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HomeMy WebLinkAbout0107 RED OAK LANE 4 �I. i (59voopd NO. 152 1/3 ORA �l YeAlIL- f i r1 4 r � Town of Barnstable *Permit# " Regulatory Services fee 6 months from issue date • ' ASS, � Richard V.Scali,Director 1639• ♦ w� o. ✓✓✓ Building Division , Paul Roma,Building Commissie er 200 Main Street,Hyannis,MA d 6 /1 AU� 31 1%49� www.town.bamstable.ma.us ?��1 Office: 508-862-4038 4A Ra�T� 08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL Not Valid without Red X-Press Imprint Map/parcel Number Property Address &II AQ� e�&bo4w 'Residential ' Value of Work$ Q®• �o Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address rz -&- -h__ .- 6/_ Contractor's Nam Telephone Numb& tmy 0:NWI % � Home Improvement Contractor License#(if applicable) Ein ait �� ��Or�(� L��r�Q - Construction Supervisor's License#(if applicable) KWorkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name f��ll fJ/� Workman's Comp.Policy#le'W(/� Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to , ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: •Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. i .SIGNATURE: QAWPFILESTORMSUilding permit formslEXPRESS.doc 01/2:5/17 27ze CommompeaM of Afamga rnsdt s Depasbrraut a kfrudirslrialAc cideWs Orke of1m?�sagatia m 600`Wash&gt=}street Boston,CIA 02111 Mov.Masstigm1dia Worlmrs' Cmffipens-,ftmaInmu=ce Affidavit Buflde7icCmtracwrslmwt lcianslFl=bers AypHcmit.Thfmmiaim Please Print Name onfla�vidual} Aridt;es. Z u a n employer?Beck appro � ' e ban ' Type of project(recl�edy- IRM ❑ I am a general confrsctor and I ❑ employes(e andfor lime;).* lydve lured the sob-contractors fi New oonsizuc£ion 2.❑ I am a sole prupridwr orpartuer- Tiered onthe attached sheet. 7 ElRemodehnrg strip and have no employees Theme factors ha7e 8-,❑Demolsfioa 1 ave wadcers' worlworkingfvrrr�in aany ��andh9. ❑B,uildmg ad3ifior! LNQ warmers' comp.issmamce Comp.ks: raneel - • 5. ❑ We are a toxporafiau and its M❑Electrical repairs or add lions officers have exercised du!ir 3_❑ I am.a bomea�dniug all work I Plumbingrepaiss or aeons• . rmysem No waiiam' _ might of a =pfibn per ESQ. afr inv==ereclukedjy c.15Z §1Mandwe have moo q)aixS employees-(No votes' d er comp_mmmace required.] Bay apg&��stcheftboa fl mad alsn ffioartthz sectroabdmvs @ie¢�vn3sess'«p�sstiaapoluyiafnrma6ca 1311: s trLo submit dds of ix c they axe iag s1f�raa3c aid tfiea Lae o-�side caalmctorsamst submit a new s�da�t uxdi sa di reax=cCoa•&u.2AWjiLFsboamotetaftr-ly addifimsl shad slioudng the nameoflLe endstatewhegmor met ftseea itiesbav employees.If thesnbtaxetradvxshave empIoyes,dhepmns*pm-aleftir wars ess'comp.pokey amxnbm I am ari elrtplaysr Butt is prouidrixg n�rkets'cottrpertsrdtart�sriraaca for�eiRpTvy�ees Beroly is tld�ptrficy artd jvb site inforlRatFmL Insurance Company Name: •Paficy-IfL or SdFf--in 71C4:, lP� 't7l�V/ 41 .fFmpisatiouDate: Job 0a Addtessr1 iFY0 ��� CiiylStafef�.tp Attach a copy of the workers°courpensationpolicy-dedTarait hm page(showing the poficy number and e=piration