HomeMy WebLinkAbout0044 KNOTTY PINE LANE J
1
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel /0� Application # U"'/ 7
Health Division Date Issued.
Conservation Division Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board vetmo_:
Historic.- OKH _ Preservation/Hyannis
Cmpa-L, s
Project Street Address W4 loomaR,?
Village
Owner T Arlarl.-W? Address k'.0 p1lu-
Telephone 771 ttV—'�-ga o
Permit Request f f
J
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total newer
Zoning District Flood Plain Groundwater Overlay
Project Valuation /Doi 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 Room Count
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑.'existing O'new;maize_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: .
k i
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
-.. .�.
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
(::--.Name �Telephone Number
Address License #
Home Improvement Contractor#
E Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
`SIGNATURE 71-2 QeeJ� (DATE-- � 9 /(a
FOR OFFICIAL USE ONLY
APPLICATION #
DATE ISSUED
MAP/ PARCEL NO.
ADDRESS VILLAGE
OWNER
~ DATE OF INSPECTION:
FOUNDATION ;:F6Pu05 o9)
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
' 6
Department offudustmal AcadTaitr.
Office ufLTPC&66a
600 iiTashbiL#on sheet .
Bas vY4 MA 02HI
sPvvmmas&g`lP1dw
War mrs' CumpeniafimtI Is>—mce xvit:Bulier-rJC1m.tractarsMectdcian&Thmlhers
Applies lufmm atiou Please PrintY
-Na= 7114-Ac� vlr-
Are you an employer?Checkthe appropriate bow TpPe of psaject(required}_
I-❑ I am a emplayerwith 4. ❑I am a genmal caairactor and I
etxtdrkt (fall armor part-dime * e hire the szE� fi. ❑New o
2.❑ I am a sole propdztcff or partner- listed On. the attached sheet 7. ❑11-modeligg
sip and have no employees these sub-cam.hat*e S ❑Demolafiian
tvaddng form is any capacity. erqApyees and have wadmrs' 9. ❑Build addifiou
INa cv�s'Comp.i�„�e comp-in�nce$
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3-K�fI am.a l=wmmx doigg all . ' officars have exercised f nk 1L❑Plumbiagrepaim or adcEtions '
cif per M(M ❑ ��
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Job Mte Addn= MT1StafeM
Arch a copy of the workere compensaflonpoRcy declarat as gage.(showing the policy number and expiration date}.
Farlate to semm coverage as regmredvader Sedmn 25A of MGL c-M can lead to 8ie i mpositioa of cximiaal peaaltses of a
fine up to$154D 4Q andfor one-Tearimpdso m w&as civR peaslfsgs m fhe fb=of a STOP WORK t]RDERand a Effie
of up to -@}tl a day as+�#Fie violator. Be uhised that a copy of this zbh meet maybe furvmded to the Of Ece of
Invesfipa fws ofthe DIAL Ric h=araa�e covemge vedficafic n-
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AWC Guide to Wood Construction in High,Wind Areas:l l t mph,Wind Zone
Massachusetts_Checkiist for Compliance(780 C=INIR53ot.z.l.1)t'
Compliance
1.1 SCOPE
Wind Speed(3-sec,gust).. 110 mph..
y . ..........
Wind Exposure Category ............................................................. B _
1.2 APPLICABILITY
Number of Stories .......................................(Fig Z)....,. stories's 2 stories
Roof Pitch '.............(Fig 2)...................
Mean Roof Height .:..:(Fig )...... ft 5 33' —_
Fl 2 ...
Building Width,W (Fig 3)...... _ft 5 80' _
Building Length,L ................................................:.............(Fig 3)...... .:.....:. ........................ It 5 80'
Building Aspect Ratio(UW) ...............................................(Fig 4) ... .. <_3:1 —
Nominal Height of Tallest Opening2 .... _.I..............(Fig 4).::... ...:...:. .......................
1.3 FRAMING CONNECTIONS .
General compliance with framing connections ........:::....(Table 2)...
F
2.1 FOUNDATION
Foundation Walls meeting requirements of 780 CMR 5404.1
Concrete..... ........ .....
Concrete Masonry..... .............. ... ........: ......:: .........................
