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0179 WALNUT STREET
} o a n I �. Town of Barnstable *Permit# ZOI 5 & Q Expires 6 months from issue date Regulatory Services. Fee • .nxrarnsM • . "'"S& Richard V.Scali,Director 1. Building Division X'PRESS Tom Perry,CBO,Building Commissioner PERMi 200 Main Street,Hyannis,MA 02601 SEP 2 3 2015 www.town.barnstable.ma. Office: 508-862-4038 TOWN OF BARN�S -790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL o V jWV P O Not Valid without Red X-Press Imprint Map/parcel Number J Q Property Address ���i/� �a✓5��1 / ` �� (Residential Value of Work$ OZ( do Minimum fee of$35.00 for work under$6000.00 �M r Owner's Name&Address `7 Contractor's Name C`?i��� ✓(, Telephone Number �Sr Home Improvement Contractor License#(if applicable) I d d 3 (.J:' Email: C_cc Zea-U l 7 7 Construction Supervisor's License#(if applicable) /. (� O 7 g�&orkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation(Insurance Insurance Company Name / 'G sZ Workman's Comp.Policy# d`D O_o Go 36� d Copy of Insurance Compliance Certificate must accompany each permit. Permit Re est(check box) VRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is j requir d. SIGNATURE: 11,14 )x7x C:\Users\Decollik\AppData\Local\Mic tsoft\Windows\Tempo e-etFiles\Content.Outlook\2PI01DHR\EXPRESS.doc Revised 040215 i The Commonwealth of Massachusetft Deprr whit of Industrial Accidents Office of Investigations 600 Washbigton Street Boston,MA 02111 wwlvanass.gov/dia Workers' Compensation Insurance Affidavit Builders/ContractorslElectricians/Plumbers Applicant Information Please Print Leaffity Name(Busineess/Oiganiza ion/ladividual): 99 6kZCau (P Address: �� /✓� /G�G� City/Stat&Zip: C l Phone# Are you an employer?Check the appropriate box: Type of project(required): 1.V'I am a employer with 4. ❑ I am a general contractor and I employees(fall 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 worlung for me in any capacity. employees and have wodcers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.1 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 1 LE]Plumbing repairs or additions myself[No wormers'oomp. right of exemption per MGL 12.❑Roof repairs insurance required.]1 c.152,§1(4),and we have no employees-[No workers' 13.0 Other comp.insurance required] •Any applicant that checks how pl must also fill out rice section below shooing their wotlters'compensation policy information- Homeowners Homeowners who submit this affidavit indicating they ue doing all meA and then hire outside connacmrs nmtst submit a new affidavit®dicaung;,such- IConuactors tbat cbeck this box must attached sn additional sheet showing the name of the sdb4mmactats and state whethw air not those entities hale employees. If the smbcoutracctots have employees,they oast provide their workers'comp.policy number. I am an employer that is providing workers'cnn alion insurance for my enWleyem Below is the policy aced job site information. Insurance Company Name: C �,�`` C�3 / Policy#or Self ins.Lic.#: 01-o f)o 36 ! d� Expiration Date. `l Job Site Address-. / "/ d L nnr3" S^ s CAylStateJZap: /1^ l/ (),,2� Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required unties Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S 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 e s andvenabyeuwury that the information provided above is bzte and correct S' Date: J Phone Qffiefai use only. Do not write in this area,to be completed by city or town officiat City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cltyffown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 R CAZEAtt PROOFING. &RIEPAIRS PROPOSAL Proposal No. 15-779 August 7,2015 To: Ann Quirk Work to be performed at 179 Walnut St Marctnn4 lYsl11.Q MA We hereby propose to furnish the materials and perform the labor necessary for the completion of: . ROOF REPLACEMENT 1. Remove existing Shingle roof 2. Secure and repair plywood 3. Install new aluminum drip edge 4. Install ice and water barrier 5, Cover roof with t 5ah.felt 6. Flash all pipes 7. Reroof with 30 architectural shingles to match existing 8. Install ridge vent 9. Remove all rubbish from project Labor and Materials $2,600 All material is guaranteed to be as specified,and the above work to be performed in accordance with the specifications and completed in a substantial workmanlike manner for the sum of Two Thousand and Sig Hundred Dollars$2,600 with.payment as follows: One Thousand-and.Three Hundred Dollars$1,300-due with acceptance of proposal and- One Thousand and` ree Hundred Dollars$1,300 due upon Completion Respectfully Richard P. t.Jr. 198 Five C ers Road Centerville, MA .02632 (508.)420=5482 Acceptance of Proposal No.- 15-779 The above prices, specifications and conditions are satisfactory and are hereby accepted. ' Yomare autho * ;4ed to do the work as specified. Payment is outlined above. r / Signature Date CERTIFICATE OF LIABILITY INSURANCE FD4TE@AM2015 5/12/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY. AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an-ADDITIONAL INSURED,the pol)cy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the'policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER - - CONTACT ' NAN(E: Berkley Assigned Risk Services McShea Insurance — A)C.NI;_E,a: 800 634-4589 Faa No.): 866 215-8118 1550 Falmouth Rd RT 28 Ste 2 E-MAIL AWREss: PolicyServices@berkleyrisk.00m Centerville,MA 02632 INSURER AFFORDING COVERAGE NAIC# INSURER A INSURED INSURER 8: Richard Cazeault Jr INsURI>i 198 Five Comers Road INSURER a. Centerville,MA 02632 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INS INSR TYPE OF INSURANCE A OL SUBR POLICYNUMBER POLICY EFF POLICY EXP. LIMITS LTR INSR WVD MMIDDIYYY MMIDDIYYYY GENERAL LIABILITY AUTOMOBILE LIABILITY $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN - _ TORY LIMITS nER ANY PROPRIETORIPARTNERIEXECUTIVE O E.L EACH ACCIDENT $ 500,000 A OFFICEIMEMBER EXCLUDED? NIA ❑ WC-20-20-003093-03 02/04/2015 02/04/2016 (Mandatory In NH) E.L.DISEASE.EA EMPLOYEE $ 500,000 . It yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMB 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach.ACORD 101,Additional Remarks Schedule,i more space is required) Coverage Election Category Elect Status Name States) = All Entities/Locations Sole Proprietor Exclude Richard Cazeault Jr MA Cazeault Jr 198 Five Comers Road Centerville,MA 02632 CERTIFICATE HOLDER CANCELLATION .SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Sea Meadow Village AUTHORIZED REPRESENTATIVE" 720 Pitchers Way Hyannis,MA 02601 Signature: � •� ' ` •� ACORD 25(2010/05) BRAC 3139 , .1 �C�'tJaF; sg3 �s^,1 + yr " .. Construction-;urn.^ ..G se CS-10n393• �•:::'.: _ RICHARD P C ALTL'I�JR f' 198 Five Comers Ron Centerville MA 01632" Y74P„„:159IR11�' 02104{'�01 .v nj (Q6DJt1Jt07[fCtCllfl�.p - Oflice.of.ConsuTerAffairs.