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0522 OLD STAGE ROAD
,.� . � •.�. •.Ya"1 f3 �rY.d... °.i. ,,,.;.,. ` Y ..,o :. �' .�f � .,a" .z � c;.t4s v,eD °►✓'� tm,` _ a� � '� <. .YP+ �i t` :. .. ,i.,.^"r ,r O C TOWN OF BARNSTABLE BUILDING PERMIT,APPLICATION, Map lfgo0 t - Parcel 11C7 `Application# 6003 Health Division I 728 "Date Issued 4 Conservation Division :.Application. Fee Fee I Planning Dept. *;:Permit Fee � - Date Definitive Plan Approved by Planning Board • Historic _ OKH Preservation/ Hyannis Project Street Address 'J 0 i�5/^�,�° � i P Village Cw1TU'�C� Owner S-e/ 8,42AE) Address '?-_ old Telephone (� la l cot �� r — '�- Permit Request L-1c �. .� Pv 0� box A ReLid VJ o 1`l�" Alec. FIBS PYfIf -e4- d ��.'Cfp Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zonin District. Flood Plain Groundwater: Y 1project Valuation 00 v Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family :0 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ 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 ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑existing ❑:new size _Shed: ❑existing ❑ new size _ Other: i a 4;g7 c7n Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes No If yes, site plan review# 0 Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name n*,:PL4f�) Telephone Number Sow 134 J7 Address ���- o f?� 51 P (�i� License # C-enT-'/tc, /4- Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO i,U-SAP SIGNATURE DATE a 6 FOR OFFICIAL USE ONLY APPLICATION# { DATE ISSUED MAP/PARCEL NO. t 'E f td;f ADDRESS 6 i VILLAGE OWNER r DATE OF INSPECTION: r - # FOUNDATION . i " FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t ts-of DATE CLOSED OUT rt r ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston, MA 02111 M =� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): T. Address: a �J ►� City/State/Zip: (Ana �„ A4 6-A65a Phone.#: S770Y 11-1-13bl— 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 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 g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY $ 9. ❑Building addition [No workers'comp.insurance comp.insurance. 10. required.] 5. ❑ We are a corporation and its ❑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.F]Roof repairs insurance required]] t c. 152, §1(4),and we have no employees. [No workers' 13.[ Other CO.M 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. $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.Lie.#: 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 tip 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 Investieations of the DIA for insurance coverage verification. I do hereby certify ah der in pains angpenalties of perjury that the information provided above is true and correct. signafore: Dater all Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this'statute,an employee is defined as"...every person in.the service o'another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporatio or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal represe fives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal en ,employing employees. However the owner of a dwelling house Having not more than three apartments and who r sides therein,or the occupant of the dwelling house of another who`employs persons to do maintenance,constru tion or repair work on such dwelling house or on the grounds or building app enant thereto shall not because of such mployment be deemed to be an employer." MGL chapter 152, §25C(6)also states 'at"every state or local licensing gency shall withhold the issuance or renewal of a license or permit to operate`a business or to construct b ildings in the commonwealth for any applicant who has not produced acceptabli'evidence of compliance th the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonw alth nor any of its political subdivisions shall . enter into any contract for,the performance of pubs work unto accep ble evidence of compliance with the insurance requirements of this chapter have been presented to a contracting ai} ority." Applicants Please fill out the workers'compensation affidavit completel b checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),addresses)and ph a number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liab i artnerships(LLP)with no employees other than the members or partners, are not required to carry