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0053 SUOMI ROAD
�3 f f I i `} Town of Barnstable Building Department oFTHe T°yq, Brian Florence,CBO C� Building Commissioner BARNSTABLE, ► 200 Main Street,Hyannis,MA 02601 y� mass. $ 1639• www.town.barnstable.ma.us ArEo MAC p Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: �Cl Phone#: 5� J� q &V�(CJ VC b \ Address: 5 3 c�\-a Q � Village: P UO L� Name of Business: E L TE ��U Ts Type of Business: C Ef ap/Lot: Q(V INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal 0 1_residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the a W following conditions: =) OC • The activity is carried on by the permanent resident of a single family residential dwelling unit,located U J within that dwelling unit. 0 WQ • Such use occupies no more than 400 square feet of space. W _ • There are no external alterations to the dwelling which are not customary in residential buildings,and there -M to W is no outside evidence of such use. a_O • No traffic will be generated in excess of normal residential volumes. X E' • The use does not involve the production of offensive noise,vibration, smoke,.dust or other particular E matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials, in excess J of normal household quantities. g • Any need for parking generated by such use shall be met on the same lot containing the Customary Home O Z Occupation,and not within the required front yard. u} • There is no exterior storage or display of materials or equipment. CL UCL • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one. 0 pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. v I,the unde ve read and agre a ove restrictions for my home occupation I am registering. ` Applicants Date: ( / Homeoc.doc Rev. 10/17 Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ina.us Pre-application for Business Certificate Date O Map ( ' Parcel Lam" Applicant Information Applicants Name j( `7 CK C,\'�J i, I Applicants Address C > i Y 1 � ! } ( Email Address Telephone Number C) 2(44 (K Listed ❑ Unlisted Business Information New Business? _ Yes No -------------------------------------- Business is a registered corporation? ________________________. Yes No If yes Name of Corporation Does business operate under the registered corporate name? Yes DO Is the business a sole proprietorship or home occupation? ________ Yes No If yes then a Home Occupation Registration is required—See Building Division Staff Name of Business Business Address r 1 1 l : 81 Type of Business Building om ' sinner Office Use Only Conditions ltD Building Commission r �n Date /C7 /he Clerk Office Use Only TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �b Map Parcel Application ��J Health Division Date Issued Conservation Division Application F Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board 1 Historic - OKH _ Preservation/ Hyannis Project Street Address 3 SU�Y)')/ Poad Village 1 -N a nn 1-� . Owner cl V Address �53 Suomi Telephone' Permit Request [AW)/i Off",- ij j- -0 Uy Y Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing neW "A o� Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count'f Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other CO w- Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/ oal stove ❑Yes ❑ No 99 Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑existing t❑ new size_ torn Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ .Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f-elf- }'ro Telephone Number hO g C2 Address l License Lr-an 61 - D Home Improvement Contractor# I V9 Worker's Compensation # WL�Zr! -AVI�_L D[q ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO v rc e R - �OOF SIGNATURE DATE Y F FOR OFFICIAL USE ONLY F• APPLICATION# DATE ISSUED MAP PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME E, INSULATION :y FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. I' r n The Commonwealth of Massachusetts ,rik Department of Industrial Accidents Office of Investigations 600.Washington Street -Boston, HA 02111 www>mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): RISE Engineering; A Division of Thielsch Engineering Address: 1341 Elmwood Avenue City/State/Zip: Cranston, RI 02910 Phone #: 401-784-3700 or' 1-800-422-5365 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* "have hired the sub-contractors 2.❑ I am a sole proprietor or partner listed on the attached sheet. 