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HomeMy WebLinkAbout0139 PARK AVENUE�, �# - _ . y : . . � . � v . � .. .. ,,. a �, .. o �. - o .. � � . . , � ,, A � � a F _ .. Y .. .. - ., a :, .. ,. -., A l - ,. � ... w TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �- • �0 Application 'rdlg��c� Map Parcel _ Health Division Date Issued 3 l Conservation Division Application Fee ? Planning Dept. Permit Fee J Date Definitive Plan Approved by Planning Board JZJ 3)13 Historic - OKH Preservation/Hyannis Project Street Address l 3 9 �a�l�. A v e rs LU Village CeA+0rV Owner �,0.rles W c y Address aM C Telephone Permit Request vwlc 't �C� vi4h �' �'g Ce vw Ose,. Square feet: 1 st floor: existing proposed 2nd floor: existing 'proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ��00 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 0 No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other ZE Basement Finished Area(sq.ft.) Basement Unfinished Area b(sq.ft) a Number of Baths: Full: existing new Half: existing + new ; Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Hoom Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: 0 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Il No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: 0 existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes WNo If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name W i 11 I am Rc.Clvo _S Telephone Number 5 a 3 03q Address ownim i�n License# j' �_ i n IkT4 b N' �+ )(�rrn f � Q b �( Home Improvement Contractor# k 14 3 g 0 Worker's Compensation # 7 WC 3 3 S 3 9 6 g r ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE , 3 (13 �i .w FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. k r� �t - :; ADDRESS VILLAGE i :w OWNER DATE OF INSPECTION: t FOUNDATION, a FRAME INSULATION 'r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL G FINAL BUILDING I r F i DATE CLOSED OUT r ASSOCIATION PLAN NO. k f The Commonwealth of Massachusetts -. Department of Industrial Accidents t _ Office of Investigations t.� I Congress Street, Suite 100 �1 4 ` Boston,MA 02114-201.7 �I e ✓ P„p �• www.mass.gov/din Workers Compensation Insurance Affidavit: Builders/Contractors/Electriciaps/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Cape Save Inc. Address: 7D Huntington Aver City/State/Zip: South Yarmouth, MA 02664 Phone #: 508-398-0398 i Are you an employer?Check the appropriate box: Type of projec (required):' 1. ✓❑ I am a employer with 4 ❑ I am a general contractor and I I� employees(full and/or part-time). have hired the sub-contractors ❑ 6. New construction listed on the attached sheet. 7. ❑ Remodeling 2.❑ 1 am a sole proprietor or partner- These sub-contractors have !l ship and have no employees 8. ❑ Demoliti{n employees and have workers' f working for me in any capacity. 9. ❑ Building(addition [No workers' comp. insurance comp. insurance.'' (t ❑ 5. ❑ We are a corporation and its 10. Electrical repairs or additions required.] officers have exercised their 11.❑ Plumbing repairs or additions 3.❑ I am a homeowner doing all work if right of exemption per MGL 12.❑Roof re'.' airs myself. [No workers comp. repairs insurance required.] c. 152, §1(4), and we have no employees. [No workers' 13.❑✓ Other Insulation comp. insurance required.] 4E 'Any applicant that checks box#1 must also filI 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. E 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site t information. 1 Insurance Company Name: Technology Insurance Company n ft > l Policy#or Self-ins. Lic.#: TWC3353968 Expiration'Date: 04/09/2014 M1 i4 , • Job Site Address: l 3 l �� A" e City/State/Zip: C e n�tr'ry l — Attach a copy of the workers' compensation_policy declaration page(showing the policy number a!d 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 WOif RK 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. 