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0143 SADDLER LANE
Ill1 �cYt� UPC 12543 % atio No. HASTMGS, MN ......a+�!. C;)o � t� � �aa T Town of Barnstable *Permit# Q. Expires 6 mo the om is date Regulatory Services Fee = sAaxs�rs, ; MASS 039. Thomas F. Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number /3 ® 7(S Property Address t y3 5eM 1.ev_ L� +�P (tJP�� l�riirl�>T-� �P / - 6 26�e� XResidential Value of Work f z ti o 0,07) Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �o�� >� , F e C'✓ 1q3 >r�ir!_'1ty" Lph (,c�L7Sf fV1S+;,77le. A'1 '► Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance X�,PRES� PERMITCheck one: C ❑ I am a sole proprietor g I am the Homeowner "AAY 2 4 20 11 ❑ I have Worker's Compensation Insurance TQWN OF BjARNSTABLE Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) NrRe-side [ Replacement Windows/doors/sliders. U-Value (', 5 0 (maximum .44 #of doors O )#of windows _ ''Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. iIGNATURE: !:\WPFILESTORWbuildingpermitforns\EXP SS. oc I revised III 10 The Commonwealth of Massachusetts l r ! Department of Industrial Accidents i Office of Investigations 600 Washington Street Boston,MA 02111 �v 1 r z� www.mass gov/dia Workers' Compensation tnsnrance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Q Please Print Leeibly ame (B rus ness/Organization/Individual): / o N O L o Jq GAddres§.;-�) 3 - SIPP L C-l2 2— 19 /1 , C- Phone#:' -7 7 Are you an employer?Check the appropriateebb x:, Type of project(required): 1.El am a employer with . �4-__VI am general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. 0 New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its I0.❑ Electrical repairs or additions ---required officers have exercised their ❑-I am-a-homeowner doing all work -right of exemption per MGL 1 I.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' ]3.❑ Other comp. insurance required.] *Arty applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer drat is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c under the p d penalties of perjury that the information provided above is true and correct Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# I Issuing Authority(circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: Information. and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the t p 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." D 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 P applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Tlcither the commonwealth nor any�of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of jj�, 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or.marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia Town of Barnstable ��'oE t►+e ray . . . . . „�. Regulatory Services Z urtrrsuslE S Thomas F. Geiler,Director v MASS. 16 Building Division QED { Tom Perry,Building Commissioner 200 Mairi•Sfreet,_Ayannis,MA_02601 www.town.barustabl e.ma-us Office: 508-862-403 8 Fax: 508-790-6230 HOl\ OWNER LICENSE EXEMPTION —�� /� Please Print DA IE.5'—2 / 41 number /� rn L�+ 4ev street `� village "HOM�EO-"E-i ":—ter)60 1� ,l'T 1"1 C' —S 2I 3 T ��,/� name m + hoe phone# work phone# C.MURR C?v1AlI_II�IG ADDRESS:' j T S 0d� I,& Ln ne (des t 13a(t)Sf,--61 cityltown 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. DEF7ATTi-ION OF HOMEOWNER Persons)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 responstb]e for all such work performed under the on permit (Section 109.1.1) The undersigned"hoineowme'assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations: The undersigned"homeowner"certifies that.be/she understands the Town of Barnstable Building Department 7rme inspection procedures and requirements and that he/she will comply with said procedures and nts. ,ysignature-of_Homco_ 14 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 bomeowner performing work for which a building permit is required shaD be exempt from the provisions of this section.(Section 109.1.1 -U=is-ing of construction Supervisors);provided that if the homeo,;yner engages a persons)far hire to do such work,that such Homcowncr shah ad as supervisor."• Many homcowncrs who use this=cmption are unaware that they are assurning the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bflen results in serious pmbla ns,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 My aware of his/her responsibilities,many communities require,as part of the permit application, that the homcovmcr 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 corranunity. Q:forms:hom=cmpt Town of Barnstable Regulatory Services • u.�xsr.