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Home My WebLink About1065 SERVICE ROAD /�!�S �ev►/,�ee_ boa c/ t� I i j a� i �i i � 1 /m I UPC 12543 No. 53LOR p�ST•CONSJ� HASTINGS, MN r i a i r e P K a n n • I c C i G w ��P � � 1 �� _. 2 �00 jo-- 0 -be n 7Dn l (( n (fr i U-e OCI Luke.0 cL A-" � a n nn c�,+,dla S �2 e� �82xc-eOl e- DA-..-,-A-f c c �A 1� f 01�-s cv� �►-.4 c�ecQ i�� r e vL �- r Sk 2 4- -C- C'o . nn 2 e �(4P 3 y J { .y 1� �7q ,VS j Z i 1 a a s a y R 3 i Town of Barnstable RECEIPT. w 200 Main Street, Hyannis MA 02601 508-862-4038 .�� C y o Application for Building Permit PP g h : z Application No: TB-17-171 Date Recieved: 1/23/2017 p Job Location: 1065 SERVICE ROAD,WEST BARNSTABLE - kn Permit For: Building-Solar Panel-Residential tv w r Contractor's Name: JOSEPH M WYLDCHIRICO State Lic. No: CS-093115 u' Address: Seekonk, MA 02771 Applicant Phone: (401) 574-6684 (Home)Owner's Name: TAVANO,RICHARD J& KIRSTEN L Phone: (508)280-0026 (Home)Owner's Address: 1065 SERVICE RD; WEST BARNSTABLE,MA 02668 Work Description: Installing 36 PV solar panels on roof. Total Value Of Work To Be Performed: $36,000.00 `. Structure Size: 0.00 0.00 0.00 Width Depth Total Area I hereby swear and attest that I will'require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued, it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true'and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Joseph Wyld-Chirico 1/23/2017 (401)574-6684 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $36,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $233.60 ...._.................................._.................................................................................................................................................................................................................................................................................. Total Permit Fee Paid: $0.00 ` ►.� Town of Barnstable Building Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 1639. Posted Until Final Inspection Has Been Made. Permit ► 'Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-17-171 Applicant Name: Joseph Wyld-Chirico Approvals Date Issued: 01/27/2017 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 07/27/2017 Foundation: Location: 1065 SERVICE ROAD,WEST BARNSTABLE _Map/Lot: 153-037 - Zoning District: RF Sheathing: i Owner on Record: TAVANO, RICHARD J&KIRSTEN L Contractor Name: JOSEPH M WYLDCHIRICO Framing: 1 Address: 1065 SERVICE RD Contractor License:`,CS-093115 2 WEST BARNSTABLE,MA 02668 ' Est. Project Cost: $36,000.00 Chimney: Description: Installing 36 PV solar panels on roof. 10.26K1N Permit Fee: $233.60 Insulation: Project Review Req: Installing 36 PV solar panels on roof. 10.26KW Fee Paid: $233.60 i Final: Date: ; 1/27/2017 Plumbing/Gas Rough Plumbing: BuildingOfficial Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:! 1.Foundation or Footing Rough: 2.Sheathing Inspection _ .___--- 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT . .Commonwealth of Massachusetts Sheet Metal Permit Map Parcel Date: X-PRESS PERMIT Permit gz�b4� oc;? Estimated Job Cost: $ APR 2 9 2015 Permit Fee: $ &.6 -1 Plans Submitted: YES NOT..OWN OF BARNSfttgeviewed: YES NO Business License# Applicant License# (`Q �3 Business Information: Property Owner/Job Location Information: Name: C��p eCtk \r Name: Street: O Street: �C�V City/Town: \� )C�C ��\� Cityfrown:CY,54 eS� Telephone: SO� —a �'6 0 " 00 _I Telephone: Photo I.D. required/Copy of Photo I.D. attached: YES,v- NO Staff In''al J-1 /unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less j Residential: 1-2 family ✓ Multi-family Condo/Townhouses Other Commercial: Office Retail Industrial Educational i E Fire Dept. Approval Institutional_ Other Square Footage: under 10,000 sq. ft.J- over 10,000 sq. ft. Number of Stories: Sheet metal work to be completed: New Work: ✓ Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: I i . i • 1 INSURANCE COVERAGE: I have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch.112 Yes Q/NO ❑ M 1 If you have checked Y 1 indicate the type of coverage by checking the appropriate box below: A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. 9 Check One Only a a )�alOwner ET"— Agent ❑ i Signa of Owner or Owner's Agent By checking this box❑,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be 0 in compliance with all pertinent.provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress InsRecfions u - _ Date Comments Final Insynection Date Comments I Type of License: 3y el-Master rrtle ❑ Master-Restricted :ity/Town ❑Joumeyperson Signature of Licensee permit# ❑Joumeyperson-Restricted License Number. =ee$ ❑ Check at www.mass.aovldnf . l nspector Signature of Permit Approval I i ASSIGNED RISK SERVICES r.u.tsox otn4s,minneapotls,minnesoia o_v►oy-v v4a Phone(605)945-2144 Fax(866)215-8118 Toll Free(800)634-4589 www.berkleyassignedrisk.com policyservices@berkleydsk.com INFORMATION PAGE enewal Of No. WC-20-20-004598-01 �. The Insured: Normal AIR Policy Number:WC-20-20-004598-02 Risk ID:0066006 Richard Tavano 1065 Service Rd Tax ID#: S XXX-XX-8286 West Barnstable,MA 02668 Date of Mailing: 3/12/2015 X�Individual Partnership ❑Corporation Other ether workplaces not shown above: See Schedule 2.The policy period is from 12:01 a.m.3/19/2015 to 12:01 a.m.3/19/2016 at the insured's mailing address. 3.A.Workers'Compensation Insurance:Part One of the policy applies to the Workers'Compensation Law of the states listed here: MA B.Employers Liability Insurance:Part Two of the policy applies to work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury By Accident $100,000 each accident. Bodily Injury By Disease $500,000 policy limit. Bodily Injury By Disease $100,000 each employee. C.Other States Insurance:Part Three of the policy applies to the states,if any,listed here: - COVERAGE REPLACED BY ENDORSEMENT WC 20-03-06 (B) D.This policy includes these endorsements and schedules: VC000308 WC000403 WC000404 WC000414 WC000421D WC000422B WC200301 WC200302A WC200303D WC200306B WC200307 VC200401 WC200403 VVC200405 WC200601A WC200604 WC990001A WC990601 4.The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS RATES ENTRIES IN THIS ITEM,EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED ESTIMATED TOTAL PER$100 OF CODE ELSEWHERE IN THIS CONTRACT,DO NOT MODIFY ANY OF ANNUAL ANNUAL REMUNERATION REMUNERATION NO. THE OTHER PROVISIONS OF THIS POLICY.- PREMIUM Manual Premium $0.00 .See Schedule ubject Premium $0.00 Merit Rating 0.95 $0.00 Minimum Premium: $486.00 Modified Premium $0.00 Standard Premium $0.00 Loss Constant $50.00 Expense Constant $159.00 Terrorism 0.03 $0.00' Minimum Premium Adjustment $277.00 Total Estimated Annual Premium $486.00 Agency Name and Address DIA Assessment 1.058 $0.00 Fair Insurance Agency Inc Total Fees&Premium $486.00 619 Main ST 7 Net Deposit Premium Required $486.00 Centerville,MA 02632 Premium Paid to Date ($486.00) Total Premium Due $0.00 )ATE: 3/12/2015 Signature_ dudes copyright material of the National Council on Compensation Insurance used with its permission. WC 99-00-01 1983 A 1991 National Council Compensation Insurance The Commonwealth of Massachusetts Department of In6strial Accidents Office oflnvestigations 600 Washington Street Boston,MA 02111 UV. www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual):j C—Y Q V -tour C) , U _G* s� • ' A o Address: 1 l7( o S -e City/State/Zip:juj1.,\,�at J Phone.#: L Are you an employer?Check the appropriate box: -Type of project(required):: 1.❑ I am a employer with 4• ❑ I am a general contractor and I ployees(full and/or part-time).•, have hired the sub-contractors 6. New construction . 2.VI 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 me in any capacity.acitY• employees and have workers' a. 9. ❑Buiidmg addition [No workers' comp.;ncrrran� comp.insurance.* required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions '3.❑ I am a homeowner doing all work officers have exercised their I1.❑Phmtbing repairs or additions ' myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no - employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that chr..ks box#1 rmst also fill out the section below showing tlmir workers'compensation policy information. t Homeowncts who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. 4`the sub-contractors have en=loyees,they must provide their wmi='comp.policy nrmnbc. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: C3,ec \C l`Q Policy#or Self-ins.Lic.rU-)G a O a 6 W Expiration Date: I _ Job Site Address: CtV City/State/Zip: lJS �V _Attach a copy of the workers'compensation policy declaration page'6howing 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 tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investieations of the DIA for insurance coveraae verification. I ilo hereby ce under the -and penalties of perjury that the information provided above is true and correct Si afar . , Date: Phone ire: Offcial use only. Do not write in this area,to be completed by city or town offu:iaL City or Town: Permit/License# .Issuing Authority(circle one): l A.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector i 6. Other Contact Person: Phone#: I Town of Barnstable Regulatory Sen ices E& Thomas F.Geiler,Director s yea' , +p Building Division Tom Ferry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ' I Property Owner Must Complete and Sign This Section If UsinL A Builder j� -,as Owner of the subproperty '' II 1 hereby authorize 1 C\! a\_L�u -&Ci -\K CL i (' to act on my behalf, in all•matters relative to work authorized by this building permit. D " _1 4� S__� - (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. tli'bature of Owner S tore plicant iLs` a ' � C�I_vd Print Name Print Name Date Q:FORM&O WNERPERMISSIONPOOLS f RICHARD J TAVANO (SM) 1065 SERVICE RD W BARNSTABLE MA 02668-1849 �.'!� Fold,Then Detach Along All Perforations ...._................. ................... . .................... .._.................. ..................... ... .................. _ . ........ _ _ > :<GOMMONWEALTH OF MASUeHUSFan,'`>J ,..BOARE OF SHEETi METAL W;ORKZ.DS: ' SS.UES.JtTHE FOLLOWf`W I CENS€"' A"`MAST.E;R-UNRESFTR.hC7ED,,'> p > R>1CARD J TAVANO' a �.. Z i >4�t``BARNS :A$L.E€>'=<::MA 026 9 :....6� 34815 9 ............ ................................. ........................._... . .................... i Town of Barnstable Regulatory Services BARNSTABL& �. MASS g Thomas F. Geiler, Director 1639. Building Division Thomas Perry, CBO, Building Commissioner 200 Main Street, .Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 March 12, 2007 Rick & Kirsten Tavano 1065 Service Road W. Barnstable, MA 02668 Dear Mr. & Mrs. Tavano: Please complete and return the enclosed annual family apartment affidavit. Sincerely, Lois Barry Division Assistant Enclosure faco Town. of Barnstable Building Department - 200 Main Street BARNSTABLE, # Hyannis, MA 02601 MASS. (5Q 1639• 862-4038 9Qj Arfo�°' Certificate of Occupancy Application Number: 86911 CO Number: 20070044 Parcel ID: 153037 CO Issue Date: 03108107 Location: 1065 SERVICE ROAD Zoning Classification: RESIDENCE F DISTRICT Proposed Use: SINGLE FAMILY HOME Village: WEST BARNSTABLE Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: FAMILY APARTMENT FOR SALLY LUCAS Building Department(44ture Date Signed .—To OF BARNSTABLE ; BUILDING PERMIT PARCEL ID 153 037 GEOBASE ID r ADDRESS 1065 SERVICE RD. PHONE i WEST BARNSTABLE ZIP LOT 2 BLOCX LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 86911 DESCRIPTION FAMILY APARTMENT ABOVE GARAGE;5' OPEN. IN H ° PERMIT TYPE BFAM TITLE FAMILY APARTMENT CONTRACTORS: PROPERTY OWNER �E�w 1T #a Dep artment of ARCHITECTS: S- 4 Regulatory Services TOTAL FEES: $253.88 /Z G=/4Rw�E BOND $.00 CONSTRUCTION COSTS $49,728.00 " FAMILY APARTMENT AFF. 1 PRIVATE t ,, Q• . anRtvsrnB�, • 039. FO MA'S A BUILDING DIVISION BY DATE ISSUED 09/15/2005 EXPIRATION DATE ' - TOWN OF BAUSTABLE `BU"_ILDING PERMIT e PARCEL ID 153 037 GEOBASE ID ADDRESS— ` 1065 SERVICE RD. PHONE WEST BARNSTABLE ZIP )LOT 2 BLOCK LOT SIZE DFA DEVELOP MENT DISTRICT °', PERMIT 88911 DESCRIPTION FAMILY APARTMENT ABOVE-GARAGE;5' OPEN- ,IN H PERMIT TYPE. BFAM TITLE FAMILY APARTMENT CONTRACTORS: PROPERTY OWNER PER W ,r � Department of -ARCHITECTS: , p a'a -4 1 Regulatory Services TOTAL FEES: $253.88 BOND $.00 �=a d� 6-0 9 0 GE CONSTRUCTION COSTS $49,728.00 j FAMILY APARTMENT AFF. 1 PRIVATE I OI".. * BAMSrABM • MASS. 039. i0rF0 BUILD NG DIVISION l� ,-: DATE ISSUED 09/15/2005 EXPIRATION DAlt Y 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 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU FOR - ELECTRICAL,PLUMBING AND M FOR (READY TO LATH). PANCY IS REQUIRED, SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. CH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. 41 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS R 6 1 1 o 6/0 62) 1 / 2 2 2 AO 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT @ �J \p 2 � BOA O H H OTHER: SITE PLAN REVIEW APPROVAL o ` 5,0 WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE 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. e �� f� .:��.' >9 e ty, � sl f�. %'� '�i i `7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 4 Parcel Permit# ?1 1 `'Health Division �' . � � � � g � Date Issued 'nl Conservation Division .� y Application Fee Tax Collector �, . 4 �O Permit Fee Treasurer % U14 Planning Dept. C�iS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis u1 �,. Project Street Address S �� l� ��• _ Village ' �` Owner ✓/440 Address 51407 6F Telephone Permit Request 1/ Q J (A,V,.e D A coo on A-D-r4 4 :rcm_ ()i'r Square feet: 1 st floor: existing /00 0proposed�_ 2nd floor: existing@ proposed 0 Total new 7 Zoning District Flood Plain Groundwater Overlay Project Valuation 000,,000 Construction Type Lot Size 2 . 3 0Q_1AfCS Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. 