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HomeMy WebLinkAbout0119 WHITEHALL WAY I1 �t � 1;►�e, hall uic Town of Barnstable *Permit# Do? t� Expires 6 months from issue date Regulatory Services Fee o X-PRESS PERMIT Thomas F.Geiler,Director APR 3 0 2007 Building Division Tom Perry, CBO Building Commissioner Y � g TOWN OF BARNSTABLiE 200 Main Street,Hyannis,MA 02601 www.towm.barnstable,ma.us Office: 508-862-403 8 Fax: 508-790-6230. EXPRESS PERMIT APPLICATION RESIDENTIAL ed ONLY / Not Valid without R X-Press Imprint ap/parcel Number 6*��ol ? -1�(D :operty Address Residential Value of Work 5 0 Minimum fee of S25.00 for work under$6000.00 vner's Name&Address Ot y GW NGO4AJ ontractor's Name M r iv /�111Ji!</.L _ itJ�l�l�• Telephone NTumber �-53r.?- tome Improvement Contractor License#(if applicable) l 0517fZ :a$-sf� � , SSug�rPisor'�L�uense-n(�-app'�ieabi�) 06��� ]Workman's Compensation Insurance c Check one: - I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance ssurance Company Name Vorktnan's Comp.Policy ;opy of Insurance Compliance Certificate must be on file. -ermit Request(check box) eRe-roof(stripping old shingles) All construction debris will be taken to `� exco ❑Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required; ISsnance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,eta ***Note: Property Owner must sign Property.Owner.Letter of Permission. A co of the Home Improvement Contractors License is required. ;I GNATURE: 1:Ycm :expmtrg ,evise061306 ;��,•� ,.e:.s s ,bry ..-° F.. ^ air.,p 1 � < # s 's•nY- # N. ✓.y M'" 3J.,�»v �s<�, j`s ". t° �--5,� ^'�•t �" ,� rr,.-�'Y _ . �1J1��lAR1f�f���" o k a� ��"� � �«"`z� +»e•5" ^'rz*ar��i" �`x�'cJa��'�"^� � `�`' '�� x�r��s�' �„ i-aa"�'r ^n't= .t„• yr � �> � .�,lt��►I�,1�i�a � �� ,�1?r�parea �Q1�9tOt7,� �, ��, b � pap::. 1���, •7ax.,_o .c„,..r.>. .A,.,r-:::.,. ,,,.,��, ,'.,., xv„.q..�l,r, ,,..v,d�.F,...,x r e+xe ac;.�Xx v ,'.t�A�:, ..i,e a7a4u.•.._ ,,k:�,! a;"wh.st,� err¢�.��-,-3,d .,aw2 �� '�': �..r.,, �rMd� ' For: Matthew Dunhill Br den �Sullivan Ins A en ` -c Y 9 Y 16 Swain Circle of Dennis Inc. - ' Mashpee, MA -• .` - 485 Route 134, PO Box 1497 02649 508-539-9891 So. Dennis, MA 02660 508-398-6.060 COVe(2 �:.. .. ?,,:>.. Y.,... Amotlnt ": COm an .,ya ."« :ry f,ti Ipb�(Cry�GtO. .._ � vE, r,§Pre(nIHIT Business Owners Policy NGM Insurance Company MP090956 11/28/06 11/28/07 1104.00 Liability Limits BI&PD Per Occurrence Limit 1,000,000 BI&PD Per Occurrence Deductible 250 BI&PD Aggregate Limit 2,000,000 Medical Expense(Per Person)Limit 10,000 Damage to Rented Premises Limit 500,000 Products/Completed Operations Limit 2,000,000 Products/Completed Operations 250 Deductible ` Personal and Advertising Injury Limit 1,000,000 Location 001 Building CARPENTRY-RESIDENTIAL -Class Code. 74171 Premium Basis $28,600 F Payroll-per n, ` $1,000/payroll ✓R, T 491t4PtfY/t[fJI Q.E O�✓U ((�Jg _� f .'.' ✓ -�DO�i/AlI97ROLt1JQ+ ¢ ..,rlq.CxOdIJ t•. t3t/1RDBUtL431NG REGUTAfIQNS ¢ s= Board of Building r� :Regulsttons and Standards [ is Uce CQNSR{ CTION StJPERYtSOR HOME lMpR0vEMEf4T'C—TO 4C OR s {£ Number CS 0:6.402, a Ragtst�3ton l }t0�08;/1969 125982 +, .l , iF�tttottr16/2008 ! 103 `a8 T. no. 27>7.84 -' r- NI ' victual : . Re*Sx ; {✓, MATTHEW M DW�� f. MATT iE1t� MATTHEW DUNt#L1: - 16 C SWAIfVCA .— . _ MASHPEI MA 02649 C-bmm"Csslb� = �f Adsni-._ rafor i al a is no >fIM JoQ 5= 1rEZ ti4£(8881N3a '31D 3#�fSlt] 1 P.0 t _ pe V.CC I esuaol►slut to.uwueao�e�a esnea s1 { Bfl tZ0'sylt`uo;sob: •; ' apGD tpUnO stets sg sn asss qt b ' ifl£T a3a14 tto1.0(11 qsd auto 11, acµ 10 ao jwetaa„n a s8s>tGd Ot 1000 t sPAR"14S Pus s401181►MI fivittla r P1go$ `. s®wa ��ts Z t EE. � s0)tut>;aa Ps403 JI WsP ubRs4td'Na 041 aq tit f4uo ass IuP1AEPg!gat-fi�4tg;►sot# l a:to ass",I (l09 Silt�"i�W) 1 � 1 he Uommonwealth,ol Massachusetts Department oflndustrialAccidents _ Office of Investigations ' a 600 Washington Street Boston,MA 02111 www.mass.gov/dia ' Workers' Compensation hasurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Letzibly Name(Business/Organization/Individual):_ i #eW _D 11A 1 t.L •Adclress: lee Srwgi N Gr let g City/State/Zip:_ �I�t P SAW Ak4 Phone.