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Town of Barnstable
Approved Regulatory Services TOWN OF BARNS TABLE
Fee Thomas F.Geiler,Director
Building Division 2003 JAN -7 Phl 12: 40
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601..
DIVISION
Office: 508-862-4038 Fax: 508-790-6230
�j Home Occupation Registration
Date: N 3
0/'�i Phone#: �b? 71 D —3 5�`�
Name: ,C) ,()
I �a ��Z. �rsl. 1�
Address: Z_ /i I 0 Village:-^-� p
Name of Business: l�
pp_ 06 ►s Pt2c1
Type of Business: " t '� ^� C�^S� �'~ti _Map/Lot: PI �6 J 18
INTENT: it is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
.-Within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the
activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual
alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal
residential volumes;and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located `
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and
there is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration, smoke,dust or other particular
matter, odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess
of normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I,the undersigned,have read a ee wi e a e restrictions for my home occupation I am registering.
Applicant:
Date: �
irnm einn
YOU WI +..
SH T 0 OPE
N A BUSINESS.
For Your Info�rriation: Business Certificates cost $30.00 for 4 years. A Business Certificate ONLY REGISTERS YOUR NAME in
town (which you must-do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town
Clerk's Office, 1' FL., 367 Main Street, Hyannis, MA OR601 (Town Hall) and 200 Main Street Offices at the Licensing counter.
DATE:
} Xi
Fill in please:
APPLICANT'S YOUR NAME: /�{ i/ -�- p ; ,
BUSINESS
YOUR HOME ADDRESS:
7 g o - �36Z
TELEPHONE # Home Telephone Number:
r
NAME OF NEW BUSINESS^P(,c r0_ r)a4c 0 F TYPE OF BUSINESS Ph
IS THIS A HOME OCCUPATION? YES N0
Have you been given approval from the building division? YES NO
ADDRESS OF BUSINESS i q'a M cc-�,sh P., ct ' . , q P/ P
!1 MAP/PARCEEL NUMBER
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of
the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200
Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally
operate your business in this town.
1 . BUILDING COMMISSIONER'S OFFICE j
This individual has been informed of any permit requirements that ertain to this e of busines . \v P type s f , ,t`
Authorized Signature** v
COMMENTS:
2. BOARD OF HEALTH
,.
This individual has been informed of the permit requirements that pertain to this type of business.
Authorized Signature
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AUTHORITY)
This individual has been informed-of the..licensing requirements that pertain to.this type of business.
- f
Authorized Signature
COMMENTS:
{� Town of Barnstable
Regulatory Services
�SHE Tpw
P� o Thomas F. Geiler,Director
* BuildingDivision
snnuasTwan.E.
v ennss: g Tom Perry,Building Commissioner
iOtEo Mpt a 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Pee: .25--
Permit#:
HOME OCCUPATION REGISTRATION
Date:
Nanie: Phone#:
Address: village:
Name of Business:.
Type of Business: Map/Lot:
INTENT: It is the intent of this section to allow the residents of the Town,of Barnstable to operate a home occupation
within single family dwelli igs,subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity
shall not be discenmible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the
prenuses which would suggest anything other than a residential use;no'increase in traffic above nornnal residential volumes;
and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carved on by the pemament resident of a.single_family residential dwelling unit,located within
that dwelling unit.
• Such use occupies no more than 400 square feet of space. "
• There are no external alte.rations to the dwelling which are not customary in residential buildings,arid there is
no outside evidence of.such use.
• No traffic will be generated un excess of normal residential volumes.
The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,
odors,electrical disturbance,beat,glare,humidity or other objectionable effects.
• There is no storage'or use of toxic or hazardous materials,or flammable or explosive materials,in excess of
normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not wRthin the.required trout yard.
• There is no exterior storage or display of materials or equipment.
• There are no commercial vehicles related to the Customary Honme Occupation,other than one van or one
pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet hi length and not to
exceed 4 tires,parked on the same lot contai nung the Customary Home Occupation.
• No•signn shall be displayed indicatnmg the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address slmall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling uiut.
I, the undersigned,have.read and agree,viththe above restrictions for my home occupation I an registering.
Applicant: Date:
Honieoc.doc Rer.01/3/08
'g R (�UZ r
PER ' *Permit �l.V`C VJ
li
Town of Barnstable
i A Expires 6 mo► hs m issue date
Zo
1`E Regulatory ServicesMAM
059. Richard V.Scali,Interim Director
163A A1� �
p Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
EXPRESS PERMT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address l y d,
Ptesidential Value of Work$ d Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address ��'
Contractor's Name " ` 7COV 64 �C Telephone Number
Home Improvement Contractor License#(if applicable) G Q Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
[� I have Worker's Compensation Insurance
lv C
Insurance Company Name �.SI -C
Workman's Comp.Policy# w6 G —,-;z a o oa- ( G
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
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 Improvement Contractors License&Construction Supervisors License is
required. .
SIGNATURE:
TAKEVIN Muilding Changes\EXPRESS PERMI XPRESS.doc
Revised 061313
l,.
PROPOSAL
Proposal No. 14-252
May 5,2014
To: Gary Morris Work to be performed at
192 Great Marsh Rd
Centerville MA
We hereby propose to fnrnish the materials and perform the labor necessary for the
completion of:
SIDING
1. Remove existing siding and insulation ,
2. Cover with housewrap
3. Install Certainteed fiber cement board siding(White color max)
4. Install all necessary flashings
5. Remove all rubbish from project
Labor and Materials$7,400
RAKE TRIM
1.Remove existing rake trim
2.Install new lx8 and lx3 PVC trim
Labor and Materials$450
PRIVACY PANELS
1.Remove existing panels
2.Install new PVC privacy panels
Labor and Materials$200
ROOFING(back area)
1. Remove five courses of shingles
2.Install Ice and water barrier
3.Tab seal area
Labor and Materials$450
Permit to be secured with Town of Barnstable
Labor warranty for 5 yrs
TOTAL PROJECT COST$8,500
All material is guaranteed to be as specified,and the above work to be performed in
accordance with the specifications and completed in a substantial workmanlike manner for
the sum of Eight Thousand and Five Hundred Dollars$8,500 with payment as follows:
Four Thousand Two Hundred and Fifty Dollars$4,250 due with acceptance of proposal
and
Four Thousand Two Hundred and Fifty Dollars$4,250 Due upon Completion
Respectfully suO 'tte
Richard P.C SzeauOr. HIC#168607 CSL#100393
198 Five Corners Road Workmans Comp and Liability with
Centerville,MA 02632 Mcshea Ins Ost
Acceptance of Proposal No. 14-252
The above prices, specifications and conditions are satisfactory and are hereby accepted.
