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0025 ANGELA WAY
r • ,1 UPC 12543 3 • No. 5LOR. L�. HASTINGS. NN rr.�'.��__— ..1..��..... .—_.fudlJ�ei4..AYW�a....�....::Yid.mu,.n::�_...:�.,._.�.`_v.A�.sr:,..�.:._u1�s.u�- _ -��:..�.' •• .� Town of Barnstable 2 0 M,0 _ Building sMA Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept BAIRU a� �`� Posted.Until Final Inspection Has Been Made. Permit � Where a Certificate of Occupancy is Required,such;Building shall Not be Occupied until a Final Inspection has been ernl made. G m Permit No. B-18-4057 Applicant Name: Dani Cuozzo Approvals Date Issued: 12/19/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 06/19/2019 Foundation: Location: 25 ANGELA WAY,WEST BARNSTABLE Map/Lot: 133-074 Zoning District: RF Sheathing: Owner on Record: EICHLER,JOEL M&LOIS S TRS Contractor Name Framing: 1 Address: 93 MONADNOCK ROAD I, Contractor License: 2 CHESTNUT HILL, MA 02467 ! Est. Proje 11 ct Cost: $28,000.00 Chimney: Description: Installation of a 18.360 kW roof mounted solar array using 51 LG Permit Fee: $ 192.80 Electronics LG360Q1C-A5 modules,51 Enphase Energy IQ7PLUS-72- J' Fee Paid:; S 192.80 Insulation: 2-US micro inverters,and all associated electrical work. / Date: r' 12/19/2018 Final kc( ate. Project Review Req: Plumbing/Gas Rough Plumbing: Building Official \� Final Plumbing: 4 Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. j Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on thispermit. Rough: Minimum of Five Call Inspections Required for All Construction Work:` - 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel App scat on # Health Division :20222 �a`1 Date Issued Conservation Division - Application Fee ] Planning Dept. IJtN ��, Zoe�, Permit Fee 12 Date Definitive Plan Approved by Planning Board L�A- } a�A Historic - OKH nl� 20��rvation / ya nis Project Street Address Z Village ,W - a� Owner Address Permit:Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ProjecfValuation 2-0 j0^ 1 -Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) N � Age of Existing Structure Historic House: ❑Yes ❑ No On Old Kin Highways ❑Ys ❑ No o Basement Type: II ❑ Crawl ❑Walkout ❑ Other cn 2 r--, Basement Finished Area (sq.ft.) Basement Unfinished Area (q.ft) Number of Baths: Full: existing S new Half: existing n w a Number of Bedrooms: existing _new w r-- Total Room Count (not including baths): existing new First Floor Room Count° rn Heat Type and Fuel: O'Gas ❑ Oil ❑ Electric ❑ Other Central Air: EP(6s ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage:existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION ; 3 ) -7 W/ (BUILDER OR=HOMEOWNER) Name `� `� 5010phone Number Address 2 S 5 t �"�`� License # Home Improvement Contractor# tmaii: Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WNh BE TAKEN TO SIGNATURE DATE ' _ I TOR OFFICIAL USE ONLY 4 APPLICATION# DATE ISSUED ' MAP/PARCEL NO. ' r ADDRESS VILLAGE _y OWNER DATE OF INSPECTION: _ wF(D.UNDAtTI.ON L) i/o_,o f�o�l 3 R�►t�-lam--` FRAM E; 0NSULATION;. F �aai_ ' .. ► ;�+�: FIREPLACE r. ELECTRICAL: ROUGH FINAL - - PLUMBING: ROUGH FINAL " GAS: ROUGH FINAL ~ r FINAL BUILDING-' Rah - -DATE CLOSED. OUT ASSOCIATION PLAN NO. - _ ?the Commonwealth of Massachusetts Degartment oflndustrial Accidadr Office of.'Investigations ' 600 washawan Street Boston,MA 02111 www.mas&gov✓dia Workers' Compensation Insurance Affidavit:Bmidersl trician&Mumbers Applicant Information Please Prmt LeeibIy Name(Bvs�logan�ianlladnridnai}: �� � _-- Address: 2 .S� ..t, n �A� CitylSta&Zip- W " `) I�"`� Phone#: �� S Are you an employer?Cbeck the appropnate box: Type:of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time)_* have Hired the sub-contractor 2.❑ I am a sole proprietor or listed an the attached sheet. ?- ❑Remodeling These sub-contractors have ship and have no employees 8_ ❑Demolition working for mein any capacity- employees and have wodoers' 9 ❑Build"ang addition [No[liolicers'comp.imwrance camp.insurance I d] 5. ❑ We are a corporation.and its 14_❑Electrical repairs or additions 1211 am a homeowner doing all work officers have exercised their I I_❑Plumbing repairs or additions myself.[No workers'camp- right of exemption.per MGL 12-[1 Roaf repairs insurance required.]T c.152,§1(4�and we have no employees.[No wodms' 13.❑Other comp_insurance required Any apptccav±Beat chedcs boos#1 y also fin our the sectionbelow showing di&vorkeW compensate m ply ia5ormation- Homeovinus who submit this affidavit indicating they am doing all wal and then hoe outside camuacmts most submit a new 20dwk indicatmg such_ rCoatmcmrs tbat cbecY this boot must attached m additional sheet sbowa>s the name of ft sub-comttactM and state whethf oc not those sties bZ- employees. Ifthe so])-coutctaots base employees,they mustpmride their warkwe tromp.policy avmber. Jam an employer that is providing workers'compensation insurance for tay employees. Befotr is Ste policy recut job sits inforinatiom Insurance Company Name: - Policy A or Self-ins-Lic.#k Fxpiration Date: Job Site Address: Qty/StatelZip: 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 t:.152.can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonmefd as well as civil penalties in,the form of a STOP WORK ORDER and a fine of up to MO-0-0 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c ut palms and nattier afper�ury that the infornmtionprotRttetFtrbaysis hue and correct tee: Date: r O.0kiat use onI}t Do not write in this area,to be completed by city ortMM a,Oklat City or Town: PcrmiMcense# Issuing Authority(circle one): 1.Board of Health 2.b3fldining Department 3.CiWrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person. Phone d' 6 Town of Barnstable Regulatory Services ' _" Thomas F.Geiler,Director �A. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town barnst,ble.mn.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION -DATE: .�>��^ / — 13 Please Print .,JOa LOCATION: ' �s VI- number � street village "HOMEOWNER": -11 name (� home phone# work phone# ` CURRENT T M_AnJNG ADDRESS: _ I V c 6-01�/ °I 1 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 twoo-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 proce es and requirements and that he/she will comply with said procedures and requirements. `Sign meo er — Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with.the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This-lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollilc\AppData\I.ocalW=soft\wmdows\Temporary Intemet Files\ContentOudook\QRE6ZUBNIEXPRFSS.doc Revised 053012 WE Town of Barnstable Regulatory Services IA►ea Thomas F.Geiler,Director 0.1 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 as Owner of the subject property hereby authorize to act on my behalf, 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 performed and accepted. Signature of Owner ' Signature of Applicant Print Name Print Name Date QTORM&owrlERPE NSSroxPooLS 62012 i 4► IL `o 1 Pc 44 N �j 4 N � 1 � QQ q ' 4V. 7 V ti { ` y Bs ' 0y 3 /o ,y Y -j 0JQ IJ, . o . (f 4- F TOWN Off' BARS/-sTABL�, /`7.9 LOT SSA ANGEL-9 W4 Y S' L / DATE SEPT �2 /98� I. / CER T/,� Y TyAT y►/f�A T /-S SyOy✓N ON Ty/S PL A� /S .9S /T Ex/STS Di(/ Tf�E Tf�E TON�iV fZEG UL AT/U NS 4 T I L.AA/,D S 6�4 YE YD R � Barnstable Old Kings Highway Historic District Committee ,,,UM ABL& ; 200 Main Street,Hyannis, MA 02601, TEL: 508-862-4787 Fax 508-862-4784 'D[A99. 659. APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply, 1. Building construction: El New ElAddition E Alteration 2. Type of Building: 19 House ❑,�Garage/barn ElShed Elcommercial ElOther 3. Exterior Painting,roof Elnew roof L�1'color/material change, of trim, siding,window, door 4. Ste: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign i 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date Z 2 O 3 NOTE AU applications must be signed by the current owner Owner(print): �����1 o h e S Telephone#: 71 / 9 Address of Proposed Work: f L Village Fw S 4- Map Lot# 133 0 7 1 Mailing Address(if different) Q0. &O A_-)—) 1�q�H��� �c �IL 1-0 Owner's Signature 11 Description of ProposedWor Give particulars of work to be done: Rf <c� HC i��^.� W iydlAwJ S -e -C4owt S� 2 C �+ ' gn14�Seit div;d' / "A 1`a Nt.j -eC,4 w w abk 44%Ja•nS Agent or Contractor(print): '-^To`eS Telephone#: go T`� �UV 7 Address: Z s �t�. t W 1 AL �..� O �' Contractor/Agent' signature: For committee use only. This Certificate is hereby P VED/DE D Date Members signatures J.g 11013n J4a�;7T 1 Q:Woards and Commissions101d Kings HighwaylOKHApplicationslOKH 2O11 Cert Appropriateness.doc i .OF1H Town of Barnstable E T O„ BAR`STABLE. Regulatory Services 9 MASS. %639. Building Division prFO MAC a 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 ; Inspection Correction Notice Type of Inspection P Location Permit Number Zo ( 3 o ( v l) Owner �rd.� Builder One notice to remain on job site, one notice on file in Building,Department. The follow' g items need correcting: L�iitivtia 7- �� AZPL4 ir?c- Ap /P n a r,e car o Please call: 508-862-4t3--'for re-inspection. Inspected by 7L `�' L Date /0 L13 i I j.: . a _ n.�.cot.ur-c►ls I F Town of Barnstable Regulatory Services ' "SLF� ' Thomas F.Geller,Director IL63r,9,{• � 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name j �r hhoome phone# work phone# CURRENT MAILING ADDRESS: n` J� G 0 2 (,3D cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER 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 proce ures requirements and that he/she will comply with said procedures and requirements. Signature o Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community C:\Users\decoflilc\AppData\Local\Microsoft\windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRESS.doc Revised 053012 Town of Barnstable Regulatory Services 9=axNssiEg' Thomas F. Geiler,Director 1639• ♦0 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 h t .J J it � 1 0 Property Owner Must" ' Complete and Sign•�This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, 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 performed and accepted. i Signature of Owner Signature of Applicant Print Name Print Name Date QTORMS:OWNEUERMISSIONPOOLS 62012 W � AlD 0Q0 �Jo� • ° ,� Barnstable Old Kings Highway Historic District Committee 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 1(ASS O APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for. Check all categories that apply, 1. Building construction: ElNew ElIK Addition Alteration 2. Type of Building: House ,❑/Garage/barn ❑ Shed ❑ Commercial El Other 3. Exterior Painting roof ❑ new roof LK color/material change,of trim,siding,window,door 4. Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date q tZ 1 1 2,013 NOTE AU applications must be signed by the current owner Owner(print): � `t 1 - o h e S Telephone#: O °� 3 7 1 I l Address of Proposed Work: d, Villages R 4--M(c Map Lot# 133 a-1 q Mailing Address(if different) P $a X Owner's Signature Description of Proposed Wor : Giive partic/pulars of work to be done: Re I'E a irk-` W ia� S4` e - 14.•�f S'2 C W '� CA-4-1er tj dividt . o II( I h �"�Mlp,.vl .J 4 W , . 60j"A Agent or Contractor(print): Telephone#: -7 10 Address: Z.�' -A- Contractor/Agent'signature: For committee use only. This Certificate is hereby VE . D100 IVIED Date t i l 1 13 Members signatures NN 2 i �goWro 1 Q.-Woards and Commissions101d Kings HighwaylOKHApplicationslOKH 2O11 Cert Appropriateness.doc Ii I c t T 6 own of Barnstable *Permit'# Expires Fee 6 riom issue dale Regulatory Services • L►atasrea 4 • MAM. Richard V.Scali,Interim Director 163g6 Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY f 'Not Valid without Red X-Press Imprint Map/parcel Numbei ( `�( ,n � Property Address Z s e. 1 VV 6 [ -Residential Value of Work$ 2 OI 0 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address J e f' J .-- � Contractor's Name �__j Telephone Number Home Improvement Contractor License#(if applicable) Email: �A T Construction Supervisor's License#(if applicable) X.hRESS FERMI 1 ❑Workman's Compensation Insurance Check one: OCT 15 209 ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request ck box) e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to Ov"'`e ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILESTORMS\building perrm orms\EXPRESS.do Revised 061313 Email - Town of Barnstable Regulatory Services • snRNSrwsi.s, 9 ass. g Thomas F.Geiler,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 i Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on ray behalf, 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 performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOL•S 62012 L a �,iKE, � Town of Barnstable Regulatory Services. � f BARNSTAMM, " Thomas F.Geiler,Director Building Division iOrEa r�'�• Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1 DATE: 1 O — fl— 13 Please Print JOB LOCATION: 2— number street village _ "HOMEOWNER": " r name ^^ home phone# work phone# CURRENT MAILING ADDRESS:_ V �O 2G3 � 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.undersi ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures d're ements 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&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollilcWppData\Local\Microsoft\Windows\Temporary Internet Files\ContentOutlook\QRE6ZUBN\EXPRESS.doc Revised 053012 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 any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)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 number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations'has to contact you regarding the applicant- Please be sure to fill in the permitAicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 bum 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 Departinmt of Industrial Accidents Office of kvestigatiGns 600 washingtou Street Boston,MA 02111 Tt,-I. #617-727-4900 W 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 WWW.masS-govldia ne Commoynuealth ofMassachusefts Deparftmt of Itr bu&ial Accidents Office o,f Instigations 600 Washington Street Boston,M4 02L11 wnm>7na-,mgovldia Yorkers' Compensafian Insurance Affidavit:Builders/Contractors/E ectricianslPlumbers Applicant Information Please Print . b ti. Name(Businessrazganization/Individuan: Address: Is City/state/Zip: Pho=� S� 3 ? C S Are you an employer?Check the appropriate box: T of project r 4. I am a contractor and I YI3e � 1 (���� 1_❑ I am a employer with ❑ � 6- ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet'; 7- ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity employees and have workers' 9. ❑Building addition [No workers' comp.iusmance comp-insurance-- 5. ❑ [ate area corporation and its 10..❑Electrical repairs or additions 3qaimdJ3. am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself.[No war1=s'comp. right of estetnption per MGL 12..❑RDof repairs - insurance required.]j c. 152, §1(4k and we hnm no employees-[No workers' 131❑Other comp-insurance required_/ *Any agpti�nt flat checks boa#1 most also fll out the section below showing their wodn3s'compensa iou policy ix&rma&m- Homeowners who submit this afffilavrt indicsting they are doing all war£sad then hue outside contractors ma9t submit a new affidavit indicating such- tConiracmrs th9t check this box must attached an additional sheet showing the name of the Mb-CaMftW "and state Whether or not these emities have employees. If the sub-cant mans bare employees,they must provide their workers'comp.policy number. lam an employer tltatisprovidYng workers'comporm lfon insurance for my employees Belaty is Hie policy and job site information Insurance Company Name: Police#or Self-ins-Lic.# Expiration Date: Job Site Address: City/State/Zip: Attach a ICOPY 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 ofcriminal 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$250-00 a.day against the violator. Be advised that a copy of this statement may be fDrwarded to the Office of Investigations of the DIA fior insurance coverage verification. I do hereby cc render tlt �?enalties ofpedury that information provided above is true and correct Si ttrre: /t q Date: / o ? Phone#: } ` , 7 '? (1 f Olx'cial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Binding Department 3.City/Fown Cleric 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 r Town of Barnstable o*0 t� y Expires 6 months from issue ` Regulatory Services Fee :�A C��2 • n�►aiesresr.� • . mAB& s F.Thoma Geiler,Director 639• ��eg " Building Division Tom Perry,CBO, Building Commissioner . .200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number f ( , Property Address Residential Value of Work$ 2-0 r b od � Minimum fee of$35.00 for work under$6000.00 -ToName&Address �e' � o R,j Contractor's Name Telephone Number -S-O Cr Home Improvement Contractor License#(if applicable) Email: w Construction Supervisor's License#(if applicable) � RA � ❑Workmnn's Compensation Insurance Oct Check one: ❑ I am a sole proprietor 'j►QW ❑ lam the Homeowner N OF ❑ I have Worker's Compensation Insurance � �d\Y / Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re- _ 3 eplacement Windows/doors/sliders.U-Value (maximurn.35)#of windows #of doors: S ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not 6mmpt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. QAWPFII.ES\FORMS\building permit forms RFSS.doc Revised 060513 I /' i � i i 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 hue, 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 any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-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 line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be.sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submif one affidavit indicating current ! policy information(if necessary)and under"Job Site Address"the applicant should write"all locations mi (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 oa 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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of 1myestigations 600 Washington Sb=t Boston,MA 02111 ToI.A 617-727-4900 at 406 or 14�77-MASS.AFE Revised 4-24-07 Fax#617-727-7749 - ass env/dia The Con inmriveakh afMassachuseffs Department of liuksftial.4ccidents O, 1ice of Investigadons ' 09 M'rr srshingfon SMeet Boston,M,4 02L11 wn w.Yna=gov1dia Workers' Compensation lnsnrance Affidavit Builders/C:onteactors/Flectricmns/Plumbers Applicant Information Please Print LeziMy Name(&u�Oaganizationllndividn . Address: atylState/Zip: Phone 9-7 Are you an employer?Check the appropriate box: Type of, o•ect r 4_ I am a contractor and i Yi�e � 3 (equiretl}: 1.❑ I am a employer with ❑ f�� 6_ ❑New construction. employees(€all and/or part-time)-* have hired the sub-con��S 2.El am a sole proprietor or partner- listed on the attached sheet y- ❑Remodeling ship and have no employees These sob-contractors have g. ❑Demolition wotlring for in any capacity_ employees and have workers' 9 ❑Building addition a insurance' comp_in� arre comp_mcim nce 1 ed.] 5_❑ We area corporationand its 10_❑Electrical repairs or additions 3_ I RU a homeowner doing all workofficers hai a exercised their IT, ❑Plumbing repairs or additions myself [No workers'comp_ right of fxe mgfioti per MGL 12.❑Roof 152 c_ , have nos insurance regIIlrEd.�l §1(�'and we 13_0Other employees-[No,workers' comp.insurance required.} *Any applaatflatchecks box#1umst also fill out the section below shawmgdreirwoken'compensatioapolicyinforma an- T Homeowners who sabmit this RfRdavit indicating they an doing 2a wont and&m hue oatride comiumtors mast submit a neat afd3vh indicating sadL tContcacmrs that check this bax mast attacbed sa additional sheet showing the name of the s.ab-cantacbm and state whathe r ornot those exmties have mployees. Ifthe soh,c tmcrars have employees,they must provide their workers'comp.policy number I am an efnpinyer thatisprmidittg workers'compansation insurance for my employeaL Belau is thepoUcy an.d job site informatiOiL Insurance Company Name: Policy:9 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 requireduuder 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 imprison 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification- I do hereby ce&)y r rder the s an penalties ofperjury that the informed an provided above is hum and correct- Si ture: -v —1 Date: Phone#: Ofw&l use only. Do not write in this area,to be caalnpleted by city or fawn official City or Town- ease# Issuing Authority(drde,one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map_ I' Parc;l �1 1 Permit# 76 L Health Division a � 3 �� t • , "'Dat&Jssued Conservation Division Application Fee Tax Collector I Permit FeeOlt Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board SEPTIC SYVEM MUST BE ALLIED IN COIAPLIANCE Historic-OKH Preservation/Hyannis WITH TITLE 5 Project Street Address (� 2S Rh �-e lk �4� TOWN REGULATIONS ( {f Village Wes- �c�vNbd'�^ Owner eJ Address Z S 4v,5Y 1, Telephone SD Permit Request (^hG�oS-P Ao,,C,� Yk- J ecs fat- P 16Ns Square feet: 1st 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 W Two Family Cl Multi-Family(#units) Age of Existing Structure e., 14 Historic House: ❑Yes t4 On Old King's Highway: 3-Yes ❑No Basement Type: a ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 2tuber of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing I new First Floor Room Count Heat Type and Fu as ❑Oil ❑ Electric ❑Other Central Air: es ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑Zisting g ❑new size Pool:❑existing O new size Barn:❑existing ❑new size Attached ara e:a ❑new size Shed:O existin ❑new size Other: 9 9 9 Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0 No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION J Name e S� 3�- 5 / 5 Telephone Number Address ZS , �s Un License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO = i SIGNATURE DATE tog FOR OFFICIAL USE ONLY i r. A Pz-RMIT NO. DATE ISSUED s- MAP/PARCEL NO. ADDRESS VILLAGE ` OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH too N FINAL` OC Q _a GAS: ROUGH >S FINAL -y FINAL BUILDING M0 :2 �NNIrrv000 DATE CLOSED OUT F-a tit ASSOCIATION PLAN NO. The Commonwealth of Massachusetts '. Department of IndustrialAeeidents' 66o'Washington Street _ ' Boston,Mass. 02111 ' Workers'..CC ensation.dnsurance Affidavit-General Businesses Mi 7. address: state ' c, zi L 4 hone# _ -- work site location full addressating ' I am•a sole proprietor and have no on6 Bpsiness Type:' �OEl ffi Sestaurnclnding Real Estate,Antos�etc.)' wozking in any capacity. �. r . . . I am an em to er with ein•1 ees(frill&' art time. Other %����/%% //ii�i�ii�% �%��/%l/ 1�%Arkin on this fob.. . I am an employer providing viorkers compensation for my ems y ; . .: g , r ;ti :::� F, ,• ^.y.,::u4�!