#: saw s3 _ a'9/ Are you an employer? Check the'appropriate box: -Type of project(required):, 1.❑ I am a employer with 4• ❑ I am a general contractor and I n ployees (fall and/or part-time). * have hired the stab-contractors 6, ❑New construction . 2. 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.insurance comp,insurance.t iequired] 5. ❑ 'Fe are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3.❑ I am a homeowner doing.all work 11.0Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12` oof repairs ?�F— � insurance required.]t c. 152, §1(4),and we have no 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet sbowing the name of the sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policynumber. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self ins. Lic,#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine tip 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 statemezit maybe forwarded to the Off ce of _ Investigations of the DIA for insurance coverage verification. I do hereby certify under the paitts d penaIties of perjury that the information provided above is true and.correct,' Si afore:. Date: �A# d Phone Official use only.. Do not write.in this area, to be completeri by city or town offrciai City or Town: Permit/License# I{ Issuing Authority(circle one): • ' fi 1..Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5,Plumbing Inspector 6,Other Contact Person: Phone#: Information and Ins tucti®nS r 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 hiie, 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 =ecvnr tr�ictee 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 ren-wa!of a license or pernnit 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 un�•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 it certificates o cessa Supply sub-contractors names , address es and hone numbers along with their O f • ne ry, PP Y O O address(es) P ) ins-.Trance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other.than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit.or.license is being requested,not the Department of Industrial Accidents.; Should you have any questions regarding the law-or-if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should-enter their self-insurance license number on the appropriate-line. City or Town Officials. Phase 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. Phase be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy*information(if necessary)and under"Job Site Address"the applicant should write"all•locations'in (city-or town)."A copy of the affidavit that has.been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a 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 bum 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 questio_,_,— please do not hesitate to give us a call. The Department's address,telephone-and fax number; bth -Commanwealth of Massachusetts Dgput l`ment of IA Must ial Aczci.dent5 Office of Investigation 640-Washington Streot Boston,MA 02111 T4.#617-727-4900 ext 406 or 1-$f7-MASSAFE Fax#61'I-727-7749 Revised 11-22-06 www.mass.go,-v1clia i r °FINE Town of Barnstable R Regulatory Services �BAMMISLE,$ Thomas F.Geiler,Director fD;9..