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0156 CAPES TRAIL
�: \ �_ J �� �� I I :� I f ♦.�.� gin'. �.`„!, try, Y x M ��, , - �. i � �� l t { ��,q �J E 1 0 �o�c � lcc ed lo�q�6 i t Application number QaFee ........................................ Building Inspectors Initials........... �................. 165 0) Date Issued....................LatiVii-01..................... Map/Parcel....0..KY...... let TO.W" N' OFBARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 16 NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: 5z &� C�Cell Phone Number 737—71� Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize 14 ri2w to make application for a building permit in accordance with 780 CA Owner Signature: Date: TYPE OF WORK Siding ❑ Windows (no header change)# ED Insulation/Weatherization Doors(no header change) # Commercial Doors require an inspector's review E3 Roof(not applying more than I layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)#. (attach copy) Construction Supervisor's License# 65 (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE S70ROU—CTURES OVER 75 YEARS OLD OR IF THE SUaIECT PROPER TY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION.NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE i Signature Aftl qaLQ Date 10. 16. 2U� All permit applications are subject to a building offs ial's approval prior to issuance. r E I qo TO - - TIME DATES ",K ham. y - �YuuFRE ®V DR6EAI� ceEephone ;. ��ltetumed Palled ion �� OF ���IeaEse�' r��' ❑Wanh to£r�� wll f yo„ s PHONE �iNdiwll �You91 ; MESSAGE OPERATOR: C AA 23-024-400 SETS 23-027-200 SETS ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly f Name(Business/Organization/Individual): Address: 53 City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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 8. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp. insurance comp.insurance.: required.] 5. Ulwe are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑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 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 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 certify der the ptbifa enaldes of perjury that the information provided above is true and correct. Signature: Date: 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#: r z, 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 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 afdavit 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 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 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 Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia w Commonwealth of Massachusetts Division of Professional Licensure `®l Board of Building Regulations and Standards Constrt�Cti�r��i�p�rvisor CS-061665 iR ires: 07/01/2021 WILLIAM E FP'kRINGTQ 17 JAN SEBASTIAN Er13 % SANDWICH to C)/S�3d0 Commissioner �G.�c • .Office of ConsurnAP. Affairs and Business Regulation (oCABR) HIC Registration Complaints 7 Registration 0 115356 ' Registrant FARRINGTON BUILDING&REMODELING,INC. 4, IName WiLLIAMFARRINGTON I IAddress 33 BOARDLEY RD. .. pity,state Zip SANDWICH,MA 02563 / Expiration Date 051082020 Complaints DgWS . .a NoTComplaints found for this reg'st—L -"'Y'—w an also iaw arbifradon and Guerenty Fund hi-ton. Town of Barnstable L 'n Bulldl g s ),Post This Card So That it is Visible From the Street-Approve_d Plans Must be Retained on Job and.this Card Must be Kept RAPJWABM MA,S& IPOsted Until Final Inspection Has Been Made. bO. R :Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. I Permit a...._ __ .... � .. .- -- -......_......r,.......,.....tea_..............,_. _.....M...«.-.-..._-. ..__,.� «__. .�. ...�. Permit No. B-19-2286 Applicant Name: FARRINGTON BUILDING & REMODELING INC. Approvals 'Date Issued: 08/06/2019 Current Use: Structure Permit Type: Building-Addition/Alteration- Residential Expiration Date: 02/06/2020 Foundation: Location: 156 CAPES TRAIL,WEST BARNSTABLE Map/Lot: 088-006-007 Zoning District: RF Sheathing: Owner on Record: YOUNG,MICHAEL PATRICK&MARGARET M Contractor Name: FARRINGTON BUILDING & Framing: 1 REMODELING INC. Address: 156 CAPES TRAIL 2 Contractor License: 115356 WEST BARNSTABLE, MA 02668 Chimney: t Description: ADD 16'X 20"FAMILY ROOM, EXTEND KITCHEN 12'X8' BUILD Est. Project Cost: $ 125,000.00 16'X16' DECK Permit Fee: $687.50 Insulation: ' Fee Paid: $687.50 Final: Project Review Req: _ Dater 8/6/2019 Plumbing/Gas Rough Plumbing: Final Plumbing: SO -This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuan All work authorized by this permit shall conform to the approved application and the approved construction documents foe 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. i %y t ti I - -- 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:i , Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 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 �IHE Application Number... , * •ARNSrABLE. + . MAS& Permit Fee............ . .............. ........Other Fee:....................... 639. RFD Total Fee Paid........ . .... . ... .+ . .. ...................... ...... TOWN OF BARNSTABLE Permit Approval by...qM),,,,,,,,,,,,,,pn,. BUILDING PERMIT Map................ .. .............. D Parcel....... .(o.... ... ......... .... APPLICATION Section 1 — Owner's Information and Project Location Project Address ' (yam. �na t' Village t &A S+Irl,W e— Owners Name {"la�r & TTV e+ lit Vt Owners Legal Address (a We �y � u� city �` cL��� � � ZE state M to - Zip O o96& � .- Owners Cell #56� -- 3� "� C7 E-mail ` O L L n �C- '�S� C , a.:- ham, Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System X Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 - Work Description A844 16 x ZD T7rL nn I l y Roo/�-A 3 � y AA A l 6 'fie c h J• Last undated: 11/152018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction (9LSr 00 b• C o Square Footage of Project Age of Structure 0 Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 0 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wing ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom ` j Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane ❑ Yes ❑ No Section 7 —Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ H Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard Required 00 Proposed Rear Yard Required_ Proposed �-t P Side Yard Required_ Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 Application Number............................................ Section 9= Construction Supervisor Name W i 0 1 a✓v) L' +O n Telephone Number S G 2 O Address 1 -7 TL—) Of I-, (-) State M Zip ©a's 3 License Number CS-0�,1 6 LS License Type 6 u Expiration Date b-7 © t a 1 �1 Contractors Email —C' Y✓'b O�OCo rnCo�S�, Cell # 0$' b b — I O b I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 C and the Town of Barnstable.Attach a copy of your license. Signature �` Date O '0 Section 10—Home Improvement Contractor ; Name W III 0-w1 'i::VL Telephone Number S 6 _ S( a O Address I-1 yA-n S-,lS}iAr,Dz Gi W►c �n State t%4�q Zip 0 9-S 3 5 o,'},e ( 3 Registration Number Expiration Date 0b ( O 8 I a O a O I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date �7 ' ( O 1 1 C) Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date /, Print Name.VJ t I (,,IV yv Telephone Number,569 E-mail permit to: W i l IA 1 _ V 1 2%�Y rjyw l ( d 4�vw-v—'6 1 C d r CAS-- , V�--E— Last updated: 11/15/2018 .. i y 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 MAQGRQC_1 `IDLING as Owner of the subject property hereby authorize' W (LU A K�, FA Qki M GT O to act on my behalf, in all matters relative to work authorized by this building ermit application for: t. �56 MPCS TP-AIL WEST biANSTA (Y)h C)ZbbK (Address of j ob) A Inn 10 1c, I t\D 9 - 11 - O( 9 Signature of Owner date MA RGAeE T Print Name f { P4 1 (C, I N Last updated: 11/15/2018 t y4 —70�� r rq I Emil 111 30] _ wl■w�lw ■1■i� '� w wi 1�11■I ■I■I�i �I�I■ wrr ■■■ ■■ r�i _� I doll _ ■.'.tea I�I■I■ u .��iiu�� l�l� . !■I■I■� !►�I■I■ ��■■�■,.�;���� ■'/ � !■I■I■ � �l■ `11111 'Iii�ii ■ .I -� h� .. __ iliii — oil w ■m..■�.�_r Ii1i�l� l�I a.�� ■I Iwu� ww■ �I �� _Ir 1 �u� ■�lin_n�-� II ! �■�il W ■ �=��■nls■■. .1 � nt.� IIt�I�IJ�i� ■■Iw �� �� 'W.+..a➢._Ltl•.gii'i,-�'n�`- ✓_.,t :r- -. 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I� x 163.97 c� / ,' �x 1 C�j• � 3-500 GALLON CHAMBERS N 1� i SURROUNDED W/4' STONE Pse. '' �' I PROPOSED SEPTIC TANK T - , 152.66 156.s , ; . 11 BENCHMARK r' % 2.42 9� HED I i LT. FRONT COR./RAMP EL.=157.17 088-007-004 '�96 161. RET 7.2 x I HOUSE#170 57.83 152.43 t- &O 4:1 _ x 157.84 p p - �(H OF 41gS,p_ r 15 . N 155.801 �GtA EX. \ x tARY S.LABIR �65 DEc 158.60 I (remove NO.40039 �• o 62.3' ` ,� 0 I I 157.29 1s7.671 EXIS77NG i M, 8 J HOUSE(#156) GARAG L\ 157.68+ 158.45 //�- .39 EX. WELL x 158.74 v c yG PETER T. J' - McENTEE ° (7 nl O N 159.12`'r. ''': frT60.03X WELL v CIVIL - a° : ls9.la15�"L 05 � No. 35109 x 1s9.228 XL 'PAVED; x 16o.aeS 5x GIST ` ps.• 24 `DRIVE E A-86. t 159.35 t59.91+I60.44 A�4.94. 0. 158.39 R-275.00 r.. :• I :` �• 9.96 / - FLOOD ZONE DESIGNATION 1�.54 edge °f 160.54 NON HAZARD-ZONE X Povernent ZONING CLASSIFICATION: ZONE RF 160.20 160.57 SETBACKS: FRONT YARD=30' OWNER OF RECORD SIDE/REAR YARD=15' YOUNG, MICHAEL PATRICK & MARGARET M TRS CAPES TRAIL LOT AREA = 43,560 SF 156 CAPTAINS TRAIL MAXIMUM BUILDING HEIGHT = 30' WEST BARNSTABLE, MA 02668 WIND EXPOSURE CATEGORY: Exposure B Engineers: Surveyors: SCALE DRAWN JOB. No. PROPOSED SEPTIC SYSTEM SITE PLAN Engineering Works,Inc. Warwick&Assoc.,Inc. 1"=30' P.T.M. 144-14 12 West Crossfield Road Box 801-63 County Road DATE CHECKED SHEET No. 156 CAPES TRAIL WEST BARNSTABLE MA Forestdole, MA 0264-4 North Falmouth, MA 02556 (508) 477-5313 (508) 563-7777 6/4/19 P.T.M. 1 of 2 Prepared for: Michael Young, 156 Capes Trail, West Barnstable, MA 02668 v NOTE: TO PREVENT BREAKOUT, THE PROPOSED FINISH GRADE SHALL NOT BE < EL:153.7 FOR A DISTANCE OF 15' AROUND THE PROPOSED SEPTIC TANK PROPOSED D-BOX PERIMETER OF THE S.A.S. INSTALL RISERS & COVERS OVER INLET AND INSTALL WATERTIGHT RISER & PROPOSED S.A.S. OUTLET. SET TO 6" OF FINISH GRADE. COVER SET TO 6" OF GRADE. PROVIDE ONE ACCESS MANHOLE TO WITHIN 3" OF FINISH GRADE FOR INSPECTION PURPOSES. T.O.F.=159.43 F.G. EL: 156.0 to 158.0t F.G. EL.=86.2 F.G. EL.=156.0t ,- F.G. EL: 155.0t VENT / MAINTAIN 2% GRADE (MIN.) OVER S.A.S. L = 55' L = 15' L 23'(MAX.) ® S=1% (MIN.) p S=1% (MIN.) @ S=1% (MIN.) 4"SCH40 PVC 4"SCH40 PVC 4"SCH40 PVC 6" IT 0"I 96 as 14, 6 aa9 aaa aaaa00 INV.=153.50 48' LIQUID aaaaaaa LEVEL 4' 4.8' 4' INV.=154.60 GAS BAFFLE INV.=153.60 PROPOSED INV.=153.43 EFFECTIVE WIDTH = 12.8' INV.=153.75 D-BOX INV.=153.20 H-20 RATED 3-500 GALLON LEACHING CHAMBERS PROPOSED SEPTIC TANK SURROUNDED WITH STONE AS SHOWN ' H-20 RATED TOP CONC. ELEV.=153.3t BREAKOUT ELEV.=153.70 INV. ELEV.=153.20 aaar33.5' aaa aBaaa ease ease NOTES: BOTTOM ELEV.=151.20 1) SEPTIC TANK & D-BOX SHALL BE SET LEVEL AND TRUE 4' 3 X 8.5'=25.5'TO GRADE ON A MECHANICALLY COMPACTED 6" CRUSHED 4' MIN. ABOVE BOTTOM OF EFFECTIVE LENGTH = BASE, AS SPECIFIED IN 310 CMR 15.221(2). T.P. EXCAVATION OR G.W. 2) INSTALL INLET & OUTLET TEES AS REQUIRED. LEACHING SYSTEM SECTION NO GROUNDWATER, EL.=145.2 - 3) GAS BAFFLE TO BE INSTALLED ON OUTLET TEE AS MANUFACTURED BY TUF-TITE, ZABEL OR EQUAL. 3/4" TO 1-1/2' DOUBLE WASHED STONE SEPTIC SYSTEM PROFILE 3- LAYER OF 1/8- TO 1/2- DOUBLE WASHED STONE N.T.S. (OR APPROVED FILTER FABRIC) GENERAL NOTES: . SOIL LOG 1. ALL CHANGES TO THIS PLAN MUST BE APPROVED BY THE LOCAL BOARD OF HEALTH AND THE DESIGN ENGINEER. DATE: MARCH 8, 2019 (REF#15,923) 2. ALL WORK AND MATERIALS SHALL CONFORM TO THE REQUIREMENTS SOIL EVALUATOR: PETER MCENTEE SE#1542 OF THE STATE ENVIRONMENTAL CODE, TITLE V, AND ANY APPLICABLE WITNESS: DAVID STANTON IRS RULES AND REGULATIONS EXCEPT AS REQUESTED BELOW: HEALTH AGENT -310 CMR 15.405(1)(b): 1) A 3' variance to the 3' maximum cover requirement, for up to ELEV. TP- 1 DEPTH ELEv. TP-2 DEPTH 6' of max. cover. S.A.S. shall be H-20 and vented. -LOCAL REGULATION Chapter 397-8(E), Well Locations: 156.6 A 0 158.2 A 0 2) A 10' variance, S.A.S. to Well (Locus), for a 140' setback. SANDY LOAM SANDY LOAM for a 125' setback. 