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0344 ANNABLE POINT ROAD
r .r w. 4 : a e i , y� rt ii i, • n r _ n y r y G : � r i v y v t „ : _ r y a. re , y r, VAW Ems. ry Application number . .... .... .........- �. . . .�' _- Date Issued ... .:r _a— .... ... '� z '_.` .®. .,,. P.=; I'd • -, -L� E, Building i nspectors Initials...N 40,P) , ... TOWN OF BA►Z'NSTABLE w. EDITEDEXP PERMIT APPLICATIONi4 5 ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATIRIZATION 6Y M1 PROPERTY INFORMATION 'AddressofProject: - _ '���. y x NUMBER '_ STREET - VII LAGE T Owner's Name: a, P.f iylQ, �+per" °' Phone Number Email Address. Ce11:Phone Number. Project cost$ Check one, Residential Commercial r ., n OWNER'S A�JTHORIZATION J eTf— As owner of the:above property I hereby authorize . fir^ IJAIA l�C[ ly w to make application for a building permit in accordance with 78 1ViR ,L/ Owner-Signature: �Q.,f "a � Date: TYPE OF WORK ❑ Siding ❑ Wvdaws(no header change)# �Insulation/Weathenzatton Y ❑ Doors(no:header change)# Commercial Doors require an mspector'sTevrewR ,,. Roof.(not applying more than 1 layer'of shingles) . _. �.. Construction be will be going to CONTRA -TOR'SINFORMATION > ,. I Contractor's name - Th C I:/_/4 6 Q. Home Improvement Contractors Registration(if applicable)# /7J l�,bb3 (attach copy) x Construction Supervisor's License# /1. 7• (attach copy) Email of':Contractor. Q �f'�^r/��j � e /jj , :Phone number ,s�'7� ALL.PROPERTIES`THAT ffA, {/E.STRUCTURES:OVER-75 Y,EARS OLD OR:/F THE:SUBJECT PROPERT 1!lS IN A HISTORIC•DISTRICT,YOU MUST OBTAIN'HISTORIC APPROVAL BEFORE A,PERMIT CAN BE ISSUED. APPLICATIONNUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X , X Additional tent dimensions can be attached on a separate piece of paper. Check one:-'this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. 1 *WOOD/COAL/PELLET STOVES • + Y Manufacturer# Model/I.D. Fuel Type Testing Lab _ t Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APP IC 'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. ,. Town of Barnstable , Rding 9, a -D ; are Post This Card So That�t is Visible From the Street App'rovFed Plans Must be Retained on Job and'this Card Must be Kept F f jPosted Until Final Inspection Has Been Made Q� R aPermit `Where a Certificate of Occupancy�s Required,such Buildmg shall Not be Occupied until a Ffnal Inspection has been made Permit NO. B-19-2545 Applicant Name: ALTERNATIVE WEATHERIZATION INC. Approvals Date Issued: 08/07/2019 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 02/07/2020 Foundation: Location: 344 ANNABLE POINT ROAD,CENTERVILLE Map/Lot: 212-007 Zoning District: RD=1 Sheathing: Owner on Record:. REASONER, MARTIN E 8i KATHERINE G Contractor-Name ALTERNATIVE WEATHERIZATION Framing: 1 INC. Address: 45 WYATT ROAD 2 GARDEN CITY,.NY 11530 Contractor Ucense: 175683 Chimney: a y: Description: Weatherization Est, Project Cost: $5,529.00 K>- Insulation: "Permit Fee: $85:00 Project Review Req: S Fee Paid: - $85.00 Final: Date:, 8/7/2019 Plumbing/Gas (C Rough Plumbing:. � 3 s Building Official final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after.,issuance. Rough Gas: All work authorized by this permit shall conform to the approved application anclA66,,approved 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. Final Gas: This permit shall be displayed in a location clear) visible from.access street or road and shall be maintained open for publi PY c inspection for the entire duration of the work until the completion of the same. w Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Bwldi and'Fite Officials are,provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ' Rough: 1.Foundation or Footing 2.Sheathinginspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4,Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable Building Department Services ie} Brian Florence,CBO 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 I� KATHERINE G REASONER , as Owner of the subject property hereby authorize rzrL to act on my behalf, in all matters relative to work authorized by this building permit application for: 344 Annable Point Road Centerville (Address of Job) µ Signature of Owner „Signatur of Applicant Print Name Print Name Date The Commonwealth of Massachusetts Department of IndustrialAccidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print LeLdbly Name(Business/Organization/Individual):ALTERNATIVE WEATHERIZATION, INC.' Address:2 LARK STREET City/State/Zip:FALL RIVER, MA 02721 Phone#:508-567-4240 Are you an employer?Check the appropriate box: Type of project(required): 1.[a I am a employer with 16 employees(full and/or part-time).* 7. New construction 2. I am a sole proprietor or partnership and have no employees working for me in ❑ 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.[]I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole I L Electrical repairs or additions p ❑ P proprietors with no employees. 12.Q Plumbing repairs or additions 5.17 I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.E]Roof repairs These sub-contractors have employees and have workers'comp.insurance.: P 14.[E Other INSULATION 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. `*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,.they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:LIBERTY MUTUAL INSURANCE Policy#or Self-ins.Lic.#:XWO58867158 Expiration Date:06/07/2020 Job Site AddressLJ ` 7 Amalie— A4— City/State/Zip: _d�A Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under ` e'' "s and alti so. e ury that the information provided abov is tr a and correct Signature: Date: Phone#:508-567-4240 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: DATE(MMIDDIYYYY) AC "R-a CERTIFICATE OF LIABILITY INSURANCE i 05t24/19 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED.BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS.WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Anthony F.Cordeiro Insurance Agency Par°NN Ext: 508-677-0407 AIC No: 508-677-0409 Fall Pleasant Street —ADDRESS:Fall River,MA 02721 SS: HSouza@Cordeiroinsurance.com INSURER(S)AFFORDING COVERAGE -NAIC tF INSURER A: Liberty Mutual INSURED INSURER B: Ohio Security Alternative Weatherization INSURER C: Ohio Casualty 2 Lark St INSURER D: Fall River,MA 02721 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT;TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER MM1DDlYYYY MMlDDIYYYY LIMITS UULr X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR PREMISES Ea occurrence) $ 300,000 MED EXP fAny one person $ 15,000 A Y Y BKS58867158 06/07/19 06/07/20 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 POLICY❑ PRJECT O- ❑LOG PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $Ea accident) 1,000,000 ANY AUTO BODILY INJURY(Per person) $ B OWNED X SCHEDULED Y BAS58867158 06107/19 06/07/20 BODILY INJURY(Per accideni AUTOS ONLY AUTOS ) $ X HIRED X NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY ,Per accideni) $ X UMBRELLA LIAR X OCCUR EACH OCCURRENCE $ 1,000,000 A EXCESS LIAB CLAIMS-MADE Y Y US058867158 06/07/19 06/07/20 [AGGREGATE $ 1,000,000 DED I I RETENTION$ g WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 500,000 C OFFICERIMEMBER EXCLUDED? � NIA XWO58867158 06/07/19 06/07/20 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Action Inc and NGRID,USA,its direct and indirect parents,subsidiaries and affiliatesshall be named as Additional Insured on commercial General Liability and Automobile Liability polcies. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN NGRID USA ACCORDANCE WITH THE POLICY PROVISIONS. 40 Sylvan Road I Waltham,MA 02451 AUTHORIZED REPRESENT r" r ©198$'-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD _. Commonwealth of Massachusetts �t ..Division of Prof essionaI.Licensure. .� Board of Building Regulations and Standards Construetibr iSJpervisor - _. CS-105454 � r iE pin es;-05/08/2021 TIMOTHY CABRAL - .58 DICKINSON STREE r�r -.PALL RIVER MA 02724 $ wrp I r, � — Commissioner _ . _ ... . w. i ✓� f� P/ e ?/77j�it��C���� G/G' �� - i i / . G . GGGGy off ..ice of Consumer Affairs and Bus:i:ness Regufation' 1"Q00:Washington Street = Suite"710 "Boston; Massachusetts 02118. Home Improvement Contractor Registration Type: Corporation q. Reyiot at n: 175683 ALTERNATIVE VVEA.THERIZATION..INC: c . .. _xplf atlon: 05/28/9021 2 LARK ST FA!_L:RIV'R; MA. 02721::.:::: :Update Address and Return Card. SCA i :C,.:20P1y05l17 Office'of Consumer.Affairs&.Business Regulation HOME IMPROVEMENT CONTRACTOR: rraion Registration valid for individual use only TYPE:Cor,,o before the expiration date. If found return to: :. ..... .. ... Registration Expiration Office of Consumer Affair and business*Regulation 175683 05/ 00?is 1000 Washington Stregt -Suite 710 ALTER - f..:i NAI IV dt EATHERIZATION INC." B^oston,.MA 02118. TIMOTHY CABAL 2 LARK ST � ,o FALL RIVER.MA02721 I� V of v4t#'withoui signature Undersecre ary A•L(ERNATIV•E . IN,EAT H E R]Z,AT!, N . •. .. . . • TORN Q����ARN: . . 1Q19SEP46 . AM1 it r)!vIcI N Date: Town of Barnstable .200 Main St ;;:Y;•;r;'f..;,a:, (:, y:,•z;s . Hyannis,MA 02601 ' -a s t -�c y� r, G/ Re:Permlt# / I ;.>��w} �r..r°p:+;.v 'Pj':'afiM:,• T."a;.'•G°;gjiX'r1•,°• ' ti:'�,•y ",j,.���::'.ti•r,w..,j7"' .,'l.,rS�,.Y: ,.YJ.:.;.r� :,:1`,S3 ei.`k � 'GY.:':^ 31 ••4Y':i:�.^`"�7;°i,`!!: :1,r.Yi'Ir;r+�:4,,:,�,�'' [,�� r::I: r� ti� :w,r',.."f�';;i'y F,�: :Ty}�e i�asulatioa'weal 'b u� ;rat., / ywsN;yiCa>. •r;.as.'+"t':n,'ty:x..y:w;..S.•:?'••A': :;k..,:^.,!:'r'.«•�:.5. .f ::,,,a. •�-• ;:iti:: ..3,•t:�.,�;„ :, .F:.�y.>.,:.,)..• '^•b u.:.!�,..;ia., •%.ny'�;n.ra �:i;�;•p "$ ^ ,::^:•eit��SY":�),MYr.'.•� '1., "•ib:j Gd.9� i:�. ��F,• ,;.?SA. com let itnce withr' '� ;,s:;?,•: ,, ,a�:., :,.,�:. r� a,�. P ;s`.`r:: ,•,. „�;•. i,,: M{s:: ..A.:c:•:".GCx' r:'E% ;,.r;.+,,3':.. :'''F'ln",:^, ` i�""�•:M l�"•' l ,•lµ,,,ry. '`;,J?C �,, rc�1? ':�"r;'r; :,y.;.:, ::;4•;:' ,'�'t�=:•::';,•;,.r.. 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ALTERNATIVEwf-THERIZA.TION@G�nAIL. M,,••',. Town of Barnstable Building F..�h� .+>•'z" '�. . :'' �Y: �k`a: .� w. ,..;��>i+. �� t ��°.�. �. '�`?� ':��k:�✓ ,ef, , .: ., ra,�+`u"� ,t,c�� ` '�v`+4 '`� e Post This C' So That rtr�s Visible From the Street Approved Plans Must be,Retained on lob and this Card Must be Kept + BARNSPABI$ , , �{ 5,., ,P' � MAC Posted Until;-Final Inspection Has Been Made s u m Where aCertificate of Occupancy Required,suh�Buildunng shall Not bye Occup�ed� t a Final Inspect�onhas been mad�ery it Permit No. B-19-1118 Applicant Name: Robert Bourque Approvals Date Issued: 04/08/2019 Current Use: Structure -Permit Type: Building-Sheet Metal-Residential Expiration Dater 10/08/2019 Foundation: Location: 344'ANNABLE.POINT ROAD,CENTERVILLE Map/Lot: 212-007 Zoning District: RD-1 Sheathing: Owner on Record: REASONER,MARTIN E&KATHERINE G _ Contractor Name AROBERT G BOURQUE • Framing: 1 Address: 45 WYATT ROAD Contractor License k6435 2 GARDEN CITY,NY 11530 Est Project Cost: $5,500.00 Chimney: Description: INSULATED,GALVANIZED SHEET METAL SUPPLY AND RETURN AIR Permit Fee: $85.00 Insulation: DISTRIBUTION SYSTEM > Fee Paid $85.00 ; 3 41, Project Review Req: DUCT WORK.. Date 4/8/2019 Final: x r9 Plumbing/Gas %� Rough Plumbing: g / Building Official ' Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzed'by this permit is commenced within sN1rn6hths after.issuance. All work authorized by this permit shall conform to the approved application'and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning bylaws and codes. This permit shall be displayed in a location clearly visible from access street or:road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and,Fire Officials arse prov ded n this permit: Minimum of Five Call Inspections Required for All Construction Work:° 25 d Service: 1:"Foundation or Footing y` <� ��� Rough: 2.Sheathing Inspection = 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation ' 7.Final Inspection before Occupancy Low Voltage Final' Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT L � Ow r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION .,Parcel �O Permit# `�� Health Division it Date Issued Conservation Division 6 &AjS53-3 96Q PC 4N Application Fee ' Tax Collector ®C�_ 6y P R Permit Fee Treasurer —/ —®� Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address k3� /� ,�Z,,g- 00�'04&r_ - Village gEX V f, ��t"".��L Owner 1_1/G LIl.x,: Address S4 M Telephone �� &-' Permit Request C�� .� Ptf Cad 5� /�` ,�•r C�iV%€� _JD C,� is � �G✓�.� �'. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type �/l�oa Lot Size 5/ Ae4c-s Grandfathered: ❑Yes ❑No If yes, attach supportin 6 ocumenfa'bon. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) w Age of Existing Structure AKoM J#7o d ies, Historic House: ❑Yes ANo On Old King's Hig way: Ca-Yes r No Basement Type: XFull-i, O Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) �so-0 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 Oil ❑Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing 3 New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Aexisting ❑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 BUILDER INFORMATION Name / 44,o� h/, ��LC.