7' Dwelling Type: Single Family &/Two Family ❑ Multi-Family(# units) Age of Existing Structure " Historic House: ❑Yes I< On Old King's Highway: ❑Yes 5f o Basement Type: ❑Full ❑Crawl ®'Walkout ❑Other Basement Finished Area(sq.ft.) C) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing O new at Number of Bedrooms: existing new Total Room Count(not including baths): existing new 2— First Floor Room Count Heat Type an7es ❑Gas zal ❑ Electric ❑Other Central Air: ❑ No Fireplaces: Existing Newer_ Existing wood/coal stove: &Ies ❑No Detached garage:❑existing ❑nn w size Pool: existing ❑new size X3 Q Barn:❑existing ❑new size, Attached garage:❑existing f new size Z�ZA Shed:❑existin9 ❑new size Other: Zoning Board of Appeals Aut rization Ell Appeal# Recorded❑ Commercial ❑Yes o If yes,site plan review# - - Current Use Proposed Use BUILDER INFORMATION Name 1 & T F AQ_Telephone Number GV K' Address 0 (n ��P tin. Cam. �rD License# S:�CAL6l,e M)�= _ Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO X2F_ SIGNATURE DATE J FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED "t MAP/PARCEL NO. ADDRESS' = VILLAGE t 1 OWNER DATE OF INSPECTION: FOUNDATION FRAME 9 INSULATION FIREPLACE ELECTRICA kaSIS GU H FINAL ®O i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING .../ (� DATE CLOSED OUT f ASSOCIATION PLAN NO. \,S Elk 20260 Ps9259 Town of Barnsfithl CF1NE 1p� 15-2005 a 12 0 19g3� Regulatory Services sAxs7aa Thomas F.Geiler,Director v Mass: � q,,, s639• �� Building Division lE0 MA'S A - Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 1065 SERVICE ROAD in WEST BARNSTABLE, MA, holding title under a deed recorded wit the Barnstable County Registry of Deeds or Barnstable County District Registry of the Land Court in Book, Page 3 , or as Document No. being shown on Assessors' Map 153 as Parcel 037, hereby agree, certify, warrant and represent to the Town of Barnstable that'the accessory attached apartment,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. The intended and authorized use is for SALLY LUCAS, MOTHER/MOTHER-IN-LAW OF THE OWNERS KIRSTEN& RICK TAVANO associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit shall not be rented as an apartment or as a single room,or in any fashion, which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building (� department. This agreement shall be updated whenever a change occurs or every calendar year. � This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this ; � day of SQ j2 F 200 TOWN OF BARNSTABLE OW R(S) By: �J4,0 - - (2,,-) 7111 uilding ommissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date` Then personally appeared the above-named (owner), • Ceo(anC-3 QY1 nr( .1 'k:s.vkw}.ro9u made oath as to the truth of the foregoing instrument, before me. Notary Public ,� • ��. :3�A L ; �� o mission Expire S i`iL A. i n ;ter° BARNSTABLE Notery IUolic REGISTRY OF gEEDSTTEST Commonwaalth a''v4ssachilstitts " A TRUE COPY, n My Comr!ss1c'1 spires SeptamDai 2-.2005 d®MN F,MEADE REGISTER - ' F Q:word/accessoryagreement ; BARNSTABLE REGISTRY OF DEEDS The Commonwealth of Massachusetts Department of IndustriaFAccidents 600'Washington Street • 'Boston,Mass. .02111 Workers' Com ensation.Insurance Affidavit-General Businesses 8ddre3S' (Yli l , cJ I \ 0' 1 �(' iN.� f�,aiQ�••I�S`�3�� State•• ' I'}'1� ap' r��e#��) ��=%��'. work 'e ovation Wi address am.a sole proprietor and have no one Business Type: 0 Retail Restaurant%Bai/Ealing EstabIishmeat working in any capacity. ❑Office[] Sales(including Real•Estate,Autos etc.)' ❑I am an emlioloyff with 'ens to ees(full&' art time: ' Other �I am an employer providing:workers' compensation for my employees working on this job. �:; f; 'f:t' ..k.U?J. . •• }• .gyp. .i{�..' , �t•-�1.1•Y: •�J�t'�:`:i'i. . 1• eoriipenV•n met i..: "7:. ,i ��• :},'r ' �i fir' :•�.. Y, •r•', .. �j': t. ..+ `q; ;�:�.�;S,:cj..F;,t:.' .5::.. _ , •a•. 1:}•t:'i�i, c:: '• _ i�>>�. ',•�i. Bd�Te9S` �'�I• :5� .,:...: +.i:.:: c..,.. :f.::::i;:i".•• -+'i:ro.::•.t.:�� •t'^r;.:.r• f. . '1 Y% .-.t•:•.vi. _ 1'•"' 1.ylti.�•,' ,•i. :, .'1:.... ..t�i.�•i•i?i - ''�� •'ti' _ - •,1'• �•t'i 4: �'t� ':a. ''xS„••1S,S::%•,l•�i•.' ;' ..a• .'. C:•S• ''Y�•'1 il.`. ~�'.'� ... .'usifr tohc. ,#'' I am a sole proprietor and have hired the independent contractors listed below who have the following workers' ,compensation polices: :.:w:r::. '' :t:•�'.�=:5^•: ':�' to-• •�,' •1•: _a� ,•}:' S�'��' �Y{1! �'I�i!`x t.`,:f�,.i:`,p.. , v. .. 7 '. Zi i:::,t,;.J•.'a•' :ih if "M1 i�' . 'rr;.:.�,. :;i,;'.. t ;.i.•]::•`:•:'' .. eddse3S:. `•' •.1• :=<.:c;C: .`s•r.�::.+:, 'y. •} 1 `•_ 1!� :!i.'..r.•�S'•"•:•. �'..:_::':. < .:1:•': ..1 •p:n'. ;.� .••: ,.� �.*."uqo, �••' •.y+t.:a1 t... :^',r•.':•::; t:.,•.. .:5'Z,i?•'�•:',::. iusurence:co. p ''•4,. ''� ) y.. 1.• ...,. .t•:•�+: e'b.! ,ti: :ft'• :o•:.. .!':..• : r•O�C #r .r.fi`::.•t:.:•A'•.i:•� '� •'�i.:i P. Ca+ ":*: may:': <' ,�'. �• `to-. °'�� co `•!'. Y.. ':.C:: •,'l•::,`•. �'.0 .Y ...tI:•:. '+'� r� v. ��f.Jl:4:•! .•i.r' . iapeiiyas�aTea '•;C.•'n:' .,?'••..•i.�:,..'i, ••'a, .9.:�:^.!'1.•!. ..t>.`_•" "o'=! •.��'.•c. ' address: f. ci�y�t. ... .., .. ,::'� hone#� =:,•. '�..:•�`i�� . . . }4:•':' •`•�':��- ,:�•:;.::•. �•... ..1:.,_ •:•.r i::.. t'4: ,'z. �.5,''?'i':7; '•i• li;, V.c�i: .. �••' :y"•:,t.: .. ... �.t„4� •a• insuraneeao: +°:•::. 7 :... y... :.`.:%.:;h !.; o�1C: Failure to secure coverage as required pder Section 25A of MGL 152 can lead to the imposition of criminal penalties of sAue up to$1,500.00 and/or one years'imprisonment as well as c penalties in the foim of a STOP WORT';ORDER and a fine of$100.00 a day against me. I understand that p copy of this statement ma be r ed to Office of Invettigatiom of the DIA for coverage verification. I do hereby ee fy u d in d penalties of perjury that the information provided above is true an correc4 Signature Date Print name Phone'# ��J x — official use only . do not write in this area to be completed by city or town ofile city or town: __ permit/license# []Building Department ❑Licensing Board -check if immediate response is required ❑selectmen's Office ❑Health Departmeni contact person: - phone#; ❑Other (mvaed Sept 2CO3)• ` Information and Instructions• Massachusetts General Laws:chaapter 152 section 25:requires all emgloyers.to provide workers'•compensation for their.. employees:' As quoted from.the `law' an employee is.defined as every person in the service of another under any contract of hire; express or implied; oral or written. An employer is defined as an individual,partnership, association,'corporation or other legal entity, or any two or mgre'cf the foregoing engaged-in a joint enferprise, 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'tnore than three apartments and-who resides therein, or the.occupant of the.dwelling house of.: another who.employs persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment.be deemed to be an employer. .., MGL chapter 152 section 25 also'staies that"eve*ry. 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.cbmmonwealth for any applicant who has not produced acceptable evidence of�compliance with the insurance coverage required Additionally,neither the '. coixnmonwealth nor.any.of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with tie insurance requirements of this chapter have been presented to the contracting . authority. �%x//////l///%//��%%//////%/%j%////%%%////O/%%/%/O%%/%%O//////%��///%G///////°%%//////////%%%%i�///%///%%%%/�//////�%///%�%/��%%%///�Oi Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also:be sure to sign and date the affidavit The affidavit should.be returned to the city or town that the application for the permit or-license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a;workers.'-coinpensationpolicy,please call the:Department at the dumber listcd:below. City or Towns . Please be sure that the affidavit is complete andprinted 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 fifl;in the permit/license number Which will be used as a reference number. The.affidayits may.be:returned to the Department bY.mail or FAX unless other'arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and shouldyou have an'y questions, please do not hesitate to give us a-mll.: . - z The Department's:address,telephone and fax number: . The Commonwealth Of Massachusetts Department of Industrial Accidents WIN of Wdesdgwens 600 Washington Street Boston,Ma. 02111 fax M (617) 727-7749 I phone#: (617) 7274900 ext:'406 Town of Barnstable Regulatory Services $ Thomas F.Geiler,Director H rs, 16g9• a`�� Building Division rED MA'S Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permituo. Date AFFIDAVIT HOME LVVROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL C. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied betiding containing at least one but not more than four dwelling twits or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other regnisements. D 1 Type of Work: �v� Es ted Cost d vo �/ 9D Address of Work: 1L Q2 � e � ��c . Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): DWork excluded by-law ❑7obUn $1,000 ❑B ' not owner-occupied er pulling own permit Notice is hereby given that: • OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICAB PROOME IMPROVEMtNTWORKDO NOT HA GRAM OR GUARANTY FUND UNDERMGLjf cC..142A. ACCESS TO THE ARBITRATION SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date act Name Registration No. D er's Name Q:fatms:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE , New Buildings $100.00 w Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET L NEW LIMGSPACE J Z x.0041= Zo9 square feet x$96/sq.foot= v plus frombelow(if applicable) pl,Tg,RATIONS/RENOVATIONS OF WaSlING SPACE square feet x$64/sq.foot= x.0041= plus'from below(if applicable) GAgAGES(attached&detached) / z s x.0041 quare feet x$32/sq.ft._ = ' ACCESSORY$TRUCTURE>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 5 } Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 f 1 f r S r Town of Barnstable OFSHE 1p�� Regulatory, Services snnrvszn>ar>r Thomas F.Geiler,Director, ' ASS ti3q. �' Building Division s ♦0 p�EO MP'lA Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 a Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print �/ DATE: �S � 10 10� JOB LOCATION:�t� `)�C 7 f:� 1 I e r ► 1 �'�_ umber street— village ^L "HOMFAwNER":� name `` -- home phone# work phone# CURRENT MAHJNG ADDRESS: city/town tate 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 submifio 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 inspe on procedures and requirements and that he/she will comply with said procedures and re emen . Signa re of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This ladk of awareness often results in serious problems,particularly when the homeowner hues unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt SMOKE DETECTORS REVIEWED I BARNSTABLE BUILDING DEPT. DATE I� • FIRE DEPARTMENT . DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITT K-7 011 * 0 o N, Fr—)!i c�i • \ A 4 • •I M� 4 i • - • �-�' .oaf a, 41w Alt — • I • ♦ — t _ - i .......... i r • - awL:m Note. 26' PLANS AND . - - - - - - SECTION r - - - - - - - - - - - - - -� 2Xd KNEE WALL 15 I CONCRETEFOCITING fiflOUtlfED 8N+'NA7lIRES Date I II .A A I CONCRETE SLAB SLAB COMPACT FILL FOR SLAB /d BEDROOM 26 Ile II KITCHEN B M ®® LIVING ROOM . O � 10, B' 5�21• 2ND FLOOR PLAN " FOUNDATION PLAN SCALE:1/a°=1'-O' SCALE:1/a•-V-O• j APPLYICEAND WATER CONTNVOV5 BARRIERTOVY PLYVRIOD 12 RIDGEVEIJTTYP. MOATOASPHN.TSNINGLE �3 ' ' INSTALLATION 28' B• 12' ... 2 6016.O.0 13 COLLARTIETYP. �10 - ' 2AO RAFTER ASPHALT POOi 41116'O.C. 5HINGM CIVP) 3/4-OSBTONGVE (p Joe. . ANDGPOOVE . 7'-8l' —. 00RJOISf L d'MEEWALL 0 6.OG 2X6 P.T.PLATE W/SILL SEAL(TYP) ODS OBR1EN DRAFTING SERVICE 18'�• 98 QUAKER 2Xd FRAME(TYP) - MEETINGHOUSE ROAD 2A EAST SANDWICH.MA.025n GARAGE/13L FLOOR S . 24' ` 9.4. / TYv.PXTEwoR wnu coNSlRurnoN - zxe s7uos mt6•oc FACED BAR INSVL pwod 0— d mom7/16'OSB W/1YVEK HOVSE.RAP . i WHrrECEDARAIINGLESIDING B• 3)6P.TSILLW/FOAMSILLSEAL , HOVSEADDITION MR.MRS RICHARD TAVANO 1065 SERVICE ROAD WEST BAR NSTABLE, 02668 DOUBLE 2X12 HEADER - W/1/2'PLY ' 7/26/2005 Al 1ST FLOOR PLAN 5Ecn0N SCALE 1/d'4'-O' z 1® SCALE:1/4'=1'-O° TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 1 Map V_53 Parcel ;i�f�Y, f?i' ^ Permit# 7 Health Division l� ��J t �T � `'"A RLE Date Issued a 2—�' Conservation Division e ®4 k- 0 1 %V,21wrAl,, Application e Tax Collector ✓? Dom" Permit Fee Treasurer �� lC Planning Dept. EXISTING PTIC SYSTEM Date Definitive Plan Approved by Planning Board LIMITED TO=#OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address SERV/CC Ro. Village Vy. 9_,q /J7r2AAe_ Owner 2dW19;,Q t 1C1,?.ST6N ,✓,/4nrD Address Sl M,6' Telephone (Soeq) .3 2T- 992!7 Permit Request r/ Square feet: 1st floor: existing proposed 0 2nd floor: existing proposed O Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �JO Construction Type Lot Size 2. 3 Aif 9K Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 YR.S. Historic House: ❑Yes o On Old King's Highway: ❑Yes O'No Basement Type: ❑ Full ❑Crawl 6 Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) OOS Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing CO new First Floor Room Count 3 Heat Type and Fu I: El Gas C�Oil ❑Electric ❑Other Central Air: C'�Yes ❑No Fireplaces: Existing New Existing wood/coal stove: &1es ❑No Detached garage:❑existing enew size ZAN Pool:Uexistin ❑new size/ x 3 Barn:❑existing ❑new size g �� 9 Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Aut orization ❑ Appeal# Recorded El ❑Yes l No If yes,site plan review# Current Use Proposed Use t BUILDER INFORMATION Name r��o►J YL� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE l a , ppppp- FOR OFFICIAL USE ONLY - PERMIT NO. - - DATE ISSUED MAP/PARCEL NO. ADDRESS t -VILLAGE OWNER DATE OF INSPECTION: �= J ' � FOUNDATION • FRAME I INSULATION FIREPLACE I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL s' X 0 GAS: ROUGH N F- FINAL S FINAL BUILDING Q n 0 • DATE CLOSED OUT y co ASSOCIATION PLAN NO. m Q ® - ,' N l - • �t�r Town of Barnstable Regulatory Services L Thomas F.Geiler,n�zsrtsrr►ars. : ,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ( Please Print DATE:—ID 1 L�_Z, 1)�1 JOB LOCATION: `O(o )P r\i i LQ 12 number street village "HOMEOVNl:It":�i,CA -IV name ` home phone# work phone# CURRENT MAMMO ADDRESS: \0 co - • 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 lie,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 responsrble 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,nrles and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspe o procedures and requirements and that he/she will comply with said procedures and re eats. Signs of I omeowner - 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-Licensipg of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons:In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:farms:bomeexempt The Commonwealth of Massachusetts Department of Industrial Accidents _ Me 91 WM 600 Washington Street x Boston,Mass. 02111 ,,�:• �W�orkers' Compensation Insurance Affidavit-General Businesses PONj r rVIMi i I/ / MR. state: work site location full address ❑ I am a sole proprietor and have no one Business Type. ❑Retail El Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑Sal (including Real Estate,Autos etc,) ❑I am an em loyer with em to ees(full& art time). �6ther ///////%/.1/%/%//%/ // //% I am an employer providing workers' comvensation for my employees worldng on this job. compsnv name: • _ _. .•:,. - .. '' hone#• •' city: • •'• ' '' ••... ,•. � .:�f:••i• :�••�• olio. � '.: :•::' . , •r.: � : , . . fnsdrance.ebs.:'.:' /�'j j / .., e 00 //////// / ....: ..� /// /,•.. //////� �] I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: 4. com an name. aaaress: ; '. �`- . •• ', .`' .•,".'