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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel r�6 n _ Permit#
Health Division I�Q�� of — b Date Issued
L12—G j Conservation Division �J f1 .Ti ' % �'1 (� f 3 Application Fee _
Tax Collector f I Permit Fee cl.
Treasurer a:`I S'0 IH SEPTIC SYSTEM MUST BE
Planning Dept. WSTALLED IN C®MPLIANCZ7
INITH TITLE 5
Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODS AN[
Historic-OKH Preservation/Hyannis
TOW14 REGUU,71=
Project Street Address �A D \3 "D \\\ k, .F— ,
Village
Owner �1�t`y �a ���o. ��\ Address Ay!�
Telephone 5
Permit Request M_��� X 1 P--' SZ�,Y�
Square feet: 1st floor: existing proposed 3-Q)_ 2nd floor: existing proposed Total new 1 f
Zoning District Flood Plain Groundwater Overlay �g
Project Valuation 0-�5� Construction Type
Lot Size `-7 5 Grandfathered: 0 Yes -4No If yes, attach supporting documentation.
Dwelling Type: Single Family/"S Two Family O Multi-Family(#units)
Age of Existing Structure C Historic House: U Yes )ANo On Old King's Highway: ❑Yes No
Basement TypeAFull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Z5::�)f Basement Unfinished Area(sq.ft) �s
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 —�
Nl Heat Type and Fuel: ❑Gas 0 Oil ❑ Electric U Other
entral Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ®No
etached garage:O existing ®new size Pool: O existing ❑new size Barn:®existing ❑new size
Attached garage:O existing ❑new size Shed:O existing ❑new size Other:
Zoning Board of Appeals Authorization O Appeal# Recorded
Commercial ❑Yes ANo If yes, site plan review#
Current Use Proposed Use 3�5��� SlaC1C
BUILDER INFORMATION
Nam Atln(lcp, Telephone Number 190_<�s
Address License# O9 16-0 Lo
Home Improvement Contractor# CT`1
Worker's Compensation#--",S 1x�9G
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOS
SIGNATURE DATE �I Id U
�1 FOR OFFICIAL USE ONLY
t
PERMIT NO..
J
DATE ISSUED
MAP/PARCEL NO.
.j
ADDRESS VILLAGE
OWNER
i
DATE OF INSPECTION:
FOUNDATION ,�Jy0 1� /A LO
FRAME
INSULATION
I
FIREPLACE
f} ELECTRICAL: ROUGH FINAL
7t) PLUMBING: ROUGH ' FINAL
GAS: ROUGH ' : ` ' FINAL
r FINAL BUILDING < = 3
1 A
ti
}, DATE CLOSED OUT
j ASSOCIATION PLAN NO.
1
I
RESIDENTIAL BUILDING PER MT FEES .'
APPLICATION FEE
New Buildings,Additions $
so.00
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WORKSAEET
NEW LIVING SPACE c
/3 2 square feet x$96/sq.foot= /a -? a—x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot-= x.003I=
plus from below(if applicable) r
ACCESSORY STRUCTURE>120 sq.1�
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf-1500 sf 100.00
>1500 sf-Same as new building permit: x.0031=
square feet x$96/sq.foot=
STAND ALONE PERMITS
Open Porch _x$30.00=
(number)
Deck _x$30.00=
(number)
Fireplace/Chimney —z$25,00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
r
Relocation/Moving $150,00
(plus above if applicable) Permit Fee .�7 02 —
projcost
The Corrimonwea-lth of Massachusetts
„ Department of Industrial Accidents
= Of/fce oflny.-Smadeffs
_ 600 Washington Street
-= t Boston,Mass. 02111
Workers' Com ensation Insurance Affidavit
rname
location- 5 pg l 15al
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hone#
I am a homeowner peiformin gall work myself
I am a sole rietor and have no one workin in capacity
so,,/ rs' co ensation for my employees working on this job.
