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A;* t„! � 2t fit' q�•ram! ,<i: :w �i'�..r r:�N� VA. �. �'l'ld'rr'.- J.11 •{;3 q�iY,',�'• iY•t,„a" $ �t h l'ti. 1 ly' f VAN y :r I .t sr tT',..r._`•(, r i, r:9 }, i" iC _, >. ° , r 'Y„Yr ' ,Y ., .A 4t♦ rr..�d,.r ,;��_ ''� ,ty �;1:� '''}••, ;ji'., .''�})'.'< t tt5' ��)_Ir,.., ,tr°-a. rt p�1.Jt, ,'�ti:'�yr ...,k! :iS.°' I�, ttr ^f 'Y. 1•dr;d+r, @:yda..r i _ .,-�I f t► 13/ � 1 ► MMCCARTHY CONSTRUCTION CO. lkko MMC Date: mjmccarthyconst@gnail. - com Building Commissioner Building Department PO Box 52 13W57A J r West Dennis,Ma R--SS 02670 To whom it may concern, This affidavit is to certify that all work completed for Permit Location: q-9 Br—lor?J LAme Has been inspected by a certified Building Performance Institute(BPI) inspector.All work performed meets or exceed Federal and State requirements. Sincerely yours Mic el McCart Application number.....,......................................... ?5 0 0 Fee ........................................................... . ........... 4 MAM Building Inspectors Initials.......... .............. Ak SE? 27 2018 Date Issued ........... ............ "fl � � FMAM O� 8ARNSABLE 16q, (931 , COVI Map/Parcel.............................."................................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATiltRIZATION PROPERTY INFORMATION Address of.Project: 9 �r-(a,e-1 IA., NUMBER STREET VILLAGE Owner's Name: Phone Number � ' ) 3(7-0-k- Email Address: Cell Phone Number Project cost$ Check one Residential ✓ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: ���7//ii TYPE OF WORK ED Siding 0 Windows (no header change) kEg/insulation/Weatherization 0 Doors (no header change) # Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to S4- lta(,(4 CONTRACTOR'S INFORMATION Contractor's name Mike McCarthy Construction PO Box 52 West Dennis, M 0 670 Home Improvement Contractors Registration(if applicable) # '. :�E rh copy) CSL-58633 HIC-169393 Construction Supervisor's License# (attach copy) Email of Contiactor vPhone number ALL PROPERTIES THAT HA 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.' APPLICATION NUMBER ............................................................ *For Tents Only* Date Tent(s)will be erected Removed on ' number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. 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 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 P I ANT9S SIGNATURE Signature ' Date All permit applicatio Isare subject to a building official's approval prior to issuance. 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 Legibly Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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 working for me in any capacity. employees and have workers' # 9. ❑Building addition [No workers' comp.insurance comp.insurance. 10.❑Electrical repairs or additions required.] 5. ❑ We are a corporation and its 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑,Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date'. Job Site Address: City/State/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$1,500.00 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 under the pains and penalties of perjury that the information provided above is true and correct. S ignature: Date: Phone#: 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#: 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 ram..... - 1....... _l 1_ sl�_T...�....�.A..,.......4, - "—beict`iiYi�eC tG-`rii cifijF$i CG$rzdr[ii ut,Er�ztIVt -it t -? se b:dc{! -sG Fsr�z;; r ,��ss�eca 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 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 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 0211.1 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#61.7-727-7749 Revised 4-24-07 ww4v,mass.g©v/dia Jun. 8. 2018 3:38PM No. 321.1 P. 6 CF(I — S195'Zj�� lari rA--3- tHE Town of Barnstable s! — sit o� -Z 4 Regulatory Services Richard V.Scalf,Director y MASS: m , Building Division Paul Roma Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office:508-8624038 Fax:508-790-6230 Property Owner Must Complete and Sign This Section L CHARLES C CASE , as Owner;of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: 49 Beldan Lane Centerville,MA 02632 (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License lxemption Form. C.\Usm\Eecollik\Appbata\L,ocal\Microsoft\Windows\INeiCache\ContentOutlook\L7U69LF21EXPP,ESS(2).doc 61/25/17 �.J y� �Qi1� �' • C�/tr'LCZ'�):If�C�2:!�JE�•[,I� Office Of Consumer Affairs and Business Regulation 101 Park Plaza Suite 5170 Boston*, tlsetts 02116 Home Improva tractor.Registration Type: . I. MICHAELMCCARTHY ; ' "`"` Registration; 139C; P.O.BOX 52 691ration: O 15/3019 WEST DENNIS,MA'02670 Y' - SCA1 ti 20M-05/11 Update Addressand return card. Mark reason forctisnge. molet`�wnt Cl Lea Cant- Office fie�ia�x9�ao�auiea�i o�c�a�;rarluQelta of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:Individual before the expiration date. N found return to: [t °nftImtIon Office of Consumer Affairs and Business Regulation _ _Q3 06/15/2019 10 Park Plaza-Suite 5170 . .. •'.......:i MICHAEL MCC NW- Boston,MA 115 MICHAEL F.MCC', 1 CG ts F. 6 RANGLEY LN. : SOUTH DENNIS,MA*`b2660 Undersecretary Not valid without signature � Commonwealth of Massachusetts Division of Professional,Licensure Michael MCC$li y Board of Building Regulations and Standards Con str : F ow6 b May Qonstruatioh pervisor Has sut uliy completed do National Faster G5-058 t 63S Cellulose Training Coarse _ C Tres 04/i0/2020 &"ft day of August 2011 MICHAEL i hiecA Y PO BOX 52 WEST DENNIS MA 0. ha ( .f.O�area. NATIONAL FIBER //JJ IVOlYIfkfYaftlaeal60fiaf/ ^s••+nc+.w.evc..a..we.�ve, - Gofnmissioner OSHA 001558712 - A; U.S.oepaltrrrent of tabor Oxupational-Satety and Health Administration Michael McCarthy corabbled hassucoessfufiycompleted:ailOhourtkarpal�onafSatetyandHaalth S oa afety 71am�ng Course b1" 3s Acaes ofabu 77mbea id a bouts of field,'ine Cons on Sal &Health::,. R h (Pate) *�- The ConnoxwmM ofMmadmeo Hof IdUdFkd44 1 Cotes S She 100 Soft%MA 6114-2017 wwanwoMa Workers'Compensation Insurance Afiiidevit:BuIldadContradersilleibiclUMVPhunbers. TO BE FILED WITH THE PERIlid9 MNG AMWORI"lY. Mate(Bu31aeai/Organiaadou4odMdnQ: Address: M 4- a1c7�-Phone#: 5-04 Are you sa mooyer?Oink thtappmPrIate box: Type of project(rqNhred): I,E6.am a uployer with_ (full Wwar perV 7. ❑New coastiuction 2.[]I ematph po*toror paron ft and hm no employees woddog foam in V 6. DRoodeling tiny .(No wetkmt'doing.h>shmm tegWmQ g. []Dawlition 3.Q I am a horroew w doing ail wodt mr'W..(No WIDOW=uP.hw=0 teFWQ t 4.0 I am er a Wwwwn and will he hh ft caWadmes to eoodnat ill work on uW putty. i will 10 Building addition owe eat all ceatraatcte either have wwkue m wmmatbm ieturaoce or amarle 11.01Beehrieal repairs or additions pmFietm wkb no employes. 12.