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FA5 P-- �
� T Town of Barnstable Building
PostaThis CardSoThat it is,Visible:From the Street,;Approyed.S"'Plans Must be Retained on Joband.this.Gard Must,be Kept
w �'", $ Posted'Untif Final Inspection Has Been Made ' '" /'�
�Whea Certificate of Occ pancy;� Requ red,such Bu�ldi�g�sha"II Not be Ocpd until a Final Inspection has been made �m,
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Permit No. B-19-3795 Applicant Name: Nathan Hindemith Approvals
Date Issued: 11/14/2019 Current Use: Structure
Permit Type: Building-Stove Expiration Date: 05/14/2020 Foundation:
Location: 84 ALLAN ROAD,CENTERVILLE Map/Lot: 194-001-009 Zoning District: RF Sheathing:
Owner on Record: PLETTNER,EBENEZER&CLYMER,JULIE ' Contractor Name ,NATHAN J HINDEMITH Framing: 1
Address: 84 ALLAN ROAD Ccintra. po�,License: CSFA-049288 2
WEST BARNSTABLE, MA 02668 Est Project Cost: $4,945.00 Chimney:
Description: installing woodburning insert into existing masonry fireplace. Lining Pe'rm rt.Fee: $35.00
Insulation:
chimney to the top with'a stainless steel linerand cap Fee Paid" $35.00
Project Review Req: r' Date 11/14/2019 Final
x Plumbing/Gas
j
Rough Plumbing:
T 177 OF
This permit shall be deemed abandoned and invalid unless the work authorized.by this permit is commenced within ix months after issuance. Final Plumbing:
All work authorized by this permit shall conform to the approved applitatiori4nd tWapproved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning=by laws and codes. Rough Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public mspecti n for the entire duration of the
work until the completion of the same. Final Gas:
The Certificate of Occupancy will not be issued until all applicable signatures"byQthe Bwldmg and-Fire Officials are"provided on this`permit• Electrical
Minimum of Five Call Inspections Required for All Construction Work
1.Foundation or Footing Service:
2.Sheathing Inspection g
3.All Fireplaces must be inspected at the throat level before firest flue-lining is installed Rough:
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection
5.Prior to Covering Structural Members(Frame Inspection) Final:
6.Insulation
7.Final Inspection before Occupancy Low Voltage Rough:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final:
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
Final:
� f
RMIT Town of Barnstable *Permit
Expires 6 months from is�etfate
Regulatory Services Fee,
BARNSrAB 142015,
"ASS& Richard V.Scali,Director
16;9. ,��.. BARNSTABLE
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number / 9</t0,d/0 0 9 p
Property Address S, T Xll'4n /Ca/ Cerrk Q.
[Residential Value of Work$ (n�006;00 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address WAYPC gocke o
-7 y( N i4C1.,,S G✓4 Y �l��ni S
Contractor's Name S�40A_ C(W Telephone Number .Sots 31,q 2`(S(o
Home Improvement Contractor License#(if applicable) /749 570 Email: SAGS . •$M f.2 JX N;1. Cd 107
Construction Supervisor's License#(if applicable) CS- 0 9A 95S
❑Workman's Compensation Insurance
Che one:
Iaam 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 Reque t(check box) �10 po// o C'�`
�e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to /� -4
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and 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
requi ed. D
SIGNATURE:
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
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MARSTONS MILLS, MA
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D'parhnent of fnc strial Accidents
_ -- Office of Investigations
600 Washinigion Street
Boston,MA 02111
Workers' CompensitiouInsurance-Affidavit-$nilders/ ntt-aetorslEk ticians/Plumbet-s
Applicant Information Please Print Legibly
Name(But�essiOrganizaiionfTnditi-ideal): Ar".t. ?wtta
Address cg I c�45De`
ityl tat ' ip_ fAaci ens N^{<<S 01 4 Phone# .S b'8
Are you an employer:' C7 eck the appropriate:box:
Type of project(regnu-ed)c
1-❑ I am a �o emp t er with. 4. 0 I am a general contractor and I
u_ ❑New construction
�,(employees(full androrpartt.-time:}* have lured the sub-contractors
2-LEI 1 am a sole proprietor or partner- listed oathe attached sheet. y- ❑Remodeling
slip and hate no employees 'These sub-contractors have g- ❑Demolition.
working for mein any capacity_ employees and have workers' g- 0 Building addition
[No worloers'comp-insurance comp-insurance.,
required.] 5- ❑ We are a corporation and its. 14-0 Electrical repairs or additions
1 officers.have exercised,their 11- Plumbic repairs or additions.