1 do Hereby certi under the pains and penalties o er' that the in ormation provided above is true and correct. Signature: Date � � .3 �,3 i, �z Phone#: 508-398-0398 ` F se only. Do not write in this area, to be completed by city or town official. ;f own• Permit/License# uthority(circle one): of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5. Plumbing Inspector Co ntact Person: Phone#: � J i DATE(MMIDDIYYYY) Ac® CERTIFICATE OF LIABILITY INSURANCE 1 10/22/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate do'�s not confer rights to the certificate holder in lieu of such endorsements). CONTACT Colleen Crowley PRODUCER NAME: Risk Strategies Company PHGONE Up. . (781)986-4400 FAX Nc:(781)963-4920 15 Pacella Park Drive l Suite 240 INSURERS AFFORDING COVERAGE i1 NAIC s Randolph MA 02368 i1SURERA:Selective Ins. of America INSURED INSURERB:Safet Insurance C an` 3618 Cape Save, Inc iNsuRERC:Technolo Insurance C an I 7 D Huntington Ave INSURERD: INSURER E: South Yarmouth Mh 02664 INSURERF: COVERAGES CERTIFICATE NUMBER:CL13102268490 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WrT11 RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ,. LTR DL POLICY EFF POLICY EXP j I LIMITS TYPE OF INSURANCE POLICY NUMBER MMI� MMIDD GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES SES Ea occurrence $ 100,000 A CLAIMS-MADE �X OCCUR 1994480 0/16/2013 0/16/2014 MED EXP(Any one'person) $ 10,000 PERSONAL&ADV!INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OP AGG $ 2,000,000 GF1J'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO X LOC S $ MIN L IT 1 OOO 0O0 AUTOMOBILE LIABILITY Ea accident BODILY INJURY(Per person) $ ANY AUTO $ 1/6/2013 1/6/2014 BODILY INJURY(Per accident) $ ALLOYED X AUTOS ROPERTY DAMAGE 'AUTOS (Per accident) :I $ i X HIRED AUTOS X AUTOS $ tI X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 A 0/16/2013 0/16/2014 $ DED RETENTION HZ 1994480 V%C STATU-1 OTH- C WORKERS COMPENSATION fficers Included for X T YLIMITSER AND EMPLOYERS'LIABILITY YIN overage E.L.EACH ACCIDENT $ 500 000 ANY PROPRIETORIPARTNERIEXECUTIVE14 NIA /9/2013 /9/2014 500 0OO OFFICERIMEMBEREXCLUDED9 3353968 E.L.DISEASE-EA EMPLOY $ (Mandatory in NH) If s,describe under E.L.DISEASE-POLICY LIMIT $ 500,000 IDESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Weatherization Specialists GL: Blnkt AI, Blnkt PNC, Blnkt WOS, Per Proj Agg, Per Loc Agg / GL Exclusions: Snow ?& Ice Removal/OCIP/Wrap Ups CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS AUTHORIZED REPRESENTATIVE 5. i INi chael Christian/CLCly ACORD 25(2010105) ©1988.2010 ACORD CORPORATION. All rights reserved. INS02512010051.01 The ACORD name and logo are registered marks of ACORD I 9 Massachusetts -Department of public Safety - Board of Building Regulations and Standards Construction Supervisor Specialtc License: CSSL-102776 WELLIAM J MC C-LUSKEY `= ` ' 37 NAUSET ROAD '*4F ° West Yarmouth MA 02673 Commissioner 06/28/2015 ` e } , a Office of Consumer Affairs and usiness Regulation z 10 Park Plaza - Suite 5170 - Boston, Massachusetts 02116 s' Home Improvement Contractor Registration Registration: 171380 i Type: Corporation - Expiration: 3/14/2014 Tr# 222184 CAPE SAVE INC. WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE w SOUTH YARMOUTH, MA 02664 E Update Address and return card.Mark reason for change. �.BPS-GAt ea 50M-04I04-G101216 Address D Renewal Empioyment 7 Lost Card ✓te �a�rvnwouoeal� �..:lfaaucc�uael�a -- __ _ -- -- E -- L'\ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only n._ ,,fie HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: (( 1 Registration 1.71380 Type: Office of Consumer Affairs and Business Regulation �02F+' Expiration 3/14/2014 Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 y CA pE SAVE INC WILLIAM