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0011 MOCO ROAD
� (J) 1 0. 152 113 0 °4r' J l li`6;r 1 u XI Town of Barnstable *Permit# /�—0? 7 e 7 es Regulatory Services Fee 6monthsjrom issue d ` 1ARNt4RAB I,+ . 5n r nos a U. Richard V.Scali,Director Lq.7 i63q ♦0 QEDN1�`�' $rP 2�j Building Division . Paul Roma,Building Commissioner TO7 U N �} �� L?00 Main Street,Hyannis,MA 02601 'A' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY (, 1 Not Valid without Red X-Press Imprint Map/parcel Number ii ' \ Property Address 1, lL' Q W E S (esidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address l,L' Q:::��Asj v ` eDGONX)JAID Contractor's Name Q,00C wm Telephone Number Home Improvement Contractor License#(if applicable) Email:_V-6LI34 ( Q9 UO& «-Btu ,cn� Construction Supervisor's License#(if applicable)_ Q ❑Workman's Compensation-Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner EZ I have Worker's Compensation Insurance Insurance Company Name _ L,,�,� � Workman's Comp.Policy#6-j S 102y 61 E n 12> Copy of Insurance Compliance.Certificate must accompany each permit. Permit Re (check box) tAn Re-roof t (hurricane nailed)(stripping old shingles) All construction debris will betaken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum .32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. . 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is -req�it�ed. SIGNATURE: QAWPFILESTORMS\building permit forms\EXPRESS.doc 06/20/16 f KELLY ROOFING MA CSL #99167 PH 508 509 4640 8 RHINE ROAD. MA HIC #128957 YARMOUTHPORT MA 02675 kellyroofing@icioud.com September 1' 2016 Proposal submitted to Mr. Mike Donovan of 11 Moco Road West Barnstable MA We propose to supply all materials and labor necessary to remove and replace the existing asphalt roof at the address above. All Debris to be removed to town transfer. 8" White aluminum drip edge to be installed on all eaves.Retaining Vented Drip Edge where applicable. Ice and water damage protection membrane to be installed on first six feet of all eaves, in all valley areas of and around all protrusions. Remainder of deck to be covered with #15 Felt Paper. Lifetime limited warranty Architect style shingle to be installed, (Color To be Specified) All shingles to be storm nailed. (6) Bathroom vent pipe boots to be replaced with new. Install Shingle Vent II Ridge Vent On All Ridges with Hand Nailed Caps. Repair/Replace all (lashings as necessary. Protect all walls, windows, decks, plants, shrubs, etc. during roof strip. Complete cleanup of area during and after procedure including all nails and cleaning of gutters. Obtaining of Town Permit. At a Total Cost of $8800 (Garage Section Represents $3400 of Cost) Payment schedule,50% at Project Start, balance upon completion. Respectfully Submitted, Oliver Kelly. I i Proposal accepted by; Date Q� /2016 If acceptable please sig n remit o copy o the address above, keeping a copy for your records, this propos I is valid for 45 days from date above, please call to verify thereafter. i Ulassachiisptts D.epartrnerit of Public Safety ' 'Board of Building Regulations and Standards _ ' License:CSSL-099167 c'f divisor Specialty - Constructionpup OLNER M KELLY 8 RHINE ROAD a ?t=zs. 3 ' YARMOUTki PORT(iAA 02676` +zF _._. Expiration:'' tl�^^� `� 0912812017- Commissioner 5r�a (t/12 . �{1 :}I�.l.^.71�(l•C,.L~yI JSi�r%,y�S/�� f /.% '/'! 1 �/l�G��'c�'� +�•�3�A i^yl¢f 3 C`' t\.: li'�I/1 L•.�'!�.'�. � l•lr lam-i.'L C� L' Z%J ✓ (J i/ �'tL t1�1�a��/:. L V fi1��-C'4 Office of Consumer Affairs and Business Regulation 10.Park Plaza- Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 128957 Type: Individuai Expiration: 6/14/2017 Tr# 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd - Yarmouthport, MA 02675 Update Address and return card.Mark reason for change. SCA 1 u 20M-MI Address Ej Renewal Employment Ej Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for indMdul use only �= r^ before the expiration date. If found return to: " 1IOME IMPROVEMENT CONTRACTOR igegistration• 128957 Type: Office of Consumer Affairs and Business Regulation x 10 Park Plaza-Suite 5170 • ;;:Expiration: 6/1412017 Individual Boston,MA 02116 Oliver Kelly Oliver Kelly 8 Rhine Rd. �a-S sc-k Yarmouthnort.MA 02675 `' ii.,.l,-tam Arnt W0611 mithnnt cianaturp 77re Coninionivealth of Massachusetts ' Department of Industrial Accidents Will ~ Office of Investigations 600 Washington Street q,--� f r Boston,.,VA 02111 iri,tw%mass.gmldia `Yorkers' Compensation Insurance Affidavit: Builders/Conti-actors/Electiicians/Plnmbers Applicant Information Please Print Leaibh Name(BtusmesslOrganizationlI &,ideal): Address: 6 i CitylStatelZip: i a PA R�Z� Phone#: :SO2; c�. O 9 Lt b 4-0 Are ou 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.❑ I 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. T 9. Building addition c insurance.! required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeoumer doing all work officers have exercised their I LE]Plumbing repair or additions myself o workers'c right of exemption per MGL my- � °mP- 12. Roof repairs insurance required.]T c. 152,§1(4),and we have no employees.[No worker' 13.❑Other comp.insurance required.] *Any applicant tbat chedks bcm 1l must also Sll out the section below showing their workers'compensation policy information T Homeowners who submit this affidam indicating they we doing all work and then hire outside contractors mast submit a new affift". indicating such. :Contractors that check this box must attached an additional sheet showing the frame of the sub-conaactors and state whether or not those entities hire t employees. If the sub-conttaaors have employees,they must provide their workers'comp.policy number. I ant an einplm-er that is protzding Workers'contpeitsatiat irisrtrance for n v eelpins-ees. Below is the policy and job site information. Insurance Company Name: (;G nnlC.•t{rJ Policy#or Self-ins.Lie.rt: (.5 e6 2- Q 1J Q 2 E -l 0[ Jl [6 Expiration Date: r0 ' L(o Job Site Address: \ ROCO k Ate' Citylstate/Zip: A 4 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 6,61 penalties in the form of a STOP INTORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage.verification. I do hereby certifj'under the pains and pe a of perjury that the information protaded ab is true and correct Si ture: c^ f (� t ' Date ov_ l� Phone fr �$ O"I 14 6`1 O Official use onh: Do not trrite in this area,to be completed ky cihy or town off4ciaL City or Town: Permit/License# Issuing: thority.(circle one): 1.Board of Health 1.Buildik Department 3.CitylIbum Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other P Contact Person: Phone#: i AC"R& CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY1) `� 05/27/2016 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 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 rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTANAME: Christine Davies DOWLING & O'NEIL INSURANCE AGENCY PHONE 508 775 1620 A/ No: E-MAIL ADDRESS: odavies@doins.com 973IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC# HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURER E: YARMOUTHPORT MA 02675 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 56798 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 CONTRACT OR 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 SUER POLICY NUMBER MOM/DLI D/EFF Pip EXP LT LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGETO CLAIMS-MADE F1 OCCUR PREMISES EaEaccu ence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY El PRO- a LOC PRODUCTS-COMP/OP AGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTO S AUTOS N/A BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X AND EMPLOYERS'LIABILITY Y/N STATUTE ER H ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? I WA WA WA 6S62UB2E90137116 05/06/2016 05/06/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached it more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwdtworkers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hastings Meadow Condominiums ACCORDANCE WITH THE POLICY PROVISIONS. 135 West Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel M.Cr*fey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD kI i _ 04 �( TORIC rov>raoEPRSA?nisi, HISE$r., ------- I - , Uf --�, - _�)pM RESIDENTIAL-MULTIFAMILY•COMMERCIAL Mj . Mrs Barba-r-�: • Building, �� Remodeling 721 Main Street,Rt.28 Office:508-394-0931 West Dennis,MA02670 Fax:508.394.4403 r—n/ pra web site:Iramcoinc.com email:Iramco®Cape.c0m deb, 4,1 04. 