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0171 MARINER CIRCLE
�pp tHE rp,` Town of Barnstable RA"STASM MAf& P 200 Main Street,Hyannis,MA Tel.(508)862-4644 r e Eb MP'� INSPECTION REPORT Y Permit: Building - Insulation - Residential Use: Date: 12/3012019 1:49-PM Inspector : barrowsd Permit Number: TBA 9-4262 Name: SUYER, ALEX TR Address: 171 MARINER CIRCLE, COTUIT Unit No. Inspection Type Inspection Item Status Comment Building Admin - BA - Property Owner NIC owner is authorizing Housing Asst. Corp Solar& Insulation Authorization, if Builder is Applicant Inspection Overall Comment: Overall Inspection Status: FAILED Re-Inspection Date: a Inspector Signature Owner Signature Total Score: 100 Town of Barnstable REE�=P AaKASS 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit tam *.,. R z 0: Application No: TB-19-4262 Date Recieved: 12/30/2019 =' w '�*+ o - Job Location: 171 MARINER CIRCLE,COTUIT Permit For: Building-Insulation - Residential Contractor's Name: CAPE COD INSULATION INC State Lic. No: 153567 Address: 18 REARDON CIRCLE SO. YARMOUTH`MA Applicant Phone: (508) 775-1214 02664, (Home)Owner's Name: SUYER, ALEX•TR Phone: (774)253-0120 (Home)Owner's Address: 171 MARINER CIRCLE, COTUIT,MA 02635 Work Description: Insulation/Weatherization Total Value Of Work To Be Performed: $2,600.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area I T ereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she'engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). 1 understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner,of the-property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. ' All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Henry Cassidy ` . . 12/30/2019 (508)775-1214 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees Total Project Cost : $2,600.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 _ 12/30/2019 M$35.00 XXXX-7i✓C}D{X)M V Credit Card ! 2286 Total Permit Fee Paid: $85.00 12/30/2019 I $5000 'XXXX-)OM- -I _. Credit Card 2286 ee It IS'ISsNOT AaPERMIT f Efficient Buildings, LLC October 31, 2011 Town of Barnstable Attn: Thomas Perry, CBO 200 Main Street Hyannis, MA 02601 re: 171 Mariner Circle, Cotuit, MA 02635 Dear Mr. Perry: - This affidavit is to certify that all work completed at.171 Mariner Circle, Cotuit, MA 02635, has been inspected by a certified Building Performance Institute (BPI) inspector. Work included installation of 42 sq. ft. of 6.25" Fiberglass batting on attic floor, 480 sq. ft. of 4" cellulose and 1012 sq. ft. of 7" cellulose in attic. All work performed meets or exceeds Federal and State requirements. Sincerely, Steve C. White Owner/Managing Member Efficient Buildings, LLC 8 Jan Sebastian Drive, Unit 10, Sandwich, MA 02563 Tel: 508-888-1110 Fax: 508-888-1109 } Town of Barnstable Bu nildi : < g t This Card So That rt iS Y�s�k�leFrom the,5treet Approved Plans:Must be=Retained on;Job and,th�s Card Must be Kept *: tAE`A1t3TA.Y1.L ',:_.. r:<: `�,.' ' .< � +,•.< `. .... .�:r< i' v £ \z '\° <. "i 2 3 ,x ti '`� . M Posted�Unti1 Final'Inspection Has iBeenMade - < ._. R. ., . . Permit -: Where a Cewrtificate�of,.Occu anc pis Re ,uiretl such.B ild�n ,sFtall Not be�Occu ietl:until a�Final Ins ect�on�has been made � '- >,�... ....; i:. aaS�� �.�.4 «" p��:.&. Y .<.�.. �;w ..•, ,r: ..: �":. '.ss,a..���::, ,.. a - a�" k::•.a•°�"•.. .az�<_.,.�..�p�'::.�.��._.�,.:;.a�s.�...