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0306 WILLIMANTIC DRIVE
a r w. P r i Town of Barnstable Building t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept DAM M M" Posted Until Final Inspection Has Been Made. 1 Permit � Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-396 Applicant Name: Lloyd R Smith Vivint Solar LLC Approvals Date Issued: 02/11/2019 Current Use: Structure Permit Type: Building-Solar Panel- Residential Expiration Date: 08/11/2019 Foundation: Location: 306 WILLIMANTIC DRIVE, MARSTONS MILLS . Map/Lot: 103-083-002 Zoning District: RF Sheathing: Owner on Record: CRAWFORD, DUNCAN&GRETCHEN - Contractor Name:` BRIEN LANGILL Framing: 1 Address: 306 WILLIMANTIC DRIVE Contractor License: CS'106675 2 MARSTONS MILLS, MA 02648 ' Est. Project Cost: $22,506.00 :Chimne jjj Y Description: installation of roof mounted photovoltaic solar system 33 panels Permit Fee: $ 164.78 10.23kw ! t Insulation: Fee Paid:' 5164.78 Project Review Req: ;� Date: 2/11/2019 Final: i Plumbing/Gas Rough Plumbing: — Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months aftePh' die. Final Plumbing: All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: 1 The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and Fire-Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footings Service: 2.Sheathing Inspection ^ Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 6N Lrr-r-'&R- t � tl1E � 1 � • • ' . Town of Barnstable � �a� cf a Building i Post This Card SoiThat it is Visible From the Street=Approved Plans Must be Retained ;`Jo6 and'tliis Card Must be Kept e�vsree�. .. z .. ., WAS& Posted Until Final`Inspection Has Been Made. ;, Permit 163% - _ Y.- a s,i u w w : , < Permit m r R Where a Certificate of.Occupancy-is Required;such'Buil'ding shall Not-be Occupied untd'a Final Inspection has been made. Permit No. B-18-3089 Applicant Name: Roland Langevin Approvals Date Issued: 09/24/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 03/24/2019 Foundation: Location: 306 WILLIMANTIC DRIVE, MARSTONS MILLS Map/Lot: 103-083-002 Zoning District: RF Sheathing: Owner on Record: Gretchen Crawford Contractor Name:`.,ROLAND LANGEVIN Framing: 1 Address: 306 WILLIMANTIC DRIVE Contractor License: CS-103861 2 MARSTONS MILLS, MA 02648 - Est. Project Cost: $2,640.00 Chimney: Description: Weatherstrip door&add sweep,air sealing,ventilation chutes, Permit Fee: $85.00 4"x16"soffit vents,kneewall slope:2" rigid board,6"fiberglass R19, r` Insulation: insulate bulkhead door. I Fee Paid: $85.00 - ��,� Date: �f 9/24/2018 Final: Project Review Req: Signed installers certificate is required to close. Plumbing/Gas Rough Plumbing: �\Building Official Final Plumbing: t l h # tI Rough Gas: F This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the;approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local-oning by-laws and codes. s Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. + Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work:° �— —_ _-. 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: � � y � ���� � ��� # � � d �� �� �/iy � �� � ��� �� �. .;.. . ,. . . ,: . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 'Map -1 0 3 Parcel 0!J MD 2 23 Permit# 6 22 � Health Division �,M k7 11 102 -M-J01Q Date Issued 2S Conservation Division A 117-1\4()), C'I Application Fee 00 Tax Collector Permit Fee Treasurer 7 ' ��' D SEPTIC SYSTEM MUST DE INSTALLED IN COMPLIANCE Planning Dept. V=TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUU-TIONS Project Street Address Village M eC�S `NS c Owner G 'b6f .0._� Address oL, Telephone Permit Request s-Z_=,Z3y\S-W\ as\ �c1A,\i\o, ��� .�.fl orc�.c�4�S _ T1r�-�;C'�. �J`��� �o�, t`o �. '�('� C� ��,u1�`�o► f�(d Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new 104-1 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 5 — R Lot Size Grandfathered: O Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family' Two Family O Multi-Family(#units) Age of Existing Structure Historic House: O Yes ❑No On Old King's High ay: ❑Sees JNo Basement Type: ❑Full ❑Crawl O Walkout ❑Other - r Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) : ' c: Number of Baths: Full: existing new Half:existing 1 new, Z x �� Number of Bedrooms: existing newco cn - r Total Room Count(not including baths): existing new I First Floor Room Coun %_0 r" Heat Type and Fuel: O Gas ❑Oil O Electric ❑Other N Central Air: ❑Yes &No Fireplaces: Existing New Existing wood/coal stove: O Yes -M No Detached garage:0 existing 0 new size Pool:O existing ❑new size Barn:U existing ❑new size Attached garage:0 existing 0 new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization U Appeal# Recorded❑ Commercial U Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Ate- ltk_ os Gf\Telephone Number• 5�g-3`f3— C7 Gr:� Address 60 c'c-\s