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0030 BURSLEY PATH
i 0 UPC 12543 No.Sv. 3LOR: HASTINGS,MN �*VIN I Town of Barnstable Building t Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept HAS& Posted Until Final Inspection Has Been Made. Permit cJl Nud' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.on Permit No. B-20-2029 Applicant Name: Adam Glenn Approvals Date Issued: 07/31/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/31/2021 Foundation: Location: 30 BURSLEY PATH,WEST BARNSTABLE Map/Lot: 089-009 Zoning District: RF Sheathing: Owner on Record: CATIGNANI,BRIAN L&LAUREN E Contractor Name: HOME WORKS ENERGY INC. Framing: 1 i Address: 190 CONNERS ROAD Contractor License: 181138 2 CENTERVILLE,MA 02632 Est. Projict Cost: $3,978.00 Chimney: Description: Insulation and air sealing work in the home. No structural changes Permit Fee: $85.00 Insulation: Project Review Req: Fee Paid: $85.00 Date: 7/31/2020 Final: �C Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within�six months after'issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. 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 Final Gas: work until the completion of the same. . Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection -w_, _ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 0►iL-t., E,,,� Town of Barnstable � . .. Building SUB Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card'Must be'Kept - BARWM 14AM Posted Until Final Inspection Has Been Made:i63¢•`� Permit Jll Jll1 l� ram+ Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Pey.mit Permit No. B-19-556 Applicant Name: HAYES, KRISTA C Approvals Date Issued: 02/25/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 08/25/2019 Foundation: Residential Map/Lot: 089-009 _ Zoning District: RF Sheathing: Location: 30 BURSLEY PATH,WEST BARNSTABLE . Contractor Name:'-� Framingoti --�— Owner on Record: HAYES,KRISTA C I Contractor License: , 2 Address: 30 BURSLEY PATH f -- �- — - � � Est. Project Cost: $2,000.00 Chimney: WEST BARNSTABLE, MA 02668 Permit Fee: $85.00 } � Description: LEGALIZE PLAYROOM AND BEDROOM ABOVE GARGE. CREATE 5' Fee Paid:,{ $85.00 Insulation:4*�j- —Iq CASED OPENING IN PLAYROOM Date: ,' 2/25/2019 Final:w� — UPGRADE HOUSE FOR SMOKE DETECTORS in Project Review Req: Plumb g/Gas Rough Plumbing: f t=� Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afteyssuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. 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 Final Gas: work until the completion of the same. ; The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:, �,` Service: 1.Foundation or Footing j 2.Sheathing Inspection ` ' Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed-- 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage 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. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: ,� e�� , �a O Application Number . .. ...................................................... * MAS&B O LI ABU PermitFee.......................................Other Fee........................ s639 `��' 1L� IAJP FGS �'otal Fee Paid......................................n M .................. ...... "i e-YY�Zc�tlt TOWN OF BARNSTABLE h �Petmii/AppibYal by..WI D................On..(;1. ... ................. BUILDING PERMIT ? ......................Parcel.............�.. ....................... APPLICATION Section 1 — Owner's Information and Project Location Project Address W Xyr5l-et Pqt� Village_l/�t- rf�r� die Owners Name &L5tq C, Yq Y-e5 I ,Dv jI W 2 `Ptr r Owners Legal Address 57 Zo#=S Zq q e City Gt/ 5f &rg5a-e State L!J/ Zip 0a&6 Owners Cell #y ��� 1/9 6p E-mail ��( YOB! Lt14q`�I t et l Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet © iingle/Two Family Dwelling F-- Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure Ea"'Ciange of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment El Sprinkler System ❑ Addition ❑ Retaining wall ❑ . Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description Le ` Ze 1aWkv Last updated. 11/15/2018 Application Number..................................................... Section 5—Detail Cost of Proposed Construction ��.� Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom i Water Supply ❑ Public M'Ynvate i Sewage Disposal ❑ Municipal ©-15;Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes 0 o Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No 2 Section 8—Zoning Information Zgning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated 11/15/2018 it Application Number........................................... Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date k Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and f documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date f Section 10-Home Improvement Contractor I Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 f CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 1i--Home Owners License Exemption Home Owners Name: �75�a t Telephone Number 50$- 73 Cell or Work Number r. I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation re ' ed by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date t Print Name Telephone Number �-ff-9MI-I J ZCP E-mail permit to: t^ �`F/LtRi C�o�-r �� l'c,yb ,� Last updated: 11/15/2018 .Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I k7e r r , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date kern Print Name i Last updated: 11/15/2018 The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 1 / Please Print L 'b Name(Business/Organization/Individual): � 14, 14::�ef Y- % Address: 3n lu r,,�/e U City/State/Zip: , F f OoA,,69_Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition working for me in any capacity.acitY• employees and have workers' t 9. ❑Building addition [No workers' comp.insurance comp•insurance. ed] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.EJ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowner;who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cenYify under the pains and penalties o perjury th the in • n provided above is true and correct Sianafore: OA664W 2eL ate: a Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit(License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, 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 shallnot because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)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,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-insisted companies should enter their self-insurance license number on the appropriate fine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents O►ffice of Investigatiow 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.maw.gov/dia. I •- � .. ;. .. -, ... ,. V .�. .t -_ :ram: _ -�� J'.:Aaiv `p� '•sJ. rR•r. .1• L'�K 1• - r Y J.. 'l •:fir,+�� Y ..�;_ ., '• Y. _ _ �Z f�- 71. 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I{ B 1 .,�•_ V.. - sl'x'.r;r .7.� _ .it:.:.lt f.:(t•;r.;�rf'� r. i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application#&&o 61 Health Division Conservation Division Permit# Tax Collector Date Issued 0 Treasurer - Application Fee 5u, U Planning Dept. Permit Feed Date Definitive Plan Approved by Planning Board �� PfL Historic-OKH Preservation/Hyannis Project Street Address 30 Village Owner C�1J��� Address 7 Telephone Permit Request �� i/'� 2�� so �� L 1671c0 C� Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay ,Project Valuation F!ljMonstruction Type 'Lot Size * Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family "Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes o "C-Ki—ng s s 43 o Basement Type: Cl Full ❑Crawl a9'W Ikout ❑Other Basement Finished Area(sq.ft.) e�� Basement Unfinished Area(sq.ft) Number of Baths: Full:existing - new et Half:existing new c/5 T Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new t1i First Floor Room Count Heat Type and Fuel: G� as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes C9 o Fireplaces: Existing I New_� Existing wood/coal stove: ❑Yes Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: t c"T .i C^ Zoning Board of Appeals Authorization ❑ Appeal# -- Recorded❑ i r Commercial ❑Yes ❑No If yes, site plan review# `D Current Use Proposed Use BUILDER INFORMATION Name •�(' .Q (&P 15LA Lb6P—S Telephone Number Addressesex>se RA License# C�>t D PA� 15TP&Ce c lV4k 2 403nHome Improvement Contractor# f (0 Worker's Compensation# cy1 j cr— ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �J SP+3c Ni Fes, SIGNATURE DATE 7— CF —06 FOR OFFICIAL USE ONLY a . W P£RMIT NO. i DATE ISSUED MAP/PARCEL NO. ADDRESS, V ILLAG E OWNER " t DATE OF INSPECTION: FOUNDATION ! FRAME re— / s V INSULATION © ' � cje FIREPLACE ELECTRICAL: ROUGH . FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F t 6 . �\ 1/LG I.+VI/ui•vi•r►c�s•a�• v✓ 111 MYJ••..�w..�-�.. . \ Department of Industrial Accidents Office of Investigations a' 600 Washington Street Boston,MA 02111 y www mass.gov/dia Workers' Compensation'Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A_DDlicant Information Please Print Legibly Name (Business/organization/Individual): Address: 1�0 �jC� (� 4� City/State/Zip: b6fW MA 62&30 Phone#: Are yo employer? ChecI-appropriate boa: Type of project(required): 1, amaemployerwith 4. ❑ I am a general contractor and I 6 ❑ New construction employees(full and/or pme).