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1696 OST.-W.BARN. RD
I to Qlo C�S�•/(,�•ga,r nS�cD • � UPC 12543 No. 53�LOROR HASTIN09.UN rr Town of Barnstable - - - Building • Post This Card So That it is Visible From the Street-Approved Plans Must.be Retained on Job and this Card Must be Kept ewasreRl c = I $ Posted Until Final Inspection Has Been Made. Permit i63¢0�0 ��►r ,Where"a Certificate'of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3857 Applicant Name: MICHAEL MCCARTHY Approvals Date Issued:. 11/15/2019 Current Use: Structure Permit Type: Building-Insulation- Residential Expiration Date: 05/15/2020 Foundation: Location: 1696 OST.-W.BARN. RD,WEST BARNSTABLE Map/Lot: 128-018 Zoning District: RF Sheathing: Owner on Record: SHUFELT, ERIC W& LAURA F Contractor Name: MICHAEL J McCARTHY Framing: 1 Address: 1696 OST-W BARNS RD Contractor License: CS-058633 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 1,500.00 Chimney: Description: weatherization Permit Fee: $85.00 Insulation: Fee Paid: $85.00 Project Review Req: Date: ,' 11/15/2019 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. • Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: r� Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed _ - F Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Application number ` .....................................�.....S Q„ Fee ........................... ................................... _ ' = Building Inspectors Initials....................`.l................ DateIssued.......................... .......................... Map/Parcel..... .............. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVESAVEATHERIZATION PROPERTY INFORMATION Address of Project: ) 6( �-J ��, NUMBER STREET VILLAGE Owner's Name: Phone Number_C�&> qua— o) 7 S Email Address: Cell Phone Number Project cost$ _ ��2� Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize ���, to make application for a building permit in accordance with 780 CMR Owner Signature: 14I :L.9, Date: TYPE OF WORK ❑ Siding ❑ Windows(no header change)# "ulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Mike McCarthy Constr ution. Contractor's name PO Box 52 West Dennis, MA 02670 Home Improvement Contractors Registration(if applicable)# Cell (508) 28% ,0opy) CSL-58633 HIC-1693 3 Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTYIS IN A wcrnow nic7wirr vniI MIICT nRTA1M micrnR/r APPRnvAI nomnRF A PFRM/T rAM RF Iccmrn APPLICATION NUMBER............................................................ (� *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or>Yes No , if yes, a gas permit is required. Natural Gas Yes No ,if yes,a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature +► ,>}rE Date r ICANT'S SIGNATURE Signature Date I I All permit applic 'ons are subject to a building official's approval prior to issuance. DocuSign Envelope ID:700E7BD7-lDFB4E9F-836E-ACBC54D78FO4 0 - � '�5—;4�f �F SHE TQ C. e 60S E wy Town of Barnstable � g nA AIR ; Building Department Services ASS. Brian Florence CBO ' rfb RAJ p'oe Building Commissioner - - 200 Main Street,Hyannis,MA 02601 www.town.barnstable.mams Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Laura Shufelt , as Owner of the subject property hereby authorize C( 6 +. to act on my behalf, in all matters relative to work authorized by this building permit application for: 1696 Osterville W Barnstable Road West Bams (Address of Job) DocuSigned by: Signature of Owner Signature of Applicant Laura Shufelt Print Name Print Name 10/4/2019 1 10:32 PM EDT Date ' - The Commonwealth of Massachusetts Department oflndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly NaII1e{Business/Organization/Individual): hfichael McC arthy�c,r��}r..��vu>. �>��• Address: PO Box 52 MA City/State/Zip: �eS� opi Are you an employer?Check the appropriate box: Type of project(required)' I.Q I am a employer with �. employees(full and/or part-time).* 7. 0 New construction 2.❑I am d sole proprietor or partnership and have no employees working forme in 8. Remodeling any capacity.[No workers'comp,insurance required.)• 3.O I am a homeowner doing all work myself.[No workers'comp.insurance required.]t' 9. El Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my properly. I will 10 0 Building addition ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.❑I am.a general contractor end 1 have hired the sub-contractors listed on the attached sheet Th 13.❑Roof repairs nest sub-contractors have employees and have workers'comp.insurance) 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[Other_ Sr 0—k• , 152.§1(4).and we have no employees.(No workers'comp.insurance required.) *Any applicant that checks box#1 must also till 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 e'new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the pbliey and job site Information'. Insurance Company Name: Ak� Qn. �i c�; i 1 i •F 'f f- Tr.c Policy#or Self-ins.Lic.#: �/��`I S�y Expiration Date: 1'.)-I I f'19 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 MGL c.152,§25A is a criminal violation punishable.by•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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and t e ins enaldes of perjury that the information provided above is true and correct Si ature: Date: 11- Phone#: SC,0 air;-G SG c/ Official use only. Do not write in this area,to he completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): } 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer.Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improveme.At'Contractor Registration _3 f Type: Individual Registration: 169393 MICHAEL MCCARTHY _ --.. _. ,,:, Expiration: 06/15/2021 P.O.BOX 52 a WEST DENNIS,MA 02670 S. ... ?n Update Address and Return Card. SCA 1 0 20M-05/17 . . ro ., .... .. ................................. __- ... .-. ....---..._........................ .. ......... ... .. .. .. ✓i�� l�orrrmoieureal�o�'✓�lia�,•12c�.�n/./ ' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Individual before the expiration date. If found return to: Reglsthation Expiration Office of Consumer Affairs and Business Regulation F�69393= - 06/15/2021 1000 Washington Street -Suite 710 - - Boston,MA 02I MICHAEL MC GA 1 FtINI!" j Via`au MICHAEL F.MCCART1 -r ✓ / J 6 RANGLEY LN. ;; SOUTH DENNIS,M4, 2,s6D U ecretary Not valf"ahout signature �«�' '+�• �r•-r' : COM.t.OnWeaith of M0.9 achDivisioh of�ProfessionasLitenS u�e Bo% ` Board of Bulldtng Re ell M0C., Why � �dlati t. Michael, ons and$1811dards: Cons�rr}; visor y CS 3.3 4586 Has enaf iit Alin 1 the amal FIWar' t` C1111811111"e t+ oft QOeee 23 r d11y Of l$ 2Q'11 MICHg1sL J 44e: / .:;. . PO BOX42 WEST O1 NNIS . . 'tillNl4tlitti/etdFabar• .�� "�r'����Ecll�'`' commissloh r 4vlhiltla�,v�a.. OSHA :00.15- �+a�ii,uma Us.Department of tabor 1ti` OOR�!gaiety enO Heallh Admi dstrello'rr t j3. �}yy �Fc��,,�`:r ,•, ',:::i Michao-1 McCarthy ... . .. . .... .: :::. raltiing.Cbut� - - - .`3?�Aomsof�oR$rieiit�8lioolsof •. � .. .. .. . . . !"(Dalai - •�: %'�".::-w..�=►�:w..- �; Application number ...... VFOYRS Fee ( , 0V4M ... .........................r • 8 MUMMA B M HAM : SEP 0 4 2019 Building Inspectors Initials.... ................ t65 C TM0 ' ...............................) 0� bAHNSIMLE Date Issued.:....... ........... Map/Parcel......'? Jo.).. .. ............................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDINGAVINDOWS/DOOPS/TFNTS/STOVFS/WFATHEPIZATION PROPERTY INFORMATION Address of Project: SC \,_). da 1..k/,J NUMBER STREET VILLAGE Owner's Name: s �.3c ) I.- —Phone Number Email Address: Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 1CMR Owner Signature: Date: S/`/ TYPE OF WORK E3 Siding- ED Windows(no header change) k UInsulation/Weatherization ED Doors(no header change)# Commercial Doors require an inspector's review 13 Roof(not applying more than I layer of shingles) Construction Debris will be going to S�- f�4 (a CONTRACTOR'S INFORMATION 6 lvj[,Ke NIcCartifty eanst"fte- 5ii� Contractor's name PO Box 52 West Dennis.) MA 02670 Home Improvement Contractors Registration(if applicable)# Cell (508) 280-696 1 - - -JktWh copy) CSL-58633 HIU-IOYJ�;FJ Construction Supervisor's License# (attach copy) Email of Contractor L 7)Y--,CC d j2 r,-/7 Phone number ALL PROPERTIES THAT HAVE STRUCTLIRES OVER45 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN A HISTORIC'DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No ' (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No____, if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLIC 'S SIGNATURE Signature Date N/ All permit applications re subject to a building official's approval prior to issuance. r 6-4)00 47-4) 06—?-� �,.THE.Tp �C�� ' U��S62� G � Town of Barnstable i BA ABLE, Building Department Services . s F ��`� s Z L ynss:9 B 16 rian Florence,CBO�pA. 39., ,0� , TFO p�p�a' Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Laura Shufelt , as Owner of the subject property hereby authorize C�.YkI- c, to act on my behalf, in all matters relative to work authorized by this building permit application for: 1696 Osterville W Barnstable Road West Barns (Address of Job) Signature of Owner Signature of Applicant Lacyva Sha(e. Print Name Print Name y 1-1 Date 4 + 1 �\ The Commonwealth of Massachusetts ° Department of lndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-20I7 www mass gov/dia I-Vorkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information *,�_/� ` Please PrintLe ibly Name{Business/Organiza6on/Individual): Wchsel �.lcCartljv. �Grt�}r..�Tv�r. Address: TO Bog 52 West MA 02670 City/State/Zip: one : Are you an employer?Check the appropriate box: Type of project(iequired): I.[ilI am a employer with mployees(full and/or part-time).* 7. D New construction 2. am tole proprietor or partnership and have no employees working for me in ❑I al any capacity. ❑Remodeling.[No workers'Comp.insurance required.]. , 3.O lam,a homeowner doin ell work m self. p,' q j 9. ❑Demolition g y [No workers'coin insurance re uirrA t ❑4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.E]I am.a general contractor and I have hired the sub-contractors listed on the attached sheet 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insumnce.f 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. .14. Other_1►'� /�•/+..� 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box a 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 subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing iporkers'compensation insurance for my employees. Below is the policy and fob site Information'. Insurance Company Name:__N,�Ft Li cf,;114, + ) ►,rc V .mot Policy#or Self-ins.Lie.#: 1 V C�`I-4 Sly Expiration Date:_ i 19 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 MGL c.152,§25A is a criminal violation punishable by•a fine up to$1,500.00 and/or one-year jmprisonmdnt,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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and t e ins maldes of perjury that the information provided above is true and correct, Signature: Date: 11-I rf/I F Phone#: CS-0 afro-G SG b Official use only. Do not write in this area,to he completed by city or town offreia[ City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: �i e� ��/iY���?iC(tP�Cl'G��OL��iG����•c�-�(�CG��1�" , L Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement,Contractor Registration Type: Individual Registration: 169393 MICHAEL MCCARTHY Expiration: 06/15/2021 P.O.BOX 52 WEST DENNIS,MA 02670 ,;•;: ' Update Address and Return Card. SCA 1 0 20M-05/17 .. ... ...._..._.... ................ .. ......... Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. If found return to: Reglstiation Expiration Office of Consumer Affairs and Business Regulation 169393_-= 06/15/2021 1000 Washington Street -Suite 710 MICHAEL MC Boston,MA 02119' GAF,tT-HY r_ t+; Z MICHAEL F.MCCART .; /f- l 6 RANGLEYLN. SOUTH DENNIS,MA`0 66D undersecretary v' Not valydr k out signature Gor"'Onyleatth of Massachusetts OivLsioh of I?rofessio.:nal:L)I:ansure Board of Building Reationt.and Stafidards, . Nli�hi�e�f IVtc�ardliy. Cons qul � May C)onstaAreur r irtS; pvl>;or Re mess Has enf fiL4OO Mpllsl�l> N8OMI Fiber k CS-058.63 j; � _ a ip o� �tltrdoae tiietlrina i ;�• _ 1'`f.; (2..:-:.0 , .: : �°dltYofAttgr�EZO'11 - iiAt=1:a PO BOXS2 ' NN4T401NAL FMBR ; .7trltfMrga�tMed - 1rfw.....t,.nr /-A• . . coMro,istioh�r :8 OSHA OR55871 :. :. Us.Department of labor Oowpatior►et.Safety entl Meafth Adm'adstratiort MichaelMcCarthy cx!nyeren.erta.+!ou. wr»r :aitd.►+�nh �"'� . � :�! la��asb�: �: Tdriini 01 + .iq'.., , :Health: ::.•;: ,`c a .07 '- $ flelb eLne r .:9 oxft :,• • - i Town of Barnstable Building vsr�� PostrThis Card`So Th i it is Visible From the Street=Approved Plans Must be Retained on Job and this Card Must be Kept BAR"�"� Posted Until Final Inspection Has Been Made. _ .639., e. Permit Where a Certificate'of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been mad Permit No. B-18-2626 Applicant Name: STEPHEN MATHIAS DBA CENTER LINE INSTALLATIONS Approvals AND REMODELING Structure Date Issued: 08/31/2018 Current Use: Foundation: Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 02/28/2019 _ Sheathing: Residential Map/Lot: 128-018_— _ --- - Zoning District: RF Location: 1696 OST W.BARN.RD,WEST BARNSTABLE Framing: 1 : ,Contractor Name: STEPHEN MATHIAS DBA CENTER Owner on Record: SHUFELT,ERIC W&LAURA F LINE INSTALLATIONS AND 2 - ' — REMODELING Address: 1696 OST-W BARNS RD �' 1 Chimney: WEST BARNSTABLE,MA 02668 Contractor License: 168054 }r ! Insulation: Description: Remove Closet in Kitchen,replace kitchen windows(no Header Est. Proj�ct Cost: $21,000.00 Final: Change) remove existing cabinets and countertops,prep room for � ,. Permit Fee: $ 157.10 new cabinetry Fee Paid: $ 157.10 Plumbing/Gas Project Review Req: _ Date:., 8/31/2018 Rough Plumbing: Final Plumbing: Building Official Rough Gas: i Final Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is com_ _ we n six months after'issuance. Electrical All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws/and codes. Service: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. �� Y � _ _ `� Rough: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Final: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Low Voltage Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Health 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Final: 7.Final Inspection before Occupancy Fire Department Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). �' ►� Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and'this Card Must be Kept �weue. : _ •63P �� Posted Until Final Inspection Has Been Made. Permit +' Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until,a Final Inspection has been made. Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i ' ..... iI Applicatioa Number..:4�, .................. 510 MAMLPermit Fee.................................I ......Other Fee.................:...... tilll�� � .................. .......Total Fee Paid...... ..... .... .... bY..�la..............Oa.. .. .1... (\®.//... TOWN OF BARNSTABLE Permit�� BUILDING PER UT1--U ............Parcel.......... .... APPLICATION Section I — Owner's Information and Project Location IQFM Project Address(�(� ,'CAL(U�� �o4•P U e►� Owners Name y, Owners Legal Address�'� City -tL-*�T"(*-,- State d Zip 07 Owners Cell# T A- G1 q4 26 Zk E-mail L-StW ki�A� co tA 06- CD H Section 2—Use of Structare Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet [ 'Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Al_a�m . Rebuild ❑ Deck Apartment ❑ Sprin&g System C ❑ Addi'on ❑ Retaining wall ❑ Solar z0 r Renovation ❑ Pool ❑ Insulation LMr Other—Specify z o fit Section 4-Work Description -� n�.. �_ .1�V�yK (Z�Ql�1 FOAL NI&AL �04(E1 - c ��..s. .iuv V C>r y � - T act rmdsh!&2192019 I .i Application Number.................................................... Section 5—Detail Cost of Proposed Conshruction 2),dzy Square Footage of Project Age of Structure Dig Safe Number 1.4 IA # Of Bedrooms Existing ?j Total#Of Bedrooms(proposed) C� 110 MPH Wind Zone Compliance Method MA Checklist WFCM Checklist Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ❑ Smoke Detectors` Plumbing ❑ Gas y ❑ Fire Suppression 19 Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water supply ❑- Public Private Sewage Disposal ❑ Municipal �On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility:�5�jA � � I am using a crane ❑ Yes P'go Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No 0� Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard . .t Required Proposed , Side Yard :_ Required' Proposed • . Has this property had relief from the Zoning Board in the past? ❑ Yes R/"'No iastmaata 2/9r2019 Application Number........................................... Section 9—.Construction Supervisor Nameq, Telephone Number Adamdress L.RA — '�Q���CiiX.t%MaeXW�State —zip 4p �o Zir License Number License Type "ek!rYA_ Expiration Date gl,Z1.0 1 �lGj Contractors Email-,tAL_1fi I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation b and Town of Barnstable.Attach a copy of your license. Sigaahne ` Section-10 =Home Improvement Contractor N` Name S 61 Ac5 &QR>)(F, Telephone Number Address City State zip Registration Number �10BQ S+ Expiration Date ) Q> 1 pj I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required y 7 and the wn ofBamstable.Attach a copy of your H.LC... Signature Date 8 Section 11—Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and l- documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date 8 Print Name 5iL�9Q\S MAT0 V j4g Telephone Number E-mail permit to: urzlbdT bS a.Co T-.d...