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0036 BRALEY JENKINS ROAD
� � F ��m 8 _ r . . .. .� � � G ` .. � - _ .. �� � C .. ry '� � /t �.�..o.�r..� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I 1 Application# Health Division 2A -570-F Conservation Division Permit# Tax Collector r1 Date Issued Z- U - ) Treasurer Application Fee Planning Dept. Permit Fee DO Date Definitive Plan Approved by Planning Board ' EXISTING SEFnC SYSTEM Historic-OKH Preservation/Hyannis LIMITED TO-1-Y.0 OF BEPRO 77 aaU Project Street Address 36 Village C Akri' �V t i,1_ Owner WIL-LIAM ►�. 1140►ti►P'�-oIV Address 5fl-Mg_ Telephone S 0 - " t Zo- S-3i Permit Request 61-A'9-A-c-e rFrM1`'( p"� Square feet: 1st floor:existing boo proposed -3�0 2nd floor:existing 600 proposed '-j Total+new Zoning District AP Flood Plain Groundwater Overlay Project Valuation ea Construction Type 2 4 wood X Lot Size 1 oo?r 150' Grandfathered: ❑Yes ❑No If yes,attach supporting do umentation. F e.tf i z Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 19 Vas Historic House: ❑Yes . Oho On Old King's Highway: ❑Yes Q No Basement Type: Ufull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) t4/A Basement Unfinished Area(sq.ft) &3- Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new - `, Total Room Count(not including baths):existing 7 new First Floor Room Count Heat Type and Fuel: 0"Gias ❑Oil ❑Electric ❑Other Central Air: ❑Yes Colo Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes 0 Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:11rexisting ❑new size Shed:R existing ❑new size z- Other: Zoning Board of Appeals Authorization ❑- Appeal# Recorded❑ Commercial ❑Yes ❑No. If yes, site plan review# Current Use Proposed Use n BUILDE NFORMATION Name WILL-4Am -Mo o Telephone Num be Sal Address 3!o P2A-��� ��.��c e�s �� License# - Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1 111Of0 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION p FRAME 1 �7L)gl a!6� �dfd-- Asq 6,0 -4ro ache. INSULATION FIREPLACE .., c ELECTRICAL: ROUGH tY1 FINAL PLUMBING: ROUGH ® FINAL GAS: ROUGH t FINAL FINAL BUILDING A bV m DATE CLOSED OUT Q ASSOCIATION PLAN NO. Department of hidtisti ial Accidents Office of Investigations- a 600 Washington Street Boston,MA 02111' .�` www.rnassgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridaids/Pliunbers ApipHeant Information Please Print Legibly Name (Buginess/OrPoization/Individual): Address. City/State/Zip: ceoTel"►u C M 6 . Phone#: `/ Ski to 7 . Are you an employer? Check the,appropriate box:. type of project(required):- 1•❑ Z am a employer with 4. ❑ I am a general contractor and I ' 6. ❑New construction employees (far and/or part time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.$ �• LJ xemodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any'capacity. workers' comp.insurance. 9. ❑ Building addition o workers' comp.insurance' 5. ❑ We are a corporation and its Cl`T 10.❑ Electricalrepairs or.additions ,eq�ed•) officers have exercised their 3. I am a homeowner doing aIl work right of exemption per MGL 1'1.❑ Plunibmg repairs or additions o rkers' co c. 152, §1(4), and we have no 12. Roof repairs myself: coo ❑ trip. ep insurance required.]t employees.[No workere- 13.❑ Other comp.insurance required.] +Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonnat ou: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must subnnt anew affi&iit indicating such tcontwtors that check this bo must attached an additional sheet showing the name of the sub-contrabtors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees.'Below is the pollcy 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 le 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 certifyLndder the pains and penalties of pedury that the information provided ai ove is true and correct Si ague: Date: D fa Phone#: L40 Official use only. Do not write in this area,to be completed by city,or town official. City or Town* PermitUcense# Issuing Authority(circle one): I.Board of Health 2.lluilding(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 1 Information and Instructions Massachusetts General La`n 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." era ' ..association,Furporation or other legal entity,or any two or more An employer is defined as•..a clxvi .:P P�. of the foregoing engaged m a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,p artnership, association or other regal entity,employing employees. How�er;tlle- 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 woikvu such dwelling house appurtenant thereto shall not because of such employmentbe deemed to be an em "ployer. or on the grounds orbur7dmg 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." ter 152, 25C 7 states"Neither the commonwealth nor any of its'political subdivisions shall Additionally,MGL chap § ( ) ce of public work until acceptable.'evidence of compliance with the insurance enter into any contract for the performan iequirements of this chapter have been presented to the contracting authority. Applicants e workers com�ens ation affidavit completely,by checking the boxes that apply to your sitaation and,if. Please fill out the f necessary,supply sub-contractors)name(s), address(es)and phone n6mrber(s)along with they certrfieate(s)o ability Companies(LLC)or Limited Liability Partnerships(L•LP)with no employees other than the insurance. Limited Li or members or partners, are not required to carry workers' oompensa ion be submitted to the Depinsurance. If an LLarture t of�Industrial employees, a policy is required. Be advised that this affidavit may Accidents for confirmation of insurance coverage. Also be sure to sign and date the aiFadavit. 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' comp ensatioupolicy,please call the Department at the number listedbelow.. 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 Investigation t. s 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 permitllicense applications in any given year,need only submit one affidavit indicating current information(if necessary)and under"Job Site Address"'the applicant should write"all locations in (city or policy A of the-affidavit that has been officially stamped or marked by the city or town.may be provided to the town). �Pl! applicant as proof that•a valid affidavit is tin 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 pewit not related to any business or commercial venture (Le. 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 cogperation and should you have any questions, please do nothesitate to give us a call. The Dep artment's address,telephone and.fax number: The Commonwealth of Massachusetts . .. ' Department of industrial.Accidents ...Office 9f jnvests atioAS .. �S e et . y : 600•Washm.gton..�r. , . Boston,MA 02111. 'Tel.