The URL can be used to link to this page

Home My WebLink About0542 SOUTH MAIN STREET .Y ,a} lf�f�j s 1 Vrf 4� r� � � � 1 fi 1t l.'�6� .k' �1. tt. " "d 'i., §- fry i i� � - (W��) :e G' ''F 1 -�� .�r�. 1.4.f �a i�1i� W i I Y4 Y Y `o,C. B a u 01, x A - u m b' 1 1' 8r� 'fix 2, iP % ,.� .., - t.. ' ! sk Yo ..V :llv L>; , ..,n n s �O r` t o a ,a` N ,,1r.. # F 4 ,A r 'tl a1 2 la 1t d a d d A R 9 �� iC 1�' ,I q ) ` 9 5' 4 '.�A F U { H ,L S, �) � a 1 Iq '+ n+ f, I a �' ,f,' �b c +t ��'6i �. �' •,� .� .P -� .',. ••��, 'sad .p ri " ❑ i. t +,. �',' 6 fi ', l 1.n: 2t s - 9a 'r t `t'� " a (� p':'t,, 5 J.. V , i ", qr ' Ir aNr iA ni \fir „".� F 1�°y. '1, a ",., F: t {� ,i w'4!' V. °�. i A", t ` '$ , p 4'. '-a c ,-.,4 r �,�,r ,9i,s4 ;�c a. 0 wt „' ,+•�, " y£G a r a i.. ,f Jl rr I. i . �. n .# L ;`G, uiY ai�` . t 111 ", �." .,Q a p, . u ,,; e ,� q, N w .� " "ti. �� N ..fr I�:,N,. .� ,y ! �� °� r ro Ac' -4 ��'e 4(' 'i"<" ,� ,h{ 4` (t'C r 1',.,=., �t '•^S, m' Q ,�8.. to two r a x. ,�;' as m o r .':� ;i d .: Y 2 J '�'' .y c may. '.� 'ps. - �...: b �� r P N ,�. " "b, .'% ,,,,. .� Li q r 1 y, Y``n,. .vi q r "I `a,• f .,.H..x ! 1��' _ S .,. A 11"I jj p ys [� fir. �� Y ..tlM �+ 'S rA, ,, r�� rn,Pr �.p k t ' d b,! .i1. 4. 4, 4 M1_ s°,,, ' v , ,m, '.f, o�q d > .A14 >, ,16.' t� ! 'a. f "1. 1d" �1 dl. r�, I,Ji .t,.:: '�i '.� .js. 4 'I � .. 6 M rt�F, 1 .ip4- { k ,y e .0 . ,r N' .4,11 V I,� B, 'lP rL 1 Y, ,I 4 �?i e ti >ki 6 n W ,� � J'. ".e''. IY "`, dt s u:' 4t'� i,A yt, < �'. "# ',ha, ;,. x d Vr 6+ h mi 2 +r k, � 'a J: i xL b x .'�, .a. Vu. '..>, ..u' s t r,' 4, f �'� .,`, 'b " i .ra`.' -. ,> r 4 ,a{ rx." P t r ,I r w t' "u ha . w� R ", a w. r p 1r " >V 1+ it -.# :L 4'. i 1 't, s;: 41. a #' ��,1 "r. L p`. n t - ! W ! ,j�� 4 P , h, .. ' ,. . �;. ,c. . a S e�. .J'. ,I' ;�t /. ' •i tN",e ry �� _ ...,,, rr. #Q "r .;gyp a, t' "tr �.,,... e r ,. ...t .. 5' ,:.. �4, ,, :;y,y. �`r,. ..,,,r. ,,;:t 4 N d+ m 14' fG+ �,. f (��,1 r >x k'. r �8 e s'n F y . v3� a a r- o- i t, a ,.,: ... ,...,u�,, ,,...: a, :u .m.:..'. a' 'g*, pp h ::rs '° ,C'; fir, 'a. "` •.! _ is c L o > a r ;. .:: ., .kr, .:o:`+. , '; 1 I11 1� a yi: r .+r I '� tx ,� t .' {f T_ v {� I d., y , fir" P i x '' V•u ,gi :,a a r w+ s e �+ t n �q Y , rF A. Y K { L.. 7 r f3*. .n ,p .�A li .1 ,fie., q - '�. i.::V. 'dI, , x i y., r,. r ,..,i.:'I 'ti.._.! ,:'...0 II Wi L14> .a,.',. std M1:� ° i6 'L y; r, :, 9 ! ✓ � 6` .t ti, -,�Q �� t d 0.". t v a ,u 4 r, g' . I' i it °iv. �'6 x 9' a t, v,. " r, �. 0., 1r' + �, �r �4 .Saw . �' P -.6. Y ,y' §e ��6 �' 1+ h ` , r -•, _ffi..'r +1.....,, `,' a....•u` 1s. ,.f' " '� 'I: ,x r .t.', y'. { �'s.... 'p e�L :,n �, " _� 1 Y ti' a1. N :$. w , ,yr ,t. ,.. a �� !-. 0 { t. rI e ' N 4 rye• ri A. f 1v AI t �;4. t f 1. �4 Q o {y� •4e .0� 1 'ti i a F f, i' 1 kl. r r (e1 x• 1" F .h g 1 `.fs: i 1. .9 g 'xl. K. 'i, I „- ,1. �, t ;I r. 1 Y.:. '� ti' S.. p V4 1 4 �.p 4,' iy Fr. .,4 �. a �.. r +fin �" 'A x 1 a - M } t p I ip. rr 4 # ,1 't y f. Y 2 I�^ q.4' ... '1' x r "49 'A e:. 1 �2 P. yy p�J 1 .: " , 1, p� y 1 n P I 12 Y i y{ L y �'•� W L I�IY. 4 r' k a ;[1','. '.'a P 4rr ti'`�: � r V A C, A f' "4 .e' r`q� t, Aa a 5 r i `u' L �:;, u iM,cx% , f. a fl a' N e x r .P. :I'1. r )ri: r,y x� 1y .y 2, r e L- �f'ct• n. .,m 1' "X'' u w t. ,,1 ." ➢ 'd,, it '�� i , ,C'R. r (" °R ° Otl.( v, .r •{i ,t, 4 tr. Lr s �I,1' yy l a I i a, A �� ' M r x p ti i ri". +w 4, .fl' if I I �.°},. . r,5q i' 11 'r mn Y .p° . �a ,A.y�,�� ,A1 n1ff ',. 4 �� ' R R r �i t it ry v .` tl' °1 . , i, µ5 �"' v,� B r a. n '�p .�c '1 llf'I g': �U" ar:.:. '•p ,%: n M t 4 J '1, at .V ''e e" �f�d 17�'4 �, 'w:' 1 r�.,,.. ",y m '+° 11, „ .,,., ,p µ, t p` � `� L,. �,{�. y r a k, ' l� i v ."I x, 1, r '1�1 r< .�M ' Rla, V ':��. .p>b+ x� l.+f r, � °t ,fie' Y►'!''7P '� ��'� i„p •iP ��iV 1� � 1h� (M , "1 -.I e 'I ti ��' fi ��r L�Ip }V. F �, rt� 4} - 1 .� 11F ,�� 1 N.. ',. �,I s,i< r 8 �i` �I '"'f _I •4, '14+.., v:':P i Tk �. _i„ r1.'.r i P 'C aI , .,t, d. I '1 W,. °� a i !, a „11 ,. " e- .<4¢ + ,}. , > +.' n'�., 1' o a `� a' 'tlr. ,, ;, „. a.: ,.n Ks,_i`i{ _ .r.c.Tf '!�r.r t. ..rs�.n .! a _ _ _r.A".. __ .1r M. - M _ rn ,.. __ t.. r.. �t L..'.. ,r_ t. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1 Parcel �� s Permit# f Health Division W-s-60.�°S `� 3d "�� _ Date'Issued / a� Conservation Division i �. �s Feed rr O ;2_ Tax Collector' ,• = �af� Treasurer}'' ��bor� SEPTIC SYSTEM MUST BE y F INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic`.OKH Preservation/Hyannis . Project Street Address Village CPn c`_'.r V i I/c— Owner SD ik� A and (90-1� (��'��" �- Address S�� ,¢i/Ilo �e i 7 e ll,'11L Telephone �'' `6 q ' Permit Request cari/ Square feet: 1 st floor: existing a proposed, 2nd floor:existing ash proposed �6i � Total new ` Estimated Project Cost lo<b Dqt)..—Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Lko' Two Family ❑ Multi-Family(#units) Age of Existing Structure f D ij �. ,�r' 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 2— new Half:existing new Number of Bedrooms: existing - 3 new Total Room Count(not including baths):existing new_� First Floor Room Count Heat Type and Fuel: ❑Gas UldiI ❑ Electric ❑Other Central Air: ❑Yes Lido Fireplaces: Existing 1 New_0 Existing wood/coal stove: ❑Yes U�ft Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:existing ❑new size _I Attached garage:O 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 C;4, BUILDER INFORMATION Name Telephone Number Address x License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE " 'V DATE FOR OFFICIAL USE ONLY MIT NO. ' DATE ISSUED MAP/PARCEL NO: , ADDRESS' VILLAGE ` OWNER t DATE OF INSPECN: ' FOUNDATION FRAME to l/ INSULATION /1. rho •+ • r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH -r FINAL t GAS: ROUG_ ;e+C FINAL FINAL BUILDING _ _� � "! t DATE CLOSED OUT' - j 14 fur ,may i e� ASSOCIATION PLAN NO.)- 01 ` • The Commonwealth of Massachusetts r..- -7- ---_—� _ 2;ZI - Department of Industrial Accidents -_ _= Ofllci"of/mestigatioQs t 600 Washington Street Boston,Mass 02111 Workers' Compensation Insurance davit / IMIN Ill ,., name CitVI IIOPIIJ etl; <fir 0" t e9 u hone# I am a homeowner performing all work myself. ❑ I am a sole p rietor and have no one workin in anv /%/ON ------------ /%/O/0/%%%/////%%//O%%%%%�%%/�%%%%%%%%%%%O//////%%%%%%/ 1 providing workers' compensation for my employees:working on this job. :: :: :::: :::.. .:::.:..... . ❑ I am an empamox over p...::::: $ .::.;.;.::;>,;;?<:<:<:»>:;:.;;:.:;<::>::;;::>::>::>: coni anv name. . A _ :...::..:... :.........:...........:.....: :.................. ;:;>:< .;:-hone#. cttvw.<, insurance cu. V CIA ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the followingworkers' compensation polices: ;:; com anv name. <t :<.......: a d d r e s ,{ .............. .......... insurance cos:<;.:.'>•:.:. ... ///G/�%�//%/ Hone# .::.:.:.::::::. .::.. i - •.'fiti:>.:'i:{::t:rn[titi;:itv'::iiii:w:i:w::::n?!:ii'rii:ji:::ii:.i:ii:>iiSi:Jiiii:t i::iiYi::?J i.y:ii:Jii�jiiiiii ii:i}ii is?•i:ii:•i:•:?: :...... ..•ii`:L:??4ii::•ii:: :•iiii:^:v:::::.�::n:.:v•v:.:•. .... .................:::::::w:::w:::::�v.>}:?•:}Y.:^:4iii:•::v:�:::::•::•.�:::::::::•:::w:::::, ..,• .. .................................... in�nrance>co:. �j Failure to secure coverage m req�red order Section 25A of MGL 14 can lead to the imposWon of criminal penaltin of a Bne to S1,500.00 and/or one yeah'impzisomnent a,weII a,tivn penalties in the[orm of a STOP WORK ORDER and a Sue of S100.00 s day against me. I miderstand that a copy of this statement may be forwarded to the Once o[Inv om of the DU for coverage verincation I do hereby certify under the pairs and penalties of perjury that the information provided above,is true and correct 01WDate /�. eC2e2 Signature ,.r ,f, -- _: — Print name h� IV'�< , f 2�,ePw C..• Phone# official use only. do not write in this area to be completed by city or town official city or town: pern"cense# OBuilding Department ` ❑Licensing Board ❑Selectmen's Office, ❑checkif immediate response is required , ❑Health Department *R phone ❑Other _ contact person• ; a oa ucd 9/95 PIA) t Instructions Information and Instru . Massachuse tts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their contract other under an co « e defined as eve error m the service of an Y an toe is every P As quoted from the"law", employee employees. qu of hire, express or implied, oral or written. an two or more of artnershi association, corporation or other legal entity, or y employer is de fined as an individual,p p, � receiver or rece the foregoing engaged in a joint enterprise, and including the legal representatives of deceased However the owner ec a trustee of an individual,partnership, association or other legal entity, employing employees. 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 submitted to the Department of Industrial Accidents for canfirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be reburied 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. lax ME FINE M 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 fin out is the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pemmit/license number which will be used as a reference number. The affidavits may be returned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would lice to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a ca]L The Department's address,telephone and fax number.. The Commonwealth Of Massachusetts Department of Industrial Accidents Me0adons of Imst1 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 THE The Town of Barnstable MASS, $ Department of Health Safety and Environmental Services 9�A 'esv Building Division �Et)rM't 367 Main Street.Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Fax: 508-790-6230 Building Commissio, 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. i(9�/ Estimated Cost ,NO Type of Work: Address of Work: ��1 S `�`�� r4w Owner's Name: c 1 igh fv ui e (C) Date of Application: Vv" 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 Defter pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WOE DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT 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. Contractor Name Registration No. Date OR Date Owner's Name q:forms:Affidav EST/MATED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X $115/sq. foot= �4 � (above average construction) square feet X $96/sq. foot= (average construction) 1 square feet X $57/sq. foot= r GARAGE (UNFINISHED) square feet X $25/sq. foot= PORCH square feet X $20/sq. foot= DECK ,-b /1- square feet X $15/sq. foot= i ' O OTHER square feet.X $??