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Home My WebLink About0215 LEWIS POND ROAD oYF111HE/yy, The Town of Barnstable P` O� BA LE.MASS. Department of Health Safety and Environmental Services MASS. 4 039 prEUMP�° Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice f, . (3) peem �s Type of Inspection Location tCNiS &tVq Rd Permit Number �eRSL`Owner Builder 7;i7 , One notice to remain on job site, one notice on file in Building Department. The following items need correcting: �� OIfOiZ EYi'oS�t) 4) !/ a -e 2 S%A� /2$ O�� N � I Goato <T /� A�' r sAe .TAAl dLAT° F1064I U�v/J'PAP, '( (e- P. W LiGf/� � Please call: 508-862- -38-for re-inspection. Inspected by z Date •'s w � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �- Af 01 vs Map- Parcel_®� A Permit# 0 U Health Division c2 �� / � �� Date Issued Jr_1 q-bE!$ Conservation Division Application Fee 00 Tax Collector !a(7C7 S��(g�o3 Permit Fee Treasurer �G� Iv L. - �D�0-3 SEPTXc� S'a:�3�� Ur"�B sT CE Planning Dept. �v I1w i AL LEI)IN COMPLIANCE MTH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE ANG TOMI REGULATI=0 Historic-OKH Preservation/Hyannis Project Street Address LAFIA)ILS --- Village C oT U F-1 Owner ,,,% T c-wIS Address ( LL'i S Telephone � Permit Request � G E 6C ddr�1 CIPOC Ct-'1-QL,1Ct Square feet: 1 st floor: existing p$� proposed 2nd floor: existing �( propposed Total new 4 N 521 Zoning District Flood Plain Groundwater Overlay Project Valuation ® Construction Type W00b AM 6 Lot Size—Z� Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure t 7 Historic House: ❑Yes kNo On Old King's Highway: ❑Yes XNo Basement Type: VFull ❑Crawl Walkout ❑Other Basement Finished Area(sq.ft.) Z©' kt57-46 °�o0�n/��Basement Unfinished Area(sq.ft) f00 EYlST11J& &Y& AIALJ Number of Baths: Full: existing 1 new Half:existing new O Number of Bedrooms: existing_ new ® ` Total Room Count(not including baths):existing new ,.J First Floor Room Count Heat Type and Fuel: tGas ❑Oil ❑Electric ❑Other Central Air: I Yes ❑ No Fireplaces: Existing New_� Existing wood/coal stove: XYes ❑No ` Detached garage:X existing ❑new size Ma Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Xnew size Shed:,X existing ❑new size Other: ' Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes XNo If yes,site plan review# Current Use A/G-GE !G 6CG/I[/(7 Proposed Use S1*&6C Aaa(_1,V6 BUILDER INFORMATION Name 1 OngOnGeS l" Telephone Number. Sp8 Address 293 d0° License# 9V 7 7 Home Improvement Contractor# y y Z CP Worker's Compensation# `1 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO�[/V6 >(J4l SIGNATURE DATE .S 7 a3 FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED -: P MAP/PARCEL NO. ADDRESS VILLAGE n i OWNvR — CTION DATE OF INSPE : / ari t - FOUNDATION (o �J 04- 0 Poo 2. Vij d3 FRAME INSULATION )203 ` �-- FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH' ! ' FINAL GAS: ROUGH c : ` FINAL r FINAL BUILDING f f f . tP' sC t= DATE CLOSED OUT ASSOCIATION PLAN NO. :3 i <�'�. . The Commonwealth of Massachusetts Department of Industrial Accidents _= = - Office offaresdgatfons . . . 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance davit - . i name: �,S location: city phone# ,PoQ /(f S ISR� I am a homeowner performing all work myself. - . I am a sole r rietor and have no one workin in ca achy /// %% /% % ❑ I am an employer providing workers' compensation for my employees working on this job. .. .:::.:::::.:.:.::...:... comeJanv'name -- _ Yrt :><:::::>:: >>;;: :::::;>:::;';::. hose# .:.::::..:..:...:.::... i1tV A .........:::::::.::..:::::: ::.::::::::::::::::::.:::. :,. �j . ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices::::::::.:::::.......:.::::::::-:::::. :..:::::::.:_,:::::::..;;:.;:<:::.::::::::;::::.:::::.:::.::::::.:::::::::.:::::;:::.:.:;::::::.: % ;; Vomnanv name ::::::.....,:::: '`�d kCSS><::::::::i:i i''`:i<��? :`i I.!>i '':r i is :::y;:;iz:i;i% is S: 'i.%.—'.:`';;>%i Ti% ;�i:i:` : :j ($':'::i::ai::iC:':%:::: i ':'....I,....::::: : :` i ....%,:::`:i '>: no fi� >><; ..................... o h�H-ran .; ////J%%%/li. 'aces ': : : ::11:::::::: ?�':... `:::. : ;V. ; :':: '::: : : ' :::ti< ? `<�>?' ? :::2 < ; ?;; i; 2<; ? `5> ` ` ` 1 X. isi:i2i%:: :?::?::>Y: :?:i :>i 2::: '' <:L::G S:Z:F::2 :::ass::::?:< : :>:2::::i:::' s ;!i!i; ,.: -,:?::: : ...',.>: ;:< :::::<:::i:::2::iL: :i:: iti ?i: iii:i:Sri: :-1,s t:f '' y?a:i :`: :.:::.. adllress. ... ......:..... .::.::::::.:. ....:.::::.:......:::..:::..... h :. ........x. .......:. ::.:..................................::........................:..:::..................................:..:...................................:............ :risuraitice Fafinre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify - the pains penalties of perjury that the information provided above isQtr�ao can correct ate V �/I Signature D - Print name l ®M A- �, )t C,CS� Phone# 5Dis W-rlS"57 === 9.111vn official use only do not write in this area to be completed by city or town official . city or town: permit/license# ❑Building Department ❑Licensing Board 11 ❑checkif immediate response is required / ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (teased 9/95 PJA) r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain'a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out it the event the Office ofInvestigations has to contact you regarding the applicant Pease --- - be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnedtn the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r . °FIME, Town of Barnstable P Regulatory Services Thomas F.Geiler, Mass. ,Director 161[g.�A`0� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj agent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. (� Type.of Wozk: `` ``�1�N Estimated Cost U Address of Work: o� I.�wls �r fi Q oplutr Owner's Name: R O w-T- L e-(-Aj i-S Date of Application: I hereby certify that: Registration is not required for the following reason(s): ]Work excluded by law ❑Job Under$1, 0 0 0 []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 ap ly for a permit as the agent of the owner: 51;� cc) j�YaQS lo(4-0ce Date Contractor Name Registration No. OR Date Owner's Name ix 10 < ; �,� �cc ` � o x 3 i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE % 00 square feet x$96/sq.foot= �0 Jai 6 x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq. ft._ '�� Y x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $ 35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck I x$30.00= 3000 (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 17 Permit Fee RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE — l® New Buildings,Additions $50.00 J Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSAEET NEW LIV G SPACE 0 square feet x$96/sq.foot= x.0031= pqQ . , g plus from elow(if applicable) ALTERATIONSIRE VATIONS OF EXISTING S ACE Z eet x$64/sq.foot= 200 x.0031= plus from below(if a 'cable) ACCESSORY STRUCTURE>12 q. t O >120 sf-500 sf 35.00 >500 sf-750 sf 0.00 >750 sf- 1000 sf 00 0 >1000 sf-1500 sf 100. r >1500 sf-Same as new buil g permit: x.0031= square feet 961sq.foot= STAND ALONE PERMITS Open Porch ' x$30.00= (number) Deck I _x$30.00= (number) Fireplace/Chimn y x$25.00= � (number) Inground S mming Pool $60.00 ;® Above G and Swimming Pool $25.00 ED Relocation/Moving $150.00 (plus above if applicable) permit Fee ° projcost 790 CMR AppaxUx! Table J53-Ib(canduned) Prescriptive Paaga for One and Two-Family Fleaidendal Buildings Heated witb Foaszl Fuels MAXIMUM MINIMUM Wall Floor Basement Slab Heating/Cooling Glaring Glaring Ceiling Wall perimeter Equipment F1Fcicncy� Area'(Yo) U-value= R-valuej R-value R-values R-value' R-value' package 5101 to 6500 Heating Degree Days' 6 Normal Q 121% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 I9 19 10 85 AFUE g 12% 0.50 38 13 19 10 6 N/A Narrtsai T 15% 0.36 38 13 13 N/A 6 Nomal U 15% 0.46 38 19 19 10 N/A 85 AFUE V 15% 0.44 38 13 25 N/A 6 85 AFUE w 15% 0.52 30 19 19 10 N/A No�ma1 x 18% 032 38 13 25 N/A y 19% 0.42 38 19 25 N/A N/A Normal 6 90 AFUE Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 10 1. ADDRESS OF PROPERTY: mA 40 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 1! C 3 o/o G AREA 93 DIVIDED BY#2): '- OZ o/o 4. GLAZING 5. SELECT PACKAGE(Q- AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303 a + 780 CMR Appendix J Footnotes to Table AIM I Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded from a building design with 300&of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. The ceiling..R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R 6 insulating sheathing. Wall requirements apply to wood-fcanie or mass(concrete,masonry, log)wall constructions,but do not apply to metal-frame construction. 5 The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement &-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package, . 'For Heating Degree Day requirements of the closest city or town see-Table J5.2.la NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass_ area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)if a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). °pTHE To Town of Barnstable Regulatory Services BMWSTABLS. ' Thomas F.Geiler,Director yip MASS.1 . � g' Tf0 39.y Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize�O� �� S to act on my behalf, in all matters relative to work authorized by this building permit application for (address of job) OQ s ��s `?o' k 4 Signature of Owner Date /3 oP� RT Print Name Q:FORMS:O WNERPERMISS ION BOARD OF R1 ILDING REGUL•A*t License C®NSTRIO�IOt�SUPERVIISr "" Number°_CS' 009474 F ` '. Ex�tr+ ::Q8 2 O:b3 Tr..no:. 151'9 Restm'ted .00 THOMAS R MOi 393 LAKESHORe[)!tt AIDWI-Iii 'MAD�6g"- ; A`d'nAi_6_, QT ' 'J_.> - �'f�-Pomyiauuea,� o�✓�aaaacluraelta_ lugBoard of Building Regulations and Standards- HOME Igp VEMENT CONTRACTOR Repsfron 4296 2004 THOMAS R.MOR E`R13LIN homas.Morse ,393 Lakeshore Dr Sandwich,MA Q2563 " +'' MORTG/ -'E INSPECTION SKETCH OF PP"N"PERTY ' In •Cn?'U 1-r SARA1JA77i4ALEc County,MA j Appiicant: R d B EV LE I—g Book 8G 92 Page A LC.Cert.No. Scale: /° =So Date:. d-3/-CD 3� WlS -P��vD lit �J(2S2tS.f� i 'I L a7- 1 9 B . � �w g3,230""s•F TAT#L ARcA� '� LaT 26 8 iso FAgRCELJ (4ZS=s.F) p f; Y�O,Dt 1 f [ #ZV rq l�l'c�A ow F�W- µPAUJ.. a- .C4gA/CY J-7..A D CIT/SAN F.,/<shown ,� S.A. — In my p 0165so lal/` ,^^'P the� C�� (�locatedarelocatedµ ed on the gm as s l, hwea and conlomied to the applicable hormntal drralmnel yard setback requirements Ofvim the Zu"By-laws of the T'a W Al of 8,FR nl S?-A a/ F at the time of £ '� construction or is so, from violation enforcement action under Mass Ger wal laws Chaptw 4C1A-Section 7,the dw Q11,..g. as shown does not fal within a 100 year Special Flood . a lard Zone as deiineeLed on the FBANRA Nstional Flood Utsuance Program Map: dQw piL Ai Comm*No. �a dd/ Panel a M2/D paled 7-2-�2 Zone G Technical Park�nve v s�a �irwnr iu 1 woo nsi�+w a rr�.w.�iiri�oorr�ie�r MN~�A�`m ,: ' �r maw.•�reron.o..a rarer arms as aoopru by ar rald Maoca�an a t"cnr�paa go soar. i H:(781 ok, 02343 Frver.ra w orrloaoe ID M ho bw i by au Ism. S�er.yois an0'Ciw W a t y. 400 NOTE ��Y rw+eaaw aw na neuow n er mnq canrra�an 4 at+aar above qmw��0 p001Q GK ) 7- -58 1) 767-5873 i HEfOk� The Town of Barnstable BARM . MASS.ASS. p ' Department of Health Safety and Environmental Services 9 0 1639. �0 prE�M A, Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection 05 L1 Location / ��w s 5 �� nCl Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. ,.t j The following items need correcting:C T 'C)l� q 1 Please call: 508-862-4038 for re-inspection. 1 Inspected by ,F DateE�I2n3 . TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel {t =' e {. � ,xIS TA 8j Permit# Health Division �� R)9-5 10-3 AGO- 3 3 q � �� Date Issued i 140s-W Conservation Division ��, _ ' Application Fee Tax Collector Permit Fee' 11�2!& po Treasurer _ f i'IU,4 SEPTIC �nST SYSTEM MUST EE Planning Dept. LED DIN COUPLMCc Date DefinitivePlan Approved b Planning Board TITLE 5 PP Y 9 EId1/1 �O"ENTAL CODE ANC Historic-OKH Preservation/Hyannis TOWN REGUU?-iONc; Project Street Address was at, Village 1 1 Owner rW `S Address _ 1 S c.y IS �o�► �0 �J� Telephone Permit Request 0®r, L m/Opj IN0 ,?� 411 //V 16('j �( ' Square feet: 1 st floor: existing � 1 b proposed 2nd floor: existing 2O�proposed '39Y Total new ISO Zoning District Flood Plain Groundwater Overlay Project Valuation 4 nt c Construction Type wcOb f R4,G - Lot Sized Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family X Two Family ❑ Multi-Family(#units) Age of Existing Structure 1617 Historic House: ❑Yes Ao On Old King's Highway: ❑Yes Xo Basement Type: AFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) D Basement Unfinished Area(sq.ft) 3 9 7 Number of Baths: Full: existing 'ZI 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 Ceritral Air: ❑Yes YkNo Fireplaces: Existing _a I New ® Existing wood/coal stove: )(Yes ❑ No Detached garage:)4existing ❑new size 0 A?- Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:Aexisting ❑new size a!f JZZKShed:9existing ❑new size (1K 0 y Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current'Use - _ =_ r. .. —___Proposed Use BUILDER INFORMATION �y p Name Q Telephone Number Address License# ® Q V 7 T Q/fC-41 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO {�I N� bonn'Os � SIGNATURE DATE c o 3 t ` FOR OFFICIAL USE ONLY 5 ` 1. PERMIT NO. DATE ISSUED MAP/PARCEL NO. ;, r ADDRESS VILLAGE OWNER i DATE OF INSPECTION: FOUNDATION CGS po FRAME D I INSULATION } FIREPLACE �CEiI►'► k �� _ n ELECTRICAL: ROUGH FINAL } PLUMBING: ROUGH. ',-' FINAL GAS: ROUGH „ -' FINAL-+ r } FINAL BUILDING DATE CLOSED OUT ,; ASSOCIATION PLAN NO. - tpg 1 a, r f RESIDENTI4,I,CB1 DING PERMIT FEES APPLICATION FEE A = New Buildings,Additions $50.00 » Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE u*� square) feet x$961sq.foot= x.0031= ' plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= 0 x.0031= 3. plus from below(if applicable) ; ACCESSORY STRUCTURE>120 sq.ft >120 sf-500 sf $35.00 >500,sf 450 sf 50.00 >750,sf=1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: x.0031= square feet x$961sq.foot= STAND ALONE PERMITS Open Porch x$30.00 (number) . Deck _x$30.00= (number) Fireplace/Chimney —x$25.00 (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee ` projcost' The Commonwealth of Massachusetts '— Department of Industrial Accidents = Office offnlrestfgatioas 600 Washington Street Boston,Mass. 02111 Workers Com ensation Insurance Affidavit name. mil.t S U r•• J 0. , location: I I f I am a homeowner performing all work myself. I am a so, r netor and have no one worki>z in/a ca achy workers co ensation for my employees working on this job.:::.:: :::{::::,}:: i•::ry::,::ry:?:<:>;;::, ,>::y,:::;:;;:;::;: em 1 rovidin mF?....................:..::::...:...,...: ....r:.......... .....:::::::::::.