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HomeMy WebLinkAbout0119 FIFTH AVENUE (HYANNIS) TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION R Map Parcel Application # 2b Health Division Date Issued Conservation Division Application Fee Planning Dept. Perrpit Fee Date Definitive Plan Approved by Planning Board ,p Historic - OKH Preservation/Hyannis Project Street Address Village Owner A ti, �D ti Q ti A ,h r,.P Address 114 i FTL P Telephone Z-_S`i --Zy' 10� Permit Request VAI C __(LeAl in l in l�.v', Ati D 3 �Tha c v 1,6 rA 1h Square feet: 1 st floor: existing proposed 2nd floor: 'existing 6 proposed C) Total new C7 Zoning District Flood Plain Groundwater Overlay Project Valuation !t)K Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family '2--_ Two Family ❑ Multi-Family (# units) L -' Age of Existing Structure `I 0 Historic House: ❑Yes Urfq-o On Old King's Highway: O'Yes�.❑X% Basement Type: ❑ Full ❑'Crawl ❑Walkout ❑Other i Basement Finished Area (sq.ft.) CD Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2. new Half: existing rJ new a Number of Bedrooms: 3 : — existing —new Total Room Count (not including baths): existing f new o First Floor Room Count Heat Type and Fuel: ❑'Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 01Go Fireplaces: Existing_A_New . Existing wood/coal stove: ❑Yes UNo 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 /tA t Q kNe e.� Z �� Telephone Number S D Address 3 t�ti-P License # � uv le rs, Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ory AJ l Ati® � U SIGNATUREA;Aatl�qlDATE FOR.OFFICIAL USE ONLY APPLICATION# `1 L i is DATE ISSUED j `,MAP/PARCEL NO. ADDRESS VILLAGE OWNER fr DATE OF INSPECTION: s .;(FOUNDATION . = :44DRT FRAME r ;"INSULATION,"_A_ i FIREPLACE r y< ELECTRICAL: ROUGH _ FINAL ` '. PLUMBING: ROUGH FINAL GAS > f ROUGH . fE L 3. FINAL - =wi'FJNAL,_BUILDING= ._. tS#� .. - i7:DATE CLOSED OUT _ ASSOCIATION PLAN NO. f y t' �s The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations i i►t,i J i 600 Washington Street 't t►S1i: I, Boston, MA 02111 c www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): it., t U,t 1��•�" Z \ G�S l h .,Cal Address: 3 $7 N 1 •y ,cam t y i l��.t City/State/Zip: ) Phone #: 170 Are you an employer?Check-the appropriate box: Type of project(required): 1.❑ I am a employer with 4.'❑ 1 am a general contractor and 1 6. ❑New construction e ployees(full and/or part-time).* have hired the sub-contractors a sole proprietor or partner- listed on the attached sheet. I . L'J Kemodeling 2. I am ship and have no employees These sub-contractors have 8. Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp, insurance 5. ❑ 'We are a corporation and its officers have exercised their 10.❑ Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work right of exemption per MGL 1 I.El Plumbing repairs or additions myself, [No workers' comp. c. 152, §](4), and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify the pains and penalties of perjury that the information-provided above is true and correct / Signature: '' .. �J T 4 9 R Date: t//!Z//—. Phone# L only. Do not write in this area,to be completed by city or town official n:. Permit/L.icense# hority(circle one): Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: 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 pe`rsorisioo 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 cense•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,tefephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia 30 t�� 3U' —6I'- 7 34:' i 12 e. !I 15:' 124' 76' 3W, 1v� 11 J 38' i 2�w 21'- RZ?1 "4 F_ Il .;; I �� w o3o ' � W3030 W*O;2 } W34930 R 17!pESIGI!i 1�1 _ L P MAN Z_ 'YI ............ .................. ................ ..... ................ ....... _ .. . ......... 30r WA5F}ER 1$•vI�HW 5830 24-GABS 4Ah1GE DEAIZR 11- PZRLLAT MASTOWWZE AND PRYER 1$ pW 24 RANGE MANPE L POOR STYLE LOCATION SPAGE !0. M]GROWAVE PULL-OVERLAY °F. ! SPACE WF1ITE LAMINATE 3�. REP 5T9 BOX CANSTIwLSCl7Ott A � BROOt4 PANTRY (FARTKXZ BOARD S®ES) 1 5f'AGE ti T FtOl1-0!J rr5t4) MAME! POVETAIL PRAWER5 tiGT=72 ;ID I VTK-VOID TOE VTK-VOID TOE REM V"* L Wt'Fh1 SUM 50FT-CLOSE Gt11DE5 ! . ...................... .._ `! i! UI$2484RG?484.4F�03 83o•?�WFAF2l. AtGEF�50WE5= N. NO GROWN A-VI LL LLIqp�AA WK3ls�2 s 5A1�3-3o/yC1t}WA�i8er r r"`C,I. &WEPT- "C/'T• 1N42✓� I wwo U) ToaS.—A Mrte, r R TUKWH(1) Key W u 1 H ��.w__._.__- 18w___�c________38- ' 30'—, 12' 15;• ! ! ��ir36w 1493'' E All dimensions_size designations This is an original design and must Designed: 12/15/2010 f given are subject to verification on not be released or copied unless Printed: 12/1512010 ^job site and adjustment to fit job applicable fee has been paid or job conditions. order placed. 1 r� 1 Cr '� Renzi Design H 121410 rill Drawing#: 1 �.r l,� W�tinow A�\�~ ,� W � ���- 5��� �� � 1 v �. l`� ��.. �� ��� � d° yQ , ��a�� J �Ql� �� �� �9�od •I.0J92/200$ 00:35 15087789504 MZKERENZZ PAGE 05109 T Town of Byrn-st hle Regulatory,derv' LS 'R NMI Tore iB 7,);Wld ng COMMI Qonar 200 Main,Sbrcct Hymisa MA i 2601 �tr}v�f.lovvn,barnd�able,�x+) �us Dffici.- S09-867..-40IR I Fax: 508-79$••623f i I Property Owner st Complete and Sigpvn Thi Secdon XF Trs.Ln,&A Build - • I I hereby a'ix o izeAAj to act am my behalf, la all z tt=relative to I=*Authoi=d by this buil ing t. 't applcatio k for: f (Ar1drr:,;a of job) i I 5ipafure of Ow=r ,Date i i N,V C.Z�A 17239,F �'rinr I�a.cx�e If X'ropexty(-wneris applying for permit bease cox'x pxet:e the Homebwncrs License Exemption Fotm 66 fc ircverse side. Bo�ro m m eguCSCtio° a�d 3fan License or registration valid for individul use only 4 HOME IMPROVEMENT COIW,RACTbR before the expiration date. If found return to: Registration; 111859 Board ofBuilding Regulations and Standards Expiration 2/4/2011 Tr# 279440 t One Ashburton Place Rm 1301 . Boston,Ma.02108 MICHAEL RENZI CONSTRUCTION M1C-HAEL.RE NZI j 341' 387 PHINNEY'S �"�NTERVILLE,MA 02633 -- —— Administrator Not vali thXt signature r iVlussuchusetts- Department of Public SafetN .Board of Building Regulations and Standards Construction Supervisor License License: CS 58266 Restricted to: 1G '- MICHAEL J RENZI s �' 387 PHINNEYS LN CENTERVILLE, MA 02632 • �� ,< Expiration: 1/30/2012 Tr#: 13520 Commissioner a t w 4�j�- Town of Barnstable �OptHE Tp�� NAP o� Regulatory Services - gpRNSipBLE, Thomas F.Geiler,Director 9�A : Building Division TED MAC A Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERNIIT NUMBER �,.�;J (Permit required in order to process inspection) Today's Date bgn L Requested Date of Inspection 4Z-12- 1lr 7 I,Lor; - T j, ,-A hereby request an inspection under Massachusetts General (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). c� The installation is complete and ready for inspection at (Property Location) Type of inspection requested: ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection Service Inspection ❑ Final Re-inspection ❑ Rough Inspection for Final Inspection for ❑ Other Owner or tenant !M i 1Lt _ ✓:C,l,� / ( C�7`ftM i3P 6 Licensee's name, address, and phone �- License number E-1 Licensee's Signature 26 This sectie completed b' arnstable Inspector of Wires APR 0 � Inspection date LC'Proved ❑Not Approved This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: l 0:WPFi1es:B1dg:E1eaequest Town of Barnstable TO IYU f 1:3DIE ��FSHE tOk'` yP o� Regulatory Services .