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HomeMy WebLinkAbout0195 DUNN'S POND ROAD -f � ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map -7 Parcel A �. Permit# � Health Division '3�- `� �� Date Issued Conservation Division-. f S1 j ' ' jApplieation Fee Tax Collector 41 Permit Fee �L�• Treasurer '` _. f; !PEP X-SYSTEM MUST EE INSTALLED IN COMPLIANCE Planning Dept. ' WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANL TOWN REGUUTIONS Historic-OKH Preservation/Hyannis Project Street Address "15 �Ot�V�S �u�►C{ Z�/ .� Village 6LV,O i C Owner � � rGe� ( � I Address 4 pn I L ' ?k _C, Telephone Sn Cia-� ��— nn Permit Request AT: 4ozT4,1d, Square feet: 1st floor: existing proposed P 2nd floor: existing N proposed Total new Zoning District Flood Plain No Groundwater Overlay 412-1:0ject Valuation VAXVi ad 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 4P ' Historic House: ❑Yes Alo On Old King's Highway: ❑Yes No Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) JS�JD�- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 1 new C, 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 O Oil ❑ Electric 0 Other • Central Air: ❑Yes *No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size 4- Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed-.'' .existing ❑new size' Other: ' t Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ _ Commercial ❑Yes ❑No if yes,site plan review# • - - - - - H Current Use Proposed Use - /J / BUILDER INFORMATION 1 Name Telephone Number I (7161/589 -33(o 5. Address License# L L2d74:7 7 lev, Home Improvement Contractor# UALWorker's Compensation# \_ I -- 'a 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOE fl"k&" SIGNATURE DATE 4 FOR OFFICIAL USE ONLY PERMIT NO. „ DATE ISSUED MAP/PARCEL'NO. }. ADDRESS VILLAGE OWNER DATE OF INSPECTION:Sv N FOUNDATION FRAME INSULATION „r FIREPLACE ELECTRICAL: ROUGH ..FINAL PLUMBING: ROU6144 6 . ' FINAL ' GAS: ROUGH °j r FINAL , . . r, 4- : , Op FINAL BUILDING 0 DATE CLOSED OUT ASSOCIATION PLAN NO. —�_ The Commonwealth of Massachusetts Department of Industrial Accidents office of/nyesti9alions 600 Washington Street y Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit name: location: ci 12, hone# L7 I a homeowner pe'rf ing all work myself. ' El 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 chat s--z-,• c�n-.d" t S' u" .r`' tT_c�. .17Jx3'_':.:3 -vr £ iTx. y k ^�'. 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' �': +•. s• s.# �n P .sY h.Cli. „r k S.n-�'P-1 1 s u,. -4 a.G•`v P r {+r4. '4 3'a $j ", q-s ru rr�1'S ��'ac'' }Wn a? �, ,.,, ,+t• .F s.ar�'�aE�.�-'"t?a,�3 �`'-�3 r ' a�.'�1as.n �,:3 .� �c ,. <a ?yy'}Q UIIGV��� _'h-...5 ..' _'........ v. 2 4.--;�t�e9r.4'S>� :.i.:a..�.-_•:��.c'�..'2.i'.?,._,,:v Insurance-co � 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 S1,500.00 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 certify nd pains and penalties of perju t the information provided above is truje�aQnd c/forr�ecnt. Date / o /off 9�,1 Signature Print name Phone# L y '�� �� official use only do not write in this area to be completed by city or town official city or town: permit/license# F—Building Department ❑Licensing Board [] []Selectmen's Office check if immediate response is required ❑Health Department contact person: phone#; (-10ther 1 ' y (revised 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the-"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. 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 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 ZME r � Town of Barnstable °-^ Regulatory Services 13AMSMLA ' Thomas F.Geller,Director Muss. 9`bpr0119.