{:.:.....:�::..:.:'.:...:::..:.}:..,::..:..:... }.:.......::..:: anym I am an oiler g.............. ........ :;:.::.:::. ..............:..,............:.......... :::.:... -: a'r"`ems;.;>; � z<7> �`d < >':� ��'��';» :�s;:'•:'>?:>.><><>:::>::?;>:::;;<:;::::::><;:>;>::::: :;»<:<z<;;:<%::><:«:s::;<;;:;:;:;<:;::::%}:?.}:::?:�;>:-}Y•;>::<?•:;;r.:.::};;•;:;{:,,.:.:: ......... ...n......• .. ......... i::::i.i:{::i��::.....:;'.,.;:?•»:•:;•}:�:�.}>;%ii'::.:c�;?:;•i+:{....:.•::,::....�.,�,,;•Y:..�::.�:.`.;�.. ...........�•. ..:}}?><::;:?:iiiiiiir::;,>:•}:i?^:ii:i•;;:i•:::.• r.•......y:.;;:;n.:.:.............:.v::.. ... •}:•}:}:4}n?•}}?:P}i}:{{•}isv:•}?:•}:,{^:v;;.>ti^:vp;.?`:?v?)�:v::}}::}':::;}:}C:y{{4)}:+•.}v::.;:»i:;:{?•}{i::::j;>:y:??v:''^.yw:{�:•::::w::::::.....:::.......:.. •?::?:•:::?•:::?•Y::i::•}::;:•::v}:•:??:^i:•.is-0.;%?:;3;{?{{{{{••Y{:••••::v:?::}.v:;...v.v:f:,v;:-.:4:%%•?:;:{::.'::•::'':�}. .::.>{{9;:::.i v:;:.v?:};::?'?:$?v?. ....................... ....:.....:::.......:::::.:?:�:•:::nv::•}i:;?:i}?};{•:•}i:•}:•}ii:tii}:i:::?.:::::..::4::::Y:}:•}:<•:.•'.w:::%'Lii???'i'>%:CC%ri:?{•:{.}i::Y;:;:•?i:•i;{r?Y;{ti:iii�:i:' ............. ........... ................ ...v.............................. ................-.:}:::::w:.v:::.:.:{•}:ti•}:???•}}:�:;:v:nv.::..............:..;:;;.. •tit;}}i%i:R;iii ..... ..........- ..... ::::•:::•:.:}}•?:=::�?}::•:::•.v:?4:::.vu:.. .....:............•:::::::::v::::w:}:::......:::::<...::::::n:,•..n:.v::::::::.:.v.:.ktitiii%?`:.:}iiF?ii: `�risaranc ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the co ensation ohces. orkers P ............. ...... ..:.......... ......... .......... ............. ...::•...;...-.....,...........:•:r:::.v:.:v:w::::::v.v::.:..::}:v:? v{•v .. ............................. .......v...r..... .........r...n...• ..................:-. .................... .................. v:•.v};}:.v::::.v?:::::•v::•:nv:::{{v.v::..vv: ... .... .. .{... ...... ..................: ............:......•:nv::::::::::..• -.:...............+:•::•.v::••:,v•..,.wx::::::w::::::::.v.;. ,..... ....,.r ..vv.;-,,.4}.`,.Y\?::}ii},<;%;;` ... ....... ........ ....... ....................::v:wr,...,.......................:::::::::.v:::::::::w:::::: ,.v:r.wn:..n. v.x......... ............. :.:v:::•::�:..:.,.;;.;.;...�: ...:..... .... .. ..........:::::::::::::::::�:::�::i:.}'{P:�';;4}ii}:�:}}}?:';�Y:•}?}.v:;::v:i:i'i}iii:S:<%"%i'�i?'iti,+ii::;{::?: f�... .............. ...: .:...:..:n::::.:::•i'4ii:}}}iiw::::.v?•}?'•}:?4i}:::::::x:.?}}}}:::}.yyx:::.;:.r...........Y;.r. 4r?K .. ....v..... .......r.., .. .................. ...........................::........ ...:.v:::w:........ri}}:?.Y-..:•}:^:::: .:::v}::v.:::.v::::•.:..n, .v.:v.v ..:.Y?<•.. ..-. ..... r. .... ....................................... �..}....... l..r:.i:{:.}:•::{:v::• Y:}':v.{;.••{p;;}?.}�ti,.+_"vi'4{,Ik:::::{i::iii ...:..}......................... ......r..F....nr.•..:................................. ........................:................v.v:•i}i:O}:v?•}i?}:?2'; r:.:}.;};�•.:h,{;;.i:�::::. ............:::n.........:w:::........r..:..::.v,:...:........v:::::...........-:v::::•:............:......;...... .......r..:w:::. v:::nv:,:O:?•}:4::.v{{:?:W.v?::•:. ... .. ... •.,+:riy{:Y.}'::; :,:{:•.,:::•.:....:•:•:::::.:...::::?•r.�::•r::.:.....:::•:::::•}::.....:.......... ,.... ...... ............ .. hone#� ::j:{':$i.....'rii'i}:}:,>:j:n? i:i+' +i tiv j^;wn vtijti'{%i1:.'•:^'.ti:;C:;:i? ........... ns ......... 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L1ll ::•::...........- .;.........:....:;............ :'p:titi?•::•:•}:::::::}v?::v:;{{:::::...{v'r?::::::•:?:{•:'v}:•}:v:::.}:•???}:•i?is�i::::?.}:t•i>isi:?;ii:;::L:�::i?:.(i%:Si:iiT?;ii}�?::}^?:•:i?i}:•}i:;.i:{{::.v:: .. gage to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one yam,imprisonment as well Is civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of ails statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify a pains and pen es of perjury that the information provided above ishtrtuland eorre 03 Date - Signature Phone# Y 2-�� Print name s official use only do not write in this area to be completed by city or town official city or towns permitllicense# ❑Building Department ❑Licensing Board is required ❑Selectmen's Office ❑check if immediate responseq (3Health Department contact person: - phoneN; _ ❑Other (Unwed 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any cqm Tact of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,Partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit tooperate a business or to construct buildings in the commonwealth for any applicant who has not pr oduced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants ' Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,.address and phone numbers along with a certificate of insurance as all affidavits maybe ; submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and -£t 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the Permrt/license number which will be used as a reference number. The affidavits may be retame3 io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to.give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents . On of Iovestlgatlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 no CMR App;+jdh J R F Table.15.11b(continued) Fa FosaD Fuels pmCri tiye Paekaga far oce:nd Two- asily Residential Hulldtag�13eated�� MAXfMUM •Hesuing/Coaling Dig Glaang f Ceiling Walt Floor Basaneat Perim Equipment MciencY' Area'(`/.) U-yaluca R-valued R-value{ R-y&1uw wi R &valuer F=kmge 3701 to 6500 Heating Degm Days° 6 Normal Q + 0.40 3S 13 • I9 10 NonrW 30 19 19 10 6 Igy. 0.52 6 - 13 AFUE 5 12Y. 0.30 38 13 19 10 Normal + 0.36 3H 13 N/A N/A Narnal T 15/+ 6 U 15% 0.46 38 19 19 ID 15 AFUE 13 � 25 N/A N/A V 15% 0.44 38 6 13 AFUE �y 13% 0.52 30 19 19 ID Normal13 25 NIA N/A X 18`/e 03Z 31 19 ?S N/A NIA Normal y 18`/. 0.42 33 8 90 AFUE Z 18% 0.42 33 13 19 1Q 90.AFUE I m. 0.50 30 19 19 la 6 1. ADDRESS OF PROPERTY: 2, SQUARE FOOTAGE OF ALL EXTERIOR WALLS; r 3. SQUARE FOOTAGE OF ALL GLAZING' 4. o/a GLAZING AREA(#3 DIVIDED BY 42): O y I 5, SELECT PACKAGE(Q--AA-see chart above): VOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE, ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: °YES: NO: q4orms-080303 a 780 CMR Appendix J Footnotes to Table A2.Ib: lass doors, skylights, and Glazing area is the ratio of the area of the glazing assemblies (including sliding-g basement windows if located in walls that enclose conditioned space,but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example, 3 f of decorative glass may be excluded from a building design with 300 Rz of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council WRC) test procedure, or taken from Table 11.