�stP; Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barustable.ma.us Office: 508-862-4038 Fax: 508-790-6230 o Property Owner Must Complete and Sign This Section If Using A Builder I' Owner of the subject.property hereby auzhonze to act on my behalf, in all matters relative to work authorized by bA permit application for. (Ad ss 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:FO RMS:0 WNERP ERMISSION Massachusetts Workers' Compensation Insurance Plan Acadia Insurance Company Administered by Berkley Risk Administrators Company, LLC PO Box 1100, Mpls, MN 55440-1100 222 S 9th St, Mpls, MN 55402 Acadia InsurancePhone(605)945-2144 Fax(866)215-8118 Toll Free(800)634-4589 NCCI Carrier Code 33391 CERTIFICATE OF INSURANCE 1. The Insured: WCIP Policy Number: WC-20-20-002862-00 Richard Kapisky Tax ID#: UNKNOWN 2440 Lyannough Rd West Barnstable;MA 02668 Policy Period: From: 1/21/2011 To: 1/21/2012 Date of Mailing:5/17/2011 The Certificate is issued as a matter of information only and confers no rights upon the Certificate Holder. This Certificate does not amend, extend or alter the coverage afforded by.the Policy listed below. This is to certify that the Policy of Insurance describedherein:has been issued to the Insured named above for the policy period indicated. Notwithstanding any requirement,.term or condition of:any contract or other document with respect to which this Certificate may be issued or may pertain, the insurance afforded by the Policy described herein is subject to all the terms, exclusions and conditions of such Policy. Coverage Part One State(s) Workers'Compensation Statutory MA Part Two Bodily Injury by Accident $100,000 each accident. Employers'Liability Bodily Injury by Disease $500,000 policy limit. Bodily Injury by Disease $100,000 each employee. Should any of the above described policies be cancelled before the expiration date thereof, notice will be delivered in accordance with the policy provisions. All Entities/Insureds: Certificate Holder's Name and Address: Kapisky Election Election Ronald Pfeiffer Category Status Name 143 Smiler Lane Sole Proprietor Include Richard Kapisky West Barnstable, MA 02668 Date Issued: 5/17/2011 RSC Insurance Brokerage Inc Risk Strategies Co . 15 Pacella Park Dr 240 Randolph, MA 02368 Signature_ - BA 3140 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION., Map /S/ --- Parcel, 6-S t. Application # 0� Health-Division =' ' Date Issued I Zl C7 Conservation Division -: Application Fee V Planning Dept. Permit Fee 20 5 Date Definitive Plan Approved by Planning Board Historic?- OKH Preservation/ Hyannis R Project Street'Address SADPL9-e LAwi Village .W ES'r iS^N45rASL- _ Owner R[ om :t 5U5A? F-e.Ke-t- Address-7811 P-RA"r-L�M 5"C. WoieLa3T-G Z V 4 9 ll 7 V $3 _ 03 6�raoy Telephone S6 J Z Permit Request I g X 14 50J2ooNti AQQ,,-t' tlm Irr 2c�1-2 aF r���MrL 1 N ,p 1AcE aF `. 1✓X�S�?7�11s IS (e X 14� D�-C-1� Square feet: 1 st floor: existing r: Oby proposed / 2nd floor: existing proposed Total new /9(a Zoning District Flood Plain Groundwater Overlay Project Valuation 1 I 3 ."°Construction Type Lot Size" D • 44 At 9 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family, ,:9"" Two Family ❑ Multi-Family(# units) Age of Existing Structure Z 3 Historic House: ❑Yes At No On Old King's Highway: ❑Yes 6 No Basement Type: A Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 13 S y 5&F-r- Number of Baths: Full: existing 2 new Half: existing new Number of Bedrooms: 3* existing _new Total Room Count (not including baths): existing ( new I First Floor Room Count /�I Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes )dNo Fireplaces: Existing I New Existing wood/coal stove: ❑Yes,4No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage:X 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 nos�`bEN711- Proposed Use o APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �.-L- f'1N1 DR.c_ liN- 121PrP3CSTelephone Number C30-fl3 410 Address p o t36X 1-7 (,V-nr'rt-(2 U 1ZI.E V -License # C S 9 0O V 7 2 a 0o En1 V jrLt2?iA/ \'ZO&V Home Improvement Contractor# I� Nh,/►'►2-STtsNs w�;11 s �1A,,4. oz(��l� Worker's Compensation # 1<1=W -9O 3$1 to ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO PI-APA S F t/� iZ.�=S Wv�2sra✓v5 rM�b l S . o z(�� S SIGNATURE G%/G� ATE /z J1061y s FOR OFFICIAL USE ONLY APPLICATION# 4 4"ATE ISSUED MAP/PARCEL N0. '3 - ADDRESS ' VILLAGE - OWNER i DATE OF INSPECTION: = FOUNDATION 2 to /e - E a led 1 FRAME --INSULATION Ale 46 2 _ FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL K ' GAS: _ ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ' s ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual): Address _ Q f3tP l City/State/Zip: ('��% '(`i(L F %l�� 4 b 3� Phone#: 6 U g q 20 W.3 Arr you an employer?Check the appropriate box:. Type of project(required): 1. I am a employer with 03 4. I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These subcontractors have g. ruilding L+'tion working for me in any capacity. employees and have workers' 9 addition [No workers'comp.insurance comp•insurance.t required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption.per MGL 12.❑Roof repairs insuranceaequired:]t c. 152,§1(4),and we have no 13.❑Other employees.