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Home My WebLink About1039 SERVICE ROAD r Oxforcr NO. 1521/3 ORA M, °pTNE T°� Town of Barnstable Per It 07 �o �3 t Expires 6 mo it/rs from issue.date Regulatory Services Fees O —� BARNSTABLE, 9Q MASS. C Thomas F. Geiler, Director O i639• ATED MX A �, Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.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 _ I ' Property Address __ Q.Y V l �'v v�'�/✓� �y`�/`" �''�`'� — — esidential Value of•Work OD Minimum fee of$25.00 for work under$6000.00 Owner's Name & Address ��e (Vj U . i? 6a,rns Telephone Number Contractor's Name I Ionic Improvement Contractor License# (if applicable) Construction Supervisor's License # (if applicable) ❑Workman's Compensation Insurance X-PRESS M Check one: APR2 2010 am a sole proprietor ❑ 1 atn the Homeowner TOWN OF BARNSTABL� ❑ 1 have Worker's Compensation Ins/uura�nncce Insurance Company Name Workman's Comp. Policy # I I � Copy of Insurance Compliance Certificate must be on file. Permit Request (check box) I of(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro erty?wn,. must sign Property Owner Letter of Permission. A/c py oo e Improvement Contractors License is required. SIGNATURE: i�.'\\I'I II.I:S.fe)RMS\building permit forms\EXPRESS.doe Revised 100608 4 7 l 3. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Pl ase Print Legibly Name(Business/Organization/Individual): Address: �( City/State/Zip: C) mrl . �rl�/l �� Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors ..2:❑ I am a'soleproprietor or partner-' listed on the attached sheet 7. -❑Remodeling ship and have no employees These sub-contractors have 8.'❑Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers'•comp.•insurance comp. insurance.$ qu - 5. 0 We are a corporation and its 10.❑Electricalectrical repairs or additions reired] 3.El I qu a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. rightbf exemption per MGL 12.❑Roof repairs insurance required] t c. 152, §1(4), and we have no employees.[No workers' 13.❑ Other comp.insurance required] •Any applicant that checks box#1 must also fill out the section below showing their workers'corrq3ensation 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 state whether or not those entities have employees. If the sub-contractors have employees,they must providt their workers'comp•policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site • information. r^ Insurance Company Na7me: �/I -- 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 io secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal 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 tray be forwarded to the Office of Investigations of the 14IA for insurance co rage verification. I do hereby certi der the p an penalties of perjury that the information provided above ' true and correct. Si e: 4 JA Date: - — Phone# Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health "2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written_" An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more 7. of the foregoing engag m a)om en rp— use inclube leg -represenmIiiTe�6fiteceasetimpirrye�,oche-___._._ : —:: receiver or tiustee 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 inrmce 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 certificates) 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 gown 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 permitfhcense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all-locations in (city or town),".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that'a valid affidavit is on file for future permits or licenses. A ne*affidavit must be filled out each year.Where a homeowner or citizen is obtainin a license or permit not related fo any business or commercial venture (Le.a dog license or permit to bum 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, telephoae•and fax number: Tht:Commonwealth of MassachUS-C tM Department of Industrial Accidents 4fxce of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext-406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass_gov/dia i Page 1 of 2 David Sawyer Construction 318 Meiggs Backus Rd Sandwich,MA 02563 508.539.1992 a Proposal Submitted To Work Address , Helen Ranta r 1039 Service Rd Po Box 322 West Barnstable,Ma 02668 508.362.3508 Work to be Performed:` House Only: *Strip off roof shingles--Replace with CertainTeed 30 yr AR Architect Shingles *Nail plywood as needed *Clean gutters as needed *Install : White Aluminum