HomeMy WebLinkAbout0021 THE PLAINS ROAD NORTH NO
0
�ON�ENT b?
�0.
@ M
9
LO a
.—M C.
1 Ln a.
Y U �
O a
=)Z.. z
r'
S�� �"
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
M,ap r S 3 Parcel 0 ODj Permit#
Health Division Date Issued
Conservation Division Application Fee
Tax Collector Permit Fee �'l �-�: �D
Treasurer
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address/� e P)a I ns P C1 JVaV�h
Village Wes) Av rd1s4r, $Ie_
Owner )U.SY/n 4 'S Lt.<,a i)AP 0.CoA D0- Address � > � �1 n I1\S A2
Telephone S-M, 3 LP Z fib))
Permit Request Cyns�-rL9 c} e%.o Z_ c-c-Ls ra V ��) � � n S S r o CCCiD�
Square feet: tst floor: existing jb[,q proposed ) 2)9 2nd floor: existing tvR 1_ proposed 169 Total new f ) 1
Zoning District Flood Plain N fA t Groundwater Overlay
Project Valua n i!&D,j2br) Construction Type WQo y YLZ M-e-
Lot Size Grandfathered: ❑Yes UIKO If yes,attach supporting d umentation.
Dwelling Type: Single Family Q Two Family ❑ Multi-Family(#units) Qj ZE
.D)
Age of Existing Structure Z tbyZ Historic House: ❑Yes i"No On Old King's Highway: ❑Yes e:No
Basement Type: lull ❑Crawl ❑Walkout ❑Other w
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) =�
I C
Number of Baths: Full: existing new Half:existing I new.
Number of Bedrooms: existing_ new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas UOil ❑ Electric ❑Other
Central Air: ❑Yes W4o Fireplaces: Existing �_ New _ Existing wood/coal stove: Q es ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing Ynew 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 1A n r Telephone Number = �pZ
r
Address c License#
Home Improvement Contractor#
J Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO c�
SIGNATURE DATE
v
FOR OFFICIAL USE ONLY • ' "'
PtRMIT NO. S
,DATE ISSUED
MAP/PARCEL NO. y
ADDRESS VILLAGE
OWNER a
DATE OF INSPECTION: �� v je'
FOUNDATION AF l�oD �� tV �C � 40"J^ Tv
FRAME
INSULATION 5100 z1ozhi.�1 �
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
t
FINAL BUILDING � _
DATE CLOSED OUT'
ASSOCIATION PLAN NO.
I1 - ,
f 1
i
Town of Barnstable
Regulatory Services
BAPMt "11MMASS. Thomas F. Geiler,Director
039. 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
PLAN REVIEW
Owner: D &biyvV-r& Map/Parcel:
0 mod
Project Address 2ZJ( 5 1 /tbj47,,Builder:
G�
The following items were noted on reviewing:
a � �vFnsy eo�x�u.�vcE �iF�c�t�
1
DaJ ;PC— T//ZS-rLb�R .
QA/ D/C fill�Z/ZlC�itJ� _� 1pG'r Z A)-6
":t' 0-6 z&xe. ?
Reviewed by:
Date: C
Q:Forms:Plnrvw
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name (Business/Organization/Individual): l �
—�1 S 1 A�II � 116 r
Address: 02( -
City/State/Zip: one #: S 6--76
Are you an employer?Check the appropriate bog: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees(full and/or part-time).
* have hired the sub-contractors 6. El New construction
2.❑ 1 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. employees and have workers'
[No workers' comp. insurance comp. insurance.: 9. wilding addition
rruuired.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions
3.2 I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions
myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs
insurance required.] t c. 152, §1(4),and we have no
employees. [No workers' 13.0 Other
comp. insurance required.]
Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify un er the pains andpenalties of perjury that the information provided above is true and correct
Si ature: Date:
Phone#: �' —.310 Z- W"
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone M
Town of Barnstable
Regulatory Services
ox Richard V.Scali,Interim Director
Building Division
` >;�arAES,n�. ` Tom Perry,Building Commissioner
tiiasa.
039. a�� 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION: �21 /
num'be`r� �--. street village
"HOMEOWNER : ✓l�S 1 1 X6600(_
1 1 1�I — #name ome p ne# work phone#
CURRENT MAILING ADDRESS: 74
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
minim u inspection procedures and requirements and that he/she will comply with said procedures and
require nts.
Si 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 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.
ONs Mh
� of
f It t t,rrrrl,� lr, ►I ur,rl ( nr►�n�rn lr„n ir► lli�l► II inrl Irru�: llll rr►Irl► II ir►rl /.unc'
�I;1ss;lrilll�c'tt� Checklist for Compliance t�xuir \114 53111.1.1.11"
C'nmrliancc
1.1 SCOPE
Wind Speed(3•sec. gust) .. ..............110 mph —
Wind Exposure Category .. . . ......... ........... ..... I.. ....B
1.2 APPLICABILITY
Number of Stones .... ..... ...... J . ....... . . . . ....(Fig 2)...... . ... .. . .... ... 2 stones 5 2 stories —
Roof Pitch .. ... .. . 2 , .S .. .(Fig 2) . . ... .. . . ..... ..... 1.2• s 12:12 —
Mean Roof Height ..... ... .. .. ..... .. . . . --',... . .. ........(Fig 2)..... ..... . .. .......... ............ .... . . ft 5 33'
Building Width. W .. .. ... ........ I....... . ....`... .. . ... .. .. .... .(Fig 3). ................. .................. ...... �¢
Building Length. L ..... ..... ........(Fig 3).. ...... . ... . ............ .. . .. ........f,�ft 5 80
Building Aspect Ratio(UW) ...�. ? • 1 ......(Fig 4)............. . .......... .. ............. . t r 5 3:1
Nominal Height of Tallest Opening ....Ca......�..11. .......... ....(Fig 4)..... .................... ................. .. 2—-6 8"
1.3 FRAMING CONNECTIONS
General compliance with framing connections..... .... . ......(Table 2).................................................... .... ......
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concrete..... .. ........... ... ... ... ......... .... .... ....... . .................. .........................................
ConcreteMasonry ..... ... ..................... .. ..... . ... .. . ... ..... .... ............... . .... ....... .. ............ ... . ....
2.2 ANCHORAGE TO FOUNDATION'''
5/8"Anchor Bolts imbedded or 5/8" Proprieta Mechanical Anchors as an alternative in concrete onl�j,�
Bolt Spacing-general . ....... .... 47 4 Q�6.....(Table 4)..... .-U..'-.�........ ......... .. �T ,n.
Bolt-Spacing from end/joint of plate . ....... ... .. . .. ......(Fig 5)................ ........ ....... . _7iin. s 6"- 12"
Bolt Embedment-concrete............. ....... ... .... . ... ....(Fig 5).................................... ........... in. >_ 7"
Bolt Embedment-masonry... .............. .. ........ ..........(Fig 5)..... ... .. .. .. ......................... i in. >_ 15" —
PlateWasher ........ . .... . ............................... . . .....(Fig 5)...............................................a 3"x 3" x 'A"
3.1 FLOORS
Floor framing member spans checked .. .. ..... ......... ........(per 780 CMR Chapter 55).................................. .
Maximum Floor Opening Dimension.............. . .......... .......(Fig.6)......................... .&ft<_ 12'or U2 or W/2 —
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)................................. . .... —
Maximum Floor Joist Setbacks
Supporting Loadbearing Walls or Shearwall.. ..... .......(Fig 7)..................... ............... ........... ..=ft s d —
Maximum Cantilevered Floor Joists
Supporting Loadbearing Walls or Shearwall..... . ...(Fig 8).. .............. ............I....... . .. ........ —ft <_d
FloorBracing at Endwalls ........... ......................... .... .......(Fig 9)....................... .................................. . . .....
Floor Sheathing Type ...... ................... ...... .. .. .... . ..... :.(per 780 CMR Chapter 55)................. . • in.
Floor Sheathing Thickness ... .... ..................... . (per 780 CM Chapter 55).....................
Floor Sheathing Fastening ...... .I....... ........ ..........(Table 2).. d nails at in edge I f 2 in field
4.1 WALLS
Wall Height
Loadbearing walls . ......._ ... .... .......... . .. . . .... .......(Fig 10 and Table 5)............ ........44. tt 5 10' —
Non-Loadbearing walls. .. . . . .......(Fig 10 and Table 5)....................... s 20' —
Wall Stud Spacing . . . ........ .... ........ .... .......:..(Fig 10 and Table 5)....................*in. 5 24"o.c. _
Wall Story Offsets . .......... ...... ..... ... .......... (Figs 7&8)............................................— ft S d
... . . .. . . . g
4.2 EXTERIOR WALLS
Wood Studs 9
T _9 ft_in.
Loadbearing walls .... . .. .... ............. ... .... (Table 5)....._...... . ................2x
Non-Loadbearing walls..... . ... . _ .• ...• .......(Table 5). ....... ............ ......2x A 'ft�in. —
Gable End Wall Bracing
Full Height Endwall Studs... (Fig 10)............. .................................... . . ....... _
WSP Attic Floor Length..... . ... ..... . .. .... ......... ......(Fig 11).... ...... .............................. — ft aW/3
Gypsum Ceiling Length(if WSP not used).... .... ....(Fig 11).. . ........ ..
ft a 0.9W —
a��pLVOFyq� 2 x 4 Continuous atera race @ 6 ft. o.c. .. (Fig 11).... . . : .. . ...... ... ..��...'.....• .•.. •. • —
�4- M►CHELE q°s U r 5 W AU, 7, , :o,,,
o Cuo►LO
sr m
Aucr7 R �
No 34774AL co
9osSOke EcNG���Q
I I! r (,rrrrlc rr� ft rrr,rl ( r�„�►rrrr lir„r i►r lli�l, ff iurl trc u�: lllf►►rl, ► tt ►►►r nnc' 2 CF
{,t`�;tchudctt. ( ItcckIIs1 1'O1- ('()mplianee (-Ktl ( \m ;.=1i1.'_ 1 1 )'
Loadbearing Wall Connections Go1496clt?'-
Lateral (no. of endnailed 16d common nails). .. ......(Table 7). . ..... ...... . . ......... ..... ................. . —
Non-Loadbearing Wall Connections
Lateral(no. of endnailed 16d common nails).... . . .. . (Table 8).. .. .... .... .... .... . ...... .. . . . . .. . . �' —
Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
Header Spans r (Table 9).. ...... .. .. in. s 1
m1'
Sill Plate Spans Y1.'-P M. (Table 9) in. s 1 1' —
............. . . . ... .....
