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0113 LINDEN STREET
AUF o °Ft r Town of Barnstable *Permit# Erpires 6 montlufrom issue date- ' Regulatory Services Fee BARNSrABLE, + v MASS. $ Thomas F. Geiler,Director 1679• plED Mpl A Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION . RESIDENT1AZ61VLY Not Valid without Red X-Press Imprint Map/parcel Number 31© 1'-j'S`6 Property Address m l0-7 S L ❑Residential Value of Work G G Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone NumberG� 37 Home Improvement Contractor License#(if applicable) /^U r- :2A 5 Construction Supervisor's License#(if applicable) (_. k G ❑Workman's Compensation Insurance Che k one: X-PRESS PERMIT u I am a sole proprietor ❑ I am the Homeowner MAY 2 4 .2010 ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) `3 j dRe-roof(stripping old shingles) All construction debris will be taken,to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side #of doors F ❑ Replacement Windows/doors/sliders.U.-Value. (maximum .44)#of windows ' *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc., 'Note: Property Owner`rimust sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is require. SIGNATURE: QAWPFILESWORMS\building permit forms\EXPRESS.doc Revised 090809 \ Board off Bjjildin�r g�]?,gUtaio d ` HOltii[IMAROVEMEN,':'CONT RACIOP Registration: 1 102785. on -;7/2/201,0 Trl .2702; ? z 7Ype: Individual PETER EDWgRL JOHfON Peter Johnson r 7 PENELOPE LANE COTUIT, M,A 02635 1d�ui�i:i•111i�. ;�� 1 ' License or registration valid for individul use only I f ore the,expiration date. If found return ( be Boxed of T3ui and Sta ding Regulations ndar ds 01ie Ashburton Place Rtn 1301 i Bostou,Ivta:`U2108 i �� \ot 11id without signature --� •._ iNIassachUsetts Department of PUbl"C Satands I �.. Boar(! of Buil(Iin�„ Rc!"Ulations and Standar `I -Construction Supervisor License f License: CS 62830 Restricted to: 00 '!! PETER E JOHNSON E 7 PENELOPE LN ! '1 - COTU IT, MA 02635 I Expiration: 8/2912011 Tr#: 1739 ("11 Illilll]SII IiII'i• , s t+ The Commonwealth of Massachusetts Department of Industrial Accidents Office oflnvestigations I' 600 Washington Street L� Boston, MA 02111 wfvw.nsass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lelzibly Name (Business/Organization/Individual): z �, Address: ir-t City/State/Zip: `7��c. 7t' Phone #: G Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I loyees (full and/or part-lime). * have hired the sub-contractors 6. ❑ New construction 2.Ol am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y P Y� 9. ❑.Building addition [No workers' comp. insurance comp.insurance.$ required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions myself. o workers' com right of exemption per MGL y [N p. 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'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. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: 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 1� r he p nd penalties ofperjury'chat the information provided above is true and correct. Si nature: — Date: �c . o Phone M 3`7 71 G`I Official use only. Do not write in this area, to be completed by city or town official. i F City or Town: Permit/License# Issuing Authority (circle one): I.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S, g Inspector 6. Other Contact Person:. Phone#: j'. 1 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,constriction 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 conunonwealth nor,any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence ofcompliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary;supply sub-contractors)name(s), address(es)and phone number(s)along with their 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 pen-nit 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 fixture 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 4-24-07 www.mass.gov/dia d �IHE roy Town of Barnstable ys Regulatory. Services i inxxsTns hcnss. Thomas F. Geiler,Director