2.2 ANCHORAGE TO FOUNDATION a
5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only
Bolt Spacing—general .................................I(Table 4) :...::....:.:. in.
Bolt Spacing from endpoint of plate (Fig 5)..................... .• in.s 6"—12"
plate ...................
Bolt Embedment—concrete..........:...............................(Fig 5).....::...:.:..................:..:..::......... in.a 7"
Bolt Embedment—mason .....................' Fl 5
ry :.. ( 9 )...........................................1in.z 15"
.,
Plate Washer.:............ :::. ' .. .....(Fig 5)..............:.............................:.1a 3"x 3"x'/s"
3.1 FLOORS ;,, r
Floor framing member spans checked .........................: (per 780 CMR Chapter 55)...................................... -
Maximum Floor Opening Dimension ....... ............(Fig 6)............................_ft s 12 or U2 or W/2
Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6) ....... . .......: ..:. ..........
Maximum Floor Joist Setbacks „
Supporting Loadbearing Walls or Shearwall.................(Fig 7).-:................ __ft,5 d
Maximum Cantilevered Floor Joists —
Supporting Loadbearing Walls or Shearwall.................(Fig 8)...................:
—ft 5d .
Floor Bracing at Endwalls ........(Fig 9)......................
:..... —
Floor Sheathing Type ............•....(per 780 CMR Chapter 55)...
Floor Sheathing Thickness`. : :.. .... .................(per 780 CMR Chapter 55)....................... in.
Floor Sheathing Fastening.. ...... ......•.(Table 2).._d Halls at in edge/_in field
4.1 WALLS
Wall Height
Loadbearing walls.. .... .......(Fig 10 and Table 5) ........: _ft.5 10,
Non-Loadbearing walls .....:. ...... ..............(Fig 10 and Table 5).............. ........ ft 5 20'
Wall Stud Spacing ......... .. :_:... !:'...........(Fig 10 and Table 5)..................._in.s 24"o.c.
Wall Story Offsets
... ...........(Figs 7$8). ..................... - ft 5 d
42 EXTERIOR WALLS'.
Wood Studs r
Loadbearing walls......... ......... ....:...........(Table 5)...................
2x ft in: '
Non-Loadbearing walls............. " able 5 ' — —...... .....:.......... R )..... ._...... .........2x ft in.
`
Gable End Wall Bracing — — — —
Full Height Endwall Studs` ................(Fig 10)................
.............
(Fig 11)....... .. ft>W/3`
WSP Attic Floor Length................................................. ..:..:......,... ..:
.... ......
Gypsum Ceiling Length(if WSP not used) ..::._.,_.•(Fig 11) ft z 0 9W"
f 2 x 4 Continuous Lateral Brace @ 6 ft.o.c...(Fig 11)...:... .....::
..............
Double Top Plate —
Splice Length ....................................................(Fig 13 and Table 6)...................................... ft
Splice Connection(no.of 16d common nails)..............(Table 6)........................ ................................
AWC Guide to Wood Construction in High Wind Areas:110 mph Wind Zone
Massachusetts Checklist for Compliance(780 C117R 5301.2.1.1)t
Loadbearing Wail Connections
Lateral(no.of endnailed 16d common nails)..............(Table T).........I....................................
Non-Loadbearing Wall Connections
Lateral(no.of endnaled 16d common nails)...............(Table 8)............
Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
HeaderSpans ..................................................:.....(Table 9).................................._ft_in.s 11,
SillPlate Spans ........................................................(Table 9)......................................................... ft_in.511,
Full Height Studs (no.of studs)...................................(Table 9)................ _—.........................................
Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9)
HeaderSpans..................................................I..........(Table 9)..................................—ft in.512'
Sill Plate Spans.................... (Table 9).................... —
Full Height Studs(no.of studs)....................................(Table 9)..................., —
....................................
Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously"
Minimum Building Dimension,W
Nominal Height of Tallest Opening2 ........................................................... ..... s 6'8"
Sheathing Type..............................................(note 4)..............................
Edge Nail Spacing........................:................(Table 10 or note 4 if less)........................ in.
Field Nail Spacing.......:..................................(Table 10)..............:.
Shear Connection(no.of 16d common nails)(Table 10)...............,.. .....*. ........... ',_.,.. _
.....
