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Y: .. ,,.,,s r ,.. ,., a t - .. �.,..�, .. ,,. „t.. � _..,..,. ,. ...._ -..o,.. ,{ ,...__. .__...�_ .,.� ,>.t-. .:�i_.�n.,,�St&i3Yaat.1,...xi b..ku.4 -19 0-76 2_)o T Town of Barnstable =Pe Expires 6 nrarulrs from issue dire -�-�, Re uhtolEy Services Fee 2CJ :nmseescs. q� 3" ��� Thomas F.Gefler,Director�F $1Rding DIVISIUri Tom Perry,CBO, Bmldin;Comarissioner 200 Main street,Hsamais,MA 02601 ww-c4.townb amstab]e.maus Oice: 508-862-4038 Fax:508-790-6230 EXPRESS PERT M APPLICATION - Imo+SIDE TIAL �(� � Voz Valid sviihout RedX--Press Imprvu Map/parceiNtttnber (� � PropertyAddress t C•( �1 NUE, �wl(, mM *Iesw_� Valm ofVMork S Q c C Ib7iruEmmmfee of S35.00 for work minderS6000.00 Owner's Name&Address Co=racror's Name ',�ra5 o �!�C V LA r j / hone Number Home Irxprovement ConrraciorLicroseT(ifappHeable) I Id55 J EmazZ: `,��'t7 Cz lr�l►5 LC-*L6L .c,0(V 7 Con:5'=t ion Stxg�r'sLicense T(zf4plicable) nrennaw e worktmn's Compensationlnsu ante Check one: Q I=a sole proprietor OCT 15 2014 RI-baveWorker's amtheHomeowner rape at lusura=e T WI 11 BARNSTABLE i *MnQp Compatry Name [ � e �J SU ro�j 01 Workn='s CoLm.Policy, WC qr)fnf-,, Copy ofInsurance Compliance Certificate must accompany each permit. Perms Re (check box) Re-roof(harricane nailed)(stripping old sbiab-les)-A]Iconstructiondebris w.dlbe takento ❑Re-roo£ rordcaue wailed not s —� � )( mppitts. Going over layers ofxoof) ❑ Re-side [3 Rephcemen Windows/doors/sliders.U-Value (mar m+m .35)#of'windows n ofdcors: ❑ Smoke/CarbonMonoxide detectors 4 floorplans marked with red S and inspections regtdred. Separate Flectrimi&Fire Permits required ° l=c rcatued:Isswmce ofthis peseta does sot exemPtc0mp78aee with o6er tows depaz==regu&Tkns,ie Ristotic,Conser�eze. x**Note: Property Ow.oernm3stsinPmperty0wnerLerterofFermission. A copy of e Home Improvement Contractors License&Constmcdon Supervisors License is required. C_A smz d`c6M&xAppD=%LoeaRl2ierow$1WmdowslTeznporarYlmcnexF�s\Cx¢mzOot?oolc\8iL76BD�TA11~XP SS.do e Pxvised 061313 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bI Name (Business/Organ' ation/Individual): Address x City/State/Zip: I (� Phone#: Are y u an employer?Check the appropriate boa: Type of project(required): 1.&I am a employer with 10 4. ❑ I am a general contractor and I employees(full and/or part-time). have hired the sub-contractors 6. El New construction 2.❑ I am a sole proprietor or partner listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance.* required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions _ myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy wid job site information. , i,$ (.-p Insurance Company Name: � f J L aafv 0s(,'rI f u Co, Policy#or Self ins.Lie.#: V V q ,© i Expiration Dater g&, L.I � � AO A Job Site Address:_: - �- City/State/Zip: �c��,�f��ot���1/� 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 ofperjury that the information provided above is true and correct. .Sig mature: Date: 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 Contact Person: Phone#: FRASCON-01 PAAS DATE(MMIODIYYYI) �..� CERTIFICATE OF LIABILITY INSURANCE 9/29/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTTFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the oolicy(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 (508)676-0309 NAME CT A h1ey Paiva Viveiros Insurance Agency,Inc. PHONE Ezt: 508-689-2713 (AC,No): 508-324-4553 375 Airport Road Fall River,MA 02720 ADDRESS:APaiva Viveirosinsurance.com INSURER(S)AFFORDING COVERAGE NAIC* INSURERA:Granite State Insurance Co INSURED Fraser Construction LLC INSURERB: PO Box 1845 INISURER C: Cotuit, MA 02635 INSURERD: INSURER S: INSURERF: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I SR TYPE OF INSURANCE L"TR tNSR WVD POUCYNUMBER MMIIOD E MM1DD P LIMITS GENERALLIABWTY I EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence S CLA INIS-MADE F OCCUR I MED EXP(Anyone person) S PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'LAGGREGATELWITAPPLIESPER ` I PRODUCTS-COMPIOPAGG $ POLICY PRO- LOC I $ AUTOMOBILE LIABILITY Otv SINGLE LIC11T Ee accident) $ ANY AUTO BODILY INJURY(Per person) . S ALL OWNED SCHEDULED AUTOS AUTOS BODILY NJURY(Per acdclent) $ }H,REDAUrOS NON-OWNED (PROPERTY PERACCIDENT) E $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAMS-MADE AGGREGATE $ DED I I RETENTION $ $ WORKERS COMPENSA'nON V!C STATU- 11, AND EMPLOYERS'LIABILITY x TOR Y UM TS ER A ANY O IFF PROPRIETORI ERPA LC p EXED)CUTE Y� N!A WC009930601 9126120i4 9/2612015 E_L EACH ACCIDENT $ 500,000 CERWE(Mandatory In NH) E.L.DISEASE-FA EMPLOYEE $ 500,000 "'es, describe under DES CRIPTIONOF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS 1VEH[CLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable Building Division THE EXPIRATION DATE THEREOF. NOTICE WILL BE DELIVERED IN 200 Main Street ACCORDANCE WITH TH£POLICY PROVISIONS. Hyannis, MA02601- AUTHORIZED REPRESENTATIVE I O 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks ofACORD �' Massdchusetts .IJeputmenl of Fuh►ic Safety 80ard of Bullding Roplattpns and Standards Construction snpol-l- or ? License: C8-097668 BASF FALMOl1 ty ¢ • Cummissloner 0610712015 ----------------- ` �G; •l��r�llrflZ'uua�i'r c- �r`�.�f� s lam} Office o Consixme�r.Affairs and Pus in Re�Zativ� f 10-Park Plaza-State 5170 b Boston;Massachusetts 02116 Home Impxavement Contractor Registration Registr on:' 112536 Tyne: DBA FRASER CONSTRUCTION CO; Expaafan_ 3/23/2016 Tr' 237059 DEAN FRASER P.O. BOX 1845 COTU IT, MA ()2635 UAdateAddress and retnrn card_Mark reason for change_ Sr,:n, � 20f1••4ti:,r �j Address ❑ReaeWai p Emp:oyrnent Last card OfficcaSCo,csaaur��i�,&Susiaas7ic�,C�tyoa xicebscor t�lE1MPROVEMEm COt�t7'RAC7aR bcforethe straSoavaTdioriadividultssconly v;�„' •-C31s1rdLan: 112536 P r+tiao d3tc. 7#'£ound retara to: Type: office of Caasumer Affairs and ftsjum pegu"On - D8A 10Park-)Pj s-Suit,5170 . FRASER C0NST?U0yj()t CO. ,Boston,MA 02116 DEAN FRASER 104 TWINN VIEW CANE E FALMOUTH,MA 02a36 IIadcisceretary -� jvOtV�tId WIthoui siq=ture t , Anv deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements r, contingent upon strikes, accidents or delays are beyond our control. Owner should f` carry fire, tornado and other necessary insurance upon the above work. We,'if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION, LLC: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: Homeowner Fraser Construction, LLC P ii i , • 1 i F ` 5 The Town of Barnstable BAMSTABM 9c� ,' 10$ Department of Health Safety and Environmental Services �FDMA'�� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner SHED REGISTRATION Locatio 4sh address) / Property owner's name Telephone number O x /U Size of Shed ignature `ate Hyannis Main Street Waterfront Historic District? / Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg hh (y ^ r) Map O�� Parcel Q a ' Permit# ® House# Date Issued -L � Board of Health Ord floor)(8:15 -9:30/ jYl) _ • Fee71 ,1 , Conservation Office(4th floor)(8:30- 9:30/1:00 2:00) P _ _ - ' EEPTIC SYST E . INSTALLED IN , 19 VUtT 1 , CE GABLE, TOWN OF•BARN5TAfif R r 1 N° LA NS Buildin ermit Applica ' Project Stree ddress Village - Owner ' Address ' .r. _ e eA-)et~ V) If .Telephone 17 `? l Permit equest r First Floor square feet Second Floor square feet Cons ruction Type �— .,,Cons Project Cost $ l Zoning District C, '� '(U^blood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family © Two Family ❑ Multi-Family(#units) Age of Existing Structure ke ;, ,, Historic House ❑Yes L1No On Old King's Highway ❑Yes pNo Basement Type: ❑Full rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half. Existing New No.of Bedrooms: Existing New Jam- �t2� Total Room Count(not including baths): Existing ;`r New First Floor Room Count _3 Heat Type and Fuel: ❑Gas ❑Oil ❑-Electric ❑Other Central Air ❑Yes p-No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) None ®Shed(size) ❑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 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 y- - -BUILDING PERMIT DENIED OR THE FOLLOWING REASON(S) e - FOR OFFICIAL USE ONLY - Ll PERMIT NO. DATE ISSUED MAP/PARCEL NO. ' ADDRESS �. VILLAGE OWNER DATE OF'INSPECTION: - FOUNDATION ' FRAME INSULATION FIREPLACE ELECTRICAL: R(j-UGI FINAL PLUMBING: ,:B!