You a do the work as specified.Payment is outlined above.MV,
6gna Date
I
r 9 Massachusetts -Department of Public Safety
Board of Building R gaiatrazns and Sta:_�darcis
Construction Supervisor
License: CS-100393
r rTS.
RICHARD P CAZ_AULT-JRL
199 Five Corners Roac1
s
Centerville MA 0!632
J�.+ .lrle�...�riti, Expiration .
J Commissioner 021OW2016
"tF _[1�71772fkPlfUnCC�tf! r' L C ; _ s. ar� .. -...
f .LILee61•1.�n9RL�rA cr £C v •,
a,rs&Bas,gss!te to License.or r isti at.on�! tad
t or snc vttDu.I use trft
f rE j'�o'� `' "^rtT !►CTpx before the exp�rat�un date ne egistr3t,cr 163607 _ return to
YF�� anice of Consume Affairs a;ine
piratio� .$12015 _Reulatio {
Indroidual 10 Park Plaza-swte 51:7U
RICHARD P CAZ�::LT JR ; Boston,MA 02116
RICHARD CAZEAULT "
198 FIVE CORNERS RD _
CENTERVILLE,AAA 02631
,. Undersecretary ,I t slid w' out }
= re.
7H.
5
r
27re Connnornvealth of Massadiusetes
Deparment of Industrial Accidents
Office of Investigations
wi 600 Washington Street
Boston,MA 02111
rviviv mass gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Leeibly
Name(Business/Organizationdadivitiml):
Address:
City/State/Zip: Phone#:
Are you an employer?Check the appropriate box:
Type of project(required):
11E I am a employer with '2- 4.— ❑ I am a general contractor and I
employees(full and/or part-time).
s 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 S- ❑Demolition
w for me in an i employees and have workers'
°fig y capacity.� �'- 9. ❑Building addition
[No insurance
.workers'comp.insance comp.insurance Y
required-] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12. Roof repairs
insurance required.]i c.152,§1(4),and we have no ❑
employees-[No workers' 13-E.Vd r
comp.insurance required-]
•Airy applictirit that checks box#1 must also fill out the section below showing trier workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all wo*and then hire outside contractors mast submit a new affrdam indicating such.
Contrutors that check this boot must attached sn additional sheet showing the name of the sub-com actors and state whether or not those entities bare
employees. If the sub-contmaors Dave employees,they must provide their workers'comp.policy number.
1 am an employer titat is protddirrg aporkers'conrpensalion insttrmlce for my eniployem Below is the policy and job site
information. /,,�
Insurance Company Name: / C f f-k l AI S
Policy Al or Self-ins.Lic.#: ~ ono ~ '-t�d a FS " �OLExpiration Date: 0�
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 S 1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pa' s tr s of imry it t the irrfornration prosided above is true and correct
Si lure: Date:
Phone#: �_:r7_F
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: PermidUcense#
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#:
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N�sddq��
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f`t r a COMMONWEALTH I DEPARTMENT OF PUBLIC SAFETY
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OF 1010 COMMONWEALTH AVE. j
MASSACHUSETTS BOS�Q�I, t.02216
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EXPIRATION DATE ,*
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e EFFECTIVE DATE LIC NO
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,._ Joseph D. DaLuz Telephoner 790-6227
Building Commissioner-
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
TOWN OFFICE BUILDING
HYANNIS , MASS . 02601
DAT E r
TO: /A,) fi% lL a�vC�
le 7
'
The ��� y i -e inspection at /eo Z-ltpl V V
not comply with MA Building
Code No. 2-116 /
Please contact this office for reinspection.
Thank you ,
Building Inspector
AEMrkm
l
INSTALLED IN C® PLIANC
WITH TITLE 5
Assessor's office(1st Floor): G ,
ENVIRONMENTAL CODF.,4�,�!__
Assessor's map and lot num -'` D 7 Gq i TOWN REGU P�re TMe70�,`
Conservation R� �� �� ew
Board of Health(3rd floor): __-- .
Sewage Permit numberZl--2 SAW3rARL ;
Engineering Department(3rd floor): -� G� f �oo„�e1o`.�`�d°
House number
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
APPLICATION FOR PERMIT TO Rely-no a-c- d- �eGcJ�ti� � )De,,-k
TYPE OF CONSTRUCTION �eC�l� Jam:/, gloc-I\
A01— 19 9,3
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location �e cc�+ IJIA C 104, 3.2
Proposed Use w xJ Qe-e�L
Zoning District A9 w —/ Fire District
Name of Owner �oo ly'rACAW%, Address t/
Name of Builder X-w I Y1 1 �C-Y\-ci Address 3 y� 91 SA4-1] �,
I` Cl. I
Name of Architect 4117 Address
Number of Rooms ���/7 Foundation
Exterior���, Roofing
Floors /10t� 'Interior 4
Heating Plumbing
Fireplace Approximate Cost _ S,oG�d 6
Area
Diagram of Lot and Building with Dimensions Fee
D
K1
/G
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
G �'f3SS
0 Construction Supervisor's License � ll�
}` KOPELMAN, Robert
1
t f `
No 35765 Permit For REMOVE & REBUILD DECK-,
Single Family Dwelling
f -
Location ' 192 Great Marsh Road 4 +
f
+ Centerville
'' �Rober' t Kopelman + Lt 4
a ner 1 fi E
Type of Construction' ',.'Frame
Plot a1I. Lot : . , t ! LY -i
# #
Permit Granted Apr i 1 14 _ 4 19 9 3
Date of,lnsp ction `��/di' 19x-
j tt n X
{ cr
Date Completed 19
e +
Assessor's map and lot number ! T ' .. Q/f 7
0-,-r7 ,/
Sewage Permit number .....................`.....`"�.............................
,t C� ,
`T"ET � TOWN�OF BARNSTABLE
i BARESTADLE, i
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO Gt Ly -
TYPE OF CONSTRUCTION ....................... "r '..l:......'........:...1...................................... .............................
nc�r'
Octobor 11, 77
......... ... .......19.
...... ..... .......
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ...........1.. ..............:. :...r..`............ t!? .: ?L.... `.J. / i � ......... .. :: .f.... .. :.`. .. ....................
