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0020 HIGHLAND AVENUE
�� � � �� f __ _ _ �� PL N®T sr� AM IV } I T � _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ` =,Application ®�Cx Health Division Date Issued 1 Z Conservation Division `:Application Fee J� Planning Dept: Permit Fee; Date Definitive:Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street Address 20 .it,(s►-�,VQ k_&, Village 00 o Owner -.cu- ,2b t�cdt�.� Address zc�' 416-fuD� � i0ti ` Telephone ITN 23(� GI ZG Permit Request �:7i�tSIA Lks&AC4A i 1.,JSoINice Square feet: 1 st floor: existing f°00 proposed o 2nd floor: existing Rb proposed 6 Total new VM Zoning District QF Flood Plain Mo Groundwater Overlay A-P Project Valuation 'Z0;nao Construction Type 540A. Gy\-;nn r✓ Lot Size 11 . -3 ZC. <, C-q- Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure S Historic House: ❑Yes V No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.). ecoR&A `Isb Basement Unfinished Area(sq.ft) 2S_Q Number of Baths: Full: existing I. new ® Half: existing 1 new 1 Number of Bedrooms: existing 0 new Total Room Count (not including baths): existing new First Floor Room Count 1- Heat Type and Fuel: ❑Gas Oil ❑ Electric ❑ Other i _%Q del Central Air: ❑Yes 34 No Fireplaces: Existing New a Existing wood/clalstovjf Yes ❑ No ""� Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑Bx1sting new4 size_ �zt 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 Telephone Number "1 z3 (� I Zb t Address License # C�oTJ Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6NA- LiE 0 Q SIGNATURE �.' DATE FOR OFFICIAL USE ONLY r APPLICATION# 4 DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER t . DATE OF INSPECTION: 1 FOUNDATION ~FRAME /3fiZI?2 INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. r �,E tj Town of Barnstable Regulatory Services RMRNgTA)8 �. , Thomas F. Geiler,X}irector °rEa : Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnsta ble.ma.us Office: 508-862--4038 Fax: 508-790-6230 PLAN REVIEW Owner: /J f2 YZ Map/Parcel: 2 �P Project Address 20 �116HIW)b fit* Builder: 1 0W r 6GVNc%f2 The following items were noted on reviewing: 1A) kNAc- C— 42,00h d0M.45S IN G00T)4,--'T G(J714-DIUC)eC E✓Orfaoti. G0i-. -0 .c1 D/V '096"o-N . -/N6SW,5�- C'EtC-iNC /3H7-ff/Lo®Ov- C*N a l✓/ �s�-.r�,�.��« m�y 5'�r���� �-�Sr �trriF �ti d 5' IAJ ra Reviewed by: � c Date: l O Q:Fon:ns:Plnrvw The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizatiordlndividual): iLt a- ' 6LA Ii Address: 1-a 1) �e 0 . City/State/Zip:, MA- Z)zz,• Phone.#: --al Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 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:$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' .com right of exemption per MGL P 12.❑Roof repairs insurance required.] t c. 152, §1(4), and we have no t employees. [No workers' .13.V Other f i.0, 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 submita new affidavit indicating such. $Contractors 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 g q P 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ert' nder thepaigs and penalties of perjury that the information provided above i's true and correct. Sign re: Date: Phone#: µ. Offacial 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#: 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 trustee of an individual,partnership,association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house.of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter.152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract fu the performance of public work until acceptable evidence of co.irpliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of insurance.. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance.coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department-at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submi rm t multiple peit/license.applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address" the applicant should write"all locations in__(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town maybe 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 Indi4stri.al Accidents Office of Investigations. 