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0020 HIGH STREET
�llu 14t-tgctsD ° UPC 12543 No. $p�si•COWSJ�D HASTINGS, MN ___ _ - _...��,�.�.._ �_ .�� -� .....:a ,..x'i_ � -� � ': r "-:r5-�f s�.-.�:..u. -.a L�.q. ': ,tiI�vSS���JYsir=,l�r �_ w�:a�/M_ �1_�+- ___ ___ _ TOWN OF BARNSTABLE BUILDING PERMIT APPLIC Map Parcel U Application:# Health Division G Date Issued its UJ Conservation Division Application Fee I) Planning Dept. Permit Fee O �/ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner %' Address 51 Aller5�// .rT ter/• /�/'-��. Telephone Permit Request Square feet: l st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation. Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ 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 Ro'orm Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other U �<S ��It%`" �•� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woodMAl�stQve: ❑Yes 0 No Detached garage: ❑ existing ❑ new size_Pool:-❑ existing ❑ new size _ Barn: ❑ existingJl R❑ r 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) Name �'7 /, /J/ 1 .�i'�/I Telephone Number �-a40 Address T4ez ke/ ,///- Zee License Home Improvement Contractor# A0OC2 Z ep Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO g?4V/J ftZ - SIGNATURE r VAT FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL. PLUMBING: ROUGH FINAL S: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. . The Cowowwenhh ofMaswa&useffy Depa,rbffext oflud-ustnEdAccid Office of . . ' 60.0 Washhxeon Strret Boon,MA 02111 tiarv>�7a.ma�g�vrf�a Wwimrs' CbnVeniatim Insm-ance Affiizvit lkgders/Contrm:ft3rs/Mec&icLanstPlu3nbers AppEgmt IufMM33fir}n Please Print Iy Add€es c s� Phow �-- Are you an employer?Check the appropriate box: .Type of project(req�dy- I.El am a I Berth 4 ❑I am a general confractor and I 5 New ❑ employees(andlor part-fime s Imge hiredthe sd Constlaction 2. I am a sole grop6etar or partner- listed on the atcbed sheet 7- ❑Beffiadeliug and have as empldrgees Dzese sub-contractors.haste 9. ❑Demolition wading for me is aay capacity 'tare xvdn" 9. ❑Buikff,addition Rio wodm& camp.fimmznce °Qffip-;"sucanc 1 - j 5. ❑ We are a coxporati=and its 16.❑Elec;Edcal repairs or adaions 3-❑ I ama bameorwrier doing zU Rork officers bmm exercised their 1L❑Plumbiagrepairs or addstiens ' myself[Nowarkers'oomp_ - rig�ht of§l{ ffiwerM L 12..❑Bnofrepaim J insurance reqd_j 7 13-❑Olber employees.[NO WMjMss` camp-insmmme require&] 'any agp Bunt eher t�Os�l mast also fiIlo t��dioaheiaiv eieea ices'ce®persstinapaTieyiafiacrostsoa__ 1 amm�ngavd:o sahoni sins sTidae*imEcafig atey mdakg a1F =A then bim eatd&cnmtmcsosMnSt suBmit a nezv sffidzlEft inffirWfia 5� ICa�s Est t tins�»s ffi addiGamsl si>e�sSoarnag them of the st<b coot& t& state�rheths ornot�nse emitirslne employees.I€theshave empIoS�zs,B�eg�stPm4ideffis$ '�R Po�S � lam mr eucpiaj�sr 9iatis prrzg workers'daoagncrrsafltrrz i�zsrirarzCa for zrz eu�F� Be7nev it flee prr8cy arad job side izzform�a . Insmaase C'dmtpazYNaMfr Pdrficy:g or Self--ius_Lid~& FSgira aIlzde= Job Site Addre= C ylSta t .tp Attach as copy of the Barkers'compensatianpolicf decl amfian page(showing the policy number and expiration date}. Fa7me to sec um coverage as required under Section 25A of hMM c.152 can lead to the imposition,of cimiaal penalties of a fine up to SL500:OD amVor ore-yearimprisoamerd.as well as civR penalties.in the fmm of a STQP WORK 01MER and a fine of up to$250M a da,y against the violator. Be advised that a copy of dais statemmi maybe frnRarded to tine Office of hives ofthe DIAL for insta-aace coverage ver>fcalioa. I do heraby Cgr*Budsr pains mid powhks ofpedkg that the aaformation prmnded above is bars and carred Sia�nata Date- QB%d d aw only: Da not irate to iTib axed ta be ceznpfetd by cite ortoom aorerair City or Town.: Per Mcesse 4 I Issnng A *arfty(dude one): L Board of MI6 I IBwlTmg Department 3.CRyfrawn Cork 4�Electrical Inspwtne S.Pinmbing Inspector 6.other contact Person: Phone : 6 Taformation and fnstructions : Massarsefs GmteralLaws eha;.Y=M regoaes-a etapIq=to provide worIXas'campeusatiam fzs•leis enPIaf=- Parmaantto this s-tatofe,an evqrIoyee is of MIathcr under mqcaatcart ofhircy express or izaplied,oral or " Aa Maya is de�fmcd as�aaindividaal,per, assmfid n.corporation or other legal ur ,or any two or made m a oint andinclnrl— III e Iegals�epresetiives ofa deceased Mmplvyes,or fie of the fi�cEgoiag cmgaged J , reeeiM or trustee of an individual,pal,M(X iatirm or offierlegal entify,ClaPIQYmg MPI.Oyecs. However ihe owner of a.dwelling house haviog not more than$tee aPaaim emts and who resides(herein,Cr the occ ofthe- dweIImg horse of anD4her whD eozpinys persons to do mac,ca asjra n or repair wodc on such dwelling horse or on the gromads or bar7dmg apparf�r -diem shallnotbecnse of sash exploymentbe deemedt»be an=oployea" MGL chapter 152.§25CC6)also states that¢every sf�or local Tice ismg agency shell wifhllDId the issuance or renewal ofa license or perms to operate a bnsiaess or to construct bMEdings inn the coffimonwealth for any applicantw iLo has notprodured acceptable evidence of edmpIian.ee with the iacva-ance coverzge requited" AdditiDn .MGL chBPtrr 152,§25C(7)sues=Te ifhe-the commaawcalfli nor airy off political subdivisions shall ewer into any camtract for the pace ofpubho wail-mntiI able evidence of conapha:acewith the insorzace._ regOa-eojeLtS of this chaj f have bees Prese�ated to the=&actin.g aaffiozity" A.ppHcanh, Please fiIl oit fie w compensation affidavit completely,by chcciciag the boxes that apply to your sitakion and,if n=msary,supply s)narne(s). s{es)and phone— erCs) along with then=tEca:IeCs)of insaramce. L=dt rd Liability Companies(LLC)or Limited LiabIl y-P s(LLP)wifhno =3ployecs other than the me j:,, s or partners,are not rtqu±:ed to nary watice campensafroa i3�a. If an LLC or 112 does have employees,a policy is rmpire3 Be.advisedthatthis afhdaThmaybe sabm>tft!d to the Deparfmm t of Du stdal Accidents for oon'amat m ofinsuranoe covwagu Also be sin a to sign and date a aidavif: The a�davirt should be rataxned to the city or town that the applirafiM for fhe pcOM.it or Icense is being=jaesbA not the Depm:tnicat of inghj5ftjaj,ACC dea7t3 Should you have awry qn=d s regarding the law or ifyou are regcdred to obtain a woficrrs' comp policy,please call the Departmeotat$ire= bezH%Indbelow. Self-insaredcampanicsshonlde their self-in sar=c.m license nambet on the appragriafn line. City or Town Officials icia is t _ Please be sate that the affidavit is mmplct-;and priftdlegiibly. The Depemeotbas provided a.spam at the bottmn ofthe affidavit for you to fIl out in the eves the Office