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HomeMy WebLinkAbout0094 PONTIAC STREET �y �o a�-�i ac 5-�-, 1 TOWN OF-BARNSTABLE BUILDING PERMIT APPLICATION... Map -1Gq Parcel �90'� 'Application # 2 Health. ealth Division Date Issued 't; 2 Conservation Division Application Fee Planning,Dept: 'Permit Fee Date Definitive;Plan Approved by Planning Board Historic OW Preservation/ Hyannis . Project Street Address / ion 7W Village Aft"X Owner J�lQ /siGG; } Address 19 Amn4k_ S _ 141i97totwS Telephone SDI 77/- 76�� Permit Request /!'N �.ii'/SrIy1G ��N/ie�j�� �i�ffl?1/�yY-'ofwIr¢ L37S lShiy �� 60X*kx t, Aria AftsT ofx zle z' 6i71VA-141 ftf7Y -, Square feet: 1 st floor: existing 70proposed b 2nd floor: existing proposed 'Total new Zoning District, Flood Plain Groundwater.Overlay Pe Project Valuation 7 , < Construction Type Lot.Size Grandfathered: U les ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .< ' Two Family ❑ Multi-Family (# units) Age of Existing Structure / A Historic House: ❑Yes to On OldcKing's Highi&ay: ZJ Yes XVo Basement Type: 4'Full ❑ Crawl ❑Walkout ❑Other ,m _ Basement Finished Area(sq.ft.) 37,E Basement Unfinished Area`(sq.ft) +-,le Number of Baths: Full: existing new '- Half: existing i new _ ..iin P,yp 3 Number of Bedrooms: oZ existing j�new 00 Total Room Count (not including baths): existing 4C new First Floor Doom Cat Heat Type and Fuel: al, as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes EN"o Fireplaces: Existing / New Existing wood/coal stove: ❑Yes WNo Detached garage: Wle<sting ❑ 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 VNo If yes, site plan review# Current Use s /1r/!n Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name j� lYiy 9� Telephone Number 7ff/ 77/-07e Address �Q /A"' �/��. License # 676 Home Improvement Contractor# Worker's Compensation # o37/fa-7 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Gi SAu� N SIGNATURE DATE .0�/©6 FOR.OFFICIAL USE ONLY APPLICATION# o DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE s OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f The Commonwealth of Massachusetts Department of.1ndustrial Accidents Office of Investigations 600 Washington Street - Boston,MA 02111 . www.mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /�/ p� Please Print Legibly � tr 6 Name (Business/Organization/Individual): 62A4 � G�&0/VMT" Address: ale S'oowkr rho City/Slate/Zip: &�'d 144 g zgaZ1 Phone#: (7el)XW- A Are Vu an employer?Check the appropriate box: Type of project(required): I. I am a employer with' 4aA f 4. ❑ I am a general contractor and 1 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2. ] 1 am a sole proprietor or partner- listed on the attached sheet.t Remodeling ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp, insurance. q. F1 Building addition [No workers'comp. insurance 5• ® We are a corporation and its required.] officers have exercised their t0;' Electrical repairs or additions 3.[] 1 am a homeowner doing all work right of exemption per MGL I Ln Plumbing repairs or additions myself [No workers' comp. c. 152,§1(4),and we have no 12.[] Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp:insurance required.) *Any applicant that checks box#l 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 roust submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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 �� Ft E7 '� Policy#or Self-ins,Lic,#: oQ � � Q7//° � Expiration Date: Job Site Address: "7 ft�YlTls�L'S City/State/Zip: ,pw / _ !