�.❑ I am a homeowner doing all work ❑ � ep
myself [No workers'camp- right of exemption per MGL 12 E[j' oofrepairs•
insurance required.] c..152,§1(4);andwe have no
enTlo5 s-[No workers' 13.0 other
comp-insurance required-]
..Any applicant that checks box#13msk also filloutthe section below shoteing'theirwoikers'compensation policy information,
I Homeowners who submit this affidnrit indicating they are domg all wodt and then hire outside contractors arrest suom r a new of dar it in&catmg such
!�C'outmc€urs that check This box must attached an additional sheet shocsing the name of the sub`cour actors and state whether or=those eadtie;have
empioyees. If the sorb-contractors bane employees,they must prouide their worken'comp.policy number.
Iam an employer tJtrrt is Prot ding workers'cantpertsatioit hasacrrutce for null eteipIol=ees. $eloty is the policy artdl.Qb site
info.rmadom
Insurance Companytanie:
Policy,or Self-ins-lie_,: Expiration Date:
Job Site Addis: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(shorting the policy number and expiration date).
Failure to secure coverage.as required under Section 25A of MGL cr 152 can lead to the imposition of criminal penalties of a:
fine up to$1,500-00 and`ar one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a•day against the violator- Be advised that a copy of this statement may be fares-arded to.the Office of
Investigations.of the DIA for insurance coverage verification-
I do hereby rerh.y anderr the pains penabYes of pedurp that the information prod led abol,e is t Be ar�d correct
a:1z turee: LS'/'��••- hate:
Phone _ tl " o�y,S&
Official use only. Do not»:rite in tills area,to be completed by city or tolvil of c ia£
City or Town: Permit/License 9
Issuing Authority(circle one):
L hoard of Health 2.Building Department 3.CitylTona Clerk 4.Electrical Inspector 5.Plumbing Inspector
b..Other
' Contact Person: Phone
6
P�OFTHE TO��
i
* BARNSTABLE,NAM
-
�$ 16yq. ,m� Town of Barnstable
prfa rM't" '
Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-623 0
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, WAYNE MOW , as Owner of the subject property
hereby authorize ��N��E PAc.NEGv to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature o Owner Date
LJ�y�u� ��cHECo
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
Q:\WFFILES\FORMS\building permit forms\EXFRESS.doc
Revised 061313
A
Town of Barnstable -
Regulatory Services
P�oF rHe roty,� Richard V. Scali,Director
Building Division
tM1RNSTABM Tom Perry,Building Commissioner
MASS.
Q3 1639• 200 Main Street, Hyannis,MA 02601
ATFDt a www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: ,
j.
JOB LOCATION:
number street i village
"HOMEOWNER":
name home phone# work phone 9
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was exten e o include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who oes no ossess a license,provided that the owner acts as supervisor.
DEFINI N OF HOMEOWNER
Person(s)who owns a parcel of land on which e/she resides o tends to reside,on which there is,or is intended to be a one or two-
family dwelling,attached or detached siructuj s accessory to suc use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be cons- red a homeowner. ch"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he she shall be res onsible f all such work performed under the building permit. (Section
109.1.1)
The undersigned"homeowne;ass" s responsibility for compliance with e State Building Code and other applicable codes,
bylaws,rules and regulations. . ,,a;The undersigned"homeownes that he/she understands the Town of Barnstable Building Department minimum inspection
procedures and requirementse/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 homeown4lpei�6tming work for which a.building permits 5jrequired sho1 ;e 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 1° )`p;hls lack of��Aiar°nnP� 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:\VdPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 061313
in Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
snBxsraste
9 Mnas< g Tom Perry,Building Commissioner
JEpy��0 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 9® 230
Approved:
Fee:
Permit#:
HOME OCCUPATION REGISTRATION
Date:__"c
Name: delM S���i� Phone#:
Address:\4?X '&A-7 'e Village:
Name of Business: era fi/'y.'
Type of Business: u f Map/Lot:T..% f—'60 lv a f Ca T�el�
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity
shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the
premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;
and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located within
that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there is
no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,
odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of
normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in flie Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned,ha read and agree the above restrictions for my home occupation I am registering.
Applicant: . Date: Za1-'�Iollf
Homeoc.doc Rev.5/30/03
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY.REGISTERS YOUR NAME in town (which you
must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1s` FL.,.367 Main
Street, Hyannis, MA 02601 (Town Hall)
DATE: rp -9r
i0 fw ad
Fill in please: 44 //
th
APPLICANT'S YOUR NAME: li
BUSINESS YOUR HOME ADDRESS:
F ; all ma TELEPHONE # Home Telephone Number � �Zc7^ ��97
NAME OF NEW BUSINESS 1 -� TYPE OF BUSINESS 4W,ff
IS THIS A HOME OCCUPATION? YES N.O
ADDRESS OF BUSINESS r 11,94 lei- NO MAP/PARCEL NUMBER /I4100/00 7 Loy 7 "
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable.
