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HomeMy WebLinkAbout0111 BRIDGET'S PATH � 9 o _ e e . tl . o 3 e 0 m OT � "n 04QLJJL 04,CZ � I � U ✓�*� iI I o . � swr p . 3 � y •s y oa `� �t� t "t v DIME� Town of Barnstable Regulatory Services eaxPrM SS. Thomas F.Geiler,Director Fo;p�A��� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 October 10, 2013 John Soroka Mary Yeomans I I I Bridget's Path Centerville, MA. 02632 RE: 111 Bridget's Path, Centerville Map: 170 Parcel: 225 Dear Property Owners: This letter shall serve as denial to application number 201305240 submitted on September 23,2013. As indicated in a prior letter dated August 8, 2013 sent by this office, the basement has been finished without the benefit of the proper permits (780 CMR R105.1) and you have been hereby ordered to bring the property into compliance. No building permit may be issued on the property which does not bring the property into compliance and a stop work order remains in effect. Compliance may be achieved by obtaining a building permit to: 1) Finish the basement in compliance with 780 CMR(along with successful completion of all required subsequent inspections) or; 2) Dismantling all construction for which no building permit was issued (along with successful completion of all required subsequent inspections. Please feel free to contact this office with any questions. By Order, hP/--- L. Lauzon Local Inspector j effreylauzongtown.barnstable.ma.us (508) 862- 4034 r Ir � PERMIT PAYMENT RECEIPT TOWN OE BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS MA 02601 DATE: 09/23/13 TIME: 09:32 ---=--------------TOTALS---- ----------- 9 F. n PERMIT $ PAID 50.00`" y AMT TENDERED: 50.00 AMT APPLIED: 50.00' CHANGE: .00 APPLICATION NUMBER: 201305240,, ' PAYMENT METH: CHECK . PAYMENT REF: 8160 V " TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION boo Pgffe, S Map ao��� ' Parcel d Application's Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address /// J3 i,/,C>a E7T.5 Pf1XX Village (2L,J T 6 K_ V / L L r Owner �o iw A • SG ao l-Ni Address Saws -e_ g.S above Telephone J 6 6 -4a SI" 55-9 errnit R t d 6 r q r' e e I A \_ rct q e J - i. ' �l� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District' Flood Plain Groundwater Overlay Project Valuation ®i Odd Construction Type UJ6© Lot Size e �O Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) / Age of Existing Structure J r Historic House: ❑Yes WVKo On Old King's Highway: ❑Yes EI No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (s = o Number of Baths: Full: existing new Half: existing n�' never Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Roo Count? '- _ � Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other w �- rr3 Central Air: ❑Yes //❑ No Fireplaces: Existing New Existing wood/coal stoveFU Yes ❑ No Detached garage: 3existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals horization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# Current Use (c)a,r Lac- I p Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name —�"�fJ�1 A 66 AC Telephone Number {a Address License # (�� cJ�'g/�.(1 i�LC nZ(2X E_ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO /Js e'er 5- �L SIGNATURE DATE FOR OFFICIAL USE ONLY t: APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ,,_ FOUNDATION, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 'TOWN-OF BARNSTABLE BUILDING PERMITAPPLICATION � ­.. 1 Ma �� ��� 33� Parcel ''1 ''— A �lication # r p ". .r pp Health Division "" Date Issued y Conservation Division �� Application Fee Planning Dept. ' Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/.Hyannis Project Street Address / R/ 1-S P 67 C/uTF,lz � �. ' Village e f Owner —IC NiU SG aG" Address SGw! q CX b O V e*'t"7 Telephone 5 G`� ` 4�k er it R,q t 6 u e .Gh C - G 1'f PC a C� IS ina * . V traRe . f 1CA P Square feet: 1 st floor: existing proposed 2nd floor: existing proposed To new Zoning District Flood Plai Groundwater Overlay d Project Valuation /0t 16 Construction Lot Size �O Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family A/ Two Family -d' Multi-Family(# units) Age of Existing Structure 5 V r5 Historic House: , ❑Yes &No On,Old King's Highway: ❑Yes 0 No Basement-Type-% ❑ Full— :0 Crawl ❑Walkout ❑ Other Basement°Finished Area (sq.ft.) Basement Unfinished)Area (sq;ft) Number of Baths: Full: existing new Half: existing new Number of Bedroll s: existing new — r Total Room Count (not including baths): existing new First Floor Room Count Heat-Type and Fuel: ❑.Gas f-DTOil ❑ Electric ❑ Other z ,r Central Air: ❑Yes ,�/+❑ N6 Fireplaces: Existing New Existing wood/coal stove. ❑Yes :❑ 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 5rization ❑ Appeal # Recorded ❑ Commercial .❑Yes No If yes, site plan review# Current Use o r c, le, Proposed Use Y APPLICANT INFORMATION" ' g (BUILDER OR HOMEOWNER) %Name Sd ueC kf4 f Telephone Number r Address /I/ Aa TS ,�jQ'%�� License # rogV Le , �, 01 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS'•PROJECT WILL BE TAKEN TO SIGNATURE f G✓��� DATE- `S ^ � FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts UFDepartment of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): k lb ape" Address: 11 P* City/State/Zip:an`�. Phone#: ' Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. 9. Vem uildinog addition lition working for me in any capacity. employees and have workers' o workers' comp.insurance comp. insurance. # required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.Z I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 13.❑ Other employees.[No workers' 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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.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$1,50.0.00 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 der the p 'ns d penalties of perjury that the information provided above ' true and correct. Si ature: C Date: / Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant-to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should 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 p that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to 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 1-877-MASWE Revised 4-24-07 Fax## 617-727-7749 www.mass_gov/dia Town of Barnstable Regulatory Services � t r t Ae�NCPAR.i.£ # rsnss Thomas F.Geiler,Director `b'�En ►`. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: d n p L JOB LOCATION: �/I /CAR!D 6&TS op'//��47W number— ^ street ' village "HOMEOWNER": ---70//A/ STPO(CA 0 —YN name home phone# work phone# CURRENT MAILING ADDRESS: 'lY1 e- 4S e/le- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelIinps of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requireme is that he/ he will comply with said procedures and requirements. JA �L S awr of me woer Approval of Building Official ti Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons: In this case,our Board cannot proceed against the unlicensed person as'it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollrk\AppData\Local\Microsoft\Windows\Tempoiary Internet Files\ContentOutlooMQRE6ZUBNIEX2RESS.doc Revised 053012 rti . Town of Barnstable Regulatory Services 9 ASS Thomas F.Geiler,Director '�Fn►w�" Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 'Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on ray behalf, in all matters relative to work authorized by this building permit (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QTORM&OWNERPERMISSIONPOOLS 62012 �•` A TYC Guide to Wood Consiructior� in Hid Ir end Areas:II D, ph Knd Zon.e Massachusetts Checklist for Compliance(78o chTR53D12-1.1)r C+i1.chak couipuaz,re 1.1 SCOPE Wind Speed(3-sec_ gust)_.._.........:............ _.... _.................. _.-------- _........................ ...... _...._....._.. 110 mph WindExposure.Category........_....................-....__..._ .:...:............................................................................B 'Wind Exposure Category................Engineering Required For Entire Project.......................................0 12 APPLICABILITY. Number of Stories(a roof which exceeds 8 in 12 slope shall be considered a story) stones 2 stories Roof Pitch .............. Ft 2 % < - MeanRoof Height ............._........_............................ , (Fig 2)...................._........................... ft 5 33' ` Building Width,W Bulding Length, L ................................. -- •-(Fig 3)---------........................................ Building Aspect Ratio (Fig 4 <-3.1 • 9 ASP (L/W) .......:............................._..-----•( 9 )------:..------.._.._.._-----..._._..---•----• Nominal Height of Tallest Openingz .......................-__.:.....(Fig 4)------------------------------------------------ <613' 13 FRAMING CONNECTiDNS - -- - General compliance with framirig connections._... _...........(Table 2).............................................................. 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Conate................................................................................................................................. C �oncr Masonry..............•--•--•--.._............-•---.........._.... _...._......._...... _ = .............. 22 ANCHORAGE TO FDUNDATION"3 5/t3'Anchor Boh imbedded or 5/8'Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general ...................................----:.(Table 4)........................................._.... 'In. Bolt Spacing from end(oint of plate..._...........:............(Fig 5).................................... in.<W-12". Bolt Embedment-concrete..........-................:............(Fig 5)........_.._.....:__,_.._.....*.... ....._..... in.?:7" Bolt Embedment-masonry.................:......................(Fig b).....:......z............................... PlateWasher........_...........................-................. ........(Fig 5)----------------------------------------------- 3`x 3'x/,' 3.1 FLOORS Fioor•framing member spans checked ...............................(per 780 CMR Chapter 55)............................. Maximum FloarOpening Dimension....................._............(Fig 6)..... ...-_._......._:_....________..__...__._. �` ft_12' :.: Full Height Wall Studs at FlDor Openings less than 2'from Exterior Wall(Fig 6)........................_......... ... - Mt3ximrim Floor Joist Setbacks Supporting Loadbearing Waifs or Shearwall...._..........Fig 7).................................................... ft 5 d Maximum Cantt'levered Floor Joists Supporting Loadbeanng Walls•or Shearwall (Fig 8)....................... .............. ft <-d FloorBracingat Endwalls............................._.....................(Fig g).............- --•----..__.._..._......_...................... Floor Sheathing Type .._......_.............................................(per 780 CMR Chapter 55)................................. Floor Sheathing Thickness ........................................._-.....(per 78D CMR Chapter 55)....................... in. Floor Sheathing•Fastening......................._..............._....=..(Table 2).. d nails at in edge/ in field �c 4.1 WALLS Wall Height Loadbearing walls ..(Fig 10 and Table 5 ft 510' Non-Loadbearing walls.._. ......................................(Fig 10 and Table 5)._........._.._........__.. ft 520' c Watl Stud Spacing .............__._._..._..:_......._.................... i 10 and Table 5 in_ 24-o.c Fa 9 (Fig ) __... ✓ Wall Story Offsets ....__..............................................:..(Figs 7&8) ..................-................. ft s d 42 EXTERIOR-WALLS' Wood Studs Loadbearing walls.....................................................(Table.).............................2x -4'ft ��in. Non-Loadbearing walls.___..........................................(Table-5)..............................2x_ff_- ftLULin. Gable End Wall Bracing Full.Height Endwall Studs.......................----..............(Fig 10)..................................:.......................... _. WSP•Affic Floor Length._......_._........................_._...-(Fig 11).:._____....................._......._...._. ftzW/3 AT Gypsum Ceiling Length(if WSP not used)...................(Fig 11)...._...................................... ft>_0.9W and 2 x 4 GbnbnUDus 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 ar truss bays �e� Double Top Plate Splice Length _.(Fig 13 and Table 6)........................ AFVC Guide to Wood Constr•uctiou in High Find lireas: 110 Ffiph Krrd Zone MassachlLsetts Checklist for CoMplianlce (790 CNIR5301.2.1.1)I Loadbearing Wall Connections - Lateral(no.of 16d common nails).._............................(Tables 7)----------------------------------------------------- Non-L'aadbearing Wall Connections Lateral(no.of 16d common nails)......................... B)................................................... Load Bearing Wall Openings(record largest opening but check all openings for complance to Table 9) Header Spans ................................... _............... able 9 _in.5 111 r Sill Plate Spans ------------_------------.............._...........(Table 9)................................._ft_in.<11' Full Height Studs (no. ofstuds)----.--__..____._.__-----.-------(Table 9)...........-........-............. ..__. _--- � Non-Laad Bearing Wall Openings (record largest opening but check all openings for compliance to Table 9) ry/ able 9 c Header Spans..................................................-..........(T )_.._..__........---••-......_.._ft_rn. 12' Sill Plate Spans.... able 9 .Full.Height'Studs(no.of studs)....................................(Table 9)----------.--•----.-•----•----------------------•••. Exterior Wall Sheathing to Resist Uplift and Shear Simuftaneously4 Minimum Building Dimension, W ✓? Nominal Height of Tallest OpeniriV .......................-........................................-__.:........ �<6'B' SheathingType......................................•-......(note 4)----------------------------------------------- Edge Nail Spacing able 10 ar-note 4 if less ....................... in. Field Nail Spacing able 10).............................................. in. ` Shear Connection(no.of 16d common nails)(Table 10)--------_-_--•--------------•--.•.-----_---------.-----.— Percent Fu&Height Sheathing...................:.