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Town of BarnstableBuilding
«.....�» "^ n . '„ 1
Post,This Card So That it`is Visible From the Street=Approved':Plans'Must be Retained on.Job and this Card,Must`be Kept „�
UARlYS`CAQIp ,x .^"z. at.w. "c y h "A
rr �,„a.R �.
Posted Until Final Inspection Has Been Made _ "4 3 .= ,
i639 �� "£: .•as ,'-I " .i;a,. . tea : x=", ,m , a r. fi r;. K 'rtxar 'a_"`" ki a LS" Y$ <r"tPermit
a +Where a Ceitificafe of Occupancy is Required;;such<Buildmg-shall Not be',Occupiedr;until a Final Inspection.has'been.m.ade `.
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Permit No. B-18-3132 Applicant Name: Mark Lemon Approvals
Date Issued: 09/24/2018 Current Use: Structure
Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 03/24/2019 Foundation:
Location: 609 BAY LANE,CENTERVILLE Map/Lot 187-051 Zoning District: RD-1 Sheathing.
Owner on Record: CULLIVAN,JOHN ; Contractor,Name, MARK J LEMON Framing: 1
,� ._
Address: 635 LUMBERT MILL ROAD t Contractor`License xCSSL-100207 2
CENTERVILLE, MA 02632 4 a t'
Est Project Cost: $5,000.00 Chimney:
Description: strip existing roof shingles and install new 30 year.architect roof Permit.Fee: $35.00
shingles t _ �' Insulation:
i � Fee Paid:' $35.00
Final
Project Review Req: _,Date' 9/24/2018
Plumbing/Gasauk
_
Rough Plumbing:
r is a. Building Official Final Plumbing:
tv,
Rough Gas:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance.
All work authorized by this permit shall conform to the approved application' d the`approved construction documents4or which this permit has been granted. Final Gas:
All construction,alterations and changes of use of any building and structuresshalCbe in compliance with the local zoning by=laws'and codes.
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open forpubllc inspection for the entire duration of the
work until the completion of the same.
Electrical
x r ' Service:.
. ..
ed
The Certificate of Occupancy will not be issued until all applicable signatures by the Building.a'nd Fire Officials are provid on this permit.
y. '_ -
Minimum of Five Call Inspections Required for All Construction Work: =; Rough:
1.Foundation or Footing
2.Sheathing Inspection 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)
s 6.Insulation Low Voltage Final:
7.Final Inspection before Occupancy
Health
Where applicable,separate permits are required for Electrical Plumbing,and Mechanical Installations.
PP p P 41 � '�
g �Vj Final.
Work shall not proceed until the Inspector has approved the various stages of construction.
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department
Final:
Building plans are to be available on site
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
oF'THE„� Town of Barnstable, f *Permit
Expires 6 mo hs ro is we e
i7 Regulatory Services Fee
• EMP.Nsrns[.e, •
� MAM Richard V.Scali,Director
�rEO MA't A
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION. - RESIDENTIAL ONLY
�J Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address (Od� �/�'� Li't�� Ei✓% �/I C L�
Residential Value of Work$ app Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address ULU✓A J
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor ' ��PRESS
I am the Homeowner u1] (J
I have.Worker's Compensation.Insurance DEC 15
2015
Insurance Company Name MIAMI OF BARNSTABLE
WVVIVWorkman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be to
❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
JZjRe-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property.Owner must sign Property Owner Letter of Permission.
A c y of the Home Improvement Contractors License&Construction Supervisors License is
re
SIGNAT
Q:\WPFILES ORMS\b ' forms\EXPRESS:doc
Revised 04 IS
Tlie Cominonrreakh of Vassachuseta
Deparbnent c�,f ru dushial Acciderds
@,f -ce of.£n wfigadens
600 Washington Street .
- ---- Boston,CIA 02111— - -- -
_ t
wro-s-t mrmLgvv1dia
Workers' Compensafian Insurance Affidavit:Bndders/Cantractars/EIectricianslPlumbers
Brant Information Please Print �I
Name(Bosbnesslorganization dual}_ P/
Address: Titer ZA
ifytState/Z-pr. >:—,�/1LL�` �02�3 � �'SO R •So g `l`{9(3 j
Are you an employer?Check the appropriate box: Type of project(required).
