Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0026 NANCYS LANE
a 5Cs - 110 i 2Co N�.Icc�'S L r��, ���1►5 M � p �25�--1/t� I I i I i i TOWN. QF BAR�lST BLE N ��-t^ ( - ►gym ;�r�E�f~t��J���.,rs :L� �c.�n..�.�t�.._. �I�> APR 7 A � .. . MAP.INSTALI:EC)Bil 'biNC:PRQOU(',l S I: F O Bolt i�05 V SAGA BE,aGH MA;Oz562 i INSU6ATICIN CERTIFICA'TICIN PGR IEC,C:i3,Q.i"A.1 L: INSULAl-ION` i Fxz2nprwalls:,Bf t+tol TypeGtt1u- (i1`Man€fact`urer_ 1�?iA:f _ f2 4afuc �+ Exter€or wal►s:(tither} , "Iulac.. __,_ Mani;factur.eri _ R Va►ut Irte€€or:VV�lls/SYairwl!' Ma,eifiacturer R Value _. _ a. wd, 13asarrtY Ceilii_i Type er; R Value _. _. . .Manufactt�r I F►it Ceilings;' T r.:. . Manufacturr rl R Value . .. - - Slopeif C.ilings> - i' Marufacture;, R Vdlut' 1 ;ILOVdN It iStJLiaTION FItiCFtGLAS5 0R.CELLUIUSE=� Exterioralls Manufacturer-; lled thickness; TYp?. . SetttedTh�Ci�cness Settled R-Value Installed derls€ty Cavern Brea Number of f3ags .a ` >` Flat Ceiling;: aYPt..: _Manufacture : InSt'alled tticknes�'.' Sett►ec#.Th€dl<ness Settle s R Valuue lns.Ya_Iled tieri�rty �avare A€ea:` Number of;F3ags i, SLo Q_ Type. Manufacturer; Installed tracl,n ��__ Setthz.d h€cliriess' Settled R-Value Installed e,n'$1ter Coves' eA,ea: �. _' Numberp, Bags. ,,'Fa 601 In<ta`Il:C uilc#.ny P€a:clur.ts Town of Barnstable Building .. P� st:T '�'^a •,..:� � -� e .� `;�. , .^,� wool "..z�, .<� r^c, o h,s>Card So,That.ttas.UisibleFrorn the Street A'`"'roved Plans;Must be Re airied onJob and'th�s Card:Must be.Ke t � •AB?MiA(SL.P ;:a .� '� a��y ��> �.,'.i � ��. x � pp ,� �' �, y �`;;k, � �' � � 's S � x�,�.'P � � . Where a Certificate of Occupancy;is Required,'such Building slal of be Occupi 'until a Final I spection has been made Permit Permit No. B-17-4410 Applicant Name: PACHECO, LISA Approvals Date Issued: 01/12/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 07/12/2018 Foundation: Residential Map/Lot 250 110 Zoning District: RC-1 Sheathing: Location: 26 NANCYS LANE, HYANNIS p Contractor Namef Framing: 'r✓yo9 �� Owner.on Record: PACHECO, LISA Contractor License �. Address: 26 NANCYS LANE " Est Project Cost: $20,000.00 Chimney: HYANNIS, MA 02601 Permit Fee: $ 152.00 r � .n TJO �8. /1c Description: : Permit and renovate existing structural elements add additional Fee Paid: Insulatio $ 152.00 structural elements including: Y 41 Final: Fina Exercise Room with two separate doors Four closet workbench and associated storage, bathroom including:tub/shower,sink,toilet a Project Review Re Plumbing/Gas q: Rough Plumbing: =' Building Official Final Plumbing: Y This permit shall be deemed abandoned and invalid unless the work autliori ed by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the.,approved construction documents for which thi"s permit has been granted. All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoningf, y llaws and codes. Final-Gas: This permit shall be displayed in a location clearly visible from access street oriroad and shall be maintained open fortjpu is insl eOttion for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy.will not be issued until all applicable signatures by the bdildang and Fire Officals are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 3 MA, #`F 1.Foundation or Footing 7 " Y Rough: .r 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_notproceed 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 ( n n—a I l rem �6n o,� ,�, e WILDING DEPT. im to 2010 TOWN OF BARNSTABLE iE i i y!„ p Bar'A.Sta��U.I@ rOFJprO e.maus/PlanningBoard;.. 4 Members, Costello Cleo Paul vcurley. David Munsell 'Fred LaSelva Town=Council Liaison en't D t.Staff Su ores ' ins,RICP.,Director Principal Planner qq karen.herrand iown.barnstable.ma us , arnstable G BOARD Wes 14,2017 Present Present Present Present Present Present ` Piinr`invil A sictnnt THE t r J6A pplicadon Number."' I�— I I • rAsr.�. • Q �. nsnss. Permit Fee....b,.�..Q)?.:.. ..................Other Fee........................ TotalFee Paid...................................................................... TOWN OF BARNSTABLE IJ2�l 8 Permit Approval by. ........................on...l..................... BUILDING PERMIT Map d....................Par�i........:.....L...Q..................:..... APPLICATION Section 1 — Owners Information and Project Location Project Address_ IY A-/1\/Y &#';kX- Village_ Owners Name Owners Legal Address�(y City L!YPCW ;6 State V"��_ = Zip 0 2-6Q - f-) / I y l 4VA 1 � Owners Cell# �9l � '' �� _7"� L�' E-mail r�� _�� N ,L h Section 2-Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3-Type of Permit ❑ New Construction ❑ . Move/Relocate ❑ Accessory Structure ❑ Change of use F ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler System ❑❑ Addition ❑ Retaining wall ❑ Solar L" Renovation ❑ Pool ❑ Insulation Other-Specify w Section 4—Detail Cost of Proposed Contra ioh--o 0-0 0 —Squarer p Footage of Proj ect Age of Structure .L 1 is �*5 Dig Safe Number # Of Bedrooms Existing Total#Of Bedrooms (proposed) 11�0 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Last updated:11/72017 Section 5 -Work Description -"V-KAA w � d� Section 6—Project Specifics Wiring (] Oil Tank Storage Smoke Detectors Plumbing ❑ Gas ❑.Fire Suppression ET Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ :P *vate Sewage Disposal -❑ Municipal Site Historic District ❑ Hyannis Historic District [] Old Kings Highway y I Debris Disposal Facility:Y I am using a crane C Yes E"No Section 7—Flood Zone Flood Zone Designation J Within or adjacent to a wetland,coastal bank? Yes ❑ No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed i Has this property had relief from the Zoning Board in the past? ❑ Yes 0 No Last updated:11/7/2017 Section 9- Construction Supervisor Name Telephone Number Address City State Zip License Number- License Type Expiration Date ; Contractors Email Cell# 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 Barnstable.Attach a copy of your license. Signature Date Section 10-Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors 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 Barnstable.Attach a copy of your H.I.C.., Signature Date Section I1 -Home Owners License Exemption Home Owners Name: ) LL Telephone Number j�a 0 Cell or Work Number _ 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 CMR and the Town of Bamstable. '/--gignature ate h/w/— s� APPLICANT SIGNATURE Signature Date Print Name _ k, C-&Telephone Number 0/7- �7(,) - ��/o E-mail permit to: 1��i/mil' (m-Wcd y � P' t L10 r(-1 Ca 14.1 p Last updated.11nr2017 4 Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13— Owner's Authorization I, , 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 1 'I i Last updated:.1l l2017 13 f / . t / ' t , a w Cape Cod Energy Solu4ions LLC , Customer �Ct - lz�l 4 K 9f� 378 Roa.te:130,:Sandwich MQ 02563 ....I..%��....I,�,:..,r...�,1.,,:1.,..I,�.�.�I,,.:..��r..�:'1I�Il 3�I..�.",i�.:.I ::..,:.,�,.r-.::�L br.�.'!_���..,.,;.r..,.'.�,,:.,._1:.��I,. -b�:.:I�"',,Ll,.._-P�'-".'%�.,,:'1�.1:-.,".:1�.�.�.._. .,.,�"_j�-,.�.-., ,,rrr,.�:�..,,.'r:;�'...CI-r:..;'.;�I�;�.I .-�:.�r:,�-..I..:.,:..,�-,�.-.:l._'-�*.1�.I,...,1�,�.,�,.,�,��Ib.a..::'��..:::..��r:::�1:,;�.,,'.,-.�'.,�...-"�'..-.,r,I�-...:..,_.,'..�.:.:!'",,,l—�lI.L�1 M�:."':,.,,.,,. e "w" a mil + «s� d::r:':...�'.I::...r.:M.'1.r;�.1.:I.�:��.,]��.� �-...:,::-*,".�::,.�.r,:b.,�.�. ,-",�r��:.�.�.�_....,-,.,�I?_.,I�:.I_._-I..,�I�::.�.,.,:- j. Address C •. �„ � C 774 205 2001 844 90 AUDIT tC � . Pre B A.S. �. CFM50 � F - : EndBAS CFM50 CelrtifiCateof Insulation �� r l , .. _ ... ATTIC MALLS BASEMENT z Square Feet•: Square Feet _Square Feet F `i `:,r�.�,:,�-. Manufacturer -ei� .Manufacturer Manufacturer L Cl v a QpR I Material Usedi e Qt'1��( fvtaterial.Used. Material Used , ` #Ba s' R=Value �" #Bags R Valuef #,Bags R Ualu•e g ,_ I i . .: .t .....:. .,..s ,: 1! 11`. y,. :. :.r in accordance with.all a licable.b"uildm 'codes'.and. the q,( I` " certif that.the above measures were installed pp g I, r` Wc— �c U y above in ormat' n is true to the best of my;knowledge r .� Signature . Date �.7 1 26 Nancy Lane , Hyannis ® Proposed Basement Layout Storage with Electrical 4avdA Existing ® Electrical Closet ® ® Execise Room. TV.Sitting Area 0 w J b� ® N z b4 Up z m o a o $ 5 Z m o J;A4 ®. ® ® e6moke Storage HllAC ® Storage p Rad' nt Heat F ring ® Q)® ®, 0Q Fum ® Work Bench ® Shelves Storage .Storage `D Other than foundation walls, drawing is not to scale and all dimensions are approximate � . Town of zpBarnstableBuilding .- � ,,3ef'�1,,'' ..�.'..�T� '�' �,.%'�.;7.„"? s?'�,2dn S„ ;" , ,;: u.3...:,> 'F.,?p� .:,�� P,ostThis-Card So That rtisUis�blehFromithe�Street-A� roved PlansiM,ust�be,Retained onuJoband�this Card Must be°Kept BAR+yfYCABLE; r fi r Wiz. d s .xs,,' i ,> sPp, "�. '� `� -: � M" Posted Until.Fina) Inspection Has BeenMade FPermit ° Where a Certificate.of:Occw anc .as Re ulred;such'B"uildm ,shall Not,:be Occupied='.until a Final Inspection has been made ' ' ;3Wo .�... . ..