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HomeMy WebLinkAbout0011 WINFIELD LANE / l 1r� i h�i e � G� �,cz�,� 6 .. /fry:.. sa'?�..�nrr�. qr`.- --..•,.. .—. �...__�..�.. �...._:i::-. ... �'':_� .r"2vn±w7r:"r+ - �dn � .,!<"'rtTo- s._�_ .Y!�4A-- ._ ... Pf - .. .. � .. .. �. F a 2�......... AppficationNmmber.. f R��lil.�LRfJl� t I. , . :. Pe rt Fee.............:.ache.. ... ....�....OS�er Fee........................ MABEL ToolFa Paid...................... ......................................... i TOWN OF BARNSTABLE Pe .. .yi.S�I` . . Pew Approval try...... on.. t }" BUILDING PERMIT (,, .. ... I....... ... APPLICATION l�,�o i� Sp �n TInformation and Project Location / ProJ ect Address �'p a Village Owners Namezde�ZA ; l Owners Legal Address �.�. . city Styezip Owners Cell# - Co - E-mail { F Section 2—Strnctaral Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet rt_ Section 3—Type of Permit r' ❑ New Construction r❑ . Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(ere stracturej ❑. Finish Basement ❑ Family/Amnesty ❑ Fire Alarm X r Rebuild [ ( Deck Apartment ❑ Sprinkler System ❑ Addition ❑ RP# TnTnu wall ❑ Solar r; I ❑ Renovation ❑ R0 1 ❑ 'oa i Other-.Specify. 2 koz I Section 4—Detail Cost of Proposed Construction 060.00 Square Footage of Project (oB I . Age of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 11.0 MPH Wand Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updatzd:l IM2017 4 3, Section 5 -Work Description Section.6—Project Specifics ❑ Wiring ❑ Oil Tank Storage . , s ❑ Smoke Detectors . ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑.Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal - ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane C Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required. Proposed Has this property had relief from the Zoning Board m the past? ❑ Yes 0 No • Last updated:11r72017 Section 9—Construction Supervisor �ame4a)'11" Dhon umber Address 4City State_-7� Zip License Number — /Y,;?,icense Type ( Expiration Date• a Contractors Rmall24 Cell# I understand my responsibilities under the es and 'aus for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation requireTZO 7/the", Barnstable.Attach a copy of your license. SignatureDate1'95?, ecti —Home Improvement Contractor Name r Telephone Number Address /� CityState , Zip Registration Number Expiration Date Za&70? I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and acumentation required by 780 CMR and the Town of Barnstable.Attach a copy of your FLLC... Signature Date Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date'-**'/�///4-r� dFintName Telephone Number E-mail permit to: A'11,--2 �44&— Last updated:i in2017 Section 12 Department Sign-Offs } Health Department ® Zoning Board(if required} Historic District 0 Site Plan Review C¢required) ❑ Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approvat Section 13—Owner's Authorization L , as Owner of the subject property hereby authorize to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner _ daze Print Name Lastupd-W 11/7/2017 r Client#:10798 2RILEYCJ ACORD.. CERTIFICATE OF LIABILITY INSURANCE UAT 01/25/201825/2018 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 policy(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 NAME: Dowling&O'Neil Insurance Agy Eo A/C No5087781218O 508 775=1620 973 lyannough Road E-MAIL P.O.Box 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:NGM insurance Company 14788 INSURED INSURER B: C.J.Riley Builder,Inc. P.O.Box 382 INSURER C: Osterville,MA 02655 INSURER D: 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 CONTRACTOR 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. LTR TYPE OF INSURANCE NSR W DR POLICY NUMBER MWDID/YYYY MNWDNYYY LIMITS A GENERALUABILITY MP059664 S/02/2017 05/02/2018 pEAApC��A,HppOEECCCURRENCE $1 000000 PR X COMMERCIAL GENERAL LIABILITY EMISES &%wED nce $500 OOO CLAIMS-MADE a OCCUR MED EXP(Any one person) $10 000 PERSONAL&ADV INJURY $1 000 000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGG $2,000,000 POLICY PRO LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ • ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS PROPERTY DAMAGE NON-OWNED Per accident $ HIRED AUTOS AUTOS A X UMBRELLA LIAB X OCCUR CUT0115J 5/02/2017 05/02/2018 EACH OCCURRENCE $3 000 000 EXCESS LIAR CLAIMS-MADE AGGREGATE s3,000,000 DED I X RETENTION$10000 $ WORKERS COMPENSATION WC STATU• OTH- AND'EMPLOYERS'LIABILITY Y/N FR ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? ❑ N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under. DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Lee and Moll LaROchelle SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE y THE EXPIRATION DATE THEREOF, NOTICE WILL'BE DELIVERED IN 11 Winfield Lane ACCORDANCE WITH THE POLICY PROVISIONS. Osterville,MA 02655 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S205332/M205331 LS1 I I A CERTIFICATE OF LIABILITY INSURANCE FDATE(MMIDD/YYYY) 11/03/2017 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 policy(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 CONTANAME:CT Christine Davies DOWLING &O'NEIL INSURANCE AGENCY °A"/�"Ne Ext: (508)775-1620 FAX No: E-MAIL cdavies@doins.com ADDRESS: @ oins.COm 9731YANNOUGH RD INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURRA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B C J RILEY BUILDER INC INSURERC: INSURER D: PO BOX 382 INSURER E: OSTERVILLE MA 02655 INSURER F: COVERAGES CERTIFICATE NUMBER: 209221 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. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER MM/LDDY/YYYY MM/DD EFF EXP LIMITS COMMERCIAL GENERAL LIABILITY EACHOCCURRENCE $ CLAIMS-MADE OCCUR AMA RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY a JECT LOC PRODUCTS-COMP/OP AGG S OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident • ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLALIAB OCCUR EACHOCCURRENCE S EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION /� STER ATUTE ERH AND EMPLOYRS'LIABILITY Y/N A OFFICER/MEMBER EXCLUDED?ANYPROPRIETORIPARTNER/EXECUTIVE N/A NIA NIA 6S62UB2E89906917 05/05/2017 05/05/2018 E.L.EACH ACCIDENT $ 500,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Lee and Molly LaRochelle ACCORDANCE WITH THE POLICY PROVISIONS. 11 Winfield Lane AUTHORIZED REPRESENTATIVE • Osterville MA 02655 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD a � 006 ���� • � • • e Wom.nonweallIx a�b,&amac/ujala Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:°Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation u5-7,99- 01/29/2020 10 Park Plaza-Suite 5170 C.J.RILEY BUILDER INC Boston,MA 02116 CRAIG J.RILEY 749 MAIN STREET"-''- U� UNIT D Ot H Oaf M Ure OSTERVILLE,MA 02655 Undersecretary • 4 Commonwealth of Massachusetts Division of Professional Licensure lug Board of Building Regulations and Standards Constr;40*Itbpgrvisor CS-066147 — -' Ej ires: 02/05/2019 CRAIG RILEY,J PO BOX 382 'J OSTERVILLE MAC 026li5! % f Commissioner CeLi • i Section 12—Department Sign-Offs Health Department ❑ Zoning Board(f regtur4 Kistmio nistrict 0 sme Play Review.cif ❑ Fire Department Cl ConsmvaH= For comnsadd work,please take your plans dr=*to the fire depoftent for gPrm aL Section 13—Owner's,Authorization as owner of the subject property hereby authorize C'.T to_act on my behalf,in a matters relative to work aulorized,by this building permit application for. (Address of job) .� Zf �g Signature.of Ownqr Print Name • i I Last updaft:&I LPW2017 I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION TOWN GF BARPI S I AbLt- a/4ew/W- Map 1 Parcel bq!J ZQ)�: �P 23 �;� I Application Health Division Date Issued ,l Conservation Division Application Fee Planning Dept. DIVIS10 Permit Fee Date Definitive Plan Approved by Planning Board / Historic - OKH Preservation/Hyannis IV Project Street Address 11 rw T l e1_n l ►., Village q99s : 6 £NdRZ5 K RD tT�S1 Owner L►mwkc-t_ L a Ra,+r=%...t- E Address 2_00J ti 'Telephone ao l L(, 12.0,6� =Permit Request RF_Pl.>aC>F_ Dc�JR nGF nFct; ►til ejNtZl REPLACE EA STiN[, D Kwt- (AlyX 6 PT) 13:tf ��5/ X 6 Ime12A1NTI 1hY, Iy becK MLA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new ;Zoning District 2 F - Flood Plain Groundwater Overlay 'Project Valuation+-3,, oo. 0'0 Construction Type�%oo© '74wIF Lot Size 0S9 Acmes Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Well", Two Family ❑ Multi-Family (# units) Age of Existing Structure + Historic House: ❑Yes �Q-Ko On Old King's Highway: ❑Yes ®'I5o Basement Type: UFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑existing .❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use S/u6l E r-om i t_Y Proposed Use S)9m£ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Roe c ar . Cook Telephone Number .Sv8 - q 9s Address 1 Qc_p V_rW�oK R-D License #—(' Shy 3 89 6 PA%_mouTq , !M19 Home Improvement Contractor# ib.S? 2-2- 0 zt 3 Worker's Compensation # (-' St o u y-i o6si nl3a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE PAR_, DATE r ' . FOR OFFICIAL USE ONLY i r 6PPLICATION# DATE,ISSUED I f MAP/PARCEL NO. " 7 ADDRESS VILLAGE OWNER r , r DATE OF INSPECTION: k' .��FOUNDATION!. �;,, ,:�•, r•t.,r�4►���;:�_,�„ ri r FRAME - INSULATIfti FIREPLACE t ELECTRICAL: ROUGH FINAL 2 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL o r- r FINAL BUILDING E: DATE CLOSED OUT ASSOCIATION PLAN NO. i r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/orgmAzation/Individual): R012,F 12T Address: 1 R GILD 1LiE W `?oN ID. City/State/Zip: — ouTH MA o Phone k s-06 4f-• l 9 ((f, Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6 ❑New construction 2.ix I am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g• 0 Demolition working for me in any capacity. employees and have workers' [No workers'comp. mmce comp.incur nce,i 9. ❑Building addition nn required.] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152,§1(4),and we have no 13 0 Otheremployees. [No workers' comp.insurance required.] *Arty applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). .Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,50.0.00 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 ksurance coverage verification. I do hereby certify un r the p and alties ofpedury that the information provided above is true and correct- Si ature- Date: Phone#: O Official use only. Do not write in this area,to be completed by city or town oficiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor dny of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance. requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Depaitnent of Industrial Accidents Office of Xnvestigations 640 Washington Sheet Boston,MA 02111 TO.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 - w .mass.govfdia r Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-043896 ``GX:r.r.ti 19 „�. ROBERT J CQO�C 18 OLD KENfON.-RD * E FALMOU fH MA i 02536f v Commissioner r4, Expiration 03/07/2014 Office of Consumer Affairs and Business Regulation J 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 105222 Type: Individual Expiration: 7/16/2014 Tr# 227292 ROBERT J. COOK Robert Cook 18 OLD KENYON RD w E.FALMOUTH, MA 02536 - Update Address and return card.Mark reason for change. sCA r is 2OM-05/11 Ej Address Renewal Employment Lost Card ,._ e �canL»zaracuercll�,old /lcr�ruc�rraelt "-- - --- —- -- ---- - - - — —- Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: gistration: 105222 Type: Office of Consumer Affairs and Business Regulation xpiration: 7/16/20.14 . Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 ROBERT J.COOK ,,.. Robert Cook 18 OLD KENYON RD E.FALMOUTH,MA 02536 ' Undersecretary Not vali without signature r Town of Barnstable Regulatory Services • a�ansr� � � .. KAS& g Thomas F.Geiler,Director b► 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 � l G ,as Owner of the subject property hereby authorize AZ( to act on my bebal� in all matters relative to work authorized by this building permit (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 perfo ed and accepted. SIgnature of Owner Signature of Applicant 000, Z-4 Ila Print Name Print Name 4�h C/ Da QF0R vZ:oWNERFERNff= 00L•S 612012 Print Page 4/15/14 12:05 PM 20 2 UST 3 GAR 13 2'3 FAV ,12 &R BAS l3MT T QS AsBuilt Card N/A • Constructions Details - Map/Block/Lot: 116/099/- Use Code: 1010 Building Details Land Building value $ 195,400 Bedrooms 4 Bedrooms USE CODE 1010 Replacement Cost $210,123 Bathrooms 5 Full + 1H Lot Size (Acres) 0.58 Model Residential Total Rooms 9 Rooms Appraised Value $ 919,500 Style Gambrel Heat Fuel Gas Assessed Value $ 919,500 Grade Average Heat Type Hot Water Year Built 1971 AC Type Central Effective depreciation 7 Interior Floors CarpetHardwood Stories 1 3/4 Stories Interior Walls Drywall Living Area sq/ft 2,470 Exterior Walls Wood Shingle Gross Area sq/ft 6,222 Roof Structure Gambrel Roof Cover Wood Shingle • Outbuildings & Extra Features Map/Block/Lot: 116/099/- Use Code: 1010 Code Description Units/SQ ft Appraised Value Assessed Value GAR Attached Garage 575 $ 14,200 $ 14,200 BMT Basement- 1472 $ 28,800 $ 28,800 http://www.town.barnstable.ma.us/assessing/print14.asp?ap=0&searchparceI=116099 Page 3 of 4 Town of Barnstable Geographic Information System April 15,2014 •,a �:1• F,y+y s• A" Y/, a ~� St 88 to -,� ..� ^�.;'•4 DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:116 Parcel:099 boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel 1'=100'may not meet established map accuracy standards. The parcel lines on this map Owner.LAROCHELLE,LIONEL E 8 MOLLY Total Assessed Value:$1210200 W E are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner. Acreage:0.58 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:11 WINFIELD LANE such as building locations. Buffer �� LAROCHELLE GARAGE II WI N F I E L D LN. X I S T I N G C-ON DI TI ONS 2�P►-PC-L EXI��N..(�/aLvM• S.�-�O�c Z pRTE: `{-LB- 14 SCP�-�:. �y = �1` E�, Nl= C)PFg 4 TO_ 6 �6 ?CAA.AV4 G T& _S�R�cT�R�. r l6` Du i DECK 6-o 0 M S/y x b C-, H 0 U S E \-SD G 91 eAEAM y X 44 PT t�o5r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel:, Application # -YD a al I S Health Division Date Issued Conservation Division Application Fee _' 4 Planning Dept. Permit Fee (.� Z Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address Village V Owner Address S Telephone Permit Request ri k1r o r l��G ic,d VX Z nd . ,Cw "e,& ,r&a, llew -�,�er�or alaor , -�-i-(m - m t k s/ 4ew� l . P4 . 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 Basement Type: 0 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 .a 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 newa size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: =' v Zoning Board of Appeals Authorization ❑ .Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Ves 4AMP-L Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �MW, Bw I etw, IA(' Telephone Number t,ov� ) �� � " *q` I Address 'T� �Owq LAU:_:� License # L9Q 301151 (5 14 01,00 Home Improvement Contractor# (e / i Worker's Compensation # 05M �� r ALL CONSTRUCTIgN DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO V A bw .5 S SIGNATURE SATE Li/6 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. " J 'ADDRESS - VILLAGE OWNER - ' f i r • DATE OF INSPECTION: FOUNDATION FRAME - INSULATION - - = FIREPLACE ELECTRICAL: ROUGH FINAL r `- "rr PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Office of Consumer Affairs and vusiness Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Ca p or Registralion Registration: 110609 s✓—�. Type: Private Corporation f z Expiration:- 11/3/2012 Tr# 205399 E J JAXTIMER, BUILDER, INC. iW ERNEST JAXTIMER � n 48 ROSARY LN. HYANNIS, MA 02601 0� Update Address and return card.Mark reason for change. ❑ Address Renewal Q Employment R Lost Card DPS-CA1 G 50M-04/04-G101216 . .................... .. ............. — Office 0 o�m t�rs&'13ifsines��gu7atio License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 110609 Type: Office of Consumer Affairs and Business Regulation : A. 10 Park Plaza-Suite 5170 Expiration: 1a13`L2012 Private Corporation — — Boston,MA 02116 E TIMER, 1301L_— t� _ WE ERNEST JAXTIMER� 48 ROSARY LN Q HYANNIS; MA 02601� f Undersecretary Not valid without signature - Massachusetts- Department of Public Safety Board of Buildin( Regulations and Standards Construction.Supervisor License License: CS 3251 .^ • Restricted to: 00 _.ERNEST J_JAXTIMER 48 ROSARY LANE HYANNIS, MA 02601 Expiration: 1/1 4120 1 2 l (linunissiuner Tr#: 13122 I. j ® DA ��1A�EP CERTIFICATE OF LIABILITY INSURANCE 03/D01 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 poiicy(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). CONTACT ;PRODUCE NAME: Erica H.O'Connor HART INSURANCE AGENCY,INC. , PHONE (508)759 7326 FAx 243 MAIN STREET Auc No;(508)759 7366 PO BOX 700 ADDRESS: BUZZARDS BAY,MA 025320700 DISU S AFFORDING COVERAGE NAIC 3 INSURER A: ARBELLA PROTECTION INS CO 41360 D�uREo EJ Ja.-timer Builder,Incy�e; ARBELLA PROTECTION INS.CC 41360 48 Rosary Lane ARBELLA PROTECTION INS CO 41360 Hyannis,MA 02601 INSURER C asuRER=o: ARBELLA INDEMNITY INSURANCE COMPANY 10017 '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.Limms SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. R TYPE OF INSURANCE SUER IN. VAM POLICY NUMBER .POLICYEF.F I POLICY ow LIDS A . GENERAL LIABILM 850OD42039 10110112011 01/012012 EACH OCCURRENCE _ 1000000 COMMERCIAL GENERAL LWBArrYOAMAS EMI RE ED S 300000 CiAIMS-MADE ®OCCUR MEDEXP(AnymepentoM S, 500Q. PERSONAL B ADV INJURY S 1ODD000 GENERAL AGGREGATE S 200MO GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPAP AGG S 2000000 POLICY - PRO- LOC g AL7T08108RE Lwan ff 216624DD004 01/012011 01/012012 m SINGLE LIMIT 1D00000 ANY AUrO BODILY INJURY(Per person) S ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per a=wem S HIRED AUTOS NON-OWNEDPROPERTY,DAMAGEAUTOS S 2 C uMISRELC LIAR OCCUR 46GOD42040 D1/012011 01/012012 EACH OCCURRENCE s 2.00D,000 EXCESS L AO CLAWS-AADE AGGREGATE. S 2,000.000 DED REnwnON S S D WORKERS COOWEMSATION OD53890111 01/012011 01/012012 WCSTATu- oTH- AND 004AWERV LIABILIN Y-J N ANY PROPRIETORMARTNERIEXECUTNE Q NIA EL EACH ACCIDENT WIr S 500,000 OFFICERIMEMBER EXCDE (Mm"Miary in"") EL DISEASE-EA EMPLOYEE S 500,000 tl fyeeee&VT desa-10 bv under . OES N OF OPERATIONS below E.L.DISEASE-POLICY UMR S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 10%AddHIonW Ranarts Sclydute,I m space la required) . CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN HYANNIS,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. j AUTNORL»REPRESENTA�.� ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 RIM 0/05) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information f y/ Please Print Legibly y Name (Business/Organization/Individual): ' •J. Q u Address: City/State/Zip: N4t-"S m/i 02&0 / Phone#: (602) '7'12 , ! l Are you an employer? eck the appropriate box: Type of project(required): 1. 1 am a employer with a0 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. [Kemodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp.insurance. 9. ❑ Building addition required.] 5. ❑ We are a corporation and its ME] Electrical repairs or additions q ] 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. fight of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If.the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Q n p� Insurance Company Name: p���i�i�[ //P4Z2K''1_?0PL( I XJ s C . Policy#or Self-ins.Lie.