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TOWN OF BARNSTABLE BIRLDING PERMIT APPLICATION
Map 99 Parcel Permit#
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Health Division � 10 N J �, Date Issued
���''` ' 1
Conservation Division 3� t'01 04- k— Fee C:) �.olk` UVJA �
Tax Collector A A
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SEPTIC SYSTERR MUST BE
Treasurer Y �M C w l u ,,- : ' l�� 12; -�3 � 4 �- rINSTALLED IN COMPLIANCE
Planning Dept. i e WITH TITLE 5
{MAR 14 200f NVIRONL
Date Definitive Plan Approved by Planning Board T 'w;.'
Historic-OKH Preservation/Hyannis
I I V r 'k IL
Project Street'Address
Village
Owner [4 t- `ten (til IA el i n dC) . Address 5 Q y
Telephone '14 Z a OS^-
_Permit Request P IDD 0" X 3 0 � 2 0-9 F q.0'r 0 I2 X 1fr" Svn Pvr6�► Re �9Ge
\ J C I4y1 at C SO yn-G i ►1TGc"1 o-- rc)Owr� L.a� �7`S ; _L r Jq
new, 6�eVl 4 _ ne.W 10 o4�\ 0 t V vure_S
Square fee Al st floor: existing proposed L 2nd floor: existing �s proposed III Total new �1
Valuation Zoning District Flood Plain Groundwater Overlay
Construction Type W 00 b
Lot Size o �cr Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family V' Two Family ❑ Multi-Family(#units)
Age of Existing Structure Q 7 - Historic House: ❑Yes Ao On Old King's Highway: ❑Yes � No
Basement Type: ❑Full ❑Crawl ❑Walkout 11 Other S I 1Q:5
Basement Finished Area(sq.ft.) D - Basement Unfinished Area(sq.ft) C7
Number of Baths: Full: existing .3 new 0 Half: existing new
Number of Bedrooms: existing new * 0
Total Room Count(not including baths): existing new C7 First Floor Room Count H
Heat Type and Fuel: L/Gas ❑Oil Electric ❑Other
Central Air: ❑Yes UC Fireplaces: Existing Q New Existing wood/coal stove: ❑Yes XNo
Detached garage:❑/existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
,
Attached garage: existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes t(No If yes, site
11 plan review#
Current Use e-5 yb eYl VGV l Proposed Use R esweroV• t oy
/ BUILDER INFORMATION
Name �'V � �;� Telephone Number
Address 3 1 Loi�VI License# w 7/
n
Gr� All Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO q C 6
SIGNATURE DATE 3 13 ;0 J
FOR OFFICIAL USE ONLY
F
PERMIT.NO.
DATE ISSUED
MAP/PARCEL NO. ,
e ADDRESS _ : I VILLAGE = -
4
OWNER
DATE OF INSPECTIONS
• J
FOUNDATIr.
�FRAME �
INSULATION
FIREPLACE .
t y
ELECTRICAL: ROUGH FINAL -
PLUMBING: ROUGH ' - FINAL
GAS: ROUG9b € FINAL
COT" —
FINAL
FINAL BUILDING �
Fri
� ► ..: ,.. �" a_
DATE CLOSED OUT
ASSOCIATION PLAN NO.
i
e own o arns a e
EARNSTAI1e Regulatory Services16,39.
f
�, Eo Thomas F. Geiler,Director
Building Division
Elbert Ulshoeffer, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
r
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
Wilding 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
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requirements. 1
Type of Work: R to 4e,I fi— �` � Estimated Cost 50)00 Z)
Address of Work: � gct4
Owner's Name:.
Date of Application: t 1,
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
[]Job Under$1,000
[]Building not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNERthT.
PENAL , S OF PERJURY
I here'y a ply for a permit as the agen
iq
Date I teontractor Name Registration No.