ofInvesfi,gafio=has to camfaetycaregardingtho aP.PH=f Please be sane to fM inthe pe;o lLWaemr mmzb=which vM be med as are5xmce ammbw- Ia-adcli ion,an applicant $rat insist sabmit multiple permit/liceose appIiiztions in may given year,need only sal=rt one affidavit indirata =mt policy information.Cif necessary)and,,,,,3 -16b.ShE�Address"the applicant should wore-all locations ia Cc ly or town)_"A copy of the-affidavit that has been officially staarped or--miced by the city or gown maybe provided to the ' ' , applicant as proof ti>at a valid affidavit is on fle for�e permits os liicenses A new affidavit must bm fiIIed obt cash i tizen is obtaiaaing a Iiceasc or permit not xelaied to css any bBsin ar commercial venf� year.Where a home owner or c Ci..e_a dDg license orp=m t to bmn jeavm efn_)said person is NOT.rcquircdto cample#e this affidavit The ofam of Invesdgsfl as would Irkz to thmak you m abm=fur your coopmm±ion and sbovld you hav's a>zp qu=d ms, please do not hesitate to give vs a call 'Ibe DepBrtmeafs addressy telephone and fzxn=bc r TheCD=M0Mqedft of Mas-sar hhnet.9 Departnmt c& Awidfmta 6W waabgm Sit M&Dill - Ta.4 617- -4900 co t4-06 car 1477 M SS� Fay 9 617'27 '7� x �isea¢Za-�7 g��f�a m aaaat.nuacua vcro,un..n.v, -•� Board of Building Regulations and Standards License: CS-004354 Construction Supervisor STEVEN A LEAF 106 WAQUOIT HOW)( E FALMOUTH MA 0253 - ;. CA_ Expiration: Commissioner 08/01/2017 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Co tractor Registration _ R--- Registration: 103230 Type: Individual Expiration: 7/7/2016 Tr# 253429 STEVEN A. LEAF Steven Leaf 106.Waquoit Hgwy ;;V E Falmouth MA 02536 �\ _-__r� 1W, Update Address and return card.Mark reason for change. SCA 1 Co 20M-05/11 Address ❑ Renewal Employment Lost Card v/ze�panvnzoruu a�C�/��cue�uaeC� Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: (463230 Type: Office of Consumer Affairs and Business Regulation U'V xpiration:6qWz.<Of6 Individual 10 Park Plaza-Suite 5170 Boston,MA 02116 STEVEN A.LEAF •1� r ("I , ) Steven Leaf 13r r 106 Waquoit Hgwy E Falmouth,MA 02536 Undersecretary Not valid signature DATE(MM/DD/YYYY) ACCO o® CERTIFICATE OF LIABILITY INSURANCE 4/19/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Andrew Roth NAME: Murray & MacDonald Insurance Services, Inc. ac°No Ext: (508)540-2400 a/c Na: (508)289-4111 550 MacArthur Blvd. E-MAIL andy@riskadvice.com ADDRESS: INSURERS AFFORDING COVERAGE NAIC# Bourne MA 02532 INSURERA:Main Street America 11066 INSURED INSURER B:HartfOrd Casualty Ins. Co 29424 Joseph Lodico INSURERC: 18 SEACOAST SHORES BLVD INSURERD: INSURER E EAST FALMOUTH MA 02536-5470 INSURERF: COVERAGES CERTIFICATE NUMBER:16-17 Master 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. INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE J=WVD POLICY NUMBER JMM1DDNYYYI (MMIDDNYYYILIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 --UA-MAGETO RENTED A CLAIMS-MADE �X OCCUR PREMISES Ea occurrence) $ 500,000 MPT7837V 2/12/2016 2/12/2017 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 Pq POLICY PRO ❑LOC POLICYPRODUCTS-COMP/OPAGG $ 2,000,000 JECT OTHER: DATAC $ 25,000 AUTOMOBILE LIABILITY BINED S $INGLE LIMIT EaCOM accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEOT I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) 08WECCIS770 3/28/2016 3/28/2017 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below I I E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION (508) 540-3144 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Steven Leaf THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 106 Waquoit Highway ACCORDANCE WITH THE POLICY PROVISIONS. East Falmouth, MA 02536 AUTHORIZED REPRESENTATIVE Andrew Roth/AJR �{-1 ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025(201401) 20 High St Deck Replacement Plans and details by Mark Builder: Begley, home owner, Steven A. Leaf based on : Prescriptive 106 Waquoit Hwy Residential Wood Deck Construction Guide East Falmouth, MA 02536-5539 • Lic. #4354 p � 9G� Ud � ",PR 1 g RECD D . By __j 20 High Street Plotw Plan 3,,Z .41 / 0 Same 20'distance from deck to property line Replace existing deck(58'long) Zo - a with new deck In same location 3 Proposed replacement deck t" V w ' Septic system located here in ` front yard y Mark Linda Begley -30 year old existing deck 20 Highh St Deck Replacement a CERTIFIED PLOT PLAN ' LOCATION , DK" - - 8 \ I .WcsT BxuSrA{?4g" R (.�_ yam' u i 3 BG 4 17 1 �i SCALE ....".......... DATE ..�..�........ ` 15 AS if 26 PLAN REFERENCE .ljE?!��G..�?r 3.. US 44 AS 14 BAR 24 MT MT 8 1 g 2E 4 24 14 c*``rj.�'('�.• /' .. ....... . ............ . ... . .. ... .. . ... 44 P1d 24 I CERTIFY THAT THE t/ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REOUIREMENTS OF THE TOWN OF •• WHEN CONSTRUCTED. DATE MAP'.�j(JBL ss •pEjJT/u�/t."!': F,P/�►.i/G �R�in/E" REGISTERED LAND SURVEYOR !� � -20 High Street Framing Plan Lumber species:5outhern Pine* (see Table 1) Chi Bay n Y r 2„x1011edger �� board with %" dia. 6" long J. bolts/lag screws/anchors N � @ 18" o.c. or l-edgerl-ok s M > -� m - oc rn3 g � joist hanger:600 Ibs o -6 _� USO _O 0 0 C: J � ° I double or triple trimmer hanger:_Ug lbs N M " N/AX trimmer w (see Table f1j— c4 +� N O ci � 95) a) 0 o o o�J o lI�I '- 6x6 post rim joist X N N } stair stringers: 2"x12" cut-orsolid j - L (see o £ (see FygwFe 2g.) detail) J 'o treads: LBA max. beam span (LB): see Table 3 LBA max. overhang Ingle, double, or triple 2x10; Lg= 9'- '� overhang overall deck width:58'-0 " *Preservative Treated Wood 20 High Street Cross Section Deck Attached at House and Bearing Over Beam 1" x 4" wood decking existing wall 2' overhang joist rim joist I /I`, blocking (at overhanging III foists only) — — — — — — — foist �anger ledger board beam (flush fight bearing) 6"x 6" �-- past ILo or U4 maximum —� joists .an � IL<L overhang 10" 20 High Street Ledger EXTERIOR SHEATHING EXISTING STUD WALL EXISTING 2x BAND JOIST OR ENGINEERED RIM BOARD 2" MIN. I DECK JOIST 1-5/8" MIN.t Ledgerlok, 5"MAX. , LAG SCREWS OR BOLTS 6" min "2 MIN. I FLOOR FRAMING •!�•• '�•• ' �;�• ;�• �; JOIST HANGER EXISTING— FOUNDATION WALL •'O • 0- .0 _ z STAGGER FASTENI `*4 g IN 2 ROWS 5.5"MIN. FOR 2 X 8' 5"MAX 6.5"MIN. FOR 2 X 1-0 ® .5' 2 12 2"MIN. Ledgerlok, - T LEDGER LAG SCREW OR BOLT 3/4"MIN. 2" x 10" 20 High Street Joist Connections Joist Joist Hangers for 2" x 10 600 lb., galvanized NAIL ALL ©�w HOLES IN mechanical HANGER; 011 I JOIST HANGER or NAIL .. hurricane clop { O O ao _ - ao Beam Rim Joist Connection Details joists secure decking to top of rim joist with 10d threaded nails or#10 x 3" minimum wood screws @ 6"o.c. I _ I • attach rim joist to end of each joist with ® (3)10d threaded nails or(3)#10 x 3" ® minimum wood screws rim joist 20 High Street ( 3 ) 2 x 10" beam Post Cap Attachment _�-•--.