�.;� +.Z& .;� ...a�.H.;:�,.r,w.,;.. ':A. Permit No. B-17-3931 Applicant Name: Craig Bishop Approvals Date Issued: 01/04/2018 Current Use: Structure Permit Type: .Building-'Insulation-Residential Expiration Date: 07/04/2018 Foundation: Location: 26 NANCYS LANE, HYANNIS Map/Lot: 250-110 Zoning District: RC-1 Sheathing: -. - Owner on Record: PACHECO, LISA Contractor Name Craig P Bishop Framing: 1 r � Address: 26 NANCYS LANE Contractor.;Li�cense CS 109777 2 HYANNIS,MA 02601 Est Protect Cost: $3,105.00 Chimne Description: Air Sealing&Weatherization Pe rrut Fee: $85.00 Insulation: V,� F�ee Paid: $85.00 Project Review Req: Final: Date 1/4/2018 Plumbing/Gas Gas g/ ` IMP, Rough Plumbing: Building Official Final Plumbing: - h ` This permit shall be deemed abandoned and invalid unless the work authorzed,by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and!theapproved construction documents fo hic r wh'this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall 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 mspecto'n for the entire duration of the Electrical work until the completion of the same. ;A kk� The Certificate of Occupancy will not be issued until all applicable signatur s by the Bu ld ng and Fire Officials�a�e prow d on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work.. Rough: 1.Foundation or Footing g 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. 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 0�►� Building y Town of Barnstable); Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on job and this Card Must be Kept �4 Mass. �f Posted Until Final Inspection Has Been Made. �b3g ti0f Permit �0r� Where a Certificate.of Occupancy is Required,.such"Building-shall Not be Occupied until a.Final Inspection has been made. j Permit No. B-17-3593 Applicant Name: . PACHECO, LISA Approvals Date Issued: 11/02/2017 Current Use:' .: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 05/02/2018 Foundation: =" Residential Map/Lot` 250-110 Zoning District: RC-1 Sheathing: Location 26 NANCYS LANE, HYANNIS Contractor Name: Framing: 1 Owner on Record: PACHECO, LISA Contractor License: 2 Address: 26 NANCYS LANE -- Est. Project Cost: $3,500.00 Chimney: HYANNIS, MA 02601 Permit Fee: $85.00 Description: Convert partially finished room in existing garage bay to finished ' Fee Paid: $85.00 Insulation: office . No change to footprint. Add 3x3 enclosure around electrical panel in basement. Date: 11/2/2017 Final: Project Review Req,: NEW PERMIT FOR PREVIOUSLY ISSUED EXPIRED PERMIT - -" : ' Plumbing/Gas 200902077. Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized b this permit is commenced within ix months r p y p ced t s o the after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final 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 work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing 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 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION-• 2 jA Map Parcel Application # Health Division Date Issued Z Conservation Division Application Fee Planning Dept. Permit Fee �� O Date Definitive Plan Approved by Planning Board Historic - OKH' _ Preservation/Hyannis Project Street Address Villages /5 Owner 0 s o� AA ( all up Address I-oypC A&AIIJ Telephone O9-" 73 Permit Request (!�1 %C . &9jit'd Fll� hA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3Q Construction Type Lot Size q& Grandfathered: ❑Yes 0 No, If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family 0 Multi-Family(# units) Age of Existing Structure S Historic House: ❑Yes UIN'o On Old KingKs Highwayz0 Yes_ ❑ No Basement Type: &<u-il ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.) C10 = ! Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existin new Total Room Count (not including baths): existing _new First Floor Room Count- Heat Type and Fuel: ryas ❑ Oil r�lectric ❑ Other Central Air: ❑Yes W-Ko"_ Fireplaces: Existing New Existing wood/coal stove: ❑Yes o Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ .Attached garage: M4xisting ❑ new size _Shed: xisting ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes a<7 If yes, site plan review# Current Use 1 /&WU Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number �v�'/37— Address Lois License# 11Z r'1 ► ( / ��� Home Improvement Contractor# AL EmailnGJf� �. d j 4 Sf�4lL. CEO Worker's Compensation # `t ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE /� I Z� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 4 i t FRAME s INSULATION j FIREPLACE f I ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL f GAS: ROUGH p FINAL ~ Isr ��tiw 01L FINAL BUILDING J4 �� i DATE CLOSED OUT ASSOCIATION PLAN NO. i . be Comm -=iveaWt qjf-4&ssadrusetls. Deparhmut gfru iTs- id Accderd#.r . . 6DO Washingta rt Street -- $astdzi AIA 02111 Wbilmrs' CumpensAim Insm-mce AfEdzvit-Bmlder-s/CantractursMecftkia s Phmibers AppUcamt Informatia Please print Name(gne„rRce�x�a�a�n� ,City/S ate l 13 k kd/ PfiCnM--"1-. SO .7 J/'7 P A' Are you an employer?Checkthe appropriate ban ' Type of project r L❑ I am a employer w. 4 ❑I am a general cmbmctor and I FFe Pr 1 ( = 6. ❑New constructibn employees(fan an&or part fime).* Ise lured the sub-contmdozs 2. I am a sole proprietor orpartner listed oath-e attached sheet. 7. & Hng- scb•-contractors hake s4irp and have:•no employees. These • 8_ Q Demolition , wadzing forte in any capacity. employees an&have wo6mrs* 9. El building addition a ENO WP&Mre camp.insm me comp_insarant�� 5. ❑ We are a corporafion.and its 10-[ i c l repairs or a dCm one officers have exE�ed ther 1L re airs or adc9fiams 3_ I ama bomeowaer daigg auwor3c. $ i 0 Plutabsa g P . Myself No woikffi. - right of emac4don per M-(M I'❑Roafregaim ,mciriar�reieclnir8d�[ c.1..52,§1(4)6 andwe have no employees [L'O Wails' 13:0 other cam_insu=m required-] •AnyaPg Chstchedmbox#l�talsoffiomtth�sectEaabe�ow mdagtliraiuorkers'ca�pensefia�poyepia�cmauo� T Samiemnei who sabot dris sffidal u t3wY am tiain�sg W�aa�tiiea lrEzxe aatflde crahsfi+*�nmst suTffmita new sffid�-®t indicsting sacTi fCa chea iizi b MuQ t sftarl�ffiaddi6ana1 s3reri sl�ntic�gtUenzm of the sob-ca�ctasamd sF�etehether arnotrbnse ent¢tiesha employees.IMP-mff-ccntxctmsA1Ve emptvYb?-'s,they pmt••i&thek Workea'•mmp.pa1.iY 1LUMbM I arrt arm srxpFa}�xr flat;i�gr�r-�v�it�rlmets'za�risrdiort uuzirarccs�vr trc��I�S�e,� ,�croav is flee po�c���d jQb sda i'rr,{araz a6m Ittsurance Company Fame: - - Po-ficy 1 or Self-ems uc_ gizafiauI?afe: Job Re Address City/5��a: Affach a copy of the work-ere compensationpoUcy-declaratioa page(showing the poTicy number and.expiration date). Failure to secm-e coverage as required nuder Section 25A of MGL C.1-572 can lead to the imposition of Cstmi'mal penalties of a fine up to$L5aa OU an&tGr one-year impxiso as well as civil penalties in the farm of a STOP WORK ORDERand a ffae of up to$25100 a day against the violator. He adtrised that a copy of this statement maybe kwvrarded to the Of of Itnesfigations.o€the MA.for insucam..ce coverage��catiom do Fier cettif��ra gs�raris mcd p8r ger�crr?�atflra ircfar�atrmm prm�d a72bm/ �" and carrect re_ G- ;IJFate' /D � 0,okkd use wily. Do not wrote in tfds urea,6st Be wingfeta by,cry artoiru gjgL-al Cif-or'Fhwa: Permit Ucewe# issing Au&or€fy(circle one): L Board of Health BugTmg Ilepar[ment 3.CRyl£owix Clerk 4.Electrical hnpectar S.Phrmbi mg Inspector 6.Other Contact Person: Phone it: I r- haformafio)a and T-ns&Uefi0,Ls Massachuse#fs C,.c al Laws c 152 rem all�oY� provids wo ens'compensation for men euiPIoye � Fm�tf $o this statof,an e�Iopee is def2ned as"_�+etYP.etsonin$�a service of a ���5'CO S°f express or fi3:[PliE-,A'oral or wrifte f as��inidual,P ° ,assoaaiiox�corporaion or other IegaI e�iy,or arty °or more e�afives of a deceased employes,or me o€the forego=g=gagedm a3omt eofeapuse,andmcb rrmgthe legal=pres association or oth MIega1 e�ity,=Vlopmg CPIOY�- ee Howeverthes reim or trastez;of an �l io P 4- me o of me- owner of a dwr Ting horse having not more than threes apartmeds andwho resides theme, dw Mag horse of anon who Toys pemons to do ma:btmmjm.rrrr,shmct an or repay wDik on such dwelling house u�nm - i=tc)9nUnotbeoanse of �Plopmr�be deemed to be an emPlopen" or on the gL armds or btn7.dmg app . MQ, §25C(�also sf es�¢every s zte or'local firev agmcy shall hold$ie iss=cce or ter 152, renew of a ficense or permit to operate EL Tjusncess or to c onstraet buffdinV is the commonwealth for nay applrcantw-h.o.has notprodnc ed acmptable evidence of cnmp�an�with iIIsarance coveragerequired- Ad�onall5r,MCrL cbapt�152,§25ek7)sfates abTeiihe�f3ie _ nor�y ofits political snbdivisior s shall mtrz- into any=atrad for the,pwR=.aaw ofpublio vPoku a1 accptable evidence of camplim wffi the fi1=mce• ref of this rliapteahave b=prese dio the confrariing.aufholiiy Applicants •• - eusationaffidavit compleialy,by dig�baxes$at apply to your situation and,if Phase 01 out the wow'comp their s)of necessary,SUPPly sub r(s)name(s), ad&ss(es)and phone numbers) along V itii other than the insur�ce Lizuited Liability Compmncs(LLG�or I.imitedF.iability Par[nets7�igs( )with no emp yeeS members or pazineas,ate not regaaed fn emy wur�s'eompensaiicm msoranca If an LLC or LLP does have: eatployee s,a policy is mod- B e advised thA thus affidavh maybe mbmi, %d to the Depa-[meat of