}�/( , .. •t:• .+,+,tY.p r�'..'.'t:.;: +:1'3,'.7• 1� — �!:i�•tf '.i. :(i:::frSt •.'fLi.. =, tt t� 'f:t' .1,i��: •'i:.i� ftir;- , •.1. •'''., _' •' _. r • COID^EIl >lmet 1 t. f j�t.e�, :Jw• . ..�' S• •! i+,' 't, .1'�.t.;i. ir•:.` "l i ;� ... ' �1 't.. t �f:.;;..5::•- Jr.�..•:x.., .Ir: 1.;yf. gtf.J.: .y r7•-Y�:.• $di3re"3s:' f..li: S. I :.f L.:'..'� t: ".•T i'S,{fi!\. •t:�';(i t-i(::,:r • 1.. .A':'.ti:n.\':.V f� ••':''' "`FY S�•i~:•C•r•'' {~ '•:'' •':•wi.� '•J'• rl' .(. J: .'\: •1 :• ' •• tit, � .i"•,. .lnsurarice.co: f.�t :..t:._i MONOMER T am a sole proprietor and have hired the independent contractors listed below who have the following workers' ,compensation polices: ••4.. t:S •t'. ::ri:'t•4yi,.�?;.T:r 'r";.�rt : com name! Y,• ,,. ;'a. -;e,.a.l.�., , •.,.. c..f 1•`:' :•r,. :f. ,r. .Q,l,!':' ,• rl•i t :S'.1 ,w-'i:irt'.Y+i`:'�• .a� ��yN \t�,�`y•' S .;. t;.,}L.,?i•:'• I� A•t •;.�: =:• tv •tr t: :.r. .. � '. t.r•. .C:•�' i1 :r.°f•'•.'1' ,i�,•;`:ct':�:. r„f;! h:.t,,:t: ,'• .�i. ls• .l:.,o,. ,tl:S7'`t:.�: ' CII ••t' .....5 ' .. •:i.,,. .•. ,;iyi.... . ;�:�. :t:` :i.'n:•t '!' J',"n'': '•. •'i'' ' •:5:. :Sf. •rw'r •:e!:if: (.� .:'i�'1 ,'�• 't`}�:;: t;�,:i. '.ii: . :: �'''''i.•'� `'fct.,,�'S. I�q^ i; . •;. �' .:^ r°.e,.:• :'ys�u''�2J •,'•t t'� .}• .rL'L•OiiiC � .a:i��2 i.:,:31i• ,.•.. 1 r: F:r i t,ale i P " e.t•;.'::': .:a•r.!: �:(.j.Jt• .'(: '`• �:C^ .•li:r' -,. :,e.tr;'�'� fit,.���; .<,., ryt,L,;?i.tl:'ti•!'''•S'!.•t•:` :�a�4' .t:.'. '.,r•,.,•r:.:air. nam •t,t. rt ':.C� ,.7�J+t'• 1 •:C ~!: i,•.1:�:...:• 'L •}i'1' i ' _ f 1: coin e � .. _ ••,' .�� '�?,• ,�' .• ' address:. �. . : "�'�'�.'�• ..�',w<•`�— � � ' .. ±t. ,; „ :.. o.• 1101E qy ' +..-L b''ii •�. •Pi :.t'.:�' •. ••,.• .. i ?r..•!f. .i�:.•. :tt •r• `.11•r1,',tt�r.•! ':1, '.'tf' "i: u,�, •p:CO:.f+: ,l7''r:�Y, :f......t.. ',b�..f .•�: ,cr•..,_ 4.a,•,• C.;,f>.S�:w•-�.;.. 'OZjC. >�: ..i,. •. Failure to secure coverage as required trader Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$l¢00.00 and/or one years'imprisonment as well u civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that K statement may be forwarded to the Office of Investigations of the DIAfor coverage verification copy of this Y , I do hereby eerti under the pains and penalties of perjury that the inform anon provided above is Prue and r l� 6 3 Date Signature Phone# 'S N 31 Print name official use only do not write in this area to be completed by city or town official permit/license# 2Building Departmentcity or town! Licensing BoardSelectmen's OfficeC4 check if immediate response is required Health Department ,phone#; Other contact person: "ed Sept 200) Information and Instructions. Massachusetts General Laws-*pter 152 section 25,requires all employers to provide Qvorkers' ecrTpensatidn fof 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 employ er er is defined as an individual,partnership, association, corporation or other legal entity, or any two or rngre of ' the foregoing engaged in a joint enferprise,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 emploj�spersoris to do.maintenance, construction or repair work on such dweHing house`or on the grounds or building appurtenant thereto shall not because of suchemployment.be deemed to be aii employer....., MGL chapter 152 section 25 also'states lffiafeve-ry. state or lbcal licensing-agency shall idthhold 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.eviaence*of•cornpliance 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 unt17 acceptable evidence of compliance with tpe insurance requirements of this chapter have been presented to the contracting authority: Applicants Please 0 in the acorkers'�eonmpensati:on affidavit completely,by checldng the box that applies to your situation.• Please Supply company name, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the Department-Of industrial Accidents•for confirmation of insurance coverage. Alsobe sure to sign and date the affidavit. The affidavit shouldbe returnedto the city or town that the application for the permit or license is being requested, not the Department ofTndustrial Accidents. Should you have any questions regarding the"law"dr if you ale required to obtain a.rvorkersr-compensation policy,please call the Department at the number listedielow. , City or Towns . Please be sure that the affidavit is complete andprinted 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 regardi�og 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 'PAX unless othei'ari-angements have been made.' the Department by.mail� The Office of Investigations would like td thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a-call.•• The Deparhnent's address,!"elep�o!Eafax number: ' The Commonwealth Of Massachusetts Department of Industrial Accidents BMW of Wesffganns 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 r . ^.� _, �. • , ..'R+- •' .k�L.... i �F.: .� t... �y,. ,ts; s.t.i .u. "p Y .t.,, -a ..... t • •3. a i TMEr Town of Barnstable . of ossy o� Regulatory Services Thomas F.Geller,Director v 1639. Building Division ��'FD MAyR Tom perry,Building Cornm9ssioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUppLEMENT TO PERMIT APPLICATION MGL c.142A req �that the onstr "reconstruction,alterations,renovation,repair,modernization,cup ier ion, • d. •;snprovement,removal,demolition,or cuction of an addition to any pre-existing wx►• biding containing at Least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements- ff SO`�0 l os c i w e�u� eo-Cl(�" Estimated Cost • Type of Work: � � I y • `ti r 1 C r� n �v� I/� . of Work- ?' `' _ , Address � L� Owner's Name' Date of App•lication: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied 1�owner pulling own permit Notice is hereby given that: OWNERS PULLING MIR �LEHME n1UROVEMENT WOR DRALING WITH RK D0 NOT HAVE CONTRACTORS FOR APRIA ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A• SIGNED UNDERPENALTMS OF PERJURY Ihereby apply for apermit as the agent of the owner: Contractor Name RegistrationNo. Date . wner's ti r Town of Barnstable oFt� o„ Regulatory Services isrABz Thomas F.Geiler,Director 9 MAss. $ 0 9• .0 A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 2 r Please Print DATE: v I b JOB LOCATION: S @ number �( street village "HOMEOWNER": V'e v J name n home phone# work phone# CURRENT MAII.ING ADDRESS: 4W �lJX� k Otto r 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 tw6=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_pemut. (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 o eo er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pemut 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:forms:homeexempt 03/03/2004 03:19 15088889609 MAP INSULATION PAGE 01 F.Y ; Ti 1 �BLE MAP INSULATION CO INC. .;, ,o r p _3 t i : 43 P.O. BOX 1309 SAGAMORE BEACH,MA 02562 508 888 35 99 3/3/04 TO WHOM IT MAY CONCERN: The insulation installed at 25 Angela Way, West Barnstable for Mr. Jeff Jones consist of the following: Ceilings 9"Kraft R-30 Walls 31/2"Kraft R-l 3 Vents 1.0 If you have any further questions please.feel free to call one at the above nurnber. crely, David Murphy Sales.Representative 1 J f • RESIDENTIAL BUILDING PERMIT FEES -APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 2 O O Builaing Permit Amendment $25.00 op WAX 3 5 , 00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 00 /q2 square feet x$64/sq.foot= 88 x.0031= 3 g, plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq. ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) 'Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) O ov Permit Fee t�. pf iy 6(� EPPaVutTow- GENERAL NOTES -r:x1 1 G1=-� I�'"th"�/I P GILT 10151'�1UKePIr7NIN t?A71NGT � -T1+eY�sr�uciv�au,Y I �n t�C01ti 1-.moow!� GDgvT,c1 efi W�hVt�Wligilb. \ ---- �/DL fY� VtP D1��hf ft/X?I NPVIP PMS IH?IJI Leff Gvl W/Y13�II F�JI _ II 1STi LI ^r 2A^W�Hie?r&I-It-14 w/.EFNJ:X C:t7A.i�+'-11�1t�WN•Fi� ' t r mo t.lol thEl^I WP LIB � •"l FwL I `LT�ut � ;bl j cc�w�ll IAA PIMS gfO1 ma's W/ 9 OwrM P*4�H^5-t�U I` 0 2/a2 9'bxiHWv�CA�. U po!'IhIG N I a9laGttro�Wc�-�+I ! m t2t - W �gWH �Ca� la oah I f r�-T6T r-itHaiT,�,R.EG•I'121CA- rHYi tl 2I�IfX e�W4' I IhhCFtLU' � � /J�\ - GOI!F�TIGhfiKY 1�l/1^J�f17lEe tiG&YYP I�-�IIFY-�lll. I L� �1��- PPN7k(•� _ ,�P�b��'r��VtTP.d�P( G'%�"tNG}tWoj� I O'�FNNC�I�smo 13 1 1Y -- I 'v co'�"Y,-ir - `IXIr!ems Dot c N I tM!Or-�IMASa MTL t'diT C?�i T ' !l! 2, Gd q ro N HIS-COhH!�fiTlr7i I I j I 1 CPS i' I I - +F7 c�Gt tyt PD111 YN 4��CH t�01u���J''GTlhlt)FkL:77Lc°:1!1. I I �u c 6T S C1:1iNG7fl1(Nlu� 2-2Atl2tKE1DHPl MOW I IFExI ' �I � 2 '� I.1K1 `�TUI}j�2'2�gFUiT9 �eMr1� Ojai Lro-l-G,.plpoJlrF- r�'4 . kl II I r- 19 I ! I G U"VIt' I I I I I . 1. 6 I I I nla �+ I� I r d I I ?11 2-01 �99d Weil v a. I I $ I? c 9 i wl j i d a l I REVISIONS 9.29.0 71 r r&P O r roar/stnu 14f 1 U 3'-i"14 V P�PO✓6 ttTI0[O H5 C \AP DIMSr 2 ?h OF ❑ enis 19 e"pne.eonl aewe..ew.a.,elumu" 1617522///1 ewleno.rcMmenle.eon - p rs 1I: mea r� r wk /o JEFF&MICHELLE O O JONES 25 ANGELA WAY 1>nzY W. BARNSTABLE, MA Tor� FLOOR PLAN&. n�re O C lrr, Ml+a-0t „o INTERIOR ELEVATIONS .....0305 -43� 2003 w. T CLs .A 1 O O O 1/4"= F-0,. GENERAL NOTES fVI2- P40P-p,Ppt IGPTIDI FS l Ai l _ - �11-IIzE}D CoNti�G10��t ALL. i111 '�''S:.�_•L r 51H art Ize�sz�v>�T�f-1 I 2 � 1�FN+VL2x8 REVISIONS q•2.1.05 VD�xlp D H`Q- q� 4xi col a'n �vlon I - P2 AeotT.H�eo1 ' gGCP�gppN�t� 'I W — in' ftNiG>b o:c; tP?c711'bt I +yS FGr It�uL W. MAM CNmyr o ^r Ma � �II�DYncC "cdsleM _ - � 19ffvK / -y-- — ��alDit�uHe I o 0* Y:f`fxbCtNft'KED P'lNG-FoTo ekliT'!,T ';'i' •i;'-i ?- ents �srms+n.,ww e.n.no,,..a.m.atuo LOL t:G�HHP.2f�xfp [3tFPkil�ti i JEFF& MICHELLE JONES 25 ANGELA WAY W.BARNSTABLE, MA ELEVATION & DETAILS 0305 . �8.� 2003 H 2 _cis .. AS NOTED ij wrrrr. GENERAL NOTES 5 vwR �clyflF�?�DRPd'fEL; Cf;e � C�IUo,o . c,� �rP -vW5 1CF-EUz14Ft�lb • f P aInllwl �P��n r�A�'crH�a. Mrrrta Rp-vvn • Ih'C•rW6. .. " fizollr-r,F45 IH UtrIH LGrtlI Har-.� &xIqyx rlb 12FVRGIt �TD 2 4w��' h4Jf�'. P�LI,�URftI�Cp�i�ONsS�15Tq-. /IL-t: 'D lids It et k-'!T PmoPM-\/ZHj5 v L REVISIONS • o W. 0 AOU MaF 'E-VAY-T P.T.2110 DU4eL ❑ pj(y JOIS�IVO G• enl5 wbov tui eeewa mnueu,.w mew IG"DG W�Z+bALTJ01 _... -- - - 16u522)/e oui.ne.meb..m,.aw r-I 'CEx1�G JEFF&MICHELLE JONES �. Ps pax' t9�rx I.-F. vPz�' FsW n(a 25 ANGELA WAY �rfleu � W. BARNSTABLE, MA 3 . IIPMF#lIzPMIhiCT(� ► G �/J7Ll,�i 11NGTfiPdt DETAILS (D-0- �/o"' 0305 • 0.2 January 2004 A CLS ,//••\�` 9 D•• 3 AS NOTED. •Y.r1°rY� J SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVEFiY I ■ Complete items 1,2,and 3.Also complete A. Signature I item 4 if Restricted Delivery is desired. X / ,JCAgent ■ Print your name and address on the reverse Addressee so that we cin return the card to you. B..Received by(P. ' ed Nam) C. Date of live ■ Attach this card to the back of the mailpiece; l or on the front if space permits. e. ao" u 1. Article Addresse to: D. Is delivery address different from item 1? M Y66s If YES,enter delivery address below: ❑ No E �✓ ``mil- �������/ lr.S 13 cr�•�b� Y "`r` �vZ�� 3. Service Type ❑Certified Mail ❑ Express Mail registered JNi:Aetum Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7002 1000 0005 0781 8157 (Transfer from service/aben; � ■ un,■,r ir■r■uwm ,r,■ PS Form 3811 August 2001.. '``t. •Domestic ReturA Receipt'•t 1 t. .. t 1 t t• 102595-02-M-1540 J t li H ' 171ii i I I r :l 111 i UNITED STATES POSTALER MAC r st!OassMail.;;„ .S �, P�H Is S$g�a8�•Fee ,Paid I o "PerMit'No`. �-16 a ;, ..r . • Sender: Please pri fir' e, address end'Z1P+4`tn-ffiis�Sox'. I I I I x/0- �aew I I I � 1'IID!lIFIlil.li,!'fl,III,.lid"111!! ' I II,...hi I Ji! ' Postal (Domesticr' CERTIFIEPL MAIL RECEIPT - m �7M OFFICIAL a Postage $ u, UHere O Certified Fee O O Return Receipt Fee(Endorsement Required)O Restricted Delivery Fee O (Endorsement Required) O 1 Total Postage&Fees $ �/ C3 Sent To O O ---------- - - --------- ---- -----•--------------- ----- �.. Street, .No or PO ox No. --- •- Crty,State,ZIP+4PS Form :0r April 2002 /� I Certified Mail Provides: , ■ A mailing receipt s ■ A unique identifier for your mailpiece ■ A signature upon delivery �• ■ A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Clasp Mail or Priority Mail. ■ Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811),to the article and add applicable postage to cover the fee.Endorse mailpiece 'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ■ For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,April 2002(Reverse) 102595-02-M-1133 i TOWN OF BARNSTABLE BAR-w � 037 Ordinance or Regulation WARNING NOTICE Name of Offender/Manager ty Terf q, -To weg Address of Offender a f h,,Iy ez q w,A Y MV/MB Reg.# Village/State/Zip W. Rt9RAIS'L9 1?f 01 cry Business Name Al ,jq A?f- +rer' /,0l0 am/pm, on QGfeg 2004 Business Address A1111 � "/✓. ;/� Signature .of Enforcing Officer Village/State/Zip I- A7Aj24e,0XA1 Y 674.9'4r q pp Location of Offense S` /�N� �E'14 WR `/ AV, l/a"'W'4 Enforcing Dept/Division Offense fhiA,yor 1-0 EPIIP/r W,'7# ;1470 C4,q //O, / /A^Oz-v Aoge PeX^',r ?A,R Facts -1G feR400q foR SAAOC wage awA-ogmee w 1Ao1 A&11,0,y',P/l, -fNe T,'r r of aAj?,'AAi STOP a4R,' a 9e Q . ��Ix'S WI/j 8e .-rjw /9f7rd 7 A9y5'� This will serve only as a warning. At this time no legal action has been taken. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE Ordinance or Regulation WARNING NOTICE Name of 'offen'der/Manager Address of Offender e�'— MV/MB Reg.# Village/State/Zip Business Name am/pm, on 20,, Business Address Signature -of Enforcing Officer Village/State/Zip Location of Offense Enf orcirig Dept/Division Offense Facts This will serve only as a warning. At this' time no legal action has been t&k6n. It is the goal of Town agencies to achieve voluntary compliance of Town Ordinances, Rules and Regulations. Education efforts and warning notices are attempts to gain voluntary compliance. Subsequent violations will result in appropriate legal action by the Town. WH:TE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT. TOWN OF BARNSTABLE DEPARTMENT OF HEALTH SAFETY AND ENVIRONMENTAL SERVICES BUILDING DIVISION STOP WORK THIS STRUCTURE AND/OR PREMISES HAS BEEN INSPECTED AND THE FOLLOWING VIOLATIONS OF THE BUILDING CODE AND/OR ZONING ORDINANCE HAVE BEEN FOUND: 1) .S,`R vr_T vrz-A, ti,��,r 7C� R_CAP O f— 3) ly i'AlPOWs, AeeA5 l e1z-All' S a) 2.vJ A,07,, C- &e,4 r YOU ARE HEREBY NOTIFIED THAT NO ADDITIONAL WORK SHALL BE UNDERTAKEN UPON THESE PREMISES, OR THE PREMISES OCCUPIED UNTIL THE ABOVE VIOLATIONS ARE CORRECTED. ANY PERSON REMOVING THIS NOTICE WITHOUT PROPER AUTHORIZATION SHALL BE LIABLE TO A FINE OF NOT LESS THAN FIFTY, NOR MORE THAN ONE HUNDRED DOLLARS. Address Date Building Co d�missioner i � i 1 w GE . PRESSURE BEET SENSITIVE SHEET S i PRODUCTS k . . 