[3 Plumbing repairs or additions so I am a pmffg contanmr and I have hhW the seb•onnactcce listed on tie aMdW d at. 13.[:]Roof repairs 'These a6convaeton have emptaypm and have wodmcs mmp.Wwonm.t 6.Q We are aempention and its oBeetshave mwdad di*.d&ofa:tempt W1W UM c 14.[:]Other I A 11(,Q,and we Imve no eogdoyeea.(No wodrms'GQVqL his mw reghdrad l *Any eppIImat dret ehatdm box#1 must aim fin out tlm action bdow a wh*their wofte mmpenasfioa poficy b 6m ate. t gam mem who submit this atadavitindi&d0S they arc doing an workdad&w We o:aside comawn mast submit a dew affidavit indieatug such. tCaherdcoota fiat aha k foie box mist attached an addM mal sheet&owing fbe tame tithe dub-mmmms and state wh&eror not those entities have e:Vbsyeas lithe s�hb actors have employes,they treat pmrdde d wodwW comp.policy tromber. f tun anenphW that is providktg workm'cmremadon inswrmtw frr aty W*byM Bd awls dxPvftcy and jeb*e hformaelan. insurance Company Name: ka-.( L���,t; , P01.0y#or Sett.irs.Lic.#: 1 W C']�I'7 S'�y fixpirati�Date: 1.) Job Site Address: CitY/3tataip: AOacb a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to saeure coverage es required under MOL c.152,§25A is a criminal violation ptmid&a by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00.a day against rho violator.A copy of this statement may be forut=W to the Office of investigations of the DIA for insurance coverage veriSumtion. f do hereby cagy under ojped wy t Wdu trijbmaOmFouNd above k&usand corm Deb: 1 use on(y. Be not write In this area,to be omaplired by CW or town VBW City or Town: Perndt/Lteense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 0.Other Contact Person: Phone M e ' r MCCART9 OP[Do TH �� CERTIFICATE OF LIABILITY INSURANCE D 03/01/20 8 03/01/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(les)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER 508-398-6060 c2alAcT Dennis Office Bryden&Sullivan Ins Agency PHONE 508-398-6060 FAX 508-394.2267 of Dennis Inc. A/C,No,Ext: AIC,No 485 Route 134,PO Box 1497 INMESSO So.Dennis,MA 02660 Bryden&Sullivan Insurance INSURERS AFFORDING COVERAGE NAIC 0 INSURER A:National Liability&Fire Ins INSURED Michael McCarthy Construction INSURER B: PO Box 52 West Dennis,MA 02670 INSURER C INSURER D: INSURER E: INSURER F: COVERAGES E THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR NSR I TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE CLAIMS-MADE OCCUR DAMAGE TO RENTED PREMISES(Ea occuffence) $ MED EXP(Any one rson PERSONAL&ADV INJURY GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE POLICY❑YEL'T LOC PRODUCTS-COMP/OP AGG OTHER: AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO BODILY INJURY Perperson) OWNED SCHEDULED AUTOS ONLY AUTOS BODILY p BODILY INJURY Per accident AUTOS ONLY AUTO ONLY PPeOr ardent AMAGE UMBRELLA LIAB OCCUR EACH OCCURRENCE —1 $ EXCESS LIAR CLAIMS MADE AGGREGATE DED I RETENTION$ A WORKERS COMPENSATION X PER OTH- AND EMPLOYERS'LIABILITY STATUTE_ ER ANY PROPRIETOR/PARTNER/EXECUTIVE YIN 9WC747574 12/15/2017 12/15/2018 E.L.EACH ACCIDENT 1,000,000 (FFICa=9MBF_R EXCLUDED? ❑Y N/A 1,000,000 (Mandatory n N )describe under e Ks, E.L.DISEASE-EA EMPLOYEE y DES I TI OF OPERATIONS below E.L.DISEASE-POLICY LIMIT 1,000,000 T' . DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Michael McCarthy,President,has opted to exclude himself for Workers Compensation benefits CERTIFICATE CAPELIG SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Cape Light Compact ACCORDANCE WITH THE POLICY PROVISIONS. Box 427 Barnstable,MA 02630 AUTH O RIZ ED REPRESENNTATIVE L2016/03) ©1988-2016 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD C-C )It 9 RFL) t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ` U J Parcel / Permit# g (o 4 4 TOVIP4 OF BARNSTABLE .Health Division U //// d a Date Issued 4-c�' (� Conservation Division 4f- 63, ?CT APR I ,Q 7 3�Application F,e� 3��• 0-0 Tax Collector C 6 a T -Permit Fee Treasurer SEPTIMSTEM MUST BE INSTALUD IN COMPLIANCE Planning Dept. TITU S Date Definitive Plan Approved by Planning Board ' EWI RONMENTAL CODE AND TOWN REGUL,`.T= Historic-OKH Preservation/Hyannis Via Addl_ko,N/WiuuY"f &I Skr,1 I. Project Streeess �9 �� �� AlG�/I e t A dr Village +erVI l 1 Owner �c�✓' r .5 �� Address Telephone 5_0S 7 71— (v 4;4_9 Permit Request `i.0 _:� -4G� 7'i av� `� j C.6 en Square f v��e feet: st floor: existing proposed �� 2nd floor: existing proposed Total new q g� p p _� 9 P P Zoning District Flood Plain Groundwater Overlay Project Valuation _ _ Construction Type A>' Chi e Lot Size /00 /Z3• 3 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Veat S Historic House: O Yes XNo On Old King's Highway: ❑Yes ,t*llo Basement Type: >(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 76 9 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new£ First Floor Room Count Heat Type and Fuel: >Oas ❑Oil ❑ Electric 0 Other Central Air: ❑Yes )<No Fireplaces: Existing New Existing wood/coal stove: ❑Yes >No Detached garage:❑existing ❑new size . Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:O existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial ❑Yes Vo If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name -Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE /6 - mac, DATE 2 FOR OFFICIAL USE ONLY PERMIT NO. DATEISSUED ` MAP/PARCEL NO. " ADDRESS VILLAGE OWNER DATE OF INSPECTION: s FO UNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH j FINAL) S GAS: ROUGHT'l }—, FINAL FINAL BUILDING DATE CLOSED OUT `t ASSOCIATION PLAN NO. 0 RESIDENTIAL BUILDING PERMIT FEES * L9 APPLICATION FEE New Buildings,Additions $50.00 -mod Alterations/Renovations $25.00 J Building Permit Amendment $25.00 , FEE VALUE WORKSB EET NEW LIVING SPACE __1��d r��..—square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES (attached&detached) , square feet x$32/sq.ft, ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) 00. Deck �_x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming-Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Fee Permit 1 The Town,of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION //d't Please Print DATE: a/-, JOB LOCATION: Q N yAlg_ G✓1 2d'I//Z& number streetp / village "HOMEOWNER": OF'40 Y-) name q home phone# / work phone# CURRENT MAILING ADDRESS: '7'/ AW 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 procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed-Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. t m � i B. Lori Case 49 Beldan Lane Centerville, MA 02632 (508) 771-6449 April 15, 2003 TO: Barnstable Building Inspector RE: Building Permit Request Specifically 4 Discussion about Plot Plan To Whom It May Concern: Attached to this cover letter is a copy of the plot plan for our original house and small addition(12' x I F) that we put on the back of the house in 1986. However,there is a prior addition that went up a couple of years before this one (in 1984) but for some reason is not shown on this plot plan which is currently on your records. I am attaching a sketch of that addition which includes(a)the den/computer room, (b) family room, and(c)the deck. It is on this existing deck that we plan to build the new proposed addition for which the permit is being requested. As you can see, back in 1984, current zoning allowed us to go out 35 feet, but we only went out 24 feet. Respectfully submitted, Lori Case a M, .5 t CJn u vv a r• � i �r V►, 'tip .;� .. p .