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0023 BLOSSOM STREET (CENT)
c� � ��oSSCym �� �. �� �,. � '' .-� o �, a I k 0 i i v �� I t f3 a--r vP`.J3 f t -Pat !3 ore S. N a rp, r Sao. o: v Jovnda t i on ^� ' A•/SS.00 �hGJ4bP1U�t f Itane u0 ' ide (d .t da&Jace) qU Cape Fru���e�t � Scate I f1-30 ' . 49 ,�1dtb6ti'tZaad Date 11-7-92 ,�lyurxia, PA 02601 - 90a t3e►uwtt klodgkcza. :: - rY---a i #r "wri—on p. dri loaded " . .tea book 76 p • . 9ha oeindateon shown.on MA ptats i.-tocated vn md ad ehoam hewn .44tback 4egwZtejw.rtU ot; the o'ioA)j.&um tabte, - o IL NE f ` 0 324iJ0 - ss 9Fs�srE��9 �.. _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map e;Z4(0 Parcel �` Application,# Doll G�3 `��� Health Division Date Issued Conservation Division Application Fee Planning Dept. .Permit Fee ��7, Date Definitive Plan Approved by Planning Board Historic =OKH _ Preservation/ Hyannis Project Street Address Villageflv(cle v t G Owner -AtWY �N�f Address 5jK P Telephdne Permit Request 492- •e (A�-Ir� J Square feet: 1 st floor: existing proposed 2nd floor: existing proposed (01 UTotal new Zoning District Flood Plain Groundwater Overlay « Project Valuation das.c-jConstruction Type Lot Size Grandfathered: ❑Yes ❑ 16 If yes, attach supporting documentation. Dwelling Type: Single Family UL�-' Two Family ❑ Multi-Family (# units) Age of Existing Struuctture/� S`'.� Historic House: ❑ 11Qo`Yes ® On Old King's Highway: ❑ 17�1 Yes U_NL- Basement Type: 11 ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 3 Basement Unfinished Area(sq.ft) 7�p 39 Number of Baths: Full: existing C new Half: existing new Number of Bedrooms: 301omitte, �xisting �' new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 21, as ❑ Oil ❑ Electric ❑ Other Central Air: D-Ye--s ❑ No Fireplaces: Existing i New "` Existing wood&6al stove❑Yea ❑-Pdo Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn 0 existing ewize_ Attached garage: sting ® new size _Shed: M-eXl§fing ❑ new size — Other 011 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use it zs APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name /��`� �� Telephone Number C6S Address 1 A0 tjo License# « �Q, -G!✓v'��'� /,�, ( y `Home Improvement Contractor# Worker's Compensation # Uf-G ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IQJ SIGNATURE _ -" DATE C l i. FOR OFFICIAL USE ONLY !E APPLICATION# DATE ISSUED } MAP/PARCEL NO. t x . ADDRESS VILLAGE OWNER I G DATE OF INSPECTION: i ti FOUNDATION 60360*s a '113®lk ' s a FRAME E�ct't•� PD II o t o t�tt ' INSULATION,�gV �l FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH R` FINAL GAS: ROUGH FINAL r `f FINAL BUILDING p . 4r DATE CLOSEDIOUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents t _ Office of Investigations 600 Washington Street ;i Boston,MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianvTlumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual) ,v !41 - a Address: City/State/Zip: n6 JAc kk &,au� Phone _e7l._ d �7_6 Are you an employer?Check the appropriate box: Type of project(required): I;❑ I am a em.p 1oVffl with 4. ❑ I am a general contractor and I employee (full d/ part-tim ,* have hired the sub-contractors 6 ❑New construction 2.❑ I am a sol hetor listed on the attached sheet t 7• ❑ Remodeling ship and have no employees These sub-contractors have .8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. El We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work 'right of exemption per MGL 1],❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t_ employees. [No workers' comp.insurance required.]' 13.❑ Other *Arty applicant that checks box#I 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 now affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. ram 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.#: "'. 't-G �y�S?. b :/ �t`(Expiration Date: Job Site Address:_ W/O,-, S¢ City/State/Zip: IV, r'1s !vt Q Attach a copy of the workers' compensation policy declaration page(showing the policy number and expira ' n date). Failure to secure coverage as,required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify u pains and a hies of perjury that the information provided above is true and correct " �C..� Simafore: 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): I. Board of Health 2. Building Department 3. City/Town CIerk 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the cityor town that the applica tion for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that-the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 Ilse 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 f}ffee of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-$77-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia 'I r NOTICE NOTICE TO TO EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts' DEPARTMENT OF INDUSTRIAL ACCIDENTS , 600 Washington Street, Boston, Massachusetts 02111. 617-727-4900 As required by Massachusetts General Law' 'Chapter 152, Sections 21, 22 & 30,this will give you notice that 1(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE P.O. BOX 4070 BURLINGTON 'MA 01803-0970 ADDRESS OF INSURANCE COMPANY, WCC 500578601 M11 03/16/2011 - 03/16/2012 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street- P O Box 527 ' Agency Inc Stoughton, MA 02072 (781) 344-3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 01/31/2011 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY). DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER f 5. 1_'o.t 9 rl r .eo-t 14 1 r,844 S 9 Q J 6 s Jowidat o z N 30: Ckarc(ie7ra.y .Cane . 40, Wale ( ace) ALL CapeC, Scale 1`!-30 OW-te 4-7-92 Ryunnr&, l'A 02601 _. ... Site jet" o� o•tt, fi4 Son isexuzeU koc eats : c� on a p�cdri :.. . 44 Gook 76 pane 1. 1 ghe iowdation 4hoeevt.opt fiQA p.tari .r4: tocat-d opt �owzd as 4ho�n a txe teo s -a gc� eet�. .the I IL o ` Cn ._. rNNkv o.32 90 - .. _ _ ffGlSTE��9 r; t ..,J.. 2� t PrLCAtI:°•i e .�d �1 1 2 l!S 1 7 Rev. r-----• rr.rS r Y.O. . ►�o.� �:'C��Ph drL �t�l ! ��� lo' �) T / I.'iG..�l.:U:: .•.'ir'i.�ANY •'- . . .S,Oa. I S ' .Cat 1 LI 6,21 '1•�I•:�r � i 1Sv.:T s" � '� vAex'hole i4 &g. 3-j3,R. A�z. £�Gcauate 2 S ' hadura — w, 9.0 to a ate _ , D-e5p w/z`SraNF 0-1 r Ntrj UW'Et.L, ��, r - �5 . , �I C1O► rr� 6.7 ctrwul��vr ` Zane 14.7 '.i �10 Wade ! r +�I=..L c�y1e )vu,•,i12ne�.ir3 l -�, •� --�-V c Isto-&WA St. / Pi. Jt 12-i.:-91 II .� /s s- 40 w de 330 gin¢-,fe Nc ? Q cJpa& t . r� Csl.s.t�tc�n 1000 41 fit r, , cc pp c7kPi Ct�L ��' L" O�j .C� 4:4 :�ea.t AYVC Crude to {'Jl'ood Construction in Flies lr 11!rrcd f(r'LnS: .110 irc�i/r YViirrl Lorca MassaeIiusetts cheeldist for Co III OhmU'(7s0 c5-i.R5301-2•I.I)' Check Compliance 1.1 SCOPE Wind Speed(3 sec. gust) ......... ...:................ ...... .,........... 11D mph Wind Exposure Category :... .... ...: B [/ Wind Exposure Category........ .. .,,.Engineering Required For Entire Project ......, 1.2 APPLICABILITY R Number of Stories (a roof which exceeds 8 in.12 slope shall be considered a story)�_stones <2 stories lam' Roof Pitch ....................:. .(Fig 2) L 5 :`12 Mean Roof Height ....... ................................................. 0 ft 1_<33' (Fig 2) Building Width, W (Fig 3) 5 8 Q Building Length, L .......... ...........(Fig 3) ....... ...... .. .. . ........ _f� 0'8 -��. ' Building Aspect Ratio,(L/W) ................................................(Fig 4) ,Uc.0 <3:1 Nominal Height of Tallest Opening2 ....................................(Fig 4)..... ... . ,.:..:.. . ......:................ it 6,. 5 6'8' � 1.3 FRAMING CONNECTIONS • ` General compliance with framing connections..:. ...... ...(Table 2)...... .. .. .... ;......... (/ 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1. r ' Concrete.............I....... .... ... ........ ..... I..... :. . ......... Concrete Masonry.....I......................................... ... ... .. . . 2.2 ANCHORAGE TO FOUNDATION"' p a ternative'in concrete only ` 4asan I Mechanical AnchorsY 58Proprietary 5 8 Anchor Bolts�imbedded or / / Bolt Spacing-general........ .(Table 4) in. Bolt Spacing from end/joint of plate ........ .... ......... (Fig 5) rn 5 6':: 12"; Bolt Embedment—concrete............... ......... ......... (Fig 5) ........ .. ....... in ?7"„ Bolt Embedment—masonry... ........ .... ........(Fig 5) ...... in.> 1.5 Plate Washer.............. ...:................. .....:. :....... (Fig 5) _3 'x 3"x 1/4" 3.1 FLOORS Floor-framing member spans checked ... ......(per 780 CMR Chapter 55) .. . .. ..... .'. . Maximum Floor Opening Dimension.;..:..... ...... : ....:.:.(Fig6 :: �� ft<12' " Full Height Wall Studs at Floor Openings less than 2'from Exterior Wa,ll.(Fig 6).; ....,. Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall..... ...... . (Fig.7)........ .. ft-5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Sheanvall.... . .......(Fig 8). ............................................:.. ... :. ft <d„ _ Floor.Bracing at Endwalls.......I........ (Fig 9) . Floor Sheathing Type .......,......................... .;.(per 780 CMR-Chapter Floor Sheathing Thickness . (per 780.0 Floor Sheathin Fastening .. Table 2 .b . .d nails.at in edge/_. in field 9 g........ ... ( ) 4.1 WALLS Wall Height Loadbearing walls......... . ... ......... (Fig 10 and Table 5).... <10Non-Loadbearing walls (Fig 10 and Table 5) ... .IfItt" . 20' Wall Stud Spacing:. .(Fig 10 and Table 5) b in 5 24'so c. i Wall Story Offsets ......................................... ...............(Figs 7&8)................... ft <d 4.2 EXTERIOR-WALLS M' Wood Studs (Table�) ......... .2x - ft m ' Loadbearing walls.. �G 11 ..... Table 5 ' ... ....2x - ft L in: j Non-Load bea ring walls........... ..,:... .. ••{ ) ,... :. } . Gable End Wall Bracing FullHeight Endwall Studs...................... . ..........:.(Fig 10)................................................................. WSP.Attic Floor Length.......:..:......:....:......................... Fi 11 ft z0/3 'Gypsum Ceiling Length(if WSP not used)....:....::........(Fig 11).............I.............................. ft>_0.9W ✓ and 2 x 4 Continuous Lateral Brace. 6 ft. o.c. (Fig 11 or 1 x 3 ceiling furring strips @ 16"spacing min. with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays Double Top Plate ft Splice Length :.::....:.:.................................:....(Fig 13 and,Table 6)..........I".......,.�. SDlic'e Connection (no. of 16d common nails)..............(Table 6)..............................1�u..S�. ?.�! ..— It FTC Glide to IYood Colistrliction hi High HlMd fti-en-s: 110 niph Hlirid Zone Massachusetts .Checklist f6r C0111pliallce (780 C>,1R'S36l.2.1.1)' Loadbearing Wall Connections /. Laleral(no.of 16d common nails).................................(Tables 7)..................................... ,............... (/ Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)................................(Table 8)....................................................... Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) HeaderSpans ........................................::..............(Table 9).................................. 0 ft_in. 5 11'. Sill Plate Spans Table 9 t� Full Height Studs (no. of studs)....................................(Table 9)........................................ ... .... Non-Load Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9), Header Spans.............................................................(Table 9).................................. ft_in. 5 12' SillPlate Spans.... ..I.......................I............................(Table 9)............:...................... ft in. s 12" Full Height Studs (no.of studs)....................................(Table 9).............................................. ..... tJ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously Minimum Building Dimension, W Nominal Height of Tallest O enin 2 ..............................................................a:5 6'8" 9 P 9 Sheathing Type.......... .....:..............................(note 4)........................................,............ % 1 �i� y Edge Nail Spacing.........................................(Table 10 or note 4 if less)...............,......., in. Field Nail Spacing..........................................(Table 10).................................................. m. Co Shear Connection (no. of 16d common nails)(Table 10).................................................... 1¢ . Percent Full-Height Sheathing.......................(Table 10)...................................... 5%Additional Sheathing for Wall with Opening > 6'8"(Design Concepts).................... Maximum Building Dimension, L Nominal Height of Tallest Operiing2......................................................................... s 6'8 +>jl Sheathing Type.....................:........................(note 4)............................ i�� Edge Nail Spacing in. 1/ 9 P 9••••�•••••••••••••••�•••••••�••••••.•..•.(Table 11 or note 4 if less Field Nail Spacing.......................................:..(Table 11).....................................................j Shear Connection (no. of 16d common nails)(Table 11)..................................•..................... Percent Full-Height Sheathing................... .(Table 11).....:....... 5%Additional Sheathing for Wall with Opening> 6'8"(Design Concepts).................:.. Wall Cladding Rated for Wind Speed?.......:............... 5.1 ROOFS Roof framing member spans checked?........................(For Rafters use AWC Span Tool, see BBRS Website) " Roof Overhang ..........................I........................(Figure 19) ............. ft s smaller of 2'or U3 ; Truss or Rafter Connections at Loadbearing Walls Proprietary.Connectors Uplift..........,. ...............................