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0015 LONG POND CIRCLE
C Yp,Y4 P4 (VY ml o 07 1 01 lot— 'Y' mp *-ill' W, )f fr®rl;', vi, -Gf) wp 1;A11; 100%, P ? ip! up,%w RW' A*W�� 4, n, I# W SOM ae". -I I� , i�;� vvp i rot RN Ifv, Qq% SIM q-yk *07A ,zxwpq RON ,4MY WAY M, ir 13, P4 All P, Z'N 1w, la 1 NN lip, ;A AAA, �17 Y., 0 PRI, vv wv MP IM (fill "w g� r ' .C 10A , 1 1. 1� 'i, A (W -gin !Vi hz�a 9 OR As Into 'k pY2N7 :A Tt, 7- !i1,A-- Zf A' YPOONIA'It ilt_111�1411 IS xv 'V J-F Illy,111Y119 j 40, M, 40 AW %,�Mro A I iw�,I MR, V1, af� this' Il i, 1 1) M�IWO to "�iA RW "%r iff. 1, '94 aw !1� A 41 ,Al 7W �'J-fjfo�4),f W AM& 15, J, ilk -0','p lh�`,;i Q.Y ullio M, i-A I Zlly. P A ,?w"Pl. J1 tj 1,fll�l 11,16 Imp, WTI .1 11 x3p` "p rill ,i7 ,�wi �770 r7""`6 .71 MW All p - " 'Y"0., �'4 ml? 1 '2,15., Iw Rd Iffie vv 4"Y ? , , , ", t`i�` IF 1 4141 Awn -r0w. Iff_$�!f, W, z If Ulf- "I IN lvx V. yi AS fly, 0*1 All �Qm E, I , , � Fv, M SIR pqm Mrif KNIVITIVO 4, jk�gQl!:J,eZj�j%ff� 71� 'Ayr 4U ' Town of Barnstable uilding 7;i.- ^n 3' „ .»"^w,,, ;, ".. .rt ::.w .;arr „ ,+«yF..x. �«� „ �. �Rn mac.{es-.»c^. "'-w .. c �Post:This Card So That i is Visible From the Street Approved Plans Must be Retained on'Job and this Card Must be Kept �1A�lV$fABLE. ! .,g,:, re x ,� ,.„,:, x '"" �$ IPosted Until Final�lnspection Has;Been Made x =b w . � � _ . .. Permit Roivtai Where a Certificate of Occupancy�s Required,such Building shall Not be Occupied;until ai Final.lnspoction has been made = • .«..,.,..,..,aa,. .. w�... .3.auk....,�..r..s.,�,...,.:du.........,v....a.,. ;:: ....k__M ...m:.,�,. ..,. ..�:. .�.. _..:`..a� .-.�:...,-,....m..,.c..,-...: Permit NO. B-18-570 Applicant Name: PADRAIG J GALVIN Approvals Date.Issued: 03/20/2018 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 09/20/2018 Foundation: Residential Map/Lot 209-093 Zoning District: RD-1 Sheathing:�6!/�/�j��Q�cf� """°°° "7-�- Location: 15 LONG POND CIRCLE,CENTERVILLE '"Contractor Na eK PADRAIG GALVIN Framing: 30 (�pr��� Owner on Record: MACBRIDE,BARBARA F&ARTHUR J III TRS Contractor License:a 130184 11 Address: 15 LONG POND CIRCLE j' 2 Est.,Protect Cost: $35,000.00 Chimney: CENTERVILLE, MA 02632 Permit Fee: $228.50 .v , x . Insulation- Description: MAKING OPEN COVERED PORCH A 3 SEASONROOM ADD; Fee Paid. $228.50 WINDOWS AND 1 DOOR TO EXISTING COVERED PORCH ALSO ADD ' - x t Final: INSULATION TO FLOOR AND CEILING AT PORCH AND`INSSTALL _ Date ; 3/20/2018 I /7 HARDOOD FLOOR AND SHEETROCK ALSO AA4� Plumbing/Gas Project Review Re > 1 q Rough Plumbing: wilding Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the`approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall,be in compliance with the local zoning bylaws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and FireOffiaals are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: " 1.Foundation or Footing i gF � Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT. pF THE F, - 3-7 0 tip Application Number.... ...................................................... BARNSTABLE, MASS. Permit Fee.......................................Other Fee........................ 1 39. Total Fee Paid 4 ...................... ......... ...... TOWN OF BARNSTABLE Permit Approval by..........\4&.......... ........ BUILDING PERMIT Map......�.c�q.....................Parcel...... ........................ APPLICATION . Section I - Owner's Information and Project Location Project Address J 15 1-00at Pov)d C-4 r-r—Ie-- 'Village C&�n�wvl Owners Name 0- Bf-1, Owners Legal Address— P0-4� V city State WA zip 02-632- Owners Cell#' E-mail Section 2- Structural Use 2/11/single Two Family Dwelling F] Commercial Structure oveBUMON&DERT. ❑ Commercial Structure under 35,000 cubic feet MAR 0 12018 Section 3 -Type of Permit ❑ VCRAB`' '❑ New Construction E] Move i Relocate [:] ry C Accesso ' Structure Change of use ❑ Demo/(entire structure) El Finish Basement E] Family/Amnesty El Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar El Renovation. Fl Pool El Insulation Other-Spe6ify 2,\-, Section 4 - Work Description Oq 6A i , OAt--A C�>VW-v_-d R:rCA CC '5 F D Q \All V)C_-J ow 5 � t . 6ptitzh �Y Coy erc,_4 r_-eJn ahso P DD n 5 U LP:T/M,1 --IG FLOW- d-)-a Oiekiq ca`_ c -jJ 94nne�A,_k Last updated: 12/28/2017 Application Number..............................I...................... Section 5—Detail F.) I r) L Cost of Proposed Construction b1s,coo Square Footage of Project Grl Age'of Structure bly Dig Safe Number PG ©i4i/i►� V fejed i #Of Bedrooms Existing ' ' Total#Of Bedrooms (proposed) CD 110iMPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design I Section 6—Project Specifics [Wiring ❑ Oil Tank Storage ❑ Smoke Detectors . 1 �r [�Plumbing as ❑ Fire Suppression Y�eating System Masonry Chimney ❑ Add/relocate bedroom Water Supply Public ❑ 'Private Sewage Disposal Municipal ❑ On Site I Historic District ❑ Hyannis Historic District ❑ Old Kings Highway 'bris Disposal Facility: OA J'�U_ I am using a crane ❑ Yes l�o De p tY Section 7--Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes El No ' Section 8— Zoning Information t tt I Lot Area S Ft. Zoning District I Proposed Use 1���)d a) q 1. Total Frontage j �Percentage of Lot Co � verage #;of Dwelling Units(on site) Setbacks Front Yard Required Proposed 4 Rear Yard Required Proposed } Side Yard Required Proposed Has this property had relief from'the Zoning Board in the past? ❑ Yes ElNo • N fi Tact undated: 12/28/2017 r%/e �,m��caau�.,lI�cni/Ccrava� u:eCJa Office of consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR TYPE•Individual Registratib g1cpiratio i a 130184 01/24/2020 ' i PADRAIG GALVIN':. i PADRAIG J.GALVIN 1 20 TROTTING BRED•LN- -: WEST BARNSTABLE,MA 02668 Undersecretary A a Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-073839 Construction Supervisor PADRAIG J GALVIN 16 STEVENS ST HYANNIS MA 02601 Expiration: Commissioner 01/12/2019 t L a 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 Legibly Name(Business/Organization/Individual):_ RVM I C- ,s4LV A I — Address: 20 %0_9TT/,/G- 4WFO ` LIV City/State/Zip: V!~�T Phone#: SOF Are you an employer?Check the appropriate box: b x: Type of project(required): 1.El am a employer with 4. I�I 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ff Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' comp.insurance•# 9. ❑Building addition [No workers'comp.insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §](4),and we have no 13.El Other employees.