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0340 CEDAR STREET
D ce)1w..Ox � ford NO_ . 152 1/3 ORA ESSELTE 10% ..v v wly�• a- j i .mow � 1, .�♦ MICHELE CUDILO, P.E. Consulting Structural Engineer Centerville, Massachusetts 02632-1979 • (508)737-8521 • mcudilo@comcast.net August 31,2017 Mike Silva Builder 82 Walton Ave. Hyannis,MA 02601 RE: MODIFICATIONS TO DECK CONSTRUCTION 340 CEDAR ST.,W. BARNSTABLE,MA Dear Mr.Silva, Please note that the above captioned project has been reviewed with you at the site on August 30, 2017 for construction in accordance with requirements of the Massachusetts State Building Code 81h Edition. The scope of work is to provide a wrap-around deck on the building right hand side and rear. Engineering analysis and calculations were performed on the as-built construction of deck framing components. We concluded that the SIMPSON A35 will be added to one side of all stair stringers and deck joists outboard of the house ledger side. Note that the ledger attachment with two 5/8" diameter x 6" long lag bolts per 16"joist bay is adequate. a The Building Rough Frame approval is sought following the A35 installation. Should you have any question on any of the.above, please do nptbesitate to call. Sincerely, Michele Cudilo, P.E. oa MICHELE /2017-215 CUDILO , 4 STRUCTURAL No 34774 �O Q 9FQ/STEP g�S!ONAL�G 6G -C Wd I C .J , i t 919visNsve JQ f41"°Ql - -- - - �� � I � ,� II r l it �� > i .�•" 1 ��� h T t 4 -lam '}� l_. �• 3 _ Town of Barnstable 0 Building Post This�d So That tas 1/isible;From--- zbtreei_-..Approved Plans Must be Retained on#Job:and thisECard Must be;Kept Posted,UntilFinal nspection HasBeen Made bg 16,10 Permit may► .. Where a tertificateofOccupaney is Required, uch Buildingshall Not be Occupied until a Final Inspection has been�made. Permit No. B-17-1929 Applicant Name: MICHA-EL SILVA, Approvals Date issued: 07/03/2017 Current Use: _ r Structure Permit Type: Building-':Deck Expiration.Date: 01,/03/2018 Foundation: - Location: 340 CEDAR'STREET,WEST BARNSTABLE Map/Lot: 131-013 002 Zoning`.District: RF Sheathing: Owner on Record: GARY,THOMAS S&JANET J LAKSO- u Contractor»Name: MICHAEL SILVA :Framing: 1 Address: . 340CEDAR STREET . ContractorZ icenW ,CSFA-106219 -2 " " WEST BARNSTABLE,MA 02668 Est PcolectCost: $20*000.00 Chimney: Description: rebuild deck 26x12'4"in rear of house e:- $110:00 Insulation: Project Review Req: rebuild deck 26x12'4"in rear of house Final: y ,Date _7/3/2017 s Plumbing/Gas r ` ,Rough Plumbing:. Building Official final:Plumbi . , ng: This.permit shall be deemed.abandoned and invalid unless the work authorized by thispermit is commenced within six months afteriissuance. � � K � r Rough Gas: All work.authorized by this permit shall conform to the approved application and theeapproved construction documents:for EZ�RIwhichg-this permit has been granted All construction,alterations and changes of-use of any building and structures;shall be in compliance with,the`locaI zonin&y laws,and codes. hW",n t final Gar. This permit shall be displayed in a location clearly visible from access�street�or..ro<ad a"nd shall be maintained open.for p,blic,mspeetion.for the entire duration of the work until the completion of.the same. ` §} . '. -.Electrical The Certificate of Occupancy will not be issued until all applicable signatures b:xhe<Buildi_&and f W0rrida1sare provided omthispermit. �. � Service -_ Minimum of Five Call Inspections'Required forAll Construction Work: . , 1.Foundation or Footing - Rough. 2-Sheathing Inspection w _ 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: - 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection ' 5.'Prior to Covering Structural Members(Frame Inspection) -Low'VoltagetRough: 6.Insulation - 7.Final Inspection before Occupancy - ` Low'Voltage Final: a Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. t y Health Y t `tl 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" (asset forth in MGL c.142A) Fire Department Y ! Building plans are to be available on site Final: 7 All Permit Cards are the property of the APPLICANT-'ISSUED RECIPIENT - i Mckechnie, Robert From: Mckechnie, Robert Sent: Wednesday,June 28, 2017 9:59 AM To: 'mashpeesilva@aol.com' Subject: permit application for 340 Cedar Street,WB Good Morning, I need to know the height of the replacement deck above the grade. Also,the deck must be constructed following the requirements of the Prescriptive Wood Deck Construction Guide based on the 2009 International Residential Code.This guide can be downloaded off the American Wood Council's website. Several items on your plan will have to be addressed (i.e.: post size,attachment to the house—multiple ledger locks allowed per code,closed risers on the stairs, lateral connections or bracing). Contact me with any questions, Bob J Robert McKechnie Alp G� Local Inspector Building Department r Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 . 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ` Parcel Application #. 7 `C C Health Division Date Issued 6 7 Q �' 3 /7 I N4< Conservation Division LD1fy(3 � r Application Fee Planning Dept. UUN 0 . Permit Fee 1l Date Definitive Plan Approved by Planning Board T0VV1V n n 9 Historic - OKH Preservation/Hyannis °�� iiiJJJ Project Street Address ,� �� Village gWA<-1 ZkPZ&X7(,46Le- Owner J6 pu r-1 C19 g X Address __?YO Telephone 570 e J_;!�40 0 2 6 !/ Permit Request — Av,)z� L3 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District. Flood Plain Groundwater Overlay Project Valuatio Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: es ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ull ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) /161-t-f Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing► new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ exi ' g ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size✓ Attached garage: existin ❑ new size Shed: ❑ existin ❑ new size Other: 9 9 9 — 9 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION f (BUILDER OR HOMEOWNER) Name /�P�4�O Z ���c� Telephone Number Zy'5— Address tS � �/ �• License# eflL�� Home Improvement Contractor# Erriail ,L a§1<</,4 L w' Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i SIGNATURE DATE FOR OFFICIAL USE ONLY : ' APPLICATION # DATE ISSUED _ MAP/ PARCEL NO. ADDRESS VILLAGE OWNER L. DATE OF INSPECTION: FOUNDATION FRAME _ INSULATION }s . FIREPLACE -ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r` FINAL BUILDING r DATE CLOSED OUT ASSOCIATION PLAN NO. �s. t. i Cowmmwed* afrud-=ftd� f 6MRRaa�� `` �Wg,MA 02Hi Wwim& Qugpews�-m Limumcm Affi&'*f'Bwl*-s1C= EIS ATmE=ndInf6rzuafiDxt (� Please Frfid •I�Tame sG' �..�%L /� . Pam- Y5- 210<' Are ym an employer?Ch;ckthe appropriate ba= Type of project(regna ed}_ I_❑ I mn a layer with 4 ❑I art a gesietal deter and I 6. ❑New eau rwxtion (fiitl air part4ime)-* IM"lzitedgm 2. I am a t P rqldeto r orpartoer- fisted cnf$e attached sheep I- ❑R-renaeHng ship and have no ewpk5ees These sub-conkactas.h=e 9 ❑Demolition waddng :r5ormR isauy Wig. `'` p"1ew 9. ❑'"ik" addition [No wadonw MGM= romp, -j 5. ❑ We are a corporafian and ifs 16-❑Ekchical repairs or adQions 3-❑ I am.a bameommer doing Z work ads have ex sed tbPw 1 L❑Pi repairs ar am ions ' myself [No worken•coxap- a�of M(H f52,gI{ ha�ve� LZ_❑Enoft�s . 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J• /A .:I 1F1q.8I1i1mCWv&1V.C-�A to a. euv 1l- ��■:1 •/■�.!■■ :■/. .