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0089 WINDSHORE DRIVE
Duo \. i� �__ Town of Barnstable Building Department Brian Florence, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.bamstable.ma.us Pre-application for Business Certificate Date- _ Mag;�30 Parcel Applicant. Information Applicants Name N&�D,IGI bVP M,- Applicants Address "I W re Q(- Email Address al A. yowvy, Y (}yVl�G[Sl— VL, \JaYwaa Mgt Telephone Number Listed ❑ Unlisted ❑ Business Information New Business? ' No Business is a registered,corporation? ________________________. Ye No If yes Name of Corporation Do 6 U 1. Does business operaie under the registered corporate name? Yes Is the business a sole proprietorship or home occupation?.______'___ Yes 6No If yes then a(�Home Occupation Registration is required See Building Division Staff Name of Business �/i(1 of Cc�tit�►SQ,�a yl G1 Business Address 1 W 61 Mau n Ste 105 T WlGX1`ll t S MA Qa tp i) 1 Type of Business VY1,Q,OtU -OtAt*'1 CO Up"yj Building Cmimissiolier OfQqe Us�j Only Conditions �1 Q S' S h1 r) < < Building Commission Date; I Clerk Office Use Only Any individual,partnership or corporation doing business under a name, other than their own name or incorporated naYne, must file a Business Certificate. Any individual,partnership or corporation doing business under a name, other than their own.name or incorporated name, must file a Business Certificate. The certificate fee is $40.00 and is valid for 4 years. The Business Certificate form is must be submitted to the Building Division for review and signoff by the Building Commissioner. The form is then submitted to the Town Clerk's Office for processing. Town Clerk Building Commissioner Barnstable Town Hall Town Offices 367 Main. St, Hyannis 200 Maui St, Hyannis 508.862.4044 508.862.4038 Under the provisions of Chapter 337 of the Acts of 1985 and Chapter 110,Section 5 of the Mass. General.'Laws, business certificates shall be in effect for four years from the date of issue and shall be renewed each four years thereafter. A statement tinder oath inust be filed with the Town Clerk upon discontinuance or withdrawing from such business or partnership. Copies of such certificates shall be available at the address such business is conducted and shall.be funnished upon request during regular business hours to any person who has purchased goods or services from such.business. Violations are subject to a fine of not more than three hundred dollars, ($300.00) for each month.during which such violation occurs. The issuance of a Business Certificate does not imply that all relevant licenses required to legally operate this business have been obtained or are current. This certificate only records that a business is being conducted. f • ' . .' ALTERNATIVE• .• I ' WEATHERIZAT.ION . -------------- Cal Date: A °'" q? ' Town of Barnstable 200 Main St Hyannis,MA 02601 ill Re:Pexmit# r o -+ ; , ;•�-K .�;:,;:: ,r :_s Vages - ..,. (.I+:�•i�' a .n= .:l'`.� :''(.:�f'.�Y^� ;:%%.�.r,'�' :;i7.. 1:1•..rs:: .5!y.i, yl.3:i'W. insulation/weatilb �,506rk at • J;,i•'i'�'• �r,, �1+;:4�i:s Y•S. �y.r G�♦,.;L"�%`', n"C.'y;"rl}� .'?I,i,';:::;!;f�,r,..,p'�rt�rr,":T_.'i..- :;�.�. ' tee Ge wi Aas:beencom le n .-.^a:• ,.Py.,r .(}.., �•+1 cf.Yi� 2s �1n"._v ;t,4v "t+.+ii: ;.,�• 1. ��,:5'<:r- ,h,..,..� - 'Re '.7:`.5t"' ''fY ii::.:'G:' �7:5"} «:iil�.v:r !'%i. _ .-,t::-:•.:.�,t:.5 �:'::��;!4:�:!���i�'J�ji ::::1"'x - :r� .+:y;trf 4:,: ��.5,, .:l.�rNSt^^:.,i!•�G',r•;:.' +.l..,S•`: �.,_�,r,:."; • _ . -:F - _!("::('1=':;/•. ,.1, .•+F.;•„r:•Sy':::�'�:;1., .i"y.. '�q'•.;;4Jni:(•,r-:�3 ''� �i�' �.m Q'•y.;.??., ..s•;�1c•:;,?";•d:Ni', � _ '+•+�1.'<,M'�,:!'�i . :•ti,7..�. +�t/'g'!'w:`.F,'(';.7':�;y "' �dl,'-`�.":,:'t:� _`r„-,•,���.�,yFj�.;'.i�',':r':S` 7::' :. Timothy Cabral, President CSL-105454 58 DICKINSON STREET FALL 02721 (508)567 4240 ..:I: -L1tIZNAAVEWEATHERIZATIOM@GhAAfl:.COM Town of BarnstableBuilding Post'This.:Card'So That�t `sU�sible':From the Street-A royed,Plans;Must be.Retamed on;Job;;and�this Card Must;bebKept . 4 Ar P nil<F n I Ins ection Has Been"Made pp ys s o 1b9 OSt>zd ,. . x x = 2 y� ° Where a'Certificate of.O.ecu anc :s�Re aired such•Bu�ldm shall:Not be Occu ied;until:a Final Inspec#ion.has been made : Perm n.. .. u .. Permit No. B-19-243 Applicant Name: ALTERNATIVE WEATHERIZATION INC. Approvals Date Issued: 01/23/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 07/23/2019 Foundation: Location: 89 WINDSHORE DRIVE, HYANNIS Map/Lot: 271-140 Zoning District: RB Sheathing: w, Owner on Record: BROWN MICHAELA Contractor Name: ALTERNATIVE WEATHERIZATION Framing: 1 - . ,• � INC. Address: 89 WINDSHORE DRIVE r, 2 HYANNIS, MA 02601 i Contractor License: 175683 Chimney: Description: Weatherization Est Protect Cost: $2,873.00 Permit Fee: $85.00 Insulation: Project Review Req: z ? < Fee Paid'.< $85.00 Final: 5 = '` Date 1/23/2019 F Plumbing/Gas Rough Plumbing: t> � Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. i , < Rough Gas: All work authorized by this permit shall conform to the approved application and the.approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and st uctures,shall be in compliance with the local zoning by laws'and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. r Electrical TV The Certificate of Occupancy will not be issued until all applicable signatures by'the l36i ding and Fire Officials are provided on the permit. Service: Minimum of Five Call Inspections Required for All Construction Work:t ., Rough: 1.Foundation or Footing r g 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final:. Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT n t bA . `� Application numbet v' _:. .. .. ..)..S...... -b A Date Issued' •• .. ai Building Inspectors Initials... �E .... .. .......... . . a 1 Ali :. IVlap/Parcel ..... x TOWN OF BARNSTABLE EXPEDITED PEIMWT APPLICATION _ : •.. ,{ ROOF/SIDING/WINDO-W.S/DOORS/TENTSISTOVES/WEATHERIZATION s PROPERTY I�TFORMATION Address:of Pro'ect. II I� 5..., ER YA M. LT VII AGE Owner's Name: MCM,e�a�� Phone Number y ` Email Address: 1 X ��YI7C' Cell Phone Number i Project cost$ 0 Q 23 f Check one Residential COmmerClal u .