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0114 SEVENTH AVENUE (HYANNIS)
__ �. /mac/a�rlis�o � I , /� Z ys-: D 6 O IE 'I, . Town of Barnstable t111C11n g . z " '`" '" '. ` ".Tee # •�,*'Y� '. �0aai' �r = �.', ��..� �,.,a °'4'�- `� ,.:g``a• `",°, .r i �'f m theStr eta<A coved PlansMust>be=Retained;onJ:ob,and' his Card{Must be;Kept ;' s t Pos -This Card 3. So That rt is U�s�b a Fro 73A1i2t�SI'A ,' ,g` �s%''., ,..:,,:. .- `� •y �P'��,, s .`i �Ya x y ° ,., a n .. „�= e • bus& Posted Until Final tnspection Has Been Made�3� ��> `# �, p . .. ,,,.; •F Wh26 ere a Certificateof Occu ands Re aired such,Buil"din shall<Nofibe Oceupred until a Final Inspection has been made �� 1t < :� .. p'x.._.w.�. t Qw,...s�•.3..': 'a' - 'va«..3.ta..g�,",.ea.:a,.a:: �,«z ',.y. ,. .,.. .; :;«..< y .Y.. ...>, 4,•�r..aa"�6..^..: s. ,>t„«� Permit No. ;. B-18-1744 Applicant Name: ROBERT WALSH Approvals Date Issued: 06/28/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 12/28/2018 Foundation: Location: 114 SEVENTH AVENUE(HYANNIS), HYANNIS Map/Lot 24S-060 Zoning District: RB Sheathing: Cobt-dctor'NaMe ROBERT WALSH Framing: 1 Owner.on Record: FLASHNER,ARNOLD R g 7�15 l a' IZ>tw Address: PO BOX 523 Contractor License x141991 2 71 g WEST HYANNISPORT, MA 02672 �� 4 Est Pro�ectCost: $37,000.00 Chimney: sue " . Description: Build 16x12 4 Family Room off kitchen Permit Fee. $238.70 x �, e Insulation: -lgl�s et,v �; ,Fee Paid $238.70 Project Review Req: SMOKE DETECTOR REQUIRED IN NEW FAMILY ROOM. Daate h 6/28/2018 mal. 7 PU 5"'. v Plumbing/Gas Rough Plumbing: u k Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoAzeYbysthis permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved apply at on and�therapproved construction documen s ordwhieh this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures'shall be in compliance with the local zoning by lawsand codes. This permit shall be displayed in a location clearly visible from access street or road.and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. x e Electrical ` Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire®fficials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: �` g �• °.: Rough: �. i 1.Foundation or Footing '. �- • - � ° _ 2.Sheathing Inspection Final:. 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do.not have access to the guaranty fund" (as set forth in MGLc.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT—ISSUED RECIPIENT r 1HEo� — i -7N� �Y 0 Application Number............................................................ �+ 6 * BAMMASLE. ����� Petmit Fee%......:.....�.&176 Other Fee........................ MASS. A q 1� 16,3g6 Total Fee Paid O� TOWN OF B�, � STABLE Permit Approval by... f............ ..............on..... BUILDING PERMIT .`1/ 0(,Q � .................Parcel....... ............... APPLICATION Section 1 — Owners Information and Project Location j g (Q ue vs -l-, 1�J 1�P image a `0--4- Project Address Owners Name 2 ��° 4 Owners Legal Address_ w. I C• L City �Ce -- � State�� Zip Owners - Z�l E-mail ll# �/9� ��( - Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 -Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4 Work Description E r is T act undated_2/9/201 S Application Number...................................,.................. Section 5-Detail Cost of Proposed Construction ~4�O Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing ,. Total#Of Bedrooms(proposed) 110 MPH Wind Zone Compliance Method 0 MA'Checklist WFCM Checklist ❑ Design Section 6-Project Specifics firing Oil Tank Storage Fj Smoke Detectors [� Plumbing ❑ Gas ❑ Fire Suppression E Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water SupplyPublic ❑ Private yy 9 Sewage Disposal ❑ Municipal ff<-site j Historic District ❑ Hyannis Historic District. ❑ Old Kings Highway Debris Disposal Facility: 7-az -r►-®-0f-' I am using a crane ❑ Yes RNo Section 7-Flood Zone Flood Zone,Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section S—Zonisg Information � 9 Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required 3 d Proposed "3E� Rear Yard Required . A® Proposed Side Yard ' x x Required 4,9 Proposed GD Has this property had relief from the Zoning Board in the past? ❑ Yes © No Last=date -2/92019 NO w m u cma/ 100.00' 0 D- Q � N LOTS 573 .