I.❑ I am a employer vvith. 4. ❑I am a general contractor and I 6. ❑New construction.
employees(full andfor part-time).* leave hired the sub-contractors
2.❑ I am a soleF m 'etar orPa er- ested an the attached she
et 7. ❑Remodeling
_
ship and have no employees. These sub-contractors have g_ ❑Detnolitiou
wadting for me in any capacity. employees and have workers' 9. ❑Building;addition
[No uroflOP.[S'camp.insurance comp.ksurac[
required_] . . 5. ❑ We are a rtcorporation and its 1�❑Electrical repairs or additions
of have exercised their
3.�-�am a fiameav�er doing all urork 11_❑Plumbiagrepaiss ar'adcFitio�ns
set€ o yu��• right of exemption per MGL
nT3' � '�ffiF- - 12.❑Roof repairs
insurance required.]3 c.152,§1(4h andwe have no
employees-�hTo workers' 13.❑Other,
'
comp.insurance required.]
'Any appKcant&at checks box 91 Est also 511outthe sectionbeIawshul ing thraworkere compeasatiaupo1kyiafoamNd=
1 linmwwneu who sub=.t dais.ML—vu indac=mj they are doing all wank and then hire Gutm&contractors rnnst submit a new affidavit indication such_
'Canusc=that check this boat must attached an sdditional sheet showing the name of the sub-canuzct an snd state whether or not those entities have.
employees.Ifthesab-antractneshace employees,theymnsrpmvide&&workers'camp.policy number.
I am arc elrtplgvr tliattis pros iding ivarkers'cot gmisadatz irmirance for uty enrplojees Below is diepolicy and job site
inforrrration. -
Imurance Company Name.
Policy 4-or Self--ins.Lic-4: ExpirationDate:
Job Site Address: Citylstat zip:
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$1,50D t7O andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a rine
of up to$254-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of
lavest gations of the DIA for insurance coverage verifx ion-
I do here certi �u 'is acid jades o u that the ire orrrr ' rr sided abmw is brace acid correct
by � P� P� .i�F�,7 � .� .P�
` te:
r
O,jj'acial use only. Do not write in this area,to be coinpletad by ttify artown ajjSciaL
City or Town: PermitlLieense#
Issuing Autherfty(drde one):
1.Board of Health 2.Building Department 3.CitydTown Clerk 4.Dectrical Inspector S.Plumbing Inspector
6.Other
i
Contact Person: Phone#:
II
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers ID provide wormers'compensation for their employees. �
PMM=t tD this sttute,an.m playee is defined as."_.every person in the service of another under any contact of hire, +
express or implied,oral or written."
An enTlayer is defned as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged is 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 apm meats 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 airy
applicantwho has notproduced acceptable evidence of compliance with the insurance.coverage requir-ed_"
Additionally,MCL chapter 152, §25C(7)states'Neither the comma awrealth nor any of its political subdivisions shall
enter into any contact for the performance ofpublic WD1k until acceptable evidence of compliance with the insuranc6._
r ents of this chapter have been presented to the contracting authozity_" `
Applicants
Please fill oil the workers'compensation affidavit completely,by checlang the boxes that apply to your situation and,if
necessary,supply sub-contractor(s)nane(s), addresses)and phone number(s) along with their cerlificafe(s)of
T„cn-ra„ce. LmmitEd Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insarance. If an LLC or LLP does have
employees, apolicy is required. Be advised that this affidaYit may be submitted to the Deparhnent of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be retmmed to!he city or town that the application for the permit or license is being requested,not the Department of
h1anstrial A ccident s. Should you have aay 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 entry their
self-insurance license number on the appropriate line.
City or Town Officials .
f -
Please be sore that the affidavit is complete and printed legibly. The,Department has provided a space at f e,bottom
of the.a$davitfor you to fill out inthe event tho Office ofIuvestigations has to contact you regarding the applicant-
Please be sure to fill in the pemmit/licrose number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license,applications in any given year,need only submit one affidavit indicating current
policy inffbrnation(if necessary)and under"Job Site Address"the:applicant should write"all locations in (cty 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 ovt each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venire e
(ie_ a dog license or permit to bum leaves etc.)said person is NOT rDquired to complete this affidavit
The Office of Investigations would Izlm to:thank you i a advance for your cooperation and should you have any questions,
please do not hesitate to give us a call
The Departments address,telephone and fax number.
