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Home My WebLink About0151 WALNUT STREET ��0 1��-- Sr� ,� _ ..�. , . . . � . . ._ _ .. . tl ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 0550 Health Division Date Issued �3 Conservation Division Application Fee Planning Dept. Permit Fee lip Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis- Project Street Address 1 U3 At--N L) �" ST . kA Village �ls��" � ") Owner eE�l —( ,H Z-_ -HO G6k) Address �Q6M67 Telephone (f 05T 7 Permit Request e , /A)SLJL_AT"1P k) . 3,e'(AUA Z_L tTV/S-r(t 6 ol Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 0 roject Valuation Jf2f37� Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. rA Dwelling Type: Single Family g Two Family ❑ Multi-Family(# units) Age of Existing Structure 7 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: 4 Full 0 Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing l• new Half: existing new Number of Bedrooms: existing _new o 0 01 _n Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 0 Gas ❑ Oil ❑ Electric ❑ Other u, --a Central Air: . ❑Yes e4 No Fireplaces: Existing New Existing wood coal stove: ❑yes ❑ No o T Detached garage: ❑existing ❑ new size_Pool:46 existing ❑ new size _ Barn: ❑ existing 9b new size_ Attached garage: P existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ .Appeal # Recorded ❑ Commercial ❑Yes Q No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1 l 1 T -�H05DK Telephone Number� • ?R �Z Address / c5 l U-,� A —fJy r �� License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE : FOR OFFICIAL USE ONLY • APPLICATION# _ p _ ''DATE ISSUED MAP/PARCEL NO. _ ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION _ r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL = r= PLUMBING: ROUGH FINAL ; GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT' _ ASSOCIATION PLAN NO.. ��r r Town- of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry, CBO,Building Coriamssioner 200 Main Street, Hyannis,MA 02601 www.town.barnsta ble.ma.us 'Office( 508-862-4038 Fax: 508-790-6230 PLANREVIEW y 00 57 o Owner: V' h•-�sv�'! Map/Parcel: Project Address �/-� ciyrtiT �. Builder— /Rol The following items were noted on reviewing: 6C1--�9 LL /3 E IfM //C—)G,S'iff Q 4t,,1c&6 - eznwl 7'1 Reviewed by: —/ Q:Fotiris:Plnrvw The Commonwealth of Massachusetts Department of Industrial Accidents ' Office of Investigations 600 Washington Street C Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly ,51rNanl�ess/Organization/Individual): WetT-W Addr-esl�15� WALL-��T 5� • • / cC ty/State/Zip-.- • M I LV 5 1MIq Phone Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition workers' comp.insurance comp. insurance.l ZIequired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152,§1(4), and we have no employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under t e p in and penalties of perjury that the information provided above is true and correct. Si natur - Date: .d 7 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 S. 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 ajoint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." . Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit.. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. 'Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia FNERG'Y CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- A_ND TWO-FAMILY'DETACHED RESIDENTTAL•CONSTR-UCTION (780 CMR 61.00) pplicant Naine:`> V671-VA So Site-Address:-- 7 >��0►.4 151 �,Ac,r10T sT, grin! Z"o`� VJII: - Applicant Phone: 0 CApplicant:Signatur �Date�of Application: / I /3 0 NEW CONSTRUCTION: choose ONE of the followin two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAMA-UM Ceiling or Slab Option 1: ' Fenestration exposed Wall Floor Basement perimeter U-factor floors R Value R Value R-Value Wall R Value '� HSPF SEEF R:Value and Depth National Appliance Energy .35 R-3 8 R 19 R-19 R-10 R-10, Consuyation Act(NAECA)of 4.ft.• 1997 as amended,minimums or cater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2. REScheck Version 4.1.2 or later variant software analysis must be completed 790 CMR 6107.3.2 REScheck--Web which can be accessed at http://www.cnerg_ycc)des.goy/rrscheck/ ADMTtQNS.OR'ALTMRATIONS.TQ EMSTING BMDTNGS.OV R•5 YEARS OLD* *)3uildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b- a) SF 100 x - _ % of glazing (b) Glazing area equals SF b a If glazing is<-'40%.uge the chart below. - . If glating is> 40 %pr6ceed to "SUNROOM" section 780 CMR TABLE 6101.3 . PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA.ADDITIONS TO EYJSTING LOW-RISE RESIDENTIAL BUILDINGS Iv1TNEAUM Ceiling and Slab Perimeter Fenestration -Wall Floor Basement Wall U-factor Exposed floors R-Value R value R-Value e t R-Value endd Depth .39 R-37 a X R-13 . R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation acbieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). ' SUNROOM-An addition or alteration to an existing building/dwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Appendix 120.P o .. '4 .. 'own of Barnstable ��of Tl+e ray - ,��, o Regulatory Sez'vzces Thomas F. Geiler,Director Building Division lF0 µAt a Tom Perry,Building Commissioner 200 Maid-Street, Hyannis, MA 026.01 Yrmy.town.barnstable.ma.us Office: 508-862-403 8 Fax: 509-790-6230 HO'KEOWNER LICENSE EXEMPTION Please Print DATE: (( JOB LOCATION: I� I�-� number J� street • Q -village _ ^„HOMEOWNER": Liz b i�-,/�J q d/ J name C ,n home phone# work_pbone# CURRENT MAILING ADDRESS: 1• )I`ll�� cityhown 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 Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the$tulding 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 vrith the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that..he/sbe understands the Town of Barnstable Building Department minimum inspectt0 ocedures and requirements and that be/sbc'will comply with said procedures and requiremen . 