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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map o�0J Parcel Permit#
Health Division o 1(9 - Date Issued
Conservation Division i S, Fee
Tax Coll r NOV $ 2001 '``✓
i� EPTBC EQiA'MIDST BE
Treasur d tl z7 q By P I STALLED IN COMPLIANCE
_
Planning Dept. WITHTLE 5 CODS AND
Date Definitive Plan Approved by Planning Board '
Historic-OKH Preservation/Hyannis
Project Street Address N 3 Of)c, Q a C
Village
Owner M c„c�P L 'A So.0 H Address \ `03 \unC C
Telephone OA 0- 014-1 b
Permit Request r�pv C e �c.c S �,.�•� �o� ��
f C
Square feet: 1 st floor: existing �\03 proposed 2nd floor: existing Ic';N proposed Total new
'20
Valuation , t(0O Zoning District Q S Flood Plain Groundwater Overlay
Construction Type V coo c�
Lot Size Grandfatliered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family U Two Family ❑ Multi-Family(#units)
Age of Existing Structure l\01 y ik5 Historic House: 0 Yes ❑ No On Old King's Highway: ❑Yes 24 No
Basement Type: ❑ Full t6-Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) �&L Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half:existing ZS? new
Number of Bedrooms: existing 3 new
Total Room Count(not including baths): existing s new First Floor Room Count J
Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes 5fNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes b.No
Detached garage: ❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size
Attached garage: Jkxisting ❑new size VO a3 Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 2,No If yes, site plan review#
Current Use S Proposed Use
BUILDER INFORMATION
Name �o a r�� U `� r Telephone Number sy 9- 7>
Address 1�o� License# C)�7 a]r C
yA n r :S�o t� �"✓�9 Home Improvement Contractor# �C)
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FR M THIS PROJECT WILL BE TAKEN TO
_\
SIGNATURE DATE 10 ,�Ci 10
FOR OFFICIAL USE ONLY
r
PERMIT NO. r
DATE ISSUED r`
MAP/PARCEL NO.
ADDRESS VILLAGE
j
OWNER
;r
DATE OF INSPECTION: { a
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL ti
GAS: ROUGH_ - FINAL -
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO:
k
I
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ICI ' _.+ I ! I I �
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I
OF`HE'°`Yti The Town of Barnstable -
NWP` O�
99AR 6.
MASS.ASS. p Department of Health Safety and Environmental Services
O
t639• �0
ATFD MA+�� Building Division
367 Main Street,Hyannis, MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection
_ � I
Location Ibe'I> UL" � V�-z� �- Permit Number � Ti � 1
Owner Builder =gf- 3 4 C, .
One notice to remain on job site, one notice on file in Building Department.
The following items need correcting:
LL-
Please call: 508-862-4038 for re-inspection.
Inspected by
Date I `Z—C1 L
F iME Tp�
The Town of Barnstable
• �naNsresi.E. • ,
9 g Regulatory Services
`bp i639' � Thomas F. Geiler, Director,
lEa MA'S -
Building Division ,
Peter F. DiMatteo, Building Commissioner
367 Main Street,Hyannis MA 02601
Fax: 508-790-6230
Office: 508-862-4038
Permit no. � I
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 ocher 6
requirements. L
Type of Work: b Estimated Cost
Address of Work:
Owner's Name: �4P
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
r ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
t SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner: /®/
Jo n
L l�
Contractor Name Registration No.
Date
OR
Date Owner's Name
q:forms:Affidav:rev-070601
The Commonwealth of Massachusetts
_•,z Department of Industrial Accidents
,� _-��•� ; r 011lce of/okvestlgat/oos
600 Washington Street
Boston,Mass. 02I11
Workers' Com ensanon Insurance davit
location. — �- ;! h Z I 1 J-n C' a j f
city S hone#
❑ I am a h eowner performing all work myself.
{�..I am a sole rietor and have no one worm in anv achy
I am an em 1 rovidin workers' compensation for my employees working.on this,job. : ::: ::,,: ..,
Hddress.,i;
:::.
City _ n hone
insurance ca ..
❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
have
thefollowing workers' compensation polices:
mP ..:...........:::::.::::.:.:::::::..:::::;;::.;:.;:.:«.;:.;.;;;:::..:«.;:.;:.: .;;:<.::.:.;:.;:;.:.;:.;:.:.:.;::. ;:....:<.......:::.:.:.>„,,
g............................ .......... ... ..::.:::::::::::::::.:..:.
eom anvname.
........... ..................... XX
............................... :::................:: :::::....
......................:......
Q
............:::...................::::..:......................................:::::..................................,,,..,
........ .......................... ...... .......................:...............................:
Now
. .
adtiress.
. .............
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 51,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 3100.00 a day against me. I understand that a
copy of this statement may be fo ed to Office of Investigations of the DU for coverage verification.