� -Telephone Number Address &es , Ni✓,4i�'� 1�/WP- �J License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 6 DATE �6 02 f FOR OFFICIAL USE ONLY t r PER, IT NO. ' r DATE ISSCJED MAP[PARCEL INTO.. _ - - ADDRESS ��; �' � .:,^ � '�, � . ', •• � - VILLAGE OWNER, DATE Off'INSPECTION: • � r f f FOUNDATION j f t FRAME a f a INSULATION FIREPLACE ' ELECTRICAL:,- %ROUGH ,' FINAL t ' PLUMBING: j , ROUGH FINAL GAS: ROUGH FINAL 1 f FINAL BUILDING 1 F t DATE CLOSED OUT {f , ASSOCIATION'PLAN NO. . �x r t _ �oFISE r � Town of Barnstable Regulatory Services! - BA NSPABLE. ` Thomas F.Geiler,Director 9 MASS. �Arf 639. 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. Type of Work: 6b Estimated Cost Address of Work:{- AA1A ;V d L 45' s/UY XJ Owner's Name: 1611-L A k-,t> A4 A Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 7Building not owner-occupied tRbwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Ai AV. / /e/..cq ate Owner's"Name Q:forms:homeaffidav . I The Commonwealth of Massachusetts -I Department of Industrial Accidents ' � _- Office of/n�estigations . t 600 Washington Street -= •`3s Boston,Mass. 02111 tion Wo%rkers' C omna n�ce�fd avrt % % / % name location: �� City L� �s �c�Z hone# I am a homeowner performing all work myself. ❑ I am a sole pr rietor and have no one workiu m' an ca acity I am an em to er roviding workers' compensation for my employees working on this job. ........................P.: Y. .:P ::._:: ..: ......:. .. actrt ::::>.:�;;:<::;:::;:8:�::.:<:::;;::>::;�•:':::�:.>::.»<��«<::;::;: �:>::>::>:'.:.> :>: :><'::::<<;;;<<:>;:<:r::. :::::::��:�>':>::.>:.;•:;:� �hone# � �� •>::>::::::»::>::<:<::<:::::;:«:>::: C1tV A ............:::..... Oh :i::f isi::>::: :iGisi`::;;:;!i.F<i:;:;%<.;:::;Ci?'::.i'•;':i::.. ::.,.. __ ❑ I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: aom an.;:name.:.,::..... ,,.....:. •. _, - 'adt .... . ::::::::...............::::::::::::::.:::.....................:..:::v:.�::.:...:...............•::w:::::::::... •: Yi<:}i:{:::::•,:i$iii::ii:ii:L:iii:::i:iii?ijiTiii::ii..i...........r:;<::::::......:::j;i'i :.................•iiii:,{.;::?:,.:y:v:::::::i:::::i:u::`•::::is%v :ii?:i:ii �is�i'!::::: t•`:%::::::�::is�: :>;:St2:`yv :`;::yC;:ti ::i :ii:'v iiii:iv:•iiijiiii:::i.::::iii:.ii:iiiiY:.:i:;;::isiii"?i:::i::':::::::i:::::Ci,:{} ::.ii•:::•ii::::i::i:::S:i... ..• trT" 1) ::::•:::.::•:::::::::::::•:::.::::::.::::•:::::::::::::. ::::::::::::::::::::•:::•:::::::.:::::::::::::.::::.::.::::::.: :::;:::::.:::::::.:::.::::::: .1)0 xxxxx `'`aI1Ie?j%%?> `'?s } s `"?5 ''j'2't %; `<?''`YE`Y ?E?...... '% 2s 7r "! ......ah:::n addressr>;.... ... X. NAME 'h n li ff Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certi u the pains and penalties of perjury that the information provided above is true and correct (Date lv�1GX 0 Signature i L LC',�1 -Phone# Print name f�/L f"a/ 3 (contact fficial use only do not write in this area to be completed by city or town official ity or town: permit/license# ❑Building Departnent ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office Health De artment ❑ P person: phone#; ❑Other (revised 9/95 PJA) 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 . e ' house o f three apartments and who resides therein or the occupant of the'dwelling dwelling house having not more than thr p p lhng another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' 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 may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law'or if you are required.to obtain"a workers' compensation policy,please call the Department at the number listed below. II City or Towns e affidavit is complete and printed legibly. The Department has provided a space at the bottom of the Please be sure that the p p 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 perniitllicense number which will be used as a reference number. The affidavits may be returned to 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 Ottice of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 i :tr Town of Barnstable OF SHE l0� " 'Regulatory Services viP O Vl � sAxxsTAsLE Thomas F.Geiler,Director y MASS. � �p 1639. �0 Building Division lE0r s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �p�f j/e / ,,/gyp/ _/ �''=,r/�'��✓./LLB" JOB LOCATION: �7T / �n)umber street r� village "HOMEOWNER':f t/LLI��g �CLGtN 3�D S3' ��,5 '�5�� name home phone# work phone# CURRENT MAILING ADDRESS: ��7•�/�� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as suvervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department um inspection procedures and requirements and that he/she will comply with said procedures and e irements. ignature of Hon �--� i Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a 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 of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt _-NAILADL[RIDGEYEUT.V/ASPN:SNGL•CAP. 3 �_9Y4�'PARALI:AM_LOAO-DURG.RIDGE. .2=2a12 ru DGE(LIV:_RM_). Cz3"SPR.ST RAPt.P lc O.C. r. 12'RLDGE.(LIV.RN.).� )2 TYPJ/L6LUCDtJ+SMOOTHPL3llclsr' - cwL POLYETM.V.& I �I 1/2a'CO%PLYSC ORD SIhHG: . - ,ruLL-eNGTR PROPCRVEN ` �TZ �Da e - �IY'L FIAERGt.(R'-]O)INSU�. 1a _-z-za PC I. -5� ]+h%5S4.FoST ,. T YIODDDAP, TENTER PT:'OE'RI G .._CONTINLOUS 2 AL.YENT. w .. --22a10. Tom¢ �FR4Mf ... _ E%ISTG.FRAME.. ".,wiLL SuTPG. 5/BGOX.PLY- -U EXIST . --- .•. g. $CORD(DECAUSE OF STUD NEIGNT). DIN.nM 2 4,sem. ' CRAM a EXISjG L OEYND. SVD.i: STAIRI/D R.- a 'ZxIO5-E12 0-C: 1`L2111 - e 2-2a4 oeT[.. - .ORon. a 2-2a10 IIDR. - OFFICE 2.45lI4:. _I -W 27_.". GAD.LALLY, 2 OLFICC'FLOOn: =G AG6.F O n. .EAIST.G.❑SMj-.G.I.R. .. - CO.TAPOSLTE..._SEC:.TION r , 5 CAP_JMTAIL-_ E ACLAD_EIxS� Au�P�szzTG_ cul ELL _ Z1E_2 LT:CLAY FLOC L 1 N 6R CRicXET. _ 4 I1 LCAD LI.AS NING DC57�94=0.X. DC53796-D - t -- — ISA-C nAIL`UG TO UAVC PICK-.' R RAI EE CODE AN .. ET" .S TOM O MATCM EXISTING R41�IN6 E%- SO T L— CEhT TNCRL Is NO 5CAT.R�t3V oil - I d �CSO7BFO: GSIZHl DCS]ZBIeA O LiLLsgcon.DDARo: .: I � I+i _— .- COliPO$.1� SECT 0 1 ,� i - .• Ijl� I 1 ' � --R.EAR ELEVATIOIJ:-:.._ I ' A55VMED CAISTIG FROST'WALL. ;r;tl 1 ___ _- _ __ -- CHRISTOPHERGCROWELL.JR. I' I N*— __.___-- __-- __- _-_--- - -- __}_"'a___. DESIGNER A LWDr ER ________--_ ___-----__________________--_--___--___-_ _ ':L1�-___--__- -- - - ela eosroxPos7 Fo.