OR
Date Owner's Name l
q:forms:Affidav
I `
7 0m/RAppmftJ
' ^` TabLJS.Z1b(eomfa�
Prpmipttre Pzek&M for Qas and Twe-Fimill'RnideotW Batldta ila=d with Ed Fcds
MAXIMUM Imummu
=11 ( =zq ceiling wall Floor a slab lleazi*Cooiiag
Ama'('K) U-Vwlti R valnsI R value# R-Wild? wau Pair Maw
t R.vatue' RRrratw'
3701 to 6300 Hneio;Deum Dris'
Q m/. 1 0.40 3t 1 13 1 19 10 1 6 Normal
R 12% OM 30 1 19 19 10 6 Normal
3 12% 030 3t 13 19 10 6 is AFVH
T 15% 026 1 39 13 2S WA WA Normai
U 159A 0.46 3E 19 19 10 6 Normal
V 13% 0.44 31 13 2S WA WA I t3 AF UE
w 13% do 30 19 19 to 6 113 AFUE
X 18% 0.32 39 13 2S WA WA Nommi
Y 180/. 0,42 39 19 2S WA WA Norms)
Z '12% M42 31 13 19 10 6 40 AFC
AA tr/. O.SO 30 19 19 to 6 90 AFUE
1. ADDRESS OF PROPERTY:
_ a
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: J q
3. SQUARE FOOTAGE OF ALL GLAZING:
4. %GLAZING AREA(#3 DIVIDED BY#4-
2 0`
S. SELECT PACKAGE(Q—AA-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-f980303a
780 CMR Appendix J
Footnotes to Table J5.7.1b:
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 wall
area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft 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 sunn 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-frame construction..
'The 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 J5.2.1 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-vaIue
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.
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 more 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(035 for doors).
f
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EsTIMA TEO PROJECT COST WORKSHEET
LIVING SPACE
Value
(high end construction) square feet X$115/sq. foot=
(above average construction) square feet X$96/sq. foot=
(average construction) square feet X$57/sq. foot=
GARAGE (UNFINISHED) square feet X�$25/sq.foot=
PORCH square feet X$20/sq. foot=
DECK square feet X$15/sq. foot=
OTHER square feet X$??/sq. foot
Total Estimated Project Value
1
VMCV
- '' 600 Waslun ®n Street
Boston,Mass 02111
Workers' Compensation Insurance Affidavit
'n'€�carit/:"mat°r�tm�;�%�/////%�///%///%////.�%%�%///////�". i'•�•'�C�"`��'�//%�%%�%////�//%/////////%///%%%�%%%/%///��/%�%%/////////%"';,,....,
name:
location- A'32 McL,v,
city 0 s � hone
❑ I am a homeowner performing all work myself.
❑ I am a sole aro rietor and have no one Nvorkin En
capacityemployer providing workers' compensa for my employees working on this job.
comnnnv name
address: 6
city! 1 �► phone#° my-o l q z i a, S'0
insurance ca. u&- 006J % +Mt; � nlicv# C R'i.e/C 2 d 1 G 10
�i�iii/�ii�/a�i//ir�aiaiid/oii///ii�iiiia�iz�/�iar�/iaii//�/aa�aai�/iaWON�i//�i
❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who
haze
the folloning workers' compensation polices:
cotnonnv name•
address: :.:.. ..:.....
city: .... ,. ;,.t.; .. .
phone#-
insurnnce ca.
comnanv name: ;::;.;.:.....
:..: .. .: :.:.::`'ni%1:is•,.;.:.:.
address:
city- phone
•
.... ...... .
insurance co.
...:. .....
Failure to secure coverage as required under Section ISA of MGL 152 can lead to the imposition of criminal penalties of a Une up to si soo.0o and/or
one veers'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I tntdermnd that s
copy of this statement may be fotwarded to the Oince of Investigations of the DIA for coverage verification.
I do hereby eery der the p and penalties of perjury that the information provided above is tru.anf eorrej%
Sipatnre Date h. o
Print name yw � r Phone# '
E,ncW do not write in this area to be completed by city or town official
permit/llcense# ❑Building Departmenttediate mponse is required (]i.ieensing$oard❑Selectmen s Otn .❑Health Department phone#,, - ❑Other
(revueo 9,95 PIA) .
