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Town of Barnstable iilld In
rr,►esc ;Post This Card So That it is N�sible'From the Street Approved Plans Must be Retained on J.ob and this Card Must be Kept
b `0� ;Posted Until Final tnspect�on HasFBeen Made py� l
eta Where a Certificate of Occupancy,s Required,such Building shell Not be Occupied until a Final Inspect�onAhas been made 'g Permit
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Permit NO. B-19-3568 Applicant Name: HOMEOWNER IS APPLICANT Approvals
Date Issued: 10/23/2019 Current Use: r Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/23/2020' Foundation:
Location: 25 MARYALICE LANE,HYANNIS Map/Lot: 291-076 Zoning District: RB Sheathing:
Owner on Record: MIRANDA,MARIAMELHA FREITAS&AD'NOE ContractorName:'::.,HOMEOWNER IS APPLICANT' Framing: 1
Address: 25 MARYALICE LANE 7.
Contractor License: EXEMPT 2
HYANNIS,MA 02601 Est Project Cost: $4,000.00 Chimney:
Description: Roof Permit Fee: $35.00
Insulation:
Project Review Req: Fee Paid $35.00
Date. 10/23/2019
Final:
r 4 Plumbing/Gas
Rough Plumbing:
Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six,months after`,-,issuance.
All work authorized by this permit shall conform to the approved appl catiori apd the�approved construction documents for which this permit has been granted. Rough Gas
All construction,alterations-and changes of use of any building and str`ucturesishall be in compliance with the local zoning by laws and codes.
This permit shall be displayed in a location clearly visible from access street,or road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same.
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures bythCBuik ing and Fine°Officials�are provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work i { Service: ._.
1.Foundation or Footing
„ •Lk,' ,. ,.. �'. ._ ......a Rough:
2.Sheathing Inspection „
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health
Work shall not proceed until the Inspector has approved the various stages of construction.
Final:
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A).
Fire Department
Building plans are to be available on site
Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
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Application number.... �..60
... ...Fee ..y .......M
......... ...........
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�o�� lding Inspectors Initials......... ... .......
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JJb 1����- Date Issued.................,!. 3/`
Map/Parcel....... !.. ... ? ...P...................
TOWN OF BARNSTABLE
EXPEDITED PERMIT APPLICATION:
ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION
PROPERTY INFORMATION
Address of Project: C-( f ce.- u 0 -9-
NUMBER STREET VILLAGE
Owner's Name: A d Az m t A t Irctm la Phone Number
Email Address: A-- A i hawd a-5-70 oof& (jCACell Phone Number SIJ . 5 G
Project cost$ ® ® Check one Residential Commercial
OWNER'S AUTHORIZATION
As owner of the above property I hereby authorize
to make application for a building permit in accordance with 780 CMR
Owner Signature: Date:
TYPE OF WORK
❑ Siding 0 Windows (no header change)# . ❑ Insulation/Weatherization
❑ Doors(no header change)# Commercial Doors require an inspector's review
Roof(not applying more than 1 layer of shingles)
Construction Debris-will be going to
CONTRACTOR'S INFORMATION
Contractor's name
Home Improvement Contractors Registration(if applicable)# (attach copy)
Construction Supervisor's License# (attach copy) .
Email of Contractor Phone number
ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN
A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED.
APPLICATION NUMBER
*For Tents Only*
Date Tent(s)will be erected Removed on number of tents total
Does the tent have sides?Yes No (If yes please attach floor plan with exits marked)
Dimensions of each Tent X X X
Additional tent dimensions can be attached on a separate piece of paper.
Purpose of Event
Check one: this event is a: for profit non-profit event
Check one: Food served Yes No
Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent
Fuel source being used LP tank 201bs. or>Yes No ,if yes, a gas permit is required.
Natural Gas Yes No , if yes, a gas permit is required.
If food is being served at.your event please obtain a Health Department approval between the hours
of 8:00am-9.30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval,
*WOOD/COAL/PELLET STOVES
Manufacturer# Model/I.D.
Fuel Type Testing Lab
Offsets from combustibles: front back left side right side
HOMEOWNER'S LICENSE EXEMPTION
Homeowner's Name: d c M 1 eAq!r/J
Telephone Number 0 !Z / E Cell or Work number OG O�
I understand my responsibilities under the rules and regulations for Licensed Construction
Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand
the construction inspection procedures,specific inspections and documentation required by 780
CMR and the Town of Ba able.