0 Kimberly-Clark . n-Bridge , BAN_ �` Brown-Bridge BROWN_ BRIDGE 1 BRIDGE . 5TRI. c° A ST R I PTA C' PRESSURE . PRESSURE SENSITIVE SHEET,. �. SENSITIVE SHEET PRODUCTS , PRODUCTS Kimberly-Clark , Q Kimberly-Clark Brown-Bridge s BROWN. l Brown-Bridge BRIDGE . AACAST R IPwTAC E O O ? U L L j 0 T (V M O ry Q S O T � � C W N C oo w O LL = N GO O y O Z n N C N - to ID a H voOi a CL W 3 y w W H C O Zo W �U TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 Parcel �� Permit# 7,,�, 3 l� Health Divisio Date Issued PeConservation Division 114of Application Fe _- Tax Collector P it Fee 1' ll ' Treasurer11�77 �i Planning Dept. G(L udV. 1247046? „ 1° 11N rA'.LED IN COMPUANC JtTly TITLE Date Definitive Plan Approved by Planning Board ; d�6aO;�fFE �al� ®®E A140 Historic-OKH Preservation/Hyannis 70fF ,(�EC�l �'6,^.�; Project Street Address 2 5 4h)-elsW Village �v�S Lv-v 3 (a Owner �'e �''�-ej Address 2—,'5 h ,e Telephone So " 22 7' 7 519 Permit Request � w wJ✓." l O0 o0o - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio , & Construction Type r Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. �s Dwelling Type: Single Family �f/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: 414es ❑No Basement Type: ull ❑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 I �r Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# _._Current Use Proposed Use W BUILDER INFORMATION Name U Telephone Number �a� ��7 7� �1 Address`,, ' f License# �fv Home Improvement Contractor# ,l Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l 4 —2 I - 0 3 A `? FOR OFFICIAL USE ONLY - - r 'PERM:NO. � DATE ISSUED MAP/PARCEL NO. ADDRESS n VILLAGE OWNER DATE OF INSPECTION: FOUNDATION _�I�RiD 3PeC 1&01 ®,r i0�fwL r 100, FRAME t INSULATION FIREPLACE 3 ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL. GAS: ROUGH FINAL . >� FINAL BUILDING C� Co re cyt S e DATE CLOSED,QUT ` v � fey t j ASSOCIATION?PLAMNO. h; } ___ The Commonwealth of Massachusetts ...... - Department of Industrial Accidents - Office aflorafflatfas 600 Washington Street —= Boston,Mass. 02111 Workers' Com ensation Insurance davit name: • �^��. � �0•^'t4 ~ location. ci �,..� 1 C7 ZQ(0 t ' hone# Sot �3�� 7 Y ❑ I am a homeowner performing all work myself. ❑ I am a sole mcrPrietor and have no one worldn m* capacity ❑ I am an em foyer roviding workers' compensation for mp employees working on this job. ........................ .......................:....+........................::v:::::::::::.v:::::::W.v.+.:?-:::v::::{: v;{:•)�:4?:•i}:i,v w::••.v::}4:v):w:.v:4%:•.••:::{vi:+..::..;...;.:::?.vv ..... ..... . f........ ........................ ....................t..........................:::nv v.v.v.v r.::... +nv:...::r${}tiv:i?4:i{:::{•}TY}: w;}}:::::...... 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Y:{.};{{•}::.:�:r•.;•:L:{:4i:{:•�?•:::::Y:;.iti:i•r $at�:?;^i>}:•}?i$i:•:�;:::::: ...... ......................... ... .'•:•.t-.-:::r:::•:::.:ro-::...... ,...rx..t-:n•:.ro::.ro::.:.ax........,:., ,...$$.•r::::i:.....n::ct,:....nr:..ro::}:::::n}:....v..,{2. ..J..r...»..:.r,}:?•:....... ......:r.ro::.ro::.:ro:.:::::::........:....;:...:}................ oli :#.,..ro:;':::.:..t..,:::..:n•{{{::. r:{::i:r}:{{:............:`...:: • . . :..}}.>.:{r.:{{.ro.: rl]U:TSaCe:tD:}):.Y:•:•}:i•T:•Yr>:...•:<{•{.:.::::?::}:::::;•?:?$:>Y:.i:;-:{{?•:{.i:-;:;•))i:.{. .:::.:; .:...;:.:......:.:.:,;•,,. Failure to secure coverage as required wider Section 35A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,M.00 and/or one years'bnprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me: I understand tbat a copy of this statement may be forwarded to the Oice of Investigations of the DU for coverage verification. I do hereby certify under the p and penalties of perjury that the information provided above is true eor ea: Date i I L 0. signature - �� PhmLe# . Punt name - official use only do not write in this area to be completed by city or town official city or town: perruit/llcense# []Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office []Health Department contact pet�on• phone tt; _ ��u'_--.---- Ucv;ue 9195 PJA) f 1 fi 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,neitherthe 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 e. Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and applying company names, address and phone numbers along with a certificate-of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of inmrance 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 peimit/Iicense number which will be used as a reference number. The affidavits maybe retmi3R-to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would lie 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 Imlesugauans 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 . i °FIRE, Town of Barnstable Regulatory Services BARNSTABL& ' Thomas F.Geiler,Director Mess. v�ATf059. � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME Il"TROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. a [ 'Q Type of Work a o h e '�J Estimated Cost 201 W (� O 2 tv coo(/ Address of Work: . t ?� J Owner's Name: v� -T" Date of Application: I hereby certify that: Registration is not required for the following reason(s): FWork excluded by law ❑Job Under$1,000 ❑B ding not owner-occupied caner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME BUROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY Y I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's Name Q:forms:homeaffidav RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,eta) >120 sf-500 sf $ 35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ Uu ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ Gam_ Q:forms:dkcost eff:082301 Town of Barnstable Regulatory Services writs ML& : Thomas F.Geiler,Director %6.19. ,e� Building Division QED MAC► . Tom Perry,Building Commissioner 200 Main Street,`Hyannis,MA 02601 )ffice: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE. JOB LOCATION:. 2,s h 2 I`, �JV F J �J`�►'a J �P number n sireet �^ village ,r -I%-ej name home phone# work phone# CURRENT MAILINGADMESS: �� - uox g`S 1� We� �- SvNc�41VL a, CbZ�(e� 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. DEFIMTION 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 yermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with.the State Building Code and other applicable codes,bylaws,rules-and regulations. Theundersigned"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. Sigaatur4f T o wner 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 persoa(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This laek 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 bis/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. Application to- ®' ittg'� ig�J ap 3.eginttar PiOtoric �Digtritt l OMM. tt,c, . z r ABLE In the Town of Barnstable. 