workers'co mpe ation* urance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavi y be su ' ed to the Department of Industrial Accidents for confirmation of insurance coverage. Also be ure to sign a�ndate the affidavit. The affidavit should be returned to the city or town that the application for the pe t or licensb 'ng requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you a required to obtain a workers' compensation policy,please call the Department at the nu ber listed below. Self- ured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has pro ' ed a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you arding the applicant. Please be sure to fill in the permit/license number whi h will be used as a reference number. In dition,an applicant that must submit multiple permit/license applications any given year,need only submit one affi it indicating current policy information(if necessary)and under"Job SiteiAddress"the applicant should write"all 1!,,a o in__(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be pr vided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be d out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commerc 1 venture (i.e.a dog license or permit to burn leaves etc.)said tperson is NOT required to complete this affidavit. The Office of Investigations would like to-thank yo in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax numbe - T he e6mmonWWth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gov/dia Town of Barnstable THE 1p�y Regulatory Services BARNST+sM Thomas F.Geiler,Director tvusq • PrFo �.•� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis.MA 02601www.town.barnstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HON EOWNER LICENSE EXEMMON Please Print DATE: JOB LOCAT10N: 4;" OI LC 5I to G Ab Cc number dnC village "HOMEOWNER": -s-eDA y II f' 50r-3C? —qa•(I name ` home phone# work phone# '— CURRENT MAILING ADDRESS: �a a. Q+(�S�A� Rd . 1 • ��l�,e.��If ,�• dad� �. oity/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be 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"h owner"certifies that.he/sbe understands the Town of Barnstable Building Department minimum' ectio ocedures and requirements and that he/she will comply with said procedures and requiremen . Signature of meowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section I D9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such woik,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they an assuming the responsibilities of a supervisor(see Appendix Q. Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bften results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her respormbilities,many communities require,as part of the permit application. that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forrns:homeexempt sTa�ti Town of Barnstable Regulatory Services BAIDWABLM HAS& , Thomas F.Geiler,Director i639 �� '` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete a` d Sign This Section If Win Wina A Builder as OwXoeect property hereby authorize ct on my behalf, in all matters relative to work authorized by this buil ermit application for. (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNER.FERM ISSION .s- 1 i IKE f Town of Barnstable *Permit# Expires 6 niontks front issue dale HAMSTABLE, • Regulatory Services Fee f� 00 _S�k r$ 1MASS. Thomas F.Geiler,Director 6. Building Division X-PRESS PERMIT Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 J U N 9 - 2003 Office: 508-862-4038 " TOWN OF BARNSTABLE Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY p t Not Valid without Red X-Press Imprint Map/parcel Number Property Address s as o(� S t�t U Rct Gh4ml �L VVA ua(V 3a- - �]Residential Value of Work , ()d Owner's Name&Address Kr+7','�1 G 2A and- 5t+i 1 4,�za_rJ Contractor's Name Q O S Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor FA I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) ® Re-roof(stripping old shingles) V M S tR ❑Re-roof(not stripping. Going over existing layers of roof) Re-side =. ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation;etc. Signature Q:Forms:expmtrg �' ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 07'� J03 Permit# )C.' Health Division 8 I6 -Date Issued Conservation Division GJ � Fee ��� Tax Collector§ - �`��oa ®6 60- Treasurer ok A) L INS LED'IN C® Lira� � 1 Planning Dept. WITH TITLE 5 E"RONFAENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic=OKH Preservation/Hyannis Project Street Address G ak Old 51 4-k R� s .Village Owner ��l� ��� �CR;51,'.vA A�4R Address of Telephone 1 13�i Permit Request U; Id'ikt t° �° d � �`l�`��• h1 a_ck_r bed ro m ty;* Square feet: 1 st floor: existing proposed $ 2nd floor: existing proposed `32�} ,Total new r7 O S Valuation �(�a (lob Zoning District Flood Plain Groundwater Overlay Construction Type W 0 0 7 Lost Size L&� ,3 I1,0250 6Q A Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. U+ .3A /g, ,45g 54 44. D,Yelling Type: Single Family A Two Family ❑ Multi-Family(#units) Age of Existing Structure Ila YP_5 Historic House: ❑Yes )2§No On Old King's Highway: ❑Yes ;t No Basement Type: tl CWCrawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing �k. new 1 Half:existing new Number of Bedrooms: existing a new L Total Room Count(not including baths): existing `i' new 2- First Floor Room Count S Heat Type and Fuel: Aas ❑Oil ❑ Electric Wither W0 S►aU� Central Air: ❑Yes & Igo Fireplaces: Existing �_ New Existing wood/coal stove: ZYes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes & o if'yes, site plan review# Current Use Proposed Use - 'BUILDER INFORMATION Name Yl& r-� Telephone Number Addressu�' y (� License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �l �Z��G,I'V'l DATE L12 L o 2- FOR OFFICIAL USE ONLY y � `r PERMIT NO. 4a r DATE ISSUED MAP/PARCEL NO. ADDRESS '" VILLAGE , g OWNER_ DATE OF INSPECTIOI ; FOUNDATION FRAME ° INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL in PLUMBING: ROUG fit) FINAL I GAS: ROUGH# -1 FINAL 4 t FINAL BUILDING• f t7 ' D A x F = rul - DATE CLOSED OUT ' ' f i ' ASSOCIATION PLAN NO.. r k t r r P`pp THE ip�� The Town of Barnstable BARNSTABLE. Department of Health Safety and Environmental Services MASS P 9 i679� `0m'prEOMp� Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location 5Z- — (3 Lf) SV�Permit Number Ste' l Owner Builder V L-� y � One notice to remain on job site, one notice on file in Building Department. The following items need correcting: a r r'I� �� TQ C)F- a rC �o f � �►� 2' t _ o C_ , C f Please call: 508-862-4038 for re-inspection. Inspected by i2 st7�ue-'J Date 0 i .l'o �_ /7J,z z a koad a roar el v 60 1. w l('o 3 17,030 of a� n i ind C3 tnd i Jhe b r,� Located as shown Jhe add ti,ort id. ,the shaded area and `mae.ts. -4e thack 2ecywt�te�tceyr is on ptan. _ M 0 the 5pown o 13at4�-mttab Ce 5 to Plan of -Pa d in Cen.teaviUpa, / Ida 13e.in� a tot as47won on ptan .in Glt 2LI0 pq� 1 SS 5cate 1°-30 t Date 7-27-98 RU Cape Enfi,nee" 49 I4a,�bo t goad i kyauzis,, M4 0260� , . OF _ -. - - - = - - - --- _ j The Town of Barnstable Regulatory Services 1639• �`° Thomas F. Geiler,Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 - Fax:'- 508-790-6230 Office: 508-862-4038 i Permit no: Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction.alterations,renovation.repair.modernization,conversion, improvement,removal,demolition.or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. l 1 O V 1 4 �- � Estimated Cost Type of Work:— Address of Work: a'. Gl �0 Owners Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied E]'Owner pulling own permit Notice is hereby given that:OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ORK DO NOT CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT GUARAN'I.yT WFUND UNDER M� ARBITRATION FROG 142A. ACCESS TO THE SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the owner: Date Con fr Name Registration No. R Date ner's Name q:forms:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents Orrice of/nsestigations 600 Washington Street Boston,Mass. 02111 Workers' Cora ensation Insurance Affidavit ai oia�ai 'J�f I 1 name ko� Ill + se* 4azarr 1 location: 5a� X n-k-wi I L e-" phone# 67)�' 1 I �� city C ❑ I am a homeowner performing all work myself. ❑ I am a sole r rietor and have no one worIan in any ca aclty //%%%/ % %��%%%%%/%��%%%��%%%/%%////%%%%%///%////%%%//G%/%%/%%%%%/%%���%/%/%���%��%/�%%%%/O%�%%%%%%/%%%/G%%�/ r rovidin workers' compensation for my employees working on this job. I am an em 1 g .. cow an ;name. .........._:: hone# x. ohcv# .....:.... ... tnsurance>t:o. I am a sole proprietor, general contractor,or omeowner(circle one)and have hired the contractors listed below who have � -, workers' co ensation olices: ......it�0�((�VV�GIs .; ; :.;::.;; the following w.:......:.::.;..:..:.,mP P � :. company name '�- ` .....:s.. : d.::::::.:::. :::::,.:.:. .:::::::::::::.