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HomeMy WebLinkAbout0147 WINDSHORE DRIVE I ,_ V� ,`��1 , / l/ � ✓ �h/ ' �) EVE Town of Barnstable *Permit# tres 6 months from issue date Regulatory Services ;. Fee • BARNSI'ABLE, • MASS. Richard V.Scali,Director Building Division" If a Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 NOV O 7 2016 www.town.barnstable.ma.us Office: 508-862-4038 TOWN OF BA' -u508A-�L�6230 EXPRESS PERNIIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press InWtint Map/parcel Number Property p rty Addressl�� wl �cl�s'hor� � ©Ri vim. HVa.nl7iJ M/-I- .� 0260l g Residential Value of Work$ 3QQQ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address n(' e� rn a ri 2 —FPOI rn 1 oil, dshoof ble1,✓-P , Yannij : oal? o1 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# . Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) . Re-side Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows H #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. ^ SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC 06/20/16 27te Cmumm"reah*qfMassadiusetts Depaataeut of rmhufnEd Act dew Offwe of FmWttgadona090 . 600 Washington Street Boston, 4 02111 tPEYt-viJIQs&goP1dlli Warkere Cunipensatian.Imm=ceAffidavit:Bmldex-dCum ractursXIecfri "an¢ hunbers Applicant Informal ag Please Px1nt Ere�1IY �SfIle� LL Add>_es� (-I�- (./U 9�d.S�2P p 21 �P _ • CitgfSlatel aAQ MA OdU I Phone ga- 5o 8r 6 2- Are YOU an employer?:Check the appropriate bar: eaetal comtrsctor agd I Type of project(required):I.❑ I am a employer with ❑I oat a F 6 ❑New ocros orx employees(full andfor part-time)-* bave lvredthe sob-cort -actors . 2.❑ I am a sale proprietor orpa taee- listed outhe attached sheet 7. ❑•"-• odeHng sip and have no employees . These sub-contractors have & ❑Demolition: wotidag forme in any capacity. employees and have sgokers' 9..❑S.uifanZ at,itiou [No ty orlon g'comp.irnsu ame corny.ksuran I I required-] 5- ❑ We are a corporation and its 10-❑Electrical repairs or acidifions 3_( I am a homeowner doing all words officers have exercised their 1L❑Plumbing repairs or additions rqy 1 [No worla n'vamp- right G§I andwe r �MM 13.❑Roafrepairs insurance required.]1 employees.(Nowod=s' 13-0 offaer cam-Dance mgdred_] " my w5csntdat cbeftboz ft1 mast also fM out the smflanbeT,owshasiag ihekwale3e ca®penmfimpeRyiaf tnudon. I HameawnE s wbio sabmitt it s afRd=t uuHcz ,C fty gm damp slf waA and ilea him outside ca t3uc m Tffv sadL TCout<ac' tbst the Ir tlds baar namt xftrh =sAf id-41 sheet sbowing the nsme of the sob-ca=m:w a•sad state whether ornot flare enf ties bsRe eployees.Ifthe�have emglcyy ,they=srpnruidetturs worber5'comp.palicyntnaTsm lam an erripIo r tTiat is praur iuorkets'camperesatiort irtsrirarrca,�or my*catpTn}�ss Hefory is tine policy and f ob site rrcfotmxatran • Insumce Company Name: •Policy At'or Self-ins.I!--r ; F�piratiouDate: Job Site Addrem CitylSkatel . Aftach a-mpy of the workers'compensation policy declaration page(shoning the policy number and expiration date). Failure to secam coverage as required under Section 2 5A of MGL a 1572 can lwd to the imiposi ion of criminal penalties of a fine up to 1,SQD.OU andFor one year inzprisogmeut,as tiuell as civil penalties im the faun of a STOP WORK{7RI3ER and a me of up to$250-00 a dap against the violator. Be advised that a copy of this statement=ay,be fkwarded to the Office of Imvestigations of the DIA for insurance coverage mrifrta#ion. .I do If ere-Try e.�fy' under the pains and psnaI�es a,�pew�>txy�attJta irajorwra�m>prmdded abar�s f€6ug ar:d correct i> : n Dam Pht}ne Official use anZy. Do curt wrkg in ids area to be campieted by city ar airn ojoicial My or Tassns PerntfLieense:ff Issuing Anflaritp[code tune]: L Bowd of$talth I Buffirmg Depatneat 3.Cj12owra Clerk 4 Electrical Inspector S.Plumbing Inspector 6.other Cirtct Person: Phone 9: 6 _ Taformation and has cons M_saraiII cft Geese raI Laws chqAer I52 regnn-m all employers ID provrde W011r '=MPMSe on thr then =q)loyees. Pmrsaaat-tn this sty,an azrplvyse is deed as."