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0103 DEBBIES LANE
„-- v' ''� �- - ��.� - ,�.� ti i i gyp , Town of Barnstable M s ww:�rtrraes� POSt%Th15 CaBuilding rd So That rt:is V�s�ble.From the Street Approved°Plans Must be Retained on Job and this Card Must be Kept I sr �$' Posted Until.Final Inspection Has Been Made r' ' Permit� Where a Certificate:'of Occu anc `Is Re wired,such Bu�ldm shall Not be Occu red until a Final InsF ection;has been made Permit No. B-19-3993 Applicant Name: W. Ray Colwell Approvals Date Issued: 11/26/2019 Current Use: Structure Permit Type: Building- Insulation-Residential Expiration Date: 05/26/2020 Foundation: Location: 103 DEBBIES LANE,COTUIT Map/Lot: 011-018 Zoning District: RF Sheathing: Owner on Record: ANDERSON, ERIK Contractor Name`:'1-.5C Energy Framing: 1 Address: 103 DEBBIES LANE ' Contractor License' 194390 2 MARSTONS MILLS, MA 026.48 Est.,Project Cost: $3,538.00 Chimney: Description:. Insulation;See Contract k Permit Fee: $85.00 Insulation: Project Review.Req: Fee Paid:` $85.00 ..Date. .y 11/26/2019 Final: Plumbing/Gas x Rough Plumbing: Building Official Final Plumbing: i This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and theapproved construction documents for which this permit has been granted. Rough 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 publicinspection for the entire duration of the Final Gas: work until the completion of the same. i 5 i c Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are'provided on thispermit. Service: Minimum of Five Call Inspections Required for AII'Construction Work 0 :' 1.Foundation or Footing x � 2.Sheathing Inspection Rough: 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 Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates [cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures-on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required-by law. .e .,., ,.. to„�� a DATE: 1 — 5 f 6 Fill.in please: :,..tc,:.,r r,: YOUR NAME/S: Ec��G. An6ec �C1 ••�>>r,x�s.� 'aW+du�� ', APPLICANT'S • BUSINESS YOUR HOME ADDRESS ' \y3 �,h;es L� r 'r�• g •,:,�- � -- "` 3 ��'`�l�y�' -� TELEPHONE # Home Telephone Number {�� E—MAIL: r �9 —CV NAME OF CORPORATION: NAME OF NEW BUSINESS �c:V _ < u Go,s r7�&= c� � `� YPE OF BUSINESS IS THIS A HOME OCCUPATION? YES N0. ADDRESS OF BUSINESS 1OS NDM6< cn Mqr ��an1 r�'��s�IN'A of MAP/PARCEL.NUMBER O\ g (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regul'ations'of the Town of. Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S FIC MUST COMPLY WITH HOME OCCUPATION This individual has been inf med I r is that pertain to this ty of business-RULES AND REGULATIONS, FAILURE TO c�, T COMPLY MAY RESULT IN FINES. Authorize Si ature* C0MM NTS: 2. BOARD OF HEALTH ' This individual has been informed of the permit.requirements that pei=tain to this type of business., Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS [LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: . .n — Town of Barnstable SHE Regulatory Services pF Tp� o Richard V. Scab,Director &Uaysre LE, Building Division MAS& Paul Roma,Building Commissioner ' i63q. � �1D�Eo nn 200 Main Street,Hyannis,MA 02601 r . www.town.barnstable.ma.us - Office: 508-862-4038 F : 508-790--6230 Approved: ,,P/33 r; Fee: S Permit#: HOME OCCUPATION REGISTRATION Date. ��' s Name: br 1 V) Phone#: 5 o -,7 q ^_ [ S6 I Address: �.�� �i e S l�(1 Village. 1, NameofBusiness: li(—iV) ende.c TJn cas T - Type of Business: l��7��Gn�� f nG �' Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the remises which would suggest an other than a residential use,;no increase in traffic above normal It v o P gg anything , residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located, within that dwelling unit.' • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,.glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. , • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed.indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit a I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: �/ Date: Homeoc.doc Rev.06/20/16 r a slLyl�� 0 TOWN, OF 1''.i ^:to L'� • ps_ U a u save W e a t h e r i z a t i o n & Insulation 410 Grove St,Fall River,Ma 02723 Insulateasavenet May 28,2014 Town Of Barnstable Thomas Perry, CB,-, Building Division 200 Main Street Hyannis,MA.02601 RE: 103 Debbies Lane; ( � Dear Mr.Perry, This Affidavit is to certify that all work completed for insulation work at 103 Debbies Lane has been inspected by'a certified Building Performance Institute(BPD Inspector.., All work performed Meets or exceeds Federal and State Requirements, Sincerely, Roland Langevin Insulate 2 Save,Inc President CSL 103861 HIC 166311 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �I 0. 00 L4 i� Mapnil Parcel pplica on�# Health Division Date Issued —* Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address T.birh Village I`Y rnklln (Yl i I S OwnerL6Y.