#617-727-4900 ext 406 or•1-.K7-MASSAFE • Fax#617-7274749 Revised 5-2645 www.mass.gov/dia Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 wvvw.town.barnstable.ma,us 508-862-4038 Fax: 508-79M230 Permit= Data • AFFIDAVIT HOME IMROVEYLM CONTRACTORLAW SUPPLEMENT TO PERMIT APPLICATION MG'sL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or constructign of an addition to any pre-existing owner-occupied building containing at least one but not-mote 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. ' pe.ofW),k �b�i 'Estimated Cost Address of Work (o �j2A-t H 'C to A1`S Owner's Name: t fl,►�N1 P• �� }-1 o WA F',�->0 tJ Date of Application:I 3 I ®6 I hereby cer*that: Registration is not required for the following reason(s): 0Work excluded by law []lob Under$1,000 OBu ding not owner-occupied [+ caner pulling own permit ' Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH•UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMTROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBTI'RATION PROGRAM OR GUARANTY FUND UNDER MGL.c,142A. SIGNED UNDER PENALTIES OF PEI=Y I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. 0 Date Owner's Wame TWO iLub(conthwed) th Fvastl P'Qsda' , • #ne Packages for dne and 7w*- ludU ResideatW Brt3ldings Elated id MUM ]I m 'Hea:iaglCk+ollaa F Wall , roar �� p et,er > Fmk Ftlldeacy' GellingAres=M) U•valtie9 R.vaiu� R value R vatu�e R Ya p �YAUsckw, ° 5701 to d500 dus D Da ' 31 13 19 10 6 Norccal CAA 6. iFosmal Q' '19 19 10 ,=38 U2 30 • • R 12l. b. g 12'/•' 0:s0___ _-..-36 13_ —,g- l 10 A _ 38 13 25 NA - 85. V 0.46_ 33 13' ' Z' N!A y.; ,: .•IS'/. 0.44. - 6 is Ant �y:a lsy. O,ss 30 ' 19 19 t1tA NIA Normal. ' X .15% oss' 38 1#_. 21 N/A Normal Y 1'8'/. '' 0.42• 3E 19-.- Zi NIA 19 10 90 AFUE 13 6 . Z, .I8y. 0.4Z 3a 14 19 10 a 90 AFV1t AA 18Y. 0.30 30 .' . � L•ADD RE550F'PRQPERT'Y; . ,.. Ll 2, 'SQUARE FOOTAGE OF ALL E?M . . ' . 3. SQUARE FOOTAGE OF ALL'GLAZG: - 4, °/a GLAZIN(z AREA►(#3 DIVIDED BY#2): ' 5, SELECT PACKAGE(Q..AA.see chart above): OTMRMM INVOLVED bMT$ODS OF DETERMDMG ENBRGY F�8Q 5 'N . ARE AVAILABLE. A Y,US FORTIES WORMATION. BUILDING INSPECTOR APPROVAL: YES. N0: ' a,•fatms•88Q343a 780 CMR.Appendix J lass doors, skylights, and Footnotes to Table J$.Z.ib: assemblies (including sliding-g opaque doors)to the gross wall Glazing area is the ratio of the area of the giaondi g�ecnent windows if located in walls that enclost owl1 yea m be xcluded from the U value requirement. ressed as a percentage.Up to 1/a of the 8area. °� ass may be excluded from a building design with 300 fi'of glazing For example,3 of�800ve glass y be tested and documented by the manufacturer accordance with = 1, 1999, glazing U-values mast taken from Table 11.533.A. U-values an for anuary cedars or After J est•radon Rating Council (NMQ test pro , ' . 'coal Fee the Nair U-values cannot be used. whole units t center-of 8 onstniction. If the insulation ac}uaves the fl�Il . 'TIiG.Ceiling•R glues do not assume a raised or oversized c be snl?stituted for R 38 , the exterior vYalls'vv#thout compression, R 30 insulation MY insul'atlon�thickness over — ' ' d'for�R=49,'*insuladdn. CefliagR-xaIdP-.prosenitl�a-sum•o caY9ty .--. - _— insula on avd Rj3 fnsula-tioa tray beIttbatifu.. ed t;eilin insulating shea lag must.44.placed between . lus insWadiig sheathing(if.useci):Fc veatilat' &�� w A Insulation p of the roof, on clads the conditioned space and the ventilated pork if used). Do not In +WaII R•valuas represent the sum.of the wall cavity insulation plus insulating shee �reamgeut caulc�be at ErrhER structural she .and interior drywall.For example,an R 19 nq iften cOul. M. apply'to exterior siding, a constrnc'tion. by R 19 cavity insulation OR R 13 cavity insulation plus R 6 insulating sheathing. to wall constructions,but do not apply to metal-fram wood-frame or mass(concrete,masonry, 3) e oar requirements apply to floors over un�onditi�dned spaces(such as unconditioned crawlspaces;basements, The floor irements. de must or ages)-Floors over outside air must meet the ceiling ruN + e entire opaque Portion of any individual basement wall with an average depth less the 5dgorse of conditioned. Th do walls. Windows and sliding gl. requirement racer the same 'R=value requirement'as abov:-gra •$ments must be included with the other glazing- Basement doors must.meet,the door [7 value req boa • • . d_scribed in Note b. 4 Tne R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs. ou plan to'Install more use cam liance approach 3pm'44;or 5.•if Yi ant with the lowest ' + If the building utilizes elgdtric resistance heating P • tha n one piece of heating equipment or more hen ens piece of cooling equi ent,the'egdP? efficiency must meet.or exceed the efficiency of e18los st ciy argtown set Table 75.2.1a o NOTES' lues are maximum acceptable levels.Insulation R valves are mum acceptable levels. a) Glazing areas andV va R value requirements are for insulation only and do not include structural components. doors in the building envelope must have a V-value no greater stra procedure DtakGn fromoar utha door bU-va ue b)opaque anted by the manufacturer in accordance with the NFRC p and docuaL or contains glass and an aggregate U-value rating for that door is not available, Include the If a do o determine compliance of the door. in Table J1.5.3b. of r windows and use the opaque door U value t glass area of the door with y a be excluded from this requirement(I-On may have a w- componenthiacIudes)two or more areas with One door m Y floor,l asemarltwall,slab-adga,or crawl spec - a is eater than or a al to c)If aceiiinng,WA. Wu differ ant insulation levels,the component complies if the o°oT components on nts comply if the area�-weighted eve ge U- the R.value requirement far that component equal eU-value requirement(0,35 for doors), yalue of all windows or doors is Igss than of equ 43 Town of Barnstable Regulatory Services Thomas F.Geiler,Director Building Division '0�fe t�►t�' Tom Perry,Building Commissioner 200 Maier Street, Hyannis,MA 02601 www.town barnstable.ma.us Fax: 508-790-6230 Tice: 508-862-403 8 HOMEOWNER LICENSE EXEMPTION (( i please Print I DATE: Z t Z l C!� Sv JOB LocAnoN Lam''( K a�5b � ]- go 2v number sheet 6,HOMBOWNEA": P�h� phone# work phone# name CURRENT MAII3NGADDRESS' cityltown state zip code _ed in of six units-or less and d-we The current exemption for"homeowners"was extended to includef` a license,s yro ded the the owner acts as to allow homeowners,to'engage errs individual for hue who does n possess Lusm isor. DEFJNITION OF HOMEOWNER Persons)who owns a parcel of land on which he/she resides ittaemac accessory to tends to such use and/orch there farm structures.intended A to be,a one or two-family dwelling,attached or detached 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 re onsible for all such work verformed under the building nernrit. (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 uddersigned"homeowner"certifies that he/she understands the Town of Bamstable Building Department minimum inspection procedures and requirements and that heJshe will comply with said procedures and r Sign of H er Approve]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 stasis that "Any homeowner pu*nrung work for which a building permit is required shall be exempt from the provisions of this