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0038 CURLEW WAY
ay � � Uvar --- ---- / \ _ 1 /�� �.. r k � .. - v Cape Save Inc. t 7-D Huntington Avenue South Yarmouth, MA 02664 Tel: 508-398-0398 Fax: 508-398-0399 7/26/19 Brian Florence CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 RE: Insulation Permit.19-2225 - jOw��F BARBS Dear Mr. Florence: This affidavit is to certify that all work completed fort38'_Cu`rlew_Way,_Cotuit'lias 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 r .�' Town of Barnstable _ BU11dlilg srA Post This'Card,So That it is Visible From-the Street:=Approved:Plans Must be Retained on Job and this Card Must be Kept" Posted Until Final Inspection Has Been Made.: Permit s6'lW ♦� _ ° Where a Certificate=of Occupancy is Required,•such%BuiI&Ing shall Not-be Occupied,until a Final Inspection has been made 1 Permit NO. B-19-2225 Applicant Name: William McCluskey Approvals Date Issued: 07/11/2019 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 01/11/2020 Foundation: Location: 38 CURLEW WAY,COTUIT Map/Lot 010-021 Zoning District: RF Sheathing: Owner on Record: SOUZA, BARRY D& BARBARA J Contractor Name: William J McCluskley Framing: 1 4 Address: 38 CURLEW WAY I Contractor License: 102776 2 COTUIT, MA 02635 _ - _ Est. Proj get Cost: $5,000.00 Chimney: Y Description: Add R-30 fiberglass,and R-10 rigid insulation to the attic. Add R-19 Permit Fee: $85.00 fiberglass to the basement.Air seal the attic plane and-basement Insulation: Fee Paid:: $85.00 with expanding foam. General weatherization. ` Date: 7/11/2019 Final: Project Review Req: Plumbing/Gas "N Rough Plumbing: • — .. 't Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall b zoning e in compliance with the local by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Official are provided onthis permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection � _ - K Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: dN�y,✓F , r (ok CtNn S e Town of Barnstable *Permit# a 0 5DO 1pv Expires 6 inon1h9ftom issue date Regulatory Services Fee 12 2013 Thomas F.Geiler,Director y r Building DIVISlOnTONNtA r Perry,CBO, Building Commissioner 200 Main Street;Hyannis,MA 02601 www.townbarnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY ®rNot Valid without Red X-Press Imprint Map/parcel Number 0 Property Address '3 �'. 01 Z L67 L✓ w�4 y C®.T U l ❑Residential Value of Work$ k�s-� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 13�at 1`by ra SO U c 5 T' C U RL Ll=—w W,4 Y C D T'U / I Contractor's Name MULL 1 A-) Telephone Number S d 7 Home Improvement Contractor License#(if applicable) ��i 7 aZ�I Email: tvl tr I/,i n con:E n 9 ®�l Ina; ed/''1 Construction Supervisor's License#(if applicable) /D 4"0 7 6 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 2'fhave Worker's Compensation.Insurance Insurance Company Name U K l K Workman's Comp.Policy# �-U D— y 3 -- l Copy of Insurance Compliance Certificate must accompany each permit. Permit Reques (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to y,A'�mate? DU�'►P ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not ekempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. QAWPFaM\FORMS\building permit formslEXPRESS.doc Revised 060513 Details Page 1 of 1 Licensee Details Demographic Information Full Name: MARK M MULLIN Gender: Owner Name: License Address Information Address: Address 2: City: West Yarmouth State: MA Zipcode: 02673 ,Country: United States License Information License No: CS-104076 License Type: Construction Supervisor Profession: Building Licenses Date of Last Renewal: 9/11/2013 Issue Date: Expiration Date: 9/7/2015 License Status: Active Today's Date: 9/12/2013 Secondary License: Doing Business As: Status Change: 18 Prerequisite Information No Prerequisite Information Disci line No Discipline Information Documentum l http://elicense.chs.state.ma.us/Verification/Details.aspx?agency_id=1&license_id=293006& 9/12/2013 L ,r i . ... .... .... The Commonyveahk of Massachusetts Deprrftnent o,fliubu&ird Accidents - Offireof1madgations ' 6170 Mayhbigton Street Boston,MA 02M wwv inas&gavJdia Workers' CompensataanInsaranceAffidavit:Builders/€antractors/E ectricmns/Plumbers giant Information Please Frint Le?,ibIy Name cl ssrcrzpuization&&idm0: �'1 A rY\ c) L Z / �J Address: • YAP mbu M ,11- .o ac City/Stat&2l p: Phone# Are you an employer?Check the appropriate box Type of project(required}: 4. contractor an ❑ 1_�am a employer with� ❑ I am a � tt d i 6_ New con5hxtioa employees{full andlorpart-time.