•\ 1- i•l■Il ./■1 1:1, ■1ll■1 a i �-:+■.t Irf�/ •_ t1/13:.V1� frN f:.f 1. ��� ��.w11111• /•!r �1 i� f■ al-/ y3 • Oak wl� 9• f ■ �• 1 r • AWE Town of Barnstable Regulatory Services . r � Richard V. ScaI4 Director ►� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L o-,r as Owner of the subject property hereby authorize /"/f(�42/ S ` Ve, to act on my behalf in all matters relative to work authorized by this building permit application for. 3 �JD Cedars Si e sV S/OY (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all inspections are performed and accepted. tune of Owner Si tore of Applicant JJ aq eJ /a�so-(�a 1-e Ac- Lll�zz Print Name Print Name CQ a?v 1 Date QXORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services QIF Richard V.Scali,Director Building Division a�axsr Paul Roma,Building Commissioner t0 ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less.and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who.owns a parcel of land on which he/she.resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. i 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 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. Q:\WPFILES\FORMS\building permit fomis\EXPRESS.doe 06/20/16 � p ®sk, VX b � c cX 1 I O/ Xz f _J A - Jy X /O 101 �o o 4L _ r rA 3 1 l rl J � � J r N v s- � x O °3 L%oar:•' : t L'ui?;,tir.,7 lic4llli3lic•u,. •nd' :,;d CSFA-106219 MICHAEL SILVA 82 WALTON AVENUE " HYANNIS MA 02601 r 06/28/2019 Construction Supervisor 1 &.2 F Restricted to. emily - Failure to possess a current State Building Code- editio cause n of the Massachusetts " t)pS Licensing in for revocation_ r►nation visit: of this,lice W.MgSS: nse. GOV/ppS ,p� U/ze rparnyrw�uuecz�o��aaac`ivaeCCd - . .—� Office of Consumer Affairs&Business Regulation ' HOME IMPROVEMENT CONTRACTOR i2gi.3i'-:ices valld for individual Lise only .:9 ,. TYPE:Individual befo.o i't,a c-xp ration dais..N":owyd rc4urn to: eoistration Expiration Office c•'�onsusner Affairs and Business Regulation `—'t74Mb8 06/03/2019 10 Park'Plaza-Suite 5170 !I �;, n� MICHAEL SILVA:8----_,:: :— Boston,. t': 0:211 � gi �' .'C MICHAEL D.SILVA..'= r= r 82 WALTON AVE. HYANNNIS,MA 02601'" Undersecretary �o°valid Ithout signature I , I i 1 I I I � i r I 6 I � tA IL VI QLOT L 44,2y 1 I.OZ'_AC� r, 0 I I I I II • II i; JOB 84 046 CERTIFIED PLOT PLAN LOCATION. LOT 2 CEDAR STR W BARN PREPARED FOP.- SCALE. 1 11=5� DATE: 03/22/88 REFERENCE: PB 330 PG 30 JON BRITTON I HEREBY CERTIFY THAT THE BUILDING i 'SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. BUILDING CONFORMS TO SETBACK REQUIREMENTS I, OF THE TOWN .WHEN CONSTRUCTED. �k Of M I i ARNE I down cape engineering Is aA'LA ^} CIVIL ENGINEERS t R'^348 LAND SURVEYORS ROUTE 6A YARMOUTH MA DATE -SECTION - SEWAGE' 14 `0 z -SEPTIC TANK - - "D"BOX - - LEACH - ) TOP OFFDN �S-tom (MSL)st 4SMGr/� AI.►K 4u�V,TP:CSI.E FtSiz A 1)i t3rAAiGTi. " bF' t0 F)• A¢ou►.t.0 vt.aT»`� l t¢A-O Aw40 WASHED STONE C X-10P,", lot t I F S\ IN- OUT- I ; \ 14oC� IN- OUT- 1 fPT'� •1L \ `Ni \ / -7Z.ryZ -11.lo Z SEPTIC -11•�i-1 -It G7 4 -. <, IN, \ TANK •ct. ELEV. ELEV. ELEV. \ jj ELEV. \ \ / / / (>'� Q ��1 � ELEV. ELEV. CaCn•Q _� Q.S` OFV4"-1qx" ,3S6�V.wc.-�iar WASHED STONE TEST HOLE LOG CI, z 3? P 3d¢� •, \ \ \ 1 I �, 'TEST BY ��►TF�AdJ'L.,�''•�. J. TEST DATE ��:z2AI WITNESS DESIGN 3 BEDROOM HOUSE T.H. 1 -t 1.5 T.H. # 2 Oc.7° ELEV. pp ELEV. NO9 \ \ 1 �• ." 42- MIN/IN. DISPOSER DISPOSER \ l � ` PERC RATEI—� ` 4"" \ FLOW RATE 330 (GAL./DAY ) Z loct.t, L4�. SEPTIC TANK 41 y :► Mm 'REQ'D SEPTIC TANK SIZE ewe LEACH FACILITY S f1`, �r� of yam_' =•f- \ G`2/ \ \ SIDE WALL 1 1 = G/D. -1 Z" (P5.•� w�t'siV G� •�S w��2 7-o x 2.� ' ` BOTTOM 4 I t.o ) = 4oy G/D. TOTAL ,ot+) = a v0 G/D. '} �n� ��t ; - 1 `f \ \ f CLOW D.s USE: LEACHING ( •t \ zo 1 lZta' . Co1.5 itp" Coo. Zo" �'� le ,q-1l. yc Zo` kc ,u•��1. 'k1� \ 1 \ \ 15 WATER ENCOUNTERED O j \' \ \ + , -7� � 1Z.4, \\ � NOTES: (UNLESS OTHERWISE NOTED) \ \ C 1. DATUM (MSL)t TAKEN FROM..... ••.•..QUADRANGLE MAP 2.MUNICIPAL WATER....r,U_1...--_.........••.........AVAILABLE A:� l .`i ��► � �^ , 1 \ \ 1C � ^�' �A� 3:PIPE PITCH: 1I4"PER FOOT r 4'2'�f \f `C` 1' A 4. DESIGN LOADING FOR ALL PRE-CAST UNITS: AASHO- (O 44 + ; �- l 6 A!IIVE }(• j. S.MIN.GROUND COVER OVER ALL SEWAGE FACILITIES: (1) FT. , I !: ° OJALA i — 'O--'DISTANCE AS CERTIFIEssD ` r t0� q tie `} �� �\•`� 6.PIPE 40INTS SHALL BE MADE WATER TIGHT '� ` C, � 1 . � CIVIL Z3 , - � �;1' -' � f'"�_ SITE PLAN 7.CONSTRUCTION DETAILS TO BE ACCORDANCE WITH COMM.OF MASS. � !! No. 30192 �^ � r� STATE ENVIRONMENTAL CODE TITLE 5 rT ,� Y. DLTfQMlN4 LO<AZ rON v F WELcS .�cQaS� T. PR"un. t o LoroST- i..S � � tq t , 1 t ." '" L CUS: zF p y `11}, \ ./ y P kf ) I �/114r� � a • � . � l l� I X REG.PR ONAL ENGINEER !(OJ r �d� �-j- Z �t r�lk-• T REF S P.1IT` I Ot�.l �► 7 / cope ,.'eng'ineerrng� \ PREPARED FOR: -.CIVIL ENGINEERS LAND SURVEYORS --- ------ O REG. LAND SURVEYOR. _ •Q' nI -vV, r1 BOARD OF HEALTH SCALE CONTOURS (EXISTING)--------•---- S YarmouthMA ( " �• 3/ATE (PROPOSED)-O-O-O-O- APPROVED DATE MA l oK /1� V�/ rd'--' Assessor's office (1st floor): D� �{, N THEto` Assessor's map and lot number ......... �.�.3.......:.... SEPTIC ,_ �'ENU ` Board of Health (3rd floor): ., a .J' . " ^� d t a o� Sewage Permit number ^` ' %tf" ti BAH3ST&BLE. i Engineering Department (3rd floor): 30 9,a�0� House number ........................................... ............................ a . ramr,,�, ..;, b.► C`4 S i u:`►'6J 4.:` cue Definitive Plan Approved by Planning Board ________________________________19________ . �i s APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN .OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......4.P..4.> ...........C.�Cc..k.1.e.� ...... �1..���` .....�Slv�,� .......... ............ TYPE OF CONSTRUCTION ............CNG2.r/.. .......... .................:..................................................... ......................19.41. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......3..7.V......... C,.GCJ ............�.:�4 ........... .-..�l.:Nj7Q.V! ........C. �- -) ProposedUse ........................................................................................................................................ 09 Zoning District rJ ..............................Fire District ................. `.. "'S ....................................... Name of Owner J .d 1 ................................Address ... a..Ox...... GG Name of Builder ..:.....'50 ft. Address .............SQ.!f1 .. .................................................. Nameof Architect .............`....................................................Address ................................................... ................................ Numberof Rooms ..................................................................Foundation .............................................................................. Exte ior ..........5..`1.1.r�Cy.le.s.......................:...........................Roofing .......QI.�.!Z ... Floors ...........C'.rh�C + .................................................Interior ........S..G� eP�fYOC/� .............................................. Heating ..............h.1/.!I.Q......................................................Plumbing ..........CA.D.V:..e..................................................... Fireplace ............V).0H . ...._...................................... . Approximate Cost ... . . .. .. '. ............:...... ....................Area ......-�1P.......................... Diagram of Lot and Building with Dimensions Fee l... ......................... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... .. . .. .. . . .. ......................................... Construction Supervisor's License ............ I - BRITTON, JON No ...318 3 8 -Permit for ... GARAGE ................... Accessory..:�q... ......................... . ...... .. ...... Location ...3Aq...C.e.da.r...Street.................... West Barnstable . ............................................................................... 7; Owner ...,Jon...Britton..................................... .. .. .. .... .. .... Type of Construction .... ............ ............ . ............................................................................... Plot ............................. Lot ................................ 