____ _ Solid sawn or muitl ply beam Spans • L/4 maximum overhang • Splice over posts Wmin. 4 j ;! • Joists will not be attached to opposite �°S` i' '4 0 sides of the same beam Beam Assembly Details 10d threaded nail or#10 wood 2 threaded nails or screws at each end or screw 23" long, staggered in splice end; splices shall be located only over 2 rows interior posts (Figure 3) If a beam is constructed with 3-members, 16" attach each outside member to the inside typical _ member as shown here. 20 High Street Bracing :_:M1° i Diagonal bracing 'beam • Parallel to beam 2x4, typical (1) 1/2" diameter lag screw with washers, typical 20 High Street I i I Guard Post to Rim Joist hold-down anchor See Guard Rail detail joists guard post guard post fill align guard post at joist locations rim joist hold-down anchor5 rim joist rim joist joist J hold-down anchor minimum (2)1/2" min. diameter thru- 2-112" min. and 5" max. bolts and washers - 2" min. at joist location between joists SECTION PLAN VIEWS 20 High Street Guard Rail Guard Detail 6'-0" maximum spacing 2x2 baluster, typical 4x4 post, typical �— 2x6 or 5/4 board DO NOT NOTCH y ++ rail cap 36" 2x4 top and bottom; minimum attach to guard post with (2)8d threaded nails or 1 y ,e (2)#8 wood screws Z2-%2" long on inside face (2)1/2" diameter attach balusters at top and bottom openings shall not allow thru-bolts and ( �# wood screw washers the passage of a 4" post_frarne threaded nails( )s with diameter sphere 0.135" nominal diameter 20 High Street Stairs : Tread Riser, and Stringer Attachment riser may be open, but shall not allow the passage of a 4"diameter sphere 10"minimum tread width 7-314"maximum riser; height shall not deviate from risers: 1x material, minimum one another by more than 3!8" treads: see Figure 29 and Table 6 T g 3!4"- 1-1l4"nosing; nosing shall not deviate from one another by more than 318" N O Cn L C T CD 0) - M a v o rim joist or L M O outside joist handrail rhandrail shall at each end sloped joist hanger, minimum download 36" ruin. stair width capacity of 625 Ibs; see JOIST HANGERS 4" thick concrete for more requirements ad 48" x 48" 20 High Street ATTACHMENT WITH HANGERS Hardwood Wood Decking Attachment • 2-8d commons or 2-#8 screws • Spacing 1/8" • Perpendicular to joists 1 , O 1 , Same 20'distance from 0 deck to property line /II Replace existing deck (58' long) ' 2° <= with new deck in same location 0 +. 1 1 � i Septic system located here in front yard 7 M �/ �--- Mark & Linda Begley 20 High St w, Deck Replacement Q CERTI A ED PLOT PLAN c=� I LOCAT1 ON .r1r�;'. . -x�✓sr�7r�4�:. . . . . ... SCALE . .�..".`' . .... DATE PLAN REFERENCE I CERTIFY THAT THE �ST �!'1G!a7lO!J AI SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REOUIREMENTS OF THE TOWN OF �'-'�.✓3%/3`3 . .. . . . . .WHEN CONSTRUCTED. DATE !/ /3 PL77T/>^/e_--,1e - REGISTERED LAND SURVEYOR i TOWN OF BARNSTABLE. R I S E Division of Thlelsch Engineering,Inc. 7013 MAY 10 AM 11: 21. 1341 Elmwood Avenue ENGINEERING Cranston,Rhode Island02910 DIVISION May 1, 2013 Thomas Perry,-CBO • Town of Barnstable Building Division 200 Main Street . Hyannis, MA 02601 Re: Insulation permits Dear Mr. Perry, This affidavit is to certify that all insulation work completed for 20 High Street has been inspected by a Building Performance Institute (BPI) certified Professional. . All work performed meets or exceeds Federal and State requirement. Sincerely, Erik Nerstheimer Supervisor of Installations, BPI certified Building Analyst Professional and Envelope Professional, RISE Engineering, a division of Thielsch Engineering, Inc. 1341.ElmwoodAvenue Cranston, RI 02910 401-784-3700 •800-422-5365 •Fax 401-784-3710 n ( A ` 4 �t i S 3, y a — an'� �� •�y � it -� 206 S7 116452 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel C' `' Application 3?e#' (( d � p Health Division 'Date Issued Conservation Division Application Fee Planning Dept. ...'.`Permit Fee. Date Definitive Plan Approved by Planning Board r , Historic - OKH _ Preservation/ Hyannis Project Street Address 20 High street VlllageWe'st Barnstable Owner Mark Begley Address Same Telephone 508-362-9760 Permit Request Air seal ins R-10 rigid insulation at; tg kneewallr-R 30 in6ul 1 9 ;41 1 iE Roof access Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 569.00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ❑ Two Family ❑ Multi-Family (# units) -71 Age of Existing Structure Historic House: ❑Yes ElNo On Old King-.'s?Highway ❑Ys� ❑ No -T1 Basement Type: ElFull ❑ Crawl ❑ Walkout ❑ Other °` f N Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) -R P fq Number of Baths: Full: existing new Half: existing new N o N Number of Bedrooms: existing —new rn Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas . ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RISE Engineering Telephone Number 401-784-3700 EXT 161 Address 1341 Elmwood Ave, Cranston RI 02910 License# 100459 Home Improvement Contractor# 120979 Worker's Compensation # 3730961-01 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO RI Resource Recov y SIGNATURE DATE l l Erik Nerstheimer for RISE Enigineering r ' 1 � FOR OFFICIAL USE ONLY i APPLICATION# __DATE ISSUED,. .E- i ADDRESS VILLAGE OWNER DATE OF INSPECTION:. FOUNDATION ' FRAME k_ - INSULATION' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ROUGH 0-'�F" .. FINAL ::;!FINAL BUIL•DING�� ��: ::-�, : F�. 4t DATE CLOSED OUT ". ASSOCIATION PLAN`NO 3 RISE ENGINEERING' eral ID#05-0405629 Contractor Registration No 8186 A division of Thieisch Engineering Contractor Registration No 120979 UContractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI RA (401)784 3700 FAX(401) FEB14 2011 ONTCT ge 1 R I S IS CONTRACT IS ENTERED INTO BETWEEN RISE GWEERING AND THE CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER PHONE DATE client# Mark J Begley 0 02/03/2011 116452 SERVICE STREET BILLING STREET 20 High Street 20 High Street SERVICE CITY,STATE,ZIP BILLING CITY,STATE,LP West Barnstable,MA 02668 West Barnstable,MA 02668 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 include 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.) $66.00 RISE Engineering will provide labor and materials to install 2.25"R-10 semi-rigid fiberglass board insulation to 60 square feet of kneewall area. $162.00 RISE Engineering will provide labor and materials to install a 9"layer of R-30 Class 1 Cellulose added to 60 square feet of open attic space. $66.00 A linear opening will be made in the roof to access an area to be insulated. Roofing will be reinstalled when work is complete. Cost is for the first 5 lineal feet of opening. $165.00 A linear opening will be extended in the roof to access an area to be insulated. Roofing will be reinstalled when work is complete. Cost is for the lineal feet of opening beyond the first 5 feet. $110.00 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 100%incentive for air sealing. $66.00 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. -$377.25 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF ***One Hundred Twenty-Five&75/100 Dollars .