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HomeMy WebLinkAbout0114 CURLEW WAY //� � _ _ _ - ��� i '�;� �' �, ,� �� ,, i a � i, .. �. ___ i ( �r7l � r i,v o ll C Ovn Q `,ti, o co ?7ic l/ /C,) C-d lot- c� ��� .._ TO -Z 141Av/r' Clem✓� FcL ���c, ' N o /1��c r Town of Barnstable BU11Clli1 ...s•+r, ..a..ryn... ..a p,wN,ry".. ? � Post•This Card So,T"t it7is Visible From4he Street Approved Plans Must be Retained on Job and thisCard Must be Kept Posted Until Final Inspection Has Been Made. Where a Certificate of Occupancy is Regu�red,such Building shalluNot be Occupied until a - Pejlt " x final Inspection has been madeH Permit NO. B-18-3513 Applicant Name: Neal Holmgren Approvals Date Issued: 11/06/2018 Current Use: Structure Permit Type: Building-Solar Panel-Residential Expiration.Date: 05/06/2019 Foundation: Location: 114 CURLEW WAY,COTUIT Map/Lot: 025-062 Zoning District: RF Sheathing: Owner on Record: ALHARTHY,SAID S&SYLVIA Contractor Name: NEAL F HOLMGREN Framing: 1 Address: 114 CURLEW WAY Contractor License: CS-088921 2 COTUIT, MA 02635 Est. Project Cost: $40,000.00 Chimney: Description:. Installation of 41 Panasonic 315 watt solar modules flush mounted Permit Fee: $ 254.00 on existing roof planes. 12.915kw 615sgft - Insulation: Fee Paid: $254.00 Project Review Req: Date: 11/6/2018 Final: Plumbing/Gas Rough Plumbing: g - Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning 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 work until the completion of the same. Electrical Service: - The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work:, Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department - Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of BarnstableBuilding eaasacaes Post This Card So That it is U�s�ble From the Street Approved,Plans Must be Retained on Jo".b and#his Card Must be Kept b Posted Until,Final Inspection Has BeenMade b '�eat°i Where a Certificate.of Occupancy is Required,such Bu�ldmg shall Not be Occupied until a F>nMIT ade rermit Permit NO. B-18-355 Applicant Name: ALHARTHY,SAID S&SYLVIA Approvals Date Issued: 02/07/2018 Current Use: Structure Permit Type: Building-Stove Expiration Date: 08/07/2018 Foundation: Location: 114 CURLEW WAY,COTUIT Map/Lot: 025-062 Zoning,District: RF Sheathing: Owner on Record: ALHARTHY,SAID S&SYLVIA .,,.,,-Contractor Name.—, Framing: 1 Coritractor�-License: Address: 114 CURLEW WAY 12 COTUIT, MA 02635 Est Project Cost: $0.00 l , Chimney: Description: NEW-ENGLANDS STOVE WORKS INC Permit Fee: $35.00 +, a Insulation: '' Fee Paid $35.00 Project Review Req: t Date 2/7/2018 Final: am Plumbing/Gas Rough Plumbing: z Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authonied,by this permit is commenced within six months after'issuance• Rough Gas: All work authorized by this permit shall conform to the approved application and the,approved construction documents for which;this permit has been granted. All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zoning by laws and codes. Final Gas: 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 work until the completion of the same. Electrical s The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work . 1.Foundation or Footing ;T '. Rough: 2.Sheathing Inspection 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 I Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT y Town of Barnstable ermit: TME' ti� Building Department Services ate -;2/4-1/ 19 ` Brian Florence,CBO Building Commissioner ree:MAM s63s� ►��� 200 Main Street, Hyannis,MA 02601 fD MA'1 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner:_ / 1 AWA! , jW Phone:5� 7ZZ— Install at: Village: ��/��� Map/Parcel: Date: St BUILDINd DEPT. Ne /Used B. ype: Radiant/Circulating C. Manufacturer: Lab.No.' FEB 06 2018 D. Model No.: /2_4/' h.►.= /V `� / TOWN OF BARNSTABLE Chimney A. New Existin f existing,please note date of last cleaning B. Flue C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. Masonry: Lined/Unlined Hearth f A. Materials: B. Sub Floor Co ction: &->p&X Installer Name: ' Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor.# OR check'Homeowner Installing,no license required LICENSED INSTALLERS SIGNATURE: - APPLICANTS SIGNATURE: - APPROVED BY: Please make checks payable'to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove ° Rev:08/16/17 r Elie Commomvealth of Massadjus tfs Deparbnent of lardu sh id Accidents Office o, lmvs igatiew 600 Washington Street Bastin,V!02111 wrvtumassgrnIdia Workers' Campensation Insm-ance Affidavit:Bualders/Contra,ctursMecfrlcians/Phumhers AmIkant InfQrmatiOn Please Print "bIY Name Cityfstatefzig Phone 4 �- Are you an employer? a the appropriate bar: Type of project(required): L❑ I am a employes Uitb 4_ ❑I am a general contractor and I 6. ❑New eonst uctiori y employees(full andfor part-time).* ]save hiredthe sub-contra . 2.❑ I am a sole proprietor or partner--- listed on the attached sheet., 7. ❑Remodeling ship and have no employees These sub-cautractors have U❑Demolition waiting for me in any capacity. employees and have wodmrs' 9. ❑Building addition [No wodners,' comp_ e comp.msuranml required-] 5. ❑ We are a corporation and its 10❑Electrical repairs or addifions ofiticers have exercised their 1 L❑PluaNn r 3�I am a homeowner doing all work g ep airs or additions €[No, orlmrs'gyp- of you per MGI. 12.❑Roof repairs ;ns a required.]o c.152,§1(4�and we have no employees-[No waAm' 13-❑Other tang.insurance,required-] ' ;Any Wfics ihatcbedmbox n Est also Moulthe m cdonbelowshoWng t6ekwaskere compensati Ticyinfoams6ob Homeowners who submit dhis.af5d4vif insiicatiag they axe doing RU vcA and then bire outsl&can=wrs mast submit a new affidsek indieatixb serf, ZCbn=xt=tbzt check tlas boat mast attached sm addifianal skeet showing the name of the sub-cam=ctam s and state whether or not those enittieshsp- emapluyees.I€thesub-mmiractorshaseemplaye2,dSey=tstpmvi&&w workexs'comp.palicg.mumbeL lam an eefpIoper tJfatis pm ding workers'compensatdon inmirimcafor fry emWtoywes Below is the porky and job site In,�Ot7lralit7lL Insurance Company Name: 'Policy 4 or Self-ins-Uc.4. Rkpiration ate: Job Site Addte= CitV1Stat ziP: Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.udder Section 25A o€MGL c.152 can lead to the imposition of aiming penalfes-6f a fine up to$1,5OO:OU andl'or one-yearimprisoumeut,as wer ll as civil penalties.in the form of a STOP WORK ORDERand a time of up to$250-0{1 a day against the violator. Be advised that a cagy of this statement may be forwarded to the Office of Investigations ofthe DIA for instxranco c ge verifrcat cm I'do hereby cm*,usidcer s and perrah6as o,�parfury fhatflfe iafbrma#imrprmddedaboi�e is bare and correct Sit +ram: hate 1 Prone O,ioir ial we only. Do not farce in this area,to be completed by city or tot rn oilcrat City or Town: PermitlLicease� Issuing Autharity(Cir de one): 1.Board of$c dtlr 2.Building Department 3.Clty1rown Clerk 4.Electrical Inspector S.Plarrtbing Inspector 6.Other Contact Person Phone#: Information and lastructions Massachuse fs Geac al Laws chapter M regmrns all employers to provide warlMs'compensation for flies e¢�ployeec.`~ w Pursaa�this�,an M pinyee is defined as."_.eveay person in tb a service of another any co�ract of Iiae, Mgaress or implied,oral or written_" An e?npIQye-is defined as"an incfxvidael,partnersbip,association,axporation or other legal entity,or any two or more of the foregoing engaged in a Joint entm-pase,and inchuling the legal representatives of a deceased employer,or the receiver or trustee of m individual,partnership,association or other legal entity,employing employees However the owner of a dwe house having not more than three apartments and who resides therein,or the occupant of the - IImg - dwelling house of another who employs �ca persons to do maini ,constriction or repair wow on such dwelling house to shall not becanse of such employment be deemed to be air.employer." ur�na>�there � or on.the grounds or building app �p MGM cbaptnr 152,§25g6)also sites that'every state or local Hcensing agency,shall withhold file issuance ar renewal of a license or permit to operate a business or to construct buRclings in the commonwealth for aaY applicantwho has notproduced acceptable evidence of cdmpr=m with the incnran ce.covexage required.." AddiizonaIly,MQ;ChZpter 152,§25C(7)states¢Nefther the connnonwealth nor any of its Political subdivisions shall cartes tiro any contract for the performance ofpubho walk rmfil acceptable evidence of compliancewith the insurance, tnre ents of this chapter have,been preseMted to the Contracting authozity." : Applicants Please fill o-at the wod='compensation affidavit completely,by checEag the boxes that apply to your situation and,if necessary,Supply snb-Contractor(s)name(s), addresses)and Phone mmmber(s) along with their certificates) of i,-surer ce. Limited Liability Companies(LLC)or Limited LiabilityParineiships(LLP)witiino empooyees other than th e members or partners,are not rtqui ed to carry woricers'compensation insurance. If an LLC or L LP does have employees,a policy is required. Be advised that this a$idayit maybe submittr,-d to the Department of Industrial Accidents for confmnation of insurance coverage. Also be sure to sign and dates the affidavit The,affidavit should beret7mmed.to the city or town that the application for the permit or license is being requested,not the Department of ,�,�' l cc ents_ Shouldyou have any questions rega-ffing the law orifyou.are regan ed to obtain a wormers' compensation policy,please cal the Department at the number listedbelow. Self-insrnedcoaPaniesshouldentertheir self-fi„curance license m=ber an the appropriate line. City or Town Officials Please be sore that the affidavit is complete and pried legibly- The Department has provided a space at the bottom of the affidavit for you to fM out in the eve±the Office of Investigations has to confact you regarding the,applicant Pleas a be sure to fill in the permi VIicense member which vM be used as a reference nIDnber. Ia addition,an applicant that must submit multiple peen llicense.applitations in any given year,need only submit one affidavit indicating CEnrent policy information(if necessary)and under"Job Site Add ress"the applicant:should write"all locations in (cty or town)."A copy of the•a$davit 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 fcdm pennies or licenses A new affidavrtmzist be fffied out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial v&otre (i.e. a cog license or peonit to burn leaves eft--)said person is NOT required to complete ties affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any qumtions, please do not hesitate to give us a tali The Departments address,felephone and fax number-' . I�egaz�rle�of Izid A��nt� - Q MA 0y1II TFI 4, 617' -4 Qxt 4-06 or 1477 MA SAS Fax#617 727 7M Revised 424-07 —a gPVIdin Town of Barnstable �y Building Department Services Brian Florence,CBO ' Building Commissioner 200 Main Street, Hyannis,MA 02601 L►wsr,3sia, KASL www.town.barnstable.ma.us_ 1639• f1Afa . Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE' JOB LOCATION: nu er street village —"`x/ "IIOI owxER^ f z , 5e2Z—' 2 2ri 22,2—� name home p one# 'Woik p e# CURRENT MAILING ADDRESS:�� _®/ �� / ✓!/f� cityhM state zip c:We The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER. Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"ho er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures ents and that he/she will comply with said procedures and requirements. S store 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 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. Q.\WPFILES\FORMS\buildiag permit fonns\EXPRESS.doe 08/I V17 L - . Town of Barnstable Building Department Services RAIDISTAMM ` X+es Brian Florence,CBO 059. Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This'Section - If Using A Builder I, ,as Owner of the subject property hereby authorize to act on my behalf; in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the ibili ons resP tY of the applicant Pools are not to be filled or utilized before fence is installed and all final are inspections performed and accepted. Signature of Owner Sig nature of Applicant Print Name Print Name Date QTORMS:OWNEUERMISSIONPOOLS Rev:08/16/17 . Town of Barnstable Building sAxtars AM4 PostTh�s'CardSo.7hat:�t�s V�sible,From the Street-,Approved PlansMust be;Retamed on lob and'th�s,Ca,rd,Must;be;FKept M Poste!Unt1�F nal Ins ect�nHas Bkeen Made --� � ;� � Where a Certificateof Occupancy is Required;such Bu�ldmgshall Not befOcc�upied unt>l.a Final Inspect�on:hasabeen madeg Permit a ..: Permit No. B-18-355 Applicant Name: ALHARTHY,SAID S&SYLVIA Approvals Date Issued: 02/07/2018 Current Use: Structure Permit Type: Building-Stove Expiration Date: 08/07/2018 Foundation: Location: 114 CURLEW WAY,COTUIT Map/Lot: 025-062 Zoning District: RF Sheathing: " Contractor Name:` . Framing: Owner on Record: ALHARTHY,SAID S&SYLVIA Address: 114 CURLEW WAY ' Contractor<Lcense 2 x tost: $0.00EstProlCOTUIT, MA 02635 Chimney : Description: NEW-ENGLANDS STOVE WORKS INC PermitFee: $35.00 a Insulation: � Fee Paid -' $35.00 Project Review Req: ` ca ; Date 2/7/2018Final: x ' Plumbing/Gas Rough Plumbing: Building Official s Final Plumbing: This permit shall be deemed abandoned and invalid unless the work a beized,by this permit is commenced within siz months�after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. 1 , All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by laws:and codes. Final Gas: 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 work until the completion of the same. �y Electrical 43 The Certificate of Occupancy will not be issued until all applicable signatures bythe BuUding and;Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: �� r s 1.Foundation or Footing s Rough: w 2.Sheathing Inspection 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT V� ' � I - _Jr- -_ ----..._ a- . , _D DD � D CJ_ �D _ - • LL-1 Li = 0OR0 _. BAY.8IDC BUILDING Cc,Im I RED!'FEB 6 �r P 9 T. ,. ... B LE 1/AT.10 N 5 I I i _ • ��41, .. n n EH I . I I I I I BAYSIQE 6UILVIMG CoINc- CCWTeMVILLF- I I city rL- ' .._. . • IZCq:i¢r.: :.-_.._. ELeVn,�ioNg 89-IS � OF6 ti i 'III :10:.Y.r1 Iveer� ouli.. - _...AN4...riA 167 I 1o►A ..c f , a OAK co I .. . 0 ... . .go '.1. ToNC4 coC4- ;� GIB..O.• 7o Doo17,. - ..3 . ... — -- :F.C.51dGIIRROGR tt 4'. 8ya• �;o. a.. C,.v 4'.`' ZtVI �Lo• i1,v. , .. I a rap AD 3 4�.a + 14� o•---- ------ 4e,-� L. BAY9IDE BUIInING Cc IN42. 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Yr CPILW..IN FoYG2::0ULY Op - y I . 4c"I 'Vila FL.00YL �, G"P•13fLEC.L.�S......_ 7.M4 'J5 I LLt.o1-i Si L.1.��!ILf, xlf3�...•COIf10LG.w JOI•T-P.'1fA1LL/✓�•L. 1�•L'b" CONGfL•WAL.L•5 . ..: � � � 4.Q � � � µ�9PNAL.'f .CoATll-►6 .fb6l.o1J..._GfLJapa•' _x,'/L"ConwL SLnp - F3AY910E BUILDING Go11�G. CE►JTC9L V 1 L1.6 / SEcrlorl a%e" ��'.o .:._ sa• le 4epG f 'r ✓�adaar`uaelta '- OEPARTHEKT OF.PUBLIC SAFETY licease�— ONSUCTIOM SUPERVISOR �� BEY .OACEY a6�#i1RDS BAY, MA 02532 ; commi"10KER ATA 51146LI= FAMILY � $ETIEWMS N ;� 4 p� 6,AZ5Af-E 6lz VEZ. FLoW 5EI�T1C TAWL 150%= 4gSOD l/iF— loco 6Ac— d 21SFoS L PIT 1-1000 &k, 11 twer 51DEWALL AREA % IB$ SF 1�85�x2-s = 410�� BOTTOM AREA - -1 8 sr-- Q- 1� Isf x 1,0 = 15 em. + 1, -roTAL vapz w = s*0 6w, Tot•AL GAILY rLoyj = 330 APD PE2e-VLATIo4 QA - '' CO lE - I lu �isAl� oiZ LE4f � ��or �� �. Pr ti �-m OF 3 N "rower S PETER Rrau`R° SULLIVAN No. 29733 sTr:� ��@ 14 q'1,42 ovt: VIJIU LE ArEZ(AL CUEEW W,A� P 4�-32 Id' Au. �ewN� sysr�M - 1r- z�S i Loti� + - ----.r�r�-- P V.C. sugSo�L r,�C, �o Iocea i�l/, bKT �J✓ 6AL sau lu✓ J3CK 1Sdr Geaug. I vr�v a �s �, TANr 5 GAL �?y r uqsu rraaLz �: AFL 5rzv EruQ s SST�1 D. W,469S;, E SAND STONE'' MME 719AS4 4' vEEP l r2Al/EL l �IFI ED P� PL1�fJ f i IJ o sco i..s- vi v R' -=,3 EL-&s 4e4 Lam: �By DATA d)qm- a'�a5b-� PL4N 2etrEREJCZ- 1 CE;rOFY I*T THS =Wt tu4j, 1 dr' �- Si�oW N NErZEON GoM*FL 5 wl-rµ THE 51VELHJE m � TC 7DWN OF. SA12 rka4c D? FVZ 614IZ4-E-�J& Au.& Cr At. ADD 15 OTI.04ATIED w1 rAI LI WE TtDav MMU, "Pa-• ji-a Dam" _ $,e XTErz NYE (IJC, per`/0s44L�LAIJ-D Sup-VL-/ce5 -lK FLAW IS Not- F3MIED oN AN 1�14T�OtitE+JT" z�� L Ei.1GiNt tC.S �U(Z�c j aIJ� TI{� °F�SETS �'�4flu4D �III�' T3E 105TE2vILLG MAS4 , u5cO::> ro E5TAIN-KN PIzoFE2:T vl 1.1 jle5 dAPLIcANT'sPystv� U,�>�6 7 r r f 1 i 1 1I r 4 , 00 4. cki-a2 e!,Tay...:.. Na; tt YY i 1 r I j a 1 I ; i ;f G'�-.27'/.,•�-Y T/-��lT T�/E. FOr��ID�TivN �aC.4T/�� ': r I ; QCATES T�/E ,�LGcz�,oGq/y, OIT, _ . TE B5' n1 : i 0 ,E3A XT,E,eE s .ei�Eya,%/VST,2U�/ it/T,$U,el/EY Tye r /_e>T I_1A,-,ems 11/02/91 17:02 V6177277122 DEPT IND ACCID 16 001 Cotrunonwealtli of Maijac1y.tt6ett6 aU�artmenE o�J'•ndu�trial�cciden� 600 WwAington,,Sh, t James J.Campbell &Ion, Vam."i6 02 f f f Commissioner Workers' Compensation insurance Affidavit Is - with (tiansccipamiaee) a principal place of business at: ?00 0ALS— tT if/ss- (QW/St"iziv) do hereby certify under the pains and penalties of perjury, that: () I am an employer provid'mg workers' compensation coverage for my employees working on this job. Insurance Company_ Policy Ntunber O I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number O I am a homeowner performing all the work myself. ! understand th.n a copy of this statement will be forwzrded to the Office of Investigations of the DiA for coverage verification and that failure to secure coverage as regiired under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me. Signed this SZ day of D-Q- 19 Licensee a Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INF0RMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT # ,� 02 1 _ •:..::ry:•Y:•{:v:::+'I+,'fr•:::YY•x::{4CYi::i4iii:<�ii nNiiV:�liSii$iiiii:i.> .........:......... ......::.:.,•.Y:.,.y.Yv:<,:•:?.'tiY::Y•:•':::`:Y;ti�:�:::::::y: t :t:� �>Y::::•:Y::•Y: ....?".:::: <;.:::YY:.Y ATE ISSUE 0 ( {Y:4:...n...• .. ..: ..71. i} ii: ::: ;<., .'«j:4:vi«•}Y;+:;vyi::+•'.ti::4.<;)T,r:Y.i+;C,f•••Y:<t^:•Y:•::::::•y:{::::: e ::. ::: ::. n;:: �::. ..::i:?� :+. �: :::: :::. �`... � :. {.:x� .:::�::4.Yn::.::::::.YY'.�.•is:::::::.Y?YY::\.::::::::::.vi?f`:;Y.:Y::<:;v:;: : '7 y� . •:::::;•Y:;•:YY:.Y?:.::::::::::,Y......::;.?•.YY:.,..?,,,<s..?;r:<::: . 0T1011199 t !,i?Y ? ?:< i::•::.Y:.::.::v: :.i:.Y:•Y?:..i?:.Y:;•Y:>Y.'v::<•Y:t.:\�Ch..:`:i:<.Y>:.i>:.i:.YY:::.:: s::: :; . . ;;:;;•;:;•:»;;z:»::Y:.Y;:.;Y:>::»;::>:<:::Y;:.;::<.Y;:::;„;<::>;:<;:>::>::>::>:.:>;::<:>.;:.;.;:.;:::::::::............. AND AS A MATTER OF INFORMATION ONLY ::;•. e: <.:;;:^s:: a c>r:;c::x:>;::s>;::?;:,:.?:.Y:• THIS CERTIFICATE tS ISSUED PRODUCER CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE D.J.Rielly Insurance Agency,Inc. 243 Church Street DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE Pembroke, MA 02359 POLICIES BELOW. (617)826-0123 COMPANIES AFFORDING COVERAGE .......................................................................... COMPANY A WCAR/Cigna Insurance Co. : LETTER...................................................................................................................................................... .. . COMPANY B .. .............. LETTER .. ......... : COMPANY `► - Champion Builders,Inc. LETTER ......................................................................... P.O.BOX 1558 COMPANY D Buzzards Bay,MA 02532 LETTER ........................................................................... :................................................................... COMPANY E LITTER .. ..............::::::::::.::::•YY?;YYY:.rYY;::::::::::::::::::::..:........:.................::::::::::.....::•::::::::::::::�,•::::.Y:.Y:::;:?Y:::.:;i.YYY'�:::::':.;::::.`�;:::;:::: ;:::? ::>:::: .............:::::::::::::.: :??:::::;•Y:;::Y:.;:::::::.Y:.:Y:.:YY:.::::::: <•::::::::;i;•Yro:::::::::::•:?:.?::::::.:::.??::<•:::::::::.Y....:<:......<:Y:<.;:«<.:,<:•.:<.,.•.«;:,•...,.x.Y:«:•....:... :.:�.;Y>•,::::::::t•>:.;;:.:::::<.;:;.Y:,:�::::::::.:•:�?:•:::::::::t•:;Y:;•::::::::::.Y:.:�Y:.::::::::;•Y;>::•:::•:::::::•::::.::•::.Y:<.?:.Y:<::,..•.:..............:.....:..... POLICY PERIOD EFAG >::>::,:::::•?:<?.::>:......Y;::::......Y:;:.:?:.:?;:;;> •::.;???:.?;:>:z:;.Y:;:;.?:::>s>::>::>::YY;:<.:;::Y:.>:.:<.:,..:.::::,.:,::.... RED NAMED ABOVE FOR THE THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS µ INDICATED,NOTWITHSTANDING B D OR MAY PERTAIN.THE INSURANCE AFFDI DED BION OFY THE POLICIES DESCRIBED HEREI CONTRACT OR OTHER N IS SUBJECT TO ALL THE`TEIRMS.HIS CERTIFICATE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED.BY PAID CLAIMS: LIMITS ............................:.................................. POLICY NUMBER :POLICY EFFECTIVE :POLICY EXPIRATION WD TDB CO: TYPE OF INSURANCE DATE(MM/ODlYY) LTR: :GENERAL AGGREGATE :S ................................................ :GENERAL LIABILITY ;PRODUCTS COMP/OP AGG. :$ ............. ........................................ .......... : . :COMMERCIAL GENERAL LIABILITY :PERSONAL&ADV.INJURY :S ............................... ; :CLAIMS MADE: :OCCUR. : :EACH OCCURRENCE ...;:S Y.;::::::;::•.'