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®� M 152 113 ORA ESSELT 'o% o m o `pFtHE Town of Barnstable % BARNSTABLE. Regulatory Services MASS. ,6z9. O ,0� Building Division pTf MA'S a, 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location S 0 U (OX 1772 �l4-� -Permit Number Owner ' Builder I One notice to remain on job site, one notice on file in Building Department. The follo ing items need correcting: i C C. I t4-C.L lQ�' C- u Lc), x VJ AO o -T"b Ak e�:>r -� i3o T-14 Please call: 508-862-4Mg for re-inspection. Inspected by Date 1 � Wow p`pFTNE Town of Barnstable ennNsrneLe. Regulatory services 9 MASS JA i639. Building Division prED MAC A 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection C7 / r S /� 2��c(O�� Location ��� � Permit Number Owner /31z<G 4 7 Builder '501 't One notice to remain on job site, one notice on file in Building Department. The following items need correcting: Sew 3 15AC4 6N 6 '. � er061.4- � ORJ' /elf C� 24 x e— �t 5 C r dQ C A L G C. - 'S C&I r - r-ot` 6 A-I- 62� 6-Ab '5) (zc-K S+6-e--r Le-b C�-rQ 7o' 16oA �p e 17' ti, r 3 ag l� I If "o Please call: 508-862- &for re-inspection. Inspected by f�/l Gl� Date 0130 (r,> Aai M1 Town of Barnstable BARE. - - Regulatory Services MASS. t639' °� Building Division prEO MP'�A. 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 / Fax: 508-790-6230 ! e Inspection Correction Notice V Type of Inspection P , � Location �4 / /UV&6W (� 4-rf-( �� Permit Number 0 0 lam'0 Z o r •. Owner 3����''� Builder � One notice to remain on job site, one notice on file in.Building Department. . w The following items need correcting: V)az� 110, V,� �$. en SBE f/ ` / v Please call: 508-862-43$.4or re-inspection. Inspected by Date 10-3110 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Jag. Parcel i ,Healthtivisi6n ..-:Date Issued Conservation Division ':Applicati& F e n el Planning'Dept,'— Perm"bit Fee' Date Definitive Plan Approved by Planning Board .P1. Historic - OKH Preservation Hyannis Project Street Address ?0 Rooker Village W:P,4 &"te Owner E Janirtc -Rrt Address 51W U Telephone IS-Ut *0 *3 Permit Request _ 0A10A) 15 JV agnqv 00M U Square feet: 1st floor: existing A9—proposed �60 2nd floor: existing 399 —proposed Lix—Total new /83 Zoning District Flood Plain ZaNe C Groundwater Overlay Project Valuation 0121Vf()*0() Construction Typekq Lot Size Lol Grandfathered: Z11 Yes' Ll No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family Q Multi-Family (# units) Age of Existing Structure WVeq(' Historic House: 0 Yes allo On Old King's Highway: 0 Yes UKo Basement Type: Ll Full Q Crawl eWalkout Q Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) /3-7 Number of Baths: Full: existina. new Half: existing new Number of Bedrooms: 3 existing new Total Room Count (not including baths): existing 5- new —First Floor Roo Count Heat Type and Fuel: 2(Gas Q Oil 0 Electric Q Other C= Central Air: Q Yes 0'/N o Fireplaces: Existing New Existing wood/i5dal stovC-i Ll Y9S U(No Detached garage: U existing U: ew size Pool: U existing LJ new ❑size Barn: Ll ZxKjilting J_Irhew?Fbize Attached garage: LJ existing Zw size Shed: Ll existing Ll new size Other: W :F1, W Zoning Board of Appeal uthorization U Appeal # Recorded Q Commercial Q Yes Appeals o If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f�L—C_l &t V Telephone Number 90 1a-3 Address License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN) t Ds SIGNATURE DATE I FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. " ADDRESS VILLAGE OWNER `DATE OF'INSPECTION: FOUNDATION ? oto? FRAME 08 IV/6109Rkv Firelo(ac,(ts 44 INSULATION Se A602/Wk- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL !� FINAL BUILDING a�� co {/ 7•� co DATE CLOSED OUT" ASSOCIATION PLAN NO; a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations- - 600 Wdshinglon Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information I L Please Print LeLyibly Name(Business/Organization/Individual): jrL r[ 1�T Address: 7DPIONeer City/State/Zip: �K rn/;5kok (j��6 Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1. a employer with 4. I am a general contractor and I 6 New construction mployees (full and/or part-tithe).* have hired the sub-contractors 2. am a sole proprietor or,partner-' listed on the attached sheet. T. 0 Remodeling JI p and have no employees These sub-contractors have g. '0 Demolition rking for me in any capacity. employees and have workers' 9 eBuilding addition o workers'-comp.•insurance comp. insurance.#. We are a corporation and its10.❑Electrical repairs or additions uired.]3. m a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required] t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant.that checks box#1 roust 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. lContractors 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. Iam an employer that is providing workers'compensation insurance for my employees Below is the policy andjob 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 fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirial 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 may be forwarded to the'Office of Investigations of the bIA for insurance coverage verification. I do hereby certify der t pains an penalties ofperjury that the information provided bove is true and correct. Si ature: Date: Phone# 1 Sd9 y�,o Official use.only. Do not write in this area, to be compleled by city or town offcciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 1.Building Department 3. City/Town Clerk 4.Electrical Inspector S.