600 Washington Street Boston, MA 02111 Tel. # 617 7 0- 27-��0 ext 406 or 1-$77 M- . AS S AFE Fax # 617-727-7749 Revised l 1-22-06 www.mass.gQv/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE- AND TWO-FAMILY DETACHED RESIDENTIAL CONSTRUCTION (780 CMR 61.00) ApplicantName: Site Address: print Town: CJ c Applicant Phone: k- 114--?A Applicant Signature: Date of Application: I lG b NEW CONSTRUCTIO choose ONE of the following two'options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE-AND TWO-FAMILY BUILDINGS MAXIMUM MINIMUM Ceiling or Slab Option 1: Basement P Fenestration exposed Wall Floor Perimeter U-factor floors R-Value R-Value Wall R-Value AFUE HSPF SEER R-Value R-Value and Depth National Appliance Energy R-10, Conservation Act(NAECA)of .35 R-3 8 R-19 R-19 R-10 1987 as amended,minimums or 4 ft. ; eater as applicable Note: This form is not required if you choose either of the two versions of REScheck as listed below. ❑ Option 2: �, REScheck Version 4.1.2 or later variant software analysis must be completed (780 CMR 6107.3.2) REScheck—Web which can be accessed at http://www.energ, cy odes.gov/rescheck/ ADDITIONS°OR ALTERATIONS•TO EXISTING BUILDINGS.OVER 5 YEARS OLD* *Buildings under 5 years old must use option#1 or#2 in New Construction section above. Complete the following formula to determine the %o of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b -. a) i S-F 100 x — _ % of glazing (b) Glazing area equals SF b a If glazing is.<'40% use the chart below. If glazing is> 40 % proceed to "SUNROOM" section 780 CMR TABLE 6101.3 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTIAL BUILDINGS MAXIMUM MINIMUM Ceiling and Slab Perimeter Fenestration Wall Floor. Basement Wall Exposed floors R-Value i U-factor R-Value R-Value R-value R-Value and Depth .39 R-3 7 a R-13 R-19 R-10 R-102 4 feet a R-30 ceiling insulation may be used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area(i.e.not corn pressed over exterior walls, and including any access o enin s). SUNROOM—An addition or alteration to an existing building/dwelling unit where the total ❑ glazing area of said addition exceeds 40% of the combined gross wall and ceiling area of the addition. Note: Owner to fill out Consumer Information Form (found in Appendix 120.P) P4oF VE rqy� Town of Barnstable Regulatory Services BARKST.,RLY, : Thomas F.Geiler,Director �b'°TfA.•� Building Division Tom Pe '.Buildin Commissioner 200 MainStreet,_Hyannis,,MA 02601 vt'ww.to wn.b arnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 2O R(� 1J M�+ number street village "HOMEOWNER': f l Ci 4 ZO—0 `� —1 4 I U. name home phone# II ff work phone# CURRENT MAILING ADDRESS: LA&@ PO Bot, Lt CC10 t•1< MAr aZ�3j 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 Persons)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. .. � - ,-• ...r...,,$"�'�`�' "`'mac. r'r.'•:. _ t The undersigned"homeowner"certifies that,he/sbe understands the Town of Barnstable Building Department .' minimum inspection procedures and requirements and that he/she will comply with said procedures and re ts. Si ati=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 ID9.1.1-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 hues unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it arould with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responabilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms'homcexempt j ►ati Town of Barnstable Regulatory Services . BARNSrABPAAMiE' Thomas F.Geiler,Director 0.196 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 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 application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERMISSION 47 Town of Barnstable Permit: Regulatory Services Date: �ppIME TOk Thomas F.Geiler, Director 0' � Building Division Fee:' sAxxsTaarE, ' Tom Perry, Building Commissioner MASS. 1639. 200 Main Street, Hyannis, MA 02601 a rEnr www.town.barnstable.ma.us Office: 508-862-4038 k Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: 1'j+'-"Li) Phone: Install at:."24' i- i A Je Village: Map/Parcel: 62O -03(, Date: i gD101 - Stove A. New/ Use B. .Typed Ran V-5 C."'Manufact Lab. No. U L l�f 6Z 62 U LC ? D-Mod6l No.: o Chimney A. Ne / Existing (If existing, please note date of last cleaning) B. Flue Size C. Are other appliances attached to Flue? t b D. Pre-fab Type and Manufacturer �Qr Q C a e-1)1 E. Masonry: Lined/Unlined Hearth A. Materials: Utc K- B. Sub Floor Construction: Installer Name: Address: Phone: Location of Installation: H.I.0 Registration # Construction Supervisor# OR check v Homeowner Installin o license required J,µ .APPLICANTS SIGNATVPE 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 J4 ( It The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston,AM 02111 ,�•�°~ www.mass.gov/dia Workers}Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lel!iblY Name(Business/Organization/Individual): a-t Address: Zo 1ksh,ixv�lL Loi t i City/State/Zip: S 1 tJ t 1 Mr . Phone.