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Home My WebLink About0041 MONOMOY CIRCLE : .5 V � F , t V t (� i 0 6(7)C;i C74 r-) C) Q3 C-1 6Qp 0 CD CD 01 C;CD,C,Q-)�CD C-)0 o C-7 C?C)o C7 C)C,Cl,0 C-)Q1 C,Cl(7? cm C?a C4 C4 t-4 e Q -4rcl e v4wc!pCZ? A. Ij Q�U(J Q)6�7 U�m U Q)U s,-j C�Qjj,�) C) (j C-) ci C-)u ci Ci C,CJ U Cz)C.1 C,) u u u cl C)(j(:j u ci (L u u C 6 z)-co"p 6 6-:3 C:)tz)0 4;:3 obA�J gF3QeJ AA 4-Line.com 'W Stw7eff62097 1-888-860-91120 C:)0 CD n 0 0 dD C3 C)dl'3 0 0 Ci C3 0 1-3 0 0 0 CCr i -)1=1 C)C)0 0 0 C".)lio 4m C)el cn en C3 w w C)v el ej 0 m!)to 0 C-)C:) (t�d-I C)C)0 9)t:?C�l 0 0 a.W eto cn C�3 LI)e�i en&-1 C)00000000 C3 000 ro 0 0 w 0 000 eio-00 Kj wi is"i Z6 Town of Barnstable CF SHE Tp� do Building Department Services Brian Florence, CBO * RAMSrnais, MAW $ Building Commissioner - 'Enn+v+° 200 Main Street, Hyannis, MA 02601 �'� www.town.barnstable.maxs nos g � # Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Aff�.�l>a(vit " I, being on oath, depose and state as follows: My name is 9 6,n R F_t 0 ✓E 12 ,� I am the owner/resident of the property located at: �w*Cn v i l l jM�► �z �3� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: _ !� 1Q I:_P �� ✓ �=2 / s C 4 (— Name &relationship to owner: `The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the,listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. Other Sworn to under the pains and penalties of perjury this j l day of S 0 4 u Ai?y 2019. Signature Phone'Number Print Name- Yl V) Q (Q t4 A. j_i IQ V IF IQ :forms/famaffid.doc q _. rev 11/08/13 Town of Barnstable Building Department OME�� Brian Florence, CBO Building Commissioner CAB 200 Main Street, Hyannis,MA 02601 "UAL DING DEPT y ]NABS. 1639. �m www.town.barnstable.ma.us �® aTEO MA'S A SEP 06 ZO 1�3 ' ,uinuv. _�vo-ov2-4038 Fax. 508-790-62.30 OWN OF BMWs Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is (%,tkp 4 hi�' ��J j°�`�_ I.am the owner/resident of the y property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owne .r• 1 � �d�� `� �. Name &relationship to owner: Ufa-ye The Family Apartment will be the primary year-round residence for"the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing.,I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to note the Building Commissioner immediately in�the event of the sale of this property. If there is no longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of I� 018. `77J_- 6 �� Signature Phone Number i 4 Print Name' q:forms/famaffid.do c rev 11/08/12 DIME r Town of Barnstable Building Department r r Brian Florence,COO r r Building Commissioner 1639. 200 Main Street,Hyannis,MA 02601 Plc 31001 P91.23 00-296 Office: 508-862-4038 131-03-2131 S & Fak:15@*780s6230 AGREEMENT FOR FAMILY APARTMENT I Margaret Laverty, the undersigned, being the owner of property situated at 41 Monomoy Circle, Centerville, MA holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 2351, Page 167, being shown on Assessors' Map 190 as Parcel 200, hereby agree, certify, warrant and represent to the Town of Barnstable that the Family Apartment attached to the back of the garage,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. This unit shall be used for a."Family Apartment" (as defined in Zoning Ordinances)which would require compliance with the Family Apartment Rules and Regulations. The family apartment unit must be occupied only by the property owner or a member(s) of the property owner's family as accessory to an owner-occupied single-family residence. BUILDING DEP� Occupants of Main Residence: John Laverty and Christy Laverty Relationship to Owner: son and daughter-in-law JAN 0 Resident of Family Apartment: Margaret Laverty TOVNN OF 13AFINSTABLI Relationship to Owner: owner This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use. of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this 3 r� day of Ja n cc m r 20(b. TOWN OF BARNSTABLE: OWNER: By: Margaret L verty Brian Florenc , Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date 01 I03 f ao t b Then personally appeared the above-named (owner), Y)'1 a rcgct rf—f- L_ La v-e r4\ and made oath as to the truth of the foregoing instrument,before me. Notary Publi kt,14-�,`.�., Commission Expires: KATHRYN J.BENN Notary Public �' --- .__.,., Commonwealth of Massachusetts gsample My Commission Expires April 27,2023 A NE® Df tam °Ft"ET�,y Town of Barnstable s�xivST"L . Building Department-200 Main Street . �0�p Hyannis, MA 02601 '°lEn M ° Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-17-4262 CO Issue Date: 8/14/2018 Parcel ID: 190-200 Zoning Classification: RC Location: 41 MONOMOY CIRCLE, CENTERVILLE Proposed Use: Name of Tenant: Sprinklers Provided: Gen Contractor: Permit Type: Residential - Single Family Type of Construction: Design Occupant Load: 0 Comments: MARGARET LEVERTY (MOTHER) FAMILY APARTMENT 22 Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 8th Edition Town of Barnstable, ° "-1"�' I i V F Street-Approved Plans Must be Retained on Job and this Card Must K i.10mg e• AH Post This:Card So That t s Visible From the Stbe Kept Posted HARN97 I.& • � ' eM e�0$ Until Final Inspection Has Been Made. �' ° ' ►ru►+39. Vi/,,. e a Certificate of Occupancy Is Required,such Building shall Not be Occupied until a Final Inspection has been made. Per Permit No. B-17-4262 Applicant Name: LAVERTY, MARGARET L -- - A"..royals Date Issued: 01/03/2018 Current Use: Structure Permit Type: Building-Family Apartment with Construction Expiration Date: 07/03/2018 Foundations _ Location: 41 MONOMOY CIRCLE,CENTERVILLE Map/Lot: 190-200 � Zoning District: RC Sheathing: k Owner on Record: LAVERTY,MARGARET L Contractor Name: Framing: L ptf� Address: 41 MONOMOY CIRCLE' Contractor License: 2 CENTERVILLE, MA 02632 Est. Project Cost: $75,000.00 . - Chimney:: Cgri- Description: Construction of af17x33 Family Apartment to be attached to existing Permit Fee: $457.50 3 Bedroom Dwelling,Family Apartment will consist of 1 bedroom, Fee Paid: $457.50 Insulation: r � full bath,kitchenette and living room.Apartment will have(2) . W T p egresses.The apartment will be occupoed by Margeret Levert y�_ ,�� Date: 1/3/2018 Final: p^ (Mother).John,Christy and Mathrew Lavert will occupy existing ` ' � dwelling.Smokes will be updated throughout � i Plumbing/Gas Project Review Req: g Rough Plumbing: O?�` t /JL ",,,Building Official'. ' E T Final Plumbing:a0 / This permit shall be deemed abandoned and,invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: /0 f/46 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 by-lawsand 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. _ k Electrical , The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this'permit A°"- w Service: Minimum of Five Call inspections Required for All Construction Work: 1.Foundation or Footing Rough:Qk, 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is Installed Final: GaC'2— L. !p'GI/�f•% 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage'Rough: 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health 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. 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 I r--7 Town of Barnstable ,.Ir ,_ 'rrar -; w •�.; uve fir.." - Building Post;This'Card So That�t is Visible'From the Street Approvetl Plans Must be Retained'on Job and this Card Must be,Kept { , Kx :. � M" ,Posted Until Final Inspection Has:Been Made t 4 ¢ W y s t *6 _r s 7 n r„ Permit ° Where a Certificateof.Occu anc is Re wired,such:Buildm shall Noi be Occupied until a Final Ins ection`has been made , Permit NO. B-17-4262 Applicant Name: LAVERTY, MARGARET L Approvals Date Issued: 01/03/2018 Current Use: Structure / Permit Type: Building-Family Apartment with Construction Expiration Date: 07/03/2018 Foundation: 1 Location: 41 MONOMOY CIRCLE,CENTERVILLE Map/Lot: 190-200 Zoning District: RC Sheathing: Owner on Record: LAVERTY,MARGARET L ' 6 os/ Td`'1e f ,Contractor Name: Framing: ze Address: 41 MONOMOY CIRCLET x Contractor License: 2 CENTERVILLE, MA 02632 ! #` Est Project Cost: $75,000.00 Chimney: Description: Construction of a 17x33 Family Apartment to.be attached to existing Permit Fee: , $457.50 3 Bedroom Dwelling, Family Apartment will consist of fbedroom, Fee Paid:; $457.50 Insulation: full bath,kitchenette and living room.Apartment will have(2) Final: Date 1/3/2018 egresses.The apartment will be occupoed byMMargeret Levertyr , (Mother).John,Christy and Mathrew Lavert will occupy existing M dwelling.Smokes will be updated throughout . $ .