-.T • Thomas F.Geiler;Director3 i Ahi jo !0 B".NSTABLE, ' � �' Building Division 9 i6J9 ,��plED.1 , A Tom Perry,Building Commissioner_ 200 Main Street,Hyannis,MAl 02601?:I�'"`--` Fax: 508-790-6230 Office: 508-862-4038 _REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PERMIT NUMBER 9✓ -1 (Permit required in order to process inspection) TodaY's Date Requested Date of Inspection �� 1 I, �n �--- hereby request an inspection under Massachusetts General �trician) Law chapter 143, section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at (Property Location) Type of inspection requested: ❑ Temporary Service ❑ Service Re-inspection ❑ Excavation ❑ Rough Re-inspection ❑ Service Inspection ❑ Final Re-inspection [] Rough Inspection for Final Inspection fort ❑ Other Owner or tenant yag 7�S Licensee's name,address,and phone c License number Fj l Y Licensee's Signature This section to be completed by Barnstable Inspector of Wires G`62 ❑APproved ►[�NooApp�d Inspection date /�`U This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: � 6U7 �6G Town of Barnstable 'THE o� Regulatory Services • - Thomas F.Geiler,Director + BARNSTABLE, s639 9 �' Building Division • �� ATEp MA{° Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 REQUEST FOR ELECTRICAL INSPECTION ELECTRICAL PER-NUT NUMBER (a 3 5 7 3 (Permit required in order to process inspection) Today's Date Requested Date of Inspection <•traT� I, �� � - - d y S = hereby request an inspection under Massachusetts General (Electrician) Law chapter 143, section 3L and 237 CMR 4.02(3). The installation is complete and ready for inspection at !�-il I"a2T (Property Location) Type of inspection requested: ZZE €' ❑ Temporary Service ❑ Service Re-inspections ^( ❑ Excavation ❑ Rough Re-inspebcdo;n of > ❑ Service Inspection ❑ Final Re-inspection :X is �] Rough Inspection for tAc 14 ±PV17 a,00 '- Co m ❑ Final Inspection for V ❑ Other Owner or tenants Licensee's name,address,and phone np�3�i2�19'S'dC/i/3' S'Tz!Ll�!LL TY- �l License number t=t 7 !t/`7 Licensee's Signature Thi seZ400, to be completed by Barnstable Inspector of Wires Inspection date ( z Approved []Not Approved r This work was not approved for violation of the following Articles and Sections of the MA Electrical Code: Q:WPFi 1es:B1d g:E1ecrequest Commonwealth of Massachusetts utnc,ar use unty � 'r Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev. 11/991 (leave blank) . APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC ,527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL I7VFOkVf,4TION) D ate,_ City or Town.of: Barnstable To the Ihspector of Wires: By this application the undersigned gives notice of his or her intention to perform electrical work described below. Location(Street&Number) `" {f-j'JZ/zi5-to, .7 iti•Iap/Vg` Parcelp2Aj -e 5 Owner or Tenant in//eF- ��,y� Telephone No. Owner's Address Is this permit in conjunction with a building permit' Yes No ❑ (Check appropriate Box) Purpose of Building utility Authorization No. Q J Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters r New Service 1Sy�j_ Amps 1/0 Volts Overhead Undard ❑ No. of;Meters Number'of Feeders and Ampacity Location and Nature of Proposed Electrical 'Work: APL.a-_07- 25r- /D,:� Azri_4 S OU ICE Completion of the followin .table innar be svaived by the Ins ector of;mires. 