+ q. '"4 ,�6� � • N' . .,t •- �" Al 'o—A IAF ' t N- .r �O®•.4'S/^ mJ VG~ i f' R 4•I~ , .' pQ rZ,t '�• nil._' - - .. i• ,,;�y ,{!•. w Fil AA Aug"i 14 Er tw It ra r•,w•14;g'Y •: , � �J •�4�f0 ,f h � r a j'- LI,Sri.:..°t�Mt (�V 74 <1A •A fl�'s� +��e spt^.' t-. .. �' - � 4 +., R1 T`y •f y A Xa 339! .�/� •ire r s, CERTIFIED PLOT P .Aft ;` � ° biNStRUCTION ONLy FOUNDATION FEET IN 4 a " 0 --.LOW POINT OF ADJACENT AAilliSTASs N > SCALE= /"= A0 DAT�a ' E EN®NVELMllV6 La/NC CERTIFY THAT THE; P �. CLIENT SHOWN ON THIS PLAN . ENE REGISTERED JO® NO. 906 . ON -THE GROUND 'A8 IN01, Vl% LAND .' CONFORMS TO THE YOiI NO%"L- R Y�fiE'ER SURVEYOR DR BY, ' • -OF BARNS M r ;,�•' : t:A IN' BT 712 MAIN ST. CH.BY= : 191 �o V '1 S. HYANNIS, MASS. SHEETLOF / ID/1 ' ati�;Fvt 1 9 �-�. L.,,.,_�. - -�. -. .. .. .� - •�� Qom!{(. u ` � I , The Commonwealth of Massachusetts Department of Industrial Accidents Office 811flasti9ations 600 Washington Street Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit name: a' location ci e' ► /' 'de /"U ® � �oi J ^L phone#I am a homeowner performing al work myself. I am a sole proprietor and have no one working in any capacity [� I am an employer providing workers' compensation for my employees working on this job M1;kwr t J .�;"s.�" Lt-^ r �,� 3� ri l+'::t•sr .�nh�.rp _. {_, � �f�;7' -.t=�4,t v:a i < i i� °*, �`tyi��5�.`� :y�r!a tj�'^ x •`wh•�'��'��r��r ���s� ��.�v�e�fi�� tk r �r� �x F.t r v r as �-r ir� �"d�a �'�° fi°"t ,'• ,q" 5•S�,v ,� �"2,y ..x ';f"nr ; •� x L-}. ,t i p a v r h' ,r'�'y.s�? 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Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under thepains andpenalties ofperjury that the information provided above is correct.e and corrrec Signature � Date /2 /,Z vL6j3 ' Print name O L� Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# FIBuilding Department ❑Licensing Board ❑check if immediate response is required []Selectmen's Office []Health Department contact person: phone#; F10ther (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a 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 to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 �opIME Town of Barnstable ti Regulatory Services Lz� ' Thomas F.Geiler,Director 9`SpTE 63 � Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no, Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. ]] l Type.of Work: P�Sr QQVI LL1 i' e�Ci�� ��v`1 Estimated Cost ,5-00 0 Address of Work: JdQ4v Owner's Name: /3 . La/• I Date of Application: G .,J 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 ZOwner 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 4Dte Owner's Name M CMR Appeedac J Table J3.2.1b(continued) prescriptive Packages for One and Two-Family Residential 13nildtav Heated with Fossil Fuel MAXIMUM MINIMUM Giarirmg Glaring Ceiling Wall Floor Usement Slab Heating/Cooling Area'(%) U-valuer R-valuem R-value4 R-value wall Perimeter Equipment Efficiency, R-value, R-value' Package 5701 to 6500 Heating Degrse Days' I2% 0.40 38 13 19 10 6 Normal Q _ - --12/. 6 Norma! • t 0S2 30 19 19 i 10 R 6 ES AFUE S 12% 0.50 38 I3 19 10 N/A Normal T 15% 0.36 38 13 25 NIA 6 Norma] U 15% 0.46 38 19 19 10 85 AFUE V 15% 0.44 38 13 25 NIA NIA FUE W 15'/0 0.52 30 19 19 10 6 ES X 19% 032 38 13 25 NIA NIA Normal rmama y 18% 0.42 38 19 25 NIA NIA Normal Z 18•/. 0.42 38 13 19 10 6 90 AFUE AA 18Y. 0 50 30 19 19 10 6 90 AFUE 1. AD DRESS OF PROPERTY: e� -1-2✓✓� V lT GG�G9-- ®Z!a�2 - 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: /IG 3. SQUARE FOOTAGE OF ALL GLAZING: / 4. %GLAZING AREA(#3 DIVIDED BY 92): �G 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED FOR THIS S OF DETERMINING ETE I NING ORGY REQUIREMENTS ARE AVAILABLE. ASK U BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-580303 a 4l� l 780 CMR Appendix I Footnotes to TableA2.Ib: doors, skylights, and a Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass 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 fl of decorative glass may be excluded from a building design with 300 fl of glazing area. Z 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 ceiUng.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. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-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. 6 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 de-scribed 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 J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the use the opaque door U-value to determine compliance of the door.a glass area of the door with your windows and u p q One door may be excluded from this requirement(i.e.,may have a U value greater than 0.3 5). 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(0.35 for doors). 43 Engineering Dept. (3rd floor) Map Parcel 0`3/— 00 Perm t# 7 Q 6 House# - Date Issued q 2 `I Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) W I L VN Fee i U7) Conservation Office(4th floor)(8:30-9:30/1:00-2:00) 0 — `�'*4`4 SY'Sr Planning Dept. (1st floor/School Admin. Bldg.) F �� Definitive Plan Approved by Planning Board 19j° ,����•�•. ����`� HKR,i' ABL', �9 rt 74 �ED MA�'� TOWN OF BARNSTABLE � 41V Building Permit Application Project Street Address /1 A) Village Owner �S ,2 �r Address Telephone 722—-ol(,kV Permit Request Z-A First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ y SVO 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 UTo If yes, site plan review# - i Current Use Proposed Use Builder Information Name D v/� Telephone Number 1 9s Address c/o y �,( 4J i7_ License# 0"418 Home Improvement Contractor# 1,04 7 Worker's Compensation#J80$0Z 09.2,E 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 C� SIGNATUREX DATE BUILDING PERMIT DENIED FOR THE FOLLO ING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED - - MAP/PARCEL NO. i f _ ADDRESS VILLAGE, 17 OWNER } DATE OF INSPECTION: - f FOUNDATION f . FRAME ; f INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING T=_ ROUGH FINAL GAS: ,' -ROUGH FINAL FINAL BUI�DIG G �� V q6 5 r: e DATE CLOSED OUT ASSOCIATION PLAN NO. �_ �" `• - �-• �� �-- s �/1�ti..,.r•: ��'`-,rrr:-�-:e= Tii-✓:.ems•• .:.-. �. .r- r r� � �- -err � a!- �v�j_-- ��'�y- A-t� :w•� L%�i..I'����o-� .. . � . 077- - „ U� ' i ZrPgQVEr� COtT.Acta�s �znci tZ Hu=ieirs F.esLZti ers zrd t114e �sL'e�:rter. Fl.ace -rccw 134? I atts GZOS I . Eastcr., CGNTRACTOR is ri 100740 Ez�=r�t:a-, Cc -lifi -- �C�v.•^t l C CQ�.^'Q��:l �at`i j � �= �JG�%� �L�s'-.+".tB2; r - ' I • . _'•: � _ �....