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HomeMy WebLinkAbout0130 DOLPHIN LANE /3� �a/�/� /� r; _ _ � JIRM 141 L L Rod TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Ul V Parcel l G' pplic tion U f L(C/ � 2 � mot" Health Division �I1l ed '� n Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis ,P_r- Street_Str_eet-Address 130 -D o t A IA pi Village=�`� nl c ' Owner ` gg " AddressCVVE Telephone Permit Request (Iqm�4UI2 f? Xr(�� I 09 4 �2 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size'_ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size_ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) _ Name I�VIL� 31ka a"IJ elephone-Number Address L License # Mw c 0 l 210 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION:DEBRIS-`RESULTING FROM THIS'PROJECT WIEL BETAKEN TOO-�-� SIGNATURE` FOR OFFICIAL USE ONLY v APPLICATION# DATE ISSUED MAP%PARCEL NO. � y w S . 47 ADDRESS VILLAGE OWNER - s i DATE OF INSPECTION: FOUNDATION c- , FRAME ` INSULATION FIREPLACE # ELECTRICAL: ROUGH FINAL M PLUMBING: ROUGH FINAL GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 'THE � Town-of Barnstable Regulatory Services i E Richard V.Scali, Director 16 3 arA � Building Division Tom Perry,Building Commissioner '. '200 Main Street,Hyannis,MA 02601- www.town.barnstable.ma.us t Office: 508-862-4038 ` `m Fax: 508-790-6230 NOTICE TO THE BUILDING.DIVISION OF LICENSED CONSTRUCTION SUPERVISOR ASSUMPTION OF,RESPONSIBILITY L k` fit � ,J ' ; Construction Supervisor License # hereby certify that 1-have assumed responsibility for the project under construction, as authorized by building permit issued-to (property address) on 2 2. 201q. The following dqcuments are attached copy of my Massachusetts State ConstructiomSupervisor's license or Homeowner's License Exemption form'(if applicable) ' copy of my Home Improvement Contractor.registration(if applicable) Commonwealth of Massachusetts Workers' Compensation Insurance Affidavit. Road:Bond'(if applicable) KkA �9 rl DATE q/forms/newcontrb rev:040414 �mE ra Town of Barnstable Regulatory Services • r * BMMSTABLE• v NAM $ Richard V. Scali,Director 161,39. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601. Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION ONS RUCTION SUPERVISOR J�� � GJ 1 , owner of property located at d hereby certify that k,C JAA I,-, A y u �� is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit#( 6d `C , issued on I.understand that the project under construction must cease until.a successor licensed Construction Supervisor, is submitted on the records of the Building Division. P ERTY OWNER DATE q/forms/newcontr reference R-5 780 CMR rev:040414 The Commonwealth of Massachusetts Department of Industridl Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass govMa Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Oro niza fim/Individual): k�L`/l 1` Address: �� t A) ( "` d 2 6 0[ City/State/Zip: Phone 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 El New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. ��D emodeling ship and have no employees These sub-contractors have 8. emolition working for me in any capacity, employees and have workers' [No workers'comp. insurance comp.ins rance$ 9. Building addition required_] 5. We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3. I am a homeowner doing all work 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13. -1 Otlier 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 aiidevit 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: � 1JobSit`Address a=bv e vi City/State/Zip: ( A Mo Zd o 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 certi r the pains and penalises of perjury that the information provided above is true and correct Si ature: i Date: Phone#: I Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: -Information and Instructions f Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 ki 11or on the grounds or building appurtenant thereto shall not