Signature Date (a
APPLICANT'S SIGNATURE
Signatur Date,4
All perm applications are subject to a building official's approval prior to issuance.
r
•� The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111 R
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
'Applicant Information Please Print Legibly
�[
/-Name (Business/Organization/Individual): �}�/UQ/� �'1/1 t
�Address:dS MA t4 iA•U/�0 -� If-(A
City/State/Zip: 2&,O Phone C
Are you an employer. Check the appropriate box: Type of project(required):
1.❑ I am a er w employer with 4. ❑ I am a general contractor and I
P y - - 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 no employees These sub-contractors have g• ❑Demolition
workingfor me in an capacity. employees and have workers'
Y P h'• t 9. ❑Building addition
[No workers' comp.insurance comp. insurance.
e uired. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
q ] officers have exercised their 11. Plumbing repairs or additions
3. I am a homeowner doing all work. ❑ g P
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.❑Other
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 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-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 rdfy under the ains and penalties ofperjury that the information provided above is true and correct
Si ature• Date:
Phone#: 0 6 0 G 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 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
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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 nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-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 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 permittlicense 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
Revised 4-24-07
Fax#617-727-7749
www.mass.gov/dia
Town of Barnstable Buildin
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Post This Card So=That�t is:Uis�ble From th.a Street=A „ roved Plans MustSbe;Retained onbJob and,this Gard Musi-beKepi �E.
RAAMMABt. -
M'" Po`sted Until Finallnspection Has Been Made x '
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s6�p � a,. i, .': ?.. „ . .,;,� ;. : ,s .tea ,� +y p rm
s Where a Certificate'<of Occupanc�yi Required such Bugshall NotbeOecuped untrl a�Fai.ln pect�on�hasbeen made j lijl l
Permit No. B-19-1336 Applicant Name: Brien Langill Approvals
Date issued: 05/15/2019 f Current Use: Structure
Permit Type: Building-Solar Panel-Residential Expiration Date: 11/15/2019 Foundation:
Location: 25 MARYALICE LANE,HYANNIS Map/Lot: 291-076 Zoning District: RB Sheathing:
Owner on Record: MIRANDA,MARIAMELHA FREITAS&ADNOE Contractor--Name ,,BRIEN LANGILL Framing: 1
Address: 25 MARYALICE LANE , Contractor Licnse CS 106675 2 f
HYANNIS, MA 02601
t Est Project Cost: $19,778.00 Chimney:
Description: Installation of roof mounted photovoltaic solarsysterns 8.99kw 29 Permit FZee: $150.87
Insulation:
Panels
FeePaid $ 150.87
i
Project Review Req: yDate 5/15/2019 Final:
0
z ' Plumbing/Gas
s
Rough Plumbing: F
ui m icia
This permit shall be deemed abandoned and invalid unless the work a p' died,bythis WA in'is commenced in six months after issuan 2. Final Plumbing:
All work authorized by this permit shall conform to the approved application and theapproved construction documentsyforwhiehth�s permit has been granted.
All construction,alterations and changes of use of any building and structures shalt be incompliance with the local zomng<by laws and codes. Rough Gas:
.This permit shall be displayed in a location clearly visible from access street�or road and shall be maintained open for public inspection for the entire duration of the
Final Gas:
work until the completion of the same.
The Certificate of Occupancy will not be issued until all applicable si natures b the Buildin ;and Fire,Officials are'6o ided on�this permit.P Y PP g Y g p P Electrical
Minimum of Five Call Inspections Required for All Construction Work:
1.Foundation or Footings Service:
2.Sheathing Inspection
3.All Fireplaces must be inspected at the throat level before firest flue iniri is installed X � "' Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
Final
5.Prior to Covering Structural Members(Frame Inspection) `.