Y� INSURANCE ..`nc�. I DILL
GROUP Renewal Billing
Detach at the perforation and return this portion of the page with your check in the special
envelope provided. Make sure your check is made out to InterGUARD, Ltd.; includes your policy
number, and is mailed with your invoice to: GUARD Insurance Group,
P.O. Box 7640, Philadelphia, PA 19101-7640.
Policy Number Date of Billing Initial Payment Payment Due Date
CAWC201610-02 12/10/2000 $583 . 00 01/14/2001
REMEMMMER:
YOUR INITIAL PAYMENT IS REQUIRED BY 01/14/2001 FOR UNINTERRUPTED COVERAGE
TO CONTINUE. OTHERWISE, YOUR EXPIRING POLICY WILL NOT BE RENEWED, AND A
NON-RENEWAL NOTICE WILL NOT BE SENT. WE WOULD CERTAINLY REGRET ANY LAPSE,
SO WE ENCOURAGE YOU TO BE TIMELY IN MAKING YOUR PAYMENT.
4A 3 3M
Feel free to direct any questions you might have about this bill
to our Customer Service Representatives at
(800)673-2465, extension 1300.
boCcar"doWu-oilffln�ggegu atlas an an ar s
One Ashburton Place - Room 1301
Boston, Massachusetts 02108
Dome Improvement,'tontractor Registration
Registration: 118118
t- Type: Private Corporation
i,, ts;p Expiration: 02/01/2003
CAPE COD & ISLANDS PROP MNGM.NT --
KERRY MCNAMARA I,( ga — ------- ---. . .- ---
37 WHITMAR RD "-µ ¢ =_ --------- — -----
f9
MARSONS MILLS, MA 02648 g -- — ------ ---
Update Address and return card.Mark reason for change
Address Renewal Employment n Lost Card
✓lop ��s✓ /
ze IJanvrnoauueat a��iUCccddactiu0e%�4
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 118118 Board of Building Regulations and Standards
Expiration: 02/01/2003 One Ashburton Place Rm 1301
Boston,Ma.02108
Type: PRIVATE CORPORATION
CAPE COD 8 ISLANDS PROP MN
KERRY MCNAMARA
37 WHITMAR RDA _ — —
MARSONS MILLS,MA 02648 Administrator Not valid without signature
,.�; '��1�¢TO.O7I�/IltOO�tL1/CQ.G[ILo�✓�irgaaclu�aeka i
ROARDFOF'BUILDlhd REGULATIONS
License. CONS-RUCTION SUPERVISOR ri
Nu01100: . .. 04=116282. a:i
5%1,952 w.
Irs057;�l03 Tr.no: 6762
{ R®strlcted T+. !
Oki
KERRY M,MCNA NE-
$ PO.BOX 1144
OSTERVILLE, MA 02655 Administrator 1.
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4,
,-.02,<_2112001 14:32 15087714396 MELIHDA HOFFMAN PAGE 03
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THIS MOP-` GAGE I NSF>EiCT 10N PLAN IS FOR
BAMLQ$F.�ONLY
TOWN: c -a REGISTRY OWNER:
DEED REF: c,+ 0(a 19(a 2, BUYER: M/A
DATE:•�' PLAN REF: L.C; 7 SCALE:
--Thereby certify that t o GuildinS
shown on this plan is located on �� YA[VK�� SURVEY
the ground as shown and it Gt�NSUL_'TANTS
position does conform to the PAX AL 70 RASPBERRY.LANE
zoning law setback reguirecent of meftTNEWH MARSTONS
MILLS
MASS 48
rJ T 1.E
and does not lie• within the special a�
flood hsxard arse as chow" an
th ,u.d. "f ood ijap dated ® 8
s p ttn n sade frog an inetruMient ��
Paul A. Mar thew. RPLS survey, not to be• used. for fe ce' et
SMOKE DETECTORS O.K. _... .