Indiisttial Aceideuts for cow of in=-ice cove. Als°ba rare to sign and cafe�e afSdavit The affidavit should be•retnmed to me city or town that fhe agplicafim for the permit or license is being no f the D�pattme ' of r ,m om A��. �Tdyov.have�r qE s O s regarding ffie LL or ifyon are recprhed to obtain&WOEloirs compensationpolicy,Please call theDepadmentatth.enumberlisiadbelovT. Self-5nsured=933paniesshouldea,`ns$heir. self-m saraace license ramibez•an the appropriate hme. city or Town omcials . f PIease be sore the tite affidavit cnaQlete Bmdpri�d'Ieg�y- 'Ihe Deparhnenthas provided a space at the bottom of the affidavit for you to ER out in the event the Office oflnves�i� has to cox�Cf yoaregardmg the agpITHcs: Please be stye f4 fllintitepe�itlIice�se ntLnbeswhich VMbe used as arefecmm maaber.In addition,m applicmt that must sabnzh multiple p=WHreose applickions is any given year,need only sabmit one affidav�sodScaiing�?nf �d mzder"]ob 5�A �ress�$e applica�should vte"all loc ati- n (�Y or policy in�mati=@fneces�Y) be rovidbd to me ' town)_"A copy ofthe-affdae.ffi Chas been officially stamped ormar$edbyihe cRY ortovmmay p EPPlic ant as proofthaf a valid affidavit is on file far fcre•pmnifs ns or licenses- A new a$daViIUOIs be filled out earls year.There a home owner or ciii=is obtaining a Ec==or p=it not xelzbi d to arty business or=mnesciial 4m 'm (ie.a dog license orpetmhto bt leavm etc.)saidpegsonisN0TreMdta COmPC this affidavit The Office of Investigions would like to tTiank poem advance for your cooperation and shouldyou have:any q�sh�, piease do notbj:* iz to&m a C�am Ilie Dr and faxpparfinenfs address,telephone rmmber: ry . I3 C�Umm g t3 E of Massarhu&EMR Deparimemt QfY>dAAwUen: Bo MA E ].lk T(-,L GI 7-72749W uxt 4-06 or 14 MA S&AFE • Ram��.'�`��'�� gevised424-07 rnwwi as guTIf3 Town of Barnstable Building Department„Services Brian Florence,CBO Building Commissioner: ' _ ' 200 Main Street,_ Hyannis,MA 02601 t AMAss- . www.town.barnstable.mans 1639. Office: 508-862-40.3 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE ' JOB LOCATION: numlEr �I V�street J ag vill e :`"HOMEOWNER": 1, J A V�� r lXJ(Jl7i - `JV -_-q --2ZJ Z_ - . 0 - / &z name home phone# work phone# CURRENT MAILING ADDRESS: iCAXI L 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. 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/orTarm 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 buildingpermit (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 undersi ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro dares d requirem is and that he/she will comply with said procedures and requirements. Signature of Homeowner l . 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 IM 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 helshe understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit fo ms\EXPRESS.doC 08/16/17 Town of Barnstable Building Department Services R'RMA=, `KAB Brian Florence,CBO 1639� ��� Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-7.90-6230 Property Owner Must. Complete and om l Si This Section Sign If Using A Builder I, ,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) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:08/16/17 710 J � a - � .Pargel Detail Qp 1/z , /l 7 Page 1 of 4 laJ M, Logged in As: Parcel Detail 1 Tuesday November 282017 l Parcel Lookuo bc�—Coorr\ jf �_ 111 19 Parcel Info ,1V1(J _ . Parcel ID250-110 Location 326NANCYS LANE` ., Pri Sec Road,,., ,,..,,rom ... ,. Sec Frontage Village aHyanniS I Fire District HYANNIS KKI Town sewer exists at this address ENO I Road Index 1058 I Asbuilt Septic Scan: Interactive , 2501101 Map l ; j Owner Info .....................-....................................................:..._.........................._..........................................:.._..................._.............................-........................................:...................................................:.._...:...._...........................:..:.............. Owner PACHECO, LISA �- ) Co-owner Streetl ; 6 NANCYS CAN I street2 I ' �ceuro.xccmm�ro a„r _rowrxo,r✓, .vu.v.... �w W... ' City�HYANNISI _. State$MA ~ zip 02601 Country Land Info ..,._.,.. _....... Acres 0.46 Use Single Fam ML- D01 m,I Zoning;RC-1 Y "I Nghbd T, 5 I Topography?Level I Road,Paved Utilities Public Water,Gas;Septic -ro�,.. �� Locations Construction Info _...._. .....___._..__..-_...._._...m__._-__ _.__..___--.._......... ..... _.._... _,. ..,. __,.,-....._ _, _w.._.,_ _.. _.._.... ___ „ , .,.. ...... Building 1 of 1 Year —„ 1983 �.,�,.,.�.� I Ext Roof Gable/Hip✓ ✓ Wood Shin le ..,,,,,, Built Struct Wall ./ g Living F,- ,,, W Roof,-- AC t . 2314ph/F GIs/Cmp None _� Area Cover�As Type Style IColonial In D all Bed 3».Bw� ,,�., .edroom s I I, Wall, Rooms3.,,, <p�, Model�ResldenUal I Int SCarpet� I Bath `Full-1 Half I Floor Rooms Grade,Average Type Total Hot Water )Rooms Stories 2 Stories I Fuel,.Gas � I Found-ation rPoured YConc. Gross 2,....,, Area 14405 Permit History..... http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18273 . _ 11/28/2017 Parcel Detail Page 2 of 4 Issue Date Purpose Permit# Amount Insp Date Comments 6/27/2012 Out Building 201203635 $0 000 AM 12:00:0:00 SHED 1 OX14 12 3/13/2012 Swimming Pool 201200854 $24,550 4/12/2013 INGROUND POOL W 6' 12:00:00 AM STOCKADE FNC&HTR 5/18/2009 Remodel 200902077 .$3,500 9/23/2009 MUNIS HAS EXPIRED-FIN 12:00:00 AM RM IN GAR TO OFFICE 4/1/1991 Addition B34269 $5,000 1/15/1992 HY GARAGE 12:00:00 AM Visit History Date Who Purpose 5/17/2013 12:00:00 AM Robin Benjamin Bldg Permit Completed 5/27/2010 12:00:00 AM Paul Talbot Drive by inspection only 5/26/2010 12:00:00 AM Nancy Finch •Bldg Permit Completed 9/23/2009 12:00:00 AM Mike Keating New Construction 1/13/2001 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 5/15/1990 12:00:00 AM ML Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 10/13/2009 PACHECO, LISA 24090/184 $1 2 2/20/2003 PACHECO,ARTHUR M&'LISA 16425/33 $0 3 4/13/1979 PACHECO,ARTHUR M 2901/165 $0 • Assessment History _ ......... ........................................ ......... Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2017 $181,400 $44,900 $53,100 $110,500 $389,900 2 2016 $181,400 $44,900 $53,100 $111,500 $390,960 3 2015 $194,300 $44,560 '$60,000 $109,000 $407,800 4 2014 $194,300 $44,500 $61,300 $109,000 $409,100 5 2013 $194,300 $43,000 $6,500 $109,000 $352,800 6 2012 $198,800 $42,000 $5,200 $109,000 $355,000 7 2011 $219,600 $6,000 $5,100 $109,000 $339,700 8 2010 $204,700 $5,600 $1,900 $109,000 $321,200 9 2009 $219,000 $4,600 $900 $160,600 $385,100 10 2008 $225,800 $4,600 $900 $171,900 $403,200 12 2007 $2251-100 $4,600 $900 $191,700 $422,300 13 2006 $205,500 $4,600 $1,000 $157,200 $368,300 14 2005 $185,000 $4,400 '$1,000 $142,800 $333,200 15 2004 $150,400 $4,400 ' $1,000 $164,200 $320,000 16 2003 $133,300 $4,40.0 $1,000 $44,000 $182,700 17 2002 $133,300 $4,400 $1,000 $44,000 $182,700 18 2001 $133,300 $4,600 $1,000 $44,000 . $182,900 19 2000 $101,300 $4,400 $600 $29,100 $135,400 20 1999 ' $101,300 $4,400 $600 $29,100 $135,400 21 1998 $101,300 $4,400. " $600 $29,100 $135,400 22 1997 $102,800 $0 $0 $29,100 $133,600 23 1996 $102,800 $0 $0 $29,100 $133,600 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=18273 l 1/28/2017 •• •. e :oo ••o •,e oe .00 ••. •, o .oe •,o •,o eo ooe •• •, o .ee •,e ••e o0 oee •• e. ee ••e •.e ee eo eo ••e ••e e •ee o0 • ••o oe •.o ••e •, a •oe ee o ••• oe •,o •,o •, o •ee ee •• .ee `•e •,o ee • eoo •: .eo •,e •,e ee • eoe •:. .oe ••o ••o eo oeo 4 r 1 �✓ �is i,, �� a�r � c � try�'�'�� P -,gm v \A 5� g �e gas 4I1'1cJl� hz L% 3 5z Yid R, p ` v ( iEg t s ^4123r2009 12, ?p s r ? met a era-a�w�\u����o�\\\��_� r g������ ?'�'§`�� "& � �\ �'. r,ai..rh; as � \L ���"m � ay• ^i�C :. y � �o vA�enVpva AA o�iw ;ti's�`^� .�ak �� �....���\•.«.,�a ix� ��,,\\,,,`�\ �k� Q� '+`•�\.... `� >_ .. \ air , "A?�� e � � eke• • � 1" � Parcel Detail Page 4 of 4 u X gj4 d k�!— � M 1, X"•�'"�`t� �- � w f� i A S �3 R•e�, . a off, a„ http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l8273 11/28/2017 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 5 V. ` ` � 7 / p Application' # Parcel Health DivisionDate Issued Conservation Division Application Fee Planning.Dept: Permit Fee' Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis r r Project Street Address Village dl GS Owner_USA 11E a Address Telephone 3(�& 73 - WoR Permit Request (..OAI1�i A)iled rIA �' %�fl.L l- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation _3560 Construction Type Lot Size (o Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ' Two Family ❑ Multi-Family (# units) Age of Existing Structure o� Historic House: ❑Yes U-116" On Old King's Highway: ❑Yes U-N66 Basement Type: 0"Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) W Basement Unfinished Area (sq.ft) 7� Number of Baths: Full: existing: Z new Half: existing new 0 _ Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Roo Count Heat Type and Fuel: (, Gas ❑Oil electric ❑ Other Central Air: ❑Yes 9, Igo Fireplaces: Existing New Existing woo s' al stove: ❑Yes Ur o Detached garage: ❑existing 0 new size Pool: ❑existing ❑ new size _ Barn: ❑ sting ❑ nevi size_ Attached garage: Wexisting ❑ new size _Shed:(existing ❑ new size _ Other: c.r; ,-- Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ' Commercial ❑Yes 2<0 If yes, site plan review# Current Use©� ��� �v�r 1 Proposed Used ' APPLICANT INFORMATION (BUILDER OR HOMEOWNER) . C Sze Name uS ��tZ �a Telephone Number !. ' 7� Address _ � c License # YiUIS /w- e2,0 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE Ct74V DATE Z- r FOR OFFICIAL USE ONLY d APPLICATION# DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE OWNER If DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING I� DATE CLOSED OUT ASSOCIATION PLAN NO. I . �f 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 Applicant Information Please Print Le 'bl Name(Business/Organization/Individual): Address: VMV City/State/Zip: VIq MA b5 I A4. 