144 Al F� i VO OF 84q F�VpTION RGP 1 , -- -- RESIDENTIAL•MULTIFAMILY•COMMERCIAL �arnco Mr� Nlm;7 �- - Building Remodeling ,, DONTULLIE / �I/ 721 Main Street,Rt.28 •'Office:508-394-0931 West'•'� v 1 v 1� web site:framcoinc-com MA 0 'remail•Ft�xo®3cape mm t - - a w m m a p _ W 41 14 Af v W c� Gov t � I CAPE CO® 'ToWN of BARNSTABL NSULATION 2013 APR 29 AM 9. 24 LASER 0-S SEAMLESS SPRATNSAM SUSPENDED pa �/�j(9'�,7( SATES DUMRS INSULATION CEILINOS DIVISIOfq 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Date:f �3 Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Villa e �.r 4m, Pmova/? 11 Poco Gj. Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings ( Y ('X (3S�) ( ) ) Slopes ( ) ( ) ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls ( ) ( ) ( ) ( ) ( ) /�! V f'Pi� �•a:r Sincerely HhECas Jr, President Con, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application ;. l2 Health Division - Date Issued 3 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address Village YJ�V✓�'J b�-� Owner G1.v1i�I.t B ,L�q"� Address Telephone A03�� G;.Permit Request A� A woou 'Gw ale- .5al6 o" lgqer Q.-37 601 G0-Y- 10 &OVeA d VACZ; PVA +��- 2 W 141oS., AV U Pit aJIC aQi Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation I rJ • Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;a/ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. w Number of Baths: Full: existing new Half: existing news Number of Bedrooms: existing _new Total Room Count (not including bath,-,): existing new First Floor Roo Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other co a o Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove ❑Yerns ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing .❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Aut orization ❑ Appeal # Recorded ❑ Commercial ❑Yes t�o If es site plan review#Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) e Name Telephone Number 5 � Address 6 V�� License #6 fo (�� I rY `' Home Improvement Contractor# 7 Worker's Compensation # 1A)W-od 5 Z5fa 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE f FOR OFFICIAL USE ONLY ` APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: -FOUNDATION. FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL y ' GAS: ROUGH FINAL FINAL BUILDING " DATE CLOSED OUT , ASSOCIATION PLAN NO,: wk., !Nlussrtchusetts - Department of Public Safct.N l3wird'of Builtlin- Re-ufations and slandards ® Qonstruption Supervisor License a 0• Licena,' CS 100988 HENRY CASSIDY ,+ 8 SHED ROWy' WEStT \JARMOUTH, MA 02673 . Expiration: 1 1 11 1/201 3 ('ununissi„ucr TO: 7620 aft?'G' L�tzc 2cK 14(1913 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2b14 Tr# 233831 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 Update Address and return card. Marts reason for change. spa i G 2010•o5;i i Address ❑ Renewal [] 11,rriployment. Lost Card Office of Consumer Affairs& Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: egistration: 153567 Type: Office of Consumer Affairs and Business Regulation ;Expiration: 12/1`5/2014 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 CAPE COD INSULATION,INC. HENRY CASSIDY 18 REARDON CIRCLE SO YARMOUTH,MA 02664 vlwitho nat reUudersecretarY a The Commonwealth of'Massachusetts Print Form IT Department of Industrial Accidents Office of Investigation s I Congress Street, Suite 100 ff Boston, MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual): 6ael vt ( 4 Address:_ la JU ke�►�dow �r�l�, City/State/Zip: %VAA,4, MA' Phone #: yJO�- 7 ' - IZ I _ Are you an employer? Check t c appropriate box: Type of project(required): 1. 1 am a employer with 2O 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction �'.❑ I :un 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' 9. ❑ Building addition J No workers' comp. insurance comp. insurance. ❑ We are a corp required.] 5. oration and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LEI Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Root re a'rs insurance required.] .f c. 1 S2, §1(4), and we have noelp employees. [No workers' 13.� Other e� e�i ho comp. insurance required.] 'Any applicant that checks box#1 must also till out the section below showing their workers'compensation policy information. t I lomeowners 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 or the sub-contractors and state whether or not those entities have employees. It'the sub-contractors have employees,they must provide their workers'comp.policy number. I am cut employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: CC�tCi (�tU�T IVI ��� Ci� Policy #or Self-ins. Lic. #: WGA N *Z&5 q 01 Expiration Date: Joh Site Address: I/ Rp co City/State/Zip: "� ' ��✓�5 �� 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 line of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify ruler the uirts�id enalties of e er iay that the information provided above is true and correct. Si nature: J, Date: Phone#: © -7 Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector I. Other Contact Person: Phone#: IULI. Il!U�a I . , t �'' Glientfl: 1r•5U7 '1''l G•lJ 1U1.. CCINSUL. -------- CERTIFICATE OF UABILITY INSURANCE E�Ar�t�+h1,I,Rr,,,,, 1 HI}i CPk I I IhA'1'k;I S IS:iL1E'.L1 q�A PnATI ER OF INFORMA"IIL,N ONLY AND CONFERS NO RIGHTS UPON TIiB CEP.1"IFICATE HOLOCRr' lls� L'Ef:'I'IFICATE LlOI NG I AN1=tr<Mnrtv�LY pri NEGATIVELY A,aIr.I,,tS,EX OR ALTC-R TtIL COVLRACL AFFORDED BY TI'lr POL.IGIEc; t1r:L.uvv.11ns CLffI'N-ICA1'L OF INSURANCE DOES N01'CONSIrtNtr.AGONTRACTBEIVVIZEN THE IS;UING INSURIi;R($),ALI IIIQKILLLI RFr'r1*E;71:N IA I'I VI_' 014 F-I-K)DLICPR, ANO 1'HR CERTIFICATE IILiLOEI<. fPr'f'i!It'IAN1 II ll,o r.ru'tlflc,tu IlolUur iv an Abl]ITICINAL INSURI Il.Ih�pulicy(les) IIusl be eudutse(I.If SIJIlI�(--EWTION 1;i t1 AIVLf.),sutllu,a Io "<rclll''.l unLl cUnU Ill l?na Uf[11c NVIICy, 4nI'IYIn lJull[lu6 play r,,,p,h,,:,n WidOI'uuumnL.A 6lutuglefll Qn this Car lillcolt:docu 111A Gurllul(Ivht7 W plc .u,llll�,,,IIrIn,Ir1Le1 in IIpU I:1(:9Uc11 VII(IU194111CnI(YI. Gr:Iy Itr-A. -So. 1:)nruLlrt &AIE •I J 1 Kuu(u 13•I a No ea: 10b l fi0 r1602 r�X (- �J—,_�.----_ — -- _. IN�:..rulJ:.11/7•tllti I16 :,u'.lu'I luntuc., MA L)2LW0-'{LiU'I E-NAIL JIU,1:)h•1`IUiI ._ INuuaI:It1UJ/\I`I'UHI!INUCUVLH/\(lL' I u:ucu IN.uNER,I;Peerless Intiur�ul(:u 33 . '�_..-. l.:,Ipa Cuil (rlsulat(i)n Inc wsuReau:tvDnttlon II1bUr:11"I L.EI L:C)11'IiJ�ll'ly •l�I:, 1'LUIr,LnJtt1 1„")u(I Irlsureac: lcrullC_Cfl_arl_urluyUt'Inlcr: _ i I IV41111 iu, NIA 02 u0'I Ir+YukrkU^CwON1111i;rL:01n[illl'L111Ce; C.�ollll)lllY�-- J•1%5•I I .--- •-__...__.----....----•-._._.._-___... InsurtrR r CLR[IF1CATL NUMUER:_ ... .- - RLVISION NUML-W-.1t. "-II I,I ( I I<t'u Y I rIA' le- I�i)L.I%lr.,r; i)r W$URANC6 L1S'I'CQ I ILL,•4y 1IAVE BEENIS5UED TO�'lHE- INSURED NAMED AL10YE 1=01-t It IL: 1101ll-1'F'LrtIVU ..(•I dIu. IIl4AY IIziI'AlvOuvp /\rIY rtt<1u'RftvIENI', TdRhI UR CON1,4I'IONOF MY CONTRACTOR OTHER DOCUMIaN'I' WITH ItL'SNIcCI' 1"U WNIGr( Iln:; 'II Ali. 1;1AY lil I;t5L1I:C) OI1 NAA I' PPI�'1"AIN. THE INSURANCt Ilrr;,lfOEO By'Ril_ POLICIES I)PSCRIBED HEREIN IS SUl1JECT I'0 All TI'lli 11-kKi. ?PI;i ANO I;CJNL)II ION:i OF SUCH POLICIES. LIMITS SHOWN nr:'S rI,�VF riaN REDUCED BY PAID CLAIMS. AnoLsuBa -- -- ITh I Yw:LI I'114JUHANGL- - POLICY GFF ---'-------'—.__ --IPt�. T rnLlcr tiumum Ll In1AlIDOMYYI'l lAfhUL1DR'YYYI-_•T LIAII'I'I: j'1 .,LI,�I(al LIHLIII.II1' _ ' CBP82630(i3 AlU111U'12 O4/U'112U'I' r1\Cr1OCr:urtrtl Nr,.I?. �'{ [IUII UUU KI 0Jt.IN1i-Nl.,u1L U- -NAI._LIAIIILII*Y — .•-._ --_.L_..-_._-- I CIA@:11 h0AU1' X C!EaaJJt .......----.. 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Ia:11au�,L ._LCti___.._..... v,un'l:n.'l,IV6',vrl.' l.nJI;IZL:LII'Iv .rIIN ... 1,1H uu It J•I�ER L`<(,Lf�a�1$h N I NIA C:,L�I:.AcTI I AC-('101'-rr,• 1 UUII UUU �..".-J ._....1_.l_._.l.__._..._...._ 'ihiu„11u 41,E.,.Nrl) I .,r�rlut'f1l1Pt UP i)I'RIW IIUNS oclu.v I '-----•---'----- __---•------__. G.L.ulsGnsG•roucvLlr.ur y:'1 0UU UVU J�.IUPIJON Uh(MI-NA I IONN/LOCA I'IONS I VGHICI.LS(ALWOl ACURL)10 I,AJJI,LuW n„nm..G�hytl4ly,It P1VIy yPBPy 1610(pilivu) "N,'orl,el's c'Am J Infurlrlatlurl "'Olki(I0 0rrlcor0 PI'f l'CI{)rl17t01'S _ . I l:ulllNcii,I IliliJc r'ict 111cluck;d ni all additional insurod Utlow (;(mural LiUUllity WI1011 1`U(7LIIrod 13y written Lun(r,IL t ur zt}1r'ecnl�llt, —.