• .::. _..v, . •... .. , ..�,:. � OR?NER':S AUTHORIZATION a. As owner of the.above property I hereby,authorize � � ; to make application for a building permit in accordance vv�th 7$ IVIR 1/t�_..:.:. v , Owner Signature: L Date. TYPE OF WORK D ASidng . Windows(no header t Ins�alatton/Weathenzahon � 0 Doors (no header change)# Commercial Doors require an=rnspector'srevrew ❑ Roof.(not applying more than 1 layer of shingles) ,.... Construction Debris will be going to - CONTRACTOR'S INFORMATION Contractor's name .Home Imrovement 0 Contractors Re 'stration if hcable # 73G P ( aPp ) / �3 (attach copy) + 4 Construction Supervisor's License#` / y. (attach copy) '1" y Email of Contractor 8/^hGLGt:JP` zi7 .:.P e number i ' o7' ot�0:.. lion ALL'PROPERTIES'THAT HAVESTRUCTURES;Ot/ER 75 YEARS OLD OR.IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER'...................................................e.. .�.. *For Tents Only* ,Date Tent(s)will be erected Removed on number of tents total Does kthe,tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am--9:30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval: *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. k Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's 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 APPAICOT9S SIGNATURE Signature Date o?a2 All permit applications are subject to a building official's approval prior to issuance. a TSe To Town of Barnstable CO Regulatory Services . n x.'&k F1 ,* Richard V. Scali,Director Miss. 1639. ��� Building Division D MN Paul Roma 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 I, MICHAELA E BROWN , as Owner of the subject property hereby authorize A�- ipe WM&Mtri �� �C: to act on my behalf, u4iin all matters relative to work authorized by this building permit application for: 89 Windshore Drive Hyannis, MA 02601 (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form. C:\Users\decollik\AppData\Local\Microsoft\Windows\lNetCache\Content.Outlo6k\L7U69LF2\EXPRESS(2).doc 01/25/17 The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lep-ibly Name(Business/Organization/Individual): ALTERNATIVE WEATHERIZATION, INC. Address: 2 LARK STREET City/State/Zip: FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): l.❑✓ I am a employer with 16 employees(full and/or part-time).* 7. New Construction In I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.a I am a homeowner doing all work myself.[No workers'comp.insurance required.]' 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Q Building addition ensure that all contractors either have workers'compensation insurance or are sole l 1.Q Electrical repairs or additions proprietors with no employees. 12.a Plumbing repairs or additions 5.❑f am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance.* 14.❑✓ Other INSULATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#: XWO(19)58867158 Expiration Date:6/8/19 Job Site Address: /) % / /nd S /" h / r, City/State/Zip: ajt� J /� Attach a copy of the workers' compensation policy declaration page(showing the policy nu er and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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 S250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u d ain a p lti s f perjury that the information provided above is true and correct. Signature: Date: 6 c' Phone#:508-567-4240 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#: ® DATE(MMIDDIYYYY) ACORN CERTIFICATE OF LIABILITY INSURANCE 06/11/18 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Anthony F.Cordeiro Insurance Agency (A/OPH C,N Ext: 508-677-0407 A/c No): 508-677-0409 171 Pleasant Street E-MAIL Fall River,MA 02721 . ADM.ss: HSouza@Cordeirolnsurance.com INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURERC: Ohio Casualty 2 Lark St INSURERD: Fall River,MA 02721 INSURER E INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM/DDIIYEYYY MMIDD/YYYY LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I DAMAGE TO RENTED CLAIMS-MADE �OCCUR PREMISES Ea occurrence S 300,000 MED EXP(Any one person) $ 15,000 A Y Y BKS58867158 06/08/18 06/08/19 PERSONAL&ADV INJURY S 1,000,000 GEN'LAGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident ANY AUTO BODILY INJURY(Per person) S B OWNED X SCHEDULED Y BAS58867158 06/08/18 06/08/19 BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS X HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY X AUTOS ONLY Per accident S X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y USO58867158 06/08/18 06/08/19 AGGREGATE S 1,000,000 DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY STAT YIN N UTE OR ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 500,000 C OFFICER/MEMBER EXCLUDED? NIA XWO58867158 06/08/18 06/08/19 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA its direct and indirect parents,subsidiaries and affiliates is added as an Additional Insured for General Liability on a Primary&Noncontributory basis per the terms and conditions of form CG2001 (04/13),for Ongoing Operations per the terms and conditions of form CG2010(04/13),for Completed Operations per the terms and conditions of form CG2037(04/13)and Waiver of Subrogation applies per the terms and conditions of form MEGL0241-01 (04-11) Additional Insured for Automobile Liability applies per the terms and conditions of form SCA005(02/16) Excess Liabilitv is a followinq form. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road Waltham,MA 02451 AUTHORIZED REPRESENT ©19k8-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD a�.V,a azyk„ `N..5 t7' - �A. v1sco , s r Z . i„ ...e. i I iR' E 1 Office Of Consumer Affairs and Business Regulation 10 Park Plaza- Suite 5170 Boston, Mao"Achusetts 02115 Home Improvement l tractor Registration } Type: Corporation Registration: 175M ALTERNATIVE WEATHERIZATION,INC !h£ rIration: 0512$12019 2 LARK ST , FALL RIVER,MA 02721 � ; �� .- i v Update Address and return card. Marie reason for change, _..__..-_ ...._a.,._...__..- _.. II. ss 11F�.r� ►ai I"I ,►,n1 m 0..-L0J1 t:Carr+--_...-...