HomeMy WebLinkAbout0275 WOODSIDE ROAD o
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f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel ��J'� Permit# 0�1301_T,111\
Health Division 8v ,(�`' `' � 1 Date Issued
Conservation Division - Fee &2.5o 'alo, f '`aae
Tax Collector SEPTIC SYSTEM MUST BE
Treasurercvd, I'p' (2
INSTALLED IN COMPLIANCE
/ / 99' WITH TIT� LE 5
Planning Dept. ENVIRONMENTAL CODE AND
Date Definitive Plan Approved by Planning Board TOWN REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address a-1 5 W 00 d 5 A2. "RooL
i Village Wt,4
Ownej5kr) W.j:Re_1o2CCC, 1 , i r1V0.NC_ Address a-1Jt'UJOC65►C;1e ?CnA
Telephone
Permit Request CA(\S� uc-mac o O� QC1 c On
Square feet: 1 st floor:existing TO proposed f/! 2nd floor:existing proposed Total newt//a�
Estimated Project Cost �0 O,nUC� Zoning District Flood Plain Groundwater Overlay
Construction Type U)QOQ
Lot Size �D(QD S .F. Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family G� Two,Family ❑ Multi-Family(#units)
Age of Existing Structure /477 ea-t', Historic House: ❑Yes W o On Old King's Highway: ❑Yes CYNo
Basement Type: ❑Full ❑Crawl ❑Walkout l6ther -4 S P`T4- Le..vel ICE,;fi n t��4'b
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new / Half: existing new
Number of Bedrooms: existing 14 new $"
Total Room Count(not including baths): existing -7 new of First Floor Room Count �o
Heat Type and Fuel: ►4as ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes @46' Fireplaces: Existing New Existing wood/coal stove: ❑Yes W110
allove, creaunj_— 1
Detached garage:❑existing ❑new size Pool:Y 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- VnIAM Telephone NuTipber g 6F
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 0- oe—/
SIGNATURE DATE
~ FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED ;
MAP/PARCEL NO.
ADDRESS VILLAGE '
OWNER
DATE OF INSPECTION:
s
FOUNDATION c2bOo
FRAME i
INSULATION w
FIREPLACE -
- rt
ELECTRICAL": ROUGH; =. !- FINAL
PLUMBING: ROOGr-ri; Z FINAL
GAS: ROUE 5 ! FINAL
FINAL BUILDING
w
fn
f -
DATE CLOSED OUT ;.3
ASSOCIATION PLAN NO.
f
l�-
The Commonwealth of Massachusetts
— Department of Industrial Accidents
' ` �� '• � �- Of/ICr Of/OYCSI/g8!%OOS
_ - 600 Washington Sheet
Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit
IV
name: - - — � _°'
location•
city hone# (.0
® I am a homeowner performing all work myself
❑ I ama sole etor and have no one worldn inaay capacitV. VA
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I am an employer Providing workers'compensation for my employees worldng on this job.
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I am a sole proprietor,general contractor, om er(circle one)and have hired the contractors listed below who
the following workers' compensation polices:
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allure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criu imal peaaWea of a Sete up to 3I,500.00 sad/or
ns years'imprisonment as well as dva penalties in the form of a STOP WORK ORDER and a Sne of 3.100.00 a day against me. I understand Sit a
copy of this statement may be forwarded to the Once of Investigations of the DIA for coverage verincation.
I do hereby certify under the penalties of perjury that the information provided above is true and corral
Si -�- j ,1 /1 Date y`f _ -
Print Warne �1 iV If V• /'l�fl 117� Phone# )V `c ,�) /'
I!5
:Con:t:zd�penon:
do not write in this area to be completed by city or town otHcial
permiNiwue# ❑Building Department
❑fig Board
diate response is required ❑Selectmen's OSIce
QHealih Department
pun#+ _ �0dw
MOOSE SO
(Ufr ed 9195 Pl/U
°F THE rp�,�
The Town of Barnstable
• enxivsraa�.e. -
MAS& Department of Health Safety and Environmental Services
1 t 9. a Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: ('KDAo Estimated Cost
Address of Work: 9,16 0J00a%10 e 101� KJG,�!J rcW& 19�aLr�_-,
Owner's Name . 11 'eb D A
Date of Application:1P, ` c)
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
Building not owner-occupied
P-14owner 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.
