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" 1 rr Nr,a ,1„ a 1. r "'t. `'' "' :' -fr �,Cd" ,. .r4'.r r ., <° lC;. ,. ,rR ,,4{1,,.I ,. _ . >,r. :.-:Y ��.Y y� F.' � E� � - � � � � � jm' th��. a• .fir + �v.. •` f r ' ra4 4 y� —f�` /�/ /✓./��r —= f i M rur W ! _ /r/ry — r C`1`Yk[ kN :. ry S� ^2`' ,t• -�,. w4 - t el ' x IL lr it ID ir r .• - S _ o _ c Y • v s ' i 1 • • vw, �. .. .5 llzl if t, - • T _. wi a 41 Or o Y P *C TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION " -- "� �ARPdS Map v v Parcel U TA®I application #A �1(/ Health Division ' s�' �; Date Issued u ,�- Conservation Division Application Fe Planning Dept.} Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project St re t Address ID Village�] /A-&—!::� .. Jf � Owne - f l°h C ��C�/1•� --�-r�Lc)IML Address %n "" Telephone �3 e A If—' Permit Request �- `— � �� lQf-f S /4s AZW cler" /_C ellulove 70ty y A Cc � of eAUPA , / Codo4 11eAJ 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 El`� Two Family ❑ Multi-Family (# units) Age of Existing Structure r 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: -2— existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: dGas ❑ 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 ❑ 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 APPLICANT INFORMATION' (BUILDER OR HOMEOWNER) Name �r�- �917Afadw 2 Telephone Number✓Y 179-0111 Address ocd— License Home Improvement Contractor# oo s ztl Email ('c�/�/�� v�'�Q (�� Worker's Compensation #fUl/�C/ IJ� / 01��✓� ALL CONSTRU TIONN DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO _N( Di rM SIGNATURE DATE r, A• f FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED d MAP/PARCEL NO. t { ADDRESS VILLAGE OWNER E DATE OF INSPECTION: FOUNDATION FRAME .. INSULATION a FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. F S i i++�tgy�t Town of Barnstable e Regulatory Services KASITtic6ard.V.&-.ati,Director q$ a619- Buil ing Division Tom Perry,Building Commissioner 200 Main Street,Hyanuis,i41A 02601 mm,w.tvwn.barnstabte.rna us Office: 508-862-4038 Fax.: 508-790-6230 Property Owner Must Complete acid Sign Tleis Section. If Usin,ARuilde r I, c J(�wk s w ✓"_ as Owner of the subjecr propeny hereby autboaize '`s-� To act on my behalf, in all matters relative to work authorized by this building permit application far (Ad ns—so f;Joli) Pool fences and alarms are the responsibil Lyof the applicant. Pools are not to be filled or utilized before fence is installed arid,all final inspections are performed and accepted. Sig of Owner Signature of Applicant Print Name c Print Narrlc D e Q:FORMS:0%4'NF.RPERI.SISSIONP(X)LS L ' 1 1 1 The Commonwealth of MassackpSeW Department of IndustrialAccidents Office of Investigations I congress street Suite 100 Boston,MA 02114-201 T www.massgov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/ElectriciansMiumbers Applicant Information Please Print Legibly Name(Business/Organintiowbdi%ideal): TUPPER CONSTRUCTION Address:546A HIGGINS CROWELL RD City/State/Zip:WEST YARMOUTH MA 02673 Phone:#:508-778-0111 Are you an employer?Check the appropriate box: Type of project(required)- employees ® I am a employer with 40 C ❑ 1 am a general contractor and I 6. []New jeconstructiontequir 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 shipand have no employees These sub-contractors have 8. ❑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.❑Electrical repairs or additions 3.❑ I am a homeowner doingall work officers have exercised their 11: Plumbing re❑ g pairs or additions myself. (No workers' comp. right of exemption per MGL 12❑Roof repairs insurance required.] r c. 152,§1(4),and we have no employees. [No workers' 13.N Other WEATHERIZATION comp insurance required.] "Any applicant that checks bui#1 must also till am the section below shaving their workers'compensation policy infonnation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside eantmewils must!wbmit a new a ffiiduvit indicating such. �Contzactors that check this box must attached an additional sheet showing the name of the sub-contractors mold state whether ornotthose entities have employees. If the sub-c=tractors have employes,they must provide their workers`comp.policy,number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:AEIC Policy#or Self ins.Lic.#.WCC5005593012015A Expiration Date:10/3/16 Job Site Address: 99 Lake Dr citylstate/zip: Centerville MA 02632 Attach a copy of the workers' compensation.policy declaration page(showing the policy number and expiration elate). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisorsmeni,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 fmmme coverage verification. I do hereby cer16 der th pains an penalties of per,jury that the information provided above is true and cvrreeL 5i nature: f� Date: 8/1/16 Phone#: 508-778-01 Official Use only. Do not write in this area,to be completed by city or town official. City or Tower 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 t. a ACC DATE(MNIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 12/1/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an,endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CAS CT Lora Fit.Gerald Southeastern Insurance Agency, Inc. PHONE ,: (508)$97-6061 - F( .(508)990-2731 _ Ne 439 State Rd. AIL lfita@southeasternins.com AIC ADDRESS: _ _ P.O. Box 79398 M.. urSu S AFFORDING COVERAGE I NAIC# North Dartmouth MA 02747 INSURERA Arbella Protection. .insurance 141360 INSURED RNSURER B Bost:On Insurance Brokers a Inc Tupper Construction Co LLC INSURERC: 546A Higgins Crowell Road INSURER0: ; INSURER E: i West Yarmouth MA 02673 INSURERp_ I < COVERAGES CERTIFICATE NUMHER2015-2016-1 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILR! T TYPE OF INSURANCE $ POLICY NUMBER ICYEFF 1 A EXP 1 LIMITS {X COMMERCIAL GENERAL UASTIM ! g c 1 EACH OCCURRENCE S 1,000,000 A CLAIMS-AAADE F 7X OCCUR ! 9 PREMISE Es ocamnce. .S 100,000 f!!! 9520045209 11/1/2015 11/1/2016 NEDEXP Any one person ;S 5,000 I i ? PERSONAL BADVINJURY IS 1,000,000 I GENLAGGREGATE LIMIT APPLIES PER: 1i !GENERAL AGGREGATE t S 2,000,000 $ POLICY Dl jEeT L"LOC PRODUCTS-COMPtaP AGG)s 2,000,000 OTHER: l� S AUTOMOBILELIABILITY } I a e SINGLE IS 11000,000 A I ANY AUTO (BODILY INJURY(Per perscn) IS AUTO OOS UT ED 8 gSCCHiO SCHEDULED 1020009399 12/1/2015 12/1/2016 BODILY INJURY(Peracmdelu)l S 1 NON-OWNED , PROPERTY DAMAGE k S X HIRED AUTOS x 1 AUTOS ) P I I f Uronsured motorist Bl.solft I6itit S 250,000 UNERELLA UAS l OCCUR EACH OCCURRENCE $ A i EXCESSUAB CLAIIAS-MADEJI I AGGREGATE 8 DIED RETENTIONS 1 4600058368 tititi 11/1/2015 11/1/2016:19 15 WORKERS COMPENSATION I I f TATUTE OR SE TH- AND EMPLOYERS'LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE � 1 EL EACH ACCIDENT $ 11000,000 OFFICERAMEMBER EXCLUDED? ; 1 N 1 A , $ (eAarsdaccry In NH) ! (wCC5005593012015A 10/3/2015 10/3/2016 E.L.DISEASE•EA EMPLOYE $ __1,,OOD,000 It yyes,describe under �. 1 � - �----`—.—. --.� DESCRIPTION OFOPERATIONS bebw i I E.L.DISEASE-POLICY LIMIT $ 11000.000 OESCRIPTION OF OPERATIONS I LOCATIONS I V FAua-ES(ACCORD 101,Addlttonal Remarks schedule,may be mashed it mom.epece is"igmd) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For informational purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Tupper Construction CO.,LLC ACCORDANCE WITH THE POLICY PROVISIONS. 546A Higgins Crowell Road W Yarmouth, MA 02673 AUTHORMED REPRESENTATIVE Lora FitzGerald/MEM ®1988.2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INSD26/2otama f C�t? ��'1??1`l U»ll�'-f�i2p � • �� Y.�, C2'�I�Gt'J'f.��,� f lip 1 Office of Consumer Affairs and Business Regulation r, 10 Park Plaza- Suite 5170� i Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 178434 Tvpe: LLC Expiration: 411 W2018 Trd 410291 TUPPER CONSTRUCTION CO, LLC. RICHARD TUPPER `- 546 A HIGGINS CROWALL RD - -W. YARMOUTH, MA 02673 Update Address and return card.Mark reason for change. sca 1 a 20d-wi/ [ Address i-, Renewal t : EmPloymeot L Lost Card �/r Y:nlJ�/NrirNY,'rIIII ://`"lli,,;r�riw�/ • office orcousumer Affld-1111 "s Regulation License or registration valid for individual use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 4 Registration: 178434 Type: office of Consumer Affairs and:Busiam Regulation . PF% Explratlon: 4l18I2018 LLC lop -Suite$17© 1 TUPPER CONSTRUCTION CO,LLC. RICHARD TUPPER 50 A HIGGINS CROWELL RD Q „ cc: W.YARMOUTH,MA 02873 Uudenecreftry Not without signature - BUILDING PERFORMANCE]I STJTUTE, INC. 107 Hermes Road,SUL-210 Malta,NY 12020 (077)274-1274 www.bpl.org Richard Tu pier ew IDi: - (W REVERSE SIDE FOR DFS4WD1S AND E)(PUWTION DATES) Massachusetts-Department Public Safety Unrestricted->�ildings of any ttssgetup whtch Board of Building f2eguiatiansof and Standards cotioTatn less than 35,000 cubic fed(99nm�of t�n+tru�rt�u Supr�+iq�yr =dosed Space. License:C$469M FAc'hard S Tupper 17 546 A 1s CR+�+dt: wat YaTwouth K4 a� W Failure ao possess a current edition of the Massachusetts StMa Building Code is cam for revocation of this liceme. vJ� „dl'„ c. '` s`''' Expiration For OPS1.1am irrgirdormationvisit: www.Mass,Gov/M Commissioner 121 ewe FtKEE T Town of Barnstable � r Expires 6 months from issue e Regulatory Services Fee * BAMSTASLE 9 '"ASS' $ Thomas F. Geiler,Director 039. �AlFD MA'l A,� r&41 /a, Building Division Tom Perry,CBO, Building Commissioner " 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION . - RESIDENTIAL ONLY A O 0$3 Not Valid without Red X-Press Imprint Map/parcel Number r Property Address - / 5 Za ��^1i o 1t �'La e.