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HomeMy WebLinkAbout0059 LEWIS POND ROAD ?C)/v t I+ F Vt on de& ^c'�f -c C S G�C� Town of Barnstable �,NE, Regulatory, Services Richard V. Scali,Director Building Division BARNSTABLE Thomas Perry, CBO ArED"" Building Commissioner �g 200 Main Street, Hyannis, MA 02601 www.to wn.b a r n sta b l e.m a.u s Office: 508-862-4038 Fax: 508-790-6230 January 7, 2016 + Ed Lacey 137 Sturbridge Dr. Osterville, Ma. 02655 RE: 59 Lewis Pond Rd., Cotuit,Map: 020 Parcel: 022 Dear Mr. Lacey, k This letter is in response to application number 201508342 submitted to add an addition to r the above referenced address. Unfortunately,the application can not be approved at this time because of the following: 1) The property currently has an open building permit(application number 2201401801) that needs final building and plumbing inspections. 2) The application is incomplete. (Plot plan required showing location of addition. Copy of valid construction supervisor license and home improvement registration.)• Please do not hesitate to contact this office with any questions. Respectfully, e L. Lauzon Local Inspector j effrey.lauzongtown.barnstable.ma.us (508) 862-4034 , Town of Barnstable` . � Regulatory Services ianss� Richard Scali,Director Building Division k Tom Perry, CBO,Building Commissioner. , 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Building Permit Procedure for Residential Addition Or Remodel Or Dock ❑ Determine map and parcel number and enter it on application. ❑ Historic District Commission,200 Main Street, approval required prior to construction/demolition for any properties located in a Historic District: • Old Kings Highway Historic District(north of the Mid Cape Highway) • Hyannis Main Street Waterfront Historic District(See map for boundaries) • Historic Preservation(if applicable). ❑ If ZBA relief(Special Permit or Variance is required for Project): ❑Copy of ZBA decision ❑Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date ❑ Approvals from the following departments are required and can be obtained at 200 Main St.: ❑Health Department (8:00—9:30 AM&3:30-4:30 PM {as of March 2°d,2005) ❑Conservation Department (8:00—9:30 AM&3:30—4:30 PM) ❑Tax Collector {can be obtained from Building Department} ❑Treasurer {can be obtained from Building Department} ❑ Permit must contain complete owner information, full description of project, correct square footage of project,valuation of project(must agree with Total Cost from Project Worksheet), building detail for Assessor's Office, complete builders information, including signature and date of application. ❑ 5 sets of reduced house plans measuring 11"x 17",scaled 1/4"= V &fully dimensionalized are required. Plans must include a foundation,cross section, framing schedule, insulation detail & floor plan showing location of smoke detectors(located with a Red `S'.) ****** IF USING ENGINEERED LUMBER AND/OR STRUCTURAL STEEL,ENGINEERING DATA MUST BE PROVIDED****** ❑ Plot plan or mortgage survey required for.any addition: Home Improvement Contractor's Affidavit ❑ Workers Compensation Insurance Affidavit form must be submitted for any workers hired. In the event the homeowner takes out the permit, subcontractors hired must supply this. Copy of Insurance Compliance Certificate must be on file. ❑ Energy Compliance Form ❑ Construction Supervisors License&Home Improvement Contractor's License OR ❑ Homeowner License Exemption Form must be submitted if homeowner is acting as general contractor or builder for the project: Property owner must sign Property Owner Letter of Permission.- ❑. A NON-REFUNDABLE Application Fee must be paid upon receipt of application number. All checks should be made out to the Town of Barnstable CE04NEYS: Need Home Improvement License,no plot plan required El PIERS AND DOCKS:Need Construction Super License AND Home Improvement License. OWNER CANNOT PULL OWN PERMIT. ❑ Projects requiring the use of a crane must complete the forms issued by the Aeronautics Commission 1 . I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ® Parcel O Z2 TOWN Cr R-i"'A STABLE Application# �`� S U,�3 yc� Health Division Date Issued. Conservation Division Application Fee 5� Planning Dept. Permit Fee s1. ;4 Date Definitive Plan Approved by Planning'Board ' Historic - OKH _ Preservation / Hyannis Project Street Address 3­7 1_E�ji5 Pot® ko Village C CyTt4 i7 Owner PJ 1 L I° P 13-eTW A-1-1 Y a 06AICA Address 5 l tZV1115 P®ND P2®0 Telephone "191 ' 'Z-5 F- DA Permit Request 2 '✓A .5-r tl. rTiO rWz,),/*TC t X1ST1tV2s PIS51- Z,0,dR_ j2erwla 1L,&tJZ6 Ac�_ry IS610 P-00^ (]-,D 0 r4 A->TbfL-- $A71 ,vta 9-®or eN -�wil, iwa Square feet: 1 st floor: existing propose n loor: existing proposed 7 Total new -7 5'2- Zoning District Floo I Groundwater Overlay Project Valuation 200e Co tr tion e Lot Size ndfathered: ❑Ye N If yes, attach supporting documentation. Dwelling Type: Single Family I o FXi ❑ -F fly (# units) Age of Existing S ct Is H s ❑ No On Old King's Highway: ❑Yes ❑ No It Basement Typ ❑ Full awl ❑Walko \ h r Basement Finished Area (sq. Basement Unfinished Area (sq.ft) Number of Baths: Full: exis ' t9 w Half: existing new Number of Bedrooms: new Total Room Count (not including t s): e 'i ting knew 2- First Floor Room Count S Heat Type and Fuel: 4 Gas ❑ Oi Electric ❑ Other _ Central Air: ❑Yes 'A No Fireplaces: Existing `Z- New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER-OR HOMEOWNER) Name �� �� '� Telephone Number 7 Z Address 13-1 .51"u vtS 2i 13&C DlZfy&_ License #. e'S - 6 7S5-7 3 G5"5- Home Improvement Contractor# /Z'-i ?I & Email Co t_Rcey 2(2 G Im Al L_ • w wL Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Acorn C p-R_ 0 G4r1 P s-r4f rQ SIGNATURE DATE `� FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED i MAP/ PARCEL NO. ADDRESS - VILLAGE OWNER- ' ' DATE OF INSPECTION: F: FOUNDATION " FRAME INSULATION FIREPLACE tiY ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t _ DATE CLOSED OUT ASSOCIATION PLAN NO. • i 4 TOWN OF BARNSTABLE BUILDING.PERMIT APPLICATION r Map 0 2 o Parcel O Z2 ` ` l i',` Application # r Health Division/ Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH = Preservation/ Hyannis Project Street Address �`� CCy1S PoN® A0(VD Village C CrTA 117 Owner PgtLP A.-RC_TWAA1Y cZ) D61VC_C Address gS Le."1S PvND ,QD, Telephone ! '"7 pp Z 13CTD o Permit Request TiDN, fLCnJ�✓A7c" �rig?in/U rx5T r LUd>2- t?,ecotjr'tt'kt2e. 04—/ tf- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed 6 7 Z Total new -7 S'Z 'Zoning District Flood Plain Groundwater Overlay Project Valuation Zyyt 'p Construction Type Lot Size Grandfathered: ❑Ye N If yes, attach supporting documentation. ,x Dwelling Type: Single Family ❑ Two Family ❑ I '-F ily (# units) _ Age of Existing Structure Historic H u s ❑.No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full %Crawl ❑Walko \❑ th r Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of-Baths: Full: existing f r w Z. Half: existing new Number of Bedrooms: 2- rst�qg _new Total Room Count (not including t s): e is ing _'new Z- First Floor Room Count Heat Type and Fuel: 4 Gas ❑ Oi ❑ Electric ❑ Other Central Air: ❑Yes No Fireplaces: Existing Z- New Existing'wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new---size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size —Shed: ❑ existing ❑ new size _ Other: \Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION -�._.._,:r-, -�: � .:� -��� -_� ,,.:;:-- t._-.,�-(BNUILDER::OR-HQMEOV6TNER)..-:-.i-•-- : -.� �i-:,fi:,:.�:-�,---:-=:-t- .-.=-�- f Name Telephone Number Address 13-1 51"U✓e6 210 GL 02!vC5- License # C 5 - D 7,55-7 3 oS-tia-Ut rn yZ&S 5" Home Improvement Contractor# /Z 9 Z-1-6 MW� Email CO prcC y S2 (2 G M Al L• , cy ryL Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO IoAcorn/j o-,Q- P sTc tQ - SIGNATURE DATE L FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. the Comxtoyrivealtjh of Massachusetts Departirrauit of IndustriaiAcciderrts M ice of m►estigafions - 600 Washington,street Boston,M4 02111 ft�rva�:nras�gr�v�dia - . Workers' Ccimpensatiun Insurance Affidavit. BinildersiContractur--JE_IectdciansiPlumbers Applicant Information Please Print 1,mbIY Na=(Bas®essPOrganizatiaaflndr Address: I ?i 7 D 2A Ve City/Sta&zip Q0aVj"& mk S Phone i 503 2'2-I _-r2i S' Are you an'employer?Check the appropriate box: ' Type of project(required). 1.❑ I am a employer with 4. ❑I am a ge erg contractor and I 6. New construction employees(full andlor part-time)* have hired the sub-coatmctors '2. I am a sole proprietor orpartner- Bathed on the attached sheet, 7 0 Remoking ship and have no employees Thew sub-contradors have 8: Demolition world fox me in any capacity. enaployees and ham a x>Torkers' t [No workers'comp.insurance comp_ine„MMI 9.'0 Building addition rewired-] d 5. ❑ We are a corporation and its 10.0 Electrcal repairs cr additions 3.0 I am.a homeoumer doing all work officers have exercised their. 11.0 Plumbing repairs or additions my [No wokkers' - right of exemption per MGL 12.0 Roof repairs insurance requited.]s c.152, §1(41 and we have no employees- oworkers' 13-0Other camp-insurance required-] *Any apptisan2.dut sheds box ff1 nmst also fill out the section below shaieing thekWo¢ker a compensa&upalieg information. Momeuwners who sabInd tfus affidatgt indicating they are doing all wmk and tfien lie autMe contractors amst submit anew affidavit indicating satrh =Cantracto¢s ifiat check ibis bmc must attacked au additional street showarg the name of fire sub-cantrsctm and state whether ar oat those entities have em flayees. 'ifthe srrb-cantictam have earplofee%they n=pmuide their workers'comp:policy number. I am an eenplt err Heat isgren�din �t�ark¢rs'cofrrperesataorf irrsasra>zcs for m}*¢acpF�ynees Beloly is file paticy and job s&C infornzadaon. Insurance Company Name: Policy,4-or Self-ins.l.ic4: Expiration Date: . Job Site Address: City/State/zip: Attach a copy of the workers'compensationpolicy 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$U. 00 and/or one-bear imprisonment,as we11 as chit penalties.in the form of a STOP STORK ORDER and a fine of up to$250-00 a day against the-violator. Be adcdsed that a copy of this statement may be forwarded to the Office of Irrvestigations of the DIA few insurance coverage verificatiorL I do hereby certrf}'UJIM tthee paaets and paredita¢s ofper,jdury.that the information prmi&d abmw is bare acid carrect $it ature. CJ Date- % Z _q i j` Phone if: 50 2 ZI 72 Official use.only. Do not fvrite are this area,to be.completed by city ortoan official. City or'I`own.: PermitUcense if Issuing Author*(circle one): 1.Board of Health 2.Building Department 3.Qtyffown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: phone#: Information and Instructions ' Massachusetts Gehamal Laws cbzptea 152 re,,mi=all employers to provide wormers'compensation for their employees. p m this statutp,an ernplayre is defined as`_.every person in the service of another under any contract of hirc, 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 artn association or other I entity,employing employees. However the receiver or trasfee of an individaaI,p ership, � 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 dwcI iag house or on the grounds or building appurtenant therm shall,not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also sues that'every state or IoraI licensing g g cy shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicantwho has not produced acceptable evidence of compliance with the insurance.coverage required-" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor nay of its political subdivisions shall enter mtD any contract for the perl'o=-ance ofpubho wow until acceptable evidence of compliance with the insin-an ce. requirements of this chapter have been presented to the contracting authodty_" Applicants Please fill oil the workers'compensation affidavit completely,by check ag the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), addresses)and phone number(s) along with their certificates)of ncrrrance. Limited Liability Companies(LLC)or Limited Liability Partamsbips(LLP)with no employees other thin the members or partners,are not required to carry wofirers' compensation insurance. If an LLC or LLP does have employees,a policy is regnired. Be advised that this affdavrtmaybe submitted to the Department of Industrial Accidents for confamation of m" stnanee coverage Also be sure to sign and date the affidavit The affidavit should be retuned to the city or town that the application for the pem3it or license is being requested,not the Department of Indusfziat 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. Giiy or Town Officials Please be some that the affidavit is complete and printed.legibly. The Department has provided a space of the bottom of the affidavit for you ton.out in the event tie Office of Investigations has to contact you regarding the applicant Please be sure to fill in the peunitllicense number which will be used as a reference number. In addition, sn applicant that must submit multiple pan itllicense applications is any given year,need only submit one affidavit indicating cmrent p olicy information.