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0140 DEVON LANE
r -. i t'` C. .. r i � ` ! /' i r r � t � � � ,. . r-.''�, ,. �y K (T ��r-" - � , ��^ �� J% y� I w c ��"fi ,. �. L - . DA G � 4 T JP•. f. � W� `�r� LY C. r .3 .... {i ., ep v� ��. a.�,v 1i � fJ'�. �}7 y J �' 3^., 4 t Q �`.. U - t r - ; "i TOWN OF BARNSTABLE Builng 'd tHE tpw 201201631 • * BARNSTABLE, * Issue Date: 03/28/12 Permit 9 MASS 1639• Applicant: NIALL HOPKINS BUILDERS INC. . Permit Number: B 20120662 Proposed Use: SINGLE FAMILY HOME Expiration Date: 09/25/12 Location 140 DEVON LANE Zoning District RF Permit Type: RESIDENTIAL INSULATION Map Parcel 040132 Permit Fee$ 35.00 Contractor NIALL HOPKINS BUILDERS INC. Village COTUIT App Fee$ 50.00 License Num 84916 Est Construction Cost$ 1,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND WEATHERIZATION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: CANNISTRARO,DAVID R&DIANE M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 20409 MARBLEHEAD INSPECTION HAS BEEN MADE. CORNELIUS,NC 28031 Application Entered by: RM Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY.:ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,.EITHE ARARILIOR.PERMANENTLY -'ENCROACHMENTS ON.PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE fURISDICTION.' STREET ALLEY S AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINEDFROM THE DEPARTMENT OF PUBLIC WORKS;THE ISSUANCE OF THIS PERMIT DOES NOT RELEA HE LIC FROM.THE CONDITIONS OFANY APPLICABLE SUBDIVISION ,^ - RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTR ION ORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROA L V BEFO RST FLUE LINING IS INSTALLED. ' 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETE P OR FRA E INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY AT 5. INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE UIRE 0 ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL T P S APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL VOID I CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE-PERMIT IS ISSUED OTE ABOVE. PERSONS CONTRACTING WITH UNREGIST CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map, Parcel Applicatio n#�f'c� � Health Division Date Issued 3 hdl y Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address LC� Dcvd LA Village_ t Owner D-M L-0 rRIF766 Address Telephone ( ,'Permit Request f N§ Clo 106 NO Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ,Project Valuation 05) Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other , ,, --i Basement Finished Area (sq.ft.) Basement Unfinished Area (sgzA =- Number of Baths: Full: existing new Half: existing , new Number of Bedrooms: existing _new a. Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other r Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes LINO 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) r _ . .Name �'/ C7�L�� Telephone Number ,Address t V D (7C--iC License # Home Improvement Contractor# r Email Worker's Compensation # ALL CONSTRUCTION DEBRI RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE TM I FOR OFFICIAL USE ONLY � _ 7 APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME R `� INSULATION S FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING o Rd i0,ILy DACLOSED OUT A5-S.OQATION PLAN NO: The Ctmtrrt©nwed&a,�'.bfassac-hzmd r Aqp m a of-firdmftidAccidentr tea tkgafaFr�rs 6#0 Washingtor::SWre£ wnw.raa=gotldfa Warkers' Compensaf unInsm-anceAffidauit Binders/ContractorsMec ricmns/Humbers Ate I s** rio�armatian 'lease Prm �ibbv �N•am SAS[/ 1 P Fa a - lre-ss-- c--y t(,t �A w e (� cityfSfatzr p: (�"rL) i Phone g7 � Z Are iron an employer?Checktw appropriate bo= Type of project(regaired}- I❑ I am a employer witfi 04. ❑ I am s dal coatcactor and I Io r€nll auxl/or * `l' havehired-the sub-confracfiors. 6- ❑New � Yew{ part�ume). 7_ Rr�Iode3i.� 2.❑ lam a sole propfietor orpartner- listed an the attached sheet', ❑ g ship and have no employees These mib-contractors have 9- ❑Demolifiba worms formeiaany � and havewou s' ❑Euddmgaddition [No tours'COGQ P.insx-ante Comp-mcnyrarm revire(L] 5. ❑ We ate a corvorafiaaand its 10:❑Electrical repairs or additions 3 I am a homeauuer doing all wotic oMu-.ets have exercised their 11-.0 Fhtmbing repairs or additions myself:[No gr kers'comp- ofesemptioaperl�tfGL 12.0 Roof repairs fi=aranre reed.]T c-157,§1(#),andwe,have no, employees [Nowodm& 13�4thu comp-insatance regmreAl '��S��LCa7[t�Chohc�L�r`L IIIOSt 8IS0 IIIO�Y�£S4Lh[7R hL`1tJSYShnveia�dleff'WODiCe15�COII'.prv^cafi na PQ�• {m.. ViIIelS�fhD Sg t�15 JTff7dI4IC IDd"ILSt 8LE dnmg gIItrodC sa�ifiea hlte CbIIts;tIe Ca�Ctn[SEms#Subt*fi new affidasst infrimfinv rnr?! TCbuhmcmrsf3xtCSeck1hisb=mrEstattachednCiddtho 41 shed slb -thPnamea fftemb-c tandstateuhetfiernr=tfmMt bave thl--tA- 'Comp.130Rgn—b- I am an emp£ayex thous prmiding ttrorkem'congm7L rdian insurance for rny emgTnyegs Belau is the policy and job sits informadom IUSt- =ce CompagyName: FohcytgarSelf-ins Lir-k FxptrationDate: Job Site Addxess- Cufy/StatxlZtp- Attach a copy of the wGrkers'compensation policy declaration page(show.mi g the policy number avid expiration date). Failure Ua secure coverage as retlairedunder Section 25A of MGL c.152 can lead to the imposition of criminal pemd ies of a fine up to S1,500.0D and/or mL-yearimprisoa>zsent,sa well as civil penalties is the form of a STOP WORK ORDER-and a fine of up to,$250-00 a day against the violator. Be advised that a edgy of Obis statement ma r be fortuarded to the Office of Iuvestigations of the MA for insorance coverage vetCffCatiorL Ida ihe ' s uttdparunlfies a�`�xrp thetthg ut,fot�a#rern jarmubrd chat* is brae anr£.aarrscE . Bate: Z Q, khd use miry. E�a not trrifir in tTds area,to ba campL-W by chiv at town offieiaL City or Town: Pt;rm:tUceuse LE hws AnthGnty(circle one)e: L Bomd of Health 2.Buffdmg Ilepartraent I CUyIFawn Clerk 4EIectiical Inspector S.Plumbmghupecfor 6,Other con fact Person: Phone 9-- 6 Laformation and fnstruct.ons Massachusetts General Laws chapter 152 regoires all employers to provide workers'compensation for their employees. Puasoantto this statute,an employee is defined as u-_-every person in the service of another under any contract ofhire, express or implied,oral or writ bmL" 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 shdR not because of such employment be deemed to be an employer." MGL chapter 152, §25C(t7 also states that"every slate or Iocal licensing agency shaIlwithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who"has not produced acceptable evidence of compliance with the insurance.coverage required..' Additionally,MGL chapter 152, §25C(7)stains"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-coatractor(s)name(s),address(es)and phone number(s)along with their certificatc(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are notre paired to carry workers'compensation insurance. If ao.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 eoverage.