Ca=-Ian to of Massachu etts ,
Dega dmmt of Iadnstdal Agents
Cuff m of I•veg6gatio---
�Q4�asl�ingtan t ,
Bastau..,IA Q111
Tt~L 4 617' 7-4}00 4€6 or i-,a77-MASS4FF
Fax#f 17-`27-7M
Revised 4-24-07 ww ma �a�f c�a
Town of Barnstable
,,• Regulatory Services ,
ofVKME TQ Richard V.Scali,Director
Building Division
BARNST'ABIX ' Tom Perry;Building Commissioner
MA.SI
163y. 200 Main Street, Hyannis,MA 02601
ArED www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: /S' /S
kJOB LOCATION: �✓ Tt,C 1/J LLe—
number street village
"HOMEOWNER": C Lj ova,✓o�,j
name home phone# work phone# .
CURRENT MAILING ADDRESS: r6 t L
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"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
proce equirements and that he/she will comply with said procedures and requirements.
Sinof
wner
Ag 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/he"r 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:\WPFILES\FORMS\building permit formsT-YPRESS.doC s
Revised 040215
,i
pFtHE tp�Y
T
t SARNSTABM #
MASS. ,.� Town of Barnstable -
�rEO MA't s
Richard V. Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 t Fax: 508-790-6230
Property Owne ust
Complete and Sign his Section.
If Using A uilder
I , as Owner of the subject property
hereby authorize to act on my behalf;
in all matters relative to work authorized by building permit application for:
(Address o Job)
Signature of Owner Date
Print Name
If Property Owner is applying for pe it,please complete the Homeowners License Exemption Form on the
reverse side.
QAWPFILESTORWbuilding permit forms RESS:doc
Revised 040215
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p ......l............ ..................C 1
SEPTIC sYSrE
7� INSTALLED I M MUST g'E
Sewage Permit number ..........::.............................................. WITH N COMPLIANCE
ARTICLE It
CF THE T '
TOWN OF BA RtASTAT N
Z ID3 STS11LS, r'
9� MPY M69 ;�� -LD. IIHG INSPECTOR
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O FO _f PERMIT TO .. 1��: .................�1.IO.C�1.(��...��i�!� ,... ..•5�f ..........
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F . 4��C-6
TYPE OF CONSTRUCTION .. .. ............... ....... .................................:............:..............................
;a '= ....................................1,9...
TO THE INSPECTOR OF BUILDINGS:
The undersigned_hereby applies for a permit
saccording to the following information: ko.ks
l.� i ../"i�� .�..� 1(.....�..7 .1.............................
ati n ............ .... r.. .... ... .��.. ................
ProposedUse .... ........F& ........ ..............................................................
Zoning ,District .. ... .........:...................................Fire District .......Gp.` ........................................................
Name of Owner i - %� ... �.:�� .....Address ..... � ...'" !: 3 — L=:.1�.... � -
Name of Builder , .`i4 .� �.. (�. :..`�.........Address /. J...... -�. .c..:t......................
Nameof Architect ..................................................................Address ....................................................................................
K y�
Number of Rooms .........5.. ..................................................Foundation
......1..:`�. ............ t .
Exterior ................ . ....&41v .....................................Roofing .... ...... ... ....................................................................
Floors i Aj�.0.............................................Interior .........................................:
........#.... ........ ..Q.. ..........................................
HeatingA...().. .....!✓.(V....... .�. ....................................Plumbing ... .... ......................................................
Fireplace ` ......�-...t�., .K..................................Approximate Cost ... .dd.. .........................................
l
Definitive Plan Approved by Planning Board ________________________________19________. Area .....1. � :................
Diagram of Lot and Building with Dimensions Fee j
.��?.. ..........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
� t 1
bo
Vo
P
S7 ;�.
lr
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
r
Name .; ........... .....................................................
Macallister, Robert
N
No .1,9.839..... Permit for ....Dwelling..............
...............................................................................
Location ........6.0 9..Bay..La.....Centerv. 11le......
................................................................. .............
Owner .........Robert M=allizter.................
Wood Frame
Type of Construction ..........................................
................................................................................
Plot ............................ 3A
Lot ................................