ARIIIBLE BUILDING D P :
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`OF tHF)Oyu The Town of Barnstable
BARNSTABLE. = Department of Health Safety and Environmental Services
Y NASS. 0Q
�A i639� �0
fEUMP�p Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection / A
Locatiop Permit Number
Owner - G �11fti `'� Builder
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting:
I Aug, ffi�� io
LAC
1�1 el P UAL` Ld, v3
Lol
Please call: 508-862-4.0_38 for re-inspection.
Inspected by .,� /, G
Date L� 4
oF1HE��� The Town of Barnstable
BARNSTABLE. Department of Health Safety and Environmental Services
9 MASS. 0
G�p t639. `0
rEOMP�p Building Division
367 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspections tV\-s {"
Location 49tV br-( 1 yJ• Permit Number f t
Owner �VYLII +2_ Builder s Vt-' !Z!N rt' , PLC
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting: f
l
Please call: 508-862-4038 for re-inspection.
Inspected by
Date C)(
FEE _
pb TOWN OF BARNSTABLE, MASS. �
19
yo
�.Nppp
(D FJ THIS IS TO CERTIFY THAT A PERMIT IS HEREBY GRANTED TO
V O
•. V _................................................................._.....__................_....._.......................................__....................... ..............._._..............................»..............................................
......._
O Etl a"� (PROPERTY OWNER) (ADDRESS)
�
C o 1.a TO ...........................................................................................__........................_........._..__..............................................................__.
.y pp ..............................................................................__.___
H^. P T) (BUILD) (ALTER) (REPAIR)
IDg a�
............
........................................._.................
....
_._...._.............................. .............
...........................................
........................_.........._
O O (TYPE OF BUILDING) (APPROXIMATE SIZE)
M
onLOCATION ............................................................_._..........................._........._..... .........................................................................................................................._._....__-_
I y (STREET AND NUMBER) (VILLAGE)
NAME OF BUILDER O R CONTRACTOR __..—_......_---------_----_--------------_........................................_................................................._............
cc
_...__
>h
APPROXIMATECOST ___........... ............._......................................._............. ..._
\ y c bo ca I HEREBY AGREE TO CONFORM TO ALL THE RULES AND REGULATIONS OF THE TOWN
atCD
OF BARNSTABLE, REGARDING THE ABOVE CONSTRUCTION.
o F0 0
0
0 3 "= _........_........._....._..........._.._..._..__..._................................................................ _....._..............._.........._.................................._..............................................................................
h yd's co (OWNER) (CONTRACTOR)
dyap
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... ._........................._.........._....._.__.........._........._........._._._....._......
BUILDING INSPECTOR
Subject to Approval of Board of liealth.
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Assessors map and lot number ...........................3...............
IV
INSTALLED IN COMP ANCE
i
Sewc;ge Permit number /a/ WITH ARTICLE I.......... . .........:.......................... I STATE .,.
SANITARY CODE AND,_Tfl
TOWN OF BARNS" E, L:µ
�pF TN E TO
i BARNSTABLE. i
Nb q ••� DUILDING INSPECTOR
go?M a•
APPLICATION FOR PERMIT TO ....... .......... . ............. ...............
TYPE OF CONSTRUCTION ...............lr0.. .................&1�..v`C."'...................................................
..............
.......y.. .... ......................19.7./
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......... ........ .............f........... �'.L?.� .4'.0 .v�..1...�' .......................................
......................:....
ProposedUse ......../. LUW T�.............. ........... .1. .�.1 .! . ............................................................
2 J /
Zoning District ......... ...........................................Fire District .....�.�i.�T..'.�'.��V.�..`..:p....,r.... .7�'.Q-V...l..�. �
O 6Y3 1 �. �. '�1. ......Address ....Jr......`7.�i�.h.. �-.�.......�`'.............. land is
Name of Owner 1�........(..........