I doh a pains ojperjury thatthe7Wormadon provided above is trr and coned
Signature Date ja/le�,'�-6 16
Print nam JT3 t1Q ^��(� 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
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
❑Health Department
contact person: phone#; -� ❑Other
OrA"a 9/95 PJA
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workeers com of pensation
under oon for their
any contract
employees. As quoted from the "law", an employee is defined as every person in the service
of hire, express or implied, oral or written.
y two or more of
An employer is defined as an individual, partnership, association, corporation or other legal entity, lover or the receiver or
the foregoing engaged in a joint enterprise. and including the legal representatives of a deceased employer,
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
s ce or who has
of a license or permit to operate a business or to construct buildings in the commonwealth for an applicant
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 coimacting
authority.
slim
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
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
or town that the application for the permit or license is
date the affidavit. The affidavit should be returned to the city have an questions regarding the"law"or if you
. being requested, not the Department of Industrial Accidents. Should you y
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
tebottome f the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe reaaaed t^
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.
PRE
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
office of lmlesduadons
600 Washington Street
Boston,Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 eat. 406, 409 or 375
RESIDENTIAL BUILDING PERMIT FEES .
APPLICATION FEE
New Buildings,Additions $50.00
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WOMHEET
NEW LIVING SPACE
square feet x$96/sq.foot= x.0031=
h
plus from below(if applicable) ,
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
d� square feet x$64/sq.foot x.0031= 0
plus from below(if applicable)
ACCESSORY STRUCTURE>120 sq.ftC
>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
r
710 CMR Appm=J
Table ALlb(mod) Hmtad wim Fowl Faeb
prescriptive psdmga!or One and T*wFamiir Raidmdal Baitdbw
MAXIMUM lllOTiQN um
wall Floweaaem� SobHatiag/Cooliag
A �('g) U ue &Valud R ite R value R P �° Efri°
Prsica8e
5701 to 6500 HeatbtS De ee Dam Normai
Q 12% 0.40 3E 13 19 10 i
6 Noral m
R 12% W2 30 19 19 l0 Es AFUE
S 12•/. 0.50 3E 17 19 to'- 6
WA W� Normal
T 15% 036 3E 13 Normal
ww � �
U 15% 0.46 3E 19 19 10 6
^
V 15•/. 0.44 3E 17 WA 85 ACE
w 15% 0.52 30 19 19 10 6
WA Norrrml
X 18% 032 38 17 2S WA Nommi
Y 19% 0.42 3E 19 25 WA WA
6 90 AFUE
Z 18•/. 0.42 3E I7 19. l0 90 AFUE
AA 18% 0.50 30 19 19 10 6
I. ADDRESS OF PROPERTY:
2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:
3. SQUARE FOOTAGE OF ALL GLAZING: 1 v
o DIVIDED BY#2
4. /o GLAZING AREA(#3 DIVID :)
5. SELECT PACKAGE(Q—AA-see chart above):
NOTE: OTHER MORE INVOLVED METHODS OF DEIE tM1NING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDING INSPECTOR APPROVAL:
YES: NO:
q-forms-f980303a
780 CMR Appendix J
Footnotes to Table J5.2.1b:
' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylieltts. and
basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall
area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement.
For example,3 ft of decorative glass may be excluded from a building design with 300 W of glazing area.
z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure. or taken from Table J1.5.3a. U-values are for
whole units:center-of-glass U-values cannot be used.
' The ceiling R=values do not assume a raised or oversized truss construction- If the insulation achieves the full
insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R 8
insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of cavity
insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between
the conditioned space and the ventilated portion of the roof. f used Do not include
'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing(i )•
exterior siding,structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER
by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to
wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction..
`The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements.
or Garages).Floors over outside air must meet the ceiling requirements-
'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must
mec: the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned
b,!.,ements must be included with the other glazing. Basement doors must meet the door U-value requirement
d_scribed in Note b.
The R-value requirements are for unheated slabs.Add an additional R 2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3,4,.or 5. If you plan to install more
than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest
efficiency must meet or exceed the efficiency required by the selected package.
'F_or_Heatutg-Degree Day requirements of the closest city or town see Table J51.1a
NOTES:
a)Glazing areas and U-values are maximum acceptable levels.Insulation alues are minimum acceptable levels.
R v
R-value requirements are for insulation only and do not include structuml components-
b)Opaque doors to the building envelope must have a U-value no greater than 035.Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(Le.,may have a U-value greater than 0.35).
c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(035 for doors).
_ 43
/ chimney extend Lindsay Residence
:r Location for possible cupola 163 Long Beach Rd.
Ln Asphault roof Centerville, Ma.
match existing
North Elevation
m Extend over 1 foot so as to ctr.
0
❑ F
addition
LI IJ Ij
26'-0-
Small bump out( stair way)
ONE ■���������
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T♦�������T���T���7�T�T��T�T���T7�7�7��T���1 ���T����7���������
ridge vent
Insulation to code
2x10 Rafters Grade A ceder shingle sidewall
East Elevatiopn.