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 perTrdt is required shall be exempt from the provisions of this scetion_(Src6crn 109.1.1 -Liearsing of construction Supervisors);provided that if the homeovyna engages a parson(s)for hire to do such work,that such HOmenwner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responaibilitics of a supervisor(see Appendix Q. Rulcs&Regulations for.l ccnsing Ctrnstruction Supervisors,Section 2.15) This lack of awareness born results in serious problems,particularly when the homeowner hires unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisar. The homeowner acting as Supervisor is ultimately responsible. To enure that the homwwnct is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homcowncr certify that he/she understands the responsrbilitics 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 fomr/certifteation for use in your community. Q:forn-s:homcn:cmpt r Tawn of Barnstable Regulatory Services s�xNsrAsi nsAss Thomas F_Geiler,Director 16.19. Building Division Toni Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.tow n.barnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6231 ProperLy Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject.property hereby authorize to act on my behalf, in all matters relative to work authorized by b g permit application for. (Addres of rob) Signature of Owner Da Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse "side. « TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map i Parcel +' Permit# =0 Z Health Division 7 Y �p ,j `' ) Q- Date,,Ippssued 07 Conservation Division s l b , �.' � Fee `W�`N oze Tax Collector n _ -• Treasurer �-.�,� Planning Dept. NOV 7 2001 Date Definitive Plan Approved by Planning Board •� Historic-OKH Preservation/Hyannis LB y Project Street Address Village Owner Address Telephone 'A'A Z ' 1 `A c1 Permit Request Cn� CV,N55K Lk (AIK kC, -1-1D L-A (1 Square feet: 1 st floor: existing proposed 1-17a4 • g 7 proposed Total new i Valuation 9 UJ '-� Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I`1 l-1 Historic House: O Yes No On Old King's Highway: ❑Yes O'No Basement Type: hFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing t" new Half:existing new <t-5 Number of Bedrooms: existing new O Total Room Count(not including baths): existing _ (n new First Floor Room Count Heat Type and Fuel: ❑Gas �a Oil ❑ Electric ❑Other Central Air: ❑Yes 'M No Fireplaces: Existing �; New o Existing wood/coal stove: ❑Yes ,Y No Detached garage:❑existing O new size Pool4 existing ❑new size f�x Barn:O existing ❑new size Attached garage:Cl existing �new sizelt x32- Shed:b existing O new size_Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial O Yes O No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU _ DATE 11' 7-c x FOR OFFICIAL USE ONLY P-?MIT NO. :-r DATElSSUED 5 MAP/`PARCEL NQ. ADDRESS' VILLAGE OWNER DATE OF INSPECTION: i FOUNDATION Allo } FRAME4Ilo/� INSULATION; FIREPLACE'.' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING_, DATE CLOSED OUT ASSOCIATION PLAN NO. r - :C s �.1HE ip The Town of Barnstable 9ARNSTARLE. Department of Health Safety and Environmental Services 9 MASS. ep +a39• �0 - PiFGMP� Building Division 200 Main Street, Hyannis;MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection rAynf-- Location 14Q'h14� Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: a�� i h q a,,& heei u ea Ja %o r i - a►v. ; UO J Pr l't�� ea eels �--, 3 L13 D� `1"ovf n R 2 iA I Par C C' o b14 ' 'I t Please call: 508-862-4038 for re-inspection. Inspected by Date I Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By/Date TITLE: 151 WALNUT ST. CITY:Barnstable STATE:Massachusetts HOD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 11/06/01 COMPLIANCE:Passes Maximum UA=86 Your Home=86 0.0%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 576 30.0 0.0 20 Wall 1: Wood Frame, 16"o.c. 571 15.0�' 0.0 37 Window 1: Vinyl Frame,Double Pane 40 -- 0.300 12 Door 1: Glass 56 0.300 17 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release la. The heating load for this building, and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the desi to d as specified in Sections 780CMR 1310 and J4.4. Builder/Designe Date�� ' ell i MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release la DATE: 11/06/01 TITLE: 151 WALNUT ST. Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1: Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1: Wood Frame, 16"o.c.,R-15.0 cavity insulation Comments: Windows: [ ] 1. Window 1: Vinyl Frame,Double Pane,U-factor: 0.300 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes [ ]No Comments: Doors: [ . ] 1. Door 1: Glass,U-factor: 0.300 #Panes Frame Type Thermal Break? [ ]Yes [ ]No Comments: Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. j ] Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: i [ ] All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. . Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. f Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" - Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-00 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Ping System Types Range F 2"Runouts 1" and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 . 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) 4 TOWN OF BARNSTAB10E BUJDQJNG,PER.MITAPPLICATION " Md EO Iltl cOMPLIAf�� f WITH TITLE 5 Permit#Map ,T ? Parcel </ ! ENVIRONMENTAL CODE ANID Health Division f Y-- Ob a.'D TOWN REQULATIO1`3,,3 Date Issued 2 Conservation Division _ Fee V 7 '","W Tax Collector AA 14, Treasurer 14 4& 01 o0°d Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis + Project Street Address es ttIANell- �' T• ' Village 'Owner kjyxl hi A K lew !e- 2 Address _S•4m E Telephone - RF�� - H Davey r✓�.�n�.�r Permit Request CVF' 91 DE 41.14LC t►.