�L Residential Value of Work Pl 7 S,6 Minimum fee of$25.06 for work under$6000.00, Owner's Name&Address aQ yy1 e S Fo i e r- gz Contractor's Name Mt ,e1 kjq 0 41A0e /`e_--j()u d d5 Telephone Number $3 3 6 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) �19ac 5` ❑Workman's Compensation Insurance Check one:&I am a sole proprietor �S PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance JUN 6 7 Z010 Insurance Company Name -TOVVN OF BAR STABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. i E - Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) t ( Re-side ,. #of doors ❑ Replacement Windows/doors/sliders.U-Value '(maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License& Construction Supervisors License is required. �J SIGNATURE: Q:\WPFILES\FORMS\building permit fonns\EXPRESS.doC Revised 090809 ' `The Cor`nrnonwealth ofMassachrisetis Department of Industrial Accidents Office.of Investigations a 600 YYashington Street ; ki Boston, MA 02111 >vww.mass.gov/dia' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly. Name (Business/Organization/Individual): J&tea,e e/I�•. �( 2�c✓```�i c��C .s.r , Address: a` ' City/State/Zip: Phone Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4''. I am a general contractor and I 6 New construction r 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 mein any capacity, employees and have workers' 9 Building addition > .. . comp.insurarice.1 ' [No workers- comp. insurance ' - 10.❑ Electrical repairs or additions required.] Y 5• We are a corporation and its _ ' j, c officers have exercised their r 1 L[]F]liimbing repairs or;additions 3. I am a homeowner doing all work❑ {. . right of exemption per MGL -12:QRoof.repairs insurance required.] t c. 152, §1(4), and we have no ^ employees.,[No.workers' 13,❑ Other /►Q S JG�� r� • compAnsurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are'doing.all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether`or not those entities have employees, if the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy anal job site. information. s Insurance Company Name - Policy#or Self-ins. Lic.,#: r Expiration Date: Job Site Address: City/State/Zip. Attach a copy of the workers'compensation policy'declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c:152 can lead to the imposition of criminal penalties of a fine up to$1,500,00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Bead vised that a copy of this statement may be forwarded to the Office of Investigations of the'DIA for insurance coverage verification. I do hereby certify under,the pains.and p, alties ofper'ury that the information provided,above is true and correct Signature: Date: •l {J Phone# Official use only. Do not write in this area, to be completed by city or town official, City or Town:. Permit/License# Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5. Plumbing,Inspector 6. Other y 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 representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair.work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states.that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone numbers) along with their certificate(s) of . insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to'cariy workers compensation msurance If an LLC or LLP doe`s have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should e' requested,not the Department of e application for the permit or license is being p e to the cut or town that the p g q be returned PP Y ' 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 { and printed legibly.y The Department has provided a space at the bottom Please be sure that the affidavit is completepP of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be slue to-fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license 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 provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 www.mass.gov/dia °p1HE T°� Town of Barnstable Regulatory .Services BA"STABLE, ' - 'Thomas F. Geiler,Director . z• ass - 16_19' Building Division Tom Perry, Building Commissioner. 200 Main Street;Hyannis,MA 02601 wwtiv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Sect ion If Us in2 A.Builder as Owner of the'sub'ectproperty I, FYI S I� T c)vy (e .r J hereby authorize 141el 40,Rgerl e�' to act on mybehalf, d in all matters relative-towork authorized by this building permit application for: Za)te 4 r a 4ivil—le", Ik (3 �Z 63 R (Address of Job) �l- a o ' y Signature of Owner '' Date, V (1 rn eS l 61 A l E►� Print Name If Property Owner is applying for permit please complete the ' Homeowners License Exemption Form on'the reverseside. . a . Q:FOR_MS:OWNERPERMISSION ' Town of Barnstable P�0V VE Tp � o Regulatory Services ' Thomas F.Geiler,Director BARNSTABLE, nsass 9� 1639. �� Building Division "lFfly A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone#A work phone fl CURRENT MAILING ADDRESS: city/town state, zip code The Curren exemption tion for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1:1) The undersigned "homeowner"assumes responsibility foi compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner f Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building'permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often resuhs 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. I - To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeex empt.DOC Board of Cwlu:,e Regalatw s an tail r s. License or registration valid`for individul use only F�OME IMPROVEMENT CONTRACTOR before the,ex Whtion date.:If found return to: t; Reg Board of Building ulations,and Standards Reg!#tration 153440 One Ashburton Place Rm 1301 E iration: 92/1/2010 Tr# V614t3 —$ Boston,Ma.02108 G YP ndi-.idual Ia. 'PAICHAEL AUPPER�EE RENOVATIONS m MICHAEL AUPPERLEt / G 169 SANQALWOOD DRF COTUIT MA i 635 Administratpr Not valid wit out s' Nature Massachusetts'-.Department tit Public:Safe" ' Board of Building,# RCgut►iiont ;ititd Standards, x. g'• ,Consttuctibn Supervsar, icense y License CS 49205 Restricted t o: 1G } n5' MICHAEL J AUPPERLEE. `= y 169 SANDALWOOD DR`'-r`; f{ . CO.TUIT, MA 02635 7 .tExpiration: 7/14/2010 T r#: 28358 'vsiurer- i - :• e - • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ,Map Parcel g, Permit# 'O. Health Division �� c Datea sued Conservation Division lf�J �C'�Ol� �rv1 fn�' '"`' Fee, �. ,�Ce `Tax Collector 0 K 1I f � ,r Treasurer 1 �/ Planning Dept. ' Checked in By Date Definitive Plan Approved by Planning Board ii Approved By ,T- g Historic-OKH Preservation/Hyannis Project Street Address Village Owner Address — Telephone r' - A7 r Permit Request OOP5S(P U6-''C- f,5TfO 6 24 X tp-- Square feet: 1st floor: existing fQC3a proposed 2nd floor: existing proposed Total new r �S �-° Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 0' Two Family ❑ Multi-Family(#units) Age of Existing Structure � Historic House: ❑Yes XNo On Old King's Highway: O Yes t Basement Type: o uii Ort-rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq,ft) ABC:. Number of Baths: Full: existing j r Sf/ new Half: existing new Number of Bedrooms: existing 2. new Total Room Count(not including baths): existing new j First Floor Room Count S Heat Type and Fuel: YGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 0 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:Coexisting ❑new size Pool:Cl existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:❑existing ❑new. size n Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded Commercial ❑Yes ❑No If yes,site plan review# Current Use ;. _. .. Proposed Use : ff BUILDER INFORMATION Name l� /y t IG�i�� Telephone Number Address I LAU 2Z License# C � j Q 2- �fS Home Improvement Contractor# �9 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ZA/5'`f'9' SIGNATURE DATE ' r FOR OFFICIAL USE ONLY ' f 1: x 1 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS ,� VILLAGE OWNER" DATE OF INSPECTION: FOUNDATION (�.I FRAME INSULATION FIREPLACE7 ��'� r.�rt-� ELECTRICAL: ,:k©RO.i ' FINAL v'P •�jar PLUMBING: ROUGH FINAL GAS: ROUGH FINAL. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r The Commonwealth of Massachusetts Department of Industrial Accidents Office.of Investigations ' d 600 Washington.Street •$ Boston,MA 02111 V www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/individual): Lcv� -�>L� 0 Address: City/State/Zip: /`'1� Phone#: �q . 6 T-L 7 Are you an employer? Check the-appropriate box:. Type of project(required): 1.❑ I am a employer with 4. ElI am a general contractor and I � 6. ❑ N w construction loyees (full and/or part-time).' have hired the sub-contractors 2.ErI am a sole proprietor or partner- listed on the attached sheet $ 7 Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for mein any capacity. ' workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or.additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑.Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: ` t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500..00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a.fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under,t7p ,and en ties of perjury that the information provided above is true and correct Signature:. ` Date: Phone#: IS-662 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." --q An employer is defined as`an individu at.papnership,association, corporation or other legal entity,or any two or more. of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. Howeyer.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 woik`on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable:evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers compensation policy,please call the Department at the number listed below, Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license 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 to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would file to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents ..Office of Jnvestigatio.n. s r b00 Washington Street Boston,MA 0211 L. Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/-- L _ (508)771-BUGS 7-(508)240-BUGS (2847) ' ZZ(2847) `. omfer`✓ no�c�on's TERMITE'AND PEST GONTROI" 358 WEST MAI.� N--T-•HYANNIS MA`02 �JAMESA.FOWLER,IR (508)771-5008•FAX(508)771-1278" n ' �TMe tq� Town of Barnstable °* Regulatory Services aAs1ABLE, ' Thomas F.Geiler,Director Mug 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 Permit no. Date F' 6-5 AFFIDAVIT HOME MROVEMENT 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ` Type of Work: -" l�f G/� _Estimated Cost r Address of Work: 9 9 o4f u� Owner's Name: ;TA-/ U S fz-� LA_9-L_� Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: / Date o for a Registration No. Date Owner's Name QIon-mhomeaffidav neCURAPP-Ak l Table JS b(giant mued) ` p�eriptire Psekages for One and Two-Fsmily Residential Baildla�Hated wlth Fosse Fulls MAXfMUM MINIMUM all Floor Hasemeat Slab 'HeatinglCooling Glazing Glaring Ceiilmg W perimeter Equipmeat Etliciency' Areas(y°� U-values R.value? R-value' R value° w� R valuer R-value package _ 3701 to 6500 Hntiog Degree Days' Normal Q • 12% 0.40 38 13 19 10 6 6 Normal R 12% 0.52 30 19 19 10 IsAfUE 6 3 12% 0.50 38 13 19 10 ,Normal NIA 016.--- _- 38 13 25 N/A --=-6— --Normal— -- ----- 19 19 10 0.46 38 IA SS AME N V..:..: 15% 0.44 38 13 .. 25 N/A HAM R/ 15% 0.52 30 19 19 10 N/A Normal x 18% 032 38 13 25 N/A NIA Normal y 18% 0.42 38 !9 25 NIA 90AM y - 18% 0.42 38 13 19 10 66 90 AFUE AA 18% 0.50 30 19 19 10 ERTY; �.� �� D� �� s'�� U l•L,L � 1. ADDRESS OF PROP 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:. ;7, � 3. SQUARE FOOTAGE OF ALL GLAZING: GLAZING AREA 4, /o o #3 DIVIDED BY#2): � r / , 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q.forms-580303a 780 CMR Appendix J Footnotes to Table J6.2.1b: lass doors, skylights, and Glazing area is the ratio of the area of the glazing assemblies (including sliding-g ' doves if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall basement windows area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft o f decorative glass may be excluded from a building design with 300&of glazing area• 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3.a. U-values are for whole units: center-of-glass U=values cannot be used. ' ' The ceiling.R-values do not assume a raised or oversized tress construction. If the insulation achieves the full _ insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R.738 _.. i . . -� insulauon•and�R 3�8 insulation aiay b6 stibstrtuted�for-R-49insulation: Ceiling Rvalues=represent-the.sum••o£.cavity—...--... _ insulation plus insulating sheathing(if.used).For ventilated ceilings, insulating sheathing must be..placed between the conditioned space and the ventilated portion of the roof. used). Do not include` 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing ' exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass ,doors.of conditioned. basements must be included with the other glazing. Basement doors must meet.the door.U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' if the building utilizes electric resistance heating use compliance approach 3;4, or 5.• If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest .efficiency must meet.or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see.Table J511a NOTES: , a) Glazing areas and.U-values are maximum acceptable levels.Insulation R-values are minimum acceptable•levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to door components comply Glazing or d p 1?Y if the area-weighted average U- the R-value requirement for that component. g value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). . 43 r FINE?4 Town of Barnstable •1� Regulatory Services ems'"B� ' Thomas F:Geiler,Director �AtE; t►�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder � . I S �—��,.s�,� � • ,as Owner of the subject property hereby authorizes en4 �,>�st . to act on my behalf, in all matters relative to work authorized bythis building permit application for. D (Address of Job) /2 Si of Owner Date t . Print Name QTORMS:OWNERPERMISSION F i -T�e (r� zo�uuea/l/a �./[�GerdaQe t ay ., ae e ILDIiN,GF C�al°1 !Ize , �. License: C(7NA UNION T�� Num�tie 0 a u "," _ !• Tay,no 3 _ LAMiRENY FOfE�STDA Gfl e-�nanr�nom;u'e`�,/ o��/�uaaac�ifsaP� !'� Beard of Building Regulations and Standards = OVEMENT CONTRACTOR J Ke x 21 ! 07 dual LAU'REN F ST. u '. LAUREN STAPL 1 LAUREL OIRCLE �' S Administrator. FORESTDALE,MA 02644 , — J D I. 9 ;t ,.k ar nY�. f RESID�NTIAt BUILDM(;PERMTr FEES APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 4 — Alterations/Renovations $50.00 Building Permit Amendment $25.0.0 FEE VALUE yyOSHEET N W LIMG SPACE square feet x$96/sq.foot= x.0041= 3 plus from below Q1aFP t ALTERATIONSaUNOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus f=ombelow(if applicable) GARAGES(attached&detached) ' _ square feet x$32/sq.ft= x;0041= ACCESSORY$TRUCTLME>120.sq-ft. '. . . . >120 of-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf-1500 sf 100.00 - >1500 sf-Same-U new building permit. square feet x$96/sq.foot= x.0041s •- STAND ALONE PIRXVIITS Open Porch __-x$30.00= (number) , Desk __x$30.00= (number)- gireplace/Chlmney _._____x$25.00= (cumber) Inground Swimrdng Pool $60.00 Above Ground Swimming Pool S25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Vee„ l 3 . 3 ProiCOA oFTHETpy� The Town of Barnstable BARN LE. ' Department of Health Safety and Environmental Services . y MASS 0 1679•PrEo Mpg Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: `c.j, t.-u ¢.fir Map/Parcel: R Project Address: 1 Lcd-L C Builder:Viz, 3 y Q 1n The following items were noted on reviewing: �-�O w Ca.-y-Q. N 0 U Ck n t V-\ CL C L L' 1 L o_ UJ `L 2) /i x to �� 4 1 14 Q.V\C �o Se Reviewed by: �y Q a'I .t, Z2 Date: O 2 Z O 5 q:building:forms:review „ • �QcP��cEtaTfflNc�^-� . �1 c•p �+GE r� -• : f I � � • Rio ��is J„y+s n � . - i L�rllisTtA .: 4„x�x/a-' _ �Zo _ sTuC- Cxtsr�n,� STatRS 9 9 ZAI<,' C-4arrFR UXUZ Tj f; r i i � 1 _ ..�-- -__�_.._ i i �� ` ' � , � � � i �� i � l_._- _.-_�-_�___._ _�_�_ . - � ,- __-�__� ___. .__,. _ _�w_ _-_- ._.�__.�_� __ t :� r ` �� ~� �/ �� ` � \\ , �. / / _ • .. 'i .. �.' '��` � , - i. � . .I _- � i -' ,, .... i .. a �. -- J. . �. r��`� � .. lU HEA 2,x11 fiJ�NDo� �SLA'Mt � . �6.fu.Ank�Nlr ._ L.✓� TO S'=ToN FOuNDf4Trc>k) L✓L' TR/ L)FOUAI=0� ri �_�,� ROD�=NG +S2I�e wA��?o MAtcH��aSTsNv • S Cn.X PL a EA DER • - I J orc,jn . 1 . E I� I 3� 3 X 'yG✓G o r xr r's�uv PT JorSrs �� p. � f 1� zx� �✓L J36s{oM OF�oTSTS L T-8F CovEAD) gv 3/0•PLywooD - L - � I POSTS To 63 L�`'�' — � I T Fi4,srEivc J To 1=Fx�'LTIJGS r xs5 NCB FL o r1WIGS W= C p�awt_ _5PAC Fxu�r�tiCT SAU"aTugES �. r , - x 6a 3 w v .. m AUG 1 1 2005 s �,�` A-TING a' . � - � �'� �x.,ST,tft w� U,•,�8 STex'-f .f�cS 1T?�vaC.. .. � !� . n: �X,STIY4 .2I4x4I4 - • lw .. � .,4 0_ � L"�we.ls � � .. � �IxL T+G. Wm• '1:1'•0"� � .. rAKCIIKG 0 .. m .;. �¢�2xS Qu 91�r0. L)IHoowsC4/ .. 1 Z x24r BO�Em BC CALC®2003 DESIGN REPORT - US Thursday,August 11,2005 10:30 Double 1 3/4" x 9 1/2" VERSA-LAM®3100 SP File Name: BC CALC Project:FB01 Job Name: Fowler Res. Description: Address: 99 Lake Dr. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: Same Customer: Lawrance Devine Company: -Code reports: ICBO 5512,NER 629 Misc: Per Plan 8-11-05 3 � 2 �-7 4 �1� Standard Load-40 psf 119 psf Tributary 0640-00 02-04-00 07-10-00 07-10-00 AL 06-00-00 B1 B2 B3 B4 4775 Ibs LL 2236 Ibs LL 4732 Ibs LL 1571 Ibs LL 3331 Ibs DL 489 Ibs DL 3525 lbs DL 1339 Ibs DL Total Horizontal Length-24-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 24-00-00 Live 40 psf 06-00-00 100% Member Type: Floor Beam Dead 10 psf 06-00-00 90% Number of Spans: 4 1 Reaction from CConc.Pt.B03 aRightring00-00-00 00-00-00 Live 600 Ibs n/a 100% Left Cantilever: Yes ` Dead 776 Ibs n/a 90% Right Cantilever: No 2 Reaction from CConc.Pt.1302 aRightring05-00-00 05-00-00 Live 2775 Ibs n/a 100% Dead 2154Ibs n/a 90% Slope: 0/12 3 Reaction from CConc.Pt.1301 aLeftaring00-00-00 00-00-00 Live 2400'Ibs n/a 100% Tributary: 06-00-00 Dead 1689lbs n/a 90% 4 wall load Unf.Lin. Left . 