&:. .j P. . .Bost ;' ness.Regolatioo 9 E IMRROVEM NTRgC •r Iacense or ' EAIT CQ _ �g►strahon valid for mdn." use o cty y straGom �68607 - before Oe.egPjra#on•date, If found�Ex irabon TYPE P 3/8/2017-: Office of Consumer Affairs:and:Busi ess Regulation f DBA hr. 10 Park Plaza Surte 5170 CAZEAULT ROOFING:&R.EPA'IRS:; Boston_ _. . ,MA 02'1.16 RICMARD CAZAULfi:= r ' 198 FIVE COR ERS§D CENTERVILLE;M A 02632 Undersecretary , fVot valid wout signature • is .t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ��O Parcel Permit# 77 ?3 ea Health Division Date Issued - K2-'ieo4c Conservation Division Application Fee Tax Collector , ZPermit Fee$ f 'Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address w oc IV) e e-r Village /� VtM. , C,--�� ) L M H Owner A o n Y e-vi-rc, Address e Telephone l � Permit Request _e o,? o vh : 9 x © *-1 C b n S-1'vvC't D t o" 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 ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No i� 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 0 Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/Wg�I stove: Yesclo ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:C isting C pew :size v� lA Attached garage:O existing ❑new size Shed:❑existing ❑new size Other: N) r Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name u �r ✓5 Telephone Number �16 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE pppp- FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r MAP/PARCEL NO. ADDRESS VILLAGE a OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL Y PLUMBING: ROUGH FINAL, GAS: ROUGH FINAL - FINAL BUILDING` DATE CLOSED OUT ,ASSOCIATION PLAN NO. = - .t 4 �e� PC 6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C � a Map - ® Parcel Permit# r763 01 Health Division .>.�,tE; lj Date Issued j7Z 03 Conservation Division � I0? v . ., Application Fee ,6 7 "� _ i Phi ! 5 Q� Tax Collector Permit Fee �/v) Treasurer SEPTIC SYSTEM M UST 13E Planning Dept. DIVISION INSTALLED IN COMPLIANCE . - YM TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANO Historic-OKH Preservation/Hyannis TOW?d REGUL,1 y1C)N3 Project Street Address Village // 19WSZO X9 /4/"t� Owner �/(�itl 67� 17' Address / �d&AIMT Telephone \6Z? �02 — °7a AR Permit Request / J 77 4!5 �T .�� /L✓ 64f Square feet: 1 st floor: existina -12- proposed 6W 2nd floor: existing �� proposed Total new 'T`! Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size 02 Grandfathered: Cl Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure /S' Historic House: ❑Yes *No On Old King's Highway: ❑Yes J No Basement Type: ❑ Full Cl Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing new 311 Half:existing new Number of Bedrooms: existing new --t9— Total Room Count(not including baths): existing 7 new First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: k(Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes AN Detached garage:Cl 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 VTelephone Number Address �� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �� FOR OFFICIAL USE ONLY Ir r PERMIT NO. r t N d d >DATE ISSUED r d MAP/PARCEL NO. F k ADDRESS VILLAGE ' OWNER i_ DATE OF INSPECTION: f ' 1 FOUNDATION �f3 �3'r' �$7P'� �84t � '�`�./ p FRAMES '' - ' 10, t INSULATION FIREPLACE:, ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH r-. FINAL jp GAS: ROUGH 4 ' • FINAL ' FINAL BUILDING r 1 ' DATE CLOSED OUT i •:. `�� ASSOCIATION PLAN NO. I , - _ The Commonwealth.of Massach usetts -Department of Industrial Accidents office offnyeslf9alfts 600 Washington Street P Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit a name: location city R15� S/l/),Is /'/ �� / Phone# El I am a homeowner performing all work myself. (] I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this jgg ob. y-•'v5rtn.yi F-T!m-+- STHv �.>f. r �.�'lc•;.', :.+7x- -r�,l ,«yC� T.. 1S,Ja�' .'T t�Rrf �i Ste°., �. v`"r� n.�y ^' s y. �`'C"tly d .rt ` •4 `s J 3><+-4t�f. z.yt�`. =��'n. ivi'�1r ��N "`�3`'' y "� °Sr' > 43 !� 'St' u 7 4 v" `7't �r' l,. y ;F�S.'n3Xr rr..i r ?¢ J ,T-L6ryJ},r� T G.�CF.,e''.fii ,ts� l,✓.4 ,;•'n'A( 'S .�.,ems E �F. 9 t7'fe 'Irry+��1"� �Sd �� S��rrER�sYf}c�.'I�M'i.�Ci, m�-r�J�`C!'� /�ei' � �OmQ flme^ �•' �xX�A S-i^>{'Y sr,�3.^i�firu c�'! >H -•ta +. '� i-�l�C +fit 9w• y.tir�xfst'4� !'�` r+H 7 R .: .t7��1 `Z ?i+��7• r y.. R •t Jaflr r' T fi� t t l�4�"t+ + al,�J �etJ �7�r.d J e ,+'s.� t7 G,. �tral t e p pit" �Y"Y" d,}' ,r au�. a 1a.- � .r• '� t �! ti '� �r�i`z�a ,f � b r j' ,� r'��L a t a.l 1'r`,5',�.! +� -r+�'+r hlv -•t M xk r^ ,� r._r,� � L u t r �^ a'U. 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R00,P [] I am a sole proprietor,general contractor, homeowne circle one) and have hired the contractors listed below who have the following workers' compensation polices: ! , ¢ M—mr, r'4•s. .r �.i' �'L ;�r.�r.y �`4P' r '�"�' R'�r .��..,jrsty.,.`�r -t. '—"'y''tta n5- ...Fc.s +,{'L� 't�J',�' ,.,,mom ''� { yt ffitlr ,3 �i". t .,•4 r .,y +j t,,,,p. y.ram � � ' a x a's� �t • :1m a naQC`S •i +v d. -fi t. t.. -r s h,'r`..;':t-.1 ,j, xi P'.�- r(r'S•40* it3'� ..1,'�^'P�'4C•l'a 'r- ��`7' �'; �.F,t�;1•.4"q,'+,,. p+:n-� s ��3'�" �,>xC7�'-1'<"s3:f ask �� .>+a.i�-aa.u�'�'3.�'i"M�•.�7�r.Y`t. W'¢x�5.r�. Y+_yxt�f�.i^..;� �r�ud. $ci 4A,`�t'4 s.{�s��t�. }-,�' �'S�:�p4. 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'�,,t B�UF.PSS.>«+ .G�'S' •. �It,,. erg` -'st'� .t1S,� �. - o t 1•r t Xr ,.�..��z .r-';+,251 _F a •m'�r ��q yTom.;"' •`3`f .rr` t-' .[[JJ a ''�r<„a h 3- ,S �js t1S{+n'�'-w` .fy'7;t, i,`�•S"A'Y"�t�"� ,-5"j�,,�,t Zell,.3" ej }9"-•�'..:a1' y .. rr'�`� �7'f•.y1': �! Fr, xM.s aM..�a f�`�+._ rA�..� r` �dua'�o'�`�yi`3 tr4a'jr^'.1f i&y.+#+a7`'c' vy +... '}.. !_1`sLjin L ' i ,� Ft- �.rt•`i-"i.''4-' '+y tla '"g1 t4.i-v41vS 1•t�L�. ' !'-e4 y: hon -lf �.`t tirt: ` R,r4 , 1L'I'1,4+� Ak'iS'n r +�„d• Cr •�. f : .0 e.a.;�. -�: c � •r.. R- p �y.aM,x is t - r s�yt^. k... c,iC -i& j. iFy�? r.i�',i,3..�a`�Si C Y,a n j s. .�v t�ftiTp? '�k'g�JaiYirE'� -ir. ��+Y.+�l:srT,.,ya•tr�,.+tee.. .,� x � .�I�,R°`3v .i•'.�^-� Y'!L.�.'S• '+ .141�$: �ef'��L r`Gi.0 v.-T'� �..-..r.?''���i�(. °'C s''tt,^ira ,,;,}3 •� 'n'r,�,#°Y J!; �,,.. ""�'� R� Est}� ,.u' � "% �+,7 .�5-y z.,• �C'r t`' iY�iC5. ew � } r s .�+ s�,+ �' v' 9��-tt'^:: J r'�,� �S•�'°<''--z. �� -r � �� � d'ta�Fi�. R�A�' t,Y b krw•�'y��.'61 q,z k, s ahi�..t3j;�°.�i''re:L_fix.�.s�,`�:,`x?'��1..� :. ��� .=r%'4.u: x �lnSllranCc coe�a;.t�a,..�:�..�,���,, �,' �-.'� ;��Isl,.r.'�..�„ti..�,,,.�rA•.F.., ....-_.,cFa.._,�.�, ol�c:,#�. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office at Investigations of the DIA for coverage verification. 1 do hereby certi under the pains a d allies of p m erjury that the information provided above is true and ccoorrec. Date /u Signatu a t /ll� ,//l Phone Print name � Iofficial use only do not write in this area to be completed by city or town official city or town: permit/license# FIBuilding Department ❑Licensing Board []check if immediate response is required ❑Selectmen's Office C]Health Department contact person: phone#; MOther (revised 9/95 PIA) 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 returned 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 Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 IME�° Town of Barnstable Regulatory Services enaxMBLA ' Thomas F.Geller,Director WAM °,161[9. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 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: Owner's Name: /V 7/7 Date of Application: / WJM-3 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 wilding not owner-occupied ner 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. Date Owner's Name . f I ' RESIDENTIAL BUILDING PERNHT FEES APPLICATION FEE New Buildings;Additions $50.00 Alterations/Renovatious $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSIiEET NEW LIVINGS of `f� ys o Y . sZ square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft. 