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0066 WILLOW STREET
1 7 ®xft'id'® NO. 1521/3®RA MADE w u.& a ESSE`TE y w A r 6 i 6 t t k' { t :� c t �; �� Application number.. Q� 31 — Fee ..... ..................................... ..................... BMWffABA Building Inspectors Initials.. . ........................ Ulu Date Issued...... ...............�...................................... G3q Map/Parcel................................................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE Owner's Name: , 1ylQS `� } ��.�� Phone Number c�p 35-7 Email Address: (t VU y'djt*,P CN«d, yLc+ Cell Phone Number S Project cost$ *2 L -2 a Check one Residential v Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize r�k�, to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding U Windows (no header change) # ED Insulation/Weatherization Doors (no header change) # Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to —71 C-h A14- CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable) # ( 2 477 13 (attach copy) Construction Supervisor's License# Q(0196P)O (attach copy) Email of Contractor Vet&e) 42& ovyie ,�\,Los4AA Phone number S OA �;� (C ALL PROPERTIES THAT HAVE STRUCTU S OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN ............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location (s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am -9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or-Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature UV4_c f Ls�� Date 1 - L`4• Z.y-2-O All permit applications are subje o Vab.uildin official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kv 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ,,asGoune Please Print Legibly Name(Business/Organization/Individual): 79 Mayfair Rd. South Dennis Address: Massachusetts- 02660 City/State/Zip: Phone #: -6yE slz�5' i 5(1 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 employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.: 9. Building addition required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,ees4),and have no 13. Othe WcirjaJS employees. [No workers' { y 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. I I Insurance Company Name: t�6-,r H '10S c in Policy#or Self-ins.Lic.#: QQ ( � Expiration Date: Ql - I Z 'ZQ20 Job Site Address: 0 t``i1 dW 4�(-, City/State/Zip: ( 9) ,Tct-MEI Ad e k%M U2-rof?9, 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 ce ify under the a' s and penalties of perjury that the information provided above is true and correct. Si afore: C{� Date: — � -C Z0 Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Client#:647900 2NUNEZVA ACORDr. CERTIFICATE OF LIABILITY INSURANCE D01123202yoyY) 01/23/2020 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer any rights to the certificate holder In lieu of such endorsement(s). PRODUCER CONTACT NAME: The Hilb Group of N.E.dba PHONE 508 775-1620 FAX 5 ac No Ell: ac No: 087781218 Dowling&O'Neil Insurance Agy E-MAIL P.O.BOX 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:NGM Insurance Company 14788 INSURED _ INSURER B: ' Vasco E.Nunez III D/B/A INSURER C: V.E.Nunez Carpentry INSURER D: 79 Mayfair Road INSURERS: South Dennis,MA 02660 INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER MM/DD/YYYY MWDD/YYYY A X COMMERCIAL GENERAL LIABILITY MP05117J 9/12/2019 09/12/2020 EACH q�OCCURRENCE $2 000 000 CLAIMS-MADE �OCCUR PREMISE$ Ea occurrence $500 000 MED EXP(Anyoneperson) $10 000 PERSONAL&ADV INJURY s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE s4,000,000 POLICY a JECT �LOC PRODUCTS-COMP/OP AGG s4,000,000 OTHER: $ AUTOMOBILE LIABILITY COEa accMBINident ED SINGLE LIMIT ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY(Per accident) $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADEH AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached If more space Is required) Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained In the certificate of Insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE a C— ©1988-2015 ACORD CORPORATION.All rights reserved. ACORD 25(2016/03) 1 of 1 The ACORD name and logo are registered marks of ACORD #S252670/M252669 LS1 Construction Su �`' ,; Commonwealth of Massachusetts Supervisor 1 8 2 Family E Division of Professional Licensure Board of Building Regulations and Standards Construction,$v�pJV19,b,.'I & 2'iamily CS FA-069660 Exp i res: 10/0312020 VASCO E NUNEZ,111': 79 MAYFAIR ROAD I SOUTH DENNIS, 021i8ti ' Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Commissioner (/�' Call(617)727-3200 or visit www.rnass.gov/dpl .Qi a �iirrino�rcoe¢�a�./�a�¢cr�u�ell�. ... Office of Consumer Affairs&Business Regulation j i HOME IMPROVEMENT CONTRACTOR i ndivld Expiration piratlon Registration valid for Individual use only --.. 08/24/2021 i before the expiration date. if found return to: i VASCO E.NUIP - Office of Consumer Affairs and Business Regulation x 1000 Washington Street -Suite 710 ston MA 02118 I VASCO E.NUN 78 MAYFAIR RD. :.n i S.DENNIS.MA 0 0 Undersecretary -►itlot Wftlld W th0Ut sign f IROPOSAL 94; =2pe cod Win raw ca-m 44_I.C. =124793 =508) 398.1511 - Denr_i, MA (866) 398-1511 - TioH Free Mr- fames Ro"C.--asc sfl8-?5i-0011 � 65 •r;i St. _ 9�124/20:9 . lic: + ;iiu?Ji;I:6f M Wes= 3c"nstzhle fxr 02,6fi I Ancerser �:GC-Jey:LeJ rr-iltwern Cffice 1 F.edrecm 1 001 t(i�faf=h'(=1.r1"iI 4G8G':•:a:'.f,'.'3l s:wit t5 �'!_r: _. .... _ _ ... ... -.. _-- Renove fo_r Andersen :'iarrawline dcu:alo hung windows and replace: wi-l: four Andersen SOG�3eries Ti:_wash double hua `ZU7-k ^.dCrS^ n *aM.a lwcat_o-5- IJOCationts are, I two in office and two Now. Andersen 400 series Ti_twas3c dot:ble hu"g,, 4/`rE[:QKk w: ll tT ✓4 a white exterior with 3 c:e4= pine i-terio sto a colored _•ardurare, T L'L-screens, aac3 wc� d r� iorable crill¢s with e_—e 6 - G or 2f8 pu,.-:era. New _-dersea »windows :rill have _iga perflrmAace and have t__t •,iagh t5i3.'_ty.. as�, c. Insular the- cavi=iea Of new c hit: ..- a6' w�=dray. ✓3. S•_Dpl'r :tite_rar 9L'•[ P,xtC:Ic.', tn�t. I+eSs -'.teri0: trl.-s w2_l •.• 2 lt'2' CC=4:id`_ C.?-'..=rC %rlt:l Ynde_'se= C_sar AmOCi^?__, �n_- new ext.e=i0= zr'- Iit be ?vC d , nceiwg_ ��. h plastic 1 X 3 1- 'J(; 4. T2_t:e old and any debris f=4,1 this 'ob to the to-Wi_ 1,31dtil� _ T ��{+( �0 7 .. make ra e:Ant fo= d O:.` a-4 A -down. Supply '= _e �Li t .a» Bar -s=a^ ldi^, po= an,; Historic, r q r f o. i, cert_f_ca a o- •7Fip.�CZr1ie`_ZieoS Fie:: let=e`_' a::c=oBeC.. x :'his prcrosal 'see.; rc- in=lode anY o:.`er pork not Cescrihed abol,e * All Andersen p=odi_t� wP,cr.ibcd abCve w_l l be arepai.d by the home cr.-cer_ ✓ / *' r_ V C.^_.3nges tC th'R P olpiC,13z.-i Tn-.z t e-- Gone 2i_ /In � i�-P3 a-_d accepted b} both rw�ties. '� 1_ = I3 Droncsal _3 �tZ�jJs4�i�f)�PrI pleases_jn the yr-L,Cr copy s aIId �et3=21 4J -r{ t7.