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0033 WATERFIELD ROAD
Vol I techno of Connecticut 482 Spring St TOWN OF BARNSTABLE I _ Naugatuck,Cr. 06770 i •_P. 201 IIlk' - 1H 10. 06 WORK SITE SHEET DATE: May 29 2014 Thomas Corbo Delivery Address 29 Ambrosia Way 33 Waterfeld-Rd:---- Marshfield, Ma 02050 Ostervlle=Nfa' TXpe ofproject: Deck with roof Qty Category Galv. Black Fixed H. Adj, H Ext. 7 P2-8G X 4 '/Z" 2 P 1-8G X 4 +/ Installer: ❑ Michel 11 S (vain ❑ Dave j SKETCH OF WORKSITE 11 f ft I I • MAPPING F POSTS Rota Head: ❑ Gearbox ❑OMS 125 k6MS 200 Il OMS 250 rJ A 50 # Torque Depth #Type Slnk/mm # Torque Depth #Type Sink/mm 1 900 6'-0" P 1-8G 2 900 6'-0" P 1-8G 3 1100 6-0" P2-8G 4 1100 6'-0" P2-SG 5 1100 5'-6" P2-8G 6 1100 5'-6" P2-8G ` 7 1000 5'-6" P2-8G 8 1100 6'-0" P2-8G 9 1100 5'-6" P -8G Signature of install ,nio M, eQ Tost u Ue k� Engineering & Structural Loading Information Rotary Head : Model 212-200 o Tension load bearing - Allowable Loading Chart Torque(PSI) Post model 600 700 1900 1100 1 1300 1 1500 1700 1900 1 2100 1 2300 Helix Sizes Minimum Tension load(ibs) P1 1060 1767 2474 3180 3887 4b94 b301 6008 6714 NIA Helbi sizes between n=and 2�i' P2 1060 1767 2474 3180 3887 4584 5301 6008 6714 7421 Helix sizes between 6'and 24" P3' 1060 1767 2474 3180 3887 4594 6301 6006 6714 7421 Helbc sizes between 8'and 24' P4' 1060 1767 2474 3180 3887 4594 6301 6008 6714 7421 Helix aizes between 80and 24' P5' low 1707 2474 3180 3887 4694 5301 6008 6714 7421 Helix sizes between 12'and 240 P8 1060 1767 2474 3JBO 3887 4594 5301 6008 6714 7421 Helk sizes between 120 and 24' P8` 1060 1767 2474 31W 3887 ON 5301 6008 6714 7421 Helix sizes between I V and 24" Notes : Depth may vary but as long as the psi(torque)need to confirm with the holding chart and also it need to be below the frost Una (accordingly to the buhding code of the area where the work will be done) NIA: Load would be superior to the structural capacity of the past ' : It Is possible to obtained a minimum tension bad higher than 7421 Ibs for the Piles Model P3,P4, P5, P6 and PS with a powerful equipment, L QQ tot ENGINEERING S STRUMURAL LOADING INFORMATION ROTARY HEAD:MODEL 212.2" 201U JUN r 3 AH «` 06 Posr sizes COMPRESS, LOAD NEARING-ALLOVJABLE L0AD1hfG CMAR'T �oR4uF �8I and Auger - b00 700 Model:21Z-ZOEI 900 1100 1300 (HelfxJ sizes 1 00 1700 D''VI�`-& 1900• 21d0 2304 P1-6G 6" 2482 3882 COMPRESSION LOAD 88 5283 8684 8085 NIA P1-8G 8" 2482 3882 NIA N/A P1-10G 10 NIA NIA 2482 5283 8684 3882 N/A N/A P1�?4(3 14" • 8085 NIA NIA N/A i P1-1 GG 1 2482 3882 5283 8" � 2482 �� 8085 NIA N/A NIA QUA N/A 3882 5283 P2-60 8 _., . . .. _ _ 6684 _ 8085 WANIAN/A N/A 3882 5283 .-.. NIA N/A fVlA 6684_7\ P2-OG 8" 8085 2482 3882 283 9486 10887 _WA.._:. P2-10G -10" 2482 3882 8086 N/A N/A 5283 6684 e4� 10BB7 NIA wa P 2-?� 1 Z" 2482 8085 9486 ?088T NIA 3882 5283 6684 8085 WA N/A NIA P2-14G 14" 2482 3882 5283 8884 9466 10887 NIA P2-?8G Joe- 2482 3882 @085 NIA NIA 5283 6684 94� 10887 NIA N/A 8085 9486 10887 NIA P3-80 8" 248� _ - - _ N/A 3882 5283 - �84 - NIA N!A 80@5 9486 -..,:. ., -. •-- P3-1QG ?Q" 2482 3882 5283 8684 10887 12288 13688 _ P3-11G 12" 2482 @0$3 J988 10887 15089 3882 5203 6684 8085 12288 13W 15089 P3-18G I V 2482 3882 5283 fi884 9486 10887 12288 13WB P3-18G ?8" 80$5 9486 10887 150$9 :2482 3882 5283 12288 13688 15089 P3-24G la" 2482 3882 V84 8085 9486 10887 12288 ., ... :.. _- . _,._,. . _ 5263 6664 13668 15089 P4-8G 8" - -----_-�.�_. 8Q85 . 