Date Owner's Name
q:forms:Affidav
r
i
ESTIMATED PROJECT COST WORKSHEET
Value
LIVING SPACE ) /OCR square feet X$55/sq. foot=
GARAGE (UNFMSHED) square feet X$25/sq. foot=
PORCH square feet X $20/sq. foot=
DECK square feet X$15/sq. foot=
OTHER square feet X$??/sq. foot=
Total Estimated Project Costs / (p C)
g990915b
rL,...OAK Qfp=1=J
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. Finn"iptive Paelra;s for an*and Twe4Family Rnldaaelal BaiW W Seated with Fold Fuck
MAXIMUM
aiming abwz=ing wing Wau Floor Baaemtwt Slab HamwCoog"B
uwatuas lGvalue? Rrvaino'. Wau Pe., rmzip== Emci=yl
I R.W1120 &valrro�
5/01 to 6300 Hach;Deem Dann
Q IZY. I GAO 3= 1 13 19 10 6 Normal
B 12% OJZ 30 19 19 10 6 Normal
9 12% am n 13 19 10 - 6 is AFUE
T 13% Q36 31 13 22 WA WA Normal
u 13% aq6 3= 19 19 10 6 Normal
i" i»i wd+i a`e 13 WA USIA !S AFUE
W 15% 1 am 30 19 19 10 . 6 11 AFUE
X IS% = 3= 13 25 WA WA Normal
T IWA OA2 M 19 1 2T WA WA Norma!
Z ts% OA2 n 13 19 10 6 90ARM
AA ISO/. OJO 10 19 19 10 6 90 AFVE
1. ADDRESS OF PROPERTY:
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:
3. SQUARE FOOTAGE OF ALL GLAZING. /yr�
D
4. %GLAZING AREA 03 DIVIDED BY#2):
S. SELECT PACKAGE(Q—AA-see chart above):
NOTE. OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL
YES: 4 NO:
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Office: 509-962-4033 RalDh Crosse.-,
Fax: 509-790-6230 Building Cotar..:
HOMEONVNM LICENSE EXEMMON
Please Print
DATE:
JOB LOCATION:
Mmaer sotto village
-floMEowrrEx -
otme home phone work phone s
CURRENT MAILING ADD vv
Wei-.
city/toll ,rate as cane
'The ctareas exemption for Ohnmeagmerf was extended to include a_ied dweITIM of six units
or less and to allow homeowners to engage an individual for lure who does not possess a license, vi
DEFINMON OFHOMEOWNER
person(s)who owns a parcel of land on which helshe resides or intends to reside,on which theca is,or is
intended to be,a one ortwo4mily dwelling,amcbed or delved sztnaara accessory to such use andlor..
facer stmctares. A person who cAnst:tzeu more than one home in a two-year period shall not be considered
a homeowner. Such"homeowner'sha11 submit to the B"iidiag Official on a form acceptable to the
Building Official,that he she shad be=ntt�'ble for 11 Rich wok nerforrtted tmder The imildLns rermit-
(Setxion 109.1.1)
The undersigned"homeowmer'as ==responsibility for c�mpiiance with fire State Building Code and
ostler applicable codes,bylaws,roles and mplations.
,.he undersigned"homeowner'=rdfies that helshe understands the Town of Barnstable Building
Dartm
epent minimtun inspection procedures and requirements and that helshe will comply with said
procedures and .
of Homeowner
Appmvai of Building Ofdai
Note: 'nine-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State Building Code Section 127.0 Cans=c ion Control.
