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`oF1HETO,i� The Town of Barnstable
O� f
BARNSTABLE. Department of Health Safety and Environmental Services
MASS
i639. �0
prfo y1. Building Division
367 Main Street, Hyannis,MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Inspection Correction Notice
Type of Inspection 1 1
Location '�76 Yy 4, >:1_ Permit Number 1
Owner Builder /, r �,r,
One notice to remain on jobsite, one notice on file in Building Department.
The following items need correcting: /
.--JI"
, V f ✓
4 J &2 vn 'n a 1 ,
Y► �
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Please call: 508-8-62-4038, for re-inspection.
Inspected b
P Y
Date
7
STANDARD LEGEND
5 # 385 t �'l NOTE:not all symbols will appear an a map
\ fzt—z 60LF COURSE FAIRWAY
EDGE OF DECIDUOUS TREES
EDGE OF BRUSH
ORCHARD OR NURSERY
R 1vi� V—V—T-v EDGE OF CONIFEROUS TREES
MARSH AREA
`"`�� —•••— EDGE OF WATER
48 . 9 \ DIRT ROAD
}} ' DRIVEWAY
F—PARKING LOT
PAVED ROAD
MAP 1 — ---- DRAINAGE DITCH
+ — ————— PATH/TRAIL
l
PARCEL LINE**
w W 110 E---MAP#
1�AP 2L NUMBER
�� \ # -<—HOUSE NUMBER
_ 2 FOOT CONTOUR LINE
-->�— 10 FOOT CONTOUR LINE
� ) Elevation bosed on NGVD29
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P 291 STONEWALL
X—X— FENCE
' \ w RETAINING WALL
RAIL ROAD TRACK
353 c� STORE JI M
SWIMMING POOL
/� o �� PORCH/DECI(
• ���\ — � ...-..--- �] 0 BUILDING/STRUCTURE
DOCK/PIER
HYDRANT
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T O W N O F B A R N S T A B L 11 O E 0 0 R A P N 1 C I N F O R M A T I O N S Y S T E M S U N I T q. SIGN ® S10RMDRAIN
II- PRINTED M IN FEET *NOTE fm of o **NOTE The pam i lines are only graphic represen DATA SOURCES: Pkmmehi s(man-made faaWres)wom ImerpmW from 199S GOW pho4mphs by The James p ���
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w e 0 20 40 (lallorwl Salk do not r reserd actual rebtiorrshi ro I obieds Corporetlon. nimetrl%ro phy,and
ep ps physics vegetation were mopped ro meet National Map Aaumry Standards U6HT�� o ELECTRIC BOX
c 1 IND1=401T�'�• d ERthe map. of a sob of 1°=I W.Paradinnes were digitized from 200D Town of Ban able Assessor's tax maps
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{�--` The Commonwealth of M
f Industrial Accidents
r {�_ • ' Department o
Wee otlasestfgatioQs
f� _' ' __•^ 600 Washington Street
Boston,Mass. 02111
workers' Co m ensation Insurance Afridavit //����/�����////��///���//�///////'//%%%
name. .
location'
hone#
city performing all workmysel
❑ I am a sole 'etor and have no one
oyees working oa this job.
workels msa
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imnrance co:;::::"'?:;;' :':;::"w: of aimiaal peoaitia of:flue up to S230o•00 andior
r �derSediou l"of M L LU eastlnd to tba that a
FIRM to secure eoverar as req tip form of a STOP WORD ORDER and a tine of S100.00 a day against me. I®deed
one years'tmpnsomuent to weII ea dvD penalties�of Ind of We DIA for coverage ve�8n�n.
copy of this statement may be fotwttrded to
tttdtits of Pt �dw inf°nndiOn provided above is MAP wtd correct
I do hereby certify under thepauss attd p O®
Date10
-
Sig mature ` __7_17. Phtma#
Frmt name
ofUcW use only do not write in this area to be completed by�7
or town oiSdal
permiygceawe# ❑BuIIding Deparunmt
❑Licensing Board
city or town' [JSelecunen,s Office
check if immediate response is required ❑Health Depirunent
phi - ❑Other
contact person:
Information and Instractions
General Laws chapter 152 section service requires all employers to provide workers' compensation for t^
;�gassachusetts G P to ee.is defined as every Person in the service of another under any co--_.
emplovees. As quoted from the `law„, an emp ,Y
of hire, express or implied, oral or written.
artnershi association, corporation or other legal entity,or any two or more c=
,kn emplover is defined as an individual,p P�
the foregoing engaged in a joint enterprise, and mcZuding the legal representatives of a deceased employer, or the rece.,association oror other legal entity, employing employees. However the owner of a
trustee of an individual,partnership, who resides therein, or the occupant of the dwelling house Of
dwelling house having not more than three apartments
., construction or repair an such dwelling house or on the grounc; c:
another who employs persons to do maintenance
building appurtenant thereto shall not because of such employment be deemed to-be an employer.