Fo;9;y�`�� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barristable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder to So , as Owner of the subject property u hereby authorize fej� r' ( /1) Z ti so— to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature f Owner Date Vtr l wi 4 me If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. OTORMS:OWNERPERM1SS10N t - g Town of Barnstable F'(NF Tp� Regulatory Services y y Thomas F. Geiler,Director • saarisrast.e, Mass 9q, 1679. ,�� Building Division prFD1i�'�a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barDstable.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 engagen individual for hire who does not-possess a license,provided that the .a 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 curently used by several towns. You may care t amend and adopt such a form/certification for use in your community: Q:\WPFILES\FORMS\bomeexempt.DOC f Town of Barnstable *Permit# Expires 6 nronthsjr i date, Regulatory Services Fee + BARNSTABLE, r MASS. Thomas F. Geiler,Director. 1639. �ArED MA't A .. Building Division Tom Perry,CBO, Building Commissioner- 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508:7790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address / `,h le X'\ (-�r 7 J Residential Value of Worke Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address S Contractor's Name t 'I 'e-A Ycc Telephone Number; 5 -3 3 Home Improvement Contractor License'#(if applicable) Construction Supervisor's License#(if applicable) (} X- ❑Workman's Compensation Insurance JAN 2 2 2010 Clerk one: �g ❑ I am a sole proprietor � N ® BARN.S�zAB� ❑ 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. Permit Request.(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to, ❑Re-roof(not stripping. Going over existing layers of roof) .❑ .Re-si #of doors _ Replacement Windows/doors/sliders.U-Value (maximum.44)#of windows 1� *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 ome Improvement Contractors License&Construction Supervisors License is' required. SIGNATURE: ' QOYTFILESTORMS\buildin ut f6rms\EXPRESS.doc g Pern Revised 090809 . I The Commonwealth ofNlassachusetts Department of Industrial Aecidents Office of Investigations I'_ L 600 Washington Street 4. =1 Boston MA 02111 Z�s wfviv,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information / Please Print Legibly Name (Business/Organization/Individual): rTe— vt Address: . vl� 'L City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ 1 a employer with 4. ❑ I am a general contractor and 1 ployees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. .7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition Workingfor me in an capacity. employees and have workers' Y P Y�. 9. ❑ Building addition [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1 LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MOL 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 tll 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy# or Self-iris.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 MOL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and.a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under i and penalties ofperjury that the information provided above 's trice and correct. Signature: Date:IV 6 r� Phone#: 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): I:Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector .6. Other Contact Person: Phone#: y Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as "an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,.and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or.other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.' MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal.of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth not 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 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 pen-nit 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 4-24-07 www.mass.gov/dia PROPOSAL PROPOSALNO. SHEET NO. . DATE PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME - �. ADDRESS ADDRESS 3 e DATE OF PLANS Z e PHONE NO. ARCHITECT We hereby propose,to furnish the materials and perform the labor:necessary for,the completion of, wee �'Gt7 All material is guaranteed to be' as specified,and the above.work to be performed in accordance4ith the drawings and specifications submitted for above work, and completed in a substantial workmanlike manner for.the sum of.