Drip Edge Ice& Water Barrier on all edges of roof, cheeks, & chimney Underlayment Paper System Pipe Flange 'Ridge Vent Hurricane nail roof.shingles *Strip two sidewall cheeks on back dormer—Replace with step flashing and white cedar shingles Price for House Only $ 4,975.00 Garage Only *Strip roof shingles—Replace with CertainTeed 30 yr AR Architect Shingles. *Nail plywood as needed *Clean gutters as needed *Install: White Aluminum Drip.Edge Ice and Water Barrier on all edges of roof Underlayment paper System Hurricane nail roof shingles *Clean & Remove all debris from work place and take to landfill *Includes Dump fee and Permit fee Price for Garage Only $ 3,000.00 Material & Labor Total Investment: $ see above for-price Payment due in full at time of job completion. All materials guaranteed to be as specific, and work to be performed as stated above. Work to be completed in a workmanlike manner. Page 2 Of 2 Any alteration or deviation from the work specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Please remove and or secure any fragile household items. Not responsible for broken or damage to household items. 10 Year Labor Warranty/Plus Manufactures Shingle Warranty. . We may withdraw this pro sal if not accepted within 30 days. Respectfully Submitted G Acceptance of Propos The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work..as specified. Payment is due in full at ram. job completion. Date 3 / o SignatuIe-- cam I I I Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 134313 Type: Individual. Expiration: 10/24/2011 Tr# 289550 DAVID SAWYER CONSTRUCTION DAVID SAWYER 318 MEIGGS BACKUS RD. -------_._.__._.___...__.___... _..... .. .. .. . . . .... SANDWICH, MA 02563 ----------------------•----._._ _..___-- ._ .__.._..--._-. Update Address and return card. Mark reason for change. . I Address ;J Renewal - Employment Lost Card S-CA1 0 SOM-04/04-G101216 _ ✓/e i�Jo��amra�rrueall� u�•l�aadrzclu�eCl Office of Consumer Affairs&Business Regulation License or registration valid for individul.use only HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Office of Consumer Affairs and Business Regulation Registration: 134313 10 Park Plaza-Suite 5170 Expiration: 10/24/2011 Tr# 289550 ti.• Boston,MA 02116 Type: Individual DAVID SAWYER CONSTRUCTION J DAVID SAWYER f 318 MEIGGS BACKUS RD.SANDWICH, MA MA 02563 Undersecretary Not valid w' houY 'gnatur ---- �lassachusctis - I)CIM1•tmcnl of Public tiilfct� ry E3oarcd of Buidtlin� Re-mlations :tntl St:uttdartl. ^r E.'rl]JtiG'il �t,ifit"'' iS'E?i' S'13P.Cioltv i_iCE'; 3G License: CS SL 98859 ;=. Restricted to: RF,WS p. r DAVID SAWYER , 318 MEIGGS BACKUS ROAD SANDWICH, MA 02563 f, Expiration: 1/27/2011 FI :mui .i:ncr Tr=: 98859 0 �v � 2 � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � L Mao Parcel 4 Permit# ko fit / filth Divisio �O��PvlU� " 'a-3� Date Issued C jservation Division_ (7T� Application Fee t/ Taz Collector Permit Feed 9/ J 6 Treasurer Planning Dept. . � � ' EXISTING SEPTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO #OF BEDROOMS Historic-OKH Preservation/Hyannis Project StreetwA dress ION 6e rVI C.tP e Villa9 Owner b, XVI E Address () 9W 3aa W, &rhSfubf�. Telephone ��3&D-ga Permit Request W X 13/ gaA YT Square feet: 1 st floor: existing proposed Ib 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type A-101 Lot Size I Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. 1 , Dwelling Type: Single Family Q,' Two Family ❑ Multi-Family(#units) Age of Existing Structure S Historic House: ❑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 o 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: l/Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Cl No I Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:O 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 IWA41W G Tele hone Number Address 111�) `T_0hIc,<o+ OSf— License# u4e o L( Home Improvement Contractor# / UQ 643 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE C? O?OD ` FOR OFFICIAL USE ONLY PERMIT NO. —DATE ISSUED MAP/PARCEL NO. 3 ADDRESS VILLAGE �- OWNER DATE OF INSPECTION: FOUNDATION FRAME /io v a , r ' INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r "DATE CLOSED OUT, � ? ASSOCIATION PLAN NO. " v i _ The Commonwealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 . Workers' Com ensation.Insurance Affidavit-General Businesses yi�• jt Sae43'•. +.d•.: y5,•iSc�. name: ,SC'Y V i C;e. address• IT (� ' ([� ' t ( ��'`)^� (� A # �JV A r"f/ /: 334 7 work site location full address): I am.a sole proprietor and have no one Business Type: []Retail❑RestaurantBar/Batiug'Establishment working in any capacity. Office❑ Sales(mcluding.Rzal Estate,Autos etc.)' [�I am an em toyer with S eta•lo Mull& art time).. Other am an employer providing workers' compensation for my employees working on this job., sddre'ss •� ' _' ' .t,. ..fir '.v:. •t.,,S.' %��.' 