^��va�ve� i>�2S X5 k Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost oO Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family !K� 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❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name " Telephone Number 569 rw— 7l��lJ Address Z W License# 014 3 o 41�,,ZL � D 2615^ Home Improvement Contractor# ©D S G U Worker's Compensation# 4V C 12 ALL CONSTRUCTION DEBRIS RESULTIN FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE C DATE FOR OFFICIAL USE ONLY y PERMIT NO. DATE ISSUED f MAP/PARCEL NO. t ADDRESS VILLAGE OWNER' n DATE OFINSPECTIO r� , FOUNDATION FRAME INSULATION FIREPACE ' ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r . GAS: ROUGH FINAL = FINAL BUILDING - DATE CLOSED OUT ASSOCIATION PLAN NO. Y _ The Commonwealth of Massachusetts =ice _ Department of Industrial Accidents A - -- OUNCE olmyesti9lffens -.t• 600 Washington Street " ` Boston,Mass• OZIII ation Insurance davit r' Workers Com ens ail 2 name. location' hone# c❑ I am a homeowner performing all work myself ❑ Lam a sol r1t;•tor and have no one workin is any=acitv %////%%%� ensatlon for my employees wolking on this job. am 1 rwdins.l workers, comp ................:.:::..:.::.:;:.}}}::.}}:}}: I an em oyer .:::::::::..::..::.::::::::::::... ...:.:::.................. t:OIDp anv n " r r rt " .h. k {p j r.,•ii:;:?:j.:;i:i......i'ii;::::i�:iii±i :;: �:�?i:�'�.•.:.;' dress `ad PILL �!�h ott i . : :: msaranc- co>:;::;:: : ' ' pin MEW eral contractor, homeowner(circle one)and have hired the contractors listed below who ❑ I am a sole propri have the following workers COMPensatlonp vn .01 e• CO O dd ...... ....... ........... ......... ....:.. .n:n: .. .. :A:?r........... }:: ...... .... ...r. ,., .%•:C:,v..:::v::...::.::.}:•}:rv:}}:::�}:;tiv:{�}}}i}}}}::!:i:i:;4ii:�i:i�i:i;i:ti�iii}:}:ii}:�ii:�ii:��::�ii'.v:..:::.�.r::.•:::.:::.;;�::.::�:. ........ n.. .:...x..-vn.. ......:2..........n:::::•:v:.:.•4:n:vnAv:x:w::r.v:::::::.:..:w:•::::;,; v;:.}};•.:}:v;;•.:Yi'i;:,}. ...�...........:::::::::v:::.:}}:•}}}:{:w:n,•.•w.v:.v:.v.v:ry;:n}:•:r!O. .....,:::.;.......r. , , .: n.::•.v.......n....•4.. .......n.................. .......... ................:v.........n..:•.:............1r..:.v.v:::•x.:... ..x.v:•:+: :. r.{, Nr. ::{•.C•............vw::...�•;:• ........... .,�.. ........... ......... ........ ..n....n...,• ...n. ..R.:+... 4..r}C J.:nn• .O.CkV:C, .rid:^.. ,y �•` ii:}i•:$::?''+??`:{!}x'x'� f�'Sxi?:':>i:4ii:x'ii:tix<`i ii::i:vi}i'ijr{i:y{�:? �i}?iiijiii:�i:'vi:4:�:�ii:)ti};:::}}:;{�:•;:!•i:}v::.v:•:::::.................. \.ry v: ... ... ..............:•..:......... {..v....r......... ]}.... .... ...w:w:::::!•:{v:rv::::::::.:::r.•.v::::::•}::•:.w::::.:v:::::::::•:v}::•.�::.v::::::::•::v:•.v:.�::::::::::::::::::::.v:::.......... :•:::::.v:.............•• ...-............. ,...n... r•:.w.v-:x:.v::r.vr:::rv.... v.....v: ` �i:•Yi:�:::+:T:?4�::^:^:x!^i:ii:i;}:i;:+:;i; :iii:+ �: i?i:v:�. w:::::•::v::{�::::•}}:•}}:•}:�}�iii::.":...::................ r::::!::•C:::::!•}}i}}}•::}:.v..• v:.v:;:r.},v:J}}}:•x:4}}i:�iri:i:• �...:•::::::v::.......:�:::::v..........:..... .::::•v:••...:w:xv.,:v,: --xnv v.}•::.r.:vC.•]}. ... L�..,.:ti:^..::4..:::ry:!:•::.. ......... .... ....... yr a d d re 'w.. x...v. . 's..><n ................ :::....................................... ci ..... .................................:......:.::........ ... .. ..... .:.. .............. v...................;.:,.::: ..;.,...,v{:::::....v:v::v:rry}:•}}}:•:J:WYCviii::}'Liiiii}iii�iiv:? Jiii}ii:�iiii:i}}}iiii};:<}:<•}}:•ii:�i}:?Y....•.......... .... ...v........ .. .. r..:.}:x......... .........:................................:::::vrrr.•n+w�.vv.vr.v:.v:::; ........ ............ .........:...., ..........-........:•::•::.v:.vnv:•......:•::::v:n•.• x.. .........',+,4?C...:::.v;::,v:�'........:::::' itv�::+:?::4:::�::r::•}}}ri:+�i:�:+.�ii:::ii:':.:y.:}:::;;•i`:::::.�:. ::::.�::�:::: .. .v:•:::•..............:•:•:::::.:..:•::v-....}}...}}:.!..... ::.v.:•:.vr::;v:r w......,..:::AQ`:.::::t:`....::v:::nw.:::...�.......::•:v::::..;..... ia�nran ce'�coy»>:�:.::�•. :;:>:<;;:{.}:.:;;.:}:;!;{.},..}:.}}:.:.;:.::;.�.}:.::.}}}:.;:{{.}}:•,x:r:{.:;:::::.}::.......................... Failure to secure coverage as required tinder Seetlaa ZSA of MQ.IS2 eta]sad to the of eriatinal penalties of a 5ne up to S 1,500.00 and/or one yam+imprisonment as well as civII penalties in the form of a STOP WORK ORDER and a Ste of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OIDce of Invadgatiom of the DIA for coverage verincsAom I do hereby certify under the pains ofperjury&at the utformatwn provided above is true and correct Date _ z�—N Signature � 4 �SoAJ Phaneil 7 EJ u�.Y �,1kZS� Print name . r ofncial use only do not write in this area to be completed by city or town oIDdal peradMeense# (:)Building Department city or town: ❑Licensing Board aired [:)Selectmen's OIHce ❑check if immediate response li required ❑Health Department phone#, -. ❑Other contact person: PRIIN (tensed 9/95 PJA) Information and Instructions ; to Massachusetts General Laws chapter 152 section 25 requires all employers to Provide workers' compensation for their oted from the Iaw",an employee is defined as every person in the service of another under any contract employees. As qu . 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 not more than three apartments and who resides therein, or the occupant of the dwelling house of � dwelling house having another who employs persons to do maintenance, cansttuction or repair work m 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 section 25 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, 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 is the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company naives,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for canfirmatiam of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be whimed to the city,or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should You have any questions regarding the "law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the the affidavit for you to fill out in the event e Office of has to contact you regarding the applicant. Please er which will be used asb made member. The affidavits may be rer<nmed i^ be sure to fill in the penmit l nse comb the Department by mail or FAX unless other have The Office of Investigations would like to*thank you in advance far you cooperation and should you have any questions. please do not hesitate to give us a call. / FENIA Ed Ed M m The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 0MC8 of hNestlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 �VE rq . The Town of Barnstable � S Department of Health Safety and Environmental Services 6 Building Division i367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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_ d CostI�/",4 Boo Address of Work: 4(z aZ ni v i Owner's Name: - 7-5� -41 ZY Date of Application: —lam 46 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 [30wner.