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`oFt►+e► �o� The Town of Barnstable
BARE. Department of Health-Safety and Environmental Services ,
Building Division
367 Main Street,Hyannis,MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice `
Type of Inspection
Location /d 90 111191r✓ ST" Permit Number a ��
Owner Builder s %s
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
�L G/YI f3
a. C19V, A161 I SS IJNT/ �
Please call: 508-862-4038 for re-inspection.
Inspected by ' O
Date / 0 2-
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
1 /
rl
Map d Parcel Permit# c�
Health Division 2��2 8��- Date Issued
Conservation Division I A Fee D
Tax Collector 7Z, -?Y -7 '91
SEPTIC SYSTEIM MUST GE
Treasurer 7 INSTALLED IN COptl PLIANCO
Planning Dept. r WITH TITLE 5 OA=V"
ENVIRONMENTAL CODE AMF8lglaL
Date Definitive Plan Approved by Planning Board ; TOM REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address �X 2
Village
Owner � ,,���. s��e/`n-,�r�io�.. Address '� -
Telephone 3` 7,p
Permit Request cr 1�7�� `f' �
Square feet: 1st floor: existing f 56 proposed l , 2nd floor: existing proposed Total new
Valuation Zoning District Flood Plain Groundwater Overlay
Construction Ty
pe
Lot Size Grandfathered: ❑Yes O No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure �;0 YI 1 Historic House: ❑Yes �Nlo On Old King's Highway: .9/Yes O No
Basement Type: O Full Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) She
-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 3
Heat Type and FuelyGas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes YNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes O o
Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing= ❑newL�ize m
Attached garage:O existing ❑new size Shed:❑existing O new size Other: =`
C)
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
N �
Commercial ❑Yes ;XNO If yes,, site plan review#
Current Use /�p1 ,� G, w m
�,� Proposed Use
BUILDER INFORMATION
� U
Name lP4,1d,, �2C Telephone Number J0�
Address rG License#
Home Improvement Contractor#
Worker's Compensation
s#iJgC e 0D 46/o2b 12 o
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 10'4'J2 fUy1-0--
SIGNATURE DATE 1 ��
� FOR OFFICIAL USE ONLY
PERMIT NO.
y
k
DATE ISSUED
s MAP/PARCEL NO.
t
ADDRESS — e VILLAGE
r
OWNER
DATE OF INSPECTION:
FOUNDATION
l3fRln /C) 3 fc a . /�h
FRAME !O/T a /,d z O k /0 45-?
INSULATION A/ a
x FIREPLACE
' ' P
ELECTRICAL: ROUGH FINAL
3 PLUMBING: ROUGH FINAL
GAS: ROUGH ' . FINAL
FINAL BUILDING ,
DATE CLOSED OUT sad a
ASSOCIATION PLAN
r
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings,Additions $50.00 SG�'
Alterations/Renovations $25:00
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE _
square feet x$96/sq.foot x.0031= ��
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/4q.foot= x.0031=
plus from below(if applicable)
I
ACCESSORY STRUCTURE>120 sq.ft.)