(if necessary)and under"Job Site Address"the applicant should wate"aU locations is (may 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 fide permits or licenses. Anew affidavit must be filled ovt each year.Where a home owner or citizen is obtaining a license or permit not relatEd to any business or commercial venom e tie. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Of of Investigations would at to thank you in.advance for your cooperation and should you have any questions, please do not hesitate to give us a call Me Department's address,telephone and fax number: CGMMMwcalth-of Ma sachusztts Department cif Indnstial A OZents dice ref jvestiotio= 6W washftOGIL t B ernes MA E1�111 TeL 4 6 17-727-4900 cot 406 or 1-.9 MASSAAFF, Fax 617-727 7M Revised 424 07 maw-gQtrf�a AWC Guide to WYood Construcdou in Higlr W7nd Areas: IIO r zph HIM d Zone Massachusetts Checklist for Compliance(780 CiMR5301.2.1.I)' Loadbearing Wail Connections' Lateral(no.of 16d common nails)......._..._.................(fables 7) Non4madbearing Wall Connections Lateral(no.of lad common Waits).._._......___..._..----.(fable e)._.....__»._.».....:...._.»......»_......».. Load Bearing Wall Openings(rBmrd largest opening but check all openings for corfipGance to Table 9) Header Spans »..................».»:_...»........:......»..».(Table9)».....:...»._».....».._...._ft—in.511' SIR Plate Spans ._. able 9 FLA Height Studs (no.ofstuds)__.___..___..._._:.........(Table 9)................._._......».._----____- »» Non-L-oad Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans............................_»....:.:......:.._.:._...(Table$)»....._..----...»._._........_ft_in.512' Sig Plate Spans.... ........... 9}.»».»»:.»_.»...»._:»...._ft_in.512' Full Height Studs(no.of studs):.._................. -__(Table 9)........_........_....._.....__._._».. Exterior Wafl Sheathing to Resist Uplift and Shear Simuftaneously4 Minimum Burldng Dimension,W Nominal Height of Tallest Opentng2 .......:......... .»..:_.:_ 5 6`8' Sheathing Type........................._ ...___.•(note 4):e,..»..._.................._...... ....»._ . . Edge Nail Spacing...................... --•-- .(fable 10 or note 4 if less)............._._....... in. Feld Nail Spacing.......... _._...(fable 10)........ ....._........»......... •- in. Shear Connection(no.of 16d common nails)(fable 10)... ........................................._ Percent Full-Height Sheathing.._.__:.-........:».(fable 10)........................._................_. _% 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)._.._.........._. Ma>amum Building Dimension,L Nominal Height of Tallest Openin ..............................................:...................... SheathingType...-....--.----__-------._._._..».._...(note 4)...............».---_._.»..�....»_.........» Edge Nail Spacing.......... (fable 11 or note 4 if less)..... try. Feld Nail (Table 11)........._.»..,._._.....».._.....»,....... in. Shear Connection(no.of 16d common nails)(fable 11)......._..r_.......:.._....:.»...•............... Ye Percent fuff Height Sheathing..._.;_......... -(Table 11)...»..»...._.».._»__...._...:._..:......._ 5%Additional Sheathing for Wail writh'Opening>6'8'(Design Concepts).......... ....»:.. Wall Cladding Rated for Wind Speed?......_.•_.......-_................»....._.............._........._»...... .._.:.».._..»:..__.»........_ ' 5.1 (ZOOFS r Roof framing member spans checked?.....................(For Ratters use AWC Span Toot,see BBRS Website) . Roof Overhang ................................................(Figure 19)._........::_$s smaller of 2'-or LJ3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors 12 .....U= Of Uplift....»..._._.. • . •- R )............ ........... - Lateral........................».................(Table 12).......................--......-.......L= pif Shear............................»._....:....(Table 12)............................._...._._.._S= ptf Ridge Strap Connections,if collar ties not used per page 21... (fable 13)............................T= plf Gable Rake Oudooker.................:_.....___...._._......(Figure 20)............. ft 5 smaller of 2'or L12 Truss or Rafter Connections at Non-L.oadbearing Wqs Proprietary Connecbrs , .:...........: ...:.•--.__.:.-(Table 14)........._._..._.......__»....... Lateral(no.of 16d common nails)_.(Table 14)....................................... 1 = Roof Sheathing Type_....._ ... ._ .._.»...._.._..(per 780 CMR Chapters58 and 59) ........... lb. Sheathing Thickness_............ ___..._ ............ ............................_in.z 7116'WSP ..Roof Sheathing Fastening--::_.•..._-..----»-----___.:....._:(Table 2)_........................................... _....».._ NoiEs: , •1. • This dmcldist shall be met in its entirety,excluding the specific exception noted In 2,to comply with the requirements of 780 CMR.53D121.1 item 1.If the checklist is met in its entirety then the following metal straps and hold downs are.not required per the WFCM 110 mph Guide: a. -steel Straps per Figure 5 b. 2b Gage Straps per Figure 11 m UpGtt Straps per Figure 14 d_ An Straps per Figure 17 e• Comer Stud Hold Downs per Figure 18a and Figure lab 2 'Exception:Opening heights of up to 8 ft.shall be permitted when 5%is added to the percent full-height sheathing - 'requirer-ents shown In Tables 10 and 11. 3. The bottom sIl plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. A FYC-Guide to Wood Construc don in High Wind Areas:110 niph Fiend Zone Massachusetts Checklist for Com'Panice(7so cn-rRs3oi'2.I.i)' C✓1 Check'. Compliance 1.1 SCOPE Wind Speed(3-sec gust).._....._._.»..._.._...........:...._..._.._ ......._......_._......».»..........._.._...._..110 mph WindExposure Category......-._......_.... ..............»_-...._._..............__.........._.......................__........._._B Wind Exposure Category................Engineering Required For Entire Project.......................................0 12 APPLICABILrrY Number of Stories(a roof which exceeds 8 In 12 slope shall be considered a story) stories 5 2 stories RoofPitch. .»...__.._..:._.......__...._........._......._.:... . ..(Fig 2)......................................... 512:12 Mean Roof Height._......._......_._._.»_.........._......_....».....(Fig 2)_......................_....._........._.».»_ft 5.33' Building Width,W....».._»__..»..._._......._..._.._.....:....._..(Fig 3)-.._........._..:................._..._._ft 5 BO' BuildingLength,L .......».._-._._............»._.........__:.........(Fig 3).._...................._.._.................__-ft 5 80' Building Aspect Ratio .. F 4 < - Nominal Height of Tailed OpeningZ ........... __»:r 4)........................................_. 1.3 FRAMING CONNECTIONS General compliance with framing oannections_...__.....__..(rable 2)...................................._..._........_........ 2.1 FOUNDATION - Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete...................... .:.................................................................................................. Conrxete Masonry....... _._..._......_._._............:._..__.........._..... 22 ANCHORAGE TO FOUNDATION" , 5/8'Anchor Bol s4mbedded or 5M'Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general ._._:.('fable 4)...........»..................._...._._... In. Bolt Spadrig from endfjoint of plate...-........_..._.»_...(Fig 5)..»._.._._..:................. In.15 6"-12', Bolt Embedment-concrete._........ (Flg 5). .......».........__..»..._.._......_. _in.L 7' Bolt Embedment-masonry...-..--.:..... 5)_.........I.........................._ - In.a 15' PlateWasher_:...---...._............_...._..._.._»._._....»...(Fig 5).-_--..-----------------------------..._Z 3'x 3-x'/.' 3.1 FLOORS Floorframing member spans checked ...__._.......__....».(pel 780 CMR Chapter 55)..........__............:...».» Maximum Floor Opening ._.. i 6 _ ' Pen g Qimension._:.__.............._.». Fig )....._.....;_..........._....:.._.-...._.... $S 12 Full Height Wall Studs at Floor Openings less than 2'from Fxderfor Wall(Mg 6)..:....................... ......... Mt3xtmum Floor Joist Setbacks Suppoiting Loadbearing Wails or Shearwali...._..»....» i ft 5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls'or Shearwall...._.._..__(Fig 8)_.._._........._............... ft 5 d FloorBracingat Endwals.._........................_........._.........(Fig 9)--_._._.._..-. --------.._.........._._.._..........._. Floor Sheathing Type .»....._........_.._...:...:_:.......».._.......(per 780 CMR Chapter 55)................................ Floor Sheathing Thldmess ......._._............._......_...._:...»(pdr 780 CMR Chapter 55)....................... In. Floor Sheathing Fasfe n -..(Table 2)_ d naffs at in edge/ in field 4.1 WALLS Wall Height • Loadbearing walls._-._... ...... .............._..».(Fig 10 and Table 5)__....__............._ft 510' Non-Loadbearing ........:......_. ...(Fig 10 and Table 5)......._.............._ 1 ' ft'5 21r Wall Stud Spacing ......._..»a.»........:............_..............(Fig 10 and Table 5).._.............._E<-24'o.c. Wail Y Offsets ..(Figs 7 i£8 Start ...._..:_..._..............»..__.............: )-.................................___... ft 5 d 42 On"ERIOR WALLS Wood Scuds Loadbearingv Wp..._..............._................ . 53....._._...................�k ft in. Non-Loadbearing walls........................................... ._.................._.._........_...._:(Table 5). ------- ....-....----2x_ _ft_in. -R— Gable End Wall Bracing' Full Height Endwall Studs_..:_........._..»....._._._..._...(Fig 10)_........_....».......... ..................._......:....... WSP•Affii;Floor Length_..._-._..:-....--_-..__.__.--..(Fig 11) ft zW/3 'Gypsum Ceiling Length(If WSP not used).................:.(Fig i 1).._...._.._... .................. _ft z 0.9W - and 2 x 4 Continuous Lateral Brace 9 6 fL oz�-(Fig 11)....:.... ....................._....._...._ .. or 1 x 3 ceiling furring strips @ 16'spacing min.with 2 x 4 blocidng 4 ft spacing in end joist or truss bays Double Top Plate - Splice Length .._..._....:..:._.........._._...._.._....._..(Fig 13 and Table 6)................._.........._...._ft Of 1 Splice Connection(no. 6d common nark)..»