63k f Phone.#: 6jY--731- /d 2S Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-tim.e). * have hired the sub-contractors 6. New construction ..2.El 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 working for me in any capacity. employees and have workers' 9 Building addition [No workers'-comp.-insurance comp. insurance.$ re ired.] 5. 0 We are a corporation and its 10.❑Electrical repairs or additions 3. am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself.(No workers' comp. right of exemption per MGL 12.0 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 N I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. If the subcontractors have employees,they must provide their workers'comp.policy number. Iam an employer that is providing workers'compensation insurance for my employees Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self-ins.Lic.M 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. I do hereby certify r the pains and enalties of perjury that the information provided bov is true and correct. ature: V� Date: 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): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: l 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 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 fo 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 Cornmouwealth of Massachusetts }department of Industrial Accidents Office of Investigatims, 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 ar 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia ?ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (790 CMR 61.00) Applicant Name:- Site Address: print Town: Applicant Phone: 31-7�z�' Applicant Signature: Date of Application: c f l NEW CONSTRUCTION: choose ONE of the followin two-options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND TWO-FAMILY BUILDINGS MA��nvrtlM 'MINIMUM Ceiling or_ Slab Option 1: Fenestration exposed Wall Floor Basement perimeter U-factor floors R Value R-Value R-Value wall R-Value '�UE HSPF SEER R-Value and Depth National Appliance-Energy .35 R-3 8 R-19 R=19 R-10 R-10, Conservation Act(NAECA)of 4 ft.- 1997 as amended,minimums or eater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: RES check Version 4.1.2 or later variant software analysis must be completed 780 CMR 6107.3.2 REScheck—Web which can be accessed at http://www.energycodes.Roy/rescheck/ ADDX� OIVS:OR ALTERATXONS.TO EXISTING BUILD]NGS.0;� 5 YEARS OLD* *buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b_ a) SF 100 x — = % of glazing (b) Glazing area equals SF a If glazing is<-40%.use the chart beloW. If glazing is >40 %pr9ceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTLA.L BUILDINGS MAXIMUM Iv9NIMUM Fenestration .Ceiling and Wall Floor Basement Wall Slab Perimeter U-factor Exposed floors R-Value R-value R-Value R-Value R-Value and Depth .39 R-3 7 a R-13 . R-19 R-10 R-10, 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e. not compressed over exterior walls, and including any access openings). ' SUNROOM—An addition or alteration to an existing building/dwelling unit where the total glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form found in Ap endix 120T i Town of Barnstable o Regulatory Services .� snrsrtsr"Le Thomas F.Geiler,Director r+tnss. 9q,A 1639. A��� Building Division rED MA'I 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: 1, 0 i I jr JOB LOCATION: n�um�byer,,n �p street `� -7 p��/S� 6IO village "HOMEOWNER": Wy!� �/��� 60�-/ 3/—7d'(/ l& name home phone # work phone# CURRENT MAILING ADDRESS: & t 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 re u' ents. i attire 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 form/certification for use in your community. Q:\WPFILF-S\FORMS\homeexempt.DOC r THE, Town of Barnstable Regulatory Services 8AR Thomas F.Geiler,Director AS& Mnsa. � 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 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. Q;FORM&OWNERPERMIS SION r lr v�n��� sly. obcR .� r D 1 l� Date: Oct. 5, 2017 TO: Building File FROM: R. Anderson Permit/Inspections Request 2009 Permits Locus: 26 Nancy's Lane Property owner came in on 10/4/17 to request inspections on two building permits (pool & garage) as well as electrical. All permits were pulled in 2009 by.",.' the.home owner as the home owner performing the work. Bill Amara provided me with a copy of the section of the code that clearly states any work dormant for 12 months requires a new permit. I gave a Highlighted copy of this to the applicant. The applicant also wanted inspections on the two aforementioned building permits. Jeff'was not available but I made the applicant aware that Jeff and B had a discussion about the dormancy of-these permits and I believed that.Jeff was..requiring new permits as well. I gave him Jeffs card, identified schedule and advised him to email Jeff'to confirm all information. the ,applicant_;then.wanted assurance;that. if-there--were.any code zhanges' nce the 2009 issuance date that he would:not be held to that standard I ; .. said I &d riot know that he. must speak;to Jeff. The applicant added that he was a little upset because he was iw 2 weeks ago and.the .admin staff said he was oks to continue.with the work. I apologi I ed and said that admin. staff is not inspectors and they cannot possibly be responsible for knowing all of the code changes that may or may not apply. He agreed. i , 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application (� L� Health Division Date Issued Conservation Division Application.Fee J a Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project_-Stree"t Address 1c�Cy / I0 n Cu Owner.=-r=- 3y C, z�- Address ,=D 4a flQ n tTelephone_- J�� 2 - - -7— -7 ,Permit-Request;-�-M--- nn I S 'srb G Kok © � P C. � ��!.0 cry y 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 4ProjectyValuation �SSQConstrui' Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family U-' Two Family ❑ Multi-Family(# units) Age of Existing Structure / 4ac5f,J/!SHistoric House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: mull LJ Crawl ❑Walkout ❑ Other a Basement Finished Area(sq.ft.) Basement Unfinished Area (sq„ft) Number of Baths: Full: existing new Half: existing nebq Number of Bedrooms: _ 13 existing _new € Total Room Count (not including baths): existing new First Floor Roorr Count ` 92 Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing 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# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name_. _ tTelephone.Number; Addr6-s9--.=0"5 License# l S Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S,IGNATURE.. 4 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED r4 MAP/PARCEL NO. -ADDRESS VILLAGE ( Al OWNER r DATE OF INSPECTION: f FOUNDATION : a ^FRAME INSULATION' 't FIREPLACE ELECTRICAL: ROUGH FINAL d u PLUMBING: ROUGH FINAL -GAS.: ROUGH FINAL a ._'FINAL BUILDING r DATE CLOSED OUT' ASSOCIATION PLAN NO. r r "' Commonwealth o�///aa�acella Official Use Only Permit No. 1�,2!4 /f r2® ' eUeParlment o� ire�ervicea Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C), 27 CMR 12.00 (PLEASE PRINT INWK OR UPF ALL INFORMATION) Date: Q� City or Town of: 4-N A16 To the Inspector of Wares: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number)J6 H ime l Owner or Tenant W Z} Lr_ f_aG Telephone NO. 6U-737-7?2-P1 Owner's Address 212 Is this permit in conjunction with a building permit? Yes No Check A ro date Bo P l g P ❑ ( PP P Purpose of Building l21(n/d g IU_J_7 01fl' a Utility Authorization No. e.-)r Existing Service-200 Amps . I / Z PVolts Overhead❑ Undgrd�' No.,qf eters 1 New Service s Amps / Volts Overhead❑ Undgrd❑ Now Meters Number of Feeders and Ampacity - { Location a d Nature of Proposed Electrical Work: fAl C 1 C-N C 1 S "qA p wrL®ry' _ - (— L f M o GJD 2 Q vr Lk15 U11 16 " pro n 0I-F(c/r �s r2d 17-toIV k /C,Q0',,40, ,ILQ. tot t re Ov,- Cat I` Completion o the ollowin table ma be waived by the Ins ctor of Wires. otal No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.o Transformers KV KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ n- ❑ o.o mergency Lighting nd. nd. Battery Units No.of Receptacle Outlets .f--) No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o Detection andInitiating Devices No.of Ranges No.of Air Cond. Total TonsNo.of Alerting Devices No.of Waste Disposers Heat PumpNumber ons KW No.of Self-Contained p Totals .......... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Municipal Connection ❑ Other No.of Dryers Heating Appliances KW SecuritySystems:* No.of Devices or E uivalent No.of Water KW o.of No.of Data Wiring: Heaters ISigns Ballasts No.of Devices or Equivalent No.H dromassa a Bathtubs No.of Motors Total HP a ecommunications Wiring: Y g No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: , /(d,�� (When required by municipal policy.) Work to Start: ! G% Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER..❑ (Specify:) I certify,under the pains andpenalties of perjury,that the information on this application is true and complete. FIRM NA LIC.NO.: Licensee• y Signature IC.NO.: (Ifapplicable;enter "exempt"in the license number line.) Bus. e. Address: t.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License. Lic.No, OWNER'S 1NSURAN W R: I am aware that the Licensee does not have the liability in ce coverage normally required b law. B y:1g! e b low,I hereby waive this require ent. II7am the(check one owner ❑owner's agent. Srgn / e \ Telephone No. . J��-/�Z� PERMIT FEE. $ D2S,Q� i 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 Applicant-Information Please Print Legibly Na (Business/Organization/Individual): j . dvl &U&0_a Cry/_State/Zip.:y �� � Phone.#: �a ' 7L37" Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4: ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑N construction .2.El I am a sole proprietor or partner listed on the attached sheet. 7.. emodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.$ r ired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions I am a homeowner doing all work officers have exercised their I I.❑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.❑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 ffidavit 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 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. I do hereby certify under th pains and penalti s o erjury that the information provided abov is trueand correct Si ature: Date 117 _ 7 � 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#: Assessors map 9-0 lot number 1'... eF,/ toy THE Sewage Permit number ......... .:...../r,....... BJR3STLU i House number ............. f =� �^ '� ��9. ".... s,z6 - TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .`.: .....••..69214 A....... ......... ........ ......... ......... ............................ . TYPE OF CONSTRUCTION � . . .. . .. ................. g AR ... �. TO THE INSPECTOR OF BUILDINGS: The undersigned .hereby applies.,for a permit according to the following information: Location ......... - !!�i'�/i .e....! :........... 'S ............................ ... ......... .......... . J ProposedUse ....... ......... .... ... .....�.. ....�... ......... .......... . ....... ......... ...::.... ......... ....:.::. ..... Zoning District ........ .14YA .. Fire District ............i '?� !S S Name of Owner a ►.I 4.. g!.0....Address tR.....�.�...�� ���� ................. ? tL`i' Name of Builder' .... FIR ..........................................Address A�, �' '.! ..T �. 5 m PAvt-- + As.: .. V0600 t S Name of Architect ......... ..... .................... . ................Address ,... .. ........ . ...... ...................................... l Number of Rooms Foundation Exterior ..... ��..... tn� �, :'�+............................Roofing ...... . "?y �-..t. .......:� .;LAI..'',L•��................ Floors ............. IQ : ................ ......... ........Interior .......... . Heating ............ -.......... ...... ........ .......Plumbing ..... ....,. ......e!i, ' iS .......... ....:...................... Fireplace .......n✓ W.. .AI M..0 .................. ...:.... Approximate Cost .. . . �? Q ..:. Definitive Plan Approved by Planning Board ---------------___------------19_____--• . _ -- Area. .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 G tif U\ � J&V, M 2V." 13'6� 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 . .............!... ............................ PACHECO, ARTHUR M. A=250-110 24516 Two........ Story No ................. Permit for .. .......................... Single Family Dwelling ............................................................ . Location „Lot, #15, 26 Nancy's :.............Hyannis....Y........................ . r Owner ....Arthur. M.....Pacheco................. r Type of Construction ....Frame........................ t ................................................................................ Plot ............................ Lot ................................ November 4 82 -- Permit Granted ..............................'........19 -' r rt Date of Inspection .. *19 ; Date Completed � 19 S �- " l �3 a ` f i i i ...-4y�h1P ru, ,irw.,:m,r tp.n..[}�.n.,sv,� .aa. � w'". x.zJKF \�a -t> ^w. .f, .,. r+:_. y+-i.s..,.e•=*a- ,+:y,+ ,.r .j Assessor's office(1st Floor): Assessor's map and lot number 'E>o` Board of Health(3rd floor): Sewage Permit number .- 2+ D6Ba3TULt J Engineering Department(3rd floor): // T true House number �O '` °o, 03'9• \��'' Definitive Plan,Approved by Planning Board 19 a�AvA. APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P:M.only t ; i TOWN : OF BARNSTABLE BUILDING kINS1PECTO*R $.-. APPLICATION FOR PERMIT TO 8 vi L�V GA,e&.,,E TYPE OF CONSTRUCTION j l�s 19 Cl/ TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a permit according to the following information: Location c26 A14.,,e-y tt [-r•- H VA�—N"S r -YrysS- z Proposed Use GAAAt-,E J� I Zoning District _ / Fire:District A Name of Owner M• c o Address a(v A A,# y S E • Name of Builder 44"rHvR l`� ;Dft4W6(o Address S't-E i i Name of Architect Address --A r I Number of Rooms Foundation G o►..c.R E TE Exterior S 4&"GLE S Roofing A /HA•t.T Floors Interior ; K.o C* EX 57-/"(. /1--� Heating Y7t Plumbing t ,II Fireplace \ Approximate Cost S'l o o o Area s 7 G 5 R Diagiam of Lot and Building with Dimensions ' Fee� , Od I 1 /0-0 _ . Z 2� 3G rK �V i OCCUPANCY PERMITS REOU.IRED FOR NEW DWELLINGS a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the:above.construction.f Name _/-- Construction.Supervisor's License . p3 t 8 o a- PACHECO, ARTHUR M. A=250-110 No 34269 Permit For Build (2) Car Garage Single Family dwelling Location 26 Nancy' s Lane Hyannis Owner Arthur M. Pacheco Type of Construction Frame L Plot Lot Permit Granted April 16 , 19 91 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED r i" opt ra,,, Town U Barnstable Regulatory Services anxxsznei.e, MASS. g Thomas F. Geiler,Director . �p 1639. �0 rEo 3�a Building:Division Thomas Perry,CBO Building_Commissioner 200 Main Street, Hyannis,''MA 02601 www.town.harn stab le.ma.us Office: 508-862-4038 Fax: 508-790-6230, March 8, 2012 Mr. Fred Scherer 121 Cammett Rd. P.O. Box 156 Marstons Mills, MA 02648 ' Re: 26 Nancys Lane, Hyannis, MA 02601 Dear Mr. Scherer, On February 15, 2012, application was made to install an in-ground pool at the above referenced address. The application contained no details about the gate indicated on the plot plan. Numerous unsuccessful attempts were made to.contact you. On March 8, 2012, photos of gates identified as being located at 26 Nancys Lane were dropped off at this office. Please be advised that at least one, if not both,,of the gates in the.photos fail to comply with 780 CMR (IRC w/MA amendments)AG`105 and therefore the application must be denied. The fence/gates ate the applicant's responsibility as acknowledged by.your signature on the Owner's Letter of Permission form. If you have questions, please contact this office. s Sincerely, Paul Roma Local Inspector Enc: letter of 10-5-10 from this office regarding open.permits �oFE r°,,ti Town of Barnstable Regulatory Services vI'E'g Thomas F. Geiler,Director . �A 1639. ♦0 rfo ,�a Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038. Fax: 508-790-6230 October 5, 2010 . Warren Scherer 121 Cammet Rd. Marstons Mills, MA 02648 Dear Mr. Scherer, It has come to our attention that there are many pool permits that you have obtained that lack final inspections. In order to avoid further action.from this office you need to arrange final inspections on the below. You must obtain all required inspections. A final electrical and in some cases a final gas inspection are required prior to the final building inspection. 200705191 - 55 Lisa Lane, West Barnstable 200706142—59 Saddler Lane, Marstons Mills 200800421 —636 Scudder Ave., Hyannis 200804624—982 Santuit-Newtown Road, Cotuit 201004618— 15 Nelson Lane, Marstons Mills Thank you for your attention to this matter. Sincerely, drrL uzon Building Inspector 508-862-4034 PFI ' \W LES\LAUZONJ\POOL LETTER c e S\s h rerwar Q renshellisland2010.DOC - t i i I I I REM 1��LY B�NinIfi$ 4!✓� ,yy. +�./r�' fit N'4 9 '"4tc q r t a ♦ x t. t;�.kspis.