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Home My WebLink About0017 LAUREL AVENUE /7 a n , o i J 61 ®a�5 Town of Barnstable' *Permit G Expires 6 thsJro a date M Regulatory Services Fee BA .SrABIJy - A s $ Thomas F.Geiler,Director -P SS .FERMI Building Division Tom Perry,CBO, Building Commissioner FEB 1 6 200 Main Street,Hyannis,MA 02601 201® r® www.town:bamstable.ma.us OF BARNSTARI FZ Office: 508-862-4038 Fax: 508-790- 30 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number a a 6.o -7 -67 Property Address f�-u Y 2Ave- I. YG�i�l V .) C , A. 0 2 l0 3 Z I. ( Residential Value of Work D Ub o ° Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Qy) N e s t cy- 1 -7 Lo-ure-I Ave Crak!jy" l16 t� A 0263z Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ® I am the Homeowner 4 ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. 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) ❑ Re-side of doors. Replacement Windows/doors/sliders.U-Value 7 y (maximum.44)#of windows (o *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.,Historic,Conservation,etc. .,*.**Note: Property Owner must sign Property Owner Letter,of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors.License is required: SIGNATURE: a. ,, C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.0atlook\4STGU5QO\EXPRESS.doc' Revised 090809 The Connmongvealth ofMassacliusetts Deparaneut of Industrial Accidents. O,Twe of Investigations ' 600 Washington Street Boston,M4 02111 mviv.inass:gov/dia Workers' Compensation Insurance Affidavit: Builders/Conk•actors ElectticianslPlambers Applicant Information Please Print Legibly' Name(Businesslorganization4ndividaal): Na 12 L 4 I Y Le S d l e IV- Address: z0 L. Ct u ireAve- " a City/State/Zip: 0 m vi 0?63Phone Cc1l Are you an employer?Check thV appropriate boa: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(fill and/or pert-time). s have hired the sub-contractors 6. View construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7..❑Remodeling sbip and have no employees ' 'These sub-contractors have S. Q I?enwlition working for me in any capacity. employees and have workers' 9. 0 Building addition [No workers' comp.insurance comp.insurance.1 required.] 5. El We are a corporation and its 10-0 Electrical repairs or additions 3.® I am a homeowner doing all work officers have exercised their 11.�Plumbing repairs or additions / myself[No workers'comp. right of emotion per MGL 12_El Roof repairs insurance required.]3 c.152,§1(4),and we have,no employees.[No workers' 13.0 Other ko i n d o w comp.insurance required.] 4 r e-P i ace nee"-I— Any applic=- dial checks box#1 most"fill out the section below showingtheir workers'compensation policy infortnation. Homeowners wbo submit this affidavit indicating they are doing all work aid then hue outside contractors must submit a new affidavit indicating such Contractors that check this bax roust attacl'ed an addidamal sheet showing the name of the sub-contractors and.stare whether or not those entities have enVDyees. If the.sub-contractors have employees,they must provide their workers'comp.policy number. I arrr an employer titat isproi idhW tttorkers compensation insrrance for eery employees. Below is thepolicy rued job skte information. Insurance.Company Name: Policy#or Self-ins.Lie.#: 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 2.5A 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 chil penalties in the form of a STOP WORK ORDER and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement may be-forwarded to the Office.of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pairs and penaties of pa nrf that Me information prmided obaire is true and correct Si lure: a/J'i —2). Date: Phone#: Official use only. Do not dvrite in this area,to be completed by city or town ofciaL City or Town: PerwitlLicense# Issuing Authority(circle one): 1.Board of Health 3.Building Department 3.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#:. Town of Barnstable Regulatory Services vMAM"�$' Thomas F.Geiler,Director. 1639. a 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 HOMEOWNER LICENSE EXEMPTION t Please Print C DATE: re TL4_a-c,!j )7, �0�v /� JOB LOCATION: / U L_LLL�r I A VL . CrLLiq y;be, M D �v3� number h I street village YIG V "HOMEOWNER": � a 1n i . VC.S'1l e` - .5-08'7 75- 936 z goa'�v7 name home phone# work phone# C e.I CURRENT MAILING ADDRESS: 'B ear k 12a aO # D3 l�a�;�l--a ��Y►Y,Gs �L �3y/3y city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner..Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildingXgrmit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements/and that he/she will comply with said procedures and requirements. Signature of Homeolff 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 results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc Revised 090809 F Town of Barnstable *Permit# �w 5 A C9•`z Expires 6 months from Issue date MASS Regulatory Services � Fee_ Thomas F.Geiler,Director s Building Division Tom Perry, Building Commissioner 'P 200 Main Street,.Hyannis,MA 02601 Office: 508-862-4038 ,1 U L 14 20'05 Fax; 508-790-6230 VL EXPRESS PERMIT APPLICATION - RESI N-ItbU BARiV STAB LE Not Varid without Red X Press imprint Zap/parcel Number b 7& roperty Addfessl`1 L a I t Yt: 1f e , C r ai G Residential Value of Work SUDD, a ar Iris, Minimum fee of•$25.00 for work under$6000.00 )wner's Name&Address S - o X S'2 ;ontractor_s_Nan* . Telephone NumberT08-77,<_19 iome Improvement Contractor License#(if applicable) :onstruction Supervisor's License#(if applicable) ]Workmen's Compensation Insurance Check one; I am asole proprietor I am the Homeowner I have Worker's Compensation Insurance nsura ce Company Name Lot M M 14T'Ual Workman's Comp.Policy# 2opy of Insurance Compliance Cerfincate must be on file. ?ermit 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) Re-side 1'1 S l��;o V% Replacement Windows. U Value fie 3 (maxinmim.44)- 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. Sigaature QForms:expmtrg Revise063004 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print � y Name (Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer? Check the appropriate bog:. Type of project(required): 1.❑ I am a employer with . 4. ElI am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors listed on the attached sheet. * ❑ Remodeling 2.El am a sole proprietor or partner- • ship and have no employees These sub-contractors have 8.� ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3. I am a homeowner doing all work. right of exemption per MGL 11.❑ Plumbing repairs or additions ,152 4 ,and we have no myself. [No workers' comp. c. §1O 12.❑ Roof repairs to insurance required.]t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'.comp.policy inforanation. 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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature. Dater 7 / 0 S Phone#: n 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 rI 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-contractor(s)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 pennit/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 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 5-26-05 Revised www.mass.gov/dia .�:w:, .. .. S a e. .`p '- . .a. . r;1i 'Fi n''1,p . - -"N:•.-��y i TOWN OF BARNSTABLE BUILDING.PERMIT'APPLICATION Map r,[ X. �O Parcel _ 82 Application# �Oo 7 Oa ✓1'0S Health Division Date Issued 1 Conservation Division Application Fee S-0 ,�� Tax Collector Permit Fee' 6 Treasurer Planning Dept. -fCaDill 3n1 t, Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis a Project Street Address�� ' au re/ VC a Village `(� `-ai ow, Ile 0 C32' �n W Owner Qhc cs, er Address Q Telephone s o g- 7 7 S" 9 3(,') , c�. Permit Request i ,.c - X Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation X Construction Type r t +-v-ce fed Lot Size S�e e h-%a Grandfathered: Zyes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Pt-el 11100'S Historic House: ❑Yes No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) hn V) Basement Unfinished Area(sq.ft) Number of Baths: - Full:existing-1 y new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing � new First Floor Room Count 7 Some Heat Type and Fuel: ❑Gas ❑Oil 'P Electric ❑Other Central Air: ❑Yes )i 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 `-- --- - BUILDER INFORMATION Name , Telephone Number=0_2 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE 2Z�-n cfltl / DATE l D — t , FOR OFFICIAL USE ONLY APPLICATION# 13 13 DATE ISSUED MAP/PARCEL N0. ADDRESS - VILLAGE OWNER DATE OF INSPECTION: h FOUNDATION - ' FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING �kov- DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents ff Office of Investigations 600 Washington Street _ Boston,MA 02111 www.mass.gov/dia Workers`Compensation Insurance.Affidavit: Builders/Contractors/Electriclans/Plumberg Applicant Information L Please Print Leeibly Name (Business/Organization/Individual):. O Y hn A --- A n a 9'V e-S Ter Address: 10- 1 7 City/State/Zip: Y % it A Phone.