10YR 4/2 -_ t __1.OYR._4/2 3) A 37' variance, S.A.S. to Well (house #140), for a 113' setback. 155.8 B g" 157:4 B 10" 3. THE SEWAGE DISPOSAL SYSTEM SHALL NOT BE BACKFILLED PRIOR SANDY LOAM SANDY LOAM TO INSPECTION AND APPROVAL BY THE BOARD OF HEALTH AND THE 10YR 5/8 10YR 5/8 DESIGN ENGINEER. 153.6 36" 155.4 34" 4. ANY CONDITIONS ENCOUNTERED DURING CONSTRUCTION DIFFERING C PERC C FROM THOSE SHOWN HEREON SHALL BE REPORTED TO THE DESIGN 42"/60' ENGINEER BEFORE CONSTRUCTION CONTINUES. 5. ALL ELEVATIONS BASED ON ASSUMED DATUM. 6. THE DESIGN ENGINEER IS NOT RESPONSIBLE FOR THE FAILURE OF THE CONTRACTOR OR OWNER TO NOTIFY THE LOCAL BOARD OF HEALTH FOR PROPER INSPECTIONS DURING CONSTRUCTION. SANDY LOAM SANDY LOAM 7. WATER SUPPLY PROVIDED BY PRIVATE WELL. 10YR 5/3 10YR 5/3 8. WELL LOCATIONS ARE AS SHOWN ON PLAN. 9. ALL AREAS CLEARED FOR CONSTRUCTION SHALL BE RESTORED AS AGREED UPON BY OWNER AND CONTRACTOR OR AS OTHERWISE DIRECTED BY THE APPROVING AUTHORITIES. 10. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY 145.2 132" 147.2 132" THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING CONSTRUCTION. PERC RATE 6 MIN/IN. ("C" HORIZON) 11. WHERE REQUIRED, CONTRACTOR SHALL REMOVE ALL UNSUITABLE SOILS NO GROUNDWATER OBSERVED IN THE AREA BENEATH AND FOR 5' ON ALL SIDES OF THE S.A.S. AND REPLACE WITH CLEAN SAND AS SPECIFIED IN 310 CMR 255(3). 12. AREAS REQUIRING STRIPOUT OF UNSUITABLE MATERIALS SHALL BE INSPECTED BY DESIGN ENGINEER PRIOR TO BACKFILL. �QQ� DESIGN CRITERIA ° ° NUMBER OF BEDROOMS: 3 SOIL TEXTURAL CLASS: CLASS II DESIGN PERCOLATION RATE: 6 MIN/IN (0.60 GPD/SF LOADING RATE) DAILY FLOW: 330 GPD DESIGN FLOW: 330 GPD j o GARBAGE GRINDER: NO j LEACHING AREA REQUIRED: (330 GPD) = 550.0 SF o, O 0.60 GPD/SF hr°j 0 'off PROPOSED SEPTIC TANK: 1500 GALLON CAPACITY PROPOSED DISTRIBUTION BOX: 1 INLET, 3 OUTLETS ��j,•/� �v hc� USE 3-500 GALLON LEACHING CHAMBERS IN SERIES SURROUNDED BY DOUBLE WASHED STONE ON ALL SIDES SIDEWALL AREA: 2(12.8' + 335) X 2 = 185.2 S.F. SHED ry BOTTOM AREA: 12.8' x 33.5' = 428.8 S.F. TOTAL AREA:............................................ REA:............................................ ........ ..........614.0 S.F. SEPTIC LAYOUT DESIGN FLOW PROVIDED: 0.60 GPD/SF(614.0 SF) = 368.4 GPD Engineers: Surveyors: SCALE DRAWN JOB. NO. PROPOSED SEPTIC SYSTEM SITE PLAN Engineering Works,Inc. Warwick&Assoc.,Inc. N.T.S. P.T.M. 144-14 � 56 CAPES TRAIL WEST BARNSTABLE MA 12 West Crossfield Road Box 801-63 County Road Forestdole, MA 02644 North Falmouth, MA 02556 DATE CHECKED SHEET NO. (508) 477-5313 (508) 563-7777 6/4/19 P.T.M. 2 of 2 Prepared for: Michael Young, 156 Capes Trail, West Barnstable, MA 02668 QN The Commonwealth of Massachusetts Department of IndushWAccldents Office of Investigations IF 600 Washington Street Boston,MA 02111 www.nmssgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information I , Please Print LI ezibly p Name(Business/Organization/individual): FA.YVl n4l� �y1 1�l,►�G��— 1�� �1�' I�►/ZG'� i 1 Y1C , Address: —1. a&Y-)Je 15R , S u 1-—_ t 3 J City/State/Zip: n�V�d VV l C�I M A 6�),S3Phone#: - ,S l Q p Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). 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 workingfor me in an capacity. employees and have workers' Y aP h'• 9. ❑Building addition [No workers'comp.insurance comp•insmanceJ required.] 5.,� We are a corporation and its 10.❑Electrical repass or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire offside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors 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 and job site information. Insurance Company Name: N I� Policy#or Self-ins.Lie.#: 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 certify u er the lutgadp of perjury that the information provided above is true correct Si Date: Phone#: JZ`"'6ci�) — S (� — S I O O Official use only. Do not write in this area,to be completed by city or town qfficiaL 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 budding 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 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(LLQ 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 confamation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Sheet Boston,MA 02111 - Tel.#617-727-4900 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www:mass.gov/dia [__DATE(MM/DDIYYYY) ACORN® CERTIFICATE OF LIABILITY INSURANCE 07/12/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terns and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME: Michelle Wolf HUB INTERNATIONAL NEW ENGLAND LLC A FTkX /c No. o Ext: (781)792-3298 AC No: E-MAIL ADDRESS: michelle.wolf@hubintemational.com 600 LONGWATER DRIVE INSURERS AFFORDING COVERAGE NAIC1i NORWELL MA 02061 INSURER A: AIM MUTUAL INS CO 33758 INSURED INSURER 8: FARRINGTON BUILDING& REMODELING INC INSURERC: INSURER D: 17 JAN SEBASTIAN DRIVE SUITE 13 INSURER E: SANDWICH MA 02563 INSURER F: COVERAGES CERTIFICATE NUMBER: 424433 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF EXP MM DD LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: L GENERAL AGGREGATE $ POLICY PRO ❑LOG PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per a.ZI $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE $ DIED I I RETENTION$ $ WORKERS COMPENSATION X STATUTE ERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDE1 N/A NIA N/A AWC40070322682019A 03/14/2019 03/14/2020 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.govAwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02061 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Commonwealth of Massachusetts ; V-( Division of professional ulatioicensure nsLand Standards Board of Building Reg Constri t6^6bervisor yi �ires: 0710112021 CS-061665 �`i��a� •� WILLIAM E F IN GTA 1 E 3 C ! V JAN SEBASTIAN�DR 1 SANDWICH 02�563e, IS" Commissioner 1 0 Office of Consumer'Affairs & Business Regulation- Mass.Gov Page 2 of 2 Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Sunday,July 14, 2019. Search Results Re istrantNamdRESPONSIBLBtEGISTRATMDRESS EXPIRATI A 'U INDIVIDUAL NUMBER I DATE FARRINGTON ;FARRINGTON, 115356 33 BOARDLEY i06/08/2020 Curre t BUILDING & iWILLIAM IRD. REMODELING, ;SANDWICH, MA I INC. _ 02563 I Site Policies Contact Us © 2018 Commonwealth of Massachusetts. Mass.Gov® is a registered service mark of the Commonwealth of Massachusetts. https:Hservices.oca.state.ma.us/hic/licenseelist.aspx 7/15/2019 License some age Application Submitted- Logout� Y Your application has been submitted and all fees have been-applied to your credit.card. Please print this page as your proof of submission and receipt of payment. Application Information Date Submitted:_ Monday, July 8, 2019 Applicant Name: WILLIAM E FARRI1 GTON License Number:: CS-061665 Agency- MADPS Process: Renew License process Payment Information . Authorization Code. 189002 Received Date: W81201910:48A O Alin Received Amount:. g100.00 Print Recejtpt._, Design of Beam 1: YOUNG RES Beam#1 INPUT Floor I Live Load ( K /Ft A2) : 0.98 I Slope 0 in 12 Code : 1BC I Dead Load ( K /Ft A2) : 0.53 Species wet use : No I Snow Load ( K /Ft A2) : 0 I Grade Rep. use : No TL Deflection : L/300 I Trib. width : 1' -0" Lt. Cant. : N LL Deflection : L/360 DOL : 100 Rt. Cant. : N I Pattern Loading : Yes i side Loaded : No SPAN DATA (Length is to center line of bearing) SPAN 1 Length 24' -0" Actual 124' -1.75" Brg. 3.5" 0" Min. 0" 0" Total Length : 24' -1.75" ADDITIONAL LOADS (Distances are from left end) Units: K Ft REF I LOAD I LOAD I DISTANCE I LOAD ( BEGIN I END NO. CASE TYPE TO START LENGTH ( VALUE VALUE 1 D C 12 1.00 2 1 L I c 112 I I 1.60 I MEMBER SELECTED Steel WF w12x58 IS MEMBER OK? Yes CRITICAL STRESSES SUMMARY CONTROL REACTION I BENDING ( SHEAR ( LL-DEFL I TL-DEFL ( In) I ( In/Lb A2) ( ( In/Lb A2) I ( In) I ( In) MAX VALUE 11.942e+004 I -1.913e+004 I -4425 I -0.589 I -0.912 % OF ALLOW I n/a ( 80 I 30 73 95 LOCATION ( 24' -0" i 12'-0" ( 24'-0" ( 12'-0" I 12' -0" MAXIMUM HANGER FORCES L ZX6 u/,,,O-In-(LEFT)-----------O-In (RIGHT) 12.19 In. Deep --- -- --------------------------------- - WOO 1.942e+004C 1Q 1.942e+004 lbs Max 686 ��C�� 14V A325X 6860 1 bs DL 1.256e+00 1.256e+004 lbs LL 1.9e+004 �O�'/ �c p �2( 1.9e+004 In General Notesf SidxiQxl (ffwx 7"l bi 14. 1. Beam weight is assumed to be included in Dead Load. 1, 0 gss9c 2. Load locations given are measured from the left end y of the structure. L ►A 0. 3. Locations of maximum moment, stress and deflection are ' P measured from the left end of the structure. Noe AL co 4. Bearing across full width of beam is required. Q� 5. structural adequacy of supporting members must be confirmed. ,°�F s�°/STERE°��� `4 6. Bearing lengths required maybe limited by bearing stress. on °NAME" U supporting members. 7. A negative reaction indicates that the beam must be fastened to the support to resist uplift. 9 r'anti 1 avar daft anti nn al l nu►ahl ac ara hacad nn tu6 ra tha cnan 1 annth REScheck Software Version 4.6.4 Compliance Certificate Project Energy Code: 2015 IECC Location: West Barnstable, Massachusetts Construction Type: Single-family Project Type: Addition Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 156 Capes Trail Farrington Building West Barnstable, MA �pompliance: Passes using UA trade-off Compliance: 2.8%Better Than Code Maximum UA: 109 Your ILIA: 106 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies Gross Area Cavity Cont. Perimeter Ceiling 1: Cathedral Ceiling 600 38.0 0.0 0.027 16 Wall 1: Wood Frame, 16"D.C. 710 20.0 0.0 0.059 34 Window 1: Wood Frame:Double Pane with Low-E 90 0.300 27 Door 1: Glass 42 0.300 13 Floor 1: All-Wood joistfrruss:Over Unconditioned Space 480 30.0 0.0 0.033 16 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2015 JECC requirements in REScheck Version 4.6.4 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Anderson Insulation plc-amPCCC rally 7/15/2019 Name-Title Signature Date Project Title: Report date: 07/15/19 Data filename: Untitled.rck Pagel of 9 REScheck Software Version 4.6.4 Inspection Checklist Energy Code: 2015 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified Field Verified # Pre-Inspection/Plan Review Complies? Comments/Assumptions & Req.ID Value Value 103.1, !Construction drawings and ❑Complies 103.2 ;documentation demonstrate ❑Does Not [PR1]1 !energy code compliance for the ❑Not Observable building envelope.Thermal !envelope represented on ❑Not Applicable !construction documents. 103.1, ;Construction drawings and ❑Complies 103.2, documentation demonstrate ❑Does Not 403.7 ;energy code compliance for [PR3]1 I lighting and mechanical systems. ❑Not Observable ; 0 ;Systems serving multiple ❑Not Applicable dwelling units must demonstrate ;compliance with the IECC 1 . Commercial Provisions. 1 302.1, Heating and cooling equipment is; Heating: ; Heating: ;❑Complies ; 403.7 sized per ACCA Manual S based Btu/hr Btu/hr :❑Does Not [PR2]2 on loads calculated per ACCA Manual J or other methods Cooling: Cooling: ;❑Not Observable ; U Btu/hr Btu/hr approved by the code official. ; ; ;1❑Not Applicable I I 1 I 1 I I I I I 1 I 1 I Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 2 of 9 :Section # Foundation Inspection Complies? Comments/Assumptions & Req.ID x 303.2.1 A protective covering is installed to ;❑Complies [FO11]2 protect exposed exterior insulation :❑Does Not J and extends a minimum of 6 in. below ;❑Not Observable grade. ❑Not Applicable 403.9 Snow-and ice-melting system controls;❑Complies ; [FO12]2 installed. :❑Does Not l9J :❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 3 of 9 i Section Plans Verified Field Verified # Framing/Rough-In Inspection Value Value Complies? Comments/Assumptions & Req.ID 402.1.1, ;Glazing U-factor(area-weighted ; U- U- ;❑Complies :See the Envelope assemblies 402.3.1, lfaverage). ❑Does Not ;table For values. 