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Home My WebLink About0068 LIAM LANE v s r r : a• ` A , r, + L. ' l v y s x 1 u � , _ A y ,p „.a ^ ..., a .� .. '. C � v. s- s :� r — .. ., — . ,- .: n � '. ., ., � .. ,.: '. .. _ ._ ,. . ., „. ,.. �.. u ,. � .�. .. � v. :. ,x. .�- � ::-.. .,, t,: .., ,.. .. R. '- _ .. '• ;. i. � :, ,. ,. ,. .. ... - .. .. .. �. �: ., o �. � � - �� fr a c ' ,, ;T ,:r EXISTING Ln FOUNDATION N O i 10.7 — JI 12.4 U w LOT 13 D 2 15 14.8 S.F. 0 PROPOSED DECK u < 0 t m � p — — 0 O D 7- O I (-n EXISTING DECK I I 4�' 16l R=30.00' A=47. 1 2' T=30.00' - I I G05LI NG PATH BU I L G LOCATION PLAN OR G8 LIAM LANE CENTERVILLE, MA OF Mgss PREPARED FOR �y 5TEPHEN *- CAROL PIZZOTTI STEVEN SCALE: DATE: DRAWN BY: MBA I" = 30' OG-25-2007 TMW U N rJ 9 Cry JOB NUMBER: RfV1510N: 5HEET NUMBER: A OFESSIO�P j 03-1 52 CPP-2 qNo Su(�vF� WELLER * ASSOCIATES I G45 FALMOUTH RD., SUITE 4C P.O. BOX 417 CENTERVILLE, MA 02G32 ��' \ --2 WINDY WAY, #232 NANTUCKET. MA 02554 TEL.: (505) 775-0735 — FAX: (505)775-0754 EMAIL: tri5Weller@comca5t.net _ PROPE5510NAL ENGINEERS * LAND 5URVEY0R5 I ry TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma / 7 /(� '0/S TOWN Ut BARNS`ABLE p Parcel Application# Health Division 2001 MAY 15 AM 39*.09 8 Conservation Division Permit# Tax Collector t ,t/ISt1# Date Issued Treasurer Application Fee Planning Dept. Permit Fee �i Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address (o 9 L 14H LAA)C Village 7_?�,<' ✓/LL Owner S 7EP#/y. f-CA'6[- ®!Z Z.O 7_71 Address 1? 9/14E'4 51 DC be- &::U/iy- o/fb 7 Telephone '787— y qq_,76&,o Permit Request Square feet: 1 st floor:existing 3 6 proposed 5�Q 2nd floor:existing �4� proposed `�b Total new Zoning District �� ' Flood Plain do Groundwater Overlay Project Valuation ll q, 6 K0, Construction Type11 Lot Size 2,/, S/S Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family V Two Family ❑ Multi-Family(#units) Age of Existing Structure .2 3 Y45 • Historic House: ❑Yes o On Old King's Highway: ❑Yes 0'60 0 Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) f- Basement Unfinished Area(sq.ft) q 36 Number of Baths: Full:existing 2- new Half:existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths):existing (r" new_ First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes L(No Fireplaces: Existing f New Existing wood/coal stove: ❑Yes ErNo 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 - -a"N'o If yes;site plan review# - -_ - Current Use Proposed Use BUILDER INFORMATION Name DGJN EL Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO BA-eW57,4 8L_e SIGNATURE DATE Lo 7 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. - M 1 ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: - FOUNDATION ®I -7 - /Zl .. r FRAME1 INSULATION t7 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING y p$ t1lo� DATE CLOSED OUT ASSOCIATION PLAN NO. z I °FIKEA Town of Barnstable Regulatory Services '"M�L Thomas F. Geiler,Director lEs639.. . Building Division .. , Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 PLAN REVIEW Owner:, 81 z.,2.c4-) Map/Parcel: ��`7 d 4 0/S Project Address 6T Lf a..%, L&I Builder: Ow„er - The following items were noted on reviewing: 1' UCAf me ,T rf-,dU o rh•��',n.v��,, W i wiaWs r a J 1( �; Jfvc- mo LA-i yes —v�Lq i e�r� 3° cci aA- 11 06 2-- CL J 5 moke A.�VeJmr a'e tA. re d 4r- al o Reviewed by: Date: 5I30 e LEFT M0;SA6E -1381a-7 Q:Forms:Plnrvw PROP05ED ,n 194.81 ADDITION N -� ol 12.4' U w LOT 1 3 '— 2 15 14.6 S.F. PROPOSED J Q EXI5TING �, DECK 1 SEPTIC SYSTEM o I — — O r 0 I - 1 O -1 W I 1 z1 rn EXI5TING I �I I DECK 1 6l - R=30.00' 1 A=47. 