(-,XJGHZ Q FINAL, S ' GAS: . FINAL FINAL BUILDINQ . S in =. in o ` r + 3 0 _ DATE CLOSED OUT fti LZ 3 ASSOCIATION PLANMO. 0 + oFz"e ray�y : The-Town of Barnstable • sAuvsrMUL - 9�A1079. � epartment 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 r ' Permit no. Date �. AFFIDAVIT -, tHOME IMPROVEMENT CONTRACTOR LAW i 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: ' 1 G.c W_1261remt. Cost Address of Work: cz,u i• r—'../ y Owner's Name J fPG N SP k ate of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000 Oilding not owner-occupied wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR AV't-e'awe Date wner's Name ti I. . , _, _�-�`_= The Commonwealth of Massachusetts s __ 11=�lid __= Department of Industrial Accidents - office Office of/naestigations = t 600 Washington Street . . Boston,Mass. 02111 r Workers' Com ensation Insurance Affidavit `% / N ., name: ZY2 _/ al� A- ,�?-J L, - �'�/J a 6-5�a 1-7 ,--,"location: 0�7 L _Z,/7 1-0—a- e— , ci one# �B r - �1 Z I am a homeowner performing all work myself ,.:.::.:.....1::..:�:..X�..�::-::....�i.:.II...:..:.:I::.:::1.:,.:��:"...:-".........-I.,::1:':.::.:...�:�:.1.�.:.�:I,...�..::.—.I1-.:1.�,::...-:',......1-..I..1:�.:.::.::�.:....,..�:::�...'..:...lI..::-�:........::.-.."...:�.::::..::�'::I"1-....::::�..1-'I..:�..:-�.::��:.:...�..::.::.I......:-:...:...:�:::::.:,.1.I-:::::.I..,:.,...�.:.:.:.:..�..::,::-.�..1:.:.:...-..I...,:.�,:.:�..-.-.:::::.:�.::......:':-.:..:.:...::I.::..1..�.-1:1:...�.....�:,:.:.:.:.,:.:��:�::-::.......:..:.....:V:,':.::.::..:.::.�::.�....,..:,.....�..-.....:..:.,:..�:.::.*:.ii.:......—:..�:......':-::-..::.::..:�:�*:...:..::..,.............:1X.-:..�:.:.:::,:....I.i::.:.,....:1'..::.I::..::..—::....:..:��:::..,.......1.....:.:....*:.I:.:�.:.......1�:::......:1....::.I:-::..:..:-.:.::..:..:��:::.,.......-.....:.:...�.*�::.::,:1::...,....:1�i:::......:1....::..::.:.::-::..:...:..::-::::.�.I..-.-.....:...:�:.:.:.�:1.:...,,..*-:�:::......::...:�...:.:..::.::..:-.,.:.":i::,....1-....�..:.-—.�:.:.:.:.j:.":..:i.-::.�..1'..�1.:�..::..:..::..:...,..::�;-::...-�.-I.—..:.,....,....:.�:.�.."�-:i-:.�1'...:....1.:1'.1.:..-:.::...::::..1.........I:.:�":I:.-:..�"�X....,1::..,...:.,,:..:.:..:-�:: I am a sole pro rietor and have no one workin in any ca acity %%/%%%/�%:::::////%////:%%%%%/%%%%//%//%/%/%%///%%%%%///%%%///%%l%%%%%%%%%%��%��%%%%%%%%%%%%%%%%%�%%%%%%%%%%/�%/�%/�%%%%%%%�// ❑ I am an employer providing workers' compensation for my employees working on this job. comnanv:name. address.:: city. phone#. insurance co. ohcv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have . the following workers' compensation polices: company name:: . : address.. city. <ohone#. insurance co olrev# . /,//%%%%�/ cbmaanv name. address: city- ohone# insnrarice co. olic #: :i . .; �� Failure 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 s copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do here y certi under the pains and penalties of perjury that the i ormation provided above is truo and correct S✓ i tore C�. ate 1 - Print name h Phone# d'r ,Zzzj/ 44 official use only do not write in this area to be completed by city or town official s city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (revised 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an 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 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 and supplying company names, 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 Accidents. Should you have any questions regarding the"law"or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernut/license number which will be used as a reference number. The affidavits may be retmnned fo the 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 