* 575 '" Q cn_ O 8000 S. F. 0102 W ni 27.0' a rn o z 0 —� o 0 1 O < rn PROP. z N ADD. ` N rn - 0 100.00' SUN 27 2018 TOWN OF 8,4%S-r48LF BUILDING LOCATION PLAN FOR 1 14 SEVENTH AVE., WEST HYANNI5PORT, MA NOFMcyG PREPARED FOR Q? S�yEN W. �,� ARNOLD FLASHNER 2 -4 5CALE: DATE: DRAWN BY: RUMBA c �, I " =40.35791 20' 06-25-201 8 TMW JOB NUMBER: REVI510N: 5HEET NUMBER: is �` 1 8- 1 1 2 CPP- I WELLER * ASSOCIATES P.O. BOX 417 CENTERVILLE, MA 02G32 TELEPHONE: (508) 328-4G92 EMAIL: trl5weIIcr@gmaiI'om REGISTERED LAND 5URVEYOR5 * ENVIRONMENTAL CONSULTANTS Traverse PC No J m U N 100.00' °- a Ln 0. d N LOT5 573 575 `/ �t ,� a to O 8000 5. F. g o a- ILI V, N rn/ 27.0' a rn z O O 0 z ° C 30.9' rn PRoP. 3 z N ADD. C 16 rn - 0 100.00' BUILDING LOCATION PLAN FOR if 1 14 5EVENTH AVE., WE5T HYANN15PORT, MA PREPARED FOR °F""' ARNOLD FLA5HNER SCALE: DATE: DRAWN BY: STEVEN`N' �� 1 " 20' OG-25-2018 TMW 2 RUMBA V NO.35791 w JOB NUMBER: REV1510N: SHEET NUMBER: 18- 1 12 CPP- 1 WELLER * A550CIATE5 P.O. BOX 417 CENTEPWILLE, MA 02G32 TELEPHONE: (508) 328-4G92 / _z/1. ' EMAIL: tr15Weller@cjmaii.com �v REGI5TERED LAND 5URVEYOR5 * ENVIRONMENTAL CONSULTANTS Traverse PC . The Commonwealth'of Massachusetts .fartment o Department Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gav/dia Porkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/OrganizaEon/Individual): K LvG:i� S Address: 3 City/State/Zip: Phone#: a a Yg Are you an employer?Check the appropriate bow Type of project(required): L❑ I am a em to er with 4. [] I am a general contractor and I p y have hired the sub-contractors 6. ❑New construction employees(full and/or part-time).* 2. I am a sole proprietor or partner- listed on the attached sheet. 7. El Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have.workers' 9. ❑Building addition [No workers'comp.insurance, insuranceinsurance, required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumb' repairs or additions 3.❑ I am a homeowner doing all work ❑ p myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance re ed. t c:152,§1(4),and we have no 4 ] employees.[No workers' 13.❑Other comp.insurance required_] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 1 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 vyhether or notthose entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: a Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address:~ 1 Ve City/State/Zip: J/�: 14 y n vV 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 cend under he pains d ena ties f perjury that the information provided above is true and correct Si aline: Date: / Phone#: �"6 _ $T�d Offzcial 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#: K Commonwealth of Massachusetts t Division of Professional Licensure Board of Building Regulations and Standards Construction.S'a*#6- r 1 & 2 Family CSFA-057394 } ff�pires: 06/02/2019 ROBERT G WALSH " P.O.BOX 713 �i v , MARS TONS MILLS MA48 Commissioner ' r%�r `Fr!i»>ira�uo�all�n�'^llrr�.;rrr�rrae/L; Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Individual before the expiration date. if found retvm'to. Registration Expiration Office of Consumer Affairs and Business Regulation 141991. 03/02/2020 One Ashburton Place-Suite 1301 ROBERT WALSH Boston,MA 02108 D,'13/A HARBORSIDE-REMODELING 50 CA T G.WALSH 250 CAPTAIN CROS8Y,ROAD f CENTERVILLE,MA 02632 —ALNot valid without signature Undersecretary g 1 , Town of Barnstable Building Department Services Brian Florence,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 I �•� w�� �� ,as Owner of the subject property hereby authorize + k—o'`S h to act on my behalf; in all matters relative to work authorized by this building permit application for. -fin A\J L 0 - - (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. i S' tare of 6wner Si&Qure of Applicant Print N e Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:08/16/17 Application Number........................................... N Section 9-.Construction Supervisor Itl ���r � Name � t�1.b . Telephone Number Address O, City faze Zi ��� �s'rnS 1~►.► �s t�h� o p CG� L'0 9 License Number O T 7 3q 9 License Type C Sd"-A - Expiration Date_ 4 L J ® lei Contractors Email 10 yA c 490 0( 100 1 &eJ= : Cell#C I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date d Section.10—Home Improvement Contractor ,a Name Telephone Number (-5ig) Address 29.6s3, 71 City-/yi044*-S &&tate j�4y4 I Zip 6 a2 6 y� Registration Number 1 yl 971 Expiration Date 2-1 ,-2 o 2-D 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.LC... Signature 9- Date �I 6 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 2� Print Name Imo 6t,,J^ Telephone Number , .g E-mail permit to: v. c 9,C) ( ,r . G� T e..F....A. -A."7 In^n10 Section 12 —Department Sign-Offs Health Department © Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ i Fire Department ❑ Conservation` ❑ For commercial work,please take your plans directly to the fire department for approval Section 13—Owners Authorization L , as Owner of the-subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name r j ffi �I �I j a Last undated:2/92018 Asscssor',s�Nflce 1st floor Map' '�2 M / 0b.0 d lxf-- Permit Conservation Office 4th floor C` ZgS�p' Date Issued Board of Health Ord floor I Engineeriu Dept. Ord floor House# SEP Mom'9 INS Planning Dept. (1st floor/School Admin.Bldg.): Definitive Plan Approved by Planning Board 19 ENVIR (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) TO �LCODEAM ATIONS TOWN OF BARNSTABLE I Building Permit Application � Proiect Street Address k NA �5c°�er�� fr Ue- Village n,nlSLbi'`� m Fire District �''yuiJvil s � (hyper qrr�r�)r1 _aS�/►�f Address )y SP i f0 Telephone '7`7 45 - 9 S 7 2Y . Permit Request: ' [n o'X c \ 5`lc,4'V (45 X /d aA&re-3'-\ d.