License# 0-7 O 9 1 V Home Improvement Contractor# S I �o Worker's Compensation# 35 ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO 'L , L . ti�V4�.1 S bY\S �� vJ �s•�10o v SIGNATURE DATE ;7 FOR OFFICIAL USE ONLY q t 4PERMIT NO. - DATE'ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER _ f. DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH. i FINAL , GAS: ROUGH FINAL FINAL BUILDING J, DATE,CLOSED OUT ASSOCIATION PLAN NO. ; =R` The Commonwealth of Massachusetts Department of Industrial Accidents Office ofinsestigations . ' 600 Washington Street `c3 Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: C `L—�!1 N"\ r location city ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worki>i in capacity % %%/��/%%%/%% /%� %%////////%%%%%%%%%%/���%%%/%%%%%%/%��%/%/%/%%///////G/O%/%%�//////�%%/O%%/%/ I am an employer providing workers' compensation for my employees working on this job: :romnanvname•.��XC ... ,s"+............ ... .... ..:.............:..,....::.........................:,.... > n>'' >«> ><` ttisul9ti�e.co.............. �,.... ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have oh the following workers m co ensation ces:............p s? ` ?`?`>>EE' ?< ` .' `> '<`«? `'>':> `?`<`` EJ° `ruiinaan n -{iy:Y•i::: ti?CC• >ih ......................i:C!•i}ii:C!!Ci:•i:•ii:C_:!•r:i•;!i'�:ii:::::::'.'iiiiii:::(:ii:y::.�: L:jjr��:y:isi�"':is�iiiii'riY:':fi'F.�iiiiii>:�i}i: ..n...............•................................................. n............................................ ................................... ... .:::::.:.:::..::::v..:�:n.�:....:.......................:.:..:::•:::n J.•nv.:J:C•:>.%}kJ:v;::-:m:: ........:..:•::::::..:........................:.............:•:w:.::.........................:............:.........:............:•.�:::::.::•::::w:. .�... ... ..................................I.. .......... ... .......\w::: .........................................:...: ::w.:�.:.�._:::::::....:....:.......:............. ?�:•isisv:^::C•is91:•i:•iii:.isiivi:4iiiii:Lv'4::C!ti0i;•i:^}:!!•: .. .. ryii:•i:9ii:�i}:i^:C!4:v::•i::::•:::::. ii:::•:iJiii:4i:!•::0:•}:::::::v::::::.:w::::.::::::::::::::•.�:::::::::::::. �� ...M......................................................................::::.....•::::::::::.......:, :....:... ....:......................................:..:........................................::.:..:......::.:..............:...............::::::..::......::.:....................:::....:.....................::.......... >>'... can tn�:: ...........................:::....::............................................ .. ...................... :.:..:>:•: v.{•:. ''llr <" s§i?�a. `th :.;e.'' Fafiure to secure coverage a,req�red raider Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine np to S1,500.00 X . and/or one years'imprisonment as wen as dvfi penalties in the fo of a STO WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office vestiga" of the DIA for coverage verification I do hereby certify under the p and es of p that the information provided above is true andQorre h i"`— Date / v- Signature Print named��� \`�.U�F. Phone# 5 O official u:immediate do not write in this area to be completed by city or town official city or t � permit/license# ❑Bufiding Department ❑Licensing Board ❑chec response is required ❑Selectmen's Office❑Health Departmentcontact phone#; ❑Other 0evieed 9195 PJA) 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 retuaied it . the Department by.mail of 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 Olflce of Inuestigadens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 RESIDENTIAL BUILDING PERMU FEES APPLI_CATION FEE New Buildings,Additions $50.00 ✓ �' Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE /10 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) ACCESSORY STRUCTURE>120 sq.1 , >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 Open Porch x$30.00= (number) ii 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 Ft—IL7 projcost �OFttiE 1pk� Town of Barnstable Regulatory Services ' BARNSfABLE• ' Thomas F.Geiler,Director y nsass. �* 039.�A`0 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: S y.f1(—05 C� T��CI.0 [;\Gn Estimated Cost i a m�, Address of Work: Owner's Name: Date of Application: 'rZ a I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DP NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY F ER MGL c.142A. SIGNED UNDER PENALTIES 0 I hereby apply for a permit as the agent of the owner: _-7/a) oa N\tX.rlk�6 �AAQn Date Contractor NameMedi o lk C \ Registration No. OR Date Owner's Name Q:forrms:homeaffidav LI_ /zG ,S4 O T Z7 20, 000 S,F zd S¢ UF r!a ROBERT EWNIKIS. a ' - Ida 84II0 CERTIFIED PLOT PI:Ai ' �EW__CONSTRUCTION ONLY = - M.4 re-sToA/s All TOP OF:-:FOU.ND_ATION IS 3 FEET IN AbflVE.'