Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0033 HARBOR ROAD
H ax i r r a _ VE Town of Barnstable *Permit'# " /6_as p Expires 6 months from issue dale * , Regulatory Services Fee HARMASM Richard V.Scali,Director Building Division } s Tom Perry,CBO,Building Commissioner: AUG Q 8 2016 - _ -- Main Street;-Hyannis;MA 02601 --- www.to_wn.barnstable.ma us __�_ �j ���� Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAUT APPLICATION, - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Work$ PC) Q Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address a Contractor's Name ,('_(��� (� Telephone Number Oa� ©,'(kf�� Home Improvement Contractor License#(if applicable) 136 0d--� Email: Construction Supervisor's License#(if applicable)' C—S ^ O^] ® � ❑Workman's Compensation Insurance Check one: 9-1 am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. w Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane cane nailed)(not stripping.PPi g. Going over. � existingl.ayers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value C) (maximum.32)#of windows #of doors: , ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permitsrequired. t *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is- required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 040215 27m Comm oniveakh of Mawadiusetts .r Deprtmnt a,f rnd=tria1 Accidents , - Ofiice of goons 600 Washington,street - Boston,AA 02111 immmasm, din ... y tkers' Camipensa Iusuce Emlers/Cntactrs'EleericianslPkumhers ' -- '{ICaIi TI1f 3tY0II — -- — Please-hint Address: -CiigJStatel `� a ��, 0 Phone�u- � .� V Are you an employer?Chv6k the appropriate bow: Type of project(required}: 1.❑ I am a employer vith 4 ❑I am a gmeral contractm and I * havehiredthe sulr�tmctors 6. ❑Ne�vcoustzudio:n .employees(full atrdfor part�ime�. 7, Remodeling 2., I am a sale pzoprietur orgartner- lis d on the attached sheet ❑ g These sub-contactors hate and have no employees8_ ❑17emaIition w Q forme in employees aadhave worl�s' '. -tn. �� $ 9. ❑Budding additiorP - [No 1v�3'coinp.isnsmanre comp-msm anrr required-] 5. ❑ We are a zorporatioa and its 10-❑Elechical repairs'nr add�ns - exercised 3.❑ I am a homeowner doing all workaffiem have 1 L❑Plumbing repairs or'additions . ,r,s�€ o wo rk=' tight of exemption per their MGL 17❑Roofirs repa in surance required.]i�F c.152,§1(4h andwe have nQ employees.[No worms' 13.❑Other t com4x iasuranm required] J c{ •Anyap k &atcbedmboa#lmasY also fm Out the iectionbeiawshvuiug0=woTcerecompenudoupolky=Fb m2dm- w , Romemmers who submit this sf5cknl=&catmg they are dGMff alb Wak snd th M him autside contmctarsMnst sahmit a new affida iadicabng sash_ ICanttacmts thxt check this boot mast attached smt additional sheet shooing the or—of dze sub-c�cty�sad staee whew a not fhnse a bn-e employees.If the sub-cwta M s have employees,diWmampmsdde their workeu'gip.paliey number_ K. I ant art empLayer f7eQtis prautdirrg workers'cotrgrertsrdirrrt irrsairarrce fur my emplLyeem Below is fltepaticy and job sate infor malion. , Insmnce Compmy Nome: Policy,*.or gel€ins.Lie_ r" Fs'.piration.Date , Job Site A,ddte= ` CitylSt&W2� p: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secm-e coverage as reg*ed under Section 25A of MGL r-157 can lead to the imposition of criminal penalties of a fine up to S1,54a 4Q andlor one-year imprisonment as well as civil penalties is the fora of a STOP WORK ORDER and a hue of up to$250-DO a day against the violator Be adtdsed that a copy of this sWement may;be forwarded to the Office of Inves°tsgations ofthe DIA,fakr insurance coverage verifcatian , I do hereby cei f�trader tyre prr s and attha Qf, er�ul}'thatfits infor+sutdwiprovided ubmv isb/are and correct fit tature: , Date- , A" Phase � r� 6 0jokial tree only. ,Do not write iit thb axea,to be campieted by tfiy artown offic&L City or Town: PermitUcense#€ Issuing Authority(carle one): 1.Board of health 1 Building Department 3.CRyfrown.Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone 9: formation and Instructions ' Ms3cear hus�fs GeI"eral Laws chapter 152 regois all employers b provide workers'compensation for their employees. p this fie,au.ernpla9,ee is defined as_"_.every person in the service of another under any contrast of hire, express or implied,oral or wr>f[nnf An e7np&yEr is defined as"an individual,partnership,associations anporaiou or other legal entity,or any two or more of the foregoing edged in a joint enterprise,and including the legal representatives of a deceased employer,or the reiver or trastee of al individual,partrshlp,association or other legal entity,employing employees. However the ec owner of EL dwel32ag house having not mars than.three apmrtmeuts and who resides therein,orr the occupant of the - dwm g fuse of mo1her who employs persons to do maiatz�,c^nstruc'on or repair worn on such dwelling house or on the grotmds or building shall not becanse of sack employment be deemed to be an employer." MGL chapter 152,§25CC-6)also states that"every state or local licensing agency shall withhold•Hie issuanm or renewal of a license or permit to operate a business or to construct burldiags in the commonwealth for any applicant who has,not produced acceptable evidence of compliance with the 4T,cnran ce.coverage requir c " Additionally,MGM chapter 152, §25C£7)states Neithm the commanvaealth nor guy of its poIifical subdivisions shall mtez mtD any contract for the performance ofpubho work until acceptable evidence of compliance with the insara cez._ re, ,;,Prr;ertts of this chapter have Been prese ed Io the co�radiog ar�hozity_" APplicasrts , Please frIl ovt the workers'compensation affidavit completely,by checI®g ib e boxes that apply to your situation and,if necessary,supply snb�contractor(s)name(s), addresses)and phone-m— er(s)along with tbeir certificate(s) of incnrance. Limittd Liability Companies(LLC)or United Liability"Pa tammbips(LTP)within employees othertbmthe members or pa:inms,are not required to carry workers' compensatim ias manor. If an LLC or LLP does have employees,a policy is required. Be advised that this aff dam maybe submitted to the Department of Industrial Accidents for conformation ofmmn De coverage. Also be sure to sign and date the affidavit The affidavit should be rstnrned to tb.e city or town that the application for the permit or license is being rmpest A not the Department of Iudustmi A_ccidenis should you have ray questions regarding the law or¢von are regoaed fn obtain a