° ^' Plumbing/Gas Rough Plumbing: Project Review Req: Aa ,., Building Official wf 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 tie in compliance with the local zoning by-laws 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 N work until the completion of the same. a Electrical 6 £f The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: r E 1.Foundation or Footing , ". �� 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 O AppHczdcm Numb&........................... 1 lY ................ • BAWMMAIKXNABIL - Pem3rt Fee....... { ......offer Fee... :. .. �� .� �� ate• 4 -" •- TdW Fee Paid .�.. .�........ .. �.�.. ..t. .. . ............... TOWN-OF BARRNSTABLE = Pert Approval by... ..On. ... BIT�DING-PERMIT �i ....................... APPLICATION _� .......:�. .o...... ........ ...�.. Gov. 4!!� Section 1—Owners Information and Project Location Project Address— NN.0 N P rwyo kc L�� wage--6 �J-re PV I�1 Owners Name Owners Legal Address tJ p M �� C�PIC t-6 City �.�iJ� �—�1�� State Owners Cell# 76^ 6133 Frmail ,►� Section 2—Structural Use Single/Two Family Dwelling ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Section 3—Type of Permit ❑ New Contraction ❑ .Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire struct=) ❑ Finish Basement P Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment ❑ Sprinkler S. ystem Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—°Specify Section 4—Detail r Cost of Proposed Constractionl n 0 b Square Footage of Project S(v 0 Age of Structure SS. Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed 110 MPH Wind Zone Compliance Method ❑ MA Checklist WFCM Checklist Design ,` Lastupdaud-11/72017 Section 5 -Work Description 60S1rMC') 10QN V\ k4 17 "tJ,3 i tA,,1L`4 �� - ff_��1T"t5/0i$(D ��Ll. Co y�Y(S'� �� :� ��' (�'► � ��'LL �dJ-Ti$ ; ��'rc:H�n�'tT�' /fF i� ��`'`� 6ecw (e,.b [,Avkal�t- Qwff, V1(Jr T, Section 6—Project Specifics TO 5q Wrong ❑ Oil Tank Storage . P Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression Maso Addhrelocate bedroom Heatin S Chimney VI.Heating yam m5' ey --❑_Private --------- -W-afar-Supply -= -----�-Public----------- ---- — -- Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: lov,".3 O- I an using a crane C 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 s�O Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site) Setbacks Front Yard Required o Proposed 60 Rear Yard Required 10 Proposed b Side Yard Required Proposed _ Has this property had relief from the Zoning Board in the past? ❑ Yes No Last updatuh 11M2017 f Section 9-Construction Supervisor Name Telephone Number Address City State ,Zip License Number License Type Expiration Date Contractors Emaf Cell# I understand my respons'brlities 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 49 , docamenudon required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Sig nature Date Section 10-Home Improvement Contractor p - Name Telephone Number Address City State Zip Registration Number --— - E3 pn - te - -- -- - - - -- -- -- - I understand onsibtiides under the rules and regulations galations for Home 3mprovement Cauixactors in accordance with 780 CMR the Massachusetts State Budding Code. I understand the construction inspection procedmirs,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your ELLC.- Signature Date 'k Section I I-Home Owners License Exemption Home Owners Name: O*F-Ls- I,I, j C-ILAN Telephone Number S6 g "?1 G 'cl 21 Cell or Work Number I understand my regmisbfflities under the rules and regalatims for Licensed Coastraction Supervisor in accordance with 780 CMR the Massachusetts State BmUW Code. I understand the coast action inspection procedures,specific inspections and docunimt efm required by 780 CUR and the Town of Bamstable. Signature Date N APPLICANT SIGNATURE Signatures Date -5�- 1 Print Name MW4,Krs, ( , �C T Telephone Number F OY'-7 7,5r-- '33 E-mail permit to: (��'`t �� 6 Lad updft&-1inrz017 i Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ I11storic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ Conservation For commercial world,please take your plans erectly to the fire deparbnad for approval ,Y Section 13—Owner's Authorization as Owner of the subject property hereby authorize k Q to.act on my behalf, in all matters relative to work authorized by this wilding permit application for: (Address of job) Signature of Owner date M i t L-- �_ .a Print Name I a . Last updated:l l/7/2017 e CFTHETp�, l'own of Barnstable Building Department Brian Florence,CBO r • saxtvsTas�, • y� Mass. Building Commissioner i63� .m 200 Main Street,Hyannis,MA 02601 '0reo near" Y Bk 311-301 Ps 123 296 Office: 508-862-4038 -�1_03-2018 a Fak:15084M(1�6230 AGREEMENT FOR FAMILY APARTMENT I Margaret'Laverty, the undersigned, being the owner of property situated at 41 Monomoy Circle, Centerville,MA holding title under a deed recorded with the Barnstable County Registry of Deeds in Book 2351, Page 167, being shown.on Assessors' Map 190 as Parcel 200, hereby agree, certify, warrant and represent to the Town of Barnstable that the Family Apartment attached to the back of the garage,which contains living quarters, is intended for use as a family apartment,for year-round occupancy. This unit shall be used for a "Family Apartment" (as defined in Zoning Ordinances)which would require compliance with the Family Apartment Rules and Regulations. The family apartment unit must be occupied only by the property owner or a member(s)of the property owner's family as accessory to an owner-occupied single-family residence. BUILDING DFP-T Occupants of Main Residence: John Laverty and Christy Laverty Relationship to Owner: son and daughter-in-law JAN 0 3 201 Resident of Family Apartment: Margaret Laverty TOWN OF BARNSTABU Relationship to Owner: owner This unit shall not be rented as an apartment or as a single room,or in any fashion,which rental would be a violation of the Town of Barnstable's rules, regulations, and zoning ordinances. Prior to occupancy of this unit, affidavits reciting the names of occupants are to be recorded with the building department. This agreement shall be updated whenever a change occurs or every calendar year. This Agreement shall be duly recorded-or filed at the Barnstable County Registry of Deeds/Land Court for the purpose of alerting future owners of the property of this binding Agreement concerning the use of the property as herein stated. The consideration for this Agreement is the issuance of a building permit and/or certificate of occupancy by the Town of Barnstable Building Department. WITNESS our hands and seals this 3 Y day of J_a n Cc CL r 20(b. TOWN OF BARNSTABLE: OWNER: By: Margaret L verty Brian Florenc , Building Commissioner THE COMMONWEALTH OF MASSACHUSETT BARNSTABLE COUNTY, SS Date 01 /03 Jac l b Then personally appeared the above-named (owner), rY)a rci2 red- L_ La ve r4,\ and made oath as to the truth of the foregoing instrument,before me. "==Z�LOA4 Notary Publi 6 1- My Commission Expires: KATHRYN J.BENN * Notary Public Commonwealth of Massachusetts gsample My Commission Expires April 27,2023 Town of Barnstable Building Department Services Brian Florence,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 � tea. � www.town.barnstable.ma.us 659•Mla . Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE E3104MON ' •.�DATE:- Please Print �� . JOB LOCATION: number street village IOI owNER^: u� v� �—d J VILE►° S' - `?'?c�'" �w 33 name home phone# work phone# CURRENT MAILING ADDRESS: • k ICE cityhown 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,Movided.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- f unily dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility-for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. CW, a4iH6 xSignature of H meowner ✓ . Approval of Building Official i 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. R 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 personas 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q-\WPFILES\FORMS\building permit forms\EXPRESS.doc 08/16/17 1 . t Town of Barnstable Building Department Services n.AM Brian Florence,CBO 16"5M�� Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner t C plete and Sign'Tbi. Section If Us' A Buil r r I Owner of the subject property hereby authorize to act on my behalf; in all matters relative to work autho\' d y this boil ' permit application for. (Address o ob) **Pool fences and alarms are the resp sibility of the applicant Pools are not to be filled or utilized befor nce is installed and all final inspections are performed and acc to Signature of Owner Signature o pplicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOIS Rev:09/16/17 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 ,n Please Print Legibly Name (Business/Organization/Individual): 7� Address: LA\ City/State/Zip: 3 • Are you an.employer?Check the appropriate box: ; r Type of project(required): 1.