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Y::.:v,v::.± j/.
g�to impri coverage as reqen aired under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine np to$I,SOO.QO and/or
°�yam,iaiprisonrnent as w��dvII penalties in the form of a STOP WOE ORDER and a tine of$100.00 a day against me. I utderstand a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
and penalties of perjury thad the information Provided above is true
I do hereby certify under the Pains and torte¢
Date. �10-T-
Si gnature; Q
Phonejr
Pint name `
official use only not write in this area to be completed by city or town official
perndt/license# ❑Bunding Deparbnrid,
city or town: ❑Licensing Board
❑SelechneWs Office
❑checgif(mmediate response is required ❑HealthDeparhnent
phone#; ❑Other --
contact.person:
51
O viand 9/95 PIA)
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
employs persons to do maintenance,
another who construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such employment be deemed to be an employer.
MGL chapter 152 section 25 also states that.every state or local licensing agency shall withhold the issuance or'renewal
of a license or permit to operate a business or to construct.buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 irmuan_ce requirements of this chapter have been presented to the contracting
authority.
Applicants
situaon and
Please fill in the workers' compensation affidavit completely, by checking the box of that insuranceies to your
as all affidavrtstr ma be
supplying company names, address and phone numbers along with a
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is
being requested, not the Department of Industrial Accidents. Should you have any questions regarding the'law"or if you
are required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retariiAb
the Department by mail or FAX unless other arrangements have been made.
The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions.
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
gMce of lovestlgatloas
600'Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
nhone #: (617) 727-4900 ext. 406, 409 or 375
To" of Barnstab.le
Regulatory Services
Thomas F.Geiler,Director
9�plF1 r+9. " � Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Fax:. 508-790-6230
Office: 508-862-4038
Permit no. ,
Date
AFFIDAVIT
HOME WROVEMENT 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.arc adjacent to
such residence or building be done by registered contractors,with certain exceptions, along with other
requirements.
Type.of Work:
Address of Work:
Owner's Name' 1� V`` i C\Ck
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law ,
❑lob Under$1,000
[]Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRA 0�FARBITRATION PROGRAM OR GUARANTY FUND UNDER MGPLICABLE HOME UYIPROVEN[ENT WORK DO NOT L c 142A.
ACCESS T
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a pe t as the agent of the owner:
^q, ContractorName�at ��65 RegistrationNo.
D �a�"�`zS���` C.G.
OR
n-+e Owner's Name
i
Ica
-se pkIc \Qo.ap
In
JAN
TO THE TT NA C- IZTGI�GL C.o�zP —j
AND ITS TITLE INSURERS. MORTGAGE INSPECTION PLAN .
# LOCATED IN
I CERTIFY THAT THE BUILDINGS SHOWN DO ( ) CONFORM TO SETBACK REQUIREMENTS , �� �� R I` I
I.E. (FRONT. SIDE; Ac REAR SETBACK ONLY) OF F`�/�IZIJST�T ..G /.'_ �l
WIZEN CONSTRUCTED, OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS, C.L." `
TITLE 1AI, CHAPTER 40A, SECTION 7, LOALESS.OTHERWISE NOTED. MASSACHUSETTS
T FURTHER CERTIFY THAT'TIMS PROPERTY IS NoT _ LOCATED IN 111E ESTABL)SIIED FLOOD
HAZARD AREA. DEED PANEL OOMMUNITY NEI_ NO.:2j0001 o -Be DATE:.&-'-)
THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT 10 THE RECORDED BOOK
DATE OF THE LATEST DEED OF RECORD. PACE Z
WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM 111E PROPERTY UNE IT IS ADVISED THAT
A4 TT AA MORE PRECISE SURVEY BE MADE In VERIFY THESE MEASUREMENTS, CERT. N0. —
THIS CERTIFICATION IS BASED ON THE LOCATION OF.Sl1RVEY OF O11iER5p:AND.DOES NOT PLAN BK. PAGE
REP(tESENT A PROPERTY 6URVEY. VF}TIFICATION OF'$URV� MAR ?(J D AND-OFFSETS, AS SHOVA;,
MAY BH ACCOMPLISHED ONLY 8Y AN :,CCURATE.;ISTTt4[I�E7J?`SU�tVE(,.\, PLAN ID DAT '
THIS CERTIFICATION TO BE USED FOR �rl0f�i'1GAGE PUWf hS ONLY. yvNC r� f 99�v
OFFSETS AS SHOWN ARE;N T,7,QQ_ B)~ �� ,'+� SCALE: I 4
USED FOR THE ESTABLISHMENit"'F PROI�ER`I{(. LINES'
BRADFORD
ENGINEERING CO.