�a:;�.. •�:. .t Permit NO. B-16-3120 Applicant Name: BALTIC COMPANY Approvals Date Issued: 10/21/2016 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 04/21/2017 Foundation: Location: 171 MARINER CIRCLE,COTUIT Map/Lot 024-141 Zoning District: RF Sheathing: Owner on Record: SUYER,ALEX TR Colitactor Name BALTIC COMPANY Framing: 1 IMF "®r Address: 142 OLEAN STContractor License 152372 2 WORCESTER,MA 01602 ~. .. •,,; , Est Peoiect Cost: $10,000.00 Chimney: Description: reroof I Permit Fee: $51.00 Insulation: Project Review Req: reroof Fee Paid $51.00 Final: At 10/21/2016 R WE 4 Plumbing/Gas g Rough Plumbing: Building Official final Plumbing: ,- g: This permit shall be deemed abandoned and invalid unless the work airthorrzed by th s permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents<for which#his permit has been granted. All construction,alterations and changes of use of any building and structures shall be incompliance with the local zoning by laws'and codes. Final Gas: This permit shall be displayed in a location clearly visible from.access street or,roadlhcl shall be maintained open for public mspectio for the entire duration of the work until the completion ofthe same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures bythe Building and Fi e�O�fficials are provided on th'ispermit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing Rough: 2.Sheathing Inspection ection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final' All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT O to-91 ��, Town of BarpstFab. e �. *Permit is I'll Tres 6 months from issue date Regulatory Services 00 0' goI * RARMAASS. Richard V.Scali,Director OCT 21 2016 I• b • � z639. ♦� , e 'Building DiVis oIN OF pp Paul Roma,Building Commissionerry �� FABLE 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 Property Address Residential Value of Work$ OOcO Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contractor's Name L/ M Ot& V/�-S �D�.S _ Telephone'Number 78I--267—12'3 7 Home Improvement Contractor License#(if applicable) 623 7Z Email: CPC V1 ce I' �'C- C"OLD COw Construction Supervisor's License#(if applicable) ���( / 7� �� ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietorCo(— a�'rc ` El am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ®.Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 30 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum,32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. A copy of the Home Improvement Contractors License&Construction Supervisors License is used: SIGNATURE: Q:\WPFILES\FORMS\building p rmit forms\EXPRESS.doc 06/20/16 r"1 i The Commornpeakh orfMassadrusetts Department af1nd-uslria1Acdd=& fIirwel of rmgations. 600 Wasleurglm Street Boston,M4 02.U.1 -- �vgvrt�mr �ov�dia _ Workers' tlan3pensatian hmurmce A davit 13,UitdersIC4MtractarsMectricianrdPhunbers APnUcant Infmmiatean Please Print F DIY Addresr 97 ra-4At 'Ole �. z j Pb. ne 79/-267-/73 Are FoII au eeaployer?Checkthe appropriate bow T of project r . I ant a general contractor and I Yl� per] ( exl�etl}: I.❑ I am a employer with ❑ g 6- ❑New boa employees(hall andfor part-fiime * have laredthe sub-conbzct= . 2.❑ I am a sole proprietor:orparbu r- fisted on the attached sheep I- ❑Re:moaeHgS sh£p and have no employees These mb-contractors have g, ❑D I lift. a waddng for one in any sty_ employers and bn a worms' 9..❑Iluildtag addition [No Wad= 'Comp.imssnance< P- re S. are a co oration and its UL❑Electrical repairs.or ad�oas 3. I am a bomeowner doing all work ets have exerdsed their 1L❑Plumbing repairs or additions wyseM[N - L- o workers' of ez emgfibn per MGL � ofr �in d-]a c.M, §I(4)6 aadwehaveno ❑ employees_IN()workers' 13_ Hier camp_insur ace n guired_I •day appliss�Hlat cbecksbos�1 mast alsn fiIIordthe sectioabeIaarahuudag theirwpdcers'compensaticapcycgiafn�suo� #Hamemnem who submd d=lava 1 they axe mg ag wak earl dies Iffie ou=&r..,,r=tars—ct submit a new affidatd md—g sac'fi IC3ansct=ffis1cher3ct1xisboxmastattadx mr.additimslsheets5osciagthen�eofthesubcaomsc�ammdstakeleamaat�nseerditiesbsae