#: !�®9 7 7 S Are you an employer? Check the appropriate box: . I am a general contractor and I Type of project(required):. FT4 1. I am a employer with ❑ g . employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction . 2.❑ I am a-sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees 'these sub-contractors have < +g ❑-bemolition 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 doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no •13. Other CI Ye -�a rewLn employees. [No workers' comp. insurance required.] , *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M 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 be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify:ender thepains and penalties ofperjury that the information provided above is t t rue and correc Signature• �e-&4 �• l�.td�tu Date: 71h,6 /40 � Phone#: S 09 a 7 7 S_ 936 - 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information anti 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 insurnce 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-contiactor(s)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 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 Washingto-6 Street Boston, MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 ,?�-vmmass.govfdia °FTME,�ti Town-of Barnstable y�P Regulatory Services MASS. � Thomas F.Geiler,Director 9 $ . 4 16.19. a� Btuldincr Division ' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 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 containirig 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. j� p ob Type of Work: D G G Il �NS?kUC71 G Estimated Cost Address of Work: �I) LAUREL AVE Owner's Name: �7't/V 7 ��S TC -.- Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 QBuilding not owner-occupied EjQwnei pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORD DO NOT HAVE ACCESS TO THE ARBnRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR /OAq/'O 7 �. Date Owner's Name Q:fc=-,hcmeafridav CONNECT TO HOUSE WITH JOIST HANGERS EXISTING HOUSE 1"x 6"DECKING (TYP.) (2)2"x 6"BUILT UP BEAM 10"SONOTUBE (TYP) '-4 N 4"x 4"POST(TYP) (3)2"x 6"BUILT UP BEAM A ' A TA '-0" 7'-0" 7'-9" (2)2"x 6"BUILT UP BEAM 21'-6" 2"x 6"JOIST 16"O.C. (TYP) PROPOSED 2"x 6" BUILT UP BEAM TO BE CONNECTED TO EXISTING 2"x 6" BEAM OFyi RAIL AND DECK PLAN VIEW JOOHNL. o CHURCHILL tiY�� SPINDLES PER R SCALE: 3/16" = 1' U Cl L CODE (TYP.) No. 807 1"x 6" DECKING (TYP.) I 10"SONOTUBE EXISTING (TYP.) GRADE z DECK SECTION VIEW SCALE: 3/16" = 1' PREPARED BY: 17 LAUREL AVENUE JC ENGINEERING, INC. PREPARED FOR: 2854 CRANBERRY NANCY N. NESTER HIGHWAY EAST WAREHAM, MA 02538 SEPTEMBER 29, 2007 JOB#1279 OF THE r Town of Barnstable Regulatory Services BMMSTABLE, : Thomas F.Geiler,Director Building Division ED MA'1 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 11 Please Print DATE: TLk)L, (7 U7 JOB LOCATION: 1 7 GE-1.i1(C;I \fC Y CG Vl I L number street village "HOMEOWNER": 1`l G';,I e tit S-v 2- 7 s-- 9 3 G� name home phone# work phone# CURRENT MAILING ADDRESS: 17 Lw-ky, .l Auc IN/) A vZI city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies.that he/she understands the Town of Barnstable Building.Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of H eowner 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 results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt p/ Joa No.eos-ol O� c �c BENCHMARK--TOP & CENTER OF ° CONCRETE BOUND=5.03 NGVD29 5 EXISTING HAY BALE LINE _ 5.03 p <0 NOT TO pa SCALE N/F ¢ LOCATION MAP , MARGARET EMBREE FISHER , eED-- l EXIST. 4" PVC PIPE & STONE �Ox Q P �Q� old drain pipes NOTES 5.j 5 1. LOCUS IS A.M. 226, PARCEL 76. 2. ELEVATIONS SHOWN ARE NGVD29. 5.G•v Oc/ S�v�e` J 3. LOCUS IS IN FLOOD 4. PER OWNER: (SEE2. a0�"ES A10 & BON FIRM DATED 4 OCT. 17,2003--PIPE AND 10 YDS. STONE IN- '.:.�� I 0 STALLED BY HAND. 40 YARDS SANDY SOIL SPREAD AND SEEDED WITH RYE- 9 �// II`I :.N�O NOV. 9, 2003-- YARDS LOAM SPREAD AND L \\\ PLANTED WITH RYE AND FESCUE. Pi \\ II 0' HAYBALES CONTRACTED'TO BE INSTALLED BY NOV.14, 2003. 