(� a1 Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use \. .rpy�� Proposed Use Construction Type Eaistine Information Dwelling Type: Single Family Two familv Multi-family Age of structure 30 yf. Basement tune Cm v Historic House Q`) Finished ✓ Old KinP sHi,ghway A Unfinished Number of Baths 1 No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel �pp (b S ';�occe A I r Central Air Fireplaces Garage: Detached t+ Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name J'o,rXn r. Ve-r Telephone number !7-7 5—' 7 7 S-I Address �9 (`erg Q.C.f-� �. License# Home Improvement Contractor# `010 626 Worker's Compensation NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Project Cost 5000,©r-) Fee SIGNA ATE BUILDING T DENIED FOR THE FOLLOWING REASON(S) BPERM T 1/26/95 '3-726 FOR OFFICE USE ONLY 245.060 4 LDRESS114 Seventh Avenue VILLAGE W. Hyannisport � 4 • ' 1 , OWNER Arnold Flashner DATE OF INSPECTION: FOUNDATION ? FRAME INSULATION r' FIREPLACE ELECTRICAL: ROUGH FINAL - , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING: I t DATE CLOSF.D' T ASSOCIATE P ' _---- ---_«««_�__-_ «_-_ �_- -_ --_ -«_--_«-«------_«---____ «_ _--_«___ _-_ _«__ _ _�-- --- ---- - ---«««_______«« -«-- _------ ______«___-_ -_ -«--____ _-_---_«-__-____««-____-_-« -_ -«_-�__«_-- «---- ---- -- --- «- «- __-------- --«- ---_- ---_ ---- --- -__ --�_---_ -_«_--�-_-----_----_«-««___-___« ____ _�__ «-«-____ _-__-_-____ «-- «_____-_«_- -« - ---__ «--- _ _ «-------------« -__-_«_- - ----- _-«-__-««-«-_«_-«--_«- «------_-_ ««____ -«- -__--_ =1=-- ________-__ _-_ -_ � -�- -_-_-«'-_--« -__- _ «_--««- - ««_-_ «-__-__-______ __ «___- -_ _ _«-_-_---__ «_-_-_-__- =-- --- - _ «_--_ __ _ -««_ «_ -- «-« «� «______- -_-_ --�'---_-_ -« «««__-_- -_- ___-_ --___-__-__-_ -_-_ __ __----«_-«-_- -----«-«__-_---«-_-- __------«------- ------- ---- ----------------- --«------«-------_-� - -------------------------- ----- --_ - -- -_ _ _--__ «__-_--__-- --«--_«-_ __-_«--____--«---- ------------ - --«««--«-««_ _-__-_ _«_«__ --«--_ «- -- «- ««_««_-«___-_ «_--__ -_-_- -___-««_ _ -� -_-_-_«-- ---_ --- _-_---«_--«-«--�-- _�_-____----�----_�«-__- __«-___ _ _«--_--_--«_-_ __ -- _«-- -- -----«_ _ - _ - -- -- -- ---- -- --- _ --------- _--- -- --- -_ -- ----__ _- r_ --- = ----- _------_---- --_-_-___ - _- _ -----_ ------r- ----- --=_ _ _ -- ---- --- ------------ - -''--_ - = _- --- '__ =_---_- _-------- _--- =-=----_-__--------------------------------------------- ---_=-=-----=___-__---- ----=-_=_--_ ------- _ -----=-- ------- ------ -------- -- ------- -- :__-=------__ _:--=----------_=---_--_-----�__=__----__--- -- - --- - - - - -_- -----_------------ ------------ =----- - ----- ------ ----------- ----__-- ----_-_- - _----=i- - -- - - - -- - - - - -- _ _----------_-____- _ ----- _------_ -_ --- ---- _2--_-------------_ _ _«-------«-_---- -_-__-------_____-----__ 1=--_---«_«------ -_-_---- --------__----_---__ -- --_---------------- �_« __ -----_ -__--5�----- -__ - _ ----_-_-- _-----_-- ----------------- -- -- -- ------- ------ ---- _- _ _ -__ ----_---_-_-_------__-- __- ____ -_--=---_- -_ -- - "- - -- -_ - -'t- ■ i � � � - ____ __ � �___ ■■ tit � a 4 3' 0 . . . . . . . . . . . . . . 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SN01101a1S3a < dt 4 8Wf1H11H018 lfld 'J-J3H1 'ON-011 31VO 3AI103333 �= k '1SNI`dJV N0110310dd HOA 966 LIZ U L �� 31V0 N0I1V»IdX3 F `. NOt1f1Vo 60SIA83d,tPS' d i S R 0 2 BUZO VW'NO1S08 S113snH0VSSVW 30V1d NOIUOSHSV 3NO d0 A133VS 011Bfld 301N3WlaVd30 Hl'iV3MNOWW00 � t � v E c g, 4. t I - c'r 4 s. R Cl: ' lit;t' t' M1, � ,r _ I H �= , 'lie .. _ o; 'HOME IMPROVEMENT CONTRACTORS REGISTRATION ' Board of Building Regulations and Standards i a r One Ashburton Place . Room 1301 I ; k Boston , Massachusetts 02108 Iz € Sun5� xaHOME` IMPROVEMENT G0NTRAC70R Iv____________ k � Registrtation' 106626 Expiration 07/24/96 t= � ,� ' � T,ype =�rrINDIVIDUAL i . T� 1a6 � .1u � HOME IMPROVEMENT CONTRACTOR Registration 1042611%Q1, s Sanford Tyler Type °�INDIVIDUAL t;A Y x Sanford R . Tyler Expiration `� 07/24/96; ` 68{kThird Ave . W 'Hyannisport MA 02672 Sanford Tyler "kt r` ' a rz r VA Sanford R: Tyler Rod , V £_ r 'Ihird Ave a =r AGMIhISTRATOR s � W. Hyannispol t MA 02672, -N C 11/02:94 17:02 $6177277122 DEPT INT ACCID 0 001 Cotwnonwealtli, of WaJJac{ztc etb d✓r�IartmenE o��ndttltr��cci�nfe 600 !