Permit Granted ........... .. 19...1977
Date of lnspel;tion 19
6
..Date C6mpleted ..... .........19
PERMIT.REFUSED
................................................................. 19
. .................................................................................
......................... .....................................................
................................................................ ..............
Approved ........................... ..... 19
.....................
......................................................
...............................................................................
r ,
Assessor's map and lot number—77
Sewage Permit number l_
TOWN OF. BARNSTABLE
ypi 7NE t0
A BTABLE, i
1639.0 M BUILDING INSPECTOR
O� PY a
APPLICATION FOR` PERMIT TO .. r?.'s T�� `C I4t t.-at fr F10,1AA Rf—�t(�,IIC�'f
.............................,...................................................
TYPE OF CONSTRUCTION ....... � l�. /tA
............................................................�..........................................................
....!.-.........:--..........................19!.�...
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit Jaaccording to the following information: j�
Location ��' BAY L `OV- `� IAJ �LL1 1A A U.
........................................................................................................................................................................
ProposedUse .............................................................................................................................................................................
Zoning District .. � !.............................................Fire District ....... "?................................ .................................................
VnQ)v:,MN—
Name of Owner ..............,........ ......................./..0............Address (� h. �^ _ C A 1
Name of Builder ........... ,tl._f. ..`.�?,N���.4..........Address 1`'vY�! .................. ..7....�i7/ t t lit ....:...............
Nameof Architect ..................................................................Address ....................................................................................
� T�
/U p� N �`�� u/7 .. 1 C/r1
' Number of Rooms ........!.. ..................................................Foundation C............. vT� .
Exterior .......cl,.4 tlln!-� i� ��"'�P1
�j..........................................................................Roofing ...............,....................................................................
Floors t•+'i�'r'�,0 ki117)1a..............................................Interior
....... ................... ....................................................................................
Heating :..�A.......61....1)..4.....................................Plumbing .."''.. ...................................................:...
i J
Fireplace 1/ ........`....6.�� ..................................Approximate Cost ...;//t..///Jd
Definitive Plan Approved by Planning Board ________________________________19________. Area / ?- a,.................................
Diagram of Lot and Building with Dimensions Fee ....:��............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
! Zp
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .....N... .......................................................a ...................
�
Maoallloter, Robert
No19.8.3.Q...... ..... L J^ng..............
/
^�
—~—~-----'—'----''—'---^-----'
Location —.6.097-,Ib-�Bwu.y..La~..[�eozitezz/ille--.
`
. —~—~..---.--...~..----,—..----..
. �
`
' Owner .......Robext.]Maoal.Ustmx..................
�
^ Type ofConstruction ......Wood
..Frame
____.. �
'
` ----.---.—~—.--.—..—~.,-------..
�
' Lot 3A
Plot —..---.----.. Lot .--.-----�---
�
\
Permit Granted ..049i;gMttpu.........19.--lV 77 �
Doha of Inspection ....................................
'
/ Dote Completed ----.--------]g
, .
{
'
�
PERMIT REFUSED
.—.--.,,_.....—...,....----.--. 19
'
�---7 =
/ - .
..............
�
� .----.--'....--^--_.--.-----.....—.---'
>
Approved
�
................................................ lV
/
� -------.--------...---.....—.—..
,
-----------^-------^^---'`—^''
. .
| U
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I Y 1 '
Assessor's Office(1st floor) Map ; � Lot 05/
Conservation Office(4th floor) 'J,� 5 Date Issued 3 o2g 'g
Board of Health(3rd floor)(8:30"9:30/1:00-2:00) 1 7 k Feeo
Engineering Dept.(3rd floor) House#1 ®i��,k.�
Planning Dept.(1st floor/School Admin. Bldg.), � ,
yfinitiSt,Plan Approved by Planning Board 19 �`TOWN OF�BARNSTABLEBuilding PirmitApplicationeet Address
y/ L.!iL) JuSs
Village
Owner I Ofr4 Address
Telephone 7 7 / "7
Permit Request l 13 W t Cab
Ito
Total 1 Story Area(include 1 story:garages&decks) square feet
Total 2 Story Area(total of 1st&2nd stories) square feet
Estimated Project Cost $ /,j,p
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type l C /GC;
Commercial Residential
Dwelling Type: Single Family Two Family Multi-Family
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached Barn
None Sheds
Other
Builder Information
Name (�/e �.� /c' (�'� Telephone Number --f2o S 3 7 3
Address�� � ,�� License# (91(2 8
Home Improvement Contractor# helo i 0o
Worker's Compensation#
C* /
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.6 DATE
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
i
- _ - FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED r _
MAP/PARCEL NO. t 1
ADDRESS. } i 1 VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION _
FRAME' +1 y
INSULATION
FIREPLACE + z
i
ELECTRICAL: ! ROUGH FINAL
PLUMBING: '.�� ROUGH FINAL I f I
GAS: ROUGH . FINAL ;
1
FINAL BUILDING: J
14 y,
1F
DATE CLOSED OUT
ASSOCIATION PLAN NO.
