Loading...
HomeMy WebLinkAbout1097 MAIN STREET (COTUIT) 7"0�� m� iN s� f F Application number.,F�...r,�i�.'......�.� .... Qa Fee ... ..... J�a... ........ ... s BUILD N Building Inspectors Inipti�als........... .,..1.................... JAN7 f0c�d Date Issued.:.... : .?..1..�. .�1..................... TUWIV Vr �/ - Map/Parcel..... ..7.......a.vs...................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION �t !- Address of Project: �O NUMBER STREET VILLAGE Owner's Name: ('��DCL S Phone Number Email Address: L'C_0 V C�) I^')o. L'ov1 Cell Phone Number J Project cost S / C? c)�D Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I here authorize . �F Z� to make application for a building rmit in accordance with 780 CMR Owner Signature: - Date: 10 TYPE OF WORK iding 0 Windows (no header change)# ❑ Insulation/Weatherization 0 ` Doors(no header change) # Commercial Doors require an inspector's review Q Roof(not appfying more than 1 layer of shingles) Construction Debris will be going to ��N S - CONTRACTOR'S INFORMATION Contractor's name Home Improvement.Contractors Registration(if applicable)# ?,,S (attach copy) k b Construction Supervisor's License L (attach copy) 0 Email of Contract4—UXI/0 �"�C y° � 'Phone number S `d S a ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT. YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ...............................................r...........P } *For Tents Only* F Date Tent(s)will be erected Removed on number of tents total X ?� a Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 201bs. or> Yes No_____,if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. f If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3:30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date" APPLICANTS SIGNATURE Signatur f Date /QL All per it a plications are subject to a building official's approval prior to issuance. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: t •vc;�' �.� City/State/Zip: Phone#:' Are you an employer?Checkthe appropriate box: Type of project(required): 1.❑ I am a employer with 4.,ffI am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors: 6. ❑New construction 2.�I am a sole proprietor or,partner- listed on the attached sheet. 7. ❑Remodeling ship.and have no employees These sub-contractors have g• ❑Demolition working, for me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers'comp:insurance comp. insurance.: required.] 5.,❑ .We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contnictors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as req ' d 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 o -year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a a ' t the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations o for insurance coverage verification. I do hereby a the pains and penalties of perjury that the information provided above is true and correct. >Z Si afar Date: �! 0 l , Phone Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions s 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 submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia f Massachusetts Commonwealth o Licensure of Professional Standards p piviBuil ulations and f) Board of Building R���is g,2 F amity Constructio �ires:1212012021 � CSFA-071165 .HARLES R 45 HATNAW ' OSTERVILLEA C 4. `< � �b��b1Sti t 0�� commissioner Construction Supervisor 1&2 Family a use only 1 Failure to possess a current edition of the Massachusetts individual nd return tO''ulatton State Building Code is cause for revocation of this license. valid for lf,fou Hess R89- bell, hiGo umie n airsSu t B O Call 17)727 For information 00 or viRmwww.this license rnass.gov/del 10Wa ;A 1fi9 ' out`s�gnatW10 Not2llid Wh ° Siti wt �� z 8uN RAc?.OR of Con OM C'-0 H E 10 $at'E Md tetan7 CHAALES A pUndersee 45 FIAT VILLE, `02 c 0sxO ` Application ................................................ I I k-3 4 20 ��►Y � Fee.............................................................................. u,�, ���� . Building Inspectors Initials.......... . s65 TOWN Date Issued.......I I . . ......... Map/Parcel.............:...................... .........:............ TOWN OF.BARNSTABLE�----- - EXPEDITED PERK 1T APPLICATION: ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: )65 ) NUMBER STREET VILLAGE Owner's Name: Phone Number ?&I Email Address: Cell Phone Number Project cost$ w Check one Residential Commercial J al OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK ❑ Siding ❑ Windows ( change)header char e)# �Insulation/Weatherization ❑ Doors (no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to <XC a CONTRACTOR'S INFORMATION Contractor's name Mike McCarthy Construction PO Box :52 west Dennis, MA 0267�D Home Improvement Contractors Registration(if applicable) iattach copy) ' CSL=58633 HIC-169393 Construction Supervisor's License# (attach copy) Email of Contractor ✓''1�r1 cC��fil `IaC_ , �.c�►� Phone number ALL PROPERTIES THAT HAVE STRUCTURE OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY.IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN,HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X. X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan,with the location(s)of each tent Fuel source being used LP tank 20 lbs. or>Yes No_____,if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9.30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date SIGNATURE Signature Date All permit applicationsere subject to a building official's approval prior to issuance. DocuSign Envelope ID:A70AOF1E-IABC-4CDD-A93F-E8402B146737 -791 (/3 qZ�-k DF SHE ra$ gwpy �� Town of Barnstable Cal-5Y6 s�o I y'' BuildingDepartment Services C s� i BARN-STABLE, P SF_ _ panMASS. Brian Florence,CBO ATfp p�p1 p Building Commissioner - 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, Elizabeth L MellorS , as Owner of the subject property herebyauthorize ` rn. �� � )— to act on my behalf, in all matters relative to work,authorized by this building permit application for: 1097 Main Street Cotuit (Address of Job) DocuSigned by: Signature of Owner Signature of Applicant Elizabeth Mellors Print Name Print Name 5/6/2019 1 2:12 PM EDT Date i ` The Commonwealth of Massachusetts = r Department of IndustrialAccidenis j Congress Street,Suite 100 Boston,MA 02114-2017 www mass gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information *�= Please PrintLe ibly NaMe{Business/Organization/Individual): Nfichad MCC$dhjC,r Address: Pa Box 52 City/State/Zip: Phone Are you an employer?Check the appropriate box: Type of project(required)' I.Q I am a employer with I . employees(full and/or part-time).* 7. ❑New construction 2. I am a Sole proprietor of partnership and have no erployees working for me in ❑ 8. E]Remodeling any capacity.[No workers'comp.insurance required.]• 3.D I am a homeowner doing all work myself.[No workers'comp.insurance required.]t 9. ❑Demolition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10❑Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am,a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.$ 13.❑Roof repairs 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. Other 152,§I(4).and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors 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: N�}t`�n� �i ch; i ,i'►,f'C Tr�� Policy#or Self-ins.Lic.