402.3.3, bNot Observable 402.3.6, l ; 402.5 ; ; ;❑Not Applicable [FR2]1 l i 303.1.3 ;U-factors of fenestration products ❑Complies ; [FR4]1 ;are determined in accordance ❑Does Not !with the NFRC test procedure or !taken from the default table. ❑Not Observable ; ❑Not Applicable 402.4.1.1 !Air barrier and thermal barrier ❑Complies ; [FR23]1 l installed per manufacturer's ❑Does Not ! instructions. ❑Not Observable ❑Not Applicable ! 402.4.3 ;Fenestration that is not site built ❑Complies ; [FR20J1 lis listed and labeled as meeting ❑Does Not ! AAMA/WDMA/CSA 101/I.S.2/A440 i QNot Observable or has infiltration rates per NFRC i400 that do not exceed code ❑Not Applicable limits. 402.4.5 IC-rated recessed lighting fixtures ❑Complies ; [FR16]2 sealed at housing/interior finish ❑Does Not ! and labeled to indicate :52.0 cfm ! leakage at 75 Pa. []Not Observable ; ❑Not Applicable 403.2.1 !Supply and return ducts in attics ❑Complies [FR12]1 'insulated >= R-8 where duct is ❑Does Not 00 !>= 3 inches in diameter and >_ ❑Not Observable lR-6 where < 3 inches. Supply and !return ducts in other portions of ❑Not Applicable the building insulated >= R-6 for ;diameter>= 3 inches and R-4.2 ! ;for< 3 inches in diameter. 403.3.3.5 ;Building cavities are not used as ❑Complies ; [FR15]3 `ducts or plenums. ❑Does Not ! U ; []Not Observable j ❑Not Applicable 403.4 HVAC piping conveying fluids ; R- ; R- ;❑Complies [FR17]2 above 105°F or chilled fluids ! :❑Does Not U below 55 QF are insulated to >_R- ; ;QNot Observable 3. ! :❑Not Applicable ! 403.4.1 ;Protection of insulation on HVAC ❑Complies [FR24]1 "piping. ❑Does Not QNot Observable ❑Not Applicable 403.5.3 'Hot water pipes are insulated to R- ; R- ;❑Complies ; [FR18]2 >_R-3. ❑Does Not lJ :[]Not Observable ❑Not Applicable 403.6 Automatic or gravity dampers are ❑Complies [FR19]2 installed on all outdoor air ❑Does Not ! intakes and exhausts. []Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 4 of 9 I I High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 ILow Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 5 of 9 Section " Plans Verified,. Field Verified # Insulation Inspection Complies? J...'commenti/Assump'tion s & Req.ID; Value Value r 303.1 All installed insulation is labeled ❑Complies [IN13)2 or the installed R-values ❑Does Not u provided. []Not Observable ; ❑Not Applicable 402.1.1, ;Floor insulation R-value. ; R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.6 ; ❑ Wood ❑ Wood ❑Does Not ;table for values. [IN1]1 I ❑ Steel ❑ Steel ;❑Not Observable ll� � ❑Not Applicable I 1 1 i i 303.2, ;Floor insulation installed per ❑Compli-es ; 402.2.7 ;manufacturer's instructions and ❑Does Not [IN2)1 in substantial contact with the underside of the subfloor, or floor _]Not Observable. ;framing cavity insulation is in ❑Not Applicable I contact with the top side of ; !sheathing,or continuous {insulation is installed on the underside of floor framing and ' :extends from the bottom to the Itop of all perimeter floor framing 1 members. 402.1.1, I Wall insulation R-value. If this is a: R- R- ;❑Complies ;see the Envelope Assemblies 402.2.5, !mass wall with at least 1/2 of the ❑ Wood ❑ Wood :❑Does Not ;table for values. 402.2.6 jwall insulation on the wall Mass [IN3)1 lexterior,the exterior insulation ❑ ❑ Mass ❑Not Observable ;requirement applies(FR10). ❑ Steel ❑ Steel :❑Not Applicable 303.2 'Wall insulation is installed per ❑Complies [IN4]1 `manufacturer's instructions. ❑Does Not I ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 6 of 9 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.iD 402.1.1, !Ceiling insulation R-value. ; R- ; R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ; ❑ Wood ❑ Wood :❑Does Not ;table for values. 402.2.2, ❑ Steel ❑ Steel 402.2.6 ! ; ;❑Not Observable ; [Fill' ; ; ; :❑Not Applicable 303.1.1.1,{Ceiling insulation installed per ❑Complies 303.2 !manufacturer's instructions. ❑Does Not [FI2]1 !Blown insulation marked every ! ❑ 1300 ft2. Not Observable ; ❑Not Applicable 402.2.3 Vented attics with air permeable ❑Complies [FI22]2 insulation include baffle adjacent ❑Does Not to soffit and eave vents that extends over insulation. ❑Not Observable ❑Not Applicable 402.2.4 ;Attic access hatch and door R- R- ;❑Complies ; [F13]1 i insulation >_R-value of the ! ;❑ Does Not adjacent assembly. ;❑Not Observable ❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 ACH 50 = ; ACH 50 = ;❑Complies ; [FI17]1 11ach in Climate Zones 1-2, and ! ❑Does Not I<=3 ach in Climate Zones 3-8. ❑Not Observable ❑Not Applicable 403.2.3 I Duct tightness test result of<=4 ; cfm/100 ; cfm/100 ;❑Complies ; [F14]' ;cfm/100 ft2 across the system or ft2 ft2 UDoes Not <=3 cfm/100 ft2 without air ! ! handler @ 25 Pa. For rough-in ;❑Not Observable !tests,verification may need to ; ; ;❑Not Applicable 'occur during Framing Inspection. ! ! ! 403.3.2 1 Ducts are pressure tested to ; cfm/100 ; cfm/100 ;❑Complies [F127]1 ;determine air leakage with ft2 ! ft2 :❑Does Not !either: Rough-in test:Total ; ;❑Not Observable leakage measured with a !pressure differential of 0.1 inch ; :❑Not Applicable I w.g. across the system including ! ; ;the manufacturer's air handler !enclosure if installed at time of 'test. Postconstruction test:Total ! ; leakage measured with a ,pressure differential of 0.1 inch ; ;w.g. across the entire system ; including the manufacturer's air ! ; ,handler enclosure. ; 403.3.2.1 ;Air handler leakage designated ❑Complies [F124]1 "by manufacturer at<=2%of ❑Does Not !design air flow. ! ❑Not Observable ; ❑Not Applicable 403.1.1 Programmable thermostats ❑Complies ; [FI9]2 i installed for control of primary ❑Does Not heating and cooling systems and ! initially set by manufacturer to ❑Not Observable code specifications. ❑Not Applicable 403.1.2 Heat pump thermostat installed ❑Complies [F110]2 on heat pumps. ❑Does Not ❑Not Observable ❑Not Applicable 403.5.1 Circulating service hot water ❑Complies [FI11]2 systems have automatic or ❑Does Not accessible manual controls. ❑Not Observable ; ❑Not Applicable 1 High Impact(Tier 1) 2 TMedium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 7 of 9 Section Plans Verified Field Verified # Final Inspection Provisions Value Value Complies? Comments/Assumptions & Req.ID 403.6.1 All mechanical ventilation system ❑Complies [F125]2 fans not part of tested and listed ❑Does Not HVAC equipment meet efficacy and air flow limits. ❑Not Observable ; ❑Not Applicable 403.2 Hot water boilers supplying heat ❑Complies ; [FI26]2 through one-or two-pipe heating ❑Does Not systems have outdoor setback control to lower boiler water ❑Not Observable temperature based on outdoor ❑Not Applicable temperature. 403.5.1.1 Heated water circulation systems ❑Complies [F12812 have a circulation pump.The ❑Does Not system return pipe is a dedicated return pipe or a cold water supply ❑Not Observable ; pipe. Gravity and thermos- ❑Not Applicable syphon circulation systems are not present. Controls for circulating hot water system pumps start the pump with signal ; for hot water demand within the occupancy. Controls automatically turn off the pump when water is in circulation loop ; is at set-point temperature and no demand for hot water exists. 403.5.1.2 Electric heat trace systems ❑Complies ; [F129]2 comply with IEEE 515.1 or UL ❑Does Not 515. Controls automatically ,adjust the energy input to the ❑Not Observable ; heat tracing to maintain the ❑Not Applicable desired water temperature in the piping. 403.5.2 1 Water distribution systems that ❑Complies [F130]2 j have recirculation pumps that ❑Does Not pump water from a heated water supply pipe back to the heated ❑Not Observable ; water source through a cold ❑Not Applicable water supply pipe have a demand recirculation water system. Pumps have controls ; that manage operation of the ; pump and limit the temperature of the water entering the cold water piping to 104°F. ; 403.5.4 Drain water heat recovery units ❑Complies ; [F131]2 tested in accordance with CSA ❑Does Not B55.1. Potable water-side pressure loss of drain water heat ❑Not Observable ; recovery units < 3 psi for ❑Not Applicable individual units connected to one or two showers. Potable water- side pressure loss of drain water heat recovery units < 2 psi for ; individual units connected to ;three or more showers. 404.1 {75%of lamps in permanent ❑Complies [FI6]1 'fixtures or 75%of permanent ❑Does Not 'fixtures have high efficacy lamps. ' I Does not apply to low-voltage ❑Not Observable ; a lighting. ❑Not Applicable 404.1.1 {Fuel gas lighting systems have ❑Complies ; [F123]3 !no continuous pilot light. ❑Does Not U ❑Not Observable ❑Not Applicable 11 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 1 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 8 of 9 Section Plans Verified Field Verified # Final Inspection Provisions .Value Value . Complies? Comments/Assumptions & Req.ID 401.3 Compliance certificate posted. ❑Complies [F17]2 ❑Does Not ❑Not Observable ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies ; [FI18]3 mechanical and water heating i ❑Does Not systems have been provided. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 07/15/19 Data filename: Untitled.rck Page 9 of 9 2015 IECC ' Energy NJEfficiency Certificate Insulation Rating R-Value Above-Grade Wall 20.00 Below-Grade Wall 0.00 Floor 30.00 Ceiling / Roof 38.00 Ductwork (unconditioned spaces): Glass&Door Rating U-Factor SHGC Window 0.30 Door 0.30 CoolingHeating& Heating System: Cooling System: Water Heater: Name: Date: Comments U . Application to Old Kings Highway Regional Historic District Committee pp in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470. Acts and Resolves of Massachusetts, 1.973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition ❑ Alteration Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other 2 Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign. ❑ Existing sign ❑ Repain in C ng sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole 0 Othei (Please read other side for explanation and requirements). I `�I I��� TYPE OR PRINT LEGIBLY DATE 1 ADDRESS OF PROPOSED WORK �� �"�' w ^ram IL 4 Vv GAINS ` I&SSORS MAP NO. OWNER IC N�L N� ' `�� ASSESSORS LOT NO. ND COR � , HOME ADDRESS IV G CAPES —r l/ Iw1`— T aq 0�TA8� TEL NO. 50� ��� !rr�� FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). - R �C ARD Y Klr l CAST �1 t 1 Cif S A�� KN�S1 t ILIAKIL 0 BAN" C3(' 9' Teny W . 'mM_SM& �p1 30LIC- DECOSTA , ISS CA(�,5 Ti2q(L 9 GU9S SAN�IC� AC.I,EN Ibc) CAPES T)2. AGENT OR CONTRACTOR r� +v w""'v /1 TEL. NO.50 u `� ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No. 8,other side), including materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). DEcv . I N •B'Rcr- u14 r2D � .5�� ��ANS p I�NC�I�p • Signed bel mmittee•use. ei t D e cate is hereby Dat ime A. Q . TOWN OF[3AR NSTABLE t,x I . Approved ❑ IMPORTANT: If Certifica rels pproved,approval is subject to the 10 day appeal period provided in the Act. Town of Barnstable ' Old King's Highway Historic District Committee SPEC SHEET FOUNDATION SIDING TYPE COLOR CHIMNEY TYPE COLOR ROOF MATERIAL COLOR i PITCH WINDOWS SIZE TRIM COLOR DOORS COLORS SHUTTERS COLORS GUTTERS COLORS DECKS i MATERIALS NAToep L Colo Q- i NO N GARAGE DOORS COLORS SIGNS COLORS FENCE COLOR NOTES: Hill out completely, including neasuremente and materials/colors to be used. Three copies of thin form are required for submittal of an application, along with three copies of the plot plan, landscape plan and elevation plane, when applicable. SPECSBT LOT 18 9 \ 99 LOT 56 SO. I LOT 4�+� LOT 6 & 6A �t 43,621 sq.ft 1.00 Acres �,� �`�► Doti CONC. FOUND. LOT 55 F.-160.2 i 'c9S o`�ti� 62S1c R6 T�f l JOB # 95-391 L-6 CER TIFIED PL 0 T PLA N LOCATION : CAPES TRAIL WEST BARNSTABLE, MA PREPARED FOR: SCALE : 1" = 60' DATE : FEBRUARY 20, 1997 REFERENCE LOT 6 LCP 40599—B SHEET 2 LOT 6A PB 489 PG 51 CHAMPION BUILDERS I HEREBY CERTIFY THAT THE STRUCTURE SHOWN GROUND N THIS PLAN IS AS OF AS SHOWN HEREON.LOCATED ON THE ��%Yl MAJJq o ARNE off 508-382-4541 S H. 1 fmc 508 362-98W i . 6348 o l down cape engineering, inc. CIVIL ENGINEERS ?