93 No. of Recessed Fixtures No.of Paddle Fans No. of Total \ Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA Above n- i o.of Emergency Eighting No. of Lighting Fixtures Swimming Pool grnd. arnd. Battery Units No. of Receptacle Outlets 2 No. of Oil Burners FIRE ALAR1vIS• No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices g Tons bg No. of Waste Disposers Heat Pump `Number Tons .KW No. of Self-Contained Totals: ""....."."' Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances XW Security Systems: No.of Devices or Equivalent No. of Water No. of No. of Data Wiring: Heaters KW Signs Ballasts . No.of Devices or Equivalent No.Hydro-massage Bathtubs No. of Motors Total HP Telecommunications Wiring- No.of Devices or Equivalent OTHER: 4aach additional detail if desired, oras required by the Inspector ofiVires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 9 BOND ❑ OTHER ❑ (Specify:) ' (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) . Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and coniplete. FIRM NAME: ogso r se 0 LIC. NO.: L�/) Jy7) Licensee: L� Signature74LA�6' LIC. NO.: 6f !Ifapplicable, enter "exempt"i license number line.) Bus.Tel. No.:� Address: MAC5 Alt.Tel. No.- OWNER'S INSURANCE WAIVE ••I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑owner's anent. Owner/Agent - _ I I7 G tl rIA�T T+F F• Q , Inspection Log Ins' ection T e. Date Results Inspector Temporary Service Excavation Service Partial Rough Complete Rough P 9 Partial Final Complete Final Pool Bond . Pool Final Other (Specify Type) Please be advised that all inspection requests shall either be via facsimile, or telephone in order to be placed on the schedule. Tel# (508) 862 — 4089 Fax# (508) 790 - 6230 L TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ,X- 15'" Parcel © 9 / Permit# ea Health Division D r O.z 9,5-760 Date Issued D Conservation Division �2 Application Fee Tax Collector /1 Permit Fee 3 3E'c/go..►t f Treasurer , �li PTE YSTEM z►IvU29T Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE Ar-M)TS - Historic-OKH Preservation/Hyannis OWN REOBJLATIM Project Street Address l j `T 4 u Village WVd W ?Q K—N Owner N (� (�,�� Address Telephone 9 S Permit Request 7C I b A '3) 191 1►tam T=/k.*\ L'a P7 ti r V I I 7>a; i T Square feet: 1st floor: existing proposed 3 Z 0 2nd floor:existing proposed Total new 3 2 Zoning District Flood Plain Groundwater Overlay Project Valuation `1 ) �K Construction Type Bu oo Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family e Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full brawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 1 new Half:existing new M. Number of Bedrooms: existing '_ new 4' Total Room Count(not including baths): existing new I First Floor Room Count to Heat Type and Fuel: was ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ZINo Fireplaces: Existing New Existing wood/coal stove: ❑Yes 2flo 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 BUILDER INFORMATION Name A-P � l 4,J L I Telephone Number Addresses V? License# C"�2 C, ~ h►l V` -r Home Improvement Contractor# all � )9 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `l� olaL�i� I4,,t. 0 rr 1 SIGNATURE DATE _ � ,`© -,7, FOR OFFICIAL USE ONLY IT NO. ` ISSUED MAP/PARCEL NO. _ ADDRESS ' VILLAGE ` OWNER DATE OF INSPECTION: FOUNDATION FRAME , INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. .NNE The Town of Barnstable 9AR` E. MASS. �� Department of Health Safety and Environmental Services 3, ASS. . 1639. preOMP+a Building Division 367 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection �-T +/1/i Location , 1 `� \Y\ k�; - � Permit Number U Owner Builder a i V..C �Ztg�--� One notice to remain on job site, one notice on file in Building Department. The following_ items need correcting: Please call: 50-862-4038 for re-inspection. Inspected by f ( ! Date - Q E RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions S50.00 '�® � Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIMN G'SPACE Aq 2 t Y110 square feet x$96/sq.foot= x.0031= - plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.1' >120 sf-500 sf $35.00 >500 sf.