/V mkijton St et James J.Campbell &Eon, VewaAwai& 02f f f Commissioner Workers' Compensation Insurance Affidavit `C with a principal place of business at: (eicyistsee�zEo) do hereby certify under the pains and penalties of perjury, that: O I am an employer provid'mg workers' compensation coverage for my employees working on this job. Y Insurance Company Policy Number I am a sole proprietor and have no one working for me in any capacity. O 1 am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number ` O l am a homeowner performing ail the work myself. 1 url.dersund tii;i a copy of this slternent will be forwzrded to the Office of invesdpdons of the D1A for coveraBe verification and that failure to secure cc erage as rewired under Secdon 25A of MGL 152 can lead to the imposition of criminal penalties consisdn¢of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties in the forrr of a STOP WORK ORDER and a fine of S 100.00 a day against me_ Signed this-_� day of -;�a� c,Q C' _, 19 Ucensee/Permoe Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE. BUILDING PERMIT # 3o7 Mam Sum 1-7v2fu»,NIA 02G01 Offioe: SM-79"227 F= StlB 775 3344 PlePh lea B��S�mmissioncs For office use only Permit no_ Date AFMAVIT HOME IMPROVEMENT CONTRACMR L&W: SUPPI.ElYMNTTOpERMITAPPUC1iZ ,OjI ' MQ,c`I42A requires that the-rtooruruaion alter s modaai oq improvement, rem( al,dcmotitim er consuuaion of an addition to any ping Owum O=qicd - building containing at least one but not more than four duelling units or -to st m=rrs which are ad}aoati io such rmidenoe or building be done by metered contractors,ailh attain exczpfioas,along with other ljpeof Work: . �7C�� /�d�+ ;}'e� Est.Cost J, ® O C7 ` Address of Work:_ c t "Ox-rter lame: r n 0 Datc of Permit Application: I herebt'oerufyihat: Rcgisuation is not required for the following rczson(sy Work<xcludcd by 12w _Job undo S 1 Ow Euilding not oca-ncr-Occ upicd Ok ncr pulling ovu•n painit 2T40ticx is hcrcbv given thzt: O«r;•*tp�PULLT;;G THEIR<)vN N K:Fr TOE DEALT`:G VTi:U,',,REGISTERED CO-,7PACTORS FOR APPLICABLE T ON�� I'�TROtii!.�•i �.0�r: DO IZOT i-�1'E ACCESS TO Trt` FROGRzd,.0R CU V"D LT 'ZDEF?•;Gi c. 1<2A SIGNED UNDER PEN/,LTII Is Of PLFum, crc- 1 1 cl5 P.c�,�ss2uon 3�0. OP, Datc G rKI'S n2-MC 4� Town'of Barnstable *Permit# Expires 6 month&om issue date Regulatory Services .Fee snxxsznaie, + . ass.1639. �� Thomas F.Geiler,Director ArEp MA'1� Building Division Tom Perry,CBO, Building Commissioner. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' Office: 508-862-403 8. Tax: 508-790-6230 EXPRESS PERMIT APPLICATION .:_ RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number�4�- ,06,o . Property Address 11q, "/ (� , )Par Residential Value of Wo Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name `> / i p " Telephone Number. tJ �2 Home Improvement Contractor License#(if applicable) 10 Construction Supervisor's License#(if applicable) 7 to ❑Workman's Compensation Insurance X ck one: I am a sole proprietor J U N 14 2012 I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name M. ' TOWN OF BARN$TABLE Workman's Comp..Policy# Y Copy of Insurance Compliance Certificate must accompany each permit. - 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 (maximum.35)#of windows *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 Imp rovement.•Coi tractors License&Construction Supervisors License is required. C 002, SIGNATURE: vv Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 051811 The C'ommonweahi of Massachusetts Dart o,f InsJrial Accidents OtfiiFe of Imestigations 600 Washington Street Boston,M4 02111 wrvil:rtt�gov�dia. . Workers' Compensation Insurance Affidavit Bor ders/Contr achws/Electricians/Plumbers Apiplic2ut Information Please Print Legibly Name musinewo, iz onffiwividual): Address: � -City/State/Zip- ' Phone Are you an employer?Check the appre. to box: Type of project(required): 1.❑ I am a employer with. 4. ❑I am a:general contractor and I employees(full and/or P�-�'e)- have hired the sub-contractors 6. New construction, 2. I am a sole proprietor or partner- listed on the attached sheet. ?. ❑Remodeling ship and have no employees These sub-contractors have g_ [— Demolition working for me in any capacity. employees and have wodmrs' [No wodloers'comp.insurance comp insuranc�e.I 9- ❑Building addition required-1 5, ❑ We are a corporation and its 10.❑Electrical repairs or additions . officers have exercised#wir , 3.