/sq. foot= Total Estimated Project Cost IAHFORM 1/3/00 The Town of Barnstable Ft rqy,o Department of Health Safety and Environmental Services Building Division BABrtsrnBM ` 367 Main Street,Hyannis MA 02601 MASS. 039. - ArFD IVIA'1 a Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �`� Z Spa-41 V 4,N 6e f) fe /4— numberJ� street / village "HOMEOWNER": �I��I/V �N G` /�L��/UZ_. -1 �� 2 O'7 name - home phone I# work phone# CURRENT MAILING ADDRESS: —4� Cen fer v,l/{ MA_ 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,provide d 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. K 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 procedufes and requirements. S' ature of 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 to amend and adopt such a form/certification for use in your community. T a ' i Q:FORMS:EXEMPTN File number: J4M9 Y� UNREGISTERED LAND Attorney: MARK J. GLADSTONE Deed Book 2M5 Page 307 Lender: NSA Plan Book Page Lot s Owner. JOHN&GALE GREEN REGISTERED LAND A licant: JOHN&GALE GREEN R .Book Sheet Lot(s): Date: 3/27100 Cerh'vote of Title Assessor's Map 186 Blk: Lot 49 Census Trad MORTGAGE INSPECTION PLAN . Scale: r=so' 542 SOUM MAIN STREET, CENTER VILLE, MA a . a _ W 9sses ti� ' V lob SOr s 9c�1019 , 00 � L h� 93 N a� o Qo�D � oy .. • 0 Q S ZONING DETERMINATION UNLESS OTHERWISE SHOWN,THE MAJOR STRUCTURES HEREIN WERE IN COMPLIANCE WITH LOCAL APPLICABLE ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED OR IS EXEMPT FROM VIOLATION ENFORCEMENT IF EXISTING MORE THAN TEN YEARS. THIS PLAN IS BASED ON RECORDED DEEDS,PLANS,ASSESSOR'S MAPS&OCCUPATION. FENCES,DRIVEWAYS,MINOR STRUCTURES ETC.IF SHOWN ARE SUBJECT TO SUCH CHANGES AS AN INSTRUMENT SURVEY MAY DISCLOSE. FLOOD DETERMINATION THE DWELLING SHOWN HERE DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY# 2500D1 0016 D AS ZONES B&C DATED 701992 BY THE NATIONAL FLOOD INSURANCE PROGRAM. CERTIFICATION 1 CERTIFY TO THE ABOVE ATTORNEY, BANK Olde Stone Land Survey Co., Inc. AND THEIR TITLE INSURANCE COMPANY, 325 Bedford Street THAT THERE ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT Lakeville, MA 02347- � AS SHOWN AND THAT THIS PLAN WAS 11800) 993-3302 PREPARED UNDER MY IMMEDIATE 14800) 993-3304 SUPERVISION. GENERAL NOTES: This mortgage Inspection plan was prepared for the above mentioned client as of this date afOIntended or n: o be a land or property line survey. No comers were set. It cannot be used for preparing deed descriptions,con establishing fence,h ge or building lines. The land as shown hereon Is based on client furnished Information and may be subject to further •sales,to ng 74� ments and right of way. No responsibility is extended to the land owner or occupant. It is not intended to be recorded. d ;�-4 MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 .0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2-family,' detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-30-2000 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 133 Your Home = 132 Area or Insul Sheath Glazing/Do or____ Perimeter R-Value R-Value b-Value UA CEILINGS ;t 576 30.0 0.0 i _ ___ 20 WALLS: Wood Frame, 16" O.C. .576 13.0 3.0 41 GLAZING: Windows or Doors 112 0.400 45 DOORS 20 0.350 17 FLOORS: Over Unconditioned Space 576 30.0 19 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC .equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder/Designer Date a . MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 5-30-2000 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location , WINDOWS AND GLASS DOORS: ' " [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 r ` Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-30 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and .all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed__ lights must be type IC rated and installed .with no penetrations or installed inside an appropriate air-tight assembly with a 0.511 clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION:. .; [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment .and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ f] Ducts in unconditioned spaces must be insulated to R-5 Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must -be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input_ to each: zone or floor- shall---be.-_provided..- ---- ------.-- ---- --- --- HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the. heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only) ------------------------- O U N W > NOTE MATCH EXISTING ROOF PITCH J IS �f�/'�• P�O M`�EP yV\MOLi V®'R i u p GJou��s,oNf .T„S» _ ._. --_____m =_= F"SeP . fl - ------- W PN ERPl�P1'3Y(1Nf' - 3Y - h - EXISTING NFW N TR DT,DN FRONT ELEVATION - LL-_: A o Of as O\NG OESIGµ . DECK`FOREGROUND J .