�A``� 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 SUPPLEMENYTO 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: Estimated Cost Address of Work: � J �CJbJ Owner's Name: Date of Application: A--/'1'� I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date• Contractor Name Registration No. OR Date Owner's Name RESIDENTIAL: SHEDS -POOLS -DECKS-OPEN PORCHES- GAZEBOS FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,etc.) >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—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00 (Number) PORCHES x$30.00= $ (Number) - IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ ' (Plus above fee if applicable) PERMIT FEE $ 00 Q:forms:dkcost yr` eff:082301 Town of Barnstable ti y"P Regulatory Services BnxNsts. Thomas F.Geiler,Director 9 MA$S � �' 0;AAA`` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must.Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize lira to act on my behalf, in all matters relative to work authorized by this building permit application for(address of job) 1915 0 3 Signature of Owner Da e Print Name ' 1 STRV D S — BN 8L CLIENT RESlDEN71AL TlILE SERVICES R G/ UNREGISTERED LAND TENDER. DEED BOOK PACE PARCEL Gt ER.— GLENN R. & CHRISTOPHER RHONf P N BD PAGE LO S APPLICANT: CARTY—CORDRY REGISTERED LAND DAM- APRIL 16 2003 L.C. PLAN 10614—E SHEET LOTS 2 ASSESSOR'S MAP 270 BLOCK LOT 6 loER fiCA OF 77 156349 MORTGAGE INSPECTION PL4N F 07' 195 Dt W S PaW ROAD, HYAIWW MA .rleoo�cs ' — 100.02' .F LOT 2 291173:h 80. FT. as L4T s r"n , LOT 1 P � 95' cu �.d_ 100.00, r �s� DUNN'S POND . ROAD THIS PLAN IS FOR JMCWMAGE PURPOSE'S ONLY SHEET ! OF 2 gMIMCAAON I omwy 7NAT WS PLAN WAS PRErARED IN ACCORDANCE WnfI 1NE I HEREBY CERTIFY T'O THE BEST OF MY KNO6 LEDGE' �5W "NG WAL AND 7HE/CACDWMI�E�OF PdA�IpCM SfTrS 250 AND BELIEF; TO THE ABOVF ATTGR'NEr; BANK AND CWR SECITCW etas AND W7I/ 7HF tgcmARxs swEr ArrACWD HERL'TD, ANO THEIR 71TLE'INSURANCE COMPANY, THAT THERE ARE• NO VISIBLE ENCROACHMENTS OR EASEbEN i5 EXCEPT AS SNOINV. AND THAT 7MIS PLAN WAS MOF PREPARED UNDER MY IMUMATE SUPERVISION. JOHN LAWWmM JOHN L. LIBBY CONSULTING CONSUL TING LAND SURVEYORS P.O. BOX 468. ROChIESTER, MA 02770 TEL:(506) 763—D179 FAX:(508) 7433-2WO J/hb)sw�.vuitN►gf,M/otntop.coTf1 !/ /s,//:i`� _ FILE 2003—MP-26, SKEET 2 OF 2 FLOOD ZONE DEYrWNAIM l CER11F7 THAT THE BUILDINGS) SHOWN ON THE ATTAcmrD PLAN HEREON DOES NOT FALL WHIN A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A FEDERAL EMERGENCY MANAGEMENT AGENCY FLOOD MAP FOR COMMUMITY NUMBER 25000I 0005 r, REVISED: AUGUST 19, 1985. ZONE C. ZONING DEM MINA RON THE LOW LOWYON Or 7HE OR/ N G OWN HEREON AS IN COMPLIANCE WITH LOCAL APPLICABLE ZONING OY--LAW$ IN EFFECT WHEN CONSMUCTED, WITH RESPECT TO HORIZONTAL DIMENSIONAL REOUIREMENTS ONLY, OR EXEMPT FROM WOLAWN E/VFORCEAfENr ACTION UNDER MASS. aL- 17W VA, CHAP. 40A, SEC, Z UNLESS ONERWSE NOTED OR SHOWN HEREON. A CONFIRMATORY INSTRUMENT SURVEY IS ADVISED KWN STRUCTURES ARE SH04W TO BE ONE FOOT OR LESS FROM PROPERTY OR REQUIRED ZONING SETBACK LINES NO7M. r.Yms of Mvsmnm MAN mms PRD%wv nw 7NE a4wr A9 sAwm ON sm!Lrr I, AND is NOT wm-m 6D OR ONDWSW7W ro BE A PROPERrr"vvr. NO CaMI£RS YEAS Wr, IM PLAN CAAMMT W UM FM PNM tAW_-MW QE'SIpOrP qAd COAL91MVMW OR ESrAWSlrMlp FE cr MMOE'OR BL4umoo LLW& 7w RAN Aw nepwr AAA NOT BASED QV AN NV mvA*NT swrwv ANo AAE PREPARED FUR AND SU9Wm ro rw L'Lawr rAmm FOR mmmAOC A PC lAA0 AV"W d M &^r A UASUTY FM AftMN)g# Woftj"OPM r4q AAv 4rAr a[sum=r to fumi v our—smss ►MONOs eASEYE OS APO o4kir W WAYS rMS PLAN t8 NOT AVIDADED 70 6E RECORiOEA 2 NO ISSrftffl V OR aWr4X4ftW/S AUX OR 40NAM AS M NA:AAIpM NISM MA1S