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf- 1500 sf 100.00
>1500 sf-Same as new building permit:
square feet x$96/sq.foot= x.0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
Deck x$30.00
(number)
Fireplace/Chimney x$25.00=
(number)
Inground Swimming.Pool $60.00
. Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
r(plus above if applicable)
Permit Fee d
I projcost ` • -
NWP.°FTHEr° The Town of Barnstable
BARNSTABLE. Department,�of Health Safety and Environmental Services
9 MASS. 0
�A t6}9• 0
�F°MAC Building Division
367 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
�I
PLAN REVIEW
v '4
'i
r
f Owner: Map/Parcel: / •7oc7 6/.;Z-GG/
Project Address: l694 4011K. 7- ` GUB Builder:
I •
1
The following items were noted on reviewing: '
Pfop IV,N. 1400C-;Z-) A�,'(-D4-r-1o,Af (/IZ=/YT"s
62-J444J L. Sf',9-�� V/14 0F9 SZ-.4 i3 G/f Azkc€ 6 '1�41 a 4-y
/60 US�� /�G� T �sTs
f
�A•f�
DIL yr"L - 6,Vs On
�CGr55 /luT 5146u,.v
7) A v D 8z-,0 C-/'o-"S 7 0 P 17 2,r 1 f 7
�ffow.�f-�{�T � �0/STS -A 1,41, 7—W�
P
-/2i� y /z
9)
6 /fl,4 s Ck �Ii SS i Jul
it Aoip/7-•/bi.1 0K ,4 r3/K &CA vf 0of 5 f4iOvWof �r f�RxOw�t7rn
Reviewed by:
Date: Z-
q:build ing:forms:review w
Town of Barnstable
Regulatory Services
snaxsTnBLE, Thomas F.Geiler,Director
1639. a`0� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
J n Estimated Cost
Type of Work: jV�,./11'1✓
Address of Work: le /G oto.) 5�- /S P/�
Owner's Name: � c/rn,
Date of Application: Z
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
,171)1
Date C ntractor Nam6 Registration No.
OR l /
7 eZ eLe��er�D
Date Owner's Name
Q:forms:homeaffidav
i
f` .
j 1 ✓1CPfU ��'4�'{�\yt�''� Z y�"' ° y F �
Y rra. r_ �e •yC., ���*rteq.C�tlldP.Q6 ,�
BOARD OF BUILDING REGULATIONS s iC
LiCOMM: CONSTRUCTION SUPERVISOR �•
Nu9beCS4 � 045416 .• r;.t
J,, i BlrthdabB. 09l07I1965 'e
R x {
,a' Expltea 09/07R002
ReslXicted To` 00
a cs iEf
MICHAEL T_:FITZPATRICK I� ,.
154
FORESTDALE,:MA 02644' - Administrator
r �
Board of.Buflding Regulations and Standards
HOME IMPROVE MENTCONT' :, ..t..�, RACTOR
Regls(ratton; 129598,
Explrallon:10%01l2003
,-,
�rType;; Pdvate Co
TOration
Fitzpatrick Home
Michael Fitzpatrick
8 Jan Selestio n Dr. _
Sandwich,MA 02536 •
Administrator
,
y
1
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code ; Permit #
MAScheck Software Version 2 .0
Checked by/Date
CITY: Hyannis
STATE: Massachusetts
HDD: 5973
CONSTRUCTION TYPE: 1 or 2 family, detached
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 7-16-2002
DATE OF PLANS:
TITLE:
COMPLIANCE: PASSESO
tpequired UA = 45'
Your Home = 35 4
Area or Insul Sheath Glazing/Door
Perimeter R-Value R-Value U-Value UA
------------------------------------- -----------------------------------------
CEILINGS 104 38 .0 0 . 0 3
WALLS: Wood Frame, 16" O.C. 260 15. 0 3 . 0 17
GLAZING: Windows or Doors 7 0 . 400 3
DOORS 21 0 . 350 7
FLOORS: Over Unconditioned Space 112 19 . 0 5
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design represented in these
documents is consistent with the building plans , specifications , and other
calculations submitted with the permit application. The proposed building
has been designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate
has been determined using the applicable Standard Design Conditions found
in the Code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% o the design load as specified in
sections 780CMR 1310 and . 4 .
Builder/Designer Date Jd/�
_ - The. Commonwealth of Massachusetts
Department of Industrial Accidents
- - Myce 0f15YOS119OM PAYS
600 Washington Street
Boston,Mass. 02111
_ Workers' Compensation Insurance Affidavit
itiom
phone
I am a homeowner performing all work myself.
I am a sole p rietor and have no one working ina3ca achy
I am an employer providing workers' compensation for mY employees working on this job.