❑ I am a employer with '4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the 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 workingfor me in an capacity. employees and have workers.' ' � y p ty 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 c. 152, 1 4),and we have no. insurance required.}t 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. 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: t Policy#or Self-ins.Lic.#: I 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 the pains and penalties of perjury"that the information provided above is true and correct Signature: �9 G G j Date: 2, ai 7 Phone4- #: �W Official use only. Do not write in this area,to be completed by city or town official t 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*, dividual,partnership,association,co oration or other legal entity,or any two or more of the foregoing engaged in a jo t enterprise,and including the lega representatives of a deceased employer,or the receiver or trustee of an individua, artnership,association or other legal entity,employing employees. However the owner of a dwelling house having n t more than three apartments d who resides therein,or the occupant of the dwelling house of another who emplo s persons to do maintenanc ,construction or repair work on such dwelling house or on the grounds or building appurtena t thereto shall not becaus of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that s`every state or local I ensing agency shall withhold the issuance or renewal of a license or permit to operate a usiness or to const uct buildings in the commonwealth for any applicant who has not produced acceptable idence of compli nce with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states` either the com onwealth nor any of its political subdivisions shall enter into any contract for the performance of publ work until ac eptable evidence of compliance with the insurance requirements of this chapter have been presented to t contractin authority." Applicants Please fill out the workers' compensation affidavit comple ly,by hecking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)an hon number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Li ili Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' comp on insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit ma be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit r 1 ense is being requested,not the Department of Industrial Accidents. Should you have any questions regarding a la or if you are required to obtain a workers' compensation policy,please call the Department at the number 1' ted be w. 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 Departme has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Inve 'gations has to c tact you regarding the applicant. Please be sure to fill in the permit/license number which will be sed as a reference umber. In addition,an applicant that must submit multiple permit/license applications in any giv n year,need only sub it one affidavit indicating current policy information(if necessary)and under"Job Site Address" a applicant should to"all locations in (city or town)."A copy of the affidavit that has been officially stamped r marked by the city or t wn may be provided to the applicant as proof that a valid affidavit is on file for future perm s or licenses. A new affi vit must be filled out each year. Where a home owner or citizen is obtaining a license or pe it not related to any bus' ss or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is N T required to complete this ffidavit. The Office of Investigations would like to thank you in advance r your cooperation and shoul you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of assachusetts Department of Industrial ecidents Office of Investiga 'On$ 600 Washington.Str t Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-8 -MASSAFE Fax#61.7-727-7749 Revised 4-24-07 www,mass.gOv/dia l_ o-v r'Q- �� TOWN OF BARNSTABLE NAM DEPARTMENT 2" APPLICATION FOR CERTIFICATE OF OCCUPANCY a Date Building permit application number map/par F Address of structure Area of structure C.O.will be issued to � Jy - Name of Tenant Edition of Building Code Use and Occupancy Classification Type of Construction Design Occupant Load r Is the facility licensed by a State agency Yes ❑ + No if yes If yes,name of agency Relevant Code of MA Regulations(CMR)that apply v� i�tr Automatle Sprinkler System _ Sprinklers provided? Yes No Sprinklers required? Yes 0 No Buildlag Deparrtatent Use only Special Conditions: 19C -T Liu . . QUI DE 4 GUIDE TO ";WOO® CONSTRUCTION IN HIGH! WIND AREAS FOR ONE- ANDIWO FAMILY DWELLINGS A.FAY V. American Forest & Paper Association American Wood Council NOV. - In Cooperation with the nODECOU CIr U International Code Council® CODECOUNCt� 110 MPH EXPOSURE B WIND-ZO14E Bracing Gable End Walls • WSP Attic Floor Length................................................:(Figure 11)...............................d�3 ft. >_W/3 Gypsum Ceiling Length.................................................. (Figure 11)............................. ft. >_0.9W . Double Top Plate Splice Length........................ :......:.............. ... (Figure'-13)...........................................�ft. Splice Connection (no.of 16d common nails) ..............(Table 6).................................................. Loadbearing Wall Connections V11, Uplift. (proprietary connectors)...........:.......................... (Table 7)............................*........U=U61b. Lateral (no.of 16d common nails) ................................ (Table 7)................................................ . Non-Loadbearing Wall Connections Uplift. (Proprietary connectors)...................................... (Table 8).....:...............................U = lb. Lateral (no. of 16d common nails) .................................. (Table 8)................................................ 31, f Wall Openings Header Spans...............................................................(Table 9)......................... ft. 0 in. :- 11' Sill Plate Spans..............:..............................................(Table 9)... ....................._ __ft. 0 in.< 12" Full Height Studs(no.of studs .............. Table 9 Connections at each end of header or sill Uplift. (proprietary connectors) . (Table 9) Lateral (proprietary connectors Table 9 ..::.......................................... ! Ib. ✓ Wall Sheathing Minimum Building Dimension,W Sheathing Type......................................................... (Table 10)..................... ........... W S P��f� 7 Edge Nail Spacing ......................... Table 10 ...........................:......1...... Field Nail Spacing...............................................:... (Table 10).......................................... -in. Shear Connection (no.of 16d common nails)........ (Table 10).:.....................................4...... 'T Hold Down Capacity............................................... (Table 10)......................................... ... .`. XQ lb.' ✓ Percent Full-Height Sheathing . Table 10 .................:. . Maximum Building Dimension, L ` �� Sheathing Type....................................................... (Table 11) ........... Edge Nail Spacing.... w Ed S . ' 9 P g....................:................. -...,. (Table 11)......................................... in. Field Nail Spacing................................................... (Table 11)........................................... in. _I/ Shear Connection (no.of 16d common nails)........ (Table 11)....................::..................::.......3A11r Hold Down Capacity. ............................... ........ (Table 11) ..... .............. . ...........44,0lb. Percent Full-Height Sheathing................................ (Table 11)..........................................32> 146 �c Wall Cladding Ratedfor Wind Speed?......................................................................................................................... 5.1 ROOFS framingRoof g................... ................................................(Figure ) ) Roof Overhang embers spans checked..........................."'•' Fi urer 9FCM ................................ft. <_2'or U3 Truss, I-Joist, or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift. ......................................................................(Table 12)...................................U =�Ib. Lateral................... ............ (Table 12)...................... Shear...................................................................... (Table 12)...................................S= lb. _7 Ridge Strap Connections-Tension ..... (Table 13) - Pif Gable Rafter Outlooker....................................................... (Figure 20 ft. ft.15 2'or U2 �✓ Outlooker Connections at Non-Loadbearing Walls Proprietary Connectors Uplift. ...................................................................... (Table 14)......................:............U lb. Lateral...............................................:..................... (Table 14).........:..........................L=-tit lb. Roof SheathingType `. 1RC or WFCM "� Yp ................................. ....................... ( )............:......:....., Roof Sheathing Thickness.............................................................................................�in. ;!3/8"wsp -17 Roof Sheathing Fastening................................................... (Table 2)....,.............................................. II @GMGnow 110 MPH EXPOSURE.B WIND ZONE Bracing Gable End Walls f WSP Attic Floor Length................................................. (Figure 11)............................... . ft. >_W/3 Gypsum Ceiling Length.................................................. (Figure 11)............................. ft. >_0.9W �.. Double Top Plate SpliceLength................................................................ (Figure 13)................................:.........._ft. Splice Connection (no.of 16d common nails) .............. (Table 6).................................................. Loadbearing Wall Connections Uplift. (proprietary connectors)...................................... (Table 7).....................................U= lb. Lateral (no.of 16d common nails) ................................ (Table 7)................................................ Non-Loadbearing Wall Connections Uplift. (proprietary connectors)...................................... (Table 8).....................................U = lb. Lateral (no.of 16d common nails) .......... (Table 8)......:............................................ Wall Openings Header Spans................. ........... ..........:................ (Table 9)........................._ft._in. <_ 11, Sill Plate Spans............................................................. (Table 9)........................._ft._in. <_ 12' Full Height Studs(no.of studs)..................................... (Table 9)................................................ Connections at each end of header or sill Uplift. (proprietary connectors)...............................(Table 9).............................................!lb. Lateral (proprietary connectors).............................(Table 9)............................................. lb. Wall Sheathing Minimum Building Dimension,W SheathingType......................................................(Table 10).......................................... Edge Nail Spacing.................................................. (Table 10)......................................... in. Field Nail Spacing...................................................(Table 10)..............:.....:.................... in. Shear Connection (no. of 16d common nails)........ (Table 10)................................................_ Hold Down Capacity............................................... (Table 10).......................... .............. lb. Percent Full-Height Sheathing................................ (Table 10)............................................_% Maximum Building Dimension, L SheathingType...................................................... (Table 11).......................................... Edge Nail Spacing ..............(Table ......................................... in. ........................ .....(Table 11).*............................ . Field Nail Spacing ...................... ........:.., m: Shear Connection (no..of 16d common nails)........ (Table 11).. .............................................T Hold Down Capacity............................................... (Table 11)........................................... lb. Percent Full-Height Sheathing ..... Table 11 ..................................0........._0/0 Wall Cladding Ratedfor Wind Speed?..............................................................................................._.....................:... 5.1 ROOFS Roof framing member spans checked?............................... (/RC or WFCM)...................................:.........: Roof Overhang ............ ..... ................................. (Figure 19 ...........—ft.<_2'or U3 Truss, I-Joist, or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift. ...................................................................... (Table 12)...................................U = lb. = Lateral..............................:......................................(Table 12).....................:..............L lb. Shear...................................................................... (Table 12)...................................S= lb. Ridge Strap Connections—Tension................................... (Table 13)....................:................T= plf Gable Rafter Outlooker....................................................... (Figure 20)....................--ft. ft.5 2'or U2 Outlooker Connections at Non-Loadbearing Walls Proprietary Connectors Uplift. ....... (Table 14).:.:.....................:.........U lb, ... ......................................................... Lateral..................................................................... (Table 14).....................................L= lb. Roof Sheathing Type................................................:.........ORC or WFCM)..........................' Roof Sheathing Thickness............................................................................................._in. 3/8"wsp ..... Table 2 ................ Roof Sheathing Fastening..........:..........:...............:....... ( ) ....:..---........................— RICHIE'S INSULATION INC. 111 OLD BEDFORD ROAD WESTPORT, MA 02790 508-678-4474 BUILDING DEPARTMENT TO WHOM IT MAY CONCERN: PLEASE BE ADVISED RICHIE'S INSULATION, INC. INSULATED THE FOLLOWING JOB: ADDRESS: 41 MONOMOY CIRCLE TOWN: CENTERVILLE, MA 02632 ,E ZE CONTRACTOR'S NAME:JOHN LAVERTY a —7l CONTRACTOR'S ADDRESS.41-MONOMOY CIRCLE,CENTERVILLE, MA 02632 CONTRACTOR'S TELEPHONE NUMBER: 508-221-5351 • ca THE FOLLOWING INFORMATION IS WHAT WAS USED ON THIS SPECIFIC JOB: rn v MANUFACTURE:CELL-PAK, LLC. TYPE:CELL PAK SUPREME THERMAL CONDUCTIVITY PER INCH: 3.2 PER INCH AREA THICKNESS R-VALUE CEILING 15" NETAND BLOW R-49 WALLS STAIRWELL BASEMENT CEILING GARAGE CEILING G.H.WALL CRAWL OVERHANG CATHEDRAL WALL Y CATHEDRAL CEIL PARTY WALL FOUNDATION WALL BLOCK/RUNN. r SLOPES 15" NET AND BLOW R-49 P/V THANK YOU VERY MUCH FOR YOUR COOPERATION IN THIS MATTER. IF YOU HAVE ANY FURTHER CONCERNS PLEASE CONTACT MY PHONE NUMBER. INSTALLER: ERIC JOHNSON RICHIE'S INSULATION INC. a Material Safety Data Sheet U.S. Department of Labor May be used to comply with Occupational`Safety and Health Administration OSHA's Hazard Communication Standard, (Non-Mandatory Form) 29 CFR 191..0.1200.Standard must be Form Approved consulted for specific requirements. {:)MI3 No. 121:$-0072 IDENTITY(As Used on Label) CELL-PAK SUPREME Section I. Manulacturer's Name [f-mergency Telephone Number (2$6)260-215.1 . -----:__ Address(Number,Street,City,State,and GIP Code) . Telephone Number for Information (, 645 McIntire Lane 256 260-2151 Decatur;Alabama 3$603 Date Prepared April 27,2002 Signature of Preparer(optional) Section .II-Hazard .Ingredients/Identity Information ...... .. _ ....... __.... _.. ..._ ;Hazardous Components(Specific Chemical OSHA PCI:, (AC6.14 1"LV Othommended lo(oplipnal)' o ldcntity Common Name(s:)) rr mg1m3 ............ Boric Acid H3BOj 15(total) 10 one 10-20 CAS 10043 35 3 5 J( !res it Known j i Mineral Oil I None 0.1' CA$:64741-88.=4 5 5'' Known None CAS:64742-65-0 Known F Cellulose Particulates nuisance dust tl 10 - — None} - Known _.:._.._ _...... Wheat StarchNone None None 0-1 CAS; 9005-25-8 Established LstaUlished Known Section TIT—Physical/Chemical Characteristics Boiling Point `k �1 E NIA' ('Specific Gravity(H2O=l) N/A . ' i Vapor Pressure(mm I-Ig.) Melting Point N/A N/A I i Vapor Density(AIR= 1) Evaporation Rate ' NIA l!l(Butyl Acetate= I) N/A f I 'Solubility in Water N/A (not applicable) ....... __............... Appearance and Odor j Cray fibrous material with a slight odor Section IV- Fire and Explosion Hazard Data Flash Point(Method Used) Flammable Limits ILEL UEL 1 N/A N/A j. N/A Extinguishing Media _ water Tog, COz, chemical fire,extinguishing materials. ...... _ .............. _... .._._. _........... ____ _�__ _ —_ _ _-- ___---___............. I.Special ire I tghtingl'rocedures use SCBA since burning material may produce dense smoke (Unusual Bile aid Explosion. hazards Material is treated with flame retardants.Charred or smoldering material (must'lie removed from structure(building)to avoid re-kindle. Section V Reactivity Data IStabiiity_ Unstable Conditions to Avoid Stable Incompatibility (r1'/ateria/s to Aioic/) - - Strong reducing agents,oxidizers,bases,chlorates,and nitrates J-1arardous.Decomposi(ion or Byproducts Combustion products similar to those of wood,ammonia;sulfur trioxide i Hazardous May Occur Conditions to Avoid 1Palymerization CW ill Not Occur j X . t ,. I Section V1—Health Hazard Data < Route(s)of F,ntry: tion? Skin?Transient Ingestion? f Nuisance Dust Mechanical Irritant Yes lHealth Hazards(Ame and:C,hronie) Eye contact. Cell-Pak Supreme may cause irritation to eyes during installation. Inhalation: Irritation of nose and throat may occur at dust levels greater than 10 mg/m3. Skin Contact: Cell-Pak Supreme may cause mild skin irritation especially if skin is damaged. Ingestion: Gastrointestinal symptoms may result from swallowing Cell Pak Supreme. Reproductive:A human:study.of occupational exposure to borate dust showed no adverse:effect ' 3 on reproduction. Targct Organs: No target organ has been identified in humans:for boric acid 1Ca�crnogenicity NTP? IARCMonographs? 36SIlA Rcgulatcd'.> j NO h0 None Known NO i Signs and Symptoms of lxposure: T — N/A _ <.. IMedical Conditions iGenerally Aggravated by Exposure Chronic respiratory disorders Emergency and First Aid Procedures Wash irritated areas with water Section V11-.Precautions for Safe Handling and Use Steps to Be T aken in Case Material is Released or Skilled No special precautions ti :___..,...___._...,..... ..,..._._____-_____._..._..._..._...__.:...._..................._...................................... ..........._..._._.._......�._......,.__.._..:_. .._._ i Waste Disposal Method ......... r No special precautions __- — .... _::_ Precautions to Be Taken in Handling and Storing Dust mask is recommended during handling.Dust mask is required during installation. j Other Precautions Material shall not be stored in contact with hot surfaces(temperatures greater than 180"F). °8 Section VIII—Control Measures Respiratory Protection(Specify Type) OSHA approved dust mask for protection against nuisance dust during installation and handling. Ventilation LocalE:xhaust S pecial N/A N/A Mechanical (General) Other N/A ! N/A Proteuive Gloves Eye Protection required when skin is damaged ry required if eyes are irritated _.._ ..._ _-.._. .....__.::.. .. . __....._. _.... ;Other Protective Clothing or Equipment i none .................. ...._.__.:r... j Work/[Ngienic Practices practice personal cleanliness f Disposal Considerations Disposal Guidance: Small quantities of Cell-Pak Supreme can usually be disposed of at municipal landfill siteswith.no special disposal treatment. Refer to state and local regulations for site-specific requirements.Tonnage quantities of product are not recommended for disposal at land fills.Such product quantities shouldbe used for appropriate application or recycled. RCRA(40 CFR 261) Cell-Pak SOpre ne is`notlisted in any sections of the Federal Resource .Conservation and Recovery Act. i Transport Information e DOT Hazardous Material Classification: Cell-.Pak Supreme is not a U:S.Department of Transportation Hazardous material. International Transport- Cell-Pak Supreme has no U.N. number;.;and is not regulated.under international rail,highway, water;or air-transport regulations' Regulatory Information TSCA No.: Cell-Pak Supreme doesnot appear on the EPA TSCA inventory list. Individual components(see Section.11)are listed under their respective CAS numbers. SUPERFUND: Cell-Pak Supreme is not listed under the Comprehensive Environmental Response Compensation and Liability Act or its 1986 amendments(the Superfund Amendments and Reauthorization Act. IARC: The International Agency for Research on Cancer(of,the World Health Organization)does not list or categorize Cell-Pak Supreme as it carcinogen. NTP Annual Report on Carcinogins: Cell-Pak Supreme is not.listed. OSHA Carcinogens: Cell[-Pak Supreme is not listed. t Other Information - National Fire Protection;Association(NFPA)Classification: Health-0 Flammability-0 Reactivity—0 Hazardous Materials Information System(HM'IS) Red: Flammability-0 Yellow: Reactivity-:0 Blue:Ac'ute'Health—i (chronic effects) 1 , ' Z TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map` i�t� ` Parcel �99 7nW11 tleEnit# ® o Health Division i4hlk -• ._ Date Issued A,-` Conservation Division ' 7� �� -- ! Fee p• d C,> Tax Collector o��i`/��/bi� _ Treasurer VASTALLED IN COO LIAN,-_ Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE Ask"gam Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Inp�Jo Mg H Cl oCLi Village C'E�I Z(w i1.1_i- Owner ft1 ,GAl��i L_r,V'cps Address Telephone CSOfj I Jr' 6q 63� Permit Request Kicky t A I o , ��- Square feet: 1st flpor: existing proposed 2nd floor: existing proposed Total new Valuation 4 OD Zoning District G Flood Plain Groundwater Overlay y Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 11' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes &fNo On Old King's Highway: ❑Yes ❑ No Basement Type: Cull U Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ��'�� Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Flo Fireplaces: Existing 1 New Existing wood/coal stove: ❑Yes I No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:I(existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial__O Yes,__O.No _If yes,_site_plan review# _ Current Use Proposed Use BUILDER INFORMATION i Name (,IN (� 5l��fL�� Telephone Number C � 40D 79 Address d. & � License# Q-76� co �. op o ki-ed L i Y111pr Home Improvement Contractor# .01 fO C?- Worker's Compensation# 55?34 &69D ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l-0 i u: cop SIGNATURE DATE ire-.... .. .- FOR OFFICIAL USE ONLY r .r .4 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ; f � j DATE OF INSPECTION: FOUNDATION FRAME , INSULATION 4 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL >t GAS: ROUGH - FINAL FINAL BUILDING r � DATE CLOSED OUT L ASSOCIATION PLAN NO. i a J - — Department of Industrial Accidents _ Men OfIIJYCSIi�et/OdS _ a 600 Washington Street Boston,Mass. 02111 Workers' Coma ensation Insurance Affidavit . • • AEI • m�r�oMo�y � c�a� . �• '�. • , • hone# n a homeowner perfOM#g 91 work myself. m:a sole etor and have no one wolldilg in any.capacity, ca ensation for mY em ravidin workeis ;i.,• ...:::;:::;:<.}:: ::.; an P • .. ...... ,.. .wv.••nv:::{5•t%4:•x:;.,...::n.n4 .......-.:v:v..:.n.._-.. :::•n•r.}}::{v:•... .. _ ..... .r. .n..., ... ..nrr............. ...........?--.. ... ....J... n•.- ,..... .....v_r..r::nw:r....,...::• v .. .. ,.... ...... ........... ......... ...............-......r........n......•- v}::::..r......v.v::�:•-•w:;.,:;:•v:�v':•,.:'?::;v.}}•:{•]:{•rf;,:.•�;•. ... .....J• ....... n......• ............. .........r.. n..........n•..n.:...4n•:..«{::r. r�•l.•:.wf%:.v::;'f.• .{}.:.%v.{.;.r., ...:..• -...... ...n rn .. ............... ......n... ..r:n_..... .r::{:?:•.{v::;...............::•.::.{�:r.•.::::::....... .... •l.