#: '1 W 2-38 6 i 26 Areyou an employer? Check the appropriate bog: .Type of project(required):. 4. I am a general contractor and I 1.❑ I am a employer with � 6. ❑New construction . employees(full an. part-time).* • have hired the sub-contractors 2.F]'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 o workers' insurance comp, insurance.$ � comp' 10.®•Blectrical repairs or additions required.] 5. [] We are a corporation and its 3. I am a homeowner doing all work. . officers have exercised their l l.❑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' 13.9 Other � i Fit i� jll�ui� comp,insurance required] S *Any applicant that checks box#1 must also fill cut the section below showing their workers'compensation policy information. t Homeowuers•wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees, If the sub-contractors have employees,they must provi dt;their workers'comp.po8dy number. lam 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: lob 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 maybe forwarded to the Office of Investi ations of the DIA for insurance coverage verification. I do hereby certi under the pains•and penalties of perjury that the information provided above is true and correct. Si afore: Date: Phone# 7 F only. Do not write in this area, to be completed by.city or town official n: ' Permit/License# hority(circle one): Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: 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 trustee-of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license 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 ehapter.152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public-work until acceptable evidence-of comj anoe with`tlie 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-contiactor(s)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 ibis affidavit maybe 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and unifier"Job Site Address"the applicant should write"all-locations in (c4 or town)."A copy of the of'da-v-it 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 fo any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would 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;. o Comx mouw(Wth of Massachusetts 1 epartmcmt of 1a sWal Aeoideets ()£flee of luvestgatons }l•°�, ri Str.e et �(���asl�gto Boaton,. A 02111 _ TO. #617-727-4500 ext 406 or 1-9,771VIASS `9 Fax#617-727-7749 Revised 11-22.06 Www.InasS.gErv/Clia r `A � V THE tj Town of Barnstable „�. Regulatory Services BARNSrABM : Thomas F.Geiler,Director �b = .•� Building Division AlEo rti Tom Perry,Building Commissioner 200 Marri Street,_jy_annis,MA 02601___ - www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ��, Please Print DATE:_ L O!3 - JOB LOCATION: 2d l U1 1� � COTo 1 number street village °`HOMEOWNER•': c,0;j�a 420- oT1l name ' home phone## work phone# CURRENT MAILING ADDRESS: 7-011i city/tovm 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. DEFINMON 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 buildinepermit. (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. inspection procedures and requirements and that he/she will comply with said procedures and r e e Sibiaturt 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 assunring 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 fomr/certification for use in your community. Q:forms:homeexempt l: �sroti Town of Barnstable f f Regulatory Services . BARf f '& f Thomas F.Geiler,Director `rE1619. � Building Division Tom Perry,Building Commissioner r 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 application for: . (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERPERM ISSION i f J TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map }, b2-a Parcel 036 Ld-T Q Permit# (;S30 79 Health Division y� u • ;�o� _ 3 Date Issued 0 Conservation Division I �� �� r� Application Fee 430' Tax Collector 7 Permit Feeo��J� Treasurer 3bcligw, s SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board Vs TM S ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUL.XT*NS Project Street Address 2c3 ILm LN J p kj,�5 Village 6&,L)I i Owner Address 26 ��(s1-LNa &Jr< Telephone N20�- 2"1to t (_►'l ) Lao- 0-1`"1 l Permit Request ZZ µ Zo i,&)n e,4 T toiJ of n.