_.eveaypersania the service of-Wfhe =I=any cont-act of hire, express or iiapliut oral or written_" �4n err�Ioya is def'med as"air incfivi ffi=L Pmtae"hiP,assocfion,corporation or other legal entity,or arty two or more of the:foregoing engaged is a joint et jx�,and inchrdmg,the legal rrpres of a deceased eorployea,or the receiver or trustee of am individual,parb�sbip,association or other legal entity,eatploying employees- However the owner of a.dwelling}muse having not mores than three apREtneo±s and who resides Ihm=n,or the occupant of the. - dwe .ing house of another who empkoys pe=s tQ do make,caugUnct on or repair work.on such dwelling house ter m--itthmvto shall notbec-ause ofsnch employmeotbe deemed to be an employer." or on the grounds or bm�dmg app MC3L cbaptes 152,§25C(6)also sates that"everysfate or local licens g agency Shall withhold$ze iSSaZnlce ar renewal of a Heen-m or permit to operates a business or to construct buildings is the commonwealth for any applicant Who has not produced acceptable evidence of compliance with the insurance coverage:required_" Additionally,MGL chapter I52,§25C(7)steins IXenhcathe rm=mweahhnor any of its political subdivisions shall enter into any contract for the perEm m-ance of public work until,acceptable evidence of compliance with the ice:._ rCqLUMMMtS of-this d3apirr have lie=presellbed in the ce—*J�anf a=ty-" Applicanls Please fill out the worh='compensation affidavit completely,by dmcldag ire bones.that apply to your sifnadon and,if necessarl•,supPIy sob�ontractor(s)name(s), address(es)and Phone— ea(s) along with their cmtCamteCs)of insurance- Lmmited Liability Companies(LLC)or Limited Liability Pa¢trxxships CLIP)ono employees other thaw the mertbeas or p are not regim ed to carry worke& compensation hi=ance- If an LLC or LLP does have employees,a policy is required_ Be advised that this a$dayit may be;snbraittDdto the Department ofIndustrial Accidents for confirmation of msarmce coverage. Also be sure to sigh and date the afndayit The affidavit should be retumed to me city or town that the appficaiion for the permit or license is being requested,not the Department of ; Ir st ad.A ccidnats. Should you have nay gnes't L s regarding fhe lax*or ifyon are regmred to obtam a woik=' compensation policy,please call fihe Departiaent at the number listed below. Self-msored companies should entry their s elf-i sm7a cei He mse number on the agpmpaain line. City or Town Of Please be sore that the affidavit is complete andprirded legffi y. The Deparimentbas provided a space at the bottom of the affidavit for you to fill.out is the event the Office ofluvestigati=has to confactyoaregardmglhe applicant Please be sure to Ell in the peni t(liceise Timber which vM be used as a=ference number. Tn addition,an applicant that must submit nxi&p10 pe='t/Hcrose apphbations m any given year;need only submit one affidavit m&catmg cuseut policy fi fa ation Cif necessary)and Tmrier`Job Site Address"the applicant should wLife"ail locations is (cfiy or. town)-'A copy of the•affidavit that has beers officially stamped:or marked by tie city or town may be provided t o the applicant as pr0oft�iat a valid affidavit is on file for bit pemrits or licenses Anew affidavitmust be fined oirt each year.Where a home owner or citizen is obtai ii ng a license or permit not related to any business or commercial vcntum Cie_a dog license orpennit to bum leaves et-.)saidperson is NOTregnuedt o complete Ibis affidavit The Of of Ind would h-ke to thank you in adv-aace for your coopeaafion and should you.have any questions, please do not hesitate,to give us a call The Department's address,tnlephone and fax nurubea: e Wt-,@I E of l Depailimmt cf In�al Accidents 64 woman Stc;tt M&02111 Tc,-L#617' -4-900 eat4fl6 or I-V7 M a Fax 9 617 727 7M Rj--vised 4-24-07 p,� vmas! Tf din r 4 �" Town of Barnstable Regulatory Services EARNSUMM MAM ` Richard V.Scali,Director s63 . �� 3c q Building Division. 