This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St.-(corner of Yarmouth Rd. & Main
Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMM' R'S OFFICE
This individual as be ihtor of any permit regvirem nts that pertain to this type of business.
Aut1 i e ature"" -
COMMENTS: 3
2. BOARD OF HEALTH
This individual has been informed of the permit requirements that pertain to this type of business.
Authorized Signature"
COMMENTS:
3. CONSUMER AFFAIRS(LICENSING AUTHORITY)
This individual has been informed of the licensing requirements,that pertain to this.type of business.
Authorized Signature"
COMMENTS:
iy
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co-vi+
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f
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map_' ` s_Parc& Permit#
Health Division r a
� /� � D,g#e Issued
Conservation Division / s. 16/�9 G`a Ap`p�atio®Fee M H
Tax Collector M.ft), PermA Fer "? 7 6 , y 7
Treasurer rnr `` w, �/ Aeya
SEPTIC SYSTEM? MUST BE
Planning Dept. 01STA!L'ED IN CO.'APLIANCPE
Date Definitive Plan Approved by Planning Board 'MITI;`ML E y
A-.?
Historic-OKH Preservation/Hyannis COa E ANDTtF� F4iC�., .:"IC"j
Project Street Address
Village C C, i;7/ V L Z'
Owner ��''t�1 CA,�J UGk 4/ Address
Telephone L 1 Q — 00—1
Permit Request IV t K,1 W C7 ���wti f willooV1 �� ;0:,,f-; VwuL-ky
Square feet: t st floor: existing q DO proposed `�t 2nd floor: existing q H� proposed Total new 2�
Zoning District Flood Plain Groundwater Overlay
Project Valuation lI 0c 00 0 Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
i � !
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes d'No On Old King's Highway: ❑Ads o
Basement Type: All ❑Crawl ❑Walkout ❑Other
r - _
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) I R ' ' q 00
Number of Baths: Full: existing 2- new I Half:existing new
�- Number of Bedrooms: existing_ new
Total Room Count(not including baths): existing new "Z-- First Floor Room Count yoI w� a L
Alt w h-J d 4 taut J �,
Heat Type and Fuel: ¢]Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes JNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes /N'o
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:,d6xisting ❑new size Shed:Xrexisting ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑ No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name AIN- �� �'t'✓ Telephone Number f4 ZZ
Address pb 33 4' License# 0412 CI I
Home Improvement Contractor
Worker's Compensation# L
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO f;Oc/(
SIGNATURE 'S 64 DATE LV r 0
FOR OFFICIAL USE ONLY
J
PERMIT NO.
DATE ISSUED
r
MAP;-PARCEL-NO.
ADDRESS i 4' _VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION A G_ o^ 6) /
�1
FRAME
INSULATION
FIREPLACE t
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL '
GAS: ROUGH FINAL -
FINAL BUILDING-
DATEtLOSED OUT'
ASSOCIATION PLAN NO.
_ _ r
F !
}
f
Town of Barnstable :
°FtHG T
ti
Regulatory Services -'
snRxn�rASS.�' « Thomas F.Geiler,Director
9�prED Mai p`�� Building Division
Tom Perry,Building Commissioner
200 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. I
Type of Work: M cyt� �� f Fu W 114 d®Wwi �'d��h 00 Estimated Cost (9 0 0
Address of Work: $ /�-��(t y /W.
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
[]Building not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
L®I2g-lam p« �avj,,
Date Contractor Name Registration No.
OR
Date Owner's Name
Q:fomis:homeaffidav
C
TsbL..iS-z Ab
stir 3?`�FneFs
pzstcriptFrs pzrkc�u far�isa aadT�+•�'�"1
hiIlYIMT9R B'
IySAXIT?'iL1M Will Floor Ssaamat ' sue �acc�
Qlisng cQ; R�vsl R-Ys1L%-' WLU
' 'Asn�(L) U •
Pam° 3T01 to 6500
. 3i• 13'
, 0.4a Ig 30 ES AFtIg
q 30
1J
--—�= 13 Z?
T T�%■ ws . 3s 19. 19 10 ?VA a�AFVE
ll 15'/■ 0.46 13 23 NIA !S AFVE
y 5% 0.44 30 1f 19 10 ?VA N�
w 15Y, 037 23 WA
X f1,/■ 0.4Z 3t 19 25 WA 6A 90 AFVS
:. Y IEl, 3E 130-30
34 30 6 401►FV£
Z IEY. 0:4Z 19 S4 10
1, ADDRESS OF PF'OPER'IY:
On-MOR WALLS: Z Q '
2, SQUARE FOOTAGE OF ALL
3, SQUARE,FOOTAGE OF ALL 'GLAZING'.'