���a(s arc- wed roe�rr► -- �JE ,�J+�B(sRoo�✓1 Square feet: 1 st floor: existing 4bo proposed 1-/,10 2nd floor: existing sao proposed yyo Total new F Zoning District F_F Flood Plain 9 a Groundwater Overlay A►P Project Valuation 2S�con Construction Type s i Gt- Crkwi�-: Lot Size r► , 32(� Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure -7v Historic House: 0 Yes ail No On Old King's Highway: 0 Yes 6 No Basement Type: mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing t new 0 Half:existing i new 0 Number of Bedrooms: existing 2 new I Total Room Count(not including baths): existing 5 new 2- First Floor Room Count Heat Type and Fuel: ❑Gas LXOil ❑ Electric 0 Other Central Air: O Yes SNo Fireplaces: Existing New Existing wood/coal sto e: ❑Yes? QJo cZE Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new-siz@= Attached garage:0 existing ❑new size Shed:❑existing O new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded O cap y, m Commercial 0 Yes ❑ No If yes, site plan review# Current Use -- Proposed Use w ,; v r BUILDER INFORMATION Name _ell::V_ �_d jl tAl (—Telephone Number/. Address Z©AUhf�v dl License# sass Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 2042- Q i FOR OFFICIAL USE ONLY P PERMIT NO. - DATE ISSUED _ MAP/PARCEL NO. " ADDRESS = _� r - � VILLAGE 1 OWNER DATE`OF INSPECTION: FOUNDATION (,2A FRAME OK !?�-S '-0 S INSULATION OK, FIREPLACE ELECTRICAL: ROUGH, ""t FINAL - f PLUMBING: ROUGH- ,—I � FINAL 14 GAS: ROUGH' 8:.J4' � W= FINAL FINAL BUILDINGcr , $« r C ci DATE'CLOSED OUT ? ASS OCIATION,PLAN'NO. °FTHE l° Town of Barnstable Regulatory Services BAMSTABLE, Thomas F.Geiler,Director 1639.rFD MA'S A Building Division Tom Perry,Building Commissioner , 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: 20 Y ZZ 2 S fiAttstimated Cost Address of Work: ZO 111&A6 liAll Owner's Name: 441i xd �7 Date of Application: a a z I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No.f OR at Owner's Name Q:forms:homeaffidav The Commonwealth of Massachusetts _ Department of Industrial Accidents Office affnyest#.Nff afts . 600 Washington Street --- `� Boston, Mass. 02111 `3 Workers' Co m ensation Insurance Affidavit fie; F.LG�-•V �? location Z® H If3lt9 Ac�e /i��,., hone# xt&A citT' I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worlds m' ca achy %O///%%%%/%%%//%%%///////��%/O%%%%%%%%% %%..... %%% orkers' co n for ensatio my employees working on this job. v; ±.:.y.,+4..}.r.,4:::. rovidin w mP .:::;}:::i:.vv:{.}-::.}'-i±}:::...';:�::ii;..•:v:4:Y%:?isY;-isy:}:?.}:?vi:±�$'r:::}':}':}}::::::. ...... .... :•:v>.,.:,:v:•v-..:::n:v.:.:.::::.;..:n::....:.:.;..r•v�.::v•:::nr:?......:..:n.......:::.:..n:... n::n::::;v,v:::•.v.v::::.::::n:v'r 4:4'4:%'.:nv::}}::vi;{!::}}i:iii:?:i?ii•:?i•}i}i: .. ..v....{..:::4:•7}:4}}•.vi4v:.}:�:.}:?G}:O};?.}•.}}:;•}:},;ivi:,{......y...•.:. .. .. ...........................................:.v:::n�:::r.v::}•:::.v:::::::::.:v..........::v.-:::::........:v.:v:.:v� w:::.vj..::•:.:x:••::nv•:••:•.v:w•n....,n.. ............... .....................:.v:�::::.v:.v.v:............-:.,•..::::.v::•::.v::::::....:r4::7?}}:•}7±:::?:rv::±:;:}}'•}7$}}}:i;:};:;:;:;•}:-:?•;;�:;•)}:;•:i}}:•v'}}:4r.}?•}:4Y . oIIt 8II .ii8II2 ........................... , h••:•.ix•}: ......... v...................:::::::::v.v::_•.-7::::::v.v::;u?:{:v.v::v::::::::.v.,w:::;:{i;••w:::nv.w.v,vx:•:;:?•ti;:•:+:::r}x:::::::vw:;.....;,.....•• v{::.J:v::':.:44:}::. ............. ...:........... ............ ............ ,...:....... r.2........n........................:... ....n.:::::::::::7:'•:: ..........r.;{.::w:::::::.v.,v±}:•.v:?•}Y:Y:'.}.... •:.:v:0,:;.}•.}:r. ..:.....:::::.::v:::.w........:.......n•:•:::::................:•.....n......... .....................,.....:::•..n... ....... ......... .......v. .....:...... ............. ....... .....:v:w::::::::::::.v:::v;4'.$}±}}:.i7.v.v:•...........::<::::::::nv::.:...•.:.•..:?•:.+:::•::•.v:;v::•:,:::::.:..,.n Y:.,...!v:+:!it}:n;:: ..r.... ....... .....r.... ...rn.... .............. .....::::r:::?:v:::'.•:n•:,:r•:.w..............••v::•r.•.:{•v::.,......xv::±n,:••?::n:v':..:,:............v.{:.v.:::.:...} ...{.... .... ........... .................:v..............