�NG AR ELEVATION NEW CONSTR CnON .,STING, ''� 000 pER pfFETOE CONT.RIDGE VENT 2 X 12 RIDGE BOARD _ ER '�• t0 O 0,BTP NGsp PN IE.'0��WL 2 x s x s•couaR TIES®Is"O.C. F - �/,• . . �.• ', - - 2X 1D'SO I67 O..G. I E%IS11NG DWEWNG� 4EGA\ 2% 10 RI -III 12- 10 RIME BOARD MATCH EXISTING . 0"R-30 RAKE BOARDS AND G NOTE MATCH EXISTING-ROOF PITCH 122 SHINGLE STOP CONT.DRIP CO �o VENTEDGE OR 9"R-30 VENTT 2 X O'l D.C. U 10 COUNG JOISTS 0 16"O.C. MATCH PLATE W ® _ SOFFlT Q_. B M TYPICAL WALL CON6TRLCTION M. BEDROOM M. BATH MAC Fxlsnxc slDDuc J OVER"TYVECK"OVER 1(2"EXTERIOR PLYWOOD OVER 2"X 4 X 8'-0"STUD 3 I/2'R-13 - ' ® 16"O.C.WITH 2 TOP AND 1 BOTTO WALL BEYOND PLATE=8'-4 1/2"STUD WALL 3/4"T�'G PLYWOOD SUBFl.00R PROVIDE SOLD BLOCKING MATCH FLOOR ELEVATION ® ® ® - 2 X 10 S" 12 O.C.OR 9 1 2 wCOQ I, IST o 16 O.C. - - 3-2%12'S WOOD BEAN TCH EXISTING sIDIN r - j -3 1/2"0 CONC. - - FlIIm STL COLUMN TYE. BUILDING SECTION U 6"P.C.STAB - RIGHT ELEVATION _> �Ip I� SCALE: DATE: PROJ. #: J LAVLu�� E LS A ELEVATIONS ,/EE E ' ES APR—APR 1229 GREENE RESIDENCE SHEEP //: A- 1 � a JEFFREY A. HARNABY, CPHD n D GALE & JOHN GREENE ®LIVING DESIGNSPRES0 ,'VS CO orscxs Hm GH IX THESE R APE RS CERTIFIED PROFESSIONAL BUILDING DESIGNER wxxax uw rnPrRlcxr. TxESE Plx+s APE NOT 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH, MA. 542 SOUTH MAIN STREET TO BE RDPRODUCS).CH =OR COPIED. \ TEL. 508-888-2747 CENTERVILLE, MA. 02632 rlORRORS OR DISCREPANCIES SCR FOUND . -ND Es c-. roHIE Iodw".OF OF O I I I OPTIONAL DECK 16°X 120 w MI BEL G •E 4' 5'-4' Y-2 6'.- '4' 6" >_ -------- T L 2aV-8. "BILCO" I 'I - V-0" 3'-O" 3'-43-4 aSIZE CULKHEADABOVE I co. noo jots t I s I ROP OP F FN ` J F0 9U H I S \ ------ - 2 1/4' 48 1/2 - EXISTING --- - - - - - --- .� •a - I ,_2. FOUNDATION 2 2 x 10'. 2 X 10 ® 16 O.0 OR 9 1/2" 00 I-015 ® 16 O.C. "r b}dy t y ?y 9" V-11" 2'-11' >I �\ ''�- l X / ---- 3..2 1 s w otl eP 1/' CO C. co I I - •-J uM O A I II --- _6 % _ X ID I M. BEDROOM o NO (TM --- n 4 17 B X 156 - --- I I ---- -- I M� Q 1 A/o ---- - I I IS /Y � u 1 S 19 2 0. . OR I lV21 WOOD I-IJOIRT 0 6 • ' N� ' - m -- 1 - .•.RF-PROD PI.NN58�'(EO• PULL DOWN SE \B OR SCUTTLE I ---- • OF SHE c\S PRON NS\DNS• .•o ABOVE rz== BUILT IN - - I �YAEHtd-`Ny VtO q\N�`'UP • I I I - �u •8,FE°`\St�PP,t-ER Z�rcE ( I =_ .7 I '. ,EPUtd NLGaN 4t35`�6\f3N � II- L -J .I B PO m CO UN AP W I L NCIE VIlOLl3C �z 11 /(,,/ - .6 Q J' 10"HI WI A BI MIN US_ I I !y{� Dt' SE • V� `• I C ,I + CO PN OUS PIC F TIN %P.6 I .�D ppp Pa ZO- 11 .r/L 99 X_9L/sL$[ 5Fp0.NE°fSFGcupLEs L�=ccccc=c A L-ZSOCML W ------------------ .- - �A• �p TP\N LL�SP�N O j> 24--6. �y / •°�� 6'_w 6'_2./I EG 9'-2 FOUNDATION PLAN & 1ST FL. FRAME PROPOSED FLOOR PLAN N RA N 1. SLATERS PAPER OR 'IYVECK"TO BE USED ON ROOF AND SIDEWALL 2. BASEMENT UTIUTY WINDOWS AS PER STATE BUILDING CODE, 2%OF FLOOR SPACE 3. PROVIDE GUTTERS AND DOWNSPOUTS AS REQUIRED - O INSULATION NOTES 4, PROVIDE FLASHING ABOVE ALL WINDOWS AND DOORS F--I EA L-E F2 S C I--I E U L-E 1.�ALL FLOORS BELOW HEATED SPACE AND ABOVE UNHEATED SPACE TO BE INSULATED WITH 6"R-19 F.G.INSUL MIN. 5. PROVIDE CROSSBRIDGINC ® MIDSPAN OF ALL JOISTS AS REQUIRED SUPPORTING ROOF ONLY SUPPORTING 1.STORY ABOVE SUPPORTING 2 STORY ABOVE 6. DOUBLE JOISTS UNDER ALL PARTITIONS AS REQUIRED F H MAX. N iN MAX. N TiI NTH 2. ALL CEILINGS BELOW UNHEATED SPACE AND ABOVE HEATED SPACE TO BE INSULATED WITH 9"R-30 F.G.INSUL MIN. 7. ATTIC SPACE TO BE VENTED AS PER STATE BUILDING CODE - X a a-p N 3.)ALL EXTERIOR WALLS ABUTTING HEATED SPACE AND UNHEATED SPACE TO BE INSULATED WITH 3 1/2'R-13 F.C.INSUL MIN. B. THE DESIGNER ASSUMES NO RESPONSIBILITY FOR THE CONSTRUCTION. - - a"_A N A 4. OPTIONAL ALL HIGH SOUND AREAS I.E.BATHROOMS,T.V.ROOM�KITCHEN TO BE INSULATED WITH 3 1 2"SOUND INSUTABON THE OWNER AND CONTRACTOR SHALL COMPLY WITH ALL RULES AND _ A 1 _ W / REGULATIONS IN.THE MA. STATE BUILDING CODE AND LOCAL REGULATIONS. ILUNLIN m I� �nSCALE: DATE: PROJ. /�:LLJI\\JII FLOOR PLANS . ��4�=,'-o" 24-APR-2000 ,2I: GREENE RESIDENCE SHEET (/: 3: JEFFREY A. BARNABYI CPBD ®LIVING DESIGNS 2000 CERTIFIED PROFESSIONAL BUILDING DESIGNER- D GALE & JOHN GREENE _ LMHGomasHEAEif(.E%IRESSLYRESpNESIs 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH,MA. VVV 542 SOUTH M IN STREET WMMp11.uw�PTA.�1T. f„E�6I .RENp* :Ape 6.sFlmucm.auxcm DR w+m. TEL. 508-888-2747 CENTERVILLE, A. 0202 ' ?�+a ro OR S -fro��E'o ON pF ,un„c omc„s vIweR Tp f1c srsxr a wae„. O U ui LL.I M > NOTE:MATCH IXISnNG ROOF PITCH J ------------- L U - -- ---- ------- - 0' - - ---- --- - -, > USTINB; NEW CON TRUCnON FRONT ELEVATION Q ,S N�T REAR-. ELEVATION pEGN IN;FOREGROUND -J 5 (�\\•• 4N12 CONRIDGE 80UCnON. EXL nN �I `_• C JGt\Osey\t�C S'• \' CONT.RIDGE VENT 2 X 12 RIDGE BOARD r •�Q�o e P ota��oNFe J •C,�; *Se.,;,�C f ,�• ,^ 2 X 6 X W COLLAR nES o 16"O.G. Go y�, t a • Z 2 X 10'S O 16'O..C. (�EXISDNG DWEWNC� IZ �~ • O '�f G"� 'C • "� -0 2 X 10 RIDGE BOARD 4L•• xRt� ��oo GSG EQE MATCH EXISTING , �00:. C `G / , O NOTE:HATCH EXISTING ROOF PITCH RAKE BOARDS AND 9"R-30 • .SOS ��t'� �GP �Pr1 • 12 SHINGLE STOP �1 • GP gtp:��.