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HomeMy WebLinkAbout0016 MORGAN WAY WA, J � 1 A- UPC 12643 �y No�LO HASTINGS,YM �. � �� ���c�N� � � e r� , � o �- .��, i .: _ - - - -.; r . , . .�� .. . .: �fi F f =PRESS P ER%Twn of Barnstable *Permit# 0 ( �1 Z C9cf Expires 6 fra date Regulatory Services Fee r r MAR -4 2013 g �' • IA LMAJME,MASS. Thomas F. Geiler,Director 1659. A. Yl N ®F BARNSTABLEBuilding Division Tom Perry,CBO, Building Commissioner ll1 200 Main Street,Hyannis,MA 02601 C www.town.barnstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS P RNIIT APPLICATION - RESIDENTIAL ONLY ( } Not Valid without Red X-Press Imprint Map/parcel Number �" Property.Address U— t CQ oD jaesidential Value of Work JD Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address I�A? BOA G6 KONNJ QJA e je—Lffi �► Telephone NumberContractor's Namer ibL•t ii�" Home Improvement Contractor License#(if applicable) l of t)n Construction Supervisor's License#(if applicable) ( �b ❑Workman's ompensation Insurance C one: LVI I am a sole proprietor 0 I am the Homeowner f ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Re st(check box) r Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 15aw 8� Q ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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 required. SIGNATURE: Q:IWPFILES\F05JVMw7ding p rmsUeRESS.doc l Office of Consumer Affairs Business Regulation License or registration valid for individul use only IU'HOME`IMPROVEMENT CONTRACTOR before the expiration date.. If-found return to: Registration: ti'1:50950 Type: i Office of Consumer Affairs and'Business Regulation I _ 10 Park Plaza-Suite 5170 Expiration:_`5L872-, DBA ;. = Boston;MA 02116 a PETER J.SMITHCH;O:NiE=I;MPRQVEMENT .PETER SMITH 3925 MAIN ST: ,,. CUMMAQUID, MA 026'3 *" i r Undersecretary . Not va 'd ithout signature ilkhssachusetts- Deportment of Public Safety. Board of Building Re,itilations and Standard Construction Supervisor Specialty License ..License: CS SL 99486 Restricted to: RF,WS. PETER SMITH. PO BOX 36 CUMMAQUID, MA 02637 Expiration: 11/1/2013 ('ununissiimer Tr#: 7029 . Ile Commomsveafth of Mrrssacha&'ft Dq arimeixt aflndustritd 14ccidefs t— O,flke of Fnves4 atiow 600 Muhuxg#iifa A-eet Boston,M-4 92111 rwrwrv.amass.gov/dia Workers' Compensation Insurance davit: Bl�didersfContractor,,JEleciiiciansfPlumbers Apphcant Information Please Print Le6b-1 f Nmea (B„ /( tiQn/fmdiaidual): Q�� : Ad&m: po F,-)Ox CityfStat�el2ip= J � �O Phone* Are you an employer?Check the appropriate bow Type of project(required):1.❑ I am a employer with 4- ❑ I aunt a general contractor and I ptoyees{fall andlor pat-time). * havebired the sub-contractors 6- ❑New construction 2_ I am a sole proprietor or gartrEer- listed Thean he attached sheet 7. ❑Remodeling strip and have no employees empl sob contractors have g_ ❑Demolition. w Q for me in employees and have W+�t.�ers' any capacity- 1 9.• ❑Budding addition [No workers'comp-Insurance comp-insurance required.] 5. ❑ We area coapontion and its l0.❑Electrical repairs or additions 3.❑ I am a homeDwner doing all work officers;have exercised their 11-❑P bin repairs or additions myself. [No workers'comp. right of exemption per 1v1GL 12. Roof repairs insurance required.]T C. 152,§1(4)and we have no employees_[No workers' 13.❑Other comp.insurance required.) 'Any appllcmA that Checks box#1==also tallow the secticm below showing cheer vuAers'compensatLen policy mfbn=tiaa 1 Bamemnes who submit this affidavit indi:cstng they are doing aawade and then hue outside contrvctars submit a new affidavit huftc=Z sorb_ ox tContractm that cherk this b must attached as addition-1 dwxt showing the nsme of the sub-comma and state whether ar not these endues hsee emplares. If the sab-contractors have emplafees,Pir nnrstpmvide their markers'warp.policy number_ I on an employer that is providing workm'corrgw arisrr insurance far my errrpinl'ees, Betom is tha pe�Iic�*and job site informdion. Insurance Company Name: Policy#or Self-ins-Lic.# Expiration Date: Job Site Address: tQ Q CitylStatrJZip: 36 Attach a copy of the workers' _ eusation policy declaration page(showing the pol icy member and expiration date). t7- -0 Failure to secure coverage as required under Section 25A of hr1GL c. 152 can lead to the imposition of criminal penalties of a fine up to S 000.00 andlor one-year imprisonment,as w e11 as civil penalties in the form,of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that a.c:opy of this stateameret may be forwarded to the Office of Investigations of the DIA for insurance coverage vedEcati uL I dip hereby 19;t-b under thepmns and,(vna s rrfFevYkq drat the informidion pro'77713 is brae.and correct S Date: Phone#: Offw&l use only. Der not write in this area,to be coniplated by city or to m o,,(jicial. City or Town: PermitUcense At Anthadty(curcle one): 1.Board of Health 3.BwMng Department 3.Cityll'own Clerk 4.Electrical Inspector 5.Pbqmbaeg Inspector 6.Other Phone#: - � .. ,j j . .r �- 1 • � _ r� .� /• �,/ i •R.rF1 a . � ' /lL - . �;�; �:= r - . ` �� �� _ I ,„�� r. �. ,:1..- ` � _ ,� � - '�� I a��• � - � � � C> _ ' . .i ��.`. �� ; - ��` OF IKE ram. * HARNSTABL& 9� ,�� Town of Barnstable pTED MA't a .. Regulatory Services j Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ' Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section • If Using A Builder I U,� ✓� ���< as Owner of the subject property pu'hereby authorize `3t�^rr Ce to act on my behalf, in all matters relative to work authorized by this building permit application for: ddress of Job) d e Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on,the reverse side. QAWPELESTORWbuilding permit fortns\EXPRESS.doc �ofT ram, Town of Barnstable P o ' Regulatory Services BARNSTABLE• ' Thomas F. Geiler, Director 9 HASS. �ATfnt',►go Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 r www.town.barnstable.ma.us Office:. 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: � number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Of 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.' Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 15,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1..1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction.Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. i MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108-1904 (617)723.3800 Ma Only(800)392.6108, FAX(800)851-8424 9/7/2012 Form of Notice of Casualty Loss to Building Under Mass.Gen. Laws,Ch.139,Sec.36 BARNSTABLE BUILDING COMMISSIONER 367 MAIN STREET 367 MAIN STREET HYANNIS MA 02601 Re: Insured: BARBARA BOOTH Property Address: 16 MORGAN WAY,WEST BARNSTABLE, MA 02668 Policy Number: 1033277 Type Loss: Lightning(not resulting in Fire) Date of Loss: 09/05/2012 Claim Number: 304296 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate,please direct it to the attention of the writer and include a reference to the captioned insured,location, policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 1 i; - N 00 006 LOT 16 LOT 166 z 16,895 S.F. 0,39 Ac. ti 09 GQ °QY i� ItK t i S9� LOT 167 ••� Of o o �, !q WIL'LIAl1S I N Y E ,q No. 19334 /�?v yr, CED PLOT PLAN I CER TH THE FOUNDATION I SHOWN HERON COM YS TH THE SIDELINE IDC=N CENTERVILLE AND SETBACK REQU REM TS OF THE TOWN OF WEST BARNSTABLE . BARNSTABLE, AND I N LOCATED WITHIN THE hiCgI&1"=40' 4/29/96 FLO'ODPLAI . DATE: R.L.S. P3�E�T-.RF,P'SItENCE LOT 166 THIS PLAN IS NOT BASED ON A I TRUMENT PLAN BK. 439 PG. 17 SURVEY AND THE OFFSETS SHO NOT BE USED TO. DETERMINE LOT LINES. BAYSIDE BUILDING CO. INC. I� LEGEND gsv S=Hil -� PROPOSED CONTOUR ® PROPOSED SPOT GRADE- S/'C \ --g$ -- EXISTING CONTOUR I + 96.52 EXISTING SPOT GRADE L O 66 96 BENCH MAR ____W— EXISTING WATER SERVICE h AREA = 1689 f +- / PAINT SPOT ON TEST PR �pY / 98 LANDSCAPE TIE 5 FT. SOIL REMOVA /// 'e ELEVATION T. 104.76 (see note 18) �� // \ BARNSTABLE CIS DATUM AWO /tao WAY WAY 102 ExistinQEeach PIt ��/ / LOCUS MAP N.T.S. —(See Note /i Qa GENERAL NOTES: ' / .y. 106 / / 1 6 —2 �// 1. ALL CHAWOES TO THIS PLAN MUST BE APPROVED BY THE LOCAL 96 // / DONRO OF HEALTH M!D THE DESIGN ENGINEER. 108. 2. ALL WORK k D MATERIAL$.SHALL CONFORM TO THE REQUIREMENTS I OF THE STATE 04YOMMEMAL CODE, TITLE V. AND ANY APPLICABLE 1; i10 LOCAL RULES AND REGULATIONS. EXCEPT AS REQUESTED BELOW: I: rn // sc' / // / - ��� / / - 310 CMR 15.405 (1) (9): 112 1) UP TO A 1.5 Ff. VARIANCE FROM 310 CMR 15.211 TO ALLOW 20 114 . LEACHING TO BE UP TO 4.5 FT".BELOW GRADE VS REO'D 3'FT. (VENT PROVIDED) / I 3.THE SPOSAL SYSTEM SHALL NOT BE BACKFILLED'PRIOR TTpp AND APPROVAL BY THE BOARD OF HEALTH AND THE .98 DESIG� EER. �i 4.ANY ENCOUNTERED DURING CONSTRUCTION DIFFERING y �- �i�`�� cif- _-- FROM SHOWN HEREON SWILL BE REPORIFD TO THE DESIGN c� ENCMCI�IE CONSTFLUCITON CONTINUES. 5.ALL ELEVATKINIS BASED ON ASSUMED DATUM. tiH O ��`` �! / S.THE 0 IS NOT RESPONSIBLE FOR THE FAILURE OF 1 /7] \ OR OWNER TO NOTIFY THE: LOCAL BOARD OF p \' -- �� HEALTW F PRr�RRRISPECTIONS DURING CONSTRUCTION. 10 �\ / i / / O T! 7.AWUATER SUPPLY PROVIDED BY TOWN WATER SERVICE. 102� // / j OO v/ / lv % /// 8.PO A RESTORED �NDfRgi A�L,(2WEEODUPIOi 6�ETW OWNER ANDSHALL CONTRACTOR. / / / ❑ y q Gi2 9. IT SHALL BE THE RESPONSIBILITY OF THE CONTRACTOR TO VERIFY ' 104 1> �•r` \C//V / / Q THE LOCATION OF ALL UNDERGROUND UTILITIES, PRIOR TO BEGINNING �116 ,Iu CONSTRUCTION. 106 // 1 © i l / _ / cr 10. EXISTING LEACH PR TO Br P4MP®. CRUSHED AND REMOVED \ yP •r // Q 11. 48 HOUR NOTICE FOR ENGINEER CERTIFICATION 108 .12. THIS PLAN IS TO BE USED FOR'SEPTIC SYSTEM PURPOSES ONLY O AND IS NOT TO BE CONSIDERED A PROPERTY LINE SURVEY r Q�S/ '� 118 _ 13. NO PRIVATE WELLS WITHIN.ISO FT. OF PROPOSED LEACHING 64•�3 / 14. ALL PIPING TO 8E 4- SCH 40 ® 1/8-/FT (UNLESS SPECIFIED OTHERWISE) OF (RSf it // //O - Iu0 O 15. THE DESIGN OF THIS SYSTEM DOES NOT ALLOW , O FOR THE USE OF A GARBAGE GRINDER DA cis 114- - ------ - / 16. NO WETLANDS WITHIN 1DO FT. OF PROPOSED LEACHING 17. PROPERTY IS NOT LOCATED IN A ZONE OF CONTRIBUTION. -' ----'/ ./:120\�� 18. REMOVE ALL UNSUITABLE SOILS 5 FT. AROUND LEACHING TO EL. 95.92 OR TOP OF Cl LAYER AND REPLACE WITH CLEAN MEDIUM \ SAND. PROPOSED SEPTIC SYSTEM UPGRADE PLAN 16 MORGAN WAY, W.. BARNSTABLE, MA Cj Prepared for: Jock Thomson n�f Jam,, n e� EnglneeAng by. survey6g by: SCALE DRAWN B. NO. SURVEY REFERENCE: `�"�vn �'-" �`/�'�` LOr032 DARRENU MEYER RS ALm-2wa6 A3rLroameAw i 1"=20' •DMM. PLAN OF LAND BY DOWN CAPE ENGINEERING DEED80OK 10721 POBOXM' (508) 364-0894 DATED: DUNE 16, 1987 EA8T3ANDWICN.MA02S97 DATE: CHECKED SHEET N0. DEED PAGE- 12/12/07 DMM 1 of 2 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map / Parcel' " �3 Z ;~; 'Application # Health Division - ,`Date Issued Conservation Division " .Application Fee Planning:Dept: :Permit Fee: Date Definitive;Plan Approved by Planning Board Historic _ OKH' Preservation/ Hyannis Project Street Address /A . '1147H Village ���g Owner Address �5_11�-�- Telephone S 0 Ir 1!� 3"J— Y/0 9 Permit Request _�.h , 3 6 , lop;?e • Square feet: 1 st floor: existing ?40 proposed 2nd floor: existing 206 ew- Zoning District: Flood Plain Groundwater Overlay Project Valuation �� do 0 Construction Type Lot Size Grandfathered: ❑Yes tJTNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 20 Historic House: ❑Yes ;No On Old King's Highway: ❑Yes INo Basement Type: ❑ Full ❑ Crawl Af Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) a d i Number of Baths: Full: existing Z new Half: existing new Number of Bedrooms: 3 existing_Znew Total Room Count (not including baths): existing -7 new First Floor Room Count Heat Type and Fuel:A Gas ❑ Oil ❑ Electric ❑ Other Central Air: dYes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes eNo DeJaeged-garage: ❑ existing ❑ new size_Pool;Zexisting ❑ new size art❑ existing ❑ new size_ Attached garage;,l?fexisting 0 new size _Shed existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # m Current Use Proposed Use C-) V' T APPLICANT INFORMATION 21 (BUILDER OR HOMEOWNER) r N c Name Telephone Number 7 -)�_7 r' Address Ws c License# .S �R 7­1 Home Improvement Contractor# Worker's Compensation # G✓C Z-3�s �/7 i / -o ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE /G/ DATE FOR OFFICIAL USE ONLY ',APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION .FRAME BfR 01'e O 3 INSULATION X of D� 09 RjP; FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 11 t DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts ,Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le�ib1Y Name (Business/Orgmuzation/Individual): /07As s Address: C l r G I-t— City/Statdzip: �r 0.►,r+ ;sue 147-01 OZ 60) Phone $ ) 2 % Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a emiploycr with 4. ❑ I am a general contractor and I 6. ❑Kew construction employees(full and/or part-tinoc).* have hared the 5ttb-contractors I am a'sole proprietor or partner- listed on the attached shLct 7. R- modeling 1 ship and have= employees These sub-contractors have $. Demolition working for me in any capac employees and have workers' ity. 9. ❑Building addition • . [No workers''Damp. inc�rrarCC comp Insurance.t 10_ Electrical re airs or additions rtquirrd.] 