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HomeMy WebLinkAbout0282 BAY LANE Application number...:............................................. Fee � I � Q, ......................................................................... � T0 B92 77 Building Inspectors Initials......II... ... ...............a N0� QFA Issued.... .......)' Date �1Oc 20/9 Map/Parcel.............!!.. !..�.. I ...................... �4tisT TOWN O9%ARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: Z Z �1 i°_An e_- l�C�+.�c_�,t-II-F NUMBE STREET ' VILLAGE Owner's Name: ,\ `� Phone Number 77 44 2 17 7 Email Address: 1 o e <�' Cell Phone Number C r t Protect cost$ Z® U Check one Residential Commercial i OWNER'S AUTHORIZATION As owner of the above prop Edi he'rebyrauthorize'S4w c,(,, P ����� to make application f a b ' pe tin accordance with 780 CMR Owner Signature: Date: 1 IfrL�fab.tc TYPE OF WORK ❑ Siding- ❑ Windows(no header change)# ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review gRoof(not applying more than 1 layer of s ' es) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's nam e-,5vvK Home Improvement Contractors Registration(if applicable)# /�g,�. (attach copy) Construction Supervisor's License# `Qfir 3 (attach co py) Email of Contractor 1 Phone number ?71f 3�' ► 71 ALL PROPERTIES THAT HAVE'STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY-IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. .ar APPLICATION NUMBER............................................................ *For Tents Only* I 4^ 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. Purpose of Event 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 Fuel source being used LP tank 20 lbs. or>Yes No_____, if yes, a gas permit is required. Natural Gas Yes No , if yes,a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or,3.30 pm-4.30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date All permit applications are subject to a building official's approval prior to issuance. 1�774-a38'- t l0 r . �� am OA-(563 WORK PERFORMED AT: TO: wUikk DATE 3 YOEIR WORK ORDER tV0 OUt BIO N0: a ., sin AW S �' �- ✓ cis hW tAq i �` -4 L /P 'L✓l S D( a All Material is guaranteed to be as specified,and the above work was performed in accordance with the drawings and specifications provided for the above work and was completed in a substantial workmanlike manner for the agreed sum of o`., Dollars($ 0,10U This is a El Partial ❑Full invoice due and payable by: Month Day Year in accordance with our❑Agreement El Proposal No. Dated Month- Day Year edams TC8122 11-12 The Commonwealth of Massachusetts ` Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly `, �,� Name(Business/Organization/Individual): �ecwag, � ( ? Calryy ub Address: 10 - �� U — City/State/Zip: 0A E Phone#: - Q17fj Are you an employer?Check the appropriate box: Type of project(required): 1.❑ m a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9: ❑Building addition [No workers' comp. insurance comp.insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing.all work officers have exercised their 11.❑Plumbing repairs or additions myself. o workers'comp. right of exemption per MGL . y � p c. 152, 1(4),and we have no 12.❑Roof repairs insurance required.]t § 13.❑Other 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. tContractors 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: l Policy#or Self-ins.Lic.