Loading...
HomeMy WebLinkAbout0026 MOCO ROAD o� (o mocn . boa ��ECYC(f�c UPC 12543 � No. !7I ir- 41h STf PIQ3 4AN. t, l� R ._��� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION C Map J Parcel 1007 Permit# 51456 Health Division Date Issued ® 2' Conservation Division '� ° 2'alv— Fee A,, - Tax Collector 'd L� 0 Treasurer SEPTIC SYSTEM MUST EE �e �ce� Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 co w f r Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS oo 7,,- yr Project Street Address �CC� Village W �,�..o age lry��� Owner Vwne?�N 2Q<K I Lro)LNe Address 6 Si2r-Ln!:, S �`� c.y� M 4 Telephone -7 91 �7 / /6 / 0 Permit Request Amfer- f,,iin An'tJ r �. '�✓�,Sl/�c� �n ����n;�d t P�4 �- Square feet: 1st floor: existing 60 0 proposed 2nd floor: existing /proposed Total new Valuatior �0d©t�' Zoning District Flood Plain Groundwater Overlay Construction Type ' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure e�) Historic House: ❑Yes a<0_ On Old King's Highway: ales ❑ No Basement Type: ❑ Full ❑Crawl Walkout ❑Other Basement Finished Area(sq.ft.) yap Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing q new Total Room Count(not including baths): existing new © First Floor Room Count Y Heat Type and Fuel: [/Gas Oil ElElectric ❑Other Central Air: ❑Yes N� o Fireplaces: Existing New Existing wood/coal stove: es ❑ No p 9 9 Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:udexisting ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded O Commercial ❑Yes 9'No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name.�vg,vila+p oo(-W_e_ Telephone NumbeC 791 Address License# �3� - c!o f I�l Me, D Zl�y Home Improvement Contractor# J Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO i' ? "e XV SIGNATURE DATE �y�— FOR OFFICIAL USE ONLY PERMIT NO. 3 DATE ISSUED s MAP/PARCEL NO. ADDRESS VILLAGE OWNERw DATE OF INSPECTION: FOUNDATION , FRAME r y INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL I PLUMBING: ROUGH ' a 3 , FINAL GAS: ROUGH t;v ` ' FINAL FINAL BUILDING y DATE CLOSED OUT ASSOCIATION PLAN NO. S I RESIDENTIAL BUILDING PERK T FEES. ' APPLICATION FEE ' New Buildings,Additions $50'.00 Alterations/Renovations $25.00 -- Building Permit Amendment. $25.00 7 FEE VALUE WORKSHEET NEW LIVING SPACE _square feet x$96/sq.foot= x.0031- plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE (�y s feet x$641s .foot= J x.0031= _In Q0 qua q • - plus from below(if applicable) _ ACCESSORY STRUCTURE>120 sq. >120.sf-500 sf ` $35.00 >500 sf-750 sf 50.00 ' >750 sf- 1000 sf 75.00 >1000 sf-1500 sf .100.00 >1S00 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- - (mrmber), , Fireplace/Chimney x$25.00= (number) Inground Swimming Pool". $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00' (plus above if applicable) Permit Fee PMjcost 1 _ -_ ---__ The Commonwealth of Massachuseas Department.of Industrial Accidents -- � . OflICC OIIOYCSUp81lOOS •• 600 Washington Street -_ Boston,Mass. 02111 Workers' Compensation Insurance Affidavit7. . won: 26 1111-6&0 ' AO hone# I am a homeowner performing all work myself ]. I am a sole p' 'etor and have no one worldrig in anyaci I am as 1' 'workers 'vn for 1 �P wo on- ..,...:.,.....,.::.a:.::::;{.;:.>:<::::;.:<;!;:.T: lr:::.�n•:.;::n,:..v:n.::n.:x .:•:,:•::::..:m9�oy� �g this job. ..:.......:.v::::::•v h...........r...r.h.n........}..+.......-,.}tnv+:::v..f....r......... -...........:..:{.is.;.}�::•{{{{{!•}}:•}}}:-}i}•::}.....-..r..... +•v::nw..:................................,.........;........:........::n:v:x.»n,.: :n:w::T.+f vn:v v:.. .................. ............ ..-...................,w:::...::.,v;....::.::x:h:v:.v.:v::rw.vf.•..::?::a+::::::::::}Y'•:vv::}:Y•±:W.•.�::aY.%i::}+i:•:ir}{:{}}:ii•TTt'.•rvTY::{•T.:�i:•:- ...}-.-.r 9:n�•:.v•.v.....}....•:•:,+.v:.............:::nv::vw:::::v.v::•-,.......:::.+n:•:.:::::::vn.}:::....,:.-{...-3.:-.,..v..:.:..sue);• amt�i!ii!isi %:>%'%!i::+:%:i::%ii:�%:::ii:i}{{:;}Y.;i:::}}±:%ii}:%:vi::�:}::;}:i:%i:%:4}{::�}i}:}:•}:::v.:v.v:::v:i'ti•}':,+:•}:•}+::}:::.ay. ,...... ,r..r......:.:::..n::•:::.,......-.....::.gin•:. .. •.ter. •::•}c•:t.;,-::::±:::.::,,•:•:::+•,t�:•:::•+.:;;5:;;`•::.;�.tSi:%i: }:S{;rTn{::t•}}±:}:%>:S>::a:iT:•T�::•::!:%::S:i:�r}:::�;:<:::iS-�:%::;}%ri:%:%::±:!�:�}::} ...:.... ............. ............ .......:.. ..:-...........n... ..r.............,...,•.,••:::::•:::...,r-•::._::.,:...::....:...}..,-,•.,a,r,.kTn.,.�:•:••:�::•.:::}:::•}:�}Y:•:�•:.;•::::}::.��:.�:}};.;•{:.:::..:.::,r:;•}x�:::.�::::::•.,,:..::...