[No workers' comp.insurance required.] .Any applicant that checks box ill must also fill out the section below showing their workers'compensation policy inforrnotion. t Homeowners who submit this affidavit indicating they are doing all work and'then hire outside contractors must submit a new affidavit indicating such. tConbwtors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. if the subcontractors have employees,they must provide their workers'comp.policy number. I ant an employer that is providing workers'compensation insurance for my employee's Below is the policy a,ndjob site information. Insurance Company Name: ( o t / G I���C `7 3'g 6 Expiration Date: Policy#or Self-ins.Lie.#: � p Job Site Address: /y3 SAt7U-Lute L,YVE City/State/Zip: A. Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify.u r the pains a penalties of perjury that the information provided above is true and correct Signature: e — Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: .: .... :::: ::Ij* . RR »:;•::';:OATE(AQIA,DOIYY, PRODUCER TM CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PAYCHEX AGENCY INC. HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1175 JOHN STREET' ALTER THE COVERAGEE POUCIES BELOW. WEST HENRIETTA,NY 145% j COMPANIES AFFORDING COVERAGE COMPANY GUARDINSURANCE IrrjUREu KEITH C GILMORE ENTERPRISES LLC e""Y PO BOX 17 CENTERVILLE,MA 02632- j COMPANv C COW ANV .�1F4:•i:•:::. . .:•:i:':'::::.:<.::':•}::•:::':':: •:•:•:':::': :':':•�:'i:ii'i:v':::•.............. •:':•::: :-:i::!!:v::'::.: :•:•:: •:'::�:•:•: :•i:•:::•::i:::::::::: ::•:<^::::•::':::i•:::•::'::::•:•:•:<?:�::'i: •::is THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALI,THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. Col TYPE OF INSURANCE POLICY NUMBER i POLICY EFFECTIVE POLICY EXPIRATION LTRI DATE(MWDD/YY) DATE(MWDD/YY) LIMITS I GENERALUABILITY I GENERAL AGGREGATE S O COMMERCIAL GENERAL LIABILITY PRODUCTS'COMP/OP AGG S O�LAIMS MADE=CCUR 1 — j PERSONAL 6 ADV INJURY 5 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE is FIRE DAMAGE(Any one fi.) j S MED E XP(Any one person) S AUTOMOBILE LIABILITY ANY AUTO I COMBINED SINGLE LIMIT S O ALL OWNED AUTOS j SCHEDULED AUTOS I I BODILY INJURY(Per peman) S HIRED AUTOS 1 NON-OWNED AUTOS I BODILY INJURY S i (Per accioem) !PROPERTY DAMAGE $ I GARAGE LIABILITY O ANY AUTO ' � AUTO ONLY-EA ACCIDENT is OI )) OTHER THAN AUTO ONLY. I EACH ACCIDENT S I AGGREGATE Is EXCESS LIABILITY j I EACH OCCURRENCE S UMBRELLA FORM I I I iAT OTHER THAN UMBRELLA FARM AGGREG E $ I` S WORKER'S COMPENSATION AND X Y w A ' N'A EMPLOYERS'LIABILITY ER TNEPRapatElalu EL EACH ACCIDENT is 500,000.00 PART NERVEXECUT PA ®INCL ` KEWC005928 02/04/09 02/04/10 EL DISEASE-POLICY LIMIT $ 500.000.00 ocaCERs ARE: EXCI j EL DISEASE'EA EMPLOYEE S 500,000.00 OTFIER I I DESCRIPTION OF OPERATMS(LOCATIONS/VENICLES/SPECIAL ITEMS <C£fICJ�T >:: :::<:>::::« SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUT ED REPRESENTA VE :AGOCtQ:23Si' ....,......... :.:....:.. .::•:.•::: •.:•.:.:...:.....:.,.,...:.::,..®l RK1>G'031P�i31aT(Ekk.�908•::: i ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE-AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: KE�--1 y4 L GOMO&E_ Site Address: /y3 ShMLSIZ LAVE print Town: WEST $A ZA3 S+A6L E. #t A.OL&ob b Applicant Phone: �'SOb)42o-gg3y Applicant Signature: 444�e � Date of.Application: /r/a�D9 T NEW CONSTRUCTION: (choose.ONE of the'followin -two o tions) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of 35 R-38 R-19 R-19 R-10 4 ft. 1987 as amended,minimums or greater as applicable 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.energ cy odes.izov/rescheck/ ADDITIONS OR ALTERATIONS TO EXISTING BUILDINGS OVER'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 % of glazing: (a) Gross Wall &Ceiling Area equals Formula: (100 x b_a) sG-7 SF 100 x 61(A - 6-(o7 = 11. W% of glazing (b) Glazing area equals SF b a If glazing is<_40% use the chart below. If laze is>'40 % roceed to"SUNROOM"'section. 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS.TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Fenestration Ceiling and Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth .39 R-37 a R-13 R-19 R-10 R-10,4 feet 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). El glazing —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 120.P) /y3 c1v- w�� b cam- ' AWC Cttide to {)%o(I Constrttctiott in. Hi;;lt Ifh d Aivas: 110 tttplr {•Vitrd "Lotus Massachusetts Checklist for C0111pliance (780,0),IR 5301:2.I.1)' Check Compliance 1.1 SCOPE ✓ WindSpeed (3-sec. gust).................................................................. ..............................I................. 110 mph ✓ Wind Exposure Category B Wind Exposure Category................Engineering Required For Entire Project .......................................0 1.2 APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) r' stories 5 2 stories f (Fig 2 ..........7 : 12<_ 12:12 RoofPitch ...........................................................................