�24 aY _' 4'R�,• i sm '� j ® ,Bt' -� rMl'�r��r e�$ r 3 �r'���t �y�y.'S � -_ �jai�.....,x�•, CAR ANAIR 040 14 Y Y i i a> to" 4t� -� � 1 . vif/n ��B \A"�>e - .'ti f /G{. nn"sv�� z7 Y �t�•A B��s'" A pr r t r ), fi. �a _ FF • Rx IN NUMAS J lit /ti•. �d II J?' r a -, ti,+, j •i N iY> F � 8% m.ri •` of 1.4 i� 3iC�ri� EN-1 ��� ems: 1} � ri' p 3a r3•seSvj'�e,��rr..r` •_ ;I r t4�.'� qg,rs`�t f � t7(�� �:,L.,3r"'�`� �.��, � `� S[ '-" �"��.�F/n �• 'r �i.�'`+�{{ f�'°�-�.tea irk'w; I � .� rod. y�� .•... .�;, _ �W 7 "m!. �T �� a .�,��_ s i9I! J e k°� ¢•ae F� �It s� y �'�"�ldt��. �s����C�€a�`r. '�(Q�aFas� et�f� � .,�,�%�{;�����lf Qaa,l� . g� nj�.4 i .. ,�:�b IC�� �8)rr9 t �F�ry3$ F �T1��'r' `'I<i� C F, 01� ti � fi 4 a -�� r ��' � t y3s} r'rn�� ��6 .r. �sl�y��}'.��6 a1 ���1•i ' �•' � � +sir. � �. a. �r �_„�.. a k�t, •'Sq ��ai1�� 11� 1 Ig k° •sP�- � -c r�' f' ��;'" � � 'eY w 9 '1'/'�`b � t ;a: �?€��r�� Yam. I ��►` � t•�•, � ��a t� �+d� �,r �~ � ��� �SZF k� �J^' 3'4' ��'�� 1,� f!�� 1� � 4�+f �R" �.�} f�na R�� � } ram•i m-^•s�..•s�6..'�� � � i�1' � pp •. ��. r 4� �r 1 �� 1' a , a� t -4 I XMIti .gin f� 3 t F��•� � .�. S� "�� f''I �'� MRI d iJ ' g, A � �,�• �,�r her��� . -a..�A*t� ��is I >t �. ,f, t%� � 9i f .ems... �s,`..{t1'S �. a s+sa' r � i r �.� �$q�'4��t•s � S !,^'F'4 "'S '��• :u• 2- 'E FjF'+�" l �� F is '• ! �6�� 'Yf �:�� � '^� �� �.2 S Y A '� : ff( Pb1 ,r': N .r. ,.A�13 RkL7:�.i ux'a r�..1,'.d sr4 ft rf' `y.� 'af d•�V' :s wsy n. al�."war J brrtD ''t N��'.'"�. ��v: �����+"'er ,��•�*'�,;*: � � a4\�•."�i�t i 1�s3'; �i�r��i r�C�'d; ``''�y�yyyr .y`�,Y�� �gYlsJ1y�1+� f(�� � �� � � a� :P�,as :5 9s s/�r ��` l �� '+. to.a s���•,. 4`"^ yi � 4" i`Y� ,( .,I�'1l��IID fie y.P 'Nt� 9�f Rr/9? T)Q� �•t �4i1£. f 1+ t�\ �F4 a q!f ,4'sY+r $' -"'Pt` .. � .g r.�F'�, t /i Cr - a�4 ^��1r+i>ir,lQ�t! r t •'ti' �: t Oft, d, �'1t L 5 Y .y 2.\r 'Yj _ 'O�•; i r \� 4� J r� >r gr /� rC 7 tc v g- MAN , rs� � ,� �re gs.1�' ��t�. �t,�. c; � '�•tlee��'�'z rl �•+,g'- `,t�`°** '3�� fs�� xp�,"s�K:.'`3X .z` ..,•, i5--/2� '2r�d4 -' I Nei r , �. F EEEITI L UsTED P P0 OoL' ALAM $.ETL Tested To Be In Compliance With Standard for Safety, CLOSED LOOP' . UL 2017 and Florida Building Commission Code Requirements,'Fer ETL Listing Number 3035022 ♦Exceeds Operational Requirements of Model Barrier Codes '� y ♦Microprocessor Controlled $Monitors Entry to Pbol and Spa Areas $Instant On Or 7 Second Delay Models Available $Surface or Flush Mount Models _ • ♦15.Second Adult Shunt ` ♦Low Battery Alert Recessed Surface Mount ♦Built-in Back-up Battery Capable •May Be Hard Wired To Remote 12 Volt maximum 500 mA Source or To Plug In Power Source. Applied Voltage Must Not Exceed 15 VDC. The new GRI DOOR ALERT/POOL ALARM was designed as an aid for prevention of an unattended access to a pool/spa area by a small child. Monitoring all doors or windows with CLOSED LOOP magnetic reed switches,the DOOR ALERT/ POOL ALARM will sound an alarm should anyone too,small to manage the adult pass thru:feature attempt access to the pool/spa area. For maximum protection all moveable openings should be protected in such a:manner by the GRl DOOR ALERT/POOL ALARM. ASSOCIATED ALARM SYSTEMS, INC. 1047 FALMOUTHI ROAD' HYANNIS 5.MA 02601 508-775-3'442 800-322-3339 r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) l fob Mass. Date ; I 19� Permit tt �ro ` n ulr >�anh�_ r Building Location o°l(2 1 1 Ll�( J^ 1�1 y Owner's Name 1�111 Type of Occupancy New Renovation Replacement ^ Plans Submitted: Yes[ No W A N N u CC �. _ M 0 .% , ¢ 0 u m O u '< ¢ ¢ O O O < m N Q W < W W N W Z < � Q 2 W 0 1- Z J F Z O > W < W < C 3 �" r -K W m Z O a O Z W< > CCW 2 < ¢ < O O W O � ¢ s o s66 ; c o J u e > o a ►- o sue—aSMT. BASEMENT 1ST FLOOR 2NDFLOOR 2RD FLOOR I 4TMFLOOR I STNFLOOR 6TNFLOOR 7TM FLOOR r8TH FLOOR Installing Company Name SNow,q PT.nmRTNr. & HFOTTNr. Check one: Certificate Address P.C. Box 39 ❑ Corporation W BARNSTABLE. MA 02668 ❑ Partnership Business Telephone 362-9111 Firm/Co. Name of Licensed Plumber or Gas Fitter CHRTSTQPHFR SNQW INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes EX No ❑ If you have checked yU. please indicate the type coverage by checking the appropriate box. A liability insurance policy p( Other type of indemnity❑ Bond C OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: ` • Signature of Owner orOwner's Agent Owner(] Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above plication are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issu III applicatio will be in complian ith all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the Gen By T of License: Plumber Signaffirof Licerilliod-P10hbeFor Gas fitter Title Gasfitter Master License Number 10705 Otvfrown Journeyman � - 1 �4 1 � � 1 I �a �g 7. ��v a !� PL sd4g l �5 1 � ♦ .' ik. ........+�.�� ,I� ate w Y ' f 6 44 t s — e •k w--�e pc ly TY • C i• frT i a Y T � Assessor's , lot-,'number ..r�... ... ........ *THE Sewage 'Permit nurrober ......... .SY3-.... ... ............. ..... d� ♦� ;.. / p y House number .. � {h.... ASBST MAl6 • - ''�•i639•a D ypY �SEPTIC SYSTEM RAJ N OF. ` AR T B . E 6 2> , � �� r. NS A L �� WITH 'TITLE. ENVIRONMENT AL -DOE N�u ' 3 : SOWN REGULATIO s BUILDING . INSPECTOR APPLICATION FOR PERMIT TO N RTli/R .....: : �Q ...................... . ............:............ TYPE'OF CONSTRUCTION ® Y ®� Lr../!` �?:...... r � a� ..19..P:x TO THE INSPECTOR OF BUILDINGS:The undersigned here_by applies for a permit- according to the following informations Location ......... M' /"�A!✓d .y:..s✓I ���.......: N !"...e.� .........�. !`�E........ Proposed Use rYl1,Fr✓>e� �Z LDS il1�N ... .Zoning District ............. 51 .. : Fire Districts: . ........ Name of Owner . R � . .. �1 L1 ECc� ..Address ............................p l ,C ..... .... ( �"'F Name of Builder' ...:••A�1` `'R. ...�.:.... ' 1� ...Address ....:..: ......../�} LsF� . 9..f.....m6o�Aj 1.�. .. Name of Architect .... !?i.V.0 i- .......G1A.J --............ Address C/• EA31.-....JRleH "..................................t.��©t Number of Rooms ........................... ...................................... Foundation .....leq!- I K4Q .t1r�. .A.� ........... Exierior ..... � �. ��.. �. Or£✓!h:°—. ...... ..........:....... Roofing .:. E L. ........ A ✓ r ..� ............ ... Floors ..........!nA :.PS ................................. ..... .Interior ......:- �. ...................... .......... C� 3 Heating ........... h�E.�.� �i....................................................Plumbing ... - 6. ....... ........................................... Fireplace ........�� r .... �►: ..............................................Approximate Cosh........ o ..... (� Definitive Plan Approved by Planning Board ___.____ ____:_____.____19________. Area . ........�.✓� . ... : . '.. of Lot and Building with Dimensions Diagram 9 Fee .........�.. .......... ........� . SUBJECT. TO APPROVAL OF BOARD OF. HEALTH f 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 . ,• Q ............................... r,PACHECO, AR3'HUR M.•/+ zV r 24516 Two Story - = 0 .............. Permit for ........................ .... ' Single Family Dwelling 4 ^, a ................................................... ..... anon .................Lot #15 26 Nanc ' s Lang 1 rY ? Hyannis - - Owner Arthur M. Pacheco -- 4 ......... .................... Type'of Construction .....came............. .. .. . ........................ Lot................................. Permit Granted ..... V. er. .4 .......19 82� ' s { Date of,Inspectio ° �?!.. J, �....19 f �� ` r Date'Completed .. ... �o.... �......1 ' - .. b_ t �, .. - - '.•.+erg � "'•• �,.� "" � � _ `.4C, -� ,.,_YT%• �•, �. .. _ ki � - .. �.p i 1 f . /7f N m i� '2o, 460 i RICHARD bpi BAXTER H No.24048Q CElZT1r-tEL7 ipt_o•r F@SSTV& y0� 4ko SUIN LocATIO" `�Q.I. �, e, C�sZTtt=� Tt4AT THE FoL)9bATlol�'5taotiul l pLAF.I TL�i=E��t.1GE 4-1t:t?E aw Go►MPt,�lS W t rA THE AuD SET13ACbG K'C-AVIREMctJTs OP TN n ToWW of Q2ty�iZ'{�13 ON A."tD lS ( pT' L L• �. lW F s8 >r04A, f ..WCTi t abn BQXTCIZ uYF t�tc.. to-2'"�-�'Z. tZeGlS'tz-aZED 1_ Wo SVev`YotzS THI5 PLA14 le, UOT ZA5E'O v+-� A�J o5TE2vu-La o MASS, cwsr u,c�c�.lt SvRvcY ¢ Ttae tee- ,arrs 61401Uw annul cn.►�-r pM� �. ..�.n�r �2Ti ��16Gcv Assessor's office(1st Floor): 1C SYSTEM ���"BE Assessor's map and lot number ® � (+i,.:s ALL Q�o�t"a>o�` Board of Health(3rd floor): "`(((1lltltltl E�IN COMPLIANCE e'er Sewage Permit number WITH TITLE y Engineering Department(3rd floor): ENVIRONMENTAL CODE AND ;Dsar�suranLL ` House number TOWN REGUL.A�'NS 00�02639-YAK d\,� Definitive Plan Approved by Planning Board 19 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 Vl t_0 GAkhLE r TYPE OF CONSTRUCTION t c-o010 19 `2 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 4 e n.a v e-�J tt �;/�'' H yy"Ni Proposed Use GAAA&F Zoning District — / Fire District Name of Owner d9i: aff /i't- 26C#e c e Address y 1 ti S Name of Builder 4-TNvrf I`► Pfte'yE(-o Address Name of Architect Address Number of Rooms Foundation C o,.—C X ETC Exterior S if 6I✓E 5 Roofing i95 P H/t1"T Floors Interior MCA Heating Plumbing Fireplace Approximate Cost o y O ,P-4 Area S F 4 � u Diagram of Lot and Building with Dimensions 8 Fee , O ool 1 11 1 em t e--, C�L 4 r-4 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 "— . , . ;j Construction Supervisor's License °�' PACHECO, ARTHUR M. ' No 34269 -permit For Build (2) Car -Garage . Single Family Dwelling .. Location 26 "Nancy ' s Lane ;`* -. " - _ ; - ^`_.