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Map Parcel ��- ,: .` ' Permit# Health Division �' G`-c�, �2� l4% :' ��� Date Issued � �= Conservation Division / 1 S q �- - Fee- 7/7­5V F ✓• -6, Tax Collector.: Treasurer SYSTEM �� Planning Deft: INSTALLED IN,COMPLIANCE WITH TITLE 5 Date Definitive Plan'Approved by Planning Board` ®IVM`EN�AL C®DE AND REGULATJONS Historic-OKH t Preservation/HyannisTVARN Project Street Address v Village l -� Owner Address a f _ _ y Telephone 5 6 /p 7E P�Z 7 Permit Request ? r /� Gt. G Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new • Estimated Project CostQ��OW* Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size o2O(J C� (n . Grandfathered: ❑Yes. ❑.No -If yes,attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure o2 Historic House: ❑Yes kNo On Old King's Highway: El Yes ANO Basement Type: A Full ❑Craw ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4 " Basement Unfinished Area(sq.ft) c�2,_5_�Q ' Number of Baths: Full: existing '� new Half:existing new Number of Bedrooms: existing 5 new Total Room Count(not including baths):existing �/ new (lo— First Floor Room Count Heat Type and Fuel: XGas ❑Oil U Electric ❑Other Central Air: ❑Yes XNo . Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:existing -❑new size Pool:❑existing ❑new size Barn:❑existing O 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 _ BUILDER-INFORMATION' Name c i� z Telephone Number -- �/— Address C���f�9� �� License# Home Improvement Contractor# Worker's Compensation# w D S;02z ALL CONST TION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ! 1AaJIzL 4� SIGNATURE DATE l -. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCE12 NO.' ADDRESS ;;»�- VILLAGE OWNER ril— DATE OF INSPECTION FOUNDATION: �� /��69 �Y ` / CG'� PISY i 4 a t t 3 FRAME - t `F INSULATION FIREPLACE ' ELECTRICAL:+ -ROUGH ' 4 j . e' FINAL PLUMBING: ROUGH FINAL, GAS: ROUGH ' ► FINAL FINAL BUILDING % = DATE CLOSED OUT ASSOCIATION PLAN NO. r In TOWN OF BARNSTABLL a BUILDING DEPARTMENT HOMEOWNER LICENSE E%EMPTION . " Please print. � _ --------------. DATE /✓IA-`/ JOB: LOCATIONy� Number A ' z�T�RYfLLC Street Address Section Of Town "HOMEOWNER" Name Home Phone Work Phone PRESENT MAILING ADDRESS .A S 4 Flo yr A x • - City Town ' State Zip Code The; current exemption for "homeowners" was extended to include occut�ied dwellings of six units or less and to ``4;allow suchhomeowners to . engage an individual for hire .who does not possess a license, rovided that the owner acts as su ervisor. p DEFINITION• OF HOMEOWNERS Person(s) who owns a parcel of land on which he/she resides o reside, on which there is, or is intended to be, a one to six family,. r intendsto dwelling, attached or detached structures accessory to such use y structures. and/ farm - period person who constructs more than one home in a two-year period shall not be. considered a homeowner. 'Such "homeowner" shall submit 4 to the Building Official on a form acceptable to the Buildin Official, that he/she shall be re s onsible for all such work o f 1t ' building hermit. g lal, (Section 109..1, 1) �r-ormed under the The undersigned "homeowner" assumes responsibility State Building Code and :other .applicable codes; by for compliance with the : regulations. y-laws,' rules and The :_undersigned "homeowner" certifies that he s Barnstable Building Department minimum inspection procedur / he understands. the''Town of requirements es_ and o HOMEOWNER'S SIGNATURE,`' APPROVAL OF . BUILDING OFFICIAL Note:: Three family dwellings 35,000 cubic feet required to comply with State Building Code Section larger, wil�. be , Control, 127.0, Construction�t n ,h 7 MISCS- y, l • HOME OWNER'S EXEMPTION t The .,code states that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Mary Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q for Licensing Construction Supervisors, Section 2 . 