�p`e 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 4 Property Owner Must Complete and Sign This Section If Using A Builder I, z�� ,as Owner of the subject property hereby autho e to act on my behalf, in all matters relative to.work authorized by this Building permit application for: (Address Jo ) Signa o r Date Print Narde Q:FORMS:O W NERP ERM IS S ION L - Assessor's offioe (1st floor): �y S,�s'f THE t0` I,. Assessor's map and lots number .......................... ....... .. Q ` Board uf Health (3rd floor): o IIJ Sewage Permit number ....... i MAMSTSDLE, ............................................. Engineering Department (3rd floor): �� 'oo 1639. Hous4' number '°� o-•............:....._.............. .,....f.,...,.......................... 0 YPY APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only t TOWN- OF BARNSTABLE BUILDING INSPECTOR I APPLICATION FOR PERMIT TO ...... ��', ,.... ...A��. ..C'.. j ��4_ ../`r .............. TYPE OF CONSTRUCTION .....G." ....... . ........... s .e......................................... ........................ 7,.. ?---.....19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a pelrmit according to the`foll/owing information: Location /. '�.// /.. ....X�/. , ./...(f.��-f./ ....../..,✓!' ........... ....../ ............ .... ProposedUse --�.r�l..... ...r�-a..�"?'?..�../L ......................................................................................................................... Zoning Dlstri,ct ..................�....................................................Fire District .....4 Ca.1'1A1..1.5............................................... 1 / Name of Owner .........GAP!tG r�C o f7:Dt ..,......Address d Name of Builder l -e Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ......(---?......................................................Foundation c..�''. ........... Yi ,...a�cP .P.. ��C.�f�. . ' C 15 1 1 .- .Exterior .............. .......... S.!:1�..''e�...............t........1................Roofing ..........,...v...f't(,.. ..'1 ��S ......................... Floors t.//. ..... ! 6 .. T�'JL,►...........................Interior ( C '....! .................................... Heating �/'7 to L—..7.......................Plumbin 5 Fireplace ..................................................................................Approximate Cost ....'�l.. >..t.U� ��� Definitive Plan Approved by Planning Board ---------_C_'aa_.__q------do_19 $ Area ......... ........................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH CA 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. Name ......... � ............................ !i. ............ , .. Construction Supervisor's License .. ' ��?......... i GREENBRIER CORP. A=272-186 30107 One Story No ................. Permit for .................................... Single Family Dwellinca .......................................................................... Location Lot 4.11, 1.19 Whitehall Way . ................................................................ ...................Hyannis Owner Greenbrier Corp. .................................................................. Type of Construction Frame . .......................................... ...........................:................................................... Plot ............................ Lot ................................ y Permit Granted. .......October 28...........19 86 Date of Inspection ....................................19 Date Completed ......................................19 z. r •f �FTHE}0° TOWN OF BARNSTABLE Permit No. ...30107 ° BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash /.... 2 °�tniur�� HYANNIS,MASS.02601 Bond ......... CERTIFICATE OF USE AND OCCUPANCY Issued to Greenbrier Corp. Address Lot ;#11, 119 Whitehall Way Hyannis, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. �-,j vv January 33, 19 8 7 - Building Inspector i �'fy�••'. TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING � pua HYANNIS, MASS. 02601 r MEMO TO: Town Clerk FROM: Building Department DATE: ll2.3/f 7 Ari Occupancy Permit has been issued for the building authorized by BuildingPermit $k...... d/D» ..»