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-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 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 permitllicense 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 hon:ke owner or eitizen is obtaining a license or permit not related in any business or commercial venture (i.e.a dog license of permit to bum Ieaves 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 ar 1-877-MAS.SAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFVICICIENCY FOR ONE, AND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780 CMR 61.00) Applicant Name: '�' ` Site Address: print V Town: �►les�" � Applicant Phone: L Applicant Signature: �jyy � �� Date of Application: d7A NEW CONSTRUCTION: choose ONE of the following two'o tions 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MAXUAUM 'MINIMUM Ceiling or Basement Slab a Option 1: Fenestration exposed Wall Floor Perimeter Wall AFUE HSPF SEE) U-factor floors R-Value R-Value R-Value R Value R-Value and Depth National Appliance•Enrrgy 3 5 R-3 8 R-19 R=19 R-10 R-10, Conse"alioh Act(NAECA)of 4 ft. 1997 as amended,minimums or cater as aDplicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: REScheck Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck--Web which can be accessed at http-//www.energycodes.gov/rnchf,-ck/ ADDZT)i01VS:OR ALT�RAT1"&S.TO EXISTING BwjjlNGS,.O:V' 5 YEARS OLD* *)Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_ a) SF 100 x — _ % of glazing (b) Glazing area equals SF b a If glazing 1.s<-40%.uSe the chart below. • . If gla±ing is > 40 %proce6d to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter Fenestration Wall Floor Basement Wall R-value U-factor Exposed floors R-Value R-value R-Value - R-Value and Depth .39 R-37 a R-13 . R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition.. Note: Owner to fill out Consumer Information Form found in Appendix 120T A WC Gidde to JYood Coilstructi0 ii iii fliah Wi d Areas: J10 niph Wind Zone Massachusetts Checklist fol- Compliance (78o 0\1115301:2.1.0 Check C 'r omp 1.1 SCOPE WindSpeed (3-sec.gust)................................................................... ............................................... 110 mph WindExposure Category.................................................................. ............................................................. Wind Exposure Category................Engineering Required For Entire Project ..................................... .C 1.2 APPLICABILITY I.- stories :5 2 stories Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) 12:12 .. ........................................ ....................... Roof Pitch .................. '.. .............(Fig 2) ............... . .!........(Fig 2)............... ................ ft -,5'33' MeanRoof Height ................................................. .. Building Width,W ............................................................:..(Fig 3)............... .. "AWO-f -ft :5 80, BuildingLength, L ..............................................................(Fig 3).............. ..... "Z .15 3:1 Building Aspect Ratio(L[W) ...............................................(Fig 4)................................................. Nominal Height of Tallest Opening2 .............................:.....(Fig 4)................................................ 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2).................................. ............................. 2.1 FOUNDATION Foundation Walls meeting requkements of 780 CMR 5404.1 .16'3 "8 u '0 ......... Concrete.............................................................................................................................. ConcreteMasonry...................;................................................ ..............................................:................ 2.2 ANCHORAGE TO FOUNDATION'-'. 2S 5/8"Anchor Bolts,imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only BoltSpacing-general ..........................................(Table 4)............................................... _3A in. Bolt Spacin"g from endrJoint of plate.............................(Fig 5)..................:................. it Q in.>ti Bolt Embedment-concrete.........................................(Fig 5)...... ........................................... Bolt Embedment-masonry..........................................(Fig.5)........................................... tjb;�in. .................(5:5 x x PlateWasher................................................................(Fig 5)........................... 3.1 FLOORS Floor-framing member spans checked ...............................(per 780 CMR Chapter 55)..................... I.. ....... Maximum Floor Opening Dimension...................................(Fig 6).................................................. ft:5 12' 1). A(Fin q..' Full Height Wall Studs at Floor Opprilings less than 2 from Exterior Wa.1 ,. . .....................................rm LbAv Mbximum Floor Joist Setbacks ?6114 aring Wails or Shearwall................(Fig 7)......DOES... Supporting Loadbe Maximum Cantilevered Floor Joists . < RAM Supporting Loadbearing Walls.or or Shearwall................(Fig 8)......... ......................T.............. ft -d .B Floorracing at Endwalls............:.......................................(Fig 9)................................... 44,*.....** ,. Floor Sheathing Type ........................................................(per 780 CMR Chapter 55)...&0'. ............ in. Floor Sheathing Thickness ...........................................:.....(per 780 C Chapter Floor Sheathing Fasterflng..................................................(Table 2)..1 d nails at_:)L--in edge field 4.1 WALLS Wall Height ........(Fig 10 and Table 5)................... :5 10, Loadbearing walls..................................... ........... ..... ft 5 20' Non-Loadbearing walls...................................................