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0097 BAXTER ROAD
j �, �. � �, ���� �, Zoe "-° INSULATION ' 2 Fuller St. , Carver,MA 02330 mcmahoninsulation@gmail.com" 781-831-1234*``4 Completion Date:03/18/2019 Permit#: B-18-4207 Address:97 Baxter Rd.Hyannis,MA.02601 A&:Building Inspector Jeffrey lauzon for the Town of Barnstable, We installed the following insulation/completed the following work at 97 .Baxter Rd. Hyannis, MA.02601 Including: M • Walls:dense pack cellulose to fill wall cavities via "drill-and-fill"methods JP This work has been completed to stretch energy codes applicable at the time of installation.The vF . .bti ..:. ..q. d•. a yp';- A ++..,tl a -{-N .. M fg . walls have been scanned for voids(missing insulation):with IR scans by our own crews._ This work is utility funded`and audited,and1s held-to the highest"standards of workmanshio-=; and quality:'All work has been completed in'compliance with State Building Code 780 CMR. - Please don't hesitate to contact us with any questions! Respectfully, Michael T.McMahon Owner 781-831-1234 �� � . , s� I " I ' i I , r: .4, Y F + }. s }� u _ � l, 44. J't ta 1 r LLW r .8 •a � wt p •. . m r• vi ° � f I i p S' 1 • v r. , �1y���� � �� �� -row t� .��• � . tiOr 1v+ _ ,,. ' d ".. ��ji` .. • �._ a ' - r f p L! t t 411. d J, - 9 f • s Ar 74 a 3 tAA iLu a Ila OR m i t . t a u w Mckechnie, Robert From: Mckechnie, Robert Sent. Monday,January 30, 2017,9:45 AM To: O'Connell,Timothy ; Subject: FW:97 Baxter Road, Hy Attachments: IMG 2545.JPG;ATT237970.tzt;IMG2546.JP.G;ATT237971.txt;IMG_2547.JPG; ATT237972.txt Tim, Hyannis fire called me out to this property Friday 01127/17 11:450m for an outside fire on a building at this address. When I got there I was informed that the fire was in the fire pit but the captain was concerned about the large amount of construction debris in the yard. The Building department does-not have any issue and figured it was more of a Health Dept issue.Thanks, Bob -----Original Message----- r From: Robert McKechnie [mailto:bahamabobb@aol.com]', Sent: Monday,January 30, 2017-8:42 AM To: Mckechnie, Robert Subject: 9.7 Baxter Road, Hy W 1' Town of Barnstable � ... Blll lig w¢��sran That it is Visible From the Street Approved Plans Must b'e Retained on Job i ihis'Card Must be Kept Post This Card So T " bsw ��$ Posted Until_Final Inspection"HasBeen Made: A .,,..".tifli at"e.-r«.-...,... 6 .....�..b:;s -.... .a,....m�..,.d,.,..M....�,., :,.,...,5t b,.._, _ Permit ilNhere.a Certificate of Occu anc is Re wired,such Buildm shall Not be Occupied until a Final Inspection has been made P Y q- g ..:�.: u . Permit.No. B-18-4207 - - Applicant Name: Michael McMahon - Approvals Date Issued:, 12/28/2018 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 06/28/2019 Foundationv Location: 97 BAXTER ROAD, HYANNIS Map/Lot: 310-056 Zoning District: RB Sheathing: " Owner on Records CALLE,WILSON ROMERO . Contractor Narn.e M(CHAEi T MCMAHON Framing: 1 Address`. 1 GENERAL PATTON DRIVE "Contractor>License `CS-068111 2 a A > HYANNIS, MA 02601 - ) 'AY Est Project Cost: $7,178.00 Chimney: 2 Description: weatherization,weather stripping,"air sealing, blown cellulose Permit Fee: $86.61 Insulation: Project Re Fee Paid:f $86.61 Pro J q Final: F Date ( 12/28/2018 � = Plumbing/Gas. Rough Plumbing:. ,.Building Official' g Final Plumbing: This permit shall be deemed abandoned and-invalid unless the work authorized by this permit is commenced within siii months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application an A elapproved construction documents,for which this permit has been granted. All construction,alterations and-changes of use'of any building and structures shall be in compliance with the local zoning by-lawsand codes. Final Gas: This per shall be displayed in a location clearly visible,from access streetor road and shall be maintained open for public inspection for the entire duration of the l . work.until the completion of the same. t '- --• Electricals The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:., 1.Foundation or Footing "" Rough: 2.Sheathing Inspection " 3.All Fireplaces must be inspected at the throat level before,firest flue lining is installed' final; 4:Wiring&Plumbing Inspections to.be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low.Voltage Rough:_ 6.Insulation 7.Final Inspection before Occupancy Low Voltage final' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. ":Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 4 ZT 8 l.467- Via► ��" v944r. sta 9: axe X* Du/ELL/�/G 1 GAT/i�I ?Eli-T �}ts EX/Yiv� y ai�s�/ ` Of JAME MOORE N0.33253 STERE� 1`' t1( IAN�S Town of Barnstable' *Permit# -���n OFtHE Tp� tres 6 months rom Issue date Regulatory Services fee s' — BAMSfABLE, • AAF MASS. Richard V.Scali,Director 9� 039. iwl Arfp�,ta � •, - 40R Building Division }} Paul Roma,Building Commissioner F 200 Main Street,Hyannis,MA 02601 SEP 29 2016 www.town.barnstable.ma.us ® n1 /� Office: 508-862-4038 tU OF8A)Pia�cI�50&7 0-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint --._—Map/parcel Numlier , . p a Property Address 7 C�, C . A O ' (..0 ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address es 7�(3 /7 t,YH /S 26 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor RI am the Homeowner . ❑ I have Worker's Compensation Insurance Insurance Company Name - Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Reque check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to du— vo C 9 Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) side eplacement Windows/doors/sliders.U-Value - ._ (maximum.32),#of windows #:of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property'Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement C tractors License .Construction Supervisors License is, required. SIGNATURE: Q:\WPFILES\FORMS\building forms\EXP c 06/20/16 :.;t 4 ' Ile Commornvealth of Wassadjusetts Department ofI'ndus-trial Accident4 - Q -ce-of Lnvestigatiow.' 