#:_ V V C—41-4 S I Expiration Date: 1'a- ►SI I • j Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy.number and expiration date). Failure to secure coverage as required under MGL c.152,§25A is a criminal violation punishable by•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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify and Ire enaldes of perjury that the information provided above is true and correct. Si ature: Date: 11 �'f�f F Phone#: C560 ;Lh,-6 FCC/ Official use only. Do not write in this area,to he completed by city or town offrcial City or Town: PermitUcense# 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#:. G��re �pt�n � a � C��a -c��:ie�• Office of Consumer Affairs and Business Regulation 10 Park Pima-Suite 5170 Boston,. .:' tents 02116 .::.. .. . . Home Improvt :_ ' " actor.Registration : Type: lam. z: t R istr�Liorr: lamMICHAEL MCCARTHY , : �+. �iration: O8,/15/241g P.O.BOX 52 WEST DENNIS,MA 02670 I�! SCA 1 0 2OM-Mtt Update Address and return card. Mark reason for"chlute, —•---._ _ __ _ ---- --.—_•n.Addiess rl.AiinaWal rl ml.3_ ent E Ladcard C��ae�a9�cs�avxu o�tadua¢lld Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for Individual use only TYPE:IndMdusl before the expiration date. H found return to: 1=112112n Office of Consumer Affairs and Business Regulation .. 06/16/2019 10 Park Plaza-suite 5170 ICHAEL MCCA{ Boston,MA 11 ..LD . MICHAEL 6 RANGLEYLN. ,::;x_ SOUTH DENNIS,MA 02680 Underseoreta Not valid without signature ry ' � _•f Commonwealth of Massachusetts "Division of Professional Licensure MiChael McCarthy Board of Building Re ula4ions and Standards Y Ctansl7Mattoh Constrd flp�rvisor Has suc Itai�uily i6mpleted the Nelloml Fibt'er, CS.-058633 x Cellulose Training Course t ties 04/1.O/2020' , 23 fty of August 2011 MIChf14 'L J M.CCAR PO BOX 6sZ r4 VMS D NNIS Must fabar !" NATIONAL PMGR QO!tAfadaardpteelNOiaW COMIM sSioner OSHA 0015587/2 �, Y partanent m Lebo, ' OxupationaUSafety and Health Administration, Michael McCarthy : r 5 hes Sucoesaiu6y cornpieted ai l4afour Occvpat Safety and;HeaRh � � +i�.�mob�tih safety Training Cotxse fn' Cou[se UV 3�ftoutsofdal�77me8 dehoutso eld'ttma a ' Health Mz R (betel a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 54 Parcel b Application# Health Division %$ go T�( ?J32 Conservation Division -glaciLa Permit# Tax Collector Date Issued l -'"06 — Treasurer Application Fee 0 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board EXISTING SEPTIC SYSTEM s 6 LIMITED TO.-?_#OF BEDROOMS Project Street Address 1 -1 M ii �c Sr Village CQ i C, TIF Owner Telephone CL - Z `E- t Permit Request V---[L_rC-, S -To n -LC, 7> Fhrf I r2�-� o �•�� Square feet: 1 st floor:existing a proposed o 2nd floor:existing '?zS proposed 0 Total new a Zoning District Flood Plain Groundwater Overlay Project Valuation�, d vo Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach"supporting documentation. Dwelling Type: Single Family 0--" Two Family ❑ Multi-Family(#units) Age of Existing Structure Ito O Y.ZS Historic House: 2-Nes ❑ No On Old King's Highway: O Yes O No a� :=Z) Basement Type: ❑Full O Crawl ❑Walkout ❑Other cr 3 .xa - Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Pl C�,a Number of Baths: Full:existing '�-- new Half:existing CO i n6-W ;��C g ., - Number of Bedrooms: existing 3 new d � Total Room Count(not including baths):existing new First Floor Room Count I Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other f•l �-- Central Air: ❑Yes 2"No Fireplaces: Existing t4 o New Existing wood/coal stove: ❑Yes L21"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 O"No If yes, site plan review# Current Use Proposed Use r BUILDER INFORMATION Name S ` ��I� �( �� CPF Telephone Number Sa 42-0 3 Address 7 o License# &S 3 CV -r T Z 3S Home Improvement Contractor# l u L d-S Worker's Compensation# CSL,g -o Ffi (,,ci - -1 -Ds ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE ►^" c- V 1 DATE �►._ FOR OFFICIAL USE ONLY i` PERMIT NO. 4" s DATE ISSUED MAP/PARCEL NO. T ' T ADDRESS c VILLAGE i OWNER 4 DATE OF INSPECTION: FOUNDATION �p ffi FRAME INSULATIO FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ,'= FINAL X GAS: ROUGH E— FINAL � O S FINAL BUILDING in 0 O DATE CLOSED OUT N m m ASSOCIATION PLAN NO. 0 t cu P�oFtNE�� Town of Barnstable Regulatory Services BARNSTABIZ ` Thomas F.Geiler,Director rsass. 