section(Section lo9.1.1•Licensing of construction Supervisors);provided that if the bomeowner engages a persons}for hire to do such work,thafsuch Homeowner shall act as supervisor:' the r onssbilities of a supervisor(see Appendix Q, Many homeawaers who use this exemption am unaware that they are assurrurtg �P ardix Q'] Rules&Regulations for Licensing Construction Supervisors,$ectioa 2.1� This lack of awareness often results in serious psob]errit particularly ahem the homeawaer hires unlicensed persons. Io this case,our Boa-cannot proccal against the unlicensed person as itwould with*a licensed Supervisor. The IL=W%=acting as Supervisor is ultimately resp To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit applicati on, that the honseaavner at belshe understands the responsibilities of a supervisor. On the last page of this issue is a farm currently used by ea i*th several towns. You may care t amend and adopt such a form/certificatian for use in your community. r 1 � • IMPORTANT -� ANY CONSTRUCTION THAT INCREASES LIVING cP BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE rL c`o5 � INSTALLATION OF ADDITIONAL SMOKE DETEC i OiRS, NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE V' I INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. , o% k I POP AA g ape T I cL-°sue I5Li MAC 171-187 _19 1 K 10t> i I _ ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map J71 -yffl y Parcel _t_b � -Permit# l �. Healt,� Ul4vision 28v , Date Issued Conservation Division Fee Tax Collector Treasurer Planning Dept. Checked 11*11NG SEPTIC SYSTEM__ ',p��En Tp BEDROOMS Date Definitive Plan Approved by Planning Board Appr _ 6 Historic-OKH Preservation/Hyannis n(I Project Street Address �2f �K��S IZ vi a Village ��/cc-t-�� Owner WILLA Ar P -f l4W AFSar Address Telephone 60 S q20 G-3( L Permit Request F"r AJ k S F( 2�onn ►43o J� Lie Square feet: 1st floor: existing /!Sa proposed 0 2nd floor: existing 116 o proposed ,&72- Total new 6 7z Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Sao' s� ' Grandfathered: ❑Yes 0'No If yes, attach supporting documentation. Dwelling Type: Single Family Ek"' Two Family ❑ Multi-Family(#units) Age of Existing Structure 17 Y2 5 Historic House: ❑Yes o-N� On Old King's Highway: ❑Yes L) No Basement Type: Cl Full ❑Crawl ❑Walkout `0 Other . Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new 0 Half: existing o new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing 61 new First Floor Room Count Heat Type and Fue•I: eGas 1 ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 3'No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing 0 new size Pool:0 existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Yh_e_w size ?SK29 Shed: existing❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No 1f yes ssite—plan review#__ -� Current Use Proposed Use BUILDER INFORMATION Name_(A4Ui&ji 17-69,14,1 Sp J Telephone Number L Address .J+- /S License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 7' d . 7-W4 Sr�/� SIGNATURE ATE zo �6 FOR OFFICIAL USE ONLY tv - PEkMIT NO. - DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL FINAL BUILDING 24 ^p µ DATE CLOSED OUT � ASSOCIATION PLAN NO. 0 The Commonwealth of Massachusetts Department of Industrial Accidents Off,ce of Investigations 600 Washington Street Boston,MA 02111 ��M �•''r www.mas&gov/dia Workers' Compensation Insurance Affidavit:.Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly_ Name (Business/orp=ationdndividual): W LA—LA ^^Psd Address: ? ( 9,A -S-rz�Y—',N s 27 City/State/Zip: c /i4k Phone#: Sas grzo 5-,3 6{::, Are you an employer?Check the-appropriate boX: Type of project(required): 1.❑ I am a employer with 4. YI am a general contractor and I 6. [�ew 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 $ 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. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ 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' eQ ] 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 tContractors 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 employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: 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 Vnder the pains d penalties of perjury that the information provided above is true and correct Signature: Dater t, w a� Phone M Sa S 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#: f Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership, association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners;are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant; Please be sure to fill in the permit(license number which will be used as a 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 gown)."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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 17877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www,mass.gov/dia °FZHE T° " Town of Barnstable Regulatory Services SARNSTASLE, ` Thomas F.Geiler,Director 9 MAM 039. Building Division En�, g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. ' Date �7Z 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: CFI N t S4 Estimated Cost 700 d Address of Work: 3 o JeV2-AU7_`1 ZIF�Aj ►fir IJ I Owner's Name: W d C.L-t A-M /�j Date of Application: (0 1 1 y I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under.$1,000 21 =ner g not owner-occupied 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. 2� OS OR Date V Owner's N e Q:forms:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 Change of Contractor/Builder $25.00 QA FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 7 2. square feet x$64/sq.foot= 4 x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041 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.0041= STAND ALONE PERMITS Open Porch x$30.00,= .(number) 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) �/ Permit Fee ,�'� le Projeost Rev:063004 o t� Town of Barnstable Regulatory Services snxrrsrnsr.E Thomas F.Geiler,Director �b 6 9 .m� Building Division ArfD MP'1 A . Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us k - Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION lPlease Print DATE: JOB LOCATION: .3L ,62 �y✓r 5 C'�� Vi�C� , number street village "HOMEOWNER' F4(LL1 r4 M C�►^l��/J !9>5 qeo 53/c, 5d9 9&2 38 3 name p home phone# work phone# CURRENT MAILING ADDRESS: 'K^c�S 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 ins ection procedures and requirements and that he/she will comply with said procedures and requiremen Signature of Home own 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, r' 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 The Town of Barnstable P`pF 1ME 6ARYSTA6LE. =:A aDepartment of Health Safety and Environmental Services S :MSS. , y� tb�q• `qe `'E�►��° Building Division 367 Main Street,Hyannis,MA 02601 ofrice: 508-8624038 Fax: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: �. l Project'Address:'?ts "B r 10- l'h S �Builder: The following items were noted on reviewing: ' r Reviewed by: M Date: q:buildinglortnsaeview ` 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE cement plaster is permitted to be substituted for '/z the requirements of 780 CMR 2805.0 and the inch (13 mm) of the required poured concrete mechanical code listed in Appendix A. protection, except that a minimum thickness of 3/6 inch(ten mm)of poured concrete shall be provided 722.3 Concealed installations:Insulating materials, in all reinforced concrete floors and one inch (25 where concealed as installed in buildings of any type mm) in reinforced concrete columns in addition to of construction, shall have a flame spread rating of the plaster finish. The concrete base shall be 75 or less and a smoke-developed rating of 450 or prepared in accordance with 780 CMR 2506.0. less when tested in accordance with ASTM E84 listed in Appendix A. 780 CMR 722.0 TIMRAIAL,AND ' 722.3.1 Facings: All vapor retarders, whether SOUND-INSULATING MATERIALS integral or applied separately, shall be installed 722.1 General: Insulating batts, blankets, fills or on the warm side of the building element, and similar types of materials—other than fiberboard and shall have a permeance not exceeding one perm., foam plastic insulation—including vapor retarders Where insulation. materials are installed in and breather papers or other coverings which are concealed spaces(such as wall, floor or ceiling incorporated in construction elements, shall be cavities), attics or crawl spaces in buildings of installed as required by 780 CMR 722.0. Fiberboard Types 3,4 and 5 construction,the flame spread insulation shall be installed as required by 780 CMR and smoke-developed rating limitations do not 2309.0,and foam plastic insulation shall be installed apply to facings, provided that the facing is as required by 780 CMR 2603.0. installed behind and in substantial contact with the unexposed surface of the ceiling, floor or 722.2 Exposed installations: Such materials,where wall finish. exposed as installed in rooms%or spaces, including attics and crawl spaces of buildings of any type 722.4 Cellulosic insulation: Cellulosic insulation construction, shall have a flame spread rating of 25 shall meet the requirements of CPSC 16 CFR,Parts or less and a smoke-developed rating of 450 or less 1209 and 1404,listed in Appendix A. when tested in accordance with ASTM E84 listed in ' Appendix A. Plenum installations shall comply with . l 142 780 CMR-Sixth Edition 2/7/97 (Effeciive 2/28/97) �f1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 7 Map Parcel --{ Permit# IQ (u 1+ Health Division 31310 S Date Issued 0 Conservation Division F Sf 3/3/0 5-- Application e Tax Collector / Permit Fee -� 05 Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board EXISTING SEPTi LIMITED TO—%3, S OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address 3 6 J�?"eq 4,w Village e(exje_4L-)1 t`c— r Owner lX/s���a - P— o,�,05�� Address 3'c _E97�eo �� i� _a:4 Telephone Permit Request Square feet: 1st floor: existing &,P, proposed 2nd floor: existing proposed Q Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3�2.�� Construction Type Lot Size /:Q o 5i Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family W-` Two Family O Multi-Family(#units) Age of Existing Structured Historic House:' 0 Yes ONUS On Old King's Highway: ❑Yes 2-116— Basement Type: u II 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) e:9 Basement Unfinished Area(sq.ft) Fy V. Number of Baths: Full: existing 7— new ` e"D Half:existing 0 net; Number of Bedrooms: existing new CD m • Total Room Count(not including baths): existing new G_±�?Aee .First Floor Roo ount cla 3 sus X a� Heat Type and Fuel: 46as ❑"Oil. ❑ Electric ❑Other Cn Central Air: ❑Yes Cho Fireplaces: Existing' / New� Existing wood/co stove: Yes'0 No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new. size Attached garage:0 existing WHiLs ze '7f y Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0 No If yes,site plan review# Current Use Proposed Use ,2 � P -- / BUILDER INFORMATION Name W �� � � 2N Telephone Number AddressM1 License# S-f yL/3 Home Improvement Contractor# 02 6 % Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE , ,= DATE 3Z3 D _ r FOR OFFICIAL USE ONLY } PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS. VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME r) (p • Z I u S �.J —•-7 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL / PLUMBING: ROUGH FINAL GAS: ROUGH CO ;� FINAL FINAL BUILDINGdv C i cr o 's DATE CLOSED OUT ASSOCIATION PLAN NO. C13 'dawn o f B arnstable I� r °'^ Regulatory Services s�xrasrns • Thomas F.Geiler,Director . , Buitding Division Tom Perry;'Building Commissioner 200 Main Street, $yannis,.MA 02601 www.town.barustable.ma.us - office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Qwner of the subject property ` ' to act on 'behalf, hereby authorize:' d N(� � . in all matters relative to work authorized by this building permit application for; ( dress of Job) Signature of er ate Print Name Y RESXDENTIAL BUEGDTNG PERMIT FEES M13LICAITON FEE New Buildings,Additions $50.00 � Alterations/Renovations $25.00 - Building permit Amendment $25.00 FEE VALUE WORKSIMF NEW LIVING SPACE square feet x$96/sq.foot= x.0031= Pius from below(if applicable) AI,TERATIONS/RENOVATIONS OF EXISTING SPACE --square feet x$64/sq.foot= x.0031= plus frombelow(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft ACCESSORY STRTJCTURE?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 x$30.00= Open Porch (number) Deck �x$30.00= x (number) = - Fireplace/Chimney (number)x$25.00 Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 - Relocation/Moving $150,00 (plus above if applicable) permit Fee projcost , '780 CMR App&Wk J Table J5.2-lb(continued) = prescriptive Packages for one and Two.Family Residential Buildings Heated nitb Fosoymels MAXIMUM MINIMUM Ceiling wall F1aor Basement Stab Hesting/Cooling Glazing Glazing perimeterEquipment Eflrciency' Arta!(M.) U-value' R-value' R-value' R-value° wall R-value', R value Package 5701 to 6500 Heating Degm Days 6 Normal Q 12% . 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 85 Normal S 12% O.SO 38 13 19 10 NIA Norma! FUE T 15% 036 38 13 25 NIA Normal U '15% 0.46 38 19 19 10 6 V 15% 0.44 38 13 25 N/A NIA 85 AFJE 6 83 AFUE li W 15% 0.52 30 19 19 10 Normal X 18% 032 38 13 25 NIA NIA NIA Normal Y 18% 0.42 38 !9 25 N/A 90 AFUE Z 18% 0.42 38 13 19 10 6 AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: z.; 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 070 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-1980303a 780 CMR Appendix J Footnotes to Table J$.2.1b: d Glazing area is the ratio of the area of the glazing assemblies (including sliding glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 f of decorative glass may be excluded from a building design with 300 if of glazing area. 4 Ater 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. 3 The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R 38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 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. 