carte). Fad ue to seem coverage as requiredunder Section 25A o€MM c. 1572 dam lead to the imposition of criminal perms of a true up to$UOQOQ awYor one-yearimprisonmeaiy as Well as civil penalties m fi]e faun of a STOP WORK OBDERand a free of up to$2fADO a day against the violator. Be advised that a copy of t3iis statement.maybe forwarded to the Office of Inved4p inns offhe DIA for i-sutn W coverage ti 'Ida hereby csrt�under the parrs amiss afgediury thidflte iirf orRra#iaupTOti aebmIs�%s bars�z/d correct Bate: Phone 0jWd use miry. Do not mite in tFds area,to be cmnpLeted by defy ar to►cn oficiaL City or Town.-. PermitiI,icense;9 Ling AaBmrity(cu cie one): L Board of Health BuffTmg Department S.C ylro n.Clerk 4.Electrical Lu pector S.PlumWmg Esgector 6.Other Contact Person: Phone#: laformation au' d 11astructions ' Massac Geb al Laws chapter 152 ryes all=EpIqy=to p u vulf-vaim&=33pecsat[m for f ED=cmplayeaS- par=a3tto this st&t,-,as euqrlayee is defined as.¢_evezypersonin.ihe service of anotherunder any eoxdrdct off express or implied,'oral cr vrifte . An errplvyer is defined as ,an m�idnaI,patine$ship,assocrativn,caQpar�ion or other legal 3', an3'two or more of the f Tegoi ng engaged in aim Via,and inchdmg Elie Iegal Fep�i of a deceased employer,or fhe receiV=or trustee:of an inciividoal,Pam,association cr otherlegal entity,employing=opl°y="- $owever the, owner of a dwDUis�ghousehavingnotmoretlmfln=apartments andwho resides orthe occupant ofthe- dwelling house,of ano$or who employs pmsons tb do MRfitmaacc.Luc ion cr repair woik on such dweIlmg house or on the gro=a& or bmldmg apg�:therefn shaIlnotbecanse of such employmentbe deemedfn be an employees" MOL chEpte r 152,§25C(6)also states that"every sib or local ficensm g agency shah withhold the issuance or reaevgal of a ficease or permit:to operate a bin siness or to construct bmldmgs in the cvmmonwealt h for any applieantwho has notprodrtced acceptable evidence of c6mpH=m with the;IIgy ofits coverage avisi s maicnaib,MC=rL diaper 152,§25C(7)slates"Neither the carnm�l$i nor any ofits political snbdrIL i m shall emtrr into any caattad for the performance ofpnbho work uubl acceptable evidence of compli mm With. IL iosor�ce. reTmTem ffs ofthis chBpt have beenpresertEdto the confma .m f DI;ify-" Agplicauts Please fill act the wogs'compemsafion affidavit compleisly,by g the boxes that apply tb your situation anti,if nay,supPI3'em s)n=e(s), d es)andphonenumbers)ajongvvthth r=t�- icate(s)of msrnance. Limited Liability Companies(LLC)orL=ted. abU3:ty'PartD=.shiFs(LLp)-wiftno=:rpI°yees other tbantbe members or partners,are not rt:qairEd to cagy woli=e compensafian msarenm If an LLC cr LLP does have employees,apolicy is requited. Be a.dvisedthattius affidaykmaybe snlnn>ttc;d to the Department of Industrial Accidents fbr con£o mabon of woe coverage. Also be sore to sign and date the afudavit The affidavit should bezvtmmed to ihe city or town that the application for the permit or license is being regnes[A not the Department of JudnStjl pAfs ShanIdyon have any questions reg�**�m�the law or ifyon are regrmed to obtain a woriovrs' compemsaf om policy,Please ca a tFio Depmtmcn±at fi3e mob=listmci below: Self-insinEd cauapanies should enter 1$eir self-ice Hcmase nnmbm an the apprvgriate Ime. City or Town.Officials _ c Please be sore that the affidavit is cnmpleta and pr>rttmd legibly. The Department has pmyi dcd a space at the bottom of the affidavit for you to fM out m the event the(7ffice oflnvesfi.