#: � � _/Q ��I Expiration Date: Job Site Address: 11 W I At rigy) 4411- City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the.form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify he pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: Lq kh( Phone#: Official use-only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 9085270238 Line 1 10:58:35 a.m. 06-04-2011 2/2 04/08/2011 10:38 5087754909 #4783 P. 002/002 � wt�arAarx. ? H Town of Barnstable Regulatory Services Thomas F. Geller, Director Building Division Thomas Perry, CHO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us } (iffice: 508-862-4038 Pax: ,;98 4942,10 Property Owner Must Complete and'Sign This Section ff Using .A. Builder as Owner of the subject property hereby authorize ..t.! � to act on my behalf, in AN matters rel2tive to work authorized by this building peru-ut application for: Address of job) Ygnaturt of Owner Ye P=iru Name If property Owner Is applying for permit, please complete the Homeowners License Exemption ,Form on the reverse side. Q;%Wppp g31F0lWIS1building permit formsMYPUSS.doc Revised 072110 WALL KEY • O anriw.rw�u p O rwc�.0 wu. i! sill OF 1I �� uri�at-y - J e o PrAlm O ti - w •9 1 °.°�o. i wri snW o ICI n iuu.om�to U spy�T."�'1 i� � e Howe c14w�11n I I Ma rw.w wcT. N e� IL d M 1: ' j -- -.. h , NBUM:,... C� -0 Y SECOND FLOOR PLAN FIRST FLOOR PLAN 0 0Ow iCe MACH. � 5���6 � /KITCHEN/BREAKFAST �n�gREAKFAST w ��g� JUVES Mel KITCHEN ISLAND U) U O Q AL 1. o W - g ❑FI3 I �K ITCH EN/BREAK FAST �c1K I TCH EN 1� d $ F.E B 15 2011 � � = _ JI Lij a D - u LJ s i a W DJUSTAM f" Q 9HHLV¢8 � a q� ® W 47J p UJ \ WHO � �FIREPLAGE WALL F Y FEB 15 2M.. � � • • —7V • • General Notes �mnm+m.a unmm.� . roev x..+eoc w�am�me ma .m.i w`.ma•mm mm rows ' ro.M1ro.mm m oe.�ro. w xeocmA em Ea+im�n w sm autam caa. �tR C)j Um �8 wW o WZS . w =Wc o UDLLp ._._._._._._. a U��~ 13�W-o u J�- o 5: 2 >< 3 u SHEET: �� ELEVATIONS SOUTHST ,p�ye, �/f+A souTHEAsr WE RIGHT ELEVATION C ] L +' REAR ELEVATION ' IXNNN BY. palE RPn510HS SHEET A.1 of 2 BO.ECT WiE' I ' General Notes . . w.n«povm t..w..•�eo.t ., - � crow mmunwuat • • ✓, eror rabboe l..,Pot. • ._ ` ` Wep ut�«nMr4eB .«rY m.rbw«N ao«mart «)eocrnA em Eam r..�� s.m et+ew rase o } c 28 ' DECK LIVING AREA m g Um .uaW eboran rwmwr oeamn� �• m oeoon —— — WZ5 U 0 w s ar $ U 55 -amens wru W_o UVA LIVING AREA LIVING AREA I~ E t r= co J Cbe)On � E more Bier CL ® < DECK } ROOF DECK nwooBwr�� nwurrrr omen ' ... ��. rnnvar er: JH ® Q �9 �1 OniE FEviSIOHS C'3 OO Q ore ZO m r encore e°s°�DwnTwT,°000er e� - _ ® cm LU0 1 f B m FIRST FLOOR PLAN SECOND FLOOR PLAN SHEET O A.2 of 2 ' OROIEGi OatE. ' t1100 iMB/i) 11 Winfield Lane, Osterville 4/17/12 gk. ri�,i �ii.� sessor's office(1st Floor): / Q Assessor's map and lot nu bar lO `-�T p� Conservation — / `moo ow Board of Health(3rd floor): � 3 Sewage Permit number DA817T�DLL T i y rua Engineering Department(3rd floor): �o,,�%639. `od° House number o Y1ir a 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 %U , n Tin /(p o TYPE OF CONSTRUCTION _ (Onb F 12 34 M If 4'T'ML-f C n Th 624 24a-a 2t� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location P �A) t A) FI Q-il /- US V( A-1 ltit 14S3 Proposed Use t/0!9 r 4 Vn L LL A,`a Zoning District Fire District e CAJ7e-P,yI LI.! O -^ W t'In Name of Owner_ P- 6 P02.Q I 6 tlut�' Address l C C-tJ r/b fC! OU t4- Name of Builder Address Name of Architect Address Number of Rooms Foundation Exterior Roofing IP�t 1�1111C�L Floors JA)c'706 Interior UuoUID Heating Plumbing Fireplace Approximate Cost Area Diagram of Lot and Building with Dimensions Fee r^ (2X2L) --------------- sa CSC cu O CUP CY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and.Regulations of the Town of Barnstabl egarding the above construction. Name Construction Supervisor's License n1LE, BRADFORD No 3 4 8 4 3 Permit For BLD. ATTACHED TOOL SHED Single Family Dwelling Location 11 Winfield Lane Osterville Owner. Bradford Towle Type of Construction Frame Plot'- Lot Permit Granted February 19 , 19 '� 92 Date of Inspection 19 " Date Completed 9� 19 j t r TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE ( c�2 JOB LOCATION ft . Number 'Aau t ��Street Address Section Of Town "HOMEOWNER" f624!J 42 -Z4,0L(2- 361� qo Name Home Phone Work Yhorie C PRESENT MAILING ADDRESS 29 �' l�o,v C O a-6 SS', City/Town State Q 74(, The current exemption for "homeowners" was extended to inc Zip Code 2ccunied dwellings of six units or less and to allow such homeowners t include owner- eng�age an individual for hire who does not possess a license the owner .acts as su ervisor. o provided that 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 structures. A person who constructs more than one home in a two-year farm period shall not be considered a homeowner. Such "homeowner" shall to the Building Official on a form acceptable to the Building Official, that he. she shall be responsible for all such wc)rk erformed under the building permit, (Section 109. 1. 1 0 The undersigned "homeowner" assumes responsibility for compliance with State Building Code and other applicable codes, by-laws, rules and the regulations. T.he undersigned "homeowner" certifies that he/she understands Barnstable Building Department minimum inspection proceduresande Town of requirements HOMEOWNERS SIGNATURE Ve Z,& APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will required to comply with State Building Code Section 127.0, Construction NZScs 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 Q, Rules and Regulations for Licensing Construction Supervisors, Section 2. 15) . This lack of awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor.' . The Home 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 responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in .your community. ;1' Alf FU 1-h P4 -JIM , I"Er°�♦ TOWN OF BARNSTABLE BABH9T0DLB, i �p9. DUILD.ING INSPECTOR APPLICATION FOR PERMIT TO ......... -' ".Z.c. ............. �D '. ... !.............................................. TYPE OF CONSTRUCTION ............. lr '4 .................................................................................................. ..... �................19..r..l. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a p mit according to the following information: ..F 91W.(4 Location7'Le............................................. ......................... ............................... Proposed Use ...... at (/ ................................ ZoningDistrict ........................................................................Fire District ....................................................... ..................... Name of Owner ....... �... Address ............. ...d%L1. 9� rLL . Name of Builder ....... .. .....L^E ........Address �U.G..3.A`.k........I... �. �i ....�Cd... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .........../..�.. may- ................ �!V �Q........................................Foundation .....(�if2�Piy� l.�L.:�?�t�........................... Exterior ........��U......... ....... .. .......... .... .... ............................Roofing ...... .. ...4fi�!:... e'©......................... Floors ............................................Interior G`�1' Heating .............. ..............................................Plumbing ..................�............'1L�.......................................... Fireplace ...............�G .�YL�. Approximate Cost . Difinitive Plan Approved by Planning Board ________________________________19________ . Diagram of Lot and Building with Dimensions .s THE ,PROPOSED METHOD OF PROVIDING SAL 17ARY aNATER SUPPLY SE SAN 3 % AND DR/�aN;AGE IS ,HEREBY APr'i��:•�; -�� �3 — _ _ 0 'TOWN Or' BARNSTABLE, 80ARD OF F91-*A I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. �� Name ......��I......'.��.!� . ................. � J.-~^1139 John DECs� � ���� u»�= w ^ '~' � � � No Permit add tool shed -----'' ------------ \ � to dwellina ` ..............................~....................... \\ ' -�*Winfield Lane _ IRF ZiE_-__ -° . -W,~~' __ ...Nas��______ ' A�.= � � "="=. ---- 6�o J �+��� ---.��-.. -------- � Type of Construction ..................f.?.ame............. --------------------------. � ' Plot ............................ Lot ................................ / « � Aril �O ?I Permit Granted --..������----'--.lg ` Date of Inspection -.. . ---.l9 Y� Dote Completed ....... 1........lg � � � ' PERMIT REFUSED .----._--------------- lg ' ---------.----./-----------.. , ^--------------------------. .---._--------------.---.-.- | ' / ----------.---.-...--.-...-..-.~. | � . ~ 0 Approved ,_.r-------'-----. lg. --.-------------.-.--------. ................. I ' I I _ i WALL.KEY 0 "tsTw,M,w a I . . O lMivPbnao wel.a� I I I � I - 7wuC DIVID®� Krirrw BATH " ; 9FORAGC DL`+ 'YfCL►4CYOIY - ALIGN 11GORG NLM taw 11GT, . rt GR9 C rW GMIIQT I;, �CADI I r I W.; �� 2W PC? El ftm SECOND FLOOR PLAN FIRS Ft OOR PLAN z -- FEB 1.5201: 4 _ _ A ' � General Notes �I t 120 mph wind zone requirement A.1 for >f for 780 CMR 91h Edition Ma. / - -I I / State Building Code BUILDING OEPT FEB 08 2018 TOWN OF BARNSTABLE 4y SECOIVD FLOOR Iw106ANY DECKING e i AARC111M Al DECK r } U 0 W C 5C O w CABLE RAIL 0 °' J FIRST t=taOR SYSTEM E m c _._._._._._. o , w ` CANrILEVER 21 ® ARo+m I DECK s' In 6Sa6'P.T. 3 POST TYP. _j LV I I Y J JUg< HAINTAIN♦' ' i ( i i FOiDTiILG I I I 0 = w I LU COVERAGE ICI I I I I I I I �I I W FIELD VERIFY � LL xIYfA TELY Z wj a T04 CEIfrE LL O OF LANDNG a✓FUDGE U-) 1' O SOUTHWEST FOVD 0'DAn.90NOUB SOUTHEAST vdQ wJ mBIGFOOr TG ORIGHT ELEVATION - u,AB"Coarocirm REAR ELEVATION TYPICAL 13 A.1 V H-+L" i Q� B�MAbOGANY DECTONG (� EDET. 2W P.T.DECK JOISTS 16'O.CG 6 x6'P.T.POST Q HANDSAW DECKING CONTrWOUS FM NEWEL POET JOIST ILANGER BEYOND ] - CABLE RAIL �'!r SYSTEM W2)x•p1A�, urr7j'OW P.T. WRILI-BOLTS x arb DECK JOISTS k•O.C. LAG BOLTS k•O C. / COUIRER SINK TAPERED FOR EXISTING EXISTING WAIL W/FRONT FACE OF BEAM sKAEE oErAl°LL II D ECK SHEET: LIVING AREA SKIRT BD. COL 20 BETWEEN EVA CANT.JOISTS BASE -°' ELEVATIONS S-1 II NN2110 ANGkRTTP. 