-,:x.:::.:::.t•.,•::..... .:. ..r.:•n•. r.:.:::;:..,:!.:t•:`t•iJ;{.;{:.;;•. ,.!:r.':•i:•::}:t;:Y:•+:{r-:t4::•:'•}':, ��t'Ctl<.::.:,•:n::::;.._.;.}.,.:................................:n•:::n::•:.v::::n•::.vn:•n:•:::.•r.•::-:•.. -......:•}}r-...t..a,.\'•}:•}:•}:;•T::.: :..... {-..:.....:}.,.::•h_•:t•Y^:::•n•:::::. ::2%r:;% :;%SSS:}%SS:S::!}`%:•:S'%><:%:iS:�:�<{::::�:::%SR}x:::,. ..................... .::::....... r:...iS::::::::.:%;::•}i;.y.;r}•-.�::::::::::..................-.::::.}..,-..........,.......:.�,••Y}:•}}':::::::::n..�:.:•::::n:Y:t•}}••T}r......... -. .....:. r....�r::x.y... .......:.....}...-...... ........v v::: n., n.....•:............n.n........MY.......:.nvnw::n•. t{} %±:}:;;;+r.+;:: f i}ii;yji:;j v;;riy%i::<>;i:jj:: . .:%i%:%:%;i:!;:;{::%:%{:%{;i;;:;;;;.;?�i:i?;i:%;.ti}::i;}i?:..i:%?'^:::::%:iv::::ti?•:i!i::;::;:?; :;i:?isi':ii:%::isi::%:?:ti+:v:'%'}J:':';':::%:!:i:%:<}t%:}%ii:%:::t%:%i:%:%::::i:L::yi?.:{: .. Y.- ������ty >c''2ry'�'��?' i�`^�'` �<` ' <'< >>#`>`�r :.,:.:::. :..:...,...: o :... ............. GG" /c ] I am.a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who . the following workers' 100113lion polices: . ............................ . ..r.. ,.}: ::n.}:.n•.................................... .........-.............::n{.,.;....::::.Win,:.......:• +%:%C%ri}:•:�:i%:i{{�%i}:{�i r:�i:�:{}�:�i}:'•.:iiiii'.i%:?v%i!:L{%iiii:i�ii',%::::!'•iiiiii$ii$$:{Y:;i}:{{{•:'•:•+.{i^}:ri{;i:%i'ii:i%i:iij;: ...:.......:..... n..::::.n..:. .c:.., r.n.::::�::r. .r... •_.-.- ... .. .,.;}},:.�.�T+.-:::}:::.:.�::.�•.:•::.�.�n•:•.,:.}i}�.}';•:.,}:{•T:;::-T':::.:�:•:::::::::.�::�:::::�:�:::::::::±' c•::{;•}:•r.•}:••.•:tt!•.,•:::.;::.,..........-oc•......,{•:..:x•-o::•}h.,{.�:;::n•...-.. :+.•rhi;•.,•::r.,•.::.r......o-}x:•:.:�„•:::na:..•,. .......... r..-.....-...,......,...,.... .,...... ...............:..:::::::::r,::.�,::::.}:.,:•::n•..............{..!aa...::::h•::::::.t•A::::.:...•.,.a,•.5.:.,T::=:}}o-::;:;:}:�:.�::::�:•�:::}•.}}.::•:•:{.;+••;±•....:....•::::.�:•:.:max•::.....-.._.......... .. K. :.. :+±:t: ,!.r...y: :•::.v::..;^n::::w:::::.v...•:.....................r.-....::•:nxv...............................,•............-............h.. {-... .y..:...n.........n.nv;- .a. .::. .v...... ......xn....-...:•:.:vn•:v: v:r:v:r•:..;:- ...nr rn.:......::::::n;......r..... ..,..r....... ......... ,ln+:{.„::r.{.v:v:., .. ...4'j,.';..-.!.;,. .....v..n..:r.. r..:.....-..wvv:n•.+..,-.........vvn•r-v:nv•v::�•:v:n:rr};-.}}}};::::-.v-0.::n:v.v:::::v:::::::v.:n^.... ..n,.a...Xn r.}J:::}x w}}:!n}}y,::,.M, v.4:.v:................... 4 nn•:: "'w:-n-•::w::::::n!vr:.rvv.....nr:::':•::':.........- .n...v..-„, n.......- ....... .r... ...nvvn+..... .v.S,..::/!n...::::x•v:x:::::•. :..r.. ..r.n.nn......,...v J.....}........ �v::•v::::..................n..,ay.v::v::::::::n-Y:x{••,,•:y.... ..:.A.::}:•i}}J:v::.:::::. ...n-...,......... ..............v:--. ...x-.. l..... :::::nv.........;: : „ ./.Y-•T'vv.......4::;:n•::v:m:::.::n•:A:.:,..............v............. .. .. ♦ n.r.... .n..- .vv.v...-n:....:....... ...... .......r..:v';:::tiA.}2}:»•........8::::::::•::::::::::.v:n•;�.;•nv v.v.....v..:.::-:.±..._..:..-n......... ...n. M �{{ nw............v..:n•::..•.-.....v,... :...::r:::::::.!.r-.:... ..:............ ...... ...........a..�:::•:::rv....:.. vY�i.Nv:i•i:...:.::::n?:•:::n:.:::>�...},,v:{{n...n±}:}{m}-J,.{ti::.:itirr'.!ti•}Y}i:•:±:>O:•ViC.}}:{4:i%:iiif nr......:.;vw.y:+:-}'ry.;;}.}.;}.::ni-}':::::::::{{•+:::::n+:v:::•vvr.}'{{•}i'•}}}':.,w:nvf.:•.vT.}y w:}{.}y:.............................. ,:nr...v::.::. xn...rrr;{n:•Y:F -!v ............. ....,r... •••••.•••„•:x±:4Y.{•}:i}}}:jij:t}Y'.}}•:{.}:{i�}:4}�,:�iv:>}',%>:�%}Y:<AOi:-O�A n....J..n....v.-:...... .::-.vxw:::.,:^: ,.-.r. v:•:r:•...{vv:....,.{4Y...:.....-.x::�::•.v v..........v:w:::::f{::v::::................. ..n._-.................-......•.v::::::}}:�:iv:}}}:i>.:{ii}':iT-iit!v:: {4Y4;:{:......... ... .... n:.}.:....:.......L:.i.,.-..r..:±.:-•!v-•w::{h:._.. nw::v::..v::•-:r.•.v•:v 4:,; ,.:v:.v v::nn•:.v:f:na:.::•.{.,x:'::v::•A::::::.:v:it is .............. .-!..r........ .-.vx::!:v::!^::.r!•::..yx::•:..n:.•::v.nv vn•::}::�:.w:.+•.:}r:.-.:..n.v.v....... S..nt....:. .r 4}JY+i'•::y}:iiY-:x':}::•5:::.},}w.A..v .,......- p}v.}Ti':•iT:{h;.�:;±.tii!'•Yi::::!vv-v::, '.{.vn•::::n ..n... •n•v::•::.:.....-4....-.. M': •nvv:n;h{. A.v-.<::v.:/.:!,..1•.vv:::.J:v/..•:nvx.-.:Lv::,:rn:,:r.::.v.,:n..nvt:.-{:,r:vv,:•f'•:{{}n•}!:x:nv::::.a.: .-.:...{........:..-h-..n.......4q{.a\.....:.r:T:hw:.vr:i{Y}:".n..n.