MGCLUSKEY 7-D HUNTINGTON AVENUE.? � �� •_ SOUTH YARMOUTH,MA:`02664' Undersecretary Not valid wit o signa I { k r i III - _ '.... •.. - Q.r J amass save �� sa �gh 1e,c PERMIT AUTHORIZATION FORM I, Charles Wry ,owner of f the property located at:. (Owner's Name,printed) 139 Park Ave#A Centerville (Property Street Address) (City) hereby authorize the Mass Save Home Energy Services Program assigned Participating Contractor listed below to act on my behalf and obtain a building permit to perform insulation and/or weatherization work on my property. X(a&,etPs Q 1444 g :e 7� Owner s Signature Date FOR CSG OFFICE USE ONLY' Conservation Services Group has assigned the following Mass Save Home Energy Services Participating Contractor to the above referenced project: Participa 'ng Contractor 1 d• Date For Office Use Only Rev.12232011 t Cape Save Inc. 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 DATE I Ih I lI q t Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permits Dear Mr. Perry a . This affidavit is to certify that all work completed for 139 Park Ave (#201308973) has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal and State Requirements. Sincerely, William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION All Map Parcel--ok Permit# I f ,� �P hI Health Division r /DIV wGMDate Issued —2 Conservation Division 2d a . Application /Tax Collector ! Permit Fee �� Z Treasurer Planning Dept. E037ING Date Definitive Plan Approved by Planning Board LIMITED TI ys - �n Historic-OKH Preservation/Hyannis Project Street Address Village Owner lww lwd e b/ Address Telephone f P,3 J& Permit Request�RaJ 11 / rb 6ig5T- 6te__4 GLUSaT All � !10-7-As f �.� f._ Square feet: 1st floor: existing Z&!J proposed Vgleq 2nd floor: existing o proposed Total ew--�&— Zoning District Flood Plain Groundwater Overlay Project Valuation _326. Construction Type 20 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure Z6 Y6 — Historic House: ❑Yes ,4 No On Old King's Highway: ❑Yes XNo Basement Type: ;4 Full ,4 Crawl ❑Walkout ❑Other di&7"7 t?-Z- �`-G�l?;'Vz- Basement Finished Area(sq.ft.) 300 . Basement Unfinished Area(sq.ft) Number of Baths: Full: existing / new / Half:existing ' ! new o Number of Bedrooms: existing new -4;--PP _ IL Total Room Count(not including baths): existing C0 new_ First Floor Room Count 4 Heat Type and Fuel: Y Gas ❑Oil ❑ Electric 0 Other ll Central Air: ❑Yes $No Fireplaces: Existing _I New U Existing wood/coal stove: ❑Yes ;640 Detached garage existing ❑new size Pool:O existing ❑new size Barn:O existing ❑new size Attached garage:0 existing ❑new size Shed:Cl existing 0 new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded O Commercial ❑Yes ;1No If yes,site plan review# Current Use S Proposed Use BUILDER INFORMATION Name__ �1Y �elao 16 nZ" a�c,yU�2 Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO '16S IGNATU DATE L o G a FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE k OWNER 1 DATE OF INSPECTION: r FOUNDATION- FRAM 7—7$' S s= INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH O FINAL FINAL BUILDING (� 2 2 _b 2os A DATE CLOSED OUTcl aC 1 ASSOCIATION PLAN NO. e. F 01/25/05_ 15:40 FAX 17815855249 FAMILY CHOICE MORTGAGE �001 33-- -15--�'-30'--+'r 12"- .. 45i 33,..r,. 15'- -30- 17 4sf1 !� I W153 yY�Oj7 �W922 I i WfLl31B BL i .MA J,, qO1- wC�..Cr�-._. _ r� G J Fi�TLI>Z8 O s � I .......... ........__............._......_...-- --- .__..._._... P ^� I I� m ' G0L........... m -� .ek— .vz Jls z Xt b -s m a � ru N i � m pp 38••e m .l8 ' .d� .bZ .811' .rZ �Wja COCrAo IRLW,l, 260 to rA 0 9 roG Ma C t ih lOA 00 '1 La� r y7 cy o ICJ /.3 ooturJo v,,et-e-,o a a 10JA4,r 31141,e rb �trxw-olt e fs'�'G���`' Sc:✓Y!� oCO Pn�3 /ON/l ��� . �,s'r�' ` , 4505T7/-j ' x ti I cp I[: 'Ia �I a N .a 'O �' ` / � f�rvr-iN�•d eXA5O�, �pg Z H a o w of wl ti w r N 0 i The Commonwealth of Massachusetts Department of Industrial Accidents' i�lhlld0�f . 