•4•, hone#'• •' ' insurance co. company n ni :. address: i t hone# cil 3nsura»ce co::.: :.:. Faflure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to I anerat derstand.that .00 and/or. one years'imprisonment as well as civil penalties in the form of a STOFwORK ORDER and a fine of$10o.Do a day against me. Li copy of this statement may be forwarded to I ffice o vestigations of the DIAfor coverage verification. I do hereby ce under the p s nd pe es of perJury that the inform anon provided above is true a d come y l0 �13y� Date Signature - ` Phone# Print name, official-use only do not write in this area to be completed by city or town official permittlicame# ❑Bullding Department city or town: ❑Licensing Board ❑Selectmen's Office ❑check it immediate response is required Q$ealth Department j. 1 contaetperson phone ; ❑Other Nvaed SrpL 2003) — A• ..^�, I i Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contractl of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other Iegal entity, or any two or more of f the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or association or other legal entity,employing employees. However the owner of a trustee of an individual, Partnership, 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' eto shall not because of such employment be deemed to be an employer. budding appurtenant ther ' MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants fidavit completely,by checking the box that applies to your situation. Please Please fill in the workers' compensation af supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. .Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the•"law"or if you are required to obtain a workers' compensation policy,please call the D.epartrnent at the number listed below. No ME FEN City or Towns Please be sure.that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant'. Please be sure to fill in the permit/license number which will b'e used as a reference number.,The affidavits.maybe returned to y .• mail or FAX unless other arrangements have been made.- the Department b The Office of Investigations would hke to thank you in.advance for you cooperation and should you have any questions, please do not hesitate to give us a call. IME/ The Department's address,telephone and fax number The Commonwealth Of Massachusetts i Department of Industrial Accidents ' of a of Imsfigotions 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 ! phone#: (617) 7274900 ext.406 i bwn, of B arnstable ' of�te►ors, • , Re jix atory Services � $ Thomas F.Geller,Director ' Building Division • Tom Ferry,Building Commissioner' ' 200 Main Street, Hy=rds,MA 02601 , Office: 508-862-4038 Fax: 508-790-6230 Pm mit no. . Data . MIDAVIT ' ROME WROMUNT CONTRACTOR LAW SUPPLEMENT TO PBPJY=APPLICATION • MOL 0,142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, •improvement,removal,demolition,or construction of ea additionto any pre-existing owner-occupied budding 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: (s&om L—E Estimated Cost,. Do(0 . vv Address of Work: 106,6 S V')GA RD V. S7A— &. Owner's Name; /T �1�i9�? _ • +� ��//?�S''TE/1(__ /s�r/9/y D Data of Application: I I bareby certify that; FzOstration is not required for the following reason(s): []Work excluded bylaw ❑lob Under S 1,000 ' QB ' not owner-occupied weer pulling own permit , Notice is hereby given that: OWaRS PU.LUNG MIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICA .1i HOME IMPROVEMENT WO1XD0 NOT RVE ACCESS TO TEE AMITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A, bIGNED UNDERPENALTIES OF PERMRY -Thereby apply for&permit as the agent of the owner: Date Contractor Name Revistration No. • OR Owner's Name , 7M CMR App=Wk J Table J-RZ1b(continued) Prescriptive Packages for due and Two-F=4 Residential Buildings Heated with Fossil Fuels i • MAXIMUM MINIMUM Glazing Glaring Ceiling. Wall Floor Basement Slab Reeling/Cooling Area'(Yo) U-value= R-value# R-value' R values wall 1. Perimeter Equipment Efficiency' Package R-value' R-value' 5701 to 6500 Hntfng Degree Days' Q 12% 0.40 38 13 19 10 6 Normal . R 12% 0.52 30 19 19 10 6 Normal S 12'/6 0.50 38 13 19 10 6 SS AFUE T 15% 0.36 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal v 15'/e 0.44 38 13 25 N/A N/A 85 AFUE w IS'/o 0.52 30 19 19 10 6 83 AFUE X 19% 0.32 38 13 25 N/A N/A Normal Y . 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE . AA 18% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: n� J E1�VICE 6 /g . /yli9 004�� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5: SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS. ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J$.2.1b: + Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 RZ of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the.National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling.R values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-39 -49 insulation. Ceiling R values represent the sum of cavity insulation and R-38 insulation may be substituted for R insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall.For example, an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes eleetric resistance heating use compliance approach 3;4, or.5. If you plan to install more than one piece of heating equipment.or more than one piece.of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency than by the selected package. 'For Heating Degree Day requirements of the closest city or town see.Table J5.2.1a NOTES: a)Glazing areas and U-values are.maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b: If a door contains glass and an aggregate U-value rating for that door is not available,.include the glass area of the door with your windows and use the.opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted avenge R-value is greater than or equal to the R-value requirement for that component. Glazing.or door components comply if.the.area-weighted.avenge.U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). I i 43 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 /O,-2- &-0 Residential Addition . $ 50.00 Alterations/Renovations $ 50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus frombelow(if applicable) GARAGES(attached&.detached) Q �j-/ 2 square feet x$32/sq.R._ �J�• 6 x:0041= Cl ACCESSORSTRUCTURE>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 n_...Ac1 AAA _ 1 R 2 GOlIUai AT.1 2 28 FF, - - - ELEVATIONS . iI l i I I I REQUIRED S WILIRES Date 72 ;. iGARAGE 24' T FILL FOR SL4B I I 2 t1 I M SLAB COMPPAC 2L - - __j B 12'- B r JIL.- LEFTSIDE ELEVATION RIGHTSIDE EL flW V4 c Co"NVOVS RIDGE VFM1Yv. . A 12 2n lO m I&O.C. 4.5 12 �to 12 COLA2RTETTP. Q10 1 lb. RtiviMon/laMN Oote R30C BATTINSMATION 1Ta. 13131 -�a- ---yyy--- 2.10 m te'O.0 1X2 RAKE 7-4' 3/4'OSBTONGVEANDC;WOVE 7'-4' I 1X2 RAKE � d�� 12 1X8 RAKE Q 10 :4. .:®1e FLLOCOR/OIST 4, 1X8 RAKE 2 x 10'PRESsI/RE a OBRIEN DRA DIING SERVICE i TREATED DECK 98 QUAKER MEETINGHOUSE ROAD 16' ' EAST SANDWICH,MA 02537 1 A" e'-SS 1 9'•9�" A�TYa.DOERIOR WALLCONSTRVCITON CONSTRVCnON IRun ��15NDS m 1e• 34/2'KR;kFrFACED B4TEINN- 1ATTINsuL 2ne•oSDWImvEKHoEwFAv oWE17LAv 1 GARAGE CLANS 3'CONC.STAB WMTE CEDAR SHINGLE SIDING LE SIDING axavosrrrCTVC) MR.-MPS RICHARDTAVANO SEE ElEVAno15 I WEST BARNSTABLE,MA 02668 2 PXML FOAMSILLSEAL ALL SEAL 3-2X12 STRINGERS PT GRADE - GRADE S I t 4' nnm l � 8'SONAR TUBE(TYP) 1/2•x 12•ANCHOR sous m corlc.FoonNcm-vnDE e'-o•o.c1w. r - 24' . FRONT ELEVA %10'DEEV w/'IX4 KEYWAY B•FOIMDAnON WALLS .Ls _ �M REAR-ELEVATION L 002 AT 1' WEST BARNSTABLE N77 23'2 p'E ��r�' s CHU!?Cy ST/QEE TOWN OF BARNSTABLE 0_ T 0 VERGRO WN CRANBERRY 41 BOG EIS' rn NE �4 V, LOT 3 �O�TE LOCUS rcy STI EET FLAGGED Ab. w / .� as cL, 1 40 v120JOBLO US MAP 4107'g ]V84 0-5'56'E 5' - ti p B5.09 88.47 / `1g�3/ ! PLAN REF 529 17 / ASSESSOR'S MAP 1� 153,�37 ZONING. RF SETBACKS: 30-15-15 t, f�� wT , , 1'� ,6 TANK \ „e �// 9 FLOOD ZONE: ,.C,. v_j � 1 POOL EXIST 162 PANEL NUMBER.- 250001 0015 C DO o-� �s� ► �y5 s .00' :- WELL DATED.• 08119185 D—BOX(' �0�`1 S • • Foe CAR O ! i ► jtCH �' J J �a I y PROPOSED GARAGE PLAN D�lr Ogg 183.67 i LOCATED AT.• FOO 1� �0 E ROAD N7q. 1 1 �— N � $ ,�1065 SERVICE Is WEST BARNSTABLE, MA. -\ N87 50'42"E' 201.29 �,�_�� a Fraccen " ram° i S7K �� • ''E ADT-0 PLAINS a a �_ $ $ pO •1Q73'�/ V6/�D D� MAY K� �� ss►aa, ~$ o i i i gi D� �S !� 97 0 PREPARED FOR: W ° i RICK & KIRS TEN TA VA NO N75.3 02 E �� g �, o g " SEPTEMBER 24, 2004 75• i �, i REV 40 OF i Of REV EDWAfRD L. G, REV- '" SURVEYED BY GRAPHIC SCALE Ow H wa 3mm PESCE ENGINEERING E ASSOCIATES 60 0 30 60 120 240 'pE � 4E YANKEE SURVEY CONSULTANTS 40 INDUSTRY ROAD 451 RAYMOND ROAD NIT 1, PLYMOUTN, MA, 02360 P. 0. BOX 265 ( IN FEET ) MARSTONS MILLS, MASS. 02648 PN.(508)743-9206 1 inch = 60 ft. / � � TEL 42B-0055 FAX 420-5553 SHEET 1 53598A GM/JF r - 901 0 C�D OU o r Ox5 lc� oo0 "69 4�1 � gz � y III ' Il � � ' � III W � 0 0 l 0 r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �' � 'Parcel / i/ Permit# Health Division 0 c�OZ 99-`�b Date Issued Conservation Division �. 63 3� ��fv��9�� Application Fee Tax Collector ' ` (0 `a-7 ©�' _ y Permit Fee Treasurer -02 7 ` SEPTIC SYSTE6090BE Planning Dept. INSMED IN COMPL ACE WM TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULe—10 Project Street Address©(a 5- JeC-4 %G� Village W -e sA- `,ac n-5 le- 0 wne ��6ncuca � ��lb��(1�QV C��n l� Address Telephone a(pjj) Permit Request Square feet: 1st floor: existing ' proposed 2nd floor: existing proposed Total new Zoning District I Flood Plain Groundwater Overlay Project Valuation Qa L7 O['�o Construction Type Lot Size Q . DL O Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 3 Two Family ❑ Multi-Family(#units) Age of Existing Structure U cS Historic House: ❑Yes l rNo On Old King's Highway: ❑Yes C)(No Basement Type: gk Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) :A::ZJ7A' Basement Unfinished Area(sq.ft) \ 0 2k-1 Number of Baths: Full: existing 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: ❑Gas P Oil ❑ Electric Cl Other Central Air: P Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: Yes ❑No Detached garage:❑existing ❑new size Pool:Cl existing new size Barn:❑existing El size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ .r Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION v g` Name_-"6,t'(A(_ "t )i tlCiAi e, ��7 Telephone Number Address"VOCA-'1�' 0 GA License# Q-2- (A,f L%tl\10'te UY\V� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE (/� E< FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED 1 ' MAP/PARCEL'NO. - .R 1 J ADDRESS'-' VILLAGE r - OWNER a1 It I DATE OF.INSPECTION- }� - FOUNDATION. FRAME INSULATION ` FIREPLACE ;- ELECTRICAL:.{, ,ROUGH FINAL / t ,LI 1 PLUMBING: =K?ROUGH FINAL GAS: ROUGH< M c- FINAL I ' FINAL BUILDING r.f 0 1.,„, DATE.CLOSED OUT 0 � �1 ASSOCIATION PLAN NG� The Town of Barnstable = - BARNSTABLE. ' Department of Health Safety and Environmental Services 9 MASS. 0 039 �0 �PrFo MPS Building Division r' 367 Main Street, Hyannis, MA 02601 • � - mot 4 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: k 1�"W, 6 Map/Parcel: 4573 ? 7 Project Address: vlc-e- ' Builder: The following items were noted on reviewing: i) Cop,/ p Q� fi ,lam, /�j r/ ,.- �t �'I � SW� 114d✓ci�lG' ��G$ f"�yCGc��-�D yIV 5 r4k c =N c( / �iP. �� Cr�F2r��r ,�T fps s G--i id s C, nl lj�vG l) t)14T 'sz 1 7-1 qI, 4P/L l.C> T 46 v r of - 9 , y r• � k f ti Reviewed by: Date: 7�� /O 7i q:building:forms:review I The Commonwealth of Massachusetts -- Department of Industrial Accidents -- Office 011nyestiga6ons . 600 Washington Street -Boston, Mass. 02111 f Workers' Compensation Insurance Affidavit ii.�r!a il/a�i as \ name: / 1 G�(1 Gt C file location: A Q S Se r V,\ city phone# 5 fb I am a,homeowner performing all work myself. ❑ I am a sole pr7rietor and have no one working in any ca achy I am an em to r rounding workers' compensation for my employees worlang on this job. :com an n .......... :tclalres xx .....................................................................................................:::... ..........................:.......... xitu - ristrari ]r ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: :cum an.::nam adi#tes :...:................................................................ .rr:...•::::. �j •'�i:1Y:f?';:;`;;3;;::;;yy{::.' j:: ?:::•:?!i'':> :;i::;:;:i:'.y :^:f;iFv::`}ii!24ii:i{{i<{•}:ii: <okon Ll Y :j}}':ii'i'ii::�iiin•w::::nv: :::::.v::.::.•.{4}}i}}is::w:4:{Y.:•}}i:•}::•.^}?J:{•}:!�;^:v:•}}}}:•i}:}}}}}•i}}:t4:Ji:}:Ci:{•:w::^i:v�?:;:.}}:•:}':::::::::::.:::v::.:.::::.:..............................................;...:.,...,.. ...................... ...... .......::::::::::.v:::::.v:::::}i;:4};.};•}i}ii}}:�}::^}}}}:{•}isJ:{•}}'l.:ii}i}}:S{{{J}}}}}i:•:{•}}i}::J:ti4:4}ii:{•i}}}}}i}}i:Ji:-ii:�::•}i}i}i:i•:�:•}:{•)i}:.}}}}:•}:J;}i:•}:J:•i}}}}}}:-i}}::!{^}}:•i:{•}:-}'.:..............:...................... .....................................:..::::::::::::::::•::::::::::::::::::::•:::::::::::.:v::::n�.v:::nv::.vnv; ..........;.....i.....::. .............................:................................................. y� . . �•> i a £'<`................. ....'<.................... `' >[< l<?s ' i i>i i i i;i i;i'i i ....... '>ai adilres . b ��i�iuran Failure to secure coverage as required under Section ZSA of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the O ce of Investigations of the DIA for coverage verification. I do hereby certify the d pen es of perjury that the information provided above is tru,,and correct Signature Date (0 /T/ Zd Q _ Print name Phone# � official use only do not writs in this area to be completed by city or town ofIIdal city or town: persrit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (ravised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity, employing.employees. However the owner of a . . dwelling house having not more than three apartments and who resides therein, or the occupant of-the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants - Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to . the Department by mail of FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts .Department of Industrial Accidents ' Offlce of Invest1gadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r y°FINE l° Town of Barnstable Regulatory Services ^B Thomas F.Geiler,Director 9 MASS. �* i639' `0 Building Division ATFD MA'S A g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. n Type of Work: p Estimated Cost `oL—as �0 v Address of Work: 0S,g Owner's Name: T C V 1(5 4-en Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied [Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Irae Owner'' re Q:fonns:homeaffidav The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: (_,i JOB LOCATION: 4:�`� I numb _er street village "HOMEOWNER": �'l�\C ��\1 name home phone# wofk phone# CURRENT MAnING ADDRESS: cQ <-�—P c--,3 C 4 \n c1 C L c1 �..b � city/town state zip code The current exemption for"homeowners"was extended to include owner-occuied 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 mspectio procedures and requirements and that he/she will comply with said proc es and requir ents: Si6atu7of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states.that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do,such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often.results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN []n a/e9 urawalo->w uo..cs cl[awns rN�Ipi.c[ • >I[A.Iv:[U [ I.Cr.11,a Y[ao A.