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. Date Contractor Name Registration No. OR Date Owner's Name q:fb ms:Affidav ' r - fr�.JA ,t•• , f'• '•1'tA lft .J l`I' r .. - � C' ``�'•Ty�izs' �q� t �' "` '�-� � �� NICK��It��fi:#�AEMOD� .. • . Or OM { r j ' I„ ' t t, 1 f f ' rl ti � i s j,• ?i y s t t . .� � •�' i{` s'ytt f �yl t tff.��f ( , r • I I GRANITE STATE INSURANCE COMPANY 71109-0000 WC 125-42-97 13102 ............................................. ._ szND cORR68)<ONDfdNCL :66-0300-01 P E N N S Y L V A N I A AME UCAN INTERNATIONAL CO. 119ITIONTMICKERSON BUILDING P.O.BOX 409 IN TON ICKERSON �, PARSIPPANY, NJ 07054-04M (SEE WC990013 FOR COMPLETE NAME) PHONE: 1-E00-645-2259 13 THIS WAY Member Companies of O TERVI LLE, MA 02655-0000 on American International Group EXECUTIVE OFFICES: 70 PINE STREET, NEW YORK, N.Y. 10270 SEE NAME AND ADDRESS SCHEDULE - WC990610 I.D# MA Ul# s ROGERS b GRAY INSURANCE AGENCY WORKERS COMPENSATION AND EMPLOYERS P 0 BOX 1601 LIABILITY POLICY INFORMATION PAGE 434 ROUTE 134 SOUTH DENNIS MA 02660-0000 INSURED IS PREVIOUS; E IEWA POLICY NOOK 11 INDIVIDUAL 5339 OTHER WORKPLACES NOT SHOWN ABOVE:SEE NAME AND ADDRESS SCHEDULE - WC990610 ITEM 2 POLICY PERIOD 12:01 A.M.standard time at the insureds mailing address FROM 03/02/00 TO 03/02/01 ITEM 3 A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA I B. Employers Liability Insurance: Part Two of the policy applies to the work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident S 100,000 each accident Bodily Injury by Disease S ;00,000 policy limit Bodily Injury by Disease S 100.000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT - WC200306A ITEM a The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All Information required below is subject to verification and change by audit. Estimated Total Rate Per Estimated Classifications Code Number Remuneration $100 OF Re- Premium aAnnual ❑3 Year munerstion []X Annual 13 3 Year SEE EXTENSION OF INFORMATION PAGE - WC7754 TAXES/ASSESSMENTS/SURCHARGES $112 EXPENSE CONSTANT(EXCEPT WMERE APPLICABLE BY STATE) $214 MA MINIMUM PREMIUM $500 MA TOTAL ESTIMATED PREMIUM $2,S77 If indicated below, interim adjustments of premium shall be made. ElSemi-Annually 11 Quarterly Monthly. DEPOSIT PREMIUM ENDORSEMENTS(FORM NUMBER) SEE ATTACHED FORM SCHEDULE - WC990612 r74 �/�1/ � a/ O/a�ZD H�d • all �iys-d 02/17/00 ASSIGNED RISK 66 Issue Date Issuing Office Authorized Representative WC 00 00 01 39967 INSURED'SPY CO The Commonwealth of Massachusetts r., Department of Industrial Accidents Office oilnsestigatioos 600 Washington Street , Boston,Mass. 02111 --`y Workers' Co m ensation Insurance davit nameE�'C location- city 17 T9 I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worku in ca achy rovidin workers' compensation for my employees working on this job.: : :: :: :: ::::::: :::: ::: Iam an em to g :::: :.:::::::::::::::.::::::::::,::.::::::::.::.:::...:.:::::::::.::::..:::::::::::::.:::::....::::::::::::.:.::::. znam address.. ::::.......::...... .........::::::.:.:::::.........::::::::::::::::::::.........::::::: ::::.:.:::::...... .....:.::::.:::::::::.:::::::::.::.: hone. .::::::::::..:.::..:. :;.0 7IISul'aRC6. /////. ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have ' compensation polices: e following work mP .............:::::::::::::::.::::::..::::::::::::::::::::::...:::::::::::::::::.:::::::::....::::::::..:.�:::.::.::::.::.:::.:..::::::::::::::::.::::::.;:.;:.;:.Y:.::.Y:-Y:.};.:.;:::::.:;. X . com an n 3 a 2. •::::•:;YY: saw -;:.;:.::.Y:>.Y:Y:.::::; :.Y;::.Y:> w/.•w-n Mum= ............................................::::.�::x::: ......... ....... ..:::::::3iiiY:i:J:4iiY}YiiiiY:+v:iiiiil..:.-...:::. i}}}ii:4:•Y:•i:•::i}ii:Cj >}iiiiij::: iiv: :i:`:ii::ijif::•'.ii;:;:;:;:5%:L:v:::ii::::::i::<::v::is :::^::;�:::::L::•:::::':::!`:i::::+:::�:::'::::. .. T addres n d ..:::::::::::.::................. :::::::...............::::::: : .}..Y... OIi �...#;} iii';$` :;i``<[?id<% i % `i7%i<>iiii�z'#}`i cif;':: ::::::..:,..;;:::.,,.::.,,:.; : f► 'liiSRra11CC �i Falbue to secm•e coverage as required mtder Seetion 25A of MGL 152 can lead to the imposition of etfatinal penalties of a fine IIP to SI,S00.00 and/or one years'imptisotmtent�+weII as dvII penalties in the form of a STOP WORK ORDER end a Sue o[S100.00 a day agahvt me. I mderstand that a ' copy of this atatemmt may be forwarded to the Office of Investigations of the DIA for coverage verifleation. ' I do hereby certify a pains and penalties of perjury that the information provided above is true and correct Date lU -l� • u I _ Signa Print name �Gr T 01� � � Phone# 1111111m;:Imam!!!III !III y WWWOOMMURN official use only do not write in this area to be completed by city or town official permit/license# ❑Building Department city or town: ❑Licensing Board ❑checkif inunediste response is requited ❑Selectmen's Office ❑Health Department contact person: phone#; . ❑Other Orisud 9ro5 P» Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any 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 section 25 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,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter.have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the 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. City or Towns 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. The affidavits may be rehrrhR to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of imlesugations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 FEE VALUE WORKSBEET LIVING SPACE (2000 sq ft or greater) square feet x$115/sq.foot= (less than 2000 sq ft) square feet x$96/sq. foot= (affordable housing) square feet x$57/sq.foot= (40B or low income) GARAGE(UNFINISHED) - square feet x$25/sq.foot.