10887 _ 9486 _ 12288 '' 2482 3882 = Y - 1308 15089 52@3 68�84 ...,,8085 --_ —;-�- . . - - _ P4-10G 10" 2482 9486 - 10887 = 3882 5283 fi884 � 8085 _ 5089 ..... P4-12G 12" 2482 3882 5283 9486 12288 13fi88 1 10887 Notes:Depth may vary but eB lone as the 0(lor 6684 8085 12288 8488 13888 1-�89 the work yi.R be donet !need to conform YAM ttte nakNr►g chart and also a 10887 Hasa to be below the frost Itree(�cooroF 2288 13888 45089 NZA;Load%vW be superior to tha structural cap"of the pm. �9y to the buddtrtg W e a Vre area where viu�icuie o:u� n� I I i r techno I i of Connecticut 492 spft Sr kaugaa,ck Cr. 05770 1-203-723-~off. 1-203-723-0429 Fax I 1-20348484466 cell FAX: ro: nr, ATTNo CZGc.� n'1GU Fax #: ( L - 62�3o .Pages �- Re: aLi'l(k lr�� cc: I i i I i I Give us a call wil support your world �WWW.tcch gmetalpOg.cgm E-mail: .technoMetalPost@hotmail.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , i v0l�Map 1 ( 00 Parcel Applicaton #" Health Division Date Issued Conservation Division ',) K' Application Fee Planning Dept. Permit Fee d �- Date Definitive Plan Approved by Planning Board F If- Historic - OKH _ Preservation / Hyannis C Project Street Address RA CYilIage, Ct-�2.t'V okk_ _Owner - 14T'C\��� �0. h2� Address Telephone " ���°'�� "© (0 �-�., new Permit Request C�2Gk G_r�a (���lQc� W � new w %\\ be, -01 1,0 :S_ . 0,"& 4` uw `OR- Vvi0.n �ncL 70 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 0.cProject Valuation A Ot SW Construction Type o Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docu entatiol. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ Q. Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No, Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: 0 existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPL NFORMATION (BUILDER HOMEOWNER) Telephone Number 0 V't �Zi - - � Address-2c a�oSi "L1 �- License# L'-s' FA -0G9 2� -74 .Home Improvement Contractor 5� Email �• cac�vO 3�Nksao r 1 C)4& Worker's Compensation # J� J ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ' {� r 15 GSIGNATUR C__ DATE �'I2� i FOR OFFICIAL USE ONLY APPLICATION# DAfttISSUED MAP/PARCEL N0. _ f ADDRESS VILLAGE ' OWNER f DATE OF•INSPECTION: E+ FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL QUILD_ING, p DATE�C-LOSED OUT, . .. ASSOCIATION PLAN NO. i ne c xmmonweaan of massacnuseus Deparhnent of Indusfrial Accidents Office of Investigations ` 600 Washington Street t Boston,MA 02111 www muss gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Otganiragonandm&aI): —TNS5tiY1,r�� L st3� rJ O Address: 2� .�k" fos tc- l rr City/State/Zip: Pai�k ,-a6 mps Phone#: 6e (-1^q Are you an employer?Check the appropriate box: Type of project(required): 1.❑'I am a employed with 4. ❑ I am a general contractor and I employees(fall and/or part time). * have hired the sub-contractors 6 ❑New construction 2.01am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling shy and have no employees These sub-cofactors have S. ❑Demolition working for me in any capacity, employees and have workers'ur 9. ❑Building addition [No workers'comp,insurance comp.instance. required..] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGM 12.❑Roof repairs ins;urance1equired.)t a 152, §1(4),and we have no � employees.