/d4Ol 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 file 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 D16 for insurance coverage verification. r I do hereby cert jy er lira pa' and enalties erju at the information provided above is true and tarred. Signature: / Date: l0 l0 Phone Official use only. Do not write in this area,to be completed by c(ty 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#; ACORD. CERTIFICATE OF LIABILITY INSURANCE T121312009 PRODUCER PhCne: 781-659-2262 Fax: 781-659-4725 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Andrew G. Gordon, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 680 Main Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR P_ 0. Box Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 299 Norwell MA 02061 INSURERS AFFORDING COVERAGE NAIC S INSURED INSURERA:Peerless Insurance 24198 Bay State Basement Systems, LLC 'NsuRERIkPilrrrim Insurance Com an 1750 dba Owens Corning of New England 60 Shawmut Road ff=RERC:Renaissance Marketing Canton MA 02021 INSUREtD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. OTWITHSTANUING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WBICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ L POLX:Y NINABER POLICYEFFECM POLICY EXPIRATION M11'S TYMOFINSURANCE DA LI A GENERALLMILITY CPB8512851 9/5/2009 9/5/2010 EACHODa RENCE $1 000 000 X COMMEIMALGBNERALLUIBILI Y PF ocauence $50 000 CLAM MADE ®OCCUR a ED EXPl"cw pw=) $10 0 0 0 PERSONAL&AININJURY $1 000 000 NaMERALAGGREGATE $2 000 000 GENLAGGREGATELIMRAPPIIESPER: PRODUCTS-COMPlOPAGG S2.000.000 X POUCY PRO LOc B AUTOMOBILELIABI0IY PGC10007161409 1/17/2009 1/17/2010 comBINED SINGLE Vmrr ANYAUio (Ee ,d) $1,000,000 ALLOWNEDAUTOS X SCHEDEDAUTOS �Pe—) $ UL X IAREDAUiOS ( )IL $NON-OMEDAUTos (Per iaAAAGe $ accidwtGARAGELIABILITY AUTOONLY-EAACaDENT $ ANYAUTO OTIIERIMAN EAACC $ AUTOONLY: AGO $ A EXCESSRNMBPJ33AUaeaRY CU8511953 9/5/2009 9/5/2010 EACHOO(MRRBNCE $1 000 000 X OCCUR ClAWMADE AGGREGATE $1 000 000 s HDEDUCTIBLE $ X RETENTION $10 000 $ WC C wOR��ePENsATWNAND C0371527TBI 5/24/2009 5/24/2010 ORYL TT ER ErPLOYERSLMILITY E.L.EACH ACCIDENT $1 000 000 ANY PROPRIETOMPARINERIEXECU IVE OFFICEUNNEiABEREXCLUDED? EL DISEASE-EAENPLAYEE $1 000 000 SPECIALPROVLS�IONSbebw FI DISEASE-POICYLIMR $1 000 000. OTHER DESCROrMN OFOPERATIONS i LOCATIONS I VEHX:LES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVuwNS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED Bay State Basements LLC BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER Y WILL ENDEAVOR TO MAIL 7g'DAYS WRITTEN NOTICE TO THE DBA Owens Corning of New England CERTIFICATE HOLDERrj`,� TO THE LEFT, BUT FAILURE TO DO SO DBA Owens Corning of Boston SHALL IMPOSE NO OBUN OR LIABILITY OF ANY KIND UPON 60 ShawmutRd, Canton MA 02021 THE INSURER, ITSOR REPRESENTATIVES. AUTHOR2EDREPRESENTATIVE ACORD 25(2001108) ACORD CORPORATION 1988 Board of 'NA ie�ul 2i�s an taiicar - g g s 1E One Ashburton. Place - Room 1301 Boston. Massachusetts 02108 Home Improvemerit"Contractor Registration Reqistration: 137943 Type: Supplement Carta Expiration: 1/29/2011 OWENS CORNING BASEMENT,FINISHING 7, ANTHONY METRANO 60 SHAWMUT RD 0 CANTON, MA 02021 ----------= --- — - Update Address and return card.Mark reason for change. OPS-CAS 0 50M-07/07-PCe490 Address El Renewal L, Employment L'i Lost Card 7k Pnam��zaruuealll a�./�i'acaac/accaeaa Board of Building Regulations and Standards License or registration valid for individul use only i— HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - -_ T Registration_ 137943 Board of Building Regulations and Standards Expiration:-_1/29/2011 One Ashburton Place Rm 1301 Boston,Ma.02108 _Type:'Supplement Card OWENS CORNING-B4SEMENT'Fl Z11S UN 1s' ETRANO�'• ". 60 SHMAIMUT RD`: CANTON,MA 02021 Administrator Not valid •itbout signature Afeeaiivmo4tul�c_ a y Board of Building Regulations and Standards Construction Sup6rvisor License License CS 98016 Exptratton 2/3/2012 Tr#-96076 'Restriction -00=!P � Off i ANTHQNY t1lIETRANO .'�h' 246 MEADOW STREET : CARVER;MA 02330 Con4nissioaer r {A� �(\''y ** �'{"� ' r 77,77, FIFINISHING SYSTEM SH 4w r r DESCRIPTION �� t The Owens Coming- Basement 5;cste ft is comprised Of tightweight fiber glass Panels.PVC finals(which replace conventional ` niTMgj acid foamed f1VC it m md*igs (which replace trim k niber).The trim maldinigs snap into ttie meals holding the pariels in place, �' x�,� �• '_ �� ��`�^�"���� t "� ¢ Y w Moldings and watt panels are easily removed to easy access to d t7r3rnes txovdatjonWK e .