+Yfsmaw.mlm _.... REAR (EA5j) E E VAT:ION 706 Amltl a=1=o".w.:9 b S 2'A N.t.I.I CV E nC D DAICONY.-- -----� Exl5iING DECK IlG 5_113:4 ,Lti_ S-.III'% 1'V4.. 31139 3IYb f6_,5-II�'i 1:114 2B' - ' CON.EC G.DECK i E%5 O"hALCONY. t 7 - p I NE W.DI WING ROOD - I-� RIDGG,AOOV4. i .. r. - . O °•' .. UPS TAR. DEDRM.. 31/i u`y/P.ARALLAM POSt t0 RIDGC. - t —✓ "I E nIOGE. - - F.,AMILY' RM., II� N EW LIvINGROOU NAIL LO. KI TCW EN. - — _ I y� 1 yEMO t� ;D N -� I .GLASS I 'MAR SINK; _ -F I NCW.W.INDOW:. r 3J0A41 4�Pt a'Vq ..6�-7� :.._DEDRM,3 --- - NG "MCW..TI ALLWPA K.. /^ NEW.: WALL/PART N.. V E L . - - CHRISTOPHER C.FROWELL.JR. - DESIGNER A LAND PLANNER al.7HPOaTRO-�3MK AY xa:706 bIk I/!'.ILO u+.:9 6 .... _. .... _. -- In O" __.._.-.{ NEW. EA15 LU.G. �12 , - " 41A7CN EA 157 G'.:ASPNALT'SUGL6i. AIA7tu-rAls7s_W000 sulucLEs.^ 5 IG2 Cc _ CLG.'l.lu—L.-T ^ ` -_ �_-� — � 157G.GRADIE:IaTI F.fl0N71}VIL.DING_yI N E.(f Pb RO%). - I - - - --.W E S..j _E.L..E...V.A.T I ON._...._ 1 , ---------- I-Lt--F LA LP-- oE�4 -a - PROPOSED ADDITION TO RESIDENCE OF IJILLARD W-6 JOYCE T. WELCW P ANNADELLL .RD.coi ERVILLE IJA. CHRISTOPHER C.CROWELL.JFL .. DESMNER>t LAND PL NN. - � .. - - - � 1100W1RIPWTRD.;WElTdlW oplm I I AnDITIOR . I I ___B G L.CO NY...I.R A NC LI NL,Arov G ____ ___.I— 1' _ _ _ ________ _ _ 1 __------___-__ r--------- I f 1 'LS' O`--___ __LS ZZ I',. -.SdOh 3d%a 6 .571 G 3:1: 1 I L-- ♦ I Doom:. I I• gp�Jy -� _ I . ' 1 SWOP DOA T ST OR�GE F_IC 7.L. ; 1 J/c'CONC.SLAG ON rR5ASE. GRAY EXI G o.4) Id - - ' r 1 I GL AA56.. i NO.�i - 1 _t It 20 I I L=G a�lA1N) 4 RAOMEW1-. G 9E (7000 P. I I I I I•V A Y-3"NO.S RLO RLONG ]] � I I . r I _I 1' .LT-:. 2 7,OVER I rI IC�O-�. - •�' .-.— E X I'$T 1 N G U N F I NI I}WED 5P.A CE.'.. CASTG:CONC.CLOOR IONGRAO6,(26'I ._ Dow .i.. '• NEW ..I ) (I Z ,...GARAGE'. I ?;?• -•c• I I L-LA.L L B ?t 'e. I ..E�CONGRLTL SLAM ON VREP. 'cLO'E 1° O _ -MEWRfLEuI. I I - N __ •o WER STNALL,ONOEIC. i TH {.,1 Tu-. JO_ ZD-4 �•. -.. .I 1 I .. L ---- a"o:7_0 6tI0.DOORS. _- 1 •�1- Q - .elu. -- I ' `1 T 'F-LL. i ••I I'PODRED CONc:2(1500 P.;.liNIN�TYPI Ji e - �• I _ 23 2t . :A OO ITN . W. LOWER . LE-VEL CRRISTOPR WEL . - � �- DEaYINER\l/JID MANNER / A'4 Re:706. ad.1/4•1�-O or.9 8 9d �o r�� A • G2.15 to x Q : .r 7 - 1... — . � Oe 00 71 -77 i • C rocker ti >, Aii Char%S � • - Cer f G l l — ---- Pell Map rT./' Parcel 190 Permit# � i House# '�i ii Date Issued - 6, Z q` w oard of Health 3rd floor 8:15 :9:30/1:00- ( )( �f,'' ;17. \11 Fee. /4/�,n�;• , �A';orb Conservation Office 4th floor 8:30- 9:30/1:00-.2:00 Planning Dept. (1st floor/School Admin. Bldg.) Definitive Plan .d by Planning Board LE V, 9• 10 TOWN OFtARNSTABLE, �NA Building Permit Application Project-Street Address 344 Annabelle Point Road' ; Village Centerville Owner Hillard W. Welch Address '344 Annabelle Point Rd. , ,Centerville 'Telephone (508) 775-5567 Permit Request Remodel Kitchen area: add bay window, skylight, raise ceiling app. 1 ft. , new floor, new cabinets and some new appliances. Remodel bathrooms (.2) enlarge and add larger vanities. %First Floor square feet Second Floor square feet Construction Type Frame Estimated Project Cost $ Zoning District RD 1 Flood Plain Water Protection Lot Size 4.1 acres Grandfathered ❑Yes ❑No Dwelling Type: Single Family I Two Family ❑ Multi-Family(#units) Age of Existing Structure 30 years Historic House ❑Yes No On Old King's Highway ❑Yes fN No Basement Type: ❑Full ❑Crawl El Walkout ❑Other Walk—out (Built into side of hill) Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 1456 Number of Baths: Full: Existing New Half: Existing 1 New No. of Bedrooms: Existing 4 New Total Room Count(not including baths): Existing 9 New First Floor Room Count 6 Heat Type and Fuel: ❑Gas gg Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing 3 New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) 22 x 32 ( ) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# a Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I SIGNATURE DATE BUILDING PERMIT DENIED FOR THE OLLOWING REASON(S) FOR OFFICIAL USE ONLY - y PERMIT NO. ; - a 4 o f" DATE ISSUED - MAP/PARCEL NO. t ADDRESSr VILLAGE OWNER DA TE OF INSPECTIO N: _. FOUNDATION tr t i FRAME INSULATION r j FIREPLACE'f ! ELECTRICAL:,. ROUGH FINAL _ } PLUMBING: ROUGH ' ` FINAL ' ! GAS:• .�` '� VOUGH FINAL FINAL BUILDINol �C DATE CLOSED OUT ASSOCIATION PLAN•�,O. ♦+ , ' I '�� I- R zl-- - - - — I/Z-— A � r (. _ :AIA . r r . i /yi�,Qo rJg vt-I 10. I "';, 040 .•i•w +�.-r: x=: ?4'` >+�� :=ice c�,s t ' , - � - I �� � �I .� —� - _ r {- I ; I I . I f a I ` t I I i _ 1 I I I + ' I I t I I I ; I i i I I I � � ��- ' • � I ` -_I__._ �^a-- I __ �____-____y-_._�...�._!...-..-.�..._...I I.---•- _,.._..._....____ I"f�-�S I._"` ���r�„ I ! I.. i � ... I I f I _I__ � _� _._ • h I� �I � ill i l jt � it � ► • � I . I i , , I 4 Aga -- ,� I - Y ! 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Y•.• ., / ,7:; f r, '.•-?;L:•i:�-; a•_..�• -`If-�t�':a" `7 �. r -'a G .+..r..- 1 :.^s...,, c. -.r-.t-?:. ..�_ :... a.{• L tir'!,.. ;!:°-. J.a-.. :.r;..,("., - ..r ;.MAR=;-21, � ,�, y.. �.Lr, ••�:-:P w Jr r.l- ...�., .,.�:: '.4 .eT 'a. �- h J �' 74: r}.: e♦t.. ! �.-.. - u. �' AR. .,,+: . . �. �. _' The Commonwealth of Massachusetts 5.... ?�� _== -_ Department of Industrial Accidents .` f iffte 01/nyestiigations 600 Washington Street Boston Mass. 02111 Workers Com ensation Insurance Affidavit name: Hillard V. Welch. location: 344 Annabelle Point 'Road city Centerville_, MA. 02.632_ phone# Wa.)_775-.5.5.67 0 I am a homeowner performing all work myself. ❑ I am a sole roprietor and have no one workin in any capacity ❑ I am an emplover providing workers' compensation for my employees working on this job. W. companv name _ .. address: city. phone#: insurance co. olicv# I am a sole proprietor,general contractor, ok,=homeownecircle one) and have hired the contractors listed below who ve the following workers' compensation polices: lizuce W�l.cox 4nc. company name• 4. t I 2- .