1 7•. ❑Remodeling ship and have no employees These sub-contractors have ` 8. ❑Demolition working for me in any capacity. workers' comp:insurance. 9. .❑ Building addition- [No workers' comp. insurance '5• ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof re airsl insurance required.]t employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and 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: The Preston Agency Policy#or Self-ins.Lic.#: �f��a.'"2l1 j '7 a 7 — "� Expiration Date: 04/01/ 10 _ Job Site Address: 53 S R00 City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine ' of up to$250.00 a day against the violator. Be advised'that a copy of this statement may be forwarded to the Office of . Investigations of the DIA for insurance coverage verification. Ap I do hereby certi un r the ins an penalties of perjury that the information provided above is true and correct Si nature: Date: Erik Nerstheimer for RISE ,Engineering '. Phone#: 401-784-3700 or 1-800=422-5365 Ext. 133 - Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Licensee e ai s Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security(EOPS) Mass.Gov Home Public Safety Department of Public Safety Licensee Complaints License Type Construction Supervisor License# 100459 Restriction WS,IC _ <- Name Erik Nerstheimer r City, State,Zip North Scituate, RI,02857 Expiration Date 3/28/2012 Status Current R No complaints found for this Licensee. Back To Search �1ae.T�am�rrro�xusec��/,l o�,.�aoaczc✓ucael�a - I.;;., - . • . .. . Board of Building Regulations and Standarif^s I ~ License or registration vaFid for individid use only y HOME IMPROVEMENT CONTRACTOR i. s before the expiration date. If found return to: „ e — Registratiom. 120979 Board of Building Regulations and Standards Ex ration ' �: One Ashburton Place Rm 1301 " A _3/25/2010 ^TYPe Supplemerit Card FA)gfou, la.021.0$ THIELSCH ENGIN(EERING *, �_ j ERIK NERSTHEIMER: 1341 ELMWOOD AVE. CRANSTON, RI 02910 �- Administi tor t Not valid without signz�ere~ r - http://db.state.ma-us/dps/licdetails.asp?txtSearchLN=CSL100459 /1 f)(I ) RISE)ENGMEPJNG Federal ID#06-0406629 RI Contractor Registration No 8186 A division of'1'hielseh Engineering MA Contractor Registration No 120979 CT Contractor Registration No 620120 1341 Elmwood Avenue,Cranston,RI 02910 `. (401)784-3700 FAX(401)784 3710 ;Page y '`` ^�i•y y !�& �'�F�.� THIS CONTRACT 19 ENTERED INTO BETWEEN RISE ENGINEERING AND THE CUSTOMER FOR WORK AS ENGINEERINC DESCRIBED BELOW CUSTOMER — -- .— --�—PHONE - —_-------DATE- Client#_ — Suzanne D Savage .... _..._._(508)7.7.8-26'79 10/15/2009 y 104950 SERVICE STREET BILLING STREET - - - - 53 Suomi Road 53 .Suomi.Rd SERVICE CITY,STATE,ZIP BILLING CITY,STATE,ZIP Hyannis,MA 02601 Hyannis,MA 02601 JOB DESCRIPTION RISE Engineering will provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air _ exchange and indoor air quality.Materials to be used to seat your home can nclude caulks,foams,weatherstripping and other products. , Primary areas for sealing include air leakage to attics,basements and other unheated areas(windows are not generally addressed.) This work will be performed at the rate of$66 per man per hour,which includes materials and testing. 10 man hours. $660.00 RISE Engineering will provide labor and materials to install a 8"layer of R-30 Class 1 Cellulose added to 800 square feet of open attic spacer $890.00' RISE Engineering will provide labor and materials to install an easily moved,rigid foam insulating cover for the attic access folding stair: The cover has integral weatherstripp ing to restrict air leakage. n F $160.00 RISE Engineering will provide labor and materials to insulate 72 square feet of exterior floor overhang with Class 1 Cellulose by drilling holes at the overhang from the exterior. Holes drilled will be plugged. Plugs will be puttied and left in a relatively smooth condition.Finish sanding . and touch-up priming/painting will be the customer's responsibility: $288.00 RISE Engineering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. Currently,for eligible measures,the Cape Light Compact offers 75%incentive,not to exceed$2,000 per calander year. $1,491.00 { v WE AGREE HEREBY TO FURNISH SERVICES-.COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF 1 *.**Four Hundred Ninety-Seven &00/100 D010arS $497.00 UPON FINAL INSPECTION AND APPROVAL BY ISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL.INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY ^ UNPAID BALANCE AFTER 30 DA S)SEE REVOSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES ' AUTHORIZED SIGNATURE- ISE ENGINEERING - -.CUSTOMER ACC P�NC .a �...