- Also be sure to sign and date the affidavit. The affidavit should be retzmmed to the.city ortown 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 nunber 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 pennitlfieease number which will be used as a reference number- In addition:an applicant that must submit multiple pm it'lieense applications in any given year,need only submit one affidavit indicating current policy information(ifneeessary)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 (Le,a dog license or permit to bum leaves etc.)said person is NOT requited to complete this affidavit The Office of Investigations would hlce to thank you izn 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 CDm1aQ.aWWtbL of Massach=tts Depaitca mt of 1nclusftjal Aonidwts Mce of kvew t ins 600 WaAmaton stp=A BGSt .,MA 02111 Tel.A 617'27-4905 at 4-06 or 1-9 I� SAFE Revised 4-24-07 Fax#617` 27- 49 xaus gov1dia Town of Barnstable Regulatory Services pG Tok� Richard V.Scab,Interim Director _ Building.Division I R.R ASS. , Tom Perry,Building Commissioner s63% ��� 200 Main Street, Hyannis,MA 02601 E° www.town.barnstable.ma.us Office: 508-862-4038 Fax- 508-790-6250 HOMEOWNER LICENSE ExEMPTION _ "Q Please Print DATE: . .v+ JOB.LOCATTIOiq - <<fd -60!/ n tAN,!F• 0-d-rO 0 l number street village name ll home�phone# work phone# CURRENT MAILING ADDRESS: city/town state zap 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. , nude ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro e e req ents and that he/she will comply with said procedures and requirements. afore of mcowner Appioval 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 EIE&IP'ITON 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 super-Mor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This Iack 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. « ti�nmr.rr r_ntcnn�rtnt. .7:......e....:+iG.....AVYMVIRV hurt - - Town of Barnstable Re ato Services M& $ -Richard V.Scali Interim Director 16 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 r Property Owner.Must Iete.and Sign This Sec ' n Usige A Builder I, Owner of the subject property hexeby authorize to act on my bebal� in all matters relative to work authorized by budding permit /o ' ss of Job) **Pool fences the responsibility of the applicant. Pools are not to be fibefore fence is installed and all final inspections are accepted. Signature of Owner Signatnme of Applicant t i Print Name Print Name Date ME ME MEN 0 No Emom 0 MEN ---M Room EMMEME MMOMEMEMMENMEMMEMMME MEN 0 Emm MEMNON MMMNEMMMMMMMMMMMMMMM MEN 0 M EMOME 0 MMMIMMMMMMMNMMMMMMMM MEMO 0 EMMEEME No MEEMENMENEMEMMEN MEMO MEMEMMEMEM No MOMEMOMMEMM so MMMMMMMMMMMMMMNMMMM 0 RMEMEMEMEME M EMOMEMMEMMIMIMMOMEME ON MEEMMEMMEMEMM mommoommmommommomon mom MEMNSIMEMOMME EMEMENMEMEMEMEEMMIS momMM ONE NOON NONE MEMMEMOMMEMMMOMMEMN mom MEMO No MEMMMMEMEMEMEMMEMME 0 MEMO 0 NONE MMEMENMEMMOMMMEEMME 0 ENE NONE MENN MEMMEMMEMENEEMMEMME MEN mom NONE MESON MOMMEMMEMOMME MOMM-- NONE EMEMMEMME ME MEMMOMEMEMEMMEMME ON 0 NONE M 0 0 MEMEMEMEMEMEMEMOM MEMO 0 No MMMMMMNMNMMMMEMMM mom MMEMEMMEMMEMMEMMEM ENO 0 0 M MEMENEMEMEMMEMEMME MEN M ommoommommommommon No 0 ON MEMOMMENNOMMOMMMEM ME 0 0 ommommommoommoommo so 0 ONE M NOMMEMMOMMEEMMEMNE mom 0 EMOMEMMENEMEMMEMME MEN ENEMEMENMEMENEEMOM mom ONE EMMOMEME 0 MEMMEEMMMEMM NOON mom MOMMMMEMMMEM EMEMEMEMMEM loom MENEM OMEN mommmom 0 moommomommom mom mom NONE MEMNON MOMEM MEMNON ME 0 NONE NEON MENNOME NEON MEEMEMMEME NEON NEON MENOMONEE MEMMEMENEMMEEMMEME OEM MEMNON sommomom No EMEMEMEEMEMME mom MENEM No ONEMENOMMEMONE MENEM MOMME M No moommommommoom MEN No mmmr%m%qmm mom MEMNON OMEN ENE No No ENMME0 MOMEMEMMEM EMEMEM .ME 0 0 No MONO mom MEMNON No MENEM NONE NONE M No No mom I MEMMEMEMMEMMM NEMEMEMMEM NONE moommommomm MOMMMOMEMMEME MEMMEMEMME MESIMEMMEMEM 0 MEEMMEME 0 ONE NOON MEN sommommommomommomom NEON NEON MEMMEMOM No MEMENMEMEMMEM NEON No EMOMMESIMEMMEME No MEMMEMEMENMEM ENOS No mMMMMMMMMMMMmMmMMMM MEMMEMEMOMMEM ENOS M ON MENOMONEE • I V � � 1 ' 1 1 E ot > i I 1 ti f 1 , ' I j.. MEMO ON MEEMEME 0 NONSENSE ME' MENNEN ON ISO ���� ■ f ME RIME ME soMM No ������� NEON EM 0 No ME MEN 0 ME 1 SEEM ■off M MEN MOM 1E1 ME ! N IMMEMEM ���� �■ ON ME � ESE ■00 '0 MOON MEN MIMM� SEE _ mom 0 MOM ME MEMOMME, 0 loom No ONE MEMMEMEM _ SEE 0ME MEMEMEMEMEMEMEM mom mom � � MMM 0 ON 0 � ■O =1111IMMEM ME MOMMOMMENE EM ■m�� M ME 0111111111![MW 0 mmmm Ill EMMOMMEME NEON MEMEMEMEMEM No MEN MENNEN MEMEMOMMEMEME mm Ill MEMO ON EMMEMMEMEMMENOWN 0 MENEM MEN MEMNON ME MEMEMMEMMEMEMEMMEM MMMMMMMMMMMMM MEMEMEMEMEM MEMEMMEEMEME NONE NO MENEM 00 MEMMOMMEMOMEMEM ME MOMMOMMEMEN ME mill NO ONE MEMMUMMEMEMMOOMME ME MMMMMMMMMMMMMMMMMM OMNI M= MOMMOMME MENOMMEMME MMNMMMMMMMNMMMMEMMM NEI MENEM i MMMMMMMMMMM=MMMMMM=MM=mMmI imommom No - omm Il - ME 0 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ' l�_- Parcel Application # ���l Health Division Date Issued Conservation Division Application Fee Q Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address o. Village Owner rvo, G tvtrr Address NO oeUu) to- u Telephone rO q 4 0� 95465 Permit Request A_ seaurb Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project ValuatiJ Iwo Construction Type Lot Size Grandfathered: ❑Yes /dNo If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes .14�O On Old King's Highway: ❑Yes ,2rNo 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_ Af%ched 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 Lff�)I f)C Telephone Number (J T�qq qqo Address l A(W License # 131 Home Improvement Contractor# Worker's Compensation # �� 4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO [ T� SIGNATURE DATE LIU i 1 � 1 FOR OFFICIAL USE ONLY LICATION# DATE ISSUED 1 I MAP/PARCEL NO. ADDRESS VILLAGE . OWNER DATE OF INSPECTION: ' r FOUNDATION FRAME INSULATION FIREPLACE ` ELECTRICAL: ROUGH - FINAL ' a t PLUMBING: ROUGH FINAL GAS: ROUGH FINAL,: FINAL BUILDING t { DATE CLOSED OUT ASSOCIATION PLAN NO. J f• The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invesdgations UV600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/organization&dividual):L L I^s 1�t "A I u{:'� li D r Address: `' $ i.j_er {'�'a M1� rC ` 6., tom?.--, `�,"'q�4 �:9 _ -1 1 A Ci /State/Zip: -�'' t. � � ,Phone#: � Are you an employer?Check the appropriate bog: Type of project(required): ieui am a employer with 4. ❑ 1 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 partner- listed on the attached sheet 1 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. e. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' k33'Othera:t _ `ram n F=r: tr"L comp-insurance required.] a b 'Auy applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. ?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 their workers'comp.policy information I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: P'en, kJ Policy#or Self-ins.Lic.#_.dr I U —� Expiration Date: `t 1 .