•.......... ..........• ; ................................. ... :OWNER'S 8 CONTRACTOR'S PROT. :FIRE DAMAGE(Any one fire) :S .......................................................... MED,EXPENSE(Any one person]$ COMBINED SINGLE '$ AUTO MOBILE : :UMTT ;.... Y UTOS i ; e(PeDILY INJUR r person)UTOS ; :BODILY INJURY :$ (Per acddenU .......................................... ...... ANON-OWNED AUTOS :GARAGE LIABILITY :PROPERTY DAMAGE :S :EACHOCCURRENCE :S :........................... ............. ............ _....... EXCESS LIABILITY :AGGREGATE '$ :.........UM BRELLA RELLA FOR M ' :OTHER THAN UMBRELLA FORM :STATUTORY ITS ORY LIM X EACH ACCIDENT............................ ..$ ....., 100,000 WORKER'S COMPENSATION .... ... ..... ................. WOCC41002463 06127/1994 06/27N995 A AND :DISEASE—aoucw uMrr a 500,000 ........ .... :DISEASE--EACH EMPLOYEE :S 100,000 EMPLOYERS'LIABILITY ;OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLESISPECIAL ITEMS ON3::z?'is5:iii� i%i<3ii:i;iii :'��::[iii;[%:':;. [;[iji ;iii%;;;:ii:;;iii �f:f:J; ii;iifiiii6:[:;i .i: CERTIFtGA_,t9O i,!)ER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE Town of Sandwich LEFT,BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR 145 Main Street LIABIu OF ANY IaND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Sandwich, MA 02563 .,-.AUTHOR D PRESENTATIVE :::::::::: ::: ::::::::::::::::::: 0 Al ..:. ..::.::::::...... .. ........ :::.::::.........:::::::...........::::::...............:.::.:::............:::::::::::..........:.::::::..............::::::::..........:.::::.::::............::::::::::.....IAC..........::. ::::::.......... . AGAftD 25 S �:::. M POLICY NUMBER WOC C4 10 02 46 3 INSURANCE COMPANY OF NORTH AMERICA ❑ New; ® Renewal; ❑ Rewrite of; NCCI CARRIER CODE: 14486 — SYM PREVIOUS POLICY N0. 11WOC11C40041 WORKERS COMPENSATION AND EMPLOYERS INFORMATION PAGE LIABILITY INSURANCE POLICY Item 1. FcHAMPION BUILDERS INC Inter/Intrastate Identification No.: The P 0 BOX 1558 Insured BUZZARDS BAY MA 02532 DIRECT BILLED Mailing ❑ Individual ❑Partnership Address L corporation ❑ Employer's Identification No.: FE I N # : 043145058 Other workplaces not shown above: STATE OF MASSACHUSETTS Item 2. Policy period from 06-27-94 to 06-27-95 12:01 A.M., standard time at the insured's mailing address. Item 3. A.Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MASSACHUSETTS B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 100.000 each accident Bodily Injury by Disease $ 500.000 policy limit Bodily Injury by Disease $ 100, 000 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed her SEE ENDORSEMENT WC 20 03 061 Item 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rate Code Estimated Total Per $100 of Estimated No. Annual Remuneration Remuneration Annual Premium CLERICAL OFFICE EMPLOYEES NOC 8810 45000. . 33 149. LOSS CONSTANT ( $.10. IF APPLICABLE ) 10. ESTIMATED STANDARD POLICY PREMIUM 159. ( INCLUDED IN POLICY PREMIUM OF $32 ) MASSACHUSETTS D. I .A. ASSESSMENT 3.25 5. EXPENSE CONSTANT 0900 160. Minimum Premium $ 102. Total Estimated Annual Premium $ 324. If Indicated here, interim adjust- ( PAGE, 1 LAST PAGE ments of premium will be made: ❑ Semi-Annually ❑ Quarterly ❑ Monthly Deposit Premium $ This policy includes these endorsements and schedules: WC 200306 000414 200301 .200302 200303 200401 200601 AGENCY No. 984020 04-2793460 BOS J RIELLY INS AGENCY Countersigned By ' 43 CHURCH STREET (AuThorized Agent) EMBROKE MA 02359 MARKETING OFFICE: NATIONAL WC RE P00 94186 DOC 6176A WCY CKE-4266a Ptd. in U.S.A. Copyright 1987 National Council on Ccmpensation insurance INSURED'S COPY WC 00 00 01/ 105031 r- 7 i 0 ccy) �5 S s 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel �' ` ' Permit# 3(09 Health Divisionl. v Date Issued Z � © Conservation Division ov Fee y7e Tax Collector Treasurer _ SEPTIC SYSTEM IVIUSY BE r Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE g Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODES AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address . Village co rU l Owner Lp2 �O Address r Telephone Permit Request <S WIPK 94 Square f • 1st 16 floor: existing proposed 2nd floor: existing proposed Total new Valuatio Gad Zoning District Flood Plain Groundwater Overlay Construction'TypeS7k— u m),L Lot Size /, e4cte Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family VP ;Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: Cl Yes tR(No On Old King s Highway: ❑Yes VNo Basement Type: §Full ❑Crawl ❑Walkout ❑Other Basement Finished Areas .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: VNoas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Fireplaces: Existing I New Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:`6existing ❑new size Shed: existing ❑new size Other: Zoning Board of Appeals Authorization Cl Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use se,006k, BUILDER INFORMATION Name "��- Telephone Number Address y Al�3 �1 R .,.-,�,/ s/ License# 6 09��5 Home Improvement Contractor#, 106 00 Worker's Compensation# 1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c� ,4 SIGNATURE DATE — ' �I FOR OFFICIAL USE ONLY PERMIT NO. _ DATE ISSUED MAP/PARCEL NO. ADDRESS .,+: VILLAGE' - OWNER DATE OF INSPECTION: i FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL '1 FINAL BUILDING j Y DATE CLOSED OUT 4' - ASSOCIATION PLAN NO. , • Mcrssachusens The.Commonwealth anal Accidents , . DeP t p nVESIfff ODS . 0 D Washington Stred 60 OZ111 _ B Mass. / =� Com option Insarance Affidavit /������������///////%///� Workers 11219010 - - hone# a a homes pig ll work sole UK and have no one On tbis job.:.:::::.::{:.:?:::::::.;';':::;::<?::.,.>:.:.:,<.:.:>:.:...::........ • for . :......:.�:.;;;;<::;::;: ::;>:::::::;::<-:;:><;'. WAiR', �•h,. 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I1d�e ..,..,....}.. ..r tiv:::}:}::•:.,•:.,.,;T:`:�::•;:i•}'':-:.;::•:.•,'::.;•::;:;:;{;;:�;;;:S:�r�:�"::": 3::<: . ...... ......F}.•... .:...;. •. .. ...�{ fS• m. •t•.vr.};:r:tii:{v}a�:?{.:;t:/y;.ti fit::; .;•.:::.�`:::,:.... • ;�.. .�'• ` '. . lieu# :;>.::::rr:::�:•::.:.:;;:;<•:^:�. ;zr�;ts3•.=DO - to SIS00.00 sz�o of a P of a I tmd �._,t 6at s -trance`'eo :>. :;::}}r � �=Cww&w the of S100A0 s day sg��' eonr4e as segtdtsdmtder Saii� of a b't'OP�=O��aad kftO a reri9catlow Loure to Secure, prisoms� eND tba O �y °m of>ba DL► 'e°"e::z arsa forted spy of this statmimtmay ��in foramam Prwi&d about is tire' the PMakin o fPerpwy "• _ do hereby Daft �;�tnre Phase# I U1 MINOR write in this atea to be eompb"B7 C7 or tom olIIdal QBunding Dees Ent of :OUS1 only donut Pow" �j,icennme Board f ❑Sdeccmen's OSflee ,, city or towns c3$ealth Deparcnent response is required Other---,— checkif im»�ide phme#; contract peraom Information and Instructionsy ensation for their s all employers to provide workers c om p section 25 require s in the service of another under any ccn= ,sachusetts General Laws chapter 152 seco ee is defined as everyP ,love•.s. As quoted fromthe `law ,an emPtY Ire: -press or implied, oral or written or any two or more o: armership, association, corporation or other legal entity, ,,,.,..lv... Cr emDjoyer is defined as an individual,P the legal representatives of a deceased employer, or the a in a joint enterprise, and including to employees. However the o�I of a forgoing engaged �ociation or other legal entity, emP y� R house of t�of an individual;partnerslup� who resides therein, or the occupant of the dwe ;fling house having not more thaw three apdou Pei work an such dwelling house or on the grounds or :ther who employs persons to do maintenance l be deemed to bean employer. iding app °shad not bye of such empoymeat eve"state or local licensing agency shall withhold the issuance or renewal 152 section 25 also states that erg in the commonwealth for any applicant who has '3L chapter , Iicense or permit to operate a business or construct coverage required. Additionally, produced acceptable evidence of complianceshall anY bract forthe performance of public work until :nmonwealth nor nay of its political subdivisions o.� have been presented to the contra ,-,table evidence of compliance vnth the :horny. 11`10 ;plicants On and lctcjy�by checldng the.box that applies to your numbers affdavit a s�rtific to of ins as all of dam may be ase all c the wo�� phone e. Also be sure to sign and �plvuig company Indust Accidsats{� of msaraace fication for the permit or lids-is emitted to the Department Of ,mtbatthe app to the affidavit. The affida*should be Shams you have nay questions regarding�" `�R" or it you requested,not the Depart Ml of can the Depar��at the number listed below. ` ensatiaaP Cep // � e�rquired obtain a //��� �2 ity or Towns of`d= The Departimmt has provided a spat"at the b ottom affidavit is complete and printed 1�1Y• has to Ca dad you regardrng the aPph�' please use be sure that the affida ,davit for you to fill out in the event the Off=of awill.be uscids a sef���member. The affidavits may be retu t^ sure to fill in the pie mmzberwhhave beeamade. Department bYmml or FAX unless ether arr2 0 8 and should you have any rn:esnons he O;ncr of InvestigatiMs would Ile to thank you in advance for yron cooperation, . do not hesitate to gm us a can. telephone and fax mmiber. e Department's address, The Commonwealth Of Massachusetts Department of Industrial etl U Accidents amce ofD o • 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 I phone#: (617) 77.749010 ext. 406, 409 or 375 CF IHE Ip� The Town. of Barnstable 3AgNSWILE. ' � g Department of Health Safety and Environmental Services 059• .� Building Division TFD MA'f 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissions: Fax: 508-790-6230 Permit no. Date , `f 00 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�VJ� d Estimated Cost Address of Work: Code k) Owner's Name: Date of Application: " ­G - I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law OJob Under S1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING LI WORK DO NOT 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 a agent of the owner. a 8C44-4-0 3,epubc, I Date Contractor Name Registration No. OR Dace Owner's Name a:forms:Affidav Bean IS/1L•B QFWDAILl le6 d WAAVIaCi 01(YRAIWIi M OIIfIM; - M 6A.NALv.STL_ DIAroNAL BRACE _ LIRNIua d 1K 1cIQn d a®AQ m.Rlau[D `HLNEL IRfY IPripG42 A L to u use ro•.�wArmL. 1PM C.A.n..v STEEL - I SEE SECT.a/2 AND JAT TSL I�~� I_T Le�+rf°Rrcia YLOC'i ea _ L� bl re-vesiImOLTS A.D VLSIFRS TYPK4 5-A6 IL80LTS.Atlf51, ^(_N YBALM. I .