600 Washington,street Boston,MA 02111 z IRVIs rarass-gm1diri Workers' Compensafian Insurance Affidavit:Btildei—dCuntracturs/Electricians/Phunbers Applicants Iuf"ma{iau Please Frint E,e��iIy Dame l;SusmesstOrganrza4iouffnual} ldi&l Cityftatelig i(1(1 o Y7 D /Plonk 22 Oi 2 5 Are you an employer?.theckthe appropriate box: T of project r I am a general coafrsctor and I Yl� P ] ( ���'� I.❑ I arc a employes with ❑ b 6- ❑New cons ructc'n employees(fish andfor part-time).* liave hired the sub-contractors 2.❑ I am a sole etas or partner- fisted cattle attached sheet ?- ❑RemodeEng These sub-contractors have. slip and have no employees8_ ❑Demolition working fornne in any capactty_ employee,s andbave wo&ers' 9. .❑S•nildmg addition [Na fi,-odmrs' comp.insurance comp:in ranv l (e� � 5. ❑ j,�iJeareacorporationandits 10 ❑Electrical repairs.or additions 3. tria homeowner doing all work officers have.exorcised their 1LE]Plumbingrepacrs or additions rsgU of exemption per MGL mpsel€[No workers'come: 13-❑F,flofrepairs insurance regmred]i c.152,§1(4),and we have no employees.[No workers' -El Other comp_insurance required.) fAny gVNc=&zt chedo;box#1 mast also 5llaufthe swtionbclowshuning ihe¢woffters'c®pensa&npeBcginfoemsd=- I Mamownexs wbo submit fis xMdatiu+*ffcxtiEg they axe doing sll weak sa$dmn.him outside coatmctm crest submit sLnP-wzMdavft bulicstino mcb- IContac' thst chprlr this box must zttached sa additional d at showing the name of 1be sub-cwtwtoa and state whether or not fbose entities haves employees.Ifthe5n6tontactomhave employees,theynnistpxavide&—Fir wadmn,comp.policy number_ I ant art erripLr�r tlsat is pra�2rIurg wuorkers'cocirrerrsrtiiare iisszrrattca�vr xt}*enrp£a}+ees �Setoav is iihRpaticy�turd jo7s�a - ' irrfarmrrfiarL - ; Insurance Company Name: Policy 4 or Self-ins-Lic- E,pirationDate:' Job Site Addre= CitylStxfie z�p: . Attach a-copy of the workers'compensatioirpolicy declaration page,(showing the policy,number and expiration date). Failure;to secure coverage as required under Section 25A of MGL m 1572 can lead to the imposition of criminal penalt%es of a fine up#o$150U.O0 sndtor o41e y6irimprisonmenk as well aszivil penalties.ih the farm of a STOP WORK ORDERand a fuse of up to$250_00 a clap against the violator. Be adi ised that a copy of this statement maybe fxvmded to the Office of Investigations of the DIA for insurance coverage veri cation- I d'a Ifer-eby cgtkfy rtd ptdrs dgsnaIties v:fger rsl?'fJ�atf�Tte usfaresia#rorspraticl€daba��is true and carrect Si�attsre: Date _ Phone ik ( - ti,( ciaL use arsty: Do not tvrke in this.area,to be crrrnp&L4d by efty ar tops n eirctat City or Town: Perrai f &ense# Lwaing Anthor4(circle One): L Board of lRealth 2.lautTffig Department 3. Irown.Clerk 4 Eiectrical Inspector rr.Plumbing Inspector 6.Other Contact Person: Phone-#: -- --- -- - --- 6 r faformation and lastructions a h a_Gsachuseffs General Laws chaptnr 152 requrires all employers to provide workers'compensation for their employees. pm7mantto this sfatrite,an ernpkyne s defined as"_everypersonm the service of another under any contract ofhire, express or implied,oral or wrif =n" An.eznplayer is defined as-an mdtvidoal,parnnersbip,association;corporation or other legal eddy,or any two or more of the foregoing engaged in a Joint eutzpase,and mchidmg the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or otherlegal entity,employing employees- However the owner of a.dwellimg house haviagnot more than three apadme u s and who resides therein,or the occagant of file - dwd ing house of another who employs persons to do mafiife ,construction or repair work on such dwelling house or on the grounds or b nce uuldmg appmtena�tiiereto shaIlnotbecanse of sash employmentbe deemed to be an employer." 1_�IGL chapter 152,§25C(6)also sia:tts that"every state or local licensing agency shall withhold fTie issuance or renewal of a license or permit to operate a business or to construct buildings in the commoriwealth for any a_pplicantwho has not produced acceptable evidence of compliance with the ftL rance coverage required." Additionally.MGI.chaps 152,§25C(7)states'Ntifher the commrmWealii,nor airy ofits political subdivisions shall ent rink any con:fract for the performanceof h(:;work unblacceptableevidenceofeompliancevrith the.ms,ice._ regim emus of this chaptx have been presented to the contracting anthonty." Applicants Please fill out the worlo rs'compensation affidavit completely,by checking ire,boxes that apply to your sifnation and,if necessary,suzpply sub-contractors)name(s), addresses)and phone numbers) along with t ieir certhicate(s) of hanurance. Limited.Liability Companies(LLC)or Limited Liability Pa-tamsbips(LU)with no employees other than the members or partners,ate not Mqui ed to carry workers' compensation insurance. Y an LLC or LLP does have empioyees,apolicyisrequfimd. Pc advise-d that this affidavit maybe mibroitttd to the Dff-partramt of Indiisfrial Accidents for confirmation of insnr 6 coverage. Also be sure to sign and date the afudaYit--The affidavit should be retrmm(-,d to the city or town that the application for the permit or license is being requested,not the D ePariment of ; Lnd 5trial AccidMfs. Shouldyou have any questions regardmg the law or ifyou are rego tr to obtain a workers' compensation policy,please call the Deparbent at fhe number lisind below. Self-insured companies should enter their self-fi stma ce license nmaber on the appropriate line. City ar Town Offitcials Please be sure that the affidavit is complete and pri ted legibly. The Department has provided a space at the bottom of the affidavit for you to till out in the event the Office of Investigations has to contact you regarding tine applicant_ Please be sore to f EU in the penaitilicense number which will be used as a reference number. In-addition,an applicant that must submit multiple permitlIicense applications in arty given year,need only submit one affidavit indicating CUIr en't policy filfbnna-tion Cif necessary)and under"Job Site Address"the applicant should v:rite"3II locations n (city or town):'A copy of the-affidavit that has been officially stomped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on ftle for fatoz pennlls or licenses- A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not relab-d to any business or commercial yer tee tie. a dog license or permit to bum leaves eta.)said person is NOT required d to complete fhis affidavit The Office of Invesbga d=would like to thank you in advance for your coopera d and should you have any qu estrous, please do not hesitate to give us a call The Depart nenfs address,telephone and fax number: CD-Mmar<weaSt3r Of MR.&E chnsztf;s Delta dment of hidmtdd Accidenla Ofu=of lav Er6 tio= Bostm3�MA 01 11I Te,-L 4 617 727-49-00 Qxt 4-06 or 1-,8:R-MA_S9AFE Fax 9 617 727 7M Revised 4-24-4)7 �-g1Tldia. Town of Barnstable u= �s - Regulatory Services , oxtl ,L Richard V.Scali,Director Building Division sAttxsTABLFE Paul Roma,Building Commissioner MAss. $ 039. 200 Main Street, Hyannis,MA 02601 iOrEv www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 / / HOMEOWNER LICENSE EXEMPTION DATE: a� p�0( O Please Print JOB LOCATION: pnumber &)q6ro street l village ..HOMEOW W NER": !%&0/1 66 �6�(�4-SA 23 —,�U I—gf 2.-� - name home phone# work phone.# 4Q 1� CURRENT MAILING ADDRESS: '��('� � c Yyrnrrrs J260� c' /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. s 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" rtifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures equirement d that he/she will comply with said procedures and requirements. Sigoi,fi of Hom Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall-act as supervisor." Many homeowners who use this.exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is y ultimately responsible. J 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 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC 06/20/16 : n Town of Barnstable Regulatory Services . �. g rY ASS. Richard V. Scali,Director. 1659. Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us —_Office: 508-862-4038__.-___.—.—_- -_-.._ ---_-_._ __.__ _ Fax: 508-790-6230 Property Owner Must Complete and'Sign This Section If Using A Builder i I - , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are,performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS ` a QUITCLAIM DEED We,RICHARD L. MACLELLAN and KATHLEEN M. MACLELLAN,being married to each other and having a mailing address of 20772 Corkscrew Shores Blvd., Estero, FL 33928 Grant to ' WILSON ROMERO CALLE, Individually, of 1 General Patton Drive, Hyannis, MA 02601, With Quitclaim Covenants The land with the buildings thereon now, known and numbered as 97 Baster Road, Barnstable,in that part of Barnstable known as Hyannis,Barnstable County,Massachusetts shown as: LOT 104 (BlockA) on Subdivision Plan 11519-B (Sheet 1) Subject to, and with the benefit of, all rights restrictions, reservations, easements, appurtenances and rights of way of record, insofar as the same are still in force and applicable. Grantors herein release and waive all rights of homestead in the premises herein conveyed and certifies that there are no other persons entitled to claim homestead rights in the premises herein conveyed pursuant to M.G.L. Chapter 188 or otherwise. For Grantors' title see Deed registered at Barnstable County District of the Land Court as Certificate of Title No. 173431 Property Address: 97 Baxter Road,Hyannis,MA 02601 Executed this w9 day of August, 2016 under the pains and penalties of perjury. • S Richard L. MacLellan K hleen M. MacLellan STATE OF FLORIDA Lee ., , ss. COUNTY On this;3 4"- daay of August, 2016 before me, the undersigned notary public, personally appeared Richard L. MacLellan and Kat en M. MacLellan proved to me through satisfactory evidence of identification which were [ [ ] personally known to me [ ] Other: to be the persons whose names are signed on the preceding or attached document and acknowledged to me that they signed it voluntarily for its stated purpose and who swore or affirmed to me that the contents of this document are truthful and accurate to the best of their knowledge and belief. �aunu JOSHUA L.MONDRY Notary Public•State of Florida N tary Public Commission N GG 013970 �.= My commission expires: My Comm.Expires Jul 20.2020 n„na { Mckechnie, Robert _ From: Mckechnie, Robert Sent: Monday,January 30, 2017 9:20 AM_ To: Mckechnie, Robert Subject: 97 Baxter Road, Hyannis FD responded to fire in back yard. Outdoor fire pit- while_there.observed large at of building materials and scrap/trash all around back yard. This info wasn't provided until I got to scene, from 317 Falmouth Road. Primarily health depth issue. Sent from my Verizon,Samsung,Galaxy Tablet TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map 310 Parcel OS Application # 16- Health Division Date Issued 0 1-7 / Conservation Division MAW Application Fee Planning Dept. Permit Fee S Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address 9 >n Village II © i i Owner Uyl lion 8 o meco Address = C( I - t ll s- 002ip� Telephone 5C)e` D4\Permit Request 601 a r p%4!� wt'17 dnu)5 V le/;,-?e Al- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ,Pr-oject Valuation-a,VQQ 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 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 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: ❑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 ❑ 22 Commercial ❑Yes ❑ No If yes, site plan review # -� Current Use Proposed Use = :a ' cs APPLICANT INFORMATION (BUILDER OR HOMEOWNER) w ea+ Name 0,ylcrC, Telephone Number ��`�r�� - D � c� 3 Ad'dress _� (� �et? I P * a License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ;l SIGNATURE -- DATE �� �y FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE 1 OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL 'FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. AWC Gzdde to WDod COtf t=f Ori by H7,-14 Frkd Aril 110 mph Wnd Zonz Massaffiusett3 Checkligt for ComOiance(7sD Lmsat?c.t), - 1.1 SCOPE. - V&d Speed{3-se_gr44 _ 11D mph —�`Vlruid�Expozza Catanry ..._...._D-gbeadng 1hzd€nc )ad -C u - 12 APP CASltmr ' - -- - -- �€ (3 , ta;eeds s iri:tz siapsshal! - RDOF Pfth (Fig 2) M RDofHeight Fig Z) Ek D g Width,W (Fig 3} Bing Length,L -_ _ (Fig 3) S BCr gccilding Aspect Ratio gIM (Fig 4) s 3:1 t4mtninaf Height cf Tallest DpeningZ (Fig 4) • 13 FP-AInNG DO10 EC7nOXS I GenetaJ cathpTranre writ frarrurig r nne ans (Table 2) - 2.1 FOUNDATIDN - Fotindafion Y►Falls meefmg regrfrem erds of 73D CMR 54D4.1 : CDncreb_x Masonry 2 2 ANCHORAbE TO FDUNDAMDR 513,Andnor Bob4rnbedded or.W Propdefaiy f+ adianM Anchors as an alfemafim in mncrefE only BoltSpac:ung-geneal._. (fable 4) u� Batt Spacing from endrjom of ptate (Fig 5) in_!;S` Batt Etabedment-mnrreiP (F►9�--- h y r Bolt Embedment-masonry - - 'Fig P#_-Washer Fig�y�) 3`X 3 X VT FioDrt ardng member spans dnedod (per 730 CMR Cyr 55) Maximum FbDr Opening DimansiDn --- (Fig 6) —$<_IV- Full Height WkU Studs at Floor Openings less fhan Z from Exdarior Watt(Fg h4bxnchn FbDr Joist 5e#fsada SuppDffM Lnadbearnng Waifs ar Sheatvrali (Fjg 7) tt 5 d Maximum Cm-Om Bred Floor JdmhL 5uppor6ng Laadb�ing Walls dr Shm-waIt (Fig B) - —ft s d •FloorRmcing at En s (B g)- •. Floor Sheathing Type (per7sD C.MR Chapter 55) ' Floor Sheaflbg"Mk imess _—(per 7M CMR Chapter 55) ' in_ Floor&tgu-A ring Fasts ffhg (Table 2)_ d rods at in edge t in'field 4S WALLS Wal Height -r L Dadbe e&V u aII.s. _ (Fig 1fl and Table 5) NDi�—u,g walls - (F►91D and Table:5 ft_! 2w V&1 Stud Spacing (Fig ID and Table 5) _in. Z,!r n.M • Wag Sixty DfFk (Fgs TA B) _ —it s d 4 Z t.Tl DR-WALLS= . Wood ids - - • LDadbeatiag�ralls Cfa1?ie?)_.�.r..—.•mac -_ft=in. ,� N01_1-L. .earing waft. _ --Table 5) 2x --ft_ir>_, Gable End Wag gracing Ful Heir,,,�nt Endwall Suds (Fg i D) - - Y►;P,Affc FbDr Lamt (Fg 11) - ft�Wf3 - 'Gyps=Ca3ng LeV$t[if WSP nDt used) - -(Fig 11) _ft D.9W _ abd 2 x4 Cb firmim LataaI B.raie Q S ft aa-_(Fig or 1 X 3=Fmg fi=bg ships @ 16`spacing-a vali 2 x 4 hiocffig @ 4 f1 spacing in etid jarst ortvss hays D ATMh:Pta FU 13andTable S) _ft Osfrr�f�,r,n�5an fn�of red mtrutmn t�}- {Table 5� � ; AFYC'Gaide to Mood Carutvcdan!aAgfr WrzdAr'eay. 110 B-rpk W'rzrd Zone - ' i Massachusetts Cheel[ist far Cvyng&anee(7so G�r1It53DI Isj loading Wall Connections - L ate!(no.of 16d mmmon nabs) (Tables 7) - Nan-Ixa�earing Wag Connecrons Lafesal(n�of 16d carnman narks) (fable B} Load Bearing Wall Openings(rernrd largest gming bct dv=k ag apardngs for catnpBance to Table 9) Hinder Spam (Table 9) —ff_in- 17' • SH Plate Spans (Table 9) —ti—in.s 11' _ (Table 9 . Fib Height Studs no. 1 NDn-Lead gang Wag Dpr�figs(r=3rd Jared opening W check al(openings for compliance in Table 9) (Table 9) _ft' in_51Z` SA Pala ne Spa __ _ (Table:9) —ft_in_51T FiA Height Sleds(no.of studs) (Table 9) - ade orWag Sheathing to Resist Uplift and Short S-tmultneausfy4 - _. Wr mt art Ben'idmg Dimension,W - Nomhi W Height ofTallest apeningZ _---..__ - Sheatbing T,yp (ncd3--4) . Edge Nara Spacing - (Table 10 or note 4 rF less) m_ Field Nall Spacing— (Table 1D) in_ ShmrConnettion(no_of 16d mmmon naffs)(Tabla ID) ptrt>=uW-ieight•Shea$ing - (Table 1 D) =% 5%AddRiional Sheafhbg for Wag v&h Opening>.6'Br(Design Concept!;)Ma)*rturn BL&ang Dimension,L _ Nominal Sheathing Type (now 4) - T • Edge Nab Spacing- (7 able 11 or note 4 f less) Feld Nag Spacing. - (fable 11) m- Shear ConnecOon(no_of 15d cammDn naffs)(Table 11) _ Perot Full-Height Sheaftg (Table 11) 5%Additional Sheathing fbr Wag with-Opening>SS'(Design Cnncepfs) Walt Cladding - - Raled for Wind Speed? 5,1 ROOFS _ Rant framing mernberspans checkDd7 (For Raflars use AWC Span Tpol,see BBRS Webster) Roof Overhang _-(Fgure,19) i15 smaller of 2:or L13 Truss or Baiter Connections at Loadbearing Wbl&- = Proprietary Connectors - s - Uplift (Table 12) u= pif - LaiFral (Table 12)_ I= pff . Shear S" - ff._ (Table 12) •P - Mdge Strap Connections,if mflar yes not lased per page 21-_ (Table 13) T= pif - • Gable Rake DuiiDoker — (Fgw -20).--_ ft 5 smaller of 2'or L12 Truss or Raifer Connections at Non4-oadbearing Wags - Proprietary CDrmex�rs - Upmt__ (Table 14) U= tb- L.ab ral(nm of 16d common nags)-(Table lb. RoofsheathingType (per780 CUR Chapters 53 and 59).___._____ , RcoofSheafhlng Thlc�_ _' —h?TI16`WSP - Roof g Fastening (Table 2) — NDi� - .1. , This.Est shag be met in iIs entirety,mud ng the sperilic exep5on noted in Z,to comply wMi the tati&emer fs of 7BD CMR,5301.2_1_1 Item 1. If the check&t is met in ft entirely free the Mowing malW straps and hold dm Yns arm not required per fhe WF-'9 110 mph ftiide: _ a_ Steil Straps per Fuum E LL AGage Straps per F39um 11 _ - - r . UpE Staps per Figure 14 - d All Straps per Figure 1T . e_ Comet Saud Hold Downs per Figure 1 Ba and Figure 18b - 2- 'E=ep§c)rc Dpenahg Tr Oft Df•up,fa 3 ft shall be pemflei when 5%is:added fn the percent E111-height sheathing 'req*ernestf- in Tables 1 D and 11. 3_ The boi�m stB plate in exterior walls sbaD be a minuruun 2 fn_nominalidmess prasswe -grade- _ y4FFC Guide to Wood Corrs6wadort zrr F�rraFr RuzdArreas_I£0 mph f 1=dZa� Massachusetts Check t for Compliance cna cm:R-ca.ni 2:.ls)r a_ From Tablas l B and j 1 and!oration of oran shae*ig and Building A;p RAO'.deL-Tmine Per&r7t Full-Height Sheafhing and IM Spacing nequirwr enfs ' b. Wmd Si uctual PanaFs shall ba minh nun thicknem of 711 6'and be installed as follows: . . _ L Panels shall bs lttsEalled Wr sh-r ngth ass parallel to sh& ii. M horimrbd jolr>fa shall oat over and be nalled to framing u'L On singly staty consfntc5on,panels shaD be atbched b bottom phdas and top.fnernber oFfbe double top lipp�PaAelsshaIIbeafimaWtodbe top marnber-ofAhe upper doubla top -- ---- plaL-and to band joist at boftam of panel.Upper affachrrerrf of lower panel shag be made to hand joist and lower attachment made to lowest plate at first fiaorfiaming. v. Horimnial Hall spacing of double fop plates,band joists,and g'rrdam sh4.be a double raw aF Bd - staggered at 3 inches on ceinfer per figures below:V f cal and Horimatal Nai'l'rng for Panel Affar..hment 5- Gbzbg prcitm on a)'naw.house or horiznnfal addr-fion-required hf proJac:Ck Inge or da-sarta shore(generally,south of Rh-- ZB or nnlh o(Rfa.'S) b)verfic al addition-not squired unless there 6-ertensroe renaAon to ihm frst ffc or c)replammentwiridoAm-needs enemy conservation rurrrpfrarrce only(chap 33) S.Wood Frame COr sfrurdion Manual(�►►►F'CM)for 110 MPH,Exposure B may be obbalnedfrorn the Arnericn WDDd Couna (AWb)wabsiice- �. . MR sir - t At [ _ • _ cr It •- 1 —_� .--.-. _ - .� _. tt Il tI tt� rt t JJ ' O At ttzr 1t rt y t tcaas�xc-Ir - It t E t Pa it It _ r= IF "It t l _ rl /* r S mflracr�aR PJ.HS - Y � rs�sP,aczvat�iAc . See Bali on Had Page Yer5cal and Hnfizpn{alNarTrng �� for Panel Afiariz =t ` °�eiii�I land I f rrfal Naifmg - faF Fanei Aflsr�rrr� The Commomwea#It qfMaysadutsd& O)TW3�ep��eltt c��tt�s�iafAcr�dexr� . eOf 600 Washfiro m meet , Basion,MA 0211 Warkers' C einq fim-Ls ce *davit: dex-JCbn ews/IIcctiicaurR�bers , Please Prime to n P c { � -o f ' q 13 Are�'you an.employe . Checlethe appropriate bow Type of project(required)_ L 0 I ant a employer vwi& 4 ❑I an a general contmctor and I 6. ❑New coasb�ctiorx =YZ/ ls (full anlbr pad4ime * ]ragehiredthe sue-conbMtom2.Ele proprietar orparfnr- listed cadre aft6ched sheet. 7- ❑Rffio g s4z£p acid gave no emplcyem These sub-coafract=have. ❑Demolifioa a far.me in oy�andhave w * Worwab any = �n�nc, 9- 0 addition` ��a oossxp.iu e - °mP- � _ 5_ ❑ We are a corpord=and its 14❑kcal repairs,or a d eons 3. '° I am.a b o aeo-wnw doing all work officers have exercised their 1 L❑Fh=bingrepair%or addi*= myself[No 'comp- ugbt of==Pficn per M(M l?