}* - have hired the sub-rontiactors 2-❑ I am a sole proprietor or partner- listed on the attached sheet y- ❑Remodeling ship and haze no employees These sub-contractors have g_ ❑Demolition woddng for me in any capicity. en�ployes and have workers' 9. Building addition [No workers' comp-insurance comp.mcnranrn 1 required] 5_❑ We are a corporation and its 10.:0 Electrical repairs or additions 3-❑ I am a homeowner doing all worse officers have exercised their 1 1-❑Plumbing repairs or additions mysel€.[No workers't omp. right of exemptioa per MGL 12_E]Roof repairs insurance required-]Ti c-152,§1(4),and we ham no employees-[No Workers' 13.❑Qther comp-insurance required]} *Any appUc=that checks box WI Est$Lso U out the section.below shnwing ihea wokkeie rnmpensatim poRry infarma6ciL T Homeowners who sabmit this e$davit inficstigg they are doing all m t and then hire outside contractors nmst snbm:it anew affidavit ind"ustmg such. factors that check this ba x mast attached sa additional sheet showing the name of&e sass-compactors and state whether ornot those entries have employees. If the sub-contractors have employees,they must prvvide their workers'comp.policy number. I am an employer that isprmidrrrg nrorlrers'cortuperrsatrnn rrrsrerrurce for my ctrlp7rrye�s BeIatr is fire policy a>qd job arts in forrmalrom ,pp Insurance Company Name: Policy 9 or Self-ins.Lic- (a V P7- 3-'t--j l Expiration Date: Job Site Address: 3 g G U R L.,Q&L) WAY y Cifyf5tate/Z:ip: 6 o T V )`I Attach a copy of the workers'compensation policy declaration page(showing the policy number and elation 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$1,500.0a and/or one pear imprisonment,as well as civil penalties in the,form of a STOP WORK ORDER and a fine of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIE!for insurance coverage r erffitvation- I do hereby cerh;fy' renderrttha pains andpenahUes of'perjury Mat Me information praurded above is true and correct S,ipature: '/ ��r/�— Date: ty Phone#: S.. �- - 0 S~ O uz fl use only. Do not write in this area,to be completed by city or town offiic&L City or Tzmm- ease# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Oityfrown Cleric 4.Electrical Inspector 5.Plumbing Inspector 6.Other Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual;partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer;or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or Iocal 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,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to'-fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Comm aawealth of Massachusetts Department of Industrial Accidents . t Office of lavestigatiGns 640 Washingtoa Stet Boston,MA 02111 Tel.#f 17-727-4900 ext 406 or 1--977-MASSAFE Revised 4-24-07 Fax#617-727-7749 w mass;gov/dia -- MULUN ROOFING & SIDING INC. CONSTRUCTION CONTRACT This Construction Contract (the "Contract") is made and entered into as of 9-6-13 (Date), by and between Barbara Souza (Name, hereinafter called the "Customer") and Mark M. Mullin, DBA Mullin Roofing and Siding, Inc. having its principal office at 7 Connemara Way, W. Yarmouth MA 02673 (hereafter called the "Contractor"). Property Location: 38 Curlew way Cotuit, MA In consideration of the mutual promises hereafter set forth and intending to be bound hereby, the parties hereto agree as follows: Contractor's Obligations. Contractor shall complete the following Project herein described in and shall provide supervision necessary to commence and finish the Project expeditiously, in a workmanlike manner, in accordance with the "all applicable codes, laws ordinances, rules, regulations and orders. Description of"Work". Contractor shall do all the work in accordance with the terms of this Contract, as described: Remove existing roofing while protecting the home and landscape. Inspect the roof decking for rotted or damaged decking. Replace up to fifty square feet of decking included if necessary. Nail down any loose decking to ensure a solid roof deck before installing new roof. Install ice and water shield on all eaves, valleys, skylights, pipes, rakes, and around the chimney. A high performance synthetic roofing underlayment will cover the remaining roof deck. Install new drip edge on all eaves_ Install Pro start starter strips on all eaves and rakes for optimum wind protection_ Install new Timberline roofing shingles by GAF using six nails per shingle and installed to factory specifications. Install cobra ridge vent by GAF on the ridges, and cap the ridge with a Timbertex double laminated ridge caps by GAF. Contract Sum. In consideration of the performance by Contractor of its duties and obligations, hereunder, Customer shall pay to contractor the sum of '$4,650 i Payment schedule: Owner shall pay the contractor 0% of the contract sum upon signing the contract, 50% upon starting the job, and the remaining 50% upon completion of the contract work. Contractor's Responsibility.Contractor is an independent