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0064 CROOKED POND ROAD
9 �y i t� 'I i r I j ALTERNATIVE WiEATHERIZATION } BUILWO, OUT 3 C , SEP,0ff3 . ®F BARNV TOWV� h% Date: rt . Town bf Barnstable` 200 Main St. w Hyannis,MA 02601 - k` Re:Permit# d�-� Village: The insulation/weatherization work at r\C1 has been completed in accordance with 780CMR. g Regards, Timothy Cabral, President e _ CJL-105454 58 DICKINSON STREET FALL RIVER, MA b2721 ( (508) 567-4240 1 ,ALTERNATIVEWEATHERIZATION@GMAIL.COM Town of Barnstable BuIlIldIl t Post This Curd So TFat rt is.V�s�ble±From the Street Approved,Plans Must be Retained on Job and this Card Must be Kept ,.: 9 Posted Until Final Inspection Has ,Made.''; ,,,- ,Been osuct V11h`ere a Certificate of Occupancy,is Required;such 13uildingshall Not'be`Occupied until a Final In has:been"made ° Permit Permit No. B-20-1787 Applicant Name: Timothy Cabral Approvals Date Issued: 07/16/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 01/16/2021 Foundation: Location: 64 CROOKED POND ROAD, HYANNIS Map/Lot: 291-320 Zoning District: RB Sheathing: Owner on Record: CABRAL,KARLA Contractor Name:`��JIMOTHY CABRAL Framing: 1 + Address: 64 CROOKED POND ROAD Contractor License: CS`--105454 2 HYANNIS, MA 02601 ' Est-Project Cost: $5,138.00 Chimney: Description: Air sealing,weatherstrip and sweep on exterior doors, r19 fg for Permit Fee: $85.00 sills, bulkhead door,soffit vents,propavents,t-dome:fg to, Insulation: 147 t Fee Paid: $85.00 damming and attic flat,blower door and combustion safety tests. Final: Date: 7/16/2020 V Project Review Req: ",2 4 Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for�ublic inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by,the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: - Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) - Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Cc v2C. O\ (LAC (Y\ kLIPI r v�c�� �t a tits CQVV\ -� ,CEO"Gu Ono ( VI k,µ. d b .•:L t ' 'iP^iM: :tJ'r t Y A 3 i �, h.�fyel .ae [.n'J N' d 1 y1 � �" tt y _�—'s.• ,+a Aiµ �t�: �Pra� r 2.3'�.�f f y.� � b,J`Y ,,,dtt' e�" Y t:`„ Am '! d' mom "�Fsnf, Al r per. t f.� .�? �.. t ifs. Myry ,� h .a n S:.- P_ . x� r its� -3 + d ! 1 �C t'� � 3�'^.2 ➢..f f �., 1 ffj i ,q, d�b`x w r "' `i# a �t�,,3s. Doc 2 1 s 063 s 573' ,45 11-2007, " 10059 Ctf:tr= 153064 ' QUITCL.AI*6"f)TABLE LAND COURT t' REGISTRY I, Denise M. Mitchell, of 64 Crooked Pond Road,Hyannis, Massachusetts,for .° consideration paid of Three Hundred Forty Six Thousand Dollars($346,000.00);hereby grant to Luis R. Montero of 156 Sunnywood Drive, Centerville,Massachusetts, . . WITH QUITCLAIM COVENANTS, The land,together with the buildings thereon, situated in Hyannis,Barnstable County, Massachusetts,described as follows: LOT 61 on Land Court Plan No. 1403 ' 4- M Sheet 2 r For my title, see Certificate of Title.No. 163812 and Land Court Document No. $55,573. ;• MASSACHUSETTS<STATE EXCISE`TAX BARNSTABLE LAND COURT REGISTRY Date: 05-11-2007•6 01:59on 4 Ct1lr: 1036 Dot#: 1063573 Fee:_ $1►183.32 . Cons: $346►000.00 LOCUS: 64 Crooked Pond'Roadv Hyannis,M A'02601` .. 'n.Y ^�, ,. Ate. .. ',M FY'» °. .,d/ { •a. �,, 61 W BARNSTABLE COIINTY'EXCISE TAX ' BARNSTABLE LAND-COURT REGISTRY ' Date: 05-11=2007" 1.01:59an ,. r Ct If:"1036 s , Dot:: 1063573 r Fee:' $788.88-, Cons $346►000.00 ,` 7. n x IN WITNESS WHEREOF,the undersigned has set her hand and seal this �day of A 2007. , Denise M.Mitchell COMMONWEALTH'OF MASSACHUSETTS Barnst4ble County,ss: On this day of APW2007,rbefore me,the undersigned Notary Public,personally appeared Denise M. Mitchell,proved to me throu h satisfactory evidence of j identification,which was ���VC�S U RC, ,to be the person whose name is signed on the preceding document,and acknowledged to me that she" signed it voluntarily for its stated purpose. a . Notary Public My Commission Expires: r STACEY A.CURLEY ` Notary Public Commonwealth of Massachusetts My Commission Expires December 12i 2008 ; WNWILE REG' RY of DEEDS ..�__ �_ _z �_ _ __ � � � . � � . ��� ��� �II � w � -� �� � G� -�`- 6�� �' I � ; � : , s I t i 64 Crooked Pond, Hyannis 4/29/2008 64 Crooked Pond, Hyannis 4/29/2008 64 Crooked Pond, Hyannis 4/29/2008 I e-O 7 0 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel :Appl cation,#„ Health Division c0-4q4 3 Date Issued_ � 6 Conservation Division Application Fee Tax Collector Permit Fee Treasurer Planning Dept. ' Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village " Y A�t n i S 0 n S D vlT r�— O �"`Addrass -- . CTelepi one 3 -1 6 Permit Request 19'elyn4vi 6- m- Hmo� 11114,11 OV 642WA /I Square feet: 1 st floor:existing proposed 2 d floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay + Project Valuation o 0, JD O . Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count CD Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal1stove: �OjYes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑ex sting ❑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 P posed Use BUILDER INFORMATION 1 yTelephone_Number-----L-c� Address- C 1�y k c of Pa K o� ,License# Home Improvement Contractor# Worker's Compensation# (ALL CONSTRUCTION DEBRIS RESULTING FROM THtS-PROJECT WILLyBETAKEN TO .�_.r...�,. �GNATURE DATE /0 -- �— `7 4, y i; `r F, M FOR OFFICIAL USE ONLY APPLICATION# - DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER I DATE OF INSPECTION: FOUNDATION i FRAME � INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 011410 DATE CLOSED OUT ASSOCIATION PLAN NO. t: r ' The Commonwealth of Massachusetts " Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111'' ' w�Ow.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant Information Please Print Legibly , 1�1`�e( s/Organintion/Individual):. ;i t S FZ r r.77 Adr ss: � c City/State/Z p'z�' 'a n 1' S ✓i't Phone.#: a DS Are you an employer?Check the appropriate bog: :Type ofpro]ect(required):. 1.❑ I am a employer with 4. [] I am a general contractor and I 6. ❑New construction . . employees(full and/or part-time).,* • have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the'attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, []Demolition ' 'Qyorking for mein any capacity. employees and have workers' 9. ❑_Building addition . [NO workers' comp.ianmm�Ce comp.insurance. ' 5. (] We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 11. Plumbin repairs or additions M . r3� I am-a homeowner-doing a'llwor� ❑ . g p . w _-. • o F right bf exemption per MGL myself`[No workers_co„mp. 12.[]Roof repairs insurance.re ed t c. 152, §1(4),and we have no •' employees. o 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 Homeownera.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 mum additional sheet shoving the name of the sub-contractors and state whether ornot those entities have employees. lfthe sub-contractors have employees,theymust 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.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 e. 152 can lead to the imposition of criminal penalties of a fine tip 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 thq violator. Be advised that a copy-of this statement maybe forwarded to the.Office of' Investigations of the IIA for insurance coverage verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct --'-Date i 1 Phone#:' Official use only. Do not write to this area, to be completed by,city or town officiaL City or Town: ' permit/License# Issuing Authority(circle one): A.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Town of Barnstable Regulatory Services RAMWABM Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. T y;p�&of Work ® � I,PIi¢L.L /-rr� nn rEstimated,Cost. , C2ner's Name:- Date of Apph ac hoon_--_( 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 [ Own p lhng own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date r-_._Owner!s Name QIonTalomeaffidav 'SHE Town of Barnstable �OF tp�� y�P Regulatory Services * BARNSPABLE, « Thomas F.Geiler,Director MASS. �A i639• pad Building Division rFD � 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 L--JOB-.LOCATION: C number street village -HOMEo � `S yl��T� �-,� (75 c,.)3 G-1- 1415-5 name home phone# work phone# URRENT MAILING ADDRESS ry-- (,/1 �l X,0,14 i S' aZ 6 o l 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 su erp visor. DEFINITION .OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require ments. Sign ature-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 fora/certification for.use in your community. y Q:forms:homeexempt r oFtHEr�,,, Town of Barnstable ti Regulat ory Services g Y * BARNSTABLK MASS, Thomas F.Geiler,Director Argo;p.,A``� 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 Property Owner Must Complete and Sign This Section If Using A Builder 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. QTORMS:OWNERPERMISSION �a fl-o �� . . r _ . * _ _ _ . _ � .. , . � ._ � , - � . � � e _ . : _ . _ � I Just an FYI Page 1 of 1 Giangregorio, Robin From: Lt. Don Chase [dchase@hyannisfire.org] Sent: Friday, May 04, 2007 11:43 AM To: Giangregorio, Robin Subject: Just an FYI The property @ 64 Crooked Pond Rd. is being sold nxt Wed. (5/9). There are no problems there, however, a neighbor reported that the owner was showing the new owner around the yard and pointed out where the septic was located in the back yard and where he could park his vehicles and not damage it. The new owner is Luis Monteiro. Thanks Don. 5/4/2007 %THE TOWN OF BARNSTABLE 19769 11/21/7' Permit No. Building Inspector i DAUSTAU Cash **-T 1l oo�OYPY a�� , 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 Cedar Acres Realty Address South Yarmouth lot #61 64 Crooked Pond Road, Hyannis Wiring _ Ins Pector e� - y,t� Inspection date �/� .