�v j AID 2 VRSNERS TYP T EA.PANEL END J 9T'C4.RviF1- —I s-w••LLBOLTS.MAYS sum STEELI AND Y WASHERS rm. 1 EA.PANEL OD PANEL I AND 2•W.DOLTS. S YASIERS TYP. F'HA•.-QP.I EA.PMrEL DD -� G0.GAPI STEEL ECE sw Tv:< 11 a \ I — 9 VI YL T1Pa70E55 u LV STEEL YN TL LNEA MER• ,,// CO P'fECE �� \ iY CWLRA,CO STEEL _ 6/ LIRNER 20 Yl_THINNESS I VIP _ - YL LINER rao Y)L.THICKNESS O• ——/� I VNTL LINERS i SERIES 700 a 750 Y.eYL L.ER OCTAGONAL CORNER SERIES 800 S 850(90'CORNER)T SERFS 900&950(9(1 CORNER) /51 SERIFS 550.1000 811050(TYP CORNER) + .. 2 2 2 2 2 W-TO END OF IAIEL I _ I Copp"ECEST�� .--1 AND 15-%2—SHEERS TYR • 1 EA.h1EL fl0 1 4ITO"IN BRACES BANS FOR LDd1T1016 B O M BA BALV STFEL� M BABALY STL OTNOI TTENIS N SPACE I E ms: •ry/Y TWICJL�� i M EL OKAY/ - �L p�I LLB�g IEIfS Os• PANEL YLTIOOE°S7 YD2AND 2 sWIR SENLS TYP. _ =a T_ 1NTL L1ER EA-1M1EL END Y.BOLTE.5-wY NUTS WYgTEEy FA PANEL.ENO-14 9 a; Loom • 20 YL THICKNESS I N aA.BALM Elm r22 VNYL Lo" S CORNER PIECEI (I � a—' � 2'-+o•aTgccT ®IPr:D1e° & = ANTaE.sEE SECT. )� a Fao•ArsEn:TA \ � (7 i \\ /� M GA 6ALY STEEL PW LOCATIONS - d �I LiNQ�E�SfE isr2 AM VI YIL_LINER Ss ^'PQ — z - -- PLANS HFR RNS N B vNri LINER CD 0 mm = m 3n — SERIES 1000 81 1050 EL CORNER n SERIES 700 9 750 EL CORNER n 7 R T SERIES 700 STAIR CORNER /s1• 2 2 2 2 A' •.�------5•�--�{{ 1 M 6A WLV STEFl rK B1.NAIY STEEL F.F YN.LONG DECK wPANEL r O 1 I PM1EL SFP IECL : PA EL SEE SECT. SEE INSTALLATION •.0.. I I a/2 TVPrA LR TYPICAL NOTE AND SECT art �y L S• 1 �•1Ea CORD DECK j RF aA•No \ TA I I PSIENEHE' U'`""°" Be 3 .20 111L. J►RRIERKb t rysaL7Es ITP. ._.,:• _ �LAIL - )- •N.DOLTS V THINNESS T'E T ENOI r O VNYL L/Q MOIC ffi SETT. ---f� _ 'C a/2 IW OLAGONAL L �. �. •.:51211/.'Oi ANOE CAIdIA• VIf1'L LJETt S AMD HORIZONTAL. .Vi•i VN• M BALV. - S/I•ALLTIIEAD •G BE BRACES LEVGID CANBMOE BOL7 I PANEL R00 BOLTS.NUTS PLATE 6J 6 VPL9ER" I s-wY CARRIAGE QI COLLAR NFORY- MBA.BALV STL I T1Tfk J MILL�7lS TYPE ATGN. 0 PANEL TYPICAL BE� 4 1/A' 2 (DIAGONAL SPACE) SEE I6TALLATIIN L-y�►IH-zp GA-GMY.' ® 1 No 1 M GA.BALV.STm mow••Y.BOLTS.Pam MBA.BALV.STEEL IM BA.W e STEEL �PLAN�EEW � 1 P.GA. ALV. 7J \_LAID Y W9ER5,YR FRLLA PECE ]� ,. '--1 PAIE1 BEE SECT. S-w••IL BOLTS•,7 ABOVE ,o, •�Y NVTST� �YCaI SK.R..• I YR9ENtf M4.GYY ANGLE - IISR TYPICAL _,y-YEACN I W K A• E.A.PANEL Em / SERIES 800.900.1000 8110F.y0 CogNER (@ SERIES 600 8 1000 STAR CORNER w a ETD c`rel AaE�T�' I (/� 1COLAR AROUND FULL ^ 20 THIQOE55 •noo-tl COLLAR AROUND E COIPOIENIT NOTES 2 M'T14.LATION NOTES 2 2U IPI_Tg065� ADD 1�•L��� D�) I LIE/t PE>sEKER OF POLL L ALL P ITm N PORI�PROM NATDI marBrdwc TO I.T1E I►Y Va w M PDDL N NE0winyD 01•TYFKJL aeLUJATHa1 V LIE7i .L-PTt' "''GALY I 1 NSTTLLATION NOTE NO. AITN A-em NrTN As A�.K I•wPOcrm COATIIc. s[Ne w IDAJ IIOf DOrtaIYN OAIANK G.ATW.IUAT.IRarts NNL a I AT a•OF PANEL P4NL M W, - MNII.T ODIAAK Pala. -IObl"ID MR I GAL PANEL END � 2 ALL fT�ANYLa(PANG STPse1E)ee AT PIIAIQ wAm 1. T1T'rAL M G CLARITY) I OMO/Sgll� 1—— AAS ROLLm iY01 IYTCRIAL fAN.OAdi TD AITY•->< I.IIETNi AY I•TMGI W11C1l1O COLIM ATM 41Y wM OYOE)O GALY FRIES.EHO IPTTM AR•STY A-IWa AALY COATIK AAL ARQAD M I41 Pel1RILKDI w M IOOL.TIa!N aDlll D•ETAL NREi KENO oNfEMD11 I I ' 2- I,All I n AND T1RA00 Od/OIORS QI NIAMAALTIRND !.SA0,0 LL dlTl`GENI GIITTR FAQ w RDOIE AID Dares amAUID N LAISRS FIIOY WTTleK mrdarls.N To AlTY•-IO]PA1Tf-AXK4•) IIOT H7•'rAIDIi W.EAa I.AY0I PALL E R00.E0 AND CJIIPN m TAYPCD lO r Yet nll �i - •b AIS DS PLAT[-IAWTIIdr4 bALQf Allt IDNOND leA: ILIYOr•TI YGm.FLLl POf{.IRN sT;DlA1M__= �Or IEVEL L-{- ie•LL IOI OlPQ MOII YOOLL L[V[L n YOE TNAM OIE FOOT. fy, y P ATm A.a CONVI' T YYJtp a II�m�Aq N1Atl 4OP[AYT/IKON 2 • jTYP.TOP 6 BOT. ^1 I11 5e* Y.80.T5 A.Q.L OGDO.00HY5 TAT PArlL fTIF[IPLI AND ADANRAQE COM M A RATE POT LOW TIYR t/A PIl1 FOOT. ��T ILEVELMG A#AM MAQ),AR m TOI CITY AA ALA XI IIAIYT AFfEA L-2- BF._r..) I S V2• S eVY.M ��- e.Tlea POOL rw NOT eATeY mr�PVI A aYRCNME tDADIR. L Y12 M•R Y-O•WLJ I/j a YLLlMT DIG[SHALL t rPYII WFoe A OOA1Y®K A.d1ADE frT[AROlO PODL AND 11>E WOTf ft d TO ll/T VOUrd%LVM 2•-O• I B' 1 a11S6 ANGLE WTIorWTY n xTzl FL/ID PIQlYt w RLLIm WaL TD!D a a Lms. TYPICAL WALL SECTION TYPICAL VAL_ I 2c••wOE7aCJeIATDN t.M PDDL.r E WQOLLLID n t1m6m,FACTGO TRAIm I ALLOM AFPRDYm n II4RraL POOLA.Nc. FOR 214 PANEL I I AT MITI PANED WG1L1 SECTION AT A FRAME u z z eT02- 'i�15/e9 A(.epp)n Lai o aaru[s 401[auulr[nE acly slt+usu:t n su IciRt.a urmn At[of rnlulm fJAATT�QTJK� ro.[unto rn N'r rwros[. V V^•3 Ao A/y yy C[�q�y� ' I 2� t�6EE •1� s- ' OTHER ITEMS PLANS FOR IN . IONS 16 1: BRACE) B I 14 GA GAIYSfEF1 I FANEL PRE-R=BR�tC �ST T pAGONAL BRACE 51J15D 2 owso I W�651�FKLrTTyA • 20 ND_TIIo>oEas-. (LyTIKa RlY¢�i4(z<il_V.�, nI YINTL LINER �R/WS� lD('J�.TgNS TTRCAL STNR AASEMELYD 5-Wife N.BOl7S� I BOTHER REMSN BRACE � � STAIR LIE �S AND WASI!'JLS —J -_ \ \ ✓ n PI BRICATE-FA ED MIL-THICKNESS 20E SSEM STAIRASSEMBLY I� YNVL YL THIC TL YRIeLT1e G0 U/ER STAIR ll� GA.GALx STEEL STAIR 7s .� WBWS 47' CORNER PANEL{ ` FAMEL�TTP G f S/4• WASHERS • 8T SERIES 550 6 650 STAIR CORNER SERIES 750 STAIR CORNER n SERIES 850,950E 1050 STAIR CORNER n •` n O � NID KBiER qIf Albs - - D TOR UC71W MOTOR ' �Y ♦—- - - - 1 'A'FRAME ASSEMBLY 2 v f _ 2 + LTTPCAL MERE SHOWN n ^,. T FtTER I - ' FB]E PERNAIENTLY -►---►- ► - R£7URN -•" A•FRAAE 5 rnCr® 1 Y ASSE]6LY I Y L.w 3 � T ACED _ SAFETY LIE } _ , rz 1'l/AOEOM�tTd6 .T AREAS � ! I FLAT ARFA ) e PREgNrs AREAS GOc) I I A m I m I m1 � rrAlRs ARE G L--►---� YKAY BE ort i '- S10MI�E7t C7 1Y.tfj$�SP suRFAREAA ZmOGLL.uP L3N'ATEDAT IISN SUCTION m S. vr,—'I5x?a a.SF SURF.AfEA6yj5�CJILCM �MOHs 1 4Y �I�1 111 Y � ISrr 56 b4A SF SURF AREAL 1Q4Q GAL.CAP •X YOIYZ' RETURN m m Z0.o•S84 SF SURFA EA L==GAL.CAP '• m SERIES 2000 8 2050 INGROUND 'A'FRAME ASSEABLT TYPICAL WHERE SHOWN o PUMP AND =a S1oWN•0•44 704 BE SURFAFEA L24800 GAL.CAP TOR PERrAREIrn.Y ATFOO ..,-. - �.-- - SLURS ARE OPTIONA SAFETY LJME 'f— -- 9c�v 1 RETIlB1 SERIES 2100 812150 NGROUND' SUM S o 4 W-26.3e 0-EL-622 st SLOW E AREA 1 T 6 2e02e GAL.CAP ALI z II __ usLRs ARE m SERIES 2000 8 2050 INGROUND IpPT10NAL PERMANENTLY ATTAO SAFETY LAW a a ?T!. •c.: �sHADFs PaanoNs REPR AREAS s [;fir ,ywu I +.JK,» A7 A FLREAS .� •' '( Al 7 L♦_ ♦._J 2 TYPICAL 1/1/ERE SHOWN f NAL f� SaE 90 :I G.lT 597 Sl SUW AREAL 2O72D GAL.CAP R. ALSO MAILABLE•WW41'7I3 SFSURF.AREAL24"5 GAL.CAP 2Or4p'OS!iF SURF.AREAL"2" GAL CAP SERIES 2100 8 2150 NGROUND woos J C I< Lo R5oN ) N ,, _I ti\r(t co aI`0L 1,0 I C� �b/Xu,5eo o SHED L0 T 5 LOT '� .,4, ',is: ;W • CD R=25. 00 ' l: A=21, 74 ' 50 , I `, 0.5 �72°0723„E � > 97. 42'- C URLE �yT •� ,� ZONE "RF" This MORTGAGE INSPECTION 'Plan is .For 11,00D ZoAlli"' Bank Use Onl% VN: -co I'— RE.Gf 'I in, 0k%,NI;R: /I/A/?A d 1I11;'1('r�-l ._n1_ ?c S>q D REF: �829;1= — — —BUYER _RL L' \4 IV . TE O 9zg8 — PLAN REF:,' 4091131- --. -- - CALL 1 50- - REBY CERTIFY TO 016 OF ---THAT THE. BUILDING YANICEF ��1R`') ,� tt'N ON THIS PLAN IS LOCATED ON THE C11"0l ND "AS I PAUL CONSI 1-TA'v ) r► ,' It"\` AND THAT ITS POSITION' DOES CONFORM �IOf3 . THE ZONING LAW SETBACKhf;(�l.'llzE:\FIN1� 01 THE � (,'la'I'F; J ) .. ; 'N OF _. CQZZ/f - --- - Na 320" OES_&Q_ _ LIE WITHIN THE SPECIAL FLOOD HAZARD �'�F qt�P� tlAl:. 'IU\� \I I � tl t 0:(> Sri ESS� A •AS SHOWN ON THE H.U.D. MAP DATED l ` TEL: 428--'00L_) U1 t\ 20001 021 D — U ,:'7Pan l FA\ a20-5'- 3- THIS PLAN NOT .MADE FROM AN'l S`I'RUMENT I'I. A . \11:1) F{F;N'. I c, Z: 'IP 'F Y, NOT To I3f' I)�.F:U FOR I'I:N(:'I S F:T(' ✓✓1+e �arrhnaiuuea/ o�✓�t!avaac�euaeC! BOARD OF BUILDING REGULATION: License:.CONSTRUCTION SUPERVISOR z Number. CS 009635 Expires:07Q6/2001 Tr.no: 2640 FT Restricted To! 00 RICHARD T SENOSKI - _ 10 PEEP TOAD RD L�w..�► � CENTERVILLE, MA 02632 Administrator a ' ,� `t'� Y::✓Y[6 lO6fA R4/WZ[(/{(/� ��JJ(.'�'4',, HONE IMP VEMEP{T1COPiTRACT�k • Re is '009 VI:AI (fzpiratia i07/21/00 � UP t "� tICHARD T NOSKI 10. Peep T Rd: o .", , gg ervi_� HA.02632 ADMINISTAAMR, F a3 rYa \4 The Town of Barnstable Department of Health Safety and Environmental Services nay'' Building Division . 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 _ Ralph Cressen Fax: 508-790-6230 Building Commissioner 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: 41,I Estimated Cost a D Address of Work: C�/lii�" Gtf Owner's Name: �'/� Date of Application: 3 l cI I hereby certify that: Registration is not required for the following reason(s): Work excluded by law OJob Under S1,000 Building not owner-occupied 12,0wner 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. 110 Date Owner's Name q:forms:Affidav ' TabteJ.LZIb(eoadaned) Fmcripttre Packages for Oae and TwD-Fau*ilntdmdal Boftdtagl Seaaed with Fad Foeb MAXIlyM NM MUM Glaalag (Ravi8 caun6 Wall Fbw Baaemmt Stab Heasiag/Cooiing A '(-A) U-vaiu6J R value It vaim� &-vand wan Pia �� �a� Am' Padma_e awsivaj &vduor $701 to 6300 Heating Deese Data' Q 127. 0.40 38 13 19 10 6 Normal R 12% am 30 19 19 10 6 Normal S 12Y. OJO 38 13 19 10 6 8S AFUE T 13% 0.36 38 13 23 WA WA Normal Ur115V5 13% 0.46 38 19 19 10 6 Normal vIVA 0.44 38 13 23 WA WA S AFUE W 0.52 30 19 19 10 6 8S AFUE X IVA 0.32 38 13 23 WA WA Normal _Y" 18% 0.42 38 19 23 WA WA Normai _ Z_ IV/. 0.42 11 19 t t0 6 90AFEYE AA IV/. 030 1 30 19 19 t0 6 90AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: ­rp �i I q NO: q-forma-f980303a r Footnotes to Table J5.11b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, ifid basement windows if located in wails that enclose conditioned space, but excluding opaque doors)to the gross-wail area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300&of glazing area. =After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table JI.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-7 8 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent-the sum of cavit,,, insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall. For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-flame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawispaces,basements, or garages).Floors over outside air must meet the ceiling requirements. 'The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the Iowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table JS.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table,!I.S3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c) If a ceiling,wall, floor, basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 _. _ a ommonw "--- Department of Industrial Accidents n -= Affee offovestfgaaoos . 600 Washington Street _.. .�; Boston,Mass. 02111 —' Workers' Com ensation Insurance davit name: //, 4 /f L)5 5C) location: �K ( r� r I e,.