contractor for all Work to be performed hereunder. The detailed manner and method of doing the Work shall be under the control of the Contractor. All employees of the Contractor performing Work under this Contract shall be and remain the Contractor's employees. a. The Contractor shall supervise and direct the Work, using its best skills. {4 ; i } Job Safety. Contractor shall be responsible for initiating; maintaining and supervising ali safety Precautions in connection with the`%Jork. Permits. Fees and Notices. The Contractor shall secure and pay for all permits and i governmental fees. licenses and inspections necessary for the proper execution and completion of the Works- Such permits and licenses shall be the property of the Customer and shall be delivered to the Customer upon request. The Contractor shall give all notices and € comply with all applicable codes, laws, ordinances, rules, regulations and orders of anv public authority in connection with the performance of the Worts and the Contractor's obligatio s hereunder: Insurance. Contractor aciSnowieC'ges and agrees at Customer or Owner shall not be obligated to carry any insurance in connection with the lkNores for the benefit,o?the Contra:-tor. Contractors insurance. Contractor shall at ail times maintain and kee • in full force an,' effect, at its expense, any and all insurance coverage which is prudent, necessary or desirable for the protection of the interests of Contractor. Contractor shall furnish to Customer certificates of insurance for the following types of insurance. a. Commercial General Liability Insurance- b. Workers' Compensation insurance to cover full liability under the Workers' Compensation its WITNESS WHEREOF, the parties hereto have executed this Contract as of the day and year first above written. Gusmmer Contractor Company Print Barbara Sousa Mark Mullin Mullin Roofing &Siding; Inc. 7 Connemara Way, ` _ Yarmouth MA 02673 5 8. 2211 8591 Address. 36 Curlew way, Coturt ©at 9-6-18 Date: 97-6-1 3 Phone number 508-367-6062 License No. CSL#104076 N1C#167281 Email address muilinroofing@gmaii.ccm Email address bsouza01@corncasf.net _ cPan�n�ao�ccaeal�2o��ivGaaoi�eG7o ___- \ ©flies n�L'onsdmer A;fags&k6iness Regulation 1 N �� pRCVEl1T CON License or registration valid for mdrvidul use only ' T1ACTCR. egrstrat,on y$7281 before the expiration date If found retaFn to: xpiration 8/30/2014 Type'. Office of Consumer Affairs and Business Regulation DL4' 10 Park Plaza,-Suite 5:170 'Ml1LLIN ROOFING AND SIDING _ Boston,MA 02116 1 MARK MULLIN' , F 7 CONNEMARr:WAY _ '. W.YARMOUTH, MA 026�3 i ` „ Undersecretary atu Not va 'd without sign re I i 4_ r7aMtachu:ctts _ . 1)c utn�cnt of Yufzfac 5 cfsti 4 Bmrrd of`Burl drn'�Rc�rulatrons;y Const:ruction su ind St<riidar d�`r y rursKicens ' Licens ' 1040:76 .. e 1., .� Restricted to OQ:, �' '' •' c i• MARK . MULLIN 10 PERR'Y AVE. E. REHAM, MA 025313 , Exp1Fation: 9/7/2013 't"nm�isi ncr Tr#: 104076 I ACO® D(YYYY) Allil� CERTIFICATE OF LIABILITY INSURANCEF771/4/13 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(ies) 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 does not confer rights to the certificate holder in lieu of such endorsement(s). - PRODUCER CONTACT Margaret J Grassi Ins Agency FAx PHONE 1188 Main Street g NAME: • (508) 295-2007 A/ No: (508) 291-1707 EMAIL ADDRESS: debmjgins@comcast.net West Wareham, MA 02576 INSURE S AFFORDING COVERAGE NAIC# _ INSURER A:Al 1 i ed INSURED INSURERB:COlOny Insurance AgenaV Mark M Mullin I NSU RER C 7 Connemara Way INSURERD: West Yarmouth, MA 02673 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 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 WITH 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. rLTRB ADDL SUBR POLICY EFF POLICY EXP PE OF INSURANCE INSR WVD POLICY NUMBER M/DD/Y MMIDEYYYYY LIMITS GENERALLIABILITY GL3818794 1/5/13 1/5/14 EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIAB ILITY DAMAGE TOREoNcED urree $ 100,000 CLAIMS-MADE OCCUR ME EXP(Arryone person) $ 5,000 PREMISES(Ea PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE $ 2,000,000 GEN'LAGGREGATELIMITAPPLIESPER PRODUCTS-COMP/OPAGG $ 2,000,000 POLICY PRO-- LOC $ AUTOMOBILE LIABILITY COITcNEDd.�SINGLELIMIT $ ANYAUTO BODILY INJURY(Per person) $ ALL O WNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ HIREDAUTOS NON-OWNED PROPERTY cident DAMAGE $ _AUTOS Per ac $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION 6ZZUB-4083P83-4-11 12/8112 12/8/13 }{ WCSTATU- OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECUTIVE E.L.EACH ACGDENi $ 1,000,000 OFFICE RIME MBER EXCLUDED? 