$tonef eld D tye city Easi SridyT�cli T 02637` phone#:. (508j 888-�544 Ienaissnce ins w �".gcy Inc oLcv# WC OaOCl52 E}0 insurance cis company name: _... address: _. .. . pho ne#: city i►v boll co Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that a copy of this statem y be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce under the pains an4p allies perjury that the information provided above is truo and correct Signature Date /0 _ Print name Hillard W. Welch Phone# (5081 775-5567 official use only do not write in this area to be completed by city or town official city or town:- permit/license# ❑Buflding Department ❑Licensing Board ❑check ltimmediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9195 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. v MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants - Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situatidli and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. 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 permitdicense number which will be used as a reference number. The affidavits may be returned io 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. FRI The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 011ice of Investigations 600 Washington Street Boston;Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE May 28, .199.8 JOB LOCATION 344 Annabelle Point Road Centerville::, Number Street address Section of town "HOMEOWNER" Hillard W. Welch (508) 775-5567 (5.08) ..771-6777 Name Home phone Work phone - - PRESENT MAILING ADDRESS 344 Annabelle Point Road Centerville, MA 02632-2402 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 in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFvINITION OF HOMEOWNER: Person(sJ who owns a parcel of land on which he/she resides or intends to re- side, 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 Officia: on a form acceptable to the Building Official, that he/she shall be responsiblE for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Departam nt minimum inspection procedures and requirements And that he/she will compl ith said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state 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 Owne.- shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarene: often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home '*Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Fier responsibilities, marl 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 form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Of THE r, r The Town of Barnstable a►axsr�z.E, MAIM �m�' Department of Health Safety and Environmental Services 'OTE 659. Building Division 367 Main Street, Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission: For office use only 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: Remodeling Est. Cost $15,500 Address of Work: 344 Annabelle Point Road, Centerville, MA 02632 Hillard W. Welch Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. 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 PROGZAM OR GUARANTY FUND UNDER MGL C. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR ` 7=MCUKAppmm&J Tab1sJ=b(eoadaaal) • pj.a pt&e PaeloaM for Oas said Twe-Flu*Hmidm M Build V Seated with FC'W F02W MAXIMUM MINIMUM Of Wall Floor Ba:m. t Slab UD g R im R value' RrvalueJ Will paiom EMaT Pad*m, I I I I I I R-value' &valud 3701 to 6500 Heads;Degree Dsw Q IrA 1 0.40 1 31 13 19 10 6. Normal R IrA W2 30 19 19 10 6 N� S ITb 0.50 32 13 19 10 6 U AFEj T I5J� 0.36 38 13 23 WA WA Norma U IVA 0.46 38 19 19 10 6 NormsV 1S'i L 0.44 3E 13 23 WA WA =S AFV W 13% 0.SZ 30 19 19 10 6 LS AFVE X 12% 0.32 33 13 23 WA WA N0� Y 18% 142 38 19 25 WA WA Now Z 19% 0.42 311 13 19 1 90 AFUE AA IE7. O.SO 30 19 19 10 6 �AfUE 344 Annabelle Point Road, Centerville, MA 02632 1. ADDRESS OF PROPERTY: 336 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 148 sg, ft. 3. SQUARE FOOTAGE OF ALL GLAZING. 4. %GLAZING AREA(#3 DIVIDED BY#2): 44 S. SELECT PACKAGE(Q—AA-see chart above): V NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING'INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix J Footnotes to Table.I5.2.I b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wail area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 ft of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry, log)wall constructions, but do not apply to metal-name construction. "Me floor requirements apply to floors over unconditioned spaces (such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. • The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.I a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. y One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling, wall, floor,basement wall,slab-edge, or crawl space wall component includes two or mom areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). r • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE .�Z, JOB. LOCATIONS Number Street address Section of town "HOMEOWNER" ./ /1-L Ogjer) ����' Name Home phone' Work phone . - PRESENT MAILING ADDRESS � �� ". City town State Zip code The current exemption for "homeowners" was extended to include owner-occuni_ dwellings of six units 'or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to re side, 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 Offic on a form acceptable to the Building Official, that he/she shall be responsi for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the S Building Code and other. applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Depart�m t minimum inspection procedures and requirement; and that he/she will compl ith said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Vote: Three- family dwellings 35 , 000 cubic feet, or larger, will be required to comply with. State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which--a-,- permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that Home Owner engages a persons) for hire to do such work,,\ that such Home OG shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor, (see`:Appendix 0, Rules and Regulation. for . licensing Construction' Supervisors, Section 2. 15) . This lack of aware often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed- ,against the inlicensed person as it would with licensed Supervisor. The Home Owner ac as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Fier responsibilities, _:nmunities require, as part of the permit application, that the Home Owne_ ' .. .rtify that he/she understands the responsibilities of a supervisor. On t .ust page of this issue is a form currently used by several towns.. You ma,, care to amend and adopt such a form/certification for use in your communit_ ngmeenng Map Paicel ermit# 4 House# �/'.� A Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-z!F-M) Fee rp SEPTIC SYSp�� p Conservation Office(4th floor)(8:30- 9:30/1:00 2:00) E IN CO p Wi Li'mcc Planning Dept.