= PORCH square feet x$20/sq.foot= DECK square feet x$15/sq.foot= ALTERATIONS/RENOVATIONS OF EXISTING SPACE . . . . . . . cost= . . . . • • • . • Total Project Fee Value Office Use Only Permit Fee projcost 730 CMR Appendog J Table JS=b(eoadaaed) z- preaeripdre Paekaga for One and Two-Fansiir lteddeadal Huildlap Heated with Fond Faeb / MAXIMUM MINIMUM Glaang Glazing Ceiling Wall Floor Hatrmeat Slab Heating/CooW6 Wa!! EMcieacy Area'(%) U.valuet R-valued R-value' R valuer Paid �� Package I I R value' R Wuc' 5701 to 6500 Headull Degree Dare' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 t0 6 Normal S 12% 0.50 38 13 19 t0 6 85 AFUE T 15% 0.36 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A N/A 85 AFUE W IS% 0.52 30 19 19 10 6 85 AFUE X 19% 0.32 38 13 23 WA N/A Normal Y 19% 0.42 38 19 25 N/A N/A Normal Z 18•/. 0.42 38 13 19 10 6 90 AFUE AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: Ls-t Wp t_►�uT S� . 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3.7 ' 3. SQUARE FOOTAGE OF ALL GLAZING: (S ' 7 Z- 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): S NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a ► .OFIKE A ti The Town of Barnstable • BAPNSrABLF. Regulatory Services tEOnwt° Thomas F. Geiler, Director, Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 0260f 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:[mP-e.To L,"A (U-A &Vt V>01S'U"1 Estimated Cost G ' Address of Work: \�t �►•��—'-BUT rn1�PS�vL�. `►-�—k L U,S Owner's Name: G�N SoNy� Date of Application: 1\' CQ 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 WOwner 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. I SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. J!OR e=— J Date Owner's Name q:forms:AfSdav:rev-070601 �47 " fi- *y RESIDENTIAL BUILDING PERMIT FEES }. A tf Y APPLICATION FEES o New Buildings,Additions . $50.00 $25.00 AlterationsMenovations $25.00 Building Permit Amendment FEE VALUE WORKSHEET i NEW LIVING SPACE . x.0031= square feet x$96/sq.foot= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE L/• square feet x$64/sq.foot= Sf GPI / x.0031=plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ftj $35.00 —c�_— >120 sf-500 sf 50.00 >500 sf-750 sf 75.00 s _ 0 sf 100.00 >1000 sf- 1500 sf >1500 sf-Same as new building permit_ x.0031= square feet x$96/sq. STAND ALONE PERMITS `j0 x$30.00= Open Porch (number) x$30.00= Deck (number) x$25.00= Fireplace/Chimney (number) n Inground Swimming Pool $60.00 ' r Above Ground Swimming Pool $25.00 $150.00 ' Relocation/Moviug Permit Fee I (plus above if applicable) projcost r Ago Z CIOATCRET F LOT 4 ______-_--——_= LOT • Q' c 1 SYF W:F 2QXY 'RF" 7'his IGR` Gt E INSPECTION Plan is FoF Use Only �'I,OOD ZONE.! v;tly REGIv'TRY" OWNER: -q-L .. ---------- r.EL� rcFF: $ :1! _ — DYER. _M2' �. PLAN P, 7 _? 6.`13 C ALE.1. = 30 _— .-�------------ HEREB Y CER,rtFy ' _0_" IP �S�B�11yIC __ — ---THAT THE B0131-I DIvG- _ aSt� Y NItEE SURVEY v i Gti THIS PLAN IS LOCATED 0�i THE GROUND Act-z .. PAUL CONSULTANTS . OWN1 AND THAT ITS PJSI'I'ION DOES CONFORM AL � THE ZONING LAW SETBACK REQUIRE ENTS OF TEE 40B SUITE 1 )WN OF _&4&'a7AH _LND `£FIAT INDUSTRY ROAD "arn. DOES,IMOT_ LIE_ WiTMIIv THE SPECI.Ai: F11,00 n HA74R� ��:. -.sc,_ c�, IWARRTOMR lint..q nay c.a The Town of Barnstable ' Regulatory Services fo,39— Thomas F. Geiler, Director Building Division • Peter F. Diyiatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-:�038 HONI EO'WNER LICENSE SON / Please Print DATE: I I U/ {�� f , h4(LLS LI'd VT village 10B LOCATION: street number /D 8 work phone "HOMEOWNER": home phone# name CURRENT MAILING ADDRESS: zip code State city/town owner-occuaied dwellings of six units or The current exemption for"homeowners"was extended to include �vided that less and to allow homeowners to engage an individual for hire who does not possess a license, � the owner acts as supervisor. DEFIm MON OFHOMEOWNER . who owns a parcel of land on y1hich helshe resides Or intends tO reside.ss which there e n is Person(s) accessory to such use and/or intended to be,a one or two-family dwelling,attached or detached suuctwt�period shall not be considered farm structures. A person who constructs more that one home ioffitewtaal on a form acceptable to the a homeowner. Such"homeowner'shall submit to the Building 'n�Official,that helshe shall ben onsible for all such work erformed under the building ermit. Building (Section 109.1.1) V Code and The undersigned"homeowner"assumes responsibility for compliance with the State Buildin0 •• other applicable codes,bylaws,rules and regulations. , „ understands the Town of Barnstable Building The undersigned"homeowner certifies that helshe tut with said Department minimum inspection procedures and requirements and that helshe will comply procedures requirements. ---------- Siature 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 12W7N.OER!S EMEMO°nffOl . l be exempt from the HOMED Permit's required steal The Code states that: "Any homeowner performing work for which a buildiag p provisions of this section(Section 109.1.1-licensing of construction Super"sors),provided that if the homeowner engages a p the responsibilities of a supervisor(see person(s)for hire to do such work that such Homeownat shall a e t at they Or-assuming P Many homeowners who use this exemption are unaware that�y are sue,Section Z15) 'n�lack of awareness often results to coed against the Appendix Q,Rules&Regulations for Licensing Construction Suaps�orsons In this case.our Board cannot proceed serious problems.Parnculariy when the homeowner hires anticting as Supervisor is ultimately responsible' the permit unGccnscd person as it would with a licensed Supervisor. I h0 � rrtaay Corrimunities require.as a of this issue is a To ensure that the homeowner is fully aware ofhis/herresponsibilities.onsibilities of a Supervisor. on the last p ' unity• that he/she understands the resP our comet application,that the homeowner certify caret amend and adopt such a fornt/certification for use in y form currently used by,several towns. You may Q:FORMS:EKEN1PTN p ....