00-00-00 24-00-00 Live 0 plf n/a 100% Dead 100 plf n/a 90% Live Load: 40 psf Controls Summary Dead Load: 10 psf Control Type Value %Allowable Duration Load Case Span Location Partition Load: 0 psf Moment 10655 ft-Ibs 76.3% 100% 2 2-Left Duration: 100 Neg.Moment -10655 ft-Ibs 79.3% 100% 2 1 -Right End Shear 1210 Ibs 18.8% 100% 5 4-Right Disclosure Cont.Shear 5731 Ibs 89.2% 1000/0 2 4-Left The completeness and accuracy of Total Load Defl. 2xL/207(0.27') 86.9% 4 1 -Right Support the input must be verified by anyone Live Load Defl. 2xU317(0.177') 75.7% 4 1 -Right Support who would rely on the output as Total Neg.Defl. 0.108" 21.6% 4 2 evidence of suitability for a Max Defl. 0.27" 27.0% 4 1 -Right Support particular application. The output above is based upon building Notes code-accepted design properties Design meets Code minimum(2xL/180)Total load deflection criteria. and analysis methods. Installation Design meets Code minimum(2xL240)Live load deflection criteria. of BOISE engineered wood Design meets arbitrary(1")Maximum load deflection criteria. products must be in accordance Minimum bearing length for B1 is 3". with the current Installation Guide Minimum bearing length for B2 is 3". and the applicable building codes. Minimum bearing length for B3 is 3". To obtain an Installation Guide or if Minimum bearing length for B4 is 1-12". you have any questions,please call Entered/Displayed Horizontal Span Length(s)=Clear Span+12 min.end bearing+12 intermediate bearing (800)232-0788 before beginning product installation. BC CALCO,BC FRAMER®,BCI®, BC RIM BOARD-,BC OSB RIM BOARDTm,BOISE GLULAMTm, ` VERSA-IAMO,VERSA-RIM®, VERSA-RIM PLUS®, . VERSA-STRAND'u, VERSA-STUD®,ALLJOIST®and AJSTm are trademarks of Boise Cascade Corporation. i BO�SE BC CALCO 2003 DESIGN REPORT - US Thursday,August 11,200510:30 Doable 1 3/4" x 91/2" VERSA-LAM(g)3100 SP File Name: BC CALC Project:FB01 Job Name: Fowler Res. Description: Address: 99 Lake Dr. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: Same Customer: Lawrance Devine Company: .Code reports: ICBO 5512,NER 629 Misc: Per Plan 8-11-05 Connection Diagram Consult project design professional of record or BOISE technical representative for connection design Member has no side loads. Concentrated loads are not considered in side load analysis. Connectors are:16d Sinker Nails a-2 b L _ d— b=Y c=2-3/4" a d=12" " C o tOISE' BC CALC®2003 DESIGN REPORT - US Thursday,August 11,2005 10:30 Triple 1 3/4" x 9 1/2" VERSA-LAM®3100 SP File Name: BC CALC Project:RB01 Job Name: Fowler Res. Description: Address: 99 Lake Dr. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: Same Customer: Lawrance Devine Company: .Code reports: ICBO 5512,NER 629 Misc: Per Plan 8-11-05 �0 12 7 L-Y I I- � � 1 Standard Load-25 psf 115 psf Tributary P9-06-00 - k'.�`s'��' r i{�'� m ,��k1" , t�s3 � �a irz �f��Cro�•� r ��,fi =��"�� " ��'`ram-„�y 'h.- Ys �.t`�,z-� ¢day�� t BO B1 2400 Ibs LL 2400 Ibs LL 1689 Ibs DL 1689 Ibs DL Total Horizontal Length-12-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 12-00-00 Live 25 psf 09-06-00 115% Member Type: Roof Beam Dead 15 psf 09-06-00 90% Number of Spans: 1 1 ceiling load Unf.Area Left 00-00-00 12-MOO Live 25 pst W06.00 100% Left Cantilever: No Dead 10 psf 06-06-00 90% Right Cantilever: No 2 wall load. Unf.Lin. Left 00-00-00 12-00-00 Live 0 plf n/a 100% Slope: 0/12 Dead 60 plf n/a 90% Tributary: 09-06-00 Controls Summary Control Type Value %Allowable Duration Load Case Span Location Moment 12267 ft-Ibs 51.0% 115% 3 1 -Internal Neg.Moment 0 ft-Ibs n/a 100% Live Load: 25 psf End Shear 3550 lbs 32.0% 115% 3 1 -Left Dead Load: 15 psf Total Load Defl. U340(0.424') 53.0% 3 1 Partition Load: 0 psf Live Load Defl. U579(0.249') 41.5% 3 1 Duration: 115 Max Deft. 0.424" 42A% 3 1 Disclosure Notes The completeness and accuracy of Design meets Code minimum(U180)Total load deflection criteria. the input must be verified by anyone Design meets Code minimum(L/240)Live load deflection criteria. who would rely on the output as Design meets arbitrary(1')Maximum load deflection criteria. evidence of suitability for a Minimum bearing length for BO is 1-10. particular application. The output Minimum bearing length for B1 is 1-1/2". above is based upon building Member Slope=0,consider drainage. code-accepted design properties Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing and analysis methods. Installation of BOISE engineered wood Connection Diagram products must be in accordance Consult project design professional of record or BOISE technical representative for connection design with the current Installation Guide Nailing schedule applies to both sides of the member. and the applicable building codes. Member has no side loads. To obtain an Installation Guide or if you have any questions,please call Connectors are:16d Sinker Nails (800)232-0788 before beginning product installation. a=2" BC CALC®,BC FRAMER®,BCIS, b-3 d BC RIM BOARD-,BC OSS RIM c=2-3/4" a BOARD-,BOISE GLULAMT"-, d-12 • • VERSA-LAM®,VERSA-RIMS, e-3 a o VERSA-RIM PLUS®, Offl VERSA-STRAND VERSA-STUDSUD®,ALLJOIST®and AJSTm are trademarks of • Boise Cascade Corporation. e o 0 —I � b � E^ BC CALCO 2003 DESIGN REPORT- US Thursday,August 11,200510:30 Triple 1 3/4" x 9 1/2" VERSA-LAM@ 3100 SP File Name: BC CALC Project:RB02 Job Name: Fowler Res. Description: Address: 99 Lake Dr. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: Same Customer: Lawrance Devine Company: .Code reports: ICBO 5512,NER 629 Misc: Per Plan 8-11-05 1--io 12 2 1 Standard Load-25 psf 115 psf Tributary 12-00-00 maMey` 3 BO B1 2775 Ibs LL 2775 Ibs LL 2154 Ibs DL 2154 Ibs DL Total Horizontal Length-12-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start ' End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 12-00-00 Live 25 psf 12-00-00 115% Member Type: Roof Beam Dead 15 psf 12-00-00 90% Number of Spans: 1 1 ceiling load. Unf.Area Left 00-00-00 12-00-00 Live 25 pst 06-06-00 100% Left Cantilever: No Dead 10 psf 06-06-00 90% Right Cantilever: No 2 wall load Unf.Lin. Left 00-00-00 12-00-00 Live 0 plf n/a 100% Slope: 0/12 Dead 100 plf n/a 90% Tributary: 12-00-00 Controls Summary Control Type Value %Allowable Duration Load Case Span Location Moment 14787 ft-Ibs 61.4% 115% 3 1 -Internal Neg.Moment 0 ft-Ibs n/a 100% Live Load: 25 psf End Shear 4279 lbs 38.6% 115% 3 1 -Left Dead Load: 15 psf Total Load Defl. L/282(0.511') 63.9% 3 1 Partition Load: 0 psf Live Load Defl. U501 (0.288') 47.9% 3 1 Duration: 115 Max Defl. 0.511 51.1% 3 1 Disclosure Notes The completeness and accuracy of Design meets Code minimum(U180)Total load deflection criteria. the input must be verified by anyone Design meets Code minimum(L/240)Live load deflection criteria. who would rely on the output as Design meets arbitrary(1')Maximum load deflection criteria. evidence of suitability for a Minimum bearing length for B0 is 1-1/2". particular application. The output Minimum bearing length for B1 is 1-1/2". above is based upon building Member Slope=0,consider drainage. code-accepted design properties Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+12 intermediate bearing and analysis methods. Installation of BOISE engineered wood Connection Diagram products must be in accordance Consult project design professional of record or BOISE technical representative for connection design with the current Installation Guide Nailing schedule applies to both sides of the member. and the applicable building codes.To obtain an Installation Guide or if Member has no side loads. you have any questions,please call Connectors are:16d Sinker Nails (800)232-0788 before beginning product installation. a=2" BC CALCO,BC FRAMERO,BCI@, b-3 d BC RIM BOARD' ,BC OSB RIM c=2-3l4" "' a BOARD-,BOISE GLULAM-1 d-12 • VERSA-LAM@,VERSA-RIM@, e'3 0 0 VERSA-RIM PLUS@, C VERSA ST ' VERSA-STUDOUDO,A LLJOISTO and AJSTm are trademarks of • Boise Cascade Corporation. e o 0 � b Page 1 of 1 II I SO BC CALC®2003 DESIGN REPORT- US Thursday,August 11,200510:30 Double 1 3/4" x 9 1/2" VERSA-LAM(g)3100 SP File Name: BC CALC Project:RB03 Job Name: Fowler Res. Description: Address: 99 Lake Dr. Specifier: Botello Lumber Co.Inc. City,State,Zip:Centerville,Ma. Designer: Same Customer: Lawrance Devine Company: Code reports: ICBO 5512,NER 629 Misc: Per Plan 8-11-05 �o 12 1 Standard Load-25 psf 115 psf Tributary o4-" BO 61 600 Ibs LL 600 Ibs LL 776 Ibs DL 776 Ibs DL Total Horizontal Length-12-00-00 General Data Load Summary Version: US Imperial ID Description Load Type Ref. Start End Type Value Trib. Dur. S Standard Load Unf.Area Left 00-00-00 12-00-00 Live 25 psf 04-00-00 115% Member Type: Roof Beam Dead 15 psf 04-00-00 90% Number of Spans: 1 1 wall load. Unf.Lin. Left 00-00-00 12-00-00 Live 0 plf n/a 100% Left Cantilever: No Dead 60 plf n/a 90% Right Cantilever: No Controls Summary Slope: 0/12 Control Type Value %Allowable Duration Load Case Span Location Tributary: 04-00-00 Moment 4128 ft-Ibs 25.7% 115% 2 1 -Internal Neg.Moment 0 ft-lbs n/a 100% End Shear 1195 Ibs 16.2% 115% 2 1 -Left Total Load Defl. U673(0.214') 26.7% 2 1 Live Load: 25 psf Live Load Defl. U1544(0:093') 15.5% 2 1 Dead Load: 15 psf Max Defl. 0.214" 21.4% 2 1 Partition Load: 0 psf Duration: 115 Notes Disclosure Design meets Code minimum(U180)Total load deflection criteria. Design meets Code minimum(L/240)Live load deflection criteria. The completeness and accuracy of Design meets arbitrary(1')Maximum load deflection criteria. the input must be verified by anyone Minimum bearing length for BO is 1-1/2". who would rely on the output as Minimum bearing length for B1 is 1-1/2". evidence of suitability for a Member Slope=0,consider drainage. particular application. The output Entered/Displayed Horizontal Span Length(s)=Clear Span+1/2 min.end bearing+1/2 intermediate bearing above is based upon building code-accepted design properties Connection Diagram and analysis methods. Installation Consult project design professional of record or BOISE technical representative for connection design of BOISE engineered wood Member has no side loads. products must be in accordance with the current Installation Guide Connectors are:16d Sinker Nails and the applicable building codes. To obtain an Installation Guide or if a=2" you have any questions,please call b=3., b —d (800)232-0788 before beginning c=2-3/4" -'-- product installation. d=12" VIN a BC CALC®,BC FRAMERS,BCIS, BC RIM BOARD-,BC OSB RIM C BOARDTA9,BOISE GLULAM-, VERSA-LAMS,VERSA-RIMS, ' VERSA-RIM PLUS®, VERSA-STRANDTm, VERSA-STUD®,ALLJOISTO and AJSTm are trademarks of Boise Cascade Corporation. Engineering Dept.