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 If Using; A Builder as Owner of the subject property hereby authorize to act on my behalf; in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name p Print Name Date QYORMS:OWNERPERMISSIONPOOLS Town of Barnstable ' Regulatory Services p�FtH Richard V.Scali,Director Building Division sAstvsr . = Paul Roma,Building Commissioner KAM 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION:_ 1-7 Ul 1 rids bore D 2 i vP number street village "HOMEOWNER": - name home phone# work phone# CURRENT MAILING ADDRESS: 2�GI l (n f lz f; 2 cit3#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 Qerformed 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 shali 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 1 All ti STYE TOWN OF BARNSTABLE 20066 PermitNo. -------------------------------- { »�T� ; Building Inspector cash OCCUPANCY PERMIT Bond ----------------------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No buildinZD g shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Cepeuide Development Corps Address 300 Iyanough Road, Hyannis lot -041 . 147 Hiudshore Drive, Hyannis Wiring Inspector Inspection date / Plumbing Inspector � � Inspection date, Gas Inspector � � � A Inspection date Engineering Department �/ Inspection date _/Z —�� THIS PERMIT WILL NOT BE VALID; A/ND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON .SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. 1..�!�........................ 19�� �.��r f ' cal�r..:..-!�............... . w. ..:........ ................................... B i ding Inspector ti' t4 3 AG 14� RtCHAI OATfEIR �� No.2'= a '�egia���� •� C6QT11✓I ED PLOT pL.�i,�..J ' LoGAT101 /4 tJUt� sc.Al-C I u_ 216,A-0 C.GRTtr--.( THAT' THE t�c�uNb C'tOf�1 '5"0%j j pt_A.Q 1Z F=-azeVjce. WtEeQ W CO&1Pl.YG WIT" T►-IE 51D�.LI►-�� AWZ:> SET13-AC4 k'EQUI'ZGAt'&"TS of T"e LoT Zd W w of Tc-2Al2. c ff C'ouer �=`c.A 3"l G� A a XTCtz. 2� NYE 1WG. y _ Rs�ISC tZG.t� 1.AWD 5UZVE"(O -S -� �-!qT P�nSE'D O S TE2V 1l._t a AAA ss, v N A�.! �,. It.1s�vYenEtJT SUQ�/r�( �TtaE o��S�rS SidGe,��..n al�c�>✓t eA.�..,T- � , t.lGt- ec usc0 �ro DCi sl�t.� �Atint�� - 3 �t✓veooM , . . . Llo GArzga�� GRI�.tfl� • �(� tI L� 1`Low s l to K 3 , 33C> G.p.t?. ... t t.:_ 1�p 5 -Ic TA�11C = 330;� ISU % • 5 ►" use- I ooci 6AL. DISPOSAL PIT use- Iyc."o (GAA..' .,MVWAIl. A2EA z 150 'S.P. } .�-- } ; ' .IGjC7 SF K 2.S * 3'IS G.PD. ; �• s F �....•' � 1• AA10 .... '. , 8v r'7v�Nl A¢ELs= So UT=. Y Q P!r pK TOTAL "DESI&W R'[D. 3w 6.Pp. ' 1. VElZGOI:QTIOtJ tZWrF-- � I0 J.�4 W' AY, ..OZ L . � y o Ash , 1 i RICAARp o ALA tiN BAXTE gl ee o y } 'p No. 2404pR a � •��NAL � ! t Teo Tat! F".IL 4. Lo-wt l oao 1� ,� lout� 9�I•ca� 1' � �.: $ j r t. 2 S IW- •BO INV. LsArn4 'A T. ) lc WASMED SA 0.0'I : ) 1 t LoCATIa �4 y aMIIJ 1G �! ISCAL 0 s GGGZTI I= TkA-r :TNT ` w' I-Z; .1 taaWIJ Pt.A1.1 ; R�1r E1z��.tcE z N�_PL�L,I GcaArtPL�(S �. W171-1 THE 51Di�..l.l►-�E� ,_ _ , . ..... 1 1 LOT L� A►.lD SETBACK 1~C-gUtQEMG►-ITS :OF -TN� 3 - , , + _ 7$AQ+.SSTA 4 A co v}2T g j&XTC9Z. tZCGlS'M-zstD LAIWO 15VeVG6%(O2S TI-415 PLAW l,S WOT ?-)A II.IS'I-�J!✓�C�JT ;c�F Vr_Y � Tl�c-... c�F�SE:'<<o �N�ww._` � • � :I + r €�z_ uscp .'Tu ..ueTceM:I Wl=- LD�c• 'Li Was APPI_I GAI-..lT � ` , A Assessor: map and lot;number .�1....................:...... ....... . ' a SEPT!C SYSTEM MUST BE � E IRIST/'�E:LED '! �, COMPLIANCE Sewage Permit number ..........................:.....:................:......... AwCE Y ; WITH A TiCLE 11 STAX F r r't SF�NIT AND TOWN, ' C 7HE o TOWN OF- BARNS SnNSTLIILS, i 9� 101 Yae�� RUILPF, INSPECTOR APPLICATION FOR PERMIT TO .'.... /C ... �/,�C/ /l ' ...... .............. ... TYPE OF CONSTRUCTION ............(<"/ ` � 2 c2.c�c... ............................. ......................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fo_ra permit according to. the following informations: Location .... .3''..... flr!Cri.���. t ¢!. :..D ....... !. � .......... ........ ProposedUse .. .lJ.L �iG�f/ ................................ ..................................... ........ ... .... Zoning District ......!/''... ....................................................Fire District .! .. ............... f� I� ef Name of Owner .4f. >. Address ,�°i',,�1�� .................................. Nameof Builder .......:........:...................................................Address ......................L.. ........................................................ Nameof Architect ..................................................................Address .......................................:............................................ Number of Rooms .........:...................................:................: ..Foundation .:....., >...e �. .C'-i....................................... Exterior .......... ... �pp / % ...... .J.....................................................Roofing .........���J.. rr�-/r..".�.............:.................. Cy _ Floors .....................!�.�V..!......�'.............................................. Interior ......... ............ ....................... Heatinge........�.................... ....... .../ ...................Plumbing ......................................... .......:: . ... Fireplace ............... .......:......................................................Approximate Cost ........ � {. :.;... ......................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area d! ........................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH fp 7 C� I hereby agree to conform to all the Rules and Regulations of the Town of Bornstabl egardin as construction. Nary ..... Capewide Dev. Corp. -N ......2qp6C,Permit for .............. L ...story' single family dwelling........... ....................................... L cation ......14.7..Kindshore 0 .......................jprxvg......... ....................H ........... ................... Z Owner ....... ......C Q.K.P........... Type of Construction ..................tt amp....................... ............................................................................... Plot ......................... ..................... Lot .............#4.............. Permit Grant6d.............Ap 1...3..........19 Date of Inspection ... ........1 9'� Date Completed ....j... ..............19 4� PERMIT REFUSED ................................................................ 19 I.................................................................... ........... ................ . ............................................................. ............................................................................... ........................................................... ................... -Z7 Approved .......................................... ..... 19 Q ..............................................................................;. 0 ............................................................................... Assessor's map and lot number / � . �-7� r^ Sewage Permit number .......................................................... FfHET��y� TOWN OF BARNSTABLE BARNSTABLE. "6 ON BUILDING INSPECTOR PY d' APPLICATION FOR PERMIT TO ........`. .°r.. .......•.-•% �.r`.' ;!f"J:'1 ......................................................... �. TYPE OF CONSTRUCTION ........... 1r�:^.......af..... :..: r:..{::......................................................................... r j ..........:... 1.... :................19....:..• . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r , Aocatla►I ..................................... r " ... . E f ! r.f.. ...................................................... ProposedUse .......... . e. � s .................................................................................................. !'e1.!�.fr, ,< /.ram .''��S' Zoning District Fire Distract Name of Owner fF• •F�f I�t,� E`- � Address ......... .......................................... 7. .... .....`.., ................................................... rx Nameof Builder ....................................................................Address .................................................................................... � 4 f Name of Architect ..........................Address .......:............................................................................ . ........................................ Number of Rooms .�.�............................................Foundation . '+''� !%, .