'i:. •,,...5//y:•: �.i• �;�� risurance.co5'• i I am a sole proprietor and have hired the independent contractors listed below who have tte following workers' .compensation poli es: companV'a9rii = iC:: •.flnl:7 ; • '.tom. t t�address �.. hdne #. fl 47-77 Y V. i' O i• insurance co. MCNEM //�� 7. Y. coin`eri n 4"e address: � " :'4:+ •t. : • ' ova.t' •i �c;.!t Cllr••• �lr'{; �, •9.`n't�' .i.. t tV.i: ,•.1',. .:4s•r.t:•^ ,f'•',,•4' ••i. insiirarice cb: ii:p• ;iC,•t, t: .}:'ti _ odic: :#> ' Failure to secure coverage as required under Section 25A of MGL 152 can lead 4o the imposition of criminal penalties of a flue up to$1,500.00 and/or one years'imprisonment as well as c1v11 penalties the foim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that it copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. f I do hereby ce ify under the pains and penalties of perjury that the information provided above is f rue and c red Signatu� Date Print name Phone# �%'47�` 33�T official use only do not write in this area to be completed by city or town offlclsi city or town: permittliceme# ❑Building Department c . _ ClUcensing Board ❑-check if tnimediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revaed Sept 9003) r Information and Instructions. Massachusetts Creneral Laws cl�ter�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 express or implied; oral or written. of hire, me n employer is defined as an-individual,°partnership, association,A corporation or other legal entity; or:,anydtwo or,mgre of the foregoing engaged in a•joint enferprise, and including the legal representatives of a deceased employer, or the receiver or partnership, association or other legal entity, employing employees. However the owner of a trustee of an individual, dwelling house having npt'more than three apartments and-who resides therein, or the.occupant:of the dwelling house of another who employs person's.to do.inaiutenanee,•construction-or repair work on such dwelling house or on the grounds or ` building apP urtenant thereto shall not because of such.employment.be deemed to be an employer. .. MGL chapter-152 section i:5,also'staies ht t*.`eve'ry state.gr;bear licensing agency sha l withholdihe issuance or renewal s or io construct buildings m the,commonwealth for any°applicant who has of a license or permit to operate a busines not produced acceptable evidence.of compliance with the insurance cove'rage requir&d Additionally,neither the IL 4 coirimoriwealth not.any'ofits polii7cal 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 • •t Please fill in -the workers'compensation affidavit completely,by checking the box,that applies to.your situation-.-Please supply company'narne, address and phone numbers along with a certificate`of a st4a ice as-all affidavits maybe submitted to the Department of Industrial'Accideuts-for confirmation of insurance coverage., Also'be sureito sign,and date the affidavit. The affidavit should be returned to the city or town that the applkatibn for the permit or license is being requested, not the Depar�offfidmtdd Awidmts. Should you have any questions regarding::the;`law"or if you are ers'.compensation policy,please call the Department at the number'listed below. required to obtain a:work . City or Towns . Please be sure that the affidavit is complete andprinted legibly. The Departrnent 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 01in the perrnit/license number.which will be used as a reference number. The.affidavits may.be:returned to the Department by.inail or FAX.unless other'arrangements have been maO. The Office of Investigations would like to thank you in advance for you cooperation and should you have 6-airy questions, please do not hesitate to give us a'call.