Sawfit vent
Window replace
® I
West Elevation
Window replace
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o? p S-
essor's map and lot number ... ....................................... 4
Sewage Permit number ........ ........................ '1gSTAL.L.EU IN COW ',
WITIi
House number lam . ENVtRpNMENTAL TITLE q DJSd91,Tq L
............ ................................................ %6
�s's�DE�+il ti: �j��
TOWN OF BARNSTA � ,T TO A7
TABLE C'O 3SERVATION
BUILDIN NSPECTOR COMMISSION
APPLICATION FOR PERMIT TO ............................"6jaC
.................................................................
TYPEOF CONSTRUCTION ................................................................ ....................................................................
-ai
........ ..... .................19....
l�
r .
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for
for a permit according to the following information:
Location .�D.3.....k-.4.A1.Cj...f.-�f�/...../cc/.......� ...:........................................................................
ProposedUse .......�t..(.`�SJ.i. C ?..4. ......................................................................................................................................
cl
Zoning District ........ `........................................................Fire District .L. "�l?./..✓.:.. /4..... 44. �✓1�/�.....................
Name of Owner 91C... ............Address .....iq Jon+E................................................................
Name of Builder- !'?� .1.��C :.2�:4/7k�!�? G..4/.`:�firiff.Address ... .. .f. "�✓ �`� ..!¢+!0r.. ..............
Nameof Architect ...... ..............................................Address ...... ................................................................
Number of Rooms .a�..41�/0.�?(YL..f....................................Foundation .. X..:. . .............................................................
Exterior ........... ........................................................Roofing ..16k.XS1.. ..............................:............................
Floors !t..:S. .:.......................................................Interior ............................. . ........
HeatingJ-7,A.d.........� :�.:............................................Plumbing .... ....... ' ....................
eplace X 'S t '....................................................................Approximate Cost ....!?7 L?c?. ..............................................
Definitive Plan Approved by Planning Board ------______________---------19______. Area ..........................................
Diagram of Lot and Building with Dimensions Fee ..........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
/A, 14j d` l w %S A.
/
A iCJJ u(i r C S"i C erg
'goo t
xv _
t
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. -�/Z/� �l �Opjs,5 3
Name //.. k7.4,^..G.L..'W44//.
....................
W,�NSOHAROLD
4482 REMO L
............ Permit for .............. .....................
SINGLE FAMILY DWELL NG
....................................................... .......................
Location ..1.6.3 Long B
............ .ch...... .Road.......................
Centerville
Owner Harold Swenson
..................................................................
Type of Construction Frame
..........................................
.................................................................................
Plot ............................ Lot ................................
October 20, 82
Permit Granted ........................................19
Date of Inspection ....................................19
-*,Qate Completed ...: 2 ....... .19
-� ......1..... ,._
e A A
A
Assessor's map -and lot. number ... .........
*THE Tod
Sewage Permit number .........—9. ........................
]BAR115TAX
tk NAG&
House number ...............11......Iq
039.
TOWN OF BARNSTABLE
B U I IND I N-SPECTO R
APPLICATION FOR PERMIT TO ..... .......................... .................................................................
TYPEOF CONSTRUCTION ................................................................r.................................................................
.. . .. .. .... ................19........
T.
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information-.
t
Location P.d) ....j4&X.... .................................................................... ..........
ProposedUse ........i ........................................I.................................................................................................
C/ 'e District Lz�Jy�-. �/A.....a5.Zoning District ........................................................................Fir .................................
Nameof Owner A.9.n; ..:.........Address .....A�ITJE.................................................................
Address ...... ......61911I..'s...1J .........Name of Builder*
Nameof Architect .......ljlq .................................................................................................................................Address ....
Number of Rooms ................................Foundation ...........................................................
Exterior ........... ........................................................Roofing ... ........................... ....................................
....................
Floors ........... ...................... .........................Interior ................................... ................
A?
Heating #,1t;- - 0:� - -�v",5 -,�
�')-XA0 . " J,�
..........................................................................Plumbing .........L�...&il..................................... .....................
Fireplace .......... .....................................................................Approximate Cost .....0
.....................................................e........
Definitive Plan Approved. by Planning Board -----------—------—-----------19--------- Area ..........................................
Diagram of Lot and Building with DimensionS Fee ......................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
r r S el,) ho fie. re-o)e /e
r A/ PO elic
A( 7- '4P"P -)( -1� /�?
1, 17 A� / 4
0
vo
4.
«' G !'U w
+
P0,-t 1, 4
0
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. Z-P C �OOS,56 3
Name .......... ......................................
SWENSON,d HOLD A=205-26
IIENSO�
24482 REMODEL
No ................. ermit for ....................................
d erm
Sings
j a....)..
..aU
....FAMLIY...Dvellirig.............
1 0
Locati L.Qag...B.each...IEWad.............
n ry
terville
...............................................................................
Owner ...H.ar.o.ld....S.w.ens.on............................ .... .. .... . .. ....... .....
Type of Construction ..XX4Me..........................
................................�. ..................... .....................
Plot ........ Lot ........ .......................
0 tober 20, 82
Permit Gran ed ........ ...............................19
Date of Insp ction .... ...................I...........19
Date Completed ....... ..............................19
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