1619. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 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. vt T' Estimated Cost Type of Work: l �y 7t c-L ��, Address of Work: 1 ? 01.7 W S T Owner's Name: I L 6 S 02 i Y t, L b i2 S T Date of Application: 3/ 2 g It ri I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ' ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ,J nV.11IE c 111;F pJ � l 6 Date Contractor Name Registration No. OR Date Owner's Name ' Q:forms.homeaffidav Town of Barnstable Regulatory Services BM MszABLE, v MASS, $, Thomas F.Geiler,Director 0.19. Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, 90-��-;L'2`r A-, 4-L Lo e S ,as Owner of the subject property hereby authorize S7 i716,V—Z 4 eu -c F L,l•f T'I y to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner Date Print Name r Q TO RM&O W NERP ERM IS S ION BOARD OF BUILDING REGULATIONS r License: CONSTRUCTION SUPERVISOR f .� . . Numbe> �`�S O47693 8192F1958 r71 r09130�07 Tr.no: 6108.0 f +Refs,' s it STEVEN P MCE PO BOX 460 COTUIT + MA 02635 r Commissioner � - - Board Of Building Regulations and Standards HOME(MOVEMENT CONTRACTOR ' Re Istrstt 0485 tr /2006 GROVER&MC - I j STEVE _ yS N McE L HT i f 523 MAIN ST COTUIT,MA 02635,�...; _ Administrator t'r ' 1N E �I s ': ........... _ _ �rtowTfZ C�ER� �x�s�nNt, ��osE'►' wn To Ac iri>/ ME c�T-Z:D JI .;.. Exlsr,..�a 71 { EX. WA W WA fir.. Ii + i , i HN ��rtav)T0Z C�ER� — — _ i NE �qR ' / � i t"1CrSti'j�•IC\ CLb�Ji":� +�nli�4L~ - I o i Ai i � - • \ Ntw vyR�� i f } ;i x�srl�lc. 0,st wn '{ M To et.Ho.,r-DI MEt. t I C,y1 Z� TaEp Iz.p.p,.v� jai: 4 K• - � j - �.. WA w v✓A� i . s TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 1639 Parcel )D Permit# 6 Zf Health Division I� �©��/ Date Issued dLl © Conservation Division 7i Application Fee �� ` - Tax Collector_ ,pc �. -,�[nu Permit Fee '0 2Z,a Treasurer Planning Dept. EXISTIN�GAPTIC SYS� �7 # Date Definitive Plan Approved by Planning Board LIMITED TO OF BEDROOMS Historic-OKH Preservation/Hyannis Project Street Address l 00' 1 eMA - ,4 97. C —� Village C 0 'i z. • T- Owner fZ 0 3-ems a/k die-e-z5 Address � —A,,j 5T H L*le., ytA— �a4 Telephone ? �I - -I g cl-Z H o i Permit Request i v C it S X X -7--�12 c u^- s w -4-c, icJ S'P Square feet: 1 st floor: existing wj S proposed a 2nd floor: existing 'I zS proposed ® Total new 0 Zoning District Flood Plain r-J0 Groundwater Overlay (Project'VAluation 20 . v'vW' Construction Type kN©06,-,) F.7-A—E_ Lot Size Grandfathered: I Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) r 9 Age of Existing Structure 1 S Historic House: es >(No On Old King's Highway: ❑Yes No Basement Type: ❑Full Crawl ❑Walkout ❑Other afire Co> C7_Lx-� � -- F Basement Finished Area(sq.ft.) b Basement Unfinished Area(sq.ft) tin '3 Number of Baths: Full: existing new I Half: existing 6 new':- Number of Bedrooms: existing 3 new a Total Room Count(not including baths): existing -7 new V First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ;X Other too f4 Z� Central Air: ❑Yes )4 No Fireplaces: Existing ® New ® Existing wood/coal stove: ❑Yes ANo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Cl 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 BUILDER INFORMATION Name 9;F'v r.t o'cn,"'641 i3rti"D s iNV- Telephone Number Soo- 4 r-a -5 Address 76 %VX 46,a License# c;,If-7 GO, CO Tu,e T- / 6 -Z_G S Home Improvement Contractor# 1 r d 0"5 Worker's Compensation# CS(.c,u.6-ossi car-1-1-7-,oS .ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATURE DATE Z�o 16 ro J " - FOR OFFICIAL USE ONLY PERMIT NO. V , DATE ISSUED NIAP/PARCEL NO. ADDRESS VILLAGE OWNER .. DATE OF INSPECTION: ; FOUNDATION FRAME �� INSULATION o _ FIREPLACE ELECTRICAL: ROUGH FINAL v 7 PLUMBING: ROUGH n FINAL, GAS: ROUGH FINAL n .- th FINAL BUILDING � J tU n^ co m rn DATE CLOSED OUT Q ASSOCIATION PLAN NO. c i ,r F'iHE ip�, Town of Barnstable N Regulatory Services Ba2uvSUBr s, � Thomas F.Geiler,Director 4a 1619: ,,�� Building Division Tea MAC Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ' Fax: 508-790-6230 Office: 508-862-40 8 Permit no. Date AFFIDAVIT HOME IIYIPROVEIVIENT 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: rr b ..►4 s M C L v s Z e .4 Ttr ;�(Xv ev-.Estimated Cost 2 0,c/,v a Address of Work: w, ✓I P+ i Co T- Owner's Name: ft,,. `�' w: :.L cr-!LS Date of Application: Z o f o I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law nJob Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PUt,LING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRA A OR GUARANTY FUND UNDERMGL 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 Owner's Name Date Q:fomns:homeaffidav C \ The Commonwealth of Massachusetts — Department of Industrial Accidents 600 Washington Street Boston,Mass. .02111 lb Workers' Co ensation.Insurance Affidavit-General Businesses ' � �';#rr•,�3;k}t"t�+� •.'r:�•.P>i,;'pBz'i'yN• '• '•T�`''-.°q'L:r'�.. '• .. y "• � „J.",.S4ab1 ', name' ry'i�J 7r P1 .wt t t�.�`j'' •• `To"I.a.o. ,2� t a.L C: Y9' address- It(oo city C©'r" t7 state: A--% °I zip: 0-7-•1ta"3_ phone* ' (;.D V—`'-I work site location(full address): ❑ I am.a sole proprietor and have no one )Business T)rpe: ❑Retail❑RestaurantBai•/Eating Establishment working in any capacity. ❑Office❑ Sal'es(including Real Estate,Antos etc.) ❑I am an emplover with em to ees(full&p art time.). ❑Other I am an employer providing workers, compensation for my employees working on this job. _ ,/: '+::Y:,.'-:'•_-::'b �..� .�..IL ice+••. !'�.. •,Lid-1:•�.—�V.�•S�', •v'. '•i; .. :t.%Y'� .:.a ter' .. .,' . :•t.:�• - .. :.,•n address:' '�.•®..'� J'• `frail• '�� '.• :• city) •Ca'a crc::�i;•.r 't^�i.'•� '' .". ' y•�,5 .phone;#:��.' :'�� .�: S:`�`�v.•t"5'^'s:. ''.•�iL`...r:, .F�. :` •;,:�.:�:;.. oli' ••#�' •-�•�,�O�C+I�. '—.C��'i•i'o•t�.._°�:;�:. ^�• .iiisurattce.co ' •�'.�:. �y� ©✓ I am a sole proprietor and have hired the independent contractors listed below who have the following workers' :" .compensation polices: :ASP:.' .4:1• - �; ...... 'Al companV name: address:. Y. �{ city - .4.. , _ �,_•.• insurance •;;�:; . '•.: . companY'ne'nife:- address: •• ,r,�;; . . C. 1.� - J.:y.•.i.,u •C. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$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$100.00 a day against me. I understand that 0 copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains d penalties of perjury that the information provided above is true and correct Signature ' Date Z o 0 Print name rJ .I e-1 Vl/1 Ca tk 1� �I Phone# ✓ru$ -s/ rMOM ofricialuse only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑llealth Department _ • , contact person: - phone#; ❑Other (revised Sept 2003) Information and Instructions Massachusetts General Laws,ch4 pter�152 section 25.requires all employers to provide workers' cornpensatioa 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 enferprise, 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 budding 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 p erformance 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 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 ofIndustrial 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 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 permit/license number.which will be used as a