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HomeMy WebLinkAbout0098 KATHERINE ROAD�I I' i P10. 1521/3 BGR O a 0 0 0 Town of Barnstable Building . ,;.2.. ♦ ,. b �.-','S :. '* hj . H �to J` ,.A-s K C,, l n � e `�"��„ Post This Cartl So That rt�s;Uisible From the.Stceet; A, ;roved PlansMust tleRetained ort Jo,b,andthis Card Must.be Kept s63Q d Posted Until Final Inspection Has Been,., ade t £ v . �, �.� r T: .� ,, .� E � .� � � �z a. . . .: . fi Permit 1Nhere.a Certificate„af Oceu anc.'"is Re uiretl such,FBuldm shalLNoi be Occp red until aFrnal In`s ect�onhas been made ,. aAe.F .-« -„�` �. �"::i, _..:.-za. �'."�,-d...>� .p,.<e€ ^;..,�.�.'�., ,�:,5�,. :' ', «. t:;u 2.' �,. i a.,,�i.•,.p' .i�s`?,'.r„ . � .�¢,.p;,�:.:.. .:u ,,•` i. � .x.,_�:. .,,,.. Permit No. B-18-1238 Applicant Name: ROLAND LANGEVIN Approvals Date Issued: 05/18/2018 Current Use: Structure Permit Type: Building-Insulation-Residential. Expiration Date: 11/18/2018 Foundation: Location: 98 KATHERINE ROAD,CENTERVILLE Map/Lot: 228 053 Zoning District:' RC Sheathing: Owner on Record: CATON,CHRISTOPHER 4 Contractors Name INSULATE 2 SAVE, INC. Framing: 1 t"T Cont actor License, 180747 . Address: 98 KATHERINE ROAD 2 .. . CENTERVILLE, MA 02632 ;Est Project Cost: $3,872.00 Chimney: Description: Attic:8" open cellulose,attic hatch,seal and ,ulate sheathing Permit Fee: $85.00 Insulation: access,vent.chutes, insulated exhaust hose,air seating,weather . y Fee Paid- $85.00 strip door and sweep common wall 2" rigid bga'rd,��, Date 5/18/2018 Final: Project Review Req: � - Plumbing/Gas Ruh Plumbing:Rough AN Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work author i d bythis permit is commenced within s�xgmonths aftrissuance. Rough Gas: All work authorized by this permit shall conform to the approved applCaUoffland the approved construction documents forwliich this permit has been granted. ^.All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning=by laws`and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained open for publi ion for the entire duration of the work until the completion of the same. a Electrical '' \ a The Certificate of Occupancy will not be issued until all applicable signature's by the Bu,ldi g and Fire Officials are p o�,ded on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: u Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT SUILDINGDEP . . . y° Application Number. WByAPR 2 4 2018 ................... TOWN OF BARNS!ABLE Permit Fee....................... ...Other Fee.... ate Total Fee Paid � ..... .. .... ..... ...... TOWN OF BARNSTABLE Permit royal b ...On.. BUILDING PERMIT APPLICATION iaap. ..Parcel........... . Section I —Owners Information and Project Location Project Addressa6�L eH>it e-IeV e�&yeA vl Cl 7�M ��� 3 Village vil.�i� Owners.NameiG r ,�ol�� l:aov� Owners Legal Address_eZf/��P City_ a"lye- State. Zip . t9a-,43 g? Owners'Cell# j'-2 7 E-mail el'-'G�s�o n ,e'�44 Section 2-StrucWral Use (Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic fit E Commercial Structure under 35,000 cubic feet Section 3—Type of PerziE%it New Construction ❑ Move/Relocate ❑ Accessory Structure. ❑ Charge. use Demo/(entire,structure) ❑ Finish Basement ❑ Pool ❑ Fire Alarm Rebuild ❑ Deck , ❑ Solar Sprkler System Addition ❑ Retaining wall D--"&sula�ion Renovation Other.-Specify Section 4—Detail Cost of:Proposed Construction Square Footage of Project Age.of Structure Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 11.0-MH,Wind:Zoae_Compliance Method .❑ MA.Checklist ❑ TNFCM Cheekl�st ❑ Design Last updated WV.20I7:. Section 5 Wo rk Dam ion « e-"Clts- �i�r Glr4z("o`,� cl�GrSi ��o� F Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage i ❑ Smoke Detectors ❑ Plumbing ( Gas ❑ Fire Suppression ❑. Heating System ❑ Masonry Chimney ❑Add/relocate bedroom. Water Supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic.District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility:�i/, �ed elk s.'/�Fa��1�i�f using a crane ❑ Yes. ❑ No Section 7—Flood Zon Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes_'❑ No ❑ I Section 8—Zoning Infor tion Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed'. Side Yard Required Proposed Has ihisl property had relief from the Zoning.Board in the past? Yes ❑ No Last updated: 10/31/2017 I Section 9—Construction Su or. Name lain L� -e-0 .n Telephone.Numbe` 6'0 Address ! 6 wd v e f s, City S 2YdL Zip Ua72-0 License Number /e- License Type E iration Date . ���,�1�9 Contractors Email Qu,u Naha a-s QaP��t ell',# --50 a ip, -' I understand my,responsibilities under the rules and regulations for Licensed Co Wftetion Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction insl ecti6fi procedures,specific inspectieas aad documentation require#by 780 CMR and the Town of.Barnstable.Attach a cop,of your license. Signature Date ���1� Section 10—Home Improvemeal,Contractor Naive �D/�.Lc..o�L Qzjr sz.-e Telephone N. er . J"0 '-6'7a Address 4Ga City Stal Zip ig Registration Numberej!e!-�"7 4e'7 Expiration Date I-understand my responsibilities under the rules and regulations for Home Impro vement Contractors.in accordance with:780 CMR the Massachusetts State Building Code. I understand the construction'insl ection procedures,:spec�ifc r spearons Zhd. documentation required by 780 CMR and the Town of Barnstable.Attach a cop of your H.LC... Signature Date -L�M Section 11 —Home.Owners Licens D Xx0kpti6 Home Owners Name: �!2 of 111w e-,,- a /t- Telephone Number 4L91. e Cell or Work N r I understand my responsibilities under the rules and regulations,for Licensed ction Supervisor.in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction i 'on procedures,specific.ins and . documentation required by 780 CMR and the Town of Barnstable. Signature e e er Date APPLICANT SIGN,U -Signature Date Print Marne , la'Ld 2 !21� e-,e�_"�w Telephc ne Number 5�6..�-� 7 E email permit to:. �.`ro 4 4a ll 1' l�� 5-q'ae� Last uapdated :I0/3Il0I7 a@CtlOII a— ( p l enit -OAS Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site PI Review(if required) ❑ Fire Department ❑ Conservation ❑ For.commercial work,please take o plans Y r P directly to the fire 6 epartmentfor approvak Secti n 13—Owner's Autho ' tion o as Owner o the subject t property hereby authorize _ G / to act on my behalf,in all matters relative to work authorized by this building pe application for: (Address of job) Signature of Owner date �r ,yen Print Name Last updated: 10/31/2017 f DocuSign Envelope I0:81313683-7544-4791-gl41-B5964COQ450A RISE En&eering RI5 DupoM Ave,South Yarmouth.MA0266tENGINEERING CONTRACT 508- 8-1926 FAX 508-569.1933 ftge 1 PROGRAM nAS CONTWT IS ENVEM afro BETVAPANSE CLC4 iES B=WEE3WGAWT1ffiCUST0NERf=W0MA3 . DESCRBEDSELON - - CUSTOMER PHONE _..��._.__.._.._DATE mm _ Clam# w(molum CHRISTOPHER D CATON (774)487-4910 0410412018 245804 03402 SEAME ST EET __- --_— 81U.M STREET 98 Katherine Road 98 Katherine Road UMMM CITY,STASH,as WU-q=CaY,STATE,ZP Centerville, MA 02632 Centerville, MA 02632 DESCRIPTION -------- QTY COST INCENTIVE TOTAL. ATTIC FLAT-8"OPEN R 34 CELLULOSE 1,200 $1,728.00 $1,296.00 $432.00 Provide labor and.materials to install an a"layer of R-30 Class I Cellulose to open attic space. ATTIC HATCH:SEAL&INSULATE 1 $60.00 $445:00 $1500 Provide labor and materials to insulate the back of an attic hatch.with 2"rigid insulation board.Weatherstrip the perimew. SHEATHING ACCESS 1 $35:00 $26:25 $836 Provide labor and materials to make an access opening from one at6carea to another by cutting a passage through sheathing. This access will be left open as it is between two common unheated non firewalled attic areas. VENTILATION CHUTES 94 $328:06 $246.05 $82.01 Provide labor and materials to install ventilation chutes in the rafter bays to maintain air flow. INSULATED BATIK EXHAUST HOSE 2 $120:00 :17$90 00 $3000 Provide labor and materials to install an insulated exhaust hose to e)asting bathroom fan(s). AIR SEALING 8 $640'00 $640 00 0a00 Provide labor and materials to seal areas of your home against wasteful,excess air leakage.Materials to be used to seal your home can include caulks,foams and other products. Primary areas for sealing include air leakage to.attics,basements,attached garages and other unheated areas(windows are not generally addressed.) A reduction in cubic feet per minute(cfm)of air infiltration will occur,but the actual number of cfm is not guaranteed. At the completion of the weathedzation work,and at no additional cost to the homeowner,a final blower door andlor combustion safety analysis will be conducted by the sub-contractor. WEATHERSTRIP DOOR&ADD SWEEP 2 $160.66 $160.00 $U 00 .. Provide labor and materials to install 04on weathersbipping and a doorsweep to door(s)to restrict air leakage. COMMrJN.WALL:2"RIGID BOARD 208 $800:80 ' '$6PUO. $200 20: Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to a common wall area. I - DocuSign Envelope ID:813136B3-7544-4791-B141-B5964C0D450A g RISE Engineering RS5 Dupont Ave,South Yarmouth,�►02�INEEMW CONTRACT 508.568-IM FAX 509569-1933 . Page 2 PROGRAM TIASCONTRAST Is ENTEleg WIZ BErvaZURISE CLC-HES DONWOM AW TW CUSTOMER FORVIM AS I)E.SCREIMSE104 - emotdFR____ ...._._._._....... .._._.._..... _.__.____. .._..._�.,.___.._...._._.. �......_.._...._..._._.__._. DATE CLIENTA WORKOROER PRONE CHRISTOPHER D CATON (774)487-4910 04/0412018 245804 03402 SERWCE STREET MLLMG STREET 98.Katherine Road 98 Katherine Road 36"M C",STATE,DP -.._._._.....__ __._... ........... BILLING CITY,STATE,ZIP _..-..... Centerville, MA 02632 Centerville, MA 02632 DESCRIPTION OTY COST INCENTIVE TOTAL YOUR INCENTIVE EXPLAINED For eligible measures,the Cape light Compact is offering an i ....... incentive of 75%,with no limit,and an incentive of 100%for the Air Sealing measures. Total: $3;871:65. Program Incentive: $31039.0 Customer.Total: $.76T.96 WE AGREE HEREBY To FURNISH SERVICES-COMPLETE IN ACCORDANCE WPrH ABOVE SAECIFiCATEONs.FOR THE WU OF ***Seven Hundred Sixty-Seven&961100 Dollars $767.96 - UPOM FBlAL INWECT M AND AP➢RmAL BY RFSE EMNEEFA*r.CIiSTONER AGREES To RE W A=Uffr DUE IN FULL INTEREST OF 1%VELL BE CHARGED MONTNLY ON AMY tWAM U ANCE AFTER S6 DAYS.SEE REVERSE FOR■IPOWANT INFORMATION ON GUARA nWS,W MITS OF RECISON,SOMM LINO.AND CONTOZMRR£GISTTRATIML b Dacu$igteoa ey; 4/412018 1 11:53 AM EDT ROM TIVS CONTRACT MAY BE WTHDRAWR BY US W NOT ffiOUTED WWMN DATEOF ACWTANCE .....__....._.............................._........_........._._.......:....._.._..............................__....___.............___.._............. SIGN DATE ...,30 ACCEPFANCE OF COM`RACr•T}M mm mm,BPEQRCATwo Am cc*IIim ME - SATNFACTORYTOUS-ANDARENE:REBYACCH!T .YOltfil ittJtt @TD::OOji .WORK .. AS MWXW H9.PAY'i W VM.I-IWNAOE:AS.OUn.IEDABM; .:.:'. .. i DocAgn Envelope 10-81313683-7544-4791-Bl44-B5964COD460A Town of Barnstable Regulatory Services Richard V.Scali,.Director Building Division Paul Roma Building Commissioner 200 Main Street,Hyannis,ARIA 02601 www.town.barnstable,ma.us Office:508-8624038 Fax: 5W794-6230 Property Owner Must Complete and Sign This Section I, CHRISTOPHER D CATON , as Owner of the subject property hereby authorize � _ to act on my behalf, s4, 5� �� 2�.er in all matters relative to work authorized by this building permit application-for: 98 Katherine Road Centerville, MA 02632 ----------------------------- (Address of Job) ('Oocu&igno4,by., 4/4/201.8 I 11:S3 AM EDT V-owner Date Christopher Caton Print Name If Property owner is applying for,permit,please complete the Homeowners License Exemption Form. C:;Use.mk4ecollik',AppDataEma[lMicroso#t1Windows\lNetCachetContentOuttool&L7U69LF21EXPRESS{2}:doc, OI/25117 f The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass:gov1dia Workers'Compensation Insurance Affid'avit;Builittrs/Contra►ctoislElectricianslPlumbers. 'LED WITH TTHE:P.ERMITTING AUTHORITY.TO BE F Applicant Information Please Print legibly Name(Business/Organization/Individual): Insulate2Saye Inc. Address:410 Grove Street City/State/Zip: Fall River MA 02720 Phone#:508-567-6706 Are you an employer?Check the appropriate box: Type of project(required): l.G I am a employer with 20 employees(full andior part-time)' New construction 2.Q T am a sole proprietor or partnership and have no employees workaig far me in e, ®Remodeling any capacity.[No workers'comp.insurance required.j 3. I am a homeowner doing all work myself.[No workers'comp.insurance required.]i 9. El Demolition 10 Q Building addition 4.[]l am a homeowner and will be hiring contractors to conduct all work on my property. t will ensure that all contractors either have workers'compensation'insurance or are sole I LE)Electrical repairs or additions proprietors with no employees. 11 Plumbing repairs or additions 5,0 1 am a general contractor and 1 have hired the sub-contractors listed oinhe attached sheet. These sub-contractors have employees and have workers'comp,insurance? .�RoOf repairs 6.Q We arc a corporation and its officers have exercised their right.of exemption per Mol:,C. 14.[]x Other Insulation 152;§l(4),and we have no employees.[No workers'comp.insurance required:] 'Any applicant that chccks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners submit'this affidavit indicating they are doing all wort;and then hire outside:contractors must submit.s,new aff'idavitindicating:such. *Contractors that check this box must attached an additional sheet showing the name of tha sub-contractors andstate whether or not those..entitica have employees. if the sub-contractors have employees,they must provide their workers'comg,:policy number. 7 am an employer that is providing workers'compensation insurance for.my employees. Below is the policy and job site information. Insurance Company Name. Liberty Mutual Insurance Policy or Self-ins.Lie.#: XWS 56418741 Exparatio..n Date.. 12/10/2018 Jilt .Site Address; , !;q e Q City/State/Zi . Gt, �UG LCt� .�Y119 a l0 3 A Attach a.copy'of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 1:52,§25A is a criminal violation punishable by a fine up to S1,500.00 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,A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, do hereby certify under the s an a ties of perjur7v that the information provided above.is true and correct. G r ..Signature: Date: ld Phone#: 508-567-6706 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):: I..Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. S.Piurnbing.linspector 6.Other Contact-Person: Phone#: r Office of Consumer Affairs and Business Regulafion 10 Park Plaza-Suite 5170 Boston, hllawig ; usett§ 02116 Nome Imrovem � tractor Registration 177 Type: Corporation 80747 INSULATE 2 SAVE , INC. � ` � Registration:Expiation: ins/2018 410 Grove St Fallriver, MA 02720 � k Update Address and return card. Mark reason for change: 30A 1 to 20M-W11 0 Etntaipyin # L7 Lost Card Office of Consumer Affairs&Business Regulation ` HOME.IMPROVEMENT CONTRACTOR Roistiration valid for Individuatuse only. .a - TYPE:Corpaation. before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 12i2672018 14 Park Plaza-Sulte 5170 „ ry Boston;MA 02116 a s- 'INSULATE 2 =: Roland Lan eV ,- 410 Grove Falldw,MA 027 � undersecretary Not valid without slanaturs "- Oomn"VMalt a of Massachusetts Division,of Professional Licenwe Board of SuilCftog fie ulatlons and Standards Cons r -� �„ rvtarsr . CS-103861 ° El 2n19 FROLAINOWi:J4 R � J . 