4 The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest efficiency must meet or exceed the efficiency.required by the selected package. . 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and.U-values are-maxim= 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 J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 pFIME Tom, `down of Barnstable ]regulatory Services 13 Srnsr s, i Thomas F.Geller,Director MASS. 9� 1e39. � Building Division AlED MA'S A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ' Fax: 508-790-6230 Office: 508-862-4038 • Permit no. Date AFFIDAVIT HOME IMpROVENMNT 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. ZC!rit 0111 Estimated Cost Type of Work: Address of Work: ` Owner's Name !� Date of Application'.*e d I hereby certify that: Registration is not required for the following reason(s): 0Work excluded by law []Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: tNREGISTERED OWNERS PULLING THEIR OWN PERMIT ORI DROVEMENTEALING 1'HWORK DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME ACCESS To THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY IWe ---y ply for a permit as the agent of the owner: . Contractor Name Registration No. OR Date Owner's Name The Comnwnwealth of Massachusetts M _ Department of Industrial Accidents 6Q0 Washington Street J Boston,Mass. .02111 Workers' Com ensation.'insurance davit-General Businesses �+' _,a'�:�:5u:•i :+� ;'ems .. ...+Me,-,.,Fa:Y•�,+,•, Y�a� name: �</ address: Alln city' / 2t 7`oIA�P state: � S ziv: ��%Y. phone# y77 406 7 work site location full address a sole proprietor and have no one Business Viper [I Retail RestauranVBai/Eating Establishment working in any capacity. ❑Of ice❑ Sales(including Real Estate,Autos etc.)' ❑I am an'em to er with eta to ees full& art time.): ❑Other �I am an.`employer providing viorkers' compensation for my employees working on this job.. 6IIiD2IIV•Ildmesad ress: >i•<'&: `t'. _ :.ire 'i..�;:.�: :i> `' .. . irisiira3ice.co:• 1n :. I am a sole proprietor andhave hired the independent contractors listed below who have the following workers' compensation polices: comDany flamer• 'oiie•�#. cites. D insurance co. - 11 #± ••t•;.;;`;• . • :.,.. • comperiy va, - r• 1nSllrallCeCb. . .. '','•.":.'.::''•:_':..,.•.;<•::�.•',:..' 0 11C: - - Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a dine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the foim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that i< copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby,certi er the pains d penalties of perjury that the injormaiion provided above is tr an correct Signature / y Date O Print name c rl�f�Y ,a cN��s� Phone official use only . do not write in this area to be completed by city or town ofcia1 LO'check ity or town: permit/license# ❑Building Department ❑Licensing Board if immediate response is required ❑Selectmen's Office❑Health Departmentontact person: phone#; ❑Othermveed Sept 2003) Information and Instructions. Massachusetts general Laws chapter section 25 requir 4 es all employers.to provide workers' -,co ensatioii 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 mare of the foregoing engaged in a joint enferprise, 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 bf t.e.dwelling house of another who.employspersoiis to do.maintenance, construction or repair work on such dwelling house or on the grounds or urtenant ffiereto shall not because of such employrnent.be deemed to be an employer. ,. : . .. building.app •. MGL chapter 152 section 25 also'siaies that every state or local licensing agency.shall iv thhold 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 com nonwealth 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 ,Please supply company name, 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 Departrnent at the number listed-below. , City or Towns . Please be sure that the affidavit is complete andprinted 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'arrangem m ents 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. XXI IX: The Department's:address,telephone and fax number: . The Commonwealth Of Massachusetts Department-of Industrial Accidents WIN of Weesdowens 600 Washington Street Boston,Ma. 02111 fax.#: (617)727-7749 phone#: (617) 7274900 ext:406 i I �a,al Nsb�l 3x©lbN;®3i s' Jflz A- MWaa. QPolka' ti ag unN, 2 �. ®al �fll .: 00 asua� s, 1c� 11J3,2JsJ �l'�80�a�llfi©8 I Bodrd of.Buildn►g.Regulatioiis and Stanilard5 HOME IMOVEMENT CONTRACTOR R i e strala� 10160 _ p 2006 y — idual RONALD E LAN ND RONALD _ LAR . =_ 16 PfMLICO POND - � FORESDALE,MA 02644 ?idmioistrator f + , � f a nu J `�? notllr�t ptlna ao., SP.teP.ue�S r0£I tu2laan80iz0•LIV`uoIso .. .0 urn�ai. Pue suor;nUn�a ld no�n�ys g �1f1e asn n 7. Puri o� .3 2d 2mP►�n b aup l'PIntPn!ao 3nP uom,t►�. g 10 Pivog P7na nor;�a�sr�ar ;aao3a ro q asgaa►� _ Y s ' ^•-J L ' bob-'5;oon _:�. Y _ ..- :_.�.,.. • aFnf ,Hom`es tyFe ib ss"a current edition ofthe ' srS Building,9Coc�e islefgraedocaGoc�af,-iiil—:'ense. s IG^��APE -AWL Q-,F (,$&8)34.4=7233 - E BC CALL® 2003 DESIGN REPORT - US Monday,January 31,2005 13:06 auYdr�ple 13/4" x 18" VE12SA-LAM® 3100 SP File Name: BC CALC Project:F601 � Job Name: Description: ,ddress: Specifier: Rick Lowe amity,State,Zip:, Designer: customer. Company: ;ode reports: ICBO 5512,NER 629 Misc: Standard Load-40 psf 110 psf Tributary 14-00-001 (----- -- —_ r Ak BO B1-` 6720 ibs LL 6720 Ibs LL 2105 Ibs DL 2105 Ibs DL Total Horizontai Length-24-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 24-00-00 Live 40 psf 14-00-00 100% Member Type: Floor Beam Dead 10 psf 14-00-00 90% 'dumber of Spans: 1 _eft Cantilever: No Controls Summary Right Cantilever: No Control Type Value % Allowable Duration Load Case Span Location Moment 52951 ft-Ibs 56.7% 100% 2 1 -internal Slope: 0/12 Neg.Moment 0 ft-Ibs n/a 100% -i ributary: 14-00-00 End Shear 7722 Ibs 31.7% 100% 2 1 -Left Total Load Defl. U357(0.807") 67.2% 2 1 Live Load Defl. U469(0.614") 76.8% 2 1 Max Defl. 0.807" 80.7% 2 1 Live Load: 40 psf Dead Load: 10 psf Notes' Partibon Load: 0 psf Design meets Code minimum(U240)Total load deflection criteria. Duration: 100 Design meets Code minimum(U360)Live load deflection criteria. Disclosure Design meets arbitrary1( ")Maximum load deflection criteria. Minimum bearing length for BO is 1-1/2". The completeness and accuracy of Minimum bearing length for B1 is 1-1/2". ` the input must be verified by anyone Entered/Displayed Horizontal Span Length(s)=Clear Span+112 min.end bearing+112 intermediate bearing who would rely on the output as evidence of suitability for a Connection Diagram particular application. The output Consult project design professional of record or BOISE technical representative for connection design above is based upon building Beams 7 inches wide will be assumed to be either top-loaded only,or equally loaded from each side. code-accepted design properties Bolts are assumed to be Grade 5 or higher. and analysis methods. Installation Member has no side loads. of BOISE engineered wood products must be in accordance Connectors are:1/2 in.Staggered Through Bolt with the current Installation Guide .and the applicable building codes. a=2" To obtain an Installation Guide or if b d you have any questions,please call b=2-1/2" c 7" (800)232-0788 before beginning = d product installation. =24" a \ -1— i BC CALC®,BC FRAMER®,BCIO, \'/ BC RIM BOARD"'' BC OSB RIM BOARD-,BOISE GLULAM-, C \ VERSA-LAM®,VERSA-RIM®, VERSA-RIM PLUS®, VERSA-STRANDTM ® \ VERSA-STUD®,ALLJOtST®and AJSTm are trademarks of Boise Cascade Corporation. �/ Boa.00 07` T - d - i� Opp i m 0 l o 'y' \ ' ` Posto 10 . 