% OTErTH�CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN - DATE OF ACCEPTANCE l ,�..✓' ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE ^ SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK. DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE f - ACORD CERT I C U E OF LIABILITY INSURANCE OP ID RSR DATE(MMIDD/YYYY) THIEL-1 11 05 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATIO The Preston Agency, Inc. ONLY AND CONFERS.NO RIGHTS UPON THE CERTIFICATE 1350 Division Rd Suite 303 HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR PO Box 810 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW East Greenwich RI 02818-0810 _ T Phone: 401-886-8000 Fax:401-885-1700 INSURERS AFFORDING COVERAGE , NAIC# INSURED INSURER A: Hartford Underwriters Ins. Co Thielsch Engineering, Inc INSURER B: Hartford Casualty Insurance Cc Hi Tech Group Inc. INSURER C: Liberty Mutual Insurance Group Hi Tech Realty Inc. v P 195 Frances Avenue INSURERD: North American Capacity Cranston RI 02910 _ = INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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. POLICY EFFECTIVE POLIC EXPIRATIO LTR NSR TYPE OF INSURANCE POLICY NUMBER_ DATE MM/DD/YY DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 02UUNTD5678 04/01/09 04/01/10 PREMISESEaoccurence ., $ 300,000 CLAIMS MADE ®OCCUR MED EXP(Any one person) $ 10,000 a PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s 2,000,000 POLICY X PRO- LOC Em Ben. 1,000,000- AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 B X ANY AUTO 02UENTD4850 04/01/09 04/01/10 (Ea accident) ALL OWNED AUTOS !BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ 6 (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ n ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $.10,000,000 B X OCCUR CLAIMSMADE O2XHUUF6573 04/01/09 f 04/01/10 AGGREGATE $ 10,000,000 $ DEDUCTIBLE $ X RETENTION $10,000 $ WORKERS COMPENSATION AND X TORY LIMITS ER `, EMPLOYERS'LIABILITY 01 .WC2-Zll-259874-019 04 ANY PROPRIETOR/PARTNER/EXECUTIVE / /O 9 {. 04/01/10 E.L.EACH ACCIDENT $ 5 O O,0 0 0 OFFICER/MEMBER EXCLUDED? E.L.DISEASE-EA EMPLOYE $ SOO,000 , If yes,describe under - SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 OTHER D Professional Liab DVL000025902 04/13/09 04/01/10 Prof Liab 2,000,000 A I Leased/Rented E_qp 02UUNTD5678 04/01/09. 04/01/10 Equipment.. 3.00,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES LEXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION `TOWN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN TOWIl Of Barnstable NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL Building Division S 200 Main Street IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Hyannis MA 02 601' REPRESENTATIVES. AUTHORIZED REPRES ACORD 25(2001/08) ©ACORD CORPORATION 1 t` Town of Barnstable pFVAE r 'Regulatory Services,. n - " t' Thomas F.Geiler,Director) _ � 'j;E BARNSTABLE, : '� 9 Building Division 09 APR 28 ,, F1 39. Tom Perry,Building Commissioner 3: 39 200 Main Street, Hyannis,M,-002601 www.town.barnstable.ma.usIS1Qt! Office: 508-862-4038 Fax: 508-790-6230 PERMIT# (/ l (/ l FEE: $ SHED REGISTRATION 120 square feet or less UO w► �� N h +� Location of shed(address) Village C 77`�_Z Property owner's name Telephone number �p (o t t✓ . Size of Shed Map/Parcel# AmAture Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE-SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A � PLOT PLAN 1 L � Q-forms-shedreg REV:042506 • n Town of Barnstable Geographic Information System April 27,2009 269113 #57 269112 269114 # 65 269111 #55 #73 of 1 $4 ed V / #53 mom t3 R. #49 r 268202 (Ear $en's Pond y 268201 #51 0 23 Feet DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal Map:268 Parcel:304 boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner.SAVAGE,FRANCIS J 8 SUZANNE D Total Assessed Value:$315800 Selected Parcel '� 1"=100'may not meet established map accuracy standards. The parcel lines on this map - - tiY ;,� � are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: - Acreage:0.51 acres Abutters boundaries and do not represent accurate relationships to physical features on the map Location:53 SUOMI ROAD such as bulking locations. - Buffer :. m 5 h n - am - Tt w� Yam"°' S ���,,.: .