_ ' 1117 17 111 �P LAND SURVEYORS oae main st. yarmouth, ma DATE REG. SURVEYOR P.T. RAIL 20' 0" 2 P.T. 2X10" BEAM WITH 04" SUPPORT WITH BOLTS. STAIRS 12" CONSTRUCTION TUBE Owners: YOUNCi CDAddress: �{� � "(I I(_ r4►�NST4 Not to Scale: MAIN HOUSE NOT TO SCALE. P.T. 2 X 6" RAIL P.T .5/4 X 6" DECKING P.T. 4 X 4" RAIL.POST 1 X 12" KICK BOARD P.T. 2 X 2" X 36" BALUSTERS I 'i i c 1; P.T. 2= 2 X 10" BEAM �1" AIR SPACE -___ P.T. 4 X4" SUPPORT P.T. 2 X 10" FLOOR JOIST. 2= 5/8 X12" GALV. CARRIAGE BOLTS P.T. 4 X 6" POST CONCRETE FOUND. WALL == GALV. POST SUPPORT 1/2 X 8 GALV. LAG BOLTS 12" CONSTRUCTION TUBE 4 0" BELOW GRADE. I I . I 1 I I I I I 1 I I I Owners: JOUNG Address:166 Not to Scole: p ra. °roperty Location: 85 PETER BLOSSOM LANE MAP ID: 088/ 007/ 00511 :L/ - —' Other ID: Bldg#: 1 Card 1 of 1 Print Date:'07/31/1998 ONE a :fl i.; am a9 ..v' u:� s r i"a:a,,�...�s�",v + + � .+� r?4c-tY«f�*�ss�;.�;,e;.�.u+�wass�r�. ....a' i+c�raea ;..• ....a�awe.+aeAS. •... •.• ` .!3«icawzrf+,.._ r+;.u�aro.-tiawsr.raaa,r�sem�•. escnp ion o e I Appraiseavalue ASSeSSea value %CRAM,ROBERT F JR&LYNN M IOU 47,6U( ' 801 85 PETER BLOSSOM LN RESIDNTL 1010 100,10 100,10 W BARNSTABLE,MA 02668Ixg BARNSTABLE, Account# 4353A7 Plan Kei. Tax Dist. 500 Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT 18 L Notes: DL 2 C40599B- oa , , ��.w:kk4TM.z�aor! t '.' "ad'.diM> ww-. .+xa. - 3 51$ai,'+. c8x: ee.'a.a. Yri3'"•;se-,+.. xxre; r �°.1?s Y +F a .;w'.a4s.'.-' aR =`w& .'- ,°5d.�• _ xw .:.'4cfiBn w',3em`.+s�fn�+.:,..vr;NnKzerzaaty..+..avrrrr.wefi::aetsez;sx... «:'-.ai° .i7. :. r. I Loae I ASSeSSeavalue Yr. Gode Assessea Value Yr. Gode ssess a ue SNOWDEN,LAURIE P TR C141853 8/15/9 U V 10 B LEBEL,JAMES A C141000 6/15/9 U V 25,00 N SNOWDEN,LAURIE P TRS C135475 11/15/9 U V 103,001 A CRAM,ROBERT F JR&LYNN M C143701 2/28/9 Q I 168,89 00 TOa11 36,3fig o 36,3u To!!!.j ti r �,. y is signature ac now a ges a vts y a a s o eetor or ssessor ;.:airvm.r eats:`rsa rsr^.44.,1;r..£,,..._. -.. Kw.,, .f aX ;t.� �' rhx. 'cu;•e'„wro. +z.�rx.aa+x.c+,.x..4fvave x .'`. � ear yp escnp ton Amounto e esenption Number Amountomm.I Int. 9`. '�utKs:�k. 3$d'#r:aXaea9fE'e'fr?F :i§5;69.. ,a"._. Appraised Bldg.Value(Card) 99,600 Appraised XF(B)Value(Bldg) 500 Appraised OB(L)Value(Bldg)o 0 . . ) 47,600 0 Appraised Lan Value(Bldg) Special Land Value Total Appraised Card,Value Total Appraised Parcel Value 147,700 Valuation Method: Cost/Market Valuation Net TotalAppraised arce Value ]-`d+Fr e r , ep .a, p r r 's:' { •,ID �. 6 "� rs. { . g d. l' Iy�,1 F� � t P.��•�'.i���.�f -`.taaas�.$s.��,«.".`ab ;". _ ++�.,. k. .. ...,..' - xMws�te '' .. .r,ro.t xs ae.»c.i.,. ,a�ii.�: ` � .e4 �^ san`SSusw.em: ?`ars9u•;»aarrrosmec. ehy .`�... n Permit IV Issue Date lype Description Amownt Insp.Date Yo Comp. Date Comp. Comments ate ID Gd. Purpos esu t UU Measured and Listedn e PA tm` tlR�L�.>:Ps. Feat:�' 31 ,; ,. $ �.fa '.ns.ra+,s��crc .;rictisFer„k,•: .;*aba'ee.��«s£ei.m�w, ,o47:R:. a a�i� ` ems^ .'• e�TSir <"'_ ..�. :e t8:t cx .` tril Use Gode Description Zone D trontage Depth Units Unit Pr6ce actor to cing �. nt nce anF a ue 1 f010 Singg le Fain RF 5 0.04 AC 475,000.0 1.0 5 .1.00 85AB OAC 190,000.01 7,60 ot.1 i5ndnii I.U�A� �-.fat Landa u , 7roperty Location: 80 PETER BLOSSOM LANE MAP ID: 088/ 006/ 003// Other ID: Bldg#: 1 Card 1 of 1 Print Date:07/31/1998 escnp ion Coae Appraised Value Assess 16 10 PARK AVE-YARMOUTH CAMP GRD ' ' 801 HYANNIS,MA 02601 BARNSTABLE,MA . . , ., .. ccoun zMay Plan . ax Dist. Soo Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT 56& Notes: DL 2 17 Total , 45,8011 - AECURDUffIvIffmWilp U11 lm ql*l y �._. ..-.t• : r. GO de ssesse a ue r. o e ssess a ue r. Code AssessedValue OLIVE,GRACE A 9562/069 2/15/9 Q V 43,90 SNOWDEN,LAURIE P TR 9432/178 11/15/9 U V 10 B CALLAHAN,JOHN T III 9432/175 11/15/9 U V 1 B PRINCI,MICHAEL J& 6843/055 8/15/8 U V l A oa ota. oa4,UUU is a ure acknowledges a v a s o or or Assessor sign a ges y a ear 1ypelDescnplion Amount Gode Description Number Amount Comm.Int. Appraised Bldg.Value(Card) 0 Appraised NF(B)Value(Bldg) 0 Appraised OB(L)Value(Bldg) 0 ota. Appraised Land Value(Bldg) 45,800 Special Land Value Spe ' 0 Total Appraised Card Value Total Appraised Parcel Value 45,900 Valuation Method: Cost/Market Valuation Net TotalAppraised arce ue - - - - -- - Fennit IV Issue Date e Description Amount Insp.Date Vo Comp. ate Comp. Gomments Date urpos esu LANDLINk Use Gode Description ne D Prontage Depth Units unit Price L Pactor . . actor, f. I Notes-A RKi cing /. unit mce Lana value 1 1300 RESACLNDV RF 5 0:46 AC 31,600.0 LOC 5 1.00 85AB 0.4011 1RESIDUAL 129640.0 5,80 Totalnunuljoial Lana valul , property Location: 155 CAPES TRAIL MAP ID: 088/ 006/ 006// , Other ID: Bldg#: 1 Card 1 of 1 Print Date:07/31/1999 GU escnp ton LOae Appraised Value Assessed value CAPES TRAIL SIDNTL 1010 74iuiu ,UUC 80 74,80 801 W BARNSTABLE,MA BARNSTABLE,MA 02668 KE8ount# 42BY14 Flan ax Dist. 500 Land Ct# er.Prop. #SR VISION Life Estate DL 1 LOT 5& Notes: DL 2 SA TO 14,8U9 , q![ V t r. Code -Assessed value Yr.M GO de 'Assessed a ue Yr. e Assessed Value DECOSTA,LEO J JR&JULIE 10158208 4/15/9 U 113,45 P CHAMPION BUILDERS INC C139187 12/15/9 U V 150,004 A CHAMPION BUILDERS INC 9963/287 12/15/9 U V 150900 N SNOWDEN,LAURIE P TR 9432/178 11/15/9 U V 10 B CALLAHAN,JOHN T III 9432/175 11/15/9 U V B oa. o ota. 2,49C , . . , ...: ,. . -.. u signature acknowledges ege s a visa y a ata Collector or sesor Year' p esenptton AmountCode Description Number mount Comm.Int. Appraised Bldg.Value(Card) 71,800 Appraised XF(B)Value(Bldg) 39000 Appraised OB(L)Value(Bldg) 0 ° Appraised Land Value(Bldg) 40,000 Special Land Value 0 Total Appraised Card Value Total Appraised Parcel Value 1149800 Valuation Method: Cost/Market Valuation Net TotalAppraised Parcel Value ermtIssue Date lype vescnphon Amount Insp.Date Yu Comp. Date Comp. Comments atet-upposeli(esult est en easur an is a e VAL < , yi, i r use Code Description Lone ron age Depth UnigUnit Price 1.tractor S.I. ac or Ad o es- pecta Pricing j. nt nce n a ue tng a am Totaln ntil I i.U11 Al I ro-tal Landa 4U,UU9 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE �jWF 99 `' ..... , JOB. LOCATION I 5`0 CAPES F�I�� w ES-T. 8APCN)STpELC Number Street address Section of town "HOMEOWNER" m CnL L M RRGAaT �JCU NG 3(o2 - I S6(1- Name Home phone Work phone PRESENT MAILING ADDRESS_ �� CA 'PE S Trm C- =' City town State Zip code The current exemption for "homeowners" was extended to include owner-occupies dwellings of six units or less and to allow such homeowners -io-;engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, 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 Offic'- on a form acGept'able to the Building Official, that he/she shall be responsib. for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes .responsibility for compliance with the St. Building Code -an c d other applicable odes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands ..the Town of Barnstable Building Department mini inspection procedures and requirements and that he/she will co 7�r with+. wztid procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "An Home Owner �-. y performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1.1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do .such work, that such Home Own shall act as supervisor. " Many Home Owners who use this exemption are unaware .thatithey are assuming the responsibilities of 'a supervisor (see Appendix Q, Rules and Regulations for • licensing Construction Supervisors, Section 2.15) . . This lack of awaren( often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our -Board ,cannotiproceed• against the inlicensed person as it would with licensed Supervisor. The Home"Owner act: as supervisor is ultimately responsible. To ensure that the Home Owneilis fully� aware` of his/tier responsibilities, mz communities require, as part of the permit application, that• the Home Owner certify' that he/she understands _theiresponsibilities of. a supervisor. On t!: last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in -your community. i The Commonwealth of Massachusetts Department of Industrial Accidents ��=' '= , ---- � Office ofln�estigatiolls -_ 600 Washington Street Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit name: 111 IC1TAREL 1 1 FrlK91- I .9 )l W75 'location: I JV N1 ES I I AI(-- city WEST LT A U IAU- IIIA VGu-,� J phone# kT8 2� 1364 EJ I am a homeowner perfoiming all work myself. ❑ lamas I d have no one workin in amr ca acity ❑ I am an employer providing workers' compensation for my employees working on this job.. comaanv name address: :....... .......::...:::::.::.::...:::::....::::.::.:.:•:;;;:::::.:.. .: ...,....:.:::•.:::.:::::::•::,.::::::.,:. . . .. ..... ..:::... . city: phone#: insurance co. ACV# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: :: address: ::»>:<:.....<:;:;>. :. ........ ..... ..... . .. ... .... ....... .::...:..:..:. cih* p Mine#- .; insurance co. :>>:�•>ss:s::::;::;.;:.;::;::,,�:..::.:.�:;.:>:<•::•::: company ::;••: ;: : 'name: address: :;;;;:>:;.;::;>:::;,.;.>;>:::.; :< : <::. :>';:::>:>:>: ::<>"' ieunrenc Fallnre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cf epais a ¢p perjury that the information provided above istrue and correct `f qq� Signature4UO Date `.SG DUI 1U . a4 1 /_ 8 Priest name ���la U � Phone# e �2 official use only do not write in this area to be completed by city or town ofIIcial city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (Mviud 9/95 PIA) The Town of Barnstable MAM • a�artsr�. _ N Department of Health Safety and Environmental Services MR Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. c Date —CDs" )_q 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. n 1 � ,/ Type of Work: MEW 1cr Estimated Cost Address of Work: C�1 i:Q to -. T sE6eKS 5A6LE Owner's Name: r'n)C11 EL � 0 QCS Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied "weer 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. Date Contractor Name Registration No. OR Date J Owner's Nam q:forms:Affidav �oFIRE,ote Town of Barnstable *Permit# P o ` Evpires 6 monthsLrour issue date Regulatory Services. . Pee C�?5 , HARNSTABLE, + v� 6 ss. �g Thomas F. Geiler,Director Building Division FFe � om Perry, CBO, Building Commissioner r�� 2010 w200 Main Street,Hyannis,MA 02601 ,,Q�� ww.town.barns table.ma.us Office: 5 8 8 �g0M43 Fax: 508-790-6230 EYPREZJ&RMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number. Property Address 4 5t6 CAC� -��1 L, [Residential Value of WorksR OD Minimum fee of$25.00 for work under$6000.00. Owner's Name&Address_ i' 1�✓ t ��:�f�[^T Contractor's Name �� ' L�:`� Telephone Number6D i'S Z Ll Home.Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) GI l l01 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner r;rr ave Vorkor's ompensatton Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany.each permit. r Permit Request(check box) Ell Re-roof(stripping old shingles) All construction debris will be taken to "fAarnl,6��'-� ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows *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:\WPFILES\F0n4S\building permit forms\EXPRESS.doc Revised 090809 l� t The Commonwealth of Massachusetts • Department of Industrial Accidents Offlce of Investdgatdons 600 Washington Street Boston,MA 02111 www mass gov/dla Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumben ,'.Ppflcant Information Please Print Leelbly Name(Business/Or indodlndividual): -LkZ�, Address:dl =�2 -�' •��� City/State/Zip: , ��bb4 Are on an employer?Check the appropriate box: Type of project(required): 1. I am a employer with_-_ 4. ❑ I am a general contractor and I employees(full and/or part-time).• have hired the sub-contractors 6. ❑New construction 2.❑ 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' insurance.t 9. 0Building addition co [No workers'comp.insurance tvP• requd,] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumb' myself. [No workers'comp. right of exemption per MGL Plumbing repairs or additions insurance required.]t c. 152,§1(4),and we have no 12.