P.O. BOX 1244
HAVERHILL MA. 01031
JAMES W. BOU'GIOUKAS- R:I.S, #9529 IEL (500) 373-2396
EX15M 6'1700E
Ft;OM HOU5E
PROP05W NEW PECK II'x12'
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et±erlivin �f p�5MNCF
c n'D C 40 W0017LANn AVE. A—
` U V ROOMS HYANNI5,MA 02601
78 Turnpike Road Westboro,MA 01581
Phone(508)870 1900 Fax(508)870 1838
Date:II/5/05 Sheet I of I
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Property Owner Must Complete and Sign This Section If Using A Builder
I� AUri� R�l� A 2t G
A ,�f
as Owner of the subject property
hereby authorize Betterliving Patio Rooms (d.b.a. =Patio Rooms of_america) to act on
my behalf, in all matters relative to work authorized by this building p=n�It application
for (address of job) p�foa
Signature of Owner Date
(2: �• nr it nY (a� g�TFi off)�K P' Ni just Complete lel.e ai-ki SC�1 �ni
ii-i 5 Sec" F
v�vva
as Owner/Authorized
gent r the foregoing application for
a
hereby declare that dl statements and infoin-iatlon on
(address of job) are t;-ue and
-cc,,irate to the best of my knowledge and bcli f.
Signed under the pains and penalties of perjury.
Print Dame
Si nature of Owner/IA, Date
�ISUM[ERNFORMT'ION: ORh'IO S
'•' '� ', - .pie
...�y..�o+w�...a.s,...._:...:.i.._.....,..�. a ._i�..,.r...y.i.....ti.+n .. .tur�.:.._:..�..- •.__. � - . .tl i .� _i
. .. '..-r-- .7-t
f ssillditusetrS ate iz�Iilui ; oLL.c (78U NII2' A en `J ecttonf ; .1. r"1:R'
The Massachusetts State Building Code (780 CAM) includes provisions to ensure that houses and
house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION
FORM is to be filed as part of the building permit application when a builder/contractor or homeowner,
constructing/installing a house addition witli very large percentage of glass to opaque wall, seeks to utilize a
special energy conservation exemption option for "sunroorn" additions to an existing house (780 CM;,
Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a
"sunroom" of any size, configuration, orientation, form of construction or percent glazing, but rather is only
intended to assist homeowners in becoming aware of some of the important energy conservation and year-
round comfort considerations involved in selecting and utilizing a "sunroom"addition.
The connection of "sunroom" structures to residential buildings may create comfort and energy
consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In
the selection and construction/installation of"sunrooins", included below is a iron-required,"open-ended Iist
of product and design considerations that- a homeowner may wish to consider . before actually
constructing/installing a ",sunroom". It is recommended that consumers carefully review these options with
their designer, builder, or contractor, in order to minimize potential energy consumption and/or house
discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired
are important considerations.
PRODUCT AND DESIGN CONSIDERATIONS RELATED TO "SUNROOMS"
• Solar Orientation and Natural Shading -
• Type of Glazing
• Insulating value
• Solar heat gain
• Frarne materials
® Glazing to frame sealing and gasketing materials/seal durability and/or
weather tightness of the sunroom
• Adequate ventilation - Operable windows and fans
Applied Shading Systems `
° Insulation level in floors*,wills, and ceilinbs
• Possible Sunroonl isolation from the main house via a wail and/or door or slider
• Heating and Cooling Methods: Efficiency,Zoning and Controls
Homeowner Acknowledgment
The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner. (not the
owner's agent or representative) acknowledge receipt of this CONSUMER INFORMATION FOF-14 prior to
issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential
building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read
'the information in this document concerning sunroorn comfort and energy conservation.