� w���' I Y city 0 t � pub S-- hone# v2 '16o1-1? ff I am a homeowner pedbrming all work myselfp tq . IV ❑ lam an employer providing workers'compensation for my employees working on this job._:: ::::.:::..:.::::::.::::.:::::::::::::::::: ::: coatoanv nam ::::1<:i::::iiir::::::::'rrir::'::'':..i: ::::: :;:i::.-.-.:i�:::;:�`:::;:: :: :::r:...:. ::r r ::::::---.—i::'rI X..'.%:r:�:�:: :�2; :; :::i:;rr::: :�:; :": iaaress> iii......::::i::i;>::i:ii-..-.. ..................... ...... ptw :.;::.;:_;;:.;;':, phone ... .::. ... . .:.:.:::.:..:::..:.:...;... . . ....... ...................:.:...:::::::: :::::,:::.:::........:...::. ....................................................................................:.:...:.:::::.:::::::.:::::..:::.:.......................................:.:::........:::::..:.:;;;:;<:::;;;;:;t::tt•::;;.;::;:;:;;.:.;:;:.:;.;::::; insurance ca -. alicv:# _»':: >:::::.;:::> ; . _. ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company n address. ......................::.:::::::.:.:::......:..............:::.:::::::::::::::::::::::.::::::::::::::::: f: ?''t.S .....-.::::.................... .................................................................. .......................:,::::. 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Fnflnre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae up to$1,500.00 sad/or one years'imprisonment as well as civil penalties 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 Office of Investigations of the DIA for coverage verification. I do hereby certify wider the paint and penalties of perjury that the information provided above is&w and correct Signature �� A --�� D� ?.�—/ ,9 _ - Print name NxIet I USSo Phone# 7a, /(O/ official use only do not write in this area to be completed by city or town ofiidalLO city or town: Building Department permlt/l[cense# g Board❑checkif immediste response is required teen's Office• lth Departmentcontact person: phone#,, Other (revised 9/95 PIN Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",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 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,neidier 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 dtuation 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 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. 1111111171111111111 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 fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit&eose number which will be used as a reference number. The affidavits may be remmed io 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 questions. please do not hesitate to give us a call. MAIN The Department's address,telephone and fax number The Commonwealth Of Massachusetts Department of Industrial Accidents emce of Imiesugadons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Y , ' OS s6 CQ =��'�; Pisa-uv Zw.o"YNn. ,,I_ ;. ,e„ _____ _— _ —_ �.•us q'p�� NAU-'IN GLU;F--T . O2 } 6 6 1 ' Go. Jam'• I . .• . L$���„�.-- - ®fie `! I �: fic Health sion 7 pub ', f Bamstabie M `�".''" __ ✓' Town o useiis 0260 z POBnS 1�h I $ �n 775 �Hyan 14 Fax(508) " Phone(508)?90- GL LIB'— _o A- I o " i 1 -Ci V� N �I II II v�hh'( w � �GEOaa�µarrh I I rx I II 1 iI • ---1NQ1�-1.�L�uA"t•IDN _.::Qcvr =i11Nre5'-TD MATZ k1 -: Exw1CWG.H�.G.fv�cR.�.STfI� _ !•�\e� +- ' I 1 I I - FED] El tCta.1'i:v6i:.. �^S�j�"S�Sn :�.-rimo ■ 9cwwo or. o•,eµ � - _ I � _... •I-,� --------_ is\ i. — ..-2 1 - — T — 241^0— � rW'� .^sue. +�.:f•: r•�Y.1L�.':M'• -:•.- ' ,1 � ICI �V.A" • 'Q 4 _ c GONC. 77 —'OUN D.WAl.l •_JI - xiU�.ac_}camNv K N -3 .Gonl c.S'Ab �ylr�:xno:�m—. r a CO o uJ aT,42..—✓' OA :O Q II3 j Department of Health Safety and Environmental Services Building Division 1 367 Maio Street HYamis MA Mal OM= 508-862-4038 Ralph Crosses Fax: 509-790-6230 Banding Commisc HOMEOWNF.RIU=aE 604wMB � • oaamQ � � San 1AI agate sip ago The surest C=Mocm for ohnmeamuffe was cmded to incWff of sa mots or less an to individual farhW who notpo a ac a ad to allow homeoovnas engage ftwu(s)who owns a parcel of laud an vMch hdshe resides ar momds to nude,=which then is,or is b=dcd to bc.acuortwoam3lydwdb&auwdzdardeumhWstcnEtIes Z=cmyto such Mg andlarfarm=== A p=Mwho mat ===home inatwo-yaarpgdodsWnot6ecadaidahomeo - Such shall sobmittothe HoMing Offtciai cnafotan tD the /�1 O��hekbe shn l be for• r.- !An at VM&w ed Mef erthe�I.. �J � 109.L1) The aadasigped awM r+aponsh1 Y for CMqffiM=w&ft State Huffing Code and othcr applicable codas,kJa M soles andregaladom The smda pted'4tomeowna"Mffwthathdshe tmdastaads the Town ofBamstable Building Department mmw==pow=pso cam aadregaizGm M anddWhdshe wM cm*wfth saidproce&M and fpco I-Pna- a�HoaseownQ AppmraiafH�offiod Note: MUwfw*&mftp=midoB AM CUWc fM oe largerw0lbezpqnuIto cOMPIY with the State Huffing Co&Session 127.0 C.a wrocnian CAnUoL � ��whkh a � {m fmm the �tish:adoatS�eaias 1�1.1•Ltoeasio8 5 �`O'id°d t�tit�e bomeo for tdeeto domdtwoekt4tssadt8omeoaraeeshtll aaa:avpen� tLe ofampa.isortsaAPP�°�Q' �, whotaetbb � t��'a°a RW=A �� 0 Sup Saadm 13) 'tom oaf awseaea o®msanit:m aaioas Fable" whanthaimuimwue<hiaes tom. Int6hare.ae8a�� �t�emri�edp�amitaoaid wahaito wedsworwim 'Tlyefm�eowmrs�8 � �, ,ge,a5pactofthe To eawsethattha � Oathalmtpa®eoftbisissue is aform dotthehoMeoWMun*tbthefs w Mdecanads theta MEAMIS ups by scyaai town=. You may cme to ammd and adopt such a haaloa M Lo DERSoN y ARM S `SAN 2750� _ 1 a N\F C�EL S C ARO L A MIT L�;T 4 ' Q .ice. _` A .. � • - � IQ � SHED � LOT 5. LOT 3 R=25. 00' , A=21. 74 50 a 4 N72°0723"E y 97. 42, CURLEW WA Y ° RES.. ZONE.- 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE. "C" Bank Use Only TOWN: COTUIT_ _ — _ REGISTRY OWNER: M<112k_& UYE'RE,SA M •RUS"SO DEED REF: _98�114 BUYER: _RE YL4N DATE: 10 9Z98_ _ PLAN REF: 402Z31_ _SCALE: 1"= 50FT. I HEREBY CERTIFY TO f'LEET_MQ9TCACE_C0.-______- H Of ___THAT THE BUILDING �A YANKEE SURVEY' SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS p�ut CONSULTANTS SHOWN AND THAT ITS POSITION DOES ____ CONFORM � � � 40B (SUITE 1) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE y TOWN OF COTUIT ______ __AND THAT N0' INDUSTRI I:OAG IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD ��FE$SIp�P� MARSTONS MILLS,, MA. 02603 AREA AS SHOWN ON THE H.U.D. MAP DATED_2 /�J __ TEL: 428-0055 CoMlu tv-Panal 4 250001 0021 D SuFN FAX: 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT P, UL A. MER1' HEW—P S -------- SURVEY NOT TO BP, USED FOR FENCES ETC. 25118 CB w 3 Y C , r -Public'Hcalth-Divisi®q �- - _ Tow_n of Barnstable -PO Box 534 __ -- _------ ----__ Hyannis,.Massachusetts..02601--_ Fax(508)775-3344 Phone.(508).790-6265._ ___-- t '• Yy"i iJa Pv1i �`i 4t I � i + � k I i � � I I c r i � ► I � I � � 1 � i i i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map CJ Sic Parcel � Permit# Health Division /q /// Date Issued 6,s t y? Conservation Division �` 3 , Fee 7 5-0 Tax Collector yy LOC., 3 iZ#06?v)w,s L Treasurer(�'%Y1� �I�I Q ° SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH Tf' 5 ENVIRONMENT'' f Date Definitive Plan Approved by Planning Board . �CCDE AND - TOWN REGULATIONS Historic-OKH Preservation/Hyannis , ° 2, fh,o( arw,J e,j, ,,c Project Street Address I LI' C L&r i ?it t) U-)mil Village Cx-r u►a Owner (flay_ -1- T-hz.r-e_- R u 5 sn Address 1I L1 G(,;-r1466 (. )" Telephoned Permit Request Acu J'6`4DO - ^;Is el 6 w1 IRI_e�d'+ Square feet: 1st floor: existing proposed ��yy 2nd floor:existing proposed Total new Estimated Project Cost -�S,000 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size I.U Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family A Two Family ❑ Multi-Family,(#units) Age of Existing Structure s qtS Historic House: ❑Yes 'la No On Old King's Highway: ❑Yes XNo Basement Type: O Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing C2 new '3 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 (3 Other Central Air: ❑Yes ,i4 No Fireplaces: Existing New Existing wood/coal stove: ❑Yes )0 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shedd existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Ao If yes,site plan review# J Current Use Proposed Use BUILDER INFORMATION Name__ 0 w 1-7 -e. / Telephone Number Address = License# Home Improvement Contractor# Worker's Compensation# ` ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE•- go& DATE '' 5 7 - ; FOR OFFICIAL'USE ONLY ar IT PERMIT_NO. DATE ISSUED. , I •i S t=w MAP/PARCEL NO. G'�t 4 J , ti. • 1 ADDRESS f , ` VILLAGE OWNER • .1 }mot" t�f • � f = � ➢ 1 , - .. - z _ i ' , -- i }., � DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH' ; FINAL GAS: ROUG y � Q �} FINAL 4 �' _ - ; ; . i .• FINAL BUILDING - a. DATE CLOSED OUT Si ° • 4 ASSOCIATION PLAN NO. d in ? r i F ► I o�TME Town of Barnstable *Permi //d 3 6j • sssNs�,st.E, • Regulatory Services F—V&w 6mnndufrom issue date • Fee tZ &�e� Thomas F.Geiler,Director �aY Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town-bamstabld.ma.us Office: 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTIAL.ONL'Fax: 508-790-6230 Not Valid without Red X-Press Imprint Map/parcel Numbe� OGO Property Address �� Oi 1 Residential Value of Work Nnimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name Telephone Number � ��. Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ]Workman's Compensation Insurance ®� ��� PERMIT one: R ❑ I am a sole proprietor �© I am the Homeowner ❑ I have Worker's Compensation Insurance TOWN OF BARNSTABL isurance Company Name lorkman's Comp. Policy# opy of Insurance Compliance Certificate must accompany each permit. ;rmit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to Re-roof(not stripping. Going over_j_existing layers of r000 ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value #of doors (maximum.44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. NATURE: . i PFILESTORMSIbuilding permit formsOTRESS.doc sed 070I10 The Commonwealth of Massachusetts Ji Department of IndusMalAccidents Office of Investigations 600 Washington Street ; Boston, MA 02I.71 www.massgov/did Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/ I ndividual).' Mll.Re K- j'' 1 P-6{^.B Address: City/State/Zip: ov t k, Phone #:_ Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I_am a sole proprietor or partr�er-. listed on the attached sheet # 7•. ❑Remodeling, ship and have no employees These sub-contractors have 8. ❑ Demolition working forme in any capacity. workers' comp. insurance. g [] Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3. I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152, §](4), and we have no ]2.