4 Permit Granted ......April.. ..27.1...........19 88' .... Date 6f Inspection ...... 19 Date Completed . ..... ...e ................19 o t i ; I; �I I II I lii I li i i i L +1 l 1 n N I A U I 'i 6.ci til r x `O_.� I: W V' 'I LOT 7 I t 24E.IZ __ i I CEDAR` STfi E_!L. II li BOO # 84-046 CERTIFIED PLDT PLAN PREPARED FOP.- LOCATION. LOT 2 CEDAR STR W BARN SCALE: III=550 ' DATE: 03/22/88 REFERENCE: PB 330 PG 30 JON BRITTON I I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. BUILDING CONFORMS TO ,SETBACK REQUIREMENTS _ OF THE. TOWN :WHEN CONSTRUCTED. � 0 M s�`ya l o ARNE down cape engineering " �, . _ aAv+ Y CIVIL ENGINEERS 01-348 ; i_ LAND SURVEYORS ISt( ROUTE 6A YARMOUTH MA DATE R ^ - D SURVEYOR r _ l a �f- t �.� 44 ,z3q 5 + Jr . �'. • . M +a"'�. amend - � - o e e,4-C>4G •'� 4ocA-r�io.v:.r EST�BA��:15Tf}E3LE, MASS. " .E'EF'EeC,c%Es PP E PA F=E.i� Po�; troT 2 -z�- PLf t" Bk. 330 PG. 3o TTON •F.. ,�• .�/�dBBY Ce�GTtF.Y TN�7' T,�� Bui�.a�,�,i¢ ' S"lC>w4/ o t/ TA,I/S X>4 000AV /S LOC�iT�a O.t/ Txde� �vciic✓a ,95 �AI�O W,V Fti!�GBOK/. OF Mry ARNE ds o H. OJALA wn ca�x' an9�r�ecrir�c� *26348 cis r,E�Oc/TE GA^*`�J4.�MOG/•Ts-�� .N�4S C,,*TC- Assessor'sF4nap and lot number. .,,,. � N Sewage Permit number ... ......: . . .L 10LFD I' �r �, s d� o� d . Z BARNSTADLE, House number ........v?....1.0................................................. �:'�la e �` qo rnea t639- 0 Mid TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... M TYPEOF CONSTRUCTION .............. ......faiu.✓.1.t ............................................................................. . ....................19 a `f TO THE INSPECTOR *OF BUILDINGS: i The undersigned hereby applies for a permit according,,tp the jollowing information:: ) c L Location .......L �. ... � �.... �..........C��:n.fir,.. . . .. ProposedUse ..... ......................................................................................................................................... Zoning District .............f......��..........................................Fire District .........LN. .. ...... ....... c Name of Owner ........ ..G .13ri r% .... C\: vj.............................Address ......�iQd E?Gl�` ... �:�....L✓:. .GRiI�!1. ... Name of Builder .........�arm�Q ...........................................Address ............. ............ ................... Name of Architect .......................................Address ���!�`�- ............. . ...................................... Number of Rooms .............5?...................................................Foundation ............ ..... Ovf� ............ ............. 11 Exterior ......... ............................Roofing ..............149 eiat........................................... Floors /L�........... J...............................................................Interior .........E. e,:11-.gCk, ....................................... .� Heating .......Ko..1....... .........................Plumbing ........1Z................................................................... 1 Fireplace ........... . .........................Approximate. Cost �Qyt,(�U� Definitive Plan Approved by Planning Board ----------------__ ..,.,.. -------------�9-------• Area .yG S Jtd Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 9 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 2ZZ� Name ..... .. 71A... a. ........................................ Construction Supervisor's License ....U.O�.k.O / 3RITIONI , JON p N . Ho 26297.... Permit for 1 z Sto ................ Singl6 Family Dwelling 4........................................................................... Location J,�t.2, _ 340 Cedar Street .............................................................. West Barnstable ................. .............................. W , C) Owner ..Abn BiHttori .................. '00 Type of Construction Frame............................... .......... r Jr ............................................. ................ .................. lei Plot ............................. Lot .................................. 'April, .12,....0 �j 9 84 Permit,Granted ....................... Date-of.Inspection < 9 Date Completed /:7;4 7 rA;l 9 r '0 N .1 C)oollz -7 s v _ CYI " Assessor's office (Ist floor): j, OK �Oe�/l_. //�/ed T Assessor's map and lot number ........ i3n.40.0. Board of Health Ord floor): Sewage Permit number ................................. Engineering"Department (3r'd floor): NAM 3(/0 1639- Housenumber .........*....... ...................................... 0 MA Qefin roved by Planning Board itive Plan APP ----------------- ------------19-------- - APPLICATICWS PROCESSED 8:30-9:30 A.M. and 1:00-'2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........AR.L.?.............. . ............ 0*0, TYPE OF CONSTRUCTION ............ .W ......... ................. .....` .-....a ... .... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: tt S-24 ).�Q -.?. Location ...... ..........Cesl k�....................... .... r 7:.............1��V ....I.. .................... ProposedUse ....... CW10t.. ...........;................................................................................................................................. Zoning District ................�? ...........................................Fire District ............................ ....................................... 0 -(7 Name of Owner ..Jco .................................Address ...(.............. a- ......... Name of Builder �.........................................4ddress ............:.Sq.m.-.9... .................................................. Nameof Architect ..................................................................Address .......................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior .......... %.t^Cj�le-s- ............*,,**,****,,***,,*.............Rooping ....... 1-2.4. ................................................... Floors ........... ..................................................Interior ........ C k..................................................... Heating ..............ho.0..4e.:.......:............................................Plumbing .......... .. .......................................... ............................. ...........Xpproximate Cost ... Fireplace ............. C4.-e—-- -------- .................. .... Area ....... . . ...... ................... Diagram of Lot and Building with Dimensions Fee ...... 0.1........ .................... OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the-Town of Barnstable regarding the above construction. I... ....... Name ...... ..+ ....................................... Construction Supervisor's License ............ BRITTON JON A=131 013 . 002 A=13, 1 0 Build Gar...ge No Permit for .......................... ?�C,ces.so4�y to Dwe li .......... ........ . ........ ..... ..................... ...... .. . .. ......... 340 /Cedar StreeV .... ............... Location .............. ............................... ................ West Barnstable Owner .......Jon. Britton ....... ...................................... ............ Type of Construction ....:FAZcame......................... ............................. ................................................. Plot ............................ Lot. ................................. Permit Granted ......April...2.7..............19 88 Date of Inspection ....................................19 Date Completed ......................................19 D/ 3,-- Assessor's office (1st floor): Assessors map and lot number ................. Board-of Health (3rd floor): `O a Permit number ....... .Sewo . � Z 33ABB4TdDLE, i Engineering Department Ord floor): 70 FJS- y raea i639 House number e ,APPLICATIONS,PROCESSED 8:30-9:30 A.M. and 1:00-2:00.'P.M. only TOWN OF BARNSTABLE BUILDING. INSPECTOR APPLICATION FOR PERMIT TO �3�( /v. v d .................... ......... ... . ............. ................ TYPEOF CONSTRUCTION .......................f....:.... .. .............................................................................................. (. ............................ 19.. TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the following information: Location ' .. f..o ....., .T..... . ................ ProposedUse ................H4.&A�............................................................................................................................................... • E Zoning District .......... �........ .Fire District Cy /. . ........ F .................. ... . ... .... Name of Owner .... ........................... 3�fu- Ce. Y Address ...................................................-............................... o/lc�lcPodName of Builder ............................. / Address �3v2Z4�-C� X .............................. IName of Architect ..............................'...................................Address .................................................................................... • ' Number of Rooms./...................................................................Foundation .............................. .............................................:. Exlerior .......................................:............................................Roofing .............:........................... Floors ......................................................................................Interior .:................................................................................... HeatingPlumbing ................... .................................................. Fireplace ..................................................................................Approximate Cost .............,�� �D!...................................... Definitive Plan Approved by Planning Board ________________________________19________ . Area ................... ................ r Diagram of Lot and Building with, Dimensions Fee !4 . ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I l� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ...... . vvConstruo Supervisor's License V ............................. BRITTON, JON A=131a-013-002 No Permit for .....Q Q r,uc.t. a....... ........P9.01.............................................................. Location -340. Cedar Stet Lot #2 ........ .....................r..e................................ ..........W.P-st-Rarn5.t.ablp.................................... Owner ........................JQj1..Rrit.tctn Type of Construction ....... vinyl.................... . ................................................................................. y. Plot ............................ Lot ................................ Permit Granted .........................Mqy..jq..1986 Date of Inspection .....................................19 Date Completed ......................................19 Assessors office (lst floor): _ s SYSTEM MUST o THE ro Assessors map and lot number ..�.3.�. �.3..^ ........... NSTi4LLED IN C®NII'LI Board of Health (3rd floor): 4 : 4 _��. . T11 TITLE e Sewage Permit number �....1.....�..s...1. �,�I'���{�� p, ^5g� � t`.......... Engineering,Department (3rd floor): �3 V �JS.. �W, kj.RF:0-?rq �-.x `000 ,"639. r House number .................................... . ....... 0 a� gPLICATIONS PROCESSED 8:30=9:30 A.M. and' 1:00-2:00 P.M. only TOWN OF BA*RNSTABLE' - BUILDING INPECTOR APPLICATION FOR PERMIT TO .........� C!(./ ....................... ............................................................................. TYPEOF CONSTRUCTION ...................... .. ................................................................................:............. . ._.. ............19. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to. the following information: Location •• ..............�. � ........C....:.. �............ ................... ............... .. .�7 .... .., ?-.. ..a.... . ;�� ProposedUse ................................................................................................................ ZoningDistrict ................[..1..F..........................................Fire District ................. ............................... Name of Owner ....30.r,...... ............................Address .fa &f v.. Name of Builder ......... ��/�. .yl...... 04...!.................Address ....... ....../ G7a- " ......... ................................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors .Interior .................................................................................... Heating ..................................................................................Plumbing ................... Fireplace ..................................................................................Approximate Cost ............ ,fiJl a................. Definitive Plan Approved by Planning Board _______________________________19________ . Area Diagram of Lot and Building with Dimensions Fee . J......��................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 , I � I - 9 1 � � t� V OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of )hekvn of Barnstable regarding the above construction. Name .. .�1�... ................................ ConstrSupervisor's LicenseQo..1../..a...el............. BRITTON, JON A=131-013-002 No 2935.7....... Permit for -CQ13J5.trur-t..a........... ..Pool..................................................................... Location Ilk... West Barnstable ........................................ Owner ...........Jor.fA..r..i..t..t.on............................... ..... . .. .... Type of Construction ...... ........................ ................................................................................ Plot ............................ Lot ................................. Permit Granted ...................May..19........1986 Date of Inspection ....................................19 Date Completed 19 n) �i V �. ��,.� � _.� _ , a �- � „�� �����{� '1•'✓`t�Y� Z''• �.'�f�kw . Assessor's map and lot number ./.-... .. �..... THE Sewage Permit number .............. .N.... ....... Q /� Z BAHBSTSDLE, i Housenumber ...............!.......................................................... ro MAaa O/`C ie39.a\e�° 0 YPY r TOWN OF BARN STABLE BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO .......00.6f rt/L .......�n.C1.!.L....��..!.! .... `t' II IYIq................. TYPE OF CONSTRUCTION ............:�.p5?.�......+fCi!?!� ...�....................................................................... Z-- 19 �I............. .r. ......................... r � i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according o the following information: L �F a C ar/1 �r S-/ . �,Q S a,v,.t�s/e, Location �� ProposedUse reS...�e� ��................................................... ......Q.................. g .......................................................Fire District ..........I/.. ......I �.......a..!..... ....... Zoning District LeName of Owner .......V..O ...... .............................Address .......,/���111.hAYc �V L✓ �CIYvI a' Sa rn , Gk re Nameof Builder ....................................................................Address .............,............................................. ................G,....... Name of Architect SCt IK .e �.....................................:.Address .....:.......................��(�. .............. .... .................................................. Number of Rooms o ..............................................Foundation CC*" C ........Rd Exterior .........\,kJU�J.C�.....SY.�.