(Fig 10 and Table 5)....... .......... .1, -o.c. Wall Stud Spacing . .......................... ..........................(Fig 10 and Table 5)...................W in.15 24 WallStory Offsets ........................................................(Figs 7 &8)............................................ ft 15 d 4.2 EXTERIOR-WALLS' Wood Studs 2x q in. Loadbearingwalls........................................................(Table.5)............................... -ff- in. Non-Loadbearing walls ................................................(Table 5).......................... 2x Gable End Wall Bracing FullHeight Endwall Studs............................................(Fig 10)..........:...........,......................01..... ....... WSP.Attic Floor Length..................................................(Fig 11)............................................. ft Z0/3 'Gypsum Ceiling Length(if.WSP not used ....:...............(Fig 11)............................................�'0.9W and 2 x 4 Continuous Lateral Brabe @ 6 ft. o.c. ..(Fig 11)........................................................ or 1 x 3 ceiling furring strips @ 16'spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate .....................................(Fiq 13 and Table 6).................................... ft AH,C Guide to 1•Vood Cousti-tictioir iil H11,Ii IViiid Areas: 110 Inph Wind zone Massachusetts Checklist for Compliance (780 ci)RR5301.2.1.1)' Loadbearing Wall Connections ' Lateral(no.of 16d common nails).......................'.........(Tables 7)..................................................... Non-Load bearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)..............................................I......... Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans ........................... ft�'T ........................................................(Table 9).......• Sill Plate.Spans ........................................................(Table 9).........................:........ ft in.5 1'1 Full Height Studs (no. of studs)....................................(Table 9)....................................................... Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(Table 9).................................. - ft_in. 5 12' Sill Plate Spans.... ..................:....................................(Table 9)...,.............................._ft_in.5 12" e„ Full Height Studs(no. of s�*ds)....................................(Table 9)....................................................... �.. Minimum Nom ring Dim plift and Shear Simultaneously Exterior Wall Sheathjg-to.Resis Height of Tallest Opening2 .............................................................................../j V 6'8" �~ SheathingType..............................................(note 4)...................................................... en}G ✓ Edge Nail Spacing.............................. ( )........... Table 10 or note 4 if less ......................:. q in. Field Nail Spacing........................................... 10)....................... &o in. ........... .......................... Shear Connection(no. of 16d common nails)(Table 10)....................................................... Percent Full-Height Sheathing...................:...(Table 10)..................................................._% 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................... Maximum Building Dimension, L Nominal Height of Tallest Opening2...................................................................1....fps 6'8" SheathingType..............................................(note 4)..................................................... ��. Edge Nail Spacing...................:.....................(Table 11 or note 4 if less)........................ 4 _in. �L ' Field Nail Spacing...........................................(Table 11).......................................................L in. Shear Connection(no.of 16d common nails)(Table 11)........ ............................. ...................._ Percent Full-Height Sheathing......:................(Table 11)............................................:......._% 5%Additional Sheathing for Wall with'Opening> 6'8"(Design Concepts).................... Wall Cladding Ratedfor Wind Speed?.............................................................. ............................................................... 5.1 ROOFS Roof framing member spans checked?........................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19) ............. / ft 5 smaller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(fable 12)............................................U= plf Lateral .............................................(Table 12).......................... .............L= pif Shear...............................................(Table 12)............................................S= plf Ridge Strap Connections; if collar ties not used per page 21... (table 13)...............................T= plf Gable Rake Oudooker..........................................(Figure 20) ............._ft s smaller of 2'or L/2 ' Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14).............................................U= lb. Lateral (no. of 16d common nails)...(Table 14).......................................L= . lb. Roof Sheathing Type..............:.....................................