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UNVI050
MADE IN USA
. : Town of Barnstable Building
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That it is Visible Fromahe Street-A roved'Plans Must be Retained on J
wFrvsrn Post.This Card So Th, pp, ob"and this`Card Must be Kept
Muss.- Posted Until Final InspectionMas Been.Made PeY'1111t 1 1 JliJl 1,
°i Where a Certificate«of Occupancy is quired,such Building shall Not be Occupi ed until a Final Inspection has been made.
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Permit No. B-19-3701 Applicant Name: BARBEL, KUAF&ANDREA Approvals
Date Issued: 12/24/2019 Current Use: Structure
Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/24/2020 Foundation:
Residential Map/Lot: 190-1S9 Zoning District: RC Sheathing:
Location: 11 MONOMOY CIRCLE,CENTERVILLE
Contractor-Name:� Framing: 1 l y Zp
Owner on Record: BARBEL, KUAF&ANDREA �: Contractor�License:
2
Address: 11 MONOMOY CIRCLE Project Cost: $ 18,000.00
Chimney:
CENTERVILLE, MA 02632 Permit Fe $ 141.80
p g gym garage. g $ 141.80 Insulation:
Description: Adding a m and iffcue area to the ara e.We are also adding a Fee Paid."
bathroom for use in the gym
Date: 12/24/2019 Final:
Project Review Req: ADDITIONAL SMOKE DETECTOR TO BE ADDEDFOR SQUARE .
FOOTAGE. FOUR FOOT OPENINGS BETWEEWROOMS AS Plumbing/Gas
SHOWN ON PLANS. r Rough Plumbing;
Building Official
Final Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withm,ssix months afterrissuance.
All work authorized by this permit shall conform to the approved appl cationyand I 11 ' thetapproved construction documents-for which this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes.
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 Final Gas:
work until the completion of the same.
- Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are,provided on this permit.
Minimum of Five Call Inspections Required for All Construction Work:' " Service:
1.Foundation or Footing
2.Sheathing Inspection . Rough:
3.All Fireplaces must be inspected at the throat level before firest flue'lining is installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health.
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site
Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
IKE
Application Number.................................................
MASS. Permit Fee................ ...vuler Fee,.......................
1639.
Totalfee Paid............................................................... ......
TOWN OF BARNSTABLE Permit Approval by.... ......................�..On...
BUILDING PERMIT
map....i...................................Parcel.................... ........................
APPLICATION
Section 1 --Owner's Infoimation and Project Location
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Project Address en o C I Village
Owners Name Adv�?a lga�z_ I—.-
Owners teigalwddress)
`City`' State-=� Gtzip
owner—s Car# O 6_ A& SO— 02 776 E-mail �%A6g
Section 2. —Use of Structure
Use Group �_ ❑ Commercial Structure over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet .
Single.X:T-wo Family Dwelling
Section 3 — Type of Permit
❑ New Construction F1 Move/Relocate E] Accessory Structure ❑ Change of use
El Demo/(entire structure) El Finish Basement El Family/Amnesty El Fire Alarm'
Rebuild El Deck Apartment El- sprinkler system
❑ Addition E] Retiining wall F] Solar
1:1 Renovation El Pool El Insulation
Other—Specify
Section 4 -'Work Description)
bax6Mid 6!21— /64:2 IQ & /,,I le,
T..q-t iinfinti-d- 11/1 5n.n I R
` Application Number.............. ................... .: ...........
Section 5— Detail
Cost of Proposed Construction �/ w"d Square Footage of Project
Age of Structure . Dig Safe Number
` Total-#-Of Bedrooms-.(proposed) Sa to �o
Of Bediooms�Existing G/6C
110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design
Section 6—Project Specifics
❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors
❑ Plumbing ❑ Gas ❑ Fire Suppression
❑ Heating System • ❑ Masonry Chimney ❑ Add/relocate bedroom
Water Supply ❑ Public - 0-Private
Sewage Disposal ❑ Municipal ❑ On Site
Historic District ❑ Hyannis Historic District [-]'Old Kings Highway
Debris Disposal Facility: I am using a crane ❑ Yes ❑ No
Section 7—Flood Zone
Flood Zone Designation
Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑
Section 8—Zoning Information.
Zoning District Proposed Use Lot Area Sq. Ft.
Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site)
Setbacks Front Yard Required Proposed
Rear Yard Required Proposed
Side Yard Required Proposed
Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No
Last updated: 11/15/2018
a
x
Application Number...........................................
Section 9- Construction Supervisor
Name Telephone Number
Address City State Zip
License Number License Type Expiration Date
Contractors Email Cell #
° 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.Attach a copy of your license.