Sr nature of Actual Building Owner Date C,
/lr w /�e_ G/(� ®gib A� .�1W�,e1es
Print Name Address of Permitted Project
Owner Address"(if different than project location) Owner's telephone number
y
• 1
S-'Y1"""
all xadciresssur�roo�ns". ,
eva "iN�LYI �n ai)-,v ...r:. '>,L1..r.. <^Z., - •..•._ � � r.:.iLO WiaY+::Y. J (lo
Exception: Srrnroorn Additions I Consumei'.Notification ,Sunrooms, as defined in 780 CMR .
Appendix jZ n Tat lYlr i I tON ,41f. tl be exciiili! nUi: tlic cc iitpIl`ancc requirements set.forth in 780
CMR J 1.1.2.3.1 and. J 1.1.3 provided that the actual.properly owner (not.the owner's agent or
representative) of the structure onto which the sunroom addition is being made, provides a signed
copy of the Sunroom "CONSUMER INFORMATION FORM" (found in 780 CMR, Appendix B)
to the Building Department. This signed "CONSUMER INFORMATION FORM" shall be
submitted to the building official'as a requirement of building permit issuance, and shall remain as
part of the construction documents. If such sunroom additions are separated from the main house by
a wall and are conditioned spaces, then a readily accessible manual or automatic means shall be
provided to partially restrict or shut off the heating and/or cooling input to the sunroom addition
space. That portion of a wall that separates the sunroom addition from the existing
building/dwelling unit, if an existing exterior wall, shall be allowed to remain and neither that
portion of said wall or any fenestration within said portion and commori to the sunroom addition,
need comply with the thermal envelope requirements of Appendix J.
ccfionep� A ecic3 E�+'IN TIOI�S tarovrcie efu�ahm 'o :
n .. 7Z,- :.,� ! tiict^*+ ;n tY u r }.trr�, ;' ou..
. y �51 r
pf:S,IInx `i,'. 15 ,,_• £RY.'.�hi' �.i;F_'"",...`r5'r fr-v t.`�. y-,`,-,�,ES '' ',vt
780 CMR J2.0 DEFINITIONS
SUNROOM: An addition to an existing building/dwelling unit where the total area (rough opening
or unit dimensions) of glazed fenestration products of said addition exceeds 40% of the combined
gross wall and ceiling area of the addition.
SIrME-WmlO 7 � aee oo an�ng
a o y{ en �3softhe..Code,�n��i�•�t�e,iloc$ied rnnrraecirate � nt~�a�� � F.:
DATE(MMIDOm)
r4COd4D,, CERTIFICATE OF LIABILITY INSURANCE 03/18r2003
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Joseph McKeane HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
JP McKeone Insurance Agency, Inc. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW,
P.O. BOX 333 INSURERS AFFORDING COVERAGE
Ann Arbor,MI 48106-0333
1N5uaEb— Patio Rooms of America INSURER A: Hartford,
dba SetterLiving Patio Rooms INsuREa a: Arbe±la___—_• _.,—_-__. _.__._.
78 Turnpike Rd INSURER 0:
Westborough,MA 01581-1730 INSURER D:
INSURER E: —
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEDA13OVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDRION 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 SUBJECTTO ALL THETERMS,EXCLUSIONS AND CONDrrIoN3 of SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS,.