...._....(Table 6)...»..__._........-............._.....».�...... . AfYC Grcide to load Corrstrrrction ul Hio lr Wind Areas: 110 mph 1 sd Zone Massachusetts Checklist for Compliance(790 CZAR s-301.2-1. ' 4. a. From Tables 10 and 11 and location of wall sheathing and Buldtng Aspect Ratio,determine Percent Full-Height Sheathing and Nan Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16*and be installed as follows: L Panels shall be Installed With strength axis parallel to studs. it. Hll horizontal joints shall occur over and be nailed to framing. in. On single story construction,panels shall be attached to bottom plates and top member of the double top plate. . iv. On two story constructlon, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nal spacing afdouble top plates,band joists,and girders shall be a double row of Bd staggered at 3 Inches on center per figures betow:Vertical and Horizontal Nailing for Panel Attachment S. Glazing pmtectlon:a)new house or horizontal addition—required if project is 1 mile or closer to shore(generally,south of Rte.28 or north of Rte.B) b)vertical addition—not required unless there is extensive renovation to the first'tioor c)replacement windows—needs energy conservation compliance only(chap 93) . 6.Wood Frame-Construction Manual(WFCM)for 110 MPH,Exposure B may be obtained from the American Wood Council (AWC)website. vVfiENT=aXE1V-E1 DN MANI iG MEW NAILS AT6'b= • i; . ;.; -fir t n 11 'l to 9 At ..11 Il•p 1 1 (+ ` �. y e i1 '�1f•1T- 1 l f f Y I ;; FRAnarG,L49ABOG m +' V 1 t ED6EMTE ll It G t d 1; toto it Ill t Y 11 fi + if NAIt�S?ACIN[s �`i W PATERN 3`hd14 E PAt� �-; PAWL EDGE Lrl 00U ENAiLEDGESPACMDUAL See Detail on Next Page Detail Vertical and Horizontal Nailing Vertical and Horizontal Nailing for Panel Attachment for Panel Attachment ' �"E Town of Barnstable Regulatory Services BAMSTMM suss Richard V.Scali,Director 1659. � Building Division g 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 1, '&T►'�A y QA EIIJ C , 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: 6' L6W I`j P&VrJ (Address of Job) r I **Pool fences and alarms are the responsibility of the applicant. Pools + are not to be filled or,utilized before fence is installed'and all final inspections are performed and accepted. Signature of e ign Signature of Applicant � pp - �rpp l 134rna.N �C7 C-C— L I—AC-6 Print Name ' Print Name // 3 /-Pev/'s Date Q:FORM&OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services oFT Richard V.Scali,Director , Building Division a►xrtsTwsi.E. ' Tom Perry,Building Commissioner MASS. i639- � 200 Main Street, Hyannis,MA 02601 QED A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling 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 sli ervisor. 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 buildingpermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. j The undersigned"homeowner"certifies that fie/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. F 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 to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 ��_q °7 �.p I C T M AWC Guide to Wood Construeti n in High Wiid�rehs: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 cMR 5301.2.1.1)' Check Compliance 1.1 SCOPE Wind Speed( gust) Wind Exposure C tegory.................................................................. .................................................110 mph ................................................... ........ ................................................. ....... B 1.2 APPLICABILITY Number of Stories ..............................................................(Fig 2)............................ 2t- stories <_2 stories RoofPitch ..........................................................................(Fig 2) .............................:,......... 2 s 12:12 MeanRoof Height ..............................................................(Fig 2)..............................................ly ft :5 33' BuildingWidth,W...............................................................(Fig 3)................................................ ft 5 80' BuildingLength, L ..............................................................(Fig 3)..................................:............. ft <_80' Building Aspect Ratio(L/W) ......... .....................................(Fig 4)...,..............................7.............. <_3:1 Nominal Height of Tallest Opening2 ..................................:(Fig 4)................................................ - <_68„ 1.3 FRAMING CONNECTIONS General compliance with framing connections....................(Table 2):............................................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete....................................................:......................................................................... ConcreteMasonry .................................................................... ................................................................ 2.2 ANCHORAGE TO FOUNDATION'3 kh, IN CetJe tv` 5/8"Anchor Bolts imbedded or 5/8" Proprietary Mechanical Anchors as an aft r a've i con rete only— 'i0/� Bolt Spacing-general ..........................................(Table 4).iZA...N � .. �("( Bolt Spacing from endroint of plate ............................(Fig 5)................................... in.<_6"-12" Bolt Embedment-concrete.........................................(Fig 5).................................................2 in.>7„ Bolt Embedment-masonry.........................................(Fig 5)............................................ — in.>15" y Plate Washer .....(Fig 5)................................................. ...............................................>_3"x 3"x,/4" 3.1 FLOORS Floor framing member spans checked ................................(per 780 CMR Chapter Z5).................................... Maximum Floor Opening Dimension...................................(Fig 6).......................... !4?-ft 5 12'or U2 or W/2 Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)........................................ Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwall................(Fig 7)....................................................=ft 5 d Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)....................................................—ft <_d Floor Bracing at Endwalls................................................ ..(Fig 9).................................................................... Floor Sheathing Type ........................................................(per 780 CMR Chapter 55).......................... .,.... Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55).....................s'1 in. Floor Sheathing Fastening..................................................(Table 2).. d•nails at in edge/ in field 4.1 WALLS Wall Height Loadbearing walls........................................................(Fig 10 and,Table 5)....................... ft 5 10, Non-Loadbearing walls................................................(Fig 10 and Table 5)................ . ,lr. ft <_20' Wall Stud Spacing ........................................................(Fig 10 and Table 5).............. in._<24"o.c. WallStory Offsets ........................................................(Figs 7&8).............................................—ft <_d 4.2 EXTERIOR WALLS' Wood Studs Loadbearing walls........................................................(Table 5)..............V k�.......2x ft_in. Non-Loadbearing walls................................................(Table 5)..............I...... � ft in. 2x - Gable End Wall Bracing' Full Height Endwall Studs............................................(Fig 10) ... WSP Attic Floor Length................................................(Fig 11) ./ 'CI*i' Gypsum Ceiling Length(if WSP not used)...................(Fig 11)................. .... S. ft z 0.9W �,of MASSgc 2 x 4 Continuous Lateral Brace @ 6 ft. o.c. .. (Fig 1'1)................................ .............................. le Top Plate o �1Go`O lice Length ........................................................(Fig 13 and Table 6)....�iZ...;.(itl! �4..1...y ft g G�C�ORPI- N lice Connection (no. of 16d common nails)..............(Table 6)..................................................... .... Q`FSSIONIXV r A WC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Z D F Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)' Loadbearing Wall Connections Lateral(no. of endnailed 16d common nails)..............(Table 7)........................................................ �" Non-Loadbearing Wall Connections /L Lateral (no.of endnailed 16d common nails)...............(Table 8)............................................. .. Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ........................................................(Table 9).................................. ft in.s 11' SillPlate Spans ........................................................(Table 9)...................................6LJ ft_in.:s Full Height Studs (no. of studs)...................................(Table 9)................................. . ....................�1 Non-Load Bearing Wall Openings(record largest opening but check all openings for co liance to Table 9) HeaderSpans.............................................................(Table 9).............................. ft_in.s 12' SillPlate Spans...........................................................(Table 9)........... ..................... _ft_in.s 12„ Full Height Studs(no.of studs)....................................(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 Minimum Building Dimension,W Nominal Height of Tallest Openingz .............................................................................JZ$ 6'8" SheathingType..............................................(note 4)....................................:. .�t.�.......... 1 . Edge Nail Spacing.........................................(Table 10 or note 4 if less(I?A-:a.J.n(gnf.-� -in. ` Field Nail Spacing ....... ...... ...... ............. Table 10 in Shear Connection(no.of 16d common nails)(Table 10).......................... ............... P •� t Percent Full-Height Sheathing.......................(Table 10).................... .:. . . ...Z..�S( 2 1t /°X i 5%Additional Sheathing for Wall with Opening>6'8"(Design Co cepts)G...........� X s2Lj Maximum Building Dimension, L Nominal Height of Tallest Opening2.............................................................:......... ''r��6'8" SheathingType..............................................(note 4)........................sS ........ Edge Nail Spacing.........................................(Table 11 or note 4 if IessL. ../�`.`.J.�,t>au►t= a in. Field Nail Spacing..........................................(Table 11)........................ ........................ in. Shear Connection(no.of 16d common nails)(Table 11).............................. ......... Percent Full-Height Sheathingable 11 ................................ .......r� .. % t 5%Additional Sheathing for Wall with Opening>6'8"(Design C 'ice �......... / � Wall Cladding / Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?.......................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ................................................... (Figure 19)............ 2ft<_smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Mlt"C 511W4 t7,� SI mp-,� Proprietary Connectors Uplift................................................(Table 12)............................................U= L� tfiK d tl Lateral.............................................