5. ❑ We are a corporation and its p 3.❑ I am a homeowner doing all work officers'havc exercised their 11.❑Plumbing repairs or additions mysclL [No workers' comp, right o£exemption per MGL 12.0 Roof repairs incrrran�requiard]t P. 152, §1(4), and we have no 13.❑ Other et�Iloyees. [No workers' comp.msuranco rcgturcd] *Any appiicant that cbcc)a box#1 mart also fill out the reC6on below showing their work=V mrapcasatim policy information t Homaowocn who submit this af5davit indicating tbcy arc doing all work and then hint outside cantractors must cubnrit a new af5L-Y it indicating such. ICantraetom that ebcck this box mast attamhcd an additional cbmt,showing the name of the sub-contractnrs znd state wbcther ur not those cndtits have employers. kthe sub-contractDrs have crriploycec,they must pnrvidb their woTiccn,comp.policy nrnnber. I am an employer that is providing workers' compensation insurance for my employees. BeLaw is the policy and jab site information. Insurance Company Name: C ) �����{ ,Z7, An o• / Policy#or Self--ins. Lic. #: P/C L- - 3 7 z�.I) - 0 3 T Expiration Datc: l d 3 o Job Sitc Address: / Yl a ,e �, City/StatdZip:-=Z, P, 't Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to scctn-c coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimiri al penalties of a fins up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Bc advised that a copy of this statcmcrit may be forwarded to the Office of Investi tiaras of the DIA for incnrancc coves c vcrifficatiou, I do hereby certify under the pains•and penalb:es of perjury that the information provided above is true and cornea Simatare ' Date 6 — Phone# f D -e 7 1 7:1 .Official use only. Do not write in this area, to be completed by city or town off City or Town: Permit/Licewa# Issuing Authority (circle one): 1. Board of Health 2.Branding Department 3. City/Towu Clerk 4.Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone#: i Massachusetts Gcmral Laws chapter 152 requires all employers to provide workers'compensation for their cmployecs: pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written-" An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing.engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of anindividual,partnership, association or other legal entity, employing employees. Flowcvcr ,the owner of a dwelling house having not more than three apartments.and who resides therein, or the occupant of the iwclling house of another who employs persons to do maintenance,construction or repair work on such dwelling house )r on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." xlGL chapter 152, §25C(6) also states that"every state or Iocal licensing agency shall withhold the issuance or -enewal of a license or.permit to operate a business or to construct buildings in the commonwealth for any ipplicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Vdditionally,MGL chapter 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall Inter into any contract for the performance of public work until acceptable cvidcnee of compliance RZth the m-miame cquiremenfs of this chapter have been presented to the conlraLting authority. ,pplicants Icase fill out the workers' compensation affidavit completely,by checking the boxes that apply tm.your situation and, if cccssary,supply sab-eontractor(s)name(s), address(cs) and phone numbcr(s) along with their ccrtificate(s)of mn-ance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no-cmployccs other than the jcrnbers or partners, arz not required to carry workers' compensation inmirance. If an LLC or LLP does have mployees, a policy is required. Be advised that this affidavit may be submitted to the Dcpartment of Industrial ccidrats for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should returned to the city or town that the application for the pcn33it or license is being requested, not the Department of idustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' ,mpcnsation policy,please call the Department at the nurgber listed below. Self-insured companies should enter their elf-insur-,mGo license number on the appropriate line. ity or ToWP Officials case be sure that the affidavit is complete and printed legibly. The Dcpartrnent has provided a'space at the bottom 'the affidavit for you to 0 out in the event the Office of Investigations has to contact you regarding the applicant case be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant rt must submit multiple permitllicenso applications in any given year, need only submit onp affidavit indicating current trey information(if necessary) and under"Job Site Address" the applicaiiit should write"all locations in (city or um)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the plicaat as proof that a valid affidavit is on fide for future permits or licenses. A new affidavit.must be filled out each ir.Whero a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture :. a dog license or permit to bum leaves etc.) said persog is NOT required to completz this affidavit c Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, ase do not hesitate to give us a call Depa;.iment's address, telephone-and fax number. The C6mmonwwlth of Massachusetts Dq)ai�Dnt of kdustrial Accidents Office of Investigations 6.00 Washington Street Boston, MA 02111 Tel. # 617-727-490.0 ext'4.06 Gr 1-V7-MASSAFB Fax# 617-727-7749, . 11-22-06 www.mass.gov/dia Er y 'ToWn of Barnstable Regulatory Services pius� � ThomasF. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsta ble_ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This'Sectio.n If Using A Builder as Owner of the subject property hereby authorize_- 5$2:-r,X-C L, o�.d lt\ to act on my behalf, in all matters relative to work authorized by this building permit application for: 6' /70 44 (Add-ress of job) Signature of Owner Date ems- h.a. . Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th:e reverse side. Town of )Barnstable H�of THE Tp{ Regulatory Services Thomas F. Geiler,Director • swxrrsrwst..>:. 