'V 9 303 CERTIFIED PLOT PLAN LOCATI O N: CtEAwo'�_APU///e `I/J/9• FOR:Z::�--L3��,-.SdL�E� ,S Z/E SCALE: /"=30/ DATE: /98� REFERENCE: /<✓G C.o T/S i9S S�(Q�cJ�i �✓ O /9T Qi92A•1S7_A, 3Gj .4ej5_c5%ST/C>l" I CERTIFY TO THE BEST MY KNOWLEDGE AND BELIEF FROM INFORMATION ACQ ED HATTHE,lQuAvo-y7'io.v SHOWN ON THIS PLAN IS LO AT O TH - ROUND AS SHOWN ( EON. OF TE R E S S 1 0 N A L LAN URVEYOR _Q J®MEN o MONAHAN,JR. � J. M. MONAHAN, JR. & ASSOCIATES No. 13M PROFESSIONAL LAND SURVEYORS & ENGINEERS IST-�wyo`� TOWNE PLAZA - 900 ROUTE 134 SOUTH DENN.IS, MA. 02660 N� SUR`I�' J.N.87-1.0 5? • I CI M11. t;umber:_I� 1879_uaic • Completed by C..M . SHOX7- _ e' HIGH GROUND-WA1ER LEVEL COMPUTATION Site Location: 13fLAt�y Sc�/k��_S 12D �'��✓ �Z✓!t[E Lot No. + Owner: SMf>< <- Address: Contractor: L ��EL .Soz.40vV-9 Dz=✓.Address: !31 OLD Notes: OC)ZSo USA° >C�''' LvT s /S2 F /S3 STEP 1 Measure depth to water table to nearest 1/10 ft. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ��//7 r 9� date STEP 2 Using Water-Level Range Zone and Index Well Map locate site and determine: A/�✓230 A) Appropriate index well . . . . . . . . . . . . B) Water-level range zone . . . , . . . . . . . . 8 STEP 3 Using monthly report"Current Water Resources Conditions" determine current depth to water level for index .well . . . . . .1a/�S mo yr STEP Using Table of Water-level Adjustments for index well TSTEP 2A , current dLpth. to water level for index well (STEP 3) , and water-level zone (STEP 26) determine water-level adjustment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . STEP 5 Estimate depth to high water by subtracting the water- level adjustment (STEP 4) , from measured depth to water level at site (STEP 1 ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . L �.� i o P @ E L 43', 8 vwoze. @ FL 39__O 13 T' L e a c ti 4 3 , Assessor's office (1st floor): /. r 2��v?r5 G 'il �FTNETO Assessor's map and lot number ... ............ ... .... . ... IC sysTEM klvzj _ �Q•• �o Board of Health (3rd floor): C®MPUAW..E d — S® & gNSTALLED IN . Sewage Permit number ............................. ............,.. . ' �' y� WITH TITLE 5 >i 323 SeTa LE, Engineering Department (3rd floor): / VIR®NNIENTAL CODE A 'oo t639- eye to , House number ... ........................... EN �''�ami, a� APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M, only TOWN RECULA'I'1®' ND TOWN OF BARNSTABLE BUILDING INSPECTOR 5� _ APPLICATION FOR PERMIT TO Build" a House TYPEOF CONSTRUCTION ............................W..Q.Qd..k'"X'zme............................................................................... ' If d0,1WJ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r Location Lot /�$ ......Bra"leY...Jenkins..R4 .d........Cex1 exV.�11e......................................................... ..................""............ ProposedUse Dwell"ing........................................................................................................................................ ZoningDistrict ................... C.................................................Fire District .............0...and..Q.............................................. Name of Owner .. Lebel Sol1.ows„"Trust Address ....J..3.1...Q.1d-.Rau"to..13"2...ayannis...MA...0.2601 Name of Builder Lebel Sollow.s "Development-..Address .1.3.1...Ql.d...Rout.e...1.32..H"yanai.s",...MA,...Q2601 Name of Architect Northsi.de. Des.i.an.........................Address ......Rt...6A...Yar"z Yarmauthpart,...MA.................... Number of Rooms ..........Five. . ..............................................Foundation .....GOXICr.et.e.................................................... .. .... .. Exterior ..............qlc Pp ...and...Shingle.S......................Roofing ......A. p.h �t............................................................ _Floors "`'........Plywood...................................................Interior ......))xywall....................................... ..................... Heating ........Ga.s........................................................:.....Plumbing ....P.V"C/".cu..2..baths......................................... Fireplace YO.s................. Approximate Cost p .......................... pp ...$.60.,..0,0.0...0.0............. ...... ........... Definitive Plan Approved by Planning Board -,Iu.l-y-------L6----------19-$A.- . Area ....... ........................ Diagram of Lot and Building with Dimensions ��� `Fee ?"< ' v�N ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the own am able qr �arding the above construction. Name .... ........................... :............ . .. ................... Construction Supervisor's Licens ....................... ............ LEBEL SOLLOWS TRUST ! No ".31.271.. Permit for ...1.?..Story. .......................... ..... ....... I 1 e .Famly Singli .................... ... c ............ ................ ..... Lot #154 , 36 Braley..Jenkins Location .................................................... ....... Road Centerville ............ Owner ......Le ke.1....S.0.1.1.ow.s....T r.u.s.t.......... ti ..... .. . .. .... .. . .. Type of Construction Frame ........................................... .....................!..................................................... Plot ............................ 'Lot ......;.......................... PY, Permit Granted ......0 c t.ob QX... ...........ig 87 Date of Inspection ....................................19 Date Completed9?—...... .. . ............... ...1 4 % Assessor's office (1st floor): FTHET Assessor's map and lot number ...`b ........ �. � a ce—. Board of Health (3rd floor): fO �� Sewage Permit number ............................. .....:�.o V- ......... 2 BJHBSTADLE, Engineering Department (3rd floor): y�- f 90o Mb q, \0m° House number }. (o ,. >.............................. o Mar 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 ....................Build..a...House....................................................................... TYPE OF CONSTRUCTION Wood....,.FrA..zne............................................................................... /�/`� �G r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot... ..... ra1eY...Jenkiss...Ront ad........Qe ......................................... ................. Proposed Use Dwelling .................................._.......................................................................................................................................... y ,r ?