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Home My WebLink About0022 NOB HILL ROAD _. ,�, ,� r �V, Town of Barnstable *Permit#/5— Regulatory ServicesExpire Fees 6 months from issue ate a s + BABN3TABM .039 Richard V.Scali,Director , i639 RFD Mid A , Building Division awsp Tom Perry,CBO,Building Commissiongg, 200 Main Street,Hyannis,MA 02601 IV 8 2016 www.town.barnstable.ma is p�� Office: 508-862-4038 OF BA RIV� axL_t08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number c2d �'� � �`- r Property Address esidential Value of Work$ 9, 1/0(� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 4AJD.-I Y e_r1? VL& oI Ailolo &// hl sha,/, 1-11 Contractor's Name gaea4z �S ajeo Telephone Number SYV� ?7 6 290 v Home Improvement Contractor License#(if applicable) /B 5 Email: SU S�Ko—m G (0 yh or-t'/• ep ro Construction Supervisor's License#(if applicable) 106 0 ❑Workman's Compensation Insurance Check e: am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Reque (check box) �/ �p L Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to /CL1^- V ez 'h, IX- ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\AppData\L.ocal\Microsoft\Windows\Temporary Internet Files\Content.0utlook\21`I0I DHR\EXPRESS.doc Revised 040215 t 7be Corer►eonivealth of Massachusetts _ Department ofludustrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 ivmv.niasxgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegibYy N3mc(Busmen orgmizationllndividiwy &iP e" fw"'Al o Address: lj/ P/"0 Ma //�O� City/Stateizm: U• J'&/w_ae-,_,W1 /Y4- Phone#: g y g -77&- 2t000 Are you an employer?Check the appropriate boa: 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- ❑Neu*construction 2-tl�r am a sole proprietor or partner- listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have S. ❑Demolition. working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance. 5. ❑ We are a corporation and its 10-0 Electrical repairs or additionsietpliied] officers have exercised their 3.❑ I am a homeowner doing all work 11-0 Plumbing repairs or additions myself[No workers'comp. right of exemption per MGL 12 oof repairs insurance required-]t c. 152,§1(4),and we have no employees-[No workers' 13.❑Other comp.insurance required-) 'Any applicam that checks boa#1 mast also fill out the section below showing their workers'compensation policy informatium Z Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors nmst submit anew affidavit indicating such. tContractors that sheds this box must attached an additions i sheet showing the time of the strb-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they met provide their workers'camp.policy number- lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information, Insurance Company Name: Policy g or Self-ins-Inc.4: Expiration Date: Job Site Address: City/State/zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c.. 152 can lead to the imposition of criminal penalties of a fine up to$1,500-00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under thepains and penalties ofpeduty that the information provided above is tnw and correct Sienature: S-S Date: 7 Phone#: S�0 B ^ 77 eOO Official use only. Do not write in this area,to be completed by cify or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector .6.Other Contact Person: Phone#: 6 - Ntas�tassdtsDe�a�tmeaetotr PabficSa�nty. � BoaaW ofof fluMog Regut&ow and manduds :¢ On _. 