Name of Builder ... !�1 .....!`�C� e S Address 5'Ni���C�;� „✓??U �2? �O T! � Oa��► .
........................Address ...........� �:.'!�`r.....................................................
Name of Architect ..�.��.. .......1.��:Ps
i
Number of Rooms " ...............................................Foundation ...: ..... ......... .l�?. l:.�................
............ �«. ...
Exterior ......... a. r:7.C..4..........................Roofing .... l l
........... ................... �.��...................
Floors/ .Gc<.C�.0...4°.�...... /�:�j,� .1.:.(.t�^ ...............Interior ........ ..........................................
Heating .(.�" .l Y.�.!..0..................................................Plumbing .....1...G i4l �;i.......1.......1....... ....f.T t....................
Fireplace ......../hO.................................................................Approximate Cost .....��. ..,G�. ............................. :.........
Definitive Plan Approved by Planning Board -------------------_-----------19________. ;� Area ..........� a. .............
s
Diagram of Lot and Building with Dimensions Fee ..... ................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
4
I hereby agree to conform to all the Rules and Regulations o the Town of rnsiable`regar ing the above
construction.
Name ...... .....................
Hoffman, Robert A.
�75 r Permit for one stork'
No ....................................
r
single family dwelling
Location ..........Bad'.Lane....................................
Centerville j
...............................................................................
Owner Robert..A....Hoffman. .............
............. .... .... ...........
Type of Construction .....frame
........................... ................................................. e
Plot ............................ Lot ................................
Permit Granted .......... pril...... ..:...,.19 7 C
I
Date of Inspection ........ ......... ................19
Date Completed .........19
E
PERMIT REFUSED !
................................................................ 19 :
................................................................................ 1
jII
................................................................................ 1
............................................................................... t
Approved ..,.':........................................... 19
{
............................................................................... _
Assessor's map and lot number ............................ l7
n1, 4I �: Q�
9f F THE
Sewa Permit number�..:... ...G7..� �0`�:.3 6������ Jo -
:. DING p�
®oY�4 L T ADL
House number ... .... .... LE a
= TOWN' OF BARNSTTA L� lI IVIRONMENTAL CODE
EN
TIONs .
: 1UILD1N,G INSPECTOR
APPLICATION FOR PERMIT TO .......1.7.ao.....r.?1/ �� ..... '. ......... � C ......:.....................::.
........:...........:................... TYPE OF•.CONSTRUCTION .........4!.oQf>)......�.�!,��,,,'/9C ...:.......................................
} ............ ....... ....f...............I q.. 3
TO THE INSPECTOR OF BUILDINGS:
,The: undersigned,,hereby applies for a permit according,to the following information-
-A/
Location ............ ..... .. L !'r ...../.. .L. /• .........................I ......................... .................................
Proposed Use .... C��' f�....:�7i� ' Fr /......."�!9�45............ ........ ............ ... ........................
Zoning District ........!�.A . ................................................. .Fire District ................. G•STL�TUI.L_C .....................
Name.of Owner l`a.'•�P/�� �GuLZlf1//�9..1'T�!/7 Rlslll�� .Address .4Y........ ............. �1 G L .. .�..... r
Nameof Builder .. 2t. ............................. ..............Address- ....................... ........................................... _ ..........
Name of Architect s .... ...........Address ....
C3) ,� ,� e s /� e a �y') w iTl4 root/Nrs
Number, of Rooms ....... .. .. 1��.. 1./.....7v...! �'.,..:....:Foundation ... _ 4.. .... .
Roofing '
Exterior V�'Af ... . sIP
.....................:......................
Floors Interior
lei
Heating /P �21C r �� Plumbing —
....... %93... �3t�.... ............. .................. ....... ..
Fireplace ............ .... ........................... .Approximate Cost` .:(F.�C ......
Definitive Plan Approved by Planning•Board _ __________________________19 ______. ' , Area ... .......