7 N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Renerks Schedule,if more space is required) 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. AU 7H0 RE PRE1ENTAT1 E iAA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: Twow I � I ' 1 I C All. I i i I i i C e a I I10 06 C/ -. .: - _. __� _ _ _ -- __ i _. . . _ _ _ . _ . F --- __ _ _ y�F THE T� TOWN,' OF BA.RNSTABLE 1 .13ARNSTADL& i 9� 1639. BUILDING 1HSPE"CTOR ` APPLICATION FOR PERMIT TO .. ..0.........................................................' -' ......... ,r'. .............. TYPE OF CONSTRUCTION .........` ...P.!�'d`�./......r . ....... � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...........I?........C.U4t...E „ ��...... ............................ .................................. ProposedUse ........6�.�..�.'✓ I ................................................................................. ............ r— Zoning District /� %✓ %js..' ,,Fire District ...... � / �/. . .. .. .. ... Name of Owner :: r......e e�......... .z'/0.....Address ......... O vl.................. Nameof Builder ..............� ........ ..-:_..................................Address .................. .,.............................................. Name of Architect ..... ,..........................................Address ............. ................................................... l k;�/�� .`f.............. ��..�ro`........5..... Number of Rooms ..................Foundation ..... . .... Exterior .../ cJ .....//`.......d�....i '�l/G�......Roofin Sl��jry/ ............ .Interior Floors /. ��.n. ..........r'1......:... .._.��!j � ......................................................................:... Heating ............. f/...... �4�. ... ...Plumbing .. -. /� . ��..... . ........ i �-................. � . _ Fireplace ........ ?1.�J ............................................Approximate Cost ....... . o� Definitive Plan Approved by Planning .Board -------------------------------- �19,_______1_ Diagram of Lot and Build ing with Dimensions SUBJECT TO APPROVAL OF BOARD OF HEALTH i LLJ � � � �^ I < ® f_e LU lz-, €� 41,v" 0 € \ v7L-Li U)Ld t tUJ nl .. s ax I hereby agree to conform to all the Rules and Regulations of,the Town of.Barnstable regard'ng the above construction. 4 Name ...aa ....! ............ ... ... _ .. v ^ ` ' . . Souza, Barry D. 16o64 one story single- family dwelling . ' 3° ' " | �l� �n�I�� ��y Location ........................................... � . � / ` .--------..=-====.�=..^-°°�^. �^.x.�......... ----- .��.. �� �—' —' ---- . Type of Cnnm,uchon --..������-------. - � -----~—.-----------^--.----. � | ' � � | Plot -----_--- Lot ---.�.^o-----' \ , ' J�mril �� � � Permit Granted ~,r- lg ^ ~ | ----- | '^ | ' Date of Inspection Date Completed .......... ` PERMIT REFUSED . / .----_—''------------- lA . ......................... —'-----.--.—..—.--------------- � . —.----..---------.—..—_.--.----. ���� - �� `» ' . ----.--...-----.--.~.----.--.--. , / Approved ................................................ lQ ^ ---------------'--^-------'— . ^ ----------------------.---.. �. ` . � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o Parcel _ da / Application# Health Division -✓� I z '��� Conservation Division Permit# Tax Collector �, /- , / _ Date Issued Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board r EXISTING SEPTIC SYSTEM Historic-OKH Preservation/Hyannis UM" TO OF BEDROOMS s Fsln " ,If 41_OV Project Street Address 3 Q (2I-P-Go Village '1lJ Owner O W Address Telephone Permit Request Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ` (ram, 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 Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: c2-11 a Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# CD Current Use Proposed Use BUILDER INFORMATION Name v r w Telephone NumberSUe3— Address g l -C � License# N/9 A Home Improvement Contractor# ,6/ Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE g-/1-0 So FOR OFFICIAL USE ONLY , PERM1 NO. DATE4SSUED ' i MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION U ,L FRAME C ' S'`?�� y— INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING j 1Lo Fv DATE CLOSED OUT N ats ASSOCIATION PLAN NO. '� tV l The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations ' 600 Washington Street i -- Boston,MA 02111 a^M SV•Ji �. www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers ApIplicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: 3 S Phone#: Are you an employer? Check the-appropriate box:. Type of project(required): ❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑ New construction .