4HPOIEWOMIUM i i �•�� X�ACa$L�EH: � Cent�aaissioaaer Office of Conmmw Ads and Btfifmm _ 10Farkpl=-Suite 5170 Bost, 02116 Home Improvement Contractor 1le�on 1 TVPM. DM SUS HOME IMPROVEMENT EUGENY$: SA'SHKO- 41 PINEWOOD RD. - WEST YARMOUTK MA 02M � Oirmarc AB s&Be s Lies�ear d�ia�i lasea>d1r %. ;HQ MWgtW81BWCOlnRACWR � da1r. �o®dt+et�a�ae IN= Tom Offiee�Co ecAi"ss 6 6t�P�l8 um 1i cPlsa-R�51� - - = Bmsto%YAOUW 41 PWeAVW RQ - CAll WE rYAIB/OUltfy 1@AGNU - SUS HOME IMPROVEMENT 41 PINEWOOD RD. W. YARMOUTH, MA 02673 PHONE 1-(774) 521-2054 CERTAINTEED LANDMARK LIFETIME-ALGAE RESISTANT ARCHITECTURAL STYLE RE-ROOFING PROPOSAL September 4, 2016 ANTON YERENIUK 22 NOB HILL RD. HYANNISPORT, MA TEL: 508-776-8145 SUS HOME IMPROVEMENT herby proposes to perform the following services in a neat and professional manner and in accordance with the manufacturer's specifications and local building codes. Remove and haul Away All of the Old Asphalt Roofing Shingles (one layer) from the HOUSE. Supply and Install CERTAINTEED LANDMARK AR: COLOR: CO LONIAL SLATE. Supply and Install 8" WHITE ALUMINUM DRIP EDGE on All of the Eaves. Supply and Install #15 BLACK SATURATED FELT ROOFING PAPER. Supply and Install CERTAINTEED WINTER-GUARD (Ice & Water) WATERPROOF UNDERLAYMENT SYSTEM Supply and Install AIR VENT SHINGLE VENT II RIDGE VENT Supply and Install 8" WHITE ALUMINUM DRIP EDGE Clean and Remove Debris from work area after job is completed. TOTAL INVESTMENT -----------------------------$ 99400.00 PAYMENT SCHEDULE: A Deposit of One Half is due at the Signing of this Roof Proposal and the Final payment for the Balance is Due Immediately Upon Completion. , WORK SCHEDULE: All Roof Work is Normally Scheduled for Completion Within 45 Days of Acceptance and Receipt of Deposit Providing the Materials are Available. SUS HOME IMPROVEMENT Warranties the Shingles and Labor for 10 Years. . f CERTAINTEED Warranties the shingles and labor 100% for the first 10 years and the shingles your LIFETIME if the shingles becomes defective. CERTAINTEED Warrants the shingles up to CATEGORY III HURRICANR-130 MPH WIND WARRANT. CERTAINTEED Warrants the Shingles to be Algae resistant for a Full 10 Years. SUS HOME IMPROVEMENT Carries Workman's Compensation and Public Liability Insurance on the above work. DATE OF ACCEPTANCE: ACCEPTED BY: v ANTON YERENIUK EVGENY SUSHKO HOMEOWNER SUS HOME IMPROVEMENT I Town of Barnstable *Permit# (� Expires 6 nur fyenrtssue date Regulatory Services Fee s = Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 6 200 Main Street,Hyannis,MA 0260.1' www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 1 n Z Property Address l �f, T►l ( I u/IJl(5NA - ❑Residential Value of Work C yG U Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address_�.,4,v'1 i;G w,ti n w1_U l C.Af- Contractor's Name ��1- 1-C-- Telephone Number, I• �� _ U Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workmen's Compensation Insurance. Check one: ❑ I am a sole proprietor ❑ I am the Homeowner EJ'T—have Worker's Compensation Insurance' Insurance Company Name 1✓l5 ✓t \�L Z ci T t e -x >��n .,�t c�e�\ 1199 _ Workman's Comp.Policy# 2- TQ 7 f l Copy of Insurance Compliance Certificate must accompany each permit be Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side #of doors Replacement Windows/doors/sliders.U-Value l.tivl-� � _ /` (maximum.35)#of windows," L *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,eta ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. - SIGNATURE: C:\Users\decollikWppData\I,ocal\Microsoft\Windows\Temporary Internet Files\Content Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 l - �IKE swRxsrae�e, 9� `;� , Town of Barnstable �EDM�p Regulatory Services Thomas F.Geiler,Director Building Division Thomas Perry,CBO 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 4 I, � ��,rVI�1 Cal ,as Owner of the subject property hereby authorize �rc�rr ' -L— T ��`'� f�at �v>?j�ivcfiu� to act on my behalf, in all matters relative to work authorized by this building permit application for: 12-3o- q Sig ature 4 Owner Date �JVIyIC Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 f , - Slays tchusetts [Department of PublicSato% Boal'M of Building Regulations and Standards Construction Supervisor License License: CS 58500 Restricted to: 00 : DEAN M FALL 1 MOSSIE Vt/AY BRIDGEWATER, MA 02324 cam Expiration<-312312012 ('ommissiy,cr Tr#="'19M Wi �r License or registration valid for individul use only - . d#6ce:ot'Consamer�ays&Bn ness egn AND before the expiration date. If found return to: Ep SCR Office of Consumer Affairs and Business Regulation Regrstrafiorr ` 12455{D Type 10 Park Plaza-Suite 5170 - Expirat+on 7iofL093 DBA': Boston,MA 02116 L iiail-Cotutasi::�sn . 