workers' compensation policy,Please call thie Department at the number listed below: Self-marred companies should enter their - self-insurance license nurnber on the appropriate Ime. City or Town Officials . t _ Please be snie that the afdavit is complete andpried legIly. The Departmenthas provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investi�has to cord-act you regarding the applicant Please be sure in fill.in the pen�ni/Iicense munber which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense appliz�tinnc in any given year,need only submit one affidavit indicating cat a olicy i:l rrnation(if nmessary)and under"Job Site Address"the applicant should write all locations n (�Y or �town}_"A copy of the•affidavit thzat has been officially stamped or marked by the city or tx>wn may b e provided to the applicant as proof that a valid affidavit is on file for f 3tra pen its or licenses. A new affidavit must be filled oirt tar-h. year.Where a home owner or citizen is obtaining a license or p=itnot relafsd in any bn�;ness or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to co�Iete thus affidavit 'lLe Office of Ines vtigations would Hm to thank you in advance for your coopmddon and should you have any question , please do not hem to give us a call. The Department's address,telephone and fax number: CommonWmjthE of Massachusetis DeparEmmt of Ii dual i AccZents r��e r��tve�fig�l�o� ��-�ashingtan Bastes 1&0�1IF Tf,-L 4 617727-4 c-xt 406 or 1477 lv4 A I AM Fax 9 617` 27 77 Kevised4-24-07 zflagQgfrfia MAM 1 ,� Town of Barnstable „ Regulatory Services Richard V.Sca%Director a ._-_----_-Building Division--- ; ,Thomas...Perry, Building Commissioner r. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us ` Office: 508-862-4038 Fax 508-790-6230 Property Owner Must' Complete and Sign This Section t If Using A Builder . as Owner of the subject property .. •. - �/j hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: hd,r (Address of Job) — r 17 CwCIL a Signature of Owner Date Print Name- If Propei-ty Owner is applying for permit;.please complete the Homeowners License Exemption Form kon the reverse side.' QAWPF=SIFORMS\building permit fbrms=RESS.doc ° A Revised 0.40215 4 Town of Barnstable ' Regulatory Services �oFzHE r, Richard V.Scali,Director Building Division * RMINf.UELF. : Tom Perry;Building Commissioner L 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print ' DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: cityhown 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. DEFINTTION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town ofBarnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval ofBuilding Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the.provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 r ��ie rOammzcouaecz�o�6%uGcraaac�ureCTl Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration:`'`136003 Type: Expi ration:=�'S(�QF2Q11 Individual �— 2. �-- BRUCE P.MILLS BRUCE MILLS jir=a--; 16 CROOKED POND`RO:=: �.:: '' HYANNIS,MA 02601 1- „ Undersecretary S t Construction Supervisor Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of . enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. a DIPS Licensing information visit: WWW.MASS.GOV/DPS " Massachusetts Department of Public Safety lug Board of Building Regulations and Standards License-' CS-078687 Construction Supervisor BRUCE P MILLS 16 CROOKED POND ROAD"My HYANNIS MA 02601,`'.1 - Expiration: Commissioner ` 05/29/2018" TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel j W 7 a ® / Application # O Health Division `Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village Oh69 Owner Address - gAln �on ST j A 04� 0 awc _ �x Telephone Permit Request Z� 4 L' i oo on Square feet: 1 st floor: existing—proposed ?nd floor: existing pro posed Total new ` Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: U Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family.' Two Family ❑ Multi-Fa2o# units) Age of Existing Structure J r Historic House: ❑Yes On Old King s ighway: -.Q Yeses ®'IQo Basement Type: dFull ❑Crawl ❑Walkout ❑Other -- Basement Finished Area (sq.ft.) 1900 Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new- r- j Number of Bedrooms: existing new C) Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: aKas U Oil ❑ Electric ❑ Other Central Air: ❑Yes L o Fireplaces: Existing J/ New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage:existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# �J6�9 Current Use 146K Pr posed Use T-nT INIDf— APPLICANT INFORMATION V (BUILDER OR HOMEOWNER) Name Telephone Number -Address 33 License #41 4ALAkA n '� I V w Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# > DATE ISSUED > MAP../PARCEL NO., l ADDRESS VILLAGE OWNER N I `r DATE OF INSPECTION: T,d FOUNDATION E FRAME INSULATION.. — FIREPLACE r ELECTRICAL: ROUGH FINAL .r PLUMBING: ROUGH FINAL . °GAS: ROUGH FINAL .' r�,IFINAL BUILDING =' DATE CLOSED OUT ' ASSOCIATION PLAN NO: f rr The Commonwealth of Massachusetts Department of Industrial Accidents h Office of Investigations 600 Washington Street Boston, MA 02111 °' _�• www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/PIumbers Applicant Information Please Print Le 'bl Name(Business/Organization/Individual): AA"-t__, Address: City/State/Zip: Phone.#: Are you an employer? Check the appropriate bozo Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-tirn.el.* have hired the sub-contractors 6. ❑New construction 2.0 I am a sole proprietor or partner-' listed on the attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor mein an capacity. employees and have workers' Y P t5'• 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ e uired. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions ,� q J. 3.L� I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required_] t c. 152, §1(4), and we have no ! employees. [No workers' 13.eother :60 comp. insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide;their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is the policy andjob 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 tip to$1,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against 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. Ido hereby certify under the pains andpenalties ofperjury that the information provided aboo/ve is true and correct Si ature: C Date: /0 Phone#: 7 D r O Official use only. Do not write in,this area, to be completed by city or town officiaL "City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4,Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instrrnc ions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as". .every person in.the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or'other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for,the performance of public work until acceptable evidence of compliance vizth the insurance, requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractors)name(s),-addresses)and phone number(s) along with their certificates)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 tie 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations. 