Signature Date
F
Section 10—Home Improvement Contractor
Name Telephone Number
Address City . State Zip
Registration Number . Expiration Date
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 Date
Section li HHome=Owners:LicenseEzemption
�Home`Owners Name: Aldf g--a- -e/
T-elephone.Numbe —=5 —S(o q —,�776C-el-l-or'ork-Number:�P 7�
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 require by 7 CMR and a To arnstable. )
Signor a Date
APPLICANT SIGNATURE
17
Signature.,,,,, �� fDate-j
Print.lVame� /A/w���a �afr Lk
� Teleph no e Number
E;=mail-mail t to: f/fOl��ct
Last uvdated: 11/15/2018
i
Section 12 —Department Sign-Offs
r
Health Department ❑ Zoning Board(if required) ❑
Historic District ❑ Site Plan Review(if required) ❑
i
Fire Department ❑
Conservation ❑
For commercial work,please take your,plans directly to the fire department for approval
Section 13— Owner's Authorization
i
I, , as Owner of the subject property hereby
authorize to act on my behalf, in all
matters relative to work authorized by this building permit application for:
i
(Address of job)
Signature of Owner date
Print Name
r
I� Last updated: 11/15/2018
I
The Commonwealth of Massachusetts
Department of IndustrialAccidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass gov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electriciaas/Plunbers�
Applicant Information Please Print Legibly
Name(Business/Organization/individual):
Address:--,ZZ ln- 04om 0V C/
City/_StateLZip_:3 l%Gdl �/i��.� /�a_ Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with- A. [] 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- wed 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'
t 9. El Building addition
[No workers'comp.insurance comp•insurance•
5. We are a corporation and its 10.❑Electrical repairs or additions
L� I am a homeowner doing all work officers have exercised their 11.E Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12.[Roof repair
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 mast submit anew 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.M 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 der a pains an pe 'es o erjury that the information provided above is true and correct
Si attire: (Date:-
,Phone-#•a O J�����0 7—0Z7,,
Official use only. Do not write in this area,to be completed by city or town of xial
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,o or written."
An employer is defined as 'individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a int enterprise;and including the legal repres 'ves of a deceased employer,or the
receiver or trustee of an indivi arlaership,association or other legal entity, ploying employees. However the
owner of a dwelling house having not re than three apartments and who res s therein,or the occupant of the
dwelling house of another who employs p ns to do maintenance,constructi or repair work on such dwelling house
or on the grounds or building appurtenant th not because of such emp yment tl deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state local licensing age cy shaII withhold the issuance or
renewal of a license or permit to operate a business or t nstract build' in the commonwealth for any
applicant who has not produced acceptable evidence of co fiance with a insurance coverage required"
Additionally,MGL chapter 152,§25C(7)states"Neither the co onwealth or any of its political subdivisions shall
enter into any contract for the performance of public work until table a 'dence oicompliance with the insurance
requirements of this chapter have been presented to the contracting on "
Applicants
Please fill out the workers' compensation affidavit completely,by chec ' the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone n )along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability P ' s(L P)with no employees other than the
members or partners,are not required to carry workers'compensatio . If mLLC or LLP does have
employees,a oli is Be advised that this affidavit may a miffed the Department of Industrial
policy � Y eP
Accidents for confirmation of insurance coverage. Also be sure t si and date l e affidavit. The affidavit should
be returned to the city or town that the application for the permit li e is being ested,not the Department of
Industrial Accidents. Should you have any questions regarding a la or if you are ' ed to obtain a workers'
compensation policy,please call the Department at the number elow. Self t mpanies 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 le ly. Th Deparfirent has vided a space at the bottom
of the affidavit for you to fill out in the event the Office o Investi ions has to contact ou regarding the applicant.
Please be sure to fill in the permit/license number whic be us as a reference number. In addition,an applicant
that must submit multiple permit/license applications" any given ear,need only tone affidavit indicating current
policy information(if necessary)and under"Job Site ddress"th applicant should writ "all locations in (city or
town)"A copy of the affidavit that has been offici stamped or marked by the city or wn may be provided to the
applicant as proof that a valid affidavit is on file for/future permi or licenses. A new a davit must be filled out each
year.Where a home owner or citizen is obtaining license or p it not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)s 'd person is N T required to complete this affidavit.
The Office of Investigations would hlce to Von`in advan for your cooperation an should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone and faxAber:
The Commonweal of Massachusetts
DepartmenE of In 'al Accidents
Qfce of estigations t
600 W an Street �.
Boston, 02111 -
Tel.#617-727-4900 ext D6 or 1-877 MASSME
Revised 4-24-07 Fax#617-727-7749
wwwMass.govfdia
Lauzon, Jeffrey
From: Lauzon,Jeffrey
Sent: Thursday, December 12, 2019 11:19 AM
To: 'andrealarsen44@gmaiI.com' -
Cc: Lauzon,Jeffrey
Subject: ViewPermit, Permit No:TB-19-3701
Applicant,
Please be advised that the above application has been reviewed and the following is noted:
1) The construction documents are incomplete. No insulation details submitted. no separation from garage shown.