6. Da2n0 Moss eway. :. . r' Bndgewater MA 02324 Undersecretary Not valid without signature Y The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston,MA 02111 www.mass.gov/dia .Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): . � L(i Address: ? G City/State/Zip: A1'�U2.32 Phone.#: 570�-757gV 6&ate 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 loyees(full and/or part-time).*. have hired the sub contractors 6. New construction . 2. I;_0 am a sole proprietor or partner- listed on the atkached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an 'ca aci employees and have workers' y P �'• $ 9. ❑Building addition [No workers' comp.insurance comp.insurance. Electrical. repairs or additions required.] 5. ❑ We are a corporation and its 10❑ P 3.❑ I am a homeowner doing all_work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers.' comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other 1 09—J 2 isc �A 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: 1() f Ae Policy#or Self-ins.Lic.#: 2-M `�7-Z(� Expiration Date: ('e" —,3O — I Job Site Address: 2 2 `Li City/State/Zip: _A/1-t n rS pof--F- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby er ify under the pains and penalties of perjury that the information provided above is true and correct~ Si a e:_ 4 Date: /Z 7 f' 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#: 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-contractor's)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any'given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all-locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related io any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.. The Office of Investigations would like to thank you in advance for your cooperation and should you have any.questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. The Commoiiwealth of Massachusetts Department of lndustr al Acoidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.##617-727-4900 ext 406 or 1-977-MASSAFE Fax 4 617-727-7749 Revised 11-22-06 www.rnass.govldia JUL 14, 2005 8:56AM SCUIER CONSTRUCTION NO. 245 P. 1 1. 582 • Bey Lane • Centerville MA 02632 • 608-771-5211 Fax 508-771-6612 Fax To: Torn Perry Fromi Debbie Fax: 508-790.6230 Pages: 2 Phone; 508-862.4038 Date; 7/14/2005 Re: CC, Urgent El For Review M Please Comment 0 Please Reply ®Please Recycle e Comments: Tam, The following i'for the Yereriuk,house C 22 1�%Hill in I-Iyannisport, Thank.you, Debbie :! L. 14, 21i;j ) APJ �C1.117 CCU` -NCT1"N J0 24F P. 2 .cape Cod Insulation, Inc. 45 5 Yarmouth Road Hyannis, Ma. 02601 Ph.1.800-696-6611 Fax. 1-508-778-5735 To: Barnstable Building Inspector ]fie: 22 ob Hill Road Hyannis port, Ma. 7 o) Cape Cod Insulation installed p . Ceilings R-30 Walls R- 13 S use Construction in -19 in q floors. Keith Press wood Sales Manager TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel _ Permit# Health Division•-6 76�- Date Issued dJ� Conservation 1ivision S Fee Tas Collector S AAA MUST BE G�� INS LED IN COMPLIANC "Yreasurer WITH TITLE 5 ' Planning Dept. Ch� CODE WENTAL AND - S Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis IV Project Street A dress Village Owner �dress Telephone �� cf' Permit Request d�C�✓� c S� A _ S 1A n` 1 W.6,0A. Ck Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new, Pn Valuation to noo " Zoning District Flood Plain Groundwa er Overlay iz c r - Construction Type C5%cP(�G� Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family IQ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: 16 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) L't Basement Unfinished Area(sq.ft) Number of Baths: Full: existing LA new Half: existing new Number of Bedrooms: existing 1�) new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: [ Gas ❑Oil ❑ Electric ❑Other Central Air: 6Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes l No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:Cl existing ❑new size Attached garage:*existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑ es lNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION f Name v� 6� Telephone Number Address License# CS 06 1 7&3C) (\' 14W Home Improvement Contractor# Worker's Compensation# � ALL CONSTRUCTION DEBRIS RESULTING F M THIS PROJECT WILL BE TAKEN TO � f SIGNATURE DATE m n. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ` ADDRESS VILLAGE ` J OWNER ' DATE OF INSPECTION- FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL•' m �O U s PLUMBING: RO;U:GH> �_ FINAL ' • GAS: b43HH S FINAL` FINAL BUILDING sue.•• K - n I 2 o Via-- M 0 � DATE CLOSED OUTS` c i m r, ASSOCIATION PLAN NO. , OFjliE Tp . Town of_B arn able Regulatory Services 3 � Thomas=I':Geer,-Director:Dun - _ ... . 9�� • Building Division ; Building Commissioner -Tom Perry, ' 200 Mafia Street,'74yaaats,MA 02601 - - W town barnstable;ma,us ' Fax: 508-790-6230 office: 508-862-4038 - Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property e .to act onmybehg s . . hereby authorize in all rriatters relative to avork authorized by this binding permit application for: 14 (Addres of Job) ignature of er ate : • r Lk To Anne, y en Pr t Na.= OFiBUILd;}NO R�GULATIONSh „License WNSTF�UC PION S41P RVhSOR � c }Birthdate 210y�K 6,4 a r �}� , J 1A5 gQ6`y TQ. G;'r►Q 169Q3 RestrWO N { ,i. � MICHAEK L SQUIER r ' 582 CENTERVILLE ,IVIA 02632 Acting v mis ; r aa r` IpA[ aote.Ijslmmpd r Z£9Z0 VW3 111A2OiN30 Nl AVB Z84 ti � ti If10S -13`dH01W �ONIyNQI f1LIJ SN00 ZJ31f1DS SOTZO'eW uoasog uoilejodjo0 aley�u d�(j loci WH aaeld ublan ,s`d O au 900Z/86�1 of eai AU k s ae ue P P aS Pue suogeln�ag�uipiing Io paeog 9001 :o;uan;aa puno331 aaep uoyealdxa ayl aaolary 8p1Db211NO01N3W3A0 dlNl 3WOH fpio asn Inpinlpul JOJ prleA uol;ea;siffaa.►o asu.aa1 t spaepuetS Pua suo!;eln;Iay 21ulp11n11Jo Im L1011 r _ f v� °FIMET Town of Barnstable Regulatory Services * * * BARNSTABLE Thomas F.Geiler,Director i639• ♦0 rFo.19 & 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 Pemut no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernizations conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: CS� Estimated Cost �G Address of Work: Owner's Name:. �i11�C'9(�P ,� ._� �'��. �eft V - , : •. Date of Application: Ehrl k,45 I hereby certify that: ' Registration is not required for the following reason(s): ❑Work excluded by law w ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit � Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED R P AL OF PERJURY I hereby apply for a permit as the a e o er: _ Date ' " Ftl C actor Name Registration No. OR Date Owner's Name P Q:forms:homeaffidav ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS j 780 CMR Appendix J (effective 3/1198) Applicant Name: ' Site Address: 2.Z, Applicant Address; Ot, City/Town: : �-w Ate►S , ay , 07f,01 Use Group: Date of Application: Applicant Phone: SOS-77! - 5g I I Applicant Signature: -- ALTERNATIVE FOR ADDITIONS ONLY: a. Gross wan +Ceiling Area 1=sq.R. b. Glazing Area' ZS sq.R c. Glazing°!°(IOQ x b+a)22 71 29 ADDITION with Glazing%Ic.) OP to 40% may use 790 CMR Table 11.1Z3.1-. _-- _ below: MAXIMUM MINIMUM Fenestration Ceiling wall Floor Basement wall Slab Perimeter U-value R-value R-value R-value R-Value R-value and Depth 0.39 11471 R 43 R 49 Rao R40, 4 ft 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 (Le. -not compressed over exterior walls,and including -any access opedsvgs.) [3 "SUNROOhr addition(greater than 40%&Zia&to-wrap and ceiling gross area) Attach"Consumer kib matica fora"fima 730 CMR Appendix B. 0 iidaVs Name.