•, ... ............................................................. Exterior 'f � -. ... ..a.....................................................Roofng ..........f. . ..................................................... Floors ...................................... Floors C- -...............................................Interior Heating ..........:...............r.......�....f-...:.....R........................Plumbing .................................................................................. Fireplace '..................................................................Approximate Cost .........- .............:!.......G::......................... Definitive Plan Approved by Planning Board ________________________________19________. Area `f Diagram of Lot and Building with Dimensions Fee . i cy-s—, .......................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH T I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable,regarding the above construction. V .::................. Name ..........................` .. _ ..:':: .......-......... V P Capewide Dev. Corp. A=271-135 *20066 1 1/2 story Po ................. Permit for .................................... single family dwell ' ............................... ... ... ........... ....... ........ Location ........147 WiQ4 Drive ............. .................... .......................HXann..s.......................................... Capewide Dev. Co?�p. Owner ........ ............ ................ Type of Construction"'�**fr,.ame . ...................... ................................................ .............................. Lot .........#4 Plot ............................ ... ..................... pril 3 78 A Permit Granted(/ Aril............................19 Date of Inspection ....................................19 17. Date Completed ......... ......................19 PERMIT FUSED rJ .................................. ............................. 19 ........... ............. .................................................... .... ........ .. .. ................. ............... ............................ . .......................... ................. ............................................................. Approved ................................................ 19 0 ...............0............................................................... > .................... ..................................................... ,: TOWN OF BARNSTABLE BUILDING�PERMIT APPLICATION SEPTIC SYSTEM MUST BE Map `+ Parcel ] .. INSTALLED IN OOMPLIA lnit# WITH TITLE 5 Health Divisions t - 60 acd - Issu 0a' VI I Conservation Division0L•�k ';)Fee Tax Collector Treasurer 7 a�.�c-e a Z !c IZ(�Z7� Planning Dept. Date Definitive Plan Approved by Planning Board r Historic-OKH Preservation/Hyannis Project Street Address 1 q / (dir� Village //yi�7:ns Owner Lb[JJ I ac# : Address Telephone Permit Request _ 1E—c-1 rsj Q) i . Square feet: 1 st floor:existing Proposed T 2nd floor:existing — �-.� proposed Total new Estimated Project Costa Zoning District Flood Plain Groundwater Overlay Construction Type D /" Lot Size Grandfathered:. ❑Yes Cl No If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas QI'oil . ❑Electric ❑Other ' Central Air: ❑Yes 2Ko Fireplaces: Existing New Existing wood/coal stove: ❑Yes M*96 Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing-❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use B'�U/ILDER�INFORMATION Name A .s-i ze,l + � /7 Telephone Number• 5� "� 71U r Address M rmy C' 1/16 License# 6-S L 1 -(7 Z-7 Home Improvement Contractor# ? ` 6d-G(b Worker's Compensation# ALL CONSTRUCTION DEBRIS,RESULTING FROM THIS PROJECT WILL BETAKEN TO D Lf-- S(,4-E.) SIGNATURE DATE _ �!` "^ FOR OFFICIAL USE ONLY . I EMIT NO. DATE ISSUED a F # MAP I PARCEL NO. k ADDRESS - a VILLAGE .' OWNER ' DATE OF INSPECThON: FOUNDATION r FRAME INSULATION �IV12 oc-D _ 1 - r FIREPLACE - - ELECTRICAL: `ROUGH FINAL PLUMBING: ROUGH FINAL- GAS: ROUGH FINAL FINAL BUILDING# f DATE'CCOSED.OUT - ASSOCIATION PLAN NO. r ♦ ' L The Commonwealth of Massachusetts =s- — Department of Industrial Accidents ,� = Olflce 011fiYOS&O' boos -� 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit name: /-IL�3 7 CL— 1 ' location: city h n1 hone# ❑ I am a omeowner performing all work myself. lam.a sol rietor and have no one rkin in anv capacity dia workers' compensation for my employees working on.this job.; : ;;:;;;;:;;:;:>;:::;;;:::;:; ❑ I am an employer company metre: :;:.;: are s3. ....... ct .....: xx- oitcv# : :<;:; insurance co. I am a or,g eral contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers, compensation o.li..c.:e:.:s.:: .:..:::.:::...::::::.:::: » :. ;; : :«:>.