91MPSON ABUii TYP. CABLE RAJ I I LDROPPED SYSTEM EXISTING ALIGN 1'1AILOGAIVY DECKING HOUSE PROPOSED OF�DOOR/b' WALL.MEMBRANE TO BOTTOM EXISTING DOOR — — t - BLL CAP ale P.T.DECK 21D P.T.DECK BEYOND MA1IOGAHr DtflCING I I JOISTS k'O.C. JOISTS IL•O.C. 1'U11OrdIdY DELKIWG aa0 TAPERED SLEEPERS ABOVE MIEMBRANE I I x'DIA.r ts'u✓4 ki'11DOK BOLT HAWAR TYP. FOR DADMEG I i ANCHOR BOLT DRAWN BY: JH ------- POST� EXISTING E�IISTING FRATTING DEL.are LIVING ARE arc W oz. EPOI'7 ADHERED RooFlNG nEreRANE L, DBL.ale BETiEEN 4-arb P.T. p0gT1 _ DATE REVISIONS CANT JOISTS HEADER IOC PLYWOOD atoear dec s sairs 2-ar P.T. 1/16/18 BCA BASE HEADER 2,10 P.T.DECK JOISTS k•O.C. SLOPE"'12 pTa t/18/18 stairs at rear deck gads P.T. 7 are P.T.LEDGER DET. EXISTING TAPERED u✓I/E 14 PITC21 TO A IIM.N 9XISM ST HOUSE -------- VIA. 1123118 CD NEADETL )x•OIA. Z BEYOND - 1/31/18 C tXicPPa� LAG BCLT9 k•oC. ����Ds� its BCA CAP JOIST HANGER i'ri'P.T. are'SST 0NO P.T. EXISTING 212I18 newel pose POST TYP. HAllam TYR POST TYP*-=, SLAB FEXISTING WILL V-GROOVE CEILING SCALE:1/8"=t'-0" PROVIDE W DIAI'I.SONOTUBE 1`I EXISTING I I PROVIDE 10' DM.SONOTIBE I arb P.T.LEDGER . BF-2S&GFOOr FOOTING . PROVIDE FOOTING(BF'2S) i MAWAIN 1' BASEMENT i i FOR POT FoonNG(BF1e) )x' 0 1 2 4 8 LAG BDL fC'o c OR POST u✓ABUK CONVECTION FOR POST ur/ABUiL CIOlOVJf�:TT10N CAL ��E TYPICAL SHEET AN A A.1 OF 3 SECTION A-A SECTION B-B ROOF DECK DETAIL 2 POST FOOTING DETAIL PROJECT: DATE: SCALE:1/4"=1'-0" SCALE:1/4"=V-0" SCALE 1)z"=V-0" SCALE 1 Y2"=1'-0" t7-too 12/26/17 Fw General Notes 120 mph wind zone requirement for 780 CMR 9th Edition Me. State Building Code CN `1 co ¢ o w co EXISTING / / ! !EXISTING / / / / / / / ! / / / !! !/ // / ! / J N Z N DECK // /!!/LIVING AREA �/ /// /// /// / !// // //////////!// !/ U Co ° g w O o. ALIGN EXISTING AND FW50POSED rwCGWIr NG EXTENDED X------ DECK AREA j------ // // // /// //// / // //// /!/ //// /// // ! / ! / / ! / / Y J w W LU W Z J J w = O w J II eI eI �I �I aI 41I II O II II t-Y O a X>YTOPv "TE.Y zw HATC CENTER CABLE RAIL O F F LANDING uSYSTEn ofw0U Q • / !//////!/////// 9 EXISTING / / / / / ! U J LL /!LIVING AREA ,/!%/ /!%!///�!!%/ -T• -r I-T• s REMOVE STAIRS a T2 E EXISTING / !/ // +-a V J 01 S E L LIVING AREA/ i// !/! /// // I C] 'u r � m° o wSLU EXISTING SHEET: LOWER DEC A ��®,� FLOOR PLANS i•IXEA STEP AND RE7TDI/E STEP LOP PROPOSED TI PROPOSED DECK a a ROOF DECK a t y MAIIOGANY DECKING MmOGAW DECKING DRAWN BY: JH DATE REVISIONS CABLE RAIL STST'EFI 1/16/18 al rear dec s s ays 1/18/18 stairs at rear deck RfT10yE CANTILEVER 1/23I18 CD EXISTING ROOF CANTILEVER DECK 7rAROM twig ��NG� �A�IS �y b 1/31/18 T N ST IRS AT THIS AREA REBUILD 2/2/18 newel post 4P AND REBUILD b' LSCALE:1/8"=V-0" A A A.1 A.1 0 1 2 4 8 • FIRST FLOOR DECK PLAN SECOND FLOOR DEC PLAN SHEET A.2 C- 3 PROJECT: DATE: 17-100 12/26/17 General Notes 120 mph wind zone requirement 2. for 780 CMR 9th Edition Me. State Building Code 2 ROWS OF 2-PLY BEAM 16d NAILS 17 0.0 3J!'WIDE 2 ROW$OF r•THROUGH BOLTS 3PLY BEAM 170.0'WASHERS Sy'WIDE MULTIPLE LVL BEAM CONNECTION SCALE 1'=1'd EXISTING ROOF DEOC ABOVE W — �o _j �¢ e Lu �, o EXISTING / /// /// //// / / / // // / / // / N/ /GARAGE/ / C / / / / / / / // // // / // / C.) Co Mo t n w a D EXISTING AND PROPOSED ALIGN EXISTING / / / / / / / / / / / / / / / / // // //// D5=NG EXIISTING FRAMING E7LIS 2r6 k•O.C. 4�A- - 2 o P.T ———— —.-- A / W M6 P.T. JOISTS / J W J U Z< / / / ow WZ <Lu o J 0{ � GGJU lo, v�uo, LL(ro W00 EXISTING /,BASEMENT/ ER WJOIST A6IN6I. a B / A.1 8 /' � _? PROVIDE b'OM.91(7BN�OTpU)BI. /// /// /// /// // / / / / EXISTING / / / / // // /// /// rn N /?E 5. FOR POST u✓ �ONlKTION // // // // // / / / / /LIVING AREA/// / / / / / // v p o o TYPICAL 3 I;�r 2 ° 0 � E a+_ U HANGER TYP. SHEET: 20 JOIST // / / / / / / / / / / // / / / / / / / / / / 1 I 1 0{I U i I 2d0 P.T.� FOUNDATION s-fibPTU W P.T.LEDGER O.G. & FRAMING u)% VIA I x O ab JaST B� 2 �T a i i HANGER TYP. I 1 21 P.T.D JOIM O.L. I Q D O.L I ®UAA'� TO A MIN. I DRAWN BY: JH I p r SHEADER-2r P. "66 P.T. _T �OROPP _ I 1 DMypppEp m I I �DRG P D DATE REVISIONS B I L I r=3 B B e IB I 1/16118 on al rear deck s s eRs PROVIDE W DUM.SONOTIBE - - 1118/18 stairs at rear deck uWWWOOT FOOTING( ) 1/23/1B CD 131 FOR POST u✓ABL"eckxiLTION - L��'•y11_I yf Ex 7��p pE TYPICAL HEADER tl311i8 REMOVEDECI S c LJNE OF c DROPPED 2l2/ta newel post CANTIL.ENFRED DECK AREA SCALE:118"=1'A" A A A.1 A.1 0 1 2 4 8 • FOUNDATION PLAN/ SECOND FLOOR DECK FRAMING PLAN SHEET . FIRST FLOOR DECK FRAMING PLAN A.3 OF 3 PROJECT: DATE: 17.100 12/26/17 ICI General Notes A A 1 120 mph wind zone requirement for 780 C M R 91h Edition Me. State Building Code �9F.CCQm FLOOR YL 74 g CJVlTED 0 LU W c �0 10 o; 0 1n m CABLE RAIL- SYSTEMRom d c FIFt4T FLoaa - IY U m 1 pp n . _._._._._._._ W 0 CANTILEVER r'a J ARCHED 7 DECK 2' m 1 i i1R✓P.T. POST TYP. JLV t I 1 I I Y J U Z a I 1 I I I W LL1 Z 2 MAINTAIN 4 *f I I I I [- i i = w J 1 O J COVERAGE I I j I I I I I I I I 1 I I � C.) W> 1 1 I I I I I I FIELD VERIFY i i O Z TO APPR'SOMATEL7 MATCH CENTERi i 0 O ~ A.1 OF LANDING r✓RIDGE d � w 0 SOUTHWEST PROVIDE 00 DIAM.SONDTIlee SOUTHEAST w J RIGHT ELEVATION --- 013� w REAR ELEVATION TYPICAL _ B A.1 • +' u P N E r v Q m DOCKM • oEr. _ MAHOGANY JOfsT9.1dsY9 W 04 Q 9 00 111,61 POST ECONTRaWILIS FOR WOOL POST O � m E MMIOQANY DECKING JOIgT HANGER BEYOND ] U } CABLE RAIL 4-j'SrW P.T.HEADER SYGT931 2110 P.T.LEDGER •y•VIA.THRU-80.T9 UAW 16,VIA. CgA,TER 9MC 2rb DECK JOISTS k•O.C. LAG BOLTS 'O.C. EXITING FIALL /' u✓FRONT FACE OF BEAM TAPERED FOR EXISTING -- - N DECK LIVING AREAdk ART BD• SHEET: BI BASE A T� ELEVATIONS SIMPSON3-1 yJyA)j.