MUd4 E TIVE- PQIJQYIEXPIRAMNLTR TYPEOF INSURANCE _ POLICY NUMBER DATEfMMfDDNYl DATE MMID LIMIT B
A GENERAL LIABILITY 35 SSW KM6352 11/01/.2002 11/01/2004 !EACH OCCURRENCE 1 9 2,000,000
X COMMERCIAL GENERAL LIABILITY ; FIRE DAMAGE fAny one Ere) $ 100,000
M (Any onR Per?aN S
CLAIMS MADE ,�OCCUR EO EXP
_ .. ..._. _._ 10,000
Cop raClUaliy_.--_.-_ _--• PERSONAL a AAV INJURY S 1,000 000
GEN_ERALA_GGRIEGATE_ 11 _—V2 000 000
GEN'L AGGREGATE LIMIT APPLIES PER: I i PRODUOTS-COMPKIF AGO Z _ Q�000,000
POLICY�PRO_ Ix I LOC I I I I .. —
AUTOMOBILELIABrf.ITY 79957400001 12/1512002 12/15/2004 'COMBINED SINGLE LIMIT a 1,000,000
_ ANY AUTO
All OWNED AUTOS BODILY INJURY
— " $C:HEDULED AUTOS (Per pemon)
JC HIRED AUTOS BODILY INJURY $
NON-OWNED AUTOS - (Peraddanq
PROPERTY DAMAGE S H---
- _._ (Pw acddent)
OARAOr;LIABILITY I AUTO ONLY-EA ACCIDENT Is
ANYAUTO OTHER THAN EA ACC S
AUTO ONLY: AGG I $
2XCESSUABIL17Y EACHOCCURRENCE $ 2,000,000
,q V 35 SSW KM6352 11l01/2002 11101l2004 -:
X I OCCUR u CLAIMS MADE AGGREGATE — #._ 2,000,000
S
DEDUCTIOLE
RETENTION . ._.--
n C STATU• IOTH-
WORKERS COMPEILITY N ANa 35 WBG JJ9353 0810/12003 08/0112004 TORY LIMITS _L_ER,
EMPLOYERS'LIABILITY -
`c.L.EACHACCIOeTIT 5 100,Q00
_ - E.L.DISEASE-EAEMPLDYEE S 100,000
LL.DISEASE-POLICY LIMIT I$ 500 000
OTHER I -
I
DESCRIPTION OF OPERATIONSILOCATIONSNEHICLEWMLU-NONSADDED BY ENDORSEMENTISPECIAL PROV.WONS
CERTIFICATE HOLDER I ADDITIONAL INSURED;INSURER LETTER.; CANCELLATION
SHOVLDANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE ExPlRAT*N
DATA THEREOF,THE ISSLRNG INSURER WILL ENDEAVOR TO MAIL DAYS WRITTEN
INSURED COPY mcmcF TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$0-SHALL
IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR
REPRESENTAIT*S
AUTH'ORrMFD REPRESENT
ACORD 25-S(7197) ®AC ORPORATION 1988
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPR6VEMENT CONTRACTOR before the expiration date. If found return to:
Re isfraf'o"n.`...�38971 Board of Building Regulations and Standards
9—_-
Ezp.raf on..:.8�2�2005 One Ashburton Place Rm 1301
Boston Ma.0210
_Types=Supplemert Card
PATIO ROOMS OF`AMEEOW...;3
JAMES RINGER';=.
78 TURNPIKE RD.
'JVESTBOROUGH,MA 01581 Administrator �/� Not valid with o signature
_ ✓YL� V/O�IYIi/4'//✓�+zui%GsGLI Cy�i iLfiiJ�C.,C!?dci8�.",G -
BOARD OF BUILDING REGU'LATIO,NS
License:„CONS T RUC T ION SUPERVISOR
Number:=•CS 078016
j r, � Birihdate +11/08/2000
1108(2004 Tr.no 78015
Restricted T6. -
JAMES F RINGER`,'
44 CANDICE STREET=`
CLINTON, .M,A 0151.0
Administrator
I
T,
--
_ .. ,. _
7 - -
'Ci. ur _ -ri1_v v �.:_ _ ^J__�T-t-"?_S ✓� G S V=�__<t�-;
02 I
Y
SUNROOMS
78 Tunlpike Rd.Westboro,MA 01581 508-870-1900 fax 508-870-5756
The enclosed permit package is for the proposed building of a three-season sunroom
on a new wood deck.