(3rd floor) Map ��r) Parcel Permit# 3 1 4 S House# Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00 430) d - FeA tiy IQ'0 Conservation Office(4th floor)(00-9:30/1:00-2:00) r4`C� � Planning Dept.(1st floor/School Admin. Bldg.) Definitive Plan App Planning Board 19 f IIARNST + CEO MA�'p`•q�"��.7 TOWN OF'BARNSTABLE, rc - Building Permit Application ` Project Street Address 9 q F Village �P44f pa i 11 c AIS 95 OrL G,7 2 Owner 4-v�e- S il'-y C .)L.Oz, Address es yt•,-e Telephone4029 Permit Request e�� !n /S7^ .E 11 CP Z . , r, First Floor ZOO O square feet Second Floor square feet Construction Type b-�®o CR Estimated Project Cost $ a-00 C Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family [ Two Family ❑ Multi-Family(#units) Age of Existing Structure SO KeS• Historic House ❑Yes f <o On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other 89 S e~4 T Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /CR:>O . r>-O Number of Baths: Full: Existing_� New Half: Existing New No.of Bedrooms: Existing `� New Total Room Count(not inc uding baths): Existing New First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central A;Detached Yes Co Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: (size) Z Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ly'Shed(size) 0 A- S t ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number ge—s3 200S_� c. Address n�1), y,c License# s 0!3�c;, /)"1�63 Z , Home Improvement Contractor# IO/G/O'7 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. / ALL CONST UCTION DEBRIS RESULTI ROM THIS PROJECT WILL BE TAKEN TO hj�/'vt S rc�✓f SIGNATURE qt DATE 8 / G PERMIT El EDP F 41i�E FOLLOWING REASON(S) t FOR OFFICIAL USE ONLY :PERMIT NO. } • DATE ISSU ED., , . MAP/PARCEL NO. VILLAGE 1 ADDRESS OWNER DATE OF INSPECTION: FOUNDATION FRAME i INSULATION i FIREPLACE ELECTRICAL: ROUGH ' ' i FINAL PLUMBING; ROUGH FINAL GAS: i ROUGH FINAL R ' FINAL BUILDING'' - DATE CLOSED OUT - ASSOCIATION PLAN NO. R "L. Of VIE T s�axsl•,+az,e, The Town of Barnstable 9� 19�- Department of Health Safety and Environmental Services A,Fp " Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only t 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. r Type of Work: l�ePl� �• bS1 -�• oAst.Cost 3U ' Address of Work: `e✓" -cr�•t` e /"`/A Y - •� i Owner's Name �t�)Ooe` S Date of Permit Application: V J✓' /S 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 ap ly for a permit as t agent of th ow er: 1 08/9 e Da a Contractor Name Registration No. OR Date Owner's Name ' The Connnottircalth of Massachusetts Dc parniz nt of Industtral.-I ccidL •�' 1- OffferOflayest/92MRs 601111•a.dibi turrStreet ?A Boston.Maas. U2111. Workers'Compensation Insurance AMdavit --IZi rm 'tin• —.. - -•,.�..,....�....�..�.._..._...,.__ ---- -- - v 2 . El I a homeowner performing all work-'myself. I am a sole proprietor and have no one working in any capacity [] I am an emplover providing workers' compensation for my empioyees working on this job. omnanv namcr - Idrets• • �tr" nhnnc ft• • incttrance co. "Offer# C] I am a sole proprietor. ;eneral contractor,or homeowner ner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: cmmnanr• namcr adtlrcrc• � I nhnnc/l• incuranre ro. "ofiev 0 cnntnnnv namo- ltldresc• rim nhnnc p• incuranee cO. noffev it Attach additional sheet if necessa�'_....r�_ i.--+,',..,y y_... :•,.:....:. .........•....,.;..,. Frilure to acrurr euverace as required under Section 3A of I%lGL 153 can lead to lac imposition of criminal penalties of a fine up to 51300.UU andior one crars'imprisonment as well as civil penalties in the form 0172 STOP WORK ORDER and a fine ofS100.00 a day against me. 1 understand that a copy of flu%statement may be forwarded to the Office of lavestigations of the DIA for coverage verification. /Jo lterehr cerr/j urrlrr the pain ud pet tries ojp rju,y that the iajormatfon provided above is trae an cc ct Signature Date b s Print name 1/—Qc cJ f`•e.K GL ��tz_c9i't Phone 0 �Oc>�_ (0fricial use only do not,trite in this area to be completed by city or town otliciaf -' city or town: permitAieense tf r1Building Department C3Lfcensing Buard L check if immediate response is required OSeleetmen's Offtcr Otleallh Department contact person: phoneM• rlOthcr i. information and Instructions Massachusetts General Laws chapter 152 section '_5 requires all employers to provide workers* compensation for th .. � cr under any employees. As quoted from the"1a�� . an enrPlnree is defined as every person in the service of an0 th contract of hire, express or implied. oral or written. An emplaver is defined as an individual. partnership, association. corporation or other legal entity, or any two or me the foregoing cnga�,ed. in a_joint enterprise,and including the legal representatives of a deceased employer. or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However t: rn\Iner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dN+-cllin,, house of another who employs persons to do maintenance,construction or repair work on such dwellim_ he or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioy MGL chapter 152 seetion 25 also states that every state or local licensing agency shall withhold the issuance or renewal of, license or permit to operate a business or to construct buildings in the commou�rec for any ;applicant who leas not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor anyof 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 been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and Supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have any questions regarding the "law'or if you are require to obtain a «ori:ers' compensation policy. please call the Department at the number listed below. City oC rowns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for_you to fill out in the event the Office of Investigations has to contact you regarding the applicant. PI be sure to fill in the permit/1 icense number which will be used as a reference number. The affidavits may be returnee tite Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questic please do not hesitate to give us a call. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents ... Office of Investigations 600 Washington Street Boston,Ma. 02111 ; fax#: (617) 727-7749 phone Y: (617) 727-4900 cat. 406, 409 or 375 RECOMMENDED MAXIMUM SPANS FOR FLOOR JOISTS 60.I'S14 LIVE LOAD PLUS 1.0 PS1! DE-4 LOAD Normal Load Duration 1-1, = 1000 Iasi E = L,300,000 Iasi 'I ypic.ul values ror Soutllern-YClloW l'iile #2 (Pressure Treated) Exterior use (e.g. decks) .Dist Size Joist Sl.)�1c1 --�— •11g 2x6 W 2x10 2x12 � � f • 12" 8-6 1 1 -7 14-3 17-4 1611 7-4 '10-0 - '12-4 1.5-0 20 6-7 5-1.1 11-0 13-5 24" 6-o 8-2 104 12-3 Dcsi gn Critcria: Strength: - Live loud f 60 psf )Itls Dead load � b b o l i cif :I0 ps1' produces bending stress of im psi at spalls shown. Note: Design values adjusted ror normal duration loading. Town of Barnstable *Permit#9 Fxplra 6 months from issue darn MARM RM : Regulatory Services FeeKAM o7� Thomas F.Geiler,Director Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601w IT Office: 508-862-4038 Fax: 508-790-6230 APR 18 2003 EXPRESS PERMIT APPLICATION Not Valid without RedX-Press Imprint TOWN OF BARNSTABLE Map/parcel Number 3D /)yC3 Property Address 1 r-))Rjycr C&)� ��)-Z•��(Residential OR ' Commercial Value of Work ��a)o Owner's Name&Address -T#races Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) o q ,/ q 9. ; 1, []Worl man's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name G5500EED aMUYLS I'AMWE COAP Workman's Comp.Policy# 5-0659 6-0 12 D®2 Permit Request(check box) D—Ie-roof(stripping old shingles) Re-roof(not stripping. Going over existing layers of roof) Re-side Replacement Windows. U-Value (maximum.44) ' Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. Signature ' expmtrg �tM Town of Barnstable Regulatory Services 9snxtvest.E,MAM g Thomas F.Geiler,Director 039. q'Arfcv.