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727,7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable 'THE Regulatory Services r tARNSfASLE Thomas F. Geiler,Director MASS. 9q, 1619. ,�� Building Division ATED MA'I A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ,� I JOB LOCATION: �� 1�u CA 1A_A 1 v` number street Qj village "HOMEOWNER": C , (. 19-ga 0o jk sb-ca cekJ- name 1 home phhoonee�# work phone# CURRENT MAILING ADDRESS: 3�J I J 1 ► 1 S f'f l '"I / city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER ` Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A`} person who constructs more than one`home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1...0 The undersigned"homeowner assumes responsibility for compliance with the State Building Code and other. applicable codes,bylaws, rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply.with said procedures and, requirements. Signature of Homeowner a 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 actm supervisor:" Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this'case,our Board'cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form•currently used by m several towns. You may care t amend and adopt such a form/certification for use in your community. s Q:\WPFILES\FORMS\homeexempt.DOC oFTHErq Town of Barnstable Regulatory Services 4 � sna AS& Huss. Thomas F.Geiler,Director y g. 0. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Usina A Builder L , as Owner of the subject property hereby authorize to act on my behalf, an all matters relative to work authorized bythis building permit application for. (Address of Job) Signature of Owner _ Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMIS SION ® .ate i 4/20111 THIS CERM `� P sE a = �- I NFks 2 t J kI -WT-uK— rq I- A intinfion:asn+rr&In Aj;*Itr, � i3OR 'I I I C 6Rr FICATG DOE f��T Nu 1T;f�11 tIdEtr ,'E TENG�J .kLTEf;-niF 6r'a;G pFroRDr-G y i,a�.£ nk,,� � 19•:dl t 1�t TIiE: IE� ELI+ :, Iiaa,rJ ti t Rsti. I�t�#JF�� `� A ,Reiu@ wrft Ves'°(3MUP.Tres ifs Tiabr Fkr, Qv.rtl r M7 r INSURER r INSURER M E � ER E _.� "s � _ IMM M11P G c i<da.WIV& rtre" Oo.,i., t 1 L _ � _. E.FC: 7!EFaatla�lfHE rl l tED.t 1 4f#i T 9CV �tf" t r€is Tdott� ,4biirsaa'F auu.-,txin csT W[C H W L E s iTH ExFE%Y'Tr3 �tf�H T i6 nF[a Y g E i ED rt , 3°' [c xs err ,wsss ai a sYe S TtE F+: € LE �:AIEECaH�§Eii�,ks 1_ E € R 11HE tERk ,E eLU b�3 kd}CQP�s'Yip..: ' ;9LC.,4PC41CAE.k.AGMrroVMu;k•rrSMVA14p.�w ;r ',rE LlMAk[yAlEtB ,MuC�Ws � A#.�!.-r ��.s°!� T�'cam'�' `��'x�'�f� a: a' •4°„F .a.�`r. �r t '-- :r�6'a�r� ' Q', .aSL.wL�P•d,'af F `x••:.�'s r�-9a, 9-. a.... a. .f:�fl,ovaCa4;^4'IC.L3FINi4i%�9.1 �31 ... ,+;A17s f. . I.... 144R,�r4;L91�w3.1'FY ��.�•�;', ..+i.3 g Lie—TL�1Y 13m ME w rY art _;� Lar X ' r%,ITS q PLOW $. :::Voif' 4`. ti a s F�aMY(E� 10dB i1�7 lRl1R:�s�9��v Ee°_ i C>ems_ s rr^�z.7 C PWI.ca ZW V,)4.4,T-:;.7-i,.U..U77F ,eF Ff RIF:. 4Jlu MTM, ClAIN97pliLAN cm., m 1`:+E krA."f +ATE TiEK- TEE-t. lFtA It l A1�L G a 31-t xAY`c` i I7"PEtlh nCETOTHr R's1 RCA T0HCkbr8 NO, �9r1� t ea Mk T%3THE LEFT Edda ld'�ET E tz ! 1 dCM a' 77 _. _ _ .,.. .. . 1. 1. r e # ,J1_J 't�r1. 5s r" JL C �-s: T y I� �JE } '� f�� rat:, le]mr5 P' TPxi Via: , tip 1. t' ;! -:10 - , ,L ` . - �4 ' I .Tl Y�v -, syt1. - 5 €4, I — ... .. 5 ':..,_:,:�......� � — �.. � .. .-.. � .. . . I .. .. .— p 1 I .I... 1. � � — I � I- " �� - I VIL�g-, .4T72'._:—,,,, , � .�.[� ; ; _, L t§ - •. � TOafi� DES$ tPPP*1 PFtI1. �A% ' lat - to d ,�t"� ' 4s 78,1.1 a TAYI, r F 4l t t=F S � � !_ r4h.P,� �11�fH Fs , "ifL. 1. r FJ;� t l t�1 IJTI1.P j�j ��i n I.•- c} 1. " h �'' 7.' 1� ^ .. .. .. r * , ' ' , : tfl c'at� r� i� .3 � � °rd: tf f a�a t' ltl ft � t a t � �t , e�x r . " r �'! rticl do r t d. iD l r��ft�� r 1 � h 1i# µ � .LL f r ! . r. L. a� , 2,1L 1.t . t" 1.F �6le . ' �f d � mod: d r .lY.t� f :, ": 1 � III ford p � # ' � {� 1L � , . ,, L . w _, __. �___ r_ _ _. .�� G t,n, ��_ t.," �. .L"T� 1. t e . __�_� - . �� L. r gar �'+fir, ,, r R 1 3i.:m ' mil..;.� ,,..M.L. a:.. 1.IN6,a � _. LIB 11 ?�J _ -----, --- o.a„ s tic t� -- �o �;���*� s1a it t' j'effRES1� e�� lit 'I #1 ,,��4 t�. iI'L ,,- LL E� +—tic r :; r rei r r r `3�3 ~ L€J L' .a J C .—.. . . i� 5..: . '1HE„� M PEA wn of Barnstable *Permit#Oak q Expires 6 months from issue date Y - 6 2008 Regulatory Services Pee 0� Thomas F.Geiler,Director 9 MASS. .$ �sr �. ��� ABLE Building Division hO f63Q. �0 ArED MA't _ Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us - Office: 508-862-4038 Fax 508-790-6230 EXPRESS PERMIT APPLICATION : RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number —7V�0 e Property A ess �(�'�t_ 1�/ /7 2 W A,1 s esidential Value of Work r �' Minimum fee of$25.00 for work under$6000.00 . Owner's Name&Address C2 �Q I A)? . Contractor's Name � y�� � Telephone Number Home Improvement Contractor License#(if applicable)_ 13workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner.- ❑ I have Worker's Compensation Insurance Insurance Company Name �Le h S Workman's Comp.Policy# %-7• `2 V-jo A 7— 67 Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) e-roof(stripping old shingles) All.construction debris will be taken to 2 u A,f P ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License is required. SIGNATURE.: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 oF�HE, Town of Barnstable Regulatory Services Thomas F. Geiler,Director �prEo„n. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 tY ProP er Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to.act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form-on the reverse side. Town of Barnstable 1HE T ti 0 Regulatory Services E, Thomas F.Geiler,Director BARNSUB[ Y MASS. 1e59. Building Division TfD � Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 wvmtown.barnstabl e.