employees.I€thesub-ras:hactes have emplbyaasit6e}'rmsrpmvidethm trodms'tomp.pa1i1aumiser. I am an emplaer Heat ig preivh1heg warkees'compensalian fimwaawfor my emplayees $atua4 is ttea ptrticP rued jeb site Insurance Company Name: Policy 4f,or Self-inL U-c_ l pirat aI3ate: Job Site AA e= Cityl5tawr;p: Attach a-carpy of the warkers'campensationpolicy dedEaratitsn page(shaving the policy nrmber and expiration date). Failure to secure coverage as required under Sec ion 25A of MGI,c_1572 can lead to the imposition of criminal penalties of a fine up to SUOD aU and for oni y&ir impdsmunent,as we11 as ri.vil penalties is the fonn.of a STOP WORK ORDER and a foe of up to _00 a dap against the violator_ Se ad;dsed tarot a copy of this'statemenit npy be farywarded to&e Office of Iavestigata .of 1he DIA for ice coverage vedffcatiam_ Ida teereby car* pains aced per: get' that tha irefarmaf>=prot hW abmw is trim and correct aoaafnra• Date: l Phone is. � 2 G7 /73 7 Ojai aael� Do not m4reA4 ire flib area,to be campleted by city artown o,oidmI City or Tarn= Pernt'lLicense;9 Issuing Audarity(carte one): L Board of Real& g Department 3,f4Irowea Clerk 4.Electrical Iaspwtw S.Phanbing Fnspector 6.other Comtact Person: - Phone;9- - — - 6 ormation and Instructions � ' M=sacjj=et is C e=jal Laws cJ Vftx M r$q=m all employees`Eo Fovrde vuai='=npensatM for then•'euuployees. 1 P fir st3totq,an mpkg. a is defined as"_.everypecsoain�e service of anofher under any comma ofhir-c, express or implied,oral or writ" An Foyer is d�fined as San mctividnal,per,assochdan,cozPoraiion or other Iega1 entity,or any two more of the R=goi og e<agaged in a joint ,and the legal rep7Cserda&m of a deceased employer,or the receives or trastee of an mdh idaA p ip,associafion or ofhe r legal entity,employing=PIDY=- However the owner of a.&MIlbaghouse havingnotmare than three apartments and who resides ffie-c-c or the occ pant of the - dwelling house of ano$ier who employs pees to do maint=-ce,r�,a&acct on or repair woI on such dw iE g or on the grounds or bazZd'mg appurfunarzf House thereto sbaIlnDtbmm=of such employmentbe,deem;edto be an employer." MQ,chapter 152,§25C(t7 also states bunt"every stain or local licensing ageb cy shaII withhold ffie issaance or renewal of a license or permit to operate a business or to construct buuildmgs in the commonwealth for=y applica.ntwho has not produced acceptable evidence of compliance with the insurance.coverage require Additionalb,M(H-chapter L52,§25C(7)states fiFeifherthe c T�Mwralib.nor airy ofifspoliiical snbdiivisions shall enter'into any contract for the p�m anee ofpubIic wajc unfit acceptable evidence of compliance withe ice. regu=Eats of t 33 s cbspter have been.presented to the contacting mfaoazt Agpli� Please flI o-ot the wo,3=1 compensation affidavit completely,by checking the boxes&at apply to your situation and,if necessary,supply sob-contractor(s)name(s), address(es)andphonennmber(s) alongwiththea certifrcde(s) of insorance. Limited Liability Companies(LLC)or L.imit:ed Liabiility-Parinenhips CLEF)with no employes o$ier than the members or pmtatas,are not reqaned to carry workers'compensation..msm-mce- If an I=or LLP does have employees,apolicyisrequired. Beacivisedthaf this a$dayitmaybesalimittDdt-o the Dep-dramtoflndastrial Accidents for confrmafm of insurance coverage Also be sure to sign and date the affi .it The affidavit should be ret amed to the city or town that the applicannc a for the permit or license is being requested,not the Department of ; o siiiai?,rcid� - Shnuldyou have any questions regard ag the law or if you a=e required to obtam a woricras' compensation policy,please call the Department at the m=bea listed below. Self-insured companies should catrr their