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HomeMy WebLinkAbout0071 MARINER CIRCLE�� -- - - - i� i �ZHE Town of Barnstable *Permit Building Department e 6 issue doe ee 1 MUMST MA « Brian Florence,CBO 9cbp 039�- ,� Building Commissioner rFD MAt A 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number l � ,c Property Address r 22 ❑Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address rC �' �/ l/ 7-4 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Work Compensation Insurance Check one' ®� §07-V Check � '� " t ❑ I a sole proprietor EB 1 am the Homeowner �l,rr ecJ ❑ I have Worker's Compensation Insurance TOWN O� 6ARIIISfABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) r a e- of(hurricane nailed)(stripping old shingles) All construction debris will be taken to `r•f�C �� 1'Re-roof(hurricane nailed not stripping. Goingover — --existinglayers of roof) ,C_ Re-side ❑,Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. opy of the/Home Improvement Contractors License&Construction Supervisors License is e uired. SIGNATURE:, Q:IWPFILESTORMSTMESS2017 Its the Comuromveakh ofMassadmsetts Department r�,fIndustria!Acdd.=& x - Office a,f 1MVS6gatiew 600 Washbigion Street Boston,Al 02HI ww w masmg rldia '"Tnrkers' CalupensateanInsarau Affidavit Baders/ContracterstEIecb cians/Phmzbers APpHcantInfw=afiuu Please Print Na=tBnsm anfladoal 4�-'` es '�it '' / �ify/5tatxsf v Phone Are you an employer?Checkthe appropriate born: ' Type of project(required)- 1-❑ I art a employer with 4_ ❑I am a general contractor and I 6- ❑New eoastructioa employees(fallamVDrpart-time).* h:avehiredthe sub-contractors 2.❑ I am a sale proprietor arpartuer- ILftd enthe attached sheet, 7. ❑RemodeRing ship and bane no.emplayees These sub-contractars have g-,❑Demolition woti-ing far me in any capacity. employees and have woedters' [No warless' comp.irtazance: comp.iasaranMI 9. ❑BRuildmg addition r 5- ❑ We are a-corporation and its 10.❑Electrical repairs er add>tions 3. ama homeow2w doing all work officers have esescised their I E]Plumbingrepairs or additiems myself o workers' - rigs 12. ]oaf of exemption per MGL repairs i�+ ce[No Y c.132,§1(4k aadwe have no employees-[No wodness' 13_0 Other comp.insurance required-] •Any appfican¢ihat cliedmbaa f1—also flloathe swdanbeTawshov ing dmkwa&eie cmapeasati=yaHcyiafizM6on_ #Homen mers who sabot this iffiidn*iadf[a=J tLzp we doing alf warm and rhea hire oatsde contrsctoismast sabmit anew affida t indiea3iog ssulL fCoauactms Wu box Estattachedsnadm6mal shod shoamgthenameofthemlb-�and stEewhethaor mat 4wseeaddeshsae emphwees.Iftbe m-utnrt actmslme elapIcyeas,diepnmstpmvide their workas'tomg poliy numbm I one an ernpIvy�rr flirt ie protz workers'cotrrperesafirrrt insriranca f nr }*enrpTay�ees $eToev is flte pv cy arrd jab s&e informadam Trtsurance Company Name: 'Policy 4l,'cr Self-its Lic.l FxpirationDate: Job Re Address: city/Statelzip: Attach a copy of the work-ers'comppensationpoTcf-declaration page(shaving the policy number and expiration date). Fadare to secure coverage as raeq*ed under Section 25A of MGL m 15 can lead to the imposition of cuirninai pettald s of a fine up to$1,SQO:OD an for one-year imprisonment,as well as civil, penalties in the form of a STOP WORK ORDER and a time of up to$250-DO a day against the violator. Be advised that a copy of this sta#ement maybe fxvmded to the Office of Irrvestigations ofthe DIA for inswmnce coverag5verff=tim. nla Jeereby car a thepaints andpsnaMej afp&jury dratijTee innforr9ut€mi-prmhW abmw is bare and correct isoahrre_ Date_ Phone ik t),fsfal use anZy. Do nat write in this area,to be evinpTetted by city artenrn ar,cIat City or Town: PermitUcense# B=ng Authority(tacit~one): L Board of Etealth 2.BuRding Dgnr(mcat 3.atyyrown Clerk 4.Electrical Inspector S.Pbrtubing Inspector 6.Other Contact Person: Phone#: — -- -- - 6 Information and Instructions all I 'tn de wO&='compensation fW their employees. M�ccarhuse#fs Ge3reaalLads cTisptz�152 requires employers 1�� p this ,an ezrqrIoyre is defined as.¢_.cmy person in the smvim of another under any contract ofhirr, express or inrpliect Oral or watts.." An MTIvyer is defined as"an individual,partnership,association,corporation or other legal eOy,or any two or more of the fisregoing eagaged jrL a Joint enferpase,and incbdmg the legal represetafives of a.deceased employer,or the receiV=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 thereb,or the oc 4=3t of the - dwallmg house of another who employs persons iD dO maintenance,COIIS'�LQctIOII or repair work on such dwelling house or on the grounds or building app thereto shallnotbecanse of sack employmentbe deemedfn be an employer." MGL chapter 152,§2.5g6)also states that"every state or local Rcen in agency shall withhold the issuance or renewal of a Hceazse or permit to operate a business or to construct bufldmgs is the commonwealth for any applicaatwho has not produced acceptable evidence of cdmpPrance wn t ate:hour- -ovexage rpga