Full Height Studs (no of studs) .. . 3). . ..(Table 9) .... .. .. . . . .... .. —
Non-Load Bearing Wall Openings (recorklargest opening but check all openings for compliance to Table 9)
.(Table 9 . . . .... .. ..��ft in-. 5 12'
Header Spans .. .. . .. . .. . . .. .. .. ).. . . — —
Sill Plate Spans.. . . ...... (Table 9)....... . . .............. ..`eft_—m. <_ 12" —
Full Height Studs(no.of studs)... .. . . . . . .(Table 9).... .. —l— —
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously°
Minimum Building Dimension. W
Nominal Height of Tallest Opening . ... .. ....Ms 6'8"
•I <<pp
SheathingType... .......... ..... ................. : ....(note 4).............. . .................... .............. . —
Edge Nail Spacing ..... .:.... .... .. . . . . . .....(Table 10 or note 4 if less)...... .............. .. .7, in. _
Field Nail Spacing.. . . ......... . .....(Table 10)...... ......... .............. . ............... .in —
Shear Connection(no. of 16d c on nails)(Table 10).................. ..................... ...
ble 10) . . . .................. .......�.. �t t
Percent Full-Height Sheathing. Zt
7 0.�►3.$� .. ... . Sf X2(p�
5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)...... .... .
Maximum Building Dimension, L t
Nominal Height of Tallest Opening'....:............ .. .. .. .. ...... ... ....... ....... (�' rs 6 8
Sheathing Type........ ... ..... . . . .. ..........(note 4).. . ....... ........ _..... . . ........
.
Edge Nail Spacing . ............ (Table 11 or note 4 if less)...... . ............. �—in —
Field Nail Spacing..... ........ . . .....(Table 11)..... ....... .. ..................... .. ....:..�L in —
Shear Connection(no.of 16d comcnon nails)(Table 11).... .... ..................... .... .... r --�
Percent Full-Height Sheathing3.'.... . ble 11 . .. Z) °
5%Additional Sheathing for Wall with >6'8" (Design Concepts) Sr .4....X /1
Wall Cladding
Ratedfor Wind Speed?..... . . . ...... ..................... .......................... ... . .
5.1 ROOFS
Roof framing member spans checked? . .. . ... .. . . (For Rafters use AWC Span Tool,see BBRS Website) —
Roof Overhang .... ..... ... (Figure 19).. ... .. ..r,ft s smaller of 2'or U3
Truss or Rafter Connections .....at Loadbearing Walls,
Proprietary Connectors �r
UPtift......... . (o. . .. . Table 12)............... ............................U=
2 t. �..... . . ........( .�2 5�--
Lateral. .. ... ........(Table 12).................... ... ...... ............L=�7fp
Shear .. ... ................... .... (Table 12)....... ..... ...................... .. .... S=�J —
Ridge Strap Connections, if ollar ti not se r page 21..... (Table 13)..............................T= —
�. (Figure 20 N//Ir ft<_smaller of 2'or U2
Gable Rake Outlooker.......... . .... ... ...... ...... .... ( 9 )........... T'�
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors
Uplift. . ... ....... ... ....(Table 14) .... .. ...... ......................U= — lb.
Lateral (no. of 16d common nails)...(Table 14)......................... ....... . ..L ==lb. —
Roof Sheathing Type. ... . .... .. ... . . .. .... .. ...........(per 780 CMR Chapters 58 ano 59).................
Roof Sheathing Thickness . ... . . ..... . 7 in.t 7/16"WSP —
.... ......................... .. ................
Roof Sheathing Fastening . .... (Table 2)....... .. ....... d "requirements
Notes: (� '1. This checklist must be met in its entirety, excluding the specific exception noted in 2,to comply with the of
780 CM 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs ares not
required per the WFCM 110 mph Guide:
a. Steel Straps per Figure 5
b. 20 Gage Straps per Figure 11
c Uplift Straps per Figure 14
d All Straps per Figure 17
e. Corner Stud Hold Downs per Figure 18a
tion: Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing
y�kA��H ents shown in Tables 10 and 11.
Jall sill plate in exterior walls shall be a minimum 2 in. nominal thickness. pressure treated p2-grade
o S CUDII�tCCo w e 1A.
c> IR ORAL M
(�r
34 IN
.4r,Et�1G�
I
0.G
' I IN'lk.Rt�{tF:D1h'[E EDGE .
. I I d�IG►��i��NP• t��Ma`Lgt TYP.-� I
I
- I
� ..;� ���ti L PP►'fT��l�l 3�8 I I
; • I
--IpAt
YYSP ATTACHMENT
go'f 'f0 5CG4L E
T-OR VBR-T kmb A0itIZ. mTAGAMBMT _._ .....
NOTES:
Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows:
i. Panels shall be installed with strength axis parallel to studs.
ii. All horizontal joints•shaJI occur over and be nailed to framing.
iii. On single story construction,panels shall be attached to bottom plates and top member of the double
top plate.
iv. On two story construction,upper panels shall be attached to the top member of u1e upper double top
.plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and
lower attachment made to lowest plate at first floor framing.
v. Horizontal nail spacing at double top•plates,band joists, and girders shall be a double row of Sd
staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment
Cote 2 of
r
Sd N�►1.5 �����" o.c.
TT
ci
� � I•• I I J � 0
-
I.�
I � II I Ii
�00D -9'%WOILN� V'A MEL
W�SP g44EAT INCH
WSP ATTACHMENT o .
t4 07 10 5 C/A L.L - - --
_ IG 1. +40RIZQNTAL
A.-CT CH M B
GENERAL NOTES AND MATERIAL SPECIFICATIONS: (Residential IRC Construction) SK-1
FOUNDATIONS
I.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition.
2. For site location and grading information;see Site Plan,by others.
3. Assumed net allowable soil bearing capacity,q=3000 psf,for a medium sand/gravel composition. Other soils encountered,
contact the Engineer of Record.
4. Concrete: Minimum 28 day strength, fc=3000 psi,3/4"aggregate,designed per American Concrete Institute Code,latest
issue,maximum slump=4".
a.) Anchor bolts ASTM A307 galvanized,min.5/8"diameter, 12" long,w/2-1/2"hook spaced per Code Checklist,or in
concrete piers w/Simpson ABU-series base;SPACED 2'o/c for slab-on-grade construction(i.e.Garage,Basement,etc.).
b.) All walls to have min.2#4 top horizontal,2"clear,to prevent shrinkage
c.) All walls longer than 25' shall have vertical control joint with waterstopping between wall joint.
FRAMING
1.All workmanship to conform to the requirements of the Massachusetts State Building Code, latest edition.
2. Structural Design Loads:
Dead Loads:Actual Weight of Building Components
Live Loads: Snow Load =30 psf(plus drift)with applicable reduction
ATTIC Storage=20 psf
Living Floor=40 psf
Sleeping Floor=30 psf
Decks and Balconies=40 psf
Wind Load: Criteria used for 110 MPH Exposure B or C as noted per plans
3. Structural Steel: (as required)
a. ASTM A572 Grade 50;shop paint with rust inhibitive paint.Thru-Bolts: ASTM A307, 1/2"diameter;punched holes:
9/16"diameter.
b. Welds: Shop weld cap and base plates to columns;shop weld bearing plates to beams, use E70xx electrodes.
Alternatively, field weld by certified welders.
c. Deflection Criteria: L/360 total load deflection.
4.Timber Framing:
a.All new timber framing:Spruce-Pine-Fir No.2 with Fb=1000psi,E=1;300,000 psi,or better.
b.Pressure treated timber(P.T.):Southern Pine with Fb=1300 psi,E=1,600,000 psi,or better.
c. Laminated Veneer Lumber:All L.V.L.shall be 1.9E L.V.L.with Fb=2925 psi,E=1,900 ksi,Fv=285 psi, Fc_per=750 psi,
Fc_par=3035 psi. Parallam(PSL):All PSL shall be min. 1.9E ES with Fb=2900 psi,E=1,900 ksi,Fv=285 psi,Fc_per--750 psi,
Fc_par-2900 psi. Note that Microllam and Parallam may be used interchangeably.
1. Deflection Criteria: L/480 Live Load,L/360 Total Load
2. Optional: Provide shop drawing submittal of engineered lumber systems for approval prior to materials purchasing.
5.Metal Connectors:
As manufactured by Simpson Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail
holes filled,with the sire nail as specified by mfgr.or herein.
a. Rafter to Ridge Beam: Simpson LSSU-series,or Simpson Straps over top of plywood,spaced 16"o/c;
Rafter to Ridge Plate: Collar ties min. 1 x6@ 16"o/c at top or Simpson Straps over top of plywood spaced 16"o/c
b. Rafter ends to top plate: Simpson H2.5A
c. Band Joist: Simpson straps at 4'o/c: CS-14R-48"centered at band joist
6.Bolts:
Bolts in wood framing shall be standard machine bolts unless noted otherwise.Bolt holes in wood shall be 1/32"larger than
bolt diameter.Bolt heads and nuts shall bear on standard malleable iron washers,or square plate washers.All nuts shall be
retightened at completion of job.
7. Blocking:
a.Blocking shall be solid blocking,2x minimum,and full depth of member.
b.Stud Walls:provide blocking at 8'-0"o/c,maximum height. Corners to be blocked at 48"o/c with plywood edge nailing
to this blocking for the first 48"of these building corners.
c.Nailing Schedule:
Solid Blocking to Bearing 2-8d toenails ea: side
Blocking Between Studs 2-10d toenails ea.end,or 2-16d end-nails ea. End
d. New Framing:Provide 2x blocking for 2 joist/rafter bays and spaced 48"o/c in joist and rafter plane at all edges;attach
plywood edges to this blocking
8.Nailing Schedule:
All nailing shall be in accordance with Appendix 120.Q,unless noted herein specifically.
Multiple Studs 16d @ 12"staggered
a.All nails shall be common wire nails.
b.Sub-bore where;nails tend to split wood.
9. Headers less than 4'-0",use 2-2x6-.all others per MA State Building Code.
s. CONSTRUCTION DETAILS FOR THE APA NARROW WALL BRACING METHOD
FIGURE I
I
NARROW WALL OVER CONCRETE OR MASONRY BLOCK FOUNDATION
Oubido Elevation Side Elevation
-. Extent of header(two braced wall segments) ---
.- - ---- Extent of header(one braced wall segment) - Top plate continuity is
required per R602.3.2
C ti 1 Sheathing filler
r Min 3'x 11 1/4'tsd Irollrr r ` •;• if needed
2'to IS'(finished width! - i•• {�' �•
16d sinker nails
-Fasten sheathing to header with 8d common Wit (0.148'x 3-1/4")'c,
M nails(0.131"x 2-1/2")in 3'grid pattern as shown : in 2 rows @
and 3'o.c.in all framing(studs and sills)Np' ;: 3"o.c.'
•.
M; 1,000lb.heoder-to-jock-stud strop ^^ ^' I,00016. header
on both sides of opening 44M to-jack-stud strop
(install on backside as shown on on both sides
,� ;4�; j �� ;..,
Mox. two Side Elevation,Ref.No.LSTA24) ;; oo of opening(Ref.
height
h01 "�
g �Min.(2)2x4 M No. LSTA241
P,
"^• If panel splice is needed it sholl Braced wall
occur within 24`of mid-height. segment R602 10.5 +� ' 3/8`min.
M Blocking is not required. " thickness wood
..•� !') structural panel
• "I -Min.width bored on b:I No.of '^ ^'I
M ^q sheathing
height-to-width ratio: For jack studs
ex ample:l6`min.for 8'height, per Coble
20"for 10'height,etc. R502.5(1&2) j;• +•!