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•..the following wo�eis' compensation polices••p
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tare to secure coverage as required mnder.Seetion 25A of MGL 152 can lead to the iraposttion.of crhnhml pe;Wties of a ftne`up to 51;600.00 and/or
years'imprisownient as well a'civil penalties in the form of a STOP.WORK ORDER and a fine of S100.00 a day against me..I rmderataad that a
,y of this statement may be forwarded to the Ofnce of the DIA for coverage verincation.
o hereby certify under he pains aloes of perjury that the information provided above is airs and correct
mature Date' A
rat name v`
Phone#
ofncial use only do not write in this area to be completed by city'or town official
city'or town: pernritNcense t! [3Bidlding Department
❑IAcensing Board
i ❑checkif immediate response is required ❑Selectmen's Ofnce
Health Department
contact pers on: phone IN; ❑Other
Information and Instructions
sachusetts General Laws chapter 152 section 25 requires all employers to.provide workers' compensation for their
ovees. As quoted from the "law".. an employee is-defined as every person in the service of another under any contract
re, express or implied, oral or written. :
mployer is defined as an individual, partnership, association,.corporation or other legal entity, or any two or more of
oregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
ee of an individual, partnership, association or other legal entity, employing.employees.. However the owner of a
ling house having not more than three apartments and who resides therein; or the occupant of the dwelling house.of
'. her who employs persons to do maintenance, construction or repair work on such dwelling house or oil the grounds or
ling appurtenant thereto shall not because-of such employment be deemed to bean employer. :
L chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance.or renewal .
license or permit to operate a business or to to buildings in the commonwealth iorIany applicant who has
produced accepUble evidence of compliance with the insurance coverage required. Additionally,.neither the
monwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until
ptable,evidence of compliance with the insurance requirements of this chapter have been presented to the-contracting
ority.
)licants
tse fill in the workers', compensation affidavit completely,by checking the box that applies.to your situation and
?lying.comp=y.names; address and phone numbers along-with a.certificate of ins;irance'as all affidavits may be
Witted to the Department-of Industrial Accidents for confirmation of insurance coverage: Also be sure to sign and.
the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
9 requested, not the Department of Industrial Accidents. Should you have any questions.regarding the"law"or if you
required-to obtain a workers'.compensation policy,please call the Department at the number listed below.
r or.Towns
Lse be-sure that the affidavit is'complete and printed legibly. The Department.has provided a space at the bottom of the
iavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
in-
ure to'fill in the pernut/lice .se number which will be,used as a reference number. The affidavitss-may be retuned in
Department by mail or FAX unless-other-arrangements have'bemmade:
Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
use do not hesitate to give us a call.
Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of Iosestl0ations
600 Washington Street
Boston,Ma. 02111.
fax#: (617) 727-7749
phone#f(617) 727-4900 ext. 406, 409..or.. 375:
Application to
®ib Rittg'o 'kigbWap Regional �)iotoric jBigtrict Committee
In the Town of Barnstable
2002` ° 1 .32
CERTIFICATE OF APPROPRIATENESS
Application is hereby made,with four complete sets,for the issuance of a Certificate of Appropriateness under Section
6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans,
drawings,or photographs accompanying this application for.
CHECK CATEGORIES THAT APPLY:
1. Exterior building construction: El New Addition ❑ Alteration
Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other
2. Exterior Painting: ❑
3. Signs or Billboards: ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign
4. Structure: El Fence El Wall ❑ Flagpole ❑Other
TYPE OR PRINT LEGIBLY: DATE 6a
ADDRESS OF PROPOSED WORK Ad V A%-/� s - ASSESSOR'S MAP NO.
OWNER ASSESSOR'S LOT NOJ
��1�'ro.n )c�rc��s►-,er�io��l f
HOME ADDRESS //1576 'c p Y _TELEPHONE NO. 76a, // 71?
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS,*including those of adjacent property owners across any
public street or way. (Attach additional sheet if necessary.)