�N�Se • ONi.DRIP 1 // • • OF •• SOFFliOR 9-R-31 O "1 tye• • • �T 2 X 0'$ O.C. U 10 CEAJNC JOISTS O I6"O.C. MATCH PLATE UJ > BX TYPI.A WA I .ONCTR I.nON J M. BEDROOM M. BATH MATCH EXISTING SIDING OVER MATCH. OVER 1/2"EXTERIOR 77 q ii PLYWOOD OVER 2"X 4'X.8,-0"STUD 7 3 1/2"R-I3 O 76"O.C.WITH 2 TOP AND 7 BOTTO WALL BEYOND PLATE=8•-4 1/2"STUD WALL 3/4"i¢�C PlYW000 SUBFLOOR PROVIDE SOLID BLACKING MATCH FLOOR ELEVATION 803887 2 X IDS" ,12 O.C.OR 9 1/2 WOOQ I IST O I6 O.C. 3-2 X 12'S MOO BEAM iCH IXISnNG SIDING7. - - 3 I/2"0 CONC. O FILED STL COLUMN TYP. BUILDING SECTION • , b'P.C.SLAB RIGHT ELEVATION > Ev InIn ID ES In I,� In InSCALE: DATE: SHEEP 2: JIILJI�\\\u�l�l�l IIiII ��'° II�C L II'II�LUf\\\\\J�I�I�I � A � ELEVATIONS '/4"=�'-a 24-APR-2000 1229 � ICJ !", GREENE RESIDENCE #: JEFFREY A. BARNABY, CPBD 11 D - ®LIVING DESIGNS VPR Do �I CERTIFIED PROFESSIONAL BUILDING DESIGNER 1�.•.(/ GALE & JOHN GREENE DWNG DE9GNs HER�BT aTMRE RED- CONIbH LAW COPIRIWR. ESE PIlb�6 ARE NOT 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH, MA. 542 SOUTH MAIN STREET m BE REPROppGEp.CHWGEp OR C-ED. OR —N.ON- TEL. 508-988-2747 ANr ERRORS mscREPANco-S CENTERVILLE, MA. 02632 Pwrs ARE m 6EBRo0GHT m,HE ATTEN OF WIG G_RRroR m me STARE aF wORX. OF , y� o OPTIONAL DECK c� x COL.Fl - 16°X 12' w - SO OTUB a' 2- .T. %-S MI - - - - MI ------ I T 26-0 J 5 0 2 0' 2'-0' 3'-G' - 3'-a' 3 •T I I:"SIZE C'I - e J IBULKHEADI II - I I ABOVE I I I 15. ROP,0P F RN `- - -FO BU H - 5 G: S 1/4" 48 1/2 - EXISTING — FOUNDATION 0` �A a+ ?x� ' a I -N ^n 5'-0•%6•-6'BIFOID m iP%� \dIJY� A� 2 X 10 16 O.C. OR 9 1 Z 00 I-OIS ® 16 O.C. 4 + tyy - -i - -i i •+,e . � �: (� ; �v fix .. Wp 1' 6-2• 6-0_ _ 3 2 , s•od ea 1/' CO C. .. L M t1 e M, BEDROOM •-6 % '-6 %10• I I u NG(tt 17aX 156 - ---- X1 I S 0 12"10.1. OR I 1 2 WOD1-01T 16 I 9ULL DOWN x^ - s G � �••• \O OR SC�UiTLE rL_- BUILT IN I - - O `nr T ID'XIG WI A BI MIN V5 �'•• 8 CI( d ••:. II. V V.I,.C. \/ P LT NIS 0 A %16 LO N 4/,OU3 P.L TIN P. f • f - C ... V tr.C�s . 59 X o9L/SL 94 w - - - - - i3.c.. z-zscWL W e --------- ----------- .! "��'_P\S (L LL" -___- ,� p� V o wp 24•-0" �1 •• 0 .OF ••��V s'-m' 6•-z' ,z'-9' FOUNDATION PLAN & 1 ST FL. FRAM` ILU= EGP�, 24-0 PROPOSED FLOOR PLAN - - GENERAL NOTES- P a - 1. SLATERS PAPER OR 'YYVECK"TO BE USED ON ROOF AND SIDEWALL 2. BASEMENT UTILITY WINDOWS AS PER STATE BUILDING CODE, 2%:OF BOOR SPACE ` 3. PROVIDE GUTTERS AND DOWNSPOUTS AS REQUIRED I—I EA E F2 S C I-i E C�.IJ LE INSULATION NO TE$ 4. PROVIDE FLASHING ABOVE ALL WINDOWS AND DOORS - - Q 1.)All FLOORS BELOW HEATED SPACE AND ABOVE UNHEATED SPACE TO BE INSULATED WITH 6"R-19 F.C.INSUL MIN.` 5. PROVIDE CROSSBRIDGING®MIDSPAN OF ALL JOISTS AS REQUIRED SUPPORTING ROOF ONLY SUPPamNc 1 STORY ABOVE SUPPORTING 2 sioRY ABOVE U 6. DOUBLE JOISTS UNDER ALL PARTITIONS AS REQUIRED I OF N MAX. NTH MAR. GTH MAX. NM TN 2.)ALL CEELINGS BELOW UNHEATED SPACE AND ABOVE HEATED SPACE TO BE INSULATED WITH 9'R-30 F.G.INSUL MIN. 7. ATTIC SPACE TO BE VENTED AS PER STATE BUILDING CODE - x a a-O 3.X EXTERIOR WALLS ABUTRNG HEATED SPACE AND UNHEATED SPACE TO BE INSULATED WITH 3 1/2"R-13 F.G.INSUL MIN. B. THE DESIGNER ASSUMES NO RESPONSIBILITY FOR THE CONSTRUCTION, - X - 4-A N A N 4.3 To (OPTIONAL)All HIGH SOUND AREAS I.E.BATHROOMS,T.V.ROOM k KITCHEN TO BE INSULATED WITH 3 1/2-SOUND INSULATION REGULATIONTHE OWNER S IN THE NMA.CSTATE BUILDING CODE R SHALL COMPLY IAND LOCAL REGULATIONS.TH ALL RULES AND 2 - x 1 e - _ 6N-A Q III� ''I Inn\\I I'I�'I Ld SCALE: J Coe FLOOR PLANS S � �/4"=�'-�" DATE: PROJ. #: 24-APR-2000 ,zzs � GREENE RESIDENCE SHEET #: aaa�44fff JEFFREY A. BARNABY, CPBD ®WING DESIGNS 2000 CERTIFIED PROFESSIONAL BUILDING DESIGNER B D - GALE & JOHN .GREENS ,�,.D(PPE4LY Rp1�5115 131 QUAKER MEETINGHOUSE ROAD, EAST SANDWICH, MA. 542 SOUTH M IN STREET • TEL. 508-888-2747 q J 'ro-mlmRsoRtt ResANc�.s wIIN�99N,HrsR CENTERVILLE;T. 02632R5.R6 ro BE�9M�R ro R6. RON 9F of�- '. _ - - ;:uMNc ocslr,Nfi PRI9R ro TNe sswn a waRx. Engineering Dept. (3rd floor) Map a Parcel f I � _ Permit# t r House# =SG G� Date Issued Fee ��2 .o� ConservatSnT flff'n Oth oiws) 50 4-m d 19 .. __. BARNSTABLE. ` i639. .do TOWN OF BARNSTABLE Building Permit Application yProje ress ,� „7 c� �'F' . • Village I/t,?�e 3 Owner Address Telephone Permit Request First Floor square feet Second Floor square feet Construction Type 'Estimated Project Cost $ S �� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Ce4tral Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) �r ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use N Builder Information Name nn�" . �� Telephone Number Address 3 `� 61LX-Ah /-c�ic lye /C64-. License# /1 (¢D f0 6a - V &UQ 0 -�L65'SHome ImprKefii�t actor# WC eP —3/6-- ' 0Y3'7 _ D/ �o Worker's Compensation# /1� 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 SIGNATURE DATE 1 t �S ' BUILDING PERMIT DENIED FO HE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED" t « MAP/4PAR`CEL NO.' ; • 3) ADDRESS'-' ; VILLAGE OWNER ,r f DATE.OF INSPECTION: FOUNDATION FRAME + _ INSULATION FIREPLACE • 1 ELECTRICAL: " ROUGH FINAL _ e i PLUMBING: ROUGH FINAL GAS: ROUGH FINAL - FINAL BUILDING " DATE CLOSED OUT '% / • i T ASSOCIATION PLAN NO. 4 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) m A- DATA ��f °� �'�t{ry ,^ rca*"5.