6 �0 \\�� II (f1 5.6 ��\\` (n 5. PER OWNER: W 6.96 ` APRIL 20, 2004-EXPRESS BUILDING PERMIT ISSUED \V 4 TO REROOF, RESIDE, AND REPLACE 7 WINDOWS. \ ��,�/> END OFF MAROOBUILDER DISCOVERS UNSAFE WALLS ::' v 5 . _ I g`___� 8:t :•8.5 7.23 20N6 P N/F DUNE TO REPLACE MISSING�WALLS &CEILING ISSUED :.. EXIST. 4" PVC �\NMARGARET PIPE & STONE �- ��\S 0 �O SGP��.f�000 1aN�6 EMBREE FISHER 8 - toGF - ::':: � / MAURA/MCCAW { Po�i / 1 0 ca�� 1 cc)' `10.5 EXIST. STONE W/O PIPE EXISTING CONDITIONS PLAN FOR THIS IGIN A VALID COPY DSIGNA IT BEARS NORWOOD REALTY TRUST • AN ORRIGINALL RED STAMP.AND SIGNATURE. LOT C, 10 LAUREL AVENUE, CRAIGVILLE, MA JULY 22, 2004 SCALE: 1"=10' L,EGIM RONALD J. CADILLAC, PLS, RS PROFESSIONAL LAND SURVEYOR & REGISTERED SANITARIAN .5 117 EXISTING k PROPOSED ELEVAnONS('X'MARKS POINT) P.O. BOX 258. —6— EXIsnNG CONTOUR WEST YARMOUTH, MA 02673 —B-- PROPOSED CONTOUR HEALTH AGENT APPROVAL DATE (508) 775-9700 PAGE 1 OF 1 OC 2004 BY R.J. CADILLAC I PERMIT PAYMENT RECEIPT TOWN OF _B,ARNSTABLE �� 0 F BARNS TA B L I: o• "��-�-Rom-- BUILDING DEPARTMENT _` ° , 200 MAIN STREET _( �� '"� HYANNIS, MA 026.01 106588 ��" DATE: 04/08/08 �� ✓�� 3� TIME: 10:36 TER,N.ANCY N TR ------------- ----TOTALS----------------- 3LE FAMILY HOME PERMIT $ PAID 50.00 5 Zoning District RC Permit Type: DECK �,�,�) AMT TENDERED: 50.00 AMT PPLIED: 50.00 . g 30.00 Contractor PROPER, CHANGE: _ :00-_•. - � (� . _ k $ 50.00 License Num OWNER APPLICATION NUMBER: 200706588 PAYMENT METH: CHECK Is 0 �5 ✓ �� ,/�� PAYMENT REF:. ` 5355 �.... APPROVED PLANS THIS CARD MUST INSPECTION HAS 1 /N� CERTIFICATE OF, y V �r Owner on Record: VESTER, NANCY N TR BUILDING SHALL. ,�� ' Address: P O BOX 182 INSPECTION HAS BEEN MADE. ST ALBANS BAY,VT 05481 Application Entered by: JL Building Permit Issued By: THIS PERMIT CONVEYS N0;RIGHT,TO OCCUPYANY.;STREET,ALLY,OR SIDEWALK,OR A ART Ti4EA0fjj4THU TEMPORARILY OR PERMANENTLY; ENC.ROACHEMENTS.ON PUBLIC PROPERTY NOT SPECIFICALLY-PERMITTED UNDER THE BUII DING CODE;MUST BE APPROVED BY THE JURISDICTION: STREET OR ALLY GRADES'AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM:THE DEPARTMENT OF PUBLIC WORKS ,. ..,, THE'.ISSUANCE OFTHIS PERMIT DOES NOT RELEASE.THE APPLICANT;FROMTHE CON.DITIONS OF ANY APPLICABLE SUBDIVISION;RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FO y ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF rs Norman R Vester p �( !82 Bay, VT 05481 61 usn 41 , t Q• r- ---- -- ----- III PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE :- z BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 DATE: 04/08/06 TIME: 10:36 ------------------TOTALS-------------------- PERMIT $ PAID 50.00 AMT TENDERED: 50.00 AMT APPLIED: 50.00 .CHANGE: .00 APPLICATION NUMBER: 2.00706588 PAYMENT METH: CHECK PAYMENT REF: 5355 ti. - i °FtNE r Town of Barnstable °^ Regulatory Services * BMWSTABLE. + MAS& Thomas F. Geiler, Director •i639 ♦0 1639 Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Date: C To: � C a�tc�DO� -- 5-, l a RE: Permit for property located at For project: .U070658 0CX� "✓/�/� We have attempted to reach you by telephone on several occasions. Your permit is ready to be picked up at 200 Main Street, Hyannis in the Building Department. We are open Monday through Friday from 8:30 AM to 4:30 PM (excepting holidays). OD The balance that is owed for this permit is $ 50, 'RJR and is payable by personal/business check of EXACT CASH. If you have any questions or wish to cancel this permit, please contact us at(508) 862- 403 8. Thank you. Q:\WPFILES\FORMS\permitready.doc ' I l ;, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ` . �. Parcel 7�O Permit# ii M Health [division b� Date Issued(a R I �y wo L we Conservation Division ��^ �Y� , Application Fee - Tax Collecfo)r �r �� i 0Y Per Fee 45, °`I A — Treasurer_ Planning Dept. SEPTIC SYOM MUST SE INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board WITH TITLE 5 Historic-OKH Preservation/Hyannis ENVIRONMENTAL CODE ANDTOWN REGULATIONS Project Street Address D ' L-a re A V e mcke- Village Cyak% avi Ile- Owner G e- s f e r Address L a to re A ye> Crai V' 11 c Telephone .SO S' - 7 7 S- �(3 G D_ thou `Permit Request e o a Y i vh 90 * down _to the eXi S�l►ifi -fl oor eer0i V1 e S a.