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. S The ceiling•R-values do not assume a raised or oversized fruss construction. If the insulation achieves the full insulation•thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulatingsheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding, structural sheathing, and interior drywall.For example, an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to woad-iiadle or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. s The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages)-Floors over outside air must meet the ceiling requirements. ` The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with,the other glazing. Basement.doors must meet the door U-value requirement described in Note b. The R-vauue requirements are for unheated slabs.Add an additional R-2 for heated slabs. 3 If the building utilizes elebtric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency trust meet or exceed the efficiency required by the selected package. For Heating Degree Day requirements of the closest city or town secTable 15.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R--value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). i �pMEIO Town of Barnstable �'P fps Regulatory Services 9B iE$ Thomas F.Geiler,Director �p f63q. le MA'S A Buildin Division g Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. AType of Work: Est'ij4ted Cost Address of Work: K0 Owner's Name: C✓ ��S Date of Application: �/ 03 I hereby certify that: Registration is not required for the following reason(s): . ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY ` hereby apply for a permit as the agent of the owner: g z ' v - 4 UsC loyz9k - Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav Town of Barnstable Regulatory Services "* BMWgrnac.e, S Mass. Thomas F.Geiler,Director ;,. A Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder f I v� �w I , as Owner of the subject property herebyauthorize r_i�( ��S to act on m behalf, Y in all matters relative to work authorized by this building permit ap lication for: o� �wis9o" (Address of Job) 2 � e3 ian e of Owner Date �T E CAJ Print Name Q:FORM&O WNERPERMISS ION MOATGo INSPECTION SKETCH OF Pi'-PEATY ' In 'i7errtI ►'r 19ARAIA7--A8LE County.MA i Apppicant: Rdt3ERT� /'.4�rctt-t=gN N. LE Wt S Book 8492 .r Page _ L.C.Cart.No. Nx: Date:. lit . 3s-�Zs2ts sr l�� o, Tc Ld - 19B LaT 26 8 /54 �423:S.F> L01 .7T /8A 0 340 S geV A4M= TjZWL. _Pi' uL -. .C�-d4A/Cy .�it..A�D C!T/BJ1/V/� , F.S.S. 1 my proJimsronal option the bLA"are appr=Tiat*located on the ground as shown arson and oortiormed to the appficable homn.ptal dmer>sional yard setback requirements of »4, z0�rtir��g�..��W4.aws of the from - o w AJ of t--R At 4ST-A SL- /�_att ft�tim Of msMxgi A. o is so, from acth under � Gowal Laws 1'► .�. � R., hipter 40ASectbn 7,the dwoll,s.as shown does not Id within a 100 year Special Food „r gird Zone as delineated on the FEMAMA Naflor>al Flood ktevrw= Program Map: ,ortmurity No. aSr1 il&l Panel f1 0 12/D Dated Z=2-V2 Zone G t i q, "—•'"•"• +ra aaa ww o..n rmgp..as .oa+rn pvooa•a argr ana is na lots or aarra.s'ran a--to a auwq.4 ariaw ;, ;>.- Technical Park Drive Uasr�waaome a,a a an.aav,ra auvq"s+000marrra at a rr coo.w VA na to raapo for am cl- VW Door. ' ; Holbrook, 02343 1r nogg. Caan in baa0 1�a1 I.Cf.1Ca1 s1a�,M•ampab(J►a+a Ala.aa,7f,aab AaaoCtilaOn d lan0 spa anO.C+a . +was.as a.+rao.rm a ua.nr o..�mass w a..wnn ` ' (781) 7-1400 ort�raacu aasaaoy aa,aoa.�w ra.+aua.a n to mrrp aarale..at .rro. scow vas q 000rl 5K _ 1)767-5873 , m r } 80A D OF 0 Q.RE SOU Lieen$e +,QwS' 2bAQN SL�tPI=f # Nutpke 009474 ' '. # t�� r E w1 }8•. Tr,rte•. j"9 r t' r tnted BH THOMAS R MO rA ®�IN4�„°�bdl• YIM4 d43 a r, J.-.:. ,p��- �lze U�o�umanwea�t�t o�✓vLaooac�utdetla�; Board of Building Regulations and Standards ; HOME IVEMENT CONTRACTOR Re. i 96 1 2004 L THOMAS R.MO�r - awN omas.Morse 3;.3 Lakeshore Dr , :Sandwich,MA Q2563M =: TO 3449 DATE '( s AMOUNT THIS CHECK ` `�i�/�� V 7 r�C�'! � 444 �� ', _ } -, ,r�.,, � f ¢3 22*30 sc. � • i � � it i i rX)�.h'774ni i;;4n'N m' 7Z7/f ALA IM ,. 25 d FIST ' _ ` f �ONAI E f A4 carws 7,)ry,90> fl �S ty �' •'{ Assessor's map and lot number ........ .........i ........ ....... V Sewage Permit number �PyoFTNEra�yo TOWN OF BARNSTABLE i 323 STABLE. .r "6 BUILDING INSPECTOR O,�EPY Q M �. APPLICATION FOR PERMIT TO ............L: F'NiS" � � ............................................................................. TYPE OF CONSTRUCTION �f.(VI-j'.aL.1�5; ...Al .04 ./[/.1 4,1 . 1.1k ir�.�!!'t-1 ............✓ .............................19:.7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... .....�1 ..:.....1.... Q./..'. f.l.!.......................................................................................... ProposedUse .......... ..J�: !.t;'. .; QJ. ..............................................................................................................F.......... . ZoningDistrict ...........: :. �.................................................Fire District ..........:( . �.: ............................................. Name of Ownerd4c�-Address ... .. .��.��,, `��1Y / 4 .,'. ..... 1.............11 `( ` Name of Builder ........... ....................................Address ...........................................................................:........ Name of Architect /{ .......................Address Number of Rooms �f....1� ..fG ...Foundation ..... Ua ... `ed.. ..... . , fs ...... Roofing .......... 5 ' ...........Exterior ........... . .1 . I t P �Y1>�' jV� t` l , CC( aI/Iij,:. ....Interior Floors .... .............................. Heating ...........' .f i! ..GL. !........,..,,......'t PlumbingCQt �? `G:r�? � .. ............. `' 4` Fireplace ................ ............................�.................Approzimate. Cost ...... ...: ... ^. �. ....... .......................... t ! + Definitive Plan Approved by Planning Board ________________________________19________, A Area .. .� `. Diagram of Lot and Building with Dimensions Fee .......... �........ : .4... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH TIM/ I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. • rName . Q1 ..-.. X'_ ................................. f Charles & Laurie LEberl I fill Sewage 336 No .17-972.... Permit for .........i... .....AI-5............................................................... Lewis Pd. Rd. , Cotuit Location ................................................................ ............................................................................... Owner ... Charles ,&ILaurie Eberle ............................................................... Type of Construction/.................W.o.dd............... ................................... ........................................... Plot ........2.0.-n 5 7......... Lot .............. ................. Permit Granted, .ctober...3)................19 75 Date of Inspedfion .....................)...............19 Date Completed .................... ................19 PERMIT REFUSED ..................................... ....................... 19 is............................................................................... .......... ............................................. .... . . . .... . .. ........... .. .... ..........................I.................... Approved ................................................ 