+Fa - i n,� S A"sfi,..E " •r`att'x` ..j,�r r ..�t ,p-�, tp�r�� }t h:r '�.s-�i, �'"-'^ j�.�'�$ 4R l 's'Y.?i' :' 1`„z�.4�., �fL}.,p 's:. � •r��r�� k+Y+va y� ': �y, ra{5 ". .. .. � �y ':.�i{�.Y d'at`:s*:(�`q\� {y L�'�§st � .'4x�..;j ��6.i�� Y � .T 4d`�f�� '� ,'�"`�.'T �(•X �;q��yi•, � /.�..��P 1:� .cnvf+ t':C°k \^'L'.�"{«p /�/�'•.� `Tj�� x r/jlj, : la'+s. .: � y `'N1 is�, :w,p: ,�a-.3��< yd �'� ,�„ •�,V�. 'V��J�'��`E��ZT�Tif�/ z s � c`�` 544 oME M a,`�.`� s'�� R� �, ,�,F ,:.' � b.`1 �v r s,.r ti � rs '' + "s' _ ..2 x'��' s`�"f-��• -{i� .., IPRROVEME T. R,egu a 3 onsv.and« . � b •`�1 �' - `sRo°o:m'u'1�3�tSx1 �. - n �Y,ND '�tOOFI� a TR , � 'w ',,�, � ,, .� �,• M 9lst�at�'�� 1 �ON AC10 _ BNNE ER �� 7Y1�1AfLp type: DB 64 '' 47 R r >x 4 TEAVILLE 's,. ,''.. f.+''"` Y x`'S' Y a; ..•,. `�;t#r}�v�r��,'�'�" � ,y�; S 8 ."gin..,. �� .. ;` _� -MR' ERTF �'"flTiVUfiL •;05TERVI N ' 50 655 °FINE t : . The Town of Barnstable MASS• s�ttrsr,►si.E. • ' Department of Health Safety and Environmental Services '0'EnNw�° Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only 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:J Est.Cost 3, 0 D Address of Work:— �� -'l �' v e,4 iz Owner's Name Date of Permit Application: �'� ( to 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 Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name V Registration No. OR Date Owner's Name r" T11C Cottttttotttrealth of 4fassuchusctty .=tz.;- Department of Industrial Accidents t :1� V1110EOl/QYESI/gal/OQS i;E� 600 11 ashing;ton Street Boston, A1ass. 02111 Workers Compensation Insurance Affidavit .�nlic t—n nformation Please PRINT'le-tbly name* PI c 1; 1�.1'l" (z,�! t, M� Phone 0 C a eo3 2 7 76 m ❑ I am a homeowner performing all work myself. [zy1 am a sole proprietor and have no one tivorking in any capacity f�,•,,,•,_�•,�,^_._ L._''�.:mow.�:••T�:.�.•�...r....a...c__s.-�.+.e!�I.�7v°�r7';`._ - _. � :._ -... �.J.:r�....� �. ❑ 1 am an employer providing workers' compensation for my employees working on this job. coninnny name: address• sit% Phone!!• insurance co noiicv# ❑ I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below whc the following workers' compensation polices: comrinni, name' ddres cih nhonc d- insurance co Pniic� •w.,V:•TL�_��'7•.- �'rt•.. _ _�--r.•a�.� .��'.i�` S^.�w�Fs. T _ �` .�� -_tt _ _._. ram nnv name• •tddre c- cih, hone 0• sur•tnce co. "olicy B Attach additional sheet if tiecess sr +.� v_ '�.""+�rsi�i►i�i�ir-t.+..�{ •'.r£..•►..L��x-�+� •• a..g.nf �,.'„iw„ Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to S1SOU.UU an one Fears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand tt cap),of this statement may be forwarded to the Ofrtce of Investigations of the DIA for coverage verification. I do herehr ccrri •wader the pains and penalties of perjun•that t/te information provided above is true and correct. Sianature Date I t' C:PS' F 1 Print name 066 / t IF tU C—) A c Phone# I-1010r ■L�f•u•��frRl IfIfR��R�P�.1�� otriciai use only do not write in this area to be completed by city or town ofrtcial city or town: permit/license q r9Buitding Department C3Ucensing Board check if immediate response is required 05electmen's Office C31lc2ith Department contact person: phone#: r90ther___ x _ 'Information and Instructions Massachusetts General Laws chapter 152 section '?5 requires all employers to pin the of another under aworkers* compensation m• employees. As quoted from the "law an emplvree is defined as every person in the service - contract of hire, express or implied. oral or written. An emplui'cr is defined as an individual, partnership, association, corporation or other legal entity, or ally two or rr the foregoing ens•nued in a joint enterprise, and including the le-Mal representatives of a deceased employer, or the receiver or tnistee of an individual , partnership. association or other legal entity, employing employees. However owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the o n�z house of another who employs persons to do maintenance , construction or repair work on such dwellingd++�clli or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an emplc MGL chapter 152 seaion :5 also states that every state or local licensing agene,. shall +(nl1mo'd`tC a issuaalth nce of renewal of a license or permit to operate a business or to construct buildings in the fiance with the applicant ,who has not produced acceptable evidence of comp l entea nce coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance forance of public work until acceptable evidence of compliance with the insurance requirements of this chapt been presented to Elie contracting authority. I Applicants Please fill in the workers' compensation affidavit completely, by checking the b x that Witted plies to your Department iof on y supplying company names. address and phone numbers as all affidavits may b idai Industrial Accidents for confirmation of insurance cover age. Also be sureerotn�t or 1 ce segn and t stbeinile e requested 1e aff idayit should be returned to the city or town that the application for the p not the Department of Industrial Accidents. Should you have any questions regarding the "law- or if you are re-,- . to obtain a workers co mpensation policy, pie--se call theDepartm ent at the number listed belo++ .. .