-.xn:v.:.w+v.«:!^:•}}}:{C{4:-}Y:iY::{iJ.. :.\�' .v .. \.....a......n:n., {n, .O1..at�..H...::x.... n..r..............:±::.v:r.,4r.F.v.4Y•,.v. ::•:,..:r........ .:.•-':�4::vr::::::::::r':....-••:via xv:-:.��::::•n4:•:}-{..v,•.v::.y>:•'^:}r+rf.::::..v.'•:^:{{h::J:{4f-4.;{,.....,.:n,v:.a. vn\:•i::4i}:::4.v:}h4A C•Y- , .C.;}..Yes.S...:.....::..... -f.{•h:{•:�..:h;.L:.:-n...f::•.•.... :n:r:... y:.v......+n.k. ::-{!-b,.::::8.Y:.... +::.t ,l..J; :.,J..vnvvn:•r.>.•:.:::.}:.,}v:::::::......... n\ :{.J24.?4(:hJ. ..::n::.v::r.::n...i.8:k•}:ri.........., ............................:rv:n:v::}h;{•:{•Y:;:vn.nnn�•:x:v�::! y ...-..n.n...p::•-T'�}:�:::v:••;r••/.;na-•}}+r.;ay:x..v f`j:M-.:.•. t: .:::.•r.::.: mraar:•�«•.......................................::::•:n:::v:::.v::::v:.v:::n::v.v:::::::.v.v:...vn.:.:::::::;•.vn•.v::::•n•:+It:•:::::• O �. v:v±i:•:4}:{{.}}.:{n}{-{.--{.;n.-.}h:.}.r-.rt?.v.v}::hv::}}:4}_±.r•::•.O}?n}v4Ww,✓Jh11Qv:,::::::.v •::::..... ........rhi.}y::.v.v:v:::nv.............." wn:v:::.v::�:.v:::::�v:.v:v.v.v:::..:.v:::.v::::::::,v::::v::rr^:nv::n,�::::::::.:v:.v...................... a ////, vv:v.:v:..•}J:�:tiLY'•}+T•.T;":v.v:... ..-..+ :.v:>:x:•::.v..:vv ....n•:•:v::vv::•.:.........v::w::•.v....n..--.- v. h......... :.v:•„aw.v:v:::.v::..::n:•v:n'{:a•.ay.w.vw:::•w:::.r p.r::,v:F.,{n•}Y}}T•:::.vn•YTiT:i4TJ'•}: .:....r.:r!:v:::::f:!:!•.-.+.w:v!v:r:!:vx:.............r.,a.;:...-.,+.....vn•v.K.;.h.:•;{,{;•rT.:::J::w.v:-vn!vnvv.{•.vrv:+•:::.v:.-u.;,n...-......,.r:::•}. r-v...... .....in........,..-h-.....-.... ....v........r.-,.z.......-.- • r..:::n•:::r•:•::•::n•::r:f••.::;:;:r}}•.}••. ......:._:,•::::.n.:r.,}:}}:c:�-::•:::r....:::.:-.r..... .:... .... ......:::::::..•:•:.......:•:•:::.-:...,.. .-:.+•;�i}•:.:::�:.�:::�. r.+..:....:.r..„.{...: :{:.:t.;;.s;.;r{.}{.,:c•±SYYx:,i}Y::;.:;;{•.'•:::•is•}'::•:.�.......,...:.......... ...........{.......... ..,.rn•::::T::.,;.;.;... :... :,:.:is t;:%>:%;:};,;v::{:::..;. •-..:n.,:!•::n::{{•::•::,:.�.:.;.,..,.:..,�:.�:::�r......-.:r:::r yr n..:......:........ ,{......... .:._..-:ta.t..{..-...r.....-.......... ......... ...n........ :..r..::n4:.......r:n..rx::..�::i•,.-.�::n•::. n.r::•:••::.........,<-,•:::.,,••:.�::: ..:...,..::::.. ...........................r.........,,:t:t;r•,•:�:•::::n::::::..... �r.•::::::.�-.�::.r}:.:!•}Ti:::::r•:~+::}�:.,,{::...,,........r--.........:•::::.... :••:...rr.:::::: .:}s..:}:..,a}.::.,}: rt............. .v....-...x. .:{:y::vv...•:v:.v!w::::.v::nvn•.••::•v.v^n•::av:.,v±+xr::;.n:-�•.v::^::•.v:•. ......... .....v.v.��.vri•;}r;{{;.}„y.{{vv::'Jv»....;.{.::- ..T.v n.v..n,...,...\h.v.x::.vr;nv...,.- .n•�v}-na:.r.:•:hw::::: mDsnynHrrr ........... .......:......"..........vn. r:'r.•.:.t:...n+r}:::.v}�n..:v::.v::::...-..-......._...................::r:.:.-................::r:J....4.,.v:n:...:...v.v.,.,......-..-,-:...•n{vv:^: „ .,.. Y9'•T;{•}}}Yit{..!}v v::::.:v:.:.'.v:::::!4:•}'•:i•:!i{:?•i:?>.•}::{•±'::v::l::4 v.:::'•}Y{{+ — ..f.. •}:•!:•:T:-}}:tii:{.iiii:::::::v::{4Y:�}:•i:•::v:"::it:::�...•}::::.v:.v v.;;.v:...................••nv::::v:v.r.., ...n...:. +.•.....:..............n.-..............:..x.::::::.;}..:..:.v:.v::::}:v:•:}w::::{{.}w:::v:.+w:::x:.:}}ixT:vv}}:{:. }............. .......v..J...O.- {av::r.:•:•- ... ta,ww„ ..... ..... ..:-.v...-...... ...vf;.:................r.........n..-...................v...n•:::::...:::..+.:v.v:::•.v:v::::::.....-....:::::::x:.-v-.v:::::::n:vA::::.�::nvn::v::}.L4x•i.%i:Q•X`..v-..... �}:n::iY•}':r:l n.n...... ,.r......a:..,v..............:...:vn•,v... vv.•:^:::�vv:.t:•:;::{::::{::.;r.}'.,v::rx:r::::^'...: ::::•++Y!{:•}isi4}v:::+'•:.!{•::.}:::ti{...,.:. %ii%*;:?_:!;^}}±}}i:�'9T}}:{!{{-i}}T::a�r „•h.:h:.i•:}:i.n';�(:>';i n';:?$: ....... r:n:::w;!.vnyyvv.v........m.::.v:nv.v::::T':•L}•:T}:............::.::::...... v.v::::•: :::.v .. n•:v.:::.v::.,..... .:::: ..n::•--... ......:...........::. .. .. ...:.......:.. :.:....-..:..t....... ...w:.w:.v::::.v::::.v:-.::w:.v::vnvv:: ,.:...... }..,,..•..n!.,::;;:;:a:; };:jj:'i%:^;�:{{ %?ii:a•"i':�:}:t%iiii:':i:.'•J:i{i?::�:Tr;i:±}':;i.';:;{:i} N +2 f :•:+.{{{^'•;}}aT'.v:::::r.:v:•-:,:•:�::n•:::::::�:u.!•:vY::::.v:::::::::•w.v::.v.}v.:::.:.w::.v.�..�.:;..::r:.:::._.:•:::::.�:::�:.w::.�::::.:�.:-.;:% h r•-,. ..:-.:::::.:•:;:.........��:�T:�::::•-:;:•-::.gin•:.::.......:.....,:.:::.:.:.n•. r. '• 'i�.....,:T::.�::::n•:n:•::::::•:::::::.. ......:... •r.. ,:•..::.:n•.:�::.::�:.�::::.._...-..:.:. .n. ....:. ... a.::n:•::�{•,.,.,5.}Y:•>}:»}:•TT%}}:;Y.:•}r':%:'•:%2:Si:;%:;.