[No workers' comp.insurance required.] *My applicant that checks box#] 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. U 6 Expiration-Date: A Ile Job Site Address: I GONE 109AID Cl aCL.IF. City/State/Zip: QZ"6 3- 2— 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 c fy under the pa' and penalties of perjury that the information provided above,' true d correct Si ature: ✓ }' Date: 21 2v Phone#: SOC? 6 49 4(2 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 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." IMGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)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 P multiple ermit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Addregs"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lie to thank you in advance for your cooperation and should you have any questions, ' please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street RosbDn,MA 02111 Tel,#617-727-4900 ext 406 or 1477-MASS Fax##617-727-7749 Revised 4-24-07 www.mass.gov/dia 0 DOJO A1 . � Z p L,+ c, �a 'LEIN 80.17•30" 0 o p. e 'o, 214.71• 0 �_ CB_DH_FD a y C� iv CB_DH_FD 0 PROPOSED ADDITION y� 0� �o -10 Q N As � �. �� �° 0 CB_DH_FD -- -- 0 MCO v n ) h OQ) �^ V � I R = 17.02' L = 35.90' A = 120'51'11" 30 0 15 . 30 60 120 ( IN FEET ) 1 inch = 30 ft. ASSESSOR MAP 209 PAGE 93 BARNSTABLE REGISTRY PLAN BOOK 273 PAGE 99 LOT AREA: 23,200±SF PER RECORD PLAN FLOOD ZONE: c [ SITE PLAN- PROPOSED ADDITION 2500010005C REV 08/19/1985 SEPTIC SYSTEM LOCATION APPROXIMATE FROM HEALTH DEPARTMENT RECORDS 15 LONG POND CIRCLE OF CENTERVILLE, MASSACHUSETTS z =�P��N SSyc SCALE: V - 30, DATE: 3-22-10 DAVID yG T-HULIN ' No.39403 DAVID C. THULIN, PE, PLS _ 211 MILL ROAD pQ�ND -EAST SANDWICH, MASSACHUSETTS 02537 su (508) 888-2345 FAX (508) 888-7259 PREP. FOR: MACBRIDE DRAWN BY: PST I CHKD BY: OCT JOB No: 10-010 REV. _ �� SHEET 1 1 C771 - 6 - i' i a f of II �DD �►���1et,RDD 0 n 4A h,f��I�sV�f V u u 0 2c, l6 OC << AID 4 } n ; L . i J �j ' rxis--n Al L EPT { F • . . ry h � it ' a.3 J $ i— a 9 , Application Number........... Section 9— Construction Supervisor Name PAt) (-;,Ae--V I W Telephone Number Address 20 -fka TT y& gRp t*-ity Wet- °9,Ne-State VA Zip O 04 License Number d Z- �3� License Type' Expiration Date 01 Contractors Email PAD Al&64Le C-,M#(L Com Cell # 507 b'4fi � I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation! ed/I by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature r(f ` Date UMi-tiNJ Section 10 —Home Improvement Contractor Name Q.Jme �� Telephone Number Address '� T`f f V6- WoSD TityV4�' &,r-n 4*.ble.State (YI Zip Registration Number ( 30 t �6 4 Expiration Date () c 2-Li / 20 2d I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature "tq I—,. 11 ve%► Date 02 ! $ Section 11 —Home Owners License Exemption Home Owners.Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature q Date 0 2-0 - C Print Name P 6AW I [J Telephone Number CM 07 '34 2-6 E-mail permit to: ( C- L, P1!1 Last updated: 12/28/2017 i t Section 12 —Department Sign-Offs Health Department ❑ Zoning Board (if required) Historic District Site Plan Review(if required) ❑ < Fire Department Conservation ffFor commercial work,please take your plans directly to the fire department for approval. 1 Section 13 - Owner's Authorization as Owner of the subject property hereby iauthorize HOLZ G lJ 1!1 to act on my behalf, in all matters relative to work authorized by this building permit application for: -6"...(Address of j ob) E&AL,Jt4 W, a I� S i tore of Own '• d to i Print Name f Last updated: 12/28/2017 CO-8) y1�1 6 Town of Barnstable Regulatory Services.��N OF BA€_�iSTABIE Thomas F.Geiler,Director, - tip? 3- 47 BAHNSTABLE, ` Building Division MASS. Tom Perry,Building Commissioner FD MA A - 200 Main Street, Hyannis,MA 0264-t- -' '— www.town.barnstable.ma.01VIS Office: 508-862-4038 Fax: 508-790-6230 PERMIT#p;016 Q /Q FEE: $ r SHED REGISTRATION 120 square feet or less Location of shed.(a ress Village Property owner's name Telephone number o X 1 o T 23 Size of Shed Map/Parcel# i�i ature _ Date Hyannis Main Street Waterfront Historic District? v Old King's Highway Historic District Commission jurisdiction? r`Li Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. 'PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. y THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042506 ('' O 'Z � 5h SOD Gp 4; Qr to -A-plZ Z O�0 W O N �c w �. -� -10` vo E Z Ln moo. \ 214.71, �o CB_DH_FD Q Zo 30 CB_DH_FD 0 PROPOSED ADDITION .N v J 2 o O V `o, - CB_DH_FD 0 00 ^�' ^� J h y .CO* O - � O � R = 17.02' L = 35.90' = 120'51'11" 30 0 15 30 60 120 ( IN FEET ) 1 inch = 30 ft. ASSESSOR MAP 209..PAGE 93 BARNSTABLE REGISTRY PLAN BOOK 273 PAGE 99 LOT AREA: 23,200±SF PER RECORD PLAN FLOOD ZONE: C 2500010005C REV 08/19/1985 SITE PLAN- PROPOSED ADDITION SEPTIC SYSTEM LOCATION APPROXIMATE FROM HEALTH DEPARTMENT RECORDS 15 LONG POND CIRCLE �P_,NOFMgss CENTERVILLE, MASSACHUSETTS y> onvlo �p SCALE: 1" = 30, DATE: 3-22-10 C. THULIN 21 No.394o3 j DAVID C. THULIN' PE, . PLS �O �PQ 211 MILL ROAD SURVElO ��I�JJJ EAST SANDWICH, MASSACHUSETTS 02537 (508) 888-2345 FAX (508) 888-7259 PREP. FOR: MACBRIDE DRAWN BY: PST I CHKD BY- DCT JOB No: 10-010 REV. ?j 0 SHEET 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel C Application #0)6 a.5 Health Division Date Issued C7 Conservation Division - Application FeeGO � .. Planning Dept. �.. Permit Fee t � : Date Definitive Plan,Approved by Planning Board ( 613�ID Historic _ OKH Preservation/Hyannis Project Street Address iS ��� IW fa 621-AC I e Village Ce lTelp'llr Owner ^%h w.� a4/k4e,4 #A c `RIPlO{,0 Address I-S-1619 I�b40vd,P Telephone S 6- 775-' 70c 3 Permit Request ® Atd o. ,¢GYq�iToyl Square feet: 1 st floor: existing ko proposed 00 2nd floor: existing 1500 proposed Total newO kw Zoning District Flood Plain Groundwater Overlay Project Valuation � Construction Type Lot Size c23 1;00 5 E Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family. Two Family ❑ Multi-Family(# units) Age of Existing Structure 2q kies Historic House: ❑Yes YN"o On Old King's Highway: ❑.Yes 2'Clo Basement Type: ull ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing -3 new 451- Half: existing new Number of Bedrooms: J existing _new Total Room Count (not including baths): existing new 1 First Floor Room Count 3 Heat Type and Fuel: a Gas ❑ Oil ❑ Electric El Other 'F' r Central Air: r9 Yes ❑ No Fireplaces: Existing New Existing woodkoal stoves ❑Yes ❑ No 'n Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ouezisting a:newF,0size_ Attached rv`'' garage: 2r/existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 110 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ co M Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) - - - r-- Name 1 �,4? ?4$ s 1 c s Telephone Number 77l /$W Address 1,9a3 Pieu) License # CJ06G 5`3 %eA`loiIlE� ,� Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR DATE 7 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED - - MAP/PARCEL NO. ADDRESS VILLAGE _ OWNER �r _ } DATE OF INSPECTION: FOUNDATION FRAME rr)2,3 ho ` } INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. a i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street `t Boston MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information p Please Print Legibly Name (Business/Organization/Individual): Z,[j�/Os (,tt IX�✓1� @ � Q `d��1 Address: G®�j A(ry1q�/ec.