13A Building Division 16 Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 R•ww.town.barnstabl e.ma.us fice: 508-862-4038 Fax: 508-790-6230 ROhfEOwNER LICENSE EXEMPT70N Please Print DATE: JOB LOCATION: village number itrcct g "HOMEOWNER": work phone# name home phone# ,. CL RRENT MArUNG ADDRESS: city/town state rip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on'which he/she resides or intends to reside, on which there is, or is intended to- . be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a Iwo-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. Me undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department ,,;n=um inspection procedures and requirements and that be/she will comply with said procedures and •equirements. :ignaturc of Homeowner I •ppro`'al of Building Official Note: •Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the tate Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION i The Code states that "Any homeowner performing work for which a building permit is required such gvircd shall be exempt from the provisions 'this section (Section 109.1,1 -Iiemsing of construction Supervisors);provided that if the homeowner engages a persons)for hire to )rk,that such Homeowner shall act as supervisor:" Many homeowners who use this exemption an unaware That they arc assuming the res s often e u is a supervisor(sec Appendix Q. Iles&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly un the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it'would With a iiccnscd peryisar. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her rrsponsibilitics,many co mmunitiu require,as part of the permit application, .t the homeowner certify that he/she understands the responat-bilitics of a Supervisor. On the last page of this issue is a form currently used by rcral towns. You may care t amend and adopt such a fomi/ecrtification for use in your community. • I I I `} 74 &aar.�no�ecueialC!'o�/�aaa�ivaetla Board of Building Regulatio s and Standards_ Constrfiction Supervisor'Licensed rt a License CS 58987�,sF Expiation ti 1 Restriction_80 STEPHEN E BOBOLA: r ' 24 S.T FRANCIS HYANNIS,MA 02601 Commission -er ' I _7& e.uue.a o�/flaaaaclauertla Board of Building Regulations and Standards License or registration valid for individul use only I _ HOME IMPROVEMENT CONTRACTOR before the expiration date: If found return to: f Board of Building Regulations and Standards Registration:\158588 - Expiration:-2/11/2010 Tr# 264154 One Ashburton Place Rm 1301 !' '' # =—ern Boston Ma.02108 �1= Tjrpe:=Partnership •i MASS BUILDING-SYSTEMSv STEPHEN BOBOLA = 4 i 24 ST. FARNCIS CIRG HYANNIS,MA 02601 Administrator Not va id�tsii For aA96,LA GC- Cwh-C.Yi4 elv 114I x%S tr.s i✓I 0W+ 6 /70t�v,�, �{�' off (A C l 15Al 1 AA �� Q e-n r,-4 c4td p/Ld'a n �tia.r i n gJ1+1s►1 S , Its tA zy r y a �--- 3 6 -� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map '7 S Parcel 0 3 f2, Application# ��G�o Health Division Conservation Divisions Permit# Tax Collector Date Issued O I d ZJ Treasurer Application F Planning Dept. Permit Fee ate- Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village V)~ —&4- Owner / 600 Address /4 h,U04"l Aj •l Telephone Permit Request �/✓ �� 46 x/ 1 q,7rP/ bAieo Square feet: 1st floor:existing proposed.S� 2nd floor:existing proposed Total new J 1A I Zoning District Flood Plain Groundwater Overlay Project Valuation 600 Construction Type 07-el 4,,k��� 1/i,j y L Li.�N� Lot Size 4 915— Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure �4, Historic House: ❑Yes No On Old King's Highway: ❑Yes No Basement Type: UV ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3� Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing? new Total Room Count(not including baths):existing new First Floor Room Count i ,.,at Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air: Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes CY No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existin' ❑ne X 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# a Current Use Proposed Use oo m BUILDER INFORMATION [C `— Name �f�k&to &�A/OSU Telephone Number 309 0 77 g Address,3y13 MAN 5j License# 60 ?63 5 S+A57-4 Ole r M,+ 0,�6 31 Home Improvement Contractor# 10 6 0 o g Worker's Compensation# 700 57 01 DO 7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v / w I_ f�( SIGNATUR DATE G —3 - O� FOR OFFICIAL USE ONLY r - r PERMIT NO. ' DATE ISSUED ; MAP/PARCEL NO. B ADDRESS VILLAGE OWNER DATE OF INSPECTION: ` 3 FOUNDATION ��L 1 p3 R FRAME INSULATION 'FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - .GAS: ROUGH FINAL FINAL BUILDING c $ ., DATE CLOSED OUT, ASSOCIATION PLAN NO. ,M The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers" Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information c / Please Print Le 'bl /In Name(Business/Organizationdividual): . I (._kA-,w v•� �51�t Address: _3q(3 0444eJ 5 � City/State/Zip: 13Q"5r-,4 te, . Aft— 0-b30 Phone.#: 50(( 3 C Z^97? / Are you an employer? Check the appropriate bog: Type of project(required):. 1. am a e to er with ( 4. ❑ I am a general contractor and I mP Y 6. ❑New construction . employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' Y P t5' $. 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] - 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their IL 3.❑ I am a homeowner doing all work ffi h id h ❑Plumbing, g repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs- insurance,required.]t c. 152, §1(4),and we have no ' employees. [No workers' . 13.0 Other SW kmm l d G 4-0 comp. insurance required.] . 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. I Insurance Company Name: UTO ` us• C 0 Policy#or Self-ins.Lic.#: 70 OS-5 7 5 d 0 0 7 Expiration Date: — 1 - ` Oe Job Site Address: b Momoo Why City/State/Zip: �. ��Nd7/� go- pg� Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for' urance coverage verification. I do hereby ce and he ailts-and penalties of perjury that the information provided above is true and correct � SiEnatme: Date: 6 Phone#: Jig ' 3 bZ~ 6 I Official use only. Do not write in this area,tb be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions s. Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two,or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the' dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer." MGL chapter 152, §25C(6)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,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of cornpliauce with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in {city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. g The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. Jhe Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-IvTASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.go-r/dia Town of Barnstable. Regulatory Services STASI9WAM '$ Thomas F.Geller,Director �p 36j9- A,� Building Division JFD MAC Tom?erry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www-town.b arnstable.ma.us Office: 508-862-403 8 Fax: 5 08-790-623 0 Property Owner Must Complete and Sign.This Section If Using A Builder as Owner of the subject property herebyauthorize i �,� Gy1 os��. to act on my behalf, in all matters relative to work authorized by this Molding permit application for; / /'12 o v- Gt 4 h/ & p14 DZ6 6F Address of Job) o� Signature of Owner Date Print Name QFOP�5:0 vTIVHRPBRMLSSION ' N fT CoDe . 