IGL chapter 152 section 25 also states that eV 'state or local licensing agency shall withhold the issuance or renew a
P in the commonwealth for any applicant who :.
of a license or permit to operate a business or to construct buildings neither the
not produced acceptable evidence of compliance with the insurance c coverage red.the Additionally,
PSublic work u
commonwealth nor any of its political subdivisions shall.enter into of this chapter have been presented to the contrC
acceptable evidence of comphaace with msuianee
authority. b . ......
r
:applicants
situation and
,} � m vh completely,by checldng the box that applies to your
C et�satt � A
oIkerS may by
.
Please fill in thew �P. .... -----_...._�.__..._;.,.v... - with a certificate of insurance as all affidavits
address_and phone members slang^ .
suPPI�comPpy�' oil.of ir�sara=coverage.: Also be sure to sign ana
Department of Industrial Accsdeats
submitted to the Dep �town that�application for the permit or license is
date the affidavit. The affidavit should be returned d to the city have any questions regarding the "Iaw"or if
not the Department of Industrial A,ccideats. :Should you
being requested, o1z .- Iease`�the Department at the number listed below.
are required to obtain a workers coazpensati p cy`:P
70 .
City or Towns
•bl} The Department has provided a space at the bottom of the
Please be sure that the affidavit is complete and printed legs y re the applicant. Please
affidavit for you to fill out in the event the Office of lave dgzdm has to contact You regarding
be sure to fill in the permit�license number which wi7lbe us ed.as a reference member. The affidavits may be returned t^
the Department by mail or FAX unless other have been made•
u in advance for'vou cooperation and should you have any questions.
The Office of Investigations would file to thank yo
please do not hesitate to give us a call.
ME
The Deparunmt's address,telephone and fax number
The Commonwealth Of Massachusetts
Department of Industrial Accidents
- -
Otflee ollnttestlgatlons
600 Washington street
Boston,Ma. 02111
fax it: (617) 727-7749
"" ` ph6ne#: (617) 7274900 eat. 406, 409 or 375
r
The Town of Barnstable
' a�errsresr.E. -
9 16 gym$' Department of Health Safety and Environmental Services
ram '' Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commission
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: Estimated Cost
Address of Work:
T
Owner's Name:
Date of Application: 6 h(,.1C 0
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
E111wner 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 er's Name
q:fbnns:Affidav
MAScheck INSPECTION CHECKLIST M
Massachusetts Energy Code
MAScheck Software Version 2 .0
DATE: 6-16-2000
Bldg.
Dept.
Use
CEILINGS:
[ l 1. R-30
Comments/Location '
WALLS:
[ ] 1. Wood Frame, 16" O.C. , R-13 + R-3
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] 1. U-value: 0.40
For windows without labeled U-values, describe features:
# Panes Frame Type Thermal Break? [ ] Yes [ ] No
Comments/Location
DOORS:
[ ] 1. U-value: 0.35
Comments/Location
FLOORS:
[ ] 1. Over Unconditioned Space, R-19
Comments/Location
AIR LEAKAGE:
[ ] Joints, penetrations, and all other such openings in the building
envelope that are sources of air leakage must be sealed. Recessed
lights must be type IC rated and installed with no penetrations
or installed inside an appropriate air-tight assembly with a 0.511
clearance from combustible materials and 3" clearance from insulation.
VAPOR RETARDER:
[ ] Required on the warm-in-winter side of all non-vented framed
ceilings, walls, and floors.
MATERIALS IDENTIFICATION:
[ ) Materials and equipment must be identified so that compliance can
be determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
provided. Insulation R-values and glazing U-values must be clearly
marked on the building plans or specifications.,
DUCT INSULATION:
[ ] Ducts in unconditioned spaces must be insulated to R-5. `
Ducts outside the building must be insulated to R-8.0.
DUCT CONSTRUCTION:
[ ] All ducts must be sealed with mastic and fibrous backing tape.
Pressure-sensitive tape may be used for fibrous ducts. The HVAC
system must provide a means for balancing air and water systems.
TEMPERATURE CONTROLS:
[ ] Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
and/or--cooling input-to each, zone or- floor shall -be--provided - --
HVAC EQUIPMENT SIZING:
[ , ] Rated output capacity of the heating/cooling system is
not greater than 125% of the design load as specified
in sections 780CMR 1310 and J4.4.