600 Washington Street Boston,Mass. '.02111 Workers',, Co %%eIn ation.Insurance Affidavit-General Businesses --- %/�%%/ %///////j ' >2 �i:s•:4 %' '?� t;r wry *v.,•. . :'a: iLau� acne: �,0.Q'7 G�/Z Pilil� S address: ,L /fl�14 city �J tI �y�`/�� state: /.W ziv: Q.40 g2ahone# J i work site location(full address): ❑ I am a sole proprietor and have no one Business Types 0 Retail❑RestaurantBai/Eating Establis eat ' working in any capacity. ❑Office❑ Sales('including Real Estate,Autos etc.) ❑I am an em to er with eln to es full& art time.: er is U ME OMPIWOVIN/I No �I am an employer providing workers' compensation for my employees working on this job.. COIlipBIIV•II91net• }'' •�4' ' address: ,, �,..'. :r...;„ :Y•.'• .,. -�:.'.:::' insurance.ca'+ ,.,, :L..4. :�:s :•..:>:,.. oil # • ::..r;is ....i'r .:.-.. •.:•::.-..:..., 'i.t ... .. ,. , .•-.: •...i.'..:s is •: ....:.•:.. :":.•n•.:.... IIII I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: comAanv'asme= _ .Q,9, rt• Ci! DllOne" . ty' t .. 1 tee. {q�i*-1. :r•:}.':;•.-, ;•(4 - . .. �.: Yak` '�°• .if•: '%i�r:' •a.� itisur n A. 9•'` it compati naa�e•� - ,� address: ,r Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that to copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereb e 1 under the pains and penalties of perjury that the information provided above is tru and correct Signs 7LB�/� Date _ �l✓ Print name Phone# 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 (mvi3ed Sept 2C 03) Information and Instructions Massachus�Geiieral Laws,•chf pter 152 section 25,requires all employers to provide Workers'.compensation for their.. em `la ployees: Mquoted from the w', an employee is.defined as every person inthe service'of another under any contract of hire, express°or implied, oral or written. An employer is defined as an indtvrcival,partnership, association, corporation or other legal entity, any two or more of the foregoing engaged in a joint enterprise, and including the legal.representatives of a deceased. loyer, or the receiver or trustee of an individual,partnership,association or other legal entity, employing employees. *H ever the owner of a dwelling house having',not inure than three apartments and who resides therein, or the.occup of the dwelling house of another who.employspersoris to do.maintenance, construction or repair work on such dwe ' 9 house or on the grounds or building appurtenant thereto shall not because of such,employment.be deemed to be an, Dyer. . : :. MGL chapter 152 section 2 also'slates that every. state'or local licensing agency,sh withhold the issuance or renewal P of a license or permit to op ate a business or to construct buildings in the.Comm wealth for any applicant who has not produced acceptable evi ce orcompliance with the insurance coverage re aired. Additionally,neither the conitnonwealth nor.any.of its po 'cal subdivisions shall enter into any contract far the performance of public work until acceptable evidence of compliance 'th the insurance requirements of this chapt have been presented to the contracting . authority. Applicants Please fill in .the workers' compensation a t completely,by chec ' the box that applies to your situation..Please ffi supply company name, address.and phone numb along with a certifi a of insurance as all affidavits may be submitted to the Department.of Industrial Accidents for con tion of insuranc coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the ci town that th application for the permit or license is being requested, not the Department of Industrial Accidents. ould you ve any questions regarding'the"law" or if you are required to obtain a:workers' compensation policy,please ll the epartment at the number listed.below. City or Towns . Please be sure that the affidavit is ebmplete andprinted le .ly. The D t has provided a space at the bottom of the affidavit for you to fill out in the event'the Office of Ines gZt ons has to c tact you regarding the applicant Please be sure to fill in the perrnit/licens.e number.which will b'e ed as a reference n er. The.affidavits.may.be returned to the Department mail or FAX uriless other arrang s have been made. The Office of Investigations would like to thank y' advance for you cooperation d 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 ice of lelrostlp�tlons . 