( 9 ) ................................. 1 , (Fig 2 ..ift �t 5 33' t! MeanRoof Height .....................................................:........( 9 ).................................. . .... ... —�/ BuildingWidth, W ...........................................:...................(Fig 3).........................................��Zft 5 80' .........(Fig 3 .. . 5 80' Building Length, L ................ ( 9 (Fig 4 . 1•2S_ 3:1 Building Aspect Ratio (UW) .......,.Z...................................• (Fig 4)............................................:...b,�•�s 6'8" � Nominal Height of Tallest Opening ................................. .( 9 )............................................ ... 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2)............................................................... 2.1 FOUNDATION Foundation Walls meeting requirements'off7780 CMR 5404.1 concrete.....'W06...F, U 'l7✓( .. .................................................................................... Concrete Masonry .............................................:...................... ............................. .......I........................... N IA 2.2 ANCHORAGE TO FOUNDATION1'3 5/8"Anchor Bolts:imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only in. Bolt Spacing—general ........................................:.(Table 4).....................................t........ Bolt Spacing from end/joint of plate .............................(Fig 5)......................................S /7 in. s 6"_.2". Bolt Embedment—concrete.........................................(Fig 5).....................................:....... _in. _ 7" in.>_ 15" f Bolt Embedment-masonry.........................................(Fig 5)............................................ PlateWasher................................................................(Fig 5).............. ...............................>_3"x 3"x%" 3.1 FLOORS Floor framing member spans checked ................................(per 780 CMR Chapter 55).........................f ft 5.: ...2 '12 Maximum Floor Opening Dimension...................................(Fig 6).._.................,....:..........................— �J,c'� Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall.................(Fig.7)...................................................._ft _-5 d f� Maximum Cantilevered Floor Joists Supporting Loadbearing Walls'or Shearwall....:...........(Fig 8)...................................................._ft <_d Floor Bracing at Endwalls..............:.....................................(Fig 9).................................................... N � Floor Sheathing Type .:......................................................(per 780 CMR Chapter 55)................................... • (per CMR Chapter 55 ..........3 m. � Floor Sheathing Thickness ...........:................................:....(p P )............. Floor SheathingFastening ........ ....(Table 2)..�d nails at�in edge///Z in field 4.1 WALLS Wall Height Loadbearing walls..........:.............................................(Fig 10 and Table 5).........................D� t s 20' r� Non-Loadbearing walls...................................... ..........(Fig 10 and Table 5)........................./.gam Wall Stud Spacing ........................................................(Fig 10 and Table 5)...................�in. 5 24".o.c. WallStory Offsets ........................................................(Figs 7&8)............................................_ft 5 d f1 4.2 EXTERIOR WALLS Wood Studs f/ ' Loadbearing walls.........:..............................................(Table 5).............................:.2x�- ft in. ............................... Table 5 ..............................2x�- ft in. Non-Loadbearing walls................ ( ) Gable End Wall Bracing Full Height Endwall Studs............................................(Fig 10)..........:...................................................... � WSP Attic Floor Length..........:......:..............................(Fig 11)............................................. ft Gypsum Ceiling Length(if WSP not used)....:..............(Fig 11).........................:.................. ft 2W/3>_0.9W and 2.x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 11)..................................................... ........ •1 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 (Fig 13 and Table 6 ft /� A SpliceLength ..................................:.....................( g )...........:........................_ Solice Connection (no. of 16d common nails)..............(Table 6).............:......................................... AIYC Caiide to Iyou(j Construction hi High 1,11ind Areas: 110 mph hYitid Zone Massachusetts Checklist fol COI11l�.liallCe (780 Ci\[R5301.2.1.1)' Loadbearing Wall Connections Lateral (no.of 16d common nails)................................