>%;:::Tt.%:%:;::::':5:}.:•�:}v:.J:•i±:{•`.•>�•..�:-ix�:;�}}>: ............................... .......} ............................................ �.,.�r::.:b�lbtit'�S•{.;;.�.T;.;�.v..>•:•±±}::..,..:..,..- } r:::n!::•.��:;:%r:TT:•>:.T:•Y:i<%:<:::>: ,-h ..............:•::::.:::}:v•::•±:...n.:n• ....... .... J.v.:....x:•±}:±i:!.}i:•T:•T$:•}}:t:•}:•'J.{ .......-....... ;.:}:ti}:•}}:•}}:4:t<i}:{{{:•}::}:•...::•.'•:}:i}:{•:{:!;:!;::±:{••}:•:;i ..;,{np;„ ..h.-. ..,x....1::::n:vy.J}}^ .v:.r.rrT}:+: v.A•n•-:.,..,r{.;;..:!.r.•::n!.v:�.,, .....-.. .._....-.-i}}';.v:nv:••'v v:•:::.'.v;.:::--.:.: t.... r.,i.a ..:.::::::.,..::::!.:!•}+:v:?•:n:•:!:.::�:{{v%r:i•::,+:a•}'i.{..:..,,,......:::r:•::•.v�:•:::•::.{•}:v .... ......:.•.:::•}'•±::h.,.,:: .....:............. ...............,:• o-i:;.;•:;.}.•:•::S{:::.�}r:.r TY;•...;,.,..a.:.}•:.. .5,.......r..........a.... :•::.:•::.,---..{....-.-..... +•...•r ......t...!...:........„{.•:.x.: -:.: n•.,,•-:.star:�•::•.,•:, .....,::.:�f•::fr:•..... .. .-......::••::r::/:.:.::...}}t.._::}}n•:f•;5:::•aa::•.vAt.,rh,::::......... ,.. ...,....-. ...--.a._::. '.........::•::.�:::. ...t....:.::.......n r..fi+;:.;;{:{.. .:.}:..t::...:.... ..}o.::.�.•::::!n.,{f}:.,�:.:•:.,.r..t... :fi':• .:rr..... ..r.•:}::5:•::";'•.uJ:n•:,.�:. .......................:.:�•:nv.'.• .,::nv•:•:•:::n•:fw;�<;{..::: ...v.9Y}::{..y::K-}.wn,{•.vn{:.::x.!y,:t{:A...--....- x r.„x.v:w:r.a a.�'... a..,w,.;•.;.�:,::;yY:•:::.::%::.,�::;{{.::{-{!o.:..:..-r...{....Y,..._.-....off h:.:��3:}}:::;x::..n .r.+..;�;:}:;:'<;%: TaEt`e Q.:::. .. ..�:.. .. . .....:,.:,;:.;.?:•::.T:�:�;::..,.,:::{:•:::;Y:<{•}::<:... . . ... ::.:::::.::::,: t.-�.,�{.as;.,,r,i.}.:.:{....;-.-}.{.a..{.;».,v..a�::.•.�::.:::::T bae to seems eoveta fe ae regait ed�det.Sa�iaa 2SA of MQ.152 am lead b tLe b oy►o of a�e to S or l rieamtrent as well as dyn P up 1.rxt and QLatxMd a years �p peaaltles fa the form of a STOP WORN ORDER and a sue of 5100.00 a day asainst nw I�eastana•that e 7 of this statement mey be forwarded to the OM of Invesligadom of the DIA for coverage verlscatim 7 hereby cerZ6 uodwthepains artd p edury duo the information provided above is true mid irect - nt name � .Phama# . Isicial use only do not write to this area to be completed by city or town oMcb1 ity or town: permlt/license# - Qguilding Departaaent chedclfbmmsdWe response is required __E3TJc=w6 Board Oseleetmen' Os sfee ontad person: phi#, ❑Health Department — ❑Othrr tviwd 9193 Pw �. • •HI .• • . 1/ / . iU_. �/ • . / 1• 1 - :/ • 1• Gifts •• 1/ • 11 u11./• • • • 1•/ II sh. toI N 1 I law.Mftia,P11 •II • • 1 • • • w•eI• • _ • • w • • • 1 w • I • /• s1kiffs 111-4 141 q II(&I RAI1 .11 I k I I11:1U•. .II I • • wr • 11 w 11 • 11 14of •1• II • 1 • • 1 1• • • • • m,1 • I• m1111• • w I •tI • • • 11 111 wI 1 r •11 • IT-"*(*1Igo I •.I • •1•. till 1 1 • • 11 • • • • •11 •I L • •i • • 1 • •1•• w• 142 11:1 • 1 1 1 • •_✓.1 • 1 I w/•11 • II w•1 • /_w11_• 1• • - .11 wI11• • •w • • w • •11 • •'.•/w •1 .1 1 Fifell 6 / V I I 1 I I 1 1 1 1 1 I :I 1 1 • 1 1111t!jUj 1 • 1 1 1 -+ 1 1 Y I 1 • 1 r 0-111 Its 1411th's hli1 1 1 1 11 1 1 - 1 / 1 ' 1 / 1 t / • 1 I - I • 1 • I 1 I 11 • 1 1 11 1 1 Y' 1 1 1 _I •• 1• •t1 I • 1 w1/• w •• • Is • •� 1 I •• 1 • 1•. • • 1• ✓. •• '1 •1I YI 1 _Ili.n 111 i .II r•Ilt• « • 11 •w • •11 .10 r • • / • • • •. I.1• Y. • •w/ r II r•11II• I r • ilI /I U 11 1 r _• 111 �,II w111 • /11 1 .11 Iw / •_�1 • w•1 _• • // •III• ••• "I 11 1/ 1 •. � r•I111•w1 `I:1• •1• . •• • . 1 r•III11 w/ I I_ .•11 • 1/ • •► II .1 .1• • • • 11 `111/ ./• •11 .1• • 1/ • 011110 -ifislAski11 • U w/. .11• • 1 HI 11 III •w•. •11 • 11 rw •J• t.•;U • 11 el .II r 1 i• 111. 11 I Is i• • / , • ••1 o•U •1 1 I11 •• « •••/Il 1•J r•I1111••• •1• •11 •1 11 1/•:11 r r• •w 1 • I I V �• I • 1 I 1 1 •1 • I 1 • 1 to • •1111 _•&talk II MI okAftl qooiqj�*j III /1 .1 11 .11 I ✓.1• •II •1 /I • w••111 •1 vw1 off 1_0 1 1 11 , . .• •N•••1 . 1 •11 .. « . w111 71 . . ' . 1 1 .11 1 / .� . .11 •••Y.1 . 1• • u • • • 1 / _I • • oil,i 11 WA- :4w r•11I1•_I♦:1• •11 *lei • ✓• 1 •I 1 _••: •II wIl .1 /1 I11111 •w 1_I • • ' • 11 /1 •I •1 itl • 1 r•II11• w1 .11 • • 1111_I .•V • 1 1 •% I/1 wIt 1 • • • _t • r .1 II • • • •1•I • • ' I H • 11 w •� -'1y _. wlw ••I IIIIII .w • •It•• _• 11 •• •wil•/1 rw/ 111111 . w • 1 / I I 1 •1 • 1•. 11 .. •11 w11 ► • 1• .) III . /I w . .II • .•••.•/1•. 1 ._�•1 11✓. . .. • 1 •� • •/.1•1911 •• bile talk 11 .11 r4h.,jejb*I,IF,Is k.r.II If. . .II • I w • . • • /U w•I •. w� ------------ • vials[ .11 • t'••' 11 II• •w ( 1 11 11 1 1 1 • 1 1.