�:...:::::::::::::::::.:� t.::,::::.�.. .:: t: ...:::::,::::.::::.::.� t A phone# d .. .. ' i;:>;>:::::::::::<:>;:::z:::E::z:;3:::z:;;:Y::;::;> f'i:: :.;:;g;:;:. ;:: : ::«:;;;><::>::;i:;;::;:;<,.;,:;:<.;;:;<:: ......::::.::.......................:: "8m n _.c _... address; . ............. :::.::........... h en ;:.:. gsRrae to secure coverage a,required wider Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500;00 and/or one years,bnprisomnent as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against ma I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under th p penalties of perjury that the information provided above is true and correct Signature Date Print name Q f A7-1 Phone# Wxx official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other A (tevind 9/95 PIA) I . Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. 'However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter'152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance.coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be cidents for confirmation of insurance coverage. Also be sure to sign and submitted to the Department of Industrial Ac date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the evert the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the piiiil license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The'Commonwealth Of Massachusetts Department of Industrial Accidents Office of Imlesduallons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 .4 phone#: (617) 727-4900 ext. 406, 409 or 375 RESIDENTIAL BUILDING PERMIT FEES RP66 APPLICATION FEE New Buildings,Additions $50.00v Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot x.0031= Z C O Y jkuls from below if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.f� . >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 51000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$961sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving _ $150.00 (plus above if applicable) Permit Fee projcost � NAM ��� Regulatory Services t 659. Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-62-10 HOMEOWNER LICENSE EXEMPTION Please Print DATE: `� _1 JOB LOCATION: a oZ St'a G� Rd C 01+e_r V 1 number street village "HOMEOWNER": Se.;- l Hazard 5K-� 1 )-1-7565 5b9- 3bLj -gaL13 name chome phone# work phone# • CURRENT MAILING ADDRESS: 5 a a O((I& Sta-G 2 Aj ' en ter ya 1 I e, N+; oar 3�1.- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as suyervisor. DEFINIMON OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work verformed 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"ho sown "certifies tha-he/she understands the Town of Barnstable Building Department ini � insp tion procedures'and requirements and that he/she will comply with said procedures /reme Signature of t0m,owler 61 1 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors.Section 2.15) This lack of awareness often results in serious problems.particularly when the homeowner hires unlicensed persons. In this case.our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN 1 . ,I r` t+t! i �I �ir i ��' I. � ,`7 �rl I jIj .,� �, ��t � � �,; _ �� �! ��I `3 ��i - ' ,; �I► ��a ��I ��I }+ �1 +� _ fi ��I t�+ ,,� 'I ,� ► t r�� �I ��� ��� �;� �1� � 0 �� I , � e ��.� I f, � . . �� j; �,� ��� f�l ' ��� t ii� Y - �� . f�� Ac p ' [0 S - a�1�G� o+1st ko VENT �' w ��`r-r►c-Imo' ��-e�UP�TI�I�I Lq Ms- z Vim oos o.c- �Oom A-DD /n U N �p KZcf bx e1',mr p I��T Gx►z` sPariS a0J�b� GAL prof -rP,7 5 I.,Ca+Nn wit 2 5ao P ZOC- 1'L-2.7 0"l l lo Sooq 3 2x �dN k6 OrC: r S r Pow n • � r j I n j 3 2�iC�' y7an,lon - g n - 0!ST A O' to ,t.?c�- %-I a--vca1 1 14-79 �a VAcn Of Q �. lk I77 �.i 1 ZxlcvrTcr � 45 V 2 x PND o '� -rAG Se ,. r F t.0 0 fL s SCALE: I '�� APPROVED BY: DRAWN BY `�� DATE: _Z REVISED No. FEE AOO ` COMMONWEALTH OF MASSAl.Hi SETTS Board of Health, � C�SL�, MA. DISPOSAL SYSTEM CONSTRUCTION PERMIT Permission is herrebby, ygrante to; Construc ) Repa' ) Upgrade Abandon( ) an individual sewage disposal system at ULJ S `z- -e- - `' as described in the application for Disposal System Construction Permit No. dated IV- W*4 Provided: Construction shall be completed wi in ree years of the date of"ise All local p9ditions must be.met.'