- Zoning District ..................RC.................................................Fire District .............('.. .i<a.d....0.............................................. Name of Owner,€�...Lebel .So11owS.. TRUH�3,t..............Address ....1,31...0.1.d...RO1ate....1..3.2....H.va.? ni..0...M.A. ..0.2601 Name of Builder Lebe1 Sollows. Development,..Address .1 3.1...0:�A...Rc0t.It e...1..32...Ey,.ce.itr.1is:.r...MA...0.2601 .c7]r Name of Architect,NOrthSlde„Design........................Address ......R.t...6,�...Xs rin..a. ttk1 t.f....1$A.................. :. Number of Rooms ..........Five ........................................................Foundation .....QQ:nqr.e.t:.e.................................................... Cla sand Shin les Exterior A �1. A..p.k�al.t ............................Roofing ........�� r ' Floors .................P...1� ....... 00d ....................................................Interior ......1).x.vw l..ir............................................................ i - Heating Gas . Plumbirig ...P�7(',�r?a... ....k�a.t.135.......................................... ....................................................... YesFireplace ..................................................................................Approximate Cost ...$.F.a.0. 0.0—f?.17....................................... owl i 1 Definitive Plan Approved by Planning Board -July____-16--_-___-__19_RA_ . Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r t; .Yxx 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. . Names.--Gt .. ............................ Construction Supervisor's License Q5 ....'...... LEBEL SOLL/OjWS TRUST No .31271 permit for .....?...S tory Single Family Dwelling ............................................................... Location ...Lot #154, 36 Bralev Jenkins Road ............... Centerville ............................................................................... Owner ..Leb!...$.4.1,.1.Q.Ws...TJC.ua.t............. Frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ....October: 7, 19 87 Date of Inspection ....................................19 Date Completed ......................................19 i n l { y +�...atw,."Mi.�v-_M•..�`.. 1!..a,..,,,r.r 'ilr+.v'k' �. 3.y P.�L r.. .S� +�"Ynw- �e�k"`��-Y,N..pY"�'rwwS4 r.".r+4:e � ..,�4..r A^"".+'Xrsr.'r•.f.r.y .. — -"' .rv�� 35�"Y�~ v ��� -„ . .J �(9M'i - �}T')31.F 'C>0_ ,•. P' f�!>�r.. '. `ht�` � � . #` SF -for TOWN OF BARNSTABLE - 31271 - Permit No. ................ BUILDING DEPARTMENT f a�aan I TOWN OFFICE BUILDING Cash a�aa v "�9rnr HYANNIS.MASS.02601 Bond ....... CERTIFICATE OF USE AND OCCUPANCY Issued to LEBEL SOLLOWS TRUST Address lot #154 36 Braley Jenkins Road, eente.rville USE GROUP FIRE GRADING OCCUPANCY LOAD r. 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. a ...........Apri1.........., 19................. ........... ... ?!--..-. Building Inspector t TOWN OF BARNSTABLE BUILDING DEPARTMENT S aseaS out TOWN OFFICE BUILDING a. ♦g 1639' HYANNIS, MASS. 02601 0■AY MEMO TO: Town Clerk FROM: Building Department DATE: 7� /.�I An Occupancy Permit has been issued for the building authorized by BuildingPermit #/.......��/, „7 �.•»..-..-..-...-.................................. ..............................................»...................»....................... � ........»». issued to /..r. !1:.... ,. (��a:l.. ....... .:............. ..... Please release the performance bond. - -- - ,, :. , 11 . . I . � I . , I- - 1. � . . ", �_ _ , _"< TOWN OF VARNSTABLE, tV1ASSACHUSETTS �a < . ' S n M r. 4 �4a r �yt 9 `�tr 1.Y-" l rt I 1 ;. n t �} z ' ,...._��,�--:",.,.�:I..!.,-::;..�.-7�._'.l:6�.-:.'%,..I...,,/�.,.'-:�.�,,.7.:...i,1,.'.I';,jz?.�,-..,��I-�-'..�i��i,-!I:V.:.��,,_.11�.1.,;-I'�,,Iy-,��"�::I,_�I'I.'l-.:.,...',.7:7:4"f._.:i,,1.11�I',.::1�,-;,..,r�:I-,.,�1��.;;,..-I.I.'�I.,'1,I.��.�.;...:I,.���i!...�::11�,...,�:�i�..�':�,.1�'�,7_:�..:-1,.�—.�.:�1.�....�:.�..'.��.1.":,,�,I,.l,:�,�'-:!:,',�..�,.s.�,�,,,:,:I���_,;..:'�.�.:..1�&I".I.:_1.-,.,:Ir��:�."�I_.::,:.*,;.I.,.�;'..�,,.-,�,...:��.3 i 7�'�.I;....I--,1..).I:,�.,.I�;'.,."',.�.:�.._,I.�,.%:.!r�I:I,.:.-�.�:��,..-j:.,,.I�,��I.',,�'.-,,,ri.I:�. 71�Z3b EF 1 t Y,..r �µ DATE c A* o 7 M k !:. :}� *iar'"4.Sr.� ", ro � i.. r t.; • y P vt 05 x PER T APPLICANT i 4 Y ADD ESS - s 6k �; \ &6h gY�r >f ` < ,6 t ( r '( t / at it 7k p�rj , i T�'rS Ii 4�,� 4 ; .. M ( 1 STORY 5 V Q 1 � PER IT TO � �,1 D4x�d>-k� Q?N£LLINCUTJITiSr � „ ,,„ � ,_,,.i TYPE_o� IMP.R OYEMF,N '1N0 . ''r, 'Pfl 7 n: r - '<' r - < .( ZONING, 1.., f y,M AT (LOCATIONS T.h*: $1 did Arlc�r T } Ys S - 3 (NO - ET�I� ���� 7 t,,, �ez'�uF7c e. ;t�. i - OISTRIC7 r f f BETWEEN t; , AND ,[ 'x ,.(GROSS STREET1 ('CROSS STREET) 7n. . 0 SUBDIVIfiION ti LOT BLOCK E ! s 3 t �� _: c Y' .? - c BUILOING,lSfjOj�E t I pT WIOE BY FT LONG BY'` FT IN,HEIGHT AND SHALL CONFORM IN CONSTRUCTION ` r t) tivtaa , ,r : fx v TO TYPE��? '},¢ USE GROUP BASEMENT WALLS OR FOUNDgT1ON ` Iy1.y r " S il ZV`• r r t,Z' 4 f(TY.PE) t r, tj,,Lr ; 'tax y ci REMAi3KS„ y� ( Q I �z r t v ..` ^rR 3 c111 ^P f F h �e ��rt�Yrr r;. t `), 3 and VOLUME A PERMIT! 0r E5TIMATEb COST 74 t c.� ft.lg ARE-FEETI / •• E �' -ac V :i f YyY y OWNER `i T'a},al Gn�� f. J` -ri'xt1a� ADDRESS--�_�7�I n I r? S '..,,.0 i*,�::.�(.-1m-,,-'�.,',t._�v.,.k"Z'F�-�i:.I:.-.;,;1,,0�..-`"l p���-i�0;""' BUILDING DEPT ..L t r a { , 7 yt�.:. L -i -J u , xq s"(RFFf4X, 'sr t ;% r :t r Y1rte,µ)S1 t n r V r._1 1 4}ys t r. :r rf S.a { x. ; a, ' r 't:` IY` x�`'ic* L( a .S x i y r THIS PERMIT,CONVEYS NO RIGHT TO .00CUPY ANY STREET; ALLEY OR SIDEWALK OR ANY. PART'THERE'OF ,E_ITHER TEIy1PORARiLY PERMANENTLY;'ENCROACHMENTS ON:P.UBLiC PROP.ERTY,.NOT SPECIFIq'ALLY PERMIT.TED`•UNDER'THE`.BUILDIN6'CODE '=MUSTrBE PROVED BY THE 'JURISDICTION. STREET OR ALLEY GRADES AS.WELL AS DEPTH AND LQ;:ATION OF'.PUBLIC.:SEWERS MAYBE OBTAID :FROM.THEFDEPARTMENT OF PUBLIC WORKS-THE ISSUANCE OF THIS PERMIT DOES:NOT RELEASE THE APPLI,CANT;FROM THE-CONDITit OF ANY APPLICABLE SUBDIVISION RESTRICTIONS, ,,.�: * tr I,: t MINIMUM OF'REQUIE CALL APPROVED PLANS MUST:BE RETAINED\ON,JOB AND THIS, WHERE: APPLI'CABLE'SEPARATE IN$P.ECTIONS REQUIRED FOR ALL CONSTRUCTION WORK- CARD,KEPT POSTED.'Uly, IL FINAL IN$PECTION HAS BEE► °.PERMITS ARE REQUIRED,.,FOR I FOUNDATIONS OR.FOOTINGS. ELECTRICAL�,PLUMBING ."AND MADE.: WHERE A CERTFI�ATE OF,..00CUPANCY ,IS RE MECHANICAL INSTALLATIONS. 2 PRIOR TO COVERING STRUCTURAL .QUIRE^,SUCY$UILDlNGiS !ALL NOT BE OCCUPIED.UNTIL' MEMB'ERS(READY'TO LATH). (FINAL INSPECTION HAS BEEN MADE: 9 :FINAL INSPECTION BEFORE. ,� OCCUPANCY. - ,.. . POST THIS CARD' SO-IT IS, VISIBLE FROM STREET ` BUILDING INSPECTION+APPROVALS PLUMBING INSPECTfON APPROVALS 1 ELECTRICAL'INSPECTION APPROVALS. ' EGG ` ~ ' r N` ,' -:1�,L,:.e:..,,;,,...;,:::...1.,��:�.�..../,!,I'�,'":I��I,�v.4,,I1,��,-,.��7.._.!�..�7.. ,2 2 - v ' s k y I , S i HEATING:INSPECTING APPROVALS. REFRIG TION INSPECTION AP PROV'AL k .. 1 . }; Gil E ICI . S ..OTHER '\. . 