� l��► City/State/Zip: C e,v e.,,/"Y 0 6 �?_ Phone#: 6-09-771—lV/U Are you,an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I ,{employees(full and/or part-time).* have hired the sub-contractors 6. ❑.New construction 2.�J 1 am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition workingfor me in an capacity. employees and have workers' Y9. ❑ Building addition [No workers' comp. insurance comp. insurance.# required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 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' 13.0 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. tContractors 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 DIA for insurance coverage verification. I do hereby certify under a s and n s of perjury that the information provided above is true and correct. Signature: Date: Phone#: Offtcial 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#i Information and Instructions ` Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building_appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to 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 Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax # 617-727-7749 www.mass.gov/dia A THE rok'L Town of Barnstable Regulatory Services 1ARNSTABLE, Thomas F. Geiler,Director MAes. F1639. � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize [ S /t S I CJJ to act on my behalf, in all matters relative to work authorized by this building permit application for: Address of rob Signature of Owner Date J C Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side, Q:rORMS:OWN ERPERMIS SION , F Town of Barnstable - Regulatory. Services Thomas F. Geiler,Director + EA INSTABLE, '""03�'9. Building Division ArFD �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION * Please Print DATE: JOB LOCATION: village number street "HOMEOWNER": hone# name home phone# workp CURRENT MAILING ADDRESS: J 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 y responsible for all such work performed under the building permit. _(Section 109.1,1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. { The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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 Construc tion 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 foma/certification for use in your community. Q:\WPFILESTORMS\homeexempt.DOC 0+J17f2010 20:07 5088889609 , MAP INSULATION PAGE 01/04 i. { REScheck Software Versiod 4.3.0 i Co�mpliarice Certificate Project Title: CHUCK PALTSIOS j j Energy Code: m71EG6 f 1 Location: Centerville(Barnstable),Massachusetts Construction Type- Single Family i conditioned Floor Area: 90{{2 Glazing Area Percentage: 16°Jo Heating Degree Days: 6137 s Climate zone; 5 l Construction Site: Owner/Agent: Designer/Contractor: 1 15 LONGPOND CIR. 1 CENTERVILLE,MA Compliance: Maximum UA:19 Your UA:18 Gross Cavity Cont. Glazing UA Area or R-ValLle R-Valup. or Door Calling 1:Cathedral Ceiling(no attic) 90 30,0 0.0 3 Wall 1:Wood Frame,16"o.c. 120' 19.0 0,0 6 Window 1:Wood Frame:Doublg Pane 19 0.320 6 SHGCf 0.30 Floor 1:All-Wood Jolst/Truss-Over Unconditioned Space 90 30.0 0.0 3 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 2007 IECC requirements in REScheck Version 4.3.0 and to comply with the mandatory requirerents listed in the REScheck Inspection Checklist. { Name-Title Signature pate I i i j i i i I i Project Title:CHUCK PALT$10$ Report date: 05118110 Data filename: Untitled.rck Page 1 of 3 " i � 1 Ft5717I2010 28 07 5088889609 ' i MAP INSULATION PAGE 84/64 G 2007 IECC Energ CNJ/ EfficiencyCrifit i Cefling 1 Roof { wall i 19.00 � i . Floor/Foundation 30.DQ Ductwork(unconditioned spaces).' 1 Glass&Door Rating EU:F 7a,!,r j i Mmdow 0.32 0.30 i Door I i Heating& . ■ ■ Equipment E6 j Wt a er Heater: Nam: ------ - --- �� Date: Comments: E i i i 1 . I i f 1 , t t I . fill I - I i 1 � i _ i h1A1'-24-2010 21 c 50 FROh1:MURPHY RES. 150133481345 T0:150$7711410 P.1/2 i AWC Guide to Wood Consonetion 1n High Wind Arcaes:'hO mph Wind Zone Massachusetts Checklist for{Compliance(790 CMR 5301.2.1.I)' Check i Compliance 1.1 SCOPE { Wind Speed(3-eek:-gust) 110 mph .... Wind Exposure Category .. !..... .................... B M I 1.2 APPLICASILIYY r . Number of Stories I .....;...{F { j•; stone$ s2stories ig 2 Roof Pitch ............................:...:.............. ....... F'igg 2)...:...•..........:.. a 12 (Fig )...........c............. ........•.._...... j Mean Roof Haight .......::.....:.....:............... ........................( ,..:.......................j�R s 33' Buildin Width W F 2 g F' 3 ft S 80' Building Length,L ..:....::.... •.....:-.....------......' (Fig 3)...........:...... R Soo, ....._ Building Aspect Ratio(L/W) (F 4 .........M S 3:1 19 )...........:..... Nominal Height of Tallest Opening Pi 4 ` 1.3 FRAMING CONNECTIONS General oompliance with framing connections...............:.... able 2 I 2,1 FOUNDATION Foundation Walls meting requirements of 780 CMR 5404.1' Concrete Masonry. ........... ••`' 1 2.2 ANCHORAGE TO FOUNDATION" i 5/8'Anchor Bolts Imbedded or 5/8'Proprietary Mechanical E{nchors as an altemative in concrete only Bolt Spacing from end oint of plate ..................:.........(Fig 5)...........;...,......... ........ ..... .. in. Bolt Spacing-general......... ...... ..... j j g J_in.s6`-12" Bolt Embedment-concrete....................................... � 84 . (Fig 5)...................: . ................... ._ i in,z 7" { Bofte Wesherent•-masonry............................ . .... ....(F`; 5)................. ......:.................. .in. 15° Plat ..................................................... ...........................k 3"x 3"x%; j 3,1 FLOORS ( ; Floor framing member spans checked Fier 780 CMR Chapter 55 ! .-. ).................................... Maximum Floor Opening Dimension...................................(F19 6).......,...:.......p..:.:.._R S 12'or L12 or W/2 Full Height Wall Studs at Floor Openings less than 2'from E,iderior Wall(Fig 8)........................ .. j Maximum Floor Joist Setbacks Supporting Loadbearing Wel>fr or Shearwall......!:.........(Fig 7)............7..............!......................... _..,ft sd I Maximum Cantilevered Floor Joists Supporting L001)88dri g Walla or Shea rwall................(Fig 8)-..................................................--._.ft S d Floor Bracing at Endwalls ....(G(Fig g)................ g ..:: Floor Sheathing Type .................... .. ter s5}....... ... .1.. Floor Sheathing Thickness Ater 55 in. Floor Sheathing Fastefiing........:.......... .0'able ).fkd nails at a in adge J ` in field 4.1 WALLS Wall Height Loadbdadrig walls. .... .(Fig 10 and Table 5).........................) ft S 10' I�A Non-Loadbeadng walls. ..... (Fig 10 and fable 5 ........ Wall$tud-Spacing .............................................. •..... (F and Table .......... f 0, )...,.. ...;. ft S 2 .1. ....... ... Ig 10 leis 5)................... n.s 24"a.c. Wall Story Offsets — F' s 7&8 ------. ft s d i p,( i9 4.2 EXTERIOR WALLS' Wood Studs Non-Loadbearing walls.................................... (fable 5)......................:.......2x - R in. Loadbearing walls....... ................. ........................... :-........(1 sb10 5)...............:.....:........2x�- R in. Gable End wall Bracing Full Height Endwall Studs............................................(FAl0� )......---'.............:.................. WSP Attic Floor Length.......................:............. .........-(Fig 11)..... .:.......:..... .. _• ft aW/3 . .... ....... Gypsum Ceiling Length(i{WSF'not used).........:.........(F:ig 11).,.,-.,,.:.....,,..,,..•... ft k 0.9W 2 x 4 Continuous Lateral Brace 6 ft o.c... F;ig 11)........:.......... Double Top Plate { Splice Length (Flg 13 and Table G)...! ft V .-....---.................... Splice Connection no.oil6d common nails)..............( •ebleB),.,.,. ,. .._.'..,...; „.,......-.....- i 1'.IAY-24-2010`21:50 FROM:MURPHY RtS. 15083481345 T0:15087711410 P.2/2 i i i A WC Guide to Wood Construction Ingigh Wind Areas �!110 mph Wind Zone Massachusetts Checklist for' 'Compliance'(78e cMa s3o>I.2.><.t)1 Loadbearing Wall Connections )....... Lateral(no.of endnriiled 16d common narls)...:....:.:...(rable 7 ..........' Non-Loadbeering Wall Connections Lateral(no.of endnailed 18d common nails)...............(table B)...-.. _...-,-:.._ ................................... i Load fearing Wall Openings(record largest opening but rctck all openings for compliance to Table 9 Header Spans !...................... ...... '_,•...." . . . ............. .("table 9)........... , „ ..-,. In •-..... •••^ft� ,S ll' Sill Plate Spans (Table 9). _ft_in.511' Full Height Studs (no.of surds) .................... . .(rablea). . ................................... Non Load Bearing Wall Openings(record largatit opening d check all openings for compliance to Table 9) Header Spans,.,.,. fable 9 Sill Plate Spans - (fable 9). . ,....., ...... .L�.ft in.S 12' Full Height Studs(no,of studs).............. ...................(Fable 9)............................................................. 1 Exterior Wall Sheathing to Resist Uplift and Shear SimuRan(iousIY" Minimum Building Dimension,W i; Nominal Height of TallestOpening2 .. .......................... .................................ram S Or i Sheathing Type................... (liote 4)......... -•--....... Cr(7`�.......:..........,�(,�C Edge Nail Spacing j 9.........................................(fable 10 or Hate 4 ii less),.............,......... in. j Field Nail Spacing...:..........................:.. ('table 1Q).....r........ ...................-............ Shear Connection(no.of 16d common naile)('ruble 10)....!:............:. U ..................•_ Percent Full(eight Sheathing.............:....... (•table 10).-..!.....--:...._t.-... ' % 516 Additional Sheathing for Wall with;Opening>6'8*(Design Concepts)...... .............. dJ Maximum Building Dimension,L Nominal Height of Tallest Opening ...... Sheathi T ([iota 4. )..................... ..(..67`y.......... .-.. Edge Nail Spacing.........................................(gable 11 or note 4 if less)........................ U in. i Field Nail pa rig- • ...........:....•.....(rable 11) ....... .....:......-..._:..._..._.......... in. I Shear Connection(no.of 18d common nails)Cir able 11 i Percent Full-Hei Full-Height f ).................. %9 9.............:...:.....(- able 71 ............. ........._ ! 5%Additional Sheathing for Wall with'Opening}6V(Design Concepts)..................... Wall Cladding i Rated for Wind Speed?.:................•.,,, ............ 6.1 ROOFS. p (For Rattans u V i Roof framing members ens checked?..----..... $e AWC.Span Tool,we BBRS Website) RoofOverhang ...................................... . .......... .......... ... ............(Figure ... ' ... ft s smaller of 2'or U3.. .,, ., ..:. Truss or Rafter Connections at Loadbearing Wails Proprietary Connect(" Uplift.....::................:. --........---...('cable 12 pif IQ Lateral ..�,............... . (Fable 12)....'............ .Shear -(iabl a 12�• ... --- ......................... = pif .. : Ridge Strap Connections,if o3llar ties not used per p89+1 21.-- able 13)............................ .T= p f Gable Rake Outlooker. p igure 20), ft s smaller of 2'or U2 j Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift...........................................�...(,Fable (able 14)...-. .::....'..... .................... ..... Lateral(no.of 16d co m n Haile fable 14 ...................L B (QIb_ Roof Sheathing Type....:........,............' r. Y...............(liar 780 CMR Chapters 56 and 59)............_.._.. Roof Sheathing Thickness..........:.................................•,able 2 ....--.....�in.a 7l16"WSP i Roof Sheathing Fastening (, )...............'.._.../ n9 rig.:.........................................(,table c 1. This chaddist must be met in'it9 entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301,2.1.1 Item 1.If the chaddist is met in its entirety then the following metal straps and hold downs are not required w the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 o Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Mold Downs per Figure 18a 2. Exception:Opening heights of up to$ft.shall be permitted uphen 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. I The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness.pressure treated#2-grade. I ✓�ze -Van�nooicuea�.C�i ��iaGaaaac�iuoe�6 1 _ ____—_, ------- ---- -.---, • . Office of Consumer Affairs& usiness Rebaplaho,n' License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR ' before the expiration date. If found return to: m x Registrations° Office of Consumer Affairs and Business Regulation \114644 Expiration: 1.0/8/2011 - to 5170 —� � Tr# 288141 i" � - 10 Park Plaza Suite Type:) DBA v Boston,NIA 02116 ' ' ((; i - C.PALTSIOS BLDG_&REMODELING i ChIAfLES PA ITSIOS j 'I L -- 183 L�ONGVIEW'f3R . CENTERVILLE, MA 02632 Undersecretary _ a Not va id without signature �artn►ent,of Public -Del' Standards 117assachusefts - Regulations and _ Board of`Buildin�su ervisor License - p Constr uctton _ License:.CS 6653 00 Restricted Leo �, . SA 1,83 LONGW M02632 ` �CENTERVIL�� y. _ • 21201 1. .