❑ I am a homeowner doing all:vsorlc 11_❑Plumbing repairs or additions ourself: [No workers'comp. Fight of exemption per MGL 12 Roof insurance,re t C.152,§1(4�and we have no repairs employees.[No workers' 13. ther comp insurance required] ;Any agplica�.brat checks box#1 mast alsa fiII out tip section below showing ihea amAere camP��p�9�+�ti� H.ameoa�ners who submit this affidavti mdicstmg they ne:doing all wink and then hire outside cant mcnnrs mast submit a new aff davit indicating such. ZConuactors that check this box must atm hed an additional sheet showing the name of the sub-cantrachus and:state whether oruot those entities have employees. If the.sub-coubacturs Lase employees,they must provide their workers'comp.policy number- lam an employer that is priivi ing w vrkers'compensation.insurance for my eeuptayiees. Below is the policy turd job site. information. Iusurance CompanyName: Policy#or Self ins.Lic.#: Expiration Date: Job Site Address: CityfStateiZip: 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,is well as civil penalties in the form of a STOP WORK ORDER and a tine 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 insdrance coverage verification. I do Hereby certffl,under the pains nut c tthe informaAmptoviArdabove fs true and correct si tie: Bate: J � - Phone#; Official use only. Do not write in this area,to be completed by city or town o,oiciat City or Town: PerumtUcense# Issuing Authority(circle.one): 1.Board of Health 3.'Budding Department 3.City/Town Cleric d..Electr ical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: 6 'i Z 1MM i - y� 16;9. own of Barnstable ,0�' ' �oA 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 as.Owner of the P ro e subject'P rix . 1n n , hereby,authorize V—` a o r V' e a to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date CI cL Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit fonms\EXPRESS.doC Revised 051811 f �tHE Town of Barnstable Regulatory Services BARNSTABLE' * Thomas F. Geiler,Director Ep;A.,•``� 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 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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 Ferson(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 wbo 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 Derformed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code.and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as'supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of-his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q.',WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 051811 '`- Massachusetts- Dcpartincnt of Public Sarctv Board of Building Rc�'Fulations and Standards Construction Supervisor License One-and Two-Family Dwellings I Licenser CS 47505 BRIAN G MCCARTHY 80 SRANDISH WAY . , W YARMOUTH, MA 02673 ; Expiration: 9/11/2013 ('ummissi file r . Tr#: 2305 t Office otr`o me A ai B inc egul�a`in License or'_reg►stration valid for mdividul use only S HOME IMPROVEMENT CONTRACTOR before the expiration date..If found return to: Registration: _rn1.07723 Type: iP.. Office of Consumer Affairs and Business Regulation f x Expiration 8%5l2012 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 r M RTHY BUILDERS.A Brian McCarthy `', 32 Carver Road W Ykrm6uth .MA 02673 e, ._ Undersecretary j Not valid without signatur ii ...1...1-• ` } TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map :)`A 5 Parcel D to 0 Permit# 7 7 Health Division 9 1 QJ 3&Qi, 11�� { , �f` ;Dateilssued Conservation Division 1&010q� 1! Jff� ' Application Fee Tax Collector �,:�/�`�/L Permit Fee Treasurer Planning Dept. Copy AND U► Date Definitive Plan Approved by Planning Board �4 > U (IONS REG .� Historic-OKH Preservation/Hyannis Project Street Address 1 1 y Je.,zr}�-. to 1-1 ��r �+ VNl,, Village Owner \A Address 1 iy !Se\AY_A n Gee w•N., ��,yPe.�' Telephone Ct\ q (. Permit Request NO ,\.� Square feet: 1 st floor: existing 10 5s`1 proposed WAO 2nd floor: existing proposed Total new s 3 y Zoning District S, Flood Plain Groundwater Overlay Project Valuation 000 Construction Type Lot Size S Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Cl-*' Two Family ❑ Multi-Family(#units) Age of Existing Structure 5A ye,,. Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes _❑No Basement Type: ❑Full LKrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: 21'16'as ❑Oil ❑ Electric ❑Other Central Air: O'eYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No \�+ Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size �1P Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes /'No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name e-ys� tf, -�'�. Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AI SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED _ � rr MAP/PARCEL NO. ADDRESS. —. t VILLAGE - . -- }J y OWNER . -DATE OF INSPECTION: FOUNDATION FRAME ��Pq� y . INSULATION z L FIREPLACE ELECTRICAL: ROUG fib _ FINAL PLUMBING: ROU FINAL_ r i GAS: ROU r". . ��• _FINAL ° FINAL BUILDINGew DATE CLOSED OUT 1 l it 1 ASSOCIATION PLAN NO. t 1 The'Commonwealth of Massachusetts Department of!Industrial Accidents , 0xCe o/lgyestfg8tlans . 600 Washington Street Boston, Mass. 02111 �3 Workers' Com ensation Insurance Affidavit / location: `. } - �� hone# S��-�►S �`�S �. _ ci all work rarelL - I am a homeowner p orming • . 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Mies of a 9ne np to 51,500.D0 and/or Failure to secure coverage as re4uiredunder---monZ5Abf MGL 15Z came. to-Reimpositio zne n of ef$100lp one years'imprisonment as well as civil penalties in the form of a ti T of DIA for co nag°ve cation.00 a dap agamat ma I tmdersiand 4iat a' copy of this stat entmay be forwarded to the Office of Inv estig .• I doh ereby-certi an-ad. enaltes-of-perju ryih�the-informatian-p hip n r-ouiderLabnue_is.2ur�au�coirec't M _ Date �� 5 Signature .,.-•-:..;.`_ ,.. , .....'r Phone# mom e do nat write in this area tob ecompleted by city or town oMdal Sdaluse only ermit4icense# ('Bilding DepartmenE❑Licensing Board y or town: - []C el ectmeze s ODIC- contadtperson: r Information and Instructions Massachusetts General Laws chapter�152 section 25 requires employers person , the serviceers) compensation for of another under any their rlovees. As_quoted from the `law , an employee every .. .of hire,'express orimplied, or or in , association, corporation or other legal entity, or any two or more of An employer is defined as an individual, Partnership, _ the foregoing engaged in a]oint 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 zesides 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 onthe grounds or building appurtenant thereto'shall not because of such employment be deemed to be an employer. c MGL chapter 15Z section 25 also states that every state or local licensing any applicant who has of a license or permit.to operate a business or to construct buildings in the commonwealth wealth for not produced acceptable evidence of compliance with the ins uroance c o�verage act for required. erforrna Additionally, ti o public w tm commonwealth•nor any of its political subdivisions shall enter m y P acceptable evidence Qf complian cb with the insurance requirements of this chapter have been presented to the contracting autho#ty •` r a .. . .. r.• r1 /r r!% /�/ /r Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted the Depaztmeut,of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'l�ie'aff'idavh should-be retumed to the city or townthatth�pp1n questions regardingation for ePe the nit�`law'o=�if you being requested,not the Department of Industrial Accidents. Should you have y qu obtain a workers' compensat ' olioy,please ca11;'tlie Depaitmeiit afthe number-listed below:. are reT=ed•to City or Towns •. be sure that the affidavit is complete and printed legibly. The Department fins provided a space at the bottomeof"be Please Investigations has to contact you regarding the applicartt, affidavit for you to fill out in the event the Office of Y „ euiirtlh`censeber wliichwill be useid'as a reference numli'er. TFie''affi�avits may�i'e'r t ' be sme.toemail of FAX unless other arrangements have been made: -� the DepartrnentbY., .. ^.,,,,.• Investigations would like to thank you in advance for you cooperation and should you have,anY9,uestions. . The Office of Investig, s � _, .,. ... please do not hesitate to give•us'a call. The Department's address,telephone and fax numb er. The•Commonwealth Of Massachusetts .Department of Industrial Accidents 0MCe©f inirestlgatlons 600 Washington Street Boston,Ma, 02111 , fax#: (617) 727-7749 rtin'na ii• «171727-4900 eat. 406, 409 or 375 °FI►+E71 Town of Barnstable Regulatory Services t ASTABLE. ' Thomas F.Geiler,Director 9 MASS. 039. a�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, 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. 