(Table 12)......:.....................................U= J- plf a / Lateral..............................................(Table 12).............................................L=,_j_�pif Shear................................................(Table.12)............................................S=-!2-'?plf Ridge Strap Connections, if collar ties not used per page 21... (Table 13)...............................T= P ff Gable Rake Outlooker...........................................(Figure 20) ............. Z•---,ft 5 smaller of 2'or U2 c� Truss or Rafter Connections at Non-Loadbearing Walls Proprietay Connectors Uplift....................:..:........................(Table 14)............................................U= lb. Lateral(no. of 16d common nails)...(Table 14) _ . Roof SheathingType.................. yp . .•..............................(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness.............................................I................:......... > in. >7/16"WSP Roof Sheathing Fastening.................... .(Table 2).............. d ....... r.! Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 78D CMR.5301:2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the,WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception: Opening heights of up io 8 ft. shall be permitted when 5%is added to the percent full-height sheathing -•requirerrients shown in Tables 10 and 11. 3. The bottom sill plate In exterior walls shall be a minimum 2 in. nominal thickness pressure treated#2-grade.. THWE LtaA,S1'l Ri�� - - 9� Town of Barnstable Regulatory Services Thomas F. Geifer,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arns to ble.m a.us 'Office: 508-862-4038 Fax: 508-790-6230. Property Owner Must Complete and Sign This Section If Using A Builder $I,U(LsSKP as Owner of the subject property hereby authorize ��tom, A Q��'P{i 0 to act on my behalf, I in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Nainc If Property Owner is applying for permit,please complete the Homeowners License Eremption Farm on the reverse side. C:1Userr'doeollik\AppDataU,ocaRMicrosoMWindowslTcmporary InLcrnct FileslConttnt.DudooklDDV87AAZT-XpRESS.doc Revised 072110 ®Boise Cascade Double 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Roof Beam1RBO2 BC CALL®3.0 Design Report- US 1 span No cantilevers 1 0/12 slope Tuesday,June 21,2011 Build 517 File Name: P Appleton_23 Blossom - Job Name: Description: ridge-center Address: 23 Blossom Street Specifier: Joe Madera City, State,Zip: Centerville, MA Designer: Customer: Peter Appleton Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: �o 12 ff c lSO nx 03-09-08 BO,3-1/2" B1,3-1/2" DL 572 Ibs DL 572 Ibs SL 1,100 Ibs SL 1,100 Ibs Total Horizontal Product Length=03-09-08 Live Dead Snow Wind Roof Live Trib. Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area(psf) L 00-00-00 03-09-08 15 30 14-00-00 2 Unf.Area(psf) L 00-00-00 03-09-08 10 20 08-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 1,225 ft-Ibs 5.0% 115% 3 1 - Internal Completeness and accuracy of input must End Shear 542 Ibs 6.0% 115% 3 1 -Left be verified by anyone who would rely on Total Load Defl. L/15,954(0.003") 1.1% 3 1 output as evidence of suitability for Live Load Defl. L/24,253(0.002") 1.0% 3 1 particular application.Output here based 3 on building code-accepted design Max Defl. .003" 0.3° 3 1 properties and analysis methods. Span/Depth .4 n/aa 1 Installation of BOISE engineered wood products must be in accordance with. %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 1,672 Ibs n/a 18.2% Unspecified or ask questions,please call B1 Post 3-1/2"x 3-1/2" 1,672 Ibs n/a 18.2% Unspecified (800)232-0788 before installation. BC CALC®,BC FRAMER®,AJSTM', Cautions ALLJOIST@,BC RIM BOARD-,BCI®, BOISE GLULAM- SIMPLE FRAMING For roof members with slope(1/4)/12 or less final design must ensure that ponding instability SYSTEM®,VERSA-LAM®,VERSA-RIM will not occur. PLUS®,VERSA-RIM®, For roof members with slope'(1/2)/12 or less final design must account for Rain-on-Snow VERSA-STRAND®,VERSA-STUD®are surcharge load. trademarks of Boise Cascade Wood t Products L.L.C. Notes Design meets Code minimum(L/180)Total load deflection criteria. Design meets Code minimum(L/240)Live load deflection criteria. Design meets arbitrary(1")Maximum load deflection criteria. Fastener Manufacturer: TrussLok(tm) I - Page 1 of 2 ®Boise Cascade Double 1-3/4" x 11-7/8" VERSA-LAM® 2.0 3100 SP Roof BeamXR1302 BC CALC@ 3.0 Design Report-US 1 span No cantilevers 1 0/12 slope Tuesday,June 21,2011 Build 517 File Name: P Appleton_23 Blossom Job Name: Description: ridge-center Address: 23 Blossom Street Specifier: Joe Madera City, State,Zip: Centerville, MA Designer: Customer: Peter Appleton Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: Connection Diagram Disclosure b - d Completeness and accuracy of input must be verified by anyone who would rely on a output as evidence of suitability for . • • particular application.Output here based on building code-accepted design properties and analysis methods. Installation of BOISE engineered wood products must be in accordance with e current Installation Guide and applicable building codes.To obtain Installation Guide a minimum=2" c= 7-7/8" or ask questions,please call b minimum=4" d=24" (800)232-0788 before installation. e minimum= 1" BC CALC®,BC FRAMER®,AJS-, ALLJOIST@, BC RIM BOARD- BCI@, All TrussLok screws may be installed from one side of multiple ply VERSA-LAM beams. BOISE GLULAMTM'SIMPLE FRAMING All TrussLok screws may be installed from one side of multiply Versa-Lam beams. SYSTEM®,VERSA-LAM®,VERSA-RIM Member has no side loads. PLUS@,VERSA-RIM®, Connectors are: FMTSL338 VERSA-STRAND@,VERSA-STUD@ are trademarks of Boise Cascade Wood Products L.L.C. J Offce 6f�o,5s8fA'P�°,?s`�lBft �rr � License or registration valid for mdividul use only before the expiration date..If found return to: HOME IMPROVEEr7.EtvT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: .a103218 Type: I -.;. 10 Park Plaza-Suite 5170 Expiration:. rZ/6/2012 OBA Boston,MA 02116 A ON CONSTR4JCTQN=;; i Peter Appleton = 37 Baird Way Centerville,MA 02632 Undersecretary Not valid without , atu Massachusetts- Department of Public Safety Board of Buildin�o Regulations and Standards Construction Supervisor License License: c.S 5414 Restricted to: 00 PETER J APPLETON 37 BAIRD WAY CENTERVILLE, MA 02632 Expiration: 6/8/2012 Tr#: 26907 commissioner Y SIMOKE DETECTORS REVIEWED b SUILDI u DEPT. �E DATE VACM TO. FIRE DEPARTMENT DATE 60tii S1;NATUPES ARE REQUIRED FOR PERMITTING NeW LA alr. WALMAK" NEW xV ta�N 3*0 LIMp SPACM TT. a ►,aarrWALL NNW. &AIN 0 44R PAWADOgo A ocsr. am 3440p iru AoosaLAUY ►oerr G 1 ]NNW rosr,00ut LoaT=* I NEW SUVA �+oK w,M4 oowN �as essay. ' UP uvsis r wee memo AMW zaao NEAOBt AMWMTDIVAM O su.eanwo4oMrs we; MIR ee+ 0 RENOVATED 1ST FLoop ,I l4T ROOF be" bokwa STACK BATH WALLS ; I - 33'4 vr•/_ OVER 15TFL RATH WALL FOR FLUAYMM 4'61/21 1 3.4• 2RW3o46 W/r a�3� STMPOCKET w" W/D i EQ EQ . 