��ions has to co styou regazdfng the applicant Pleas a be sure to fill.in tie peam.$/licease mmber which will be used as a cute m=bcr. Iu addition,an applicant that mnst submit M.UItiple permVI"cause appl[t ab=S in any givem yew,need.only sohmit one,affidavit indicating eusent policy infb=@.EC n[if nxessaly)and modes"lob Site.Ad&mm-, the applicant should wr>$"an locations in (may or town)-"A copy of the affidavittizat has bca officially stamped or ma imd by the c>iy car town maY be provided to�e applicant as pmofthat a valid affidavit is on file for fir[m 'pa®its or licenses_ Anew affidavit=Lst be filled o�xt each year.'Where a home owuc$or citizen is obtaining a license or pconk not mlatod to any business or comme3 W vm±L= e or to bum Ieavm etc_)said person is NOT regained to an�Ietm this affidavit a dug licens The Office of Inve,�wouldhb--to thank you in advance for your cooperation and should you.have any questions, please do not hesiiatm to give m a call �e 1?e�arizn emt's address,telephone and;faX mm�er. - . Dm�t of� .�Aciridents • . laa MA CdI II -Ta: GI7-TZ7-4 QExt406 or 1477 MAMAY Fax#617 727 7M Revised¢24 07 WW.mas5,gpV�c�a Town of Barnstable Regulatory Services ox Richard V.Scali,Director Building Division > Paul Roma,Building Commissioner KAM � 16396 ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building_permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 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 3.M This lack-of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used-by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\E)PRESS.doc 06/20/16 WE Town of Barnstable t Regulatory Services ` Richard V.Scab,Director. . 6. Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authoriz VAto act on my behalf m all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized befort fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOTS Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS•034718 Construction Super/isor THOMAS A HILCHiY 82 OLD CHATHAM HARWICN MA 02645 4 ZU .CA- Expiration: Commissioner 091 2017 Cl3:iC[ch"Je :i - rorua�zo�uoecclf/e o��Jlt R ulatlon. use Only irs 8 Business- e9 Reglstratlon valid for indivi ff found return to: office of Consumer Alfa CONTRACTOR before the expiration date- ulation HOME,IMPROVEME14T of Consumer Affairs and Business e9 Office top TYPe Individual r 10 Park Plaza-Suite 5170 -- - R 11:0649 11 0 Boston,MA 02116 Thomas A. Thomas Hilchey: . _`r:; !l Cl .�' 82 Old Chatham:Road __ - (�. Not valid v+nthout signatu . Harwich,MA 02645; Undersecretary .�cs:vri� Urml Irmop%i c yr �..