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s) who owns a.parcel of land onwhich 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" Official on a form acceptable to the Building Official,that he/she shall be Building homeowner shall submit to the g p.. g responsible for all such work performed under the building pemnt. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and P requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1,.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he✓she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by form/certification for use in our community. several towns. You may care t amend and adopt such a f Y tY Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Ampficant Information Please Print Le 'bl Name(BusinesstOrganization/Individual):.. Address: �kv t City/State/Zip: � ` Phone.#: _4'7122 26� />) Are you an employer? Check the appropriate box- Type of project(required): 1.El I am a employer with 4. am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a-sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have m employees These sub-contractors have g. ❑Demolition working for mein any capacity. employee comp.insurance# ❑s and have workers' 9 Building addition [No workers' C07IIp.•incrrrance 5. We are a corporation and its 10.0 Electrical repairs or additions rup&ed.] officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself;[No workers' comp. right 6f exemption per MGL 12 ❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp,insurance required.] Any applicant that checks box#I must also fill out the section below showing their workers'coon policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must providt their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: f 7 v . ti►✓ Policy#or Self-ins.Lic.M �z ds Za Expiration Date: Job Site Address:12�2✓4y, City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to socu re coverage as required under Section 25A of MGL c. 152 can lead to the imposition of Final penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of for insurance coverage verification I do hereby c fy under a pains-and penalties of perjury that the information provided above' tr a and correct Signature: Date: s _ Phone# Official use only. Do not write in this area,to be completed by city or town off ciaL City or Town; Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant.to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing.engaged in a joint enterprise, and including the legal representative's of a.deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner.of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for•the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,i.f necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificates)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 Towp 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 onr,affidavit indicating cun-ent 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 cititen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Qffitce of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 4-06 Qr 1-977-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.govldia 'ACORD CERTIFICATE OF LIABILITY INSURANCEAT T. 104/008/(2008 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER INFORMATION SCHLEGEL INSURANCE ONLY AND ,CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 34 MAIN ST ALTER THE COVERAGE AFFORDED BY THE POLICIES' BELOW. WEST. YAWAOUTH, MA 02673 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:NORTHLAND INSURANCE Paul Buckmiller INSURER B: TRAVELERS INSURANCE DBA BUCIQ-IILLER ROOFING INSURER C: INSURER D: Hyannis, MA 02601 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ,ISSUED N THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. -NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADIrL POLICY EFFECTIVE POLICY EXPIRAMON LTR INSRD TYPE OF INSURANCE. - POLICY NUMBER GATE(ASNDDIYY) DATE PKVDDIV Y) LIMITS - A GENERAL LIABILITY CP46859504 05/15/07 05/15/08 EACH OCCURRENCE s.1,000,000 X COMMERCIAL GENERALLIABILrrY PREMISES(Ea ocoamce). E 50,000 CLAIMS MADE X❑OCCUR MED EXP(any one person) s EXCLUDED PERSONAL&ADV INJURY E 1,000,000 . GENERAL AGGREGATE s2,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG s2,000,000 POLICYED PRO- LOC AUTOMOBILE LUOUTY COMBINED SINGLE LIMIT ANY AUTO (Ea acdded) E ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per parson) HIRED AUTOS BODILY INJURY E NONOWNEO AUTOS (Per sodded) . PROPERTY DAMAGE E (Per sodded) GARAGE LIABILITY - AUTO.ONLY-EA ACCIDENT: E ANY AUTO OTHER THAN EA ACC E AUTO ONLY: AGO S EXCESBSAABRELLA LIABILITY EACH OCCURRENCE E 1 OCCUR ❑CIAIMSMADE AGGREGATE E E DEDUCTIBLE E RETENTION E E B voRKERscowsm-nGNAND 7PJUB-7430A7-07 04/11/07 04/11/08 X TORYL.WS ER EMPLOYERS'uAmuTY 7PJUB-743OA7-08 04//11/08 04/11/09 E.L EACH ACCIDENT E 100,000 ANY PROPRIETOWARTNERIEXECUTIVE OFFICERIMEMBER EXCLUDED? E.L DISEASE-EA EMPLOYEE $100,000 IT yes.deso ine under YES SPECIAL.PROVISIONS bebw EL.DISEASE-POLICY LIMIT E 500,000 OTHER DFSCIBPRON OF OPERATIONS I LOCATIONS I vEI cm I E](Cuman ADS BY e=RsBmT I sPEC1AL PRowstaNB THE WORKERS COMPENSATION POLICY DOES NOT PROVIDE COVERAGE FOR PAUL BUCKMILLER CERTIFICATE HOLDER CANCELLATION COREY &COREY SNDU O ANY OF WE OaTBED POLIQES BE CANCELLED BEFORE THE E)MRAMON 1694 FALMOUTH RD #115 DATE THEREOF, THE ISSIANG WILL ENDEAVOR TO MAIL 21 DAYS VAUTrEN CENTERVILLE,. MA 02632 NOTICE TO THE 1 CATE.HOLOER f TO THE LEFT, BUT FAILURE TO 00 SO "U IMPOSE NO Canal DR LIABI IOF ANY IGND UPON THE INSURER, ITS AGENTS -OR REP ENTA .. AVii1WBgDR E9ENTATNE 1; . FAX: 508-775-0155 ACORD 25(2001M) 0 ACORD CORPORATION I H.'