- Dollars ($ with payments to be made as follows:. Respectfully submitted Any alteration or deviation from above specifications involving extra costs will be executed only upon written order, and will become an extra charge Per over.and above the estimate. All agreements contingent upon strikes, ac- cidents,or delays beyond our control. Note.- This proposal maybe withdrawn by us if not accepted within days. y L ACCETANCE OFPROPOSA - _. The above prices, specifications and conditions are satisfactory and are hereby accepted,Y r orized to do the work as specified. Payments will,be.made as outlined above. Signature Date__z Signature 4 L:!1) D8118 PROPOSAL _ adams.MADE IN MEXICO � � - J1 • 40a d of l3utldl g Regulalioii, tandij, �1 101VIE1MPROVEME NT CONTRgCTOR Rec�lstr Lion: 10?785. I. E P!rT on 7g2/2C10s Te* 270-'), �t �. ;YPe lndividlial PETER EDWARG'JO� Pet :7')-lc Johnson ' 7 PENELOPE LANE ` '1 ' COTUIT, MA 02635 '+ t,', s� °•,ems l L AUanniaj''i19� L!cppke or registration valid for individui use only hefore the�apiration.date If'found r6turn to: Roarll`of Building Regulations and Standards / One VAfton,Pl ace Rm Bosto y lVla 11 2.1.08 rated without signature Massachusc,tts- Department 4Public Safety ?� Board of Building Reaulatlonti,and Standards Construction Supervisor License' Licenser CS 62830 Restricted to 00 11 - i, PETER E JOHNSON 7 PENELOPE.^LN COTU IT, MA 02635 Expiration: 8/29/2011 Tr#: 1739 • commissioner t �pTME T Town of Barnst4l0$@� yP� ti� b� N OF C?ARNSTABLE * t Regulatory Services * BARNSTABLE, v� MASS. g Thomas F.Geiler,Directo'rr0a 7 M A R 19 PM 12: 09 i639. ♦0 039 a Building Division Peter F.DiMatteo,Building Commissioner 200 Main Street, Hyannis,MA 02601 D!V!S 10 N Office: 508-862-4038 Fax: 508-790-6230 PERMIT# FEE: $ 06 SHED REGISTRATION 120 square feet or less. 113 Linden Street Hyannis, MA 02601 Location of shed(address) Village Virginia E. Johnson 508-771=9705 Property owner's name Telephone number 8 x 10 `3 /0 VS0 a Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? no Old King's Highway Historic District Commission jurisdiction? no Conservation Commission(signature required) yZe PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 .and inBAFA ST*BLE Belonging to Ralph..L:..Simpson............... Deed in Book,3431.:...,. Page 98 Land Court Certificate No. ..... ......... in Book.,........... Page............ In ..Barnstable„ Registry,of,.Deeds,,,, .• .•,••.• 8eco►ded Plan ..La.n.d..I.n. Barnstable by.,Eldredge Engineering Co., Inc. June 24, 1981 ............ ........ Date of Plan in ...Barnstable. Registry„of Deeds.. ...Plan Book,355....... . 51 ...........,-.............................. . .No. ........ Filed Plan No. ........................................ oAORTGAGE INSPECTION PLAN WILLIAM E. CROWELL, JR., ESQ. Virginia E. Johnson .oen No. 113 Linden Street, Hyannis (Barnstable) S 32.' >� ONE % J, rroRY �} LOT 1 wove N No.113 n N /SSA: 70) M maw V11 C^ LINDEN STREET J June 16, 1993 N 60694 gale v,_ 40.' I CERTIFY THAT THIS PLAN WAS PREPARED IN ACCORDANCE WITH THE COMMONWEALTH OF MASSACHUSETTS PROCEDURAL AND �MINI s .NY TECHNICL STANDARDS FOR THE PRACTICE F ;; : :� ;:.