(Table 12).............................................L=� Shear........... .... (Table 12)............................................S= Ridge Strap Connections, ' collar tie not ed er page 21..... (Table 13)..............................T= �— Gable Rake Outlooker......................................... (Figure 20)............. ft<_smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift.....:.......................................:..(Table14)..................... ....................U= lb. Lateral (no. of 16d common nails)...(Table 14).................. ....................L= lb. Roof Sheathing Type.........:.........................................(per 780 CMR Chapters 58 an 59).................. Roof Sheathing Thickness..........................................: .................... . in.z 7/16".WSP Roof Sheathing Fastening ...........................................(fable Notes: 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a 2. Exception: Opening heights of up to 8 ft. shall be permitted when 5% is added to the percent full-height sheathi �X\ MASSaeyGs requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in. nominal thickness. pressure treated#2-grade. 2``� �GN��p�P� m 00 &EG15 9 SSioNP` 30 pf c'3r.1TT Ai'n4lJ.� Fl IX CIE 4�4 77 w v.Ab S'CRUC YOR:JkL pkl�til. WISP ATTAR H I EN Rol 'to 6�CA CK lG L0_RIZ4T ►t- Q 7�4 i 1 $a ���� ; ► 1 k o.6. I I✓. v691. CIE � I { fi11N19� A,T!t�• I ) l r -MIN. INS P ATTACH M EN T k VERT . kAb 0� Wood'Structural Panels shalt be'minimum'thicicness,of 7/16"and be installed as follows: i. Panels shall be installed with strength axis paralleli tci,,s . ' ii All horizontal joints shall'occur over and be nailed to framing. iii On single.story,constrtrciion,panels shall be at to`boudrn plates and top-member of the•`doubEe top plate. i iv. On two story construction,upper panels shall be attached to the top member of tite.upper double top plate and to band joist at bottom of paneL.Upper attacl ment.of lower`panel shall be nmadeto band joist and lower attachment made to lowest plate at firscfloor framing e: .Horizontal nail spacing.at double top plates,banal joists,andgiiders shall be a double row.:of 8dr staggered:at 3 inches on center per figures below:Vertical an&Hdrizontal Nailing for Panel Attachrnerit . ,..,..... ,_.. .. ..... S or A WC Guide.to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CNiR 5301.2.1.1)' 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio, determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment -11V ENN THIS EDNE RESTS ON RRAhUNG USESd NA,TS AT6�o.c. 11 11 • 1! If Y 1.1 71 11 11 1 /1 It 11 11 It II 11 1 It 11 ! II 1 I 11 O 1 It I! V 11 IL � Y 1 11 11 It I I O 14 of j � f1 11 d !1 1( 1id I 0 Ifl I t 1 Z It 11 !! m 1 ✓L I/ II I/ 11 I1 ' t 0 fl If Ili �1 1.1 �y 1 .�JIF I, jj F 1 It fG 11 it � ! 1 ILL a IJ IJ i4 II j 11 1t � 1 I Q ii - ii Yl 1 li � ii ii � i • IJ 1 1 II 11 JI 1 rI 1 11 It t ♦ NAR..SPACING y See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1.1)' t a 1 1 ZN t / 1 1 1 1 / 1 ,r II FRAW 1 1 • , i 1 MEM 1 , 1 eDs 1 I I Z e2 2 3M� ; 1 1 1 , STAGGfFiEO ��TT�� 3'MNL USA PATTERN � PANEL PAWL EDGE DOUBLE NAIL EDGE SPACING DETAL C Detail Vertical and Horizontal Nailing for Panel Attachment GENERAL NOTES AND MATERIAL SPECIFICATIONS: (Residential IRC Construction) SK-1 FOUNDATIONS 1.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2. For site location and grading information,see Site Plan,by others. 3. Assumed net allowable soil bearing capacity,q=3000 psf,for a medium sand/gravel composition. Other soils encountered, contact the Engineer of Record. 4. Concrete: Minimum 28 day strength,fc=3000 psi,3/4"aggregate,designed per American Concrete Institute Code,latest issue,maximum slump=4". a.) Anchorbolts ASTM A307 galvanized,min.5/8"diameter, 12"long,w/2-1/2"hook spaced per Code Checklist,or in concrete piers w/Simpson ABU-series base;SPACED 2' o/c for slab-on-grade construction(i.e.Gauge,Basement,etc.). b.) All walls to have min.2#4 top horizontal,2"clear,to prevent shrinkage c.) All walls longer than 25' shall have vertical control joint with waterstopping between wall joint. FRAMING 1.All workmanship to conform to the requirements of the Massachusetts State Building Code,latest edition. 2.Structural Design Loads: Dead Loads:Actual Weight of Building Components Live Loads: Snow Load =30 psf(plus drift)with applicable reduction ATTIC Storage=20 psf Living Floor=40 psf Sleeping Floor=30 psf Decks and Balconies=40 psf Wind Load.: Criteria used for 110 MPH Exposure B:or C-as noted per plans 3. Structural Steel: (as required) .. a. ASTM A572 Grade 50;shop paint with rust inhibitive paint.Thru-Bolts: ASTM A307, 1/2"diameter;punched holes: 9/16"diameter. b. Welds: Shop weld cap and base plates to columns;shop weld bearing plates to beams;use E70xx electrodes. Alternatively,field weld by certified welders. c. Deflection Criteria: L/360 total load deflection. 4.Timber Framing: i a.All new timber framing: Spruce-Pine-Fir No.2 with Fb=1000psi,E=1,300,000 psi,or better. b.Pressure treated timber(P`T.):Southern Pine with Fb--1300 psi,E=1,600,000 psi,or better. c.Laminated Veneer Lumber:All L.V.L.shall be 1.9E L.V.L.with Fb=2925 psi,E=1,900 ksi,Fv=285 psi,Fc_per=750 psi, Fear=3035 psi. Parallam(PSL):All PSL'shall be min.7.9E ES with Fb=2900 psi;E=1,900 ksi,Fv=285 psi,Fc_per750 psi, Fc_pat-2900 psi. Note that Microllam and Parallam may be used interchangeably. 1. Deflection Criteria: L/480 Live Load,U366 Total Load 2. Optional: Provide shop drawing submittal of engineered lumber systems for approval prior to materials purchasing. 5.Metal Connectors: As manufactured by Simpson.Strong-Tie Co.shall be handled and installed per manufacturer requirements,with all nail holes filled,with the size nail as specified by mfgr.or herein. a. Rafter to Ridge Beam: Simpson LSSU-series,or Simpson Straps over top of plywood,spaced 16"o/c; Rafter to Ridge Plate: Collar ties min. Ix6@ 16"o/c at top'or Si pson Straps over top of plywood spaced 16"o/c b. Rafter ends to top plate: Simpson H2,.5A c. Band Joist: Simpson straps at 4'ok: CS--14R-48"centered atbapd joist 6.Bolts: Bolts in wood framing shall be standard machine bolts unless rioted qherwisb.Bolt holes in wood shall be 1/32"larger than bolt diameter.Bolt heads and riuts-shall:bear on standard malleable irr n washers,or square plate washers.All nuts shall be retightened at completion of job: ` 7.Blocking: a.Blocking shall be solid blocking,2x minimum,and full depth of member. b.Stud Walls:provide blocking at 8'-0"o/c,maximum height. Comers to be blocked at 48"o/c with plywood edge nailing to this blocking for the first 48"of these building comers. c.Nailing Schedule: Solid Blocking to Bearing 2-8d toenails ea.side. Blocking Between Studs 2710d toenails ea.end,or 2-16d end-nails ea.End d. New Framing:Provide 2x blocking for 2 joist/rafter bays and spaced 48"o/c in joist and rafter plane at all edges;attach plywood edges to this blocking 8.Nailing Schedule: All nailing shall be in accordance with the WFCM Table 3.1 unless noted herein specifically. Multiple Studs 16d @ 12"'staggered 1 a.All nails shall be common wire nails. b.Sub'-bore where;nails tend to split wood. 9. Headers less than 4'-0",'use 2-2x6;all others per MA State Building Code. /V//� 4,/ads �s 3�.� �w� "� ��0115 I it TOWN OF BARN$TABLE B u I I d I 11 g 201504545 . . Building P • BASTABLE, Issue Date: 07/28/15 e rm 't RN y MASS. i639• �� Applicant: CON-SERVE ENERGY RFD MAC s Permit Number: B 20152006 Proposed Use: SINGLE FAMILY HOME Expiration Date: 01/25/16 Location 59 LEWIS POND ROAD Zoning District RF Permit Type: RESIDENTIAL INSULATION Map Parcel 020022 Permit Fee$ 35.00 Contractor CON-SERVE ENERGY Village COTUIT App Fee$ 50.00 License Num. 171251 Est Construction Cost$ 2,100 . '\ Remarks \ APPROVED PLANS MUST BE RETAINED ON JOB AND INSULATION/WEATHERIZATION THIS CARD MUST BE KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: ODENCE,L PHILIP&BETHANY J T BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 44 FARRAR RD INSPECTION HAS EN MADE. LINCOLN,MA 01773 Application Entered by: PR Building Permit Issued By: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY:OR SIDEWALK OR ANY,PART THEREOF,EITHER TEMPORARH.Y,M PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY,NO SPECIFICALLY PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVEDBY THE JURISDICTION' STREET'OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAYBE -. s ._ - - OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OPYTHIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION; RESTRICPIONS. MINIMUM OF FIVE CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.SHEATHING INSPECTION 3.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 4.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 5.PRIOR TO COVERING STRUCTURAL MEMBERS(FRAME INSPECTION). 6.INSULATION. 7.FINAL INSPECTION BEFORE OCCUPANCY. WHERE APPLICABLE,SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS. WORK SHALL NOT PROCEED UNTIL THE INSPECTOR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN.SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). To BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health 05/14/2014 16:00 5086784480 PAGE 01 RICHIE'S INSULATION INC. 111 OLD BEDFORD ROAD WESTPORT, MA 02790 508-678-4474 BUILDING DEPARTMENT TO WHOM IT MAY CONCERN: PLEASE BEAD ISED ICHIE''INSU�L.A, `TIION, INC. INSULATED THE FOLLOWING JOB: ADDRESS: s d TOWN: t'ti . CONTRACTOR'S NAME&INFO;-* I ��n n� THE FOLLOWING INFORMATION IS WHAT WAS USED ON THIS SPECIFIC JOB: � MANUFACTURE: � ��� TYPE �x THERMAL CONDUCTIVITY PER INCH: AREA THICKNESS R-VALUE CEILING WALLS ' STAIRWELL BASE,CEIL GARAGE CEIL G.H.WALL CRAWL OVERHANG CATH,WALL CATH.CEIL W.O.WALL FOUND.WALL BLOCK/RUNN, SLOPES P/V ' THANK YOU VERY MUCH FOR YOUR COOPERATION IN THIS MATTER. IF YOU HAVE ANY FURTHER CONCERNS PLEASE CANT MY PHONE NUMBER. ` INSTALLER: RICHIE°S INSULATION,INC. -p I Town of Barnstable Op'VHE Regulatory Services �y� tio Richard V. Scali,Director �aB, Building Division BARNSTABI,E y Mass. i639 �►, «"n c� Thomas Perry, CBO pIED"" � Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 January 7, 2016 John Lennon 195 Washington St. Easton, MA. 02356 RE: 59 Lewis Pond Rd., Cotuit, Map: 020 Parcel: 022 Dear Mr. Lennon, This letter is to inform you that upon review of the permitting history of the above referenced address;permit application number 201401801 has outstanding required plumbing and building inspections. As the construction supervisor of record one of your, responsibilities is to ensure successful completion of all required inspections. Please contact this office to arrange for inspection or provide an update as to the progress of the work. Thank you for your anticipated cooperation in this matter: Respectfully, L. Lauzon Local Inspector jeffre .lauzon ,town.barnstable.ma.us (508) 862-4034 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 0 ) �`d STA 8 ` Map mZo Parcel E,zz Application # Health Division Date Issued �''" Conservation Division , Application e J� Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board /Z Historic - OKH _ Preservation/ Hyannis Project Street Address 5 Village CdT� Owner m�s E c- Address S �E♦.�.5 �o•�� Ze�•� Telephone "���- Z��- �Zo� C.n�♦, �, ti►,. r,Z��� Permit Request v �.+' ++�,Z.-tam♦o ►`,'_ .+:�. .•`� `�'` L r+.•� 6.Z C_c `�♦ 03E �t..�+ A Z♦C_ � ti+ 'S � cam,` � �+�SE e'we,� �E `.