� ....................... Assessor's ma and lot number ........ Sewage Permit number ...............`...'�..................................... f THE r0� F B TOWN O R A NS A L T B E Z BARXST"D E. • ; "6 9 .�� ' BUILDING INSPECTOR �,,. • -:: APPLICATION FOR PERMIT TO �d f/�I � � �... ..... ........ 5 TYPE OF CONSTRUCTION /l'6'y� - 17. l1i... 51 ...........19r17 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................................................................................................................... ........ ......................................... ProposedUse W ./ ...... . ........... ............ ..................................................................................................................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ....................r....................... .............`.....Address ........:.... .... .............. Name of Builder /ry �........... ��....1. ). r..Address ............................ Name of Architect ..................................................................Address ............./........:..............r ............................................... Number of Rooms ...........�................................................Foundation ...../..,:,/Ji'�1'�'C/ ......................................... Exierior " 1 fY w/• ?fUrJ.�.. ..........Roofing ......./`/5�/� �./. ...:......................................... ....................... . (ey 6) q FloorsInterior .................................................................................... Heating •�� .....................................Plumbing � 6 X. i Fireplace .....................................Approximate Cost :....::..'......... ............................................ Definitive Plan Approved by Planning Board -----------____---------------19--------. Area ........ . .............. i...... Diagram of Lot bnd Building with Dimensions Fee ................. ' SUBJECT TO APPROVAL OF BOARD OF HEALTH hereby,agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ray: J_-'.`< ..Sti:.`... .............. � Geoffr1oo° Lorin C. A=149~9 ^ ~ 19422 l 1/2 story � No ................. Permit for .................................... � � � single family dwelling � � —'------'---'—r-^—''.----'------' � Walnut Street - Location ........ Marntona Mills . ��'��,�'�� '' Lorin C. G~offrioo °/ ' Owner -----------�---__--.---. � fqe . Type or Construction [ ------------------ . ` Plot Lot . Permit Granted NDote of | ' ' Dpnr Completed ' ^ PERM�" REFUSED19 ' .................. ~ . , —'��' �^.^- ---'', ...--..—. ----. .---_---~----... . ---.— ' ` \g. ' '-----''------'' � y -------------------~..—.---.. ` ~^ Assessor's map,and lot, number ..rm L. .c. ..1�.. Qe� �61ew2- �� 7' SEPTIC SYSTEM MUST BE Csd INSTALLED IN COMPLIANCE Sewagev Per number .........................................'.........-....... WITH ARTICLE II STATE SANITARY CODE AND TOWN a� TOWN OF BARN'ST�.BLE— THE N M SS � i EAH$STODLE. i w BUILDING INSPECTOR �o ar a' •� 53 APP d�'/ G� LIGATION FOR PERMIT TO .. ..........`I..................... .................................. ......... ...... .................. TYPE OF CONSTRUCTION ..........�r�:'/�1..4,....................................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to/the �following information: Location ..... .......... -��Illrl a..1..........�z.....,./�l��S�d�?�..... !.Z r......................................... ProposedUse ....... l./,,7,9.................................................................................................................................... ZoningDistrict ...................................................................:....Fire District ................:::.......................................................... Name of Owner .oIN6r�� G rZ-o/1 Address ..� � v < / ............ Name of Builder .�z0.!r!'?......:...C_.11�� `�.�.v.?:!..Address .............. ..................................................... Al ti Nameof Architect ............�..,....................................................Address ...................................................................................... Numberof Rooms .............(..................................................Foundation .......................................... Exterior ...... .. '/�/ a.. 6� `JC� ` d Roofing ..::...i `�. 7-. ..... .... ................. s. �.. ..:.... �..... Floors ............4................................................../.....................Interior ..................2 �] ......................................................... Heating / .fit — / /j ( .�... .................... ........................Plumbing ..........1.......... lT................................................ Fireplace ................ ...............................................................Approximate Cost ..� .........�J.... ...................................... Definitive Plan Approved by Planning Board -----------____---------------19________. Area ........Y.a.�.. .................. .... Diagram of Lot and Building with Dimensions Fee 1.8�� ....... ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Namee67 ..... ........ ..... v . ' - ^ . . . ~ . | ' ' ' ^ . ^ . . / ' . ' ~ ' . ' . ^ � U . .. | ~ - , - ' ' Geoffrion, .Lork� C. 1 1/2 story pingle family dwelling Walnut Stre�t Marstons Mills Lorin C. Geoffrion frame -PERMIT REFUSED . . ~ 19 . v —.--. ' . —...— .' . . '. ^'—'—r~^^'--^—^^—^--'—^—''`^' ...........................---.,......,....�.~.....~. ' Approved - �� l� -----------.. --.. ---------.—..'~~—~~-----. . -----------.------.---... . . ' ' Assessor's map and lot 'number 9i Sewage .Permit number .... . ............. .... .........:... d Z BASd9TA8L .i House number .....................:........... ......... .. ............ V,0 39• i6 � ON a' TOWN OF i:-BARNSTABLE i BUILDING' - INSPECTOR APPLICATION FOR PERMIT TO .;.:.......0 b IR I � .........C .! it9. ...................................... TYPE OF CONSTRUCTION ..................... .. ..............1951 TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby applies for a permit according to the following information: Location .........6.. 1.......J/' .� .{� .......c. �.......... ��..... ......................................................... is ProposedUse !Z ................................................................................................................. Zoning District ................. ..........:.............................Fire District ..........n.;; .1',�../../.........:.................................... Name of Owner ..6,,,. .4N .... ...Address ...1 �..E ✓� !U. ..c� ... �� Y Name of Builder' C?cv r. .r�i 1.5Fe.�-644A�rAddress Nameof Architect .....:...�tl�! .......................................Address .............../..................................................................... Number of`Rooms, Foundation p.......................................... TtJUr.Z.?..1rf?2�rld G ....................... Exterior ........... .....................................................:Roofing ......P751Y�?L�.... 7Y.!�t/ L ,�............... Floors ?ew r 7..... r. ......................Interior ......../. --C..6�C� .................................... .. .. .......... Heating)q.....................................................Plumbing .............N ,t. .......................................................... Fireplace p �,� . .............................................Approximate Cost .................. ................................ j7 Definitive Plan Approved by Planning Board -----------_____------------19_______. Area . .... .............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Q P6=6 v S� ' GAea� � N 3 7 - .o % i Gac,-TAIL p,T � Gt/AG NET �T . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to.conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �Olo�s� Name COUSINEAU, ELIANE No ..... ermit or ....... Accessory to..Dwell ..................... ...................................... ........... Location .....15I.WaInut-axeat..................... ..................... ........ . Owner'.... -Aue-causineau. .................... Type of Construction .....F-rame................I.......... . ............................................................... ..... .......... Plot ............................... . Lot:,.......... .................. Permit Grantbcl .........V13,Y..U.......... ......19 84 Date of.lnsp6ctiorv7M,!P-c%L/........... .......19 --Q7.../� Date Completed ......19 .............. . Assessor's map and lot number ......... .. .. /' E rO� N Sewage Permit number ....6................... -r� DAWSTAX i House number 7 NNi .......:.:..............»�............_ Op t639. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO y,,.':. .' .... ..................� .... .,.. ........... ...... ........................................ TYPEOF CONSTRUCTION ....................... .. .................................................................................................... .................................................19 ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......... ...... .......... ......1..1,.: . ....... ............. ....... ......... ......... . , .. ................................................... Proposed Use t ........................................................................... ................................................................................................. ZoningDistrict ............... ........................................................Fire District ......... ., "...:: ............................................ Nameof Owner .. ........1 ......... . ........ . .. ...... . ........ ...K.....Address .................. ...............................................' ' Name of Builder" ........ ....::.. ...::;...Address ........ . ........ ........:r ......1............................................ Nameof Architect ........J.......:, .........................................Address..... .................................................................................... Number of Rooms ......... ......................................................Foundation ......... ... ...... ...I............... ., ........................... 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 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. COUSINEAU, ELIANE A149-9 26419 Build Garag'e No ................. Permit for .................................... Accessory to Dwelling ............................................................................... Location ...j5l.Wajj)q .... ...... ........................ ................. ............................... Owner ......Elaine...Caus.ineau..................................... ........ ........ .. Type of Construction, JX ............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted .... ....................19 84 Date of Inspection ....................................19 Date Completed ......................................19 -Assessor's office (1st floor): ' �•s x �FTNETO Assessor's map and lot number ..... q........ Board of Health?:(3rd floor): Sewage Permiti. number .............. "" ��-'.......... gBaea LEA Engineering Department (3rd .floor): oo i639, \0m Housenumber ........................................................................ o�a�a• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only n t S f I TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............................................................................. .......................... i?, TYPE OF CONSTRUCTION ..�................f6V/m/Y7 /�C).... ef .......POO,/— - .(Y ee. .. . ----02� .....19.8?� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... 1 GJ.