❑ Roof repairs insurance required] t employees.[No workers' comp. insurance required.] 13.❑ Other *Any applicant that cheeks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and then workers'comp.policy information. I am an employer that is providing workers'compensation insurance for trey employees Below is the policy and jab site information Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,300.00 and/or one-year 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si mature: Date: ) " Phone#: Official use only. Do not wrrte in this area to be completed by city or Lawn bffu iaL City or Town: Permit/License# Issuing Authority(circle one): I. Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspectgr,5.Plumbing Inspector 6.Other � r J Information and Instructions Massachusetts General Laws chapter.152 requires all employers to provide workers' compensation for their employees. Pursuant to 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 Iegal 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 local licensing agency shall withhold the,issuance or renewal of a license orpeimit toroperate a business or•to construcf 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 numbers)along with their certificate(s)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 permit/license 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 b the city or town may be provided to e Y tY Y P th 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice 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 Commonwealth of Massachusetts r• Department of Industrial Accidents Office of Investigations' ' 600 Washington Street Boston,-MA 02111 Tel- # 617-727-4900 ext406 or 1-877-MA-SSAFE Fax# 617-727-7749 'I 1� Town of Barnstable Yxe 'Reg-alatoty Services Thomas F. Geller,Director Building Division �Fo { Tom Perry,Building Commissioner 200 MairiStroet, Ayani , MA 02601 Rwr.fown-b arnstable_ma_us Ofcc: 508-962-403 8 Fax. 508-790-5230 HOMEOWNER LILT LSE EXEMPTION Please Print DATE J JOB LOCATION: J J r P6 ` number street village 'WOMEOWNSR": f✓JCu�K T h e�"e sit s 57�� �t 5re 1 S� SQ (o d name ,r (� • - ,�. be=phone N York phone# CURRENT MALTING ADDRESS: --�A A— , ert5'�� state zip code The current exanaption for`homeown="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;provitdcd that the owncr'acts as supervisor_ DEFTNTIZON OF BOMEOwINT-R Person(s)who owns a parcel of land on which he/she resides or intends to reside, an which.thcre is, or is intended to- be, a one or two-family dwelling, attached or detached structures accessory to such use and/or fa=structul s. A person who constrgcts more:than one home in a two-year period shall not be considered a homeowner, Such `$orneowner"shall submit to the Building Ofcial on a form acceptable to the Building Official, that he/she shall be resyozistble for all such work perfarmed'tmder the building permit (Section l O.1.1) Tlic umdcrsigned`bameowncr"assumes responsibility for compliance with the Statc Bunlding Coda and other applicable codes, bylaws,rules and regulations. The imdcrsigned'homeowner"certM;s that,he/she.understands the Town of Barnstable Building Dcpar#mcnt rniMITTMIM inspection procedures and re;q*;rr=ts and that he/she will comply with said procedures and requirements. 44^ Signatize of Hameawner Approval ofBurld ng•Ol$cial Note: Three-family dweIlmgs containing 3 5,000 cubic feet or larger will be required to comply with the ` State Budding Code Section 127.t)Construction Control_ EL0RZ0WNER'S EXEMPTION The Code states that: "Any bomoow rr perl an rg work for which a building parent is required shall be excerpt from the provisions of this sccd=.(Sr-cd n 1 D9.I.1-I icrosiiig of canstvction Supervisors);provided that if the hamoaZgoer=gages a person(s)for hire to do such work,that such Hamc iwncr shall art as atpervisor." A�mry homeawners who use this, tion arc unaware that they are assuming the responsibilities of it supervisor(see Appendix Q, turlcs&Regulations for liemsing Construction Superyisorz,Seetioa Z15) This lack ofawarencss bfkn resuha in serious problems,particularly vh=the homeowner hires unliccased pasonL In this ease,our Board=rmot proceed against the unlicensed person as it would with i licensed supervisor. The homeowner acting as Supervisor is ultimately respons bIc. To erasure that the bamcc%mcr is fully aware ofhiArricsponsrbilitirs,many communities require,as part of the paint application, rat the homeowner certify tbat helshe understands the responsibilities of a Supervisor. On the last page of this issue is a,form emrerttly used by .venal towns. You may care t am=d=d adopt such i forrir/ecr-dEcxdcn for use in Your community. � Ty Town of Barnstable o Regulatory Services �► Maea Thomas F. Geiler,Director ` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www-town.b arnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property r Mus t Complete and Si This Section If Us in Builder T, ► �'e� O'C . BLS" , as Owner of the subject property hereby authorize to act on my,behalf, in all matters relative to wprk auth rued by this building permit application for. Address of Job) Signature of Owner Date Print Name If Prop erty Owner is applying forperm-tplease complete. the Homeowners License Exemption Form on :the .reverse side. `�1HE rqo� The Town of Barnstable BAR Department of Health Safety and Environmental Services MASS. e'39+ Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection t Location ;+�- C �j(-L Lt,0--✓ Permit NumberZ Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: Please call: 508-79 227 for re-inspection. Inspected by Date L w The Town of Barnstable W � BARNSTABIX.o` Department of Health Safety and Environmental Services a�:c MASS. 0 �'�FO PACE ae Building Division 367 Main Street,Hyannis, MA 02601 ' Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location a Lt-L--J Permit Number Owner Builder r One notice to remain on jobsite, one notice on file in Building Department. '(The following items need correcting: Please call: 508-790-6227 for re-inspection. ... �. Inspected by Date �5 U a ti �y MINIM cEam $ at Ce+t1n$ Wall Floor 8aam Stab = Am'('/i) O.valuri R wi=J RvalueI &Wb o Wail Pw i p RVzwe & S'!OI to 6300 undue De;eee Dam Q 1Z!'. OAO 3E 13 19 to 6 Norma i i< 12'JS 032 JO 19 19 to 6 Naemai S t27a 030 3E 13 19 10 6 ES AE 3 T IS7i 036 3E !3 21 WA WA Nomma! !I U 15% GA6 3E 19 19 10 6 Norm d V 159A 0.44 3E 13 25 WA WA ES AFVE w Is% osz 30 19 19 to 6 IS AM X f IVAi 032 3i 13 21 WA WA Nomml _Y_ IVA &42 3E _ 19 2S WA WA Now ` Z Ir/a 0.42 _ 11 19 10 6 "AFEJE j AA 1E'/. 0.50 30 19 19 t0 6 90 AFUE 1. ADDRESS OF PROPERTY: AY 2. SQUARE FOOTAGE O W `t F ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: l I ! 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DEIFRMINING ENERGY REQUIREMEN 5 ARE AVAILABLE- ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: r. YES: 'S�'� ICI G NO: . i. i q-forms-t980303a p � wwul � lb 7 3-- � Z t4 (21(3 co g G® � 6 <9 z L n 3� MAScheck COMPLIANCE REPORT 10o Z I Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Checked by./Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-20-2000 COMPLIANCE: PASSES Required UA = 167 Your Home 165 Area or Cavity Cont Glazing/Door Perimeter ' R-Value R-Value U-Value U ------------------------------------------------- ------------------ CEILINGS 682 30.0 00 WALLS: Wood, Frame, 16" O.C. 706 11.0 0.0- --- 4 GLAZING: "Windows or° Doors 170 '0:'300fi� FLOORS: Over� UnconditionedSpace 816 30.0 0.0 k COMPLIANCE STATEMENT: The proposed building design described here is r,`zx..e consistent with thefbuilding 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 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code .. .,. MAScheck Software Y.Version '2.01 DATE: 1-20-2000 Bldg. .Dept. Use CEILINGS: [ ] 1. . R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-11 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.3 ,For windows .without labeled U-values, describe features: iA #, Panes Frame Type Thermal Break? [ ] Yes [ ] No „ '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. 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. 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. I DUCT INSULATION: _ [ ] Ducts shall be insulated per Table J4 .4.7 . 1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of suppiy. 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. HVAC EQUIPMENT SIZING: [ l 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. ) : PIPE SIZES (in. ) I HEATING SYSTEMS: i TEMP (F) 2" RUNOUTS 0-111 , 1.25-2" Low pressure/temp. '201-250 1.0 1.5 1.5 ' ' 2 .0 Low temperature 120-200 0.5 1.0 . 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 K } COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 .:._ . ..,.. .._: �. _., _ref rigerant.,_..:^ , ......:.. .... below. 40 .1.0 _... 1.,0. 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to. the following levels (in. ) : PIPE SIZES (in. ) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS I 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 2.0 140-166 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 i t C Engin, V��ept. d floor) Map �� Parcel k- �� � ermit#House#. Date Issued t cqa�rr oard of Health-(3rd floor)(8:15'=9:30/.1:00-4:30) Al c��w Fee- 1�2 . ann ng ep . s oor•SCh-o-o�lig �THE,p an Approved b PIanni ',19 ' p� y - BARNSTABLE. ` rFo w1a+"`e$ TOWN OFAARNSTABLE L ' Building Permit Application Project Street Address ,��7 CV r r. Village____._ Owner Ile f ea a v.S S C7 "Address �//� C 0 f J L(, ) LJ AV Telephone ' (Permit Request C©�ve t's 7L,^ Z ''-T— DO First Floor jig N,, 6 A4C-,+ CAff_nq ware feet Second Floor square feet Construction Type Estimated Project Cost $ ��Z7 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 2 Historic House ❑Yes ANo On Old King's Highway ❑Yes -j4No Basement Type: U1 Full ❑Crawl ❑Walkout ❑Other l Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ( X. 3 6 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: 4 Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes Pg No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) gj Attached(size) ❑Barn(size) f ❑None Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Q /� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# 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 _�2 � /% "�"� DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY : NO. 4'= _. 