>.; •..... OF LAND SURVEYING 250 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED HERETO.. OF KENNETli Co ANDERSON No. 31295 0 r• v�ss��fCIST L LAB S LQ'rG/-Cj� ,y TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map l D Parcel ��S—G Permit# _ D Health Division z Date Issued ®� t Conservation Division S , Fee /A4Ad Tax Collector j Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Z/ Village Owner (//ram/ �► �t G �S° Address y -c Telephone 7 Permit Request v► �; U 1K 57- p ICJ% f� l�X � '�G%z-vi �✓'� O /' C Square f : 1 st floor: existing proposed 7592nd floor: existing proposed Total new Valua i n Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size // Grandfathered: Xes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 20 �rS Historic House: ❑Yes Flo On Old King's Highway: ❑Yes O'loo, Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing �f new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing / new First Floor Room Count Heat Type and Fuel: Lei Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes O No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ZNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed: 0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded❑ Commercial ❑Yes 21 No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name � Cr ���G'S`' Telephone Number Address �� (G;4-r �� ,- License# G G a G S"— Home Improvement Contractor# Worker's Compensation# U/C l 3 ALL CONSTRUCTION DEBRIS RESULTIN FROM T IS PROJECT MILL BE TAKEN TO I SIGNATURE DATE fZ21G FOR OFFICIAL USE ONLY PERMIT NO. q DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE i OWNER DATE OF INSPECTION: r� FOUNDATION r , FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 3 PLUMBING: ROUGH FINAL I GAS: ROUGH FINAL FINAL BUILDING t . _ i DATE CLOSED OUT ASSOCIATION PLAN NO. t � t r RESIDENTIAL BUILDING PERMIT FEES . APPLICATION FEE New Buildings,Additions $50.00 �G Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$961sq.foot= , x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EMSTING SPACE square feet x$64/sq-foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 ' >150 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$961sq.foot= x.0031= STAND ALONE PERMITS Open Porch �_x$30.00= (member) Deck x$30.00= (member) 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 e projcost Table Jl=b(eon Praeriptive Psdmga for 06 and TWD Fsmilr Residmdal BuddbW Hueed wdh Fomd Foab MAXIMUM aluIt01NM QIaring IGU=g Ceiling Well Floor Bonn, c 8Lb Areal(•/8) U.value' R-value R veiuo' R•vafud Wau Pltsmeaer ae> Pad=e Rvatrt� B'�0d 3"1 to 6500 H aing Degree ifla�er Q 1201. ' 0.40 38 13 19 10• 6 Noses R 12% 032 30 19 19 10 6 Noel S 129,11 0.50 38 13 19 to. 6 83 AFUE T 15% 0.36. 38 13 25 WA - WA Normal U 15514 0." 38 19 19 . 10 6 Normal v IS/. 0.44 31 13 25 WA WA W AFVE W 15% 0.52 30 19 19 10 6 8S AFUB FX 18% 032 38 13 2S A WA Normal Y 19% 0.42 38 19 2S WA WA Normal Z I8•/. 0.42 38 13 19 10 6 90 AF JE AA 18% 0.50 30 19 19 10 6 90 AFLJE 1. ADDRESS OF PROPERTY: l °1%c �► �� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: Co3 u 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): e S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a Footnotes to Table J5.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights,'and„ basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area. expressed as a percenmee. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example.3 ft'of decorative glass may be excluded from a building design with 300 8=of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall.For example,an R.19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,Iog)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. 'Tf:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must me=t the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br..,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipme nt with the,lowest selected e. efficiency must meet or exceed the efficiency required by thepackage. . 'For Heating Degree Day requirements of the closest city or town see Table J5.2.Ia NOTES.: a)Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35). c) If a ceiling,wall;floor,basement wall,slab-edge,or crawl space wall component in two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 1 1 1 1 1 1 1 1 1 1 1 1 1 1 ,'F%!i.:i._ .._i./:%�:. / �%:::i::i ma's"1.