600 Washington Street Boston,Ma. 02111 fax# 1 727-774.9 6 phone#: (617) 727-4900 ext.406 Town of Barnstable oFINE Regulatory Services Thomas F.Geller,Director .._..... ._. . . . 9� Building Division s639• ATED MA'1 a _ . =--Torn Perry,Building Commi§signer 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ` ' - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ,Q JOB LOCATION: f.3GI Awl— number numbber street village "HOMEOWNER': E"� /W W,0 ✓y name / home'11�phone# work phone# CURRENT MAIIdNG ADDRESS: �S L�/ , y/y 6 ,6j- ---- ------- —---G� �--- -- DZ�3 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 procedures and req ' eme`nts. 'gna re o Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control.. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as.it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor: On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt o�TMe toy Town of Barnstable Regulatory Services 13 srnsr.E,g Thomas F.Geiler,Director mass. Building Division rED MAy Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-?90-6230 Permit no. Date AFFIDAVIT HOME LNUROVENENT 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. Estimated Cost D,o 6 Type of Work: Address bf Work: l , � / � 7/!ad�tf/6f to2��2 Owner's Name: Date of Application: /w/y� I hereby certify that: Registration is not required for the following reason(s): DWork excluded by law ❑Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMT OR DEALING WITH UNREGISTERED • MXNTWOAKDO CONTRACTORS FOR APPLICABLE� ME OMAE OR GU VIPROEARANT4'FUND UNDERMGNOT HAVE' e{.142A. ACCESS TO THE ARBITRATION PR SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date owner's Name Q:forms:homeafPidav RESIDENTIAL BUILDING PERMIT FEES APPY,ICATION FEE , New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 Pil s FEE VALUE WORKSHEET NEyV LIVING SPACE y square feet x$96/sq.foot= x.0041- plus frombelow(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE , / Z square feet x$64/sq.foot= 9 Z d D x.0041= i'� plus from below(if applicable) - GARAGES(attached&detached) square feet x$32/sq.ft. ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf-1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Parch x$30.00= (number) Deck (/ x _x$30.00= i (number) Fireplace/Chimney x$25.00= ' (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00. Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 a 790 CMR Appmdis J , Table JS=b(continued) preeriptive Packages for One and Two-Family Resideatlal Building;Hated with Fmd Fuel MAXIMUM MINIMUM Wall Floor Basement 91ab Heating/Cooling Glazing Glazing Ceiling Wall Perimeter Equipment Eflicicncy Area'(%) U-value= lt-value' R-value R-value R-value° R value? Package 5701 to 6500 Hating Degme Day;' Norma! Q 12% 0.40 38 13 i9 10 6 ti N� R 12%a 0.52 30 19 19 10 3 .45 AFUE g 120/6 0.50 38 13 19 10 N/A Normal 13 25 N/A Normal--. .,----- -------- - U •15% 0.46 38 19 l9 10 N/A 85 AFUE V 15% 0.44 38 13 25 N/A 6 85 AFUE W 15% 0.52 30 19 19 10 N/A Natural X 18% 0.32 38 13 25 N/A N/ rm A Noal LZ 18% 0.42 38 19 25 N/A 6g0 AFUE 18% 0.42 38 13 19 10 ti 90 AFUE 18% 0 50 30 1- 19 1Q1. ADDRESS OF PROPERTY: 1,3qS UARE FOOTAGE OF ALL EXTERIOR WALLS: 2. Q 3. SQUARE FOOTAGE'OF ALL GLAZING: - 4, %GLAZING AREA(93 DIVIDED BY 92): " 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR.THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J$.LM - is and i Glazing area is the ratio of the area of the glazing assemblies (including sliding glass doom,skylights, 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 ft of decorative glass may excluded from a building design with 300 fl 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. 3 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 subsrituted-for�R-49-insulation: Ceiling Rvalues-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. 4 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-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. S The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,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 elettric 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.I a 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 pFIMF Tp The Town of_Barnstable.. - P� p '• BARNSTABLE. Department of Health Safety and Environmental Services MASS 4 i639• �0 p'fOMp�p Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Map/Parcel: Owner: Project Address: J�� I / r �V Builder: U ` �- ✓ The following items were noted on reviewing: ) (� e i S —71 a C� _7 ` t� ' D me.- �Z : Gv.Q I v .P n-4 'l'C�. C k o nv Reviewed by: Date: 2- - U q:buildinglorms:review I ♦m From- T-610 P-002/002 F-551 ,cCC?l 1V6F.NDEDMAXIMUM SPANS FOR FLOOR JOISTS 60 PSF LIVE LOAD PLUS 10 PSF DEAD LOAD Normal Duration Loading* Dead Load — 10 psf lave Load 60 psf Fb= 1000 psi E = 1,300,000 psi (Typical Values for'Pressure.Preservative Treated sout&wn l Pine#2 used under exterior conditions, e,g. decks) Yellow � Joist ,Joist Size Spacing 2x6 2x8 WO 2x12 12" 8s 11:6 14-8 1061 1061 1061 1061 16' 7.11 10-6 13-4 ' .16_3 1167 1167 1167 1167 20 7.4 10-0 12-4 16.1 1242 1254 1248 1262 24" 641 • 9-2. 114 14-2 1336 1336' 1336 1336 Design.Criteria:. De�: 'Fai•60 psf live load limited to span in incies divided by 360. Str�ength; Live load of 60 psf plus dead coati of 10 psf determiryas fiber stress shown. * Note: D � . . . esign values adjusted for normal duration loading.. Town of Barnstable *Permit# o �� O� Expires 6 months from issue date ,,, , : Regulatory Services Fee MAW a639. Thomas F.Geiler,Director �� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 X-PREss pER� V t office: 508-862-4038 '° ax: 508-790-6230 OCT 2 5 2004 EXPRESS PERMIT APPLICATION - RESIDENTIAL Y Not Valid without Red X Press Imprint OF BARNSTA6 r_ 'parcel Number a-0'710 2-%, erty Address I SY ef-1V/ZXVtU-L� !P•. tl.-2 6�3� residential Value of Work ®®� Minimum fee of.$25.00 for work under$6000.00 sue: �V S Ler's Name&Address t/�f9®� C U L///UGC r"M S 0/7'J 6 IV"of T 5 &�j c tk/a J tractor's Name Telephone Number �0 03 2 6,410 ae Improvement Contractor License#(if applicable) istruction Supervisor's License#(if applicable) R01 Norkman's Compensation Insurance Check one: : ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance trance Company Nam rl=an's Comp.Policy# py of Insurance Compliance Certificate must be on file. mit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to , I— AL0#*J0Fll ❑Re-roof(not stripping. Going over existing layers of roof) Re-side . �ND�2Sa oil 'T�D -ft3 -� 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. ;nature ?owns:expmtrg dse063004 (omit if not -------------------------- -------------------------- -- --------------------- ------------------------ ------------------------ - ---------------- providedfor -- in Offer to ------------------------ ------------------------ --------------------- Purchase) ------------- - ------------------------------------------------ ---------- ------------------------ ------ ------------------------- ------------------------ ---------------- --------------------- 27. CONSTRUCTION This