6.Insulation
Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
°Ft Town of Barnstable
Regulatory Services
' =" MASS.� ' Thomas F.Geiler,Director
9�A1M6A3s9S' ,�$'
rF1639tA Building Division
Peter F.DiMatteo,Building Commissioner
367 Main Street, Hyannis,MA 02601
Office: 508-8624038 Fax: 508-790-6230
PERMIT# FEE: $ �..5 C
SHED REGISTRATION
120 square feet or les .(
I
Location of shed(ad ress) Village
Property owner's name Telephone number
Size of Shed Map/Parcel#
)igniture Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required) , S` M101
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:083001
� -- ----- �- �� ________ STANDARD LEGEND
____
'MAP 291 x NOTE:not all symbols will appear on a map
P 1 � GOLF COURSE FAIRWAY
# 52 7 0 1--X MAP 291 7 �� EDGE OF DECIDUOUS TREES
t
EDGE OF BRUSH
# 30 # 1 --_ X F _% ORCHARD OR NURSERY
Iv—V—V—V EDGE OF CONIFEROUS TREES
MARSH AREA
— — EDGE OF WATER
DIRT ROAD
E DRIVEWAY
�—PARKING LOT
�-PAVED ROAD
— — DRAINAGE DITCH
— — — — PATH/TRAIL
1 M PARCEL LINE**
291 MA 291 MAP 2 1P110 <—MAP#
21 E PARCEL NUMBER
#redo —HOUSE 2 FOOT CONTOUR NUMBER
# 45 73� NE
6 ` - - - -# 15
# # 2 5 io 10 FOOT CONTOUR LINE
Elevation based on NGVD29
4.9 SPOT ELEVATION
�o STONE WALL
—X—X— FENCE
X _ �( RETAINING WALL
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IL:
291 - - - NEAP 291 MAP_MRAIL ROAD TRACK
8 MAP 291 I STONE JETTY
# 52 g 2 pp # 16 SWIMMING POOL
# 20 X PORCH/DECK
[�j 0 BUILDING/STRUCTURE
X
X DOCK/PIER
HYDRANT
e VALVE O MANHOLE
0 POST p'" FLAG POLE
T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S u N 1 T A SIGN ® STORM DRAIN
N PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James
+ _ o — 1"=100'scale map and may NOT meet of property boundaries.They are not tru_ locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE p TOWER
d we 0 c 30 60 National Map Accuracy Standards at this do not represent actual relationships to I cal objectsl Corporation. Planimetrics,topography,and vegetation were mapped to meet National Mop Accuracy Standards
s W 1 INCH=60 FEET* enlarged scale. an the map. at a scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps. 4 LIGHT POLE O ELECTRIC BOX
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SEPTIC SYSTEM MUST
y . INSTALLED IAJ COMPLIANCE
V�'ITH AR/ SA ! q TIULE fI STATE
ypi TH E
TOWN OF BARNSI Ui' � E AND TOWN
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i BABBSTABLE. i
9� 0 p BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... ...... . . . .... ....... .. ...................: .......
�r',.. ................... ..........
TYPE OF CONSTRUCTION ...... CJ... ......��� ....?:!'...:...............................................................................
V'k " ........ ................19, �
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TO THE INSPECTOR OF BUILDINGS: +
E The undersigned hereby appll s fora rmit according th following information:
Location .....%/? ......... ,j. ,................ ........................ :. :.s..
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ProposedUse ...... .... . .......... ......................... . ............... .........
ZoningDistrict .........,1 .,�. . ...................... .......................Fire District ... . ... ................................................................
Name of Owner .. :..���� ...::... ... . . .....Address . J... .... '�'w�. /1....
Name of Builder 1l .Au .....................Address ...............,'�
Name of Architect .. .................Address l .. f
Number o('21OL—)
......................Foundation ... .. ..... ....................................................
ExteriorRoofing .... .. ... .: .................... . ............................................
Floors ....... .. ..........................................................Interior ..... ...... .......... .......
.... .. .... .........
Heating ....... + ........................................Plumbing ... ... 4
U ................................................
Fireplace ....Approximate Cost .. � s ^
p ........... .............................................................. J.
Difinitive Plan Approved by Planning Board -----------____---------------19________.
Diagram of Lot and Building with Dimensions "ra
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I hereby agree to conform to all the Rule nd RJegulations of the Town of Barnstable regarding the above
construction. d�
Name ............
J bHNSON, WILLIAM
No ..16785.... Permit for one sto
..... .. .
...........single family..dwelling...................
i Ma°ry Alice Lane,
Location .......... .......... ...... .......... ...................... V/��
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................. . Sranni s................... ................
Owner William Johnson.......................
I frame /_�IrrST�,c,Si�9L���v,�L,�t�=oor��,�.�
Type ofof Construction ..........................................
................................................................................ `' /xia P"f kot �'n XAdl
Plot ......................... Lot ................AQ.......... _ J t
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December 11 73
Permit Granted ..............................
........ .............................19 .'
Date of Inspection ... ................0 -� -
Date Completed. ..
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f
PERMIT REFUSED'
�.�,.................................../ ........ 19 .. _ - '
..........Z. ..... �... ff ....... ...................... i� ....
.. ..• ..•.. • ... ..................................
Approved ................................................ 19 r
............................................................................... `.
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.................... ......................................................... I