•a..T.....a...._....:?i:?ri:+•}:••+ .................... :...:.n...... ........... ...... ..:........ ...n........n, ....- .....,....«::::.:.:::::v.vn'r.......,-.-............::�:�::+.•}:{•:v�:•:{•}:•}':4}:jii:.::... •::fw}:%•r�:w::.v;}::i :i?i?: ..f -•.ivv:::n.-.....r. r......n......f ..gY. .. .. :. .. v.v::::}:4:tt4:::4•}.v::n_::::•:::v::.v}Tx•.v:"":?•vf^?}:.;:::;:ri{{:}ii'{:jt•}}: ..................r.. .....n.. _... ... .. .., ... ..... r .. .., ... ::•::::::}::-v::::•::;}:n,., r.r.. .....�{::::{`:�`.`v':::4`}:::.tiv:!ti?v{:;:;C'+,':if}i::::^:i:•??{{ti•}:•}}:• •}::::v}y.v:::.v.v•:nw+•.;:::K:......:: .....nv...•n....., ; _.},• ••,,�1[•[t;. :.4:�:•:..: ::??:ii:v::,:`:••.v::::::::Y:.,:•::•.: .....:<.:..:..:.....v:•::.:.+:?•::.v•r••..:: -Via..,•:::}.•.: •:• .. ... }::J. .�.... �.....::: .. .. w•r..:-. :•:T.:.::::.r!.;:...,:r:_.... . :.r•:.::::: t;.?..::::w• ..... ,..... ,... ._r...... ..... ...,.............:.:...:•:.:.....r.,......,•..:.a...:: .... ,...... ,::{:{. :•'••o-i:%:ram ::•:ti::4:•i i}: :::............ ..... .. .. ...-..::::. ... :.._J.,.r... ..........w:...:.-_«:::::n.; .... .r,:+•.-^::•::]}:.}:• -r:.::::v'•.:.,v:.!}:.:..:::r:vS?{'fy-.}•Q:::v}}}n}t:,i•}::: ;C.7..,}.}::�•G:;::::•:r-::• ............ ..:.. ..........:..::.:r.•.nn...r..yr:•.v::.........:vr•:F.•.r.x.....v•.,:+-.v:.,:.-...-........,.._.....,..::••x....,.n..1 ri}:f::•:v .... .:}.,.. .;;..:•:::. ,..n}:�}::}::•}:?{4}'^:i::l.C•}$i}:+:{•%{{•:iTvfA}:ti+•i:. !v:`:.r.,..r.. .._. ...n.......:.::....v.::..:: .. .. .. -_.. .................r.::_:::::?....:}:}4-}'{ii:t:-•::.:.v::::.:.::::•.vav:,...::.,,,:]4:tv:•:::;;..;;,.: {:,r};};y;•�;. :ti:•Y:v•':n:•}:!::+.•:»:i+:v'• }..:.... ...:?.:::v::_....:{::?v.v:...... w.i':::.}i:!n:,........:.:.wv:.... .... .. , .:. ..r ....nn .n\•... ..;4}h••: .:.:+:•:�i:r!v: n:K!4:•:.v::w:�}:•):4}}}'h}:•i{.,;ii:iiiv.?�:..}•�ti?:iY �':i:•: .v+ �•,:•:�:?1{:;i:::�:ti is i}ii 'T } Q S { 4 •:}r: ,t� 4 •:r.••.r is am a sole proprietor; general contractor, or homeowner(circle one) and have hired the contractors listed below who le following ' '}. n olices: eYJdL.►o W ............ .:•:::::::::.vx.v:;+{{4'4}i.v:}?Y:•}:4:{t4:?{t•i:•f.:t?4}}:v%?•}?:{!t{•i}:^Y:{i•:^:• .. r:•:::ir:{:}4{:4}:•{}/:,4,:}... .,..:w•::n..:.:..:r:::r}.:>:;{!.:<{?n:.<.,tr::::4.:-:. ::: r::::: wvv<:::{:::.....:...;,. }i'sn r........ .,.. 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I underst d e'e to secure eovtrate s�reequiree m�de;•Section 25A of MGL 152 can Iesd to the imposition of erhainal penaltin of a fine nP to S1;S00.00 and/or t , Lean,imprisonment as r as penaltin is the form of.a STOB WORK ORDER and a lbne of S10md that a of this statement may be forRnrded to the Office of Invations of the DIA for eovera=e verifintion hereby certify the pauu and pe allies of paju y that the information provided above is trap and correct Date ^ (.4 _ . .. nat are Lhs Phone �S'0 .�6"1`r at name -- oiSdal use only do not write in this area to be completed by city or town offidal peitnitilicense# • E3ft(Lding Depattiment city or town: ❑Licensing Board required ❑Selectmen's Office ❑cheekif immedisie response q C3Hea1th Department phone ❑Other contact person: #; - (cruised 9/95 PIN Information and Instructions ,huseas General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their ees. As quoted from the 'law" i employee is defned as every person in the'service of another under any contract express or implied, orai.or written 7loyer is defined as an individual; p ership, association, corporati or other legal entity, or any two or more of going engaged in a joint enterprise, an including the legal represen' fives of a deceased employer, or the receiver or of an individual, paztnership, associati or other legal entity, em, oying.employees. However the owner of•a ig house having not more than three ap ents and who resides rein, or the occupant of the dwelling house of r who employs persons to do maintenance, onstructionorrepii work on such dwelling house or on the.grounds or ,g appurtenant thereto shall not because-of su employment be eemed to be as employer. chapter 152 section 25 also states that every stat or local lice sing agency shall withhold the:issuance or'renewal sense or permit to operate a business or to co . ct buildi s is the commonwealth for any applicant who has •oduced'acceptable evidence:of compliance with th 'insuran a coverage required. Additionally,.aeither the onwealth nor any of its political subdivisions shall en p�into y contract for the performance of public work until able evidence of compliance with the insurance requiremts f this chapter have been presented to the contracting .cants e fill in the workers'. compensation affidavit completely,by heckiag the box that applies to your situation and ying,company names, address and phone numbers along wi a•certificat of insurance as'all affidavits maybe itted to the Department-of Industrial Accidents foi co 'on of in_��*anc coverage: Also be sure to sign and. the affidavit. 'The,affidavit sfiould be returned to the city o town that the ap 'cation for the permit or license is requested, not the Department of Industrial Accidents. Sh d you have any qu 'ons regarding the`law"or if you squired to obtain a•workers' compensation policy,.please c' the Department at the ber listed below. or Towns : se be-sure that the affidavit is'complete and printed legibly. Eareferenci a Department.has provided a space a the bottom of the avit for you to fill out in the event the Office of Investigatiohas to contact you regarding the appli Please ire to fill in the perniitllicecse number which will be used as number. 'The affidavits'Maytieepartment by marl or FAX unToss"othez`aiiangements havem.made: Office of Investigations would like to thank you in advance or you cooperation and should you have any questions. se do not hesitate to give us acall. ', �Departruent'•s address,telephone anal fax number: .•' • . .' The Commonwealth . Massachusetts' Department of Industrial Accidents Otjlce of Wesugauans : 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406,409..or.. 375. f q The Town of Barnstable Regulatory Services Thomas F. Geller,Director 'Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. N Date 2—Z —0-1 AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are-adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work:_ � :, ,a� �0 t Estimated Cost Address of Work: LAM•Dfib �/ j qL cL.E * Estimated 1 t-a� -(A* Owner's Name:' Date of Application: t9 I hereby certify that: Registration is not required for the following reasou(s): []Work excluded bylaw []Job Under$1,000 OBuilding not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ' Date Contractor Name Registration No. j OR q:f6rs:Afr1dav .rev-122001 1 �c P CrnS - , I y- : I i : , CIA : f pis r . � - : , I, ` i 1. � I n�"c°'n�.�-�1'^-✓'°ti.. � ... � -- � f 1 I I I f I I I f 1 � I I h f i I � I 1. ,• i _ : f : , , - • I : _ : i f x� , r I �° *�,x}� ✓jie�rdnvirca�ruuea�a�,,��Laeu�c�s •. BOARD OF BUILDING REGULATIONS j Licervse• CONSTRUCTION SUPERVISOR 4 , l Number: CS 076460; � � 4 "` .`' "�� Birthdate: 09/•.16/1962 Expires: 09M6l2003 Tr.no: '76460' Restricted To: 00 JOHN R LAVERTY _ PO BOX 200 W HYANNISPORT, MA 02672 Administrator oo�w1 .1.2,!TZ'c9xNra+l2lGn_�{f!c a�.(.�adJaAftuu .q oo��eekk�.,s+s+lll x ;7i7 4 k PROY{'gp f3gjTp'gj0p lN P4nis� �Ii� : I2� 5 4pa; .4414ydu1 AtIII R, LAVERTY ADMlMsTcwrc 7�t HRIY ai. AEI, a } 4s 5 G ' / ly Ol BAXTE o m ) sum` i �c �zt=r•=i 4 EiJ Cam:. / CE-,��--,�,� Th/A T TEE fpvc,'z�a�•:�.�.' � �,-j- �' row°-v ✓� ,� yS #V,n-1 � Z4x)/N6 64W6 71--/a TUtUit,= �� i�q� ,f,�, Z7Z � 5p ,�Af'hf�Tf1�G� zR TE 1 e `-�L tj J vc rw4 �r��✓�1,i 1. Il A h The Town of Barnstable 9ARMASS. . MASS. Department of Health Safety and Environmental Services Y 0q •_ plfo Mai' Building Division 367 Main Street, Hyannis,MA 02601 I Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: .��2��2 ? �ff) ,F127 Map/Parcel: /90 Z,5;2� Project Address: BuiIder: ty/v 'Vz%Y The following items were noted on reviewing: v� 140D rtf i�1,)s s Reviewe/d/by: Date: gtuilding:forms:review Town of Barnstable *Permit#�/ Expires 6 months from issue date Regulatory Services Fee ��• S"� 3� X'PRESS PEl� lT Thomas F.Geiler,Director --- MAR 2 3 2006-_;�) S. --•-BUilding.Division Tom Perry,CBO, Building Commissioner TOWN OF BARNSTABLE . 