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.0031= ' STAND ALONE PERMITS x$30.00= 3 o' �d Open Porch (number) 3 6., p i, Deck x$30.00= (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 r FME,10%0 The Town of Barnstable o. R.�6TASM Department of Health Safety and Environmental_Services MAS& �p ' Building Division FO MCy� ' 367 Main Street,Hyannis,MA 02601 508-8624038 508.790-6230 PLAN REVIEW Owner: Pe hT06 Map/Parcel: 07A Project Address: W0AT%W+ J� Builder: OW OCR The following items were noted on reviewing: © Dcc.1, hn%N%� be ' i-CAP OA-CA On 59SKt - cs ay%&C J LL4 a 7l1,Zl63 Reviewed by: Date: -Z/2 The Town of Barnstable .Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �y I /� � Please Print DATE: / /Y�� ��7 JOB LOCATION: number ' street village oe "HOMEOWER":z / zz / 1/ //; 7/ a —I p•66 name / home phone# -work phone# CURRENTMAILINGADDRESS: Llyu7V / ���A AIiZ1s city/town I state zip code The current exemption for"homeowners"was extended to include owner-occUied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said proc ures and require nt . 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 supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed•Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fom•Jcertification for use in your community. A4' ti � . ..... f LOT 2 n /'72 . 00 ' CEi2 T/F/ED PL O T PL/9 Al AF30 ELERoAG L. OCAT/ ON: MA/25710A/S /y/ (,.e-S FRONTING LOT. REFERENCE: BEING LOT / AS SHOWN ON A PLAN RECORDED AS, /N THE BARNSTABLE COUNTY DATE REG /S'TRY OF DEEDS PL.AA1 BOOK 239 PAGE S/• -C2 fl,2w / HEREBY CERTIFY THAT THE FOUN.DATlON REG. LAND SUR. EYOR SHOWN ON Thl/S PLAN /S LOCATED ON THE GROUND AS SHOWN HEREON AND THAT / T -00E 5 C ONFOfRM TO THE IH OF,� SUI LDIN.G SETBACK REQUIREMENTS OF •�y�E THE TOWN OF 6AZAj s7 M 8LE GEORGE yN : . PA LOW.1R. ---OR9E LOW AAID CO: YARM o UrHPoRT , MASS, ���c/ST6P�op� SURVS G � B01Mn BC CALC®2002 DESIGN REPORT - US Monday,February 24,200319:56 File Single 1 3/4,' x 9 1/2" VERSA-LAM® 2800 DF Name - struc calcs.BCC:FB01 Job Name - Penta Description - gable wall suport Address - 179 Walnut Street Specter - City,State,Zip - Marston Mills,MA 02648 Designer - Ray Castano Customer - Ann Penta Company - Plans That Work Code reports - ICBO 5663,NER 442 Misc - z 1 Standard Load-30 PSF 110 PSF Tributary 00-08-00 10-00-00 10-00-00 BO,5-1/7' 131,3-1/2" B2,5-1/2" 522 Ibs 1687 Ibs 522 Ibs Total Horizontal Length-20-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Live Dead Trib. Dur. S Standard Unf.Area Load Left 00-00-00 20-00-00 30 PSF 10 PSF 00-08-00 100 Member Type: - Floor Beam 1 gable wall Unf.Lin.Load Left 00-00-00 20-00-00 0 PLF 80 PLF n/a 90 Number of Spans - 2 2 roof load Unf.Lin.Load Left 00-00-00 20-00-00 6 PLF 18 PLF n/a 115 Left Cantilever - No Right Cantilever - No Controls Summary Control Type Value %Allowable Duration Loadcase Span Location Slope- 0/12 Moment 1612 ft-Ibs 25.6% @ 100% 2 1 -Right Tributary 00-08-00 End Shear 381 Ibs 12.1% @ 100% 2 1 -Left Repetitive nla Cont.Shear 704 Ibs 22.3% @ 100% 2 1 -Right Construction Type n/a Total Deflection U2103(0.057") 11.4% 4 1 Live Deflection U7373(0.016) 6.5% 4 1 Live Load 30 PSF Max.Defl. 0.057"(Limit:0.375"15.2% 4 1 Dead Load 10 PSF Span/Depth 12.6 1 Part Load 0 PSF Duration 100 Bearing Supports %Allow %Allow Disclosure Name Type Dim.(L x W) Value Support Merrirber 'Material The completeness and accuracy of BO Wall/Plate 5-12"x 1-3/4" 522 Ibs 12.8% 6.0% Spruce-Pine-Fir the input must be verified by anyone B1 Post 3-1/7'x 1-3/4" 1687 Ibs 38.0% 30.6% Spruce-Pine-Fir who would rely on the output as B2 WaIYPlate 5-1/7 x 1-3/4" 522 Ibs 12.8% 6.0% Spruce-Pine-Fir evidence of suitability for a particular application. The output above is based upon building code-accepted NOTES: design properties and analysis Design meets Code minimum(L1240)Total load deflection criteria. methods. Installation of BOISE Design meets User specified(U480)Live load deflection criteria. engineered wood products must be in accordance with the current Design meets arbitrary(0.375")Maximum load deflection criteria. Installation Guide and the applicable Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing building codes. To obtain an Installation Guide or if you have any questions,please call(800)232-0788 before beginning product installation. BC CALC®,BC FRAMER®, BCI®, BC RIM BOARD1m,BC OSB RIM BOARD TM, BOISE GLULAMT°", VERSA-LAM@,VERSA-RIM®, VERSA-RIM PLUS@, VERSA-STRANDT-, VERSA-STUD®,ALLJOIST®and AJSTA°are registered trademarks of Boise Cascade Corporation. Page 1 of 1 Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoflware Version 3.5 Release 1 Data filename: C:\plans\Ver 8 Jobs\Penta\energy\calc.rck TITLE:Penta Addition CITY:Marstons Mills STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached l " HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 02/24/03 DATE OF PLANS: 2/20/03 PROJECT INFORMATION: Penta addition 179 Walnut St. Marston Mills,MA 02648 COMPLIANCE:Passes Maximum UA= 121 Your Home UA= 109 9.9%Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Wall 1: Wood Frame, 16"o.c. 168 19.0 0.0 8 Door:FWG 6068: Glass 40 0.330 13 Wall 2: Wood Frame, 16"o.c. 206 19.0 0.0 9 Window: TW18-DHP31046-18: Vinyl Frame,Double Pane with Low-E 36 0.340 12 Door: 2868: Solid 19 0.350 7 Wall 3: Wood Frame, 16"o.c. 53 19.0 0.0 3 Wall 5: Wood Frame, 16"o.c. 115 19.0 0.0 6 Window: 2432: Vinyl Frame,Double Pane with Low-E 9 0.340 3 Wall 4: Wood Frame, 16"o.c. 38 19.0 0.0 2 Wall 7: Wood Frame, 16"o.c. 7 0.0 0.0 2 Wall 6: Wood Frame, 16"o.c. 36 19.0 0.0 2 Wall 7: Wood Frame, 16"o.c. 7 19.0 0.0 0 Wall 8: Wood Frame, 16"o.c. 7 19.0 0.0 0 Floor 2: All-Wood Joist/Truss,Over Unconditioned Space 62 19.0 0.0 3 Floor 1: All-Wood Joist/Truss,Over Unconditioned Space 400 19.0 0.0 19 Ceiling 4: Cathedral Ceiling(no attic) 80 30.0 0.0 2 Skylight: VS 304: Wood Frame,Double Pane with Low-E 8 0.420 3 I Ceiling 3: Cathedral Ceiling(no attic) 80 30.0 0.0 2 Skylight: VS 304: Wood Frame,Double Pane with Low-E 8 0.420 3 Ceiling 2:Flat Ceiling or Scissor Truss 62 30.0 0.0 2 Ceiling 1;Flat Ceiling or Scissor Truss 230 30.0 0.0 8 Furnace 1:Forced Hot Air,82 AFUE 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 REScheckVersion 3.5 Release 1 (formerly MECchecl and to comply with the mandatory requirements listed in the RESchecklnspection Checklist. 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 design load as specified in Sections 780CNM 1310 and AA Builder/Designer Date I REScheck Inspection Checklist Massachusetts Energy Code REScheckSoftware Version 3.5 Release 1 DATE:02/24/03 TITLE:Penta Addition Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 4: Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: slope [ ] I 2. Ceiling 3: Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: slope [ ] I 3. Ceiling 2:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Bath and hall [ ] I 4. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments:family flat I Above-Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16"o.c.,R-19.0 cavity insulation. Comments:Rear wall [ ] I 2. Wall 2: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: front wall [ ] I 3. Wall 3: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: end wall [ ] I 4. Wall 5: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments:end wall [ ] I 5. Wall 4: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: end wall [ ] I 6. Wall 7: Wood Frame, 16"o.c.,R-0(uninsulated) Comments:chapel wall [ ] I 7. Wall 6: Wood Frame, 16"o.c.,R 19.0 cavity insulation Comments: chapel wall [ ] I 8. Wall 7: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments: chapel wall [ ] I 9. Wall 8: Wood Frame, 16"o.c.,R-19.0 cavity insulation Comments:chapel wall I Windows: [ ] I 1. Window: TW 18-DBP31046-18: Vinyl Frame,Double Pane with Low-E,U-factor: 0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: W2 [ ] I 2. Window: 2432: Vinyl Frame,Double Pane with Low-E,U-factor: 0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes [ ] No Comments: TW2432 WO1 I Skylights: [ ] I 1. Skylight: VS 304:Wood Frame,Double Pane with Low-E,U-factor: 0.420 For skylights without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes [ ] No Comments: [ ] I 2. Skylight: VS 304: Wood Frame,Double Pane with Low-E,U-factor: 0.420 For skylights without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ]Yes [ ] No Comments: I Doors: [ ] 1. Door:FWG 6068: Glass,U-factor: 0.330 Comments: [ ] I 2. Door: 2868: Solid,U-factor:0.350 Comments:front entry D02 I Floors: [ ] 1. Floor 2: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: [ ] I 2. Floor 1: All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: I Heating and Cooling Equipment: [ ] I 1. Furnace 1:Forced Hot Air, 82 AFUE or higher Make and Model Number I Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I 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 cfrn(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 1.571bs/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: [ ] I Materials and equipment must be identified so that compliance can be determined. [ ] I Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] I Insulation R-values,glazing U-factors,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] I Ducts shall be insulated per Table J4.4.7.1. I 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. [ ] I The HVAC system must provide a means for balancing air and water systems. I Temperature Controls: [ ] I 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. I r Heating and Cooling Equipment Sizing: [ ] I 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. I Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I 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. I Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. 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 1.5 100-130 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 Piping 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 PADGETT BUILDERS INC. F zzr� o� 184 School Street _= P.O. Box 133 COTUIT, MASSACHUSETTS 02635 LETTER (508) 428-0001 DATE ,5�� .... Fax (508) 420-0117 .................... ............................................. To: ............................................................................................................................................................................................................ ........................ SUBJECT ..... .......:._-w1_V7.. ........70...3. ..........................._...... .................................:. .lr ......._�Z - ro ........................................................................ i...._7...9.........._ _ -, 7......s7 -r........................................................ 01..........o...F.......... sT �................................._..._.... ............ °►n!...:I...... ... 030._!.............. u.cry......_ .:........_Owtje..... ...............,..............., .......... :7A..............................._:................................. .... .. .... .. � �. Z..._........ ►•1........... Ji ��'Tc _....... `1 _►2......_ SAD .G...... 1"T........._. ......._ ....................u.T.._ST���.T............_.....�._............._.. Y�1. s..T.v..j-1S..........`l 1�u s..._ ..................................................... - _ r � ` -r- Q........... > Cq.ET7...........: ._ f_-7E .S..........._ _ S_P....._...._�1 L.........� .. 71 .1 C..............._�_�........................................................._.._...............__..._._...................... _.._......._ _ :......._ ._ .........:..._Q................... �9-��►.....1�N.._:: .._......__...........................................................................__....._..............................._................ ....._�J. c �� .. u �....... .. ...._..... .......... _V` ......._ ......... _r�_ ...C. l (.5..............._ ............_ i...._.._!Z9 J........................._.................................-............._......---............... ...� ............... -2,�+x..................-I..........................._�......C�........:F�7...........-............................................................................................................................................._.............................................................. .�� _cZ.............. .................Z. ..-.._.Q...00�.........................................................l. r .ft ................ .0 4 ..............,.................................................................................................. ❑ Please Reply ❑ No Reply Necessary SIGNED ar 4��1 t r ,a, r tti. 1 •-A�Ll.� 1�l' gr t' ss'� BAM t.OWN: Qs ' ErRMIT , d1}• ,'_7. s. ;,_x, •.,r' '+r'i, it t�"&�h��'f)�i� �'���+�.i•''. ir•1�S S,y,•i �_, <-. PARCEL' ID :150 073 ?:F GBOBASE ID' 8713 r'��o" U HONE�ADDRESS 1 P MARS'rONS MILLS r' Key ' ZIP . LOT 1 ? -`BLOCK ',Yy` '+ >. LOT SIZfi ' DBA DEVELOPMENT at '6�;, 1_ DISTRICT CO... PERMIT 703U1t DESCRIPTION 20'X24 5'r•: FAMI-LYWRMBATHaMOVEµEXISTING DECK PERMIT TYPE BAllDI A. TITLE BUILDING PERMhT iADD TION' F t t - t. 4f( Y,].j• r r .,i" + G,•„ ,, , 4 'K.:l r ia�t�wlr}+f,,j�r-N •c•�tf �i�'Di CONTRACTORS,, PROPERTY OWNER „°° � a r I ARCHITECTS: ,,....,..}1 r � OF of } 3l t t. n♦x , yL°ff....F iXr'K" Regulatory Services: ., -,cS r d r fi" t• -5 q 7tir�t Pr.° +p, t r •, TOTAL'.FEES: ,_ °. $255.82:. . fn 00 BOND $: Yr F ti •�wCr•_ /� CONSTRUCTION COSTS �y 4 , ' $47,040'.00 s' �t'�t;h^' 1�r rvr:r`+V r. e'+.Y�r r f try r?,,rrA�• r• . • Y r r' l.'�i..: !{ i. ;'� 4Sr' :'t :. - r.t r��a Aiu 41f+�Lr:iil.f jit. ., - , 434 r •RESID..:ADD/AL`1'/CONV 1c � � l ���f �p�p y �iY��duaa�cy • a. / r�kf r r-�•,�i�r�;h' r�y,ry�:] ,°;�S`.A r I ibsa 7A A• ' ' 4 1 { l y + k r�tY t�•' fJl rl :.r r r i � f ♦ ,I r Jws.. ?• �vf {i.... -� . �:r. •I h) I •° f ., , v - y Y ,hjx(' ,4�r'„Y a��161. '�• T Nt. *T l�,..4I.5,ra. 'fi ♦ ♦ 9 cs r '{y W-!)Ikliit D V IL DIVI ON DATE ISSUED r07/23/2003 EXPIRATION 'DATE �� t J r '1'4 52 } s P A- t �,, yr •.. .,,`r.7 �t 3.`,;�' � ? Y r.f � aa; , qr �13 �„�n A "('•it Ti, ri�,�•••-r __..__...._._ iYt • �r,. ,..a�}..41k�3�.:tyxst,.t,•�.d..N, , . ,;�:t.,.rt 7�..r r :,�1 ,.. �:` �'% ..tr.•.� •,�iv t'n4r��a..`�,'r�,/'<{lrj:�{�t'or{:re^•8+`t.. '.w t...t.,, THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OWANY PART.,THEREOF,°EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELLAS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.1 :;%Y;'sat MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK „t, APPROVED PLANS MUST BE RETAINED ON.'JOB AND �rcc w ,WHERE-APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS:.., ?.:.i +.'y THIS CARD KEPT POSTED UNTIL'FINAL'INSPECTION;; a. 2.PRIOR TO COVERING STRUCTURAL.MEMBERS,; HAS BEEN MADE.