--(Table 10)---------------------------------------------------._°!o 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts).................... Maximum Building Dimension, L Nominal Height of Tallest Opening2......................................................................... SheathingType.............................................(note 4)•-----------------------_----•---•.----------------- Edge Nail Spacing.........................................(fable i 1 or note 4 if less)...•.._.._....•..._.... rn. � Field Nail Spacing.............._..................._..:_.(Table 11)----------------,. ----- ...._. in. 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 Ratedfor Wind Speed?............................---.................__.....---.. ......:-....---.........•--------------••------...-••.......•. 3.1 ROOFS. Roof framing member spares checked?........................(For Rafters use AWC`Span Tool, see BBRS Website) � Roof Overhang ..................................................:(Figure 19) ............. ft-<smaller of 2'or L13 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Upfift........................•-• •.......(Table 12)............................................U= pff . Lateral............................._..............(Table 12)..............................................L= plf Shear................................................(Table 12)--------------------------------------------5= -Pf . Ridge Strap Connections, if collar ties not used per page 21'... (Table 13)............:....................T= plf Gable Rake Ouflooker................:. -----------(Figure 20 ft<smaller of 2'or 112 ' Truss or Rafter Connections at'Non-Loadbearing Walls Proprietary Connectors Uplift................................... -........(fable 14)---•--------------•---------- - Lateral(no.of 16d common naffs)...(Table 14)......................................L- . lb. Roof Sheathing Type__......................-.................-......(per 780 CMR Chapters 5B and 59)............ Roof Sheathing Thickness.........................._...._.:..... ..............-............................._in.>_7116,WSP Roof Sheathing Fastening.................•_.......•----........ ..(fable 2) - - — �tes: _ • This checklist shall be met in its entirety, excluding the specific exception noted in 2, to comply with the requirements of 73D CMR-5301.2.1.1 Item 1. If the chec�ist is met in its entirety then the fallowing 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. Comer Stud Hold Downs per Figure iBa and Figure 18b Exception:Opening heights of up to 8 ft shall be permitted when 5°!o is added to the percent fulkheight sheathing requirements shown in Tables 10 and 11. -' The bottom sill plate in.exterior walls shall be a minimum 2 in. nominal thicmess pressure treated#2-grade. CENSUS TRACT Ct_ I E_NT : Ar torney Joi-in Cona Lhan DEED BOOK g; 8 PAGIF Tom_ OWNER : John C. McKeon PLAN BOOK_ PAGE LOT APPLICANT : John A. r Ki.mbcrti A. Sorok;l ASSESSORS PLAN PLOT MORTGAGE INSPECTION PLAN OF LAND I N B A R N S T A B L E SCALE : 1"= 60' MARCH 151 1985 "._ -�:•: N/F SMALL 92 y LOT .r, N/F BURNS C_�O 27 , 73 S. F �i } �O z� LOT 1 �2 a �~~ 4z 0'+ 1 U-) a N W LO N ' LOT 4 LOT 2 30 . 00 ' BRIDGET ' S PATH I CERTIFY TO ATTORNEY JOHN CONATHAN , BANK OF NE14 ENGLAND, N , A , AND ITS TITLE INSURANCE COMPANY , THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL .APPLICABLE ZONING BY-LAWS WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS , . THE DWELLING SHOWN HERE DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY #250001 DATED 10/1/83 BY THE F , I , A , �� iLaand Surveyors Civil Engineers VI The 0$toit '1SIITt) ot�UT-ury (90., �nir- 1 r2 �)1Ti[tinu, dal_ Nc(u Pi 0for3, 02740 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, and belief as the result of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client only as of this date. (3) This plan was not made for r,:-ording purposes, for use in preparing deed desc.ript:ions or for con— structions, (4) Verifications of properi:y lira dimensions, building offsets, fences, or lot configuration may he acomp.lished only by an accurate instrument survey. r; ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map \ Parcel Application # c?>V 90qi Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address , � 'ill J5A Village CIfl r L'e Owner S_)6)r'e3 Q Address Telephone 1��S) L Permit Request 51 n�is:h brasxm.�M+ - 'Func. 106 00/h w S*--a vmk!, A t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Z :"Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq7 ) --i Number of Baths: Full: existing new Half: existing new : yN C> Number of Bedrooms: existing new w �� ra' Total Room Count (not including baths): existing new First Floor Rohm Count_ Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woo /coal sto`r ,: ❑yYes ❑ 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 _ (BUILDER OR HOMEOWNER) { Name �V\ C-C, eA Telephone Number( !� 418° 3�5�c��LA f Address ��� �f''�� � � � License # Home Improvement Contractor# Emait Worker's Compensation # -ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a � FOR OFFICIAL USE ONLY APPLICATION# ,k __..QATE ISSUED _ ' MAP/PARCEL NO. ADDRESS VILLAGE , OWNER t E `# DATE OF INSPECTION: ,k OAFOUNDATI.OWUN il r x FRAME ►INSULATIONtr.A4.}- 1 t FIREPLACE ELECTRICAL— .-ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ® 115 r _ _ z. ,F DATE CLOSED OUT ASSOCIATION PLAN NO: l ne, Canzmmtwed1h of massackusdft Dqwtznm1qfbdustridAcddvjtr - Offim Ofinp ' W Washiagtm Shwt ---- wn�turrru�.go�drri ��3'�I3'a C'OIIfPBSSafE�II�iIPikII�91Vit�I�IS��QIItF'�C�.tT��'CtI7.C�"'n �nm g� ,. Aymfitant hdarmafim PImse Prhd LmA i o Name `n .�Or6 kAL Adams: i I 'Bet J , .11MAI Are you an emglayer?,Check the app¢'a tie ba=; Type of project(requirec)_ 1.❑ I am a employer with ,4 ❑I am a general coukaetor and I d. 0 New trction employees(Sall sndlarpatt-#inie).* have hued the sub-coubactm { 2.❑ I am a sole proprietor orpaztner- listed oathe attached sheet 7. [ R=wdeling drip and have no employees These mb-ooatracto s have g- ❑Demolition woddng for mt in nay 1r enrplogees and.have wont' 9- ❑Bnildmg addition [No wa3zrs' 4 insurance - Camp.uisorasrr f reqnired-] 5. ❑ We are a corporation and its 10❑Elechical repass or addition 3. I am a homearamw doing all work officers have emucised Their 11.❑Plumbing repairs or additions anyself[Na worime wmp rigkofamemptionperMM 120 Bnaf repairs insurance d t• c-15'1.,§1(4) and we have no J employees.[No wcrdoms' 13.