---- -- - __ _......._...._._... - - yrl;Ilhn:Alh i'IC1lt.)E:It CANCELLATION C41Ju GLILI Illtil11Jl11)11,IIIC SHOULD ANYOF THE ADOVG.OESCIWAJ UPOL.IC.Ik.IIkL;ANI.1;111 IIIhIUIp: THE EXPIRATION DATE THEREOF, NOTICE WILL HLi UE:LIVFkkU IN ACCORDANCE WITH THE POLICY PROVI 101,1tl. All 0111:LO REPRBS LN I M IVE O'IUU 2nu)ACOND CORPORATION.All I910wualrull. 1 OI' 'I Hie ACORLI timiw and logo mu fgkturud marks of ACORD If:;B3ti�U1M83Urit{ MkY OWNER AUTHORIZATION FORM t, (Owner ame) owner of the property located at /Y1 ow -/7act C/ (Property Address) (Property Address) hereby,authorize (Subcon r For): an:authorized:subcontractor for RISE Engineering, to act on mybehalf to obtain a building permit and to perform work on my property. ' Owners nature Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map f Parce Permit# Z-0 G �� Health Divisio . � '�'� - "� rit 7Psa— Date Issued �o Conservation Division , o� `��'"� Application Fee Tax Collector ry 1, Permit Fee f D �! y Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 1 aco D C"1 Village (A-)25T 'K90S_1ZML1_ Owner /'1LZC LL i MAA1 Address // A<fp Rb &RA..15;X1&f_ Telephone 5 �y Permit Request Z�RWT IIW6 `d. KA±± ►6 R"" Ab0 iMcNi 4 r "9 -rZZ A 7 r�JJ CAL" ATROWD 7XI Square feet: 1 st floor: existing proposedQ�J�� 2nd floor: existing proposed Totaghew Zoning District f FIFlood Plain fZRdundwater Overlay i .CD Project.Valuation Construction Type 58 5 �� ,. 't' �3 Lot Size"'. '. IS�17� G andfathereA' ❑Yes ❑No If yes, attach supporting?o umenta n. Dwelling Type: Single Family ' Two Family ❑ Multi-Family(#units) kn m Age of Existing Structure Historic House: ❑Yes No On Old King's High ay: Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout Other {.AW 8 - S090 M Tt625 Basement Fihished Area(sq.ft.) A//j/A Basement Unfinished Area(sq.ft) AI A _ Number of Baths: Full: ezis��d' new Half: e,)Listingi new Number of Bedrooms: existg _ new Total Room Count(not including baths): existing ' '` new First,Floor Room Count Heat Type and Fuel: 'Gas ❑Oil ❑ Electric ❑Other f T Central Air: ❑Yes ❑No (Fireplaces: Existing 1 New® Vim" E i ng wood/coal stove: ❑Yes 0 Detached garage:Wexisting ❑new size A06 Pool:❑existing ❑new size Barn:❑existing El 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 k&-5Z DA1TMZ- Proposed Use J ►J i 1 BUILDER INFORMATION Name T_ , 1 O�IA'21� Telephone Number 77Y• �v9 • C7 c21 / Address /S 61"- wA PbAD License# ow�6,w �0441 VAgMaZIN 4 fiA QX_6q Home Improvement Contractor# 13(�59_0 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO LG $TdT-4 AAS T'21 S )2 SIGNATURE DATE t S FOR OFFICIAL USE ONLY PER NO. t �) 3 DATE ISSUED MAP/PARCEL`NO. a k d ADDRESS i VILLAGE OWNER DATE OF INSPECTION: 1 V t FOUNDATION SOh/9 Ty 9 FS 0 FRAME INSULATION �$i�yy D� �-'►-d# �i r Q) FIREPLACE = •T r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINALV) a' l FINAL BUILDING. .��`!N 4 /'t �C% °'t � Y"llr �� r t5) t DATECLOSED OUT 'ASSOCIATION-PLAN NO. ! G' f r n r ga3 via Fcsxfl 'urlx 'I`xislr.I5 1.tb(cQuti�uaij . / ., ct far vita snd Tr'�'��'��tdRtttlxl HulldLtlp ' p=-cserlptiYe I'xrkx& KiM •g %/Coaling sub gssass� � pquipas�ns �ta4ascyl h•1AY.fM cil, ��� �,��s gyaiva t . R,•Ytlur U.Yzlapz}•r� Karui�l . gesso S'7t}1 to 650011eatln Z5 B ]a jZarrccxi • 0,40 31 13 I9 10 is AFUV. R Ixf= 30 19 to 6 Nars�� 1x/1 13 NI , sa 3b �- VIA A tx/. a Nams� 33 13 t0 is A� I5Y/. 438 73 15 19 NIA v/ • is AM 0.44 V ISf 1i 0.44 3E 19 g la 14IA Norrn�l Y 15'h 042 30 13 NIA WA riarrnai 31 19 as NIA QO1►Ft1� is=/= a,4x 33 19 1a ga.t► 4 13 6 ]g�!= 0,4x 9i I9 ]9 10 0,50 30 1fl!= ' s� DD59 OF PROPER'Z"f s SQRd UAB'FOOTAQE OF ALLTBRO 2• , pRE FoOTAdE 01e ALL GLAzvc,i 3 , s4� SD BY aka (SLAW NQ AREA(0 Drilm 5 g��,10 TAO� {Q.,.�•sea ohart abaYb�; E'I'F,RM1�� gC}Y�,Q,�EMET['X'S aR1a,INVO�� s�Og�'�'SOrt; � ,,D�tG SpgC 10R APPPM kv, Vol, Yes' q•focm;•�a0303 a , F— RESIDENTIAL BUILDING PERMIT FEES A.PP41CATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= a 11 S17(�' x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES.(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck _x$30.00= •Q� (number) Fireplace/Chimney x$25.00= (number) •Inground.Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 4fio6 e 1Q Permit Fee projcost ` • •' t. t Comm? n�eajth of 11�"assachusetts The Y , ar'.Accidents' ' • ' • --- Department of Industri . ' 6Q0'Washineon Sfrdet - �` • Boston;mass. .02111 . Worker C m ensat9on,Snsurance AffidaQlt-General Businesses / dress: , b eVIP •�. . . • t p� • state- address l'/' 'Restaurant/BaF/EafirigFstablishm ad work s>te locatirni � d have no one ' Bases e: Retaxl❑ REal gstae,Antos etc.)' 1 b.asoleproprietoz an 0 p�i,ce[�Sales(including . ca achy. '• er wor�g�,and F "etn'�lo ees full&' art time: , to er with• � /��%%//// s'ob. ��//////////%/%%�%%/% /%/ on for my employees v;/orl#9 on i ern .g yyQrkers eb veusati ;• i . .. z�,�,•em�loy PLOW''. .i.. 11t'.7?�t •:` 7'' �•{ S'�`:.I• ' •`•'y(lr'' »'�,7rh'••:•f�� '::(:��'''.. t'.'a'•:�'r•:+�.• .:; .t [,( J• t ti. •{,� '1•':{.�,? :yt'•' '� ••:i:�r+i�i•i•':+t3.::t'r, 'tt •}i' .•t.,.ls`�'ti!'.t.11 l:•. + '• �c.�. '�.r '�r•':`:e::. . ,r.t,.s, r •' A�'r•' '' ,t t t .,.. ,�• ..,.»:• ,'. •�i ,'•"141e�.p,.•9.}•%•!:l'{t}t.:•7'w t.; : �3%)rl t li:'.•• ••ti3'' r.(,. . 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' ol1C',fiI'' .. + •%�/ atsui�>�ae.cad, 1 t?:`° 4 r' b who havd-t ie following i�'orkers e M e independent contractors listed Blow .` I ano.a sole proprietor and'hav ed t2t •'Co . ' ;, ' ,, `• .t,• •tt•tl ,!N .r.,�I�.�Y4�tt { •t.!•6°y��.tsyL ' t pppe�ation�!O11ceS: ?_ :�', a%'i}.C:.�y:Gyk.�r:>:rSrti.ts"*"ht'�tr• :9Y. :a::=.••'. ''t . .Ifs •y. '• 1 A'•1 t:i :�.hlt!}1',f�i't'' •St<'• . 1: '• .�• ''.'',P..•�'•' "i�••Y�. ••••*r•��i'C:!•'''.. `(•l:t'11f'S'• ,•�'.rt:�'r:�t�:ar...w. t f'.b,•.h,. 't..•,• '�'••••' '',.•'J•Sr;•�J�:'`:•''l Ott'• ey••�3t+•tti•'{'' '• tr CUrn 9II'ri1fi1>1 ' �''.. i •tt }+:,:.�•ttf.nf( %t�'?`S ''t'' it..v:t:l:' :'1 :{%•.��. h: 'i .r.;':.. r ,}'.•,t.1��tij.'}I�•?rF:;!•�. �JI.�•' »his .i. t' t '�••+' t'•�i:t•• '^+ •.'" '.tr, ;..•. t. ri'r: •:r~ 't •''. L:e�i';t'• + +i,t'<,, .t , � t 1. ,{l't 2.(,y• t. �:' •�. {. ', ;r.. •�.' ti 1.1• }�. 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'�t;Mlif+` •r;r. » rt. i%j 'rt ,!;{ t •r r 'r• i..'' •'��: ';/;'...•, •t: �••, r',a;,.t a t. '."•tom •'rti•_,• .i:t, •! .� �•).l�!�4'''i' f'.1 7 t :iaf. l�N' t;: .�titii;.+1:°t {':15}5'iiu�.� OLCt': i• �"'y' t i.'r r..`...b {it;•. !':;4,°;�.,;.i:';a•• 1^' enaYties of a fine up to s1,soo,00 an or osition of crimir►sip e re aired under Section 23A of MGL 152 can lead to the lmp . y must me, I underatand that X Failure to secure Ceyerag 9 der S es f n the fdrm of a STOP WORK o"M and a fine of s100.00 a da ag f + ruomnent as well as ctyllp a yeriiication. o>re years imp be forwarded to the Office of TnvesHgatiom of the DTAfor coverag I copy o f this statement may ' e6 certify under the pains and penalties bf pedury that the informatiox provided above i a� �re 7 do hereby _ Data Signature hone# 77$ ofitcial use only do not write in this as'ea to be campletcd by city or town oMeia� ❑Building Departmentp ermitNcense# Licensing Board city or town: ❑Selectmen's Office edfate response is required 0E[m1thDeparbnenf [}'check if farm phone (]Other. , ir; COntzetptr3o , • ni'orMatloii and Xnsfrli Lions. , chapter 152 s • .5 equines all employers to provi$c workers' compensatidin for their. L'aws ection 2 r ., .•v.��. Massachiisett� Gefl erson in the service of another under any contract As oted•fromthe f`lalw",, an employee is.defined as every p pshed'r oral or written.e, a or ' a ers , association corporation or other legal entity, ar any two or more of employer is defuied as an individual,p luP tAn he foregoing�gaged•in a joint enferprise,and including the,legal zepresentatives.Pf a deceased,employer, or the receiver or artnershi association or other legal entity, employing employees. 