Percent Full-Height Sheathing.......................(Table 10)...................... % _
5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts ... "
)......... .. "'
Maximum Building Dimension,L —
Nominal Height of Tallest Opening2.,,,.,"**'*............................_...................... ..... <6'8"
Sheathing Type........................................._...(note 4)......................................................
Edge Nail Spacing...................._...................(Table 11 or note 4 If less)......:.......:......... in.
Field Nall Spacing..........................................(Table 11)............................ —
Shear Connection(no.of 16d common nails)(Table 11).............. —
Percent Full-Height Sheathing.......................(Table 11)...............,........
Wall Cladding
....
oncepts).....................
-
Ratedfor Wind Speed?.............................................................................................................................. _
5.1 ROOFS
Roof framing member spans checked?......:.:..............(For Rafters use AWC Span Tool,see BBRS Website)
Roof Overhang .................................................. —
.(Figure 19).............._ft ssmaller of 2'or l./3
Truss or Rafter Connections at Loadbearing Walls
Proprietary Connectors
Uplift................................................(Table 12)............................................U= plf —
Lateral...:.........................................(Table 12)...................... - p
if
Shear...............................................(Table 12).............:................. - p
Ridge Strap Connections,If collar ties not used per page 21.._(Table 13).......:.............. if
- p T- If
Gable Rake Outlooker.........................................(Figure 20).............. ft s smaller of 2'or L/2
Truss or Rafter Connections at Non-Loadbearing Walls —
Proprietary Connectors
Uplift.........................................:......(Table14)............................................U= lb.
Lateral(no,of 16d common nails)...(Table 14)...................... ...4......L=—lb.
Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59). _—
Roof Sheathing Thickness..................................................... _in.a 7/16"WSP
. ....................................
......
Notes: ...
Roof Sheathing Fastening...........................................(Table 2)............................. --"
..............._ —
1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of
780 CMR 5301.2.1.1 Item 1.If the checklist Is met in its entirety then the failowing metal straps and hold downs are not
required per the WFCM 110 mph Guide:
a. Steel Straps per Figure 5
b. 20 Gage Straps per Figure 11
c. Uplift Straps per Figure 14
d. All Straps per Figure 17
e. Comer Stud Hold Downs per Figure 18a
2. Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing
requirements shown in Tables 10 and 11.
3. The bottom sill plate in exterior walls shall be a minimum 2 in,nominal thickness,pressure treated#2-grade.
j
A,WC Guide to Wood Construction in High Wind
Checklist for i Lance Aso C.l7R 53 12.1..1)
nd Areas: I10 mph Wind Zone
Massach t
Com�3 ( 0
4.
a. From Table 10 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height
Sheathing requirements
b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows;
1. Panels shall be installed with strength axis parallel to studs.
R. All horizontal joints shall occur over and be nailed to framing.
"nl. On single story construction,panels shall be attached to bottom plates and top member 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 lower attachment made to lowest plate at first floor framing.
v. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d
staggered at 3 inches on center per the Figure, Vertical and Horizontal Nailing for Panel Attachment
I
AWC Guide to Wood Construction in Hish Wind Areas: 110 mph Wind Zone
Massachusetts Checklist for Compliance(780 CMR 5301.2.1.1)'
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See Detail on Next Page
Vertical and Horizontal Mailing
for Panel Attachment
o� Toyy Town of Barnstable
Regulatory Services
Richard V.Scali,Director
Building Division
Tom Perry,Building Commissioner
200 Main.Street,Hyannis,MA 02601
www.town.b arnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
4 ,as Owner of the subject property
hereby authorize ' to act on my behalf;
in all matters relative to work authorized bytbis bolding permit application for.
(Address of Job)
Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
r
Date
QF0RMS:0V ERPERIMSI0NP00LS
Town of Barnstable
Regulatory Services
04 raty� Richard V.Scali,Director
4 Raiiding Division
�A mas ASSs Tom Perry,Building Commissioner
59-
p�pr 200 Main Street; Hyannis,MA 02601
wwr?r.towa.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER UCE ESE E ZeUON
'YIeaseYrint
DATE:
JOB LOCATiOx to ki2 j:zre )-e!z4 Ce, 7-CAr
^y�number vDIage
fiOMEOWNER"'// Cry -lneo/► -7 7J , 4q7-A444 tZ
name home-phone-# work phone#
T
CURRENT MAMING ADDRESS: _
city/tnwn s(ata zip code
The current exemption for"homeowners"was extended to include owner-occttpied 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.