[No workers' 13.ElA Other 1'QW rXCK, comp.insurance required-] *Any applicant that checks box#1 mast also fill out the section below showing their workers'compensation policy information. t Anmeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors znd state whether or not these entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is provulii:g workers'compensafion insurance for nq employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State%Lip: - Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the foam 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 cerdh under thepaba andpenakies ofperjwy that the information pravided above is true and correct It S Date: 2 Phone#: Offccial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide wodcers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, t 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 repay 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 chaptor-152, §25C(e7 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 prodaced.acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract:for the perfoffiance of public work until acceptable evidence of compliance with the insmance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the m.nnber listed below. Self-insured companies should enter their self-insurmce license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submif multiple pmnit/license applications m any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit_ The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of lavestigations 600 Washington Street. ' Boston,,MA 02111 Tel,#f 17-727-4900 ext 406 or 1-877-MA.SSAFE Revised 424-07. Fax#f 17-727-7749. wwwm s.go-fdia Massachusetts -Department of Public Safety f� C%/ze�panvmoracun�aCUz o�n/Glaarac/c�aei �I" aa,\ rJffic�;^of�.clisumc+r,�7•ffaus 9cclius!P c,�iYs�„� t.cic• ',.� Board of Building Regulations ulations and Standards !' MF IMPRQVEMLNT(.Oh'ia/ Construction Supervisor 1 &2 Family — eg!'trr on:. r1`7`4Q37+, License: CSFA-05927513 x ir+t!on: 3/22/jt515 Indivie! !,.. THOMAS E CORo i rHoraf)`< e) 29 AMBROSIA VIiAYJ MARSHFIELD NIA 02050 I tiro RB !HrJi iS (OO T29 AMF R�7.SIA WAY MP'F7.Sf IFIELD; MA Expiration Expiration s; Commissioner 04/05/2016 + o r 1 �IKE>n; Town of Barnstable Regulatory Services • Bnxxsr,+s�. yb MASS Richard V.Scali,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, P' `� °` ,as Owner of the subject property hereby authorize_ 6 to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. ignature o erSignature of Applicant rint Name Print Name a� t q Date Q:FORM&O WNERPER MISSIONPOOIS Town of Barnstable Regulatory Services �oF raxy,� Richard V.Scali,Director Building Division f � • WRNST, LE Mass Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to-engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to'reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 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&ReguIations'for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFU,ES\FORMS\building permit foims\EXPRESS.doc Revised 061313 I ��-�lGti1 bQ.TA` l_.10 C�AIZf3L1G.1= C>RI atDt=1Z Ddt t_�f FLow _ I lb +c = 33o G.P•D. �' Z S�r-Ic -ram-I{L = 330 (Sc % • 45 6-Po. _ d 9 uS4r— k o00 6,A L-. pI5Po5AL 100o S�L(,/ALL jEA = lSD S.F. ISo SF -4.S 3'7'S $aTTt�,K &OSA t E;O ST=. "'N., 1 .o _ . So TOTAL -F->ES16tJ = .425 G.P.D. / DWEl.I. , TTOTL�L �dl l_�f Fc.otiv = 33p 6.PD. / Sort PMC-C>L&TIO J O&TE : I� IU 2hcl u 02 l� 1S•3 I006 GAL Z Ply-)X// � � , Tit• .� WILLIAM Yn C. i J'e \sue I V 0 0 0 \ENO. is T'f=ST Tor 1-uc W�•1A � �'Pve I o00 1►h/• '.� f 4' -7.3 .. r -Boy, 7, S�nC l o 3 - - WV. Tn�tK GAL• �,G.� GU•� ,; D 1 FlTN ••� � w�rN •) U " WAS►MID sTON� 40 .5 ti CECZTtF-taD pLc PL.ati Q P2pT=-(Li= LcbCATIo" 11l_L.E, O I-�o W t�i2�- •� • CGIzT1F�( T�4A7' THE Zf-'P OVJQI.dI '5&A0'� tZ�1=��c�.1G1✓ �E:�L=t��J CcaNlPL�(S W ITI-i TNi= �jIDE.LI►-�E= T ��,-T' AWa SETVAC1� �C-QUI`:E�Uc1.1Ty of THE Y2A� FvtiZ T1�UN��S , ' CArtt1 ►JL�1.,! v� oWU off" C3 �1 )5 �- ILA+c_� r DaTG S '�'`) � ( `.•;.� -: B A)(TE4Z c2cGt5 rLr i=D L�.!�G SL)ZVE'fo�S L.I CT AS C U t•1 A aJ OSTE.v-ViL1 G o AMASS•. 