instrument, executed in multi ple OF AGREEMENT take effect as a sealed instrument, sets forth rthe entire contract be construed as a enures to the benefit of the parties hereto and their ire Massachusetts contract, is d contract between the parties, is binding upon and successors and assigns, and may be cancelled, respective heirs, devisees, executors, administrators, executed by both the SELLER and the BUYER. If two or more persons are a modified or amended only by a written instrument obligations hereunder shall be joint and several. The captions and marginal no matter of convenience and are not to be considered a part of this agreement or to b named-herein as BUYER their the intent of the parties to it. tee are used only as a 28. LEAD PAINT LAW a used in determining The parties acknowledge that, under Massachusetts law, age resides in any residential premises in whenever a dangerous levels of lead, the owner an child or children under six years of y Paint, plaster or other accessible material so as to make it inaccessible tof children under six Years of age premises must remove r cover said material contains 29. SMOKE DETECTORS The SELLER shall, at the time of the delivery Paint, plaster or other the city or town in which P ry of the deed, deliver a certificate from the fire department of approved smoke detectors in conformity es are located stating that said premises have 30. ADDITIONAL with applicable law. been equipped with PROVISIONS The initialed riders,if any, attached hereto,are incorporated herein by reference. Seller to provide a Sewage Disposal System Certificate prior to closing stating that it passed State Environmental Code. Property Transfer Lead Paint Notification Certification attach ed. FOR RESIDENTIAL PROPERTY CONSTRUCTED PRIOR TO 1978, BUYER LEAD PAINT"PROPERTY TRANSFER NOTIFICATION CERTIFICATION" NOTICE: This is a legal document that creates binding obligations. MUST ALSO HAVE SIGNED If not understood,consult an attorney. SELLER ' G 1 re Uzgrns & Reda Somonaitis, � �S Taxpayer ID/ BUYER Daniel C.Wood and or nominee G Taxpayer ID/ SE R(or Spouse)Kristin chols Taxpayer ID/ BU. R " T aye rID/ BROKERS � ( ) Century 21 Cobb-Nowak ` This form was created by Century 21 Cobb Network using e-FORMS• a-FORMS is copyright protected O 1979,1984,1986,1987,1988,1991 G and may not be BEATER BOSTON REAL ESTATE BOARD used by any other party ® . All rights reserved. Y • � p Assessor's map and lot number 0.:7.�. a!'.........) _ -' 7 ypF THE tOf� Sewage Permit number, !�( SEPTIC SYSTEM MAST [i. INSTALLED IN COMP LIAN, 8aaasTnnrB. : ' WITH ARTICLE II STATE : NAB House number ............................................................ .......... _ . �p i63q. 9� SANITARY CODE AND TOW TOWN 'OF BARN:ATX9tE BUILDING INSPECTOR ADD/Tom/ �� X/ ' APPLICATIONFOR PERMIT TO .............................................../.................................................................:.......... TYPE OF CONSTRUCTION .......Lf-1.7 4 ............................................................ ......................................... .................�.l.. �...z......19.2 I TO THE INSPECTOR OF BUILDINGS: The undersigned herebyy applies for a permit according to the following information: Location ..... .......P9 r........ ................�•�....17; �1�/L.�:�i.........�.1..�..... ................... ...... ..... .... .... ....... ProposedUse ....!�.� .............. .................................................................................................. ZoningDistrict ......................................../................................Fire District .............................................................................. . Name of Owner /��..fR/ �T' ...�`. !/> !91. T! 5....Address .............. 