9,��-S SPL�C�Ds -ro 13 e LG a-K�06 OT 165 L o� PIZ o P �'x►sT1�� ou �eactil^�5 : . N,E Lp h 0 LOT 167 ti Oh p� f S9, . p WILLIAM yJ ��4w, C. NYE ,o No. 1933s 0 IST IWO. 1 pax � I. CER TH THE FOUNDATION SHOWN HERON COM YS TH THE SIDELINE CENTERVILLE AND SETBACK REQU REM TS OF THE TOWN OF WEST BARNSTABLE . BARNSTABLE. AND I N LOCATED- WITHIN THE =AMj&&1n=40'nAlM 4/29/96 FLOODPLAI . R.L.S. DATE. LOT 166 THIS PLAN IS NOT BASED ON AV INSTRUMENT PLAN BK. 439 PG. 17 SURVEY AND THE OFFSETS SHO NOT BEdNT USED TO. DETERMINE LOT LINES. BAYSIDE BUILDING CO. INC. ISSUE DATE 0110412008 3RODUCER �.. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND Jnited Insurance Agency Inc CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE ?O Box 1013 DOES NOT AMEND,EXPEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3uzzards Bay,MA 02532- COMPANIES AFFORDING COVERAGE NSURED tichard T Senoski 3413 Main Street COMPANY A A.I.M.Mutual Insurance Co 3amstable,MA 02630-1234 LETTER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDIIVG ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS.CERTIFICATE MAY...BE ISSUED OR MAY-RERTAIN;I#iE INS1 RANCE AFFORDED BY THE Pf)LIGIES DESCRIBED HEREIN-IS-SUBJECT - TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. co LT TYPE OF INSURANCE POLICYEFFECTIVE POLICYEXPIRATION LIMITS LTR POLICY NUMBER - - .DATE(MM/DD/YY) DATE(MMmD/YY) GENERAL UABI ITY GENERAL AGGREGATE =COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. PERSONAL R ADV.INJURY =CLAIMS MADE=OCCUR EACH OCCURRENCE =OWNERS A CONTRACTOR'S PROT. _ FIRE DAMAGE(Anyme tie) MED.EXPENSE(Any=pcm®) ' AUTOMOBILE LIABILITY .. COMBINED SINGLE .. . LIMIT - ANY AUTO ALL OWNED AUTOSBODILY INJURY " (Pa DmwI SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS - BODILY NIURY GARAGE LIABI ITY (Pa mddW) PROPERTY DAMAGE EXCESS LIABILITY EACH OCCURRENCE UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FOAM 'g+J. �: + :- D NO WORKERS COMPENSATION AND • TATUTORY LIMITS OTHER EMPLOYERS LIABILITY X THE Pe SNEXEC�VE EL EACH ACCIDENT 100,000 FFICIERSARE - A : 7005575012007 11/17/2007 11/17/2008 ELDISEASE-POLICY LIMIT 'g SOO OOO INCL ' g mm , EL DISEAS>r EACH 100,000 EMPLOYEE COMMENTS/DESCRIP ION OF OPERATIONS OR LOCATIONS: VO PARTNERS ARE COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICA LHOI:DBR �� •.�- - - "�'":`�' 'O�j '�. � t � HOULD ANY OF THE-ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE TOWN-OF YA.RMOUTH rHEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 15 WRrrrEN NOTICE TO THE CERTIFICA OLDER NAMED TO THE LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION R LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. 1146 RTE 28 SOUTH YARMOUTH,MA 02664 UTHORIZED REPRESENTATIVE c6ea, i I �/ie •COan�nnaraureal� aP✓UGaaJacfzuse�a ; • F?oard of Building Rcgulatiq;s and Stand::rds I License or registration valid for iadividul use or,! HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 106009 Board of Building Regulations and Standards - Expiration: 7/2172008 One Ashburton Place Rm 1301 Boston,-Mi.�Ia.02108 Type: Individual Ie' RICH.ARD T. SENOSKI' Richard Senoski i3,113 MAIN ST. i RAr*,:STABLE,N1;k 02630.` >Depatq ldmiuisiratc: Not valid without signature Board of Building Regulations and standards I ' Construction Supervisor License ' License: CS i 1 . 1' 4Edrat 267009- Tr# 17471 1 f #' Restrict(o�ri:=0:0�J� RICHARD T SENO:SK .= c 3413 MAIN ST BARNSTABLE,MA 02630 Commissioner i ! Exclusive,Swing- See-Through All Components Heavy-Duty,High- Away Hand Knobs Strainer Cover Molded of Corrosion- Performance Motor make strainer cover removal lets you see when basket Proof PermaGlassXr with air-flow ventilation for ' easy. No tools required... needs cleaning and eliminates for extra durability quieter,cooler operation. no loose parts... no clamps. guesswork.Special self-adjusting and long life. seal ensures dependable sealing. Heat-Resistant,Industrial- Mounting Base provides Size Ceramic Seal stable,stress free support, plus is long-wearing and 100% versatility for any installation drip proof.For fresh or requirement Adapts 48- S saltwater use. and 56-frame motors. Super-Size Housing and diffuser ensure rapid priming. I � Corrosion-Proof Service-Ease Design Noryl'Impeller gives simple access to all has smooth,wide openings internal parts.Motor and entire to prevent fouling or clogging. drive group assembly can be Energy-efficient design removed,without disturbing produces more flow at pipe or mounting connections, equivalent horsepower. by disengaging just four bolts. OVERALL D[MENSIONS MODEL Motor Power Pipe Size Dimension"A" HP KW inches inches mm 4'- SP2600X5 1/2 0.37 11/2 10 254 SP2605X7 3/4 0.56 11/2 lOs/s 270 SP2607X10* SP2610X15* 11/2 1.12 11/2 121/8 308 ati' I rw� SP2615X20* 2 1.50 2 131/16 332 4rm ��'°°"� �•' SP2621X25 i 21/2 1.88 2 131/16 332 msmw -_ *Super Pumps available with dual-speed motors. m tt 30 100 27 90 24 80 21 70 0 16 60 = 1s so 21/2°P-1 8 Super-Size 110-Cubic-Inch Basket 0 12 40 has extra leaf-holding capacity and F SP261SX20 9 30 (2 HP-1.s0 extends time between cleanings. Rigid 6 20 construction with load-extender ribbing OXIS SP2 07X10 1/2HP 1.12 KV ensures free-flowing operation for heavy 3 10ITT HP o.7s (1/2H -0.37 KW) debris loads. (3�P- 0 10 20 30 40 50 60 70 80 90 100 110 120 130 140 GPM Super Pump Series Pumps are listed by: 0 38 76 114 151 189 227 265 303 341 379 416 454 492 530 LPM CAPACITY PER MINUTE @ * CID www.haywardnet.com HAYWARD°Poof Products 0o tmdemaft Pl aW PeW are n dd Kward NAM,kcO HaywudPW mduk hx -01) 1-888-HAYWARD One source. y P Ever ool. UTRFM i Combination Pressure and Cleaning-Cycle-Indicator Gauge gives visual indication when cartridge filter elements need cleaning. I Manual Air Relief provides an easy way to manually purge air from filter. Screenless Internal Air Relief continuously vents and eliminates clogging. Improved High-Strength FllterTank molded from new and stronger PermaGlass XL material for dependable, corrosion-free performance. High-Impact Grid Elements designed for up-flow filtration and top-down backwashing for maximum efficiency. - Self-Aligned TankTop and Bottom make access to servicing grid elements fast and