�'�. �. '�..................................Roofing .............�? P,..l1,!/.L ............................................ Floors ..................V.d C. ............................................Interior ......... n..e r.!.'. ! ` ........................................... ........................ Heatingj� 1 .......................................:...:Plumbing...........:..........:.:............................................................ r Fireplace ........... ., .VI.....`...................................................Approximate. Cost ......... !.vU.v........................................ Definitive Flan Approved by Planning Board ---------------____-----------19--------. Area .......................................... Diagram of°Lot and Building with Dimensions fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and .Regulations of the Town of Barnstable regarding the above construction. Name .. r Construction Supervisor's License ... U..� .o..C/.........a- BlUTrON, JON A7-131-13-2 No 26297..... Permit for 13-, Story ............ .................................... .......Sinqle..F.amijy..pWg;kji:qg............. .. ...... Location ...W.1;..2 ......340... ........ .................. ............................ Owner .....Joll-Bri-ttQ11.................................... Type of Construction FrAMP-1............................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ....April 12, ........19 84 ....................... Date of Inspection .....................................19 Date Completed .......................................19 6- 3 w FROM TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr. Francis Lahteine 367 MAIN STREET HYANNIS, MA 02801 Town Clerk Phone: 775-1120 L SUBJECT: FOEDHERE DATE December 3, 1984 MESSAGE Work has been completed under Building Permit #24803 & Permit #26297 (Jon Britton) . Please release Bonds. SIGNED � / ' DATE j/ REPLY I SIGNED N87•RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A. L SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. TOWN OF BARNSTABLE 2629? ... Permit No. ------------------------------ Building Inspector I u"3TAU s s Cash -------- --- -- /YL - X OCCUPANCY PERMIT Bond _____ _ Issued to Jon Brittcn Address lat 2. 344 Cedar Stitt a 'We,t Barnstable Wiring Inspector Sf f�L Inspection date Plumbing Inspectorx��.,-A r kLI � - Inspection date Gas Inspector � 17 l/fy/� 12 Inspection date ' }Engineering Department- . Inspection date ] 7" Board of Health Inspection date r � l THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDIINNG7 CODE. 19,9 ............. _ �,� Building Inspector Official Website of The Town of Barnstable - Property Lookup Page 1 of 4 Select Language I♦ , I I Assessing Division Property Lookup Results - 2016 367 Main Street,Hyannis,MA.02601 61�j <<BACK TO SEARCH<< AlPrint Friendly Owner Information-Map/Block/Lot:131/013/002-Use Code: 1010 r� Owner " I�! � Owner Name as of MICHAUD,PHILLIP 8 Map/Block/Lot GIS MAPS 1/1115 PRANCES 131/013/002 ,r V 340 CEDAR ST Property Address 1 ` � WEST BARNSTABLE,MA. 340 CEDAR STREET 02668 .\ Village:West Barnstable V Co-Owner Name \� • Town Sewer At Address:No J GIS Zoning Value:RF Assessed Values 2016-Map/Block/Lot:131/0.13/002-Use Code:1010 �� 2016 Appraised Value2016 Assessed Value Past Comparisons Building $242,600 $242,600 Year Total Assessed Value: Value 1 Extra $59,300 $59,300 2015-$441,200 f� , J Features: 2014-$442,000 v" i e�L ? 2013-$449,000Outbuildings:$16,300 $16,300 2012-$444,400ro 2011 -$444,200 .� V Land Value: $171,300 $171,300 2010-$452,400 2009-$464,300 I` 2016 Totals $489,500 $489,500 2008-$497,300 2007-$545,500 v R idential emption Received=$90,000 J d'� 'fax Information 2016-Map/Block/Lot:131/013/002-Use Code:1010 U Taxes W.Barnstable FD Tax $ Fiscal Year 2016 TAX RATES HERE 40 ,\ (, (Residential) 1,311.86 - �v IL5U O ,�+! Community Preservation $111.58 rp Act Tax / Town ^Tax(Residential) $ / 3,71 es,142.79 O http://www.townofbamstable. /Assessing/propertydisplayscreenl6.asp?ap=0&searchparc... 8/31/2016 Official Website of The Town of Barnstable - Property Lookup Page 2 of 4 Sales History-Map/Block/Lot:131/013/002-Use Code:1010 History: Owner: Sale Date Book/Page: Sale Price: MICHAUD,PHILLIP&FRANCES 1992-02-28 7896/156 $173750 BRITTON,KATHLEEN J 1989-11-07 6948/173 $1 BRITTON,JOHATHAN P&KATHLEEN J1984-03-16 4038/339 $25000 AVALLONE,DANIEL J 1984-03-16 4038/338 $0 Photos 131 /013/002-Use Code:1010 a- - - . (G� V Sketches-Map/Block/Lot:131/0131 002-Use Code:1010 20 AS 1 GAR GAR2 32 0_ 20 "AS 15 14_s Ia. BMr.-1 12 •2a --- 38 'TQS BAS. BMT 38 AS Built CardS:Click card#to view:Card#1 Constructions Details-Map/Block/Lot:131/013/002-Use Code:1010 r Building betails Land Building value $242,600 Bedrooms 5 Bedrooms USE CODE 1010 Replacement Cost $295,908 Bathrooms 3 Full-0 Half Lot Size 1.01 (Acres) Model Residential Total Rooms 8 Rooms Appraised $171,300 Value Style Cape Cod Heat Fuel Oil Assessed $ Value 171,300 Grade Average Heat Type Hot Water Plus Year Built 1985 AC Type None Effective 18 Interior Floors Wide Pine depreciation Stories 1 1/2 Stories Interior Walls Drywall Living Area sq/ft 2,984 Exterior Walls Wood Shingle Gross Area sq/ft 6,148 Gable/Hip http://www.townofbamstable.us/Assessing/propertydisplaysereen 16.asp?ap=0&searchparc... 8/31/2016 Official Website of The Town of Barnstable - Property Lookup Page 3 of 4 Roof Structure Roof Cover Asph/F GIs/Cmp Outbuildings&Extra Features-Map/Block/Lot:131/013/002-Use Code:1010 Code Description Units/SQ ft Appraised Value Assessed Value FPL2 Fireplace 1.5 2 $9,100 $9,100 stories GAR Attached Garage 720 $17,700 $17,700 FOP Open Porch-roof- 60 $3,000 $3,000 ceiling SPL2 Pool Vinyl 576 $12,400 $12,400 BMT Basement- 1424 $29,500 $29,500 Unfinished WDCK Wood Decking 344 $3,900 $3,900 w/railings Sketch Legend Property Sketch Legend 82N Bam-any 2nd story area FPC Open Porch Concrete Floor REF Reference Only BAS First Floor,Living Area FTS Third Story Living Area(Finished) SOL Solarium BMT Basement Area(Unfinished)FUS Second Story Living Area SPE Pool Enclosure (Finished) BRN Barn GAR Garage TQS Three Quarters Story(Finished) CAN Canopy GAZ Gazebo UAT, Attic Area(Unfinished) CLP Loading Platform GRN Greenhouse UHS Half Story(Unfinished) FAT Attic Area(Finished) GXT Garage Extension Front UST Utility Area(Unfinished) r FCP Carport KEN Kennel UTQ Three Quarters Story (Unfinished) FEP Enclosed Porch MZ1 Mezzanine,Unfinished UUA Unfinished Utility Attic FHS Half Story(Finished) PRG Pergola UUS Full Upper 2nd Story (Unfinished) FOP Open or Screened in Porch PRT Portico WDK Wood Deck PTO Patio Print Friendly Contact Director of Assessing IJeffrey Rudziak http://www.townofbamstable.us/Assessing/propertydisplayscreen 16.asp?ap=0&searchparc... 8/31/2016 Official Website of The Town of Barnstable - Property Lookup Page 4 of 4 P 508-8624022 F 508-862-4722 8:30a.m.to 4:30p.m. Helpful Links to Downloads j Abatements SALES LISTINGS Barnstable FD Residential C.O.M.M FD Residential Commercial-Industrial- Mixed Use Cotuit FD Residential Hyannis FD Residential Townwide Condominium W.Barnstable FD Residential Department of Revenue Exemptions Parcel Consolidation Questions about values Town Tax Rates Town Land Use Codes Helpful Maps All Town Maps Flood Insurance Maps Property Maps Owned and Operated by The Town of Barnstable-Information Technology Home I Departments&Services I Boards&Committees I Residents&Visitors I Doing Business Town Calendar I Phone Directory I Employment I Email Town Hall http://www.townofbamstable.us/Assessing/propertydisplayscreen 16.asp?ap=0&searchparc... 8/31/2016 4 Y 1� a " OwnALM .01 y,Fi,►�,`�^,� J, �A�....�� ��''t�r4rn- 1- . r• y 't..- y'�tlll�i�•—yiy(�i� �aib `to�'tE�!/�� 9.•fi ��� � '! �. ~� fr jJs`r /•nary s,:`^will, fv i._LJW'�>•m.�``' i i+ Zip1 .V�•'1t ����rnt7t{v-�ji r �L•1 / P �`lsYbA.i• `t ���' Tnf6'�'IV Us 1.'C1'�V�1�71�t;��. .