-. Office of Conaumer Ai' im&8usin"s Rogulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only r TYPE:Coiatiat before the expiration date. If found return to: y Ration Office of Consumer Affairs and Business Regulation f S� �•r•?� ...� �. .:.. 05l28120 I,7 10 Park 7'faVia'•Suite 6170 0 ALTERNATIVE WEA"J"'J i TlON,INC. n,MA 02116 r TIMOTHY CABRAL 2 LARK ST FALL RIVER,MA 02721 Undersecretary Ot V O.:- Si 8tut� ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel BUILDINGApplication #✓' "� Health Division Date Issued �! /8 / 7 jConservation Division AUG 172017 Application Fee Planning Dept. TOWN or, 13ARn)STABLE Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address `6 `�,�Sh o re, -ye Village A I S Owner/-PrQNc•e �_A?6ft) 5,,`1, gS Address ?1T��'n �5_ 61,e iTelephone 5_6 8 , Permit Request C r Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation(C Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) K30 flAge of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: (Id/Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: 2, existing _new --t...s, Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas LWOil ❑ Electric ❑Other Central Air: ❑Yes El No Fireplaces: Existing New Existing wood/coal stove: ❑Yes @ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: 0 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 ��w��°�� S� �A �� Telephone Number —,2 k Address Gv�`n �Sl�o�c License# Home Improvement Contractor# ,sEmail "Sf Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO y' A /� SIGNATURE �i.• DATE r .. FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. P` " Depat kfrent of rudustrid Accide7ls � — - face a�'.iim��tigau`io7ss - . 600 Wazshhzgton Street Boston,,M 02U1 .!5 }u�vt�ntas�gov�iiin , Warlmrs, Cumpen anInsn-ance kfEdayit]3uilrie>e-s/C�antracturs/EecftdcianslPlmmbers A mUcca nt lnfgmii gn Please Print Naige r•r nc e - S�`A A Addiens: g� wr`��sld- "4�ityf £at�l p� /�/�n�:'s/i,,A/©1 sir-ZSy - Ph(=--" —0 — Z S S `f Are you an emplo-yer?Check the appropriate bear ' T of project r L❑ I am a employes vault 4. ❑I am a general coniractar and I Type e 1 (required): employew.(fa andfor part-#�ime * bavelied.t&e Mb-con actors 6_ ❑Ides ooayst cti 2.❑I am a sale pmprieta>r or gartaet-- Tilted on the attached sheet. 7. ❑Remodeling slop and have as employ These sab-con ractors have ees $. ❑Demalifiori wo Lrmi g for me in any capacifg employees andhace worlwre 9. ❑Buildfag ad3ifiorQ [No wodar,is' comp_insu=ce cOmP-i,, # j 5. ❑ We are a corporafica and ifs 10.❑Eleo ic;al repairs ar a,dditi . 3- I am a bomeov a er doing all work afficeas have•xEr ed their 1 L❑Plumbsagrepaus or additious. myself o wozkers tight of emer;3p6m per MGL Roorrepaim istciriance requif ed:�F c.152,§IM andwe have no �'l�-INO wodoess' 13-❑Other comp-insurance require&j �$¢yapgli �stcbed3bos#1tmrsltalsofiIIao th�sectEoahPlaiv�rmdng�eirrvo3sea'mmpeasatiaffpoycgiaformssi� fi t3ameawa�rvrho sabnrit rEris stfidavu i-r—ing t3iay are daiag sTF�ra�it sad tbeahae autsid�cautmctars�st SvTo-mit a new affidattit iedi as sacfi fCaatuuanstFatchwXthisboutmastattachedtar.sdditiw sheetsbawingthemmneofthesub-cant=tamsndsFfewhedmor not rfoseentidesbne =ployees.Iftheml-cantadaeshaseemployee.%tfiegmastp=i&tbeir worken'tamp.palicyaumbm I warn ara a=rrtpr tltrrf;is pra}zrIr�r„n�axricers'rotigre-rtsrdtart uisural�s,jar mS*ear1vla}�es: $eIoty is tltepa8cy alyd jela sate' hiforrfsalion: Iasumce CompanyName: Policy .If or Sqelf-ins I.ic_ ExpiratiauDate: Job Re tiddrers: Cifyf5tafel r: AEtach a copy of the warkers'compmsatioapolicy-declaration page(showing the policy number and respiration date). FaAnre to secure coverage as required under Section 25A of MQ,c.157—can lead to the imposition of criminal penalties of a fine up to$UOO,.OG aadfar one-yearimprisonmeak as well as civil penalties is the foam of a STOP WORK ORDI Rand a fine of up to$250-00 a dap against the violator. Be advised that a copy of this sWement.maybe frnwarded ta the Office of. Inre stigations of the DIA fair is'lW."ce coverage ywffiCati= M Ida hereby. c %ai d rr thiff pains mtdrpersattips a F cr that t hir in/brma6or>•prm-vW a bore is trans mid carrect 5:�..,+,�/� �• �� Bate v Ph Doa ial use mi£}: Da not write in t ds area,to be srrfupTWed by czfy aribirn official C"zt<j or Tow m PermftT icewe 9 Bsuing Anthmriky(carte once) L Board of Health Buff4ing Department 3.atimown Qerk d:Electrical Inspector S.E lumbing hmpecter 6.Other Conbct Person: Mane#: a s- c ions , ir �a�z • mi fOr fieir employe�s- Mz*cc3r-�rrzse#S G eaaII-aws d:, •152 ram=��oy=to pr_ av&Wco±a ' imd� c��,ad of�e, e p�-fo this sty,an�Pk3'�is defined as. ,every person m�.e serva rZ f �y express or IInplied,oral crwch." An err Foyer is d�fined as_anmffiva ,par j=b,s ,amcfi on,coaporafion or ofi�Legal et�y,or an two or more andmchndmgthe legal rep=m3teivm of a dwzased employer,or�e of the frsregv�g in a3°mt employing employPP� However fhB recei�or trnste�of an indrvidual,p ap.associ fi=or o•6ier.Iegal Mtty, owner of a dwori3,ghonsebaemgnDtm=tT2mf3neeapartincnis andwho resides,ortho occopant oftbie- dwelling house of anot3W who employs persons to do maims Ce•,c=dMc_t;on or repair wo$c on such dwrli mg house urf�.>tthencn shonotbmanse of such employmedbe daemedto be an earploYm7 or on•Hie grotmds or bm7rlmg�p MGL djapter 152,§25C{6)also states that¢eveTy.state or kcal IiicenS Eng ageb.cy shall Wiffihold•Ham iss =Ct-.ar. renewal of a ficen a or permit to operate a business or to contract b-au7dings in the commonwealth for away appincantwho has notprodnced acceptable vdffenm of cumpHancm with the m¢rance coverage raga=ecl-" Additionalb,MG`L chapter ISZ,§25CM stairs-Iefther the comm.anmalft nor a'ay offs political subdivisions shaII enter into any contract far tho per�ee ofpmblic work untl ac a:ptablD evidence of con3PIian cew>*h the msm$n cam. er[fs of this chapfra have Been presented in the CMIMCCting anfa=tY-7 ALiPiic-ants •' Please fol o-ot the wojars'campensati on affidavit completel(,by dig-de boxes tip aPPIy tti you dhaation and,if nerzssaoy,SupPfy ems)name(s), adda-ess(es)and PHOUt=mbMCS)along w&ffi a=tficatc(s)of or I,imitrd Liabr�ityP Fs(LIP)wrthno�kY�o$aer fig the