KS ON 7W MW 46 We PROMly AS POM M MU RI Ld"ED AND LlADiMQCD OV JW O MMrp POW MA PMM FICIN Mr MC OLEO WSORA MW AND RFICWOM PUNS NO Q �)HAW BUM MADE WIN ANY"WMM NOMWINIM We IW ON 77r4 PLAN MAW "*M MON LOCA7EV Nr flW FXID BY A rAPE MWWr OR AMC-VMMW ON A FELORO PLAN WIN MEASL41CNE VTS M ME FROPOP"eOUNVAR Mq, 0 FLOW 2UW 0E3P0WV W IS VASED ON W pLogo PLAM!AS=WWjWA r Sp~ W Vff pnM RAPS 1HC FCOOo 000VA710V IS Nor BASED av ON AMAL FEW 9tfVA 0VS OF AN E1.EvAWM eMly CAIE REMARKfS: rwoF JOHN I.AWWNCE ORB JOHN L. LMBY CONSULTING CONSULTING LAND SURVEYORS P.O. BOX 468. ROCNEVER, MA 02770 TFL.(308) 763-0179 FAX(a0e) 763-2WO C 3 M/bbYca►f.4YItI110afOIT01Lcam �..... w •�, ��. rnw.. ■♦ge.7`17�a/+ AIIOrJAL^CC lull V - 0 � ✓lze �o�.r�.nauuecr�ll �ac/u�ael�a � ' N BOARD OF BUILDIG f��GtJ;�At10N$ .; License- CONSTRUCTION SUPERVISOi� Numbe.��C�S 074787 airth14ate a21.131959 xRis 9217f-3 005 °Tr.no: 8356 T !, �!1 4 WILLIAM TOM4S6L0f NORINOOD, --�._.: Adrninistrator • fie,�anvnzonurecc%,� o�✓�,craaa�iu,arlfa , i Board of Braiding Regulations and Standards HOME IMPRbVEMENT CONTRACTOR; iib Registration 133535 t- Sxi��ration 07%09/2003 Type Pnlvate;Corporau WILLIAM TAOMASELO�HOUSE-,W ♦ �Irt AO'TOMASE LO"-T 142 PLEASANT ST.~n, "`✓ � � NORWOOD, MA 02062 Adrnimstrato 00-35 000 of enclosed space -— (1013L it.112 S;60L) 1A-Masonry' only i 1 G-1 8 2 Family Homes 6 Failure to possess Alcurrent edition of the I Ma cassachusetts State Bwlding Code Z is use for revocation of3dis licenser DIG SAFE CALL CENTER (899)344-7233 C is License or,r e istration valid for indMdul use,only g before the.expiration date. If found return to Board of.Building Regulations and Standards One Ashburton Place Rm.,1301 Boston,'AIA.Q2109 Not valid with ut signature i i 4 1f ! r ,-may-- -- at ---- - ( - s _� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ~ Map a -7 a Parcel ©O - Permit# k3&6 Health Division < Date Issued 91,31-la6 Conservation Division d , 0 Q` _ Fee Tax Collector , ,w 3 SEPTIC SYSTER MUST SE Treasurer 00 INSTALLED IN COMPLIANCE Planning Dept. G WITH TITLE 5 w .r Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANDT01MN REGULAT 131'!S Historic-OKH Preservation/Hyannis Project Street Address b 5 d _,Village C �,otir,�rS l Owner' �`z, /� (-� v,;.-� Address Telephone 5�O -- 2 71 11,3 t Permit Request vJle 1 G Square feet: 1st floor: existing�a proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: 0 Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family I -Two Family ❑ Multi-Family(#units) ' Age of Existing Structure 5 v S Historic IHouse: ❑Yes XNo On Old King's Highway: ❑Yes ❑ No z;. Basement Type: 0 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: XGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �No. Fireplaces: Existing New Existing wood/coal stove: ❑Yes �No Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed:0 existing O new size Other: Zoning Board of Appeals Authorization .0 Appeal# Recorded❑ Commercial _O Yes O No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number 5 OfS - 7 7`- 3 Address 9S u „�_ () ,, P License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM T PROJECT WILL BE TAKEN TO SIGNAT DATE OCR FOR OFFICIAL USE ONLY F 1. PERMIT NO. ' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER '.. DATE OF INSPECTIONL-�: Sty n�A FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH' - FINAL PLUMBING: ROUGH ' FINAL GAS: ROUGH t ` FINAL 4 - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. of t�ram, The Town of Barnstable r r + BABNSTABLE. • MASS, ��� Regulatory Services prED Mp't a Thomas F. Geiler, Director Building Division Ralph Crossen, Building Commissioner 367 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: k -c Estimated Cost OQ, od Address of Work: Owner's Name: Date of Application: g '-3 1"O d 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, wner 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 R i tration No. Date Owner's Name q:forms:Affidav The Cofnmonwealth of Massachusetts `-= _'- ==.�� Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 `�..•r Workers' Compensation Insurance Affidavit in c^it rfar`tira�u�t %�/������/������%%%%/� name: Iocati c hone# city Q I am a homeowner performing all work myself. I am a sole�ronrietor and have no one working in any ca acity I am an employer providing workers' compensation for my employees working on this job. comnnnv nnme: :;.:.:::.. :.:::.:.::.: . 02 address: hone#:... .: city: _ oiicv ///% /i////G////%/////// / // Q I am a sole proprietor, general ; or homeowner a one) and have hired the contractors listed below who have the :ollonlng workers compensation polices: comoanv name: eS address: g ;,. � hone# �:�'::•;:: ':�: ��� �: city: . "iinsurnnce cn. //////// /// .. .... ::.. .. .. '�.�::::.....::::..:......,.:�:..:::::.;::•»::;>;�;:;:::<::�::�:::::::%;::�::;:.'>;?:>;:::i::�:;:':•+:':�:f!:�>:'>:: :'::Gi:��i:�.-.�:.:::. comnnnv name: address: one#. ci tti . : oiicv insurance co. /� of a fine u pe es GL 152 can lead to the imposition of Failure for zzl .....caas well as civil penalties in the formSA of lof a STOP WORK ORDER and a Due of SS10 00 a day against me-I understand that ato S1,500.00 r one r canimprisonment copy of this statement may be forwarded to the Office of Investigations of the flIA for coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct Date — - Sisttature Phone# Print name „fflcial use only do not write in this area to be completed by city or town official Department permitllicetue# _ • ❑Bttllding De p city or town: ❑Liceming Board []selectmen's Office check if immediate response is required ❑Health Department ❑Other. phone#; contact person: ry` 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 con=--: lov emp . of hire, express or implied, oral or written. employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more o Anrepresentatives of a deceased employer, or the receive" ed in a joint enterprise, and including the legal rep However the owner oin H e employees.the foregoing g�� to ' employ • other 1 ,CmP Y� on or entity, associate ' of a trustee of an individual,partnership, or the occupant of the dwelling house of dwelling house having not more than three apartments and who resides therein, P who to persons to do maintenance, constreictton or rep,�vr work on such dwelling house or on the grounds � another employs a of such employment be deemed to be an employer. building appurtenantO shall not because . eve state or local licensing agency shall withhold the issuance or renev MGL chapter 152 section.25 also states that every of a license or permit to operate a business or to construct buildings in the commonwealth weealt for�yPPn Z ° h: not produced acceptable evidence of compliance��the insurance coverage� �rrequired.performance of public work until the Pu commonwealth nor any of its political subdivisions shall eater'into f�this chapter have been presented to the contracting acceptable evidence of compliance with the��� � authority. t Applicants Please fill in the workers' compensation affidavit Completely,by checking the box that applies to your situation _ �..;� numbers along with a certificate of insurance as all affidavits may be #- supplying company�,address�P�• of insurance coverage. Also be sure to sign and of Industrial Accidents for Cron