Included in this Permit package:
e Plot Plan and septic diagram if applicable.
® Beck Framing Plan
* kG',LEu
�f s eCl F, k f.EE t1h
. i 'G stF,LEr IPVt L n .
* Homeowners Permission to represent them in securing this ,err►ait
* Signed consumer information form for Sun rooms
'- t a vVi vb i.i e.€.jr' . isCii i..x..v.r.D., .:.6hu s.t¢✓w:., R m:n.a::.__ _,u Licensee
� Pt E95^P Eif 85 or,x�--_".G 'Co- pen a.x n Coverne '..
W Debris Removal Plan
srEa.Ldt you [. cfFe/a=EEC` for Sue^.a C`cssaSi.aE-a.e,. _'lease cal! 1T1..
M ormation you need.
�e�f ,C-7.�pg9 rr�re+9
Rose King
508-870-1900 ext. 223
' 1
.. Assessor's offioe (1st floor): SEPno SYVMM o
Assessor's map and lot number ................ `NSviq IN�.............. . . .
Board of Health (3rd floor): . 111l�
Sewage Permit number Mq` . ......VW0 EJW1 BARASTSDLE,
Engineering Department (3rd floor): /fib rJs ,{
House number ......................................................................... ULAT! ray a`
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only
TOWN '®E BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .........1 .�� .«/T�. .<..Y.........................:......................
`�TYPE OF CONSTRUCTION �7> rG�r.............. .
9/' F......... <•1 ...... g
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby
//applies for a permit acfco�rddiing to J/the ,�fo/llowing information:
Location .. V a....................... //y cn"/UJ .........................
Proposed Use ........F ,x/,x.....a!p./V... ... .. ..'. /.... ..!�/.! �.�
r. Zoning District .......S�C ..................................................Fire District .. < All -J
' >G6�
Name of Owner �. ..............���`�...�a�.��..�.Address .../.�!R..�a.�"��?�4>...��.�::......a�. . ...��......... ......
.F .D P r, l/
Name of Builder .V.".r � 3`�Y e /. GAddress /V /u)7� C���
..... ... .. �. ....... .............
Name of Architect ...... 301i". ..........................Address .....................� 2�.....................................
It
Number of Rooms ........... ......Foundation ...... .. eo� T
Exlerior .....CZY... Z... .......................Roofing ... {� L f�.. � ./�"4>�'( .........
........ ............Floors ......................Interior ... .. :G: � ..(1w.../ �.�....
'rieating 6f ..(slf .. I� `...�%�.. J�(. :iPlumbing f........ ..y. . .................................................... ....eo _ / ../ S��'l
Fireplace ... ............................................................Approximate Cost ........ f r
...................................
Definitive.Plan Approved by Planning Board ________________________________19________ . Area �(�..�?.................... e
Diagram of Lot and Building with Dimensions `e-
Fee .............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..... ....... .... -
Construction Su ervisor's License ���� . �
p ...... .............
BELL, PATRICIA & ALLEN
No .. Permit for ....BUILD...AUDIMON
�9 i.ngle...F.ami.ly...AWelli.ng........... -
Location ....Lsat...#.69.t......4.0...Wbadland...Avenue
x _
.....................Hy a an.i.s........................................ -
Owner .Patr. icia. .... ...
& Allen. . ...Bel. .l }
....... ....... .... .. .... .. ..... .... ..
` Type of Construction = A
Plot ............................ Lot ................................ _
T
-- Permit Granted .....August...2.4 f.......19 89 7
Date of Inspection
Date Completed ..........`.2,13 .......19
Sc
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OTE CHANGES
TOWN OF BARNSTABLE '
Building Inspection Department r
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TOWN OF BARNSTABLE
BUILDING DEPARTMENT
---HOMEOWNER LICENSE EXEMPTION
Please print.