17 18 CERTIFICATE OF APPROPRIATENESS __ CD Ificr SectiorD> lication is hereby made, with four complete sets,for the issuance setts 1973, for proposed a Cart woak aste desc�bedtbelow andeness eon p a s ue' 'Chaptet 470, Acts and Resolves of Massachusetts, Wrings, or photographs accompanying this application for. --� ECK CATEGORIES THAT APPLY: _ ❑ New ❑ Addition ❑ Alteration t'r1 cn Exterior building construction: ❑ Commercial ❑ Other cn Indicate type of building: ❑ House ❑ Garage Exterior Painting: �� Signs or Blllbo rds: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign t Structure: Fence ❑ Wall ❑ Flagpole 17 Other P-b0 L DATE- 1117'PE OR PRINT LEGIBLY: 0 3 2.S 1e ►DRESS OF PROPOSED WORK ASSESSOR'S MAP NO. 133 0 ASSESSOR'S LOT NO. . NNER3-zT4, 1% 1 WeI" �� r_s •a��b4 TELEPHONE NO. 3`��- )ME ADDRESS 0 1 '" Q ` JLL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any ibiic street or way. (Attach additional sheet if necessary.) (( R Cook h 'CAN w- ���7" Uti�N►�� W a•z(eWl ------------ ,GENT OR CONTRACTOR TELEPHONE NO. S^o� 3(02-13J�- �0 t I� (/� Wes ��d��� 01W. 4 ADDRESS _ )ESCR1PT10N OF PROPOSED WORK Give particulars of work to be done, including materials to be used. Please nclude locations of proposed signs.' I N ew Poo I W.(T d�w�Or,� CQI-rve Signed 0 e ontr r- gent For Committee Use Only This Certificate is hereby Date qC> o Approved/ CofWittee Members' Signatures: INETpyY�p� The Town of Barnstable BAR Department of Health Safety and Environmental Services Building Division pTfO Mph�' 367 Main Street,Hyannis,MA 02601 Mice: 508-862-4038 Ix: 508-790.6230 PLAN REVIEW I, Owner: ��fi �o•Y�S Map/Parcel: Project Address: �� GeG/9 W�� Builder: /Z i The following items were noted on reviewing: ,�y1r p®o'gS 1y foo t ,7,,VGLoS 1112 C . /yi9 d i9 i9 B« Reviewed by: 7 Date: y✓ ' 49 : . G s p2 t ��O.B7 ��� p: ���'�•a W � w/ O I-wr . ..... 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Tl Aal�n v.O 0.aDCUmWO.wlet V!'.Q 9.LLL aTmra.m•atl•al J "--"1 M«Y.m•�• •�1m.aFS aSfYd MO Ya ZP[MIro, leala•Ipl TWfYiI�. y, �,� �y�,,, W ..na�ca.wee—fraawoa^.rm •maetaw.u.•ro e®manaevwaaoa.r•rwv.mue.r.svae aq� KIONEY e TYOICAL WALL STIFF L<Rzs b v. SJi�SA' awsla••�l�atim9tD<a®Kf1af4TM 01V.[fL aor�TwT welq•eef, pICI EYG!•Yt.11pN d .wt.a.amL scale: 4T I -PANEL — R3 F s.nasavoiw.saerasommw•a♦a,aQ�n•onc ScALE:1%"-1• TY L IQY- a tm•an.o•m w ust nen t•waa ro soaT eo!•unrtwo ram+e _ •st.Plt:: - Town of Barnstable *Permit# Expires 6 months from issue date ,,Rr,B,,E, : Regulatory Services Fee lO 16 9. ,0�' Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner �/ ' 200 Main Street, Hyannis,MA 02601 X-PRESS P ERA'= Office: 508-862-4038 NOV 2 5 2003 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDEnM_W BARNSTA8LE 1 Not Valid without Red X-Press Imprint Map/parcel Number ✓ b 1 Property Address Z S f I " "�, V 6%,,ULu, O O 2 (0(p esidential ^ Value of Work f-� Owners Name&Address 6 / A Contractor's Name #�� y ' Telephone Number Z -7 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Chec I a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ❑'Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side f r Zplacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home rovement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 Complaint Number: 16011 Taken by: UILQjN—TG S-R X.ES Date: 12 7 99 1VIaU/��arcel: Referred to: UJLDIJ-G SUBJECT OF COMPLAINT Business/Occupant Name: _ Number 25 Street: JANGELAWAY &Z 2- S� Village: S-T—BARTSS-IQB�.L COMPLAINT INFORMATION Complainant's Name: MEDIA ONE Address: Telephone Number: Complaint Description: 5 COMPUTERS INSIDE HOME WITH 5 WORKERS ALSO. Actions Taken/Results: REFER TO B. MARTIN Date Closed: (PH.ONE CALL -FOR "v��� n DATE / 77TIME�D'J P.M. M G Lk C OF f L) S WOCILS-[_S / �IS NED ©p D PHONE j `(S YO R CALL AREA CODE NUMBER EXTENSIO PLEASE CALL MESSAGE EZ�► , / WILL GALL W AGAIN uj- Q g, 1 s CAME t0 I7 P`-N 11 SEE YOU WANTS SEE YOU_ S I G N E D J vAiversal 48003 z cn a ,r- r�:Y""_"Tbrr'"'"•+!r""'• ;b��•7`-,r•..-.�.,.-w,rr^ •---"*'M�'.�.r.?'4+r•+'�-'.;-r.+ti...1,.e..,yr�r�G.iP�?�+�.^,..r��.'.."^.9"'.'m""'...�w,�,. t"v�'ry"o"'� s.••x•.-,.—�. ..�-c---,��^�.-'r _v' 3 a TOWN OF BARNSTABLE 29953 Permit No. ................ BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .... HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY MAC- Issued to DAVID j�DOUGALL Address lot #25 25'Angela Way, West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. June..24..........., 19.....$a........ �1�.................... Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department C�2 DATE: An Occupancy Permit has been issuedfor the building authorized by Building Permit �$...� !_ ... %� ..............................................._....._......�........... w ._.__....__..... issued to ....................... vL /7'GG.. %. `'� .......... .. . ... .....__........._..__.._ Please release the performance bond. TOWN Or BARNSTABLE, MASSACHUSETTS uILDING g-- RM' DATE— 17 PERMIT N0.1 .APPLICANT ADDRESS. (NC.; (S':REET) (CONTR'S LICENSEI PERMIT,TO (_) STORY NUMBER OF . • (TYPE OF IMPROVEMENT) NO. (PRONOSED USE) DWELLING UNITS AT (LOCATION) ZONING DISTRICT (N0.) (STREET) BETWEEN AND (CROSS STREET) ACROSS STREET) LOT SUBDIVISION, - LOT BLOCK SIZE ' BUILDING IS TO BE. FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION. TO TYPE USE GROUP —BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS: AREA OR PERMIT VOLUME ESTIMATED COST $ FEE (CUBIC/SOUARE FEE'tl OWNER ADDRESS BUILDING DEPT. BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STRFFT. ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR ® PERMANENTLY. ENCROACHMFNTS ON PI)Rl.lf: PRr)1.1.1.I Y. II++I ':I•I r II"I)'AI.I.Y 1"I'.I'tMI'r'rise) UNDI-17 T'lll: r"J1l_I)INO (:Olir, MUST f11. AP- E PROVED BY TH JURISDICTION. STREET OR ALLEY GRADLD AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE-DEPARTMENT OF PUBLIC WORKS'. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY-APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF `THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APLICABLE SEPARATE INSPECTIONS REOUIRED FOR ?Cl i.ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS rP RF. PEQI:In d:7 �:CTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF C`C'�Ui�.\NCY IS RE-1 MFCHANI CAL INST A.:_I_-+.r..0 Hi.-- •-- - 2. PRIOR TO'CO_VER,NG ST.RI-17TUF,AL C)IIIq. ;'�•r- 'f';;:,, r) ..-�'aF�;)�,C�rIE.0 UNTILi ' TC 1 AT::1_ ._,.. ...o ,..�.. 3.FINAL INSP•ECT!UN BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. POST TheS CAR® SO IT IS VISIBLE FROM STREET BUILD Ir1G INSP/E>C710N PROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS ' 2. 3 HEATING IINSPL-CTION APPROVALS ENGINEERING DEPARTMENT OTHER BOARD OF HEALTH to/ORK SHALL NOT PROCEED UNTIL THE INSPEC. PERMIT W!L L 3 E C OM E NULL AND VOID IF.CONSTRUCT 10 N INSPECTIONS INDICATED ON THIS CARD CAN BE TOR H.AS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SI. MONTHS 0F'DATE THE ARRANGED FOR BY TELEPHONE OR VVRITTEN -CONSTRUCTIOI`. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. L t d�tL,,,. `t ., �t 4. 'YLt•.4r\v_+�.le:a��z�•. T *SFy ,y,53 �A� t i� r,� 4♦ I , tl • > ',fR {itµ 'S '`, r".'„ !=x S +. S � ,. ( 6- is n 2tyals; r•r�J. 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Z.. , os g 4 'ON , Ob 5 5- : 31VH 3113d Slld 9NIHOV31 1Sd339d SflflS3H IS31 3113d F P e) 1 V&6 /3-3 -•074 O tt,gCS ' Ass*ssor's atfioe (1st floor):-' ST SEPTIC SYSTEM MU HE r Assessor's map„ and lot number .... ...................................... oard of Health (3rd floor): ? INSTALLED 114 COMP Sewage Permit, number .................... ...