- - Official's Signature. Applkation Approved Denied 13 Date of ApprovaliDenial: Raascn(s) for DeniaL• (provide additional details as needed on back side) Glazing Area may be eid w Rough Opening or Unit d mensiasn. Bess as+t a' 77te Commonwealth of Massachusetts = Department of Industrial Accidents � _- ' '� 011fcro!la�as�lpalloDs ' 600 Washington Strut < Boston,Mass. 02111 Workers' Com tnsatfon Iasnrance Affidavit rLaM �ti�: •. ❑ I am a p ail work myself: ❑ I am a sole gcmnictcr and haven one wqJ is aav " tm this'ob. for �8 J I am as em..... Providm$workers^� °Y • . M-xv.:,} =.wf ~ :n.,.. ....... ..:-:.,•.:.:{x;..}.:{-x{•�::. .. aN!�•aT'.':+>>�+..:.. ...:.�.,:. ::.;:..'::^`.:•:.,.^..,• •: ......� .. ..:. •;fa.,xa:. '�'.. 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Fame to seeaae eo�ee+ele o �t3eetfon 2SA of MQ.Is2 tanld tw th+a�dss#e�peaaftiea of a t'l;fe ap fe S1rS00-oo aadiar ow I1"1 3mprhmawat a weR ss dTQ pwalda to the form of a SLOP WOBS G==d n deer ocnojLw a dv zphnt ms. Iaadastimd ami a cMofU&zw—w,*=qb*(OvM tM OIDes oSxqftdvduM of ft mkfw.colones tt:d&MIad I do hereby CatIy aav aPaPU7 fhwake AniaA p�rrdadabotae is erg tarred Pk ofsaw in*osll "'not write is this area to be eomgided b7 cRT or town offfdal p�l1lcsme 11 ❑BIIildtaC pepartrnad efty or town: QlSraszaaL Boa=+d ❑chrcidf it�sdiste cd4°n"it tT4zvd ❑Sefecrosen's O , , _QHes1W Degs� eoataet person• Phon N; �der (terw M5 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for th..r employees. As quoted fro the."law"m , an employee is defined as every person is the service of another under any carrG�' of hire, __xpress or implied_oial 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'etnplo. r, Or the trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartrocitc and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair vie&on such dwelling house or on the noun s cr building appurtenant tbereto shall not because of such employment be deemed to be as cmployar. MGL chapter 152 section 25 also states that every state or local1iceasing ageney.sball withhold.the issuance or renewai 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,TiCith t� commonwealth nor any of its political subdivisions shall enter into nay cormart forte perfo==co of public wort until acceptable evidence of campliaacc withthe*nR**mace:requires of this chapter have beta presented to the coati-..." t authority. � -Applicants Please fill in the walkers' compensation affidavit completely,by cbecling the.box that applies to your sitiiatioa and Sapp company names,address and phone numbers along with a Ccrdfic3tc-of�*+�+_ce as all a$davits may be submitted to the Depar=cnt of Industrial Accidents for c�rmatiaa afiassuanix covetagF• Also be sure to sign and date the affidavit The affidavit should be,retrzmed to the city or to that the application for the peraih or license is "law"or if 5 nu being requested,not the Department of Industrial Accidents. Should pan have any questions the are required to obtain a workers' cctopeasadoa policy,Please ciR the Department the member listed below. . City or Towns artmcnt has provided a space at the bottom of t1'W Please be sure that the affidavit is complete and printed leginly. The Dep P li� 'Please for Yost to fill cut the event the Office of has to cantadyaa aPP affidavit ed to a ntmib&which will be used as a refazace a Tier. The affidavits cony be retain the >mrtlliceas be sure to fill is pe the Department by mailor FAX unless other aaangcmeats have been made. The Office of Investigations would like to thank you in advance for you cooPerariaa and should you have nay questions. please do not hesitate to give us a can. The Deparnaeat's address,telephone and faxn mbar: ' The Commonwealth Of Massachusetts Department of Industrial Accidents Me of lavesucatiods 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 Assessor's map and lot number ....... a fwST- 6 = �GE�T . 7 ' 3 0- 7.5' Sewage Permit number .............. lL.......................................... TOWN OF BARNSTABLE Z BAWSMULE, i 9� op9�,e�� BUILDING INSPECTOR Construct a garage and breezeway APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE OF CONSTRUCTION ....,Wood frame ..................................................................................................................... .... ulX..