Proposed Use ..................1..Amily Dwolling, trlth Garage (Gambrel w/2 floors)
ZoningDistrict ........................................................................Fire District ..............................................................................
� 4;!tnit� �� �.z E'411K 188 Long-view Drive, Centerville
Name of Owner ......................................................................Address ..........................................-..........................................
• Name of Builder Ronaldailvia Off Centerville Ave., Centerville
a ...................................................................Address ....................................................................................
6&me
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms .....5..........................................................Foundation .......Cement..........................................................
.'ood blood 3hinCle;s
Exterior ...................................................................................Roofing ............ ..............................................................
Carpeting ,heetrock
Floors ......................................................................................Interior ....................................................................................
ylectric 2. anct •,• bathe
Heating
..................................................................................Plumbing .......................,.:........................................................
Fireplace ........................Z........................................................Approximate Cost ..............: P.000.... ..................................
-4. 1--- / S JoC
Definitive Plan Approved by Planning Board 14*r'64-,5T19 �q' •
-- Area ........................................
Diagram of Lot and Building with Dimensions Fee ��.............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
t!'
_ - I
-w
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name�` . ... s ...................K=A ...`- .................
LaFleur, Raymor,
A=210-187
2.0747
No ................. Permit for ...... �RVY..........
.........sin.gle...famil.y. ...dwelling. .....................
...... ...... .......... . .... . . ......
6 r t Marsh R
Location ..........192 G e a
............ ...........
Center, 11e
...................................... .....................................
r e/1
Raymo LaFleur
Owner .............
Type of'Construction ........fr4mg......................
......................................*.........................................
..Plot ....... ............../ Lot ........"Z1.1...................
A
V )ctober 25 7
Permit Granted .......... ..............................19 8 Date of Inspection ..... ..............................19
Date Completed ...... ..............................19
PERMIT REFUSED
.................................. ............................ 19
................................... ....................... .......
...... �oA
.--�. . ... .................................
........................ . ........ . .... .... ....................
... .........
................................
Approved ................................................ 19
...............................................................................
.............................................................................
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map �° - d 7 Parcel f Permit# 4
Health Division l -6 9 6'' �1 �'i'` Date Issued J
1
Conservation Division l Fee ob
Tax Collector �il` —/l//,/� y „Qe��'�vv►"J /�p1�
Treasurer _ Mp gi D IG
v ; INSTALLED IN COMPLIANCE
Planning Dept. WITH TITLE 5
Date Definitive Plan Approved by Planning Board LONMENTAL CODE AND
WN REGULATIO
NS
Historic-OKH Preservation/Hyannis
Project Street Address
Ad A4,awl Zel
Village
Owner Address
Telephone
'Permit Request
Square feet: 1st floor: existing proposed 2nd floor: existing - proposed Total new
. �jorx� nn
Estimated Project Cost Zoning District U' Flood Plain Groundwater Overlay
Construction Type
Lot Size. �o 11 Grandfathered: 0 Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family,(#units) ;
Age of Existing Structure_,_ Historic House: ❑Yes Cl No On Old King's Highway: O Yes ❑No
Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other y
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing to new _�3 First Floor Room Count
Heat Type and Fuel: �Gas ❑Oil ❑ Electric ❑Other
Central Air: O Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool: 0 existing .❑new size Barn:0 existing ❑new size
Attached garage:O existing 0 new -size Shed:0 existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial 0 Yes 0 No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone Number ap
Address 02 License# /s �i"io
.. `
4:2Z-0 Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -
SIGNATURE DATE
FOR OFFICIAL USE ONLY
PERMIT NO.
DATE ISSUED � k
MAP/PARCEL NO.
77.
!. , A * t
ADDRESS ` VILLAGE'
OWNER
DATE OF INSPECT1 N:
A
FOUNDATION �` �1 �` 'f •+ — .
FRAME •'
INSULATION
FIREPLACE t �!
ELECTRICAL: ROUGH _ FINAL
f
PLUMBING: ROUGHFINAL +�
r
GAS: ROUGH FINAL n� f
FINAL BUILDING
DATE CLOSED OUT �' , H• f `
•_ -a � *,� � may. . � ' s '�.� J[ �f
ASSOCIATION PLAN NO. - . r �
{
yp{ He Tp�`
�''� °• TOWN OF BARNSTABLE p
seaasT�sa
o�9►� MASSACHUSETTS
Solid Fuel Stovg Permit
DATE OF APPLICATION FIB. ISSUING PERMIT ............ ..............................................
.................................................................
NAME (owner) °b +- p�M.C1/.. .. AME (Installer) .........f ...�
(...........
r-
ADDRESS ....'`1. .. � �....�`..... .:................. DDRESS .......Fi$e�S...................n...........................................dl:r�L�.�`(
STOVE TYPE �L ..................C1..`................................ HIMNEY: NEW ........................ EXISTING .........
ManufacturerMPI..�. ! ............................ CHIMNEY: Masonry ................ ..................................................... ..................................................J .. ......
Mass. Approval ... ;74.r ................ CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed
address in accordance with an application on file with the ....:T .A........... yP..!'........................ Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
Issued By: .:............................ J
rs�...........................................Title �� ���,,�...................... Date ...`.�.....�/�,j
Permit to install expires 60 days after issue date
Stove ....................... / J' . .:. .P-L '.......k.L'.'..F... ..........Pf.....�1 d .d�............................................................................................................
�0
StoveClearancelo e0�� ........................................................................................... ............ L� .............................. ...........................................
Floor Lie, S •�i ..........................................................................................
.............................................................................. .. ........................................................,.....................................................................
SmokePipe ..............................ti z e .4e........1 S.P. L......................................................................................................:
SmokePipe Clearance .................................... ..........: 1.....!1.e ... .. :►.e ...................................................................................................................................
ChimneyZ. 9;��?;y...C' ....................................................................................................................................................................................................................
SmokeDetector ...................................... 43..............................................................................................................................................t...........................................................................
The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au-
thority of permit dated ........zQf .......... has been made in accordance with provisions e monwealt
of Massachusetts State Building Code now currently in effect and pertaining thereto ..V..:.:...... ......................................
Installer
INSTALLATION APPROVED `� Title..� �.