�:`► h Eicpiration:,9(2 2790 _ m5issioner� � ' C'on O Lo � Z - Z O- w ul no �0'. �10 N 80'17'30,, .E o 214.71' 01 Go `o. O: G W Z � CB_DH_FD q o Y,. V iN CB_DH_FD 0 PROPOSED `r ADDITION ya, 0 �p jOl O }C ^ W Ljj „N N C� sue. O V Q CB_DH_FD Q 0) MCO4.0 ^o J o h ^lb* 0 R = 17.02' L = 35.90' = 120*51'11" 30 0 15 30 60 120 ( IN FEET ) 1 inch = 30 ft. ASSESSOR MAP 203 PAGE 93 BARNSTABLE REGISTRY PLAN BOOK 273 PAGE 99 LOT AREA: 23,200±SF PER RECORD PLAN FLOOD ZONE: c SITE .PLAN— PROPOSED ADDITION 2500010005C REV 08/19/1985 h SEPTIC SYSTEM LOCATION APPROXIMATE FROM HEALTH DEPARTMENT RECORDS 'IJ LONG POND CIRCLE y CENTERVILLE, MASSACHUSETTS OFMgss9 SCALE: 1" 30' DATE: 3-22-10 = DAVID cyG O C. cn T+i3940 No.39403 DAVID C. THULIN, PEA. PLS � � UP" 211 MILL ROAD pP BEAST SANDWICH, MASSACHUSETTS 02537 (9�Osu>av� (508) 888-2345 FAX (568) 888-7259 PREP. FOR: MACBRIDE DRAWN BY: PST I CHKD,BY: OCT JOB No: 10-010 REV. 9 SHEET 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION... r Map 2ZI Parcel 'Application f b� Health Division Date Issued Conservation Division E9 Application Fee Planning-Dept: `Permit Fee- Date Definitive Plan Approved by Planning Board C9 Historic - OKH Preservation/ Hyannis Project Street Address / � 0 42 Village eeV%�P/`P;11? Owner ,Ai�hu r Rolm y,4 .,oe�d Address Telephone Permit Request pZP&we owpe ex/-s ita deq Sf' CkI1,4-ee iLn Square feet: 1 st floor: existing proposed 2nd floor: existing proposed -1:15 tal new Zoning District Flood Plain Groundwater Overlay - , Project Valuation ,�' Construction Type _ o Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sup orting`dbcurntation. Dwelling Type: Single Family,, Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes Jo On Old King's Highway: ❑Yes 4HI�o Basement Type: U ctFull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new-40- Number of Bedrooms: existing tgnew Total Room Count (not including baths): existing new First Floor Room Count 3Heat Type and Fuel: ff Gas, ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes 8 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes lr�lo Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name C/�6✓� r/C�- ��/�y�O� Telephone Number., am/ lam-0 7/ Address ,9-3 -�C lI�w Z>,4 License# 6 6\S3 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS"RESULTING FROM THIS PROJECT WILL BE TAKEN TO PaAq DATE SIGNATURE- lr f/ FOR OFFICIAL USE ONLY 1 APPLICATION# DATE ISSUED ti MAP/PARCEL NO. ADDRESS VILLAGE - OWNER DATE OF INSPECTION: FOUNDATION FRAME //o/04 ABC 'f INSULATION I FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING ((&&31 lo r _ DATE CLOSED OUT ASSOCIATION PLAN NO. 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 Legibly Name (Business/Organization/Individual): j�L.' lQ Address:-&? �G�i�ceJ Jj; City/State/Zip: Phone#: Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp.insurance comp. insurance.$ 9. Building addition 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 I LE] Plumbing repairs or additions o myself. work ' right of exemption per MGL y � workers'comp. 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. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un aces d ties of perjury that the information provided above is true and correct. Si nature: Date: //14!117q JIF Phone#:j w e e ?�� A11C) 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#: r . Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the 4 dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house t or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states.that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. 4 Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia • ^ � ✓/ZC �Q9J7/I/2lYIZC(/Cp� M.� �t[L6P.�Q � � ° ! Board of Building Regulations and Standards r Construction Supervisor License ` i" Li a se:`CS 6653 i Birthdate_g/22/1944 i , - { { y piration 9/22/2009 Tr# 2482 J • , �R��ction QO ' E- CHARLES 183 LONGVIEW G-PALTSIOS f' j D'R �`� CENTERVILLE, MA 02632 Commissioner . Board of Build�;�zor�and Standardsu - -- - --- e. - License or registration valid for indi HOME IMPROVEMENT CONTRACTOR vidul use only. Registration �' before the expiration date. If found return to: 114644 Board of Buildin Expiration 1.: g Regulations and Standards 10/8/2009 Tr# 260168 J One'Ashburtou Place Rm 1301 TYpe DBA' Boston,Ma.02108. C.PALTSIOS BLDG f3, &REMOM1 NG CHARLES PALTSIOS.� 183 LONGVIEW CENTERVILLE,MA 02632 Administrator. ' Not valid o t signa re - l 1 IKEr, Town of Barnstable ` Regulatory Services BARNsrj B v Mess. Thomas F. Geiler,Director Building Division, Tom Perry,Building Commissioner. 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, B,4 r } el , as Owner of the subject property hereby authorize C "�a4Y' €�$ i S lr�'� to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Efate Print Name If PropejU Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. , t Q:FORMS:O WNERPERMISS]ON 4 I Town of Barnstable'THE t Regulatory Services BAMSICAB Thomas F. Geiler,Director MAIM All Building Division xED FM't 1 Tom Perry,Building Commissioner 200 Mairi.S,reet,.Hyannis,MA_02601 www.town.barnstable.ma.us Office: 1508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1 Please Print DATE: JOB LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code Tlie 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. DEF7NTITON 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 resl5onsib1e for all such work perforated under the building permit. (Section 109.l.l)--- --— The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The.undersigned"homeowner"certifies that.he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. i Signature of Homeowner 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 I D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)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)icensed 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 helshe understands the responsibilities of a Supervisor. On the last page of this issue is a.fonn currently used by several towns. You may care t amend and adopt such a forrn/certification for use in your community. Q:forms:homeexempt pQ r Town of Barnstable *Permit# 4 l Expires 6 months-from issue date i # saxxsrABLE Regulatory Services Fee MAss. g Thomas F.Geiler,�Director 'L 6 i639.. �0 (� e 0. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-403 8 - Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number r Property A ess 44 e' Residential Value of Work Owner's Name&Address aC—A? eI lenlof u114e Contractor's Name Telephone Number --5—eF7'Y77-O y Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) us 5 ❑Workman's Compensation Insurance Y' r sole proprietor X-PRESS PERMIT he Homeowner ❑ I have Worker's Compensation Insurance J U N 0 3 2002 Insurance Company Name. `r'OWN OF BARPI 'STABLE Workman's Comp.Policy# Permit Request(check box) r] Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-s' a Replacement Windows. U-Value % (maximum.44) . ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance vhth other town department regulations,i.e.Historic,Conservation,etc. Sigma Q:Forms:expmtrg Revised121901 'fle i�anvmoauaea�i a�.,�aaaar�isaetYa , �. BOARD OF BUILDING REGULATIONS. License: C,QNSTRUCTION SUPERVISOR d Numbed� 065651 Birtlazlate �lOT 973 1 �� F cpt 0j- 004 Tr.no: 24151 � E Re (I i MICHAEL D CRO,Wt. !Uf A / PO BOX 92 MASHPEE, MA 02649—$ Administrator Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR � Regtstr��G-6i 1 .938i1 T RMX! n 'yy��y 2003 t �_� t7 0 y e--? 