-a-*-A.n tnmm o Section 12—Department Sign-Offs Health Department ® Zoning Board Cif required) ❑ Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ Conservation ❑ - - . , . . s take our laps d Er to the fire wftent or approvab For commercial work;please y p �y fo' �P f Section 13—Owners Authorization as Owner of th - bb*- property hereby authorize W- o V t ac n behalf, in all my matters relative to work authorized by this building permit application`fbi: (Address of j ob) Signature of Owner date Print Name i x t Last wdatrd:2192018 cATO G (�o� v e— ucm TO -�,-� SO o'er D < CD o: io 3 — � 1� C� l ae .3. � aCN 43" 7r Al 5 fD to 34" 571." p1 c n to m ^ (A Vl N a N e•' 1 0S N OAl �•' O 0' 0t 00 O m A CD o UB30a4.12 W N f= c Loll xbn. 00 d380 c j coW N Vl N < y `• dd380 N: L11 Q1 W N o is �:. � NCD ox.cm N 7 BFH421 N. f ° t (A i W � o 10 .0 W T r CDN N r� 'W O 6BBz$ d l C ION N v J N a b ° QAp Z� ° A J oMy Am EO'8L08,8LOM8' . 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BFH42 12 o (D CD t m Oto T O w m n j 3 11 tom O Ip CD C O tp 0 CBHZ c ro N a' � (D p "' w aS0 w cu m 0 o•eiae eLam 4Z ZT9cam -� OEZ4M 10E6zM P. a �' `;ni :#t � _ - _+fin „se mz �3z s fD L3 V7 - O �• y0E1 9£ u ZV „LZ „LZ ri — oiDa• —I O ?J b C7 i Z c fD ; cn rn a > -� 00 O n p N w o- 00 �: I office of Consumer Affairs>i Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE:Individual Registration Expiration 168054 12/08/2018 STEPHEN MATHIAS D/B/A CENTER LINE INSTALLATIONS AND REMODELING STEPHEN MATHIAS �1? CGS 304 STRAWBERRY HILL ROAD CENTERVILLE,MA 02632 Undersecretary Commonwealth of Massachusetts Division of R ofessionai l_icensure Board of Budding Regulalons and Standards Constr#Ctichi'jt pervisor CS-035267 Expires: 08/26/201g i , STEPHEN F MATHIAS 304 STRAWBERRY HILL ROAD CENTERVILLEIMA 02632 � �... Commissioner Cj The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): tU` WAS Address:�9,04 t4ya , 20 City/State/Zip hone#: 15bS,1 .3-1 - p Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with- 4. ❑ I am a general contractor and I �,yKployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. E<emodeling 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.: required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I 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 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 a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi pains a penalties of perjury that the information provided above is true and correct. Sip-nature: Date: Phone# Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation.for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the _ dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the,commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents . Office of Investigations 600 Washington.Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia I I i i Town of Permit OF1HE Tp� f Barnstable * / / Expires 6 in �rQ�i sn e Regulatory Services Fee * EARNSTABL% v� MAsa.1639. Richard V.Scali,Interim Director �m ajF0 MAyA Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRE PER HT"PLZCATION - RESIDENTIAL ONLY I of © I Not Ynild without Red X-Press Imprint Map/parcel Number Q'�J( � Property Address Residential Value of Work$ '0i Minimum fee of$35.00 for work under$6000.00 _V4 Owner's Name&Address Ole 4 U 4 Contractor's Name v � t.0 lXW Telephone Number Home Improvement Contractor License#(if applicable) I "f Email:AV& V�a QC.v -y)C A- ,A-M ERN � Construction Supervisor's License#(if applicable) —1—I I� �/ ur ❑Workman's Compensation Insurance NOV 0 2 2015 ch k one: proprietor I am a sole ro rietor• TOWN OF BARNSTABLE ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Regt;rlst(check box) MR Q� 6 � Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to t0`*/l��'1 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.- Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Own st gn Proper Owner Letter of Permission. A copy a Ho pro en ontractors License&Construction Supervisors License is quir SIGNATURE: Q:\\VPFILES\FORMS\ utiding permit formS\EXPRESS.d e Revised 061313 oF�H�Ta,, : • Town of Barnstable ~` Regulatory Services & Thomas F.Geiler,Director 16 59. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnsta6le.mams Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder' as Owner of the subject property heteby'authotize to act on my behalf, in all matters relative to wotk authorized by this building petnait. 1� � S-� 1-e� c►� �C�rn� (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. x -�-- �-S Signature of Owner ' Signature of Ap lican Print Name Print Name 11 7ib Date f Q:F0RIvMS:01VNERPHRMiSSI0NP00I;S 62012 t Massachusetts-Department of Public Safety 1 Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-099138 ;. :i.