:w•j �� � Itiw �.
;4 _ Min.2"xTO/16'plate washer
r ----- --.. _ ... _ —.�_ - -----
Anchor bolt per R403..1.6 Typ. Foundation per code
Not to scale
'Or other code-recognized fasteners providing lateral resistance equal to or better than the prescribed nails.
I
Now riii,n in,w %kA nr.trtr._.,egm:rnt nwet,
me u:.::u::.n: requacutcnt, to; %%.ii, ':.+ ;u� FIGURE 2
:++.+.I, in thr i+Lutr ++: tar N,.;:!' :.tt:
:+ta!au.t dr,tgnr; •it+xdd .:nrrra:nr 'Al'i .;I. EXAMPLE OF REQUIRED OUTSIDE CORNER DETAIL(IRC R602.10.5)
.ne ne,e. r'to pn+ctor a.,+tuplrir
a p.;ut i.n ..•utg tht,I+re+in,tt:n;r-uu:,urr _
At corners,connect the - 16d nail of 12"o.c.
two walls together os
outlined in this detail to
provide overturning l Orientation of stud may vory
restraint. II
j Gypsum,when required,
installed in accordance
with IRC Chapter 7
i
< Wood structural panel
6
REScheck Software Version 4.6.0
Compliance Certificate
Project
a
Energy Code: Wes IECC �+
Location: West Barnstable, Massachusetts
Construction Type: Single-family m4- ar� a
Project Type: Addition
Climate Zone: 5 (6137 HDD)
Permit Date: SD
Permit Number:
Construction Site: Owner/Agent: Designer/Contractor:
RE-RE -5 Kumigumaug5a
Compliance: 2.9%Better Than Code Maximum UA: 69 Your UA: 67
The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules.
It'DOES NOT provide an estimate of energy use or cost relative to a minimum-code home.
Envelope Assemblies
Gross Area Cavity Cont. Glazing
Assembly or R-Value R-Value or Door UAN
Perimeter U-Factor
Ceiling 1: Cathedral Ceiling 187 41.0 0.0 0.026 5
Wall 1: Wood Frame, 16" o.c. 391 21.0 0.0 0.057 16
Window 1:Vinyl Frame:Double Pane with Low-E 50 0.310 16
Door 1: Glass 19 0.310 6
Door 2: Solid 19 0.190 4
Door 3: Solid 19 0.190 4
Floor 1:All-Wood Joi st/Truss:Over Unconditioned Space 187 30.0 0.0 0.033 6
Crawl 1: Solid Concrete or Masonry 187 0.0 10.0 0.080 10
Wall height: 6.0'
Depth below grade:4.0'
Insulation depth: 4.0'
Compliance Statement: The proposed building design described here is consistent with the building plans, specifications, and other
calculations submitted with the permit application.The proposed building has been designed to meet the 2012 IECC requirements in
REScheck Version 4.6.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist.
Name-Title Signature Date
.................
90 :01 6Z d13S h19Z
Project Title: - Report date: 09/29/14
Data filename: C:\Users\Sue\Documents\Documents\Sue Builder\O'Connor Garage\9-29-14 ResCheck Page 1 of 8
revised.rck
' rY
*Ba,rnst`ble Old Kings Highway Historic District Committee
200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784
MA & af639. -
& ' APPEICATION, CERTIFICATE OF APPROPRIATENESS
Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter
470,Acts and Resolves of Massachusetts, 1973;for proposed work as described below and on plans,drawings,or photographs
accompanying this application for:
Check all categories that apply;
1. Building construction: ❑ New Addition ❑ Alteration
2. Type of Building: ❑ House i2�arage/barn ❑ Shed ❑ Commercial ❑ Otl ef��
3. Exterior Painting roof dnew roof ❑ color/material change;.of trim, siding;window;doorDo T _
4. Sign : El New Sign - El Existing Sign O:Repainting Existing Sign" PV
"•.i'u.J �v�� J;',;. E,..,�
5. Structure: ❑ Fence ❑ Wall 0 Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other
6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other
Type or Print Legibly: Date
NOTE All applications must be signed by the current owner
Owner(print): �}3-h A �41 1� n-n Telephone#: !�
Address of Proposed Work 9— y'ld�d4- K(!(.:( Village' Map Lot#
Mailing Address(if different)
Owner's Signature
Description of Proposed Work: Give particulars of work to be done: l y}i,'Yt/L 4— .Q
ac,or iSY rtj; Ll !` C_rsn �.� Telephone#:
Address: A .
Contractor/Agent' signature:
For corm fmittee use only. This Certificate is hereby APPROVED/DENIED
Date ' 1 a3tan I Members si atures
03 C-9- �
o�4
Nv
VAEl
G-RO
APPROVE®
Town of Barnstable
Old King's Highway 1
Q:tBoards and Commissions101d Kings HighwaylOKHApplicationslOKH2O11 CertAppropriateness.doc Committee
Foundation Type; (Mak. 12"exposed)(material-brick/cement,other) VAAAUl
v ,
Siding 74ype: Clapboard_ shingle__V- other
Material: red cedar white cedar —�L other Color: Aftoca--
Chimney Material: Color:
Roof Material: (make&style) ��, n Q � Color: I�,gj
Roof Pitch(s): (7/12 minimum) tk (specify on plans for new buildings, major additions)
Window and door trim material: wood ' other material,specify
Size of cornerboards f x-T size of casings G X 4 min.) color
j N J
Rakes Ist member _2°d member [ �C.3 Depth of overhang
Window: (make/model) material Etc color
(provide window schedule on plan for new buildings, major additions)
Window grills (please check all that apply_.
true divided lights_ exterior glued grills grills between glass removable interior None
�I
Door style and make: ry material Color:
Garage Door,Style Size of opening f r L .Material = Color 1� l ov
Shutter Type/Style/Material: Color:
^ fl r Ir ,
Gutter Type/Material: (�.t y yyL(Oti(tj UU-, ► � �l.r>�.o�. Color:
Deck material: wood—4-- other material,specify Color: �.
Skylight,type/make/model/: material Color: Size:
JUL 2 32014
Sign size: Type/Materials: Color:
own o arnsta e
Fence Type(max 6' )Style material: Color: ���Commtteeway
Retaining wall: Material:
Lighting, freestanding `A1 ,* At. on building V, illuminating sign
OTHER INFORMATION:
THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED
'Please provide samples of paint colors,manufacturers brochure of windows,doo garage door,fences,lamp posts etc
Signed: (plan preparer) Tu� n. �a �Q r Print Name
RECE D . 2
Q:W"ds and Commissions101d Kings HighwaylOKHApplicationslOKH2O11 CertAppropriaten=doc
JUL Q2 2014
GROWTH MANAGEMENT
dates. ALL NEW HOUSE OR COMMERCIAL BUILDING PLANS MUST HAVE AN ORIGINAL
ANTI" Orr A AM i'f? A ATXr ry A a:Z r--n-r�r.-, x
;'.A..i. ltJ1V1)✓;1V1!'1ClJ V t 1Vl r l�l 1•I:UlV 1'1<Al:'1 OR, UNLESS 1 t�1S RE(�i1u°uvir.�v
IS,WAIVED BY THE OKH DISTRICT-COMMITTEE.
/� e er,•iH'nr. n„rl 1-nr 7rn.,r-, n.•..ln
y Elevations of all (affected)sides of the building,with dimensions includir_g,height fiom the natural grade
adjacent to the building to the to of One,_t[iu__
tl Window schedule on pla-.
_Name of applicant, street address,assessor's map and parcel number.
Anma arlrlracc and tc•lnnhnnP m,mt%or^47 fkP nlan nrF+narcr• -1— A�+u —A Al +
VThe location of existing and proposed buildings and structures,and lot lines.
Natural features of site(e.g.rock outcroppings; streams,wetlands,etc.).
-i:,AiJLiLg miller areas-10 reMalfi.
�cation and species of trees outside of buffer areas greater than 12"caliper to be retained or removed.
Dtiveway,parking areas,walkways,and patios indicating materials to be used. /
moval of stone walls,file Demolition Form).
All proposed exterior liehtina and si*r^
L/ .Stretch or photos of nAjacent prop:r ties. r,
---• ••-•••-•-•• •••• •`^r,:::.:. :^.: ;G,^.:•?:;,r:a;,cent hnildin¢c,where nrecent; along both si gc of the street
:.�...:, <oinmorciat nui id ng in scale ana in reiationsntp to me existing
buildings. Please discuss with staff if you do not think this is relevant to vour attnlication.
V/P otographs of all sides of existing buildings to remain,or being added to .
APPROVED
'r'ir.:�RE-i•ee"eee-e)ire`A laid• eencer.:rsr.�-
JUL 2 3 2014
v '_ n
••---•-•---- -- •• •• � Town of Barnstable
- -
- - - - - - - ------ - - -- - - - -- -- Committee
Building 1 sq. ft. &J I a:_ A.
New building or
= s�
Building 1 a - ::.::.:_ --- ---
New Building or addition,gross floor area,including area of finished basement:
Building 1 sq. ft. Building 2
CEMD
(� i�
4
Q:IBoards and Commissions101d Kings HiglnvaylOKHApplicationslOKH2O11 CertAppropriateness.doe JUL 0 2 2014
GROWTH MANAGEMENT
Town of Barnstable Geographic Information System July 8,2014
130018 130017001
#30 #2049 164004
#20 ® 164007002
154005 #50
C) #ao
154002
Boon 154006 #o
#2049 AZ(� #106
P,@ 1#007
3� 130016 •
y�4 #29*OJ
16300401602 ♦ t 64# 1
153018 . 0
FqSri_
153004004#59 #122 t530o5 1�03 163006
72
160 ®#196
J
C&4" s
C T 153022
n #216
1R
;4 IS3004003 153003
O #47 #0
oseool pCt 1530D4001®921 SA
ST '#812
#876 * 153026
#215
129011
#981 163012002
129007 153002 #20
129008 #0 #9
#0
.129003
128010 �26 1290021 c�gA�11 163 029 ' #19�1
#0 #1039 ® ��
° 153034
#1049
129006 129004001 16024
01926 035 152#250 t 001 #90
163035
163037 153025
#1065 #134�
129004002 #1061
1 8 Feet 1za013 #55 01096 �;eLl.r
#o
DISCLAIMERS:This map Is for planning purposes only. It Is not adequate for legal Map:153 Parcel:004001
boundary determination or regulatory interpretation. Enlargements beyond a scale of Selected Parcel
1'=100'may not meet established map accuracy standards.The parcel lines on this map Owner.OCONNOR,JUSTIN 8 SUSANNE E Total Assessed Value:$337100
are only graphic representations of Assessors tax parcels. They are not true property Co-Owner. Acreage:2.04 acres Abutters W E
boundaries and do not represent accurate relationships to physical features on the map Location:21 THE PLAINS ROAD NORTH '�..i
such as building locations. Buffer %�
r �
f /----------------
106 / p
-'108-----------
----------------------
y��1I i 1 3 C
I r--
„ i
I
----�_-
�+
li
/ -- - ------- -- + -
1
7;_:
f.,
❑ %
I
rM❑
❑ -- ..........