(per 780 CMR Chapters 58 and 59) ............. (n"a ✓ Roof Sheathing Thickness.....................................:..... ............................................. in.z 7/16'WS ✓ Roof Sheathing Fastening ............... able 2 .:....................................................... �iryy v Notes: -- 1. , This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 780 CMR•5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are.not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 26 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 1 Ba and Figure 18b 2. Exception:Opening heights of up to 8 ft. shall be permitted when 5% is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. Town of Barnstable �1HE r, Regulatory Services r ww6rxBLe Thomas F.Geiler,Director Muss. 94,p 03.9. IN Building Division TEn � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 6�X L JOB LOCATION: ',TO Prolve'er PSI V1 �V� {xt`N�f7ie(.� number street village "HOMEOWNER": �i�r0� �hL /S� ��d 9El lsD��C/S 6 eX SS name �j home phone# work phone# CURRENT MAILING ADDRESS: OD Weer ru - C04a 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 'L n procedures and requirements and that he/she will comply with said procedures and requir e Signature of Hommner 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 V Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\homeexempt.DOC Town of Barnstable Regulatory Services. 0s^M ' ; Thomas F.Geiler,Director 0;. 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 Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the . Homeowners License Exemption Form on the reverse side. Q:FORMS DAINERPERMIS S ION 299. 7- ,yv V It I certify that this property is located in Flood Hazard Zone C (out- side .the 500 year flood) ae identified "by the Department of Housing and Urban Development (HUD) . Date CERTI F9 ED PLOT PLAN OFF s •Y �' yyyU Ste^ LOCATION q;e.A-I-s7Aq,&Z E f o� E°�E. y l SCALE ���S6 ' .. . . ... .... DATE . .. . . .. .,. .. .. �. V Re a 2 ry r• PLAN REFERENCE �EC/SiERS '� tn/iLi p�c/ •L5'. :` . . . LL I certify to its title insurance company that there are no .vlSlble encroachments IGERTIFY THAT. THE & -57ivC' Dk/CLL/CtG Pr.., easements except as shown and that this SHOWN ON THIS PLAN IS.LOCATED ON THE GROUND plan 'was. prepared under my immediate AS SHOWN HEREON AND THAT IT CONFORMS TO THE suPervision. SETBACK REQUIREMENTS OF THE TOWN OF : . .WHEN CONSTRUCTED. DATE 9.L ' REGISTERED LAND s1inVFYQ,4 . ul 03 09 11 : 39a Thirwood Place 5087604110 p. l Thirwood Ptacc SEND TO: kk4A[e, FROM: ATTENTION: DATE: 719 Q TIME: FAX NUMBER: .NUMBER OF PAGES: COMMENTS: Vdd tJ 1ere t-) b e n1 s 237 .tiorth Main Street South Yarmouth, MA 02664 61-800-248-5023 (508) 398-8000 a. Fax (508) 760-4110 Visit us at our wehsite. 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DAI t: FIREDEPARTMENT i' DATE BOTH SIGNATURES ARE REQUIRED FOR-PERMITTING • I _: �. � I IMPORTANT-UPGRADE REQUIRED STATE BUILDING CODE REQUIRES THE UPGRADING OF SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. t NOTE: A SEPARAr PERMITIS.REQUIRED FOR THE w DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS_REQUIREMENT. CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE MR WORT7 06 E-6w TNI981*v -ff Sw*Q O6 T wAb.— <,:1 nRG1lITEQV�T�• Cb,vu Wf.c . w 7 n RKFv..tJ TO T,+cW ,owrm_,-j noo:_eo rioa -N.mb__. rn W J d ' I F tk 't 1 • g y� I ,'r y I: I - ' d Q J J J�� Q ✓1 �i �3J cd CP' w � fpfr �i� ytlw - Jar s fa J'i III ° � _.•� :,�. . r ti I I ' I •4 N I a f J _ 0 iTMff�V) - . •°' as -© -�K��--('` ____ --- '�. �`0 8��E� � C •' e,'I � —�-- : .:_r-c u� � j � ' �'�-r'' � so..ervea s.wmar ige-.w� o• i ?o 1� � .15 ZNo'Wl,,.o�rRRk �,' ^• Fib*�� .. }v�'C• HER A was= aim-- - �_Sti�N4>�__ �a,-- ' OI��� I'�M(n SW6PA-L+P�L �v�TJo.Il,olO OYrF•QKa�� n'f QU-V-\.l. .4O So�TS- 500X.h Pi„k fin.-�w2m.3EiRl�LwLtvi tdm byMu sF . .. InTVL4GGTbtfJ I[unlL WtJS owq Ctiuol.si^6 cP WcQ.,tPefiNiu63 nNp w.+nw� N@notes . WcLL9 T Ut `.+laficnro O t+'„N.,..,,,..1'YZw pj•,� ,a�n.L 5 w�iL4) RSL ClOA apt zQ FI23T FLW wnus a G-Sn < swag Bt 2Kc°iS(srouLfi NNt Fa Noe m%iWv (!! pll oTu lP-wnu.b 2K'1 b7,q c7,tx�t�S P(•(,t¢naPal F, AM.-BO"FI '.gtitA:��A.1..A__-_. E STnflO co—kowz ;�F w 1.R L(vf.(,r+ 2..°lkvtL L,nwa 00L OM+,LS a suf4T A8145 --- `1— 7. as +4 . wM e onGu T nr Yeo:,�Yon�m ryl SECTk*J A—A . o' 3"d?a:•euo One 14u Ce Ilbetuw'- pv;r4 wfo liM1.,tv..a. . —- FF a V61 :.ate jfN98� J Cet9ls:.vw�sa,o) O1W SEE wm*3 veq µ�at:MYo� � t .iv . T, MCO io sd.WL4LY �(I��.' .I .Q ice`\ .•^I _ � .�ld�\ I Marcawt WTEs 02.+o LVL 2k%dt,JVPLi.Cbc 5o�1�r0 II/''4r�" ' (tip•2 of 6GRRL� . O AIJ.OIM EC 3b�n 5llctt qt WmK.t P,.+G FY1. St—) . y �p��•N 04 »7 �So�sz uwWis RGclul�im�W..�`sn Cnrr...+b kQlb S\.t CF f..u*VTb ' o� QR.. �SRIKVnr�bTEEL''�t� tY<got:st 9 g RarGa Py Sc.vi 8T - Y."T Bted�c,,,� rp051 Y y Q w� I :. tl I s r CP . a'�� '+ J kk qr o uii, ��� 333 3 hill.g9 y � G9S�v .. ,�1 •c g� FF zg qk; o°•.n.p • 9a •tiff": ..t ro...,.,�w - Nt 4 7 + i I E d r J ' bE I co 9 I� I 1 I I 4, I � I i o� � �' 8�� Il n y f�d 3 '£ 5522 d 9 P � J�j ?i �:ya2 pN r�•� iF I �•C V m 8 + I•I�I� �• I �I r --' �' �� M I I��y C.• I i ' I I b f 4L b 1 + �• V ^ 1 •li + TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 'ON o03 Permit# Health Division Z -�3 'a'�7t$ v3N OF SARfS fRBLE Date Issued `/ Conservation Division Z 2003 APR 28 AN •g: 32 Application Fee Tax Collector Permit Fee 6D Treasurer DIV SION Planning Dept. �NSTa:IED IN SEPTIC SYSTE COMPLIANCE SE MPLIIANCE Date Definitive Plan Approved by Planning Board YM TITLES QW Historic-OKH Preservation/Hyannis E TO NMENTAL CODE AND - N REGU p 7,of ; Project Street Address 7 r Village Owner Address Telephone r Permit Request f 51 Square feet: 1 st floor: existing GNU proposed i&O 2nd floor: existing proposed' Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size 7 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure /` Historic House: El 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 9` new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: !,KGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 6& 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 BUILDER INFORMATION Name E%✓� c. ,; , Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i FOR OFFICIAL USE ONLY b PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ;1 FOUNDATION FRAME INSULATION �: 1 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH r FINAL GAS: ROUGH;� FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. - k J r ' . The Commonwealth of Massachusetts Department of Industrial Accidents office offnyesti9atioes W—ve 600 Washington Street ' Boston, Mass. 02111 Workers' Compensation.Insurance Affidavit $ -EMMATO1. name: I-�✓"t G ,� ., location: ci phone" I am a homeowner performing all work myself. �" am a sole proprietor and have no one working in any capacity [] I am an employer providing workers' compensation for my employees working on this job "- 'ny7at s -4-r �' ��t'is1F{' ., q -t .i� �r3y-V '+ �. •r+47"' sty. ,, .za ,'. ,•rq� ..! !eC a. a t{yKi��, ` ±•' �i a ,� �? 