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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
I
Map Parcel 11 Application #
Health'Division `� Date Issued b*
Conservation Division Application Fee
Planning Dept. Permit Fee ��
Date Definitive Plan Approved by Planning Board �"��12(v//L �G
Historic - OKH _ Preservation / Hyannis
Project Street Address
Village 4�� 4V_Z✓&
Owner e weM� 9✓.t/ 2&4I-ax —Address ,
Telephone J� J� V-- 4e 7
Permit Request rQS��Ww-re
OF
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Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new 1
Zoning District Flood Plain Groundwater Overlay
Project Valuation �� dG D, d Construction Type p,i-o'
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 Flo On Old King's Highway: ❑Yes .Z.�o
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 0 new size _Shed: ❑ existing ❑ new size Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use - - _ _- __ Proposed-Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ZAe,Le Telephone Number _f7j' AP— IV-
Address 11 M_AWo Az/ �� License
Home Improvement Contractor#/✓�����,�
Worker's Compensation #X!2x a✓
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
/2 v
SIGNATURE DATE
i
4
i
FOR OFFICIAL USE ONLY
APPLICATION#
DATE ISSUED s
MAP/PARCEL NO.
• .
I` .
'F
ADDRESS VILLAGE
r
OWNER
DATE OF INSPECTION:
E 'FOUNDATION
4
f FRAME
t
INSULATION' {
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: w ROUGH -. FINAL
tFINAL BUILDING:,-
DATE CLOSED OUT
ASSOCIATION PLAN NO.
ov
OWNER AUTHORIZATION FORM
1
(Ow is Name)
A
owner of the property located at ,
(Property Address)
lid 0*2
(Property Address)
C0 t
hereby authorize �1—�'1 )Ck�/'GA)
(Subco ractor)
an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building
permit and to perform work on my property.
• L
:Owner's Signature
• • � �' ems. , .
Date
t v
MAY 2 5. 2012
f
0� 36
CAPE COD i
TOWN OF R"DIsTiABCE
INSULATION
FIBERGLASS SEAMLESS SPRATFOAM SUSPENDED
IIATTS GUTTERS INSULATION CEILING! -
1-800-696-6611
}
Town of Barnstable
Regulatory Services
Building Division
200 Main St
Hyannis, MA 02601
Date:
Dear Building Inspector
Please accept this Affidavit as'documentation that Cape Cod Insulation, Inc.'performed &
completed the insulation and weatherizationwork at the property listed below. Cape Cod
Insulation did this in accordance to the specifications listed on the building permit
application. All work has been inspected'by a certified Building Performance Institute
'(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. ,
Property Owner Property Address Village
h'/ '10lie
Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted
Ceilings ( ) ( ) ( ) ( ) ( )
Slopes ( ) ( ) ( ) ( ) )
J
Floors
Walls ( ) ( ) ( ) ( ) ( )
�ive✓'� (VOr rror1 1e0l
Sincerely
rHy ssration,
sident
Insc.
IP1140 '
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
0 2o►,t OvZ�3
Map Parcel 1 Application # 1
Health Division Date Issued
Conservation Division Application Fee �l
Planning Dept. Permit Fee '
Date Definitive Plan.Approved by Planning Board 5 I )uil
Historic - OKH Preservation/Hyannis
Project Street Address 854 Phinneys Lane
Village Centerville
Owner Gwendolyn Brown Address same
Telephone 508-534-9171
Permit Request air Saaling,attiC insulation
Square feet: 1 st floor: existing proposed 2nd floor:.existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation 3858 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: ❑ Full ❑ Crawl ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing new--2
Number of Bedrooms: existing _new
-r;
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 L3 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 ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name RISE Engineering Telephone Number 401-784-3700
Address 1341 Elmwood Ave, Cranston RI License# 100459
Home Improvement Contractor# 120979
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
Erik Nerstheimer for RISE Eng.
r
` FOR OFFICIAL USE ONLY
F ,
i APPLICATION#
DATE ISSUED
i
r ' MAR/PARCEL NO.
}
} ADDRESS VILLAGE
J
OWNER
S
k
DATE OF INSPECTION:
_ FOUNDATION ^`
FRAME
Y
INSULATION .
FIREPLACE
ti ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
ROUGH FINAL
G
it FINAL BUILDING
t
DATE CLOSED OUT
�` ASSOCIATION PLAN NO.