self-;,,wince Ii=mo nzmber an the appropriate lime. City or Town Officials r - Please be sore that the afhdavif is complete and prihedlegffily. The Depar[menthas provided a space at the bottom of the affidavit for you to fill out in the event the Office ofInvestigaiions has to contact youregmEn9 the applicant Pleasebe smm to filliathepeona t censemrmbeswhichwrIIbeusedas areferencenumber. Imaddition,an applicant at must submit m-vltiple pennii'lliceose applicEHms m auy give year;need only submit one affidavit indicaimg coast that policy infamlation Cif necessary)and under"Job Sits.4_ddress"the applicant should wr¢e Sall Ioc�ons in (may or ;own)"A copy of the;-affidavit t3iat has been officially stamped or marlmd by the city or town may be provided to the applicant as-proaYthd a valid affidavit is on file far futm'e pe®its or licenses Anew affidavitmust be hIled oit each year- (i.e. a home owner or citizen is obtaining a license or pr�it not related to any business or commercial vft t= or to burn leaves etc. said person is NOT req�d to complete this affidavit Cie.a dog license permit , ) The Of ofInvestigafioas wouldigm to thmir you in. dv aance for your cooperation and shouldyou have any questims, please do not hesiinft to give us a call. The Deparfinenfs ads,telephone and fax number: T t of Its Depart. wt of li&Etdal Accidents �tce of�fio� Rastm.Irk CdI11 Tf,-1.:'617' -4 wt 4-06 az'1-M MA GAFF Fax#6 7'27'749 Revised.4-24-07 - � Town of Barnstable Regulatory Services � SAEAjgPA$jj. s a _ XAM Richard V.Scali,Director. 1639. ► Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 ' www.town.barnstable.maus y Office: 508-862-4038 Fax: 508-790-6230 • Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property. /��zii � PAY hereby authorize /N C_� to act on my behalf, in all matters relative to work authorized by this;building permit application for: l7l I'�_- L'��L' (/1.���"i Cam• (/V Vl./K/•. //WV•. 1.,�: (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. f Owner Signature of Applicant S411atLI/to V) Print Name Print Name , } Date QYORMS:OWNERPERMISSIONPOOIS Town of Barnstable Regulatory Services pUTIM 'Richard V.Scali,Director Building Division s�artsresiz, Paul Roma,Building Comm issioner XAM ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied 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. 1 The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procq es and req ' ents and that he/she will comply with said procedures and requirements. Signature of H eowner 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 this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Massachusetts Department of Public Safety r ,Board of Building Regulations and Standards License: CS-09"76 Construction Supervisor LINAS REVINSKAS 87 CAMP OPECHE CENTERVILLE CA-- Expiration: Commissioner 10102/2017 c�1eo-nz�nc�Lrue«lff a��c?/l�aa ccclu eCIJ License or registration valid for individual use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: c HOME IMPROVEMENT CONTRACTOR Office of Consumer Affairs and Business Regulation Registration.:,","1.52372 Type' 10 Park Plaza-Suite 5170 Expiration.. 8/23/2018 DBA Boston,MA 02116 BALTIC COMPANY LINAS REVINSKAS 87 CAMP OPECHEE RD CENTERVILLE,MA 02632 '" Undersecretary Not valid without signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Application # ( �©2 Health Division Date Issued , Z a3�1 c7 Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board o,> Historic - OKH _ Preservation/Hyannis a Project Street Address Village O `� Owner `L-e Jo'(Q,/ Address 9, Z4 wt oe Telephone v c�_ 55- 0 l a-C) Permit Request _ L - Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuati 00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing 0 new.. size_ Attached garage: ❑existing ❑ new size _Shed:❑ existing ❑ new size _ Other Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ,. Commercial ❑Yes ❑ No If yes, site plan review# "=Current Use Proposed Use n 4-7 APPLICANT INFORMATION Y - (BUILDER OR HOMEOWNER) Name -T�v� ��� r -'� Telephone Number J`C7 �c � Address License # SJ rites Home Improvement Contractor# 6 Worker's Compensation # ��c ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 1cP11Gd I� r i t 1 ' FOR OFFICIAL USE ONLY •, r .. APPLICATION# F DATE ISSUED IV)=E _' t"' r 7 MAP/PARCEL NO:_ ADDRESS. VILLAGE OWNER 44 �t 4 ~4 DATE OF INSPECTION: u. FOUNDATION' " I FRAME INSULATION 1 { , FIREPLACE ELECTRICAL: ROUGH FINAL t PLUMBING: ROUGH FINAL `c GAS:--, '-,ROUGH 9t.:UU�—' G: FINAL :FLNAL BUILDING=t ; Stt itu a r _ = _ DATE CLOSED OUT ASSOCIATION PLAN NO. ' The Commonwealth of Massachusetts Department of Industrial Accidents ^5 Office of Investigations 600 Washington Street IIIIY ; Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit:-Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): �l Address: 1 A- KURZ— City/State/Zip: Phone#: Ael an employer? Check th ppropriate box: Type of project(required): 1. m a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or p -time).* have hired the sub-contractors 2.❑ I am a sole proprietor o 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. workers' comp.insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their ]0,❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions . myself [No workers' comp. c. 152, §1(4), and we have nop 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.[ Other gJ comp. insurance required.] *Any applicant that checks box#I 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 their workers'comp.policy information. 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. #: W 7`1"cv� LyS. 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 imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.' Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certif and he pains and penalties of perjury that the information provided above is true and correct. Signature: � Date: 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#: r J Information and Instructions ° Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for-their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual, partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials r 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 f iture.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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 5-26-05 www.mass..gov/dia Massachusetts- Department of Public Safety Board of Buildim. Regulations and Standards Construction Supervisor License License: CS 95038 Restricted to: 00 STEVEN WHITE 147 RIDGEWOOD AVENUE HYANNIS, MA 02601 Expiration: 2/2812012 C mmi.�i ncr Tr#: 19311 Board of Building Regalatio and Standards HOME IMPROVEMENT CONTRACTOR R154359 9=11 . Tr# 280764 7y _.Ltd.'Liability.Corporation CALIBER ButLDIN RELINE,LLC. STEVEN WHITE ,y 147 RIDGEWOOD HYANNIS,MA 02601 Administrator s License or reglishution,vaBd-for individal use only before the ezpiratiiun date. If found return to: Board of Bdt'iding Regulations and Standards One Ashlsurton p-,bieeRtn 1301 Boston,Ma.0210S Not valid without signature a as owner(s) of the subject property at: hereby authorize Steve White of Caliber Building And Remodeling, LLC (contractor)to act on my behalf in all matters relati the building permit application. sig a of owner date signature of owner date CORD CERTIFICATE OF LIABILITY INSURANCE FDATE(MM/201Y) A • '" 09/152010 PRODUCER 508.945.0393 FAX 508.945.4048 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Eldredge & Lumpki n Ins. Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 697 Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Chatham, MA 02633 INSURERS AFFORDING COVERAGE NAIC# INSURED Caliber Building and Remodeling LLC INSURERA: National Grange Mutual Ins Co 14788 INSURER B: Commerce Group CIGOO1 147 Ridgewood Ave INsuRERc: Granite State Ins. Co.-ARWC 13102 Hyannis, MA 02601 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR DD'� TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LTR NSR 'DATE MM/DD/YYYY DATE MM/DDIYYYY LIMITS GENERAL LIABILITY MP027360 1 09/15/2010 09/15/2011 ;EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY ;_PREMIS E nce) $ SOD,OO CLAIMS MADE FX OCCUR MED EXP(Any one person) S 10,000 A PERSONAL&ADV INJURY $ 11000,000 GENERAL AGGREGATE _$ 2,000,00 GEN'L AGGREGATE LIMIT APPLIES PER: i PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY PRO--JECT F7 LOC AUTOMOBILE LIABILITY BBNVCS 02/16/2010 02/16/2011 COMBINED SINGLE LIMIT ANY AUTO (Ee accident) $ 11000,000 ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $ B r-- HIRED AUTOS i BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ 1 ANY AUTO FA ACC($ I OTHER THAN AUTO ONLY: AGG i EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ 7 j DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION WC7425405 03/02 2010 03 02 2011 AND EMPLOYERS'LIABILITY / / / TORY LIMITS Y/N ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ C OFFICER/MEMBEREXCLUDED? 500+QQ (Mandatory in NH) E.L.DISEASE-FA EMPLOYEE $ It yes,describe under _- 500,00 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 5O0.000 OTHER I DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS arpentry CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL L DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL Town of Barnstable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR Attention: Building Department REPRESENTATIVES. 200 Main Street AUTHORIZED REPRESENTATIVE Hy nnis, MA 02601 lAlan R. Long Presiden ilt ACORD 25(2009101) ©1988-2009 ACORD CORPO ION. All rights reserved. The ACORD name and logo are registered marks of ACORD I • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Map N q • ` Parcel �} Permit# Health Division ,, 12�, /02 �'�c�I� Date Issued .,Conservation Division � 2 �Ot `�_ '? � `. Fee Tax Collector` flog— �� �_.14 TreasurerI �/o� Gj/z SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. � t V=TITLE S Date Definitive Plan Approved by Planning Board. ENVIRONMENTAL CODE AND. Historic-OKH Preservation/Hyannis r'^1 ._ TOWN REGULATION Project Street Address nni-- 1C/Y'ck Village 4"U! Owner J r Address /7/. kD1911, Telephone 08 40A 62/S— C'07ZI17- M% DZe&{— Permit Request �Zh2al� 6K 1 c Square feet: 1st floor:existing ll DI proposed 2nd floor: existing proposed Total new Estimated Project Cost 17-f0b.M Zoning District Flood Plain Groundwater Overlay Construction Type ie)Cn Lot Size 26 D7ti S Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family i, Two Family ❑ Multi=Family(#units) Age of Existing Structure Historic House: ❑Yes 14 No On Old King's Highway: ❑Yes No Basement Type: gFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing / new Z. Half: existing n I Number of Bedrooms: existing_ new Total Room Count(not including baths):existing new z- First Floor Room unt "'� 00 Heat Type and Fuel: (Gas ❑Oil ❑ Electric ❑Other Central Air: �Yes ❑No Fireplaces: Existing _� New — Existing wood/coal tove: Wes - No Detached garage:❑existing El new size Pool:❑existing ❑new size Barn:❑exis ng ❑new size Attached garage:9existihg ❑new size 3yf� Shed:❑existing ❑new size . Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes '.No If yes,site plan review# Current Use 5����i�_ ' Proposed Use !