� ". v<alis.Because traditional wood and paper R 3*�` � k based building materials are replaced with fiber glass and PVC materials.the Basement Finishing SyEterrn otters Inherent sesestance to mo'asture, # meld and mildew."The.system is covered by <, .1' a lifetime limited transferable warranty tom- fmm Owens Corning. USES ]-he C wcm Co, Basement Finishing System is an innovative system designed to ^` � insulate and finish basernment waifs.It insulates. € acoustically treats and aesthetically finishes ."• s.W: s ID a few simple steps-The system can be installed over both masonry foundation walls PHYSICAL PROPERTIES and interi s•'parmbri walls built with either wood or metal members. Propertlr Test Medmd Value For F bw Gloss eoe rlr AVAILABILITY WaterVapor Sorption ASTM C 1104 <2%by wt. 20W, 4� x 112'Panels 95%RH 44•g., a u 1:?+teats Compressive Strength ASTM C 165 @10%deformation 25 psf Trim MokiM @25%deformation 90 Ps( Cove Molding Tf eemiat Resistwice ASTM C 516 R-f 1 vertical Battens Normal Density ,ASTM C 303 3.2 PCF Base Molding For Fi!td*ed Panek Utmfde Comer casing Noise Redi iori CoefFc nt ASTM C 423 Jamb.Extemler Type A Mount. 0.95 Chair Ra;i Surface Burning Characteristics :ASTM E 84+ Class A Flame Spread 25 Caiur Cftoices_ -Meets Class A Bun Rath a Smoke.DeveiGped 450 interior Textile Finish Fire ClassificMicin NFPA-266 Meets Acceptance Panels:"t_nen 1 aist'+Ak"n fatmic critti-w Trim:All trust available in White of Woodgrain. Mold Resistance ASTM C 1338 � lass trn WrtiN^vertical trim available in fabik took ASTM G 21 PUS finish nr Fabric wrapped to match panels, 'fine sumac.+-bxrMV dw'z teirsrr,�,of the ftnwvc cn�=%e Paeua were dKeffnned en accc.CWIce AS[M.E&i.Th S Rai dare n1C4' ,ci and dexIx-t the ptwmtre of itytvdjj,(Yt LKjs r31 romnbwK r.tr qyy"to f199T mri flxne v tar CODE COMPLIANCE t€N di WS-Daa 61um AST-1 E 8-4 orb Girrarat tX�ua..€t to de'gTebe ct 4%m fine� a 416 cx time rKi:of matsrsat V'06-cts w assen'bi'm aA of fis•faRtd:s pnZmar,roan assessmrnr a.fibs ire nea�ct tit 'WD BOCA Fvaluatjon tt 21 24 �ga!1'W14r end us--y Agn acr. a;�aeu W thr W4--st:r;!± A)04 iCC Repert#NER-6.35 i. iSe Ube mu-Wt,and deer of the C}xc'ris Con" tiaaYru±ri!.fin y rT Sin re4rt rr dd aid Wcfew:the SY3I r..a.,.A fir("f.t'r nvigatc mod if ihr condrtranj a et eQgay br m M stwath.'#Ztrmse eras in ymr b4em". "Sir a:7aWi Y•an-di1t9•fpr'detdcds,i.mriatiara I REScheck Software Version 4.3.1 Compliance Certificate Project Title: Renovation - Basement Family Room Energy Code: 2007 II CC Location: Duxbury,Massachusetts Construction Type: Single Family Project Type: Addition/Alteration Heating Degree Days: 6333 Climate Zone: 5 Construction Site: Owner/Agent: Designer/Contractor: 94 Pontiac Street Anthony Metrano Owens Coming Basement Finishing Hyannis,MA 02601 Owens Corning Basement Finishing Systems Systems 60 Shawmut Road 60 Shawmut Road Canton,MA 02021 Canton,MA 02021 781 821-0060 781 771-0078 ametrano@ocboston.com . . Compliance: Maximum UA:59 Your UA:58 ISM Basement Wall 1:Solid Concrete or Masonry 615 0.0 12.0 28 Wall height:7.0' Depth below grade:6.8' Insulation depth:6.8' Window 1:Vinyl Frame:Double Pane with Low-E 9 0.550 5 Door 1:Solid 20 0.460 9 Door 2:Solid 17 0.460 8 Door 3:Solid 17 0.460 8 Compliance Statement The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 2007 IECC requirements in REScheck Version 4.3.1 and to comply with the mandatory requirements li ted in the Scheck Inspection Checklist. Anthony Metrano-Project Mngr/CSU Name-Title Signature Date Project Title: Renovation-Basement Family Room Report date:05/06/10 Data filename:C:\Users\Tony\Documents\REScheck\Bill.rck Page 1 of 1 i■an MEN■■■■■■■■■■■■ ■ ■ A�° MEN ■n t moans■MEN/■■■■a■ ■■ 3n'z �■■■ ll■ala■■a■■1■■l ■■ ■■ ■■a■ ■ ■■■aaaa�a■■■■■aa■ n■ ��i■!!■it■ate®■■■�: ■■■■i■■■n■■ ■■ ■■■ ■ ■■■■■1!l� 1r1on ji moon ■■ ■■IIGi■■ � LJ ■ ■■ i ■ltatL't:■/■■■ �� INN ■■ //■aaa■■ltt■■ t�itttt■■■■t0tlt■/ /t a tlat<lllatl■■aia aaa/ ■ ■■■■■■■■■ ■■�o/■IMF ■■■■■■allla///■//a'Z■t■a ■■a■tag/■t^<C�ltlt In am an 11 ,/F�/ //s/■■i// ■ ` ■ EEN an ME ■►►`■�:,a■ l■ / ■■ / aaI�■ a■/■a//�t`ia■■■■ta■ta� /a E�iN man/■■/../tail■/nt�■i Nil on /a■a■■/■■■■■■a■ma■/aa/a ■■ IMEMINn■ta■aa■■■aa■Matinla tta ■■aa• !