7r n 2/TW3046 W/3' RATH ING SITT .� SMFOCKET p AREA 11'4yd1'o'•% CRAWLSFAAi I i I _•r J%B O ( - 2d66 q iARW i DOWN OP94PAX 3aOyy NEW ab Ktl 2b68 OPEN TO BELOW l4•r GRAWI.SPACE I I BATHMEN NEW 2ND f. BELOW TO BE 2A., PORCW DECK w•oe wig/ CROSS SECTION z far r+ R-19 K im I 36•RAD- R-- i I 7'BD NEW 2ND FLOOR PUN 2xM JOrSTS 2x4 PT TAPERED CONT.Ixl PT POSTS TAPERED TOWARDS SLEii9t3 W/DECKII46 @ SOrooe j LEFT ELEVATION Of T'BD UP TO DfQC BEAM ( JI HOVSE W/sw - 'I t AV%OOR6LUE0AND t4 NADkb W/olm"A IE ROM" i I T lr SONOTUBES 3/2xt0 FT BE W/23•BEGFOOT 2xlo PT JOTS MD L 4'BELOW H4N6&5 @ i MADE W/ur TO BEAM a ANOM BOLTS �� �Ile- 2. Each staff personover the • Name; home address, number(s), and emerg • Written authorization f parent/guardian. • Travel location and tel during camp session. • The name, address, an health care provider or +_ # • If the camper or staff t written authorization t parent/guardiari. . •. Copies of injury report Care Of Mildly III Camper_ A. Plan for the care of mildly it 1. With permission from the p with mild colds may be permit will not be permitted to attend F 2. Campers who are mildly III t Health Supervisor. They will bE . Supervisor-should the illness b J 3. Mildly ill campers may be al camp day. BmRAroLlswroc pE TOWN OF „ . .ST D EJLJ s V v1 �n `l1PCT ! 3 PA3: l6 ICI wdr d rr �}{ ealirLl .�F STACK BAnlwAus - - �Rmae TO BE • • rostaanBREBErseT b�3ti }4_t ��eIIaTPL MIII am BY Of1EAa PROMRIMF0RgEAMW a WALLl44RAWAVO 8 4'Bur TraceTO a$0M y :� LJLJL S &M*vo W/r r I i snDPODmT araz wro a N'P YBV! MT ` U woo W/r ♦ BA7N gftDBO 11D in alP0O2T A O _ AReA .CRAWl9AfF ROOF FRAMIN6/POST LAYOUT {{s a q :eBe E ° } a Bev BELOW — -- New _ aaeer 3 �! RB Babe Z 3i II ; Er u e r BELO W of �e BELOW 5O"wider N' J $ OLIN�NAfR .< 1� >a � East . NEW END FL WAL0 T�M•OC IS t i POR"DECK wawwr nm+B E me®a�o �" rsavcarDBProN. data 6-20 11 i 7XC. h mO PELTNOUNWRAP WEBBY RONf . 11 1 CROSS SECTION' R4906 VMU MM aoEan MtlC WA4 STRAPP" RAPl913 W REMAM Bmk 1/4• 10 ravr WAu -:AImR,W awnucBmN. �+ ' MAME NEBGfP Ub �1 R ww Emo noon. NEW 2ND PLAN To OMST"ale � ww." AAW /DBC7m SoNoTt s Beam rmara . EPaewn/r CEFPEIEVATUNOP 7BD CR W DEOl BEAM a1MBI0ORVAft . NOUlE W/ELT• mm sM AM WZ D NMP000114UBD AID DORM W WM . NAL.ED W/MEIIBAAIL DEOmi ROOF" . W/EYOT Bra PTBmaTa M'OC TOKMOONNeCTM ODEeWO'{AM AMMMIOLM r� _ 'CROSS SECTION _ - ! PAGE 4 OF 4 J n.:J' f e V u I `i � )yCA f LP eol j Jet. tE 0 kot S� JI c 0 September 15, 2011 M c K ' TIE t ENGINEERING Mr. Peter Appleton CONSULTANTS 37 Baird Way structural civil environmental Centerville, MA 02632 RE: Change in Size of Sunporch, 23 Blossom St. Centerville Dear Mr.Appleton, McKenzie Engineering Consultants, Inc was retained by you to complete wind analysis for the proposed screen porch for 23 Blossom Street in Centerville. We provided a stamped annotated plan showing connection requirements to address wind uplift and shear. .a w. Based on our discussion,the owner wants to increase the size of the sun porch from 14 feet to 16 feet. We looked at the analysis we originally completed and find that the requirements we originally designed are still valid for the increased area and no additional measures are necessary. If there are any questions, feel free to give me a call. iH of MARK A. tiG Y Sincerel , McKENZI a CIVIL 0 M k A. McKenzie, P.E. `�ss o s r e N NAL E G P s., McKenzie Engineers ants, Inc. t. 1279 Millstone Road Brewster,MA 02631 t 774.353.2144 f 774.353.2142 www.mckengineers.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #go )C�L Health Division Date Issued l l Conservation Division Application Fee i Planning Dept. Permit Fee �s .0 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Village ���`��1 Owner CZ, Address C2 3 5 A Telephone Permit Request '✓���Vt DUk8(//e- 14`'!�J w i,od L-> Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new , Zoning District Flood Plain Groundwater Overlay Project Valuation-I*t/4; avyi 0J Construction Type Ulo—,P Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0-- Two Family ❑ Multi-Family (# units) Age of Existing Structure r5 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: &F-3 ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq- t / f �dLiG t Number of Baths: Full: existing new Half: existing n - C) Number of Bedrooms: existing _new -- Total Room Count (not including baths): existing new First Floor Room Count ° Heat Type and Fuel: 0,11as ❑Oil ❑ Electric ❑ Other .o Central Air: es ❑ No Fireplaces: Existing New Existing wood/coal stoves ❑l ❑ No 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 ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION r, (BUILDER OR HOMEOWNER) Name If zf d Telephone Number Address -L-icense # 1�7- 0"if V ` L e, �'I t Home Improvement Contractor# Worker's Compensation # Cry��� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS FROJECT WILL BE TAKEN TO SIGNATURE DATE �� �� 'r FOR OFFICIAL USE ONLY r `APPLICATION# DATE ISSUED MAP/PARCEL NO. t ADDRESS VILLAGE OWNER r f i DATE OF INSPECTION: ► FOUNDATION �3 fosos a �2�ii a FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL �F b r PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts rc Department of Industrial Accidents t Office of Investigations 600 Washington Street i Boston,llfA 02111 www mass gov/dza Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (B rgan' usincss/0 rraiion/Individusi): /�,�%�.- ' �.v•���.���, ��� Address: �-- -/ City/State/ZiP�.l��K '�_ �e 1,.�✓� ` � Phone#: 5� � y "�� 0 Are you an employer?Check the appropriate box: Type of project(required): 1. I am a emC(ZlUlrjani �part-tim 4. I am a general contractor and I employeee * have hired the sub-contractors6 ❑New construction2.❑ I am a solr parts listed on the attached sheet $ ?• ❑ Remodeling ship and have no employees These sub-contractors have , 8. Demolition working for me m any capacity. workers' comp,insurance. [No workers' comp. insurance 5. ❑ We are a coIporation.and its 9. El Building addition required.] officers have exercised their 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all work *right of exemption per MGL l l EJ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp. insurance required.j- 13.❑ Other 'fury applicant that checks box#I 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 hue outside contractors must submit a new affidavit indicating such.4Contracinrs that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for.my employe inforrnadon. es Below is the policy and job site " Insurance Company Name:_ Policy#or Self-ins. Lic.