because of sac&employment be deemed to be an employer." MGL'ch'pter 152' §25C(6)alsostates that"every state or Iocal 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 certificates)of Y 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 Lcense is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the Iaw 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 lime. City or Town Officials t 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 p ermit/license number which will be used as a reference number. In addition,,an applicant licant f` submit.one affidavit indicatin current ea ions in an given ear,need'onl g � � y , that'must submit multiple permit/Iicense apple tt Y Ip Y ,,�,, ,„ Y , policy information(if necessary)and under"Job Site Address"the applicant sholrld 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 addressjele'Bone and fax number. The Commanwcalth of Mai achusetts Department of Industrial Accidents Office of Xnivestigations 600 Washington Street Easton,MA Q1 I I I Tel.9 617-727-490.0 ext 406 or 1-977 IMASSAFE Fax 4 617-727-7749 Revised 4-24-07 www_mass_gov/dia Town of Barnstable Regulatory Services �OFIME TOlyp Richard V.Scali,Director Building Division �RARNSrABerg` Tom Perry,Building Commissioner 1639. �� 200 Main Street, Hyannis,MA 02601 AIEOt a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION r\/� l 2o r` Please Print DATE: l"` ` r - I 1 ',��k"%j JOB LOCATION: �t l \0�/ ` tj number r J p street ( �Q 'lage "HOMEOWNER": �( 4�c ll Gal �'U� �l — �C1 ``�'. t0 42—C4Ll�J [C name P 1` home phone# work phone# CURRENT MAILING ADDRESS: EA �V W k s c.EA_ /Lt.-lk- ©A RID 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 tAderslgned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection p s and requirements and that he/she will comply with said procedures and requirements. I a Horn eowrf6r Appro I 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 061313 + J snxrvsrnar.E. 9� ' ,� Town of Barnstable ArED NIA' A Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 '} j f - t www.town.barnstable:ma.us i 'Officer 5'08-862-4038` y �'� i �' ', A; J �, Fax• 508=7.90-6230 �... 4 �J.l�1 F ,1 •_� V-Property O+caner Must .iil' Complete and Sign This Section If Using A Builder 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: x _f (Address of Job) Signature of Owner Date Print Nam e If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QANVPFILES\FORMS\building permit formsTYPRESS.doc Revised 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION n Map Parcel Application Application Health Division Date Issued 2—Z� 71 LI DPP Conservation Division Application Fee J(J Planning Dept. Permit Fee �2 3 Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address o `l) aL,('kf f AJ (1,d Village IJ/y I S Owner (U LL t2( 'At A- Co ,San Address Telephone Permit Request Square feet: 1 st floor: existing 1proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 5d- Two Family ❑ Multi-Family (# units) Age of Existing Structure V6 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: QtFull 14Crawl ❑ Walkout ❑ Other Basement Finished Area(sq.ft.) I , 27 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 RT;m Coun"_ 4 Heat Type and Fuel: -A Gas ❑ Oil ❑ Electric ❑ Other Central Air: ';❑Yes No Fireplaces: Existing / New Existing wood/coal stove? ❑Ys ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing O"new n ize_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: I g Zoning Board of Appeals.Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use `T APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1V/G GI4 1e"L_ 19Mi So Telephone Number � 'S - 7 y Address e2.'2-v L—kf D/Z V- c5' License# C.S- d 69 0P 7 2 Home Improvement Contractor# Email d1 .J Sg 6?,o+0 L 4A Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ®✓��t SIGNATURE O'A�AJGJr � DATE L FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED , MAP/PARCELNO. ADDRESS i VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION t _• FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL-, GAS: ROUGH FINAL FINAL BUILDING w ,Y ` DATE CLOSED OUT , ASSOCIATION PLAN NO. 