................/� .... ............. By: ..................... .......... .
date
WHITE: FIRE DEPARTMENT — CANARY: BUILDING INSPECTOR — PINK: APPLICANT
TOWN OF BARNSTABLE
i L1I7T
MASSACHUSETTS
F o Permit Solid Fuel Stove Pmit
DATE OF APPLICATION .............................................................................. FIRE DEPT. ISSUING PERMIT ............_..............................................
NAME (owner) ..........................................................................:........._......................... NAME (Installer) ..... ..........................._..................................................................
ADDRESS ......................................................................................... �................� ADDRESS ..................:........................................................................................................
STOVE TYPE ....................................................................�......... ...�................ CHIMNEY: NEW ........................ EXISTING ........................
Manufacturer ..................................................................................................................... CHIMNEY: Masonry .............................................................................................
Mass. Approval ............................................................................................................... CHIMNEY: Metal ...................................................................................................
This is to certify that the above installer has permission to install a solid fuel burning appliance at the listed
address in accordance with an application on file with the ................................................................................................... Fire Department,
and subject to the provisions of the Commonwealth of Massachusetts State Building Code and regulations made
under the authority thereof.
IssuedBy: .................................................................................................................................Title .................................................................................... Date ..........................................
Permit to install expires 60 days after issue date
Stove .............................................................................................................................................................................................................................................................................................................
StoveClearance ..................................................................................................................................................................................................................................................................................
Floor .............................................................................................................................................................................................................................................................................................................
SmokePipe ..............................................................................................................................................................................................................................................................................................
SmokePipe Clearance ................................................................................................................................................................................................................................................................
Chimney ....................................................................................................................................................................................................................................................................................................
SmokeDetector ..................................................................................................................................................................................................................................................................................
The undersigned hereby certifies that the installation of solid fuel burning stove and equipment made under au-
thority of permit dated ...................................................... has been made in accordance with provisions of the Commonwealth
of Massachusetts State Building Code now currently in effect and pertaining thereto ........................................................................
Installer
INSTALLATIONAPPROVED ............................................................ By:.......................................................................................... Title: ................................................
date
WHITE: FIRE DEPARTMENT - CANARY: BUILDING INSPECTOR - PINK: APPLICANT
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SM KE DETECTORS O.K. o
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BARNSTABLE BUILDING DEFT.
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PO Box 534
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Fax(508)775-3 6265 Q
Phone(508)79
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REGULATIONS FOR 50 J4\" c oDe E
S � a
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TALL 8E ACCESSIBLE QROP
MAINING ACCESS z
'SH GRADE.
_L BE CAPABLE OF w �S�ac d` -3B ��
!NDER OR WITHIN 10'
USED UNDER OR WITHIN
110
-OCATION OF ALL 40 �� �\♦� $� :�`
AT 0.02 SLOPE. 6 ,
d ♦�` �� JN�t . 34
;FiADE SHALL BE N♦2_ - •- '� �`�, `•.L .J,� �
FEET PER FOOT. 48
38
OIL
40
$L-,-- -48 -
d 9
�� ,��• ♦ `\ NOTE
x i7(ISTING FOUR BEDROOM S.A.S.
SHALL NOT BE DISTURBED.
36
4N 1 1 G
43.684 sq.ftt 1 i / 38 'ham ♦ zo
Note: water service to t 10, y>°`
front of dwelling 1 / 40 &I �w" ZONING DISTRICT: RD7
Q
x 1 1 ! 42 9, t< . � OVERLAY DISTRICT: AP C - .•.."t'1`� -I
46.43',' a� ------ ,�. I 44 d� BUILDING SETBACKS:
X, �. '^----------- I ♦'� FRONT 30' . ..
9> 65J2' N 1 46 /� SIDE 10'
52�6'3E' REAR 10'
--------r - - /
'1 RECORD PLAN. 3. 7
i
�5
46
ASSESSORS DATA:
MAP 210-181, ._..'
RECORD DEED: ? C'
i / 10779-250
•,C - '- - OWNER;APPL'-!CANT: II' '�• ��
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MORTGAGE INSPECTION .PL AN
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- 192 GREAT MARSH ROAD
CEN TER VILLE, MA.
BARNS TABLE RE615 TRY OF DEEDS.' BK. 8406 PG 115
PLAN.* , BK. 317 PG. 41
CERTIFIED TO.' GREAT WESTERN MORTGAGE CORPORATION I
SCAL E.' l"- ' MAY 07, /996,
/00, DA TE.
O
BF:�?• 42E8 RESERVE, J �l
40Q19' 0/H UNE- - _MOLE 403. Sh'CRED 1Q .. --- -- -- Qj
Q PARCEL B I J
E s'o Y- �, zs Wio 43,664 SF t Q
S.yARED GRAVEL (�i��\� �s w/r J
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NOTES.' S i N
l) DO NOT USE OFFSETS TO ESTABLISH PROPERTY LINE
OR TO ERECT ANY STRUC TURE. A s °
2)PROPERTY LINES ARE DETERMINED FROM COMPILED 49# sV.
„ rQ
/NfORMAT/ON TO BE USED FOR MORTGAGE PURPOSES ONLY �4,°`FslvDsusI I
CERT/F/CA T/ONS:'
BASED ON MY KNOWLEDGE, INFORMATION AND BELIE,, l
HEREBY CERTIFY THAT THE PERMANENT STRUCTURES INDICATED
ARE LOCATED ON THE GROUND APPROXIMATELY AS SHOWN AND ARE
CONFORMING TO THE ZONING SETBACK REaIIREMENTS OF THE MUNICIPAL i T Y OF
CENTERVILLEWHEN CONSTRUCTED AND THAT THE STRUCTURE SHOWN/S NOT
LOCATED /N A FLOOD HAZARD ZONE AS PER FE.M.A. MAP,
COMMUNITY NO. 25000/ EFFECTIVE DATE.*08-19-85 ZONE.' C
✓OHN ABAGIS ' B ASSOCIATES, PROFESSIONAL LAND SURVEYORS
I37 CHANDLER ROAD, A NDOVER, MA., (508) 688— 4899
N0. P 2701
APPL/CANAPPLICANT' MORRIS8 PEL USl
To
Date Time
WHILE YOU !M =RE OUT
M
of
Phone
Area Code Number Extension
TELEPHONED PLEASE CALL
CALLED TO SEE YOU WILL CALL AGAIN
WANTS TO SEE YOU ,URGENT
RETURNED YOUR CALL
Me ge, —.