�j"it'hed le. *� Abase eke hec K -ayable to :rascr, Minez caraent-ry *.n tLe Amnj t 4f � I,94.?7 far S*O'2. new ?.ndersE:� �,i:d v : eucri rod above, a_nd .".'lease Include th-'s check LZ-t: JCS .J4_ Proposal. Please al cw 3 = _ _ Ur rs. �� k S .:-,or twliT:3r:' _a'o is d =aGtO=� o=der. ik' S�Cc F��'"kv.Q a ►te e �rc�Lty, •►Z5%m.r S-Q-C-X:i ta. c_,ri j M :C—Un e Qa �V.JZ S�stry, V/ E?OS8 n :r•. --tit.^rn tr�it�r.� �r— `) n; 3r1:t?� ,tf2Cle(3:!i + t ti�3.'� t:iLl: c a:.'c•,t..::e_i�E:d6u:�.`tx ifi�... / -_.iee ThouzaZ•1 si:i >='_nd<reC Z'A't+�' rY -Cnad: ✓ �5.•TAr,1,T.'r=r.E:]5 :ahc_. �08 i3_c:r, cc-{plc-ir:r. tie c= cc3m�e_ion.. . .. . . . .. . .... . .. ........ . ....$ 20.00 {7t5,i L�c•at. . . . u` • • .. . .. ... ...... . . . ..... .. . . .. 824.00 . . . .r 1,'.40.00 LI •i:fa1:r.. i't.4tn:4.-,! . - .� i-J n:r{•iJ r ...�_..._ �_ Y _ Art _:yvt•cJ - f ,C .; 'S 1 y ..f, r J'•Y: iPrT k:t•.z-�w..n,. =[.i1t:. PZUL_.Tni .a.tn...wr t�l: .. e: _ �i,_t••_.tA. r ... �;,.'uH-::�:;{I•tJ::;i('Jt: � Acceptance-of Proposal, e Qti i"S is,:J u•.�.1' Sr::t{:..s. i:'{i.. w�t ! .!S _::1^:::o':i�'r r-:tt7=:-... �y�!•L71E,:C � i.� 14. db 101 Share Tweet Shares Custom Search Property Display 156 / 034/ - Use Code: 1010 Owner Information v Map/Block/Lot:156/034/ Owner Name as of 1/1/19: Property Address ROBICHAUD,JAMES F 66 WILLOW STREET 66 WILLOW ST Village:West Barnstable Town Sewer At Address:No WEST BARNSTABLE,MA. GIS Zoning Value:RF 02668 Co-Owner Name Assessed Values v Tax Information v Sales History v Photos v Sketches v Construction Details v Outbuildings and Extra Features v Town of Barnstable 2019 Contact Social Media Quick Links (llnsLezmp) Town Hall I0 Facebook Departments De artments.as Town Records Access Officer 367 Main Street jbliDs://www.facebook.com/townofbarnstabBbbrds and Committees Ann Quirk Hyannis MA 02601 fret=ts) j/BoardsCommittees.asol Public Records Request Form 508-862-4956 D Twitter Calendar f/calendar asol j/Department geview.asp?M-F 8:30 a.m.to 4:30 p.m. (httDs://twitter.com/BarnstableM8) Property.Look uo file=Office Information/Public- Email Us j/Departments/Assessing/Propertv_V lues Records- jhttps://tobweb.town.barnstable.ma.us/townmeganet/tele hp one- Look-UD.asol Bgguest html&title=Public%20Records%20aggges"p—Office_InformatiW Employment P 508-862-4044 j/Departments/HumanResources/pagom F 508-790-6326 file=EmDloymenUBarnstable- Emoloyment- Opportun ities.html&title=Barnstable%20Er Contact Us (https://tobweb.town.barnstable.ma.us/toy. directorv.aSDx i I jAndersen Andersen Windows -Abbreviated Quote Report Andersen' Project Name: Robichaud ® Quote M 9447 Print Date: 01/27/2020_ Quote Date: 09/18/2019 iQ Version: 19.2 Dealer: Shepley AW Showcase Customer: Vasco Nunez 75 Ben Franklin Way Billing Hyannis, MA 02601 Address: Office 508-771-7227 ehaskell@shepleywood.com Phone: Fax: Sales Rep: Craig Fischer Contact: Created By: Elh Trade ID: 713869 Promotion Code: Item Qty Item Size(Operation) Location 000 1 RO Size=N/A Unit Size=N/A Not Applicable 400 Series TW White exterior Clear pine interior' 3/4"Fine light grilles between the glass Split finish White exterior/terratone interior Full standard screen Stone hardware Please carefully review quote to ensure all details are correct prior to ordering. Once Ordered-No Changes-No Cancellation Items Are Special Ordered&Non-Returnable Quote M 9447 Print Date: 01/27/2020 Page 1 Of 3 iQ Version: 19.2 Item Qty Item Size(Operation) Location ® 0001 1 TW2842(AA) Office RO Size=2'10 1/8"W x 4'4 7/8"H Unit Size=2'9 5/8"W x 4'4 7/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/Clear Pine, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial, 3W2H, White/Terratone, 3/4"(Each Sash) Insect Screen,White Viewed from Exterior 1-1-Factor:0.30, SHGC:0.28 ® 0002 1 TW3042(AA) Office ROSize=3'21/8"Wx4'47/8"H Unit Size=3'15/8"Wx4'47/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/Clear Pine, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial,4W2H, Whitefferratone, 3/4"(Each Sash) Insect Screen,White Viewed from Exterior U-Factor:0.30, SHGC:0.28 ® 0003 2 TW2842(AA) Back Corner Bedroom RO Size=2'10 1/8"Wx4'47/8"H Unit Size=2'95/8"Wx4'47/8"H 400 Series Unit, Equal Sash, Nailing Flange Installation,White/Clear Pine, High Performance Low-E4 Glass, Finelight Grilles-Between-the-Glass, Colonial, 3W2H, LLU White/Terratone, 3/4"(Each Sash) Insect Screen,White Viewed from Exterior 1-1-Factor:0.30, SHGC:0.28 Quote M 9447 Print Date: 01/27/2020 Page 2Of 3 iQ Version: 19.2 Item Qty, Item Size(Operation) Location Total Load Factor Customer Signature 1.101 Dealer Signature **All graphics viewed from the exterior '•Rough opening dimensions are minimums and may need to be increased to allow for use of building wraps or flashings or sill panning or brackets or fasteners or other items. MAsk to see if all of the products you purchase can be upgraded to be ENERGY STAR®certified. This image indicates that the product selected is certified in the US ENERGY STAR®climate zone that you have selected. Data is current as of August 2019.This data may change over time due to ongoing product changes or updated test results or requirements. Ratings for all sizes are specified by NFRC for testing and certification.Ratings may vary depending on the use of tempered glass or different grille options or glass for high altitudes etc. Neba is a registered trademark of Ingersoll Rand Inc. Project Comments: Quote M 9447 Print Date: 01/27/2020 Page 3Of 3 iQ Version: 19.2 � .� Town of Barnstable Building � g z Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept MASa Posted Until Final Inspection Has Been Made. Permit , .esa p�� 5 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3396 Applicant Name: Dean Fraser Approvals Date Issued- 10/16/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/16/2020 Foundation: Location: 66 WILLOW STREET,WEST BARNSTABLE Map/Lot: 156-034 Zoning District: RF Sheathing: Owner on Record: ROBICHAUD,JAMES F Contractor Name:',_Fraser Construction Company Inc. Framing: 1 Address: 66 WILLOW ST Contractor License: 194747 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 11,940.00 Chimney: y Description: Partial re-roof Permit Fee: $60.89 Insulation: Project Review Req: Fee Paid; $60.89 Date- 10/16/2019 Final: Plumbing/Gas Rough Plumbing: \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after`issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. 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 Final Gas: work until the completion of the same. i 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: L 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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: 5� i Town of Barnstable Regulatory Services �P'q. r ?3M BLE Thomas F.Geiler,Director C Building Division 3 20 BARNSMBIX v KABs Tom Perry,Building Commissioner 16 .t16.