19 ............................................................................... _ /Z /f � Assessor's map and lot number ...... ` of THE To Q. 4 Sewage Permit number .�f/4,..�h,a.S. .•.- . r IN STALLED `��NEB MUST COMP LIAIv BABa9T&BLE, House number ........................................................................ iWITH TITLE 5 va rnea � TOWN OF BARNSTABLE'n"\Is BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..........F.�L /l .�� 1�. . S7.�................................. .................. .. n� TYPE OF CONSTRUCTION ........s�ti.................................................... ..y....... Al .......... �......................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location �0AJA /... .............. !..s........................... .... ..... .G?. ../...T............................................................... Proposed Use .OeM e4-0� Zoning District ki ........................Fire District u T ame of Owner ......��✓giPLES r.L�C>okk'lE � Address � '.' �d �. C'o- 611............................... .................. ...... ............. .. ... .................... Name of Builder ��/� u w ......................I....4 .....�.......................Address .................................................................................... Nameof Architect ........ .........................................................Address .............../.................................................................... Number of Rooms .......6......................................................Foundation ........&,.0- e. ........... ........./...p..................................... Exlerior ................... (oL,�.. W.:.. !�!7.I� ....Roofing .......UfSII�CGE....0 /l �D.... eQ 1..... —et).0.................................................Interior .................................................................................... Floors .........................//.. Heating Gt� ..... .T/el C..............................Plumbing 00 Fireplace Fl 5 �� Approximate Cost ............ Qv u Definitive Plan Approved by Planning Board ____ __________________________19________ . Area ..........................71................ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH _I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ��/ Name .. ....:�i7.GG.!-Gt�........li.. ................. EBERLE, CHARLES & LAURIE //3 -7L� No Permit for ADDITI.ON ................... Single Family Dwelling Location .....�.1:5 Lewis Pond,.Road.......,. Cotuit Owner Charles & Laurie................................. ............... Type of Construction ....Frame......................... ` 0 ® N ................................................................................ N jr /V Plot ,�-ll P� ......... Lot ...........�. .............. ./ Permit Granted ........March 10. .19 13' CX Date of Inspection '. - .......� ......,19 Date Completed ................... .1 !1 44) j41 Y A 46 y F Assessor's map and lot number /A,)/ -,/ 4�. it;e ESewage Permit number .�Jl� :.. .✓?,q�. I MAUSTODLE, i House number ..............:....................................................... rues 9 �p 1639. \00� �'E YPY�`• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............6: 4I1?CE /T d k S.......... ............. TYPE OF CONSTRUCTION ........ a G! ......F41;71/v' Y.....66d GL:/.!.....0 ............................. /1lIA�. It).......... Sz ............................... 19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `� ...... 15.....PoA)b f(I) f Q 77,,* J T ProposedUse .......... , ��! .! . .ra ................................................................................................................................. Zoning District ...............7..............4t.!C.........................Fire District ........."7-U /.T............................................ 61YMLt�5 L�t,.e,�'/F CC' v ?QX `7��, CO-To/ (,.`Name of Owner ................................�...............-........�.....::Address ...............:....................................... ...;. ...................... Name of Builder. . /d... , .�CA.......................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .......49.......................................................Foundation ....... � G, ................................................... Exterior cY�/ �vi� L�Lt�. C o}R /.....Roofing ................................. ......................... Floors �Lc) a.................................................Interior .................................................................................... ..................................... r Heating �... ...............................Plumbing ........................... Fireplace LJC /.-.- 3` ( l.��,......................Approximate Cost ............1�... .Q ...........................;.:.......... Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .!/11 6 CC.(,lit:C ..... �Kam................. EBERLE, CHARLES & LAURIE J 0(c) , t No .23863 permit for .,,,ADDITION Single Family Dwelling ............................................................................... Location 215 Lewis Pond Road ............................................ Cotuit ............................................................................... Owner ...Charles & Laurie Eberle ................................................. Type of Construction ..Fram.e ............................ ................................................................................ Plot ......................... .. Lot ................................ - 1 Permit Granted ....March 10, ..19 82 Date of Inspection 19 ' Date Completed ......................................19 r s THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I M j L DATA Assessor's map and lot number ............................................ 5*THETo�o SewagePermit number ........................................................ e Z 339HHSTADLE, i House number ........................................................................ ro rasa Oo�i639• ♦� �E0 MAI a TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. Zoning- District ........................................................................Fire District .............................................................................. Nameof Owner ............... ...............................................Address .................................................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exterior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating ..................................................................................Plumbing .................................................................................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved b Planning Board __________________________ __19 _______ . Area ....................T.. . PP Y 9 .��.....;'.. Diagram of Lot and Building with Dimensions Fee ............:................................. (� SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree a to conform to all the Rules and Regulations of the Town of Barnstable regarding the above 9 9 9 9 construction. Name .................................................................................. BURNSIDE, H.E.W. ~ �A-20-14- 20-57 No 2.25 4.... Permit for ...AIA0...JjQr5.e...Stable Accessory to„Dw ,], c� Location ...Lewis Pond...Road......... Cotuit ............................................................................... Owner ...H'..........w....Burns ................... Type of Construction ...F.rame ...............................................Z*.'