- fi F The Department's.address,telephone and fax number: . The Commonwealth Of Massachusetts- Department of Industrial Accidents efffce of leitosUmMons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 oF,tHE rod, Town of Barnstable Regulatory Services IBAMMBLE Thomas F.Geiler,Director 9`bp,E 39. & � 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 I 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. Type of Work: Al-V�ON-\ Estimated Cost '(R!5�6W. Address of Work: 1 0 3cl -!W V 1 L`e Owner's Name:2obeet . g t't'e.l eh Date of Application: i p—a o 0 4 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 i 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: to avl 6a 3`f Da a Contractor Nam Registration No. OR Date Owner's Name Q: n-mhomeaffidav Cti RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 4 .50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE 51� square feet x$96/sq. foot= f y q 7 �e x .0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable). GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf - 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving . $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 SAVERS Workers Compensation and Cc I'l�l'EI:T" Employers Liability Insurance Policy" CASUAITY INSURANCE e Bvld, Suite 500 11880 College COMPANY Information Page g Overland Park, Kansas 66210-1224 Policy Number Renewal Of Policy Period Agency WC0001031 WC0001031 10/15/2003 to 10/15/2004 0000750 Item Named Insured and Address Agent 1. Tim Gray Building & Remodeling, Inc Renaissance Insurance Agency, Inca 15 Tobisset Street 981 Worcester Street Mashpee, MA 02649 Wellesley, MA 02482 FED ID Number: 04-3559727 NCCI Carrier Code No.: 31771 Risk ID No.: 311276 Other workplaces not shown above:'gone Entity: Corporation 2. Policy Period: 10/15/2003 to 10/15/2004 12:01 am standard time at the insured's mailing address. 3A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation law and any occupational disease law of each of the states listed here: MA 3B. Employers Liability Insurance: Part Two of the policy applies to Employers Liability Insurance for work in each state listed in Item 3A. The Limits of Liability are: Bodily Injury by Accident $100,000 Each Employee Bodily Injury by Disease $500,000 Policy Limit Bodily Injury by Disease $100,000 Each Accident 3C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: All states except ND, OH, WA, WV, WY and states designated in Item 3A of the Information Page. 3D. 'This policy includes these endorsements and schedules: See attached schedule. 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All Information below is subject to verification and change by audit. Adjustment of premium shall be made at: Policy Expiration Classification of Operations: See attached schedule Minimum Premium: $500 Expense Constant: $244 Deposit Premium: $3,509 Total Estimated Annual Premium: $11,693 Countersigned 09/29/2003_ By DATE Authorized Agent This Inforration Page with the Workers Compensation and Employers Liability Insurance Policy and Endorsements, if any. issued to form a part thereof, completes the above number policy. I i I, i 0-,itP. of ISSuP, nq/2q/2003 Insurers \f\/(; nn on t11 SV (12198 E t 1 �•��il�� Gcf�� ---_ - • � CIF'/"a� G�c% /�iT'�' --- -- �%'O P�7" t� Envelope Compliance Report Massachusetts Commercial Code COMcheck-EZ Software Version 2.2 Release la Section 1: Project Information Project Information: MR&MRS ROBERT RANTA 1039 SERVICE RD W BARNSTABLE Owner/Agent Information: TIMOTHY GRAY BUILDING&REMODELING,INC Document Author: Telephone: Date: Notes: BATH ROOM ADDITION 12X13 Section 2: General Information Building Location: Barnstable,Massachusetts Climate Zone: 12a Heating Degree Days(base 65 degrees F): 5884 Cooling Degree Days(base 65 degrees F): 606 Building Use Method of Compliance: Whole Building Method Project Description(check on New Construction _ ddition _Alteration Unconditioned Shell(File Affidavit) - Section 3: Requirements Checklist Air Leakage,Component Certification,and Vapor Retarder Requirements Inspection Approved Initial Date (YM) All joints and penetrations are caulked,gasketed, weather-stripped,or otherwise sealed Windows,doors,and skylights certified as meeting leakage requirements Component R-values&U-factors labeled as certified Vapor retarder installed i Climate-Specific Requirements Gross Cavity Cont. Proposed Budget Component Name/Description Area R-Value R-Value U-Factor U-Factor 0 Roof 1:All-Wood Joist/Rafter/Truss 156 30.0 .