DEFIIMON 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 Off cial,that he/she shall be responsible for all such work performed under the bml4iu permit (Section
109.1.1)
The undersigned.`.`homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations. =
The undersigned`homeowner"certifies that he/she understands the Town of Bamstable Building Department minimum inspection
procedures and requirements and that he/she will comply with said procedures and requirements.
Siguatua of Homeowner
Approval ofBuDdmgOificial
Note: Three-family dwellings conaming 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 C:onsfrvction Control
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109JA-Licensing of construction Supervisors);provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor-
(see Appendix Q,Rules Be-Regulations for Licensing Construction Supervisors,Section 2.15) This Iark of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot
proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fuIIy aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that helshe understands the responsibilities of a Supervisor. On the Iast page
of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in
your community.
Q 1wPFUMTORla%uddkg permit fmms=PMS.doe
Revised 061313
`
S
42.99
M ui 34
36 d�S "
M NO, 44 . ;
110.00 ;tJ,
Y> KNOTTY PINE LAN E
AN INSPECTION ICI!][3171
MORTGAGE L® _
SAGAMORE SURVEY ASSOCIATES SCALE: 1 IN.= 50-,, T 1vtO`
P.O. BOX 28 :° DATj4. MAY 26, 20.SAGA ,� Toot
(508 M 888 8667ORE H, MA. 02562 � � � o � �,
c� POPls% h't�.
I CERTIFY TO,CAPE COD COOPERATIVE BANK era. 1,4
THAT THE LOCATION OF THE BUILDING SHOWN HEREON CONFORMS
TO THE ZONING `OF THE TOWN OF BARNSTABLE
- I CERTIFY THAT- LOCUS DOES NOT LIE WITHIN THE FLOOD;- HAZARD
ZONE AS DELINIATED ON MAP 0015C COMMUNITY N0. 250001
PLAN REFERENCE: BARNSTABLE REGISTRY- OF DEEDS REGISTRY OWNER:
BOOK/PAGE: LC NO 32898—B =}T.
LOT NO.: 35 .
. 'PLAN BY: BUYER:
V
DATED.
THIS INSPECTION NOT MADE FROM AN INSTRUMENT SURVEY -AND IS NOT TO f13 USED
FOR FENCES, `HEDGES OR TO ESTABLISH LOT LINES. FOR USE OF BANK ONLY. !
i
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D:-ck wAu to ap?rzzd t_1 K% .Squiars f__t and 14 isthas; iiChove grate Dam—MU is tuilt IA inch a,,vuy fs,=t slat on- mad_ way
and nitl fry itattds. Rtish t-:911nu gilt c.ui t m 2 cauthwas -�n:-5 21.12 str=treat d. 3- it =tuda .8= rsst
it--Ltiy zu .fps F�Zt t4k=.and jrAL '9J With 1.? ini-h J.71 suz_ tam -or.LiTtam. jirtf JVL" ez_ t-T t_ Z.412 p=kaul= to=nt-_j--adv n
�11s��* +itt� 12 ia�ha: _:azt:r Zpatulins s 3i:tnc norastai tti Y f -t 6 ita:ha:.F_ ZV t �,a 12 ins f ,:rt d za,:�?
--ma i thm 3#Est 2p.or . L=cldttg W-In* O_ 1a4 m2II-Z9snY Jets•x ii to to L-sasnm with 2;12 hatg es.A!Marti=-.1du be
,ii=an-ad Pei nta uf?Ct=es imtrtt'-'tl;tu.
TOWN,OF BARNSTABLE BUILDING.PERMIT APPLICATION
Map .� 4' Parcel ?L j Permit#
` ivision Date Issued 2-S —9-9
eoftseffatie� • Fee '2.�.o
Tax Collector "
Treasurer m(f '
Planning Dept.