red_" Additionally.MGL chapter M,§25C('7)sides"Neither the cammaawvan nor jay ofits political subdivisions shall emotes ink any contract for the perfor mane 0fpublic wor3cm3ml acceptable evidence of compliance7vith the ms m7a nce. rcTli ements of this chapt er.have been presemtf d to the contracting v anthoaty.7 Applicants - Please:fill oil the woijers'compensation a-Efidavit completely;by rheckmg the boxes that apply to your situation and,if necessary,supply� o r(s)narne(s), a ri&-ms(es)and Phone numbers) along with their certificate(s)of fiance. Limited Liability Companies(LLC)or Limited LiabiiityParineasbigs(I LP)widrno employees Other.than the members or partners,are not regoned to carry workers'comzpensa$on insr rice If an LLC or LLP does have employees, apolicyisrequired. Be advised that this affdayitmaybesabmi.tied try theDepartmentofIndu_siiial Accidents for confnaation of bsm�PUce coverage Also be sure to sign and date Jre affidavit The affidavit should be-retcnned to the city or town that the appEcation for the permit or license is being requested,not the Department of Ldnstrial A ccid�+� Should you have any,gne s'tions regarding the law or ifyou.are rcquhed to obtain a vworl=' compensation policy,please c&U the Department at the n=berlL,-sd beIow SeIf-km=d companies should enter their self-ins ra ce license number an.the appropriate line. City or Town Officials t _ Please be sine that the affidavit is complete and pri�.d legibly- The Departrnenthas provided a space at the bottom ofthe affidavit for you to fM out in the event the Of ofIuvesSmoons has to coutactyouregardingthe applicant Please be sure to fill in the permitllicease n-mmber which will be used as a reference number. In addition,an applicant that must submi L multiple p eunit Ucense applications in any 9MM year,need only submit one affidavit indicating cusent p olicy infonmatioa(if necessary)and under`Job Sib--.A ddress"the applicant should write"all locatitins in (city or town):'A copy of the affidavit that has be=officially stamped.or ma=krd.by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fdare permits or I%censm A new affidavitmust be filled out each year.Where a home owner or citizen is obtaining a hcease or peLa not relat e to any business or commercial venture (i-e. a dog license or permit to bum leaves etc_)said person is NOT regaizEd to complete this affidavit Office of In would like to thank you in advance for your cooperation and should you have any qu eshons, The Please do not hesitate to give us a call The Depmtmza_fs address,telephone and fax number: CGMMMwed-ffiE of Massachcusdts - Depadmmt Qfli� AWUaUt% ow wasl i ,L Sty D,14, '27-49W Qxt 4-06 or I-977-I&A SAS Fagg 6I7 727 7M Revised4-244)7 m as5.9PV1dhL 1 V vv u t11 "al uD LaU1c �pFTHE Tpk, Building Department Brian Florence CBO tSUB Building CommissionerRARNM - MASS. 200 Main Street, Hyannis,MA 02601 pTFo ,�a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: n her �Swt � vill p eg ay. "HOMEOWNER": home phone# work phone# CURRENT MAILING ADDRESS: 2 c*/town state zip code The current exemption for"homeowners"was extended to include owner-occnpied.dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building hermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility.for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection.proc dures and requirements and that he/she will comply with said procedures and requirem Signature o omeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0.Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for.which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. °FIMHE ram, Town of Barnstable ti * °* Building Department '"M„��� Brian Florence,CBO Ec ��� Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must C_ omplete and Sign This.Section If Using,A Builder as Owner of the ro subject l property hereby authorize to act on my behalf, in all matters relative to work authorized by'trhis b ding permit application for: /' ed ob)� **Pool fences an onsi ili of the applicant. Pools P `` tY PP are not to be fire fence is installed.and all final inspections arepted. - Signature of Owner -- - -Signature of A licant - Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS Rev:10/17 L-VL- F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map. cD_3 Parcel Application # Health Division Date Issued l Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address 2 l NAE4&A-- zf f W/ Village. 1`- Owner —Address Telephone _ r Permit Request ` Square feet: 1 st floor: existing proposed _2nd floor: existing proposed Total new Zoning District Flood Plain / Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 011' Two Family ❑ Multi-Family (# units) Age of Existing Struct e Historic House: ❑Yes V o On Old King's Highway: ❑Yes ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: exiling new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Co.