��,�. . t; ..:.......,�...._ i varum<u r THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATM ONLY AND CONFERS NG RIGHTS UPON THE CERTIFICATE HOLBI:R.THIS i CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, ©(TEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURE-RIS), AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. WPORTANT. If the cartifims fiektsr is an ADORMNtAL WSURED.the paUcyl►ss) mush ba endum&t It SUEROGATiON I5 WAIVED, &uWct to We tones and eoaddiorm of the Polk*certain poilerdr- may require an andmsement: A fitarormnt on this csrtMcm doss na confer-nghis to the cerufceeto hrrtd=�r in li*u of such enlorsemgnlSa} �y ?r�c ;3:g�e3L• x:i i�'�:�st ayaa --;�� Suffivan Insurance Agency SULLIVAN INSURANCE AGENCY (978)851-$600 (9T8j 851.4848 885 MAIN STIH ET TEWKWURY MA$1876 �dSiit�Sl A�t3R[:CtG SIIViNAfzc rtntr a ACE Group s TO XS Brokers lnsurancc - THOMAS A H1LCtiEY °i-"s=a A}attcy,lctt USIA THOMAS A HILCHEY CONSTRUCTION 82 OLD CHATHAM ROAD i HARWICH MA 02645 = COVERAGES CEfMFICATE NUMBER: 27111 REVISION NUMSEA- Tt'15 :.S -10 rERTtFY THAT THE, POUGfES OF L E-7 c1 'c f Tel INS lq r EJ t:.._t'}:!i HAii�. 3�'7 r_S JF OTt�I.a.,li.� � �• 1t1,.41t_s- YL f e':R T-rfl: *'-uuC P= 4fG'f':JlTr+STANDI G ANY REQUI�R►IENt. T—%t OR � .d t`,= � TR c ±- ,: t^6.. %:ePt cc�: s ANY t;fJ?� AG' t� vF>ie4 C�Ei.,�35•�:T t*JtEif ��'tCT Tt'I :.HI% T � C'tR';irir�lT= .t.y ee_-'isZUE2 OR ?vAY:refitTAX ;HE INSURANCE A.-r�C;MM SY j- �_�` r-ee -1 k3"a S -r_�a' L rE Ee�v s �u C�Tv :+ :THE-L FxcL lle":+Js fait.'.rXxN 4nl c S L-'SUCH r' 4.:r!ES iitQ ili.:AY ttAEr E_+rFEDUCEC!0:)A r1yt,,e •_ irFE t9F LtiSudiCE .� "' '' RQi1CY P31dA19. arnrea EFt ? pa.et.eta+ ?-�— - - eunb�lrY :emu ,°�y�Yt tltG78 { caa iusrrr 3Eis2?tA 0912l1l6 D9rZ6tt? StCisSEtti: L� g 11000.000: 1 _X _ ! . jtTc:�i��.'4rl&A.3'Jlta.:..^%;• �: 'I,QDQ.QQD� L4= - .(rr/31ie2t;..� .liE3tr� � .. � � .. - _•A=Tva aE�'ri' i- ------------- v C Ea`A'S�tia r q `. «Ev 1:.�. �2It$-2095a0-8.17 ll3ri5tt7 G3tt5lts •twu 6AI0'LDYEZS' L-muinr ET AM, rFP?Cr n" L:W A 9 Ta Ml IEG71CiE Y+h � � ,EiE::f4,ftCCI z=1i`•' 1NYA ;w�xvrmrrtir =1 1 'EL G 100.090 �GF G_�RATtGtiGd Lf3CAT14r13 i'�tiCLS=ram,ACW�H.tDI,rt&Jttr�si3t ttrmirta r�d.+..:tt{77�3E xpza t3 rBGvvo�) .. Thom5 Hichey is excluded from tho warkers eomp_n3tlan policy CERYIF CAT€ HOLDER CANCELLATION TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL ID 127 043 WOO i GEOBASE• ID` , 35430 ADDRESS . 107 RED OAK LANE PHONE W BARNSTABLE ZIP - ILOT PT 14 _ BLOCK LOT SIZE IDBA DEVELOPMENT DISTRICT WB ( PERM T 32488 DESCRIPTION I PENIT -TYPE, BC00 TITLE CERTIFICATE OF OCCUPANCY" CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES I BOND $.00 THE ' CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY . .1. PRIVATE P : + •ARNSTABM + MASS. •., ..--� Ep M1�►l ' BU I DIVI O I -, B �.», DATE ISSUED 08/03/1998 - EXPIRATION DATE 1,"' '.) 173 41 0 3 p s" UEOBASE 11L 35,:30 11L,)it► `;L 1-'17 KL:1) T•',t'!k "u',, >, 1 BfOCK LOT S T Y- 1�► DkVELOYI,I.LON`I' G_0- it1 C� ["3 J 'r r'i? �?