�• sc OPEN Q O e n 1 y t n o pppc IN a ye air 5. �. '9 51 10 Wl mom... �.-.'.r"�is..^ '-."� � " - -.—►.a" �,� _ ,� --mac_--� 4 � re s b � H x x a - M1 y K ^ 1 n k a 4 n 7 r r x Town of BarnstablePermit: oFTHe rok, Regulatory Services ate: yP` tio�, Thomas F.Geiler,Director } Building Division sAxxsTnsLE. MASS. �m� Tom Perry, Building Commissioner �ArE� �a 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230""y TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT . Owner: C\5 S Phone: Install at: �� ,emu �\ CC Village: i'���1��/1[S" Map/Parcel: Date: 12— 1 0 Stov A.Zp /Used B. : 6adi /Circulatin Lab.No. LL C C. Manufacturer: U9 D. Model No.: Chimney v� tica`'`'✓1 A. Ne /Existin (If existing,please note date of last cleaning) 4'—O 3 Ntve►2 Vs� B. Flue Size /? C. Are other appliances attached to Flue? D D. Pre-fab Type and M facturer E. Masonry: Line relined Hearth �) A. Materials: -R2�CI� B. Sub Floor Construction. C-2v✓1 Installer -i S 'iCcc7 a✓+�yl Address: Name: �C Phone: Location of Installation: , e . l �, 1 APPROVED BY. Please make checks payable to the Town of Barnstable =*Thistitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove i i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Par el -L° Permit# �49� Health Division &6� c h/� �` Date Issued fyC) Conservation Division ' 'F Fee y"ocS�_ 0 Tax Collector 6�74E Treasurer x. R SEPTIC SYSTEM M �) hQrc� 1,1 / _ . ��: INSTALLED IN COMPLIANCE ,r Planning Dept. WffH' E.: ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis .Project Street Address ^��Son � Village Owner S Address j � `1 Telephone 4 Permit Request "y� i .. C t Square fe t: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size���r c_C Grandfatliered: ❑Yes %No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure A Historic House: ❑Yes %No On Old King's Highway: ❑Yes No Basement Type: Full ❑Crawl ❑W kout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new, Number of Bedrooms: existing_ new Total Room Count(not including baths): existing t new�_ First Floor Room Count 1 Heat Type and Fuel: )§Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes 'b No Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes ,V No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Urexisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes , ❑No If yes, site plan review# Current Use C: A2 Proposed Use BUILDER INFORMATION Name h1�,� Telephone Number. Address License# Home Improvement Contractor# Worker's Compensation# p- -� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ( — FOR OFFICIAL USE ONLY - PERMIT NO. DATE ISSUED °' { MAP/PARCEL NO. ' •i ADDRESS' VILLAGE OWNER -•" a+s DATE OF INSPECTION FOUNDATION t FRAMEZ'a.3 f INSULATION S`O 3 /� /17Aag FIREPLACE ; ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH, .4 FINAL - GAS: ROUGH- OM FINAL IqRL FINAL BUILDING R. �{4�y DATE CLOSED OUT ASSOCIATION PLAN NO `ryI • 1 1 11 1 1 1 1 1 1 1 1 1 WMt 11 1.=c)w• 1:d •art /1 1all workmyself ■ 11 1 � 11 • • � . • . 1 • •. r. � Y• 111•�11 .11 • 1 • 11 �1111• • • • ..� 1 • • 1 1 1• MR RM �1 II 1 II + 1 '' 11 / • 1•1• •) 1 1 I • 1 I 1 11 �1 1 -, Y / .11 / 1 1 �. 1 YI 1 1 • �• •- 1 • ••1 1 ' 05 IN 11 •C S. 1 • 1 1 • � ' 1 1 I 14 _ _I 1 _ _ • • • 1 �1' 1 I I I 1'•� • it 1 r .w•111 li G .I IIIII 1 ti ■ • 11 " (juccusing Board . checkff 11 II � • J 1 t Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers 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 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.tlu=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 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,neitherthe 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 requacments of this chapter have been presented to the contracting authority. y:gr4 w Applicants s Please fill is the workers' compensation affidavitcompletely,by chwJcipg the box that applies to your situation and address and phone mimbers along with a certificate of insurance as all affidavits maybe ` P1Ym8 campy for confirmation,of insurance coverage. Also be sure to sign and submitted to the Department of Industrial Accidents . date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is urn k being requested,not the Department of Industrial Accidents. Should you have any questions regarding the`9aw"or if you K' are required to obtain a workers' compensatidn Policy,Please call the Department at the member listed below. VIA 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 icease number which will be used as a reference number. The affidavits may be retauriiPo the Department by marl or FAX unless other anangem 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. y The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Me of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 MCZMAppdisJ �y ' F00fi Foeh Pnsaipefre P:elca8e for dae aad Twe�Fsmr7r RnWmdd BafWtap Heated wi0t MAMMUM 1rIDVONUM WaII Floor 8aae:mar 91ab �8 U."voes oua * &va R•vatueJ Will Plate Ema� padre I-Vai rd 5"1 to d=Heniux Deem D&W Q 12%. 