�@-t— 0.035 0.059 Exterior Wall 1: Wood Frame,Any Spacing 296 13.0 0.091 0.089 Window 1: Vinyl Frame,Triple Pane with Low-E Tinted,shgc 0.40 16 --- --- 0.400(c) 0.592 (b)Basement Wall 1:Solid Concrete or Masonry<=8" Furring None, Wall Ht 4.8 Depth B.G. 4.0 156 --- 0.0 0.735 0.112 Floor 1: All-Wood Joist/Truss 156 19.0 4 - 0.049 0.054 i (a)Budget U-factors are used for software baseline calculations ONLY,and are not code requirements. (b)This component fails a mandatory U-factor/R-value requirement(components that fail are printed in italics). (c)Claimed performance does not exceed defaults in Tables 1301.9.3.1.No manufacturer certification required. Envelope Compliance: UNKNOWN (Insufficient Data) '7 Y ArlIrdt1/4 Section 4: Compliance Statement The proposed envelope design represented in this document is consistent with the building plans, specifications and other calculations submitted with this permit application. The proposed envelope system has been designed to meet the Massachusetts Commercial Code requirements in COMcheck-EZ Version 2.2 Release 1 a. Principal Envelope Designer-Name Signature Date oFtHEfoK, Town of Barnstable Regulatory Services, Thomas F.Geiler,Director q� s6g9 A,� Building Division ATfDy Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 . W".town:b.arnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 rope Owner Complete and SgxiThis Section ;. ._ If Us ing A Builder as Owner of the subject property ctonmybehalf, hereby authorize .J in all matters relative to work authorized by this building permit application for. (Address of Job) a4Qi q Signature of Owner Date Prmt Name /ee '�arivrieo�rzr�ea�Cl a�.iTltrutic�uvelta S~� Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 102634 Expiration: 7/2/2006 Type: Private Corporation TIMOTHY GRAY BUILDING 8 REMODELING Timothy Gray 15 Tobisset Sty Mashpee,MA 02649 Administrator ✓� iJovnirrz77 �✓G�a��tr BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS O46234 Bi rthdate: 11/30/1959 Expires: 11/30/2006 Tr. no: 3286.0 Restricted: 1 G TIMOTHY GRAY 15 TOBISSET ST G- 4 MASHPEE, MA 02649 41� Commissioner FLOOR PLAN �J 1039 SERVICE ROAD Robert and Helen Ranta's existing house (Note—Note to scale) First Floor C �C w_ BEDROOM#1 FAMILY ROOM KITCHEN o Bathroom PORCH {! R ----------------------------------------------- Lljj! FAMILYROOM]�, DINING ROOM Q 0 T rf ` FLOOR PLAN 1039 SERVICE ROAD Robert and Helen Ranta's existing house (Note—Note to scale) 0 Second Floor 4 Bathroom i /n Unfinished Attic BEDROOM 03 BEDROOM tit i I 1 I 10 1 I T A mnn 1° 1®lOPE7°NG j I --------------- - --------------- I g� < I IT 1 �I 1 •\ AA 1 •.I u �8 �I •.1 �� 1''I O {9f p l•' I ggii I I W OL 1'� I (idov� I•. I 1 I 11 (� s 1•� � `7ni s k �P rn 70 A N 0 a p1 to 3 ;u m(AP EXt57 O N A A so �/ D n Z r m D /\ m 3D n C X D a $ —be"e. e 9a e R17 Z 1.•6'0' i'o b'o• � � LHrr d lei v ____==_==NG -- ---- -_ LO let IMAA h I1 i u s jr L5 ------------------ I � 8 IlII I S I � I � I e • spa ' a L ao 6g m F1 A q lA a �p I € a lip o --- • p D i o >r -D a r t� 66e S S11 F, r�i1 w� D D Assessor's office (1st floor): THE Assessor's map and lot number ..:` i2g 3 L °i o♦ Board of Health (3rd floor): , Sewage Permit number ....... .rrt.'... -. r.�S .............. Z BALSST&BLL, Engineering Department (3rd floor): �o rasa House number ... 14 z6 .. . . . . � o +b3a ........................... ..................... C MA-1 Definitive Plan Approved by Planning Board ----_---------------------------19-------- . 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 �..... TYPE OF CONSTRUCTION ....................................................................................................................... ........................p.......... h........19..6.:'..: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following /information: Location ............: .`.-.................... .......`.............`......... ................................." .... .......... .......... ...................................... ProposedUse ............. ......�... ............................................................................................................................................. Zoning District �h .........................................................Fire District 4�. ........... .. A Name of Owner ...� 1>�.�:..7....1......t f ... ..`... ............Address ...... .`... ........ �..:..:.....: ... i......` °............ Name of Builders. ..... >r .......: . ....'... i. " z :..?..Address 9f d. ,� �,; o., . ... .. s ... . ............. . ................. ............ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .....................:............................................Foundation .............................................::......... �...:.`..:'.:�:..::.•. ; Exl "iOr .......... ..... ,%:.................:.:............. °..... ..... fi ....... i i f Floors .............. ...'