`0 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION ' MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,'conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost i IV 0 Address of Work: Owner's Name: 3)9MrL5 FA OW 1- Date of Application: 14!f k/G3 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 agent of the owner: U 4, gith VA PWAAAN Date U Contra or Name ': Registration No. OR Date Owner's Name Q:fomu:homeaffidav s u i '� ✓�ie -Varrvnzanurea�i a��%Z�aaaac�ivaelt6 - Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 106141 Exp i ration: 7/22/2004 Type: Private Corporation , STEVEN J.BISHOPRIC INC. Steven Bishopric 1112 MAIN ST UNIT 18 OSTERVILLE,MA 02655 Administrator ✓fie r0amxnwouaeai a��aCaaaacluaetta ' BOARD OF BUILDING REGULATIONS.:License: CONSTRUCTION SUPERVISOR Number: CS O47928 F Bi rthdate: 09/29/1948 Expires: 09/29/2003 Tr.no: 12189 Restricted: 00 j STEVEN J BISHOPRIC PO BOX 656 ( ...,.� . MARSTONS MILLS, MA 02648 Administrator i 9 a A-Z "'�\ The Commonwealth of Massachusetts iN Department of Industrial Accidents ■ _.. I Office ot/ayestigatinos _ 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit locationI I 1 04 H-i/0 city LJS 4EZU _✓h n S5- phone 1! ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worlds in ca achy I am an 1 rovidin workers'compensation for rap employees•working•on•this job.:.:.:::::?.:::::.:..}:::::.:.:::::::: : ::::::: :::::::,?:::,:,}:: ,:: :: ` u I co�tJ v ....................................... r.h... .................:................:.:........:.......................... .. ..... ..... gddress �� c}: :un ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have llowin workers'co ensation polices: :: ;;'::::.:.::.:.:.. :..:.::.:.::.-.,.:::.::..:•:::::.tt,•.:t„t,,,•. ,r;:;;,::;,;;;<: the fo mP . ........... ....................:,::.�.�::::::................::,.:::.:::..............::::. .:. ....::::::::.:::..;..;.:.:}:..�::.::.:..-::>:.:.}}}>:.::;{.}}}::.}}}::}:;::>::»::;<>:<:}::.�;.}}:<.}::. g.................:..::::.:::::::.:::::...........::.::.:.:::::::..::::.::. :::::::::::.:......................... ::::ii•:}i::;:;:{isii:::St:::::i:::::ii::is?;:}: isS Sin:i''rS:vii:t::::ii'si??;:'i::is :;:!ii:;ij%y:.J:i:i ..... ::L:ii`i'riii:':i'{i::ii }::J:•isjM:;;};:{•i}i .:.......:... .}:.::ry:... .... •.. • :.... .. .. ...:..is awman 'name. .:.:.... ... .....::.:::.:. :. .....: ....... ... ...............::....:.::................................ r:m..........r..........:: •.... ......... f..... ....n........................... .............................:::v.v::::.,•:::::::::::4}:::::........::::::::::::.v.v:::::::::::::::.v:::v.v:.v::::::::;:n:}:•}i:}}:.:::.}••n........ ....:.:::::Ji}}}i:;4:::::::::::r.•:x:::::::.v::::v::::...........t....:..:::::::{{:v::::w:::::::v:::::::................:.v.............t:...:...;...:..;;.......::•.:...••vn....y....,}`}�4: ::::.w::nv:::::::::r.:v:::::::.v::::::::v:::::n;{ii}S:;:SSSS:i4:{;;•}ii}};:}}:•}}}:{4;;;•}:{•:4::;{4;;:;%v:ii?::�...:?:?:?:ii:???::::.::':'::ti?::iiii::i$iS::i:i?�i:S�:S{.}:'}:Sin::,;}:?:•}:?{•::4•S'?'}•S}:•S}};:v?:::}n;,}w:•.::;{ r4tih. .. :.r.... .............. ............ r. .-r.;.}:4:ti?C:::... ,........,vtv;::•::: r•v:.}r.;i. r. ... .. .........n...................:::•::v:::r.. ...... ...v:....................• r...??{;54:•'f•}:•}}}:•}::.?wx:?t•...,v.,... ¢ K::Mr..:?v::v ... .... .Y: % .... ..{/....n.vr.. .. ....n. ......, r. .. ... ............ ... ...v:::::•.v:.v ::::::.v......... :..r.........:......:x vv::t:......{•.v.. .,,.�....'.; �:::f .t,...xx...n,.x...••. .......r.... ...r. :••..:..•...v...rn......:�{ r..F r;.�.r....rr....�f::.n..• .}n... ...}......... }..r.....r. ........{.. ...t{:v•...........v.v:::::.......w:rii•:.::?:iv}}:{•:i.}i}}:•i:4}}}'r:•}}}}i}}v:}::v::::::.v::......Y'•::W..t h:t: •.•}...O,rti::.:i: ....r :•:x.•.........r....,.r.... ....-{.::} .v r...n.....x...$..;.:•.v:v......v....r....... .........}:.v:::::.v.............•v::•::.........v:-•:?•:::•:. .....,........................n....r...........:...,v., :. vK,n Y.((...•}.i}: ;...+v?S{•.5............................fr.::�•.....x............v:;f.::.,..n.................:•:::t }.................:•.v:n................... ..........v...... ..:vv�:•:::::::r.•:::......tv .J:•.. ..:::.wn..................••v:.vx:...n..................•:f•::....:...................n..v^::....n............t..n........n..• ..............::•. •v;.v.. - .:....:...:: ............ ...........n. ........ x:r:r.................v........... :....n..... ...:.:.:.....:v.µ:;r.};;?;:is:i?};'}::?}}?y<;':S:ivnn,'?•r�i ..r;\\ TrT�� 4 r.... ....r... ...v.v.... r....... ...... ....... ...:... .. n ......r .r..... .......r...... .:. .::::::::::::::•:x: •.,{:v:.v::::::r.•r: .r. ..r....:::•:.?•....n...µA...,v.r. %•.+S.•r../. .:...v......r..v...::.:w.....r..n4...... .,:{.:S G+{v. .......4......:....:..n....... ...............,...r:•:{.}L};{•}}}}:;:^Yh.................:i`?:{J.:C.::.v::::v:.v .'4,Sr.:w,v........n.......:v.v:. .n.Jr.•. ...v.....::::..:.... ...... ..{v:whtt S.v..J.µ.... \.. ;.}.. ,..... :: ..................t.. ...::r.{Y4 .. r r•m::.v:.t......v fr. ....... ,.....'Q•::::...r:}::•::.::m............. ................................:.:..... ....................::::v:::{?�::;:}::::� . ?::...:............:: •:::x::.;.�?S;.}:•::\,v.+�%?r.•+.. 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Oli - :#'•::wr}:;;o}};}:•:<:};;•;:�::•;}}}h:::.�:::...:::::::<:}:::::::o-::;::•::.::r...,:.:...:.:,...•:...,.,,....... n7A1'AIlCC:tO:::?::;�<>;:z':<,�;?�:x:;!<.;;.}•{;•}}::,:•:;?.:•>:�:;:{{.:,:.:::..�:::�::::.::J:4;:;{•:•}};.;:?.::.}:•:{.}>:;a•::.:::}::>}:>:•:{::�,:.t:::.�•::.:�:•. Fanm a to recme rnverage as req�ed raider Section 25A o[MGL 152 can lead to the imposition of criminal penalties of a Sue up to SI,500.00 and/or one years'imprisonment as wen as dvfi penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand dW a copy of this statement may be fozwarded to the Oifice of Investigations of the DIA for coverage verification. I do hereby certify under dir penalties ofperJury that the information provided above is true.and correct Signature Date _ Print name, official use only do not write in this area to be completed by city or town official permit/license city or town: # ❑fig Department city ard ❑checkif immediate response-is required ❑Selectmen's OIDoe _ ❑Health Department contact person: phone tt; ❑Other d r w Uniud 9J95 PJ/q Val ff'; N0. :5d842E4541 Apr, 17 2W3 03:22em P� �V�rB.r ®dF •a�S 1AL1��11�V .Regulatory Services h Building DivisYou a»o Ca��toner 200'M;4n 8M4 1lY" Mn 02601 �aac: SQ9.790.6230 0$ce: �r�•562�4u3� , icta aind Sign`h is section if � Vs�n property Owl',, ust Bada • I the subject PMP9rq I to not on mybel�elf, bq ' &77- rlori 'rkssj Permitl to ova au i TO 3!DVd SNOS CNN 831M03 ZZE98LL8091 0E ,9T E00Z/8T/b0 V ^, r� �/ Engineeri :(3 ng Deptrd Map �� ParcelV(33' �`� ' Permit# _�z�� ti House# c Date Issued 27 ; •Board of Health Ord floor)-(8:15 -9:30/1:00-4:30) ItlQ ✓Conservation Office(4th floor)(8:30 9:30/1:00-2:00) ' b Planning Dept.(1st floor/School Admin. Bldg.) N$r�C$Y S1" o BE Definitive Plan Approved;by Planning Board 19 ..'ENVIRONAAME CE t T®Wl�I OF BAISTABI:E roe, OEaND Building Permit Application NEGUL AT1®NS Project Street Address 99 Lake Drive Village Centerville Owner James and Geraldine Fowler Address 99 Lake Drive, Centerville, 14A 02632 Telephone 5os-77R-' 602 a 5 Permit Request Building ermit to modifv kitchenoarea inside garage to establish a j bar sink and bar area. First Floor : 200 square feet Second Floor N/A s uare feet q Construction Type Carpentry (interior only) Estimated Project Cost $ 1,000 '. Zoning,District RD-1 Res _dPnti ai Flood Plain Water Protection GP Groundwater D-1 Zoning District Protection District Lot Size .62 acres Grandfathered ❑Yes ®No Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure 29 yrs. Historic House ❑.Yes M No On Old King's Highway ❑Yes X3 No Basement Type: ❑Full ❑Crawl ❑Walkout ®Other N/A Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing .New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ®Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes [INo Fireplaces: Existing 0 New 0 Existing wood/coal stove ❑Yes ®No Garage: ®Detached(size) 2 car Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes El No If yes, site plan review# - Current Use Single family dwelling Proposed Use Single family dwelling Builder Information Name �,Q Telephone Number Address License# ' Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ;/ BUILDING PE IT DENIED FOR THE FO OWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. r f w ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION f r FRAME'",_.-- INSULATION + s FIREPLACE = ELECTRICAL: ROUGH FINAL � . PLUMBING: r'n.—UGf FINAL GAS: '" FINAL co FINAL BUILDINGca ' :.• 20 too DATE CLOSED OUTS r, 00 ` ASSOCIATION PLANIN 9r. in r+ The Conn»onlreallll of:1lassachuselts Department of Inditstrial.-fccitlents • OlfcPallayestlgallans 600 f f'asliittl;fait Street A_ ''• Bustun.,'11u�x. (I2111 Workers' Compensation Insurance Affidavit t info r _mation� ._•. P1i se PRINT iebi�tl'_ ` dliPlirin n2MC• James and Geraldine Fowler Inc ttion• 99 Lake Drive CII�• Centerville (Barnstable) hn -N508-778-6029 1 am a homeowner performin_ all work mvself. I am a sole proprietor and have no one working_ in any capacity � .z �.