#: Let k4' Expiration Date: Job Site Address: XA 1\3fk L,-- City/State/Zip: (fe" (ix'4e j66C `- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u he pains and penalties of perjury that the information provided above is true and correct. Si ature: Date: /I f�;b J!J Phone#:. L - 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#: l Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,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,§25C(6)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,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required_ Be advised that this affidavit 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a r`efei•ence number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your 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 Investigations ` 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mam.gov/dia 0 0 D DAD 0D ZMK N 1'/ OM n OM n 2. D� Eo m n ci _7 n rn �a 0 iZM- -I M v m m Ico m�x n�D� a �mmD s.� D z Z N ; �y rnZpp CA) O \^�`C/) a � 0 N 33 y C CD 0 .. . 3 O 03 00 zn O O 3 < Cn (D ? N 0 O Z D�om � h O U rt N o C�.d 9FRrq'r 0) N (OD Q. 1 3 of a f l c M 03 a i "'' o �M O � CL DC .��.dda CD _. Cn Commonwealth of Massachusetts p e . =Cm rn� � Op y ® Division of Professional Licensure rt m a o o y a: � O � Board of Building Regulations and Standards y a W C H a c onstrQ,-6t�r��Spg!v isor � cp m :4 o a »m 0 C C y ' N _ C CS-108553 � empires 01/2512021 MR _ IV b t c 6. O t• r ^ y W <' JAMES PICAC�IELLO_ � i fly z°� o 10 ROLLINGE LAND 7 N n� SANDWICH MA���563 ',r �...�. a n m Commissioner n TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map . ,I gb Parcel Z 1 Permit# Health Division Date Issued Conservation Division Ti J oa �3 36 �/*d'PZAN 415/a�Fee � Tax Collector ' " Treasurer Planning Dept. SEPTIC SYSTEM MUST BE Date Definitive Plan Approved by Planning Board INSTALLED IN COMPLIANCE Historic-OKH Preservation/Hyannis WITH TITLE 5 C.NVIPONMENTAL CODE AND Project Street Address � � Village Ceov� Owner orc,*A o Jh�e AP%2L D,,tot .V Address Ekku Lvi Cen CrJ4/01- Telephone Spa 771 u o 7/ Permit Request�r .fct�� P .S�v��, S rr\ s�Cce-epak, + ti('pe_-2,c )c,J I ivi �0 }DiTT 5a,_Six� ►Cny4a_��A b:11 Cuv�11(�d,drt p 04&i'l hc,)C: S,3n Oec 4 �o b ee t octi Je,,) &6 AEC QU4 5Chl F&I77') . Square feet: 1st floor: existing_ proposed a7 '2 2nd floor:existing proposed Total new .27Z Estimated Project Cost 20,360 Zoning District Flood Plain C Groundwater Overlay Construction Type Zy((A �Lje7 Lot Size I (02 Acre- Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Jd' Two Family ❑ Multi-Family(#units) Age of Existing Structure i Historic House: ❑Yes XNo On Old King's Highway: ❑Yes XNo Basement Type: X Full XCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) R6�{ Number of Baths: Full: existing - new Half: existing % new Number of Bedrooms: existing_3 new 41--ax Total Room Count(not including baths): existing —new First Floor Room Count 7A L12) Heat Type and Fuel: ❑Gas XOil ❑Electric Cl Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:,4 existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:0 existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes &No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name - Telephone Number °6 — Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE r t FOR OFFICIAL USE ONLY s PERMIT NO.' - $ DATE ISSUEDI a ' _ t. MAP/PARCEL NO. ADDRESS VILLAGE OWNER -, DATE OF INSPECT O - _ FOUNDATION".. FRAME ` INSULATION FIREPLACE ELECTRICAL:f ROUGH : .; FINAL , 't PLUMBING: r ROUGH n, .-- FINAL GAS: ROUGH 4 FINAL f FINAL BUILDING - rn DATE CLOSED OUT ASSOCIATION PLAN NO. 04 �:.4, �k �_ � ,. �..�-30•� yip. 97 4 WA ec14 1 y' + 4 �v 1. ' WIC't�sffl P�ac icy rill 441 . � � \ � �.. _ �^��. _•---�_�'��.-.ram �`. "1R—:ru�2- 17- /� GxW{4 CxNs6 Ga��w�u► GtwlL', 3 1l d t 6 , . :.`► .' .,PLEASE �VIg - 1 k J 1 . ... Zy� ��l`l�l� - R�►.Q E�€vATto►J f�.. :1�•.,,_ ,, .. ... .. .... ..... ..