- 1 1 •11 1 1 1 1 . 1 1 1 1 1 I I 1112Py The Town of Barnstable • usivsrnars. . � g. Regulatory Services Eta5y��m Thomas F. Geiler,Director Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 3ff ce: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction..alterations,renovation.repair.modernization,conversion, improvement.removal.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors.with certain exceptions,along with other requirements. �G06U, G!� Type of Works Estimated Cost Address of Work: O fo Owner's Name: (,610 e Date of Application: Z I hereby certify that: Registration is not required for the following reason(s): C]Work excluded by law ❑Job Under$1,000 ❑Bui ding not owner-dccupied ner 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. i Date Contractor Name Registration No. . O _ 0 ee/� os Dace Owner's Name � c s v g 0 0 1 I o 4 i Town of Barnstable OE THE Tp� Regulatory Services r BaxxsrnBLE, = Thomas F. Geiler,Director y Mass. . a open MA �O` Building Division Pete F.DiMatteo'Building Commissioner 200 Main Street,Hyannis,MA.02601. Office: 508-862-4038 Fax: 508=790-6230' REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER (Permit required in order to process inspection) Today's'Date - I, hereby request and inspection under Massachusetts'General (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at (Property Location) Type of inspection requested: Temporary Service ❑ Service Reinspection ❑ Excavation ❑ Rough Reinspection ❑ Service Inspection ❑ Final Reinspection ❑ Rough Inspection for ❑ Final Inspection for ❑ Other Owner or tenant Licensee's name, address,and phone License number Licensee's Signature This section to be completed by Barnstable Inspector of Wires Inspection date []Approved pp ❑Not Approved This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: Q:WPFi1es:B 1dg:Elecrequest r ` k v� VM Q o g � F l \� 4 t � 40 A v> v) �. 3 � S 3 •�y o y- M Town of Barnstable �pE tME Tp� Regulatory Services BARNSTABLE, : Thomas F. Geiler,Director y MASS. 0a 4'peoM9- '1A Building Division Pete F.DiMatteo Building Commissioner 200 Main Street,Hyannis,MA,02601 Office: 508-862-4038 Fax: 508=790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER (Peraut required in order to process inspection) Today's Date - I, hereby request and inspection under Massachusetts'Ge'neral (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at (Property Location) Type of inspection requested: ❑ Temporary Service ❑ Service Reinspection ❑ Excavation ❑ Rough Reinspection ❑ Service Inspection ❑ Final Reinspection ❑ Rough Inspection for ❑ Final Inspection for ❑ Other Owner or tenant Licensee's name, address,and phone License number Licensee's Signature This section to be completed by Barnstable Inspector of Wires Inspection date ❑Approved ❑Not Approved This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: Q:wPFi1es:B1dg:E1ecrequest Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Checked By/Date TITLE:26 MOCO RD. CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE: Other(Non-Electric Resistance) DATE: 01/25/02 COMPLIANCE: Passes Maximum UA=95 Your Home=81 14.7%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Wall 1: Wood Frame, 16"o.c. 768 13.0 0.0 58 Window 1: Wood Frame,Double Pane with Low-E 66 0.350 23 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications,and other calculations submitted with the permit application. The proposed building has been r designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release 1 a. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date i MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release I DATE: 01/25/02 TITLE:26 MOCO RD. Bldg. Dept. Use Above-Grade Walls: [ J L Wall 1: Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: Windows: [ ] 1. Window 1: Wood Frame,Double Pane with Low-E,U-factor: 0.350 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? [ ] Yes [ ]No Comments: Air Leakage: [ ] Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [. ] When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. [ ] Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. Duct Insulation: [ ] Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints,seams,and connections of supply,and return ductwork located outside . conditioned space, including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ j The HVAC system must provide a means for balancing air and water systems. Temperature Controls: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. r . Heating and Cooling Equipment Sizing: [ ] Rated output capacity of the heating/cooling system is not greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Circulating Hot Water Systems: [ ] Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 OF or chilled fluids below 55 OF must be insulated to the levels in Table 2. Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating- Runouts Circulating-Mains and Runouts Temperature(F) Up to 1„ Up to 1.25" 1.5"to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping-System Types Range F 2"Runouts i" and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) i P� ti HARNSMILE, The Town of Barnstable MASS. Regulatory Services Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main-Street,Hyannis MA 02601 . office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION C/ Please Print DATE: JOB LOCATION: �� /G ��G /Z 0/ C/y /�z✓/�5�T4/�/ n b street �j� ,p ^� vjillage "HOMEOWNER": ; �yJ�7eP,��/ PP�`�(/l�/l a /yl a/7�olU,v name home phone#. work phone# CURRENT MAILING ADDRESS: �r'�/z�i10 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied-dwellings of six units or less and to allow homeowners to engage andridividual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Si cure of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states.that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such woik,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part.of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN r 2002 007 Application to T0`VVN 4)J6r ing'o 30f gbWap Regional J�i,5toric Migtric�- r 3 BARNSTAQI_E. MASO. 21D? Jt1H 16 AM 9: 10 In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS Application is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings, or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior building construction: ew El - Addition �Alteration Indicate type of building: ouse- ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other TYPE OR PRINT LEGIBLY: DATE 1 Z f&/-0 ADDRESS O PROPOSED WO E 0 ASSESSOR'S MAP NO. OWNER rio LC ov\'Q ASSESSOR'S LOT NO. QQ HOME ADDRESS J S� CtVA TELEPHONE NO a r l 10 O FULL NAMES AND ADDRESSES OF ABUTTING.OWNERS, including those of adjacent property owners across any public street or way. (Attach additional sheet if necessary.) vi 6 i AGENT OR CONTRACTOR TELEPHONE NO. ADDRESS DESCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be us Please include locations of proposed signs.Jill �g } P C. U / l / � / / 114 Signed Pe- Owner-Contractor-Agent PQ01 mr For Committee Use Only P IV V LLJ This Certificate is hereby Date C Ll V L� Approved/Den d U t 1, 1. 1 2001 Co ittee Members' Signatures: f Lk , &&24� TOWN OF BARNSTABLE ' Olin KING'S HIGHWAY r f f 2 002 001 Town of Barnstable Old King's Highway Historic District Committee S SPEC SHEET 1 FOUNDATION SIDING TYPE 1 fOt( t COLOR 1 , CHIMNEY TYPE n s COLOR t c,1,.L ROOF MATERIAL�� U ��`I°�^ (�� COLOR A PITCH 664 `I -1 C WINDOWS COLOR :ti�^Q. SIz � ,• /r� l33/ TRIM COLORPer) DOORS COLORS Ltd(/ SHUTTERS COLORS GUTTERS J 0 r COLORS `NIn,\ DECKS ! MATERIALS -17f0 1r\ W 06J GARAGE DOORS PpRnVFD ....COLORS SKYLIGHTS SIZE �— COLORS -� .1 ari j, SIGNS, 1 �, cz-±.1I \J COLORS 11 2001 FENCE ,-- r,"' �Af 1 COLOR r r r NOTES: Fill out completely, including measurements and materials/colors to be used. Four copies of this form are required for submittal of an application, along with Four copies of the plot plan, landscape plan and elevation plans, when applicable. SPECSHT Revised 11/98 w ,,,_ � Andersen Windows Unit Specification Report Project Name: Quick Spec Qu+ot®� 2147483647 Print Date: 12/11/2001 Quote Date: iQ Version: Page 2 Of 3 Dealer: Customer: Shipping Address: N Phone: SalesRe : Contact: I !,t�flli Unit site 24310.2 C) Unit Operation AAAA M Dimensions: Width® Height Unit: 4' 11 6/16" 4'1 1/4" Rough Opening: 4111 13/16" 411 1/4' Max. Clr, Open: 2'2 11/16' 1'8 g/le" Floor to Sill: 3'0 1/8" IV Projection: n/a Opening Specifications: CDiV Glass Area: 13.80 SQ FEET Vent Area: 714 SD FEET I C Max. Clr, Open: 3,81 SO FEET Extension Jambs: Not Applicable Andersen Windows Unit Specification Report Project Name: Quick Spec Quote#; 2147483647 Print Date: 12/11/2001 Quote Date: iQ Version: Page 3 Of 3 Dealer: Customer: Shipping Address: Phone: Sales Rep: Contact: Unit Size 3032 Unit Operation AA Dimensions: Width Height Unit: 3' 1 5/8" 315 1/4" Rough Opening: 3'2 1/8" 3'5 1/4" Max. Clr, Open: 2' 10 11/le" V 4 We" Floor to Sill: 3'8 1/8" Projection: n/e s Opening Specifications: N Glass Area: 7.20 SQ FEET C Vent Area: 4,00 SQ FEET _ C Max, Clr, Open: 3,99 SQ FEET Extension Jambs: Not Applicable U t J STAB LE _ `;H1AIA r Line Item#. 