#: t--CC Yw z_u.t Expiration Date: Job Site Address:_ City/State/Zip Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration p n 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 ce under th pains #aides of perjury that the in provided abov is and correct Si ature: Phone#: U ..3 iC tv 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): L Board of Health 2.Building Department, 3,City/Town CIerk 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( )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-contractors)name(s),address(es)and phone number(s)along with their certificates)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 th at this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to '�' sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured-companies ompanies should enter their self-insurance license number.on the appropriate line. City or Town Officials Please be sure thatthe 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 toavn)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the lic t app an as proof that a valid affidavit is on file for future permits or licenses. Anew 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 (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hke 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 Massarh=tts Department of Industrial Accidents G.Mce of Investigations 600 Washington Street Roston,MA 0.2111 Tel. # 617-72-7-4900 ext 406 cir 1-877-MASSAF Revised 5-26-05 Fax # 617-727-7749 WWW.mass.gov/dia NOTICE NOTICE TO TO r EMPLOYEES EMPLOYEES The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY S 54 THIRD AVENUE, P.O. BOX 4070 BURLINGTON MA 01803.0970 ADDRESS OF INSURANCE COMPANY WCC 5005786012011 03/16/2011 - 03/16/2012 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street- P O Box 527 Agency Inc Stoughton, MA 02072 (781) 344-'3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 01/31/2011 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT, The above named insurer is required in cases of personal injuries arising out of and in.the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS TO. RE POSTED BY EMPLOYER �P� o B.l.ixs'Tt trr�r u,tss Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 ' wWw.town.b arnstable.malus Office; 508-862-4038 Fax' 508-790-6230. Property Owner Must Complete and Sign This Section If Using A Builder I tt a z i x. t& j Al SU �Step is'Owner of the subject property hereby authorize tA� to act on my behalf, in all matters reladve to work authorized by this buildingermit a P PPliCaaon for. (Address of Job) Signature of Owner G> «� Date Print Naiine If Property Ormer is applyingfor permit,please complete the Homeowners License reverse side. se Exemption Form on the C;lUsersld=olliklAppDat,U-,ca MicrosoftllVindows\Temporary tntrrnet FileslContent.0udookIDQV67AAZlEXp Revised 0721 10 . RESS.dx Vna��aa.nuxri� - vc�r.0 uncnr rn urnr� .,7.0 crr :.A Board of Building Regulations anti Standards I Construction Supervisor License License: CS 5414 I Restricted to: 00s``' i PETER J APPLETON {! 37 BAIRD WAY CENTERVILLE, MA 02632 j Expiration: 6/8/2012 t'onunissioner Tr#: 26907 License or registration valid for indiYidul use only . Officeio before the expiration date.._If found return to: HOME IMPROVEh9tkt CONTRACTOR Office of Consumer Affairs and Business Regulation Registration: 1032T8. Type' ` 9 ys 10 Park Plaza-Suite 5170 '- ° Expiration 7/.6/2012 DBA Boston,MA 02116 A TON CONSTRKU6N _ Peter Appleton 37 Baird.Way } g �` 'B"Pam- Not valid without r atu Ce�terVille, MA 026�2 Undersecretary 1 1 r L I - 1 • 1 i � �1 I t 1 it t I 4111 C`.; U f Aft ,j r3 y t I eoc jA i, i 7 , C f J f` o l y ,�t cc, }t 09/14/2011 14:17 7743532142 MCKENZIE ENGRG CONS PAGE 01/01 C' N'Z[E September 15,2011. ENGINEERING CONSULTANTSMr. Peter Appleton , 1'ftWWM1'eml,M10ronmenmi 37 Baird Way Centerville,MA 02632 RE: Change in Sizc of Sunporch.; 23 Blossomy St:Centerville Dear Mr.Appleton, McKenzie Engineering Consultants,Inc was retained by you to complete wind.analysis .for the proposed screen porch for 23 Blossom Street in Centerviil.l.e. We provided a stamped annotated plan showing connection requirements to address wind uplift and shear. Based on,our discussion,the owner wants to increase the size of the sun porch from 14 feet to 16 feet. We looked at the analysis we originally completed and find that the requiretnents we originally designed are still valid for the increased area and no additional measures are necessary. If there are any questions,feel free to give me a call.. ro T" KOF „y Sincerer sS A. o MA K a Y �.Y;;;4,�,a> M McKenzie, P. s £ ;R ;:. McKenzie Engine 5, riC. 1279 Millstone Rood Brewster,MA 02631 f 774.353.2144 F 774.353.2142 www.mckengineors.com TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application'# 0 Health Division Date Issued - 1 Conservation Division Application Fee Planning Dept. Permit Fee J Date Definitive Plan Approved by Planning Board 71.�1d1 Historic - OKH _ Preservation/ Hyannis Project Street Address Village Owner Z ✓ A/, 2_..51 / Address `(S 6d ,'HZ� tb. Telephone d -7 Y_ go . Permit Request - ef Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type 1)-v.,-�O A7d*'4` e , r --� , a Lot Size r �, �`/�� � Grandfathered: ❑Yes C�'I l�o If yes, attach ��u)?porting crocunr@ntation. .V v i 5 Dwelling Type: Single Family 3--_ Two Family ❑ Multi-Family (# units) 3-J. Age of Existing Structure Y Historic House: ❑Yes a4l'o- On Old King's Highway:'b Yes; ff-NT- Basement Type: ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new 1 Half: existing new Number of Bedrooms: existing Anew Total Room Count (not including baths): existing � new First Floor Room Count Heat Type and Fuel: u-Gas ❑Oil ❑ Electric ❑ Other Central Air: Wes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: U, xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ` ��/ �'� Telephone Number o b Address 7 7 �r U� - License '# !�- 41 t� J � �� Home Improvement Contractor# • Worker's Compensation # 1 CSC TCO, 7 (01 v l ALL CONSTRUCTION QE RIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE C ,v ,F FOR OFFICIAL USE ONLY APPLICATION# n DATE ISSUED MAP/PARCEL N0. i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION I' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT " ASSOCIATION PLAN NO. ;1 f The.Commonwealth'of Massachusetts 1 - ( Department of Industrial Accidents ' Offwe of Investigations i� I'r3a 600 Washington Street i` Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name (Business/Organization/Indivi dual): �✓! '�� =�' J Y �d. «. Address: 771 ��✓ � � City/State/Zip: Phone Are you an employer?Check the appropriate box; Type of project(required):, 1.❑ I am a emplo er with : / 4. ❑ I am a general contractor.and I ' 6. ❑New construction employees full d/ part e).* . have hired the sub-contractors � ' 2.❑ I am a sole p opneto&per- `' listed on the attached sheet.# ❑ Remodeling ship and have no employees These sub-contractors have 8. 0 Demolition working for me in any capacity. workers' comp. insurance. g• ❑ Building addition [No workers' comp. insurance 5.. ❑ We are a corporation and its required.] officers have exercised their, .r 10.