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HomeMy WebLinkAbout0009 CARLETON LANE kF1_. ( F, f 4 _ t. �� .. ry .. .: ,. i. ' _ ,.�t r � 6 u� � i a-.. ... ' ., G I � o i 4� - n ., c � m TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION z• Map Parcel *Application#�� � Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 4 Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project-Street Address COCIJ-+06 �—A&k ' t�V_illage Gi 0 ne t1) .Address �. 1��-e-Tz11V1-4y Telephone --"1- 37c-0 Perk mit Request iZ ()1Ir�s lap- i s Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project-Valuation 560 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 9 Two Family ❑ Multi-Family(# units) Age of Existing Structt e Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes Q.No Basement Type: [ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) V� Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: C9- existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: VGas ❑ Oil . ❑ Electric ❑ Other Central Air: 0 Yes Flo Fireplaces: Existing New Existing wood/coal stove: Ies°0 No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ exis,ting ❑ new size_ Attached garage: Vexisting ❑ new size _Shed: ❑ existing ❑ new size — Other: , Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ t^ : , Commercial ❑Yes ❑ No If yes, site plan review# _CurrentyUse. -Proposed Use _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Telephone Number ag -771a3-4-10 Address � `'_ 1,A1 License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -SIGNATURE DATE �� FOR,'OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCELNO. ' I' ADDRESS - VILLAGE OWNER DATE OF INSPECTION: FOUNDATIONS ' FRAME i INSULATION FIREPLACE f ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. vMMonweah* eMassacliusear e Deparfineig vfIAdkvtrial A dd=ts office of frivesfigafiotcs ^• = '��?D Washington Street- ' BasforS AM 02I11 wtw.mass gaPIa ' Workers' Compensation fnsurAnce Affidavit.g'olderslCoatraetorsl iectrd erg Applicant Information Please PrmtLe�� - Are u an Ya empicrYer? Check the apgragriafe bow Tama with 4: am a 'TYPe of project(require �PinY� � generaI corm ctm•and I eployees(toll and/or part due). have hired tine snb�contrars fi ❑r NC 2.❑ I am�giopxietor•or partner- listed an lhe-at shed sheet 7., de g snp no muplopees These sub-r have worl�g for me hr my capa c ty, =.Pluaes-and have worl-� ' g' ❑Demnliiiari [NO w�' comp insurance .. cam..: ce.#. 9. :E3 Roflmg addition ` regct¢ed] 5 ❑ We are a-carPoteian and its 10.[]Eectacal repaia or additions '3.❑ I an a hu=oW'='doing aU.wurk officers have exP,T;red then niysel£ [No wor±=' romp.. ri9k of per MGI, 11. Phanbing repaiis.ar addificm T*�.emz=regcrimd_J t c-152, §I(4), and we have no 12-❑Roofrepah s employees. N6 wnrkers' . 13.❑ Otbsr camp insurance regtared j *-lWY apphMut fatcbeeks box#1 nmst also fM out�e secfiun beinW shDwing$ wurkas'c eusation nIi t Hnmeawners who subnuit his an_ avzt °mP P cY inf�on. �am doing aII work and thin has outside conha��.mast �Coatraolars that oheok�s boz must a d"._d an additional sheet submit anew affidavits ficating such. �P1oY—• ff the snb-coa a have=#.) ea, showing�e came of thb sLLb-+-�,.t=and state wh=d=ornot those emirs have fhI7=Mtp-vidb fh= comp.poHcynombm Iam an employer that is pro>ri�g7parkers'compensation insurance far my enspZvyees. BeTaty is the policy and jab site information. ice Company Name: Policy#or Seaf ms.Lie.# Exgirafinnl?ate: ' Job S91m Address: Attach a copy Of the workers' compensation PoRcY declara don gyp: p2ge-(shn7ing the pohcY=Mbar and expiration date),Failmae•to.secure coverage as rcgcdredBndcr Secdon25A afMG.I,c. 152 can lead to fhe' o fine tip to $1,500.00 w2d/or one-Ye ar � sitian of mat penalties afa �P � as eIl as Oc penalises in of upto $250.D0 a daY against$>E violator. Be advised that EL of the DTA for insurance c capsTY of the foam of a STOP V►TORK ORDER and a fine statem�maY be faded to the Office of verifrcatian• I do hereby certify under otPeTJWY that the info=afwz;provided above ' true d carrec� Phone Official use ors y. Do teat write ut this yea, fa-be cun?eted by city or.faFarc affzri¢L City or'town: . PetmitlLicense# Fssrfmg Authority(circle one): 6.Board of Health 2.Bm'Idiug Deparimertf 3.CifYauwn Clerk 4.Electrical Fnspector P S.Plumbing Ins actor 5. Other . p Cantaet Person: Phone# The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 N www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): t ja 15 � —T Address: 33 AJ 1 VefZf � City/State/Zip: vv fG Phone M S 66 W 7Y 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 �mployees(full and/or part-time). * have hired the sub-contractors 6. ❑ ew 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. ❑Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑Building addition required.] 