4 4c,t /Lr-> All— i / A � Assessor's map,:a,nd lot number THE T U Quo o� Sewage Permit number .44.....Or.Kz...R•.ilifi?..... BARNS' .. ............................................ j�0b MAO9 L 00 House number .................. 9 0, YA9 `e 'Ep A• £' r TOWN OF BARNSTABLE BUILDING INSPECTOR r APPLICATION FOR PERMIT TO ^• �CIiL .)�/L21/'i > }`i1llLl �'..... tLP�1L TYPE OF CONSTRUCTION ..............(:.�J ............................11.................................................. , ................. . ............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 1 Location ..... /. .....#.............. /�(/l1:�..... ,� . ...R./�f ,......1,/�S .......................................Pro osed Use ....J.......................... ...... .................................... ZoningDistrict + �d?e'u -• ........................................................................Fire District .............:.................-...... ......:.....::.................::�.:. Name of Owner . !!i(/!7.'r..7(�'1; �.6(.Address .................................................................................... Name of Builder .. 1•:G (kJ�... / .1 ? .......Address �'��h ; !� � ...�� � r..... `C. ............... ............ a -Name of Architect ..................................................................Address .................................................................................... Number of Rooms ..............S..p..............................................Foundation ( U���/� '�1�.� ............ ..................................................... Exterior J;(" l )� : -c'o �..(: � C �Roofin �!e GLI ... "Gf!C '7��ZZc!.��................ ....... ......... ......... ................... g . Floors f '«� Interior : .......................... Heating f.( P,( ��(' .....Plumbing .......r - - ...... ,.,,... ...................................................... ...�..�....... .. ................ Fireplace ............t r�Gj............................................................Approximate Cost ............... ........... .�:.vc ............................. Definitive Plan Approved by Planning Board --------- 19 4J(0. Area 1 �...-!:'............. .................. Diagram of Lot and Building with .Dimensions Fee .J�� SUBJECT TO APPROVAL,OF. BOARD OF HEALTH Vo loll- I hereby agree to conforms to all the-Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ! ( �r//� ....... rr. " �~ ' A=118-125 � .~ CA8�PANEI,I,Z , JAN & .��Dm , 22363 One Story No ................. Pe,nh/ for ................................. . / __S.i__l.e_I�am�ill' _. � .11io�7_____ Location ..LCd� ...#.Z']��t��field.� _. ` -----.D5termill��.................................... ` ' Owner � Ii ' ^ Frame '' ` ' ncx . . kly 23, .' U Permit Granted Date of 19 . uu/o 'Complete/ ' . - ' � _-.- ~ ' lV ' ---- - � " .. 'T--JJ--'l[-T- ........................... ......................................... ..................................... ' -------------. ----. ' -----' ...................................... - ' ' Approved ................................................ lA ` ` ------------------------.,-. . ' ---------------------.---.-. | | w TOWN OF BARNSTABLE `�, •e Permit No., l Vmn.0 Building Inspector Cash v A() 7 XYL 'o ,e,v. VO L\ 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 ceiitificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .............................................._...._, 19� _ _ ...................................................................... -- Building Inspector �i v / ID GCAI CMr-Tit=14 TOAT' T141= PpVOZ)Vnib c c_C. t-!Ct?EL�F,� C.Qt/LPl_�(a V✓ ITI-� '�I-l[=: iPC 1.