^unt ' Heat Type and Fuel: Zo ❑ Oil ❑ Electric ❑ Otherr, � Central Air: ❑Yes Fireplaces: Existing �r p g New Existing wood/coal stove: O�Yes ❑ No Detached garage:ZWisting ❑ new size_Pool: ❑ existing ❑ new size Barn: 0 existing.o❑ newsize_C3a Attached garage: ting ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name , �,//////�—� '�� Telephone Number ?t—�®(� Address /°"�D ; / 2 � License # 04 Home Improvement Contractor# 1 ` � Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FR M THIS PROJECT WILL BE TAKEN TO C J SIGNATURE DATE '— ✓ FOR OFFICIAL USE ONLY A�PLICATION# k �N ` DATE ISSUED c MAP/PARCEL NO. ,l ADDRESS VILLAGE OWNER DATE OF INSPECTION: - FOUNDATION (3)36-ju a k shy I FRAME INSULATION lna4 Gjcos�o•-s y FIREPLACE Pi ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t' GAS: ROUGH FINAL I� FINAL BUILDING F h F ti DATE CLOSED OUT P r k ASSOCIATION PLAN NO. 4t F F The Commonwealth of Massachusetts Department of Industrial Accident Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contracturs/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organiza onandividual): '220"A IZ�n, �'�� Address: /-�r (// �/r V Y City/State/Zip: L;�Lblffhone#: � Are yo an employer?Check the appropriate bog: Type of project(required): 4. I am a general contractor and I 1. am a employer with_� ❑ g � 6. El New"construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity, employees and have workers' incinsurance.: 9. ding addition comp. [No workers' 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.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13 ❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then 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-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy and job site information. - Insurance Company Name: ���� � l Policy#or Self-ins.Lic. Expiration Date: Job Site Address: City/State/Zip. . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year hnprisomnent;'as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce under t and enatties ofperjury that the in provided above is true and correct Signature: Date: Phone#: &1,161� 4iz Official use only. Do not write in,this area,to he 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.EIectrical Inspector 5.Plumbing Inspector: 6.Other Contact Person:. Phone#: TRAVELERS WORKEN S COMPENSATION xs AND EMPLOYERS LIABILITY POLICY TYPE.AR ANFORMATION P 4GE WC 00 00 01 ( A) POLICY NUMBER: (CHUB-4861 F48-8-13) RENEWAL OF (GKUB-4861 P�143-8-12) INSURER: THE TRAVELERS INDEMNITY COMPANY,,OF AME:RICA $ NCCI (:0 CODE: 13439 INSURED: PRODUCER: DANFORTH, JAMES DBA PAUL PETERS AGENCY INC JAMES DANFORTH REMODELING 680 FALMOUTH ROAD PO BOX 973 MASHPEE MA 02649 .. COTUIT MA 02635 Insured is AN INDIVIDUAL Other work places and identification numbers are shown in the schedule(s) attached. 2. The policy period is from 09-29-13 to 09-29-14 12:01 A.M. at the insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE--;Part One,of the policy applies to tre Workers Compensation Law of the state(s),listed here' MA fi B. EMPLOYERS LIABILITY INSURANCE:, Part Two of the policy applies to work it Each state listed in item 3.A. The limits of our liability under Part Two.are: Bodily Injury by Accident: $ 100000. Each Accident Bodily Injury by Disease.: $ 500000 Policy Limit Bodily Injury by Disease:. $ 100000 Each Employee C. OTHER STATES INSURANCE: Part Three of the policy applies to he states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC. 20 03 06A D. This policy includes these endorsements and schedules: 0 SEE LISTING OF ENDORSEMENTS --. EXTENSION OF INFO PAGE 4. The premium for this policy will be determined by our Manuals of Fules, Classificatiors, Rates and Rating Plans. All required information is subject to verification and change by audit to be mz cde ANNUALLY. DATE OF ISSUE: o9-13-13 WC ST ASSIGN: MA OFFICE: ORLANDO INDUS AFF 161 PRODUCER: PAUL PETERS. AGENCY INC 28LBR. 002270 T i a �'ME T Town of Barnstable • • a Regulatory Services * g Richard V.Scali,Interim Director 1639. �9 fay► 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 -go^v'®r ,as Owner of the ro subject l property • hereby authorize Py, , % _5 AjQ to act on mp behalf, in all matters relative to work authorized by this building permit Mcif;ne r c-ir Cott.& )rll' W-63S� (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. IV4 Signat4te of Owner Suture of Applicant Print Nade Print N e Date Town of Barnstable : -. Regulatory Services - OpTHE rod Richard V.Scali,Interim Director °-� Building Division peR,,�►Rrs, $ Tom Perry,Building Commissioner - 200 Main Street, Hyannis,MA 02601 'DrEn�u� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6250 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB.LOCATION: number street village "HOMEOWNER': name home phone# work phone# CURRENT MAILING ADDRESS: cityAown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached jr detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form ' acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Appi-oval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any.homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1091.