3 ''�"k'g•.!yru �' --'�SSi-}rT.]h'�•rr�r. 1 rrt "-r Y e 4,j n* M Y- ��(s �1�� ..�'�� ...J•'7:'•� -K� <i3..crs '3 `:f� i a.- ,S( a..fi tt•; t ,r u caw .s�Y �a ) i• r s`t `J-r"st t^ r o- •s.Y r,r, rey+...$•,- -.. ra �auFn.a...•.rt ry ><,e •i` C w, '+r+ "t'..YI y-r,�r ,�t ,� testy ` t„1.+Cit�4A tVlx tp,tJY�•ri 't ?�-rt' JPw r.Sll re �i1•-�j (' ;'`"c a - i N. L•t�-Y'r ,Y9fyy tr r.3ylr^d"'�s+'1M�' 7si "'3 + 1.' Ali- }u. 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'r.-'�K- �'x,ti�,i�� ,y. �,� 3s?x tYy �:-a.��fyy,'K��3 f�: ✓ t;y�c{ Stet}s t'*-�a` `�a� a yf•`•d,� �lnsurance co��r. aK-'4`fi"bid jr �,C`t •�•+ fr li+�H+ , r P Y• ''Y t f +,hu.r �+ia..3.e _1,�ti1�;_ v� M jy I am a sole proprietor,general contractor omeowner ircle one) and have hired the contractors listed below who have the following workers' compensation polices: T ' _r-n.c�; '�°,v�" 1%5�'A+ C•��7z mn•• ,y u Frµ I at!-,�y�i -YPq'Wrr 4 -. n sr K •tt rNyr„'rr,t'F 1 r w 11.x'?,°t-33� 4 +r- nYi. 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F` J�. i...p � s�__..}} /J.�.�1 +�4y .•1• �.ELF � .�'..a' �!"'Y I: • l�"' - � t .Ft'a"trt r .t`�i i tw4"e' �. } ''gt:'�'' l a' `x �N;"�'tF.. � v „ a^ tT - °'L•--'a`i--rT'Y s c 6.7R-lt' .�"�'} it' d a" s�s'n .sr '.,.d',t t+t rfr tis"t 3. .t t✓ a .t? ,l:f x`G''S f- �'�3y`�'r' .-"�" t }' y':ai-E ., .t±.y'T" yy 3"r''� s rr .. p9 4' r t s• i ih t�. !j3# `'ryr.c 't 'l�i?`KF.r r' t ..r•- 3z6 ,s1 ]'Y•-.,y� Y.:y. 2'rka t fFr' -L4 d <S �, t � ,r k'�' rr,,�/((;;.n r- 'e':rt,,fi�tt -s r �-s" �- '' ��yn,, x t ` " .L "$ai r s'. b r tt Fy-.i71 L"4 YF>•'�T!'.j i N c , i� d�c �r Lri- , ` 4 .qa �1Y"'b-`t�•T,,y r��t a �Y,'1ty..•rlt+ti.r r r rf i-+ a� 5-a. ,2. 7 -� r h 077 e< S-.YS.u- .( .. -. C� � e.rti Yr`� .'7k'•�,.W xb.Cr'l�w�. Tt7'�� t y� L.'t ,.r R:.msrr r��'�f-r s.:�:i•a.-c. t�tsr :a� rz'P Y�g�.. .xi. � . �ra f d:k� }.-a�ky '� r :S' ?��(s w$y. . A �Fs rvr'y�r��'L,�v�'�i`e!° 3 .a t! cYt�`CrYr�'4.t��'sr�('atS��a"51!.��"'dLp.3rt . '�.ci. �;1r.} rr�'. .t5c,.�i- i•y,: �'xt='ir, ��"�' �.t 3•�" i�tr' ,j,to r.r� ,",r i ..t i'-..1 rr'��'A�;I.f,�,rf k�t"�e *}�tiyy �,r'�".t'�•+.jtt,( !i�y�., j;<w�,y f�+ 2.' "ta7kr.-1d-'kj7yn,�t�1;'G ss t} ,.,, at. '�'t'-1'++.'�r��ti •r 'w!{ � e •�� 's� s t t�s �'h � �`-�OlI4Y#? ,h:r C rr*t a rst.- f1!._ 4�;�`4..,ea, kin., i 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 years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify., der the pa' and penalties of perjury that the information provided above is true and correct Date 41-a7 3 Signature G Print name ilC fV Phone# �dO e iz') 3 official use only do not write in this area to be completed by city or town official city or town: permitflicense# FIBuilding Department [)Licensing Board []check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; rl0ther (rovised 9/95 PIA) f 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 of 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 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. i 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. IEEE I I! 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 applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to 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. Jog 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 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 r ,1 �oF�HE, y Town of Barnstable Regulatory Services ' eaarrsT"LZ ' Thomas F.Geiler,Director MASS 9`�pr16119;.ta`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. � � • 1-4 Type.of Work: Estimated Cost 6�)e;ld Address of Work: A0)lj?i? Owner's Name: Pr1i ` Date of Application: " 7 I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑lob 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 MIPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name The Town of Barnstable .Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:�" �C-3 JOB LOCATION: /1 v f"O oZet-✓�I�I'S number n street �i village "HOMEOWNER': F,ri' (�/r - ��G' 7,7 name hh�ome phone# -work phone# CURRENT MAILING ADDRESS:_ city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellin_s 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 proced s a4nd re q ' meats. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. I e L o 4 , 232tS•� 90 ; a ,19 00) � QP� 1 MT1AL ISSUE G I THIS PLAN IS NEITHER INTENDED Na DATE I DCSCWT" By FOR, NOR SHALL IT 6E USED FOR AS-BUILT FOUNDATION PLAN-LOT / MORTGAGE LOAN PURPOSES. onrPE.e P.�rr1 1-0,OF M4`� Ti,�E E61/BR iE,e Gci2 P SCALE. "a 1, CERTIFY E FO ND T10N PAUL A. {,. 0 SHOWN 0 N CATED LEVY ON THE G UND A DI TED. No. �o�i� ,� .. IBR, >QDI�GB � TAGt�t LS�OAIIFS lI1G DATE REGISTERED LAND SU YOR Sup,%rs °01� �'� ""�' Lo i sea Tyr Wuat &TRW cI TINT= Mu emu T� sl-a►/ (3oIt /04, 4-x wx r2 ra S� ppo., 4- a �pov 1Cv�WI p 3�y " p1 y wanD Deck C Oyu 4/x g wags -Koo*F Z C DX (o dv lZ cox I ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .Map 236- Parcel Permit# Health Division Date Issued Conservation DivisionJ Fee Tax Collector J . Treasurer. _ (? �.