56 Mown FALt.iWER.M° f " \s CC?Tr misSionLi r ' C DATE CERTIFICATE E OF LIABILITY INSURANCE as�o7n8 . THIS.CERTI,fICATE JS JI SUWAS A-MATTER OF INFORMAT(pN..pt Y A{Vd CODERS M RIGkITS ttPC)N THE.CJER FAA }1p >: CERTIFICATE DOES NOT AFFIRMATNELY OR:NEGATtVELY AMEND,EXTEN#3 t!R ALTER 771E COVEti�tGE AFfORaEt3tBY Tf POl1C1ES $FLOW THIS CERfFtCATE QF MiSURANC E DOES NOT CONSTITUTE ACON t RACT-BEN;.THE t REPRESENTATII/E OR PttODtICER,AND NE C£R3 MATfYf0f:11ER �S)'71tITHt3�D IMPORTANT the certificate=holder:is an ADDITIONAL:INSt1RED,the 1Eoris or iredorsed:; Pdkwiiesj must have ADDITIONAL NS1 D ff Sil13ROGATION iS WAA►ED,'slibject to the'terms and conditions of the'policy,cerfa�n pot c lctes may raquere an er�dotsemeirt. A statement.on thts eer6fiate does:not coriferr WS t0 the certificate holder in lieu of-such endoisement(s� PRODUCER NAME:.. ' AnthonY F.Cordeiro Insurance ''F1O''H 508-M-048T: Ne 5E►8-677-0409 171 Pie,ii,rt,Stteet W River,MA,02721 acDREss tdeFsoinsurancecan -" - AFFORDirIG COVE[iAGE . NAIC S INSURED wsttRERA: :Liberty Mutual MsuranCe_ INSURER 6 Insulate 2 Saye,Inc. tNsuRER c 410 Grove St._ fall Rorer,MA 02720 INSURER a: INSURER E: IN. R:F COVERAEa'ES ` CER17FlCATENUNIBER . REi!#StON��lt1[IABER' ,THESitS TO CE13TlFYxT!iAT THE POC ICtEB OFINSURfCNCE t}STED BELOU1l'FfiAVE'BEEN tSSUED TO'THE 'NMA INSUREDED AgOVEFf)a TFiE POIJCY PERIOD INDICATED NOTWITHSTANiSINGANY REC2UIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEPFT.WFTti RESPECT TO-WFCH:THIS CfRTiFtCATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES pESCRIBED HEREIN IS.8U6lECT EO AU THE TERhA$; IXCLIJSIONSAND CONDITIONS'OF SUCH POLICIES:LIMITS SHOW_N MAY HAVE BEEN REDUCED BY PAID CLAIMS. CTR TYPE OF.IN$URANCE ' 1 POLICY.NUMBER C0611II1EFLCUILG6J13i/N:(,fpB7Lfiy OMITS EACH OCCURREP(CE $ 1,6fi0,000. CCNMS AMDE �X OCCUR PREdIS $ II,flHQ 1 A Y Y SKS56418741 12f10117. 12110178 C ILAGGREGATEUMrrAPPLIESPER x'POUCY Ej PRO- LOCjECT GENETtiLL AGGREGATE $ 2;01 0� 'PRODUCTS--COMPIOPAGG $ r OTHER. •. -_. AtJTONOBII.E L,tABItIT'Y' S ANY AUTO BOCILYIN;it1RY(Per person) $ II' A >oWNED.. SCHEDULED AUTOS oruv X auros Y. Y BAA 56418741 12110117 12/10/18 BoDILv IN tuRY(Per acadenq $ HIRED 'AUTOS;ONLY AUTO ELOY PRo $ X;UMBRELLA LUI6 X OCCUR EACH OCCURRENCE $ p Excess Alu CLAIMS-MADE Y Y USO 56418741 12/10/17 12l10/18 aGGREGAfE WORKERS COIIPENSAT10Nr g ;'< !' . AlID;EMPPOYERS'LIAINLtTY YINATl1TE ANY PROPRIETORJPAFRTFERtE)(ECU7"IVE' A OFF7GEi2lMEMREXCLUDED? N!AAIS':56418741 EL:;EPigiACC�ENT $ S0Q;000 Ir Mici f2M0/17 ; 12/10t18 describe under EL"DfSEA3E.,EA EfuOY ON OF OPEItATrONS below . ,�° EL DISEASE POLICYL)kAT `S SEW'SQO 4EW.MP 10N OF OPERATIONS I LOCAMONS I VMCLE5(ACORD 10'I,Additnal Remaft Sahedut%maY be atftt,ed;tr more spaea.is required) CERTIFlCATE HOLDER CANCELLAfi1 SHOULD ANY OF THE ABOVE DESCRIBEp PO11dES BE_CANCELLED BEFORE EXPMMN DATE.THEREOF,'710EICEVIt1tLBEDi}13N Proof of Insurance POL[CY,PROIS ED AUTHORIZED RERRE$ 01 Z015 ACORN COitl?O}�ATION, All►lghts ACOR0125(NI16LQ3) .. The ACORD name and logo are n.glsteted marks of ACORD i f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Cr *�-. QF BARNSTABLE Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee � 11►{ Tri Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address /V 14 47W9_"1JV_ ®2 Village IL Owner G/*7/4 dl/9- Af Address 9 f Telephone Permit Request / & /O xl f< Square feet: 1 st floor: existing proposed 2nd floor: existing proposed _/'_,� otal new Zoning District Flood Plain Groundwater Overlay Project Valuation POO Construction Type Lot Size ` >f Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes 4No On Old King's Highway: ❑Yes 8Ao Basement Type: AfFull OtCrawl ❑Walkout ❑ Other 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 new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: 64es ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:64existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use -� �� Proposed Use :5r, APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 3,,w Telephone Number ag /3 '36 2,0 Address �S/-� ������ ����� License # "(k OV Home Improvement Contractor# li 1cx�J C CC)MCCASt� Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 'e SIGNATURE DATE r FOR OFFICIAL USE ONLY 4 APPLICATION# DATE ISSUED i MAP/PARCEL NO. ADDRESS VILLAGE '> OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION i' FIREPLACE t ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. d Dqpw*nmt Df Ikdm-fFWAcddm& Oice oflrrvesizgafians •600 W ashuzgton,Street Bosto74 HA 02,111 tvwtv_mnssgw/di¢ Workers' Couipensafion Insurance Affidavit:Btff ders/Contra -tordEIectricLuL%TImnbers Applicant Information Please Print:LeeffiIy Nmne(Busii a organization/l &ideal): Address: 1S3 / 0W,0e-.V- PA,ar .4aLs- ` City/ z4: Jv Mo. 4:791 Phone#: Aire you an employer?Check the appropriate box: Type of Project 4. I am a ]? I • I.❑ I am a employer with 0 Victor and I IP I0Y=(M and/or part tim -c�xacluts e). have hired the sub 6. El New consfraction 2. I mn a sole propHdor or pmt2m- listed on file attmhed sheet 7. Q Remodeling ship and have no employees* 'These sob-�tors have g. Q Demolition wad#g far me in my capacity, employees-and have workers' 9 [No work='camp.insurance camp.fimn- ce t Q Bmld>ag addition ' regIIire3l S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their l I.C1 PhmA ing repairs or additions Myself-[No wor,=,comp. riit of exemption per MGL irsm a aDo req��j fi c.152,§1(4),and we have no 1 13.0 Other f repaizs employees.[No workers' Q O Other gyp,ins rulaired-I *Any applicant that❑becks box#1 mmt also fo ont Sic section bclnw sho wing$cirwozbzrs'co�casation pnficy iniaffia$on. Hnmmwacss wbo sobarif tha affidavit indicafmg thry arc doing all wod�and thco biro o�idc comma must snbnrit a new affidavit indicating mclL $Cow that check 9sis box mast atachcd an additional shect showing fe name ofthe mb-cmd;T�and sin m vrhef cr or not the=ewes have empIoy=s.If the snl}co I f have maployaS,fmy amstpinvidc their wnrirca'camp.policy,aamb¢ I am an employer that is prgvidmg workers'corrTemadon huarance for mcy Employem Below is tF.e po&y and job site irzforn:rrBorL Inmzzac,Company Name: ' Policy#or Self-in.Lic.#: ti FiratiOn Dais: lob Site Address: Cry/Stater: _ Attach a copy of the workers' compensation policy declaration page(showiag the policy umnber and expiration date). Failure to seclae coverage as reqiired under Sutton 25A ofMGL c.152 can lead to the imposition of criminal penalties of a EE�e up to$1,500.00 and/or one-year impusonmeeuf;as well as civil penalties in the f=m of a STOP WORK-ORDER and a fine of np fn$250.00 a day against the violafar. Be advised that a COPY.of this siatzment may be forwarded to the Office of. Investigations of the DIA for insnzance coverage vacation. I do hereby certify the pains midPeizalfies afPerjiuY th&the irzforma ion.provided abope it true and correct S' Date: �I Phone# O07dal use only. Do not write in this area to be conTleted by city or town of 7dm[ Cify or Town: PermitlI�icease Isseaug AutTiority(circle one): 1.Board of Health 2.BuAdmgDePartment I City/Town Clerk 4.Mw ri6412spector 5.Plumbing Inspector 6.Other Contact Person'. Phone f 1 Information and Wtructions Mm¢a4m General Laws chapizs 152 r'egnaes all employers to provide wo&eas'compensation far the it employees Prasuaat to ibis siafn1a,an employee is defied as"_every person in the service of another under any wnftact ofhire, express or implied,and or " An ernplayer is defined as'an indivirhz pasta ship,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal reprmentatives of a deceased omployer,or the receiver or trustee of an individual,partncmhip,association or other legal entity,employing employees. However fie owner of a dwelling house having not more than tfu ee apartments and who resides therein,or the occupant of the dweIliag house of another who employs pmsons.to do maintenance,construction ' repair rwgzl-on such dweIhg house or on fie grounds or building appmfeuant f erein shall not bese of s ali employment be deemed to be an employes." MGL chapter 152,§25C(6)also states that"every state or`IQeaI licensing agency shall withhold the issuance or renewal of a license of permit to operate a business or to construct buildings in the commouWealth for any applicantwho has not produced.acceptable evidence of compliance with the my ce coverage require�L" Additionally,MGL chapter 152, §25C(7)states`Neither the commowealthnor any of its political subdivisions shall enirr into any contract fir the pace ofpnbHr work uatil acceptable evidonce of compliance with the insurance requirements of this chapter have been presented to tine contracting snthozify." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),addresses)and phone numbmr s)along with their ceatfficate(s)of insurance. Limited Liability Companies(LLG�or Limited liability Partnerships(LLP)with no employees other than the i members or partners,are notrmpi-r-d to carry workers' compensationmSUrEnce. If snLLC or LLP does have employees, a policy is required_ Be advised that this affidavitmay be submitted to the Department of Industrial Accidents for confirmation of i romance coverage. Also be sure to sign and date the affidavit The affidavit should be mt amed to the city or town that the application for the permit or license is being requested,not the Department of Indust ial Accidents. Should you have aay questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Deparlineut at the n�m.ber listed below. Self-insured companies should enter th5ir self-inm ranee license number onthe appropriate line. City or Town Officials Please be srse that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fal out in the event the Office of Iuvestigaiions has to contact you regarding the applicant Please be sore to fill in the pmmiillicense number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/licemse applications many given Year,need only submit one affidavit indicating current policy mfomnation Cif necessary)and un den slob 5ibe Address"the applicant should write"all locations i a (city or town)_"A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant:as proof that avalid affidavit ism file for fuzee permits or fioenses. Anew affidavit mnd be filled out each year.Where a home owner or citizen is obtaining a Iiceuse or p=#no'trelaisd to arty business or commercial venture (i e. a dog license or pemait to bum leaves ef:c)said person is NOT required to'complete this affidavit. The Office of 1•nVWtig3ti0us would hIM to thank you in advance for your cooperation and should you have any questions, please do not hmitate to give us a call. ' The Department's address,telephone and faximnabea: The-ammonia&of Departnont of In&utdal Ac cUdmts ,,..,�• - �ic�a�I�ave�ti�tia� I GW washinn stleltt . sow.,YA Ol I `eel.#617 727-44940�xt 406 or 1-V7-IA_,Q5.AFE Revised 4-24-DZ Fix##617-` 27;7.749. A FVC Guide to Wood Cansfrrictiorr irr FlVt )end Areas:110 frZplr Wrrrd zone Massachusetts Checklist for Comp4iance (7so ch-rR 530 1.1)' . ✓�check . cbUTIlanca 1-1 SCOPE. Wind Speed{3-see gustJ�____...._`..___.--------.._.�_-----.-----_---- ----_..�;--•--------:.11 D mph Wind Exposure Category__- ------__—.-----__.__�_._.......-__ _...----.--_----_-.---.:__:_.---•-••-- __B Wind Exposure Category.._.............Engineering Required For Entire Project..........:.............. ...........0 12 APPUCABiLIZY ` -Number of Sbries(a roof which exceeds B in 12 slope shah be cansidered a story) stories 5 2 stories 2) Mean Roof Height __ _.-----.-------:-._._.__-_--=---(Rg2).------------ _ft _<'33' Building Width,W_---..._.____.._..---__.._------_—._--(Fig 3) Building Len L Fi 3 .__--- 6ulding Aspect Ratio(UW) _.,:___:_._ ,_.-._.---._.�._(Fig 4).__------------__----------_. c 3:1 Nominal Height of Tallest DpeningZ _.__.___.__-_..�_ (Fig 4)------_---__-•-------•-------:. 5 6 B" 13 FRAMING CONNECTIONS General compliance with framing connedions----------=.(Table 2)__::______....._..._....--_--__-------•-•_-_-- 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1. Concr __._......................................•-••.........--•._...._....•... .................................................... Conn Masonry....... 22 ANCHORAGE TO FDUNDATIDNt� 5/B"Anchor Bolts*imbedded or 5lB"Proprietary Mechanical Anchors as an alternative in concrete only - BOltSpacing-general.................:..:.:..........._-tz.(Table 4)---------._._�....----:..___-------- - in. olt Spacing from end(oint of plate_­_. (Fig 5).•_-.__.____�..-__-..-_ in.<6"-12". B Bolt Embedment-concrete_._--- .___.__------.:....(Fig 5)......_---._..___._-:----- -__-:._in.>_7- BD It Embedment-masonry---.._--._._--....._---_.__.(Fig 5)--- ---=_----.....---------. 'in->1S" Plate Washer =--. �.- ;•.�:�--_-_--- -(Fi9 -------- - ----.-L 3"x 3.x t c- 3.1 FLOORS Floor-framing member spans checked ___ _.___--•-_(per 7BO CMR Chapter 55) Maxii ilm Floor Opening Dimension_-- ___.-._----- _(Fig 6)...... ...-_-.--:-----._._ft<_'I2' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Watts or 5hearwall_..___.___(Fig 7).____.__._..........--------- Maximum Cantlevered Floor Joists Supporing L•aadbearing Waits or Shearwall_ �__--(Fig B)----___..:.--..__-.-----.---- _.__._ti _<d •FloorBracing at Endwalls_.:_:...._..........__..___. 9)-_-�----__.-.__.--.---•-----:----.�_�_._.__. Floor Sheathing Type .Y_-----�_--_---_._.----------_-..._(per 7B6 CMR Chapter 55}_---_._:__---- --_-_- Floor Sheathing Thidmess_.-- -----._�;.�_:_.�____�_(per 78D GMR Chapter 55)----.--__-�_--- Floor Sheathin Faste6in ..._._ ,_ _'_ able 2 _ d nails at in edge 9 9-...,.._...- - R ) — 9 /_in field 4-1 WALLS Wall Height ' Loadbearing walls_ _..- --_-----------�_ _._:(Fig 1 Q and Table 5)_ .__�_...---_�-_ft510' NDn-Loadbearing v�alts. - ------_r__ �_.-._.(Fig 1 D and Table 5) +---__._.._____ft's 20' Wall Stud Spacing _._.....__. ........_--.,___.._..-_[Fig 10 and Table 5)__.__-------._in.<_W o.r- Wall Story Offsets (Figs 7&8}---.__---._.--- ft s d yet `t 42 LKTEPIOR:WALLS Wood Studs Loadbearirigvialks._..__.......................... ft in. Non--LDadbearing walls ft in. . - Gable End WaA Bracing — Full Height Endwall (Fig 1 D) WSP-Atfic Floor Length ______:: _.__.._ (Fig 11)--� fti:W/3 'Gypsum Celling Length Cif WSP not used)_.,_--_.......:.(Fig 11)_______.._. ...__....__-_-.—ft i'0.9W - and 2 x 4 Continuous Lateral Brae,-@ 6 ft o.c.-(Fig 11}_.._............. or 1 x 3 ceiling furring strips @ 1 V spacing-min.wffh 2 x 4 blocking @ 4 ft spacing in end joist or truss bays_., Dorible Tap PIate Sprice Length 13-and Table 6)---- ft _' SPGce C'DnneCt!on (no.•bf 15d common nar-is)--_----.(Table 6)._.____...-•----:---- ----•::------ AWC rsuide fo ,wood CorrstrUc iorr ifr Aigfr Wnd,Lreas: II o firph HTrrd Zone ' Massachusetts Checklist for Compliance (90 CMRs3012.l_t)f Laadbearing Wall Connections Lateral (no-of 16d common nags)-_---._----_-_-.__._-(Tables 7) Non--:Dadbearing Wall Connections Lateral(no.of 15d common nags)._..__.__-___._.--(fable 8)___._.._-_.____.._-_------•-_-._-_-- Laad Bearing Wag Openings(record largest opening but check all openings for mnf pflance to Table 9) Header Spans __r.___--.---- .--------------•--(Table 9)__-__.__--------_—fit—in.511' Sig Plate Spans ---__--- -`_:-__-_ _.--_.(fable 9)_-----_-__._._._..._—ft— Full Height Studs (no. of"sfuds)_-----_-.--.•---.._--.__(Table 9)..........__..._____..._--_----------- Non-l-oad Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.....__.___..----_--_ ___..: _._-._(Table 9}_.__--_.- ------•—ft_in 512' Sig Plate Spans._-- 9)--_-- __..__-..—ft_in--<12' Full Height Studs(no.of sfvds)_------___.-.--(Table 9)__._.____.------.._ .-------- --- Exterior Wag Shealhing to Resist Uplift and Shear Simultaneously{ Minimum Brnlding Dimension,W Nominal Height of Tallest Dpeningz -------•.-----._---------..-.._._-..... _...___..._..=5 6'B` Sheathing Type----__=-__----.__-_-__• -(note 4)----_ -- --- --------:-- Edge Mail Spacing____.._.__-:.____.�_�_____.(fable 10 or note 4 if less)-___.._..._._--_- irL irL Field Nail Spacing._._.._._._.._._._-.___.-. able 10 Shear Connection (no-of 16d common nails)(Table 10)----____:__._..____--_--.__.____._._. . Percent FuMeight Sheathing.___._'____.:-.(Table 1 D)__-_------------__-•-------.------------•.—°�° 5%Additional Sheathing for Wall with Opening>.6'8"(Design Concepts)._______.._.__.. Maximum Building Dimension,L Nominal Height of Tallest O enin Sheathing Type.________.-----------.__._...(note 4)----------_---------Edge Nail Spacing - -- able 11 or note 4 if less)----.----_---- rn• 9 P 9 --- - _ - - _.-_ (T Field Nail Spacing-----.-----•----__ .-.-_(fable 11)______----- -------_-.-------- in. Shear Connection(no. of 16d common nags)(Table 11)--•.--.___,_.___._-_-____�._.__.___-• Percent Full-Height Sheathin able 11 5%Addrfional Sheathing for Wall with Opening>6B`(Design Concepts)-.-.-_-----_--_. Wall Cladding Rated for Wind 5.1 ROOFS Roof framing member.spans checked?._-__----_-__-(For Rafters use AWC Span To_ol,see BBRS Website) Roof Overhang -----------------------------------------------(Figure 19) ---.:------- f15 smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls - Proprietary Connectors Upfrft.-__.__._._.......-......___-__-.(Table 12)-------- _--- - - ---Ll--- pif Lateral __..-------..-----(Table 12)_------------ _-_L' pff Shear.-___.__-_.-..__ 12)--------- S- P�- Ridge Strap Connec9ons,if collar ties not ftsed per page 21__. (Table 13)___............._.___-_.--T= plf Gable Rake OLADoker---------------- ------.-__.-.(Figure 2D) .__�...-___fix_<smaller of 2'or L12 Truss or Rafter Connectons at Non-Loadbearing Walls Proprietary Connectors Uplift--- -- ------ - ----.(Table 14)--•----------------•----U- lb. _ Lateral(no-of 16d common nails)...(Table 14)--------------------------------------- = . lb. e__________:-.-_.__ -.__-_ _--(per7B0 CMR Chapters 53 and 59)......__.. . �Roof Sheathing Type . Roof Sheathing Thickness__._._..__.______ in ?7116'WSP Roof Sheathing Fastening-----------•---_-_--_....__.(fable 2) :---------------------•— f Dbtt tS�:.., T . This.}ehecic6st shall be met in its entirety,excluding the spec exception noted in 2,to compiy with the regrfirements of ` 760 CMRS 2 3D11.1 Item 1. ff the checldist is met in fis entirety then the fggowing metal straps and hold downs are not required per the WFCM 110 mph Guide: a_ Steel Straps per Figure 5 b. 2b Gage Straps per Figure 11 c Uprrtt Straps per Figure 14 d_ Alt Straps per Figure 17 e. Comer Stud Hold Downs per Figure 1Ba and Figure lab 2_ Exception:Opening heights ofup to S ft shall be petmilfed when 5%is added to the percent fu"elght sheathing reqWht r entr shdwn in Tables 10 and 11. 3_ The bottom sgf plate in exterior walls shall be a minimum 2 in-nominal Uckness pressure treated#Z-gr-ade. P • t _ " ATVC Grcide fa Xbod Corrsfructiort Lu Hi�It 13,indAreas_ 110 rrzTh fir rd Zoaze Massachusetts Checklist for Compda'=e(7,90 CIVIR53.0i:.J:1)r 4. - a- From Tables I and 11 and location of wall sheathing and Buldrng Aspect Ratio,determine Percerit Futf-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7116"and be installed as follows: b Panels shall be installed With strength exis parallel to studs, ; I AI!horizontal joints Shall occur over and be nailed to framing. iir. On single storyy construction,panels shall be attached to bottom plates and top inember of the double top plate, iv. On two story construction,upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel-Upper attachment of lower panel shall be made to band joist and tower attachment made to lowest plate at first floor framing. v. HorQontal nail spacing at double top plates, band joists,and girders shall-be a double row of Bd staggered at 3 inches on center per figures betbw:Vertical and Hortmntal Mailing for Panel Attachment S. Glazing protection:a),new house orhorizontal addition-required if projectls i mile or closerto shore(generally,south of Rte.28 or north of Rte•6) b)vertical addition—not required unless there is extensive renovafion to the first floor c)replacementwiridows—needs energy conservation compGahC:--only(chap 93) S.Wood Frame Constructon Manual(WFCM)for 11D MPH, Exposure B maybe obtained from the American Wood Council (AWC)website. • lYrierxrnsIDc;Er3r^srsou - us�sd ua�ts • 11 11 - 1 11i tl • it It .7 1 t 11 - II ,• a �Q B � .. rt H , a c1 t - r o ii rl 4 r •, � i • - 1 f 17zCL IL [y d t t W V ii 1 tL ii it g ! 1 s it at s 1 i z srs' t 'rW4L i r lj _ r t -l1- T�e1IL-.•-r-r� --+ RL}tl$l E t; STAGGEFED 3` 6,V+1L-.S�AG�R1G i � - N�.2 PATiH3x Z F 1 ZOUT-FiNAX-EDGESPACM DETAL See Detail on Next Page' • Vertical and HiAmrital NaTng Uefiail• 1-or Panel Attachment Vet:ai and Hor7z-antat Nailing for Panel Attaohment Town of Barnstable o� Regulatory Services 9 MAM% $ Richard V.Scaii,Director E1 u. 16 BnUding Division Tom Perry,Building Commissioner 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owrier Must Complete and Sign This Section If Using A Builder as Owner of the subject property here D byauthon7P ,�j�1 Gf1D� to act on my behalf, in all matters relative to work authorized bytbis building permit application for. (Address of Job). Pool fences and a1armc are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant € Print Name Trint Name QTDRMS:OWNERPF_RMISSIONPOOLS } L ' 1 Town of Barnstable Regulatory Services oFTKE rosyM Richard V_ScaI4 Director Building Division `< EAsi ST-IkB E. Tom Perry,Building Commissioner p$ a6;g. ,a�' 200 Main Street, Hyannis,MA 02601 wwwtown_barnstable mn us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION � PlcascPrint DATE: JOB LOCATION- shot village "HOMEOWNER name home phone# work phone# CURRENT MAILING ADDRESS_ city/town star rip code - ne 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. DEFWMON OR 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 melt 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_ - ,• ��►\ a �`.: y+,- ., \ �\ The undersigned"homeowner"certifies that hehhe understands the Town ofBarnstable Building Depatiment minimum inspection procedures and requirements and that he/she will comply with said procedures and requaements. Signatum of Homcowncr 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 a, \ �: o1No*, 1%R's EXENIPTTON 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." 'i Many homeowners who use this exemption are unaware that:they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations fb'r.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 respon.sible: To ensure that the homeowner is fnHy aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. Ou the last page of this issue is a form currently used by several towns. You may rare t amend and adopt such a form/certification for use in your community_ Q:IWPFa ES\FOF,hMbwlding permit foi=\MRESS.doc Revised 061313 ,p� ���a�nirreo�craea/.�°�C �aaeCla �\ .QEfice of Consumer Affairs&Business Regulation OME IMPROVEMENI%CON°TI A,C.TOR egistration: Expiration: `73 Type: I + DBA j J GROUP DANIEL WOOD 153 POWDER POI:NT9 DUXBURY,MA 02332 Undersecretary Massachusetts •Department of Public Safet�f . Board at-Building Regulations.and Standard - Family Supe-Tvisgrl-&2 Family Yicense-CSFA-062822 TV DAIVIEL C W OOD` ',- 196 SCUDDER B" s Centerville MA 0632� / — -:wP--�� �i i���• -- Expiration -- License or registration valid for mdividul use only x IIbefore the:ezpkr# on yiate. If found return;to: '( Offce of Consumer Affairs and Business Reation it 10 Park Plaza-Suite 5110 li Boston,MA 02116 ' Not valid without signature Restricted-One-and two-family dwellings or any accessory building thereto,irrespective of size. A Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS 0 ! v ' c Lq 10 IN LM N � a E .. , F 7�/t\ o Z N d � ., sTr:'ti•ray r�! �r.., _w ,,. �.;.:i 4 ..,Y^r�ys�yv '+; "�--'"''r„'t• ,-: ,r� �St.. w... - `oF.ME l � Town of Bamstable BARNSTABLE. : Regulatory Services 9 tlASS. �A _ a6yq Building Division prEO MPS>. 200 Main Street, Hyannis;MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection De e K Location S-8 k-a+ker n Q Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. f The following items need correcting: � V , Please call: 508-862-403-S for re-inspection. Inspected,by `1 L Date U� U TOWN OF BARNSTABLE,B.UILDING PERMIT APPLICATION Map ZL Parcel o 5 3 TP1141 Application 00 lU Health Division Date Issued N. S f Conservation Division Application Fee a �G Planning Dept. Permit Fee ���- o Date Definitive Plan Approved by Planning Board'' =' `' Historic - OKH _ Preservation / Hyannis Project Street Address 9' (CA--TP M JgJ R , Village <<AJTO'LVr c,LC Owner <f- -T,bJ Address AID Telephone -7'7`f- L/S-7- 'J 9i o Permit Request 1 Square feet: 1 st floor: existing 4Y32 proposed 1,s76 2nd floor: existing 1,11A proposed Total new /gq Zoning District Flood Plain Groundwater Overlay Project Valuation ®t 000 Construction Type Lot Size O. ZSac Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 3' Two Family ❑ Multi-Family (# units) Age of Existing Structure 3S Historic House: ❑Yes ® No On Old King's Highway: ❑Yes ® No Basement Type: ❑ Full ❑ Crawl ❑Walkout M Other P4e„A-L_ FucI Basement Finished Area (sq.ft.) A/A Basement Unfinished Area (sq.ft) Number of Baths: Full: existing 2-- new A Half: existing -J/g new NlA Number of Bedrooms: 2- existing I new Total Room Count (not including baths): existing 5- new i First Floor Room Count S A. Heat Type and Fuel: ® Gas ❑ Oil ❑ Electric ❑ Other Central Air: ®Yes ❑ No Fireplaces: Existing l 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 0 new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ® No If yes, site plan review# Current Use Proposed Use SAKE APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Gt,e4) Telephone Number CIF Address /'GuJDex k License # 4!!:� ®� Home Improvement Contractor# = Email ��ie/ ��'��� Loin�as�f- � f Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE �' l FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED R I MAP/PARCEL NO. ADDRESS VILLAGE I OWNER DATE OF INSPECTION: FOUNDATION FRAME x INSULATION o �" FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL FINAL BUILDING Y DATE CLOSED OUT t ASSOCIATION PLAN NO. Town of Barnstable �tHe,gw Regulatory. Services Richard V. Scali,Director , ,CABXX Building Division BARNSTABLE p MASI A W�0.AOM1'SBMIIIS•OSiF0.VI11FNNTSiirt&2VSTA9IF //TV s63q. �m0 Thomas Perry, CBO 1639-5- Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 September 18, 2015 Dan Wood 153 Powder Point Ave. Duxbury,MA. 02332 RE: 98 Katherine Rd., Centerville, Map- 228 Parcel: 053 Dear Mr. Wood, This letter is in response to application number 201505296 submitted to do alterations at the above referenced address. Unfortunately,the application can not be approved'at this time for the following reason(s): 1) Construction documents submitted are incomplete and do not include insulation details. 2) A smoke detector upgrade is required and the construction documents do not ti demonstrate compliance with the requirements of 780 CMR. F Please do not hesitate to contact this office with any questions, - Respectfully, VJe4./Lau/zoln Local Inspector jeffrey.lauzon@,town.bamstable.ma.us 1 (508) 862-4034 �.: �J G ' (�1h0 i KC:31c'necK aunware eversion 4. .0 Compliance p ance Certificate Project Energy Code: 2012 IECC Location: Centerville (Barnstable), Construction Type: Single-family Project Type: Alteration Climate Zone: 5 (6137 HDD) Permit Date: Permit Number: Construction Site: Owner/Agent: Designer/Contractor: 11 e V7_ a, w. Compliance: 0.0%Better Than Code Maximum UA: 38 Your UA: 38 The%Better or Worse Than Code Index reflects how close to compliance the house is based on code trade-off rules. It DOES NOT provide an estimate of energy use or cost relative to a minimum-code home. Envelope Assemblies �xr h v Wall 2: Wood Frame, 16"o.c. 100 21.0 0.0 0.057 6 Ceiling 1: Flat Ceiling or Scissor Truss 160 38.0 0.0 0.030 5 Wall 1:Wood Frame, 16"o.c. 169 21.0 0.0 0.057 7 Window 1:Vinyl Frame:Double Pane with Low-E 49 0.300 15 Floor 1:All-Wood joist/Truss:Over Unconditioned Space 160 28.0 0.0 0.034 5 Compliance Statement: The proposed building design described here is consistent with the building plans,specifications, and other calculations submitted with the permit application.The proposed building has been designed to meet the 2012 IECC requirements in REScheck Version 4.6.0 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. Name-Title Signature Date --_ co PW 31. Project Title: Report date: 09/30/15 K r-:)cnecK :)o V webs version 14.o. / Inspection Checklist Energy Code: 2012 IECC Requirements: 0.0% were addressed directly in the REScheck software Text in the "Comments/Assumptions" column is provided by the user in the REScheck Requirements screen. For each requirement, the user certifies that a code requirement will be met and how that is documented, or that an exception is being claimed. Where compliance is itemized in a separate table, a reference to that table is provided. Section Plans Verified ; Field Verified # ; Pre-Inspection/Plan Review Complies? s Comments/Assumptions I Value value I& RegJ. D -- -- - — ---j 103.1, Construction drawings and [ Complies 103.2 documentation demonstrate []Does Not 3 [PR1]1 energy code compliance for the i building envelope. ❑Not Observable j ❑Not Applicable e _ —_ _______..----- -------------------__. _ _ _ _-- '103.1, Construction drawings and ❑Complies 103.2, documentation demonstrate ❑Does Not 403.7 energy code compliance for [PR3]1 lighting and mechanical systems. ❑Not Observable Systems serving multiple ❑Not Applicable dwelling units must demonstrate t compliance with the IECC Commercial Provisions. T � i 302.1, Heating and cooling equipment is Heating: Heating: _ ❑Complies 403.6 sized per ACCA Manual S based Btu/hr Btu/hr ❑Does Not 1 [PR2]2 on loads calculated per ACCA Cooling: Cooling: ❑Not Observable I Manual J or other methods Btu/hr Btu/hr approved by the code official. []Not Applicable Additional Comments/Assumptions: 1 :High Impact(Tier 1) 2 '!Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 09/30/15 2012 IECCE Foundation Inspection Complies? iComments/Assumptions 303.2.1 A protective covering is installed to ❑Complies i[F011]z protect exposed exterior insulation ❑Does Not } and extends a minimum of 6 in.below i grade. ❑Not Observable i ❑Not Applicable 1403.8 Snow-and ice-melting system controls ❑Complies f [F012]2 installed. ❑Does Not []Not Observable ❑Not Applicable Additional Comments/Assumptions: 1 High Impact(Tier 1) }} 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) _ -------------- Project Title: Report date: 09/30/15 f Plans-Verified Field Verified i t & Re ID Framing /Rough-in Inspection; Value ! Value Complies? Comments/Assumptions 402.1.1, 'Glazing U-factor(area-weighted U- U- !❑Complies See the Envelope Assemblies 402.3.1, average). ❑Does Not table for values. 402.3.3, 402.3.6, t ;❑Not Observable , 402.5 ; s ❑Not Applicable [FR211 303.1.3 U-factors of fenestration products ❑Complies [FR4]1 are determined in accordance i,�c 113Does Not q with the NFRC test procedure or taken from the default table. ❑Not Observable __ _ _ , Not Applicable 402.4.1.1 :Air barrier and thermal barrier— _ _ ❑Complies — [FR23]1 installed per manufacturer's []Does Not instructions. ] . .,❑Not Observable 'i❑Not Applicable__ 402.4.3 Fenestration that is not site built ❑Complies 1 [FR20]1 is listed and labeled as meeting ❑Does Not AAMA/WDMA/CSA 101/I.S.2/A440 aP❑Not Observable for has infiltration rates per NFRC # 400 that do not exceed code ❑Not Applicable l _ limits. 402.4.4 IC-rated recessed lighting fixtures 3 ❑Complies �� " ^ 1 [FR16]2 -seated at housingfinterior finish - -• •��-•- --- -. _•__.,._. -• ❑Does Not r-- II and labeled to indicate<_2.0 cfm leakage at 75 Pa. ❑Not Observable ❑Not Applicable 403.2.1 Supply ducts in attics are ^p` R-_ R- '❑Complies ^ (FR12]1 insulated to>_R-8.All other ducts ❑Does Not in unconditioned spaces or R- R- outside the building envelope are: ❑Not Observable 'insulated to>11-6. UNot Applicable 1403.2.2 All joints and seams of air ducts, ❑Complies 1 1(FR13]1 air handlers,and filter boxes are ❑Does Not i sealed. 1 �wx-. ' "_.. _1❑Not Observable ❑Not Applicable_ ? 403.2.3 Building cavities are not used as ❑Complies [FR15]3 ducts or plenums. ❑Does Not ' _•W I ( ❑Not Observable ❑Not Applicable 403.3 HVAC piping conveying fluids R- R- ❑Complies [FR17]2 above 105°F or chilled fluids []Does Not 4 below 55°F are insulated to>R- 3 []Not Observable .❑Not Applicable r03.3.1 Protection of insulation on HVAC '❑CompliesR24]1 piping. ❑Does Not ❑Not Observable '[]Not Applicable ' 1403.4.2 Hot water pipes are insulated to R- R- ❑Complies [FR18]2 _>R-3. ❑Does Not i ❑Not Observable j ❑Not Applicable ((403.5 Automatic or gravity dampers are ❑Complies ![FR19]2 installed on all outdoor air ❑Does Not i1 intakes and exhausts. ❑Not Observable ❑Not Applicable Additional Comments/Assumptions: _.___.--___.___-_____..___ 1 Hi h Impact(Tier 1) ry-—g mp —yF 2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) __._.. Project Title: Report date: 09/30/15 1 ;High Impact(Tier 1) 2. Medium Impact(Tier 2) 3 f Low Impact(Tier 3) Project Title: Report date: 09/30/15 Plans Verified field Verified # Insulation Inspection Value Value Complies? a Comments/Assumptions &Req.ID l �, 303.1 All installed insulation is labeled ❑Complies [IN13]2 Ior the installed R-values I❑Does Not provided. - a❑Not Observable f❑Not Applicable 402.1.1, !Floor insulation R-value. ; R- R- '❑Complies ;See the Envelope Assemblies 402.2.6 ;❑ Wood ;❑ Wood i❑Does Not 'table for values. [IN1]1 ; ❑ Steel t❑ Steel ❑Not Observable E❑Not Applicable r � , 303.2, 'Floor insulation installed per ` ❑Complies 402.2.7 manufacturer's instructions,and ❑Does Not [IN2]1 ;in substantial contact with the i F underside of the subfloor. ❑Not Observable Y _ ]❑Not Applicable z 402.1.1, ;Wall insulation R-value. If this is a: R- R- :❑Complies ;see the Envelope Assemblies 402.2.5, =mass wall with at least 1h of the ❑ Wood ;❑ Wood ❑Does Not :table for values. 402.2.6 wall insulation on the wall [IN3]1 ;exterior,the exterior insulation ❑ mass ❑ Mass s❑Not Observable requirement applies(FR10). ❑ Steel }❑ Steel []Not Applicable ; 303.2 ;Wall insulation is installed per � 1❑Complies [IN4]1 -manufacturer's instructions. ; ❑Does Not ; `• x° = �. -§❑Not Observable ❑Not Applicable j Additional Comments/Assumptions: 1 High Impact(Tier 1) 2r Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 09/30/15 "Plans Verified" "'Field Verified' # Final Inspection Provisions Value ,Value - Complies? Comments/Assumptions & Req.ID 402.1.1, ;Ceiling insulation R-value. R- R- ;❑Complies ;See the Envelope Assemblies 402.2.1, ;❑ Wood ;❑ Wood ❑Does Not table for values. 402.2.2, 402.2.E ❑ Steel ❑ Steel ❑Not Observable [Fill' I t❑Not Applicable a a a a4ya i a a a e `Ql a a a a a 303.1.1.1,;Ceiling insulation installed per ❑Complies 303.2 :manufacturer's instructions. ❑Does Not , [F12]' ;Blown insulation marked every 300 ft2. " ❑Not Observable ❑Not Applicable ; 402.2.3 ;Vented attics with air permeable ❑Complies [FI22]2insulation include baffle adjacent ❑Does Not ;to soffit and eave vents that !extends over insulation. ❑Not Observable , ❑Not Applicable ; 402.2.4 ;Attic access hatch and door R- R- ;❑Complies ; [FI3]' !insulation>_R-value of the I ,❑Does Not , ;adjacent assembly. a ;❑Not Observable a ❑Not Applicable 402.4.1.2 ;Blower door test @ 50 Pa. <=5 1 ACH 50 = ACH 50 = DComplies ; [FI17]' iach in Climate Zones 1-2,and 1 ,❑Does Not a a a I<=3 ach in Climate Zones 3-8. ,❑Not Observable ' ❑Not Applicable 403.2.2 :Duct tightness test result of<=4 cfm/100 cfm/100 ;❑Complies [FI4]' Icfm/100 ft2 across the system or 1 ftz s ftz ;❑Does Not <=3 cfm/100 ft2 without air handler @ 25 Pa.For rough-in ❑Not Observable ; tests,verification may need to 1 ;❑Not Applicable ,occur during Framing Inspection. a a a a 403.2.2.1 ;Air handler leakage designated k f ❑Complies [FI24]' by manufacturer at<=2%of ❑Does Not , design air flow. 1 I ❑Not Observable ; ]EINot Applicable 403.1.1 Programmable thermostats ❑Complies ; [FI9]2 installed on forced air furnaces. ❑Does Not , �. ❑Not Observable ❑Not Applicable 403.1.2 (Heat pump thermostat installed ❑Complies [F[10]2 `on heat pumps. ❑Does Not ❑Not Observable M ❑Not Applicable , a 403.4.1 ;Circulating service hot water '❑Complies [Flll]2 i systems have automatic or ; ❑Does Not UP accessible manual controls. , ❑Not Observable ; ' ❑Not Applicable , 403.5.1 !All mechanical ventilation system ❑Complies [f[25]2 fans not part of tested and listed ❑Does Not , [HVAC equipment meet efficacy and airflow limits. ❑Not Observable ; ❑Not Applicable 404.1 75%of lamps in permanent l❑Complies [FIE]' {fixtures or 75%of permanent ❑Does Not ;fixtures have high efficacy lamps. ❑Not Observable , ;Does not apply to low-voltage , lighting. _ ❑Not Applicable a 1 High Impact(Tier 1) `2 Medium Impact(Tier 2) 3 Low Impact(Tier 3) Project Title: Report date: 09/30/15 r ' ans Verified"Field-Verified' V #��.� Final Inspection Provisions PlValue Value °"Complies? _' 'Comments/Assumptions & Req.ID 404.1.1 Fuel gas lighting systems have ;, -- ❑Complies [F123]3 no continuous pilot light. ❑Does Not []Not Observable ; ..«;.:'., . _ ❑Not Applicable 401.3Compliance certificate posted. ❑Complies ; {F[7)2 ❑Does Not ❑Not Observable ; . ..k ( ❑Not Applicable 303.3 Manufacturer manuals for ❑Complies ; [FI18]3 mechanical and water heating ❑Does Not l systems have been provided. ❑Not Observable ; IDNot Applicable ; Additional Comments/Assumptions: 1 High Impact(Tier 1) 12 1 Medium Impact(Tier 2) 3" Low Impact(Tier 3) Project Title: Report date: 09/30/15 2012 MCC Energy Efficiency certificate • re. I k Above-Grade Wall 21.00 Below-Grade Wall 0.00 Floor 28.00 Ceiling / Roof 38.00 Ductwork(unconditioned spaces): Window 0.30 Door Heating System: Cooling System: Water Heater: 4 Name: Date: Comments i d-cAV72.i1tU-.& r Vz2Z S6E 77AT G/ST a/- lmoo �4 o. Z,:;�VAZ- /AJ ! 12 5- or 9 &1RNB1'ABIE MA9 wn of Barnstable Hyannis Main Street Wa rfront Histor' istrict Commission Ap ica ' n Certificate of,.. napplicability Application is here made for the issuance of a certificat f nonapplica t under M.G.L. Chapter.40C,,The Historic Districts Act for proposed work as scribed herein: Assessor's Map No:. Parcel:No. Address of Proposed Work Applica`nf Name Applicant Mailing Address, Town/State/Zip Applicant Phone Number l{, Applicant E-Mail Property Owner Name Owner Mailing Address n/State/Zip Owner Phone r ' Agent or Contractor Name Agent or Contractor Address Tow tate/Zip Agent or Contractor Phone. --Agent or Coniractor.&Mail:_\ This application is for exemption of proposed exterio onstruction on the ground that: ❑ It will not be visible from any public way r does not involve any exterior arc 'tectural or site tures. (OR) ❑ It is within a category declared titled to exemption fro review by t Commission: PROPOSED WORK: Describe the oposed work,along with the loc on f the proposed work relative to all public ways. Signature: Petitioner/Agent Date i _ Depofte7t ofIm%*fflAcrsdm& - ` 007M oflmverhgrrfiorrs 600 Winhingi m SWeet ` Bestbz4 HA UM www.m=grrvldra Workers' CompensationIwm-"ceAff&rftBWI&zs/ContractorsMeefri.cians/Plmnbers APPRcant Information Please Print Lefdbly Name Jatit�DD� ' City/SelTp• Phone#k Are YOU an employer?Check i3te appropriate bow ' Type of protect(req�re�- L El ism a employer wi h 4. I am a gcnmal cafac nr and I ^�plopees(fanand/or pmt tone).* have hazel the 6 ❑Newer 2.2 I am a solo proprietor err pager- listed om th a attached sbeet 7. ®Ranndr1ing Wong forme in�� -��ploy �� 8. r]Danoliiian [No wod= -cam.I-aso-raDDO- �. $. 9. �Bmldmg eddrtton S. We are a cozpm-ation and its 10-tZMectricalrepaim or adffiam 3.❑ I am ahame wner doing eII Work offic=have=rdsed their ILQ PhmbmgMairs or additions n7self [No wm a w Ccump. . tight of ezemptimper MGL 12-El Roof repass insoremcx I t t:152§1(41 and we haven omplaye [No wca3crrs' 13.0 Other P.mOrmwe -] *Any ggH=atthet dm�m b=#1 mastalso EU autt,eati=brbw sbmft&*wmioaa m Pa�Y tHomeawnecsvrhasnbmitS�isatti�avitn�i�' g8�eymndaiag�IIwadcaad�mhaeoatsidnaam�a�oaMMstsabmiteneRra�darrtmdir�mgsnch. #Coafrad�tb�ehecicttus bmc�t�cbed sa eddniaml shatsbowmg�e nine aftbe ffib- and s�whdhaornotfbose�itirs have mzployr.�Ifthe sob-mt�dna hive emP�9�.�9�Fla��'gyp.pommy maabet , I am an envbyyo•that ispcnvigyrgworkers'eorr matiatt insra==far ury earPlayee= $eloty it thepuTiry and job sitr Insare nm Company Name: Policy#or Self-ins.Lie.#: r=idionDafe: Job Siiz Addizss: tCiy/Sfa Iap: Attacli a copy of the workers'campensafion policy decl;aafion page(s1lowb3.g the poTtcy ntanber and=pkaffoxx dato). Fa-b3re to sect cavecago as regnitnd tinder Sectim25A ofMGL�IS2 cm lm d to&e imposition of caonmal peaa lfics of a EM Mi to$1,500.00 aadlor one-yew hoppsomanmt,as weR as cif penalties is the fOEM of a STOP WORK ORDER and a fine of nP to$250.00 a day against the violator. Be advised that a copy of this statzmeot may be f awarded to the Office of 3nyesti�of fho DIA fin insmm=cavecage vedffcaffi n. I der hereby artder tlu pays and peeal s afPajm'3' h Ad�ormafian prani&d above is =d comer Fon�): Fd!only. Do not write in this area,io be con,pkted by d or tmva ofliciaL own: ppr„�;�r, �. ofITeam 2.jj 1d Departrneztt 3.CityfToWa Clerk 4Blleeizical7aseci SPhbiagInspedar. erson: phone Information and Instrueflons Massacboseft Ge; and Laws IJU=qm=all employers to pruvide workers'oouIPem>satiun far thca employees. Piasoahhtto this sbtt;Bn eplayre is defined es=eve�p pe3son m$ie scaiw of another under my mmkad anurp, ems or implied,orn1 or vxft m:, An.eraplayer is defined as`�mt mclivimmaI,parinecsimip,essoc®fiom,croaporafiart ar ofherr legal earthly,�airy two or mole • of the f'na�ga>ntg engaged in a joihrt and inclodmg the Iegal n�res�fives of a deceased employer,or the receiver or trustee of au indivi&A partr=Sbip,associatiaa,ar offmer Iegal ea W,employing employees. However the owner of a dwe:IImg house havingnot mare them three mipmatcnezds and whb resides thmem,ar the occupant of tine dweIImg house of another who employs peons to dn`maintedancr;c astructim or repaa'work on such dwelling house or an fire gnma&or bml&g g4wx>+oa f=- fn sh4not because of such employment be deemed to be Bn employea" MC IL checptw 1:52,§25C(6)also fhetaevwystste or local lire ageacyshalI Withhold$re issuance or renewal of a license or permit to operate a business or to construct bmldmcgs in the connnonwealth for any applicautwrho has not produced acceptable evidence,of compliance with the nmsm=cr,coverage required." Additionally,MCrL chapter 152,§25C(i7 states the ca�anwealfh nor say of political subdivisiaas shall ...... eater into airy contract for the pmfmm nee ofynblic work until,acceptable evAeam of campEnamvrth file i mnMce.. requixzmetrt;ofthiscbBpterhmtemp=matmdtD•tie gautzamdy.7 Applicants , Please fill out fhe waaiorrs'compensation affidavit completely,by chexking the booms that apply to yam sitnidm and,if s s es and phone numb s along with their=bficate(s)of insmance. Limited Liability Companies(LLq or Lmntrd Lwb:ilrty Part amilups(LLP)wino employees other than,the members or piers,are not rimed to easy wcd=h. compensafiaa insaranm If an LLC or LLP does have employees,apoliay is regard. Be advisedthmdffhis affidiryitmaybe saber to the Department of Indushial Accidents for grad m ofhmmance mvmmgm Also be sure to sign and daft-the affidavit The affidavit should be regent to fee city ar town that the application for the permit or license is being rcgoested,not the Department of Industrial Accidents. 