4' % GLAZING AREAL(#3 DIVID ED BY ); {�/►/
A,pL see chart abate):• � .
SELECT PACKAGE(Q--
. yED TyiEIFiODS OF Dili
G ENERGY.'REQ�?•EMENrs .
NOTE: •OTHER MORE nNv
ARE AVAu p,BLE. ASK VS FOP'THYS INFORMATION-
gUYLDING INSPECTOR APPROVAL:
yES,
I` .f0mu.fg80303a
a • ,
Footnoie's to Table'JS,Z.Ib:'
and
Glazing area is the ratio of the area of the glazing assemblies (including sliding-aloes door to the1�5'wa l
basement windows if located In walls that enclose conditioned ipace, but excluding opaque doors)
area. expres5pd as a percentage. Up to 1% of file total glazing area may be axcluded.from the U-value requirement.
For example;3 ft= of decorative glass rhay be excluded f;oni a building design with.300 ft=of glazing area.
: After January I, 1999, alaziag U-"Iues'must be tested and documented by the manufacturer in accordance with
the National' Fenestration Elating Council (NFRC) test Procedur=, or takca•frora Table 11.5.3a. LI-values are for
whole units:'center-of--glass U-values cannot be used. the full
a The ceiling R-valdes do riot assume a raised or ove�izad truss n ,tln be iubstiruted f r R 8
insulation thickness. over the exterior walls without pussOf"viry
insulation and Rmay
-38 insulation may be substituted for A=49 lasulai3on- Ceiling g sirup itstt bthe lat d berwe n
insulation plus insulating sheathing (If.used). For.ventiltiated ceiling,.insulag.
the conditioned space and-the ventilated portion of the roof. sheathing (if used). Do not include
I Wall R-values represent the sum pf the wall cavity.6mLstioa plus i W 9 �t could be met EITiMR
exterior siding, structural sheathing, and interior'dryv�rall.For example, �all'requiremcnrs apply to
by R.15 cavity insulation'OA R-13•cavity insulation plus 6 S insulating CathWg-
wood=frame or mass (concrete,amasonry, Iog)wall constructi6ns, do not apply fo taetal=frame construction.
The floor'requiretnents apply to floors'oYer unconditiotied spaces (such as unconditioned crawLspaces, basements,
or gamges). Ploors over outside air must meet the ceiling requiremems•
The entire opaque portion of any individual basement wall with as average depth less than 50%below grade must
oors of conditioned
rne_t the same R-value requirement-as abov °Hasemc= chars musttmeetalls. Windowi and dt the�door dU-value requirement
ba,ements must be Included with the other glazing.
d-scribed in Note b.
The R-value requirements are for untreated slabs,'Add an additional R?for heated slabs.
' pl to install more
If the building utilizes electric resistance heating use compliance approach 3;, or S. Ifni rnont with the I west
than one piece of heating equipment or.more than one pier of cooling eqou
uigm t, et1 p
efficiency must meet or exceed the efficiency requiredby the seieeizdpackage.
For'Hcating'Degrae Day requirements of the closest city or town see Table JSs.la.
NOTES:
a Glazing areas and U-values are maximum acceptable,levels.Insulation R-values are minimum acceptable levels. i
R-value requirements are for insulation only and do nqt include swartzsal eommp hin035 Door U-vaIues must 6e tested
b) Opaque doors in the building envelope must have a U-va"lue no -p cedars or taken from the door U-Value
and docuinented:by the manufacturer in.aeeotdaace with the �1 for�door is not available, include the
in Table J1.5.3b. If a door contains glass and an aggreg.
c to dtermine co
glass area of the door with your windows and use ° opque door n have a V-val eugresterethan 035).mpliance of the door.'
One door may be excluded from this requirement(I.e,ma Y
c) if a ceiling,wall, floor,basement wall,slab-edga,or�wspace weighted component
alued s greater than or equales two or more-areas s o
different insulation levels, the,component complies if the Sh
the R-value requirement for that component Glazing or door eompo�m nt�Q 35 for oh,weighted.average U-
value of all windows or doors is less than or equal to the U-value rcq
43
f Massachusetts
The Commonwealth o
- = - ,Department of Industrial Accidents
- effrce Ofinyestl98dans..
600 Washington Street
Boston, Mass, 02111
`j Workers' Com ensation Insurance Affidavit /
e: ®
V IIl k M 4 oZ Z:
f� 5 � hie#
[] •I am a homeowner p orming all work myself.