�0 200 Main Street, Hyannis,MA 02601 ���VtSIO�d Office: 508-862-4038 , 508-790-6230 Approved. Fee: Permit#: �Cr� HOME OCCUPATION REGISTRATION Date: g /Ih 0 Name:" II ,Pr) Phone#• 717q . Address: b Name of Business: Type of Business: 1/ Map/Lot: ]IVTET - It is the intent of this section to allow the residents.of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to-the- premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home"occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space; • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of.normal residential volumes. • The use does pot involve the production of offensive noise,vibration,smoke,dust or other particular matter,* odors,electrical disturbance,heat,glare,humidity or other objectionable effects. . r There is no-storage'or:use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. s Any need for parking generated by such use shall be me o' n the same lot containing the Customary Home Occupation,,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one piek-up>t3uek"not fa•exceed•one•tort4capacity,and one trailer not to exceed 20 feet in length and-not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occiipatibn. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit . I,the undersigned, have �read and agree with the above restrictions for my home occupation I am registering. Applicant" A .t__" ' A Date: z2L4Llu Iny YOU WISH TO OPEN A.BUSINESS? For Your Information: Business Certificates COST $30.00 for 4 years. A Business Certificate ONLY -REGISTERS YOUR NAME.in the Town ' (WHICH YOU MUST DO BY'M.G.L. - it does not give you permission to operate). You must first obtain the necessary signatures on-this form at 200`Main St:, Hyannis. Take the completed form to the Town Clerk's Office, 151 FI., 367 Main.'St., Hyannis, MA 02601(Town Hall).and get the Business Certificate that is required by law. 5,.wyL.�'x.�. t�[•rn r ,`.'` ` j'' DATE: I'•'��Fill in please: � kxti r , APPLICANT'S YOUR NAME: �r BUSINESS lo YOUR HOME ADDRESS: ��f'. �d� ���� y)r� ��� A t (n �J TELEPHONE # Home Telephone Number: ' '�C�- �j /rl• NAME OF NEW BUSINESS—"J-- " r) ; (-� CS5 TYPE OF USINESS IS THIS A HOME OCCUPATION? . YES NO Have you been given approval from the building division? YES NO ADDRESS OF BUSINESS 7 'S �1(j,� MAP/PARCEL NUMBER VD�C When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. — (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits 4nd licenses required to legally operate your business in this town. 1. BUILDING COMKAISSIOTI R'S OFFICE This individual ha' be4 inf- Po f an permit requirements that pertain to this type of business. f Aut •Ariz Signatu- °* MUST COMPLY WITH HOME OCCUPATION COMMENTS: iJ:1 'lu �i �. (,( ' lV �,t,' RULES AND REGULATIONSi i ,per Tr, N COMPLY MAY RFS111 T IF 2. BOARD OF HEALTH This individual has bee nformed ,f th e it requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual ha n info d-of the li in re uXe ents that pertain to this type of business. Authorized Signature** COMMENTS: Town of Barnstable r Regulatory Services vBMWSTABIAMAS& g- Thomas F.Geiler,Director n 39. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TO: John Greenleaf FROM: Angela Whelan DATE: November 18,2002 RE: James Robichaud,66 Willow St.,W.Barnstable Please refund$200.91 to the above person. He was overcharged on his building permit. You can take it from 016301 433150. Thank you. i II a Assessor's office(1st Floor):. ' L H E / �' T Assessor's map and lot nu b r _©0 �� �� P o� >o` -�—ConServation(4th Floor): ' ✓ I y�, ; �) MPLIANCE .-"*Board of Health(3rd floor): - t Sewage Permit number ' —/ ! - 9 T q.. �A ;N � 2 t saaz�r�nt VA._tr�.+aL�� �;€ O 'moo .e o• d' Engineering De . Department(3rd floor): } House number Y r:n .. "'_(;"".71r oerr Definitive Plan Approved by Planning Board a 19 r � , APPLICATIONS PROCESSED 8:30-9:30.A.M.'and 1':00-2:00 P.M.only TOWN ' OF BARNSTABLE MILDIAG INSPECtOR APPLICATION FOR PERMIT TO t��j k Ll� S t -rzJn r TYPE OF'CONSTRUCTION �jgpj) Q }dY\�• 19 �3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for ,a^permit according to the following information: Location �� W .JVl.O zzl+ W - ' Proposed Use V Zoning District Fire District Name of Owner OT4 frMQ S f_1.x C- Address VJ 0 „a- ( :+M Name of Builder S`� �� Address Name of Architect Address Number of Rooms Foundation + Exterior • S �"�� -�S Roofing ��'—� Floors ` Interior Heating Plumbing N•�• Fireplace �=� Approximate Cost # S�rJ Area Diagram of Lot and Building with Dimensions Fee A OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Si ipervisor's License �f7 ROBICHAUD, JAMES No Permit For BUILD SHED Accessory to Dwelling Location 66 Willow Street West Barnstable -� Owner James Robichaud l Type of Construction Frame ti Plot Lot < "„ Permit Granted December 14,-s 19 93 " Date of Inspection: \•, Frame 1,9 - Insulation 19 _ Fireplace = 19 d Date Completed y 19 _ f. ry . TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Q%I -J- Number -� Street Address gSection Of Town "HOMEOWNER" -z-rN1--S 1�0�`t1G� 3102 -'48 n f ( 71 S I�D�� Name Home Phone Work Phone PRESENT MAILING ADDRESS ✓VW w1 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 such 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 to six 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, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspectio rocedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction IA HOME OWNER'S EXEMPTION The code states that: "Any Home Owner 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' Home Owner engages a person(s) . for hire to do such. work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Append ix.•Q, .!Rules and .Regulations for Licensing Construction Supervisors, Section` 2:15)'." This lack of awareness often results, in serious problems; ?part icularly when the .Home Owner. -hiires-.•unlicensed`-persons:�.' In° this case' our Board'-cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. , To' ensure that the Home Owner is fully aware of his/her responsibilities, many communities require, as part of the permit, application, that the Home Owner certify that he/she understands' the "responsibilities of a supervisor. On the last page of this issue is a form currently used byl several,,towns., � You may d°are) t'o 'amend and adopt such 'al form/certification foi use in your community. I Iff Application to oi.SP p,NS.PP 44S f,p V / Old Kings Highway Regional Historic District Committee 2 ' 5 in the Town of Barnstable for a I CERTIFICATE OF APPROPRIATENESS Application is hereby made, in triplicate, 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. Exterior Building Construction: ONew Building ❑ Addition ❑ Alteration S � Indicate type of building: ❑ House ❑ Garage ❑ Commercial Q'Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other_- ° (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE �L 3 , ADDRESS OF PROPOSED WORK 66 � �� ASSESSORS MAP NO. r OWNER T6n193 + ��t4AwC '`d t3u ASSESSORS LOT NO. 034 HOME ADDRESS L&LJ Tt r" TEL. NO. '3* v 4 —49 N FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public et or way. (Attach additional sheet if necessary). /trxctrvd.:r C, Th d-to ux 6 9 W alo:•l �S . (i�/. .3NRV at atrF_ ,�� 02668 .3 L.