- Job Site Address: 140 ELM (�Q� D City/State/Zip: � Attach a copy of the workers compensation policy declaration page(showing the policy number and explra on 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 msuran verage verification. I do hereby certify under the es nd ofperjury that the information provided abo ,e is t' and correct Signature: Date: Sill Phone M QKkial use o► Virelewi te in this area,to.be completed by city or town ojgWal, City or Town: Permit/Ucense# Issuing Authore): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ^� U CERTIFICATE OF LIABILITY INSURANCE 01/11/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. CONTACT PRODUCER NAME: Mark Sylvia Insurance Agency PHONE 508 28-0440 FAX(AJC.No):508 20-9227 771 Main Street E-MAIL • ADDRESS:mark(a)marksylviainsurance.com Osterville,MA 02655 INSURE S AFFORDING COVERAGE NAIC A INSURER A:Farm Family Casualty Insurance INSURED INSURER B: Niall Hopkins Builders,Inc. INSURER C 118 Lakefiekl Road PO Box 231 INSURER D: South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ��SUBR POLICY NUMBER MPMILDDY EFF MWDD EXP LIMITS LTR A GENERAL LIABILITY 2001 L6275 10/30/2011 10/30/2012 EACH OCCURRENCE _ $ 1,000,000 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 CLAIMS-MADE FxJ OCCUR - MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENLAGGREGATELIMITAPPLIESPER: PRODUCTS-COMPIOPAGG $ 1,000,000 JECT X POLICY PRO LOC * $ A AUTOMOBILE LIABILITY 2001 C53575A 6/25/2011 6/25/2012 E°Ms�lry ErD NGLE OMIT it ANY AUTO BODILY INJURY(Per person) S 1,060,000 ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ 1,000,000 X AUTOS NONO.OWNED PROPERTY DAMAGE $ 1,000,000 HIRED AUTOS AUTOS Per accident A x UMBRELLA LIAB OCCUR TBA 1/11/2012 . 1/11/2013 EACH OCCURRENCE S 1,000,000 EXCESS LIAR CLAIMS-MADE - AGGREGATE $ 1 000 000 g DED=RETENTION S A WORKERS COMPENSATION 2001 W6459 9/8/2011 9/8/2012 1 WCYTATU- x OTH- AND EMPLOYERS'LIABILITY ANY PROPRIETORPARTNEWEXECUTIVE YIN—] I N E.L.EACH ACCIDENT $ 500,000 OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) FE.LDISEASE EASE-EA EMPLOYE S 500,000 ffYas•d—be under -POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD'101,Additional Remarks Schedule,if more space is required) Carpentry,Electrical CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Conservation Services Group THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 40 Washington Street Ste 3000 Westborough,MA 01581 AUTHORIZED REPRESENTATIVE L ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD 8 11:tk�aifiu.cit�-Depat•imcnl 01'pul"lC c:�tci� i3+r}tttl 01 Buildin•�fZe_'ul:triam and`iantf.arct' C�nst=ucticsn upe j"or Lic�rse Licq = CS g4916 NIALL J MOM! sFy BOX 231 so,YARMOUTH;:MA 02664 Expiration: 4rZW3 Try: 1451)4 ,� QtFiee of onsumern irs c� oe won^ License or registration valid:forindividul use:onty ' FiOiV1E IMPROVEMENT CONTRACTOR before the expiration date. Iffound return a R09ittradon 161773. Type: Office of ConsumerAHairsand-Basiness Ala ion, r;y G Expiration h/ZD/2012 Private Corporation IO`Rark Plaza -Suite 5170 $ostuio-_MA' N HOPKINS BUILDERS-ING NIALL HOPKINS 21 G t RUEAN AV E,= -SOUTH YARMOUTH; Undersseret3ry fifotval' without signature _ --- . i -S f . Gy I �. OWNER AUTHORIZATION FORM (Owner's Name) owner ofthe property located at 010 bt -o rl LAVE. (Property Address) (Property Address hereby authorize (Sub ontractor) an authorized subcontractor for RISE Engineering, to act on my behalf.to obtain a building permit and to perform work on my property, lf� Owner's Signature Date 1 i� i t 7 i dS t Town of Barnstable _ gym..-� ^-'-'..- Regulatory Services 1" a"'u''sz"B`'E' Thomas F.Geiler,DirectorI. 1 06 Building Division I�� NOV 2 1 2001 Peter F.DiMatteo,Building Commissioner 367 Main Street, Hyannis,MA 02601 By Office: 508-862-4038 Fax: 508-790-6230 o o I PERMIT# s.S 7 39 5 FEE: $ 2,57 e-a SHED REGISTRATION 120 square feet or less } 140 leu<)n r. Y yiy-S�drS Location of shed(address) Village Property owners name Telephone number 46 r3a Size of Shed Map/Parcel# 7 �vu 1110uer,beA I -, aayl Signature Date Hyannis Main Street Waterfront Historic District? Old Kin 's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:083001 �t Town of Barnstable _ Regulatory Services u[KASM&t.e. Thomas F.Geller,Director 9� .0� � NOV 2 1 20-01 iOlED Na+� Building Division Peter F.DiMatteo,Building Commissioner 367 Main Street, Hyannis,MA 02601 By Office: 508-862-4038 Fax: 508-790-6230 PERMIT# .� 7 39 FEE: $ 2,57 SHED REGISTRATION 120 square feet or less 140 -beur)n l a yy' INI rS�e,rS Location of shed(address) Village �avI� � re.Y-b ag - 9( 9 � Property owner's name Telephone number 10 02- 462 -3,;� Size of Shed Map/Parcel# I�c;.v �vt� I�ou em U eA 1 9 a OW Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A-REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:083001 `�&,/oil 1q t \ LOT 8 49, 500 S. F. ,o?. Lor 7 \ loo, N N 96' '- ��, D6VON LANE / " o Sr — - - - - — — — — — — — tS I (3O.00 wraE DUMASE EA�IT) TOW REFERENCE: 189.00 - ASSESSO09'S MAP 40 PARCEL 192 I 8 69 1B'22 w LOT B m7uSE sI0 1 ► I f3O.00 NME EA LOT PLOT PLAN OF _LAND 'TO THE BEST OF MY KNOwLEDGQ 7w FowwA LOCH TED IN SMOwN av THIS PLAN SS AS IT ACTUALLY E rSTS AAV BARNSTABLE — MASS. THAT rT CaoAIS TO THE rower ar BARNSTABLE ZANSNS REMXA rIONSr RESARDIN6 YARD SETBACKS' �%.�`i of °T s' � PREPARED FOR oA ,XrvE ss, s9 THE Nom N TRUST P.L.S. QA 1>E`./t<AVE ss, s897 SCALE s'�O FT. FLOOD zawE c zAf#D FERREIRA ASSOCIA TES OVOW-AMA ) p_,p�DL QLAWC�ps :,' `.=., ,., • A 5 ;. I I SPRING BARS RD. FALMOUTH—MA. AL -A� 740e" ' Parcel 152- Permit# � Conservation Office(4th floor)(8 30-9:30/1:00,2:00) �lgl ate Issued Q Board of Health(3rd floor)(8:15 -9:30/1:00-4:45) 9 r.2 _F Planning Dept. 1st floor/School Admin. Bldg.) Definitive Plan Approved by Planning B ,ard �� l� 1.9 OWN OF BA STABLE( • _ , i Building Permit Application a ; Project Street Address 'LOT #08 , HOUSE #140, D:EVON LANE', "DEVON CROSSING" 77EV. G07 #d Village ft'RlR MARSTONS MTT,T,S ,Owner DEVON ,REALTY TRUST , Address P.O. BOX 599, MASHPEE, MA Telephone (508 ) 477-0023 ' 6 Permit Request TO CONSTRUC T A NEW SINGLE FAMILY DWELLING., , ! 9 f a a'. .First Floor 1 , 532 i n c-. garage & deck square feet ' Second Floor 864 square feet Estimated Project Cost $ 1X3TONEXON (�S 6caa r— Zoning District RESIDENTIAL Flood Plain "C" Water Protection Lot Size 49 ,500 s. f. Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use RAW/VACANT LAND Proposed Use RESIDENTIAL HOME Construction Type WOOD FRAME, CONCRETE FOUNDATION Commercial Residential X Dwelling Type: Single Family X Two Family Multi-Family Age of Existing Structure NSA Basement Type: Finished Historic House Unfinished X Old King's Highway Number of Baths 2 2 No. of Bedrooms 3 Total Room Count(not including baths) 7' First Floor 4 Heat Type and Fuel FHW BY GAS Central Air . Fireplaces 1 Garage: Detached Other Detached Structures: Pool Attached X Barn None Sheds Other THE NORMAN TRUST Builder Information Name DONALD H. PRIESTLY, TRUSTEE —Telephone Number. (508 ) 477-0023 Address 13 STEEPLE STREET, SUITE 202 License# 001023 - P.P.O. B O X 599 Home Improvement Contractor# 10 7 2 6 3 MAS HP E E, MA 02649 Worker's Compensation# WC 2-31 S-2.2 2 0 9 0-212 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 TOWN DUMP i SIGNATURE DATE TXYMM 0 5/0 8/9 7 fife"BUILDING PERMIT DENIED FORFOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. _ DATE ISSUED I�/PARCEL NO. ' AIDRESS. { VILLAGE OWNER 1 , DATE OF INSPECTION: r FOUNDATION t FRAME INSULATION ''.20 FIREPLACE I l j _ F ELECTRICAL: %ROUGH FINAL ' =, x, PL'UMBINC� �7- f, r FINAL d Ire GAS: FINALca FINALBUILDII�� 1P +« = I « DATE CLOSED OUT ASSOCIATION PLAN NO. g , .