(] r a sole ro netor and have no one worlds in ca aci�y
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[] I am a sole proprietor,,general contractor, or homeowner(circle one) and have hired the contractors listed below who
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:�1iJAY$i2Ce'>'.Co :<s.<<>`::s..<:;:r>•:;:4'::::n4. •::::.r:... enalties of a�e rap to S 1,500.00 and/or
Faffure to secure covers;e nquirednnder Section 25A'of MGL 152 canlead to the imposition of criminal p
one years'iznprisanment as dvil Penalties in the form of a STOY WORK ORDER and a fine of S100.00 a dap against me. I mtders4susd that a'
copy of this statement=ybe forwarded to the Office of Investigations of the DU for coverage verification -
es-o er u that-the-information- r-ovaidedabna�e-issr aud-carrec't
I do hereby"eeztify-undefthep and penalti f-P. 1 r1' P
Date
Signature ",,'AA���" 2�
' Priat name
Y��I U ..�U✓�Vl'�✓ Phase#
ofma2iuse only da not write in this area to b e completed by city or town offidal -
p ermif%license# [{BulLding Department
dty or town: OLicensing Board
�]Sele�tr*ten's Office
- p:1Jtd F}
contact person:
Information and Instructions
' es all employers to rovide workers' compensation for their
'on 25 reP
Massackiusetts General Laws chapter 1 52 sect
quoted from the,law,,, an employee is:defined as every person in the service of another under any cautract
employees. As
.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]Dort enterprise, and including the Legal representatives of a deceased employer, or the receiver or
trustee of an individual,partaerslup, association or other legal entity, employing employees. However the owner.of a•...
dwellin house having not more than.t1=apartments and who resides therein; or the occupant of the dwelling house of
g
another who employs persons to do maintenance, construction
f such employmobey d ern d be an employer.on such dwellingDose or onthe'groinids or
building appurtenant thereto'shall not because ong agency shall withhold the issuanci
MGL chapter 152 section 25 also states that o to co st uct te or local
businessthe coin onwealth for any applic t who has
of a license or permit.to operate aith the insurance coverage business
not produced acceptable evidence'of com�pli ce enter into any contract for the w- ilperfbrmaaAdditionally,
e o public workuntil
commonwealth•aor any of its political sub
acceptable evidence of compliance with the insurance requirements of this•chapter have been presented to the co�cacting
authority. FINE 1111111111111,
Applicants
Please fa,' the vvbrkers' compensation affidavit completely,by checking the box that applies to your situation and-
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits maybe
artment.of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and '
submitted to the Dep '^
date the affidavit. Tlie•affidavit should'be returned to the city or town that the application far the permit os license is
not the Department of Industrial Accidents. Should you have any questions regarding the"law"o �if yQu
being requested, a�rork . , c6inpensation policy,please ca -!Ee Department at the number listed below.:
are required,to obtain err =; ~
RN
City or Towns •~
Please be sure that the affidavit is complete and printed legibly. The Department has provided the space at li he bottom Please the
affidavit for you to fill.out inthe event the Office of Investigations has to contact you regarding PP
mrt�licens utnbei wliicliwilJ.be used as a reference num'E;E"The affidavits maybe rem_to..
be sure. fill m e e ne'ss othei arrangements have beeniriade. ~~
a�rtaieut by mail of FAX,,, ,. _, ,,.
the Dep . , .�•.,: .. '• ._ . • ', d you have
anY9,uestions.
e Office of Investigations would like to thank you in advance for you cooperation and shoal y e
Na 1,
please do not hesitate to givens a'call.
Elm
The Departments address,telephone and fax number:
. •. . . ......, .. : r .:, .•.•.
The•Commonwealth Of Massachusetts
_Department of Industrial Accidents A.
�t�ce of IQYestlgatl�ns r .
,z'.
600 Washington Street
Boston,Ma. 02111
fax#; (617) 727-7749
W I 727-4900 eat. 406, 409 or 375
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings,Additions $50.00 v�19 O
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WOFMHEET
NEW LIVING SPACE n A
q ti� square feet x$96/sq.foot= ��p l'tJ x.0031= 22 ` `r
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
square feet x$64/sq.foot= x.0031=
plus from below(if applicable)
ACCESSORY STRUCTURE>120 sq.ft.
>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:
square feet x$96/sq.foot= x .0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
Deck x$30.00=
(number)
Fireplace/Chimney x$25.00=
(number) '
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00 X
(plus above if applicable) L/
Permit Fee a 76 ,
!