- Pmdemm Address_ 103 DPhbie�S l Telephone 550S-- cl:M Permit Request n 4- to QJ-Ik' C '(y7 •-ko i n-I- Qcl i r)S 4ion ' ► IOW 11 5 n -�i o °-� o 9 z0 Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay lUi Project Valuations aao15 Construction Type, Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.. Dwelling Type: Single Family .EY' Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other _ Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas . ❑ Oil ❑ Electric- ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name a nd Urney n Telephone Number _JbZs - :5(k-l-U71CLe Address I C) r`7-L)J P License # k2)SCLl R�\[e r., rm Home Improvement Contractor# I u'3 l Worker's Compensation #_X N WC-, 1 I q 3, ALL CONSTRUCTION DEBRIS RESULTING FROM,T,IIS PROJECT WILL BE TAKEN TO C 5m,,/e -:cam~� CZ� .-e-f &Y-\ SIGNATURE DATE DEC 2 0 2013 i .i FOR OFFICIAL USE ONLY hPPLICATION# DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER i� DATE OF INSPECTION: ' FOUNDATION FRAME } r INSULATION i FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL r GAS: �ROUGH FINAL _. FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. -�j �I`' ., The Common wealth of Massachusetts Department of Industrial Accidents Office of Investigations s b . 600 Washington,Street Boston,NIA 02111 www,mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Individual):_1'1St 1 Q it 2 a S CA V e Address:_Q110 6--YUJ? 15+ City/State/Zip: 1 ,V p l yy Phone #: C�� 54 `j .-C a"70 U 71am ployer?Check the appropriate box: ---- ployer with l— 4. [] I am a general contractor and I Type of project(required): s(full and/or part-time).* have hired the sub-contractors 6. ❑New construction e proprietor or partner- listed on the attached sheet. [7. Remodeling ship and have no employees These sub-contractors have working for me in any capacity. employees and have.workers' 8' ❑Demolition [No workers' comp. insurance comp. insurance.+ 9. ❑ Building addition 3.❑ required.] 5. [] We are a corporation and its 10.❑Electrical repairs or additions I am a homeowner doing all work officers have exercised their myself. [No workers'comp. right of exemption per MGL I LEI Plumbing repairs or additions insurance required.]t c. 152, §1(4),and we have no 12.❑ Roof repairs employees. [No workers' 13.V Other lYlSLcl1 tjdl comp. insurance required.] *Any applicant that checks 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. *Contractors that check this box must attached an additional shect showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:Lua V C..k T r6;_►vrn vu r ------------ Policy#or Self-ins. Lic.#:-lam` Expiration Date: 1� IT Job Site Address:I 6 3 bebb�e 2� l n City/State/Zip; (Y1C.t,rS�t)y1 an,it e 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$1,500.00 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 andpenalties of perjury that the information provided above is true and correct. Si nature: ��`/� �C/ DEC `� Date: ® 20 1 3 Phone#: '7-(Q-70Lp '- Official use only. 'Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): ]inspector 1.Board of Health 2. Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbin6. Other Contact Person: Phone#: 1GG Q�c����G Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 _ Boston, Massachusetts 02116 Home Improvement Con actor Registration Registration: 166311 Type: DBA. Expiration: 5/11/2014 Tr# 222532 INSULATE 2 SAVE ROLAND LANGEVIN _ _-,.....---------------:---..------..------= 536 EASTERN AVE. FALLRIVER, MA 02723 -- - -- -------— -- _.-- Update Address and return card.Mark reason for change. I_J Address ; Renewal j Employment j_i Lost Card DPS-GA1 0 50M-04/04-G101216 '' ✓fie '°"v"Z°"u`ealC� o�� aac/'c`aet�a License or registration valid for individul'use onl Office of Consumer Affairs&Business Regulation g y =HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1 Registration: 166311 Type: Office of Consumer Affairs and Business Regulation r Expiration: 5/11/2014 DBA 10 Park Plaza-Suite 5170 y Boston,MA 02116 INS'LATE 2 SAVE ROLAND LANGEVIN 536 EASTERN AVE.,. - FALLRIVER,MA 02723 Undersecretary Not valid without signature Massachusetts -Depar-meet or P-+di+c Safety Board of Building Regulations and Standards Construction Supervisor _;tense: CS-103861 ROLAND LAN GEVIN 536 EASTERN AVE. Fall River MA 01723 omr�iss over 08/24/2015 CERTIFICATE OF LIABILITY INSURANCE 712111/13(MMMDIY YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate,holder is an ADDITIONAL INSURED;the policy(ies) must be endorsed: If SUBROGATION IS WAIVED,subject to the terms and conditions ofthe policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen4s);. PRODUCER CONTACT NAME: _ Anthony F. Cordeiro Insurance PHONE (jOB). 677-0407 FAx Ne. (508) 677-0409 171 Pleasant Street Fall River, MA 02721 ADR�Ess: lbrizido:@cordeiroinsurance.com _ _ INSURER(S]AFFORDINGCOVERAGE NAICa! INSURERA-.Atlantic Casualty Ins. Co. _^- _—__ INSURED INSURER B:Torus__peclalty Ins. Co. Insulate 2 Save, Inc. INEuRERc:Great American Ins. Falll River, MA 02720 Grove St. INSURERD:Guard Insurance Group Fal ----- INSURER It:. INSURERF• -- � � COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, .. -INSR _. _ .IADDLf§U8R ................. ....._---.... POLICY EFF PCIJGY EXP....... A ABPEOFINSURANCE -WRPOUCYNUMBER MIDO!YYw M'MfDDryyyY, LIMITS p, GENERAL LIABILITY Y Y M081000174-1 6/12/13 6/12/14 EACHOCCURRENCE S 1,000 00O X COMMERCIAL GENE PAL�LIABILITY OAMAGETORE TE6 _...._._. ._I CLAIMS-MADE I +�J OCCUR P.REMI$E.$.(E2.o:.dS.aefLC) . 1.QQ OOO ME EXP(Anyone person)~_ ..___._.._...._.. --_ PERSONALdADVINJURY $ I OOO OOO GENERAL AGGREGATE $ 2,000,000 _ GENT AGGREGATE LIMITAPP"LIIEESPER -- -i PRODUCTS-COMP/OPAGG $ 2 QOO OOO X POLICY ._-_ PRO ` I LOC _ . AUTOMOBILE LIABILITY EaaMBccrdjr( IN it $ ANYAUTO ALLOWNED SCHEDULED BODILY INJURY(Par person) $ AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED HIREDAUTOS _AUTOS I PROPERTY DAMAGE _ $ ahacciden! _............. _...__.............................._...._. ..._...__... $ B X UMBRELLA LAB AB X OCCUR 78264D131ALI 6/12/13 6/12/14 EACH OCCURRENCEEXCESS $ 2,000,000 _ CLAIMS-MADE I AGGREGATE I S 2,000,OOO DED X. RETENTION S 10,000 D INORKERS COMPENSATION $ AND EMPLOYERS LIABILITY INWC311431 12/10/13 12/10/14 X I WC STATU- OTH- Y I N _...._T.OELY_ill�!TS..._.._ ..E.fZ ANY PROPRIETOR/PARTNER/EXECUT)1/E OFFICERMIEMBER EXCLUDED? N/A El EAOH ACGOENT $_ 500,000 (Mandatory In NH) ifyyes describeunder E.L,DISEASE;EA EMPLOYEE$ _ 500,000 OESf RlPTION OF OPERATIONS below j E.L.DISEASE-POLICY LIMB I$ 500,000 C Equipment Floater IMP 375-99-76-01 6/12113 6/12/14 Shop Storage 75,350 Veh Storage 76,250 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Renerks Schedule,If more space Is requrrd) Proof of Insurance. Residential Insulation Contractor. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS, 200 Main St Hyannis, Ma 02601 AUTHORIZEDREPRESENTATNE I ©1988-2010 ACO CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Phone: Fax: E-Mail: l OWNER AUTHORIZATION FORM A-1 I CO.PY. ' dery (Owner's Name) owner of the property located at (Property Address) / � Gr r t c .ti . 1 /S � 4, (Property Address)�— hereby authorize (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's S re Date ttegu>latory Nerv><ces Hate:t61Z31r oFIHe r� Thomas F. Geiler,Director. 35 y�P�-��°• Fee: Building Division. eaxwsrea[.e, : Tom Perry, Building Commissioner o?O /30 -7 V1 ��� 200 Main Street, Hyannis, MA 0260.1. pIFO �a www.town.barnstable.ma.us 11 LG/� Office: 508-862-4038` Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID:FUEL- STOVE ]PERMIT Owner: Phone:: 2-7 o/ Install at: �` U �'�e L Village: >� 0\CyLfG fY-)L \7- 0 Map/Parcel: D I I D I. - Date:: (G - Z -1 Stove `. A Ne / Used B. ype: �Rkdian /,CirculatingC. Manufactu S p 1L Lab. No. D. Model No:: l l $ ��u c V< C'crr �✓ rr�, Chimney '= A. New x'stin (If existing, please note date of last cleaning 1 U '23- i 13. Flue Size 7 CD C: Are other appliances attached to'FIue? : -Al U D. P -fab Type'and Manufacttrer E Mason LnedlUnlined Hear A. Materials: Gem o�m c B. Sub Floor Construction:' Installer Name: Q f n ef Address x. Phone: Location of Installation: . H.I.0 Registration#: Construction Supervisor# OR check_Homeowner Installing, no license irequir&d t APPLICANTS SIG 'Aj URE APPROVED BY: Please make,Chec Wabe the Town of Barnstable *This.constitutes an of ciol.stove permit after inspection, photographed, and:ap roved by the Building-Inspector O:forms:stove 7e• /1. The;Commonwealth of Massachusetts' Department of Industrial Accidents Office of Investigations 600 Washington Street „ Boston, MA 02111 •� " www.mass. ' v/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers APPUcant Information " Please Print Legibly Name(Business/Organization/Individual): &!. , 0 r j,r, Address: City/State/Zip:mo�- M`L ,ino oz 64➢ Phone.#: SC��'• Z.7`y y,,5�1 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with .4.. 1 am'a general contractor and I employees(full and/or part-time).*. have hired the sub-contractors 6. Q New construction 2. I am a sole proprietor or partner listed on the"attached sheet. '7..Q"Remodeling These sub-contractors have .ship and have no employees 8, Demolition '. workingfor me in an capacity. employees and have workers' Y P ty� � 9. ❑Building addition - (No workers'•comp.-insurance comp.insurance.required-] 5. 10:We are a corporation and its []Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their. 11-[]Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL, 12: Roof repairs insurance required.]1 c. 152,§1(4),and we have,no } J employees.'[No workers' 13. Other(/✓OU GJ�LI i1��1 I Comp.insurance regtred J *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infomration. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractor:must submit new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether of not those entities have employees. if the sub-contractor;have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers',compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/Statelzip: " 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 arimirial penalties of a fine tip to$1,500.00 and/or one-year,imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy;of.this statemetit may be forwarded to the-Office of Investigations of the DIA for insurance coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Sip-nature: Date U _ Phone#: S C) 2 Official use only..Do not write in this area,to be completed by city or town offieiaL ' City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health'2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector. ; 6.Other Contact Percnnr Phnne.#_. x Town of Barnstable Regulatory Services NAB&'1 'a Thomas F.Geiler,Director r 6j9- Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 2 Please Print DATE:. I O-�J--I� JOB LOCATION: O Z LJ(,�Y�i l� Cn _ number street village "HOMEOWNER":-(-$'i V Gr��e(�cn 7y name home phone# work phone#` CURRENT MAILING ADDRESS: 103 D��,ble a)a (I q city/town state zip code The current exemption for``homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or.detached structures accessory to such use and/or farm structures. A person who constructs more than one - home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedure _quirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction-Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot - proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. C:\Users\decollikWppData\Local\Microsoft\Windows\Temporary Internet Files\Content OWook\QRE6ZUBN\EXPRESS.doc Revised 053012 Town of Barnstable Regulatory Services MUMSrssl E' * Thomas F. Geiler,Director s6;q. 0. Building Division Tom Perry,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 as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 6/2012 Parcel.Detail Page 1 of 6 gY 0 S a f v ` �. BAtihST{r61.��w � - 41 Gn + Logged Ln As: Parcel Detail October 23 013 Parcel Lookup Parcel Info Parcel.011-018 ( Developer LOT 105 I D Lot ....... .... Pri{ _-... Location 103 DEBBIES LANE I Frontage 1145 Sec - =- -— - --- - - - -- Sec Road Frontage 1 I Fire Village'COTUIT I I District COTUIT I Town sewer exists at this Road _-.... 0430 address No I Index Asbuilt Septic Scan: y 011018_1 Interactive 011018_2 Map �a, 0110183 w Owner Info Owner IHAMBLIN,THOM H AS &JULIE E ~�1I\ ¢ %ANDERSON, ERIK&NELSON,TARXIM Owner — ........ ..._......... ... .............. _ Street1_52 LAURIES LANE street2 I City IMARSTONS MILLS I State IMA JZip 02648 Country Ir Land Info Acres 0.46 rSin Ie Fam MDL-01 Zoning RF ,0.__ �Use� s ( g! ����Nghbd!o1o5 TopographylBelow Street I Road l,Paved Utilities Gas,septic � � I Location Construction Info Building 1 of 1 Year;1984 I RoofGable/Hip I Ext IW d Shingle Built` Struct Wall Living 12298 I Roof Asph/F Gls/Cmp j I AC'None Area Cover Type Int Bed Style ICape Codes�) Wall Drywall I Rooms i3 B Brooms I Model;Residential I Int Hardwood I Bath 12 Full+1H 'I http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=331 10/23/2013 Parcel Detail Page 3 of 6 IIAM Sales History Line Sale Owner Book/Page Sale Date Price 1 2/8/2002 HAMBLIN, THOMAS H & 14799/160 $0 JULIE E 2 3/11/1983 HAMBLIN, THOMAS HALL 3690/191 $51500 " ANDERSON ERIK.& 3 5/14/2013 ---�---- 27373/4 $335,000 NELSON, TARA M Assessment History Save Building Land Total # Year Value XF Value OB Value Value Parcel Value 1 2013 $186,700 $67,000 $4,200 $109,000 $366,900 2 2012 $1397300 $38,000 $20,900 $109,000 $3071200 3 2011 $176,000 $41900 $19,300 $1097000 $309,200 4 2010 $1751900 $4,900 $20,400 $109,000 $310,200 5 2009 $1741600 $7,200 $12,800 $146,000 $340,600 6 2008 $2037400 $71200 $121500 $1527100 $3751200 8 2007 $2021100 $71200 $121500 $1521100 $3731900 9 2006 $1741800 $7,200 $13,000 $157,200 $352,200 10 2005 $90,000 $0 $131200 $1211400 $2247600 11 2004 $627000 $0 $77900 $851700 $1551600 12 2003 $56,100 $0 $8,100 $40,400 $104,600 13 2002 $561100 $0 $8,100 $401400 $104,600 14 2001 $561100 $0 $81100 $401400 $104,600 15 2000 $461400 .$0 $81400 $21 ,800 $76,600 16 1999 $441000 $2,600 $61700 $211800 $75,100 17 1998 $44,000 $21600 $6,700 $21 ,800 $75,100 18 1997 $481600 $0 $0 $21 ,800 $75,900 19 1996 $487600 $0 $0 $21 ,800 $75,900 20 1995 $48,600 $0 $0 $211800 $75,900 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=331 10/23/2013 �t Town of Barnstable Building Department - 200 Main Street • �� . * Hyannis, MA 02601 b' ate ' (508) 862-4038 FO�A1B Certificate of Occupancy Application Number: 201301343 CO Number: 20130019 Parcel ID: 011018 CO Issue Date: 03106113 Location: 103 DEBBIES LANE Zoning Classification: RESIDENCE F DISTRICT Proposed Use: SINGLE FAMILY HOME Village COTUIT Gen Contractor: PROPERTY OWNER Permit Type: RCOO CERTIFICATE OF OCCUPANCY RES Comments: COMPLETED 11/14185 Building Department Signature Date Signed b re e 79 i 103 Debbies Lane, Cotuit 9/22/2010 ( r mo Tom. 103 Debbies Lane, Cotuit 9/22/2010 Town of Barnstable Permit: < ` Regulatory Services Date: ( KD �Op'ME TO{y Thomas F. Geiler, Director 125- Building Division Fee: • r eaansrastg, Tom Perry, Building Commissioner MASS. g 0.19. 200 Main Street, Hyannis, MA 02601 ArEp �a www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: 40/41/V-S #AA b It� Phone: 50 Install at: T 0 3 %4S � Ia - Village: 9A 5 v t Map/Parcel: ® � Date: 66 //0 Stove A. New Used B. Type: Radiant/Circulating 1 C. Manufactur Lab. No. D. Model No.: Chimney A. New/Existin If existing, please n to date of last cleaning B. Flue tze tt w� m. C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer E. Masonry: Lined/Unlined AUG 2 7 REC'D Hearth A. Materials: //`e B. Sub Floor Construction: W&O Installer Name: Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor# OR check_ Homeowner Installing, no license required APPLICANTS SIGD� U 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 103107 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 4 Please Print Legibly ti Name(Business/Organizatiordlndividual): ZIA Address: Q , /'_e Z,V City/State/Zip:�/ f /k Phone.#: Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner-, listed on the attached sheet. 7.. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp. insurance.$ A�ama e ] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. meowner doing all work officers have exercised.their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks 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 anew affidavit indicating such. Idontractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job 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$1,500.00 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 c u r the pains pen ies of perjury that the information provided ab ve.is ue and correct. Si afore: C Date: Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r 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 legal representatives of a deceased employer,or the receiver or tiustee 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 of on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." i 1 V ' MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." MGL cha ter 152 25C 7 states"Neither the commonwealth nor any of its political subdivisions shall . Additionally, P .� § ( ) 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, it necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(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 permitilicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: } ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia o r Town of Barnstable ZIKE "a Regulatory Services zsrAs Thomas F.Geiler,Director s. 9 MAs � i639. ,� Building Division Ar fpt a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: �//e T JOB LOCATION: /V t'of 1A1, /� '/J'``�r MIS M,l`' number street village HOMEOWNER": Dlrls91jT/aI/✓l�A/ �O 0 `7�t� U V�7 name A home phone# work phone# CURRENT MAILING ADDRESS: ��41-1 t o �46, city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as ,I supervisor. DEFINITION OF HOMEOWNER - Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection.procedures and requirements and that he/she will comply with said procedures and require Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly. when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORM S\homeexempt.DOC �1He r Town of Barnstable Regulatory Services snxM E, AS& Thomas F. Geiler,Director v^ 1639- Building Division Tom Perry,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) Signature of Owner Date Print Name If Propedy Owner is applying for permit.please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS:OWNERPERMISSION r7-7 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 1 °tom7'E � �� t# 2q�r�. ING L q`�� '� �7���.LED IN G®9�p �. _ P Health Division ,�'�,� .9yed l�-i y E �6i TITLE 5 Conservation Division IZ��i��� e�'�ffs�E l'AL C. W, .� i�a 6 • �a�c"�f� I���L��a��.^ Tax Collector Treasurer� GyZr�� .. . _ � Planning Dept. r Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address _l 0h(.e Village Owner as #—AM 19/,Az Address � ��4 S N Telephonea� Permit Request A*77'I`0A—) «/-) -50 0TX Ai 0) lffqa e �0 (f0A,N-e0-7- &V57_R 7_0 G Square feet: 1st floor: existing �Q proposed'// 2nd floor:existing proposed Total new Z16T) Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family �, Two Family ❑ Multi-Family(#units) Age of Existing Structure r Historic House: ❑Yes *o On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl [['Walkout ❑Other Basement Finished Area(sq.ft.) Y3 U Basement Unfinished Area(sq.ft) , NFU Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new_ First Floor Room Count Heat Type and Fuel ❑Gas /ilu Electric ❑Other Central Air: ❑Yes . ❑No Fireplaces: Existing New Existing wood/coal stove: s ❑No Detached garage:X.existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size" Attached garage:❑existing new size ;00 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use �v ~' BUILDER INFORMATION Name �!'� /t /, Telephone Number ,/ ! i Address 0 b �.S (AJ License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE r FOR OFFICIAL USE ONLY q ' PERMIT NO. � y DATE ISSUED MAP/PARCEL NO. - " Ar t ADDRESS a VILLAGE �. OWNER — K .j DATEAF INSPECTION: t ^ FOUNDATION /j � FRAME : r INSULATION z FIREPLACE " r' t ELECTRICAL: ROUGH FINAL E PLUMBING:s r3 ROUGH FINAL GAS: - .ROUGH FINAL ' FINAL BUILDING, DATE CLOSED OUT e 4 t ASSOCIATION PLAN NO. F Assessor's map and lot number A .......?......w........... J %THE..... Sewage Permit number .... 3�.�� '?.....!!' �.{ .............. w`�P ♦� '°' Z BARNSTABLE i House number ............... 25.........`.................................. �o MAsa p 163q. \0� TOWN OF-.BARNST•ABLE BUILDING INSPECTOR _ �� � 4i APPLICATION FOR PERMIT TO ..................................�...._...... ..:................................f...........................:.......... TYPEOF CONSTRUCTION .............................. -............................................................................. .... . .19. ..� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies appli}ems +for a permit according to the following information:f Location ..... ....!rC r� fi'1 f.e � ......f i �:...., ./.�1re�]....1". .. /I/.... ..... .!: .':':�.:.....�0 .:/..65 ................. ....................................Proposed Use r l .a- ..... .. p ............... *.�.-.�' Zoning District ..................... f........................................Fire District .......`^.�7,—i�.t...N.............................................. Name of Owner h... .: '.l�.......�M )9-jy,L„MAddress ...........................................................::..1..................... Nameof Builder ....................................................................Address ................................................................ .............. Name of Architect ..................................................................Address ...................................... ....... .... Number of Rooms .....................9:,l!?.....................................Foundation ......... .....C� 7�,flG� . Exterior .......... ........... ...^'.................................................Roofing .................... Floors ........... 7� f(� r.�n. ..............................lnteriort..............c ?;/( .. 17) Heating ................................... :.........v... ..................... .Plumbing ...... ...... ......` ........................ Fireplace .............W .�,. .......................................Approximate. Cost........... ................................ Definitive Plan Approved by Planning Board _____ 1�____._19_2 1__. Area l f ............. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT 'TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS fi A ,7,4 _ I hereby agree to conform to all the' Rules and Regulations of the Town of Barnstable regarding the above construction. r Name !......... ... �.. ?! � : Construction Supervisor's license /�`C!°°" �e HAMBLIN, THOMAS A=11-18 No .... Permit for ...One...S:�Y......... Single Family Dwll ' ........................................... e .............iTlg............... Location ........10. .3...D.eb.b.i.e. .5....Lare Marstons Mills ............................................................................... Owner ......T.hom.as....H a.mb l.i n,--�....................... ....... .. . .... ....... ....... Type of Construction ...... ....................... .............................................................. ................. Plot ............................ Lot ................................ Dec. 28. ...........19 83 Permit Granted ...................:......... Date of Inspection ....................................19 Date Completed ....................19 Oro Assessor's office(1st Floor): _ S'EPM0p � " I Assessor's map and lot number �S INST Board of Health(3rd floor): Sewage Permit number Engineering n ineerin9 Department(3rd floor) : Huse number � - OWN REG � ®� Definitive Plan Approved by Planning Board 19 c raY APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING . INSPECTOR APPLICATION FOR PERMIT TO L U�L1� /T/� -- 4DI D Do Rfi?- Q TYPE OF CONSTRUCTION 19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location j '✓ A4 11-5Q Proposed Use ©� /vaLE— Zoning District Fire District �`ys Name of Owner / Address��� L� �ZS AlI' Name of Builder / Address > / Name of Architect AddressNumber of of Rooms z Foundation � I L Exterior � LDS Roofing z�J���L/ Floors Interior Heating Plumbing Fireplace _ Approximate Cost %. Area O G. Diagram of Feed I .3q " J Ea y - OCCUPANCY'PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to confomm to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's Licensee HAMBLIN, THOMAS ` No 3 2 9 3 0 Permit For BUILD GARAGE_ ADD ' DORMER Single Family Dwelling I Location 103 Debbies Lane Owner- Thomas Hamblin , r r. Frame Type of Construction # w Plot Lot y ;- Permit Granted May 26 , 19 89 Date of Inspection 19 t i t Date Completed 19 F P2 I °t�s. i� DEB81ES LAIVU -- r LO T"1105 20,000W t r NETLAND LOT#lO6 � i 340 \ LOT-'l04 J i 41 135,00':t rA 8.3 2/2 1 T'/F/&-D ADZ.OT F A.AiV PREPAPED FOR: TOM 14AMSL IIV L ocq•rio.v• MARS TONS MILLS, MA. aFarc -4eEFEAecAvcE: LOT 10S PLAIV Ek 272 PC 92 _ �,/E,eEeY CE�CT/FY TN�iT THE BCJ/LD/�t./�r SHON/Av OAV Tf,//S AoL/ciAV /S LOGgTEa OA./ TLIE AS 3NOWA/ NE,eBo.V A4Ava TNgT /T Z>o�S 4C4D.v/0'otn f T+D rN.� zo.vi.vG BY-1-,oQW6 Oo- rA/E 7bWA/ OF �%��%V5'TA � 4` -. Sfr . �'yi� I •o ARNE H. -{ WALA 9 9 , ' 425348 G/�//G. e,vG/AvEBCs ° l i Lq,vD St/eV6Yo�� /2 819.3 ,20 uTE Gq^-Y�7.eMOUTs�, Mg53, aATt �e4. C e�Yoe DZ`B 1ES L.14M1 7 OF 364,98' 145, 40' f LOT 4105 20,OOOW t r NETLAA/0 nRip, ss t 4$ { o ZoUn/o4T/piY N ar . LOTS/06 � �40 �° LOT-"104 J 41 / of pIR �d`C R-200, 00, 93 2/2 CZ-A.P. 004 dT A.L AN PREPARED FOR; TA4 HAA48L IIV ,c OcgTiOw: MARSTOIVS MILLS, MA. SG�4L E- : 1'_3' a,c:i7'C: " 3 ,,eEFE,ecvcE: LOT 105 PLA/V BK. 272 PC 92 � 4 ._ ,NEeEBy CEGT/FY TNF�iT Ti�./E BGJ/LD/.c/�i SHON/.V p.V Ts-I/S PL AN /S LOCATEa OA/ THE yBov,VD QS 3NO N/.V NEd'E4M.1• 40"D TNgT /T �G7F5 GO.VFOG/N TO T/•i'AC- - OC) - ��1N OF �y4 \ BY-LAWS O.� T/,/E 710WA/ OF .�A�N STI�_ AL� ^1"C-.V G0A1S T,E'G/C TE Z% I G ARNE J wn c-s�ae er�9in�eerir�9 ()!ALA 6 Nl — ——— gS .2oc/TE GA^-Y�.�Yv10UTi�-�, M�i55. aArr es4. �e��e Assessor's map and lot number......... ............... *TNE SEPTIC -0yo" S4wa-ge Permit number ............................. ...... .....NS"AALLED IN CC". WiTN TlY' House number .............. ........................................... MRONIMENIA�L� NAG& TOWN TOWN OF BARNSTABLE. BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........................................ ..... ... . .. ......... ...................................... TYPEOF CONSTRUCTION ........... ...................... 607PL.............................................................................. ......................... 19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..... 0 .7. ....... A ........ ..................-...9 kF xProposed Use ....... ............................................................................................................................. Zoning District ................. ..........................................Fire District ....... r..................................... ..... Name of Owner ... .—...... s.....1�m,e�b/-'z..?VAciclress .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ............................................ .......................... S ....................... . .......1? -.1 Number of Rooms ..................... ..............Foundation ........... ....... .............. .... .. Exierior ...................... ..................................................Roofing ..................... . ... ............................................ Floors ............../../...........7AP.n.Y1.6...................................Interior ............... ... ... .... .................................. ................................................Heating. .................. 4. Plumbing ..................... ............................. Fireplace ............ une ............................................Approximate Cost ............ ................................. .......... Definitive Plan Approved by Planning Board -------19-21- Area .... . .............. Diagram of Lot and Building with Dimensions Fee ... ......... ......... ......... SUBJECT TO APPROVAL OF BOARD OF HEALTH cob /,5;,5 6,/V" --OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS A I hereby agree to conform to all the Rules and Regulations of the Town 4ornstable; regarding the a ove construction.* / A Name . . ..... .......... ... ........ ,A. . ......... Construction Supervisor's License ........ mad HAMBLIN, THOMASI 2�92.3:° Permit for ...One StorX......... - ,�lo ..,,., ... ti � . • Sin le Family Dwelling ' Location Lot 105 10 3 Debbie s,,,Lane Marstons Mills , Owner Thomas. Hamblin = i Type,of Construction ...Fra?Me.......................... , J .......................................................................... + �� ♦y .l - Plot ....................... Lot ............................... ='Dec. -2 , Permit Granted .. 8,......................................19 83 Date of Inspection ....................................19 r Date Completed '.11?................AJ 9 ry r y u, °F IME y ~°� The Town of Barnstable BMMSTABIZ M Q Department of Health Safety and Environmental Services TED M0'�s Building Division 367 Main Street,Hyannis MA 02601 I Office: 508-862-4038 Ralph Crossen 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. Estimated Cost Type of Work: n Address of Work:x®� '/-eM C S_ /,4j --mi s 7-ows -/�it�l S Owner's Name: astl Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Bui not owner-occupied ka6w_ ner 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: e Date Contractor Name Registration No. R1 Date Owner's Name glorms:Affidav 759 . Tabla.lSiib(eoadaoad) Prrsaiptire Padragd for doe and Two-Faa aY RaidweW Baildinp flood with F009 Faeia MAXIMUM MBVIM 1H Walt Floor 130== Mail Ne:aiaB�Coolia8 Altai U-vaiae: Rrvahwl Rrvaim'. Rrvduer wall Paimm Fma=yl 1padm Rrvdnar a vwwl 5701 to 6500 HeariaR Draw DAW Q 12%. 0,40 31 13 19 10 6 Normal R 12% 032 30 19 19 10 6 Normal S 12r% a 50 31 13 19 10 6 13 AFUE T H-3% s% U6 31 13 23 WA WA Now U 0A6 31 19 19 10 6 Normal y logo viA 25 AFUE Avis a Isis Lu 30 19 19 10 - 6 1S AFUE x 1S'/. an 31 13 2s wA wA Normal T IV/. 0.42 31 19 25 WA WA Normal Z IVA 0.42 31 13 19 10 6 "ARM AA Ir/. (LSD 30 19 19 10 90Al'EUYE � l 1. ADDRESS F PROPERTY: D (JC fly 2. SQUARE FOOTAG OF ALL EX'I 0 WALLS: 3. SQUARE FOOTAGE 0 ALL G G: 4. %GLAZING AREA(#3 D BY#2): 3. SELECT PACKAGE(Q— -see chart above): NOTE: OTHER M INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AV BLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-R980303a r _ The Commonwealth of Massachusetts . Department of Industrial Accidents w. _ 600 Washington Sheet Boston,Mass. 02111 Workers' Compensation Insurance davit , P name: location citv f_✓P( S Zd� 0,44c(`l phone# I am a homeowner.performing all work myself. ❑ I am a sole moprietor and have no one worldng in arry capacity ''/////%//%%%%�%/%/%%%/0,%/%O//.O//,%////%%%%//%//////////////////'/�D%///%//////%% %%/%//%%/%%/%%///O%/%%%//J///l///////////////%//O/%%///%%/////////%//%///%//��/////�//%%/%/�/%/%//��, I am an em 1 providing workers' compensation for my employees working on this job.: .......... ...... ::::;{;............... .:::::::::::::::.:::.::::.::.:..:.:.::..::......::.:...:::.. .. tom snv name:. ,. :.;.:. ,.•' fin ddre s a ... 'ham ::::.:::;..?::.:.:.;... ::::.:. ...... ........... p q — :...::... ................:.::..:.:.::::..::::.::.:::::::::.:.:::.:: - 3i i i:ii i i s .;..;.;;:�;?;:?; of L;v#. . .. .........:....:... •:: :;:><>i:ii:.•::;?;:'<'i:JS:•«::;:;:;>::;.: insurance co.: ::::..,.., :::.:...:.:... i ❑ I am a sole proprietor,general contractor, r homeowner ' cle one)and have hired the contractors listed below who have the following workers' compensation polices: ...................................:...:::::::::::::::::.:::::::::::.:::::::.;:{.:::...... xx con anv nam dre s s :;:' :: ::....:::::..::.::.:. ad ....................... :.?x... one .... ::::{.:...:........:......:::.....:. tv �h ......::.:................:.....................v:: .. ..................... ........................ .................v::.v v...................• v:::::::::::.v.w.v::::::.:v:.:?{{{4'i ....................... ...:....r............:.::...:v:::.:.. :i ............................... ............... ............: ::::::::..................;................r.:..:......::::.a•::::::rr.v::::::::.v:•::::.v:::::::: - _#i:: i v+:i< f y>::):jtij::ti�i! i�i:+.�..:::..,.....::.::. :•.:,.:_:' ::: ^1?:::+:: c anwname ::x. address: ....................... ............... phone titP ................ ... ...........:...........................................:..................................................:...........:........................... ....................,................: Failure to secure coverage as required under Section 25A of MGL 152 can had to the imposition of criminal penalties of a sae up to$1,500.00 and/or one years'imprisonment as wen 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 veriseation. I do hereby certify under a pains and Pen o edury that the information provided above is trw and tarred signature Date . Print name a M 7/� �/'t��✓/N Phone# oincial use only do not write in this area to be completed by city or town oindal city or town• permit/license 0 (]Building Department QLicensimg Board ❑checkif immediate response is required ❑selectmen's Oslce Medth Department contact person. phone#; ~ ❑emu'—_;_ (Jevaed 9/95 PJA) ESTIMATED PROJECT COST WORKSHEET r Value LIVING SPACE square feet X$55/sq. foot GARAGE (UNFINISHED) _ _square feet X $25/sq. foot= a�0 00 PORCH square feet X $20/sq. foot= DECK square feet X$15/sq. foot= 3 Co©4 OTHER square feet X$??/sq. foot= Total Estimated Project Cost (o K 940 O g990915b • r y �.. L0T a/05 f• ~- �UNOAT/n,�/ N �) 3¢0, L O I t^ •`�'..;,o � ./OF - '�*• Cl t / I 2/2 P.L.AA.1 PRePAPED FDP; TC) & J�f L ocATib.v� M4fiP\S TONS M/L%S, M4. aATC: -2 -63 �eEFE,eC.vcEa L0T l05 PLAN Sk 272 PG 92 X /-/E,eEBY CI=A-- Y TNOgT T.NE S<-/4C:5kVA-1 O.V Ti-//S PLAN /S LOCATED O.t/ 42oc%VD .9S 3NOW.�/ "OAVC=OA/ AAdD TNgT /T , DG7�5 COA/F'OGA✓! TO Tf•/E- ZOA//.t/grr i' \ BY-L.4/NS O.c r.�•/E 7-0WA.1 0,=* 4,1u ARNE wry cep �n9ineerir�c� �.J.At.P. i n?ui4� t MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 12-7-1999 DATE OF PLANS: 12/7/99 TITLE: PROJECT INFORMATION: TOM HAMBLIN 103 DEBBIES LN COMPLIANCE: PASSES Required UA = 251 Your Home = 251 '7. . Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 1100 30.0 0:0 39 WALLS: Wood Frame, 16" O.C. 1162 11.0 0.0 104 GLAZING: Windows or Doors 86 0.320 28 DOORS 80 0.350 28 FLOORS: Over Unconditioned Space 1100 19.0 52 ------------------------------------------------------------------------------ COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, _and .other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of .the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4 . . Builder/Designer Date },,; x Ly r - MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 _. . DATE: 12-7-1999 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: 0.32 For windows without labeled U-values, describe features # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location ' .`.., DOORS [ ] 1. U-value: 0.35 Comments/Location FLOORS: [e) 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, - and all other such openings in the building envelope that are sources .of air leakage must be sealed. Recessed__ lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ] Materials and equipment must be identified so that compliance .can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be [ provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. . DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. ..,, , ,. i Pressure-sensitive tape may be used for fibrous ducts. The HVAC , system must provide a means for balancing air and water systems. r 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 .co. oling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified . in sections 780CMR 1310 and J4 .4. MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- SMOKE DETECTORS O.K. s� z5 ( - � LDIWG DEFT. W a<(t (N�r) dy - << ► 7 1 i 1 bvm S69t0ltl A: D T/41-1 Q C. d4T AN I Ti LA ,k O-C dy xia ten3e,)- S7 j VI 7 A r 8'` - � a . . J iz) r l