Licensee Details Y &-Page-1 of l
The Official Website of the Executive Office of,Public Safety.and Security(EOPS) ~
Mass.Gov Home a
Public Safety
Department of Public Safety Licensee Complaints F
License Type Construction Supervisor; r
License# 100459
Restriction WS,IC
Name Erik Nerstheimer.
City,State,Zip North Scituate,RI;02857
Expiration Date 3/28/2012 y
Status - Current; y.
No complaints found for this Licensee. F
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http://db.state.ma.us/dps/licdetails.asp,?txtSearchLN=CSL 100459 . 1/7/20I'l.
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A,divWon of Thletsch Engineering 1AA C+,npuCtor RegisbuWn No 120979
CT CoRRtrae�oT Rejw"tlon N08201'�0
! 1341 elmiwood Alvenue,Cranston,]RI 02910 T�/� I
i (401)784-3700 FAX(401)7134-3710 C014 RAC 1,
., Pale 2. i
RISE . Term oDNrRhcrBENT�Eo,ggsogE.ela N�II
AImTHECRIBTONN3.aTrTg FORWOR Ie% '
E1�'CIN��fe1NG _ aeaerpeEo> ar: I.
CWTOMER - - ;. PRONE. DATE dlMiRj ;
GvvCndvlytl Brown (508)534-9171 10/21/2010 111140
BERWWA ATRW. .. . .r._.........._._...— I- ---'- enlnlui aTREEf ---
954 Rhinneys Lane P O Box 2924
$ERWCE CITY.eTAM L® - MUN0 CITY,STATE,LP .
Centerville,MA 02632 HyeizWs,MA 02601
-- � • JOB DESCRIPTION � —
$100,00 i
RISE Engineering will provide labor and materiels to install 7/ P"X 16"rectangular aluminum ME vents vents to inctc v6itil8tion in BSCtG
areas.
' I •S119.00 "�
RISE EnginoLdng will prbsidc labair and materials to install 92 square feet of R-19 faced fibereass insulation to the perimeter of the boeinlent ! .
ceiling at the house si1L
$101,20 I
RISE Engmoering will apply all applicable,eligible incentives to this contract. You will be billed only the Net amount. CuTrl;Btly,for elimbic '
momuz,the Cape Light Compact offers 7r/o ioccntivc,not to exceed S2,000 per caiander year.
-$3;223.16
I
i
WE AGM KOREBY;TO W RNISM SERVICES-COMPLETE IN ACCORDANCE WmI ABOVE SPEdPiCAT10N$FOR THE SUN OF �
Six Hundred Thirty4%ur&391100 Dollars I $834.39
UPON AN4kL BdBPECr10NVIkAPPRINAL eY RISE EMG*WR •CWTOMP ADREEB TO NEWT AMOUNT Old IN FULL MITERSST OF 1%WILL BE CWAW MONTHLY ON ANY:
UraAtp BALANCE AFTgt SEE REVOWE FOR IMPORTANT INFORMATION ON GUARANTEE%W.HTS OF REMICK SCIIDUUNA,AND CONTRACTOR REOIBTRATIOK
DO N,OT SIGN THIS CONTRACT IF THERE ARE ANY LANK SPACES
AUTIICRILEp -RI4E.IlRING TONER ACCEPTANCE
NOTE:THIS CONTRACT Y!!WRNDRAWN t1Y 118'F NOT EIRCIITED WITHIN DATE DF ACCEPTANCE
ACCE"AWM OF COM"Wr-'n1E WM MAM.WUMAYM>W A OOCIPiC MIB ARE
BATIBFACTORY TO UDAND ARE HEREBY A@037M.YOU ARE AUTil NIAZED TO DO'THEWO K-
_ DAYS, t AR SPECM,PAYMENT WILL NE IRW AB,OUTt IM ABOVE: J;
TOWN OF SARI P:ABLE
R I S E 213 Pqy 10 66: 2Q
Division of Thielsch Engineering,Inc.
1341 Elmwood Avenue
ENGINEERING Cranston,Rhode Island 02910
May 1, 2013
Thomas Perry, CBO
Town of Barnstable
Building Division
200 Main Street
Hyannis, MA 02601
Re: Insulation permits
Dear Mr. Perry,
This affidavit is to certify that all insulation work completed for 854 Phinney's Lane has been
inspected by a Building Performance Institute (BPI) certified Professional.