l9a
Operator
011� AMPAD 23-021 200 SETS
EFFICIENCY® 23-421-400SETS CARBONLESS
bke(1st floor) Map / (' Parcel Permit# ��741
Conservation Office(4th floor)(8:30-9:30/1:00- 2:00) Date Iss ed
Board of Health(3rd floor)(8:15 -'9:30/1:00-4:45) . U Fee
p, ,5 7}a
4C��
1 Engineering Dept. (3rd.floor) House# d.r.7 C tNE
P f i 4j f6�9R ��', RAR
' a �
•rd 19 �� � �� A eia
TOWN OF BARNSTABLE ;
Building;Permit Application J��
Project Str et dd ss �9� �� /� ' ;'•
i r
Village
Owner Address
Telephone gwr-
tvV
Permit Request
w t l
n v `
st Floor qu feet
�r �xSecond Floor square feet
Estimated Project Cost $ SO
Zoning District Flood Plain Water Protection
Lot Size 3 6 Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use /?pp �! Proposed Use
Construction Type
Commercial Residential
Dwelling Type: Single Family 1 4,% ALA., Two Family Multi-Family•
Age of Existing Structure Basement Type: Finished _
Historic House Unfinished
Old King's Highway
Number of Baths No.of Bedrooms At
Total Room Count(not including baths) _.�; First Floor
Heat Type and Fuel ����9/.P. Central Air Fireplaces
Garage: Detached Other Detached Structures: Pool. -
Attached 41 fig/ 00W Barn
None c �s'P� Sheds
Other
Builder Information
_ t
Name Telephone Number j�0�—
Address � �p_ A License#' CS / J
Home Improvement Contractor#
Worker's Compensation#
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
14-24V,4 I
SIGNATURE DATE
BUILDING PERMI E FO 'E FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY
PERMIT NO. `
DATE ISSUED f '
MAP/PARCEL NO.
ADDRESS - + VILLAGE
OWNER
1
' DATE OF INSPECTION:
FOUNDATION
FRAME. �' L� ► ` �'
INSULATION "
FIREPLACE _
ELECTRICAL: ROUGH FINAL ! s '.
PLUMBING:, ROUGH FINAL }
GAS: _ _ `ROUGH FINAL
FINAL BUILDING "'��• /h j 3 e f Y, T f
DATE CLOSED OUT '
ASSOCIATION PLAN NO.
- -----------i
lonnzmanuAea1/jj, o1✓11.7aJf7,e i41tMeA
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 066147
i
Expires: 02/05/2001 Tr.no: 7036
iI
i Restricted To: 00
CRAIG J RILEY
PO BOX 382 � /�+'- F
OSTERVILLE, MA 02655 Administrator
'MPftt?9'f41f#EdNYhC'I4TTi-m
Registration 125799
Type - PRIVATE CORPORATION
Expiration 03/04/00
tat-z�-i5ov C.J. RILEY BUILDER INC
CRAIG J. RILEY
67 FIRESTATION RD/PO BOX 382
G�1,�,Q-a 7,- 6-,,06JERVILLE MA 02655
ADMINISTRATOR
License or registration valid for individual
onlY before expiration elate.return t(': One Ashburton Pl found
ace If If 1301
I3osron Ma.02108
00-35,000 cf enclosed space
(MGL C.112 S.60L) .
1A-Masonry only
1 G-1 8 2 Family Homes
Failure to possess a current edition of the
Massachusetts State Building Code ;
is cause for revocation of this license.
is
DIG SAFE CALL CENTER:1 800 322-4844
I
_ The Commonwealth of Massachusetts
' = Department of Industrial Accidents
� _= — OflICeOI/pYESdg8tl0OS •
600 Washington Street
- - Boston,Mass 02111
Worke Com sation Insurance Affidavit
rs' en
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name:
location:
city
• phone#
❑ I am a homeowner performing all work iuyselL
❑ I am a sole Proprietor have no one workin in
1 ti my employees.working on this job.}}:.;:.:<.Y:{.;:;.}:.}}:R:.:?.}}:.:;.}}}::;.>:.:$<$::;
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❑ I am a sole proprietor,general contractor, homeowner(circle one)and have hired the contractors listed below who
have
workers' tmssatian lices:
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FaOnre to seeue coverage as required der Section 25A of MGL 152 esa lead to the imposition of erfmioai penalties of a fine up to S1,S00.00 and/or
am�, sa vNA as viva penalties in the form of a s OP WORK ORDER and a fine of$100.00 a day against me I understand that a
Dopy of this statement may be forwarded to the Of ee of Investigad m of We DU for coverage vaificdlo®• .
I do hereby cff* p jperlury that the information provided above is urr co
Signature r Date
f
Print name Phone#-4;�r /^i
ofBclaL use only do G s am to be by city or town offldal
city or town: pWINIMllcense re Building Depainent
Licensing Board
❑check kif inunediste regmmse is required ❑sdeetmews Office
QHe&M Department
contact person: p�fi' C1�r
amud 9/95 PLV
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M CUR Appmdit J
Table JS=b(condaned)
Prescriptive Paelragm for One and Two4amilr Resideatiai Baiidiap Hewed with Food Fnab
MAXIMUM MINIMUM
Glazing Glazing Ceiling Wall Flaar Basement Slab Heanng/Coohng
Area!(!I) U value? R valuar R-value' R•vatue° Wall perimeter
Equipment F.EScieacy'
Package R value Rvalud
$701 to 6500 Heating Degree Days'
Q 12% 0.40 39 13 19 10 6 Normal
R 12% 0.52 30 19 19 10 6 Normal
S 12% O30 3E 13 19 l0 6 85 AFUE
T 13% 036 3E 13 23 WA WA Normal
U 15% 0.46 3E 19 19 10 6 Normal
V 13% 0 44 36 13 25 WA WA 85 AFUE
W IS% 0.52 30 19 19 10 6 85 AFUE
X 121/0 032 33 13 25 WA WA Normal
Y 19% 0.42 3E 19 25 WA WA Normal
Z 19% 0.42 33 13 19 10 6 90 AFUE
AA 189/6 0.50 30 19 19 10 6 90 AFUE
1. ADDRESS OF PROPERTY:
c
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: e—
3. SQUARE FOOTAGE OF ALL GLAZING: fZD
4. %GLAZING AREA(#3 DIVIDED BY#2):
5. SELECT PACKAGE(Q-AA-see chart above): r
NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-080303a
780 CMR Appendix J
Footnotes to Table J5.2.1b:
Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall
area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 fl of decorative glass may be excluded from a building design with 300 W of glazing area.