�_—•�.,: ice:� C�, T?t Hat-i` _z"_�QVE:MMN--, T'•�C. j ftcmas CaQ 1 ��� j�.G�r�tCii► �C - t rn,�r� r DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPEP.VISOR LICENSE Nuaber: Expires: Restricted Te: It ., THOMAS I CAPIZZI JR 286 PERCIVAL DR i 2 . . .. .. __ AB.E, MA 1.665 • BARNSi The Commonwealth of Massachusetts Department of Industrial Accidents exceORMS&FIfffsss 600 Washington Street Boston, Mass 02111 Workers' Compensation Insurance Affidavit Applicant pans :. location ciry ��/9TT�i /�/� 02. G 9 f- phone IZ�^�S�l� v� I am a homeowner performing all work myself. A am a sole proprietor and have no one working in anv capacity I am an employer pro%iding workers' compensation for my employees working on this job. comi2anv name: nddress:' city phone 9: insurance co oolicv it e5Z-54 le3Q 7-Z 52.E I am a sole proprietor. general contractor.or homeowner(circle one) and have hired the contractors listed below who have the following workers* zompensation polices: company name: address: cn phone 9- insurance co oolicv At comi2nnv name: phone#• insurance co Ian'# a Failure to secure coverage as required under Section ZSA of 41GL 152 can lead to the imposition of criminal penalties of a line up to S1,5M 0 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of SI00.00 a day against me. I understand that a copy of this statement may be forwarded to the Oft;ce of Investigations of the DIA for coverage verification. /do hereby certify under Oa-pains and pen a of perjury that the information provided above is true and correct Signature - Date —1l�Z^ 97 Print name ��r'J'fi�?_� �•� ��� Phone 9 of 621 use only do not-4 rite in this area to be completed by city or town otileial city or town: _ permittlicense p riBuilding Department �Licessing Board check if immediate response is required 261 ❑Selectmen's Ottiee OHealtb Department contact person: phone a;_ (508) 398--2231 ext. mother trevesed;:a3 PJA1 t•�, pfr� _ The Town of Barnstable Department of Health Safety and Environmental Services • 9� � �� P 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- //,/Z ;I AFFIDAVIT HOME Ili IPROVEMENT 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 ;74IA15�16� AV1_1571_1Z114 Est. Cost_ -6 Address of Work: 01 ;��yL ,�oJ Owner's Name_ 2ellyj 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 PERbIIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME I12ROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A SIGNED UNDER PENALTIES OF PERJURY I hereby applyfor a permit as the agent o the owner: Date Contractor m Registration No. w OR Date Owner's Name PLOT P LAN �;� FOR LOT Indicate-location of gauge or accessory building Aaditio=with dashed hats - 5 _ierige disposal (cesspool) ED (Lotr...................fr-.rear) I IS. --.— — ,�• Abuttor's e Name Rear yard tat# R • ..............:..fr. is is a °' if this is a t ,_ : cnrae:lot, writc is nz=c of Ct' Sideyard HOUSE Sideyard other szicet. •h, it. S Set Back 1 : ................:ft. ftvs:tage) , / /A,/ of sneer) / � Iaforination . . M=rk No rth Point 4 -zq �4-, krc,C, S �Y vl� �� 1 Y .e f 'TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map � Parcel p 0 / 00, Permit# 440.3,E Health Division 2— 12 07 -Pe'L tz, Date Issued y�—� /1 Conservation Division P410�i n JA Application Fee Tax Collector 4 Permit Fee43Q � Treasurer X- 7 O Planning Dept. SEPTIC SYSTEM MUST EE ' INSTALLED IN COMPLIAN Date Definitive Plan Approved by Planning Board VM TITLE 5 Historic-OKH Preservation/Hyannis gMRONMENTAL CODE AND iwuLoONS Project Street A�Ie-[):kr ess ,,.,o4/)e Village V) �. Owner 0 ri Ca Address � � ✓1 /Vt��� Telephone Permit Request Square feet 1st floor: existing / proposed 2nd floor: existing ��� proposed —' Total new Zoning District Flood Plain Groundwater Overlay —Project Valuation---,/cS Construction Type Lot Size -/ >C' / 73 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 'V Two Family ❑ Multi-Family(#units) Age of Existing Structure yea r� Historic House: ❑Yes o On Old King's Highway: ❑Yes !Ii�No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 76 1 Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count PIZ --� Heat Type and Fuel:XGas ❑Oil ❑Electric ❑Other Central Air. ❑Yes Vo Fireplaces. Existing _ New_ Existing wood/coal stq,,e: O`Yes ' )klqo Detached garage: ❑existing ❑new size Pool:❑existing ❑new size Bari❑existing ❑iAw size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Othe : �a Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ � rn Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name ,� P �lI✓/ �— .� Telephone Number ��—� 21-6 _Address /�-�/� L License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 d • „ FOR OFFICIAL USE ONLY PERMIT NO:' DATE ISSUED t MAPI PARCEL NO. r. •� ADDRESS VILLAGE y OWNER t ' r DATE-OF INSPECTION: FOUNDATION ` FRAME INSULATION 4 ! � FIREPLACE ; ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL • GAS: ROUGH -' } . FINAL' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. �' ` �•� • t , n f 0 The Commonwealth of Massachusetts - - - Department of Industrial Accidents Office ofloyeslig8daas _ 600 Washington Street _ Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit VIAii ci Pam\ 2 r0 I 1 �v 3 I am a homeowner performing all work myself. 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':?.:.F:::, x.,i•.,.:;;<.:.,r.::?•.y ..,:.:,.:n.7:::,.:. aired m►der Section 25A of MGL 152 csa lead to the imposition of erlminal penalties of It fine up to 51,500.0o and/or Faitma to scrota coverage req enalties the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. Imtderstmd that a one years'imprLsonment as weII as civII p copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage veriHcatfon. hereby certify under the pains and penalties ofPedurY that the information provided above is^and correct Date JC.{/ 2- 4 _ Signature Phone# FS Print name aMcial use only do not write in this area to be completed by city or town official . - perndt/iicense# • ❑Building Department city or town: �Licensing Board ❑Selectznea'a Office &e if Immediate response is required ❑HealthDepartment contact person: phone#; _ ❑Other (xniwd 9/93 PJN Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct.buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. VON Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situationand supplying company names, address and phone numbers along with a certificate-of insurance as all affidavits maybe 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 peimit/license number which will be used as a reference number. The affidavits may be retumed 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. OEM- The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents amce of investlgatlons 600'Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhone#: (617) 727-4900 ext. 406, 409 or 375 i �oFtHe, ti Town of Barnstable Regulatory Services &UMSTABU, i Thomas F.Geller,Director ar.