[�1 . .•- •'Tx 10.1 vfl>IW A.r ni:r[Sl. f� 3 DIADaIAL�{� ......<I �ILs�'s�I�Z�y� I s• I •,I I 2% PLANS FOR LOCATT014' 2.1 I . BBRACE) f1EA15 eV I I ,1 li NEl&GALYSTEEL pTe;_rABRIUTED F ' s-]le'a MAo1EE OAGd/LL BRA�CEw� \ ]-]/B'I ERS �i9ER5 Tl'F� I' 20 AdTMIC10ESS L It( W,QGAGAW �' At[I1 2 YR".J1ER5 YOWL LW ER 15EE SECTrW2 AND �YPN:LL STYR ASSEYBLT, PIIOIS F011 LOUTIOiS STAIR LIE 5.uu�.M.BOUS B OTHER(TEA6 N BRACE WITS AND Y9Eyl5 1 TYB n m YIL•3NOOEY' PRE-RBRICATETI �' mHLMO[NFSS VIITL LITER / AIR ASSEMBLY VNTL�� STAn LK _ y GA.6ALY Sim i ( STAIR LIB Klrs BATS Is y` CORNETT 11NEL I j S N EL DO EA. 1111 i E SERIES 550 6 650 STAIR CORNER SERIES 750 STAIR CORNER n SERIES 850,950E 1050 STAIR CORNER /1'^ Rl�Arm R RAIP AMR. SNYER ] ] wE MOTOR MOTON CTTON ON n� _ —'"�--� — ♦�——— —� —— — —1 'A'FRAJIE ASSEMBLY • -T I 2 LTYRCIIL WHERE SRO+N flTJRN 2 o UR? RTER FLTTJi I —� - Z 1 FTLTE --- �— —� T PERMANENTLY y • i. I rncYL tel a' 1 ETwN 'A'FRAME NE ASSEMBLY 1ERq 1 x v... ArD SAFE"LIC .ly +^•'c:yV�Et7�.� I .� ISI[AOEo P 11 •� i n ♦ �PomTo a dT EG �`•`' I e LFLAT AREAS Warp ANDS 1 .:•�S' e- •56- LC .�, r(1•. �, MOTpt J luT!-,y` ,jr Zj' �• •yy I FIR YEA {,p ''- ♦ ►RESENTS AREAS ' 14•. m rr I Iz - 7 __S •• CIPTIO ARE I - _ '•< .- MAYBEOR Y•::• SIOAOAER p Ra zr aw• SF SURF Y[EAe ffiOGAL.Ue LOCATED AT 'I I I SUCTION m j SIZESNOR'1��6aY SOB--SE SWFMEA6�B4QfJILCAP POSm _ONS ♦ ,� IBI[]6`.. SF Sl1fE AREA L 2 M GAL CAP m m 20 4o•LRG.SF sue'AREA 6 211244 GAL.CAP L_._ ►.—-——� 2 3 ULT SERIES 2000 81 2050 INGROUND A•FitAL AME °55EnSHO D TYPICAL WHERE SNONN 10 CD D SWE SOWN.0.14 781 SF HIRE YTEAL21B00 fJL.CAR LTER Pl�AMO _ PERWIEMLY ATTc3 OTRi - STAIRS ARE OPTIO SAFETY lME (' ————~ ——v ER ..—10— � 0'SERIES 2100 9 2150 INGROUND SaE S+o.N 0.26.]e 9 EL_022 SE SLO F AREA -�— 1 /I%Tx. .r RETT 6 26920 GAL.CAP .�, Z IOPP.ALL s. SERIES 2000 9 2050 INGROUND ♦ PERATAMENTLY .4=" I I 11 f�AFETY LIE REPREMEWlS FLAT AREAS .`-:B�' :, ;'.r ��5 14rr I RE7T/M 'A'FRAME A55 EYBLT O TYPICAL WHERE S,IOMN •'•y 4/1-f; 5a[vorN 16.1Y 367 SE Surf AREA L L 20720 GA GAP •T••. ALSO r ,A[1L.W.- Ta 5FSLNFANEA.L].9SS ULL.CAP zo-•S es] SF sRtF AREAL 29¢2a GAL f AP SERIES 2100 9 2150 NGROUND WEST BARNSTABLEsa PLAN REF 529117 RES. ZONE. RF" J Cyp�.y 57YPd' ASSESSORS MAP 153 LOT 37 / ; ; / �39 \ \ FLOOD ZONE 'G'"' STABLE m ' ' / ; ;/ 0 000 ^' •` \` \\ PINS FEMA PANEL ,f 250001 0015 C of BARN I ( � _ �6 LOCUS DATED.• AUGUST 19, 1985 Tows GR°�N 1tsr t�tAg y��y Orl?BERRY cn s, B �.d � a w�"" GRAN°Gi c / , .b FLACC3D '1 .. LOCUS MAP . y —--------'�/ / / / / / / / �d 126 '� �•' ^ - '� R /` / S06 42W47 68, . Q -' Ile r^ Al P ST(NG=m AppR°x Wes_ fa ---- '' 3_Bfur pNj G IA4 Fs00,0 vi t. I 00 g,. �.._..p _.._.. / ST, _--- 3, FLACCED $ 1 ___-- -�y- PLA/NS A ,,�` "'- $ ,� -- /' y WN WA KNO _ ------- ssar0a/ J 171RA pELED D/RT------------- / $ �� $ _.. / --- - �'�s'pp19 �` PLANS ACCOMPANYING NO TICE OF INTENT OF SHEET 1 OF 2 PESCE ENGINEERING E ASSOCIATES of ,>� peg e�, �..�� '' EXISTING CONDITIONS PAM �K p P.O. BOX 321 y fig® 0.•% �y, = LOCATED A7` OSTERVILLE, MA. 02655 E°WaRo L. �,� �' ° �•P�scE 1065 SER VICE ROAD PI-I.(508)428-3730 . ��►� WEST BARNSTABLE; MA. NO. 32001 PREPARED FiOR- �ISTE RICK & KIRS TEN TA VA NO APRIL 19, 2002 SCALE: I"=50' ✓ 52949A �1i FES37 Ov 0- ol 126 AD � '•' `c , 106 4235, - Nl � /12� �' � ' , Ile 68, 47 ,- . 09 ., �,,. ._tt \ ((��, � . ' ,-- . • _ 19 5s`Yc�� le to 120 .. ', / -\TONE WALLS/ - -�_ __,; u JJ6 _' e' Pl? ,, r SED 1. / ODEC p14 8 , 18• JJ 5 s / T P. _-=_==--ING-=� y� ER PRO GAR. +--Ex,ST .- - — zzo1 36 114 00 -106 \ gii -.lam 1 a2 O IN, PLANS ACCOMPANYING ' \-- - NOTICE OF INTENT / / SHEET 2 OF 2 ' \\. \�\ \� \ �•`_ ,,✓''� loe �' , ��'5�---- --�' �-: -�<; �! PROPOSED POOL & DECK LOCATED AT. 1065 SERVICE ROAD StQz721_-W" �__ �� -__-��- WEST EARNSTAELE; MA. PREPARED Mk o RICK & KIRSTEN TA VANO f '' \)` ----------\ =----- `" o o c e� APRIL 19, 2002 \ -------- „THE PLAINS_--------- - ,,/ ,' y ,.� ,,y► �, SCALE 1"=30' --- KNO WN--$----' ------ ,/ ' - \- o TRA VELED__-- DIRT---- - Y------------ FsE100.1Of PESCE ENGINEERING E ASSOCIATES END L P.O. BOX 321 y a y p 1 r avi� y� OSTERV.ILLE, MA. 02655 Ejoo s .., \\ oQ �,' WETLANDS jLACCE'D BY q PN.(508)428-3730 ' "may F.E.S. 8113198 �y � \\ /' J� 52949A 3/89 &jp,WC11OwS at OaA IKS pW col1AINIK TK 04161"; .to ssc^Aimi of int toclat1a OF at COoc AAL Sol mulwaticc Oc 10 •( VST0 (09 ANY ►W►CS'.. , , 3 oIAQONnL. 2 Vd' ®ISEE xSEl:T.13/Z s PLANS FOR 2' 1 i 1 2� OTHER M311S B r 9-O BRACE) i I 14 GA-GALY_STEEL PANEL pRF.F#BRICATED STAIR ASSDABLY DIAGONAL BRACE v 5-3/8'0M.BOLTS MACHINE l:px9mffT5vp 2D MTL.TTIIQOESS' L I wix F&12 Gk Gkw�+ / TVTYPICAL E-RkMCATEC .• VINYL LINER (SEE SECT W2 AND ASSEMELr PLANS FOR LDcATIONS STAIR S-3/8's OI.BOLIS 8 OTHER ITEMSNBRACE STAIR.LIE NUTS ANO WASFEbiS, ILZ j TYP_ PRE-FABRIG/RED ___ 2O MILATSCIQ� STAIR ASSEMBLY VxYL LINER STAIR VINYL LINEN GA.GALX STEEL STAii l lEJ STAIR F"EL L9EJ / � 80175 �� Ce3TbER APO 2 as W&SHERS TYP.EA PAtEL END _ SERIES 550 6 650 STAIR CORNER 1 SERIES 750 STAIR CORNER �1 SERIES 850,950 Et 1050 STAIR CORNER �1 PIA AMY R 3 PL1�P APOMOTOR SIMER 3 5 MOTOR r _ ON � - '_1 -- ► — -- — —� 'A'FRAhCE ASSEMBLY -� : _ i LTYwc�►L w+,1E s..orN KILTER ,� ' Z 1 FILTER I '� —� -' 2 1 FTIlE — ► —— 0-- — ► --� RETURN .11 ►: 3 3 . PER�I/►NE N TLY TUBN E 1 TT]►CFIED - 2 -A-FRAaE ' a� u; I T L04EASSEUBLY 1 1 2 zs. n SAPET TYPW-AL W"EFtq s_:: PEAt9i001ENTLYlACHlED SiI' 1..�.:aas aAa AF � • LINE �e•• '.'S'•l j '�'• ...,..�. �. I t.;• ITS' SHADE0 t ax x I ' AT .�c.e PUIrP dWD ( ,• 1F1 2 POKTKYtS s; I:r " .`r „` r L- MOTOR * ` . Ta ..x. 0 Flff AREA ��5- �' �_• �► r"ESIENTS a. 1 V - :. ` « ... AREAS 0 T STAIRS ARE ( - 1--� d — ► — — —� OPnot"L OR MAY BE ,. ". S06MMER 0 _ Q'x2<lBA SF SUR'f.ARiEAs $ GAL•a L.Of-ATED AT I SUCTION j 0 SIZE SNpWN^ 16x37 SOB- 5.f SURF.AREA 6 �$Q.QGAL- POSmomS - 'x Y OR'Z TURN +� .. � _ I�36 �_ S f SURE.AREA L 21��-C/►P. � m zo640'1_gfL SF SuRFAREA S 2nN GAL.CAP L-— -- jo .— — — —J 2 'A'FRAME ASSOeBLY .. D SERIES 2000 a 2050 INGROUND TYPICAL WHERE SHOWN � rILP AJO SIZE 9gWN-IBti44 T81 S.F. SURF AREA&21800 GAL.GAP PERStA/EARL.Y AT'T MM ILTER MOTOR SDURS AitE OPTIO SAFETY la1E OD SKIIAMER� —� SERIES 2100 a 2150 INGROUND SIZE SHOWN I8m26.3e 90-EL.S22 S-E SURE AREA RETURN - 6 261928 GAL_ CAP ' Ef LIS 51=Ri1=5 2000 �8 2050 INGROUND T10 M PERMANENTLY rk SAFE T T L 11E JO PaFmoms 1 RANTS ( o� So r-j f,Ce 11� �Jr �✓Q�-c,S �� L G v TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION i /� Map% / Parcel 037 ``�� Permit# Health Division M ��a� l 9q r l ub Date Issued S Conservation Division Application Fee Tax Collector :;a 0 cg !��- "r��/ao��Qo� Permit Fee 0 Treasurer ok [,) SEPTIC SYSTEM BUST BE Planning Dept. INSTALLED IN COMPLIANCE VIM TITLE S Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND ,p Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address /0 6/S 6-e_'y)'Q, *d Village 6d__e / /St aa,-n!S -a6/C Owner �r�10( ro....v Address /06 7 Wirr6r. r-A aeS)- &m5bUc Telephone 9D?' 3 7� �y79 Permit Request /ZX /I �e� 1,1,7� C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total W o Zoning District Flood Plain Groundwater Overlay Project Valuation&0,0 Construction Type N co Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting doh mentatiq. n Dwelling Type: Single Family ❑ Two Family O Multi-Family(#units) 77a, Age of Existing Structure Historic House: ❑Yes ❑No On Old King's High ay: ❑Wes rD No Basement Type: ❑Full ❑Crawl 2rWalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 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: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name ,Lr1 tr__ lZ2vtGuJ Telephone Numbers T— 7S`9- 6 6 Y? . .Address W4jtplicn- e_-(Mk_ License# 0(�q t mo t/d 0AR 6 Z3 c o Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO F,-7- SIGNATURE DATE IRaV �Z e. s, FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCE60. ADDRESS ' _V,-ILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ` r' INSULATION FIREPLACE ELECTRICAL:' ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGE - FINAL.- FINAL BUILDING . .. ` ' aT Larzj �)o� f all DATE CLOSED OUT ASSOCIATION PLAN NO.— ..DLO � • , I n a (..UlTlmulLrvGucLn vJ L,A•••�•,•••.•.•...----- . - ' 'Pep artmerit of Industrial Accidents - - 0197C�Gf IOYCStlg8lfOdS � . 600 Washington Street Boston, Mass. 02111 Workers' Corn ensation Insurance Affidavit ------------- hone# am a homeowner perfozming W1work myself. am a sole etor and have no one wbiTQn inany.capacityall er rave workers co ensation for m 1 g e an P ..... ..}.. am P �....... .:n•:•nvv.......n.x...n;:.:•n•:. .n?•X:?••:v.L......r•:.:t........4;.n+•.: rh... :..r::.:.......... ........ .r. .: ....... .....r r}. nn.• .:.n......X. ............ ::::::::•:::::::::v' ..{... .••X:{•:w:::}??r;{4:?•}%•...v...d}�.•;}:}:S,:;�i::#L�ti'w•. .........r v,.....,• .:-r, .. ..n...n,....v:.R.. r.....n.:n..............•:•.... :n:.: n........r..:{.}.w;}.{{G4?:4:+::i•:Ri t'.::R'{R:{•}'•}:{:•r...:••:. .rY...:::.::::: ...........r...r...:r....... .}}. .:.}hv.............n..•L•: :.. .. ...v..............••:•.r. ....... .... .... ...♦ .. .,..... .rdv...r. ... ...:}::::.v+v.,..x:::{r:v:x:::::x•..x:•., v...m:....::...:.......,.rx.v:%;:: rn:n;.. .... ...: ,... .. ... ........ ............r.i.r:.,4•:::;}::.............r::d•.,.......nrd};>:i:'•?':?i$::?$:.:::.','::y,:X$�i$$i;}••{;,};{-:::.:;:}$•::]. ...............r•:•........ r....r{{.•.:......,......L..::,•:.. .: .....!•:.: ..:...r..}. .: .... .......... ..r..}.r.:..•:•:Y:•::.:.r.......::•}:::::......::::..: ,r%,:•...... ......::......•;.•.n....r..-. ...,......:::...).........f..n•. ..,,..R;}, .....:.:r ... .:w:::::x............ vnv;n n.L.;;.v:.}r•: .r................ .. ..... :.... ... .,.r:.,,..r..n... .S :.., ....r:•::::.... r....... .:; :.�i:}r,•-;;.%.$;;{.};i:#:y.{ %•i}:::.}ii:`y ::.{•.v}•?.vk:::}YYi:4i:{} :{r' ;^)?.•.{tiR:{:•}}.Y,!•.{:}:{{!{-:.v.v;;•::::::... ... • .... ......� •:.::.}}}:L{S:v?>}r!?}Y,X;{,;:y:r•r•.f:.}'•}?Y::{ rn.... r.v ..........r•.v:.:, •:.v:•.vv;:;{t!•}}?::....:.......:?�iS?:i{<?'.!.}}}}:�•}'r.?'{:X? ..,v.,i:.4y.,t;•.;>;{::::}:::}vS: e.�. .i:•}:•.. :•}:4X{.:r..::::.rr.}:.}?:.::,:.:,.�.�:$�{>:r:{s:#:>i:,#.;.;;.}Y...;;:,;.i:.y.:. .... ..................:::.:.•:•..:.v:••4i?::::r:•:•.v.: ::•:in{•}'•]:•:{•:4?}:::•.;:•}:^).'!:•]::•$S...r..i•inri•:::.,!•:"•..:{.}:::•:.. ......:•rr:.. •..{.•}Y'•:::.:v:}::•S''}::}+} ..... .......vr::,•:::r.a... ::••:.••:r.v.,v:::....:Y•r::: ..,+• .....}r.:::.:•:::.r...:.+.•,•::}::?•::•.vh•r..,...{.::n•..:}.•::r.. ,..,.}..... ...... ..... ......... ..n...... t r n.,..... ...n.. ....,...G....wn.;, nv.vr•?)::R:i�{:v.v•:.:::.::.?;:.2y;:}i: !�y{':S#:5;:}•$:f? {::,!.y:?: ...... .:........ .r. ...r. ..Y.r.. n, .r.r ..r ...v.v..,..a .... r...t..r.hw:?::.. .... ......v.,........rr ...rr .n rn.. .......}�.r .,....i.... n•r}. ...... ...........r. ...r............. 4:•}]'•}}r.•:.v;-.... r.. •::.•. ,qjn.{t•.rS:{ ... ...., .... .]....... r....rr ..vn... ...... .. .... }.r r......v::::.{:.}::.r•:•r•:::;, {:•:•}'•:•.. .n.,..•:.;ti: :.{.]{ ... ..... ........ .. .. .. .. .. : ..<...n .,..k..... ...2 r.. .r..:... ...:. .... ?$%}:::Ld.•r.•...k•'}�:`:{i};dY:{.•>:r.dii•;.''{;`'•}#%�kt {•K�;{$•{:.Y•i. ..... ..r.. ....t ... ... :.:.t... ,..r... .. .}r.. .. .......tr�:•r:::•.,.,::r:.:..,, ,.:..� fr.t•:rr:4i:•`.�`,:,: .. ..... ....$... ...r.r.. .t.... ... ..:..$... ... r rn ....tL.,:....... .r..,: f:::•:.}:{{:;r.;...,. . ........ ... ....Ar:r n... r ..... .. :'.p ....:n. r........., .......,:^:::•.<w:�. ..v..G:::?::.- v rt..r.`.•::i•%,v.;?;}:9:•;n:•::n•..k:r:•{:::xv:•..�Y'i;{:Xv::$;::S4:ri{}}•{:v:;:S$$:;�;`.: ..:.:::v.v•.v:.:,v• .v 4rr:r:v ,v;.. ? rr .r::n{.} :.:5.;. ..r..{ .... ...r... ....:.r+r ... :. ........ vY!• .. .:r.y.Y:;:•}••w•.:.,>Y}.`4:o}i:•f;;:n,•.::}.:»`•:{{?•}]r.:.{.:•.:.,•:.�r.•:::n:!v::•..:. .:Y::..v•..nt.... r.•lt::.. ` .. .r. 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Invests . • . , • - dohereby c under the pains enalties of perjury that the information provided abovee is ow.and correct Date Ay mature Phoned riot nameGrl ofadal use omy do not write in this area to lie completed by aty'or town offldal eiatitt/liceme# ❑Btdlding Departznast city or town: [)Licensing Board ❑Selectmen's Oaice ❑.checkif immediate response is regmred Health Department phone#; - Other contact person: (teviaed 9195 PJA Infornaatian and Instructions ' 3chusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their ivees. As quoted from the "law"., an employee is defined as every person in the service of another under any contract express or implied, orai.or written.' riployer is defined as an individual; partnership, association, corporation or other legal entity, or any two or more of ,regoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or :e of an individual, partnership, association or other legal entity, employing.employees. However the owner of•a ing house having not more than three apartments and who resides therein; or the occupant of the dwelling house of Les who employs persons to do maintenance, constriction or repair work on such dwelling house or on the.grounds or ing appurtenant thereto shall not because-of such employment be deemed to be an employer. chapter 152 section 25 also states that':every state or local licensing agency shall withhold the:issuance or renewal license or permit to operate-a business or to construct buildings in the commonwealth for any applicant who has )roduced�acceptible evidence:of compliance with the insurance coverage required. Additionally,.iieither the nonwealth nor.any of its political subdivisions shall enter into any contract for the performance of public work until ptable,evidence of compliance with the in!surmace requirements of this chapter have been presented to the'contracting ili cants se fill in the workers'. compensation'affidavit completely,by checking the box that applies:to your situation and g company.pames, address and phone numbers along with a certificate of in *mince as all affidavits maybe ply nitted to the Department-of Industrial Accidents for confirmation of fimzmce coverage: Also be sure to sign and. the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is ig requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you required to obtain a•workers' compensation policy,.please call the Department at the slumber listed below. y or.Towns ase be-sure thatthe affid is'complete and printed legibly. The Department.has provided a space at the bottom of the avit .davit for you to fill out in the event the Office of Investigations.has to contact you regarding the applicant. Please dire to'fill in the peiniit/licesise number which will be used'as a reference number. 