0001 Line Item Qty: 2 Location: 2 ® 0 Ifiitial: RO Size=6'315116"Wx4'11/4"H Unit Size=6'3 5116"W x 4'1 11,1 H - 400 Series, Double-wide Units Unit Code/Itemem Size: 30310-2 Operation/Handing:AAAA Part Number. 1606548 Exterior Color: White Interior Color. Clear Pine Glass Type: High Performance Screens: Insect Screen,White Standard Hardware: Standard Lock/Lift Hardware-Stone Comments: Qty Part Num Item Size Description Total Price Extended Price 1 1606548 30310-2 Unit,White/Clear Pine with High Performance $ 428.93 $ 857.86 Glass 2 1610138 30310 Insect Screen, White $ 41.67 $ 83.34 $ 470.60 $ 941.20 SUBMITTED BY: SUBTOTAL $ 941.20 TAXES( 5.000 %) $ 47.06 ACCEPTED BY: GRAND TOTAL $ 988.26 DATE: APF"ROVED DEC 11 2001 QUOTE: 000597 Print Date: 11/20/2001 Page 2 Of 2 iQ Version: iQ1.3 f Town of Barnstable *Permit# 7 r Expires 6 months from issue date sUttvsrnsi e. : Regulatory Services Fee ; -...— �,►S. v� 1639. ,�$ Thomas F.Geiler,Director plED Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 w �-PRESS PERMIT ®M I T Office: 508-862-4038 I" I'C I Fax: 508-790-6230 FEB 1 5 2001 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint TOWN OF BARNSTABLE Map/parcel Number ��06 Pro2sidenOR ddress b 6 cal ); D �,i rn,l A,/4f tial ❑Commercial Value of Work3 QO. Owner's Name&Address h C-vt 6�a `^' /�� •it �l� lit Contractor's Name Telephone Number?F/ - 7 S /0 7 Home Improvement Contractor License#(if applicable) Construct;on Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I ole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit R;�Reroof t(c ox) /'C aa �' �, !� �� vSl�►f SS� O l/Po� � ���f •7 Cl' - (stnppmg old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature o2 -/S`d expmtrg f ` r) Map ' 071�5_ Parcel 60 Permit# �I House# �,� �� • �- Date Issued �- Board of Health(3rd floor)(8:15 -9:30/ 1:00-436) 60 Conservation Office (4th floor)(8:30-9:30/1:00-2:00) ' .AYAK SEPTIC SY MUST BE Planning Dept.(1st floor/School Admin. Bldg.) INSTAL LE LIANCE Definitive Plan Approved by Planning Board 19 VU ENV IRON DE AND TOWN OF'BARNSTABLE TOWK` .24, Building Permit Application Project Street Address /t//b e d Village Gl�. tr�t/IS`f�-61P Owner f7 ,�a�G bSS�C6�-P Address` /_V 6" O�Q Cl 61) &,-/157410 6�P .,.Telephone 0 / 7- 7.71-0 3S Ce!/ 'Permit Request 4,014-eel- (@.-t1- I-QzWd r,& f First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ G. n a Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure r-5 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.ft) Number of Baths: Full: Existing / New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing (o New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil &Electric ❑Other Central Air ❑Yes dNo Fireplaces: Existing New Existin wood/ al stove @' 'es ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑/Barn(size) ((None In Shed(size) X ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# - Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRU ION DEBRIS RESULTING FROM THIS PROJECT WI L BE TAKEN TO SIGNATUR DATE �— 49t BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) r , FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE,OF JNSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: dROUGH FINAL GAS: F�I�UUGH FINAL FINAL BUILDING M f� 0 DATE CLOSED OU ' ASSOCIATION PL 04 NO. �' • � The Town of Barnstable • ,�srtsr�,eta: • 9 'm �e�' Department of Health Safety and Environmental Services � "9. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissio-e f For once 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. Type of Work• '�Jc��/� �p/a - Est. Cost f 00 Address of Work: T► Owner's Name Date of Permit Application: L .�� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied 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 X2 _d9. 9e- Date Owners Name The Commonwealth of Massachusetts : � � � Department of'Industrial Accidents Oflice af/nyeafffaffew 600 Washington Street Boston,Mass. 02111 Workers"Compensation in�s:,�u�/rann/c�/ee Affidavit riiiJIFVj/r�r/1ri/////i�ir////iti��iiiiirirm ���������/�������������� ; riiiii�t(cif'Yi.U"t /rtIi'i/���������������������������������%/%%ir.