❑'1�oof repairs employees.[No workers' 13.0 Other comp.insurance required] 'Any applicant that checks box#1 tract also fill out the section below showing drdv workers'compensation policy infomndon. t Homeowners who submit this affidavit indicating they ate doing all work and then him outside contractors must submit a new affidavit indicating such, tcontractors that check this box must attached an additional sheet showing the acne of the suit-contractors and stater whether or not those entities have employees. If the subcontnctm have employees,they must provide their workers'comp.policy number. I an an employer that Is providing workers'compensation Insurance for my employees Below Is the polley and Job sits Information. Insurance Company Name: Policy#or Self-ins. Lic.#:G)C2Z(S S325 2-1 2�-) Expiration Date: lZ-?_% '20(�O Job Site Addrem: 1 so Q� City/State/Zip: 4 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 fee of up to S250.00 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 coveraste verification 1 do hereby ce t er flit palms and penalties of pert that the Injormatlon provide obo !s trite and correct: Si a Da • � ?� - ,, _ Phone g s© Qfflciial use only. Do not write In 1his area,to be comp etc y c or town ojJlcla[ City or Town: Permit/License# Issuing authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: infor mation and Instructions = Massachusetts General Laws chapter 152 requires all empl0y6es 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 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-contractor(s)name(s),address(es)and phmn number(s)along with their certificates)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 permitllicense number which will be used as a reference number. In addition,an applicant that must submit multiple permiUlicense 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.When 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 YOT 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. #617-7274900 ext 406 or 1-877-MASSAFE Fax #617-727-7749 Revised 11-22-06 www.mass.gov/dia KELLY ROOFING 127 EVERGREEN STREET SOUTH YARMOUTH PH/FAX 508 775 4498 MA. REG.# 128957 MA 02664 CELL 508 509 4640 LIC. # 99167 Okelly52@comcast:net INSURED February 6, 2010 Proposal submitted to Mike Young of 156 Cape's Trail West Barnstable Ma. We propose to supply all materials and labor'necessary to remove and replace the existing roof at the address above. All debris to be removed to town transfer. Vented Aluminum drip edge to be retained on all eaves. Ice and water damage protection membrane to be installed on first three feet of eaves and around all protrusions Remainder of deck to be covered with#15 felt paper. 30 Year Limited warranty Architect style shingle to be installed(Color to be specified) Bathroom vent pipe boots to be replaced with new. Shingle Vent II Ridge vent to be installed on all ridges with hand nailed caps Protect all walls, windows, decks,plants and shrubs etc. during roof strip Obtaining of town permit. At a total cost of$3900 Payment Schedule; balance upon completion. Respectfully submitted, Oliver Kelly J f Proposal accepted by, f'.Ie Date U/ / S /2010 If acceptable,please sign and return one copy anoekeep 6Xie for your records. This proposal is valid for 60 days from date above I ' t r '1�1u»achuu.ttti-':Dcpa Pui;lic Safer%"+ Board of Buil((ling $cgulations tnd%Standar ils j ,Construction S_ upervisor Specialty license .a-�L cerise: CS SL 99167<ti 'Restricted to:. RF,W3— }k1 ` ► }s OLIVER�KELLY. .,''� ` ;�9 PEREGRINE'LANE '- OUTWYARMOUTH;MA.b2664" Ex iration 9[28/2011 Tr 99167 bs`I Board o>Vimg eegg'ufatds an tan arls-" License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 128957 Board of Building Regulations and Standards ExPlration'"'6/14/2011 Tr/t 284841 One Ashburton Place Rm 1301 UF � � 3 Boston,Ma.02108 `—`Tyi�pe: Individual � ;� Oliver Kelly `_ t Oliver Kelly V;,• _— _ v 9 Peregrine lane South Yarmouth,MA 02664' =' Administrator Not valid without signature 2/25/2010 6:35:1B AM PST (GMT-8) FROM: insurancevisions.com-TO: 15087906230 Page: 2 of 2 DATE(MM/DD/YYYY) ,a41coR01 CERTIFICATE OF LIABILITY INSURANCE 2/25/2010 PRODUCER DOWLING & ONEIL INS AGCY INC THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PO BOX 1990. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HYANNIS, 90 02601 HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (508)775-1620 INSURERS AFFORDING COVERAGE NAIC# INSURED OLIVER KELLY INSURER A: LIBERTY MUTUAL GROUP 127.EVERGREEN STREET INSURERS: SOUTH YARMOUTH MA 02664 INSURER C: INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRADD' POLICY EFFECTIVE POLICY EXPIRATION LTR NSRD1 TYPE OF INSURANCE POLICY NUMBER LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ CLAIMS MADE OCCUR MED FRCP(An one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY JFCT PRO LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ _ EXCESS/UMBRELLA UABIUTY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $. A WORKERS COMPENSATION WC2-31 S-338804-029 12/28/2009 3/8/2010 ,/ I WC sTATrLIMUTORY I oTHFR AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTNE E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? ❑Y (Manda(ory in NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES 7 EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PR6 k$jgNS Workers Compensation Insurance: Part One of the policy applies only to the Workers'Compensation Laws of the State of MA. THE WORKERS'COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR OLIVER KELLY CERTIFICATE HOLDER CANCELLATION SHOULD ANYOFTHE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORETHE EXPIRATION TOWN OF BARNSTABLE DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN 200 MAIN STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL HYANNIS MA 02601 IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,rTS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Jeff Eldridge ACORD 25(2009101) ©1988-2009 ACORD CORPORATION. All rightsreserved. CERT,NO.: 6911154 CLIENT CODE: 1329955 Deb Decochemont 2/25/2010 6:32:58 Hn Page 1 of L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ��c�o . (.� 1/ Permit# �l Health Division �X�. 3///k\ (� Date Issued `� P 1 S� Conservation Division Sr 0 Fee �I Tax Collector / Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved09STING SEFnQ SYSTEM . .w5. .v .� .,. M�:G�. ...ti2�'- �i�OOMS Historic-OKH Preservation/Hyannis rr�� =- - Project �U� rn Street Address 1_) Ste' Village 6-:- Owner ,/' %CXi5PC-L f /4014;!�XZe7 YNC, Address ,&7, 1,1.4.E Telephone 50f9 r Permit Request / Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation �`Cxt'�Zoning District Flood Plain Groundwater Overlay Construction Type 1ejoor> Lot Size /Acet Grandfathered: ❑Yes ❑ No If yes, attach supporting co,Umentati-F. c 1 Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure 144W-5 Historic House: ❑Yes 0�<o On Old King's High ay: ❑�Ts ko Basement Type: Ellull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing a new Half: existing new Number of Bedrooms: existing . 3 new Total Room Count(not including baths): existing new First Floor Room Count I Heat Type and Fuel: VGas ❑Oil ❑ Electric ❑Other Central Air: O Yes ©<o Fireplaces: Existing Wdvy6- New Existing wood/coal stove: ❑Yes CN,To- Detached garage:O existing ❑new size Pool: O existing ❑new size Barn:O existing O new size Attached garage:existing O new size Shed:❑existing Cl new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes O No If yes,site plan review# Current Use - Proposed Use J / BUILDER INFORMATION Name iG 2�� ! .I/l Telephone Number Address /�& 4! 9Z .S License# �iLCy,ST 8Z4 ;Vie. Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE6S— L 5 FOR OFFICIAL USE ONLY p PERMIT NO. t. DATE ISSUED MAP/PARCEL`NO. �' ADDRESS r VILLAGE , OWNER Y DATE OF INSPECTION: FOUNDATION S FRAME �F T iL�'I 0/C —/ —0 S a INSULATION AotfSL"Z Ole— FIREPLACE ELECTRICAL: ROUGH FINAL ,- PLUMBING: ROUGH FINAL GAS: ROUGH FINAL-' FINAL BUILDING ca DATE CLOSED OUT N ASSOCIATION PLAN NO. N - I The Commonwealth of Massachusetts Department of Industria6Accidents' a; - 600•Washington Street - Boston,Mass. .02111 Workers!; Com ensation.`Lisurance Affidavit-General Businesses -- C: 'Jt"�Y 'Kd.'•. ;pE°p�••/ •Tp:e-"�ig;r"'e.w. � • �.: .. �— 'i'�*eb1 '. / name: 0 i x t u•' address: S city-( sue ��/7 S/�/�Lam/ state:' ' � � zip: hone work site location(full address): ❑ I am.a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBai/Eating Bstablishmeat working in any capacity. ❑Oflice❑ Sales(including Real Estate,Autos etc.), ❑I am an em to er with em to ees(full& art time: ' Other O% %��%%//7711171%%%/�%///////��/%//%%/%� �I am an employer providing v�orkers' compensation for my employees working on this job.. ad regs, ::;•: ' '..::•- r. ^::ice.;••• �;:,'. .,.• .•:::•; .::;` _ .iriytirarice.cOs .5:^ ,t:-y: ':s2 Y' �t%ec,i�::•. 011 .#" - •c' . I am a sole proprietor and have hired the independent contractors listed below.who have the following workers compensation polices: >e'' amec spa comp address:. � :i;•'? �• � _ :1: - '_,5`:%a::: '••e- _ eitv:• blioa insurance-Co.comnany nende:a '<•• _ ai`;':•• :,.._ :�`. address:. . . . :: . .-•='•..•' '; .. . .:- - _ 4. insurance:so: . :•:;,`. ..:::•:::.:, .::;•.. .'�, ' ]i :# Failure to secure coverage as required under Section 25A of MGL 152 can lead to the osition of criminal j%g q imp penalties of a Sne up to S1,SOO.DO and/or one years'imprisonment as well as civil penalties in the foim of a STOP WORT{ORDER and a fine of$100.00 a day against me, I understand that it copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under th sin d pe alties 'ury that the information provided above is flue d coned Signature Date Print name Phone# S d"�c3�.1� ' official use only . do not write in this area to be completed by city or town official city or town: ___ permittlicense# ❑Buihiing Department — ❑Licensing Board ❑check if immediate response 1s required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other (revised Sept 2003). r Information and Instructions- Massachusetts General haws:chaapter 152 section 25.tequires all en&yers.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 mqre of the foregoing engaged.in a joint enfeiprise, 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:gf the.dwelling house of.: another who.employs ' ons 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 l52 section 25 also-staies that'every. state'or local licensing agency.shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required Additionally,neither the ' commonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with t�a insurance requirements of this chapter have been presented to the contracting . authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation..-Please ' supply company name, address.and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department-of Industrial Accidents-for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should.be returned to the city or town that the application for the permit or.license is being of Accidents'. Should you have any questions regarding the"law"or if you are requested, not the Department required to obtain a:workers."compensation policy,please call the Department at the number lists below. ; City or Towns . Please be sure that the affidavit is complete andprmted 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 filLin the permit/license number.which will be used as a reference number. The.affidavits-maybe.returned to the Department ,mail or FAX unless other"arrangements have been made. The Office of Investigations would lice to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a-call.: The Departn=t's:address,telephone and fax number: The Commonwealth Of Massachusetts Department.of Industrial Accidents BMW of Wesugaffens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext:406 f of Town of Barnstable N Regulatory Services Hnfuvsrasrs. S Thomas F.Geller,Director 1 a � Building Division lfD MP'� Tom Perry,Building Commissioner 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 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 foul dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other ' requirements. �! Type of Work: /✓�S�i /_� Estimated Cost ' ::C� Address of Work: /�� ���ES Tip G �la�T /. �/� • a2&6� . 