`LO.YV .POINT OF ADJACENT SAAASfAJ*Ljl4�A So. ROAD_ y SCALES 4D'_ DATE= rLDIPEDGE £NG/N�ER/NG COTIN CLIENT I CERTIFY. THAT'; THE F�un/D.4 EGISTERED LEGTERED 78.E a,� SHOW WON ON THIS' PLAN ll--•.LOCATED CIVIL '. ( ND JOB NO. ' ON THE GROUND AS INDICATED. :AND:- INFORMS 'TO THE .ZONIMe LA;ENGINEER EYOR DR.BYE ,. . ., ..:Q_A:RNST BLE , MASS.:' :33.'.�10: h1AIN ST 712 MAIN ST. CH:BY R ,, J!- ��.4f .r-�e,�� r 1> - UJ mAAir 1 - VILLAGE Q�3 Wiz. �12ST0�5 �i �tiS INSTA LLER'S NAME i D'DRESS I i B U fL OE R OR OWNER ��n��.R +�s�'►�� CmRPn�4TlAAl i DATE PERMIT ISSUED I OAT E COMPLIANCE ISSUED Ii I Y8 ' y� O yip 4-0.us � I EXISTNG 3'POOR-� EYNNG 7ECK 18'X22'(APPROX) FROM HOUSE 1.2X8 Pf FDX @ 16"O.C. 2.5/4"X 6"PT PECKING 3,4X4 P05f5 4.UNOEfERMNEP FOOTINGS 51-011 5.ODL 2X8 6EAM(WPMN) 6.J015T HANGERS a 1.5MR5 IT 9" PROP05E19 UPGRADES f0 EXISTING PECK 2 I.fO PM 2'X 15'PECK EVENSK)N,2X8 Pf FRAME 16"O.C. �' '-�' 2,fO AM(4) I T O X 46"PEEP FIC6 W/ ANCHORS I6 16 I 3,f0 APO 5/4"1&G PLY OVNIAY 3' 18 4.f0 APO 6X6 POSTS ON 5,f0 APO M Pf 2X8 ENO REAM 6.fO AOP 2X8 Pf SIDE 1065 @"A" WAIL 2' 7.f0 APP AB Pf SIDE J0615 @"C" WA A, 13) PWF05EV 5 5EA50N PORCH --_� 8'X W(APPRO U 5WI0 5ntt EN0,051f 3"EP5+ H ROOF 5Y5TEM (8'SPAN) NEW 6'POOR FROM PORCH (NOf SHOWN IN f� N5 VIEW) wJ_ I it 14 IFFII r � J .J L LJ ' Lr7 J tJ UJ%NG EX6TNG ® 5TAn 5& O 5fA15& MING NOf RANG NOf SHOWN FOR SHOWN FOR CLARITY aARITY proms; 5�a1e:1/8"�!'-0" Prawlrq: etterl ivoing MATON&P ff-5MNC� PATIO ROOMS 506 WILLIMAW PRNE A- BMA15fON MLL5,MA 02646 i I00 Otis t (5W))3393 t) tax(5W)�393 0340 6/n7 �W6�YiN Property Owner Must Complete and Sign This Section If Usina A Builder I, m Qu he 2 h MacJ 0 yic_1 , as Owner of the subject property hereby authorize Betterliving Patio Rooms (d.b.a.—Patio Rooms of America) to act on my behalf, in all matters relative to work authorized by this building permit application for (address of job) 1 " i�c�d� o Signature of Owner' ate Owner or Builder.(as Agent of Owner) Must Complete and Sign This Section as Owner/Authorized Agent hereby declare that the statements and information on the foregoing-application for (address of job) 3c 1- 1,- kV, a�GSA� c \b�� v� are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Signature of Owner/Agent Date i3J� aw�Y tc���..wt✓ ::w!.� .^..'Y.•._Y��/.�:a�.14:':i+�1 �iCYt��pp..� The Massachusetts State Building Code (780 CMI) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as_part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, , Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from. selecting a "sunroom" of any size'. configuration, orientation, form of construction or percent glazing, but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year= round comfort considerations involved in selecting and utilizing a "sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installatioil of"sunrooms". included below is a non-required,.open-ended Iist of product and design considerations that a homeowner may wish to consider before actually constructing/installing a "sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, iii order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN.CONSIDERATIONS RELATED TO "SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Fralne materials Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation -Operable windows and fans C Applied Shading'Systenis _ • Insulation level in floors,` RIIS, and ceilings • Possible Sunrooln-isolation from the main house via a wall and/or door or slider Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section JI.I.2.3.1, requires that the actual property owner.(not the owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FOFJv4 prior to issuance of a Building Permit .for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read nation in this doe ent c ncerning sunroom comfort and energy conservation. I Lure of Actual Building wncr Date / r7�o:! 3G c- Gui z,, -n.7yc I�L Print Name Add ess of P rmitted Project (�r s', /1 1`�/s� Owner Address (if different than project location) Owner's telephone number 'CLI °iue en to'D�J4 dCi!, r.,l: :k..� ;5 ":g ,. t��r-,tz�¢o=leaa�l�..l ad i"ress�5uriii; :o n ♦. 1: ::t(efa.,::.:. :s:,i:F�FYj:. .. a:;.....�-.. ..:xi`?..u_ ..s:.::aub...oY�tLaui..�:.'L:.