$125.75 UPON FINAL INSPECT19.N AND APPROVAJBY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE W FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE 30 D VS.SEE E FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF REGSION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES le4_ V l AUTHORIZED SIGNATURE-RISE ENGINEERING CUS ER ACCE TANCE NOTE:THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN DATE OF ACCEPTANCE -� / ACCEPTANCE OF CONTRACT-THE ABOVE P CES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY A TED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE 5 5(, -t- 46 tom. A ` _ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, Mass. 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Blame(Business/Organization/Individual): RISE Engineering a division of Thiel ch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone#: (401)784-3700 or 1-800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1. N I am an employer with 4. 0 I am a general contractor and I 6. 0 New construction employees(full and/or part time).* have hired the sub-contractors ❑Remodeling 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance. $ 9. ❑Building addition required] 5.0 We are a corporation and its 10. ❑Electrical repairs or additions 3. ❑ lam a homeowner doing all work officers have exercised their 11. ❑Plumbing repairs or additions y [No workers' comp. right of exemption perm MGL insurance required] t c. 152, § 1(4),and we have no 12. ❑Roof repairs employees. [no workers' 13. N Other Insulate comp.insurance required.] *Any applicant that checks box#1 must also Till out the section below showing their workers'compensation policy information. tHomeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contactors that check this box must attach 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: The Preston Agency Policy#or Self-ins.Lic.#: 3730961-01 Expiration Date: 1/1/12. 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 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 $250.00 a.day against violator.Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. Zdo herby certi and the ins enalties ofperjury that the information provided above is true and.correct. Si nature: '` .- Date: Print Name: Erik Nerstheimer Phone #:(401)784-3700 or '1 800 422 365 x 1 31 Of 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): LBoard of Heath 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: �1 OP ID: 31 CERTIFICATE OF LIABILITY INSURANCE DATE(M 12/30/1YYY) 0/10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 401-886-8000 CONTACT NAME: The Preston Agency,Inc. 401-886-1700 PHONE FAx 1350 Division Rd Suite 303 A/c o Ext: AC No): PO Box 810 ADDRESS: East Greenwich,RI 02818-0810 CUSTOMER ID a:THIEL-1 INSURERS AFFORDING COVERAGE NAIC p INSURED Thielsch Engineering,Inc INSURER A:Zurich-American Ins Co. Thielsch Group Inc. INSURER B:American Guarantee&Liability Tech Realty inc. 1 INSURER C:North American Capacity 95 Frances Avenue p ty Cranston,RI 02910 INSURER D:Hartford Insurance Company INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DDY/YYYY MMILDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 A X COMM ERCIAL GENERAL LIABILITY 3730962-01 01/01/11 01/01/12 PREMISES Eaocrre— a $ 300,00 CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $ 10,00 PERSONAL 8 ADV INJURY $ 1,000,00 GENERALAGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,00 POLICY PRO- X LOC I Emp Ben. $ 1,000,00 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 2,000,00 A X ANY AUTO 3730963-01 01/01/11 01/01/12 (Ea accident) BODILY INJURY(Per person) $ ALL OWNED AUTOS SCHEDULED AUTOS BODILY INJURY(Per accident) $ PROPERTY DAMAGE $ HIRED AUTOS (Per accident NON-OWNED AUTOS $ $ UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 10,000,00 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,00 B .. AUC-4867188-00 01/01/11 01/01/12 DEDUCTIBLE RETENTION $ $ WORKERS COMPENSATION X VvC STATU• OTH- AND EMPLOYERS'LIABILITY Y/N IMI ER -A ANY PROPRIETOR/PARTNER/EXECUTIVE 3730961-01 01/01/11 01/01/12 E.L.EACH ACCIDENT $ 11000,00 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In es,describe under If ndnd er E.L.DISEASE-EA EMPLOYE $ 1,000,00 y DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1$ 1,000,00 C Professional Liab tt DVL000026800 04/01/10 04/01/11 Prof Llab 2,000,000 D Leased/Rented Eqp 02UUNTD5678 01/01/11 01/01/12 Equipment 100,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD NOTEPAD THIEL-1 PACE 2 INSURED'S NAME Thielsch Engineering,Inc OP ID:31 DATE 12/30/10 RIK g :. pgineerin ,a division of Thielsch En meerin ,Inc. gk ell Associates a divisio f Thiels h! i ineenh ,Inc. Nater La oratory,a aivlslono }elsch n InSeri ,Inc. O oretor ,a drvi$ign.o 0 1 sch�n In . Vil Inc Enginee n9 drvision offf nielsch rh9 inee in ,inc. anagemek ervices,a division of h�ielsch Ef gineering, Inc. I I 91te ice o nsumer aia(an usines�u ration O o g 10 Park Plaza - Suite 5 170 , Boston) ssachusetts 02116 Home Improve ontractor Registration _ Registration: 120979 m Type: Supplement Card Z w Expiration: 3/25/2012 THIELSCH ENGINEERING ERIK NERSTHEIMER 1341 ELMWOOD AVE. ° CRANSTON, RI 02910 h Q f 4 Update Address and return card.Mark reason for change. ❑ Address ❑ Renewal Employment Lost Card DPS-CAI 0 50M-04/04-G10I216 ✓�ie {vomrmzo7ei�seal.� ���aaaac�u�aella � • Office of Consumer Affairs&Bu mess Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation U19 Reg istration $79 Type: 10 Park Plaza-Suite 5170 Expira 12 Supplement Card Boston,MA 02116 THIELSCH ENGQ 1,000, ERIK NERSTH 1341 ELMWOOD CRANSTON;RI 02 Undersecretary Not valid without signature Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC Name Erik Nerstheimer City,State,Zip North Scituate,RI,02857 Expiration Date 3/28/2012 Status Current No complaints Pound for this Licensee. Back To Search http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=CSL 100459 1/7/2011 e i ® "t NAT-24531 - 1 Control No: 34244 mom THE COMMONWEALTH OF MASSACHUSETTS DEPARTMENT OF LABOR d DIVISION OF OCCUPATIONAL SAFETY 19 STANIF'ORD STREET,BOsTON,MAssACHus=s 02114 LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER RISE Engineering A Division of Thielsch Engineering, Inc. 1341 Elmwood Avenue Cranston, RI 02910 WAIVER: LW000672 EXPIRES: April 15,2015 IN ACCORDANCE WITH M.G.L. C. 111, § 1970)(b) AND 454 CMR 22.03(3)(b), THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER IS ISSUED BY THE DIV. OF OCCUPATIONAL SAFETY TO THE CONTRACTOR ABOVE FOR THE PURPOSE OF PERFORMING LEAD-SAFE RENOVATION WORK. THIS LEAD-SAFE RENOVATION CONTRACTOR LICENSING WAIVER MUST BE MAINTAINED BY THE CONTRACTOR IN ACCORDANCE WITH M.G.L. C. 111, § 197B(b)AND 454 CMR 22.04 WHEN PERFORMING LEAD-SAFE RENOVATION WORK. I -?