%�•.-'i�'.:'.'.. J . 11 1. 11�..• /�1 /�1/ • 11 1 •... 11 • �1 11 1 �111 1 1 .1 • • 1 1 •'/ ., .1 •. 1111�11 `✓.1• C 1 • 11 �1111/ 1 � •'• .,. 1 . 1 1 •1 . 1/ 1 1 1• • • :11 1 1 1 1 . 1 1 ,1 - 1 111 1 1 �/ 1 •1 1 • • �1 1 1 • ••1. 1 1 In SEEM 1 IIE -I 1 - - •11 , „ i •1 1,1 ,. 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I ss • 1 w o •Y.to •le • • • le .II Eft-kolk f Il • • • .II[Ow-f(e) • 1 .11 • 1 • •/ / • 1• IwV1Y.B • •1 ✓• 1 ��"FIN ' • •I• Ill /• k • I •/1 .•1 r ►:.' 11 1•l •..1 I oil 1 1 1 1 low I 1 L: 1 1 1 • 1 1 l l 1 1 1 1 1 1111 1 ' ll 11 1 ' 1 -- - ,° 67 BOARD OF•BUILDING REGULATIQ;NS LicenseONSTRUCTI'ON SUPERVIS' R Numbe3S 062830 BI ��119; 4 1 xps�0�'2_J003 Tr.no: 15802 ` c � R�6 tn`c�tetl PETER E JO.HNS�O 1l1 97 BARTER ROAD / I HYANNIS, MA 02601 Atlmn'istrator ;+ I ' HOME IMPROVEMENT CONTRACTOR a Registration: 102785 Expiration: 712102 Type: Indiaidnal " PETER EDYARD JOHNSON Peter Johnson l� 97 BAXTER RO MINISTRATOR HYANNIS MA 02601 BARNSTABLE Land ln ....................................... _. ........ Belonging to Ralph L: Simpson.............. Deed in Book.3431....... Page 98...... Land Court Certificate No. ................. in Book ................ Page ............ In . Barnstable Registry ,of„Deeds•••,,, 'Recorded Plan Land in Barnstable by Eldredge Engineering Co., Inc. June 24, 1981 ............ ... Date of Plan .............. in ...Barnstable. Registry..°f .Deeds......Plan. Book -3 .......... 51........ _.............................. No. Filed Plan No. ........................................ MORTGAGE INSPECTION PLAN WILLIAM E. CROWELL, JR., ESQ. Virginia E. Johnson Loan No. 113 Linden Street, .Hyannis (Barnstable) t ,2. 3• in rroR N or lO/SCo.. 26 , N 73.63� • ���' .�P� mil; LINDEN STREET J June 16, 1993 N 60694 le 1"= 40.' - �-. - - _. _ _.-.. '4.�� .-•�. �.- ,,,__.:`- �.,.•ice, - ` - • q` I CERTIFY THAT THIS PLAN WAS PREPARED Y 1 IN ACCORDANCE WITH THE COMMONWEALTH f y' OF MASSACHUSETTS PROCEDURAL AND s €. s ,., . TECHNICAL STANDARDS FOR THE PRACTICE : q O F LAND SURV EYING CY N f 50 CMR 6.05 AND WITH THE SPECIFICATION SHEET ATTACHED HERETO i E D G OF M� ' s '•,� �0`,3� KENNETI�9cy�� - .` ANDERSON CA No. 31298Isyt 0 " a)`::..t.s,:.. :sr< r::S:•':� :>y,>�:`.s�.�,''.e4'^.?yr;"�`,•..:.?�.x. l��;.<a., / . L L ti ' . The Town of Barnstable MAM Regulatory Services 1659. y'�� Thomas F. Geiler, Director Building Division Peter F. Dfflatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 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. lr k G CPG� 0 0 � T e of Works / ' U Estimated Cost wellYP Addre ss of Work' �l P T Owner's Name: / �'/% �'l Ul S'c Date of Application:_ 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 []Owner pulling own Permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED. CONTRACTORS FOR APPLICABLE HOME IMPROVEbIlENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL.c. 142A. SIGNED UNDER PEN TIES OF PERJURY I hereby a ly for a permit as the f t"he�cywne Date ontractor Name Registration No. OR Date Owner's Name Assessor's map and lot number/El!r....... THE Sewage Permit number Z House number .. ` .. ............................................. oBlBB9TlDLE,� i MAM p 1639. \0� `D NO 6' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... .........i � � V I v TYPE OF CONSTRUCTION ......... :—)D . .................................................................................................................... .j 2 19. - ......... ..... ...... ........ ... TO THE INSPECTOR OF BUILDINGS: 6 The undersigned hereby applies for/..A.. a permit according to the following information: ......::: Location f I ti....................... . .-t t.I .. �� . .............. .................................................................................................... Proposed Use ....: �''..J !r....... .=k��!... .. .....[ tr 14?..`../.l.l. ................................................................................. Zoning District Fire District�.