♦., y`.o�E � O Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Zoo 00. Construction Type Lot Size / Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family O" Two Family ❑ Multi-Family (# units) Age of Existing Structure \ gLzd Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing X new Half: existing new Number of Bedrooms: 3 existing —new Total Room Count (not including baths): existing _V new First Floor Room Count Heat Type and Fuel: Hbas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Y,,vr Telephone Number Address 3 '�,e.�. ♦ ti License # -N 46 Home Improvement Contractor# ♦�k i Zs N Email Worker's Compensation # t,a ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO mow, o t SIGNATURE DATE , 1210 FOR OFFICIAL USE ONLY APPLICATION# y DATEISSUED MAP/PARCEL NO. - r - ADDRESS VILLAGE OWNER. DATE OF INSPECTION: 4 - 's FOUNDATION t FRAME 'i t f INSULATION FIREPLACE ` ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Mwoxh tj Elm' i277� 39 iCNR�11ttO �9C SAGO 8 t r .si�rs�t. >0�7i91i2t1�t1 _ Y' +nrm�«.war.�:.:��.,a..y...�.,-�'�z-we,naon....+. ..'""'a^.h• it w,....a.+a._,.p�,w.,e,„sH. ..•*.w.wa�a%is.Mrv/-,-- ,..... :;¢0.i ��/.f'�:'.�4 •ll9i:dlJ�r''`<i"Fe��:d� ��'F`,�e tdJ i.wB'3_'��) _ ...,.. ,,.,,..a... .°__.�-. .-...<..,...:. .w., w—�„. ice of C000r Aftaars 8 sines !R ula�Fa¢ aeense;or ra» t cotton valixt ft+r individial use, anty E IMPROVEMENT OQkYl.ACTQ before the up4.rstlOn date; If foce rl rn#ttm to: tstrataowl+ 17 12st Type,. 0frke®t Gcsrrsur igr Aifai a€�d Business I uDnt€on xpirataon 1 16- parts sMR ii3 rack#' -sidle silo Boston='elA OPlti . CC?tfER1t£#f';tEfx'faY CO NOR.MCINERNEY . 376 RO 130 SURE t SANDWICH WNW »_I of�ots'd�irlcEectist sl Btu i } • 4_ i S. .. Este-oseara:s I mve vis rsuuus.::r%any t nc.l:mn I Irrua 1 t nl ru2ett. IMPORTANT:<If the certfficabe holder is an ADDITIONAL INSURED,the potley{iesj must he endorsed.!f fiU13FtOGATION I.S WAIVED,subject to the tetnhu aW conditions of the policy,certain paNctes may rgquinim an endorsement.A statement on this certificate doss not confer rIgt6 to. the certificate holder in lieu of such eridarseMent s. PRODUCER _ — CONTACT NAME:. CS&SIWORKCOMPONE PHONE Fax Exl: A/C•No P0.136X 948580 Elaaa ADDRESS: Maitland,FL 32784.8680 INSURERS AFFORDING'COVERAGE NAIC# . 1-877-724=2669 INSURER,, Conttnentat Casualty.Company. 20443 wsl�lEo _ _ ii iNsuRER a: _ , CONSERVISION ENERGY . INSURER C. 376 ROUTE.130. INSURER D SUITE C_ PISURER E SANDWICH,'MA 02563 INSURER F., COVERAGES CER WICATE NUMBERS j REASIM NUMBER THIS IS TO CERTIFY THAT THE POLICIES<OF INSURANCE LISTED.BELOW HAVE BEEN :ISSUED 7O THE INSURED NAMED ABOVE FOR THE POLICY rE 10D INDICATED, NOTWIIHSTANDINGANY REQUIREMENT, TERM OR CONgf[1ON OF'ANY CONTRACT :OR OTHER DOCUMENT WITH RESPECT TO WHICH THE 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 Pouci B.LIMITS SHOWIR`MAY HA�IE BEEN REDUCED.BY PAID CLAIMS. tIQSR - WL. R - .POLICY EFF... ..POLICY EXP TYPE Of INSURANCE POLICY rr ... . LTR ' ttMM D NIMID - LJIM - pl r NERAL Lu►eam y 601131633 I 03H 1/15. 03l11116 EACH OCCUARENCE 1 000 000 DAMAGE TO RENTED, COMMERCIAL GENERAL LIABILITY � PREtJISEs� ;.306,660 CL�fS•{uaDE.®OCCUR NED EXP(Ay one peB«,a !4 t100 PERSONAL B:PDV INAIRY 1`OOO 000 GENERAL AGGREGATE..:. 2,000 000' GEN'L AGGREGATE LiMi T APPLIES PER PROOwrs-coupiop Aao $ 2 000 000, A' auroaweI Euaearti 60113163315:. 03/11115 03/11116 (Eaardent)ED SIN a 1,000,000 ANY AUTO:- BODILY INJURY(PO p- ALL OWNED SCHEDULED BODILY MJURY(Fer ectiGent) $ . AUTOS. :.:.. AUTOS. : _.�._. . NON-OAMED PROPERTY QAINAGE HIRED AUTOS /� AUTOS. (RBr acddenl A ulae ua LIABMCLAW&MADEE OCCUR 6011316353 Q311111 b 03111/!.6 EACH OCCURRENCE:., 2 00 000 EXCESS AGGREGATE 000 000 DED X'RETEWTION s 1 000 A 0y LL18R�Iry YIN 6011a1630 03111KIS 03-if TORYL[MffT Ell ANY PR TORIPARTNER!l�ECUME _ Or-fMMUMJ MMM EXCLUDEW, NIA '. E .EACH ACCIOFNT s 600,000 .. (Nu+datory to HH) EL,DISgASE-EA EMPLOYE 3 500 000 It Yes.describe tmdei DESCRIPTION OF OPERATIONS below . . ... E.LDISASE;POLICYLIMIT WCS OTHER TORY OMITS ER EJ_FJ�H ACCIDENT. S El DSEASE E.l,DZ.E.--:POLICY LIMIT M •,tES Certiflcate:Holder is added as an additionat`insured+as provided In.the blanket addi.tioriaf Insured:endorsement as It pertains tci..work being`perfom ed by.named Insured underwritten eontracL INCLUDES PRIMARY AND NON-CONTRIBUTORY: J` CERTIFICATE HOLDER - . . . . . CANCELLATION Rise;EnglneBring SHOULD ANY OF THE ABOVE:DESCRIBED POLICIES BE CANCELLED BEFORE THE:EMRATION DATE THEREOF,:,NOTICE WILL. .131E.. UELNEREtl;: pN ACCORDANCE WITH THE POLICY PROVISIONS: 1341:Elmwood Ave: Cranston,R1.0Z810 :AUTHORIZED KVR=M= ��'t wit pF¢fv.:' ®T Sea-2010 ACORD CORt ►TIOfu<All rlghts reserved AC6.9 26 R201.0(06} thie'Aon name and Ilagq are 1*91sterad matt of.ACORD, i } ajr 3 } C The:Corn omvealth of Marssachrtsetts Ut�partmerttofI,rdksWa(A.cckfenb O, fce of lave N adons tS 8 dYssJ�Pagto�.street �goston NA OZIl1 *'WW' as gayl�ia Workera' Compe rs/ContractorslElectriclaQs/Pinmbers Aoalicantt�nforzaatio®- ,> Please Print Name fBuaitiesalOrgaaizatiotrltndtridt ConsgA.cmon,Energy Inc Address: 378 Route 130 0 IStaWZi : SAndw ch, MA 0.2563 ' Phone#- 508-633 8384 Are you ttrt emptsyer2 atzclY the appropriate bar am a t:mpioyor wtth rVe a ge mew contractor and t Type iDf�►} (re'9employees(Rtll.and/or part-tinnej" hir+�ci`the actors 6 0 New:aorchoa 2 Q I aat a sole proprietor arparmer- �' on the attached sheet, 7: Q Remadating: ship and bave no employeesbconttaciors have working :for cne in any ca aci ! g Q DecnohtFon P h'`. �and have workers [No.workerai'camp. insurance �Qmp insurance.t; 9 []Building a�i tion. requind:� 5 (� We an_a oration and'ts I O.Q Btectrtcat repairs or;additions 3'.❑ i anq a hatineowner doing"art worts o cers have euamstb thenPhunbmg irs or>additions myself.[No workers'comp ti ,'t of exmsption par Midi. instrrance,requim&j t c•�tS2, l(q).and we havt3 no 11.( Roof;tepairs .3a.Q I am a hoeteownar acting ea a c ' .Ioyees;:jNo okers 13.Q Other Weatherizaton, gcnersl coz�aetatr(refer is�) cp. f�Y apDticW that cLo&s bax A tmtat atao tilt out tha aec Ce t Nom a woo submit this affidavit' ss tboir wotkas Qy 8 ref aze'doing al�wads add dead tta,s outside canuactrmtttt subunit a ttaw affidavit tCoatncbota jM that check tips box matt aarched an additiadal:sbast ' t; h ; the xsmo of die and state.wti or not d>oap edtitia hays cm�ta3aea.`If tlm have er>xdoyas, they n:»F� ' their warkett'came.PoiicY ink I w»ew ellrptpyer drat is pravldiirg tvori�'� Ir+fie�lW'O�et of . I oretadorsgh° f empfoyeewt, Bettiese f Po�ey'arulJob slte Durance Company Name CS,&SNVC7RKC.OMPCNE Policy t�or.Self-ins.Ltc # 60113 9, Fatp - - tration Data: 3=11 2016 Job Site Address City/Statcm :. 77� Att:ch s Copy of rite wartrers'compensattan porky tka Faihtra to secure coverage ase 4a ° °g�1°lfii'nnmbm'antd elratfOe:iiate}. t�egttrextrrr wader Sow 2Sral:of MC#L c. i52 can lead ro the fiao uP to'i l,St :t30 and/or opo- ear' 3 imposition of.crtsn -pevaitiea:of a. Y : tmpcisann�eat,as Well as civrl of b 2Sti.(ID a.da a penalties in the farm>of.a ST©P WORK©"ER and a fine Y 8t sha;viotat Be advised hat a copy of this statement may:be forvliaaiai to die Otyrce+of investigations of the DCA.for msuraace citverag®venfscatron.. !rlo Adab►eern�► /h palms an d penalties:of that�r b� p Alm b,�rr arrd cort►,e,ca ;. Zv Do w*ldtrl+t tlrb;asrq tuba raplsted by clip or rotvri..oif QTcJat Clhr o>•Town: � PerrrtltlCtcetise g;. ;issntn `:Au tda a n e . 1w Battu^d of NeitEtb 2.Li lid Deprtrtmtent;3 CitJ� l'ovr$Cterk 4:Ekcftk Inapectar S Plumb ib eele ` Uther Contest Person: Phone .. r - OWNER AUTHORIZATION FORM or of pry kmew at aWwlm C4n9eMWwv Ene;W,to act on rw behWto bra a bt Wng W tD ®a E w-A OP.my pmpny. . S6 Dam a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel G;Z,_Z TOWN OF FA f'STA j1 Application #Q al Health Division rai'1 r;: Date Issued 'VAR_�6 Conservation Division Application Fdv(C� Planning Dept. _ Permit Fee �'�4 5 —sazsl . Date Definitive Plan Approved by Planning Board DID' i J.�S+� ' Historic - OKH _ Preservation/ Hyannis Project Street Address �� P_[.c,/S Ro 0,0 7L dvO Village r C(0,T h_f-T Owner_ k�7e7 1 l�ev1 C� Address �C�✓y\, e— Telephone Permit Request 'De.W)U c"S, fs fi ccxii+z-7 Sk�eC� Sl s�e ZX<' F tc�c�s TU e?�s�►��, 2�c iZR . ��l�r <cer��yCc��9�r. k J 11,e 106,�fvq tul'A sk,,,% co►+ ✓--kuv, s-k— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation QW Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. pp g Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No' Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 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 �--��S � V)V.)on Telephone Number (�Q Address Cl a S 41' 6 ft.�-� �� License # <fsE ' rz� (M45,5 Home Improvement Contractor# AD/ $65 Email �UO •C-iwi Worker's Compensation # WCGsoo54OS ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ����� RQG-i�c�l r-, �oc.�-�c�� ✓Yl�5� SIGNATURE DATE R.` FOR OFFICIAL USE ONLY APPLICATION# DATE.ISSUED s MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION a•• t FRAME OR) ra ' 19 INSULATION 5 L41 of lit J f, FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL G GAS: ROUGH FINAL r FINAL BUILDING 3EB IL DATE•-CLOSED OUT ' ' ASOCION PLAN NO. a., ACO® \ DATE(MWDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 3/25/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Select Dept. ext 66807 Eastern Insurance Group LLC NAME: T_FAX PHONE (508)651-7700 (A/C.No:(781)586-8244 233 West Central Street E-MAIL' ADDRESS:selectwork@easterninsurance.com INSURE S AFFORDING COVERAGE NAIC# Natick MA 01760 INSURERA:Selective Ins Co of Southeast 39926 INSURED INSURER Associated Employers Insurance JACK LENNON FINISH CARPENTRY INC. INSURERC: EASTON KITCHENS AND BATH INSURERD: 195 WASHINGTON STREET INSURERE: NORTH EASTON MA 02356-1116 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1421128218 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. 1LTR TYPE OF INSURANCE POLICY NUMBER ADDLSUBR MNWDY� MNWD� LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY PREMISES Ea occurrence $ 100,000 A CLAIMS-MADE OCCUR S 1917998 2/22/2013 12/22/2014 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 3,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 3,000,000 POLICY X PRO LOC e $ AUTOMOBILE LIABILITY Co cc r SINGLE LIMIT 1,000,000 A ANY AUTO - BODILY INJURY(Per person) $ALL OWNED M SCHEDULED 9092712 2/22/2013 2/22/2014 AUTOS AUTOS gODILYINJURY(Peraccident)X HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident Uninsured motorist property $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ HEXCESS LIAB CLAIMS-MADE AGGREGATE " $ DED RETENTION$ $ B WORKERS COMPENSATION X WC STATU- OTH- AND EMPLOYERS'LIABILITYL,1141 . ER ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N. E.L.EACH ACCIDENT $ 500,000 B OFFICER/MEMBER EXCLUDED? � NIA rC50050057182014A /6/2014 /6/2015(Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ 500 •000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CARPENTRY CONTRACTOR Re: 59 Lewis Pond Road, Cotuit MA CERTIFICATE HOLDER CANCELLATION (508)790-6230 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis, MA 02635 AUTHORIZED REPRESENTATIVE Ronald Cleaves/CMH2 � ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025l7mrin9 rrt Tho ar-np l nnma nnrl Inn^era raniefornrl mnAre of arr1Rr1 The.Commonwealth of Massachuseffs Department of IndustrialAccidents - Office of Investigations ' 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/Organization/Individual): ( �vL�iC [GtCSv, Address: City/State/Zip: 5 c Phone 7_'3S-�G•7k Are yo an employer?Check the appropriate box: Type of project(required): 1. am a employer with 4. ❑ I am a general contractor and 1. employees(full and/or part-time).* have hired the sub-contractors 6. ❑New constriction 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 workingme in an aci employees and have workers' for Y capacity. �• comp.in�trrance,# 9. ❑Building addition [No workers'comp.insurance p• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbing repairs or additions 3.