-1►-��: ' a �� �GOJL7 SLR-t�,AClC X'C-(�c�if?Ertit�l-►-1S ot= F-11� . -t'nv,Iw ot= G' �.xTCtZtWc- l2LGlS Tt-dIS ' C7f_hl-1 IS I-(O�C t3la�,l-=� V�-f I�RJ o�•'tEf�v�l.lC- o P:��'.5��. >rl�tJ�LEl' .�J� �cl��/��( � T:a� Ur=t=';.�•C"� •�!-!C,!LJt..iD .mac, :u<� D rc� o�re��AAIWt:i LoT 1 ti',1 tc/mayJ-r SIiJGL-'-- F&MIL_`'( - 3 LAC GArraar.E. 6;,Wl QdE1Z q Tads Lam{ FLOW I lb +� t 3�0 G PD• J Z SE�T'I C TL�a.1 V_ = �530�r IS G % • 4-9 S 6.P.D. �/ d USA- 100CI 6,A,L.. �ISPoSAt PIT - uSE I o0o GAA . VJ StP&WALL A>zEA __ c50 s P. CE:o yam. I .o - So s.RO. TOTAL -DSSI&W = -42S G.RD. oV111'cu- TOT,&L T:>A-1U4 FLU V-/ = 330 6.PD. PMOCOL&T100 O&TE `rr10 SM1Q. 01Z \. T►G AL'SdP Z V1ST WILUAAI f e s M L Al IN C. ,fy iic. 2933�.Q ,� +l`:." s h„-A 7 �; 'tr ' •G� -X� ij TOP F*yD 'L 100.0 -� 4.•p� \ l.V tf.�pe IOoO 111V. a1 t TAWIC M (000 IWV. IIJV• 'i. GAL. ail E- LEacN - i — - PIT �- W 1 TtJ •i S I.O CEQTl1=tED Pl_b-r PL.Q�i ` D P9ZoT='1 L_E� LbGATI OtJ -.�� b'ATt✓ �r•�`V�' a . �. tGQTIF-( T44AT TNG-?WR nWJRU W5"0'." .1 Pt_islJ RL-i=' �EI.iG� �1=1F1�L=DIJ GC:v1rlPL�IS V�/ ITI-1 T►-li:= �jID�.LI►-�� �C,T Z a sc-r0AclC G I~ 4v M I�EcuTS of T"E Tc s ' 6) B A)(TG VZ �c- t2CG1S-IL-tzED LA►�G SUa`Vi=`lc�eS '�1�i5 C7LA�.-1 15 LILT LASC-V 064 4" OSTErv%L_l G o I�CASS• UJS!-e;.�',�C_w� �,uc.�i�a�{ �• TNL: c�FI=,F f�, 51-1owLA �►'�PL_t GAI-_1T_-TYtGM�.sS Cp'►�1�k.�! 1»'1'C. c::M l w1l _1�c�'Y l_I tiles•� - Z7 Y ;`Asses*or s map and lot number !" SEPTIC SYM Md§f Sewage Permit number .$.4.-..a.4.S.....�F.fG�../L/ ....5.-1-3-8D. 'Ny.�. 0 RUED IN 660LI House number ..............�3-3 1Y n'TITLE 5 r B�nea ae� ................................................. t6 0 TOWN OF BARNSTABLE� ',J;�� B-UILDING INSPECTOR APPLICATION FOR PERMIT TO ...f, ...... .... ........ ......... ... ............ ....... ..................... TYPEOF CONSTRUCTION ............1/... ..................................................................................................... x ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......oL-C! ./.......................... �! r.� �i�.....:t-f .�....... S.l�7� .. .......................+.`.v. '� ProposedUse ... !v ..: �. 2 ................................................................., ......... Zoning District ........................................................................Fire District C ................. .....!....D ........................ Name of Owner ... . .. V.'.f..1...4:,.�z/YWp.a.n .Address .................................................................................... Name of Builder ..�/ .......... ... .......Address -Name of Architect ..................................................................Address .................................................................v............... Number of Rooms Cam..............................................Foundation ...... ..........................:...................«...........:........... Exierior ....... �........... .. !°�rZ! .Roofing ....: ... ................... Floors :.................. Interior .........125�' w(- !1J............................. ........ n. D ... ............................... P,. ..... Heating .........�,�� f�' :............:.................:Plumbing ............. i .. C' .e` 09 Fireplace ..:........Y��...........................................................Approximate Cost .............. .. .vV.v............................... Definitive Plan Approved by Planning Board ____-____- 19 K$P. Area -...1.. -`.