_ Yoc HEATHER E. ROWE,ACTING COMMISSIONER t� Printed on Recycled paper 1 'J,V-•, - -- - - t G _ VI ly �. - � ,_ J t``�......_ .��� ......--_..,...--._ ^�_�__w� a .:yam � � ,..•+ -ar �,{ ti i R 4 ° L fu._ _a �_.- I•/�I 0 , ll�o O� t r fi PERMIT PAYMENT RECEIPT : TOWN OF-BARNSTABLE BUILDING-DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 // DATE: 10/31/08 TIME: 15:14 ------------------TOTALS----------------- PERMIT $ PAID 25.00 AMT TENDERED: 25.00 AMT APPLIED: 25.00 CHANGE: APPLICATION NUMBER: 200806.148� rn.� PAYMENT METH: CHECK' PAYMENT '{ PAYMENT REF: _.__ - mama Town of Barnstable P . t Regulatory Services Date: �OF1HE Toy Thomas F. Geiler,Director _ Fee�as Building Division BARNSrABLE, Tom Perry, Building Commissioner v 039. ��� 200 Main Street, Hyannis, MA 02601 �AlE�MP�a www.town.barnstable.ma.us O Office: 508-862-4038 Fax 508-71j-Q 623;0 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT CIO _ h Owner: >�4 W4 ��o6 'Fs�F/ Phone: �� w r Install at: e2zo Z//� z .ff Village: �/, ���r1 E rn Map/Parcel: Doi 0D0 Date: /ezLIA Stove A.<ly v�/ Used B. Type: adiant Circulating C. Manufacturer: �6�1-142 'Af-e Lab. No.CcG /yf—c . GtL G I D. Model No.: Nee Chimney A. New/ xistin (If existing, please note date of last cleaning)/ B. Flue Size C. Are other appliances attached to Flue? /YO D. Pre-fab Type and Manufacturer E. Masonry: ine nlined Hearth A. Materials: "/G/C B. Sub Floor Construction: Ca,* C rep f� Installer Name: Address: Phone: Location of Installation: H.I.0 Registration # Construction Supervisor# OR check_ Homeowner Installing, no license required APPLICANTS SIGNATURE APPROVED BY: ! �v Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection, photographed, and approved by the Building Inspector Q:forms:stove Rcv 103107 The Commonwealth of Massachusetts • Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston,MA 02111 www.mass.gov/dia ' Workers} Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant Information Please Print Legibly. Name(Business/Organization/Individual): . Address: City/State/Zip: Phone.#: r2. .you an employer? Checkthe appropriate bog: :Type of project(required):. 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). ? Remodeling I am a'sole proprietor or partner- listed on the-attached sheet ❑ g ship and have no employees These sub-contractors have g. Demolition have workers' working for me in any capacity. temployees and h , 9. []Building addition [No workers' comp.insurance comp, insurance. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] � ' 3.❑ I am a homeowner doing all work. . officers have exercised their l l.[]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 13.❑ Other employees. [No workers' comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. f Homeowners.wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the$ub-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: Policy#or Self-ins.Lic.#: Expiration Date: lob 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of per that the information provided above is true and correct. Si ature: Date: — Phone#: Fth only. Do not write in this area, tb be completed by,city or town officiaL Town: . Permit/License# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: 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 4ouse 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 ehapter..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-compliaace with:thi 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-contiactor(s)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 maybe 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 complewand 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 permittlicense 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 17eput nwt of to tstdal Accidents Offiee of Investigations 640 Washingt6 Street Boston,.MA Q2111 - . TO. #617-727-4500 ext 406 or 1-877-MASSA.FE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia �o � �� UL -��y.-e- , 3 '� ���//` to act on my behalf, rized by this building permit application for: ess of Job) Date rmit please complete the Homeowners License BIKE ram, Town of Barnstable *Permit#,._;_Cy,6 Expires 6 months from issue date Regulatory Services Fee EL4XN9rnsi.e. Thomas F.Geiler,Director nsnas 16s9. .0 Building Division lf0 PAAr a 9 1C Tom Perry,CBO, Building Commissioner O 200 Main Street,Hyannis,MA 02601 www.town.bamstable.m.a.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /-J1 — 4°z�? — �1 Property Address 9 6) SX �S f T� [Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) MCOMOIT ❑Workman's Compensation Insurance _ Check one: APR 2 5 2008 ❑ I am a sole proprietor E I am the Homeowner TOWN OF BARNSTABLE ❑ I have Worker's Compensation Insurance J� l Insurance Company Name 14 ! Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. 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) El"'Re-side [' Replacement Windows/doors/sliders.U-Value (maximum *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. I ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE: .1 1 Q:\WPFILES\FORMS\building permit forms\EXPRESSAP Revise020108 4 s � The Commonwealth of Massachusetts 0. 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 A licant-Information / Please Print Legibly Name(Business/Orimdnrion/Indiv ddual): " F� Addre s i_ y l City/Statozip: .I�/ Phone-#: 7�1 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with - 4. ❑ I am a general contractor and I employees(fall 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' 9 ❑Building addition [No workers' comp.•insurance comp.insurance 10.