�A R.. L E S C OR... E Y Th,e- VvilRodees 00 1694 FALMOUTH RD #115, CENTERVILLE, MA 02632 C_ E-. RTAI NT E. EMI N R ' ! .S: P R C; ail I � M STREAK HGHTER ARCHITECTURAL STYLE March 17, 2008 RE,,- R0QFMG PROPOSAL. CAROL NAPPA INSTALLATION ADDRESS: 341 ARLINGTON ST. 33 HARBOR ROAD WATERTOWN, MA 02472 ,HYANNIS, MA Phone: 617-924-0638 Home Phone: 617-650-6302 Cell CHARL,ES COREY hereby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturers specifications and local building codes. Remove and $aul Away All of the Old Asphalt Roofing Shingles. Supply and.Install CERTAINTEED LANDIAA E PREMIUM: LIFETIME WARRANTY, 10 YEAR SURE START PROTECTION, CLASS A FIRE RATED, 10 YEAR STREAK FIGHTER WARRANTY-ALGAE RESISTANT, 300 POUND EXTRA HEAVY WEIGHT, SELF-SEALING, 110 MPH WIND WARRANTY, CATEGORY H HURRICANE, STORM/HURICANE NAILED (6 NAILS PER SHINGLE),, MULTI-LAYERED,LAMINATED ARCHITECTURAL STYLE, FIBERGLASS BASED ASPHALT SHINGLE with New England's exclusive COPPER/CERAMIC STOKES with a FULL 10 YEAR WARRANTY AGAINST ALGAE CONTAMINENT COLOR: HUN'-P0C, (§eV p KJ Supply and Install 8" WHITE ALUMINUM DRIP EDGE on All of the Eaves. Supply and Install CERTAINTEED WINTER-GUARD ( lee & Water Shield )WATERPROOF JNDERLAYMENT SYSTEM on Roof-Eaves, Under the Step Flashing on the Skylights, Chimney and Gable Walls and 100% Total Coverage on the Shallow Pitched Rear Dormer Roof Area. Supply andInstall SMART SOFFIT VENT SYSTEM on All of the Eaves. Supply and Install, ALPHAPROTECTOR-S,UL "REX" SYNTHETIC UNDERLAYMENT :,Supply and Install AIR`TENT SHINGLE,VENT H RIDGE VENT on the Four Main Ridges. Supply and Install ALUMINUM &,NEOPRENE SOIL PIPE FLASHINGS Clean and Remove Debris from work area after job is completed. COREY CHARL, ES� n p p p , TOTAL INVESTMENT $ 9250.00 Including Senior Citizen Discount Payable immediately upon completion. POSSIBLE EXTRA CARPENTRY: Any Rotted or Otherwise Deteriorated Trim Boards, Plywood Sheathing, Missing Metal Flashing, Side Walling or Any Other Carpentry Needing Replacement will be done and charged for as an Extra: Materials Plus Labor at the Rate of$ 75.00 per Hour CENTER CHIMNEYS: CHARLES COREY cannot Warrant your chimney against leakage or to be water tight to any degree because a properly installed PAN FLASHING or CHATHAM PAN FLASHING was not installed by the Mason when your chimney was built. PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing.of this Roof Proposal and the Final Payment for the Balance is Due Immediately Upon Completion. WORD SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 30 Days of Acceptance and Receipt of Deposit providing the Materials are Available. Please Make Checks Payable to: CHARLESCOREY CHARLES CO EY Warranties the Shingles and Labor for 10 years. CERTAINTEED Warranties the shingles and labor 100% for the First 10 Years and the Shingles for LIFETIME if the shingles becomes defective. CERTAINTEED Warrants the Shingles up to a 110 MPH WIND WARRANTY ( CATEGORY 2 HURRICANE) . CERTAINTEED Warrants the Shingles to be Algae Resistant for.a Full 10 Fears. Any alteration or deviation from above specifications,will be executed only upon written orders and will become an extra charge,over and above the.estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire,tornado,and other necessary insurance upon the above work. This proposal may be withdrawn by us if not accepted within thirty days. CHARLES COREY carries Workman's Compensation and Public Liability Insurance on the above work DATE OF ACCEPTANCE: ��/S -d ACCEPTED BY: SUBMITTED BY: CAROB. KAPPA CHARLES CORE' Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration ,26066 Exp�ra ion 61612008 t ;Type D13A ENTS COREY&'COREY HOME IMPROVEM J CHARLES COREY,, /1 D. R .. 1684 FALMOUTH ;W._.'-' Deputy Administrator CENTERVILLE,MA 02632 _ .. s n� tt q qg 'SyS r�. fi r �,Rf7�4 .w..x. wk :� v�F` �,,,_„ dw «" 6' ', ^5� , '� . gg said } i only 1 valid for individul Use o. or registration If found return 1 License expiration date. and Standards I before to BujdingRegnladons I Board lace Vr►1301 1 shburton V One A -Ma,02108 '1 Boston, :.. Bos - 1 I nature valid without sig I , i ' ! TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 30(0 ~ Parcel t-71 —004 Permit# Health Division4 33 3� '� 7 03 Date Issued Conservation Division Application Fee Tax Collector Permit Fee l� Treasurer q w Planning Dept. 4-pM�CISTGBg�A EN PER '� G ]V1I IlVF,E T F Date Definitive Plan Approved by Planning Board cONSTRUct 0 D�SIONp o r1E N TO Historic-OKH Preservation/Hyannis Project Street Address 33 N yL b O yL Je Village A-n n r S Owner &o / 4 A9 Address 3 3 WAALi U� Telephone — 7 Permit Request O 7� v" Square feet: 1 st floor: existing proposed C2 2nd floor: existing proposed 0 Total new 0 Zoning District Flood Plain Groundwater Overlay roject Valuation G0 0 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 l Y�*� Historic House: ❑Yes Ell No On Old King's Highway: ❑Yes 0 No Basement Type: 21Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) a Basement Unfinished Area(sq.ft) 88 Number of Baths: Full: existing 3 new 0 Half:existing d new C� Number of Bedrooms: existing 3 new O Total Room Count(not including baths): existing 7 new U First Floor Room Count Heat Type and Fuel: W<as 0 Oil 0 Electric ❑Other Central Air: ❑Yes 2Ao `'Fireplaces: Existing New Existing wood/coal stove: 0 Yes Bflo Detached garage:0 existing ❑new size Pool: ❑existing ❑new size Barn:0 existing ❑new size Attached garage:misting O new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name 0' n0 Telephone Number -SUS-7 / — d-y Address 33 /1 A ow License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE ~ FOR OFFICIAL USE ONLY r PERMIT NO. DATE ISSUED MAP/PARCEL NO. III `ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME S��Ill 0 t-\ L/a � J;77 INSULATION A I Y t ej *f FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL i. GAS: ROUGH FINAL- FINAL BUILDING .Y DATE CLOSED OUT ASSOCIATION PLAN NO. 4 I� r � _ The Commonwealth of Massachusetts _ Department of Industrial Accidents Office ORWes1192#917S 600 Washington Street Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit /� a a name l./l�X j1111V W �� location city hone# 7 1- I a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity [� I am an employer providing workers' compensation for my employees working on this job ... 4.eib ?�>;tCC ,fi'•'t�$",.� rc?F"TW r,.r,*rir=.._..,fix x t S 3 rr�:, h rsr ..ti�c { x xh". '.rt�'� ;y�LaP4 t. 4 r5 k 7 u t "'r" 4 P,�.-{..b�,vR" ;,G eyX..� ix- Ti 'Cr}_ 5trla; _k r �t��.y,.,, 2 � 'ter. ,T�cI''g4•f7 f "� v: rt'� zI^�Lr yF�iY Tea.a,..' .r :.','�`Yx.+.,7'S "tsfJ ..".a' r''. "x-r-5 -� t}'Y +3RY"' ax,7 7'r - n ,.c.i =coin an name. k f 1 `h s, �. r7 yk8�",+s, �x?i i,.d 4q .h�...I ' n,�ri�* C. yi.. 3� wa. AC-�r �'r,•. 7 - h �r.+�rti9All ru,-,� �j�a, ,ti�i r 1[ *FL u< 1 ✓�.y r ryY. ,h y 2-v.r+"'S Y ,� r +y„r w. ..ads �r +i''� •+ ar' R.r.� •.C�-�. ..sL�L, .;'1in}�v 3 t ' : t.r`'C''r �"�„+' [`T {ay 4 '. AYiy i+"iy jro ?fir cr., J 5 �� 'J_ fid� .kix .""'y, ` k�''4•.� :CILt�g't�`hxf+,r' 5 '3y +Aa +` d,5� _ t iy� u.. r; h ,,,ti. rd }'m ''`k'.yx•' x-gT, 1nS1lrA'QCe''CO. •7i, [] I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices '�r+t,, y� r `}A�'',`"'-.P?J!" . 'ts'aY'.)• Y:. xsr [ (� 3' g,"'s_t r,,rA'.t f 21'e�iwr`'rrx.�vr 7''{q'r.� 2r i5� S N sc Y s� i L pSXt+x} 15 13 �—'-� iMi an ltame ��r R t,Fin v, M6C,:'S•}'bt v iJ rf�ja, 1�L 5�.