5. ❑ We are a corporation and its 10:❑ Electrical repairs or additions 3.El officers have exercised their I am a homeowner doing all work11.❑Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the.section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 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 certi der a ain nd pen •es of perjury that the information provided o e is true and correct. Signature: 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#: Town of Barnstable ~ o„ Regulatory Services sARNSTABLE, : Thomas F.Geiler,Director r-. MASS. .r_ �A i639• Building Division rFD MA'I A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 A HOMEOWNER LICENSE EXEMPTION ` Please Print ` '_JOB_-LOCATION—_::4 qTT Cd a TO In �U Cl~I tteyla 1 116 144 0/2 Z 3 2 number street village @�HOME_O_WNER"V��h /t' II� Sd� s"r ?2y sod'S's7 9�'oD name home phone# work phone# CURRENT MAILING ADDRESS: 9 /alj�)e. 6�/rtel'v,'!le_ 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 undersignedXn" " ertifies"that he/she understands the Town of Barnstable Building Department minimum inspeand requirements:and that he/she will comply with said procedures and requireme i tur omeowner`t�t 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 caret amend and adopt such a form/certification for use in your community. Q:foimsihomeexempt Town of Barnstable Regulatory Services * BAMMBLE, MASS. g Thomas F.Geiler,Director '°ten 39. & 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_ ust . Complete and Sign is Section If-Using A ' der h , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work thorize y this building permit. (Ad ess of Job) **Pool fences and alar are the responsibility of the plicant. Pools are not to be filled or uti zed before fence is installed and all final inspections are perform d and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 6/2012 kn�+ 5T4b,5 ' W 1,7 r "A' PAc s Q-.3�► i�) d 34%�A F. O.39no V PK ANN4, 4-0" X 6 - �1 Fw �� � � r�l r - � - _ �4 .. . � � .. ' ,i OF *Permit# l a�`�SHE Tp� Town of Barnstable �9a . Expires 6 n:ontlts front issue-dafE� Regulatory Services Fee_ S BARNSPABLE, 9e_A 63Q Thomas F. Geiler, Director 3 0`6? D rfp �A /3 ! . Building Division Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �Not Vnlid without Red X-Press Imprint Map/parcel Number PL„^, Property Address _ =V �/��v�d�-� �IV ( &z LI_2vtIt [f Residential Value of Wort. Minimum fee of$25.00 for work under$6000.00 Owner's Name & Address tU l Contractor's Name Telephone Number I Ionic Improvement Contractor License 4 (if applicable) Construction Supervisor's License 4(if applicable) ❑Workman's Compensation Insurance -PRESS" IT Check one: MAR 17 Z000 am a sole proprietor El the Homeowner ®11�/fV ®F E�ARNSTA�I�� ❑ 1 have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy # Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [R/Re-roof(stripping old shingles) All construction debris will be taken to ❑ 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 ust sign roperty Owner Letter of Permission. A copy of th ome Im ovement Contractors License is required. SIGNATURE: �>:'\kl'I11.1:511t)RMS\huild er it ms\E ESS. oc kevised'100608 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 •� '�� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual):_� � f IAddress:---i y�-�(.,e+'& i N CitylStateLZip:��,��2.•,��P Phone.#: SOF 77/ 37t)6 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. T. ❑;Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an ca act employees and Have workers' Y P city. � 9. ❑Building addition [No workers',comp.insurance ' comp.insurance. equired.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.Lr1 I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors 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$1,500.00 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 Investiggations of the DIA for insurance covera a verifica I do hereby certify under the pen es o e that the information provided above is true and correct Signature: D 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 `x Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/lieense 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 maybe 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 MCC of Investigations. 