-.. w ..w:/q...-.A -.T.. .... ..Yf. '•r�..+��r-w��.•1�.!'.�� . ... .. ..3r. ... ..Mr.. ..1�� •..�' • • City o n�i r -r o S Please be sure that the affidavit is complete and printed legibly. The Department has provided a-sp th ece at the bo tc regardg the affidavit for you to fill out in the event the Office of Investigations hs to contact ence number. tile affidav is ma vbe return be sure to fill in the permit/license number which will be used as a refer 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 que please do not hesitate to `ive us a call. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents office of investigations 600 Washington Street Boston, Ma. O2111 Assessor's offioe (1st floor): f r/ Assessor's map and lot number ............. .... ......................... B and of Health (3rd floor): ^-� ® � STewoge Permit number ...../...>�'.....?�9� ............ '�� TRYLE Z BABa9TABLE. i )Engineering Department 3rd floor): � rb a } p, �Op� 39 �0 ouse number APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only A p P R 0 n E gOWN OF BARNSTABLE stabzo Cor.serv8tion Gom isgiBUILDING INSPECTOR ,1jLq igned APPLICATION F80ERMIT TO o �........... 0 r G TYPE OF CONSTRUCTION ...... S.�.Nr'��. .... .. .�. 4......4!.. !t . ............................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location r.v..�.......��`� .�..........-5...... ........ ..........�. � . ProposedUse ..... .!!!. .`... ........... ................................................................................................................. tP --1 Ceti ZoningDistrict ........................................................................Fire Districtc................................................."............�........... Name of Owner .Jv .... ..�/.�.It......6. '.' e '� J c�'� .S, ! 14..e•'� C .......Address .................................. ... .M14........ Nameof Builder ........................Address.................... .................................................................................... Name of Architect ..................................................................Address Numberof Rooms ..................................................................Foundation ............0.................................................................... Exterior ....................................................................................Roofing .....1�1�.A#?1� Floors ....WAP 4......................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace Approximate Cost ......... ® u /. Definitive Plan Approved by Planning Board ________________________________19________ . Area .... � ....�.0.��. v Diagram of Lot and Building with Dimensions Fee _ a....................... SUBJECT TO APPROVAL OF BOARD OF HEALTH GGd{►✓' 3'w�a�0 a /o s D P r 1 1 I 1 1 1 6 6 obi 100rGA Imo^ . i 31 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .�.... .......... .............. ...................................... Construction Supervisor's License ..:.............. i , ^ ^ z» - 7. No Permit" " = r4t ADD' 20R/ S1 i I� �� =�=`=� =' ' 54 �1� ` Location .� .�y!�� .� --. ` ` ----. !��. g=�� —..----.. ` Owner �� & ------. . Type of Construction — ...................... ' � � � i� ---:-------------'��--------' .' .Plot ............................ Lot ----------' � ' ^' `- r October I5 87 � � Permit G,onlyd -----------�--l9 - Date of Inspection ------------l9 ' ' `. . ~ Date Completed '................ ......................lV � ^ � ~ / . � � \ . �.� . � ' - ' � - � � ^ ' ~ . � � ^ ' . � ' ^ \ �. , *. Assessor's offioe (1st floor): ✓ /(�`� y0FTNET0 Assessor's map and lot number ................ Q �♦ Board of Health (3rd floor): S®wage Permit number ....� .......................... i BASdsTODLL, Engineering Department (3rd floor): °o 16 9• e� Feouse number - �,�,, a Apr a• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00• P.M. only TOWN OF BARNSTABLE _ BUILDING INSPECTOR APPLICATION FOR PERMIT TO ......?4. ......... ........................................................................... �ep r G �t f TYPE OF CONSTRUCTION ......S �.Nc�� ............ " / .."..(.f....�f...... .. k a�✓Y/��ii,-............................... i ......... . ....... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... ..� - ...... ` .J/V.....- ,.......... ` "" °`'`'. .. .f f'................................................Proposed Use ..... .N.J.`... ........... '.N". ....`"t�.........................I.......................u..................... "t � � Zoning District ........................................................................Fire District ...C........................................: .......................... <'r Name of Owner ...C'�.�.� ......G..... ! ..Address ...�..' .....................{��!............ ... Nameof Builder ..................... 'a? .