himm-ance. Laafi�dLiabi[ity�Pantes(ILQ members or partners,are not rbgmzed to cony wad=—e crmzpensahon ms- ce If an LLC or LLP does have empIoyees,apolicy igreqai1ed. Be advised-ffiA this affidaYitmaybe submitbd to the Depa-fineat of ludustrial Accidents for coofmnation of msorance coverage Also be rare to sign and date the affidavit_ The affidavit should be ret=c d to$e city or town that the application for the P'Eag t or license is b sing requested, notthe Deparfinent of Ldusixial Ad mts- Shonldyota have any gnestions regErc �e law or ifyou are reed to obtain a works' compmsationpolicy,please call th.D Department atihemmnbeslistedbelow Self-ms��d��essbauld en xl$eir self-mcrn-ance IiCMSO amber on the;appropriafe Ime. City or Town OffciaTs _ Please be sure ffiat the affidavit is complete and.pra>tedleglly- The Departmeathas provided a space of th e bottom of the.affida-vt for you to fill out in the event the Office oflnvestigati has to ContactyOurcgMTungtho applicant P Lease:be sure to f[1 m tine p=WHccnse nombet which wM be nsed as a=5r- <ace mmnber-In addition,an applicant ffi-a t must suhmIt multiple pennWHce s,a applbudons is m3y given year,need only submit one affidavit indicating caffeat and under°Tob SSfe a_�sS17 lie applicant should write-aII loratiLns in (city or p olicy, info' aaation(if aces ary) ed or mad[ed by the city or town maybe provided to fiie town)--A copy ofthe affidavitfizathas bey officiallyP applicant as pmofthat a valid affidavit is on file for fuinre•pmmits or iieeases_ A nevi affidav ,c-Ast bmmerc ial vet year.Where a home owner or citizen.is obtaining a license or PeLa not mlaied fo any business rn:e_a dog license or penart to burn Leaves etc.)said person is XOTrujoiccdto caIqIet,this affidavit The Office of Invesiig would Pike to thank you m advamm far your Oopertion and should you have any questions, please do not hesUatu to give us a caI- The DepE -tum ,%address,telephone and fax mvnber: y • . �f�a�xSt1�of .ah, • • fc��,f�e�ffrg�fio� Ta 4 G1'1- �•�' - =t 406 or 1-��IAA,'STAFF Fax It617` 27 7749 IZeviscd4 24-07Zr�d AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)1 Q Check Compliance 1.1 SCOPE Wind Speed(3-sec.gust):..................................................................................:...............,.............110 mph WindExposure Category.................................................................. ..............................................................B 1..2..APPLICABILITY Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) stories 5 2 stories RoofPitch ..........................................................................(Fig 2)....................................,...... s 12:12 MeanRoof Height ..............................................................(Fig 2)................ ...... _ft 5 33' BuildingWidth,W............................... ...........................(Fig 3)................................................ _ft 5 80, BuildingLength,L ...............................................................(Fig 3)................................................._ft <_80' Building Aspect Ratio(LW) ...............................................(Fig 4)............................................... 5 3:1 Nominal Height of Tallest Opening2 ...................................(Fig 4).............................. ............. <_6'8" 1.3 FRAMING CONNECTIONS General compliance with framing connections..............:.....(Table 2). ............. .................. ................... r 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete........................................................... ................................................................... ConcreteMasonry................................................................... ................................................................ F 2.2 ANCHORAGE TO FOUNDATION'.3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general................................. ........(fable 4)............................................... in. Bolt Spacing from endfjoint of plate ...(Fig 5)..................................... in.<-6"-12" Bolt Embedment-concrete.................................. .(Fig 5).................................................. in.z 7" ..... Bolt Embedment-masonry....................... (Fig 5):................ ..... in.>15 " PlateWasher...............................................................(Fig 5)...............................................z 3"x 3"x Y4" 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).................................... Maximum Floor Opening Dimension.............................. .(Fig 6). ................................................ ft s 12' _ Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks. Supporting Loadbearing Walls or Shearwall.:........:.:...(Fig 7).....,................................................ ft s d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8).............,......................:............... ft <_d FloorBracing at Endwalls...................................................(Fig 9)....................................................:. Floor Sheathing Type .....:................ ..........(per 780 CMR Chapter 55)...................... - Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)....................... in. Floor Sheathing Fastening...............................�.................(Table 2)... d nails at in edge/ in field 4.1 WALLS Wall Height Loadbearing walls.......................................... ............(Fig 10 and Table 5)............................_ft 510, , Non-Loadbearing walls............................ .(Fig 10 and Table 5)..........................._ft 5 20' Wall Stud Spacing ........................................................(Fig 10 and Table 5)...................—in.5 24"o.c. Wall Story Offsets ..... ... ....................(Figs 7&8) ........................... ..... _ft s d 4.2 :EXTERIOR WALLS' Wood Studs Loadbearing walls........ .............. ...... . :................(Table.5)...............................2x —ft_in. Non-Loadbearing walls................................................