• ....,...... ............ ........n..,..•:v::::::::.v:::•:::::::•}....{...........:.........:::::�•.::...n..,..v:::i±'{:{:;?•:•:•:::...:nv::w::::::::-:{::..:•...,..r..F:jn•:t:':7'•r:ttN�:•:....:::Y ...... ...... .......... .......... ,...... ..,..... ..... x::•::::::... m:'::Y;•:}:i,?,n: :?vnt!k=w:: ..:..:.::::.::.::•i:•:}:-}:-:::4:::;::.:}:•x'�}�?::is�i:t;}:�: :`•is�:..::::..:•}:.;;:'t;:}>•;•i:;•±,.y•�-:::::::.......:....:..,•...... ...:.:•::._.}::••}}:•::::::.:}•.yiR�?:«•:.. oh e:j(j:;'riiiri i:Ji:{ii}}:•}:4:•}:?•};{.}:•±}'4:h ... :::::.:::..:.,•::•i}::•::::::•;:<::;:c•`.Y?•:•:i;;:7:;}:•:::i::+:�i;i:::... :............ ..........:.................,..:.:::::::::::::;::.ii::•::::::. olf'•�•.`�<iSY �`.•�a`•r� �:s` � { <`?3 :%�r��` s:�`:�::.t..�::.�:•::::.�.�::::}:}}::::.:. i •�iSstanc�.t: /. ❑ I.am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who _ have .' 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I....:n......•:•::.......w•::n....I.v...:...:.....n....i.•.x:L+........n:n::,............ v: ............:?n.,ip......... :...... ....t.....;.iiv:•i'?:i:?:titi{•}ivi:}$�•',`:i•:.•".v.vnti;:i:. r.....,.::::•.........{r.:..:.....,•.+.•.•,:r::n.. ..:..w:::............:�.::...........:::r..::.i:.::-::::n:A.. v.....,n...... v+:..v...v....... ............... •::........:i.:.v::,:....•::f.•::.v::...-:f•:;�..,::1:v::. ..,•v,-:::.....•...t..:•::::::::.•.•:..::y;±}.::::::}::::::.........:.v::.:.......:.} .:. ..:.::•..:..:. •....,.....:.:.:..............:: Failure to secure coverage is required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine e. I undenf�d filar a' to S 1,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against ma copy of this statement may be forwarded to the Oface of Investigations of the DIA for coverage verification + -- - the airs aced- enalties of-perjury-that-the-inform ton-pr-ouided-above_ishus_and.corsect= . I do hereby c nder -P p Date Signature .,. ,. •,r'—�. . :• ,,,..• � -27�� —.. .. Phone# friat name ofacialwe only do not write in this area to be completed by city or town official ...''permit./license# C]Building Department city or town: ❑Licensing Board ❑Selectmen's OMce ❑checkif immediate response is required ❑HealthDepartrnent contact person: phone#; ❑Other (pviwd 9195 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 contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in'a joint enterprise, and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner.of a .... dwelling house having not more than three apartments and who resides therein,-or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer: MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit.to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe' 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 ifyou are requ#ed,to 0 tam.a workers compensation policy,please call:the Departmen-iiit 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 the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. •Ple�se# be sure to fill in the•permitthcensenumber which willbe used as a reference riuml;er. The:affidavits may e'rRiuned.t�,. the Department tiy`aiaiT or•FAX iinle'ss other arrangements have been'made: The Office of Investigations would like to thank you in advance for you cooperation and should you have anyguestions, . hesitate 'veus a call. please do not h to gl ., The Department's address,telephone and fax number: E The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investlgatlons 600 Washington Street �t Boston,Ma. 02111 fax#: (617) 727.7749 ` : phone#: (617) 727-4960 ezt. 406, 409 or 375 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE o� New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE _square feet x$96/sq foot= x.0031= plus from below(if applicable) ALTERATIONSIRENOVATIONS OF EXISTING SPACE square feet x W/sq.foot= x.0031= applicable) plus from Below(if app ) . ACCESSORY STRUCTURE>120 sq.f >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 - >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS , Open Porch x$30.00= (number) Deck x$30.00= �® w (der) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 f Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost TAId 10-1b • prweriptfre psrkst,,for das wad T,..Fs..Iy MAxi8i1]M A� � Slab � plug Flow Pew Ffi� ut Arcs' U-ral �� P�icaae rml to 6500 Flestta;Dora*Da7� 6 Noses t3 19 1D Normal Q 1Z!