� �a31a �laraaia�a�_ s anning oa , klis#e�is---9�H Preservatirn�#yarmis-- � ' Project Street Address -0 Village We.S{� &Y-6--sl4k • ' T Owner Address Telephone -1010 Permit Request 41`` ec do ws lev ao X �IX 2E) A 57 Square feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 5006',00 Zoning District Flood Plain /Vy Groundwater Overlay Construction Type Lot Size f eeT Grandfathered: ❑Yes O 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 O'No Basement Type: th Full O Crawl UWalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 FY Number of Baths: Full: existing a` new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count 3 Heat Type and Fuel: Oas ❑Oil O Electric ❑Other Central Air: ❑Yes Z<o Fireplaces: Existing New Existing wood/coal stove: ❑Yes &IVo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing O new size , Shed:❑existing O new size Other: I r Zoning Board of Appeals Authorization ❑ Appeal# Recorded O Commercial ❑Yes O No If yes,site plan review# - Current Use IV cCwdf,oya Proposed Use BUILDER INFORMATION Name 1 e��. r' 1p - Telephone Number 30' 6 1 b Address ay ibar vac o f�cl License# C S O 2-�S Z 1 yH►'�i��1 � f�j�SS, D2-67S Home Improvement Contractor# Worker's Compensation# Wb ria Iewt ftovee' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOil(s b �P 7�rlJ SIGNATURE DATE r FOR OFFICIAL USE ONLY PERMIT NO. � U _ DATE ISSUED MAP/PARCEL NO. - - ADDRESS _ VILLAGE OWNER DATE OF INSPECT IT, . FOUNDATIONFCj � � FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ` PLUMBING: ROUGH FINAL - GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ` w -Z).fir. t;o C L, // -(34,( a Assessor's offioe (1st'•floor):; (�-i) y— Lo J ;�� Of THE>o r ��.r<I '�'- `o Assessor's map and lot number ........... ..... ........:.......... d Board of Health (3rd floor): ,¢ Sewage Permit number ....�1.............',/'17,....�Y Z IALM4DLE, i Engineering Department (3rd floor): - vo MU IL House number ................... 1639- ......................................�.... �pYpYd�e APPLICATIONS PROCESSED 8:30-9:30 A.M. and, 1:00•2:00"P.M. only' TOWN OF BARNSTABLE 4' E n BUILDING INSPECTOR '�� 1eI► -Z7-000 � �.L�G APPLICATION FOR PERMIT TO Caws r��ue � �w E TYPE OF CONSTRUCTION ....... s�G C C. ' ,4 M i. y L✓ o J � _l.�l.......19 _ ..... r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: `�l •.`J If U..jC--(-K �/ /i• I.J. h/7K/S?p C C� Location .........................................................y..........11................................... ......................................................................... i Proposed Use ...........SI NG C `�/V-1-'E �/ ................................................................................................................................................................. ZoningDistrict ........................................................................Fire District ......................................... Name of Owner"'- .(,e F F,+(�r� ,rF%t Cvv �. 5 id � F rf ,r V k r ( C ................. .....................f.................Address ..........................................:......................................... Nameof Builder ....................................................................Address .................................................................................... Name of Architect // :....' 4A..........................................Address ..............A,/................................................................ � , Number of Rooms. ..................................................................Foundation ......J�w(z.F.:?...........C U le C C ..................................... Exterior r 41s.�................................................ Roofing J�nc i Floors .. .ff..et % /v ', y L Interior Sir ................................................... ,, �/ 5 Heating ....... c.:off........ .../...................................................Plumbing .................... ..................................................::.... Fireplace ., .�� pp .... ,.• ,,,,,,..........................................................'"Approximate Cost .......... �� ..................................... .....A Definitive Plan Approved by Planning Board ____________� -------19 7_ . Area ......-71 .......................... / ) J Diagram of Lot and Building with Dimensions Fee � .. ! "`r ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS .. .... I herebyagree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above 9 9 g g o e construction. � Name ........Al............:.............v...................................... Construction Supervisor's License ....C."� .?.)..... 6REENBRIER CORP. A=128-.004 .WOO No ..3.3.35.2... Permit for Ji... U.............. Single Famil D ell ' 9............. ..............9........ Location ...Lq:I; Path P i o n e e r.... . ........................... West Barnstable ............................................................................... Owner ..Greenbrier„C.6rp........................ Type of Construction ..Frame.,.,..,.,,................. .. .. ............................................................................... Plot ............................ Lot ................................ - Permit Gron November, led .........t..................... 13 19 89 Date of Inspection ................... ................19 Date Completed ......................................19 541i� 299•oc, u A/ZA i llela E ZO 7- I certify that this property is located in Flood Hazard Zone C (out- side the 500 year flood) as identified .by the Department of Housing and Urban Development (HUD) . Date sir. CERTI FI ED PLOT PLAN H G' Q • �A�` gsf9 LOCATION EA . E. SCALE . . ��. b DATE SlrTi4/y99 y. . Re a 2 v r PLAN REFERENCE-. o'nes 9FCI ST ER �S So lnr�i d�/ /�:�.f� � •. . . ' i L�ac�� I certify to its title insurance company that there are no visible encroachments I CERTIFY THAT THE DWG-LG/CtG or. easements except as shown and that this • • SHOWN ON THIS PLAN IS.LOCATED ON THE GROUND plan, was prepared under my immediate AS SHOWN HEREON AND THAT IT CONFORMS TO THE supervision. SETBACK REQUIREMENTS OF THE TOWN OF .9�1,t�.S7i�JLr3Llti•• . . . .WHEN CONSTRUCTED. GATE .. . . . . . ./�1� s •" � 11 REGISTERED LAND SURVEY R _..