❑Other cam4x iusorauce require&I 'Aey tgpErsat But cbedcsbat Ql umstalso IM otttlu mcfionbelowshowing ti&wodreLs'mmpensafimpoaP infntmat on_ i$umeowaeS oho subs obis affidavit iouffatmg they as doing wR wak.iad theahnE Outside rnntrKMSnmst subarit thew affidavit mdic¢fian sow ICu thatcberY thisboa mssi avacbed an addifinnal shept dwYdngtbename of the sub-Miftxma lad hate eringw Snattbose eatitksIm employees. If t1msu]�-c�luveeta&Tw.,2heynmsrpa=d&theirvmke&camp.yormyrntaber I mn art employer thatisprovOug warksrs'compensation invirance for my enrpinyses, igdarr is die paTrcy arrd jab site utfaratahbrt• Insurance Company Name: Policy 4 Cr Self--ins.lie. k Fxpi m ianDate Job Site Address Ei#yl5tate/TsP: Attach a copy of the workers'compensation policy dedaration page(shvwing the policy number and ezpaitian date). FaRure to secum coverage as raquired undff Section 25A of MOI..c.Mom lead to the impositirm of criminal penalties of a fine up to SM00.00 and/or one-year imprisonment,as wen as c ivr3 penalties in the fvrm of a STOP WORK ORDI Rand a fine of up to$250-00 a dap against the violator. Be advised fir t a copy of this statement maybe Erwarded to the OSim of Investigations of the DIA for insm,nre coverage veriicatim Ida hereby ca*)yr under theptrins and,penai'fi ofpar�tuythatthe2r�otwud npsovzdeiab�uuaishueantecoraact C late .1)ate= 120,1 Phone,* @ iris amF .Do Trot writs in.&a emery to be campkMd by city artam v k*l My or Tuww hssoing Aa#1'iar4(tu cle ona)- L Board of Heal& 2.Ong Depwtnent 3.CitylTMOR Cl=k 4.Electrical 14m:toc S.Ph=b'iag Inspector &O&W Canbu t Ptrsoa: ;Phu= 6 Ar r Town of Barnstable Regulatory Services pfr �byl� Richard V.Scali,Interim Director Building Division t sMINsn+=t.E, r Tom Perry,Building Commissioner KA 116y ,��. 200 Main Street, Hyannis,MA 02601 RFDy� www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ` Please Print CDATB: Z ., OB.LOCATIOIV:" `' PA 6. v r v��l . number street gq village "HOMEOWNER": Jodi) ro6A /PA name '— me pfione #[ work phone# CURRENT MAILING ADDRESS: I cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is;or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc zd=and requirements an th /he/ e will comply with said procedures and requirements. ign r meo er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." . Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix,Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use.in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doe Revised 061313 �TME T Town of Barnstable Re ulato Services BARNSM3 - -- MASS.M� Richard V.Scali,Interim Director i6gq. �0 - -Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date 0:F0RMS:0WNERPEB1vffSSI0NP00LS 10113 v T 1 r: r s } y t 7 ) � S j t ] y � f l t I t x tv,2 two Sh Gus Y 1 l OIL KIM QQ of 1 t # f } �., 1 1` y �•.� .� y 4 l'• .i 1 1. RANKS y _ I +. .. t J J 1 + , Y / SM ., amms cat mmm to ME Am hot go Am AN. Ask ago C 1 + t � r t S 1IV f 1 ' J i � r 1 a A SKETCH ADDENDUM Fite No. 0603024 Borrower SOROKA _ Property Address 111 BRIDGETS PATH - City CENTERVILLE County BARNSTABLE State MA Zip Code 02632 Y' Lender/Client GUARANTY RESIDENTIAL LENDING Address 5 BRISTOL DRIVE S_EASTON,MA 02375 tokA— • ° a • A s t 42 �. ..,...aerrrnrr�wmr�I�o-�•w. I ' 66 . qr) -~ lya 0 6 Ice I v � k; L e. . .. _ EdSkoF�i a•a A.+.s�t' WAS TONI rtr I shot Ap MCA Mani Nag tam; ANY ht fin an _ � G -� _ z Imy , t W: Soto ! � r r i r t t i � � � �L ."' � t, lt;s 3 r � •1 f, y 4 ] r : ,! l: i { � y < k' ( rf 1 i < 1 , 4 t : t 1 S i NaW ru UN166MASOMM :' � .,:... 0 a ' OFFICIAL CEI Postage $ ru O Certified Fee O Return Receipt Fee P stmark s O (Endorsement Required) Here C3 C7 Restricted Delivery Fee --,� O (Endorsement Required) rq O Total Postage&Fees aru IV Sent To �... 1 ---64-1 =------------- --- p Street,Apt No.; n - i N or PO Box No. City Slate.Z%P+ char•G - 71�.4 oz��a ,. _= „ Certified Mail Provides: e A mailing receipt o A unique identifier for your mailpiece o A record of delivery kept by the Postal Service for two years Important Reminders: e Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. o Certified Mail is not available for any class of international mail. a;NO"INSURANCE COVERAGE IS PROVIDED with Certified Mail. For ^valuables,please consider Insured or Registered Mail. 11. For an additional fee,a Return Receipt may be requested to provide proof of, delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for 1 a duplicate return receipt,a USPSe postmark on your Certified Mail receipt is required. o For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". a If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 'THE Tp� Town of Barnstable ti Regulatory Services * EBL42N TnaLe, boas. Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 August 8, 2013 John Soroka Mary Yeomans 111 Bridget's Path Centerville, MA. 02632 RE: EXIT ORDER I I I Bridget's Path,Centerville Map: 170 Parcel: 225 Dear Property Owners: This letter shall serve as notice that the basement bedroom is declared dangerous and unsafe and its use must cease immediately. The basement has been finished without the benefit of the proper permits and you are hereby ordered to bring the property into compliance. Compliance may be achieved by obtaining a building permit to: 1) Finish the basement in compliance with 780 CMR(along with successful completion of all required subsequent inspections) or; 2) Dismantling all construction for which no building permit was issued (along with successful completion of all required subsequent inspections. Thank you for your anticipated cooperation in this matter. By Order, ow� La-Tizon Local Inspector jeffrey.lauzon@town.bamstable.ma.us (508) 862- 4034 S��IDER: C.OMPLETE THIS SECTIO N COMPLETE THIS S ECT ION ON DELIVERY ■ Complete items 1,2,and 3.Also complete-;'.' A. Sign ❑Agent item 4 if Restricted Delivery is desired. �°(/ El Addressee ■ Print your name and address on the reverse so that we can return the card to you. eceived b ( 'nt e) C. Da of D dive ■ Attach this card to the back of the mailpiece, � or on the front if space permits. D. Is delivery address different from Rem 1? 10 Y 1. Article Addressed to: �j If YES,enter delivery address below: &Uo Ye e-)' lG-"✓ 3. Service Type eie Mail ❑Express Mail ❑Registered flrReturn Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 7 012 1010 0000 2851 0 312 (Transfer from service label) PS Form 3811,August 2001 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit MO.G-10 • Sender: Please print your name, address, and ZIP+4 in this box• TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. 11YANNIS,MA 02601 ..... ...... ... .. ... .. PP! ..Iit il ICD f�- Ir 0 F• I `yam•I Ln CD Postage L-9 $ �tJ�s Mq O C3 Certified Fee d,g � �` Postmark � a Return Receipt Fee JUL, Here(j p (Endorsement Required) O Restricted Delivery Fee (Endorsement Required) a @ LISPS p Total Postage&Fees $ r- ru Se meet,pt. o.; r --PO Box No. r.r_1_�hd s—.lG.( ty fate, P+4 ? -- 1 Certified Mail Provides: a A mailing receipt a A unique identifier for your mailpiece n A record of delivery kept by the Postal Service for two years, Important Reminders: t q Certified Mail may ONLY be combined with First-Class Mail®or Priority Maile. a Certified Mail is not available for any class of international mail.