'Howevei'.tbe owner of a Trustee of an individual,P • Px �otmore than three apartments and who resides therein, or the.00cupaut,o the:dwelling house bf dwellg house having ,. . •• • coon or r air wdrlt on such dwelling ho0e 6r on the grounds or another who•emp1byspersons to clo mainkenance, constx� eP 1 �{en t thereto shall not because of such;e#joymeat be deemed to beau employer, ,.1 -building aPP an . , � chapter-j 52 section 25 also'states that"every state or local licensing-agency shall tivithhold the fssuanco dr renewal Ofa P t too operate a business or to construct buildings in the.conu nonwealth for any applicant who has Of a license or pe?m?,. p not pro acceptable'evidence of compliance with enter into any contract for the perfom�an e of ublictwork unt}'T, cotranonwealthnor.any•of its political subdivisions shall e y of compliwe with t�e insurance requirements of this chapter have been presented:to the contra acceptable evidencecting.. :.,. , . • , authority: Applicants e tiZe w s�'eompens Pleas a6m affidavit completely,by checking the box That applies to your sitdapon.,Please ply conopany name, a ss an ddredphone nu tubers along with a certificate of insurance as all affidavits maybe subnitted P to The Deparfmeit'of industrial Accidents for confiTrnation of insurance coverage. ,Also be sur`eto sign and date the affidavit The davit should be returned to the city or town that the application for the permit or license is being not the bD pax•6ment of;Tndustdal Accidents. Should you have any questions regardiri the'"Iaw".or if'you are requested, ens pli , e call the Depaztment at•the niunber listr�l;belovsr. t aired to obtain a vs'oer�'•comp P oY pleas "`1 I. • . • • • ' City or Pleas e b e sure that the affidavit cbmplete anclprinted legibly. The.Department has provided a space at the bottom of the affidavit for you to fill oust in the event the Office of Investigations has to contact you regarding the applicant 'lease th ermzt/licensenuinber'which WM eusedas areferencenumber• The.affiday;ts noay.beretuzuedtq be;siaetofAin e gementshavebeenmade,• t w': theDepartment V. , orFAX,wiless otheir:arran . The Office of Investigations world lie to thanit y'ou in advance for you cooperation and sllould you have any questions, esitate to give us a'cat"' ' please do notb. / ent's address,teleph6ne and:fax number: . , The Dep The Commonwealth Of Massachusetts Department.of Industrial Accidents • . Bt�ce of t$�sstli�tetis . 600 Washington Street Boston)MR. 02111 fag M. (617)77,7-7749 �► Tom of Barnstable yof oKy . o� P egulatou Services - i Thomas F.Geller,Director 1659. A,�� Building Division Fn MA Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax; 508-790-6230 Office, 508.862-4038 • Permit no. Data AFMAIVIT HSWP�ME CONTRACTOR TO ERMIT A.PPL CATION MQL c 142A requires that the"reconstruction,alterations,renovation,repair,modemiza er o,cu ier ion, improvement,removal,demolition,or construction of an additiounin to any poetexisting which p b g containing at least one but not more than four dwelling units to to structures which are adjacent to such residence of building b e done by registered contractors,with certain exceptions,along with other requirements, Estimated Cost 3 C — 'type of Work: Address of Work AXo AT) GtJ �R�/ST D . . Owner's Name' iz a/0l/34 Date of Application: `� lei I hereby certify that; Registration is not required for the following reason(s); []Work excluded bylaw []Sob Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice i;;hereby given that; OWNERS PULLING THEIR OWN PEMyg IMTROVEMENT WORK.DO NOT gA•YE COCTORS FOR A.PPLICABL ACCESS TO THE ARBITRATION PRO GRAM OR GUABANTX FM UNDER MGL c,142A, SIGNED UNDERPBNALTMS OF PERTURY Thereby apply for apermit as the agept of the ovrmer; /.?6s90 s S Contractor Name Regishationl�to. Date OR Owner's Name Results Page 1 of 1 Licensed Contractor Look Up Select the search method: License Maximum number of matches: 25 it Enter Search terms separated by spaces. 176694 Select Search type: AND G OR ` `Sea'rcl; Search Results City/Town Name Type Lic. # Restriction Expiration Street State .Zip SO YARMOUTH11 HARAY CS 76694 00 10/21/2005 15 GENEVAJ TIlI4OTH ROAD �02664 Total of 1 Records matched. Back to Home Page BBRS Privacy Statement http://db.state.ma.usibbrs/contract.pl 5/28/2004 Results Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City, Name, or License number Select Search type: r AND r OR Search Search Results Reg. No. 11 Applicant] StreetI City State ZipI Name lExpirationi TIMOTHY 15 S. O'HARA, 136590 O,HARA GE�VA YARMOUTH MA 02664 TIMOTHY OWNER 8/5/2004 Total of 1 Records matched. Back to Home Page BBRS Privacy Statement E _ t i . r + i http://db.state.ma.usibbis/hic.pl 5/28/2004 F MAY.14.?-004 8:36AM SHEPLEY SALES NO.565 P.3 MIF - BC CALL®2003 DESIGN REPORT-US Friday,May 14,2no4 08:01 Double 1 314" x 91IT VERSA-LAMS 3100 SP File Name: BC CALC Project:F802 Job Name: Ddnoven Job Description:beam holding ceiling and roof Address 11 Marp Rd Speafler. Tim©hate City,State,23p;West Barnstable,Us Designer: Bill Campbell Customer Company: Shepley Wood Produces Code reports: JCBO 5512,NER 629 Mist LI _ lord L -M pZf 114 pl J_ - B1 2860 ms LL 28W Ibs LL 1481 Ibs DL 1481 Ibs DL Total Horizontal Length-11-M-00 General Load Summary VBndQn: US Imperial 10 Description Load Type Ref. Start End Type Value Trib. Dur, S Standard Load UK Area Left 00-00-00 11.00.00 Uve 20 Psf 08.OB-00 100% Member Type: Floor Seats Dead 10 psi 08-05-0D 909b Number of spans: 1 1 roof Unf.Area Left 004XM 11-00-00 Live 30 psf 13-00-00 115% Left Cantilever. No Dead 15 psf 1340-00 90% Right Captilwer. No Controls Summary Slope: 0/12 Control Type Value %Allowable Duration Load Case span Location Tributary: 06-06-00 Mornent 11939 f6bs 74,4% 115% 3 1-Internal Neg.Moment 0 ftdbs n/a 100% End Shear 3717 Ibs 50.3% 115°J6 3 1-Left Live Load: 20 Total Load Defl. U254(0.52') 94.6% 3 1 psf Live Load Defl. L/385(0.3431) 93.4% 3 1 Dead Load: 10 psf Max Deft. 0.52' 52.0% 3 1 Partition Load: 0 psf Duration: 100 Not" Dlaclosute D�9n mew Code minimum(L/240)Total load defle�on criteria. The completeness and accuracy of Design meet's Code minimum(V=)We load deflection criteria. the input must es verified accuracy anyone Design m�arbOn(10)Matdmum load deflection Criteria. who would re y on vile MmimuM tearing length for 130 is 1-1/2". P a$ Minimum bearing N"M for 61 is 1-1121. evidence of s.tltabiliy for a l ntereMisplayed Horizontal Span Length(s)=dear Span+1/2 min.end bearing+1/2 interrnediate bearing padlcular application. 71te oUtput above is bammi upon building Connection Diagram code oompted design properties Member has no side lads. and analysis methods. Installation of 1301SE englineerad wood Conned are;16d Sinker Nam products mUet be in accorganoe wjM the current Installation Guide a=2" b _d and the applicable buitiivig codes. b=3, To min an Installation Guide or if c=6-112" a X. you have any questions,please tail d_12- 4. . (800)232-0788 before beg'mnutg Product installation. C BC CALC®,130 FRAMERS,BOO. BC RIM•BOARDTu SO OSB RIM BOARDTM.BOISE GLUTAMW, a �� VERSA4 AMS,VERSA-RIMS, VERSA-RIM PLUSSS, VERSA-STRANDW, VERSA-STUDS,ALLJOISTS and AJSTM are trWernarks of Boise Casmie Corporation. Page 1 of 1 FROM 508 862 6012 TO Tim O'Hara 5/14/2004 8:24 AM Page 3 MAY.14.2004 8:36AM SHEPLEY SALES NO.565 P.2 f� BC CALM 2003 DESIGN REPORT-US Friday,May 14,2004 08:00 Double 1 314"X 11 718"VERSArLAMS 3100 SP File Name; BC CALL Project'.R501 Job Name: Donovan Job Description:Structural Ridge Address: 11`Moco Rd Specifier. Tim 01hara Ctlyy,Slate,2ifr:was(t Barr-Sfabie,ma Designer, Siff Campbell Customer. Company: Shepley Wood Products Cade re ICBO 5512,NER 629 12 ��— ... standard Load-'sc p�i s�r _nrour�_y o�awoa •— _ - B1 1 1=Ibs LL 1054 In UL 1054 Ibs uL i' Total Horizontal length-16-0040 General Data Load Summary Vemiop; US Imperial ID Description Load Type Ref. Start End Type Value Trib, Our. S Standard Load Unf.Area left W40-00 19-00-W Live 30 psf 0840-00 115% Member Type: Roof Beam Dead 15 psf 08.00-00 90% Number of Spans: 1 Loft Cantilever No Controls Summary Right Cwtilew. No Control Type Value %Allowable Duratlon Load Case Span Location Slaps D/12 Moment 11894ft4bs 48.6% 116% 2 1-Internal Tloply. y: 0/12 Neg.Moment 0 ftabs n/e 100% End Shear 2606 Ibs 2a.2% 116% 2 1-Left Total Load Dell. L/342(0.581") 52.0% 2 1 Live Load Deft. L/530(0.36n 45.3% 2 1 Live Load: 30 pfff Max Dell. 0.581" 56.1% 2 1 Dead Load: 18 psf Notes Partition load: 0 psf Design meets Code minimum"80)Total load deflection criteria. Dunalon: 11 S Design meets Code minimum(L/2+40)Live load deflection criteria. Disclosure Design roasts arbitrary(1'I Maximum load deflection criteria. The omple�ltes8 and emus�' Minimum bearing length for Bo is 1.112". Minimum bearing length for B1 Is 1-1/2". the input must be verified by anyone Member Slope=0,consider drainage. who would rely on the output as Entered/Displayed Horizontal Span Length(s)=Clear Span+112 min.end bearing+1/2 intamtedlate bearing evidence of suitabtTity for a prarticular application. The output Connection Diagram above is bas4d upon buffdbtg Member has no side loads. * ' ead"mptod design properties and analysis methods.Installation Connectors are:16d Sinker Nails of BOISE angbleared wood ` products must be in aecerdarf6a a=2" b d with the cement Installation Guide b a 3" < and the applicable building codes. c=7-7/8" a To obtain an Installation Guide or if d=12" you have any questions,please call I (800)232.0768 before beginning I product Installation. C BC CALC®,13C FRAMER®,SCt®, BC RIM BOARDW,BC OSB RIM BOAROW,BOISE GLULAMTK ` 1/ERSA-i.AM9,VERSA-RIME, r - 1/ER&A-RIM PLUSS, VI_RSA-3'fRANDTM, VgRSA-M1a9,ALLJOIM and AJSTM are tr&demarks of Bolo Cascade Corporation. Page 1 of 1 FROM 508 862 6012 TO Tim O'Hara 5/14/2004 8:24 AM Page 2 SrrL ,{_ s� LZ WAY :. :.::.: .: fir , ✓✓ • � Fo�N caT�a.l.. U N E �, ' a SIX Z• N c�` ` �X15T�uG e8 AO ; ;-: .