-..�F r.._..S+a4Y ......... _ ......_£r�C i E I I i r 11Fll�Iwr F_ 6 _ .ems f3o l-fs MmT Hah�e✓S fLy . zxPT . t ► i PT r l ti. z X _ R a 1/a s4v 1r.S. . PT i t -� 1. i � �.. _ �'.• � T —_ — The Commonwealth of Massachusetts • :-= Department of Industrial Accidents :F. — OtBce of/�estigatloos _ 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name rl-, . rL " k _location ;To 60-'Aleel- Pa-►" ' city W QS 6191, g /P vhone# ff I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worlds in anv ca adty % %%%%/%%///%%%%%%%��%%/%/G%%/%/%//%///////%%%///%%/%%%%��%/%%%%%////%/%%/%/%/%%%////%%%%%%%�%%/�%%%%/O%%/%%%%%/%/%%%%%/ I am an employerroviding workers' compensation for my employees working on this job.::: ::::::-:;:::::::::::::...... :::;::>;;::::::::::<:;;: ;:1.:> e.:.;::::: vn name— ....cow an _. ..... ad are l l ::.:::.:..:::: p On :.....,.:::::::.:::::::::::.:::::.::.:: 0 licv insurance-co. ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: m an v-nam ad dre s ..................:::::��...,.;.. ..... ... .......... ........ ......nW:::::ww......... `> on D h tV` ..:::::::::................. z::>:::: 011 R lnsui•attce .,. ........ .................................. .............. c anv n awe:>::;:::>:<:»>:•:•;:;<:;•:<:;:.>;:;:;•::;:;:;;::«;.;:.:;:..:..;.::::.;:•::...:.. address: ee :::: ..... .............::::::: ct tP inaranc 0 Faiinre to secure coverage as required wider Seetton ISA of MGL 152 cars lead to the imposition of crhninai penalties of a flee ap to S1,500.00 and/or one y�,�imprisonment as weII as dvil penalties in the foam of a STOP WORK ORDER and a tine of 5100.00 a day against me. I�derstand that a wpy of this statement may be torearded to the Ofllce of Investigations of the DIA for coverage veriScatton. I do hereby certify the . and penalties of perjury that the information provided above is Mw and correct signature Date 6 -3 Print name Phone# official use only do not write in this area to be completed by city or town official 4 city or town — permMcense# Ednpartment wl /Q checkif Immediate response V required Office rtment contact person: phone#; — (mewed 9/95 PJA) e Town. of Barnstable �FfHE Department of Health Safety and Environmental Services ' Building Division S'^Bi'E' ' 367 Main Street,Hyannis MA 02601 Mass. y i639. `0g' �prEt)MAC& ' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION �1 Please Print DATE: JOB LOCATION: number j �stieet Gvillage "HOMEOWNER": !�/�cC � ,�L lam" —���� Z/D - -6 name Vhome phone# work phone# CURRENT MAILING ADDRESS: /1 �� & 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 proced equirem nts. Signature of Homeo 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 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN IME The Town of Barnstable r + + RARNSfABLE. ' XAS& �0� Department of Health Safety and Environmental Services 039. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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 I such residence or building be done by registered contractors,with certain exceptions;along with other requirements. Type of Work: Deb- Estimated Cost ,A0dd� Address of Work: xy &Iefc kleo �R1��✓>l '(P Owner's Name: r C, Date of Application: y d 3 J "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: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav r• ri �� � r ..9�.�..: �n .. y.. ,.-�-rr"'"r r�.:r.r,. ..:h -.' �.�-►+�-r:�•�.a.;r-7t'-�.. .,.� �� .��.. ._ .. ...,.. ., _ � TOWN OF BARNSTABLE Permit No. .3 52 • ice BUILDING DEPARTMENT { :: I TOWN OFFICE BUILDING Cash ............. ,6,j HYANNIS,MASS.02601 Bond .....x. N CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot #1 , 105 Pioneer Path West Barnstablke, Mass. 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. December 21! 89 ............... .... 19........ .................... ................. Building Inspector I y. v•,wy,ri,•-'"jf"�r1�{ �.,`����.. �` •. ,. ,: ..�, � -. +�. ':_i•' rl Fir .v.v�-'�!•�•J.i}'...�r(Wk+r-�•..�e. +.. r• I ;fy'7..aiw t rt�f�,- I3Y'fi vsry'Y�Z°'r.•.. s�� .�'�'ir ��•.° °�.w TOWN OF BARNSTABLE BUILDING DEPARTMENT _ D°8°0TAIM ' TOWN OFFICE BUILDING � rua . °b�'639•M`� HYANNIS, MASS. 02601 oNO MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit $k. _...... . ..................................................................................._......_.......... _.. _. issued to _ . _.%Y� ...... ......... _..M..._ ... __._......_.�_.___ Please release the performance bond. '.TOWN OF•BARNSTABLE, MASSACHUSETTS . 1 L D I N G P EI i�lhi A4128-004.00.• NOvember 13 . 89 ® 33352.. DATE 19 PERMIT NO.- APPLICANT Owner ADDRESS 9 • 1 IN0.1 (STREET) (CONTR'S LICENSE) PERMIT TO Build dwelling ( 1} ) STORY Single filamily dwelling NUMBERNG UNITS j ' (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) lot ail. 105 Pioneer Path, West Barnstable ZONING RP . . • (NO.) (STREET) • • DISTRICT BETWEEN AND ' (CROSS STREET) (CROSS STREET) SUBDIVISION LOT BLOCK g ZE ♦ y BUILDING IS TO BE -FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN'CONSTRUCTI( TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION .(TYPE) REMARKS: Sewage #89.516 BOND •-AREA OR 768 sq. ft. 45 VOLUME 45,000 FEE. 61.50 ESTIMATED COST .