❑ I am a sole proprietor or partner- listed on the attached sheet $ 7- ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9• ❑ Building addition [No workers' comp. insurance 5. ❑ We.are a corporation and its equired.] officers have ekercised their 10•❑ Electrical repairs or.additions I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers- comp.insurance required.] any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information �n 3omeowners.who submit this affidavit.indicating they are doing all work'and then hire outside contractors must submit a new affidavit indicating such 'ontracton that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site formation. isurance Company Name: 31icy#or Self-ins.Lie.#: Expiration Date: :b Site Address: City/State/Zip: ttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). inure to.secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal peiiAlties of a ie up to$.1,500•.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a.fine 'up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of vestigations of the DIA for insurance coverage verification. to hereby certify nder the pains a penalties of perjury that the information provided above is true and correct a Date: ,one#: Official use only. Do not write in this area,to be completed by city or town of xiak City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• Information and Instructions 1 vlassachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees; ?ursuant to this statute, an employee is defined.as"...every person in the service of another under any contract of hire, ry ;xpress or implied,oral or written." An employer is defined as--"an individual,,partuership,,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. Howeyer.the owner of a dwelling house having not more than three apartments and who resides therein, or.the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work-on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)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,MGL chapter 152, §25C(7)states"Neither the commonwealth noz 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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships'(LI;P)with no employees other than the members or partners are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' corrTensation policy;please call the Department at the number listed below.: Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the perr.mVlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy olio information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or r town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that.a valid affidavit is on file for:fixture permits.or-licenses..A new affidavit must be filled out.each year.Where a home owner or citizen-is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit_ ance for your cooperation and should you have any questions, The Office of Investigations would like to thank you in adv 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 ,r ..Office 9.f Investigations r. 600 Washington Street . Boston,MA 0211 L Tel. #617-727-4900 ext 406 or-1,877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia I Town of Barnstable OF ZNE Tp� Regulatory Services BMWSTABLE, Thomas F.Geiler,Director MASS. %639• ,0$ Building Division a rFo � Tom Perry,Building Commissioner 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: �/ � t�J JOB LOCATION: I`e_uo VlJ Coto ( i number street / ^� village "HOMEOWNER": C_�Ir� J b(A-Za-- J 0 q-4�ZS/- `J O d name home phone# work phone# CURRENT MAILING ADDRESS: Co TU I 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 doe_s 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 pro - ures and requirements and that he/she will comply with said procedures and Z ments. VI Signature o m wn r 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 l_ °Qt ro,,b Town of Barnstable Regulatory Services BAMMAM STAB Thomas F.Geiler,Director 39. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition;or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence_or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:beck"e (X Estimated Cost � Address of Work: 3�1 ry TU / Owner's Name: �L Date of Application: f 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 Registration No. OR Date Owne e Q:formslomeaffidav ,e"'"�.*,"t;..C...,,-',.tv,I1�1.1.�I,q:,Io-.!...�;I1,t1�..I�.�,.�L I,,"4,—,,'I.I-'-,I;1,.:,,f.,""II41,�"),.�-.,.,.��a..,.ti.�.�..,�.-.-..:..1.-.,�.17,.���",�.,.%�,.,,-,-�.�.�.I.-,I..i i,',...�,,l.,"-��..,-.tI...-..,.,:"I,,.,..,I:,,�.,:.�.-,'4..,."�::I,�.,�.-.,;,..-:.I.-.,j.-I,-,.:,.1I.--t,..,.;.,�.r��.,.�,,,.,�..,1,.f.� -.....-:.,.,,,.,,,I-�...1i,�,,,!,!,I.�a..�.-�."�.�,.::Al]13-;-":.���,�-,.�::,.*,,--:-.,,..;,*-.-�-,;.�,4;.-.::1,,.,..—:,p.,�,��.;' frt < • ', Y t t 9 + 1 •, 4: t 1,,�,�.'I,r,,_-1!.�1.1l'—,.I_,I t,',.,",-1,..�i.,,�-,1:_,,."%.,�-"�.,,4-.;�,.f,1.-4-;A.-,Ii t-.,�1,--;--:-!,-.,�r�;"-,,-,t.,:..:,::..rI..'..It��I.,-,_,x..;-.",,-I?,4.3r�',,.'�.--,,'-,-:�-..-..r:_.,i,,,,,,.,.C.:�I,,,-..-.�,-I-.";;-��,_.