%PsiQ�D BUILDER INFORMATION Name _ n`1 C G�9�i�Jitios Telephone Number ,�0� 9Z ���,-7 Address T.7�- 4�21,-k GAl License# 0/ 7- G 5�.3 C4T71/7J, IAh 9 l7-6 Home Improvement Contractor# lU 9 P) 6 Worker's Compensation# GUC SS/ 2,7.� ALL CONSTRUCTION DEBRIS RE TING FROM THIS PROJECT WILL BE TAKEN TO ��c� ti SIGN �RE DATE 0 FOR OFFICIAL USE ONLY FRMIT NO. _ = DATE ISSUED MAP/PARCEU NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: , FOUNDATION. FRAME �6 INSULATION _ FIREPLACE ' ELECTRICAL: ROUGH FINAL rr PLUMBING: ROUGH co r°°s FINAL . a- t .. GAS: ROUGH FINAL Ito `t FINAL BUILDINGtr go 44 'DATE;CL'OSED OUT ot C. t ASSOCIATION PLAN NO: rn ''.� RESIDENTIAL BUILDING PERMIT FEES .' - APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE w square feet x$96/sq.foot= `� Z x.0031= �� 3 l plus from below(if applicable) s ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. >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$961sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (der) 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 F � T projcost MAScheck COMPLIANCE REPORT I ��✓� � Massachus-etts Energy Code Permit # MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-24-2002 DATE OF PLANS: 5-1-2002 TITLE: Williams Addition PROJECT INFORMATION: Williams Addition Williams Addition 171 Mariner Circle Cotuit, MA 02635 COMPANY INFORMATION: Lagadinos Building and Design Inc. 13 Thankful Lane Cotuit, MA 02635 COMPLIANCE: PASSES Required UA = 415 Your Home = 379 Area or Cavity font. ,.,Glazing/Door Perimeter R-Value R-Value U-Value UA CEILINGS 1821 300.., 0.0 64 WALLS: Wood Frame, 16" O.C. 1595. 13..0 .. 0.0 131 GLAZING: Windows or Doors 180 0.360 65 DOORS 81 0.400 32 FLOORS: Over Unconditioned Space 1821 19.0 0.0 86 HVAC EQUIPMENT: Furnace, 87.0 AFUE HVAC EQUIPMENT: Air Conditioner, 10.0 SEER ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC ipment sel ct d to heat or cool the building shall be no grea an'125% of de ign load as specified in Sections 780CM 310 and J4.4. � Builder/Designer Date J MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Williams Addition DATE: 5-24-2002 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.36 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.4 Comments/Location FLOORS: ( ] 1. Over Unconditioned Space, R-19 Comments/Location HVAC EQUIPMENT: . [ ] I 1. Furnace, 87.0 AFUE or higher Make and Model Number = [ ] 2. Air Conditioner, 10.0,SEER AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: ( ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values, glazing U-values, and heating equipment efficiency must be clearly marked on the building plans or specifications. DUCT INSULATION: ( ] Ducts shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. [ ] SWIMMING POOLS: All. heated swimming pools must have an on/off:• heater switch and require a cover.unless over 201 of the heating ,energy is from . non-depletable sources. Pool pumps require a. time clock. ( ] I HVAC PIPING INSULATION: , HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.) : PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 [ ] CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : PIPE SIZES (in. ) NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F) : RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 1401-160 0.5 I 0.5 1.0 1.5 100-130 0.5 I 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only) ------------------------- l .m ✓fze �anvrna�uueall� a�..�aaaac`ivael�a ! BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR I Number CS;; 012653 Birthd[aitei 07116fj954 Expires j07116/2003 Tr.no: 714 h Restricted �!00 ,I NICHOLAS A LAGADINOS 13 THANKFUL LANE,,,. COTUIT, MA 02635 Administrator HONE INPROUEHENT CONTRACTOR Registration: 104804 Expiration: 7115102 Type: Private=Corporatio LAGAOINOS BUILDING 6 DESIG Nicholas Lagadinos &P/ 13 Thankful Lane ADMINISTRATOR Cotuit - NA -02635 °'z. �,..