+ss 9� i639• A Building Division AlfO�,� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Work: Estimated Cost Address of Work: Z / ��/ � T�flUI Owner's Name: Date of Application: d 0-3 I hereby certify that: " Registration is not required for the following reason(s): []Work excluded by law ❑lob Under$1,000 []Building not owner-occupied weer pulling own permit Notice is hereby given that: a 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. 2o� R T, .e Owner's Name THE Town of Barnstable Regulatory Services BARNSTAB Thomas F.Geiler,Director 0 MASS. .e� Building Division TEG Mph s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: f�I / number street village W «HOMEONER": Q r if �� S P 71 / ��� �O — ✓�Q name �j home phone# work phone# CURRENT MAILING ADDRESS: 7 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as 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.ASection 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 procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official _ Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION t .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section*109.1.1=Licensing of construction Supervisors);provided that if the homeowner engages a person(s).for hire to do such _ work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed. Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt TO: Jack Fitzgerald Building Inspector Town of Barnstable RE: Deck Application 49 Beldan Lane Centerville ON: July 24, 2003 Dear Mr. Fitzgerald, On May 8, your office issued a building permit(#68644)for a kitchen addition at the above address. On that application, we forgot to request and include in our plans a deck to replace the one we were removing to build the new addition. Currently, we are at a standstill ip trying to finish up the electrical and obviously cannot proceed with the insulation and sheet rock until the rough electrical inspection is approved and also your rough inspection for the framing is approved following the electrical inspection(plumbing has already been approved). I only have one more week before we go on vacation and would like to get the addition weather tight (hope to have the electrical inspected on Monday). Since there is nothing else that can be done for now until both rough inspections (mentioned above) are approved, the only thing that can proceed to keep the building progress moving forward is the building of the deck. As we started to plan for its construction, it suddenly dawned on us that we had not included it in the original application for a building permit. I was wondering if you would be so kind and look favorably on us by looking at the attached plans and application and approve them at your earliest convenience. I apologize for this oversight and appreciate any immediate attention you can give to this quick approval. - Thank you so much for your consideration! Respectfully, B. Lori Case Owner of the Home 49 Beldan Lane Centerville, MA 02632 (508) 771-6449 f �A �4 The deck will be constructed with nine(9) sonitubes on the outside of the deck. The joists will be supported by a 1Ox12 pressure treated board on the larger space side and a 2x10 pressure treated board on the smaller space side. The joists will be placed every 16 inches on center. The widest span of the deck for any joist support will be ten feet (10') Or `'� �1a S. f .✓S`��Oifi �V� ' i �j�/ -'^"'� v2tt �=S' ��1 S nf, -fl xr fir' ,M•a IV CAS Ze 1 r # ow%) " M J J �2l'.7� ,ar Iw.� � _ • X �tee' Eei. ' �'0, Ag 6 11 4 � ,3:�:.• : ' CERTIFIED PLAT X new ~; � 49TRUCTION ONLY : , IN _ wK: OUNDATION IS 4 FEET. � ��.�A � <4. , �+ :.L �► POINT OF ADJACENT `A . il x . SCALE' : :/ `-00 DATEt yn•.. � '� �0�/NE7E'R61VG �®.l� if I CERTIFY THAT Tii CLIENT E: SHOWN ON THIS PLAN 1 fi � ThE REflISTEREO 790� ON THE eR0UN0 A$ IND) JOB NO. � LAND . CONFORMS. TO T'HE ZONII�d��#t�'9��r, � �r SURVEYOR DR.by �-- OF ®ARNST jb IW` S 7I2 MAIN ST. CH.BYE _ .r' SS. HYANNIS, MASS. SHEETLOF DA E RE®. LAND � ! ``7.1 4 1�.! A i e a = ✓ t i tt a. 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Fa a > fq�,.>•r pS � r-3�'sx APIA `6 CERTIFIED `PLOT, r PL �r _; �g�y�"p{�p�(�..5+.�, (�,� mF � l.�/�/v��Yi�/G l.+✓�v.J -7. y 5 3 �� ���� ��try tp�WF {¢ry�{IlYCp8uB 9��SfllYp/C Y I®N ONLY Y ✓ {� Q i { ri��/i !{"OYyi�®ATI®N IOi� `'i �.1-'EQi 1 IN }F No 'I CEitTIrIY' THAT THE w uFk� CLIERIT SHWON -.' THIS PL 19 ° -REGOSTER ViL LAND C"ONF®RIAS TO,! THE 1Z® �Ik EW SURVEYOR DR. ®Y9 ®F.: PARRISY I� > •J F zsa t.f/ t7f3 is S ' 712iAIN ST. CIS.By"` Y 9 ss HVAiP � L ®A- E �REQ, LA �5 � ; ff � SF v 7,:a -��.,n, �-+i_ -"":`:�;- '-�-'"' Assessor's- ffice (1st .floor): Assessor's map and lot number ..�.Q... ..-�......:.�� :7�I./Y, SUE , TMEtO�` Board of Health (3rd floor): SEPTIC SYSTEM DIN COSP-.fSewa a Permit number NSTALLE ras t B9B agTADLE. Engineering Department (3rd floor): WITH TITLE 5 9 House number. .................:...................................................... ENVIRONMENTAL CO® c a�a. APPLICATIONS. PROCESSED 8:30-9:30 A.M. and 1:00.2.06 P.M. only T®WN REGULATI®N TOWN, OFrBARNSTABLE BUILDING. ' I.NSPECTOR ' APPLICATION, FOR PERMIT TO )Onn.d...1*A-I. 1--;,)�R?... : TYPEOF CONSTRUCTION ............................................ ........................................................................................ . ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .A4 . Beldan...Lane Centerville.,.... ...Q. .6 .2.............................................................................. Proposed Use ..extension of first„ j1]laJ...rQ.am...&...add it;iax1...a ... xd ..be.dx apm...... Zoning, District ........................................................................Fire District ...C.eA er.Vllle ..Qat.er.v.il l.e................. Name of Owner .Charles...C......(JT:lq) ..&...B.,,...LQr ...CAB�'ress .4.9...Beldan...La.ne.....�ent.� Name of Builder Owner.....................................................Address ....9a e....................................................................... . . Name of Architect Latimer... ..., 4W,5,Qn........................Address ...Taunt.on. MA.....02.7.8.Q................................. -------------- :< S Number of Rooms E'-.Xte?ZS.lOI1,..1. „jbedt0.QM...........Foundation poured...cancre.te..slab......................... Exterior .............:.Roofing asphal.t..................................................................................................... FloorsCdrpet...................................................................Interior .shoe-trick......................' Heatingx1011e........................................................................Plumbingxox........NONE......................................................... Fireplace none ....Approximate Cost $6 000 Definitive Plan Approved by Planning Board ________________________________19_:______. Area - S.q...f t..,/3 ..: . � a ea Diagram of Lot and Building with Dimensions Fee .......... ................