*"**,.,*,.*,."""..".**.*"' Plot ............................ Lot ................................ Permit Granted .....5e�?tember 3 0,,..19 80 Date of Inspection I...............................19 Date Completed ....I.................................19 PERMIT REFUSED ...................................... .. �.. ... . 19 .................. �............ .............................. K ............................................... r ....................... ....................................................... Approved ................................................ 19 ............................................................................... ............................................................................... The Town of Barnstable Department of Health, Safety and Environmental Services URMAMM _ Building Division NAM 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph M.Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration b Date: 9 Name: Inar a✓2¢ Lt-4arra�aw Phone#: ' or Address: .z t S— kiii ad pout_ �0 �� l�. �; �G lCt f Type of Business: DDit 1 Sti t�Q Map/I,ot: INTENT. It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning oadiaance,provided that the activity shall not be discernible from outside the dwelling: these shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traff c above normal residential volumes;and no increase in air or groundwater polution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwellingtmiL • Such use occupies no more than 400 square feet of space. • There are no external aherations to the dwellingwhich are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required float yard. • There is no exterior storage or display of materials or egttipmenL There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and tine trader not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot contairm the Customary Home Occupation. • No sign shall be displayed indicating the Custorna y Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the_ I,the undersigned,have read and agree with the above restrictions for my home occupation I am registerm& • ---Date: Applies Homeoe.doc TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcels � '� r : Permit# "�" '� Health Division j q,— fie , ,� �� R, � � ,DateAssued (�e�Ajp Conservation Division h Z �i /V6—•VI/ °� i. A Fee,�► Tax Collector,. �.. .�` Treasurer-t I qfi Planning,Dept. l _ r Date Definitive Plan Approved by Planning Board Historic--OKH Preservation/Hyannis Project Street Address z f r Village c'v Owner �� 416 AM-44A^13 Address "Telephone �17_6 - 09?/ Permit Request A (� � ZZ_ Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost f 1, Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size R� �+ =� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes �oo On Old King's Highway: ❑Yes No Basement Type: ❑Full OCrawl ❑Walkout ❑Other a 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 sizeRXZZ 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 0 Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name �c ��y (' �m�7% Telephone Number Address. 'Qmx License# 6Z16 Lfzl 77 Home Improvement Contractor# Worker's Compensation#alb 61 S ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO �I S SIGNATURE DATE f6 Z8 ` r 1 f FOR OFFICIAL USE ONLY - f PERMIT NO. L4 5 /) J ( 4 DATE ISSUED MMAP/PARCEL NO: ADDRESS "'' ` VILLAGE r OWNER ., DATE OF INSPECTION: - Y t ' FOUNDATION n , FRAME INSULATION FIREPLACE <, + ELECTRICAL: ROUGH I FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' FINAL BUILDING, 60h DATE CLOSED OUT r� ASSOCIATION PLAN NO. r' �, -TOWN OF BARNSTABLE t BUILDING PERMIT ( PARCEL ID 020 014 GEOBASE ID 787 ADDRESS •2.15 LEWIS POND ROAD PHONE COTUIT ZIP - LOT 19B & P Bi&K LOT SIZE _. DBA DEVELOPMENT :STRICT CT PERMIT 34544 DESCRIPTION 17'X22' DETACHED 1 CAR GARAGE II PERMIT TYPE BUILDA TITLE NEW BUILDING PERMIT ACCES l CONTRACTORS: D & V CONSTRUCTION, INC. Department of Health, Safety ARCHITECTS: and Environmental Services ` TOTAL FEES: $62.00 .BOND $.Oq tHE CONSTRUCTION COSTS $20,000.00 i 434 RESID ADD/ALT/CONV 1 PRIVATE P;*, ERNsrAB MASS. EpMp► BiL BY DATE ISSUED 11/04/1998 EXPIRATION DATE r1.'OWN OF BA 'STABLE 4 ..� BUILDING PERMIT PARCEL 1 - 020 014 GE013ASE ID 7617 ADDRESS 1216 LrwisPOND ROAD PRONE N"COTUIT '- flip T � �'� P LOCK �� ?s LOT SIZE - 3 PER1IIT 34544 DESCRIPTION 17'X22" -DETAC HED` 1 :CAR GARAGE PERMIT TYPE BUILDA. TITLE NWT MJILDING PERMIT ACGES � OONTRACTDRS D V. CONSTRUCTION INC. Department of Health, Safety -AE ITWTI and Environmental Services w. NE ' Os .00 °k� ti -CONSTRUCTION COSTS $20,000.00 434 SID. , I3j 1Ia`J"�/d (JJ �T PRIVATE` K, * BARNSTABLE, MASS.. �► _ '" EDpNA1�►!� BU ,"D' 'b ION LATE: ISSUE 1:1,/ 4/1SS8 EXPIRATION DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY,OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: ? APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1,FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2.'PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN,MADE.WHERE A CERTIFICATE OF OCCU- ELECTRICAL,PLUMBING AND MECH- (READY TO LATH). PANCY,IS REQUIRED,SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. a 4.FINAL INSPECTION BEFORE OCCUPANCY. r VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 2 2 2 ' F 3 1 HEATING INSPECTION APPROVALS ENGINEERING,DEPARTMENT 2 BOARD OF HEALTH , fV r SITE PLAN REVIEW APPROVAL OTHER: WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDING PERMIT - . The Town of Barnstable �$ Department of Se31th Safety and Environmental Services ... Building Dion 1VW 367 Main SUM:;Hyannis MA C60I h Croce= Ott SOS.790-6727 B Coma'.=-r: fax: SO8.790-Ma For office use only permit no. Dau AFFMAVIT HOME zWROVEMENT'CONTRAC 0R LAW - SUPPLEMENT TO PM MTt APPUCA77ON MGL e. 14 .A esquires that the *Mwnstracdon, siterattons, reaovatfon, jepair, moderuirstion. conversion. improvement, removal, demolition, or construction of an addition to nay pre-ezisting owner 'occupied building containing at hiss one but not more than ibur dwelling units or to contractors, with structures which are adincent to such residence or building be done by rcgbtered certain exception&siong with other requirements Type otwark: i A-6E - Est.Cast ` Address of work: -1/ owner's Name L�4z- Date of Permit Appil=d=: I hereby certify that: Registration is not requircd for the following reason(s): Work exduded by law ,lob under SI.000. Building not owner-occupied wner puking awn permit Notice �t OING� awN PERMrr OR DFALJ1gG W QNREGSF3 APPLI LE HOME MORCIVEMOT WORK DO NOT CONTRACTORS FOR TION PROC:L�h OR GUARANTY FUND UNDER MGI.14ZA � AGCE55 TO TSE•�I� qG;= MEB pWALTIES OF PMUMY t iy f or a.permit as the agent of the owner. ' Cantrector Name RegWnZtton No. D OR pwnerrs Name Date -_\ The Commonwealth of Massachusetts -- _ — . V — Department of Industrial Accidents Office 011are599,1 fees - - < 600 Washington Street -"_.