*WHERE'A CERTIFICATE'_OF,OCCU-b; !*,PERMITS; ARE; REQUIRED FOR (READY TO LATH) f PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE 'r=ELECTRICAL PLUMBING AND MECH- ANICAL INSTALLATIONS i 3.INSULATION.i;?r�.'w�" ?;,Yr#E: �:>,,��rra��, ;OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE> +, . -4.FINAL INSPECTION BEFORE OCCUPANCY:j».i WEI a I:I Wm-]01*01 6-11:111:4;1 as]ly]m 1-.1 wr3v t:fl:n •.s i3�ai3"�;:iwh <4` i ret': * i,�s ��tom,. cF ,: r .ti;. BUILDING INSPECTION APPROVALSri s ^'•.'.;'a PLUMBING INS PECTION'APPROVALS`10' % M-i ELECTRICAL.INSPECTION APPROVALS ` i Tt'rr4 r, _..tM1-•, .Lw ffr � } r. rr J + r r:+3�i��S.r✓ rY$n �•..r�i f+,�s. •�i..'k,`.y!J Y y, •�t i3. l ,c =s .� r ✓ H C < 4; D5.r r Yt,� 2�i ac '1 rYy? ''m lNE i°tic .. r r •', ii I- ti.7,rJ y��ia4 x t Tf��t:,�'S-`� � .k ,- t '.. 3 :•s '.r. , t!.ti:.S.'i`ts.��''r.S°. *f5�,j�� r 4."C.°r!'`'.7, _� :_�c1. r 2 2 - lcruLd ti'I 2 '� 1 f. r t .' "•�'' %f-�`iS.p�Ay �t rv^r�a?-,A�'f,ly,3-."�r. 2 r`rZ rS�t x 71 Y�gY?v, rr S t h"fA P R c .. 3 •I fl+,• ,i qY,r ? `!r4,1'.e.�'.YC-tit.Y�o-.,Y'�L ,. '.,., . 3 , • 1 HEATING INSPECTION APPROVALS � ;,,z ENGINEERING DEPARTMENT r,1 � 44 ` r .• r �r "t 1 4 m � tt ,,� r �•-i ,i"r'-�,,Sl t»,�r, r T� l G .cr �9 v `11 jS i j t. si l�kyo?aCeG+a '�.•{Git�!�YSYr1 JJ S s - s> 2 L�' {f'" F �"t^�� 4l yn1.BOARD OF HEALTH -, cr'�`.�ikyc .3F.�J °vxi=l'j (y,�r�F}�„�+•x�r� C..,�5ti r3 . . ..�,�;c '�,. .. ,r... . , 'Z' -3 ' 'ig". }."..'' � nlh':"' t fr.l.�f t�i �r:?4 a.y?,„v'�k.,T#1t`4:c�+rJ%?7�«za'4�. 3�� `•}�l ,,�,? OTHER: ;:r <. ;! SITE PLAN.REVIEW APPROVAL , z x ' .,i i '"'� t+°YTaS.Ast �YI` •2M�ys '2 Kra Jpp*•-# .. .. .,:.a� L .J r.!°{:'.£'.:Y ....Wl .i.. � ,., .•., .ai` ° s ]�.. N �L "cS K`t+?t,,,y-J .. F , y .. /Y 5' Me'M.t.,3Y1utK Nx"Win t^WW�.,� V�.bW9'i�I,RS.}'C�q •h1f - .... i'4;` � .. `rr• Ai Y.S - s+iri ry r- r ,:-:'r r }; r`Tf TL �N>:'k`>Y:3r<i-V.tk P4ttt. v-t..w:.e:,..m4f rw:,,., -�:r��;.+.k��"v,i}�,o �4..'�:ft,Mho.tz;<t''t�stT�i,��',�:CtWY+a.�„�ytr•1'4t.,M),�.. '.Y:. . WORK SHALL NOT PROCEEDUNTIL:: PERMIT WILL'BECOME NULL`AND.VOID'IF.CONr! :;.INSPECTIONS INDICATED•.ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX•;'; "CARD CAN BE ARRANGED FOR BY VARIOUS STAGES.OF. CONSTRUC•; MONTHS OF DATE THE PERMIT IS ISSUED AS ,t `TELEPHONE.OR WRITTEN NOTIFICA- TION. :jys. .NOTED ABOVE: '^. 'f.c. ,.,, 7TION:; °Ft �ati Town of Barnstable Regulatory. Services EA"STABLE, Thomas F.Geiler,Director �'A�Eo;0�►�0 Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must.Complete and'Sign This Section If Using A Builder I, AQhJ 4"Jf� , as Owner of the subject property hereby authorize?{10 c6�f�pG��Tf (ADC ,D u iu7po5, T,. . to act on my behalf, in all matters relative to work authorized by this building pernit application for(address of job) 119 N l,IN- U-T t. �-Tv�►s 161,us, I°Ili r Signature of Owner 15ate �-Ni►J 1 z�"T-A Print Name ✓lie oPomrnnanurea�� o� aaac/u�aek2 0-35,000 cf enclosed space BOARD OF BUILDING REGULATIONS (MGL C.112 S.eOI) F IA-Masonry only, pv icense: CONSTRUCTION SUPERVISOR G.1&2 Family Homes ;' 4 Number2CS, 048859 Failure to possess a current edition of the - - assachusetts State Building Code s cause for revocation of this license, i E�Z'p res.02. 2/2006 ITr.no: 16904. {' - ROBERT R PADGE=1T 184 SCHOOL ST/P0 .COTUIT, MA 02635 " o Acting'Co4imissi&tner DIG SAFE CALL CENTER: (888)344-7233. iYq?i!)bO7b!!waa, d�,/(i�ggpCLC1LUdQC Board of Building Regulations and Standards ' r--�. License or registration valid for individul use only r HOME IMRROVEMENT CONTRACTOR before the expiration date. If found return to: r >\ Regis2ratioh: =100131 Board of Building Regulations and Standards rt a__ rn -4 i (;Expiration._ 6jg�2004 ( One Ashburton Place Rm 1301 I- �A--f 'e —-" Boston,Ma.02108 -I i t- TyPe:_Private Corporation i PADGETT BUILD RS;=INC-' Robert Padgett I/. PO Box 133/184 School St'"" Cotuit,MA 02635 111 Administrator Not vale With. Sienatu e y tr, i The Commonwealth of Massachusetts _ � Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit-General Businesses /oii for ,air r aio r ���������, r name �R �Ii CFT( A address: 6x ci state: t 1 au: 7 phone# (�Q "l' 00 work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I an an employer with ens loyees(full &part time). ❑Other I am an employer providing workers' compensation for my employees worldng on this job. Company name: address: city: Phone#. p .insurance co; 1:YJ' .J ul1►j �Q I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: comtieny name: address: city: :•.:., _ . phone :• insurance co. :. company name: address: city: insurance �0 Icy Failure to secure coverage as re ed under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1r500.00 and/or one years'imprisonment as w civil penalties in J"e'or of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a COPY of this statement may fo r d to the O cesti ations of the DIA for coverage verification. I do hereby certify un r t epai s a ti at t e information provided above is tru/et�a/nd ccorrect Signature' Date 5l !!V_TT Print name S Phone# ( n u official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department L ediate response is required ❑Licensing Board ❑Selectmen a Office hone#; ❑HealthDepartment p ❑Other ................... .................... ..... ................................. .......... .. ......... ......... ...... ........ ... ...................... .... . .... ........... .............. ................ ............................. .............................. . ............... RI . .. ................................................... .X................. ..................................... ................................ .. ......... ...................................... ......... DATE(MM\DD\Y Y) . . SUA . . G-06—O 03 .............................. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MYCOCK INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 20 SCHOOL ST ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PO BOX 437, COMPANIES AFFORDING COVERAGE COTUIT MA 02635 COMPANY 297SB A ROYAL INSURANCE COMPANY OF AMERICA INSURED COMPANY PADGETT BUILDERS INC B PO, BOX 133 COMPANY COTUIT MA 02635 C COMPANY D ................ . ......... ....... ................................................................................................. ........ ....... ........... ...................................................... ........... ... ................................... ............. ......... ...............%................... .:,: . :. X ................. .............................................. ........ ... ... . ............. .. . ....... :..COVERAGES;.:................... ................ . ........ ................. .............................. .... ........ . ...... .. .......................................... ...................... . ..... ......................I.............................................................%............. ..................... ...... ............. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR I DATE(MM\DD\YY) DATE(MM\DD\YY) GENERAL LIABILITY GENERAL AGGREGATE S COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. CLAIMS MADE F7 PERSONAL&ADV.INJURY OCCUR. S OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE IS FIRE DAMAGE(Any one fire) is MED.EXPENSE(Any one person)l S AUTOMOBILE LIABILITY COMBINED SINGLE S ANY AUTO LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) S HIRED AUTOS BODILY INJURY S NON*OWNED AUTOS (Per Accident) PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHER THAN AUTO ONLY: ........... EACH ACCIDENT S AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE S UMBRELLA FORM AGGREGATE S OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND STATUTORY LIMITS EMPLOYER,S LIABILITY (UB-733X562-0-03) 06-01-03 06-01-04 I ................. ................... THE PR9RPS RETOR' EACH ACCIDENT S 100,000 PARTNERS/EXECUTIVE INCL DISEASE—POLICY LIMIT S 500,000 OFFICERS ARE: EXCL DISEASE—EACH EMPLOYEE S 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. ............................... .............. ................ ........... ............................................................................................................................ ... ............ ................. ............................. ....................................................... ... ........ .... .................. a-.4.0 ...................... ......... ...... ................ xxxxxwx X. ...............................ERTIFICA.'.E-' ER ... X . ATE'.: .::....... .......... .......................................... ................. ........................... ..................................... ................................ CANC.R. .'T .................................................................. ....... .................................... ........................................................................................... .......... ... . . . .. .... ........ ..... ... ................................ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF BARNSTABLE 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BUILDING INSPECTOR LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 367 MAIN ST LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. HYANNIS MA 02GOI AUTHORIZED REPRESENTATIVE .................... ...................... ............... ... ... . .. ............................. ............................. ..................... ... .................... ............ ........... ............ ....... .... .......... ............ ................... ........ ROYAL& s'r SUNALLLANCE- t - .,t1000 LEGION PL i,J'tt.,iTiCJikORLANDOJt'(FL A (1= ;r -32801 •fTi a•:i.f• i it irr• _, r Lt° S-.! 1.�. r :J1 i J .. �t'vSQ J.M T rT ,.ci:� TOWN OF BARNSTABLE '`') BUILDING INSPECTOR 367 MAIN ST - _ _HYANNIS _--_ --•._ __ _ MA 02601 Tli i' ._ ? •, ` - - -,C -it, TU <:JnJ 1C4 ar, i�it ITS '� Ci ilr, U"i t.F - t' A' I,til .f ,ott�hi�Fia.^iH Y✓fi i.Yil;:.. 2 VI •Fi :'�1.,•� , %.J Ls .:i i t J I' _ t i t`• t.JJ:U Y, ,HT t+ETA i4 Y:�li FQ 0?L.:'!I ° q, r7 +>) eTi711. ;ir:'t 5-i'11. . 2 ICI1 �" •Q' .. : Jt'• ' �.; ;t „ Rat••" .!Y:7UU'i i :ram►,.`.h !. '_ "�n !J� I xiq 2,3.. kn .r .,7.'CAf,;t 1,4 .in_t J.J IF "rn�--•- r _._ _.lr tui3.i - _.r _,, a 1'F';�- J• Si)SY.r�.,,a , I Ur�.riOffA t3 .. _ Rt4 ..n J" ,furl . a�. f :C•,-2.i ACORD �= CERTIFICATE , OF j N!+ .q:.�a;�tf�iRScFr,� F�IH�ysE,ciTs�o� #avt,.u:•r��J ,tip.��' INSURANCE 3 ?SAY L►' i.1' , „ 17C N 1 t ri; J ,T ,J Q:�U";CI 9TA�T�iTA3J A[J;R't YttA 2 •-,. �- (06 Reverse) ' f • 7J:-1 Cif. , t. , J 1 1•J' o j i 1, )T to tlYA+t to J Lxw "J, I. ,;, r 'I'll i' V I „ , 1,• r. •,ff f , r t r r t .-:e.f:.iM.,..Y%.. .,PIC 2^,,...r+,t lz:l.,.,,•.,f..Jd+) !`,!' n1X YYt9 ,:i.t J � ,.. . ( 'Z ,, 044665 -1f+C :,rJit•:i�._ .__ ._ � _. - - -- ---. _ ..._...--- -- --- - _._.:.__-. .. E 1 `own of Barnstable . of any o� Regulatory Services Thomas ss F.Geller,Director � sas9 ,+� Building Division. , pIFD MP•l A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 office: 508-862-4038 Permit no. Q3° Date f' 0 AFFMAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"on,o r onstruction of an addition to mypre-existing modernization, vvAeor o,c pied ion, improvement,removal,demolition,or bug�g 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. 00 ,z G ,z �y Estimated Cost "I Type of Work: rn, i Address of Work ,`1 Owner's Name: licition: 1 Date of App ::i I hereby certify that: Registration is not required for the following reason(s): QWork excluded by law []lob Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OwnRS PULLING THEIR OWN iEHME MROVEMENT WT OR DEALING WITH UORRY UNREGISTERED SAYE CONTRACTORS FOR APPLIC ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERIURY Ihereby apply for apermit as the agept of"the owner: Contractor Name Registration l�to. Date OR Owner's Name °Ft Kati Town of Barnstable Regulatory Services BAmsiriBv �$" Thomas F.Geiler,Director �A s639. ♦0 a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 J NOTICE TO THE BUILDING DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF RESPONSIBILITY Y '� �A� c , Construction Supervisor License #_ ��51 , hereby certify that I have assumed responsibility for the project under construction, as authorized by building permit# 6 3 61 , issued to (property address) ' t l N I on , 20001 The following documents are attached: copy of my Massachusetts State Construction Supervisor's license or Homeowner's License Exemption form (if applicable) copy of my Home Improvement Contractor registration (if applicable) .Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road Bond(if applicable) LICENSE HOLDER DAT q/forms/newcontrb rev:080102 333✓✓✓ s,h •� ai'"" TOWN OF BARNSTABLE 21382 �. Permit,No. _._____�_ Building Inspector nusr..c ` Cash 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 Ann Trask Address r lot #1 179 Walnut Street. Marstons Mills Wiring Inspector � � - Inspection date Plumbing Inspector �^ Inspection date Gras Inspector ,� ( Inspection date X Engineering Department - i�/11/ �� Inspection date `Q. THIS PERMIT WILL,NOT BE VALID, 'AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 19: a_�j.................. ..... .... .......__ t /B/uilding Inspector 1,/�I A 4.o r, 2 0', /�v �_ 4..' * '' +un.�� ��f>�^.r't`'�'�� r;��sr ' '-c�„3+ �°f•a, .- , Y. ij•#"- Y+' i • •• fix.' 'O c. ��rt �,� 3 �• i• �1�.. 2 N W e /'72 • oo L\/AL /`lU77 S / . �eEE � C E2 TI FI E D ILL O T PL A lN! A,3 0 EL E 'OA D LOCATION: "A/eS7V"S 1-f/ LC..5 FRONT/ NG LOT. SCALE. . �`= .30+ DATE: 79 REFERENCE: BEING LOT SHOWN ON A PLAN 'RECORDED ryyF IS,- /N THE 8A RNST.4 BLE C O UN'TY DATE REGISTRY OF DEEDS PLAAJ BOOK 239 PAGE REG. LAND SUR. EYOR I HEREBY CERTIFY THAT THE FOUN.DAT/ ON , SHOWN ON TI-l/S PLAN /S LOCATED ON THE GROUND AS SHOWN HEREoN AND THAT / T -DOES CONFORM TO THE P`tNOF,N BUILDING SETBACK REQUIREMENTS OF .• '�E THE OWN OF 6AeAj57-,,9SLE '>�' 's' � i+ r GEORGE yG LOW.JR. q. 9EOR9E LOW AND CO. ti YA RM O U -rHPORT , MAss, �� �IsT6�' O� O SURVE r 1 q � 1 '/ �w Asses�or's mop and lot numbe ......... ..s o............ 3.. �J D/�/�Ci% — (� 7- of THE Ta ySewage• Pe�mit number' 7Q '� o .... �3./G............ Q .... House number .......: D sTsnte, . O 39. nea AL DE ' Al a. TOWN OF BAoRNS7 # T�On BUILDIHGI .-J.HSPECTOR APPLICATION FOR PERMIT TO ...... !AIF�uCL'.............................................. TYPE OF CONSTRUCTION ..,.WAR?.....E2AiuC............................................................................................. �. ..................... ....F..J..UN ..19.n. TO THE INSPECTOR OF BUILDINGS: The undersigned 'hereby applies for a permit according to the following information: Location ........q#! 