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ 7 emodeling ship and have no employees These sub-contractors have & ❑ Demolition working for me in any capacity. workers' comp,insurance. 9. ❑ Building addition [No workers' Comp.insurance 5. ❑ We are a corporation and its I O.❑ Electrical repairs•or additions required.] ' officers have exercised their 3.❑ I am a homeowner doing all work right of exemption p er MGL 11.❑ Plumbing repairs ox additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance requited.] t . employees. (No workers' 13.❑ Other comp,insurance required.] *Any applicant that chech box#1 must also fill out the section below showing their warkers'compensation policy information:' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such 1coatractn&tbat checkthiafioa must attached an additional sheet showing the name of the subcontractors and their workers'amp.policy infor=ativn. I am an employer that is providing workers'compensation insurance or a s.—Below is e Information. `C,%1��� ��l�►� � .._ .. ' Insurance Company Name: �— Policy#or Self-ins.Lie.#: `' ` � Expiration Date: b Job Site Address: 30 oues PA7M' OZ&(V City/State/Zip: (JEST— Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).. Fa1'lure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andTena..Ities ofp ry that the information provided abovv7e is true and correct. -.T Si afore: Date: l (�'`— Phone# - Official use only. Do not write in this area,to be completed by city or town offzciaL City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department. 3.Ctty/Town Clerk 4.Electrical Inspector.5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, 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 Lobe an.employer." MGL chapter 152, §25C(6)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,MGL chapter 152,'§25C(7)states`Neither the comrn ealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of cono9liance with the insurance requirements of this chapter have been presented to to contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone mmmber(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 Dep artment of Industrial . Accidents foi confirmation of mmn*ance coverage. Also be sure to sign and date the affidavit. The-affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law.or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate lime. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. . - ofine affidavit for you to fill out in the event the Office of Investigations has to contict-you regarding the applicant.. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in_�_(cit}i or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that.a valid affidavit is on file for fiituze permits or licenses. Anew 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 Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406'or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www,mass.gov/dia - no QNR AppaWk 1 Table JS.Zlb(continued) Prescriptive Packages for One and Two-Family Residential Buildings Heated with"Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Arch'(•/.) U•valud R-value' R-value' R-value' wall Equipment EMciency' Package R-value° R-value' 5701 to 6500 Heating Degree Days' W, 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 l9 10 6 Normal S 12% 0.50 38 13 19 10 6 MAIM T 15% 0.36 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A N/A 85 AFUE W 15% 0.52 30 19 19 10 6 95 AFUE X 19% 032 38 13 25 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA I8°/. OSO 30 19 19 !0 6 90 AFUE 1. ADDRESS OF PROPERTY: 30 O Lw5 c-Ey 6iF—� I'03 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): a NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-fonns-f980303a Y w 4 Z +I 780 CMR Appendix J Footnotes to Table A2.lb: e` Glazing area is the ratio of.the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling.R-values do not assume a raised or oversized Truss construction: If the insulation-achieves--the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity, insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-b insulating sheathing. Wall requirements apply to wood-frarne or mass(concrete,masonry,log)wall constructions,but do not apply to metal-f wne construction. The floor requirements apply to floors over unconditioned spaces (such as.unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding. glass doors of conditioned basements must be included with the other glazing. Basement doors must meet tl'ie door U-value requirement described in Note b. The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see-Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC.test procedure or taken from the door.U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). I 43 r— ' RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.00 ,C70 of Change of Contractor/Builder $25.00 i FEE VALUE WORKSHEET NEW LIVING SPACE square feet x plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE `> D square feet x$64/sq. foot= Z` UzJl� x .0041= plus from below(if applicable) i . GARAGES(attached&detached) square feet x$32/sq. ft. = x .0041= 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 .0041= 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 $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 vaF�E Town of Barnstable ]regulatory Services ZBAPAS sa LA Thomas F.Geller,Director 16 9. e �p T ATED �1 � Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA b2601 www.town.b arnstabl e.ma.us Office: 508-862-403 8 Fax: 508-790-6230 i Property Owner Must Complete and Sign This Section. If Using A Builder �ISTO�I�,7 - �A Aes I, ' 1 , as Owner of the subject property hereby authorize F0G L E 4140 /)Wl 4 14-rf l LP�l2Sto act.on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) A-4 le Signature of Owner Date Print Name Q:FORMS:O WNERPERMMSION OFT E Ta Town of Barnstable Regulatory Services B^ MASS. Thomas F.Geiler,Director y 'MASS. �n � i639' �0 i°lFDNw'�0' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: &eL$ JQ Estimated Cost Address of Work: Owner's Name: Date of Application: —7--LQ ®�& I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: _`®.U69. 1 6-e—, - Date Contractor ignature Registration No. OR Date Owner's Signature Q:wpfiles.forms:homeaffid av Rev: 060606 r c BOA[®OF MELDING REGUI ATIONS Lioe: CONSTRUCTION SUPERVISOR .CS 01030 E _ B3rtl1�0e:OvAmn9'Jt •' -,� , — 4UMAMMWTr_nw 1122.0- ReWu _BEY P WRIGHT V{I dp(�I E:f Iii6 MMI OIL JAILM BARNSrABLE. MA _-;, . • t` i+ wkk •r: '�_ J U IQ ro o .� N' STc\kE Sf o V 0 . /V' ., \\Ix J /f \ REPARED FOR ►ul ► r>/,.t, Z t L_ 10 ,f :t CER TIFIED PL 0 T PL AN = W r sT �3.L�1Ziu STa,C7 lr C l✓1 v55. LOCATION SCALE: I''=4F'(:5' DATE: Ip— 2- t CIS q '.' REFERENCE LOT 5 s_.:a•_ap..: l L.C.P. _ E6'r"EIT II. FL 00D ZONE: .C„ '3 HI!l".RLEY i+> I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE w GROUND AS SHOWN HEREON, AND THAT IT r%r;;�,�• CONFORM TO THE ZONING _ BY-LAWS OF THE TOWN Of- WHEN CONSTRUCTED. Fr LOW A WEL L ER INC. 714 MAIN SThEET �_� ?.� J , RMOUTH, MASS. DAT `'N( TOWN OF BARNSTABLE Permit No. ..,3,332,1,.... BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash 7 .Y� ,6�9• x HYANNIS,MASS.02601 Bond L' CERTIFICATE OF USE AND OCCUPANCY l Issued to Joseph Danzilio ! Address Lot #36, 30 Bursley Path West Barnstable, Mass. 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. July..27..........., 19.....99........ ......... ... q ............. G . Buildi g Inspector i { TOWN OF BARNSTABLE Permit No. . BUILDING DEPARTMENT I ' I TOWN OFFICE BUILDING Cash ......... 61+ HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to Addressy 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. i .......... 19.... ............ .... ....... .................. i Building Inspector a Assessor's office(1 st Floor): p n n R ALLE® Assessor's map and lot number 0 l �) o / 4AM.��• WITH��® �Qc� Tod o Board of Health(3rd floor): i, EX14R®NM fi TITLE ��• ro Sewage Permit number 7• �`l—53 22� . ENTAL C� •T TOWN AEGfJLA119 i '� AXLE Engineering Department(3rd floor): r� rues , House number 3639. \0m Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUI D NG , INSPECTO APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location En f 3 C. ( -i� C,V-`^ G1/1 Proposed Use Zoning District / t / Fire District r Name of Owner o s-e 0 C�,wz,^\c(. Address 1 '01 L( S u jjo L r % S C VKCt jr-ilo uY O OACk, Name of Builder \bcAwz2�\ (C. Address R G VI&V1 Ci LA WyC4 Lt\A�S VACX Name of Architect Address Number of Rooms �, Foundation C P VIA`P yl Exterior r?-e Ck ar Q Roofing �' S O�A v` Floors •P rk0aVIA ECG — '1W O O Interior C1 S'�'Q r Heating C9 C:. S -- �V� Plumbing�Y S Fireplace Y `p S Approximate Cost 0 O CD © � (� • H°use 1300 2 Area �Gar--c'�S 2 S 7 Co Diagram of Lot and Building with Dimensions Fe / . �r7 06 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - Name \ ` 1 Construction Supervisor's License a`{C4 J C '.' DANZILIO, JOSEPH y Flo 3 3 3211 Permit For Two Story Single Family Dwellinq Location Lot #36 , 3n B 7rS1PV Path t� 1 West Barnstable Owner Joseph lanai l ie A Type of Construction Frames s' Plot Lot Permit Granted Oct 2 7, - 19 89 Date of Inspection �l �o `-U 19 D to Completed oS�a 19 � t gb--, C?t� r � 04 N11 two 2 1 'TOWN.-OF BARNSTABLE, MASSACHUSETTS BUILDING * PERNII.1 I f ts=089—U09 .r DATE 19_ PERMIT NO 3314,1 i 3 Vr7. .• APPLICANT ^i1,lf'� { i),`r' ADDRESS •i-'I., tit ' (N0.) (STREET) '(CONTR'S LICENSE) ` NUMBER OF PERMIT TO 1�111.1C ;i't`If• , ! (_`) STORY_ •. 