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L_�_ _t �' ,� -I I I I � �A-7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Iq o Parcel. 094 Application # I a 3 Health Division Cl- Date Issued / 7/1 c Conservation Division 0 , Application Fee Planning Dept. o Permit Fee53 Date Definitive Plan Approved by Planning Board —/ ;�, h 2 07__ ipoo Historic - OKH _ Preservation/Hyannis' Project Street Address 31% G4Lcy�-r v4g/ !: tk a-o. Village Owner Address 44 EA C S'T10cwt¢J en. ov—% &-A Telephone Permit Request A.nU xcoo;r Ar- ' ���T►a G To EQ�STD.16 '�1rL • ' Square feet: 1 st floor: existing►Tproposed 0 2nd floor: existing o proposed o Total new O Zoning District Flood Plain Groundwater Overlay Project Valuation 30oQ —Construction Type WOOD Lot Size • 4- A,cllcv ,- _ Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 5r Two Family ❑ Multi-Family (# units) Age of Existing Structure 41W Historic House: ❑Yes id No On Old King's Highway: ❑Yes %No Basement Type: ..9 Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft)_102M Number of Baths: Full: existing 2 new 0 Half: existing o new 0 Number of Bedrooms: le existing 0 new Total Room Count (not including baths): existing 'S new o First Floor Room Count 3' Heat Type and Fuel: ❑ Gas 14 Oil ❑ Electric ❑ Other Central Air: id Yes ❑ No . Fireplaces: Existing Z. New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# 3 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Etc CeL A— rowar.»l ,insC. _ Telephone Number 1FZg-(0k a(1 Address 4 4S W►. License# 10290t9 w*, 02.E 5 S Home Improvement Contractor# 1 L4 IB8 Worker's Compensation # 4.SLoU3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �u T-��r3 "c 5��. s�4Tl o•J SIGNATURE DATE �231i2 I FOR OFFICIAL USE ONLY APPLICATION# -DATE ISSUED `'MAP/PARCEL NO. 4 ` ADDRESS VILLAGE z OWNER 1 S DATE OF INSPECTION: i II ' FOUNDATION sjiJo3 oM6= ` FRAME s/%-11t �-INSULATION'- FIREPLACL ELECTRICAL: ROUGH FINAL x R PLUMBING: ROUGH FINAL 'GAS:" ROUGH . FINAL .� r r FINAL BUILDING < Fi ` DATE CLOSED OUT i - ASSOCIATION PLAN NO. yo ./ R ° The Commonwealth of Massachusetts Department of I"ndusbzal AccidenLr D,Tce ofbwes6gations 600 Washington Street Boston,MA 02zz1 '• �+nt.massgoy/dia , Workers' Compensation.Insurance Affidavit: Builders/Contractors/Electricians/Plnrabers A licant Information Please Print Le 'b Name (Business/orgmi=ionllndividuaD: 9.O 4.,M.S Address: �t as-r vJ. City/State/Zip: p t%_� Phone#: FMYSDIE n employer? Check the a ro rate bor.• Pp P a employer with I 1 4. ❑I am a general contractor and I Type of project(required):loyees (M and/or part-time).* have hired the sub-D'ontractors ❑New construction a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling and have.no employeesThese sub-contcactdrs have far me in an c ac to ❑Demolition mg Y rtY• CmP Y�and have workersorkers'comp.marmrnre Comp,insurance,$ 9. ®Building additionrPd] 5. We are a corporation and its 10.❑Electrical repairs or:additions a homeowner doing all work officers have exercised their11.❑Phmmbinf [No workers' camp. right of exemption per MGL. g or additions insurance requfred.]t c. 152, §1(4), and we have no 12•❑Roof repairs employees• NO workers' 13.