- ' - � (>1 I :. I SfafT'U4 M44La /.e••DI.TI4J i t y iai :ji r..nv«a�wros f .y Ma�ING r1t,Y4 11Mf��A� � 2 4 � 7 Y♦a p t< F-YLSPTI N; Q0usr2 _._.. .. .. r Z�dL N��rJ P.L.• � r f ..� ' O.C. G � z The Commonwealth of Massachusetts aftDepartment of Industrial Accidents == = Office 91/0e5#98 ions. : i 600 Washington Street - - Boston,Mass. 02111 Workers' om ensation Insurance Affidavit name: -A M location: ZKZ ��a.•l city n..\. r .}��`d M vhone# y7/I A Z�7 ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worki>i in ca achy I am an em to er providing workers' compensation for my employees working on this job. _::: ...... :: 0 P Y cow anv;name.>: 8ddress. "<., cites One: # Kxs: :::::;:: insurance co. ii... o cv#:::: I am a sole proprietor, general contractor, homeowner cle one and have hired the contractors listed below who have the followingworkers' compensation polices: :.;;:.;>::.;:.;:.;:.;;:.:.:: : >: camiianv name : I ' :.. -.� .... ::':;:.;:.;::::.;;:.;:.:....;'::.;.:.:..:...;:::.:'.:::.::.::::.;:.;:.; .....:::...::.:.::.:::. ' :'..�: " address ^�: . :.:.. .,... . . <:: i-�` phone#> .............. � ...... ....:..:.......................... .. .. ..._.:.�...... ..::::i:v••: '.iiii: '11'.i:S:..... .::;}i:S:'•:ti.::.iii:.:ii: ii:i'ii" ... ..... ........:.. .......:..........:. :::::::: :..: �. v.•.::..: w:...a:.iii:�:::: :::::::.:: �::._:::::.:.:::::._: .::.. ::•:: :•:::::.:•: �:: cV:. :::.:: :• .::::::: �: �: .. .:::::: { •::�;:- :'::iY'::Y/::iti::i'.:' `: . '.:::.i:.i:.i::i:: .. .:...ii:,. ...i:% ::.?>}y: ::} .iii:..�'i:::.:::: ;;;IMl: i::•::;'..' ;. ;.,�?,.{?..::`�I i}:ii:. ':: VOORNMENEENE c any :>:::>.;:•; :::; _.... <: address: :..: ;bitone :...;.: ::::::,:... city- _--- ansnrance ci►.; ::.:.:;';:::::::::::::::. ::> oli # Failure to secure coverage s,required wider Section 25A of MGL 152 can lead to the imposition of criminal penalties of s thu ap to 51,500.00 and/or one.years'imprisonment as weII ss dvfi penalties in the form of a SPOP WORK ORDER and a Sae of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office o[Investigations of the DIA for coverage verification I do hereby certify nder the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name- Gtei. h�r/ly� Phone# .ZD official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Bufiding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9/95 PIA) II Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their . n in the another under an contract to ee ' defined eve person service of anoth _ As quoted from the law an ern is ed as Y employees. q r Y rY! 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 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 permit/license 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents IWO of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r r ; y °f IME a44 The Town of Barnstable • anxivsrABLL KAS& g Department of Health Safety and Environmental Services `bA,E16 9;. Building Division 367 Main.Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: rrc oer,.gi pfac S 1 ,�c Estimated Cost } eOr �1 Address of Work: 2 ter a L� k `- Cr �``'e Owner's Name: -q;41Cc.A1.&t4A JS&L_ iD.A f,Id Date of Application: `-V 131 o cp I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under S1,000 []Building not owner-occupied ?lwner 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 cz �.. ate Owner's Name q:forms:Affidav , ESTIMATED PROJECT COST WOR&SHEET Value LIVING SPACE Z- square feet X S55/sq. foot GARAGE (UNFINISHED) square feet X S25/sq. foot= PORCH square feet X$20/sq. foot DECK square feet X S15/sq. foot= 5 g 00 OTHER square feet X$??