� to , •,�,j. JAMES P CURLE, '•, 287 FULLER ROAD Centerville MA 0263211, ✓fir�, �rra`' Expiration 01128/2016 commissioner j C��e�2c�r�»�eo�aenealC�01QAcddcic1beedeZtd Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before'the ex.piration date. If found return to: egistration: :124310 Type: Office of Consumer Affairs and Business Regulation Expiration====`611720;1sT' Individual 10 Park Plaza-Suite 5170 =_ Boston,N A 02116 James Curley James Curley `• �i 287 Fuller Rd_ Centerville, MA 02632 J Undersecretary Tot valid without signa re 37ie Commonwealth ofMassachusetfs Department of ludr sfiial Accidents Of,�'ire of Invatigafions 600 Washhigfort Street Boston,M,4 02111 wmi nasngovldia Workers' CompensationPnsaranceAffidavit:Builders/Contractors/FlectricianslPlumbers Applicant Information Please Print Legibly Name 0Rminessldrganization/InaiNidnaq: Address: 1 . Z. VAA ( 3 City/staWZip: GA'N� ��QZ�01 Phone 4- Are you an employer. eckthe appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I ant a general contractor and I 6. ❑New arnsfxuction /pployees(full andlorpart-time)_* havehiredthe sub-contractors 2. I am a sole proprietor orpartner- wed on the attached sheet y- ❑Remodeling slip and have no employees 2liese sub-contractors have 8. ❑Demolitioa worlring for mein any capacity. employees and have workers' ❑Building addition [No workers' comp.insurance comp.insurance., required] 5. ❑ We area corporation and its ME]Electrical repairs or additions 3.❑ I am.a homemmer doing all worn offiers c have exercised(heir 1L❑Plumbing repairs or additions myself[No workErs'camp. right of eszraptiouper MGL 1 }roof,' c.152,§1(4},and.we have no 2� repairs instrnance required.] employees.[No workers' 13-❑other camp.insurance required.] *Any appUcmt that checksbmr-N must also fallout the section below showing Bich wod-ers'compensation policy infnrmrtion. THomeowners wbo submit this affidavit in&cfffmg they ate doing all nook andthm brie outside conttactotxtims'submit anew affidavit indicating such 1Cantractors that check this box mast attached art additional sheet showing the nsme of the silts-omztirxlnrs and state whether ocnot those mathies hne employees. If the sub-contmctorshwe employees,they nnist piavide their worker'comp.policynumber. I aiti arc employer tliatisproti&Ag irorkm'conipernsatlon insrtrrutc.e f br my enrploye,a. Belois is the policy raid job site iftfofYrralrPtl. Insurance CompanyName: Policy#or Self-ins.Lac.#: Expiration.Date: Job Site Address: City/StatelZip: Attach a copy of the workers'compensation policy declaration page(shoNving the policy number And expiration date). Failure to secure coverage as requiredunder Section.25A of MGL c. 152 can lead io the imposition of-criminal penalties of a fine up to$1.500.00 and/or one yearinTrisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that:a copy of this statement may tie forwarded to the Office of Imtestigations of the DIA for" erage verification. I do Ir a cerli y- der the "t all rallies ofpedury Heat the infornzrdioti pratridad abo a is 4me aiid correct Si fuze ' Date- Ph- e#: O,oWirl use only. Do not irrite in this area,to be conipleted by city or tolvil o,QSciaL City or Town: Peradt/Ucense# IssuingAuthmit-y(circle one): 1.Board of Health 2.Building Department 3.City/I"own Clerk 4.Electrical Inspector S.Plumbing In3ltector 6.other Cant$et Person: Phone 9: 6 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 .0 l0 2 Q8" Checked by/ ate CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 10-27-1998 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 160 Your Home = 152 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 512 30.0 0.0 18 WALLS: Wood Frame, 16" O.C. 847 11.0 3.0 65 GLAZING: Windows or Doors 113 0.400 45 FLOORS: Over Unconditioned Space 512 19.0 24 ------------------------------------------------------------------------------- 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% of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder/Designer Date 2-) r '> TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map g Parcel �/ g Permit# 3 5-r Health Division %,�'�(�T,� /VO ���jj,(�/� f� 9�y _ Date Issued C© �L ` zi� Conservation Divisiori O Fee f/,• Tax Collector , /G��� i �E ':i EwjMST ESE Treasurer • �FTi Y N�J i!tl@�e mm�g oar MM REGULATION'S Project Street Address Village W. Q Ar N 3+ -b I e_ ' Owner 9fr-k'cr I L p v P.w Address S oqm e. Telephone SU$- 14 zv- y 5-7 9 Permit Request �� �,o� % X Sl Eq&i 1y �oc7 wi AA p Z 5 ic:7oor /r3Pcl'roo 2a,4{ %/vor �-d�i ra o►� . Square feet: 1st floor: existing %7Y proposed 2nd floor: existing S Z$' proposed 3S2. Total new 7-3(o Estimated Project Cost sO 000mooning District Flood Plain — Groundwater Overlay Construction Type W o o n Lot Size /, 19 A-c r•r 3 Grandfathered: ❑Yes XNo if yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I/' v rs Historic House: ❑Yes XNo On Old King's Highway: ❑Yes XNo Basement Type: Full 0 Crawl 4WNalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) q 7 1/ Number of Baths: Full: existing I new Half:existing 0 new ,O Number of Bedrooms: existing 3 new O Total Room Count(not including baths): existing -46- new / First Floor Room Count Heat Type and Fuel: ❑Gas )(Oil ❑Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing I New O Existing wood/coal stove: b(Yes ❑ No N� 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 XNo If yes, site plan review# Current Use LCe- ;L-I Proposed Use _ S1qw► r_ BUILDER INFORMATION Name Telephone Number Svc 3�Z "3"1 Co Address SS �ow er ��1� � License# Home Improvement Contractor# �17922-- Worker's Compensation# 5E L-c- tw."26�y ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO P_�(zc� SIGNATURE� C.. Jam— DATE -TA y FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED , MAP/PARCEL.NO. ADDRESS ' VILLAGE OWNER _ DATE OF INSPECTION FOUNDATION FRAME r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT t ASSOCIATION PLAN NO. 0 ,'�"+, - Y A :i�"FPS t�!