6r??.. .......... ....................................... Name of Builder ........................Address ....P.�.��... d.?�....11 Name of Architect .................................................................Address .................... Number of Rooms ....../..........................................................Foundation. .............. �ff./ Exterior ...............................Roofing .....e��. .................:....................................... Floors ....j(W.1.VA4-7- / ...n�,Y Interior ....... /.Cz/ . Heating ....`/..7.(/h!L.............................................................Plumbing ................. ............................................................... Fireplace ..:..... � L .......................................................Approximate Cost .......... ,9.0.0'...0--0 ...................:............. Definitive Plan Approved by Planning Board ________________________________19_______. Area ..... 1.�.... . .............I...... _ Diagram of Lot and Building with Dimensions Fee ...... �r�f. .... . ................... SUBJECT TO APPROVAL OF BOARD OF HEALTH pRor�sF�t ''�,o4lTidy gel i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ... ............ ..........1�41 ....................... Lengraitis, Walter No ...? 159... Permit fp-r .........add...t.o...dwelling .............................................i*............................... 139 Park Avenue , Location ................................................................ Centerville ............................................................................... Owner. ...............a 1....W t e.r......Len.g.rai.t.i.s..................... .... . ...... . . .. Type of Construction frame.......................................... '"N ................................................................................ Plot ...................... Lot ................................ Permit:Granted ..........Apri1..--2...............:19 79 Date of Inspection .......I......./......... ........19 Date Completed J���............19 k PERMIT REFUSED ...................................................... ..... 19 dA ........................... ............................ ............ .................................................... ...................... ........................ .............................................. ............................................................................... Approvecl.................................................. 19 ................................................................................ ........................................................................... I ;3 � , � �(rSrNS•o� f f Y F7 77 /c c<mu✓cj ��+'rsrll..ry Se,/r Lam_ rs+"��sni`sS ��/c�lvvsrrra.� Ivor �p ucr�.-� U�a7 JZ/g'2�3� /�J�d'+C. �Is�'f�'S/'�d"S � �IQyO Ul!� G�• � r! ,.m Building Sketch (Page - 1) Borrower Client Wood Jr,Daniel C - Pro eft Address 139 Park Ave -- Ci Centerville COUn Barnstable State MA Zip Code 02632-3429 Lender Famil Choice Mortgage .Mesa, Cy !!1R1FIM I� 12.0Lt ' �. Wood Deck I 18.0' 20.0' Enclosed " _-- Porch Family Room Patio Bath Kitchen q Dining FIRST FLOOR Ny..�-___ Patio' Living Room Area 04 -- Dining Room 6.0' Closet or Bedroom b --T 9.0' 32.0' ------ "' 32.0' -- E2 -�-----=r-�:.- Bath U) Bedroom w SECOND FLOOR v Bedroom 0 — Clst Fa� 32.0' =t Sketch Apex IV- Comments: AREA CALCULATIONS SUMMARY LIVING AREA BREAKDOWN Code Description Size Net Totals Breakdown Subtotals GLAl First Floor 1148.00 1148.00 First Floor _ — GLA2 Second Floor 608.00 608.00 16.0 x 38.0 608.00 P/P Enclosed Porch 168.00 14.0 x 18.0 252.00 Patio 216.00 9.0 x 32.0 288.00 Patio 280.00 664.00 Second Floor OTH Wood Deck 72.00 72.00 19.0 x 32.0 608.00 _ TOTAL LIVABLE (rounded) 1756 4 Calculations Total (rounded) 1756 Form SKT.BIdSkI—"TOTAL for Windows"appraisal software by a la made,Inc.—1-800-ALAMODE.