- - Ul I
I I .
-- -------------
9-2 — >Z I 3:
lD :i
. 0
m I
... ....
i D
Y
. n p _
M :jO L P %m9
�
z o n c c m
o�+$ o y m rn m
_ i --
`gym D�D m ,
A b C m { -1
' rn�m Oo�� `^� v n j ••�� '�
ppm
S m O P ;u C ~ O
C)_ �n n a In _ •%7
N r :�
e II1?nnNm 3�n Z T �A
�mm �<C
ymo m0 z 3 g o p
y l_IP 0ipn = ml m> Q '� O
�m Nmm
O'Connor Residence
o T H Garage
9 g �; 21 The Plains Road North
`§ D R a Barnstable,MA
L J
r
4 _
D �Z
I
1----___---I
I i I
I I I
1 I 1
I
� j
I
I 1 1
I 1 I I 1
I 1
I 1 I
I I 1
1 I I
I
I I
I , I
I I I
I , 1
I I I
Sic
I I I
1___
------------
-I
--------------- ------------
-------------
I I
1 u 1 I I
1
I I I I
I I
I I 1 1
I I I I
I 1 I 1
I I I
I I
I
I
I
I
I I
I 1
1 I
I I
I 1 _
I I
I 1
I I
I I
I 1
I I
1 I
I 1
I ,
I I .
I I
_______________
I
O'Connor Residence
f = o Garage
8 a 21 The Plains Road North
Barnstable,MA
J
r �
5
P
• L_� 1 J w.aem
§ -------------- f-
i�
tG--------------
--------------
FT
-----------------------------
I i
I
I
I 1
1
II
� I
II
I I
I
L_i I I
Ij II � 4
I I
it
II
I
II
1j
1
I I
II
II
I 1
11
II
I I
11
II
II
' II
II
II
II
II
1 r---
n
IIJI
I L---� 1`-----•--::: -
<_____________
III111
I q ,
N 4 N O'Connor Residence
a Garage
O y o� 21 The Plains Road North
s d o p a a '� Barnstable,MA J
L
r
F
r
qP P 6 € a= s aTI
i< ➢ ---------
-----------------
i
i
i
i
a
vi'----
nil
f$
P
5 -
F ,
Q
6 c
pf
O'Connor Residence
�$ Garage
m
s o� 21 The Plains Road North
a Barnstable,MA
b
Hh"11 e g
gi o o �
m m g x
a a p
-- --- b m
c
i � m
i
if r;V_ y i
sq 3
2 P P e �
N eg
�'e �
Z a
------------------
Ell
--------------
�a s
---------------
--' � � .tS�C
r�
i
I
w (e O'Connor Residence
CD !
COMMON
a Garage
tiA
21 The Plains Road North
cmi y N o a o i ° Barnstable,MA
k ; =r vp z kJ+pm sr
L °6 z 2 om�y
•�,� c�FFN SLL3S��n
I' `pFINE ip Town,of Barnstable
pn
• BARNSTABLE. • Regulatory Services
t639 Building Division
prEO MPy�.
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
r
Type of Inspection
Location 2/ � d�,�rys � /Vo►eT� Permit Number
Owner �Gay Builder
One notice to remain on job site, one notice on file in Building Department.
I
The following items need correcting:
� �ix� l z,3,cK//U(r 4/S.5//UC'- A0 w� /U o K
� ,Q r f
/ t-x k �rw ad
66
o ��
v
Please call: 508-862=4�8 for-re-inspee�tdn.
w�
Inspected by /2 J Z"rW
Date
AGRI BALANCEO 00.
CAPE COD INSULATION 1-800-696-6611
Company Name Phone Number
Jose Espinol ; Installation Date 11-24-2015
Jobsite Address
21 The Plains North A-Side Lot#'s ORY1000339
Permit Number B-Side Lot #'s 353359
In
I
Walls
9" R-40 260 sf
Attic
www.Demilec.com
c8DEMILEC
TOWN OF BARNSTABLE
Old FEB —2 Pig! is 41
�7IVIS�ON
4
r
s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �� �gCO
{ Ma 0— •TOWN OF' BARNSTABLE S'�
p J Parcel f�/�1� �o �a��ermit# (�
Health Division 4'J .�' �' r Date Issued O Z
q p g 2 1 Conser tion Division e / 0/ / %M U,0 Feexiil
Tax Collector v ` ,OPT
* OiVISION
Treasurer •—/) SEPTIC SYSTEM MUST BE
� prSTAUED IN COMPLIANCE
Planning Dept. /�v/ /b�ou� V=TITLE a
Date Definitive Plan Approved by Planning Board ^ ° ENVMON AL CODE AND
TOWN REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address - / :D�j pa((1 S e-dnA q6-t k
,Village Situ,N
Owner V7 ��6 rl(10(� Address � p
Telephone
Permit Request alll_-elr
141 ?,/Y)C _21 t01-2- "4 a/Z
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed. Total new�e�, �
Valuation: -� Zoning District Flood Plain Groundwater Overlay
Construction Type f
Lot Size DY CA C7 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
t
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes C!i.No On Old King's Highway: ❑Yes XNo
Basement Type: ❑Full ❑Crawl CoNalkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing &�e new .3
Total Room Count(not including baths): existing new 7 First Floor Room Count
Heat Type and Fuel: ❑Gas 14 Oil ❑ Electric ❑Other
Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detach ed<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 J C)S i)ld 0 Cio Telephone Number
Address Hon c did OEr License#
Home Improvement Contractor#
Worker's Compensation# `
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
FOR OFFICIAL USE ONLY
r
..'y ►. T - t 1
♦ t 4 l
PERMIT NO.
DATE ISSUED '
MAP/PARCELNO.
ADDRESS, , VILLAGE 1
OWNER T mot_ i
DATE OF INSPECTION: "
FOUNDATION
FRAME
INSULATION . �✓. �o- U'� ' a
FIREPLACE
r r '
zc
ELECTRICAL: _=ROUGI 1�- M" FINAL
PLUMBING:.,.- ROUG FINAL
.s.
GAS: V ROUGIt= s FINAL
FINAL BUILDING 2-Y D'k Z
00
DATE CLOSED OUT Fri
} ASSOCIATION PLAN NO. r ,
z
_(2
JI
„y.i r.' ..,,..,vhi!`.c.y.",,.,._r[v*L+7.'Y s+aY ��r+�.i�w,�w.—�*'frLa�'�->�^�•,va-r�"�.. n`r ”` ,;«k�..��a �y��+ ,6,�A'r.�.Cy,n. 4, �J'�.�.
�.aA ;� �tHErgo� The Town of Barnstable
HARNSTABU. - Department of Health Safety and Environmental Services .
MASS.
i639' �0
Building Division
367 Main Street, Hyannis,MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection .
Location I i\- PQn Pb• 'rvl. Lj iPJ :Permit Number d
Owner Builder
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting:
Please call: 508-790-6227 for re-inspection.
Inspected by .4
l
Date —o�—G
r
Affidavit of Substantial Financial Interest
1, J c,sT�u
of , on oath
depose and state as follows:
1. 1 am an applicant for a building permit for the property located at Map /S3 , Parcel
00Y-001 The address of the property is 21 %tis Plf)A /?21 N°'4)-
2. 1 have OZ % legal or equitable interest in the real property which is'the
subject of the building permit application which is identified in paragraph 1 above.
3. Within in the last twelve months from today's date, which is �' _, the
following individuals or entities have had a 1% or greater legal or equitable interest in
the real property which.is.the subject of the building permit application which is
identified in paragraph 1 above:
Name Address
4. Within the last twelve months, from today's date, which is 1,2 0 Z , I have had
a 1% or greater,legal or equitable interest in the following properties which have been
the subject of a building permit application:
Map/Parcel' Address FGc Pj,1r,�s P.. /` a�A
IS3 0by 'G01 21
5. .Within this calendar year, I have submitted building permit applications for
property in which I have a 1% or greater legal or equitable interest.
6. Within the last ten days, I have submitted �_ building permit applications for
property in which I have a 1% or greater legal or equitable interest.
7. Within this month; I have submitted. I building permit applications for property in
which I have a 1% legal or equitable interest.
8. Within this month, I have received d building permits for property in which I have
a 1% legal or equitable interest.
.Signed under the pains and penalties o erjury, this I7 day of 5c , 200
2001-0050/affin
1
O/LOTTERY/AFFIDAVIT
iARNSt'ABI.E. : .
t659. � Regulatory Services
'�fo«►�{' Thomas F. Geiler, Director
Building Division
Elbert Ulshoeffer, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION `
Please Print
DATE: nn
JOB LOCATION:
number street f street p village
,.HOMEOWNER": 1�Us11� Ill f J(1111 or Lsbe-
name home phone# work phone#
• CURRENT MAILING ADDRESS: �� a/u�a/'d ��//4 -
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.
DEFINPPION OF HOMEOWNER
Person(s) who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is
intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or
farm structures. A person who constructs more than one home in a two-year period shall not be considered
a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the
Building Official, that he/she shall be responsible for all such work performed under the building permit.
(Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
�pqedureS
and requirements.
Sign c e of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a
person(s)for hire to do such work.that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see
Appendix Q,Rules&Regulations for Licensing Construction Supervisors.Section 2.15) This lack of awareness often results in
serious problems.particularly when the homeowner hires unlicensed persons. In this case.our Board cannot proceed against the
unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require.as part of the permit
application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a
form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:FORMS:EXEMPTN
` The Commonwealth of Massachusetts
;� -�-- Department of'Indtistrial Accidents
� • 0I11ry'caalla�estlp8tloos
--0 600 Washington Street
..
Boston,Mass OZIII
tv`J
Workers' Cam ensation Insurance Affidavit
MM
name: :l i t)a 0"C O N f'0e-
location:
city phone#Sop) 2?S 7
❑ I am a homeowner performing ail worm mysei£
❑ I am a sole atvorietor and have no one working in any capacity
❑ I am an employer providing workers' aompens mon for my working on this job.
...:.:...:......
.
}:::.;?L:6:^:-:i}:}:}:�:-:;�Y::•:�i:?;<;^:;•:C•:L:�:::� •ii:•i}:;C:{{::;{:.;.;.:.}.:.vv:::•+:':.....}}.....v::.:•.:. M.:'• •:4}i;:L::ri;C:m:}:4•`:�'ii3Y:;•}Y::}}}Y:d}:•}ii3::•}i}:•ih+:�::.::}�$;Y-.i':::i::i:::ii:}Y:rn��
............
... ..:::::.:�:•:....v:•::::.�-:..:::::.:.�..........::::�.�::::::•. .v::::::.,,,vnv.v:..-:n,....+.:...:::nw:.;}. /.•...v.:.:-.vhvfw;;^.fi:}}.v:'vu3:::.-,..v.v.::v::•::v.v-.v:::v::.,.:.P.::::•:i::::}:}?ri•:{{}fi:-i}iY?::4:i:
address::-. . . .... . .. ...........