❑Electrical repairs or additions ed.] 5. ❑ We are a corporation and its officers have exercised their 11.0 Plumbing repairs or additions am a homeowner doing all work 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 work='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. (Contractors that check this box crust 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 providb 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.M 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 socun a coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine•uIp 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 cerd der the/pains-and penalties of perj that the information provided above is true and correct Si ature:� _ �C Date: Phone k Official use only. Do not write in this area,to be completed by city or town offtciaL 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 `P ' 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 affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses)and phone number(s) along with their certificates)of insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLY)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 Towp 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 onp affidavit indicating cun-ent 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 io any business or commercial venture (Le.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 Washingtn Street Boston, MA 02111 TO. #617-727-4900 ext 4-06 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia t �oFtrti Town of Barnstable Regulatory Services 0 1ARNSTABIA • may, Thomas F. Geiler,Director i63g. � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: '508-790-6230 Property Owner. Must Complete and Sign This Section If Using A Builde as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorize by this building permit application for: (Addr ss of Job si ' ature of weer / to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on thee reverse side. s Town of Barnstable �OFtHE Tp�� Regulatory Services Thomas F. Geiler,Director • satuvsrwars, . 9q, MASS. Building Division pjFD 11��p Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOD4E.UWNER_LICENSE E}CEMPTIOIV:�-� Please Print DATE: / JOB LOCATION:_ d` S7 ���'^�'f00, 6` number /� /� / street ,( / /village ".HOMEOWNER": I�Q, 4 it /J E41�// name / h'ome phone# work phone# CURRENT MAILING ADDRESS:��ZY// ( ,S J city/town state zip ccocTe 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 409.1.1) 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. of Ho er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing.work for which a building permit is required shall be exempt from the provisions. of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption aTe 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. Town of Barnstable *Permit �( o <r` � Expires 6 months from 'sae date D Regulatory Services Fee Thomas F. Gefier,Director Building Division r- s 0� Tom Perry,CEO', Building Commissioner O v / 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTLAI, O Fax: 508-790-623 Not Valid without Red X-Press Imprint ap/parcel Number operty Address i _J Residential Value of Works -O Minimum fee of$25.00 for work under S.6000.00 xner's Name&Address r E mtractor's Name Telephone Number-. ome Improvement Contractor License#(if applicable) r trf ppheibic) ]VWrkman's Compensation Insurance. ❑Check one: ®PRESS PERMIT am a sole proprietor �`"`�� [ I am the Homeovimer ❑ 3 have Worker's Compensation Insurance MAY — 7 2007 surance Company Name �44f,��� 1/f� TOWN OF BARNSTABLE _orkman's Corset.Policy# - - - - - - opy of Insurance Compliance Certificate must be on file. .rmit 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) [K Re-side G rA ejew G C ds r /'/%1 4-1S�1.r G✓� r 0 �6� t r G.v 4/ dr y Replacement Windows/doors/sliders. U-Value (maximum.44) / "Where required: lssu`ance of this permit does not exempt compliance with other town de amnent regulations,i.e.Historic,conservation,etc. a71. ***Note: Property Owner must sign Property Owner-Letter of Permission. A co y of the Home Improvement Contractors ease is required. iGNATURE: L— A n t DZ Fornu:expmtrg ,nse061306 ' The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' m0w.mass.gov/dia ' Workers}Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers ADDUcant Information Please Print Le bl Name(Business/Organization/Individual): . F Address• City/State/Zip: /�. �-��-� �S 7Z,!;, 6 `4 Phone.#: �J� — 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). 7. Remode 2.❑ I am a'sole proprietor or Partner- ship and have no employees These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition o workers' eo insurance comp.msuranee.t' quired.] 5. ❑ We aze a corporation and its 10.❑Electrical repairs or additions 3.e am a homeowner doing all work . efficers have exercised their 11.❑Plumbing repairs or additions ' myself.[No workers' comp. right of exemption per MOL 12,(]Roof repairs insurance.required.]t c. 152, §1(4),and we have no ] employees. [No workers' 13.❑ Other comp,insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners,who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew 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 then workers'comp.policy number. I a an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site nt ' information. Insurance CompanyNalne: 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). Faihze.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investi ations of the MA,for insurance coverage verification. I'do hereby certify u der the pain •and pena 'es of p ' ry that the information provided abo-ove is true and correct: Si tune: Date: / !�d� Phone#: F only. Do not write in this area, to.be completed by,city or town official n: .Perminicense# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: Information and instruction ' 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 bite, 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." AdditionaIly,MGL chapter-152,§25C( )states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the perfomiaince of public-work until acceptable r6dene6 Of•c0mplL_U4 7ith:t1ie 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-conti-actor(s)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 maybe 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 sel€insurance license number on the appropriate-line. City or Towp 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 ono 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 fo any business or commercial venture (i.e.a dog license or permit to burn leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you-in advance for your cooperation and should you have any questions, please'do not hesitate to give us a call The Department's address,telephone-and fax number:. The Commonww%of ma=ausotts Dquvt amt of Jn.dusWal Aeoidects Q .ce of f�;'Vesdiptlow 600 WaWn&6 Stmd B�stca,.MA 02121 - Tel.#617-727-490 ext 406 of I-V7-MAS•SAFE Fax#617-727-7749 Revised 11-22;06 www.m=.gov/dia yP�oF1IKWGE r��o� Town of Barnstable Regulatory Services snRrisrnar E Thomas F.Geiler,Director 9 MASS. 1639• Building Division rFD p Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number / street village "HOMEOWNER name home phone# work phone# CURRENT MAILING ADDRESS: i 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 requiremen . Signature oKiomeown 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 I Town of Barnstable aS3 � Approved Regulatory Services Fee 15, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Home Occupation Registration Date: Name: / Phone#: 3 o� Address: d - f7Z Village:—A--- Name of Business: �E�a 4AY/-A //T 7,4 Type of Business:,2V_,�l 4 Map/Lot:/.2 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 right subject to the �► following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located Ilk, within 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 there is no outside evidence of such use. • 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 other 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. o :� • There is no exterior storage or display of materials or equipment. ^' • There is no commercial vehicles related to the Customary Home Occupation,other th one varor one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet inIme gth and�&t to_n co exceed 4 tires,parked on the same lot containing the Customary Home Occupation.:!!� N • No sign shall be displayed indicating the Customary Home Occupation. o d • If the Customary Home Occupation is listed or advertised as a business,the street adds ss shall not be included. co • No person shall be employed in the Customary Home Occupation who is not a permane it reside f thte� dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am regis ering. Applicant: Date: Homeoc.doc YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates cost$30.00 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, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall). DATE: oZ D Fill in please: APPLICANT'S YOUR NAME: A,4 E' /E ram} IFI '." BUSINESS YOUR HOME ADDRESS: 6 f TELEPHONE # Home Telephone Number: - nr v-+. a ,_!.ba,=-•._v.v� ,!. ::!nB.:S._� _ . _..._.-_...___ ___.__... _....._........ ..... , _...._.....__..._....._.._ v....ry v.,., v._svn.._....,_. ...,_-,.,.v._r__n _ =P L_ .4_._..v „s,... .... .... . .. ..y -}. r -"32, 'La,•,:u-r' rLr4M __.f ...___._..._..._. •. ,. r:_v,_m_ .. e._r__._..I K. = - ... ..v __.. .... 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I(,J]].!� .. { .. .; �: .,: . `� �. ,.,_.� r. _..,...,_. . .:._._,._,,.._.._.._. „T:,::_,,.he:...�T-.r..•..r',.�:�,:!EiF:_ ._ rrr.....a ... _ ,. __. _ N r-Pv.. ..., .....,v6.,.4- ., ::,:..,.. .Pi'.i:r• ....!:_ p :,::i,:_:�'C....,I...._-?i�iP` ._.�_..,,5._ .___._ rti._,,.__. ,•��.m ., al=.�.,..._�.o.r.. r ., ,,... r.,.a...._,. __ ,..... � r_ .. ,:i ,_:.:;2!drr .,l...:.. [!: � ":!T". ",�iih!"'L _! - .,. s ...ura. _ __+..�E,.._.. .. ,;rm ro, • r. ,..r ::r+�.- !. .......:.... ...G. :,. :4-/✓!6�'_,>:. „!.:� .•.L,uL.. r:r,rrr_-,...R� ,.P���.I�VE_I�'. �'Y M47�Q ���� ,,,1� ,5 .i -_?hrv,-.��R .. �; C ._.... 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 COMMISSIONER' FFI This individual has bee i rme of ny permit requirements that pertain to this type of business. uthorized Si ature" ,,,JCOMMENTS: 2. BOARD OF HEALTH This individual as'b en iaforMed pf the permit requirements that pertain to this type of business. A orized Signature*" � � COMMENTS: a� 02 - 3. CONSUMER.AFFAIRS (LICENSING AUTHORITY) This individual een i rmed oflic si equirements that pertain to this type of business. Authorized Signature" COMMENTS: ►'. s TOWN OF BARNSTABLE Permit No 30264 . ....... .. v BUILDING DEPARTMENT 7°: } TOWN OFFICE BUILDING Cash ' ouv HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to BARBARA BUCKLEY Address lot #3 20 High Street, West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY-THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN 'REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 23 89....... .......................:.... 19........ . ��'Ca��•r...................... Building Inspector 7OWN-,.OF BARNSTABLE, MASSACHUSETTS BUILDING• PERMIT A=133-28— DATE Deci tuber 9 19 86 PERMIT APPLICANT Frank F a i n ADDRESS 144 Phipps . Quincy; �MA oD4 3_Q IN0.1 (STREET)- (CONTR'S'LICENSE) PERMIT TO r1.Tn l 1 i no NUMBER OF' (_)Z STORV Si nv]o_Y;�mi 1 v r1 Tr.l 1 ino DWELLING UNITS (TYPE OF IMPROVEMEN N0, �'� IPR OPOSED US ) � AT (LOCATION) lot- #3 Ct'fPPt u1Pc- ZONING (NO.) fF sTRgTI t $a rns-rahl n DISTRICT_ RV BETWEEN AND (CROSS STREET) (CROSS STREET) .. . SUBDIVISION LOT BLOCK SIZE ^^ BUILDIqQ 1S TO BE FT, WIDE BY FT. LONG BY FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TOE USE GROUP BASEMENT WALLS OR FOUNDATION ' (TYPE) ' REMARKS: AREA OR BOND VOLUME _ 1 (1t;(� ESTIMATED COST $_ 1 nnPnnn FEE PERMIT s 145 M' (CUBIC/SOUARE FEET) OWNER A--- J� rbara BUG-klo ADDRESS BUILDING DEPT. BY lEi''•"""' jBT OFlL7 .....E SUBDIVISION RICTIOi'E`FSSYJ"A'fJ'1"E'pF`T•lif5"PERMfT"D'CJ'E15'I�f(ST-R"EL-E'A SE•TFi I= A�PP't1"cl*i`F'T�'�.nf51J�`��•1��'Ci bITb ITTOAS -"-_. OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR I. ELECTRICAL, PLUMBING AND FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. ' 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS -- PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 D e? HEATING INSPECTION AP ROVAI.S _-_.._•_,-"_._•__ _ — ENGINEERING DEPARTMENT t BOARD DD]OF IIEALIH j 1 � i �"�bo•�f2�"y//� Wl)HK SHAII NU1 PROCEI'I)UN111 1HI INSPIc PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION 1011 HAS APPHOVLU IHL VAIIIODUti SIAI;LS OF I WORK IS NOT STARTED WITHIN INSPErIIONS INDICATED ON THIS CARD CAN UE W SI: MONTHS OF DATE THE L'UNSTHUCTIOP PERMIT IS ISSUED AS NOTED ABOVE, ARRANGED FOR BY TELEPHONE OR WRITTIEN NOTIFICATION. DATF f0 0� 3 CO,'T I NUATI ON' OF ROAD BOND BUILDING PE;NIT (� The undersigned owner/contractor hereby agree to maintain their road bond in force until the following work items are completed to the ; satisfaction of the Engineering Section of the Department of Public Works. loam and se d shoulders as soon as l / weather pewits. v other (explain) p�c� f!-T �C7:yrt✓ , LOCATIO\ ; ("7- 3 ) 02� Alal q 1-31eh� SIGNED Vrner/Contractor E CI;;EERIt' k0THC•5:I ATIOf 1 r r o' w 1 a �7 c� • CERTIFIED PLOT PLAN I LOCATION .W.csT 3.9?eivsr,9 � SCALE . .�.�: ,��.... DATE PLAN REFERENCE .--3.E?!%!a ZT, X13 -�i�1�✓•✓ oiV � .t?L�� Ijoa.� �08 �A�1N OF �'qs, .'