�a 0.40 3E 19 10 6 12% OSZ 30 19 6 ES ARM 030 3E 13 19 10 Norte 13 23 Ii/A lilt T 13'/. tug 3E 1D 6 Noemal 3E 19. 19 E?AFt7E l! 1Sy. 0.46 l3 ZS WA NIA 0.44 3E 6 E3 AtVE pr 15% D32 30 19 19 10 Normal 13 25 I#A NIA X IE'/. 03Z. 3E lyA NIA Nary( y 1 EY. 0.42 31< 19 ZJ 6 90 AFUE 32 13 19 10 90 AFUE y I E'h 0.41 6 AA Ism. OSO 30 l9 t9.. 10 L ADDRESS OF PROPERTY: 2� 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4, %GLAZING AREA(#3 DIVIDED BY#2): . S:'SELECT PACKAGE(Q—AA-see chart above): • • . . G ENERGY•REQUIREMENTS NOTE: OTHER MORE INVO V US FO THIS ODS OF DEr INFORMATION. ARE AVAILABLE. A C/k BUILDING IN-SPECMDR APPROVAL: YES: NO: q,f0r=-f9 803 03 a ' - 9 Footnotes to Table.l'5.2.Ib: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass-doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area. expressed as a percentage. Up to 1% of the total glazing area may be excluded.finm the U-value requirement. For example;3 ftz ofdecorative glass may be excluded frome tested a building design with.300 fl of glazing area. = After January 1, 1999, glazing U-values-must be and documented by the manufacturer in accordance with the Naiionaf Fenestration Rating Council (NFRC) test procedure, or taken'from Table 11.5.3a U-values are for whale units:center-of-giazs U-va lues cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compassion, R30 insulation may be substituted for R-3S .insulation and R-38 insulation maybe substituted for R49 insulation- Ceiling R-values represent the sum of cavity insulation Plus insulating sheathing (if.used). For ventilated ceilings,.insulating sheath in -must be placed between . the conditioned space and the ventilated portion of the roof.Wall RP �e . Do not include -values re resent the sum of the wall cavity.insulation plus insulating sheathing ('t{ � • exterior siding, structural sheathing, and iitterior'drywall.For example,as R-19 requireme nt could be met EITHER � uirements •apply to by R.19 cavity insulation*OR*R-13'cavity insulation p WaII relus R-6 insulating, sheathing. 4 wood-frame or mass(concrete,masonry,log)wall.constructions,but do not apply to metal=frame construction. 'The floor•requirements apply to floors'over unconditioned spaces (stub as unconditioned erawispaces,basements, or garages).Floors over outside*must meet the ceiling requirements. , must ''['1:e entire opaque portion of any individual basement wall with as average depth le ss than 50/a below, grade me_: the same R-value requirement.as above-grade wails."'Windows and sliding glass.doors of conditioned bc.,eme with the must be included w the other glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. ° ' The R-value requirements are for unheated slabs,Add an additional R Z far heated slabs. ' if the building utilizes electric resistance heating use compliance approach 3;4, or S. if you plan to install more than one piece.of heating equipment or-more-than one pier of cooling equipment, the equipment with the lowest' efficiency must meet or exceed the efficiency required by the selected package• 'For Heating Degree Day requ' cats of the closest city or town see Table J52.1a. NOTES;: a) Glazing areas and U-values are maximum acceptabialevels.Insulation R-valua are minimum aczcptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have.a,U-value no greater than 0.35. Door U-vaIues must be tested and documented by the manufacturer in.accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this regnirement•(i.e.,may have a U-value greater than 0.35). c) If a ceiling, wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the•component complies if the area-weighted average R value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors)..' 43 1 y I LOT A / � 5 0 VERHEAD 0 / LOT B � r o�g ,� tit• do _ c� cfl / / HSE= -- - co N057057"W 170• 00 FND. c B. / \ , S83 3959"w FNP 14.28 NOTE PRE-EXISTING NONCONFORMING. RES. ZONE "RF" This MORTGAGE INSPECTION Plan is For FLOOD. ZONE "C" Bank Use Only TOWN: C0 T _ REGISTRY OWNER: GREG A. & ROBERT S. BINFORD DEED REF: 7771 189 _ _BUYER: RIC-HRD—HARD &M4.