• • \ N •t 9 !O LOT 8 49, 500 S. F. „ • Lor !00• H �b DEVON LANE 1 " t - - - - - - - - - - - - (30.00 MIE ZMMASE EASEMENT! t TOW REFERENCE.' ml 1a9.00 ASSESSORS MAP 40 PARCEL 132 S B9 19'22'M LOT B HOUSE 14O ` W.00 WME ZMM46E EASEMENT! � - - - -LOT.9- - - - - - -� E ► PLOT PLAN OF _.LAND 'TO THE BEST OF MY moxEDGQ THE FO[ANDATION LOCATED IN SHOI✓N ON THIS PLAN IS AS IT ACTUALL Y EXISTS AND BARNS TABL E — MASS• THA T IT Cowa4MS TO THE TOdN oF BARl11STABLE Z[vriv6 RS&X A TIONSr REGARDING YARD SETBACKS T PREPARED FOR DA •"E 11, s ��c�� g 4 THE NORMAN TRUS T FLU" IFFNA _ _ _ _ • P.L.S. w9 S59 QA TE yaw -f Z 1997 L SCALE 1'-so FT. 9 p or A ASSO FERREIR CIA TES FLOW ZONE C #"W#- AZARD) D-Am OL/We/ps 131 SPRING BARS RD. FALMOUTH--MA . TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY PARCEL, ID 040 132 GEOBASE ID 38698 ADDRESS 140 DEVON LANE PHONE COVE Y T GIP - LOT 8 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CT PERMIT 27793 DESCRIPTION SINGLE FAMILY DWELLING (PM7.#22966) PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety i ARCHITECTS: and Environmental Services TOTAL FEES: BOND .00 OxI NE CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY t * B RNSTABLE. MASS. 039. FD Mlr►� BUILDING DIIW971ON. j BY DATE ISSUED 12/16/1997 EXPIRATION DATE ti. TOWN OF BARNSTABLE . � BUILDTNG' PERMIT RCEL-i- --O 132 GEOBASE ID 38698 DRESS 140 DEVON LANE PHONE � - ?U4,52 N5 MILLS ZIP- ,rvtA ;OT 8 BLOCK LOT SIZE 'BA DEVELOPMENT 'DISTRICT CT ERMIT 22966 i) SCRT ETION NEW 3 BEDROOM SINGLE FAMILY HOME ,ERMIT TYPE BUILD TITLE NEW RESIDENTIAL BLDG PMT:, _ ONTRACTORS_ PRI ESTY, DONALD H_ Department-of-Health Safety RCHITECTS d and'-Erivironmerital Services �Y 'OTAL FEES: $327.36 _BOND 'T. $.00 ,ONSTRUCTION COSTS $105,600.00 u, 101 SINGLE FAM HOME DETACHED ;1 PRIVATE P y. WNER REAL/PROPERTY, SE Y 639� 1 i DDRESS' 226 MAIN STREETFD A i MIS WAREHAM MA BUILDING DIVI N DATE ISSUED 05/08/1997 EXPIRATION DATE 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 t.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- (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. 0 BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 54 K - l ... ..a (sUvlL= `3'y-= i 1 HEATING INSPECTION'APP1ROVALS-°° ENGINEERING DEPARTMENT s^ 'ZI —81-.�,,.��: �.».�.h�.�. . 2 1:��.I 2—al"7 .BOARD OF HEALTH l � ' OTHEERR:::k / pi' _ TztY'C SITE PLAN REVIEW APPROVAL ;z WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS 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. 6 �'� 3 . ... ... .... .. v.. .. .. .. ... .... .•/ .. ....,:I .v:.,t. ,u::.Y ..__..i.y�1\.'a*,J'..._..ui�'::J_�1_L..::_. vi.L:_i�.-.� TOWN OF BARNSTAPLE a _ - BUILDING PERMIT PARCEL ID 040 132 GEOBASE ID 38698 �- ADDRESS 140 DEVON LANE PHONE Cotuit ZIP LOT 8 BLOCK - — LOT SIZE DBA DEVELOPMENT DISTRICT. CT PERMIT 22966 DESCRIPTION NEW 3 BEDROOM SINGLE '.FAMILY HOME PERMIT TYPE BUILD TITLE NEW RESIDENT IAL BLDG PMT CONTRACTORS: PRIESTY, DONALD H_ D ARCHITECTS: iepartment of Health, Safety ,.....,.,,,Y and Environmental Services TOTAL FEES: $327.36 BOND $.00 pkIm CONSTRUCTION COSTS $105,600.00 101 SINGLE FAM HOME DETACHED 1 PRIVATE P • • HARNBTABU. +*' OWNER REAL/PROPERTY, SE ADDRESS 226 MAIN STREETl WAREHAM MA BUILD `DINT DATE ISSUED 05/08/1997 EXPIRATION DATE 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- (READY TO 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. POSTITH IS -C-ARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS . PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 H, LT OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS 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. To Date Time WHILE YOU WE OUT M of Phone Area Code Number,, Extension TELEPHONED 4LEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL Message �© Operator AMPAD 23-021-200 SETS �j EFFICIENCYe 23-421-400 SETS CARBONLESS Page 17 NASCOR JOIST SPAN TABLES - Inco orating#2 & Better Chords- For use in the United States Only " LOAD ON CENTER NASCOR JOIST SPAN(ft-in) U360 NASCOR JOIST SPAN (ft-in) U480 (PSF) SPACING NJ10 NJ12 NJH10 NJH12 NJ10 NJ12 NJH10 NJH12 LIVE LOAD - 11" 20' 40 16" 15'- 7" 18'- 5" 16'- 11" 20'-2". 14' - 1" 17'-2" 15'-4 18' - 4" DEAD LOAD11 10 24" 13'- 7" 15'.- 1" 13'- 10" 16'- 5" 12'-4" 15'-0" 13'- 5" 16' - 0" LIVE LOAD 12" 40 16" 15'- 7" 17'- 7" 16'- 11" 19' - 3" 14' - 1" 17' -2" 15'-4" 18'- 4" DEAD LOAD 15 24" 12' - 11" 14 -4" 13'- 3" 15' - 5" 12'- 4" 14' -4" 13'- 3" 15 - 5" LIVE LOAD18'..8', i;T- .....3 20' 7" =11' 40 16" 14 - 7" 16' -2" 14' - 11" 17'- 8" 14'- 1" 16' - 2' 14' - 11" 17 - 8" DEAD LOAD • 14' 25 24" 11 - 11" 13' - 2" 12' - 3" 13' - 0" 11' - 11" 13' - 2" 12'- 2" 13 - 0" LIVE LOAD 50 16" 14' - 5" 16'-2" 14'- 11" 17'- 8" 13'- 1" 15'- 11 17 - 0" DEAD LOAD 15 24" 11' - 11" 13 -Y2" 12'- 2" 13'- 0" 11'- 5" 13' -2" w12' 2 13 - 0" LIVE LOAD 12" 1;5' $" 17 .5 1 fi' 0" : 19 14:.'. $" 17 .,.. , 50 16" 13'- 7" 15'- 1" 13'- 10" 16' - 5" 13'- 1" 15' - 1" 13' - 10" 16' - 5" DEAD LOAD ' Zr9 2" ti ;. 25 24" 11'- 1" 12 - 3" 11'- 0" 11'-4" 11' . 1" 12' - 3" 11'-0" 11' -4 LIVE LOAD 1Z" 't3' 11" 15` 3" 14' 3" ;`18' 11" 13' 1" ...5' S:.' 14'•=3" 16' 11 50 16" 12'- 1" 13'-4" 12'- 4" 13'- 5" 12' - 1" 13'-4" 12'-4' 13 - 5" DEAD LOAD 19 2" 11' 0 i2' 2' 10' 11" 11' 2" 0" 12' 2" 10' 45 24" 9'- 10" 10'- 11" 8'- 8' 8'- 11" 9'- 10" 10'- 11 8'- 8" y 8' - 11 NOTES ON SPAN CHARTS: •Permissible spans are based upon the allowable Modulus of Elasticity for SPF.from the 1991 National Design Specification,1994 Uniform Building Code and in accordance with ASTM Standard D5055-92,"Standard Specification for Establishing and Monitoring Structural Capacities of Prefabricated Wood Joists." •Total Load deflection limited to L/240. •Spans are based on simple span conditions and reflect no increase for composite action of decking. •Spans are based on uniform loading conditions only,for any other loading conditions,please refer to pound per lineal foot tables. •Span lengths are based on clear span,from inside of support to inside of support. •Minimum bearing required=1%". See bearing tables for further information. •For end loading of joists,please refer to bearing tables. •For cantilevered areas,please refer to cantilever tables. The HAscoe JOISTS Quiet Type" NJ200 June 1/95 ANASCOR'" -'._„�,�yy..`...,.^r-n•4,;...•'.r,.,,.-,..K-.,w..�.vi.. -. •.ry ti„ra.... •d.' .< r _. � • .-a.-.. •, ... .��.�. +. _ ,.. .r .. r �1HE r � The Town of Barnstable BARNSTABLE. Department of Health Safety and Environmental Services MASS. g 039, .�a'0 Building4Division 367 Main Street,.Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice'` rO Type of Inspection �2 ... Location Permit Number Owner Builder One notice,to remain on jobsite, one notice on file in Building Department. The following items need correcting: - r. I/ / �� �-o .# t •Jr' Ul. N ? -l erl f l �1 t1 A rU a P'.2 O nt rV i� 1 i 7 1 el 1 4 43 4 f '7 ? �f a�1? -t�. .t► fir. r C i `�t� Ili? C� t1 L� ! �r R) (a-j U 1F�(7/L� `tom i rn/!rtcs-.. 't 2 ( N r JO S r 4 r U d N (41+N -t 2S 0 -r 2 )3 Lr 1-1 c.� -!'A�?c.( —CAD r Itil l 0 /. AJPP S r 2 U,, D 14— /v 4 F-- Please call;, 508-790-6227 for`re-nspection. Y Inspected by' �, _ .�.