�: WITH I=S ADLL. ngineering Department (3rd floor): ENVIRONMENTAL CD ,6}9• e�° ouse number 's.a ... J•5.........'. 'TOWN REGULATIO. n ray a� 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 ............................. �..�yZ... ... ../.�.. ....... .. ..:. �.�!. TYPEOF CONSTRUCTION ................lf ..................................................................... - ...-•--•........................................19......._ e � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ...!.V. zod..I..n,�_t6 Y'R5......... !�'.:..' = Proposed Use ..........g6LA5.C.,......00/1:5i.Ti-4-.Q1 uc................................:.....................................................................`. Zoning District ...............�`.` ..,L�`!a..�. .J1. /�-�?� .-.....Fire• District ....... p , Name of Owner(n�tR a.1M! .... 0%1q S%1... b '7vUSy1-r'. ..Address .................................................................................... Name of Builder .....f 01.1�. .. .1�1 ................Address ...... ,.13....a6....,,WAA'4......caj.......at4z45��/ � Name of Architect ....... /)'J ,O�!,1..... �/i�� '� ........Address ........ ...0?•..... .................. Numberof Rooms ..................................................................Foundation ........lU........................................: ... .................... s Exlerior ........ N�!.....C_:'NelA.X......:GY1.1oa c'l.S.,........Roofing ........./Q l„C ?Er 69}2.,............................................. Floors ..................... ................................................ ......Interior ........... .(.� J Heating ........ /.. ................................................................Plumbing .............J..... [S i� \�......................... Fireplace ........... ................."................................................Approximate Cost ...........Q.70. .................................... Definitive Plan Approved by Planning Board ________________________________19-------- . Area 45�Z:-" ................ Diagram of Lot and Buildin with Dimensions (p ®2._- 9 9 Fee ...r..... .......... SUBJECT TO APPROVAL OF BOARD OF HEALTH n 1 , 3 a6c OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding t e above construction. Name ... :. ................. .. ..•.... .... .... .......... ................. Construction Supervisor's LicenseY"'0J.0g?Z5, McDOUGALL, DAVID 29953 T St Igo ................. Permit for .... ......Hy.............. Location .... ....2.LAPge14..Yay.......... ................West Bqrnstqble. . ... . . .............................. Owner ..........Day.i.d...McDougall....................... Type of Construction ...........FKAIR(I..................... • ............................................................................... Plot ............................. Lot ................................ Permit.Granted ....September 23•....,•„•19 86 Date of Inspection .(......00)...................19 Date Completed W 71U ..................19 s,jt s a w ~ 0 x• ryof 10 Lq ry ±r"• v O a • W'v' ' ••,1. •r ,, �. , I rr,I ` 'r. t y!1 `) t' �'. i n�: •-nl»-i:•-r---•�' ,`' I .1 fr:@ ly! a?:+ t' �� '"•. ' 1 ' IP / d il ,' r'' Ip..�'� •;yl , R'a P „ l '1 , I' "P- - 'lye„';1.�l�'= .__ 1 '1 ',; , I, `iAr, I iU�1.-f �k��i�r� &tr4F' ,tl ti F■(/ M r t �} l i. ..•• I 1. • i .I,:; ," , •;,• , it �;. , •� '�N '.M l/ - a,j r`i :n l,ia v.�i�rf!llr� 1 •••?„ P •.^'7,:, r j' _•.`, -------------- ir s, 4 t' 1+ i k ,aq I i 9 3•'r. , .__. _ _. ,• •„ 1, : .��, '�• .,'• , r .a ,., �: 1: !� � .� :errs, I : •.• , .. ,.• :. , , :,f.,, ,:I. y 1 Ind. .., • ..',,.. ,i .. ., w' '1 1 .k • h 6 �_—� �L - •: •. '. .. ::.: .,r. 1. ,-':.(b;r.t1, ��':41y!,,:'�. .',•. :�:•,:I 1 .�I� ,, 1..Y1,` M��1t4,. w l 1, pj f f , --•-T-•e`^." �••,4:. .I'� _.�,-�_'�'4..'_. :Mi. •�i-.:�y I } '' N: �:I .1.!!.yl`�'otip.t•Y �:�.''I,{',' h 'Y 4 is .:... . . � '-• '.1,: ,' .,.,. ., iff{ ,:,r .;` 'i�° r+' L. -. .. •. i .:, ... - .. .'. •.,.;� .. .. .....,. �...• , M R .� a r. 1 ,F'y_."�/'' ., ,. ,. , ..t ., , .. .:4 I.:•:F ,,1".. y 1, •1{'rt:;. M fir• ,. , '♦ r _ _. _CAA _ .. -.; I /,i.. ,'. .,.. !. •r'' '.is s f<, or f� r :r r r) t �P• 4' �e r•• I , v n t ••J i , r 1. .f, / R rpr 1. �• • .t. ,}4 .J•:.♦ .. :: .- , .. .,,t-. �,t..S :.. ..,,•, }-.. 1. tti � :. .._: ,, I �:, •. .� n " � .. ". .. 'r .,;;: M .., .ram•.'--r,.r__.....—..,. ;: .; I:, �.. NN 4 C yy1� [:,'T.{9,..,.� r,a,• :.. .:•. .!1.: tv. 'M.q' ,. I pt i 1. ,.: r .. '. •'^', r.f', ,err 1S1 ++ j 1 �•., •. ,; �1 :.. r• tir 1 S r . r ♦ •a T"�fh' Ir , � t r I .. ir • H EXPOSURE B WIND ZONE110 �� a r . '•i. Table 2. General NailingSchedule. 1 , 1 I 1 _ Number of Number JOINT DESCRIPTION m r o all Spacing r .,� ,:. ; .j:1 ,�, � \ ,�; ! , d.• ---- - - - Common Natls Box Nails 4 - •� i y.i r RFramingr • :• ,. ii' , f ,' ► :�� a o •r, r 1 r• �n w k 1 N +a r n r _... n o Rafter(Toe-nailed) 2-8d 2 10d each end �•Blocks t fter('r � l• � " Rim Board to Rafter(End nailed 16d each end , ., , . _,r,:._ •."�•,• , •r ', •. � .. ,.r .., ; �; 4,,. P ,t "1 1 {, .. .., t .! ? th n >rR— Roof Shea i !. J Structural Panels .` Wood tru i' t 6 edge/e/6 field , d u to 16 O trusses ace I Rafters r ru s P P / . • f t• n� t'r e/ field .. 10d .4 edge/4 Rafters or trusses s aced aver 16 - I ' b ... i ,.. ,.,.... ..,. ......... .. --'.' f i t 10d S edge/e/6 field ( . 8d Q t .. -. as _.. ,.. It�a.,•., +,,. +.M..••.,:. ..-,. .-, ,¢r,- •.. . . .. ,... ._,..,.., •. .Yet 1 /.. +. � able overhang' 9 dwa I rake or rake truss w/o rtt 9 Gable en I I. .�,r ai' w ,,,? . r, I. n• I , ., >: .;fi'; 1 .<��' •.ri.. b Y F- r.t a•� u f ,r •n t d 6 le ,, .k ',r rt• 1 <, •1 F �d 0o ens i I Y ral t 9 ct s w stru• /tru s t �..t wall k orrake e end rake ..Gable a b' b 1' a 1 d 10 d 4 d el field 1 1 J • t lock wl lookout b - •o ke s wall rake •ra truss Gabl e end r '•� � ---- .- ____. s.�,►__ spy _.:��fr , . :. ,;<,', •�'., '!"�� • '„ Ir : ._•fir._.--�-_.. _-_......— ..__-__.__.._.-.-.._ .r - r .. .. T.. .. ':-'.,,. i .,, � ',e ,_ "I � '� 9'H, h .. - ♦, :, shirr� . w •" _' .._.- - Ir ' Ii '• i !••! }' it •.,t , _ . M )r ♦ ' � P yJ,::r.V,i : i• ,, ,i; . e 1i;1 •, _{: ,,�t4;t:•:• ! �'4, a, ..gy�pp,1•.,''�'�l, .. , � '1i 'Y y t fi yt k — P I. 1 ar •�w f♦ M v v v s Y R02 , , F '14 I 1• e yy , s , r It .. _....-.....-.. .— -.__........._.._..._.. _.•..� __..__-•..__ � � 1 1 µ r � J _. r� t k 1 I � ' 1� '�! fir'♦ "S • pp 333 .. 1 RECEIVED I AUG 2 7 ?01 GROWTH MANAGE h"t~' . r •r , _ i - h .. J •'1'r:i.t 1 NL O C , . i 'u ' I' � _ r ;is i, 7. :l:• M ,1 fcrbT-�GcS � _ L R�.10Er�'1� ,a : r..t.,; , • , .. „ r' .. 'i "t •. �„�ta,�cs_�.Sw__..h1---:-- 1 ;,; ... :'�.,• ,.,, h. r ter: •�-�••4. - - •IKlip. , J' .� _ r O�i�VrT'4,r�,t�tJhC1Wi..•�rhP .. ...__ _,--,-•.•- ' , ., . •. •r:,ti.� �r>l'�s• :F ,�,'' , a: t , I t'•,7 �t ,r i , i. r tt t ':r • 1 �,,.. .'. •' - it I 1 •.' •...,. ,. ,; l�k' t,•t• '�t� ► I 3 '1 7 ii ,r �,.. .�• t' i y f• j L 1 , 4 ♦t M1I •t I'v 6' c F' 1 1 y .!y' ,f.. t .�;,� rein �rJ ;► , r. , , r 1 1 d• 1 I d r .a 1't 1 N ' Wa' nrR rl r s ;k` t 1 , I >; I P ti i I ,1' +pf ti;a r' r4 4�i A 1 r , } r'' 41 $ r .1► ,J I•' t y • ' n i , ,, ,?' ^r'� _ r '�1'•�!.��#�•�^_+IIr' 7- r'�.r�....li' — -t_.�. fr• f•,;�.^�r' 1Y 1r• i ,J 1 , gtl�w 4. _. A / �j I • . � , _ ., i' 4.r DRAWWp r . • • I f