DATE t
l
JO$: LOCATION Ck Y-\r �
Number` Street Address Section Of Town
„HOMEOWNER'. IA L� G
Name Home Phone
Work Phone
PRESENT MAILING ADDRESS 4o :
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 such homeowners to
engage an individual for hire who does not possess a license,the=owner acts as supervisor. cense, provided that
DEFINITION OF;HOMEOWNER:
Person(s) � who :owns a parcel of land on which" hip/she resides or intends
reside, on which there is, or is intended to. be, a one to six familyto
dwelling, attached or detached structures accessory to such use and/or
structures. A. person who constructs more. than ;One home in a two-ye farm
period shall not be considered a homeowner. ' ar
shall submit
to the Building Official on a form acceptable Stoh the oBuilding Official,
that he she shall be res onsible for all such work erformed under the
building permit. '
.:(Section 109. 1. 1) ;
The undersigned "homeowner" assumes responsibility for 'com
State Building Code and other applicable codes, by-laws, rulesnandwith the
regulations.
The undersigned "homeowner" certifies that he/she understands
Barnstable Building Department minimum inspection procedures
the Town of
requsrements P ures and
HOMEOWNER'S. SIGNATURE 4
APPR11 OVAL OF BUILDING OFFICIAL
Note.: Three family dwellings 35,000 cubic feet
required to comply with State Bui000c Code Section 1
Control. or larger, will, be
27.0, Construction
HISC5
,j
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HOME OWNER'S EXEMPTION
The .code states that: "Any Home Owner 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
Home Owner engages a person(s) for hire to do such work, that such Home
Owner shall act as supervisor. "
Many Home Owners who use this exemption are unaware that-they- are assuming
the`: responsibilities of a supervisor (see Appendix Q
Rules and Regulations
for; Licensing Construction Supervisors, Section 2.'15) .
awzireness often results in serious problems, parti lack of
cularl This l the Home
Owner hires unlicensed persons. In this case our Board cannot proceed
against the unlicensed person as it would with; licensed supervisor. The
Home Owner-acting as supervisor is ultimately responsible.
c c
To ensure that the -Home Owner is fully, aware of his/her responsibilities,
many communities require,- as part of the permit application, that ' the Home
Owner certify that he/she understands the responsibilities of a supervisor.
On the last page of this issue is a formrcurrently used by several towns.
You may care to amend and adopt such a form/certification for use in your
community.
w ,
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41,v
Assessor's office(1st Floor): SEPTIC SYSTEM MUST BE
Assessor's map and lot number — 00 INSTALLED IN COMPLIANCE oS TNc To
Conservation `� —9� WITH TITLE 5 `� `•.
Board of Health(3rd floor): ENVIRONMENTAL CODE A
Sewage Permit number —�� `TOWN REGULATIONS sus UL
ruL
Engineering Department(3rd floor): i6j0'
House number '�a �� �o rbr►•
Definitive Plan Approved by Planning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ",2 2A,
TYPE OF CONSTRUCTION Lt,)O O d I— r&q /Y1 e—
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location Z2 6zoa d
Proposed Use T4®�22 -S
i f
Zoning District Fire District
� 1� 7�ie!5�.� "��
Name of Owner rf/ Address 7,26- SSe{cl LW
e
Name of Builder Address
Name of Architect Address
Number of Rooms a Foundation
Exterior c`aof�a�d �� 12,1!Yi Roofing
Floors IJ C ,oeT Interior
Heating �/l/ Plumbing - Zatx
vd
Fireplace 1�29 Approximate Cost
Area _ 10,61�/'CA C�.�.✓�C
Diagram of Lot and Building with Dimensions Fee
I
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
N Name
v
Construction Supervisor's License
BELL, ALLEN & PATRICIA- A.
r,
No —3t5= Permit For ADD 2ND FLOOR
Single Family Dwelling -
Location
40 Woodland Avenue
Hyannis ; • - F'i
'S
Owner Allen & Patricia A. Bell
Type of Construction; '.Frame
Plot ° , �' Lot
V All,
August 7
Permit Granted . = 19 92
Date of Inspection ` _ `' 19, •
Date Completed y 19
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