«<:«; com anv na . ............... address. .<::..::.::..::...... .. .. . ..: ::,.. :::.. s:<;»�: � n ci ..............................................................................................................:................... cP anv name- .: ;:;«::::;::<::::<::>:•;:;:•::>:;:;::;::;..;•:;:::•-:::.. address: h on e iE: Cita: :. .:... :::. .:..:::.:;.;;:.::;:.;:.;::.:::::r;<:::::»::;:z;•;:•>:.;:•;:•::•;:•;::::>:;:«<:>::s:z::>:::�:::.:<<: :;;:;:<::> :>:<:;;.:>:;::<::::>z:�:z::::�>:.:.,:::....: 'lieu FaIInre to seeuze rnverage as required mmder Section 25A of MGL 152 can lead to the imposition of eri�minal penalties of t Zhu to S1,S00.00 and/or a une yam'itnprisommtent be�rwatded to ththe Office of Ltv oestiga�tts of DIA for cO erage vie eiillcatioa00 t day agsftut me. I m�derstami that a copy of thb statement may I do hereby certify the pants mid penaltles eduty that the information provided above is trap coned • _ Date �� �� _ - Stgoa _PhPhone# ��`. 71 3 Print e official use only do not write in this area to be completed by city or town official permMcense# ❑B��g Department city or town: �Llce�, g Board . ❑seh ctmen's office ❑check if immediate response is required ❑Health Department contact person: phone#, ❑Other���. (mused 9/95 PIA) . PrnaiptE►e Past n a for 0ae and TwaFamil!ReddsosW Batlding Hand with Fossil Fads MAXIMUM MWIMUM Glazing GIN Ceil;n wau Roar Bum= Stab Anal��� U-vdoe= R iai=l R.V"I Rrvalaej Will Ate. EMa�' Pacim a RwajU0 tGMM" 5"1 to 6500 HeadaS Demo D&W Q 12% 1 0.40 1 31 13 19 10 6 Normai R 12% 0,5 1 30 19 19 10 6 Norma S I29A 0.30 1 31 13 19 10 6 IS AFUE T 13% 0U6 31 13 23 N/A WA Nanaat U 13% OA6 31 w 19 10 6 Norma Y is% &44 30- 1+ w Nls ;�:: RS AFUE w 15% U2 30 19 1 19 to • 6 is AFUE X IVla M32 31 13 2s I WA WA Norma T IVA OA2 31 19 2S al WA WA Norm Z IVA 0.42 31 13 19 10 6 90AFUE AA 129/. d jo 30 19 19 10 6 90 AnM 1. ADDRESS OF PROPERTY: 0d ©v^ 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING., 4. %GLAZING AREA(#3 DIVIDED BY#2): 0� S. 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 APP AL: YES: NO: q-fo=4980303a THE The Town of Barnstable snxivsTnsLE. Department of Health Safety and Environmental Services ATForA Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other. requirements. Type of Work: '1 i.a 11- (% v Estimated Cost �� (5 Address of Work:_�-� lr(JL�tQ� %ice Owner's Name: Name: Date of Application: .. �- `t 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 fora permit as the agent of the owner: �p Date -°'� Contract fp l;rame Registration No. OR Date Owner's Name q:forms:Affidav ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X /sq. foot= GARAGE (UNFINISHED) square feet X $25/sq. foot= PORCH square feet X $20/sq. foot= DECK square feet X $15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost g990915b Iry 2411 to Ili 63 77 1I1 I �o v ,F v� 1 1 • t i I Y Y i `d C V► . a a, m� 1_ Z O y f V% m 00 tp w 4 � l Town of Barnstable r Regulatory Services • MRMABM • MAS& Thomas F.Geiler,Director i16 o{►�° Building Division Elbert Ulshoeffer,Building Commissioner ` 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 S REGISTRATION HID REGISTRATI 120 square feet or less ? (� /�17 - Location of shed(address) Village 1 —( 2q Property owner's name Telephone number /0 .xt� 7l13� Size of Shed Map/Parcel# 7/111/ atwe f E�to Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? f / Conservation Commission(signature required) �Z/ PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q46rms-shedreg »� p i Q*- 2 23 leg „- �3 / = m z It I O 3 m N 1 o'3 c N T N no lA 0 O m m r C O O N m A LT O .N 70 I] ® �_ OO v v o n v p o op n v iv o 5-- CD o oT f x z Co a o y. c� A n n nao g m n z m v p - _ JO _ C. _ r-� m ri 'i 2 <_z y z O v C r<T, = T O - m a T T. 0 o x n a CD CD N I'1'r m ly D G