■■man aaaim■a►iza■ aa as ■ittllaar21219a/a a _ _ .rl■iriit�liiiii[ � :::' rAiiiaiH�! a■■■■■ a■■■■t1 1w0c; aai/aria r�ltilll��■al//l///a won MOB MOBS a■■■ ■•��WAIN■■■■■■■■11■■aa. laws L_Ja■■■■e M-8 , son on 1!l�1f■a■■oil n la■/■■//ae■ I�CLa�!!! ■■ V! !!a1L!.jl/ emtzmm all ■a■■■R�"■■ iir i taani o..ii■�.,. e1,it!t�/■L ► ■®! at<l/rQt ll■il>■aliaE�/a'RIN+ it � �■l� IAfa�ftlCl�� atli C� �■a�t■ea�ra�� MUM ■ P� t���l� ��rr Mc- Kim %2■01a0■a■ atll a� ■■ allCa ■Vf%�/d�■ a�l al►2� a ti■►� ■■ . ■■ca,��oa�.a� aae ,.�o �. � � ■ tat/� ���//■ NoMak tt. tat■l�� �1t�a111■ �; .. ■©ice ���■I � �tna■�/I�aa ■n�■spa Q �a SIMa■ �;i am ■a ■/ �Ciaaa NQ ■IN'1L� ■k,� at<tS �now■11i■` ■���■ i i� taaa�■�.a�:actafONa■■�■ Ra�lMnia:�lli■talla mum lt■■ME ■bt M►.!l/slam/O■■na�iClp IME Town of Barnstabte Regulatory Services ' HMAM AMSTABIAThomas F.Geiler,Director E16 A � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ina.us Office: 508-862-4038 Fax: 508-790-6230 :.J Property Owner Must Complete and Sign This Section_ If Using A Builder as Owner of the subject property hereby authorize Aakv OWN GP to.a t on m behalf, Y in all matters relative to work authorized-by this building permit application for. (Address of Job) t� s/V10 3" a`fiue of et Date i Print Name If Property Owner is applying for permit please-complete the Homeowners License Exemption Form,on the reverse side.. Q:FO RM S:O wN ERPERM IS S ION j . .........�.. .... Z IIA i :Y.6 0 -0*THE Assessor's map and lot number ,:�.. ... � Y / A-� G� Sewage Permit number ... ...:..� f..,........./..;(. ��t��................. d / Z BAR3STADLE, i . a M�a House number ........;,.q.....:...... ...........�.................:...,............... 90 p 2639. SEC NPY a�9 TOWN OF BARNSTABLE BUILDING INSPECTOR - APPLICATION FOR PERMIT TO / TYPE OF CONSTRUCTION . !A, 1.0 0 t' .................................................................:............... ........................... 1 ...............................:.....�...........19.'p'Y TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... �'rf........ ��'?. �)` /. ! ,........... ..7............ .c (?l t �! ( •tl, 1, � { ?.......................� ........... ;•�• !• Proposed Use .........(�-, 19 /✓O� J....... :. W ZoningDistrict ........................................................................Fire District ..........................J..................................................... 1 Name of Owner ... 1.T. ? ... ...... d. ...........Address .. ` ...` : ..........).f....... Name of Builder , co..Q.�'.:.r%......�:`/ r : ��........Address .. _' . Nameof Architect '.................................:.................................Address .................................................................................... • j -Number of Rooms ..................Foundation Exterior .....f ce' T;f� !�- /i 1�� � A� .:......ry.../..L`......... .................................Roofing ...;........ ......7...../. ...................................................... Floors' / -'? l/$+�'�� 7 ...............................................Interior .................................................................................. ........................ Heating ....�. ....................................................................Plumbing ...................................................................... Fireplaces o Approximate Cost ........ '^. Definitive Plan Approved by Planning Board --------------------------------19--------. Area ...- .....5. .:...... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r , 1 tj I d� ti � M r t i l 1' J I hereby agree to conform to all the Rules and Regulations of the Town o`f Barnstable regarding.-the above construction. Bill, Judith S. A=269-192 21784 garage ara e No .................,Pern�fP-for .................. .................. 94 Ftntiac Street Location ............... .o. .......................................... HyaKnis ............................................................................... Owner Judith S. Bill .................................................................. Type of Construction frame i .................................................. Plot ................ .... L ............... ... Permit Granted .Novae er 1 79 .......................................19 Date of Inspection ....................................19 Date Completed ......................................19 1 PERMIT REFUSED .................................................. ... 19 .......... v................. 0 .......... ffyp... ................................... ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... . I /C .. goo �� 30 Assessor's map and lot number ..-2.62....I?......... — CIS, oFTMEtO Sewage Permit number .:�� �Gr� ,. ............. Q / / S STABLE, • House number .......��' '............J.. ...................... 1AIST s � AUE� N COM VWTH E 6 MKI*. TOWN :OF BARNS Btr � n N BUILDING INSPECTOR 02 a APPLICATION FOR PERMIT TO ............ V....... ..........C_: ��.......... ' ..... .. ................. TYPE OF CONSTRUCTION ...Z,�,.O.o. .................................................................... .......................................... .................. .......... .......,9 17.9 TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the following information: +' Location ..... .� ....... Cry.........� ./.... ......... . ........ 1� ProposedUse .........( W. 9,...r.........CyA- 4.................................................................................................................. ZoningDistrict ........................✓...............................................Fire District .............................................................................. f , Name of Owner ... it ....... ....... ). .. ..............Address ....... .... Name of Builder C s�( � -.1 .......H, ,.............Address .....s:1319.1ne............................................................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation :. / a� �.......... .................................... Exterior7Lv .......... .............................Roofing .. ...................................................... Floor/. ......... ....................................:. .Interior Heating ' ......Plumbing ,'Z3.............................. Fireplace .....k..6....................................................................Approximate Cost � Definitive Plan Approved by Planning Board ________________ _ ---------------�9-------• Area o a . .. Diagram of Lot and Building with Dimensions Fee ......... •..'. ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH �7- l� Ic D I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r ardin ove construction. Bill, Judith S. No -..2lYm+_ 9a,,�Lfor ....................................��ra�e p ` ` � � ----~-------~---~.—.—.---~.. . } � ` 94 Pontiac Street ' \ Location ---------------------' / - , . . —.—.�.----�.������'---~—.-------. - ^ Judith S. Bill � Owner —.------------_.._______ � frame Type of Construction -----._-------. � ^ ' ' --------'-------^—^----'----' . . � plot ............................ Lot ................................ | � November l 79 � Permit Granted -------------lq Date of Inspection ---'--------]V �/ ' Dote Como|a�a6 --^~J���..^x------lg u^� . . PERM � ' � ������� ^ ' lg � . -' M . � .. � —_..�... ........................................................ �� ~. �---------------.. r�T � 10 -11 ....................................................... . Approve M: .....................................1-1 lQ ' --------'—'-----~^'''--'^----'-- ' -------'---....----...—.....—..—.. ' U . . Assessor's offioe 1st floor):'t ( r= SEPTIC i'THE TO Assessor's.,mop lot number ......... ..'. .....l.. ! r SYSTEM MU Board of Health'(3rd floor): f) _ � ��T N C4P �� /I ALLED t Sewage Permit number t WITH TITLE 5 Z EAUSTADLE. Engine ring Department (3rd floor). "NVIR®NMENT r�a •\�j, Housd number ...... 9 - REGULATION a• APPLICATIONS PROCESSED 8:30�-9:30 A.M. and 1:00-2:00 P.M.•only; TOWN OF' BARNSTABLE� ' IUKDIH.G ��- INSPECTOR APPLICATION FOR `PERMIT TO ..!