5hould3rou have Buy gnesiions regardmg the law or ifyou are rimed to obtain a vad=s' compe asadonpolicy,please call the Department at the number listed below. Self-msred companies should eater their self-fi sorance license immber on the epprap ist r line. City or Town Officials Please be sort;that the affidavit is cximpletc and printed Iegrbly. no Department has provided a space at time bottom of the affidavit for you to fill out in the evert the Office of Investigations has to cohfact you regarding the applicant Please be score to fia in the pen�i Ulicemse mmnber which will be used as a refhrmce number. In addition,an applicant that mnnst Sabinit mulfiPl0 pe®.idIicrose 2pplit2iiams in any!gym y=,need only sabmit one affidavit indicSfing emreut policy fi f arum ion(ff necessary)mind under"Job Site Address"the applicaut should vn iUe"all locations in (city or town)_"A copy of the•affidavit brat has been offidaIlp stamped or>na*ed bythe city or town may be provided to ffie ' applicant as proof that a valid affidavit is on file liar false permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a R==or permit not meted to Buy bvsi arm or commercial veutiue (i_e. a:dog license or permit to bmn leaves etc.)said pmsm is NOT requh-ed to complete this affidavit . The Office of Invesligaflow wanldifim to tihankyaain advance foryoar cooperation and should yon have any questions, please do not hesitate to give us a call. The Departmeur>f's address,telephone and faxnumber: Departtneat afAts _ mice of jxwtio= . C�UQ��hingtan Sit ' Bann,-M&01 111 TeL#617 727-4900 ext 4-06 or 1-977 MA SSAFE Fax#617-727'7� Revised 424-07 amt;�gng� Town of Barnstable " Regulatory Services _ Richard V.Seal%Director '. Building Division Tom Perry,Bwlding Commdssioner 200 Main Sty Hyannis,MA 02601 www.town.barnstable maxs office: 508-862-4038 Fax: 508-790-6230 Property Owner Must . - Complete`and Sign This Section - If-Using A Builder - - 6AI>fJ y as Owner of the subject property, herebyauthorize L-r,*J 6u 10D - to act on mybehA in all matters relative to work authorized bythis building permit application for. . - (Address of Job) ' " ''-Pool fences and alarms are the responsibi7ityof the applicant. Pools' are not to be filled or utilized before fence is installed and all final inspections are perform d and accepted JA j Signature of Owner rgnatzue of Applicant } Print Name Print Name Date Q:FORMSrowNtIItPER IMSM M00IS Town of.tfarnstame Regulatory Services , of Richard Y.ScalL Director ` o" BufIding birvWon # m� Tom Perry,Building Commissioner aL►aQ 200 Main Street; Hyannis,MA 02601 www town.barnstable.maus Office: 508-862-4038 Fax 508-790-6230 HOMEOWNM LICENSE EJCE>iIMON o --- �7eleasePtint DATE: JDB LOCAII R number s vMW name home phone I wank phone� cautENTMAmLINGADDRESS: ® o -- --- ----- — —— A1awa --- — --anti:.----- zip code — -- ---- --- - The current exemption for"homeowners"was extended to include owner-0 ied dwellin of six units or less and p _ ccuo Fs to allow homeowners to engage an individual for hire who does notpossess a license,provided that the owner acts as supervisor- DEFINITION OR HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to inside,oa 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 structums. 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 oa a form acceptable to the Building Official,that he/she shall be mMausrble for all such work performed under the building permit (Section 109.1.1) The imdemmgaed`.`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 understR ids the Town ofBamstable Building Department mmannm inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signa um ofHomcownrr AppmQam dBuilding Official Note: Tie-family dwellings contammg 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. - HOMEOR'NE>3'S EXEhhIp'ITON The Code states that: 'Arty homeowner performing work for which a building permit is required shag be exempt 'from the provisions of this section(Section 109.11-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities;of a supervisor 8c(see Appendix Q,Rules Regulations for' Licensing Construction Supervisors,Section 2.15) This Tack of awareness often results in serious problems,particularly when the homeowner hires mffwmsed persons. Th this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor_ The homeowner acting as Supervisor Is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/cerfifrcation for use in your community. Q:IWPFIt�FORMSIbwldmgpamit�ms��xr�Fce�e . Revised 061313 OOffice of Consumer Affairs&Business Regulation OME IMPROVEMENT CONTRACTOR egistration: A2:773 DBAxpiration-- Type: J GROUP TI =% DANIEL WOOD 2, ;; �• 153 POWDER POINT`S DUXSURY,MA 02332 Undersecretary I _ w Massachusetts .Department of Publija2 A Board of.Building Regulations.and St Cons.trucilofl Supekvisgrl•&2 Famil- liccrise-CSFA-062822 DANIEL C WOOD-` 196 SCUDDER BAY } Centerville MA 02632" Expiration Commissioner 03/28/2016 License or registration valid for mdividul use only , I before the expiration date. 'If found return to: 3 Office'of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 j 4 I Not valid without signature Restricted-One-and two-family dwellings or any - � b accessory building thereto, irrespective of size. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Licensing information visit: www.Mass.Gov/DPS i y V 1 _ ` 4 Ili LA Ilk � r i 1 i '•1 't _ . R o ZI i /I /0JI1261 "4en Ar JX61 .�- 2, i°6 �QG�l/l�Li�l,'fZ t�tfClos� W(1-77 (U-' 67in. rz) AS- A,&r- zXWee - � Jil iVDf /A/'eGD/!Z 12' o Bath First Floor m [1462 Sq ft] Po h 34' 12, in aster Bedroom N 4' Din(g. E Kitchen N < Full Basement V) Closet " Family 1 Car Att `n [ q ] 0 r" I. .0 CI Bath I 252 S ft I . ' [1 Liv I Cl 12_ 15' iv Bedroom ^ No bsmt 20' Cl 15' Family Room could serve as 3rd sleeping area Living room and kitchen have cathedral ceilings TOTAL Sketch by a)a mode,im. Area Calculations Summary Living Area , Calculation Details x First Floor 1462 Sq ft 12 x iT= 144 30 x 15= 450 26 x 20= 520 15 x 21= 315 11x3 = 33 Total Living Any(Rounded): 1462 Sq ft Nonliving Area. 1 Car Att 252 Sq ft 21 x 12= 252 Form SKT.BldSkl—"WinTOTAU'appraisal software by a la mode,inc.—1-800-AIAMODE n/o JX0 6a"w. Z, P6iu1� Gdr�.c�u%z y 3 P/�eN/i�4s tv 3LI &O-W /iJ- .JGr-1.11&e- , f. vn � zy /ems ZC(7l�/ G". zZadw rS , C0rfrtcru"2 /a�sz1C A� �'/ �r�v�c���z ray � fio/�� %/��oaou� f� Lao� • 12' 1/ �( lti v� o Bath First Floor R [1462 Sq ft] Po h S 34 aster 12, m Bedroom 1 N 4 Din g. E I —RJCL� ( � rJ Kitchen N < Full Basement O L' Closet i J dv�s co1� �j t /L� ?� t' w F Ily ��S N J.Car Att o CI Bath [252 Sq ft] u �' l ' Cl ---12 Be room _�� 1S' N ^No bsmt 20' Cl 9 Family Room could serve as 3rd sleeping area Living room and kitchen have cathedral ceilings . Area Calculations Summary Living Area Calculation Details _ 1462 Sq it 12 x 12=144 30 z 15=450 15x2.1 315 , r - 11R3 = 33 Total LMnq Area(Rounded): - 1462 Sq R - Non-lMn9 Area 252 Sq tt 21 x 12=252 - 1 Car Att SMOKE DETECTORS REVIEWED Form SKT.BldSkl—°NfinTOTAI!auoraisal software by a la mode,inc.—1-800-AIAMODE t LL t- A _E BUILDING DEPT. DATE I I FARE DEPARTMENT. DATE 0 S GIIATURES ARE;EOU13EB FOR PERMITTING r Jk nJb is /1JF'h • V `f �rc�o s� r f/ri711 �o� �. lam. 1�in'JE�ISiCN� iC/r Alf r-e_ rtV&_r/)I/°ePeA, 12, t�C o Bath First Floor [1462 Sq ft] Po h { ' ..= m 34' aster 12' m Bedroom � 1 N 4' in g. E Kitchen +� i S < Full Basement Closet 1 y / 1 a, Family !��✓C�C4��uT ��QQ��'33��1� L�.�O,VLt 0 sbD N i 1 Car Att o CI Bath �V' " 1/"`ccz% C [252 Sq ft] v. �� ©�,♦ I lJ NJ 1 CI 1 — Bedroom 12, 15' N . n No bsmt 20' a CI y / 15, . Family Room could serve as 3rd sleeping area Living room and kitchen have cathedral ceilings . 140 6 04ZZ- ` C-D H,71NAD 1/-k 12- mT,a sk<en br,E.mods ux. - Area Calculatinns summary - calculation Details - Uving Area - - 12 x 12=144 Flrst floor 1462 Sq It 30 x 15=450 26 x 20=520 - • •15x21=315 11x3 = 33 - Total Living Area(Rounded): 1462 sq R - Non-living Area 2525q ft 21 x 12=252 I Car Att - MOK DETECTORS REVIEWED Farm SKT.BldSkI—W nTOTALQaporaisaf software by a la made,inc.—1-800 AtAMODE �: a 'ALE BUILDING DEPT. :DATE .... i T FRE OSPARTMENT DATE 9T;)& llfi9RES A14i i Cl��1ED FOR PERMITI NC APPROVED TOWN OF BARNSTABLE ❑ GAS ❑ VIRING ❑ PLUMBING rg BUILDING �1 tIEPT H EAT LO K 00. RAftks7A TO JANO72016 D@ffuft s2j TOWN OF BARNSTABLE J Company Name ' Phone Number _ s�--C9L� Applicator Name Installation Date AU - 's - Zol Jobsite Address �I � �� j .r A-Side Lot #'s, Permit Number B-Side Lot`#'s o o oClWMAMM ' • o0 0 - �, Walls Attic wwweDe, ileC.C®r� C81DEMImr Town" of•}Barnstable , �1HE Tqy, Regulatory Services - �y�' ti� Richard V. Scali,Director BARMS ABLE ; Building Division BARNSTABI,E MA&4, ouwsrait•cartumu.e•cmurt•inlxnis Thomas Per CBO '"`OhlKW-O�VJ`-"�'�' j 16f9. �� Perry, 1639-2014 ArED1A0�A Building Commissioner �Dg 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:f508-790-6230 January 26, 2016 Daniel Wood 153 Powder Point Ave. Duxbury, MA. 02332 RE: 98 Katherine Rd., Centerville, Map: 228 Parcel: 053 Dear Mr. Wood, This letter shall serve as notice that a final inspection was conducted by this office at the . above referenced property for permit application number 201505296 and the following deficiencies were found: 1) Newly created bedroom,does not have an emergency escape and rescue opening meeting the requirements of 780 CMR R310.1.2 2) Garage separation does not meet the minimum requirements of 780 CMRR302.6 3) Fire department inspection needed as required by 780 CMR 109.1.5 As construction supervisor of record one of your responsibilities is to ensure compliance with 780 CMR. Please correct the above deficiencies and arrange for inspection. Failure to comply by March 26, 2016 will result in a complaint filed against you with the BBRS. Thank you for your anticipated cooperation in this matter. By Order, L. La oG Local Inspector jeffrey.lauzon@town.barnsfable.ma.us (508) 862-4034 j g cis kE GaossMk� c, .Efl (�LS�IG 3: YspM �t"Eti Shed OF TOWNBARNSTABLE Permit * BARNSTABLE, ; MASS. � i61 39. A Permit Number.- Application Ref: 201507165 20153120 Issue Date: 11/03/15 Applicant: Proposed Use: Accessory Structure Permit Type: SHEDS 200 SQ FT &UNDER Permit Fee $ 35.00 Location 98 KATHERINE ROAD Map Parcel 228053 Town CENTERVILLE Zoning District" RC Contractor PROPERTY OWNER y Remarks SHED 92 FT @ 8X12 Owner: CORKERY, MATTHEW B &ANN M 7 Address: 251 CANAAN RD SALISBURY, CT 06068 Issued By: A POST THIS CARD SO THAT IS VISIBLE FROM THE STREET J Town of Barnstable ,AWE Regulatory Services o* Richard V. Scali,Director _" MASS. Building Division M"sa i6;q. ♦0 j°rfn s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.bariistable'ma.us Office: 508-862-4038 Fax: 508-790-6230 PE RMIT# J 1 l/J J FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY -- k.i �1 200 square feet or less ,tia Ln T. Location of shed(address) Village ' C14-4-is-r®,0+4 15-2 Cr-rlorl E _7'7Y- Y 8'7- y9 /o Property owner's name Telephone number oS3 Size of Shed Map/Parcel# Signature Date Hyannis Main Street Waterfront.Historic District? M(A Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway E j Conservation Commission(signature is required), Sign off hours for Conservation 8:00-9:30&3:30-4:30 &A VS A, (�►-Fer�"`Q�� PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE ` COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS.FORM MUST BE ACCOMPANIED BY A PLOTPLAN _ Q-forms-shedreg REV:040914 �1HEh�,� TOWN OF BARNSTABLE Building Application Ref: 200803917 * BARNSTABLE, * Issue Date: 08/06/08 - P ' rmit 9 MASS. QpA i639• ��� Applicant: PETER HOPPLE rFC�.t s Permit Number: B 20081651 Proposed Use: SINGLE FAMILY HOME Expiration Date: 02/03/09 Location 98 KATHERINE ROAD Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 228053 Permit Fee$ 214.20 Contractor PETER HOPPLE Village CENTERVILLE App Fee$ 50.00 License Num 149665 Est Construction Cost$ 42,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND REPLACE THE INSULATION SHEETROCK,FLOORS AND FLOORS THIS CARD MUST BE KEPT POSTED UNTIL FINAL DAMAGED BY WATER NO CHANGE TO FLOOR PLAN-PUT CONT CIl6SPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CORKERY,MATTHEW B&ANN M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 251 CANAAN RD INSPECTION HAS BEEN SALISBURY,CT 06068 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY"WPERMANENTLY. ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5. INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). e / BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept ` Fire Dept 2 Board of Health 4 TOWN O.F BARNSTABLE BUILDING PERMIT APPLICATION i Map Parcel ' �: � .; _.� Application # Health Division 'Z-000 ail r Date Issued lon Conservation Division Application Fe �. Planning Dept. y. Permit Fee r� 9 p ., Date Definitive Plan Approved by Planning Board U Historic - OKH Preservation/Hyannis Project Street Address k&-_-V Village Owner -j'l V� �'OV �-'t✓� Address q 9 k"t�r� R U1 Telephone Perms equest - R-e PIW (4 I h (4 fl.t-t,c, y l,4A,d-VU t;n J-L4, �L. ✓i Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay I� Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room,Count (not including baths): existing new First Floor Roo Count Heat Type and Fuel: i1rGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood oal stove: ❑Yes Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ isting� net size_ Attached garage: &existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: N) Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes O'No If yes, site plan review# Current Use Proposed Use - _ - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) f game I�'C`�"y - Telephone Number 42�s Address V`If& License# Y-An'tct, Pa4'' ✓Ll > ©'j—G Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE `1 FOR OFFICIAL USE ONLY AFPPLICATION# � DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ;j OWNER 1 'r DATE OF INSPECTION: k FOUNDATION FRAME (A It-130AT A44- uli b�oF 4 INSULATION CbJ4 !i y FIREPLACE ' ELECTRICAL: ROUGH FINAL j PLUMBING: ROUGH FINAL GAS: ROUGH FINAL -FINAL BUILDING �146�) IY 4 - ` DATE CLOSED OUT h ASSOCIATION PLAN NO. ."Y ,per The Commonwealth of Massachusetts \ Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AfA.02111 www.mass.gov/dia Workers' Compensation Insurance A_ffid-a'vi.t: Builders/Contractors(EIectricians/Plumbers A_ licant Information Plerase Print Le6bI Name (Business! 'onllndividual): C,.i P-e � ' �-�n r-. Address: ,CjC 9 carffqN City/State/Zip: o-q,rw G h Po r r�- /"► Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor,and I 6 Ncw construction part-time).* have hired the Mib-contractors employees(full and/or 2 I am a'solc proprietor or partner- listcd on the atfached sheet 7. modeling ship and have no employees These sub-contractors bavc g, Q Demolition ees and have workers'loy working for me in any capacity. emp 9. ❑Building addition • .. [No workers' camp. T,once comp.in&ur nce.f in� 5. We arc a corporation and.its 10_0 Electrical repairs or additions required-.] officers"have exercised their 11.0 Pl=bing repairs or azlditions 3.❑ I am a homcownrs doing all work mysclL[No workers' comp. right of exemption per MGL 1Z ❑Roofrepairs incnrancc req�cd_j t c. 152, §1(4), and we hoot no 13.[] Other employees. [No workers' coutp.insurance regtrircd.] *Any applicant that ebecla box#1 must also fill out the section below sbowing their workers'eoropMSVADn policy inforamtiM-L t Homeowners who submit this ej5davit indicating they arc doing all work and then bin outside contractors must subTuh anew affidavit indicating such_ rContractors thxl ebcek this box must atiacbcd an additional abed showing the name of the sub--contratirna and staff wi�ett�er or not thost entities have cmployns. If the sub-contractors have employees,they must pruvidh their vvorkLrs'comp.policy nurnbcr. j am an employer that is providing workers'compensation insurance for my employees. Below is the polity and job site ' irzforrrtation_ • Insurance Company Name: Policy#or Sclf--ins. Lic. #: Expiration Date: Job Site Address: City/Stawap: Attach a copy of.the workers' compensation policy declaration page(showing the policy number and expiration datr-). Failure to sccurc coverage as required undrr Section 25A of MGL c. 152 can lead to the imposition of rrimirial penalties of a finc tip to$1,500.D0 and/or one-year i mpris=n 11, as well as civil penalties in the form of a STOP WORK ORDER and a floc of up to$250.00 a day against the violator. Bc advisod,that a copy-of this statrmcrit may be forwarded to t]ao Office of Iaves'd atitms of the DIA for inenrancc coverage Verification. I do hereby certify'u r the pains•and penalties of perjury th"at the information provided above Isftrue and.cerrecl. Si ablic: Datc: illu ZL3 6 _ Phone Offufn!use only. Do not write in this area, to be completed by city or town offtciaL City or Town: Permit/Ucense# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3. City/Tow-a Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: pursuant to this statute, an employee is dcfncd as "...every person in the service of another under any contract of hire, , express or implied, oral or written.," r ;w An employer is defined as "an individual,Partnership, association, corporation or other legal entity, or any two or more of the foregoing.engagcd in a joint cutcrprisc, and including the legal representatives of a deceased employer, or the cecciver.or trusted of an individual,Partnership, association or other legal entity, employing employees. However the owner of a dwelling house apartment baying not more than throe apartmen and who resides therein, or the occupant of the iwclling house of another who employs persons to do maintenance, construction or.repair work on such dwelling house )r on the grounds or building appurtenant thereto shall not because of such r-mployment be deemed to be an employer." \4GL chapter 152, §25C(6) also states that"every state or local licensing agency shall'withhold the issuance or Tnewal of a license or permit to,operate a business or to construct buildings,in the commonwealth for any applicant who has notproduced-acceptable evidence of compliance with the insurance coverage required - additionally,MGL ohaptcr 152, §25C(7) states `Neither the commonwealth nor any of its political.subdivisions shall rater into any contract for,the periormancc of public work un�acceptable evidence of compliance with the ire cquircments of this chapter have been presented to the contracting authority. ,pplicants lease fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if cecssary, supply sib-c-onfra.ctor(s)name(s), address(cs) and phone numbers) along with their certificate(s) of Suz-ance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no-employccs othcx than the icmbers or partners, arc not required to carry workers' compensation insurance. If an LLC or LLP does have uployces, a policy is required. Bc advised that this affidavit may be submitted to the Department of Industrial ccidcnts for confaradion of insurance coverage. Also be sure to sign and date the affidavit The affidavit should ;returned to the city or town that the application for the permit or license is being rcqucstcd,not the Department of idustrW Aczi&cE s. Should you have any questions regarding the law or if you are required to obtain a workers' )mpcnsation policy,please call the Department at the nurctber listed below. Self-insured companies should enter their ;If-inn ramp license number on the appropriate line. ity or Towli Officials ease be sure that the affidavit is complete and printed legibly. The Dcpartracut has provided a space at the bottom 'tile affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant case be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant at must submit m�ultiplc permit/licensc applications in any given year,need only submit oap affidavit indicating euaent ,licy information(if nmrma y) and under"Job Site Address" the applicant should write"all locations in (city or + vm)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the plicant as proof that a valid affidavit is on fie for fubirc permits or licenses. A new affidavit.must be filed out each ar.Whero a home owner or citizen is obtaining a license or permit not related to any business or cotrmercial venture a dog license or pcunit to bum.leaves etc.) said persotl is NOT required to complctc this affidavit d Office of Investigatians would hke to thank you in advance for your cooperation and should you have any questions, ;asr do nothcsitatc to give us a call Department's address, telcphonc-and fax number. The,C6mmonWt,-alth of Mas�GhusfA' s Dent of ludustdal A.ccidonts Office of Investig-afions 6.00 WashingtGn Street Boston, MA 02111 To-I. # 617-727-49-0.0 cxt 4-06 or 1-V7-MASSAFF Fax# t517-727-7749 ( 11-22-06 YrvwdnaSS.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE-AND,TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) Applicant Name: ' P.--tp- r ,.#d Site Address: 19 k- Town: Applicant Phone: ;OR Applicant Signature: Date of Application: NEW CONSTRUC N: (choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- AND•TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab 0 tion 1: Basement -_p Fenestration exposed Wall Floor Wall Perimeter AFUE I4SPF S EIER U-factor floors. R-Value R-Value R Value R-Value R-Value and Depth National Appliance Energy 35 R-10, Conservation Act(NAECA)of R-3 8 R-19 R-19 R-10 4 ft. 1991 as amended,minimums or reatcr as applicable Note: This form is not required if you choose either of the-two versions of REScheck.as.listed below. Option 2: RES check Version 4.1.2 or,later variant software analysis must-be completed (780 CMR.6107,3.2 R.EScheck--Web which can be accessed at http://www,cnerg cY odes•gov/reschecld Dp7TI0NS'0 A X,TERA.TZONS :TO`:EIS'I'11VG.BUS ]JINGS:'0 {R 5:SEA RS OI,D 3uildings under 5 years old must use option#1 or#2 in New Construction section above; . Dmplete the following formula to determine the % of glazing: (a) Gross.Wall & Ceiling Area equals Formula: (100.x b_ a) SF 100 x — _ % of glazing b a (b) Glazing area equals. SF 7lazing is chart bolo.w. Ifglazir .is>.40m`% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVEL,.OPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL, BUILDINGS MAXIMUM MINIMUM Lx, iling and wall Floor Basement Wall Slab Perimeter Fenestrationosed floors R-Value U-factor R-Value R-value R-Value ' and Depth: -Value;39 -37 a j R-13 + R-19 R-10 R-10, 4 feet R-30 ceiling insulation may be used in place ofR-37 if the insulation achieves the full R-value over the entire ceiling area i.e, not com ressed over exterior Walls, and including any access o enin s).- SUNROOM—An addition or alteration to an existing buildink/dwelling unit where-the total glazing area of said addition exceeds 40% of the combined gross wall arui peiling area of the addition, . Note:. Owner to fill out Consumer Information Farm (found in Appendix 120,P) Jul 24 2008 5: 12PM Cape Coastal Builders 774-237-0181 ti o ro Town of'BaMstable Regulatory Services T Thomas F.Geiler, Director• Building Division Tom Perry, Building Commissionet 200 Main Street, Hyannis,MA 02601 www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-740-6230 Property Owner Must complete and Sign `)hi.s'Secti.on If Usi2 g A Builder I Ii C,(�. . �1 , as Owner of the'subject property hereby authazXze �.�-f'e✓ Or P(� to act on m7 behalf, in all matters relative to woxk authorized by this building per t application for: (Address of Job) Signature f Owner ate Kyrl .. LyRKCA Print Name If.property Owner is applying for pernnA please corapletc the Homeawners License' Exemption Fozm on the reverse side. t N O ' � Q g � f9# i 1 ' � a h f , �►r . � �- . �` � ,,. c � �. � k Y � g � _ .. V e � - 5 ���,x` - F ,t F_ - - -- - �� �' � i � . KA THERINE ROAD N 06'24'00"E 100.00 4/ I LOT 8 HSE.98 10, 776 SF. 14.20 3 W 0 20.00 zz o � 26.10 no to m p o EXISTING DWELLING o m M 46.00 O EXISTING ry'ADDITION tp 16.30 22 12.00 24 100.00 S 06'18'51"W a TO THE BEST OF MY KNOWLEDGE, THE PLOT PLAN OF LAND ADDITION SHOWN ON THIS PLAN IS AS LOCH TED IN IT ACTUALLY EXISTS AND CONFgRtfq TO CEN TER VIL L E - MASS. THE ZONING REGULATIONS I -.W Tb0l, OF BARNSTABLE, REGARDING YfffiD`•Sg-BADKS";, PREPARED FOR DATE: DULY 11, 2000 %= PADGETT BUILDERS DATE.• JULY 11. 2000 SCALE: 1 "-20 FT. R A CAPE 6 ISLANDS ENGINEERING FLOOD ZONE C (NON-HAZA D-69 BC BAP 'd MASHPEE - MASS. P 92/1 61,111 r171I/.144 11 .i"I�CII.;Jtip,!�G/8G"F b - _- Board of Building-Regulations and Standards HOME IMPROVEME CTOR Registratidii: V � i f /' t 1 1/1 Expirat1 . : 1/27/2008 I t/1 1 n Type, rporatio7n CAPE COASTAL BUILDERS 1 ( I PETER HOPPLE 41 ROSARY LANE _ HYANNIS,MA 02001 Administrator a=�,1,w.'.-adlmvp.�_ c_r�++'C<�+'.•+rn+..ry+w.-:+..�.�w.«-M.:—Fes.-�:.•..+.eaww..�-./ti '«....,...rn.m+cs,yrya. _ ��fto '�ovivnu�ru«tz�l/ al, - BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 092702 E Sirtndate:Oa/01/1976 Expires: 03/01/2009 Tr. no: 92702 Restricted: 00 Pp-*'R V HOPPLE PO Box 827 c, ARWICH. MA 02646 Commissioner SLJO Licensee Details Page 1 of 1 The Official Website of the Executive Office of Public Safety and Security (FOPS) Public Safety Mass.Gov Home DPS Home EOPSS Home Mass.Gov Home State Agencies State Online Services Department of Public Safety Licensee Complaints License Type Home Improvement Contractor License# 149665 Restriction Company Cape Coastal Builders Name Peter Hopple Address 41 Roasary Lane City, State, Zip Hyannis, MA, 02001 , Expiration Date 1/27/2010 Status Current No complaints found for this Licensee. �\ Back To Search 1 http://db.state.ma.us/dps/licdetails.asp?txtSearchLN=HIC 149665 7/29/2008 BOWE- Triple 1-3/4" x 9-1/2" VERSA-LAMOiO 3100 SP Roof Beam\131301 BC CALCO 2.0 Design Report-US 1 span No cantilevers 1 0/12 slope Wednesday, November 05,2008 15:00 Build 276 File Name: P Hopple_Kathrine.BCC Job Name: Description: RIDGE BEAM Address: 98 Kathrine Road Specifier: Joe Madera City, State,Zip:Centerville, MA Designer: Customer: Peter Hopple Company: Shepley Wood Products Code reports: ESR-1040 Misc: 12 .- I 17-05-00 BO,3-1/2" f B1,3-1/2" DL 999 lbs DL 999 Ibs SL 1,753 16s SL 1,753 Ibs Total Horizontal Product Length=17-05-00 Load Summary Live Dead Snow Wind Roof Live Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% Trib. 1 Standard Load Unf.Area(psf) Left 00-00-00 17-05-00 15 30 06-08-08 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 11,357 ft-Ibs 47.2% 115% 3 1 - Internal Completeness and accuracy of input must End Shear 2,409 Ibs 22.1% 115%, 3 1 - Left be verified by anyone who would rely on Total Load Defl. U260(0.784") 69.3% 3 1 output as evidence of suitability for Live Load Defl. U408(0.499") 58.9% 3 1 particular application.Output here based Max Defl. 0.784" 78.4% 3 1 on building code-accepted design properties and analysis methods. Span/Depth 21.4 n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearing Supports Dim.(L x W) Value Support Member Material building codes.To obtain Installation Guide BO Post 3-1/2"x 3-1/2" 2,751 Ibs n/a 26.0% Unspecified or ask questions,please call 131 Post 3-1/2"x 3-1/2" 2,751 Ibs n/a 26.0% Unspecified v (800)232-0788 before installation. BC CALCO,BC FRAMER®,AJS- Cautions ALLJOISTO,BC RIM BOARD-,BCI®, Member is not fully supported at post BO. A connector is required at this bearing. BOISE GLULAMT^^ SIMPLE FRAMING Member is not fully supported at post B1. A connector is required at this bearing. f; SYSTEM®,VERSA-LAMB,VERSA-RIM For roof members with sloe 1/4/12 or less final design must ensure that ondin instability PLUS®,VERSA RIM®, p ( ) g p g y VERSA-STRAND®,VERSA-STUD®are will not occur. trademarks of Boise Wood Products, For roof members with slope(1/2)/12 or less final design must account for Rain-on-Snow L.L.C. surcharge load. 1 Notes Design meets Code minimum (U180)Total load deflection criteria. Design meets Code minimum(U240) Live load deflection criteria. Design meets arbitrary(1") Maximum load deflection criteria. Connection Diagram L'b d a 0 o c e 0 0 0 a minimum=2" c=4-1/2" l b minimum=3" d= 12" T e minimum=3" Nailing schedule applies to both sides of the member. Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 oFtME� Town of Barnstable Regulatory Services • sa Le MASS. Thomas F.Geiler,Director y mass. � 039. 16 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 29, 2008 David M. Reggiani 590 Washington St. Pembroke, MA 02359 RE: 98 Katherine Rd., Centerville, MA, Map228 Parcel 053 Dear Mr. Reggiani: A review of our records, including the permitting history of 98 Katherine Rd., Centerville indicates that you are in violation of 780 CMR 5110.1. Upon a recent inspection of the above referenced address, it was observed that demolition work was being performed. Although you have applied for; and this office has approved, a permit for demolition work; the building permit has not been issued. You are hereby ordered to obtain the proper permit for work done or this office will file a complaint with the BBRS in accordance with 780 CMR I I O.R5.2.9.1. Thank you for your attention in this matter. You may call (508) 862-4034 with any questions. By Order, r L Lauzon Local Inspector Cox)J I' ob> Q:zoning5 .<s c t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 22� Parcel .� ,^3 Z�c� �✓!y-�c� p Application # Health-Division Date Issued 3 a`� ,:Iz Conservation so Divi i n k pp A lication Fee Planning Dept. Permit Fee " Date Definitive Plan Approved by Planning Board � V Historic - OKH Preservation/Hyannis - Project Street:Address 9 Village Owner rY'�/ e�/c�C�2y Address 77 7 ezz `11 Telephone 5' 2.Z. yl 6 T�' J Permit Request € G DAW/7-i�,',6> ICI E'Y�rl ck %YA I ,4 C-ro J' Square feet: 1 st floor: existing proposed '2nd floor: existing - proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family-. Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: *ull ❑Crawl ❑Walkout ❑ Other 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 new First Floor Room Count Heat Type and Fuel: ❑ Gas Oil ❑ Electric 0 Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No i Detached garage: ❑ existing 0 new size_Pool: ❑existing ❑ new size _ Barn: L3,1 existingI3 ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ CD Commercial ❑Yes *0 If yes, site plan review# co Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name ti/+• `'Plr/e'h,i/ Telephone Number Address �S `T0 ruts -r%• License # Cs D 69/ 7 9 &14 ®Z-7 Home Improvement Contractor# 7 Worker's Compensation # ( J C ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A/1Mf- -PAY-,-7*i7el y SIGNATURE �" DATE 3/2-/�� .f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. } ADDRESS VILLAGE OWNER DATE OF INSPECTION: 4 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 1 GAS: ROUGH FINAL FINAL BUILDING 40 liloi- DATE CLOSED OUT ASSOCIATION PLAN NO. k 1 1 k .t Y ! ,l �72��LO J7,LlfC?GGIL O��//�Gd4dpCl2LL6P.�61 1 .Board'oGBuildingl'Regul'ations.and.Standards Consttuction Supervisor License -L'icense CS 69.179 i. y '� � � � Birthdate `11/26/1`958 i%r ���`�M� Ezpi"ration 11/,26/20Q8 3 Restriction DAVID MIRE GI c�, _ �y 590 WASHIN.GTON ST PEMBROKE, MA 02359 Commissioner �/� U/O71Y/92Oi/Y.L!/�2GU� o�,./�aaaac�iuoetta , Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR. Registration 137817 lug Expiration _1/912009 ', T _ ype Supplement Card NEW ENGLAND BUILD.&rRESTOR 5AD REGGLANI 590WASHINGTON`ST PEMBROKE,MA 02359 4' Administrator ii From:Amy Kelly At Hannon-Ryan Ins Assoc Inc FaxID:781-293-7943 To:Mike Bozik Date: 11/1/2007 11:47 AM Page:1 of 1 CSR AM DATE(MMIDDIYWY) ACORD CERTIFICATE-OF LIABILITY INSURANCE NEBRINC 11,01/07 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Hannon-Ryan Insurance ONLY AND CONFERS NO RIGHTS UPON THE.CERTIFICATE Associates, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 166 Center St. , P.0. Box 457 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Pembroke MA 02359 Phone: 781-293-5500 Fax:781-293-7943 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Guard Ins Group INSURER B: New England Build &Restore Inc wsuRERc 590 Washi[1LTton St INSURERD: Pembroke jdA02359 INSURER E: COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IMIK LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MWDDIYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurence) $ CLAIMS MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY f JPEd LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO - ALL OWNED AUTOS BODILY INJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILY INJURY - $ (Per accident) NON•OWNED AUTOS PROPERTY DAMAGE $ (Per accident)- GARAGE LIABILITY AUTO ONLY-EA ACCIDENT. $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND TORY LIMITS ER A EMPLOYERS'LIABILITY NEWC803610 11/01/07 11/01/08 E.L.EACH ACCIDENT $500000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $ 500000 If yes,describe under E.L.DISEASE-POLICY LIMIT $500000 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS USUAL TO THE INSURED . CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. r IZED REPRESENTATIVE AUTHORIZED an - ... wwnen nnn nn o,A Tln►�4600 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 . www.mass.gov/dia Workers' Compensation Insurance Afridavit Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): A?, �Es�Z/��c� li��; Address: �—S �2/ rfi..c 7Tii✓ �T. City/State/Zip: 10E _Moire Gz_?N- Phone.#: WY - 80-2 6 - 7 2- Are you an employer?Check the appropriate box: Type of project(required): 1.�1 am a employer with '?- Y — 4. ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees 'These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers'comp.insurance comp.insurance,$ required.] 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 I LE]Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12 [j Roof repairs , insurance required.]t c. 152,§1(4),and we have no 13.❑Other employees. [No workers' - comp.insurance required.] *Any applicant that checks box#1 must also fin 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 rmmst attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors 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. '1 Insurance Company Name: Policy#or Self-ins.Lic.#: lV E c,/c J--U 3 6/(). Expiration Date: ! Z11—a Job Site Address: �` City/State/Zip: 6-3Z Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to se'cure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crimirial 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 cerW&i1Y4er the pains-and penalties of perjury that the information provided above is true and correct Cc z Z I J_0 Signature: Date: Phone k 7 / — 12 6 — ? 2 C Official use only. Do not write in this area,to be completed by city or town officiaL ; City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions •- Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representative's of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the embers or partners,are not required to c workers'compensation insurance. If an LLC or LLP does have m P q �3' mP employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation.of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitAicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (Le.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office-of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone-and fax number: The C6mmonwealth of Massachusetts Department ofIndustrial Accidents Qfftce of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 4.06 or 1-977-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia I _ � Mar 20 2008 10:01AK SALISBURY SCHOOL BUSINESS OFFICE No. 4567 P. 1 M6. �.. „". PRO ,, ,.,,.. .�.., .,, . ". 508-778-7379 p,. Oro �t HE r Town of Barnstable ti Regulatory Services I uaw+ssnp�, Thomas F.Ceder,Director Building Diyisian Toot Ftrrv,Building Commissioner 200 Main Street,Ryannis,MA C2601 www.town.barusrable.ma.t�s ' Office: 508-862-4038 Fax: 508-190.6230 Property Owner Must Complete and Sign This Section If Using A Builder- I, &d X eat/GHQy ,as Owner of the subject property hereby a�thori2e -5 f,,p-V 97e, to¢ct on MY behalf, in aulmat*..ers relative to work authorized bythis building pertrut application for KR1-i+f'a„J4 Id d 0uo,ilt, (Addccss of job) sigria- e o Owner Date Pent Larne . If Proveit-v Owner is applying for peradt please complete the Homeowners License Exemption Form on the reverse side. �y r i + 0.d` yr t+• f �t �. :1� '•• f �' t V 4' • , ta;� r i *dry • s��'� �!' 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[�. w r t�•j4. i t •3 .• • ya�.,;�,a r'•'"f. y �'x',�,.�C•+• r r t�t F k gr; { 4 _ ..x =N` 9 a a PH r.3�gp s ki A ;G $ � , � �,� �,� �# ��' . F +{� `, �. �, Y � � i � � � �'. � �` ,, �,. 1 y � i � � i``` ��< ' Jrr a �. f ���y � -J r� r Y �� ..r �� ��� t a �° � 1 �; .�� �� � ,� �, t t�' .j. ,3 � ;,,;� i �f' r � �' - - Y. �ag,�r ;,� { � � „ „ .. d� � �� � � �� � t �`'; � 1 � 4 1 t.,�, E..-..� � �. � � � �� r � ills � �.. ,: ,� ' t � , � r k`e ,� � � , �, �r., 9 i ��' �� � 3 1': � j � �� .l A 0 �1 a�r� y, S 1 i + #R • • Y° 4 *+=y •.'"trip •ar .a1��.�"-..+�' _ j_ • _ a ° •+:y't,... � -y, ��• + +'aF ,rnx '�'r �!' +c3. III AW 40 lk e • Y i i •. 1f, • 1 SERVPRO`of the Mid and Outer Cape I x TM 0 -Fire.&Water.- Cleanup & Restoration BARRY H OLT "? z barry®servprootmoc.com 24 HOUR t sn. a EMERGENCYSERVICE _ 1=800-581-1944 r f : ;,c 508-778-7378 126 B Mid TechFax.508-778-7379 b I West Yarmouth,MA'02673kffJr �ndr,drntly Ow.d and Opnarrd - Bldg. Dept. '.APE CIDD, MA 02< 200 Main St. ;w.= s �. rfik� �..„ Hyannis; Ma. 02601 � , �: 9�- r �E'£ 0 a PI7n�EY HOv17E5 02 1A $ 00.410 0004606238 APR29 2008 p MAILED FROM ZIP CODE 02601 a1� £� {4 :Yp David M. Reggiani 590 Washington St. f Pembroke, MA 02359 RETURN 'TO SENDER SNSI.Jf'I ICIENT ADDRESS UNABLE 'TO FORWARD 0260 1P4002 ' :let =titt� i ii� tr i ji t= tit �f t r� . r. Town of Barnstable Regulatory Services r r a MASS. a Thomas F.Geiler,Director y nss. �, i639• ♦0 �EDMA'�A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 29, 2008 David M. Reggiani - 590 Washington St. Pembroke, MA 02359 RE: 98 Katherine Rd., Centerville, MA, Map228 Parcel 053 Dear Mr. Reggiani: A review of our records, including the permitting history of 98 Katherine Rd., Centerville indicates that you are in violation of 780 CMR 5110.1. Upon a recent inspection of the above referenced address, it was observed that demolition work was being performed. Although you have applied for; and this office has approved, a permit for demolition work; the building permit has not been issued. You are hereby ordered to obtain the proper permit for work done or this office will file a complaint with the BBRS in accordance with 780 CMR I I O.R5.2.9.1. Thank you for your attention in this matter. You may call (508) 862-4034 with any questions. By Order, e rey L Lauzon Local Inspector Q:zoning5 V V e 2 ��� TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY-BLDG.PMT#52067-7-BDRM PARCEL ID 228 053 GEOBASE ID 13925 ADDRESS 98 KATHERINE ROAD PHONE CENTERVILLE ZIP LOT 8 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO PERMIT 52067 DESCRIPTION CERTIFICATE OF OCCUPANCY---BLDG.PMT#46309 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY j CONTRACTORS: Department of Health, Safety ARCHITECTS: and Environmental Services TOTAL FEES: IME BOND $.00 CONSTRUCTION COSTS $.00 I 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE P "41E�.� _ ; * BABIVSTABLF, • MASS. - ED MfCI BUILDING DIV ON BY DATE ISSUED 03/13/200L EXPIRATION DATE s TOWN OF BARR�SzA1BLE BUILDLNG PERMIT � a" YARCEL`�Ir�228 053 >.°OEOI3 aE 11) 13,025 ADDRESS 98 KA.THERINE ROAD P14-O �E CE&TERVILLE ZIP LAOT a BLOCK LOT SIZE DBA IDEVEI:,0PHENT DISTRICT CO 'PERMIT 4;6309 DESCRIPTION EXTEND ,t3EI ROOM/REM0D.K'FT.REPLACE WINDOWS PERMIT TYPE. BADDI TITLE BUILDING PERMIT ADDITION I .CONTRACTORS= PADGET`.I' BUILDERS Department of Health, Safety ARC,HIT CTS: and Environmental'Services TOTAL FEES: BOND . $.0() QONSTRUCTION COSTS $75,000.00 � � Qi► - e 434 ;RED.IP A,DD/ALT/ ONV 1. PRIVATE .P! *' 9 "' * •AMMBLF, • . - MA83. , 'Ile A �- � ,, • DMA ~4` BUILDING�DshV610.N i .� .. BY DATE ISSUED 05/24/201b /XIRtA T N DATE y t - -• �r �, t., i THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM,THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF TH!S.__ PERMIT DOES NOT RELEASE.THE APPLICANT FROM THE CONDITIONS OF ANY,APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED a = FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APP.LICABLE., SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS _cp ' 2 t J 2 ` i 2 Al fl- 3 1 ATI G INSPECTION PPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED'UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 55 oco j _� TOWN OF BARNSTABLE BUILDING PERMIT°APPLICATION; Map Parcel 0 5 Permit Health Division �;? ,00-fo 911 aV y Date Issued Conservation Division i S Fee �3a, Tax Collector Treasurer' SYSTEM MUST BE ' SETICP. IN IANCE Planning,Dept. �... INSTALLED. TITLE 6 • - }WITH Date Definitive Plan Approved by Planning Board ENVIRONMENTAL C O AND T®WN RECULATINS Historic-OKH Preservation/Hyannis Project Street Address q � "f4�L ROUE Village Ca►JTwRJil. t l �- 51�4_(S3u _lf L . 7.51 CAPJAA J' Owner Mr'►*ft-� AtJ J CCR� Address 5fla5e,934. 9.i LX00e8 F Telephone NoO-) �t-35 92103 r • Permit Request i L �( tZt `C'1115'1;G-r_ inn ��fT S,t� r1TfAc�-I en�l �A '. i 1.J Sr,PTrc • �'eST>?1Y1_:_ 1 � �•�J,�-��t 1 SlciLiG�fif r4D`>5 W I=QQ1 J ,! t&5H �t��S ��1"fi� Ir-Ft7L4.S�• �- �'t7��' 9 Square feet: 1 st floor: existing 41 proposed 144 4 ` 2nd floor: existing _� proposed _� Total new Estimated Project Cost 7 5, DoQ CO Zoning District , Flood Plain C Groundwater Overlay Construction Type WO'D'O F�1tY'�1E Lot Size /D, 77 S5 Grandfathered: ❑Yes ❑ No If yes;attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 012-AAS Historic House: ❑Yes t4.No On Old King's Highway: ❑Yes 040 Basement Type: AFull. ❑Crawl ❑Walkout, ❑Other r Basement Finished Area(sq.ft.) - Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 0 WE new bt-JE Half:existing new Number of Bedrooms: existing__ new Total Room Count(not including baths) existing Jr new JC First Floor Room Count S Heat Type and Fuel: ❑Gas ` I Oil ❑Electric ❑Other . Central Air: ❑Yes *o Fireplaces: Existing ONE New Existing wood/coal stove: ❑Yes KNo Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn:❑existing ❑new size Attached garage:)(existing ❑new size Shed:❑existing ❑new ,size Other: ` Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes �No If yes, site plan review# Current Use S1}JGLE Proposed Use SlYM6 BUILDER INFORMATION Name J Z . Telephone Number (Soo �ZU —:0061 Address X 3 License# 0if n 57 �ltS,� c�C' TUL SST Home Improvement Contractor# 1 0© 13 L-fJ /c_l i�T d Z403 5 Worker's Compensation'#112 6- 3" 9 61 ALL CONSTRUCTION DEBRIS RESULTING'FROM THIS PROJECT WILL BE TAKEN TO BF SIGNATURE DATE 5 ILA 100 FOR OFFICIAL USE ONLY ,Ph MIfNO. DATE ISSUED MAP/PARCEL NO. -'\ r ADDRESS VILLAGE OWNER, .r x• ,, f , - - DATE OF INSPECTIO1: 4 �` FOUNDATION FRAME INSULATION iPC-0 ' FIREPLACE ELECTRICAL: ROUGH: ,:!�'. FINAL2,,t { < - # ♦ _ - ; ' PLUMBING: ROUGH> 0 H' FINAL- GAS: ROUGH ' �+ I,. ;'4 FINAL FINAL BUILDING �` /Tf A *; rot •DATE CLOSED OUT '� ♦ .. .+.'+ it ' 3 - ASSOCIATION PLAN NO. I ,, DZTECTOR REOU{RE{V{GNTS ARE i— EVEN THE ADDIT{ON OF A i S�. ...� AR= f� j t �. M WILL TRIGGER AN �. NEW ,00 F THE SMOKE DETECTORS I !i UP E 7910 OUSE• YOU MUST I FOI T CC OR ' tUD' HAVE YOUR PLAN E APPROPRtATE IRE a ELE PER�IttjT¢�T THE F F4ll FouNDfMaJ �_�. •. V � � ! 3`I+,�'� --a �-i�a..� � i tK. i =SEL_Tl'oN Z -.. � '� �Li: -1» ,.� i' Fi, i 3s- -A, II ............L _ 1� � z i . MEE- F7-1 .......... PROJECT COST WORKSHEET l ESTMA TED Value LIVING SPACE (high end construction) square feet X$115/sq. foot= (above average construction) `t square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X $20/sq. foot= DECK square feet X $15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Cost IAHFORM 1/3/00 °FINE r, •'1,°� The Town of Barnstable M � • BAMSTABUEr 9 M'S Department of Health Safety and Environmental Services 1639. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 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. i 2,X 12 Type of Work: D tJ 4 Estimated Cost 7 .1 o®® Address of Work: 913 KftwegwE Ca_ T�QgAL.E Owner's Name: P1'i t✓t Afl ��1� Date of Application: ) w0 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 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 Sent of the owner: cX) 131 Date Contractor Name Registration No. OR Date Owner's Name .q:forms:Affidav ... ..a . (MMWD\YY). . : : : DATE 06 14 99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE 'CERTIFICATE MYCOCK INS AGCY HOLDER. THIS CERTIFICATE DOES NOT AMEND' EXTEND OR P 0 BOX 437 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COTUIT MA 02635 COMPANIES AFFORDING COVERAGE COMPANY 297SB A RELIANCE INSURANCE COMPANY ' INSURED COMPANY PADGETT BUILDERS, INC. B P.O. BOX 133 COMPANY COTUIT MA 02635 COMPANY i.4 E rt %.!l' :.:::::::::::. .................................... .... .. ... .... .....................................................................................................................................:.:.::.:::::::::.:::...:::.::::::.::....::.:::::::...:..: 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 MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO POLICY EFFECTIVE POLICY EXPIRATION LTA TYPE OF INSURANCE POLICY NUMBER DATE(MM\DD\YY) DATE(MMWD\YY) LIMITS GENERAL LIABILITY GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY, PRODUCTS-COMP/OP AGG. $ CLAIMS MADE a OCCUR. PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT. s EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ MED.EXPENSE(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE. $ ANY AUTO LIMIT - ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per Person) $ HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per Accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY 'AUTO ONLY' EA ACCIDENTS $ t' ANY AUTO OTHER THAN AUTO ONLY: . EACH ACCIDENT; AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ } OTHER THAN UMBRELLA FORM A WORKER'S COMPENSATION AND STATUTORY LIMITS EMPLOYER'S LIABILITY (LIB-955K917-7-99) 06-01-99 06-01-00 " EACH ACCIDENT L $ 106 060 THE PROPRIETOR/ X PAFITNERSAZXECUTIVE INCL DISEASE—POLICY LIMIT $ 500,000 OFFICERS ARE: EXCL DISEASE-EACH EMPLOYEE $ 100;000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS,. THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO' THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE:; ................._.._................._...........:::::::.:: ....:..:.::_::..:...:...::.._:.....::......:..:...:..........:::......:....::.::::...:.:::::::::.:. C£RTII ICATE:H OL ER<::s::>::»:>::>>;::>::>:::>::>::>::>:::>::::>::::>:::>>::>: >::::s:=::>: :<:>::>::::::....::::>::::;>:<:»::>:>::»:»:::>::»::»::: .................................:.:.........:::.:::::::::::::::::::.::::::::::::::::::::.::.::.::::::::::.::::.::::..CANCE�EA�EQK.::.:.:.:.................................................................................................. SHOULD'ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOF[i;•THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL TOWN OF MASHPE E 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE BUILDING DEPARTMENT LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 16 GREAT NECK ROAD NORTH LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. MASHPEE ; MA 02649 AUTHORIZED REPRESENTATIVE t • CIOM: ..S.319..............:....._:.::::::::::::::::::::.::::::::::::::::::::::::::::::::::::::::::::::::::::::::::.::::::....::.:::.:::...................................................................l9AGQ.RO;CQRE±0Et�11iO:N:7993: ........ .....................................................................................................:.....:.:::..:...:...: . ::::::::::::.-:::::::: Appmelix ' ' TabladSZ.2b(eoatWaad) • Pmaiptfre Packages for Qae and Two-FSMUY R—WeatW Buildings fSeated with Final Fads MAXIMUM hurmuM Qom$ Q. cein,g WaU I Floor 8sam..t r Slab Hcui*Coofrag Am'(�) U-vdnr= Rrvaius� Rrvaiwl li vaiu. Wall Puinuw Wacccy� p� R.vab� R•valtxr 3"1 to 690 Hamming De¢sa Dam Q 12-. 0.40 3E 13 19 IO 6 Nozraai R 12% 03Z 30 19 19 !0 6 Ninumi S 12% 030 3E 13 19 !0 6 ES AFUE T 15% 036 3E 13 ZS WA WA N� U 13% U6 3E 19 1 19 10 6 Nannal i gill 270 IR44 is 13 v NMv:: 25 AFIJESMS am 30 19 19 f0 - 6 95AFUE E•/. 03Z 3E 13 2S WA WA Nonnai s•/. 0.42 3E 19±EJEWA23 WA NommiVA 0.42 3E 13 10 6 40AFUE /. 0.30 30 !9 0 6 90A� f1� . I. ADDRESS OF PROPERTY: KftT�4e • V 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED.BY#2): J S.. SELECT PACKAGE(Q—AA-see chart above): �S NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a Qp ;,. Br 'iO tlYYlt!!/Bq It 0 :s s ad"em ` 00 3§,000 d endosed space BOARD OF BUILDING REGULATION[$- I ` License.. ONSTRUCTION, UP�RYISOR=` (MGL C 112S eol) ��� 1A Masonry only � I. Num � 048858 r, 1G 1'82FamilyHomes ' }. 0 a. r Faliure to Qossess a current edition of the 1 �„ ./- �,� � Massachusetts State Building Code f; �•q "15721, Is cause for revocation of this UoenSe. ROBERT 184 SCHOOL ST � ?�?�. u: f, COTUIT, MA 02635 Admin�strator DIG SAFE CALL CENTER (88,8)344-7233 I - _�— - - 07e xo�w�a o�.i�aaoaa/uraelta<' ' u HONE INPROVENENT CONTRACTOR , ;;• l f' F Registration: 100131 . a j Expiration: 06/09/2002 I License or registration valid'for individual f use onl before ex iration date-If found' ! Type: Private.Corporatio - Ij I P , ! return :One Ashburton lace Rm 1301 1 PADGETT BUILDERS, INC. !! Bosto a.021 Robert Padgett I F i i I qf-t�i Box 133/184 School St ADMINISTRATOR Cotuit NA 02635 ! l The Commonwealth of Massachusetts Department.of Industrial Accidents Office of Investigations 600 Washington Street Boston,'MBA 02111 Workers' Compensation Insurance Affidavit Applicant Information: PLEASE PRINT ++ ; NAME - 1141J 1 t?5-D� LOCATION O , X Tc�L, CITY Cgt a-T STATE MA ZIP CODE OU-5 S —PHONE #' 503L{2 -6 O I am a homeowner performing all work myself. O I am a sole proprietor and have no one working in any capacity.' 65�_ I am an employer providing workers'compensation for my employees working.on this job. Company Name S l= As A5r)Q . Address C'ry State Zip Code Phone# Insurance Co. IlCttltrJCE Policy#1IRr1 01-7-7 `jJ Expiration Date t 00 0 I am a sole proprietor, general contractor,or homeowner,(circle one)and have hired the contractors listed below who have the following workers' compensation policies: Company Name Address C'ry State ZipCode Phone# Insuran ce Co. Policy# - . Expiration Date Company Name Address • City State Zip Code Phone# Insurance Co. Polio # y Expiration Date Failure to secure coverage as required under Section 25A of IvIGL 152 can lead to the imposition of criminal penalties of a fine up to. $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby cerri u d the p pe alti f perjury that the information provided above is mie and correct., ,Signature �j Date f Z- 00 Print name Phone# �SOP� Official use only—do not write in this area-to be completed by ciry.or town official _City or town Permit/license# 0 Building Department 0 Licensing Board S 0 Selectmen's Office 0 check if immediate response is required ` _ O Health Department ' 0 Other Contact person Phone# `' Py�FTNEt0�4 TOWN OF BAR.NSTABLE BARNST' ABL$, i 90 NA 039 .`e� BUILDING INSPECTOR ENe/-0 S i' £X/s7/N C pa2 C` APPLICATION FOR PERMIT TO .......... 9! !.G ......f3.l.'.A. 7Q✓.G. .............................................. TYPEOF CONSTRUCTION .....F.r.. .r?.!............................................................................................................... ............ ..................19.%U. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �. !c,......l�c. .............. ?T e✓., . ............................................................................................... ProposedUse ...9 �'t �.t=......�....t��?'.5-.�... .... ....................................................................................................................... ZoningDistrict ..../.P..........................................................Fire District .............................................................................. Name of Owner/.`.?.es.S....... •..f.....h!Cgofu.c.A.r............Address .. ... �'h.e.r.�.r�.e.�3�f........Gp�T.r.�u:.�.�c�... Name of Builder `�,.� 7.....I-.�.� e.�! 66 ..............Address ..SP.r....... e ........... Nameof Architect ....... .......................................................Address .................................................................................... Number of Rooms ..................................................................Foundation ...C..rsax.c.r.A..�._,.................................................... Exlerior ...,51i.!Nyg./.e................................................................Roofing ........ ?sz�.a..L.'T........................................................ Floors ... ...........................................................Interior Heating Plumbing ....................................... Fireplace ........../` ?..................................................................Approximate Cost ....... ® ................... . . Difinitive Plan Approved by Planning Board -------------------_-----------19--------- : 7 6 Diagram of Lot and Building with Dimensions .M Z �- < = U r 0 (D -0 Co 'ma y �L (40 R�c F LL �. ® 0 r 0 0 0 4 Wj � I-� [n W La �r-'1"�. to 1'-. ,LtJ J v f(1�7her/Ne RaQ y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name'.. ^ ,!���..., �. rfa.............. /l 6 f O cd Id Au W m N a ® r-i R; : O ®: ih W -NLU cc °' co m iv 2 all o •Q' r i C ° O ° t O V O O O C N + N y fi E/, GB ,G SYS ;:p TOP FNON. z EL . FINISH GRADE6 �- 'y FINISH GRADE G'VER P. SEPTIC TANK @@! G D MAX. + ; _.�'B istR �G/y for••j d'..a::�:�: .Cd•:4G.a�: 0.•::Q'o�b'0' •v.p.'pP:b'bCpi�'.di•' ,r •A'1•b.•t lO '0 o :o.0•Pe % •o• G•y�/ 4� e� �' :fie•°e 0 G3,93' o' 'pe eo o —C. I. OR P VC TEES a:. .r ee 1500 BSMT FL . o GALLON e: I EL PRECAST" CONCPE TE H= /-0 REINFORCED a. `_: .�tI1D:41'�.d,:y '.4�'�: '•D::O .:bl•l1•:A•Qb' 'V :DSO. w.s. •°. .. 0. ••i:'� .•o,.v . -o•o•. •o:? .•b. .D..e:::. .a.�•J�r .oap° •:V•Y.obA4: a SEP TIC TANK { , INSTALL ON LEVEL BASE a _ KA THERINE ROAD -� w4 too.•20. u` -' ALL _ v ORS st 3. THE i ♦a 77� s� WHEN TO B, ® 3 M M I 4. ANY B Y TI SURVi 5 MA TES COMP ro r' CODE 14.20 r� /c,f- 7' RULE, 20.oo Ti 6. NOR c O b N I 26.10 IS N1 p o ' EXISTING o 7. .FL 001 m ~ DWELLING o ~ B. WA TEI t. 46.00 N Gam'V b 16.30 �..'rooc.f.cep! I�t/e1i fi o .y Lt —�� 100.00 S 06.18'51'W E/, G 7..7..... f ' �t TOP FNON. EL . FINISH GRADEG �� h' FINISH GRADE GYVER SEPTIC TANK i �e,0/�». 6 ooQ�i� 12" MAX. (+;li}4 7fo srA �G� '.Hof''�: �....e;i•b. ;00•,Q�.•a�,O'::Q.e�D'p.P've,•pP.b64p'�.e,•. � .e'ti'C••.r i 0 i 311 P.OoO #j .v 0:;.0• .4• �D j :!e ce 0 G3.9s' o be a ..00bo C. I. OR PVC TEES b� r 1500 IV BSMT FL . J �' ro GALLON p D. y: EL . o '�a�•'v,''� ..: 9 PPECA S T CONCRETE a H- /0 REINFORCED ao i,; � Ib:4Y�.dt:�'.C�'�: 'D.:O a'�!�'Qb"'' Dpp.D'O. w.e. •0. .. o. d,+ �:'�••'�•v► .c•o•. .ore 'b•:D.•s.. . •D.� Pr1;°p� ;q•�..4p7?P: SEPTIC TANK INSTALL ON LEVEL BASE ;; _ `-� KA THERINE ROAD _ I 4 N " ^ r �- - �i.. l,Yo lei r S✓c 1 . 100.00 - OR 3. THE io 77L J Ic Y h MHE TO 4. ANY ,S!: a5 f+ SlstJik 7BY R MA ry ( 5. T! _ coml t. r CM V 14.20 a b R 4i 7 RUL t 20.00 28.10 0 5. NOR e I IS l ho EXISTING 7. •FL OI oilj 'DWELLING o B. MA T1 Z Sri.// �.Si•, ! I N _ \ v 46.00 100.00 S 06'18'51"I✓ -- 4, 70 . GG 7`0,o c B L 8 6 7, ..T_.... i . - tf1 ^ r AJ I•/ .. J a f TOP FNON. .y EL . FINISH GRADE FINISH GRADE 0VER a D SEPTIC TANK o atQO MAX a r.... t n c/r °��•i' °°n....e: ;oo•;c�.ae'::Q.e�De 'c o.Ybo..l • ! 1b,•r i0 311 ! w:Cp' 4 D •o q. L �c b C. I. OR PVC TEES �a QQ �; •o p;a p• �. Dy r ti 1500 a` GALLON r BSMt FL . 'e, o o.o �. o PECA S T COl`✓CF-�E TE I dap°• Q �g a H- / 0' PEINFOPCED t,: `•�r.b�v o,:bo•.apC'dab;:0-b:.:li•!!';o'Qb:p"Dpp:D'�'4'c•°' '°.0 A°' ,. SEP TIC TA NK INS TA L L ON LEVEL BASE ;. KA THERINE ROAD r- ,. �x s��.. �Y.a,�.�- Svc , 1. ALL -- _. -i - -_ `...----•_^' � 1CJ0':UO`• --�I' -- ---_ --- _ _ G o .,... .e. .G =- ,qL;L OR 3. THE 1 WHE TO B Y SUF 5. MA 7 CON r ryk. 14.20 COL RUL ' O N 20.00 a 6. NOA IS o EXISTING :'� 7, •FL G DWELLING N B. WA 7 5. 46.00 16.30 �'� �►I _/off 22 T• ,y t L ��e� W� C 1 ----a 100.00 S 06'1B'51 "W y,oP CIS G G f i . . I7f AT nI •♦J . S YS TEM PROFILE r a NOT TO SCALE FINISH GRADE TOP FNDN. FINISH GRADE OVER OVER TRENCHES EL. FINISH GRADE G 7, H FINISH GRADE CVER DIST. BOX s" •i'o SEPTIC TANK a y, o o 12" MAX. �1 �e•w /a.., moo:v 6 i r .• 3 / 1<1 (rave-r i n s�rr i�a r__. d o.4 4, pC .••pti' ;p0'.�'.a1�•?Q:'Q'vf p•0' •O.o, �4p• .•i•• .e'ti"0•'.1' l0 � � � ' :.e.•f.� o o TOTAL LENGTH OF TRENCH 2 ' T` OUTLET PIPE LEVEL•w �R �6/, a c.o.. �. 3 FOR 2 FT T. MIN. G ' .O O oi• •. : . . o.. ..Q.. , D: Y�Q, := ., . w dA6. 0 p,OoQ .4 10 B" Q ;�: ,Y b• a .w� .r pQ°00�0 � o P; � ee• .� y Qu•, oo ev�o , :o v:0 y"' L3,9S o G3 o Gs�, .r7 G2 90 ' r ' •� C. I. OR PVC TEES � ' o � • a... . r h---1 oo:po• ' �: i 0 0.0 1500 GA L L ON Di'S TRIBUTION BOX b'• BSMT. FL . o,..•• 'o .INSTALL ON LEVEL. BASE fI 500 GALLON OR YWEL L S EL. . o. 9 o PRECAST COl`✓CAE TE 0 sap.'! aid;"a`�::1�0 '•o.•e:;. .o b di.�. �4 H_ 0 REINFORCED i b :/•�i�:oo v,�e�•.bp�'�+ 'O.;p�.:�•O�'Qb'� :�•p�.�,'c' �y°. 7qQ: i TRENCH SECTION SEPTIC TANK INSTALL ON L E VE:L BASE NOTE.' EXCA VA TE TO EL EV ��� OR LONER TO REMOVE ALL IMPERVIOUS „� . MA TERIAL BENEA TH THE L EA CHINE AREA 4" DIAM. 12".MIN. M OF 1/B"— " REPLACE EXCAVATED MATERIAL WITH a• b; a.;o, «o c' b'i o':e;• '�}2}� 3 1/2 .4 0." .b '.• . WASHED PEASTONE CL EAN. CL A Y FREE SAND .3/4" - 1-1/2" WASHED "RUSHED S TONE KA THERINE ROAD TRENCH MID TH J G G GENERA. NOTES rye �/ �- _ .. �X ,,�,,. ky /• - -�" . - 1. ALL ELEVATIONS SHOWN ARE BASED ON ASSUMED . NUMBER OF TRENCHES 1 ' NUMBER OF ORYWELL S 2 z B'24'00"E 2. ALL PIPES IN THE. SYSTEM MUST BE CAST IRON �00.0o c n cr n Ii F' _�- ``,PVC; T ,- - .,• .-_r _ _ .SEA'VA � P.I T 3. THE BOARD OF HEALTH MUST BE NOTIFIED P-9693 WHEN CONSTRUCTION IS COMPLETE PRIOR b PERCOL A TION RATE.• Q .m s TO BA L ING <5 MIN./IN. 3 I 4. ANY CHANGES IN THIS PLAN MUST BE APPROVED NITNESSED BY* BY THE BOARD OF HEALTH AND CAPE 6 ISLANDS o! o .0 3 ( * �. SURVEYING CO.. INC. DONNA MIORANDA 5. MATERIALS AND .INSTALLATION SHALL BE IN BARNS. BAD. OF HEALTH COMPL LANCE MI TH THE STA TE SA TARP DESIGN DA TA — � r DATE: _MAR_9•L2000 CODE - TITLE V - AND LOCAL APPLICABLE � N 14.20 (�� ,G 7 RULES AND REGUL A TIONS %" S tip/-� NUMBER OF BEDROOMS — �� a �' 20.00 _ 6. NORTH ARROW IS FROM RECORD PLANS AND GARBAGE DISPOSAL NO I 28.10 ^ °o IS NOT TO BE [1SE0 FOR SOLAR PURPOSES ,5, _¢ - C.a -- '�r z/2- GAL . to m ,� �o 4 DA IL Y FL ON 330 n, ^ o M 7. •FL OOD HAZARD ZON C ANON-HAZARD) e A. y_. s-• GA L EXISTING �b r.2 i� SEPTIC TANK PEG 'D. 1500 o B. WA TER SUPPL Yi TOWN WA TER �2 SEPTIC TANK PROVIDED 1500 GAL . ao DI✓EL L LNG N ao „ _ o LEA CHING REQUIRED 330 D. 46.00 N to 16-90 SIDENALL AREA = 15P S.F. 'L 2 2 ' _ /z /�ieem..t te�_ v<<•,a, , •,� ..y I'O y k' _�G �' �►� _/o/ 9- -- - 152S. F.X 0. 74G/S.F. = 112 GPO. ,- BOTTOM AREA =,.-929 S.F. • 329S.F.X O. 74G/S.F. _ 243 GPO LEGEND �,�•o LEACHING PROVIDED = 355 GPD , PROPOSED ELEVA TION 100.00 S 06'1e'51"w --G G -- EXrS TING CONTOUR SEPTIC. UPGRADE PROPOSED A DDI TION 06SERVA TION .PI T O DI.!"TRIBUTIDN BOX 'n `G PROPOSED SEWAGE DISPOSAL SYSTEM 70 8 roP ,e -� Ji RENCH _ , ,.`� � PREPARED FOR ji 0 o SEPTIC TANK fir. 0- _ � a x ,- . ���� PADGET T BUILDERS LOT 8 (HSE. N0. 98) KA THERINE L A NE !_..._! RESERVE AREA r � 10 CENTER VIL L E—BARNS TABL E—MA SSDAVID . u G3•yo PIPE INVERT EL EVA TION cH 1`ILE5 s `f +HI Jh'K,) n 4 I . €s att OA TE-�7A.�h 20, 2oa o CAPE 6 ISLANDS ENGINEERING �� �� �� SCALE AS NOTED 800 FALMDUTH ROAD — SUITE 301 PLOT PLAN \Fi�,t E� i�. SCALE.• s "� 2 0 , s,3 cg 98 '�%s�� �.. O• o za Qo MASHPEE, MASS. N ,�l Gar . PLA