= a NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail a For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. a For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". o If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed;detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry.. PS Form 3800,August 2006(Reverse)PSN 7530-02-000-9047 Town of Barnstable Regulatory Services Thomas F.Geiler,Director BARNBLF. Building Division 1639. AS 0. Tom Perry,Building Commissioner ED M' 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 'Fax: 508-790-6230 Notice of Building Code Violation(s) and Order to Cease, Desist and Abate: Mr.John Soroka and Ms. Mary Yeomans and all persons having notice of this order,as owner/occupant of the premises/structure located at 111 Bridget's Path Centerville Map 170 Parcel 225 you are hereby notified that you are in violation of the Massachusetts State Building Code and are ORDERED this date, July 30,2013 to: 1. CEASE AND DESIST IMMEDIATELY,all functions and uses connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATIONS: 1) Construction without the benefit of proper permits(780 CMR R105.1). 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: 1) Obtain the proper permits and subsequent required inspections. And, if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the State Building Code Appeals Board within forty-five(45)days after the service of this notice. If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. .By order, ! a zon Oocal Inspector ieffre .lauzon e,town.barnstable.ma.us (508) 862-4034 •MPLETE THIS SE&'TbN COMPLETE • oNbELIVERY ■ Complete items 1,2,and 3.Also complete A. Signature item 4 if Restricted Delivery is desired. X. ❑Agent ■ Print your name and address on the reverse v ❑Addressee so that we can return the card to you. ce' d by(Printed Name) C. D of livery ■ Attach this card to the back of the mailpiece, C , or on the front if space permits. 1. Article Addressed to: D. Is delivery address different from item 1? ❑ e If YES,enter delivery address below: Q�Wb of n SoroYxiq i i s . d� 3. Service Type -17- 11r JUL) .. U.Certifled Mail ❑Express Mail ❑Registered [ Retum Receipt for Merchandise vj ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number ( 7012 -1010 000O 2850 97�81, Transfer from service labeq _ _ ,I PS Form 3811,February 2004 Domestic Return Receipt .102pgs-02-M-1540;I UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid LISPS, Permit No.G-10 • Sender: Please print your name, address, and ZIP+4 In this box • TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST. XM 02601 Oil I W I A r Town of Barnstable *Permit# Q606-1f C/o 91oe Expires 6 onthsfrom issue date Re gu�aGolryD Services Fee �C®PRESS PERMIT Thomas � ,tea NOV 2 7 2006 Building Division Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE 200 Main street,Hyannis,MA 02601 www.town.bamstable.ma.us Dffice: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY -f— Not Valid without Red X Press Imprint i/parcel Number A )erty Address 4 p 6 E=—TS Zesidential Value of Work ' 'v (J d Minimum fee of$25.00 for work under$6000.00 ier's Name&Address ,tractor's Name zf0/0 or Telephone Number- C ne Improvement Contractor License#(if applicable) isfrtt fstu i'visor IsT . ertse—It � ppiie ble Workman's Compensation Insurance Cheek one: ©' am a sole proprietor []I am the Homeowner ❑ I have Worker's Compensation Insurance trance Company Name rkman's Comp.Policy# )y of Insurance Compliance Certificate must be on file. nit Request check box) Re-roof(stripping old shingles) All construction debris will be taken to C4 5C--a 119 STC ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home pro ement Contractors License is required. .NATURE: )rms:expmtrg .se061306 The Commonwealth-ofMassachusetts ,�i f Department of Industrial Accidents •s i Office of Investigations 600 Washington Street ' Boston, MA 02111 www-Mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address:�//�f� �� V z(S T/7 City/State/Zip: (_Ix )Phone#: � Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the'sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. g, ❑Building addition /tNo workers' comp. insurance 5. ❑ We are a corporation and its 3.6 required.] officers have exercised their 10.❑Electrical repairs or additions I am a homeowner doing all work right of exemption per MGL I L[D 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.] kAny applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. t am an employer that is providing workers'compensation insurance for my.employees. Below is the policy and job site information. [nsurance Company Name: Policy#or Self-ins.Lie.M Expiration Date: fob 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 :me 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 )f up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of unvestigations of the DIA for insurance coverage verification. f do hereby certify under the pains a d enalties ofperjury that the information provided above is true and correct 3i ature: Date: alcy ?hone M Official use only. Do not write in this area, to be completed by city or town of ftciat City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: -Information and Instructions . Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of lure, 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 pf 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(UP)with no employees other than the members or partners,are not required to carry workers' compensation insurance, If an LLC or UP 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy.information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or.permit not related to any business or commercial venture (i.e. a dog license or permit to 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 Bostoia,Mai 0.21 11 Teel. # 617-727-4900 ext 406 or 1-8.77-MASSAFE Fax 617-727-7749 Revised 5-26-OS www mass.pvfdia °ftK�E� � Town'of Barnstable Regulatory Services yeSTABM as, Thomas F. Geller,Director 16.39. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 :face: 508-862-4038 Fax: 508-79076230 Property Owner Must Complete and Sign This Section If Using A Builder zo�D�IT , as Owner of the subject property hereby authorize C- to act on my behalf, in all matters relative to work authorized by this building permit application for: r C'4- VAz-C (Address of Job) c4o" -t-A' 0 �� /Cfa(,,/ cP7 0d � Signature of OwZer Date Print Name Q:F0RMS:0WNERPERMISSI0N w7.,. Assessor's office.(1st floor): SEPTIC SYSTEM MUST FTNEt o 0 rssessor's map-and lot number .....................:.....:..:.......:..... INSTALLED IN COMPLIA o Board 'of Health (3rd floor): S7 _ WITH TITLE 5 Sewage Permit number ...... .............. / ��/I L C®�E Maea LE. • r' RONMENTA 1 „ Engineering Department (3rd'floor)6 �L 7'114f °o tb39• e� ... �� REOI��./.'�7P,.. I� � House number .........................../I .......... . .................... �.7) 1°rtoMllYa. APPLICATIONS PROCESSED 8:30-9:30 A.M. and' 1:00-2:00 P.M. only TOWN .OF BARNSTABLE BUILDING .. INSPECTOR j ' G APPLICATION FOR PERMIT TO ........... .......................................1 -' Z... .. ......: A�`'9 E ��................................... TYPE OF.CONSTRUCTION ............0......: M...... ....GDG�........................................................ ��.-----...I...............19A TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............���.....Q2/�.�. 5... .. t(..T�t�............L. ... 3......:......C /Urv�L.GC-........................... Proposed Use /� A. .. ...........14 .UT ........................................................................................................ .................