--�----a._- �'� I T`-0 V f, Date KIWI- I e' t f 2 C�4�v t -J4 ( If 4Roc r )5 ISSUED THROUGH A. A. DORITY COMPANY BOSTON STREET PERMIT BOND KNOW ALL MEN BY THESE PRESENTS, That we Devon Realty Trust , of PO Box 599 Mashpee , MA 02649, hereinafter referred to as Principal, and Western Surety Company a corporation organized and existing under the laws of the State of South Dakota and authorized to do business in the Commonwealth of Massachusetts, as Surety, are held Lot 8 # 140 Devon L.arie:; :M.ars_tons Mills, MA and firmly bound unto Town of Barnstable , hereinafter referred to as Obligee, in the sum of Six Hundred&No/100 Dollars ($600.00) lawful money of the United States of America,to the payment of which sum,well and truely to be made,we bind _ ourselves, our executors, administrators, successors and assigns, firmly by these presents. THE CONDITION OF THIS OBLIGATION IS SUCH, That whereas, the Principal has made application for a license or permit to the Obligee for the purpose of opening and/or occupying a public way. NOW, THEREFORE, if the Principal shall faithfully comply with all ordinances, rules and regulations which have been or may hereafter be in force concerning said License or Permit, and shall save and keep harmless the Obligee from all loss or damage which it may sustain or for which it may become liable on account of the issuance of said license or permit to the Principal,then this obligation shall be null and void;otherwise,to remain in full force and effect. " THIS BOND WILL CONTINUE IN FULL FORCE UNTIL CANCELLED BY THE SURETY. The Surety may at any time terminate its liability by giving thirty(30) days written notice to the Obligee,and the Surety shall not be liable for any default after such thirty day notice period, except for defaults occuring prior thereto. SIGNED, SEALED AND DATED May 16th,1997. By: Devon Realty Trust West et Company y Bond No. 22196314 B PhilVB.Crmvfor Attorney-fit-Fact A.A.Dorlty Company,Lic. 262 Washington Street, St e 99 -'Boston,MA 02108 (617)523-2935 POWER OFe ATTORNEY,- - (I rrevoc able) N B 50801680 Kno iv A 11 Men by These0. -Presents. � That this Power of Attorney is not valid or in'effect unless attached to the bond which it authorizes executed, but may he detached by the approving officer if desired. That Western Surety Company, a corporation, does hereby make, constitute and appoint Edmund R. Crawford, C. Whitney Crawford , Philip B.' Crawford Richard W. Crawford _ in the City of __Boston , State of _MaSsaChUSett5, with limited authority, its true and lawful Attorney-in-Fact, with full power and authority hereby conferred, to sign, execute, acknowledge and deliver for and on its behalf as Surety, one of the following bonds: An ORIGINAL, bond required by Statute, Decree of Court or Ordinance for: MAXIMUM PENALTY (A) ADMINISTRATOR EXECUTOR PERSONAL REPRESENTATIVF. GUARDIAN CONSERVATOR CURATOR TRUSTEE— (Testamentary Only) $1,000,000 SALE OF HEAL OR PERSONAL PROPERTY—when this company has qualifying bond or when it is a separate bond for accounting of proceeds of sale only; REFEREE IN PARTITION COMMISSIONER TO SELL REAL ESTATE TRUSTEE OR RECEIVER — In Bankruptcy (Excluding Chapter'11) (B) NOTARY Pl`BLIC PUBLIC OFFICIAL AND DEPUTIES $ 50,000 RECEIVER — (In State Court Only) (C) PLAINTIFF'S COURT BOND—Banks, Savings d Loan, and Trust Companiesr •' $ 100,000 —All Others, except bonds prohibited by "NOTE"below $ 20,000 (D) COST ON APPEAL ). EXCLUDING OPEN PENALTY,, , REMOVAL OF CAUSE) STAY, SUPERSEDERS OR $ 2,000 GUARANTEE OF A JUDGMENT', ' - (E) LICENSE, PERMIT, OR QUIET TITLE—City, County $ -25,000 State $ 15,000 (F) ANY SUPPLY BID OR SUPPLY CONTRACT BOND, providing the $ 10,000 contract price does not exceed $10,000. (G) ANY BOND OH INDEMNITY provided there is attached to this Power of Attorney, written authority in, the form of an endorsement, letter or telegram; signed by the Chairman of the Board, President, Vice- President, .assistant Vice President, Secretary, Treasurer or Assistant Secretary of Western Surety Company specifically authorizing its execution. NOTE: SUPERSEDEAS, OR OPEN PENALTY OR STAY BONDS ON APPEAL OR GUAP.ANTEE OF JUDGMENT, OR BAIL BONDS OR CONSTRUCTION BID OR CONTRACT BONDS,OR BONDS FOR DEFENDANTS ARE NOT AUTHORIZED BY THrS POWER OF ATTORNEY,except os provided in Section 1G1. .Thee acknowledgment and execution of any such document by the said Attorney-in-Fact, shall be as binding upon this.Company as if such tsmd had been executed and acknowledged by the regularly-elected officers of this Company. 'WESTERN SURETY COMPANY further certifies that the following is a true and exact copy of Section'? of the By-Laws of the Western Surety Coto pa ny,duly adopted and now in force, to-wit: "Section 7. All bond.4. policies, undertakings. Powers of Attorney or other obligations of the.cori o.w. tlorf shaN:be executed in the corporate.oame of the !;c,mpany by the Chsomn;of'he !?, a-d. " -rev u!ent, S >.• Set- ... , .:p. 1e.;: or,any Vice Pros i,ie nt, or by such other utticet:v as the 14ua r,i of.Director% may authoriu,.Tne-'Chairman of the li a- , P—iiiew. any Vice :'1evltent,: Secretary.any Assistant Secretary, of the. Tremsurer may appoint Attorneys in Fact.or Agents who shall have authority to issue Is-ndv, -1a 11 irt", o' undertwkimts in the name(if the Company. The corporate seal is not neresvary (or the validity of any M1ndN, policies undertakings, Powers of Attbrnty or other obligation, of the c,11-p-Ration - the signature of any such officer and the cn u"Mlrate seat may be printed by facsimile-" IN WNCNESS WREREOF, the said WESTERN SURFTY COMPANY has cau.ved these presents to be executed by its 1'residcnt with it, corporate Heal affixed thin 114th day of March, 111S3. - ATTEST-'. - Assistant Secretary . ., By STATE OF SOUTH DAKOTA I President COUNTY OP• IIINNEIIAHA i'vs On this 1Sth day of March. 1118:3, 1--fore me. a Notary Pi.bl iv. personally appeared JOF; BY, who, living by duly -orn, acknowledged. � that he signed the alane ,'ower of Attorney.as%President of the N.id-WESTERN Sl1RF.1'Y COS 1'ANY and.acknowledged s instrument to la• the voluntary act and deed'o( said rmporation. __- Septtmbel 7 ` „' t10 a tt , _ N to�t 1 ubl it ti ,th liak to ` 1, the undersigned uffiver 1( the it,^ctein tiut,ty C-11—y. a s tork corporation of the State.(if South .I) kots,. do, hereby ce1tifR that the, attached Power of Attorney and Certificate of Authority.. N2 50801 680 - . y .__ is in full force and effect and is irrevocable; and 'M' N t Section 7 of the by-laws of. the company andthe resolution of the Board of Directors sat set forth in the ertitiCate of.- arew in force. e - _ y whereof. I. have set my hand .and the seal. of.-the Western Surety Company this =: M ' is _ _ WESTERN S-URETY C0MPANd.yofT: This date must be_ filled in before d--to the hond`and`it must be the same a - - = d tit as-tht' liond. Y I n G n�F-- �3 TAB dgPNdLi SHINGLES III II III II I I � � III � - I I I II III I I III � - - I III III IIl II III 9N — 12 2AX24 2A HALF XD.OVER= 14XIq 14X24 24-2 q �. 11 I i I i � o III III I � cc��--- 1 34 24 - i IX5 GdSING UDCb R.C.SIDING J u FONT =L=VL'TION �o T- Og I y0) C vca I - n1 C C?c G N G U S E C• TUIT 2 g tt ttD u)Q4 DC3/IXS RAKE HRDS. tt IX5AX4 CORNER BRDS. 24X24 W/C PaHNGL5 I I I- G O LEA? PLFVGTION I� I I 24X14 - - 24X14 .. i , 24X24-2 RIQL4T PI wdTION I 3 TAB GSPLiOLT SWINGU-5 - I I I I I lil ' III 2AX16 14X16 I IX5AX6 CORNER BRDS. _W/C SWINGLES . ' NT 3<X16 DLd5ET1E - . i i i g�AR EI FV4TIDN a FT 6 I I0X12 FXT.DFGK .•o• 1J o --{ IL4 RATW � S/S RRE CODE SHEETROCK r Q -ON THISW10EILJNG___i �b � BREAK-AST Q _ -- � , KIT #-ice T 4'CONC.SLAB _ r 7s• 7�' it HALL 4PCS.1.3/4XS4V2 LVL BEAMS 1` ABOVE R JSH W/CEUNG. 2 GAR GARAGE r________________"-, I-- ---, LJNE d - - 4 DINING ROOM Xii LIVING ROOM Q Q r r HALF WALL 2.ZXIO W/V2 PLYWOOD i GARAGE DOOR HEADER$ i rOYFR R CATHEDRAL Q 4'-0' Q 0 FIRST FLOOR PLAN 60'-0' �1 CLOSET S; BB`TH @/aTN � @EDROOM 03 Q .