✓c W- 13, M c_1L_aLA om . Bc'A 464 t fib. 8ll9NS�A. r- /hti 0 Z668 t C`f Vt JIQ/JA. tioo^1 M4 N r W. .R NSr* _ . C)?_6C�s lPh&!`p T. 4 Silctro J Sc.v_etQr, m.56 V�Alow S-i, W. FJrNSW5(,r t m/� 0zC.&B gNVl iZr1usro1x-r t4UTt}t)2tTy' 5-o Mick _7L aC f iryn; .'N CJgz !O AGENT OR CONTRACTOR J � TEL. NO. SAME ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side),.including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). Signed Owner-Con tractor-Agent Space below line for Committee use. 7 0 F A?3 rtific a is reby Date OCT 131993 im TOWN OF BARNSTABLE BY n r.veni�•c uV_u� v Approved ❑ IMPORTANT: If Certificate is approved,approval Is subject to the 10 day appeal period provided in the Act. Disapproved ❑ Meeting of the Old King's Highway Historic District Committee November 3, 1993 A regularly scheduled and duly posted hearing for the Town of Barnstable's Old King's Highway Historic District Committee (OKH) was held on Wednesday, November 3, 1993 at the Community Building, Route 149, West Barnstable, MA. The hearing was advertised in the Cape Cod Times on October 27 , 1993. OKH Committee Members Peter L. Freeman, Chairman Robert Stewart, Vice-Chairman Paul Schoemaker, Clerk Lee Davis Doak Martin, Architect A quorum being met with only Doak Martin absent, Chairman Peter Freeman called the meeting to order at 7:40pm. He explained the hearing and appeal process and invited the public to address the Committee and view plans of interest. Bertram French, 4181 Main Street, Cummaguid - Demolition and Remove/House and Cottage/Addition (Continued) William Mullin, Contactor, was present and Peter Freeman explained that it was desirable to continue the application to • the following hearing of November 17th as the preservation restriction to preserve and protect the property in perpetuity was about to be filed in the next few days. Lee Davis voiced his concern as to what would ultimately be built in place of the structures as the Committee had not yet seen any plans. He said that whatever was to be there would be critical to Route 6A. Mr. Mullin said that the- applicant was first taking care of this phase of the project, but that he would bring pictures of a like house to the next meeting. James -&Diarine Robi-cchard 66 Willow Street West Barnstable - New ~Building/Shed + James and Dianne Robichard were present and addressed the Committee regarding the shed project. i Meeting of the Old Rings Highway Historic Page Two District Committee - November 3, 1993 Motion was made by Lee Davis and seconded by Robert Stewart that the Committee approve the application of James and Dianne Robichard. The motion was unanimously approved. Jim Spalt, 85 Braggs Way, Barnstable Village - Addition/Paint Stephen Devlin, Builder, was present for the applicant and explained that the two-foot addition would be 10 ft. x 10 ft. to the back, west side of the house and would have a 7 pitch roof. Motion was made by Lee Davis and seconded by Robert Stewart that the Committee approve the application of Jim Spalt as submitted. The motion was unanimously. approved. William Lento, Lot 23, 229 Percival Drive, West Barnstable - New House William Lento came before the Committee and the plans and dimensions were reviewed and discussed. Motion was made by Paul Schoemaker and seconded by Lee Davis that the Committee approve the application of William Lento as submitted. The motion was unanimously approved. Edward S. , Jr. & Nancy Vaughn, 40 Collie Lane, Cummaquid - Garage Edward Vaughn explained that the garage roof would be red cedar shingles and a 6/12 pitch and ' the elevation drawings were discussed. Mr. Vaughn showed pictures to the Committee for viewing of the adjacent garage which is also a 6/12 pitch. The Committee agreed with Peter Freeman's comment that the roof pitch would allow the garage a lower profile so as not to overpower the house. Motion was made by Robert Stewart and seconded by Lee Davis that the Committee approve the application of Edward S. , Jr. and Nancy Vaughn. The motion was unanimously approved. John_ 0. & Barbara A. Della Morte, 1578 Main Street, West Barnstable - Radio Tower Atty. Russ Redgate was present with John Della Morte to address the Committee. Also present were abutters John and Elizabeth O'Neil. Mr. and Mrs. Della Morte had an Exemption application OLD KING'S HIGHWAY HISTORIC DISTRICT S P E C S H E E T FOUNDATION ©N' T04L G TYPE ��1 C� ' COLOR � ► CGee SIDING CHIMNEY TYPE Lv COLOR "j �Gi GT him lJ� 3 / COLORA&Lrj 0 C �r ROOF MATERIAL � `► � PITCH 5f� WINDOWS ldbb htltJq 8 L, S I ZE TRIM COLOR DOORS ( e V rb ° (�1GGviLs COLOR ti SHUTTERS dv/ve GUTTERS �Vvl v DECK I GARAGE DOORS COLOR Notes : Fill out completely, including measurements and- materials/colorsto be used. Three copies of this form are required for submittal ' of an application, along with three copies each of the plot plan, landscape plan and elevation plans, when applicable. "Plot plan need not be "Certified" , but should show all structures on the lot to scale. T— -71 IT- TA I — —._ . OC . SNEn M3 • �O t RIGS . SF-tED LOCA7-;-�N (Nrsl. ._ . — - -- 0 -- rn IK 2 0 12��On I -TOOL: SHED FOP-: -- —MR�-F1R5 TIM ROBICHAUD- - V�!rtco.wT.-W�ARi� _.- i i. TLi i �� --'--' I-f�-_ ��4 I. 1 I -T i i � i � I I I I I I I � --- I ' I I • , i i i I i' VILT i .......... '_ I I- �� . •+- i ,.... .. ,. .. .-TX.B-FPS-�,.� , ��� I 8-RWK F _ ;1 I i i j I 1 I • I I I � -CORNER.BOARDS - - ;_ - r 11 - . I 20'-0" 24"DIA io 0 0 0 N ci 24":DIA `4 ADDITION 5'-0" G) 24"DIA p 0 o to a ZD J 22'-3" 24"DIA i EXISTING o w a • N � 33'-11' �� Vli �l_0 `lT a Pe lloo$3 f'a� A Ye v ®NT � I � ti r - oF��E��ti The Town of Barnstable' BARNSTABLE. Department of Health Safety and Environmental Services MASS. a p�Fo,�• Building Division 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection rA15 y1. Location AZ I'L/eAl 5 T Permit Number Owner Builder Ya1411Vz /Z'. One notice to remain on job site, one notice on file in Building Department. The following items need correcting: l/ I T, Je l l C l/ Pti V-e Pv T d 2 t/I S> 945 -P n-I k fq ZwS vz , Please call: 5088--862r--44003,88 for re-inspection. Inspected by i Date y AAR 2/416—P3,6C SySTEM MUST�E Asssessor's office(ist Floor): C Assessor's map and--lot number J 6 `. INSTALLED IN Ciro Board of Health (3rd.floor): ® �' P ♦w Sewage Permit number 3 �,► 1 Barns v R6 Engineering Department(3rd floor): Lr Cd— L House number -fr - °o +a q. �lan Approved byyPlanning Board F=2f �, I`5(�� 19 i ed .