(Tables 7)..................................................... t/ Non-Loadbearing Wall Connections Lateral (no.of 16d common nails)................................(Table 8)....................................................... 2 �C Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans .:......................................................(Table 9)..................................Z ft .5 11' Sill Plate Spans ........................................................(Table 9)..................................Z ft�in.in. 5 11' Full Height Studs (no. of studs)....................................(Table 9).......................................................___i —k:n Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................(Table 9).................................. -7 ft in.5 12' ✓ Sill Plate Spans.... .......................................................(Table 9).................................. ft " Z �in. 5 12 J� Full Height Studs (no.of studs)....................................(Table 9).......................................................-3- Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension, W Nominal Height of Tallest Opening2 ... . 6_&5 6'8" ✓ Sheathing Type..............................................(note 4).............................................!/.Z...wNn57D2uA05 �. Edge Nail Spacing..........................................(Table 10 or note 4 if less)........................ 3 in. Field Nail Spacing .... ........ ...... Table 10 ................................................. 1 2. in, P 9...................... ( ) ✓ 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 OpeningZ.................................................................�......0 105 6'8" ✓ Sheathing Type..............................................(note 4)..........................................Y�...-0, r�a�OSB Edge Nail Spacing..........................................(Table 11 or note 4 if less)........................ 3 in. Field Nail Spacing.......................................:.. Table 11 ................................................. 1 2- in. �G Shear Connection(no. of 16d common nails)(Table 11)........................................:..............'//"r ✓ Percent Full-Height Sheathing Table 11 ....................................../-7-% l� 5%Additional Sheathing for Wall with Opening > 6'8"(Design Concepts).................... N 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) ............. I ft 5 smaller of 2'or L/3 ✓ Truss or Rafter Connections at Loadbearing Walls Proprietary.Connectors Uplift..........:.....................................(Table 12)............................................U=�plf ...................(Table 12).............................................L= Lateral..............................................(Table pif ✓ Shear............................:..................(Table 12)............................................S=ZZ Of ✓ Ridge Strap Connections, if collar ties not used per page 21... (Table 13)...............................T=LD pif Gable Rake Outlooker.................... (Figure 20) ............. ft 5 smaller of 2'or L/2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietay Connectors Uplift................................................(Table 14)..................... ......................U=y/7 lb. Lateral (no. of 16d common nails)...(Table 14).......................................L 71 lb. N Roof Sheathing Type...................................................(per 780 CMR Chapters 58.and 59) ............ Roof Sheathing Thickness.....................................:..... .............................................t�in. >_7/16"WSP ✓ Roof Sheathing Fastening............................................(Table 2)....................:....................................— 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. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a 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. i p '. :��tr, 'Llcynvr�arrncveac(/� 0��;4lltgkiC/Tti[06�d Board of Building Regulatiods and Standards Construction Supervisor License License: CS 98047 L Expiration: 7/15/2011 Tr# 98047 Restriction: 00 KEITH GILMORE PO BOX 17 CENTERVILLE,MA 02632 Commissioner 00-35.000 of enclosed space IA -Masonry only IG- 1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. ✓fze 'C�omvnzaruuea o�✓vCaaaacfui4e�4 License or registration valid for individul use only lugOffice of Consumer Affairs& Business Regulation before the expiration date. if found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration;_ `'134443 10 Park Plaza-Suite 5170 Expiration 10/29/2011 Tr# 800061 Boston,MA 02116 Typ6 'Ltd�Liability Corpor ENTERPRISES,LLC KEITH GILMORE 28 HIDDEN VALLEY RD: / _-J/G —-- — MARSTONS MILLS, MA 02648 Undersecretary Not valid with ut signature Keith C. Gilmore Enterprises, LLC Tr�yosal P.O. Box 17 Centerville MA 02632 O Date Estimate# 9/29/2009 PFE01 Name/Address/Phone Work Address Ron&Susan Pfeiffer