Z After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used.
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing(if used). For ventilated,ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include
exterior siding,structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements,
or garages).Floors over outside air must meet the ceiling requirements.
ne entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
ba iements must be included with the other glazing. Basement doors must meet the door U-value requirement
described in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the,lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J52.la
NOTES:
a)Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors'in the building envelope must have a U-value no greater than 035. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c If a ceiling,wall floor,basement wall,slab-edge,or crawl space wail component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
1
43
780 CMR Appendix J
Footnotes to Table J5.7-Ib:
' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall
area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft'of decorative glass may excluded from a building design with 300 ft of glazing area.
'After January 1, 1999,glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used
' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full
insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R-38
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity
insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof.
'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing(if used). Do not include
exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction.
'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements,
or garages).Floors over outside air must meet the ceiling requirements.
Tl:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
meet the same R value requirement as above-grade walls. Windows and sliding glass doors of conditioned
basements must be included with the other glazing. Basement doors must meet the door U-value requirement
d:scribed in Note b.
'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a
NOTES:
a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35).
c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
t
43.
,;ram
r
ESTIMATED PROJECT COST WORKSHEET
Value
LIVING SPACE square feet X$100/sq. foot=
GARAGE (UNFINISHED) square feet X$50/sq. foot=
1
PORCH rr square feet X$25/sq. foot=
DECK square feet X$15/sq. foot=
OTHER square feet X$??/sq. foot=
Total Estimated Project Cost
q*915b
The Town of Barnstable
AS%• .�eNsresra.
�m Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601-
Office: 508-8624038 - Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Permit no,
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: EsUm
ated Cost 110,006
Address of Work: Ad
Owner's Name:
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):'
❑Work excluded by law }
❑Job Under$1,000
❑Building not owner-occupied
❑Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME 01PROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY .
I hereby a ply for a permit as the agent of the o r.
.O�6
� 9
Date
ct Registration No.
2
OR
ail
Date O er's N&9e
r .
q:forms:Affidav
- r "^'....+y."^w..r�.^^'^•:M4r'`''°".y^".''."4•-..-...!'-:h.:s`n-�.�'rr-.n.a.'9'�'�f�Y^w.1S3..+».'�•'�"-.%��'v?,i,F'l'*Z.r..,-r'.l�i�;l�.sa:�'+..a:"'q:.-�.*.rr.�.�,'WF2ww 71r"JmMY"4''^'H'..r.}e'—^�*"W.++.'+.'+i.h,44Y�fidit�'r
3
f
The Town of Barnstable
BAMSTASLE.
M"9'tbg9. Department of Health Safety and Environmental Services
�0
'°rFn►�e+" Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
PLAN REVIEW
Owner: Map/Parcel: "' I
Project Address: 17 �luilder: C
The following items were noted on reviewing:
del
Please call 508 862-4038 for re-inspection.
\I,��Q.c R , S�LUv�J
jXs.pected by: ( �J
Date:
q:building:focros:review
s
/st
pop
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The Town of Barns �
' $ Department of Health Safety and Eavzronmental Services
Building Division
367 Main Strut,Hyannis MA 02601
RalPh Crm=
Office 509-790-6227 Big COMM.
Fhr 508-775-3344
For office use oniY
Permit no-
Dau AFFIDAVIT `
} HOME nWpROVEMENT CONTRACTOR LAW
SIIPPLEMENT TO PE mr APPLICATION
n,alterations,reaoM1ratioa.stY moderaizfft conversion,
MGL c. 142A requires that the"ucons"uetio of an addition �., ng owner occ*ed
�imPtvveme ,tznrotial, demolition, ns
err coaneuon units or to ��am adjaeeat
building containing at least one but not more than four units
wain=ePtons, along with other
to such trsidence cr building be done by registered contractors. ,
0
r requirements.
Type of Wa
� Est. CostJo 4�
Address of Work: �02
Oaaer.Name:
Date of Permit Application:
t
I herctt%ctrsify that:
Registration is not required for the following nason(s):
Work coduded by law
Job trader SI,000
Building not ow=-ooa�ied
__- g own pc=it
OwncrPullin
Notice is h=by gh-en that: G WITH UNRE CONTRACTORS
OWNERS PULLING 7HEIR OWN PERMIT OR DEALIN
FOR APPLICABLE HOME IIMPROVEMEN L WORK DO NOT HAVE ACCESS TO THE
ARBITRATION PROGRAM OR GUI FUND'=EII MM c 142A
SIGNED UNDER PENALTIES OF PERJURY
t
I hereby apply for a permit as the agent of the oulner.
!O Registration No.
Date
OR
The Coninuon lrcallh of Afassach usctts
'D� artntent o Industrial Accidents
.n Ofl/ceallm�s�l9atloas
�;E . .•':� 600 !t irsllin W tr Street
Boston.Afars 02111
�--' Workers' Compensation Insurance Afriidavit
PRIM
Anne
r `
• �� • - 6
1 am a homeowner performing all work myself-
1 am a sole proprietor and have no one working in any capacity
!am an employer providing workers' compensation for my employees working on this job.
aildress:
girl nhene k •
incurince co Dehcv .------►---
am a sole proprietor.general contractor,or homeowner(code one)and have hued the contractors listed below wi-
the following workers' compensation polices:
conlryiny n
re
ci
nhene#�
rsror+�..aa�..-vier+-r��
m inv na e•
cin phone 0,
ins unnee co,
:Attach additional'sbee[ff tieet�sar�, � •+� '�"'''"'�'`""'�
Failure to swore coverage as required under section 3A of AIGL 152 can Ind to the imposition of eritaiaai penguin of s titre up to S1300.00
one years'imprisonment as well as civil penalties in the form of a STOP'%VORK ORDER and a line ofS100.00 s day against me. I understand
copy of this statement may be forwarded to the Olnce of Investigations of the D1A for coverage veriiiestion.
! hereby errrif•unrlcr t/lc a' penalties ojperjurr that the information provided above is true and cotmt
q
Signature -- & — / ? —/
Print name C, one b
�3 �6
oflicial-useoniv do not write in ibis area to be completed by city or town otYttia!