604 Washington Street Boston, MA 02111 Tel. #617--727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 >+ www.mass-gQv/dia ' n Town of Barnstable y`rP��tliE T�y� Regulatory Services RlR>,rcr�RT r . Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner - .... ...-—.. ... .. ._.-200 Mairi=Street Hyannis;MA 02-6fl1 _....: ... _.._. . .. _.__._...... www.town.barnstable-ma.us Office: 50 8-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE 3 /7 / JOB LOCATION: -lam 1'&Pl e►alT /n" nu— m5cr�r street village "HOMEOWNER': rTC� t�9M Sow Z71 37a 4 Sos- qSS S3 a r�#urre ` home phone# work phone# CURRENT MAILING ADDRESS: i 'L cityhown state zip code The current exemption far"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 BOMEOWNIER 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. . t The undersigned.."homeo er"ce es that.he/she understands the Tpwn of Barnstable.Buildipg I�eparhnent . minimum inspection cedur requirements and that he/sbe will comply with said procedures and Si o Homeowner r .t Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to.complyrw'th 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 ID9.1.I-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 assure ing the responsibilities of a supervisor(see Appendix Q. Rules&Ragulations for Licensing Cons vction 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 rrsponnbilities,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 mmmmunity. Q:forms:homccxcmpt l f trg,�ti Town of Barnstable Regulatory Services yMAE& Thomas F.Geiler,Director 16;F96 16' Building Division Tom Perry,Building Commissioner, 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Sec ' n If UsingA Builde r ©k� ola J ,as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to rk thorized by this building permit application for. fo ?1 /610le Address of Job) S bate P ' t Name -7nn If Property Owner is applying for pe it please complete the Homeowners License Exemption Fo on the reverse side. Q:FO RM S:0 VJNERPERMISSION �w Town of BarnstablePermit: Regulatory Services YW I � �_ Thomas F.Geiler,Director 0�) 11ABNSTAB14 ' Building Division ee:0&- KAM Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: :(0 uU -f Srg✓-o P-a N M Phone: _ _6'0 8- 7-71- 3 7 a(p Install at: AtAe470 W 10 Village: L o 'eR v i I l �e Map/Parcel: I g d Date: Stove A. ew/ sed B. ype: Radian /Circulating C. Manufacturer: r(�L, Lab.No. 7 y�9 D. Model No.: JszStc� 3 USA Chimney A. New Existing .(If existing,please note date of last cleaning) O O�-200S- B. Flue size 6 '� .C. Are other appliances attached to Flue? No D. Yjzzf&Typ6 and Manufacturer en'< - E. Masonry Lined/Unlined Hearth , A. Materials: r i C B. Sub Floor Construction: e S Installer Name: - ri l� -�qla. Address: Phone: . :6 7 7 3 7a Location of Installation: 5-M IZ., APPROVED BY: -. 7 Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector a �yq p.. t - ! } _ 'ate .:4 .'""' `. '•"[e. xJ a3 • u • e � , r 2/12/2005 .. ,, 9 CARLTO DR. ,1 y p JC TUL kAOIAN emu" '. ,� �t �rr."�`"ww.�����•ww:d �`'� } � ��'«.N+ Aim ssys�. r y F� _ f - c 4 � i ♦ :'' is � ' n liww+�.� A� G^ i , t, - - ". 4 "��, ' a.pyq+ ° � f xialM" � d. � a�•.,�•%f n 1 e x . v y� a a c s 3 x Ot 3.11 7; k ';�Ic CP ' �CST. ��� •a � .b p.. v "x( gf Qp v 3 O F'.4� �� At o 4 . - s on�,,..� j`Y, -cop%' rs a V. r . ' 9 Carleton Lane . Cent. 12/12/05 . ..... ..�.- ..- .�.. '` � F J _ �. .. .I f i ,' , s 4 C��� � ��. x 'd� ��1, y �. .,. `.- .- � • � (D USA/Canada -- JONI F 3 Clearances OStove Clearances _ Unprotected Surfaces Protected Surfaces Top vent/vertical _�•_per NFPA 211 or CAN/CSA•836yM Rear heatshleld with Side Rear Corner Side Rear Corner r Single wall pipe 24 2S" i8, 10 14- 10" Rear heatshicid with 6iomm 635mm 460mm zSSmm 35Smm zSSmm Double wall pipe or shields i8" 10" s4" 6' 6" 6" rn 46omm z55mm 355mm 15omm isomm 150mm V Stove Clearances --- -- --! Unprotected Surfaces Protected Surfaces `rnJ Rear Vent/Horizontal per NFPA 211 or CANKSA-8365-M Side Rear Corner Side Rear Corner _ Rear healshield with �4" 25., 20" 10" 25" 18" i Single wall pipe 61omm 635mm S,omm 255mm 635mm 46omm Rear heatshield with 18" 14" 17" 6' 6" 6" Double wall pipe or shields 46omm 355mm 430mm 15omm 150mm 15omm Connector Unprotected Surface Protected Surface Clearances per NFPA 211 or CAN/CSA•B365•M Singlewall pipe-vertical installations 