.:::.::..; 1.,:.::.^•.5:,.::.:::.:::.....�:.::....-,.n,s;... .};::::::::..:}�..,:,{..,•.
...:•:•.�:::::.v:::::..::•.v:}::ii�::+-:;�;::;i•}:.�.i:-i:{i:'-:}i:{::::..::::w..::::::..v...... ........,..::..,:.whv......:r:ivy=.:, •:.x:?v:.v. :..:h v4 .. ...:v.;{v'::::::.Y3:{i:v:•{i{:{�ti:i:ii:::.
...........::........ .....:.-;....:. -• ::::•..::.::.......: ....:.:::•.:•.:v... .,w::.v....:?•nvr,....v.:.w:::::f.Sw:}:hvw,hN:'^3:. .{.,,-v:--:.:�:3:
.....,.... ............... ........ ...... ... ......-.......... ... fi:::w;J�4+iX }.:;.}yv. ..>..:•i}:;i•X•}X;{•�;J::�:•' ti:�::::tiy v}vyi:ii;:ti;ii}:ti•}}•ii}:-ii>
.....-. ....... ............. .:i?:;;;w.v.;•?::.•:.....v:{.::}}-:•.•:tiiY!•.rS'\,•.i S[:;,.S.,Y};{Sy
t�ty -...:•...... .... ..:. ........ .: ... -�:-:r.:w.:.: h:v::.X.v.....:.:5:...:.4;4.n.r't)iloQt3'�:. •j;;:::ii:+f
aim
...........:•::::w.:�:•:......... .. ..... :.................... -h::.:fi:ti4:J:fi};:::•::•{. {.vv'•'ri-v:: :{. .Y.
LY:SJ}}•::::.:r.
....... ............ ....,:X:.'fiYX?S?^'v:3:Y:v::+:t::v-- ., vw.v.i:•{:::.}:•:{v-:�S:fi.v:: �i�i:i�:v::
.....:.:. .v...................::.w:::::•.:v::n:n:w::tit::::w:•:i.vnxvx:n•:rw•• .n•:m••n
............ .... ...... .... r.R..-...-. ..n<u.....R....S.hn:,.;.�.:v ...ri3}:•}:i:w::is{•?}}}.v::::::::::::::::.
..:..i :i:.:._:.......:.:;.
,...,.•. '..::.:LS:.,....:�.:::tilY.y}y:�'•vi}:..S.n::•.::.::.9i�i•}:{i?:}:Y:�::i:�\SAY•;Y::
•t�:•:.:::� ..�....... .- ..... .;.::t•Y:.:JitiS•}:C:,:,::4'•:{'..:'i!4::?:v.{,;i, }:i:;:i+;':::??:.?;:;::�::ii:;:;+.::;?`i.
Inaezrarree ..::.:..::'•.::::.:.::..�:.;.,::->.�.::..:..: ....:;.:+ <:{::.}.::.:;'.:>::
I-am a sole proprietor,general contractor,or o (carcte ogre)and have hired the cwmrtactors listed b:dow wi
have
the following workers' cempeasatinn polices•
.........:.::.x:.:::.::.:.wr..:.. ... . ...............:::•r?::.. ....�:. .:::.,.nr::o:•r.:•:�::::n:,:....rw�..�.,.;nXrX�!�„�.•n.,�.•.}}.axteorxwee.
... ................ ... ........ ... .r. •::.}::•:v:v:�v: :.n:•.vv::;.;:..........: :•n. ......v:n v.v!vY.v-.}....:::�::.4+,!�M 4iO4^!nX+w•3:?;7MSW>?OJ}T:•\:,:•.y}},}wx.};n.........-
........ .............. ... ............ ............... .. �.::.� .....v.. .... ..v... ...:. •.v:}..w:X•x... +::•}i ivi}}};.}••n::•YS}:v.??•Y{j:i}:JY}}}:::y:.:v}:
'•.:�y(y � •r•...:•.:v v:v:w::v:by::xr:x:::�•h•.v•.::}:{•:::+w..::;.:::.v.....
V.t/l`!-..... .� ..��.:-::•v::::.:-._::v.v...;...nn.....:.-..:.:....vrhv}::K-.:.::v::.:v::A•nl�:ti~.vvfih n4v....v.vv:::.v.:!??{:fiy:::•<}ji:iti�:;}:ti::'L:}>isi:>::?viiJj�:ii'}ii`.{:?:j'}?:}::_?:�:
comasttvnatae- G ..... .:.:.:.....-...:::.. :. .......::.......... ...:.:.::...S.r::.:.:..-......nfi.
............... ..4,•.:,:.................................. ... •:::::::.fik�M.r ::n1)L.};{ vv}:::•::::}n•:r...rr.,. -.:., h ........ ..:::}'.:i'.;:......
............:.......................
..............:.,.3:...........:...............,................:.:�:.}3:•Y:•+;•-;:;?;. :. mcrc+Y..-..-.�.,.:.:.: !:...c,c,K+.mcc rrr{Wcc•.»o}x:. :.....:::::...........:.::::•
.....:::..
......................... ......:........ .................,...r... ..... ...-........:.of ......v,,...:r....4....:w:-.�...::::v..v:};f;?1.;:'{;}�%M'?{n:•.••,. ...
........................ ...... ,.:.......:......ih+!v: fig- ........
............. ...:. ...... .. .. .. .... v...................rh .:.::Vn...- vnm.::v �. w::;_,v::.:.......••:::v:{:::::::}?:}:dill}}i>:::i::i::.
..... J-Kt.nr...:•7t!.....W... +..yi}:G-.ih:;Y.;:....:n::v:•::•.v:^:?:{.}}}}}Y:j;:::::
.,.... .: .:•:�:.: �.; ....... . •• ...................t,r......r,w.....x:m..•:..-..n!.KR.r..h,w.. r ,..:,nrX.....tta{c:;t.
:.:: . ..a`�... ......g..�:. ... ........................ .. ... ........... .h....h. ... o....... ..�.... .'4y,:::::3.`t `::: r>rvi: :%<: :�:::�:�:;�:�:::i::�:�r::2%i
�addrelr�':��":{•:••.� � .. ...E.!l"�,�.....1�::::.::.:in:,.r:.,.n-:.tsuh,{•.:.:}}::?.�:.,.::.:+:::R?cbctMY .,-:kh,.r_ ,...}v'Y°j;, "9,.5.::.....,.
- .: 1� .. ........... ..... . ..... ..... •?{... �,�t, .-..Xfi,X•:;�:; •;:-}i:;r:?;:;•;•-:i.i:.i:;;•i:�:-;;.i;.;::::::.
:................:......::::::...::::.:::::.:::.:::..::..i}}::::.:..
......... .rn{(n...3.,,,..:}}.h•.r.M.....::v.v:::: ... J.h. •:.r.•:{.;vx, •.wn:vn �( vvv:x::•{{ri.,
vw:•••.fi.••...v::nv.,.:h.............:: ... ).•:•:;w::.:..::....fi}w•....h•.:.hv, •R]PYw/R.... ti,1i:,i...... 'k'p. tt,Ytj Y..-
........:.....:.......................... .,,•:::• ...-.-.}}:::.,•::::...RC•24}.?!:::. ?R;3*••:•:n --..�!..., ..... .- ....°4+• .................
..,•:-.,•..;:. .:::•.�:::- -:::•::•::: ..:.., ..:::::.:::::.... .:......,.!cfi:Yr.•:..�..��raao ::2•fk�`-0C.a�....Sf aY g ....
......-.}, .:}••}••:;{•:;S •: ::--�Y4:::-:}':.,•.,:..�..{ .n•}C\!RY>n f r.�:3`i`ck:c�3.•' {rc .,,{.�fi
:... .,, �......:..::::.`:X��.•.:•. 2`.•rxiRl`Yi .••::::xii�. Axt ��!YQ � .,::. •.;.,,.'�...x+..- '�-n •� •�'�. .<>`%:�:��:��%.:Y::: :i
:.............,.,................... .:... n.....::•:.,,•. :•.:,..
..... <.. ,•.,... ..r::::::.:x•.:.::••,•.•.,fiX;:,:,;:::: 4rR: ,•, Y ..::...:•::.:x::•:•.:�x.:.,•:.w::.,, ::: ..:.�.::::.::;,•r•
..,•,•:.�:.:•..... •.n:•....:.,,•:--:::::.:::....:::::?•......:h?.;d;.,...........:•::•::r.•r .•.. •:h.: .. .. .... .n,}^(^.. • mS•...
...............�::::.�:•.�::•::x................. r::::.{.333:'•::<•}:•:::•.:,,•.,:`.!}.4:`.4.<:•?}:.r +},.r,w7tRtk, Xif� ..5: 'x:'--...c.�:Y. ::-•.. .+;:•-••-
................ ...............:..:::::::::::.R:•:;;;{•:•}SY:......................... .-:.:.... ...�...... .......-.. .... �n. r3aw+eb}Yfi::r�•:':} .:t• }
.•:>.•:5:.:-.:xx rah � .•.+>.�-:.�:::::.{%;::;::::<:::`•:2:'
{{::nv::::•}-,n}....Y•:Ow`vP•:!• ....): .1.3R..
'•::.�?• ....i•}}.v.v:::::::•i}:•S:x.;:{.x;r.-v,.}:? vvti�;•. .. �CSti:4
K'vu;ZW.Cy .F} .Sr-YR.•.•.•.v^v+YM.•n-•.-.•{+vO�.+P�OK• •)JK{,}}.r.l :xb%K!::. \.......
.....................: ...}:L•}:.:n...r:.::......n:x:.d�..-`.�.�.SSh�2,v}`?��?`' .....-- ....;.:.:$?�S.e.�'�'k.^aSp:SC-to?�}K2y�Ot;X.�y�}C:\v.T£t<::....}:�.eaa•R+-.'�!'^',^^,n�:«..
...........:�::... ....,...,.::::::•.::�•r::::..:::::.::::::.�::.}.............::::•::::% ................
rm:i+3 -. .fi, .rc. .R?�; .a..;; .......::•• ,rahx.t{<.,,::•...
.........:.... ....................................,.,.........4........ ...}c•".w..... M. ..xq>x•n..:::.. •:,.:..}:.yh:::•:::.;.;..:,,•,•.}•.:{.:-o}:::•i::,•.•.;•.:{::::::::::i.._.�
.. ........::.,:•::.�:......,....... .................... ,:n'rt?•.::..'X•Yd»:M•._._{,x?Rk?caowi�t?4�oob. ��� '
'LQrIIDHRY:11Hr[1CS" ...::.........;:::.:.�:;:,:•:.�:.�:::::.::::::.::.... r+\\... .rY;::.c xV ..R•>:n+cR, a,,3raa+,.. :.,•y-•iic;;r.3' ::,:.,- '
::::.:�::........:•:::::•.�:......... ....::..:.:,.....,......:.�::::::.�:.........:. �:...........,............,..:.fiY3:n•:rn•::.:•.:.}n}>.wn• -•.•:::•.:<•x..rY.h.....mv.......{t,....,•:n+rhh„•r:n•}.-,xYrh......4h............. �r:i::;:::�:�::;•:
...... ...::..............,...........:..vv.:v::+v+'?!.....}G!n!ww,wnw!>Y...Q+!2.... ....fi+.2yv???+3.2tk?rt"^ 4..?^!vniha:ki?{<iv,?:.'vwMiJiiYYSCt:}:.{wti:iUi?:vv: "nJ:CO.vn<i:0::::::;::: �.