— /'�0 v b� At4R APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M.only Date TOWN ., OF BARNSTABLE .. BUILDING - INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION V 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a p r nit according to the f Ilowing information: Location Proposed Use ✓� v Zoning District ��, Fire District rVGfS�ol�ccr `� i� 7'/ddress ILU r Name of Owne M �J Name of Builder Address Name of Architect Address Number of Rooms Foundation �� CMG d�a� Ck 4r h( e� l cM✓ Exterior - Roofing Floors 2 Interior Heating �� yvG^ " Plumbing 1A,17-ems��— Fireplace / v approximate Cost " Area c Diagram of Lot and Building with Dimensions Feed f f r 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License ///� �ERGBXCHARD.,, J.AMES & BARTER, DIANNE i BUILD r No 34621 . ;Permit For ADDITION Single Family Dwelling Location 66 Willow Street West Barnstable Owner` James Robichard & Dianne Barter Type of Construction Wood Frame e Plot Lot e Permit.Granted• October 8 1991 Date of Inspection,z-- j 19 e Date Completed i2 ` 19 �4A tT to C f: m i I 4— ' y K a a �1'IILOYAST)VEFFP1R� T0OT101Y&A0,017101V A. EXTERIOR - First Floor 1. Complete stripping of old roof, new roof, GAF Royal Sovereign color platinum", 25 year shingles. Roof shingles on dormer prox 4" to weather with Weather Watch ice & rain barrier on whole dormer. 2. Complete stripping of old shingles, Tyvek house wrap & 3 walls to be white cedar shingles prox 5" to weather, Front to be red cedar clapboard prox. 3.5" to weather with clear natural finish. 3. All windows to be Anderson high performance (white). a. Front Side Right- boxed mullion, r.o. prox. 6x4.5' (#aV) i� b. Front Side Left- one double hung, r.o. prox 3'x4.5' (# c. Left Side Front- one double hung, r.o. prox 3'x4.5' (#. ) d. Left Side Back- one double hung, r.o. prox 3'x4.5' (#2 ) e. Back Side Left- one double hung, r.o. prox 3'x4.5' (# 2) f. Back Side Center-one double hung, r.o. prox 2.5'x3.5' (#2432) g. Back Side Right-one casement r.o. prox 3.5x3.5' (#cn235) h. Right Side Back- one french door slider, r.o, prox 6'x7' (#fwg606BL) i. Right Side Front- one boxed out mullions, r.o. prox 6x4.5' (#2842) NOTE: all windows to have decorative crosshead trim, 4" flat casing and grille inserts and screens. 4. One insulated 3' steel, 4/lite door, including crosshead lentil trim and pilasters.. 5. Replace corner boards & trim facia boards with lentil moulding 6. Paint trim and gutters 7. New downspouts and seamless gutters on dormer. 8. Masonry brick.=steps 9. Rototill and seed lawn, low shrubery in front and sides, mist. landscape. 10. New title 5 septic, 1000 gallon. 11. New pressure treated deck prox. 12'x14' -Second Floor 1. Full dormer -set in prox. 2.5' on both sides and raise entire roof ridge prox. 2' to maintain prox. 4" pitch on dormer roof. 2. Windows - type and style as specified above. a. Right Gable- one mullion, r.o. prox. 6x4.5' (#2842) b. Back Side Right- one mullion, r.o. prox. 6'x4.5' (#2842) c. Back Side Center- one double hung, r.o. prox. 3'x4,5'(#2842) e. Back Side Left- one double hung r.o. prox. 3'x4.5' (#2842) f. Left Gable- one double hung r.o, prox. 3x4.5 (#2842) INTERIOR 1. Complete stripping and replacement of all exterior wall sheetrock. and new R-13 insulation. t , 2. Complete stripping and refinishing of interior walls. 3. Sanding and refinishing of all hardwood floors. 4. Expand current pass-thru on kitcken/living room wall to prox 6'. 5. New linoleum kitchen floor, and replacement of subflooring, 6. New kitchen counter tops. 7. Refinish existing kitchen cabinets and new hardware. 6, Refinish baseboard radiators. 9. New bathroom floor, counter and misc. repairs. 10. Replace all interor doors - 6 panel moulded hollow core 11. New Kitchen appliances, stove and refrigerator. 12, Replace all interior trim. 13. Complete plumbing to dormer - Heat & Bathroom 14. New circuit-braker panel, new service at side of house and complete to second floor. 15. Misc. exterior light fixtures. 16. Open stairway to second floor & necessary finish work as discussed. tj om NO r ki ra to -. _ ] � - � �+-. ��' � •.,`f is 4}- / �1 �y, - k r ,F �V� �• 9 ..fix �*�� ��� �Y:.� �� { - �- 3 'T ' s T , tj ...... .,,., t• . ! C'�: � � two Sk , . r _ - Application to Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTI FICATE OF APPROPRIATENESS Application is hereby made, iri triplicate, 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. Exterior Building Construction- ❑ New Building j�Addition ] eAlteration Indicate type of building: House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). ��CC TYPE OR PRINT LEGIBLY DATE �10r'�. ADDRESS OF PROPOSED WORK 610 MUU ` TW ZA ASSESSORS MAP NO. OWNER a ASSESSORS LOT NO. HOME ADDRESS d LZaSTEL. NO. FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. '(Attach additional sheet if necessary). e < /3leA�n�d�s' . '�my rov s c,�. cf�%las 5Htr�, w• F3a�aFC.,h 1t . n�t4 02 6 C8 :. Z, C►ia Ui S. o,rrti,I '6 e:.e,,d.k_z_r , N t7 t ralo" SY 2U-C 62- LJ 9MFv1{t'.0 �fnff �2-6 dv 5. Luc,cltA a. /rlcC.cd1 � 20$ k4- _&tNt.4e-bte , enA C4,6 Y. FZ«h or d F 4 + y,c.r r la C Q h CU -t ryl A l Ar Seal knr, knvAt b i m r Oe-6 4 .tsyf". ;,J err fZ �aLki•e- QJVA/,o rnJ9 CD2601 AGENT OR CONTRACTOR TEL. NO. ADDRESS ► DETAILED DESCRIPTION OF:PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including i materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if n\ece�ssarr\y). APpRaytC� -� Signe Owner-Contractor-A t Space below line for Committee us Received by H.D.C.DJtii p E C' E I V E D The Ce i e is hereby ,e { Date ` z- Time SEP 1 (1 1991 �� (✓ �� BOA n 'KINGS HIGHWAY Approved ❑ IMPORTANT: If Certificate is approved,approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ HOME OWNER'S EXEMPTION The code state that: "Any Home owner permit is required shall be exempt frometherprovisions work fof thishseationding' ' (Section 109. 1 . 1 - Licensing of Construction Supervisors Home Owner engages a person (s) for hire to do; such work; that sucH Home Ow shall act as supervisor. " � : Provided that . ne: Many Home Owners who use this exemption are unaware that the areas the- responsibilities of a supervisor (see A for licensing Construction. Supervisors , Section 2. 