=Naw.-.1.�trS T.wetw'./1�'.�.-7T.w - .w�aw�.YY�� `.It'�w•.-= Mwr.^r..�-�. .....r - --war —_ r I am an empiover arovi.din, workers compensation for tm• employees working on t °s ob. emmn•trn• name• •tddrr5v city Ithnnc#- incurnncc cn Wolin•� __ [� I am a soie proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed beiow who na the following workers compensation polices: comnani• n•ttne• ntldresc- cin•• nhnne 0- nnlicy _ incnrincc rn cmmn.inv n•ttnc• nddrescr city• Ithnne l�• incur•tncc co ^^lice'a Attache• -Ji_:v. - _-- -..r •"�-+.+ter.• �►..v: �iT .... additional sheet if neccssarv� �,;; -::L'��-==-`;— �.. _ Aftu--r Failure tit secure cttverace as required under Section SA of NIGL 152 can lead to the imposition of criminal penalties ol•a lineup to S1.500.00 andiur unc cars'imprisonment as well as civil penalties in the form of a STOP N%'ORK ORDER and a floc of S100.00 a dap against me. I understand that a cope of this,tatentcut ma a forwarded to the Olrtce of Investigations of the D1A for coverage verification. 1 do hereby cerri tinder the parrs mid p tics ojp rt•that the information provided above is true and correct Sicnature Date /b g 7 Print name James Fowler, Jr. Phone# 508-778-6029 w - oflicial use only do not write in this area to be completed by city or town ofrcial r� cite or town: permitilicense d t'tlluilding Department Licensing Board L check if immediate response is required C3scicetmcn•s Ufftcc ►'• E contact person: phone 4: O11caith Department Other. �rrtrc:rrtnn:� Massachusetts General Lags chapter 152 section 25 requires all emplovers to provide workers' compensation for their employees. As quoted from the -law-. an emp1gree is defined as even,person in the service of another under any contract of lure.igxpress or implied. oral or written. An etyrph rer is defined as an individual, partnership, association. corporation or other legal entity. or any two or more ,,he foregoing cngaued in a joint enterprise: and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership. association or other legal entity, employing; employees. Howevcr the -)caner of a dweliing house having not more than three apartments and who resides therein. or the occupant of the 1xvc1lim_ house of another who employs persons to do maintenance , construction or repair work on such dwcllii- hous )r on the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. •,,iGL chanter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or ene��ai of a license or permit to operate a business or to construct buildings in the commomyealth for an• -hpiicant who has not produced acceptable evidence of compliance-vyith the insurance coverage required. �dditionall�. neither tine commonwealth nor any of its political subdivisions shall enter into any contract for tine crfornnance of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha .en presented to the contracting authority. hhlicants 'ease fill in tine workers' compensation affidavit completely, by checking the box that applies to your situatio» a pplying company names. address and phone numbers as all affidavits may be submitted to the Department of dustrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The 'tidavit should be returned to the city or town that the application for tine permit or license is being requested. )t tine Department of Industrial Accidents. Should you have any questions regarding the "law- or if you are required obtain a .vorkers* compensation policy. please call the Department at the number listed below. . n• or Towns =ase be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of : affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas sure to fill in the permit/license number which will be used.as a reference number. 71re aMdavits may be returned to Department by mail or FAX unless other arrangements have been made. e Office of Investi=ations would like to thank you in advance for you cooperation and should you have any questions. ease do not hesitate to _give us a call. e Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office at Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (6I7) 7274900 ext. 406, 409 or 375 WE The Town of Barnstable 9� 'M �0�' Department of Health Safety and Environmental Services 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. Type of Work: Carpentry- Est-Cost . $1,000 ~Address of Work 99 Lake Drive, Centerville, MA Owner's Name James and Geraldine Fowler Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded.by law Job under S1,000. Building not owner-occupied _Owner pulling own permit t 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: r t Date Contractor Name Registration No. OR Date Owner's Name ' TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE D JOB LOCATION - Number Stree address Section of town "HOMEOWNER" Name Ho a phone Work—phone PRESENT MA LING ADDRESS City/town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Officia on a form acceptable to the Building Official, that he/she shall be responsibl for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Sta Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said ocedu and equirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING FFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER' S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section'-2. 15) . This lack of awarenes often results in serious problems, particularly`-when the Home Owner hires unlicensed persons. In this case our Board cannot,-proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/vier responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. ti 3t�.. STATE 7PROPERTV ADDRESS I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHDPARCEL KEY NO. 0090 LAKE DRIVE 10 RD-1 30C 1000 07/09/95 1011 JJ 42WC R230 083. 142754 NUMBER LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS T Lantl By/Date Dimension LOC./VR.SPEC.CLASS ADJ. COND. VP UNIT AD PRICE IT ACRES/UNITS VALUE Description F 0 WL E R. J AM E S J R& G E R AL D I N E MAP— S"'CD. FF-De m/Acres .4 L AN D 1 101,500 r- CARDS IN ACCOUNT - L 15 1WATERFNT: 1 x' .6 =loc 131 124999.9E 163749.9 .62 10150J #3LDG(S)-CARD-1 1 66,800 01 OF 01 A I #OTHER FEATURE 1 7,000 COST 0— N BATHS 1 .1 U X C= 100 6000.00 6000.00 1.00 6000 8 #PL 99 LAKE DR CENT MARKET 173500 D - NO BSMT S X C= 100 6.7C 6.70 1056 71UU-3 #DL LOT 11C INCOME RG2 DETGAR S 22 X- 24 196 C= 66 16.55 10.92 528 5300 F #RR 0854 0080 USE p SHED S 10 X' 22 196 D= 71 9.7 5.3 220 1200 F #UP FY96 APPRAISED VALUE p J A 175,300 A S PARCLAND SUMMARY T 101500 DGS „q .T 0-IMPS 6 IMPS 7000 M TOTAL 17530C F E CNST E N DEED REFERENCE Tyke DATE Rer:ortlec PRIOR YEAR VALUE A T Book Page t^at. Mo. vr.O salsa Pr c. AND 101500 T S 9403/166YE140/94 270000 LDGS 73800 U 3253/152: 1:10/92 A 100 �OTAL 17530C R 7515/237JTIb5/91 265000 E - - BUILDING PERMIT S` .. Number Dale Type Amount LAND LAND-A DJ INCOME SE SP-BLDS FEATURES BLD-ADJS UNITS 101500 7000 1100- C_m Tot. ,.. T B it! Norm. Obsv. Class Ur.its I Jnils I Base Rate AGI_Flat F--.k:ys,-1- -++a Ape I Depr. ConC. CND Loc %R G Rapt Cost New Atll Rspl Value Stories Me�gM Rooms Fms�Baibs •Fia. Pertywall Fae. 01C+ 000 110 110 64.15 70.57 65 75 19 80 11C 100 88 75370 666JJ 1 .J 5 2 1.1 6.0 Description I Rate 1 Square Feet Rep,.Cost MKT.INDEX:.. 1.00 IMP.BY/DATE: / SCALE: 1/00.69 ELEMENTS CODEJ CONSTRUCTION DETAIL S BAS IJC 170.57 I 1056 74522 Urcuaa I4AtA I U.5 6 SINULE4 DWELLING CNST GP;? , �I T FWD 85 i S.5(-1 288 244o j *1 -------24------* . �TYL ` J3 ANCH----- -- 0.0 11 R i I ! FWD ! f ESlGN ADJMI JZ =SIGN ADJUST 12 12 XT R jALL J1 JOD FRA0 E -- v.ul -L_CTRI_C T14---*-------24---40-*----------* NTER.F.iNl3h -Ju ------ D_.0I_ T I __ U I ! ! ;[NT 4LHYO'JT .SI _ __ _ Ii-CI R Tt4 AJALTY J2'AaME AS_ t7i TER. O.OI A I i i iia BASE ! `LL , „ Z_ 7c; -- ---- - u.0 L E -.let Areas At 288 Ba:e= 105b ! ! jiOJf TYPc -- JG -- --------- O.i �y -- ---- --- ------ ' BUILDING DIMENSIONS - 28 -L E(.f RI�.�;L T 6AS W16 1112 W38 N16 E14 FWD N12 *------------38-----------* ! 0U_WDAT-1ON' - JO -- ---- ------ 99.9 A E24 S12 W24 .. SAS E40 S28 .. ! ! r--- ---- --- -- -- ---- ------- - 1 12 -LEVTcRVILLE COP! W QUA UELAKE) r` L ! ! I LAND TOTAL MARKET ! ! PARCEL 101500 175300 *----16----X AREA 15603 4ARIA:NCE +0 +1023 STANDARD 20 FOUNDATION BSMT. &-ATTIC PLUMBING PRICING - LAND COST ConetWalN ` Fin.Bsmt.Area Bath Room Base -.. :>b BLDG.COST Canc:Blk:Walls Bsmt.Rec.-Room. St.Shower Balk Bsmt. :`�PURCH DATE` —z,. t" %,}NS2 Z.—';Slab - Bsmt.Garage St.Shower Ext. •:ICE Walls Brick Walls,. ,, ^+' .. Attic .&Stairs -PORCH PR Toilet Room Roof RENT '"` + •�'" of Stone Walls "!.- Fin.Attic Two Fist.Bath 4 r Floors Piers. INTERIOR FINISH Lavatory Extra a s,5ac - • •T 23 Sink a J- -i waterco..Extra Attic. O p EXTERIOR WAnotty Pine Water OnlyDoubts Siding lywood No Plumbing Bsmt.Fin. Single Siding lasterboard _ _ '. let Fin. - tA/ - Shingles TILING(' P Bath FI. : Heat _-. /a .D e„•, ;a.On .= `p.; Int.Layout "'4. • Bath FI.