�" Plumbing Inspectoro/K V -1 L, I Inspection date Gas Inspector A / 4 Inspection date Engineering Department L---4,11 Inspection date 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. C c�...................................................... 1gr "' Building Inspector a � y*TTHE TOWN OF BARNSTABLE permit No. 10769_____11l`11,1 Building Inspector . ameT►ai Cash ----------------—------------ 'oo 039. \ OCCUPANCY' PERMIT Bond ____-_PUA — "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 Codar boro'.l' Realty Address South Yamouth lot #61 64 Crookod Pond Road,, Hyannis I e f Wiring Inspector � 'e.0 4 Inspection date + Plumbing Inspector` s Inspection date Gas Inspector ^ =^s,� r , f Inspection date f 4 t p Engineering Department i, -- Inspection date 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. .....� . ............................... Building Inspector HEREBY CERTIFY THAT THIS FOUNDA110N t5 LOC T ON THE LOT AS SHOWN AND Al CONFORMS TO THE TOWN Or 04"XrX914e ZONING REGUI=AT10NS REGARDING SETBACKS FROM STREET LINES AND I OT LIMES, 23+ a ro b o y ° ?o p M N V v ILI ° y a R GOM,yo 41", 4� 2a 3r2 ^� Assessor's map and lot °number a C� � �c 7_ l&5 �' TIC SYSTEM MUST' BE- NS ALLED IN G PLI 2,w ...:.................1. v � ....... ''�NI1"H QM ANTE ARTICLE II STATE age Permit number SANITARY *THE ro 7 •_. Gt COD v QWN A TOWN OF BAR ii 5; i i B8BH9TODL 4t -4115 rz NAG& 6 oa.a, � BUILDING;- INSPECTOR APPLICATION"FOR' PERMIT tb ... �.1 ' :: e. ...:: .. .: � �r ......... ......... TYPE OF CONSTRUCTION �'r :�. .... .... ..... . .LOTCa TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a`�perm`tit according to they `following/ information: Cocafion ..... :: .:..... ....... ....... . . ..1�. �.�J. i. .... ...Q..!"•�....l.Y ..... .................. .................................... ProposedUse ........... . . .fir.C-l 1 -C% ............................................................................................................ ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ... '; 7P .. .. ......Address �� f�:�'✓ Nameof Builder ...� . . .............................. ....................... .................. Nameof Architect .................. ...........................................Address .............//.....:..................Q.............................................. Number of Rooms .............. ...............................................Foundation ..... ,,/..I :.! - . ....F .... Exterior ..... Roofing ........... . 4t.......... ../l . 5 Floors .......c .c,�.Z,6........................................Interior ........ .... ......�/ /� .:. ................... . . Heating ..�. ..I.!1�L�::�+�.::.1� � �...Plumbing � �1..�`:'... �•:�:'•.�1.............. Fireplace ............ .. .. ............................ .............Approximate Cost ......... . .. v.t . . .... . ...... ..... 04 Definitive Plan Approved by Planning Board ______ _-=_ _________19_(1,�. Area 1 . Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH . t _ I PIT I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A Name . !� �&d?....... ` ........ 4 Cedar Acres R alty -e , No .19769... . Permit.vfor<:...Dwelling.............. _ < ............................. Location`'.Lot' 61.....64 Cl<o4Res .. 'd.. . d....... ......... . ........................HyalauD ,S 4 y. Owner. Cedar Acres Realty, ; Type of�Construction ............W.0Qd T?xaDae....... € rc ............. ............................................ .................. - _ i Plot ............... Lot .....29 320.... ... ............ �< Permit Granted. .... Nov.... 21. ..........9 77 0y t� Date of Inspection Q 4�Ql,l.7 ...... ......19 Date Complete_d' ..�'?/.:��1.:?0•�..............19 Y `• ; -P,ERMIT-REFUSED " ..... ................. . ................................ .. I ` • •....•........�...................... ...................... Approved ..................................... ... 19 M. .......................................................................... . . r >.,.a.# ` fl' t +w "F r W j,mf . s y r"v;r _ s rN ;✓x a `k'�" 2 :: h,`,', 7 n„ a,` ', / '"+£s ° 7 tit.' '' ' .. +. y t .,, x'C`f,' f +'+o- -?,,.1',,,..,I'�.I.,.,.,..1-�-",.,-'�.I4:-.0.I_�r,_. ,,4,,,—vB--I J,I.I�.,,.I.-.'.�'l`.I'.Z,'.,r..,��,.,,-.1..�.�_.11.1�.,�...'"--I1:1,:.A�,:.-,_�N,","-:�, �•(fJJ(j� ,,-w. Assessors.map and lot-number ......... ' a . t t y 6 i t� 5, 1 •I , .y'•, Sew . 7 age Permit, number �. <� y G ' i ; r 4' 1 j;' V. t ,F ' to , -t?. m '���TH E TO q" �< ,:V�.1 (�. I. BABHSTABLE, o° C1_ .. �' � "'�,I),... - rY 9O�Y a`�D r. "L �` ft �s I. 1. OD 1�p9 9 � �.. a {, r' ` APPLICATION' FOR PERMIT TO a�' t>. T .. . ..TY,PE OF=CONSTRUCTION C ....:... ..... 3. a - t r ., -_TO :THE-iNSP.ECTOR OF; BUILDINGS` , 1 r :.,_,. —. The undersigned hereby applies for a permit' according to',the following information . - y 9 . .,, w�' '•1 t W2. tr "f 1 ` ,1r f l'i d I �V d:.Yq` �:.'�• ,�'� �i r `� A Location .i .. s - ti ,Proposed Use ri W l ` '" f •:x; ....4 .. ' .... .. , r Zoning District .... ..... .... . . . ..Fire District .... f , ; , . : Name of Owner -' c��1, ,a' t1�-1', I A 4~`ukn. ' ,t Address + e'�{ Ja s�s .�i`"' R R/r I wi .. -. a � „ fvu Name of Builder . J.,...... .,... Ad8res0s1 ... .. , ,_,. r ' ff , _ _ .4 :Name of Architect ' ......: . ....::: ..Address ... .... r h , s r Number,of� Rooms. ...:.. Bf':?::. ....:... ..:. .foundQtr�on .... t /t/ C3' '.�=% ..'I " (' `• •! • _• :{ :..r"' ;r... >r , ✓� .� 'z� "a``f 1f 1, h,r. ••.•, ,p,.?. �._ t.. "'' ,,f r , Exterior ...:. A,, `��:, t t o { aa_, �. r#� }:.Roofings 1 r' �f 'r i ?t✓ w.,? S 4 t .. .y I.. /f•• fP^•.' V.II ! t .....!� .,. .f„'. t '"`i..:s„"•.i ' ram,-3....I: 11" �.. ...7 I f w+ ,4 t Y J.' ..�1i .. ._�,--�I i I_.I,-rT��.:'�:�I�Ie,I,;;.-.�.,*�,I�i.1t.-.,-":,-'7 Floors ... .... :: .:.Intenor, ........ %. P f4 x �C •.•°'- ._ Heating c d w 1_ �_ 4� - - -A r"� "` -P,lurribing t',' „ �r ? , �' s ' .,, Fireplace ..:: ....... ....N.1.(....... .... ... . . ..... .......: .... .Approximate.Cost / y ... 4 _ 1 .. r c 1s 7' Definitive Plan Approved' by Planning Board.:__ -_.__ __ ______19 �1.. Area" .. �� . : . , / � 1 +� Diagram .of Lot., and Building •with .Dimensions ' ' Fee. .,..,�u,�- .t .. r' / • ' SUBJECT`TO APPROVAL OF ''BOARD': OF''HEALTH •\ • „ ": .. l r t -.r . . • , , 1, Y' , . .. : •. �� ., , i k t .. - Y�F (C 4 1 , J� Yi it r a } f i r � /; ! . t is ' f i r ,' , 1=.,�R. ., t t 3 is i, _ t 1 Zt i ; , a 4, ' I „ n " J.' - t . , �, r _ _ ,� .4 .. ` }} . .. , ";r, �, t .w "`f"`"` 'a�. r - - +re2Y4Yn:� .� w+.. I __ - ,. ..- ,; I.� ',.-I hereby ,agree to conform to all the Rules arid Regulations:of the,Town,of Barnstable.•regarding the above construction r '1 ,' r; r £* ' r +Y ,. b 1 7 n' 7 ,� l , ryy f t 7.'s' :r Name ,, .rG'"�' *.e .N r I" I t Y' } Y ` .4, d 'G Y._ A l f l _ t i F f { ,,. .. a `i f .. x' r.' Cedar Acres Realty D9 E 2-0 19769 No ................. Permit for PWRUIR&.........i:....... ............................................................................... Location Lot. 61 64..Q.T.Q.Qk.e.d..F&...Rd........ ...... ............... ................................IV.4naia.1......................... Owner ...... .................... Type of Construction x/ ..Wozd. F-r-ame..... ................................................................................ Plot ............................ Lot......29-L....320......... Permit Granted ..................N o 1 9 77 Date of Inspection ....... ........ .......19 Date Completed ..............................19 19 PERMIT REFUSED ................................................................ 19 ................. ... ............................... � I . f . I ........... .. .............. ....................... ....... ............................... jj ... .......... ....... .... ............ .................... Approved ... ...................... .......... 19 .................... .......................................................... ............................................................................... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# LA 1 Health Division q�_ q 3 (o �0-5 3 ubpzM Date Issued 1 -a3 Conservation Division'' by 1 l 'l©l Application Fee Tax Collector Permit Fee ' Treasurer SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. VM TITLE Date Definitive Plan Approved by Planning Board EWRONpAENTAL CODE ANL Historic-OKH' Preservation/Hyannis 'TOYM REGULATIONS Project Street Address COWICI PO Y -.f Ri . Village n In 1 Owner wl i A Address t-60 5og g �5- i5 0� o - of Telephone CO-CL�( � �`7� �g g u� fig- ,�(�Lo- q706 f(Jg(o Permit Request Y-ocb . Y)CLO owoy)t+�b ntc-�6o0li n6i (-e.,- cot L ZZ Square feet: 1st floor: existing IRV proposeda. �oCh� nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 4 AD,006 Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Struct-re a� Historic House: ❑Yes o On Old King's Highway: ❑ ❑Yes No Basement Type: lull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing i new 710 LhOmA:e- Half: existing new no Chan Number of Bedrooms: existing 3 new Cha.'KaJ Total Room Count(not including baths): existing =newqiLC, First Floor Room Count Heat Type and Fuel C,Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes Ul No Fireplaces: Existing New V10 rt Existing wood/coal stove: ❑Yes a'No Detached garage:❑e fisting ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size no Y�0 Attached garage: existing ❑new size Chtu�G,z Shed:3/existing ❑new size CYYL rA60ther: - Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial LJ Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# - Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO G QL (04-6 — -q00 -a3 q- 3 1q5 SIGNATURE Sjq6j DATE I o— 05 17 _.,. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ^ MAP/PARCEL'NO. ADDRESS . VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION t A , FIREPLACE ELECTRICAL: ROUGH-_ FINAL PLUMBING: ROUGH-w FINAL t i ». GAS: ROUGHS ;= �'F4 .�» FINAL • FINAL BUILDING �� ^ -7'® -7 .. c3 ofz DATE CLOSED OUT ASSOCIATION PLAN NO. G The Commonwealth of Massachusetts Department of Industrial Accidents , _ office olinlrestigations 600 Washington Street Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit 'dea _ a _--- name: 11 i�� 1 VI . {1 l JC. e I 1 location: tP 4 C(w w-A ci Q 1)15 " ' ` ' hone# I am a hom owner performing all work myself. 5D FS` a 70' a 38 I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job 4 .u.my. {t .F•4t v WtrF r,,;,, >` m, "v. yM �,.. c r— ,S z ,.; f `' }af x PF.:4.cr `x t Y S; r ncm; e ¢yr• 4.s:'. kr; a h a #r i.. r r > 1 s't _,r sy 'cv5 'f tg :�} 's ai' s, � 5 s, r _ 17 "!' '✓n;e S.w$a4 .y +`�.'f,r dL^' axnr � + r "E „Y: ,P 3;,:�`Saintl N 9 t-`e '�tiZ•-e• §t @ 51" y } p. t s 4 _. [] I am a sole proprietor,general contractor or homeowner circle one) and have hired the contractors listed below who have the following workers' compensation polices g i �" k �Wp� M ; u Yr a * +5'k..-."'�.t. 1�:.4]-.,. v •+� S.1 4 t C-{ x r r',r r �°'.'. v��Y f]l+��.�Y ���CS�+�'l Fx „g'"1."a'�r4;�"P'.�s` CItY' ckfvzP s u+ t ks n } a PA�*��st�5°�E�-m'+,�,"7�+%�.ps} f r Mi ) '�. �t,,c.� .i-y�-'�.7��`' •'s.� ��>r'y+.�y&R < W�_x i;'}�'.: zs t �, � 4 � ,.f� tt {,r u xN �,• is ���.;�.�a v.csrk���p,,�`�'���t ; � r*-+ COm' en u name � y;.�%y,�a,,���s�c'h��x �3��C '`.� � ` � r,t r t3,�� i' �z�.{s ` `: v� '�1. ti ,; r r :_ Y k *�',,� e"�VJ t•.�.�'m�... to,�'}'_.f� ' s.*„r x^�.t`'�vRrd st"'� '^rs'Y ��i �{ r1C.Y P,,,fy.�,y ri,���fi�si7"1i S�a r, s i< v / f...� y,-Yi "x � G✓e'. ��. s�`Or X.�I�.w r! paddress �'z� atS�YStM arC� { � z S M s � `?.xS^7��{ r�S��fa �`'+q$L r'a kris °ter 4t ''sy1 �1 4 �}t 1 i'�tr r ,7�s 0.•z+ �7 t`�Y air f ����� {°� +fir ,r�r1r� ft. •, t^ i`�fxr ' ♦..:<.Nt' ._ >Y '.ih d :.av�,t ��Yu+,� SS L yrR_i'J w* h .t".. Y: Da ollc,:r� .,5,.' ,.>' . Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the��Office of Investigations of the DIA for coverage verification. I do hereby certi under the p ins an penalties perjury tha the infor do provided above is true and correct. SignatureAA y Date U ��� Print name X.I I 1 V I�Gr I Phone official use only do not write in this area to be completed by city or town official city or town: permit/license# nBuilding Department ❑Licensing Board ❑check if immediate response is required []Selectmen's Office ❑Health Department contact person: phone#; FlOther r r (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, 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 trusteeof 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 I iy .. °FtHE ta,, Town of Barnstable P Regulatory Services sA MAM Thomas F.Geiler,Director a:ass. � 039..�00 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type.of Work: (w 01)6A 16Y1 Estimated Cost old y UOO. Address of Work: L (06 V- 1'66Cll_�4, 0,V) I/D Owner's Name: (t 5e V V \• y `1 �C Date of Application: l u hJ I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law YOwneir der$1,000 g not owner-occupied pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of.the owner: Date Contractor Name Registration No. Date Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 �' Building Permit Amendment $25.00 FEE VALUE WORKSBEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE �O square feet x$64/sq.foot= UU• x.0031= 3� U plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= 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 $6000 Above Ground Swimming Pool . $25.00 Relocation/Moving $150.00 (plus above if applicable) O$ Permit Fee 3 7=o C2AK Appendix J Table.I53.1b(continued) prescriptive packages far One and Two-Family Residential Buildings Hated with Fam"Fuel MAXIMUM MINIMUM WaII Floor 13ase'meat Slab •Heating/Coaling alaung Glaung Ceiling pesimcta Equipment Mcienc)� Area,(%) U-value= R-vaiusa R-vuluei R-value! w R- ml R-valuc° Package 5701 to 6500 Heating Degree Days' Nacmal 6 Q 12% 0.40. 38 13 19 10 6 Norisui R 12% 0.52 30 I9 14 10 83 AFUE 6 g 12% 0.50 38 13 19 10 NJA N/A Normal T 15% 036 33 13 25 Naff al U 15% 0.46 38 19 19 N/A 83 AFUE `r 15% 0.44 is l3 2S NIA 6 6 iS AFUESy IS'/. 0.52 30 19 19 10 13 25 N/A NIA Narmai X 18% 032 38 Normal y 18% 0.42 38 19 25 N/A N/A � 13 19 10 6 AFUE Z 18% 0.42 38 6 90 AFLIE 30 14 14 I O 1. ADDRESS OF PROPERTY. C� 1- OV00 Ir!2� 'Po o Zi t� Qt� rlis VYIA 2. SQUARE FO OTAGE OF ALL EXTERIOR WALLS: "I nn 0 3. SQUARE FOOTAGE OF ALL GLAZING: I(Pv 4. %GLAZING AREA(93 DIVIDED BY 92): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US OR THIS INFORMATION' B[JILDING INSPECTOR APPROVAL: YES: N0: q-forms-580363a 780 CMR Appendix J Footnotes to Table A2.Ib: •1 Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example, 3 f of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 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 ed for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between insulation and R-38 insulation maybe substitut the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include 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-fradie 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. The 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 basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. The R-value requirements are for unheated slabs.Add an additional R-2 far heated slabs. 3 If the building utilizes eleotric 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 J5.2.1a 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 0.35. 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(0.35 for doors). The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 )ffice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEIYIPTION Please Print DATE: ! ' tJ� C r / I O, _,�U O 5 JOB LOCATION: lQ 4 C(Oo Ke 1 Poo J,sA; L n n 1 er street nllage "HOMEOWNER'r 3(o name 1 home phone# -work phone# CURRENT M v1 AILING ADDRESS: 3 ES+0.0 V- d • �jh�Q ll`F�1/�it�U �� 0 I��-�-� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more-than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building 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 minim inspectio procedures and requirements and that he/she will comply with said p oc ,ures and require ` ts. ignature 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 fnrm currently used by several towns. You may care t amend and adopt such a form/certification for use in vour community. Town of Barnsta a *Qermt T �p Tp� Expires 6 rnonsh,Jrorn issra calf SME ,Fee • `~' ' Regulatory Services * BAiLKASS0� . �� l" b J 9� + m'� Thomas F.Geiter,Director � t6?9• Fo1'" Building Division ,�. Pete r F.Di�iatteo, Building Co�noae� �e S S 367 Main Street, Hyann MA 02601w is, OC r29 Office: 508-562=0315 , Zoo� Fax: :08 90-6220 _ BEN �L 4LY EXPRESS PERMIT APPLICATION N / Not Valid wuhotu Rd X•Press Imprint " AB` V (_ Vlao'parcei Number ` 13.20 Property Address C�OcI 'n Value of Work ci Residential Owner's Name&address Telephone Number Contractors Name Home Improvement Contractor license (if applicable) r Construction Supervisor's License_(if applicable) QWorkman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner C I have Worker's Compensation Insurance . Insurance Company\ame Worianan's Comp•PoliCy Permit Request(check boxl. M Re-roof(stripping old shingles) Q Re-roof(not stripping. Going over -existing layers of roof) 11 Re-side 01 RepIacetnent Windows. U-Value ( ) I .. Other(sp ecifi•) �j uired: ssuaace of this permit does not exempt compliance with other tom deparanent regulations.i.e.Historic.Cons n sn n where reQ , Signature Q:Forms:exomtrc:r-'v-4)10601 Engineering Dept.(3rd floor) Map o'lr1/ Parcel 3aD ��/ Pormit# House# (P Date Issued 9�� Board of Health(3rd floor)`(8:15 -9:30/1:00-4:30) LieeJ ,Conservation Office.(4th floor)(8:30-9:30/1:00-2:00) lv Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC S UST BE Defi ' ve Pla proved by Planning Board 19 INSTALL LIANCE NVIRON ODE:AND TOWN OF BARNSTABLe TOWN Building Permit Application Pro' ct Street ddress Y 6eoo P01U,0 LOT Village ( 1 Owner . 1oY1n1 �jS�d Address Telephone 50 9- 7 75- D 33 8 Permit Request z e G K /6 x / 7 First Floor square feet Second Floor square feet Construction Type 12. W 0-7--7� It Estimated Project Cost $ 2,SDb•Db Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes OfNo On Old King's Highway ❑Yes ❑No Basement Type: W Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing I New Half: Existing New No. of Bedrooms: Existing 3 New Total Room Count(not including baths):Existing0 New First Floor Room Count Heat Type and Fuel: 9 Gas ❑Oil '❑Electric ❑Other Central Air ❑Yes M No Fireplaces:Existing V/ New Existing wood/coal stove ❑Yes E No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) 0 Attached(size) //Y 0 x, ❑Barn(size) ❑None ®Shed(size) t( g ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# - Current Use Proposed Use Builder Information Name �j�{�� - Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE G I)a g 7 BUILDING,PERMAENI6 FOR THE FOLLOWING REASON(S) ,ter -J r� t � FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED'. MAP/PARCEL NO. f -f ADDRESS 1 VILLAGE OWNER �` ► ! _ , DATE OF INSPECTION: T" FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH 'FINAL PLUMBING: e?jtDUGH FINAL I f GAS:," , ;R!P.• GI FINAL FINAL;BUILDING k s f 1 i rI 1 O DATE CLOSED O .4 y . • ems+ ' �.�� i 1 i 1 , I � e , i ( ' � ( f ASSOCIATION PLI TO .. t The Town of Barnstable � $ Department of Health Safety and Environmental Services Building Division -367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissic For office use only Permit no.__ Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,(along with other requirements. Zype of Work:— Ne C' Est.Cost i —66- Address of Work: U66LN /'DAD M. ' v�f�� J wSs`1 �wner s Name i Date of Permit Applications I hereby certify that: Registration is not required for the following reason(s): _ Work excluded by law Job under S1,000. Building not owner-occupied =Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME EffROVEMENT 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. 6 13 fq Date Registration No. OR TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE / 7 JOB. LOCATION Number Street address Section of town "HOMEOWNER" T6L 6sH,) "V 1-22-re u2 ��1__t?._��0 0, Name Home phone Work phone - - � fir• ; PRESENT MAILING ADDRESS �D � ��D(���U �®//T�® "Y City town State Zip code The current exemption for "homeowners" was extended to include owner-occupie dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re side, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Offic: on a form acceptable to the Building Official, that he/she shall be responsii for all such work performed under the building ermit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the S Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "ho::;eowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which 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 G Home Owner engages a person (s) for hire to do such work, that such Home Ownex shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Homer'Owner' actin as supervisor is ultimately responsible. To ensure that the Home Owner is ful.: y aware` of his/der responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the la--t page of this issue is a form currently used by several towns. You may --are to amend and adopt such a form/certification for use in your community. r The Cotltlllonlrealllt of atassachlrscltti Deptiriiyzerll of lllf11l1trlal.4ccltieizts 3 pc�allllyestlgatlons ' r : •�\.Mils __��::+` 61111 11 aslli igrott Street 4;,•;`'`i Bustutr. Ma.u. (12111 �• Workers' compensation lnsurancc AMdavit �lililie rot information' - Plc,se PRINTznarn iebj� •�—�' c Jox'sy I am a homeowner performing all wort: myself. , F [[ 1 am a soli: proprietor and have no one working in any capacity .-+.. ..w.-.�w�...��........w�•�.�.r.�..w.�rc t�'�w^^ ��7'r'. ...•�w��•�....r.�� .=!1.�"�'�"'r.—•..•w..•.�.�— . .....�. .�.:.L.�....�.�..�...—+..._..ems—�..� L-- --` _•--'-•- �• .�—.r.- 71 1 am an emplover,providin_ workers' compensation for my employees working on this job. enn tiatt n tmt• •ttltlrccc• City- nhnnc tt• • incur�ncc cn _ nnlicv d Cj I am a sole proprietor. ;eneral contractor, or homeowner(circle Otte) and have hired the contractors listed below who the following workers' compensation polices: cmmn:ln%, nntnc- atltlrccc• cin•• - nhnnc a- incnrnnrr rn _ - nnkic`'T .-. s• _ �� - cnm nm• nhnnc- addrecc' — -- city• nhnnc i�• - incur•rice co nnlicL'Attach additional sheet if necesiari^ -''' _.. .. ___`.`r. :''�••.....�,,...... .• •••--r �;;;�._•_ ,.•�, F::iiurc to secure corcracc as required under section.SA of 11GL 153 can toad to the imposition of cnmtnai penalties oi'a line up to S1SOU.UU ant one+cars'imprisonment as weil as civil penalties in the form of a STOP AVORK ORDER and a fine of 5100.00 a day against me. I understand th:, cope of this,tatcutent may be furmircird to the OIr of Inv estigations of the DIA for coverage s•eriiication. /do hereht•cerri rtuier are paills and penaltics of perjum that the information prorrded above is true ttd cornet Signature Date �3Af7 Print name Phone>r T official use only do not))•rite in this area to be completed by city or town official t permitilicense d r1guilding Department WV or town: r Cuccnsing Board [ Selectmen'.Uflicr check:irimrncdiatc response is required t: E21lc2ith Department G ,:. ... r-f litter I .lassachusetts General Lrlws chapter 152 section 25 requires all employers to provide workers compensation for their mployees. As quoted from the " nw an empint•ee is defined as every person in the service of :11lother utider any ontract of hire:express or implied. oral or written. .n c•lrrpinr er is dcf incd as an individual. partnership. association. corporation or other legal entity. or an•two or more . ►c forc�goin�_ engaged in a,joint enterprise. and including the legal representatives of a deceased employer. or the :ceiver or trustee of an individual . partnership. association or other legal entity, employing employees. However the !i ,xncr of a dwelling house haying not more than three apartments and who resides therein. or the occupant of the XcI in�g house of another who employs persons to do maintenance , construction or repair work on such dvelling hous on the _grcunds or building appurtenant thereto shall not because of such employment be deemed to be an employer. 'GL chanter I52 section 25 also states that even state or local licensing agency sliall withhold the issuance or neival of a license or permit to operate a business or to construct buildings in the commmvenith for sn� •plicant who has not produced acceptable evidence of compliance with the insurance coverage required iditionalk. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the -form-eicc of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha _n presented to the contracting authority. plicants ase f il' in the workers' compensation affidavit completely, by checking the box that applies to your situation and :flvin_ company names. address and phone numbers as all affidavits may be submitted to the Department of istriai Accidents for confirmation of insurance coyera`e. Also be sure to sign and elate the affidavit. The .4:ivit should be returned to the city or town that the application for the permit or license is being requested. the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required li air workers' compensation: police. please call the Department at the number listed below. or Towns :se be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of :ffidayit for you to fiI1 out in the event the Office of Investigations has to contact you regarding the applicant. Pleas Ire to fill in the permitilicense number which will be used as a reference number. The affidavits may be returned to Department by mail or FAX unless other arrangements have been made. Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. se do not hesitate to _give us a call. . Department's address. telephone and fax number. The Commonwealth Of Massachusetts A Department of Industrial Accidents r i Office of Investigations 600 Washington Street Boston,Ma 02111 fax #: (617) 77.7-7749 phone #: (617) 7274900 ext. 406, 409 or 375 ASTORIA» N81.26 55 E ��� 34.55 R � cb. �9, �• A 23'� --- •r, 3 _cp O �, ==HSE==_= o_ LOT LOT o--, 64- _- 61 w 60 ��-•� tom' 2•0 SHED n t1 2. 117.32 �. 81'26 'S5"W d - S LOT 62 RES.. ZONE.- "RB" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Onl TOWN: _&Y41►!N1bS------------- REGISTRY OWNER: MIRE-FQBQ_____________ DEED , REF CTF�_78513--------BUYER: �IDFIN�J��QSMQ _ _ ---- DATE: _8 ,2 93 ___ PLAN REF: _14L�34 rLi_SHEE_T_,2__ SCALE: 30 _FT. I HEREBY CERTIFY TO 1YQBn'F�T_hCQ 1'Sa.6-GE 1Y�_____ ---_.� ___ _____ ______THAT THE BUILDING ���; OF dt ` SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS � �F PAUl.A,`Ac��o YANKEE SURVEY SHOWN AND THAT ITS POSITION DOES ____ CONFORM CONSULTANTS TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MEA THEW 40B (SUITE 5) TOWN OF J?A8 5TA�-F'______-_M___AND THAT p No. 32098 INDUSTRY ROAD IT DOES_NOT_ LIE WITHIN THE SPECIAL FLOOD HAZARD �� ? ' c�! F,ps�!'�`SH?-.`.`„y MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED�f ,��,1 TEL: 428-0055 Co unit -Panel # 250001 0005 C ::`•.--."��'= FAX 420-5553 � THIS PLAN NOT MADE FROM AN INSTRUMENT Afi7L A. MERIT LS - SURVEY, NOT TO BE USED FOR FENCES, ETC. 12308 DPG Town of Barnstable R � of THE Tp� o Regulatory Services Thomas F. Geiler, Director • BARNSTABLE, Y MASS. $ Building Division i639• ♦0 iOTEn n�+" Thomas Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: I d 127)()7 LOCATION: UNDER THE PROVISIONS OF 780 CMR, THE STATE BUILDING CODE, SECTION 3400.5.1, YOU ARE HEREBY ORDERED TO IMMEDIATELY DISCONTINUE THE USE OF THE CELLAR/BASEMENT AREA FOR SLEEPING PURPOSES. LO S CTOR *GNATURE OF E T ODEM DE SAIDA DATA: LOCALIDADE: DE ACORDO COM O PROVISORIO 780 CMR, CODIGO DE CONSTRUCAO DO ESTADO, PARAGRAFO 3400.5.1, VOCE ESTA ORDENADO DE DEIXAR DE USAR, IMEDIATAMENTE, A AREA DO PORAO/BASEMENT PARA 0 PROPOSITO DE DORMIR. 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