1 2' T=30.00' I _ 1 - 169.88' � j .GOSLING PATH BUILDING LOCATION PLAN FOR G6 LIAM LANE CENTERVILLE, MA OF Mq 9 PREPARED FOR STEPH EN * CAROL PIZZOTTI T VEN tiG 5CALE: DATE: DRAWN BY: U.M 1" = 30' 04-25-2007 TMW U V~i JOB NUMBER: REVISION: 511EET NUMBER: 03-1 52 CPP-I AA�FESS1 j qNo suRv�`° WELLER * ASSOCIATES 1.645 FALMOUTH RD., SUITE 4C— P.O. BOX 417 CENTERVILLE. MA 02632 2 WINDY.WAY. #232 NANTUCKET. MA02554 TELL: (508)775-0735 — FAX: (508) 775-0754 EMAIL: trl5weIIcr@C0mca5t.net PROFE5510NAL ENGINEERS LAND SURVEYORS S}1E -L V rr-LA V 1 i-F saa saw?L,"PO A v Regulatory S&vlees Thomas T,Geiler,Director Building Division Tom.Perry,Building Commissioner .200 Main Street, Hy=nis,MA 02601 www.town.,barnstable,ma.us i Fax 508-862-4038 Fa 508-790-6230 permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c, 142Arequires thatthe"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an additioato any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which'are adj scent to \ such residence or b�ulding be done by registered contractors,with cert �* exceptions,along vt ith other requirements. Type of Work: A ' Estimated Cost Ad&ess of Work: 6 Oyrner's Name: 3 Mf IfS70 ;t e_ ' `�!Zzo r7 7• Date of Application: I hereby certify that Registration is not required for the following reason(s): []Work excluded by law []Job Under S 1,000 rriding not owner-occupied Qr pulling own pe=ait Notice is bereby given that: OVNERS 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 PBRJURy I hereby epply for a permit as the agent of the owner: Date Contractor Signature RegistrationNo, R Date Own is i a e Q wpfiles.fflrms:homeafridev Rsv: 064b0b y `w REScheck Software Version 4.0.1 Compliance Certificate Project Title: New Addition / Renovation Report Date:04/24/07 Data filename:C:\Program Files\Check\REScheck\#6245.rck Energy Code: 1995 MEC Location: Centerville(Barnstable),Massachusetts Construction Type: Single Family Glazing Area Percentage: 18% Heating Degree Days: 6137 Construction Site: Owner/Agent: Designer/Contractor: 68 Liam Lane Steve Pizzotti Sharon Malone Johnson Centerville,MA 02632 17 Riverside Drive Sharon Malone Johnson Reading,MA 01867 781-944-7660 Ceiling 1:Cathedral Ceiling(no attic): 262 30.0 0.0 9 Ceiling 2:Flat Ceiling or Scissor Truss: 1286 30.0 0.0 45 Wall 1:Wood Frame,16"o.c.: 1029 13.0 0.0 66 Window 1:Wood Frame:Double Pane with Low-E: 162 0.330 53 Door 1:Glass: 40 0.340 14 Door 2:Solid: 20 0.400 8 Wall 2:Wood Frame,16"o.c.: 1588 19.0 0.0 78 Window 2:Wood Frame:Double Pane with Low-E: 216 0.330 71 Door 3:Glass: 60 0.340 20 Door 4:Solid: 20 0.220 4 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space: 1524 19.0 0.0 72 Furnace 1:Forced Hot Air.86 AFUE Compliance Statement. The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application.The proposed building has been designed to meet the 1995 MEC requirements in REScheck Version 4.0.1 and to comply with the mandatory requirements listed in the REScheck Inspection Checklist. 5�tv�'-" :1 . ei z". � - = 6,111-67 Name I Title Signatu a V I Date Project Notes: REScheck by Cape Cod Insulation,Inc. 455 Yarmouth Road Hyannis,Ma. 02601 1-800-696-6611 #6245 New Addition/Renovation Page 1 of 4 4 REScheck Software Version 4.0.1 Inspection Checklist Date:04/24/07 Ceilings: ❑ Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation Comments: ❑ Ceiling 2:flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: Above-Grade Walls: ❑ Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation Comments: ❑ Wall 2:Wood Frame,16"o.c.,R-19.0 cavity insulation Comments: Windows: ❑ Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: ❑ Window 2:Wood Frame:Double Pane with Low-E,U-factor:0.330 For windows without labeled U-factors,describe features: #Panes Frame Type Thermal Break? Yes No Comments: Doors: ❑ Door 1:Glass,U-factor:0.340 Comments: ❑ Door 2:Solid U-factor.0.400 Comments: ❑ Door 3:Glass,U-factor:0.340 Comments: ❑ Door 4:Solid,U-factor:0.220 Comments: Floors: ❑ Floor 1:All-Wood Joist/Truss:Over Unconditioned Space,R-19:0 cavity insulation Comments: Heating and Cooling Equipment: ❑ Furnace 1:Forced Hot Air:86 AFUE or higher Make and Model Number: Air Leakage: ❑ Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage are sealed. ❑ Recessed lights are 1)Type IC rated,or 2)installed inside an appropriate air-tight assembly with a 0.5"clearance from combustible materials.If non-IC rated,fixtures are installed with a 3"clearance from insulation. New Addition/Renovation Page 2 of 4 Vapor Retarder: Installed on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: Materials and equipment are identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment have been provided. 0 Insulation R-values,glazing ll-factors,and heating equipment efficiency are dearly marked on the building plans or specifications. Li Insulation is installed according to manufacturer's instructions,in substantial contact with the surface being insulated,and in a manner that achieves the rated R-value without compressing the insulation. Duct Insulation: Ej Ducts in unconditioned spaces are insulated to R-5.Ducts outside the building are insulated to R-6.5. Duct Construction: All ducts are sealed with mastic and fibrous backing tape.Pressure-sensitive tape may be used for fibrous ducts.Duct tape is not permitted. The HVAC system provides a means for balancing air and water systems. Temperature Controls: Thermostats exist for each separate HVAC system.A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor is provided. Circulating Hot Water Systems: Circulating hot water pipes are insulated to the levels in Table 1. Swimming Pools: EI All heated swimming pools have an on/off heater switch and a cover unless over 20%of the heating energy is from non-depletable sources.Pool pumps have a time clock. Heating and Cooling Piping Insulation: HVAC piping conveying fluids above 120 degrees F or chilled fluids below 55 degrees F are insulated to the levels in Table 2. New Addition/Renovation Page 3 of 4 a . Table 1:Minimum Insulation Thickness for Circulating Hot Water Pipes Insulation Thickness in Inches by Pipe Sizes Non-Circulating Runouts Circulating Mains and Runouts Heated Water Up to 1" Up to 1.25" 1.5"to 2.0" Over 2" Temperature(°F) 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2:Minimum Insulation Thickness for HVAC Pipes Insulation Thickness in Inches by Pipe Sizes Piping System Types Fluid Temp.Range("F) 2"Runouts 1"and Less 1.25"to 2.0" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 '0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water;Refrigerant and 40-55 0.5 0.5 0.75 1.0 Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD:(Building Department Use Only) New Addition/Renovation Page 4 of 4 f oFt r Town of Barnstable Regulatory Services BARNsrABLE, Thomas F.Geiler,Director MASS 1639. A.O� Building Division rFp 1,�.t 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: `f�2 4 bo 0-7 JOB LOCATION: 6 r L/4M (-.4mE CEN-/�eX_V/c_t_E number street village "HOMEOWNER": T. �Z_Z,T11 7tt-IVq- 746 617- 8gZ4b1-3 name home phone# work phone# CURRENT MAILING ADDRESS: 17 R/Vk7,t 5(1)E OIL. Re-A-0/ke, MA OIeG 7 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 requir ents Signature of fiomeowrV 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 ® Aesign ® Engineering& ROBERT M. DE5R051ER5, P.E. D Co., inc. Consulting Engineer 508-946-3561 155 East Grove Street • Fbeit Office Box 649 Fax 508-946-1653 Middleborough, MA 02346 April 20,2007 Project No. 2007-099 Mr. Steve Pizzotti 17 Riverside Drive Reading, MA 01867 Re: Design Review of Steel Beams for Proposed Addition to 68 Liam Lane, Centerville,MA Mr. Pizzotti: You asked me to design two steel beams to support a portions of the first and second floors of the addition to the referenced residence. The proposed addition is an 18' by 24' two-story ell. With the exception of the steel