❑ I am a homeowner doing all work � ❑ g P myself. [No workers'comp. right of exemption per MGL 12.[]Roof repairs insurance required.]t c. 152, §1(4),and we have no ' employees.[No workers' 13.❑Other comp.insurance required.] *Any.applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. tContractors 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: F Policy#or Self-ins.Lic.#: I�VGL /FZc)I'/A1 Expiration Date: Job Site Address:!Z Lat.,,( S..,.pot,10 /L�24w City/State/Zip: (2;h /T f sS. Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th ains and Penalties ofperjury that the information provided above ' true and correct Signature: Date: Phone 4: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 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 for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their 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 submif multiple permitllicense applications in any.given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le.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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel,#617-727-4900 ext 406 or 1--V7-MASSAFE Revised 4-24-07 Fax#f 17-727-7749. www.mass.gov/dia a stood �bq • ...... I(769TL:JJLOJl1UCIXlIld .,.,. OfticeotConsumer:A'ftairs&)�usiness;Regulatiou } ME IMPttOVEMENT CONTRACTQR eglstfatior} AD, TYPe xpiratlon 6/29120 i4 Private Cotporatic JACK LENNON FINI H CARPENTRY,INC John Lennon N4 51Nashington St NE aston,MA' 2356 I7nder§ccretary 4 ssachusetts .De artment isf Publfc:SaTety,`4 Ma .; P t3d of 6uildrng f2eguMations artl Standards a, cene CBF-A-0b3Z15 q �@, i_C 195 W ASH[1VGT(3N 5T 23 EASTON MAC 0 Sb - � a a `r 11 lsl. X'(af �ttOR osr2 v2tifa A s rid t t d721 (parrUryaaracuealC�o�C�Glcv�Oac�uaeC�- Office of Consumer Affairs&Business Regulation License or registration valid for mdividul use only ; ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: r1egistration: 10,1869 Type: _ Office of Consumer Affairs and Business Regulation iration r 6/29l2019; Private Corporatic' 10 Park Plaza-Suite 5170 a T Boston,MA 02116 JACK LENNON FINISH CARPENTRY`INC: - John Lennon i 195 Washington St �_. N Easton,MA 02356' - Undersecret ry Not va without signature V'V ' I cn �n II I II O I i I � I I � I I � I I V-O 1/ " 2'-6" V-4 1/44" I I I 'I' I I I � I a I < I HEN • I 12'-6 1/2" r r L. PhiI p and Bethany Odence 59 Lewis Pond Road Cotuit,MA 02635 March 27, 2014 Town of Barnstable Building Department 200 Main Street Hyannis,MA.`02601 Attention: Sally.Shea Regarding: Odence Building Permit/59 Lewis Pond Road I Bethany Odence authorize Jack Lennon of Jack Lennon Finished Carpentry Inc.to do work on my house at 59 Lewis Pond Road,Cotuit MA 02635, Sincerely, Bethany 1. T. deuce •3: TOWN OF 9ARNSTABLE BUILDING PERMIT APPLICATION nAa p Parcel O azd Permit# "3'�-°7 . 2-'2-- Health Division ).0o 'mate Issued Conservation Division �" 200'APR _6 AN, It: 3 plication Fee Tax Collector i Permit Fee Treasurer EX4TINt3 SEPTIC SYSTEM Planning Dept. UMMOTO„ , ,,,> OF OOROOMS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ' Project Street Address [G- I; Rd v�J_ I Village (�esKcfi Owner � + k 4to Dd6nee_ Address +war . L f ftl us 14A Telephone 74;Q 2XI 12t'!ft Permit Request st-, 42?�Xr Square feet: 1st floor: existing d proposed Z 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type y Lot Size • 3 _ Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family �J' Two Family ❑ Multi-Family.(#units) Age of rExisting Structure YS7 Historic House: ❑Yes -e o On Old King's Highway: ❑Yes W-t4'o Basement Type: ❑Full ❑Crawl ❑Walkout 21"Other_!a vti 1 c���•�'` / -F� c� awe Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) o v Number of Baths: Full: existing 1 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 UOUNI ❑ Electric ❑Other Central Air: ❑Yes O'`o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size, Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use A / BUILDER INFORMATION Name Fhr lf O ('sc,(f� Telephone Number 78Y al'5 (Z°9 Address 1pm,N ►-- 2d License# Home Improvement Contractor# Worker's Compensation# x ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE' DATE FOR OFFICIAL USE ONLY d { s. 1 t PERMIT NO. i � V DATE ISSUED �• MAP/PARCEL NO. r� - "- •. ` ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATIONy q� FRAME INSULATION � I FIREPLACE ELECTRICAL: ROUGH .., FINAL-- ` - f PLUMBING: ROUGH" FINAL M GAS: ROUGH 15 FINAL BUILDING DATE CLOSED OUT (1 s ASSOCIATION PLAN NO. _ t I 1 oFJHE-ray, Town of Barnstable Regulatory Services Y BA '''ST"B , " Thomas F.Geiler,Director �Qp M�1 A1�$ ` Building Division Tom Perry',Building Commissioner �e " 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 E 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: (Ins�'•-�+��"1 Estimated Cost 42b"> Address of Work: S'9 L" S 16'+c-1 G C< r-t 1 I +'l�- Owner's Name: Date of Application: I hereby certify that: a Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑ ilding not owner-occupied [ weer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR ` 6 ,r P4111 odCh C_C-- L - Date Owners Name QIorms:homeaffidav The Corrcfnonweaith of Massachusetts Department of Industrial Accidents' MVO V!bw$MVM — 600 Washington Street f Boston,Mass. 02111 . Workers! Com ensatioon..Insurance Affidavit-General Businesses �� //•��///� ��/ /��//� //�///�� //////////�/���//1���" %���//% ����:4•:,•'•-"'�}. ,;Ti%Y,stev>• .j'a4 cr�M{:�,r'aT.w,. .. --. .n � ` .,. ,:\- �—•.:i'+.Xie59] 4, address: gyp' Mtv �1 nGo`n - r state:* m -4- ziv: L?1t}•�'� Rhone# /.o I.L�`3. I.Z�7 work site location full address): ❑ I am.a sole proprietor and have no one Business Types []Retail 0 Restaurant%Bar/Eating•Establishment ' working in any capacity. ❑Office[] Sales(including-Real Estate,Autos etc.) I am an em to er with em loyees�111& art rim, [-}' ther ©why I am an,employer providing Workers' compensation for my employees working on this job. • �. :. :fit:::f? •t.• '!i•'• :q•...• lt:L i '!:' u'i '•i:{•?•' 'fir t', co an 7. .mot,. ' •!4: .'i' ,.P rr� '•l r'' •L ..J•. ,L. 5''ri(: '{.. i 'nsurance.co'' / I am a sole proprietor and have hired_the independent contractors listed below who have the following workers' .compensation polices: Pan nam coin .rY� .v,''' - ,•A 77."1•••S•i'•.:,ar4't;. •A,i• .tr _ hsine*i. :. r.,.. '+' a;. c•"•d.l"1as 'r'. ''U•liC :.#,: ,e.?�':L.. '}r'.i'.`:`i'•• '•'>'•..`f.•; insurance co. �` :'r �'e' %�%%//%%O//• / - is '9••r.:y :t��:G:�i•:• `„ :. �,S.:fr f'Jt t•' '�,. ,j•� .'h :t'1 ;t.'' a r.• "•'L�{. '! . coin`6n neaie9`�'�f •s'`` •`�` - . a$dre'ss: o insurance cb: '' Failure to secure coverage as required under Section 25?,of MGL I52 can lead to the imposition of criminal penalties of a fine up to S1,500.00 anator one years'imprisonment as well as civil penalties!a the fsirm of a STOP WORK OILDER aad a fine of$100.D0 a day against me. I uaderatand that tt • copy of this statement maybe forwarded to the Office of Investigations of the DIA,for coverage verification. I do hereby certify under the pains and penalties of perjury that the inform provided above is true and/correct Si tore 4Date riot name i P O D€4 G� - Phone# Zd 1 Z `Z9 P official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department . _ ElLicensing Board ❑-check if immediate response is required ❑Selectmen's Office ❑Health Department contact person phone#; ❑Other (revised SepL 2003) a 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 m the service'of another under any contract of hire, express or implied; oral or written. .1.' An employer is defined as an in vidual,paYtnership, association, corporation or other legal entity, or any two,or,mgre 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 en ployspersons to -main , 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 br 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, 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.,Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Departrnent of Industrial Accidents-for confizmation 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 epartment of industrial Accidents. Should you have any questions regarding'the"law"or if you are requested, not the D 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 andprinted 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 perrrnt/licens.e number.which will be used as a reference number. The.affidavits may.be',returned to the Department b' unless other have been made. Y.ina or FAX The Office of Investigations would h`lce to thank you in advance for you cooperation and should you have ahy questions, Please do not hesita didgive.us a-call. The Department's address,telephone and fax number: , The Commonwealth Of Massachusetts- Department of Industrial Accidents 8mce of wesuganons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (6I7) 7274900 ext:406 Town of Barnstable Regulatory Services snxrtsTABL& ; Thomas F.Geiler,Director 9� ass.039. .� Building Division � AlEO MA'I s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 9�3 0. JOB LOCATION: 15_/ �"� �Oh '`C Cie�U l number I n street village W "HOMEONER': 5A, f PK��IC� �Kce Zrl 2s? 11- °I . 7f,11 246 3,13e name home phone# work phone# �j�/ CURRENT MAILING ADDRESS: —['l k-e­gr- city/town state zip code The current exemption for"homeowners was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures..A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. . The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Ho owner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 1... Odence Shed 59 Lewis Pond Road 24' i Cotuit Map 020 Parcel 022 Plan 4.1.05 _ 4 �z. Cm CV HER V YJ co I - N n ---- �- 5' 7'6 6'10 4-8 24' zS Ridgepole x6 Rafters ouble 2x6 x4 Studs on ouble 2x4 eader 16"centers eader Sliding Barn Door Odence Shed Scale: 1/240: 1 59 Lewis Pond Road ` Cotuit Map 020 Parcel 022 N Plot Plan 4.1.05 s 160'-0" 0 4 Q Bt5, Bl gm 00 36'-0" 00 * Proposed ;4 ��dlva �Ullru �Ullurr - \\yaY��� Q\y�J �\yaYw i __ C -_�_� C� C `-- oCO Y� I I C i Se ao Q _.._.._. C cu ss SEPTIC, Lewis Pond Road Odence Shed 59 Lewis Pond Road Cotuit , i Map 020 Parcel 022 101. Foundation Plan 4.1.05 Sonotubes Double 2"x8" -- with Big Feet 2"x8"Floor Floor Box Aye Joists c+lb.. ft�s 240.00 16.00 120.00 07/27/2004 08:41 FAX 17817210 93 HALL AND SULLIVAN W02/002 JUL-27-2004 09 :57 AM p. 03 . REGISTRY: S L TITLE REFERENCE: 4% PLAN REFERENCE:Plwz &241__ �i Lod" I Get, °0 4EGK �N 4 7 . soPt�� 1 --E W iS Po N D 1Zl OAia This plan was not prepared tom an instrument survey. MORTGAGE INSPECTI PLAN Offsets and distances shown should not be used to establish property lines. o LOCATION This plan is intended for mortgage purposes only. a,,,/a I certify that the atrueturC .___shown on this Plan SCALI=: � DATE �•�= ---- `ja-s.,in conformance with zoning setbacks in effect at the time or construction, CERTIFIED TO: ?7" CA.MERON BROTHERS INC. Job No. 11 Towo Ave.Medford, MA (781)324-9566 I 06/03/2005 06:37 FAX 7819938973 EMPIRIX CONTACT CENTER 10001 r, 1 FAX To: Jeff Luzon , Fr: Phil Odence,phone 781.258.9502; email-Phil-odence@a,um.darrmouth.org Jeff, ; Attached is a copy of the site survey I recently commissioned for 59 Lewis Pond Rd, Cotuit. The good news (whew)is that the setback is 17'5" which means not shed moving is required. Could you let me know how we can close your file on the building? It is locked, so if you need to see the inside, we'll have to make arrangements. I don't know if you work on weekends ever,but I will be there tomorrow and Sunday. (The number above is my cell phone,it should be on.)Alternatively,my father lives very close by and could let you in. (His number is 508.420.0956.) , Please let me know what needs to be done. THANKS, Phil , t 06/03/2005 06:39 FAX 7819938973 EhiPIRIX CONTACT.CENTER" 062 1 (FND), 06 r j. P'//'o, n //.op.1^0 w 1�r ///// e oo A /// ////i/i/////////.. //.1//PPP///PP//r +P DECK LP. A.M. 20123 r; ///// �- w oe O. // /// A.M. 20124 e• � f` . ¢-fir is ` r r•. - - "i..,. _ , s , h • 06/03/2005 06:40 FAX 7819938973 EMPIRIX CONTACT CENTER 2003 a (�,B, LOTUll P«¢ �D 0 T COTUIT ROAD (FND) STREET BA Y ScKoo I LOCUS LOCUS MAP PLAN REF. 26—71 & 127-27 0 ASSESSOR'S MAP: 20-22 ZONING: "RF SETBACKS.'