�' Form 1255 Rev.5/96 A.M.Sulkin Co.Boston,MA Date( Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �Q Parcel 6-7 -ISTABLE Permit# Health Division Zoo l 2-6 � �� Date Issued A ---2'3' Conservation Division Fee 0 Tax Collector,;,7"/d&//a D . Treasurer c/< w S�fl d Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 5 a oZ t�l SGtGQ (�► Village U \ eA(Vd 1 e_ , t Owner U5--I r)o_ 1 6(!Jh ` 6L-2a.ird Address 53�)L- 0►d Sfi�G� i(- , Telephone d 11_7 1 —1:5 to Permit Request ftdJ i n C3, o 'S -�o rLk n+c) -fl/uL aG� L; . Y 1 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation i9'0 d. U 0> Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: XFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 3 new Half: existing new I Number of Bedrooms: existing new Total Room Count(not including baths): existing 10 new First Floor Room Count Heat Type and Fuel: Gas O Oil ❑ Electric ❑Other Central Air: ❑Yes XNo Fireplaces: Existing . New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing ❑new size Shed:LJ existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use ,,FWW ,KV[S- n0k_ f A20-KcA BUILDER INFORMATION Name Telephone Number - -I 1 —15 b 5� Address 00 S- aqt Rd- License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUREKAAPA0_ DATE 'I ^D o2 k a r . ;t FOR OFFICIAL USE ONLY F PERMIT NO. DATE ISSUED MAP/PARCEL NO- ADDRESS VILLAGE ? 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II�hCC:{OL:'{t:•:�:!}::::$y}+.;?E:?:i..,::}..:Y,.};.c{:{:::i{.:.??iv,$:{{•'r-•.!;.{::f::::r. } u e secure,eovera;e as regmted mnder'Section 25A of MGL 152 am lead to the impoai#Ou of Criminal penalties of a line np to Sl'rS00.00 aadlor femT imprisonment ai weIl as civil penalties in the form of a STOE WORK ORDER and a fine Of$100.00 a day agaitntme. Imtaeratmd that a sf this statement may be forwarded to the OIDce of Investigations of the DIA for coverage verification. hereby certify under the pains and penalties of perjury that the infotnuation provided above is true and carted Dou nature ;fit name I'I Sfi I`Vl�ti �L:ZI.a 1�� Phone ofncial use only do not wrtte in this area to be completed by city or town otticial ei1nitlucense# QButlding Departrneat city or town: ❑Licensing Board edlate response is required [ Selectmen's Office Q checkifimm QHeelthDepartment Other contact person: r phone#; - ❑ Informatian and "Instructions ,husetts General Laws chapter 152 section 25 requires all employers to provide-wor rs' compensation for their ees. As quoted from th6 'law" an employee is defined as every person in the servi a of another under any contract express or implied, orA.i.or written.' 7loyer is defined an individual; partiiership, association, corporation or othe egal entity, or any two or more of ;going engaged in 'oint enterprise, and including the legal representatives of deceased employer, or the receiver or of an individual, p ership, association or other legal entity, employing. loyees. However the owner of.a. ig house having not mo a than three apartments and who resides therein; or a occupant of the dwelling house of r who employs persons do maintenance, construction or repair work on ch dwelling house or on the.grounds or ;g appurtenant thereto s not because-of such employment be deemed a an employer. chapter 152 section 25 also es that every state or local licensing a, , ncy sW1 withhold the'issuance or'renewal sense or permit to,operate a b iness or to construct buildings in a commonwealth for any applicant who has •oduced'acceptable evidence:of c pliance with the insurance co erage required. Additionally,.,=ther the onwealth nor any of its political sub 'visions shall enter into any c ct for the performance of public work until able evidence of compliance with the ce requirements of chapter have been presented to thecontracting '• .cants fill in the workers', compensation'affidavit comp e ,by checking the box that applies;to your situation and ying.pompnny,pames, address and phone numbers aI -with a.certificate of insurance''as all affidavits may be tted to the Department of Industrial Accidents foi o lion of in�,� nce coverage: Also be sure to sign and. the affidavit. The,affidavit should be returned to a or town that the application for the permit or license is requested, not the Department of Industrial Acci eats. Sho d you have any questions regarding the`haw"or if you squired to obtain a workers' compensation polic ,please call Department at the number listed below. or Towns : se be-sure that the affidavit is completed printed legibly. The.Departm .has provided a space at the bottom of the avit for you to fill out in the event, Office of Investigations has to conta u regarding the applicant. Please ire to fill in the peimit/licer�,se n er which will be used as a reference num r. The affidavit;'May tie reammed to )epartment by mail or FAX'u e'ss"btliei`arrangemeuts have•beea made: - ---- -----~�_� .