• : , ; : . _- �.� Qom . (P,P.00 CE,27% EO CLOT ZaCA-rIa c/ •W. SS,4ZV STABLE .5CA L;E-- %'T . :.. o q TE JW. 22, 199b 4� � > UXTM w atar > Ae- /73 9/ ' �26G/STE•2F� L��p SU.eliE'yar� ', A/'.,c./CA/r- itiJ�c�lA UO• VAn!JQ x r' Any and all agreements between the parties including any previous contracts between the parties are hereby superceded and shall have no force and effect. The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Pavment will be made as outlined above. Prices quoted valid for 30 days. Signed & Presented this 18th day of May,2004 by; Tim O'Hara Constructio - 1 5 14-1-� imoth Accepted by: Print Name( . Accepted by:_ Print Name{s): Please make checks payable to: Timothy O'Hara By signing below,the pantie ac owledge recei a copy of this agreement. Responsible parry#1 Responsible party#2:' r 01"Co fit 0. DESIGN o BUILDING a REMODELING 721 MAIN STREET WEST DENNIS, MA 02670 (508) 394-0931 Fax:(508) 394-4403 PROPOSAL TO: Mary Ann Donovan Job Location: 11 Moco Rd. 11 Moco Rd. West Barnstable, MA 026.68 We hereby submit specifications and estimates for: 1. Demo 2. 12'x16'Addition off Dining Room a. Heated through existing system b. Sona Tube Foundation System c. Wood Framed Construction to Mass Building Code. d. Floor,walls and ceiling to be insulated to Mass Code. e. Electric to Code from existing supply ' f. Walls Finish selected b Owner could be D y Y Drywall, Skim coat W" AV Plaster or Bead Board Plywood. erg. Vaulted ceiling h. Windows to be Harvey Double Hung to match existing i. W-Andersen or V� j. Direct Vent Fireplace allowance$2,500.00 in�Quotedning +-from dining area 1. Floor(carpet by owner)-Floor to be flush with existing Dining Room Floor. m Interior and exterior painting by Framco. Color choice by owner. n. Interior trim to match existing o. Exterior siding to be Vinyl 3. Exterior deck-off new addition to be: 8'x 12' 1. Pressure treated framing supported by Sona Tubes. 2. Mahogany decking 3. White Vinyl Rail System 031 - Application to I: 04 A R 4 'g3q3[ 'gbb,ap 3.egionaf 3bIsstDriC Mi0trict �Committee BARk'STABLE in th(Tt& A Gk6P=%table ..J CE' TIFIQATE OF APPROPRYATENESS Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as d bed-below.and-on-plus, drawings, or photographs accompanying this application for. n EC r= LI WE ' � U IFt CHECK CATEGORIES THAT APPLY: MAR 2-5 700. 4 ii 1. Exterior building construction: ❑ New C9 Addition ❑ Alteration STAB Indicate type of building: House ❑ Garage Commercial 0 e�lOW ❑ N OF' -rRI A; 2. Exterior Painting: ❑ V 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: El Fence El wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE 3 ZI{ D ADDRESS OF PROPOSED WORK 11 140co ASSESSOR'S MAP NO. OWNER avl c �kWW "40 ASSESSOR'S LOT NO. 03 HOME ADDRESS t I AOco Rd W , vAtr" e, ____ _ TELEPHONE NO. 36Z Z401 FULL NAMES AND'ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) v— C `C�ie�c�► 754 oW S► . ,rAvp^ "C- 7&jr 0.4 S 1. w M . aro rind 14 nr fJ 9. c.�4 Pa A4,c r$e, 3 3 AlOw AGENT OR CONTRACTOR [Ancc) h TELEPHONE NO.SC9-Vi4-093 i ADDRESS % go:X U1, I ZI J,A,,n �-h• �) �er,N 1 S M�c. DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please include locations of proposed signs. Gr&4 I&Y O 'b,K%n9.morn -kQ oYcir ®� e`gsAi j cLe-V;k�• AAA-ov\ � � en l o� v�d concre'f° Sorca I��s f wa J -gym ,ej �1 Gs �►��'E remote C�jc�ri w S18l � ��J1n l �O Ma GKiS'Hh �K�Yehnr taa�� �0� i wt c,vod -r,w, Q 1\�d Maw eus�-� � rA-e-d, Signe caner-Contractor-Agent For Committee Use Only This Certificate is hereby Date App ve eni Committee Members' Signatures: i Town of Barnstable Old King's Highway Historic District Committee SPEC SHEETa� �' S FOUNDATION H1S COLOR SIDING TYPE v\ CHIMNEY TYPE J� �1Z COLOR ROOF MATERIAL COLOR 4C:;� MOU, PITCH a • 7i r o r 6 WINDOWS&U A-6 L 11evL COLO SIZE K5 ? Z TRIM COLORi DOORS •� -<>-[I Aim COLORS W . V h f SHUTTERS l�- - COLORS GUTTERS U Ike_ ktu M Iviy!z - __COLORS DECKS ` O��C Z MATERIALS h n GARAGE DOORS /� COLORS SKYLIGHTS A( /A SIZE COLORS SIGNS COLORS —� FENCE N/1 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 -.i-A 'f 1 /Op From:Joe Madera 508-862-6007 To:Fax#1-508-760-1481 Date:a/2/2004 Time:4:41 30 PM Page 1 of 1 BC CALC®2003 DESIGN REPORT i US Monday,August 02,2004 16:41 Double 13/4" x e1'1 7/8"VERSA-LAM®3100 SP File Name: T OHara_DONOVAN.BCC:FB02 Job Name: DONOVAN• Description: Address: 11 MOCO ROAD Specifier: City,State,Zip:WEST BARNSTABLE,MA Designer. Joe Madera Customer: TIM O HARA Company: SHEPLEY WOOD PRODUCTS Code reports: ICBO 5512,NER 629 Misc: t ' Standard Load•20 psf 110 psf Tributary 06-00-0 ............... AL BO 131 3232 Ibs LL i 3198 Ibs LL 1986 Ibs DL 1963 Ibs DL Total Horizontal Length-11-06.00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. 'S Standard Load Unf.Area Left 00-00-00 11-06-00 Live 20 psf 06-00-00 100% Member Type: Floor Beam Dead 10 psf 06-00-00 90% Number of.Spans: 1 1 ROOF UM.Area Left 00-00-00 11-06-00 Live 25 psf 12-00-00 115% Left Cantilever: No Dead 15 psf 12-0D-00 90% Right Cantilever: No 2 Conc.Pt Left 05-07-08 05-07-08 Live 1600 Ibs n/a 115% Slope: 0/12 Dead 1054lbs n/a 90% Tributary: 06-00-00 Controls Summary ' Control Type Value %Allowable Duration Load Case Span Location - Moment 18725"ft-Ibs 76.5% 115% 3 1-Intemal Live Load: 20 psf Neg.Moment 0 ftabs n/a 100% p End Shear 4553 Ibs 49.3% 115% 3 1-Left Dead Load: 10'psf Total Load Defl. L/329(0.419') 72.9% 3 1 Partition Load: .0 psi Live Load Defl. L/533(0.259") ` 67.5% 3 1 Duration: '100 Max Defl. 0.419' 41.9% 3 1 Disclosure Notes The'completeness and accuracy of Design meets Code minimum(L240)Total load deflection criteria. "the input must be vertfled by anyone Design meets Code minimum(L/360)Live load deflection criteria. who would rely on the output as Design meets arbitrary(1")Ma)dmum load deflection criteria. evidence of suitability fora Minimum bearing length for BO Is 1-3/4". particldar application. The output Minimum bearing length for B1 is 1-3/4'. above Is based upon building Entered/Displayed Horizontal Span Length(s)=Clear Span+12 min.end bearing+12 intermediate bearing code-accepted design properties and analysis methods. Installation Connection Diagram of BOISE engineered wood Concentrated loads are riot considered in side load analysis. products must be in accordance with the current Installation Guide Connectors are:16d Sinker Nails and the applicable building codes. To obtain an Installation Guide or if a=2„ you have any questlons,please call b=T' IJ d (800)232-0788 before beginning c=7-78" a product InstaRatlon. d=12" BC CALC®,BC FRAMERO,BCIS, BC RIM BOARDTM,BC OSB RIM C BOARD'"',BOISE GLULAMT"', VERSA-LAM®,VERSA-RIM®, I�—y VERSA-RIM PLUS®, VERSA-STRANDrm, i' VERSA-STUDS,ALLJOISTO and AJSTM are trademarks of Boise Cascade Corporation. Page 1 of 1 I FROM Shepley Wood TO Tim O'Hara 8/2/2004 4:40 PM Page 1 .y _ s � S I IL From:Joe Madera 508462-6007 To:TIM 0KNIM — Date:7112001014 Time:9:12:46 AM Page 4 of 4 ' BC CALCS 2003 DESIGN REPORT-US Monday,July 12,2004 09:12 R � Double 13/4"x 11718"VERSA4LAMS 3100 SP File Name: T OHera DONOVAN.BCC:FBO2 Job Name: DONOVAN Description: Address: 11 MOCO ROAD Specifier: City,State,Zip:WEST BARNSTABLE,MA Designer. Joe Madera Customer: TIM O'HARA CompW. SHEPLEY WOOD PRODUCTS Code reports: ICBO 5512,NER 629 Misc: 1 Load•20 psf 110 paf Tdbtdm 66- �y _._.a...._ _ ._ .._.p.,: _ ,ti t1..r)t7_. _.._�t__ d4=„u,,,..r-„y.,. t.. •t. �} •t�.rc _ __ :4 _iX __ AL ,-,h.S .----._.d:, .•�'�.^,--.z— _.. f�,,_...._.:_,:�-._._ :_;,may..,.