0.40 38 13 19 !0 6 N� tt 12-A am 30 19 19 .10 6 Noma! 9 12A' 0.50 3s 13 19 10 - 6 U AFUE T 15% 036 3= 13 25 WA WA Nmmat u Is% us Si* 19 19 10 6 Katmai V 15% Huai 3e 13 - WA ;s;A 25 AFUE W 15% O,3Z 30 19 19 f0• 6 ISAIMM x IM am 3t 13 25 WA WA Normal T IIMA OA2 3= 19 25 WA WA Norma! t IVA Q42 32 13 19 10 6 90AFE E AA IV1. 050 30 19 19 10 6 90AFVE i i. ADDRESS OF PROPERTY: Cam' (S 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY#2): 3. SELECT PACKAGE(Q—AA-see chart move): NOTE. OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-1980303a 780 CMR Appendix J Footnotes to Table JS.11b: It ts and Glazing area is the ratio of the area of the glazing assemblies (including sliding-g1 �o�+ Y'Sh basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing a=tray be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded fiom a building design with 300 fl of glazing area.=Aft January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordanCe with the National Fenestration Rating Council (NFRQ test Proms+ of taken from Table J1.53a. U-values are for whole units:center-of-glass U-values cannot be used. The ceiling R-values do not assume a raised or oversized thus construction. If the insulation achieves the full insulation thickness.�� the exterior wails without compression, R-30 insulation may be substituted for R 38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insula�g sheathing must be placed between me condiuoned space nuts the ven`.:�d p�tim of L't .`• _ •Wall R-values represent the sum of the wall cavity insulation plus insvlativng sheathing t could be met ETIT�ER used)• Do not include exterior siding,structural sheathing,and interior drywall.For example,an R 19 rcgttiremeat by R-19 cavity insulation OR R-13 cavity insulation plus R-6 iasulattng sheathing. Wall requirements apply to wood.fiame or mass(concrete,tnasomY,log)wall consteuarons,but do not apply to metal-flame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned ciawlspaces,basements, or garages).Floors over outside,*trust meet the Ceiling requirements. less than 50%below grade must `The entire opaque portion of any individual basement wall with an average depth slidingldows and doors of conditioned meet the same R value requirement as above-grade east doors must meet the do r U-value requirement basements must be included with the other glazin& described in Note b. The R-value requiranents:are for unheated slabs.Add an additional R-2 for heated slabs. `: "�" • If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest.,::_ efficiency must meet or exceed the efficiency required by the selected package° For Heating Degree Day requirements of the closest city or town see Table JS.Z.l a NOTES: le levels'-' a)Glazing arras and U-values are maximum acceptable levels Insulation R-values are minimum acceptable _.. R-value requirements are for insulation only and do not include components. . b)Opaque doors in the building envelope must have a U-value no�than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or or taken from the door U-value in Table J1.53b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space`wall component includes two�or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply S for doors).weighted average U- value of all windows or doors is less than or equal to the U-value 43 ESTIMA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X.$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$15/sq. foot= OTHER ' square feet X$??