�w.v��w�i .fi.� •� '` 5�, ", ItCe{I'. � ,�1 ` aT► w a 7 y,.g �• { Z "t' + .0 till ►!at ?; S � IA�k �b + �fa�� +��� 4'".�'i' 9ei^... ...,r. � .���r�4llSid\01 �if+`(,M4•+ ��w 1���(�,\1 ' � ��� �t} ,�� fiv 7 .?•% .�A' I✓L4Y4�'1a' JY.{�A�'ai.... 1y�JibA �Q'�► t c.+� ' ':• 11AFarp® =i/!'�`+.�A�i ItYZ�I •.rtv�?a\.J1 = gut A( !f►IIYs. dN,'T�t• A kt'.��1''� � -tr.fi2+ i tea--' •�,- �` 1 e7,,�p'uo.rw•.►.-s; Il �_ 1vY ..$iI�I�3f.1.[+:r'ojj�tsY Ssb ,'u �g11s .�.r ,,,,.,....�. _� `7w f ;r1o�iY►�0,.:.W.e+a.�.M1i..a xd�►1��1 +('�`1�•� �t��� .w"$, } + . r•+i%+l' ....�y .�'�.Y''� ..✓.I i1 .\,j� 14i'w.Yl�v �'�'1. `.^G.'�.. ,,r•cl i.. �� „� r{h_.ow s..dt _.srJ� ( a,}l. Q 1pol. �k.:t_. s. ;/i ,Iry �►,Sa..�.n'.'i�� � tN`�\art���S�f?�,y1"��1,��,;Y'�f�t :1�.,�_ { 1' �3•. itl� � � +� 1/ '!1r t�A ZA IQ �d 4sb '..L �`!'`• ,sin\�1-+R'�•P'•�� Page 2 of 2 A r i i r http://townofbamstable.us/propertyimages/00/01/03/20.jpg 8/31/2016 F, a TOWN OF BARNSTABLE.BUILDING PERMIT APPLICATION Map 131 13 D 6 02 Parcel'. `�/ ± ` Application U®�''J � Health Division Date Issued I Z O Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Q� Project Street Address Village s Owner p�+ ,l��to 14, Address s� � Telephone �FL r?di d., 7 Y,/<T // / Permit Request �.,s� �fY'�2 h�}zf�e �a�1 key ����'h 1`�r'►Z�� 6 SZ2 tz a"V-- 4�cj k--, -1�) 41r-r 1-ks"" J 2-s$ At- 9- -1 4? F Square feet: 1st floor: existing proposed 2nd floor: existing proposed �_1* Total anew 1;-1 -n Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type , Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docQmentation. r- a � Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) rn Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing 0 new size—Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION / - (BUILDER OR HOMEOWNER) �z �h�`,e �so� a - 28 3 ?mod X-16 Name Telephone Number `'� � 7 Address 13 K ( 1,LIia License # Da f 35-' �t-� r Ax- Home Improvement Contractor# /0 s / Worker's Compensation # h( a --a-1 71% O it ALL CONSTRUCTION DEB IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l l a A FOR OFFICIAL USE ONLY APPLICATION# ' DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER- , DATE OF INSPECTION: FOUNDATION FRAME L } INSULATION f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 J. R y I S E Division of Thielsch Engineering,Inc. 1341 Elmwood Avenue :NGINEERING Cranston,Rhode Island02910 ✓/1•C VGN;r;L�r,��71LECL(.C�L ��///Gp�CLC/LCCOQGCd Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registr,.140.1:, 120979 Board of Building Regulations and Standards ExpiaBoPa>�725/2010 Tr# 263460 One Ashburton Place Rm 1301 ;1':'• __:;== Boston,Ma. 02108 _4`- _i- ate Corporation , THIELSCH ENGP{VEER_iNG._= ` STEPHEN HINES 1341 ELMWOOD CRANSTON, RI 02910 Administrator Not valid without signature �--'Vt 100463 WS,IC STEPHEN HINFS ,,. `ry 222 NARRAG k ETT AVENUE 'R+ ` JAMESTOWN, r..02835 � 6/23/2012 100463 1 7- 102935 a_......_. . 00 STEPHEN HINES 222 NARRAGANSETT AVENUE JAMESTOWN, RI 02835 6/23/2013 :. 102935 r _ '� The Commonwealth of Massach usetts - Department of Industrial Accidents 1 Office of Investigations 600 Washington Street c RP Boston, MA 02111 yf www.mass.gov/dia Workers' Compensation Insurance Affidavit: ]Builders/Contractors/Electricians/Plumbers Aplificant Information Please Print Le ibl t Name (Business/Organization/Individual): ! �G 't e"n Address:-rz�f/., b✓ City/State/Zip: e A h5�^ ��� 9�� Phone #: ��� 7$U� AVyan employer?Check the appropriate box: Type of project(required): a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am.a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.0 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 t!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. A A4 Insurance Company Name: c� P��� A t� . 2_1/ 1 /� Policy#or Self-ins. Lic.#: I c ► �' — Expiration Date: / 201 d Job Site Address: `3 y0 G e' 14' City/State/Zip: li. Q�✓ 0+54& r'/'J p�4•�jg' 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 nder ties of perjury that the information provided above is true and correct. Si nature: Date: Z Z f7 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#: I q,�• • LIABILITY ®�1���o DATE(MMIDD/YYYY) AC®>�� CERTIFICA ®F LIABILITY INSURANCE THIEL-/1 08/07/09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION The Preston Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. East Greenwich RI 02818-0810 Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER P; Hartford Underwriters Ins. Co INSURER B: Hartford Casualty Insurance Cc Thielsch Engineering, Inc INSURERC: Liberty Mutual Insurance Group 195 Frances Avenue Cranston RI 02910 INSURER D: North American Capacity 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. LTR INSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YV DATE MM/DD/YY LIMITS GENERAL LIABILITY - EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERAL LIABILITY 02LTUNTD5678 04/01/09 04/01/10 PREMISES Eaoccurence $ 300,000 CLAIMS MADE a OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY X JE O LOC Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1 000 000 B X ANY AUTO- 02UENTD4850 04/01/09 04/01/10 (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 LIABILITY EACH OCCURRENCE $10,000,000 $ X OCCUR ❑CLAIMS.MADE 02XHUUF6573 04/01/09 04/01/10 AGGREGATE $ 10,000,000 $ RDEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X I TORY LIMITS _ ER C EMPLOYERS'LIABILITY WC2—Z11-259874-019 04/01/09 04/01/10 E.L.EACH ACCIDENT $ 500,000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYEE $500,OOO 11 yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,OOO OTHER D Professional Liab DVL000025902 04/13/09 04/01/10 Prof Liab 2,000,000 A Leased/Rented Eqp 02UUNTD5678 04/01/09 04/01/10 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS *Except 10 days for non payment of premium. Certificate Holder is included as an additional insured as required by a written contract with respect to the General.Liability coverage. CERTIFICATE HOLDER CANCELLATION TWNBARN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN Building Division NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Attn: Tom Perry IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR 200 Main Street Hyannis MA 02601 REPRESENTATIVES. AUTHORIZED EPRES ACORD 25(2001108) cr NZ ©ACORD CORPORATION 1988 NOTEPAD,. Engineering, g . g THIEL-1 PAGE 2 IWSURED'S NAME Thielsch En ineerin , Inc OP ID 27 - DATE 08/07/09 Also for RISE Engineering, a division of Thielsch Engineering, Inc. Gaskell Associates, a division of Thielsch Engineering, Inc. BAL Laboratory, a division of Thielsch Engineering, Inc. ESS Laboratory, a division of Thielsch Engineering, Inc. ALCO Engineering, a division of Thielsch Engineering, Inc. Water Management Services, a division of Thielsch Engineering, Inc. {�r Federal ID#0"405629 RISE ENGINEERING RI Contractor Registration No 8186 { A division o.'Thieisch Engineering MA Contractor Registration No 120979 t CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,R102910 ,,ppi�ss wwgg �pp pp�� (401)784-3700 X t4 1 FAX(401)784-3710 4rONTIONJACT Page 1 THIS CONTRACT IS ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS E N C;f N E E R I N G DESCRIBED BELOW CUSTOMER PHONE DATE Client C Phillip R Michaud (508)362-7453 10/1 _ i5J24. SERVICE STREET BILLING STREET _ r;., j '�'y( {!'