2� Estimated Cost Type of Work: 5 o o d Address of Work: S�' � Gam. �• ����r��oa�� �� Owner's Name: �Y V1%0 i� �4s ti.c✓ Date of Application: I hereby certify that: Registration is not required for the following reason(s): nWork excluded by law ❑lob Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT O�ROVEMENTR DEALING W WORK DO UNREGISTERED NOT HAVE CONTRACTORS FOR APPLICABLE HOME ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date OrrLer's_va re RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE `a O q uare feet x$96/sq.foot= �3,o y o x.0031= -7 1 `{ a s plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x .0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) �-Z Permit Fee projcost JAN, -30' 03 (THU) 16: 18 ATTNY, F ITZGERALD TEL: 781 231 2657 P. 001 L_-o T 478 L-dT - I 1-4�,T5 577 1 5-7 t i j . (f>ogf:> FZ t . I'71t STo P--r p (_c:�:ST 5 7 i) 11+ m �, T�-+ -hIU MORTGAGE INSPECTION PLAN uuirER: A IZ1-I O l_D LOCAieu III 14 litE �—� jZ I I"1 T'G� - Cc'• +-F`1-A F-4 I�� (�P 1T Jill) na TIRE ulsunens. oxanul`Y 111AT I IIAVs E1)IAL1111E11 lite PIIEI.115CS Alit) 111E ItIImillIC9 51111NI1 PO rV ) MASSACHUSETTS C4111/111) 14 'IIIE 1 111 i AMO 1 D At1E lUtIE1115, 1.9 1'11011T, SIM. & IIEAR 1'All SEIIIA IC ap.Y.OF a �TA W11E11 Cc11S11111tW). LD IfltlllllEll CEIIIIF7 HAT 1105 PIIO IS r�T• &.0CA1111 III lite ES1A111151ikt1 II.UUU . 1* IAIAIIu AIIEA. 2$aao d�c )eb G 8- 1 -8S uuu►t �.J�o2 3 EXALW1AlNllt OF 111E 1190001/9 19 HA1IE,011t-Y 51111SF.411t11T l0 111E ll[r.Oullrn uAW OF 'IIIE 1 AIESI I1EE0,A1111 uOrs 11p1 nisi 11E voird110 111E ACCUIIACY OF lilt: Uttli ItESCIIIII11'RI P114V11AIS JU M UAW Ol IlkCW111. c1111. Ito. t1Y9 C014PA11Y Is IIOT IIESPI31151111 E frill IUIY 111UEIIlUItES ►►AOE LUUsEQ141117 '10 111E IIItC01111Eu OAIE: Of 111E Iw1EST 11EE9 Or ItECUno, - 2 V41911EVEn 01111 1111 10 9 AI1E 511OW11 IESS 111m OII@ FOOT nu11.1 111E rI1arCIl1Y IIIIE,I'f IS AOMSE0 Plwn w<. 1•ACE ,IIIAT A MUM POECISE SURVEY OL UADV TO VEIIWY lilt.sE IIEASu1lEl1E111S. VLAII / OA1EU ' 1109 CEn11(ICA11O11 15 OASE Oil 111E 1OCA11011 Of SIIIIVEY ►IMIIEIIS OF 0111[ItS, Alit) VOE9 f_ TL1 7T HOT OrrnESrlir A PRulhEltl'r SURVEY. -- -� IY90 J1119 CEIMICA11011 1'n DE t1Slso ran 1,101iWACE PURPOSES 0111_Y. SCAIFt OFFSETS AS SIInVAI A119 NOT TO TIC USED FOR Illk- EsrADUSIIIAEIIf 01' 1'1101'LItTY LIIIES BRADFORD UNGINE, WRING CO.. P.D. BOX 1244 IIAVIIIIIIIU. MA. 01,031 - M q- Rp 11.1_s, �la�o7 lEl (000) 313-2390 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE: //;2 JOB LOCATION: 11"A �even��n �V`t, li� N�o4�nvi�S,Dcy� V v tS ' number street village "HOMEOWNER": Q rY-i pN SO$- CL" itfi t- ay5- SAS� name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedur d requirements. Si re of Homeown r Approval of Building Official PP g 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:EXEMPTN., --------------- --------------- -------------- ------------------------------ - ----- -- ----------------- =_====_-=__-_==_-===_ =_--_==__--- ='=='==============================--====____===___-----=_== -_______---- - - ------- _ ---- -- __-_- --- __ _----- --- -_____-- --_---__-----_-- --_ _ - _ _ _-_-_- -_-_- -- - -_-_ - - - - _1� - -------------- ---- ----- ---- ---. ----- - - -- ---- -- -- �- ---__-- - ----�- _ -_-----�___- -- --______-----_-_- __ _ �- --_ ---- _---�-ASS -_---__- ---- - --_____- __-_--- ------ --___ _-- - ---- ----�---- --------- - -- �__-- ---__ --_--_-_-- - ---_�_ -__-----_-__-------_-_ _----- --------_--_---------- --------- ---_-__-_--___----�L= -- - - ----- ------- -------------- ------ -- __ - --__- - --__' ------___-__--- _--__- ---___------_____-_--_-_ _ ____-__ --__ -_ _- �t -�_-__--- --- -_---- "-- -- --------- - - --_-_�-------_�-- ----- -----_----- ---_-------_- --------------_ ----___-_--------_-__--- -_-__ __----- - -- -_ -_- -- --__ --� �._--- - -- -----_ ------- -_-_- _------- ----_ --_-__-� - -- - - -----_ - -� -_--�- - _-__-__- -_�--- -_ -- ----- _---_--_------ --_--_-- --__-----__ __--- _------_--_ - --- _ _ _ _-____-- _---__ _--_______-__--_-___---_----_--_--___--___ _-_-_-_ --____--- ----------- ------- -------------------------_-_-t---- -_-_ ------ --- _ ___ _ --- ---- -- ---------- ------- - - _'i- ►Da 0 A . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 - ® II 3 IDE-] JE=] C u a3s � a cc\A�c n 0 1 G 1_Q 11 East Elelvation � . CAc��c�:an) South elevation .............. ------------ LLJ -------------- --------------- 81-011 North Elevation ..... .:.......... t ",_:•.. ;�`F�-6,•.;A,.-s•o- ,^xl, e .t:., .. r 7�•-9 .h�ti'4` •*`^�s.��X ;yk.,� r. ,- .�..ne a-w ' 7� yy��'•�'�"`Ff' ti.f 0 oil C t t ,�c23W --- -. ---� ---)�-- � (�e��?•may .,. vv:..+i o-.^✓ ---- �` , L / a E Fj'1 VV�}n R e► J 3�J6- f� s�r�tt ►�e.bC?13 p 1 -:t FIBREGLASS SHINGLES 30#ASPH IMP FELT 1/2"CDX PLWD DECK TRUSSES @ 24" R-19 1NSUL If 2'-0t' METAL EDGE 2X2 2X6 1/6 _................ DBL 2X4 GYP BD DBL 2X6 WINDOW HEAD ALUM SOFFIT 1X4 SIDING - SHEATHING 1X4 ALUM WDW Note: Vent Soffit to Regional Conditions o 0o 0o WINDOW SILL 2X4 @ 16"O.C. INSULATION SHEATHING SIDING 2X4 TREATED BASE 4"SLAB ANCH BLT @ 4'-0" 4"SAND "L"BLOCK FILLED P.BAR. CONC. BLOCK SLOPE 1/47FT - v J. 34 FIN GRADE 4.4.4 . 