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 Name(Business/Organization/Individual): M1 C-4W 14 c L DA]//S 0/✓ Address: City/State/Zip: 9A ST 4&.,w o�i/� Phone#: —`7 `7 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 8. ❑Demolition working for me in any capacity. employees and have workers' insurance.t 9. ❑Building addition [No workers comp.comp, insurance p• required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑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: -P� / 9 -0 D o t-- 0 0 l/�3 (2-o ✓;) City/State/Zip: Ct.—#kc'arLV1 LL8 MA Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and}ppenalties of perjury that the information provided above is true and correct Si ature: Date: Phone#: So 8 S 7 '-7 8 7 P Official use only. Do not write in this area,to be completed by city or town official r City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions 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-contractor(s)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 0211.1 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia �'ME To�ti Town of Barnstable Regulatory Services • ,narsr„ M Hass. Richard V.5cali,Interim Director 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 1 t 4 ��( JAC, ro as Owner of the subject > J l P Peity hereby authorize l v y C 1 V L N to act on ray behalf, in all matters relative to work authorized by this building permit (A dress of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled utilized before fence is installed and all final inspections erformed and accepted. ign me of Owner Signature of Applicant Vti co Print Ne Print Naine _ Date - - t t . Town Of Barnstable - Regulatory Services FttlE Tery� Richard V.Scali,Interim Director °-� Building Division a RARWGTARM : Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 QED www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION '. Please Print DATE: JOB.LOCATIOM number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building 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 Appioval 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 FICEMPTION 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. (1.1WA�'rT FC\Fl1RT.fClhnilriinv nermTt ftmns\AXPRESS-doC • Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: 4 7805 Type: Office of Consumer Affairs and Business Regulation xpiratiow-2/10%20;1.6a Individual 10 Park Plaza-Suite 5170 - - Boston,MA 02116 i MICHAELC.DAVISO•N-'3,ix.-_.=_:�:-;.- MICHAEL DAVIS0N :, 220 LAKESHORE DR E. FALOMOLITH,MA 02536'-"`.r"5 SG=�wit6u��� UndersecretaryNotvalid ture Massachusetts -Department of Public Safety ; Board of Building - Regulations and Standards Construction Supervisor j License: CS-069279 MICHAEL C DAV�{SO 220 LAKE SHORE DI FALMOUTH MA 02 3 j- Expiration Commissioner 03/21/2015: _. .._. 3 9 a. _. /L.Cd l�t��L 444.4. - C ► hr14;'�IbkFitN, K01 -ce Art w ct*be W C-411 W tit 04. 1 • t1 hd � 2� tVllcMELE oyG� :CUDILO ST p 34774 L m Q MODIFICATIONS to EXIST. MICHELE CUDILO, P.E. —, -1'f>f-- .HDbA44rt4g. .... ConsultingStructural En ineer .... .. .. .... Centerville. Massachusetts 02632-1979 508 771-7601 Drawn By: MC Date:. 01/22/14 Drawing 130 DOLPHIN ROAD Osterville, MA Scale: AS NOTED Rev. 0 SK— 1 File Name:DAVISON Project No.2014-12 i%L� 1' E ` MEMBER REPORT Level clg,Copy of Floor Flush Beam PASSED • 2 piece(s) 13/4" x 117/8" 1.9E Microllam@ LVL Overall Length: 15' IEW "a, � ' � ' �' � .>�.. �, �7 '�£'��#•- ex ">''�` .�'C� ,mot"S' '�s e"� 3}� xs r: 19 1•. J",77_.....3 �.��.< �. ifda .s.3. ..s. ..a, ..k'`.t'�.,:Y3 ��''! ,1":�._ 0 All locations are measured from the outside face of left support(or left cantilever end).Ail dimensions are horizontal Design Results i►cfval®�oc�adon Allovued .. Resutt LDE: Load Coml"naWon(..;, ri) System:Floor Member Reaction(Ibs) 4249 @ 1 1/2" 4463(3.00") Passed(95%) -- 1.0 D+0.75 L+0.75 S(All Spans) Member Type:Flush Beam Shear(Ibs) 3546 @ 1'2 7/8" 9081 Passed(39%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 15406 @ 7'6" 20525 Passed(75%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.442 @ 7'6" 0.492 Passed(L/401) -- 1.0 D+0.75 L+0.75 S(All Spans) Design Methodology:A51) Total Load Defl.