................
:..}}• .ate YM1ti..
.::•..::....:..:............ .............::. .: - ..n.. ...n..,........+....,:•::::}. t!C>., .. ::•YS. v.•.IX3:.:,,•:?r::i:::.v:C:?i:: S::i•{::::•::}S::i}:::?i:Y:y::::ti::i::i:::i:+-}.
............:................: ........:..............:y}:.v::: •.:} .............:.. .._...v................:::•}}:.:..h4>.'-.•..::3r•-v. .>..^9�6�.�.>fh)Q•: .:hv;�•;{.};v..........::.:•.:...:::::-:.v!w.:::�:::•:v.....:•v.�:::::....�
...:}: .......... •nw:vY+w:•:•: •v ::ti•}hxv.:.�:... :•X•ivv::::::::.
1 {�:.1�i•??;•?}}}:{:?::;iii;:$;:;:i:{>':i: i3:i'v{?:i}`:viii: is iir:i'i:>S:vri3}iiij:.....:
.......... ................. ....-................ ........:........:::...�..:•.:.n.::.::.:•.v.v3h\.}.{v...... .......
t .. ....:C•.;, PX•h4•.."a{S•Y,'Y.r......rn...::..!:4.!•:SJi:{:v.M...::........ :.:.
............... ........................ . ........ ........................ .....................................,........,:,•:. an•.;,,+...,....rrn•'.'YR`.•:{:.;h:X.};{;::.;::::::::::..::::::::::::..::..:..:::::::::::.:••::::..:::::•:::.:.:::.}i:4:•:�ii:<i:::
.:::::::::..:i4:{?v.v::•..:.:v::::v;;•:A•}:::::w::�:�'{::::::..:._-::::w::vii::•:::.v:.v::w::::::nv•:nv�•v::v:-.,...v:.....,,.......:•::^w:i::•.W r.:nv ...,v.........................................n..................... ......
.............:..................::•::...... ..........-:.:::...................-........................,....vh:.t.,...:vh..r{.,;•n.:.,v.,.• ..:.ur:v.. :+p3X•Y,h4„W:v:+:'.,v:::.::v.,v:.w.v:::::•4v:::..:.v...
:..:::v::-:.vn:•v::n•:.w::::...v.x..:n.......:.............:::::::..i •.,w,w,w.,,,vx:+ .:... �. ..r{.....r......xu...vm::w:.v.:w:::::n�w.,_..nv::wrv::•-::'i::h':v.:,v:.:va..• ,.........YXO
•}}Xv+b>Y•r} ..:::r.. +'rrv!...;:r..............n...............
....... ...........r:.,..::.v:::;.-......::....v.if::Yiiv..i•i:i<•>'4YY:fiY'•:•}::'•Y}Y}Y}•:... ,r::..... .......h..... .... .v.......
.. :.:.::..........•........::•::•}:::.,r........:..:......:.......,..{:...,..,xw3c}X�YY7d•X�+r'•'t::•S„+,xK,+. ,...........
I17tnTnlRCC:•CO.., ...........:.:::.,•:::...:.:..;,..........n..•:.;.........•:•.:..�::a:3...........+.?4k. ...aXca' O��CV'i�,,T:•'.:cuk•}.,.{.tR:�::ti::�;::•:{{ci:+iizi�2}w.a�;..�r•.::3?,c,.�};is:$.,.�..iiu:::•:;::>:�::::i5:-:
pslistre to swam coverage a:required raider 5eetion 15A of Mtn.LU ears lei to thatmpooM m of ed-1 pmaitles of a Has up to S1300.00 and/or
one Ynn'Imprisonment as well sa dvil peadtles in the torn of a SLOP WOGS ORDER and a Han of SI00.00 a day against me. l mdersamd thu s
coPy of this statement ma7 be forwarded to the Onke of Iavesti;stions of the D7A for coverage vedfiadm
I do herchy certify undfr the panes wtd penalties of peyury that the infonnadonr provided abovr is meet corrtrd
�
Signamre --
Print name
T,s-rio 0 'c, # �,Sok) e�9
oflicw use only do not write in this area to be completed by city or town ofmciai
city or town• perdocenxe O ❑Bnilftg Department
a ❑Llcet=g Board
❑checkiflmmedlate response is required �g�t•re.�'s O!>!ee
❑Hnith Department i
contact person: phone!!; ❑Other
w
t
,
UrA"a W95 PJAj
1 1 11 1 1 1 1 1 1 1
• „• / • • •11 • 11 •11•Ir • r r • r • • :1 •III•w1I •1• •1/ • •
/
• • • • •1/1 1 .11 J . I •�1/1•�• r •11 1• • • 1• • •••.� ./1 ••1• .
• • 1I.1• �•• • • 1•;«l
• r
• 0 ,/ • II• • L.Jr.I set e• •1 •too 1 b • ••1 .Ir •I/ • r• • •11 • • •-/ l: :1I/• • I • • • ••• •
_• 11 • I11 w1I �1 • .11 • /I • II • I J% • w•I Y.Ir ti • • .•..: _• �1••1• • • • �Y •
• I 1•• slA •11 • •/ / 1/ •M .1• •1• • • 1�1 •Y. �111.1 • ..•/I• • 1/ • �1.11• • �.a, • • �/ // • • •M •
w11 • I• • 11 • 1 • 1/ •1 1 .11 III .1• .1 •I•«Ilw .11 • I • Y •M rl_1 ti11 •I •1 • 11• .III • II • r I•_ 1 • •/
/• I.61 • /• �11/1• • / •11 /• • • 11 .•IIIIw1 .11 •• •••1• • 1 M/ •11 •1 • .1• • •Ir. •11 1 / • • r 1• • /•1 • •11 •• •J ••1•• •1
• • 1 • r • 1/ 1«•.111 1�1 /•, 1 I 1 • •J✓.1/ V • 1 MI wI111 • ' 11-111 • •_«II _• /• � .11 w•11• • .1
/ • �1 • •11 • Y.IIM /1 .1 ♦:1/' 1 1 JI 1 ' 1 1 ; 1 1 1 1 1 1 I I w 1 1 '
/ I 1 / 11 1 1 1 I l y l 1 1 1 1 • 1 •1 I I 1 1 J. 1 1 • 11111 1 1 1 1 1 1 1 r: 11 1 • 1
/ • , / / • 1 1 1 r 1 1 1111 WOO •1 •1 11 1 .11 1 ' • 1 1 • •11• •11 r •_II.1-I
•r1•I/•1• • I • • • .11 • Iw • • 11 ✓. / • •1 I Y •11 yl I ..111.1 1111• .11 •111• - M •I / •�1 • ••• •1• • • • •'•1•. •1.1/
• • •�1•�' •) •••1111• .11 V • 1•I I/ 11 /Ir:1• �• _• 111 �•111_•1♦ •) •11 M/ .1• .H / •_w• • h«•1 _• /• 1• ••111• ••/
I
:rr 11 •1 ••1111• w1• •11 . •• • . ' 1 ••I111• a1 MI_ .•11 • •1 • ••; /I .t .1/ • 1• • 11 yl•1✓.1• •11 .11 •
r • • 1 • • 1 •111 14*,aI • _0 •I11' III w l ••• ✓•11 • 11 11 ..•• I - •/ . 1• .. I'
•1/•I r �• • / ' • .1 111.w 11 •1 1 111 y••% « •till.. 1.1 •••III I1.11 GU •11 Its1 11 6/Y•11 .• •• � .1 V 1 1 11 •1 iJI 1
1 I / 1 ./•1 • ' I / • I • • 1101 _• 1• 11 MI v' •I 16 •' go•l .1 11 .1• • ✓.11 •11 1.1 1 •�1••11/ •I _•1
/_• 1 I 11 1 •Y.1 •/1 w1I •1 11 •11 y•r✓. « • 7, .. Ir • 1 1 • • I r .11 • 1 ^ • •11 r •In • 1 •1 •
II L• 1• • r Y.UI •Ir.a•. •••I111••••• w,1• UI / • • ✓. I 11 1 �1•%• •11.+II .1 /1 U1111 •�1 1_•
%%/
1• . .1 •.y :. . • 1 V•1111• .•1 .II . 11.1111_• w•J . 1� i . ...w11 1 . . ._. . .1 11 . . •1.111
• • • :ll • 11 11 II w•1 •1 , •• •• • 11 ^ • •Y.11 •I1/. 1 kij 1• ••1.1Y. « • 1 w•Y.• •111 II .IJ • ✓•111 1
. ., 1• r1 •-1.1111 wl •111.1 .., ' 11 . r •1 , �_. .•1�1 w• •. 1111•I .-• 1 :. . • Iw /1Y. • �1.11.1_.
• •//w,/ • I/ •t IU • ••ti .•• •Il • �••w•IA 1Y. • •_mil /1Y. •
•• • . • y • •11 • 1 • I/ •11 • 1• • • .11•• • • ••• •wl •Ir •1/ .1/• /• 1 • I .11 • •� • •1•
� •. •••.Iu •n «. • 1•u1 .11• ry ulu• •-1
1 1 11 11 1 1 I 1 I A
1 / . /11 1 1 1 1 I ' I A
1 1 1 I I I 1 1
1 1 1 � 1 11 1 1 • _J
4
QUITCLAIM DEED
I, Sean T. Doyle, a.k.a. Shawn T. Doyle of Sagamore Beach, MA
For consideration of EIGHTY-SEVEN THOUSAND FIVE HUNDRED ($87,500.00)
DOLLARS
Grant to Justin O'Connor and Susanne E. Stoico, as joint tenants with right of
survivorship, with a mailing address of 30 Union Street, Apt. 3, Cambridge, MA 02141
with QUITCLAIM COVENANTS
the land in Barnstable(West), Barnstable County,Massachusetts, bounded and described
as follows:
NORTHWESTERLY by Lot 2 on a plan hereinafter mentioned, Three
Hundred Seventy-Two and 44/100 (372.44)feet;
SOUTHWESTERLY by the Mid-Cape Highway(Rte.6)Four Hundred forty
(440)feet, more or less;
SOUTHERLY by Old Cotuit road, an undefined way, Sixty-Nine(69)
feet, more or less;
EASTERLY by The Plains Road, as shown on said plan, Four
Hundred Three(403)feet, more or less.
Containing 2.04 acres and being shown.as Lot 1 on a plan entitled"Plan of Land in
(West Barnstable, Mass. prepared for Howard Woolard, Scale 1"=60'February 2, 1983,
Down Cape Engineering C.E., L.S. Rte 6A Yarmouth,Mass." Said plan is recorded at
the Barnstable Registry of Deeds in Plan Book 371,Page 42.