15) , y laming Appendix Q, Rules and .Regulations often results in serious problems This lack. ot � awarene: unlicensed persons. In this case �ourrBoardacannoteproceedn the �against. hires : inlicensed person as. it would with licensed Supervisor. The H as supervisor is ultimately responsible, g .lust .ahe ome .Owner�'actir To ensure that the Home Owner is fully aware' of his/her 4 communities require, as part of the permit application, that the �Hoirie �Owner � certify that he/she understands the responsibilities o that t sibil ties.,-' r last page of this issue is a form currently used b several f a �supervisor. :,�On the YOu may care to amend and adopt such a form/certification for use -in tyour•community community. ... ,i . i TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATEou JOB LOCATION L '? " w;�•• ` 'Y Number Street address '' ° "HOMEOWNER" Sectlon of ;to�tr�:,P; Name 36 2 7 7 ,,� •• • gg �tdl.�Z C Home. .phone Work PRESENT MAILING ADDRESSPhone;,;,.,.: .. lty tow State _F- The current exemption for "homeowners" was extendedZip Code dwellings of six units or less and to allow such to include owner-occu ied d 1 ual for hire who does not P h homeowners to engage an in- acts as su ervisor. Possess a license DEFINITION OF Provided that the owner Person s HOMEOWNER: ( ) who owns a parcel of side, on which there is land on which he/she resides attached or detached structuresintended to or intends to A person who constructs more than one home be, a °ne to six family re- 0 person accessory to such use Y dwelling, Bred a homeowner. and/or farm structures. on a form acceptableSuch e In a two-year period shall homeowner" shall not be for all such to the Buildin submit to the -Building work performed under the0buildin, that he/she shallibei, 'O:tapffiible cial The undersigned ermit. (Section log. 1. 1) Building g ' homeowner" assumes responsibility g Code and other applicable codes , for compliance with the Stat The undersi ned by-laws, rules and re Barnstable g . "homeowner" certifies that he/sheregulations. and that wilding Department pe ion understands he/she will minimum ins the-Town of.• Pl with said proced Procedures and requirements HOMEOWNER'S SIGNATURE es and requirements. APPROVAL OF BUILDING OFFICIAL Note: Three family to comply with t dwellings 35 000 State Buildin cubic feet " g Code Section °r larger. 'will be 127 . 0 Construction required Control. •r �.tt ' v_� . i4 - .I- •:.1 trtr�, ���}33}yl..�,F"t aY: . � - � .. Da,. W S TREET - " "200.00, i EXIST.37.0 '/. WELL I N LOTS 1 / 90 �� N W . (/156/034 ) 2.54+/- AC.. NOTE: NO WETLANDS WITHIN 100' OF --� J �\ y PROPOSED S.A.S OR ADDITION 16.50' ` 79 N 37.7 39.0 EXISTING 38 / 3 BEDROOM \� Gravei Drive DWELLING 87' \ ` Deck HOUSE#66 78! -- 40 90' 39.2 1500 Gallon P POSED Septic Tank DITION 11' i M BTA , - id Exist.Septic Tank, + Dist. Box&Leach. Pit w to be pumped-out& N D-Box filled-in or removed 3$1 as required 38.5 5'STRIP-OUT REQUIRED N0 WELLSVITHIN 150' OF PROP. S.A.Sco Co N I N I 117' 10.83' 79' 40 I i i N Be I 171.52' Ai 4' SITE PLAN/ G SEPTIC UPGRADE PLAN N , y�€ B LOT 1 ! #66 WILLOW ST ,� C1V.. . . F�F�1Sr<<;yv : , SIQNAL Et %R; BAR'NSTABLE , MA. �M AP ;J i i G j ;►.- APPLICANT: ENGINEER: (�F10SMAN NO 3�rt� 9MAN James F. Robichaud Norman Grossman, PE, RLS No. 12"s 66 Willow Street 10 Marsh View Road , , fST1R���?!;� LOCUS MAP West Barnstable, MA 02668 East Falmouth, MA. 02536 WAi LAtI�? 1+-' SCALE : 1°=2000' 508-367-7820 '508-548-1920 '- MAP -SEC PAR LOT FLOOD ZONE ELEV. MAP SCALE DATE SHEET NO PLAN NO.' 156 . 034 1 C --- 250001'0011•D 1" = 30' MAY 17, 2002 1 OF 2 H-71.3-1 30'-8' 4,�„ 21'-2' 3'-2" 2'-0" 1,-5„ 1'3" .R cn Y � O O � o �aster bath 1 o - co o Ir (p ................. M master bedroom NNp ® walk in clos.04 © o 0 q lW-s" o 13'-7„ L 34'-0" ti a N o' 20'-0' X-O" 1'-8 r 5'-0"Rail 5l-0"Rail 16l-11"(Open) FO OD -1 04 T-2" 00 O C) C? 04 G rn family room-12 vaulted ceiling N3 CO `4 04 C3 00 2l-2' 6'-0" DECK IW-5' ail 14 cv) A W-6- 00 laundry 04 '6'-O'l= 33l-10 C.) 6'-1" 20'-5" I I .................... ......... O bath kitchen CO X-O"--Ir CO A O 3'4" - -2� bedroom 2 8 CO :Il-g" -7' .................. ............ ............ ............... (�'-O"Rail 2-4" 8l-2" 9-4- 13l-1" 7'4 - T-8" bedroom 3 living room office dining 'L6 p cv) 36'W 10.0017 ............... 3 2'-0" �7,�„ 91P I f'—JOl-1TZ 4C 34'-0"-- 20'-0 G-)24"DIA N O O O N O 24"DIA ADD N N 24"DIA O o in - 6 0 22'-3' S 24"DIA EXISTING o w N J �3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map tiJ�� Parcel , ,.SABLE Permit# Health Division .�®G I'` Date Issued >;e Conservation Division e 713 ?4�2 JUG -3 PP�i 2' 06 Application Fee ��0. &-y Tax Collector 0 A �4 h3 Lf _ � � �� � ermit Fee ����� l I STEM way Be Treasurer �' "-riji4'IS 110� NSTALM IN MPLIANOV Ok PlanningDept. Mm mu s p ENVIRONMENTAL,C008 AND Date Definitive Plan Approved by Planning Board `. TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Lk L)1 11f1w &Irepj- . . Village _ X�LhS- �P. Owner JCC rYl" Address bl P G�1�ll/1� tJ 'w Telephone 'P�" .3wo - yB�1 Permit Request �y U Qf "" (0�O-� ��,A� 0/✓ d/y ��/'7�02 h 4 AI L�l � t '1 oN ,i►v�tP tS 6 � R o�3 AA- // / Square feet: 1 st floor: existingproposed U'� 2nd floor: existing ll Id, proposed Total new 400 Zoning Districtg6iC&kl�Q-Q., Flood Plain No Groundwater Overlay 00 Project Valuation 03 -0 Construction Type 4� Lot Size • J`t afJ1, s Grandfathered: 0 Yes $lo If yes, attach supporting documentation. Dwelling Type: Single Family fd Two Family ❑ Multi-Family(#units) Age of Existing Structure &WW U Historic House: O Yes XNo On Old King's Highway: 4Yes ❑No Basement Type: )4 Full ElCrawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sgq./.fft�t) l� Number of Baths: Full: existing new Half:existing V/ new Number of Bedrooms: existing new Total Room Count(not including baths):existing L new First Floor Room Count Heat Type and Fuel: Q/Gas ❑Oil 0 Electric '❑Other Central Air: Yes ❑No Fireplaces: Existing _ New Existing wood/coal stove: ❑Yes '� No Detached garage:0 existing ❑new size Pool:❑existing 0 new size Barn:0 existing ❑new size r �� Attached garage:0 existing ❑new size N Shed:®existing 0 new size 1%-0 Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded 0 Commercial ❑Yes V*<o If yes,site plan review# Current Use _ Proposed Use //�� �C-d_a BUILDER INFORMATION .� j Name es kok add. Telephone Number Address U(P W i//aw SfK-e - License# 21-�7 I' Of 0a(o!o 7 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FR T IS PROJECT WILL BE TAKEN TO"60_4nS J�_ bU4-MP_ SIGNATURE DATE V C7 FOR OFFICIAL USE ONLY j PERMIT NO. 4 DATE ISSUED MAP/PARCEL°NO. _ ADDRFS$.,i VILLAGE :. OWNER, G DATE••O�INSRECTION: - ' FOUNDATION �Ci' .o� l��c jilY o:l `yam FRAME *fA# AX 150-4/-1,Vy INSULATION FIREPLACE o ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED,OU'lw ` ASSOCIATI.ON PLAN NO. The Town of Barnstable 1HE.Tp�� BABeB7ABLE: Department of Health Safety and Environmental Services v Hnss. 0 � ,63q. �0 IMA Building Division 367,,Main Street, Hyannis,MA 02601 Office: 508-862-4038- Fax: 508-790-6230 PLAN REVIEW Owner: -S �o/; IC.Ff,*r-, Map/Parcel: 3 Project Address: is IV,19,scNBui1der: rl- 1 , The following items were noted on reviewing: . `L`�. t-oo`s S' -S, 40Xc,NTIZGL Jc��vrs 1912- P P v D�T/aN i0 /V Of WS / f 5�4044, H X Tien- A. , �c a j , .JTit 1J GTt/ /o 9� TIV �✓�rzOwiatf ei4;7-G 4" 13 rl2rc 4340P DlZ ''�... 