`/9�0 r�:;ORIP�'ION ?S`r. COWNIAV/AITAQ4. CAR. �r�?t097-'1"..01 )' a++T i TYFT; "It'IT_n fI`"L-9 NUO RESIDENTTAL PUG Pr"P 'ILM°1OF ;: if:LI_UP, 5TA11E Department of Health, Safety '1tU!'r Ti''c i''' and Environmental Services TUT'11 I'N�;S. ���1 H. 50 : tNE 0Y1) C;ON"wTRJC`1'I0;' CO 1'0 $135 .000.00 01 SI 'G, I. iZAA HOW DLTACHED 1 PR1VAL'E � '•,+ �I:: _ # 1ARNSTABL F, + MASS. 039. A�O� 0 BUILDING DIVISION 14,TA :1:SU'.:D 12/s9/1q'I•' EXPI'ATION DATE v THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS VOW 2 4� 2s; 2 VIZ 41 2 ol G 9 3 1 4EATINGr/ INSPECTION APPROVALS ENGINEERING DEPARTMENT wry 2 RD OF HEALTH OTHER: FjAe MrL "► SIT PLAN REVIEW APP AL F1R1 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HASAPPROVEDTHE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 32��t� S 0� BUILDING y f' O t t • r . t ,cam VW' 2..�;�,A Engineering Dept. (3rd floor) Map /off 7 Parcel ,�j y ��� Permit# 2-T 60 House# /p Date Issue 12-. Board of Health(3rd floor)(8:15 -9:30/1:00-4:30)9'7 Fee ' , Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 3 �3 vas Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC W,U-ST BE Definitive Plan Approved by Planning Board 0 ` { 19 R S D N�NST PLIANCE 4-of Iy 1Lereu fcd !o��LINSTABLE PM 5 TOWN OF ENVIRo CODS AND (90 �1TOWN R ULAMONS Building Pert Application Project Street Address Village Owner 1M 4e Address Telephone ( t" k�11: ell Permit Request .' —1 First Floor square feet Second Floor � square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size I DVVL A Grandfathered ❑Yes ❑No Dwelling Type: Single Family lBr' Two Family ❑ Multi-Family(#units) Age of Existing Structure ' Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: Oull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) J:�4 n Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ®Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) (,. ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# 1 Current Use Proposed Use Builder Information Name Telephone Number Address (z at,)% ('1q . � icense#_1i4 o)(-�a A;� 1� T1, 5rQ)a -`f, Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ti SIGNATURE DATE �, L BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) _ r FOR OFFICIAL USE ONLY ©-� - PERMIT NO. f DATE ISSUED 1 ' j MAP/PARCEL NO. ADDRESS VILLAGES OWNER ;. DATE OF INSPECTION:- FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL: GAS: FINAL FINAL BUILDING �a f m DATE•CLOSED OUTA t ; ASSOCIATION PLAIi� m �xi STAKE `SsQ �s- 06 LO T 15 2p p, Qs o FpUNDA�I 6¢� l o o r u. 0 � o 0 �tK 5� Y, I LOT 14 AREA- -48,561 S.F-1 ASSESSORS MAP 127143 l\rAKE 55,54"E LOT 13 may. o FLOOD ZONE "C"_ FO UNDA TION CERTIFICATION RES ZONE.. "RF" TO WN..W. BARNSTABLE SCALE.1"=40 PL.REF.-398 64 ELEV I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON �``A of , P. 0. BOX 265 THE GROUND AS SHOWN, AND o�� PAUL CyG UNIT 1, 40B INDUSTRY ROAD ITS POSITION DOE—_____ A. MARSTONS MILLS MASS. 02648 CONFORM TO THE ZONING LAW MERITHEW No. 32088 e TEL: 428—0055 SETS CK REQUIREMENTS OF �o ° FAX 420—5553 _ BARNSTABLE �so �'uposo� ct4A_U --------- JOB PA UL A. MERITHEW DATE.