-~~ Office of Investigations would like to thank you in•advance foi you cooperation an should you have any questions, se do not hesitate to give us'a call. Departmentrs address,telephone a4d fax number: The Commonwealth .Of Massachusetts Department of Industrial Accidents Office of iovestigatlous : 600 Washington Street Boston,Ma. 02111. fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406,409..or.. 375. i q The Town of Barnstable Regulatory Services Thomas F. Geller,Director -Building Division Peter F. Matteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing.at least one but not more than four dwelling units or to structures which are-adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: �a rnw,` S I'{�0 rL V l Estimated Cost Address of Work: 5 a 5- iacLe._. P t- G n4c ryi N e 1 d A- co-to 3 0�-- T Owner's Name:' KV I`J-� e-f j4A Zczrd Date of Application:_ I hereby certify that: Registration is not required for the following reason(s): Work excluded by law E]Job Under$1,000 Building not owner-occupied [weer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME RVIPROVEMENT 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.. 4 OR � ( V q:fo=s:Afftdav :rev-122001 RESIDENTIAL: " SHEDS -POOLS-DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft. (Sheds,detached garages,gazebos,eta). >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS x$30.00= $ (Number) PORCHES x$30.00= (Number) I IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) PERMIT FEE $ �� Q:forms:dkcost eff:082301 ! /7J, O.Cd eX:iiti,►xc� ./ ex:ititin� a.eptcc . S� e. dw el;L. / 60 wide j .('opt 3 17,030 .a� i E i Cl3 tnd I-o-t. 4 - 0// 1 !he b -vi ,. oca ted ad. afwwn She addition .ice. ,the 4haded rte."and m the-ae tbacfc re,�,t,� _. :.. _ on. ,i.. . . . :.. o f-.the ?owit o? pl-...._ .. . s _ an o Xa d .i-rc Ce►ttewi&es, M9 a 90 Seth./da lie&a a tot3 a� wn .on pin -in bk 2110 pf 1 S Scale i"-30 t date 7-27-98 RGt Cape �►�yryrze�riru� 49 Na2boti goad ; kyr�ruzi i, M4 0260 i ` _....... Wi.33M I- r--------- + ----- -• -- - - .----- --_ �.__ _..._. .- --- - - - -� - -- --._ %� t20e' T>G ILA 'fib WA—t,� �6 TAG SIOluu.. "or- Sty tm-- : �►, ►�_; r S6R10-AA-s a- r2 S if v nt t,,. wimp 11 t.41- s �� 1 S`rt fir.oo� MA�to�Aiv� 21Gto RT 19 ac s.s s p ftral6• SIR?�(< AO 44 -- �v n n SCALE: ` `g r 1!r oii APPROVED BY: DRAWN BY j C DATE: [ 102�. REVISED DRAWING NUMBER • A "r ° The Town of Barnstable 1, .NSTABLL b Regulatory Services r-�" °lEo►�+' Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 . Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ^I lf1 ^V JOB LOCATION: a (mot S number J street village j !"HOMEOWNER": 1� I S�no, k r�A z Vy1 y�(�f•( c6 — name C home phone# work phone# CURRENT MAILING ADDRESS: JaAM— -- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than-'one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be 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 rocedures and require(nm�ents. X ignature of Homeowner. j Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN vJL AG�ALLA"XW iDiv a"R'M = Department of Health Safety and Environmental Services 63�' •� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner TOWN OF BARNSTABLE Permit: /�303 q SOLID FUEL STOVE PERMIT Dater • Fee45. � Owner: Kr I St i na Se t(n Nu z�G�(� Phone: l ( - 3 Address: 5. (A e (�� . Village: C P n to r u+ l l e- Map/Parcel: /q a n'7 Date: Q C 13 e Stove A. Ne U _ B. Type: Rad' Circulating C. Manufacturer: j e4 ;,�c Lab. No, 'X D. Model Chiming A. Fue Existing (If existing,please note date of last cleaning B. Size 4� C. Are other appliances attached to Flue? I\1 o D. Pre-fab Type and Manufacturer We FF"g I l7771:, -, � E. Masonry: Lined/Unlined Hearth A. Materials: 1 �/Inu2a�e Sao ye I�rx•al B. Sub Floor Construction- Installer Name: _ w'CLi lm e �,WIP Address: Opt 0 Cs, Phone: -s%t,q V �t14 Location