Diagram of Lot and Building vyith• Dimensions Fee
�b0
° ,SUBJECT TO APPROVAL OF' BOARD`OF HEALTH
L
07 o
--UPANCY ARLD FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstableyregarding-the above
construction.
. °
Name
Construction Supervisor's. License
E HOFFMAN, ROBERT & MELINDA
to ADDITION
No 2 4 8 4. , Permit for ....................
FOYER & GARAGE %Single •Family Dwelling r
..... .... ............................ ........ ..................... -- ;
695 Bay Lane
Location
.................F.................
Centerville , ..
............. ................................... ............. - 1
t Owner , Robert & Melinda Hoffman
........................................................
-� Type of Construction .Frame........................................ _ .
! Plot .......... ............. Lot .................... ?
March 14, 83,
Permit^Granted rl 9 j+ ............................ 1' S
y Date of Inspection ..............................19 ;
Date Completed J�:1�".<--....Z-:......, .l �3 +
1
Assessor's ma and lot number ......................7 p CF THE TO
O�
Sewage Permit number--7........... -../ .�.�?............. s
tea' Z 139H39TABLE, i
Hose number ........ .. '°0 1 39• 0�
A a MAY a'
TOWN OF BARNSTABLE
BUILDING : INSPECTOR
APPLICATION FOR PERMIT TO .......A�h.. l� r� . /J � ......................
TYPE OF CONSTRUCTION .........�!A5.J../Q......//?/Z t e� ..........................................:....................................
............s�.........d ...............19.k
TO THE INSPECTOR OF BUILDINGS:
The undersignedhereby applies for a permit according to the following information:
/
Location ..........."..9,6- ..& 9v.......Z.(.,q 7�'..... .. ;,G—: U. GLL. ....,.. y?. .`... ..:..
Proposed Use j`O/C/? f...... 1. /P Fj /°":0 .....�'!4�� ............ ........................I.........................
ZoningDistrict .... I�..............f....................................................Fire District ....................,.........................................................
Name of Owner !`a.�!°l�l' <!!U(Z/I<<i?!?..•f..?i,./�."•!G✓J,X .Address ..S-l?.?. .....��.�...� ...... .........'...C�'j!t!.��...........
Nameof Builder ....5 '!?C^...............................................Address ....................................................................................
Nameof Architect ... J .................................................Address ....................................................................................
Number of Rooms (31 �PfC-,�", � �I` S e SLl9Q .1r,?)�I, �;S. �f�(Y,�jjwr�L(.
`...✓.....:!?�......9..........Foundation
Exterior .vc'.� /..5!�!!f^rC f' iZ�X7z�jP� II I..........:.Roofin /.......y�......�....`. .. �Pf
L _S7��E7. .. '
.J....../............................................
Floors : ......................Interior ....,............ .............................................
iHeating /PCf I - �✓� t! h.........................Plumbing ...............'..... ......................................................
._�;...
Fireplace ..................................................................................Approximate Cost .........-......................................
................
Definitive Plan Approved by Planning Boarda ____________________________19 _______ Area
Diagram of Lot and Building with Dimensions Fee ........ :....:.... ✓' �`�
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I
a' OGA
/
�S
J L
6?
1—MUCTMANCY—APE-R—MUS REUIRED FOR NEW DWCLLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ..... ... ...`...... . ...............
Construction Supervisor's License ....................................
HOFFMAN, ROBERT & MELINDA A;jIS-,/ 71
)q'g --7
M
24849{ ADDITION
No ........:......*-Permit for ....................................
Foyer & Garage/ Single Family I3welling
...............................................................................
695 Bay Lane
Location ................................................................
Centerville
...............................................................................
Robert & Melinda Hoffman
Owner ..................................................................
Frame
Type of Construction ...........................................
................................................................................
Plot `............................ Lot ................................