> I�Y.SyS 3 i f 1 }+ rf" I C 1. � � ..2 t i �t f �� I.. ,tf� 1 rff..yfr�4�YT .+lr fi,.� 97j"�'� RISE un�1�•y§0 �rt ri_'.wy f� � �"\w�t�M}�5 3:n1+ 1 4 -5 sLt�It fi�.kr tf rt y „F� kS}. r�7L I !� l^;14A� F. r. a ra-Ri S 1Y-ya i Asa x m � �7 d - t + .�gg.'n'�j J�,rf}�A���^'�' a, d,;s.:v, .�+. '�.ti.K•+rc„i�.y, W.�: �h c'.. .:..�.T`2(-^iurt�f i�'}.._ � { � 'r` :< b� 'b'� r S7ea +L'r''S''r�,T�+X'+C t S 5:..'f t �tti} �{ y * � MOM u✓+.5 rr.8. ��iF.rr xxC.6� r i ,c'"'^}'"4 +A L...d G x 3+ r J . .w .� b �k�w��«.-..�r,.Wq�p' �y Q�'tr 'y, .�'Y/ -u rr t r st ��r r}✓� nu: i � "':w��a.y�'�.� x"s..t*} y. ..� :sS'1 ..f i i��..�'b�`i.S.�.s..,m'vt`�'�."i i.T Y La� v'. •`x•:a. 5 3 n.FS ��{-Fi.�nrn 7 r+rr�.• � � �t �yti r..'l'iy'S p a•'X'r��,'F,�a�1.1 y{7rt;;`a .r��.'�I�a �°�� -t�,�1',3f.t'�}�'�`.'tx'` ( J y�,�n;s'�' r ����ti,".t;, i a''Jr••nY' .�,� d � r�n"x' h v t r�,r5 't r.a -r'r ,._5 t 4.}r r 5 i hyd Cs�'c�L:%,,x° 7, � 7r �13'r r i r.'I?as,!'�+-�"Ft`�'y^�. 1.s. �. lnsuraoce ca -vr v ...... � ,p, q?„+�1 '+^-..n M ] v1c h 'S t':: a rg�v� '`S„s i '�)G nx -N"' i `+�''.n� } ai�•s [ �r � t}�5� �8.j :{ i . �7-•s�s'�r�t N�q� Fat c ::F .�...'x a x z i `t`t,.rf,.�'-7 ti= xr t,. J'r. c '�a� �c .r '1R�y�".i�"�i, zrMI ,qw r +�5{ . 3 X'� .:#'c�iu •+'^`:'fi s b 'i.' : fir' r. }.t5 �:. z x'7° r �k y'. '�,.tslr .» � , ,t F},u4". ,Coin $nGzT1a1I1C` %1" iifr6*ar` rn Ry e� �tiT S tp r s k }Nr *r tJi$.! �brXk1 f W .yF, :•t > 2 lvr �h ^lkf tf G.''b�-� iq N. ° 4:k r "k4 IT``gMdivt,-:ftY_..e. �*.r ,�y1Xi`.,,y.•5�.*.i c3'l1rryr ~ 'r�k`'^a* L'av i.C.a-,t•„^., .-L w krkG t'F` g 'tvb' '�. * Z` '3''�fia1'.Wr�*j a�-Su`'f4 x�::'' s rt•'.5{. r+'.I,�a• 5 r .,`rT "Fh rx<.I, i 'r4s tr'}t.`,� r Yt - t�. a't5'.�.:`!x� .�,y,t ...:.�.. � y,� �r,{1._q s tti-•'.; st,,.•h ,5r,,�...V �,i"r Xt` i'r{,�t St+?�,3r'�,, } 5 r c "1 'Y.r x qua � 3 u-fdfr 3r "rt ti :a r,+a } a w ,t^x ttY T d''�,,� 5+ �1. naJ,X. � -�z Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Z/ 3 Print name Phone# �.7 D�"'M 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 []check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; r10ther r (revised 9/95 P!A) r 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 inthe service of another under any ; contract of hire, express or implied, oral or written. z + a �k An employer4 is.defined as a"ifidividual, partnership, association, corporation or other legal entity, or any two of more of the foregoing engaged in a joint enterprise,and including the legal representatives of'a deceased employer,or the:`'R�, receiver or trustee of an individual, partnership, association or other legal entity, employing employees. Howevefthe 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 Iicensing 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 permitilicense 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 s a call. i 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 f Town of Barnstable ti Regulatory Services BAMSTA BLA ' Thomas F.Geiler,Director KAM 94'PT 01[g. a � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 Fax: 508-790-6230 P ermit 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: 3 3 Aq t Aox Rd Owner's Name:e',61W 1 /Zj� Date of Application: 4— y '" D 3 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 [i}PSwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT 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. �f/ �p OR Date Owmer's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 , a Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE ,;L _square feet x$64/sq.foot= S� S� x.0031= plus from below(if applicable) GARAGES (attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq,foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee /I �oFtHe tom, Town of Barnstable Regulatory Services * Ba M LE, A$& = Thomas F.Geiler,Director Fs6 p.� 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, �p�o/ /�/ ,f//f�rl/9 _____ , as Owner of the subject property hereby authorize C' to act on my behalf, in all matters relative to work authorized b this building permit application for(address of job 3 0�t 3 ��� � N v zti! '7 1 S Signature of Owner Date Print Name The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: r 3 JOB LOCATION: 3„3 F_4-21 h h r `S number street village "HOMEOWNER':C 0 J9 7?/-9.1 y9 name home pone# work phone# CURRENT MAILING ADDRESS:A3_.. 7'�/b on K.•C�_ • /�T /}7�Nt t � f>��o V l �•! city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings.containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a fonn/certification for use in your community. � ' -- APPA RESIDENur. F O 00 0 C> Zo =o 33 HARBOR ROAD a HYAle NIS, MASSACHUSETTS � � " 0 N Cl cn W GENERAL NOTES:. SYMBOLS/LEGEND: � Z O c_ri 1. THE SCOPE OF WORK TO BE PERFORMED UNDER THIS CONTRACT SHALL BE � WALL TAG DOOR TAG DONE IN ACCORDANCE W/ ALL STATE AND LOCAL BUILDING CODES & REGULATIONS. (.J — o00 , . Z W z W 2. THE GENERAL CONTRACTOR SHALL DIRECT ALL COORSPONDANCE REGARDING THIS < W PROJECT TO THE CLIENT: CARMINE NAPPA, (508) 771-9249. KEYNOTE TAG PT1 FINISH TAG _ v — 0 W O 3, DOORS: ALL NEW DOORS & CASING/TRIM SHALL MATCH EXISTING DOORS THROUGHOUT THE HOUSE, OWNER TO SELECT STYLE & FINAL FINISH. w <C 4. PAINT: ALL NEW &-EXISTING GWB SURFACE TO RECEIVE FINAL PAINTED FINISH - 00 COLORS TO BE SELECTED BY THE OWNER. fn Lu DUPLEX OUTLET TELEPHONE OUTLET Lij Q L UJ- 5. UNLESS INDICATED OTHERWISE ALL TELEPHONE, DATA & ELECTRICAL SYMBOLS 'SHOWN SHALL BE CONSIDERED NEW. ALL NEW OUTLETS SHALL BE MOUNTED ® 18 CATV m ~ � AFF: FINISH = WHITE ON WHITE. QUADRAPLEX OUTLET CABLE TV OUTLET J Q T_ 0 ly- Q }- d Q W m Z M ¢ O t: SPECIAL PURPOSE SWITCH O Q OUTLET NEW DOOR. "t 1 REFER TO PLAN FOR SIZE. EXISTING CONCRETE mar FOUNDATION WALL k�' ; . we NEW GWB �i� NEW BI-FOLD DOOR. PARTITION REFER TO PLAN FOR SIZE. Mo Q _ o owQ EZc6 .� ¢ z < -a Co a Ak -- - O EXISTING WINDOW TO REMAIN. - 1 - ° EXISTING PLYWOOD BACK BOARD & ELECTRICAL O a CD <C) -- -. - - ------ 2 PANEL TO-REMAIN- A WORK AREA/ UP 5 3 WALL MTD STORAGE CABIN TO REMAIN. s O s a EXISTING WA S OFFICE004 O O OEXISTING WASHER/DRYER T0.REMAIN. EXIST POWER IN _ CPT - •• - STORAGE/LAUNDRY - A EXISTING BULKHEAD STAIR TO GRADE 70 REMAIN. AREA TO REMAIN. - - 5 W B O O EXISTING WASTE PIPES ABOVE TO REMAIN. 