$ y@�,e Y�t ^•�' 3 H Y 'Y N N V y'-�++•� .��t0.1�O,t�'� .4J� t.._ Q�: 'I �'� - ,ls%S ►- ����p�.o i!.¢fat -QUO }�S¢ . i� �V1 :1 'l e ♦�J��- VV 1 ° 0 1 A B 4 The 'Town of Barnstable ,AM �$ Department Of Sealthh Safety and Environment Services :�. Buz3ding Division :> 367 Main Street;Hyannis MA OZ60I . Croaa Office: 509-7904M •. guddiq CoauuiSr,.- Far 509-790.6Z30 For WTI=use only Permit no. Dan AFMAVIT SOME IIVPROVEMENT'CON•TIiACTOR LAW S11 LE MENTTO PERMIT APPLIGIT'ION MGz• a: 14ZA re4 uwa that the armostraction, alterations, recovatim repair, modernirstion. conversion. improvement. removal. demolition. or construction of as addition to nay pre-e=istkg containing at least ace but not more than fbur dwelling units or to owner occupied buildingeye Structures which ate ad f agent to such resideace or building be done by regist :d contractors. with eernin cs ccptions.along with other requirements. Fjt. / l Type of Work. Cali- Addrrss of work: (o�l� O %1�-e Owner's Name � \L Date of Permit AppllcztJon' l y 123 1 _ I hereby certify that: Registration is not required for the following reason(s): Work ezdoded by law Job under SI.000. .Building not owner-occupied owner pulling owe permit Nosier is her+P �G� O`vN PERMIT OR DEALING WITH ON OWNERS MIUOVENUM WORK Do NOT RAVE CONTRACTORS FOR APPLICABLENPRO G:t O OR GZJARAN'[Y FUND QNDER MGS.24ZA ACCF35 TO TSE dRBI'�T10 SiGYED =ER jrENALT=OF PEP.=Y thereby uppiT fora.Parma the agent of the owner: rGv. o� A6- JAL� Go== lama Bq0nratioa No. 1 Dam OR [hvners Name _�_ The Commonwealth of Massachusetts _= ........ _.. _. _�; Department of Industrial Accidents `>Q Office OffalestigatioNs : , -- ` 600 Washington Street Boston Mass. 02111 Workers' Co m ensation Insurance Affidavit name: location: city RAJ y,5 LL,3 t KAI phone# 50" b 3(;o Z 3Z6� ❑ I am a homeowner performing all work myself. 21 am a sole ro netor and have no one workin in any ca acity VE ❑ I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone#: insura a cn. Rolicv# I tole propriet r, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: companv name• - address: city: phone#: insurance co. ///,%//%/////%%% company name: address: city phone#s ff insurance co. _.. olicv# .....:... ..... 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 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of Oils statement may be forwarded to the OfIIce of Investigations of the DIA for coverage verification. I do hereh rti un t p ns and penalties of perjury that the information provided above is truo and correct Signature Date to Zl _ Print a � h � Phone# Svc ofticial us do not write in this area to be completed by city or town oMcW city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9/95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including'thd 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 section 25 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,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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being 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. City or Towns 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 applicanL Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be redrraed io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. 'S _The Department's address,telephone and fax number: , The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Invesugations 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I I. F HR §wv tt wT •ADD,'-C. � .. war.'�_,"L.. .w.ovco n: o..w wr r•.�, C,J .�iApowl•wwicw F-1DII,J foal ,SOA-771{.r,7q� _ :rt -I I� irL ' ...•, RIb4T 4CL 11 ATI6/,j' �iLALE /F' .. f Ism • � } M•SJ-rJ,Y i � I 91, 4)"Ru\ WALI kl Vyk ' \ �• Rkt1SL I ' i i>Y�c'F kvJ ! ! r w ` OA f+tpt I,'ly t"fit � �.' V .. �t�'11 I I I I F,�•, I Q1 I G I I 4'91 AlU•1 ,t �w • •aPkaA K. � ��d_ISKLKLLi _�umtA. I�.. / I i -- --'-------.- 111 i 1�71 >�•_ i ADD 2ru4E Vkanao- Tr+ tv,y,. 50cG or VENT NEtJ ar,o fao.a, vnr_,c,� �.r t ocF'•�' AS PIIn L tr� 1X8 Ix� RAtt ' _ �_ AtVen� frviTEa�,r3Pou�� i� I x$ DF T FI µ 4HGM Jr I' F'RItQE (J Ixi+_A7oP Ec)7• ]-atxlo AIL -M1)./'LATC' I ' -iI i k - ZXbj F/b O/. .7 V"S7'uof I°r+,+•'n !'! 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I ai 'lY Y"Tnd,, df U&H11 :,/.Lcf' w�::•..1..,j q: y�Givert. oar3 .'iye / P I.j 0 3r' cAp I i I JxY e/L ve. ax Id NOR . )wc P.T.+3ILC CeAWL 5PAcE DUST CA10 I I k•.''< �vt K of ' � I y.p•'H/6H P'TONf. - 1 Flcc�c �'r:�•�rs � I, L. . &ALc o'/G"v8"CouT' • SE Lbw 'GOADS --'------�• — I ID ql I ..-.. L�1rND0a• t}TE RIO,f DCL'.L�C//LUL'L!' • B �7c06 UBL VX •1710A, �/LAAJ • I A L . ref T-16-1998" 16:►18 FR011 ATTY R I CHARD DUE I N TO 3623870 P.01 .6Y LAND COURT PLAN f rI V I �o DRf VEW,4 Y 0 VER �� LOT 7 LOT 7 TO ACCESS , LOT 6 iia`�' a� t�equtr,ra,rr'P.0`+^rmrsaa: . c,., ..;�.. ,r .. �•`1;fS:•�..�t:-...• � „ , .. •. .�i696 IV LOT 6 PECK '3 X52 0' RES.. ZONE' "!7F" This MORTGAGE INSPECTION Manx u� .Plan is Only FLOOD ZONE' "C TM REGISTRY OWNER: _.0 CC_ Y_A,_LWHA F.�..X�kabT__— _ DEED REF; CTE 9-5Vs1_———--BUYER: . EMAUNC — — —_ _ DATE: R%X 7Z,92—— — PLAN REF: . ?' 5 SQL I HE, �Y �ERTIFY TO l,s�2A dL4'ELM .K� ....___ ^ COR ORA?10N ___ _THAT THE BUILDING ►� �`����' g''tsfy, YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS �=?, PAUL SHOVirT AND THAT ITS POSITIQN DOES CONFORMA. CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE � �P $269g 143 ROUTE 149 TOWN OF ' THAT MARSTONS MILLS, MA, 02648 IT DOES,.MZ_ UE WITHIN THE SPECIAL FLOOD HAZARD �,.' n QC� y4, TEL'. 