�I Boston,Mass. 02111 Workers' Com ensation Insurance davit �/ name: � :296--7 J`"e6� location "!'e© , 9D L- � �el city Y�r 5`ma,,- 0 111 phone# ❑ I am a homeowner performing all work myself. ty ,,� netor and have no one worldnJum Fam an employer providing workers'compensation for my employees working on this job. 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':.:..'':> ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractorslisted below who have the following,workers'compensation polices::::::::::.:.:::::.:::.:::.:::.:::.:::::.:::::.:::::::.:::::::.:::::::.::............................... ::..:::::::::::.::::.:..................................................................::::........... ............ ............................................................:.::::::.::::::::::::.::.:...:..::;...'.-:..::::::::•::::::::::::...:...?..?.......:.....:.. ;:::::::::::: any'name. .:::::.' address: {. ?:.;:.?:.:: ?:.?:.?::.?::.: .?::.........::.;.•::::..:.?:{:>:::.:.; :::.:::::::::. :..:::.;....:.:.:.1..... :::::::::.:.................. .. l one0 ��;;<:i; > .:....<i;> %,:— < < > ;< `?=:M><»< ><>< ::.:.....:::...... .::..::..... ... :::::::::.::::::::..:....???::...:::..::::.:::: c9tv::.... ...........:: :::.: ..::::i:.... .. .......... .... .. .�:::::...:v::: tiJ:<di f::•J.. :;i:'r.:iS::;:;y .; :i}:<!:?:•isL:i:^:vi•isisi R:siii:<:iii}}}:vi??::"'.....'.... ::::i<:i:::?:?':'?::::�:yy;:jinn:•:`:{''::ir:i::^::::'rii?:?^i;isv;:st%:::iiiiiiiji?isvt<J?:^'%v i'ri?ii:>i i i:'v?i i"iii?iT}T::'iijiiji:. .:.v:::.::::::................ii�.......... :.:5':�'::::::::.v::::::::, :.i..:...: :vi:J:S?�': :::v::.::.�:::::.�:::::::::.v:.v: w:.;::::...:......::::%.,.::::.; :.v.............................................::::....v:::.:.::.z....... (�.... ....................................................................... ............... ....... .. :::::......... ..................:•:.. .....::::::::: ....:...:...........:..........:.:.................:.:...:........................... .......... ...............................<.............v...{........,vAw.n v6iN)�N•:.w....... r"CeT /lOiti {::•?: .... an name ::::<::.::.?:{.?:•:::: ?:.... y :.??:.?.:::.:::: :. ?;::::::::::::: ?:. .......::..:::.:;::;::.. . .... ... .... ddress. :::<:;.::::::..:.: :;::::;:::::::::<;:: A :,..;,. ::z:?:: >.> 1. 41 ?::::::>::`i:'?.:>:::.:::: z:.;:::�::>; :....::.;:::;:::?::>.:::: 1. % ........................................ ......... .... :.: . w«. ;.-??::.??::�::,.�.......... > t >> :':'>::>::>:; i>:>�................. nsnrance'cQ;::.....•...:::::%%..::::::.<::::;:.:::::;:::,%.:.:>:::;:;:;;:::::..:.::.:.::.::.:.:::::.::: :>:>:::;.?::.?:::.;::.:,::::::;:: {?:.......:..., .: I..:.. Fafiu a to seeus coverage as required under Section 2SA of iiE 152 can had to the imposition of eninninal penalties of a fine up to S1,4Oo oo aad/or one years'imprisonment as well as dvfi penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this may be forwarded to the Office of Investigations of the DU for coverage verification I do hereby c under th ains p ' ofped ury that the information provided above is trw.any cone lt ^✓�� Date /t� � / Signature �/' �p _ Print nameA\.0ax1-:512��Nlj k_�'� Phone#SM l'?6 8`o Z official use only do not write in this area to be completed by city or town official city or town: permit/llcense# ❑Building Department ❑Licensing Board ❑duxkif Immediate response is required ❑Selectmen's Ofte _ OHealth Department contact person• phone#; ❑Other wed 9195 r: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 in the service of another under any co=-"z-, 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 m a joint enterprise, and including the legal representatives of a deceased employer,,or the receive: c_ trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant.who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is ::being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to cmrtact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retmfi6d io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents OMca of Investigatlons 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 eat 406, 409 or 375 °F TFIE ram, The Town:of Barnstable 9� ,0�' Department of Health Safety and Environmental Services ArED5.�a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION i 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: mod 2 l Est.Cost (� Address of Work: 2 I S Le-iAi is I and (b 77a tY Owner's Name Date of Permit Application: I hereby certify that: ' t Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 1,42A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of thZ�4, /2 -` 7Q- f6lf �� Date Contractor N e Registration No. OR Date Owner's Name CIS UNIT ASSESSOR'S MAP 020 151x 1r_ 32x \.�.;:.:. < IAN -^.. 150 !�� uox 13x �` na , Iz' t 8 I / nu lax 14-2 I ..rn WK 104 34 .. rnS r._ INK *27 139 no i ` •7/ 31 DISK ! r I r , ....._....-,,.....,._. 1 7 I 1 ' _./ 6 t \' I \ _enk� 1 t nee A ! tax rut ( +la 12 atlxx 8 1 y� r v1 111x rx i Ir }� � : T mlu � `r 12UK x 7-��e- ..r„. - •.... 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NOTICE H NOTICE TO a TO EMPLOYEES EMPLOYEES W V The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 600 Washington Street; Boston, Massachusetts 02111 617-727-4900 As required by Massachusetts General Law, Chapter 152, Sections 21, 22 & 30, this will give you notice that I (we) have provided for payment to,our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES -----------------------------------------------=------=----------- NAME OF INSURANCE COMPANY ONE TOWER SQUARE HARTFORD, CT OG183 ------------------ --------------------- ADDRESS OF INSURANCE COMPANY (GNUB-30OX167-7-98) # ' 062498 TO 062499 ------------------------------------------------------------------- POLICY NUMBER EFFECTIVE DATES EDWARD A GRAZUL INS AGCY P .O. BOX 337: a_ MARSTONS MILL'S MA 02648 �-- -------------=---=--------------=-----------------------------'---- m NAME OF INSURANCE AGENT ADDRESS PHONE D &-V CONSTRUCTION INC 38 PIERRE 'VERNIER -DRIVE o ' o SANDWICH MA 025G3 o ----------------=---`---- ----------------------------------=----- EMP LOYER ADDRESS ° EMPLOYER'S WORKERS COMPENSATION OFFICER (IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course'of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers _Compensation Act. A copy of the First Report of Injury•must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician,will be paid by the insurer, if the treatment is necessary and reasonably,connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the ----------------------------------- NAME OF HOSPITAL ADDRESS TO BE POSTED BY EMPLOYER TravelersProperty Casualty 1 W20P1H95 w® 005844 w aTravelersGroup 1¢ � '� � � �fie-(�dnv�nanerea.�faa� � F• ? . 1 3f'• '� [ Ky�. L I1 i 'z G4�' DEPARTMENT'OF PUBLIC SAFETY t` 1 � CONSTRUCTION SUPERVISOR,LICENSE I� ' — j;;Nanber' � s Expires'. ' 4 .�� .. - ry,Fes. _� f "✓.. �' 1�. , , +• .. 38 PtEARE�YERNI'Efl OR SANDWICH rMA 02563 r :'I � ✓��innirreomroral!/i a�� ; 1• F HOME IMPROVEMENT CONTRACTOR Registration 124520 Type - PRIVATE CORPORATION Expiration 07/14/99 t' D 6 V Construction, Inc ' Andrew R: Davidson F , G� &-OWierre Vernier Dr ADMINISTRATOR Sandwich MA 02563 �t , C. a t r - The Commonwealth of Afassachusetts Departinew of Lrdustrial Accidents ` Office 0101 11921fons 600 !i'ashinrtun Street Boston, Alas. 02111 Workers' Compensation Insurance Affidavit ;Applicant information: Please PRINT lei Y_� - " " name: �41®Yvl 13 C1"IAG t� S Iocition: cjt�, re�St-,- Mk 0 Z63 Phone# 509 8 6-77-1 I am a homeowner performing all work myself. I am a sole proprietor and have no one working to any capacity ' .7 '9• �L^L4^.