Ron&Susan Pfeiffer 784 Franklin Street 143 Saddler Lane Worcester,MA 01604 West Barnstable,MA 02668 Project #I Three Season Room Description *Design and permit to demolish the existing rear deck and construct a new 14'x 14'three season room addition. *The new addition will feature concrete tube footing foundation,enclosed pressure treated lumber frame floor system,wood framed walls and roof system according to the I 1 Ob Wood Frame Construction Manual criteria,Azek PVC exterior trims and step landing,Miabec white cedar shingle siding,Certainteed asphalt roofing to match the existing roof system,three Harvey Building Products white vinyl six lite GBG four unit casement windows,one ThermaTru Smoothstar fiberglass fifteen lite GBG entry door with Schlage lockset and deadbolt,sheetrock walls and ceiling with white pine wainscoting chair rail trims,pre-finished hardwood flooring,electrical outlets and one ceiling fan/light combo,plumbing gas line rough in and finish connection of customer supplied gas fireplace unit and vent supply,finish exterior and interior painting. *This estimate includes all design,permitting,labor,materials,waste and job site management fees. Total Labor& Materials: $41,153.00 Sming.`jm"Xmw 9mpwwment Needo Since 1989! HIC#134443 MA CSL#98047 Customer Approval Phone# Web Site (508)420-9934 www.gilmoreenterprises.net I I *A COPY PAYMENT TERMS The amount or estimated amount of said contract is $41,153.00 Customer agrees to pay the Contractor according to the following terms: /15% To Schedule [$6,172.00] 50% To Order Materials [$20,576.60] 20% At Start of Job [$8,230.60] IGIr 15% At Start of Interior Finish with $1,000.00 Held Back Until Completion 51 75- 1/ Description of payment terms All work will cease under this contract if payments are not made pursuant to the terms described herein. Workmanship issues must be documented by the Customer in writing to the Contractor within fourteen(14)days that Homeowner knew or should have known. There will be no refund for special-order materials and/or any other non-stocked items after three days from approved proposal. The Contractor retains all legal remedies available if the Customer fails to pay including the recording of a mechanic's lien on the property pursuant to M.G.L. 254,§5 to secure the payment of all labor, including construction management and general contractor services and materials, including those furnished by Keith Gilmore Enterprises. Customer guaranties the payment of all sums owed to the Contractor. Customer understands that any debt to Contractor over 30 days past due is subject to a 1%%finance charge per month(APR 18%). Customer agrees to pay all legal fees and costs incurred in the collection of any money owed to Contractor. Customer acknowledges that Keith Gilmore Enterprises has a reasonable expectation of payment from the Customer for any materials furnished by Keith Gilmore Enterprises as part of this project between the Customer and Contractor notwithstanding any payments to or disputes with the Contractor. This Notice of Contract is to be construed and interpreted according to the laws of the Commonwealth of Massachusetts. The undersigned acknowledge that they have read and understood all of the enclosed terms and that their signatures appear freely and voluntarily below: Customer Date lqil ntractor Date Page 2 of 2 Initials / �oT 1Z �v P Z V 0 2�' e-1 c. 3 o A �y yo N6W 2¢xiSiw4 cP / Sw+>uor� OCt K y I.aLrt xiSf�N / ■/ %, 6ARA66 i O aP /U L-cz-T -7 4 ,D JOB # 85-309 CERTIFIED PLOT PLAN PREPARED FOR: LOCATION: L-73 SADDLER LN . BARN . SCALE: 1=40 DATE: /2//(%9- REFERENCE: PB 420 PG 97 LEBEL / SOLLOWS I HEREBY CERTIFY THAT THE BUILDINGS SHOWN ON THIS PLAN -IS LOCATED ON THE i GROUND AS SHOWN HEREON. BUILDINGS CONFORM TO SETBACK REQUIREMENTS �� `H Of OF THE- TOWN WHEN CONSTRUCTED. y •o'c ARNE G� H, = Cj OJALA �+ down cape engineering CIVIL ENGINEERS LAND SURVEYORS ROUTE 6A YARMOUTH MA DATE REG. LAN SURVEYOR of E� TOWN OF BARNSTABLE Permit No. ..?.9 9 8?...... o BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash j. .. dour HYANNIS,MASS.02601 Bond ..... CERTIFICATE OF USE AND OCCUPANCY Issued to S 1 5 2 r u s t Address „C,t t,73, 143 Se,cidler Lano 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. 87 ........................... 19................. ... ................ Building Inspector i 1 ��..� °•yew TOWN OF BARNSTABLE ' = BUILDING DEPARTMENT aaaisr . TOWN OFFICE BUILDING � rua g i611 HYANNIS MASS. 02601 MEMO TO: Town Clerk +� FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #... 9F(' Z` _....._...... .............................................._...._......._...._.......... __...._ ..... _._ issued to�Z ��-...'ejol73 ��3...S,q�¢�Le�._...