7�t�t.��DF ��-T� ��2 £X�s Ti�iG- yY�� o� /���i,u� �/sr.��n. . . • VecrC �G�/rs 416 s CMG . ��7-r*141 Reviewed by: Date: q:building:forms:review . RESIDENTIAL BUILDING PERMU FEES APPLICATION FEE New Buildings,Additions 550.00 Alterations/Renovations - • $25.00 Building Permit Amendment S25.00 FEE VALUE WORKSHEET NEW L,IYING*SPACE square feet x$96/sq.foot=1 !��✓- i x.0031= 7-��: plus from below-(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq. foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft( >120 sf-500 sf S 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.00 STAND ALONE PERMITS Open Porch x$30.00= (der) x$30.00= 0, oti Deck , (number) x$25.00= — Fireplace/Chimney (number) Inground Swimming Pool $60.00 ; Above Ground Swimming Pool $25.00 - Relocation/Moving $150.00 (plus above if applicable) Permit Fee pmjcost Application to ®rb Ring'o 30igbhlap Regionar 30iotorir MiotriCt Committee In the Town of Barnstable 2 002 9 107 CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: New 9 Addition ❑ Alteration Indicate type of building: 2 House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: Q 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence El Wall ❑ Flagpole ❑ Other '" TYPE OR PRINT LEGIBLY: DATE H LEI. "�7 C ADDRESS OF PROPOSED WORK (o�J W �-�-U ST q ASSESSOR'S MAP NO. vd`?�D :- m r- OWNER -TR M C>S 'R03%c-WiV-Q ASSESSOR'S LOT NO. 3^ N HOME ADDRESS G(o W kLL(?� S -tz T TELEPHONE NO. �J V-A w - FULL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any pu lic street or way. (Attach additional sheet if necessary.L -r 3z���� C-%A C4Lt-%a$' , i'j 50 t`,SHEt_L t_c�rr� , vJ, �c�:ti rSTfl�.�, rnt� oZbl,g 1�� � �� + '3�\g c ,e. St—sooe:& , 5o w�lt✓w��� W. cJitA,8, PC41, -nAC -OOV- (off oz-f4(06 (4r4M:, �)o.a(�d s , A'4 k14,LUDO S"fr.te-)t , W. 3a42NSTiA- C3 LF-, nnA o-t,69b mc:�is f32`a T2r,,OS Pow, A\j yx400--� . 5o t�1UN �C� F_T . 3o s�� : r4-144 oz Lv^ccL�\-E 8 : r"A�- CV�"Jah . 3o.i. QzL'-'b AGENT OR CONTRACTOR SAMEA TELEPHONE NO. �c1l • 3 6Z-y��� ADDRESS �a(a w\t-L-Q v,/ OZ 6(oS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Zv Z . , �v1 6V:V, , 0 I40 J5 � . MA.�r2.�L.S (.-OL-OrENn- W gilt E-)L- Cr S12..4 -TV•c..tt, ���T�N!� L ,.-� fZ%1 r k) T =3 E SEA-4 L.a n f"00 Signed off o ner-Contractor-Agent P For Committee Use Only � ZQQ(his�Certificate is hereby Date S-Z:Z-✓`- i� prove -enied K °Committee Members' Signatures: — � r Town of Barnstable O W Old King's Highway Historic District Committee 002 SPEC SHEET FOUNDATION '?'OJ'2. C 1E Vx,1 •- P�o� ��-Q�C� Str�.�►G i �S , SIDING TYPE '• �Q(U3� �i� �-�P. COLOR C�-�H� •- S'►A�N�� CHIMNEY TYPE JCL v,,� COLOR . ROOF MATERIAL COLOR Lk c;%4-r P+`1 C �LF3T�t�1Vtn� I PITCH (t 11'Z- ' 4�Z_ f 1 2—" WINDOWS Vw4L-r-- O-MN6 �CMEM COLOR WO SIZE V PT-UP0 �F.-IYGIa-�NDOQ G-L�r�q�-, TRIM COLOR 1� "I .. x j Al So q o S 1 A. 44SC.t DOORS M� L ;t`�1 y�.(�c� 36 COLORS -\2�p o SHUTTERS (4-0 COLORS GUTTERS ��� COLORS W VAr \Z-C DECKS ,6� MATERIALS Utf\PO% \'T V- (- GARAGE DOORS E-j O COLORS SKYLIGHTS SIZE COLORS SIGNS t �I �C COLORS —2 2002 �;i r" h AFF TO E""ROVD FENCE c"Jo K COLOR 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 plan and elevation plans, when applicable. SPECSHT Revised 11/98 J ------------- I 14- � Z p ro k 2 U ' (7i 00 L°� K�ST C_o(L'Xe o' ?.° c7 � l -SSG. 9 'X 2002 , � u L��yD.r rzkl � I I certify that this property is 'F�= located in Flood Hazard Zone C ( out- side the 500 year flood) as identified by the Department of 1!ousing and Urban Development (HUD) . Date CERTIFIED PLOT PLAN �. LOCATION .Q/al?!✓�T.. .. . .. . . /L`: SCALE . .. .. . . . DATE yj;:. nd Surveyor PLAN REFERENCE . C�E7-fG Lv7- wl Fte�. L2 .y.. .. .. . . . . . . .. . . . . . . . . . . MAY -? 2002 r-%O-VED . . . . . . . . I certify t,,O .its titl i'ns, rance company that there are no visible encroachments I CERTIFY THAT THE �fXl-S??"!C. DI,✓ez�IAI6 or easements except- as shown and that this SHOWN ON THIS PLAN IS LOCATED ON ME GROU.'1D plan was prepared under my immediate AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF supervision. ;BAlz.c%S`T,gl3GL; . . ,WHEN CONSTRUCTED. DATE 13EGISTERED LAND SIIRVEYO 2002 , wA•,�� _ 3.ti X W n*xolam 12 � \` -1 8 / 1-- a•s va• \ 1fZ'CDX plywood,15B felt,asphalt shingles R 30 insulation with proper vents above / 2X 101 le,O.C. \ 2 X 4 walls,W-Cl)),150 fat WC ld j, Family Room R131neulallon 2 X 101 Ifr O.C. Rig Inetdalbn 3/2 X 70 QM wBh 3.6'IaYy odunme 8-ow"Ote wall,3,BBOM oonaete 16"X B'fbdhP,4 oorvete floor 7X7x1'Deft A7- �7- MAY -? 2002 I I Window Schedule Quantity A&C 2'-8"x 4'-0" Narrowline DH#2842 14 B T-0"x 4'-0" Narrowline DH#3042 1 D 2'-0"x 3'-0" Narrowline#2432 1 E 2'-4"x T-0°Casement CN235 1 O g F 1 -8 x 4-8 Narrowline#2056 8 G 2'-0"x 1'-0"Transom#244FX2410 4 H 3'-0"x 3'-0"Casement C235 1 Window Schedule Totals 16 Door Schedule Quantity J FW Glider#6068 1 K FW Hinged#FW2968 1 1 'L (J SAY -9 2002 3-17-02 schedule windows&doors.xls 5/2/20021:50 AM ell — _ The Commonwealth of Massachusetts = Department of Industrial Accidents 60U Washington Street Boston,Mass. 02111 Workers' Compensation Affidavit surance���/O/�/O//O/�����/O/0������������������/0������% i name .Jame-:S f�®bi AmAj X . location: (AD n r city W �C�f1CT[ID�Ie. phone-# ❑ 'I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one workin in ca acity I am an e to er rovidin workers' compensation for my employees working on this job. i$ie�><c` '' YipiE?< zi«>`%s`>:•< <' Ez�i i2i?>� <>>ia?E `<??:: :: j`:?::sE<::::iiii�;>:<:3E:'ici2? ii`>:i<:?'''`:`:>i:> :>�>;<;;:;:<>i'`>`z>>;;>;�#<'>>:':::''?:`>''''': ; sr;":{':<`�:':�';:.'"::::, :'" `«::`>? :eom an':>nam ............... » :'.' C 1 jL 'i'i ''j' fk':i:;:ii??` :is Si;' '[[[i '..........'isk2<ii'ti i <`i%:.'?;':>''`: �istraace. o l I.am a sole proprietor, general contractor,or omeowner(cir le one)and have hired the contractors listed below who...-. the followin workers w ensation polices: '• '- •' :. 4, . tv ..::. .... . .corn D any nam k UNM i,�� ...........................:::::. ............................ Ix r . 4 r-.N••:. r• isi•:}is4i:}:{^ii:i•};vi}}}::}}:v}::'i'4i:;:}i}iiiii;{:iii:�iiii:i ........:.. ........... 4:is•}}i}:8 ::S�iil•}::}}}};:} i•.:i}:9:}}i:::}}}i};v}}:^:}i:•}}ii:;^:•}:•. :4::.. :w::;viv'::::::w....... '•..}::F iii" iw::::.�:.