All work performed meets or exceeds Federal and State requirement.
Sincerely,
Erik Nerstheimer
Supervisor of Installations,
BPI certified Building Analyst Professional and Envelope Professional,
RISE Engineering, a division of Thielsch Engineering, Inc.
1341 Elmwood Avenue
Cranston, RI 02910
401-784-3700 800-422-5365 •Fax 401-784-3710
Town of Barnstable *Permit#
Expires 6 months1mm issue dad
Regulatory Services Fee Wo
:alp. Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 t Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number }
r.
Property Address �_' / /f7r✓� �S L Cif�LiJi �
Residential Value of Work 3 l Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address 4�F,,J 90 C q/y r-� �10LI/^J
Contractor's Name �' Via. Telephone Number _�09-77/ 2�78
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name ��,�u, S' '�✓
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to `
❑Re-roof(hurricane nailed)(not stripping. Going over. existing layers of roof).
❑ Re-side
#of doors Replacement Windows/doors/sliders.U-Value " 3 o (maximum.35)#of windows 1`f
*Where required: Issuance of this permit does not exempt compliance with other Town department regulations,i.e.Historic,Conservation,etc.
***,Note: Property Owner must sigh Property.Owner Letter of Permission.
A copy of the Home Improvement Contractors License&'Construction Supervisors License is
equire .
SIGNATURE:
C:\Users\decollikWppData\Local crosoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
Town of Barnstable
.Regulatory Services
�AxxsrAsrs. � • .
v MA&9. g Thomas F. Geiler,Director
Eo J6 Building Division
Tom Perry, Building Commissioner
200 Main'Street,'Hyannis,MA 0260I
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790=6230
Property Owner Must
Complete and Sign This, Section
If Using A Builder
I► we��a�` �d�.� as-Owner of die subject property
hereby authorize U, ur;\.� to act on my behalf,
in all matters relative to work authorized by this building permit application for.
(Ad ss of Job)
Signatuxe of OwAr-
Date .
� R •
Print Name • .
If Property Owner applying forpermit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:O WNERPERMISSION
r
Town of Barnstable
Prof TRE ray
o Regulatory Services
t sAxNsrws = Thomas F. Geiler,Director
tu_as.
16jq. Building Division
PrfD MA't a
Tom Perry, Building Commission r
200 Main.Street; Hyannis,MA 02 01
www.town.barnstable.ma. s
Office: 508-862-4038 . Fax: 508-790-6230
HOnTEOV NER LICENSE E TION
Please Print
DATE:
JOB LOCATION:
number strmt village
"HOMEOWNER":
name home ph e# work phone#
CURRENT MAILING ADDRESS:-
city/to, state zip code
The current exemption for"homeowners"w extended t include owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual. r hire wh does not possess a license,provided that the owner acts as
supervisor.
DEFIN ON F HOMEOWNER
Persons)who owns a parcel of land on which be/sh re 'des or intends to reside, on which there is, or is intended to
be, a one or two-family dwelling, attached or detache s ctures accessory to such use and/or farm structures. A
person who constrgcts more than one home in a two-ye period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a acceptable to the Building Official, that he/she shall be
responsible for all such•work erformed under the boil ermit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for co Hance with the State Building Code and other
applicable codes, bylaws,rules and regulations.
The undersigned.."homeowner"certifies that.he/she derstands the own of Barnstable Building Department
minimum inspection procedures and requirements that he/she will omply with said procedures and
requirements. + \
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings con g 35,000 cubic feet or larger will be quired to corripliwith the
State Building Code Section 127.0 Constructio Control.
HO OWNER'S EXEMPTION
.The code states that "Any homeowner perfo ing work for which a building pernvt is required shall a exempt from the provisions
Of this Section(Section 1 D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a mon(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption ar�unaware that they arc assurrring the responsibilities of a sup sot(set Appendix Q,
Rules&Regulations for Licensing Construction Supavrnsors,Section 2.15) This lack of awareness often results in seriou.problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot pmcetd against the unlicensed person;s§ ' vould with a licensed
Supervisor. The homeowner acting as Supervisor is ultimalcly responsible.
To ensure that the homeowner is fully aware of I�Vhcr rtsponnbili[ia,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 fomr/ccrtification for use in your corrrnunity.
Q:for ms:homccxcmpt
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