7 fEz }i CROWE BUILDING mar MICHAEL-CROWL, 75 CAYUGA AUE � � MA84EE'MA-62649 <Adm inistrator Assessor's office(1st Floor): 4 - Assessor's map and lot num / / �_� Pyoi THE to`` Conservation(4th Floor): Board of Health(3rd floo • • Sewage Permit numbs - sLUSTAX2 ' Engineering Department( rd floor): �Sio 639'e��� House number Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1.00-2:00 P.M.only TOWN t OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �� C— �(J T TYPE OF CONSTRUCTION _ IJO 0 Fr,a i Z 19 1`7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap lies for a per ccording to t following information: Location Proposed Use �0 2t✓�' Zoning District Fire District !M Name of Owner /q Address- Name of Builder Cap"v Address ���(� Name of Architect Address Number of Rooms Foundation Exterior— dr`-� Roofing � �J Floors PT- pgam- Interior Heating 0-1/i Plumbing O ZU Fireplace 0 Approximate Cost �v Area C Diagram of Lot and Building with Dimensions Fee 1�2- Dedc- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst ble arding a ove con ction. Name ( / Construction Supervisor's License ©6 ` w ((MICHAEL REALTY TRUST ENCLOSE No 8-6-6-59'• Permit For DECK. Single Family Dwelling Location 15 Long Pond Circle r _ Centerville ' 'Michael Realty Trust - Owner` - - Type of Construction Wood Frame Plot Lot Permit Granted April 27 , -- 9 94 Date of Inspection: Frame �` 19 r' Insulation - 19 Fireplace 19 Date Completed , r C rJo 1.:371�'7-03= 7�'rj 11 •--�.. �•�v - - �a•*�cs_ Ga »mac iOS)O�. 3\1JiSSACH3� 73. US - �<•— s�c �G ZS COMPEP} Aa IOH"ISURANCE Al.WT (i7eatseclpaatic:cc) Knrl�s principal plzcccfbcuit=/ do hereby carifj;under the p2imjod pc wda afperj ; =m 2n crnplovcr pro�icir�g ncc foll°"'inS`"o css com' job_ pcnsarion COscformrcmploycsY.tior ; orz zliis InSUr2ncc Company Policy Number �) I am a sole propricrorand hew nooncwerkins for me fVT"I sm s Solt propricro gcrcJ conu:ao r homeowner ardc ��o "--w nc�following wo. c: com ( onc)=nd h:vc I�ircd nc�contrsctors lircd pc=d0n insurzncc polio,= bclo.� Irncc Co:. arTclicr Kc:r-bcr Namc f—Con nor I nscu_ncc Comp:nyPol;(�frrzbcr r:.c ofCor�_C:o: ' Insu=inc:C:..pz j�i'olic7i�cu:n rc 1�.::n- � r7c I<ecc�•cr.�•%o<r-_•�]c��<r.-eer co le tr-:iec <,<•nci rctc L`C:r«cc:v rt�.0 L<Iacrx<�. <=u•GGCCtttVG�cc<!tcls�t�-C�.:C!r C <e<�c:Z«cZ to b<ec= <lsJr.o lcr:Zvcloc tS< Fcr Fk;<*r`LettxCJejcr.-�� t- FreveZr tseteeoact4Doe�eett-?Ij• a< n;( F'c- -t•oc/Cet�Gl_�75�..<c 1(S)),t I:ci•ce b t LcjcI r�r.rc. «_lcN•ct`cdcr �-• Y tfoC2 fvocot< L�<rJof�<ft�t.OQ"<cr3t'CC/•!L beCwc cz r . f - «L:,CCc<<.!_ rr �` Z<L'r«�•.r«vr.Lcr<<f:..•cr. /, �! - �� - • c. t cc_t,,.,.�{._L.<.:--_.c�.-•- � =S c. !�,?)�•:c:S-_f cc c;c rr., cr:( •r.<! _t tc cri c!_cccp�cc1 Or1c =:1 = c�ayof_ � . ]9 1-.iccn_cd1'crr:.i:.cc 7-7 Assessors map and lot. number ............................................ cFTNeTo Sewage Permit numberSI BAUSTAMLE, i House,number .......�......., .............................. 'oo M639 �0 0 MAY a' TOWN OF BAR s T NS ABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... ©,VIS. uC ................................................................................... TYPE OF CONSTRUCTION ...... QCQ� .7=4 cv .............. .............................................................................................. .. ..Q�...p .......................19... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applie for ermit according to to the following information:( Location �� �� ... ....�� Q� Kc-z......... ��.. .U.�.1>�J� ... .. r..................... °�- ...................... .......... ' ProposedUse �eC ..C—� .. ..��. ....................................................................................................................... ZoningDistrict ........... ...�..............................................Fire District ..........0 -. .........:.......................................... Name of OwnerC.,7 U.... . .(c.t... KkJ. R ddress .A. ...�_00.. .................... Name of Builder Address `—� �.�.'"� '............................................. ......_.......................... J. .! .............................. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..............!...................................................Foundation 4:.4. s"t_ . .o......�.>? ...................... Exterior ... :Q.... .! '�^'�:�j..`Qr..............................Roofing �C � ��..� Floors .... ...57 Interior ... .. . ..l4l.A.�. �Q."� ��..........-...Sao............... Heating .... I � ...............................................Plumbing .......!`.!.4................................................................... Fireplace �1 ..................................................................Approximate.Cost �?,So !`�!.0 .............................I............. Definitive Plan Approved by Planning Board ________________________________19________. Area .... ..!. .:.... ......... 0 v Diagram of Lot and Building-with Dimensions Fee '~................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FO'R NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of th j wn of Bar able regarding the above construction. Name ... .... ... .................................. too 4:1 ..:Construction Supervisor's License �2Z ................................. GUY COLETTI/MICHAEL REALTY TRUST A=209-93 No 28381t,� Permit for Build„S.t.9trage,,,Shed, Accessory'to' Dwelling Location ..... .................. Centerville Owner ...... Mi049L.1RP-a j. .y, Trust Type of Construction ......F.rame.......................... A,1! ................................................................................ _ Plot ............................ Lot ................................ Permit Granted .,,September 4,...........19 85 'b Date of Inspection ....................................19 Date Completed ............................:::.......19 0A STEM MUST . Assessor's map and lot number. ............................................ THE r STALLED IN COMPLIANCE o� o Sewage Permit number ................... � : '` r y ��jENTAL CODE AND '�IdVIRO C,IJLATIONS t B,SBSTADLE. • Hous_' number .................... ..........0.,.........................'... WN I�E 9 MAO& T® 1639. j 'f0 Nxi ` TORN OF BARNSTABLE BUILDING INSPECTOR 'APPLICATION FOR PERMIT TO �©�s �C' T W 000 TYPEOF CONSTRUCTION :..................................................................................................................................... ............................................... ... . �{ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applie fora ermit according to the following information: Location �1 ..........�. C..c v�Q�,.......................................... � !�c., . . ......Lo.....q. . ..R,r. .!�! ,C . ...................... .......... .... . ........ ProposedUselC .. 