❑.Other comp•insurance required] `AnY applicant that checks box#1 must also fM out the scab..below sbowiag then workers+compensation policy tnfarmatioa t Homeowners who submit boxti=affidavit indicating tbey are do-g eIl woo:and thm hire outside contractors must sabont a new affidavit indicating such Contractors that check this box mast attached ea additional sheet showing the name of the sub contractors and state whether or not those entities have employers If the sob-contractors have employees,thy*mmst provide their workers'camp•Policy number, I am an employer that is providing warkers'.conp infarmafian emalion irraarance for my employees. Below is the policy and job site Insurance Company Name: tL�e+-l..�'�pe�0 kc zm.ie.. Policy#or Self ins.Lic:# le t L O U� 497 7 P r 2 12 Expiration Date: � Job Site Address:_ City/State/Zip• [`o_ .�.J�`•�.0 nA., O'iL(.?L Attach a copy of the Workers' compensation policy declaration page(showing the poky number and ezpu afion date}. FatTure to secure coverage as rDgLd ed under Sect ion25A of MGL c. 152 can lead to the imposition of penalties of a fine up to$1,500.00 and/or one-year' as well as civil penalties in the form of a STOP WORK ORDER and a fine' , Of up to$250M a day against the violator. Be advised-that a co of this statement May be Investigations of the DIA for insurance cove PY y forwarded to the.Office of rage verification. I do hereby certify the d P 0fPelM7'that the information provided above is true and correct Si tore: - Date: t b 9 /i2_ Phone# Dial ase only. Do not write in this area to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): L Board of Health 2.Banding Department 3. City/ own Cl fi. Other erk 4.Electrical Inspector 5.Plumbing Inspector Contact Person: Phone#:. !� ROGER-1 0'P ID: KG' CERTIFICATE OF1IABILITY INSURANCE F'D ATE(MMI°°IYYYY) 01118112 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER 508-771-1632 NAME: cT Northwood Ins.Agency,Inc. 508�93-2955 PHONE 540 Main Street,Suite 9 c No Ec : ac No: Hyannis,MA 02601 E�1Aa ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC/ INSURERA:General Casualty Insurance Co. 24414 INSURED Rogers&Mamey, Inc. INSURERB:Hartford Insurance Co Gary Souza P.O.Box 310 INSURER C: ' Osterville,MA 02655 INSURER D: ' INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAYHAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE LTR POLICY NUMBER- MMIDDIW MMIDDIYYYY LIMITS` GENERAL LIABILITY EACH OCCURRENCE $ 1,000,0001 DAMAGE TO RENTED- A X COMMERCIAL GENERAL LIABILITY CCI 0395621 `03/20/11 03/20/12 PREMISES Ea occurrence $ 100,00 CLAIMS-MADE a OCCUR s MED EXP(Any one person) $ 5,00 PERSONAL&ADV INJURY $ 1,000,0 'r 'GENERAL AGGREGATE $ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: "° PRODUCTS-COMPIOP AGG $ 2,000,00 POLICY PRO- LOC $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT ` Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED INJURY.BODILY I Pei accident) $ AUTOS AUTOS 4' ( ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE q AGGREGATE $ ` DED RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY T RY LIMITS R B ANY PROPRIETORIPARTNERIFECUTIVE YIN 6S60UB-4977P25-242 01/01112 01/01/13 E.L.EACH ACCIDENT $ ' 500,00 OFFICERIMEMBER EXCLUDED? El N 1 A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 500,00 Ifyes,describe under - DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101,.Additional Remarks Schedule,If more space Is required) - CERTIFICATE HOLDER CANCELLATION TOWNFAL SHOULD ANY-OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE "TOWN OF FALMOUTH + ' �- THE EXPIRATION DATE THEREOF, NOTICE •WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. TOWN HALL SQUARE FALMOUTH,MA 02540 AUTHORIZED REPRESENTATIVE �-,(�,��•tea° . O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) ° The ACORD name and logo are registered marks of ACORD r - 00HF Tp� Town of Barnstable P� ti Regulatory Services • BARYSfAB[E. v MASS. m Thomas F.Geiler,Director e �'ple0Ma�'� Building Division Tom Perry', Buildin; Commissioner 200 Main Street, Hyannis, NLa 02601 Office: 50S-862- 03S Fax: 50S-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 2001"1a � • &uZA , as Omer of the subject property- hereby authorize ROGERS & MARNEY, INC. to act on my behalf, in all matters relative to work-authorized by this building permit application for(address of job) Jg,agz Slqrfawre of Omer Date Print?game 4 Q Mr;;L%tS 0',t��nNCP`IDJ;O� Massachusetts_ Department of Public Safety a Board of Building Regulations-and Standards Construction Supervisor 'License License: CS 102999 ' Restricted to 00 , GARY SOUZA ' P.O. BOXiIi COTUIT, MA 02635., a S Expiration: &1612012 ' Tr#: 102999 i • y � � � �•'4 . . � yea.' 4, .1 e � . • . • r t • V � V Office of Consumer Affairs and usiness Regulation e lOPa rk Plaza - Suite 5170 . Boston, Massaclsetts 0211 6 6 Home Improvement CW for Registration Registration: 164688 F Type: Private Corporation ._. # Expiration: 10/30/2013 Tr# 217452 Q R --GER`S AND MARNEY, INC. GARY SOUZA j O ;BOX 310 - 3 OSTERVILLE, MA 02655 _ F Update Address and return card.Mark reason for change. -- Address Renewal Employment Lost Card DPS-CAI 0 50M-04/04-G101216 OL ell License or registration valid for individul use only Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Ulm Registration: .-164688 Type: Office of Consumer Affairs and Business Regulation Expiration tb=/2013 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 RO RS AND MARNEY GARY SOUZA 445 WEST BARNSTf16LE RD. OSTERYILLE,MA 02655 Undersecretary of vali thout 'gnat re - Page 1 of 1 1 x My a f .. • f��b1�,.3!o (Ldo� OV�� 'r.rX 1 S i►�J� ��'C.K y > - } y ` http://www.town:bamstable.ma.us/sketchesl2/13181_13638.jpg 1/23/2012 t 0 8 2 202.56 c� LOT '9 10T 10 Z , — 219 920 +/- 00 S . F. Lj NO. 375 I C Li �- zg,� _ - \ Li z: z O i J 172.66 PrlJfl► �G loaf Oct GREAT MARSH ROAD * NOTE: DWELLING . IS. "GRANDFATHERED" WITH RESPECT TO ZONING BUT BUILDING SET-BACKS AND LOT DIMENSIONS MAY NOT MEET CURRRENT ZONING REOUIREMENTS. - MOR AG LOAN INSPECTION SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN.- 5 FT. �14aFM P.O.. BOX, 2$ DATE- JULY 21 , SAGAMORE BEACH, MA. 02562 THOMAS s° 508 888 866T � . c. m f fl PONT3RIAND- CERTIFY TO No.34314 ; THAT THE LOCATION OF THE BUILDING SHOWN H REON. CONFORMS j q9 TO THE LON,ING. OF THE TOWN ,OF BARNSTABLE CENTERVILLE) * ell Ffss,o�'Q ' I CERTIFY THAT LOC-US ...DOES NOT . LIE WITHIN THE FLOOD HAZARD °SUAvf_ N;E.ZO AS DELINIAf 0 ON, MAP ,.001.5 CO.M, UNITY . NO... 250001 PLAN REFERENCE: B-ARN'STABLE REGISTRYGI BOOK/PAGE: PLAN BOOK 177, PAGE 049 LOT NO.: 9 AND LOT 10, PLAN BY: DAVID. H. GREENE BUYER: DATED:. MAY 1963 ECTION NOT WE PROM AN INSTRUMENT TURVEY AND IS N57 T5 BE UgED FOR: FENCES, HEDGES OR, 10. ESTABLISH .,LOT LINES. FOR USE OF BANK ONLY. u€ - a. _ "_', �,�._ .. *. •. �....x '�'� £ FAY,". (( �Y -�^ ...�.. i s �� °M � �r x _ p £y �;w f�. < ...E �{. � �i, W' .. `. • ��'_ R t"�, x� � � ,� ., +� a � R Via, ta,'.ym' n, �3m.Y. �„ .