beams,the addition will be conventionally framed with mix of engineered lumber and ordinary dimensional lumber products. The first beam is located at the first floor framing level, on the centerline of the building. It supports a tributary load from the first floor. The maximum beam span is 18 feet. The second beam is located at the second floor framing level, directly above the first beam.It supports a tributary load from the second floor. The maximum beam span is 18 feet. The appropriate beam for both locations is a W8x28 manufactured from ASTM A992 structural steel (grade 50). At the first floor level,the framing will frame over the top of the beam. The beam must be rigidly attached to the wood floor framing. This can be accomplished by attaching a continuous 2x8 wood nailer to the top flange of the beam with 1/2"bolts at 24"on center, staggered side to side, and toe-nailing the floor joists to the nailer. The beam should be supported at each end by the concrete foundation wall, in pockets provided for it. At the second floor level,the beam will be flush-framed into the floor joist system. The beam must be rigidly attached to the wood floor framing. This can be accomplished by attaching continuous wood blocking to each side of the beam web with 1/2"bolts at 16"on center, staggered top and bottom, and utilizing steel joist hangers to attach the floor joists. The beam should be supported at one end by a minimum of four(4)2x4 studs, or the equivalent solid post, integral with the exterior stud wall framing. The beam to post connection should be fastened with two (2) 3/8" lag bolts. The other end of the beam falls above a 6'-0"wide door opening and should be bear upon a double (2) 1 3/4"x 9 %2" LVL I I door header with two (2) 2A jamb studs on each end. The posts should be blocked solid down to the concrete foundation wall below. If installed as specified herein, and according to good construction practice, these beams will meet the structural requirements of the Massachusetts State Building Code, Sixth Edition. If you have any questions regarding this report, or if you require additional information,please do not hesitate to call. Very Truly Yours, Robert M.Desrosiers,P.E. POSH OF M� BE T ESR ERS m 6770 nUCTURA �'OIYRL E�6 I AMPD,ts1gn Englneering& ROBERT M. DE5R051ER5, P.E. Co., Inc. Consulting Engineer 155 East Grove Street . Poet Office Box 649 508-946-3561 Middleborough, MA 02346 Fax 508-946-1653 September 19,2007 Project No.2007-099 Mr. Steve Pizzotti 17 Riverside Drive Reading,MA 01867 Re: Design Review of Steel Beams for Proposed Addition to 68 Liam Lane,Centerville,AM Mr. Pizzotti: I understand that the framer made some minor deviations from the framing details described in my previous report dated April 20, 2007. You have described two items to me which vary`from the recommended design. The first item is that the steel beam was installed onto the wood post without the recommended 3/8"lag bolts. I recommend that lag bolt be used to fasten the beam to the column as a safety procedure during construction.Normally,beams are erected while partitions and other framing elements are only temporarily braced. In my view, it is prudent to make a positive and rigid connection between the wood and the steel to prevent the potential movement during construction. In my view,the lag bolts are no longer required once the deck assembly has been installed and properly fastened,which completely eliminates the potential for movement of the beam relative to its supports. The second item is the support for the LVL header. I had recommended a double jack stud under each end, but I understand that only a single jack stud was installed. I have reviewed the header load,the minimum bearing required for the LVL,and the capacity of the single jack and king stud assembly. In my view,the assembly,as built is adequate for the imposed loads and meets the bearing length requirements for the LVL. If you have any questions regarding this re ort or if q _ p you require additional information, please do not hesitate to call. Very Truly Yours, ��P�j+j of M,,�, o) BER M G c SRO 5 m Robert M.Desrosiers,P.E. ° c UR I y t r i ..., ._� .. 