of Installation: 4-�j;,j APPROVED BY: Please make checks payable to the,Town of Barnstable *This constitutes an official stove permit after inspection,photographed and approved by the Building Inspector Stove.doc �v2 ©IGQ S � Engi eeg .Dept �zr� t�r,or) Map %® Parcel y,7y/ --mom Permit# 3 2-6 C 2— b o r � House# 3-220'f Date Issued g'' '�` C3 Board of Health(3rd floor)(8:15 -9:30/1:00- Fees . Conservation Office(4th floor)(8:30-9:30/ 1:00'Z 2:00) Q TIC SYSTEM MUST BE Planning Dept. (1st floor/School Admin. Bldg.) EP NCE LLED IN Definitive Plan Approved by Planning Board 19 TIRONMEN WITH NO N RED •p °�.. .:� TOWN OYBARNSTAB`LE Buildin JPermit Application Fp g �T _ , Project Street Address at n. -aa Old k f� q p_ r Village �g. t Owner ' •"� &-Ah at)d eh0,(1, v,0c_ 1102-67r6l Address dame Telephone .Permit Request S/1743`e cSAVLr / 0Cl��/7'�/lam 2 �j First Floor 5-60 square feet Second Floor square feet Construction Type Wood Dy:r m p, Estimated Project Cost $ JO, 0jq/) Zoning District Flood Plain Water Protection Lot Size /7 0 3© ��4 �'� Grandfathered ❑Yes ❑No Dwelling Type: Single Family W Two Family ❑ Multi-Family(#units) Age of Existing Structure a?S Historic House ❑Yes Ulo On Old King's Highway ❑Yes @I o Basement Type: ❑1full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ® Basement Unfinished Area(sq.ft) a Number of Baths: Full: Existing / New / Half: Existing New No.of Bedrooms: Existing / New / Total Room Count(not including baths): ExistingsY New a First Floor Room Count Heat Type and Fuel: ❑Gas �kdi1 ❑Electric ❑Other Central Air ❑Yes �10 Fireplaces: Existing New Existing wood/coal stove ❑Yes W410 Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) lone ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes U o If yes, site plan review# Current Use Sl l n Q/P L m 1 Li Proposed Use 'c/ /--- Builder Information Name -®%d h r7 0'!P /C S' Telephone Number d/a- in V a Address -1/0 rnCi®S4 I P. h License# (-,L,) &An ma Home Improvement Contractor# 11,3060 Worker's Compensation# A69.6 cSC ff emV h1 Ve0/ NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Aandli SIGNATUR �— DATE O l/�19d BUILDIN PE' IT DEN D FOR THE FOLLOWING REASON(S) -74M FOR OFFICIAL USE ONLY _ PERMIT NO. ✓y y DATE ISSUED . MAP/PARCEL NO. ADDRESS VILLAGE: ` 'OWNER DATE OF.INSPECTION: FOUNDATION FRAME' INSULATION- FIREPLACE- ELECTRICAL: -ROUGH FINAL r PLUMBING- M !ROUGH FINAL GAS:- I'ROUGH FINAL " .;. FINAL BUILDINGS ►-. ; 2 - - = sir.= .:_ . • r DATE CLOSEMIDT, ASSOCIATION PLAN NO. oFTMe . .. °: The Town of Barnstable • �uerisrns� • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW 32 2- Owner: � APD Map/Parcel: ��' Q —C)Q3 Project Address: '2 DID � � Builder: E LD v The following items were noted on reviewing: c�40��C,- N�T12E 4ov Sc 9us 3� amass W � gDCAN5 IN 214Z Please call 508 8624038 for re-inspection. Eby; S"l C,V �i'►—�5' Date• / v q:building:forms:mview -- { i 4. otcl Stage ko addwe�t. / N f 60 i !7,030 e4 , i a lot 4 I � f -- She uitd vs , Dca-ted ay shown She addition on id. the 4haded a4.ea --arrd Meeta aetback•aecyeCctence'rts _ on plan; - - { 0 --the Jow,i of i3�Ce _ 1 I I R i 5i to Plat of .hand girt 1,ente.IW4iue� _. __ ..70,t Seth-/dVort ...__$ ge irac� a - o-t 3 a1 on p,l a t. .in bk, 240 pq ! 5 E . 5caCe l"-30.1t_ bate 7-27-98 . . j AEG Cap e Cnyi►ieP:tin .. r: :. _ :. 49 Ma�bot load 71, FIE"I Ji, i ! I C - + � t � 1 I 1 _ _ -14 t =0=AppendixJ TableJ3=b(eon"aq prperiptive Packages for One and Two4amilr Residentbd Buildings Heated with Fosd Fueb MAXIMUM MINIMUM Coming Glazing Ceiling Wall Floor Basemea< Slab AB�COOling Ann'CA) U•value= R value' It value' Wvala wan Purees F.ffidencY' padrw tGvalum� Brvalua' 5101 to 6500 Heating Degree Dart' Q 12% 0.40 38 1 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal s 12•/. 0 50 38 13 19 10 6 93 AFUE T 15% 0.36 38 13 25 WA WA Normal U 15% 0.46 38 19 19 10 6 Nam V Ism. 0.44 38 13 25 WA WA 85 AFUE W Is% 0M 30 19 19 10 6 85 AFUE X 18% 0.32 38 13 25 WA WA Normal Y 19% 0.42 38 19 25 WA WA Normal Z 12% 0.42 38 13 19 10 6 "AFUE AA 187. 0.50 30 19 19 10 6 90 AFUE I. ADDRESS OF PROPERTY: sa a 0/0/ Cer) -le-r r/ /1e, me Oa63 a.. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: ,6-/0 3. SQUARE FOOTAGE OF ALL GLAZING: 6 q 4. %GLAZING AREA(#3 DIVIDED BY#2): r �� 5. SELECT PACKAGE(Q—AA-see chart above): R r NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix J Footnotes to Table J5.2.1b: liding-glass doors,.skylights, and S Glazin area is the rat io of the area of the glazing assemblies (including s basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall:For example,an R-19 requirement could be met EITHER by R 19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frarne or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements:are for unheated slabs.Add an additional R-2 for heated slabs. 'If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 f Y j IEEI .3 ao' El aii►'r.' •.,&e R,sF_a N6uJ AbDf�o�+ �f; rn. . I vt El ..'. '/.�C Cox . �9u .z�cy t7or8�E s ��pfE ���. 8 Pour LF .• L LLi: s } i � THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / LI DATA i i f, w cn ca LU p m O W H i I U) DD qt� i l � i � ! i i S � Y i R alSO - a down Csz llQ� l Up in a_f--l-ic 6ENERAL NOTES.' SOIL TEST PIT DATA f J. THIS PLAN 1S FOR THE DESIGN AND INVERT ELEVATIONS.' T.P• '1 T.P. -� CONSTRUCTION OF THE SEXAGE DISPOSAL A S1�fi 'b GRND. ELEV. 9 .90 FACILITY ONL Y. �?. G.Y. ELEY. G.h'. ELEY. INVEAT AT BUILDING "�� � 2. ALL camsrRI vTIDN METHODS MATERIALS AND INVERT IN. AT SEPTIC TANK .Z6 MAMMVANCE FOR THE.SEPI`IC SYSTEM SHALL 0 °t 8`?.f'1 EPTIC TAMIC��! ACCESS LOVERS MUST BE NITHIN 6 ' OF FINISH GAADEH CONFORM TO MASS. D.E.O.E. TITLE 5 AND LOCAL INVEAT our AT S BOARD OF HEAL TH REGULATIONS. INVERT M AT DIST. BOX N q 6. r F1'}-t1 INDICATES INVERT OUT•AT DIS.�. BOX 6 7 PERC. TEST �L g'j ec 3. ALL SEPTIC SfSTEM COMPON��--M SUBJECT TO i �°`�a MIN. 2' OFDC I VEHICLE LOADING (I.E. UNDER ORIVENAYS, ETC.) INVERT IN AT; S.A.S. � (c►• 60•+ SHALL BE DESIGNED TO lf✓ITHSTAND H-20 LOADING. �' 4' XIN. �°O e .G4 MY1-1/2` DIA. BOTTOM OF 1 S.A,S. t o HASHED STONE INDICA TES 4. ALL SEMW PrAf SHALL BE SWE XAE 40 OR OBSERVED Gf�iJ WA M? •9 O o LIQUID I OBSERVED APPROVED EQUAL. ADJUSTED GROUNDA'ATEA .G lD• DEPTH Mr. �i� /4'-t 1/2' DI> .. GRDUNvD!✓ATEA S� L.� 4 0 ! ,:�.40 SAL. BOX �W 1✓ASHED STONE 3. BE row Swam cammuerrON CALL DIG SAFE J-800-322-4844 FOR LOCATION OF - St TIC T NK N-1 O ,�d INDICATES UNDERGROUND UTILITIES. � P'S'1 "fK Jn BE SET N A }�►��' --' t} '--+�r y - TEST PIT D 5" 1S 6. DATUM IS SS1.S1v►�b �t'�= b/�k IO �L�G WCr4? TO HATER IEST"OX TO PfI01�°. S.A.��, ? � 7. NO DETERMINATION HAS,EEEd MADE AS TO COAiNLIANCE -24 1 h'ITH DEED RESTRICTIONS OR ZONING REGULATIONS. µ Groh b�tAR' ' IT SHALL REMAIN-THE owNER os AESPONSIBILITY TO g N OBTAIN ALL REQUIRED PERMITS, SPECIAL PS9MITS, - - J/ v y. • DATE C1 Z001 �d p- /C Jr- Q `� VARIANCES, ETC. FOR THIS PROJECT. . Wei-I. SVAJ V57. Z ' � TEST GAMA LAt�V SvR.V tc.�t>s B. IT SHALL REMAIN THE D!✓NER'S RESPONSIBILITY FD _._ ,__.__ : R�cA-v 1>► �5'�v ,, E BY.4`1 .7 ��TO HAVE THE PROPOSEDDWELLING FOUNDATION � � k'ITNESSED BY.•DESIGNED TO ACCOUNT FOR THE EXISTING GRADE )th from Surface Soil Horizon Soil Texture Soil color G 5 AND.SOIL CONDITIONS AT THE LOCATION OF THE Z�is� '� `: j PROPOSED OMELLING. f inched (USDA) (Munsell) A-V 'V)5,1 PERC• RA TE MIN./ IN. 5 t*s A�, zOe.�►Ft, Orr CL'�1`sTRa$u�"1�� .., � � i `ro ,�4= Pu t >✓i c vT�-R, sv 't-� (� --� 1q, S,�✓b�+�-OA to y1� h2. d$Stcjtv�� 23 f�ESIGN �'f�ITERIA.' {3 �.�C1S�'1 6 �SScvR00 a s 1 Lrov ow. G t,. . SL $ 6 .°10 vRo ' { ,at'b�US'T�,nD 1�� 3&1,9009 Oh'ELLMG L6 110 GAL/DAY PcR BEDROOM f 03 ,h m� d W .S L_g a1.6d ,�r E OUAL S GALS. PER DAY. �A SEPTIC.. TAB',%; RFQUTAED• ' COD X P.dOA - S GAL. >� H r✓b ,: . SEPTIC 4A v PROVIDED.' _ . 1 S 0 O SAL. j . LdCuS '� �� u I v G�•- meDNA, �Dfly, i M �? SIZE OF LEACHING F„GILITY 17 OUTP,SO .. F--► x 6q-,�p R N DESIGN PERC. RATE _ 5 MINUTF41INCH y �pq rZi SIZE OF L�EACH.rNG FQCIL ITY PR5 1IDED.- r 4' r�t��ti 5 ' "'� � ca a�.Te. s-i��c�'uc 15 �5 0 0 6A c 4 ,1 l �� =" SI0,FXALL 1 B� S.F. X O•`1 BOTTOM _ Z'2 C rorrL Sc _ �. �C.F. OF W GL QoAr" RO ERPA L G , V'G.r MICHN I 20 r` x N0. DATE REVIS t,V �. aLMOv�• UL. V 1� 11i3 1 s� G T� .t 7B.22 - OFESSI L ENG EA q A vvvv10 L SG'iGt1-s C7 b . , , ,a b•10 .0 j . 5 i �,.. ._ at , °1.7 EX1S''N. cosy Ov xr „ PR•oQ. C�DkbT C K. FAUl s9c 'GJ > tti• R . TP•1 00 yG N MAR! 0.32448 .M.A o o A o r. • P� PLAN .HOLING A PROPOSED UPGRADE TO AN r _ EXISTING SUBSURFACE`SEPTIC DISPOSAL SYSTEM L ... LOT 3 OLD STAGE ROAD, BARNSTABLE, MA 96 .: OCT08ER 9, 2001 SCALE 1 " 30 ' of S ONA A OR CANAL LAND SURVEYING 160. 33 qe - 306 OLD PL YMOUTH ROAD, SAGAMORE BEACH, MA - ..- OA E P�90JECT NUMBER O.i-094 : r j