%U.x�,j: J.C. ..............�.'4WC�/.7°./(,1J......................................................... . TYPE OF CONSTRUCTION . ....... ...... . .................................................... TO THE INSPECTOR OF BUILDINGS: - The undersigned he�a�a applies for a permit according to_ the following information: �T ...... ....... . ., / � �// .. .. _ .......................... Location .................. ....,...... .� .........;.. �:.... Proposed Use .. .....f�Eld:Ufa1................................ .......................................... ZoningDistrict .'.Fire District '.,�.. :.�............................................ ... ..... ..... ,w Name of Owner�.,�!/��1.` �7....... .......FC//..!...............Address 9j4 ... ........U...fJ. ..( Name of Builder Sa l.. .........:.......... .....- .....................'.Address •............:.,.. .................................. I� Address ' Name of Architect ....'.......... lam. ?.j� ........ .�.,.:. Number of Rooms ........l............................ .....Foundation ......?,o ..�� ......................... Exterior ..�7r%//.1 .�1:/.f�.. .....-...............t.....:..........................Roofing ...... 1/. / ....... Floors ....6,�1'.5.2..e...................................................................Interior ................................/ ...................................................... ✓ . a : ® � .R ... ..... .................... ... .................................... m .......Heating ...................... Fireplace ......, ..................................:'....................Approximate:Cost ........Lt :.(/. !..Y..................................... .... ` � �7�. ... . .. Definitive Plan 'Approved by Planning Board ________________________________19________ . Area ...... Diagram of Lot and Building with Dimensions Fee 0®"� SUBJECT TO APPROVAL OF BOARD OF HEALTH - o-m V . OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to.conform to all. the Rules and Regulations of the Town of Barnsta a arding-the above construction. Name ... ........ .................... C truction Supervisor's License C <!U� !fG;....... .... BILL, JUDITH S . ' i 30213 Add ' , No ....... ... Pern4it for ............Sunroom..... r Single Family Dwelling r; .......................* ............................................... 94` Pontiac Stree, t •' Y Location ....... .... ................... .. .................. Hyannis 1 ` Hnis µ..................... ............................................ Owner ........Judith,.S..., Bill... ; .} ... ......... .� t. Type of Construction 4......Frame • Y ............................ .... ......`ice .......^.................... /i ' • •J • •r J,� .. - •4j Plot ... i..... >a .......... Lot° :....... ........ y Novembe: ....r 21..,... . 86 Permit'G nranled ........ . .... . 19 Date of spection ......O .. .1� .. ...19 Date Completed ......... /j`�� .......19 yam` G� >... i Y } A w y s Assessor's offioe Ust floor)- 7NE Assessor's map.and lot number ......... .��...ff.'.1..�1 �� toy♦ Board of Health (3rd floor): _ � Z Sewage Permit number ....!...................................... ....p...... Z BaH.39TGDLE, S Engine.ring Department (3rd floor): YA°9. Hous7 number ' 9 2639. o APPL,I ATIONS PROCESSED 8:30-9:30 A-M, and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING 'INSPECTOR APPLICATION FOR PERMIT TO .. (lri'/S�f G<J ...,:r,. C�/. f('./J........................................... ............... TYPE OF CONSTRUCTION `......., .. ..J........... .j. .................................................................... .................... .. a.19..9L TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �7` ��/ J/f r�� Location ............................ �ra ...... ......................... .1 / / 5.........;/.!.:J .........��o�.(O 0 ProposedUse ,...... (J. - �DO ................................................................................... ................................................ Zoning District �j� ,//, ..........�`�:�:.................................................Fire Distract ....;,1�.''