6wner's Name:' i�'� ,y/jG�lA�� (��✓s+i� Date of Application: 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 210' caner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ACCESSCONTR TO THEORS ARBITRATIONPROGRAM OR GUA IMPROVEMENTOR APPLICABLE HOME FUND UNDERMGL cWORK DO NOT c.142A. ACCESS _ SIGNED UNDERPENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. 0 ld DSOoG�rd� D 0 a's Name Q:fomis:homeaffidav 1 C� C Daniel E. Braman, P.E. 1/tJ�S '� G rJ DTP►Ill-E 189 Harbor Point Rd. y Cummaquid MA 02637-0361' V j R t,cam. two too- JA ��s�� F�t�� M � �LC.30 L.V L. � Q�t-cc�J o� L �LLY ���vMQ� C rL-lki Lo.'�� t►-ice : �Loo�- `t].L.,. = �ejPS�.� L.L .= �-C7pS'�, c K- x c�-c ►�! '�j - I o S :EEC. �t 'fix 2 t .4 s. C-Q—,`7 t VI �h,2ocn- r7.35 cs t- G\n kl5 C', d�vu�n 5tc:vs dk CM C. e ® STRUCTURAL RAMSBEAM V2 . 0 - Gravity Beam Design. Licensed to: Dan Braman, P.E. Job: Steel Code: AISC 9th Ed. SPAN INFORMATION: Beam Size (User Selected) = W8X15 Fy = 36. 0 ksi Total Beam Length (ft) = 12 . 25 Top Flange Braced By Decking LOADS: Self Weight = 0 . 015 k/ft Point Loads (kips) : Flange Bracing Dist DL Pre DL LL Top Bottom 2 . 50 . 1 . 05 0 . 00 2 . 80 Yes Yes 10 . 25 1 . 05 0 . 00 2 . 80 Yes Yes Line Loads (k/ft) : Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2 0 . 00 12 . 25 0 . 170 0 . 170 0 . 000 0 . 000 ' 0 . 453 0 . 453 SHEAR: Max V (kips) = 7 . 92 fv (ksi) = 3 . 98 Fv = 14 . 40 MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft ft ft fb Fb fb Fb Center Max + 20 . 7 5. 9 0 . 0 1 . 00 21 . 00 24 . 00 21 . 00 24 . 00 Controlling 20 . 7 5. 9 0 . 0 1 . 00 21 . 00 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 2 . 14 2 . 23 Max + LL reaction 5 . 46 5. 69 Max + total reaction 7 . 60 7 . 92 DEFLECTIONS: Dead load. (in) at 6 . 13 ft = -0 . 120 L/D = 1226 Live load (in) at 6. 13 ft = -0 . 305 L/D = 482 Total load (in) at 6. 13 ft = -0 . 425 L/D = 346 F °flHf li• �`� ]Re g atory Services . sAxivsrnBLE; iomAs-F::: efler,Divector.k_.•_. ... _.. .. 9 .. Building Division 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:_ n�ujmber � street village "HOMEOWNER":1i///G ������phone � —���yag—name # work phone# CURRENT MAILING ADDRESS: �/f��S ? i¢•LoST AN. �,)( g 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 pot be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building'Official,thathe/she shall be responsible for all such work performed under the buildin 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 Tovym of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required-to comply with the State Building Code Section.127.0 Construction Control.. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&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. Q:forms:homeexempt 30'9 TOP AT 28'4 2'5 C1\_ .a1 uP LO 2'6 c6 FURNACE ao CN O (V Bar Prep Area = �IY4• a x � 7— LV j {, —S 3'0"x6'6" 24"Shelving x 2 N i( ZD LO I Storage p .i Bulkhead 8'7 2'-- 107 5'8 12' 28'3 Mike & Margaret Young �� l� Finished Basement Qcc��2 t iugi - t,(3rd floor) Map Parcel Permit# � Q House# / Date Issued B' Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) �y obi 6ffice th floor)(8:30-9:30/1:00-2:00) P ) SEMIC S ST BE Definitive and 19 INSTALLE® I �� f (9I��I�61 EIS t a,. AND TOWN OF BARNSTAB�t. OW;� ,4e r Building Permit Application Project Street Address,�J C APES TQRIL Village Owner rn�c��� k i 1R�A � ��U Address APVP Telephone �j� 3(p2 n �— ' Permit Request t' I N s H SECDNn PL .�vM y First Floor 8 I b_ I square feet Second Floor (n 12- square feet Construction Type N E V V Estimated Project Cost $ 3500 Zoning District Flood Plain Water Protection Lot Size I R CRE Grandfathered ❑Yes ❑No Dwelling Type: Single Family Lk"' Two Family ❑ Multi-Family(#units) Age of Existing Structure ) 112 yR S Historic House ❑Yes XNo On Old King's Highway ❑Yes ❑No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1 2. Number of Baths: Full: Existing New Half. Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New 3 First Floor Room Count_ ; Heat Type and Fuel: )JGas ❑Oil ❑Electric ❑Other Central Air ❑Yes [(No Fireplaces: Existing New Existing wood/coal stove ❑Yes �No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) 'Attached(size) 14 Y ZZ ❑Barn(size) p None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 0 GtJ/!/ -e_ r?, Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE 2 BUILDING PERMIT DENIED FOR TH LLO G REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. C?y ` DATE ISSUED MAP/PARCEL NO. ADDRESS I VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION FRAME - . INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: `ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING • - - i - DATE CLOSED OUT . ASSOCIATION PLAN NO. ' �� f . _ The Commonwealth of Massachusetts == _ Department of Industrial Accidents office of/nsest�gatfons t 600 Washington Street --- � Boston,Mass. 02111 Workers' Compensation Insurance Affidavit ����ODO/��ffff0/O��� mr////������//��/////�//�////////��//��00��//////��/////�////D/������%%�i. name: M I I. N N�l 1 D U N(.1 . . location: 156 M PpS �1 kA l� ci V V GS I eA`�1 I ' 8LC— M A 02 hone# SOB .3162 )&> I am a homeowner performing all work myself. - I am a sole r rietor and have no one workin in ca aci ❑ I am an employer providing workers',compensation for my employees working.on this job.: ::::: :: ::: -Xxx ::;8n ��nBIe ':`j ? ? � f < ' '':. 2' ':z2 '<'2 '':`: 2 ? :. Y ? < ; 2? 22' ?` >. COTItp Y :.Q::: . Q %;::::%;.:;:::;'..>?`•`<: ..;.Y:'.: .` ".%;.2::.:.%:G .:'.':.: `..*.,�:::5:£:?:;.'.::::::i i. 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WLranC'.e::.<•Q::>:+::ti::!'::.}iiiiiiiiiiiiii}iii}iii}}ii:<•}}:i.•::.iiiiii:i::•:i:.}iiiii}iii}}i::.iiiiiii}i:}}}'i:.:::.::::::::::::::::::::::::::.:::::. .. �� tiv.v:::::::v.�:::::•:.:::::•::v.a:v::::::::::::::.::::::::::::v:::.............•:':::::::::::v::::::::::::::::•iiiii.::::::::::::::::•.::•......................:::::::::::::::::::::::::::::::::.::::::::::::::::::.::::::::::::V.-..:nv.v:::::.v. }}i}:}ii}'iii::vh:v:iii:::'i•i:•Jii'fiiiii'iii:i:i::^:tiitiiii:iiiii:P:'vi}iii}.:;:iiiii:::i:iii':jii:::i:iJ:li:iiii:i iii):iii:�!i:•%i::iiiii:v.:.::isi::i iiiJii::Jiiiiiit:i:i::iii}i:;i:.:;:}....—.v:f::i:.. fig::::.. iii:iiv'::;iii':iy:iii:!!:C:::!:iiiiii;:ji:;{:?:iiiiii::;:}::iii i:i::):tiiLi................. csa:.name:::::.:::::::::::::.::,:....1 ::::::::.:: :. ......... ...... ......... ....................... ....... sdthBss : ::i..i:.i:.i:.,.iii : 11 ........... ..... :.i .:.:::.::::::::: ........:,.X,:....: ...:,:....................................................... .......... ........1n :..... :... :.::: ::>:::iii:'::is:i::>.::i;:i:i::>:i:i:..iiiii:.....iii....iiiii.....::iiiii::i::i::i:iii:.i:-.'iii:.i:*..:....:i --'..;:..-::.;:.;:<•:;::.:.:.:...,:..ii::.i:.;:.}:.i:•}i;i; :: :k:>::>:<:>.<:>: :<:<: isiiiii<:::i::i:::i::>::>.i<:>::>:.:.<:.«:.::. :.::»:::.:;>:<:<:>;.:;«:.<:. :<::».<. <.:.<:.::::.::.>;:>.:».:.<:.<:>.>:.>:: >::>;<>::>;><.:::«<::;>.:>::».:>::>::>.. :.:. nynranre:ca'>:.;:.}}.....iiiii.................}} ;:< :iiiii:<:.}:;:::,;. tiit Fafiure to secure coverage as requited under Section 25A of MGL 152.can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penaities in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify they j . that the information provided above is hw.and correct Signature Date 11 -3 -�9R - Print name I L I AE L. ? �U1 v Phone# .5 D8 3b2 12)6 - official use only do not write in this area to be completed by city or town official . city or town• pennit/license# ❑Bullding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectrnen's Office _ 0Health Depar�nent contact person phone#; ❑Other Onised 9/95 PJfa ? . The Town of Barnstable . n s& Department Of Health Safet r and Fny1t0nmental Sernces Binding Division 367 Main Slre4 Hyannis MA M601 Raip&Grasses Old ?08-790.6ZZ7 Building Con Mi=io-- Faz s08-790-GZ30 For ofIIce use only Permit ao._ Dau I I-30-9� . AFMAVIT SOME II"ROVEMENT'CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION >sires that the "reeonstracdon, sites-.dons, renovation. repair. modermi=don. MGL a . im Rq demolition, or construction of an addition to an,y pre-�g conversion. improvement, removal. units or to Omer occupied building containing at least are but not more than tbur dwelling structures which are adJ scent to such residence or building be done by regstered contractors. with esrtsin csceptions.along with other requirements. Est.cost Sad Type of work: ' S _ L WCST 8ARN ABLE Add rrss of work: I� Owner's Name m 1 C H'E L Y M06ARET YDONG Date of Permit Appilcotion: I hereby certify that: Registration is not required for the following rrsson(s): Worts esciaded by taw bJob underS1.00L .Building not owner-oeeapied Owner puffing own permit Notice is hereby qG� O`VN PERMIT OR DEG � OWNE$S PUI.LIN B05TE M2PROVEMW WORK DO NOT HAVE CONTRACTORS FOR APPLICABLE GZ1h OR GZJARAN'tY FOND QNDER MGT.142A ACCESS TO THE,�RgIZ'RATIO SIGYED MWER PWALTIFS OF PERJURY i hereby apply 17 a permit as the agent of the owner Date t:oatrstxar Name ��No. OR pwnerjs Name =C3=Appwufta Tabtalt2:ib( ' Pmmnpdm Faelrasa for One and TwoWamily Residential BuiU&p Hewed with Foug Foda MAXIMUM MINIMUM at cgil;n Wall Flow Baaemmt Slab N�C00�e �) I�valua; Rwalucy R value' P vdueJ Wall Ptrits E P E pip Rrvaluet &Val=? 3"1 to 6500 Headaw D Dare' Q 12Y. 0.40 38 13 19 !0 6 Normal Rp5% 127s 032 30 19 19 IO 6 Normal S12•A Wo 38 13 19 10 6. 85 AM T15% 036 38 13 25 WA WA Now U15% a" 38 19 19 10 6 Now V39A 0.44 38 13 25 WA WA 83 AFUE W om 30 19 19 10 6 85 AFUE X 1VA 032 38 13 25 WA WA Normal Y IVA 0.42 38 19. 2S WA WA Normal Z IVA 0.42 38 13 19 10 6 90AFUE AA 18Y. 0.50 30 19 19 10 6 90 AFTJE 1. ADDRESS OF PROPERTY: I�v )(NIL WCST 'MRNS j A6LE. 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): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-1980303a TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION �5� W�S TO L Vl!C,J BR k�ST B LC= Number Street address Section of town "HOMEOWNER" m I UM L L U►V31,91 Name Home phone Work phone . PRESENT MAILING ADDRESS l�Ip la 1 L. W�S I �IZNSTt��I.� (MASS � 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 such homeowners lo_ engage an in- dividual for hire who does not possess a license, provided that the owner a= as supervisor. DEFINITION OF HOMEOWNER,— Person(sj who owns a parcel of land. on which he/she resides or intends to re- side, 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 Offic_ on a form acceptable to the Building Official, that he/she shall be resnonsi� for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes . responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands ..the Town of Barnstable Building Department minir.am ins ion procedures and requirements and that he/she will compJv wi =mid a and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that i- Home Owner engages a person(s) for hire to do such work, that such Home 0 - 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 and Regulations for • licensing Construction Supervisors, Section 2.15) . . This lack of iwarenE often results in serious problems, particularly when the Home Owner hires unlicensed persons. In ,this. case, our ,Board� cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner act-' as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Hier responsibilities, ma communities require, as part of the permit application, that the Home Owner certify that he/she understands,'•the responsibilities of, a supervisor. On th last, page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in -your community. 