a is submitted to the Departtaeat that application for the permit or livens date the affidavit. The affidavit should be returned to the�3'or town aPP the.1aw»or if yc not the Department of Rantrial Accidents• Should you have any questions regarding being�' policy, lease call the Department at the number listed below. are required to obtain a workers COMPeosation P CYO P �r City or Towns Iete and printed legibly. The Department has provided a space at the bottom of t Please be sure that the affidavit is complete. ons has to contact You� g the apphcaat. Please affidavit for you to fill out in the evat the Office of Iavestigati be=Writ a t^ be sure to fill in the penmitllicense number which will be used as a reference number. The affidavits may the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would Mo to thank you is advmice for you,cooperation and should you have any TustlOIIS- please do not hesitate to give us a calL MEMERRIE MO The Departimeat's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents oMcg of ImlesdDadons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 1 508-432-3730 508-432-3730 FAX a A � Unlinished Furndule. Woodenware. Craps ROUTE 28 GEOFF PORT W.HARWiCK MA02671 FLEE delivery (to most areas) & built on your site! ; � • cSTQ� Shed Construction site Requirements - d •J o ®� o Clearance Walls Unfinished Furniture, Woodenware, Crafts Shed site needs to be located at least 3'from any fences,trees, • 2x4 construction,tongue &on center Harwichport,MA•Dennisport,MA • Pine&Cedar: tongue&groove(horizontal) etc.Please remove tree branches,brush or other obstacles 3' t Here's What our customers say: • Texture- 111:exterior plywood siding(vertical) around perimeter of shed and 12'above ground. *Note additional West Yarmouth, MA•Plymouth,MA • Wall height=71" charges. "Outstanding. . . (the crew)went out of their way to show Canton, MA•Malden,MA Roof Land Grade ! the utmost courtesy, respect and consideration New Bedford, MA•Fall River,MA • 5/8"plywood l —R.T.,Nashua NH Westborough,MA• Scarborough,ME P Y Land must be less than a 6"slope,with no protruding rocks or ! • 2x4 construction,24"on center stumps in the area. *Note additional charges. Nashua,NH•Manchester, CT • Self-sealing asphalt shingles w/20 year warranty i "Many thanks. . . the quality of your product will be available in black,white/gray or brown Access brought to the attention of neighbors and others. . ." • Heights -8'wide peak=8'3" Shed is delivered in prefab panels;clear access to site is neces- ! —R.C.,Pembroke,MA -8'wide gambrel-9' - 10'wide peak=8'11" sary—stairs,narrow walkways,fences,gates,shrubs,carports, "(The office staff)was very helpful and friendly." a -•�v' �'' -10'wide gambrel=9'5" awnings,arbors,etc. may present difficulties and should be —V.N.,Tiverton,RI - • Your choice of peak,gambrel or saltbox at no charge brought to the attention of SHEDS USA prior to delivery. *Note 'Wpr additional charges 's- Floor (Floor sizes are approximate) "Your construction crew left the yard immaculate." ty - f • 5/8"plywood Land Quali —E.P.,Plymouth,MA • 2x4 construction, 16"on center for 8'wide units Consider other factors when choosing your site,including prop- er 9 • 2x6 construction, 16"on center for 10'wide units drainage,firmness of earth,etc. very competent, neat,polite and friendly." I • Concrete block supports—4 comers,front&back —R.P.,Franklin Square,NY t;If I•Mt ; center of outside frame. Permits • If preparing your own foundation/footings please Permits are the sole responsibility of the homeowner.Please "Thank you again for your follow-through and diligence." call SHEDS USA for exact