.y!�j,� ..�/... ...............................:'........... l /77 J l Address��" 5 7���{l!jl� .Name of Owner �.W,..�......../....................:....... ....../.. ................... ................... Name of Builder ..,SP./. .................................................Address ;/7n. Nameof Architect .......... fll .....................................Address .................-S,/ 4e.p... ........................................... Number of Rooms .........1.......................................................Foundation ..... %.<,) ��• L�/.(. ...... / !a ................ Exterior :.. 1J/!C/.../p..S...... ................................................Roofing ...... X� / ................................................ Floors ) .!�-.....................................................................Interior a.................................................... Heating ....................................................................Plumbing .4'_ . . Fireplace ...... ..........................................................................Approximate Cost ........./.i, .. ' Definitive Plan Approved by Planning Board:------'------------- -------------1;9------ . Area ... ... .; Diagram of Lot and Building with Dimensions Fee ► SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 /7OUS� I� I � 1 v 0 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstolal�garding the above construction. Name �.. ?(..- .. ..... Construction Supervisor's License .r r.( r % ............. BILL, JUDITH S . A=269-192 No Perrot for r'.I, ......P.ing.IjEft..FAte.'.Jy...1).W.e.1.1 j ag.......... Location .......9.4...P.O.Rtia.Q...S.t r.e.et............ ......................Hyanlui.5.............................I......... Owner ......... ..................... Type of Construction ...Frame.......................... ............................................................................... Plot ............................ Lot ................................. Permit Granted ..........November'_.. . . . ..2.1.49 86 ..... .. . .. . .. Date of Inspection ....................................19 Date Completed ......................................19 * W THE� Town of Barnstable Permit# Fxpires 6 1 months from issue date - �"M '.�. Regulatory Re ulator Services Feed . „ 1639. $ Thomas F.Geiler,Director Building Division IT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 J U N 3 2005 Office: 508=862-4038 Fax: 508-790-6230 TOWN OF BARNS(ABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Of I Z /J Property Address g Residential Value of Work& Minimum fee of$2 .00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑WOrkman's Compensation Insurance Check orie: I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) Re-side [g]—Replacement Windows. -U-Value (maximum.44) � � J047--I< *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. *** ote: Prope caner must si Property Owner Letter of Permission. Ho a Impro ement ntr ors L' erase is required. a Signature . F g mtr �. Revise063004 = s-= The Commonwealth o Massach i_ f usetts Department of Industrial Accidents — Office of Investigations < 600 Washington Street, ?th Floor Boston,Mass. 02111 Workers'Com ens_ation Insuranc^e�r Affidavit:Build in /Plumbing/Electrical Contractors ....o" .y ��tiA��Ry,^:'�'�`.���tE$�51��]�•'e- 1. 2; �rc ci{•� R"�:'d�i?};,�'a�"�; ['•t.�,� .,,.q�. name: address: ` cifstate:' zi 4—�R)__A601 phone work site location(full address): / I am a homeowner performing all work myself. Project Type: []New Construction❑Remodel I amy a sole proprietor and have no one working in anX capacity. ❑Buildiri Addition ' '`-"+,"c'f�'.'F t`.'.!'!" "=i +'.•F•;'2:. '�,.''r�.,r: ,'�',.,.'?,'C'.y,`�§"p�.i-3f1:�P;P: .,°.Pv`G% `'YF' .)18q a. ,r i,,.p rf, ,rn+•<•:GY: b`g�^�' "F -x'^4- n,!' :ti!c +� c .,. 7E,.C'i•+. :,rt Y�:�'°''•i:,�'�'','L:b°:'+`.:..:5`.°�'� r:a-•'.: �"•_b'S£'°.;''.i'�'':�'`°'Fl.;:a°�b,..•`�r7 r;a.L�_b c'•,'F. M] I am an employer providing workers' compensation for my employees working on this job. -� A company name: address:' city phone#• insurance co. • : ... . .. . T)Olicv# i&. i3snesX. A.'olio=iYXuZ�3'.:s#K+tk.i3':`•m' is.