�j ZoningDistrict ................./......................................................Fire District .........................e.. .�........................................ ., fit, Name of Owner ..... C). ... '.h�/Wt........5. -ft.K4 ll/ /.�R�� .� pxz-ff.....!<Ii e ......Address ........ ...... Gr ri k?I �7 Nameof Builder ....................�5AI.�r................................Address .............................................. b Nameof Architect .................5 ..................................Address .................................................................................... Number of Rooms .......................... . • I Exie for ........................Aic r ................................Roofing �� .... . ... l/ ......... ............. 7.11 Floors ............................ �.(� '. �............... Interior ............................................................... Heating ............................. ......................................Plumbing ...............................<.!'..d`1/�� .................................. Fireplace ............................. �J..............................................Approximate Cost ....................�. ...................... .................. Definitive Plan Approved by Planning Board ________________________________19________ . Area ...........`�`/!�': Diagram of Lot and Building with Dimensions Fee ........! .0.0..................... ..... b � ' SUBJECT TO APPROVAL OF BOARD OF HEALTH ' m W7- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ......... .. C` ...................... Construction Supervisor's License .... ......... SOROKA, JOHN & KIM A=170-225 N6 Permit for Build Frame tits ...... .................................... Garage ............... ................................................................. Location . 11l' Bridget's Path . Centerville , ................................................................................. Own& .......John '& Kim Soroka .... .........:............................................... k. Type of Construction ..-.".Frame........................... . ........... I................................................................... ' .............Plot ............................. Lot ................ Permit Granted ......�July...3.....................jq, 86 Date of I gpection ......... ....................19 Date Completed ......................................19 jb� Assessor's office (1st floor). THE 2�S y�FTHET� Assessor's map and lot number .......................................... a �♦ Board of Health (3rd floor): Sewage Permit number ...... j BAUSTAME i Engineering Department (3rd floor): �. ,639, House number ..............................f.............. .�....................... i° o war a• w, APPLICATIONS PROCESSED 8:30-9:30 A.M. and 100-2:00 P.M. only TOWN OF BARNSTABLE BUILDING - INSPECTOR APPLICATIONFOR PERMIT TO ............/-..:....... ....::........................................................................... ....... ..... TYPE OF CONSTRUCTION ............ s ....................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .... ��/ I'-�(, . r/cr:7...f....... /.�..�...i �/. �:::`.7.......7.... ............ kR!i' .�. .�.. ..,. .�...t�...� .... v ProposedUse ............................................................ ZoningDistrict ........................................................................Fire District ............................................................................. �l Jl...... f ... ...... / " "f Name of Owner :......'.. 1 Address ........................................... ......................... ............ f Name of Builder .....................::.....:...:...................................Address .................................................................................... Name of Architect ................Address Numberof Rooms ..................................................................Foundation ................................................................... Exterior ...........5:..:.:.: :....:............................................Roofing ................. ...�:�. :r7. .... ..:.. `.r?/ ..a........... Floors + .................:..........Interior_. ...................................................................................:..... ni. k Heating ...................................... .................................. '.......Plumbing .................................�............................................... ` �a Fireplace .............................. .................................................Approximate Cost .....................( .:.......................:.................. Definitive Plan Approved by Planning Board ________________________________19'_____ . Area -7.. ..................... Diagram of Lot 'and Building with Dimensions Fee .. ... ...../ n... ... ............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i 4 wh OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree,to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................... ... ........................ Construction Supervisor's License ......fr.' .. h.-� SOROKA, JOHN & KIM A=170-225 ... Permit for ....Build Frame ........................... .........................PiEM'Age......................................... Location ........III BridRet's Path k-f Z .................................................... Centerville .................. ............................................................ Owner .............John...&...Kim...S a r.o.ka................ . ...... ...... . .... Type of Construction ........Frame....................... ................................................................................ Plot ............................ Lot ................................ Permit Gr6nted .......... July 3, ........19 86 ........... .......... Date of Inspection ....................................19 Date Completed ......................................19 ` FILE II _ CENSUS TRACT N Ai i 1_ I_E_N_T : c,r ne y •ie;i,n „r ,�t i , , DFi:-.0 i 00K is+„j PAGE 6WNER : Jelin C. W-Kcon PLAN BOOK PAGE LOT APPLICANT : Jc;l;n A. 4 Ki.i:l.;cr-1 i. A. ;:c;r.ok;i ASSESSORS PLAN PLOT Mi0RT6A6E INSPECTION PLAN OF LAND I N B A R N S T A B L E SCALE : 1"= 60' MARCH 15, 1985 N/F SMALL LOT 3 BURNS Q)F N/ 27 . I39±s., F � I O , O p � LOT 1 a 12 �~~ 4z 0'. N. to N rO `_ LD LOT 2e e LOT 4 s- Iy4 .1 30 . 00 ' BRIDGET ' S PATH I CERTIFY TO ATTORNEY JOHN CONATHAN , BANK OF NEV/ ENGLAND, N . A . AND ITS TITLE INSURANCE COMPANY , THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION , 'THE LOCATION OF THE DWELLING AS SH014N HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY—LAWS WITH RESPECT TO HORIZONTAL �,�^�• �^ DIMENSIONAL REQUIREMENTS THE DWELLING SHOWN HERE DOES P40T FALL WITHIN A SPECIAL FLOOD HAZARD ZONE AS Df_L 1 NEATED 1�r ' :" :!A ON A M-AP OF COMMUNITY #250001 DATED 10/1/83 B Y THE F , I , A . Land Surveyors Civil Engineers • (3�(l� �n$t�Ytt �irtnl �urt1r� (�o., �n�. . 