•. -' ` - ^r Hyannis ` Owner' Arthur M. Pacheco Type of Construction Frame �r Plot y Lot s Permit Granted April 16 , 19 911 s t .1 ` Date of Inspection 19 F p .;D Co 'p eted ih Z 19 M kv „` t6, i r e� f ` III • ) A r Abe` 'S LA . b /7 f �pj ctl FFa. N --- N m H ILL o e � 4L p,Oo L 1'Lo-vo a tK OF� RICHARO GN A. . BAXTER y nto.2ao48 SUIN LOCATI0" Q.I�►� Cr-RT1F`l TkAT Tldi= -OLWbQTJoi�%AauQ R�-At,l R�FctZEa1GE Wr--ZMMW CCOAPLYS WIT" TI-AG -rjID-E.LTwE-- /S.tJD SETBACK - WC-AUIIZEAAEWTS OP T14C- Tow tJ of -43p- 1 -e T'A-6 LS. A."tD I5 1.(OT• PL . �L• 28 : rlo •. t.� - oGA rr=V'. Wl'Ti-11 C ooD aAT� . _. .�,� _ - REGISt�tZ�D LALIp 5t�evGYo2S T141S pLAW IS UOT BASE'S OW 41-1 OSTE2V1t_lG o l�(AS4, u.dStr��Jrtncc.iT 5v�v�-f ¢ T4�� o��,��Ts S�toe��n APPt-t OA."T �n-r, tt'�Gt�EGp Field a 3 q 6300� FRMI 0 '. ,# '. PROM '067ONC09 yi SPEC CONd � ' 6 s ac `t ; i 5 BU0.DIIJ5 FRAME i 4' 3` 0!'" x✓a2' All NEEDS MORE VENTUdG IAIDER FL00R ,�. � � � E7� g5 Vip20111 . t r p r 3r aYi :3 taab f� 6300. §^Y GRUI 0S �:.; .:. F s �, BUllDING GAS ROU 1 r` etQ 0 ..;:,,,.W.. _-.. y f¢ ........ ! � ae y 6300: I INSI =a a a0g a rna ,r.„ PROM 1512 9 J. 00 BUDDING INS It�I adp 0 „� 06.Fb "I 6300. PFNI PLUM FIN atgs� 0 m _ 6�0:. e> PRUI C. a__ BU6DING s PLLTIRW 1 :. h'xs LS„ Town of Barnstable CD ry Services j Regulato L Y r Thomas F.Geiler,Director Building Division w Tom Pe�c rry,Building Commissioner 200 Main Street H i , yannis,MA 02601 www.town.barnstable.ma.us w Office: 508-8624038 Fax: 508-790-6230 PRRmM 3 3� FED: $ Lv SHED REGISTRATION ' -200 square feet or less Location of shed(address) Village st Property owner's name Telephone number Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront Historic District? ZZ— Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required)' Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: IF YOU AREION �.' COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APOF PLICATION CA OF THE ABOVE PLEASE SEE THE APPROPRIATE COMMIISSION FOR DETAILS. ON FED. , THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN I Q-forms-shedreg REV:05201 o, . b of _ ~ m mo RIGHARD BAXTER nw.zaoasQ - LEIZTlFI�t� pLb"T" Pt..b.0 sulti LocATIo" arJ lJ i 57— t. G6rZTtF%( Tl-lAT T1-li= Fool >xTlol�5�larv►J pt-Atil IZ P, t•��Eat•.� COv1�PL�lS. u!fTl-i �i'i-l.E SI nE.t.t►-1� _ I rb,t lD SE" nAc.4 Vc-:aUllZEAAawPP OF TNT "- �(o bcl U of _426 p2A 57A-6 LS. A,"t> _ I'S l4r. l:.oGAT�fl Wt Tip t V= 'lt�D P,_A1 Q BA.YTEt2 4* uYF 1"•1G. REGIS"rV-=X t> LA_W _SI��Vi=YocZS ``14l'S VLAW IS' LIOT l3ASE'Q O p�J OSTEfLV1LLG0, It.dSf�cJ�i/\GNT Sv .fc�{ ¢ Ti-W-a t.R•..':%rrt�'.iilf' 1'A'[".::. l:ai-1L� - �(7T,- AG!`lE�D The Commomwealth of � . Dgpm*neltt Of Industl'la Al d if eilfs D,Bice pfhvestzgati,mrr 4, ' 3 600 Washington Street Bostoi 11�U kI1I www.mas&gov/rlia Workers' Compensation Insurance Afbdav t:'BuRders/Contractors/Mecfricians/Plumbers. � r A-Pillicallt.hnfornzation = Please Print Le 'b ' City/State/Zip !�n i s:. Phone-# � 7 7 777 Ff an employer?Check the appropriate boa: a er �� I am a 77 � ectwith eral co actor�P�3' t� and I'loyees(full * have hired fe sub=coniractarsconstructionand/or part-time).a'sole pioprietor of partner_ listed on the-attached sheet. ciehng and have no employees These sub-contractors haveDemo an ing forme is any capacity: employees and hive wor1=1 �. workers' comp.msurance comp.insure. xk :9: 0 Bm'Icfing arldi on R red] 5: [] We area co=porafion and its I0.[]IIeclrical repairs a homeowner doing aIl work offices have exercised theirILE]P�mgrepairsal£ [No workem'comp. right of exemption pI,.irr,re re d tc. 152 Z 4 r12Roafr4� ] , § O, and we have no . eloyees:[No workers' L3• 'Other comp ice required] `�Y appli-nt that checks boa#I must also f!U out the section below sho wing t Homeowners who submit this affidavit mdica' ffiea workzcs'compensation poficy i r formation tmg they arc doing all work and then him oUtside contractors must submit anew aindavitindicating such Contractors that check this boa Est attached an addifia3e sheet showing the name of me sub-contractors and state wheflier ornnt thdse entities have' employers ff the sub-con' have®ployees, �7�atprovidt their makers' oIi warp,p cymm�bet. - Iam arc employer that isprovirfing workers'compensation insurance for my erizployees. Below.as thepolccy aizd�ob site information. Insurance Company Name: fi f r Policy#or Self-ins.Lic.# ExgizationDate: Job Site Address: _4ttach a copy of the Workers' campensafion policy declarafiou page'(shewing the policy camber and expiraitan,date): F" a Failum to secure covers as re �>ge paired under Secfion 25A of MCI,c. 152 can lead to the imposition of cri�iaat`penalties of a q -fine up:to$1,500:00 and/or one--year IIs 3`e �P as weI1 as civzZ penaltres in the form of a STOP WORg OKDER'and a fine'af up to$250.OD a day against Ehe violator.:Be advised thaf.a copy of this statement=y be forwarded to.the;QfGce of Invests Lions of the WA for in.Srrranne covers e verrficatian t. e.• ,J 4 ._� Ldn hereby certify under a pahuznd enalfi -+¢ ;'• P, penury that the information provided abope is a and Sianature:--T-� � ' `Date j Official use on y: 13o'rtot write in.this area,to be completed by city or:toit�n t1dalCity or Tows: Pei'miS-1License,Issuing AIIthority(circleone1.Board of Health 2.BmI ' De artMent 3.City/Town Clerk 4.Electr S..Plumh' # s fi. Qther p' ing Inspeetar Contact Person: Phone-# ,j 'THE Tow .n of Barnstable X. a Regulato . Services * msnatvsrnare # Thomas F.Geller,Director 619. Build><ng Division.: l Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 w,ww.t6wn.barnstable.ina.us_. - Office: 508-862-403 8 . Fax. 508-790=6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE; ^ JOB LOCATION: ,. number street, M village 4 g �Q rt, "HOMEOWNER L I S C� V C�C . I G�, �.�j" '� / 3 7 a X'. -=-name home phone,# work phone# � CURRENT MAILING ADDRESS: �,Q �iL�' S' , city/tpwn state zip code ` ?� The current exemption for"homeowners" .was extended:;to include owner-occupieddwelhngsbf six units or les's;and. r to allow homeowners to engage an individual for-hire,who does not possess a license,provided,that the owner acts as supervisor. DEFINITIONS OF HOMEOWNER Person(s)who owns a parcel of land on,.which he/she resides or intends to reside,'oil which there is;or is intended to be,a,one or two-family dwelling,attached ordetached.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, hat'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 tliat:he/she will comply said procedures and" r gFeme cSign ure-of-Homeowner a Approval of Building Official , f Note: Three-family dwellings coniaining,35,000.,cubic feet or larger will be required to comply with the { State Building Code.Section 12TO Construction Control. HOMEOWNER'S EXEMPTION a The Code states that ."Any homeowner performingwork for which a building permit is required shall be exempt from the provisions k 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 215) This lack of awareness often results in serio_us 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 perrnif application r 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 fotm/certificationfor use in your.community,.--," Q:forms:homeexempt d ' a Town of Barnstable Regulatory Services f RARMA UX MASS � Thomas F.Geiler,Director 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 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 (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all`final inspections are performed and accepted. Signature of Owner . Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS The Commonwealth of Massachusetts Department of Industrial Accidents Office jice of Investigations . a 600 Wash in'ton Street UTBoston,MA 02111 www.mass.gov/dig Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly, Name(Business/organization/Iq duat): �J e J (; 0 1')&_ Address: City/State/Zip: !"�I�f2c'�tt1S. c Phone.#:_50 s/(:;�K Are you an employer? Check the appropriate bog: Type of project(required):,' . 1.❑ 1 am a employer with. -4• [] I am a general contractor and I `* have hired the sub=contractors 6. ❑New construction employees(full and/or part-time). . 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 working for mein:any capacity. employees and have workers' [No workers'comp.insurance comp;insurance,# 9.' 0 Building addition required.] -5. ❑ We are a corporation and its 10.❑Electrical repairs or`additions Officers have exercised their 3.❑ I am a homeowner doing all work ��11.El 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.❑ 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. $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 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 unprisonnient,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 the pains andpenalties of perjury that the information provided above is true and correct Sign e: X N' Date: �( �_z Phone 0: 430(') o -S 1 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#: r In O'CA © a x. s , � ® ® i . � 8'.DEEP : _:- p®. - o ® - - ,o ao va wlam / rr.r.i 1 . _ _ . 