-.,, - �' r-,Vs.�� .'�*rt ti:::=:'-isi' _ _;a.: ,yr = ?s�i�-ti - - "G%---��✓�3-•�''`.i�✓.�� .�r-'�'�- ' �,y _ �.ti �:: ��-o: r-�- ..:?--:,3�_ .. ?'e��s:�£',s5=yy'�Y`e" .-�=�s' u:��: BO 61 3232 tics ILL 3198lbs LL 1986 Ibs DL 19631bs DL Total Horizontal Length-11-06-W General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left OD-00-00 114)6-00 Live 20 psf 064 0.00 10D% Member Type: Floor Beam Dead 10 psf 06.00-00 90% Number of Spans: 1 1 ROOF Unf.Area Left 0040-00 11-06-00 Live 25 psf 12-MOO 1150A Left Cantilever: No Dead 15 psf 12-00-00 90% RigMCantifever. No 2 Conc.Pt Left 05-07-08 -05-07-08 Live 16M lbs n1a 116%. Dead 1054lbs We 90% Slope: 0112 Tributary: 0640-00 COMMIS Summary Control Type Value %Allowable Duration Load Case Span Location Moment 18725 ft4bs 76.5% 115% 3 1-Internal Neg.Moment 0 ft4bs r9a 100% Live Load: 20 psf End Shear 4553 tbs 49.3% 1150/0 3 1-Left Dead Load: 10 psf Total Load Defl. L/329(0.419-) 72.9% 3 1 Partition Load: 0 psf Live Load Defl. L 533(0259-) 67.5% 3 1 Dhlation: 100 Max Deft. 0.419' 41.9% 3 1 Disclosure Notes The convileteness and accuracy of Design meets Code minimum(L240)Total bad deflection criteria. the Input must be verlfled by anyone Design meets Code minimum(I Rom)Lire load deflection atterta. who would rely on the output as Design meets arbitrary 01 Ma-Amuun bad deflection atteata. evidence of suitability for a Minimum bearing length for BO is 1-3/4'. particular application. The output Minimum bearing length for B1 is 1-3W. cabove ism properties Entered0splayed Horizontal Span Lengths)=Clear Span+12 min.end bearing+12 Intermediate bearing and analysis meftds• Installation Connection Diagram of BOISE engineered wood Member has no side loads. products must be in accordance Concentrated loads are not corrsdered in side bad analysis. with the cuawt Installation Guide and the applicable building codes. Connectors.are:16d Sinker Nails To obtain an Installation Guide or It you have any questions,please call a=2' b d (800)232-0788 before beginning b=3' product Instaitatiom c=7-7/8' a BC CALC®.BC FRAMER®.SCID, d=12' BC RIM BOARD"',BC OSB RIM BOARDTM,BOISE GLULAMTM. C VERSA-LAM®,VERSA-RIMS, VERSA-RIM PLUS VERSASTRAND- VERSA-STUDS,ALLJOISTO and AJSTM are trademarks of Boise Cascade Corporation. Page 1 of 1 FROM Shepley Wood TO Tim O'Hara 7/12/2004 9:13 AM Page 4 /� ��g��c F��, Go �� /y0T c�2�•9'�� �7� 774 - �3 ° I e / I - 1 A Engineering Deft.(3rd floor) Map �l�J Parcel S' Permit# �v House# ti, JS Date Issued 2 Qg ,o Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) e 62 v J/Conservation Office(4th floor)(8:30- 9:30/1:00:2:00) 7 SE I ) ' MDST P-Ianiring-Hept.(1st floor/School Admin. Bldg.) sEP't1C SD N GM CE man Approved by Planning Board 19 INSTAL W1?H 01 ND RDNME� TOWN OF�BARNSTANVON RED C_J Building Permit Application -r ProjectStreetAddress � ��n(a P; I 0—D&V LOTJ� l Village l W '�ifl'Q/�1.ST4b,.r_ ," � Owner p'V11 (''L/ /Y. (,U�fCH fC. '�10i�0Ur3� [ Address 1 W1cgep 4 -b Telephone Permit Request First Floor square feet Second Floor. square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size a Grandfathered @rl�es ❑No Dwelling Type: Single Family d Two Family ❑ Multi-Family(#units) Age of Existing Structure 21V Historic House ❑Yes 4No On Old King's Highway es ❑No Basement Type: URI/Full ❑Crawl Walkout ❑Others�� Basement Finished Area(sq.ft.) _L�rf}dt64,C Q 4(!? ��Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing �2_. fig._ r <<,�..., I aPn T7IfN.,1i.sA Ol-fps Total Room Count(not including baths): Existing New _�First Floor Room Count 1 Heat Type and Fuel: ❑Gas ❑Oil �lectric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing 4 New Existing wood/coal stove ❑Yes ❑No Garage: Cl Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) J6 1(28 A(,I yJ ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes f No If yes, site plan review# Current Use Proposed Use Builder Information Name IML TM fl V(,��n� Telephone Number � .3 , Address C)5 T Ld 8"/1( dZJJ�) License# ,5' 062 03 M (?AA/5 1M 1U,S fh �L Home Improvement Contractor# [D� Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. p, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO O SIGNATURE DATE CI BUILDING PERMIT ENIED FOR THE FOLL NG REASON(S) I/ s FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE " 'L OWNER J? DATE OF INSPECTION: FOUNDATION FRAME` f( D INSULATION FIREPLACE ELECTRICAL: P-ROUGH FINAL PLUMBING':, RQUGI FINAL 0 -4 � � � FINAL GAS: lam$ FINAL BUILDINGA DATE CLOSED,ODT ASSOCIATION PLAN NO. �a;r.tYy-�"+sv.+r, rr,,--��v��:!USOC`".�1:r:•.r 'r,'�Y—•.'+s.�,�...,'•—.a-.x.,..-_..r.,.,.�oy,� The Town of Barnstable ' BAaM .g Department of Health Safety and Environmental Services t 39• �0 QED ru.+" 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 I Location l t 0 C"_G Y 1.V,2 Permit Number Z3 6 J Owner Builder , ��1��L� 10.w One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: tJ Please call: '508-790-6227 for re-inspection. Inspected by Date A 1 � ` Via•+.-n�.....ir•�fav«*r��sraaK+"y°�1w.da�v+++wr..w,-.-'.�aw•--.wo..t.�.x.. _ .+.,C'M�r� �4r'�aT�'�`''~.. �'�,aw.,fii:�.*-vswvP.�yw `-.n,-�-�+-.--� ' tME T The Town of Barnstable BARNSrABLE. ` Department of Health Safety and Environmental Services MASS. �► P y , t6yP �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 (( nA oc o Permit Number 3 Z 3(�, Owner Builder le 2 V%-.e(-s . One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Wo— �� 0G G © SPT } q ,j �A�c� � �� � alb' � Please call: 508-790-6227 fo�re-inspection. Inspected by c Date it (Z �QL 1 � 9 WA n r _ sne �o�N oaTia.►.. Li a s . ' N 1 I ea � 40 AO (POP,vo RAW srdazE OF a� �G a�o /73 w u ,8.4 X7;GA-eS Al>< x f H. d Z 9 ITO eeO: J r W • j r , UA r 9 luLL f „ 'o yr Q .. 9n � � s '� � � � � � � ` ,o � �E 3 \J e .�q \ � a � � � s / r .',\ � / \ \ � \ � � � / � �•� i y.L i � M � � ��' � / � � .\ ••� _�� �� � i �r�/ �� r , �? .�;; • �� � � \ / ��� \ . �A � � �� / ` �.. / ? / -+� � �..,( �� �' r� /�' ,b,L �8 • � 1i d Z w � 156 � - 1 . Ell] _ I L❑ jig I , i` i � E a $ w � s 0 CAR Cil ® ' ii ❑iI� r IrM •I: - I. �. luui� • 1. iI � 1 • Iili L ' ; ; ,: �' - _ 9 � 1 . T 13 CE TT T-1 T o � f i I �. j i 8 a � a y r7. - Z I 10 —Z �' A 1I i i i i I l r i �L iY Q n � d I ' q � 3 � � A � EQ � W I� . I , • S j L1 i r �cb • .y 7 X fy"a Z 4 1— ' P b w 3 � IL 0 o ' �'z� I AO ccz� It w ?�. If zi i 4► Z o vj p Va s _ Q VQ c- �n 7:7- 74 O N 7L c-�, Q r ble Town ®f BarnstThe g1 Department of Henith Safety and EnvironnIeIItal Service- Building Division 367 Main street,Hymmis MA M 0I Raiait C Office: 508-7+90-62-17 Buiidins Cz Fax: 508--,90-6Z 0 For office use only Permit no. Date AFFIDAVIT HOME ffVWROVEMENT CONTRACTOR LAW SUPPI, ivMNT TO PERMIT APPLICATION construction alterations, renovation, repair, moderaizrticn. MC:. � 14ZA requires that the -reconstruction, re-esistir.< . conversion, improvement, removal, demolition,least one bnconstruction rt ot�moref an than four°n to ally dwelling trails or to owner occupied building containing tared contractors, wit:: structures which are adjacent to such residence or building be done by regis i certain exceptions.along with other requirements Type of Wont: (�.-�� ( (� Est. Cost Addrrss of Work: O%vner's Name L Date of Permit .application: ILI I hereby certify that: Registration is not required for the following renson(s): Work excluded by law _Jab underS1.00. Building not owner-vccnpied Owner pulling own permit Notice is hereby given that: UNREG ' OWNERS PULLING T IiE� O��N PERMIT OR DEALING WITH i CONTRACTORS FOR APPLIC-kBLEGZAM OR J- HOME R FUND UNDER MG'a I42A oVEM= WORK DO NOT � ACCE=S TO T RB HE:AITRATION PRO SIGNED UNDER PENALIZES OF PER" I herebv apply for a permi as th a at of the awner. 90 Cintrnmor, ame Registrtion�l`Io. Date y Tht:• CI)nt/nan"' ill, of:ltaseachusetts De partnufr1 Of 111dustrial Accidents off effOixW=9atlons 1�:• •..: i ;, b!1!l f ra r», tutt Street • 4���•�•' ��• Busrrrrr.A1wa. 02111 Workcrs' Compensation Insurance Afridavit Annlic•tnt ini,,nnfnrntatirin.. .._.. ._.._ ......_.,, / ...-.fe:S�v •-- .�.. _. . � —_.-- -,_ name 1 W��L �1 z 1�at,5 LV location• i 2. �S^l O S T \., /5 64-(UO U Lab cites___ ,Ul S UAItL liLl:l aS nhr,nc� `t�b `f103 � M I am a homeowner perfbrmin_ail wort:myself. [.,-I am a sole proprietor and have no one working in any capacity [I I am an emplover prov^idin_workers' compensation for my employees working on this job. enntnanc mime: bL —1 to tk ••,{ N{,(/t/�l7t'/vt C� I-,o city- (r? L A AE L Ptf i- nhnne 2 incurnnce cn. nnliev tt LL I/-- Jan r I 1 am a sole proprietor. seneral contractor. or homeowner(circle one) and have hired the contractors listed below who have the following workers compensation polices: cmmriatt narnc� atitirccc� phone 0: inctirnnrr rn. nnliev 0 cmmnnov natnr- �titlrccc� -ir.