❑Electrical repairs or additions 3•❑ I am a homeowner doing all work right of exemption per MGL 11.E Plumbing repairs or additions myself. [No workers' comp. : c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.]t- employees. [No workers'-. ., 13.❑ Other comp.insurance required:] *Any applicant that checks box ti 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 now affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-conhactors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site' information. Insurance Company Name: A�f—6 P�/ `�' �j ��`6 *-.1 . c Policy#or Self-ins. Lie.#: �(1 e���UU S') Gfi (jjl -r Expiration Dater �(J% Job Site Address: g 1 � -5)pl- 61. t'f f�rek+./ od ,, , City/State/Zip:(�f.-`11ys� • � gt��f Attach a copy of the workers' compensation policy der aration page(showing the policy number and expiration e). 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 iithe 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 maybe forwarded to.the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify :der the pains an�aftlies ury that the information provided above is true and correct w Si afore: Date: ' 6✓ ./ i Phone#: ^� of - op -71 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#: i 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-contractors)name(s),address(es).and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/licease 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The-Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-7274900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia of TKEr ` MRNSTA-13LF- MASS. Town of Barnstable -Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry, CB0 Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstWe.ma'.us Office: S08-862-4038 Fax: 508-790-6230. Property. Owner Must Complete and Sxgn.TMs`Section If Using A.Builder ♦".try Zo= g ,"'TSlk/4 as Owner of the subject property, hereby authorize (,eTP0— f''P L,.g't-0 "J to act on my behalf, in all matters relative to work authorized by this building permit application for: (Addres,s of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please coMPlete the Homeowners License Exemption Form on the reverse side." C:\Users\deco)lik\AppData\Local\Microsofr\Windows\Tcrriporzry Intcrr ct Filcs\Content.ollt)o0k1DDV87AAZ\EXPRESS.doC Revised 0721 10 Town of BarnstaWeI l>f IHE P. Regulatory Services Thomas F. Geiler, Director �gKAS& BuiIding Division �tD Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.tdwn.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: t JOB LOCATION:Z2, C` o S S t S *— �` ( number / street,"' villa / HOME ER": IC S,N tS <C� G name home phone# x work4hone# �f URRENT MAILING ADDRESS � y r ti IZ`� AG o AI a it`y/town ' � state zip code The current emption for"ho.meowners"was extended to include owner-occupied dwellings ofsiunits or less and to allow meowners tXngage an individualffor 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 tie responsible for all such work performed under the building? permit. (Section 109.1.1) The undersigned "homeowner,'Ia sumes responsibility for compliance with the State Building Code and other applicable codes, bylaws•les 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 wit r•said procedures and . requirements. Signature of omcowncr Approval of Building Official ✓ Note: Three-family dwellings containing 35,000 cubic feet or1arger will be required to comply with the State Building Code'Section 127.0 Construction Control: HOMEOWNER'S EXEMPTION The Codc states that: "Any hbllteowoer 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 persons)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 ofawarmcss 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 ofhis/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/ecrtification for use in your community. Q:forms:ho mccxcrnpt NOTICE NOTICE TO TO . EMPLOY EES r EMPLOYEES f The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street, Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: ASSOCIATED EMPLOYERS INSURANCE COMPANY NAME OF INSURANCE COMPANY 54 THIRD AVENUE, P.O. BOX 4070, BURLINGTON, MA 01803-0970 ADDRESS OF INSURANCE COMPANY WCC 5005786012011 03/16/2011 - 03/16/2012 POLICY NUMBER EFFECTIVE DATES Malcolm & Parsons Insurance 6 Freeman Street- P O Box 527 Agency Inc Stoughton, MA 02072 (781) 344-3200 NAME OF INSURANCE AGENT ADDRESS PHONE Peter Appleton dba Appleton Construction 37 Baird Way Centerville, MA 02632 EMPLOYER ADDRESS 01/31/2011 EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY). DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer,if the treatment is necessary and reasonably connected to the work related injury. In cases requiring hospital attention,employees are hereby notified that the insurer has arranged for such attention at the NEAREST AND BEST MEDICAL FACILITY NAME OF HOSPITAL ADDRESS Tn ur D"Q!TTT" RV T`A%lUT nVT.ID Massachusetts- Dcpartmcnt of Nuhlic �)aici' Board of Buildint; Rcgulations and Standards Construction Supervisor License License: CS 5414 , Restricted to: 00 PETER J APPLETON 37 BAIRD WAY CENTERVILLE, MA 02632 Now Expiration: 618/2012 Tr#• 26907 ('nnunisaiuncr Officelo�5s°B7lf �`dCiBiiihe;5 & License or registration valid for mdividul use only HOME IMPROVEMENT'CONTRACTOR before the expiration date. If found return to: Registration 903218 I Type: Office of Consumer Affairs and Business Regulation VA �01\1 7/6/2012 DBA 10 Park Plaza-Suite 5170 ExpirationBoston,MA 02116 CONSTMJUT:ION ; 7 r E Peter Appleton s 37 Baird,Way CenterGille; MA 626�2 Undersecretary allotithout I atu 7 SPAaW TO. e.a I NEW bN&C. WALL F Nt1M poftaq VS LP./- VAC"TVP. PAD OUMALL OQ3T. TO Acw.VGR BATH O 7ND FL i6UNtINi 084ov, loft OAST o j t'1,--� iaMOw� • . LD✓ AN aV uu r { PODMo m ooum"WBsMNr F+eoxe Roa+ EnoaT _ VOBT AYM LOCATfAfli j, NEW STAW UPANDOOIMN a Raw. OAST am#2 UV" j Ur S*CASED OPENMIG ZMW NEAM ABOVE ALLV=r.wlmboWB 0 AND DOORS TO AEMATVI NBJOr. OQd BATH 0 I RENOVATED 1ST FLOOR GdIJF�" �PA C k k Sys 1,4 P vD" L,,4115 ,OC BREAKFAST AREA &A T" 03 KrrCH N BED BATH am EXIST.1ST FLOOR ` kC Town of of Barnstable Of THE r � Regulatory Services Thomas F. Geiler,Director ' MAS& ' Building Division A Tom Perry,Building Commissioner Fp MA 200 Main Street, Hyannis,MA 02601 ° www.town.barnstable.ma.us - Office: 508-862-4038 Fax: 508-790-6230 PERAI[IT# � .� , G FEE:is SHED REGISTRATION 120 square feet or less Location of shed(address) Village CJ Property owner's name Telephone.number k= Size of Shed Map/Parcel# . Signature Date Hyannis Main Street Waterfront Historic District?, Old King's Highway Historic,District Commission jurisdiction?, �Conserv'ation Commission_(signature is required) Sign off hours for Conservation 8.00-930 &3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. _TEe� YIIS.F0RMM[YJST CC NO PL- OTPI,AN V eCoi Q-forms-shedreg. REV 42S 6.0 0 . �� C) i', 77 75 ^, w iy vI�Y ��Nps Ov r Rev. t. f iw.S r ; l�e.s t1G.te�L �L1L. mil( r\ ,� n®fQ r � cvc.nCt 7 l �oG�/ f f. : . r7Plr�-LtU, � ._...