4W FMISN - t .{'"4p-FDVISN ® - •iQ -•i •1 - • _ ^SUED.au PANEL rn065 F.1 _ ' • ': .� •i ! __ T i _I 1 Laui;K=@RILE MME 'r_- ' 0 4 - '' ' •1 ~ ,' ? 1 t 1!t=55 11Y '© 4'' eA30T I8 \ a'-�6icnlmnatYL •1 n - .6 PGcp AS A m m" 9'OT]P : •}-- % .-� - _ 3II/4;Z fir IX=�21 1 6 - ' tQ 1 - - : 3Y ti• .. 4j. _ 115E maSET 4,IMS _ m . q 3 CII01%sys Otff.ET. \. II IIE�s7aEI I6- I-•' ARCA-5 a90.FF. PCLR.&T t-Ot _bNs-'I6I25 p5 ® 14 cl.cuION�B Aut2E Q A.'CA�.FwesA© P.�iexTTR 01od6]/! GA1tn<a-xwwo AE@A-64tf60.I t: PCRPf1 R 1"6 3/r GALLONS-::clan' CAPRi GRECiAN. ©. •©SY a/d,iP•e -`O RECTANGLE REVERSE RECTANGLE IV X 3r PMJURED-Also AURAME'w T1T,FOltDP IG ODES: OASIS ,C x" PICDRIFD-asa aVAXA1AE w THE F0J.01a1G SIZES: 10•X PICIIAIED-AISD AVAXARL4 w 1fE FOl1D?NO 51715 93 A2EA(SOt2) PEI'aihT@t CA1A011S Ir x 3C:PKRkIED-ALSO AVARAIVE N lW:FOUDT"92ESL - 92E. AtPAL50FTJ TWIER 'OAtL.YAIs, 'WE AREkSO.FL) PEM& T.aLmis 14•x ffi 3Eo TC "14675 .SQE ARFA(sOAT•) TTk GILWIIS 14HIaA - ',r z zb 2BR ECG J/i-icw W x 3r.512".076 3/r 1111" W.X. BN6 tar Nzzs IW X 3d. sm TTYN ..2trtso _ . it x ffi 392 OVfi 3/ TYPICAL.ALL COlBTWRA710tLiO 2C x 4C 000 tt66 3, 3o0ao - 2C x'4s ltm SaSt lama _ ly \ y� IV X 3r 512 929 J/r•162M1" 1_OT/T,NIC 110ANR1Y AND:' s' d K _ d 6' It i S 578 '.,as5 3/r "GOO LOCAi TO AOAWIED FOt s'az _ - _ It X 40• 71D »rater.z70m LARGER POOLS AM ACTUAL STAIR END VIEW ffi,i 4C 1M0 ,16'6 3!r"300m ---3G-O •. - 2II'%44• M 124.6 3/r 33a00 Sr9ECT701L •T T ®. "_O.,IIa SPdxav r:LTk'tc.PA710.NLa12t cs t 1 _:=A11f1E BRACING.INSTALL AT.ITDI ISm R JmIF fis/e•xloa Q _ TYPICAL DEPTH AND e,s I� aL - 3 . o A,m Cm1En FOR 0°�' Rar.a�r. h _ LE v -R-�-- •a-- - --- 1 $ ` a m ® - �� 1 •R .1i01C,dIG6xLm BE �T p� ® .o INFORMATION !� - .Ir-Ir-- ® _ •, .7 •, 1 m ITN®t F// _0_ ,o �o - 90 FINISH ® - -J ?~I b - -C -4Y }. 7P•Ym• :i i �- 1 T �i i SIDE VIEW i pp Q -® 1 1 T •�: 1 ' ' t I - 'Ter Rig/ t 1 g06B- -Lgfi m Y o® _ v 6ASC FT HRIFIFk /f `® p IH Aril V C 5~ o. 'a TRUE ELL .. •1 ® �5lfix4n t ` Sue.am 5oa�. it x 4V eenra-NSD AY4A(dE N lIi,utaaclt gas! TRUE KIDNEY Im ' w4�a A4 ,PtvAs,1a ANF1 FAIs ® Y„ x ®6 d -V.WES 1d-T - It ARTAI�lL)"�'GI111.a1LS 1B x 36 PL-mm-ALSO AV/BAKE N T/s FOILOINIC 92F4 ICII Q 9 tkUm MDED QOFR.A l[X 3C 72C 1ZlB 1/r IT30i1 512E AXEAISOFI i•�HTTR GAM - . ,s x 3r Safi al so 3/r xN7s. TYPICAL HANDRAIL nIsa R. ns i/6" OxLaHs- - - - F'w 2r x 4i• 966 /oG'R 3/r SI:aS. - - - - -- MOUNTING . CELEBRITY RIGHT u r m o r o C � ® , 2C x m PL•IlatEn-A150.AVlILAME M of FOILOWIM sp"'s _ .1.m - ® INSTALLATION NOTES: TYPICAL LADDER .A�AlSNFTa �' c:3lcts t.i) BASIC DESIG)1 OF THE Pool Is L t[%3r 526 9391/2• 196m - - .MOUNT . Nr X 36'' 651 10Yr 24413 z< � _ PREDICATED ON a TYPICAL INSTALLATION - U s saAd BEAF24C IN SIL NOT CONTAINING . i AL , HIGHLY 7 F1IlADS OR MANIC CLAYS.PEA -Y _ IV Pk ft SO a Ss P ® •i •1 J - _ ® EXPANSIVE SOR.S, .. -a•. s 4. "_ - ---Irk ,--9-c-=--, - j '_ - 2 BiHE B A b TEHCK CONCRETE V ATION _ •Ivfa4r 1 5 s,mA d slai Statr po - t - _ •Y '6• -� IY G AT EAROUUNND�THE FULL PI Ili Tl R N V _ r ����LL�������..J��y 4e !� - _, •' •' - •_' _ 11-C POOL SEE' (� 3_.BACIOILL WITH "CLEAN EARTH FREE OF 6 ' d STAIRS gg O RooTs ANUS IN 9'LTFTs'EACH or cLTa �. .y:�".•.•' •; ';' drs ,lrASTa dl21mtt ® zs 3/ �Af/P roBE E V�S•CARERAJ_Y 1 A.______ __ 4' 4-��l4'-0=______ T I.,9'-s- :.� ® © 4.CON(YtETE WALKWAYS.ARE TO SLOPE . • AT L 8'PER FOOT .. Y FROM COPING r rlNn Y AWA I �`t7• d KIDNEY 1/Y. Pz STRAIGHT WALL o b STEEPER. . t � r NNc srs�_ w TIE FauD . N" S x lr REA(SMD Atso ETER GE - OR 5 THIS POOL FilLS NOT BEEN DESIGNED so'Fa,L5,1 _ _ - - _ AILMS 1r�X 3r SIA SnFL-cr ass3 FOR SURCHARGEA POOL AND USE - x 41, SITE AROUND zr GRADE ... -- 'i •.7a ' ' - � -' .D/ETNT BACHFIIl TO LIART EQIAVALENT eeo - SOIL TO 30 AWED OF RETAINED-_- FIl11D PRESSURE . - V R LESS �� APPLICABLE CODE INFORMATION 7.SML OHAV AREA=T3esa.R PFRII.4TER-Lid,GAIIAM 27rr 1 r7.b. .® , - _ - _ 7.SLXL TO HAVE A MINIMUM BEARWG LAZY ELL BAP_CA E TO P.S.F. r - Ic c eTA B.LOCATE TOP.�POOL AT LEAST 6' I42 W x 4Y T' )RED-ALSO AVAILABLE N 111E FOLLOU 92FS - •j •^==iGAa•F CMINONWE4IN 'APPMA F�CO,OIEG=T CODES ApP1IC.enIF STATE V HEY!YORK APPLE ABOVE SURROUNDING LAND ELEVATION � U S17E ARFAISOFL)'PE.'MRaR OALLLRS • OF MAWS tllllE DATA - f1IDE DATA OF VERm CWE ,6•x3F 592 l0P .22200 - 0 2=1 INTERNATIONAL SUIUM CODE DADA ( /2' I2•` iF•�,-11 z0%44• IRO I2r 307511 - .. POLL @ISTATLA7IGN TO P^Kb!'of 01e 2OW-RN7ERNATNIN BUILDING WOE GENERAL NOTES �'•"C3 71--i�••( . -�pA-yq�a PL pF xvm-, ;I, GN-IDNS-rS3 COTSOW TO APPUCAB E 2005 STATE fAlaiRIC CODE Y3TH YWRIGCODEmosiS OF ADAPTED PREVEYERMONT FIRE .COMPONENT NOTES: LILT (d F-i m 6.. Q T ® ®d SINGLE ROMAN END C0DE5 mOLirowc STATE OF WNNEc=T AS BtMDalc IX1pE a<NEW raac PPi�ff1/DON AND '-4 $20D.T wTEf0lAilONAI RESIDENTIAL CODE STATE' SPECIFIC'RED jREUFNT AF DURO"CODE S I/z• 1.ALL GUAT2=STEII.5 FORAGED FROM GALVANIZED COATING-NG O 4 o N 1 6' or IB'-x 36'PKIUIED-AISD AY•i ewr w Tlff FVLLo,mTn-SUES: $CPmmw.ne01N or =-ar 1Ha 24063 CLASS AND 3/09 ay TO ASTN A-525 WITH ASFM A-165 GALVANIZED COATING_ �rV mN NIFsCSn ) GAunxs Hcss>Imamtts B.ed J 2005 siA LAw._-CODE ENDLD uRFs TO BE ME L- STATE ALTENBC tRTI /•-0:1/2- Z A(]..STEEL ANGLES(PANEL STFFENERS AT FRAME BRACE) F•c•f ,C x ss sTs kd 19908 Code STATE 6 cMmmT=T _ WMA_ E MADE FROM MATERIAL CONFORMING TO ASIM"A-525 .. D3 a•m STATE AL7FRAT1@NS . .;. ffi X 40' wo 1153• 30375 q'7eO fJAT((S1Xth£dltlm) $2003 DDERNAl1ONAL'MECNAMCAL CODE �Ci1O7"5OC3 OF 7NE A 8`DEEP ::=- -Ii• $421A S•.Sa•Sh Palo $2W3 INTERNATIONAL PW1®wG COOS' �VA�ON WOE DEFINES- 1997 MMA-101& 'Is-@M TRANSOM" TATFI A57M A-i GaLV/ADED COMPONENTS ' n•iA2r ELL TReamMl m' 7. N.-4�•o b,- - 19RManr ENERGY R)TM0•A 3.ALL BOOS AND THREADED COMPONENTS ARE .� td.yo , • e s.. IT d :d. g1999 NEC-ART.650 q 217D3 MODEL ENF72GT'CWE .POOL ETffRGY fx1DE1R&S MANUFACTURED FREL1 MATERIAL CONFORMgNG TO ASTM o O _m - I o _ . . q NEc 20W'NATIONAL ELFCiIaC coDE GuaEFIVATtON eLFwM TO -- A-307;A-563GA,AfHI ARE ZINC"PLATED. a 0 77 i 11. •-Y -5-0=- �- 1C.A'=---- --Y--t2•-3•------ .. MATERIALS m. [TAT"TO: q Nx/ANS A 117-1-IMS ACL648IE LATEST A9WAE 90-1-99 4 All T$1DED.IDD1Ts ARE COATED WITH AN ALiAdD'Alkl. - 'Q W Zx- . 0 a-_. •:•II ,/4K - 1 AND UsAet£9wDNG AND FncnTTFs =NSOF'Tffc - T OF PAW AFTER VELDWG A"TOt LSE SAFETY CODE. "DEP TMENT p� (�I •�- _ RELl6aRW6 sn31-'ASIM 41997 Ft♦$ W.. 'U . --•" : ® e _ 1 40'FO.M $A615 GRAB 4.0 q 2005.NFPA-.79 TiaitOM ELEcmtc AND A117_1� � NEAUKRmTL.Anan S.WNJCWAY.77)BE 200)ps1 COMPRESSIVE STRENGTH BY o_TL. '40*FUOSH 1• _ : ® FOR WATER QUALITY. � .. .. }/-�- i P - 6Wl:&ED LffiE MF91-ASIM CODE - POOL(x1wm s.,o TIC � D��• � - � ��� . _ . -NEW.YDR1T STATE SAMMY cooE _ AR71ff1/T'w •• -q AQ'3T -.ACM CHAPTER.1.SMPART 6-IM. PUMM 110t 1•-2 1/X• - .. ----- t -7r .-- - Pa OEf2C'._ q CMG.SIETL .. - .� ,ODtf 301. . ,T - >000 _- �:iTa.-6.'20D0). GMA. . ASTU Abu LatAOE to Y(clNy..1WtE ME9F-ISIYA.7B$ .�ww•w.wROKIN KENO IRANSAPN L �• ffi' .. ?r tT o® - CK 1DONImEIE-Aa:5o/-300D P9 DECICr W T�a'D- - 9[.71w - - - AREA w 6T5M R'PV*1El,XfT Mt CALLONS'.-25313 4' .. .. - .. GRECIAN �.' '3Y tAzr S�PCOOED-AI.SD.AW1aAwE N'111E Fm1DV11G 5@s• T-- . sa PHmERR FdDDDK . . Ts9T116C - VO#DANCE :ALL STATES ALL FOOLS. ' s N APM ENT..A � ,6 z 502sr .'??53 .,. .. : .+A,IFA-. .�. 99-aa/, GAiLas-24273 E' - FANS'.TO PREVENT SUCTION "zis iME RL.,7tnIDiMn " la[- 4606E .. �2r:m''file ,os .s42s SINGLE ROMAN,Et30'w�2 RADIUS CORNERS. ALL SUCTiONd OUTLET`SYSTEMSS:M _ f 36•TxcnXan-Atso wv7AA�.'61 TIE FWLD'A;NO sus ENTRAPMENT, IT-IS;ESSEN. ... IAL AT THE a .. - o. _ , RFA(sDsrJ.T•amlcm.'wiays ', '.. . ANSI 1-5:-STANDARDS:FOR'RERESWENTTBPOOL-:2003ASWELLASaAINYSTATE OLOCAL 7-z1/2• _ . . .: Ch 2x x 4C ns1 ns9 3µ. . ... � . ... ., .. .. "m.. Iaslam y TAWS RE TIONS"AND ORDINANCES APPQJDIX G OF THE INTERNATIONAL RESIDENTIALmmmm " ... E3EEN ADOPTED IN SOME STATE,INSTALLERS SHOULD CON ADOPTED. AND/OR COD AS HAS... ,.� ages STAY CODE OFFICALS:TO.bETERM IRE YNFI S APPENDIX HAS BEEN ADOPTED.'. . ' Rm"DINtiEZTD: - -- - .. esvms. 1 T 1�p'wAkOE '.. mRR71 wSBR d C ® 1 TDRaR I ~ .,LOB NO- I/ .. fib,! -.� b �. 6'EC1 a ®- C 'Y6-RAatIS .- '_I >Qa I INN• F=h=,IIA st!-. t52!OtSA �.1� DATE . } : . a o TYPICAL CORNER t t/Y.=1 - - • ; ;' zssa111kE C�C1aE 71 i 40•Sin" '' •'•. 40'I1Hm1 ; INFORMATION SCALE-AS NOT LW © - $ - - t4oatm m h 51ep 4 •-o' --6'-G-- a____a4•..yr------ ----»•-9=---- sTl -O• -4-0" t DRAVAN BY:Ave '; 'q „ -p '4• ©o C OFtP v JT�. C 04D Q ® C DEEP ' , �_ •� •b, � ,�'-���`1® ���===�'r��JgV11JlYfYt.�i14a . ho b R' YC maN+ •_i i 61oa �J - .. T• :. - - . pr i3o' n •'� i�� .. r`+mo4 Vp syrs' - a1r lrsi .. • - 's �-r�' ® I s - -.,, _ ,qMw-s41eu 41;, -k[r -zNxo® Htf'72 __ -. er I-® Fe,PfAlN[1ER-TO,ro- wlnls-r,9m P. 9t! . -__- .11"Sa.FC V00WOR-94'3 5j :GA11AN5-24/5D . DOUBLE ROMAN END RaN�,IAA slr A1E1 MARTINiOUE. T1Y x ar txnlaco-AisO wYAXAt6E N ttC FOLIA1NM`sam .DOUBLE ROMAN END 1i 'Y RADIUS'CORNERS Te':l,f RCIVkEv-AM wvaTtATeE w T1A cuADTaNG 513s 39i -"SIIFV FERNETER'eA1tA+ss ffi%xr 1t:ttX1ED Also AVAT,uME N D¢FOUD"AM 3UM 9� .A;gA(sDETJ PIRYEIER OANSD,K it X as'sv SW 201311 'sm A I�mIs6FL) PFRIYC@R GN1O6" 20'X i0' 7T0 �T6- 2BL,s 2T XVC !m NICE' 300m M NTT:'3/r'TSOD- _- -