Date Definitive Plan Approved by Planning Board
f�isteric-off l Pr vi ;
,Project Street Address � a
Village 9161 —
Owner l C KrAw , ll Address &c, li�lfi/l e
Telephone r�
Permit Request (9) Svl c b 011'1UL R epl-. -Dox i"TLA16 b0 -baufs (same siLof
de
Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new
Estimated Project Cost Zonin District Flood Plain Groundwater Overla
1 ��-c�— 9 - Y
Construction Type wb rf_
Lot Size Grandfathered: ❑Yes W:Pd6 If yes,attach supporting documentation.
-Dwelling Type: Single Family Io Two Family ❑' Multi-Family #units
Age of Existing Structure Historic House: ❑Yes W Ko On Old King's Highway: ❑Yes C4-Pd"0
Basement Type: ❑Full ❑Crawl r ❑Walkout - ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)_
-Number of Baths: Full: existing new g -Half:existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new . First Floor Room Count
Heat Type and Fuel: ElGas ❑Oil ❑Electric ❑'Other
Central Air:. ❑Yes ❑No Fireplaces: Existing New Existing-wood/coal stove: ❑Yes ❑No
Detached garage'U existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:Cl existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization. ❑ Appeal# Recorded❑
If yes,site plan review#
Commercial L)Yes M�
Current Use Proposed Use
BUILDER INFORMATION
Nam Telephone Number
Address ' -Crz YOU=. License# a- s 7 4(g
` . . .,
Home Improvement Contractor.# AQ 7`/0
ce�
Worker's Compensation# �C80 S
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATUR ' �4_da�k DATE
� [ o �
T
- FOR OFFICIAL USE-ONLY
PERMIT-NO. '� ,r � _-,. ! . . -. '• ` _ - ... :1 r
y
DATE ISSUED
MAP/PARCEL NO.
ADDRESS bs VILLAGE? A
t.
' - •A � r `ter
OWNER
_ i'
DATE OF INSPECTION s tt , , j r " ; ;•',_. r ,
FOUNDATION ? , t ; - = `? ` t • }
FRAME
INSULATION
FIREPLACE
- ELECTRICAL: ROUGH-' F FINAL
PLUMBING: ROUGH FINAL
ell
GAS: ROUGH .FINAL' tr
FINAL BUILDING + i " • r - �'l; `
DATE CLOSED OUT
ASSOCIATION`PLAN NO.
Window & Door Prime Products Page or
1-lARVEY
Order Form I Harvey Industries, Inc. 725 Huse Road • Manchester, NH 03103-2339
Dealer Name ��/�� Z Z y �c �F<�f.� Account.11 Ship Via Delivery Request Dale Ordered
U Warehouse Truck U Standard -
Address ❑Factory Direct U Special Cusl. P.O.
U Factory Pickup
U Pick up at
Ordered by
Job Name h �3 kPICi
(Delivery Aron)
Wlndo Speciflcatlons• Interior --Exterlo Glazing: Scree Bay/Bow
Typ Slze: Color Co . U CI all U DH Angle: Flankers: Wall Depth: Veneer
Inyl pening rile Whilo _ U Full U CSMT U 10* ❑ 1'5" ❑4 9/16"(STD) Interior:
U Wood U Buck. U Almond U Almond ow E Argon U None U Center DH U 30, U 1'9" U Other U Oak
❑Aluminum U TTT U Bronze U Med.Bronze U Obscure ❑Center PW U 450 U 2'0" -s U Birch
U Stock U Pino U Dark Bronze U Special Temp. Grids: U Multi-point lock U 2'4"
E
Holdod
pe: ❑Catalog Size U Oak Fra U Other U Colonial In-Glass (qof Illes)
nical U Oaktone eplacemenl U Colonial Snap-In
U Nail Fin U Diamond In-Glass
COMMENTS:
Productc . _
Comments
•. glass-boft=Sash)
• � o W E - o•�
�— Vinyl Patio Doors
Colonial
Quantity Size Style Grids Glazing Color
U Standard
U Low-E
❑ Argon
❑ Bevelled
Wall Hardware Prep
Depth
Wood U Brass U Multi-Point Locklnq
❑Stainless system Includes cuslom
rt Deadboll Steel Wheels pollshed brass handle
/ � w
Customer Signalure:
The Town of Barnstable
• =ABN3t• E •
Department of Health Safety and Environmental Services
rFD • Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
For office use only
Permit no.