�YF�N�A I' DAtTE: 254_ _ — PLAN REF: 448Z69_ — — _SCALE:1" 30 FT. I HEREBY CERTIFY TO _PL_Y9Q_U__ ox�caGE moo_____ �Ey, YANKEE SURVEY __1------------------------THAT THE BUILDING lZN Mqc SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS +F y UL CONSULTANTS SHOWN AND THAT ITS POSITION DOES _ __ CONFORM PA. 40B (SUITE 1) ITO ;THE ZONING LAW SETBACK REQUIREMENTS OF THE 3 MlRITHEW . H INDUSTRY ROAD TOWN OF _— BARNSTABLE_ --------AND THAT ft. 32098 IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD A p MARSTONS MILLS, MA. 02648 AREA AS SHOWN ON THE H.U.D. MAP DATED_7_ �_� �ss� F�ISTER� . , TEL: 428-0055 Co nit Panel 250001 0021 D °NqL LANas FAX 420-5553 _ __ THIS PLAN NOT MADE FROM AN N RUMENT 14710 BJS PAL A. MERITH LS SURVEY NOT TO BE USED FOR FENCES ETC. F CuTuly, I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE 28 IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL '(E STANDARDS FOR THE PRACTICE OF LAND SURVE}7NC IN Cwa ROB THE COMMONWEALTH OF MASSACHUSE777S is PAUL A. MERITHEW" P.L S. DATE / m / M m aZ / Z P COTUIT SCHOOL HARBORS ,, STREET P5Ivo P / / LOCUS MAP L0 ASSESSORS AfAP• 20, LOT 36 go �5 / - PLAN REF. 448169, LOT B ZON/NC: 'RF"" SS '' FLOOD ZONE C"" (OVER) COMMUNITY" PANEL # SS 250001 0021 D SHED DATED: 7/02,/92 PLOT, PLAN 32./ / og= °==N� ��`�• OF LAND LOCATED AT LOT B �.'-- - - - - / ?O HIGHLAND A VENUE AREA BARNSTABLE,. MASS <�Iqv go� � � PREPARED FOR as°7 A-r- RICHARD G & MARY ELLEN BARRY 170. 00' MAY 4, 2001 N83°39 '59 E AS/LOT 26 YANKEE SURVEY C0IVSUL7.1N7J o GRAPHIC SCALE UNIT I, 40B INDUSTRY ROAD P.0 Boll" 065 0 20 0 10 20 .0 s� MARSTONS AfILLS" AIASS 026.18 p MA m _ TEL 428-0055 FAX 420-5553 ( IN FEET ) 1 inch = 20 ft. - ✓d .52742 D(_'8 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE: irh . / l JOB LOCATION: 20 f/�G�! €'��/ � ��Ali- number street village "HOMEOWNER!': ElcA&✓ b �.�r�;a J y20- 2'7b1 .420-01-1 1 name i home phone# work phone# CURRENT MAILING ADDRESS: T® 2x 4 aZ_G 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 um inspection procedures and requirements and that he/she will comply with said proced and requir ents. Si ature of Home er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often.results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN �'' f Permit Number MECclieck Compliance Report Massachusetts Energy Code MECcheck Software Version 3.2 Release la Chcckcd By/Date TITLE: Fantilyroom/Bedroom Adition CITY: Barnstable STATE:Massachusetts HDD:6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) DATE: 10/01/01 DATE OF PLANS: 10/1/01 PROJECT INFORMATION: Rick Barry 20 Highland Ave Cotuit,MA COMPANY INFORMATION: Kenneth Sadler Associates P.O.Box 1149 Hyannis,MA NOTES: Calculations for Addition only COMPLIANCE:Passes Maximum UA=155 Your Home= 152 1.9%Better Than Code Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-Factor UA Ceiling 1:Flat Ceiling or Scissor Truss 455 30.0 0.0 16 Wall 1:Wood Frame, 16"o.c. 984 15.0 2.5 54 Window 1:Wood Frame,Double Pane with Low-E 120 0.310 37 Door 1:Glass 80 0.330 26 Floor 1:All-Wood Joist/Truss,Over Unconditioned Space 422 21.0 0.0 19 COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plants, specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the Massachusetts Energy Code requirements in MECclieck Version 3.2 Release la. The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Stgiidard,Design Conditions found ui the Code. The HVAC equipment selected to heat or cool the building shall be rlo greater than 125%of the design load as specified in Sections 780C:MR 1310 and J4.4. Builder/Designer 1/ll ��'�� I -- � ----- Date �---- C) 0q I r NI ECcheck Inspection Checklist Massachusetts Energy Code MECcheck Software Version 3.2 Release la DATE: 10/01/01 TITLE:Familyroom/Bedroom Adition Bldg. Dept. Use Ceilings [ ] I L Ceiling 1: Flat Ceiling or Scissor Truss,R-30.0 cavity insulation I Comments: Above-Grade Walls: [ ] I 1• Wall 1:Wood Frame, 16"o.c.,R-15.0 cavity+R-2.5 continuous insulation Comments.- Windows: [ ] I 1. Window 1:Wood Frame,Double Pane with Low-E,U-factor:0.310 For windows without labeled 0-factors,describe features: #Panes Frame Type Thenual Break?[ ) Yes [ ]No Comments: Doors: [ ) I 1. Door L Glass,U-factor:0.330 #Panes Frame Type" Thermal Break'?[ ] Yes[ ]No Comments: Floors: [ ) I 1. Floor 1:All-Wood Joist/Truss,Over Unconditioned Space,R-21.0 cavity insulation Comments: Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air leakage must be sealed. [ ] I When installed in the building envelope,recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated,manufactured with no penetrations between the uiside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated,in accordance with Standard ASTM E 283,with no more than 2.0 cfin(0.944 Us)air movement from the the conditioned space to the ceiling cavity. 