1'8"X10"FOOTING W/2#4 CONT r: T r 40 44444444. Design Footing 444 0444444 to Soil Bearing 40044444444 04444440444 TYPICAL WALL SECTION t APPLICATION FOR PERMIT TO-INSTALL AND REQUEST FOR ELECTRICAL SERVICE . C Inspector of Wigs &ring PermiT# c COM/Electric# ` Town of Massachusetts Building Permit# Date . g^ Customer: 7g` If�O�Q1�t?3��/r ion(Street#) Lot# in the village of �'""`�� ih y pole number•=or underground number �{ y Customer's billing"address `:Temporary ' New installation Ch ge Off service Starting Date Job description ? i riC��CG Q. �} lr�a� s Service entrance voltage f�G- Amperage G Phase Wire size(cu.or-al)- Conductor per phase Number of meters Water heater Off peak:Yes— No— Estimated load Electric heat kw, lights kw, Range dryer Motors, H.P.& Phase Ready for first inspeotwnr_z 3" F.3- Ready for final inspection -�R/��/ 4 /�/ '? .y ors? 1�1�76 Electrical Contra for _ pia# Telephone# Address �yUt LJ , 'C .d..f Additional Remarks: Do Not Write Below This Line _ �0nnpECTRICAL WIRING INSPECTOR OF WIRES CERTIFICATE INSPECTIONS U DATE FEE CHARGE Temporary Service ix Roughing in .0� f Service and Meter `. r Off Peak Meter Final Approval..-. z`7 Disap proved* i 'For the following reasons CERTIFICATE OF INSPECTION DATE To the COMMONWEALTH ELECTRIC COMPANY.The installatio described above has been completed and has this day been inspected and approval granted for connection to your service. r' Inspector of Wires WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION Permit Good For One YearFFrom_Date Of Issue CA46-,' 7 White-COM/Electric Green _. Inspector Canary Town Receipt Pink—Inspector's Copy Goldenrod—Electrical Contractor { - to COM/Electric 1 r` Office Use only 7-lie Commonwealth of Massachusetts Permit No. Department of Public Sofcty Occupancy a:Fee Chocked BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12:00 3,90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Work to be performed In accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3-/O "L� TOWN OF BARNSTABLE To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 6 Numbeer) / f�/ 11IV 7;? Owner or Tenant 14 14/0l� Owner's Address Is this permit in conjunction with a building permit: Yes ® No ❑ (Check Appropriate Box) J /3!,Z Purpose of Building 04 Utility Authorization NO. O Existing Service la�Amps / volts Overhead Undgrd❑ Ho.-of Meters _ New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work it//4-c- go® awl No. of Lighting Outlets No. of Hot Tubs ,: No. of Transformers Total Above In- No. of Lighting Fixtures Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets a No. of Oil Burners No. of Emergency Lighting Batter Units No. of Switch Outlets ,S� No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total one No. of Detection and Initiating Devices t No. of Disposal No. of pumps Total Total s Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW Local Municipal ❑Other ❑ Connection No. of Water Heaters KW Noy o No. of Low Voltage Sijzns Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its 'substantial equivalent. YES❑ NO I have submitted valid proof of same to this office' YES❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) (Expiration ate Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Signed under the penalties of perjury: FIRM NAME LIC.-NO- Licensee Signature L IC. N0. 1 Address cel� �ios��. oa�*�-c C� Bus- Tel. No. . Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does t have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent � i, J(L J f a SMOKE DETECTORS REVIEWED . 1�J I IN PT. DATE -FIRED ARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING . ._. z. ��- �� � � -•_ Ba rMtable Bldg.Dept. Approved bY: permit#: i t _ _ 7Z4 - ---'-- ----- -- - - ----- - -'------- ----------------- - - - - - - - -- -- -- - -._... ....... i _ i I URN { r IEE w 1 s . ...... -Row �N`J` •Ns 4 I% i i. s - l1 �t U 0-, - � I _ ,�► 6"t" 1..o,J Cby fe l ov -419 - I i r__•,^'�..:.��!v4 ems..! C_�S'+.�" �/� a VvJ�S Y w S . j e "e 'A a + � C wl ���o .�-LJD .� C.Ccy C:�•�-� i --i -S } Gill f i1 � - s a y a � f • Z �'�-( � Wit_00�2 ---t� `='TS 3 .�rLAr`it'J� �Y���� �,F?_.G.5:,.j.,.Jl�' i� ��"T'.. � -'its.. 1�-/1•PL---f S i - 3 j 1 i oe i ECCLLOMDG-KT y. A� %"x2A"SOS Screw rincluded) - i I Typical - ECCLBDMD-Kr i - - Installation i I :to I New l2xao r'oo . 77 j I v y f M-G i : 5 T w - F k, w ------—. �eO I L6 -�L� !' Apt, As 1 1 auy Wo` L L CUSCa4 Wo --- hA xSi 11 " Q c. bAs i ape N6 N y -v7i, auH P N y a Pos+a �,� �k ►dare ���V�. C- S d'• a •aloe�� �`Naow= �, �9 Pasf- _ o du Li Vubs p� 3 zxFr haoa••�, au� P►�� _ �.xP• �o�d gl,z.Y Sobc PC.t}e `/�cti�e a ' .� rap `4 u�w a.�t tw 3Jy TaG p��wo.e Qeci. S1�<� 7 S�•cP _ _ _ ...-.. a...... w "wn.; y'below - R,, / I r � F I 1: . I 1 a i r { i 4 a! r r 1 � y y it-" T' t ' 6 Q®'�� { o14, J .. W