(Table 5). ................ .......2x - ft in. Gable End Wall Bracing Full Height Endwall Studs............................................(Fig 10).................................................................. WSP Attic Floor Length..................:............................(Fig 11). .................. . .... _ ft 2:W/3 Gypsum Ceiling Length(if WSP not used)..................(Fig 11)............ ...............:.. .. ft Z 0.9W ......: . and 2 x 4 Continuous Lateral Brace @ 6 ft.'o.c...(Fig 11).............................. ............ ............... or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing in end joist or truss bays Double Top Plate Splice Length ........................................................(Fig 13 and Table 6). ............... ..... ... ft Splice Connection(no.of 16d common nails) ............(Table 6)........................................................... ' E AWC Guide to Wood Construction in Sigh Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMx 5301.2.1.1)` Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Tables 7)...................................................... Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Table 8)............................................:........... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9).................................._ft_in.s 11' Sill Plate Spans ........................................................(Table 9).................................._ft_in.511' Full Height Studs (no.of studs)...................................(Table 9)........................................................ Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans..............................................................(Table 9).................................._ft_in._512' Sill Plate Spans...........................................................(Table 9).................................._ft--in.512° FullHeight Studs(no.of studs)....................................(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W . Nominal Height of Tallest Opening2 .............................................................................._s 6180 SheathingType.............................................(note 4)...................................................... Edge Nail Spacing.................................:...... (Table 10 or.note 4 if less)....................... in. FieldNail Spacing.........................................(Table 10). ............................ ............. in. Shear Connection(no.of 16d common nails)(Table 10)............................................... Percent Full-Height Sheathing.......................(Table 10)................................................... _% 5%Additional Sheathing for Wall with Opening>6'80(Design Concepts)..................... Maximum Building Dimension,L Nominal Height of Tallest Opening2........................................................................._s 6'80 SheathingType.............................................(note 4)...................................................... Edge Nail Spacing............:............................(Table 11 or note 4 if less)....................... in. Field Nail Spacing .......................................(Table 11).............................................. in. Shear Connection(no.of 16d common nails)(Table 11). .................................................... Percent Full-Height Sheathing able 11 _% 5%Additional Sheathing for Wall with Opening>6'8°(Design Concepts). ............... Wall Cladding Ratedfor Wind Speed?............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ...................................................(Figure 19)............._ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................U= pif Lateral.............................................(Table 12). ................................. . .....L= pif Shear..............................................(Table 12)..............................................S= plf Ridge Strap Connections,if collar ties not used per page 21... (Table 13)...............................T= pif Gable Rake Outlooker.........................................(Figure 20).............._ft 5 smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= lb. Lateral(no.of 16d common nails)...(Table 14).......................................L= lb. Roof Sheathing Type...... ...........................................(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness........................................... .............................................. in.z 7/16°WSP Roof Sheathing Fastening ..........................................(Table 2)....................................................... — . Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e: Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing . requirements shown in Tables 10 and 11, 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. r f AWC Guide to Wood Construction in High Wind Areas:110 mph.Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)t 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. il. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment r "V44M THIS EDGE FZE M ON FRAMING USE Sd NAiL$ AT6"br- _� rr=-== -- ' - 11 14 • ii li ii 1 u Ir I n u 1 11 n lIj 1� . 11 Il N Il F di K 40 li 11 L 1 • It Q 11 itid 11 ry YI 1 Z too it ii � 1 5 11 11 - " w i i i g I 11 6 1 1 11 LN 1 - a u Lr� 'a W - - > 11 L r DOU13LEEDG ------ MAILSPACM _ r� PAtfEl_ _"1{vy, See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in Sigh Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(7sa Cmx 5301:2.1.1)` 4 0It !