15) .Rules Thisand lackeoflations awareness often results in serious problems, particularly when the Home owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed personas it would with licensed supervisor. The Horne Owner acting as supervisor is ultimately responsible. To ensure that the -Home Owner is fully aware of his/her responsibilities, many communities require, as part of the permit application, that the Home Owner 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. ----------- D r� -------------- .............. Lill lz� ul f } 1 i 4 � i I s � __ _ -- ----- t cx r ! n: Assessor's office(1st Floor): 00�� Assessor's ma and lot number U I o o z3n a ricTHE q� Conservation ( — _ 7 'NSTjaL � er` f� � a�P `w i.Board-of Health 3rd floor: (r+O Rm Sewage Permit number_ �pql� MpL) sr�►nt ���r VV Ap�� �.1�ua Engineering Department(3rd floor): , o�� �"�� ,wr $ °moo esT House number x�rr� Definitive Plan Approved by Planning Board 1g . RIFOuLA,'o 6 A0 APPLICATIONS PROCESSED 8:30-9.30 A.M.and 1:00-2*0 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO Z)ec�� TYPE OF CONSTRUCTION _ 14 0 d 19 l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby Jhereeby applies for a�peermit according to the following information../ Location 5,` /rl k P44 '}"'e1-d1P ZIV. ( I— Ut!/y Proposed Use SLt P r Zoning District Fire District Name of Owner Gr/ ,� cO✓8--c' �� d^P �I� ' -O Address � �/ C2��(�f`/1 Name of Builder ' Address Name of Architect .Address Number of Rooms Foundation Exterior �T Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost D® s Area Diagram of Lot and Building with Dimensions Fee 14X �. 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 "'e-+� Construction Supervisor's License JACQUES, WILLIAM 2-(0 - 69'2' No � Permit For ADD DECK. Single .Family Dwelling , Location `- 52 Thread Needle Lane .f S + Centerville 4+ Owner ' William Jacques t . Type of Construction Wood Frame } t + I I q At t " i C, Plot f ; Lot • z -jam ` } ! t � I ! ! " Permit Granted May, 14 _ 1992 2 •,t " i i r Date of Inspection ` 19"i - } Date Completed 'S ��� J 19 + ' t w i• i } i I MAScheck COMPLIANCE REPORTL Massachusetts Energy Code Permit # MAScheck Software Version 2 .01 :� I Checked by/Date y � CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 11-18-1999 COMPLIANCE: PASSES . Required UA = 103 Your Home 90 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value U CEILINGSiJ -------__ _..__-,� .i ' 500 30.0 0.0 WALLS: Wood Frame 1 16" O:C. 519 13.0 0.0 - - - 4 GLAZING: Windows or'Doors 25 0.330" FLOORS: Over+ Unconditioned"+Space 450 19.0 0.0 2 ----------------------------------- COMPLIANCE STATEMENT: The proposed building design described here 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 y' MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software. Version 2 :.01 DATE: 11-18-1999 - Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS [ ] 1. Wood Frame, 161 O.C. , R-13 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.33 For windows. without labeled U-values, describe features: # Panes - '' Frame' Type Thermal Break? [ ] Yes { ] No Comments/Location FLOORS 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: ." [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures .__:__:.