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HomeMy WebLinkAbout0035 COUNTY SEAT STREET�� CaaoT� -r�WZy � c Application number..... ....... .... .... .?`. ........ Fee ................ .. a)............. ....... K,�, Building Inspectors Initials................. i.... ........ JUL 24 ~-1 Q Date Issued.:....................../...1.�`."�.. ........1.......... lip ABID 0 Map/Parcel... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: 35 cQutai 660 11 NUMBER STREET VILLAGE �/ l Owner's Name: J3R1/90 ALA (J)&=0 Phone Number � G���f•7 Email Address: 61-vn/1°,_ 05A o2.0a 140f. C�ell Phone Number 506 �f7 7 J 0S Project cost$ 3 •5®o. - Check one Residential ,� Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize 1710 1✓_@�� to make application for a buildi g it in accordance with 780 CMR Owner Signature: Date: 0.1 0 q/20/ 1 TYPE OF WORK ® Siding ❑ Windows(no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# ` '- (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR/F THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER.....................................................:.. .. *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or>Yes No ,if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.34pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side �j HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: &&±D A'pe-� Telephone Number �j 3 6 4 -- 7 70 5 Cell or Work number .I- e I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of stable. Signature Date t APPLICANT'S SIGNATURE Signature Date ® -]( o� koo All permit applic re subject to a building official's approval prior to issuance. .>a .a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly YName(Business/Organizationnndividual): lkary A kX &Ot Z X- Address: 3 5' cv ukl-r y .�A-( _�5-( City/State/Zip: A A/ /S-/4A - 60/ Phone#: 506 340 '7 3o5 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).*, have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: 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.t a ins and penalties of perjury that the inform 'on provided above is true and correct. Si ature: %te: o r I� Phone#: O ' 5k 130 / Official use only. Do not write in this area,to be completed by city or town official City or Town: PermittLicense# 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#: r 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 not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn 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 Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia Town of Barnstable Building Department °FINE T° Brian Florence,CBO Building Commissioner ;- lAFtNSPABLE. + 200 Main Street,Hyannis,MA 02601 Muss. rcb ib39. � ww-w.town.barnstable.ma.us �TED MP'�A Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: � HOME OCCUPATION RMSTRA . Date: 0 -01- 11 Name: Phone#: SOS- St5_9� 6 Address: 35 COU P"'I 5t AT 'G-T Village: 44 y A N N i5 Name of Business: 'O A 9 G COIF SS tj 1 q C-L Er �ors tG 1'NG�j Type of Business: C L t ANI N6 Map/Lot: / 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 A of the Zoning ordinance,provided that the activity shall not be 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 C) :L .:- within that dwelling unit. 0 C r`. Such use occupies no more than 400 square feet of space. � mc a U) • There are no external alterations to the dwelling which are not customary in residential buildings,and there < Y ' is no outside evidence of such use. K 0 No traffic will be generated in excess of normal residential volumes. < r The use does not involve the production of offensive noise,vibration,smoke, dust or other particular M m .matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. m CAC `' There is no storage or use of toxic or hazardous materials,or flammable'or explosive materials,in excess C �. � of normal household quantities. _ y Any need for parking generated by such use shall be met on the same lot containing the Customary Home Z equired front yard. Z 0 Occupation,and not within the r -n �0 :—;7- There is no exterior storage or display of materials or equipment. Z ►r► hn -n 0 • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one C-) pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to CC C exceed 4 tires,parked on the same lot containing the Customary Home Occupation. M a • 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 0 included Z • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: Date: Q'q ' 21 1C) Homeoc.doc Rev.10/17 .� Town of Barnstable Building Post- This Card,So That rt is,Uis�ble;From,the Street Ap`proued;Plans Must be_Reta�ned on Job and this,CardMust be Kept �ATtNSPABL6, ,z�`- ,�," ,, s.✓.��°�i., "`.� .x ��� '"�` :.� � f a� { ��"1"- x � r ��'� F a� � +� � • 6" R Posted Un'1I Final Inspection Has;Been Made 3•. 1 / _ :, x A Permit ear +� Where a Cer'tifi�cate of Occupancy is Required,suchBuildmg shall Not be Occupied until a Final Inspection has'been made .. :Fxaa.w.b`f•+,z�T '"2.w. t'3ivkaaat% a`a.o�d�_�..>,. „g`w.x3unWik. r�'b .a.,-,,c Permit NO. B-18-4196 Applicant Name: Lloyd R Smith Vivint Solar Developer LLC Approvals Date Issued: 02/26/2019 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration Date: 08/26/2019 Foundation: Location: 35 COUNTY SEAT STREET, HYANNIS Map/Lot: 291-167 Zoning District: RB Sheathing: r Owner on Record: BELOW,BRUNO&DEMATOS-BELOZO, ' Contractor Name ,BRIEN LANGILL Framing: 1 Address: 35 COUNTY SEAT STREET Contiractor License: GCS 106675 2 a ti x HYANNIS, MA 02601 `�� ,EstProlect Cost: $2,182.00 . Chimney: Description: Installation of roof mounted photovp;taic sol system4�96 KW 16 Permit fee: $85.00 Panels , Insulation: ? Fee Paid $85.00 Project Review Req: Dane 2/26/2019 Final: � t - Plumbing/Gas Rough Plumbing: ui m icia This permit shall be deemed abandoned and invalid unless the work authonzed by this permit is commenced within six months after issuan Final Plumbing: All work authorized by this permit shall conform to the approved applicati n and the,approved construction documents for which this permit has been granted. Ze All construction,alterations and changes of use of any building and steuctuees shall 4e in compliance with the local zonmgaby flaik" d codes. Rough Gas: ` This permit shall be displayed in a location clearly visible from access greet orroad and shall be maintained open for public inspection for the•entire duration of the work until the completion of the same. s i' Final Gas: 4` The Certificate of Occupancy will not be issued until all applicable signatures by'the Building and Fire Officials are'providd on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work = 1.Foundation or Footing Service: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining isinstalled �I ;• ,a ., - Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department -�o All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �- �`� � « 1 Commonwealth of Massachusetts. Sheet Metal Permit Ma ' Parcel l Date: Permit 1 Estimated Job Cost: $ ,l ov0 .0-a Permit Fee: $ Plans Submitted: YES NO 4 Plans Reviewed: YES NO Business License# 14D Applicant License# �� Business Information: Property Owner/Job Location Information: Name: -eve Cam+l- Name: Street: t S eet— � Ci /Town: tY Q Sf q_ Gtl Hja o ►j6-1-3City/Town: 9��r�► f MA Telephone: Telephone: 5 m f® ,— aisL I .gg Photo I.D. required/Copy of Photo I.D. attached: YES NO Staff Initial J-1/M-1-unrestricted license J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq.ft. /2-stories or less Residential: 1-2 family Multi-family Condo/Townhouses ether31 Commercial: Office Retail Industrial Educational l Fire Dept. Approval Institutional_ Other =? Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of St ries: ' ~ ' Sheet metal work to be completed: New Work: w Renovation: HVAC Metal Watershed Roofing Kitchen Exhaust System Metal Chimney/Vents Air Balancing Provide detailed description of work to be done: .S` VSURANCE COVERAGE: have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes jo No ❑ you have checked Xa, indicate the type of coverage by checking the appropriate box below: liability insurance policy Other type of indemnity ❑ Bond ❑ WNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the :assachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent r checking this bo:i ,I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and :curate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final Inspection i Date Comments i Type of License: Master ❑ Master-Restricted ,Rown ❑Journeyperson Sig ature of Licensee mit# ❑Journeyperson-Restricted License Number Check at www.mass.gov/di2i )ector Signature of Permit Approval . The Commonwealth of Massachusetts r Department oflndustrial Accidents Office of Invadgadons -600 Washington Street Boston,MA 02111 www.massgov/din ' Workers' Compensation Itisurmnce Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name PMfa ss/organizatiiona&vidual): syL `�. Address: °�,o f-t c l i s S g QE►iie City/State/Zip: tJ i/&VAk � n 7 Phone.#: .5 D tR . _'�C,v 9sq 0 Are you an employer?Check the appropriate boa: 4. I am a -Type of project(required):.' I.[] I am a employer with ❑ general contractor and I employees(fall and/or part time).* have hired the stab-contractors F6. ❑New construction 2. I am a'sole p'mprietor oi•partaeer- listed on the'attached sheet 7. Remodeling c�rs ship and have no employees These sub-contra have g• Demolition working for me in any capacity. employees and have workers' [No workers'comp:insurance comp:insurance.$' 9. ❑Building addition required.] 5• ❑ We area corporation and its . 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing iR work officers have exercised their 11.n Plumb*repairs or additions myself: [No workers'comp. ri&of exemption per MGL 12.[]Roof repairs '.. insurance required.]t c. 152,§1(4), and,we have no . employees. [No workers' 13.0 Other comp.insurance required.] *Any applicant that checks box#1 must also fin out the section below showing then worl='compensation policy h fmmatim t Homeowners who submit this affidavit indicating$Ley are doing all work and then hire outside contractors must submit a new affidavit indicating such.xC=t—tors that check this box most attached an additional sheet showing the name of thb sub•cantractors and state whether ornot those entities have employees. If the sub-contractors have employees,they mustprcvidt their workers'c policy number. omp.p cY I am an employer that 1s providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: Guy/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 ofMGL c. 152 can lead to the imposition of canal penalties of a f ae up to$1,500.00 and/or one-year imprisomnmrt as well as civil penalties in the form of a STOP WORK ORDER and a fore of up to$250.00 a day against the viohitor- Be advised that copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un the. s•andpenalties of perjury that the information provided above is true and correct Signature: Date: Phone# Official use.only. Do not.write in this area,tb be completed by chy or.town of xiaC City or Town: PermitlLicense# Issuing Authority(circle cle one): .1.Board of Health 2,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: - HETown of Barnstable Regulatory Se • . , g ry Services Vesa � Thomas F.Geller,Director 039 Building Division... Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section =g A Builder as-Owner s ct pr9pett7 Hereby authorize act on my behal{y in all matters relative to work authorized by this building permit (Address of Job) . Pool fences and alarm_s are the res onsibili of e th P tY.. applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date WORMS:OWNERPMUSSIONPOOIS i l Of THE Town of Barnstable - Regulatory Services �Aatvs�rs, : Thomas F.Geller,Director MABEL 16 r Building Division Tom Perry,Building Commissioner O. 200 Main Street, Hyannis,MA 02601 / www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1 JOB LOCATION: number - street village "HOMEOWNER": name home phone# work phone# CURRENT MAMG ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. R - DEFINITION OF HOM .OWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner i 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 ultimately'responsible. To ensure that the homeowner is fully aware ofhis/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/ceriifrcation for use in u co r yo mmunity. Q:forms:homeexempt. COMMOfWW�ALTH OF.MA SACHU ET,TS i SHEET METRL W(?RKERS AS A pLWASTER,QNF tSTRICTE� t IS8UES,THE`A8M:LICENSE TO laAl 4 30 MELT55A DR , � I`�` I YAR'f10UTM MA 02673 14G3 i 420. 06/28/13 15004 Az %o�A s SST �,GT,F SEYJ t, .� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel :`Application # Qo 1 5 Q (� Health Division Date Issued Conservation Division Application Fee LW Planning Dept. ' Permit Fee �.. Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 3 5 CcrL,141 Lee,4 Village J1 y'9'a4- 'S Owner �.ee. 1�tc% Address 7�/ �1e� .-�r �,� i� Telephone `7 4 S o Permit Request P-I&I 4ek," FloeY%� F � ��� /1 e L-* n® Soaczs b'so,� Ilk' 3,S Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �3 ? 0 Project Valuation�'7 p00 Construction Type ``' Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docume9ation. Dwelling Type: Single Family ,S" Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: 1 Yes-] No Basement Type: O'full ❑ Crawl ❑Walkout ❑ Other X= Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing o2 new Half: existing new Number of Bedrooms: -3 existing 0 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil dElectric ❑ 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 ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Re5 �,4e g Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name (Sb Telephone Number Address e <- )6�1 License# e y 9 �S Al'f4�7' ZV11 f a­2 L c1b Home Improvement Contractor# d `/V d Worker's Compensation # ALL CONSTRUCTION DEBRIIS>RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �/���� G*�� DATE ,A '{ FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i MAP/PARCEL NO. t ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION z FRAME INSULATION: FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH --.--,-- FINAL x -FINAL BUILDING .' >> DATE CLOSED OUT , ASSOCIATION PLAN NO. The Commonwealth oflKassachusetls Deparhnent of Industrial Acc iddents Ofjice offizyestjgadons 600 Washington Street Boston,MA 02111 wwx.mass goy/din - Workers' Compensation Insurance.AJUdayit.Builders/Contr acto rs/Mectridans/Plmabers A ficant Information Please Print Le Name P s-inmdorg�ion tndiv dol): Address: City/State/Zip: MArS5 i l�JSjPhone#: 0 �- 5`S Are you an employer7 Cherk the appropriate box: L[] I am a employer with 4, ❑I am a general conliacfar and I Type-of project(required): . �l0Y=s(M and/or part-tmmme).* have hied the sub-contractors 6. Q New contraction 2.L"1 1 am a sole proprietor or partner- Ested on the attached sheet: 7. �& ag ship and have no employees These sub-contractors.�,e Working for in an capacity. In 8, ❑Demolition rkmg Y aF itY• �P Y�and have workers [No.workers'comp,ffiSUjanne comp,hasurance,l 9• ❑�.g addition . 3.❑ regmrE&j 5. 0 We are a corporation and its 10.0 Electrical repairs or additions -I am a homeowner doing aIl work' officers have exercised their. 11. Phmzb' myself No, worlr�r' cam; that of exemption per MGL repairs or additions ffismmce reqused.]t c. 152, §I(4),and we have no 12•❑Roof repairs employees. [No workers' 13.[]Other comp•insuance reged] *Ant aM&aut that eh=h box#1 mnst also 5Il out the section below showing.thds via±='compeasalion policy information Homeowners Who submit this affidavit chcd m a thcy arc doing all work and then hire outnda contractors mast snbrat a new atndavit mdir>ti D such tContracturs t}rat chrcr Svs box must attached as additioael sheet the name of the cmployccs If @rc sab-conhacton have employees,ffi y mast id�� o _0 �and s�vrhetber or not those cuti$rs have Provide their.wor$zxs'eomp.po&cy mmmher, I am an employer that is prmJiding workers'caarpensaiion Below i insurance for my employees s'the po&cy and job site z�ornratzort Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: CityAttach a copy of the workers' canrpeasation policy declaration page(showing/e y n Taa=to secure coo as re policy umber and eapiraiion date). ,overage gtmed ender 5ecb.on s VA Of c. 152 can lead to the imposition of caminaj pr:nalties of a Of up fine zap to$L,500.00 and/or one-year irrr�risommenf; as.well as civil p�eS in the form of a STOP WORK ORDER and a fine to$250.00 a day against file violator. Be advised alat a copy of this statement may be forwarded to the Office of Iuves-tigafions of the DIA for inS==e coverage verification. . Ida hereby certijy u theP -Penalties o . fPe7�'_that the irzforasafion prvrided above is true and carrec4 Date:. : Y l-Z Phone# .SS.O 6 S 6 T pi Sf Y(0 CJ1 7cial use only. Do not write in this area to be completed by city or town o jicw City or Town: PermiflI:icease# Issuing Authority(circle one): L Board of Health Z.BUUdh2gDeparfineut 3, City/Town Clerk 4.RI I .6. Other ectrical Tuspector .5.Plumbing Inspector Contact Person: Phone#: u , �z Town of Barnstable x �` Regulatory Services sAari ANZ, ` KABS A Thomas F.Geiler,Director n ` Building Division - Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 . www.town.barnstable.ma.us Office: 5.08-8 62-403 8 ..Fax:..508-790-:6230.._: ... -_ Property Owner Must _ Complete and Sign This-Section If Using A.Builder as Ownet of the subject ptopettp hetebp authorize ,S c»e pac ece to act on mp beha] in all matters relative to work authorized by this building permit 3S Cou A-y Sew + (Address of Job). Pool fences and alarms are the responsibility of the applicant. Pools are not-to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. S.ignatut of.Owncx Signature of Applicant tia ynB 1pC c'_IA C Print Name Print Name Date Q:FORMS:OWId WERWSSI0NP00LS �slE Town of Barnstable Regulatory Services t >�►xrrsr�ac� Thomas F.Geiler,Director r61659.tom" Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 - www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures, A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner i 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 plicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt . Ma ach0 etts -Department of Public Safety 7 f - > `l � �a.�znaoouuealC/ �/�a4oac�euaelta Board of Building Regulations and Standards i ,r Office o onsumer-Affairs&B smess,I,egulatio L Cons tructiun'super isur : ' 'HQME IMPROVEMENT CONTRAgTOR. License CS-092958 t Registration �164440' Type: `v;�;.r r'ti ���• i° R Expiration 10/6/2013 ?: Individual SHANE PACAE1,O i €. 143 HAVES hb " S .P. PACHECO) , r Y CENTERVIaE MA i02632 SHAKE PACHECO 143 HAYES RD. CENTERVILLE,MA 02F32 Undersecreta Expiration (Y „ Commissioner f 10/17/2013 n of t• r'' License or registration valid4or individul use only t before the expiration date. If found return to: Office of.Consumer Affairs and Business Regulation j 10,Park Plaza=Suite 5170 Boston,MA_02116 X Not valid without signature f t ' s TIC seco"Ic ' boa 1. M 1 q rovr A cl 1 REVISIONS ZONE REV DESCRIPTION DATE .APPROVED 0 0 1.' r•o Drawn fay:'Gary 5W66lnr Judy Brooks 55 Canty Seat Rd, F Ir Ont �.levatlofl Hyami5,Ma.02601 SIZE FSCM NO. DWG NO. , REV SCALEV9 _ �' SHEET i - REVISIONS ZONE REV DESCRIPTION DATE APPROVED \ I I V I V view I7rarrn by: Judy Prcob Gary F,5tu6km 55 Canty 5CA U. Hyamis•Mz,02601 SIZE FSCM NO. •DWG NO. I - REV SCALE�6 I I� SHEEr . • - REVISIONS ' ZONE REV DESCRIPTION DATE APPROVED H7 a o j: v. �r l'. - ....emu'.::... ..... •,•'� - a i .f. +t Ju, q4 3rocb brawn 13q; Garr. P, %bbins 35 cart4 5cA1U. Hyamis,Ma.02601 SIZE I FSCM N0. DWG NO. ' REV SCALE�4'I a 1' i SHEET REVISIONS ZONE REV: DESCRIPTION DATE APPROVED 7' ..r. Prawn 134: View Judy Brooksoft 506 H4 Cw rty Seat 6 Nyamls,Ma.02601 SIZE FSCM NO. DWG NO. REV SCALE��I = SHEET REVISIONS - .. ZONE REV DESCRIP'nON DATE APPROVED 2"Y.12"lodge 2"xl0" Uler516"O,C, CIA 5heatkrq 2"x 8"W Joi5t516"O,C, 9" In5ulaticn Codinla5 Hlcb Vent fyvec CA 5heatkN 2"x 4"5tud 16"O.C. e 4"In5ulaticn ��I f96 5ubfloor 211 0"Floor Joi5t5 9"Jnsulatlon 2"x 6"PT 5ill b"Huck Wall 8"x 16"Footinq Addition Cross 5ection Prawn 6y; Gary P.5W66IM5 y 13roob 55 Courtly 5eat U H4amj5 Ma,02601 SIZE FSCM No. DWG NO. I REV SCALE SHEET t •. . ... - - REVISIONS � DESCRIPTION . ,. .•. ., . �- ZONE REV DATE - APPROVED •.- - :• f r`oposed Crawl Space Aue55 1 Crawl Space �xistinq 9 Basement Access Window Window 4'Nigh Concrete Wall . 8"xlb"Footlrq, Drawn fay; Judy Prooks Gary I:.5tub6in5 35 Carb{5eat U. - Nyann s,Ma,02601 SIZE FSCM NO. DWG NO. REV Foundation plan SCALE I SHEET 4 . . REVISIONS ZONE REV DESCRIPTION DATE- APPROVED - 5'-4° —9° —108° —68° 7'-8_ 7'-6' 6> '-4' ae,, Vag 4'_1• 45",40 Vale N.q ' 4'—ll4 5 s vfaaV L--7'-34=� T—9d 10-82' 10'-9" —I—�'-8 6 —4'-616 k�dy brooks t2ra'wn �3q: Gary{ f, %bbin5 55 Camty 5eat U I ir5t Floor Plan Nyare�s,Ma.G SIZE FSCM NO. DWG NO. REV SCALE V4n m �� SHEET C I herebyagree to conform to 'all the Rules and Regulations of the Town of Barnstable regarding t - above 9 � construction. ' N. Name ..... . Ja ..... . ....... ... . . .. r ;Assessors map and lot number .......................................... 6) SEPTIC SYSTEM ' :a Sewage Permit number ...:....:........�,�L...3.....................:...... 1111STALL M MUST' BC ' WITH ED'IN COMPLIANCE ; c, ART k " -TATE' �Q,,of7�ETo� TOWN OF BARN aL �:A� rWD TOWI S. s, 1; BJflB9TADLE, i .BUIL 3 tr DING INSPECTOR s69• �9. 4 t� •--. i.: .. o APPLICATION fOR PERMIT T t ....................................�' $ .""D"". '. .`' TYPE OF CONSTRUCTION ........... .... 1.�G��'h. .......................................................:......:.......:........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information;.,, - 4 Location ............( ✓....� 1{ .....� ...�..........�r ......�� .! ............................................ !! �,�i� rc� ProposedUse ............?.L,��l .............. .. ................................................................... RZoning District ......................................Fire District ..................... Name of Owner !l.. Y '.d l K . .. ..........Address .� ° .... z Ci(/�Ya t/ Name of Builder . i '....... ..........................................................Address ..................Oe. �r ......................... ....................................... Nameof Architect ..................................................................Address ..:................................................................................ Number of Rooms ...................... ..................:...................Foundation .... .................. Exterior .......... -�......1.l...l..... ` LCf'G?f��� � oting .....................:....rrf�....................................................... Floors . .. ... ., g': ......Interior :................................................................................... Heating ..... r ..� ...... l .. ..................Plumbing .................................................................................. Fireplace ....... ...........................................................Approximate Cost ............ f.. /. .. ....................... Definitive Plan Approved by Planning Board -----------_-------------------19'________. Area 'n. .'T........................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH HEALTH Franco Real Estate Dev. A-219 -167 No ...... Permit forCount Seat St '1� ............................................................................... Location .... ..................................... ........................... I/ Owner ........ AAC,.Q..kggt.I..Ejs.tajtje Tyoof Construction .........IF9.4ft....................... ;r ............. ................................................................. --'plot ... .................... Lot .............t.... ............. V. /Permit Granted ...........4AILY 29 19 76 Date of Inspectioln t7 f':11 9 **"**'Date Completed .... ........19 7L .......... .... Zlt-1)' PERMIT-REFUSED r- fl j I ................ ...... .................. 19 ............................ .......................... .................... ....................................................... `�, ' f'/: `'- iy _ _ ....... .....• .. . ..... , ............................................... .... ............. ff ............................................. ................................. ,Approved .............................................n.. 19 t . ..............................................o.........I.-................... ........................................................................... Assessor's map and lot number ............................ A Sewage Permit number .....................yOF ....... ............................ THE TOWN OF BARNSTABLE MARISTAIME, 63 mum 19. lop BUI.LDING INSPECTOR APPLICATION FOR PERMIT TO ..... . ...... �v TYPEOF CONSTRUCTION ..... ................................................................................. ........./..........................19.24 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:, Location ........... ........... .............................................. Arl ..............0 -Proposed Use ............ ............................................................ ....... ....................................................................... Zoning District ........... ......................................Fire District ..... ........................................... ....... ....... .......................Name of OwnerA"445.kt.we��_,a�...........Address ............................................... .... ....... Nameof Builder ...........A....................................Address ..................#t.......................... .................................... Nameof Architect ............................... ..................................................................................... Number of Rooms .......................6......................................Foundation ....Fo-"�, .......... ..... ........................... Exlerior ......... la-f A 14YAO`Rlc�fff n .g .......................... ........................................................ .... .F... ............. Floors .... ..................Interior .................................................................................... . ...........................................V.......... Heatin g ...... 4&d— )=0/9 .................................:......................................Plumbing ................................................................................... Fireplace ......."7e......................................................t...Approximate Cost ...........CQ 16/, e 0 .............. .............n...................... A 'N2�'4� �Definitive Plan Approved by Planning Board --------------------------------19--------- Area ....................................... Diagram of Lot and Building with Dimensions Fee ... ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Z/ 0 137 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... ......... ........................ Franco Real Estate Day. A~291~167 '18539 No --- ....... Permit for ...�KggPA..Ra.al..Ea.tate ' --------------------------' - Location —C ,_________ ' . . ................ ............................................... , ~ Owner .....Fzaowzo'Raya&''Qa-tate------' ~ . Type of Construction ........Frme-------.. --------------------------. . . . . , ^'xz ' . . � Pe,mit { ron/ed ' . . . ' � Date of | ' ' ~.`~ ~~ .'~ ' \PRMIT REFUSED ' . ` ' , . 19 - ' ~' . . — ....................... . ~ ' ' v ...l.�...�...��°— _— —__---__. ' ~ ' ' . � ------'.------.�—.—.�---.---.—.. � ----'�---''r~----^~^----'^^^--^— . . ^ ` - - Approved ,'--------------- lg ' ' --------------------------' ^ � | i ----------^^---------'~''^^^^^` � ` �^ cv u c t v eNii,.tANA No, 19134 c�c T/may�h/.4T� -• t3©vim- 84 'Ir r45-�' ,sWa VvA/ , c1 rv/.Z TIoA/ cc-.vFde1y,j ,ems-�57-L=,F2W 4 4 rtry sU�er/�Yc,�S 6�`'•. ;el lot number n i i.�• - w l� l o- 1 ti ad, 6�` mite number ................v� thJ;i € 8 STCM. R/t�IST..B (I ..... ...... Cr of a, �1P ): '•,; A�w �' WN TO THE TO ,,d +1 €I IE a ----- ------- fi•; r. _ .. fir, .� r �.. - .. •r-, 3iABX3TAIILE;,i oo�i639. UUI'LDIH.G IH;SPECTOR ci E YFY a 4r�,. APPLICATION FOR PERMIT T �'— .... .. ........ / • � TYPE OF CONSTRUCTION ........... :: 1.�...... . ......... .............................. .... .� � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:,. A J Location ............... ��4 z ....� f $ .�....... �. .'... .Cc/G(11!L''-' J.. ...... .��;e/L L�.................. ProposedUse ............ .G .... ........... f.�4--.0 .:.......... .....{.......................................... Zoning District ...........! ..�.:....................................................Fire District Name of Owner `u A/✓r C?� uS.,P �4 ..........Address 7„y'..... ��'s; L. C: r Name of Builder :.. �':'iY�:<...........`.`...................'........:.........Address ................................................. Name of Architect ..................................:...............................Address..................................................................................... Number of Rooms � ....Foundation ....... � ,�'���`��' .... .... ... Exterior ............ � � o9 ................ .... ..........:...........:..................... Floors 7�f1f.4 l��i:l 1C ... ... Interior ........ ..... ... .... ........ ...................................... Heating .���............�.�..!�...!........................Plumbing ....... ... ................... Fireplace u......../., r " .......................�•��............................................... .........Approximate Cost �� Definitive Plan Approved by Planning Board ------------_-----_-----------19________. Area ......................................... Diagram of Lot and Building with Dimensions Fee 7�490 SUBJECT TO APPROVAL OF BOARD OF HEALTH r� 4e i � • y r I hereby agree to conform to 'all the Rules and Regulations of the Town of Barnstable regarding_ t q above construction. Name ..... . � .G � . ..... . .... f/� i 3kA' ' .. i j �I :- .134 45 / �'C�?T-/�yi 77�/�cT�-�'�,f,�o;.1� ,�,�1.��E� �'•�.�yl�; /tip . .S'No .-> 77-7�E I RL �� c .:fit[ is .,JAssesior's-map and lot numb /:.�........ ..... ....... Sewage 'Permit number . .0..... . ... ..... . Z BAWSTABLE. i House number rasa 3.s.............. .............. . I� W C �p t639. \009 B YAY A, TOWN OF BARNSTABLE BUILDING • INSPECTOR APPLICATION FOR. PERMIT TO s [ ��? .....4-..:/.'�Yc.ego?.... ?"�i .. °�' 4e,....................... TYPE OF CONSTRUCTION tV e'0a d ..t""f. ........................ .................... ....... ..... ..................:....................................... ........ 6........................19A� TO THE INSPECTOR OF BUILDINGS: IThe undersigned hereby applies for a permit according to the following information: Location .......... .. ..... -.Y.. ?. 1..`�C� ...........<.7..r/ !' 1.�.�.. .G ..................... ................................... Proposed Use ZoningDistrict, ...//.........................................................Fire District .................................................. Name of Owner ...<... ....... ..V� �!.....!v`.�.IGS..:.....Address ..... '.Ar'`.*.................................................. ' Name of Builder ... ::..`... `9�✓/�: ...` ........ Address ... ..: ,l. P .�%i ��- ..,II'�o%.</ .f. Nameof Architect ....... .............................................Address ...................................................................... �f�'?r' .G... ? Number of Rooms ........�................................................... ...Foundation ....,. ... : Exierior ......C.(.} ..:.............................................................Roofing ...... /................................. Floors `.....................................................................r Interior .....A....../'Va�`e..................................................-................... Heating ...............................................:..............Plumbing ....... J. .................................................................... � ®� - .. .. Fireplace ................VO................................... Approximate. Cost ....... ... ....................................: Defin itive Plan Approved by Planning Board ---------------------------------19_______. Area ....fp.4 Diagram of Lot and Building with Dimensions Fee / .... ....................... J SUBJECT. TO APPROVAL OF BOARD OF HEALTH 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. �y Name .. !'�... ... f ........................ Construction Supervisor's License ... ........... BROOKS, PHIL & JUDY c TPermit for ....ADDITION Single Family Dwellin.7..................................................9....................... _ Location .35..County..Seat. .. .....:........... Street A' .... .............. ...... .. ............. L ..................Hyannis.............................................. 'c Owne��..Phil & Judyj3X�Q.P S.... ................... 4 Type of Construction ..k:Xm-p...................... .- .... , '"Plot '...... Lot ................................ .Jul.. 6 34 - .. Permit Granted ............ .....'....................19 ``Date,cf'Inspection ... .............:..................19 Date Completed .. ... ..... ........19 ke w - ' f Assessor's map and lot number ....� �......... ....,z.. yOFTHETO� Sewage Permit number ............. ..... �� d .' � Z BJBBM. LE, i / House number ........................ ............................ 90O tG q. �` �OYPrAre� TOWN OF . BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO '.... ��►5 {, � .�?-....�.�. .... °i°in �d 7�"'rt..: ��!t.?.... . ........................ ........... TYPE OF CONSTRUCTION W®"c1 igr+� ............ ....................................... ................................................................... ................ ..............................................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby/�applies for a (permit according to �the following information: Location ..........��...`� ......... G.�.?.. .............. oa�/ !N .: ..�/.f. ....................... ................................... r f� ProposedUse ........C.,!!`c't-?.............................................................:.............................:.............................................................. Zoning District '`.... .........................................................Fire District ...1 !.....^........................................... .............. U , r•.• Name of Owner ........ '..�.... .. `.... `�f......[... ........�G 5..:.....Address .....mac: ?'' ....:.......................................................... Name of Builder ...l:7cj/ltL fir ...4,0 C. ........Address ...�R75 '� �f. ^�® � ... `�......!��! Nameof Architect ....... .............................................Address .............................................................................. Numberof Rooms ........ ...:...................................................Foundation .....Pc?v.e c`..�ot ...:.......................... �' ' Roofing �� Exterior ...... .....�.�..:........:.............................................. ...............w..................................................................... ......Interior / Floors ........ ....�...n.`s...�...........:=............................................... Heatinge ...................Plumbing � ' .......................... .......................................................................... Fireplace // ..............................................................Approximate. Cost ....... ............................I............... .......... Definitive Plan Approved by Planning Board ---------------____-----------19________. Area ....�% .U( �� ................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. Name . ... .....~� .. .:.e ` '!fr ........................ ,, Ca Construction Supervisor's License BROOKS, PHIL & JUDY, A=291-16.7 No 26667 Permit for .ADDITION Single„Family.Dwelling Location .35..C4Un;;i Seat,Str.'eet,,,,,,,,,,,,,,,, ................... ' ls.............................................. Owner ...... hil..&„JudX..Brooks... .... .. Type of Construction .... i........................... ! . ................................................................................ Plot ............................ Lot ................................ . ..............Permit Gran,ed ......Jul. .X....6 r ......19 84 Date of Inspection 19 Date Completed ......................................19 Town of Barnstable *PermitV1 0/ 00f 9 l l Expires 6 months fro t issu� e Regulatory Services Fee sAMSrABLE Des.039. Thomas F.Geiler,Director ptEC(�1p'1► Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www..town.bamstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number ( �� Property Address Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �i/a„mac ALZII /1/ / �rJ� �Y fyV4nnIJ Contractor's Name. `j - C. Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) O,L)a 9se ❑Workman's Compensation Insurance ®TRESS PERMIT Vk one: am a sole proprietor ❑ I am the Homeowner APR ® 3 2012 ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF 6 RNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. f Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑Fence over 6' #of doors 3 _ [ErReplacement Windows/doors/sliders.U-Value -31 (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. SIGNATURE: /1L ,lacliej%_ Q:\WPFILES\FORMS\building permit fonms\EXPRESS.doc Revised 051811 I The Commonwealth of Massachusetts Department of Industrial Accidents Off we of Investigations 600 Washington Street Boston,CIA 02111 wmv.mamgov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectricians/Plumhers Applicant Information / Please Print Legibly Name(Business,'Ok�onandividuau: c� Address: 291 �.Spei oCcA P?a,.s-4 ,, S rO`i f 1S 001. City/State/Zip: 1'�'I y (c q8 Phone#: —'14SG Are you an employer?Check the appropriate box: _ of project 4. am a general contractor and I Yl� p '� (required): 1.El I am a employer with ❑ I g 6- ❑New construction ,,employees(full and/or part-time)-* have hired the sub-contractors 2.Z I am a sole proprietor or partner- listed on the attached sheet. 7- B-ftemodeling ship and have no employees These;sub-contractors have g- 0 Demolition woddng far me in any capacity. employees and have workers' tY- 9_ ❑Building addition. [No worlcers'comp.insurance camp.msmane I ❑ We.are a corporation and its 10.❑Electrical repairs or additions required.] 5. 3.❑ I am a homeowner doing all work officers have exercised their 1 L❑Plumbing repairs or additions myself[No workers'comp- right of exemption per MGL 12.❑Roof repairs incmance required.]T c.152, §1(4X and we have no employees-[No workers' 13.0 Other comp.insurance required.]': 'Any applicant that checks box#1 mn9t also fill out the section below showing the¢wozkere compensation policy ithimation_ Homeowners who submit this affidavit indicating they are doing all wo3k end then hoe outside contractors must submit a new affidavit indicating such- fContractaas that check this box must attached an additional sheet showing the name of the sub-c to¢s and state whether or not those entities have employees. If the sub-caattamrs hare employees,they mustpmuide their workers'comp.policy number. I am an emplo wr that is prmiding workers'compensa on.insurance for my employees. Below is the palicy and job site information Insurance:Company Name: Policy#or Self-ins.Lic.it: Expiration Bate: 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the-violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cerhf,under the pains dpmaides ofpetyuty that the information-provided abatre is true and correct Si tune: Date: Phone#: Off Feial use only. Do not write in this area,to be completed by city or town o frciar . City or Town: - PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.CityfFown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 • 1WWSTAB14 • - MASS. Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I as Owner of th e r, e subject property hereby authorize S&M fo4G to act on my behalf, in all matters relative to work authorized by this building permit application for: 36 Couni4e4 (Address of Job) Signatur of Owner Date R 114IL1R49- &Chew Print Name If Property Owner is applying for permit;please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit forms\EXPRESS.doc Revised 051811 wv �I HE p Town of Barnstable Regulatory egu ory Services . EARPMAas$` Thomas F. Geiler,Director MASS i639. '°renter► Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINTTION OF HOMEOWNER . Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. x Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building-Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION - The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 051811 Massachusetts -Department of Public Safety Board of Building Regulations and Standards Cirostructiun Supervisor License: CS-092958FS { ' SHAKE PACHE60 - I P 143 HAYES Rb ri CENTERVI LE MA 02L2 j4t Expiration Commissioner 10/17/2013 '. - � �0777/I7207"NUCO� �/y✓�w�.�LIIQPf�d � . Office of Consumer Affairs&BIU(smess Regulation 1 l HOME IMPROVEMENT CONTRAd TOR Registration: ��1,64440 Type Expiration: 1Q/612013 I-ndividual t . S PACHECOF 1" SHANE PACHECO ,�` 143 HAYES RD. CENTERVILLE, MA 02632 .._ Undersecretary.' / Massachusetts - Department of Public Safety Board of Building Regulations and Standards C'imstructiun SuhcrN isur License: CS-092958 SHANE PACHEI�O .143 HAYES IW A CENTERVIt LE MA~02632 Expiration Commissioner 10/17/2013 . ....:............... .._ ............ . License or registration valid-for individul use only before the expiration date If found return to: r.Y Office of Consumer Affairs*and,.* ugliness Regulation y 10.Park Plaza=Suite 5170 Boston,MA 02116 s i �! I Not valid without signature Town of Barnstable *Permit tr 214E Tp� &pues 6 months from issue date o� CO sr►tttvsznst.s. • Regulatory Services Fee v� MAS& $ Thomas F.Geller,Director t6?q59. Building Division ; Peter F.DiMatteo, Building Commissioner; 367 Main Street, Hyannts,MA 02 601w S Office: 508-862-4038 ADIy 9�6 , Fax: 508-790-6230 �OP 1 EXPRESS PERMIT APPLICATION e q� t Valid wit/lout Red X-Press Imprint `V T ^ Map/parcel Number �� Property Ad dress s �. P Y esidential OR ❑ Commercial Value of Work ��� Owner's Name&Address ;�;;za -,t{' _Telephone Number Contractor's Name Home Improvement Contractor License#(if applicable) 2 l l 1 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I OX the Homeowner 91fhave Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(c ck box) Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) . ❑ Other(specify) liance with other town department regulations.i.e.Historic.Conservation.etc. *Where required: Issuance of this permit does not exempt comp Signature Q:Forms:expmtrg:rev-070601 cA TOWN OF BARNSTABLE BUILDING PERMIT PPLICATION Map Parcel 2-°I N 1 l.o Permit# Health Division 10�otj l� CD- 0 C T 2. 5 2001 Date Issued % o Conservation Division O IZS16DP/AQ- Fee Tax Collector SEPTIC SYSTEM P Treasurer .f ������Z r AWS��02 INSTALLED IN CCti PU ra P:" Planning Dept. WITH TiTL,7. C ENVIRONME6h'y�°�.�, Date Definitive Plan Approved by Planning Board TO Ko Historic-OKH Preservation/Hyannis Project Street Address S ` Village I)N Ali?ii� Owner j o w evA72eb\�LS Address 16 ezu-At^i agar vz-> Telephone i 60b -n t 5b 5Ce Permit Request f'1p kLtm n oj-k --yo r x�P �O 1<\T-C Xkri_rl Y\-"14 17--)m5 Square feet: 1 st floor: existing proposed i bO 2nd floor: existing 5•�(v proposed Total new I Valuation t7l 7-Yd Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Url*" Two Family ❑ Multi-Family(#units) Age of Existing Structure �!g0ta Historic House: ❑Yes C�No On Old King's Highway: ❑ 'I�lo Yes I� Basement Type: C�Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 5-7 (n lf:_17— Number of Baths: Full: existing new Half:existing I new Number of Bedrooms: existing—,6 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil &<ectric ❑Other ;-' Central Air: ❑Yes 2* o Fireplaces: Existing New Existing wood/coal stove: ❑Yes &<O f Detached garage: ❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use y 1 BUILDER INFORMATION Name Telephone Number f)C) 9 0 : vk Address t ZiQ L NvA(-0L,�k R7\�> License# 0:Y) `)(3`1 Y `\N"itM15 N1 0'" C)\ Home Improvement Contractor# 13 Zl 0 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. . ADDRESS VILLAGE ` OWNER r , t DATE OF INSPECTION: 1 FOUNDATION FRAME I' 4 INSULATION k FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL i GAS: ROUGH, FINAL FINAL BUILDING . DATE CLOSED OUT f„ r `` ASSOCIATION PLAN NO. _ ne Commonweauh ofMassacnuseu3 1 a��`'. Department of Industrial Accidents =I OIIICZ'Ol/Of�SII�OdS --'_ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit tilt rW/O :wxxxi%/���� ����%/%•, name: r location —ri e—ou T-w F—KV- dt, ia�` 1��5 oyiPr (),ZEDQ` phone# b ❑ lam a homeowner performing all work myself ❑ I am a sole rovnetor and have no one woricingm aav rs workers' i'or my ems as this job. over 00"I P1'oq�.......................:::x:::::.,:.::.:..:.?:,.>.q};}:}.{,�.:;.::..,:.�.::�::.�::,.n.:.:.:t.:.: �...:._:}:::::.:-:::,......:...:.:.:•.. .. :. .:: �.:.::.... :..: .. 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R : ..-•:+.; roYc�»xo•:}•}9q{.}•:4';%`�:•:x•. ......... .......... .......... ................ ...................... t..... .. k v�''v.' .,NC Y..i w:F.�. ....:v�.v.;,�5: .......................................:..........n....................................n..•:v:v:h.....:,. ....: + ..^•. k'yu.....fr--X•.:k}+f:?:::Y{:uf•%J.Y.•::.v,2.3:•'ik:Y.*,.: :.::::::.:::::•:::::;:::::::.�n•::.,...:.....?...F{.}.o:}.};.:...;............... ,.?,:;--f;::.t. n t: �Jao?tn � r...?..r....:. Faflme to teems eovcrate as required order Seetlan 25A o[MQ.152 tau lead to tha ln�odtloa ote�mdml pemdtlea of fine up to 514muse and/or against me. I tmdesstmd that a one years'tmptitomnmt as weII Isdvd penaitirs in the rotor of a STOP WORE ORDEBaad a doe of 5100.00 a day copy of this statement may be(otsrarded to the OtIIte orInsestl�tlens o[dte DL►for oaiQation. 1 do hcrcby c the paint and tatalties ofpgyW y��*aTmadO°provMd above it&w.and coned Signature - Phcne# Print name oiiidal we oniy do not write in this area to be compieted by city or tom GOWA n # � • psaildlagvep city or tenor: ULicwinL Board ' pseleetmed:Office [3 che&uinmrediste response is required C]Hgith Deputment contact person: phone#: ❑Other UrA m 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to Provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every Person in the service of another under any contract of hire, express or implied., oral or written. oration or other legal entity, or any two or more of An emplover is defined as an individuaL partnership,association, or the recerver c: the foregoing engaged in a joint enterprise,and including the legal representaruves of a deceased employer, , r other legal entity,employing employees. However the owner trustee of an individual,parmerslup association o of a not more than three apartments and who resides therein,or the occupant of the dwelling house of dwelling house havingair work on such dwelling house or�the grounds or another who employs persons to do maintenance,constractiarl rep be deemed to be as employer. building appurtenant thereto shall not because of such employment MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance who has of a license or permit to operate a business or to construct bindings is the commornvealAdditi for�yp�the not produced acceptable evidence of compliance shall��my� r the performance of public work until commonwealth nor any of its political subdivisionshave been presented to the contracting acceptable evidence of compliance with the insurance regairemem ofthis chapter authority. FEEN /ems: IM Applicants n the workers' c°mpmsatim affidavit completely,by checWn the.box that dies to your situate and Please fill i ames,address and phone numbers along with a certificate of insurance as all affidavits may be supplying company n arttneat o f Industrial Accidents for of iasa�coverage. Also be sire to sign and submitted to the Dep ortowathatthe appficatim fin the permit cr license is date the affidavit. The affidavit should be retuned to the Should�have my moons regal the"law"or if you being requested,not the Department of Industrial A,cciden ts. below• ensatiah policy, a call the Department at the number listed are to obtain a workers'comp P� . /% City or Towns .. _ ..__... ._, .. The Department has Provided a space at the bottom of the Please be sure that the affidavit is ceauplete and printed legibly' has to contact You g aPPhr�nt Please affidavit for you to fill out is the event the Office of Inv tamer. The affidavits may be retained t^ be sure to fill in the Pm number which will be used as a reSerence the Department by main or FAX unless other anangemmts have been,made. would lake to thank you is advance for you cooperation and should you have any ques The Office of Iavestigati°IIStions• please do not hesitate to give us a call. The Departuneat's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investloatloos 600 Washington street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext. 406,409 or 375 790 CMR Appada J Table JS21b(eommsed) . PM ipdve Packages for One and Two•Famiir Raideedai BaiWisp Reefed Mth Fowl F°eb MAXIMUM KINI IUM Glazing Glazing Wing Wall Flow 8aaemet Slab �Ci'ng Area'(Va) U-vaiuej R-valuer it-value R valaJ Wall perimew �MP� M�a�Y' Pale Rrvairfa� &vabter S70I to 6500 Hadna Degree Daw Q 12% 1 0.40 38 13 19 l0 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10. 6 ssAFUE T 15% 0.36 38 13 2S WA WA Normal U IS•/. 0." 38 19 19 10 6 Normal V 1S•/. 0.44 38 13 23 WA WA 85 AFUE W 15% 0.52 30 19 19 10 6 8S AFUE X 18% 032 38 13 2S WA WA Normal Y 18% 0.42 38 19 2S WA WA Normal FUE Z 18% 0.42 38 13 19 10 6 �'4 AA is% OSO 30 19 19 10 6 90AFUE 1. ADDRESS OF PROPERTY: Cp� C`P� �zA3— ° oZ(Q al 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: Zq y 3. SQUARE FOOTAGE OF ALL GLAZING: 3 4. %GLAZING AREA(#3 DIVIDED BY#2): t12- 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix 1 Footnotes to Table J5Z.Ib: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and excluding opaque doors)to the gross wall at enclose conditioned space,but g basement windows if located in walls that pq utrement. area, expressed as a percentage. Up to 1/o of the fatal glazing area may be excluded from the U-value re For example,3 ft of decorative.glass may be excluded from a building design with 300 ft of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values.do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 ins ulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathingif used). For ventilated ceilings, insulating sheathing must be placed between ( the conditioned space and the ventilated portion of the roof. Do not include 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing(if used). exterior siding,structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-fiance or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'T}:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br..,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.la NOTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 THE ' . The Town of Barnstable eA MASS, � Reaulato Services ,�. ry 9 i639• °� b Director, Thomas F. Geiler, Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 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. i Type of Work: �Zt�-��- 1�1't�N�� A¢e �,\F_stimated Cost C) 'LZ-9 Address of Work: �S CuVTtrl S¢�-t 2� �`I V�rKcS VA Owner's Name: U'b 52`e� 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 RBITPRA E ACCESS TO THE TION 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: 0 -1?'30 —2S6Registration No. Date C�ni®rNam�e OR Date Owner's Name q:forms:Affidav:rev-070601 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 � Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE C ` square feet x$96/sq.foot= 280 x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft` >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) t Permit Fee projcost r. L 1 ' ,`._ r � ✓�ze i�anrmzoni.�ea�a��aaar/tUde� _ -' -. - , Board of Building Regulations and Standards License or registration valid for individul use onl% = HOME IMPROVEMENT CONTRACTOR. before the'expiration date. If found return to: Registration 132117 ` Board of Building Regulations and Standards Expiration 1/20/2002 ?; One Ashburton Place Rm 1301 Type Boston,Sla.02108 . GARY R.STUBBINS GARY STUBBINS 126 i_INCOW RD 1 !•iYAN�AS MA^2601 � — �i s AIm��strAtnr t% va'irl witbnnt cisvnature ' h��i -.v:rYe -�yin �`•+��- `�x 1.. � "w .-.- _. 1 '•'+(1J1 � f � 1 J . .. y ,. 1 t -- - �'✓��MLIJW'ItIIM,UU/L'O�✓6�CQ'd6U�UJEl�6 -j r BOARD OF BUILDING REGULATIONS ` cede: CONSTRUCTION SUPERVISOR - 9, Number CS 077307 � r) dlrtfN�tW 06/2111966 expires=21R004 Tr.no: 77307 III Restridw To. ; '{, GARY R STUBBINS ` fZ�t1N�OLN RD - .ru" <:iYANNIS, MA 02601 Administrator t cJ - FO ULI . 44 7 7- z / 7� .S�f-Io Wit/ ��G ivi.J�T7G� CLAN Fd,�'/Lfs T!,) 77-70 M-j /�y`4A v�/S 1r #A 4 _ ' r jk y , 7 #` j LA U'b ll 7` lip / / .^?'ram � ���,-W/ �� � J• � I��© /� y - �, ,I- 77/- So s-r_ t ; [441 - , _ { f 6 1 i