2 � - u t�e, Z 9� 2 AR ALl'H Y �2:�drrt -6 j'41it . . , ,,;. � - I .. . I- , /i - .V .. ; 1. WORK SHALL.NOT PROCEED UNTJ,L'.THE PERMIT WILL BECOME NULL"ANq VO(D.IF`CONSTRUCTION INSPECTIONS'1{!D'FCATED,ON THIS-Ct . ! I INSPECTOR HAS.APPROVED.THE;-VARIOUS ' ,'WORK IS NOT STARTED WITHIN SIX MONTH$`OF.DATF..THE CAN. BE ARRANGED:FOR BY SEL'EPHC ! STAGES`OF',CONSTRUCTION. LOT 153 ASSESSORS CIO 0 % MAP 171-186 pp LOT 154 p ASSESSORS tip MAP 171-187 ol AREA=15000fS.F. ............. ............ �o i FOUNDATION pp 9 p, pro. � y�8' tip ' o •oo, � r LOT 155 (STA TE FOREST) • ASSESSORS ! ASSESSORS MAP 171-188 MAP 171-002 ' FLOOD ZONE "C" FO UNDA T N CERTIFICATION RES ZONE. "Rc" TOWN.• CENTERVILLE SCALE- 1"=30' PL REF- 306-22 ELEV N/A SETBACKS.- 20'-10-lO' I CERTIFY THAT THE ABOVE ��►�► ���� YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON .' �o OF MASS, '. v '0 T cy v P. 0. BOX 265 THE GROUND AS SHOWN, AND ��a. �G`S'EAFo Gs� UNIT 1, 40B INDUSTRY ROAD IT'S POSITION DOES QSTEPHEN W' � DOY.E N � MARSTONS MILLS, MASS. 02648 CONFORM TO THE ZONING LA SETBACK REQUIREMENTS OF #375 ° TEL• 428—0055 FAX 420-5553 B. RNSTABLE - ---- JOB STEP N J. DOYLE, R.P.L.S. DATE.• 04-27-05 NUMBER 5384OFND o D li J , i r , + r ! i . t {r v; rr v r + S � 7 �,o �r<Y •� a IN SCALE' ._ r APPR011�D FAY. � A DRAWN B'Y AT. R4r1t1S t7 .. .. a ExRAM1i1NC�N4JMQE �l.M41 ' '� S .4 LOT 153 C.B. AIM 171-186 w (FND) LOT 153 - ASSESSORS `S'6'2• MAP 171-186 lovA'QU .s Epp' LOT 154 AIM 171-187 , 0.34 ACRE CENTER VILLE 14 o IS ':HO USE pw PLAN REF 306-22 , , - ASSESSORS MAR- 171-187 ZONING: "RC" SETBACKS: 20'-10'-10, DEED REF 14400-249 THE SEPTIC S '> 2 - YSTEM ' J WAS DRAWN FROM THE TOWN of BARNSTABLE PLOT PLAN OF LAND I �� lb `?y' SEPTIC INSTALLERS CARD LOCATED AT- PROPOSED - 36 BRALEY JENKINS ROAD ADDITION 4 pp �. .� CENTER VILLE, MA. ♦ �n0 � p' oo �tN�F«ASS �� �• ♦ � 6'e, y o� Q�G FO GJ, �' 2�0♦ i g STEPHEN ♦ . a J. N ► �• DOYLE ► s, sQ� a q ;,; v . PREPARED FOR:WILLIAM P. THOMPSON FEBUARY 22,. 2005 •p jso REV LOT 155 00. REV- AIM 171-188 (STA TE FOREST) REV- AIM 171-002 YANKEE LAND SURVEYORS & CONSULTANTS P.O. BOX 265 UNIT 1, 40 INDUSTRY ROAD MARSTONS MILLS, MA 02648' ' TM 508-428-0055 FAX 508-420-5553 SHEET 1 OF I JOB 53840 JF F r -_-- - - _ ------- --- If _ i -- --- ---- ------_. SCALE; ��r O APPROVED BY: - ORAWN BY - DATE: REVISEO r ` ORAWMGNUMBER - , i • i ova f� �\I - I . 3M��r xor a 3 41•ncc.a•at•� ____ - _ — �-r�7-iodAt. q��ST�aib.dlo i - Y ., - __ - I___ _: -.._ . . -,. _,___ �E Prz.o✓,o � ♦..D i � --•���,s�is/__6 3---�3_��J_?�cx��L_r,tc���•-=� .... ..._ ._.. -- -j4..sf.z__At i.r os—�t.��L�..���ccz—sr�ss�' �z�-_.v,o,�,� i�'�'---- �— '6 �� 2v /da✓Sr S _ ; _SO,a.lh:.B.CO— ���a•C��—�� '23�W K_._ I `bl . .. ro9'T C,ose: ' — — — I �s` _A�<L� L»t. I I �iYS GA.Z•9GC DnI�.0 _ I ' � IT/ O -"e_h'.v 7Jr1 1 { eJ! .J•� '/'2f1.•rSUn'/ ... ��� _ r n . ,P -�_s"��___-. -F1..-—... ____"_.__., (.. ..'. 5:•._...,.._�_. .... _.. .ram.-?.... .... '>.�U�. I ... - s m,,t . .7'_._.�Oc�_2 cz tel ' SCALE: APPROVfiD Or: - -7_:_)�' DRAWN BY G - DATE: RfiVISlD DRAWING NUMBgq ......... 21 1 _._ IIfIIf SCALE: APPROVED BY: DRAWN BY DATE: REVSEO - . '. - DRAWBiONVMBER ;Zxice 250< »T ✓, �o:, z_ �r 1 . R F : ,y AVVROVHO BV:l �U REVMJED .. 4 t DRAW VM NUMBER s• f _ °�__._fI;'/CdJR. !LS CSC T�. ���.G '"'�. �•- - G SCALE: ' APPROVED BT: - -. . DATE: REVL4fiD _ ^I DRAWING NUMBER - r p b4 fJ0 0 S g5" Ss4 o2l. ---ti is • r�` /� - y 44, k I I . I t 1 I•. i`' s - - u LR---i _ s . SCALE: /O l APPROVED BY: DRAWN BY DATE: a oZ Y �. REVISED G O z cr_:v �o- G� DRAWING NUMBER CD , • _ ��UV��Q.• Collar�leS "� �.. f � _ t - a > f F, r ^ k , d s , _ ,. ks r� ry , r , u .. - •. - _rR. OIL C�/�-� (I.. p� I -. 4 � n 4 i , ,a... � .d• .- t._ .' .. ,-• � .' �, .. .� u � - -' - � ate.;.. ,. . W^ f • o. _. v+ L/• - _ - . R - z S ace M r ' T r _,. -• - a ' s , -Y 4� -`i `:.'K.' c 1 .., :,.,.. ., � a ..°... '' ^ # ., .' «.�.. -... .:�;.: :. _ � n>•P. Ss. � .. - c 1• Ada � .- - - - , >' ��E�C' � � _-aL✓Zt C'o�r7� ELT G.� .• � a - • _ ,� • ,. .. 7--0 ��t ��.�c� � ��AGE �Bc1t-•rrrio 6 /t?r�rr/'sH�c:aS� - -. ,a r - a� r• k e *, 7; r , w.z r , v - ,r n� APPROVE SCALE: D BY; DRAWN BY DATE: REVISED s' - r was 2a F Z"qC-e-- < s DRAWING NU MBER t #" - i LOT 153 C.B. _ AIM_1714 186 w i (FAD) . LOT 1 5.34LOCUS _ 0 ASSESSORS . : s 6'�• MAP 171'-186 �� { goo. LOT 154 zR oq�f AIM 171-187 15,000� S.F' ' R Y 0.34 ACRE - o• CENTER VILLE - HO USE- ' wG .mo _ D - PLAN REF. 306-22, - 36;'• `' ASSESSORS MAR 171-187 �? -, ZONING. „RCS, , SHED` 0' 0' - - " SETBACKS• 2 1 0' 1 DEED .REF 14400 249; THE SEPTIC SYSTEM WAS DRAWN'FROM THE TOWN OF g-IIRNSTABLE e, PLOT PLAN OF LAND SEPTIC INSTALLERS CARD LOCATED AT.• PROPOSED • Y 36 BRALEY JENKINS ROAD ADDITION - y AA CENTER VILLE, MA. (�, �`' / r-< ... f'8 : 2�P�GIS'C,QFv Gs - , - x,, •� - t 1 z 6�s .s pOy PREPARED FOR. k` 7 3 y� 559 W ILL JAM P THOMPSON ►.. FEB UARY 22, 2005 ,,- js p REV - LOT 155 op. I. REV- AIM A/M 171-188 (STA TE FOREST) REV- AIM 171-002 YANKEE LAND SUR VEYORS & CONSULTANTS k P. 0. BOX 265 4 UNIT 1, 40 INDUSTRY ROAD MARSTONS MILLS, MA 02648 TEL• 508—428—0055 FAX -508—420—5553 SHEET 1 OF 1 JOB # 53840 JF SOI L LOG L or Z 7 F3 D AT E: 7 N WITNESSED BY : Z 713 E_ L J? V If- tit lz 40'! 4 3 2' *3 2- -3 w UANHOLES AND COVER rO BE BUILT WITHIN ELEV. TOP OF 12" OF FIN ISHED GRADE . FOUNDATION I FINISHED kAIN. 27. SLOPE GRADE cp 4%AST I RO 0 OR PVC SC 40 1ST 4 PVC SC H. P I T C H I Z'LE VE' UIN. 2" LAYER P (TC H (9 1 8 112 P EA STONE --) ✓ 44 , B 3 0 3 F T. Is.0 cc) INVERT GALLON I N V E R DIST. I N V iE R Tylk I N V E R T 8 0 K Q 0.4. 3/4"- 1 (12" 3 5 E P7 I C T A N K /.o C\4 INVERT .4 V E R T WASH E D STONE L f /7? INVERT uj C)*�' ALL AROUND U 3/4 Vv A SH ALL L c __E L E t'_4-Tc L e .. ....lie I GARBAGE -0 ELEV. BOTTOU s 7 § 0 3 E 0 MIN. 6 R I N D 0 F c) v 1 7? C) c,r -4 4, 7 E ev • 20' UIN . 4 �"O'D 7- 4 CD Z_ ELEV. c7•c). -D c PROFILE OF GROUND WATER TABLE ;ok- (pe- "if _� .s r SANITARY DISPOSAL SYSTEM ,, / 00 NOT TO SCALE -DESIGN DATA 2- e_5- 12 BEDROOMS CONSTRUCTION OF SANITARY DISPOSAL SYSTEM SHALL CONFORM TO MASS . DESIGN FLOW 33 GAL ./DAY ENVIRONMENTAL CODE TITLE V (REVISED 7- 1 - 77) LEACH RATE -.c:- L ' MIN./INCH — I '--� L &= PROPOSED LEACH CAPACITY : AND THE TOWN OF 2 S' HEALTH REGULATIONS . • SEPTIC TANK., DISTRIBUTION BOX AND LEACHING PITTO BE OF REINFORCED CONCRETE : 04 — GAL. DAY MI N. CONCRETE STRENGTH 3000 PSI 47 ? MIN . STEEL STRENGTH 20'0 OOP 3 1 H 10 DESIGN LOADING • DRIVEWAYS NOTTO BE LOCATED OVER SYSTE M UNLESS H - 20 DESIGN LOADING IS USED. • ALL PIPES AND FITT I NGS TO BE WATERTIGHT AND TO BE OF CAST IRON OR SCHED 40 P.V. C. SITE PLAN SHOWING PROPOSED CONSTRUCTION SH . _" OF ISHS LEGEND Fol C7 . L 0 C A T 1 0 N: —2 1`1 7'__'O�/ ':l tf ; ':1 jf."' 7f)"Vf f2 /-v /_ FOR : P, APPROVED 19 SCALE: / " T 130 DATE : BOARD OF HEALTH BUILDING SETBACK REGULATIONS PER EXISTING CONTOUR REFERENCE: 23 BUILDING INSPECTOR OR BUILDVNG COMMISSIONER . z PROPOSED CONTOUR 16 DATE AGENT M IN. FRONT SETBACK EXISTING SPOT ELEVATION 17. 6 MIN. SIDE SETBACK PROPOSED WATER SERVICE _W_ xl OF GR. Al- TEST HOLE LOCATION MIN. REAR SETBACK Z oo.127483R N C vIsTt PROFESSIONAL LAND SURVEYORS L ENGINEERS IVAL 1586 MAIN STREET (RTE. 65A) EAST DENNIS, MASS. 02641 I NJ