(1st floor/School Admin. Bldg.) r ENVIRON1W E 5 TOWN ANri Definitive Plan Approved b i Planning Board 19 . : RARNST9. A TOWN OF BARNSTABLE '�° Building Permit Application Project Street Address 344 Annabelle Point Road Village Centerville Owner Hillard W. Welch Address 344 Annabelle Point Road, Centerville Telephone (508) 775-5567 'Permit Request �" 9- eei 1=e�1 ""964 Og i30412es� t4iAg-(22 €eet 'k4ge`) 8 @i4o44�. To add a separate roo4m to t e e oom wing cyq!igj g a�yTa 1 for a hall through and thereby eliminating �i28M5e�BSnh:� eR3� e evee eie=eeie:a 'Bceet`��tit�"ler i an existing bedroom3 . fhe shape ot the new room is rectangular wit a trapezoi a extension across the long side. First Floor 176 square feet square feet Second Floor square feet Construction Type Frame with crawl space foundation under, (cement) . Estimated Project Cost $ 8,000.00 Zoning District RD 1 Flood Plain Water Protection Lot Size 4.1 acres Grandfathered ❑Yes ❑No Dwelling Type: Single Family 3 Two Family ❑ Multi-Family(#units) Age of Existing Structure30-20 years Historic House ❑Yes tj No On Old King's Highway ❑Yes Ifl No��- Basement Type: ❑Full 6 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing 3 New Half: Existing 1 New No.of Bedrooms: Existing 4 New Total Room Count(not including baths): Existing X 9. New 1 4 First Floor Room Count 6 Heat Type and Fuel: ❑Gas 0 Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing 3 New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) M Attached(size) 22 x 32 ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) P 1 FOR OFFICIAL USE ONLY PERMIT NO. - 1 DATE ISSUED - - - MAP/PARCEL NO. ADDRESS• - } " VILLAGE } _ # OWNER ` DATE OF4NSPECTION: FOUNDATION FRAME '�C�`" �� G b INSULATION. ' FIREPLACE ELECTRICAL: 1 ROUGH FINAL PLUMBING,: ROUGH FINAL CID _ { GAS: ,, x. ROUGH FINAL FINAL I1UIL•DINd! DATE CLOSED OUT' ASSOCIATION`PLANNO. ' M CUR Appends 1 Table JSZlb(continued) Prescriptive Padmga for One and Two-Family Residential Buildings Heated with Fossil Fuels MAXIMUM MINIMUM Glazing (Hating Ceiling Wall Floor Baseman Slab Heating/Cooling Atra'(%) U-value= R-vadut R value' R-values Wall Perimeter Equipment Efl ciency' Page R value` R-value' $701 to 6500 Heating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Nomal S 12% 0.50 38 13 19 10 6 83 AFUE T 15% 036 38 13 23 N/A N/A Nomtai U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 NIA NIA 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X 18% 0.32 38 13 25 N/A NIA Nomad Y 18% 0.42 38 19 25 N/A N/A Nonni Z 19% 0.42 38 13 19 10 6 90 AFUE AA 19% 0.50 30 19 19 10 6 90 AFUE I ADDRESS OF PROPERTY: 344 Annabelle Point Road, Centerville, MA 02632 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 336 sq. ft. 3. SQUARE FOOTAGE OF ALL GLAZING: 31.5 sq. ft. 4. %GLAZING AREA(#3 DIVIDED BY#2): 9.3% R 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. d BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a °F THE rpyy : . The Town of Barnstable URNSLUM 9�A ,m�' Department of Health Safety and Environmental Services TEc ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227. Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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. e/ Type of Work: Room addition to existing house Est. Cost $8,000.00 j Address of Work: 344 Annabelle Point Road, Centerville, MA 02632 wner's Name Hillard W. Welch June 11, 1998 ate of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied X 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: Date Contractor Name Registration No. OR illard W. Welch, 344 Annabelle Point Rd. , Centerville 4t/ Date Owner's Name f The Commonwealth of Massachusetts t ltr _ Department of Industrial Accidents =: office offnyestigatioos 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: Hillard- W. Welch location: 344 Annabelle Point Road Centerville MA 02632 hone# 775-5567 am a homeowner performing all work myself. ❑ I am a sole pro rietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. _: cbnmany name: :: address.:: city.- . phone#. insurance co. r ohcv# X❑ I am a sole proprietor, general contractor, or homeowner" circle one)and have hired the contractors listed below who have the following workers' compensation polices Bay: Colony Concrete:Forms, Inc \1 ' company name. _. 32 Thzrd Avenue �� address MA02655 one Gomme>Vie. az�d. Travelers'::Tns CompanYes 6EE 15; K4250 45 insurance co blicv# I Q� $race Wilcox, Inc comaanv name �► ddress. 2 St;onefzeld Drive East: SandJich, MA 02537 �nhone# 833 1544 l n 0..... .avarice co. . . . ... ��. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement n be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify r the pains and pe ies of jury that the information provided above is u and correct Signature` Date �� 7 _ Printname Hillard W. Welch Phone# (508) 775-5567 official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9l95 PJA) � I Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a ` dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or 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 insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and ti supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. 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 peimtt/license number which will be used as a reference number. The affidavits may be rednmedte 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 Office of Inllesuganons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 1 R I 1 I I I 1 -...{. _-.i i I Vill _WH__jr _ A. _ ✓,!�«� -- -1..-�- _ _2C%o �ALV.io/ r NA�h. , J ; I `!'v 19 -- ;� , ! i 1 t I - 1 : I n ' is I ' 1. : I ! �:. iz 54 IF Moto � , bdir7aN' r : M_ : I... ��. 1 I T a--- --;��•� � , L . ��f^l' � �. ,,; i i:.. I. rv=�uQs a Usr cgp _ - I i -1 - ---,. _... .__ ..,.,.._ __. � _T_._._; .:.. ., .. �.. .I_ I '.,. 