13'-3'• O VERIFY LOCATIONS ON SITE. VIF 4'-3" Cn ry 36" ca — NEW WOOD NIN P TFR -T ALIGN 0 LA O G LA O M O L G 7 / / Z EXISTING TREAD - MATCH HEIGHT - Z ' — Q Z. EXISTING WOOD STAIR ASSEMBLY TO REMAIN. . A 36. A - - = a O, EXISTING WATER HEATER & BOILER TO REMAIN - WV - . PROVIDE CLEARANCE FOR MAINTENANCE. O Z Q : WO O UNFINISHED ED f B OPEN OCPT EXISTING W000 BEAM ABOVE _ REFER TO J CEILING PLAN FOR ADDITIONAL INFORMATION. — . -LLSTORAGE/LAUNDRY BASEMENT O W O m i-- W PARTITION TYPES: Q a' 2 - .• . �qp, 10 CLOSET A GWB FURRING: 1-1/2•' WOOD STUDS/BLOCKING, H Q Z 3 Q - 1.0 B 003 O _ M 4 1 1 2" RIDGID INSULATION & t LAYER OF 1 2" m / O / GWB FROM FINISHED FLOOR TO FINISHED CEILING. O Z M - w TYPICAL INTERIOR PARTITION: 2x4 WOOD STUDS @ ----`-�'�-` - - g B CPT A t6" CC W/-(-t)-LAYER OF 7/2" GWB FROM FINISHED a'- N O FLOOR TO FINISHED CEILING EACH SIDE. � - 0. ` INTERIOR"PARTITION: -2x4 WOOD STUDS ® 76" OC W/ (7) LAYER OF 7/2- GWB FROM FINISHED FLOOR B p TO FINISHED CEILING EACH SIDE. FILL W/ 3-1/2 BATT INSULATION O a - . ° B O . -..4 UNDER STAIR - ALIGN - 2 A EDGE. PROVIDE GWB CON _� FINISHES: - EXPOSED FACE ONLY. „+ O o Fp , R A ° CPT CARPET - STYLE BE SELECTED BY OWNER. 26"' - - - ° - UP q 36„ CLOSET CON EXISTING CONCRE<3> UTILITY E SLAB TO REMAIN EXPOSED. �_ - .. 002 Q II C) DASHED LINE INDICATES - � o _ - d WB H���EWALFINSHE70 BE SELECTED BY OWNER.HOUT <o<m E m o - - EDGE OF EXIST TREAD a - 3 - EXTEND TO CREATE NEW LANDING. - a KEYNOTES: O 'EXISTING FLOOR JOISTS/UNFINISHED CEILING " CENTER CEILING GRID TO REMAIN. ` WITHIN ROOM. ° - e 4 ° O EXISTING WOOD BEAM TO:REMAIN. p c4 " 3 EXISTING WOOD BEAM TO BE WRAPPED IN GWB — s s ' O ALIGN W/ NEW GWB PARTITIONS � p o AS INDICATED. p y O. REUSE/RELOCATE.EXISTING CEILING MOUNTED LIGHT FIXTURES - COORDINATE DUAIVTITY'Bc LOCATIONS " W/ OWNER ON SITE. - OEXISTING WASTE PIPES-- UNDERSIDE OF PIPES ¢ . VARIES (LOW POINT � 6'AFF). PIPES TO REMAIN WITHIN TIE INTO EXIST CEILING MTD 2' O _ NEW ACOT CEILING ASSEMBLY�U VERIFY�OCATIONS EA & UNDER - LIGHT FIXTURES (TYP). - ON SITE. Z _ N LEGEND: LLJ 2 OO O NEW RECESSED FLUORESCENT LIGHT FIXTURE V (TO BE SELECTED BY OWNER). COORDINATE Z Q ' ' SIZE & LOCATION W/ EXIST FLOOR JOISTS - W O Z SPACED 0 16" OC Q _ Cn CL' w Lu O P—j rL NEW 2x2 ACOUSTICAL CEILING ASSEMBLY HUNG. m F-- (' FROM.EXIST FLOOR JOISTS/SUBFLOOR ABOVE. uj Q 0 Z y - LAYOUT SHOWN FOR REFERENCE ONLY - d Q z J - \ COORDINATE W/ EXIST FLOOR JOISTS ABOVE -' mCL Q M Q W J - / DASHED.LINE INDICATES SWITCH CONFIGURATION. " ------ COORDINATE ALL. POWER REQUIREMENTS W/ a 3 ELECTRICAL SUBCONTRACTOR. 2 w 5 EXIST O O 5 STAIR ;. OPG' CEILING MOUNTED SMOKE DETECTOR. rofIt � co L o OFIHE Tp The Town of Barnstable BAR`ASS. 0a E. MASS. De"partment of Health Safety and Environmental Services 9 i639' �0 p�EOMFyp Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: 3 0 6 - % 7 5/ D G Project Address: Builder: The following items were noted on reviewing: 1 MVS T 7 Ar1j, 'e"/9S S Ca.o % Reviewed by: Date: Y e a 3 q:building:forms:review Q�THE� TOWN OF BARNSTABLE Permit No. . 29281 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash .........n,. .. . O6pY HYANNIS,MASS.02601 Bond x... CERTIFICATE OF USE AND OCCUPANCY Issued to Bayside Building .Co. Address Lot #4, 33 Harbor Road Hyannis, Massachusetts USE GROUP. FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE.VALID, AND THE BUILDING SHALL NOT,BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ............ 19 fo......... ..................... .....l2-.... (� Building Inspector a'�y�••: TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING rur. HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: �'So An Occupancy Permit has been- issued for the building authorized by Building Permit $k...a�.9.°2.? .........._ ...........................�................................................. ... /............... ...._........ ....................� issued t04i.4��42L .... .. ..�....... � I.....�.. :.�` .%.:. � o� _.. _»» Please release the performance bond. / i BUILDING TOWN OF BARNSTABLE, MASSACHUSETTS PERMIT (( _ JOB WEATHER CARD Q� 1�4 bld61�GATE _ 19 PERMIT NO. APPLICANT ADDRESS : (NO.)' (STREET) (CONTR'S^LICENSE) PERMIT TO NUMBER OF (_' ) STORY "` '' DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) - - ZONING AT (LOCATION) DISTRICT IN0.) (STREET) BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) } REMARKS: AREA OR ::;•}:, r:,. i i. PERMIT ( VOLUME ESTIMATED COST $ FEE .� " (CUBIC/SQUARE FEET) - OWNER i; BUILDING DEPT. ( ADDRESS BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR '® PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED.BY THE JURISDICTION. STREET- OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEC FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. . MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR 1 ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING.SHALL NOT BE OCCUPIED UNTIL FINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET .. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS • / Qom/ r } z 2 V �! 2 I 3 HEATING !NSPECTING APPROVALS REFRIGERATION INSPECTION APPROVALS llllwb ri:u -64fJ_ i TOWN OF BARNSTA13LE E IVISTOJ� /pv JL OA OTHER 12 --.-.---_.- ._ --. 'WORK SHALL NOT PROOEED UNT:L THE PERMIT WILL BECOME NULL AND.VOID IF CONSTRUCTION iNSPECTIONS•JVQ ICATED ON THIS CAR( ' INSPECTOR -iAS APPRCVED THE VARIOUS WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CAN BE ARRANGED FOR BY TELEPHONE STAGES OF CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. OR WRITTEN NOTIFICATION. o At 0. L _ Lid ....... 4W !00% �xti.�,ti vacs ° iZoad o i4;0 l S00 t v }£ a0 wide o _ "'ZI , • ownJ -__ •-- ., _ ! ..fin. 1_.:.. l-6:1 6 T (a1,/2;1. titone p:. z4.s Zoo l/Soo srx I0 � Jaiue t PK• .._, i c d 4e a zo�' h Can �ccLCe I 30. . Dote 3-r246 l SDO 'Is, a , , 1-6 �'f art W/2,/'.4�L(J{'iP ,rrrl Ad,L 49 Pa bo t hoad J. Sk_a.cA /)takes io j .Carol a n /dye, lla, i �02 Allan �Letche f _. t3.euu '. �1._,aa:_%lhowrz:..arc a-p�Curi 3an.�.tcb Ce �a %ce8co�. c ei � �864 I s : ; Leuc�t.Loiv� aliown'a%e. on , t' t . �at` evlt--1� �tvs tcr�Zeoc%J o e Th ......_.......... - -, + ._ __ ._.._ ! !_ ir i r r I j I { I the1Wund 6u2dc.�r ovi � oui hr2 ovi_ i p-Cci�t iv `,toca�ted7e �-i t /�-3582 onc� a,. shown heteon, and nseet� 'the. ade / 9 / aPGack % CPU At� o die gown o 1�ah.4.tab Ce. GU,ct.; � n�.acobti ! � � 2?- s6 No;wa�>6t woUHAt' rate j�ete: -ncte 2 ►wwz -p e�c ! fop i I F. I ' 1 dLP,CLLtAIyt _ _ i VJ i- ILUA(v 13.r U No.324 399ti n�,, n:� �Yr ,.. ,~ �` // / / I - � Assessor's office (1st floor): Assessor's map and lot number .J...�...'6^.........�7...