- Z_K__ 8 NUMBER 50923FND i-- PAT 10 o 7,0- 9-9• , 1• 0',• .o•,:b-, 5-9" I 0 L l V 1 N 6- 'RAII- I _ r , TG E S 'o 3-Sh 4'-5'/t 1''' �i�7-1'i II 8'_O' ST6O �'•��O FOR mi( 0y OwJiR . m ...FW1N NOA RTN 1 6�1�1-♦s p O 1 D ANEW u A V.r �I I N 1 N E h T D Y. o • L 01 i .. . rL• yl , �w000 Ln O DG� INb� _ y '�� 'DY6 AL yGO oFa NIN¢(7YF) GoN 6_0• !)IIII /2'-6' S'-o' . 1 .s_I'i s'_lo" T'./:i �'�' +II 6-10•• sLl.. 1 T 36=0- I I b 3 I 1 2STTI'0 R 'PLAN 1 - � M2 MRS IKt GKcdi�R o� 61 OAK LN; W.BARW3TA15LE � = � SfEVE -MELIoR• 6Uf�-DER. ' IIr FLOOR. PLAN 70 4. I �— la o, 4 � pA 6 4 T I4� i L a ;P i 'P jo 'I c I worn G7 ��"• W ' W � n �, a �, o r, v 3` R r77o� i V oD m 7- m _3 Z <.c� 3 0 rn a p 7K o Z- 70 0 �Zfit o F f[� N' m IT!DP +, p m r-ram r- -1 Y En L I .. I i_h J N •D� A I m I' ! I � I r S v� I • Mil M8 a m Jt— r� D O I I II IA I H o 0 n j soo•• .....� e a o I I 00 "La. A I I Z I I m 14 1 � jllr D r-- m gwr � Y m `n >a`• `^vA LR -A- -� o z o r P p -♦ Z 0 0 m �. n__ A �n� V i z ? � 83 [♦E e n op o0 1 zA� o � E A eta a Z �E � i rF ^a 'XIn o 1 ° L v zv TLS 2� c tiLF '1 M� p fy A i m: I - I i I I I `1 y I N � a - �� I U— I I a I D I � N r v L I ° � I z n R P I � I' Lj Lr— R I m rL_ i To oY i � I I_ lore j n IJ---I maoA � Ga.m3 0 3 r Z. m g3 UZm O ;iJv m ,w � F m 1 `ASCU ALT SUIN41 5) A�iMn�r3Nw 1rs 1T i g7GV ALf SFill.l lTLEi� `\VMI fE CEDN2 SY�r.I¢�E>•\ �i I — Jcop.— ROOD �9 No\V nJDO��TQ,�M AL 8 FHoe I l� 1 i I I a.l L�- - - --- - - - - - -• - - - - - - - - - - -.7_J L-''- - - J.I - - I_1. _.II' _L_ l2EAQ ELEV4TION LCF-r ELEVLITrDN LE WILF MR M2'5 MIKE CRLVI EQ 1 ' 107 F_D CILk L4. ���CiA4�1 STA NLE yT9VE MELLOQ P,UIU)F.IZ FI.FVnTI �N'i 7:f-77 s 4 To ? Date Time 0 � WHILE YOU WERE OUT KA Phone 9 44 '� Aw rea Code---- _ Number. Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Me sage �t L — Oper for G' AMPAD 23-021-200 SETS � EFFICIENCY® 23-421-400 SETS CARBONLESS E �J ,� ✓fie �anUrrea�aurealC� o�.flar,tae�re;teCC� ; ••Z j� -��•,.�.. ,i-t Restricted To: 00 t fill! ? DEPARTMENT OF PUBLIC SA "TY �' CONSTRUCTION SG?F.+�T `'S300 None 'ULbeI_ :spires: Birthdate: 1A - Masonry only $�1 T 9= '?;;;eB /?J-.51 1G - - •& mil CS �15 9 19 t 9 n�� ly 4,tg�aS Y tes ted:,Tb, 00. Failure to possess E current edition of the Massachusetts State Building Code `STEVEN L MMUR is cause for revocation of this license. 'PO NX 3:4 W 8M.5STSBI., 1A 120S , / / /p� E• I I n e.e A tle y�_.yso gms // A0 10:0 I I O O OZ \11,e01 rn o r c'.� o o a � '0d0 I � � �• m �gM 8 / / n y ° �aZ ZE ti Q�_Z, aj o ::d Loco 61 f �_.�_.`_•..�; ova a W I (AV TOP OF FOUNDATION GRADE 20' MIN. M/N PITCH J/8 PER FT. 4COVERS MUST BE BROUGHT II 10' MIN. WITHIN 6"OF FINISHED 4"SCHEDULE 40 P.V.C. G 111 CONCRE7E COVERS //B 1/2 2"LAYER F VENT i i i i CONCRETE COVER 111 WASHED S70NE REpU/RED 4"CAST IRON PIPE 6"MA.Y PMINIMUM 07CHQ/4'�PER FT. CLEAN SAND 9" FLOW LINE HIM 107..50 INVERT 1M N /4^ _ EL.= Il0___ INVERT LE L 0 0 0 o a o 0 INVERT CAS BAFFLE EL.=109.50 INVERT/ 1-INVERT O 0 o O O o 0 0 109.75 INVERT isog____caccolvs DISTRIBUTION EL.