#**; ........................Address .................................................................................... Nameof Architect ..........................:.......................................Address .............................................................:...................... Numberof Rooms ..................................................................Foundation ...................................................., Exierior .................................................... Roofing ..... If.7�� Floors ......................................................................Interior .................................................................................... Heating .............................................Plumbing ......................... Fireplace .....................................!.............................................Approximate Cost .......... ® v .�- /I. ................��.. •. .................... Definitive Plan Approved by Planning Board ________________________________19________ . Area .....W ..... .o i, O Diagram of Lot and Building with Dimensions Fee 150 SUBJECT TO APPROVAL OF BOARD OF HEALTH � g �d CettA� -rWA p 5W 4 M1 �}S ' Sotoh M4 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS , I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .�...`V� ...... ...... ...................................... O Construction Supervisor's License ............. GREEN, JOHN & GALE A=186-049 - . 64:A No .3112 9 8... Permit for ....Add Porch Single Family..Dwell.ing..... Location .. 542 South Main Street,,,,, ............................. Centerville Owner ..John & Gale Green Type of Construction Frame........................... ,Plot ............................ Lot ................................ Permit Granted ....October. . . . . ....1.5..,. ..19 87 ..... .. . .. .. . .. . . Date of Inspection ....................................19 Date Completed ......................................19 Assessor's office (1st floor): ofINEtO Assessor's map and lot number ....., ""....1. ... Q � Board of Health (3rd floor): Sewage Permit number ...................& 33ARNSTAXLE. Engineering Department Ord floor): w '�c rb 9. Housenumber ........................................................................ o MA-4 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF B=ARNSTABLE �/a,/�BUILDING INSPECTOR C� APPLICATION FOR PERMIT TO V` G 000 ...............� v i .................. TYPE OF CONSTRUCTION r'°t"` 1 ............... 19-rF TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....: ......�)a).!.4!.4��.w....... h.(.(/ .................... f //.(.�ILI ,......................................................... r ProposedUse ....:-,O)W f?!!/ ...... D„O.`�- ......................................................................................................................... ZoningDistrict ..... .............. .(.7...............................................Fire District .............................................................................. Name of Owner .//..�!� ,J(04./ Tr!/. ...Address ��i(?!�(/�OdC/ �ezk.�......................... Name of Builder .... .+1.,/F;�7Q.!:`........ G.�.G...��.00..q.45.................. ..............:��,rev �....�J'�.:............>.!.....�/''� Name of Architect "" .........Address Numberof Rooms .............................................................Foundation 1... r,�flc................................................... Exterior ..........."o '°:........................................ .........................Roofin g ......... .......................................................................... Floors ......................................................................................Interior .................................................:.................................. Heating ,...........................................................................Plumbing ............ .............................................................. . !.... .� Fireplace ..............:...................................................................Approximate Cost ..........,...J�^ .............................. Definitive Plan Approved by Planning Board _______________________________19________ . Area ........41.1� ... � .............. Diagram of Lot and Building with Dimensions gZ-/omte ww7" Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name��-� Construction Supervisor's License A.(5f!. 2.36........ SMITH, KEN A=188-148 No ..28961 Permit for ..Build Swimming Pool Accessory to Dwelling ..... ........................ Location ....54 Rainbow Drive . .............................................. Centerville ............................................................................... Owner ......Ken...Smith . .. .................................................. Type of Construction ......Frame ..................................................:............................. Plot ............................ Lot ................................ Permit Granted February 25, 19 86 Date of Inspection ....................................19 Date Completed ......................................19 R PAL r