/sq. foot Total Estimated Project Cost -7,D i l .990915b N 1 4L p 1 ► ' !3 I v p[.,B►� 3 I P� 4�. ? Q 3 � Zo T 13 --- way �---_--- — , I ` i2'Wiot PG.BIL 73 PG.s- .S3 Ora i Z certify that this iS located dwelling in Flood Hazard Zone C side the 500 year flood out- ) by the Department of Housin iden�;ified Development .(HUD) . sn,, Urban Date sties C ERTI FI EQ PLOT PLAN . E LOCATION C'4 tog SCALE S�.... DATE SwE 23/9. .,. PLAN REFERENCE �-iAIG �r �' 99 tST • i9,vt� to j- r z .. . . � .. . . . . . . ..certify to itstitl • • . . . . . . . . . . . . . that there are no- e insurance company THE LOCATION OF THE ORIGINAL visible encroachments SHOWN HEREON ,EITHER WAg N COMPLIANCE or easements except as shown and that this Plan was prepared .urider m WITH THE LOCAL APPLICABLE ZONING BYLAWS 6UPeY'Vi8ion� y. immediate IN EFFECT WHEN CONSTRUCTED (WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS ONLY),OR EXEMPT FROM �o�t/A7�/anN /? ,{� �-�A r1ACDan��Lz;,_� ITLETION NFO ERE 40NT ACTION UNDER M-G.L, . � OTHERWISE NOTED OR SHOWNCHIEREONUNLESS a usSbteB dingGo e' .80 "A ends: ectio� 1 'Z31 The Massachusetts State Building Code (780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2.3.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration,orientation, form of construction or percent glazing,but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that a homeowner may wish to consider before actually constructinglinstalling a"sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation-Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.1.2.3.1, requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and energy conservation. Signature of Actual Building Owner Date Print Name Address of Permitted Project Ul*63`L 6-16,�> 7 7/— Y&- r Owner Address(if different than project location) Owner's telephone number Building Division aear►srAW L ' 367 Main Street,Hyannis MA 02601 . Mess 9 i6?9. ,0 'OrfO MP'I t. , Office: 508-362-4038 Ralph Crossen Fax: 508-790-6230 Building Commis: HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: =2z tAA,0— '�'`�'qAt-e— number street village .•HOMEOWNER": 10 N Wu-t.AK 01W. u -7 71 4VO71 lam, e ?2 name home phone rI work phone tt CURRENT MAILING ADDRESS: 7qz 2`3 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official.that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assurnes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner'certifies that he/she understands the Town of Barnstable Building Department minimum ins ecn n procedures and requirements and that he/she will comply with said proced and re n . Signatur f Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with,the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION . The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a 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 245) 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 to amend and adopt such a formicertification for use in your community. Q:FORMS:EXEDIPTN . T�j � �C�C ►- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION - r Map 186 Parcel 21 Permit# �/ Health Division 9��y� P/2 �'�''� � Date Issued Conservation Division �� �GD Fee 15/Zd . X Tax Collector ��T�Pe Treasurer � � u����������� y INSTALLED IN CO E 51ANCE Planning Dept. WITHWL MEVrr1kL CopE AND Date Definitive Plan Approved by Planning Board �N�IN�N TOWN R ATIONS ,RE UL �� Historic-OKH Preservation/Hyannis yd aA A -Project Street Address 282 Bay Lane Village Centerville -Owner Jonathan & Rebecca Mac Donald Address 282 Bay Lane . Telephone 508 771 4071 Permit Request GCf' (oSe. anp cao Sj►eJ - cJal` C ►n f2c�t` 2 bnc, aJ;sc_- tucy-kcIrs iv\ -0i-cn 4 Square feet: 1 st floor: existing 1484 proposed 14 ;, 2nd floor:existing -- proposed 1044 Total new 10:!f1 Estimated Project Cost $7., Zoning District RD 1 Flood Plain C Groundwater Overlay Construction Type Wood Frame Lot.Size .63 Grandfathered: u Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family 3 Two Family ❑ Multi-Family(#units) Age of Existing Structure 4 2 Yr s Historic House: ❑Yes 6 No On Old King's Highway: ❑Yes X❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑OthePredom.inantly full - two small crawlspaces Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 825 (full ) Number of Baths: Full: existing 2 new 1* exist. ful l�aeif: eAstih°gnverted to 1/2new Number of Bedrooms: existing 3 new 1* total b/r count to remain 3 Total Room Count(not including baths): existing 6 new 2 First Floor Room Count 6 Heat Type and Fuel: ❑Gas n Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing 1. New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:®existing ❑new size 352 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 Uk,J C,2 Telephone Number Address .. i License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION BRI R ULTI G OM THIS PROJECT WILL BE TAKEN TO SIGNATURE - DATE Z-Z -00 FOR OFFICIAL USE ONLY - RMIT NO. r , DATE ISSUED MAP/PARCEL NO. ADDRESS Y VILLAGE , OWNER DATE OF INSPECTION.i FOUNDATION - FRAME #/2' /2cc7o tj INSULATION A �, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL + GAS: ROUGH = FINAL FINAL BUILDING , i is .r' Ka DATE CLOSED OUT = ASSOCIATION PLAN NO. r `c.1 cc C,i ,,/ Ta6b.tSZ.ib Prssaipdvw FaduLcm for Qao and Two-FsumdY RUMOMW Buildup Seated with Fossil Fads i NAMIUM NIDmum Wag Roar nest Slab �B Anal i U velaar a waGaLl B-vdnst RPvaluj W.0 Pecim P=k= R,vaiaot I-vabd 5701 to 6500 Headm Deem DsW Q 12Y. 0.40 3E 13 1 19 1 10 6 R�at>ad R 12% am 30 19 1 19 10 6 Nosma! s 12•� QJO 3E 12 19 t0 6 15 AFEM T 13% G36 3E 13 23 WA WA Matllld u 15% 0A6 3E 19 19 10 6 NanzW Ian a:� �e 13 WA PA Bs AFUE w 13% am 30 19 19 to .- 6 E3 AFEJE ;7- x rE'/. Q3Z 3E 13 - 25 WA WA Naaas! 0,42 31 19 73 WA WA Z IVA d42 3E 13 19 10 6 90AFi7Ei� AA Ir/. wo 30 19 19 10 6 90AFUE 1. ADDRESS OF PROPERTY: `VJ-- Lune 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: ZZ l 3. SQUARE FOOTAGE OF ALL GLAZING: ' �) 4. %GLAZING AREA(#3 DIVIDED BY#2): -z®©/n 3. SELECT PACKAGE(Q—AA-see chart above): t,G.h}s ; cigs"C.I or ?uk\o NOTE. OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR AP V .YES: NO: q-for=4980303a 'uie 'i,own ot tsarnstanie f7HE Tp �O Department of Health Safety and Environmental Services Building Division txsz�t 367 Main Street,Hyannis MA 02601 MASS. � 059• ArfO tMP't A ' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number 1 1 street I village "HOMEOWNER": Ton K\uc ­ u AU "7 7 I LI137l "t ZO 6 Z 7 name home phone# work phone# CURRENT MAILING ADDRESS: 1,APC C20 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"h7,e r"certifies that he/she understands the Town of Barnstable Building Dep rt ent mi ' in ec1 ion procedures and requirements and that he/she will comply with said uTes q ern n . Si lure of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMM N /:{ �.w.r�c,) � r--�`«w e 1 r,,...,,� .e,...-��.,a...,...,... ......., f I •�w 1�.-r';; ..�Z - , � Ererria' __ _______ I _ Aaaer. saws , � � �•'� j: .��1 VQ 1 m r�••r LEFT 61DE Et-EVATIOrJ +�.�a:�s`.1'-0' 2Ir_AT SIDE ELEVRTioh1 , i 4 � � • A%ter. 6RA0! 1' t 1 f1:2 t FRo�JT IrLEVAT101.� w,.c'./.•-I'� `�" f • s Fry V. M ^- 1 a • _ 1 r w•r,.� «� I I .••••-••••"• 2F !i RGOP Te !2^l VE �y`� � � Y .s r =•1"�a rtaz�f 5!w >/rI� �_-� ,-�.e.�iwa amw I \_O�m,IP I PIJ IUF Pa.R 4LLY � %- •IF I la.Fl GNTILEVER ~-IF~filER4Y Yul-♦ �� •� Mt e....