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T
BOARD OF'BUILDING REGULATIONS
' License::CONSTRUCTION SUPERVISOR
{ Number GS O47291
Birt
t1 Eitp�res 01/22/2004 Tr.no: 578
l k i=
MICHAEL J GARDNE-R
PO BOX
OSTERVILLE, MA 02655 Administrator
I
j ✓!ze i�oa.�mza,,..aea�i o�✓Glaa�aclu:�aetta
hI Board of Building Regulations and Standards
I HOME IMPROVEMENT CONTRACTOR
Re istr ,'on: 49
_Expiration: 11/12/03
pe: .BA
MICHAEL J GARDNER BUILDER
MIKE GARDNER
37 WINTERGREEN CIR _d
OSTERVILLE,MA 02655 Administrator
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S4 ALlGRN RoAb MASMP- BELTRooAt ANa FAMIL-Y ROOM ADDIT/o.J
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NEW SMOKE DEIEGI REQUIREMENTS
ARE NOW LAW. EViW"E ADDITION OFA
NEW BEDROOM WELL TRIGGER AN
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ALLRN E Cn1YdI'Ai IMc.l-1. �. _. ........�.�1.
`•: '�._•.: -�\ SMOKE DET 0�
\ I BARNS ABLE BUILDING DEPT.
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8Y ALL.A I•! ROr}P
Mq srcf� BEU 2[Ohl AND F N11�Y K__ r//G Oi S•&ALLEY 7/fL
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• TOWN OF BARNSTABLE Permit No. - ___ 28672
Building Inspector cash
OCCUPANCY PERMIT
Bond _..-----------x-�
Issued to Jack McKeon Address
of #9 84 Allan Road, Centerville
Wiring Inspector /, Inspection date
Plumbing Inspector j Inspection date
Gas Inspector �� _� Inspection date
Engineering Department ' '�,L1�'7� Q r Inspection date
Board of Health t1 ) Inspection date '�j �
tx `
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE.
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Building Inspector
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.LEGEND
EXISTING SPOT ELEVATION Ox0 F GF CERTIFIED PLOT PLAN
Sti$ `\
EXISTING CONTOUR --- 0 —— —
FINISHED SPOT ELEVATION �Q.O ROBE
L� T �'� A��.s�� ''z�.a- �
°FINISHED - CONTOUR 0 B. CEA/7�r<V/ -4-E
ELDREDGE
No. 19367 IN
APPROVED BOARD OF HEALTH _
�'�NOS��a� .9 All kJ8 t ')� LA ,WASS
�
DATE AGENT - ALE= / "=g� ^ DATE t
LDREDGE ENGINEERING. CO. IN - MGM< o.v
CLIENT. i CERTIFY THAT THE PROPOSED
REGISTER REGISTERED J08 NO. �`� �7 BUILDING SHOWN ON THIS PLAN
CIVIL - LAND A- ,4_� CONFORMS TO, THE ZONING LAWS
ENGINEER SURVEYOR DR.BY= OF ARNSTABLE , MASS
z 712 MAIN- STREET CH. BY: 2 )12L
N Y A N N I S, MASS. °-
SHEET2 OF ATE REG. LAND SURVEYOR
01
IR�
Assessors map.and lot number ..l...l....J...,....OQ.........0... $E Ig
OL V E STp�-LED Y�TLE S®� pN of THE ro��
Sewage Permit number ................v..��.......� .�j ...a w E��p►�.�+ �'It's
9S 6HBABa LE.
/ ^House number .................... .. .... .......................... i
O i639. \0�
MPY A,.
TOWN OF BARNSTABLE
BUILDING ' INSPECTOR
APPLICATIONFOR PERMIT TO 0(L C. .................................. . ................................. ... .. .............. ...........................
TYPEOF CONSTRUCTION t o. a..... ...................... ......................................................................................
i
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit accordin to the followin information:
Location .............. ot aAA.lixn o 0-d lit
.........................................................................................................................................................................
S � �Q &M4'.1j r'��+ > . 0 eProposed Use . ............................................ ........................................................
.
Zoning District ..................................................... ..................Fire District .... n Ost
,.
Name of Owner ....... ..... ....Address ..................... `.' ..J "..... ....................... C
�►/�y^� y� p
Name of Builder ..... � 4t4�'..�.. i(,ZS�rn .`. rr1s Ti.0'..&A.A45
.... .. ... ......... ..
Name of Architect .....Jlau.M.....M1... `d.`Address ......L..!...'C> ' roR M.4
..........................
9 .�..............
Number of R ms � � ...................................Foundation- CDncre `'`-�......................... ..............................................................................