•- nhpnc�' ncurnnee co nnlic`• Mach additional sheet if netei_sarv_-:•.'—.: ,_... _.,:�:..�,y•,_ . .•.._�.......�__.....::�,._ -•.:.., +.....a•, .: =air—.""•w..:=:.L ailurc t o secure ctir•craec:ts required under�eetion 25A of AlG L 151 can lead to the imposition of criminal penalties of a lineup to S1S00.00 andiur or cars*imprisonment as cir•il penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a op) of this statement mac c furwardcd to the Offce of Investirations of the DIA for corerarc verification. tlo herchr ccrrift•tin •r the pr s a d penalties of perjury that the information pror ided above is true and correct. i_...aturc Date /2Z5 n1 rint name Phone 0 ��� 3 official use unir• do tint write in this area to be completed by city or town official cin•or tnwn: permit/license d riBuilding Department (3Ucensin0 Board C check if immediate response is required C3Seleetmen's Office �11t:alth Department contact per!ctin: phone#: nOther r. Information and Instructions Massachusctts General Laws chapter 152 section 25 requires all employers to provide workers* compensation for employees. As quoted from the -12W". an Implorer is-dermcd as every person in the service of another under an: contra_c :of hire. express or implied. oral or wrincn. , An einplayer is defined as an individual. partnership.association. corporation or other legal cntiti% or am• two or the foregoing en�anued 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 legs entity, employing employees. Howet•e owner a dwelling hrntsc having not more than three apartments and who resides therein. or the occupant of the d%%cllittg house of another who employs persons to do maintenance,, construction or repair work on such dwcllin,-, or out the:_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empi, MGL chapter I U section 25 also states that every state or local licensing nbenci•shall withhold the issuance o. renew-M of a license or permit-to operate a business or to construct buildings in tilen commui•caltlt for snv appiie:ant who fins not produced acceptable evidence of compliance with the insurance coverage required. Additionaiiv. neither the commonwealth nor any of its political subdivisions shall enter into any contract for tite ble evidence of compliance with the insurance requirements of this chaps perforniance of public work until accepta been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation ai supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance covemae. Also be sure to si;n and date the affidavit. The afffdayi should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are reeu: to obtain a workers' compensation polio•. please call the Department at the number listed below. city oi'i'owns Please be' sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottor the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. I be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be return the Department by mail or FAX unless odic' ratrangements have been made. The Office of Iunvesti=ations would like to thank you in advance for you cooperation and should you have an} quest Please do not hesitate to _give us a call. The Depaizment's address. telephone and fax number. The Commonwealth Of?Massachusetts Department of Industrial Accidents Office of Investigations 600 «'ashington Street Boston,Ma. 02111 fax#: (617) 727-7749' :106, 409 or.� a phone #: (617) 727-4900 ext. M CZAR Appwft j Table JLLlb(eondaaed) prseripdve Padiages for Oae and Two-Family Residential Buildings Heated with Foci!Fuels MAXIMUM MINIMUM Glazing Olaang cciNg Wall Floor I Basement Slab HeaunwCooliag �'('/•) U-value= R-value' R value' R valuer Wall Pleas F.gwpmcat Efficiency' Page it-value, R value' 5101 to 6500 Hating Degree Dare' Q 12% 0.40 38 13 19 10 6 Normal R 12`/. 0.32 30 19 19 10 6 Now S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 036 38 13 23 WA WA Norma! U 13% 0.46 38 1 19 19 10 6 Normal V IS•/. 0.44 33- 13 23 WA WA 85 AFUE W 1351. 0.52 30 19 19 10 6 83 AFUE X 19% 1 0.32 38 13 23 WA WA Normal Y 19% 0.42 38 19 23 WA WA Normal Z 18% 0.42 38 1 13 1 19 1 10 6 90 AFUUE AA 18•/. 0.50 30 10 1 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: jl BCD 1�� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: jj9j 3. SQUARE FOOTAGE OF ALL GLAZING:. ISO 4. %GLAZING AREA(#3 DIVIDED BY#2): I o�, 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: NO: q-forms-080303a I 780 CMR Appendix J Footnotes to Table J5.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors,.skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fe of decorative glass may be excluded from a building design with 300 ft2 of glazing area. z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness,over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilatcu portion of the roof. - `Wall R-values represent the sum of the wall cavity insulation plus insulating.sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned'crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements:are for unheated slabs.Add an additional R-2 for heated slabs. ` If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 DBPARTRENT OF PUBLIC WK. CONSTRUCTION. SUPERVISOR LICENSE rExpires., :RestncCedPo, 00 ABI�. TERKELSEN 251 05T/W/BARN RD "AARSTONS MTT-LS. NA 112648 Ale Registration 126638 Type - INDIVIDUAL ' Expiration 06/29/00 NEIL TERKELSEN NEIL A. TERKELSEN 2.5j OST - W BARN RD STONS MILLS MA 02648 ADMINISTRATOR i Application to c PNEG� E tP ' I; e�o+"toaA.NcN gpNPNg+PP P,g EP ``P t. Old Kings Highway Regional Historic District Committe in the Town of Barnstable for a CERTIFICATE 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 Addition ❑ Alteration 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 &Va11 ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY 7 DATE 2 2S112 ADDRESS OF PROPOSED WORK II born U`-�-) 1) - SftRnl ASSESSORS MAP NO. 16— OWNER IT,),fg0u4t q ASSESSORS LOT NO. HOME ADDRESS' - a5 a,4b� TEL. NO. 94d � FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). 161 AGENT OR CONTRACTOR TEL. NO. 00- cf ADDRESS J 2 I (S 1 W LMN �1C� 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). 6 ��a I` 711 iI; U I Signed Owner-Contractor-Agent Space below line.for Committee use. ei D ' >� q ate a Certificate is here Date �^ imVfA,t 1s70ayz" GRIWWIR m WN OF BARNSTAB � i AY "' Approved,`' ❑ IMPORTANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. Disapproved ❑ r' I` Town of Barnstable Old King's Highway Historic District Committee / SPEC SHEET FOUNDATION (16 r4 C er-IF-5 i SIDING TYPE C_(-4P OoA<-D COLOR W (17 7- CHIMNEY TYPE 32►C IC -�9_Xs)sn(44 COLOR (Z£Qb ROOF MATERIAL 3 {^� { ptT COLOR PITCH 12 WINDOW SCdjeQ(f le- SIZE TRIM COLOR y i 13- DOORS ,�P dj/k o? /J f� ,� COLOR SHUTTERS h//Gr.. !�/� COLOR -61K GUTTERS DECK GARAGE DOORS COLOR SIGNS ,(/�J/ COLORS FENCE COLOR W � NOTES: Pill out completely, including measurements and materials/colors to be used. Three copies of this form are required for submittal of as application, along with three copies each of the plot plea, landscape plan and elevation plans, when applicable. Site plan should show all structures on the lot to scale.„ SPECSHT' at Engineering Dept.(3rd floor) Map ?,/S_ Parcel 03/ L�"-'" Permit# -i' �� House# /f C? Date Issued j Board of Health(3rd floor)(8:15 - 9:30/1:00-4:30) 0Z14 FeeA!V Alp S Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) 9/�n SEPTIC SYS T SE 19 INSTALLED NCE aI� N TOWN OF BARNSTAB IRONME AND TOWN REGULATOMS _ Building Permit Application Project Street Address Village Ar Owner C Address Telephone Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ U Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes 8-No On Old King's Highway ❑Yes f l o Basement Type: ❑Full ❑Crawl ©"Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing oZ New / Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil Q'i✓ectric ❑Other Central Air ❑Yes fj]'No Fireplaces: Existing / New Existing wood/coal stove ff�es ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) f8'None 9d'Shed(size) �X/D ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes --U r' o If yes, site plan review# - Current Use re-51 Yg Proposed Use Builder Information v / Name Irld ,SQ ' Telephone Number Address a j j fi a- mltI kd License# e6 0 54 Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE A14WL— DATE BUILDING PERMIT ENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE ' OWNER w DATE OF INSPECTION: vs FOUNDATION y FRAME- INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING:-, H FINAL GAS: Q .a FINAL FINAL BUILDINGS DATE CLOSED OUT ASSOCIATION PL w-.1 O. j i�A /I fi/AAI)im n n q zz O. G . 