., •r �r � '
• I,,... r it �:.!i�..'A, !
rr�
F
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WAY
04
A
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•� ,y'I.�J,y,, 1 f
CERTIFIED PLOT PLAN /N
1. +'�". � ' t.•T�-- LOT*3 A �
&AY GA NE
CERT/��Y THAT THE FGEJNJAT/ON RICNARD U. O'NEARN, R.L.S.,
AWN ON THIS PLAN /S LOCATED 191 MAW ST.
om THE GROUND AS /ND/CATED AND WEST DENNIS , MASS .
CONFORMS TO THE PON/NG' LAWS
OF.BAK.�-;��i��'•�y MASS. DATE: _ /2-Yi2177 S CAL E:
JOB NO. 03/ CL/ENT.• /Y/4:'.A: Z. -rA�V
zTq �
TE• REG. LAND SURVEYOR DR. 8 Y SHEET_ OF
dP�
The Town of Barnstable
&%RrrsrAMZ
KM& tee$ Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-775-3344 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
containing at least one but not more than four dwelling units or to structures which are adjacent
building g g
to such residence or building be done by registered contractors,with certain exceptions, along with other
requirements.
Type of Work:, --6 yCl/ Est. Cost 3 000
r
Address of Work: L
Owner Name: Zoo ('ltTL/A al416
Date of Permit Application:
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
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 hcreby apply for a permit as the agent of the owner:
Dail
�J Co tra for name Registration No. -
OR
Date Owner's name
/. A n n
LorunoiuvioaltlL of J71aJjachu4etb
Y �aPa.finenl o��'•iu�frial�ccu�ew
600 ! WhU-Vton sty
James J.Campbell &Ion, ///aaac 6dd& 02f f f
Commissioner
Workers' Compensadon -insurance Affidavit
with a principal place of business at:
AVI - 0,Y
(csrisr�z�a)
do hereby certify under the pains and penalties of perjury, that
() I am an employer provid'mg workers' compensation coverage for my employees wori
this job.
r
/x&0/2v,(4)Ce 41A?2lCrJ %4,Q
Insurance Company Policy Number
() I am a sole proprietor and have no one working for me in any capacity.
() I am a'sole proprietor, general contractor or homeowner (circle one) and have hired
conrraccors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Policy Ncr
Contractor Insurance Compare /_pcficy NLr
Contractor Insurance CompanylPolicy Nu
O 1 am a homeowner performing all the work myself.
Cozy of c S_:emem wil:to fo^r:arcee to tf:e Office of in erdgtors of tf,e DTA for enrage verifiaticr and that fyiiu:
cc�raje ree_:ed uncer Sec::en 2rA of MGL 152 un iva to rote Invcsirion of criminai peruities eortsistine of 2 fine of Lp to S 1,SOrJ.G"
•ea imFric--ent well:s ci�•ii ;rinaitia in the far,-cf a STOP WORK ORDER and 2 flne cf Si00.00 a day aPizc me-
Signed this S'T day of lac). 14
r
Licensee/Permittee Building Department
Licensing Board
Selectmens Office
Health Department
iNFOPTxiA.7011' C LL: 6 t 7-727-cc00 X403, 404,
-COMMONWEALTH DEPARTMENT Pf PUBLIC.4AFETY' =� 1
I OF ONE ASHBQRTON PL4CE
MASSACHUSETTS- BOSTON,MA 0.2108
f LICENSE �.
CONSTR. SUPERVISOR CAUTION
•�,�� EXPIRATION DATE �
05/22/1996 . I I FOR PROTECTION AGAINST
EFFECTIVE DATE. LIC-NO.