��•`i� _/� Please release the performance bond. TOWN QF BA*NST�:&BLE, MASSACHUSETTS BUILDING PE DATE 1; 19 (,-t, PERMIT APPLICANT ADDRESS (N 0.) (STREET) (CONT: NUMBER OF PERMIT TO STORY 0 1 DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) "I ZONING A i, IN 0.) (STREET), DISTRICT BETWEEN AND (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WI DE By FT. LOJVY-FT. IN HEIGHT AND SHALL CONFORM IN CCNSTR TO TYPE USE GROUP BASEMENT 4 ALLS OR FOUNDAT.ION (TYPE) REMARKS: AREA OR VOLUME 1 4 PERMIT ESTIMATED COST $ FEE $ (CUBIC/SOUARE FEET) OWNER ADDRESS BUILDING OEP.T. By THIS PERMIT CONVEYS NO RIGHT TO OC PY ANY STREET, ALLEY OR SIDEWALK 'OR A-NY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS'ON' PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET YR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE OEPARTYENT 0 i-PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES 140T RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR APPROVED PLANS MUST BE RETAINED ON JOB AND THIS \'.'HERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK: CARD KE7T POSTED UNTIL FINAL INSrECTION HAS BEEN PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF. OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. Z. PRIOR.TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINA.'-- INSPECTION HAS BEEN MADE. OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET I zyf3UILDINC-INSFc'CTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTR L INSPECTION APPROVALS 2 2 2 h. 'y6ATING INSPECTION APPROVALS G I NEERING DEPARTMENT f olo -OTHER PBOq HEALTH OeW Age& tv L lz� do WORK SHALL.NOT PROCEED UNTIL THE INSPEC- F PERMIT W!LL BECOME NULL AND 'DID IF CONSTRUCTION INSPECTIONS IGDICATED ON%'HIS CARD CAN BE TOR HAS APPROVED THE VARICLUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE i"HE ARRANGED FOR BY TELE'AONE OR-',IVRITTEN CONSTRUCTION. PERMIT :S ISSUEG AS NOTED AROVE, NOTIFICATION. i . w v P i Z N /ti 7� 18`7 53 SFt 0 P 0 / P . J -7 4 D joe # 85-309 CERTIFIED 'PLOT PLAN PREPARED FOR: LOCATION: L-73 SADDLER LN . BARN . SCALE: 1=40 DATE: 9/17/86 REFERENCE: PB 420 PG 97 LEBEL / SOLLOWS I HEREBY CEPTIFY THAT THE BUILDINGS SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. BUILDINGS CONFORM TO SETBACK PEGUIPEMENTS of . OF THE TOWN WHEN CONSTRUCTED. o� ARNE down cape engineering °JW .� CIVIL ENGINEERS e'f� A it LAND SURVEYORS[========PLOUTC 6A YARMOUTH MA DATE PEG. LAN SURVEYOR of �� TOWN OF BARNSTABLE Permit No. .:19a,� ...... ifs BUILDING DEPARTMENT Cash TOWN OFFICE BUILDING ,'.. �Bp,Y HYANNIS,MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to S :j S Trust Address . of 03, ; 43 Sr,(Adlur Lar,o �R-st 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. Fu.,Y�li iU, 19 ��1 .......................... ................. ........ ................... Building Inspector Asses%pr's of*e (1st floor)::' -•/ Assessor's,map and lot number � ...1 `-.P.�V.:T. P c� Q..oF THE to`` Board of Health (3rd floor): - SEPTIC SYSTEM MUS Sewage Permit number ... '.... .(. .. .... ..........................:.... ��1STAI.LED IN COMP � STABLE.� Engineering Department (3rd floor): / 3 � S' WITH�S 'moo ''6 9• e� House number ........................ ............................................... . . ENVIRONMENTAL C= gar p\ APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00'P,M. only TOWN REGULATIONS TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........PMi.1d...1...Me...Story...................................................................... TYPE OF CONSTRUCTION ........W od..Erame..:................................................................................................ ......August......11-19-8.6. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the fgollowing information: �Location Lot. 3........../ ..V/` .4P........to..... I r/...':1.. .................................... ProposedUse Dweli.ing................ .................................................................................................... Zoning District ..... .................................Fire District .......... Name of Owner SLS Trust ,...,,•.................Address .... ......, Name of Builder Lebe1-_So.1.1ows..........................Address ....YZAX14. .S, JVIA................................... ............................... Name of Architect ...Northsid2„Design................ ....Address ....X?. I)1Q.11. YIOX. .r... ............... ...................... Number of Rooms ...5....... ....................................................Foundation ......PQP1r.Q.d...G.QjA9n .t .................:.............. Exierior ..Cedar. Shingles.............................................Roofing ....As.P?ha.lt.................. ............................................. Floors .......3 A...T&G PlywOOd.......................................Interior .....She.et.x'9C.k........................................................ Heating GAs....................................................................Plumbing ........P.V.C..dA.d...C.QPP.ex'....Ba h,5...................... Fireplace .....Ma.SQI?r. ..........................................................Approximate Cost .......6.0.,.0.0.0........................ .... . Definitive Plan Approved by Planning Board ______ o?_� 19 Area ,/�1�7........ Diagram of Lot and Building with Dimensions %% Fee Ci `-- SUBJECT TO APPROVAL OF BOARD OF HEALTH 7 i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barn ble regarding the above construction. Nam '..... ..... ........ ............. Construction Supervisor's License ............:Q.4.3.41.5......... S L S TRUST One Story Permit for .................................... ....Single Family, .................. .... ............................ Location ..LP�t.JtD......!A3.. ..Lane..... ...................W. Barnst ............................... Owner .......8...L..S....Trust.................................. Type of Construction ....FKamp............................ ............................................................................... Plot ............................ Lot ................................ Permit Granted .....September 29,...................................19 86 Date of Inspection ....................................19 Q Date Com leted ...... ..le...... ............19 IZ, 1-7 fr -1 55 Assessor's offi,e (1st floor): / Assessor's}map and lot number;�? ....�-f!.�A�/. .r� Gf .,oF THE rO`* Board of Health (3rd floor): �Q c d Sewage Permit-number ..Q 0 R..............(.. ................................ Z BAHd9TODLE, Engineering Department (3rd floor): � 3 • S" 'off Me& �+ House number ......................... ,o, • APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.,only. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .........Bui.ld 1 .L' Story............. TYPE OF CONSTRUCTION .......?doCad...:Frame........"........................................................................................... " ...................Avgust......11..19..$6.- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a pe1rmmiit accordinng to the following information: J� Location Lot. .......... .. .. 1` .1—.47'.ti.......IO.l,..../..! .�1..'.�7 ? ./go.. ..................................... Proposed Use ........Dwe. ...11in. . q:,............................................................................................................................................... .... .. .. .. ...., ZoningDistrict .R...............................................................Fire District .... :.... .......................................................... Name of Owner ......,SLS I.Trust.......................................Address ....gy„annis.,,...MA................................................... Name of Builder .......Lebel-So0 ..........................Address ....fI �1r111cQS.r.... r................................................. ........................11W S Name of Architect ...Northside.. Design.....................Address ....' armouthport,�.„MA. ........................................ Number of Rooms 5 ..............................Foundation Poured.. Concrete ....... .............................................. Exterior ..Cedar Shingles.............................................Roofing ....Asphalt............................................................. Floors .......3/4 T&G..Plywood.......................................Interior ....Sheet•rock ............................................................ Gas.. Heating ..................................................................................Plumbing .:.Bdth.s...................... Fireplace .....Masonry.............................. ...........................Approximate Cost ....... Definitive Plan Approved by Planning Board ____�1/d�_ 19_ C�, Area /.� 7.....`.....,.............. Diagram of Lot and Building with DimensionsO Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH i 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 04.3415 S L S TRUST A=-1-5-I.---O-CF4'-TOO Ar-1-0 No !29982.... Permit for, ..One Story .................................. ...Single Family..Dwelling.......................... ............�� .................. Location ..Lot. #73, 143 Saddler Lane ...... ....................................................... W. Barnstable ............................................................................... Owner ........ S L S Trust' ............................................................. Type of Construction .......F.ram.e......................... ............................................................................... Plot ............................ Lot.................................. Permit Granted ..........S.Pp.tP-mb.P,.r,..29.,J9 86 Date of Inspection ....................................19 Date Completed .......................................19 610 0 �, -P �/o - 7: . 3x Yr LA N D « hIDP rr I D"SO N�4' lu7f&)) , rr ►r _ s E �'/W NAJ . LO W 46,rf A v E © "P_ a.Xs ►yGy I G"GY " E t� [^ LAOD►N(� 3�n 8 ?fn�P�26r7 JyX ► y �C'OpN( risr O ' q >,,4, '.rT P�S K4 � A?-0 �' A , t� 5oN A,e cd� ,BJb SOD i IN � ,� �` � .� i � LTG f . 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