHALL .EXTEND A MINIMUM OF 6 f ,� 4. LOCUS INFORMATION THE FLOW LINE AND SHALL BE ON THE CENTERLINE AND /� � � IN LOCATED DIRECTLY UNDER THE CLEAN OUT MANHOLES. '�' ti HA N THAN BARNSTABLE, MASSACHUSETTS 8. THE INLET PIPE INVERT ELEVATION SHALL BE O LESS a INVERT / 2- INCHES NOR MORE THAN 3 INCHES 'ABOVE THE .,.. ELEVATION OF THE OUTLET'PIPE. #302 !: CURRENT OWNER WILLIAM do MAGGIE WALSH SCALE 1 =30 DATE. 12 3 05 f REV..,12 9 05 9. THE SEPTIC TANK,SHALL' HAVE A MINIMUM COVER OF 9 INCHES j/ 1$5.fi � I � , . f A C� ADDRESS #302 WAKEBY ROAD 10. THE OUTLET SANITARY TEE SHALL BE EQUIPPED WITH A GAS WELL MARSTON5 MILLS BAFFLE, '4 INCHES IN DIAMETER AND CONSTRUCTED OF 4" PVC / I �5 PREPARED FOR. , 11: ALL PIPES SHALL BE SCHEDULE 40 PVC SEWER PIPE AND l t�'� MA 02648 SHALL BE SLOPED 1/4 INCH 'PER FOOT MIN. EXCEPT FOR THE IRON PIP Ao WI LLI AM & M AGGI E WALSH FOUND PLAN REFERENCE 317/85 FIRST TWO FEET OUT .OF THE DISTRIBUTION BOX WHICH SHALL p� {� WAKEBY ROAD BE LEVEL ZONING DISTRICT RF 1 HANG OR REVISIONS TO SEPTIC DESIGN REQUIRE NOTIFICATION O ZO D R c ES o QU � MA STONS MILLS TO EAS SURVEY INC. FOR B.O.H.` AND DESIGN ENGINEERS REVIEW SETBACKS FRONT 30 -SIDE 15 AND APPROVAL. M A 0 1 \� REAR 5 ,. CONSTRUCTION <NOTES. t FLOOD ZONE C DATED 8 19 85 s 8 �. - PREPARED : BY: 4 47 3 . c `�. 0 PANEL 250001 15C . 1, `CONTRACTORS INSTALLERS SHALL `VERIFY GRADES AND t1AEN . A N A I CONDITIONS PRIOR T COMMENCING M. EAS SURVEYf INC ,. .:.ELEV TICi S AND SITE COND t}NS O 0 C ME _ ,,. ,. ASSESSORS MAP 43 M .�' �.� , ��� _ W+C� C) E SITE E _, ,. ,: ,. � � -.� „ _ D � G PARCEL RCEL 6 �. t. . NO DETERMINATION HAS N M AS TO COMPLIANCE ,� �2 DETE M INV .BEE MADE � OF' P WELL _ � . r c v ``�. . WITH �? ZONING REGULATIONS. OWNER APPLICANT '`�.. DEEDED Z 5 / �E � ��, � WP P•0• B 0 7 29 a GROUNDWATER PROTECTION , Kea I Tfl OBTAIN ::SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. R trAR . 3. :VEHICULAR ,TRAFFIC PARKING OF VEHICLES AND PLACING SAND WIGF� � MA {�2�"�►3 G u � LO T AREA 84 637f S. _ MATERIALS OVER THE TANK DISTRIBUTION BOX AND o TE - �. 1 , P 3 J H �a <�sa s ,A S. AREA S PROHIBITED ) :. S . E OH D TE X 4 FA B 8 5 $ B 29� _ 0 _- -- __