�::::::::::•:v�.:�:.:::;•in•X4ii::•i:�}iiii:v}:v:::::::v:•: ....:..... X. :� an;liatn ..... }•., ..N:..................... �''}iti::•,::;:!i}i:jj;:;: :jf 4:i:: i! };:il:j:'>:!ryj:•iii ?si i:•i}}iii:+; :}}y iiiii:v:i ii`:if�.':i}iijiji.:iii?i....:.......:;i:}}::::. X. ..QQp ._ ... ...... . a. :. ..... .... .. ..: :....: ......... ... 3 'X•}: f.. Fafiure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sue 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 may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby.certify under the pains and penald erjury that the information provided above is true an correct Signature Date PrinE name Plione# $ 1,255559,02855 official use only do not write in this area to be completed by city or town official city or town: permit/license# OBuilding Department ❑Licensing Board. (3 checkif immediate response is required []Selectmen's Office _❑Health Department contact person: phone#; ❑Other (�evieed 9/95 PIA) JI 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 orYenewval 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 of 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 die 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 whichill be w used as a reference number..Tlie:-affidavits may be•ietumed;t _ m r s the Department by mail or FAX unless other arrangements have been ade. " " 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 Office of Investigations 600 Washington Street p Boston,Ma. 02111 fax#: (617.) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I oFINE�p� Town of Barnstable ~; Regulatory Services. �B KAILM. Thomas F.Geiler,Director �f1639. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW i 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. (60,000 Type of Work: IAC,{CC/7/ .-Estimated Cost ; Address of Work:_ Owner's Name: R4 (=h a Au Q� Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 Ouilding not owner-occupied wner 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. �tvlz, 20, 02 Date wner's Name I Q:forms:homeaffidav r THE Town of Barnstable �pp 1p�� �P Regulatory Services BARNSI'ABLE Thomas F.Geiler,Director 9 MASS. �A i639• Building Division lEn �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION p x Please Print DATE:_ I D V JOB LOCATION: number ,�j,,,, , ,,street�Q �) �j village /� 1��( "HOMEOWNER": :.J7�_0 �)W 4y �W� J10�" �O�% SU&- c-M— /�1(�� name home phone# l work phone# CURRENT MAILING ADDRESS: Le l3cv�-Y�s 1'UhL�, rn� C Q(e(o 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 resRonsible 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"homeowne "certifies that he/she understands the Town of Barnstable Building Department minimum inspection proce es a d requirements and that he/she will comply with said procedures and ents. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 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. J 1 Q:forms:homeexempt w Permit Number MECcheck Compliance Report Checked By/Date Massachusetts Energy Code MECcheck Software Version 3.3 Release lb Data filename:C:\Documents and Settings\Administrator\My Documents\MECHECK-WORST CASE.cck TITLE:Jim Robichaud&Colleen Cabral CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: I or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:06/06/02 DATE OF PLANS:6-6-02 PROJECT INFORMATION: Addition-66 Willow Street,West Barnstable COMPLIANCE:Passes Maximum UA= 160 Your Home= 156 2.5%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 467 38.0 0.0 14 Ceiling 2:Cathedral Ceiling(no attic) 280 38.0 0.0 8 Wall 1:Wood Frame, 16" o.c. 702 13.0 0.0 41 Window 1:Wood Frame,Double Pane with Low-E 178 0.330 59 Door 1:Solid 21 0.300 6 Floor 2:All-Wood Joist/Truss,Over Unconditioned Space 600 19.0 0.0 28 Boiler 1:Other(Exept Gas-Fired Steam),92 AFUE Air Conditioner 4:Electric Central Air, 12 SEER 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 Massachusetts Energy Code requirements in MECcheck Version 3.3 Release lb and to comply with the mandatory requirements listed in the MECcheck Inspection Checklist. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The C equipment selected to heat or cool the building shall be no greater than 125%of the the design load as specified S ctions 780CMR 1310 and J4.4. Builder/Designer v � Dat�.11-m•.� 2c'� 0 2, �— ESPN.com - MLB - Recap - Red Sox at Tigers - 06/05/2002 Page 4 of 4 I MIJ I More Useful Everyday MSN Home I Hotmail Search Shopping I Money People&Chat ©2002 Microsoft Corporation. All rights reserved. http://sports.espn.go.com/mlb/recap?gameld=220605106 6/6/2002 r MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.3 Release lb DATE:06/06/02 TITLE:Jim Robichaud&Colleen Cabral Bldg. Dept. Use Ceilings: [ ] 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-38.0 cavity insulation Comments: [ ] 2. Ceiling 2:Cathedral Ceiling(no attic),R-38.0 cavity insulation Comments: Above-Grade Walls: [ ] 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: [ ] 1. Window 1:Wood Frame,Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: Doors: [ ) 1. Door l:Solid,U-factor:0.300 Comments: Floors: [ ] 1. Floor 2:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: Heating and Cooling Equipment:; [ ] 1. Boiler 1 Other(Exept Gas-Fired Steam),92 AFUE or higher Make and Model Number [ ] 2. Air Conditioner 4:Electric Central Air,' 12 SEER or higher, Make and Model Number Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R-values,glazing U-factors,and heating and cooling equipment efficiency must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ J All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120'F or chilled fluids below 55°F must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range(F) 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) I 47 Old Church Street BR.IDFORD L. HALL Yarmouthport, MA 02675 Environmental Consultant M. (508)362-3397 July 1,2002 James F. Robichaud 66 Willow Street West Barnstable, MA...02668 Re: Line Description, GIS mapping Dear Jim, The line that appears on the GIS map is an isolated ditch that contains water most of the year. After careful examination,the ditch does not drain into or exit from any wetland area. It should not be considered a river or stream. It is simply an isolated water hole. Very truly yours, Bradford L. Hall, Environmental Consultant recycled paper Environmental Permitting • Wetland Delineations • Indigeneous Botanical Inventories ,2 --] 8 plywood,,5f3 felt,asphalt shingles / , , R 30 insulation with proper vents above ' i2Xt0/,8'o.C. \\ - - - - - - - - - - - - - - - - - - - - - - - - \ 2 X 4 w.%,}k'MX.Igo foe,M elrFglee Family Room R1131neutatlon 2 X,01 Ifir O.C. . RIB Irreutatbn 92 X 10 Btrt with 3.6'Ie1y oolunma B'oonoraee wall,3,01MV omaete . ,6'X 8'foo(lrQ%4'oonuete floor 4 - 2X7xPpeda