Pennimicense# nStWding Department
cin•or town: DUeetsio%Board
check if immediate response is required uSeieetmen's Omcc
C311mith Department
phone is: pother___
contact person:
Information and Instructions ;
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation fc
employees. As quoted from the "taw", an employee is defined as every person in the service of another under ar
contract of hire. express or implied. oral or,%vrittert.
An emp/nrer is defined as an individual• partnership. association. corporation or other legal entity. or any two or
the fore--ohm engaged in a joint enterprise. and including the legal representatives of a deceased employer. or tht
recciver or trustee of an individual . partnership. association or other legal entity, employing employees. Howe..,
owner of a dweiline 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 wort: on such dwellin
or on.the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an emp
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance c
reneival of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who iras not produced acceptable evidence of compliance with the insurance coverage required.
Additionally. neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the
performance of public Nvork until acceptable evidence of compliance with the insurance requirements of this chap
been presented to the contracting authority.
1 •�-�+-.w�.. .•.�+��w . "4• .. '1�L.i:L..• . .,^'y •• .-y...a;tir;IT...^J.Q.B ir•:J.•:-{���:.. .FYI.i.:i�Y�."':,ri�.'���!"'_•aY �-
Applicants
Please `ill in tite workers' compensation affidavit completely, by checking the box that applies to your situation a
supplying company narnes. address and phone numbers as all affidavits may be submitted to the Department of
Industrial Accidents for confirmation of insurance coveaage. Also be sure to sign and date the afTdavit. Tile
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 requ
to obtain a workers' compensation policy, please call the Department at the number listed below.
.�. .� -. .w+e.sw. � - ..•..��..r.-..-�� _ � � ._ •. .ate..
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottoi
the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant•
be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be return
the Department by mail or FAX unless other arrangements have been made.
The Office of investigations would like to thank you in advance for you cooperation and should you have any ques,
please do not hesitate toaive us a call.
The Department's address. telephone and fax number.
The Commonwealth Of Massachusetts
�4+n
Department of Industrial Accidents r•
Office of lnvesagations
600 Washington Street
Boston,Ma. 02111
fax 4* (617) 727-7749
' - .'--, 4 . �, . .: 3 1 '.y.i?"•'F.SiN"C.M.T..Fig,:vc.MMd "'�r'6�'..<
' HOME IMPROVEMENT CONTRACTORS REGISTRATION
: Board of- Bui.,lding Recaula.ti.orls and Sta.ndaT ds ;
• One: ,Ashburton Place .- ,Room 1301
Boston,, Massachusetts 02108
MErN7 CONTRACTOR —
HOME - -. ------------------- -
HOME IMPROVE
a F2egistr;ation' 1214227 ` Expi-rat ion 05/07/9E3
Type - PRIVATE CORPOF2ATION HOME IMPROVEMENT CONTRACTOR
Registration 121422
ro
Type - PRIVATE CORPORATION
Ya RILEY CONST INC Uv
Expiration05/07/98 .
CRA:IG i PILE.Y
t 746 MAINST/PQ BOX 382 RILEY CONST INC
r + OSTERVILLL MA .U2655 CCgAIG. J. RILEY `
MAIN ST/PO BOX 382
I
_. AOMINIsTRAm '' OSTERVILLE MA 02655
47
•, ,. 'i- ,. - `. .\. .. yj./ -.�..-.....,..d-..as...r.....x�J..c:.u.�d.i:ei..a..ad.ti%.:�.-...r...t4 ..a...�;�:':...�....;..•-� .
. � ✓/ee �om�nanureald a�✓�aaaac�ivaelta
DEPARTMENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Numbers Expires:
: -
lff-elcted-la:: 00
CRAIG'J RILEY
PO>BO% 382
OSTERVILLE. NA 02655
i
TOWN OT BARNS 1ABLE
Town of BaNsble PM 1: 06
Regulatory Services
Th omas IF.Geiler; 7ft'€c`fr $ O N
M"9. Building Division
fEDV Tom Perry,Building Commissioner
/ 200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
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Fax: 508-790-6230
-PERAtT# 6 S ? FEE: $ S-
SHED REGISTRATION
120 square feet or less
Location of shed(address)"` L ���
Village'
Cr-
Property own s name Telephone number
21 D 1 Q
Size of Shed — v
Map/Parcel#
Signa . e
Date
Hyannis Main Street Waterfront Historic District?
Old King's Highway Historic District Commission jurisdiction?
Conservation Commission(signature required)
• G �
PLEASE NOTE: IF YOU ARE WITB]N THE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE.
PLEASE SEE THE APPROPRIATE COMI12iSSION FOR DETAILS.
THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN
MORTGAGE INSPECTION PLAN
AT
S 192 GREAT MARSH ROA D
CENTER V/L L E, MA.
BARNSTi4BLERErt/STRY OF DEEDS. BK. 8406 PG. 115
PLAN.' BK. 3/7 PG. 41
CERTIFIED TO.' GREAT WESTERN MORTGAGE CORPORATION
SCALE.' /"_ /00 DA TE.' MAY 07, 1996.
4
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7
40819, 21H UNE- u-41Oz E 403.T?
` SHARED •� �-� � ill
PAVED- ' 1 PEL
DRIVE._�� El
sE4SM oFc,Q_ . 2s 43,664Sfyi
SHARD GRAVEL r . Cam`.._�`�; as W/F w/o
DRIVEWAY' \ , \ >C,
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NOTES.' �?y,N t;F!,/,�`p,
/) DO NOT USE OFFSETS TO ESTABLISH PROPERTY LINES � c
OR TO ERECT ANY STRUCTURE. A S
2)PROPER T Y LINES ARE DETERMINED FROM COMPILED 9# 3P„
INFORMATION TO BE USED FOR MORTGAGE PURPOSES ONLY.