RESTRICTIONS THEFT, PUT RIGHT THUMa
NONE ` 02/213/11)/4 642838
0 ON LI NSE.
�4 WARREA _ F. SCHIL�t ER +
° 224 Ib A R I 'I E R C I R C L E BLASTINT`$5'F�E A
SS q U1L1-42-7275 ''.` = CQTUIT ria 02635 . �Il��i
AC 1 'i.
*PHOTO OAsrwG OPR ONLY) FEE' f, t "
• U 0 O O NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
STAMPED-OR-SIGNATURE OF THE COMMISSIONER I D
HEIGHT: , '
f I M ,. "1 1S•.
�,r'�•'\ : DOB: � � •
/
I
lilJl.sc/"
I
p�I�I I La- w THIS DOCUMENT My$P BE ' �. J_ SIGN NAME IN FULL ABOVE SIGNATURE LINE
�J� `�� �Y�;.:.-�j CARRIED ON THE PERSOIOF � SIGNATURE OF LICENSEE -
ly'-N.
:�.��'"� �� L' THE HOLDER WHEN EN-
THDMBM r.
- OTMERS-RIG PR I GAGED W THIS OCCUPATION. t, ONER -—
f NOWe
! ' HOME IMPROVEMENT CONTRACTORS REGISTRATION d '
Board of Building Regulations and Standards
One Ashburton Place -- Room 1301
Boston , Massachusetts 02108 $ ?,
rD
HOME IMPROVEMENT CONTRACTOR
Registration 116666 Expiration 07/05/96
4' Type - INDIVIDUAL
WARREN F SCHERER ' s
WARREN F . SCHERER i 9, } `
224 MARINER CIR i .
COTUIT MA 02635 f
A ro 8 26-lG!/8"
8-0° B 0' O° 4 R FOR ACTUAL POOL.
"
(t r ( LOCATION
2
4'-0
• -I m
p rS�atetye /'_p" �� 6'R.FOR WORK AREA ~
I a• ��
b Digging Layout
NSPI )
f � ).r�NO
o TYPE II DIMENSIONAL tr�.1lirCcla
4R.T12Y
- 1 1 SPECIFICATIONS AS APPLIED TO
WEATHERKING POOLS
32 0" 1. Overhang of diving board from edge r'.. o,C.
11 of pool is 2'-8 7/8" (=3 inches).
PLAN LAYOUT ^ ?��' '_�
:� � -&
2. Water depth under tip of diving board
e 4 t
u„ is a minimum of 72" at Point"A". \r, •�j
3. Maximum board length is 8' -0".
2' -8 7/8" (- 3") Overhang Distance 4. Maximum board height over water is .xc[o P iEiCWi
20 inches. '
_ I
R Y'
/, O• �— 20" Maximum Height Above Water 5. Diving board must be centered in width a ""`
I I pool.
of
66d you•E•
Safety Line—Y I Minimum Water Level 6. Refer to manufacturers'specifications -----
4" Below Top Of Linerry) for fulcrum locations.
7. Safety lines must be mechanically at-
Point "A". N Cc tached on one side supported by
Undisturbed Earth—� See Note 2 buoys.
8. A step or ladder or other approved
Vinyl Liner Over means shall be provided at both the
2" Compacted Sand ----
shallow and deep ends. -
LONGITUDINAL SECTION Q—X FOLLOW ALL APPLICABLE SAFETY AND_ _"
BUILDING CODES, AS WELL AS INSTAIlk
TION INSTRUCTIONS .FOR THE POOL
7==7 LEGEND AND ALL EQUIPMENT AND ACCESSORIES.
WR WL WR WL CAUTION: DIVE FROM DIVING BOARD ONLY.
o A-Frame Ass'y
2# 18E 2 Mid-Panel Support Ass'y WEATHERKING PRODUCTS, INC.
WL WR WL WR f ,. ' EAST GREENWICk ! .
DRAWN:R.E.L. APP' J.P.P.
NOTE: SAFETY SIGN SHOULD BE 16x32x8 4RT11 85
POSTED WHERE IT CAN BE SEEN DATE: 12_84
Holiday Coping Layout BY ALL POOL USERS. RADIUS RECTANGLE
f � -
s ,