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities'of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,.particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that be/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFII.ES\FOR.MS\buildmg permit for=VDMRESS.doc 1 .�� 'o UOIJLl97,(y Q,� ©Tftcc. f�onsurzz ! AFL ors �as �azttaU�� � 7 � x �. s „° v�aSSf4Y;i1lTSet$i eSartrTlErlt tli Public 3etT2t i � wor,rr fltfiFRCV�i�'ENYCONTRAT-1030 0_ Re r�tratocn `Board of Building Regulations as.ti Starsdards _ r�1 a1 Type 'Constru .tion Super,asa r Cxplri on l e2 i1 3 lag Ear ' =r License: CS U08267 c— ,t' �`Yv 3 :g JAMES D DANFORTH PO;BOX 973' N ? a Y Y COT;IJIT MA 02&3i, s ° - S 1 C5�tU?OST r2� t r ;' g. 4 � d -C17 r Jl'r.'1A 02635 c •-----r' l �d .tt ' e;s � J �� ExufraVor _T Cnmm.sstasa 05/20/2014 r s , , �.._... - —r'"`---•--- 'M a� 3'M.�,,++x wi ..t,...+amr �w«'+f .. sCw+r7. .ur ..3: 'K1s".au3-''+ - H? " x 771rs ceeate Is Presented to X �A �s e-r .�p, (�w,'*fi s'? x 't}, -k.;a. r s Asa s� ;## t fix{�rL4i aft@ti e g �T� l eattt> � nsstna '�ar�Cofpietrgn}df FXC6let?C2rliTafety'S �,b` .. , , t - FA L PI OTECTION TRAINING COURS€v *� 'Ar W„Va i'es2CDaz���r��t ejttl,iat sheptey�,l�Vooi I Products,`HyanntG A �y>}ti ���� r���°�<,r� +� �Y n 1 =�� � z 4 x - �+Y 7 e �csf#{rrspetdafieck cu#Saci raie rare P4ealt . � f"1J0�v y.c.a „V Ey +" t R � 'P S �'z.. �'�a'�..�+s'�t,`�t�• *,✓t1rl.�rfi ts�iUF�c�1't. ff�.<r'sf'ff1 k-.`°9^i � x; S w . Nnvemher.5 2008 ;. 3 rt w xk f ca ,1#Tralmng`Date Office of Consumer Affairs & Business Regulation Mass.Gov Page 1 of 1 The Official Website of the Office of Consumer Affairs&Business Regulation(OCABR) = Consumer Affairs and Business Regulation Home Consumer Rights and Resources Home Improvement Contracting Home Improvement Contractor Registration Lookup You can search/filter the registration list by any of the criteria below. Search by Registration Number 114813 _�lSearch Search by Registrant Name Search by City Zip Code { Search Registrants Click on the registration number to view complaint history. You can also view arbitration and Guaranty Fund history. The list is current as of Monday, April 7, 2014. Search Results REGISTRANT RESPONSIBLE REGISTRATION EXPIRATION NAME INDIVIDUAL NUMBER ADDRESS �DATE STATUS JAMES D DANFORTH N/A 114813 P.O. BOX 973 10/27/2015 Current REMOD COTUIT, MA 02635 http,:Hservices.oca.state.ma.us/hic/licenseelist.aspx 4/8/2014 THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) Im ^ACC DATA : r / l No «d -oo I.W 00 0 L 0- p oML uW PLAN SHOWING z;}i� 'QU-NDATIQN LOCATIO. W N- w O TUI T MASSACHU, ETS N OWNED BY.: a w � w z z -DATE Gtl- „ _. Z.v. . . SCALE= a¢tu N'OhtMAN GROSSMAN---- REGISTERED LANfl"SURVEYOR I HtRJEBY GERTIFY THAT• THIS FOUNDATION IS LOCATED yeµ IF t}IV`7tNE`LOT 'AS SHOWN.AND CONFORMS TO THE TOWN NQtih1AM �' OF BARNSTABLE ZONING REGULATIONS REGARDING GROSSMAN SETBACKS FROM 5TRLTE-7 LINES AND LOT LINES . i2r7s Mt9R161AN GIiUSSAi t1t R.L.S.' DATE , � a mse To w-TCH109 e FA ® o .m TW2ii40 +I DN FeW—w^LLs Prcx I �u SHOWN H^'rO-rP. Ko. ELEVATION SCALE 1/4' = T-C' U < L rx,vogcser+rWr — — — — — — — — — — — — — — NeW K,TCfi£,1 CXfet1610h,— I , — II _PITS I I 0V F=10Vr-SrOTIC"ar WALL —LPL BEA�1— I _ EXiST1HG KITCHEN 3 - — .. — — — BELOW W � , 'U I ' X 48° I I FRAME NEW GABLE 24 lag 24 AND i i W I I ROOF OVER EXISTING PITCHED ROOF 17'-0" t I I I � I � 0ILI � II LL — — — — — — — — — — — — — — — — FLOOR PLAN SCALE 1/4' = 1'-01 - ROOF PLAN SCALE 114• T-o• IE- 4'X 4'P0.4TS ON 2 X 8 NEW ROOF _ r 42.O coNc.Plf---Rs RAFTERS (TYP) --- ...�' -- ----- '1 9 413/4" X 9 1/4' LVL 2 X 8 NEW ROOF RAFTERS AQ g f2 ®Ea ® cs • o x o HANGERS EXISTINR o I I ROOF IE 8 0 . A 9 u CLG. FRAMING CUP /' 2 X 4 NEW BEAM x x — _ I I CORNP:,Y' CEILING JOISTS ' i v S9 F3 ' 1 1 L J2X10 L — r—i EXISTING DECK FRAMING PLAN WALL TO 3 - 4 3/4• X 9 1/4' LVL REMOVE 5 of CT r415FW PCG VCL K LC AT 6'D0..OW r#19HtP K1Ta O-m rLOR •® II 11 1 8 68J 1 FIX FR • � r- �to DECKXrixrr+on In�*� DETAILS 1 AND 2 O rvre5rev rLoaR SCALE_ 1 1/2' - 1'-0' p 7 C O b 2X I 4 2x40pea� l — 2 r 6 coLLnrzs ITYrI 0'X 4V DL40M MR-1 7•-9vr 7•-gvr i r _ � czr-rxtT — — —__-4 — — — — QQ -, oN r � TO r -1 To r -t DO j — d @ d cork.rrc�s. i 3 6 fflPl ^HCHOR WEE CCAM TO w . r z I'Tl1'1 �, FES r A :IN WnLL 1 2 X 40 rRC55QM TRCnTrP LCPCM r¢'dSH MOOR eLevnnoN TM coL7tP To exfFimcs nn6OYKY '�I rn, fq IS) Q1. To nnra-1 exlsrrk3 rOUNPAT10N WALL ` '� �`"�' FRAME NEW GABLE KrTcreH rLooR euvAnat stnL.DOrrOn ar JOl6T A55ereLY WITH caMG �r ITYPI ROOF OVER EXISTING PWOCK OR OTHM nGCCPT NDLC CM-MI-IT DP. SLOPED ROOF LAY V MMOLAS PI5M-nTION DCTW=H JOf6Ts. DETAIL 3 FLOOR FRAMING PLAN ROOF FRAMING PLAN [ 4 SCALE 1/4' T-O' SCALE 1 4/2' = 1'-0' SCALE 1/4° = 1'-O' AGRA ' WOIA:OF BARNSTABLE BUILDING PERMIT APPLICATION Map_d6S"f2 Parcel (J Application# �� C Nw Health Division x Conservation Division Permit# Tax Collector Date