simple. �. - Heavy-Duty,Tamper-Proof One-Piece Clamp securely fastens tank top and bottom together and allows quick access to all internal components without disturbing - piping or connections. _ Marked Short Element and Manifold provide dear guidelines for re-assembly of grid elements during cleaning. - Inlet Diffuser ElbOVV distributes flow of incoming water evenly to all filter elements. - NoryI® Bulkhead Fittings for extra strength and heat resistance. Full-Size 11/2 I Integral Drain provides fast,100%clean-out and easier flushing. Union LOcknuts make disassembly/reassembly of filter from piping fast and easy. Plumbing Versatility means a wide variety of valve options for customized control of your filtration system, including Hayward's 2'; 2-position slide valve. Valve Options SPECIFICATIONS—..O D D.E. FILTERTYPE Vertical Grid Diatomite:24,36,48,60,72 ft.2(2.2,3.3,4.4,5.5,6.6 m2) FILTERTANK Injection-molded PermaGlass XL FILTER ELEMENTS Monofilament polypropylene cover fitted over 8 curved, high-impact grids 11/2"or 2,7-position Vari-Flo'",2,4-position Selecta-Flo, CONTROL VALVE 2",4-position slide valve.May also be plumbed singularly or in series with quick-connect union couplings. PERFORMANCE RANGE 1/2 to 3 HP(30 to 150 GPM) DE2420—23"W x 321/2"H(58 cm x 83 cm) DE3620-23"W x 341/2"H (58 cm x 88 cm) 4-or 7-Position Multiport Valve DIMENSIONS DE4820—23"W x 401/2"H(58 cm x 103 cm) DE6020—23"W x 461/2"H(58 cm x 118 cm) DE7220—23"W x 521/2"H(58 cm x 133 cm) PERFORMANCE DATA r7EFFECTNE DESIGN TURNOVER MODELFILTRATION AREA FLOW RATE" GALLONS KILOLITERS 1 E 24 2.2 48 182 23,040 28,800 87 M164 36 3.3 72 272 34,560 43,200 131 48 4.4 96 363 46,080 57,600 174 60 5.5 120 454 57,600 72000 218 72 6.6 144 545 69,120 86,400 261 2-position Slide Valve `Determined by pump size and piping system hydraulics;P piping is recommended for flow rates equal to or greater than 90 GPM(341 IPM).Hayward doesn't recommend flow rates above 150 GPM. www.haywardnet.com HSF HAYWARD°Pooi Products ®Harvard and tkryl are registered trademarks and PermaGlass XL,Pm-Gdd,Selena-Fb and Hlo Vad- aretrademadtdH,a�rdPeelProd�a,�o2G06H,a�rdPWPrd�a,k.Cn�) 1-888-HAYWARD One source. Every pool. OOL t.a 8'L-(f 12)• Ot 1.81• 410A M.g7wf4j.l.p.ey.p.M:tt ANY0400100d 9N1 SI�B18Q Selaeg - SI 4� �tjejoduweiuoo'pue.olgBelo IGLIIIIl 1 W " �� .p A l s , I.I.. N <_ ) 'B m CA 1 0'r y[MI' im I . l �� z f frL-l- 4.1into m � i <lj. r S1135 �.: F g - O � ,�i• ( W N QF1 M l O '% •L it o a N m Z z I o L! Nm fill s Jf :1_��• � � 17(Q er rrhM 1 f�i•! �� N n • � N � � N � I 1 i • I W� 1�'�i �N b JW tidy �� N 71/1 4 1 ------- - d r � a N N I '-4 tgit d Ni$y. �}rssyu•�x�,� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,Map Parcel Permit#- 7 - Health Division �/j'�ate Issued 1 Conservation Division' L I Fee Tax Collector ll/l�lD I CIS S Me �� 6D nn Treasurer LWALLM IN WOU P. Planning Dept. , Date Definitive Plan Approved by Planning Board B �' d Historic-OKH Preservation/Hyannis Project Street Address Village s / Owner T 'LUw4, 0tNJ Address l� �Oz��•v �/,�� - Telephone ,��" �`� ��✓�-� Permit Request EA1A,65:E- Xi S�r✓ta pca :.l.-471 Sc mac/ Pc� •l � � ao Square feet: 1st floor: existing o1W proposed 5� 2nd floor: existing proposed Total new Valuation go O 0 Zoning District Flood Plain Groundwater Overlay Construction Type o Lot Site Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family � Two Family ❑ Multi-Family #units 9 YP 9 Y Y Y( )) Age of Existing Structure Historic House: ❑Yes Q No On Old King's Highway: ❑Yes ❑ No Basement Type: O(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new ,Number of Bedrooms: existing new _ Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: Cl Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ 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 Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use - _ _ Proposed Use BUILDER INFORMATION Name sr_��_Qe_n �. 1ooCL+ C J4/Y' . Telephone Number (0 Address 6 N 15 License# I 1 v<I Home Improvement Contractor# / 0(a/y/ Worker's Compensation# tA-) -�— ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE u DATE FOR OFFICIAL USE ONLY rt . i j = PERb4IT NO. y DATE ISSUED i ` MAP/PARCEL NO. ADDRESS VILLAGE OWNER " .I DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE o ELECTRICAL: .ROUGH FINAL PLUMBING: ROUGH FINAL OAS: ROUGH FINAL FINAL,BUILDING ' 1 DATE CLOSED TOUT 3 ASSOCIATION PLAN NO. RESIDENTIAL BUILDING PERMIT FEES . APPLICATION FEE �O r New Buildings,Additions $50.00 . Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE Yosquare feet x$96/sq.foot= 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) ACCESSORY STRUCTURE>120 sq."I >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: x.0031= square feet x$96/sq.foot= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$.30.00= (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) permit Fee j projcost �e '%�anr�na�uueal� o�✓�a�uaella ��.�.�------- Boarc!i►!Bulidtng kegulatlons and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Reglstratlon: 106141 ' Board of Building Regulations and Standards Expira.ion.:07/22/2002 One Ashburton Place Rm 1301 ' Type: PRIVATE CO?pCR.AT:7N Boston,Ma.02I08 STEVEN J.BISHOP_ RIC INC_: Stbven Bishopric PO BOX 687/1112 MAINS'UNI' . OSTERVILLE,MA 02655 ' ' Administrator Not vg!' without si nature LIsenBsep:g CRCODSN upS�TRBUU►LDl y�G R:�EGU�CTIO Sjue 0 VISON SNurnbe UPS OR 19697657161rp a _ : 1 ExPirps, 's R es '°grog 03 0 �` tilcted Tc. 00 Tr,no: 76571 27 SC CAPRI CORN CIRCLE E FgOUTMI' MA' 02536 a � E COMMONWEALTH OF MASSACHUSEI� S �^ P DaIJChUNT OF L1,7DUST7RiAL ACCIDFNIS 600 WASHINGTON ST-k� James.: C.artooetl 130STON, MASSACHUS=S 02111 -c—.eussdone• WORKERS'COMPENSATION INSURANCE AFFIDAVIT Steven J. Bishopric Ina. P / HR Logic i (liccnscc/Pcrrni act) with a principal place of business/residcncc ac P 0 Box 687 Osterville, MA 02655 (City/statc/Zip) do hereby c=ifj; under the pains and pcnaldes of perjury; that- [ )(I am an employer providing the following workcrs' compensation coverage for my employees-orking on this job. Liber.tv •Mutual WA2-63D-004155' 017 Insurance Company Policy Number (j I am a sole proprietor and havc no onc working for mc. j J 1 am a sole proprietor,general eonuaaor or homeowner (eirde one) and havc hired the eontraaors listed below who havc the following workers'eompcusuion uuurance.poliacs: Name ofConuaczor Iusurance Company/Policy Number Name of Contraaor Insurance Company/Policy Numbcr I,,hmc of Contraaor Ins=ncc Company/Policy Numbcr I am a homeowner performing all the work myself: DOTE Phasc be A%wc that wbili bomcowacrs wbo csoploy persoas to do raaintcaaacc.COastrua'so0 or repair work on a dwelling of not more tbs o tbr«units io wbi&the boraeowaer aJso ruides or on the grounds appuriaaaat thereto arc ant gcaerauy i considered to be employers ua&t the'Workcd Compeasatioa Act(GL C.152,sect. 1(5)),appliutioo by a boraeowoer for a Iiewsc or permit may cvidcacc the Ic1aJ status of sa ctc?loyce undcr tbc'Workcri Coropcosattoo Act. i vnacrstand that a copy of ties statement wis be forwarded to tits Dcpa;tr..cnt of Industrial Acddcnu*Ofiicc olI.-lic nce for.cavcraic vc4fk3don and that failure to sceuce coverage is requited undcr Section 25A of MGL 152 cut kad to the imposition oWminaJ pcna t;cs consisting all f nc of up to S1500.00 ardor imprisonnnmt of up to onc year and avil penalties in the form of s Stop vjork Ordcr and a fax of S100.00 a day against sac. Signed this day of Uccnscc/Pcrmitzcc Ucensor/Pcrmiaor s 1 1 i i (3,C, I l � i I � � SG NO -w5k5 � DINING FAMILY 28'4 x 14' 10'11 x 14' GARAGE 13'10 x 27'8' i KITCHEN. 397 x 13'4 t i 805N,6- DN ���$ v6i (9LCkc • ..... „._.,,,,;tiii< ....'alk:!&:iC<i;i;i3:S i�32�i2i1:L}ii}1�1�?�. N I - p0 O tk '� °, T 165 o °°, LO rn co LOT 166 z 16,895 S.F. 0.39 Ac. t XY Gp rr tK so. LOT 167. LL = C. a..:� NYE .: No. 19333 Ca- II t CEftTTF M PLAT PLAN I CERTI Y TH T THE FOUNDATION SHOWN HERON COM LYS TH THE SIDELINE U)C&Mg CENTERVILLE AND SETBACK REQU REM TS OF THE TOWN OF WEST BARNSTABLE BARNSTABLE. AND IS, N LOCATED WITHIN THE S AT2, 1"=40'13,_ 4/29/96 FLOODPLAI . DATE: 4 R.L.S. LOT 166 THIS PLAN IS NOT BASED ON A I TRUMENT PLAN BK. 439 PG. 17 SURVEY AND THE OFFSETS SHO NOT BE APPIIC ANT USED TO DETERMINE LOT LINES. BAYSIDE BUILDING CO. INC. , i N �o , °• LOT 165 -� 0 o o°• � o) fp LOT 166 a 16,895 S.F. 0,39 Ac, ti LOT 167 9 OF • '•I ��` W H;lIAM G�� i C. o NYE `� •Q No. 19334 O CERTIFIED PLOT PLAN i 'CERTIFY THAT THE FOUNDATION SHOWN HERON -,COMPLYS WITH THE SIDELINE jQN CENTERVILLE AND SETBACK REQUIREMENTS OF THE TOWN OF WEST BARNSTABLE BARNSTABLE,• AND. .IS` NOT LOCATED WITHIN THE ECAL& 1"=40' nAM 4/29/96 FLOODPLAI . PJAN REFERENCE DATE: 4 R.L.S. LOT 166 THIS PLAN IS NOT BASED ON A I TRUMENT PLAN BK. 439 PG. 17 SURVEY AND THE OFFSETS SHO NOT BE USED TO DETERMINE LOT LINES: BAYSIDE BUILDING CO. INC. TOWN OF BARNSTABLE -CERTIFICATE OF OCCUPANCY PARCEL ID 175 032 GEOBASE ID 38895 ADDRESS " 16 MORGAN WAY PHONE - W_ Barnstable ZIP - 1 LOT 166 BLOCK LOT SIZE . DBA DEVELOPMENT DISTRICT WB PERMIT 17566 DESCRIPTION SINGLE FAMILY DWELLING (PMT.#11726) PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS; -and Environmental Services ( TOTAL FEES: BOND .: $.00 � CONSTRUCTION COSTS $.00 756/ CERTIFICATE OF OCCUPANCY HARNSTAHLE *' .MASS. OWNER DACEY, BRIAN T TR s619' ADDRESS P 0 BOX 95 CENTERV I LLE MA BUILrG IVISIO BY �.t. DATE ISSUED 08/28/1996 EXPIRATION DATE . . 7 , , GEC t . UU ,. �7 i 'r'I 1:)i'LY'Ilil,�.c3U lf� �,.:.• . i.1 f7A Cj 2 V1 1.,!... tl +l "� 1, ':1,•f• 'N4� ..�,i s• , +n G' ' f 1 PE-1 1 .� 1-', ,'',•i .'i.,.)l:L.l_f .I.riN ,.- ! :''rCJ'. . i:-iNl.l �,C JD(N. I n:�� .� t)F� M <L°. +; 3�� Lit _+ .l:,,; ';i4.t{r . ik.'i, :; !t 'Department of Health, Safety (j�3.�:R���:;r )��s: !_�!,�T:� �� : laic, . �:►� c and Environmental Services r+(�LAft El.EIS Lei,) v + I:UN,771P.(J(.,Z:'_Ji�1V .0010 G i . • i O i ,.i'til.i L;.L•: �{t•,CI :i.:L:. ,J+.:,L, , .. .1s..1. F i• BARN3PABLE. A MASS. i "r' ( vr t••l�,k� i?.'-?l;,. . tS}{.�•`'.`1i', '�' 'll: ED A BUILI)ING DIVISION ILI THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED APPROVED PLANS MUST BE RETAINED ON JOB AND FOR ALL CONSTRUCTION WORK: WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. ['"WAN • BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 99Z 2 2Q 2 r a, ;jj� 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT / 2 ^x ' BOARD OF E H OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PR CEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 508-790-6227 r Qp of 1 ! J d � ! Wli I ----- ....;-- Y, N U lI' ! _I _�_I U ' lr . i '� :. IL i : } ': I•III ' ! / I J. 40 LP : I I I !•:: ��Ir-�-�� li<I:!ilil IL I;III�iII ;'! j. 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I 7)702i���rlS..crj.. ruerls MOD 3NI13Z ,t," `Sv�c�axog: p� � — ...._-. - r 2b II N Io j kJ7f•10.71 .. rtrzNlx3';,$l -, � —___...._.__._.____-_— __-.. ... 1 I i g-S \4y� ! b I ir6 s r '�K I!II it II.i' Mom 4��� ;. :a Gil �. a,,o�s ,�.. .• - . . a ......... - _ ......... N 90 is c4 diy ,4 cq ')7nV/ O m DAd :. .. col N: a, I t 0 t)Ti LN V a uj IL � to 2 i I I I STiiarS -VNP-2d.. I ol ! I , I II � i I � LLL1� -� Z a o• �, ,-�� gin; I��•... ! C\ ` ` { u - —i -i - — 191 — — — — —i al, b -,01._... „O-,8�, I41 QT7 9 I 1 V INA : I- - - a 7S �n ?S T •;1 S I r-.1 l� it r-Il, - i T CI QL n �, I //' N I!I 1 j /ll �V II i N •B ,L ..o I1 . I � J V 0i N LL r 0 'CD 0 0 0 IL Lj: , e a co 9 i c �1A, I� ,Q To Date 42 Time— WHILE YOU WERE OUT M of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE,YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message, Operator AMPAD 23-021 •200 SETS EFFICIENCY® 23.421 -400 SETS CARBONLESS l _� '�O �. 5 � 4 V i i' i i �; � �� �� �� � �� � �� _ i � I i __ f 3 \ 1 2 `OFtHE TO,,� The Town of Barnstable O� 7 BARMAS AA.BLE.$ Department of Health Safety and Environmental Services t6j9- �0 ° Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 - alph Crossen Fax: 508-790-6230 Buil Commissioner Cam" Inspection Correction Notice Type of Inspection Tr4z Location Vn VA a 6 G A-W \ Permit Number Z_r Owner �1_A.� Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: i 11 l 1, s r a 1 ,q (_ ��fi►� 14-`C&,4zt fit_ w6A t 1 r v Vajj( 4:�,,AJ I � 4 Please call: 508-790-6227 for reeinspection. Inspected by �� C�'�.ci-�.✓ Date Lk p�� `OF fHE TO, I The Town of Barnstable 9 BARARS. E. MASS. o` Department of Health Safety and Environmental Services 0 i639. �0 ° Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection ff w Location b �l.dl(�_(S ,� W� Permit Number Owner v V 1AA S Iil--A - J Builder 5i.o fl One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 1 '- 6 b t.,1r�6Kt,/ f i r ` t ' e h 6, 1 Ir 1 J IVAI--02 A C A t/1 Please call: 508-790-6227 for reeinspection. Inspected bya,N - Date - _ I I �.v r� ���.�.�-�——��.��� ram--ram�� ..c+rwv� �r ewv�� �r"l��Y•-•-++�'�������-��r��� COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY tb = t s OF I ONE ASHBORTON-PLACE.- IF MASSACHUSETTS SOSTOd;l�rliri'u . .LICENSEi. . CAUTION EXPIRATION DATE CONSTR. SUPERVISOR 04/19/19 96 EFFECTIVE DATE LICNO FOR PROTECTION AGAINST - . RESTRICTIONS THEFT, PUT RIGHT THUMB NONE '1 n- ( 06130/1 993 005645 1 PRINT IN APPROPRIATE C. BOX ON LICENSE. BRIAN T DACEY z 62 FERBRCOK LANE r� BLASTING OPERATORS CENTERVILL MA 02632 m I MUST INCLUDE PHOTO. _ PHOTO(BLASTING OPR ONLY) F' I NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY PAID (• HEIGHT: STAMPED-OR-SIGNATURE OF MMISSIONER I -. �` 2 1993 • THIS DOCUMENT MUST B i « SIGN NAME IN FULL ABOVE SIGNATURE LINE - - CARRIED ON THE PERSON U' IGNATURE OF LICENSEE THE HOLDER WHEN EN I �,oP3. OTHERS•RIGHT THUMB PRINT GAGEDINTHISOCCUPATIOR I!%ia� mew R I ' i a\ f COMMONWEALTH OF MASSACHUSETTS `=P DEFA NI' OF INDUSTRIALACCID.Ugn 600 WASHINGTON STREET BOSTON, MASSACHUSEM 02111 games Ganooel �or-m:ss�one WORM' COMPENSATION INSURANCE AFFIDAVIT 1 7 - 01ccnscc/permitscc) . with a principal place of business/residence ac 6 3 a (GrylSr=cMp) do hereby cerrify, under the pains and per aloes of perjury,thar. (J I am an employer providing the following workers' compensation coverage for my employees working on this job. Insurance Company Policy Number ( J I am a sole propricror and have no one working for me.. ( J I am i sole propricror, nenl contraaor r homeowner (circle one) and have hired the contractors lined below who have the following woe e:s compensation insurance policies: Name of Contractor Insurance Company/Policy Number Name of Contractor Insurance Companv/Policy Number Dame of Contractor Insurance Companv/Policy Number 0 1 am a homeowner performing all the work myself. NOTE .Please be aware ttv while bomeo—ners wito empio-e Perroas to do ma.inteaanec. eoostruetioo or repair work on a 6MTinnt: of not more than: three uatcs is —nick the noraeo-^mcr ciao resiacs or on the Frouaas appumenzot there are snot teaerail�' constacrra to be cr_oiovrri uaacr 6c.Q'orxcn' Comvcasauoa a Act (GL C 152. sect- 1(5)). appiication by a borncowncr for a lieetssc or permit may mcrocc Lac ieFaJ sutui of an empiovcr tanner 6c Woriccra' Cornpeasatioo Act 1 understand :hat : eao,•of this statc.:rnt will be fomarced to the Dct)u--tent of Industrial Ac6denu' Ofnec of buuranm tot e°--2-.r vcr::,:::ton anc :iv:wurc to secure tmrrzrc as rceuircc unacr Seenon Z;A'of V1Gi 15= can lead to the 'ME)anuon o(ai:..aL �0� ecnstsane of: i,nc of ue to S1 500.00 and/or imprisorss tot or up to one yea: and avu pcnaiues in the form or a Stop Q"ioric Order snd a fine of S100. a 6ay a€a:ns: me. r i SHEETROC&: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID'S REMODELING: (L) COMMERCIAL UNION - NB F821442 DAVID BIK: (L) MERCHANTS INS GRP- 8CM0278579150 (W) TRAVELERS - 176K337-8-94 OAK INSTALLER: ROBERT BUDDEN: (L) NORTHERN ASSUR. - NBF528652 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) AMERICAN POLICY - WCC 186604 ROUSSEAU, AL (L) MERCHANTS MUTUAL - 8CM0278570179 (W) EASTERN CASUALTY - ??? GARAGE DOORS: ALL CAPE GARAGE DOOR: (L) U S F & G - BSC14667590301 (W) COMMERCIAL UNION - CBH573757 STORMS & GUTTERS: ALUMINUM PRODUCTS: (L) AETNA - MPOO21014146 (W) AETNA - JC89258880 OAK FINISHER: AMERICAN FLOORS: (L) TRAVELERS - 680 342W754-0 CARPET, VINYL & TILE: CARPET BARN: (L) VERMONT MUTUAL - SBP6507393 (W) PHOENIX INS. - 6NUB476J652794 WIRE SHELVING: CAPE. COD CLOSETS: (L) U S F & G - BSC146983441 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS: L & M GLASS: (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY'S BROOK: (L) COMMERCIAL UNION - ABR345850 (W) CIGNA COMPANIES - C41138178 DRIVEWAYS: NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 i r' SUBCONTRACTOR'S INSURANCE ENGINEEER: BAXTER & NYE ENG: (L) FIREMENS FUND - S30MXX80564866 (W) LIBERTY MUTUAL - WC1312595563023 EXCAVATION & SEPTIC: DRISCOLL, JJ: (L) U S F & G - HGL 110093 (W) U S F & G - 7708711936 FOUNDATION: BAYSIDE FOUNDATIONS: (L) COMMERCIAL UNION- ABR406267 (W) LIBERTY MUTUAL - WC1312201785044 WELLS: DENNIS SCANNELL (L) TRAVELERS . - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS: MICHAEL BROWN: (L) AETNA - MP0023672849 FRAMERS: ROBERT DORRER: (L) TRAVELERS - W680526K991TIA9 (W) AETNA - 006C0023972416C MICHAEL DUFFLEY: (.L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - .WC13124927.27024 ROOFER & SIDEWALL: JOHN MEE: (L) AMERICAN STATES - 01CD1486783 (W) TRAVELERS - 6NUB448K275894 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED ELECTRICIAN: CHAVES ELECTRIC: (L) HANOVER INS. - LHN2964649 (W) MISCELLANEOUS INS CO. - 0708878 91 1 PLUMB & HEAT: WHITELY PLUMBING: (L) TRAVELERS - 660365K1782COF9 (W) EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: (L) FIRST FINANCIAL - FF0131 G400831 (W) COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION: (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 Assessor's Office 1st floor Map Z7 / 5� Lot �� t, Permit# Conservation Office 4th floor � -� —�� Date Issued Board of Health Ord floor Engineering Dept. Ord floor) House# Planning Dept. lstfloor/School Admin.Bldg.): O7' 2'e�.�Gs� Definitive Plan Approved by Planning Board P9 e .44,F A lications ss :30-9:30 a.m.& 1:00-2:00 .m`. �° TOWN OF BARNSTABLE Building Permit Application Pro•ect Street ddress l� Z Village / n Fire District Alo Owner 9�LC_ Address Telephone 7 Permit Rcauest:11 ('.(wAzet Q Zoning District /�- Flood Plain (— Water Protection Lot Size - 16, �"l S Grandfathered — Zoning Board of AppLAjs Authorization Recorded Current Use 1/OX4wt ��t Proposed Use Construction Type a2LL- / Eaistine Information Dwelling Type: Single Family t/ Two family Multi-family Age of structure /VFUZ-1 Basement t,K Historic House Finished Old King's Highway Unfinished Number of Baths No. of Bedrooms Total Room Count not including baths First Floor Heat Type and Fuel&ICIA10-�1 2c.a Central Air -P Fireplaces Garage: Detached Other Detached Structures' Pool Attached f Clt!,4A Barn None Sheds Other Builder Information Name Telephone number 7 7/ _ l� lJ Address `(S� License# 06 5�� S^ Home Improvement Contractor# �— Worker's Compensation # bgJ l 3 12 �Z2 7T 6 13 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 Project Cost SIGNATURE DATE i BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T FOR OFFICE USE ONLY ADDRESS VILLAGE OWNER ; DATE OF NSPECTION: - FOUNDATION FRAME INSULATION FIREPLACE' 1 ` ELECTRICAL: ROUGH FINAL .. PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL FINAL BUILDING:, DATE CLOSED OUT: ASSOCIATE PLAN NO.- o Lb LC JAW PC) /,v� U' i1J ►sf po,el cl- CL- � / � k� ! _°/ G uT �'v�odo�d � I•, Q. v � — Q� � L � J � C" 3 0 _ o s� r oX � Fo c`► r, m �, ,y? \[\a p tom- TTs � �4 a� t- tL LZ rl (11 , CL V — ' _ a zr wcr 7Z a SQ A .N F- o �O Q J v► 15 Q 111 o p r W � �101� ' n m