0 i ' C v v L/L/7 iv C/(A'�G2�L� d"'rY ' ell r-O v Ail) AT I wALi�r i • B chrt�l �Laa� Sr. B 7ffid,1 The, own of Barnstables crto I\ 1 Denartment of Health Safety and Environmental Services t ' •..L�.,. < � '} o;.�V� .jl" �+����'Li jl Intl i ��� i . ..,.. .. .. ... _ - I { I 1 The Commonwealth of Afassacl►usettt i i Department of Industrial Accidents OlticeoJlnvestlgatlons 600 WitAiti- otr Street Bncrotr, A1uss. 02111 Workers' Compensation Insurance Affidavit t// m sit n• City •0 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity . .•. rv-.,_...:......_,....!_..;�1rw.i.�wsgr[s..'+..�.n+:/.7�:!a�•:�I`r!�'^^!++'!�!!�^r.+��.w•�.r.�.T.�r..-•.nw•+.....•._...�.�•,�..._......__..... M I am an employer providing workers' compensation for my employees working on this job. coutpany name: atltlress• sin•: phone#• insurance cn. policy# ,_.._.. .. ..fir..,�... _...,,,r,...�.�..w.ry�.- ..... �......r.......++...+.�w��—+.►+.....—. .._..,. ...�. .. I am a sole proprietor. general contractor, or homeowner(circle otte) and have hired the contractors listed below who have the following workers compensation polices: company name address: cin•: 0hone#: - insurance cn poiicv# . - •.: _�.�_. •.:...ram::_- ._- -�r^c�.':��\' �T'-}!7nw•S �T�..._._ _��..t•�. :.�._.—... cnmpany n•tme- address- sin•: Phone#: inur•tnce co policy# .Attach additional sheet if neressary - • -- - F:a_'.'. ��.'-.'..o..:�'•.r.�'•�•�.::�iSiv.r_�...r._ '-���.s=� ._...�.� — - - :aie•�.ac�ae•.r�:.�..in. Failur-e to,secure-_..cuveraec as required under Section=5A of AIGL 152 can lead to the imposition of criminal penalties of a lineup to S1.500.00 andiur unc%-cars'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against Me. I understand that a cope of this statement may be fumvarded to the One of Investigations of the D1A fur coverage verification. I do hereh tiler the p its and p /t cs Jof p�jer�jun that tlrc information prodded above is true at orre 1. Si_natur G�!�:f/ Date Print name Phone# .:+�r�r�crr '•of icill use only do not write in this area to be compacted by city or town oMcial city or town: permittlicense# rilluitding Department Licensing Board C]check if immediate response is required �Scleetmen's Office C3I1calth Department contact person: phone#: r j0ther ?111.0 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for thei- employees. As quoted f Qom the "1a�� an empl( ree is dcfincd as every person in the service of ,uunher..,uttdcr an.' contract of hire, express or implied. oral or written. An emplurer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more the foregoing_ engaged in a•joint enterprise, and including the le-al representatives of a deceased employer. or the rccci\,er or trustee of an individual , partnership. association or other legal entity, employing employees. However the owner of a dx\elling house having not more than three apartments and who resides therein. or the occupant of the d%\.clIin�,, house of another who employs persons to do maintenance , construction or repair work on such dwcllin-- hog: or o» the `rounds or buiidi►tg appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even, state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter iiz been presented to the contracting authority. Applicants Please fill in tite workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required to obtain a workers' compensation policy. please call the Department at the number listed below. City oC rowns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investibations has to contact you regarding the applicant. Plea: be sure to fill in the permit/license number which will be used as a reference number. 17he affidavits may be returned t; the Department by mail or FAX unless other arrangements have been made. Tile Office of Inyestications would like to thank you in advance for you cooperation and should you have any question: please do not liesitate 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«'ashington Street t Boston,Ma. 02111 fax #: (617) 727-7749 i phone 9,: (617) 727-4900 ext. 406, 409 or 37S WE The Town of Barnstable �04 _ Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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. d Type of Work: Est.Cost /0?ro 6 Address of Work: // �w is Name r �� G Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. B Idsng not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date 'Contractor Name Registration No. OR Da Owner's Ome • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE 7 JOB LOCATION C�� 0�• ,� � . /l Number S reet address Section of town /"HOMEOWNER" ��.G��. Nam# , Home phone Work phone . PRESENt MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupiec dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to re- side, 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 Off ici on a form aceerptable to the Building Official, that he/she shall be responsih for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes ..responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands ..the Town of Barnstable Building Departtment minimum inspection procedures and requirements and that he/she will comply ' th said proce res and requirements. HOMEOWNER'S SIGNATURE G�/J�' 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 Control. i 77 HOME OWNER'S EXEMPTION The code state 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 Ownez shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarene; often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our. Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home " wner-' actir. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man 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 by several towns. You may care to amend and adopt such a form/certification for use in your community. I • 'qq.3 N �° 0 � 9'• o nor i <C*-, a 15409 ¢ S. F. l f GAR O p hh(o t � ill SHED i �t M PECK PROPOSED I6• X 16' � \ ADDITION 5 66,4 6 N 70 _. 66 68.00' R-83.73 DEC EHE MAR 2.i 2004 At4 (D6 ' `f ashy TOWN OF BARNSTABLE fl' HISTORIC PRESERVATION FRANK wHrrlNG N0.29869 @. THE DWELLING DEPICTED ON THIS ���® 'STE�Eo��`' PLAN WAS LOCATED ON THE GROUND BY SURVEY ON MAR. 9, 2004 AND EXISTS AS SHOWN AS OF THE DATE 311,19 o¢ PLOT PLAN OF LOCATION. IN B.4BIVIS.TABLE, MA. THIS PLAN IS FOR PLOT PLAN PURPOSES ONLY AND NOT FOR SCALE: I '-20' AIAR. 18, 200.1 RECORDING. DEED DESCRIPTIONS EAGLE SURVEYING , INC OR ESTABLISHING .PROPERTY LINES. 923 Flouts as Yamlouthport, MA. 02675 u (508) 362-8132 THIS PLAN IS VOID IF NOT (5Qa) '�32-5333 STAMPED AND SIGNED IN RED. 0 l0 20 40 PROJECT NO. 04-022 4y `� �o o• . ( � C9 1p0 00 m LOT cl- 15409 + S. F. N f / / l GAR DECK l /6. 14 PROPOSED V 16 ' X 16' ADDITION 5 b6, 3, . _ w, 10 0 4 i �o 66°Al 0' R-El3.73 p ECCON�C MAR 2 5 2004 TOWN OF BARNSTABLE HISTORIC PRESERVATION K �p��p���f7Y�3�� pVm`' N THE DWELLING DEPICTED ON THISSTE�� 2� ' E ' PLAN WAS LOCATED ON THE GROUND BY SURVEY ON MAR. 9. 2004 AND ` - `�%� PLOT PLAN EXISTS AS SHOWN AS OF THE DATE -3 z.op¢ !N OF LOCATION. / BARNS.TABLE. MA. THIS PLAN IS FOR PLOT PLAN SCALE: 1 '-2(?' MAR. 18. 2004 PURPOSES ONLY AND NOT FOR RECORDING. DEED DESCRIPTIONS EAGLE SURVEYING , INC OR ESTABLISHING PROPERTY LINES. 923 [touts BA Yornputhpurt, MA. 02675 G (508) 362-8132 TH/S PLAN IS VOID IF NOT (508) 432-5333 STAMPED AND SIGNED IN RED. !� 0 /0 20 40 PROJECT NO. 04-022 r . r f YY or WAY 1 - 10 Zy c f tµa`3� ---_-_ 17 i •. »�y 'dap 440..3 ? M tK'i 50• �•a Or 1 / 40 P M J� ; ��� � �O?3♦ &dN/e :S / 233g0Y: = 4r y « g \ ;� lu 10 If '"t"$ f—` .)I ^ a t�,2S - l: 4` S ' /•( 4006. e1 r cr PLAN oF LAND - _ . . i lV - [r..•a,M / Le ewe: • Lee Sf.• WEST BARN STABLE,MAsS. °.°e- OMYao By ED%%ArV E. \:ovuc 5CALL I.w.cOc-v AvaysT Z *92 . (� .\.t tus w`� f'Iras «•e► 44 B -l.a.. ei Gaoeaa E Mavaa Clvla E►.a,l[t■ llet r.•k o< ge«,!e►le ° u t►e t1...1 ai 5.— CI A-a.row:Avc M[i t�SE, Ida.. a.d o +7