• 30'-15'-15' DEED REF 18388=166 FLOOD ,ZONE.• ® PLOT FLAN OF LAND LOCATED A2% 59 LEWIS POND ROAD LOT 187 COTUIT .MA. v 20/22 ` s� P`S�OF tiusss��r , t i U sTE PHO PREPARED .F'OR. ' ppYLE , #a� r ,PH1L. P .& BETHANY ODENCE JUNE 12, 2003 . ' LOT 164 REV �$0� A.M. 20121 REV- REV _ YANKEE LAND SURVEYORS GRAPHIC > SCALE & CONSULTANTS -zo o 10 zo eo P.0, BOX-265 . E UNIT 1, 40 INDUSTRY ROAD MARSTONS MILL: MA 02648 1 inch ="20 ft, 9EL• 508-426-0055 FAX`508-4P0-5553 SHEET 1 OF 1 ✓OB ,¢� 53893 "✓F - - .. 1. � � •' _ - E ., - � . Engineering Dept:(3rd floor) Map Parcel i' (� �.. _ Permit House#. // • Date Issued 1b Board of Health(3rd floor)(8:15'-9:30/11:00-4:30) Irl Fee � ✓ti�0 �Lf/�'�t"J Gees ion Office(4th floor)(8:30-9:30/1:00-,2:00) A miflg�t.(1st floor/School Admin. Bldg.) Definijfrylan Approved by Planning Board 19 ' ,i�.O!. # : BARNSTABLE • . MASS. i639. ., TOWN OF BARNSTABLEF° �� Building Permit Application ProjectNtreet Address j�d ' Village Owner` Va, Address ,J2 LeG( f5 r-Telephone )R— 3ci -Permit Request ` L?f 70-Ah j') alhl-pel-y 3 " First Floor I square feet Second Floor square feet 'Construction Type a - Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size 100 Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 65 14 r5 Historic House ❑Yes �56o On Old King's Highway ❑Yes 1Qo 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 No.of Bedrooms: Existing :3�New Total Room Count(not including baths): Existing_ New First Floor Room Count Heat Type and Fuel: ❑Gas XOil >(Electric ❑Other Central Air ❑Yes '(No Fireplaces: Existing New Existing wood/coal stove ❑Yes )41No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) `None ❑Shed(size) . j' \ ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes .,XNo If yes, site plan review# Current Use e,5 e n Proposed Use Builder Information Name Telephone Number CAR Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO , SIGNATURE DATE &OZ-, BUILDING PE I ENIED F E FOLLOWI ASON(S) i FOR OFFICIAL USE ONLY PERMIT NO. GG DATE ISSUED �a MAP/PARCEL NO. " ! - :� ,;' ! 4 r• ` +�. a; -. - r `� # —i. • � � "'`4 _ s ..L - t i s �-!7 "':may ADDRESS -: `= VILLAGE OWNER - DATE OF INSPECTION: " - I FOUNDATION FRAME 4- Dfq� INSULATION (FIREPLACE ! i t ELECTRICAL: ROUGH i ; FINAL PLUMBING: ROUGH " _ FINAL ' • r r` f' GAS:' ROUGH FINAL : - rrfilt ? ,.. FINAL BUILDING �, `) G�! } � - - _ • ` K' DATE CLOSED OUT f ' ASSOCIATION PLAN NO. fi t °Ftwe A The Town of Barnstable • snxrisr�ai.E• - 9�A ,0�' Department of Health Safety and Environmental Services rEDMA't� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Per no. ! Date AFFIDAVIT s 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: ( Est. Cost Address of Work: Le d 60b, ,:5,5 Owner's Name,,7— t)a 1,M, I MCA 06t V aa-- Date of Permit Application: i hereby certify that: Registration is not required for the following reason(s): fit• � n Work excluded by law ' Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS 'PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE , ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR gm, (2-z Date Y WOwner's Name The Cunrnruin+-calt/t rlj?Itrrssacltusctts �!,i _._. �•��- Department of ludustrial Accidents office 01/77estf9211flts •R 600 If aWlittwtun Street ��::�_•:� Bustutr,A1ass. fJZlll. Workers' Compensation Insurance Affidavit _ Annlicant information': Plcnse PRINT ZMUI r. name\X� V location i 2 en,2d &0/ zA yin c V �,� ` I �r � nhonc 7'v lJ "1 (� t I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity . . —..--- _•.._...�—��'s...-..�,..cs.-w.•.•.ors—Sa•w ............--.......----•---• .. [! I am an eniplover providing workers' compensation for my employees working on this job. mmeam• name: address- city nhnne#- incur-ince co.— XT am a sole proprietor. general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: o m am• name• a:YI 1� ddresc: • � �` [� ►�j city 11 ,5 Y"�J-)I:5 , nhonc N• I SOX incurincr co.— noliev 9 conip.1 nnmo: 1 addres.r. tits•• a rs tors r hone II• insurance co. nolict•# Attach additional sheet if necessary. �'— -i c _ * -^+�• e;y,.-_ •�• '% �'' "r•c y-+— " +^-'^ —' Failure to secure covernec as required under Section=5A of NIGL 153 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur unc y cars'imprisonment as well as civil pCn21tics in the form of a STOP NVORI:ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statentcut ma% be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do here;� T; uttler the gait enalries erjurr Ilia'the information prorided above is true and con t.. Signature Date Print nam �/V /y / L�Q Phone# ' official use only do not write in this area to be completed by city or town official T' . city or town: permit/license N nBuilding Department C31.1censing Board check if immediate response is required., C3Seieetmen's Office C311calth Department contact persnn; phone#: tnUlher . o �� w4 Information and Instructions ' Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the employees. As quoted front the "law". an emploree is defined as every person in the service of anutlicr under anv 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 mo: the fore�_oin- 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.emplovees, However tl-. 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 he or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that every state or local licensing agency small withhold the issuance or renewal ofa license or permit to operate a business or to construct buildings in the commom%caith for any applicant m.•ho has 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 been presented to the contracting authority. T- Applicants r , 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 as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Alio 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 require: to obtain a workers' compensation policy. please call the Department at the number listed below. City or•i owns t Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom c the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned 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 questio: please do not hesitate to Live us a call. ' The Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations 600 Washington Street s Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 37S =.NOON■■■■■'■■■■■NOON■_I■■■■■■■■■■■■■■■� !�OO��"��■■■'■■■■■■■■■■I■■■■■■■■■■■■■■■ ■■■'■■■IIR'•_�■■■■■■■■■■N■1■■Y�ii�al�lii�l�il�iY■■■ ■N`i/■Eri■■■■■■■■■N■I■■O■�■■fit■■■■■■■ ■■■■■■■■■■■■■■■■■■■I■■■■■■■■■■■NONE; ; O■■■■■■NEE■■■■L:'�i�i "O`O■I■■■■■■■■■■■NON■ ■ENE■■■EN■■PI■■L'vi� ■I■■■■■■■■■■■■O■■ ■■■■■■■■■■irr�■■INEi�■JNE■■■■E■■E■ ■■■■■N■■■■■,■■N■■■■■I■■■■■■■■■■■OO■■I NNE■■■E■N■t:!!i■O■■■■■■I■■■■■■E■■■■■O■Eli ■EON■■■O■■r�■■■■■■■�!■OOO■N■■E■■■■■■If O■■NO■■■■NEON■■■■■■N■■■■■■■■■■■■■■■! ■■■NO■■■■■■■■■■■■■■■O■■■O■■■NNE■■NEB ■N■■■■■■■■N■■■■■■■■■■■■■■■■■■■■NONE;MEMO ■■■■O■■■■■■■ �� i[��ilr■Oil■■■■O■■■■■■■■■' NEW ■■■NE■■■■■■NNE■■■N■■■■■■■■■■■■■■■■E . NNE■■■■■■■N■■■O■■■■■■■■■N■■■■■■■■■■! ■NCO■i�■N■■■■■■�lE[►����lE �rr�■■E■■■■E■■■: ■■�O■If■■■■■■■■>■■■■■■■Ell■�O■■■■■■■■' ■EEO■ti■■■■■■■I■■■■■■Nii�' ��■■■■■■■N■. s • -W 500 SHEETS.FILLER 5 SQUARE 4238l 42 50 SHEETS EYE-EASE®5 SQUARE NNad011a1®BrBnA 42 38 SHEETS EYE-EASE'5 SQUARE �SHEETS EYE-EASE'5 SQUARE 42-392 100 RECYCLED WHITE 5 SQUARE 42-399 200 RECYCLED WHITE 5 SQUARE —e In U.S.A. 1 . i. S ii 1 If 1 i I , J � 1 J � t.4 \ 1! t I! r+u y ■■■■■■■■■■■■■■■■■eery■■■■�,���■■■■■■■ ff WREN NONE 0 y7rl MEN ■■i�7■■I■■■■■■■■Ie■■■■■■■C■a!��J■ � i■■. ■e■■■��■■■e■�■■e■■■ee■■■eye■■■■■■■■■■ 13782 0SHEETS YE-EASE 5SQUARE 42-381 50 SHEETS EYE LEASE®5 SQUARE NNetlonel®Brand EYE-EASE'5 SQUARE 2 89 100 SHEETSSHEETS EYE-EASE'5 SQUARE • 42-392 100 RECYCLED WHITE 5SQUARE 42.399 200 RECYCLED WHITE 5 SQUARE Me4a in U.S.A i i f i ! r a a + o j r w f r' j f I, � r f • TOWN OF BA.RNSTABLE : • BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE JOB. LOCATION �� `QG, ) Number Street address Section of to "HOMEOWNER" a r�, Name Home phone Work phone PRESENT MAILING ADDRESS PO 'D 1� /R c City town State Zip coc The current exemption for "homeowners" was extended to include owner-odc-= dwellings of six units or less and to allow such homeowners to engage an i. dividual for hire who does not possess a license, provided that the owner acts as suoer-visor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one or two family dwellii attached or detached structures accessory to such use and/or farm struct•.ir_ A person who constructs more than one home in a two-year period shall not r considered a homeowner. Such "homeowner" shall submit to the Building Of': on a form acceptable to the Building Official, that he/she shall be resrenz for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Building Code and other applicable codes, by-laws, rules and regulations. he unde_s;,aed "homeowner"' certifies that he/she understands the Town of arnstable Building Department minimum inspection procedures and requiremen nd that he/she will comply ' th said procedures and requirements. OMEOWNER'S SIGNATURE �;�z 2e OPROVAL OF BUILDING OFFICIAL ate: Three family dwellings 35., 000 cubic feet, or larger, will be require_ comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION ,ram The code state that: "Any Home Owner performing work for which permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that is Home Owner engages a person (s) for hire to do such work, that such Home Oki shall act as supervisor. " Many Home Owners .who use this exemption are unaware that they are assuming the responsibil.iti.es, of a supervisor (see Appendix Q., Rules and Regulationz for licensing Construction Supervisors;' Section 2. 15) : This lack of aware:. often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the nlicensed person as it would, with, licensed pervisor. The Home "Owner- acz as supervisor is ultimat Su ely �tesponsibie.' , "o ensure that the Home Owner is fully aware of his/her responsibilities, m. communities require, as part of the permit' appiication, that the Home Owner oertify that he/she understands the responsibilities of a supervisor. On t: .ast page of this issue is a form currently used by several towns. You ma-: pare to amend and adopt such a form/certification for use in your eommunit- . ' d +:ra.: Assessor's map and lot number�0....J�................ / Sewage Permit number 1..4!1-1A.../A. ....... �QyO%TNETO�yO TOWN OF BARNSTABLE i BABHSTOBU, ° 1639. .e� BUILDING 'INSPECTOR ° 1 APPLICATIONFOR PERMIT TO ........... ...��....................... ..... ............................. ..................................... IA& TYPEOF.CONSTRUCTION ............................ ........................................ 41. ... ......................:..:............ yy i. lG�...... .........197 s TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies f"orr a permit according to thee followinginformation: Location .... .. .(o........+ .Wa..i.S... .Yid.......11Q ...... . . ... .Q Vi..!'.......................:........:... .1..