(in) 0.695 @ 7'6" 0.738 Passed(L/255) 1.0 D+0.75 L+0.75 S(All Spans) Deflection criteria:LL(L/360)and TL(L/240). •Bracing(Lu):All compression edges(top and bottom)must be braced at 8'8 118"o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing is required to achieve member stability. Beanng Length Loads;ta Supports(Ibs) Supports Totals .Atrarlable Regmred Death F Snow TLive otal Accessories 1-Stud wall-SPF 3.00" 3.00" 2.86" 1549 900 2700 5149 Blocking 2-Stud wall-SPF 3.00" 3.00" 2.86" 1549 900 2700 5149 Blocking •Blocking Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. - TribYtary.. ;: Dead Floor;lire, _ .:. Smm :: L02dS ., lacagon= -::Width (090);r (100) (1,15) Comments 1-Uniform(PSF) 0 to 15' 12' 16.2 10.0 30.0 as rb Member Notes , , 14.5'opng Weyerhateuser NOtCS 3 :. 1 SUSTAINABLE FORESTRY INITIATIVE Weyerhaeuser warrants that the sizing of Its products will be in accordance with Weyerhaeuser product design criteria and published design values. l Weyerhaeuser opessly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocking Panels and Squash Blocks)are not designed by this software.Use of this software is not intended to circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project.Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by DAVISON tH OF o MICHELE CUDILO o STRUCTURAL NO 34774 CA 9 /STEP�� Q sS/QAIAL ENG� Forte Software Operator Job Notes 1/ 412014 2:24:4 PM Michele Cudilo 130 DOLPHIN RD. Forte v4.1,Design Engine:V5.7.0.245 Michele Cudilo.P..E. CENTERVILLE,MA 2014 92DAVISONl30d0/phlR.4te (508)771-7601 mcudiloacomcast.net Page 1 of 1 f:"'�� MEMBER REPORT Level clg,Copy of Copy of Floor.Flush Beam PASSED 2 piece(s) 2 x 12 Spruce-Pine-Fir No. 1 / No. 2 Overall Length:8' 'OR el MEN- 0 cr 0 .� an 7.6" a - o All locations are measured from the outside face of left support(or left cantilever end).All dimensions are horizontal. D2SIgt1•ReSU11LS Acpial Loeation Allowed tZ It LDF Load Cornbination(Pattern) System:Floor Member Reaction(Ibs) 2254 @ 1 1/2" 3825(3.00") Passed(59%) - 1.0 D+0.75 L+0.75 S(All Spans) Member Type:Flush Beam Shear(Ibs) 1585 @ 1'2 1/4" 3493 Passed(45%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Use:Residential Moment(Ft-Ibs) 4231 @ 4' 5306 Passed(800%) 1.15 1.0 D+0.75 L+0.75 S(All Spans) Building Code:IBC Live Load Defl.(in) 0.059 @ 4' 0.258 Passed(L/999+) -- 1.0 D+0.75 L+0.75 S(All Spans) Design Methodology:ASO Total Load Defl.(in) 0.092 @ 4' 0.387 Passed(L/999+) — 1.0 D+0.75 L+0.75 S(All Spans) •Deflection criteria:LL(L/360)and TL(1.1240). Bracing(Lu):All compression edges(top and bottom)must be braced at 8'o/c unless detailed otherwise.Proper attachment and positioning of lateral bracing Is required to achieve member stability. Applicable calculations are based on NOS 2005 methodology. gearing t engtlr . Load;to Supports(Ibs): SUpI`ports Total Arailabte_ Required DeaO FUv'e Snow Total Aeaessarle§ -..___, . 1-Stud wall-SPF 3.00" 3.00" 1.77" 814 480 1440 2734 Blocking 2-Stud wall-SPF 3.00" 3.00" 1.77" 814 480 1440 2734 Biocldng •Blockdng Panels are assumed to carry no loads applied directly above them and the full load is applied to the member being designed. iz 7FrbYtary Dead_ Boor Lhee Snow Loiads Lorapcn Width (0.90) {3 00) {1 1S),!. Commeirts 1-Uniform(PSF) 0 to 8' 1 12' 16.2 10.0 1 30.0 RB Member Notes 7.5'opng as rb ' - - SUSTAINABLE FORESTRY INITIATIVE Weyefiaeuser Notes `` Weyerhaeuser warrants that the stung of its products will be in accordance with Weyerhaeuser product design criteria and published design values. Weyerhaeuser expressly disclaims any other warranties related to the software.Refer to current Weyerhaeuser literature