....... ..............................................................._.........................................»................ _ . ..»..»»». ? issued to �f .cJ.dr� /-.........../0" Please release the performance bond. e*te... - ° ... i M y `'i ,�+. r'✓;& ,fie yi �i� ^'+ ���1 �r ''", `� +. t Yt.+ ,.,,- y G S. r -v a�`i. 3 OF:B�RNS'r ULt .1...1..`..-._.-+.a9.'.r,• _:.rr"w 5"=�1.�3.u.+xs�;�__...: ..n . .._...�.�.... ..�..........,s..s� v w.�.. ���_(_}_ �—trt'-;�e.�.a&.;.•�.�1,... ........ �.. �.—i6b U�coi�.r tS � xPERMIT DATE 19 nfTtlX •101 O7 r ('. Green r-�r t . 0. �c!:•: Sl.,, (;e::;itrv _:t7.ce fiyi)L39i Ana ANT t'nr�}• ADDRESS (NO.) (STREET) (CONY R'S LICENSEI s 6uild Llwl:.,'il l't.; -1 NUMBER OF TO - (_) STORY i r'-._ N.11I:11.,`,a t)krr•i.L'il}': LING.UNITS d (TYPE OF IMPROVEMENT) % NO. (PROPOSED USE) - " n ZONING i•a.—t r r*AT (LOCATION) i.UL- 1111, 11�� kilft:fSCL•:i..�.i 11;a`,'p r,:'�°C. T.!.lEi DISTRICT IN0.) (STREET) BETWEEN AND 'ya (CROSS STREET) (CROSS STREET) - LOT SUBDIVIS!ON LOT BLOCK SIZE sir BUILDING IS TO BE FT, WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE)- - REMARKS: AREA OR 1.5�a} B y'(=• 45,tl00.00 PERMIT VOLUME �• ESTIMATED COST $ -FE•E (CUBIC/SQUARE FEET) - Greeabrler Corp. �- OWNER • ,. >t a,F - mac. -`= BUILDING DEPT. `q t ADDRESS BY �'`�'•' THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL y, µ` MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. OCCUPANCY. :`r 1 POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS . JvU 4 y — 2 2 j 2 `Y `. 3 &A5 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT s:. { OTHER Z 1f\jj fYj�/� BOARD OF ALTH wl ° c fan. Y,9e7 . /c a,! ?ERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE {( WORK SHALL NOT PROCEED UNTIL THE INSPEC- TOR HAS APPROVED THE VARIODUS STAGES OF ?Ar WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN .n�,. E � CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. Z0 N F `�G-- '�3, S6 C) s, F. -r G ' ssv carp ! Pu�7Ej_-7r-F_C:, 0Nr_>F_K -76VJtJ 1�1CT T cH, SIC G. N 12* 44 38,, x io a LOT I ' LOT I - z a y. (� 30 'TIC :m SQ .70,E W y'4 way) (SD' W IO E r'R/V,47E - r I CERTIFY T AT THE F'O UrJ DAl-(D £ PAUL X 14 SHOWN ON THIS PLAN IS No i0617 t=J LOCATEDON THE GROUND 'Fie AS INDLCATED AND CONFORINS \" r: � Ire TO •THE ZONING LAWS OF • J RV Z &&65'EL.L , MA r ki DATE P4 !LGJSTERED LAND SURVEYO ;ice L! E VY a ELDREDGE ASSOCIATES,INC. CERTIFIED PLOT ', FL.��� CLIENTISCLSE'i - '. 3 � �p NGINEERS — LANDSCAPE ARCHITECTS JOB N01�4.� ,LoT�� w,�,r�1r, ,, GJ 3 LANNERS— LAND SURVEYORS DR. BY' IN aa CHKD.BY, DPrI'1. 889 WEST MAIN STREET � _ x • CENTE611-LE, MA. 02632 SHE ET..L.OF— ., SCALE s J — 40 gy .ac.+e-_::.�1.-_z.,..:n ,...s._:.. ....,.. W:.:a.,.n.:,..,v.�.xvzmme r,...rw.•.n,:w..e.swmr,.r..,.,,:...e».,.:,....;,.....�,..�.,...,,.,.Rao. -.....,..n-.•.ems.. .,., -.,...,..u:e.I. m....�... IAssessor's offioe ,(1st floor): 2� _ /?� Assessor's map and lot number ...... a..:...................... (0.. C,_ SEPTIC SYSTEM MUST BE �oFTNETO� Board of Health (3rd flood): L � �6S' INSTALLED IN COMPLIANC ..........................�- WITH TITLES • Sewage Permit number ......... ... Z BAWSTADLE, . Engineering Department (3rd floor): �� - �L ENVIRONMENTAL CODE 9 AN p0�1639•p House' number ............................... TOWN REGULATIONS 0 Apr APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN -OF BARNSTABLE BUILDI G IN PECTOR APPLICATION FOR PERMIT TO ..... . ... .. .C.. ./ 4 .f.. ..<.. /.. � ............... TYPE OF CONSTRUCTION .... .. ........C../. ...... lTf '1.P........................................ ........................ J�. ....l...��. TO THE INSPECTOR OF BUILDINGS: The undersigned her y applies for a p rmit acco in to the followin information: Location .�. i.. ........ .. ... Gt. ..... ..... ... ... .. �f ` ProposedUse ........0:1... .1.e.......�.r!:1.1........ ........................................................................................................:................. Zoning District ......................... .........a...................c.......Fire District .... ..C i .I.5......... Name of Owner ..Qlf�il .6 �r.....� ......Address d....��......2...�....�...�..:....Ic�....(.'.. ..�..�.......... Nameof Builder ..... t.' .....................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... ........................Foundation � CO a41 .lP . . . Number of Rooms ..... ...............Yl� �►—�...... ... . / Exterior ... .. .,5.�.(.► �... 1.es.... ..... .� Roofing .. .1. ...... .�? �......................... Floors ...On. .. ...`..... ......�..... .. . ..e4..........................Interior �..�.t,..���.�.�.. )1.1%� Heating / ..... .�. .........G,s.......................Plumbing �. ... :.T.. S ......... 1 C Fireplace .................................................................Approximate Cost ... ..J,, .Q.Q ............................. Definitive Plan Approved by Planning Board _______ �4 --__aa_19_$y . Area .J"7XO �� ... ...................... Diagram of Lot and Building with Dimensions ; Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 P C `I cc,c'C,� �P 16 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. Name ..... .. . ....... .`........ ..- r• ..... . .. ......... o $ Construction Supervisor's License ......... .GREENBRIER CORP. 30107 Ore "tort' yNo ...:............. Permit for .. ......... ....................... Single Family Dwel ............................... ...g....................... Location Lot #11, 119 Whitehall Way - Hyannis .. ..........................`.. .................... .................... _ Owner Greenbrier Corp. y ............... .. ............. . ......................... Type of. Construction ....Frame J ............................................................................... Plot ............................ Lot' ................................. Permit: Granted .....Qat.ober...2B,.:..,.....-19 86 Date of Inspection ..........................::....../'19 r Date Complet d .....................................19 F "v - �' � Ca SO -In Cr go 0� t � a n3; ,. . s - r r) Map —] Parcel Permit#,- �(O House# ` ( � rJS, Date Issued — 2 — o �� rd floor)8 15 =9:3(�/1.00 4:30) f' GG Conservation Office (4th floor)(8:30-9 30/1:00-2:00) - r 1 n ep 1 t flo cho d ldg. SEPTIC SY UST BE INSTALLE LIANCE initi an prov y PI ing oard 19 HI ' 3 (IRON `• 'C DEAN® TOWN OF BARNSTABLE T NW` IONS Building Pe it Application r Project Street Address t Village H 1'Vrl t ' Owner o Is . o lJ Address q \.N �'1; 0., di,l, ,_Telephone ' o O r 2 ' Permit Request 7O C0. rl(`p 6 or) lJf1` I n S�PO` rickOoy'� First Floor square feet Second Floor square feet Construction Types Estimated Project Cost $ ( © O 6 Zoning District Flood Playfi ,. ?'`•:_ Water Protection .4 •1 Lot Size Grandfa hered 'p Lek t p No Dwelling Type: Single Family Two FaAk, 1piE,n ( Age of Existing Structure e0.�s pist&ic•House•,-'JYos< 26To On Old King's'Mighway `L]Yes ❑No Basement Type: 9'Full ❑Crawl ❑Walk d ­❑Other Basement Finished Area(sq.ft.) Based,merit Unfimshid Area(sq ft� J��0 Number of Baths: Full: Existing�_ New ., I '�lf Existing, '� New No. of Bedrooms: Existing New . ty Total Room Count(not including baths): Existing New [ °q'ikrst Floor Room Count tt Heat Type and Fuel: ❑Gas �/Oil ❑Electric ❑Other Central Air ❑Yes U/No Fireplaces:Existing New Existing.wood/coal stove ❑Yes lld'N0 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) . ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name O� r �� 1 t� Telephone Number � �(3 q 4 Cp Cp Address- PLC), C�bk '4-� License# 14(o C I m si, Home Improvement Contractor# Coin\ cCLi 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 BE TAKEN TO SIGNATURE �. DATE �' q O BUILDING PERMIT DENIED FOIE THE FOLLO ING REASON(S) w. d i3 FOR OFFICIAL USE ONLY% - * ..�•RMIT NO. � 'ATE ISSUED -'J�AP/PARCEL NO. ^ . .w -^~ l� -..;r`J.•F �,- .. ,�� u .• _ ,' _ _' , . . t r"S. .w�,r- .1 ., ..Y ds ` � ` S4 ADDRESS • VILLAGE. 3• OWNER DATE OF INSPECTION: FOUNDATION ve , = _, 3 ice. � C ! y •;;"`t _. y `' > FRAME INSULATION FIREPLACE ELECTRICAL: ' ROUGH Y. FINAL e t 41 'f 1 e • i 4e' PLUMBING: ROUGH FINAL � s n•� � GAS: M ROUGH s FINAL i e rt - ♦♦' Y i .^ r 1 _ FINAL BUILDIN ,0 -1 �l 7 [� DATE CLOSED OYJ') ASSOCIATION PLAR.NO.0 tME The Town of Barnstable snfuvsTnsi.E. • 9�A '& ' Department of Health Safety and Environmental Services rFn " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 _ Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only i 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: I t��R Est.Cost G O(!) Address of Work: I � 1/ Q ct Tl i'lGS Owner's Name L e.e.. O L U 6 Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work 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 c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a per U—± he owner:3/3�28 , I9- Date Contractor Name Registration No. OR Date Owner's Name + The Conrrrron lrcaltlr of 1 tussac•Ir usctts •T, Department of lnduxrr&1 Accidents officeollttyest/gatfotts (inii �:- .•,\�::..:.-__r � 600 lf'u.01im►tu►r Street Bosom.Mass. 02111 Workers' Compensation Insurance Affidavit ii �in inf rm `ti '— I- - •" ""`_.�.� --'_ - name: c ldr(P- M Cin. 06nv-ja�� IA n • 413 O I am a homeownerlerforrAing all work myself. &-l'am a sole proprietor and have no one work-in_ in any capacity C] I am an emplover providin_workers' compensation for my employees working on this job. catnnany name: address. • city: [!hone#• . insurance cn. Isot;cy# [I I am a ole proprieto —contractor, or homeowner(circle one)and have hired the contractors listed below who have the followin_workers' compensation polices: comninv natnc: addresc: t city• r nhane#• ingurnnrc ro. nniicv# cmmnnny namr: address- rity ghnne#• insurance co, nolicv it Attach additio_n21 Sheet ifneeei'sary- i�_ -_ - ++• �-•;L.-: _ - %• "'-�•c �-+-- Failure to secure cuveracc as required under Sectioe 3A of�IGL 152 can lead to the imposition of-criminal penalties of aline up t SI.500.UU andiur one years'imprisonment as well as civil penalties in'the form of a STOP WORT:ORDER and a line of S100.00 a day against me. I understand that a COPY of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. I do herehr t 1 tier tit pains d penal! <Perj •that the information provided above is true and correct. Si:nature C��-��`1/�. Date 3 ctQ Print name ��` �e6� �• v1 C.� Phone# `0 1 °' 4`0� 'otTicial uxc only du not,write in this area to he completed by city or town otlicial city or tn„•n: permit/license# ntluifding Department C3Liccnsing Huard C2 check if immediate response is required Oscicetmen•s Offfcc F Otleafth Department contact persr•n: phone#• nOther information and Instructions 4 Mcssachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the employees. As quoted from the' "law". an empinree is defined as every person in the service of :in i lier qu oted under an.' contract of hire, express or implied. oral or written. Ai: employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or mor the forc�_oin��cn��a�=cd 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 th 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 ho or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that even•state or local licensing agency shall withhold the issuance or .. rencival of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who leas not produced acceptable evidence of compliance with the insurance coverage required. Additionallv. 