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................. ............ ...... Construction Supervisor's License ..... ......... CASE, CHARLES C. JR. & LORI B. 29505 Two Story No ................. Permit for ...... ........................... Single Family Dwelling ................................................................................ Location ....4.9...Be.l.d.an...Lane.............I.................. Centerville . ............................................................................... Owner ........Charles...C.....&..Lori.A-....Case...Jr. Type of Construction ...Frame............................ . ................ ................................................................. Plot ........ ................... Lot ................................ Permit Grahted ........,June 13, .. ...... ....19 86 ............... .... Date of 1'nspection 19 a Date Completed .................. ...........I 9A� -71 ii 0) Assessor's pffice (1st floor): Assessor's map and lot number ... ��� .�...... j{, �"Eton Board of Health (3rd floor): % ✓ — fO�Q ♦� Sewage Permit number ....... .'~'...... .-":... (?9 ...� ' ► ' )r - 2 Basa9TADLE, i. � �. Engineering Department (3rd floor): 900 ,M639• House number • ............................................................. .......... o war a� APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... .........a:...Cl�n!gG ..!...a.;?...... ... f TYPEOF CONSTRUCTION ...................................................................................................................................... t ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 49 Beldan...Lane Centery lle.... MA...0.26.32............................................................................ . P��.1.d.an... .......................... Proposed Use ..!Xx.t.e.n51.Ori of...f rst...f loor..dux►..x g....ro.m...&...adds addition of...Ir:d...) oom C� t x� �e/Os x�ra ��e Zoning District ..Fire District .......::Xb..:�....7...�•.................�..............................:.. Name of Owner .Charles C.jj-K.)....4...8,....Lox�;.-CAMess .4.9...BPS d. aj,..�,a,.x!.�.....Cen.te.r�al�2.e.: .MA. Nameof Builder .own.er.....................................................Address ...SZXMe...................................................................... Name of Architect Latimlp;r &...L3WSQn........................Address ....'.Z'a?unt M .....Q.T.78.0........................ - 7 -:3 6- cD"`s Number of Rooms eXtension..,ax�d,,bedf Q.o ............Foundation z?t?t.i r.:f'c.3... ' nrr tQ„ 7 ......................... Exterior .W0.0...ah]1..1C1tcgleS................................................Roofing a..spbal.t................................................................. Floors ...94 7.Pf'.t...................................................................Interior .-,beetro.rk............., Heating .....................................PlumbingY*'s n........NOt*.T.)+"......................................................... Fireplace ..non@.....................................................................Approximate Cost ...$.6.r.0.00.................................................. Definitive Plan Approved by Planning Board -____________________ _______19-------- . Area ?Sc ft �3Z dU Diagram of Lot and Building with Dimensions Fee --"'' SUBJECT TO APPROVAL OF BOARD OF HEALTH A OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .:..v........b ....c...... `........... al .'"`'..... Construction Supervisor's License ............. CASE, CHARLES C. JR. & LORI B. A=189-031-004 29505 Two Story No ................... Permit for .................................... •;, Single Family Dwelling ............................................................................... Location 49 Beldan Lane Centerville .....................................................................I......... Owner Charles C. & Lori B. Case .................................................................. Type of Construction Frame ................................................................................ Plot ............................ Lot ................................ Permit Granted ....June,.J1 A...................19 86 Date of Inspection ......................:.............19 �. Date Completed ......................................19 0-A CHARLES & LORI CASE 49 Beldan Lane w Centerville, MA 02632 (508) 771-6449 May 27, 2004 Jack Fitzgerald Town of Barnstable Building Inspector Hyannis, MA 02601 RE: Final Inspection Dear Mr. Fitzgerald, We are finally done with the construction of our kitchen and deck. There are two outstanding building permits as I forgot to include the deck in my plans for the kitchen. The outstanding issues you wanted me to resolve before you came back for the final inspection are as follows: (1) Make sure that there was a soffet vent for each air passage way created by the roof trusses; (2) Pour a large cement retaining wall in a short 4 foot open section where the old foundation met the new foundation; and (3) Submit plans to you showing that the roof line had been changed from our original plans. Items 1 and 2 have been totally completed, and item 3 is being, submitted to you along with this cover letter. If you wish to inspect the final product, please call me at my office (508-790-3050) to arrange a time mutually beneficial to us both. Thank you kindly for your attention to this matter. Cordially yours, Charlie Case TOWN OF BARNSTABLE Permit No. ---------_--------- y t Building Inspector »n.0 � rua Cash -------------------- 00 OCCUPANCY PERMIT Bond -._----_--_-- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ........................4..................... ................................I.................................. ............ ...�....__......._._.�_._ _.__ Building Inspector „ i�"• � >'p to - '"'4.. �� �����7 j�f r+' t�l e �. $ _;�,.. (r:..� t t i •'r ! -, `f ,,..+ ha C rti4�'`�'�ftt�.�a a�.,, �� �' X �� ��d dA _ ,�C/�iG�r��/Y r.� r ;�,� O/'�/Y� ., r �� •S tFr+�si�r„TNa6#�'�fx�� �sl a� ' � �d!{!.•� E;'v,� i 1s:. 1..'>.: • i. ,, �. . K•..ii t #�' t'•r+ 1� 'S'��a e�>r��vr t a tyl, i n t -[s�' t R - ~/` - +' .u s• a t�M- +� r a T,p,�,�r�i �� '�i� rx„ ._ ,. ,gyp .. `�� fi E r x„ � { fraR,$•La i'e LYA., '4�F'•„5 1 �, Ott-� >�4*' , ti I ,T t x ,,�z� v f{,,�y,,�};- 'iff(C�,•„i�.. �•,"K-0,' rr r lil t {�`•sZ 5� \ '��y'�4 "�,-�..�...�i� ` , a� a-}}. y�, Y,, r'y�',�+t�t'y�., `",i.+�` .(�+�,. p sy u�^ drt j3 F'tJ- M• . 5 i' t i'�2'zS p .1a q•s 1 V .e_ .cf^., u '� "7 C„"t ,Y 41 ,. S''F �FTJ`Y-T Al ,. r /7 3 3� V 4 �� ki vt - �(1Q. Q� 3 r'-•'r nY £r y,y+k1 744 AL , A s� sk s:a a. .. :9 ;Cw.`NK�I�•d I z .6# ':.,,h f. �11y��J'' s� �`--- /1� Co<..� — G1.'S~ _ s�C .Lc/ :, +. ' r 7 '��s� ��."� �•� �,F as - y i a”IU`aF� 'R t +.,., 't "^ .o•s,�g 9�T� 1hlY _ 4 t r N p 7 7 CERTIFIED PLOT ti rRuc-TOON ON ' i� 4 �® FOUNDATION 9S 3 FEET � � LOW :POINT OF. ADJACENT �� � lit VIA Z . SCALE: ®ATtE� IG9NEFR0NG CO.