-r-ne, -� o o 1-P,r i-,A-) C.o c- re.R I&C e me►��-; Square feet: 1st floor: existing /q0 proposed l 0 2nd floor: existing proposed Total new (Tans b-j P►2S. ,;. Zoning District Sec Flood Plain Groundwater Overlay ' Project Valuation UhIfoc 4DLO 000,Construction Type F rcme- Lot Size Sc e- 121 ans Grandfathered: Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure C&A 1100 'S Historic House: CA Yes ❑No On Old King's Highway: ❑Yes No Basement Type: ❑Full 1d Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) all Number of Baths:. Full: existing new Half:existing NA new Number of Bedrooms: existing a new b e i r 5 M Total Room Count(not including baths):existing new bey _ First Floor Room Count Z reb�.� It Heat Type and Fuel: ❑Gas ❑Oil Electric ❑Other Central Air: ❑Yes 1 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:U.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 T BUILDER INFORMATION Name` I W 5 Telephone Numb er• S'09' 275+ 3:6 -Z- Address- License# Cu b a b 3 _1 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �tt,,,,�,o s{-Gr= I�A,cb w•�er SIGNATURE DATE a t , FOR OFFICIAL USE ONLY t - - ` PERMIT NO. -IDATE ISSUED MAP/PARCEL NO. , ADDRESS V I LL-AGE OWNER DATE OF INSPECTION: FOUNDATION FRAME r ` INSULATION ,3 FIREPLACE r ELECTRICAL: ROUGH FINAL- , i PLUMBING: ROUGH FINAL . S GAS: ROUGH m FINAL > S FINAL BUILDING m C9 n S v M cz c DATE CLOSED OUT ASSOCIATION PLAN NO. =c' w a l-:z m S RM i RESIDENTIAL BUILDING PERNIIT FEES AppLICATION FEE r . New Buildings,Additions - $50.00 Alterations/Renovations $25.00 ! Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot=- �`�� x.0031= �b� plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-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 as new building permit; square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost OF THE ram, Town of Barnstable Regulatory Services A A lAMSTrABLE, Thomas F.Geiler,Director 9`bA,F 3;�s`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: ��i Y C w►G t. �'r. Estimated Cost t.t qlt,% Address of Work: 17 1-auY L Au e C CQ.i a- v i (te M k o a L 3 Owner's Name: v�C Ve-S e'c 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 Contractor Name Registration No. !� 3 o A-n Date Owner's Naile / Q:forms:homeaffidav V f ==J The Commonwealth of Massachusetts Department of Industrial Accidents < 600 Washington Street Boston.,Mass. 02111 Workers' Com ensation.Insurance Affidavit-General Businesses • yak x�t.�;.:aRr"`emu.. 's.}.9A?c�';-ey,,zp.<, a'w+,�:.: `•••r,n' .: � _ 'E':A,c'ni , name: Ile. 5 address• A je /l city C`C state: zin: o,-7�3:?- yhone# -5 S— 7 75P work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/BaAating Establishment worlang in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an em lover with etn to ees(full& art time... ❑Other o rn c®ia9v�c r /% %///m/3— �I am an employer providing workers' compensation for my employees worlflng on this job.. company•name:..' :•: address: .- r: IN citV� phone.#��• •. 0 I am a sole proprietor and have hired the independent contractors listed below who have the following workers'. compensation polices: company name: address: phone- ` '#i cify . insurance co..... No E 6. com D en `n eiree p v address:. •. .• ::� . :,-'. •' '; , ill . p' one�#� C1tV. ' msuranc_eo: DO lcv*' Fallure to secure coverage as required under Section 25A.of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me,.I understand that g copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date G/V 3/Cl� .. ..• Print name P Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# []Building Department . 1 _ ❑Licensing Board ❑check if immediate response is required []Selectmen's Office ❑Health Department contact person: _ phone#; ❑Other , (revived Sept 2003) Information and Instructions II Massachusetts General Laws chapter 152 section 25.requires all employers to provide workers compensation for their. employees.. As quoted from the t`law",an employee is.defined as every person in the.service, #f another under any contract of hire, express or implied; oral or written. an individual partnership, association, corporation or other legal entity, or an two or more of An employer is defined as ,p hip, n, rp gY the foregoing engaged in ajoint 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 einploys_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 bean employer.... MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, address and phone numbers along with a certificate of insurance 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 Accidems. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill.in the permit/license number which will b�e used as a reference number. The.affidavits may be returned to the Department by mail or FA3X unless other arrangements have been made. ; The Office of Investigations would lice to thank you in advance for you 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 Mce of Westlgadons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 Town of Barnstable Regulatory Services BAVMABIE, : Thomas F.Geiler,Director MAM �4, .•� Building Division ABED 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: l �C-i.(re_j V `1 number' street village "HOMEOWNER": Q;Y]C.0 — 7 75- lq362 - name J home phone# work phone# CURRENT MAILING ADDRESS: 17 0 U re- e city/town state zip code The current..exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less-and -- to allow homeowners to engage an individual for hire"who does not possess a license,provided that the owner acts as - supervisor. DEFINITION OF HOMEOWNER r, Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to ' be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such _ "homeowner shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed-under the building permit: (Section 109-1 1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other - applicable codes,bylaws,rules and regulations. The.undersigned"homeowner"certifies that he/she understands the.Town of Barnstable Building Department - - minimum inspection procedures and requirements and;that he/she will comply with said procedures and requirements. Signature of Hom owner 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 exennp.�from'the provisions of this section(Section 1091.1-Licensing of construction Supervisors);provided that if the homeowner engages a persbn�s7 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 results in serious problems,particularly when the homeowner hires unlicensed.persons. In this case,our.Board cannot proceed against the unlicensed personas it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ... - To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by -weral towns. You may care t amend and adopt such a form/certification for use in your community. FINE ram, Town of Barnstable *Permit# Expires 6 tnonths from issue date BAMS.,BLE, : Regulatory Services Fee grass Thomas F.Geiler,Director' t639. �0 p'E01A°'`a Building Division t Tom Perry, Building Commissioner! Xe 200 Main Street, Hyannis,MA 02601 �, ' Office: 508-862-4038 r s APR > O 2004 Fax: 508-790-6230 EXPRESS PERMIT AP CATION '- :,RESIDENTIAZOMMF SARNST Not Valid witlio,ut Red X Press' Imprint ASLE j f2� Map/parcel Number L b�'S `��.a�a�� , Property Address' VC C Y [�]Residential Value of Work Gwn a 0, n o 0 Owner's Name&Address h P O Box VT 0, Contractor's Name c3 Y Q 0 r� S K 6 Telephone Number 0 z 7�-� -Q-?so Home Improvement Contractor License#(if applicable) i s 3 ,y Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: t F ❑ I am a sole proprietor ® I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name O m G Workman's Comp.;Policy# Copy of Insurance Compliance Certificate must be on file. r Permit Request(check box) , r ,•r s i Re-roof(stripping old shingles) All construction debris"will be;taken to -w�bSt Cam- i7 Ca to,. Oa/Re-roof(not stripping. Going over, existing layers of roof) Rie-side s. , , i 4 [replacement Windows. U-Value"(I (maxnrium *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 Permissiori. Home Improvement Contractors License'is required. Signature ; GdTt I Q:Forms:expmtrg Revise053003 f , Town of Barnstable *Permit Expires 6 months from issue date t GD ,,,�,�� = Regulatory Services Fee v� MAW. Thomas F.Geiler,Director Building Division f Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 w iF Office: 508-862-4038 Fax: 508-796-6230 EXPRESS PERMIT APPLICATION Not Valid without Red X-Press Imprint Map/parcel Number 676 Property Address 01 LQ q ref Ave- , 1 ra i q V` @` " Value of Work Residential OR [�Commercial Owner's Flame&Address v (5 0 7 7 _17 _a a v211 ' p o S I�anS a O S a� . Contractor's Name L!S��I� Telephone Numberp� Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: am a sole proprietor FI am the Homeowner • � a- l I have Worker's Compensation Insurance Q� 'C Insurance Company Name V1 A A 113 IMU" N O 0 . Workman's Comp.Policy# Permit Request(check box) MA Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) Re-side Qf Replacement Windows. U-Value 0, 33 (maximum.44) FM Other(specify) IYKJ[ *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic.Conservation.etc. Signature a expmtrg / 3 0 V G°✓�,--C_ �J 7'1 