•: name /l Ot? -4 y6d 1-6 Q/Q, ASS C-0 tiP location a�to� city Z4) • ll i'/7S7�C J/P ALL ff' hone 7 71-05 3,5- I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. com anv name: address- city _ phone# olicv it insurance co. ❑ I am a sole proprietor, general contractort or homeowner(circle one) and have hired the contractors listed below who i have the following workers' compensation polices: company name: address: .::::.:.. ........... ty phone ci #• :.::.;::<:.:.:...:.:.:•:::•:. :.:.:: insurance co. ......... . cam anv name- address: phone#: dtv- insurance co.. VIN / /% Faaure to secure Coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to SI.500.00 and/or one years,Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a ane of SI00.00 a day against me. I understand that a copy of this statement may be forwarded to the OfIlce of Investigations of the DIA for coverage verification. 1 do herebv certify tut the pains and penalties of perjury that the information provided above is truo and correct Sigsiature � Date J`-o��� �r ff- _ -J�- Print name Q/�Q rCL O 5 S, C A ,c 0 Phone f� ofltdal use only do not write in this area to be completed by city or town official d permit/Ucense 0 QBuilding Department city or town:— QLtcensing Board . ❑Sdeetmm's OtIIce ❑checkif immediate mQonse is required C3gealth Department contact person: phone#• ❑Other (maw 9,95 P)A1 Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual;partnership, assdciation, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a "dwelling house having not more than three apartments and who resides,therem, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or.FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of IndustriaUAccidents , Me of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE j- 9 JOB. LOCATION Number Street address Section of town "HOMEOWNER" Name Home phone Work phone . - PRESENT MAILING ADDRESS 5 �, • t q c�� - City town State Zip code The current exemption for "homeowners" was extended to include owner-occupies.: 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 (s)' 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 Offici on a form. acceptable to the Building Official, that he/she shall be resnonsib 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 Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE o 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. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which--Fa=-building permit is required shall be exempt '-from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that ii Home Owner engages a person (s) for hire to do such work, that such Home Owr. 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 awaren 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 'Owner act., as supervisor is ultimately responsible. To ensure that the Home Owner is fully` aware• of\ his/tier responsibilities, mz f:mmunities require, as part of the 'permit application, that the Home Owner -.-.rtify that he/she understands the responsibilities of a �supervisor. On th Nast pacgetof .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. } \1 CD N Of^D7� �t0 O • I � O y N • I � 11 A ---------- ol , 1 TOWN OF MASSACHUSETTS BUILDING Dr✓I'nl? I MEN f s•—r O.C. (hW...) XB CONTINUOUSW POsr --- ..._..._......---._. 4 WOOD 2X6 NAILER BEYOND 2 X 2 BALUSTERS 4' CLEAN SPACE DETWEEN-Q4AY..)___- --'----- END �.. LLe 1/r O.C. a- CLEAR (MAX.) RAIL PLAN ?;' NOTE: THIS TAPERED CAP ;• DETAIL IS FOJINFORMATIONAL PURPOSES ONLY. EACH INDIVIDUAL DECK FRAMING DESIGN 7 . SHOULD BE CHECKED BY A REGISTERED ITS -//O STRUCTURAL ENGINEER TO INSURE 'S 1X3 TRIM BOARD xC SAFETY AND CONFORMANCE TO THE LATEST � 'REQUIREMENTS OF THE MASSACHUSETTS STATE 2 _ NAILER BUILDING CODE 2 X 2 BALUSTERS 4 ET MAX. CLEAR SPACE BWEEN `,l 6 S' 06 WOOD POST AT 5'—J D.C. MAX, i CONTINUOUS TO FOUNDATION yr; ' 'D s , r SIDING 1i0H6 NAILER 20 OL. ALUM. FLASHING •;r 4X4 ALUMINUM PLYNTH BLOCK SPACER _ _ �DECKING A/ Y i 01D.C.A O TS a C( (---- i— 2 — l BEAM •'y SfACGER I THROUGH BOLT TO EACH POST ' 1' AIR SPACE STAGGER, DECK JOISTS AT 1B' O.C.7 i•-- WITH TWO 3311C DIAMETER BO_TS SHEATHING 2X0 HEADER LINE OF METAL JOIST HANGER AT SOTH ENDS OF BUILDING 1XB LEDGER BOLTED TO SOLID BLOCKING EACH JOIST 4 1 W/ J/4 LAG BOLTS 2'-B' O.C. STAGGER SEAL BOLT HEAD T CONTINUOUS 4X6 WOOD POST • ''I L20 OZ.ALUM. FLASHING 10'-0` MAX. SPAN W b Z V 7 ALL DECK FRAMING TO BE PRESSURE TREATED 0 - METAL POh�TT ANCHOR .. .. ( WOLMANIZED .40 LBS./CU. FT. ) / �� (!," > . p ER CONCRETE BASE ALL HARDWARE &NAILS TO BE GALVANIZED 'MIN. 4'-0' BELOW GRADE � I I t0 I I LINE OF GRADE 1 KRECOMMDNDED DECK CONS'1'1ZUC'1'ION TO SCALL 3/90 _i i J � '7 >,