+utliimr - Exception: Srcnroorn Addifions/_Consumei`.Notif cation:Sunrooms, as defined in 780 CMR . Appeiidlx z:n I3CtlYiFl I lolli�, �l�al1 too exis5iit lltii.ii ilac coiiipilancc rdgtiiidmdnts set forth in 780 CMR A 1.2.3.1 and JL 1:3 p-iovided that the actual. Property`owner(not.the owner's agent or representative) of the structure onto which the sunroom addition is being made,provides a signed copy of the Sunroom "CONSUMER INFORMATION FORM" (found in 780 CMR, Appendix B) to the Building Department. This signed "CONSUMER INFORMATION FORM" shall be submitted to the building official-as a requirement of building permit issuance,and shall remain as part of the construction documents. If such sunroom additions are separated from the main house by a wall and are conditioned spaces, then a readily accessible manual or automatic means shall be provided to partially restrict or shut off the heating and/or cooling input to the sunroom addition space. That portion of a wall that separates the sunroom addition from the existing building/dwelling unit, if an existing exterior wall, shall be allowed to remain and neither that portion of said wall or any fenestration within said portion and common io the sunroom addition, . need comply with the thermal envelope requirements of-Appendix J. y�'cfion� eP'--'L ndJ2 t)rI?EyI+'IN>ITI®1MI�IS;*toirode;>a;�lef ifon :a: riin 780 CMR J2.0 DEFINITIONS SUNROOM: An addition to an existing building/dwelling unit where the total area (rough opening- or unit dimensions) of glazed fenestration products of said addition exceeds 40%of the combined gross wall and ceiling area of the addition. isae ei� echo StrptG' t cid auCO SLTMEFLINTr��tiAO s.ee t,o®o -aca" e t.�;. v 5 t �s.4r' , i ei rn'3r =r t �"+�tT�` '".• �,. '1. o en ?133©Vrhe�C6d6-%1W �0 be,Iocstect it�tmedxate _ ldtmlNr=`N*'^ iOlIS»,� tlsofound1xnEAppeiidax76� r �_ ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YY) PRODUCER 12/18/2001 Joseph MCKeon2 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIOHTO UPON THE CERT(FICAT JP McKeone Insurance Agency; Inc: HOLOE13 H S T FICATE DO d N T AMBN® 8>tfi®N O P.O. Sox 333 L sR 1 �o� A�e A��ot4bb dYTHL' POLrcIEs eELOw. Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE INSURED Patio Rooms of America, Inc. - — INSURER A: HARTFORD INSURANCE OF THE MIDWEST John Ester 100 Otis St. INSURER B: Northboro,MA 01532 INSURER C: INSURER D: COVERAGE$ INSURER E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUE D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUC D BY PAID CLAIMS. LTA TYPE OF INSURANCE POLICY NUMBER p DO 0 MMpmT A GENERAL LIABILITY LIMITS 35 UUC 35019 COMMERCIAL GENERAL LIABILITY 11/01/2001 11/01/2002 EACH OCCURRENCE S 1,000,000 CLAIMS MADE OCCUR FIRE DAMAGE(Any on_e fire) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL B ADV INJURY S 1,000 000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2 000 000 POLICY PRO- LOC PRODUCTS-COMP/OP AGG $ 2 000 ODO A AUTOMOBILE LIABILITY 35 MCC 302718 ANY AUTO 11/01/2001 11/01/2002 COMBINED SINGLE LIMIT ALL OWNED AUTOS (Ea accident) $ 1,000,000 _ SCHEDULED AUTOS BODILY INJURY X HIRED AUTOS (Perpetson) $ NON-OWNEDAUTOS BODILY INJURY S(Per eeddent) P O RTYDAMAGE $ GARAGE LIABILITY ANYAUTO AUTO ONLY.EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG S EXCESS LIABILITY OCCUR CLAIMS MADE EACH OCCURRENCE $ ._ AGGREGATE g DEDUCTIBLE S RETENTION g $ A EMovCOMPENSATION AND 35 W8C F13935 08/01/2001 08/01/2002 TORY LIMITS ER $ E.L.EACH ACCIDENT $ 1,000,()00 E.L.DISEASE-EA EMPLOYEE $ 1,000,000 A OTHER F,L.DISEASE-POLICY LIMIT S 1 000 000 PROPERTY 35 UUC 35019 11/01/2001 11/01/2002 Includes Rlcho:Copier AFFICIO270 Account 41997706 to Include Theft DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLESIEXCLUSIONS ADDED BY El OORSEMENT/SPECIAL PROVISIONS Certificate Holder is additional insured CERTIFICATE HOLDER ApDIT10NAL INSURED:INSURER LETTER: CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION INSURED COPY DATE THEREOF,THE ISSUING IN WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 25-S(T197) O AC,OR CORPORATION 1988 YOUT FLANS WALL SECTIONS , r EX15TING OUILDING 4 llll/1/� 1�1/�ll/llll� "` r � r� _r o• �' _ � —57"— --5T —5T'— —57"— �,� k, v o Q :r t, � S r,: •''t'� O. :.,a x� a ++ :•' ,.`f,;:�5�:.': UL ' DM 5TUD10 51DE WALL(A) 5-1-UPIO 51DE WALL(C) 5708"D 57'x78"P J-- D WALL STUDIO r�ooR PLAT I = y S E M B LY D ETA I L5.l a `' sS >, - .a G. (N0T70 SCALE) ALUM.PANEL HANGL"R GOPIhIECTS'10 WALL 5'NDS >.r- OR ROOF RAF'fEP,S '-A �96.75" :fi..° SEE ALLOWABLE LOAD:.i•'3 TABLE FOR PANEL 51ZES`Ir�` 141-11IvIUM SLOPE GUI-1EK FASCIA_- t �~kIEiIDER SUPPORT BEAM 5TUD10 FRONT WALL(B) ALUM.SLIDING TI;ANSOM(OPTIONAL) (A OWAI3L'L= LIYEsL0AD=1=Af3L-E-FON 11r1 T:PANEL WITHs10 faTORsLESS`51'At`t POOR OF WINDOW�'— 1 'D PSF _ 25 PSF 3o r5f "'35 115F AO rSF 45 PSF 50 PSF 55 PSF r 60 3'HC 31-IC 3"IiC' "\'''3`.'I IC 3"HG 3"11C f 3"HC 3" - ; ' TEMPERED GLA55 -S'L"PS+H �'EI Sa-H 'i.'.'EPS+II''z:.. ?i'EPS+I I 'i'ErS+H 3"EP5+11 WEPS+N� 4.5"EPSi Fl f�15 Ei?5 rFl ' S11 1 SLIDING DOOR ON q.1•: SECTION WITH DOOP, ,�xNOTC5 FOP. STUDIO 00N5TP.UCTION FLOOR CHANNEL t 5TRUCfURAL MEMI3E5 ShIALL COMPP.15L" 4.WIbIV LOADS=20 r5F ID.A66REVIATIONSi' %;,` ' FOR 80 MPH EXPOSURE A,B,C D=POOP �c�`* `D i 6063 1.6 ALUk•11tJUM L•7CfkU510N5 rPOVIDED DMA.VOOP`:MUCLIOIJ �- '"'''"-�'~�" • 5.DEAD LOADS=5 P5F T ' 6Y CRAFT-@ILUMANUfAGTUP.ING COMPANY. 