&Wains. - _ Auto HL Unit :Veneer Int.Cond. Bath FI.8 Walls Fireplace Brk."On HEATING Toilet Rm.FL. Plumbing r .rr - '' ��i a '•, �,� _ ._i .. Con-.'Brk r Hot Air' Toilet Rm.F1.8Wains. -- Tiling "'-',_ • Steam Toilet Rm.FL&Walls - blanketj'9_i Hot Water. St.Shower - oof Ins.-. Air Cond.' Tub Area Total a • i Floor Furn.. - ROOFING' - _COMPUTATIONS .-Stngle. PiDeleu Furn. rD ij' S.F. p '•� >., - '� I - - - SF No Heat•- . r - S.F. A bs Sh ngl r _ Oil Burne S.F. O O : Slate .r Coal Stoker: - S.F. - - _ ::.. ." v- `�.5..�.. ..,...•a,� �, ..Gas' S.F. ...,.,.�.....- .'Z -.....z!:T"OUTBUILDINGS . ROOF TYPE ElecVlc "` - " ba :,:. Flat S.F. _ 1 2 3 4 5 6 7 8 91101 -..+:.:; 1 2 114 '516171819 10 MEASURED - re. Hip Mansard FIREPLACES `:.S.F. - ". +.' Pier Found ...' .: Floor u Gambrel:; "'•. - Fireplace Stack: / - - - Wall Found' 0.H..Door, - - .FLO RS :�:. Fireplace . ,w :- ., � � •„ Sgle:Sdg �,` a Roll Roofing LISTED s Cone. LIGHTING' -Dble.$dg.„r , ShlnHle.Roof: y No Elect.....,,.:. __ ...:. ,.. `.DATE = Shingle Walls - Plumbing; r ✓"' l - r�-O Hardwood:4':'t- ROOMS- - _ - Cement Blk.. - *` Electric': ,. - ASDh Bsmt...'-..' 1st d TOTALPRICED - ,•'l.. .. I 2nd.. 3rd FACTOR - •wrr : "� i' _ - lV` REPLACEMENT S, OCCUPANCY. )• CONSTRUCTION SIZE .._,AREA'_., CLASS AGE:, REMOD. COND. y. REPL-VAL�� Phy Dep PHYS'�VALUEi Funct DeD. ACTUAL:VAL. - - - ow 96 7`7., �)78 /� -' oa Y .: xi0'a3 }i4 tea,- -t• - �.. .,!` e ...$ t •x?" .� - - ,10,E§<`✓ .x ... - _ :.W, _ ",y'" x.' y�i T4,s'.` o?,% T.i:.^"v aev w ro R:'_, ,. -.. y. .. ....:. .. � ,_...;_... .:. _. r.. ,.. .•.y.rr•.; _. ,;r,, ^x,; `.``a.' ^,1.. TOTAL:. $ ,A' 7` -'�'' .,y,:r.'-q N4, f,. i vr'4r;".+'d', '`"�r t are, ))'3: i .5 F^• - pp �"'a, 'k.;.•i':�.. c:t.. 3 �. ^e ,-,�"" by :. - S. -r T ',. 5- ."" .. M 3 ,;e: ,i i �?.yxa,� F x '..,d. .;. �,^°.• �.s-+. �•sT.tzn.�s^s .:.tu;«bi ..,:,.* r� +r.Y .. A. - � 4 '.'i F. � -m faJ• Jj.• 4 � k .e§,<,..r�,..R_,,v.,.."..+.....«.,._,....,,.ew,.............,,... � __ .. ... ,._ mi.•..a•w._.,.-.+ u" _.,. s.:«_.,..«.i..a..,.�.....*.�«�..�». a..-.b:.�......».°«.....,,.e.,�?'?".«:.u,.".-...-.. _�._... .. ,,,... .-........+ ... _ • .+ .r -'. .._....._.. .4 ._ .. - w"i-.. .,.. -. �fis=.=*�._"- _ :'"x �,;�7,"s' ,:t�? a,..k. �t�t.�$�'� .a-=r +�. n a�>.� '.. rr�^•,� ..�+ -� t.�,r=s°-.' to"4,' _ -.- .. �� . r '�'a.."i� `x.A.« `kar �"we <� .�.�'" .Y' �,a..S � ,ae,,,,s• F.�� ,.? , RESIDENTIAL`-PROPERTY a LOT'NO .,. `^ `7 .;F,, ,'^'F"`, ? + i, .-v '` `o-f Ir ' .+.-•�'' _i FIRE DISTRICT SUMMARY 4 -fir F;, zri5 T S REET Lalc6�.DT de nterville �j LAND 3/ Qom. c 7 to S ..' J: :± .h _ 3 - i•" _ BLDGS. o?. OWNER' 4 �✓ ��\._• a. - C-O- TOTAL, t _ -. •.- LAND 'l :RECORD OF TRANSFER .S c' -DdrE "BK _PW I.R S REMARKS: i .. .. BLDGS TOTAL '.i. C�-: 1l,, "�' -.a•. u. 4-i 5- i .'P LAND . > •:fi�/�O I,fi rsn :�, ,� .f•" } 'BLDGSa. -" 76 rA. r TOTAL Zar / r Z i 'F :f:,G'ti i-�r 1 r f r"'.1.ba. ..... .,�'-.'. a ,y..:.t f .; ".a":: "T .;,Sr_:Y 's-�:. +? �3.,t•�. F: :a..�' �+; .LAND y •�_ BLDGS - .� TOTALLAND- •{ :BLDGS: ?'+Si .-. ... w r TOTAL :LAND wg BLDGS. Ol TOTAL LAND BLDGS. TOTAL _ - isan. - LAND zp INTERIOR INSPECTED:' - '"•' .,. - - . BLDGS. - c/ TOTAL DATE: 7/ LAND - -_ - - •:'ACREAGE-COMP TATIONS BLDGS. »€,LAND TYPE #OF ACRES .PRICE wTOTAL Sw�* r„ ,DEPR f-r„, {,VALUE; TOTAL LAND .CLEARED FRONT • - z BLDGS. _ - b.._ .'-.^REAR TOTAL .. -.WOOD58SPROUT FRONT7;_,..�. -. ...,:: .... �.A... ,..:�.., w:�sr..._. ��rn»-� �'c ""� =x .^-..k __ 'LAND - _.----:.. y � EAR _,y.- , :... ...f., ..� �.ats� OI". .. - - - --- .,.W _ a - - BLDG.S _ T ,�,�Yn'b TOTAL REAR -_ -- - '_ - -- - ,w- .' ..�.". .4 - Land qc;r•t - - - - _ x Ft.. _ w -BLDGS. - -'s,.i •y.: .. - _ °+'Y",}"' _ TOTAL LAND - BLDGS. —LOT COMPUTATIONS .•sm-,z'^ '�' "^ D..FACTORS TO fAL l a•,.y FRON%.a -'DEPTH.. STREET PRICE DEPTH% FRONT FT:PRICE., r-7`TOTAL ,., DEPR. COR -INf ,.f.3:yYALUE"""�,,., HILLY .:^.^ -� - TOWN SEWER - LAND - T ROUGH" TOWN WATER BLDGS. a - - ^•^ . ,`. _ .THIGH. GRAVEL RD. TOTAL ,.LOW. DIRT RD. LAno _ SWAMPY- NO RD. BLDGS. TOWN OF BARNSTA FILE MASS _ — - UNITED APPRAISAL CO..EAST HARTFORD CONN - _- 9& es ArFowlef=Jr. 99�Lake Drive_.. Centerville;NM02632 �May.l9;�199'7 Town of Barnstable Dept. of Health, Safety& Environmental Svices. Building Division 367 Main Street Hyannis, MA 02601 Dear Gloria M. Urenas: This letter is to inform you that L James A. Fowler, Jr., residing at 99 Lake Drive, Centerville, MA, have complied in full with the modifications stipulated by Ralph M. Crossen, Building Commissioner of the Town of Barnstable, MA. These modifications pertain to quarters located on our property behind the detached garage, and are as follows: 1) The stove has been removed and the gas pipes capped off 2) The sink and countertop have been removed- a bar sink will be be installed at a later date Thank you for your cooperation in this matter. Sincerely, �p l/C James A. Fowler, Jr. JAF/mb '�� TOWN OF BARNSTABLE REPORT SUPPLEMENTARY/CONTINUATION REPORT NAME ( FIRnST, MIDDLE) DIVIS /DHY? NOTE DETAILS i OB ERVATIONS-ITEMIZE EVIDENCE, SERIAL 1S ETC. 3 4 cc�n�P�-�- �• JL �� 1� (2��..o�-e GrC t-r- "t- ( �l SUBMITTED BY PAGE /� P 229 . 805 tr US Po§tal Service Receipt for Certified Mail No Insurance Coverage Provided. Do not use for International Mail See reverse Sent to FOWLER Street&Number Post Office,State,&ZIP Code Postage Certified Fee Special Delivery Fee Restricted Delivery Fee LO Return Receipt Showing to r Whom&Date Delivered n Return Receipt Showing to Whom, Q Date,&Addressee's Address 0 TOTAL Postage&Fees Postmark or Date 0 ILL Stick postage stamps to article to cover First-Class postage,certified mall fee,and charges for any selected optional services(See front). 1.If you want this receipt postmarked,stick the gummed stub to the right of the return address leaving the receipt attached, and present the article at a post office service window or hand it to your rural carrier(no extra charge). 2. It you do not want this receipt postmarked,stick the gummed stub to the right of the Ireturn address of the article,date,detach,and retain the receipt,and mail the article. i 3. If you want a return receipt,write the cart rn certified mail number and your name and address M 6 on a return receipt card,Form 3811,and attach it to the front of the article by means of the gummed ends if space permits. Otherwise,affix to back of article. Endorse front of article a RETURN RECEIPT REQUESTED adjacent to the number. Q 4. If you want delivery restricted to the addressee, or to an authorized agent of the10 r addressee,endorse RESTRICTED DELIVERY on the front of the article. 00 5. Enter fees for the services requested in the appropriate spaces on the front of this , receipt. If return receipt is requested,check the applicable blocks in item 1 of Form 3811. l€ 6. Save this receipt and present it if you make an inquiry. a d SENDER: 1 also wish to receive the V ■Complete items 1 and/or 2 for additional services. ra ■Complete items 3,4a,and 4b. following services(for an y •Print your name and address on the reverse of this form so that we can return this extra fee): card to you. v d ■Attach this form to the front of the.mailpiecp,or on the back if space does not 1. ❑ Addressee's Address 4) permit. d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery N t ■The Return Receipt will show to-whom the article was delivered and the date .. M delivered. Consult postmaster for fee. a 'a> (-a Article Addressed to: 4a.Article Number �. P 229 805 384 ` c E James Fowler, Jr. 4b.Service Type g 0 99 Lake Dr. . ❑ Registered ❑ Certified CM N Centerville, MAC 02632 ❑ Express Mail ❑ Insured H ❑ Retum Receipt for Merchandise ❑ COD a 7.Date of Delivery o.� m 5.Received By: (Print Name) 8.Addressee's Address(Only if requested W t and fee is paid) t Q ~ g 6.Signature: Ad ee rAgent) 0 y S Form.11, December 1994 Domestic Return Receipt .��:�.•�°"'��,- <Fi�st='EI��'s"itAail �•.�. UNITED STATES POSTAL SERVICE to F M �_ -Few �; 7 j uL • Print yotr name, as ress, and ZIP Code in t i TOWN OF BAR N S T A 8 L E I BU ILD ING DINIS ION 367 MAIN, ST HYANNI S MA 02601 I II�!t'.'!!{ltll�tl�i!E!!lillfillll!IE.'.'1.1�!!�11t!�fttl!!i�l!!11� FSHE The Town of Barnstable * snxxsrnsie, 9�A ' a►`e� Department of Health Safety and Environmental Services r FD Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner July 22, 1996 James Fowler,Jr. 99 Lake Drive Centerville,MA 02632 Re: c99-L--ake-Drive;Ccnwkrville;.MA� Garage apartment Dear Sir: A review of our records, including the permitting history of 99 Lake Drive,as well as the Zoning Board of Appeals records indicates that the use of that property as anything other than a single family home is illegal. You are hereby ordered to discontinue the current use of the above referenced property and restore it to a garage. You are to accomplish this work and notify this office to inspect within 14 days of your receipt of this letter. A building permit must be applied for to redesign the layout to accommodate the conversion. You must do this before you make any changes. You have the right to appeal this decision. If you so choose,we will be more than happy to help you. If we do not hear from you within 14 days,we will be forced to seek criminal action against you. Sincerely, C% Ralph M. Crossen Building Commissioner RMC/km CERTIFIED MAIL P 229 805 384 R.R.R. p Q960722A