$1 (CUBIC/SQUARE FEET) owNER, Greenbrier Corp. T. . box Centerville, BUILDING DEPT.7. ) 1 ADDRESS BY OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. uvc� rvv l trtC FTh Y'C1- `p �O? STh-o! MINIMUM of THREE CALL WHERE APPLICABLE SEPARATE APPROVED PLANS MUST BE RETAINED ON JOB AND THIS INSPECTIONS REQUIRED FOR MADE. WHERE A CERTIFICATE OF OCCUPANCY PERMITS ARE REQUIRED FOR + ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN I. FOUNDATIONS OR FOOTINGS. ELECTRICAL, PLUMBING AND IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION TI TO LATHE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY, POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS y ' � 0 OG 40, 105(cilw /•vo I 2 Z 2 1 X 3 HEATING INSPECTION APPROVALS / EN INE R G EPA TMENT 1 a ao OTHER ` J XI(/Q�/ -/Q Ll(Z• BOARD OF HEALTH --�� WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. ARRANGED FOR BY.TELEPHONE OR WRITT NOTIFICATION. I , 1 . : . ;: Lor l �9 L.or � 4�, 23Z t s•� 9. 0 ` i N o V ISSUE THIS PLAN IS NEITHER INTENDED � I"'� N0. DATE DESCRPl10N BY FOR, NOR SHALL IT BE USED FOR AS—BUILT FOUNDATION PLAN—LOT / MORTGAGE LOAN PURPOSES. F/OVFE,e Parr/ 3 A a A/S 7"�fB L E.) KA SS. N or-M 7,�L- �TeEEa/BR iE2 Go,Z P ( CERTIFY E FOU D T10N �h° PAUL A. r 0 9 SHOWN 0 AN L CATED LEVY ON THE GR ND 'AS IC TED. " No, IGG37NEW 1p 3 S_T1 ,`� (BST, EIZ=$ Trm 1111 III'1�.5 K , DATE REGISTERED LAND SU YOR Now 8� us SEM U9 vm punt mw czwrmtfnis iu otsar I I I ___ _ ___ I I L—_—t _ - . - - sue-' w+-�...�•1.��:.� - i It— e-so 4,1-- jcs 9' G'•�r Lip C',d 0�1e� •�tD' 1 8 a-r a w c 1 •si. o.+•N`r r 1 I � , _ 1 t � �MFEFrb��r°� �.nir:e GcrtP- u+t',uu'/ L 1 I - gyp :CM Ftif' _ hss�d1G�OC� ..—J At I t )u.✓ ��4'Ymt'tt�:�-�CTYft� I iG '(-�F'�� .:,�11 h�a-�-•...__ I . 2•w G IG'a�• _tii swan.. I I I-3 tZ'e� tL o' 1 1 I Ir isr ccwpait Ib'S.fi"!o•+r u+�.��i- I 1 V--F.P.G furs.FD t i APPROVE CHANGES - WN OF BARN ABLE w w+E3'L•Y'r0 pV.�ay7 orl .ay.a® ilding Inspection Department a ` �. Z 3 �• i 4 •i; 94-e • I 9!./ r�e!� • Q Q. Q ° i a N• °, tt=to' t if It 1 spvw/E F•.T 7444r_NioN 7 Gf'z31�ti'/• r.R'„i•w.o rPcr/,/J * 17Ai.a! HILAAl .yy j pKrv�alL tz°�[►'cv+- .,:a .,�.y-.. .>•ira�f a 'ry ' 1�•aG�r• L-Wt'a7/GilO�/1 y. •1 u c see• ALA- 1 � MrSV►J ►4�6` 9K•r_q'�5 .j < .'_• o.�a �i-HiG'� •cw`° IKJIMI►11t� �/J`.L i�r.r. [./�'L/f^I-•r-aG iIK r� ,r,.uµt Mk.A '^"" - i ,r Z4'f32' 2 B�i�-C.iPE/� ITt1f� 3 few r� O 0 i w'e frZ b .:' 161ra�' � cry iit{g. ��i��-.� '3 F,�►vl:)- . r It Assessor's offioe (1st floor):' a, Assessor's map_and lot number - '. ',)'. v �.^�Q M MD E TO ` Board of Health .(3rd floor):W _� INSTALLED IN C®V� Sewage Permit number :.........:...............................�. . .!� "TH TITLE Engineering Department (3rd floo ANMENTAL Cam' +o' '.'Mb House number • /�. „�, ��sN �a //��� aka ?to Y'6�e • 'G�LyL.t YA APPLICATIONS PROCESSED 8:30,.'9:30-A.M. and 1:00-2:00 P.M. only, TOWN OF BARNSTABLE e/ BUILDING INSPECTOR CdAl6 TR.UC i i�W-f--'c LI;j APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION ....:. �s C�/ W.O.O.132� qq .............................. ...... .1.�.......,9...0... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according // to they following information: L..r . ...v[E/L. //'!1/ W. /»�ZniS:/ C ................................................. Location ................................. ........................ .. .....�............................................................... Proposed Use ............Sy.^�G C E M S / .................. .............. ............ .......................................................................................... Zoning District ......1�Q F1...............:...................................Fire District .......... ....'.................................................... G,zEE,.��rt.lEa Coz p,d 3dX S/0 ` E'.rf- vS(f C Nameof Owner ................................................... ..............Address .................................................................................... P Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ............... !�................................:.........Address ..............A//A............................................................ Number of Rooms ..............................................:...................Foundation ......% CuNCiZeT( Exterior ..........C ......L s. / .�'/ SN1 r/Ci ec'S ,o S p/✓/?- i ... .. / .... ..................,...........................Roofing f••............................................................ C� � �i �y�H ..................................Interior 5N E14 I to 0C 1C Floors .....................�......... .............r. �wR /'7 S - Heating ................Plumbing ...:................ . Fireplace ......... .............................................................Approximate Cost ..........4 .v !..................................... Definitive Plan Approved by Planning Board ------------6!�"2_ Q . sDiagram of Lot and Building with Dimensions f Fee ........ ...............................!...Z SUBJECT TO APPROVAL OF BOARD OF HEALTH Llf OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License ....06...131 .�.)..... GREENBRIER CORP. ',, No Permit for ......1 ....S t.o.r y......... .. .... .. .. Single Family Dwellin(j......... ............................... .. . Location Jjq:�... 4=W Pioneer Path ....... ................................... West Barnstable ...................................I........................................... Owner ....Greenbrier Genbrier..Corp.,....................r.....e................. ........ Type of Construction ....Frame ........................... ....... ........................................................................... Plot .............................. Lot ........ .................... Permit'Granted ......November .........................13 ..19 89 -Date of, Inspection ....................................19 Date Completed ... 1-29.....19