� • � i 8a � t' I V41 i fil 1 ' FRAMING MEMBERS �1 iil MFAMEDUITE � �i I r anN. �_ ' STAGG� 3•M�1. . NAIL PATTERN � PANM PANM EDGE DOUBLE NAIL EDGE SPAMG DML Detail Vertical and Horizontal Nailing for Panel Attachment r f AWC Guide to Wood Construction in High Wind Areas:110 inph Wind Zone Massachusetts Checklist for Compliance(7so CMR 5301.2.1.1)1 FAQ*: WFCM Checklist Question: I understand if a new home is built in a town in a i10 mph wind zone then the American Forest and Paper Association (AF&PA) Wood Frame Construction Manual can be used to prescriptively design it. I also understand that in some cases the home can be framed per,the WFCM1oo mph Guide, if it meets certain requirements including but not limited to aspect ratio, roof height, number of stories, and exposure category (B). I have heard that Massachusetts has a "modified" checklist that can be used instead of the checklist at the end of the Guide. Is this true and what can you tell me about this "modified" checklist? Answer: You are correct on the items that you have noted. MA has modified the checklist in several important ways. The MA version allows a roof with a pitch up to and including 8 in 12 to not be "counted" as a story. Further it does not require steel hold downs and straps in many locations if full height sheathing is used as defined in the MA checklist. Further, if the building will have furring strips installed in the ceiling abutting the gable wall then 2 x 4s installed on top of the ceiling joists are not required. There are other changes as well that were not noted here. The MA version of the checklist was formulated in recognition of the highly regarded framing methods used in MA for many years and wood framing that has been used in North Carolina over the past 10 to 15 years which has performed well in severe hurricane weather in that state. *Answers to FAQs are opinions of the BBRS Staff and do not reflect official positions or code interpretations of the BBRS. t + Town of Barnstable Regulatory Services dpttE Richard V.Scali,Director Building Division t Paul 1STALI •17! : 'n mm' si ner aul Roma Building Co is o rasa �, 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 s HOMEOWNER LICENSE EXEMPTION Please Print 'DATE: JOB LOCATION: ! w,%��S(,�e JW. number street village "HOMEOWNER":Zll�I,r>'Acc -'��►f,s✓ name / home phone# work phone# CURRENT MAILING ADDRESS: 1 /J�ir�✓�oslc. CND�rr`s/ ��• Y��G�/ rZ T6 C 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 proce5Wres and requir ments and that he/she will comply with said procedures and requirements. . Signature of Homeowner 'Approval of Building Official r 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFU,ESIFORMS\building permit forms\EXPRESS.doc 06/20/16 Town of Barnstable Regulatory Services BARNS'"' Richard V. Scan,Director Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maus Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using,A Builder I ,as Owner of the subject property hereby authorize to act on,my beh4 in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized beforo- fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QYORMS:OWNERPERMISSIONPOOLS Ale p J n 44 Co Av flu in IV ` o :J '. 4 dL IL o q o ��! r�sivad jO Nnno_� LIOZ 4 T gnv dEIGE)NIG-irIb r i Anderson, Robin From: Bill Rex<wrex@hyannisfire.org> Sent. Wednesday, August 16, 2017 5:29 PM To: Anderson, Robin II -. Subject: FW: 89 Windshore Drive Hyannis (eh file at building today and no permits found for items listed below. Owner apparently finished half the basement and was unaware that he needed permits. I advised him to go to building department. He is trying to•sell, property CaptairrBill.Rex Hyannis Fire-Department 9 -Hi h School Road E_xt Hyanffis;MA'02601 508 7.751300' From: Bill Rex 5eh -Wbdnesda'y' August 16, 2017 2:10 PM To Sally Shea <Sally.Shea@town.barnstable.ma:us> $ubgect:89 Windshore Drive Hyannis He lq,c:E. Found two rooms and bathroom in basement at this address. Rooms have privacy doors without proper egress. Checking to see if any building permits issued for finishing basement. Than'k�you,' t�.. .• Captain Bill Rex HVM' rtrs Fire Department 95~High'School Road Ext: Hyannis;MA'02603' C� BCL�I17 508 775 1300 ` PT t �jzi .���5 �l.�W��.✓ t ' : pop r .41 ji- '" _' t ' ' O j I. ` 1 y 7 j .• r 1 k s .je 7r i'` 1 't 4 i�t � '- i t `� ` r ♦ .. ... a. t•.f ( ! -Q t stt j t s.� � a+" ♦ ., , �, S, r �: , .. .},� .♦r+.ii+tw�4 a..:?.YM c.W h '..� .af..�' I r t _t t f t-. � f. � F ! �+• 4 .. 1. I r + 1 t i f s i. s--de. .f..K;:... .,.,..J.{. I..I••. I i f - i I .1 1^j r I 77 }+,+i, F r .•� 4 ¢,. R f t i t j 1 I (�� � ' s. ' �•:.p r ( � t f I S ♦ + fi r t � � -' -[ ;J L + r I � � j i..i i � 1 r { i � � � � �j.� � I ��+ i ; >.� r I £ �p ,� r�t•I a P ,. ` F ; [ '� I�h r ! I •M , O11.V , ,1 ` f 1 -0 �� ♦r 1 i �. l 1 :1 M b y 'y� k.b. ; ,r f L .}•,.. , .� 1 .� ! _ , .. .r :.i +. - r- �_. ,t ..t..,( { � � r � _.{ { � 7:l�.i } r .f (. h �- a ;�-ter r X•., [ t 1 s f f 1 ! • ' 1 } ! t j 1 � i.Y Y ' } � ', I i � �. is ` .j r I 1 I r � r �I ! - P t 2� r f ) t'} y I { r • v. L- S t r f 1'.. I � L I � I f I f I 1. � { 7 � y a , F I. r � r ' ' 1 9 ♦ t..,_ I + i i { r ( �.,i t `_ �i 1 � � r { ` f �� � r " � � ' a� �, 4 f { p trnF,'/��07_• `jfJ'\';�' i ! ` r t f j k i -_ ` I �. .c t I � "' . . R9CHFIRJ �,. {, A. BAXTER No.24048 j % IST . �t �o .. CEQTOFIED LC)-r }'. { ter:I'D SURv� OCA LTIO" A l C—MZZTIK1( T"AT" TNT �ov 17A"Ptoc�.5"ow PLA1.l R FE��NGE ��Er�W Gc�vIPL�lS ' W I.TN .1't�tr 51 D•�..1..1 r•.•i� _.. . � � � l � , - ' .. f�� . - a J. A//.��UD1 ISETt3AGIGrt-mrzx�o��- OF 'TNT; Cue T. 3-� �► t w . '� -. t3AXTCtiZ �.•'uYE INc. ., tZEGtS C�Z�A _.t�1.1p 5vevcYo`IZ� T"I-S FLAW IS LIOT _BA—SGV C)6-4 A,W OSTER.V1t,LE; o 11rCASS. l�•l�cJ�E�.IT' SvcZVC�{ � T��e—. oFG'S�TS S�aGe+�l.a. APPt_I CA1�1'T j � KZIT gL USC:0 To' Dei'CIzM1_%Ic LoTr LlWe 4—Assessor's map..: and lot number ... ...................... C SYSTEM, W!"isy BE Seuvage�uPermit number .................................."........................ . I H Al�.1..9CL= I `°rC r•'3 Q�FTNErO� 4�• + TOWN OF BA'RN15' I''` 'BLE t:2 roe" ✓On t r to Z BA"ST1►DLE. i ffi i y M'nee r 4.3 ��� � BUI-�DI �/ G INSPECTOR Y C... 10 �� + ry -'�' ��✓ 0 U APPLICATION'-FOR PERMITCTO ...:....... .................... 1.� � .?. ........................................'......... ' �. TYPE OF CONSTRUCTION ...............*! ,�:?c>.C.l.:. .......................................................................... 