'The affidavits may be retunied t^ pepartmentbymail or FAX'unlas5-btliei`aiiangements have•been.madE: e Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. ase do not hesitate to give us a call. z Departraent"s-address,telephone az}d fax number: ' The Commonwealth Of Massachusetf� Department of Industrial Accidents Office of IovestlaBUDDS 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone#: (617j 7274900 eict. 406, 409,.or•. 375. The Town of-Barnstable Regulatory Services Thomas F. Geiler, Director -Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW + .SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are-adjacent to such residence or building be done by registered contractors,.with.oertain exceptions, along with other requirements. Type-of Work:_ �C+e�'la►T '��(L Estimated Cost s�� Address of Work: �� 5tf U '� f G d y PS+- e— Owner's Name: c Vr t I Gift vlp Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ' ZZ w2 rrZ(C VOLAW1Z�l�g DatW Contractor Nam Registration No. OR ' g1orms:AfHdav :rev-122001 Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: c, AND r1 OR Search ........._._.._..— ---------........................--... -...-..................----...-........................................................ I Search Results Reg. No. Applicant Street City State Zip Name Title Expiration Franey 12 Franey, � 125198 Whitmar Plymouth MA 02360 Owner 10/27/2003 Construction Cir Total of 1 Records matched. Back to Home Page B.BRS .Privacy Statement I http://db.state.ma.us/bbrs/hic.pl 5/22/02 . � �'l,.e �oovvrr�az+uea//z o�./�aaoac/zccaetk BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Num'be'c 069686 a B i IFicte- 07/f} 1rrr9��69 A W 07�0377dt33 —Tr.no: 68 es- jo Restglrcted tC� PATRICK M F.. i 12 WHI-TMAR CIR � a" G• «�— , PLYMOUTH, MA 0 i Administrator f pp ram,7r � R { S i I 1 1 , ,S t , , 1 , , o , , 1 • 1 1 f{ _ 1 t I^/ ry a �_ "*j J / .�0.1 A gA c�7 / I�y ,,t1 / IX S -- -- ..�- ' ol N' — a ` • I , I 1 I ; , , 1V� v I i K 6 � ,iL) I 1 (C l� • 1 , 1 I i _ .. I r i � I 1 , 'fit •` ' � 'V '� ' I I i _ .... , , I �J , 1 , v i j i, , I • I I I � i I r j I -V Z G N .41 G ! � ry 7j� _ 1 o(J , Co 5° ....................... J P� f rv. 1v I -2:7' v 0 I r rN 4 09 � G SERUIC`E (1949 70�L4+aar loo'�r ROAD \� N5254 b9"jy ASSESSORS MAP 153 LOT 37 LOT 2 0° o_ AREA-94,020f S.F. 110 `—— r Mtn\ i� • �N 69.40' o 0 � ` \ 03 c o_ 1 O+ \ ok IV �Y Tio , o� C� ab � n O � NOTE F � UBSKETCH IS NOT TO SCALE �\ FLOOD ZONE "c"_ FO UNDA TION CERTIFICATION RES ZONE. "RF" TO WN.BARNSTABLE SCALE.-1"=100 PL.REF-529 17 ELEV N/A I CERTIFY THAT THE ABOVE — YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON P. 0. BOX 265 THE GROUND AS SHOWN, AND UNIT 1, 40B INDUSTRY ROAD ITS POSITION_ DOES _____ R' ;r MARSTONS MILLS, MASS. 02648 CONFORM TO THE ZONING LAW4':: SETBACK REQUIREMENTS OF 428—0055 _ B RN TABLE' "r: FAA X 420-5553 —� JOB PA UL A. MERITHEW IDATE. 5105199 NUMBER 51632FND TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION � OD3 INSTALLED .� � Map Parcel IN COMPLIAIilnit# o� WITH TITLE 5 Health Divisioip.n �•' O ENVIRONMENTAL CODE Issued Conservation Division0 T•(3 ��I\1 REC��w.'-''0' Feeo?� 6 Tax Collector • :t4f4i—k ek .aV. usurer"' Planning Dep Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address e fi�Ut.� e C�l��LC_ D 0-O Village��I) e_!�A- �- Owner -�C) czr k A- h\ Address 1 D to S 60-C V"'Co-, = • l.� �Jfe��'lS Telephone F.7 s " 9 a:`9 ,�' d Permit Request C C ec .C.t w1---4 V—C- Z-Ai gYl Square feet: 1st.0or:existing proposed 2nd floor:existing a proposed Total new �� Estimated Project Cost Co lDntp Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size. J W Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 1A Two Family ❑ Multi-Family(#units) Age of Existing Structure Dsv�1n Historic House: ❑Yes O No On Old King's Highway: ❑Yes NO Basement Type: ❑Full ❑Crawl Walkout ❑Other ✓ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) L 00� Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing_ new r 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 AN Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes;site plan review# Current Use Proposed Use BUILDER INFORMATION Name � Telephone Number Address License# Home Improvement Contractor# t Worker's Compensation# 1 - ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE !I FOR OFFICIAL USE ONLY zs _P MIT NO. • DATE ISSUED • - - ' MAP/PARCEL NO. S ) ADDRESS VILLAGE Mt OWNER DATE OF INSPECTION: - Y 3 FOUNDATION FRAME; INSULATION, r FIREPLACE '« ` t 0 -1 ELECTRICAL ROUGH FINAL f I PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING r DATE CLOSED OUT ' r ASSOCIATION PLAN NO. TOWN 07 BARNSTABLE CERTIFICATE OF OCCUPANCY . PARCEL ID 000 000 143 GEOBASE ID , ADDRESS 1065 SERVICE ROAD PHONE WEST BARNSTABLE 'A ZIP LOT 2 . BLOCK LOT SIZE DBA DES ELSPMENT-` DISTRICT PERMIT 44570 . DESCRIPTION CERTIFICATE -OF OCCUPANCY PERMIT TYPE' BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health Safety ARCHITECTS: � P , y and Environmental Services ' TOTAL FEES: BOND $.00 CONSTRUCTION COSTS $.00 . 756 "CERTIFICATE OF OCCUPANCY 1 PRIVATE P...C. + BARNSTABLE. MASS. Ep MO;I �---- BUI I IVY I BY DATE ISSUED, 03/07/2000 EXPIRATION DATE ` TOWN OF BARNSTABLE � _ " 50 DAX TEMPORARY OCCUPANCY PERMIT PARCEL- ID "000 000 ''I43��• GEOBASE"-I' ADDRESS' 1065 SERVICE ROAD PHONE WEST-•BARNSTABLE ZIP LOT . 2 ' BLOCK LOT SIZE DBA —DEVELOPMENT' :DISTRICT MET 4-�. 7 g. 'DD TT��ppoogg�� QQ��ccUUpp MET TYPE 44838 �MEEIPTION .TSMPAY0CR$ &ffYPERrIITANCY CONTRACTORS: ., Department of Health, Safety ARCHITECTS: `� and Environmental Services TOTAL FEES: ,BOND $.:00 INE CONSTRUCTION COSTS $.00 756 '` CERTIFICATE OF. OCCUPANCY 1 PRIVATE P T-EL + BARNSTABM '► �iMAS& ` ED MI►�A BUIL VIS dN B DATE ISSUED 03/07/2000 EXPIRATION DATE. �Lo K +� - _/'_ •_• ` ,_'yam. I Dr,V%I..,)1'Ia.t' ,` 1115TT'.� ',. I I I J. �'_ i/ } LjI r'rj•t1'. aL,.r)(T', Department of Health, Safety and Environmental Services INE r► f10,''. ,CL,"ki,. '1 I 11Rf6'r+.'I':, * „iAItN31'ABLE. Muss. 039. A�O� Ep mil. BUILD, 1. IdN,f-� BY r"1'14 1 0l_ 'G7/1099 ;.XPT+{A'TTi,', 1AT1 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- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE gNICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. taglEm E=0 1 OM 12 iam BUILDI G INSP APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 � i � � d 2 e 4 ce . I 3 L`v SK( {� 1 HEATING INSPECTION 1#ROVALS ENGINEERING btPARTMENT �- ©� �"� 2 HEALT �41rr( / 17106 OTHER:%V gd� lG M SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE 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. INT7 a All ear'.ra:aluwvq-�t,:,x``.kAft- PERMIT -BUILDING w ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Af3 Parcel 3 / 10`�) '1" �� _ Permit# Health Division � LLLD 8E Date Issued ` 9 AConservation Division f yf Vj s l'plYFi.7'iTL ! LIANC Fee � ��oy Collect / ° j•" � 9 reasurel` ,.,-Pranning Dept. V ' Da efinitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis .-4roject Street Address 10&S so?ill e. R0,06 Z� c/ Village f� - Owner zclq 9 o 7-44 .s-yo '1ddress a 2 TiLn!sm,& RD, /-iilw-177s telephone WO --2 &0 Permit Request A-Square feet: 1 st floor: existing r ose /OAD 2nd floor:existing ropose /ooy Total new 006y Estimated Project Cost /D 000 Zoning District /G Flood Plain Groundwater Overlay Construction Type Lot Size o? , / 7 AIL Grandfathered: ❑Yes 0 No If yes,attach supporting documentation. Dwelling Type: Single Family S- Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: 0 Yes 6<0 On Old King's Highway: 0 Yes 6No Basement Type: ❑Full ElCrawl Walkout ❑Other Basement Finished Area(sq.ft.) /VONF Basement Unfinished Area(sq.ft) 1000 Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new 3 Total Room Count(not including baths): existing JV new First Floor Room Count Heat Type and Fuel: ❑Gas Oil ❑Electric ❑Other ACeD 9,,T- C✓,q-rCR Central Air: ❑Yes 8/No Fireplaces: Existing New_� Existing wood/coal stove: ❑Yes ❑No Detached garage:O existing 96new size Pool:O existing ❑new size Barn:❑existing 0 new size Attached garage:O existing 0 new size Shed:❑existing ❑new size Other: Zoning B of Appeals Authorizatio 0 Appeal# Recorded❑ Commercial 0 Yes No If yes,site p view# Current Use Proposed Use BUILDER INFORMATION r / rf nc,11Zamp_ h ✓'� �` phone Numberc�1dress PZ W�;�- �, C r C�e_ License# 0 69 So 0'^Q°�� (3 c) Home Improvement Contractor# 1ZSj 7� ✓1111orker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE � � DATE FOR OFFICIAL USE ONLY PERMIT NO. :577 c G DATE ISSUED y. MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECT FOUNDATION �a FRAME ' �Q-2.5— INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: . ROUGH FINAL 9 GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOGkATION PLAN NO. ' I r - °� The Town of Barnstable • ansxsrA=F. • Department of Health Safety and Environmental Services rEorr' - Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 :Building Commission, Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION • MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: .p C291C> Estimated Cost Ce Address of Work: \,C) (.as- ";,p;C\S� C9-- ws wo Owner's Name.&I C \1 SI�e Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied 1 IOweer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. DWItown er's Name q:fortns:Affidav Massachusetts The Commonwealth of Department of In dustrial Accidents Mee otlmrestl9atioas 600 Washington Street Boston,Mass. 02111 v ` workers' Compensation Insurance Affidavit alit �n ii _ same: - lOcation� r� ,C f l honetl! # city all Work�� am a homeowner p is aavtv ❑ I am a sole Dronetor and have III one ' //// EllDyers working oh this job.•};;'.;;:.:!.:.>:::>::>:::::<;::::<:>:<<><::»«: workers 1 r a.n .. . .a.a. ,n,.. ...... .fin ..... r.n..:.» .M...... 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Do- :.•n:•: eIIe.�'::....:.:r:.:}:::{>.:::;:::.::.::::. :::.?:.;:.7:.;:.}:{:.�.•...........,..,..:.::::';:>:::: :3':>::i>:::;>:: .. ... ,rr wrw 7� %•i94F,'•�lfi,}?:•:�{tifr yr::.��:;::•}:;:fi'}Ci::::.. city' {a ar-.,;Fn3v•:.::•)!9 hx\t::''•},.}.:}a;w::,:.:.:;:!v.:::::...: ..... ... ..... nr.r. v. {-K-•• ..�,•.... •.. }�:h.+:}::[...,}>:?<•..,,v'i:}::.:::-r:::v.:w::::::::::.v v v7'::::' ................,•:.........:::.�x:::,F.:.r...,:•....:.,a-::. .,.::.r,. ..F�•{r .. ., O��GY' ....:::7::.�.�:::::-::•::r:•}.�:: ::::•.......... ....... .,;{n. .gym'...•,:... .. �-h.:h r insvrance'to:�>:;:�a;:•::;:?.::;?:::.... malkiea of Sae UP to 513�•00 and/or ceder 6eetioa'M of Mtn.r.4 can 1�to the of erb3buil p that a FaIIare to secure coverage in the form of a STOP WORE ORDER and a fine of Sr00.00 a day against me. 1�rstsad one years'bmprisomnent as van"dT2 penaWa of the J)m for Coverage veri9sadm copy of this statementmay be forwarded to the O the pataltics P that the information provided above is ttru'mid correct 1 do hereby certify P Date �Si- v phmc# punt name wn otndar use only do not write in this or to ofi3dal am to be eompleted b7 CH7 Department meat pe�yBcensett ❑Building p ❑Licensing Board city or town: [jSeleetinen,3 OMce check if immediate response is required ❑Health Depu=ent Other�, phone 1t; contact person: Information and Instructions sachusetts General Laws chapter 152 section 25 requires all employers to provide workers' eof another�und0zan� � -� �4as o ee is defined as every person in the employees. As quoted from the "law", an emPtY of hire. express or implied, oral or written armershi association, corporation or other legal entity, or any two or more c= ;fin employer is defined as an individual, p P� a -- P ed in a joint rise, and including the legal representatives of a deceased employer; or th.. r.,...,..�.the foregoing engag . J enterprise, to employees.ees. However the owner of a trustee of an individual, Partnership, association or other legal entity, a he Y P Y g house c dwelling house haling not more than three apartments and who resides therein, or the occupant of the dweliin� . Toys persons to do maintenance , consuuc�or mPwr work an such dwelling house or on the groun^� c: another who employs 1 be deemed tube an employer. building appurtenant thereto shall not because of such emp oymeat L chanter 152 section 25 also states that every state or local licensing agency shall withhold the issuance o: re�er a MG m the commonwealth for any applicant who of a Iicense or permit to operate a business or to construct buildings Neither the not produced acceptable evidence of compliance with the e c°V required.the rfo cc Public worm commonwealth nor any of its political subdrvisrotu shall etrter Y of this chapter have been presented to the cor�aL acceptable evidence of compliance with the insurance authority. _ ... :applicants workers' c easation affidavit comliletsly,by checking the box that applies to your situation and Please fill in the °� hone numbers along with {davrts may a certificate of insurance as all a supplying compauynames, �.. P ortownthatthe application for the permit or license is be sure to_sign an- submitted to the Department of IndustriaTAceidents won of.insurauce coveraga.- date the affidavit. The affidavit should be returned to the city or regarding the "law"or if being requested, not the Department of Industrial Accidents. Should you have at the amber listed below. are required to obtain a workers' compensation policy,Please can the Department City or Towns 1 The Department has provided a space at the bottom of the Please be sure that the affidavit is complete andpnnted Y• has to contact you regarding the applicant. Please affidavit for you to fill out in the event the office• be retuned TO be sure to fill in the pem* icense mrmber which will be used as a reference member. The affidavits may the Department by mail or FAX unless other arrangements have beau made.' u in advance for you cooperation and should you have anv questions. The Office of Investigations would Re to thank yo please do not hesitate to give us a call. lele 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 faz#: (617) 727-7749 phone.#: (617) 7274900 ext. 406, 409 or 375 r 780 CMR Appals 1 peesciipebe Paduiggs for Oaa aad Two-FwwV Reafilen d Baildiap Heated with Foal Foeb I . � lY�1II41UM Ca7io; wau Floor Bad slab geariag/t.00liog Arse'alaz('K) U Rwalaar R*vabra� . R.valo2 Wall Pia �' pwimp SIO1 m 6soo t�ntlag De�ss nar' Q 12% OAO 3= 1 13 19 10 6 Normal R 12% am 10 19 19 10 6 Normal s 120A 050 39 13 19 t0 6 85 AME T 15% I36 38 >3 25 NIA WA Normal U 15% OA6 3i 19 19 ... 10 6 Normal V 159A OM 31 V 25 NIA NIA >B AF1JE W 15% 032 30 19 19 10 . 6 83 AME x IV/0 (I32 " 13 25 NIA WA Normal Y 13% OA2 38 19 25 WA NIA NOS Z 1!