�. - Z WALF WALL 9 UNFINISHED AgrA r. 4 MASTER BEDROOM o �' BEDROOM 67 Ell 4 4 i3' s r -FOYER BE!OW `'• - ' i i 14'-0• ' i i 60'-0' SECOND FLOOR PLAN �- -f7 �.� ZI'E' 1 ___________________ _______ _ ________________ _- -------------------—- i r cull I RASEMENT - p ' i i .Zc�������a� �T��������ao9���e�� �c� ' i -� •___� ' 1. - - _ 3-2XQ GIRDER !r'dR GARGC-= i -- i i 30'x30'XQ'iHK.CONC.FTG.FOR ' ' 3-In RD.CONC.FILLED LALLY COL ' '• i 4'CONC.SLAB - --------- ' m ---i ---------------- ---- ------s�'---- , n = ----------------- ----------------- -- S'DIA.CONC.FILLED SONG r TUBE ON 24'X24'XQ'FTG. OR EQUAL. -- 6-10 -- 7-0 - - S-0 7-0° 6,-p, 24,0' ;:QUNDdTIDN P' 4N f RIDGE VENT 2X10 RIDGE 2X8 RAFTERS 10 W O.C. - - VK OSB SWEATWING _ Bf ASPHALT PAPER _ ASPHALT SWINGLES - 12 g - 2X4 COLLAR TIES 2X8 CJ.9 16"OL. R30 INSW_ IX3 STRAPPING ® 112 DRYWALL . U2 DRYWALL 2X4 9 16'oz. RII IN_WL = /I6 055 SHEAT'.11NG TYVEK WRAP OR EQUAL m WIC SWINGLES . 2X8 RAFTERS 9 16 0,C VAII I6 OSB SHEATHING L 15�ASPHALT PAPER 3/4 T/G PLYWOOD GLUED i YWO . ASPHALT SWINGES 2X10 ENG.LUMBER 9 11Y OL. PLY.2 W/ DO STRAPPING . V!PLY.CASED VL DRYWALL . FOT=_R IK TCI-4EN POD c R 3/4 T/G PLYWOOD GLUED 4 NAILED 2X8 P.7.9 I6 OL. 2XIO ENG.LUMBER 91%t O.C. 2-M P T. ED b Xb'ALUM I RIB INSUL POST SUPPORT 3-2X112 GIRDER i 3-I1V CONC.RLL.D COL R A EMF NT C m 4'CONC.SLAB MAIN CROSS SECTION I1/ ASPHALT SHINGLES 150 ASPHALT PAPER W/C SHINGLES 1/16 OS3 SHEATHING TTY=_K OR EQUAL — — — —1 I 1/16 055 SHEATHING- VENTED DRIP EDGE S"ALUM.GUTTER W/C SHINGLES STARTER IX8 FACIA COARSE IX8 SOFFIT I 1-1/2 BED MLD.ON IX&FREIZE ' 2X6 PT SILL 0 1/2X6 SILL SEALER o -- 5/SX5°ANCHOR BOLTS 0 d a 8°CONCRETE WALL DAt1PpROOFNG-SA APPROVED. X a'KET A'POURED CONC.SLAB - - S,X 16'CONC.FiG. FOOTING DETAIL 5" ar-NGR=-= - �_- T h e Common wealth of Massach usetts 6 Department of Industrial Accidents -__ - oxce 0I/nyrs1/f►atlons 600 Washington Street Boston,Mass., 02111 Workers' Compensation Insurance Affidavit NUMBER 1011011011L, tt;a>Lc ' location: city phone# I am a homeowner..performing all work myself. 0 1 am a sole proprietor and have no one working in any capacity ® I am an employer providing workers' compensation for my employees working on this job. sQin�anx lne' I7evon Rea1tY ' fU+�t► Dori lc� i. PrrestIY ::Tjructee tfd�ressc ..13..St St.xe#; uit� 20 0.'. 13ox 599 ; MasYap e, MA 02649 ltv: pone tl. ( 0 8') 4 7 7=0023 '. lnsuraneeco: Li berty.Mut.tt&1. I11su.Yancts policy# W 2 31.5-222090-017 [) I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the fallowing workers' compensation polices: company name: address city pltotie N: insurance co. ia911sJi N company name• address: situ• phone R: poxN tnsurantsc co. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'Imprisonment ns well as civil penalties In the form ors STOP WORK ORDER and a line of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Inveslignlions of the DIA for coverage verification. 1 do hereby eerr fy under the p ins and pe nl ' of uy that the information provided above is true and correct. Sign t P- Date � 9t Print name Donald H. Priestly Phone# ( 508 ) 477-0023 of use only do not write In this area to be completed by city or town official T ! city or town: permit/license H f1lBuilding Department k! QLicensing-Board _l. p check iriinmediate response Is required C]Seltetmett'S Office 1:1 • i]ilealth Department I. contact person: phone ff; flUlher ~ISSUING OFFICE 181 LIBERTY Workers Compensation and INFORMATION PAGE MUTUAL. Employers Liability Policy ACCOUNT NO. ISUB ACCT 90. Liberty Mutual Insurance Group/Boston 22 20 9010002 LIBERTY MUTUAL FIRE INSURANCE COMPANY 16586 POLICY NO. TDJCD SALES OFFICE CODE SALES REPRESENTATIVE CODE NJ IST YEAR C2-31S-222090-01798/0WESTWOOD 101 ASSIGNED 3000 .2 93 Item 1.Name of DONALD H . PRIESTLY Insured P O BOX 599 MASHPEE , MA 02649 FEIN 206328861 Address Status INDIVIDUAL Other workplaces not shown above: M A S H P E E : 13 STEEPLE STREET, SUITE 202, 02649 Mo. Day Year Mo. Day Year Item 2. Policy Period: From 03 25 97 to 03 25 98 12: 01 AM standard time at the address of the insured as stated herein. Item 3.Coverage A. Workers Compensation Insurance: Part One of the policy.applies to the Workers Compensation Law of the states listed here: MA 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 $ 10 0 ,0 0 0 each accident Bodily Injury by Disease $ 5 0 0 , 0 0 0 policy limit Bodily Injury by Disease $ 10 0,0 0 0 each employee C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: SEE ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: SEE EXTENSION O F .INFORMATION PAGE Item 4.Premium—The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rates LINE 1 1 0 Estimated Per$100 Estimated Code Total Annual of Re- Annual Classifications No. Remuneration muneration Premiums SEE EXTENSION OF INFORMATION PAGE MA ASSESSMENT S 17 Minimum Premium $ 5 0 0 (MA) Total Estimated Annual Premium $ 500 Interim adjustment of premium shall be made: ANNUALLY Deposit Premium $ 5 0 0 *N*9N00* ARC 45 This policy, including all endorsements issued therewith, is hereby countersigned Authorize Representative Date 01/29/97 THIS PROPOSED RENEWAL POLICY WILL NOT TAKE EFFECT UNLESS THE POLICY PREMIUM IS PAID BY 03/25/97 Los.Cod�1/29/9 erm.Oper. B C Audit Basis Periodic Payment Rating Basis Pol.H.G. Home State Dividend RENEWAL 0 F 1 7 1 NR MA IWC2-31S-222090-016 WC000001A GPO 4033 R1 Copyright 1987 National Council on Compensation Insurance ' �. �.• ...s,. ... ✓�ie V�anvnwnuseal� o�✓�aoaac/auaella �� �~. d . Restri cted To, 00 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - None Nu-ber: Expires 1G - i & 2 Family Homes Restricted To 00 Failure to possess a current edition of the Massachusetts State Buiilding Code DONALD B PRIESTLY is cause for revocation of this license. 4 :PO BOX 599 x MASPEE, NA 02649 1 rr ' f Ed.a I HOME IMPROVEMENT CONTRACTORS REGISTRATION � Board of Building Regula.tions and Standards i One Ashburton Place —Room 1301. Boston ,-Massachusetts 021.6E3 j I HOME IMPROVEMENT CONTRACTOR -�`--- ------- - ------- -- ------ ---- I Registration 167263 Expiration 07/30/96 Type - INDIVIDUAL i HOME. IMPROVEMENT CONTPKTOR IBMI me" Registration 107263 f Type - INDIVIDUAL DONALD H . PRIESTLY Expiration 07/30/98 PO Box 599 , 13 Steeple St .Suite 202 Mashpee MA 02649 I DONALD H. PRIESTLY I � Box 599, 13 Steeple St.Sui I ADMINISTRATOR Mashpee MA 02649 I (datal\permilba) Town of Barnstable Building Permit Application Fees: 1.) ($55 x Sq. Ft. of living space) $55 x WS Sq. Ft. 2.) ($20 x Sq. Ft. of garage space) $20 x 524 Sq. Ft. = $ O 3.) (Leave out Sq. Ft. of deck) _ $ NA 4.) (Add items 1 thru 3) Sub-Total 5.) (Multiply by .0031) x .0031 6. Check amount Total = $ 3 2: ----------------------------------------------- Other Fees: Health Dept. $100.00 ------------------------------------------------------------------ Need: 4 Site & Sewerage Plans 3 Sets of Building Plans (Reduced Set - 8'/2 x I V Only) 1 Application For Sewage Installation I Building Permit Application 1 (Signed Ins. form, copy of Building License & Driver's License) 2 Checks 2 Floor ) 7S c. may' F todg S 47 I 5ZI 1416 1 �s Y M ICLX12=XT D=_GK �1 r II ci III II� S ATu ' 5/6 RR--CODE 5NE8TROCK I p cEiuNG - - - w t-- ------ / IT N=A*CONC.SLAB - BR=AK=AST 4 1 ' r -3 �5by _ ti9L1. A 3•1. 6•�. 