1 rz �utiuitiur fit. �c(u �ljr�rfnra, 1T2740 GENERAL NOTES: (1) The declarations made above are on the basis of my knowledge, information, and belief as the result. of a mortgage plot plan tape survey inspection made to the normal standard of care of registered land surveyors practicing in Massachusetts. (2) Declarations are made to the above named client only as of this date. (3) This plan was not: made for rc-ording purposes, for use in preparing deed descriptions or for con- structions. (4) Verifications of property Iir: dimensions, building offsets, fences, or lot configuration may be accomplishe(l only by an accurate inO.rument s;)rvcy. Assessor's office (.1st floor): _ / - *THET Assessor's ,map and lot number B gTSTI"M MUST 19E.oard of Health (3rd floor): c -�7/� ,. � � - Sewage Permit number ..... .t�.�...l.l�t....a'�.�......,. :...` r .. :` i BanesTSB LE. S`engineering Department (3rd floor): JS �° moo- rb 9• ..............................�...�.....�r............:. .......?. a House number ,� � �; ,.,q 4� 'O�FOBp� ` PP Y 9 ----IL9"11ii-REGUL ►TIONS ` Definitive Plan Approved ti Planning Board �_______________________ 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 .........ri ....... %..... q...... d�S TYPE OF CONSTRUCTION ........:............1!SOLI:Q............ iC�AH!� ...........................................................:.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information:. 11 /�/4 ET l / �! If/�L LocationQ�.... .......... .......... .........., ....... 1......~.............. N..'T.C.`P............. .............:........................... Proposed Use .... ......................................... ................A .....................................,...........,......................... Zoning District .......... .......:... ..:G...................................Fire District ...................... ...:f��'Y>l.�?l.................... Name of Owner ....... Q.t(.0....... .. .................. ..................,��../.`j..l�'1.�................................................. Name of Builder S /v/E ...........O.H.i,.......SOAR O.,KPf.....................Address ......................................................:. ........... Name of Architect ..................................................................Address ............. Number of Rooms .2 �90X'L.3 ..............Foundation ........ ......P.. .Q.1z. 0 Z........GQ.IkC.l� .1 ...... Exlerior :.................: .P:r1 ... .Roofin tn7 ...............................:.............. Floors .................. .L9�0:6.�P...............................................Interior ................5.. . . '. SIC,G:`1�.................................... Heating .................. 7vAln4_.............. .....................Plumbing ..eF 6?....: . Fireplace ...............................kw.e........................... .........Approximate Cost .............. � .).......................... . .�1S�Ur!� Area . ...a.... V . Diagram of Lot and Building with Dimensions Fee 00 2 ,01 ,,..,. OCCUPANCY PERMITS'.REOUIRED. FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town o Barnstable regarding the above- construction. , Name : ��.0 ....................... . e -Construction Supervisor's 'License ..... �r— SOROKA, JOHN r' ~ZX No Permit for ADDITION Single Family Dwelling „ _ - -- ' Location :..Zot #3 , 111 Bridget ' s Path `� r .Centerville.............................. } Owner ..John Soroka •..... n �'" f - �. ^_ - ?. Type of.Construction - .Frame.. E.. - - 41 ....... ........... .......................................... « ......... f �` Plot'..............- Lot' Permit Granted .. October 26, 19 88 t .. ems' t !_ - 'J r •� � ^� Date of Inspection .... ............ .... .. .1.9 Date,':Completed ...:.... ...... •-� ! T - � r ��.Y�-4'• a*r !. ell T � Assessor's office (1st floor), 1� .. oo�THETo Assessor's map and lot number ........................................... fir. d'oard of Health (3rd floor): Sewage Permit number BAH39TSBLE, KAGIL kngineering Department (3rd floor): I , rJ s moo_ 1639• �0 Hduse number ......`.......... 0�0 YAK a' Definitive Plan Approved by Planning Board ________________________________19-------- , APPLICATIONS PROCESSED 8:30 9:'30 A.M. and 1:00.2:00 P.M. only' TOWN OF BARNSTABLE BUILDING INSPECTOR L � 1 APPLICATION FOR PERMIT TO ..........�. ram. �7v .a�......./....�. J'C..... ... Y 15%.... .....�'?USE TYPE OF CONSTRUCTION .....................fc/ ".1-c.)............ ............................................................... ....... ........................................19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 9.6.7........?..........�.... .I e.. . S /fl T//.......... F`�!Tc{ !✓/�L F......................................... �W 'LL 1 ProposedUse 1�1.............................................. .................................................................................... Zoning District ....................... W.. ....................................Fire District .......................�-:...... ....fr .ya'1 ................... A;Name of Owner ..... 5:),+/..h:).......: CS.R.Q.«W ...................` let,)<r................................................ Name of Builder ...... U.N.N.......-So .�n.9.A....................Address ............ ..................................................... .......... Nameof Architect ......................... ......................................Address ........................,.................................................I.......... Number of Rooms �".. ...................Foundation ....................P.6.Q.(? .........r.6.& .(".T..r.....: Exterior 5 �•+ N. t..C-..s......................................Roofin �Cn 1�>4 LT .......................... . 1. g ...................... . ........................................................... Floors .................. .I,V,GU0.0.io..............................................Interior ................5f�.P .�. .��.��.................................... f 'r`ieatirig `"p` ,C 'k'r� .......`.........`....: .. ......Plumbing`. 7 ....f /.... Fireplace ................................ 0, ..�`'...................................Approximate Cost .................�� /(�.................... Area ........... rga..................... 00 I Diagram of Lot and Building with Dimensions Fee t I . 41 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..... ` .. / /! A' I ,�%.I;�A:...Cy.,,, .. ,� x.....a.� ...................... �u ,'Construction Supervisor's License .....Qt��v/� ...................... f SOROKA, JOHN A=170-225 No ..3.238.�.. Permit for .,ADDITION Single Family dwelling t Location ....Lot #3 j 111 Bridget ' s Path ................. enterville Owner ...John Soroka .............................................. Type of Construction ......Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ...October. . . . . ....2.6, .l 9 8 8 .. .. .... .. . .. . .. Date of Inspection ....................................19 Date Completed ......................................19 ���• " Toy TOWN OF BARNSTABLE Permit No. i Building Inspector i fuinAn Cash -- ---- ---- -- � rua OCCUPANCY PERMIT Bond _____--__ Issued to il_ Vie. Address 11.1 Brid get' Path, Cpntr i-rifle 71 Wiring Inspector %// Inspection date Plumbing Inspector e i. I t� ,. Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ....................................................... 