4DATE ISSUED MAP/PARCEL NO. ADDRESS '+ 1 VILLAGE OWNER DATE OF INSPECTION:. FOUNDATION r s FRAME .: .Y p IN'SULATION FIREPLACE ' I ELECTRICAL: ROUGH FINAL= c PLUMBING: ROUGH y FINAL �$ _ GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT f , ASSOCIATION PLAN NO. T11[• 11111111 U 11 l i'CIl 1 01 3RISSaC11"SCHN DeptIr1111Ctrt of ludzurrial Accidents Of CZ0IfyeS1lga11ons. •.\ ,,_�_ __� .: _ 60H !f'asltiugtun Street .. 4-: `.�.a�• � �:. - '� Biistull. .9111a:1: U3111 • Work-en' Compensation Insurance AMdayit Aitpiicintinfrirntatinn — PIc'1se f RfNT Ie,^,+iiiv'��� nark• /1/1/�-/z,� f2 v� s � . Inc-,-inn- ��% CU f /-e w CttV �(�/ / nhnnc I —AI-� 1 am a homeowner performing all work myself. ( am a sole proprietor and have no one working in anv cnpaciry I am an empiover providing workers' compensation for my empiovees working on this job. rnnrnntn• nnmt•- ntirlrrcc• • city•• nhnnc#• incnr^nrr '•n ` nnlicv 0 [ I am a soie proprietor. eenerni contractor, or homeowner(circle vireJ and have hired the contractors listed beiow wx C the "Oilo%ving workers' compensation polices: cmm�•rm n•tmr• Ctr`" nhnnc�' in•tir--irr rn - - ...� � •. -�-- .�.... _r-'rt. T Tom.-.•.1. _ _ T' � S• r-- cmmn7!n% n trnr :7ti�lrr�.• r1t�•• nhnnc�� in,mr••nre rn nt►iic�• 1tt�ch sdditio_nal sheet ifnecesi Iry �.�"- _ .r.�r.+.••�+�'.'"' :air•—.. ...w...x. F:rnurc to secure cin-crat•e as required under-nection_°A of i►1GL 152 tan Iead to the imposition of crtmtnai penalties 01 a line up to SI-400.UU anurcr tine cars imprisonment a. %%cll as cis ii penalties in the form of a STOP WORK ORDER and a fine of S100.00 a dad•against me. 1 understand thI.t cap) Of thi.,tatcmcut no. be furs ardrd to the Orrice of Invcstientions of the DL1 for coveritre verification. I«o hercnr ccrrifr unrierr ilre pains and penalties nfperjun•that the informarion provided above is true urrd correct. �Oatc Print n:. C Phone; ,tTiciaiw,c univ do not rite in this area to be compieted by city orto%vn ofticiai - E city or tnw n• permit/license is rtlluildin_Department CUccnsint: Board Selectmen's Ufficc ` t.. i. ctieck if immediate respunse is required 1`111caith Department contact ncrsnn: phone o: r•-tUther_�� Information and Instructions i Massachusetts C,rner.:! Laws chapter 15'_ section _'5 requires all ernplovers to provide workers• cvnipetlsat'011 tc' enlnlovecs. As quoted from the "la++ an einpluree is defined as every person in the service of :au thcr undc: contra ofhire_ express or implied. oni or-wrincn. An emplurcr is defined as an individual. partnership. association. corporation or other legal entity. or any two or tits f ore_aina en__a__s:d in a joint cnterprisc,and including the 1=1 representatives of a dcceasezl employe.: or;f:c rcceiver or tnrstce of an individual . partnership. association-or other le=f entity. employing employees. Howe-.': owncr of a dwelling_ house having not more than three apartments and who resides therein. or the occupant of;he d++clline house of another who employs persons to do maintenance,construction or repair worm on such dwcllin , or tail the __.rounds or building appurtenant thereto shall not because of such employment be deemed to be an er.:t :`. Iv1GL .:banter 152 section :5 also states that even-state or local licensing agcney shall withhuld the issuance o. �•_++aI of a license or permit to operate a business or to construct'buildings in the commonwealth for sn} cc::nt who has not produced acceptable evidence of compliance i,%itlt the insurance coverage requires". of its political subdivisions shall enter into any contract for the Aa�.:ionall+. neither the commomveaitlt nor any per i�rnlz::ce of public wort: until acceptable evidence of compliance with the insurance requirements of this c::a=: he=:: prese:aed to the contracting authoritt. Al'Piicents F case fill in the workers' compensation affidavit, completely, by checking the box that applies to your situation c: st:cpi�in__ cotnV"n+• names. address and phone numbers as all affidavits may be submitted to the Department of !nc axial \cc:dc:lts roi- cotlJtrnizrion of insurance coverage. Also be sure to sign and date the aflidaviL 71te :c1 it silouid be returned :o tale cin or town that the application for the permit or license is being guested. r :;te Deccrtnle:a of•Industrial .accidents. Should you have anv questions regarding the "law-or if you are .O octc::l a «•crkc:-s• compensation polic}•. ple=e c:11 the Department at the number listed below. City .►r To%-n.s Ple� �-e --ura that tile.affida+•it is complete and printed legibly. The Department has provided a space at the bcr.;:t- the z'"aaVit for you to fiil out in the event the Office of Investigations has to contact you reg riling die applicant. be - : to ftil in the permit/license number which will be used as a reference number. The affidavits may be re:ur;.: -:le Department by mail or FAX unless other arranacments have been made. The Office of Irl+•esti=atioils would like :o thank you in advance for you cooperation and should you have any quest pie::se do not hesitate to _iye us a CZ11. The Decarnzenr-s address. teiepnone and fax number. The Commomveaith Of Massachusetts Department of Industrial Accidents -• Office"of Investgigatians 600 Washington Street Boston,Ma. 02111 fa-, ®r: (6I7) 772'-7749 phone =. :6 i"i - —=900 exr. 406. 409 or _ f Barnsta ble The Tow 0- ., � g f Health Safety and EnvlronmeII�Iservices Department o ,Building Division �367 Main Stream Hyannis MA 02601 Raipn Grosser Office: 508,90-6ZZ7 f Building Ca: Fax: 508-7,90-6Z30 For office use only Permit no. Date ► AFTIDAVIT ` HOME MWROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, muovatton, repair, modernization. conversion, improvement, removal, demolition, or construction of than foam dwelling n to any pre-unit oring to owner occupied building containing at lust one but not-more[ contractors, with structures which are adjacent to such residence or building be done by registered certain exceptions,along with other requirements e p C� �— Est. Cost Type of Work: l � Address of Work: i9' �7Lc� Owner's Naive Date of Permit Application: 4 �/S l hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. Building not owner-occupied _Owner pulling awn permit Notice is hereby given that: OWNERS PULLING 'I'HEIg OWN PERMIT OR DEALING WIM UNREGISTERED CONTRACTORS FOR APPLIGAB GRAM OR G�iJARANFUND UNDER MGL WORK Do o 141.E � ACCESS TO THE ARBITRATION PRO SIGNED UNDER PENALTIES OF PERJURY I hereby apply fora permit as the agent of the owner. Contractor Name Regis=tioa NO Date • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please JOB. LOCATION (.`} !i-Y CO�c� -}- . Number Street addregA Section of town "HOMEOWNER" 0 Y�2 0 7?. , Name Home phone Work phone PRESENT MAILING ADDRESS �''•_ City town State Zip code The current exemption for "homeowners" was extended to include owner-oc:upi dwellings of six units or less and to allow such homeowners to engage an in dividual .for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to r: side, on which there is, or is intended to be, a one or two family dwellinc attached or detached structures accessory to such use and/or farm structure_ 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 Of-�ic n a form acceptable to the Building Official, that he/she shall be resrons- for all such work performed under the building permit. (Section 109.1. 1) he undersigned "homeowner" assumes . responsibility for compliance with the S uilding Code and other applicable codes, by-laws, rules and regulations. he undersigned "homeowner" certifies that he/she understands the Town of arnstable Building Department minimum inspection procedures and requirement: nd that he/she will comply with said procedures and requirements. OMEOWNER'S SIGNATURE PROVAL OF BUILDING OFFICIAL ate: T II hree family dwellings- 35 , 000 cubic feet, or larger, will be required comply with State Building Code Section 127. 0,. Construction Control. . HOME OWNER'S EXEMPTION - - 'I 'The code state that: "Any Home Owner performing work for which WIbuilding Permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that i- Home Owner engages a persons) for hire to do such work, that such Home 0 - shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2. 15) . This lack of awarenc often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the nlicensed person as it would with licensed Supervisor. The Home "Owner act_ as supervisor is ultimately responsible. % , To ensure that the Home Owner is fully aware of his/her responsibilities, ma communities require, as part of the permit application, that the Home Owner :ertify that he/she understands the responsibilities of a supervisor. On t Last page of this issue is a form currently used by several towns. You may ;are to amend and adopt such a form/certification for use in your community. J �C1�r�t'C2 St� �E 2.. - - ;lA rl rl f AjI M n A 4 , OG , r � SSA S iC ;,� LbQ,Z �� t�frxlG p S� IL ' , Siaf W*42-L . r • Bcr� �C,aaR S'r. B T�tc�l Barnstable own of C —S'�5-c o �1 r � AlJQ .001 :II.A-MAf.E` v o.. CLT Rooca N � i 1 • N 1� 1a: r �tµ Vw "y - AR^ L01J• �O q S I r r k It(r3 14 4 w L .1(.. y .. � 'Y I. + - f• � { h. 1 y �r- �FA. JE A4�.a - - 14t p• _ jir- J1. BAY9IDE BUILDING Co lwa .CItNTtriVILL[ /NA94. E GI REV r Cm 4bIV s- -F1=d Ola. ..PLAN Slt Be IS )41 4,K'. ------------ �2��z!.-z 771 ......... ...... .7- TT OF q RK*AWj.X� !A. 1--;_: I. • Calep 7-1,4=1,=-,O CAA1 ZOC.47-1041' 7/,C-7>I" 7-A,�47' 7-/-/,f-- AoovoA no1v A/2�7,7AL;,Er,:�7/,/ .000ow 72— V., 2`7 /97,� SA0,,=_1, A.NO 4 oV: 7,41.= loe �S�.EX/C Ale 41v r ,4ocA 7;e-z:> e5le:20A.44/4� AR4 : -7 N 40 .......... Z__o7A 7-,cF q1W. A_, 4t. IEA X -4-A-b- IV40 7- HA,5-,6O.Oiv Ate(/ >oo 7 IV07— t r TOWN OF BARNSTABLE, { CERTIFICATE OF OCCUPANCY r:NGEL ID 025 062 GE013AGE ID 35241. ADDRESS 114 CURLEW WAY PHONE (617)525--3800 cotui t ZIP a LOT 4 BL.,OCE. � # LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 9906 DESCRIPTION SINGLE FAMILY' .DWELLING PERMIT TYPE BCOO TITL"E rERTIFICATE OF pCI a `aittrnent of Health, Safety CONTRACTORS: and Environmental Services i ARCHITECTS: ' TOTAL FEES T11E BOND I $.OQ CONSTRUCTION COSTS . $.06 QA t BARNSTABLE, � OWNER CHAMPION BUILDERS, INC;_ , �,I7DRESS 110 STATE ROAD UNIT 3-A BUZZARDS BAD', MA • BUIL ° N DATE ISSUED 08/24/1995 EXPIRATION DATE BY l i DIVISION APPROVALS FOR CERTIFICATE OF OCCUPANCY TO BE SIGNED:BY EACH DIVISION HEAD UPON COMPLETION BUILDING: �� . • DATE: + COMMENTS:, a 1 PLUMBING: "fry — DATE: "'COMMENTS:`~` ELECTRICAL: _ DATE: COMMENTS: GAS: DATE: COMMENTS: CONSERVATION: DATE: COMMENTS: OKH: DATE: COMMENTS: HISTORIC: DATE: COMMENTS: FIRE DEPT.:. DATE: COMMENTS: OTHER:. DATE: COMMENTS: TURN THIS IN TO THE BUILDING COMMISSIONER AFTER ALL SIGN-OF COMPLETED.A CERTIFICATE OF OCCUPANCY WILL BE,ISSUED AT TH TOWN OF BARNSTABLE GERTIFICATR OF OCCUPANCY �. I 's CEL _ID'h025 06 GEOPASE D 35241: -ADDRESS.,-- 1� CtT LFW WAX PHONE (61?.)826-38061 Cotuit h I LOT 4 BLOCK ' I,t1T SIZE DBA DEVELOPMENT DISTRICT PERMIT 9966 DESCRIPTION SINGLE FAMILY' DWELLING PERMIT TYPE BCOO TITLE CERTIFICATE OF QC06!p inent of Health, Safety CONTRACTORS: u ' andi Environmental Services ARCHITECTS. TOTAL FEES CONSTRUCTION COSTS $..00 �► s + BARNSTABLE, • MASS. i39. 