PROPERTY ADDRESS: 21 The Plains Road North,West Barnstable, MA
For my title see deed recorded with said Registry in Book 4028,Page 171.
EXECUTED as a sealed instrument this /Aday of July, 2001.
SEAN T. DOYLE
aka SHAWN T. DOYLE
COMMONWEALTH OF MASSACHUSETTS
Barnstable, ss. July/2,2001 I
i
Then personally appeared the above named Sean T.Doyle a.ka. Shawn T. Doyle and
acknowledged the foregoing instrument to be his free act and deed, before me
WHIAAM A. PRICE,
Notary Public
My Commission Expires: December 15,2006
j
`i
I
j
I
i
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
CO
New Buildings,Additions $50.00
Alterations/Renovations $25:00
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
till (n_square feet x$96/sq. foot= 3�'��o x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
i square feet x$64/sq.foot= x.0031=
plus from below(if applicable)
ACCESSORY STRUCTURE>120 sq.ft.l
>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.0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
Deck e x$30.00=
(number)
Fireplace/Chimney _�x$25.00= 2 Y-
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable) _
Permit Fee
projcost
OVERLAY DISTRICT. °° d '
WP — Wellhead Protection Overlay District
RPOO — Resourse Protection Overlay District
ZONE:
RF
Area (min.) 87,120 (RPOD)
Frontage (min) 150'
O 4
Setbacks:
Fron t 30' j °
oX
Side 15 ."�
Rear 15' "
FLOOD ZONE: p
r °
Zone X Vg�
Community Panel No.
#250001 0001 J LOCATION MAP '
July 16, 2014
- Scale: 1" = 2000'f
ASSESSORS REF.:
15310041001
PM
a
dh/cb
off
4!
N65° 51 32"E
372.44 - - - - - - - _' —
c
\ I c o
\ I o o�
k \ I to
\ Lot 1 I co
\ Area: 2.04 A.C.f Existing
\ 2 Sty w/f
\ Dwelling
I
0 \ I dh/cb
#21 held
\ I
\
\ 1
I % �� \ I
I 9 dh/cb \\ 1 31.3'
�o. off
\ Existing I
\ Concrete
\ Foundation I
\ I N
P�ZHOFMgSS t o0 \� I
^�o ,
J HN�. cyG� F \ 189.0 Q
c.ti8168 \ I
90� 6/STER��
FSS/ONAL
I certify that the structures shown \ I
hereon conform to the setback \ I
requirements of the Zoning Bylaws of \
the Town of Barnstable.
, r
N70° 07'00"E
69t
TITLE: PREPARED BY. PREPARED FOR: NOTES
Site Plan , 1.)The property line information shown was
Existing Conditions Ep�pcer(pbo& Justin & Susanne E O'Connor compiled from available record information
At Sullivan Coneultlng,I� 21 The Plains Road North 2.9 e dwelling located from an on the y
round survey performed on or between June
2i The Plains Road North 0 4MUO-M°'M°'�""'�'6O°"°""�° West Barnstable MA 02668 20, 2014 and January 19, 2015.
Barnstable ( t B.et°ble) Mass. Droll: CTR Field: CTR a 20 40
DATE:• SCALE., Review JOD Ccla: CM
January 19, 2015 1" = 40' Project 340017 Pre a Jusyl o'=:n�®rA
I
i
TOWN OF BARNSTABLE M. ASSANUSETT�
Iial �• A11 :.,
(M'�S ASSESSORS. MAPS
a
ly
u 3 Dj f
Cf
o I
O Sr , oio
De �L 1 3 Isl �`
0.22Pic. c /
Ay orrp�; L FK 5t
�. 3t
k .
G� Lori
n
r yP v I f
WN
I .• T•O OF 8AR/J37?1BLB ._ 3 r
it \
" CROd(E� pgRK GiN6r my a
r c
I \ 2 d
t
8.71 ac v I1c�RMtCK �R
a I
r c
�c \ \
t 1 • N
r �
e . 34 a
t.22AC 1 \ Q
O, �P tent
Ac
fir✓ � % r� 1•r. •
I ► I I 1 rc\ +s
Z.3 L^ p
Vr
�� ��' 4.4BAC Tov►y �v 11 h� �O Lao uwrwo �
.oaweT '90 •>
1.33 AC MWAA_ it
37 9e A/
r I
q R
< 2.09.uwwD � �•� 0 ti :.
fKlt .07 W Ef 11 1 �Y4
{ 80Ca a I, /Tow@4 os B^AMIkA81f W
u co
AL
I I � I .j , OVCji4140WN / � V
In
o 'lid
1.10AG c
a
IlOND
I Ir • � oo p
PREPARED UNDER, T E DIRECTION OF THE o
\/ SARNSTA9LE SOAIRD OF ASSESSORS SCALE 1%100•
W
AVIS AIR A I i
306 w
MASSACHUSETTS w
F / ` O NNECTICUT
r
y J
\ \ -j f\
\ \\ a N OS
\ \ . N N
\ \ w 0 04
/ \\ \\ W In RD
N \
I 00 \\ \\ OD
\ b w N ^
II oi II iI \ \1 \
Z io PROPOSED , E u. a MRT o
EXISTING o
h
WELL00
V x
\ r4
_
: ', cl, _ ® U o
�(3 0 Z N
3 \; O USGS - SANDWICH QUAD `N w 0
_ \ / � \ / -110\ O i000 o s000 moo .000 `�'.'`W f
' / ` ` // .\:\\ \ I ` / I. ; \\ 1• 7DW FEET
O 6� i!
1500 GALLOW SEPTIC TANK \`' � 1 / \ A�Pp / `� ASSESSORS MAP 153 PARCEL 004001 0
1 _ 33 ►\ PLAN REF: PLAN BOOK 371 PAGE 42 vi
PLAN DATE: 2/2/85 0
�Or ► APPLICABLE ZONING REQUIREMENTS: _
ZONING DISTRICT: RF Ji
o
FRONTAGE: 150 z� am o
RI FRONT SETBACK: 30 FT rn
WAY // / i SIDE YARD SETBACK: 15 FT W o
TP qs/ , i I REAR YARD SETBACK: 15 FT "
114 - - - / / / 1� / I� DATE OF SURVEY: APRIL 30• 2001 N Cl
2 ' / / / 4 I I O O O z N LU
w
0A,
1 Ij w m z Q y N
^ 1 1 I Ll O V Z)
3- 6 GALLON CHAMBER 13 / / I I i' , az = W d::W 4 STONE ALL AROU / ILEGEND (a u 0 N a J
DISIRou iolsl-BOX
106 - _ \\ EXISTING CONTOUR ,
p�-- PROPOSED CONTOUR 0 F-
LJ
p J--�,..�.. PROP. TREE/SHRUB LINE � `
I 1 _ _ X SO.O EXISTING SPOT ELEVATION a v wt
` .J Q z N
T.B.M. - TOP CONC. BND �, _ ! - / / I / i D_ E zo
ELEVATION = 107.21 (ASSUMED) 4 108 - - - _ / / _ \ / / l / / I I [50.0] PROPOSED SPOT ELEVATION w 0 Q
�c 10
TP
°• / /// l :- , / I I /r i TEST PIT LOCATION o J Z w
PT* LLJ
I _ I , Q TEST PIT/PERC TEST a cna
114 / LOT AREA ���` // \ I i i �p �. G— EXISTING GAS MAIN a c^ -1�
88.875Q. FT.t4' ti / I �' WAT p Z cr w
40 0 20 40 eo 160 1 sc // i i , � DAVID Ssc UT ID ss9cy m �O
O ��
C. G
THULIN C° m En
( IN FEET ) �O¢' / 1 TH IN. -+
r -= 1.inch = 40 ft. 06 J 04 o No.2ss76 0 N 39403
1
f A9F CIVIL P" -
No ss
• SHEET'1`OF 2
1500 GALLONto
SEPTIC TANK 2�9 a o'N
EDGE WASHED STONE w 1�
W I
SEE PROFILE FOR TOTAL TRENCH LENGTH - - - - - - - - --- - _ - -.� I y � V) 00
a O w co
COMPACTED Z A - e - - - , ':I I DECK GAF Z � 0
EARTH STONE SPLASFL PAD
REMOVABLE ACCESS COVER ti I I O J Q
BACKFILL w
1 S
6 NOS D :x
\ 4" PVC INLET
y' SEE PLAN FOR LOCATIONS I I
n o 0 DODO D o o m 0 0 0 0 3 PEASTONE
0C= c- 00 0c 0C3 DODO _ I I SAS• U
N 000000000 000000 O�:Q O to m y U 0
0 0 0 0 0 0 0 0 0 o coo 3/WASHED 2 Z �74
RESERVE r�
LEVEL BASE SPLASH PAD - - - -
4" INLET INVERT STONE - - - - - - 0 Z N
500 GAL- LEACHING CHAMBER
NOTE: UNSUITABLE SOIL REMOVAL DISTRIBUTION BOX
LEACHING CHAMBER � 5 N 00
SECTION A - A PLAN WHERE REQUIRED TO EXTEND AT 1- 00
LEAST 5' BEYOND LIMITS OF Q to ..
LEACHING CHAMBER DETAIL STONE TRENCH. //� N p N W CO
NTS - - - - - � � v
33,'S' 3 - 500 GALLON CHAMBERS
W/4 STONE ALL AROUND
SEPTIC SYSTEM DIMENSION DETAIL o
SEPTIC SYSTEM DESIGN DATA
SEWAGE FLOW ESTIMATE GENERAL NOTES o
SOURCE UNITS . GPD/UNIT O.TY GPD COMMENT 1, ALL MATERIALS AND CONSTRUCTION METHDDS SHALL 4. THE LOCATIONS OF UNDERGROUND UTILITIES SHOWN 6, REMOVE ALL UNSUITABLE SOIL, Oe. A, AND Bw Ld
ON THIS PLAN ARE APPROXIMATE. AT LEAST 72 V1
CONFORM TO THE PROVISIONS OF THE COMMONWEALTH HOURS PRIOR-TO ANY EXCAVATION FOR THIS HORIZONS FROM BELOW THE SAS INVERT ELEVATIONS
SINGLE FAMILY RESIDENCE BEDROOM 110 4 440 310 CMR 15.02 13 OF MASSACHUSETTS ENVIRONMENTAL CODE TITLE V.' AND WITHIN 5 FEET OF THE PROPOSED LEACHING
PROTECT WORK, THE CONTRACTOR SHALL MAKE THE SYSTEM, REPLACE WITH CLEAN SAND FILL MEETING S
TOTAL ESTIMATED PEAK DAY FLOW 440 GPD - NO GARBAGE GRINDER 2. EXCEPT AS OTHERWISE NOTED, ALL PROPOSEO REOUIREO NOTIFICATION .TO 010 SAFE (1-800-322- THE REOUIREMENTS OF 310CUR 15.255.