March 14, 83
Permit Granted ........................................19
Date of Inspection ....................................19
Date Completed ......................................19
/y/v
I
gineering Dept. (3rd floor) Map Parcel �2 rmit# r `T
House# Date Issued
Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Fee �S
Conservation Office(4th floor)(8:30-9:30/1:00-2:00)
Planning Dept. (1st floor/School Admin. Bldg.) TNE rq
Definitiv pproved by Planning Board 19 ;
_ RNSTARLE
TOWN OF, BARNSTABLE
Building Permit Application
Project Street Address r f
Village 4:4 (el CsLiE t'
Owner Address �� 9 Sr �j' �'�/ C-111f
Telephone ���— �� 27
Permit Request — DO
oo
First Floor square feet Second Floor square feet
"Construction Type
Estimated Project Cost $
Zoning District Flood Plain Water Protection
Lot Size Grandfathered ❑Yes ❑No
Dwelling Type: Single Family ❑ Two,Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: Existing New Half: Existing New
No.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 ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No
Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size)
❑Attached(size) ❑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 Q®�?�16OTelephone Number
Address � � License# 4 2&2 2 5
Home Improvement Contractor# a/Z
4f2 Worker's Compensation# ej6,,C— 1-7zn9y�Op
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FRO THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
BUILDING PERMIT DENIED FOR THE FOL OWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH. FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
The Commonwealth of Afassachusctts
Department of Industrial Accidents
} ` � �� Olf/ceol/n�esllgaUons
600 N'ashin;;ton Street
> ` Boston, Afuv.v. 02111
Workers' Compensation Insurance Affidavit
�r.lir,tnt inform/ati/on• Plestse PR1NT legi�l�=sa , , ', ,
„ame ► ���f?/I�4/�1/
city phone#
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
'!^o`.L' / +'�r-i' JSC!!'+t7'A ,'P•er,'y�4FTN. _ .F•�tf Rr•.—.,'r..�s,Prr. '
., r +-.,..v -, lJ. n ;.} �?i� T. M;.!�{+'yesN�l7�.'.w"rY►��nr"+"'.."'"�y9':.i~,.:'s.Sli�'`'T{�.'_� s�:...��:.....�._�.._._._��
"•• '�..f... - .J M .1V1YWi���— �•�•�. - '"'•+•�� —Lifif Ll V1
I am an emplover providing work-er-s•' compensation for my employees working
.on`this job.
company name �J ��Gi7r%/�i� �j /��✓7 ��D/�/�t�
address; �X �� s f
cite�� �/L S /�� ���4D phone#•
instlr.ince co GW,--,,d/7 police'#
... .r:{. -,.,.,......�,.,.,,...,,.v..,'7�,•..,.... w.,�•rw..,.-�.....sa.....,...g•, +.tLTNylrx,:.•�..-r.•'^'.•--<...�,.:...........�. ..
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:
company n•ttnc•
iddress•
citv: phone#•
insurance co policy#
:.. .......... y..'.—':..^ .. .... �a ...,� _...,..,,.... N�n{.. ... ._cF-;asr �l•Rrl'i'r"• :.T�,^�T4�."�'�o t±RrT:-;'c
, .. .. .. +04 'T•.Y, S.Y�t`•D`M11r! '`?�!kW'�.r.s.��'7Vf� �`H'..$^SF.'i ........._..�
�.._�_...,......�._r1...�..._.__ .. "i-'^ ".iii+i�..�i�i�.r'iiJi►i+► rll{tiLYiilOfYy � 'i:WLGu�"•'•"' .L:+�Y_J"S.
company name:
address:
cin•• phone# -
insur•tnce co IoSX#
_
Attach additional sheet if necessar. .�__._y
r' { .. �• - lii'.i1�Yt4cd'' 4 , IfiY Y/7»irZi[^S�•.1.fLc i:✓i1'.
Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a fine up to SI,SOO.00 andier
one.cars' imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of 5100.00 a day against me. I understand that a
Copy of this statement may be forwarded to the Office of Investigations of the D1A for coverage verification.
1 do herehr Certify 1 the pains and penal!' s of perjun•that lire information provided above is true and correct.
Si=nature Date _Z2Z.Z �
Print name Phone# -7G.2?
rt�.