0 s� o`IXy W Ai I '`. BEDROOM 2 �x to,STORAGE~ y v i 14 x 1p HALLWAY 12 x 18 'SECOND FLOOR = 612 SQ. FT.. SUNDECK 20 X 12 •�+ `• • ) O t KI 10 -PC HEN 8 x DINING ROOM .t:r + 136 x 12 oc!; 126 x 12 r- L �••---� REFRIG -; ! PULL DOWN HALVWAY i GARAGE << 3 14 x 22 �� BEDROOM .. r:.:.. r f _ LIVING ROOM OR 17 x 12 DEN I1x12 a . } -. FOYER.... Ist FLOOR 816 SQ. FT. 1428 'IDTAL SQ. FT. dimensions given are approximate representations.Actual measurements may vary slightly. tome items shown are optional. "Expect the Best' ' CHAMP 1 O N Builders • Developers • Contractors. B U I L D E R S , ^ ;< 1 :N C. (617) 826-3800 FAX:(617) 829-0000 P Town of Barnstable %-7= Old King's Highway Historic District Committee SPEC SHEET Lot 6 Capes Trail FOUNDATION Poured concrete Sides & rear - white cedar shingles SIDING TYPE Front - cedar clapboard COLOR White CHIMNEY TYPE Brick COLOR. Red . ROOF MATERIAL Asphalt shingles COLOR Black PITCH 7 WINDOW RIVCO.wood double hung SIZE 24/24 TRIM COLOR - White DOORS 30/.68 , 2 lite,: 6 panel steel COLOR White SHUTTERS Black GUTTERS White DECK 10 ' x 12 ' pressure treated GARAGE DOORS COLOR NOTES: Fill out completely, including measurements materials/colors to be used. Three copies of this form are required for submittal of an application, along with n.. _ J three copies each of the plot plan, landscape plan and elevation plans, when applicable. Plot plan need not be "Certified", but . should show all structures on the lot to scale: SPECSHT "Expect the Best" it,@CHAMPION Builders• Developers • Contractors B U I L D E R S , I N C. (617) 826-3800 FAX: (617) 829-0000 LANDSCAPING SPECIFICATIONS Lot 6 Capes Trail, West Barnstable Each house will have a minimum of ten (10) foundation plantings, consisting of yews, rhododendrons, arvervities, bayberry and ileac. Lawns will be a minimum of 1,000 square feet of sod. The balance of the disturbed areas will be loamed and seeded. All driveways will consist of a paved apron and 3/4 to 1 112 1bluestone driveway. fit, eq 9 g ea Specializing in Affordable Single Family Custom Homes Corporate-Park 300 Oak Street • Suite 155 • Pembroke, Massachusetts 02359 t I LANDHA P I N G PLAN 9 9 Ct ' LOT 43, to-LI S r. II I �� -- •'7�,{.,'"."^ft'is r=. _ r ,�;,Ycr�' #. L NoUSEED PRoP `1 15to GAR, _ ' , WELL0 WELL WE ti 'r X I' FnGE op -- P.qV\ N\T1�r� PAVeD A PU O ES TRAIL_ D � CJ a u u J I Q 60 cn � z a m TE D � Q I I I I I I � I ( I � I I j I I � I 6 i i rn r l � D F-7 o � 0 l Y A r D j -______ � /� �� �� 7 I _ Application to -6 , 0 87 sP�PN OENN���P w PNs l 0pE OkPy,,PM . Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, 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 CATEGORIES THAT APPLY: 1. Exterior Building Constructio ' 52(New Build* ❑ Addition ❑ Alteration Indicate type of building: House Rrage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE A.P2tt_ Z.4 Igq(o ADDRESS OF PROPOSED WORK -LOT It►S(, APES Tg—A►L ASSESSORS MAP N0. OWNER CNAMPIOrJ PQ1l_DERV INC ASSESSORS LOT NO. G HOME ADDRESS SCO QEyS-19,E 1. SU;-VF KS PEM8R01(.EyMA ["l���q TEL. NO. Sai1 - R2(a-AR�o FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). Fuc.1-IAC_D N1. CAtTQN; #14-0 CAPES -TQAtL 0 VQES� MA QVO(0 3 Lova_tE P. SrJ0,A)r N(TPvSTEE- 1416Nv164 REAUNT2vS-C) 6c,0 FALnn0.3n1 VoAD, LENTE2viLi.E, MA OW,S-L Gr,,KCE A. OL E; 410 PAR-IL Aver . `/A.SZ#AoUT1•i cAh,\P (,,Rotn.PCc uyANNhS. MA 02(001 CkAw.P,o•J tau;�O t f�,,NL• vntOc2 4�4.bE+/lEty�-To NI.A-,-V- S. 4'JAWtZ: L:L LED.J I, JUL-IE E- D6(.0SIA ITT CAGES 'AV.AlL WEB' BAt?_t15-44R�_E, &AA .1C(jA'1Ni.1\1 m Z TkEIZEhA (j(ZAI-ICJ :F,3q CA4E5 - "tA ., WFST 1"_10(:.'3 --AGENT OR CONTRACTOR CAANAPI0t\1 g\_)xL_DE:Q_S, IIVt_.. TEL. NO. 611 -492(0 ADDRESS W OAK_. S-tR£070 521M ISSN FEnng20iLE�ry1e OZ3�9 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). rl Signed Owner- tractor-Agent Space below-one for Gornrraittee use. F ce ed l y C. Datsp - 96 Time r The ertificate is hereby Date M1' ) TOWN OF BARNSTABLE gy,D KING"S_HIGHWAY ` Approved ❑ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved 71 Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET LOT (o j i$(, c-APes T r,�L FOUNDATION Pot-R.Eo C.or1C.R�TF S�OtS � SAE; WM�T� �.FJJ41L5�11r�C��„E$ N4TvfL.Ql.... SIDING TYPE FONT; C-EDAc. C_"PG0AQDS COLOR wvt CHIMNEY TYPE BR_kC_ COLOR ZEC> ROOF MATERIAL AS Pl-1ALT 5`�4,\&fGtLes COLOR 1z31LA<_V. I PITCH WINDOW R%VL0* W65D DOv3L-E 14uVjG SIZE 24� Zd TRIM COLOR W"11'E DOORS 30 f&rd 2 L%TE . (o PA t-J;. S-MF-L COLOR )AJ N VTC SHUTTERS BI�AC_K. GUTTERS W u DECK 10`x. lZ! F'R-ESE TtA `p GARAGE DOORS RAiSr D Q l ,�_L STC�L COLOR rc� NOTES: Fill out completely, including measurements and materials/colors. to be used. Three copies of this form are required for submittal of an application, along with three copies each of the plot plan, 17� landscape plan and elevation plans, when applicable. "Certified" , �( PP Plot plan need not be but should show all structures on the lot to scale. SPECSHT "Expect the Bes " 11f,ICHAMP16N Builders Developers Contractors B U I L D E R S , 1 'N C. (617) 826-3800 FAX: (617) 824-0000 LANDSCAPING SPECIFICATIONS Lot 6 Capes Trail, West Barnstable Each house will have a minimum of ten (10) foundation plantings, consisting of yews, rhododendrons, arvervities, bayberry and ileac. Lawns will be a minimum of 1,000 square feet of sod. The balance of the disturbed areas will be loarmed and seeded. All.driveways will consist of a paved apron and 3/4 to 1 1/2 bluestone driveway. i f i Specializing in Affordable Single Family Custom Homes Corporate Park • 300 Oak Street .• Suite 155 Pembroke, Massachusetts 02359 y�Kr ri8�ys NSTABIEI MASSACHUSETTS 'ASSESSORS MAPS tAvy °K•f li � � r - r � 'its 1-10 ' ED 1-1� I.00AL • '� I.O O AS- te'" i 00ac S AC. 1' Q 1.00nc .{.) .�� 3 3 0 / fop G. TV" k� � 4oL dA 1.0° �p •� '+° riti G, ate, GOAL J��, AG It ✓°�.r�l (• , M ryo. Ar- °f• hd"Aw.W:Is 0 `eV 11[Y.BY AVH wo •._ IMAI /D6I tnu I'•lod ; '^ IV 14 N°�►a:ui:m a r 1.03 A.G. i � \ \ \ \ e -\ \ 4z•SG 1-4 K9 •j� � ��� /c �� ��---- \ /Sig i,err � � ��S\'•j_j�,,"`�,►+,ram. �r•'"� / ._. 131 =a ` ll �6f I� F /G GG��• Qt. G I D •r •.ter ~~j •�' t:,.��. •t�;.�'�., ��. �• •t �•�r' i •� ��•iris u� • t s�,� •t..t �� /!• is �: �• va& dP r�•••!M `�� �{�� ;,;�.:K� � "31, �".� •ram.�:t. �.i'�'� • , •. - :.-r. .�►� � �?rr„v • � q �° :,vim+_ :� �-� _ , z:--�,- �.� —.cx —.,. ,,; , I'r l t` MASTER z BEDROOM BEDROOM 2 STORAGE i r.. HALLWAY 12 x 18 t; 14 x 18 ) r � 7 • !; f ` •SECOND FLOOR =.612 SQ. FT. SUNDECK 20 x 12 r' i F .. 4 i ' $Q pW��a� �. Kl'PCHEN DINING ROOM ' 13' x 12 K,� ' 126 x 12 3>j r I � � REFRIG ; PULL DOWN s ' 4 1 • 4 HALLWAY r r � 1 GARAGE ,` ` d Y Y 1ax22 - , k }. q BEDROOM s G ROOM, OR LIVING � � " f 17 x 12 ~, _: DEN 1 °��tiµ.'° 11 x 12 ,r FOYER / 1st FLOOR = 816 SQ. FT. t 1428 TOTAL SQ. FT. 4 The dimensions given are approximate representations.Artual measurements may vary slightly. Some items shown are optional. . Tl� r "Expect the Best' ' HAMPION Builders • Developers • Contractors, ® B U I L D E R S , I ,�8 C. . (617) 826-3800 FAX:(617) 829-0000 ` "" The Cumnnmntrealth of Massachusetts Department of Industrial Accidents - t ONCE 0"fivest/9alloas 6110 N'a.vidiigton Street • ` •: �: Boston.Alas. 02111 ' Workers' Compensation Insurance AlTidavit 451lcant tntor•mation• Please 1'RINT'le bl ��'� narnz CHAMPION BUILDERS INC loc•Jtion• 300 Oak Sr t-ntw Suire A-1-55 cin Pembroke, MA 02359 nhonc0617) 826-3900 _ I am a homeowner performing all work myself. 0 1 am a sole proprietor and have no one working in any capacity ® lam an employer providing workers' compensation for my employees working on this job. cmmrany nnmc• AS ABOVE'' •tildre��• - citv. ohnne#- in uran' co PLEASE SEE ATTACHED CERTTFICATR OF icy# TNSTTRANr-R ® I am a sole proprietor, general contractor,or homeowner(circle otre)and have hired the contractors listed below who I the following workers' compensation polices: m nnm address- ;,�.. phone#• incurnnce co. # 's� -- 4c,.7r+ •sue.-=r.-r�r-1+r.-�*�s.v-=s•--v. --�-7�Vt,�alg•'e1r�CT;�4f7 ' "'"1'� .>--- cmmnlnv name• •address• - — city• phone#• _- inaurince co .Atinchadditioriai'shiiiif'nifEna wac,�. •�•c^'er...�:=cam_,,; s._: ' r-_•..`.� �'"'o.a".•'Ir�s e = --- ,;,..'' Failure to secure coverage as required under Section 2SA of 1%1GL 152 can lead to the imposition of criminal Penalties of a fine up to SI.300.00 ane unc vicars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a flue of SI00A0 a day against me. 1 understand tht cope of this statement may be forwarded to the omce of investigations of the DIA for coverage verification. I do herebt•cerfifj•un the d eualties ojpedurt'that the injornmtion,provided above is true and correct Sir-nature -Date 12/12/95 Print name Matthew one# (617) 826-3800 } 0 Iicial-use oniv do not write in this area to be completed by city or town oflkiah cih or town permiiAlceuse# r9tiuiiding Department `• Licensing Buard O check if immediate respunse is required [3Seleetmea's Office C3I1alth Department contact pcnon: phone#• r JOther uevlsed 3195 PJAI �r , .::...:. ::..:..::.:...:..::......::... `:' < >`: :>"a:::::;; .:`:<:::<: < ;; :z<`<:>': ' : i; : ;: t::>c:z ;j._ .>?<E >si< »E .....,.Ti-.................. , CARD ,� T CRTIFIC: IE O LlAB1L�1 'Y IN.SU:RAN:CE............. OATE(MMIDDIYY) NK.fd,•TH:..:.f.•fiVi:A:::f.LPN%:J:u:t':viS.vv:::.v.v: :.........:.v:pJ:PT>Tii%O"•....::�„ii:<:.:ii::.TTiii:};::T:•ii:••::•:••w..> .::.:.T.::i€. 12/01/95 z' PRODUCER (617)826-0123 FAX (617)826-0301 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION .]. Rielly Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND,OR 243 Church Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pembroke, MA 02359 COMPANIES AFFORDING COVERAGE .................................................................................................................................................. COMPANY Hanover Insurance Company Attn: Ext: A .. ...................................................................................................................................................:...............................,.................................................................................................................. �I(suREo, ' ' COMPANY Cigna Insurance Co. `hamplon Builders, Inc. B CorporatePark ':.................................................................................................................................................... Suite 155A COMPANY C Pembroke,' MA 02359 ..........................................................................................................:....................................... COMPANY D ` :..............................:...............:...:..:............:......::.........:::::::..........:... ............' :: :>::«: <:>; :<:: ::>; .. .»> .>MEN <::>> : :>:<»>:::>»»3i<':: >::;::>;»»»>:'•>:i:»::::::><:<::::•»»>:s»> ...........................> ;; ::: ::> >::> .k:;;:•'.:::2:::;::•.;�;:.:.;T••:•TT:�;��;;>`:><:;:sr•�i:>� :>S:b:S: �r::�:;:;>:t:<::<y:;:;�:�5;;;:�;:>::;:i;:�::sS:::<e�T;::.;T••T:>.•>:•T:fT ::«<T;s>:>c :;:::.�::::::::.........:::.........::.�::.:.,;.::•:.;;.;........::... .;:;.:;•TTi:.:.;T:,. .........::::::.....:::.:::...........::.....,TT%JiT::i:• .:....:.....:......,....i..:.....,:.,,......T...,.:...,...,,i..,v:::,.:.::.,.::N».:.::,.,..:.J.,�:.�,,.::.::..::::..:T.:�,;:.%.%.TTi;:>: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ' CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. .............................................................................................................................................................................:.................................;..................................................................................... CO TYPE OF INSURANCE POLICY NUMBER :POLICY EFFECTIVE :POLICY EXPIRATION LTR: DATE(MM/DD/YY) DATE(MMJDD/YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE :f 2,000,000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ 1,000,000 :'::::;':........ ......... :.................................................................................... CLAIMS MADE X :OCCUR: PERSONAL 3 ADV INJURY :$ 1,000 000 A <::: :::....., ZDN3851016-03 :: 04/01/1995 04/01/1996 ........................................... .......1.......... ...... OWNER'S 3 CONTRACTOR'S PROT ... EACH OCCURRENCE f 1,000,000 ...... .................................................... E(Any one fire) .$...................50,000 ............................................... FIRE DAMAGE MED EXP(Any one person) f 5,000 i AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT i ANY ALTO i i : . ;COM f ....... ALL OWNED AUTOS : BODILY I........Y SCHEDULED AUTOS .................. 1 000,000 X S : pew+) R q :.......; AMN385097303 € 04/01/1995 04/01/1996 ..............................................:. ................................... X :HIRED AUTOS BODILY INJURY .q •X•• NON-OWNED AUTOS (Per a=idenq $ " .......: .................................................... PROPERTY DAMAGE :$ i GARAGE LIABILITY . { AUTO ONLY-EA ACCIDENT $ ,t :ANY AUiP :OTHER THAN AUTO ONLY: ...........:::.... ::::::............:::::.:::::::::::::.: EACH ACCIDENT:$ .............................................v..................................... AGGREGATE:$ EXCESS LIABILITY EACH OCCURRENCE :$ UMBRELLA FORM :AGGREGATE :$ ................................. OTHER THAN UMBRELLA FORM is WORKERS COMPENSATION AND :TORWC Y UMTS: ER ':':: EMPLOYERS'LIABILITY ......:..................................... .,,,,.,...,... EACH B THEPROPRIETOR/ WOCC41,601279 06/27/1995 06/27/1996 [E� � $ 100 •• ••DENT•••••••••••• ::.. PARTNERS/EXECUTIVE .....: Ir�L ;EL DISEASE-POLICY LIMIT s 500,000 ...............:.............................. OFFICERS ARE EXCL EL DISEASE-EA EMPLOYEE:$ 100,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES/SPECUIL ITEMS T. . �ATE.HOLDER. ........................................................... ........ :::::::.::.:::::::::::::::.::.T:.T:;.;:.T.TT�.TTTT•.:;:<:::::::::::::.:�::..:::::::::::::::::.:.,..�:.::::.::.:::.:;.>:.:.: ..CAN CE T10N:.:.TTr::iTiT�::�.T:.;�.TTTT:.T..:...............:.::.::::::•;:.;TTTT:::::::::::..:::::::::::.T:.;:.;::.;:.;:;::::........::::::.::::::::::............... .......................................,...:.................................... .....,..N..f::�.:.....r:T:Tx:;•%;•T;.Ni':::::.::.::,:::;.:i'.•.:.f:'::>:::::::PTT:P�:Tii:ii:Tr:.TNT%::R:::S�::::>Gii:�i:;c::::::::::•.'::;:�:s:tiTi:.TT:R,:: : SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town Of BarnstableEXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL Building Department ; lO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Main Street BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE No oBLJOATKk1 OR UABILfTY -/ Hyannis, MA 02601 OF ANY KIND UPON THE CO AP NY,ITS AGENTS OR REFUESENTATNES. AUTHORIZED REPRESENTAT nita Chesson x:TTT:•T:T:,,.,::.:r:; :.T:»:�.T::..T:::.T;T:.TT:.>. ,�,. .,.........:PT:.::..,.::.: ::.iT;T:;;:.;..;::.:;:.�,.,.>:.,T�:.Tr.;::•T:.:.::T:.;:::.�.:::::::.. ,•..:�>.::•> :::::::::::::::::::::.::::..:::....M..........................::::::::.::.................. e A6 i kI$tR[�:TIONS: 1G I j � lie -Parrrr�uyuvea/.� a�..2�rau�c<u�eCta ( OEPARTMENT OF PUBLIC SAFETY i i 00 - None 1A - Masonry only License....CONSTRUCTION SUPERVISOR t 'G - 1 8 2 Faoily Nooes U01res Birthdate CS " -0.KO20, 01'%06/1997 01/06/1962 "� MATTE J� OACEY "'a8U11RROS BAY, MA usk t COMMISSIONER Y .. '• 1 1. 9 x1• . ��`�` \ \\ \\ �`\ ISM ` � '�� ��S s7 � LOT 18 99 9S / -- LOT 56 42 SD' LOT 4 LOT 6 & 6A 43,621 sq.ft �O 1.00 Acres O� .�y %Ko ti 356� Off. CONC. FOUND. F.-160.2 LOT 55 T� �I l JOB # 95-391 L-6 CERTIFIED PLO T PLAN 41s(. LOCATION : CAPES TRAIL HEST BARNSTABLE, MA SCALE : 1" = 60' DATE : FEBRUARY 20, 1997 PREPARED FOR: REFERENCE LOT 6 LCP 40599-B SHEET 2 LOT 6A PB 489 PG 51 CHAMPION BUILDERS I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE �`AN Of ,y GROUND AS SHOWN HEREON. o�� ARNE G off SM-362-4541 = H. fox SOB 362—NW a4 OJALA - I 8 0 l down cape engineering, inc. CIVIL ENGINEERS LAND SLJRVEYOR9 — — — -- — ------ aae mein at. yarmouth, ma DATE REG. SURVEYOR U?SIS-�ib(12-007 i v. A69' ob' - Qo'(�- 67 Engineering Dept. (3rd floor) Map Parcel Permit# ��"�``3 House# I 5b Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) �' Fee s Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) C SYSTE M M E Planning Dept.(1st floor/School Admin. Bldg.) nn INSTALLED IN GO Definitive Plan Approved by Planning Board t'IU� arp 19 l. WITH TIT ; EN"ONMENTAL • RNSTABLE. ` TOWN OF-BARNSTA&V REGULQ�,�Q BBuilding Permit Application Project Street Address 156 101AIPS TM i c_ .� Village WEST N MF�I C Owner M J CJAA�L Y MAQ�At FT ,UU N6 Address 15(,1 CJVES 7 01 L (AJ E_W�E*ck Telephone 5c z l ��- -Permit Request 'f0 , 8DO A 14 )20 bECX ON 1'1 P)ACX Off• *CI)Sif First Floor square feet Second Floor '' square feet Construction Type NEW Estimated Project Cost $ `7 Zoning District Flood Plain Water Protection Lot Size I ACRE Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I U � Historic House ❑Yes )2�No On Old King's Highway 91Yes ❑No Basement Type: oFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing ( New Half: Existing New No. of Bedrooms: Existing I New Total Room Count(not including baths): Existing 4 New First Floor Room Count Heat Type and Fuel: VGas ❑Oil ❑Electric ❑Other Central Air ❑Yes )I No Fireplaces: Existing NO New Existing wood/coal stove ❑Yes ZJ No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IGNATURE DATE BUILDING PERMIT DENIED FOR THE F LLO ING REASON(S) FOR OFFICIAL USE ONLY R PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER . DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: Rt YPH FINAL GAS: -R0-GH FINAL FINAL BUILDING a �rl , DATE CLOSED OUT ASSOCIATION PLAN NO. Ow -oco -oil Asses5or's Office(1st floor) Map "8 Parcel "It� (YePermit# Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Z Wvn Date Issued oZ o2 I Board of Health(3rd floor)(8:15 -9:30/1:00-4:45)91,,— �MR.A. /U • �� Engineering Dept. (3rd floor) House# G S�o � �/ �� �� �IKE ra, Planning Dept.(1st floor/School Admin. Bldg.) ®' �� 5" % �dpw :. BARNSI'ARLE. Definiit ivee lap Approved by Pla ng Board 19 �LJ- ter., .T�,�Eo,'Aa�+`�� c� �— 2-vle c/ sy TOWN OF BARWTABL Building Permit Application ProjecP' Address Lot 6 Capes Trail (House 156 ) Village• West Barnstable ' Owner Champion Builders Inc. Address 300 Oak StreP-r_ Suite 1 5S, PPmhrnkP, If A • Telephone (617) 826- 3800 02359 Permit Request To construct a 28 ' x 44 ' ranch style dwelling with 3 bedrooms and 12 baths First Floor 1 , 232 square feet Second Floor — square feet Estimated Project Cost $ cS 7 -76d• c Zoning District RF Flood Plain C Water Protection n/a Lot Size 43,621 s g.f t . Grandfathered ? no Zoning Board of Appeals Authorization Recorded Current Use land Proposed Use new home Construction Type wood frame Commercial Residential x I Dwelling Type: Single Family x Two Family Multi-Family Age of Existing Structure n/a Basement Type: Finished Historic House n/a Unfinished X Old King's Highway Number of Baths 1 i No.of Bedrooms 3 Total Room Count(not including baths) 5 First Floor 5 Heat Type and Fuel F.W.A. by gasCentral Air n/a Fireplaces — Garage: Detached Other Detached Structures: Pool Attached Barn None x Sheds Other Builder Information Name Champion Builders, Inc. Telephone Number (617) 826-3800 Address 300 Oak Street, Suite 155 License# 046020 Pembroke, MA 02359 Home Improvement Contractor# 101920 Worker's Compensation# WOCC 41601279 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. . ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO local dump CHAR d , INC. 1995 SIGNATURE DATE Dec. 11 , BUILDING PERMIT DENIED 01 '1 sL1G REASON(S) FOR OFFICIAL USE ONLY i a PERMIT NO. 6 L DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME. INSULATION - FIREPLACE ELECTRICAL? ROUGH FINAL PLUMBING_ i� ROUGH FINAL GAS: ROUGH FINAL , FINAL BUILDING ���C�i� � DATE CLOSED OUT y ASSOCIATION PLAN NO. TOWN OF BARNSTABL �� CERTIFICATE OF OCCUPANCY PARCEL ID 000 000 041 GEOBASE ID ADDRESS 156 CAPES TRAIL PHONE (617)826-3800 WEST BARNSTABLE, MA ZIP 02668— � x t LOT 6 BLOCK f LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 22716 DESCRIPTION SINGLE FAMILY DWELLING (BLDG PMT #13377) PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmegtal Services TOTAL FEES: BOND $ 00 i Ox ' CONSTRUCTION COSTS $ ` 0 < . 753 MISC. NOT CODED ELS ERA * BARNSI'ABLE, •' OWNER CHAMPION BUILDERS, INC. , 0339.1 ADDRESS #155 -- ED M1� 300 OAK STREET BU -� / PEMBROKE, MA ILD : V QN � s B ��� DATE ISSUED 04/29/1997 EXPIRATION DATE Department of Health, Safety and Environmental Services 1 >: BARNS TABLE, w' MASS.039. ���► BUILDING DIVIS�ON� BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES 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 FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. z 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS . ;OWAC.1 2 2 / 2 ?6$P;F 3 1 HEATING 1NSPF0T!0N APPROVALS ENGINEERING DEPARTMENT 2 'y 23 p,7 � BOARD OF HEALTH OTHER: e r n SITE PLAN REVIEW APPRddAf- 67f 7 WORK SHALL NOT PROCEED UNTIL LNOTEDf8nVE. T WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE TION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- HS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. TION. BUILDING PERMIT, LOT (o c-A P ES TRAI L 12*-0• Cowhous RIDGE VENT • f 2x10 CONTH=S RIDGE BOARD 12 7/ I ASPHALT GLES ON j/2' Y EXTERIOR PLWOOD ROOF 12 5HEATHNG `7 2xa RAFTLR5 AT 16' O.C. ATTIC N5U.ATM - R-30 i T 1 VENTED DRIFEDGE 1x6 FASCIA BOARD NOTE, AT FAMLY ROOM PROVIDE IXGFTI SOT BOARD L2' DRYWALL WITH FNSM 2x8 CMNG JOISTS AT 12' O.C. Y 1/2' EXTERIOR PLYWOOD SMEATHNG WITH SIDING WEWAt N5ULA7IoN R-11 3/4' T+G PLYWOOD 5MnoOR 2xb FLOM JOISTS AT 1G' O.C. WTTH C 55 BRIDGING J GX1O SOLID GRT �ADt. BASEMENT NSU.ATION R-19 r,j// r J i 202xG P.T. SLLS WITH ll EADS AT 9' rJ1/ 1/2' x 12' DEEP ANCHOR BOLTS rJ / DAMP PROOF ALL 13 SAT B' r*J. 3 1/2' LALLY GOUJMH f. FDN5 BELOW GRADE t r.J rJ / J j �i r b• P.G. FOU'iDATON WALLS 2'x4' COW. KEY / 3' P.C. SLAB N I I 24' WIDE x 12' DEEP P.C. CONTNUOU5 WALL FOOTING30' WIDE x 30' LOMG x 12' DEEP P.G. FOOTING BUILDING GROSS 5ECTION 1� Sao 3-O - 3'-0• ate. CELLAR CeLLAR (o �' 5A5H SASH 24' WOE x 12' rp P.G. OKTNUOUS WALL FOOTN -------- -----� I I I RN I I I '� Lft x I " In of I I I o� U 02 d =� Op ;1 1 1 Ro jO x i4s I I i o41 S � I I of I o I to I I I I I b N I � I POMT — ----- I I I I 3'-G- 1s'-o 1 Application to 1996 006 epP�tO NN tE P'N�N`' Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, 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 CATEGORIES THAT APPLY: 1. Exterior Building Construction: New Building ❑ Addition r] Alteration Indicate type of building: House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE /1 1 /95 ADDRESS OF PROPOSED WORK. Lot 6 Capes Trail (House 1 56 L_ ASSESSORS MAP NO. 88/6-7 OWNER Champion Builders, Inc. ASSESSORS LOT NO. 6 HOME ADDRESS 300 Oak Street, Suite #155, Pembroke, MA 02359 TEL. NO. ...(6e17) 926 3990 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). Kristen M. Plausioc 125 Canes Trail, West Barnstable' ilk Mary Ann Laczko, 155 Berkshire Trail, West Barnstable, MA Grace A. Olive, 80 Peter Blossom Lane West BarnstablP, MA Mr. & Mrs. David Belcher, 107 Capes Trail, West Barnstable, MA 71; OR CONTRACTOR Champion Builders, Inc. TEL. NO. (617) 976-3800 ADDRESS 300 Oak Street, #155, Pembroke, MA 02359 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No. 8,other side), including ' materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Construct new single-family dwelling (see specs attached) L l(i1+�1(�f ,il ; �� CH ILD RS, INC. �� r�T Signed Owner- ntractor-Agent Space below line for Committee_use. By: Matthew .I aces, President .-R ecei ved`by-H.D:C. Date �-' The C�iis herohJ n 0 Date TimeDEC I $ 1995 By, rit- 3Ai N'-,TA. A9 Approved ❑ IMPORTANk If Cert/cate4ysapproved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion .of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. si 2 b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. r_ c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color.. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall.