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0080 CONNEMARA CIRCLE
. _�___ _ �o, L e�� . I/ / ii ♦' i "MNI OF B NS n, C ; Q a ° s ,n �•�' I N S LA`T I C?' 7nI# Kv H ,A d IN 01 r L ., _EIBEN DEA35 n11E33 $1 AT EpAM 3U3VENDLD IN3UEA31O V lE0.3: N CEIIIND a - 6ATT3 r _ a n i 1 ,-696-6611 GI " �.,a +d`r L "hown of � N Y' Regulatory ;�Y Building:Div lion Address Address .•y 4n. � ° Date: t; Dear I3uildin Inspector' k _ice e y 6.0 rt♦ ' } .y'l,n I ,. e. .. Please accept'this Affidavit as document, on"that Cape Cod Insulation,'klnc..perforrhed & i cornpleted,tl e insulation and weathers &ionQwork at the property listedbelow: C ape Cod r Insulation did this in accordance to the specifications listed on'•the building permit application. All'work has been inspected'by a certified Building Performance,Institute Y (BPI) inspector.-All work preformed meets or'exceosfederal &•State}Requirements Property, Owner} .� Pro erty Address, ro P V illae F C�jl'1nQ.V1�Ifltf`��ic�Gl�` &AYJI - �. lnsulation Installed:'Fiberglass r 'Cellul6se R-Value ` Resiricted '� � Unrestricted,ro ° r Ceiliii�s ¢"� �. �k .�, � � .� �sw ^>;� • Y.♦ a . , a. a Slopes Walls k. S. F ry I=, ssid r, esident i 5 11 Ins' Ca�pe-Co tiori, Inc. a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application # 0O 3 I _ & Health Division Date Issued Z Conservation Division Application Fee S� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation/ Hyannis Project Street Address q0 Cd 1Y6,.Vwg— —A Vo Pi Village 4-601 1V2 Owner N i rnal a. Address Telephone Permit Request .��Z fZ GEC `�dL��S Cif✓ ,[� 2 � if �,! (✓�� �' -�l1l f��. // Oq Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 071OL7- 0'0 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 Rom!Count -' Z Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other ' CD ,1 Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coax stove: a'Yesl No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ ne s _ 1 Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ral o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ta,�tdll,41n, Telephone Number 7?f - 124 Address License# I�� f 44 4- Home Improvement Contractor# �7 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM T IS PROJECT WILL BE TAKEN TO �P,Neza - 6". SIGNATURE DATE A- /V ��- » { FORD FF CI L USE ONLY } f APPLICATION# } ' DATE ISSUED \ MAP/PARCE NO. ADDRESS VILLAGE ƒ OWNER \ ` \ DATE OF INSPEC20\ . ƒ FOUNDATION { FRAME } INSULATION FIREPLACE $ ELECTRICAL: ROUGH FINAL ƒ PLUMBING: ROUGH FINAL GAS: ROUGH FINAL / } ƒ FINAL BUILDING . ƒ ` ƒ DATE CLOSED OUT . ) ASSOCIATION PLAN NO. { f Z is 10 Park Plaza = Suite 5170 4 , Boston, Massachusetts 0211.E , wM Home Improvement Contractor Registration ' Registration:" 153567 y Type:,- Private Corporation e' Expiration: 12/15/2012. T►# '206433 CAPE COD INSULATION, INC HENRY CASSIDY } 455 YARMOUTH RD. - HYANNIS, MA 02601 y},i 7 — �. G r, — �� , Update Address and return card.Mark reason for change. r Address ❑ Renewal''E] Employment 0 Lost Card DPS-CA1 0 50M-04/04-G101216 - Office o-�`'mcr Affairs Bus ne Re ul�tion License or registration valid for iividn! e ^!y HOMSE66W_ � ivaelt before the expiration date. If found return to r ' a Registration: 153567 Type: Office of Consumer Affairs and Business Regulation Expiration. y2/15/2012 Private Corporation 10 Park Plaza Suite 5170 Boston MA 02116 OD INSULATION`1- HENRY CASSIDY �V 455 YARMOUTH RD n 4�_�_ � HYANNIS, MA 0260�I Undersecretary t alid ith t si tune r s * i 4 r M.Assachusetts- Department of Public Safety- M" Board of &iildin!� Re-ulations and Standards t r Construction Supervisor License { License:+CS 100988 « , HENRY CASSIDY , 8 SHED ROW' ' ;, ' -WEST�,ARMOUTH, MA'02673 Expiration: 11/11/2013 t`ununissiuner"' ., Tr#' 7620 ,{ x Client#:4597 CCINSUL ACORD TM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 2/02/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY-THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDEk IMPORTANT:it e certificate holder is an the po lcy les must be endorsed. ,subject o the terms and conditions of the policy, certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). ' PRODUCER Margar etyg6ng rW Rogers 8r Gray Ins.-So. Dennis' •.. y'PrA+orEie FAX' 434 Route 134 1(A/C No.-MAILExt):508-760-4602_._._ _ _ (ac,.No) 877-816-2156 , P.O.Box 1601 ` . ;'ADDRESS: oungma@rogersgray;com ,v, t. {,.PRODUCEIT e: South Dennis,MA 02660-1601 'CUSTOMER ID#: *' INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A:Peerless Insurance , Cape Cod Insulation Inc i, 18333 455 Yarmouth Road INSURER B:Ohio Casualty Insurance Company Hyannis,MA 02601 - INSURERC:Atlantic Charter Insurance d W INSURER D:Corn Insurance Company 34754 s - .. INSURER"E': INSURER F a COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE , ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ' NSR ADDL SUBR POLICY EFF POLICY EXP A ;GENERAL LIABILITY _ CBP8263063 '. ,, a. ` 04/01/2011'04/01/2012 EACH OCCURRENCE t;. $.1,000,000 X COMMERCIAL GENERAL LIABILITY w + RENTED r' PREMlSESO a occurrence) $100,000 ,{ CLAIMS-MADE X OCCUR r -• .�. '. . .. < , `°`'• , — --._ MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $1,000,000 , r r GE. AT r$2,000,0ff NERALAGGREG E GEN'L AGGREGATE LIMIT APPLIES PER: - - PRODUCTS-COMP/OP AGG 1$2,000,000, ' PRO ,.PRODUCTS.- ... .�.. . D AUTOMOBILE LIABILITY 11 MMBCKVMK ' 04/01/2011"04/01/2012 COMBINED SINGLE LIMIT $ANY AUTO (Ea accident) * 1,000,000+ ,i _ � � v r _ BODILY,INJURY (Per`person)$ ALL OWNED AUTOS X SCHEDULED AUTOS BODILY INJURY(Per accident),,$ ° • �r - .." ., ' X HIRED AUTOS PROPERTY, DAMAGE • n ;' • - (Per accident) X NON-OWNED AUTOS $ B UMBRELLA LIAB 'X OCCUR 0001254514645?pc 04/01/2011.04/0112012 EACH OCCURRENCE I$1,000,000 EXCESS LIHB CLAIMS-MADE AGGREGATE. $1,000,000 DEDUCTIBLE $ w XRETENTION' $ 10000 .. ,.. „. , ..�... - .,°.. C WORKERS COMPENSATION WCA00525902 U6130/2011 WC STATU- OTW AND EMPLOYERS LIABILITY Y!N ' 06/30/2012 X_.TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE "" 4, y. ,. OF EXCLUDED? - E L"'EACH ACCIDENT $500,000 u (Mandatory in NH) "" NIA E L..DISEASE-EA EMPLOYEE 500,000 If yes•describe underQP-C.PIPTION OF OPERATIONS h,j - - - ' E.L.DISEASE-POLICY DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) , Workers Comp Information Included Officers or Proprietors CERTIFICATE HOLDER ' CANCELLATION21 :.Y 3, SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE " a EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE a 01988-2009 ACORD CO_ RPORATION.All rights reserved. ACORD 25(2009109) _ 1 of'I The ACORD name and logo are registered marks of ACORD #S77368/M68179 MEY " \ The Commonwealth,of Massachusetts Department of Industrial Accidents y' Office of Investigations 600 Washington Street - Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affi.davitc,Builders%Contractors/Electricians/Plumbers Applicant Information Please Print LejZibly Name (Business/Organization/Individual): CA o d I al tal a' <[4-1 6� A,t"� Address: �5s - /�P MOV�I7 City/State/Zip: t(, Phone #:• x771 Are you an employer. C14ek the appropriate box: +Type of project(required): Z� 4. I am a general contractor and I 1. t am a employer with 6. New employees(full and/or part-time).* have hired the sub-contractors ❑ ew construction :p 2.❑ 1 am a sole proprietor or partner- . ' listed on the attached sheet. 7. ❑ Rernodeling ship and have no employees - These'sub-contractors have . g• ❑ Demolition ' working for me in any capacity.. - employees and have workers' [No workers' comp. insurance comp. insurance.$ 9. ❑ Building addition required.] 5. ❑�We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their L1.❑ Plumbing repairs or additions ` myself. o workers' com a, right of exemption per MGL Y � p• 12.0 Roof repairs insurance required.] t c. 152, §1(4);and we have ino ` employees. [No workers • IIEI Other , comp. insurance required.],'' *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information: t- t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. - U #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. InsuranceCompany Name: %4T GA/l�'�e !/J,Q � �_ ALSO ►riq✓1('Q Cn . « t Policy#or Se If-ins. Lic. #: .w C��4 oa �rq® r , 4 . 'Expiration.Date: Job Site Address: u ���(� City/State/Zip: Attach a copy of the workers' compensation'policy declaratiou'page(showing the policy number an'd expiration date). g 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 insurance coverage verification. I do hereby certify u e pains nd penalties of perjury that the information provided above is true and correct Signature: " Date: 1 Phone#: _ s i Official use only. Do not write in this area, to be completed by city or town official,,,, City or Town: Permit/License# ' Issuing Authority(circle one): 1. Board*of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other ' Contact Person: Phone#: OWNER AUTHORIZATION•.FORM (Owner's Name) - owner of the property located at -nil CD Co 0-ftu g- fr (Property Address) 414 5 ago / (Property.Address) ' hereby authorize Ca O�?il U L (Subc tractor) } an authorized subcontractor for RISE Engineering; to act on my behalf to obtain a building i permit and to perform work on my property. , Owner's-Sig ure�-- 0.,2 /, .2 i� LL_ , 2 ,.Date . .tea:. • ., FHB � x w _ , �oFrttr�� Town of Barnstable *Permit.# y O L rpires 61honlhs•from issue dale Regulatory Services Fee w s.Art3vs1a 3 E. _V /ASS. 16j9- ThomasF, Geiler, Director.-PR `_' Building ]division VVV Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MAMM/N OF A www.town,barnstable,ma.us Ill �l�r � Office: 508-862-4038 - Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nol Valid wilhoul Red X-Press Imprint Map/parcel Number Property Address �L'7�� � /x� I.,�' Residential Value of Work 4,;64�. e7e)0, 0 U Minimum fee of S35.00 for work under$6000.00 Owner's Name & Address Contractor's Name Telephone Number lL -5 Home Improvement Contractor License#(if applicable). Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name y �z(,/ �,i Workman's Comp:Po, licy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to L?I�e-roof(hurricane nailed) (not stripping. Going over existing-layers ofroofl ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .35)#of windows *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, GNATURC: W` .r s�41 The Commonwealth of Massachusetts Department of Industrial Accidents i! ~� 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 Legibly Name (Business/Organization/individual): A16<4 Aq-4 Address: c� 17� '7��" ►'•� City/State/Zip: Phone #: 3VY--5--34-- fe ' Are you an employer? Check the appropriate box: . Type of project(required): 1.❑ I am a employer with _ 4. ❑ 1 am a general contractor and 1 - ❑New construction employees (full and/or part-time).* have hired the sub-contractors 6. 2.❑ I am a sole proprietor or partner- listed on the attached sheet. $ 7. ❑ Remodeling ship and have no employees These sub-contractors have , 8. ❑ Demolition working for mein any capacity, workers' comp, insurance, . 9. ❑ Building addition [No workers' comp. insurance .5. ❑ We are a corporation and its officers have exercised their 10.❑Electrical repairs or additions required.] of 3.C'I am a homeowner doing all work. - right of exemption per MGL I I.❑Plumbing repairs or additions myself. [No workers',comp. c. 152, §](4), and we have no 121]'IFoof repairs insurance required.] t employees. [No workers' comp, insurance required.] 13..❑Other *Any applicant that checks box#I 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 their workers'comp,policy information. I am an employer that is providing workers'compensation.insurance for my employees. Below is the policy and job site information. Insurance Company Name: . Policy#or Self-ins. Lie.#: Expiration Date: Job Site Address: City/State/Zip: 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 insurance coverage verification. I do hereby certify under the pains an/d'penalties of perjury that the information provided above is true and correct Si nature: Date: / //, &2/f { Phone#• � �34—�— Official use only. Do not write in this area, to be completed by city or town official City or.Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department, 3. City/Town Clerk 4. Electrical Inspector .5. Plumbing Inspector 6. Other. Contact Person: N Phone M Information and Instructions 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 notmore 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 be an 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 compliance 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-contractor(s)name(s), address(es)and phone number(s) along with their certificates)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. 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: The 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-MASSAFE 2 Fax # 617- - 7497 77 Revised 5-26-05 www.mass.gov/dia 01HFr _ Town of Barnstable Regulatory ,Services * ianjjSrnstE'ss. � Thomas F. Geiler, Director 619.ln ra�,t Building Division - Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 wrvw.town.barnstable,ma,us Office: 518-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Plense Print DATE: JOB LOCATION: —�� G/�7c�r✓C� r�f� number street village HOMEOWNERd11e11?7A2 , c%r��� �a� 3¢- �0�( Sof-7`7,n 7�� name home phone N work phone H CURRENT MAILNG ADDRESS: 967. city/town state zip code The current exernption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners toengage an individual for hire who does not possess a license, provided that the owner acts assuperviso�. 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-yearperiod shall not be considered a homeowner. Such "homeowner"shall submit to the"Building Official on a,form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws, rules and regulations. . The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements, G / - Signature of Homeowner Approval of 8uildingOfficial Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section.)27.0 Construction Control HOMEOWNER'S EXEMPTION The Code stales 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 ofconstruction 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. OF THE r + HARNSTAHLE, + 9� MASS. Town of Barnstable �rED MA'S A . Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA.02601 www.town.barnstable.ma.us Office: 508-862-403 8 w, Pax: 508-790-6230 Property Owner Must Complete an&Sign This Section If Using A Builder I, /�/�'�"✓✓�'L , 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) Signature of Owner Date Print Name If Property owner is applying for permit, please complete the.Homeowners License Exemption Form on the reverse side. Assessor's office(1st Floor): ��/. ' Assessor's map and lot num r o THE t0 Conservation SEPTIC SYSTEM MUST SE Q�w `o Board of Health(3rd floor): ` 1STALLED IN COMPLIANCE Sewage Permit number �' �1 ��'��I�IoE t BAR13T► LZ Engineering Department(3rd floor): 9�VIRONMENTAL CODE AND ��o r6 q ° House number 60 �� OWN' REGULATIONS �carr 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 BUIL® IRNG IPISPECTOR _ APPLICATION FOR PERMIT TO (J l d eG TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ��7n� C'rrzc.c�_ /�.� 4 © a � Proposed Use Zoning District 0Fire District 1 .yvi�S Name of Owner �/�£�i�FT7r� Tub -r,04 -J elf 'Z Address SB C'0�,1T- ),g Name of Builder S"�9�� Address Name of Architect 5-,9'n Address Number of Rooms �ec K" Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost----'- ,-200a�® Area 36 O d Diagram of Lot and Building with Dimensions Feed D �® OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � J Name Construction Supervisor's License i— CUTLER, KENNETH & JOAN f ,. No 35859 Permit For BUILD DECK. Single Family Dwelling Location 80 Connemara Circle �- Hyannis Owner Kenneth & Joan Cutler Type of Construction Frame Plot Lot Permit Granted May 11 , 19 93 Date of Inspection 19 Date Completed 19 kj. +n 3 gu; e Y r Mid-Cape Home Centers DECK PACKAGES You don't have to be a master carpenter to build a beautiful wood deck. A few basic tools and our complete materi- als deck package is all you need: The result, a spacious deck that will bring you years of enjoyment and add beauty and value to your home. 1 r 1 1 rw ''r -Ir V n r fIr r -i r ,.r sir� ZXa�(i L.�CGc I wi TI 2! . . �. WI Qj —' 6/4}X PIT S`(P DK NG -N Q I 4X4 RAIL- NC, .. . P ST PIT co 2X8 /T-LibX-] l5T 2 x t3 ?IT SYP Ot5?5 (SDI "O. .. Wlzx PIT BLOC INy _ oirr S ! �otIST ANG RS • 1 Zx T?[ BLK I 4X4 SUF�'�T r S �� ._. 21Zx3 BOX I;30►ST P. EQ EQ . ''.T CMG::--.--- — i 4X4 DKK POST PIT I Ex15TI�tG BUILDING LINE' :.. . g14X(o PIT DECKING IIZ"Y.(e* CeAW. UCCi S%:.REWS W(SPACERS ZXB Ph EQX JOIST 2Kg PIT LEDGER wI BLOCKINCa =— - = --� i' i'L'X8 CARRIIuC+EBOLT ZKr9 PIT JOIST t6"o.G: -. - -v SCCTIOty GAt_V. _.. __. -_ Z:x9fr .-J015T HANGERS I BOX J�1is1` - • ORLEANS Main Street KINGSTON 255-0200 Route 53 , ' SO. DENNIS 585-4394 Route .134 398-607.1 • WELLFLEET�_ t Commercial Street • • HUNNIS 349-3734 Be"$$r.sds Way, . 775-6112 -�;. • VINEYARD HAVEN - • POCASSET Main Street THE NICKERSON COMPANIES Bar lowa Landing Roadt. 693-3374 SINCE_1895 . 563.2271 DECK PACKAGE MATERIAL LIST THE NICKERSON COMPANIES ITEM STOCK QUANTITY/LUMBER SIZE 8'x 12' 12'x 12' 12'x 18' 12'x 24' POSTS I 4 x 4' P/T 5/8' 5/8, 6/8' 7/8' 'IF DECK IS OFF THE GROUND 6'OR MORE,USE 4 X 6 POSTS GIRDERS (WOOD) 2 X 8 P/T 2/12' 2/12' 3/12'. 4/12' LEDGERS 2 X 8 P/T 1/12' 1/12' 2/10' "7 ,. 2/12' DECK JOISTS 2 X 8 (16"O.C.) P/T 4/16' 8/12' 13/12' 17/12' DECK BOX JOISTS 2 X 8 P/T 2/16' 4/12' 4/12' 4/12' DECK BLOCKING I 2 X 4 P/T 1/12' 1/12' 2/8' 2/8, DECKING 5/4 X 6 P/T 18/12' 26/12' 40/12' 40/16' RAILING 2 X 4 P/T 2/12' 6/12' 7/12' 8/12' 4/8' BALLUSTERS 2"X 2"X 36" P/T 40 52 60 2"X 2"X 48" P/T 14 70 18 21 - 70 DECK NAILS 8D GALV. BOX 10# 10# 15# 1524# . 8D GALV. COMMON 10# 10# 15# 15# 16D GALV.COMMON 10# 10# 15# 15# JOIST HANGERS 2 x 8 SINGLE#LUS28 16 16 26 34 LAG BOLTS WWASHER 1/2"x 6"(2 @ 24"o.c.)GALV. 12 12 18 24 LAG BOLT SPACER '/2"CPVC COUPLING 1 12 12 18 24 CARRIAGE BOLT w/WASH. 1/2"x 8"(2 per post)GALV. 14 14 16 . 18 ALUM. POST BASE 4 x 4 #APS-4 3 3 4 5 OPTIONS: STAIR STRINGERS STAIR TREADS — STAIR KICK BOARDS STAIR RAILING CONCRETE FOOTINGS CONSTRUCTION TIPS: • When nailing two boards together, always nail the thinner board to the `Zx4 thicker. • Place nails no closer to the end of the board than the,thickness of that I I ZK Z N A L'!R board.And from the edges, no closer than one half the beard t�ickness. • For greater holding power, drive nails at a slight angle lowards each other. 4 x4 P,�s i • Use two nails across a flat 2" x 4"and three nails across a 2" x 6". Use just one nail for 2"lumber on edge. Z"xZ" P/r 3 8•0.c, BA.LLUS E 5 • To reduce the chance of splitting when nailing close to an edge, pre-drill the hole about three quarters the diameter of the nail to be used. • When sanding or sawing wood, treated or untreated, care should be taken to avoid inhaling dust particles; it can cause nose and throat irritation. Eyes zxz NA► E P. are extremely sensitive to foreign matter; care should also be taken to avoid getting dust or wood"chips in your eyes. Ask us about dust masks and protective eye gear. z x 4• BOTTOM -RAIL. Wear gloves to help avoid splinters. 5/4 xCw PIT ct=cKING • CAUTION:.Pressure-treated lumber should not be burned either indoors or outdoors. 'Although every effort has been made to make these plans accurate,the possibility of error always exists. 4, .ZX5 JOISTS If you have any questions,please see your Mid-Cape.Home Center store manager. 'Mid-Cape Home Center shall not be responsible or liable therefore for results obtained or for injury or _ damages arising from the use of the information presented. 'Check with local officials concerning building codes.Building permit is the responsibility of the owner. -- 1?�.1�1 'Deck designed for grade level use.Stairs and concrete footings not inc'uded. YYY 1,ry� # " TOWN OF t \ h UARNSTABLE I i���Efi, y}F arXi�r r BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION A 3 Y'ease print. �tra LOCATION 8p k 15i z } { C�CJ J7�CAPliS Jr 00 -��LCR . r F,i•N, ' , ,� ', ' Number Street JVA t Address Section Of yt „ HOMEOWNER" ��j, Name ?��-S"iS p Townx. Home Phone f gib, PRESENT MAILING ADDRESS gD Work Ph0.21e. ®h:b�'lJ7,ra�Ty1 e.�2C'p. t t z C ty Town s • , State �wThe current exemption for "homeowners" w Z Pr,Co..d. roecu ied dwellin s of six units or less as extended to include engage an individual for hire who and to allow such the; owner acts as su does not o homeowne�rs; to b ervisor. Possess a license, ,.proyided' tha+'� b 71NITION OF HOMEOWNER; er-son.(s) who } �n r t owns a xreside Parcel of land ` ., =�dr y, r on which there on which he/she ' welliri is , or is intended resides or intends ; ` 9� attached or detached structures to be, a one to tQ'. �•w truet'u'rea. A person who constructs l, x" ° lper3.od< shall not be considered a accessory to such .use >+ more than one the: Building Off homeowner. Such „home in a two8ye$rr `fahtrt that a she shall be on a form acce homeowner" ' �' shall Isubiff 'di ng permit . re onsible for alltsuch to the Building Offie3a1 `�* (Section 109 . 1 , 1 � work erformed • ` under ;the signed ., "homeowner,- f a '.k g homeowner"State Buildin assumes g Code and other a sponsibilit r_4filations. PPlic .e Y for com liar 4; sal z codes, by-laws P nce' witl�rthe�` .rules and fihe`-undersi Barnstable geed "homeowner" certifies ghat he/she a��w� `reQuirements g Department minimum understands X 5� , inspection the:` ToWri Of �„ss n HD procedures . and � i MEOWNER'S S §i 4 IGNATURE R, A ,PRQVAL OF BUII DIraG OFI'IC: i Al T : �'c'�iNOte Threefamily T F " : required dwellin h , Control to comply with Stage Buildingcl��bic feet, or larger Code Sect , will b'e 127 , 0 ion Const ruct3.on , a © w , TOWN OF BARNSTABLE Permit No. ------21247 t V,"n..r a Building Inspector Cash' ,°,°. �� °°`` 'y OCCUPANCY PERMIT Bond No building nor structure shall be,erected, and no land, building or structure shall be _ used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Gray—Oaks Devi Corps x Address Box 957, Hyannis, h,A lot #67 A 80 Connemara Circle, Hvannis Wiring Inspector �i":"F+- i Inspection date " .� Plumbing mspq&r ( Inspection date , Gras Inspector s f/,. Inspection date Engineering Department "f' l! Inspection date r THIS PERMIT WILL NOT BE VALID,, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. n I J ill O . �� (,j r, .....................�,............................, 19�........,. ........................�Building..Inspector _...._......_. � Assessocfs-map4and lot number ... FIC SYSTEM I,!IIUST Be THE CID SIEP" PUANCE Sewage Permit number .............. .................. pISTALLED 14 W"111 VITH, ARTICLE 11 STATE 11 33ARESTAMLE House number ...................7:i-05. .... ................................ SAN ITARY,CODE A-N D NAG REGULAnONS, oo M a 1639 Ar O TOWN OF BARNSTABLE ECTO'R ' G I N'S P HUM APPLICATION FOR PERMIT TO ........ ....................................Q........................................................ TYPE OF CONSTRUCTION ........ ...... ............................................................................ ..........31- 7f............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby appft os--for a permit according to the following information: :...Location .....ciu,16!m(�emA.........cl&....... ................................................................ ProposedUse ............................................. .............................................................................................. ZoningDistrict ........................................................................Fire .District .............................................................................. Name of Owner 1�.X'A'V:�MAJ../P k...6M.............Address ... ......40� ................... Nameof Builder ...................5A?Y.!9..................................Address ...................................................................... Name of Architect ...... MIQVuAl........................Address .... ....... ............................... ...............4 .. ..............................................Foundation p .. ................... Number of Rooms ...........................Foundation ................................................................. Exterior .... ....IC ..................................Roofing ........ ...... ............................ Floors ...... .............................................Interior ......... .. 4 ...................... ..... .................................... Heating ........ ...................................................Plumbing ..............0:..........................!-111-1-11......... ........ Fireplace .......... 7-.Y/..9)......................Approximate Cost ..... .................................... L12 Definitive, Plan Approved by Planning Board --------------------------------19--------- Area .1.......01.. .......................Diagram of Lot and Building with Dimensions Fee .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH t. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name4qt... . . .. .................................................. Gray-Oaks Development Corp. No :21242.. Permit for ? .single-family...dwelling. Location ..........80-Ccmemara..Circle........... . ................. E. Owner ........GX.Ay.7Q.al�a..D.eVelo.pMerit,...Corp.. 'r f f`Z 1 Type of Construction frame....................... { ........................... ................................. .......... 1 .Plot ....... Lot ..............#67............ d Permit Granted ..... .............................41 r Date of Inspection ......:.............................19 �f.` � ......:.... Date .Completed .. ....... 19 PERMIT REFUSED i - ......................... .................................. 19 ....... .............................................................. 1 .. Approved ................................................ 19 ............... ...................................................................................................................... y � t '\As3,ess,,Pr's_.mqp and lot number ..... •............... ... THE w T P�pF Tp1` ti { Sewage Permit number ................79/....z.�.��.................. y • i li 2 STIIDLE, • House number ................-�-'- .....•!,,,I ................................. Mnea t639- '>lE 0 YAy Ar. TOWN OF BARNSTABLE BUILDING , IHG INSPECTOR r / APPLICATIONFOR PERMIT TO ........ .j.......................:............................................................................:.......... TYPE OF CONSTRUCTION ........RZ 0.�;�........; ' L ................................:............................................ ........ .. ..............19...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .:�-.. ....�....... .f�( Cu. 1'l. r;'(!� l:l........ �,1." :......... YAK lY/.j:S.................:............ �l, 1. .. . ProposedUse ............................................................................................................................. . ............ ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner u/L}�i/:<•' ��.j . �'� ....t�U/1� ..............Address ... V l �t(.!.�......;1 �I �... > ...................... 9 s A& Address t . �J!" Name of Builder .......................................................... ....................................................................... Name of Architect .: ;` j�Ik ,/�� �n .i"� �...: .................. .................................Address .....,................................................................................ Number of Rooms ...............`....................................................Foundation ..... .......! .:..f!t......... .. ..................................... Exterior ... ... - ..............................:�...................................Roofing ............. ......................,h.... .`.'................................. ... ..... Floors h. . rp. — . L Interior ..........�r G.?,.?. �.`:f....... % :.......................... .............................. Heating ........''....�:J ..' '..................................:!... Plumbing .................,! ......... Fireplace ..:.......!........ ............./3.... .',% } Approximate Cost tea„ rye Definitive Plan Approved by Planning Board -------------------_-----------19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH t F 3fu t I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �'` a `/t'" ................................................. Gray-Oaks Development Corp. A=291-286 No .......WA7 Permit for .....9M.AWKY.......... s ............bgl1 g..�f ly..dmau4g................. L&ation ....... ...QQM(NMra..UrUe............... Hyannis ............... Owner, ........Gray-Oaks Development Corp. ........................................................ Type of Construction frame .......................................... .................................................. ............... Plot ............................ Lot #67 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed .......................................19 PERMIT REFUSED ................................................................ 19 .................. ............................... ..... ...... .............. .......... ....... . . .... .. ....................... ................................. .......................... ........... Approved ................................................. 19 ............................................................................... ............................................................................... °FTME r� The Town of Barnstable 9 MA"M Department of Health Safety and Environmental Services 059. 1% Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION Location of shed(address) Village D S d '23*91 Prope owner's name Telephone number Size of Shed Map/Parcel# Signa Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction?. Conservation Commission(signature required) `� !� 4 J94c— PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg - 10.25 2 LOT 66 4-°01 35 w ti (b• w 7vQ 4 0 j� 0 O/ t . LOT 671 LOT 68 . NOTE- LOTS 66 & 67 SHARE`A DIRT PARKING AREA, BUT IT APPEARS TO BE SHARED IN THE`CIRCLE ONLY. RES.. ZONE-. "RE" This - .MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" - Bank Use Only TOWN: _FIYAN IVIS -_____---- REGISTRY OWNER: JAY J & ANNETTE K CURLEY______ DEED REF: _ CTF 141725 -------BUYER: _W_A_Y-NE_SMITH & LINDA KLUDY __�_________ DATE: _4 1�99________- PLAN REF: _27099_ 2_=_____SCALE:1"= 30 FT. I HEREBY CERTIFY TO NORTH AtYIERICAIV MORTGAGE__ %�� sr COMPANY. __ THAT THE BUILDING o � �y YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON ,,THE GROUND' AS pA r CONSULTANTS SHOWN AND THAT :ITS POSITION DOES CONFORM TO THE ZONING LAW SETBACK. REQUIREMENTS ;OF THE No, 40B (SUITE 1) TOWN OF __EARNSTARLE_________ __AND THAT P� INDUSTRY, ROAD IT DOES_NO_T_ LIE WITHIN THE SPECIAL FLOOD HAZARD � ' MARSTONS MILLS, MA. 02648 ffiAASSHOWN ON, THE H.U.D. MAP DATED 19z/ ,4 TEL: 428-00.55 it -Parcel'" 2500.01 0005 C FAX: 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT26623 CB MERITHEW, PLS SURVEY. NOT TO BE USED FOR FENCES ETC. c , Town of Barnstable pp�HETp� Regulatory Services c Thomas F.Geller,Director Building Division •AxxsrABM MASS. �' Tom Perry,Building Commissioner 9 i63 . ♦0 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 08-790-6230 Approved: Fee: �' U Permit#: HOME OCCUPATION REGISTRATION Date: 00 45104 Name: GJ2bQstACA O sGgq Phone#:(9D1) G3 Addresslo C-enm`cni-a Qc c' 2L Village: Name of Business: Type of Business: PQ,�.rti' Map/Lot: -7a 9(a. INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family-dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall notbe discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution._ After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare;humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not-to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling t. I,the undersigned,have re d agree the a v e ictions for my home occupation I am registering. Applicant: Date: C W 451 n4 f Homeoc.doc Rev.5/30/03 TO ALL NEW BUSINESS OWNERS DATE: 041 Fill in please: YOUR NAME: bp 4H4_ �3 APPLICANT'S ' — 1, YOUR HOME ADDRESS: �o G°rir�e,K,ac-� fBUSI^NMESS 6rc-1e— `�dA�1-5'5 Dl �. - Tale hone Number Home TELEPHONE r YPE OF BUSINESS-, ' ^� NAME OF NEW BUSINESS NO� IS THIS A HOME OCCUPATION? YE Have you been given approval from the building division? YES NO o MAP/PARCEL NUMBER ons of the Town of ADDRESS OF BUSINESS o r rn l things �"" nd com with the rules a When starting a new busi ness there are several things you must do in order to be in lOnceeyou have obtained the required red signatures, listed o to Barnstable. This form is intended to assist you in obtaining the information you may need. below,you may apply for a busi ness certificate at the Town Clerk's Office [Ist floor-Town Hall) or if you get the business certificate first you MU g ts and licenses.. the following office to macor ureof Yarmouth Rdu have all the r& Main Streeequired t) and you will find the following offices: GO TO 200 Main St. ( C 1. BUILDING C MI 10 ER' This individual h s b e in f m y rmit equirements that.pertain to this type of business. uth zed ignature* COMMENTS: 2. BOARD OF HEALTH informed of the permit requirements that pertain to this type of business. This individual has been Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature" COMMENTS: UR NAME in which you must do by M.G.L. t 30.00 for 4 years). A business certificate ONLY REGISTERsS rocesses from the various departments involved. Business certificates (cos ffi p -it does not give you permission Cooperate you must get that through completion of th 919NsisAPPROVAL FORA BUSINESSGrrRIIF(GAT��N�Y f: + _ t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# Health Division i Z71JC' � i Date Issued - o Conservation Division 3 Z Fee I� e� Tax Collector C`3 0�/ 5P a IC SYSTEM MUST BE Treasurer -� Z11"Z. 66 INSTALLED IN COMPLIANCE Planning Dept. V 4TH TITLE 5 EN°JaFF 0NN. @' 7-T",AL COIDE AND Date Definitive Plan Approved by Planning Board Te .`r eel R 1.I ATIONS Historic-OKH Preservation/Hyannis Project Street Address L 1w a°�/��✓� �-� �. Village Owner Address v ��, Telephone 3 ���i Permit Request �c /T ( �✓ �^� �Z (x o2 , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost A P Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size 1 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 r Attached garage existing ❑new size Zy 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 Telephone Number Address `v-P� c License# Z �� Home Improvement Contractor#-7/ e / Worker's Compensation# 02 S13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE G� FOR OFFICIAL USE ONLY w P ERMIT NO 7 r f t DATE ISSUED MAP/PARCEL NO. ADDRESS . VILLAGE _ r OWNERr; �Lf •mar .. .. y r V DATE OF INSPECTIO ' f FOUNDATION 12 FRAME INSULATION w � FIREPLACE ELECTRICAL: ROUGHC FINAL +r PLUMBING: ROUGH FINAL ' GAS: ROUGH, ' FINAL }' FINAL BUILDING KN DATE,CLOSED OUT M p ASSOCIATION PLAN NO. r t t � i •=' Department of Industrial Accidents -,�� _:•-: _� Ofllceollosestl�adoas 600 Washington Street Boston,Mass OZlll , ce davit Workers Compensation Insaran location - � city �J phone# ❑ I am a homeowner performing all work myself: ❑ I am a sole etor and have no one worldu in any achy � e den workers co an g rapensation for my employees working on this job. comaan v na me:e .::...:::. ..::..:. ' ..�•:: :::::::::...............vn................................. ...................................................... p :`,r %` .....::: i< ::::';:;;: city' insurance co. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hued the contractors listed below who have n workers' co ensation polices: the following mP ..... ... .:p .:::::::.: :::..::. .::. :.:.:.::.:::::.}} ::.:::.::::..:.:..: . .:::::..:::::..:::.:._.::::::. :::::::.::::::::.. :.::. tom anvnatne: �z{:...........:.....<......<:�>:�:=� S:. ..S ad tirl' ............................. .............:� ......... .... .... ..-..:...................::.......... .....{w:::::::.�..{.......nvwC•.v::•.r•r...............xrrx:::w::::.v•N-{}:24:J:4: ..... .......... .......x ...................... ..:....... .}. v::•.vv•••:{..Avn:v::n.,,• 4Y.v: nvv::x:::. .. .......................... ..................................................vv:::.+........i.. .......rn:•.. ..t +...:.Y};{{{{............:{a;{{•}:...............::v:: iTJii:'vi?ii:::i}::$:::•iii:•::ii::.................. ........tiff....:i`: . ..:...:..::;.:::::::::.}"::••i•:r.i.;;}}i:}}:L:•iv:::::C•ii:'iii}}}:�}}:?�iiiiiiii:•iiiiYii:•}4Yii}Yiii::•::}:ori>:{{%::;.}:•}:{v{{{{{•}:•}:•Y:{{:Y}::::}}:{:{{d:;;:.•Y•:•�•-:w:.•...... fMf :...:..:...:. ..:......:::....::::::.:: ............... address: ...........:.:........ ....::................................... a tv- ::::r:::`•::5:<i::`<$: is�:}:i.'-:;:k;?'•.'•i:>:::iiii:r}iii$:::•YY•i:j�:•ii:;}:•Y:�i:-}}:{{•}:•:::-:::::::2:+>::'r:::ii::�:' '::{J:4:Li:}{{S{{:.}•::{{$}?'':i`:Yi$i`i:`v`.:i:}{::::{:i'riiii:{{i:•.::i:iYi?'i: :;i:v:L::.^•::$'J}iiii::i:t"r ..... .....:.v�:::-.v�:�::.Y•:�}:�:�:•YY?:-::{{•}:Y}}: >:.:iT}i:�}Yi>:-»:{•>:->:-Y:•}: .. .r::::+ •:::...... :....... ........:..... .r...r..r..:.. ..................................................v:::••:-... .v--.:.v.}:•.�:{{{•::: %Y... ..... ::.�:::r:::.•?:'i•.:-:.v::::::.v..v••-::: ...................::•..............................:•::•..............................................::.... :.:...r. {..............:}.......{•}Y:{•}. �j, {}k• }......... ...... ...........::::•... .... .�:......... •v:-::v.:.r...............................:v::•.v::::::r...... .. •:v.�:•;•,•.. ,#'.:::::.�v:::: •:{r.�;::::.;:.yy}!...{.:,:.?.r':�Y:O};:.:;�.�::::.::...:::�:::::........:........... Fathue to secure coverage as required under Section 25A of MQ.1S2 can lead to the impa®tlon of criminal penalties of a t3ae lump to S1, stand and/or one yew'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100A0 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Iavestl;atiom of the DIA for coverage veri>lcRUM 1 do hereby certify under the pains and enalties of pedury that the information provided above it trw and carted Date _ - Sigaature p _T Print name oincial use only do not weite in this area to be completed by city or town of rfai city or town* peril! eense i$ ❑Building Department UIdcens;ng Board V required, ❑Selectmen's Oince ❑check if immediate responsere4 ❑Health Department phone#contact person: ; Other. (tensed 9195 PIA) . TabL.tSiib(eoa�aed) Pracg ji for PackaM for Oar and Twe•F=14 Anidsasial BoiW"W 139atsd with Fossil Fads MAXIMUM lal=� 8 ( ccdi;n8 Watt Hoar R*ww""s FSlab Arm'(K) Uwaiuc� R,v &-Ma os RrvaIU6j Watt bi== Em4== FMc=—),lp=imw j IR.va�te' Rrvat�' S10I to 6300 Huda;Dew Daw Q 12Y. OAO I 31 13 19 1 10 6 Normal I R I2% Q Q 30 19 19 10 6 S 12Ss am 31 tJ 19 10 6 AFUE T ;aim- w 016 31 13 AS WA I WA Normal I U � 0A6 31 •9 19 10 1 6 Nom r i�7i k� JO d" ivis •�::• !S AF[IE 13% am 30 1 19 19 f0 • 6 1S AFUE I x 11'/. 03Z 31 10 8 WA A Normal T la% I a42 31 1 19 25 WA WA xormai I Z ts'iL 142 .1s 1 119 10 6 � AA 1EY. ul) 30 19 19 10 6 40 AF�JE I 1. ADDRESS OF PROP TY: 2. SQUARE FOOTAGE OF ALL OR 3. SQUARE FOOTAGE OF ALL - 4. %GLAZING AREA(#3 DIVIDED Y #Z S. SELECT PACKAGE(Q-AA- ee chart above NOTE: OTHER MORE INVO VED METHODS OF D ING ENERGY REQUIRE1r11T5 ARE AVAILABLE. K US FOR THIS INFO ON. BUILDING INSPECTOR APPROVAL: YES: NO: y.fcr=-f930303a CF THE Tp�� y` 4 The Town of Barnstable nnnNsrnac.E. 9�A MAS& ��� Department of Health Safety and Environmental Services rEo 59. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO.PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. /� l !/ Type of Work: Estimated Cost J � / Address of Work: (- � ���G'L��— Owner's Name: r Date of Application: 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 here apply for a permit as the agent of the owner: Date Contractor.Name Registration No. OR Date Owner's Name q:fonns:Affidav s^ ESTIMA TED PROJECT COST WORKSHEET Value I LIVING SPACE square feet X$55/sq. foot= � GARAGE (UNF'MSHED K' square feet X $25/sq. foot ) PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost a990915b � I Wayne & Linda Smith 80 Connamara Hyannis Ma . 02601 .i I. I I a li y 7, _ L j N BATH BEDROOM KiTCHU, 61 i GARAGE I` —�- LIVING _I BEDROOM I i I I I • � i i a - �..�''� it _f ' LIVING AREA I F lr' I ,I i ! r Wayne lit Linda Smith ! 30 Connamara Pcl. Hyannis Ma. 02601 . ,X16 ,o f ; . I; � i • ! I� i I I ------------- Ij j ! y j Ile -it S d • _ .` �moo,,, Y .. - �b•� --.'fY.INW+.- :..�:, � a tFKieWMY.N�/ .. II�IW. , I I ' ,7� r I '.'t i' �� � I .,.., ..5�1 I. 4li f�� . ..(�e �I �'S� •�I J I. I I :.., t r—...._.. �. , . t I *j I I'PT' Tu f ,+tom 'I � I. . � 'r' , If' ,.I' I. I .'I: ? .{ ; � I .: •,i•. ! � = °. ' . t l: 'I � ., � N � .. I� •'I• . . ' '. 'i,'� Till I I + f .I I '(' I:. �"`•t• �. 'I I.! � ; ''_ y1 ki 1IN 1`I t F TOME I�R OVEMENT CONTR CfiUK;z` l�egis i low�109482.'<•� k IYpe . iN ,IDUA4 � '27 Q 0 Boxlubjf�' KNI RIVER RO "^'�" :. { R� 05M l A0648 ADMINISTRATOR s _,f.L ,j,.€y.`.�FLc k-..�i_r+.1•r.c�a•_a� - - /, ..�.y ��iuoelta ' ����ie•�rvnraneu�ea� °� BO ARD OF BUILDING REGULATIONS J. License; CONSTRUCTION SUPERVISOR Number'CSk 048502 1 1958 i 'tee. Birthda _ , . 11294 07d001 T .no: To: 00 EUGENE P FRIEFF r r,. %� POB 1063 a MARSTONS MILLS, MA 02648 Administrator SOIL LOG v"PEA 3T 11 - L0Ahi S FILLLL IIIII .Gil 411C I IU � DIST. a I•'."' � a , ° � At a 1000 BOX I 1000 GAL. I 0 MIN. � --- '•• a ----- GAL. -- J �e:%�, PRECAST OR o 24' •�r.'.r.,'• .. SEPTIC -- — I' BLOCK • ` ' I MIN eS-• TANK 6' ;�sa.� SEEPAGE i ° ' . : 1 -. PIT • • : I -af S'a"r..i I] -_. nJ 4 ..� 2 0' M I N. — —__y,f '� • • d I i r c:Y r, N f•G m' lnH. �, . FOUNDATION ; I I „- - - - - - - - ' I � � a 1 /2 WASHED STONE I I i I ELEVATION SKETCH -- --- 10' PER C. RATE= -' rm 2,w-4 - . SCALE C 4' TEST BY TOWN INSPECTOR % BACKHOE OPERATOR r� C_:• '�� TEST MADE ON •�• ? ______ _ Q) a I NE�ZEBr C�,2Ti 6 4.)AP ;rIOh. .` YOAVN fjE42&QN hVA95 .f / � d,. '`�-��V/ pia /+7tJ1/T3 O r T�� 7GXr✓�; / \ JAMES .98 db 4.jl All LoT 67 rn f `V, // / 2 co -7 F: ' o ,s-►�.vy Conr-rocfr� o � 20' ! . / .� �, ! ��� • !log<ti i If 19 19 r v r' rO[ 4-7ct-0 ELEVATION SCHEDULE !^, PROPOSED SITE PLAN I. INV AT FOUNDATION = 99oL a 2 INV INTO SEPTIC TANK SEWAGE SYSTEM DESIGN dN 3 INV. OUT OF SEPTIC TANK = ag 67 4 INV INTO DISTRIBUTION BOX = y 7 / F ���• SCALE I" = 19 5 INV. OUT OF DISTRIBUTION BOX - �/4 C 6 INV. INTO SEEPAGE PIT = 48 CAPE COD SURVEY CONSULTANTS ROUTE 132 7. BOTTOM OF PIT = HYANNIS ,MASS.