outside floor dimensions. —L.R.,Nashua,NH contact your local town office soon after ordering your shed to E Windows determine any restrictions or set-back requirements. � • Functional windows w/flower boxes and shutters "Excellent quality. Customer service highly professional. - • 8x8,8x10 and 10xl0 units include one window.All *Additional Charges We were very pleased-our shed looks great. . we will tell others include two. Shed site must be 150'(feet)or less from where a large tractor- others about Sheds USA." = __ trailer can park.Shed site 150'-300'from truck parking area will Doors be a$50.00 fee payable to the delivery crew. If your site is further —R.P.,Trumbull,CT - • 40"double door,standard than 300'please contact our main office. • Optional single door. The above site requirements allow us to build a safe,sturdy shed "Product looks great, staff are hardworking and profes- • Optional double doors up to 78" for our customers.If my of these requirements are not met,your sional." + I V shed may not be built and a return fee of$150.00 will be charged. —D.P.,Bat,CT IVI All sizes are approximate. SHEDS USA will only reschedule a delivery/install date if forced to by events out of our control(weather concerns,illness,mechani- Standae [Features cal or other difficulties).SHEDS USA crews deliver/install several Unique 10-Year Warranty • Custom placement of door(s)and window(s)FREE sheds per day,therefore the status of one customer's order affects I many others.To provide the best service for all of our customers, SHEDS USA Inc. warranties labor,materials and . • Choice of siding:Texture-111,Pine,or Cedar once a delivery/install date has been agreed to and scheduled by ' ' structural soundness for IO years with proper • Choice of roof styles: Peak,Gambrel or Saltbox FREE the customer and SHEDS USA,postponement or cancellation by maintenance. This warranty does not include fire, • Asphalt shingles—choice of 3 colors the customer will result in a fee. . flood, windstorm,doors,screens, windows, or Factory direct to you! • Functional windows— 12'longsheds and larger have About Delivery g P g g neglect. Customer must stain or reserve building two windows with flower boxes and shutters •SHEDS USA will acknowledge the receipt of your order within 60 days of delivery.SHEDS USA Delivered Built Guaranteed! • 5/8"exterior plywood floor, 16"on center by phone or by mail.Please provide a daytime phone number at recommends that cedar buildings and doors on all , , time of purchase! • 5/8"exterior plywood roof units be sealed on both the interior and exterior. (603) • • SHEDS USA will schedule delivery by contacting customer 1 to em other warran is ex ressed or im lied b an Heavy-duty 40'double door S weeks in advance. ty p p yy 868- 1300 • All galvanized nails&hardware included employee or sales agent. g • Delivery times will fluctuate based on seasonal volume, i • Concrete blocks used at 6 pts.for foundation weather conditions,etc.• FREE delivery to most areas&built on your site! • Shed delivery date and installation date may differ. ME, NH, MA PRICING � Pine arMILL STORES PRICING xture �I -111 —Shown in 8 x 10— —Shown in 8 x 12— —Shown in 8 x 14— SIZES PRICE ,�. 8X8 . . . . . . . . . . . .$ 969.00 8X10 . . . . . . . . . . .$ 1,199.00 8X12 . . . . . . . . . . .$ 1,425.00 r �x -r --..�- �� _:�. _. ._- — -.r —•.-- - . r �tj J�: 8X14 . . . . . . . . . . $ 1,649.00 8X16 .$ 65 00 10X10 . . . . . . . . . . .$ 1,449.00 �• � � t � � .:- �� � � j' ', 10X12 1,715.00 1OX14 . . . . . . . . . . .$ 1 7 It l + •_ 1 OX16 . . . . . . . . . . .$ 2,199.00 1OX18 . . . . . . . . . . .$ 2 4 1OX20 . . . . . . . . . . .