�.................. .................. ................... ................................................ Name of Owner ...................................................:.......... ......:..Address ........................................................a......... .................. y' Name of Builder l � � t �t �� {' it�v �•�- �� �" v L.,� �/ (/!�f ji ' ..................................................... .. Address ................................................................... ?. ........ Nameof Architect ........ .................................Address .......................................................d...... .............. Number of Rooms ............................................Foundation 0 d V`'P �/ r` d`� r r . �c ................ . .. .............................................................................. Exierior ./C{.:�' i� r F t c,• .t.....fl;I..�/��, f� , ,,.�j�A.Raofing ...............y.�.�/)`r9.�............ .... ... Floors �:. s`x Ql_ Y'. Interior �� N c�� .......... .................................... ......'�;'!{'�•N-.. .'.....Interior ............:.......................................................... f� Heating 1 ^� ' • t-/i Plumbing E cr /�n ti^ r� )7` ............................................ ................0....................'...:.—1............................. Fireplace ....... ' ..........Approximate Cost u . i �l u f 1. ............. �..�s ................. Definitive Plan Approved by Planning Board __ �_L+�+=� �'__`_ 19____ ? . Area Diagram of Lot and Building with Dimensions Fee / >. ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH r� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name ........... /�.,�, ��P ` / d''..` .................... OCEAN C/`BUILDtRS—, -I-NC—.--'�- �� NoZ 3.7..5..... Permit for .......... Sin .l.e..Fa.mi..l Y...Dwe1.1.i..n...5................ j Location Lot....#.1......1.1.3..Lkglde.Tl...S.tXeet ' ...............HY.a.?m .:�;............................................. Ocean Blue Builders, Inc. Owner .................................................................. Frame Type of Construction .......................................... Plot ............................ Lot ................................ Permit Granted August 14 , 19 81 ................................. Date of Inspection.....................................19 Date Completed ......................................19 PERMIT REFUSED .................................. ......................... 19 /................................................ ............ ./ .� ............................... Approved ................................................ 19 ............................................................................... ............................................................................... 1 4- Assessor's map and lot .. . . .... . ..... ,,f F7HET0� �V Epp TE Sewage Permit number ���'�t.:GcnG�2s �"^�t' ��c�E Y$ ��ST e``Q ♦� - ® ' s 2 House number ....mac. 1 ..................... ....:...........:. .........�. 7 ,�.�� M� a 9oeasa� LeO�. „-.FNVj T�,E " a war a- �� NTAL TOWN "OF BA�RSTB � �� BUILDING INSPECTOR r APPLICATION FOR PERMIT To 6).: 6 � b B c� l'(t A(/Ul. L6- �- TYPE OF CONSTRUCTION .........W....................... ............................................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for 'a permit according to the following information: Location . ...., a� .....: :.�..............1.�.4.!'...�...:'........ 1........ .... ............ ........................... ProposedUse ... 4�'. (.�c....... ........: ................................................................ Zoning District ............. . 1. J.. _.........Fire District ....: ..:. !J. ?". ....:�:............ ................... Name of Owner ...4.- fr�i�^ ,..`!.� �!.�.. ��.l.dPf!5.�,�, ,ddress .LL�....�-�.C�1.. .......... `or k Name of Builder . � :. �..lJ ::{J ..: .�,, [QIF'ivJ" Ad ess .... ` !'.. ............................