�: +_� t5C>v"� •:. �, � �` � � �,:< � ����� � i ate "`"•`, •�+-e '`� "'... M ,° _ '� £€ FNR �4 ' � ,� -_ �..•�•�.. � u.= £x� ...�.,� �^-' � � _ -y�' � may' � y=.- � x. Ar 3, 1 "°"'�"-++^-•°s""`— wr�'� tx��' Y x W„� t v w.. .A ; .. �' s ^"- € @ •,,.., • ';ors - £ •,�£,�.. ..` .,�.,.� � .,,e-'.....�. - � �.�g#'.�yr`�'�•tea _ . L •'».�•s:..A #, c��'i-,+.y.,a, 'R.�_;i�. '3.a„ne,_«E�_ �' irR�„� � •'<.k :�q't �. _ 4 a �•�. 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Attn: Gary Souza PO BOX 310 Osterville,Ma. 02655 y RE: 378 Great Marsh Rd., Centerville Map: 190 Parcel: 099 Dear Mr. Souza: This letter is in response to application number 201200388 submitted to install a front porch at the above referenced address. Unfortunately,the application can not be approved at this time because of missing construction documents. Specifically,a certified plot plan is needed to show compliance with zoning requirements (a mortgage survey is not sufficient in this case). Please do not hesitate to contact this office with any questions. Respectfully, L. Lauzon Local Inspector (508) 862-4034 o N 10.0 n 20.0 Qn �o r Lot 9 Leach j Lot 10� -- 10.0' p ° 41.1 i y _ ; 1 0 ` Total Area _ 0 11 ^ h 21,874t S.F. Shang i O 0 ; 0.50f AC. Dec i Setb Exist. Dwq. ack #378 Cl) r r 001, r .66' 29.2'- _t N 8018 O5„ 20.0' c B/DH/FND. ROAD Proposed d addition to include deck replacement with roof. STREET ADDRESS: #378 GREAT MARSH ROAD ASSESSORS MAP 190 PARCEL 99 OWNER: EDWARD B. SOUZA AND JUDITH E. SOUZA DEED REF.: BK. 10869 PG. 291 CURRENT TOWN OF BARNSTABLE ZONING PLAN REF.:PL. BK. 177 PG 49 LOTS 9 & 10 BY—LAW ZONE : RC (PRE—EXISTING, NON—CONFORMING) SETBACKS FRONT = 20 I CERTIFY THAT TO THE BEST OF MY PROFESSIONAL SIDE = 10' KNOWLEDGE, INFORMATION AND BELIEF THE DWELLING REAR = 10' SHOWN HEREON CONFORMED TO THE HORIZONTAL SETBACKS OF THE ZONING BY—LAW FOR 7HE TOWN OF BARNSTABLE AT 7HE 77ME OF CONSTRUCTION PROPERTY LINES SHOWN HEREON WERE COMPILED FROM AVAILABLE ��a�1N0FMA$Sgcy PLANS OF RECORD AND VERIFIED ��� TERRY Gs�' ON THE GROUND. 8 ANN N WARNER - - THE DWELLING DEPICTED ON THIS SHOWING SHOWING PROPOSED ADDITION PLAN WAS LOCATED ON THE GROUND IN BY SURVEY ON FEB. 21, 2012 AND BARNSTABLE, MASS EXISTS AS SHOWN AS OF THE DATE ��/2 OF LOCATION. SCALE. 1"=40' FEB. 23, 2012 THIS PLAN IS FOR PLOT PLAN TERRY A. WARNER, P.L.S. PURPOSES ONLY. 22 LONG ROAD HARWICH, MA. 02645 (508) 432-8309 THIS PLAN IS VOID lF NOT STAMPED AND SIGNED IN RED. 0 20 40 80 PROJECT NO. 12-111 z RO GERS&MARNEY,INC. , BUILDERS February 29, 2012 Mr. Jeffrey L. Lauzon Town of Barnstable Building Division , 200 Main Street Hyannis, MA 02601 Re: 378 Great Marsh Road, Centerville - Map: 190 Parcel: 099 Dear Mr. Lauzon, Attached please find a certified plot plan of the above referenced property. These documents are submitted to complete our building permit application 201200388. The plan shows that the new deck and porch roof will be positioned 10.1 feet away from the right (easterly) lot line and 29.2 feet.away from the front (southerly) lot line in compliance with the required building setbacks in that area of the Town of Barnstable. Thank you for your time. Sincerel , f Gary Jo za (r ` �r Building Quality Honies Since 1968 • rogersandmarneybuilders.corn post Office l ox 310, Ostewillc, MA 02655 • tel 508.428.6106 • fax 508 420.3550 • email glsCrogersCniarneybuildcis.crnii �IME, Town of Barnstable *Permit# 6Z) a Expires 6 months from issue date Regulatory Services Fee satwsrABLK Thomas F.Geiler,Director MASS. ' Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number �® Q Property Address R esidential Value of Vv%rk 2-000 CP Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 3-7 F &rC e-A-f A vc--S C t ry C" rw� 1 M P( Contractor's Name Telephone Number oy Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor -PRESS �T Q'I am the Homeowner. ❑ I have Worker's Compensation Insurance OCT 2 4 2007 Insurance Company Name TOWN DF13ARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) RRe-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission,' A copy of th otrte Improvement Contractors License is required. � " ":- "' .• SIGNATURE: Q:Forms:buildingpermits/express Revise091307 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invesdgations 600 Washington Street Boston,MA 021117 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): -A 50 0 Address:. s" &.s L, — City/State/Zip: ^► Are you an employer?Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New.construction employees(full and/or part-time). , 2.❑ I am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for rile in any capacity. employees and have workers' [No workers'comp. insurance comp. insurance.$ 9. ❑Building addition jxquired.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp: right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no 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: - e5raxwr l"\fiIt City/State/Zip;CEAI1%.4v 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 under the airs andpenalties ofpedury that the information provided abo//��e is true and correct. Si ature: _ Date: V 7 Phone#:-SO f 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#: �oF1Ht Tom. Town of Barnstable Regulatory Services awxxsr�sre Thomas F.Geiler, Director hum 039. p Building Division lFD Mp'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 509-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE: JOB LOCATION: 37R ►9&SA ►'LS/ Q 1" I/j QZ 3� number street village "HOMEOWNER": (-'Sts(J, name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and. to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned`.`homeowner"certifies that he/she understands the Town of Barnstable. .Building Department. minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 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 Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Engineering Dept. (3r�floor) Ma _ c P . P Parcel 9 J Permit#__ 0 & 5 L House# ' FR)J Date Issued -1to- gvl �'" y- C Board of Health(3r floor)-(8:15 -9:30/1:00-4:30).9 7-,�lf ��,�,f2-p �J Fee ill ,570 Conservation Office.(4th floor)(8:30;- 9:30/1:00-2.00) Planning Dept.(1st floor/School Admin. Bldg.) - or'"E Definitive Plan Approved by Planning Board 19 ' SEPTIC Sif DE INSTALLED 1 , ANCE TOWN OF BARNSTABLE � Building Permit A plication ENVIRONMENTAL CODE AND T®WN REGULATIONS Project Street Address 2 7 Village Owner . SuJ '50 rc Z� Address 6�Y�A,�Qj,!r— 0,37YX f, Telephone 5-0 _f 3S- !7 Permit Request Ovd 42 x &_ e /vT6 a_� W 7'A First Floor square feet Second Floor square feet Construction Type /,(/o Estimated Project Cost $ /S o® Zoning District Flood Plain Water Protection Lot Size V Grandfathered 5Yes ❑No Dwelling Type: Single Family UK Two Family ❑ Multi-Family(#units) Age of Existing Structure 3,3 45 • Historic House ❑Yes 5al�o On Old King's Highway ❑Yes R o Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Ic� � Number of Baths: Full: Existing_�2, New Half: Existing New No.of Bedrooms: Existing_/' New Total Room Count(not including baths): Existing New �_First Floor Room Count Heat Type and Fuel: 210as ❑Oil ❑Electric ❑Other Central Air ❑Yes Of4o Fireplaces: Existing New Existing wood/coal stove ❑Yes &(No Ii Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) !P pit'A ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes fr10 If yes,site plan review# - Current Use �&s/ de m-rl a_1 Proposed Use i d e vatu Builder Information Names Telephone Number Address License# 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 V�f Q� caxz i e SIGNATURE DATE BUILDING PERMIT DENIED FOR THE F LOWING REASON(S) �1 iL FOR OFFICIAL USE ONLY - PERMIT NO. DATE ISSUED �MAP/PARCEL NO. ADDRESS J VILLAGE ! , OWNER , DATE OF INSPECTION:, } FOUNDATION,_ r • _ , i - FRAME 100 2� to 0 A-2 INSULATION l[��7 /9 Y7- GP C(�--✓1 a/�/ t • - FIREPLACE - ELECTRICAL: ROUGH,- FINAL PLUMBING: ROUG FINAL f - < GAS: R04-i9 _�a FINAL . FINAL BUILDINGa DATE CLOSED OUT in `tom ASSOCIATION PLAN NO. , �1�t'C2 Sl �E eG 1 F' C � t lid S� IL vU�4LL i ' : • 9PffW6dr PL66R Sum T(�tcl� T .�r�lL�ln�G The" own of Barnstable CA?jnss _s.��,a ,� • � - t f r _ J it c 30 7, , .�'E:�tw► / >C77 k�W - 141� ' Ap lt �z /X I� Oe- E f 8 2 J J _ 202.36. LOT 9 . ! LOT. 10 W Z 21 920 + J 00 S• F rIJUcR7 1NT3 S Cs Z W FrtM zM. NO. 378 u�, p W Z8?�c�-r. F~a- �3 W W � ! �� 3�, '7 Z 0 0 '>j 172.66 GREAT MARSH ROAD • NOTE: DWELLING IS "GRAN DFATHERED" WITH RESPECT TO ZONING BUT BUILDING SET—BACKS AND LOT DIMENSIONS MAY NOT MEET CURRRENT ZONING REOUIREMENTS. MORTGAGE LOAN INSPECTION ::MI`i944 SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN. 50 FT. tiOFA, P.O. BOX 28. DATE- DULY 21 , SAGAMORE BEACH, MA. 02562 ,pto T140MAS s 508 888 8667 � FONT RIAND CERTIFY TO ` C. �u No.34314 THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS t q9 TO THE ZONING OF THE TOWN OF BARNSTABLE (CENTERVILLE) opFss*oNP I CERTIFY THAT LOCUS DOES NOT _ LIE WITHIN THE FLOOD HAZARD 9b0sunt/Er°� ZONE AS DELINIATED ON MAP 0015C COMMUNITY N0. 250001 ova LAN REFERENCE.: BARNSTAB E EGIS Y bF DEEDS GI OWNER: BOOK/PAGE: PLAN BOOK 177, PAGE 049 LOT NO.: 9 AND LOT 1.0 PLAN BY: DAVID. H. GREENE BUYER: DATED: MAY 1963 THIS INSPECTIONT MAUL FROM AN INSTRUMENTAND IS NOT TO BL UZ)LU FOR FENCES, HEDGES OR TO ESTABLISH LOT LINES. FOR USE OF BANK :ONLY. r THE�O The Town of Barnstable NAM �e� Department of Health Safety and Environmental Services 'biro " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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 requiremen . axi /o Xi6 'Type of Work: �• Est.Cost Address of Work: 1AZIO ld/l f - .[1/ d Owner's Name ZDate of Permit Application: — 92 1 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 IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner' ame - The Contntornrealth of Alassachusetty Dcparttncnt ofltttlustrialAccidcnts 011iceollnvestigatlons :; >' Boston. Ya.Y.v. 02111 Workers' Compensation Insurance Affidavit name* J Uoal ir� o 5D LCZ,a_- --T - c•tv ceu7' 1/'/1, Ile, ho •#4 1 am a homeowner performing all work myself. ell I am an employer providing workers' compensation for my employees working on this job. cnm mow name: address• � - cih: phone#- insurance co. nnlir•# 1 am a sole proprietor, general contractor, or homeowner(circle arc) and have hired the contractors listed below who have the followin` workers' compensation polices: comanny name: address: " city: phone#• insurance co. noliev# cnmtinny name: address: cin•: phnne#- insurance co rolicy# Attach additional sheet if necessary..