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TOWN: OF BARNSTABLE Building Permit Application `'' � � P 'ect Stre Address 344 Annabelle Point Road Village Centerville Fire District Centerville—Osterville (hvner Hillard W. and Joyce T. Welch Address 344 Annabelle Point Road, Centerville Telephone (508) 775-5567 - Permit Request: To add to existing dwelling, living room, diriing room and entrance hall with garage under living room. 2500 4, lb Zoning District RD-1 Flood Plain li Water Protection Lot Size 4 a c r e s +/— Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Single family dwelling Proposed Use Single family dwelling Construction Type Frame Eaistinz Information Dwelling Type: Single Family XX Two family Multi-family Age of structure 28 and 20 years Basement type Cement Historic House Finished Old King s_Highway Unfinished Number of Baths 3 —1/2 No.of Bedrooms 4 Total Room Count(not including baths) 6 First Floor 4 Heat Type and Fuel Electric Central Air Fireplaces 2 Garage: Detached Other Detached Structures: Pool Attached Barn None X Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Com usation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �ro'ect Costs �`P b o G Fee oGoGJ� � �C SIGNAtPDENIED �-�� Z DATE BUILD FOR THE FOLLOWING REASON(S) BPERM T r FOR OFFICE USE ONLY 10204 212 007 9/12/95 ADDRESS 344 Annable Point Road VILLAGECenterville Hillard W. Welch OWNER i DATE OF INSPECTION: r FOUNDATION Q: s FRAME r \ n vrt WSUL.ATION,t' a. J FIREPLACE } ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: -' DATE CLOSED OUT: �'�• ASSOCIATE PLAN NO. ` The Town of Barnstable BA Department of Health Safety and Environmental Services MASS. 1639. �0� MAIN., Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection P Y Location � 0 Permit Number ( -C") Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: 7- 'V/' C2 t-coq rc�;ft—o A L -r n i Please call: 508-790-6227 for reeinspection. Inspected by Date " � , I� r TOWN OF BARNSTABLE i i BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION. Please print. DATE JOB LOCATION 344 Annabelle Point Road Centerville Number Street Address . Section Of Town "HOMEOWNER" Hillard W. and Joyce T. Welch (508) 775-5567, (508) 771-6777 A.7ame vc.-n S�+oho �.,_. i_ "L--- S•...� ••vaue CaaVi1C nVl.S talV alC PRESENT MAILING ADDRESS 344 Annabelle Point Road, i Center le v. l MA 02632-24 02 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, 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 to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Depar ent minimum inspection procedures and requirements HOMEOWNER'S SIGNATURE ' APPROVAL OF BUILDING OFFICIAL i Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, ..Construction Control. HIScs e , HOME OWNER'S EXEMPTION The code states that: "A ny Home Owner performing work for which a building permit is required shall be exempt. from the provisions of this section r (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) . This lack of awareness often results in serious problems, particularly when the Home .Owner hires unlicensed persons. In this case our Board cannot proceed agfainst the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. 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 form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. l The Town of Barnstable • .snniveresi.e, • ,'6 9. `0�' Department of Health Safety and Environmental Services '�Eo►�A�" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION 344 Annabelle Point Road, Centerville Location of shed(address) Hillard W. and Joyce T. Welch (503) 775-5567 Property owner's name Telephone number 12' x 10' Size of Shed f April 7, 19.9.8 ignature ' Date rannMain Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) 11-40 THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg r(ar /-/-73 Assessor's map and lot number .....` .............. 3 SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Sewage Permit number ........ .� 1t;ITH A:�TICL E II STATE � SANITARY CODE AND TOWN ro�'Qyof 7N E T���w T O ♦1j 1v O F B A R 10���L Z BABBSTLU i 90 "6 9 BUILDING INSPECTOR' ounta APPLICATIONFOR PERMIT TO .............:............................................................................................................... TYPEOF CONSTRUCTION .............. . 40-11-4.................................................................................................... ............. ........19.7- TO THE INSPECTOR OF BUILDINGS: r The undersigned hereby applies for permit cording to thee following form ,ion: l .... ..!!� ........P' ?�!........n�... �'�: .. ........... .................. .................. Location 1............ ..... ........ ... ® I ProposedUse ........41 6 ..................................................................... ............ ................... ............... ............ ZoningDistrict .............. ...........................................Fire District .....................................;......................................... Name of Owner )GUL ....... .../))" .._......Address .�J *-' 1.�'[........ Name of Builder ..l.Y.."Y�...... ............................. ......Address GJr_�'.. cr!i+i. .�t �aa ..... Nameof Architect .........................J.....................................Address .................................................................................... Number of Rooms .............:�...............................................Foundation ..... E. ............. ............... Exterior ..... .. .... ...............Roofing ........ .. .. .. .................... Floors /I...... .. Interior '.........:. ...... . ...... ............. Heating ........ .C............................................................Plumbing .......... ... ........ .................................................... d� Fireplace ...........; C �...........................................................Approximate Cost ......�?.OD.v............. Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area A. .` .... ............... Diagram of Lot and Building with. Dimensions Fee .. . ..�.. .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH w JJ t � I hereby agree to conform to all the Rules and Regulatic ns of the Town of Barnstable regarding the above construction. rr— Name .....�.—.V....... ....lal. ....:............. i . .......... No ...... Permit for .......AddfLt4/ W ........................................................... ... ........... ...................... :Nq Location i Annabell .................Centerville...................................... Owner .......... Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted November...26.............1973 ........... .... - FO Date of Inspection 2j..........;,.tl .10 Date Completed It 7o PERMIT REFUSED ................................................................ 19 .....................................I......................................... .......................... ............................................. ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............... .................................................. 