-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 - >1500 sf Same as new building permit: - square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (der) Deck x$30.00= J (der) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) �permit Fee projcost 1 fl a (,,UrlTmurl rvGu.u.« vJ 111►s�l.a rr....�.r��—_. �= Department of Industrial Accidents - Office oflor'dstfgalfaas - 600 Washington Street - ' Boston., Mass. 02111 Workers, Compensation Insurance Affidavit end a homeowner performing allwork myself sole slot and have no one wbrlan in carp t or ahaves no o l/�/%%%/�%%%%%/i.. ensationfor my employees working:°n:th s jobr 'din workers co ::?.{.4>:::::-:v..:. {.:.::•::::.:?-:.::{.::{:{..}:>.$.}:.:a:;:>:3::.}::: ':;: ;:.:$$•:;:;•:4:.$::{�}.{::. 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I mtdersbmd that a Qy o f this statement may be forwarded to the OMce of Inge . es of perjury that the information provided above issue and co io hereby certify under the pains and penaliz rrect C Date gnature 7 /' °L phone#f dint name do not in this area to be completed.by city or town ofIldal ofHcialtue only �• perinit/ilcente# oBuj ding D epu tal city or town: ❑I3censin=Board ❑selectmen's Office ❑chckitizm ediste response is rngmred 0$ealth Department Other phone#; — her • contactperson' r ' Inforzaatian and 'Instructions :iusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their . S. As quoted froin the "law'; an employee is defined as every person in the service of another under any cqn Tact express or implied, orai.or written.' Moyer is defined as an individual; partnership, association, corporation or other legal entity, or any two or more of :going engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or of an individ':aal, partnership, association or other legal entity, employing.employees. However the owner'of•a g house having not more than three apartments and who resides therein; or the occupant of the dweUing house of :.,who employs persons to do maintenance, constrtictioa or repair work on such dwelling house or on ttie grounds or appurtenant thereto shall not because-of such employment be deemed to be an,employer. chapter 152 section 25 also statet that'every state or local licensing agency shall withhold the,issuance or renewal ,sense or permit to operate a business or to construct buildings in the com monwealth f6r any applicant who has -oduced acceptable evidence:of compliance with the insurance coverage required. Additionally,.aei her the onwealth nor any of its political subdivisions shall enter into any contact for the performance of public work until able evidence of cai liance with the incitmce requirements of this chapter have been presented to the contracting Zty• : ' 1cants . e fill in the workers'. compensation affidavit completely,by checking the box that applies-to your situation and �ing,compnnynaes, address and phone numbers along with a.certificate of insurance all affidavits may b .fitted to the Department•:of Industrial Accidents for confirmation of inc�rai►ce coverage: Also be sure to sign and, the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is requested, no't the Department of Industrial Accidents. Should you have any questions regarding the"law" or if you equired to obtain a.workers' cnrapen. on policy,please call the Departmemt at the number listed below. or Towns : se be-sure that the affidavit is complete and printed legibly. ae Department.has provided a space at the bottom Pe f the 3avit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant, in the ermitlliceisse number which will be used as a reference number. 