428--0055 AREA AS SHOWN ON THE H,U.D. MAP DATED�l19Zdf__ �px�et .aN5-` FAX 420-�5553 Co �I;litv-Pa 1 270001 00j5 C � ,,� THIS P.,AN NOT MAGE rR0 dam' INSTRIiMTNT nrir- � � .r-n� �i :w Pi_ "--- SITRVEY. NOT TO BE USED FOR 6096 FENCES. ETC. MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 10-27-1998 Bldg. Dept. Use CEILINGS: [ ) 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-11 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic .and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. TOWN OF BARNSTABLE 261i Permit No. -•----�---------19----------- I nunBuilding Inspector Cash .eta 8 OCCUPANCY PERMIT Bond Eric & Laura Shufelt Issued to Address lot #7 1696 Osterville-hest Barnstable Rd., West Barnstable Wiring Inspector Inspection date Plumbing Inspector M ! w �� k Inspection date Gas Inspector -,�' i Inspection date Engineering Department Inspection date n -- Board of Health { j r_"z Inspection date 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. � 19 ;................................ l^{.._._......_. 4 Building Inspector TOWN OF BARNSTABLE -- , Permit No. ._a__,.--__-------_ I . F Building Inspector cash � �w OCCUPANCY PERMIT Bond :r1z L Laura Shufelt Issued to Address log_ - 7 1696 Osterville-West Barnstable Rd., I:est rwro-stable Wiring Inspector / f. Inspection date Plumbing Inspector . - Inspection date f Gas Inspector ,:'� ( Inspection date Engineering Department Inspection date Board of Health .-i�� Inspection date 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. ................................... 19J� Building Inspector FROM TOWN OF BARNSTABLE -�•� BUILDING DEPARTMENT ` . Mr. Francis Lahteine 3$ .MAIN STREET HYANNIS, MA 02WI Zbwn Clerk »�.�.�....p..�.�,��....,..�.. f ..�. �. Phone: 715-1120 !� SUBJECT: FOLD HERE DATE a MESSAGE vabAlary / 1985 {•*aTa hT•t.r s+g�..y e'!w.f YT.rw.f F S � P Work has.been 1efJad under Pernut #26819 (Eric & Laura shufelt`/•V1sw�s+►.tr «O.Sa•yRT.'.rwT ask.6+r•I+ww"�D.'lfdT�R1+1?4. �l.y�Y•B�f'w.1�§�. w�.r�w+,*+y g..+•�.....V'w.s i.ro♦ s1l. Please release Bond. . . �awoox»sr cr w+es�oaoa*ar aff�N s�eae�a�+w�t.ie+9'visT st«sy. r� • SIGNED DATE f REP.LY: SIGNED N87•RMI • RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY PRINTED IN U.S.A ro SENDER:,SNAP OUT.YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. -77 Alsessor's map and lot number ....... .......CA�" IN Sewage Permit number .. ." ........... ... ....... House number ....... ... ........ ....................... TOWN OF OARNSTABLE",, ki ow sUAT BUILDING,; INSPECTOR APPLICATION FOR PERMIT TO ? .1. .P..........`. � 1/........................................................................ ............. TYPE OF CONSTRUCTION ..................klRP..I)..........r pIw.1l :1;t✓{ .b......................................................:....... ........... !J�Y .... ............19.. �` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: LocationhV'.7-1--�'..2.... ..f!��ii�.��.���.......j�.iE;r�rfl!:� �..........��1�...�. ....!�).d.................................................... ProposedUse ........... w rV.. ?....................................................................................................................................... Zoning District ...............dZ.i..................... .k..............................Fire District ....... .%........;�'r..... ..{..:........... Name of Owner �R/C-L .,/-7Uk�'.........29VFA.,(7 .....Address ..............r,.,)>-rvS,/e)- .................................... ............... ............................................. f)�Z�RF-S7....................................Address �.C12,�✓S��j?�C Name of Builder .... .__. ................. .............................................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .........................................Foundation �9'�v.' ..V.l.............................................. .................... .. .............. Exterior .........kA71l ....... ...Roofing ........../K�� t/Ali ................................................. r . Floors .................... r �/ ......................................................Interior .........;1�E�.�.......��.. ............................................. .......L,. Heating rl!`.l'F' -............................Plumbin Fireplace s���IC....................................................Approximate. Cost• Qw .................... .. a..................................s.. Definitive Plan Approved by Planning Board ______________________________19_______. Area ......... .!.. . .......:......... Diagram of Lot and Building with Dimensions Fee ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH .�• �(' Y. w • d5gnrv5 a ry �e 1 Av�4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable egarding the above construction. Name .. .................... Construction Supervisor's License ........... SHUFEL,T, ERIC & LAURA 2�819 Y No Permit for ..l? StorX s Single Family..Dwelling..................... L. .................... Location .....16:96 Osterville-West Barnstable Rd........................ . - West Barnstable Owner ...Eric & Laura Shufelt = l; - Type of Construction ...Frame........................... ,i ....... .............. ................................................ Plot ............................ Lot ................................ August 8; Permit Granted ..:.:........: 19 84 Date'of lnspectior�? � .........:........19 c+ Date Completed a?--•O�...r..., 19 v z •r� U � Od 387.04 L-OT 7 r[ 34Z . 10 t U LOT 6 US t F � i, I � • L oz.gT'io.v: s errA 8 L scp4- - c,o aA"7-e r Z 7 AS part O W t4 I t L.C-. P 3-7157 B . FOP . ER-16 5ALJFF-LT r+I S. P RO P'E 42-r`1' L i C 5 " t r1 J �' ,rNGCEBY GEL'T/F-Y Ti-/R.T T/-IE BC//LD/.v�r ,e./' S.HGaJ%W.t/ O.V 7-A-1/.