<� ProposedUse ..... ....................................................................................................................... i Zoning District ...C�l j, � .10.t.......... .... ............Fire District C4A.Sd.!t........................................... Name of Owner l d.11 OX A A.....>-t>.1 - . ........................Address ....�.:b..�n... 1A3;-1,5 tJ`f�l� .....41. �.... .CO. U°►:t Name of Builder � . �S��e ..... ......... ��czwo.V.................................Address (e.,5. .14.u.Y\ .A.n�...1'!.X1% :.:........:�.ria�.; ............. ............ .... . Nameof Architect ..................................................................Address .......................-........................................................... r Number of Rooms ...........T.:U�l.+.0........................................Foundation .......:O:n.�rc�e....�.\S1.c�s...............:....... Exterior .W10QA.a......:�.h.►.x,�l.f........................................Roofing ....... .�:�.�.Gk�.�............ .i�. Q.......................... p Floors L. ..':..... Interior .........._ .�.y.la? e>C� ... .aC. .� .+..(\. ............ .....C�?C�S.......................................... Heating ....................... .J. .� .�!,.�...................................Plumbing .......................(ko 1 .............................................. 4 Approximate Cost Q� Fireplace q7%.X:................................ pp ..................... .p..... ................................... Definitive Plan Approved by Planning Board -----------_--_--___- ®+D v �...5" - -------19-------. Area ............................ 61, Diagram of Lot and Building with Dimensions Fee (� -- SUBJECT TO APPROVAL OF BOARD OF HEALTH r 1 - --g G 3' N I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . t ,,c....... ,t..s�...�( .................... d• Hardy, Edward A. ' add to y No ..�����—. Permit for —_—.----.������ | \' ............. �......�.......�...........----------.. �~ \ ~/ Location —i3A6 lewis Pond Road. � --------:.�xr.......-------------. Owner ` JL ---r=`==��'�---'=��*------' ' y i Type of 'Construction --. ....................... � -----.--------------------.. � l ' { Plot ............................ Lot ................................ , x St 73 ,e,'"./ c"umev ' � ` Date of Inspection / ,. -_- Completed_ 19 ^ . � ` PERMIT REFUSED lg | � ------- . . . ................................... ^ —~-----^—^~ ---'—`'------'' . � --.-------- �y..*~^�—.~—.—..--_--. � . ' ' ' '--.-------..-------..—...—~—.— / r Approved ................................................. 19 � ' ---------------'—^-----^'---' \ � ------------------------.-- . ' | ` | -K Assessor's Office 1st floor Ma d1-9 Lot � Permit# Conservation Office 4th floor �� :S� Date Issued 0/9S✓ xBoard of Health Ord floor S 3 U KEngineering Dept. Ord floor) House# dP Bldg.): S HARNMUZ, _ N Dc d 19 SEA MUST BE (Applications rocessed 8:30-9:30wa.m. & 1:00-2:00 .m. INSTALLED COMPLIANCE WITH TITLE 5 EigV1 C fl"i �,V;� .��"fir TOWN OF BARNSTABLE Building Permit Application Project Street Address Village COT(. Fire District ,,Q T//17— Owner f'1� 12(�/ �" �/S Ti O�' � Address /( NCCS/f lJ�- Telcphonc 'o20 3 —roS//--C?//--S (E) U 7. o Permit Request: -D�C�1 Zoning District Flood Plain Water Protection A P Lot Size Grandfathered Zoning Board of Anneals Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling T-wel=Famil Two family Multi-family Age of structure �,11 r nl W�`� Basement tvDe Historic House AjV �inisfied Old King's Highway Unfinished Number of Baths f No.of Bedrooms 3 Total Room Count(not including baths) 7 First Floor 14 L-:-L E14S"T 11--L04- Heat Tyne and Fuel Cal C_ Central Air Fireplaces Garage: Detached A d Other Detached Structures: Pool °—'- Attached Barn None Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO jjPrpject Cost Fee -�4-OZ SIGNATURE blo-AA/", DATE 7 a I J BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) Inn J ��S BPERM T . 5/10/9 5 FOR OFFICE USE ONLY 020.022 ADDRESS 59 Lewis Pond Road VILLAGE Cotuit Marvin Rothe OWNER I DATE OF INSPECTION. FOUNDATION FRANIIE INSULATION + •FIREPLACE , ELECTRICAL: ROUGH FINAL + PLUMBING: ROUGH FINAL GAS: r ROUGH FINAL FINAL BUILDING: 4 •' , to q Y • f + 1 P .. r I} f f f DATE CLOSED OUT: ' ' ASSOCIATE PLAN NO..' 5 S I TOWN OF BARNSTABLE ` BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB. LOCATION 5'� Z,G-uj (5 . /'�G/v� /� C CJ�-t t j- M og Number' , Street address Section of town "HOMEOWNER" MAR vm) ?C)Tt1E /3 10 3 7.3.3 .5/!. .. Name Home phone Work phone PRESENT MAILING ADDRESS l.b uSA2c-1 12,4/4, „'• City .town State Zip code The current exemption for "homeowners" was extended to include owner-occupi dwellings of six units or less and to allow such homeowners to engage an in dividual. for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to r; side, on which there is, or is intended to be, a one to six family dwelling attached or detached structures accessory to such use and/or farm structure: A person who constructs more than one home in a two-year period shall not bE considered a homeowner. Such "homeowner" shall submit to the Building Offic on a form acgeptable to the Building Official, that he/she shall be respons: for all such work performed under the building ermit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the 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 requirement and that he/she will comply with said proc ure d requirements. HOMEOWNER'S SIGNATURE 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. 11/02'9-i 17:02 1�61772 7 7122 DEPT IND ACCID (—OnunolutlealtlL O /t ajjaclzujetb �CJapartnwnl v�.J''nc�u�fria��ceu�enfe 600 1/�/ai�ryton.�f James J.Campbell &Ion, //(amadwsftd 02f f� r' Iissidner __. .. Workers' Compensation lnsurance davit- _-.._- __ -- (aoeasec�pamaree)with a principal place of business at: do hereby certify under the pains and penalties of perjury, that: Q I am an -employer providing workers' compensation coverage for my employees working.c this job. Insurance Company Policy Humber I am a sole proprietor and have no one working for mein any capacity. O I am a sole proprietor, general conwaccor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Numbe: Contractor r Insurance CompanylPolicy Numbe: O I am a homeotiti°ner p,erforming all the work myself. 1 L,ce:<Lz,c ,a z co;:y of c:: <_:eTent will be forv:zrced to fie Once of Investi7-tions of d;e DIA for coverage verification and that fzilur a tc M cove-age�s rec_-::ed under Scc-on 2EA of MGL 152 cza leao to L.� Im=ition of criminal penalties eonsisane of a fine of up to S 1,500A0 and yez,s' imprucnment zz well as c;/ii penzltiez in the for.cf a STOP WORK ORDER and a fine of S 100.00 a day agairLt me. Signed rhis day of 19 9 lice 'see?Permitte Building Department Licensing Board Selectmens. Office Health Department TO VERIFY COVEF:AGE INT`ORMATiO1,11 CALL: 617-727-4900 X403, 404, 405, 4a9, 75 - The Town of Barnstable - aAaxerAMr- - '""SS. � Department of Health Safety and Environmental Services sbs9. �e ++ ' BuiIding Division 367 Main Street,Hyannis MA 02601 Office:_ 508-790-6227 Ralph Crosser F , 508-775-3 QQ Pu;r.�:,,r rr^ « For office use only I?ermit n:�. Date S AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMITAPPLICATTON ' MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernisation,conversion, improvement, remoxal, demolition, or construction of an addition to any pre-cdsting owner o' ied building containing at least one but not more than four dwelling units or to which are adjacent to such residence or building be done by reviverrd contra w;rti ---d�rr along with other requirements. T)pe of Work: Est C l (it Address of Work:_ Jr'q �L— W S ?Oki ! IT , CO Owner Name: 2 V 1 h) �b 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-oaupied Oomer pulling own perkut is hcrcbv given„t=,: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISIERED CONrlRACTORS FOR APPLICAELE HOME TMPROVE•MENIT WORK DO NOT HAVE ACCESS TO THE ARBITRATIO'�FROG::.\", OR GUARANTIY FUND UNDER NIGL c. 142A SIGNED UNDER PENALTIES OF PERJURY - I hereby apply for a permit as the agent of the ow-ner: - Date Contractor name Registration No. OR S Datc Owner's name -i r ' J;X2Lw' L- f r d " ail '� .tea 'R _ J � •�' _ S i .r i �L toll t ~ l 1 � r t i t \i 1 � f 9 S r .r iI I : - \`1 A I'� I O I •� '� I _ O I ® -} - is Te 1 �� 1.lex t9ix c.�<'.Cu,r.�t>•�Y_._— ,�� i6� v a z. I i y 1"P i L� I i- tCIO a j ioc 'J I o SMOKE BETECTORS REVIEWED �hlrb Ga — tYu1TG" Y)/ $jCh4 LES'.C34 �:'a s - Hk_ hrABUILDING T. DATE I __.._. ... .... ....... . ..._. -.. r FIRED P ARTMENT DATE E SN'F�CE2"i�yN"C�c x s rrwn ac �1.._. Noir nY�o�Sa «sari tv,u5 w. N Bruc,2 Devlin �� N SlGNA1'UR $ARE REQUIRED FOR PERA9ITT/NG ICI SLYI.IN [LS�U✓r.-I 11?1442 Qb.=K�J�?"Y — _SG} nlilr.5 - - �y�«S,Ir-U�n..2c�.tn-- �5 Design® . GGTu1T. raQ 77.2-l.'38i 0773 k i i I I i --- .-Ron . n��:,Los OR :..vim.•. r- 1 .g� ?-aidkr.awP.d`e._ �' � � ._.. rLLii r.•„_�scER.\:!,...__.._.--- _ � � .� m ri I I N IL _--�---- 22 n , x , lti v i � I I - 4 a mil" ..� ,. , 10 ' I � "_`: t c,' ��� a, ;� �'.�' .✓- 1.w �� ."t' { .. ' '4A">sd .: T 4 i� llw, h 9tll.�� 5.,.`1 k[.v"fC•�'i LTCS;�6 -; .. Lp ` •Y a � � - �� - �� � �----III---�^^---- s ( Z � �� � �jl;: r� --__ j ,f i . iOWN L r. : :\ 6 _c r-U�� 2LAN f .. • ._ -�.�- �, .. b SrvDfK' 6dT^ WtbA1 I t1�i51.14_NS�4.N�1Rti 1t) Bruce 3wF�s ! Ct�2�51(j r �rE y yWI}��u Desl k@ . . ,• N>da 77423 773 . ZC.tUIT hJa, — I i I I ��/ ti _,__r. j�`_L� lI .I (,.y �I� �� �•• I5 v7,_ tzL L 8 I pJ•� _ If _ 1 ,l -nC_c15— I i � s LVL I I. � I - i --- -- — ' SpgBs�oL 1 r UP pi "Uan ✓ S4iu81� _ y, ll(l� ila l= 8i rY Y y/ ePnC2K_ mi Do""w . A'RA�Cd �sC�++..9'Z.�.. �. � •/wl'e��I Zr15 � , 40•`GG j Rat W(DTt1 (rr� FACrfI RAM UNS.. If Brue Dewtift Design® 3 �! ' 1 I I :I 1 C12 C-6xabEl_ � 'I. > I , tr7y 9 _ I Qj— xs-Cas6'tuP,cc�r � . - c�t'�r-vcnl f�.4KV.f0�1� lx8'FX SC1h -t'S_iL FiC S,CI�( -rr� +.Fi `. CAS .•.�u -- ._ .- / I 1�i5_sre.. ;-_ "y2.:�'iJU ISt^rt.h'�f�Eiivt �.. �'SCl3Tl t .I- .. I -- — I � � � � : � � 2•-a'S VL'g60..12crcc::_... .. -- -F+�,}x'xE5'� .?r '•Lac, . I ��,� Ptiti✓.K.- IL �. �--�—�I -- rz la ai!�at. I g�a � � -- - --- . - � - I I �I �� --.. ...Cca_)1"•'�...,:'i.,t�t��€-... �ioc .. � � ��LZSA� - i I. � -�� KZT�se�rc��c• - .._ _ -�, 7i�: I LQr-T �I.aS¢�s _.. � I .� ---- g-4:1 ,sue�:_�I_ :- � - — — k g�C$ lu F37r (TYW�.. I. _ ' S.L�no�l e,� =ro-> �,, e� �p}cSlfJln„ �Lr�' . I x�rsrrl is �t wcnoMts L. :43racfa Devlii K�l?`js z tr, ot1>`t Ctsln� c �1 Design@ .. �✓o _s9 tsti.«s gown c r vJ: 774-23"773 STWcP P'"'t' - i —_ I I : I � A IA I ' - ,J•4. � Y � I i. � � ���� � � 'rz bt�Bi\T.i jn�'C,'--_ I i � . i : 3 a h.s y� u, —N it CE EEMi 2�tca.i I I i 0 a IL,Sl- Tr SAL _ I i — tie . gymzv . _._..... _.._--- - --. � ci�1+.. �K�a-�t`'T4f'. � � --5OC�is P,:C6Gb:.awc1 n � �!✓Y�� `� t . ii jl)p�jg•� 5 1 � � y� � ,. - t� brt WIDTH (rr) �titTR2X5loN5 i� E SIrJ $rile;, DevWx 5%�WL< IX� in rx ytp Design@ uQ r r-r38-O77 i I i i I p � 1',d•;t 1 a.e N::�srs�c{s�•_eL�;CM.cx� i j � G j,r�r'R�:i9l`--R.ti_ttic SuIbK�J nacuclsyz wMW 1 I - trans•?xZ-C-L3�s�'n � � - .. .. : - �T- - CUILT�A'T- J 1'I I lx9'FICSCth�-I Y-IZ KCSCl/. ., t� -� yft,1U&Ti...l2 G0,— � _.�': �•f OW . I f't' f�s>nx,Cil'DE4kVC , C6cm� � sq ,-' I I �• Av _. _. TI — MV5 _��KC��'�=�:� 1 ''2•Pu, (kJ 2 e Dn!TE'F 5 2cp7SG J,$,/ ... J �— � 1 I ± c,t.�' I ----- -- t�--,9 � ,2��•r c.�-1�tYxrn�.�_. I -f : i I i -'�t1.Snvxlr❑�S�',W i �T€T�.rQga`�_.-�---�-� \y � ---. _ _ {`TAp / O � .�� I 8'4 r.�..4.6o6�SL Sn81 �..,�_ _ y•� :. �. I, ryd�, � -�t'rYCinscs`fC�@��Yn-u��en ylf�s i>; I �• ptru� k-�� i I 1 1 ! �IrJFNR� et�r, j_.. - i j � _. ACT-t.ON �.�. Oe°•lo"1.�. .. .. .. S�c-fi�4�.N P�-rS-Lfiq';I:o•� l � x�rs � �t�wcnuiJ-5 �p Bruc(e Devlin �' 77423 -0 773 vl — - M