11.'c..;i i _ :.1 J - DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (I"11 OI'11'.I II"i.') ' ZONING. I�AT (LOCATION) _-;i'i' Si:} •'I -_ DISTRICT (NO.) (STRFI"rl BETWEEN AND—, ' (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LO7 BLOCK- SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTI( TO TYPE USE GROUP _BASEMENT WALL:, OR FOUNDATION (TYPE) REMARKS: �4',YuC;('y y: C•J"' :1 :< �'� ' ' I3C) 1t1 AREA OR VOLUME 1', /U ;_'.., ESTIMATED COST — l•' MIT $ 145� /J ' ' (CUBIC/SOUARE FEET) FEE OWNER BUILDING DEPT. //7 -..r.,. v ADDRESS 1..it AL!(:):il.. BY '/_T//:I/{ .• f. 1 _ — t I THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY Sl ::- Al I'. ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER a •s,2C�.'�� TEMPORARIC�Y'.) PERMANENTLY. ENCROACHMENT$ ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE `MU$T48�A) _ PROVED BY THE JURISDICTION. STREET OR ALLEY Gr AOES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS'M A.Y, BE�O,B T'/?,INE i01_0-•FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE_ OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM,TIjE'CiOJJ' _OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ,y.�v `•;50� MINIMUM OF THREE CALL WHERE APPLICA'BL T EAINED ON JOB AND THIS \:QWSE4p"' �• INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE R ED; O ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQU,IR 5. � 'Rt { ELECTRICAL,''pC'UMB�It:�G %9N0 I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSIT�A'L4Jp/ ��IP S, i 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL 1')�1"�%�? ��"a 1 MEMBERS(REAOY TO LATH). �"'•,,� .•.�.�! 1 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. '•L. .';' /! POST THIS CARD SO IT IS VISIBLE FROM STREET : $, BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS " 1 r: z 'J�ytl;i ,,pp l p n 11 J j=�• ..lx . { 3 HLArING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER — BOAR HEAL �qq L ,p 1 WORK SHALL NOT PROCEED UNTIL THE INSPEC- ?E RM I T 'W!L L B C C Om E NULL AND '/O I D CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT,STAR FED WITHIN SIX MON-'!S OF DATE THE � ARRANGED FOR BY TELEPHONE OR WRITT CONSTRUCTION. PERMIT iS ISSUED 4S NOTED ABOVE. NOTIFICATION. TOWN.Of BARNSTABLE, MASSACHUSETTS BUILDING PERMIT DATE Jt:'LG'b..:L' %'7 , 19 89 PERMIT NO.• � APPLICANT - IIjC-}'Ifio1 I);.In :l 1 i [, ADDRESS 35(� -, i'lecia.1 1Wad, Hi/uTlniz; —rv-a-2 ti T—i IND.) (STREET) (CONTR'S LICENSE) [• ' h NUMBER OF PERMIT TO BL111C3 iiln7l'_'i l_I-t7c:� (i`I STORYJI.•CI C,j k'c,!',li 1 V 1)S4E9111i2C.� DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) ° ZONING AT (LOCATION) .[7f' =r�(�r -�:) "al'r • 1'�-''••l 17J - Y-+• - �� DISTRICT INA (STREET) BETWEEN AND (CROSS STREET) (CROSS 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 [� •1 [y I (TYPE) REMARKS: Sewacre it 1'4 89-211 ' FK 89-"J31 Bond AREA OR ' VOLUME 1876 ft. ESTIMATED COST $ 100, 000. 00 FEEMIT.$ ,j %j (CUBIC/SQUARE FEET) ' OWNER JCi':iLp7i 'J112211.1U ,e,..�•� re^- •.>'i BUILDING DEPT. ADDRESS BY j5 A'l1C I7L12<P J BY THIS PERMIT CONVEYS NO RIGHT 70 OCCUPY ANY STREET, ALLEY OR SIDEWALK OR-ANY PART THEREOF, EITHER;TEMPOR7ARIL•Y.:�fljR�`.: PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,' ST PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MA.Y,�B'E�t!O,B7AINEDS{ FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM.T�HE°,C`O.NDITIONS, _OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. 'j MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICAB'L`E15EP`A�}•ATE�' INSPECTIONS REQUIRED FOR CARD KEPT POSTED UN PERMITS ARE ;FO R. a. ALL CONSTRUCTION WORK: TIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUM B,IrNSif eAND'' •Y A MDE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INS.T`AU."'ip:JONSsi.+i%: I. FOUNDATIONS OR FOOTINGS.2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL G""' f;r'• MEMBERS(READY TO LATH). •r ae: 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. )'::''':;',• OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET s BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS -kLLple a 2 2 . f Trno PIS . 2 ../ ' S►� �- . q- 90 j r i 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER BOAR HEAL WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION -INSPECTIONS INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS-APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED =nR BY TELEPHONE OR WRITTEN CONSTRUCTION. lI PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICAIIw,' " .................. >M. .:s.'. .► �:•: s:" �; ,•., :;t .7 zap:.`:r,;',' 3 ,.. '��,�.�:r�,�• _ i i '�"' r 'q'�'o''st.:.0 C ,7, :,, •H" 7?, v! - a •l',Mri � arh' i b e it a� �+4' �. 'F'r .r�"lk., ;T•� ..a'�„Y •4 :I�'�•�r�. ••x "4- � ♦- i i �. 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