�....P............. Diagram of Lot and Building with Dimensions Fee + S� SUBJECT TO APPROVAL OF BOARD OF HEALTH '71 . t jw- ecL k I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable rega ding t e above construction. /f Name � !:... t. CAMPANELLI, JAN & TOM .... Permit for Qae...Stary............ §.ing.j!��..gam.jxx... .................... ..... ..... .. Location Io.t...#.2...W.qt.e.rf.ie1.d...R .. .. . .. .. .... .. .... ....... ...... Osterville ............................................................................... Owner Jan & Tom ......... .................... ... ........ Type' of Construction FXAMe............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ........!T!4Y..2 .f............19 80 Date of Inspection ............... 19 at Date Completed ................. -01 PERMIT REFUSED Cc !a 1." ,- M tv ..... ................................................. 19 Cl) .......W.f .......................................................... ............................................................. ........................................................... .......... ........................................................ APravbcl ... ............................................ 19 ............................................................................... ............... .............................................................. ��e row Town of Barnstable *Permit# months from issue date . .•. :Regulatory Services .... _. Fee--- S - -- r� F.•Geller,Director . ivisi on —Tom Perry, B•uilding Commissioner - 200 Mak tE'eet,•Hyannis,MA 02601 • .• p�my� _ • G Fes/ E• 508-862-4038 R Office: `S�.� :._... �.L_... : . - -•• .. . Fax: :.::.:. _• PQCATIQN .. .-RESIDENTIA]M y. 2005 • .... _.. • Not Valid without Red X--Press Imprint ,lap/parcelNumber rd U/ 1 �+ a TOWN OF E3A��' :�fa�L� ?rop erty Address 3 residential Value of Work b Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /4/4/Yam// Contractor's Name " C'/JT L Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) [91�0rkmanIs Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compe(n�sation7nsurance Insurance Company Name Workman's Comp.Policy# cJ U13 571 Tot rL/—,�le Copy of Insurance Compliance Certificate'must be on file. Permit Request(check box) �roo,f(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows- U-Value (maximum.44) *Where required: Issuance of ibis 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. Home Improvement Contractors License is required. Signature Q,Forms:expmtrg Revise063004 Island,)za and Roofing a division of RLTCowtntction,Inc. Proposal To: March 9, 2005 Mr.&Mrs. Walter Stein 33 Waterfield Rd. Osterville, MA 02655 We are pleased to submit the following specifications and estimates for reroofing: Strip existing asphalt shingles and flashings Install new aluminum drip edge and pipe flashings Install 3 ft. Ice&Water Shield to eaves, interwoven w/step flashing on cheeks& skylights Install Typar 30 roof underlayment to remaining roof Install 30 yr. Tamko algae resistant architectural grade shingles or-similar' Install continuous ridge vent to all ridges Clean up and haul away all debris to landfill We hereby propose to furnish material and labor- complete in accordance with the above specification, for the sum of SIXTY-FIVE HUNDRED DOLLARS ($6,500.00) PAYMENT TO BE MADE AS FOLLOWS: $6,500.00 upon completion All material is guaranteed to'be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviations from the above specifications involving extra costs will be executed only upon written orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents,or delays beyond our control. Owners to carry