$ 2,859.00 PINE d f j—r SIZES PRICE 8X8 . . . . . . . . . . . .$ 1,049.00 D Most popular material Above unit shown with gambrel style 8X10 . . . . . . . . . . .$ 1,299.00 D Vertical exterior plywood siding D Withstands all types of weather roof and optional 26"single door. 8X12 . . . . . . . . . . .$ 1,499.00 D Durable D Classic tongue-and-groove construction 8X14 . . . . . . . . . . .$ 1,839.00 1 D Affordably priced D Durable and weather-resistant 8X . . . . . . . . . . .$ , .00 D Same quality features as cedar y p 10X10 . . . . . . . . . . .$ 1,63939.00 and pine models D Pleasant aroma naturally repels insects 1 OX12 . . . . . . . . . . .$ 2,109.00 D Economical and resists rotting 1 OX14 . . . . . . . . . . .$ 2,269.00 D Ages beautifully 1 OX16 . . . . . . . . . . .$ 2,549.00 4 1 OX18 . . . . . . . . . . .$ 2,799.00 You need a shed 0f e e e D Excellent base for stains and paint 1 OX20 $ 3,159.00 D One of the most stable types of lumber; • your car has never seen the inside of j Q' resists warping and buckling SIZES CEDAR PRICE your garage. {� r� JI�,r NOPTOONS 8X8 . . .$ 1,349.00 • passersby look at your lawn and ask 't _ - . . • • . . . 8X10 . .$ 1,499.00 if you're having a yard sale. Upgrade 40"double door to 54"double door . . . . $ 50.00 8X12 . . . . . . . . . . .$ 1,789.00 ► j I j '' I I Upgrade 40"double door to 66"double door . . . . . . 95.00 8X14 . . . . . . . . . . .$ 2,059.00 • our basement's storage capacity - - Upgrade 40"double door to 78"double door . . . . . 125.00 8X16 . . . . . . . . . . .$ 2,309.00 y g p y 2"x 6"floor joists for 8'wide sheds. . . . . . . . . . .92¢/sq.ft. 1 OX10 $ 1,885.00 ends at the last step. Pressure-treated plywood floor. . . . . . . . . . . . $1.20/sq.ft. 1 OX12 . . . . . . . . . . .$ 2 249.00 • the condition of our workshop/craft/craft This is one of our most popular layouts with a 26"single door . . . . . . . . . . . . . . . . . . . . . . . . . . . .70.00 1 OX14 $ 2,529.00 }� h Extra window(includes window box and shutters) . . . . . . . . . . 60.00 double door on the gable end and an optional 26" 10X16 . . . . . . . . . . .$ 2,899.00 room is affecting your marriage. single door in front... easy access for riding Vents (pair) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.00 1 OX18 . . . . . . . . . . .$ 3,325.00 Screens(each) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15.00 • you've been injured tripping over lawnmower and shed owner! Extra 54"door. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 90.00 10X20 . . . . . . . . . . .$ 3,635.00 children's toys. Extra 66"door . . . . . . . . . . . . . . . . . . . . . . . . . . . . 115.00 y Extra 78"door. . . . . . . . . . . . . . . . . . . . . . . . . . . . 145.00 Pressure-Treated Floor joists • opening garage the e door avalanche. Custom pool filter hole(in-house) . . . . . . . . . . . . . . 75.00 g 4'storage loft for 8'wide sheds . . . . . . . . . . . . . . . . 65.00 8x8 .................$30.00 10x10 ................$55.00 117ILL NOT BE HONORED. 4'storage loft for 10"wide sheds. . . . . . . . . . . . . . . 80.00 8xio ................$30.00 10x12 ................$60.00 4'pressure-treated ramp . . . . . . . . . . . . . . . . . . . .FREE 8x12 ................$40.00 10x14 ................$70.00 8x14 ................$40.00 10x16 ................$75.00 FREE custom placement of doors & windows./ Choose your roof style & shingle color — FREE• 8xi6 ................$50.00 10x18 ...............$125.00 � 10x20 ...............