'llne lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. Vapor Retarder: [ ] I Required on the warm-in-winter side of all non-vented framed ceilings,walls,and floors. . Materials Identification: I Materials and equipment must be identified so that compliance can be deternnined. [ ] ( Manufacturer manuals for all installed heating and cooling equipment and service water heating I equipment must be provided.. [ Insulation ulatlotu R-values and glazing U-values must be clearly marked on the building plans or specifications. I Duct Insulation: [ ] Ducts shall be insulated per Table MAT 1. I Duct Construction: [ ] I All accessible joints,seams,and connections of supply and return ductwork located outside conditioned space,including stud bays or joist cavities/spaces used to transport air,shall be scaled I using mastic and fibrous backing tape installed according to the manufactur-&s installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. [ ] I The HVAC system must provide a means for balancing air and water systems. I I Temperature Controls: [ ] I Thermostats are required for each separate HVAC.system. A manual or automatic means to I partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. I Heating and Cooling 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 JAA. I I Circulating Hot Water Systems: [ ] I Insulate circulating hot water pipes to the levels in Table 1. Swimming Pools: [ ] I All heated swi nnling pools must have an on/off heater switch and require a cover unless over 20% I of the heating energy is from non-depletable sources. Pool pumps require a tune clock. Heating and Cooling Piping Insulation: [ ] I HVAC piping conveying fluids above 120°F or chilled fluids below 55°F must be insulated to the I levels in Table 2. Table 1: Minimum Insulation Thickness.for Circulating Hot Water Pipes. Insulation llucluiess un Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulating Mains and Rtuiouts Temperature(F) Up to 1„ Up to 1.25" 1.5" to 2.0" Over 2" 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-l 30 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness_for HVAC Pipes. Fluid Temp. Insulation Tluck-ness in Inches by Pipe Sizes Piping System Types Range F 2"Runouts 1"and Less 1.25"to 2" 2.5"to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 0.5 0.75 1.0 and Brine Below 40 1.0 1.0 1.5 1.5 NOTES TO FIELD(Building Department Use Only) Daniel E. Braman, P-K C d 189 Harbor Point R emm»wgn4 MA 02637-0361 , titiT K ` %sU 'lcoX_2'z,. . 1 peq. ..__ nV t 5 VV �o K22 , LI OF : - -- 441� ,. . u s U T � 1 -- - . . i RAMSBEAM V2 . 0 - Gravity Beam Design Licensed to: Dan Braman, P.E. Job: R & R Kershaw, Centerville Steel Code: AISC 9th Ed. SPAN INFORMATION: Beam Size (User Selected) = W10X22 Fy = 36. 0 ksi Total Beam Length (ft) = 20. 00 Top Flange Braced By Decking LOADS: Self Weight = 0. 022 k/ft Line Loads (k/ft) : ' Distl Dist2 DL1 DL2 Pre DL1 Pre DL2 LL1 LL2 0. 00 20. 00 0 . 165 0 . 165 0. 000 0. 000 0. 440 0. 440 SHEAR: Max V (kips) = 6.27 fv (ksi) = 2 . 57 Fv = 14 . 40 MOMENTS: Span Cond Moment @ Lb Cb Tension Flange Comp Flange kip-ft ft ft fb Fb fb Fb Center Max + 31. 4. 10. 0 0 . 0 1. 00 16. 22 24 . 00 16.22 24 . 00 Controlling 31 . 4 10 . 0 0. 0 1 . 00 . 16.22 24 . 00 --- --- REACTIONS (kips) : Left Right DL reaction 1 . 87 1 . 87 Max + LL reaction 4 . 40 4 . 40 Max + total reaction 6. 27 6. 27 DEFLECTIONS: Dead load (in) at 10 . 00 ft = -0 . 197 L/D = 1219 Live load (in) at 10. 00 ft = -0. 463 L/D = 518 Total load (in) at 10 . 00 ft = -0 . 660 L/D = 364 CF v. tt , >� F ` .... - �- -t �_. ...�_.� .. _. . i t # ----- rs _ . 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"MM w�VB.s Z o $�saa3'8H LL I L-1 gg x .10 - Q w 0 ® ® •00 rmilmF L W 1 I 1 I 1 0 7 R 1 I I 1 I I _ I I I 1 I I I 1.________________________L._______JT____, fL__________TL_---------------------------------- ,J----------------------------------______-------- _____J1 ------------------ L_-_______-_1___ 11L • ~ O ►� eA,S:,T e-eVAToN eLeVATIoN W Q O � C m � A 3 ._S. N.E_Va. .. MR. d L-i-...I O• ILIA Or FH Ut-s r .. F ksskta c3 O LJ I I Ll cad m—moo£ rD X:f I I i m" " y'E c c -- --- -- ---- ------ ------ __ G GJOUTH eL-e y ATION DRAWING TYPE: SHEET NUMBER:`,. _ jj( � ��h t1e�� I�u o.C, �'L, I � S L_ r r `, t . � __ .� �--_ �- �._