---_--�:•i.;" ':�/- �� gyp..-. . �;:'r-- ' Yo I S .Cot ICI ,6_;71YLC1. �'t-rr s.� �• \ per/ D,w - when h01e �/� cltr4t. �_—_._� 10,.E - _1 .._- �.0 �j/` ��'•� % •g'+� . _I�' 1 3 13,R. 011, al� awwzd rtal. C41 to �h Otw. 9.0 to eJv_.unely _...— � �'J� + i000 � � I p.a I- w/z`Sruti� • I P W r~l •• P ) fir. / ( Q)f _. Cart,&5e't'uf ' i�.7 Iv i..de :• 1 � ' t( }(" 9 :[ bow o, x "-30 ' l(C[J'LLL�� l{0 v (CAt ) 3 I 3 3r.� rnC`i.l e /r!o.. �cciLe I ✓ rc I' J�'� p � .� 1 iJijl � - i+ pf TM�>0 TOWN OF BARNSTABLE - Permit No. 34966 BUILDING DEPARTMENT 1 ""'T I TOWN OFFICE BUILDING Cash 7 Ml .679• - �'>euT' HYANNIS.MASS.02601 Bond .............. CERTIFICATE OF USE AND OCCUPANCY Issued to Jania Snieska Address Lot #15, -rCranberry Lane. . West Hyannisport USE GROUP FIRE GRADING OCCUPANCY LOAD 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. August 28 92 .. . ...... .... ......�.... 19.............. .. ... ......... .. Building Inspector a'fy�••'. TOWN OF BARNSTABLE BUILDING DEPARTMENT = rsaiSTAU TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit $ .... /` ..................................................................................................................... ................................»»... issued to ........... ................. .......... � 1 _ Please release the performance bond. TOWN OF BARNSTABLE, MASSACHUSETTS RUILDI GVERMI 2 DATE 19 9 PERMIT NO. Ng 'APPLICANT Robbins Re-fnoau" I JL I ICE ADDRESS 0 4 3 7 R'7' IN0.) (CONTR'S LICENSE) build Dweliiitcl NUMBER OF .td PERMIT TO STORY Dweiiing DWELLING UNITS (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) AT (LOCATION) ]JOt 415, 41 Cranbc�rr ZONING s Y:l o r t DISTRICT—RIA IN 0.) (STREET) BETWEEN ANDS` — (CROSS STREET) (CROSS STREET) SUBDIVISION LOT LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE By FT. LONG BY F I SHAJ M IN CONSTRUCTI, TO TYPE USE GROUP BASEMENT WALLS QQ%L'I�ATI.N (TYPE) REMARKS: 9 4. j Bond ..AREA OR k VOLUME ESTIMATED COST 14 0 0 FEE PERMIT.s 96. 50 (CUBIC/SQUARE FEET) Lk OWNER A DRESS f3illin I I fuzi BUILDING DEPT. c!c BY v '-6F-'P'U-ei L-I C_WORKS: T_HE:'ISSUA'NCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM 4HE_�'6p;j;Fj OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. lot MINIMUM OF THREE CALL INSPECTIONS REQUIRED FOR -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE ALL CONSTRUCTION WORK! CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR I;-FOUNDATIONS OR FOOTINGS. ELECTRICAL, PLUMBING AND MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBERS(READY TO LATH). 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE. ..00CUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 vits- 1 9 2- 3 HEATING INSPECTION APPROVALS q, ENGI ERIN DEPARTMENT Chas %A ARD OF HEA OTHER SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL THE INSPEC. PERMIT W!LL BECOME NULL AND VOID IF CONSTRUCTION TOFt'HAS APPROVED THE VARIOLUS SIAGES OF WORK IS NOT STARTED WkTHIN SIX MON-,-115 OF DATE THE INSPECTIONS INDICATE THIS C CA ARRANGED FOR BY TED LEPON HONE ORARD WRITNTf _C0N_ PERMIT :S ISSUED AS-DOTED ABOVE. TRUCT ION, NOTIFICAT'C4.-- pot 9 .dot f S .l'ot f 4 . o . Zoop 1 I,Sup! s 9 Q 0 9 Ov 3 Ai M C/cCu/L� • 2 7.0 i . Iqu Cape kcal e f '-30 49 A-tho-t 1 oad Jute 4-7-92 Myanrtiics, fry 02601 _ Site Ravi o� Xand .in lJyanrv:4pott, Nq 1 9oa &;ure#,t hodqkind. Sew -Cot 1 S a-. i)wm oh a plan "coed ipt book- 76 pace I. S14e owukt i on 4 own on this: ptan i4'.loca ted the Wand ae. -slwwn he%eon ._and ► ee_& the x��l .o¢: the i7ocvrz o j: lSaAm tabte. x , 1 JN N N(R�IILN 32490 ,M 9FG1S1<A�� LAll . �r . .. _. Eli--n PLAN SNIESK FAUN�hTi oN �Lho I 1 6-92 A4 1 . --: .—� - DanwN av� S? VlHY I - � r CONC-,i3ASFNFNT F oOR 31�a11 1ptIC _�LLLE.D._.:_S7L ..... p � i I - i ' s o � CP►�yi1. ���� o vwi 12 OJT r` •Oi'-O�' • OI ♦ II k 1 °a = xiT6NEN G- GATNEO L I 0 to � OININ(at RM. ' � E-5'-�'I > JJoF • ,I. JIJF l III-O�� C V - P LIMN(, ROOM , o (CATHEDRAL) l JJJL �. ..MgSTER $DR►1. k, CGATNEDRP(L) o ° I J I r 8, FL. PLAN SNIESKA I- A-Z --- pRAWnI aY ; _... --_ i j - r.._--- ApjaptcRo- ROIL GLAPOOARQ.AT 3A S:E _ ___....... . _�RTcK—CH i WQ:1EY--'_.__ 8 ur:, � — — ; _ - -- - L-I � � . _ n --- ' -- R04L GLAPi3oftAD :A?.. Q�SE.-�. I I OU I F, ELEV 77- SNfesKA'.: FROND-�L_E�l�fi►--11�--�/s] r,.`- �.' ..e, _ 5-12: 'A'3 — - — -- DRRwW %Y j i I I RbLL-- C6AP(3DAR0 AT' 6h5� I I PRAWN DY_ I Y i i _-.-BRICK 4MINNEy-77 i i i REAR ELE./. 4NIGsKA P i i 1 i • i i - w RIDGE BOARD A"+�G'Y.AULtEo"-GELL�:JII7ST3�'IL"o�2..' _4%PHALT'RooF SNI"bL65 - ��=ASPNALT: QOoF.:SHINGLES \� cDA.PLV W V D . so OE`ILING 401STs •• _-.}-a"ry" PLATES, '� DIiJIN�..R9�►'1_ a IVING::Ro4M _PLYWOOD a j _ !/,�•�..-G DX. .._ r - ' ZLA.rIlO8R17-:3.'�i"'7SeG s"a? O.C. _2"±4 ' = F . E—U)." 3HEETROI.i( "- r 1eG_-.P,S�-SILL._.PLATE._ — -- ---- OIAT'.: 3TL._:LOhIC.-GILL-LALL`/ s 14'- o" cr -r J i' — — - �_3 i"JiASEP1EiJr:GonK. FL. I _8_c'zNs:_wA0. 3, • -LG ➢__GRNS�GVkC..F.T6• t ]�G••i'.j.•_ �K:15��RivC: FTm• 1' 16"cuf OC.M.. I I E_TIoN SNIESKR I- T_q2 TYR -1 -7 DRRWN 13 : I v TOWN OF BARNSTABLE THE raw OFFICE OF 13AH39TAEL i BOARD OF HEALTH HAS& °°ems i639- `bm 367 MAIN STREET fD MAY k' HYANNIS, MASS.02601 February 4 , 1992 Bennett Hodgkins — 108 Westberry Lane Cotuit, MA 02635 Dear Mr. Hodgkins: You are granted variances from the Board of Health Onsite Sewage Disposal Construction Regulation and "100 foot" Regulation to install an onsite sewage disposal system 80 feet from wetlands at Lot 15 Cranberry Lane, Hyannisport, Massachusetts. listed as parcel 23 on Assessor's Map 246, with the following conditions: ( 1) The system shall be installed in strict accordance to the revised plans dated January 30, 1992. (2) The designing engineer, Edward Kearney, shall supervise the installation of the onsite sewage disposal system and certify in writing to the Board of Health that the system was installed in strict accordance to the submitted revised plans. (3) The dwelling cannot contain more than three (3) bedrooms. Dens, study rooms, finished cellars, sleeping lofts, and similar-type rooms are considered bedrooms according to the Massachusetts Department of Environmental Protection. (4 ) The existing cesspool shall be removed or collapsed and filled with soil. The variances are granted because the existing cesspool on the property which is only 46 feet from wetlands, will be replaced with a system which meets Title V, the State Environmental Code and all other Town Health Regulations. Therefore, "Lhe new system may alleviate a source of pollution. Very truly yours, oseph C. Snow, M.D. ` Chairman BOARD OF HEALTH TOWN OF BARNSTABLE JCS/bcs copy: John Milne L - J The Town of Barnstable r c� n saun Conservation Department : 367 Main Street; Hyannis, MA 02601 Y � Office 508-790-6245 Robert W. Gatewood FAX 508-775-3344 Conservation Administrator ( % �e b. TO: Joseph Daluz, Building Commissioner FROM: Robert Gatewood RE: Occupancy Permit/Final inspection DATE: aLA r.es, C�- The following project has been granted an Order of Conditions by the Conservation Commission. Applicant: Project: ;r n Location: C Map/Parcel: aL� I a3 Our Permit #: SE 3- We would kindly ask that no Occupancy Permit or Final Inspection (as may apply) be granted by your department until a Certificate of Compliance for the project has issued from the Conservation Commission. Your assistance is very much appreciated. I �i r Assessor's office(1 st Floor): Assessor's mapj ard lot number o%TN[to SEP,7 �. r r l'C Sys' P Conservation � i' j iNS P'ALr y� m . t Board of Health(3rd floor): �.