••! ` I 340 Cedar Street 340 Cedar Street - SERVICE CITY,STATE,LP BILLING CITY,STATE,ZIP West Barnstable,MA 02668 West Barnstable,MA 02668 �tJ JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can nclude caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 8 man hours. $528.00 RISE Engineering will provide labor and materials to install 2.25"R-10 semi-rigid fiberglass board insulation to 142 square feet of vertical kneewall area. $383.40 RISE Engineering will provide labor and materials to insulate the back of the basement walk-out door with 1"rigid fiberglass board and seal the door edge with weatherstripping to restrict air leakage. $100.00 RISE Engineering will provide labor and materials to install a 9.25"layer of R-30 unfaced fiberglass batts to 32 square feet of attic space over the kitchen. $56.00 RISE Engineering will provide labor and materials to install insulation and weatherstripping to the overhead attic access hatch. $25.00 RISE Engineering will provide labor and materials to insulate the back of 2 existing kneewall access hatch(es)with I"rigid foam board insulation,and seal the edge of the hatch with weatherstripping. $170.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. $946.80 I WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***Three Hundred Fifteen &60/100 Dollars $315.60 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES a" AUTHORIZED SIG TORE-RISE ENGINEERING ;sTMER ACCEPTANCE �` NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE T- AB--f� v /'� ACCEPTANCE OF CONTRACOVE RICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK Q DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE �� P, . ........... --------- .. ......... . ............. .. -------- ......... ...........I. .. .. ...... ........... .............. . ..... .......: ........... ........... ............ ......... ------------- ---- -- ----------- . ............... ......... -------- .... ------- -------- I.......... . ............ F1 ......... ................ .. ........ ............ . ............ J 10 ........... ------ .......... . ........... ....... . . ........ ...... .......... .......... ------------- -U . .... .. . ........ .. ----------- ------ - .......... . ....... . . ....... .. . . . . . . . . . . ----------- ---------- ................... MAKE ACCESS PN 6L EXISTINGACCESS VENTUNG Oi- WA Ll. ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: 1 t Site Address: ? J ffy �C print Town: Applicant Phone: Applicant Signature: Date of Application: 12- NEW CONSTRUCTION: choose ONE of the following two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy 3 5 R-3 8 R-19 R=19 R-10 R-10, Conservation Act(NAECA)of 4 ft. 1987 as amended,minimums or eater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: RES check Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck-Web which can be accessed at http://www.energycodes.gov/rescheck/ ADDITIONS'OkALTERATIONS.TO EXISTING BUILDINGS.OVER S' YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b _ a) SF 100 x - _ % of glazing (b) Glazing area equals SF b a If glazin is<_'40%.u5e the chart below. - . If glazing is> 40 %proceed to"SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration Ceiling and .Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value and Value R-Value Depth .39 R-37 a R-13 R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not compressed over exterior walls, and including any access openings). SUNROOM-An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P b"t YOU WISH TO OPEN A BUSINESS? For Your information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: Fill in please: APPLICANT'S YOUR NAME/S: �Ifl C<0 4/22 M.s C H A U12 Y B SINESS YOUR HOME ADDRESS: �o C' �1D (� t f (S 3G O/66 bier �ce�usZ�(�LE o_16C : �: 08 f{ TELEPHONE # Home Telephone Number NAME OF CORPORATION: C NAME OF NEW BUSINESS ry,;G11uU,4 1uMbi�' (A'� 1 eaiin TYPE OF BUSINESS P L(k rd,6, _E1UC 9 LI C-A T.tti6- IS THIS A HOME OCCUPATION? YES NO _ I2 ADDRESS OF BUSINESS �0 Ce �µl- 5-t t,✓e5l 5c�lnStu 61e MAP/PARCEL NUMBER 6 / 1 J� [Assessing] _70 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING CO FF E CES ST COMPLY WITH HOME OCCUPATION C This individu I Alha eirt€ap. ell of any er it re uire ents that per'ain to this type of busine AND REGULATIONS.- FAILURE TO -� COMPLY MAY RESULT IN FINES. Au*rfzed a r COMMENT 2. BOARD OF FCALTH This individual has been informed of the permit requirements that pertain to this type of'business. Authorized Signature*.* COMMENTS: - 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha =formed of the licensing requirements that pertain to this type of business. i��ut l) �IZEA gn u ���Y{On 5 COMMENTS. 1 ;l - Town of Barnstable oFTME. Regulatory Services Richard V. Scali,Director Building Division Mass. $1639. Tom Perry,Building Commissioner �0 �Fp Mp'l A 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: 2 HOME OCCUPATION REGISTRATION Date: Name: -rli c o b /'1iGA4ad Phone#: <-O(P 3 6 7 0166 Address: 310 Ged 4 h Sr help -6-- Village: t.1 e Sfi 6&tA5f&4/e Name of Business: Type of Business: I2/(1n 614g 14 e a tiny Map/Lot: J —0 I —06 v INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of Wit subject tothe following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,locate'kwithin that dwelling unit. # • Such use occupies no more than 400 square feet of space. - • There are no external alterations to the dwelling which are not customary in residential buildings,and them no outside evidence of such use. `r • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or Ither particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. , • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned, �have read and agree with the above restrictions for my home occupation I am registering. Applicant igigk i � �'"a Date: Homeoc.doc Rev.103113 r �ire rq� Town of Barnstable *Permit#�o���� Expires 6 inont s from_sue date Regulatory Services Fee 9 163¢ `0� Thomas F. Geiler,Director mP ESS PERMIT" Building Division NOV 3 0 2011 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 OWN OF BA R N STA B LE www.town.bamstable.ma.us Office: 508-862-403 8 : Fax: 508-790-6230 EXPRESSFERNIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number O d Property Address _3�G Ce—d`'� E'Residential Value of Work s- !O O r 00 Minimum fee of$35.00 fo'r work under$6000.00 Owner's Name& Address ;l 1' v' a.N C eS a c k C_J ,A o CJ-a,sY Aul-o f K t GC .fi f. Contractor's Name A)m Q e, w Telephone Number Home Improvement Contractor License#(if applicable) ! _33 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Che one: I am a.sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name % / "l _N Sttjt.N C e- Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ['Re-side #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 requir SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 The Commonnrealth of Massachusetts Dgwronent of IndusbRal Accidents Office. of Investigations 600 Washington Street _ Boston,MA 02111 . www.mass.govldia Workers' Compensation Insurance Affidavit Builders/Cunt-actois/Elec ilicians/Plu nbers Applicant Information /� Please Print Letibh Name idnal): ka 4-w` Ld t Address-. S6 s7 L — City/State/Zip: Ce[ (,( 6 I C C �ZPlrone#: � r- 7'�� S �' Are you an employer?Check the appropriate box: T of project 4. am a contractor and I }'Pe P Ject(required): I.El I am a employer with I❑I oyees(full an&orparwime).* have hired the sub-contractors 6- ❑New construction 2.LVfI am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling Tie sub-contractors have ship and have no employees 8. ❑Demolition wig for me many capacity employees and have wodcers' [No workers'comp.insurance comp-insure c Z 9. ❑Building addition required] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'camp. right of exemption per MGL 12.❑Roof re ai insurance required.]T c. 152, §1(4),and we have no / employees.[No worlous' 13.❑Other comp.insurance required.] •Any applicant that checks boa#1 must also fill out the section beb w showing their walkers'compensation policy infmmatioo_ 1 Homeowners who submit this affidavit indicating they axe doing all want eard then hire outside contractors mmst submit anew affidavit indicating such— F'nrtnctors that check this boat roust attached an additinna!sheet showing the name of the sub-camtract m and state whether or not those entities have eMPhryees. Ifthe sub-cvatmctors have empla)es,they rmrst:provide their vAirkers'romp.policy number. I am an smployer that is providing workers'congwasMisn inmr once for my ernployees, Below is thepoiiiey and job site informaden Insurance Company Name: & C, . Policy 4 or Self-ins.Lie.