�.q.th.......................19.75.. TO THE INSPECTOR OF BUILDINGS: - The undersigned hereby applies for a permit according to the following information: Location .... ob..Hil,l Road.:...Hvannis...Po.r'.t.,...Mass. ....................................................................................... Proposed Use ... Residential... . and breezeway............................................ ..................................... .... . r Zoning District ..RC................................................................Fire District .......Hyannis Name of Owner Paul Austin ,,,,,,,,,,,,,,Address Nob„Hill Road,„Hyannis„Port.,..,Mass . ..................................... ................... Name of Builder ,John B. Lebel Constr.Co . Address 3. ...Wianno Ave . , Osterville, Mass . ....................:.............................. .................................................................... Name of Architect ..same: ,...,.....Address Number of Rooms .....gaX'aa-g.Q...r....b1.e.ezeway bl.e.eze-WaY............ ...coxl.cre.te...................................................... Exteriorwood shingl.e... ............................................Roofing ...as�halt............................................................... Floors concrete Interior rough stud .......p!:. K.e.................!... Heating .......none...................!............................................Plumbing ...none.................................................................... Fireplace none................................................................Approximate Cost $6, 000 Definitive Plan Approved by Planning Board --------------------------------19________- Area ...700. square feet Diagram of Lot and Building with Dimensions *SEE ATTACHED SKETCH Fee ...P 6.t..7.5.......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1==Xlsr/n/G 24X2� ¢ 2J ►0X10 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ..................... .................................... f Austin, Paul ' ( '! No —1-7058 .. Pen for --add— �—ree—ze =ay ---- — — — —-- ^ and garage to dwelling ' --------------------------' Nob Bill Road ` Locohon`.'—___________________ ./ . _______..u�aznn�op�r�________._.. �aol �uot�� Owner ---_ ______............................... ' frame -Type cf [bnm,ucrion ------------''— ............................................................... / > p|ct ............................ Lot ................................ r .. � � . � . . � Permit Granted ........... ��v.�3l____.]g 75 \ . . ~� \ ' Date of Inspection .................... ^ � �. ' { Dote Completed . ................... � � . . PERMIT REFUSED -----_—~—.--.--------.. 19 , ! 1 l ./ --------------------------. . > _____._,,,____,_.^_________._._ { . � . ` —.------------_..---------~. ' ! ''--------'—^—^-----~^--^----- ' . � . Approved ................................................ lQ � ^ ---------------^^---------- � ------------------------^''`' � . ~ .� ^� �r Assessor's?ma Jand lot number .283/.1�...................... j �....�..... L '✓"" _ p ... r 111 r Sewage Permit number ...............................'.......,-................ THE T TOWN OF BARNSTABLE Z SAWSTOBLE, i "6 . BUILDING INSPECTOR 0M � APPLICATION FOR PERMIT TO Construct a 7a ra gp" a rid/hry-4.z '. .................................................... P TYPE OF CONSTRUCTION ......food #Ta.m. .e ....... . ...................................................................................................... uuly 30Ea'..........................................o t,, 19.7.a.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... 11i.1I...T oRd......Hvannis. Port , Mass........................................................................................ Proposed Use .....itnsidential tiara'ae and breeze}vav.................................................................................. Zoning District ...Rc................................................................Fire District ....... ivannis Name of Owner P.ttu1„Austin ...,,,...,Address Nob Hill Road. I'vannis Port. Klass . Name of Builder .,;Tobn 5. I.ebel Constr.Co• Address ?2 Nianno Ave . 9 Osterville, Mass. ...................................... . Nameof Architect .. aEne.....................................................Address .................................................................................... Number of Rooms .....f.': d }xrRrrwr?tr............Foundation ...nnnr , .P...................................................... Exierior wood shim l.e................................................Roofing ...alpha] t ..................... ..................................................:................. Floors concrete ,,,,,,,,,,,,,,,,,,,,,Interior ., rough stud Heating none ...........................Plumbing ....�?Ct1c' ....................................................... ...................:................................................ Fireplace ........n.an.o................................................................Appr oximate Cost ... 000 .. .... .. ........................................................ Definitive Plan Approved by Planning Board -------------------_.----------19--------. Area ....7�0 stsuare feet ........................... Diagram of Lot and Building with Dimensions *SE ATTACKED St(Si`TCH Fee ....".�.1.U.'75 ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �--� ^_ I"- WOO i T - E I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name `..... :.......................................................... E Austin, Paul A=288-192 17858 add breezeway No ................. Permit for .................................... and garage to dwelling ............................................................................... Location Nob Hill Road ................................................................ Hyannisport ............................................................................... Paul Austin Owner ......................... ....................................... I frame Type of Construction ............................ ................................................................................ Plot ................. Lot ................ Permit Granted ........July. ...........F.........19 75 Date of Inspection ......... ..........................19 Date Completed ......................................19 ERMIT REFUSED ....................................... 19 ............... ...... .................. .................................... .................................................... ..................... Approved ................................................ 19 ............................................................................... ............................................................................... u WY- '-3 • - � .. 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SMITH L121:2�Ue� B A M 288-125 ` •ass. • � %. . \INak / �w RAP WAS 0 W USE 1 , LOT 1 �l ABM 288-192 .f� LOT z LOCUS MAP,' PLAN REF 297—41 A 1 M 288-1z4 ASSESSOR'S MAP.' 288-192 �/ ZONING.- RF-1 p �'/ p C� SETBACKS: 30'15'-15' DEED REF 13834-202 Cl) 00 / PLOT PLAN OF LAND Cb LOCATED A 22 NOB HILL ROAD .• , � , , f9o.,,,,,,,,,,,/,,,,.� .,,, ,,, .,,, ,,,,,,,,,,,,, HYANNIS MA. h•,///,,,,,,, ;� ,GARAGE', /� C.B. (FND) PREPARED F'OR.•: ANTON & JO—ANNE YERENIUK 0�' WC4 LfN� / APRIL 21, 2005 REV- CA, � REV G�5 ERFv G, � jO 05 REV 1�� STEPYIE N � YANKEE LAND SURVEYORS L _ & CONSULTANTS GRAPHIC SCALE 14 . SU Sys P.0. BOX 265 I I io zo •o O� UNIT 1, 40 INDUSTRY ROA15 JMR— MARSTONS MILLS, MA 02648 7EL• 508-428-0055 FAX 508-420-5553 1 inch = 20 ft. I. SHEET 1 OF 1 JOB ,¢! 53869 JF d N " o M�PSroJ A v� DA Lc�c us /V(pP MAP �1 PAecEL s iR2 124 �ti�.Si�arJc� ZotiJE - tZ.G �S �� gs 1 SG. QS S"7d d8-ate E a 0 � �N 1 � do 4 N c4 a �--� 1 L...L_. 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