$ -4 R.1/ /S LOCAgTEO O.L/ T.NE �Gyo�.vL7 r�75 sN©v�/.�/ NECK'oIV AA/D Ti•I R T /T j!•j !°.� : 1i ,.\,�� :t �?'�•�� CO�✓FO�.�f T'O, Ti4/i� .�O.tJI.c/G• �`� `� '_ � sSY: . :.gwis o,- rs/E �-aw.v of BA2�15TA�.E o ,4- >33 Assessors, map and lot number .......42!p@....:I!p L. FTHE Sewage .hermit number ...................... ............... t • ���� wz_�2/z . t Z B9HBSTSDLE, i House number .,...dr....... ........ .... 'o !6 a �° j O 39 �0 • �'0 YPY a' r TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............. ......�?V I.�.n........... ................................................................ TYPE OF' CONSTRUCTION ..................1-✓AR jf,1..... .. 1,/.. L 1✓w.v.............................................................. TO THE INSPECTOR OF BUILDINGS: The undelrsigned hereby applies for a permit according to the following information: Location4U7.�2.... n/S /�A`....... LL_ ...........d ..9................................... ProposedUse ........... ...................................................................... . Zoning District ........................... Fire District ....... ti.r.2.k: �6 ...... `........................... • 1�dfl U�4 • �. �a kSi•�7?tt^ Nameof Owner ..... .........:.. .............�'�:/ll.�'�rL.T.......Address ............. ... . . ... .......................................... Name of Builder .... FP ?,os%.....................................Address ............. � 2 ' ......................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .........Foundation � .�'�� .................... .................................... ............. ...............,..................................... G✓��/ CC l>E r� Exterior ......Roofing Floors i'!!! :... rCo .....................................................Interior ..........� ..........C. .............................................. Heating /�.. �,�1 /.E; .........Plumbing ............/....�f!i/h......... ............................................ .. 1......... Fireplace LIC ........:Approximate. Cost ........ y0...�Uv........................................ ........................................................................ Definitive Plan Approved by Planning Board -----------____---- -----------19_=_____. ` Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH , as N) X a , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform -to all the Rules and Regulations of the Town of Barnstable •egarding the above construction. Namel!.. ............................................ Construction Supervisor's License .: .���.3.. ........... SHUFELT, ERIC & IAURA A-128-18 No ..2619.... Permit for ...1z..Stor................ Single Family...Dwell' ..............:....... ..,. .. ......... Location Lot .7r..... Barnstable Rd. West Barns j ab ................:............ .......................... Owner .Eric & Laura Siiufe .................... Type of Construction ......F`rXna.............:.......:... ................................................................................. Plot ............................ Lot ........................ Permit Granted Au . t ` Date of Inspection .:..................................19 Date Completed 2 1011 79r��- 251;" - 1n 4 V„ „ 21„ 33 8„ 21„ 2„ 21" - 125" 35;" 50,'-" 33}" B fO BFH42.12 BMC24 916 1101116 WB3612.24]OL' R2130 W2 W4230 3 5„ 2 „ 18„ 29 8„ 1 8„ 2 „ 27„ 3„ 23 8„ 8 B - mp — dVNS 3 L- /SQH _ - --- - 1 6 37 6'- - --- � - � � -� � PWF..23KSKSS W2130L W2130R CLOUD45L BWD,B BD18.03 5301 SJS FS6627 �� = — TE 528 4 TEP7 2884 1 BMC24 BDE12.5L 244 60"- 362, 129 PHS920SFSS GG koh N BFHUC12 gFH08R o N r BC CLOUD45L 210" 8. 1€" 40?" —85 0<" 21 1 M >� _a 361224co N co - JVW5301SJSS - 130 0 - 11 "1 WASH.DR I .COMB N WNS0630L \ ER213OR 77 BMC24 - W2130L W2130R 00 QO 1 O O p _ c - -4 r M M -- J •o mi. _ �� [23K.KSI N Q1 - - r�- - — MO'. m - -i - m t'll BD 1 18.04 yP,HS920SFSS HUC 12T855SSJSS FSBB27VH11L W - N N i N = - — 24" 24" 0D0D i �✓ 1491" - 27" 10 23-"�" Laundry Bi-Folod By Others t � � 1 - -43 2„ A Both Panel has a 3/4" Scribe 3111 34 a„For Plumb to Wall Must be cut ��m = 2 pc.Crown Molding A 1 A 1 Crown is CL-10&8 As Needed I�+ Fascia Reverse Base Board Moltli ng M' 01 Fascia applies to the Face of The Upper RailWith Same w Distance T Doors As the Side 4230 O of The Cabinet To TheDoors. Light Rail Molding O N 18 (0 0 9 16 OD B 18 Finished Toe Kick �I Please Quote-. Schufelt Job West Barnstable Level 2 Granite Steel Grey Honed 3/8" Edge Detail BUILDING KEPT. No Back splash Farmers c0 (SINK ON Ink S SITE) t Out AUG M Slidin Range 1 I-OWN OF 13AMSTA3 Template, Fabricate, and Install 0i� rn (D Rough opening For the Cabinet �l 30 1/2"X 84 1/2" M 3. 1 Pantry Cabinet Sits into A Framed Opening (30 1/2"wide X 84 1/2"Tall From Finished floor). The Cabinet Centers In The OUtside Wall Opening. The Cabinet has a Flush Toe Kick To Allow for base board trim. mp ' he a Are Extended o T n Both Sides To -• t � .,,u �-� ' ..,1. The Top Rail Is Extended To Facilitate Mounting - _ For The crown Molding. _ - _--- ----- - The Sides Are Finished � There is A Loose Skin to Finish the Back Of The Cabinet al and 1 Outside Cornier Molds. I R311 UB3084.12 UB3084.12 � o r_ - �24 28„ y# Scaled Drawings: Note:This drawing is an artistic Cape Island Kitchens Designed:6/5/2 = 1' Eric & Laura Shufelt interpretation ofthe general Hyannis Store Printed:8/10/2( Floor Plan & Counter Top Layout is 1/2" 1696 Osterville Road appearance of the design.It is Paul Savage Elevations are 1/4" = 1' not meant to be an exact rendition. Renderings Are Not To Scale West Barnstable, Ma. 02668 psavage726@msn.com