AGENT OR CONTRACTOR a-`( 1 " C �� Cu TELEPHONE NO. H
ADDRESS
DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please
include locations of proposed signs.
Signed
AAerntractor-Agent
r COmmittee3Us lye
\ I `� �`y7 � o �
— T is Certificate is hereby Date
J U N - 20 22 pproved/De ' d
Committee embers' Signa
TOWN OF BAPRSTA3.LE
OLD KING' . FI6G�1 WAY A
—
t+
r�
Town of Barnstable
Old King's Highway Historic District Committee
2- 00 2, , . l 3. 2
SPEC SHEET
FOUNDATION ( Gtl re,,-1
SIDING TYPE �� i I Z ( _� CdJ". J/t/44�1 COLOR
CHIMNEY TYPE COLOR
ROOF MATERIAL����J�f�' COLOR
PITCH J
^ J��[[��
WINDOWSt)OA t lTu COLOR . SIZE
TRIM COLOR
DOORS !`E%�G(� 1 , OI' COLORS &/A/ �C
SHUTTERS d// COLORS
GUTTERS al COLORS
COLORS
DECKS ,'�/� ' MATERIALS
GARAGE DOORS COLORS
SKYLIGHTS /!r SIZE COLORS
SIGNS COLORS
" p HER
FENCE, /-V q COLOR
NOTES: P'il7 ut compere elys nclding measurements and materials/colors to be used. Four copies of this
TOWN 6. E3r��dv��Apar
fo
OLD KINIarm�are required for submittal of as application, along with Four copies of the plot plan, landscape
5 Fifial� 1��1�
'^""p3aa" when applicable.
SPECSHT
Revised 11/98
4 ` Application to
®Ib Ring's; J�igb iap Regional Jbigtoric Migtrict Committee
In the Town of Barnstable
0-0
CERTIFICATE OF APPROPRIATENESS 2 2 3. 2
Application is hereby made,with four complete sets, for the issuance of a Certificate of Appropriateness under Section
6 of Chapter 470, Acts and Resolves of Massachusetts,. 1973, for proposed work as described below and on plans,
drawings,or photographs accompanying this application for.
CHECK CATEGORIES THAT APPLY:
1. Exterior building construction: ❑ New XAddition ❑ Alteration
Indicate type of building: ❑ House ❑ Garage ❑ Commercial ❑ Other
2. Exterior Painting: ❑
3. Signs or Billboards: ❑ New Sign ❑ Existing Sign . ❑ Repainting Existing Sign
4. Structure: ❑ Fence El Wall El Flagpole ❑ Other
TYPE OR PRINT LEGIBLY: DATE f;/
ADDRESS OF PROPOSED WORK ASSESSOR'S MAP NO.
OWNER)�i��., cCQ �►�°� ASSESSOR'S LOT N(O r ao
HOME ADDRESS�6 5����,_'— TELEPHONE NO. 74 ^ I
FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any
public street or way. (Attach additional sheet if necessary.)
AGENT OR CONTRACTOR t f'r'i p ��� C �� Cu TELEPHONE NO. JW-
ADDRESS
DESCRIPTION OF PROPOSED WORK Give particulars of work to be done, including materials to be used. Please
include locations of proposed signs.
Signed
L
er- ntractor-Agent
F Onfal02TOWLO hi ertificate is hereby Date `O Y
N OF BARNS�-gBLE t Approved/Den d
�0�� K1NG'S H1GF rWAB
Co mittee Members' Signatures:
Town of Barnstable
Old King's Highway Historic District Committee
SPEC SHEET
I
FOUNDATION 9rf1-,,/
SIDING TYPE COLOR
CHIMNEY TYPE COLOR
ROOF MATERIAL�f�`ja/�' COLOR �G/�
PITCH 5
f J-�ff WINDOWS d�Wy COLOR � � SIZE
TRIM COLOR b Gf j< (� �`'..Z/��
DOORS T"r lc4 ( )ao(- COLORS
SHUTTERS // COLORS
GUTTERS /�� COLORS
DECKS MATERIALS
GARAGE DOORS /.,
COLORS
SKYLIGHTS SIZE COLORS
SIGO /7 _ COLORS
JUN —o
FE J- _ COLOR
-O
LD_KIN(�BA�tivSrABLE
NOTES: �Birlbl�9"t;cyovmp� tely, including measurements and materials/colors to be used. Four copies of this
form are required—fo submittal of an application, along with Four copies of the plot plan, landscape
plan and elevation plans, when applicable.