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 lnllesdoadons , 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 ~ " TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE L/ / JOB. LOCATION e J4/7/j Number Street address Section of town "HOMEOWNER" Name Home phone Work phone . PRESENT MAILING ADDRESS2� o19 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 responsible 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 prgcedures and r uirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 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 Owne: 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-' actir. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/tier responsibilities, mar 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. r r' 52) UNk UUIJft�E �= / \6• // 4j�j' LANDSCAPE TIES BUOYANCY CALCULATIONS-PUMP �s/�j WEIGHT OF EMPTY CHAMBER AND 20' 2„ PVC / ®--Place conc. block CHAMBER- 4.12 TON (PER SHOREY) Thrust -Blocks ® gO' 20" COVER= 1.67' X 4.83' X 8.5' X \ 1� 20" COVER=3.77 TON bends, as shown. TOTAL- 4.12 TON + 3.77 TON - 7.f WEIGHT OF WATER--FEIGN GROUNDWAi �/ (5.8 -3.29) :X 4.83' X 8.5' X 62.4 L WEIGHT WATER= 3.22 TON ////� DRILL 17--5/16" DIAMETER HOLES TANK AND 20" COVER ARE HEAVIER E E STO .�; IN 2" PVC PIPE SPACED 39 APART. A` , ,1`9 O /CAP ENDS OF PIPE. THE TWO END / �•. / �� / ��, HOLES GO ON TOP OF PIPE, 8" IN 3.3 N/F FROM ENDS OF CULTEC CONTACTORS. MEE / 6' i �� ALL OTHER HOLES TO BE AT BOTTOM OF PIPE. AFTER DRILLING HOLES RUN �-- A SMALLER DIAMETER PIPE INSIDE, s TO CLEAN BURRS. 6. 73.. r 6.2 TYPICAL HOLE LOCATIONS. 9 Old Bog ed e- / r N/F CHRISTIAN CAMP ,.3 6 MEETING ASSOC. 1 °°�• N 7 3 5.5 r 5.4 \S �G 8.8 09e't���� c` `Al) 9.7 x x 4 NO 1� 10. �s A ERVIOUS QdA �r / = 10.8 TM 1. RRIER .4 a� 53.80'�' \ 1 .f1 Q.5 G� RCN •y'L"� 1.1 Q BE g7 \ 4 Dt9.0 �� 1Qti 4© 2 1.E116 f'11.3 PA \1 ', 2.2 arch \ R ✓ X 1�� 1 N/F CHRi:WORK a:?> :;:;... 2.41 12UMIT , MEETING z SILT 10.1 `�' 4.5 edge 5.2 / ;f� ,2 2 ENCE 1 a �15.OR 12.5 PA REAG PARIN wetland I -15.1t�}C� �, ry 11.8, Y 8.2 �,��cj��NG {I' N/F EMBREE I STONE P / PARKING , 46 -4 = Nov N/F STRUBE �--k 11.�i Q 11.8 5 14.2 OR PROPOSED GRADES OVER 7 ACHING SEE SECTION A-A r 116 N/F NORWOOD 11.7 000 L.F. of 3' deep Impervious BENCH MARK--TOP OF CONC. ' Barrier-Top to be ® El. 11.6 BOUND = 11.55 NGVD29 t0.05' � � Top peastone Prop. 12.3 FL Prop. 11.6 Prop. 12.5 Landscape ELEV. ( ) 3, Prop. 12.0 edge Trov, XIM- UM FEASIBLE COMPLIANCE APPROVALS- REQUESTED• 12- 1 10- xis .gro a ; VARY LEACHING TO WETLAND BY 12 f (38 t PROVIDED) s; cleorta:'»::_grandulmr:t`sand::: VARY LEACHING TO WETLAND BY 62'f (38't PROVIDED) 8 C Toyer coarse sand - - - - y. VARY LEACHING TO PROPERTY LINE BY 8' (2' PROVIDED) ALL ABOVE 310CMR 15.211 (1) & LOCAL REGULATION SECTION A--A *Use AFCO 30 Mil Vinyl Fla VARY COVER OVER LEACH AREA TO 8 TOTAL. or .equivalent. Overlap ends 310CMR 15.240 (9) � SALE: 1ffm $. Seal joints ,with lap cemen VARY 5 REMOVAL TO 2 REMOVAL ALONG WAY 31OCMR 15.255 (5) NO RESERVE AREA AVAILABLE. 31OCMR 15.248 THIS PL � i� Assessor's office (1st floor): d D ��. FTNeT Assessor's map and lot number ................ .... �� T�IL� RqIJST' F �....................• v f Board of Health Ord floor): Sewage Permit number :...9 -...L,&.7• ...... .. ' Z BA$d9T/1DLE, i Engineering Department (3rd floor): E� ���Ti,: AUX a 5;. ;, . moo �6 q. House number ..................................... :...... .... ....... ...... 0 To REGULATIONS b. Definitive Plan Approved by Planning Board __:_____________________________19-------- , ` APPLICATIONS PROCESSED .8:30 9:30 A.M. .and 1:00-2:00 P.M.- only •T`OWN 'OF "'BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. Q!1157!F:( C.. .: `�.,��G.� r ��c/hwle.. /! r • l TYPE OF CONSTRUCTION .... ......................... ........................................................ ................... �. .��......... 19.Q.9 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according" to the following/information: location ....... ... .. LrZ.....:. vim. .. ............ ........ ................................. Proposed Use ......`).V:� ..... !!../....... �� el. - -ne.. .... .............................................. Zoning• District .............J...............................:..,.........:..............Fire District ...........I.................... !/ S Name of Owner ....... ... �n...........1<t/�idSQ.�c/.........:.:.....Address / i � 7FfGf�J / I.� /.S Name' of Builder .. ./...... ......,�i (!_...........................:Address ............... � .-f.. ......s..... ti • Name of Architect :...............:...................:..:....:'....................Address ................I Number of Rooms .Lx ip Y1 5 1' �/ -rl-... oundation. ... ..Pw1W ................................. . Exlerior .................. ?. .OGD. ...............Roofings !? 4%............. Floors .........�fl. J?e.. ............ .....................Interior :.... � Lt/!¢1�.................... Heating iPCYi�/ .. . g .... ...... ..............�-................ .........:.:............ . .Plumbing ...................................... Fireplace • /SU G.GO. :...............Approximate Cost............1.,..Q...r. ... Area . ......... ...C..TTu ,Diagram of Lot and Building with Dimensions Fee ® .... .. e c OCCUPANCY PERMITS REQUIRED .FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction, t Name . r ....�%....t ,.`»?r......................... Construction Supervisor's License .U.0 9! 7� SWANSON, EILEAN No ',•.3.2.345• Permit for ..,Build. ..Dormers. .. . . .... ..... .. x " Sngle_ .Family Dwelling c , Location 27 Laurel Avenue Centerville " x ............................................................................... • r - ._ . Owner ..Ei.lean`•SwanSOTl........ ' , r f Type of�:Construction' ..Frame P. ............................................................... ....... • v. .. Plot ..........:.................. Lot ................................ Permit Granted October 12 88 .....•................... ►....19 �. Date of Inspection .............................._ _ Date Completed .................... ..............119 „..si.'.w r`!ci..d'tIN' hit a::: •yyw:. 4.y.-d-,9.`�{-E+'§+� iL"L':`4�!'a 1 -s.5 at :.'Ye. J ' '� .q...._-aL : � �i��fl.ari^ k �`.Nl •�� 'p�,:�`�:�v "V�� �y'd�iv'_` 'Tx.f-��fiw • t'}r>” .f' .I Assessor's office (1st floor): / 1� 0F1NETO Assessor's map and lot number ................ ........................... Board of Health (3rd floor): d Sewage Permit number :.... d"....`..............l..r•.�..�A�....:.....�......... Z BAHd9T4DLE, i Engineering Department (3rd floor): �j���lll �o "ASn House number � / o �63q 0 .........................................:.. ''i�o MAI d` Definitive Plan Approved by Planning Board _--------------------_----------19-------- , APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR �r - APPLICATION FOR PERMIT TO H �!?6! !?rt�r�'�/>� ....... TYPE OF CONSTRUCTION ...... .1 .��.v.... ../LGG/�'................................................................................ ........................../� ............... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... ..........�L...... -l//� ........_Ue.. fjl ...................................................... .'� Proposed Use ......'S/t!��.� ..... .??>.. ...�......... �c%<(' .'./r?%��........................................................................................ ZoningDistrict .........................................................................Fire District .............................................................................. Name of Owner .......J�C.a/A. ✓._SC1.e(J e(J................ .�5.�../�yDfal�'aS1��' /CGY ;i�'�r �� ��✓�� Name of Builder ...............Address ...P6......t��t't'/-r �A. � �irt�/5..%r✓ . Nameof Architect ..................................................................Address .................................................................................... Q � A Number of Rooms .f: ?�!L.'.p......UAS..'t+'��"S......PI/ NFOundation ... vC✓/: 'F' ..l�G?iG .....................I........................ Exlerior .......................O..OU.P............................................Roofing .......ors ��/-/J- .Floors ....... .Interior ........j?-4ps.1 Heating .............. ?C 71t'/�' Plumbing.................................... ....................�......................................................... -Fireplace .......................................................I..........................Approximate Cost ....... �rJ.l�r.r.. .................................... Area ......... ...... Diagram of Lot and Building with Dimensions Fee t)...Q ..............." f A L OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. NameA4 ......................... Construction Supervisor's License ..U.Q..9. '........ ..SWANSON, EILEAN A=226-088 No .3.2.3..4.5... Permit for .Build Dormers S,ingle.,.family Dwelling Location ...2.7....Laurel,..Avenue................... � l�teryi l le............................. Owner ........E.il,ean..Swanson..................... Type of Construction ..F .dMe.......................... ............................................................................... Plot ............................ Lot ................................ Permit Granted .....QCt0be.r...1.2.........19 88 Date of Inspection ....................................19 Date Completed ......................................19 I) Assessor'sand ,lot ;number ....................................... �"l ' .. 8EPTIC -sys m t; TALL Sewage�permit,�number EI7 I°d CC; LIANCC {+NY'ARTICLE:11 S3AfiE TOWN O B A R N S�T,,ATB4 •�E j EaEasTenis "039. M` all BU "�' UNGINSPECTOR, 11 ;`' APPLICATION FOR PERMIT TO }' `40�/ j µx o •7 C. j .... . ... .. ri ' TYPE OP CONSTRUCTION ............ . ..:.......... .. :.:l.. . .......................................................... C... ........19. , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies .for a permit according to the following information: Location kv.e.., ....0.1..�.�. .J. .S.. .................................................................... Proposed`Use �.`...1.Y1 ...................................................................................I......................... ZoningDistrict .........................Fire District ................................................................... . ....................................................... �p l a �u Name of Owner "...r....{�.�.. . .4t. eCV1 .....1. i"l C address 6.. I!?5�?%.....4Y►. :. ..�.C�?.....GI..�C A.j.....A..e�►1 1 Name of Builder ..'.. o. , .1r,lC�:..�:...!�,.��..0..�..t.'1....................Address :�a.�P�...fT.(J..L..��..... ..A..11sa.ns�.,..�o...n:.�...64-6 q-Y. Nameof Architect .................. .............................................Address ................................................................. Number of Rooms .............................Foundation• .............................. Exierior ..............................:..:..................................................Roofing ............................................................:....................... Floors .......................Interior .................................. .................................. ................................. lHeating ..................................................................................Plumbing ....................... Fireplace ................................. ............................... ...........Approximate Cost ... QQ.Q............. Definitive Plan Approved by Planning Board ______--------__----------------19________. Area f..�'.�...... ..�7Z/ ! � Q ® Diagram of Lot and Building with Dimensions Fee 1....... SUBJECT TO APPROVAL OF BOARD OF HEALTH i . I hereby agree to conform to all the' Rules and Regulations of the Town of Barnstable regarding the above construction. Name . .......................... • I Halpern, Irene & Eilean St be 18077 repair (explosion No,................. Permit-for..................................... damage) ............................... - ✓` Laurel. Avenue _ ocatior 1 .... L [//ff... •' 7li� -• Cyr y \i Irene Halpern & `Eilean Strube Owner ............................................. ................ z: ' � , f rame Type of Construction ..................... ..... ............................................................. Plot .... .......�......... .. Lot ................................ s s' y +n 4 71 • - z December•- 1 75 - Permit Granted ........ .. ,.L...... ...19 _ Date of 16spection Date Completed 6 ,� � .......{...... .19 PERMIT REFUSED r . .................................................... !.... ..... ...................................... +.... .............•....... , 'ti ! jf s 'IJ 1 M ............................... . �..... .............. . �,,,/� •• Y` i-•" ..,,fit - �.� �'..; ,•'? . -• ' Approved .................................................. 19 C. ... ............. ................................................ ..... .� r . . .. � �o Assessor's ma and lot number .......................................... Sewage Permit number � . ....r..... � C-r..... y�FTHET��y TOWN OF BARNSTABLE Z ]DAUSMULE, i "6 9 , D.UILDING INSPECTOR 0 MAY a 1 APPLICATION FOR PERMIT TO .................... TYPE OF CONSTRUCTION ............":.......E:.I..:..`.....G.......... .............r.....................:........................................ ........................./ .r.............1.9....... TO THE .INSPECTOR.OF BUILDINGS: _ _-The undersigned hereby applies for a permit according to the following information: II' Location r !.:a.r n 1....�1 .0 e {,1.+r�� i 0 G 1 t I I C ..`...`..............................................I...................... Proposed Use LA m M 2 r � c.3 r. .'. ..!.!^.�J................................................:........................................................... p .. .. ..... ZoningDistrict ............. ..........................................................Fire District .............................................................................. Name of Owner �'Ph� Hn.� o�� /����?r���l ) rc� (Address ................... ............................. Name of Builder .� � l ...): n� n e � ?, ( � 1'( i n � r, ... � Address .........,...................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms QS >° fn.Y_:... ...................Foundation .............................................................................. ........................ Exterior ....................................I................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..........................................!........................................Plumbing .................................................................................. Fireplace ............................. ......................................................Approximate Cost y.... :.: Definitive Plan Approved by Planning Board --------------------------------19________, Area I �............................. Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH/ 7'— , �� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ,=a i !1 ............................ Halpern, Irene & Eilean Strube 88 um 18077 repair (axplwa1oo No ------ Permit for .................................... ' � . ^ ) � . -,.................-------.----.------- / � Laurel Avenue ' . - --_-'_ -----.-------.--.---.. � . , -------' ..�� ` ' Owner ___.Ireoe.�Balpero..��..E1leao..8trobe. Type of Construction --..z����.—.----_ ' � � � �/ -------'------------------- ' Plot ............................ Lot ------,---- � Permit Granted --.I�ecamber.L--.]A 75 - Do+a of Inspection ---.--------'lg . Dote Completed ...................................... PERMIT REFUSED ..----.--...------------... lg -----^---------.-----.------ � � ~.~—.--.------- —,-----.—. � . � � .. .—..� . �� ............................ --------- ^ ' ................. ............................................................ Approved ` �� ' ` �------- -----..� /� -------------.—..--.----~---. ^ ^ � � ----'---------------------'' ' ' ` � �