=�07 _ INSTALL 4 CULTEC CHAMBERS-RECHARGE 330 SEPTIC TA1�K BOX WITH 4' OF STONE ON ALL SIDES PLACE ON FIRM COMPACTED BASE. TO BE WATER TESTED OR ON 61"OF.STONE. IF MORE, THAN ONE OUTI.F.T •5.50 PLACE ON 6"STONE 3/�, TD ,_,/2.. SOIL ABSORP710N PROFILE OF iiASHED STONE SYSTEM (SASS SEWAGE DISPOSAL SYSTEM BOTTOM OF TEST HOLE ELEV.=_99__ NOT TO SCALE NO OBSERVED WATER TABLE.(4/Ifj196) ELEV.=_99__ OBSERVATION HOLE I ELE•v=114__ OBSERVATION HOLE 2 E•LEV.=112__ PERCOLATION RATE�5_ MIN./INCH AT 48_ INCHES IfDEPTH HORIZ TEXTURE COLOR MO TT. OTHER I DEPTH HOR121 TEXTURE COLOR IMOTT OTHER GENERAL NOTES 0"-10" A SANDY LOAM IOYR 3-2 0"-10" A SANDY LOAM IOYR 3-2 10"-36" B LOAMY SAND IOYR 4-6 10"-36' B LOAMY SAND IOYR 4-6 36"—B4" Cl SILTY 210Y 6-6 PERC 36"-72 Cl SILTY 210Y 6-6 1) ALL 1VORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E P. MED. SAND 72"_ MED. SAND TITLE 5 AND THE TOWN OF BARNSTABLE'—_—_ RULES AND 84"156" C2 MEDIUM SAND IOYR 7-4 156 C2 MEDIum SAND IOYR 7-4 REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 2) ALL COVERS TO SANITARY UNITS SHALL BE BROUGHT TO NO WATER NO WATER WITHIN 6" OF FINISHED GRADE 3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF IVITHSTANOING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN 10 FT OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE DATE OF SOIL TEST APRIL 16, 1996 SOIL TEST DONE BY BRUCE G. MURPHY, R S. I USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS 4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL DESIGN CALCULATIONS- BE MORTERED IN PLACE. NUMBER OF BEDROOMS . . . . . . 3 5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH GARBAGE DISPOSAL . . . . . . . . NONE DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO TOTAL ESTIMATED FLOW i OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. ( 110__CAL/BR./DAY x _3__ BR) 330 GAL/DAY 6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR IS TO CALL 'DIG— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS SIZE OF SEPTIC TANK . . . 1500 PRIOR TO COMMENCING WORK ON SITE. GAL 7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS [YELL AS DESIGN PERCOLATION RATE � 5 MIN. IN. SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. 'I 8) PARCEL IS IN FLOOD ZONE____ EFFLUENT LOADING RATE . . . . . . .74 GAL/DAY/S F. 9) LOT IS SHOWN ON ASSESSORS MAP L2 _ AS PARCEL t43 . LEACHING CAPACITY 470 GAL/DAY 10) DEEP AND PERC TEST TO BE PERFORMED AT TIME OF INSTALATION. RESERVE LEACHING CAPACITY. 470 GAL/DAY ((36xl2.3)x.74)+((36+36+12 3+12 3)x 74x2)I,AGE 2 o/2 JOB A/UA4BER_•50.923___ i The Conntion ivealth of Afassac•husetts Department ojludustrial.4ccidc►its 1_ Office ff"IMSM1711ons \ 600 N ashhi-t)n Street Boston, Ma.u. �02111 I Workers' Compensation Insurance Affidavit �•hplicant information: -�.- ..: _ yPleaSe PRINT leb���___.._...._. ...... + name: Y•a Incation7 city phone ft I am a homeowner performing ail work myself. I am a sole proprietor and have no one working in any capacity • .. -.v_ •....-,_er-+.-•..�n.ed,..s'�7�r1'r.�'+w�*?+'J.7r!r:...tq!r•�..�+.rw+�w'T...tf�..�.+'w�ww�..�..