Exterior ..... ........d...C. ....Oh.!.*.h .....4. �:.`.� ....Roofing �5 IU..................................../C p `,
Floors ..... / ..........�... ..... ......p�.. ....Interior ............Vhft_.�i�Ck............
........
/- j ..............
Heating ........ .......... .......... .a.s....................Plumbing ........ r F pV c
p../ J..... . ................ b ��
\ $ ll �
\ Fireplace .......... ..C)............................. ................................Approximate Cost .........................................
Definitive Plan Approved b Planning Board --____�/_JA �a--_-__--_-19 4 ~
P pp Y 9 �"� - ---- `-(�--=ti Area
Diagram of Lot and Building with Dimensions Fee ���.........
SUBJECT TO APPROVAL OF BOARD OF HEALTH a f_, 0
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. '
�- "�,
Name ......................... ....................................................
F Construction Supervisor's License ....................................
"'l-MCIMN, JACK
No .... Permit for2..§t-9rY..§A-XGle........
f aqdjy.4��qj�� .......................................... I
. . .............
84 Allan Road
Location .Lot..9.....................................................
Centerville
.................................................................... ..........
Owner ................
......................
Type of Construction .... fraffe
.......................
................................................................................
Plot ............................ Lot ................................
0
Permit.Granted .................11/14
:..xi 9 85
Date of Inspection ............................. �—,,q
C
.. . ..Date Completed !07p�. -,...... . .19
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e:!5� f
i
W BARNSTABLE
C47V V
94SIN . G J �� OF ROUTE
BRUCE
G.
ur�PHY LOCUS
No.749
TP/I\ d;-p ALLAN ROAD
Gj$TEe`
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Ar
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LOCUS MAP
LOT 8A
ASSESSORS MAP.•194/1-9
PLAN REF' 100/30
ZONING. »RF»
GA GE FLOOD ZONE: "C"
COMM. PANEL #
1o11� I Io`' fps ti DECK ,, 139 250001EMSTINGDATED. 8/19/85
3BDRM. •9cp, l
I
3 ) BENCHMARK. �, � i / lAO SITE AND SE WA GE PLAN
G / TOP OF FOUNDATION OF LAND
ELEV.=137'(ASSUMED) I l�le I I l �o t\ �, w
o �, \� •�� l�� 1 o LOCATED A T PROPOSED �1 84 ALLAN ROAD
ADDITION
WEST BARNSTABLE, MA.
ro
27 ' / o °o ryo� \ PREPARED_ FOR
I%t ,30 \ s , o \\ TP /4\\ KEITH SCHA CHTER
`\ A.M. 19411-9 OCTOBER 26, 2002
LOT 9A
EXISTING SEPTIC SYSTEM (PER insTALLERS cARD) AREA = 44,383 S.F SCALE: 1" = 30'
(TO BE REMO VED) -- TANK, D-BOX & LEACH PIT
ADDITIONAL TEST PITS -- #3 & #4
(P-5124) LOT 10A �y'
f B.0.H. - TOM MCKEAN (11113185) ` 5 YANKEE SURVEY CONSULTANTS
' LOAM' MEDIUM SAND/SOME GRA VEL A� Op UNIT 1, 40B INDUSTRY ROAD
2-11
(VERY LITTLE CLA Y) Sa �� P. O. BOX 265
MARSTONS MILLS, MASS. 02648
P 1 MIN. 30 SEC. LOT TEL 428-0055 FAX 420-5553
ERC � _ X
(BOTH TESTS SAME) 16A
J# 53283 DB SH 1 OF 2
i
r
EL. = 137 0' „
TOP OF FOUNDATION
NEW 20' MIN.
10' MIN CONCRETE COVERS 4" SCHEDULE 40 P. V.C.
1 MIN. P17rH 118 PER FT. 2"LAYER OF
4
/ / CONCRETE CO VER 118"-112"
/ ♦ ♦ ♦ / / ♦ ♦ � ♦ ♦ / / / ♦ / ♦ � ♦ ♦ WASHEDS719NE
EL=133.0' EL=131.0'
6" MAX / / ♦ /. i i i i ♦ / / / ♦ /� ♦ i i ♦ / / / / / i i i ♦ ♦ i i i i i i
4" CAST IRON PIPE s AIAx
(OR EQUAL) MINIMUM c� s" MAX
PITCH 114 PER FT. FIRST 5' j � CLEAN SAND
FLOW LINE PlYrH 114 PER FT.
AN
=130.75 "�
INVERT 1 N 14" �20•� o00 00000C3C3E. 0 agoog90 .