•°•�`J✓r.1.§!`:'ri:' �i::.cs�i`�" L' .5✓r'+:?..: •k?i,:•9.,.. n..•.� �`_, .:a. a+i- i.:❑ %:t:e'+rb1:'u.�':.C_x.:`�:j'•"•b..+..�^t.#-a•ti',is..,;,r,�`s`s'E:tii: ::�.�!-,::�.++t.<•da+�f:." .a�_h�Od +.I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address city: phone#: insurance co. olic # Owe.�•:<:a.:.y. ,,#�.•' Fs•y � ;1'{ >' w3� ;�ys•� �.��, .r........0;.sc •.i;�.s . . ..,.t�... .? -i=;:-�,�. :E�;e';'?s;s�% .. q; +,.�' 'r'�" - rro x a,•�-�..,.., >.,.,...• ,... :. ..... � ::.'�-,;.. � ,... .. company name: address: city: phone M. insurance co. olic # n y_affi dt L taVM �`"at:+e°+ tBCp �Failure to secure coverage as required under Section ZSA of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of ent may be forwarded to the Office of investigations of the DIA for coverage verification. ' I do re by certify nder a pat s and pena of per'rfy at the formation provided nbove is true and correct Signature Date Print n e Phone# ' - _ 7 official use only do not write in this area to be completed by city or town official city or town: permittlicense# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office []Health Department contact person: phone#; ❑Other (revised Sept 2003) fy Information and Instructions Massachusetts General Laws chapter 1.52 section 25 requires all tniployers to provide workers' compensation for their . employees. As quoted from the"law",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 fcregoing 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 thee grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local 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, 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. .igFw ' '�' f tom,..: ►"3�f°,+ `�'':�':°• ' MUM � �; .•�',e�� `�'�, .��'6T'1•, �"t t��'.,•.jf•j�.':= zL'q P+'�a.�.e-•• .. k .i:dr. Y'S' 1``__,, `>til' i...l.q� '•�... � A^' .N�` •�• •F:...ELEv- +6 .d'Cti�e4i7,i• .�.iti'�:`� :.�`.4. �.,rt �_ � , Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen-nit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed.below. r � 4+ F.^„ai3.?-�i�e. ,�F:�n'P'n., x �'iM3F'�•.' .{�` �, �s �7:�^.{b•?.;�:�`�'•'s.��{�(.,'�..�;..�:.:. ,f�:.. .�:..rq ` +:? �tr +�r'� {k�f'. ti:Jae-•}.r. C , 'f fi+."''++Fe �. `` '4'•".c5 J,S:yy?O.eS:`'".•.1��:.:.n+,''^�r,° sn�•.,'t.ii1'Llx,J�'ky/-'. "i-4' ;e. `'�" *'+°�4' bt' .!: +.. ;,,'18•S »'%?+:�. ,yl" �. �4;i �"3 � e, .6, rLt. t [1::.<... City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the,permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for.you cooperation and should you have any questions, please do not hesitate to give us a call. r•..�T t.... ..�.., •rw- r ..t :;ate. m Yr�t r. .�.a -"`kau SYJty,;.M4.";i�^+,s':1p`; `�'w'��.G�j>r i�'y,:'q�i ty'�1v'ut4: +hY`M�Sx "i.+�;su i,':�`iJ Y:$ •.t.• 4 .�itn 2 s y{ �'•.. 'fir S.',` p•�a �`:rari'R+' •y, _s "C'1 �i`� � j:. a'i' • -�+,�.,. � � t' e�:�'F' •"C'T.,�}• 6 h'r T'.. �F ''Vi y1..: 7' i-'Y. ,,CC r� ''t$iir�_ :c � t�'��w�..' y a. s. .� � ?¢3. T y�ar� �,7 c +" r �C� ��" }.n:X'-:y :,�'" +1. ��e:'��•,�"*t+, ' "ar, '� !e' 3'7wrT'�iR; 'r��'• .a:o_'Jai.%: Jat;SvF}rox� - .�:.�.ct: .°"�' "�A 1S��,l...r....'a:.�s.ae`,.'S5`.:w..-i+1.6'�Aa7t�:.,�.nr-.i• ,!'+..fit��X. ke.}}>: w3m�a The Department's address,telephone and fax number: • The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7`h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 f t ME Town of Barnstable - f l O Regulatory Services • a BAMSUBLE. , Thomas F.Geiler,Director gb 6 9 .�� Building Division ArFD��p 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: .> O� JOB LOCATION: S ,- r number / f treet � �- village `� f 76 (� "HOMEOWNEZ ; i// �111141171; ��0 /�! name home phone# i � nrkrhnne# - CURRENT MAILING ADDRESS: �G�r��' /e� 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 um inspection procedures d ements and that he/she will comply with said procedures and requir me ature of Homeown 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:forms:homeexempt