'The affidavits'may be returned to ure to fill P Department by mail or FAX'iinless'othei`ariangtbimts have'bem'.mad'e: - office of Investigations would like to thank you in advance for you cooperation and should you have any questions• ffs ase do not hesitate to e've us a call. e Department's address,telephone and fax number: The Commonwealth Of Massaehusetfs' Department of Industrial Accidents CMce of InYestlgatlons : 600 Washington Street Boston,Ma. 02111. fax#: (617) 7274749 phone#: (617) 727-4900 ext. 406,409•.or. 375. I q The Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are-adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost t Address of Work: 1 / `� T r4 y� {� y Pf 1 Owner's Name:" it00 m C kA^ �J►1 Date of Application: I hereby certify that: Registration is not required for the following reason(s): [1Work excluded by law 7Job Under$1,000 Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS 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 lY for a permit as the agent of the owner: ' Date ntractor Name Registration No. OR q:forms:Affidav :rev-122001 NOTES PINE S T IRON PIPE JOB NO. B02-02 FND & HELD Chombre.dwg 1. LOCUS IS A:M. 245 , PARCEL 91. FOR LINE 2. LOCUS IS IN FLOOD ZONE C ?N FIRM DATED JULY 2, 1992. 3. OFFSETS SHOWN ARE TO THE CORNERBOARDS ON EXISTING BUILDINGS, OR TO FOUNDATION ON NEW CONSTRUCTION. N/F PIPE FND. CORNER .1' S & 0.3 E N/F MCGINTY JAPPE PROPOSED ADDITION 100'-N iv cli PARKR G Q r e . N/F 40.8' 16' 32.9' KELLY EXIsr. o to HOUSE W N0. 3.9'.... 40.4' 119 z 33.2' SIDE OFFSET NOTE: RECORD 1p PLAN BOOK 34, PAGE 23, 5.9' 00 W DATED AUGUST 1893, HAS NO BEARINGS OR ANGLES SHOWN. SIDE LOT LINES SHOWN HERE N/F EXISTING SHED Q ARE HELD AS PERPENDICULAR ww TO FIFTH AVENUE, AS SCALED a ON SAID PLAN. REGAN N/F � U ELBERY w C! _ °° m LL n C.B. / D.H. FND & HELD FOREST ST. I CERTIFY THAT THE LOCATIONS SHOWN ON THIS PLAN WERE MEASURED IN THE FIELD ON JUNE 7, 2002. ASBUILT PLAN FOR .�NOFk4SS ANDRE C. & DIANE D. CHAMBRE RONAL 9°yam LOTS 370 & 372, 119 FIFTH AVENUE I C N WEST HYANNISPORT (BARNSTABLE), MA 35 9 JUNE 8, 2002 SCALE: 1"=20' w^'osu '� RONALD J. CADILLAC, PLS, IRS PROFESSIONAL LAND SURVEYOR do REGISTERED SANITARIAN f P.O. BOX 258 6 10 WEST YARMOUTH, MA 02673 ©2002 BY R.J. CADILLAC (508) 775-9700 - x 1 1 r F2 U x $'� r. 0 9'A3-'&"t' i I � 1� A 3' a ) of "o �� av�ra ra r Q o J 0 J 5° oa r �. �Aa t NAZ � t5T CI� SP T 'Doe m a'�3-�r.t ' MA-T GH E7,lbl-. e ki 7 e �✓PH A,%--r /LO©w I� N►A'`I'C-M l 5#- FELT O U-E Y8 ��•O"c-o x I �.I G I' cvN y • y D�JC1 r 1/' fO7° A-r7 ►C Ac.c Eys r#1- Ace 6y y 7-H&O C>44,5 y - �-- axio lLri� G E oc . x (Ip +X a AA 14-�e Sr. A.L.v uT-re PO U T y a�g 1 x S S oF-Ft T - /x 3Y-- y1DN C SHrA)&t-e SYa 7yVEK. O -& W Z a �rGt7J` . ��y . a _ /x Y T 12.1 �vP N t7vc.J f, f /x 5 TR!Ott 000 a s hl V-E lg;r S q U 7-T-P-12 Fk O N a /V"-f M A T C-ft -E-AlYniOtz , _' 11 x y /X DES 2 L. p I f!T GI J �x ig � /9 A) G 4 O Q-- �j U!,"T -P-E 2. GID 0-E -- 3 d� a 2T ax 8 T3ox Coll-r. I=TC'. al l� r Gol._. f"I G "rj Rlal. 3� 5T DAs4 P P QOOG . $e 4U0 f c ab U j 0/ PA n3 ^&1 D g PPAAJ 1 la f ` 1 .3 a n a 3 p AD 5 31a"coNC• W L, F1 L(k o c, A 55 t vim:��� 6t# "tit, D03T CAI °a APC44Cie -30V7- PAR GODF— � '&f--4ow G RA-D E Permit Number MECcheck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release 1 a Checked