41 l UT.... T :.. 11f} Ta nIS......... f tt.5...............:..............:............:....................... ProposedUse ........fir�t f. ...... EL.Ir! �j..................................................................................................... Zoning District R� ...............Fire District !TEZi V/�E� OSTE7z;Vl...Lr_.......... ............. . ...................................... ......... ......... ............... .............. Nameof Owner .. rrwj.... ....................................Address .................................................................................... Name of Builder ../Q.,..�.�..:.....1.�EP.gP.?.UP....................Address 7�p 8d,1C 9,�zp Nameof Architect ..................................................................Address .................................................................................... II... u/2 '� Aj Number of Rooms ...:..............................................................Foundation .... ... .. .......C-O....C!�L''T .......:.... Exterior ..` OU :.... �..........................Roofing ......!TS�J! ?4'l-r.......S#rNc�.t_e5........................ ............................... ............ Floors ��.ySC ©t f 9 'LA ' ...............................................................Interior .........................................................................I.......... Heating �. .��t� .. a ..........................Plumbing - Fireplace ................�.C1..........................................................Approximate Cost . .... ....................................... a S/7) Definitive Plan Approved by Planning Board ____kj-/z�-______________19_______. Area 57��.��................. Diagram of Lot and Building with Dimensions Fee ... ....... ..... SUBJECT TO APPROVAL OF BOARD OF HEALTH aNp' �1�� 6'17 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 1 Name ..... . ................ Trask, Arai -73 A=150 . 171 ;No' .21jB2..... Permit for ..Single...family.... �n ...............dwpl l. .p. ...:....... ............................................. n # -1 a-st...............Location ...lot1 179 W ......... ............... ..................Mar.s.toh.s..Nilb.............................. ...... . ...... . Owner ............Am-Trask................................... .. .... .. ........ Type of Construction ...............Word................. ................. .................... .......................................................... Plot .............................. Lot ................................ Permit Granted ................June. .1.5........19 79 "Date of Inspection ..... ........19 Date Completed .1.. .... ....... ..............19 PERMIT REFUSED ...... ..... .................... ..... ..... .... 19 a. ...... . ..... ..... ..... . .... ... ..... . ..... ................ -83. ........... . .......................... . ....... 00 in co AP`proQ ....... 19. 'n ............................................................................... 1,�1„ ............. y!.` "Cl�,_ / e THE T Assessor's map and plot' number ......... I �//'� / _ _ ;. Sewage Permit number ..... �...`3 � - q 0 ............................... BABH9Tl1DLE. i 1 House number ..... :. ..........:........��.9.....r.D.H................ 9 MAea ° pp t639• y TOWN OF BARNSTABLE, 1. - r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......Cc !:...1...:..:C.r..... ..:::..... ..:.!.. ......t R................................................. TYPE OF CONSTRUCTION ; °�. ..................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies ja� a permit according to the following information: Location .. :.'..!....... ................................... . .. ....... ..::.........r_t..............?..... ................................ .......................... ProposedUse ,.. 1.�.%. . .....�? :°.:.:.", r•e..r ..............................................................................................:...... Zoning District ..Fire District (;... +Tt ... .. . .... . l L: ............................... A. Name of Owner :............!!... .:.......................................Address .................................................................................... c t`+ fact-� v'� ....................Address . :...1.;�:.................................................� Name of Builder .. . .:...:r.:..................`...::......... Nameof Architect ..................................................................Address .................................................................................... " Number of Rooms /C i Y t.Ja.c: c. �.... ._ . .. .................................................................Foundation .............................................................................. 'Exterior GfiCjft.:...=:........wJ -`fK. 4-:.; .. ........................... ..................................................Roofing ............................................... ..: w ................ ........... Floors ................................................................Interior .................................................................................... Heating .... F4 i Y C.! .._ _ ....Plumbing I/ .. ......... ....... ........................................ !..... Fireplace Ct ........................................Approximate Cost �J v..:................. ................................................... Definitive Plan Approved by Planning Board _____�= _ "_____-__-------19 Area ��..•/ ..,.. ------- . ..7....6O.. ..................... . G Diagram of Lot and Building with Dimensions Fee ................................::..... ..:.. SUBJECT TO APPROVAL OF BOARD OF HEALTH so cvNoo' 6-/1-1 I a . I hereby *agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Named...:5 ' P (�...... �s:r �:.� .... �................. Trask, Azoz^ ^ A=150-73 � | / ' � --.. Permit for .m . ' —.. , , — . ' ' ____'�vw�ll' ................................................ ' - iocotion —....1n�.��..l74. ..S�^___.. _ ^ � -----'���GtJJ��..x�l 1p___'__. ........... ' ^ ! � / Owner j�M ' | | pu c� Construction/m o | ` � � , ' . | ' . . � � ! Permit Gro . � � � uo/e or mopecron Completed ` ' - � Date Completed PERMIT REFUSED ' ` . ' ^ ' ...................... lV ' � ---.. ----. ' ! —'--'t���= ------'' . . ' . ----. — ................... ~ ~ . � + ' � ----.----..t.....-----.------... ' ' � ` . ^ Ap'proved ..... 19 ` ' ---..,----------..—.-----~.---. ^ . -------------------..~.--.—. : ' � �j f. ! �j TOWN OF BARNSTABLE B,UILDING DEPARTMENT J4. HOMEOWNER LICENSE E%EM'PTION Please print. DATE �� . f, JO$i.i,. LOCATION T J :a Number Street Address Section Of Town M.: 4 "HOMEOWNER° Name. /�, Home Phone Work-Phone PRESENT MAILING ADDRESS 3w�,,�L. �f 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 such 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 to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work toerformed under the buiidina Hermit. (Section 109. 1. 