MISC REQUIREMENTS:
[ ] Refer to 780 CMR, Appendix J for requirements relating to -swimming
pools, HVAC piping. conveying fluids above 120 F or chilled fluids
below 55 F, and circulating hot water systems.
----NOTES TO FIELD (Building Department Use Only) -------------------------
F
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map / Parcel Permit#
Health Division �-�ti7� �� d -tCj Date Issued
Conservation Division Fee
Tax Collector S
. -. l 61 SEPTIC SYSTEM
Treasurer s& v� INSTALLED IN COMPLIAN"'LFu
Planning,Dept. -';` "+ WITH TITLE 5
• ` 4�-' ENVIRONMENTAL.CODE AND
Date Definitive Plan Approved by Planning Board r.
I . TOW REGULATIONS
Historic:-,OKH Preservation/Hyannis f
Project Street Address
Village • ` ~ , • •
OwnerAddress
Telephone — — O - .
Permit Request
�-5
Square feet: 1st floor:existing proposed'. 2nd floor:existing proposed Total new
Estimated Project Cost61 ,Z o ' Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation.
Dwelling Type: Single Family O Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes 3lo On Old King's Highway: ❑Yes Oho
Basement Type: a Full ❑Crawl 0 Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing c; new Half: existing new
u Number of Bedrooms: existing 3 new
f Total Room Count(not including baths):existing. new First Floor Room Count
f
Heat Type and Fuel: 12 Gas, ` 0 ❑ Electric ❑Other
Central Air: ❑Yes V:Mo Fireplaces: Existing -80 _ New Existing wood/coal stove: ❑Yes U oo
Detached garage:❑existing ❑new size Pool: ❑existing ,❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size She:d:❑existing ❑new size Other:
f
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 2-90 If yes, site plan review# -
Current Use Proposed Use
BUILDER INFORMATION
-Name_C A.ZIVA Telephone Number.
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE TE
a 'FOR OFFICIAL USE ONLY
PERMIT NO. -
DATE ISSUED
MAP/PARCEL NO.
tj
34,
ADDRESS 'r _ • VILLAGE A r I Y
OWNER
DATE OF INSPECTION:
FOUNDATION' � �
FRAME � iG I� i r `� �� ;' E • .. s
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
f - PLUMBING: ROUMR .FINAL '
GAS: ROUGiI -1 C rz r FINAL
FINAL BUILDINGor a
? - r'
DATE'CLOSED OUT vtoo
;;
ASSOCIATION PLAN NO.
cr
m
' N .31<\
y yd
o 7-
CERTIFIED
PLOT PLAN
LOTS s
TOWN OF
SCALE : /* ,, DATE
i, 9a
! ."CERTIFY THAT WHAT IS SHOWN ON
IS AS IT EXISTS ON THE GROUND THIS PLAN
J•
. TO THE TOWN REGULATIONS
AND CONFOHI�S
. . :;
QOYLE ASSOCIATES
FA LMOUTH ' ,
S
Assessor's map and lot number .. ... ..... � �,:_.., �--
�F TR E
: Sewage Permit number .....��.............................�F`.'-C!2... ...
Q Z 33AWSTGDLE. i
t House number ............................................Alp....................... Sao 11A e�
639-
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ........... Q - ................................................
f
TYPE OF CONSTRUCTION ..................... 4�' ?C .... ...........................................................................
.......:r ...... ............................19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according
��to the following information:
Location ........... �?K� .. .:C ........ r� ...^°. ........<sr CSi!Ce�✓t`...... �► ....... (Leo :Y' -'e................................
ProposedUse ...........'..,{ 5 .......69 vt l.!�-+ ....:.)c.Je,��i� �.. .........................................................................................
Zoning District ....................... :a.........................................Fi a District .......`; 44: .J.1z ...............................................
Name of Owner ..... ....:2n1 r;1 r..........................Address ................A...�����...�~�..................................
r
Name of Builder .................... .........................Address ...............:..rctipYt t..................................................
Name of Architect �.
..................................................................Address .................................................:..................................
Number of Rooms f ...............................Foundation .4s"e-0.r...............................................
ExteriorRoofin ..........................................................
Floors Oca I-y;0e ,�l�!rt�r� .......................interior
...... .. r�
Heating evcr�....... .�:... .............................Plumbing ................. �?...........
Fireplace ..................................................................................Approximate. Cost ........ ..... c..v t
Definitive Plan Approved by Planning Board ---------------____-----------19--------. Area ..... �' JJaa...�`...............
Diagram of Lot and Building with Dimensions Fee
�� ".��
............... ...r0..........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
f
41�� r
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
i
construction.
•
Name .............................................,.......... :..........................
Construction Supervisor's License .."�........ ..............
OLD STAGE INC, A=291-17 ��T~
No -25S43 Perm for �- Story
-.'- -.-----.