___._ shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between- the inside of- the recessed- fixture and ceiling cavity and sealed or gasketed' to prevent air leakage into the unconditioned space..._:_._ 2. Type IC rated, in accordance with Standard ASTM E 283; with no more-than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure ' difference and shall be labeled. :. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. - r (' MATERIALS IDENTIFICATION: . Materials and equipment must be identified so that compliance can be determined. • Manufacturer manuals.;Ifor 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: [ ] Ducts shall be insulated per Table J4.4 .7. 1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and "fibrous backing tape installed according to the manufacturer' s installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. 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. � ''.!--" .-.. I 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. [ ] SWIMMING POOLS: All heated swimming' pools must have' 'an on/off heater switch and require a cover unless over 20% of the heating energy is from non-depletable• sources. Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC 'piping conveying fluids above' 120 F or chilled fluids below 55 F must•be insulated to the following levels (in. ) : I t PIPE SIZES (in. ) HEATING SYSTEMS: . + TEMP (F) 21" RUNOUTS 0-1" 1.25-2 2.5-411 Low pressure/temp:` 201-250 1.0 1.5 1.5 t2.0 '"Low temperature 120-200 0.5 1.0 1.0. 1.5 Steam• condensate any 1.0 1.0- 1.5 2.0 d COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 y' 1.0 1.0 l e 5 , • 1.5' [ ] I CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes, to the following levels (in. ) : PIPE SIZES (in. ) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1-1 I 0-1.25" 1.5-2 .0" 2 .0+" 170-180 0-.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only) ------------------------- 0 ! 0 l.. . 0 ' f t R i iris a 1lr!t'J.R'1'�A.GEr,!::V�6'�:C�'1rLiN PL AN. Na G90RGF F.SMITH: ,.�..axrli stroauns.cc to plead ti+tulo. i'x fisno+rel L*ftd$urvry>>> Nat to to eased>n elect f i,orr, �7h�s15.% n.tiErJt1F Nnr�+e.•_A��.l.Ltii.rt.� t"1 1. .s:.NtaS.'L"R�?.. ...._. . ...._.._....---- -..._...---------�--- woRCES"--Kri,KA41G4d 5� TH2.T--A© NEEDt.. l�t.t� C I`,7"-��2a/t�,�t! ►* -._- lea: (`,S)@&T 664� RCAL,a �•to_4o uat� �Z _� 2 7.1 �°.� UOIS1RY. 4L a dc. rae Gdion provided.troquirval nx^�u�tnr'n''�' �". ...."`•w, plan 8t+d-Je �--- aese at+dt eE trvodn aaesd boiWvsg(ry dsfisa�a at�"' �~J�EOP,G t `\�'�<< We cat t4`Y f.`.nt 4ltc Euiidic�(6) Soe!'crn DRs�+• ARM MORTQAQE?+13YECf:O'1 FW..Jr.our judp— �ll F r�N Ail D !.A 3FECIAL FVJl)[t HAZARD wrdia ea�eds K�tlKfflw,awl they are aw vitals ticas aF '' j S pf,,f 11,J R. r d�C�el��'!M?tvperiY(fie ef[gws. � •� •;yiS3 —----- ----' — ?1CICb 1,d ■ro absrs �l�el> �vewrtyay tea its Iv. --- Jf Rc 'lleis±ian is��ru.xrs�e(ocst:on �;.`Nn.r'•?'r:��'•;�Td «tyo�with tsr feaeddia �� .. A n t. �' .�• y 2 5 0 r I 4 �GCs /01 U fk--S h Q --... 3 i --� ,. A DLL,r ' 3 Z' �' zs.� z•� t� t L E: t N _.._—.._.....��---.--•............ 2. C—LAIL IL 11 EXKTiN(� L�ito55._`7ecTaN . 2H %%a' _14 .z•w ,��of. oA �eu•Y end/�g K/6 au)' c'w N�IA cQZf. 9b. !8b' �Xis�vgEM �y pull 250 f� Eu,�iod 8e,owl /6 lop , !Bb" Public Health Division r---n 11 . _' I . r--I i., Town of Barnstable - ; PO Box 534 6 Hyannis,Massachusetts 02601 5 aE Fax(508)775-3344 Phone.(5QA)7. -6265 _ ..._ _. _.__._ 90 - - -. - - I I fosvc/y: /r/�Qpprf/oA/ Ec+c� - I (�aB.£.�asF'�i✓ .1i4/!1RST� _ ��!![[lG>;/yA...-. lQe oa. T"� _.��.2.Y.ULTZ ...