•=• -_ ���•�='s •,+•'•�• ;L.;;�y __ __ •%r• ''' ^'''_^-' '�- �"' '—^- Failure to secure cnwerare as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur une wears'imprisonment a.well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a cop} of this statement mad be forwarded to the Olrice of Investigations of the DIA for coverage verification. I do herehv certifi•to er the pains and penaUics of perjury that the information provided above is true and orrect. S i anature —J Date Print name Phone# oRci. use onh do not[write in this area to be completed br city or town official city or town: permit/license# riBuiiding Department E3Liccnsing hoard 1]check if immediate response is required [3Seleetmen's Office : (jlleaith Department contact person: phone#: MOther S. f irn sea 3.6;NA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law". an etnploree is defined as every person in the service of another;tinder any contract of hire, express or implied. oral or written. An enrplt rcr is defined as an individual. partnership, association, corporation or other legal entity. or any two or more 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 d\+!cllin�, house of another who employs persons to do maintenance , construction or repair work on such dwelling hou: or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 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 and• applicant who has not produced acceptable evidence of compliance with the in coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into anv contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter liz been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying_ company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required to obtain a workers' compensation policy. please call the Department at the number listed below. City or,towns 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. Plea: ,be sure to fill in the permit/license number which will be used as a reference number. 77te affidavits may be returned t: the Department by mail or FAX unless other arranizements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any question! please do not hesitate to give us a call. �r..y..r�l'!-.• ...._.�N:.w. .•��,.FWrT.f.._ 'S77 _Tr The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE . 0 /f Q` 7 JOB. LOCATION_ e3 7 � (� �QPGc•� lL s (� //�o . Number Street address Section of town "HOMEOWNER" 6 0E-Ye?,F,0 35-7 Name Home Home phone Work phone - PRESENT MAILING ADDRESS 2,66� City town State Zip code The current exemption for "homeowners" was extended to include owner-occupies dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, 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 Offici on a form acceptable to the Building Official, that he/she shall be resnonsit for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the St Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowne3" certifies that he/she under stands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 01 Construction Control. 1 HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Ownez shall act as supervisor. " Many Home Owners who use' this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarene� often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our. Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home " wner� actir as supervisor is ultimat"' *asponsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. EXISTING EXISTING BASEMENT HOUSE P.T.2 x 10 LEDGER BOARD LAG BOLTED TO w SOLID BLOCKING W/(2)LEDGERLOK BOLTS 16"o.c.W/JOISTS HANGERS 2 x 8 RAFTERS Q 15'o.c. EXIST. N NEW COVERED PORCHin P.T.2 x 8's @ 16"O.C.o.c. in � to in (1 x 4 MAHOGANY) b, AZEK OR TIMBERTECH RAILINGS 2-P.T.2 x 10's N A P.T.4 x 4 POSTS W/ FASTEN JOISTS Arb P1 AZEK CASING SI BEAM W/MPSON H8 TIES P1 NEW 12"DIA.CONC.SONOTUBE S to low 5,-6„ ON 24"DIA. BIGFOOT FOOTING M TO 4'0"BELOW GRADE,USE l "�.'� 1p" SIMPSON ABU 44 POST BASE91 00, 2-1 3/4"x 9 1/2"LVL BEAM 4�t FASTEN RAFTERS A FASTEN POSTS TO BEAM TO BEAM W/SIMPSON P1 W/SIMPSON AC4/ACE4 H10-2 TIES low sow POST CAPS FIRST FLOOR PLAN FRAMING/FOOTING PLAN loft10 NOTE: INSTALL SIMPSON DTT2Z 401 THIS PORCH REPLACES AN DECK TENSION TIES Wl 1/2'THREADEDOD(2) EXISTING DECK WHICH IS PLACES EVENLYSPACED I _ THE SAME FOOTPRINT AS APART ON THE NEW DECK I ROOF FRAMING PLAN SHOWN ON THIS PLAN i INSTALL FLASHING UNDER 1 HOUSEWRAP&DECKING t 1 DECKING EXISTING HOUSE FLOOR JOISTS 12 P.T.2 x 10 LEDGER BOARD LAG BOLTED TO P.T.2 x Vs cQ 16"o.c. EXIST. SOLID BLOCKING W/(2)LEDGERLOK BOLTS 2 x 8 RAFTERS @ 16'o.c..USE `16"o.c. STAGGERED W/JOISTS HANGERS SEE IRC2009 SECT.502.2.2. INSTALL PEEL&STICK SIMPSON H10-2 TIES TO RUBBER MEMBRANE FASTEN RAFTERS TO BEAM BETWEEN LEDGER& SHEATHING 12 �4 AZEK FASCIA&SOFFIT BOARDS TO MATCH EXISTING DECK DETAIL 12 EXIST.� P.T.2 x 6's @ 2-1 3/4"x 9 1/2"LVL BEAM AZEK BEAD- NEW ASPHALT ROOF I P.T.4 x 4 POSTS BOARD W/AZEK CASING SHINGLES TO MATCH -+-- NEW FASTEN TO BEAM W/ II I I EXISTING NEW AZEK RAKE 4 EXISTING I I SIMPSON AC4/ACE4 BOARDS TO COVE RE I I POST CAPS NEW AZEK FASCIA MATCH EXISTING HOUSE I I TO MATCH EXISTING PORCH FASTEN JOISTS TO BEAM W/GUTTER&LEADER NEW SIDING TO W/SIMPSON H8 TIES MATCH EXISTING 1 x 4 MAHOGANY DECKING FASTEN POST TO BEAM Ind W/SIMPSON BC4 POST CAP/BASE P.T. x 8'6(cl�16"O.C. AZEK 1 x 8 FASCIA NEW P.T.4 x 4 2-P.T.2 x 10's W/ POSTS W/AZEK P.T.4 x 4 POST UNDERNEATH CASING AZEK 1 x 4 VERTICAL BOARDS R EXISTING NEW 12"DIA.CONC.SONOTUBE BASEMENT ON 24"DIA. BIGFOOT FOOTING TO 4'0" BELOW GRADE,USE SIMPSON ABU 44 POST BASE P.T.2 x 10 LEDGER BOARD LAG BOLTED TO SOLID BLOCKING W/(2)LEDGERLOK BOLTS EQUAL EQUAL NEW AZEK OR TIMBERTECH L NEW AZEK 1 x 4 VERTICAL 16'o.c.W/JOISTS HANGERS RAILINGS&POSTS BOARDS,VERIFY SPACING FRONT ELEVATION. SIDE ELEVATION . A BUILDING SECTION @ PORCH THE OROMIS OMISSIONS EFOUND O DESIGNER ERRORS SCALE : DRAWING NO. : THESE C OT U I T BAY DESIGN L LC NEW ADDITION FOR : CONSTRUCTION.THE BUILDING CONTRACTOR 11 1 11 DRAWINGS PRIOR TO START OF 43 B R WSTE R ROAD WILL BE RESPONSIBLE FOR THE CONTENT 1/4 1 1 -O (� 1N THESE DRAWINGS IF CONSTRUCTION MAS H P E E ,MA. 02649 SOUZA RESIDENCE COMMENCES WITHOUT NOTIFYING THE DESIGNER OF ANY ERRORS OR OMISSIONS. DATE P H. (5b 8 274-11 V[�(�V THESE DRAWINGS ARE SOLELY FOR THE USE OF THE OWNER NOTED.ANY OTHER USE OF THESE DRAWINGS REQUIRES THE WRITTEN 1/5/2012 p 1 - FAX (50 ) 5 39-9402 378 GREAT MARSH ROAD CENTERVILLE , MA AR TECTOF UR L,C DESIGNER OPYRIGHT PROTECTION ARCHITECTURAL COPYRIGHT PROTECTION