...................................................................Interior .................................................................................... Heating ............... ..................................................................Plumbing .............................:................................................... Fireplace .. .. .....................................................Approximate Cost .......... :.::: ..... . . > Area ....... ................:.:........ .. Diagram of Lot and Building with Dimensions Fee .-...............o................ 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 ... a�'.�..t................... RANTA, ROBERT E. A=129-002 ' No. 3 2 Q55 permit for ...Build„Garage ........A�ce. sorY..to,.Dwell.in9.. ....... i,eq Location ... ............ .................W..est..Barnstable....................... Owner ..ROb.�x.t...E.�.:..Banta......................... Type of Construction :...Frame ................................................ .............................. Plot ............................ Lot ................................ Permit Gran!ed ...... ................19 88 Date of Inspection ....................................19 Date Completed .... ........:........................19 e Assessor's office (1st floor);F SEWSM MUST Be As ssor's map and lot number .. i...( ....... .# .b '�„ 4�+OIMPA.s� N'p;E ti 1:r 4 4;) of Health (3rd floor): �• �+�'. �'I�"LfC 5 age Permit number ......&zn..2 .g .. ,. C pp �'3'b`'b' iti.I`N 6 AL CODE AND Z BaaMAS& Engineering Department (3rd floor): TOWN REGULATIONS '°o,o�r63q• House number" .......................:... .. d.3... ........................ 0 MAX Definitive Plan;Approved by Planning BogrffC------------------------------19-------- . 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 � `��. ......... /� e ..... ��•�c ..,..,. .... �. TYPE OF CONSTRUCTION .........................r7.b......... mot ?e................................................................... I ..............� �...:.....: TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ............ .........0 ........ ......& ......................c!la!? t1 !a .2..�'.......................... Proposed Use .............1_J/9 h ' ........................:..............:. L 1 Zoning District . ...................:.....................................fire District i h�Cf!��/ L� ..................... . .... . ..... ..... . Name of-Owner ............Address ...... Name of Builder�1? !ZP.S....1 !... �� ..��MoI� Address .... Lf...... �?`t/. ��hS. �..... y�� Name of Architect .......... — .Address -"-'�-- Number of Rooms ..................................................................Foundation .e !lclz. ..... l ../� .lC.. ....rd.a.. l . Exterior .....��i.� .... 2Q�i9%..:.'��?.i�til`�- .:..............Roofing ....... 5 �'1�'/f .............................................. Floors 4 ................ Interior Heating ....................................................Plumbing .......... ., Fireplace ...........Approximate'Cost ........... .��6.<DI Area ........��. y....5 .'.! ..- Diagram of Lot and Building with Dimensions Fee �v r- A .............................................. 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 ('/ ?i�3?.... �'�v ` GeeC�� .. ...................................... Construction Supervisor's License ..® ��..7 RANTA, ROBERT E. i No .:;.-...5.5:.. Permit for ....Build........r.age. Accessory to �DWe In Location .. "3........................ ............d........... West Barnstable ............................................................................... Owner .....Robert E. Ranta Type of Construction ........Frame ........... ................ Plot ..................:..:....... Lot ................................ r' a Permit Gtonted July 8 19 88 ............................... `Date of Inspection ................. ..............19 bate Completed ...:..........,::.. lq T C WT fir { . i 'j < •r ;1► s # 1 Aft ...< -.........ter ' y> , Trc •r J ,,r � t �t � Fwv, .. � i n0,�.• U �'Sg43�� > /�• �,° •h f°a � - 84 _ .. • F •• . 't �� "' T- :f S Fa .;�� :►,�1i •.STx. 56,Y 'x.. bA. 01 .: 0 �.r�. 9a ` -.: �' . '- �I • � pti' ( t.z► ,��. � �� J �� .fib *Y K. 5 4= ' t �,,, to �`C3 41 IL at r1o�--- �. ~.QR'\i..t.. j a �� / in J " .:h� h'1 ti• _ •~� \ 19 MU�/�// Hor.et gE- To Tam A± 01 .••' , . '!',�-/ r Z.q 1 PYc- tart_. C• 9 .. � �. �' . . = oaf '�•'� y`�$ � ,' ..':�' ��,,"�' Tk: s-� , L;U / � 1�� r � � ji ' .; _ ` „ . err; ��. Y.��.��' o �Tk• Sl!�j-.. ..� ` ` gyp.Zl # p c. 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