1��► OWNER CHAMPION .BUILDERS INC. ADDRESS. . 11.0 STATE ROAD � UNIT _A BUZZARDS BAY, MAr BUILDr N DATE ISSUED 08/ 4/1995 EXPIRATION DATE BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM.THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS- MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL;'PLUMBING AND MECH- (READYTO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. POST THIS D O IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I 1 1 1 I I I I 2 2 2. 1 I 1 I I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF-HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED.UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS - I THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX _ CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE,PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA TION. NOTED ABOVE. TION: 508-790-6227 i i i i i I i i i i i i i i i i i i i i i i THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) I A , m / �(�C�"- IL DATA BUILDING TOWN OF BARNSTABLE, MASSACi�I►SETTS ,• I i=)'._ _ DATE :diem :l1 �I T � 8 2i +4 ( .,• . iEt::,. .iC GE.I' 19 PERMIT NO. + 3 APPLICANT V r i ADDRESS +. e i7O:l' 1_?:,. :,j(jZd�C1:y' _ci`, _1 •tr;;-y::_ IN0.) (STREET) (CONTR'S LIC�rySf ' PERMIT TO _ i...:., ( ( STORY_. «..2 "•`n•�;_ •�i.JC a NUMBER OF r•�.. .,. . DWELLING UNITS Epp (TYPE OF IMPROVEMENT) NO. (PROPOSED USE) 1 AT (LOCATION) ,•, —is-�•_ -'�i_ +�i ,:_: :" _ - ZONIN CT •' (NO.) (STREET) DISTR ,... BETWEEN AND v (CROSS STREE.'(I (CROSS STREETI ii LOT VISION _LOT-.BLOCK SIZE BUILDING IS TO BE F'T, WIDE BY FT. LONG 8Y _ FT, IN HEIGHT AND SHALL CONFORM IN CONSTRUCT�N TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) — X.; REMARKS: AREA OR + • :;�`�e )ij PERMIT �. . .`:} VOLUME ESTIMATED COST FEE (CUBIC/SOUARE FEET) i OWNER e ,? 1A - - BUILDING DEPT - -: I ''• ADDRESS e, _..i Y%,,. 1i-7 BY, THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF. EITHER TEMPORARILY OR ®)) PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY,,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP= r PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED' FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. M INSPECISPEC OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE NIMUOF REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: PERMITS ARE REQUIRED FORELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MkbE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL M SIRE ADO TO LATH 3. FINAL FINAL INSPECTION HAS BEEN MADE, L INSPECTION BEFORE - , OCCUPANCY. P T THIS C SOR IT IS VISIBLE. FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS e,' 1 /'•�,/L�P r l�a CI) 1 �(�,�I C' (!1 p` /� �,A%l` � 1 . - �,J 17 j G Lk µ I ►' HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 0 BOARD F + 'vo ; eh,;, a Lam" L L�1� HE �$� 1,L + OlHER SITE P o EVIEW APPROVAL 49906 , PERMIT 'W!LL'BECOME NULL AND VOID IF CONSTRUCTION:WORK SHALL NOT PROCEED UNTIL THE INSPEC- INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN {,COtJSTRUCTION. PERMIT iS ISSUED AS NOTED ABOVE, NOTIFICATION. _ - �. _._---� t �� j , n � Y i i Assessor's office(1st Floor): Y Assessor's map and lot n ber a �` "" SEPTIC syoymm must BE o�Ya E to Conservation(4th Floor): .�� COMPLIANCE Board of Health(3rd floorj: WITH TITLE 5 = ssas�Tant,E Sewage Permit number �� ' ,� ElyVIRON ��'�L COOF AN® ~� 039 NASL Engineering Department(3rd floor): ; ) - . ® °��'30'���� House number 1 1 4 i � N .rgEGULATIO�� o air Definitive Plan'Approved by Planning Board f B — 7 —a 19 APPLICATIONS PROCESSED 8'.30-9:30 A.M..and 1:00-2:60 P.M.only C TOWN ; OF BARN `STABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 19.1�_ TO THE INSPECTOR OF BUILDINGS: The undersigned ere by applies for a permit accordin tothe following information: Location Proposed Use Zoning District C + = Fire District l Name of Owner Address ✓ �.O S i� it r U ►a. 3 f� Name of Builder Address Name of Architect // ������ i1/( Address Number of Rooms Foundation Exterior ` Roofing L Floors 4v /L�-C' Interior A644 Heating r / `" / ` Plumbing �� ��% ��[ i✓G�� Fireplace / '�'� '�"` Approximate Cost Area / Diagram of Lot and Building with Dimensions Fee �G ' 0 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 Siipervisors License No Permit For AIZ Location Ownerr- — Type'of Construction Plot `> Lot Permit Granted 19 t . q Date of Inspection: t Frame 19 _ 1 wInsulation ��/ems 19 'Firepla'ce 19 QC t s Date Completed �` 19 4Y- f � • ...� F q � ` s �3 ' APPLICATION FOR PERMIT TO INSTALL AND REQUEST FOR ELECTRICAL SERVICE Inspector o Wires Wiring Permit# COM/Electric# c� Town of �'�-�n.s Massachusetts Building Permit# Date e-C_Q- Z Q I l g Customer: CHi4M g,6a.J �� �rs Z� `' on(Street#) l l�1�f�,Lj AD Lot# in th 'la e of ����! utilit pole number or underground number Customer's billing address Z- Temporary New installation Change of service Starting Date Job description �' Service entrance voltage ��® Amperage /5-0 Phase •A6 � Wire size(cu.or al.) - " A L Conductors r,phase 0AJA-1 Number of meters QA. Ae` Water heater Off peak:Yes— No Estimatedload:Electric h�ea kw light kw Range>d5 dryera Motors, H.P.& PhaseReady for first inspects Ready fo final inspection Electrical Contractor OL I ic.# 'Z Telephone# Address � r '� �' -Z- Additional Remarks: Do Not Write Below This Line CAL WIRING INSPECTION CERTIFICATE FIj� I,',II;J� I� INSPECTOR OF WIRES INSPECTIONS b U L`� IJ DATE FEE CHARGE Temporary Service Roughing in All Service and Meter _ Off Peak Meter Final Approval Disapproved' 'For the following reasons CERTIFICATE OF INSPECTION DATE.49"t91:9� To the COMMONWEALTH ELECTRIC COMPANY.The installation described above has been completed and ha y been inspected and approval granted for connection to your service. spector of Wires WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS READY FOR INSPECTION Permit Good For One Year From Date Of Issue CA as-, White—COM/Electric Green—Inspector Canary—Town Receipt Pink—Inspector's Copy Goldenrod—Electrical Contractor to COM/Electric �r r.'-,':; �--..;� -,-•- 'S .,:_� �:... ti .:;;rw.l '�-�,.- Y`"x_"' g.�°"'r?.a�c�+'*.N�'�t•�"�r'.�.� }.'i.*y,+c:w+ww+��^�'�-',�-k�;,r•.,�„o r....vY. f ' ti APPLICATION FOR PERMIT TO 1NS`'AL-L-AN13 REQUE-ST mt FOR ELECTRICAL SEI:VICE` Inspector oL Wires Wiring Permit# COM/Electric# } 1444 .Town of � �Massachusetts Building Permit# Date Customer n `" on(Street#) T rLj AD Lot# in the,4a e of'.eoraj/_ utili pole number or underground number Customer's billing address Tempprary. New installation Change of service Starting Date Job description: "p,Fr i �0 =_ Servicee ttance voltage f2� d, Amperage Phase x ,. Wire size(cu.or al.) A L Conductor er phase Number of meters Water heater --Off peak:Yes No— �A ' Estimated load: Electrc hea kw light kw, Range..,.,, dryer X��Motors, H.P.& Phase Ready for first mspecti Ready foe MN'inspection Electrical Contractor © 'L Lic.#A Telephone# Address,_j0'9 Z �i dr r A r � 'g!'yiIVAI />Z A 37— Additional Remarks: Do Not Write Below This Line ELECTRICAL'WIRING INSPECTION CERTIFICATE :•`= `' INSPECTOR OF WIRES INSPECTIONS- DATE FEE CHARGE -Temporary Service Ff a � - Roughing in IL f Service and Meter �� . f i w Off Peak Meter € - . . f'. T I j Final Approval Disapproved' F 'For the following reasons 41 : CERTIFICATE OF INSPECTION DATE1�:V� T To,the COMMONWEALTH ELECTRIC COMPANY.The installation described above has been completed and ha t ' been inspected and xF approval granted for connection to you`r'service. pector of Wires WIRING INSPECTOR TO BE NOTIFIED WHEN WORK IS•READY FOR INSPECTION Permit Good For One Year"From Date Of Issue ca as '- - - y v"t'_"'m+eair•rYg?!C 1$ -cam.�,�mei - White—COM/Electric Green Inspector: Canary—Town Receipt Pink—Inspector's Copy; Goldenrod—Electrical Contractor `�"��«to COM/Elec --�---- �}���Z� i i. , r " — Office Use Only Tile CommonLEcolth of Massachusetts PemutNo. AD Deportment of Public Safety Occupancy ecFee Checked _= BOARD OF FIRE PREVENTION REGULATIONS S27 CMR IZ7CO 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All nork to he performed In accordance with the Massachusern Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date/ . 2 9 /�l TOWN OF BARNSTABLE To the Inspector of Wires. The undersigned applies for a/permit to perform the electrical work described below. Location (Street 6 Number) r��� Coe-lez l /CIO �U> Owner or Ienant__ f��w! �j Owner's Address E0 U�� /- �CJ rJ L? f,�DS f'3/-�l� F� r Q? Is this permit in conjunction with a building permit: Yes ❑ No El (Check Appropriate Box) Purpose of Building -J Xal-�—, Utility Authorization NO_ Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters New Serv-ice Amps_ZZQ / 290Volts Overhead ❑ Undgrd No. of Meters Qll/e-- Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No, of Iransformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. o£ Emergency Lighting Battery Units No, of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges Total No. of Detection and 8 No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heat Total Total Pum s Tons KW No, of Sounding Devices No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other Connection No. of Water Heaters KW No, f No. of Signs Ballasts WirLow ng Voltage No. Hydro Massage Tubs No. of Motors Total HY OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current LI bilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to this office. YES❑ NO ❑ If you have checked YES, please indicate the type of coverage by cnecking the appropriate box. INSURANCE 9 BOND ❑ OTH-TIt ❑ (Please Specify) xplr Clan ate Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAMIE//_ /� LIC. .NO_ Licensee�-0 w�a. toj���p Signatur, LIC. NO./'� 2 Address�� Zn, OZ 3 Bus. Tel. No. Alt. Tel. No. -271- 6 17 06KER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General vs—, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Ielephone.No. PERMIT FEE S Signature of Owner or Agent