Issued. Treasurer t" Application Fee r- Planning Dept. Permit Fee n .11? c_:AbS� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis ' Project Street Address //__1 � //l/,� Village _ loTa%T a Owner Address _ �zz ZaAe/,� Telephone Permit Request_� ,( ,�� �0ODA1,4' do T� Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new_ Zoning District Flood Plain Groundwater Overlay Project Valuation_SO, 0 Construction Type VOOO Lot Size 90,0(1 o hoFf Grandfathered: ❑Yes ❑ No If yes,attach supporting documentation. Dwelling Type: Single Family / Two Family ❑ Multi-Family(#uni ts) Age of Existing Structure Historic House: ❑Yes VK On Old King's Highway: ❑Yes Plo Basement Type: PIF/UII ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �lA Number of Baths: Full:existing new f Half:existing / new 0 _ -lumber of Bedrooms: existing 3 new Total Room Count(not including baths):existing new First Floor Room Count—� Heat Type and Fuel: V/a s ❑Oil ❑Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing �_ New _ Existing wood/coal stove: ❑Yes al o 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 AppealYNo thorization ❑ Appeal# Recorded❑ Commercial ❑Yes If yes,site plan review# Current Use A ��,�&&S.A",( Proposed Use o7 Q LDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# �( Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO E I SIGNATURE DATE 9 N? FOR OFFICIAL USE ONLY ~ T , PERMIT NO. DATE ISSUED MAP/PARCEL NO. : ADDRESS VILLAGE OWNER i DATE OF INSPECTION: 7 FOUNDATION 9q Z Lo FOX s { FRAME �fRrh OK 9�/oJo� xpyccK Pe INSULATION /N� ®K 9/�o/pr7 FIREPLACE s ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 's GAS: ROUGH FINAL FINAL BUILDING49= i DATE CLOSED OUT ASSOCIATION PLAN NO. 'j i La The Commonwealth ofMassachusetts Department oflndustriaZAccidents , Office of Investigations 600,Washington Street ,.- Boston,MA 02111 r V-POw.mass.gov/dia ' Workers}Compensation Insurance Affidavit Builders/Contractors/Electricians/Plumbers' Applicant Information Please Print Le ' 1 Name(Business/Organization/Individual):_ LrC '` •Address: . City/State/Zip: oX �Phone.#: (J�- �� Are you an employerTCheckthe appropriate box. 1,❑ I am a employer with 4. ❑ I am a general contractor and I :Type of project(required)'- employees(full and/or part-time),* . .have hired the stab-contractors 6, ❑New construction . 2.❑ I aan a bold.p=oprietor or' 1is�ec�on the•attached sheet 7. ❑Remodeling ship.and have no employees These sub-contractors have g, ❑Demolition:. 'avorking for me in any capacity, employees and have workers' [No workers' comp.insi3imce comp, insurance t' 9. ❑Building addition �quued.] S,c ❑ We area corporation and its 10.Mtlectrical repairs of additions 3_.IV anre homeowner,doing-ill:work - '----officers-have exercised their , myself.[No workers'comb, right 6f exemption per MGL 1LEI Plumbing repairs or additions ins,3 ce.required]t . c. 152, §1(4),and we have no 12,❑Roof repairs employees, [No workers' ..13.11 Other ' comp,insurance required,] *Any applicant that checks box#1 must also fill Out the section below showing their workers'compensation policy information. t fiomeowners,wbo submit this affidavit indicating they are doing all work and then hire outside contraction must submit a new affidavit indicating such, employees, ae s, that check this box must attached an additional sheet showing the name of the sub-contractors and state whether arnot those entities have employees, If the sub-contractors have employees,they must providb their workers'comp,polio number. lam an employer•that isproyiding workers'compensation insurance for my employees. Below is.thepolicy and job site,"information. Insurance Cornpany Name: Policy#or Self-ins.Lic,#: Expiration Date: Job Site Address: City/State/Zip; Attach a copy of the workers' cgmpensation policy declaration page'(showing the policy number and expiration date); Failure,to secure coverage as required under Section 25A.ofMGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK,ORDER and a fine of to$250.00 a day against the violator, Be advised that a'Copy of this statement may be forwarded to the-Office of Investigations of the MA for insure ce coverage verification. ' I do hereby certify deth ins np alies ofperjury that th information provided above 's true any correct. Si afore: VMW Date;'" Phone#; Official use only. Do not write in this area,fa be completed by,city or town official City or Town:' Termit/License# . Issuing Authority(circle one) 1,Board of Health 2,Building Department 3., City/Town Clerk 4,Electrical Inspector 5, Plumb 6.Other ing Inspector j Contact Person: Phone#: Massachusetts General'Laws chapter 152 requires all employers to provide workers' compensation for thou 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 trusteo-of an individual,partnership,association or other legal entity,employing eirployees, 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 dee;.ed to be an employer." MGL 152� §25C 6 chapter also states that"every state or