SPECSHT
Revised 11/98
MATCH WITH EXISTING ROOF LINES
GENERAL NOTES:
A. 1. Before final Drawings and Specifications are Issued for
construction,they shall be submitted to all governing building
agencies to insure their compliance with all applicable local and
national codes. If code discrepancies In Drawings and/or ® E
Specifications appear,the Designer shall be notified of such
discrepancies in writing by Builder or building official, and TTFT
allowed to alter Drawings and Specifications so as to comply
with governing codes before construction begins.
2. Upon written receipt of approval from the governing official, LJ _1 HLLL t] I I JTT
approved final Drawings and Specifications shall be submitted
to the Builder by the Designer.
3. If code discrepancies are discovered during the construction
process, Designer shall be notified and allowed ample time to I
remedy said discrepancies.
4. All work performed shall comply with all applicable local, state
and national building codes,ordinances and regulations,and
all other authorities having jurisdiction. Following is a partial
list of applicable codes in force:
a. Massachusetts State Building Code, 780CMR,6th edition,
3 /98 FRONT ELEVATION
B. All contractors,subcontractors,suppliers,and fabricators,shall be
responsible for the content of Drawings and Specifications and for
the supply and design of appropriate materials and work
performance.
C. All manufactured articles, materials and equipment shall be applied,
installed, erected, used,cleaned and conditioned in strict
accordance with manufacturers recommendations.
D. All alternates are at the option of the Builder and shall be at the ,
Builders request,constructed in addition to or in lieu of the
typical construction,as indicated on Drawings.
u
/ MATCH WITH EXISTING ROOF LINES
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` MATCH WITH EXISTING ROOF LINES
GENERAL NOTES:
A. 1. Before final Drawings and Specifications are Issued for
construction,they shall be submitted to all governing building
agencies to insure their compliance with all applicable local and
national codes. If code discrepancies in Drawings and/or E3 E3
Specifications appear,the Designer shall be notified of such
discrepancies in writing by Builder or building official,and
allowed to alter Drawings and Specifications so as to comply
with governing codes before construction begins.
2. Upon written receipt of approval from the governing official,
approved final Drawings and Specifications shall be submitted
to the Builder by the Designer.
3. If code discrepancies are discovered during the construction
process, Designer shall be notified and a lowed ample time to
remedy said discrepancies. ; 00 1 1 11 1 1 1 1 11 1 1 1 1 1 1 1
��,`
4. All work performed shall comply with alPapplicable local,state
and national building codes,ordinances' d/regulations;and
�.,
all other authorities having jurisdictioh o lowing.is a partial
list of applicable codes in force: ��
a. Massachusetts State Building Code,f'KCMA:J( th edition,.:, ?�Y
3/1/98 '� FRONT ELEVATIONB. All contractors,subcontractors,suppliers�anla°fabricators,shall`b'6?
responsible for the content of Drawings<anb Specificatlons-and for /
the supply and design of appropriate matenalsralhd work '•.. `
performance.
C. All manufactured articles, materials and equipment shall 6e applied,
installed,erected, used,cleaned and conditioned in strict
accordance with manufacturers recommendations.
D. All alternates are at the option of the Builder and shall be at the ,
Builder's request, constructed in addition to or in lieu of the
typical construction, as indicated on Drawings.
u
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