.......S' le.. -�vwa��ing'----'' ' ^
' .
Lot 5 48 ]Irizz I.ane
Locohon . . . . -...�_____ . . . _----. .. ~ ,
' Hyannis
.-............................................................................ ,
��ld Stage Iz�o
��,ne, -----.-------..:--.-----...
. ' .
I,z
Type of [unu�w�hon --r��V�--------.
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-^^'~~^'-^^^^~^-''-'--^`^^^^'`--~-^--' -
'
Plot ............................ Lot .................................
Ootmbez' 13, 83 '
Permit Granted -------------]9
Date of Inspection -.-------.---.lR
Dote Completed ..--.--.-.----.--lg -
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_
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7"rr:.=,,.�;-•-r"._�. ,
„ TOWN OF BARNSTABLE permit No. 2 S ti 4 __.---_:
Building Inspector .l
aaa3a s Cash` "
OCCUPANCY PERMIT;. .Bond; ------- �' t
Issued to Old Stacie Inc a Address
Lot 5, 48 Erin LaneA Hyannis is
Wiring Inspector f� rrN+ _. Inspection date
.r- e
Plumbing Inspector/- .r Inspection-date ,r
Gas Inspector <�/ 9 ' Inspection date
}Engineering Department ` � � Inspection date/c*:
Board of Health �� „ Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE .00CUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR .UPON SATISFACTORY 'COMPLIANCE WITH- TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE'MASSACHUSETTS STATE
BUILDING CODE. G
�.� Building Inspector
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/�07'E: GOT Gapes- �YOT / o47.2 A;
CERTIFIED' SLOT P LC
IoR t ono .Sf,AGE /Nc LaT -
T O W M 0 F
SCALE DATE :
+00
I CERTIFY THAT WHAT IS SH BWN ON THIS PLAN
IS AS IT EXISTS OR THE GROUMD AND CONFORMS
TO THE TOM REGULATIONS _, �
�..
Assessor's map and lot number ....^......V5_�7
�..: CTHE t0
.................
Sewage Permit number Q ..... �' �"' 1 �o``Q ♦�`.. ......... .. CON.
p yw Y � CON.5 � 2 EAMSTABLE,
House number ............................�.........^R...................g `5 '-
Y �? °�0s 1 1 a 9 NAG&
:. DUCT zRt- O, i679.
z` TOWN OF 'TABLE
BUILDING, INSPECTOR
�.��� �....................................... .APPLICATION FOR PERMIT TO ...:........��...F?.izco t. .................:..
TYPE OF CONSTRUCTION ..................... ? )Pni !1 e. .........................................................................
....... ..........................1923
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for'a permit according to the following information:
Location ...........
................... ......... f.>'l... ............9�"` SPff ....... ? 5.......IWO ................................
/' .
ProposedUse ............ 411. M.!G......� 1�,..�5............................................................................................
Zoning District ....................... ......--....................................Fire District ......... l lZl:?/.',3,.................................................
�� Ei� ..:.....................Address ....d9H... .
Name of Owner ............ . .... .............. .................................
Name of Builder .................... .............. .......Address ..........=.3f?hvt!e....-..........................................
Name of Architect -moo
.........................................:........................Address ....................................................................................
e.�
Number of Rooms ......................!...........................................Foundation •............ r e.f7 .............................................
Exterior .......... CP Av .."-......C.�._.* ? d..........Roofing .............. 4 .............................................
Floors �ea.r� �. 6 z........................................Interior .........Rv9tr_�?' ................................................
Heating ........../ .....�� j��(�..,/..5-:a........ ....................Plumbing ...........�.�� !�..........................................I...........
Fireplace ....................................................................................Approximate. Cost 00 C30 0
j,.....................................................
Definitive Plan Approved by Planning Board -----------_______----_------19________. Area ...... ? ... ...................
� ���
Diagram. of Lot and Building with Dimensions Fee ........... ................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
� 4
i �4
6� .��
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Bar table regarding the above
construction.
6 �
Name ... ........ ................... ... ...........................
.1,�Construction Supervisor's License ....... .... y......
00, OLD STAGE, INC.
25643 One Story
..............- Permit for ....................................
Sin le Fai�ily...P��f�.jjing..............
..................................... .....
Location 5J.......4.8...Er.in-LAp§t.........
s ni
...................Hyannis
Owner ....Old..Sta......9..e
....... ......... ..........
Typer.,4 Construction' ....Kr?KaQ.........................
..........................................................
............
Plot ............................. Lot.................................
t
7
October 13, 83
--P,erkt,�Gronted ........................................19
Inspection ... . ... .............................19 Date a
4
ate Competec
D ........ .......1 9