4PCS.43/4XS4/2 LVL BEAMS �! v ABOVE R115W WICEIUNG. I^AR GARAG--= it _______________ -___--_--__-_--_ yd•d• 3•-1&4' i LLJ i 1 - :oii NE d 5- 4 DINING ROOM Tii I IVING ROOM s, "a ti Q" HALF WALL 7.7X10 Wro7 PLYWOOD i GARAGE DOOR NEADERSi' I b•�• i�-0' 6•.6• A.d. b•-0• g.0' 8•-0• 6-0' 1'-0• 4 m 7A'-0• 36-0• FIRST FLOOR PLAN 60'O• i�. F'� T-1• �S Z7, ll I IU 8'-O° I � f'�I + NI 10'0�• E4TI{ =FnRcom as Q © '(D 5'1• I :r-a' I b'j• _F+'-0• I 5.-a• I IO'o'h• WAtt wau 1 UNFINISHED AR9A r_ /J� J v � p F� ==ngnr_,n tr 4 MA F?SEDROOM p f] I y� SI II'-C.'1'1• �� � Il'O• � 7dfy• p 1., 9I FOYER 3ELOW 21 I ( I I Il'O• I 8'-0• 4-0'. I za'-0• I i r I, SECOND FI DOR P!GN 0EPARTHENT OF PUBLIC .1.301 Reotrict d To� ' ' JAMES O MCGRATH - - PO ROX 708) ^ -,----------'............. --------- � � DENNIS, MA O26�O ''-/ � | '.�� � K to� nof . �ic.' ~ ^ ` - ' - � � . � - _ . - HOME IMPROVEMENT CONTRACTORS REGISTRATION oard of Building Regulatione and Standards One Ashburton Place - Room 1301 ' / ^ — Boston , Massachusetts 02108 ' HOME IMPROVEMENT CONTRACTOR Registration 109374 Expiration 09/11/98 .' Type -- INDIVIDUAL ' ^ ~ . ' PINE HARBOR BUILDING CO . ,INC . JAMES D . MCGRATH P0 BOX 708/120GT WESTERN RD � . S DENNIS MA 02660 l' ' ` r) Map V Parcel •7� Permit# House# L d Date Issued t/Board of Health(3rd floor)(8:15 -9:30/'1:00-4 ) ^ Fee, 02 O-0 conservation Office(4th floor)(8:30-9:30/1:00-2:00) - Ptatining ISept.(1st floor/School Admin. Bldg.) 1NE, De€iftRive,T4an Approved by Planning Board 19 ED 59. TOWN OF BARNSTABLE ' Buildi"ngg Permit Application Project Street Address f Village C077/ ir / 6 Owner � 1 � 1� �IS' �'ay'O Address /� aOVd-/i/ �,V, .Telephone ;Permit Request � 1 •' t ' f First Floor_i9- square feet Second Floor square feet Construction Type Estimated Project Cost $ Zoning District ,!) Flood Plain Water Protection Lot Size f. /' '! Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 2— /!J r- Historic House ❑Yes &Ko On Old King's Highway ❑Yes ❑No Basement Type: U(Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) nOBasement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half. Existing / New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing L New A First Floor Room Count Heat Type and Fuel: f�Ga* ❑Oil ❑Electric ❑Other Central Air ❑Yes �Z o Fireplaces: Existing I New Existing wood/coal stove ❑Yes �No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ,Attached(size) �� G ❑Barn(size) A Pr p 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 I Name � �` Telephone Number 7�Q `,t"oU Address S QA License# i!V I lEl • _' Home Improvement Contractor# Worker's Compensation# �1—of b NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN.(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING R (S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE m ,OWNER DATE OF'INSPECTION: FOUNDATION FRAME • s .INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL . , PLUMBING: ROUGH 1 FINAL GAS: ROUGH FINAL ti FINAL BUILDING w DATE CLOSED OUT I• s + l ASSOCIATION PLAN NO. • l Th a Town of Barnstable Department of Health Safety and Environmental Services rEDt ► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Cr6ssen Fax: 508-790-6230 Building Commissione For office use only Permit no. Date AFFIDAVIT ' R 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. ' � 0Est. Cost Type of Work: " 1 Address of Work• f Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under 51,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c. 142A SI GNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR 14'.,UJ I) & 0 Date Owner's Name �. n�„� The Commonwealth of Massachusetts �� _ Department of Industrial Accidents 0lficeV11,7YeS&ff,9 ioffs 600 Washington Street _ Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: location: 1 '" c " ' "�� � shone# city ❑ I am a homeowner performing all work myself. ❑ I am a sole ro rietor and have no onegkig in any capaE anyc:apav/%/%%% //%am an employer povidigokers' cetion for my ployees working on this job. com anv name: address: city - phone#: insurance co. olicv# I am a sole proprietor, general contractor. 01 omeowner circle one) and have hired the contractors listed below who have the following worker ' compensatior►�olices: e . com anv name, 1. Q� address d insurance ca. ►'W , olicv#w v cam anv name: address: city- shone# - .....: olicv# insurance co. Failure to secure.coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one year,'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Orrice of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct �. , _ 4"f t _AA1 il 1 4 )A) I Signature /' p � Date _ Print name / I V D ( i U St r0''� Phone# L(3.h-k ly do not write in this area to be completed by city or town oflicfal permitilicense# ❑Building Department ❑Licensing Board mediate response is required ❑Selectmen's Orrice ANNEMN ❑Health Department n: --- phone#; ❑Other (rmsed 9/95 PIA) 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 contras 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 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 c 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 renew of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who hz not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for 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 yoi are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of th. 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. The affidavits may be retuned to 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. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 018ce of Investigations 5 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat. 406, 409 or 375 RECOMMIE;NDED MAXIMUM SPANS FOR FLOOR JOISTS == LOAD PLUS 1.0 PS1! DEAD LOAD GU. I'S1� 1�IV Normal Load Duration 141, = 1000 psi E = 1.,300,000 psi T( 11)iU l values (Or SOL101er11-Yellow fine #2 (Pressure Treated) Exterior use (e.g. decks.) Joist Size � Spacing i 2x6 2x5 2x 1 U 2x1.2 . _ 12" S-G 11 -7 14-3 17-4 16 7-4 1 U-U - 12-4 1.5-0 2011 6-7 841 11-0 13-5 24" G-U 8-2 1 U-1. 12-3 Design Criteria: Strength: - Live load of 60 psr plus Dead load of *10 psl• produces bending stress 01' 1.000 psi at spans shown. :r Note: Design values adjusted [or normal dur,-16011 lozidil1g. f tv .. : 00 Q14, LOT 9 Ci 49, 500 S. F. '@� LOT 7 . �o� _ � � 100 • t DEVON LANE . . Y4- Q (so.oo aE LMrMCFE EASEMENT) TOW AEFS98%ce 189. Oa ASSESSORS MAP 40 S 59 !2'22'M LOT B HOUSE 140 1- - - - -LOT 9_ _ -- _ _ _ --� PLOT PLAN 01 'TO THE BEST OF' MY XAVkLMG& THE FOLMA TIO+V j OCA TED I SVMN OW 7HXS PLAN IS AS IT AMIALL Y EXISTS ANC BARNS TABLE PLOT PLAN FOR LOT M Indicate location of garage or accessory building Additions with dished lines------------- Sewerage disposal(cesspool) ®. Well I (Lot_... ..I. ...ft- re ar) 1 Abuttor't Abut='t Name Nave !Lot# Rear Yard Lot M ........9S ...fi. It this is a 'W If this is a u ea-3c1 lot, " b cc-aer lot, write in s .: Writc in name of rame c! otber str-eeL Sic'e� rc HOUSE Sideyard ether rc et. Set Back . .ft. 30' as v / (N3me of tweet) Information / Supplied by CLV ��I � �(1�(l l 5 � vo — Mark North Point 1 i . I .� . -- � •-- - •• _ . van _ ►rra�, ' •�f�0ur )F Bo��al ( � i � Y Y j i• i Gt t3tE END Lou was a'x y'' SAL nos I LNol- a vv N) !f X y Tv P Pi.ar� f � j zx4'; AlkLIus f I 'Piyu1000 ZX L �ooY� Jo�s;r'S � i Y `p1+h 5 t ATCM. qem.FS t" l+ 3 a ::,+r-r. .�5,., �.:.a. .�'• � .- r_� ` -� � J a rt t !. � � � •Sr k. 0� Qx Z04 � t• -S' is I � �'' 1, ._ :t l � � �1.}., fl;` LLL , tit � _ r .�• 1 � /' r 20APV! c � y PS a ; 16r ENo Lou a'X y'' .GpLL14K► nos _CNOr SH-pw N� x 4 I i t 2: 4-4 Pde-Ll► ;5 rA • Y' 120 Great Western Road (508)760-4500 P.O. Box 708 Fax (508)760-4930 South Dennis, MA 02660 �D Toll Free 1 (800)368-SHED PR0� r'J 7433 58550 DEPARTMENT OF PUBLIC SAFETY _ 58550 ONE ASHBURTON PLACE, RM 1301 BOSTON,`MA 02108=1618 CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Restricted To: .1G DD , . . MAY ., JAMES D MCGRATH Detach bottom, fold , sign on PO BOX 708 ,`back, and laminate license card. S DENNIS, HA 02660 Reep •top for receipt and change of address notification. HOME IMPROVEMENT CONTRACTOR Registration 109374 Type - INDIVIDUAL Expiration_ . 09/11/98 PINE HARBOR BUILDING CO.,INC. JAMES D. McGRATH 7f., Od80X 708/120 GT..WESTERN RD nik+aPn TRaloR S DENNIS MA 02660 The Conrrnofr werrltic of,Massach usetts Department of Industrial Accidents 606 Washington Street - y� Boston,Mass. 02111 `— Workers' Compensation Insurance Affidavit � nnlicanti'mforntat►on '» •�. ����.-!7Please.:PRTNT•le�iblvnr: �:�~- �r4 _�iF__.�.ati;, ..; .�; .,, _ ,.;,•., name: location: city _ phone 4 I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity [� I am an emplo er providing workers' compensation for my employees working on this job. con any name- f address: l Ll.'( `. ,G` .. 1� { l.l A�u 'V aI� city: [ II )) u phone#: S insurance co. ffl H�j VA �� - olicv au I am a sole proprietor, general contractor,or homeowner(c„ircle one) and have hired the contractors listed belo«'who have the following workers' compensation polices: company name: address: city: phone 9: insurance co. policy# company name: address city phone#: . Insurance co. Policy.# Attach additional shee necessan , ; t if , ,: --r• Failure to secure coverage as required under Section 25A of JIGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may he forwarded to the Office of Investigations of the DIA for coverage verification: I do hereby certify undJrpy�3/aft' erjtiry that the information provided above is true and correctSignatureDate Print name Phone# 'official use only do not write in this area to be completed by city or town official \Z, x city or town: permit/license it nBuildinQ Department Ql.icensing Boatd. . ❑check if immediate response..is required. ❑Selectmen's.Office - OHealth Department contact person: phone; r Other Suggested Affidavit for Home Improvement Contractor Permit Application For OMce Use only NAME OF CITY/TOWN Perattt No. Date AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGLc.142A requires that the"reconstruction,alteration,renovation,repair,modernization,conversion,inprovement,removal,demolition, or construction of an addition to any precasting owneroccupied 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 Cof IS G 13 � Est. Cost a,4 00 Address of Work v eu on ay` k M vi Owner Name �Y1U�� Y1`t1iS `t�.`N Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): , _Work excluded by law _Job under S1,000 Building not owner-occupicd _Owner pulling own permit _Other (specify) 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 age Date tractor Na a Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit.as the'owner of the above property: Inc Nameae O r Date CONSTRUCTION SUPERVISOR FORM PLEASE PRINT DATE JOB LOCATION 14 0 n:0n ink - A PROPERTY OWNER ��1�—, -Cc.�rt�rlt<'t'��`�t,► CONSTRUCTION SUPERVISOR �S C9r LICENSE NUMBER �CJI PHONE ADDRESS PIG S•. nn LS LICENSED DESIGNEE (IF ANY) 2 . 15 Resronsibility of each license holder; 2 . 15 . 1 The license holder- shall be fully, and completely reszons_ble for all work for which. he is supervising. He shall be res,consible for seeing that all work is done pursuant to the State Building Code and the drawings as antroved by the Building Official . 2 . 15 . 2 The license holder shall be 'resconsible to subervi se t e cons`rulcryon, recors t_uc z-on,` a_t.._at_on, repair, removal. or Cei'tol i ti on involving the structural elements of buildings and _ sc emu_ s only pursuant to the Stare Bu__dinc Code and all oz.hler acolicable Laws of the Commonwealth even though he, the license holder, is not the permit holder but only a subcontractor or contractor to the permit holder : 2 . 15 . 3 The license holder shall i._* med_ately notify the b u i of=_ciai in writing of the discover-1 of any violations which are covered by the building pe`mt . 2 . 15 . 4 Any licensee who shall willfully violate Subs ec-tions 2 . 15 . 1, 2 . 15 . 2 or 2 . 15 . 3 or any other sections of theses rules and re�-_slati ons and any procedures as amended, stall be subjec-:: to revocat_on or suspension of the license by the Board. 2 . 16 All building permit applications shall contain the name, S_Cnausre and license number of the ConstruCtlon sllcervisor who is to Sunervise those e_naaced In cons-ruction, re^_onstr1co n,. al teratlon, repair, removal or demollt on ,.aS regulated by Sec'=on 109 . 1 . 1 of the .Code an these rules and regulations . In the ever_ that Such licensee is, no longer supervising said persons , the work, • S::all immediately 'cease until a successor ..� license holder is. sust_tuted on the. records of the building department. I have read and understand my reszonsibilities under: the rules and . reculat ons for . 1i cens nc .cons tract: on suD_ er%,:.sorS .in . accordance with S ec pion 10 9 . 1.. 1 of the State Building Code . I understand t ne cons=jction .insUectlOA procedures and e sb_ ,ecif c inspect._Or_s as called for by the bu;ldinc official . LICENSED CONSTRUCTION SUPERVISOR r • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION "[6 (NUVU l�C1TU 11 Number Street address Section of town "HOMEOWNER" DA0 UOosaAko 42,Y (o 2-- Name Home phone Work phone - PRESENT MAILING ADDRESS 0Txy r;_W s szo� 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFIINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, 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 OfficiE on a form acceptable to the Building Official, that he/she shall be responsib: for all such work performed under the building ermit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Stzl Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and .re uirements and that he/she will comply with said q P Y procedures and requirements. HOMEOWNER'S SIGNATURE C cam, [S I Z�b APPROVAL OF BUILDING OFFICIAL Note: ' Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which aYbuilding permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owne 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 awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner acti. as supervisor is ultimately responsible. , To ensure that the Home Owner is fully aware of his/Ater responsibilities, ma: communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. I-�. I .�I 1� I � ,, ,',,,� ",,�',-,"�, 1�,_"I- ;�,� I'll ,___n I � - -- - -- I " - — �-77--�,,--77'"--7,-.------�--�7-�,-,77-z'!,,-77',-7' , �� , � _;;'!� , , , 1� ,, � � , r7r -�'�7 , - � ,% _�.`_ -1 1. I . �-�1_ _ _ .. _ � I - 1- , I 11-�:....1'1___ . 1--1,"-.111,�,"�, - - - " ,,-,'-_'�,-77',,�'. - ',�-7. 1 �, "', , ,� � 1�I, 1 I .1 ��,�,_ -� 17-,:�,`7 - -1-11, ,. 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