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Town of Barnstable U11dlIl
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1 . Posted Until Final Inspection Has Been Made
° Where a Cect�ficate'of;Occu anc „ s,Re wired;>such Bu�ldm shall Not,be.Occup�ed untltl a�Fn"alInspection'has,beern,=made ",. Permit
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Permit No. B-194073 Applicant Name: BALTIC COMPANY Approvals
Date Issued: 04/09/2019 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only Expiration Date: 10/09/2019 Foundation:
Residential Map/Lot: 246-141 Zoning District: RB Sheathing:
M "
Location: 72 SEVENTH AVENUE(HYANNIS), HYANNIS
Contractor Name:'" ,BALTIC COMPANY Framing: 1
Owner on_Record: MCNALLY,CATHERINE TR Contractor License: 152372 2
x
Address: 180 WEST 20TH ST � ° �
Est Project Cost: $ 10,000.00 Chimney:
! Permit Fee: $ 101.00
Description: Reconfigure existing closet and bathroom Into.two ba"throgms.one FeePai Insulation:
d $ 101.00
for master bedroom. Relocating existing doors to accornodate new t Final:
bathrooms.
Dae 4/9/2019
Plumbing/Gas
Tempered
p Glass required in window.
��
RMCK ' Rough Plumbing:
:. . Building Official
Final Plumbing:
Project Review Req: \
This permit shall be deemed abandoned and invalid unless the work authonzed`by this permit is commenced within six�months afterissuance. Rough Gas:
All work authorized by this permit shall conform to the approved application and the'approved construction documents for whi4 this permit has been granted.
All construction;alterations and changes of use of any building and strudures 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<provid, on this permit. Service:
Minimum of Five Call Inspections Required for All Construction Work
1.Foundation or Footing °'' W 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
--- ---------- -
0 1 -7S
plication Number.................................................
L".."t-DING DEPr 0 D
BARNWAME, 101 B .
MASS. g Permit Fee.......................................Other Fee........................
039. APR 032019
TOWNOF BARNS'-A]�LjFee Paid............................................................... ......
a P-w4VE—
TOWN OF BARNSTABLE Permit Approval by..._.. 0 n..... .07//7
BUILDING PERMIT
Map........................................P=el.............................................
APPLICATION
Section 1 — Owner's Information-and Project Location '
Project Address 72 5ev-&— &4 five Village—? Par�
Owners Name Ca6r( l4e hC IVAW
Owners Legal Address 7 2- A-,It
Z)J-/
CityL 71- -,k State
J zip 62601
Owners Cell# E-mail
Section 2 —Use of Structure
Use Group_ F-1 Commercial Structure over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet
❑ Single/Two Family Dwelling
Section 3 Type of Permit
F-1 New Construction E] Move/Relocate E] Accessory Structure ❑ Change of use
A
El Demo/(entire structure) 0 Finish Basement El Family/Amnesty El Fire Alarm
Rebuild El Deck Apartment Sprinkler System
❑ Addition ❑ Retaining wall Solar
Renovation ❑ Pool ❑ Insulation
Other—Specify
Section 4 - Work Description
)e
L
wo exrl h 1-01a C S I do-P
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Last updated: 11/15/2018
t
Application Number....................................................
Section 5—Detail
Cost of Proposed Construction Square Footage of Project
Age of Structure Dig Safe Number
#Of Bedrooms Existing Total#Of Bedrooms(proposed)
i
110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design
Section 6—Project Specifics
❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors
❑ Plumbing ❑ Gas ❑ Fire Suppression
❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom
Water Supply ❑ Public ❑ Private
Sewage Disposal ❑ Municipal ❑ On Site
Historic District ❑ Hyannis Historic District ❑ Old Kings Highway
Debris Disposal Facility: I am using a crane ❑ Yes ❑ No
Section 7—Flood Zone
Flood Zone Designation
I
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 a
4
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Last updated: 11/15/2018
---------------
a
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600, Washington Street
Boston,MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbei-s
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): ( C CO �''t PA 't �/K C_
Address: 940 ra,4�'� -1 1,v✓Tn�ln
City/State/Zip: Mar�4145 M1,X IqA 02dk--Phone#: 774— 22 - 34
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 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
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.insurancecomp.insurance.:
required.] ,
5. We are a corporation and its 10.❑Electrical repairs or additions
3.El am a homeowner doing all work -officers have exercised their 11.❑Plumbing repairs or additions
right of exemption per MGL
myself[No workers comp. 12.❑Roof repairs
insurance required.]t c. 152,§1(4),and we have no
employees.[No workers' 13.❑Other
comp.insurance required.]
*Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
tContractors that check this box must attached an additional sheet showing the name of the sub-contractor;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. ,,/ r.� /���� . . _ •
Insurance Company Name:
Policy#or Self-ins.Lic.#: '3) _S 3U `I 1 2-`Y"--®2-7 Expiration Date:- Z 0
! �,Q
Job Site Address: 72 Seer c-`- "/'` AV 'City/State/Zip:. � �V� �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 certify u the pains and ties rjury.that the information provided above is true and correct,`
Si ature: Date:
Phone# 7 7� _ 2-2 g — 3 e'L
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." t
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 Off cials
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 permittlicense applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to 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 Commonwealth of Massachusetts
Department of Industrial Accidents
Office of investigations
600 Washington Street
Boston,ILIA 02111
Tel.#617-727-4900 ext 406 or 1-877-MASSAM
Revised 4-24-07 Fax##617-727-7749
www.mass.gov/dia
4
Division of Professional Licensure
Board of Building Regulations and.Standards
Cons�r�}A:EaiOA{SF1�Pry isor
CS-094476 Eapir es: 10/02/2049
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LINAS REVINSKAS,
87 CAMP OPEGHEE'ROAD {
CENTERVILLEpM-A 2 Z
Commissioner CIL
License or registration valid for individual use only, I Office of Consumer Affairs&Business Regulation
before the expiration date. If found return to: HOME.IMPROVEMENT CONTRACTOR.
Office of Consumer Affairs and Business Regulation Registration fN,1152372 1 Type:
10 Park Plaza-Suite 5170 Expiration 8123%2018 DBA
Boston,MA 02116 1W '�^ _- '� ;
BALTIC COMPANY((
VI\_ — !
LINAS REVINSKAS 1.}
87 CAMP OPECHEE
-•S d r
--- i CENTERVILLE,MA 02632 Undersecretary
Not valid without signature 1
i
Application Number...........................................
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.
a
Signature Date
Section 10—Home Improvement Contractor.,
Name Telephone Number f
' 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 11 —Home Owners License Exemption
Home Owners Name:
Telephone Number 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 by 780 CMR and the Town of Barnstable.
Signature Date
APPLICANT SIGNATURE
Signature '' Date 3/
Print Name 7DC�� Telephone Number
A
E-mail permit to: 5-1
v
Last updated: 11/152018
Section 12 —Department Sign-Offs
Health Department ❑ Zoning Board(if required) ❑ 0
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, e- IqC &AA as Owner of the subject property hereby
authorize a&C a c_ to act on my behalf, in all
matters "relative to work authorize y this building pe 't application for:
( ddress of job)
�3 1211
Signature of Owner date
v
Print Name
i
i
Last updated: 11/15/2018
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�cn�rf�t IECC2015 RESIDENTIAL ENERGY EFFICIENCY DETAILS J
CLIMATE ZONE 5 (USE EITHER PRESCRIPTIVE VALUES OR RESCHECK CALCULATION z
�7�z�GyL lrft I��
TABLE 402.1.2 (MINIMUM PRESCRIPTIVE INSULATION & FENESTRATION REQUIREMENTS) 0
FENESTRATION SKYLIGHT CEILING WOOD FRAMED WALLI FLOOR BASEMENT WALL BASEMENT SLAB CRAWL SPACE WAL U)
LI-FACTOR LI-FACTOR R-VALUE R-VALUE R-VALUE R-VALUE R-VALUE R-VALUE w o "t
0.30 MASS . 0.55 49 20 or 13+5 30 15/19 10(4 FT.DEEP) 15/19 0 0 �p
AMMENinc0
NOTES: Q Of Q
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1. R-VALUES ARE MINIMUMS & U-FACTORS ARE MAXIMUMS. Illw N
2. 15/19 MEANS R=15 CONTINUOUS INSULATED SHEATHING ON THE INTERIOR OR EXTERIOR w00
OF THE HOME OR R=19 INSULATION CAVITY AT THE INTERIOR OF THE BASEMENT WALL � _ �
3. REFER TO IECC 2015 CHAPTER 4 FOR ALL INSULATION & ENERGY REQUIREMENTS O m Q =
4. 13 + 5 MEANS R5 CONTINUOUS INSULATED SHEATHING ON THE WALL EXTERIOR U 2 w
32" DOOR �F\n/ 45" DEEP & R13 CAVITY INSULATION
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BEDROOM BEDROOM �O`� 1.) CONTRACTOR IS TO VERIFY ALL EXISTING CONDITIONS w
��� & DIMENSIONS IN THE FIELD J W
2.) CONTRACTOR TO VERIFY ALL INTERIOR & EXTERIOR MATERIALS, Q �
PLAN DETAILS, & FINISHES IN THE FIELD WITH OWNER z W
FLOORw � �
3.) ALL CONSTRUCTION TO CONFORM TO 780 CMR MASSACHUSETTS z 0
® SMOKE DETECTOR STATE BUILDING CODE, 9TH EDITION AMENDEMENT & IRC2015
® CARBON MONOXIDE DETECTOR 4 ) 110 MPH EXPOSURE B WIND ZONE SCALE :O
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5.) VERIFY ALL PLUMBING & ELECTRICAL DETAILS W/ OWNERS ON THE SITE
LEGEND: DURING FRAMING CONSTRUCTION DATE :
6.) TIMBER FRAMING TO BE SPRUCE/PINE/FIR NO. 2 GRADE, 900 PSI MIN. 3/29/2019
EXISTING WALLS 7.) FOLLOW ALL REQUIREMENTS OF THE IECC2015 RESIDENTIAL ENERGY DWG. NO.:
CONSTRUCTION TO BE REMOVED EFFICIENCY REQUIREMENTS & VERIFY ALL DETAILS WITH THE INSULATION AlW CONSTRUCTION INSTALLER/CONTRACTOR FOR THE STRETCH ENERGY CODE [