�',1,4.G'A•.LLC l/ 5�8.77i g6P�j. POW 6'S CRxr .QE 4vacF.M.v /7__-_ 1 - r h ExKriN(� L�itbS4 .SbcToiJ. ZH 0-111 1`0� -IR 3,icw` c 6 ConoacTC IAI eo.. cRzti 4y. lab, Exisrzvy Al L.6�s6 y �P�� pd�34 250 I 2�1- �bwNO4rNN ML v6Nl /6 op I 2S o` 19b' I IBU" w Public Health Division ; Town of Barnstable 6' PO Box 534 5 ; Hyannis, Massachusetts 02601 q`�ss i ,fv.�/rcy._. c»...LAM?-ao✓__SZ�N�,cEEac�Le. ./3aB_e�,sgd_ �_ LSriC�'evtrG�,4,rQ.. 1 ax.(508).775-3344._. .. - _ - -.__ ._. _. _ _ Phone(508) 790-6265 - - - - - - - - - - - - - - - �- 0 ou.wwTaN �,CNrss G vta „Cq.[LC 5� 79/ SfiO�/ Q 7oF/ -- TOWN OF BARNSTABLE focATION $BWACB �., ........ram-..��..� VILLAG ASSESSOR'S MAP G LOT o2w'48� INSTALL$R'9 NAME is PHONE NO.-.� SEPTIC TANK CAPACITYL C-A i LEACHINO PACILITY:(tY e)- L .(4�,�----(size) NO. OF BEDROOMS _FWATE WELL OR P LiC WA BUILDER OR OWNEtt 1 / DATE PERMIT ISSUED: DATE COMPLIANCE ISSUED;.•, VARIANCE GRANTED: Yea No- - "lot ,1 0f4' : f. t The Town of Barnstable • .�rrar�sr.E. • , '&659. Department of Health Safety and Environmental Services '�Eo Nay" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. 4750 06 Date 1148 U 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: -, i Estimated Cost ���' ell V Address of Work: L-a L /�a � �� �.t/I.z_ Owner's Name: Date of Application: �� J 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. 142-A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Ag 4me- s XV Date Contractor Name Registration No. OR Date Owner's Name q:fortns:Afftdav ---_ - The Commonwealth of Massachusetts Department of Industrial Accidents a ce ollayestigaveffs _U ­7 600 Washington Street Boston,Mass. 02111 Workers' Comiensatiion Insurance Affidavit /igi@i!�%1��31C'�/�IG�! )T)[1 TiittlQ IItRFtr/ / / t fC name: location: city t�l��. C;)— ohone# ❑ I am a homeowner perforr6ing all work myself. ❑ I am a sole ro rietor and have no one working in anv capacity I am an employ providing workers' compensation for my employees working on this job. company name address:city: U 0-6 ��_ hone#: r insurance cn. ` �!�/Z S- �!�. olicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the follo«ing workers' compensation polices: company name: address: .. t city: phone#t insurnnce cn. >: oiiiv#. s: company name- address: city Phone#' insurance co. olicv# P / P PI IPA O//////i1 i;i.to secure coverage as required under Section 15A of MGL 151 can lead to the imposition of crin anal penalties of a tine u to S1.500.00 and/or one years'imprisonment as well as civil penaides in the form of a STOP WORK ORDER and a fine of S100.00 a day against me.-I understand that a copy of this statement may be forwarded to the Ottice of Investigations of the DIA for coverage verillcadon. r do hereby certify under the painsand penalties of perjury that the information provided above is true and correct signature Cv Date 111161109 _ Print name Phone# official use only do not write in this area to be completed by city or town oM ial cito or town: permit/License q ❑BuIIding Department ❑L tensing Board ❑check if immediate response is required ❑Selectmen's OMce ❑Health Department contact person: phone#• ❑Other . .... ....;. (rrnma W95 PJA) HOME IMPROVEMENT Board of CONTRACTORS :REGISTRATION E3uildianb . — I ations and .Standards Ashburton Place t m.r 4 01 = r on sus' Ro�om 13 _ M h �setts 02108 HOME IMPROVEMENT ��1 " Y � , ' Re istratio �,CONTRACTOR � ry s 5 n :r112049 d - xP�ration�02/19/01 TYPe - `INDIVIDUALf 5 : WILLIAMLL,:$:c lLZE Y T WILLIAM yL 'SCHULZE x • � , 3 = PO BOX 288/ 65}CCKER STaf,� x CEN1 ERVILLE IN402632_ •—x-_ -- fie Vomvnza�zuiea�l/ a�;�'lcw�c/zu� DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION. SUPERVISOR LICENSE Nuttier Expires:, Restricted To 00 ' - YILIIAM,.l.._SCNULIE PO 603 288' �,,.,.,,► Jrr *CENTERVILLE, MA 02632- z