^.•�u�r - 2 � � F e.I IV FL.Pa-69d rlu ._..•. .... _ __ ... _ Q ��! •sum.w.e ,G IF wl ,n a�.Yr - •1a- 1 ' ,i �-«. IF Fu cv�_Y wstl♦S J.fa a.� a WER4Y W31 E �j'a. ®6 64eR4Yf.wua� ®7 � �( � � e 1 ram,.. S w.. ��� . r...,�r1•r�nGRswL SPK£ -a.....» F .-cur m...s e K 5 T+M1rx i IIFGE.. Fa.4J4 6 e F ,1 CnJDITnN \2 � 4 BNE RGY We>1 U tz- Al kD ...-�I- �1• � � /'� -,1�4�.-.. � �• _-...tee♦ ws�.y war-!�._"�ARYP,CS�• p - ucNEO 51ne I�y �_ _ , _a•�4Y w�o' �oerm.cm.. a'ai e'wo m ` R•'?�'• � O � ,� + _._..-.....-..-..r_.......... .....,r,... - --•yr r .;+ O-tbs'c. p 2 b.e... ,�• TYp,,e mI1M U14,4 ,t OC m* M. ].YPICAL TRP i[1f11IG DET\IL � PIRGPLI.CG ♦ CNMI.N6Y 'STA1.10►QD 06Y►1E;�+ K•w• �1 ,eW s 19 \ _ /pT� PIC, T \ . Q o Lo 7- / N 73 /t- S �� z f 3 �� Y i?'Wrote P�•BK 7-3 -AC•S Ile I.p certify that this dwelling is, t{l;oc.ated in Flood Hazard Zone C (out- the 500 year flood) as identified _€ A. tby 'th.e Department of Housing and Urban t IT et►elopment (HUD) Date CERTI A ED PLOT PLAN fit++ °F E �� LOCATION C�-'?!!T ,r21��L DW . . ..... . .. ..•.�. x- SCALE ./�rrS�.... DATE •v, r Reg, ndo-svft PLAN REFERENCE B�i�tc !or D cisTtaU°� ally , .B.fC,.,-73a � r I `certify to its title insurance company THE LOCATION OF THE ORIGINAL DWELLING that there are no visible encroachments SHOWN HEREON,EITHER WAS IN COMPLIANCE or easements except as shown and that this WITH THE LOCAL APPLICABLE ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED (WITH plan was, prepared .under my immediate RESPECT TO HORIZONTAL DIMENSIONAL supervision, REQUIREMENTS ONLY)I OR EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER M.G.L. ,� ,��L�+,q E f1ACDavr�2 -�� TITLE VI1,CHAPTER 40A,•SECTION 7,UNLESS ONAV I/3N f% OTHERWISE NOTED OR SHOWN HEREON. J F ESTIMATED PROJECT COST WORKSHEET Value 1t)Q LIVING SPACE - -- square feet X$55/sq. foot8fr' GARAGE (UNFINISHED) square feet X$25/sq. foot_ PORCH square feet X$20/sq. foot= DECK -4&2-- square feet X$15/sq. foot '' OTHER square feet X$??/sq. foot= Total Estimated Project Cost g990915b a Department of Health Safety and Environmental Service: . y' Building Division 367 Main Street,Hyannis MA 02601 08-862-4038 Ralph Crossen 508-790-6230 Building'Commission, n Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW, SUPPLEMENT TO PERhar 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 conzaining 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: P;nc y-se '�,n �t r Qr ��J s A� S mated Cost�Z o Address of work: ?SS 2 a e Owner's Name: Date of Application: 7—— Z s O y I hereby certify that: Registration is not required for the following reason(s): Work excluded by law E3Job Under$1,000 (]Building not owner-occupied Owner pulling own permit M 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 ate Owner's Name q:fb=*Afldav • The Commonwealth of Massachusetts F� Department of Industrial Accidents _ '; �_� Ottice o/%tresUeaUoos 600 Washington.Street Boston,Mass. 02111 / Workers' Com ensation Insurance Affidavit name: ocation: city phone# ❑ I am a homeowner performing all work myself I am a sole p rietor workin in anycapacity � and have no,one � ''i/////%/,%/.///,%//i" C3 I am an emplover PrMdin workers compensation for my employees worlang::::.::::::::.:: .::.:::.;:.;»:;;:.;::.::<:.:<.::.<:::>:;;::.;::.;;;:>::>:::»:::::»>s::::: :>>''> ;.::::.... .... com anv name:. ss.. ......::::... ...:::... one'#i;: ;; :::;::.:,..:::.. ci y insurance co: . I am a sole proprietor,general contractor, o homeowner(circle one)and have hired the contractors listed below who workers' co ensation lices: the followingP ..... .... ..P�.:::.::. ::::.:: .::.:::;.;:;:.::.::.::::::::::.:..:::::: :::::.:::. .:::::.::..:.;.:.:::..:.:..:. .:.::.::::::..::.::.;,.::::.::::::::::::::::::;;.:;;:.:;:.;::.:;.;:;.; compsnvnam es s..aar :. .... ...:.....:... .....:... .... .... . ...:.::...:...::.........:. ...::....... ..:. ............... ............................. .............. ..............................:....................:.:v::::::::.