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Residential Value of Workj7j Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address f Y 1A ;PkT�_ Contractor's Name �flH� rC.1�) �? fL'f �S�Dt�rp elephone Number 6 0 - J '_,3-5 1 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) CS C0 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# 6()Q SC\_k 5Q k 9-.Q Q Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to , I, ❑Re-roof(not stripping. Going over existing layers of roof) Re-side "�°""" ' "" ❑ Replacement Windows. U-Value (maximum.44) - _ - 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. SIGNATURE: Q:Forms:expmtrg Revise071405 f WE� Town of Barnstable regulatory Services �>MASSS. 'Thomas F.Geller,Director A,039. Budding Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder ;aQTJ ,as Owner of the subject property hereby authorize 0.p H °S'v) to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of job)' zd' Signature of er GZ1 Date t � A Vf: R Print Name 'QTORMS:OWNERPERMISSION The Commonwealth of'Massachusetts 02 Department of Industrial Accidents " Office of Investigations 600 Washington Street � Boston, AM 02111 wM ° www-mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le�ably Name (Business/Organization/Individual): J O�A N L-JW- Ty Address: ! nx �.�D '��N� NNo.S"fi'Qt`S�� City/State/Zip: HVWi.Sff n(t.1 d MA, D-.-7�,Phone#: �' 6 e - 17LS'31-1 Are you an employer? Check the appropriate box: Type of project(required): 1,❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet t Remodeling ship and have no employees These sub-contractors have 8m. Demolition working for mein any caPacit3• workers' comp.insurance. 9. ❑ Building addition [No workers' romp. insurance 5. Y We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t 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 andthen hire outside c outrectors must submit anew affidavit indicating such 1C'ontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for any employees. Below is the policy anal,job site information. Insurance Company Name: Q ice. J 60 Policy#or Self-ins.Lic. 4: Job 5c1\ So ® Q S' Expiration Date: �1'��6 Job Site Address: N� 4 G\ l-(,t f, f V i tW\L\A City/State/Zip:�� i�1. -.au 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 cari 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 certi render the pains andpenalties of perjury that the information provided above is true and correct Signature: w h - k� Date: x . Phone#: �_2.%- 53S'i 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/own Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions r �- 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 hue, 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, r the occupant of the dwelling house of another who employs\ery o do maintenance, construction or repa' work on such dwelling house or on the grounds or building appurtenan shall not because of such employm be deemed to be an employer." MGL chapter 152, §25C(6)also states thy state or local licensing agent shall withhold the issuance or renewal of a license or permit to operainess or to construct buildin s in the commonwealth for any applicant wbo has not produced accep 'dance of compliance with a insurance sowerage required." Additionally,MGL chapter 152, §25C(7either the commonwea nor any of its political subdivisions shall enter into any contract for the performan work until acceptab a evidence of compliance with the insurance requirements of this chapter have been p to a contracting au ority." Applicants Please fill out the workers' compensation affidavit cXdaay , checking the boxes that apply to your situation and, if necessary supply sub-contractors)name(s), address ne number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Liility Partnerships(LLP)with no employees other than the members or partners,are not required to carry workensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that thismay be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. re to sign and date the affidavit. The affidavit should be returned to the city or town that the application fot or license is being requested., not the Department of Industrial Accidents. Should you have any questionsg a law or if you are required to obtain a workers' compensation policy,please call the Department at t tad 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 ted legibly. Th\asa tment has provided a space at the bottom. of the affidavit for you to fill out in the event th Office of Investigas to contact you regarding the applicant Please be sure to fill in the pernit/license num which will be usference number. In addition,an applicant that must submit multiple permit/license appli a ions in any given e my submit one affidavit indicating current policy information(if necessary)and under" ob Site Address"thet s uld write"all locations in (city or town)."A copy of the affidavit that has be officially stamped or by the ity or town may beprovided to the applicant as proof that a valid affidavit is o file for future permits ses. A n w affidavit must be filled out each year.Where a homeowner or citizen is ob ining a license or permlated to an business or commercial venture c or ermit to bum leaves tc. said erson is NOTd to co le this affidavit. (i.e. a dog h ense p ) p mp The Office of Investigations would like to ank 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 f number: The ommonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel, - 617-727-4900 ent 406 or 1-877-N ASSAFE F a-A 617-727-7749 Revised 5-26-05 ww-w.mass.govldia f•r.�...,r;- o1EF.^vy�4-vv•y,.,......-•.�..,v+.»-s`.='ayU.:,4_;lbp�..�a• ,�, ��i,^x.•�'._ .,tt' ...f.�w rk1t.M_aT,�r'i,��.wy':1y�?'.+v,,we}••rJt��P•i:�E.[:ti'.y-y-q„Fr ••."t�;f_y:_,l. 'yv'•s".. T.•..,yw•w. �Asse . . numberp: ssor's'.'mad lot• Sewage:Permit :number,:. ... ... ..... ..... ...... WN' -:;.,0E- :B�A -NS'T 'L g •y ..61A8& t a: CFO dPY p L . APPLICATION',.FOR°•PERMIT TO .. .. 7 TYPE: OF CONSTRUCTION f: .............r¢ . d .............. 19..E TO: THE INSPECTOR OF'BUILD,INGS a The."undersigned hereby`applies` for a permit according to' the followirig information:' Location 'f ' t .. —.t Proposed Use. :....: ,a f'< r� z: ...... ...... .. ,t Zoning District .. ..: Fire Distract :. .` • 1 � � � of 1 :• �� , Name.of'Owner ..... ... .... ..... ......... . ....... Address Name of Builder .................... ...Address ...:::. ................................................ Name of Architect ... .... ........ ::::.. ..'... ...... Ad ress ...... .................... 'Number of Rooms . % .... ::...: Foundation ' ... .......................................... Exterior ` ... o.ing ... r .� �..� .. f n Ro �^•r Floorsf ...... ........ .. .. .... ..... ..... .. .Int rior jj Heating . ;... . .::.. 1. :..... birig ! ..... V. . Plu Fireplace ,fr•(�L �r1 L 1, :. : Approximate'Cost Definitive Plan".Approved by. Planning Board f'_ _________ ______ ___,1.9 __. Area 't:. .2�..9t ...L.. ... Diagram' of Lot Arid Building with',D mension s ith 'Dimensions 1� mb • „• Fee •. ' SUBJECT TO APPROVAL-:OF BOARD"OF HEALTH i a • , i + hereby agree to,conform #o.all.the Rules and•Regulations of the Town-of,Barnstable regarding the above construction. Name t �l! . Alan Small RD — ZOO No 1M9...... Permit for .We—I ng................. ............................. . . ..................................... .. r Location .42...........Mon a?�.o- Cix........................ Cente� ville ............................................................................... Owner ..........?:Lan..Sma.11i................................ Type of Construction ..... �Hodd..Frame YP . � ............ ................. .... ............................ Lot 42 Permit Granted ........Apri1,..,...6.........1976 Date of Inspection ....................................19 Date Completed .,... 19............ t , PERMIT REFUSED! t ...................................................:............ 19 ......../...1........... ........................... ............................................................................... t ............................................................................... Approved ................................................ 19 ✓.................... ............................................................................... A ---------------------------------------------- __- _._, DRAWING KEY LAVERTY ______________________"_--'-_------'.-..-------__. NEw CCN5T2UC7 0',1 KESIDENCE EXISTING C_ONS"rF<UCTICN I MONOMOY CIRCLE TO R=MAIN. CENTERVILLE .MASS EXISTINiG CONSTRUCTION MASONRY TO DE DEMCL15hED ALL nl•DiC5 1_:1 i;115 D :ilPr:, _ A.'