<9i OA2 3= 13 19 10 6 "AME M is% O50 30 19 19 l0 6 90 AF1JE 1. ADDRESS OF PROPERTY: oS � 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLA23NG AREA 03 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED ME MODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms•t980303a 780 CMR Appendix J Footnotes to Table J9.2.1b: doors, skylights, and Glazing area is the ratio of the area of the glazing assemblies ('including inopaque sliding-glass basement windows if located in walls that enclose conditioned space but excluding opaque doors)to the gross wall area,expressed as a percentage-Up to 1%of the total glazing area may be excluded fivm the U-value requirement For example,3 ft of decorative glass may be excluded fi. m a bufldmg design with 300 Rz of glazing area. 2 After January 1, 1999,glazing U-vahtes must be Med and documented by the manufaca=in accordance with the National Fenestration Rating CoMW (NFM tint taken from Table J1S3a. U-values are for whole units:center-of-glass U-values cannot be used. _ _ ' The ceiling R values do not assume a raised or oversized.mess construction. If the insulation achieves the full insulation thickness over the exterior walls without lion, R-30 won may be substituted for R 38 insulation and R 38 insulation maybe substimed for R-49 insulation� Cefling R values-ep,ent the sum of cavity insulation plus insulating sheathing(if used For ventilated ceilings, insulatimg shag must be placed between the conditioned space and the ventilated portion of the too£ ... 'Wall R values represent the sum of the wall cavil► um"Mon plus �a g mom' Do not include if exterior siding,structural sheathing,and interior dryarail.For example,an R-19 requirement could be met EIT7iFR by R 19 cavity insulation OR R-13 cavity h wilation phis R-6 insulating sheathing- Wall requirements fly to wood-fame or mass(concrete,masonry,log)waU eoustruWans,but do not apply to metal-frame construction. °The floor requirements apply to floors over unconditioned spaces(such as umcoaditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling rcgnh meets- pth less than 50%below grade must 'Tl:e entire opaque portion of any individual basement wall Windows average nd sliding glass doors of conditioned meet the same R value requirement,as above-grade basements must be included with the other.glazing. Basement doors must meet the door U-value requirement &scribed in Note b.._ __. . 'The R value requirements art for unheated slabs.Add an additional R-Z for heated slabs. ' If the building-utilizes electric resistance heating use compliance approach3,4, or S. If you plan to install more than one piece of heating equipment or more than one piece of-cooling equipment,the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closet city or tow°see Table J5.Zla NOTES: levels. a)Glazing areas and U-values are maximum aceeelitable levels.hLvdadw R-values art minimum acceptable R value requirements are for insulation only and do not include structural cmmponenu b)Opaque doors in the building envelope must have a U-value no greats than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1S.3b.If a door contains glass and an aggregate U value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge.or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is gtenter than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 1C °fiNE 1p�� Department of Health Safety and Environmental Services Building Division ■AMS[ABLB, ' 367 Main Street,Hyannis MA 02601 MASS. 9 i059. `0 �AlEO IiAP'1� Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION jPlease Print DATE: C too ` JOB LOCATION: number street village (. •HOMEOWNER": %Ci CIS �J �CAy��C� name �+ home phone# work phone# CURRENT MAILING ADDRESS: rn 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 insp procedures and requirements and that he/she will comply with said proce es and re it ents. Signatur of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EYEMPTN SER VICE (1949 70(YN(,q yOUj. ROAD N5234107"{p 50 00' 0� ASSESSORS MAP 153 LOT 37 t LOT 2 0 cr AREA-94,020i- SF •,a o_ cb \\ y \` ------ }. bs Nj o cn Iz- - N ` \•OCL• a � ' o��o�2, A �Lvp N. v y/ \ , ti',p. es• N534726"W �(,✓ O'Sp 69.40' ( J J 4- 0 CD IVD, 710 � o, 5 NOTE. UBSKETCH IS NOT TO SCALE \� I - " FLOOD ZONE "c"_ FO UNDA TION CERTIFICATION RES ZONE. TO AN.BARNS TABLE SCALE-1"=100 PL.REF.'529117 ELEV N/A I CERTIFY THAT THE ABOVE - YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON 4F y P. O. BOX 265 THE GROUND AS SHOWN, AND � A. � UNIT 1, 40B INDUSTRY ROAD ITS POSITION_DOES ` ; mom MARSTONS MILLS, MASS. 02648 CONFORM TO THE ZONING LAWJo. TEL. 428—0055 SETBACK REQUIREMENTS OF. �sv AFs�; E�.�3., . FAX 420-5553 B RN TABLE --� ---- JOB PA UL A. MERITHEW DATE- 5Z05199 NUMBER 51632FND ..^..�-r,. £`.r'n^.,....,,,..t,. ,vy.P:-.n.rf ..�_'..:Jr-•...:,.�..y.�.srp:.: ,ti ..,'^K �r»�+4i 'v r. '1R^1 '.�Y:.17'a}'.. '.� w,F;, :s,.•e.-.,-.-T•, � ..}�' `w' �• L'C*t.•};.:]i.:'4.r+Nr +t�'••FL.r'�wr'�^ N M ' OFIKE The Town of Barnstable aaaivsTnst.E, • 16.39MA . ,0�' Department of Health Safety and Environmental Services AlFOMA'�� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: 1 � A G ,Map/Parcel: 63 0 3 7— Project Address: I 0 V -.)v \�( e L� '*kt4uilder: r . The following items were noted on reviewing: ,; ! r` .�--� " -� fl Psi o \14\4 i D ovi S ITS p } t t e . . r Please calle'508 862-4038 for re-inspection. .; Inspected by: n C Date: — q:building:forms:review 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE 780 CN R 3603.16 FIRE PROTECTION shall be taken from a single branch circuit which SYSTEMS also provides other electrical service to habitable, 3603.16.1 General: All one and two family supply spi=s The power source shall be on the supply side,ahead of any switches. dwellings hereafter constructed shall be equipped with a household fire warning system,in accordance 3603.16.6 Primary electrical power for other with the provisions of 780 CMR 3603.16. All household fee ww7ung systems: Low voltage devices shall be installed and maintained in household fire warning systems that include a listed accordance with the requirements of 780 CMR control unit with automatic detectors and occupant 3603.16. manu&cturers instructions and listing notification appliances shall be powered from a criteria and otherwise shall be installed and � wired AC wer source.Such maintained in accordance with Chapter 2 of NFPA P� YPAY Po 72 and 527 CMR 12.00 as listed in Appendix A AC Primary power shall be supplied either from a dedicated branch circuit or the unswitched portion of Exception: In addition to the requirements of a branch circuit also used for power and lighting of 780 CMR 3603.1.6.1, two family dwellings that habitable,ocuipiable spaces,in accordance with the contain common areas such as basements, requirements of NFPA 72 and 527 CIViR 12.00 as hallways and/or interior stairways that serve both listed in AppendxA dwelling units, but are not within the dwelling units shall be provided with multiple station 3603.16.7 Secondary electrical power.In addition smoke detectors or a listed control unit with to required primary power as discussed in 780 CMR automatic smoke detectors and occupant 3603.16.5 and 780 CMR 3603.16.6. all household notification appliances in the following locations. fire warning systems shall have secondary(standby) 1. In all common basements power supplied from monitored batteries in 2. In all common hallways. accordance with the household fire warning 3. In all common stairways on each level out- equipment requirements of NFPA-72 as listed in side the dwelling unit doorways. Appendix A. Each detection device shall cause the operation of an alarm that is clearly audible in all bedrooms 3603.16.3 Required alarm notification appliances: over background noise levels with all intervening Where more than one smoke or heat detector is doors closed. Such devices shall be installed in required by 780 CMR 3603.16.10, all required accordance with NFPA 72 and 527 CUR 12.00 as detectors shall be installed so that the activation of fisted in Appendix A. any detector shall cause the alarm in all required smoke detectors in the dwelling unit to sound. 3603.16.2 Compatibility: All devices and/or Detector activation in a dwelling unit shall not combination of devices and equipment shall be activate signals in any other dwelling unit or approved and listed for the purposes for which such common areas. devices are to be utilized. 3603.16.&1 Non-required alarm notification 3603.163 Smoke detectors:All detached one-and appliances:Non-requited smoke or heat detectors two funny buildings,including manuf=wrd homes shag be installed so that the actuation of any non- in accordance with 780 CMR 35, shall contain required detector shall cause the alarm in all fisted single and multiple station smoke detectors or required and non-required detectors in the other household fire warning systems in compliance dwelling unit to sound. Detector activation in a with ANSI/UL 217 and/or ANSLM 268 (listed in unit shall not activate signals in any Appendix A)and conforming to 780 CUR 3603.16; other dwelling unit or common areas. such household fire warning systems shall be 3603.16.9 Alarms sin in All required installed and maintained in accordance with the g requuri:mems of 780 CMR 3603.16, manufictirrers alarm-sounding appliances shall have a minimum the rating of 85 dBA at ten feet in accordance iasmuctions and listing criteria and otherwise shall with be installed and maimcairied in accordance with requirements ofNFPA 72. Chapter 2 ofNFPA 72 and 527 CMR 12.00 as fisted Exception: Sounding appliances directly located in Appendix A c ear p�Q' in bedrooms shall have a sound pressure level as �V o low as 75 dBA at test fat in accordance with the 3603.16.4 Seat detectors: (Reserved). requirements of NFPA 72. 3603.165 Primary electrical power for single '3603.16.10 Required smoke detector/beat station and multiple station smoke detectors: detector locations: Smoke detectors shall be Power for single and multiple station smoke installed in the following locations: detectors d aD be supplied from a permariemly wired 1. In the immediate vicinity of bedrooms; eonnien ion directly to an AC primary source of 2. In all bedrooms; power. All power for AC powered smoke detectors 490 780 CNIR-Siitsli Edition 217197 (Effective 2128197) 9 � s ✓ltLGG� 7 4s r x,BEPARTNENT OF PUBLIC;SAFETY rkf.. �: t E I `CU��SUPERVISOR;IICE ONSTR NSE ;<F t f � B ��JB3 J2BB1 } 81•JB3 J1969� �"� d .:� t... a � F 12,WHITNA R .`•. „ ' PLYNOUTH,G, NA 02369 G r' HOME IMPROVEMENT CONTRACTOR.. ...::' s Registration E125198 f " Type.< INDIVIDUAL. Expirati6n;'`,lOYN%99 Patrick Franey 1�2 Whitman Cir • MA.023eO ADMINISTRATOR ilmouth _ 1 : : : a I I •1 I,I 1'I , 1 1 1 : I i 1Hit. �.4. 1 -...-....-._.._......................... - o • j -_-... _-..... ... ......... .. .... .. ..._...........-__..._....._ .._...- s. r •�•ems- � —_ vr• f 1 i � i - f _ St �j o I i iI o� I u' Tlf� i i I I ' I i I i � i� The Commonwealth of Massachusetts Department of Industrial Accidents ONCE otiftrestigatioas 600 Washington Street Boston Mass. 02111 Workers' Comiensation Insurance davit %/%Effil%////%% % , ', ' name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole prourietor and have no one workin in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. com nnv name: G✓i address: i•Z i.J ( .. . u, I ;. . ...: .... :.:. .. city: 0 phone d insurance co. oiicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: companvname: ry—S'C1 ►� . address: Q o-Y, ( , phone C( � p........ insornnce cn. obey# company name: address: city- phone#' ::. ... iruarancr co. ..oiii:v# ,.. .:.;>::::;.:::::;;:;:::::;�.::.;;::. .:.;::;.�.;::::::>:::;>:.:::.:;::;: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a ane up to S1,500.00 and/or one vearn'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a nne of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriIIcation. I do hereby cerri the pains and p a perjury that the information provided above is true and correct Signature �1 L �`" ►'� Date Gclli� Print nae Y1Z41 Evav► Phonea �� m ' — 66 :check e only do not write in this area to be completed by city or town oiIIdal n: permit/license# Building Department ❑Licensing Board (CO3if immediate response is required ❑Selectmen's Oiflce ❑Health Department erson: phone N; ❑Other (muea 9i95 P)A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contr-; 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 receive:c: trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renew&: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither.the .- commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department,of Industrial Accidents.,Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Deparnnent at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. ��EM/11 The Department's address,telephone and fax number: The Commonwealth Of Massachusetts t Department of Industrial Accidents 081ce of Inuestlgadons 600 Washington Street Boston'Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406, 409 or 375 174067 MPLOYER: PATR ICK FRANEY BUREAU FILE NUMBER STATUS OF EMPLOYER. 12 'WHITMAR CIR 293548 INDIVIDUAL PLYMOUTH MA .02360 ADDITIONAL INSTRUCTIONS i l I COVERAGE UNDER THIS ASSIGNMENT '; THE WAIVER OF OUR RIGHT TO RECOVER FROM APPLIES TO MA. OPERATIONS i OTHERS ENDORSEMENT IS AVAILA3LE ON POOL ONLY, FOR COVERAGE OUTSIDE POLICIES. CONTACT AGENT FOR DETAILS- OF MA. 9 APPLY TO APPROPRIATE POOL OR PLAN. GENT WISE C QUINN INSURANCE AGENCY INC INSURANCE COMPANY: R 449 PLEASANT ST GRANITE STATE INS CO RODUCER: BROCKTON MA 02301-0000 RESIDUAL MARKET OPERATIONS P 0 BOX 409 PARSIPPANY NJ 07054-0409 (800) 645-2259 SAX IDENTIFICATION NUMBER: 04-255-4968 CLASS ESTIMATED ESTIMATED CLASSIFICATION OF OPERATION CODE RTOTAL ANNUALEMUNERATION RATE PREMIUM CARPENTRY-DETACHFD PRIVATE RESIDENCES 5645 12.21 $ CARPENTRY-DWELLINGS-3 STORIES OR LESS 5651 21050 12.21 25^ EMPLOYERS LIABILITY 1-GO/100/500 9845 LOSS CONSTANT 00,32 50 STANDARD PREMIUM 300 EXPENSE CONSTANT 0900 200 ESTIMATED ANNUAL PREMIUM 50C OIA ASSESSMENT 5.4010' OF STANDARD PREMIUM 16 EST, ANNUAL PREMIUM PLUS ASSESSMENT $ 516 INSTALLMENT BASI6NNUAL REQUIRED DEPOSIT PREMIUM $ 51 COMMENTS COVERAGE EFFECTIVE 12.01 A.M. ON 03/23/99 WITH ABOVE INSURANCE COMPANY, DATE.OF NOTICE -33/24/99 PREPARED BY JOANNE SHEA # # VOLUNTARY DIRECT ASSIGNMENT EMPLOYER .COPY MASSACHUSETTS WORKER'S COMPENSATION ASSIGNED RISK POOL ProoVd"Padea6o for One and Two-Fa wly Rmdem W nuadtap Seated wdb Foul Folk MAXIMUM Numum GlazingGlazing Cdft Wail Floor nmumw s Slab Bmdag�Caolin8 Atear(%) U alu R value Rwalua�• l6vatuel Wall Pleura Eqwpm= e Padmae Brvahma'r &vatud 3701 to 6500 tW De6ese Dam Q 12% 0.40 39 13 19 10 6 Normal B 12% 032 30 19 19 -10 6 Normal S 129A 030 3E 13 19 10 6 83 AFUE T IS% 036 33 13 23 WA WA Normal U 13% OA6 3E 19 19 10 6 Nonnal V 13% 0.44 33 13 2S WA WA 2S AFUE W 13% 032 30 19 19 t0 6 1 ti3 AF[JE x 19% 032 33 13 25 WA WA Normal Y 13% 0.42 3E 19 2S WA WA Normal t 12% 0.42 32 13 19 t0 6 90 AFUE AA Ir/. 