��� � U��ia i CERTIFY THAT ;THE. j r d w �REr REGISTERED CL0 !� SHOWN- ON THIS PLAN OS „ d®S No. 92G ON THE GROUND AS ON®OCATZ. . ,LAND A 0. .�E'R SURVEY0 ®R.BYs /�� CONFORMS T® THE Z0413� OF ®A R N ST a t lC 'S`P 712 MAIN ST. CH.®�?= �9�' 60 (root MASS.—FiYANAIYS9`AAASS: S iEET OF -/—' / — —LAND ����4�i•l.�.f� •vY.t' , 1 f i t �,y q.}�`�t�Dr � +f assessor's map and lot num . . ................... ..... ... f THE T _ , .. . .... �// Sewage Permit number....... .......a..�!..�"�.............................. � SEMC d d �e,��O STEM IVIu STADLE, i House number ....... 11 Il CoMp............:...... LI {' ' WITH TITLE.S G mo a. F BA ID® . . . _TOWN O �BARN L CO®E A �LATIONS BUILDING INS PE:CTOR ' APPLICATION FOR .PERMIT TO ...... ......................:........ ........................... .......................................:......:.: TYPE OF CONSTRUCTION ................................................:................................................ ........((........................ .. ........... ..... 1 ............1910 'TO'THE`INSPECTOR-OF-BUILDINGS: The undersigned hereby applies for a permit according to the fall wing information: .✓ /Ji Location �C/ .. ........,��.��. �............................................................. ..! .................... .....:.:............................................................ ProposedUse ............. / ..f'` /,�.� •�� .................................. .......................................................... Zoning. District .........A&..............................................Fire District .. ! �%......................... Name of Owner ..��,((.. ! �1/l�J ............ .:.........Address .... ./C/��f(.... / ..... n/ Z -1/................. Name of Builder .............5-? ...............................Address ................. ..... ........................ Nameof Architect ....................-.-'.:.................................Address ...............:...............:.A................................... Number of Rooms ... ......... oundation �I��� :........ / , 4.%1... ............. Exterior .......... Gil.F.S.!........................... ......................Roofing .......... r� Jr.. . ................... F Floors ................... !� ...........................Interior ..............���/ .................................................... :. //..... ......./ Heating :.........�...1. t�r�( . ........:......: Plumbing .. . L!.. .....,f.: .............................. Fireplace ..:. .l r.1<.....................:.:...............:..............Approximate Cost ..................................... Definitive Plan Approved by Planning Board ___ _________19 Area _4 .......�S J. Diagram of Lot and Building with Dimensions,, Fee Tr_..............7......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ewa��� I hereby agree to conform to all the Rules and Regulations of the Tow of Barnstable regarding the above construction. Name .................... .. ................................ `7REENBRIER DEVELOPMENT Corp. �No ..2.2.4.7..9.. Permit for ..Tv a...Sto.ry........... ii........S.ijag.le..Fami.l.y...D.weLling............. Location .Lod.A 4. 4.9...Re1.d.an...Lane..... ...Center. . . ...ville ............. .. .... .. .... ............................ ................ t Gr. e enbrier. ...Develo. . . . ?ent ox " ; Owner ..... .. .............. .. .. ....... ....�..p C Type of Construction .....Frame........................ � y ...................................................... ........... r Plot ............................ Lot ..........."................... F i Permit Granted September; 4, 19 8 0 ............ .............. + r Date of Inspection ....................................19 �= V - �•• y Date .Completed0-4 . r PERMIT REFUSED,— ....... �.. ....... t 4 ..................... r. `}.. ................................ .. ' E ri: ti Approved r .;,:: ... ................................. 19 jl- .. ............................................................................... i 4 .......................................� ..............�yy . �- Assessor's map and lot number ........... ...................... _ THE of ro Sewage Permit number .....:...:.............................................. Z EARNSTADLE, i House number ...... ` ..`..:?......................................................... _ 90o MAO& �0 0 YPYVol p TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............................................................................................................................... TYPE OF CONSTRUCTION �v'Gfi+ ......................... ........................ .........................:..... ................. 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �_- ;_.. '�";'� ��'✓'� !��ti.- 'ice, --� /� .. Location ............���...................................................s....:.............................. ,,...................:................................................... ProposedUse ... 'l%/4..... 1 �!.:/l!..................................................................................................... Zoning District .........ZA6...............................................Fire District .5.....�`':'`.:'J......�:: ilj... .:�.. ........................... Name of Owner ..,. .;.. .. ... .......,.. ...........Address Name of Builder �vrr>> ' ...Address �........................................................... Nameof Architect ..................................................................Address .......... '................:.................................................. ?.............................................Foundation %`��� Number of Rooms :................... r............. . ............. :................ Exterior .......... ...:.(... `Y ...................J........................... g ...... Floors / .. �.........................(`1 .d .Interior f` .............................................. Heating ....:..`..`......:... .`."....,!r................................Plumbing ......... ..........................f tt Fireplace ...-ze, ..............`....................................................Approximate Cost .....-- '`..„ i:G:........................................ Definitive Plan Approved by Planning Board _A1_---- --- 19f�__!a. Area �' .C%........................ Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH • t J� x' I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. mm Name ....`....................................1................................. GREENBRIER =7` �OPJMEN'T CORP! A=199-31 r No --21-2-4-7-9.. Permit for ..TY9...St0...y.... ...........$ij1.91.e...FAMi.1Y..1)We.11.i;19.......... Location Lot..#4.,....4.9...B.e.l..d...a...n.....L...a..n...e....... Centerville ............................................................................... Owner .....Greenbrier Development .Corp. .......................................................... Type of Construction .....Frame ..................