. . . .. . . . . . . . . . .. . . . .. . . . . . . . . . . . .. . ES KELLEY No. 261�00 1 CERTIFY THAT THE �, SHOWN ON THIS PLAN IS LOCATED ON THE GROUND eclsitF S� "�i AS'SHOWN HEREON AND THAT IT CONFORMS TO THE L LIA SETBACK REQUIREMENTS OF THE TOWN OF yr BSTfI�4 .... . . . .WHEN CONSTRUCTED. .DATE REGISTERED LAND SURVEYOR -AL- --- ---- --- l 00 C Q _ ,u,' 1 s6/° W , r N N \V- 0 uj O ' M�rj M UPLAND l� O N O a AREA OF UPLAND = 1 .002 ACRES f O o AREA OF SWAMP = 0.287 ACRES f 2 TOTAL AREA = 1.. 289 ACRES MHB ( FND) N AREA = I .043 ACRES uj CD �OO Gn- IS . O •0 O N S �8 �s8, �� ,Ir l� •^hh uj 0/1 \ t /3 3 _a-�— 3 ✓ . r �� �3.3Y#C SYSTEM MUST BE A'sses soes offioe (1st floor): - INSTALLED IN COMPLIANC Asses Board o is ma Health and lot number ...".. .. ...........+............... WITH TITLE S (3rd floor); -!D S I 'ENVIRONMENTAL CODE A ' Sewage Permit number ...0......................................... BAHIISTULE, Engineering Department (3rd floor): ` TOWN REGULATIONS *A& � ` 0 3 House number �0 NO a• APPLICATIONS PROCESSED 8:30`-9:30 AV ands•1c00•2:00 P,M. only TOWN OF B,ARNSTABLE BUILDING JASPECTOR APPLICATION 'FOR PERMIT TO ....... ........ .E �/V. TYPEOF CONSTRUCTION ........ �.Q. .........:................................................................................................ ......�Q ..�..... cr............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a per 't actor ing -fol wing n mati Location ...... ..... M.COA........... ... .. Proposed Use .....�....rmJ!.....� �/Va........ Zoning District ........... ......�.................................Fire Distri Name of Owner .� �4"OQ ..40420 '�. .... j7 �.�Address ...1 .,� .... t .'/�. .. i Name of Builder ./;;W,0 J11�!< ... .........Address .1 Vz/..0ch/.�w,5....S...T Name of Architect 5......`S.0 .W 4./. (..........Address 7a....../N-57......S:57......r—.009 A40...... *.??fO Number of Rooms ..........�.................................................Foundation .... ..........C0A,1<:7,ef-7.-C..... Exterior .........4.4,AQ.0.0....................................................Roofing ........ �14�. ............................................ Floors ....... 0.....e.-aaw/Q..................................Interior .....0X.0 Qf�2.�..."7`... Heating .......D..I....................................................:...........Plumbing .......000�.. ,...�,......f.....C()../.0�0 ~�........ Fireplace ........ /.. ......................................Approximate Cost .......�Q�UQ l ' Definitive Plan Approved by Planning Board ______________________ ___ `r 19 Area ......`......... Diagram of Lot and Building with Dimensions Fee AA SUBJECT TO APPROVAL OF BOARD OF HEALTH y . 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. Construction Supervisor's LicenseX.043-.6..L.U..Y BUCKLEY, BARBARA No ... Permit for ....2...S tory ........................... Sin le Family Dwelling ............. .......................................................... Zo 4144h Location Lot #3.. yl High Street .... ..................... . West Barnstable ............................................................................... Owner ........Barbara Buckle.y .................................... ................... Type of Construction ........Frame.......................... ....... .......................... .................................................... Plot ............................ Lot ................................ ' Permit Gran December 9g. +ed .........................................ig 86 Date of Inspection ............................. ......19 Date Completed ..........19 4e Assessor's off.ioe (1st floor): /- �3 + a� �"' Assessor's ma and lot number ......�...... �n n Oi THE TO p Board of Health Ord floor): Sewage Permit number ............................................. .......... Z B9Bd9TODLE, i Engineering Department (3rd floor): oa rb 9• House Rumber .................................< ,. ...9........ ................. 3 �� �JS `'Fo gar APPLICATIONS PROCESSED 8:30-9:30 A. an 1:00 2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......<ZOAI,? !J 7......./,.,,.. TYPE OF CONSTRUCTION .........ke. 4?0................................................................................:......................... ......�n.. /� k�............19........ TO THE INSPECTOR OF BUILDINGS: / The undersigned hereby applies for a perm't accor ing,to the�Tolow�int�h at�J Location ...... .. ....... ........:K .. .... Proposed Use ...... .......'., 7':�1./. v..(u .... .G.� �1 /..l! '.................... ..............n.... ....................................... Zoning District � ......./.................................Fire Distri 767...C ...- �/� f. 2... Name of Owner ....... � 1/� ..��Gl i`..!�.Address .. /...... Name of Builder .d.!1 /.I/'� 77lP4..Z1. ............Address 7.?'....li`y�`�rJ.. ...ST ... 1/,//r/< ,/JJ Name of Architect ......:.56494/M.........Address ......��`�...... ��./......rj..1./� Number of Rooms ..................................................................Foundation ............ Exterior .........��L J./.U.��....................................................Roofing ......... —J�1/�rJT........................................... Floors ....... ..... .�.-�...................................Interior ...... .�/. d-3(G��/?. ...f....�/fl�/?�...5 .T..��< Heating ....... ..................................................................Plumbing .......�.��:...�_.......7t:.... l),1 /,/-dJ........ ....... Fireplace ........ /.C. ...................................................Approximate Cost ....... 1�1 �0 0 Definitive Plan Approved by Planning Board ________________________________19 _____ . Area ...! .. :...............:...... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 r . w I r , 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. ........ f ' /� OVr°) �D Construction Supervisor's License .;.�................................ e Y' BUCKLEY, BARBARA A=133- 8 30264 2 Story No ................. Permit for .................... .............. Single Family Dwell n ....................... .............. A=l 33- 8 . .............. n . .. ......... Lot #3 , 14 High �treet Location .......................................... ...... ............. West Barns bl�e 3 .................................................. ........................... Barbara Buck ..........................Owner .... ........ . Type of Construction ............Fr.Ame...................... ....... ............................................................................... Plot ...................I......... Lot ................................ ber- Permit Granted ....................Dece.M.............9....19 86 Date'of Inspection ....................................19 Date Completed ................19 1111,07