reference number. The.affidavits maybe 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 The Department's address,telephone and fax number: . The Commonwealth Of Massachusetts Department of Industrial Accidents BIWA of Imsfi�tfens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext:406 f • r Town of Barnstable Regulatory Services Thomas F.Geller,Director 9� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 wvvw.town barustable;ma.us 508-862-4038 Fax: 508-790-6230 ' Office: . Property Owner Must Complete and Sign This Section If Using ABunder as Owner of the subject property hereby authorize:' 2�2 Ili!► �" l In e. to act on my behalf; in all matters relative to work authorized by this building permit application for, (Address of Job) Signature of Owner Date Print Name r t M RESIDENTIAL BUILDING PERMIT FEES . APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE O square feet x$96/sq.foot= x.0041= phis from below(if applicable) - ALTERATIONS/RENOVATIONS OF EXISTING SPACE "1® square feet x$64/sq.foot= N �0 x.0041= l -` plus from below(if applicable) GARAGES(attached&detached) square feet x$321sq.ft.= x.0041= 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.0041- 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 1%r• 1'7 Projeast Rev:063004 r t ----- GTE-� �� �✓�a� BAL\V2'©OF BUI�LD;INiG REG;UiLAITsION5 License NSTRUCTION.S.UPERVhSOR l Numbe 047693 BI a 91 1 8 ;X 05 Tr.no: .6998.0 -- Res STEVEN P MOELt /a PO BOX 2,82 COTUIT, MA 02.5 1 Adminisfirator 74e Board ofRuildin a g Regulations and Standards HOME IMpyEMENT CO License or registration valid for individul use only Re ist '�< O NTRACTOR rati�srr: 0485 before the expiration date. 7f found return to:lot Y Board of B /2006 uilding Regulations and Standards 4 One Ashburton Place Rm 1301 GROVER&MC #I Boston,Ma.02108 STEVEN WELH - S 523 MAIN ST COTUIT, e4• . .. MA 02635 .• Administrator --- �e - Not valid without si natu e I J... 1 } - OHS IC NT 3 Y NATO � T : TO gF. 2'c auED''R-ELO—� -Eki S Ye µc, .. K E'�2>o e,.. ME>zoo w. - wnw "!Ew WALE I � c �AT?Iuv tAT�os(S • M CMR App=ft J Table JS.Z-1b(eontinneQ Fuel Prescriptive Packages for One and Two-Fam0y Residential Buildings Hated with Fosu7 MAXIMUM MINIMUM Wall Floor Basement 31ab Heating/Cooling Gig Glaring Ceiling wall perimeter Equipment Wcicncy� Area'(%) U.valucr R-value' R-value' R-vaiu&j R-valud' Rwafu ' Package 5701 to 6500 Hating Degm Drys' Normal Q 12% 0.40 38 13 19 10 6 6 Normal R 12% 0.52 30 19 19 10 6 115-AFUE g 12°/a 0.50 38 13 19 l0 N/A Normal -._... I•- 38 13 25 N/A U 15% 0.46 38 19 19 10 N/A 83 AFUE �1 15% 0.44 38 13 25 N/A 85 AFUE 6 W 15% 0.52 30 19 19 10 Normal N X 18% 0.32 38 13 25 N/A N Normal /A y 18% 0.42 38 19 25 N/A I 90 AFUE Z 18% 0.42 38 13 19 10 6 90 AFM AA 18% 0.50 30 19 19 10 I. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WAL : 3. SQUARE'FOOTAGE OF ALL GLAZIN ' 4. %GLAZING AREA(#3 DIVIDE # 5. SELECT CKA E(Q-- -see ch ove): NOTE: OTHER M INVOLVED METHODS FOR THIS OF DETERMINING ENERGY REQUIREMENTS ARE AILABLE. ASK US TION- BUILDING INSPECTOR APPROVAL: YES: NO: g4orms-080303a 780 CMR Appendix J Footnotes to Table A2.1b: 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 ft of decorative glass may be excluded from a building design with 300 fl 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 iiisvlation may be siibstituted-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. 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-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(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-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 J5.2:1a 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. y 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,of crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43