CAS e0 0 00000000000 008
132.50 /NVERT �•L 0 . . . . . 0 E. 0 0 0 oo�g
BAFFLE
6 SUM o 0 00oo0000000 08 EL.=128.0'
INVERT EL.=131.25 INVERT INVERT
EL.=131.50 EL.=-131.0' EL,=130_75_ °' (3) 500 CAL LEACHING CHAMBERS °
(710 BE PLACED ON FIRV BASE) - DISTRIBUTION EL.=130_.o'
MECHANICALLY COMPACTED OR B" OF S7vNE BOX 12.8' X 335' TRENCH FORMATION ti
_150Q--GALLONS 710 BE WATER TESTED
IF MORE THAN ONE OUTLET SOIL ABSORPTION ` o
SEPTIC TANK PLACE ON 6" STONE
3/4" 7Y1 I-1/2" SYSTEM (SAS)
PROFILE OF DOUBLE WASHED S7i7NE
SEWAGE DISPOSAL SYSTEM (36' ADJ.)
NOT TO SCALE NO OBSERVED WATER TABLE AT CATCH BASIN ON STREET EL= _12 2.89'
OBSERVATION HOLE 1 ELEV.= 1333.0' OBSERVED WATER TABLE (6/5/85) EL =___ 1222.0'
PERCOLATION RATE MIN./ INCH IN MEDIUM FINE SAND ELEV= 13_3.4'
OBSERVATION HOLE 2
+y o'
0• LOAM & SUB-SOIL
LOAM & SUB-SOIL 2'
2'
MEDIUM FINE SAND, GRA VEL
GENERAL NO TES MEDIUM FINE SAND, GRA VEL
SOME COBBLES
SOME COBBLES 11.4'WATER
1) ALL WORKMANSHIP AND MATERIALS SHALL CONFORM TO D.E.P. 11' WATER SOME FINES
TITLE 5 AND THE TOWN OF _$ARNBTABLE____ RULES AND SOME Fli"M 14'
REGULATIONS FOR THE SUBSURFACE DISPOSAL OF SEWAGE. 13' SOIL TEST
2) ONE COVER ON SEPTIC TANK SHALL BE BROUGHT TO DATE OF SOIL TEST 6/5/85 SOIL TEST DONE BY ELDRIDGE ENGINEERING
WITHIN 6" OF FINISHED GRADE, OTHERS WITHIN 12"
3) ALL COMPONENTS OF THE SANITARY SYSTEM SHALL BE CAPABLE OF P—4530 WITNESSED BY P.M. CONLON
WITHSTANDING H-10 LOADING UNLESS THEY ARE UNDER OR WITHIN DESIGN CALCULA TIONS.'
10 FT. OF DRIVES OR PARKING AREAS. H-20 LOADING SHALL BE
USED UNDER OR WITHIN 10 FT. OF DRIVES OR PARKING AREAS. NUMBER OF BEDROOMS . . . . . . . . 4
4) ANY MASONARY UNITS USED TO BRING COVERS TO GRADE SHALL GARBAGE DISPOSAL . . . . . . . NO
BE MORTERED IN PLACE. TOTAL ESTIMATED FLOW 440 CAL/DAY
5) NO DETERMINATION HAS BEEN MADE AS TO COMPLIANCE WITH INSTALL- ( 110__GAL/BR./DAY x ___4 BR.)
DEEDED OR ZONING REGULATIONS. OWNER/APPLICANT IS TO (3) 500 CAL LEACHING CHAMBERS SEPTIC TANK CAPACITY 1500 GAL
OBTAIN SUCH DETERMINATION FROM APPROPRIATE AUTHORITY. WITH 4'STONE ALL AROUND SOIL CLASSIFICATION . 1
6) UTILITIES SHOWN ARE APPROXIMATE ONLY, EXCAVATION CONTRACTOR 12,8' X 33.5'
?f IS TO CALL "DIC— SAFE" AT 1-800-322-4844 AT LEAST 72 HOURS DESIGN PERCOLATION RATE . . . . . < 74 MIN./IN.
PRIOR TO COMMENCING WORK ON SITE. EFFLUENT LOADING RATE . . . . . GAL/DA Y/S.F.
7) CONTRACTOR IS TO VERIFY GRADES AND ELEVATIONS AS WELL AS LEACHING CAPACITY (AREA X RATE) 454 GAL/DAY
SITE CONDITIONS PRIOR TO COMMENCING WORK ON SITE. RESERVE LEACHING CAPACITY . . 454 CAL/DAY
8) PARCEL IS IN FLOOD ZONE_ 'C'"_____• (33.5XI2.8.1C74)t(33.5+33.5+12.8+12.8)X2X.74)
9) LOT IS SHOWN ON ASSESSORS MAP 94 AS PARCEL 1=9___. ! PAGE 2 OF 2 JOB 53283
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