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........... ............................19 Septemr 4 . 80 Date of Inspection .... ..........................19 Date Completed .. ...................................19 PERMIT LUSED .................................... ........ ..... ............ 19 ............ .. .../. ... .../.................... ......................... .... ................................................. .......................... .................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... JJ'Assesso,r s map and lot numb r )..D.�.........0..3 ,,, D y •�,,,ys e-ti r THE�,,A Sewage Permit number A.....:.1..,..�t�.r,�.:..:..,!.�.�...... e BARNSTABLE, i House number V 1A8a ....... ... 9.......... w Op i63 q D MAY TOWN OF BARNSTABLE t BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... -f ..�� ................................................... TYPE OF CONSTRUCTION .........-'�� ...... .... 'r!l.? ? .......................... ...., 194... TO THE INSPECTOR OF BUILDINGS: T'he undersigned hereby applies for a permit according to the following informatio Location ......?...,1.....�` 1. i�.... ................................................../ r..0000 ..................................... /� -7L- A V/P ProposedUse ..........................�.... .......... .:........... ... ....................................:... ..... . ..................... Zoning District / ...Fire District 1��� (" .......................................... ........... ................1/ . .. Name of Owner. .. Q//eS....r../ 4�.r�\...�".(.?,,._Address .......����. ....... ..........�� Name of Builder .Address ..........:........................................................ .................................................................................... Name of Architect r ........Address t � --// Number of Rooms ..................................................................Foundation !'2T� .................. �,_... ...............7........................ Exterior ..... ! / .....................................................Roofing ...... ', �. 7...........................................I..... Floors ........ Q.!!!' ..................:...................................Interior ...... ..P � E'...............,,............................................. Heating ......G�.,.� rr�<.................................................Plumbing ......... �Ovl/L............� ............! Fireplace ... fit 1..:,� ........... ..............................Approximate. Cost ......... . �e..dC3d.........................v. . Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area .......................................... Diagram of Lot and Building with Dimensions Fee ....... ... ................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH Y C?C/sf/�y a, h b vS2 ff / see OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the aEove construction. 12 Name .._ .................... ........................ ......... (A) ��Construction Supervisor's License ./ CASE, CHAJZLES &, LORI A=189-031 Not �..2.6 76.... Permit for ...M4,1d..Addition.. ................. ............. a g.... Location .......49..Beldaa.,Lana.......................... .....................Cexixvi 11 e................................. Owner ....Ch 1e.9...&..L0ri..CasP..................... Type of Construction ......FraM......................... ................................................................................ Plot ............................ Lot ................................ Permit Granted .......q?41Y..ip.z..............:.19 84 Date of Inspection ....................................19 Date Completed ......................................19 • i F ; s is map and lot numb .....`.. .../. .....Q ... ..... , a *THE Sewage Permit number Z E6EH9TAXE. i House number. ............................. .............. ................ .. ...... i 0 NAM 0 1639. 0� �O MPY a`e r TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......2 .......... ...... . .. .... ....`.ti. .................................................... • TYPEOF CONSTRUCTION ...........�.-'.� :::... .. . ..�•a.?'r,�...................................................................... ..... d ... ..........19. TO,THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the,following informatio : yy�t. s � C_.;+Ga���I Location ......1"...01..... ......... .........•E�-' .....................................................././.�..........:......................... Proposed Use ................ ......... ..... ...........: Zoning District WC...........................................................Fire District' ....... 1.. �<.�>! . ..............`"/�� . .. Name of Owner !`....( .Address ...........C Name of Builder ......................... �� � ...Address ........................... Name of Architect. .................... .:............................Address Number of Rooms ..................: .....................:................Foundation .... ......................................... Exterior .....f-�he ..................................................:..Roofing ....... �,<�.................... ........................... Floors �`.• ... i ................................Interior ....:. ...��'r ............................................ Heating ...... G' '!"t4.. ................................. .....Plumbing ....... /&•,0 ....... .. ... �. i Fireplace .... 1 Approximate. Cost Q , ... .... .................................... . ..d ... ...d,.. .ao...... Definitive Plan Approved by Planning Board __ ______-________________19 _______: Area :41S >�� . Diagram of Lot and Building with Dimensions Fee ............ .................... SUBJECT TO APPROVAL OF BOARD OF HEALTH t>S2 see Ir OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I Hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardin;theve. construction.' / • t Name .. . ............... ....... ...... Construction Supervisor's License .................................... x Ck E,. CHARLES & LORI 26676 Build Addition Permit for .................................... ! . .....Single Family..Dwelling.................... - • location 49 Beldan Lane 1 Centerville .. Owner .Charles &. Lori. Case...................... hl Type of Construction} .X ............................. ...........:..................................................................... Plot ............................. Lot ................................ i Perm i,Granted ...J1aly..IQ., :^19 84 -f #'_ .x y•_�._. Date ofiInspection .................4...... Date.Completed ............... ........19, 6 • L^ A , _ �' a ''4 + f d it 4�wF}��d,°��rf�1•}57y�1''J#g fi . .........eq ...'tl 1�s, *lea '� � - - - - �--...;,gyp.. �.:i:-LR ^( ?,�$y�c ..s�'e'^..•nt�-7 f�1��Y��c�� �' rsyf, 41 .,r IV e iy ¢,pAPSM G Q t a CERTIFIED PLOT A y�.. 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