for installation details. (www.woodbywy.com)Accessories(Rim Board,Blocldng Panels and Squash Blocks)are not designed by this software.Use of this software is not intended In circumvent the need for a design professional as determined by the authority having jurisdiction.The designer of record,builder or framer is responsible to assure that this calculation is compatible with the overall project Products manufactured at Weyerhaeuser facilities are third-party certified to sustainable forestry standards. The product application,input design loads,dimensions and support information have been provided by DAVISON N OF 444ss90 MICHELE yGm CUDILO STRUCTURAL ZA No 34774 9 FGISTfcP o�sS1DNAL�� Forte Software Operator Job Notes 1/24/2014 2:23:52 PM Forte v4.1,Design Engine:V5.7.0.245 Michele Cudilo 130 DOLPHIN RD. 2014-12DAVISON130dolphin.4te Michele Cudilo,P..E. CENTERVILLE.MA (508)771-7601 mcudilo@comcast.net Page 1 Of 1 cf 3•-9•x%-S'- AT $ I Il ITCHE a x t,x g MASTER$DRM "" --n n ( I I f,i .l KIT HEa 1 x 1=-r C w t w - i 4'-3T I'l = a X2b_11 r-3 .J. � _ I x - ry 1 CLOSEr- SET B i • 12 BEDROOM El KITCHEN 1 T-3•x T-V 13'-8•x 9'-8• i ( I a�mx ,oa rimn a.mx ,amn a.m. . a.mn amx mmx ammo wuuo.mm wuc,�ae wucxr ae wmamo- , - -.. ......_ �� I Rya - c.t' 'nn' •'Ppadn�lin la I 3'-9•x s- AT!. ttI i li N ITCHE MASTER DRM - x a .1•xe 17-3^x 1 1• -° KfT�C H E�4 c x ; b' LX�- 3 1 CLME SET `9• 1 � I I ' BEDROOM 17-3"X7-4- i KITCHEN 13'-8`x 9-8" I • as 3d - aumn amx bmn amx .7 6%.... Assessor's map and lot number ....M-.a.. G IkiJoLvE Sewage Permit num r .......................................................... C) ' yQFTHET��y TOWN OF BARNSTABLE d '� [� .:, err• BABBSTABL 2639. C, - GUFLDING INSPECTOR in?MPV i'' t; `? APPLICATION FORD PERMIT TO ....+...:.................�r ' � ...... �..�'�'......�.�....s............/...`.{..... ..... TYPE OF CONSTRUCTION .....W®PV..-�77 '..........::..... ........................................... .................`. -'+T............ r, ........... .... ..... . ...........19� .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................................................:...:....:.. .. ..................................�3..�...`V j� J s Proposed Use ...... .. ................................... :'•. woo-v . ..... Zoning District , � .....................Fire District i Name of Owner y' �'�'av'S ............Address ......... Name of Builder /!. r......................Address .... !` K/.9 .................................... Name of Architect ( ? ........Address Number of Rooms .............................................. ...................Foundation` .... B1ae. ...................................................... Exterior ........FJ.. ..!..v! !b..............................................Roofing Q. . .7.............................................. �. ..........Interior ...... ..�CDeih ...-................................... Floors o .. .Y.. ....... ... Heating .................................Plumbing ^------- Fireplace ........................................Approximate Cost ...... ©Q.....�/ ...........:.............................. ....................................... Definitive Plan Approved by Planning Board ________________________________19________ , Area 7�... Diagram of Lot and Building with Dimensions Fee �. SUBJECT TO APPROVAL OF BOARD OF HEALTH Sao—, c � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin the above construction. S1 .................. .................. ............... Morin, Robert No ,.„18500 Permit-for add...t.a s.ingle .. . .. .. .......... family dwelling ......................... L:�-e............... y. LoAflon ......... 30,D61phin R 7....................................... West H r!nnisport ....................................... ............................... O0 Robert Morin wner ..................................................... -Y Type-of Construction ............frame ..................... ............ ........................................................ Plot'............................ Lot ............. .4, ............. Permit Granted July 1 �"7 76 ........................................19. Date of Inspection ..... ........... .... I r1l Date Completed i....:...........19 PERMIT REFUSED .............................................. ...... 19 ............................................................................... ............................................ .................................. ................................................... ............... • .. ..... ................................................... ........ Approved .......................................... 19 V1 7, ................................................................ ............... ........................................................ ............. f. Assessor's map and lot number ................ ..�< .... .. c � Sewage-Permit number �FTHETCC. TOWN OF BARNSTABLE Z BAWSTMi. 11M BUILDING. INSPECTOR .. ....... . o APPLICATION FOR PERMIT TO ...................................../ TYPE OF CONSTRUCTION ..... [ -w".............................................................. ........ .. tc .............. ''c:r'�)...........19� .. TO THE INSPECTOR~OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location _ 5 �.__7.1 —..�-, .................................���.'.C7... 1.................. ProposedUse ....... ........ ..... ........ ......................................... ..... .... ...n..... Zoning District �' ' �.............................Fire District " oo Name of Owner .. 1!'^ t"?�1!' J! ff'r'0,10,/A.............Address .................................................................................... i........... Name of Builder a .... Y1. +.....................Address ........................ Nameof Architect ..................................................' t ................Address .................l.........'..f...................................................... Number of Rooms ..................................................................Foundation l v!,K Exterior .............. 1........................................Roofing .................................... Floors � ....... _ I .................Interior ~ !C ............................................................... Heating .................Plumbing 77: ................................................................. .................................................................................. Fireplace ..............................................................:...................Approximate Cost ....... �®0............................................... Definitive Plan Approved-by Planning Board -----------_-------------------19________. Area Diagram of Lot and Building with Dimensions Feel / 4 !r�.....`. . ....:................ SUBJECT TO APPROVAL OF BOARD OF HEALTH c j I hereby .agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. k,. � Name ...................... Morin, Robert A=268-174 18500 for addto single—..^---. Pmr ' ^ ^ ^ ' family dvwyll --.��--_-----.�-------------. . . ~ . . . 130 DolphinLame ' ' Location --______ �� .__________ West KYXHKU#PJft Hyannisport �������^����''����''����',���''... Owner Robert Morin ' ---------------------- Typo of [on ' ' Plot ' Permit Granted ......./i ilu 1 Y...I.................;19 76 Date of . Inspection/ . uote comp/oted ' PERMIT . . � . ....................................z..................................... ....................................... ................... —.—..x�(��..�.��..��.cc --'' '----'—'' � / . .—.---------..----..—.. .-------. ` . ' Approved ................................................ 19 . ^ ' ---------------.—...------.-- --------------------~---.... | ^ | � '� M.a c u,f t `y �--_- ---.., --H�►! (2e In c t r,rr* oQ"L ! It�') ,F,h ''d •�" ' �,_4} �L j/ I � � l 4 r � /C) 1 eIr y W4 he-we 1 * /���ii.��► �ra�L' tl)� a: 1-0c 12 Fro w a ! � 24 RAY _ II ! KEV --- - --- - - { t • r _