+S31lecR!':r. 7""S�'.>F^• ;af. +..��• n+,�r .dam.,... ,^.�•'"`�§''--�4�"'r'�?` ��xi,a.ser`s�'L}:•1wr..ua:tia��w.as.'�`1' is .:..n,��:�;rrd..v:::'�i :.':ni �_ _ :3'ti!a Fj I am an employer providing workers' compensation for my employees working on this job. company name: address: city: phone#• insurance co. 1101 cy# �, ..,<., . , .,, t.; -a a... •.. .« ,Y..Y.y�,•n'�- :.... ..d}.�mwai-...o+v.�wr sn...j.s^f aR. s,,n•..w.-i ..+w - I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comfam•name: address: cih phone#: insurance co. policy# a = - �an'a•�r,y`:, r -�.!l i's.^-;•st r ^n a.r• ., ,.�w r`::% - - �o.•uitn r: ^• " :uG company name: .address: city: Phone#• insurance co. policy.# -insurance shcef if necessafl"r~ '"'t �"�sF: _:* r; �7 __ �' • rw Failure to secure coverage as required under Section 25A of D1GL 1.52 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certifj nder the pains an penalties f perjury that the information provided above is true and correct. Si-nature // Date /2 r/ 7— Print name M ofS 1.9 /1 S Phone# 50h' i l"6 ` q`7 216 official use onh• do not%vritc in this area to be completed by city or town official city or town: permit/license# rnlluilding Department OLicensing Board O check if immediate response is required 0Scicctmen's Office Health Department ' contact person: phone#; Other - rn (raised„95 PJA) � i 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 emplovee is defined as every person in the service of :►nother under any contract of hire, express or implied, oral or,.vritten. , An empluver is defined as an individual, partnership, association, corporation or other regal enlity,,or a`N,two or more of the foregoing, engaged in a joint enterprise, and including the legal representatives of a deceased'employer, or the receiver or tr•usiee of an individual , partnership, association or other legal entity, emp'oying;emplovees'Flowever the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that even' 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, 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. ..-.—..•..-- . . � '4' ao•. :.fin tie t Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. ' Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application-for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. Tile affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to-give us a call. r••m,�.v.�+-. .-�.+r.�--r�.. .r.�..ce�+ - ""!?.►,..zs+?+w•,s.•=+'sc..�m..'?�:'S'S's".e,'^,',T"". .,�.,d" Yv�►..w,.s.m•.a'nr�t.nea•. -rr.-.r+v...�•ncr,...�^-mw.e' The Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 NVashington Street Boston,Ma. 02111 a` fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 Z i j L E�:=,i 5 �o�,fl ►Z�` i v � L- r LZ I OFF LC.,?- I ( 2 C 3� II I o i o II ISIL�GC.E I I �- I I 1�ZY Sv>Ml I I qv" ppl ,oI TS) II I I O O Ili I I R�aJGE 00 00 00 a I�our��rl-� L-- i a fZO1 1 I' CC(Lt�1 r GA-9 R THIS DRAWING HAS BEEN PREPARED BY AND IS THE PROPERTY OF: SGLE EACH SOUAPE E, Le<- COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 LICENSE EXPIRATION DATE 10/01/1997 CONSTR. SUPERVISOR CAUTION EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINS RESTRICTIONS THEFT, PUT RIGHT THUME 1G 1 & 2 FAMILY HOMES 04/22/1994 062318 PRINT IN APPROPRIATE BOX ON LICENSE. THOMAS E HUGHES T` 2 SMITH LANE BLASTING OPERATORS PHOTO(BLASTING OPR ONLY) FEE: BREWSTER MA 02631 MUST INCLUDE PHOTO. I NOTVALID UNTIL SIGNED BY LICENSEEAND OFFICIALLY Failure Ito POsscSSecY(feni HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER � - �' gassacAna�tts^!:�tsBnffdim <,odalac�> : :�y�ssti�t THIS DOCUMENT MUST BE +• CARRIED ON THE PERSON OF I' «NATURE OF ENSEE SIGN NAME IN FULL ABOVE SIGNATURE LINE j LIC THE HOLDER WHEN EN- �1 j• yy yy i OTHERS-RIGHT THUMB PRINT GAGED IN THISOCCUPATION. APNOV. HOME IMPROVEMENT CONTRACTOR ` Registration"115899 .Type INDIVIDUAL " ^Expiration °04/27/98 � THOMAS E}:HUfiHES { THOMAS Es.�NU6HES � ,ADMINISTRATOR a'.. 7 { �� BREWSTER MA 02631 � � k; Engineering Dept. (3rd floor) Map :ZO Parcel / Permit# 20 G -61 House#. Date Issued l a2 — / - _cf Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Conservation Office(4th floor)(8:30- 9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) SHE rqi Definitiy&thp Approved by Planning Board sue' 19 SEPT110 -1 TMMIA TOWN OF 8ARNSTABIbEiRo 9treet Building�PermitApplication ' �� REGULA170WProjec ddress 15 tew/S' 10' nc/ Village-- 0 o&i{ Owner T�In^ t Mo-rci ov-J M<G Arrci�Pt td= Address R."I P 0 as v Telephone 172 o - o 9 q/ t'_p`�lai t M l4 o a (0-95 Permit Request _ R24/�Ic7CJ1 � T��o'z'�-�" k,tic wew n,"r. First Floor `/j 936 square feet Second Floor ! square feet Construction Type zo bd Estimated Project Cost $ 7, :5'0 Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure r S Historic House ❑Yes I9d No On Old King's Highway ❑Yes M No Basement Type: P9 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 3 Number of Baths: Full: Existing New o Half: Existing New U No.of Bedrooms: Existing_—New 6 Total Room Count(not including baths): Existing_ New 0 First Floor Room Count q Heat Type and Fuel: ❑Gas a Oil ❑Electric ❑Other Central Air ❑Yes L#No Fireplaces: Existing New Existing wood/coal stove ❑Yes ;p No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ZNo If yes, site plan review# Current Use S I Q ��4v�t r{ Proposed Use 51iu5t, Builder Information Name p M f4S Lk e s Telephone Number Gj d , - 9 7 Address S M i �0.�� License# (� 3 1 -r eA,v S bey- 0 7- 3 1 Home Improvement Contractor# [ 1 5 S-1 Worker's Compensation# A11A 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 `l 9 SIGNATURE DATE BUILDING PERMIT DENIED FORA/HE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. F DATE ISSUED MAP/PARCEL NO. ' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: G FINAL FINAL BUILDIN' DATE CLOSED ASSOCIATION P O. sa ` pj VIt ' t - . tt SMOKE KE DETECTORS O.K. \ i-t-- ly� aY<.�i 25'' � �� -JYx.ay� �•e�Q:J B VBLi 3UILDING DEPT. r � / ap` \ /` `\\� i I avx�vra aYK3lxa I � . • . r � • �Y 9/y w/r —�'L SST 0 �aNcrN gip,\ I 0 t ■ E _ /;'\yam.. �, \ra`'�,t.� i (,� t� r- G�ay..Av av,<.zv _P.QQAt-�L 9 � imxv,t,.y.�IL}t`t�� 1, r t' ��_ \ J4' 'Y '-•o• �G• '\ a �P DQ. \�.� A G-rC` �, 1' \: �ii �' C�,1 E c• / -- `r�l X -- y j - a AbJelt.,`G 11 `�' .�O '`\• '�'V ,*. \\y /C-,�•aY I•-Ir --r, f (_ I �IiU 7 -�} — �... 0 Q� a'-4'n3 ♦ -- - -- - - • - - - i _ 9 y"�--Ex sT_I —.� � ---------- --i_J.5 r- -'__t_'L � \ / 1 � 1 ..�,/�5�_r�c�,�. _�j'_-Lev''----%c``�cE 1'1'=-G=/3' _ ;\� ., I I �t, � - ;a l' O� •' i IT l7-0.' -- s t _ Alm a / / \ 6ay.a.vx a \� ootit All , / avx/Jf G aYxRyx s (yL a�xayxa _ ( ksT n �:�-�� lye, � � 1 ©�� roil �X�*�NL- � • . � � � � \� 34xa4 i—Ey'r, oM d� L 1111{{!1 I1I11 lb zEj zEj v - PA6£ 5 OF 7 I f �'- FFM _ Wit_ IT Arj _ I _ # 1 l I, . ,� . � � �r { ,;- n �� ' l _a� w �, i N � __ ;4 M � � _ :a .. � _. a ,.i" '`y, � r i�. .. ��'. t4 r `\ i ., 4 t i i i_ :.,, ^ .I � { .. i i � 4 7; R �� r � 1 ^/ .. 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