4gr.................. TO JHE INSPECTOR OF BU.IJ S: The undersigned hereby applies fora permit according to the following information: ' Location . . .C/a... IEv�l. 2e..... .:...................... .1 ' :.f....... ................................... Proposed. Use ..,{/.�N /1 ............................................... ....................... .................................... ... ............... Zoning District ......iJ.Y... ....................................................Fire District ................................ F1lf' /e.� �.............. ....P.. ............C........... Name of Owner .t�� GClfl .. '.... .......Address ........... 1� !v. ............................................. r Name of Builder ....................................................................Address Nameof Architect ..................................................................Address ............................/...'.................................................... Number of Rooms ..............Foundation ...... C Exterior Roofing .......... ..�1 / , - ........... Floors ............. r... i........f..................................................Interior ....... G ......GL C3vT� ................................... Heating .......1? :... ........4 /...0........................Plumbing ................../........................................................... Fireplace ................../............................................................Approximate Cost ........ ��..)... .®. ..................................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area ......:............... •/Z'.... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 hereby agree to conform to all the Rules and Regulations of the Towno�table egardinng' theabove construction.. Nam ................ Capewide Development Corp. 19924 one story single family dwelling 78 Date Completed PERMIT REFUSED � Approved ................................................ lA . . ............................................. ........................... � ^ ' ^ � ---~-----'..---------~^^^^~~^'' ^r ^ ' ~ --'' ` - �� Assessor's map and lot number ... ♦r....... ......................... - Sewage Permit number f TOWN OF BARNSTABLE Z BABBSTABLE. . "6 Q y BUILDING INSPECTOR a.`. 'FpY p`' r; APPLICATION.FOR PERMIT TO ........... ///i,a, l�� x r................................................ I TYPE OF CONSTRUCTION e...................................................................... ........,.. ....��...................19.ZZ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: rt Location ...f. /!�.+r �� laz P / .. !`�T// �1 /// ............................................. /.'.)..... ....................................:........................... .../..,.... Proposed Use ...(;v e�/!f ............................................................................................................................................. .... /........ ' Zoning District ..... •/.. ....................................................Fire District .....) ILC!1!. G../P.../ .!... .: .`. .... ........... Name of Owner .:..........................- ...._:..,..:.............�..........Address ................ /j Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................ ...........................................Foundation ...... .... ! „!.!C. ........................................ Exierior1��5 Roofingr ....................................................... ................. ...... ........................................... Floors1r^ .....................................................................................Interior .........,..... ............ / r Heating / ..... /.r ..f ....................Plumbing ..................`........................................................... ........................�..... . ...................... _ Fireplace .................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ---------------—---------------19________. Area ....................... -.... Diagram of Lot and Building with Dimensions Fee ���...... .... .�.............. SUBJECT TO APPROVAL OF BOARD OF HEALTH P� a J ' r � r P P I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable..regarding the above construction. Name^............• s m``:.................................................... Capewide Developrp. A=271-140 •' '{ 19924 one story No ................. Permit for .......................... ........ r single family dwellin .............................................................................$ Location .........89..W.indshore..Drive............... I .........Hyanni.................................................. 'r Owner Caewide Development Corp. Type of Construction frame r t ........................ ................................................... Plot ....................�Lot ............................ s Permit Granted ......Febrvar. y.. . 2 .........19 78 ..... . .. 'S • Date of Inspection ........................ ............19 Date Completed ....... .......... ....................19 't P RMIT REFUSED +. ...................... ................................. 19 ................... ...... /�.�'-� ................. . .,� t:::.................. . ...................... ..................................................... Approved ................................................ 