.=TIP._?L=.nIC APP!Y�-DUALL, N LNIAti13101'15 5`.ALL A. GENERAL 1 . QUALITY CONTROL- COMPLY WITH BRICK x INSTITUTE OF AMERICA (51A) AND NATIONAL o CONCRETE MASONRY ASSOCIATION (NCMA) RECOMMENDATIONS AND STANDARDS. NEW FOUNDATION n `I n B. PRODUCTS 1 . CONCRETE MASONRY UNITS (CMU) - ASTM C LLJ a CONCRETE FOUrIDATIOII YALL c3 10 90 . GRADE N-1 . ca POUR).Orl 12 <20`CONT.CONIC-FOOTITIG csa Iv,IPI. aELo t GRAo ) DOWEL rlE;v 2. MASONRY MORTAR C 270, TYPE S Pour,roAnor WALL Taro EZIsnNG. FOR 8" AND 1 2" WALLS, TYPE N FOR OTHER POUR A 3"DUSTCAP SLAB _ - IN THE CP�aV✓L SPACE MASONRY WALLS. 3. HORIZONTAL REINFORCING- TRUSS TYPE 9 GA. Rwlslonls: PROVIDES;a°XIS" WIRES, GALVANIZED, WIDTH AS APPROPRIATE FOR ANCHOR BOLTS SPACED C', 4'-0"o,-C 12"PROrvI WALL THICKNESS, INSTALL EACH COURSE BELOW - COP.i1ERs GRADE AND 24" ON CENTER ABOVE GRADE,.(OK AS Z. OTHERWISE NOTED IN CONTRACT DRAWINGS). 5,VV CU T NEW OPENING MTO EXI5TING POUNDATIOPI. R.O. 4-. REINFORCING BARS - ASTM A G 1 5. GRADE - 30„X 2 a., GO, DEFORMED BARS. ------------------------ C. EXECUTION I --.- I . INSTALL WITH RUNNING BOND AND CONCAVE TOOLED JOINT. SECURELY GROUT ALL REINFORCING ITEMS AND INSERT ITEMS. REMOVE EXCESS MORTAR AS WORK EXISTING FNGINEERwG SIAMP: DEN PROGRESSES. 2. PROVIDE CONTROL JOINTS AT A MAXIMUM OF 25 FEET (OK AS OTHERWISE NOTED IN CONTRACT s DOCUMENTS) D. ANCHORING 5/8" X I G" ANCHORING BOLTS SPACED 4'-0" O/C DER'( 1 2" FROM CORNERS (TYP.) gUlLD1�G ATTACH NEW FOUNDATION TO OLD W/ 24" LONG #5 PROJECT: C o 9 20�� DOWELS DRILLED AND EPDXYED @ I G" O.C. cRAYM BY: DE VERTICALLY EMBED 8" MIN. TO EXISTING. SCALE: DATE: EXISTING (TYP. AT ALL NEW END WALL CONNECTIONS) TOWN OF f3 GARAGE SHEET ruUMMR: A- I NEW FOUNDATION PLAN SCALE: I/4" = I'_o,. J i DRAWING KEY LAVERTY NE,Al C0N5TRUC:TION RE5IDENCE EXI5TING CON5T'UCT'ION 41 M EWLLE,CIRCLE Y�IJ`L/ 1•' CENTE2VILLE,MA55 wwJl TO�?ENttuN 02646 E<15TING CON5T:�UCTION ;dO7E5: j TO BE vEwIOLiSnED t AU_rICiES O>I Tn15 D�wvin? R I AE rYPICAL AMID AP PLYEOU4LLY O AD-CONIPAP.ABLE COND•TOnt ,¢Ip,E '�vo t�P-IiTEr�Dr�IF.:1510nLS 5rALL I I0.i Cu STaC/ TA;E PRECEDEI ICE. , 00 o° - `vl i I tIHNtIfIHdlHdfltH+t � - ------ NEW LIVING AREA REVISIONS: 5ECTION AA SECTION AA { Ex, IIc, l ,� i l EXISTING EXISTING , -orE cie:�. I EXISTING I. I f KITCtIN DINING ROOM BEDROOM 1 EXISTING DEN I ENGINEERING 5TAMP: F*; i EXISTING LI� t11vSTf� M EXISTING GARAGE BEDROOM SMOKE DETECTORS REVIEWED cs) PROJECT DRAWN BY: SCALE: BARNSTABLE B ILDI G T.DEP u� E DATE: t FIRE DEPAR'IAENT JE BOTH SIGNATURESARE REQUIRED Frlti' ,s,10 TING 5MEET NUMBER: FLOOR PLAN 5CALE: 1/4" = ,o° LAVERTY EXISTING HOUSE RESIDENCE TOP OF RIDGE n^-r•. ^o C'P.CLE _ C��2 iE2•,'ILLr_ nn ASS TES: aLL riC�iE3•,i T*Ii5 DPI:+anti, i .. ..�:E>i piadE,y5iOr6 3H:.LL TO GIDNIP--Z15L� I TOP OF WALL IEEEEA � I Eli TOP OF SUB FLOOR GRADE o GRADE PROPOSED ADDITION PFV151ON5: FRONT ELEVATION SCALE: 14° = 1 -o" TOP OF RIDGE EXISTING f10USE —� ROOF VENT— -- 1 I ENGINEERING STAMP: --- --- -- —TOP OF WALL iFi I TOP OF SUB FLOOR 4 GRADE _ -- 4"%4° 'os PROJECT: GRADE DRAWN BY: SCALE: tt a LTS �I C" DIA X50N036BPCURED DATE: r'=.1 CONCRETE FOOTINGS PROPOSED SHEET NUMBER: � NEW DECK PROPOSED ADDITION4 (ATTACHED TO `XISTING DECK) A-3 REAR ELEVATION SCALE: 1/4" _ -o" 2 I LAV ERTY RESIDENCE ' 4� MONOMOY CIRC.E CENTERVILLE.-MA55 TOP OF RIDGE 100I r1OTE5: ALL 1;01E5 ON 1r 15 DRA1NI1IG _ APE r'PI CAL ACID APPL'�EO'JA'_L'� O ALL C OMPARAB!E CDIICAT10'N5 PITTEI IWAEN15101`15 Sri A.LL - TAr:E PRECEDENCE. , DOT. OF TOP PLATE I 1 TOP OF SUB FLOOR TOP OF FOUNDATION 1 GRADE GRADE PROPOSED ADDITION- LEFT SIDE ELEVATION SCALE: 114" = 1'-0" 1 I EXISTING HOUSE — TOP OF RIDGE TOP OF RIDGE ENGINEERING STAMP: , j TOP OF WALL FMI ' I Fill- 11 LL_1l _ Ii J/ —TOP OF SUb FLOOR PROJECT: 1 ,� DRA./N BY: GRADE ------ GRADE SCALE: DATE:. PROPOSED ADDITION 5MEET HUI11A5ER: A-4 RIGHT 51DE ELEVATION SCALE: 1/4" _ -0" 2 I LAV E RTY RESIDENCE 4 i MONONIOY CIRCLE CENTERViLLE. MA55 02648 I i , ra0iE5: - A.'.F T>'PICAL AND APPLY EO'--'ALL'r O ALL.COMPARA.SLP.co>olmon5 t EXISTING HOUSE P?l 7E,•r oI,,e r5 c is S7 LL Ta KE"2ECEDEnrCE. + .I i f I ' i ASPHALT ROOF SHINGLES MATCH EXISTING 2"x 12" RIDGE OVER 30# FELT OVER 1/2"CDX, OVER 2X 10 RAFTERS @ I o O.C. W/ R-30 HIGH-DENSITY KRAFT-FACED INSULATION AND VENT BAFFLE5,PROVIDE 3G" ICE AND G 12 �0 G WATER SHEILD AT ROOF EDGE CONT: y\0Cd xG" COLLAR TIES 2x5@ I G"O.C. i f �K-30 i TOP OF WALL REVISIONS: (TYP.) CONT.EVE VENT (TYP.) EXTERIOR WALL, WHITE CEDAR SIDING AND EXPOSURE, 1 5# BUILDERS FELT, El 1/2"CDX PLYWD. SHEATHING, 2X4 WALL. FRAMING AT I G" O.C_ W/R 1 3 BATT. J IN5UL., 1/2" SHEETROCK INT. FINISH. K-1 3 j I (TYP.) R-30 3/4" PLY. (TYPJ SUB FLOOR TOP OF SUB FLOOR 2" x 1 O" FLOOR BEAMS - i ENGINEERING STAP�IP: 2"x4" KNEE GRADE - ANCHORING Vrt/ALL(CONT.) BOLTS (TYP.) 2"x4" P.T. 3" DU5TCAP SLAB SHOE PROJECT: SECTION "AA„ DRAWN BY: SCALE: DATE: PROPOSED NEW ADDITION SHEET NUMBER: A- 5 SECTION "AA" SCALE: /4" = 1 -O° - I i LAV E RTY RESIDENCE 41 MONOMOY CIRCLE CENTEPVILLE.MASS 0264,5 ARE n PCILAND APPLY EQUALLY nIOTES: I AL!NOTES Onl THIS D:-Asl'ING ! rO L COMPARA51-E CONOMON_ WRITTEN DIMEM51ON5 51ALL TAKE PRECEDENCE. i EXISTING HOU5E I � I I I � I I I REVISIONS: EXI5TING SLIDING DOOR2 l r ! (TO BF REMOVED i I ! I � I hFl6 I a I ENGINEEPING.5TAMP: i f f, O O ` DECKING = -- - -------- �IN+INEHfF+IffNHffN ; PROPOSED NEW ALL DECKING MATERIAL TO BE EXTERIOR ? - ADDITION I PRESSURE TREATED LUMBER V 'ROPOScD rtEv 4"X4" POSTS, 2"X8" JOISTS, 7/6"XG" DECKING r�cx�TT�ccF�D SIMPSON STRONG TIE JOIST HANGERS do Q ATTACHING JOISTS TO WALL. Qo 2"X8" P.T. LEDGER BOARD ATTACH PPOJecr: ATTACHED TO WALL DRAWN I WITH 1/2"X4" GAVANIZED LAG SCREWS "" " °' SCALE:. ,,.,, 3-.� AT 24" O.C. DATE: SHEET NUMBER: A-6 NEW DECK PLAN 5cALE: 1/4' = 1 -O° I DRAWING KEY LAVERTY i NEA;CON5TRUCTICN RESIDENCE OExIsn NG coNsreu:T IoN TO REMAN -ENT' CIRCL[ I .DIA55 C26�ad I i - � Ex15TING CCNSifUCTIpN TC BE DEMCLISttED ARE f Y P�CAL A?ID APPLY MIJALL`i f O PLL C ^:!PaRAELe CO��ICrTlO�`IS ... [tl`DIMF,171V�IS n.-LL i � ice PRe�_Delce. I i I NEW FOUNDATION I I 1 I Y i I SAW CUT NEW OPENING INTO EXISTING FOUNDATION, R.O. 30"X24" REVISIONS: I 1 I I I i I iI I I t EXISTING ENGINEERING STAMP: FOUNDATION EXISTING GARAGE SMOKE DETECTORS REVIEWED AND SCAB PROJECT oRAt,VN B•r: I l� SCALE: CATS: B RNSTABLE B ING A EPT. DATE FIRE DEPARTMENT DATE SHEET NUMBER: BOTH SIGNATURESARE REQUIRED FOR PERHITING - A-7 EXISTING FOUNDATION 5CALE: I14'�' = I'-0" i - DRAWING KEY LAVERTY . 7,_U.� / �� NF"A'CONSTRUCTION RESIDENCE • - FXISTI,NG CON5TRUCTION 41 MCNOMOY CIRCLE TO 2EN1AtN CENTERVILLE.MASS 02643 =.;aSTwG CONSTRUCTION TO DE DEMOL15hED gores:- ALL NOTE5 ON Tr15 CK"A"MG f '2E NF-CAS-4ND AM ECiJALLv 1 � , ' - 1 I (V , 3' 3., I N FRIDGE 1 i 0.7 CU. ST.ACC - I I 0 0 0 0 00 I REVISIOf�IS: I 19 II c 1 , 1 N 1 NEW LIVING AREA m ENGINEERING STAMP 4 c - 1 SECTION AA °' SECTION AA L N EXISTING PROJECT: HOUSE DRAHN 5'r: I SCALE: DATE: 5HEET NUMDER: 1 A-5 PROPOSED NEW ADDITION 5CALE: 114„ = I'-o" Centerville, I! MA OX p O (15 Map 43 Parcel 202 Map 43 Locus e�a,\,e/ Parcel 201 G Monomoy Circle 6 0�� 6203 Stoney Cliff Road r Existing Septic shown y.. 9 per Septic As—Built (O � • OD Locus Map � /, � N. T.S. O J ' 0 verb ead E'/eo ' tr,� o \ ,� o 0 0-1 Offer 24" Oak Propose / CYI » Deck House, # 41 3s w rn 4 Pine 0 � 4xisti g 20, D Q° J. ,�� O, / Deck o o / Propose Remai. oe Addl t _ r _ ' L O To Be � Map 43 10' Min 0 �Rernove 15 Sq . Parcel 203 12 , 025± Ft .Oak , 3 o 8„ pin 0, 41 ry Wooded 0): Area \ ry / III /' o •� �co o'`ecy 0 00 4b 0 Map 190 740. 00 Parcel 160 /�/ s 7 _ Wooded s S 00.. ( o / 52s ' Area Zone: RC Notes. w " Pine �� PLOT PLAN Assessors Map 190 Parcel 200 / for 43, 560 Sq. Ft. - / Deed Bk 235 Page 167 20 Oak PROPOSED g Fr n J 20 Frontage Pl. Bk. 272 Pg. 58 / 100' Min . Width 0 ADDITION This parcel is located in Resource Protection District / h Setbacks This parcel is located in Saltwater Estuary Protector Prepared For Front 20' This; Parcel is not located in the Flood Zone Pr epa ed r JOHN LAVERTY Side 10' by: �P,�� Mgss9 located at Rear 10' 02� cyG All Cape Septic LLC STEPHEN B. GRAPHIC SCALE 61 Route 28 o MOORE 41 M on om oy Circle No.39398 Centerville, MA 02632 5 Zo 4° West Yarmouth, MA 02673 Max Building Height; 30' � , (508) 771 -4200 Scale: 1 = 10 Date: November 13, 2017 IN FEET Qlicapeseptic@gmail.com �17 DWG AC-1015 1 inch = 10 ft.