SEPTIC TANK SEPTIC SYSTEM PIPING SHALL aE 4' 'SCH40 �' 4844) AND THE SANDWICH
VERIFICATION OF LWATER DISTRICT BBB- I -
PVC SET TO THE LINE AND INVERT ELEVATIONS' 2775 I%1
SHOWN. THE MINIMUM PITCH OF PIPES CARRYING 7. WATER SUPPLY FOR THIS LOT IS A PRIVATE WELL 0
TOTAL FLOW X DET. TIME = 440 GPD X 2.0 GAYS = 880 USE 1500 GALLON TANK SEWAGE OR SEPTIC TANK EFFLUENT SHALL BE i/BTH S. CONSTRUCTION OF THE SEPTIC SYSTEM SHOWN ON INSTALLED IN THE LOCATION SHOWN. ' THE LOCATION OF
SOIL ABSORPTION SYSTEM INCH PER FOOT IF NOT OTHERWISE NOTED. THIS PLAN IS SUBJECT TO THE INSPECTION OF THE WELLS ON ADJACENT LOTS ARE FROM BEST AVAILABLE
TOWN OF SANDWICH HEALTH AGENT. NO PART OF DATA. THE PROPOSED SEPTIC SYSTEM IS TO BE LOCATED Ld
CHAMBER GALLERY LEACHING AREA CAPACITY 3, PRIOR TO CONSTRUCTION OF THE SEPTIC SYSTEM THE SEPTIC SYSTEM SHALL BE BACKRLLED OR MADE AT LEAST 150 FEET FROM EXISTING PRIVATE WATER
DEPICTED ON THIS PLAN, THE CONTRACTOR SHALT. INACCESSIBLE UNTIL INSPECTED AND APPROVED BY SUPPLY WELLS.
N0. LEN WIDTH DEPTH SIDE BOTTOM SIDE BOTTOM TOTAL THE HEALTH AGENT. . THE CONTRACTOR SHALL OBTAIN A DISPOSAL WORKS CONSTRUCTION PERMIT V1 p
ft ft ft s s d d d FORM THE TOWN OF SANDWICH BOARD OF HEALTH, SCHEDULE INSPECTIONS AS REQUIRED. to w O
i 1 33.5 1 12.8 1 2.0 185 1 429 1 137 1 318 1 455 _ U ~O p
PERCOLATION RATE: 5.0 MIN./IN. LEACHING RATE: (GPD/SF) SIDE - 0.74 BOTTOM - 0.74 o p o-Z N w
CC Q N S
115
m z N N
tL O C� J
Q Y In Q U O
o U o t Q 3
TOP FOUN ATION 110.40 SOIL TEST DATA
110. DATE: 5/24/01.
FINISH GRADE EXCAVATOR: JOYCE - ~
NRES. RVE RAND CONC. COVER TO WI IN 6' of FIN. B.O.H. AGENT: G. HERRINGTON ADE ENGINEER: D.C."THULIN
LOCATION: TP4 Z =
EXISTING GRADE 2 LE L PIPE secs LOCATION: TP1 - P-9969 U
105 ELEV. DEPTH ELEV. DEPTH Q Q Z Lo N
- - - - 104.7 0.0 OaA -'DUFF - LOAMY SAND 10YR8/2
1052 i 0.0 OeA - DUFF,.LOAMY SAND 10YR3/2 d to Z O
k7 - - - - - - 102.20 - - - 1D4.2 0.5 1D4.7 a 0.5 w Q Q O
r vre a Pve B - SANDY LOAM 2,5Y6 4 X B - LOAMY SAND 10YR5/6 F- U Q
103.76 1D3.21 �020 0nO T P.EFF. DEPTH 102.20 . / k N pm
1027 2.5 Q J LL
y�� 102.96 102.55 102.2 2.5 w Z
102.38 C1 - COARSE SAND 10YR6/6 -� Cl - FINE SAND 2.SYR6/3 w Ib _J
100 OT, EFF. DEPTH 100.20 V Q N Q
INL T TEEr
OUTLET TEE 99.7 5.0 - 100.1 S.tz PERC'2 MIN./IN 0_ I'_ ��
1D' t4' BELOW C2 - MED. SAND 2.5Y8/3 1 0 Zo:wLIQUID BELOW
EVEL 15 SE LON LIQUID LEVEL �' o 97,8 7.4 O_ m O tr
LLO
27.5' 20.3' 18.1' l NGEST RUN `C2 - F-M SAND 2.5Y6/4 �.IJ�� - ,_
95 -
95.2 10:0,
-10 0 10, 20� 30 40 50 60 70 80 90 100 BOTTOM E30NO GROUNDWATER
NO GROUNDWATER a SECTION TH R U SEPTIC SYSTEM
01-038
SHEET 1 OF 2
Application to 2 00 1 1' 8 1
®Ib 7.ing'fs 3ptg�bw Regional JWstoric Icfstrict„zommittee
�jTRXS f�1f i:, IVIli\SS.
In the Town of BarnstabL-e-4 le'
CERTIFICATE OF APPROPRIATENESS�Y� 6
Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section
6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans,
drawings, or photographs accompanying this application for:
CHECK CATEGORIES THAT APPLY:
1-4 Exterior building construction: New ❑ Addition ❑ Alteration
Indicate type of building: House ❑ Garage ❑ Commercial ❑ Other
2. Exterior Painting: 9
3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign
4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other
TYPE OR PRINT LEGIBLY: DATE
ADDRESS OF PROPOSED WORK -�2/ '71 AM,n� �jl� �r�I� �,�1�/ ASSESSOR'S MAP NO.�3. I.
OWNE h CF) ASSESSOR'S LOT NO.
HOME ADDRESS
7 TELEPHONE N f � -
FULL NAMES
AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any
public street or way. (Attach additional sheet if necessary.)
AGENT OR CONTRACTOR TELEPHONE NO.
ADDRESS
DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please
include locations of proposed signs.
9
Signed
Owner-Cont or-Agent
For Committee Use Only
E
0 .0 d
his Certificate is hereby o Date 7 0
Approve Denie
AUG 1 U 2001 ommVttee Members' Signatures:
TOWNI OF BARNSTA LE
OLD KING'S HIGH Y
r
Town of Barnstable
}
Old Kings Highway Historic District Committee
SPEC SHEET
FOUNDATION
SIDING TYPE C6 a 1�bel COLOR
—�
CHIMNEY TYPEQ(� 1�6�CI� COLOR 3,r`C.�-
ROOF MATERIAL �!JkIL COLOR L
PITCH
WINDOWS COLOR I SIZE 101#W
TRIM COLOR ( "
DOORS jt COLORS � �CA,Q�Ky OL
SHUTTERS NC COLORS
GUTTERS lire ^. COLORS
DECKS h_l&(iC MATERIALS �� �• Lt,WwL /�vvl ty"'�
GARAGE DOORS COLORS
SKYLIGHTS SIZE COLORS
SIGNS COLORS
N pF
,
S�\\
FENCE .—COLOR—
NOTES:NOTES: Fill out completely, including measurements and materials/colors to be .used. Four copies of this
form are required for submittal of an application,- along with Four copies of the plot plan, landscape
i
plan and elevation plans, when applicable.
SPECSHT
Revised 11/98
i
a
f � a
{$� zillp
'Ally
z a �
co
s
x
b Z s c
g
m m
T1111 a loll
MIR
3 j `
t a •'
I
Ii I
ziIN
p I� I ► 1
g2 fe Vr fl , I
i I I'. 8PII
I
II Ia r/r fT I
0 Q_ . .. _-.. .._ a 4 � �€ �A� 1. ilia
� R
f4 .f W IV
41
� a3¢ lei( e9! R 0 enenwalaolanx
Aa Ri � e�/� 11� MB�a11�QfbEw®
i
Is
— - — -- --- ---- t e£
.
m
;r - ..-_- - TA
1,
•i w ra.u�mamr.rm �I %� av i i I a y p r� � ° ; ° p e $
I �p ��. -' •--1:i I!a a et��g ®� ����qc a� a �g+
A gg k�j 8
^
re
AIRED �^
va rau. •
v'r t
5g8,.r sew. ✓!
1 14rr
® r.•ar r.�ar sf N. fV RH
M1I •. .� 4°� Hnw
a ra'I w u S r S ra Z f•y, .w T ra
S jail fa al
,
g _
.• i� k _� � z �� S S y �g�� 5
HIMCIO
. I
Pl!
gp� Bx'
i >„�
----- !
it
' --- ---f i
— — w ! --•-------- _
------------- I -II i
A 1 I
P �I
!j
111
^� F Nil I !
-----------------El
I all
110 11% H 111 11 11 M . H o
i
:,
--,j
I ( I
Ii I i -----------='--t_ g
dY
�a lit lot fi fil 11 Is 111e
I lit I Ill 11s 1rs o
TOWN OF BARNSTABLE
CERIFICATE OF OCCUPANCY
PARCEL ID 153 004 001 GEOBASE ID 8796
ADDRESS 21 THE PLAINS ROAD NORT PHONE
W BARNSTABLE ZIP -
LOT 1 BLOCK LOT SIZE
DBA DEVELOPMENT DISTRICT WB
PERMIT 65044 DESCRIPTION NEW 3BDRM,SING.FAM.HOME
PERMIT TYPE BC00 ., TITLE CERTIFICATE OF OCCUPANCY
CONTRACTORS: Department of
I ARCHITECTS:
Regulatory Services
` TOTAL FEES:
i. BOND $.00 p1F
CONSTRUCTION COSTS $.00
756 CERTIFICATE OF OCCUPANCY 1 PRIVATE
• BARNSPABUF4 •
MAW
1639.
BUILD, D ISION
BY ( / .
_DATE ISSUED 11/Ol/2002 EXPIRATION DATE _
TOWN OF BARNS'T'ABLE
BUILDING PERMIT
PARC.EIr: ID 1.53 004 001 GEOBASj � 1.. 8796
ADDRESS 21 THE--PLAINS ROAD NORT PHONE
W BARNSTABLE. &IP -
LOT 1 BLOCK LOT SIZE: _
DBA DEVELOPMENT DISTRICT WB
"I
PERMIT 58601 DESCRIPTION NEW 3BDRM SING-FAM.HOME SEWPT002-20
,:PERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT
,CONTRACTORS: PROPERTY OWNER Department of Health, Safety
ARCHITECTS.: I
and Environmental Services 'I
TOTAL FEES: . $704..96
BOND IN
CONSTRUCTION COSTS - $193,536.00
.00
101 SINGLE FAM HOME DETACHED 1 PRTVAT.E P =k 'RT" ;
+ BARNSfABLE,
039.
BUILDING DIVISION
BY l�
I ~ DATE ISSUED 02/07/2002 EXPIRATION DATE
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 OFTHIS
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 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.
W • 1 s
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
dc'- 03, J.? /�J. <,/Jy
1 jo-z Cl--C!*Z, I
1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT
2 BOARD
O RD OF H ALTH
200 - 20 1 0 Z
OTHER: �/ SITE PLAN REVIEW APPROVAL
I
I
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.
I
�r
I
I
I
I
I
I
I
I .
I
I •
I � '
I
I