HOMEOWNER'S EXEMO'1TON
'the Code stater that "Any homeowner performing wort forwhid3 a budding permit is requited shall be exempt fmm
me p:ovisiota of this section(Seedoa 109.1.1-Llteusmg°f °II Supert'uorsl.laded that if the homeowner engages a
pergon(s)for hire to do such worm that such Homeowner shalt as as supervisor." the responsibilities of a su ervisor(see
Macy'=eosntets who use this uacemption are unswa:e that they err wsunung p
Appendix Q.Rules&Regulations ery
for I I=q g Construction Supisors.Seezi an 2-15) IZtis lade of awareness oft results in
serious problems.particularly when the homeowner hires udicetaed Persons- Ia this cases ow Board cannot Proceed against the
as itwould witb a licensed Supervisor. The hontwwner acrmg as Supervisor is ultimately responsible.
udiuxnsed pe:so:t comamnides require.ss part of the permit
To ensure that the homeowner is fully aware of hislhcr sasponsibilities.tttaay
Wpii=wn.that the homeowner certify that hershe understands the responsibilities of a Supervisor. On the last pace of this issue is
a form c==dy used by sevwai townn. You may care to amend and adept such a fanWcertiftcation for use in your communtry.
Q:FORhIS:E%MMMI
I
F I LE mip 10941 CENSUS TRACT 1.31
CLIENT : Dunni n, Forman, Kirrane; PAGE 1.02& Terry DEED BOOK 8548 PAGE 1.37 L T
OWNER: John W Pinkava/Rebecca T PLAN BO K 239
ASSESSORS PLAN PLOT
APPL I CANT ' Same
MORTGAGE INSPECTION PLAN of LAND
LOCATED AT
275 WOODSIDE ROAD
BARNSTABLE, MASSACHUSETTS MAY 18, 1998
SCALE : 1"= 50'
2.so,
-- TOWQ OF
BARNSTASLE
o '
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LOT Z(o S11 Ep
LLjT Z7 LOT 30
253.4Z 35060 S•F
YL
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1 Coo,00
WOODSIDE DRIVE
I CERTIFY TO DUNNING. FORMAN, KIRRANE. & TERRY. GMAC MORTGAGE CORPORATION.
AND ITS TITLE INSURANCE CO
OR EASEMENTS EXCEPT AS SHOWNN ANDT ERE THAT HAT VI
HIS ARE PLANOWASSIBLE PREPAREDROTS UNDEMR NMY
IMMEDIATE SUPERVISION .
THE LOCATION OF THE DWELLING AS SHOWN
HEREON IS IN COMPLIANCE WITH THE LOCAL
APPLICABLE ZONING BY—LAWS WITH RESPECT t,...
TO HORIZONTAL DIMENSIONAL REQUIREMENTS. / t<r-t•�N - li
-F File:
THE EXACT LOCATION OF THE BUILDINGS 0.
,..:
SHOWN CANNOT BE DETERMINED ' WITHOUT AN �,�� ��
ACCURATE INSTRUMENT SURVEY . - �` '
�s
THE DWELLING SHOWN HERE DOES NOT FALL
WITHIN A SPECIAL FLOOD HAZARD ZONE AS
DELINEATED ON A MAP .OF COMMUNITY #250001-
0015C DATED 8/19/85 BY. THE F . I .A. d` Kenneth R. Ferreira
Engineering, Inc.
i Ro.11.iz 1903
New Bedford,MA 027,11-1903
A Tot:SOH 492-0020• Paz:SOH 992-3374
on the
and belief as the
GCNCRAt NOtCS: (1) the declarations made above arc do,�o oche ynormal knowledge,
standard of,care information,of registered land
result of a mortgage plot plan tape survey inspection maas Of thi
surveyors practicing in Massachusetts. (2) Oeclarationcsarf �adc tinthe
above
i g a edddclienttonlyons or for cons
date. (J) ihis plan was not made for recording purpos , o
structions. (4) Verifications of property line dimensions, building offsets, fences, or lot configuration may
- 1
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POD l �
a 3b M-9 � � ��-�.� SMOKE DTORS ®.K.
1p
( C, �;' John Pinkava i�a(i275 Woodside Rd. . E BUILDING DEPT.
` West Barnstable,MA 02668-1740 �'
V
John Pinkava
275 Woodside Rd.
w-�• West Barnstable,MA 02668-1740
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.................
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John Pinkava
275 Woodside Rd.
West Barnstable,MA 02668-1740