�,t.I",�,,,1,,�*-:..;�14-.,.�,--..�",.".?,,..'-..�',I.,I. .:...-!-t,%�.�,;,.,;,.�..�1..�,q�..�,.,-i�7.,-p,-,�-i,-�..r.,,i:�,,,;:—1�,:-�!,,.�.,1p.L,-:.1:,;:-.,.:�...�a,��-:,',.t:.—�,.;;...;�,�.,.',,".*.,�..,�..,:,�,�I,,,.-,�-..;,..,,-:..,.,�j 1�,-,,;._-,��;""�,,�.�."-:�1,....,�1,-.'II,�d,�,,..I.;-,rl,�..q,1-,f,.t-W.-,...,-l",�I,:,,,,.�.:q1-,.,:-.,�--,,;,.,1.,,-..!.:;I-.1.,:,� ���:.-..;,1..;-��,:,1l-11,,4..�..,I--�..:,d+,.:,"-,,;-';i'....r.�.',...:4 r,,',...;�,:,1-.,,-,_..,�,..-'.� ,,,-,.9�,,�. o,�%;-l*.-1�1:�,��.--.,1��,,11�".r..-':.�,.��w.;-,-,1,,��;..-,%%r.�4;;�Z,.,��,.t.�.,:�,�Ir�",.-.�-.-.,t.t.1;',1 A! 'F,�/ } dyn >•1 '' }", y.{ 'fir ' 1. I. :_ i \ r t k II t V/ ��o./f�1 � i4f e �Y t i t ,I.I�,.,�. ..1:��.-1,. .�..,,1,�"I:.,,.I.,�,1�:�.'..�,,I�:i...�.,:i1-*;-..�I!.:1�.1�:.1I..I.I I, E, - _ 1 1 c ! t- y f ( 1 , t p i�° f t '' Nq ,: F r y 1.. ' �t tt'` x c S A f ;f L ` .. + l t t 1 y - A tj t l x : i y C y l 4 l t f :L ,p '1 '',Y '.iM f }, w. _' r L .C.f Aj�vA�J�✓ iC/ADC il.e'�1 1 s.. ,; L'/J( r 5, t l Y( Ns6"sa yr E ass a/ .2S'E i r „: x , 3 /p ti 3 �oB ,1�y I �1 9 I �DT� t' t M, -`;F 1 - i- 1. S.CO 1 '�_/A.�UU Y I �� 0"7 � 6` ..p�.�:.t.i:.-.-I I-'.Ir�...���..,..�-,.....—...7..,1!�;1.:,1:.�I..�'1II.�:I..:,..:I.:4...--,:..1.�..,4i.,:,��.+.I I:�.�,,..:.I:I.�::1.I.I�..:�, Nc X I; ,_, f At ' I. (i L) I Rs5 6.0' C Ufa° ! 50 t r ., ) I O WA1V +� .w � r s lq 1 + ,� 1. "'.. rl .. r:` t ,J I �� U .. , o Wtuu: 1 "� N �`--- l0/� a/�y' _� 2 Ho o`' A LoTY9: / ' 2/1 �o v,I' t ' f :Tp ? I . r X . O. t :t i.' 1 .1 ! ' ,,C"I i ..l yo2_UOu.� _'_'_ FNO ,' 6 �'. yl . . LND _ . s Sv°. 37' als I-. } 6 � 9 y 1 t w � No' �W 1D� . ,. J _ _ . L1 ' . -' f HEREBY CERTIFY .TNAT;:.TNE �I:��fiJ 01 LC.1)1G a:. T� 00.0RE WN:HEREON.WAS LOCAfCD .; STRUCTURE .$HO ON � BY AN ACTUAL.!.FIELD SURVEY' ON MA,Y :/a 19710 :'- AND 'CONFORMS T4 , 7 If [ " C:li/J'L ecv , wAY. ZONING.. BY-:LAW' O.F THE.TOWN OF 8A,/YS7ri9131E MASSACHUSETTS IN wo eb,. I!..%-,-,,...,.�,1 I-,:�—I",�:-":�4�-�,,.:.,".'1..:,-;:.,I'..1.,!,':,,.."-,.,�::...r.,,�...:.,,��I,...I,,tI:,I,,:,��:1*I I..,.....�I, eXCcPT AS-: T . frL-`_!.,�-���1,.I�,-.-::-.�-I,'.:t.,I I.,,z.*,,,�.-,,��,,�.-,.!�.;I,�,�—I,..�:,.*.�,j,I,I,���::'...qi,��;,,',�:�I�:.,..*.:1�;.''�I:..-..�;q I:,i,I,.;."..,-�;",,,I I�I.,!:`���.'1I,�,1:�1�4,.....��,�:.-,.%-,-...t.I..�'�..!��+....�1:,.I.-...�:,,,II..:A.(.,�,.-1 I--�-,:.I�,.,.".�..��..a...I.--,,:.,�I..-.I:..:-,I,:.,.,�4..��:g.1�'I;,,i...�I,,�,,���,,��,.6�-�...,..-I4,�:,,..:1�II�I,:,.�.I 1l,.,.-.:I,,"�1;%h:,r i:,.,�-,,I�",,-�t,,'*.;..,���,t"..;,,...�.;.:,,;�1--,)-,-,�,���.x�-,."r..,,,�.7�.-.�,;.-,..:,,,...�.�:,.,�.,'..;.....�.;:..�.—,�-:�',..:�,.!..."�-�.I 5._r,,.,,:�.��,,.-,:.-.�1�--.,..r-,-,�I:w.,,,�,I I�,...,m,,�.�,�, ,,G �%/ /3A/�/YSTfI�Le AlIQSS REGISTERED' LAND SU EYQR 1 ; SG^ I = ya AMY 1976 /Y�,4,/'/ 'y C S�!ol DA SN Of Mr 1 ` �,�' xI- rAPE, ri)C� Sl1F2VEY C��NSULTANTS .; . j o� .:. WILIaAMMM 6%1 1.. . r . 4 N.• �i1r A DI'/��,i)N„'GF P.QSTUfd SURVEY GQNSULTANTS, INC `` 4 fi. Iv E3RYANT F- rjU I E; 132 .3 ; �A' .p No 157,27 L1 \. i{YnPdrlls, MA�, A�,�NU S U 5t��,y�i" . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION `f Map Parcel GZ Permit# Health Division i 0 Date Issued m Conservation Division �c Fee Tax Collector Treasurer Planning Dept. A0. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH 1O Preservation/Hyannis ; —; Project Street Address '3� lbwUJ '€ u` _- Village U1 Owner c .1�"0, Address ` Telephone k: .. i r} Permit Request ^� 6 Alq ° �342> b - Square feet: 1st floor: existing n proposed 2nd floor: existing proposed Total new Valuation �5? in. Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes kNNo On Old King's Highway: ❑Yes ❑ No Basement Type: *Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) NON e Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 6 N Q— 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: WGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes YkNo Fireplaces: Existing New Existing wood/coal stove: ElYes ❑ 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 XL.No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Wv_ kA) �O � o Q elephone Number( l� �� Address Gt. v License# /4(A_/QZ-V"ome Improvement Contractor# f �o ow Worker's Compensation# ALL CONSTRUCTION DEBRI RESULTING FROM THIS PROJECT WILL BE TAKEN TO AJ 47,- �,AJ tA? a-4-�/15- Nit 6 U0 14- SIGNATUREDATE n. FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS 'VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULAUGO FIREP ` ELECTRICAL: ROUGH .r FINAL 'ter PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT v r ASSOCIATION PLAN NO. �FTHET° Town of Barnstable 'L°� Regulatory Services snnNsres . : Thomas F.Geiler,Director . e`er g Buildin Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date tn D 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. : ITV V ��N4 50 estimated Cost ' Type of Work Address of Work: V Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied []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: ate Contractor Name Registration No. Ve0� ,S Owner's Name Q:forms:homeaffidav ;, .t.. , _ . t ,_5 L c i 7 .