�.... &pTIC SYSTEM 04UST BE P�OFTNETO�y Board of Health (3rd floor) 2=�1 ; INSTALLED IN COMPLIANC Sewage Permit number '. WITH ••••;••••••••�••••••�••••• TITLE 5 Z HaEb9TanLE, i Engineering Department (3rd floor): ENVIRONMENTAL CODE A O� 7639, e0� House number ....... ............................!.................s..... '`raYP�a\ APPLICATIONS PROCESSED 8:30.'9:30 A.M. and'i 1:00.2:00 ;P.M: only TOWN REGULATIONS TOWN, 'OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....L.�'.vt.cf••� G ... .... !! . ....4--j .............. TYPE OF CONSTRUCTION ...... . ................................................. .......................19 Sv.. .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ..1/ � . 6.Location ...... G� .......��iS .. .......... ......Ak.................................................... ProposedUse .......... d!I.c.�`.'...................................................................................................................................... Zoning District .................................................Fire District ...... : ............ . /L�-0.?!! ................Q..-....�.. ..................... Name of Owner ..... ...- .Y. ly�.:�(.,....!��.... d...........Address ...............(/. .4..:.....7 7.:.. 1. ............. V I I Nameof Builder .........;�.��(f........................................Address ................... .................................................... Name of Architect X/D f°............................Address ...........D !1. ? !l�l.. `e.........................................,.. .... t..!��... � Number of Rooms ...................Foundation ................. ....... ... ........................... . Exterior ......GIAeb�.C.Z.( .... ...J.!!tkcJS `C_...................Roofing ........ ....................................................... Floors 0.11 ........V.li......CWZ(I `. .Interior ......17. .� VL.. .k (. ... ?� Heating ' '1 ...................................Plumbing .`.:..`V.:.U:�-:....: .:. :0 ..........�a.: r �!t.5 !. .!!��.......1. Fireplace ...... (1.d.4Y/s.......C�.....2.�1J.C..V..�.......................Ap�r ximate.00s ...............�. � ?Definitive Plan Approvedby Planning Board _ 1�a�_____ _19 Area .....f.y�g:�� t Diagram of Lot and Building with Dimensions Fee r ...........: .. ,......... SUBJECT TO APPROVAL OF BOARD OF HEALTH y � � � I 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 construction. Name ......r!.. . .. . ...... .�. ..... Construction Supervisor's License ....dsl- / .✓..... _} ,,,,.BAYSIDE BUILDING CO. e !`No:..29281 11 Stor.... Permit for .................................... A = Single'rFamily Dwelling 1 ... ....................................................... - f .......Lot #4, 33 Harbor Road - ..a ocation ......................................................... ,. Hyanriis .. ............................................................................... Owner ........ 4 Ba side Building Co. .......................................................... T e of Construction Frame Plot ........................... Lot ............................... r. . ..- May 186 ........................ Permit Granted ...............:,..19 - - •l Ji Date of Inspection . ..................... ..19 - 4 , r Date, Completed � ...19 � ,� r ' 2 _ Assessor's office (1st floor): �f _ �FTHEto Assessor's map and lot number �..a........ �?`.{ . "."..r'' Board of Health (3rd floor): Sewage Permit number .......................•........••• t SAUSTADLE, r Engineering Department (3rd floor): b 9• House number ........ ...�..;�................................................... �• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN - OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �' ��::�!•J..� � TYPE OF CONSTRUCTION .AJ,fi .. . ............ .. .. ... ......... ............... .......... .Ll.......................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ._..{i x , Location ,!...... ..... �.................../� ..... ��•, -..,`�.....,: .................................................... fj ProposedUse .......... `.................................................................................................................................... ZoningDistrict .........g... ✓..................................................Fire District ........ el.!-t 4! .................................................. Name of Owner .....G.?r- .ram .....��=':1./,. . .....4)...........Address ................G................................. ..................... � V Nameof Builder .........,,?; .l ........................................Address .............. ..................................................... ll Name of Architect ......<r. '... ...............I.............Address ...........0��.% ��.�h....d!(1.1. !-'.............................................. 7 - .Foundation ...�{�: ..�<......�..�(_..:!?.�?....... Number of Rooms ................................................................. ..... ........................... Exterior € f�(.i?t;) trv7..CX....f...��� .v. `. Roofing .......A .:.eta;. .. ..................................................UU r l Floors .......... ...... . .L....... ' � ............................Interior � ..., ..................................... u t I � � Heatingf 1 4 ,fit 1/�,A.�S...... g .......... �r ., ,C .......... :. f�✓c {l;' Fireplace ..... .(ls (( :_ S '.{.?,.f....[f:..........................Approximate.Cost = ,� G C�C�:.0 ?�.............. Definitive Plan Approved by Planning Board t�_--------- ____________19 " t .` � j� Area Diagram of Lot and Building with Dimensions 1 Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH : l js( a f may~ t i is� s i } _ 1 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 x construction. a .� Name ..... .. ..: Construction Supervisor's License BAYSIDE BUILDING CO. A=306-174-004, No ...29281 Permit for ....I ...Slo.r.y................. . . ...... . ily ......... Dwelling .... ................................................ Location ......,Lot...#4.......3.3...Harbor Road...... a]ni.s........................................... ...................... Owner .......Bj4X.sid.e...Bu.i.l.din��..�2 .... . . ...... Type of Construction ..,Frame............................ ................................................................................ Plot ............................ Lot.,................................ Permit Granted ,: .May...I ...............19 86 Date of Inspection ....................................19 Date Completed ........................ ................19