Oc�✓1 / �JT/YY�� a alrl kc--Zl JL) Sox V7- cl zE WO c CL h �+•q ..qy T V : v Ln •r o rVI o" Csv �� 7 75 - 93G 2 t rs. I _ �acwoc �15 '77— Al 1 T � - T �-7 7 -Z->I Ill I I III Kill I i OWN- ME�mm -ON MEN mom Emmom ON MEMENNNE mmimmmommommmm MEMEMMEN No MEMMEM No M MEMEMEMMMM MEM t / � o � r _ mmmm NINON No loom M INN M 0 0 ENE I mom OMEN 0 MEN mom mmmm NNE No mom NOMEMENEEME M mom M M M ME r y loom M ON MEN MMMMEMM 0 NNE mom ME NNE M M MEN m ENE M mom M M ME NNE MINE ME NONE ME ME 0 mom ON mom 0 NOME M ME mom ME ME ME 0 No NMI No No 0 ONE ON I NNE No M 0 ENE molmo NNE IMMEMEME moomm mom ENNNNE MEMO- NOME M No No y„ ..mom . i t r ----� i" r - ----_ ._ __. . ._ i'� ;� �;" ��; 1 .�� v v i 1 NONE mmm MESSIMMEM MISSION Em MOM NOW M Kill IN min I No IN INS IM IN 11M ME MAN ME MOME OMEN MO NONE 0 ME MMOMMEM MOM MEMO mom • MIN 0 ME MEMO mom mimmomm MOM NEE MEN MEEMMEMEMEMEMEM NEE NEESE M MEMEMMEMEM r.m... MEMEMEMM SOMEONE ME mom MENOMONEE M MEMOS mom EMMEEMSEEMEMM ME M IMENEEMEME ME ME ME mommom ME 0 M ME MEMNEEMEMOMEMOMMEMMENE mom ME ME EMEM M so mom u■ME 0 m mom ME No i No �i i■�■■i� �i ■nuu�■ i C } e J I N f r rwn'.�v.' •. r+Y.aa:w.cim.. .xr� a a+.e.r�..w.o.` .a.r...ta..... ....n. .�.r... � a. ... Y F f { i MAXIMUM FEASIBLE COMPLIANCE APPROVALS REQUESTED: NOTES m BUOYANCY CALCULATIONS-PUMP CHAMBER-H10 a' 1. VARY LEACHING TO PROPERTY LINE BY 5' (5' PROVIDED).' NOT TO WEIGHT OF EMPTY CHAMBER AND 9" OF COVER VARY SEPTIC TANK TO CRAWL SPACE BY 5' (5' PROVIDED). 1. LOCUS IS A.M. 226, PARCELS 76 & 82. rn SCALE CHAMBER= 4.12 TON (PER SHOREY) 2. ELEVATIONS SHOWN ARE NGVD29. p r n VARY SEPTIC TANK TO BVW BY 11' (14' PROVIDED). C 9" COVER= .75'(4.a3')8.5' X 110 LB./CU. FT.(1 TON/2000 LBS) VARY CHAMBER TO PROPERTY LINE BY 8 1/2' (1 1/2' PROVIDED). 3. PLAN SHOWS SCALED LOCATION OF_.FLOOD ZONES A10, B & C FROM FIRM DATED JULY 2, 1992. ov ° 9" COVER=1.69 TON 4. ALL PIPES TO BE 4" SCH 40, AND PITCHED AT 1/4" PER FOOT. (UNLESS NOTED) FT TOTAL= 4.12 TON + 1.69 TON = 5.81 TON ALL 310CMR 15.211 (1). 6 WEIGHT OF WATER--NIGH GROUNDWATER DOWN 2. NO RESERVE AREA SHOWN. 310CMR 15.248. 5. MUNICIPAL WATER IS AVAILABLE. LOTS WITHIN 100' ARE ON TOWN WATER. -' (5.8-2.13) X 4.83'(8.5') 62.4 LB/CU. FT. (1 TON/ 2000 LBS) 3. VARY LEACHING TO BVW BY 11' (89' PROVIDED). LOCAL REG. 6. COMPONENTS TO BE AASHTO H-10, UNLESS NOTED. 3 WEIGHT WATER= 4.70 TON 4. VARY "ON-SITE SEWAGE DISPOSAL CONSTRUCTION" REG. TO MEET 7. INLET TEE TO PROJECT DOWN 13", OUTLET TEE DOWN 14".8. IF TWO OR MORE LINES, WATER TEST D-BOX FOR EQUAL FLOW TANK AND 9" COVER ARE HEAVIER BY 1.1 TON. 1995 TITLE 5 REG. LOCAL REG. PART VI11: SECTION 10.00 D-BOX EXIT PIPES TO BE LEVEL FOR FIRST TWO FEET. BUOYANCY CALCULATIONS 1500 GAL H-10 TANK 9. DEPTH OF COMPONENTS NOT TO EXCEED 3', OR VENTING MUST BE PROVIDED. Craigville Beac �a BUILD UP COVERS TO WITHIN 1' OF GRADE. MORTOR CHIMNEYS IN PLACE. c" WEIGHT OF EMPTY SEPTIC TANK AND 9" OF COVER ONE COVER OF TANK TO BE WITHIN 6" OF GRADE. LOCATION MAP WATER AND SEWER LINE NOTE: �Q.- TANK= 5.74 TON (PER SHOREY) 10. STONE TO BE DOUBLE WASHED 3/4 TO 1 1/2" WITH 2" MIN. 1/8 TO 1/2" PEASTONE ON TOP. o� Sill COVER=.75' X 5.67' X 10.5' X 110 LB./CU. FT. X 1 TON/2000 LBS. 11. IF UNSUITABLE SOILS, OR SOILS DIFFERING FROM THE SOIL LOG ARE FOUND, 9" COVER=2.46 TON CONTACT THE BOARD OF HEALTH, OR R.J. CADILLAC. o TOTAL= 5.74 TON + 2.46 TON = 8.20 TON 12. IF AN OVERDIG IS CALLED FOR BELOW, FILL MATERIAL FOR 5' AROUND AND UNDER LEACHING PROPOSED 2 PVC SEWER LINE CROSSES WATER TEST HOLE 1 MAIN. 2 PVC TO BE PRESSURE TESTED AND. X 51 WEIGHT OF WATER--HIGH GROUNDWATER DOWN IS TO BE CLEAN GRANDULAR SAND MEETING SPECIFICATIONS OF 310CMR 15.255(3). 4� . ro (5.8 -2.38) X 5.67' X 10.5' X 62.4 LB/CU. FT. X 1 TON/ 2000 LBS. 13. PUMP AND FILL ANY EXISTING CESSPOOLS. CROSS 18 UNDER WATER MAIN, WEIGHT WATER= 6.35 TON F o TANK AND 9" COVER ARE HEAVIER BY 1.8 TON. 14. ALL CONSTRUCTION TO MEET TITLE 5 AND LOCAL REGULATIONS. DEPTH (inches) ELEV.(feet-NGVD29 0 0 layer 15.6 �4.1 `r TEST HOLE DATE: November 7, 1996 1" N/F X 4 X 6.6 N/F H w PERFORMED BY: Ron Cadillac, Soil Evaluator A layer 1 yr /2 REPLUMB ALL WITNESSED BY: Edward Barry, Inspector t1" y SUZANNE HARPOLE EMBREE '�, X 4.7 ti DRAINS TO EXIT Invert 7.06 PERC RATE: <2'-00"/inch (Cl & C2 layers) B layer 10yr 4/6 x 4.5 ,po , SUZANNE HARPOLE EMBR o HOUSE, AS SHOWN, SOIL SURVEY(1993): Carver coarse sand , sandy to LOT o L Proposed GEOLOGIC MAP(1986): Barnstable plain deposits ;' 30 13.1 a Cl layer 10yr 5/6 == == VQ Invert 6.63 40 loamy sand NOTE: SCALED LOCATION OF 48" 11.6 5.6 = _= USE -=- FLOOD ZONES SHOWN, DO NOT Use Gas Baffle Invert 13.04 8 RECHARGER 330'S __- _--- -NO =_- C2 layer t0yr 6/6 =_ NG MATCH FLOOD ELEVATIONS. Proposed / _ med coarse 5.15 2 _F�CFS 0 II •6'. -_�X\5 Np. 25 _ provide 9 cover see detail 13.4 sand i� d MAKE observed water TOP PEA STONE 118" 5.