�FV ; '�y f` z 7`5 3 �'R L 'i i�lr Z -S'- 'i ' R i§� --4 S t j - S q' 3 . \ #' 1 k 4 C',Q.i C l ( t1J t ( :. �� _ 7 6.1 ,j. rJ, 'T��rg j �4 .xy-,y.,`L-n i'i� t! �, , , 1 •N`F. 'h'/'iS dF 4j .p /1/ �./joC/(e,� 'r } ':' - _r t /!/L56'sae^ vS E NS5=a2/ .2S E�� r 1 \ 3 0 ___ -�- n _ 4 ® 1. /0�9 4 �+ s Y7 ti i - r _ __ • r t k W'1 E 3 Y So . , X F PCIQV�Aw,< . L \.+/��©� } is. tt::�./�aUU + I _ t.t ! a tip _ f IL F - p u. ��-p�D ' 1. S f ,_ - , R y r` L nT..r g> n1 c.� 6't3s (. is 1 oT , ; 1. it 1 I �` � w°° 1 -Rt30'CS IF U ' z i r RRp�n� 1. ivso .�_.. ��. A . I _ 1 rt f fE r P .z t= �oT_.�+gl10-z 2/ aov . 1 . — s . z i. t f 1 'O ? r. .y (r .tr �w F a o V. a I: ,l Na doLLL s o °,12 . x' fi �-- (/L J //y\J� / fJ` k �, a.: . w �� �► y . . . yo.. W1De it,t x-, ( I ... .. .. 4t '� s S .. -^ _ % ,, _ .. Srr' - -f.. i :• .. f � -y'- + : a ., ty1. . s % t A, > _ .,...} - ,. : .: :.' ,- � _ `z it I'HEREBY. CERTIFY THAT.: THE ' ` .. PLAN 01= LAO G 8� STRUCTURE i 3 STRUCTrtRE .SHOWN.HEREON_WAS CacATEO oN ''BY AN ACTUAL...FIELD,SURVEY' ON . ;.MAY /� 197b.''AND`.-CONFORMS TO TiIE. L 7 �. CU/�'l'eiv wAY TOWN OF. ZONING.^BYT,LAW:.O F_T H E ,` -::<' OA);*,MAl31e MASSACHUSETTS. IN GXCtPT %9S /°o7ab . =, �z �� ,,NI t _ �3ARrvsrs�. �. MASS ` k ` I i REGISTERED LAND SUf�tEYOR '' r 90 ply I�9710 r scAce r i. f a t z . C.— J�(p' t. I F� t 1. ", uAtN ss�� % � ,. ��' �' ` ��PE COD�S`URVE' `.CvNSUL[ANTS n �' ' �(p WILLIAM yGrr 'f'r: N �(� A.Di'!{S:rJPI :GF BOSTOI� ^UNVEY;CONSULTANTS,INC •9 —i 3 BRYANT. (., , " 4� LITE(�JE;,f32 p t No:15121. ' 1. t: j I A 9F$,'' �w0/� liYA[,i('�{S,MAa i �STr �� , _ . .� Nv su,('1� -` : `' Town of Barnstable Regulatory Services ' M ' Thomas F.Geffer,Director Building Division Tom ferry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790.-6230 Property Owner Must Complete and Sign This Section If Using A Builder D U ZA ,as Owner of the subject property hereby authorize S-L-.&j aAJ S"ION- sw!tMN4 Pao(d-S?, to act on my behalf, in aU matters relative to work authorized by this budding permit application for(address of job) 3 G u /Z- 1.eA.AJ C,u C� k+ aa�3S- �D g as igna o Owner Date Print Name ENCLOSURE FOR OUTDOOR PRIVATE SWIMMING POOL FIGURE 4 COMPLETED ENCLOSURE MEETS CPSC,NSPI BOCA&SBCCI BARRIER CODES I KrCH RELEASE III I MY LOCK � o0 LATCH a 1 I , II � 1 I 6- 6. M axim=mesh size for chain link fences shall be a 1 Much(32 nun)square unless the fence is provided with slats fastened at the top or the bottom which reduce the openings to not more than I% inches(44 mm). (see diagram below) . 1 t j CFAM MFEW ions' Ey croocs !I 7. Where the barrier is composed of diagonal members,such as a Iattice fence,the maximum Opening formed by the diagonal members shall be not more that I%inches(44 min). 8. Access gates shall comply with the requirements of 790 CMR 421.10.1 items 1 through 7,and shall be equipped to accommodate a locking device. Pedestrian access gates shall open outwards away from the pool and shall be self-closing and have a self-latching device. Where the release mechanism of the self-latching device is Iocated less than 54 inches (1372 mm)from the bottom of the gate: (a) the release mechanism shall be located on the pool side of the gate at least 3 inches(76 mm)below the top of the gate;and (b) the gate and barrier shall not have an opening greater than V2 inch(13 mm)within 18 inches (457 mm)of the release mechanism. 9. Where a wall of a dwelling serves as part of the barrier(fencing),one of the following shalt apply: House Fence Pool i 9.1 All doors with direct access to the pool through the wall shall be equipped with an alarm which produces an audible warning when the door and its screen,if present,are opened and shall sound continuously for a minimum of 30 seconds. The alarm shall have a minimum sound pressure rating of 85 dBA at ten feet(3048 mm)and the sound of the alarm shall be distinctive from other household sounds shalt as smoke alarms,telephones and door bells. The alarm shall automatically reset under all conditions. The alarm shall be equipped with manual means,such as touches or switches,to deactivate temporarily the alarm for a single opening from either direction. Such deactivation shall last for not more than 15 seconds. The deactivation touchpads or switches shall be located at least 54 inches(1372 min) above the threshold of the door. 10. Where an above-ground pool structure is used as a barrier or where the barrier is mounted on top of the pool structure,and the means of access is a fixed or removable ladder or steps, the ladder or steps shall be surrounded by a barrier which meets the requirements of 780 CMR 421,10.I items 1 through 9.