By/Date TITLE:New Family Room CITY:Barnstable STATE:Massachusetts HDD:6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE:04/25/02 DATE OF PLANS: 3-27-2002 PROJECT INFORMATION: Cambre Residence 119 Fifth Ave. West Hyannisport,Ma. 02672 COMPANY INFORMATION: Mike Renzi 387 Phinneys Lane Centerville,Ma. 02632 NOTES: MaCheck by Cape Cod Insulation INC. #2807 COMPLIANCE:Passes Maximum UA=87 Your Home=86 1.1%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 320 30.0 0.0 11 Wall 1:Wood Frame, 16"o.c. 442 13.0 0.0 28 Door 1:Glass 40 0.320 13 Window 1:Metal Frame,Double Pane with Low-E 55 0.340 19 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 320 19.0 0.0 15 Boiler 1: ,87.2 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECcheck Version 3.2 Release la. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall *be no greater than 125%of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date i I rMECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release 1 a DATE: 04/25/02 TITLE:New Family Room Bldg. Dept. Use I Ceilings: [ ] I 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: i Above-Grade Walls: [ ] I 1. Wall 1: Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: I Windows: [ ] I 1. Window 1:Metal Frame,Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break?[ ] Yes[ ]No Comments: I Doors: [ ] I 1. boor 1:Glass,U-factor:0.320 #Panes Frame Type Thermal Break?[ ]Yes[ ]No Comments: I Floors: [ ] I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-19.0 cavity insulation Comments: I Heating and Cooling Equipment: [ ] I 1. Boiler 1: ,87.2 AFUE or higher Make and Model Number I Air Leakage: [ J I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. ( ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ J I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] I 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. [ ] I Insulation R-values,glazing U-values,and heating equipment efficiency must be clearly marked on the building plans or specifications. I Duct Insulation: [ ) Ducts shall be insulated per Table J4.4.7.1. Duct Construction: [ ] All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. I Temperature Controls: [ ) I 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. Heating and Cooling Equipment Sizing: [ ) I 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. Circulating Hot Water Systems: [ ] ( Insulate circulating hot water pipes to the levels in Table 1. I Swimming Pools: [ ] I All heated swimming pools must have an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable sources. Pool pumps require a time clock. I Heating and Cooling Piping Insulation: [ ) HVAC piping conveying fluids above 120 OF or chilled fluids below 55°F must be insulated to the levels in Table 2. i r Table 1: Minimum Insulation Thickness for Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Runouts Temperature(.F) lip to 1" Up to 1.25" 1.5"to 2.0" Oyer 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Ran e F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) All � ✓fte 'Fomz✓nzarturear!l� d��i�rliw:u�c�euaelGs BOARD OF-BUILDING REGULATIONS License: iCONSTRUCTION SUPERVISOR Number:;CS 058266 x Birthdate Ol%SOA953 Expires O1130 NN Tr.no: 13512 j Restricted: 1 o MICHAEL J RENZI 387 PHINNEYS LN` CENTERVILLE, MA a2632' ' Administrator y.•_. .. ✓>l e >�d'rrvtrt4ret��P,cell� o�✓r/ ,cl tu6,4z t r 79 Board of Building Regulations and Standards A ' �d-�,�� HOME IMPROVEMENT CONTRACTOR Registration: 111859 { Expiration: 11/12/03 Type: DBA i MICHAEL RENZI CONSTRUCTION MICHAEL RENZI 387 PHINNEY'S LN Cam•• � r�,. CENTERVILLE. MA 02632 Administrator I