❑Roafrepairs ins rid-]i c. §1t4)�arid weInweao emp`oyem[NO woAss' 13-0Other . camgx ksurance required_] 'Amy spprk=ehat checL=box cl—st also flaautthe secd=beioa d e-awo&ese EMMfimpencyinamn3saom. l eoaraga�rho sabm a$idacu i g they asedc a1F�¢aQic aad�ea3�xe autadccoatmcmrsnmst sulrmi[anewaf�d�t iodicatia;sach- fCa �S�stebedcY}gzbmemastxt>ache�sasdelffiaoatshed5boaIngthe—oElhesub- =Ctammmd.stEtetabethe Or=lbasee�eshs� e q&3 ees.Tft}Bmt-taatil�km MVIafe-M,dLey=srgmttddethM wadmc'tom•PalkF MrMber lam�u erngr f7>at is prasridirrg�vQrJrets'cosaficrrt iirsnrca jar emptay�ee ,Beloev is ilex prrTicy axd jab sate` Frz,jorm�irnn • .. - Ias�nce Company Name: 'PoRcy 44 or Self-im Lic-4- l p ioal e: Job Site Address_ ; ' Cifyl5tailp: Af€ach a copy of the workers'cbmzpensatienp.olicy declaration page(showing the poficy number and expiration date). Fadre to secure,coverage as req=ednnder Seta 2 5A o€MGL a 15-7 caa lead to the imposition of teal pemhin of a fine up to SL54a OU and/or one-3arsmpfisonment as well as civil peusliir in the fam of a STOP WORK€?RDI Rand a Ene ` of up to o 5250M a dap against the violafcr. Be advised gmt a copy of this zbdemet maybe forwarded to the Office of Intestgatiom of the DIA for tin uzmnrg C 55 Verificafinfl Ida hergby cerjyy under 2 1aftaes 4�f$erlu7 fhatfJia inforwsaii'm promidrd abmw is bars/acrid correct Phone ®25I2---3 r . tOjoW d use anly. Da not mite in tla+s area€a be wmp&Ad by city artoIM OJOIdaL f City or Tama: PermitUtense# Bsuimg Authority(curie one): L Board o#$ed& 3.Bwilffimg bgmtmeat 3.CdYfrown Oerk 4L Electrical hmpector 5.Pfimi mg tnsgector C.C"her Contact Persan: Phi : 6 �/ Y -■1•r•�••- -,•� .t:.■i� �•!■I :•. -I �tlla ••�R 1• al •• ■- •••1■1�!R ►•1■t1■�r1 .n•/. a■t ■■- I •faala • �" n •f-_nt n at +. rural .n �.n . •" to�• cr, :.-•r. a.� • ran• �. •lr. n •'nnrt • ■ �.fI � .� ■aw►• : _n u n m[: .r.■ n�R•■Ir :••r..Irn m r.l .. _n as •[ .u� -r :3m1 a a■• ••• • n n - "■ Ir - •[■ ii■1■:! 17•�i .It• ■! tl•!I•: i! 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G■•.• 1 m 1 illy■ • 1 -:a ��a� - a•11 - •••t�! • Mn /i+{ •■r n U� ri1■� tl I�■■■a 1• - :■►■ a .n ••Yu w • r.lnn■� w. •il■m - a•• r:ra • a ifaO 1 N r al■a - i7 ! t�. all � �■■n �a U talon ..a' b! t•• 1 a � to • ■ •�• :1■■1 •••■ { .•" /. n.n •1 n ■ J■r" u •O r••.� .t■•rt :It• !•t a ••! a • .■r• ••w•q■ �■- �•-1 an .41 1" •1 all- .Iaa Y.► alan■a�? Y.' •.tYitYt_Y •f-v': tt i � w�"+ Y t ti.ett. ,-+1t.t tYt i•t i t t131.`ittl ' 1. i::■ A maim •�� ��sot D• itl t �t i� s• Ii-t • • �2 ' 1 .•• t1. ••i • sin Town of Barnstable Vu : Regulatory Services dE Richard V.Scali, Director Building Division Paul Roma,Building Commissioner MAM ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION f_ Please Print DATE: Q� 1 0,10`CJ JOB LACATI N: 97 number Q, street village -HOMEOWNER: (� t'lJi(Y ''f� 5bg-6Poq c�I- b 1013 name home phone# work phone# CURRENT MAILING ADDRESS: CC2SZ/ l city/toovn state yip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be 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 oedures d requirements andthat he/she will comply with said procedures and requirem,eennts.,�<J ._ Si� om 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 I . 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 Iast page of this issue is a form currently used by several towns. You may care to amend a and adopt such form/certification for use in your community. J. Town of Barnstable Regulatory Services MAM ` Richard V. Director. Building Division ' Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder f as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to worm authorized by this building permit application for: (Address of Job) **Pool fences and alarm s are the responsibility of the applicant,Pools are not to be filled or utilized before fence is installed and all final . inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS QUITCLAIM DEED We,RICHARD L.MACLELLAN and KATHLEEN M. MACLELLAN,being married to each other and having a mailing address of 20772 Corkscrew Shores Blvd.,Estero,FL 33928 Grant to Y WILSON ROMERO CALLE, Individually, of 1 General Patton Drive, Hyannis, MA 02601, With Quitclaim Covenants The land with the buildings thereon now known and numbered as 97 Baster Road, Barnstable,in that part of Barnstable known as Hyannis,Barnstable County,Massachusetts shown as: LOT 104 (B1ockA) on,Subdivision Plan 11519-B (Sheet 1) Subject to, and with the benefit of, all rights restrictions, reservations, easements, appurtenances and rights of way of record, insofar as the same are still in force and applicable. Grantors herein release and waive all rights of homestead in the premises herein conveyed. and certifies that there are no other persons entitled to claim homestead rights. in the premises herein conveyed pursuant to M.G.L. Chapter 188 or otherwise. For Grantors' title see Deed registered at Barnstable County District of the Land Court as Certificate of Title No. 173431 , Property Address: 97 Baxter Road,Hyannis,MA 02601 Engineering W' d floor) Map 4/0 Parcel 0,' 6 Zv"Permit# ,2-3 House# ��� Date Issued 6 ( 1 C�7 ' Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) /p,� ��_J"jl Fee AM,ICANT IRISTo7S;ors CONNECTION PBMT MU Us Conservation Office.(4th floor)(8:30-9:30/1:00-2:.00) BNB 0 D1Y ma RIQ$!0 Planning Dept. (1st floor/School Admin.Bldg.) �tHE►q;- o(� Definitiv Plan Approved by Planning Board 19 ; C(V\ RNMA nABI.E V W 4 �p 679' �� i. O� OI� -TOWN OF BARNSTABLE 'F° B ildin Permi p lication (yry Project Street Addre ♦ A Village Owner -c _ Sgddress Telephone Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ �� _ C) Zoning,District Flood Plain Water Protection Lot Size T 0 j s 7C�_ Grandfathered. aies ❑No Dwelling Type: Single Family Q� Two Family ❑ Multi-Family #units) -,Age of Existing Structure 5 Historic House ❑Yes l 20 On Old King Highway's Hi hwa ❑Yes 10 Basement Type: ❑Full La,6awl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /lo C) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing� New 4�K r First Floor Room Count J Heat Type and Fuel: p'Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes Q�No Fireplaces: Existing Ge"*" New Existing wood/coal stove ❑Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) &Barn(size) /a2 d JNone ❑Shed(size) . r ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name C hh,FG n Telephone Number 7 j—�� �2 Address r�'.� �.� e r License# G C, Home Improvement Contractor# low 7d ,S Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTIO EBRIS RE LILTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ��` /./` DATE / 1-i e l P BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) � —7J • r FOR OFFICIAL USE ONLY MIT NO. r ! • - r 4 TE ISSUED + MAP/PARCEL NO. _, bar S r ��, I ' fir. t,` .. � .. r I I •� .r ADDRESS J f VILLAGE r OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ol ELECTRICAL: ROUGH FINAL ' r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL B 0 gas DATE CL OUT ASSOCIAI LAN NO. �e=a�' E r f c _. a `� p I 0 1 I � N 1 � �H n o06 i ��\ ^ Nvt IN 1 � r r ' ` R ' � n �1l Q 1 . S f r Nv .t y > I � o f , o�TMe tqy� i The Town of-Barnstable 6+3ss� � Department of Health Safety and Environmental Services rEc Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. . Date ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW ' SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: ` ��` '`a Est.Cost 6c) 6 Q Address of Work: 74e/- �"y �'E' Owner's Name d 'G lf1- �� -/_ C 9 e C �G �� J-- Date of Permit Application: ic.,A? C /4 if I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied —&—"" 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 v,� ill Date Owner's Name ig Af S¢t•� �' ., x' r .• � ° a �._.. fir .✓7�.Pi�� ON HOME—' IMPROVEMENT-.,CONTRACTOR F-(i 1, T ATIQ.N r - 4 a ku °ofBuilding Regulationsancl �tnda�c:ds, x � ` 06e Ashburton -0146e', Room .a:z f;e-n{a P.e*- z4� ;� r} 4'ti,><': t�^ :, a ,4 .,, - t 3.»r �i�•�^ ^- v t L�'' G HOME IMPROVEMENT CONTRACTOR4 'a } � �m - - n � Registration ;102785 a Expiration ` act ,2.C.1YPe INDIVIDUAL x MOMS,.IMPROVEMENT.-,CONTRACTOR •t �-= e � : K -._��+� � r.. ..,A t� ax'f `^��` �'2'a,fi.:c"'sr �" �i�ry �,.. '� ° *:>'_ T ,N y M .4." �- �U ""- Re9istrattiunlO2185 < ;PETER EDWARD„�;JOHNSON � w TypeINDIVIDUAL ;• Peter E . 'Johnson , y x Expiration 101102/98_ :r a1:97 .BARTER RDeet � 5 R }iys kk�" , K € , fi- ,� < APE ER � . HYANNIS MA 02601 > f r + � �T EDWARD 0HNSON } x3� t r k tEys,v ��kd" < t ��a _ Peter E Johnson s; S mEss �`T. o�` AXTER RDeet �" e , , y r �� � � noM(NisnTOR YANNIS MA 02601 "r ''��+„a,r-a�'�4i�'� ""'t : �k-e r e :..., r�xt� �� �' 5�. .. x� c?] a ro rW. ti._ emx F� r�k?;'.�`` ,a 5 to "�•'�` r'_. ,.z 'F s f ak•. - i u t wv3�"y�:, 'sv '°'' ii 9a `p. ^-�„? _ ..>< -_•._..__ -__.. s_._`__ _� ., —_ F_,_�4 Je ^:t__"�;<..�r+ �> .� s S (a-�� �ix°i���� `1���'..� � • < 7-6 DEPARTNElYfUf PUBIICy SAFETY licenseRUCTION SUPERVISOR< Nueb�r xptre ei.rthd'te' CS ( 86__: D 9'1991. 18129/1954_ �7 w- ' h.• CIF TER ROAD * MA1N CO mNER .n ' ?^- --� � tine<`t"`<; '�' -'—`-�-•s--,-,..-=.�-c�4<a'v�.-rez,�-r „Z� "- • •e e The Conttttottfrertltlt of Afassachusetts Department njlndustrial.4ccirlctrts e 1 �. VMCVOf/17F. fgat/ons 6O0 ti'ashhzgtun Street• „ Boston.Alas. 02111 Workers' Compensation Insurance Affidavit AliPlic.int in(orrnatiori: Plcaie PRINT Ie i ]""'~""�� .._ .. ........... _ ..._....b f....._. e name: {� �, y., 4 d"v-.-) T /J Incation: �t' Cr y 1 I am a homeowner performing all work myself. ' am a sole proprietor and have no one working in any capacity ..... --L. --- —..............;�..��....�,._._-' - L�r. _. .._..-.• ',.c�.:_a.•. .: --= ...,•..' a _�....�� Cj I am an empiover providing workers' compensation for my emplovees working on this job. coinvan name: address: city: 11hone#• insurance en. police.# [j I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company narttc: address: cin•: phone#• inurance co. polio•# compare• name: address city: phnne#• insurance co. policy# .Attach additional sheet if necessary, r -=°+ • +� _ _R'"%�'�" '��'� _�'�� .. _-__... ...____._..__._ _..a��..��r.�..s.:1.'...�r: r1lSi �•=y'.�'.s� - �+r�r.r� - - '.yltt�.i:_�iE•.he3c;:..:r.1. F:tilurc to secure coverage as required under Section 25A of 111GL 152 can Iced to the imposition of criminal penalties of a tine up to 51,500.00 andior one%cars' imprisonment as� cll as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a cope of this statement mad be forwarded to the Office of investigations of the DIA for coverage verification. i rlo herchr cerrift trod r e Pains anddpp•n /tics of perjure•that the information prorided above is true and correct " Si^_nature /�'' Chi// Datc r Print name _ `�� �� PhoneGl ' otlicial use only do not write in this area to be completed by city or town official city qr town: permit/liccnse# nBuilding Department �Liccnsing hoard check if immediate response is required C3Selectmen's Office F C311calth Department contact person: phone#: rJOther P: r . Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emp lovers to provide workers compensation for the: employees. As quoted from the -law an enrpl( ree is defined as every person in the service of another under any contract of hire• express or implied. oral or written. An etnph rer is defined as an individual, partnership, association. corporation or other legal entity, or anv two or morn 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 haying 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 ho', or on the grounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an employe, MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of 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 i-. P been presented to the contracting authority. ,. _ .. .. ......,..... .., fit. 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 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 town that the application for the permit or license is being requested. affidavit should be returned to the ct>1� or pp not the Department of Industrial Accidents. Should you have any questions regarding the "law'or if you are require-- 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 o. the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple: be sure to fill in the permit/]icense number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. Tile Office of investigations would like to thank you in advance for you cooperation and should you have any questior please do not liesitate to give us a call. �... ,-�. ....-.� _ �w..sr.-rw•• s-..�..... ..�...n+,rf...�wi.+�+s....rwgrv., ....:.. .—.�•.�{�..c..w..r-m.RJ�'7r•'r. vn��•ws+..e.�.^- The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents _. Office of Investigations 600 «'ashington Street Boston,Ma. 02111 fax #: (617) 727-7749 . phone #: (617) 727-4900 cxt. 406, 409 or 375 Assessor's office(1st FAnPumbie /_167�, Assessor's map and loConservation(4th FloorBoard of Health(3rd flo • Sewage Permit numbe y scary aDct 039 Engineering Department()rd floor):` °'•�o��r►��� House number I Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED.8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE 'BUILDING INSPECTOR //WjAPPLICATION FOR PERMIT TO s TYPE OF.CONSTRUCTION _ Gpo sq:i-� / ' '� Ar 19� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location_ ��✓y 7��' ��/4 ,, 4 Proposed Use �O -P`I /�/'�l /� P�1 t'a o S Zoning District Fire Di nct ��` art�r✓I e c C�lT� � Name of Owner '� �' ` �llS�' Address :�4 �-► -C * r Name of Builder Address Name of Architect Address Number of Rooms '1 ����-c a r "''` S Foundation /J/e C Exterior �� Roofing Floors ( Interior Heating �r �4• S Plumbing -C Fireplace 4T Approximate Cost Area Diagram of Lot and Building with Dimensions Fee ev� s� ell I CX30 r� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin the above constructio . Name Construction Si ipervisor's License w Johnson, Jane No . Permit For BUILD ADDITION Location: .97 Ba ter Rd, Hyannis - Owner- Jane L. ,.Johnson Ste• J y , ! f ' Type of Construction Plot - Lot Permit Granted Au4ust r,` % f 94 Date of Inspection: `- Frame 19' { Insulation •19' Fireplace 19 Date Completed 19 • �t l TOWN OF BA`RNSTABLE BUILDING, ERMIT #" - - M, ' i ' O? JUSI��IAIrACCID�'� 600 %ASi L NGTON SEEI James Ganaoel: BOSTON, MASSAC3USEIZ5U2111 ;,or.: scone: WOPJCEP,S'.CONDJM TION .AF e -• .c :. - s �.: - =i-��":•'st �;i}'. `_� ..::_�i-• tom. - I,•- - _ :;�; . . -_ -?sue: - -`�. (tiocasalpumitu� wich a prindpJ place of busincsslrrsidcacr pains pcazlncs dperimy.th=,do hetrbyartify uad«the and I srn an emplovcr providing the following workers'compensation coverage for my cmplcyc=Vroticing on this job. Insurance Company Policy Numbs i 7 am s sole proprietor end h:vc no one working for me j J 1 sm:sole proprietor.gcncr-I contractor or homcovmc(cirdc cnc)and fmvc hind the contmcaors listed blow who have the following workers'eompc=tion ins ranee politics; Namc of Cona or Inn=oc CompanylPolicy Numbs - lame of Conurao'r Insurance Company/Policy Number 1\:me of Contraor lnstuancc CompanylPolicy Number l :n: homeowner performing:1I the work-myself NOTE_-1'kasc be:•ware t^zt—Eilc bocaco•racn woo cmpicy perwcs to 10 caiatcaaacr.construction or rcpairwvcL ca ctwcliint of riot Dort loan t:rcc Lciu is•�aict:tic bor_co•wcr ai,o rents or oa t <Frouacs appurtcaaat t3crcto arc sot rCCCr 11*- <onsittrc2 to be c=_1ovcr:-ccr t�c Ac.(G'—C 152,ccc:.1(5)),application by a boramwocr for 1 Fcccrc or pernit raaV c.icc cc Uc 1<ral :t:r,s of as<r`plovtr uacct tic�'orlcrc'Gor_pcaration Act t::: c�:.•c:t_' s.:._-r-.:w;V be fo.—rc:t to t.:�:=:-c-.t c::-cis: :t Accdcnc'O ncc orinsur:.-:` for m"r';--1` t rcccr-cc c-cc:Sccx:��=.'c: t•:C_,c c:-.lc:c to t.- i czition cf c-. �'___ . rc c: c:t<c::isC'.c a ,r.C.G0 1-.c io.t-_:Lo.7..�.t o: c: tc c-c �.c_.:_-.�r�_cr.;mac:i-. tic iorr M.of= ctcp rcc: Gnc of S 100.00:cav - :rat. Sicncd this d;v of C/ 19