1 %, THE TOWN OF BAR.NSTABLE re O� i •BABH9TADLS, i "6 q �•� D ILDI G INSPECTOR APPLICATION FOR PERMIT TO .................. .. ........... ............ G ........ TYPEOF CONSTRUCTION ..... ........ .... ........................................................ ....................................................... ......... ........... 9 / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a rmit acccrdi to the Ilowir inform 14 Location 1�� , /�// ..... .................. . ............... .................... ... ......� ProposedUse ��-C� e5 .............. . ............ .. .... ............................................................................... ZoningDistrict .......... ........................................ ...................Fire District ..................................................................... Name of Owner ..........................................Address . Nameof Builder ..... .................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exierior ....................................................................................Roofing .................................................................................... Floors ..................................................................... ................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .. � .................................... .................... Difinitive Plan Approved by Planning Board ________________________________19________ . �U1� �Q d Diagram of Lot and Building with Dimensions pp. Z, el I hereby agree to conform to all the Rules and Regulations of the ToLofnstable regarding t e above construction. Na a ..... A4��4 Welch, Hillard W. DEC 31 197ti- C- 118 No .......9....3...... Permit for .....deck............................... I .............:qi� 4....IhAct�bievl............................... �4&29=22:15R%�e Point Road -Location ................................................................ Centerville ............................................................................... Owner .........H.i.lla.r.d W....We.1 c h .. . ...... . .. ... .... ...... frame Type of Construction .......I................................... ................................................................................ Plot ............................ Lot ................................. A Permit Granted ........k14-V-A..................19 71 Date of Inspection .. .. is e .. ............................19 ,71 A Date Completed ....11:71:7M...........19 1 % PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ............................................I................................... 11 Approved ................................................ 19 ............................................................................. ............................................................................... r a /l f./ +;�� ` 'f� ✓ t�3.� �� -}ate ;- , p F���---- - \\ _`� �\ 21 ?.+ - V I N �o• TA OF Cl. Pilo rrd /Vol 25 Mor 63 .00 1l. 2 • s' • S •�� i\ Sp„" � i L8''� if � i� ' ' •s. � ,_ . s• ` `� f� � .�Z� ,�-3 � 2� it ' ��-. ;t - .34.000 r �' \ ro ar �o G J or je5 a C6 Gh t� . I -:4 ro 900 .t 0010 It o 7,34 vv;)C_- lie. o ': lz FS C' �,4 jX A ------------ 0 MAP 212 PARCEL 6 ,. Lg LOCUS KE O #6 ell 815t �•.�,•�,• _• �,�. Ago WEQUAQUET - P� LAKE of � ' .��• �� ��� INDIAN a�ae��9.`• #4 _ - TRAIL __ ��., #3 � ., � ono Pam• rb GRfA r MARSH � ROAD 0-. 968 SF `QF2 N�o ROUTE 28 I o No• � 4. 09 ACRES _ OP o�♦, Proposed 4'x20' 16" Pine Permanent Docks LOCUS MAP NO SCALE ��• (Typical) %�•# 4"x6"'.Wood Post r: (See Attached Plan) 1 Proposed 4'x8' L ' Removable Gangway - , \ e ---- oY ,, pine -----------�� vs pr�� n o < c�AVI d � Ex isting tin m s 9 B�tv Deck 26 ' Oak 55.8 _-------__ `� 13' Pine -- Concrete NOTE: /Exist House #344 ,, Patio \\ r\, chimne ' Elev.= 43.3 Y _ i \ _ r.c.= 1.r F_x_stin Condit ons & Wetlands Delineation WELL`. Exist. Beach �: Were. Taken Frorr, A Plan Prepared For Area - Hillard Welch By Down Cape Engineering, Inc. ' 939 Main Street, Yarmouth, Massachusetts ' J l Dated July 6, 1995. Shed Ir. O y MAP 211 PARCEL 6 ProP osed Dock Location Plan L` 44.0' �4x6 P.T. 344 Annabelle Point' " ; Posts IL Posts To Bea ; Centerville Massachusetts Above Decking , Shore 514 P.T. Decking • Scale. —20 April 9 ' 2002 1 A , ' 2"x6" P.T. ' " "x6 ,P.T ` 2 x6 P.T. 2 P 4.0` Bottom Of Dock To Be' 6 Above High Water Level VERNE T PORTER Jr. PLS Approx. ;,Water Level • • • -- Land Surveyors Civil Engineers EI,=34.Of 9 and Floor ' + 1 z1 " Galt'. 354 Elliot Street Newton, Massachusetts 4 02 64 Plates El.=31.6t V.=2929.6f LNG 20 40 80 120 Design By: Dock Profile Note: .`, ,. .. , ., . � Checked. By No Scale Post Base Elevations Are A Result 0 20 40 80 120 --- -- O f An A l - --_ — Actual Level Run. MAP 212 PARCEL 6 ~ '�,.. `w� .., `� OAK LOCUS `-w. ,,,•". '`' ,, \' � gyp• F aeF� -- I �( WEQUAQUET � w #6 � ` \ > �� LAKE gq 1 5r+...,4 \11., ,,.,,ti,.`��• `•` Y �w`y w ��(1�` , O TQ II 10 INDIAN of�•••'�y5� irra/� I \ "`w. `^,......, �°`,, � ww� p � Opp P�• 70/ sl GREAT MARSH ROAD ROUTE 28 4. 09 ACRES ,+ `��• r o UP �. ���� i �, Pr osed 4'x20' Pine Per anent Docks LOCUS MAP NO SCALE (Typi6el) •%�•# a \ 4"x6\Wood Post r . (See A�fached Plan) Proposed 4'x$' 1 /� '�f �, '*� • � � � `-� 4 Removable Ga kway Dine 'Lt tC Y,.. >� 55.8 Existing � ti Deck \�} 26" Dak 13" Pi;e t\ -__ � NOTE: Concrete \` ', i /, \, t t ExistingConditions & Wetlands Delineation �\ lExist House #344�f Elev.Patio43.3' ��chim ey ` Were TaKen From A Plan Prepared For 4 \1 \ f T C.=51.1 r , Exist. Beach �\ ._ . � _._ rj •, �WE�LL , Area -• Hillard Welch "By Down Cape Engineering,. Inc. 39 Main Street, Yarmouth, Massachusetts Dated July 6, 1995. 1 i / f 0 MAP 211 PARCEL 6 i Pro osed Dock Location Plan 44.0' PostsPT 344 Annabelle Point Po is To king 3' Shore 5.01f D Centerville Massachusetts Above Decking 514" P.T. Decking 2"x6" P.T. !f 2„xs P.T. 2 x6 P.T. Scale: 1 =20 April 9, 2002 4.0' Bottom Of Dock To Be Above High Water Level VERNE T. PORTER Jr., PLS E1.=34.Of Approx. �WdterLevel pond poo, Land Surveyors — Civil Engineers 1 1 v. Plates El.=31.sf 354 E Elliot Street, Newton, Massachusetts, 02464 - - - Design By: 0 -- -- 20 40 80 120 Dock Profile No Scale Note: Checked By: Post Base Elevations Are A Result 0 20 40 80 120 Of An Actual Level Run. _ - -_- Drawn By: ___- --------- _ Sheet of . ., .�"�'�"-- w .r- .. 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