19 ............................................................................... ..................... ......................................................... rw 2 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION t Map 5 Parcel Permit# o 4 Health Division ' T Date Issued Z e Conservation Division � � + ! Feed c� Tax Collector - 9 "�' 8 Treasurer / d r Planning Dept. Date Definitive Plan Approved by Plannirg Board t Historic-OKH Preservation/Hyannis Project Street Address ' J� C✓ 6V r/J-X Or-f- l k' . Village /%f `4/ jytv,s Owner� )�rz�•✓�eY�, S: s Address l�iare�- Telephone _.0 clu — i'1. �. r -Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation 3©� Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: '❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes &No On Old King's Highway: ❑Yes CMVo 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 Number of Bedrooms: existing . new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas E 11 ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 01q-o Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn: ❑existing ❑new size Attached garage:Cff�xisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Cl No If yes,site plan review# Current Use _ Proposed Use BUILDER INFORMATION t Name r:LW NEfvl— Telephone Number 5-6r— d i :�-g Address v %� N is;(It License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE f_TDt�OQ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE M:a - , E OWNER , t DATE OF INSPECTION; x FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: _ ROUGH FINAL' FINAL BUILDING Y ` ,.ate... ` , i `., } •` ` DATE CLOSED OUT ASSOCIATION PLAN NO. 3 try The Town of Barnstable 9 g Regulatory Services -, 1639• �10 Building Division ' 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: !J I village number street /I "HOMEOWNER":r,l//,;v✓/PNC P ��%��95 f�i �C3�!7'y�SYZ name </ home p/hhone# work phone# CURRENT MAILING ADDRESS: U �� N�.S?O�c "' ,4 J 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, rop vided 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 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 persons)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 . pU THE The Town of Barnstable * nniuvsrnst,�. M" . $ Regulatory Services Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: ,.f f/qc t r�.' ��I Estimated Cos co, G 0 Address of Work: 7 2&Z[,/1 d SX a0 i'e ZW Owner's Name: care A✓ct ,rA Date of Application:/ 0 0 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law F der$1,000 g not owner-occupied 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 permit as the agent of the owner: Date Contractor Name Registration No. QR 37 Oa Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts ' Department of Industrial Accidents oxce ollovesAffatfoos 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: �//�i✓Y„C. lC 51 . -�.� location: city,- %"p-'s ohone# 222`7 2�yl aL E f am a homeowner performing all work myself. ❑ I am a sole rietor and have no one working in anv achy ❑ I am an employer providing workers' compensation.for 1ay.employees.worldng onthis job.._._ . name.. _ . ::::..;;...:. ::{.;:.:...::::;;{.;::;:::;•:::.;'.:;: ::...:.: ...:......... .............. . a ss.`ail re itisuratrce ca .... ............. ::..: 1 ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have ..._the following workers' compensation polices:, ........:.:.. . :. comVeny'name. >.....:; ::<:;:»>:<:::;: ::>;;:>:«:>:::<:>::;::>:>.::>:;:<:>::< : > <:::<:;:<:<::::::<:::.::< ..�.v: ..},,,,,,,,,•:. ..4:•::.�::nw5{:•.v .vm•.v••.{Mrm:.xv:x::w4�:.vnw:::.,•.v::�:....................................... .....................................................:.... van.... ' - ::':--:::::::::•::::.v::•.v.�::::::w.::::::;ryv.;�.}•{:.}: :::: :.�.:�:::::.�::::::::::::w::::::::::•::::v:.v.:;}:::•:;:•.;:;:ji::i::•:i:??�'j;{:}i:i::::}i:•i};:.;..:v::'}::�?'�i:}}:::J:O:??;;::}i:0;•}:::•;i}•}}:}::::•:'?�}ii:is{•}y(� :ti.i:::.;.;::,:,::::.x•}>:}:?:.;{::::.v::::iji:�:•{:.y:,:•.,}:�:;;a?r.}...:..:.;.�;;::>�.}i:.:;.,_.�}}i:i}:•>::�}ii:�i: ��.... :. ,.,:,;,.:;::;.::�:::.:..: 011E ........ .. rii:iS:�r:i:�:;f:�:>r;:Y:<i r:};:�;:�:}:}}>}}:•:?•:::.r:•}:;;•}}}}r••;:::{•:{{r}:�r:�£^�is<:�;s::;�:�:�:$:�:�i�::�`:�i��; r. ........... ........... ... ............r:.:.:....;.n.:..:.:................................... ......... ..} '6{.. ....v..4.......... ........ '::::::...^{}:x:.v:::::::.}:}}..:....... ..n.}:• .ri'I.N.{:.}v{vx?ry.?`{�:''::i<i:'i: ...Y{•::::-:}.n.n. {{•.i:w.v::. }:.{{•:•:{.}:•}}:'{::. •.••J:::}i.:{{{v.:?•:iti•:iw::::::.{viRwwvvvn•}}Mwnv.:: fesaraace�co:�:::.....::...:::?;«<•;:.;;:;::;.:.;,<?{?.:.;.:.:<.:::.>;:.:;J::.;>:<;;•:; ,,:.:::::;.;:.,:.;.:.�;.�::.r::::::.,,,<•;:•.�.,.{:.:::::::.:::. o . . .:..:.;.:;::.:::::.. i;. ......................................... ................ :::.e»:w ....... city: :;>::;»:::>:srs::r::::::? :i:: ....................::.:.:.........................................::. :, . .............. nsnrance.ro... :::.�.:�._::::....:::::::.::.,:::,.:..:::::,:. . . olica�# .:. .:.:.:..::...:.::.. Faijm a to seems....overage as regmred under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1400.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the OfIIce of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of pea3ury than the infonnadon provided above is& :and coned Sigaatr Date 12/ O;z 4d T Print name �rcrt t /�, s ^'►eJ�r J/l . Phone# &-91-74 --------------- -------------- o1$daf we only do not write in this area to be completed by city or fawn official city or town• permit/licwe fE Budding Department ❑Licen ❑checkif immediate response is requited ❑Select❑Hesltcontact person: phone#t; ❑Other Ormed 9195JJN 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 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 m 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,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. �`�AP.Plicants #else fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and '�"` ' 1 ' an names,address and numbers with a certificate of insurance as all affidavits may be >.�pP�company >� � y ubmitted 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 pemut or license is »g requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you ire required to obtain a workers' compensation policy,please call the Department at the number listed below. --ity or Towns 'lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the $davit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please e sure to fill in the pEiit tense number which will be used as a refmmee ni tuber. The affidavits maybe retumed'to Department by mail or FAX unless other anangemeats have bem made. he Officerof Investigations would lice to thank you in advance for you cooperation and should you have any questions. lease do not hesitate to give us a call. he Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Omoe of mvesugatlons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat 406, 409 or 375