71. L1- tat `5w cj a 1 1 r 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 I Please Print Legibly Name(Business/Organizationdndividual): . T F1 Z 7-0+ Address: b g L-/,4 "l LANE City/State/Zip:_ _GCry 7,!:-7z V)t_.l_4 ' tik o zb 3-Z Phone W: /7-- Y 2—6) 3 Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part-time).* have hired the stab-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. 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 f❑Electrical repairs or additions [�I 3. 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 f❑ 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 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.#: 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 D1A for insurance coverage verification. I do hereby certi unde the pains and enalties ofperjury that the information provided above is true and correct. Signature: - Date: /b 6 Phone#: G17 - OyZ 6/ 3— 9 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector. 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receives or trusfee 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 produce&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-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 fo any business or commercial venture (i.e. a dog license or permit to burn 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 Investigatiola$ 600 Washington Street Boston, MA 02111 Tel. ##617-727-4900 ext 406 or 1-977-MASSAFE Fax# C 17-727-7749 Revised 11-22-06 www.mass.govidia r RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 ' Alterations/Renovations 50 r $50.00 _ — Building Permit Amendment $25.00 FEE VALUE WORKSEEET NEW LIVING SPACE S 0 J��o square feet $96/sq.foot= /Dl, 316. x.0041= plus from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE V i square feet x$64/.sq.foot;- x.0041= S D 7 plus fran below(if applicable) 7 GARAGES(attached&detached) square feet x$32/sq, x,0041= 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.0041= STAND ALONE PERMITS Open Porch I x$30.00 (number) Deck i x$30.00 (number) Fireplace/Chirriney x$25.00 (number) Inground Swimming Pool $60.00 ' Above Ground Swimming Pool $25.00 �- Relocation/Moving $150,00 (plus above if applicable) Projaost Permit Fee Rm063004 r ' Assessor's and lot riumber ... ... .. .,1.............. .......... 0,FTHETO Sewage Permit number ,? C 1g. Z 33ARBSTAMLL House number .........L2.X.. .............................................. s NAM 00 i639. 9� I am Or i TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .......................�.......(. G`''.l...�:..... .. � s'�i ;�......r ................... TYPE OF CONSTRUCTION ......................... ZA-er:(�.�..�'................ .................................................c , u .� ' may- �• ............t... ... .... �`..........19.......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................................i ... ............ t/ ............... ...✓. 7�r........... .b ............��:�.....�'�; .......... ProposedUse ................................................. .......................... #! ....................................... ..... .......... ZoningDistrict ..............f.........................................................Fire District ............................................................•... ........... Name of Owner ...........�L :2 Address ......... •:?r�...4'.... l .............. Nameof Builder. .............................. 1 4 .:.............:....Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation Exterior ........................ !`......?� �? ' f.......................Roofing .....................:Ik,. �s?1:.� .'....:�.. ............�.t •P.1y� • • Floors ........ . .. .6�-t� .'. ...'?�• » .....................Interior �,c ! ;7 !Y 1.��:. .......................... Heating !�-.f;r ''......��...i ' '`........................Plumbing ..............:....:c..::: :......... . :. ............................ Fireplace .............................. .. .... .....................................Approximate Cost. ................." /1 Fri:. .!..?...................... Definitive Plan Approved by Planning Board ________ rt2t_=_____19__ Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL-OF BOARD OF HEALTH ' ? :' .._ OP ji O� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS f. ? I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable'regoroing the above construction. / k1i. 0 Name ............ : ......... GREENBRIER CORP. A=167-16—o►S- No 24.74..7...... Permit for ..1 ...S,tory............. 5 Single_..Family Dwelling .......................................... Location ,Lot #13, 68 Liam Lane ............................................... Centerville ............................................................................... Owner Greenbrier Corp. Type of Construction ,,,Frame .......................... ............................................................................... Plot ............................ Lot ................................ January 24, 83 Permit Granted ................................ 19 Date of Inspection ....................................19 Date Completed ......................................19 Alf ' 4em Assessors d lotWb ........... i THE el Sewage Permit number CC-? ................................ . 1 STABLE H u' 8"kr 1 '--1C SYSTEM U k1t a se number ..... .,A. ................... ...................... 9. INSTALLED IN Co 0,0 1 ib TiOk M�.��CODE 5 OWN B,ARNSrTvA, F -1 It f - It A- BUILDING ' 1111SPECTOR APPLICATION'FOR PERMIT TO ....................... ...................... ..... I I I .. .... . .................. TYPE OF CONSTRUCTION ................... f,, - ..U. ..............f ........................................... I................. ......A99 E3 TO THE. INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......................................4/-.,C� ............13............... ........... .............................................. I ..Proposed Use ................................................. ............. .......... . .................................................................. Zoning District ...................... . ... I... ........ ............I....",..........Fire District ..................C............0 .............. .......... ce- A Name of Owner............ V X ... Address ...........Ao..k.... .......... ................ Nameof Builder' .................;............ ..................Address ..................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..........................I ....................................Foundation .............. .97 Exterior ........................ ......................Roofing .......... A .1 - .I.........K��..................I1 Floors ................ ......................Interior ......................... ........................... Heating ...... .F........ ...... ...... ..... ................Plumbing ..................... .............................. Fireplace ................................ .....................................Approximate Cost ................... ........................ Definitive Plan Approved by Planning Board --- Area ........../&,;9......A C) 6*"*........ Diagram of Lot and Building with Dimensions Fee ... ........cqj?............ .......... SUBJECT TO APPROVAL OF BOARD.OF- HEALTH Flo OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnsta egar i g the above construction. o -o/ 31) Name ............ ... ...... . ...... .... ..... ........ ...... ... ................ GREENBRIER,,CORP. V-2 Story 24747 No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location J!q�t...#.j,3,f......G 8...;P.:La.m...L.ane.... .... .. .. ....... . .................C...e........nte........rvi.....1l...e .. .................... ........... -dr�leenbrier Corp. Owner ................................................................. 7 Type 'of Construction .Frame.................................. ....... 45- ...........:................................................................... Plot .......................... Lot ................................ Permit Granted .. ..January 24, 11 ........................................19 83 Date of Inspection ....................................19 , . . Date Completed ........ . e- Z 7 •� TOWN OF, BARNSTABLE 24747 Building Inspector Cash - --------- --- OCCUPANCY PERMIT Bond -_----_-_``x__`3_ Issued to Greenbrier Corp• Address Lot #13, 68 Liam .Lane, Centerville F "— -. Wiring Inspector �/', � /' , Inspection date or . Inspection date Plumbing Inspect ./ /Lr ,�fq.._. k A..- 1 Y Gas Inspector n y , Inspection date 17—k)Q 2 f X Engineering Department f j� , }f� � � Inspection date ;T f- 9 5 Board of Health !'Al Inspection date 2 >j/f C'( THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL, SIGNED BY THE/BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. 5k • -� zx ....., 1s.....__ ......................................................... ........._.........._..........__.... Building Inspector e d Nn7 / E { co P ro 6 h/ i. g i SZ 8 v 400 l � /a m PEE"crHMA-a-r- e- TAP n oa JON �%'N GCS EAST��-P- Li=3M 15 M.1Cn r > 'Lo, oo �i ELE14A"na 3-4 77,08 125'W IDT 4 S H 2W4 O to' s e,2 S.B. 4N0 SURv�'y 4" EGEND ,;F .:. EX STING SPOT ELEVATION OxO CERTIFIED PLOT PLAN o ; EXISTING CONTOUR ___ 0 ___ a , PHn P �1 L�'f- 13 - LA AM L-A"a FINISHED SPOT ELEVATION �] o wE CEI-.TE2.4L.L� FINISHED CONTOUR 0 ` 6s --- . — -- IN APPROVED , BOARD OF HEALTH / s',:;;A DATE AGENT SCALE, 5o DATE ' �'1 • la• ®3 LDREDGE EN/GON&-ERIIYG CQ INS' CLIENT I CERTIFY THAT THE PROPOSED EOISTERE REGISTERED JOB NO. 3152 .- BUILDING... SHOWN ON THIS PLAN CIVIL LAND �.®,�� CONFORMS TO THE ZONING LAWS ENf31NEER RV OF BARNSTA LE , , ASS. 712 MAIN STREET. Old. BYE e N Y A N N i S, M�►3 S. I SHEET.-- OF DATE ; ,R�EG. LAND SURVEYOR n s Al- 00 / �g =:. CERTIFIED PLOT PLAN . ,La N� SEMI CONSTRUCTION ONLY # , TOP OF FOUNDATION I3—z-0 FEL � H IN ABOVE LOW POINT OF ADJACENT. A A INS I A.91 24A AS 5 . TS IS ROAD y�v�� >f YN s• SCALE, DATE , ® E G lIV I CERTIFY THAT THE fouti�ariaN CL,IBNT G ='� SHOWN ON THIS PLAN IS LOCATED EGISTENE® REGISTERS CIVIL LAN® ON THE GROUND AS INDICATED AND ENGINEER SURVIEYOR 011.9Y ' pM. CONFORMS TO THE ZONING LAWS _ OF ®ARNSTABLE , MASS. 712 MAIN .STREET CM.�Y�` eJ:��• 0183 H YA N A I S. MASS'. SMMET_! 01F- - DATE ARE®. LAND SURVEYOR .� SMOKE DETECTORS REVIEWED OAABJE BUILDING DEPT. DATE FIRE DEPARTMENT DATE -- OTH SIGNATURES ARE REQUIRED FOR PERMITTINGTETI I I III ii_L -Ell IT _ IMPORTANT I AN CONSTRUCTION THAT INCREASES LIVING SPACE BE IOND 1200 SQ. FT. PER-LEVEL MAY REQUIRE THE i _L_J___ IT 1N ALLATION 'OF ADDITIONAL SMOKE DETECTORS. —�. TTI 1 I I I il E� �— —; N : A SEPARATE PERMIT IS 'REQUIRED FOR THE I ---T� � IN TALLATION OF SMOKE DETECTORS—THE ELECTRICAL PE MIT DOES NOT SATISFY THIS REQUIREMENT. -- . _....__. ------.... - 8 v1low low I � c�T �L'-ucrrID�j CARBON MONOXIDE ALARMS MUST BE INSTALLED PER ` MASSACHU6EM BUILDING CODE J ! El i — C ------ r _ . GEN 7f4 ut c.44!�' r; C./W 9U-1.__.._ I/L V/T nO�/" SCALE: q� O/; APPROVED BY: DRAWN BY �H .. . - DATE: a I. .. 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