` zJ .. ! Name of Architect '........ .:. �. Address ( J !je f �lZ .... ...... .... ................................ `..... I.... Number of Rooms .....;..Foundation �d '�'� . .........� ............ ... . ........... ... .. Cie.......................{ Exterior �1..Roofingf ../'7.1.� /t.................. M ' Floors ............................................ ..Z.........';/��. -• " r .........&. ..k!`. ....5. r%' ... .i��� ........... Heating .... !!" V' � ...Plumbing ................J.1sA.':!.�'. Fireplace ......./Y..tJ .�':................ ...:.... ....Approximate Cost ..............3.�?�.r�.u...... Definitive Plan Approved 'by Planning Board _____ __19_ �. Area Diagram of Lot and Building with Dimensions Fee IZ.a SUBJECT .TO .APPROVAL OF BOARD OF HEALTH ev IDA I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nae . j...... ................................. OCEAN BLUE BUILDERS, INC. • �t 'b No ... Permit for ....Qzle...S.t ar.y......:.. S..... ... F:a i�4a Dwe11ir1 Location #1...1.13...Linda-n• •Street A rHyannis . .................`........................................................... Ocean .. Inc_ Blue Builders f Owner ... ............................................... ..... Type of Construction Frame .... .. ......'........................................................... Plot Lot ..........:..................... Permit Granted ....August%.14.,.........19 81 -Date of Inspection .................19 _ {Date` ompl ed ...... .lQ.--?zs19 ZOO/ PERMIT REFUSED 1 .. ....................... ......................... . ... ........... ! - i ...i } ................ ........................................ Approved `19 ............................................................................... ........................................................................... f a - q ;1 ah'd p 1 ,I �,�a- r ,-.. -. _ S a { > >. -r ,r > i > ti ,.. E. 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S m ti 5G� i " ��fC t�,j� r CERTIFIED PLOT PL"AN P` 7 t S`ei n r... f a' ,, V 'G s Ip �, 09ERT BRUGE El�t' -C'.ONSTRUCTION `ONLYS`' r i> Q.. ;t^� #I ,�/(�r /�' -- , s TOP,�OF FOUNDATION IS :? -FEET "y /sT � I. 1 g'ti ' ABOVE7 M16H` PAINT r OF �AOJACENT �,�r'� �, �'D sf>Rd� /a/( r—, gip. ! 6 '.t, q h +� L ! M ♦_�l !-s"+ �� ` ;ROAD c � fi y} Yy r, awl M fr '� b' y r a SCALE `/�`. DATE }3" . Z 8/ ' , LD�KEDGE EIVfIMEERN CQ /NC A C ._ I CERTIFY THAT THE �ov�✓v. rranl CLIENT Sp�OWN ON TMIS P , V IS L4GATED REGISTERED . - REGISTERED JOB NO, �'1 ON THE GROUND AS LNDICATED. AND .E f CIVIL LAND CONFORMS TO THE ZONING I:Atldi , % ERIGINEERS ' SURVEYORS rg A . DR. 9Y OF �Mk"157A%- ASS. ` , �`" 712 �it<IAIN ST. ' '.- / �� ..1 " 11 'XI` i1YANtyIS, MASS: SNEET,1 OF ''DATE REQ. LAND 3.URVE1t�OR '` - xx F _ „••""'• TOWN OF BARNSTABLE permit No. _---_ -- e 1 VAUSTA< x Building Inspector Cash - ----------------- OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to oCGan Blue Builders, Address - f yan is Lot 01 113 Linden Strect Wiring Inspector Gir_ ,yi Inspection date Plumbing hmector /')/ � p� Inspection date Gas Inspector '� �� 0 n *� � '� i_ Inspection date :. C' t.. . ry. Engineering Department Inspection date 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. r� ---------- Buildingispector r -7 IK AV t • - '� J 4 di i'C v r + k C JL VN r4 a9 74p L v T • BUIVIKI$ H r , ,�• r a ?: 2216210 q . ST ' NAL ECG LEGEND EXISTING. .SPOT ELEVATIONOx0 CERTIFIED PLOT PLAN ' EXISTING ` CONTOUR =-- 0 == LoT 3 �a✓f� Al FINISHED SPOT ELEVATION YA 5 FINISHED: CONTOURIN rs z A APPROVED , BOARD OF HEALTH Alm DATE AGENT : SCALES /`"_'3 O ::DATE,' 7 / LOR�OGE ENGINEERING CO IN CLIENT �,,.,.�„ :•I CERTIFY THAT THE I>ROPOSED EGI3TERE. " REOISTLRED }` jo 1d0, &R3 BIJlLDLNO SHOIbN OR! THIS . PLAN jet CIVIL LAND ,• 'CONFORMS .TO THE ZONING.. LA1 -ttl ENGIN R URV R OR,BY OF BARNSTARL , MAS '$ ; 7I2 MAIN ST CH. BY HYANMIS, MASS ;r. S�IEEI¢....G OF .L ,DATE REG. LAND SURVEYOR' 17 Y-0' F/I&fl a ",,x. 60N7. 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