$1 .00 I Sheds USA Inc. Delivered, Built, Guaranteed Roof Construction Roof Height Walls 5/8"plywood 8 ft wide peak- 8' 3" 2 x 4 construction,24"on center 2 x 4 construction,24"on center 8 ft wide gambrel -9' Siding Types: T-1 1 l Self-sealing asphalt shingles 10 ft wide peak- 8' Pine(tongue&groove) 10 ft wide gambrel -9' 5" Cedar(tongue&groove) Wall Height=71"(approx.) �e�°� — .,� '•�-rr,,;_ ...._•^- dam+--'�:. ` ....., -- t 4j , IN ...cam-• ... Windows Doors Floor Size: 18"wide x 22" tall(approx.) Standard 40"double door 5/8"plywood Functional, side hinged Optional 54. 66& 78- double door Floor joists are 16"on center Includes flower box& shutters Optional 26" single door 10 ft wide sheds=2 x 6 Optional window screens 8 ft wide sheds= 2 x 4 Concrete block support at six(6)points standard on all sheds. NOTE: Options may not be available for all sheds. Call your Distributor or Sheds USA for more information. Shed Diagram-All Distributors STANDARD LEGEND NOTE:not all symbols will appear on a map y 4=ZQ GOLF COURSE FAIRWAY mcm EDGE Of DECIDUOUS TREES EDGE Of BRUSH ORCHARD OR NURSERY V—V-" EDGE OF CONIFEROUS TREES i 1 — MARSH AREA \�J —---— EDGE OF WATER DIRT ROAD DRIVEWAY ' .E--PARKING LOT �—PAVED ROAD -------- DRAINAGE DITCH —————— PATH/TRAIL PARCEL LINE w Iio .*---MAP# MAP 27 21 0 —PARCEL NUMBER 01/60—HOUSE NUMBER / 2 FOOT CONTOUR LINE Lo \ ° is 10 FOOT CONTOUR LINE / Elevotion based on NGVD29 5 *.4 SPOT ELEVATION c�oc� STONE WALL / 390 -X—X— FENCE � ��� e � RETAINING WALL —F-F-rT RAIL ROAD TRACK - - / STONE JETTY . SWIMMING POOL - - \ PORCH/DECK MAP 27d _ _ - - - _ - - - _ / U 13 BUILDING/STRUCTURE rH-L 5DOCK/PIER HYDRANT 83 - - - 6 VALVE ® MANHOLE O POST p`" FLAG POLE T O W N O F B A R N S T A B L E O E O O R A P N I C I N F O R M A T I O N S Y S T E M S U N I T a SIGN ® STORM DRAIN N - PPJNHD SCALE:IN FEET *NOTE:This map Is on enlargemeot of a 11onthernap, *NOTE:The parcel lines are only graphic represemafiora DATA SOURCES: Planimetdcs(morrmade features)were interpreted from 1995 aerial plrotopmphs by The lames 1°=100'scale map and may NOT meet of property boundaries.They are not true location and W.Sewall(a any.Topography and vegetation were interimrid from 1989 aerial photographs by GEOD 0 Uf IUTY POLE ° TOWER 0 20 40 National ft Accuracy Standards of tha do not represent actual relationships to pbysimf objects Corporation. Pianimoft t gmphy,and vegetation were mapped to mat National Map Acwmcy Standards 1 INCH=40 FEET* enlarged sm at a scale of 1°=100'.Parcel Bares were dipitizW from 2000 Town of Barnstable Assmfs to maps. O UGHT POLE O ELECTRIC BOX ` E'tlinntMntarvAilnn Ann Ai in qn qmn r14.17-AA ei o DFZHE Tpy�O Department of Health Safety and Environmental Services Building Division BARNSM111 , 367 Main Street,Hyannis MA 02601 MASS. 9 1639• 10� Ralph Crossen Office: 508-862-4038 Building Commissioner Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print ' DATE: 30 `O d JOB LOCATION: ,vim tl number street village HOMEOWNER":G�Yrni 50 9-— 7 7/— 3 t S �s yGt name home phone# work phone# CURRENT MAILING ADDRESS: J I ci /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 submitfo=tlie'Building-Offfcial 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"certifi that he/she understands the Town of Barnstable Building Department minimum inspection pr a ures and requirements and that he/she will comply with said procedure uir • i 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 Supervisors,Section 2.15) This lack of awareness often results in Appendix Q,Rules&Regulations for Licensing Construction serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the as Supervisor is ultimately responsible. unlicensed person as it would with a licensed Supervisor. The homeowner acting 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN