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0016 LONG POND CIRCLE
lio ` fan and Ci—rc •__._ '.. ..,. � fir. � - �.. .. ` _ 0 .v ., v v - _ .. •. ..v, .. '-.• '. 'ter � 'r - _ ^ n ' Application number. :'1.. Gi� "PSIS �41 Issued............. _ ...... ...... tip. _ .;. . ibg5�. �� ` Building Inspectors Initials ... . ... ....... n1�p ( A/lap/Parcel ..... TOWN OF BARNSTABLE EXPEDITED`PERIVIIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION :- PROPERTY INFORMATION r Address of Project: NUMBER 4 _ ST ET VILLAGE Owner's Name: I _Wphone Number , Email Address.- " � 1,0• C,0 Cell Phone Number 310 � rt Project cost $ y• Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above'pro erty hereby authorize f FI D RA I(sr- C_.7 L N y J to make application fo u' g pe t ' cordance with,780 CMR Owner Signature: Date: 14 0 6- 2_:?- T OF ORK Siding F Windows (no header change)# .In ulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review G ,/Roof(not applying more than l layer of shingles) Construction Debris will be going to, cMwe�,e_1 CONTRACTOR'S INFORMATION. _ Contractor's name__J� ( "LU f $, Home Improvement Contractors Registration(if applicable)# � f '� (attach copy) Construction Supervisor's License#' L "'� �7 ` (attach copy) Email of Contractor AAr&(5iq L r2� Cam-rA ct i L- q one number �✓ � DV .A L L PROPERTIES THAT HAVE STRUCTURES OVER 75`YEARS OLD OR IF THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFOREA°PERMIT CAN BE ISSUED. r r APPLICATION NUMBER For Tents Only* Date Tent(s) will be•erected Removed on K number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X " X X Additional tent'dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event'`° Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events:may require Fire Department approvab *WOOD/COAL/PELLET STOVES Manufacturer# Y Model/I.D. Fuel Type Testing Lab' Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number f Cell or Work number It understand my responsibilities under the rules and regulations for Licensed Construction - Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand a. the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. ` Signature Date , - ,. APPLICANT'S SIGNATURE r. Signature Glc e N ✓C A - _.Date 60DI All permit applications are subject to a building official's approval prior to issuance. ' - s {. � ° � ,�' ♦ gam. •. �{ �.. •�: .���c; t r 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(Busin ess/Org anizatior>/Individual): ��VM 644,etS Cot hdrm2 LL Address: �� 111�0Yi7 t City/State/Zip: &l Phone#: � Are you an employer?Check the appropriate box: Type of project(required): 1.[2/1 am a employer with � . 4. ❑ I am a general contractor and I 6. ❑.New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity.. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance.1 required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.[Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box 41 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: ��4w 1 � "'s Policy#or Self-ins.Lic.#:;?rJUQ g,0 2 4">100.00-2 _12 Expiration Date: Job Site Address:A za& QoR C! 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 cer, under a' an pe alties of perjury that the information provided above ' true and cor ecr. / Signafore:' GA/ Date: 2� l Phone#: �� Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 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. e Office of Investigations would like to thank you in advance for our cooperation and should you have an questions, Th P Y Y g Y Y P lease do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE ' Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia r l'lN �CCJ,itCCX ( Ii: - ONice,ot Consumer ANalrs{�Business Regulatipn , HpME 111APROVENIEN'1'C©N"tRACTOq 4. TYPE Indlv�dual �ieS�stratlon Ex �rati n E 13918# O1 /2020 r - i .. y RADRAIG J.GALVIN +� � 20TROTTING BREbLN WEST BAR'NSfiAB1 E,MA 02665`: U fdersecretary J w z r Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSS-073839 Gonstrucfion Supervisor L PADRAIG J GALVIN 16 STEVENS ST , HYANNIS MA 02601 Camm►ssroai.er.: 011121�,84 f . o • FICA�+ .��/ 1 A,,�+��rp�./�.���+c. .DATE(MM/0D/YYYY) - - i�. vrT� 0F ,: � �.l,.I Jl�a7iJI[!"!!r!'vL 8/2s/2o18 THIS CERTIFICATE IS ISSUED"AS A MATTER OF, INFORMATION:ONLY AND!CONFERS NO RIGHTS UPON::THE CERTIFICATE HOLDER. THIS: CERTIFICATE DOES- NOT AFFIRMATIVELY OR•NEGATIVELY, AMEND;- EXTEND OW ALTER"-THE-COVERAGE AFFORDED': BY"THE POLICIES- BELOW. THIS CERTIFICATE OF INSURANCE.DOES .NOT.CO4STrTUTE A CONTRACT BETWEEN'THE ISSUING" INSURER(S);. AUTHORIZED . REPRESENTATIVE .OR'PRODUCER, AND THE CERTIFICATE'HOLDER. ;IMPORTANT: ?#,the certificate ;holder Is an ADDITIONAL:INSURED,.the�poticy(ies) ,must jbe endorser!: :#SUBROGATION 'IS WA1UE0, subject to the terms and.conditions of the policy,certain.policies. may require. an..endorsement.. `A,statement-on:this:.certificate..does.not.confer.rigtits_to.the- certificate holder in:lielr.of such:enddrsement(sl. PRODUCER CONTACT NAME CHARLES H CAHILL INSURANCE AGENCY sPHONE 781 837-2300 (781)837-2800 PO. Box 321 AMAIILSS.glse a ca 1 insurance.com Duxbury, MA 02331 INSURER s AFFORDING COVERAGE NA1C# . NAUTILUS INS: COMPANY INSURED- Galhomes, LLC INsuRERE, Travelers Insurance Co. PO Box 848 rss RC: West Barnstable, MA 02668 ;INSURER,D: • INSURER,. E. - - COVERAGES CERTIFICATE'NUMBER , REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED.BELOW.HAVE:BEEN,ISSUED TO-THE.INSURED.NAMED ABOVE:FOR THE:POUCY.PERIOD INDICATED. :;NOTWITHSTANDING ANY:REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER?DOCUMENT WI,TH:RESPECT TO WHICH THIS. CERTIFICATE"MAY SE ISSUED"OR-MAY-PERTAIN;THEINSURANCE AFFORDED:BY THE-POLICIES-DESCRIBED HEREIN IS SUBJECT TO-ALL THE TERMS; - - EXCLUSIONS AND CONDITIONS OF SUCH POL'ICIES.L'IMITS SHOWN MAYIHAVE BEEN,REDUCED'BYPAID CLAIMS. - INSR -LTR� TYPE OF INSURANCE ; WQp ..Y. POLICY EFF POLICY EXP POLI 13 R M I ICY + l LIMITS GENERAL LIABILITY �.EACH'•OCCURRENCE $., 1 000 000 . X' COMMERCIAL GENERALLIABILnY :PREMISES �R DcLL&I s`:. 100,000 CLAIMS-MADE.;;OCCUR ,�* , .fNEAEXP An ona erson 3 rJ- 000 NNS04697 06%15/2018 ' 6/15/2019 � 'PERSONAL B.ADV INJURY $1 OOO OOO . - ,•. " GENERAL AGGREGATE °$..$2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: ,, y, '; ' 'PRODUCTS,-COMPfQPAGC' .$'$2 000 000 S PRO- POLICY - - $ - AUTOMOBILE LIABILITY COMBINED SINGLE L MIT a accident) $ ANYAUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED r AUTOS AUTOS BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS UMBRELLA LIAB OCCUR ti �: EACH OCCURRENCE $ . EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED E O WORKERS COMPENSATION' -; ;; .- - - r:- `;WGSTAT - ;:U }( 'OTH " AND EMPLOYERS'L.IABILITYrFz ANY PROPRIETORIPARTNERIEXECUTIVE 7PJUB8D84188-3 13 11: /15/2017 1/15/2018 E.L.• EACH:'ACCIDEPF,T $. 1,000,000 r B OFFICERIMEMSER EXCLUDED? Y .�iv/A '. (Mandatory-inNH), :E.t,DiSEASE'�EA.EMPLOYEE :$ r - Ifyes,describe:�under � i :DEC IPT O OPERATIONS below" � - � -.DSE SE-'POLICY T . ,.1100010On DESCRIPTION OF:OPERATIONS/LOCATIONS/VEHICLES:(Attach ACORD 101,Addifienal Remarks Schedule,if more space is required) JOB .LOCATION: 16 .LONG �POND:DRIVE CERTIFICATE HOLDER CANCELLATION THOMAS- J. MI20 16 LONG POND DRIVE SHO.ULDANY'OF-THE'ABOVE.DESCRIBED-POLICIES;BE CANCELLED:BEFORE; THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED' .IN CENTERVILLE, MA 02632 ' ACCORDANCE WITH THE:POUCYPROVISIONS. + AUTHORIZED REPRESENTATIVE ©1988-2010'ACORD CORPORATION.All rights reserved. ACORD"25.(2010105) The ACORD name and logo-are registered marks of ACORD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2 0 9 Parcel 038 , Permit# � rr i Health Division�— 1 U 1 Ja'7 I�`1 Date Issued 9`i l a y Conservation Divisions Application Fee .Tax Collector E�- &-,x710,V Permit Fee � Treasurer :77 O v - SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic'-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address 16 Long Pond Circle - Village Centerville, MA 02632 39 Tower Hill Road, Unit 19A Owner Philip C. Bateman Address- Ostervi l l MA 0 2 6 5 I; Telephone (508) 420-9122 ,�� Cpn�l,�T' C.ccR�T 03S�C.�.� Permit Request Add one story two car garage and remodel existing nne /1xr I do Xi(// fort,G rannh Add ion. 17iVsd;' s'P TGs. �e� cv�nd �y¢,� s,�,#C , eA .Ue�.,! &C-& �v��((V*—'NA keowdd Square feet:1 st floor: existing 1565 proposed 2165 2nd floor: existing proposed ' N Total new 6 0 0 s Zoning District RD-1 Flood Plain C Groundwater Overlay AP Project Valuation $10 0,0 0 0 Construction Type wood frame Lot Size 35,396 s f Grandfathered: ❑Yes CA No If yes, attach supporting documentation. Dwelling Type: Single Family �D Two Family ❑ Multi-Family(#units) Age of Existing Structure 1965 Historic House: ❑Yes CA No On Old King's Highway: ❑Yes CRl No Basement Type: M Full C3 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area.(sq.ft) 600 s f Number of Baths: Full: existing 2 new 0 Half: existing 0 new 1 Number of Bedrooms: existing 3 new n Total Room Count(not including baths): existing 6 new 2 First Floor Room Count 8 total Heat Type and Fuel: _,Z1 Gas ❑Oil . ❑ Electric ❑Other Central Air: LF-Yes ❑No Fireplaces: Existing 1 New 1 gas Existing wood/coal stove: ❑Yes :01 No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing M new size 2 5 X 2 Shed:X existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 30 No If yes,site plan review# Current Use f SF T_ _ RP S i'rin+'P ; a l - -Proposed"lJse same---- - BUILDER INFORMATION owner Telephone Number 5 0 8 4 2 0-91 2 Address ' see above License# v Home Improvement.Contractor# Worker's Compensation# r\) co ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO / Barn/stablenLandfill SIGNAT,eR!Q �►�! l DATE �f FOR OFFICIAL USE ONLY -.4k e . PERMIT NO. DATE ISSUBB MAP/PARCEL NO. ADDRESS VILLAGE OWNERS DATE OF INSPECTION: I � FOUNDATION FRAME - 6 p INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL co t Pm w GAS: ROUGH, W a A FINAL FINAL BUILDING co m ►- N — Sm mop :D _ S � m � i-- DATE CLOSED OUT "' O m s 1` ASSOCIATION,PLAN NO m 0 c r a 'p,»+t►cy�o. The 'Town of Barnstable sARKnABLL Department of Health Safety and Environmental Service MASL s ' Building Division 367 Main Street,Hyannis,MA 02601 e: 508.862.4038 ;. 508-790.6130 PLAN REVIEW Owner: &�C1r0.v\ Map/Parcel: ®� 3 Pro ect Address: b �9 PO NA e_'r� I E j Builder: ass ne-r- The following items were noted on reviewing: \r- C- 1 3 1 'FooV, 51 it, jalix Ca% Reviewed by: Date. Tdym of Barnstable ' ' Regulatory.SeXYzdes. a� $ Thomas F.Geller,Director 1639, k,+ Building Division lFb kSA'� • • Tom perry,Building Commissioner ' 200 Main Streak Hyannis,MA 02601 Office: 508-862-4038 Fax; 508-790-6230 permit no, Data +AWMAVIT HOME WROYEMENT CONTRACTOR LAW SWPLBMENT TO 23RMTT.'APPLICATION', , • MGL 0.142A requires that the"reconstmotion,alterations,renovation,repair,modernization,conversion, • •i=proveraeut,xemoval,demolition,or construction of an additionto any pxe-existing owner-occupied buiil&ng containing at leant one but not more than four dwelling units or to structures which are adjacent to such residence or buildingbe done by registered contractors,with certain exceptions,along with other requirements. • Type of Work: C!s G Cti11 Estim4ted Cost e , - Address of Work: CJI � Owner's Name: Date of Application: j U . hereby certify that; Registration is not required for the following reason(s); ' []Work excluded bylaw []lab Under$1,004 ' []Building not owner-occupied ROwner pulling own permit Notice is hereby given that. ' _OARS PULLING THEIR OWN PERIYIIT OR DEALING WITH UNREGISTERED CONTPJCTORS FOR ATPLICAB•,S�E HOME IIYIPROYEMENT W ORKD O NOT H YE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY P'M UNDER MGL c.1h2A, bIGNED UNDERPENALTMS OF PLRTURY Thereby apply for&permit as the agent of the owner. Data Contractor Name Re4istratioarlo. OR Owner's Name �1 J RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 , Residential Addition $ 50.00 t� Alterations/Renovations $ 50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE - square feet x$96/sq.foot= x.0041= ill �I plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 3 6 25D square feet x$64/sq.foot= Aw x.0041= plus from below(if applicable) GARAGES(attached&detached) � � o a� . square feet x$32/sq.ft._ i3C®� x.0041= � O ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch �—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) 4 -6 �Iy��Z � n,� Permit Fee Proicost oFIHE Town of Barnstable Regulatory Services BARNSTABLE, : Thomas F.Geiler,Director MASS.. 9 i6; .� Building Division �pIED A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: L@,9 pZ 7 10o Ll JOB LOCATION: /LP L.o cMD number `` street village W"HOMEONER"��l name home phone#. work phone# n �,l `� ,w^ CURRENT MAILING ADDRESS: �1 y�UW II I I E e Urx 1,t_ A M A 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 strictures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. , The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Ho owner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the' State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt • •' � __ The Commonwealth of Massachusetts •. , Department of Industrial Accidents' WO Bf, "Moffm 600'Washingion Street Boston,Mass. 02111'. Workers' Com ensation.Insurance Affidavit-General Businesses /IM •h �•)x��'vim'. ..:�• ,tom,;e;,ut..v.. �.T�;ar�.y:y,r",•c,,,,." `"`%•• y.'a: . ,..`.~:.bV1 / , 1 rime: ` , address; f state; zi • hone c C1,+� work site loc afiosi full address (] I am.a sole proprietor and have no one $ mess'Type: Retail[]RestaurantBai/Eatin [� 'g F,stablishment working in any capacity. El Office El Sales(includiug•Real Estate,Autos etc.) ❑I am an em to er with employees ees(full& art timO:�0ther �%/� ��c////%%/p/%/////��/o//////////%///m/}y m��ye%s worlang on this fob.. ����%///%/ • I am employer providing vYo :�: •.ii tsf:rl:lji'. :•.7;,�, ::'i,.,P'r`,•i.,S:� ','i.7:1' '•::' � rr'•'''t'i:•4 i�"• �1t1''.'r:a;i.�"" (.. i':s.�• :i .r •��• to ;y,'f. ';�•..:. :.,.. a'�'t'' 'i':':r.1^. .�' _'�:'. �t. : '' COIn'all 31HI'n :•'•�'..': ,i •fj,•, `r: ,�Mr•,;;;r .,'.•i+', , r. .•i' ' .l •r,,,:' ,•f+••.i:;,. '�;�',:`p:� - ..5 : :t� �' ..5::•t,ai�^.'? "•'.i:�" , <''i' :)r.� !i•.�rC't'ti'`nti. ''t. ij•:.r.•if0:.,,, 1 , .. ' seeress:" •' '�•' �.' ~.' ,•,.•,,•:.\;{..; +St •''.'s.`r:�a _ �, •1a •t, 3'' �r.•q._?.:i•::t'. {'•:" %'i'L=%•3: 'i:�' r,+ .• •'}, i' J't''y,i�.'%tr' 'i: ... ' .a;' •.t •'a. 4 '':`p`' ''�4`'• , �110DC.,+a•' •:� ;` " { . of s• � ',:. ••,, :.:;• ��': .• 't . -,t• ••i; tt;• •i' .�;�, :,!,r`;': .. ' • �' ' -�t• .i :� "a�•�•`•, °:'. r; 'a..w; ;.} '•:i'}aS iid'•K.'+. O1lC. •if� t' • irisiirarice.c Y 'rrs •••<:..1: •i. .�.,,• ••'• . .;�: ..,•,_. :. ..".. : .. }.•::,• . r . _.: •..r•.•:..>. • • .:..:.,:: •,�:.:_...: i / / I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: +i �,•.y' .�':' !'r.',. ,''• `•!: .'4i'r :i�..i}S•:• :.y.:r iy• r'„'..al:ti'i '�'r •t'� •� etim"an'•'n'ame. •'.- .,•, '.:.! � ,•.�:._s:;,.:A_ ':.,:,,`ar:: ed2ress:. t, :c: 4'., :• ti: :i •�•'r,%! .k•••a• .:M! ;rp\,,: .'ea:�i•}.•'i•'.i r,:.l•' r'• L ,y.,,I�j• .i;': �•�:r.:`!:w.t%' :r�: `t`t:'S. L: •• r •'!'t.. -•i�'. , —'!: �tY'' � •li0tle•F�i`. '.1= ,t:7 -- - ,: a" .iti .f:. ,: ;t" ';4a'$.:• .'+';�.i. 7^',.'; i,.r•'r� 't' :,.ra .'• .* jf: ,� ` :�+r •OMi a#'•:,gJr.2•t•:.: .x'. •t•L'• `f•'i.<j.`7• iu'surance'co. :r;='•Y`' :'! Cy' '• :.f:. ''' •1'y,:'i, 'r' ::t •t:; 't .J J,. 7' ..a.::l'.'. .C. coinf eri• ute +',:r ::.•. ;,: :'., i` :;• 4, address:.r =• ? .. ' ,o.. '•ti. •1.'" ,'}: a�+ '.•t iti r7;LL�<.'i ,l•. . r• t�•i' OrI'E. t' •i :1 Ci :i.i ''.:h,.• ,:'l: h. i.� 6,1t•1 +j'ai '•1. .1.;"i;,.j • i'. _ .;i:Sy•; •ar ,•;1.• 'f.. a, .1. :r '•�7. a:' .:t: •,,i::.'. , i'�•,.' .i:y`+..• rl 'r cat,:„•, '•a<••' :p'•' •tr•:i;•,. :9•.r' •'�i {,:'~ i::,•�j:' •C.:•��,,t{ ','` .ii1•0".i"i',,t•' t;,,:'; !i,:• `�'�•, ••l;r. '•y:. •+i'.: :a'.•.:is 't: ,.w. +Oil v:if'i — insurancelcb:'+ G. Failure to secure coverage as required under Section 25A of MGI:152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andlor one years'imprisonment as well as civil penalties In the form of a STOP WORK ORDER aria a fine or$100m it day against me. I understand that g copy of this statement maybe forwarde8to the Office of Investigations of the DIA.for coverage verification._ I do hereby certify under the pains and penalties of perjury that the information provided above fs true an40rrg cG Date ^dip 1, L •` Phone# t12 x-.����• . r Print name do not write In this area to be completed by city or town official ofriclal use only pgrmit/license# ❑Building Department . city or town: [ILlcen'Ang Board ediate response is required ❑Selectmen's Office ❑-check itlmm p ❑Health Department contact person: phone Y; ❑Other _ (nvised Sept 2003) , Information and Instructions. Massachusetts General Laws ch4 pter�152 section 25•regiiires all employers to provide workers' compensation.for their•. rrriployees- quoted fromtlie law', an employee is.defined as every person in the service'of another under any contract of hire; express or infied; oral or written. ; p association, corp oration or other legal entity, or any two or more of An employer is de5iied as an individual,partnership, the foregoing engaged a'an enfeiprise, and including the legal representatives of a deceased,employer, or the receiver or trustee of an individual,pa.rtnership'• association or other legal entity, employing employees. 'However the owner of a dwelling house having no, three apartments and-who resides therein, or the.occupant.of the dwelling house bf another who employsp�sbns to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such:employment.be deemed to be:an employer.... MGL chapter 152 section 25 also'states that'every state'or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the.c0inmonwealth for any applicant who has not produced acceptable evidence of compliance with thesmut a�ce coveracontract for the performanceof publictwork until commonwealth nor.any.of its political subdivisions shall en yP acceptable evidence of compliance with the insurance requirements of this chapter,have been presented to the contracting . authority WE Applicants the workers''compensation affidavit completely,by checking the box that applies to your sitdation.:Please Please fill,in • _ supply company nanae, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department'of Industrial Accidents-for confirmation of insurance coverage. .Also•be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen-nit or license is being t the D ar=ent of Industrial Accidents-. Should you have any questions regarding the"law"or if you are requested, no ep ers.'•compensation policy,please call the Department at the niimber�listed.below. requu•ed to obtain a work City or Towns . Pleasebe sure that the affidavit is complete and printed legibly. The Department has provided a space at the tiottoni 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 ffl in the pennit/license number.which will be used as a reference number. The.affidavits may.be.retumed to the uretNpa aientby,rn orFAX.u61ess other arrangements have been made. The Office of Investigations would hke to thank ybu in advance for you cooperation and should you have airy questions, please do not hesitate to give us a•calL- artrnent's address,telephone and fax number: . , . ' � The Commonwealth Of Massachusetts• Department of Industrial Accidents MA of WOSUNtiens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext:406 September 7, 2004 Mr. Jeffrey Lauzon Building Inspector Town of Barnstable 200 Main Street Hyannis, MA 02601 Re: 16 Long Pond Circle, Centerville, MA Building Permit Application' Dear Jeff: As you may recall in our discussion on September 1, 2004, a few building issues were noted in your review of the submitted project plans. The following are the resolutions to those issues: 1. The stamped engineering plan on the steel I beam proposed for the garage is attached. 2. The garage floor slab will be 4" thick with a 6 mil thick poly barrier underneath. Also the porch/breezeway will be constructed with a 4" floor slab. 3. Two basement venting windows will be installed in alternate walls in foundation of family room addition. 4. Shepley reps. indicate that a LVL ridge board will not be necessary in the roof of family room addition. 5. The proposed I joists considered for the floor system in family room will be replaced with 2" X 10" X 14' conventional spruce floor joists placed 16" oc. 6. The look-down roof schematic of existing and proposed dwelling are attached. 7. All dwelling floors will have R-19 insulation, all walls will have R-13 and all ceilings will have R-30 installed. I believe the above resolutions cover all of the issues noted in the plan review. Thank you. P it Bat n r Daniel E. Braman, P.- 0 e-, P® -"C:) 189 Harbor Point Rd. Cummaquid, NIA 02637-0361 k 14904- t--C t ®�,, 4sc) -- fit.t ZZ-- '2®3 a 9 6224 U-.-) r'5 41 CL��. DC tZ Gj 2 56c� LACe, 3TRUC PLO. V®V `f RAMSBEAM V2 . 0 - Gravity Beam Design `~Lidensed to: Dan Braman, P.E. Job: 16 Long Pond Circle, Cent. Steed Code: AISC 9th Ed. SPAN INFORMATION: . Beam *ize (Uset Selected) = W12X30 Fy = 36. 0 ksi Total Beam Length (ft) = 25. 00 Top Flange Braced By Decking LOADS: Self Weight = 0. 030 k/ft Line Loads (k/ft) :. Distl Dist2 DLl DL2 Pre DL1 Pre DL2 LL1 LL2 0. 00 25. 00 0. 188 0 . 188 0. 000 0. 000 0. 500 0. 500 SHEAR: Max V (kips) = 8 . 97 fv (ksi) = 2. 80 Fv = 14 . 40 MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft ft ft fb Fb fb Fb Center Max + 56. 1 12 . 5 0. 0 1 . 00 17 . 44 24 . 00 17 . 44 24 . 00 Controlling 56. 1 12 . 5 0 . 0 1 . 00 17 . 44 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 2.72 2 . 72 Max + LL reaction 6.25 6.25 Max + total reaction 8 . 97 8 . 97 DEFLECTIONS: Dead load (in) at 12 . 50 ft = -0.277 L/D = 1081 Live load (in) at 12. 50 ft = -0. 637 L/D = 471 Total load (in) at 12. 50 ft = -0. 914 L/D = 328 RAMSBEAM V2. 0 - Gravity Beam Design `'=hi ensed to: Dan Braman, P.E. Job: 16 Long Pond Circle, Cent. Steel Code: AISC 9th Ed. SPAN INFORMATION: . Beam Size (Uset Selected) = W14X26 Fy = 36. 0 ksi Total Beam Length (ft) = 25. 00 Top Flange Braced By Decking LOADS: Self Weight = 0. 026 k/ft Line Loads (k/ft) : Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2 0. 00 25 . 00 0. 188 0 . 188 0 . 000 0. 000 0 . 500 0 . 500 SHEAR: Max V (kips) = 8 . 93 fv (ksi) = 2 . 52 Fv = 14 . 40 MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft ft ft fb Fb fb Fb Center Max + 55 . 8 12 . 5 0. 0 1. 00 18 . 97 24 . 00 18 . 97 24 . 00 Controlling 55. 8 12 . 5 0 . 0 1 . 00 18. 97 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 2 . 68 2 . 68 Max + LL reaction 6.25 6. 25 Max + total reaction 8 . 93 8 . 93 DEFLECTIONS: Dead load (in) at 12 . 50 ft = -0. 265 L/D '= 1132 Live load (in) at 12 . 50 ft = -0. 619 L/D = 485 Total load (in) at 12 .50 ft = -0. 883 L/D = 340 b5/04/2005 03:45 15080509509 MAP INSULATION PAGE 01 Permit Number MECcheck Compliance Report ,Massachusetts Energy Code MECcheck Software Version 3.2 Release 1 a Checked BytDatc TITLE4PHIL BATEMAN CITY:Barnstable STATE:Massachusetts HDD: 6137 CONSTRUCTION TYPE: I or 2 Family,Detached 14EATING SYSTEM'TYPE:OTber(Non-Electric Resistance) DATE: 05104,105 DATE OF PLANS;5405 PROJECT INFORMATION: 16 LONG POND CIR. COMPANY INFORMATION: MAP INS.CO. COTOPLIANCE;Passes Maximum UA=344 Your Iiome=284 17.40A Better.Than Code Gross Glazing Area or Cavity Cont. or.Door Perimeter, R-Valtte R-Value U-Factor UA Ceiling 1;Flat Ceiling or Scissor Truss 2060 30.0 0.0 72 Wall 1:Wood Frame, 16"o.c:.: 1110 13.0 0.0 84 Window 1;Wood Frame,Double Pane 80 0.330 26 Floor 1:All-Wood JoisdTruss Over Unconditioned Space 1980 19.0 0.0 93 Floor 2:All-Wood Joist/Tmss,Over UncoWitioued Space 2SO 30.0 0.0 9 FuTuace 1:Forced Hot Air;'87 AFUE COMPLTANCE STATEMENT: The proposed building deli&pi described here is consistent.with The building;plans, specifications,and other calculations submitted with the pernit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECchcek Version 3.2 Release 1 a. The heating load for this building,and the cooling load if appropriate,has been determined using the.applica.ble Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the design load as specified in Sections 780CMR 1310 and T4.4. Builder,De igne' C - Date 05/04/2005 03:45 150800t9609 MAP INSULATION PAGE 02 5 MECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release la DATE:05/04/05 TITLE:P111L GATEMAN Bldg. Dept. Use J J J Ceilings: [ ) J 1. Ceiling 1:Flat Ceiling or Scissor Truss,R-30.0 cavity insulation Comments: 1 J Above-Grade Walls: [ ] J 1. Wall 1:Wood Frame, 16"o.e.,R-1.3.0 cavity insulation Comments: Windows: [ ] 1. Window 1.Wood Frame,Double Pane,U-factor:0.330 J For windows without labeledU-factors,describe fearures: #Panes Frame Type Break?[ ]Yes[ ]No Comments: J J Floors: ( ] 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R.1.9.0 cavity insulation Comments: Y_ [ ] J 2. Floor 2:All-Wood Joist/Truss,Over Unconditioned Space,R-30.0 cavity insulation J Comments: { Heating and Cooling Equipment: [ ] ( 1. Furnace 1:Forced Hot Air,87 AFUF or.higher )`'lake and Model Number _ Air Leakage: [ ) Joints,penetrations,and'all other such openings in the building envelope that are sources of air J leakage must be sealed. [ ] J When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: J 1. Type 1C rated,manufactured with no penetrations blmveen the inside of the recessed fixture and ceiling cavity and scaled or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfm(0.944 L/s)air movement from the the conditioned space to the ceiling cavity. The lighting fixture J shall have been tested at 75 PA or 1,57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder [ ] J Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be identified so chat compliance can be determined. [ ] J Manufacturer manuals for all installed heating.and cooling equipment and service water hcating J equipment must be provided. [ ] ( Insulation R-values,glazing U-values,and heating equipment efficiency must be clearly marked on 03/04/2005 03:45 150EEEE9b09 MAP INSULATION PAGE 03 ( the building plans or,specifications. ( ( Duct insulation: [ ( Ducts shall be insulated per Table J4.4.7,1. ( Duct Construction: [ ] ( All accessible joints,seams,and connections of supply and return ductwork located outside ( conditioned space,including.stud bays or joist cavities/spaces used to transport air,shall be sealed using mastic and Fibrous backing tape installed according to the manufacturer's installation, instructions. Mesh tape may be omitted where gaps are less than 1/8,ineli, Duct tape is not permitted. [ ] The HVAC system must provide a means for balancing air and water 3ysterns. ( Temperature Controls: [ ] ( Thermostats are required for eaeh separate HVAC system. A manual or automatic means to ( partially restr►ct or shut off the heating and/or cooling input to each lone or floor shall be provided. Heating and Cooling]Equipment Sizing: [ ] I Ratted output capacity of the heating/cooling system is not greater than 125%of the design load as ( specified in Sections 780C.MR 1310 and J4.4. ( Circulating Not Water Systems: [ ( Imsulate circulating hot water pipes to the levels in Table 1. ( Swimming i'ool$: [ ] All heated.swimiining pools must have an on/off heater switch and require a cover unless over 2011., of the heating energy is from non-depletablc sources: Pool pumps require a time clock. Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120°F or chilled fluids below 55 OF must be insulated to the levels in Table 2. 05/04/2005 03:45 15000809609 MAP INSULATION PAGE 04 Table 1: M um inim Insulation T9uck wss far Circulafing Hol Wafer -'Pes. Insulation Thickness in Indies by ine Sizes Heated Water Non Circulating_Runoutg �i,�4�l +in�Main4 and Runouts i3n to 1" VD-Al 1.25 1.5"to,2,0_" Qw.e 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1..0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: )Vlirfimum rnSillation Thickness for#VAC Pipes. Fluid Temp. Insulation,Thickness in inches by Pipe Sizcs Pining Svste Tvne& Ra.n e F ?" n l"and Less 1.2 "to " 5-, ,to 41' Beating Systems Low Pres-ure,Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems . Chilled Water,Refrise'v.nt, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 -1.0 1.5 1.5 NOTES TO FWLD(Building Department Usc Only) E l MAP Insulation- agamore(350) Proposal Box 1309 r Sagamore Beach,MA 02562 508-888-3599 Q. 508-888-9609FAX Customer Address Job Name 16 LONG POND CIR./REHAB PHIL BATEMAN Job Address 39 TOWER HILL RD. 16 LONG POND CIR. UNIT 19A Centerville,MA 02632 OSTERVILLE,,MA 02655 Date: 4/5/2005 Job: 1103774 Workarea Inventory Item Phase: 1579491 IA PO: Walls R-13 15 x 93-Unfaced-Wood Framing Walls with Poly Poly 4 Mil 8ft4inx100 Slopes To Plate , R-30 16"x 48"Kraft Faced-Wood Framing W �� Basement Ceiling W/Blockers a R-19 15 x 93-Kraft-Wood Framing Basement Ceiling W/Blockers a R-19 11 x 93 -Kraft-Wood Framing Garage Ceilings` R-19 16 x 96-Kraft Faced-Metal Framing Ceiling R-3016"x 48"Kraft Faced-Wood Framing . Cathedral Walls R-13 15 x 93 Kraft-Wood Framing Interior Walls R-11 15 x 93 Quiet Zone Stairwell R-13 15 x 93-Kraft-Wood Framing Stairwell R 19 15 x 93-Kraft-Wood.Framing Flat Ceiling R-19 Fiberglass Blown Insulation Flat Ceiling R-30 Fiberglass Blown Insulation Exterior Garage Walls R-13 15 x 93-Kraft-Wood Framing Crawl Ceiling w/Rods R-30 16"x 48"Kraft Faced-Wood Framing Walls R-13 15 x 93-Kraft-Wood Framing Vents EAVE VENTS We propose hereby to furnish material&labor-complete in accordance with the above specifications,for the sum of; $39595.00 Terms:Net 15,Payments to be mailed to P.O.BOX 1309 Sagamore Beach,MA 02562 1.5%late payment charge on balances outstanding more than 30 days from date of invoice(18%annum). All material will be as provided in the attached description.All work will be completed in a workmanlike fashion in accordance with the standards of the industry.Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate(s).All agreements are contingent upon strikes,accidents,acts of God or delays beyond our control.Owner to carry fire and tornado insurance and other insurance that may be required by law.Our workers are covered by workers'Compensation insurance to the extent required by law. We do not warrant against and shall not be liable for any damage or injury,including but not limited to mold accumulation,when due to any of the i following causes:the failure of the builder or contractors(other than our Company)to follow the instructions and specifications of the insulation manufacturer,faulty or improper installation or maintenance of drywall or other wail covering;use of accessories or wall preparation materials that do not properly receive the insulation;and compliance with applicable building codes or other government regulations relating to surface preparation,wall coverings,required materials or mandatory procedures. Page I of 1 4/5/2005 Assessor's map and lot number `- /C SEPTIC~SYSTEM MUST BE k, Sewage ermit number :........................................:.:..............`. DIN CflM°LiANC INSTALLED r WITH ARTICLE 11 STATE t '"T n� yo� E TOWN OF :BAR�NSTAB��E � � Ac���.: �A,� T�,�,.T : ON. i 3 STADLE, i " a Y } 39." NU;ILDI.NG INSPECTOR ' �p Y63q i\00 ��MPY a � �,` � � I• S� -u f1PPlICATI6N FOR PERMIT TO ; ....:........................:..... ................................................... :...:....:. TYPE OF CONSTRUCTION ........ .... . ............................... ................................ .............. V C ...19. b , TO THE INSPECTOR OF BUILDINGS: The undersigned hereby ap lies for a ermit according to the following information: � . .... ..... ...l�.:�- ............ ............................................... Location' ............ ...°. ... .... l ........... Use .. .... ..................................1.. ... ...... ..` Proposed .................................. ............................................... ZoningDistrict ........................................................................Fire District ...........................................................�,................. j Name of Owne , .... �J�!C .�V�.............Address .Y` " ..:.................................. Name of Builder . .Address �..� Z..�c�t • /�— Nameof Architect ..................................................................Address .................................................................................... • Number of Rooms / Foundation "' ....... ..................:.!...'. ...° ............. ..°............... ........... r^ ..... ..... ... .... ............ Exterior ......... ..Q .. .Vi'� Roofing ............................ ......................................... . 'J Floors . ..........................:................................:..........................Interior ..:..........................::......................................... Heating ........................:.............Plumbing ........................... .....................,. ............................ ................................ 11 Fireplace ..................:°.........................................................•...Approximate Cost ..................,.............. ...................... .. ......... Definitive Plan Approved by Planning Board -----------_--------------------19________ , Area ...l .... �....... .. . ................ Diagram of Lot and-Building with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH L t . I hereby agree to conform to all the Rd es and Regulations of the Town of Barnstable regarding the above construction. Naa .... ........ .......................... ....... ... .'........ Peterson, Robert 18824 add porch to 2 No ................ -<:Iarmi.t"'for .................................... single family dwelling ..................... ......... -... ................................. 1 - ..16 Long Pond Circle Location ....................:........................................... Centerville :..................... ''— r -a Robert Peterson , ` —` r i Owner ................... ? h u5, .� Type of Construction frame' ..........:.......... a ....................... ..................... Plot ............................ Lot ................................ -` . . November 18 � ,, 76 r"� �: � _ ,� •-_-- __----- -.-� _.. Permit Granted ........................................19 4Date of Inspection .. ... ........� ..... ?19 �4 _ _ �� � • ` Date Completed' .:..........................+�...........19 7 - PERMIT REFUSED .................................. 19 ,f•-r r . �'� ...-_.;x -- - - - - —.-�..�� �', ......................................................J a r .....................................................'", ........ ................................I ..................................... 7 . ..........................................................a.............. Approved ................................................ 19 • ...........................................................................: ...................................................................... - .. �y.._.,?i .trr. .. •y .1r ..• ti " .. ,. _ !.. �w. iC, ,; w.w .•.-.G,;s�lr�. +:.�.. .+q�S....,....,., Assessor's map and lot number .... ....... .�! Sewage, Permit number TOWN OF ;BARNSTABLE y�F THE TO ' 31AUST"LE, i "6 9 BUILDING INSPECTOR am a' APPLICATION FOR PERMIT TO ................` .......... !.. ... ................................................. 7. TYPE OF CONSTRUCTION /tifit.r - ' ... .............................19�b v' _ TO THE INSPECTOR ,OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location //1n1j.'r14.....� � ........... - `............................................................................. ProposedUse ........ ......!s''.!.I......�C-.......--..............!4.... ... ........................................................................................ V ZoningDistrict .............. ...........................................................Fire District ...........................................................�.................. Name of Owner ..............Address .. .. .... %-- ... .�, ......... Name of Builder l X Address .. I.-� q 1�, ........................................ ............................. ............... Nameof Architect ..................................................................Address .................................................................................... . Numberof Rooms ..................................................................Foundation ...................................................,.......................... Exterior ..(1ZQ... .. Roofing ............................................. ........... ................................. ... ........ Floors ......................................................................................Interior .................................................................................... Heating ... ..y......................................Plumbing ............................................. .............................. Fireplace ..................................................................................Approximate Cost ......................................................� Definitive Plan Approved by Planning Board ________________________________19________. Area ... ............. Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name �. ...... .. ..... . ....................:........ .................. ,38 . Peterson, Robert A=209-38 ^~~^- ~~ r~^~~ .-- . ---.—__.—, _ ~ . single~ ^~—^^y ~~~^^^~e ' 16 Long . Location ............................... . Cen lll ---------------- ............................... ' Robert Be ^ == . f' .,,- of Construction_ --—_ .—.. . . . ' — ' . , ' er Permit uronnao ' °"'= of "'"re`"= Date Completed ^ ' . - PERMIT- REFUSED ' 19 _ .---.'�....--. ---.- . . � —..��.�1~7-�-+<��-�==°.�,� ' .......:.----_—.. . � � ........................................ . . .—.-----.,.—.—'---...—..._.----~. ' . � ---------------.. lg ' � � � ^ ^ --------------^''-----'~^'--`— ^ .................... --------------..~--.~ . ^ ' � � ' / + T . N� l ^ i r n _ p. f ' FF, �.06V Ira c�� v2,c� R9 r .M s . l 4 SMOKE DETECTORS REVIEWED gl BLE BUILDING DEPT. DATE FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING • I Proposed Remodehgn and Additlon Plans for 16 Long Pond Circle, Centerville, MA Designer, Builder& Owner: Philip C. Bateman - 39 Tower Hill Road, Unit 19A IMPORTANT - UPGRADE REQUIRED _ Osterville, MA 02655 STATE auN.DINc CODE REaus Tt � �+G Telephone: (508)420-9122 SMOKE DETECTORS FOR THE ENTIRE DWBJJNG WFiF�I Cell No.: (239)898-0224 ONE OR MORE SLEEPMiG AREAS ARE ADDED OR CREATEO. w3Te A SEPMtM PERMIT IS MMtED FAR THE INSTALLATION OF SMOKE DETECTORS-TW EIECTRICAI. PERMIT PgEfi-t4Z SATISFY THIS REQIMR"AW. y GREAT MARSH R0 uT R 28 A.M. IGHBOR 209140 NESHEDS ,S w ti G CB/DH LOCUS 4 9CBIDH125.00 4.30'4 0 E pA.M. 209139 w p 0 CENTERVILLE LOCUS MAP PARCEL 2 p CB/DH PLAN REF 1051125 aPROPOSEDi CB/DH� p opw 129• 76' DEED REF 79861119 �+ ____ S85 27 38 `� ZONING: RD-1 GARAGE ___ — — !� SETBACKS: 30-10-10 _ J— CB/DH Q) GROUNDWATER PROTECTION ZONE. "AP" PROPOSED, "T Ic _ T7 ADDITIONS p b '��O � PARCEL l O 2 "'� "`' W N T PLOT PLAN OF LAND 13.E�•Pelee d PARCEL 3 23 0 o x LOCATED AP olelee 16 LONG POND CIRCLE c„ Cv);IletlousE;;;;,�: CENTERVILLE,, MA. "s"s"s#1s ;ssssss;s ° A. M. 209138 C� p co PREPARED FOR• p AREA=35,396E S.F. ' olle �j BA TEMAN LAW OFFICES AUGUST 13, 2004 CB/DH pp W SCALE: 1"=30' ' PLAN) ` 5 27'30"L 126.30 ( REV N8 126. 47(CALC) .. z ►��AAA REV ca _ ► tN OF m.4s.s � REV Cal o 126. 78 PSTEPH.N f ► S84'30 40 �' J ; YANKEE SURVEY CONSULTANTS IRON pov 5 UNIT 1, 40B INDUSTRY ROAD PIPE • A.M. 209/37 e e �4 ' MARSTONS MILLS, MASS. 02648 ✓,��3— TEL• 428—0055 FAX 420—5553 SHEET I OF I ✓OB /. 53735 GM I f CP L t 771El { Oi j I y � - � rr cj�, 7 -7 �=C y -a j 2 r 0 P x IL t _I Cb T ao� i c a�0 �a� v�10 cc D M Ll 14� s o • `�S { - �Qo� � Imo__ _./_3_.-4._:".__--` � _ ld M t 4 jq �o a X!o L' oV r e--Uol o j I < ► 1 . �.� �ZD 2-p Q M ey- �t=D�-Oast kG C Sic . �„rZavJtr p LL LJ i LIS i , / r I � PC o�Z.C-k1141) i r i d P-> +s Cz Ll L � bCal� Ly aY� a "o a l L 7-,, P�- slyswL2 I J Vol t-1- fwl- f - �( QQ"�� �RQ�S J2c cPl Qj • � �Yz�-��L, Cass C �Ck 1 (e � o AIL 0n- C C f C-t�Q { Ila II � II I f y Z v / 17 16Z •I !i �I is j � �I I � �� � � �' - -- 1 i iV� n�G �0 M. c 1•01 v�oo� 14Ao- f3 atlti i `3 at Iti _ III Ua f ' r