� ants Z-16 Sewage Permit number If � *- ra EN Engineering Department 3rd floor): House number i �1 MIN R Definitive Plan Approved by Planning Board 1,9 �� � APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE 61` 'a BUILDING INSPECTOR APPLICATION FOR PERMIT TO ro C, ((i TYPE OF CONSTRUCTION /a7`+ 19 TO THE INSPECTOR OF BUILDINGS.- The undersigned hereby applies for a permit rfin�(g/to the following information: Location Ala:12 01 �o� �' � �o'er r r �r�� y�, ; Proposed Use P � Zoning District e Fire District wl"M4" � _ IIName of Owner i Address t`924kad-14C__- Name of Builder RaLLak5 A` Address (o QeA or r l��✓` op ^-'�- Name of Architect �.-�t S Address Number of Rooms X CCa ) Foundation s cr4' D Exterior e-`G s��' Roofing aSDL1+ Floors dt Cj e Interior lkt�_ Heating �� Plumbing Fireplace Approximate Cost 1"�� 000 , ©Ca Area 05, f��d Diagram of Lot and Building with Dimensions. Fee 5U V 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. n � Name JL' Construction Supervisor's License A�'11 �-7 S`a SNIESK.A, JANIA Ir"No 34966 Permit For One Story _- r Single Family Dwelling Location -Lot #15 , rry Lane iet� LL_ Ownery ~ Jania Snieska Type of.Cons'truction Frame •� /� �' � '� �. -�. .� � �� _ � r rj h \ Plot +Lot Permit Granted 'April 14 , ,, 19, 92 Date of Inspection 19 Da C pl e !' - �� -`- 19 C X 1 1 r P •575 7 7A 55-5 Receipt for,,,, Certified Mail o No Insurance Coverage Provided Do not use for International Mail (See Reverse) Sent to Bennet Hodgkins Street a'p(3bbins REmodeling P.O.,State and ZIP Code Cotuit, MA 02635 Postage l _ - Certified Fee $, Special Delivery Fee Restricted Delivery Fee Return Receipt Showing p� to Whom&Date Delivered Return Receipt Showing to Whom, C Date,and Addressee's Address 7 TOTAL Postage '1 - &Fees Postmark or Date M E 0 LL 0- STICK POSTAGE STAMPS TO ARTICLE TO COVER FIRST CLASS POSTAGE, CERTIFIED MAIL FEE,AND CHARGES FOR ANY SELECTED OPTIONAL SERVICES(see front). 1. If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached and present the article at a post office service window or hand it to your rural carrier Ino extra charge). Q 2. If you do not want this receipt postmarked,stick the gummed stub to the right of the return i address of the article,date,detach and retain the receipt,and mail the article. ( rn 3. If you want a return receipt,write the certified mail number and your name and address on a c return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ` ends if space permits.Otherwise,affix to back of article.Endorse front of article RETURN RECEIPT I REQUESTED adjacent to the number. C I 4. If you want delivery restricted to the addressee,or to an authorized agent of the addressee, M endorse RESTRICTED DELIVERY on the front of the article. E 0 5. Enter fees for the services requested in the appropriate spaces on the front of this receipt.If LL return receipt is requested,check the applicable blocks in item 1 of Form 3811. a 6. Save this receipt and present it if you make inquiry. 105603-92-B-0226 SENDER: I also wish to receive the 0 • Complete items 1 and/or 2 for additional services'. • Complete items 3,,and 4a&b. following services (for an extra N y • Print your name and address on the reverse of this form so that we can v return this card to you. fee): m • Attach this form to the front of the mailpiece,or on the back if space 1. ElAddressee's Address rn does not permit. r, t • Write"Return Receipt Requested"on the mailpiece below the article number. 2 ❑ Restricted Delivery a +• • The Return Receipt will show to whom the article was delivered and the date C delivered. Consult postmaster for fee. d �° cc 3. Article Addressed to: 4a. Article Number '= P 375 771 555 2LMr. Bennet Hodgkins 4b. Service Type o cc I Robbins REmodeling ❑ Registered ❑ Insured 0 108 Westbury Way ❑ Certified ❑ COD W Cotuit, MA 02635 ❑ Express Mail ❑ Return Receipt for 0 oC Merc andise Q7. Date of Delivery 0 ' oZC 5. Sign ure (A ress 1 8. Addressee's Address(Only if requested Y and fee is paid) W 6. Signature (Agent) H 0 H PS Form 3811, December 1991 x4 U.S.G.P.O.:1992-307-530 DOMESTIC RETURN RECEIPT UNITED STATE$ POSTAL SERVIdE ` n � Official Business °b , PEWL:fY''EOR PRIVATE' USE T©AVOID PAYMENT a-• OF POST4GE,1800 t Print your name, address and ZIP Code here Mr. Richard Bearse, Bldg. Insp. TOWN OF BARNSTABLE 367 Main Street Hyannis, MA 02601 441 ! ii !I !i iii ft 11 i i f 11 i �ft!!:!!!1l!!i Ili!I!!I�!!!i!!!1If H t . s - o'yof 1N[t�1 M ,.. � ; The Town of Barnstable • •� Inspection Department 367 Main Street, Hyannis,MA 02601 508-790-6227 Joseph D. DaLuz Building Commissioner January 20, 1993 Mr. Bennet Hodgkins rn Robbins Remodeling �osSU 108 Westbury Way Cotuit, MA 02635 RE: A=246 023 Lot #15 + Building Permit #34966 Dear Mr. Hodgkins: Please contact this office immediately re work performed at 41 Cranberry Lane, West Hyannisport under Town of Barnstable Building Permit #34966 dated April 14, 1992. Very truly yours, ichard R. Bearse Building Inspector RRB/gr cc: J. Snieska Certified mail: P 375 771 555 R.R.R. f LOC 0041 CRANBERRY LANE 01? TIDS .,300 Co k"E 117 1413510 ADDRESS—-- F C"A 101 FCs 00 llip 0'. FA R E�v'r 0 'IHESKA, AN'TANIAS MAC' AREA 55AC JV 2943103 nTf-I 0000 SNIESKA,JANINA 5,F.41 S'F 3 .�')6 S(,� -7 .1096 F 0 BOX 371 UTT2 U' HYANINISFOR7 H 02672 ffir B, .1.q 5 15 E Y.C- 1 IM 75 i au CON 57 0000 LAND 4 0 00 M F, 59900 OTHER MkT 931-)00 R DESCRIPTION——. T R U El 1EA CLASSIFIED #[�AND 34,000, Sri LND SWOO ASO W 59900 ASO OTH SiBLDG(S)-CARD-] 1 5s,.,900 L"ESCRI PTIoN TAX YR CURRENT E X E I TAXABLE #F.f'_ 41 CRANBERRY LN TA X E X B MFT #DLL LOT ..,5 RESIDENTL 9 13900 93900 0 F E N 5F A C E #Up py'94 CONIIERCIAL INDUSTRIAL EXE. F7, 10114S SALE 0,0,'i.)0 PRICE, 0, 1094 3 A F.F.) LAST '64,17' 'WITY p C R if copy amo _ } r :. •�'t �"'r�.�9-�-'1 t- k�,. i v r - r 'r„. t s`zx> "�• � •f eej , V i t 1ha, t � R5 R'EYI KE DE EAll LJLJ SMO �T IF] N I .. 1 o I DATE :. BUILDI '. DEPT. — 24 E� r DATE i FIRE DEPARTMENT BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Res b w) 11 U 11 777 r REAR ELEVATION. : . rJo 'u ` "�? "n-Mgf: r ar •N�`? ,. �. -.. t,&}, .,LG/k..c. Font r✓.'n5. 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