�.r.+.._.. w�1•�•w.••--�.wl,�..�...._-.. ... [I I am an emplover providing workers' compensation for gly employees working on this job.- enntna A- name: t . address: city: b 9 U Phone!t• �r ����.f insurance co. +C P �1�sj Palicv# , u 2S,gM k I q—h: 6 [j I am a sole proprietor, general contractor, or homeowner(circle otre) and have hired the contractors listed below who have the following workers' compensation polices: company name: nddress: nhnne 9: insurance co. policy 0 + '•:rl.::'.�. V _ .. ': �':t...::....�:::- .__ _�t•�•':�::��'.�4 iT"l��w•S'i. ^^T�'_:-.::' - •f'ti' :•i'i _ __..-_._.... •._ ._.�_-....._. _I.G-��Y.�.:_ r'Y�:a1r'.r+.Jr'- - ':.' :� �..�.1• ..- .__ .. � _r�.:yO�Y`_.. --� cnmpans• name: add:css: tits: Phnne#: insurance co. nolicv a Attach additional sheet if Failure tit secure cover:tttc as required under Section:5A of 111GL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur une years• imprisonment as((yell as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a cope of this statement may be forwarded to the O11ice of Investigations of the DIA for coverage verification. 1 do hercbr c•rrijr tinder the pains and penalties of perjure•that the information provided above is true and corrects. Si_paturc i Date Print name ', Q J•,t!_ Yl 6 - Phone# �`�� �•��' rci�n-C'r,"t.,wn: a use only Jn notwrite in this area to be cumplctcJ by cin or town official permit/license it rI13uilJing Department (]Licensing hoard 0 check if immediate response is required l]Scicctmcn•s Office (]Health Dcpartmcnt '. contact person: phone it: r j0Ihcr �' I 1. L information and Instructions k Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation fo employees. As quoted from the "la\\• an emph ree is defined as every person in the service of another-,under am contract of hire, express or implied, oral or written. An enrplorer is defined as an individual. partnership, association. corporation or other legal entity. or anv two or more the fore�_oin`_ cn��aged 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 dwcllim, house of another who employs persons to do maintenance , construction or repair work on such dwelling_ hou or oil the `_rounds or building appurtenant thereto sliall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even• 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 leas 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 hz 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 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 police. please call the Department at the number listed below. City or 'rowns Please be sore 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. Plea. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc 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 question: please do not hesitate to give us a call. . �...y.._r-..• ��w.o... _ _ .-r..... . _ .•t�..w.w_+u......w.w�•• +.._�+.•...w•r777nf:.r."•.e�•vT�•oswr-..._ • .. �.. ... .. ... _ •" ... ...ter - .. — .. .. .. :ti';..: :R.. 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, 409 or 375