19............ ......................................... Building Inspector JOWEPH.a,�DALuz TELEPHONEi 773-1120 Building Comminiontr.. EXT. 107 i TOWN OF BARNSTABLE 4 B,UILE)ING INSPECTOR. TOWN OFFICE BUILDING HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department '' f DATE: a V�.`�T' An Occupancy Permit has been issued for the building authorized by Building Permit 41 e t C r ; r� issued to--"'� Please release the performance bond. kPI. - : ,� Y 'k ro r „ } 3i ar es r6+ 3 k * 4' a P1 's.SF,+'t�,"a9} t r 3 - r .;k'L { "tv d -- +s, .a4 9 r s :: .� ' ,` rC f- +: 'rT p -ix t i +' w , " a to C Z. "�t t' r -> ^+ 1 ',. 4 n a -,t#x,s i� F ' .�, z:,�+ '`�,.� '� r ."", X -. t * 9 t x� : ., ti 3s' ,, f } ' +g'i' 1 t,r s xr,-R 'k .: � : 5•;' ,,,,3 -� -.-q. 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'{)t S"i'� F., 140 ; km �4,41 �� kl o ft" n«`�. " f.' g �} £.t ^x J e q'' i c y; ,;<t,= r.�,'ayX'tr kc�':f 5 y. m,:i , .�0 tbw�I /:i, 0 ',::�D�T'�5�/!„- � f x``. c c, a..a:.+ z r. ..':S "t',..s a.� �74r +E Q� 61��; t -r�,'I� � V ® THE ^f '9 �, j ) - ",RI.MICK4 E, R �13�' Rl �i '^ ", .,..-""." SHOWN, OBE 'THIS � PLAN I9 L®��T�Q NSF'. Vlvlt� t , i t ° ®� «! /Z.. Q� .TB�E= �R®U if A� �N®ICAT�� �Am k 2 � , + a �6 04FORMS'�TO THE ZONING �.A ;: '14:01 R,EIR a SURVEYOR � Y� C p @ �.s rrt t. �/oo'-. a ..,z a ®Y f t- d�IP6 7{�-��0. E � rM N+�07 U°',,. '' ��,y_:-�' 16, 2 MI A i I1 ., S=T,R E ET 1 •,.Y.. �,,... % ? a"1�11 . �, ". 1. a �--- k t(`fi r ,-H I:. �{1��'S V 9►1 J S r z t� ��iRj.�i 0 . �I P J r y _ _ } s; 1. al�aT'E FtE�.';LAAIQ '�UfRVEY � 1. L a �F bJ 3 L t K ti . Ass�e+ss`or sap and lot number ....... ... Sewage Permit»number ... ........... SYSTEM MUST 0 <' 'INSTALLED C FPP" I •1t"' Z BABB9TADLE •Via•. House ,number .... .... . ... ! , . ....:{................ I "lr� 9°0 ' M639 a�0�� ' LE � ' T67WN OF ' BARN"STABLE` { BUILDING pINSPECTOR APPLICATION FOR PERMIT TO v\L . TYPE-OF CONSTRUCTIONJZ �...... o :.... T. t ' .:..... ................ TO THE INSPECTOR OF BUILDINGS: { The undersigned here k�y applies for a per a cording to t e following information: Location .. .. ............. .............. ....... 1.. . . ...... �j'� ....:......�- .i�!..1�� l ........ r Proposed Use ' lt�G��a=.... i M 1!�' ... ..::i-�.>N.�='f. .l. `�. .................. Zoning District ........ ............:...............................:.:.......Fire District .......................... A5 .................................. Name of Owner ..C:..... ...........!J................ ..Address . .die .... � .... .... �.1 ... .. Name of Builder . � `"... 1 ......�! �aF��l�jl" �NAiddress ....... ...... F�.r................... :............... Name of Architect ....f�.�O.Q !"....��.`.... ............Address .:.... 4' :.....C, .... Number of Rooms ...........�.......................:...........................Foundation a^-Vf .5.,r.:Vj.. t����*Il •�' � Exterior .. ..VV.. .�...0 D r........... ........Roofing ..: 7P. --T. ...� '�.� ���,...a........ 1'f�. 1`!"' ........Y.���!. L......................Interior ......:`�.PM>...�� Floors C. . T"T..r...F..... Heating ........t - ,............................................:............Plumbing ..� .... v. ..........: ........... a- � .�� t . ¢jp 0OO Fireplace ..; .....................................................Approximate. Cost ..................... . • r:: / p / Definitive Plan Approved by Planning Board __ ___________________________19___`___. Area :..f..�:�..Q:....:......r......//.��UI�G� Diagram of Lot and Building with Dimensions Fee. .......... ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH}&)) " OCCUPANCY PERMITS REQUIRED. FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the•Town of•Barnstable°regarding the above construction. Name ..... l....I. ..v..... .................. Constructi Supervisor's License :. `.5........... a McKEDN, JOMN C. r " r27427 x� One to No} One for .. .... ............. - .. r 7 Single Family Dwe li.. . Location ... 111. Bri... et"s Path; ,r= ' Centerville ............... � Owner Joas..C....McKeon............... ........ Type of. Construction' FKiI - • .............................. .......`� ...... ................. - Plot .......:................... Lot .... ............... J. Permit Granted ...January 16, 1'9 $5 Date of Inspection,., a. Date Completed ' t 19. � As Jses"sor' r and/� ,7 /4 t nu ......,......................:............ of TNe Tod Sewage Permit number / P Z SAMTADLE, � House number ........r:.....`..y !, ........................................... 9Oo 1679 e�0 . zs AjFO Y a o' MP TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO L TYPE OF CONSTRUCTION ... ...... r—.>........ ....................................................................... 1 ...... .................19. TO THE INSPECTOR OF BUILDINGS: r. a The undersigned here y applies for a permit according to the following information: 1 1j� �� 1` Location .. �..... ' ��� `• ProposedUse .......... ! '. -. . .��...................... .................................................. Zoning District ........ .. ...........................................................Fire District ............................. !�.5T............................A....... Name of Owner ?k�1v..C:.....1.`!` ��G . .....................Address :«n. � ............ ....... . Name of Builder Iv..1/!! ...... 1 .1.`!.�ress ..................... .......................................... Name of Architect ...C�.�Q .............Address ...... Number of Rooms .......... ...................................................Foundation ............... Exterior �Z g ...7i .. �--T �.�.� �Roofin Floors CPfk�� ....A1"D......... ......................Interior ....... .�Y1��... Heating .........�L.E.rl..........................................................Plumbing ..Cry : ..... r �w. ........................................ II 0 Fireplace .... ..'I'l.. .....................................................Approximate. Cost Jd, q2 Definitive Plan Approved by Planning Board -----------_------__.---------19________, Area ...Z�2 02.................42— Diagram of Lot and Building with Dimensions Fee !" .........��......................... -.. SUBJECT TO APPROVAL OF BOARD OF HEALTH - 6/lJv OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................ 1.�!�k..�... �� ........ Construction Supervisor's License �.�`�. ............ McKEON, JOHN C. A-170-225 No 27427 Permit for One St0 .............. ................rl'............... Y. Sin le Famil Dwellin r .................................. ...............Ag..................... Location ..L4;tA ......11 ,.fir d.(t'.5...Path... .................. .................................... Owner ..JobA..Q.,..Y.[QKeoxl.................... Type of Construction ...k'raw............................ - Plot ............................ Lot .............::................. Permit .Granted ........19 85 Date of Inspection ....................................19 Date Completed t A 1 t. w TbWN , IE 9a , a M1 . 7013 . 4 DI VISIM 41, FCC. (417 s , , 1 r m a t t : p , x R r i � r r , e , O` i, ro' e'- N t e r n . r a- , r " r n m . 5 r t s w , �u , r - e , 4 . b r ' TO Rim °r T pLE 2013 SEP 23 01 DIVISION - S� Too -�/G