Tcial use only do not��rite in this area to becompleted by cityortownofficial or to permit/llcense# nlluilding Departmcnt
❑Lictasing Board
O check if immediate response is required ❑Selcetmen•s Office
Dltealth Department
contact person: phone#; nOther
Irev,sed 3;1)5 11JA)
The Tow n of Barnstable
9q, 1 39. ,e� Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227
Fax: 508-790-6230 Ralph Crossen
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.
Type of Work: /j:,� ' � hQ
Est. Cost
Address of Work:
Owner's Name-
Date of Permit Application:_ z�Za 7���-
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 a 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
�/L ' Q
Date Contractor Name
. Registration No.
OR
Date Owner's Name
mr-
if
_:r= :•_ O • O - =o Ui t toy �iR� '.'s�."+u; S� 0( i�•O ��'�r`�+s..�"i ,�"�.��y ��•n ����y, ,
MIR
Tn.
N 5 N
WIA
A ZZ
ij
4CORD..- CERTIFICATE OF LIABILI 'Y INSURANC ID DR DATE(M MID
OIYtI
�AULJ:R2: _
:cep THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE i
ke, Swan & Crocker HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
Lor' s Hollow Rd. ,PO Box 429 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Bans MA 02653-0429 COMPANIES AFFORDING COVERAGE
:er G Walther COMPANY
508-25S-3212 Fax No. A Assurance Co. of America
RED
COMPANY
B Credit General Insurance Co.
Paul J. Cazeault etal DBA Paul COMPANY
J. Cazeault &. Sons Roofing C
COMPANY
D
c. ;ERAGES
HIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
�,IDICATED.NOTWITHSTANDING ANY REQUIREMENT,T�RM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
'ERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE IMURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
XCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
.. ..........
r-- ----------- --
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS
DATE(MM/DDIYY) DATE(MMIDO/YY)
GENERAL LIABILITY GENERAL AGGREGATE !$ 1,000,000
.
.'; ;rtAr+,ERCIi,_3ENERALLIABILITY I CFP25552812 05/01/96 05/0,1/97 PRODUCTS-COMP/OPAGG IS 1,000,000 .
':_.alrn5 r•,uDE : X :OCCUR j PERSONAL&ADV INJURY $ 500,000.C JNTRACTOR'S PROT I -
EACH $ 500,000 .
FIRE DAMAGE(Any one fire) S 50,000.
MED EXP(Any one person) $ 10,000 .
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT S
ANY
�L.:.r:•r:EJ=UTOS BODILY INJURY
NJURY ,
(Per person) S
3CiicDULED AU70S j
i
-SIRE;�UTGS t - BODILY INJURY
j
(Per accident) $
rJGN J`NtVED AUTOS
---- - PROPERTY DAMAGE !S
i
I
3ARAGE LIABILITY - AUTO ONLY-EA ACCIDENT IS —
anY OTHER THAN AUTO ONLY:
jr EACH ACCIDENT S
AGGREGATE $
EXCESS LIABILITY EACH OCCURRENCE $
UMBRELLA.FORM AGGREGATE IS -�
OTHER THAN UMBRELLA FORM S
WORKERS COMPENSATION AND I WC STATU- OTHER
M •
EPLOYERS'LIABILITY i I TORY LIMITS I I
FEL EACH ACCIDENT S 100,000.
-;=PROPRIETORr INCL I SWC17005900 08/09/96 08/09/97 I EL DISEASE•POLICY LIMIT i S 500,000. �
-AR T NER /EXECUTIVE
:FFICERSARE EXCL EL DISEASE-EA EMPLOYEE $ ZOO,000.
OTHER
;RIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
,I
ofing
i
TIFICATE HOLDER CANCELLATION
tT3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THELEFT. I
I
BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
OF ANY KIND ON T E COMPANY,ITS AGENTS OR 5EPRESENTATIVES.
- AUTHORIZE ATIVE i
I
I
JRD 25-S OACORD CORPORATION 1988 j