SUR,
CERTIFICA T/ONS.' �9V
BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF, I
HEREBY CERTIFY THAT THE PERMANENT STRUCTURES INDICATED
ARE LOCATED ON THE GRGUUND APPROXIMATELY AS SHOWN AND ARE
CONFORMING TO THE ZONING SETBACK REQ'IIREMENTS OF THE MUNICIPAL/7 Y OF
CENTERVILLEWHEN CONSTRUCTED AND THAN" THE STRUCTURE SHOWN IS NOT
LOCATED IN A FLOOD HAZARD ZONE AS PER FE.M.A. MAP,
COMMUNITY NO. 250001 EFFECTIVE DATE.'08-19-85 ZONE.' C
610HIV ABA GI S 8 ASSOCIATES PROFESSIONAL LAND SURVEYORS
137 CHANDLER ROAD, A ND OVER, MA. (508) 688-4699
9
APPLICANT.' MORRIS8 PEL US/ NO. P 2701
TOWN CF BARNSTABLE 20747
Permit No. -----:---. -
{ ,=�„1 � : Building Inspector_. $100.00 (owner
' :. Cash
OCCUPANCY PERMIT Bona
"No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use, without a Building Permit therefor.
first having been obtained from the Building Inspector. No building shall b occ pi a
certificate of occupancy has been issued by the Building Inspector." �l�y ?C
Issued to Raymond LaFleur Address Centerville
////// ` .
r lot "B" 192 Great Marsh Road, Centerville
Wiring Inspector J, r
Inspection date
Plumbing mspecto Inspection date
Gas Inspector F✓ Inspection date
Engineering Department ��� � Inspection date 9-;�.
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. ✓'`
.......................................... 19._..— .....................Build g .Inspector __
4 r
r�
`�%�osTM�r oe TOWN OF BARNSTABLE Permit No. _-______-i�__`
I Building Inspector Cash Y _'!)•(:`' ' �� ei
.639
OCCUPANCY PERMIT Bona
"No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor .
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
w
Issued to i'_:.ymad I zFleur Address Cf.-1 t;r V'_11 t'
lot "B" 192 Cr-..at
Wiring Inspector Inspection date
Plumbing Inspector ` J Inspection date
Gas Inspector Inspection date
'Engineering Department 2 x
Inspection date 7 ,� ,, L• �
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.
Building Inspector
z- f
i
TOWN OF BARNSTABLE
Permit No. _------_—_- _
Building Inspector
sum Cash -----
'e +eso• ��
�nrpr► OCCUPANCY PERMIT Bond
No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged use without a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to Address
I
Wiring Inspector Inspection date
Plumbing Inspector Inspection date
CYas Inspector Inspection date
Engineering Department Inspection date
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
o
_.._.......... ................................. ......... ......
Building Inspector 6
sg�pr's ma:p and lot..-num ��� " J. ..�: • .... 0 If /,0 7
SEPTIC SYSTEM MUST, BE .
01 INSTALLED IN ,COMPLIANCE
Sewage Permit number ..............................................
............... WITH:ARTICLE II STA�TL
/ �S J 19 1 SANITARY•CODE AND TOWN
e�Q�ofTNEto�o TOWN OF BARN:' ' !MEs,. _.
i 8AHB9TODLS, i � --
:o 1639 ♦� OBJECT TO APPROVAL OF
B U I L D I N G INSPECT 4NSTABLE CONSERVATION
COMMISSION
APPLICATION FOR PERMIT TO ................................................... .... .........
c
TYPE OF CONSTRUCTION ........ .......... .. ............................ ...........................................
,
October 11, 77
` ..............................................19........
" TO`-fHE`'INSPECTOR--OFaxBUILDINGSka,-
The undersigned hereby applies for a permit according
jto the following information: " /
Location ............................. ... /g -S�.f....... l A ..........CEA17 F_A V 1 L L..��....................
10 Proposed Use .................1,•Family Dwelling with Garage (Gambrel w/2 floors)
ZoningDistrict ........................................................................Fire District ..............................................................................
1$$ Lon iew Drive Centerville
Name of�Owner �1`�. ...... ................. ...........Address .............. ....................................
Ronald Silvia Off Centerville Ave., Centerville
Nameof Builder .............................:......................................Address ....................................................................................
Same
Nameof Architect ..................................................................Address ....................................................................................
Number of Rooms .....5........................a.................................Foundation .......Cement
Wood Wood Shingles
Exterior ....................................................................................Roofing ....................................................................................
Carpeting Sheetrock
Floors ......................................................................................Interior ....................................................................................
Electric its and 1 baths
_.� —Heating................................................................:..............:....,.Plumbing ........................
...............................................,............
•
Fireplace . ..........: ......1........................................................Approximate Cost ............ 0,000
.... ....
Definitive Plan Approved by Planning Board /-}+i6v__Sr_______,(_____197__,7 , Area � Sq. �'
Diagram of Lot and Building with Dimensions Fee !/!.
SUBJECT TO APPROVAL OF BOARD OF HEALTH
CONS. s� 34 7/
" 30 }
l
1
r
I hereby agree to conform to all. the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Nam //
y/ .. .... ..........
..ti, . ,�//
LaFleur, Raymond
4 20747... two story
No . Permit for . . ............ ..... ....... . t
single family dwelling -
... .................................................... 9
Location ...:... �} 1�92 Creat Marsh Road `Yl
........................................... s
Centerville }'
............................................................................... •
r Raymond LaFleur
Owner
r frame
Type of Construction ..........................................
s4»
............................................................... .......... `l • ,
Plot ............................ Lot ......... .....................
r
October 25 78 r i
} Permit Grante''d ........................................
' Date of Inspection .......................19
Date Completed ...............19 y(j• i
`• PERMIT REFUSED
e ................................................................ 19
........... . . . ................................ n
,i ........ .. ...2s.�... .... ........................ .........
` yl......... .. ... ........... d n }}} Y
T ..........;............ .......... �... ..... ..........
7 J
Approved �7 . ...... ... 19
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.................................... �......................................... ) u
......................................... ..... ....................... ��
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- 11,
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4 - - - lki
OF hf
EDWARD ?Gs
At
$llRyf�•y
6��2 No7f-L-Z�Y/1TIONS �3iT5ErD ON �'+�hTL'%�
7ete4 S,&"pT. *q 78 = O,00
CERTIFIED PLOT PLAN
n� LDCATION .CE 7VT ✓/GGE� MCI s s -
SCALE . ��- •. . . DATE CCT 7 ��78
PLAN REFERENCE
shfow�v O�v A pl�t�v ��
�oNAGD T
pog
AOZ—
p.
penroti
e A70N0 E LR ICZ-Zd e I CERTIFY THAT THE L-3?!ST7!�G �O /DATJcyv
R/ SHOWN ON THIS PLAN IS LOCATED ON THE GROUND
GoNGVi�1✓ l7�VE AS SHOWN HEREON AND THAT IT CONFORMS TO THE
SETBACK REQUIREMENTS-OF-THE TOWN-OF
GE. . . . . . . . . WHEN CONSTRUCTED.
- DATE P.C-T .. ,,. 17 .
y
REGISTERED LAND SURVE