�::::........:::9v:•.Jii:i,.;::Q v:F:ili:;:>f:::l�H::i:;Y:,i. .. ....,,... ...... ...... ... .....................................::. ...............:::::::::................................................................................ ................................................:::..........................::::•:•:.............................:.::.t:•............................................:.....,•::::::::::•:.�::::::•:::.�:::.�.,•::.::: ................ ..... . s :........................................................... ::.:::.:.......::.:..::.::.:.. :..:............::.::::::.::.:.::,..:............::.:.:::........ .:,:::::::. hone.#>...:.. »> »?>< r> ................................................................................................................................................................ >. ::•::::...................:....... .............:..::.......................................... ................... ............................ :.........<....... : o'licv lnsoranc c anv name- :.::;::.:: address: .::..,>,..:>..... . :;:::;.>:.>::..:::,:;.::... d .. ::::::.......................................................................................:::::::::::::::::::::. :;:;;:;;:;;;;;:;;;::;;; :::::::::.:.:::::::::::::::.::.::.::::.:. ...............................................::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: ::: ::::::::: ................................................................................................................................................... Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of ciivnival penalties of a tine ail to S1,S00.00 and/or one years,imprisonment as well as civil penalties in form of a STOP WORK ORDER and a fibre of 3100.00 a day against me. I understand that a copy of this statement may be the O Investigations of the DIA for coverage verification. I do hereby cati a pen of perjury thai flu infornra Uon provided above is tnp and coned Si�ature. Date ' Z —00 — Print name Phone# ofDcial use only do not write in this area to be completed by city or town ofScial ent city or town: perndtNcense i! ❑Lkea�g BMullding oard ❑check if immediate response is requited ❑selectmen's Office ❑Health Department contact person: phone#. Other® uavaed 9/93 PJ�U • • w I tw ac. _ I , IN0.: ' 91-UMg1tJ4 RISF�. 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'ra .ar�a � tt L• «w u4rr t•rrlco.Yura• .- � N t SMOKE DETECTORS O.K. a t•. � . ` P�esT FLm2 PLAN �r.,.:,>f'.r-o"— � � R ABLE BUILDING DEPT. ,H r SMOKE DETECTORS REVIEWED FIRE DEPT.(VEN.#) DATE e•�'h"LM 110.. .F NL Rro.r. � 00.� Y"! � • � N� / �- .. �e �ucvf TtiRLN � TiUS e V.- +���I� � A.'.. +a _ lea- Jill� i SE C-T 1pt-)'- � � z � N 1 unn U" boor• •.uw . .. I yW.r.a •"K Soli te)f_ : _.` .. � y�.e t t�'i x z 4 e:: .,e'-a' � �� __— •, r t,a� �.«r.,.... ,+." ... ....�w .�� �v 14 _ y .� •- �}{ t _Lw ,ram o.:�n, -a: e _ . {"'� �y '�I •. -fW w. rv.�� _ I rs'rr.4wr6 I � � I .� 2. �`J$1i: � .Ip�,,, leruor,'• e `\ �'awwri 1�' — i � 8 n G c+a Ls,uw •a e B w - 8 1 I�Jrul _ 4�»Me Q / It .. ..... ... 4 C • t i �'. .lam. .-I — {.°-•WA6{"Q —� ea :0. . Mw..'. c..... _ j: �� W��e f � �w.nnl •.¢.¢l 14wi0A�t¢JJ y • �V/ V .. / Yti¢. .tiT.L I I ' i! j �s , K l•�t�n.gyp:j`�s�Mcicr: i � --- �w SSW fA jmo-e& so i a 6 y. i WIL 1. .t