0.30 30 19 19 10 6 90 AFUE I. ADDRESS OF PROPERTY: W, �313R�S�A�E /rl 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 1 , 530 3. SQUARE FOOTAGE OF ALL GLAZING Z�d 4. %GLAZING AREA(#3 DIVIDED BY#2): c, ( 15 S. SELECT PACKAGE(Q—AA-see chart above): I`1 NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f990303a Footnotes to Table J51.1b: r Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, ai d basement windows if located in walls that enclose conditioned space,but excluding opaque doorsi to the gross wall aura,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement For example,3 ft of decorative glass may be excluded fi+om a building design with 300 fl of glazing area. 2 After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' the ailing R values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R 38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. `Wall R values min ent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding,structural sheathing,and interior drywall.For example,as R 19 requirement could be met EITHER by R 19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-flame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `'Ile entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements•am for unheated slabs.Add an additional R-2 for heated slabs. •If the building utilizes electric resistance heating'use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a ROTES: a)Glazing arras and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available,include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more arras with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the aura-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 1 ___- _ i •t {j t t 1 I " c 1 y• i C I pFTHE rq� Town of Barnstable Building Department Services w MUMSrAB6E, ; Brian Florence, CBO TOWN OF agRMS1 AN 9$p 639 Building Commissioner 200 Main Street;Hyannis, MA 02601 7019 !AN S www.town.barnstable.ma.us 2 3 Office: 508-862-4038 Fax: 508-790-6230 DIVISION Town of Barnstable Family Apartment Affidavit I,being on oath,depose and state as follows: My name is l� `� `�.!'� ' ( t.L( Ul(; I am the owner/resident of the property located at: YC' The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: , 1 CC � �, a ;� — %. Name &relationship to owner; The Family Apartment will be the primary year-round residence for the above-identified family members. In the.event that the listed relatives vacate said apartment,I will immediately riots the.Building Commissioner in writing,I understand that no subletting or subleasing of said Family Apartment is permitted. .1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town:of Barnstable Zoning Ordinances Section 240-47..1 Family Apartments. .l agree to note the Building Commissioner immediately in the event of the sale of this.property. If there is no longer a Family Apartment at this,location,please explain: The.apartment has been dismantled. Thee apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the,paij s an�3 penalties of perjury this ?f day of �e ,2019. Signa re Phone Number Print Name , t T :(1 l f a,l/L jj i q:forms/famaffid.doc rev 11/08/13 Town of.Barnstable Building Department Brian Florence, CBO TOWN OF BARNSTAB C • STABLE, • LE NAM $ Building Commissioner 200 Main Street,Hyannis, MA 02601 Z018 JAN 19 PM 12'.2 7 www.town.b a r n s to b l e.m a.u s Office: 508-862-4038 ... ! 230 ENVISION ---T ofBami fa-Me F am- Ty� men Wff fidavi I,being on oath, depose and state as follows-, My name is - � .I.am;the`owner%resident.of the 1 property located at'. piv ` . ,O �: The following members of my family will be the sole occupants of the Family Apartment at the i aforementioned address: .— lr Name &relationship to owner: f- t owct'A o s OV-) Name&relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand,that no subletting or subleasing of said Family Apartment is permitted. I understand thatl am required-to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment..I also understand that I am required to.comply with all conditions imposed by the ZBA.Special Permit andlor the Town of Barnstable.Zoning Ordinances Section.240-.47J Family Apartments. .)agree to note the Building.Comm ssioner'immediately.in the event of the sale of this property.. If there is no longer.a Family Apartment:at this location,please-explain: l The apartment has been dismantled:,.. _. The apartment has been transferred.to the.Ainnesty Program(Appeal.No: ) Other Sworn to under the pains enalt} of perjury this day of- ��v�l�e 2018. . � A'A / ( J SignatixVPhone Number Print Name + av0-{/� q:forms/famaffid.do c rev 11./22/2017 Town of Barnstable - Regulatory Services .. Richard V.$cab,Director TOWN �►#� ,ARNSTAgLE Building Division ' 'r ' Ii7 t,n -6 c haul Roma,Btuldng'Commissloner a P6'S-I� i63� ,�°� 2Q;O:M.,ain Street; Hyannis,.MA 02601 'a. . www town barnStable,ma us. Office., 508 862=4038 Fax 50 790-,3 Town of Barnstaba'e"Family Apartme.nt:Af#�davt` I bein goon:oath,dpposeand state as follows: lviy came is T IfT�''n °C��/ --l �� the oYvner%resident of'tle property The followug members of m fanul :will:lie thesole oecu ants`of the.Fanul ',�lparkment Y . Y P Y aforementioned address: Name&relatons}up to owner x: ..... . .. .. .;. . .. relatiorslup.to owner; The Family Apartment will be the primary year round residence for"the above rdented: anvil members: In>the>everit;tliat the,lsted relittn?es vacate said aparhnent,I will tinmedtately E' � �F notify the:Burldmg Commissioner mmriting<l understand that noa,ublettrng or subleasing of saidi Family Apartment is perinetted t taIdI d am required:>to f le an Adav:t annually yutth the Burldmg Commissioner listen the names,and relattonslii o occ ants m sdid Famil. A artment I also 8 P f uP Y P understand that I.am rogt0red to..comply,with`all condthons imposed by the ZBA Special Permit and/or the TownofBarnstalile;Zoncng Qrdiricrrices Seaton 240 47n1 Famzly-Apartments: <Tagree: }: to>nottfyTtle Burldmg Co this property; >f there i era anal A �eqt at this lcicattoh, ?lease explawi s �� . ,Y.., p _.. . M .:..:::. yThe a aitinent has been dismantled. `. es ,"Pro i eat No The a �,partrnent`hasbeen transferred::;to the..... ... tY :€�'�C::.Pp.: Swom�to„under a and pe tes,.of perjur}':this; _ day o f 20T c Sgna e; Phone N.umber;.. l PrmtName . :. _:. n q:forraslfamaffd doc: i Town of Barnstable Regulatory Services oflW � Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner MAW ` 3;- 200 Main Street, -Hyannis,MA 02601 ee Ma www.town.6a J- rnstable.ma.us �� , Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is &I I am the owner/resident of the _property located at: A O t y S The following members of my family will be the sole occupants of the Family Apartment at the aforementioned.address: Name &relationship to owner: P\t r) Name&relationship to owner: The Family Apartment will be the primary year-round,residence for the above-identified family members. In the event'thdt the listed relatives vacate said apartment,I will immediately note the Building Commissioner in writing.I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of-occupants in.said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments, I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: —The apartment•has been�di srnantied. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to and a pains d penalties of perjury this�_ day of e 2016. Si a e -Number Print Print Nam C C t)` n Q��M� 9S :01 Ny 11 .,E 91i,� q:forms/famaffid.doc 31GV1S�l2itig J0 i;11'Pi01 rev 11/08/12 pf `°� Feb. 4. 2015 11 : 39AM No. 2152 P. 2 Town of Barnstable Regulatory Services Richard V. Scali,Director TOWN OF BARNSTABLE �. : Building Division ? !S F _ g I! !I 3 Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 [yIVISx0NFax: 508-790-6230 Town of Barnstable Family Apartment artment Affidavit I, being on oath,depose and state as follows: I �— .e n ' 1 Qy a I am the owner/resident of the lvZy name is cS`� property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name& relationship to owner: �T �-� cN G�c��.c, _ ' SO✓� Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted I understand that I am required to file an Affidavit annually with the.Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family.Apartment at this location, please explain: The.apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and lties of perjury thisr day of --e.10 2015. �.�o -ox'a Signature Phone Number Print Name __A C.�V�✓` _ q:forms/famaffid.doc rev 11/08/11 Regulatory Services oaf Richard V. Scali,Interim Director, Building Division Thomas Perry,CBO,Building CommissionT WN OF BA,RNSTABCE .619. �� 200 Main Street, .Hyannis, MA 02601 www.town.barnstable.ma.us 2014 FEB -4 JAIM 11' 07 Office: 508-8624038 Fax: 508-790-6230 Town of Barnstable Family ApartmentlA�ffitlavit I, being on oath, depose and state as follows: ri� I am the owner/resident of the My name is �_s�-en Q\tCk property located at: mc The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: fy\,l I)C l av-\o - sc n Name &relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notes the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location,.please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the 'nsInd pe alties of perjury this �J day of 2014. I Si a Phone Number Print Name Qt a VAb q:forms/famaffid.doc rev 11/08/11 78:48a Comm Water Dept - 5084283508 p.2 Kegnlatory Nervices . oft rq Thomas F: Geiler, Director Buildiag Division Or Thomas Perry, CBO, $uilding Commissioner,° i 200 Main Street, .Hyannis, MA 02601 www.town.barnstable.ma.us � Office: 508-862- •( 38 : : : Fax:: 508-79M230 Tow i of Barnstable 'Fam ly Apartment Affidavit I, being on oath, d 1::)se and state as*fo 'My name is ..:� �'n llows- Q� 1 am the owner/resident of the . property located ai VV The following mex I::,rs of my family will be the sole,occupants of the Family Apartment at the aforementioned ad r :ss: Name &relationsh to owner: C- f V L V Name & relationsh :i -Lo owner: The. `: nily Apartment will be the primary year-round residence for the above-identified ed family memb i In the event that the listed relatives vacate said apartment, I will immediately notes the Bu �ng Commissioner in writing.I understand that no subletting or subleasing of said Family Apar u.nt is permitted I unc !,.stand that I am required to file an Affidavit annually with the Building Commissions - 'sting the names and relationship of occupants in said Family Apartment. I also understand t; :r I am required to comply with all conditions imposed by the ZBA,Special Permit andlor the Tc r of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the: !e:lding Commissioner immediately in the event of the sale of thisproperty. If there is no longer ?amity Apartment at this Iocation,' please explain: The apartme. I ias been dismantled. The apartne; ; las been transferred to the Amnesty Program(Appeal No. ) Other Swom to - :e:ns and penalties of perjury this day of 2013, i tore Phone Number . . Print Name C G�V v`p ; q:forms/famaffid.do rev 11/08/11 = WO-1:41a Comm Water Dept 5084283508 p.1 �► Town of Barnstable Regulatory Services RAP14STAMIS, Thomas F. Geiier, Director Building Division. Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4- '.I: Fax:508-790-6230 January 4, : 1. 3 Kirsten&Ri ravano 1065 Servic I.oad �. West Barnsi ; e, MA 02668 Re: Family, Ir irtment Dear Proper )wner, Please comF 13 the enclosed Family Apartment Affidavit and return it to the Building Commission Office by February 19,2013. You are reqL I under Section 240-47.1 of the Town of Barnstable Zoning Ordinances t : ubmit an affidavit annually indicating the status of the Family Apartment. Failure to sul r t the affidavit is a violation of your Family Apartment approval and may result in the I of your rights.' If you have a it juestions, please call Brenda Coyle, Principal Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Com 'ksioner Enclosure Kirsten Tavano 5083759979 p.1 Town of Barnstable Regulatory Services Thomas F. Geiler,Director TOWN 4F B��`ClST�1�LE Building Division 1gi1 I0i 12 Pik 2: 15 - Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstabte.ma.us D lei{Y ON Office: 508-8624038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit 1, being on oath depose and sta follows: My name is C�S '� I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of'said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 140-4?.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location; please explain: The apartment has been dismantled. The apartme been transferred to the Amnesty Program(Appeal No. ) Other Sworn to the allies of perjury this day of 2,012, Signatur _—� Phone Number Print Nam q:forms/famaf fid.doc rev 11/08/11 Jan 10 11 01:43p Comm Water Dept 5084283508 p.2 Town of Barnstable Regulatory Services of"¢ Thomas F. Geiler,Director Building Division T01,11N OF B'��"P"_'S `BLE MAS&aAmsmem Thomas Perry, CBO, Building Commissioner n M v ArEo ,�. 200 Main Street, Hyannis, A 02601 °'`' r, 17 rc'1 is l0 www.town.ba rnsta ble.ma.us Office: 508-862-4038 ' Fax --50:K790-6230. 'down of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is ' r ' �� n , ��u I am the owner/resident of the property located at: �u �, e 5-p The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner,,,,w Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the even!that the listed relatives vacate said apartment, I will immediately notes the Building Commissioner in writing. I understand that no subletting or subleasing ofsaid Family Apartment is permitted. I understand that I am required to file an Afdavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply tvith all conditions imposed by the ZBA Special Permit andlor the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event ofthe sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this�� day of��hs,,� 2011. 141ature Phone Number Print Namur�. \ C(IAh 13 10 02:00p Comm Water Dept 5084283508 p.1 /< 4 Town of Barnstable Ta R'egulator��'Services 1He r �RVaf o� °wti Thomas F. GeIHer,Director Building Division �;'F1 J� 13 C't�l 1= 45 'MASS. Tom Perry, Building Comrnissione'i Y a"9• 200 Main Street, H annis'MA 02601 �rFO MA'S A y . %"w.town.barnsta ble.ma.us DIMS O\' Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I. being on oath, depose and state as follows: My name is �` � �� r :'l ' �,; � y� ' I am the owner./resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned addzess: 6 Name & relationship to owner: -�I( ,1 c 9 9 Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, [will immediately not the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to fle an Afj?davit annually with the Building Commissioner listing the names and relationship of occupants in said Family.Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/6r the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event ofthe sale of this propert}-. . If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No.- ) Other Sworn to under the pains and penalties of perjury this day of . sal 2010. S�gnatt -Phone Number Print Name Q/bld g,'forrns/fama Cfid Rcv:12Z v TOWN OF BARNSTABLE 2009 STREET LISTING V STNO NAME YOB OCCUPATION V STNO NAME PRECINCT 11 YOB OCCUPATION 33 WILLIAMS, PAUL J 1955 * 1135 MACPHEE,SANDRA M »* 40 BROWN, KATRINA CLARE 1979 * 1951 * 49 CRIGHTON, MARSHA L 1135 MULHERN, MARY A 1971 1936 RETIRED * 1347 CAPRA, DAWN M 1966 HOUSEWIFE * 52 PHILLIPS, JERRY J 1942 * 1347 CAPRA, JOSH WILLIAM * 52 PHILLIPS, PRISCILLA B 1943 ■ 1990 ` 67 SURPRENANT, DONALD C 1956 BIOLOGIST ` 1347 HOSTETTER,THOMAS MILES 1967 1541 LUNDHOLM, LORI A 1963 HAIR STYLIST ` 67 SURPRENANT, MAURA K 1964 BIOLOGIST I * 74 BRUILLARD, PAULA AA 1541 PENN, WILLIAM W 1989 1959 BARTENDER * 1547 BURKE, MATTHEW JOHN 1984 STUDENT * 80 GLASER,JEANINE M 1950 RESP THER 1547 SMITH, CHRISTOPHER A 1984 MILITARY ` 80 GLASER, RAYMOND W 1950 ENTREPRENEUR * 88 MILES, MAUREEN E * 1547 SMITH, ROBERT ALERI C 1954 SM BUS OWNER 1938 TEACHER * 1547 TAYLOR,VALERIE JOCELYN 1986 ` 96 HARRINGTON, BARBARA K 1938 SPEECH THERAP » 1559 DURNING, SABINA M 1939 RETIRED 96 HARRINGTON, MEG E 1971 ARTIST 1567 HAMMOND, CAROL 100 JOHNSON, MAUREEN L 1932 RETIRED ■ 1946 TEACHER + 1567 HAMMOND, PETER E 1946 MAINTENANCE SUP 108 SHEA, MAUREEN A 1936 RETIRED * 1585 DARDIA, JENNY E* 116 CULTER, ALISON BARBARA 1967 » 1965 EOCCXECUTIVE THERAPIST" » 1801 ALT AULT, CANIELLE B 1965 EXECUTIVE DIR. If 119 KASARJIAN, HELENJ 1917 AT HOME 1805 ALTAFFER,CASEYJAMES 1986 DRIVER * 129 SARAFIN, ANNE E 1988 STUDENT 1805 ALTAFFER, KERI A 129 SARAFIN, CAROLINE W 1990 STUDENT * 1805 MACHADO,ADAM D 1967 1967 RETAIL * 129 SARAFIN, LEE J BUSINESS 1950 SALES. * 1805 MACHADO, KAREN M 1968 OFFICE MGR ` 129 SARAFIN, SUZANNE WELCH 1954 SPEECH ASST 1821 GOLDSTEIN,SETHMATTHEW 1971 SALES * 143 PAYELIAN, ESTHERC 1923 HOUSEWIFE * 1821 GOLDSTEIN, VICTORIA NAPPI 1972 ATHOME 1 * 143 PAYELIAN,JOHN 1921 RETIRED * 146 LEARY, DEBORAH A 1956 TEACHER * 146 LEARY, KAITLYNE 1988 STUDENT SHAMMAS LN * 146 LEARY, STEPHEN J 1951 ENGINEER » * 196 ONEILL, BRIAN C 1972 ACTOR » 11 BISSETT JOANNE 1958 MACHINE OPER. * 26 STANGE, KRISTIAN S 1965 196 ONEILL, DIANE A 1941 RN * 26 STANGE, LYNN C 221 NUNHEIMER, COURTNEY 1991 STUDENT 64 * 1927 GUALBERTO,ALESSANDRADIAS 1964 AT HOME * 221 NUNHEIMER, DAVID C 1960 ATTORNEY » 27 GUALBERTO, PAULO L 1977 PAINTER * 221 NUNHEIMER, ROBERTAM 1962 RN » * 224 MOK, PATRICK W 37 HARRIS, EIIZABETH C 1951 RETIRED 1953 ACCOUNTANT * 37 HARRIS,TIMOTHY HUGH 1947 RETIRED ` 224 MURLEY, SUSAN E 1951 LECTURER * 238 GEARIN, KIMBERLY J 40 EATON, DARE VN 1990 STUDENT 1968 * 40 EATON, AREN V 1953 RETAIL ` 238 GEARIN, NEIL C 1959 » ` 253 GLYDON, JONANTHONY 1947 COMP PRES 40 40 EATON, DAVIDG 19 EATON, KEVIN T 1989 POSTAL MGR * 253 GLYDON, MEREDITH M 1947 PROCEDURES CLR : STUDENT 49 LANAHAN,JESSICA L 1988 - 49 LANAHAN,KATHLEENA 1990 SALT MEADOW LN * 49 LANAHAN,SUSANM 1961 TEACHER " 10 SPANO, SUZANNE M * 50 GAGNE, DENNIS M 1951 PLUMBER * 1952 MEDASST 50 GAGNE,JONATHANR 1980 PLUMBER 10 SPANO,THOMAS C 1952 SR APP ANALYST * 50 GAGNE, NANCY J 39 SOUZA, KAREN A 1957 OFFICE MGR + 1934 SCHOOL BUS ATTE 39 SOUZA, KIMBERLY A 1981 TEACHER * 51 GUMBERT, ELAINE P H J 1965 UNEMPLOYED * 39 SOUZA,TAMARA LEE 1982 STUDENT * 51 COCOZZA, KYLE L P 1965 NURSE 51 COCOZZA, KYLE L 1965 SALES *SANDY NECK RD 51 COCOZZA, KYLE O 1990 STUDENT * 330 POTTER, PAMELAJ 1949 TEACHER SHAWS LN * 330 VERDINI, THOMAS P 1954 SELF EMP * I * 349 BURNS, ROBERT D 1956 GRAPHIC DESIGN + 30 JENKINS, CHR 1964 GEN MG MGR ` 349 CURRY, PAULA G 30 JENKINS, THOMAASS D D 1965 EN MGR/AUTO SA 1957 FINAN ADVISOR I I * 350 RUSSELL, JEAN K 1949 HOME HEALTH CAR SHEEP MEADOW RD SANDY ST * 15 ZALL,MATTHEW KAUFMAN 1990 ` 70 LANE, CAROLE M 15 ZALL, NEAL ALAN 1947 ENGINEER 1954 FACILITY MGR * 15 ZALL, PATRICE K 1951 TEACHER " 20 KOSMAN,MAXWELLA 1986 SCORTON HILL RD * 20 KOSMAN,THOMAS E 1952 ATTORNEY * 20 WEIL, RUTH J 1952 ATTORNEY * 48 KEARNEY, EDWARD C 1967 TECHNICIAN * 66 * 48 KEARNEY,MARGARETC 1930 RETIRED * 66 JULESON, JAMESE 1926 RETIRED JULESON, TIMOTHY W 1959. BARTENDER * 48 KEARNEY, RICHARD D 1924 RETIRED * 71 GARCEAU,ARMAND S 1960 FIELD ENG " 85 SHAPIRO, ROBERTA 1941 RETIRED SERVICE RD ` 85 SHAPIRO, STUART 1940 RETIRED * 100 SLATER;DAVID 1948 ANALYST * 1049 1 BUNKER, CRES,YSTAL INACIO F 1956 * 100 SLATER, WILLIAM E 1985 STUDENT �' 1049 BUNKER, CRYSTAL DEWITT 1977 SALES " 1049 BUNKER, DANIEL E 1971 BEVERAGE MGR " 1049 VAN KLEECK, DAVID C 1974 . SOFT SHELL LN * 1051 STILL,11 DAVID B 1967 EDITOR' * 35 CHAlL1ES, JAMES V 1950 DISABLED j 1065 LUCAS, ALICE 1917 RETIRED * 35 CHALLIES, PAMELAJANE 1960. OP.SER MGR * 1065 TAVANO, KIRSTEN E 1966 BOOKKEEPER * 1%5 TAVANO,RICHARDJ 1965 BUSN.OWNER 1665 TAVANO,TREvoRR 1991" STAGE COACH RD * 1095 * SHANAHAN,MAURAA 1961 TEACHER * 6 WITT, CANDACE M 1950 CUSTOMER SERV 1125 COBB, CAROL J 1967 SUPERVISOR * 6 WITT, GEOFFREY G f * 1125 1981 USAF COBB, STEPHEN P 1960 REAGENT * 6 WITT, RALPH D 1951 MECHANIC 1135 MACPHEE, BRIANA 1952 * 9 FULP, MATTHEWBURTON 1975 1 ":INDICATES VOTER 211 Town of Barnstable Regulatory Services THE►, Thomas F. Geiler,Director R S 1pBLE ; 1 Building .Division H ASSs " ! il Tom Perry, Building,Commissioner 1 9 � 2009 FEB oTEo �p�0 200 Main Street,Hyannis, MA 02601 H"w•w.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is _ [� :� �1 \+ ; ��.1Q I am the owner./resident of the property located at: �� (L�t The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: CJ C,/ L I � Name &relationship to owner: The FamilyAportmeni will be the primaryyear-rour2d residence fur the ahove-identified family members. In the event that the listed relatives vacate said apart►nent, 1 will immediately note: the Building Comm'SSiOnCr in Writing. 1 unders•tand that no subletting or subleusino oj' soid.Vamily Apartment is pern:irted. I understand that I am,reyuired to fle an Affidavit annually with. the %jiic/inc, Commissioner listing the names and,elationship of occatpa!zts in said Farniiy Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZB31 Special Permil a.nd%or the Town orBarnsiadle Zoning Ordinances Section 2-6-;7.1 FanilyApariments. I agree to no4y the Building Commissioner immediately in the event ofthe sale uf'this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program {Appeal No. Other Sworn to under the pains and penalties of perjury this day of ?009 Signa are ��` 7 - `� C. )C Phone Number Print Name— � Q/bldg/fo-msdama It id Rey:12/Oi Z-d 909E8Zb809 Ida(] aa;eM WWOO 138b:O L 60 6 L qaj Jan 23 08 07: 14a COMM Water Dept. 508-428-3508 p. l Town of Barnstable ' Regulatory Services i'oWI OF BARRS'l-ABLE oFTHE rW�,y Thomas F.Geiler,Director Building Division - ' 2008 JAN 23 AM 7: 50 RARN ntSTABLE• ' Tom Perry, Building Commissioner AM �At 1639. a`0� 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us DIVISION i Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Dt L(\ a'\J C�\r1 C I am the o�Wn /resident of the property located at: _� � Z r ci V,-)� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship 1�o 1�1 Name & relationship to •:)caner: The Family Apartment will be the primary year-round residence for the above-identified family members. in the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that.I L'm required to comply with all conditions imposed by the ZBA Special Permit and/or the Town o;"Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property, If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn-to under the pains and penalties of perjury this ` 3 day of n 2008. . 7- (_� q-G79 Sigufiture Phone Number Print Name \ a n -�� Q/bldg/forms/famaffid � _ r BPS i CF1HE Ip� 2026� 0 �-�� Town of Barnst a �643�-j — 12219p. Regulatory Services .. % enatvsTnbm Thomas F. Geiler,Director 9 MAS& `bA 1639• �•� Building Division rFn r�r►�° Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 AGREEMENT FOR FAMILY APARTMENT I(We), the undersigned, being the owner(s) of property situated at 1065 SERVICE ROAD in WEST BARNSTABLE, MA, holding title under a deed recorded w=thernstable Cou�ty Registry of Deeds or Barnstable County District Registry of the Land Court in Book Page ,_ or as Document No. being. shown ;ori Assessors' Map 153 as:Parcel 037, hereby agree, certify, warrant and represent to the Town'of Barnstable that°1he:accessory attached apartment,which Foiitains living quarters,is intended for use as a family apartment,for year found occupancy. The intended and authorized use is for SALLY LUCAS, MOTHER/MOTHER-IN-LAW OF THE OWNERS KIRSTEN&RICK TAVANO associated with the residential use on the same premises. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances) which would require compliance with the Family Apartment Rules and Regulations. This unit-shall not be tented as an apartment or as a single room,or in any fashion, which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building i department. This agreement shall be updated whenever a change occurs or every. calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by �J the Town of Barnstable Building Department. WITNESS our hands and seals this day of 200 TOWN OF BARNSTABLE O R(S) By: uilding ommissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date Then personally appeared the above-named owner YS1 ,C�i made oath as to the truth of the foregoing instrument, before me. it No Public o mission Expire. y` R. BARNSTABLE COu SHEILA A. LON N �S REGISTRY OF DEEDS Notary Public",, A TRUE COPY,ATTEST Commonwealth c'"aassaci•u(Stts My Commissici Expires September 29. 2005 JC)HN F,MEADE REGISTER Q:word/accessoryagreement __ BARNSTABLE-REGISTRY OF DEEDS DESIGN CALCULA TIONS.• WEST BARNSTABLE fl9P OF lDfIIVDAMN 1— 20' NN. NUMBER OF BEDROOMS . . . . . . 3 cor '[ lo MIN cnn�R GARBAGE DISPOSAL . . . . . . . NO� a�a aazs 4`eetr�ovu 4o P.re i Jew pnrfl'A PrR 17 J►"tA�R O� VENT TOTAL ESTIMATED FLOW LZ= 118, comirm coYn 110 GAL BR. /D WASHM SMAT4,Car ( _____ /bAY X __3 BR.) 330 GAL AY s c �RCX s' SET E'Ir114 ZZ-109' REQUIRED SEPTIC TANK CAPACITY 1500 GAL T oR UA Rimvnarm • SOIL CLASSIFICATION . 1 i/4 pm 06.7 cl $A v DESIGN PERCOLATION RATE B MIN./IN. jd ofrm?r i ,f• EFFLUENT LOADING RATE . . .66 GAL /SAY S.F. E LOCUS PINE cAs . •• ;• . •• face • :° • •• 0.00 TOTAL LEACHING CAPACITY 356 40 GAL/DAY g09EET e smrP 4.°• 4 m I-r .•'. . .•• . CAL DAY 1 -gyp Jwraaer Jzs Et.=11�g' '/ wrsRr ° • •�� ••,'e 6104,33' RESERVE LEACHING CAPACITY . . . 356.40 a.= 114.2 £L r 112.2' £L.��1z SIDEWALL• (2RRENCHES)(42 5' X 2' X 2 S1DE5)(.66)=224.4 1AL/DAY no�' �,� � - DISTRIBUTION P B'x�o' La�ctr TRaavr^x BOTTOM ( TRENCHES)( 0 X 2.5)(.66)=132.0 GAL/DA Y i IOCRAlbMUF CVJO'ACM OR r Or SMW i —1 _cAccays - BE BOX SOIL ABSORPTION 20 94' ' SEPTIC TANKff MORE MAN ONE Ot77ar SYSTEM (SAS) INSTALL 'PLACE oN e' smNR (2) ,2.5'WIDE X 40 LONG X 2 DEEP PROFILE O F VSGS ADJUSTED HIGH GROUND WATER EL a TRENCHES' Asir , • SEWAGE DISPOSAL SYSTEM OBSERVED s-r.4NDING )LATER (meal. in ,►ill) A'LeV.a eo.e9' NOT TO SCALE 10�2B19B - OBSERVATION ROLE 1 17,EV,S_114.9' LOCUS' MAP - GENERAL NOTES PERCOLATION RATE �—"KN./INCH AT �Q= INCHES OBSERVATION HOLE.2 ELEV.= 112.3' DEPTH HO TEXTURE COLOR MOTT. OTHER DEPTH HO TEXTURE COLOR MOTT. OTHER ! PLAN REF.' 529117 1) ALL IIOR"ANSHIP AND MATERIALS SHALL CONYMY TO REP ' "a RES. ZONE: "RF" TITLE 5 AND THE TOWN OF XTAKE RULES AND ` ' A WOOD LOAM o°- • A WOOD LOAM ASSESSORS MAP 153 LOT 37 REGULA270M MR THE SUBSURFACE DLSPOSAL OF SEWAGE B'-90" B LOAMY SAND 0 - <5% 6"-92" B LOAUY SAND 0 - �S aj THAAr 2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TYJ y O=158 C SILTY SAND IOYR8-3 PERC =120 C SILTY SAND I0YR8-3 PERC iU ,. D I. COBS D Ir COBS az \ FLOOD ZONE C IPITHIN s OF MHHED GRADE OTHERS 07THDV 12 B �' FEW PANEL' 2 3) ALL COMPONENTS OF THE SANITARY SYST" SHALL BE CAPABLE OF NO GROUND HATER ENCOUNTERED NO GROUND HATER ENCOUNTERED ARNSTA 5 / / # 50001 0015 C 1I19715'TANDING H--lo LOADING UNLESS THEY ARE UNDER OR WT171IN OF B °� � / /. / I _ DATED.• AUGUST 19, 1985 10 FT. OF DRIVES.OR PARKING AREAS. H-20 LOADING SHALL BE °lw Q 0 USED UNDER OR WITIMV 10 FT• OF DRIVES OR PARKING AREAS BATE OF SOIL TEST 12/10/b76 (MT�P8822) T� OvvR 13 RRY +r i 9.01 4) ANY MASONARY UNITS USED T 9 BRING COVERS TO GRADE SHALL AN � � " BE NORTERED DV PLACE 314-IN DENSE GRADED CRUSHED STONE WITNESSED BY EDIPARD BARRY CR BpG � 0• 5) NO D�AT7ON HAS BEEN MADE' AS TO COMPLIANCE WITH SOIL TEST DONE BY JOHN P. DOYLB' DEEDED OR ZONING REGMAT70AS OLINER/APPLICANT 1S TO S'=0.005 / / �M O OBTAIN SUCH DETERMINAT70N FROM APPROPRIATE AUTHORITY �G' D 1 6) SHORN ARE APPROXIMA72�' ONLY, EXCAVAT70N CONTRACTIOR •:••°;.:::":•"ae�4" :e^:::o:;::..:,•...... ,�Y• / bO,c�O / 3 P r °•°e°O°• .. - T AtJC G IS TKO CALL DIG- SAFE' AT 1-B00-322-4844 AT LEAST 72 HOURS •EXISTING RO BASE '`O / / / 0,�/ / / / f J y� PRIOR TO COMMENCING 1R7RK ON SITE ^°°•°::• �J Q, l 7) CONTR9CM LS T O VERIFY GRADES AND ELEVA77ONS AS IPELL AS , 1� FLAGGED SITE CONDITIONS PRIOR 12O COMMENCING li7JRK ON SITE _ $ ih►. / hsT�t � B) PARCEL IS IN,FLOOD ZONE C' _. All- PLAINS 9) LOT L4 SHOWN ON ASSESSORS MAP 153 AS PARCEL / I ROAD TYPICAL CROSS SEC77ON NOT TO SCALEol NOTE: WORK LIMIT LINE / TO BE ESTABLISHED sbo KITH INSTALLED SILT FENCING. "�• 1 ,�' oti i ' / 715,E / / f�� / / 'i / �'� i' / P - M g.B• Y .� ` ._ R' 6B.47 1y1 T 1 // 171 tSr Qg'/ l $06 42 35 I , ! y355 �w ,1p /'�' oo _ OP°SED / o W h i i GAR f ED x�l J �2 20 I I $ / l o. S ,� to li i oogi LO�° t 5•F �/ 52egp0•�� ti� hti AREA,90 \ \ ro y:.. X —�. °'% 183• `- / ,i� y !- �' E `_ _ / !O EDWAAD L. yG PESCt \ /x ..y'�r '�' CIVIL n S1027'21" U.I. 9 ``_ —� ly-' -- ;_--•.. S� Al E .r. ..... Q:; FLAGGED .:: .- • , 97. i '.� , ----------- �. -•tv Q/� e4�yQ �J DIRT -WAY - O / 7 ,. w cr rn E --x x ,....... 5p1 �.��...:.:: :::.;; : .�.y_y x SITE PLAN OF PROPOSED ALI 75'°=x'• x ::: R�pDWA b �� 7U yYN B.O.H. .r. --.---......................._� yy=x .- �, e� �� VARIANCE: PEE T°T �� ' �. _�r- :::......::..:: :::;:;::::T ::: :w :;;R,TONE WIDE T° o $ SEPTIC SYSTEM DESIGN - - ----� .�.w.-`. X-i HED 5 , .� 11 �, © ��' .... ........ .............................. ............. ... .. -x- — PART VIII SEC 1.00 ........... .................. ......................._ w. _ : : :::r.-.-. :..... OF DENED �,• AN LOCATED AT 3 ...... AND _L _ D 7ti INSTALL A SEPTIC TAM LESS ?N fed Ly 100' (91) FROM A WATER COURSE LOT 9 GRAPHIC SCALE e�' �./ ' 1065 SER VICE ROAD 40 a 20 � : � 18O �JlOF PESCE ENGINEERING ASSOCIATES WEST HARNSTABLL', MA. h P.O. BOX 321 PREPARED FOR- IN c IN FEET > OSTEPVILLE, MA. 02655 RICK & KIRS TEN TA VA NO aaat® 1 inch 40 fL OCTOBER. 24, 1998 - anrs Pk- .(508)428-3730 REV. FEE 9, 1999 RoffREV. . FEB. 20,, 1999 JOB � 51632