#. Expiration Date: Job Site Address: CityfStateaip: 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 an&or one-year imprisonment,as well as civil penalties in the fonn 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 veritic ation- I do hereby ce ander the pains an penattias ofperjury that the information provided is bur � and correct 3i (�, 44,11 Date: J 30 o y Phone M J 6 '7 Official use only. Do not write in this area,to be completed by city or Mom oIJicid City or Town: PermitUcense# Luning Authority(circle one): 1.Board:of Health 3.Building Department 3.Citf/I'own Clerk 4.Electrical Inspector 5.Numbing Inspector 6.Other Contact Person: Phone#: 6 yT FtF1E3'b�,O * B&JW9rABL6. + MASS. Town of Barnstable v� 16yq. Regulatory Services Thomas F. Geiler,Director . Building Division Thomas Perry,CBO Building Commissioner 200 Main.Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize a q 'e/' C'& to act on my behalf, in all matters relative to work authorized by this building permit application for: L6 49 AA IT (Address of Job) Signature of Owner Date I Print Name If Property Owner is applying for permit, please complete the Homeowners License Exemption Form onAhe reverse side. QAWPFILESTORMSIbuilding permit formslEXPRESS.doc Revised 070110 aIlk . °FIKEr° Town of Barnstable ° Regulatory Services ' BAmiriBra, ' Thomas F. Geiler, Director Alf�A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us. Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 10B LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code ,T;he 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 fa rson(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, famlty dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home*in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. The undersigned "homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner ' Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as ` supervisor." 1. 4 \ Many homeowners who use this exemption are unaware that they dare assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for l 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 070110 .. . _ _ �[u�s..tebt 44etts- Department of -Board-if Suil4"o_Ref�r��a:i��rrs and tand..rtl ...r,., . r. C,�tla�aas�apafl in�e a EiO1�StLU.CtIAR SuperViSOF License',' �.• Z 9Zo dW'all. . lv. O + aue-1 lseaylnoS gi < License: CS 73W .- _ xoO Ja6oaRestricted to: 00 xa� :.ROGER T COX ^ 9 !'1: SOUTHEAST LANE jeFlpinlpul _ £lo 9 :uol;pJldz3 _ . CENTERVILLE, MA M02 �.; •:adA-.L, U013VRUN031N3W3A0UdWl3WOH ►; , sa s o o aal{{O Ex iratM 3/12/2012 I - (:on.misxiunrr. Tr#t: 20M FRIEDLINE& CARTER ADJUSTMENT, INC. 436 Main Street, P. 0. Box 338 Hyannis, Massachusetts 02601 Tel. (508) 771-3232 FAX (.508) 790-2344 TO: ( Building Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen ( ) Fire Department TOWN OF BARNSTABLE TOWN HALL HYANNIS, MA RE: Insured: MICHAUD, Philip R. Property Address: 340 Cedar Street W. Barnstable, MA Policy Number: H00200541 Type of Loss: Water Date of Loss: 9/23/2002 File#: 94588 Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed$1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail. R. F. LASKO Adjuster 10/15/2002 THE TOWN OF BARNSTABLE STAU MASSACHUSETTS Solid Fuel Stove Permit DATE OF APPLICATION FIRE DEPT. ISSUING PERMIT ............................................................ Docks PR Cq6C-C--1' NAME (owner) V NAME (Installer) S7-01/6 43'V.0'0 .................................................................................. ADDRESS .........W 019&NM.19� ADDRESS kYl......... ................... STOVE TYPE ......... CHIMNEY: NEW ........................ EXISTING .... Manufacturer ..................................................................................................................... CHIMNEY: Masonry /Ze . ............................................ MassApproval ..............� ....................................................................................... CHIMNEY: Metal ......................../......................................................................... This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed address in accordance with an application on file with the ................................................................................................... Fire Department, and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made under the authority thereof. Issued By: ................... ....... ......... ................. Title" ......... . ............................................ ................................ Date .... ............. Permit to install expires 60 days after issue date 4 ........... Stove ........ .. .... . ..............z...... . . . . .. ........... ..................................................................................................................................................................................... StoveClearance .................... .. ...................................................................................................................................................................................................................................................... Floor .................*....... .................. i�..............................I.......................................................................................................................................................................................................'�E'F-0 SmokePipe ..................P ........................................................................................................11..........................................................I................................................................................... SmokePipe CITarance ..................................... .............................................................................................................................................................................................................. Chimney ...........&-��....................................................................................................I......................................................................................................... SmokeDetector ......................... ................................................................................................................................................................................................................................... The undersigned hereby ce tifies that the installation of solid fuel burning stove and equipment made under au- thority of permit dated has been made in accordance with provisi 4-4he gommonwealth of Massachusetts State Building Code now currently in effect and pertaining the ........... ......................... Installer INSTALLATION APPROVED �.�. .......................date.........-5 ..... BY:........................................................................................ Title WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT �...•�.- _. �__. .... _........_ _ / 3100-11 A The Town of Barnstable q Permit# �/_ Massachusetts s�ver� Date jNAM SOLID FUEL STOVE PERMIT bisiuct Fee This constitutes an ofricial stove permit after inspection and approval by the building inspector. 0wner./fIZf l_ a «/1'9 C/D Telephone no.CCOd Address of Property, 3/C-'U cr D g 'S J Village CCU �,Q11 r Z(C Location and Stove Type CCry%F2 C X T ny? ,l?/L6-ti Date: Building Inspector 4 .