1) 1 The undersigned "homeowner" assumes responsibility for compliance with the Stage Building Code and other applicable codes, by-laws, rules and .. regulations. The 4undersigned "homeown cer ifies that he understands the Town of Barnstable Building De artm nt inimum i pe 'on procedures and requirements HOMEOWNER'S SIGNATUR APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. Y.4 y. ,i H2sc5 f i HOME OWNER'S EXEMPTION The code states that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home . Owner shall act as supervisor. " Many Home Owners who use this exemption are -unaware that they are assuming the responsibilities of a supervisor (see Appendix Y for Licensing Construction Supervisors, Section 2.1Q, •Rules and Regulations awareness- often results in serious roblems ) `This lack. of.'.' Owner hires unlicensed ersori.s. p . particularly when the Home against the unlicensed. person as it would- with this case �licensed supery ur Board cannot proceed Aome Owner acting as supervisor is ultimately responsible. To ;ensure that the .Home Owner is fully aware 'of his/her responsibilities, many communities require, as part of the permit application, that the Home Owner certify that he/she understands the res onsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. community.y care to amend and adopt such a form/certification for use in. your c `t <y I.1, l i9 �e6 I' I Assessor's office(1st Floor): Assessor's map and lot number - . SEPTIC��� Conservation INSTALLED IIV ® PLIANCI' Board of Health(3rd floor): WITH TITLE 5 i DAS17T�nLL Sewage Permit number f _ ENVIRONMENTAL.CODE ANC o,�o 39. Engineering Department(3rd floor): 1�3 � TOWN REGULATIONS . House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO eu t h��I TYPE OF CONSTRUCTION U200d i ` 19 _ TO THE INSPECTOR OF BUILDINGS: The undersigned h66ereby applies for a permit according to the following information: >>> Location `7�� & i`fJ NVT Proposed Use Zoning District Fire District G �, z w Name of Owner ��� Address Sh,)Vl� Name of Builder C►�/6�-r Address Name of Architect Address Number of Rooms Foundation ( XG vim. Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area t0 0 S Diagram of Lot and Building with Dimensions Fee 17 / �l 12— ..��� ' IN AFL-vu T- S r OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of trnstable re ng the above co ructiN :1 Construction Supervisor's License A PENTA, PAUL & ANN No 35202 permit For BUILD DECK. • Single Family Dwelling Location 179 Walnut Street Marstons Mills Owner Paul & Ann Penta , Type of Construction Frame , Plot Lot Permit Granted July 14, 19 92 Date of Inspection 19 Date Completed 19 •� � ,may, , .._4 - IJ - Existing U . New shingles®front elevation of existing match odetin m ` >_ — 3 atch ewsung "5 y1 2 to.than9 a window � u I `—nccommoda[c � fl . match exi6Nn9 new roof Ilne . y. a ❑ ❑ O N 5" re U ' W Cedar ®® Z p 5"exposure existing relor tad - W Leder O - 5"ex Sure >-> N w = Uexifiti deck rebcated - I REAR ELEVATION 1 I — ,NeW constructionlExietWA__ RIGHT 51DE ELEVATION= Exieu„ 1 New co„etrucuo„ — FRONT ELEVATION 1 0 C, N o Q existi20 ng waste pipe. i I 1 I 00 o o —— —— N NpOp 17 30'E tg..2p4. �C }� 11%"to center beIo� i �I -I - - . floorjoi6t \I 1 n 2x816'a n F - II � I� Il I KITCHEN location. . . proposed location of new t f e ste pipe,apprex head L: ereata recess to .I .. room 6•2 Vi" new crawl 6pau, . min.18'x24" �1 - ❑ s (P L Demo wan DECK - �! 3s• Q cut In new I Z kt . _ ® beam pocket I - ❑ - Note:Fxlsting deck `, I E"I,'Un9 edAtlen yq _ _ _— to be relocated O 6T,0„ L 2x10= .. G exlstin 85,000 BW. create HVAC chase.---��� g .size byother6 5 LIVING .�I 32xeabove furnna,resize by otiurs assumW '(if required) o ( ) Lot I,20.166 Sq.ft. existing 1Ox10 feed,_ e+d no post 179 Walnut street [� (a6sunwd) Mnrstons Mills,Me . rash.by others to mmaln Map 150.prcl 073 - unfinished 2x4 well exists DINING 172' ypw _i rel—to heat rim�l Demo wall . to exi floor - I I relocate existing I__ ut rJtteeL _ •.axisting water xrvlee� p ' FHA duct I 51TE PLAN y r EXISTING FIRST FLOOR PLAN Deee:r.3ov L EXISTING FOUNDATION PLAN_ o o. - Z' N s = o M � N >- F 3 I ' N Existing Deck - W ' I Relocated roll ridge vent®ell ndgee 4 Exletinq I New onstrtictlon 202 ridge 20'O' - .. to-a ' ao 0Lo 9'FG Insul.w/Prop-R 0 > - ex?ND Vent^'ar equal baffles 2'-8'-1 - IIBe . GENERAL NOTES - .. Asphalt roof shingles C� _ __ __ I I 4'-� I •. 1.ALL DETAILS,SECTIONS AND NOTES match edsGn - o o o SHOWN ON DRAWINGS ARE TYPICAL 12 we to O.C. ( 9) - . - �0• GAF^'ehinglemata ____, ____, N 31 AND SHALL APPLY TO SIMILAR I I 'd' 1/2•CDX I i FWG6068 it ' SITUATIONS ELSEWHEREOTHER- _ 12'(r) - F'V.au tVelux r 'Vdta. U p WISE NOTED. P.30 FG insul 2xIO 10"O.C: I� I Y i V5304' i V5504 n 7 mach edeting 11 - 2 THE CONTRACTOR SHALL VERIFY ALL _ -------------- _______ ___ Vented Typ. II 1 I ro DIMENSIONS AND F CONS RU TI 511E PRIOR TO I I W O COMMENCEMENT OF CONSTRUCTION. i T Famil ROOM U � ' 't o I �Prwide Simpson AH25 - 9 Oy < (V. 3.BLOCK OVER ALL CARRYING BEAMS,BEARING 5'A m humlcane tAes 0 16"o.c. _ 4e.3s WALLS,AT ALL STAIRWAYS,d WHEREVER ELSE P°lon - NEEDED FOR FIRE STOP OR NAILING .Whlu cedar(extras) ❑ 3-2"m o Typor House Wrap FAMILY ROOM ' U 4.A MIN.OF 7W'0 JOISTS UNDER ALL LONG 'A"TdG Ply,glue and nn' - 1/2•CDX PLY -_- PAP•ALLEL WALLS 2x616'O.0 I s f-- k n Z p . R19 F Glass insul / 9'-8•Cho I Cellln I LIVING edsting 3-2x8(aeeumW) J � � � BATH 1 � - O 0 5.PROVIDE SIMPSON#H25 HURRICANE TIES® 2x6 P.T.sell with sill A"u g pose(neeumW) i _ T-6•eelOngSNiOALL RAFTERS THAT DO NOT ABUT CEILING J015T seal.nd V2'anchor � w&psy u LVL �'l � AND AT ALL TRU55 LOCALS 2a4' belts a 6'•a°O.0 - .. ovee6.ALL STAIR RISERS TO BE EQUAL,y/•1/16'd AP,E BI Wminou.damp proof -----rrouq rme-------- ------coating /4'x91/2•LVL,leg boltN07 TO IXEED 816' edaVng box jdatl b'poured ca r. <7,ALL FINISHED STAIR TREADS ARE TO BE IO 14' - fourdatAonumuroe9.MIN.FINISHED 57AIR WIDTH IS 36` f0c;VngAA2°concreterover - ! Coverts poroh _ ENGINEEREDACTOR WITYALL GROSS SECTION ENGINEERED LUMBER WITH 6m11 you tom rrt d ' REGARD 10 SIZE AND APPLICATON 2 2 P° _ pa grnv A "a WITH THEIR RESPECTIVE - WINDOW SCHEDULE MANUFACTURER AND SUPPLIER. � � Scale:1/4'.I'O` NUMBEI CITY I FLOOR I R/O AREA I U•VALLUE CODE ' . WOI 1 I 301/8X413/8 TVf2432 W02 1 I 11 W1 a 0_573/8 T8-DHP31046•I5 L 9'-31/?, 2'-10•i W03 1 1 12 1 3B I/BX45 3/8 TWW56 14'-0. -i 10'-O" ' - DOOR SCHEDULE NUMBER QTY R/O AREA U VALUE LODE 40 O . 00 1 72X80 FWG6068 '1 D02 1 321/2X801/2 2-BX6.8 RH 9LITE O Q 301/2X7a V2 2-OXO-6 LH 6PAN - -, O04 3 38lmX I" 3-0X6.6 BI FLD L � ' FIR5T FLOOR PLAN �s CS) q) existing gable wall. _ - � Q <\ new sheet rock 4----------—- 1o0^ -}-4 e^ proposal location ix5 nosed -St.pipe,ap'PP-heed I ------------------_-j , 6' j - - room -2 V." S/9'ro-rod #8002 crown - t6'OC(Mp) d II �I II I j Y 1x10 - Zx816'OC - 30'k90'xi2"concrete II II II I I fsogng(tyPp.) —— t ei'i'a'/a"LVL � create access to I . . ._.. .• new crawl sp-• I min.18'SQ4` beam existing calling ik"galy lags 24"OC,Stagger - p k t I Iz'TimberBOltT"' 3.2x10 24"OC Ix10 -= -- -- #MG bed existing 2xG Studs removed cut in new j ' benm pochac > m - IX3 - - 5••v i. 6••0' I s'•a--I--s'-10' f in . ereau NVAC cham.-Z I. L elm by others S4•anchor bolts,I'back 9'X46•poured mncreu I I a o B DETAIL e from comers Max S 6' fouMatbn en a comtnuous I I 10 2 2 5/a"rood dowel. on center Max(typ) o x1e eontrete=4 I I � � N 4-1 Seale:l l/2'=1'-O' 18'OC(typ) F iu 24'$' Lt Existing I New constrvct•on ...S.min.46'babes FOUNDATION PLAN gfed` L