��Nur o�;7 M4,eSTo/✓S IVi�s 1-07 3 .................................................................................................................................................................... I ProposedUse ..........................................................................................................:.................................................................. ...................Fire District.Zoning District G.............................6 ..../25jp�tf.. ........... r,. Name of Owner ��Ai�✓E u-a�1s/�✓C/�!�/ .�� (� BUT SST Address ..........................,.........:....:..........:?.............................. �y Name of Builder ..... / ll��l..-r .. . .... !...........................Address ................. ............. ................................. . Nameof Architect .........................:.... Address .........................................................:.......................... Numberof Rooms ..................................................................Foundation .............................................................................. .P Exterior ....................................................................................Roofing ..............................:.......................`........................ a Interior .............................................. f1 Floors ................ �4 ......................... Heating ..................................................................................Plumbing ............................................... ...........................:.... Fireplace ..............:...................................................................Approximate Cost ..............;...... �..... . Definitive Plan Approved by Planning Board --------------------------------19-------- . Area ..:..v..........�d.....�. ...... i Diagram of Lot and Building with Dimension's Fee ..........................I....... SUBJECT TO APPROVAL•OF BOARD OF HEALTH i Y.2 i �'S7oeK�.hE �K/�sTi NC j� ►� leuPns�,-Z Ld4LA/1IT �T �Tl�CK�11E OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS iI hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .........................:... ............................. Construction Supervisor's License ....,:......:... ..................... COLTSINEAU, ELAINE A. A=149-009 No ..29080 permit for ...Build Swimming..Pool .................... ........AccessorY..to..Dwellin$........................ Location ...�5.1.,W41nut„5treet ........:....:....�`Iax.S.tQ .S..r?.11$......................'........ Owner .......g1 7 Re. Ap....Cous.i..n..e..a..u................... Type of Construction .....:....F.xazne...:................. Plot .................... ...... Lot .... Permit Granted . March 24;: 19 86 Date of Inspection ............:...:...................19 Date Completed ....................:::.:.............19 Assessor's office (1st floor): ® FTHET Assessor's map.and lot number .....,/�.yl�."...f d.9 SEPTIC SYSTEM MUST BE Board of Health Ord floor): INSTALLED IN C®MPLIANC Sewage Permit number . - ..� t BaSasTl►DLE t g .................. ......... �f11ITI�I TITLE 5 Engineering Department (3rd floor): rs/ NVIRCI�lMENTAL CODE AN" ,oo rb 9. House number ........................................................................ sA*^-^ ^`::' °' cMa�a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-100 P.M. only TOWN , OF BARNSTABLE BUILDING INS-PECTOR APPLICATION FOR PERMIT TO ..............................................................................//,// ...................... .... TYPE OF CONSTRUCTION .,, ......................................(nl��........... o..L:......`. 4..P............/. ........ . Z�J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �AGAIUT 2Y- 3 �T ��s77�1S LL-s �QT ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner .....Address ��I � G1T ST �j2ST��tIS�r///�5 *"*� ... ............. ......... ........... .. ... .... ....Name of Builder .... .. . . . ... ... .... .............................Address ....... . ............... .. �.A:. Nameof Architect ..................................................................Address ..................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost ....... G O . .......................................... ... Definitive Plan Approved by Planning Board ----------------------_---------19________ . Area v.�....X D Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH T S oGK/kDE x/,-3,—I NCB ISI LIJI-IL_/VL/f Si STD ck#.A6- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ........ Construction Supervisor's License I ll U COUSINEK,---;--, ELAINE A. '29080 BUILD SWIMMING POOL No ................. Permit for .................................... Accessory to Dwelling ..................................................................e........ Location .'...1.5.1.,..Walnut...Street....................... ........ ...........Ma.rs.tp:ns..M.i.11S.............................. .. .. . ...... Elaine A. Cousineau= Owner .................................................................. Type of Construction ...............Frame........................... . .............................................................. ............... Plot ............................ Lot ................................. Permit Granted ......Mar.A..214,,:.............19' 86 Date of inspection S.. .5............................19 Date Completed .............. ............19 SI• TC S-r HOLE T So,3 50,9 LOT 7- 5 - 7 7 _ i9Ga5 � fi PL Nit�Rti ,� TS � '�P LE LEV 1l L} so , - 4 ` Lohm Awo Y� l 5J•s SUIISM L Lo 4 - l� CoAQSE * ELEv O SR ��X PRNSIotJ LS R ASVA� —I — LEAc.H RREAPIT DI S'f t , j B.Ox T E'S T E IU cOu nsT F R E D ` HoLF5 5L{, ELEV t r • a . •� 3 8.6 R WRLN L f e t; a U/cam1"Cl S ET,3AC� ,EEXPUIRE.MEAl1T SC!� 12F�1 - 9 ' ✓�V'Zoa,Ms- w , SEPT I c 5 y5 7"�aN CQA/.S T2 Uc.TiL7�i/ •: .• SNA[..L. .COA/F02M TO .v/;q SS : DES%G N FL 0 N/ G�►L� PA Y. EN-V/,eQN!N.EA/7,4L .Comae_ Tiro EX ISTING L�A.� � A# F, M . �tiG�W H 'AGTN rz�Gcu�A:7"/oNs' Rt QuiR�D �f RC ! t'33 3C• � = }3•aw o' TOP OF F�2Q,vo5LC D. LE.4CN :¢1�EA:. 1� 50 °'5[DES.I t!5o BOTTrOMj E�2 V/oc�s- Go vE� MAAl14OLD�G'a'✓E,� 7b- .Eac T-E�/IJ 70 Wr 7 A4/A/, /' �C . 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