• WA ERJOI T �E RAJ r HEADER 'S Tom' mclisTiexlsTtNG DOOR LDRWPED PO4MOGANY DECKING Nam AND PROPOSED �aF DOtxtPR�MB�E1����' I I F _ _ BEYDND B"CAP 21E P.T.DECK 2 S P.T.DECK MAMOP•N Y DECKING JOISTS k'04. Jdsm 16•O.C. I I IIAWOGMJY DECKING TAPERED SLEEPERS ABOVE MEMBRANE I I I�WJri�TYP. FOR DECKING I � X'DIA.i 12•uY 2Ij'NOOK ANCHOR BOLT DRAWN BY: JH C�TO EXISTING �_21tb PT 2dr kr�z.� EPDI'7 ADHERED ROOFING ME7'10R.WE - L DATE arc onVeSCIONSs stairs LIVING AREA, Z y��YN� 1/18/18 at rea r deck at rear 'BASE �- HEADER 2HEADER T 2do P.T.DECK JOISTS k'O.C. 9L�E�'�PiTCN -_ W DU SOMMUBE 1/18/18 stairs et rear deck pfISTING TAPERED w4AW2 PITCH TO A MIN.W pfIST1NG FLOOR JOIST 123/18 CD 9-21t12 P.T. 7 21D P.T.LEDGER oEr. ----_- - NEADER W2I x'pA, - = BEYOND DROPPED LAG BOLTS .o C B�CAP JOIST IIAlGE7t 416'P.T. 2x&JOISTi4i'P.T. EIOSTING POST TYP. HAWAER TYP. POST TYP, SLAB EXISTING NAIL SCALE:1/8"=V-0' V-f.ROOVE CEILING 1 I l i I I 12,10,1)P.T.pL1A�� BF-2S BIGFOOp FOOrING 0 1 2 4 8 I I EXISTING PROVIDE 10'DAM.SONOnJOE I I LAG B0.TS K•O.C. 1� i �1 GN 41 BASEMENT FOR � i i SHEET FOR POST WABL"CONNECTION TYPICAL I I TYPICAL ; ; COVERAGE if aN A.1 OF 3 SECTION A-A SECTION B-B ROOF DECK DETAIL 2 POST FOOTING DETAIL PROJECT: tATE: SCALE:1/4"=V-0" SCALE:1/4"=V-0'• SCALE 1 Jz"=1'-0" SCALE 1 "=1'-0" 17.10026/17 General Notes 120 mph wind zone requirement for 780 C M R 8th Edition Me. Stale Building Code LLI LU C) U) N O EXSTING / / / /EXISTING `2 W C DECK / //%/LIVING AREA // CO U m o a w ALIGN EXISTING AND PROPOSED DECKING MANOGANT DUCKING ---------- AIREA ---- Ui / EXTENDEDL------ // /// // // /// /// // // /// /// // // J LV W ' CABLE RAIL w w SYSTEMF----�-�_ / / / / / / / / / / / / / / / / / / / / O Z C Ld y U tw—y ALIGN PECK PRPGS® I l l l l l l i l TO EL VERIFY p _ Z w 1AREA I I I I I I I I I 1'IA CENTERAPPROXIMATELY O O '^ w I I I I I I I I I � v'1'' 3^O GARAGE YWJL I I I I I Q LMmING u✓RIDGE H 0- LNL EXISTING /// / / / / / / / / w /IV�NGAREA 6 MOSTENIZ a STAIRS U n E I 41 EXISTING cu ) E c /LIVING AREA/ / / / / / / / / v VJ p o0g . 0 SHEET: Ar�EA w LOIQR' FLOOR PLANS b 61 b( AND REMOVE STEP UP 9 PROPOSED PROPOSED T DECK b a ROOF DECK a tr 6 r'IAr10GANY DOWNG DRAWN BY: JH 1 CABLE BL L DATE arc RonVeclONSs eus 1/16116 a rear deck T 1/18/18 stairs at rear deck CANTILJ'VER PJ31OVE ROOF CANnLEVER 1/23118 CD ARW® REMOVE DECK AT THIS ARCHED DECK 7 I.9� EXISTING DECK AREA AND DEG=4' (y� AT THIS AREA R®LALD 31-61 4/r AND REBUILD IQ SCALE:1/8'=1'-0' p� A A.t A•I o 1 z a 6 FIRST FLOOR DECK PLAN SECOND FLOOR DEC PLAN SHEET A.2 OF 3 PROJECT: DATE: 17-100 12/26/17 I General Notes 120 mph wind zone requirement for 780 CMR 811h Edition Me. Stele Building Code 2 ROWS OF 2-PLY BEAM 16d NAILS 170 C, 3r•WIDE At 2ROWSOF j!•THROUGH 80LTS 3PLY BEAM 170C WWASHERS Sy'wIDE MULTIPLE LVL BEAM CONNECTION / / / / / / / / / / / / / / // scALE:r•r-o• ALOOF DECK ABOVE Z) dQ o LU � oo EXISTING / /GARAGE// / / / / / / / // // // // / / � D � d o (gym '0 w ALIGcam ANDN DECKING EXIST INGFRAMING013STINGS 21r6 k•O.C. 2-2110 P.T. / / 2-2r10 P.T P.T. STS O / / / / / / / / / / / / / / / / / / / J W / / / / / / / / / / / / / / / / / / / / / Y JUzQ ( / / / / / / / / / / /// / / / / / /// /// o W Z �W. w = W o -� ate J015T 06•P.T N U K O rrP POST TTP. II II II 0.0 0 z w LLI /IPI60JIDE'W DIAk.SONoruBE ( d d c L)EXISTING a' /,BASEMENT/ // // //% FMPOPOSTtr✓ABIx�iCLNNECTION 0 a B A.1 cuEXISTING r^ QJ LIVING AREA/ / / / / / / // / / / / NMt5JOI TTP. //// / / /// /// / / / // // le SHEET: oil II �A W. Q ado P.T.OLLEADGER ON j II ate P.T.LGER DnR pP P.T. 1 II ,i LA�6 EMTS li•04. F& FRAMING ED c I RW2)%'DIA p PROVIDE b DW'I.SoNorusE , LAG BOLTS fi.O . I I 2.10 J015T uvWWOOr FOarM(HIM) II ala P.T. � 2 i NANGER TTP. TTPI�x FOR POST lu/ABUK CONNECTION 1 B I 2910 P.T.DEC J015r.3 O.C. P.T.DECK TB Ifi.O.0 QTAPERED ur/1/Dd2 141 TO A r11N,e RAWN BY: JH S�ADER / POST TTTP. 2-ar12 P. I I 2-2r12 P.T. D I DROPPED I I DROPPED DATE REVISIONS EEE 7 L9� PROVIDE b DIAM.50NOR 3E - - ' 1/23/18 CD wMGFOOr FOmIY( II A- FORT tu/ABL" LL LOPPED C LINE oP Q WMILEVERED OEM AREA SCALE:1/B'=1'-0' q A A.1 0 1 2 4 J A.1 FOUNDATION PLAN/ SECOND FLOOR DECK FRAMING PLAN SHEET FIRST FLOOR DECK FRAMING PLAN A.3 DF 3 PROJECT: DATE: 17-100 12/26/17 y �Q� ,A,\\C �P i I