Only one exit shown from habitable space. Floor plan unclear; new bathroom appears to be outside of existing
garage with no details shown as to impact on exiting habitable space. New smoke detector may be required.
The application is denied pending the submission of the required documents.And, if aggrieved by this notice;you may
appeal to the Building Code Appeals Board within 45 days in accordance with M.G.L. c. 143 § 100.
Respectfully,
Jeffrey Lauzon
Chief Local Inspector
(508) 862-4034
jeffrey.lauzon(c)-town.barnstable.ma.us
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SMOKE DETECTORS REVIEWED
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B*SLE BUILDING DEPT, DATE
FIRE E ENT p
$DTH SIGNATUR o ARE REQUIRED FOR PERMITTING
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Barnstable Bldg.D pt.
L^ Approved by:
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Permit#:
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Town of Barnstable
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Fes}
' Post This Card So That rt is Visible From the Street Approved Plans Must be Retained on Job and this Card Must be Kept Slleli )
9 ^4 �$ Posted UntU;Final Inspection Has Been Made � s ` c
Where a Certificate of Occupancy�s Required,such Building shall Not be Occupied until a Final%Inspection hasibeen made e�1Strditl®n
Registration Number: B-19-4239 Applicant Name: BARBEL, KUAF&ANDREA Approvals
Date Issued: 12/23/2619 Current Use: Structure
Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 06/23/2020 Foundation:
Location: 11 MONOMOY CIRCLE,CENTERVILLE Map/Lot: 190-159 Zoning District: RC Sheathing:
Owner on Record: BARBEL, KUAF&ANDREA Contractor Name: Framing: 1
Address_: 11 MONOMOY CIRCLE Contractor"License: 2
CENTERVILLE, MA 02632 Est. Project Cost: $0.00
Chimney:
Description: 8x 10 shed Permit Fee: $35.00
Fee Paid:: $35.00 Insulation:
Project Review Reg:
Date 12/23/2019 Final-
77
,r
L �scrv� Plumbing/Gas
Rough Plumbing:
Building Official
This'permit shall be deemed abandoned and invalid unless the work aorized:by this permit is commenced within s
uth ix months after issuance. Final Plumbing:
All work authorized by this permit shall conform to the approved application and the'(approved construction documents for which his permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning'by laws and codes.
This permit shall be displayed in a location clearly visible from access street br"road and shall be maintained open for public inspection for the entire duration of the Final Gas:
work until the completion of the same. _
Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and,Fire Officials are provided,pn, is.permit.
Minimum of Five Call Inspections Required for All Construction Work Service:
1.Foundation or Footing
2.Sheathing Inspection Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is'installed
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
5.Prior to Covering Structural Members(Frame Inspection)
6.Insulation Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site
Fire Department
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
Town of Barnstable
THE ti Building Department Services
Brian Florence, CBO
t RAAUSTAXE . - Building Commissioner
639.► � 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma us
Office: 508-862-4038 Fag: 508-790-6230
PERMIT# / yo?� FFE: $35.00
SHED REGISTRATION
RESIDENTIAL ONLY �Jv Cry
200 square feet or less
Location of shed(address) Village
5- 7"S�
Property owner's name Telephone number
9x /0
Size of Shed Map/Parcel#
z, Z��,ov
Signature Data
Hy=is Main Street Waterfront Historic District? .
Old King's Highway Historic District Commission jurisdiction?
You must file with Old King's Highway
Conservation Commission(signature is required)
Sign off hours for Conservation 8:00-9:30&3:304:30
PLEASE NOTE: IF YOU ARE WITHIN TEE JURISDICTION OF ANY OF THE ABOVE
COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION PEE.
PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS.
TffiS FORM MUST BF ACCOMPANIED BY A
PLOTTLAN
Q fDrms-sbc&rg
REV:08/6/17
0� �
Legend
�e J�� � �, El Parcels
- % .., , AN .. . �. �ti --Town Boundary
l s 19�I61 Railroad Tracks
r ,
41 '��r �" � Buildings
190160
/ ..... 1 i A Building
Buildin /
�'•" ] ildings
€.236 y_ Painted Lines
w " Parking Lots
f
Paved
Unpaved
✓- �ti Driveways
E3 Paved
+ 1901 Unpaved
Roads
#22&
® Paved Road
Unpaved Road
Bridge
f
-mow; ✓. - '" Y ® Paved Median
1 l
�''�. '•';F ..�x Y �:'' � 1�0162 -Streams
2 . Marsh
Water Bodies
Al
-N r _
196163
190154
# 5 / \ 1,2
Q41
1901#2153
190164
#€1 94
Map printed on: 12/23/2019 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit
adequate for legal boundary determination or representations of Assessor's tax parcels.They are
Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA o26oi
{� O 42 83 0 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 5o8-862-4624
reflect current conditions,and may contain such as building locations.
,Approx.Scale: 1 inch= 42 feet cartographic errors or omissions. gis@town.barnstable.ma.us