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 been presented to the contracting audlority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying_ company narnes. address and phone numbers as all affidavits may be submitted to the Department of Industrial Acci dents 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 require: P to obtain a workers' compensation police. please call the Department at the number listed below. - City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Ins esttaattons has to contact you regardingthe applicant. Pie be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questio; Please do not hesitate to `_iye 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,Ma. 02111 fax #: (617) 727-7749 phone Pr: (617) 727-4900 ext. 406, 409 or 375 7$OCMRAppmwkj Table J32.11;(condoned) Prescriptive Paekago for One and Two4hmilr Residendal Bnildfap Hated with Fad Fneb MAXIMUM MINIMUM Glazing Glazing ceiling Wa11 Floor 8asemeat Slab Hemiag/Cooling Am'(A) U-value= R-value' R value' R-value Wall Plameta Fgwpmm F.fliamcy' Pad mp R value' R value' 5701 to 6500 Haring Degree Dare' Q 12Y. 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Now S I29A 030 38 13 19 10 6 85 AFUE T 15% 036 38 13 25 WA WA Normal U IVA 0.46 38 19 19 10 6 Normal V 13% 0.44 38 13 25 N/A WA 85 AFUE W 15%. 1 0.52 30 1 19 19 10 6 -W AFUE X 18% 032 38 13 25 EN/A WA Normal Y 12% 0.42 38 19 E25 WA WA Normal Z 19% 0.42 38 13 19 10 6 90 AFUE AA ism. 1 0.50 30 19 19 L lo__L 6 90AFUE 1. ADDRESS OF PROPERTY: I �CL� - ol- n}s 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: C 4. %GLAZING AREA(#3 DIVIDED BY#2): t g O 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: ` q-forms-980303a 780 CMR Appendix J Footnotes to Table 35.2.1b: - ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and 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 area may be excluded from the U-value requu°ement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft'of glazing area. z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. 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 truss construction. If the insulation achieves the full insulation thickness over the exterior walls 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, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque poi 'an of.:.y irlividv,,.l basement wall with an average depth le-,s that^ 50%�nlnvr grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements 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 J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do_not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. 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 0.35). 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 if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 I i �G sti6ed To:�00 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00`- None 8 81 Number: Expires: " 1G -;1 & 2.Family Homes Restricted'I`oi` 00 Failure to possess a current edition of the 1 Massachusetts State Buiilding Code e . 'PS ROBERT. C LINCOLN is cause for revocation of this license. f i 21 ELM STREET CONWAY, HA 01341 t � t �e �e`��oo�xmeonuaal0�a� ./�aaeaa�uuell2�=. " ,NONEIMPROVENENTNTR�ACTOR C �_.. t . rReglstration114540 TYPkINDIVIDUAIX x: ? Expiration �ROBERT`C AA, O�.Boi 47/147;E1®St �� , P of ay MA�01341i� ,± i t` c u fMF Floor F� �ar10 r 2 , -- _' P4- Qom= } �c�Ar Dorn Sk ►' ��- `� �'g n 5 1 r - • FYCeM 1 M q �C.� A.7 �� R.3 V �Cel ►1 - (ex�cc' 4' lect X4 Y e51 b� (rmr%i ®)e 1