$ 0 0 5 \ T� X 5 = =__-_ 1500 Gal. ��p= yG 6 -- ____:____`• /'/� 5. _-__-_- -- Invert 6.88 WATER TIGHT P Sanitary - - - - -� 24 OG� \\ 4 __ Proposed Tee X 7.2 =- = , Bottom 2.38 8 J O�SE _ p ===_ _____= ' \ I Invert 13.21 Invert 13.00 5, 11.0 _ -- // N '=--__ Use 6" Stone under Proposed Bottom P Proposed � x 7.2 / --CIO q _ 4 E, p 1� ---_=-- S' $ x 74 USE HAYBALES OR SILT \ \ I ( I , I 9' 0 81 i-2 i High Groundwater N ' FENCE HERE \ \ �� r g _ oe = 8. 0.2' Adjustment S 8.2 y Nts! \ <o�� 5p __-____== o x a ALL DESIGN DATA Safety Factor N� (� CN x 10 v p P`S '� 00" \ q�� BEDROOMS: 5 OBSERVED WATER=5.8 \ G 9. 8.9 P 8.2 \ X FREP \ 10. OR 10. �y�n O `ONGER S�i'�.� 7 GARBAGE GRINDER: No _ == N \ 10.9 .c�� N �,,.. __G REQUIRED CAPACITY: 550 GP(1 LEACH AREA x 8. ;�� \ \� 0' 06 ��' 9.3 �,,.i ' \ <v SEPTIC TANK: (1500 required) 2000 Gal. provided USE 6 CULTEC RECHARGER 330'S WITH 4' OF STONE ON -_= 9.% �O \� _ `7 11 W GO' c -�„�0• kP \ \�4 BOTTOM LEACHING AREA: 526.1 SF SIDES AND 2' OF STONE ON ENDS FOR A 42'-8" BY N/F J.W. MCCAW, JR. �s ,... � '��QT 252 �. 11.o N/F ,\ [(42.67' x 12.33')] 12'-4" BY 2' DEEP LEACH AREA. _____---- 12 ,- -�2 >s SIDE LEACHING AREA: 220 SF 12 00 --� S.H.EMBREE 1 [2(42.64'+ 12.33') X 2' DEEP)] HIGH GROUNDWATER DETERMINATION �� / - 1- ` c •+�'� 2� 0, 14.1 _ DESIGN CAPACITY: 552 GPD PROPOSED LEACHING IS WITHIN 300 FEET OF A SALTMARSH. 1145 1 2.7 13. �- X 13.E �- - - - [(526.1 SF + 220 SF) X .74 GPD/SF] THE FRIMPTER METHOD DOES NOT APPEAR APPLICABLE C.B./d.h. LOB _�53 W IL PUMP CHAMBER STORAGE: 550 GAL. BASED UPON FOLLOWING DATA: found EXISTING TR LLED WAY _ >,L/_ DOSES PER DAY: 4 DATE OBSERVED WATER COMMENT N/F PATRIZIO Q.-- 14 7` '_' 8 -A N + B. d•h• 1/22/96 8.58 (Below Grade) MIW29 WELL BENCH MARK--TOP WOOD STAKE CARDARELLI, TR. O O x 14.3 found \ 1/23/96 5.6 NGVD29 BENCH MARK--TOP OF STONE (TH 1 HARPOLE LOT-40' AWAY) SET FLUSH = 8.59 NGVD29 X 14.7 D O, �'' \ $ U BOUND = 16.50 NGVD29 t0.1' 10/24/96 6.57 (Below Grade) MIW29 WELL H--10 1000 GAL. PUMP CHAMBER 11/7/96 5.8 NGVD29 TH 1-LOCUS PARCEL MAKE FACTORY WATER TIGHT DRILL 3/8" WEEP/VENT HOLE f 5 I'll .3 NOTICE THAT GROUNDWATER HAS RISEN 2.01' AT THE MIW29 16 15. x.�l'%. �„ -"' 18.3 INDEX WELL AT THE SAME TIME AS WATER HAS RISEN 0.2' AT line �/�/ $5 / \`\` PROPERTY LINE NOTE: LOT C HAS AN ADJUSTHE TMENT SBASED O "IS DATA AN NA SAFETY FACTOR HAS BEEN PROVIDED.D NOTE Invert 6.63 ALARM 22.5" CHECK VALVE 16.6 5 $ 0 ` ,� x 19.0 ERROR OF CLOSURE OF 0.17 OR 2". SURFACE WATER IS AT ELEVTION 4.2 AT DITCH 35 NORTH ON 20>, 1$ X 19 0 _.._. � V i OF PROPOSED TANKS, INDICATING A STEEP HYDRAULIC GRADIENT. EL. 4.05 2 `� i OFF 14" P x 7 C.B./d.h. - ' 20.6 found - �19.9 C.Br/,�l.krBottom 2.13 6" STONE UNDER - 2'G.0 E P\�A SITE PLAN found 0 FOR THIS PLAN IS A VALID COPY ONLY IF IT BEARS C.B./d.h. BENCH MARK--TOP TOP WOOD STAKE AN ORIGINAL RED STAMP AND SIGNATURE. ESTATE OF STANLEY W. NORWOOD found SET FLUSH = 7.26 NGVD29 LEGEND ALARM & PUMP NOTES � 4 rp� -7 � LOTS C, 252, 253, 10 LAUREL AVE., CRAI GVI LLE MA ROL<�I RONALD Y°� 7 NTH 1 TEST HOLE LOCATION, NUMBER 1. ALARM TO BE WIRED BY ELECTRICIAN ON `� Jra'�a j`r JANUARY 9 1997 SCALE 1 it W WATER LINE MARKINGS SEPARATE CIRCIUT FROM PUMP. CAD;LL# } o Dj y , EXISTING HYDRANT 2. ELECTRICAL WORK TO BE INSPECTED BY '3 7 . 1 -OE OVERHEAD ELECTRIC WIRES (IF SHOWN) WIRING INSPECTOR. ; �c �� 3. ALARM TO BE LOCATED IN HOUSE. y �� S��'�Sf�P � 9.5 x11,0 EXISTING & PROPOSED ELEVATIONS ( X MARKS POINT) 4. PUMP TO BE CAPABLE OF PASSING `� �S�S� �ITAP EXISTING CONTOUR 1-1/4" SOLIDS AND INSTALLED IN STRICT RONALD J. CADILLAC, PLS, RS --- PROPOSED CONTOUR CONFORMANCE WITH MANUFACTURER'S I � �( Jcj�' PROFESSIONAL LAND SURVEYOR E e SPECIFICATIONS. & REGISTERED SANITARIAN ca> UTILITY POLE (IF SHOWN) 5. USE MEYER MW50, 1/2 HP PUMP, OR --ou- OVERHEAD UTILITIES (IF SHOWN) EQUIVALENT. P.O. BOX 258 " TREE (IF SHOWN, NOT ALL SHOWN) WEST YARMOUTH, MA 0267.3 sU EXISTING SEPTIC COVER (508) 775-9700 0 EXISTING DRAINAGE CATCHBASIN HEALTH AGENT APPROVAL DATE PAGE 1 OF 1