18'(46omm) 6-(15omm) Double wall pipe-vertical installations pipe mfgr.listing pipe mfgc listing Single wall pipe-horizontal installations 18"(46omm) g" (230mm) Double wall pipe-horizontal installations pipe mfgr.listing pipe mfgr.listing Very important: ---- - - Top vent/vertical assumes the connector pipe is exiting off _ A ff 1 to any horizontal runs-the stoves position is dictated by the connector pipe clearances. Rear vent/horizontal- assumes the connector pipe Is existing out the rear of the stove and is traveling horizontally to the chimney If rear vented to vertical run- C the stove position is dictated by the connector pipe clearances. - -- Dimensions In Inches represent U.S.requirements. A:Top to Mantel 34" 86o mm Dimensions in Millimeters represent Canadian B:Top to Top Trim 20" 510 mm requirements C:Side to Side trim 13" 330 mm N Wall protection is discussed In further detail on page D:Side to Side Wall 24" 610 mm to of this manual. \ O - C.31 � ._ %� Y{�it"�F'ly+LraL rt `•P s - Will 7 ^ 4 r 4 V/� r �( 5ra rE 7 � ��f � � • 4 :7 i z r yL Is �{Y€�,t!.k�P{,.t�,h'x l4 � ',4"�\\ 7.`� r• ..AND � Q ' ' ... �t a. 7 n ;j/.So — i✓63 nG'/O"E /�S?s c•3 k~�`s>,"tS' t'. 4' a'�,+ t • � ,oO '/ • CONC CO.YC�EiE A Nt SLAB14 FxaitJA�ir� I L O / 6 e - 'iy�� t•;y.a rt r�.t y a > gyp,\' •. ' _�. � + '. ,9 sI z�'tyi�, k12$° � � Ine ,`� 1 � vF• ,z1, + / • , • • y1.Y K'� �.fir J y 7 G�V..,.({ � .. `�,.r � `• ..- •• .. .• t - • J+ CERTIFY' THAT THE . PLAWOF I-AND 8( STRUCTURE >?' STRUCTURE. SHOWN -HEREON WAS :LOCATED •BY AN ACTUAL' FIELD SURVEY ON ON y ; 104 AND. CONFORMS.TO .THE `,'ZONING .BY-LAW' OF THE TOWN'OF. MASSACHUSETTS. IN ; " f ,RE6ISTERED_*LAN URVE.Y0f L,��Pi✓1'.JEGG •� � �' SCALE . (P+:�Q' � ,197 WILI_IAM .H 'EtRYANT Gn No.15727 CAPE COD SURVEY CONSULTANTS ` ^ t•; Y ES *'' �c°c ���c�a A DIVIS!0N OF BOSTON SURVEY CONSULTANTS, INC. . , rsT��qNp SHgV`� (40UTE 132 r r , HY NN13, MA`)S. 6 -� ,sf 190-232 .� —"� Assessor's ma and lot nu .... ................ SEPTIC SYSTEM MUST Be � s- p INSTALLED IN COMPLIANCE WITH ARTICLE II STATE s; ..*........:........-... SANITARY CODE AND TOWN ' Sewa number ge Permit .............. .......... REGULATIONS.. - .} oFtHETp 'Ow TOWN OF BAR NSTABLE Q Z IAI*STeDLE; 9 11'A88 ". D'UILDIG I -SPECTOR c? OD 1639• \�0 s�, 'EO YPY a• —� ,, • C sa u; tz; APPLICATION' FOR PERMIT TO ...Single family„one...Otgry,;AWQ. 1Ing..... G t" T; t ;3 "Q wood frame ..�, TYPE OF CONSTRUCTION ............................................................................ .............May 20...................19.76.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........Lot.. ...10...Sax 1.et4,1...;tano...in....C.enterville............................................................................. Proposed Use .single...family. ..:.dingle....st.Qxry.. with...att.a.cke,d...garage...................I......................... GR C Fire District .. ................C.-0..Zoning District ..... ........................................................ Name of Owner ..J.. Alber.. .B . , B . . ....... ..,•„•••...,•„•••.: Addresspx...33...South..ya=, oath Mass............ Nameof Builder ...........►Sa.m.e..............................................Address ..................................................................................... Nameof Architect ........Sa.m.e...............................................Address. .................................................................................... Number of Rooms .....fP4.r..................................................Foundation pot 'Q.0 .: .QXl .x'e ..................................... Exierior white ceder shingles•__„••_. Roofing ....a.Sph a t...liP.7.Y1t�..Se.a� .................................................................. ............ ............... white oak Interior I� sheet rock Floors ..................................................................................... ..... ... Heating .....fOrcea...hot wat.'Pr..................................Plumbing 91T1g.�e....�atla..... ... a,XtLZx$.&..................... Fireplace ......1iv.1ng...x'.QA.m...............................................Approximate Cost .... ................................................. Definitive Plan Approved by Planning Board ________________________________19________. Area ..../.0.:T..k.. ................:.. Diagram of Lot and Building with Dimensions Fee . ' SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all. the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... .... .................................................................... �. Bassett, J. Albert 18445 one story, } No ....... ..........Permit for .................................... single family dwelling j Location ,. Carleton Lane -y ....................................... L„ Centerville ............ .............................................................. w c # J' Albert Bassett Owner ................................ .............. .......... 13 J `' Typeiof Construction ................. tt �_ ...... .......... L • �i.- -`� .............. ....... ....... ................ .................. > c k 71, Plot ! Lot IC Permit Granted 1................. . .. .. Date of Inspection ...,� .. . /'_19 Date Completed . . . ... ........G{ .. �..19 c; r• y Q PERMIT REFUSED `' C ............... .... 19 hf.................. ................................... r .......... ..................................... ` ................. (? `_' t' 0 .......................................................... .�{. ......... }-` ,{ -�J <;� e'- :.`,r`• .....:... .......................................l.............. Approved' .................. 19 - 4 O ' ............................................................................... tr ' ............................................................................... Assessor's map and lot number ..... :...�! r". Sewage•Permit number 3.S`.......................... 4. TOWN OF BARNSTABLE Z EJHHSTDDLE, S ° Q�Ya�•�� BUILDING INSPECTOR r �•1c o e Zr 1 fam":lam' -je t o7, c.�0 . 3 APPLICATIONi FOR PERMIT TO ...':.�t^... i ........... ...._ ............... , T TYPE OF CONSTRUCTION oocl L ra...© Y ti f ........................ 0...................19.. ..... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: La " Location 1O„Cflz'1O t(?1 a ane ',-,I (;en i:..rY�i l l c ............................. ............................................................. ............................................................................. Proposed Use 3 r?F; .e �' 'SST, sin��e tOX'4 17�,ti1 E3i:i t^ �?Ci rr;a_i, ,rc� ........................................................................................................a..... 5 Zoning District ..... .............................................................Fire District ..`�................('2..f1 ..................................................... Name of Owner • Albert 3aseeLt Address ',3.U...3- Sntit:h Y+�•n A1-Tt.T1 "nclr- Name of Builder . ..........................Address Nameof Architect Same................................................Address........... ... .................................................................................... Number of Rooms ......fqu.r..................................................Foundation .DOUre.d...C.On re. .t......................................... .. .... .... .. . Exterior -jritE cedar Sh.lrij;les ...Roofing asphalt ring.:.gPza: .................................................................................................................... .................... .: Floors 4 to oak Interior �rr sheet rock ..................................................................................... .....:.............................................................................. Heating .....A creed c-.nt --r- er Plumbing Sinjzle Oat:i 4 .fixture ............................................. ................................... . .. .... Fireplace 1 'tta 1". rLom ..............Approximate Cost ...2 ..00G................................................ .................................................................... ,t.,( j� Definitive Plan Approved by Planning Board ________________________________19________ . Area ....:�0..!. !�*?.................. Diagram of Lot and Building with Dimensions Fee .................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name s1 ..... .. .......... single family dwelling Lane Centerirille J. Alblert Bassett � ' 18445 one story, � ". � � . � J.Tn ' , o 76 ^ ' --' —rante&--- ' Date of . . � � Inspection ..............-- Date ^" . "p.=/=u � . . � � . � � � PERMIT REFUSED .............................../.............................. 19 ............. -------- / .. ----------- . ---/--.'., ...... ' � ' � \ --------. .----.----.--.—.---... . . � . ^ - . � Approved ................................................ lV . � ' ---------------.—...----.---.. ' . ' . � . ------------------------.—.. � . � � / ,