local licensing agency shall withhold the issuance or P O c ' for ally renewal of a license or permit to'operate a business or to constru t buildings g in the commonwealth f applicant who has not produced-acceptable evidence of compliance with the insurance coverage required,". Additionally,MGL ohapter..152,§25C(7)states"Nejthei the commonwealth nor any of its political subdivisions shall enter into any contract for,tht performance of public work until acceptable evidenee•af•compliarsce 7ithtlie 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,it necessary,supply sub-conti:actor(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. Bq 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 nuuZ.ber listed below. Self-insured companies should enter their self-insurance license number onthe,appropriate'line. City or Towrl 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 refererice number. In addition,as applicant a lications in an given ear,need only submit ono affidavit indicating current that roaisfi submit multiple permit/licensePP Y Ln Y Y ci ' •or applicant should rite all�loca ions in ( t5` policy information ifnecessar and under Sob Site Address the ppll t uI w h �_ P Y ( Y) town)."A copy of the aff.davit that.has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit mustbe flied out each year.Where a homeowner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a d u clog license or permit to bm 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 youhave-Anil questions, please'do not hesitate to give us a call. The Department's address,telephone-and fax number:; The CommopwW ofMa eh. ids Dtpartmant ofMustdal A.eei nts ' 4 .co of flavestuols ' • ' �k�4� Stet ' ton,11A 02111 TO. 617-727 000 ext 406 ar. 1-877 iriASSAIFE Revised 11-22-06. Fax 4 61 7-77.0 www.mamg6v/die /TME 1VYr11 V1 LCLAA 0LL1LFA%i Regulatory Services Thomas F,Geiler,Director WAss. 9�''°rec► �'�� Building Division Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.town.,barnstable.ma.us Face: 508-862-4039 Fax: 508-190-6230 Permit no. Date AFFIDAVIT HOME DIPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c, I42A 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 f ��J� • Estimated Cost ® CD Address of Work:. "/ 0- ner's Name: Date of Application: _ bl /v 21"� 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: OVNERS 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 UNDERMGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for permit as the agent of the owner: Date Contractor Signature. RegistrationNo. • D 0 er's ign e ; Q,vpfnes,f0=-,homeafFiday Rev 060606 Table J=b(eontlnued) Prescriptive Packages for One and Two-Family Residential Baildlap"Heated with Fossil Fuels MAXfMUM MINIMUM blaring Glaring Ceiling Wall Floor Basrmeat Slab lleating/Cooling Ar ('/a) U-value= R-value, R-value' R-YRfue' Wall Perimeter Equipment Efficienc? Package R-value° R-valuer 5701 to 6500 Heating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 1D • 6 85-1fUE T 15%. 036 38 13 25 N/A N/A Normal U 13% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A N/A 85 AFUE W IS% 0.52 30 19 19 10 6 .85 AFUE x 18% 032 .38 13 23 N/A N/A Normal Y 18% 0.42 38 19 25 1 N/A N/A' Normal Z 18%. 0.42 38 13 19 1 10 6 90 AFUE AA I8% 0.50 1 30 19 19 10 6 90 AFUE ' 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 7 3. SQUARE FOOTAGE OF ALL GLAZING: � 4. %GLAZING AREA(#3 DIVIDED BY#2): 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-080303a 780 CMR Appendix J Footnotes to Fable 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-vaIue requirement. For example,3 ftZ of decorative glass may be excluded from a building design with 3.00 W of glazing area. 1 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRQ test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. 3 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 R49 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 ponion 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 requirzments apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. I 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 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 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: -v iues are maximum acceptable levels.Insulation R values are minimum acceptable levels. 'lazing areas and U a ep a) G1 g R value re quirements uirements are for insulation only and do not include structural components. onents. b)Opaque doors in the building envelope must have a U-vaIue no greater than 0,35.Door U-values must be tested dance with the NFRC test procedure or taken from the door.0 value. manufacturer actor P documented b them , and docum y aggregate ate U-value rating for that door is not available, include the in Table J1.5.3b. If a door contains glass and an ggr g g 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 thk 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 FTHE Tp� Town of Barnstable Regulatory Services EARNSrAaLE Thomas F.Geller,Director MASS. 4,,, i639• Building Division rFD �s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstible.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION / Please Print DATE:JOB LOCATION: number stree village "HOMEOWNER!': n home one� � work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the-owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. 11 Barustabi ——-Eque pec on p edures andrequirements and that he/she will comply with said procedures and e Signa a omeowner Appro al of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . 4 HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1.Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns, You may care t amend and adopt such a form/certification for use in your community. a Q:forms:homeexempt e7 10ti 1Goau w .. _ R -4o4� i a Za' a . 4 16o -Qd ' Zw IL w phUW 11 Qr W PLAN . SHOWING dQ ' Iwozw>� �'�UNDA �"tUIV LOCATION COL. G CJT U T, MASSACHNSE ' 7' OVYNE.D BY: x.tL d SCALE /. it � 434 ' DATE Alap-• /'v A90 aQ LL NOPMAN GROSSMAN-----`- REGISTERED LAND SURVEYOR I HOEBY CERTIFY THAT THIS 'FOUNDATION IS LOCATED .� ��� �f FA ON14Wr, LOT AS .SWWAI AND CONFORMS TO THE TOWN 0 .,OF B;ARNSTABL-E ZONING REGULATIONS REGARDING AR GROZMAN coo FROM STREET LINES AND LOT LINES NORMAN GROSSIWAIV R.L.S. DATE TO OF .` STABLE LOCATION SEWAGE # VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME&PHONE NO. SEPTIC TANK CAPACITY LEACHING FACILITY: (type) � jSt (size) A*70 > NO.OF BEDROOMS r L BUII.DER OR OWNER 'mil DAAl •d,5 PERMTTDATE: COMPLIANCE DATE: Separation Distance Between the: Maximum Adjusted Groundwater Table and Bottom of Leaching Facility Feet Private Water Supply Well and Leaching Facility (If any wells exist on site or within 200 feet of.leaching facility) Feet Edge of Wetland and Leaching Facility.(If any wetlands exist, within 300 fel of I `"c ' facility Feet Furnished by,-4r ,M x , a p z .. .a;`�'F�+�', �... `' A;E,"'"'rJ''c'`e�i`+�.''�'r, ax;i�r•; d ti-r35'-" #. � ;!�`..'".� '•�"�,�S�+s�`:�'' " �,,;:.a• •?'Y>r' �; t" P�!°h [� °t�F,�h•.*�,_..:,e...+" _ ��..' �i ry`�`d'��N .� ',„Jk�x a -.rw rr r +,•K..�y�:#`o ,�' `OpfHE'°ti Town of Barnstable RARNSTARLE. : Regulatory Services 7 MASS. _,b,q• Building Division prEDMP�>, . 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice c ® i Type of Inspection Location 162 Permit Number -` Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: � s i � aP T/R r, (2)4 U ( f( ,�� c 19E x)F- '7-.E?14-7'l O'U S 6/ T 11 16,3 r7� A l3'-Ce-ig _ c i 4 W/I( Ai I'?,-A, -,tisa&-, -r ra4g! Please call: 508-862-40M ff76etL Inspected by e Date a�c� �•;"p TOWN OF BARNSTABLE Permit No. -------._----------- Building Inspector cash OCCUPANCY PERMIT Bond ----_------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................................................._, 19___ ................................._.......... _..............:. . _...m ._...�. .. .�._._ Building Inspector -rYfdp and ........... lot num . ..............AssesiWs e %THE SEPTIC SYSTEM MUST Sewage Permit number ....... .... .......................... INSTALLED IN COMPUAN WITH TITLE.5 MARNST LE, House number ......................V ' MAS& .................. ENVIRONMENTAL CODE t639. qn!A ION TOWN OF BARNSTV ' ' ATT BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... R(41- ............. ............................................................................................ TYPE OF CONSTRUCTION ..... .................................................. ....... .. ..............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................................4:........... ...... ................................................................................ ProposedUse ....... ................. ..­..........................................................................................................I.....I......................... Zoning District Fire District/- . ......4A ............................ ....... Name of Owner ........... .............Address ................. ............. ........ aw/" Nameof Builder .. .....................................Address ...................................................................................... Nameof Architect ...................................................................Address .................................................................................... Number of Rooms ........................................Foundation 445%.4t,................................. Exterior .............. .. ...... ............................... .......�.... .... .......... ......Roofing ....... .................... Y.... Floors ���.��,��......................................Interior .... ... 167, Heating ...... ..... ...........................Plumbing ...... .. .......................................... Fireplace .............. Approximate Cost. ........ Definitive Plan Approved by. Planning Board ---J�`_2 ---------19-7 Area P.7Y-0 s................. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH /y I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... .. CEDAR,.ACRES REALTY TRUST No 2 27 54„ Permit for ...01Xe...Stary.......... 5iri le...Fa il. Awellin k, cation .Lot...#.4.0...7.l..Mar.iner...Circle Owner ....Cedar...Acres...Realty...Txu.st + Type of Construction Fr.ame............................ / ^ .. ..........:.............................. ....................... ...... Plot .. .. Lot ......................... ,f ; i r i Permit Granted .....veCembe.: ...1.2......19 80 _ Date of Inspection ....................................19 Date Completed .......................................19 r PERMIT REFUSED cr CZ !=-A ................................... co,,..Q .. ......................................... ............ ` .... W. .................................................. m g ,-y Approved ........................ ........................ 19 ,. .................................................. . ..... f . Y Assessor's map and lot number:. �: .. � � ' .......... .. .............. .�C� THE TOE♦ ' Sewage Permit number .... .... ................................. 6�P Z BAHBSTADLE, i House number ....................... 1............................................ r000,Mb 9 0� RFD N a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO . f tom. .fJt ............................:.......................f................,.�................................................ TYPE OF CONSTRUCTION .... ......../ ! : f ..�: ................................................ ............11� �'::"��.................19A TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .................................................................................... ........... ......................................................................... ProposedUse .../ f.......................................................................................................................................... Zoning District ............................r' .........Fire District �. ' f� fr.....fj................... ..... ............................................................. Name of Owner ..� .! `x r:.:'.! fl : ..'( � .T..:...( ...............Address .............. ...... ...................... G tlGt'i� Name of Builder :: .......................Address .................................................................................... l Nameof Architect ...................................................................Address .................................................................................... Number of Rooms (i? Foundation .f.l!;f� {� �4, .............. .................................................. ,f v ...................Roofing . ..� Exlerior .... ................................... FloorsG.r. -r. ........ ...........................lntenor .... ....,................ ................................................... Heating � t4 J .Plumbing ............!:. ..... .� -... f............................. ........................................ Fireplace ................ ............. .............................................Approximate Cost ........,.: j... -L�^�') ...................................... Definitive Plan Approved by Planning Board 4-A l 19 z . Area -.... .`'�. ' F f Diagram of Lot and Building with Dimensions Fee .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH h zd i Z { { zy �. I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name : ' .... .......r?..............%`:�...��'9.�..%....... r, . ' . . . C BES REALTl! `TDD No -2.2I5.4.. Permit for ..Q.aP-...5.tQ.KY.......... ......S ' le...F-aouiIy..I�uoeII' ----- Locodon .Lot...#4O....7I..Mar.i��e��..Cir.ole '.........'-'—C�tg�t----'---~_.______ * Owner ....Ceda��..Aore�;..Be�lty...Tlrost Type of Construction Frame�-,)..................~~_ � . _ .. . . --. .. � � 80 Permit Granted uec ..}A Dote of Inspection -- —.lg Dote Completed --.. —]9 � � PERMIT REFUSED � -----.--.--.----------.. lV ^ '^' ' ^^^'----' ' ^~^'—'—^ -------'---''�—. '*m........................ � ..................— ................K...................................... - IGa•aa 1 1} 340 o 00 7- � "W a �a � t ILWa "T L 1011 J�l� t-U. - ,U �. ,.PLAN SHOWING r q�QQ `r �.. W C/J W. - Z;}J.. 4 FOUNDATION LOCATION i� � �, } COTUIT, MASSACHUSE T T S as N, OWNED 8 Y' �� r �* '' .,� '{ Z� t;zUW a SCALE / '� a DATE: JI/4ti• /X Vic) NORA/AlY GROSSMAN----- - REGISTERED LAND SURVEYOR I HtR€BY CERTIFY THAT THIS FOUNDATION IS LOCATED .� ��H OF ON TINE LOT AS SHOWN.ANO CONFORMS TO THE TOWN o OF $ARNSTA8LE ZONING REGULATIONS REGARDING 'Y(7Rh1A GftJSS"AiN N SETBACKS FROM STREET LINES AND LOT LINES : n0RMAN GRDSSMAN. . R:L. S. DATE p Oww ZQ W z ��W o u 3 a a 4110 o --u W A d SF 0 W z t W E�w =W W 1 ce W a o ►-cr L L] r-Ww Wcow a W ca !1 Q w c¢¢� cn�� C) o Lu a. n W ooZ a ti 3F0 L m cz)p wopa W U I C4 ct ¢_¢ c 1— owe ti 2 -'w0 0 t x � W0 wws►_ Q 0 lU F—►-- y m f�. 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