Date
'AFFIDAVIT ( !
HOME IMPROVEMENT CONTRACTOR LAW'
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the "reconstruction; alterations, renovation; repair, modernization,
conversion, improvement, removal, demolition, or construction of an addition to any pre-existing
owner occupied building containing at least one but not more than four dwelling units or to
structures which are adjacent to such residence or building be done by registered contractors, with
certain exceptions,along with other requirements. f
V�``� 't o�ss
Type of Work: e- ! V +� t' t�� Est. Cost i
Address of Work: '�t't �` Q � P C JAI
Owner's NameR1' AajzL(% A e
Date of Permit A lication: 0 L
D PP
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job under 51,000.
Building not owner-occupied
Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
(I
Date Contractor Name Registration No.
OR
Date Owner's Name
The Commonwealth of Massachusetts
,? -- Department of Industrial Accidents
-- — 00ce 011"ast108t100S
600 Washington Street
" " s Boston,Mass. 02111
Workers' Compensation Insurance Affidavit
name: ,(�
location: l y I -
citV phone#
❑ I am a hVmeowner performing all work myself.
❑ I am a sole et or and have no one workin in aci
ie � � ����,��aaia�ma��,a,���iao��iii��.�iii�
I am an employer provng workers'compensati n for sty employees working on this job.
m an na e.:
address ' W.
�GG
�O
D�
❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who
have
the following workers' compensation polices:
r:.
f!::: ;:i;::.::}: :}>......:S: }}:::+:.f::(:<:i:::::::::::: i::::i::; ::::! i�`:i'viL�?i:�ijiiii?':::� ..........
address.. __.. .. ... :. __:.. :...........:..:.:.:..:.. .::• :..:...:.•.:.:.:..... .:�::::!.:.::
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.. ... ........ ..........
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...............:..:::::::...... n•::::: .....
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blitme# ,r.f:. >. ..
...... ............................................... ... ................ ::::::::.........
.... '5.;...:...
...:.:::::.::.::::::::.::::•:::::::::::•:::::•:::::::::.:::::•::::•::•::.::::::::.�:::::::::::::::::::::::.�:•:::::::::.�:::......:... .:...........::•::::::•::a...........:................
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.........:.
::.:::..
.:. .................................................................................................................................................. w:.c...:.L.:.................:
;:;L::S: '`::: ::::::;; : `::%Y:::::Y:>:::<;:::;>;::`;:R;::i:;:;;;:;:<;;::;:; ::;;:;:::;.'!:!:::;::2;;;r:!;i::::ti::•;:!•::o:::.::u'v.;.>:'->;r::->:::.::
camnX.
any name ;....:,....................::...... :.........
... w.:::: , :„...:....
:...........:::::................................:::.:.:,...... >;:;:::.;:;::::::::::.....:::::...:.....::..:..�
:>:t ><<
address. ..<.;:':...: X.
;:...
:::::. ::::::.::.:::::::::.:::::.:::.: ........................
:..:::....:::.::::.::::::::. •: .:::.:.............:.... .
.................:.:::.::.......::.:.....................
Dewe#= :.........................:....................:...:.:................
..................
............: : :::i;:;;y: ;>::i:i>:: 5;: 5;: is <::;:;+:;;:t :..... is :c::::'•:::;:;:: t;:::::?::::'{r:;:;v:::;::'%4�'�'it
nsnrance.ra..... _.._......._......_ ....... ::»;:;;:;< :;<:>:.;�::>>:;::>:;:.:;.:::,;.;..;;;!::::.,..:»..:L::L::::::::::>�:>>:.>
Failure to secure coverage as required under Section 25A of MGL 152 can Ind to the imposition of a'tminal penalties of a nu ap to$1,500.00 and/or
one years'imprhosmmt as well as civil penalties in the form of a STOP WORK ORDER and a ilne of$100.00 a day against ma I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verinca ion.
I do hereby certify under the pains and pen - of ppedzuy that the informa don provided above is& •correct
Signature , + l Cc �i_ %f Date doh
Print name e;UOZI 001-ZI-1- Phone# / C15 1 S
offidal use only do not write in thh area to be completed by city or town official
city or town: permitlllcaue# �Buiidting Department
OLkensing Board
❑dweckif immediate response h required ❑Selectmen's Once
_ E3Heal&Department
contact person: phone#; ❑Other
0evaW 9/93 PIA)
�r
' GTE �. I
' DEPARTMENT OF PUBLIC SAFETY
Y I.
x
CONSTRUCTIAN SUPERVISOR LICENSE
Number ,,
ryff
Restricted la. 96
A
" APiZ'TllOMATd'T
��HOME IMPROVEMENT CONTRACTOR , - -
� .= rmReglstratlon 100740' 44 ,„ -, 1645 NEWTOWN`RD
Type - PRIVATE CORPORATION' COTUIT, KA 02635
_ •r Ezplration
CAPIZZI HOME .IMPROVEMENT INC
fin.{ s r a
as Caplzzl, ri }
,���ADMINISTRATOR 4645Newton"Rd
..�� 'CotuIt MA 02635 ,4,
i'``°'�{? o,.� ✓fie '[om�rm:rnu�•eallJ�r o��na:iac�ruvel�
DEPARTMENT OF PUBLIC SAFETY
' { CONSTRUCTION SUPERVISOR LICENSE
x Number Expires:
11 � Restricted 1o: 99
THONgS'X -GAPII�l JR
=, 289 PERCIVAL OR
W BARNSTABLE,—MA 02668
� `t� > '��„K 1,—✓JLC �JO�lL9JtO9EllIE[ll.I/1 O�i//GC7J�Q.filllJP,�J- e
r DEPARTMENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Number:. Expires:
r
restricted--To: Be
_ FREDERICE; V 'RASCH II
i060 BOURNE 10
i PLYMOUTH_ MA 023H
`OWN OF BARNSTABLE
LE-
BUILDING
� N@ �� 0N� INSPECTOR
! �� ��
�� DN0N| �8Qb0�� � ������B= Q� � �0 ��
=~ =, = ===, umm �� � "" ��� ���� m �� "=
,
�
�
APPLICATION FOR PERMIT TO . ......................... ''
'
TYPE OF CONSTRUCTION .....
' ----------------l9........
^ .^
| '
TO THE INSPECTOR OF BUILDINGS:
'
The undersigned hereby applies for o permit according to the following information:
Location .k.4.77-3�5
Nome of Builder -------------------_--.A66res -----------
� ' -----------.-----.
/ ~~
Nome of Architect -------------'--------.A6dneso ----------------------------
Number of Rooms ---'7..l=............. —'Fuun6oti
09
Exleho, ' :2~ —'Roofing ' --------_.
v
�
�� .`
Floors —�!�����M�`---------------------'|n�e,io, —.�~. . .............................
Heating — '�~�l�—' — ------Plum6ing ---'/---. .......................................
Fireplace ........................ Approximotp Cost .....
� Difinihve Plan Approved by Planning Board --------------------------------lg--------' � ^ � � 49
� Diagram of Lot and Building with Dimensions �1
� r
�BOARD OF HEALTH
|
TH PROPOSED METHOD OF -PROVIDING FOR,
AND DRAINAGE IS HEREBY APz`
TOWN OF BARN5T
AL b MU
F 1ERMIT. AND INSTALL SYSTEM.
IV
l ----
' A �
I hereby agree to conform to al,0(V@i0Xs a6dWegulations of the Tp�vn 0 nstable regarding the above
| �
.. ..... ---''
� ^ |
8 �
Dacey, William E. Jr. try
DEC 31 1971
No ...1 80... Permit for ......one Story,
.........
single family dwelling
...............................................................................
Location�� Knotty Pine Lane
.. ..............:.............................................
Centerville
...............................................................................
Owner ...........William E. Dacey, Jr.
........................ ......................... L
Type of Construction frame
..............................
................................................................................
Plot ............................ Lot ....... 5....... _�:
I
J .
Permit Granted .........NOY.QmbBx...s.........19 70
Date of Inspection .it�..........19 71
Date, Completed ......................................19
PERMIT REFUSED
................................................................ 19
...............................................................................
................................................... ........................ i
. ............................................................................... 0
................................................................................
Approved .................................................. 19
...............................................................................
...............................................................................
i