/sq. foot= Total Estimated Project Valu For 0 cce Use Only Inc, usiona Aff rdable Housinq Fee idential Commercial" Property Owner's Name" Project Location Project Value Permit Number **Existing Sq. Ft. ** oposed New Sq. Ft. Fee $ IAHFORM 1/3/00 °= The Town of Barnstable MAML►srrsrnecx. - �m Department of Health Safety and Environmental Services 16590. '°rEDN►o'tA Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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. Type of Work: " —' DJ*sitated Co Address of Work: �A L S O� Owner's Name: Z U Date of Application: I hereby certify that: Registration is not required for the following reason(s): QWork excluded by law []Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL a 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. Date Owner's N e q:fomis:Afdav �oF t�tom, The Town of Barnstable * t�tZt�tSr�+W • MAE& g Regulatory Services �A i639 ♦� rFo Mop A Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: numbeF_ \ street village "HOMEOWNER": name home phone# work phone# . CURRENT MAILING ADDRESS: l 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 r�l' ection procedures and requirements and that he/she will comply with said pro. � ements. - Signature of eowner 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:EXEMPTN F ` IRE 'P LAC.E I d i i f i v ) ti • i I i a � c ,4 n "77N ! d A i�a�v�;��e.,�--�-- � � �� ov.�..; � � , `�.��.���5 , ��--c.�6ol S � v� � � ��� - 26�-� i Town of Barnstable Regulatory Services • Thomas F.a�sxnst.E, : Geiler,Director ' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PERNITT# FEE: $ _ 0� 7 0 SHED REGISTRATION 120 square feet or less S- t dk,A I � � CIS . . • . Location of shed(address) Village Property owner's name Telephone number CAJ s� Size ofShed '�' Map/Parcel# Z �• co • a) rn signature — 3 0 Date Hyannis Main Street Waterfront Historic District? ------------ Old King's Highway Historic District Commission jurisdiction? --------------------- Conservation Commission(signature required) -�, l /3 P PLEASE NOTE: IF YOU ARE WITE3N THE JURISDICTION OF ANY OF THE Yo D 13Q� f(EOM COMMISSION$, THERE MAY BE A REVIEW PROCE ABOVE SS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. OAJ THIS FORM MUST BE ACCOMPANIED By A PLOT PLAN .......:..... i '3��.O 4 # 53 \ .............. l ---� -- Map 268 2 0 z # 89 .. �.- ..,-y. � � _ _ ,� •;y _ Assessor's office (1st floor): l =� THE Assessor's map and lot number ...p... .. Board of Health (3rd floor): Sewage Permit number .......:........ ..��� �? J.. ':..... Z BAUST&BLE, ....... i Engineering. Department (3rd floor): ��� _ �o NAG& House number' oy tb AI • Definitive Plan Approved by Planning Board --------------------------------19_----___ . APPLICATIONS PROCESSED 8:30=9:30 A-M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSACTOR APPLICATION FOR PERMIT TO .........Build .................................................................................................................... TYPEOF CONSTRUCTION ..............New............................................................................................................... .....................August..18 -..t 9.88 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....Lots 48 fir 49 Sauna,,Road, $der MA � - ,1, : .................................. b `. Nei+ sffigle family dwellin Proposed Use .........................................................8.................................................................................................................. r ZoningDistrict =......,<:: ......................................................Fire District .............................................................................. Name of owner ... ........Address 102 Seth parker Road, Centerville, MA Name of Builder ...13arnstahle Holding; Co., Intr.. ..Address ...... 00 West Mairi Street, Hyannis,. . .. .. MA 02601 ....... . ...... ...... ........ Name of-Architect .......Teriy LUff Address Number of Rooms ..........5......................................................Foundation .....Poured concrete .................................................................... Ex1e for .......Cedar.shin ............ .... .. s.................................................Roofing ...........AIM4,94.shingles.......................................... Floors 5%. CI)X .�lyv��od CE?l:P.et...........................Interior ............Drywall......................................................... Heating Electric ...........................................Plumbing Fireplace ........Na.....................................................................Approximate Cost .........W,000 QO �r Area ................................... Diagram of Lot and Building with Dimensions Fee �-- eX7 - 7- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � !V!/� /d n / + C Name nn l� Construction Supervisor's License .......;f�;6` �b