0 ......................................................................................................................... Zoning District ................�...�................................................Fire District ..........(......4.....Q ........................................... Name of Owner .t.-. �... ./C. ddress ..k�.Ldk-15 ...P�r1olk.ke41.c .......................... Name of Builder ..........................................................Address .......l.)..,. -... ........................... Nameof Architect ..................................................................Address .................................................................................... Q Number of Rooms ..............I...................................................Foundation 104, . ..bS . '"....1!f c, _...................... Exterior C.¢aL EJ<P' S............ Q Roofing ... ....................... ........................ l I,Joo Floors ....Y.. .. ..........-................P............................Interior MA.�.S.�J.V�... wa` • Heating ......................Plumbing ......4o.................................................................. L................................ ........................... 45,P!q Fireplace .......!�'.d..................................................................Approximate. Cost ...... ,............................................ Definitive Plan Approved by Planning Board ________________________________19--------. Area ..... b... S . Diagram of Lot and Building with Dimensions Fee O � o SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of th%Twnof Bar able regarding the above construction. Name .................... .......................................................... Construction Supervisor's License .................................... Gt COLETTI/Mi.chael,,Real5y Trust. No ... Permit for- 2LQxagQ...S.hed- --_ r 4c cessax. a..pwe]J in' ........... y... g..................... F Location ...15...Long..P.oad....Cjxcale................. Geniesvill e.................................. Owner .....Guy..Col.etz.i/..Mi.chae-L-Real-ty.. Trust yr Type of Construction Xxame.............................. ✓ - M i>x ................................................................................ L.F" -•; �--• ' ~', t}1 Plot .................. ..... Lot .................. "�• ,......September 4 _ 85 Permit Granted . . . ......a.......;a 9 -' y Date of Inspection ...................... _ f -.19 F4� Date, Completed ...................... . :'.. -piral90 OF f .yyL U �; � 73V l::b t►�C,� 1 s qo t� BAXTER 2<;^43 j S� O t°Gls L�� a GE.eT lGx f ,G-E2T/,cY 7-AIA7r T.y� 'CQG4T/��t/ �EIJT 1""L�JIc_C�� S.4�oWN,yE.2E0.(/COtild.G YS Gd/ry Sc.4 L G— ��-'EQU/.2E�s-1E.t/TS Orc Tf/�' 7'o1!t/NaF 14:1/-14 Al Il2E.c"E.E?Eit/C� IS Awo /s /✓vT' C- t / � o cc" (ue)kii-# Z.30 3 BA XT,E,C • //VST.eU/y.�it/T SU.2YEY€ Tye .E?EG/STE,2Ep L,gc.�p SU.eY6yp�' 4 — Assessor's map and lot num r ...... .,��..�..9J ..... � /OG/ I �oFropy . THE r Sewage Permit number ... CP.......................® � " ���.� ....... ............. C SYSTEM House number .../ i ............. .................................................... - ' � - INSTALLED IN�N ABLE, ' � r EN WITH TITLE 5: ��war aye TOWN ,off' 'BA-RN'S-I r %Wrrr-)L CG S Ps i . y BUILDING INSPE-CtO } -... .......... APPLICATION FOR PERMIT TO �. t �.lnvCan C ,•„•................ .... . TYPE OF CONSTRUCTION (: .�:.a .. :�....... ...... .....:.: ...................... .19.R TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a per it according tol the/following information: Location .�o.T'.,..... .L......o.....�" ......!v✓lC��. ProposedUse ..... .j. .-! '... .It .c.`' . .......1... '`.. .. ....:............................................................................. ZoningDistrict ..................................................Fire District ....... ±!q........................................................ 5:i* O 6.4+I �61 MCA I t S* v�� Vu j I Nameof Owner .. Address ... .............................. ..............r.. ...... ...................... Name of Builder•' ..... ..�.....��...... .1.r. (?l�Q'A.Address .k.........�� ........ Nameof Architect ...........................................Address ....................................................... k Number of Rooms ............... ............................................... ....��.Q! '!�.......:... Exterior ....C ' W ' ............................................................Roofing. Floors .... .."......... .........................Interior .....�r ..:::....,.a;...................................... _. ,Heating ,a` ?.!1..... . .T35....................Plumbing ......... .................................. Fireplace ...... ... .U.". p................. ................................Approximate Cost .............& ^ b(..d . Definitive Plan Approved by ,Planning_,Board _______________________ / �/� f 19 ------• Area .................... ..... :.. Diagram of Lot and Building with Dimensions Fee ........... . .................... .. SUBJECT TO APPROVAL OF BOARD OF HEALTH , , L2 it .. Q I hereby agree to conform to all the Rules and Regulations of the Town o construction. Barnstable regarding the above Name ........................... ................................................... COLETTI, BESS 23`032� Two. Stor , Permit for .. .. ................ .Sinale Family....i�..wel•liau.......... . Location ...Lot...j35.... 5... CIrcle Centervill.q. .... 71 _ ` Bess Colette Owner .... ..... ... .... .............. ... { Frame Type. of Construction Plot ..................... . Lot April 23 , ` ;4 Permit Granted ................................ :..:.1'9 81 Date of Inspection ...19 ............. ., ... .� Date Co lete / ...... —.. ..:19�'/ - PERMIT REFUSED- ....................... a �e� L , /. $•�F Yee '�na. .", r•:'.� �r..'•�/A �^y' ` -• _ -,.. - _ ............. ..... ..........i................................ ,.r M. t •'Iv.v !" "4 F ... .. -S Approved S .......................................... 19 '. { .................... ....................................................... �...�...... ............................................................... - - S1�e,tGL� � '` lL`•( - 3 �3»>�o�K !� y 4�.'� ;�,'1� 17,5 ;t,1� GAtzgA�� C�R1�.tt�1JZ �,. I ,*, • '.�49,3 t>&W4 FLOyAj _ 11G � 3 + 330 G PD N REF-rtc T iK = 330,, (r7G % • 4r7 uS� lo'� 64,E-. SPO-<AL PIT (ono G � ',P AEGA — (50 T-. !: i E MOM t��. sa:iµv#sy ` �j�• :� i..S = 37S 6.P.D ' '� p q3.� r, �o r AJ14 ' a SO y5-. 1 .p TOT,aL•' �ESIGW = .425 G.P.D." EXIT n'•�r a ?"oTo�. t%tit �f Fl.vw = 33D 6 FPD: AIwA aVE2GOl.pT1 { U tZQTE : �•��U 2M1tJ�;0¢ L�'9S: � .:, , i t~41w er.woo {49�i;4�, � M /��►'/./// � .q� ' , . � ({��� PlICHAOD • A fi a U , 51 L� M r Ge�[�4 r } i .,I{ a ' i •(�� ... k a°"�^�3�.l ( �)�I,~'�/,( • 7 . � < i y��1 d"J'�J/ , , tl + � t F• ,r t { ��y • Yet_'•, .7��1;.&?;1`�L / I� i : 3�t � .. '.. � t � �'. I� !�, li Tot' 1-uo L too.o trloc. -s/tea/ icG 93 T � < O- EL Lv dir1:. t i� ,rf.�PPC � IUV•9$'.1 : .� �Oo�? IIl� •>1 S�65o�L 4'pPEx 'Dt,;r Iw. GAL. 95.0 lw- GAI.. 1 AINV. 94.E •4, i I S,aun PIT I WdE AS• D I }..l C:EQTtFtED 'PLC)-r .SQL.A, L —t C bGATI o" ri uo Sea.�.+� 1 t �cl�t,r �r� bAT� , y. ` GGt2Tit- }'rt-(AT T44G_ T700 Jb�T1OlJ '`Stac�W�1. PLALJ RL-� R�t.1Ci= 1-t6a?G�4J Gc 1r1PL�(S W 1 Tk TNT=: �jt DE.t� WE= I A1.tta jr_-rL_,Xr �'c4utcEAA&-' tTSoF r"r PLAN ootL. 2�3 A1.t3 q9 UA-rG 6,6�XTCk � E RcGt,;m-lz D t Wco 5uev�Y��� Tt-Il5 aLAtJ tom, UOT 1'�ASEL7 ;: 064 A.&J osTE,ev%l_LG o MASS, liW,5r OAA,L-_WJ ! SutzVE-� ,. .T1Ae: ol=l=56r-S 514OWw At't�L.t t.1uc' O.e•: u�>cO- rc, 1)cTcCMI%4C-_ LOT t_tN`5 s TOWN OF BARNSTABLE Permit No. ----------—_ Building Inspector cash ma OCCUPANCY PERMIT Bond "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address i,+ •IItI:�Y�7d 1 i'� Wiring Inspector >_ E ,�' ! � Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. ................................................... .. 19...... ..................................................................._..............._..-------.__ Building Inspector 23 Assessors map and lot number 1 �F'(HE t0 Sewage Permit number ....(f)�............................................ Z MA"STAnLE, i Hqusenumber ... , /1» ................................................... r MAO& t639. 9� �Fa MPy a� TOWN OF BARNSTABLE BUILDING INSPECTOR �b PuAJ APPLICATION FOR PERMIT TO .......•�,.. ..... ..... .... . .... ®......................::........ TYPE OF CONSTRUCTION ...................t..�.'. )..dU. .......er M. �..-.,.........................................`................ ..........................19.R r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a pePO mit according to the following information: !rw Location . .....4 0 1 � ......'.. 4.d.... .fir ........... .1 �.!:`-'�...,...f.. :a..r............... ProposedUse .......... . . . ,...7�a.w...... . ......K.�....5..( 4.C!,C;-P............................................. ......................... Zoning District ....................................Fire District ...... 'f-d.............................I........................... Name of Owner ,`.J S`�....4-+y T. ..Address ........f„ G vl$t rU.1........ Name of Builder !"r......er...........:Q..a1 �.1.!.UCH O+'1..Address .. .......o5........ ......................... Name of Architect .......Address .......................................... ................QQ........................................ Number of Rooms ..............7...............................................Foundation .f ... .✓tCr�...... ............ Exierior � ............................................................Roofing !!`a Floors 5M. ...........................................Interior ..... ( ; Jv Heating ! '. ... .. ...1.4.5....................Plumbing ......... ............. .!...5.................................. ...f....-....... i�Fireplace ...... . d. .`..............................................................Approximate Cost .............b.".j.bbO.! `.............................. Definitive Plan Approved by Planning Board ________________________________19________. Area '....................................... r: Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ;L 17 a arm e, f7. , 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r i Name ............... ............................... �.. t COLETTI, BESS "`A=209-93 2-1�032'' Two Story No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location Lot 35 15 Long Pond Circle Centerville ............................................................................... Owner „Bess Coletti Type of Construction Frame - ........................................ ................................................................................ Plot ............................ Lot ......................... , Permit Granted ......A.pril................23.................19 81 I. Date of Inspection ...........d........................19 Date Completed ............1.........................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... 60llha P........1...--1.--..r3✓ Approved ................................................ 19 ............................................................................... ............................................................................... ez� uoipnatsuo� �o adA.L ...... 6 ... . , .ri. ..... JaumoIaToD -- IS LONG Pb iv i) puoa"2uo� gt .. a . �TTTaMQ o z,o Arita E�iiC � ' , ,trig ao} t w,. ' r = -o f ID Cam,- 0 oA S9v a BAXTFR -43 NO,2•.043 Is S. Ir Sh�OWit/,yE.2EO.f/C"Oti/.dL YS !-tom/Thy �� _ SCA L C) PATE Ov*- o Cc— Z30 3 z ,BAS6l� dN.�4r{/ .CEGfSTE,eEU L;�./p SU�'/,:Ey�� Coo v-i vo s /1 dye vey.— •, . /T S�:+cl s To ✓/i�TcG w/�/.�'%qLf C✓L, - �i��� eoY tr ` , - ysu 4Zyr , , , 3 a k t > Lv,Skr✓I,CG'%. V �aCnY SLlii�euq Fi TyvtY GNJ,!f is _I — o .. i/c/7/Z1> . ' _ W -Y•s i ocr • x > . , izl s lbrw eP , NSW �Y/Si//SSG- 2GcN r r r . , 13A/�SAIRA/laic 183 LONGVIEW DRIVE CmPALTSIOS SON CENTERVILLE, MA. 02632- SCALE: k[� 7/w APPROVED BY DRAWN BV: 02 oZ7 O �' - - DATE: y REVISED 771-1410 e .. DRAWING NUMBER ,.•" Bu ILDING & REMODELING LICENSE #:006653 NEW ENGLAND REPROGRAPHICS&SUPPLY CO. GAp�AG� p00� - C 19.29J 2x10 c16110.C. 12 15 LI3.13UILI?IN6 FELL 12 PROP-A-VENT OR EQ. FOAM IN5LJL_ATION " GpX SHEATHING EX15MC4 ' 3O YR.ARCHITECTURAL WINDOW C 126OJ 5HINGLE5 3� ALUM 5EAMLE55 GUTTER J015T HAMGER 3: 2X8 1X316" O.C. FOAM IN51LATION aPA1R SHINGLES / \ <-f0 MATCH EXI5MCD TYVEK PULPING or- - / \ �F ICE - 1/z' cnx PLYWoon 2x65-RV A PIVON Go R-19 INSULATION z� m Y2 N_UE130AW W/ VAP012 PAWIER 5KIMCOAT P1_A5TE1Z 3/4"OAK FLOOR Li 2x PJ.5ILL '-11" 3/4' t&G SUd FLOOR -� u �_i- \ :]E 1/2" O ANCHOR BOLT \ / cd 4'-0" O.C. P.t 2 X 10 16" O.G. FINISNEC�G E s/e" ANCHOR POLt5 8" CONCRETE BLOCK J015tRANGE1Z 9O-C2L) 5-15 12" X 20" FoonNG WINDOW 12�1'AIL - :.: 5rCTION ' - - Date: 183LONGVIEW DRIVE Drawing Name: Proposed Plans for: t0/26 C., PALTS I OS & SON CENTERVILLE, MA. 02632 Office Addition Arthur & Barbara MacBride BUILDING & R E M O D L E I N G 508-771-1410 C Long Pond Circle Centerville, Ma A2 LICENSE #-006653. EXI5TING WALLS F-X15TING PATH t?M, MOF05F-0 WALL5 G NOTE: MLOCATE t�XI511 NG REMOVE WINDOW I2IZY VENT& BATH 1?M. VEN-r' CA INET5 v F-X15-rIN16 i2ININ6 pOOM r l;2Oro5r IP OFFICE APPITION 9 0 R 5K Co I X 6 COM2E 1 OMV MATCH rX15VWCD / ERR �XI S'IG'I NGG MJ17,90C29515 COVP POPC.N III III FwISHEb FLOOK' EQ. E.Q. 10 FL0012 PLAN r-PONT ELEVATION rj — — — — — — — — — L — — — — — — — — — J NEW ADDITION 183LONGVIEW DRIVE oeta: Drawing Name: Proposed Plans for: C. PALTS I OS & SON CENTERVILLE, MA. 02632 Office Addition Arthur & Barbara MacBride BUILDING & R E M O D L E I N G 508-771-1410 C Long Pond Circle Centerville, Ma Al LICENSE # 006653 P _.. - I ,...mom L7 W Rt- LAI- IN JL SC 3RRR y z f r '®raowrw.'r+',r�„msi owsrca+�.sFya.im<••'.evr -" -f Y _ { ALA