4V-VVIIJDOW;; IYPIGAL.STU!)10'SECTION 2 ALLOW/�l3LE'LOADS ARE BASED UPON" 6.D00);AND WIbID04+/LOCATIONS V/j+q-.WINDOW MULLION o`"'e+j,EVV 4"` o c`:NOT'70 5CALE THE LE556R;OF THE ULTIMATE LOAD/2.5 AI:E INTERCHANGEABLE. U='1 CHANNEL o` .•......��'`^ `+.r OR THL":LOAD AT 5PAN/120. 7.GLASS KNEE 4VALL5 APE HC=HONEYCOIviB PANELS rnn c -'"' ---— 3.I-IC/EP5 KL"FER5 TO CRAFT-BILT.5TRUCTUKAL P?=' '""`•`_�� P('. LLf: =°t• CONTRACTOR:IN'fEP.ChIAiJGEABLE WITH i PANELS. EP5=POLYSTYP.EIJE PANELS, a_ i J MiN ;a {7-.?5jt,1`J .; ':�. = JOSS '. PANELS WITH I ALUMINUM SKINS 60tJDED TO 8.4MD'fl I OF 6-WALL MAY VARY pEl: hl=THERMALLY-BP,OKEIJ ?y'% - ; DOOR/4VIbIDOW LAYOUT UPTO 24f7. 1'•c; `^ r`= o.sss I-ION EYCOMB/rOLY5TYRENE CORE5(3",4+'h" ALU1v1 H-5TIFF- r a / c�,is J. ,�q 10�-0°X 10'-2° AND 6'Ti-IICKNE55E5.. j:. 9.AUTHORIZED FOR BETTEP.LIVING 0/1-1=OVEPHANG J�'S '=�� '��` o'`,t" STUDIO ENCL0.5C DEALER USE ONLY. P5F=POUIJDS/SCJ.F00f <. ;"i=L"''. ci ADJACENT PANELS AP,f_CONNL•C.1'ED`U51NG ao�z� e,^.>L• DWG I10.: " VINYL CLEAT,OP,I I5. c "*> ' P=PAIJEL `� ;\' .. ,' ,: c;V+ ' URA4'7i 1�ltlfv,l•ilt r OUT 's�'s:. FT=FEET a,. `�s r aC." [ ' ruin+"``'' em7010x1O.dwg GENERAL.L`AY T �•c G-.`/STE--s.�:;i' SCALE'i" 5 +�.e,... ALUM.=ALUI�IINUtiI :;Xlk':; }�?s,•',;nta«;;`' _�0" /2000 I; `; ;'' �' $.•--.`L"; ! DATE:11/27 a4 r to Lsonrci of Building Rcculadcns an.A 1'.. -egistre,tion valid. individ- 1 Cke-."k Lice.se w scol ret HOME IMPROVEMEKITC014TFI: -xpiration date. ff`our ci uz-D.tu: wsc g ��! P gl-'t A of R-_ e s P i;ldin."-RePUtionc and r..-.e kshburtop.Place Rm 1'zo E.rp B o M r., 3 210 S ype---:Private - PATIO ROOMS QR 9.OSTON::INjC' ANDREWS MAL&E :==_ 100 OTIS-ST NORTHBOROUGH, MA 015-32 r. r is cr aru r Not wifidd without sig .7,azrre B OF BUILDI ULAT,IONS ?E-3 F ION SUP�PVISO Li::enze: CONS7 PUC p Number: 03 Fifl 02123-1057 ni no: 7227 rZs- 02l2irV2n03' Restricied To: 1'.G ANDREW T MALO!�;-- 41 WASHINGTON ST:L.21 NATICK, MiA 0l,7"o Af-irniniMirator A_v-v DAV 1T with C O+a �V n�- all Q�7r1S 13` a With Pe-lCL� �r ,.��— _ .J="�Jr.�T—r ui.J:JOS�^ l!— .._e.. Lam{•/-♦ _ —/ ~f w_ - 35 d=__„�. �y V,,.�-T1, `1 T E . ! . Fi A R 4'E Y & S 0!�S ►is /—NX � ! 68 HOPK I NTON PD c c s V n o n u 119 A L3E (LLl vIN6 P.�J .,L4Z T (R E 135 ) A3rress !••�,-, r��1 Of goal mil/-ode iLeCL1•:B JETt er 12 , ` Ar"; Cie _ 7 Oi the 1i �orc�T � actia� Winder Cha��e� = r_ N/O�CPS�P= Y.Cv- C'� vi"u_io��CcS O_ y^,3^�Cy1712 rZ Ni00- :s a resu L signed cP;�= on 4�e +is =sea shallb� 3 a_�^ --- - as�osa1 facilitycrf coma,_ing �_�a following - he thA �,�ckirl5' �� wc1y�_ �'1Q _tL e C!�ar, 5 1 --7 _vC2 i,P own, O it1S Or r _is 'Drr,ina .ce lY �Y'Z C1' G r Y�pmo�t ac 1 Oii by `y ti_Zl i o5'.Lt en_ ` i Yy,�TM •e TOWN OF BARNSTABLE Permit No. ---------.---------------------- 1 »n.n = Building Inspector Cash ---- ---------------- � "YL 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 Danner -Hoyle Corp. Address lg Bay Colony Dr., Plymouth. N' " Willimantic Drive, Marsta is Mill Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Y Engineering Department >; Inspection date �.� / y 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 .... ............................................................................................................._._ Building Inspector r� � I I I00- t y S 3 9 u 30 ` N r� ' 0 fvc)wP4 r:9N • r 22, p 0 I � ( 4 0 T z� 20, 000 -F i zh, S4- 3 W C k08ERT P. '-t3A1NtKIs , ' No.8420 f I O SUM r { CERTIFIED PLOT PLAN; 4. I L-.o-r 2`7 /L z_/1tj l 7-/c j7Rl✓E � ! NEW "CONSTRUCTION ONLY MA-/T-sTon/s' Al/C_ LS '+ j _TOP OF FOUNDATION IS 3- FEET IN ' i -ABOVE LOW POINT OF ADJACENT S� ' ROAD. I 0 SCALE: /"- ¢0 . DATE : 9 i.3�;� Fi . ' ; ELDREDGE ENGINEERING CO. INC) I CERTIFY THAT THE Foun/o,c}Ti0 i,- ----- CLIENT -78'0 7' ,✓c-� SHOWN ON THIS PLAN IS LOCATED (REGISTERE— --D REGISTERED 8 JOB NO. ON THE GROUND AS INDICATED AND } CIVIL I LAND 'CONFORMS TO THE ZONING LAWS ENGINEERS SURVEYOR DR. BY: A. _ dF BARNST BLE , MASS. =; - ` 33�!v0. MAIN ST 712 MAIN ST. CH. BY YARMOUTH, MASS. HYANNIS, MASS. SHEET L_b I DATE REG. LAND SURVEYOR` T—Assessor's map and lot number ....1 '3 �/� .......................... SINE Sewage Permit number ............. ..... .......................... SYSTEM MUST d INSTALLED IN COMF'LlAN(C,k=. Z BJBB9TODLB, i House number ..3 D (v fl ITH A"'ITIDI,IE ;I STA 1= v rang ... .................................... o 039, S,,V�i u`ARY CODE AND TCV,,# oeara�e TOWN OF BA�RfNSTABLE '71 BUILDING 1"NSfECT0R � d , APPLICATION FOR PERMIT TO .0.40 .(�.Z1l��T .C11 1 rAMIA/..... .'� . . n TYPE OF CONSTRUCTION ........... .........� 1�..!'�n.'1.rr. ........................................................... ..................t..`..ri=�..................199� -- - -- ro=r�s==lAlsAtcZOR_ or.-RwL-DINGS: The undersigned hereby appli s for a permit according to the foil wing information: LLocation ........ .............. ..... .1. �.M&1.D.c.... .�..41�. ... � ....!.!!..1.�.�`l' . p t ProposedUse .............�,.. 5..1.� ................................................................................................................... Zoning District ........... ...................................................Fire District . ....� � r�!� Name of Owner Address ....I(I.....RAT..... Name of Builder ..........................�A. A.E.................Address .................. 1. .. Name of Architect ....................... !�..........................Address .............................1�� A.................................... 10..y..11Number of Rooms .........T:.i—c . .................................Foundation . .?. i�;�...... � ,.......... ..... . .... .._Exierior ...".Ll. (al 1)..................Roofing .............. 'Z ................................... Floors .....� .�1..1"..C�. .1v... ..... �! .7..1-r.............Interior ................... .1�y.4 - F,,14.......................... ...... . .Plumbing ..... .l...l.. .. ......I..X...z............... Fireplace ..:...................'.>.:'.�.!�1. ,,................................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 1 / I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable reg ing the above construction. Name ... s Banner Home Corp. 20588 1 1/2 story o ................. Permit for .................................... ., . single family dwelling ............................................................................... 1 Location 306 Willimantic Drive s�, ............................:.................................. + Marstons Mills ............................................................................... Owner .............Banner Home Corp ........................................................ / frame Type of Construction + _ ; f l.................... ............................................. Plot l�........................ Lot ..........f�27 September 18. 7 r �- Permit Granted ......,19 -•� Date of Inspection Date Comp ete . ��t� .. ........... 19 +� s. I ° PERMIT REFUSED r y� A...................... ......................... .... .1. ....................::.................... ............ ...... ...................................... ............................................................ ... ........_ Approved .... .......................... .... 19 r ' ......................................................... ................... ...`........ y .-. ....................................'................... • r i Assessor's map and lot number .G%.F....... Y ... Q �" Sewage Permit number ............. �/........................... - Q Z BAHB9T11DLS, House number .................................................. q MMa 0URa' TOWN OF BARNSTABLE BUILDING INSPECTOR Vv" APPLICATION FOR PERMIT TO .......................................................... ►. s:....!. ^ ' 1� t^1r' TYPE OF CONSTRUCTION ...................,..........,:...._................................................................................................ ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: t z� ( , t r ► tip Tt - "I 1 P t 11 r= � ±,t1.t?-�i�.� C N I ( L[�. Location ................................................................ .................................... ........................ .............+. n ('� Proposed Use 1. �C a+1 C. *Zoning District .....�................................................................Fire District ......................`.. .........................:p................. ; . ....t-� —r XWE P k-trtrt �62� Imo+'\.� �n�r,w1y l�P. L A i Name of Owner ......................................_......_............_............Address ........................,........................ r Name of Builder C, ?! . Address A ' ................................................... Name of Architect �\../A...........................Address ............................... :A..................................... .............................. Number of Rooms .!.. �.,a.�.................................Foundation � - .............................................. ................ ..........:.................. ....... r I �. L 1 Exterior .......... .....................................,...,.... .........................Roofing ..................... ?l „!� ... .... ....................................... Floorsi P>1 i..... � ................Interior ��� f�- �1 �C` f`� Q�1t AA\ 1 0 nP rr Pc 4�L�1 Heating ............_......................................... ..................Plumbing ....................................................... ......:.................. 1 Fireplace ............... ..................................Approximate Cost Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area .......7 5 '........................ ........ Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name............................... .......... ................. .. � � i ��- Bann CQrp. A ln.3(-t27.~— - l 2 D~ No —.----. Permk'for ---- — —'--.. ^� _ ~ single family dwelling ' ------------------- ................... ` | � 308 Willimantic Yrive . iocohori ............................................ ........./......... � Maratouo Mills --------------------------. � Banner Bpmo Corp. Owner ---------------------- ' ' frame Type of Construction -------------- � ^ � [ ' � . ~. --. . / . ` > September 18 78 � permit Granted ........................................lV ' Date of | ------------lq ��-,__�� � ' Dote Completed ------------..l9 _ � ' ` � PERMIT REFUSED ' ` ____ lV � / ^ � ---- —1 ------ � | j[ ` � ' _____. ----n� --''' —'--' ---��--' ' ..~—.------------....----..----. � / -------.-------.—.--`—.—.--~—. r � ~ � ---------------- l� v � . � ' --------'------------------' | � ----------^---------~'—''---'' � � , / � r } Parcel D 9 3, vo 2 ermit# `'Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Date Isssued � Board-of Health(3rd floor)(8:15 -9:30/1:00-4:45) - O//Fee O?R '7� Engineering Dept.(3rd floor) House# 306 � �, �� BIKE ept.(1st oor coo mi ��® ABLE p• TOWN OF BARNSTABLE'� Building Permit Applicationj�� � TStre' n�nv.lProject Q ` Village Owner - v akaAle- Address Telephone Co / 7 — 5/D Permit Request 7 a1 &Rm5 a- ,, B� First Floor square feet Cte L� Second Floor square feet Estimated Project Cost $a/ a-y-y Zoning District RE Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial / Residential Dwelling Type: Single Family ✓ Two Family Multi-Family Age of Existing Structure cW -E-- Basement Type: Finished Historic House Aj6 Unfinished Old King's Highway ti/d Number of Baths CD No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None ./ Sheds 1/ Other Builder Information Name d J Telephone Number ( /? — 7 940 Add ess 3 License# 4 -0 'T- 3 Home Improvement Contractor# /a6' 9 A / Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL C TRUCTION DEBRIS LT G FROM IS PROJECT WILL BE TAKEN TO SIGNATURE DATE g �9 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. �� iR DATE ISSUED MAP/PARCEL NO ADDRESS VILLAGE OWNER a DATE OF INSPECTION: FOUNDATION FRAME INSULATION 1g ]- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ', c- -, 4-' _ - GAS: ROUGH' FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. _ - -- ---- -- ' .,c- ' P Dec. Vi-- lei T 12 p�! 6 /1 �B - yJ LOLL A R TIES - Q 6 .C. i 1 ,cDX. P-/YWCOC li 2Y,4� STUD Y': -' LL l 6' O.C. 1-4 3/ !� F/cERGL/ Ste . I ` =BOSS SECT lC-. . L A NTCNE r_ L I ; C' TPJ I TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE 2 l9 96' JOB iocATloN hod' l�iLL r�•�NTi c l�f�/!/l Number Street address Section of 'town "HOMEOWNER" I��I/l IJ N,4 N /Y%G I)amLQ _.. .., Name Home phone Work phone-- -- PRESENT MAILING ADDRESS / Ca�,B y T, City town State Zip code The current exemption for "homeowners" was extended to include owner-occupi dwellings of six units or less and to allow such homeowners to engage an ix. dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to z side, on which there is, or is intended to be, a one to six family dwellinc ' attached or detached structures accessory to such use and/or farm structure - A person who constructs more than one home in a two-year period shall not h considered a homeowner. Such "homeowner"' shall submit to the Building Offi on a form acceptable to the Building Official, that he/she shall be respons for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes ..responsibility for compliance with the Building Code -aad other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requiremen- and that he/she will compl ith said proce s and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICI Note: Three family dwellings 35, 000 cubic feet, or larger, will be requirec. to comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for whiq- Ya- buiidi permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that Home Owner engages a persons) for hire to do such work, that such Home shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assumi. the responsibilities of. a- supervisor,. (see •Appendix 0, Rules and Regulati for .licensing Construction Supervisors 'Section 2.15) . This lack of awa: often results in serious problems, particularly when the Home Owner hire unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Rome"Owner as. supervisor is ultimately responsible. :. ... To ensure that the Home Owner .is .fully aware of his/her responsibilities communities require, as part'of the permit application, that the Home 'Ow: certify that he/she understands the responsibilities of a supervisor. Oi last page of this issue is a form currently used by several towns. You r 1-- -l .care to amend and adopt such a form/certification for use in your commun: HOME IMPROVEMENT CONTRACTOR Registration 120941 TYPe ' INDIVIDUAL Expiration 03.. _ /21/98 GERARD ANTONELLIS GERARD 0. ANTONELLIS r I '1DMINISTRgTOq t1h MAIN S T HINGHAM MA 02043 • .. date The Town of Barnstable & Department of Health Safety and Environmental Services � BuiIding Division 367 Main Street,Hyannis MA 02601 Ralph Crosses Offioe: 508 790�227 H��g Commis Fa�c 508 775-3344 - For office use only Permit no. Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"rxonstructicn,alterations,innovation,repair,moderni=don,eonvemM improvement,removal, demolition. or construction of an addition to nay Vm4misting owner occupied building containing at least one but not more than four dwelling units or to siructntzs which ace adjacent to such residence or building be done by registered contractors,with oatain C=Ptions,along with other mquirezne- Type of Work l� //,-6 Fst Cost I �L Address of We �v���e�O't-°��'�`-c� Owner.Name: )A4o�-� Date of Permit Application: I hereby certify. that: Registration is not required for the following rtason(s): Work aaduded by law Job under S1,000 Building not owner-ooeupied Owner pulling own permit Notice.is hereby given that: CONTRACTORS OWNERS PULLING THOR OWN PERNQT OR DEALING Wi'I'FI FOR APPLICABLE HOME 1MPROVEME4 ' WORK DO NOT RAVE AC(F-SS 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. /+Dte �Contr�j=rmme Registration No. OR ' n,.e Owner's name ". The Continotmealth of Atassacbusetts - - Department of Industrial Accidents + Ofl/ceolloyesllgal/ons • i;! 'r•;a' 6011 11'ashittgtun Street a=3 ��::�, �• Bunton.Mass. 02111 Workers' Compensation Insurance.AlMdavit .A511cant nfortnation Plestse PRINT 1 �T , - lv' • (/ .3 of l l citv A/A) G A (�o`� 3 nhenr i! G17 ❑ 1 am a homeowner performing all work myself am-a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. rnmn,lny nttme• address: city: Rhone#: . insurance ce. nnlicv# ❑ 1 am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnanv name: address, Sin': phone#: insurance cn nelicv# �s:_ �•._.T _.. _ .. •.cn,:i;..c:.••.arl� ?"7'+►?'?T�R�"'s`'„�.s`ar' - "rJVFPv�47°_4?�1^�R7+r: �r✓'^;..r" ..e14.3±5`t'+r'�^"�!' ttimnanv name: nddress- city phone#• insur:inrn rn '' noiicv# :Attach additioeal'sheet if tieeess -:•.•Y.-••ram -sue+''-•++�''p*" ``'`• '"t►�'" " ';�„o; Failure to secure coverage as required under Section 25A of h1GL 152 can lead to the imposition of criminal penalties of a fine up to$1.500.00 and/or unc rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verifieation. I do herebr certify under the paints and penalties of pq•edu that the information pmided above is trae and corre � ct C� a nt name AR-0 -AN7-0,61 4ZZI,2Phone Fch only do not write in this area to be compacted by city ortowa oficial n: permit/lteense q riBuilding Department 13Ucensing Board ' immediate response is required OSeteetmen•s Office011eailb Departmentson phone tl; MOther 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 emplmlee is defined as every person in the service of another under any contract of-hire, express or implied, oral or written. An emplitrer is defined as an individual, partnership,association. corporation or other ;, gal entity, or any two or more of the fore=gin, 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 iegal 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 dwellin-, 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 1'S2 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 itas 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. 17 �+..+g�-r�- .. � .p.:i-r:.':�.�:. .,. ',�„=!•s�i^.'.1:t.:�>ti_,.i...�! -�.•. 'r-_�;....s.'M^.w•r.�,:u ,;,G,a: gip••:._ •..t:. ; • . Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and ;upplving company names. address and phone numbers as all affidavits may be submitted to the Department of :ndustrial 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. .. .-.... -... .. .:. :: ..'..'��''!• _• � ''.'�•y .•�N,_,r.•.�5'rV,tS ... .r.'Aihi�l::, ...�!•.. r+PSY:w ... � b1'..,_ ._.:.•... .. - ..'. :.•�..:'. .. . :' -•i __ ,MST.'`• City-or Towns 'lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of he affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please ie sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to he Department by mail or FAX unless other arrangements have been made. ?lie Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, )iease do not hesitate to give us a call. -�..v..�,........p.p• •n4�L.� . . .�.�r•�..r.,- vur.r./' �' ....'..- a.�.�... - Ott "./..::.i _ .wC Ilse 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) 7274900 eat. 406, 409 or 375 I 1 . \ ram`+ / ; / �,�,`.�� � 4 t ;��/ ♦ � �� / ; `\ .. : . • ��` sue, / , ��•�.� • r f