(see diagram below) Pawl ladder I7t1�i �r1GG - A removable ladder shall not constitute an acceptable alternative to enclosure requirements. i � pj, ffw Aw" .� Board of wilding Regnla ons and Standards ` . _- On, Ashburton Place tl Room 1:301 Boston. Massachusetts 02108 Home improvement.Contractor Registration Registration: 130666 Type: DBA Emire+fi4n: 41612006 The Swim Pool Spa Sate & Ser, MaketGrp. Steven Senn P.O. Box 3612 E. Falmouth, MA 02536 Update Address and return card.Mark reason forchaug Address 71-1 Renewal j DnPloyaeot F-1-1 ost Cara? ;/tie 70oi �aavuuea�l�ol-A&wad �el�a hoard of Building Regulations and Standards License or registration valid for iudividul use only _ - HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: Y^ - Board of Building Regulations and Standards Registration: 130666 one Ashburton Place Rm 1301 = Expiration: 41612W6 Boston,Ma.02108 Type: DBA The Swim Pool Spa-Sale a Ser,MaxetGrp Steven Senna 435 Waquoit Uwy E.Falmouth,MA 02536 ' administrator Not valid without signature • EXPLODED VIEW d4bR A'-Ate q t 4 OVAL HEAO'C£.AMP SCREW g �S',#�9�tdlti�k§tesLG D. Tyl?CORNER) � an > a CLAMP TOP R z Gc z �e xf5/8 screw 31 WASHER 7 LINER 27 TOP STRAIGHT RAIL4 CURVED WALL RAIL '� $ SF TOP STRAtG►d $ 4 o-ALLRAiL , $ Yea PC 18 BUTTRESS Yak BG�Yi'Jw:STRAP �F f'"_ °:'.*,ri'. Y' •. ..2'f. 4 ;a nc, t:,.set - � .:�t•-4.._ "�.:a. _..._.. .. . .. 1♦, ' '3 STRAP _ 5 _k, ;`5'�y_.��g," 's.�•.,.'e�i§�$�R'�.�'i' CONNECTOP s 4 CURVED 1. ♦ 24 WALL !, t> � 29 .a � WALL RAIL ♦ SHEET � t Lb BUTTRESS yyLil'T VP'a 9 :ARt1it!°tm° . tip �A ;29 HOLD DOWN 14 SHEET gQlk kDPR SCStJARE CHANNEL ' f � t t \ 7t1A!$VERSAL b ;a ?�., �\Z to BUTTRESS SUPPORT 22 SCTT011A JOINER STRAIGHT WALL RAIL � ;5 STD A.fi$GLE jRACKLFET &:.A f7 g .�teaa 262 48th Strom Brooklyn,lyn,MY 11220 Tel,- (718) 492-8991 e FAX: (718)439-1254 Toll Free., 1-800-447 65 . -2 - _ W . Z 48'-& Z Q v WEATHERBEST(CRYSTALWHTTE) (%]Op - RAILING SYSTEM Q ;:.go Z �U)w - CORRECTDECK OR EQUIVALENT [^ DECKING(YERIFY_COLOR IN FIELD) .: - .� V ti N cn 00 U� NEW ' DECK B HIGH LATTICE - - - 4'$ EXIST. g WALL POOL. § A3 A3 NEW DECK ` ON - O v ITJ /I LINE OF EMST. - - - DECK - : fsa G �- w - 5 0 EXPANDED N DECK 00 OUTLINE OF - � EXIST.HOUSE SCALE: 1/4"= F-0" NEW DECK LAYOUT DATE: os NOTES: ' JOB NO.: SOUSA 1.) CONTRACTOR IS TO VERIFY EXISTING CONDITIONS AND DIMENSIONS THE DESIGNER SHALL BE NOTIFIED IF ANY IN THE FIELD PRIOR TO THE START OF WORK ERRORS OR OMISSIONS ARE FOUND ON THESE DRAWINGS PRIOR TO START OF DRAWING NO.: 2.) VERIFY ALL REQUIREMENTS WJ MANUFACTURERS RECOMMENDATIONS CONSTRUCTION THE BUILDING CONTRACTOR WILL BE RESPONSIBLE FOR THE CONTENT -- - IN THESE DRAWINGS IF CONSTRUCTION _ COMMENCES WITHOUT NOTIFYING THE - DESIGNER OF ANY ERRORS OR OMISSIONS _ - - THESE DRAWINGS ARE SOLELY FOR THE USE - OF THE OWNER NOTED.ANY OTHER USE OF Al THESE DRAWINGS REQUIRES THE WRITTEN - I CONSENT OF THE DESIGNER ..ti PT 4x4FRAMEW/ - 1xSCAP [� - �to N Q_ WHO �D��N w �cnQ00 U Q 0O) Ln NEW LATTICE LINE OF POOL V' - - BEHIND - -. LEFT ELEVATION 1' NEW LA - - NEW.LATTICE LINE OF POOL RIGHT ELEVATION BEHIND o 0 HIGH LATTICE _ WALL _ • _ ! WEATHERBEST(CRYSTALWHffE) .> RAILING SYSTEMod CORRECTDECK OR EOUIVALENT r� DECKING(VERIFY COLOR IN FIELD) - - NEW LATTICE LANE OF POOL. "BEHIND - REAR ELEVATION- SCALE: W HIGH LATTICE. 1/{}� c r-4" - WALL DATE: 4/4/2006 JOB NO.: SQUSA DRAWING NO.: FRONT ELEVATION' 6 BE'rO�FPOOLA2 t NEW 2-P-T.2x 163 b NEWPT 2x6k@16 oe b NEW .P 2x 119s - W O O Q Q� ! U)W�— ? 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II rrT c- 1'xG CAP I I1Kv � I 1� PT 4x4FRAME -i OUTLINE OF USE SIMPSON BC 40 WEATHERBEST(CRYSTAL WHITE) NEW LATTICE j 1 EXIST.HOUSE HALF BASE FASTEN RAILING SYSTEM,FOLLOW NSR'S RAILING POSTS- INSTALLATION INSTRUCTIONS v LEAVE 1'MAX - _ - BETWEEN EXIST CORRECTDECK OR EOUN. - w POOL LIP&NEW DECKING WJUFY COLOR SIMPSON BC 40 DECKING IN THE FIELD) HALF BASE c•J NEW DECK FRAMING/FOOTING PLAN ' MATCH TOP OF EXISTING POOL SCALE: NEWP 2x&'s�16'oc 2-PT.2xtlTs —r— NOTES: EXIST IA"= r-0" POOL 2-P T 2x tlTs NEW LATTICE v 1-) CONTRACTOR IS TO VERIFY EXISTING CONDITIONS AND DIMENSIONS EXISTING GRADE DATE: 4/�/2006 IN THE FIELD PRIOR TO THE START OF WORK 2.) VERIFY ALL MATERIAL REQUIREMENTS W/MANUFACTURERS RECOMMENDATIONS NEW 10'DIA CONC 5 Z SONOTUBESTO JOB NO.: 3.) USE SIMPSON JOIST HANGERS FOR ALL FLOOR JOISTS 4V BELOW GRADE SQUSA 4.) FOLLOW NAIL[NG/FASTENING SPECIFICATIONS FOR SIMPSON COMPONENTS z.T 4 x 4 POSTS FASTENED W/SIMPSON DRAWING NO. ABU 44 TO SONOTUBE&BC 4 TO GIRT A SECTION NEW DECK