fire,wind damage and other necessary insurance. RLT Construction,Inc. carries General Liability and Workman's Compensation Insurance. Certificates of Insurance provided upon request. ACCEPTANCE OF PROPOSAL: The above prices, specifications and conditions are satisfactory and hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: - O 5' Si tore. ,A/���4&, Start Date: Signature 87an Sebastian Drive, Unit 14 •Sandwich, Massachusetts 02563 Telephone 508.420.5243 and 508.833.5249 • Fax 508.833.0098 • Emilcaperoofer@caperoofer.com The Commonwealth of Massachusetts Department of Industrial Accidents Office oftnuestioatlons 600 Washington Street, ;"h Floor -- Boston.-Mass. 02111 Workers'Compensation Insurance Affidavit:Buildin /Plumbin /Electrical Contractors c a name: address: city state: zip: phone# work site location(full address): ❑ lam a homeowner performing all work myself, Project Type; ❑New Construction[]Remodel ❑ I am a sole proprietor-and-have no one working in an ca acity. 0 Building Addition I am an emUToyer providing workers'compensation for my employees working on this job. :$'^•' s.> ^yi; y++�}..s':' -F�. :�o"+•-5"r= � f<.fd.�. * -x ;l � •,:s',;:^'v.>Y.;.`::.:���i'i: .i,d.: f;....�s a-v§ y. .Zl frft'. ..1i•'v.x'i••��i�; =i! iY ss Gt'v�'.:�1'a:` ;.�' i,:�S�r ;.,{: t � x X' v9 .. .r:�' .m:.. �.. + -. ..• .: .� ::ram E,...a ^r:::.i.:..,a: ,,. <' .. -^..�•' ';:',::.:..��,-: .;,t.�."�::y�? r,:�'c- d_ �y aC:�"^$'.�sC�'•E' -�,� L.,�4- t5 X,t�• y: _ .�'.>�::W�'!h.: -;,a..rf• ; A�:ST.�se^ r't'^1",�� �C:f' i ...�rE' k� 4 -r 4 d �:r•�,, y t�$ v� .i�. �`.. :{c': r �3. 1u"^ -�..�p •Q:vf _,r.sr<<-,{+ti w iy ti y G..l. :t: 4 i�. :t. 'ir y,. i': f ,�,s?H.' :> F 9,s <'x.'-1 ..,�,:, �'�,••;• `8�dd�'eS� r•j^�:,^L...:;.y1,,.�+: ::h- .z•��' rc .ba- �`. Y�. r,. `�?�::t:•: _ `k`r,"at1 tc� �.r q t�`t�r'4t W ��+� Ez� � r'•tr� 4td�.� �f x.{� ������ ��r .a�C •t s t+�t,�a t ? �:x z, �'� s�. x i E;a..,i. { t tlt;tKiC #S �f ,y•t e 4 i,: r L3' `�{ r ^ r c �•�, P:!i:..,�'«.r >� ., 'a,3;:,t._ O�"ne3 fi:•f-:'.!'✓«,_ -U. ^,. .. r.,fw`?•3- °ti•(�1> �tkfti ,* 17:5 yMA��..':d.7 �. f��r��wi�� � ..� �'�M"3����ar oaf n.� ✓ [£ y.. +:a �" cX aawf k`•A '�. la ? F �. ✓ Insuran a ca _.,..P v:h. �d}atl x Jtr4i. .'4i �!._9 Y Cxf:>a .i3. 1 ...,a cW. iv" ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have th..e.following. o l.l,o,.w,ar yi.n_.Y:.workers' .::..scrs m,-:..er.n.�!•hs�lat'i:i•oY.�n i.....3 o.,.v l,Yi..1 c.a•.e...s�: N.y y..,, .Fw 'Y.,'. ...t„ ,.�•$a.::.jy.:d ,::J:":. N y b 4 :•t .f ..>.:.. y 11 aka^. .�..-. ,.' K. ...'Y;'�'a•..a.)?�;..;.=Y t - a-J.4iL-_.;::?ir+ 'i>�: :a=:: ...: ... _ .,,. : :.. :_.. .... . . .. .:..:._ ::...ss U �: .. .,...,.. . .:...a.�,....�_:':•_::.[Pl.r,.[.. 2- t C. •a y 1, U„ { 'Sa:�.• rS •Y : _ ,t : 9dtire§3 .r�'_,: ..:r.r,;._.+•.w.+,>•v,..._..•.-_ d..,.�...r•_. _:r.+2 <r s:::w.:.�.. .,: :city •nlrione�# _.. ...: olio..`:#�..,:::. .. ..:.._. 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 S100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify der the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name t' Phone# official use only do not write in this area to be completed by city or town official city or town: permWlicense# ❑Building Department' ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised Sept 2003) j 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. Please supply company name,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,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406 d 1D � � L-20� i i d 0 s N qP'/z." p ,�• �y 5 2'� Lei e.,r 2 Jeri Ito 9 ,o P "d9Lto 11 16" D .G 2 -1 I U 1(0' O ,G y