¢e +;-^!�''�- ,,us'c^^`:s4`"„t ar'..e'. `4'r. it",.r�'"' .r ;ir-rY'`n.?:.t�'s-�r "°• "rr j �`'"r" � � The Cominoriweallh of Massach Use E._ _ ( Department of Industrial Accidents — Ofll Of 9 us .. - 600 Washington Street . Boston Mass. 02111, Workers' Compensation Insurance Affidavit pnlicarttm armation: _ :�' lease PR I�tblv.. _ - _�� "� ,... name: Location: cit< shone I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity j I am an employer providing workers' compensation for my employees working,on this job. , t: company name address: !-2-1 city: r�C�`V 1T /N LJ[�l9 .' phone k insurance c olio # �. . .- .._., I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name address: - city: phone insurance co policy y comnnni• name• address' city; phone insurance co Dolicv u - - ?Attach addition I sheet if necc3saf Failure to secure coverage as required under Section 25A of MGL 1,.2 can lead to the imposition of criminal penalties of a fine c�to SIS00.00 and/or one years'imprisonment as v,ell as civil penalties in the form of a STOP wOMf ORDER and a f ne of 5100.00 a day against me- I understand that a copy of thi-statement may be ori.arded to the Office of Investigations of the DIA for coverage verification. . 1 do er ce. i.,un e t e ains and penalties of perjury that the information provided above is true and c rreet. ten.= Dace Print name /Y��� r/el/�/NC/` Phone official use only do not .+rice in this area to be completed by city or town official ..ein`or town: permitAicensc ]oHc2lth uildimg Department r icensin;Board electm cn•s 0 ffIce • D check if immediate response is required -0. Departmentthcr ' contact person:' phone#: — ; The Town of Barnstable • anxasr•�r.e. • . $ Department of Health Safety`and Environmental Services rru�� Building Division 367 Main Street,Hyanrds MA 02601 Office: 508 790-6227 Ralph Crosea Fax 508 775-3344 Building Cbminissioner For office use only Permit no Date AFFMAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO MRMIT APPLICATION MGL c. 142A requires that the"moonstruction,21lera6062,TCWV26M repair,modernization,conversion. improvement, removal, demolition, or construction of an addition to any pne.Wsting owner occupied building containing at teast one but not more than four dwelling units or to structums which Ste adjacent ttoy}such }.}residence or building be done by registemd cootradors,with certain voceptio is,along with other Type of Work:_. _ &U, �4 elyL -- ESt.Cost 5 > Address of Work- 7/ ll"C!P t O%7w Name:- 1`/, ► i" s Date of Permit Application I hereby cettifv that: Registration is not required for the follovang r+easan(s)' a• Work excluded by law Job under S 1,000 Building not ownar-0octrpied Owner pulling own pemut Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEAL314G WITH UNREGISTERED CONTRACMRS FOR APPLICABLE HOME IINIPROVEMENT WORK DO NOT HAVE ACCESS TO THE AR$1TR.ATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hcreb%.app]v for a permit as the agent of the owmcr; S� off, OjI U D Dat Contractor name Registration 146. OR „ Date Owner's name r�.�,`;a t.; .�f...:,�.,..,.. ;. .. ,# �..,w ,, .,. .; .. .« .. ;,::..,,:rs}sip+�,,,,j'y,,,.f=•-r.w+.-^-..�i•�:---�-.... �� pFtHE fpy� The Town of Barnstable BARE. - Department of Health Safety and Environmental Services �PrFo;9.y1, Building Division 367 Main Street, Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection (k ) Location I h I MG ir,t rn c r C-t r CJ— Permit Number � to I S,(o Owner Builder One notice to remain on jobsite, one notice on file in.Building Department. s The following ite ed correcting:s ne /4 . 1 r 751 ' D Z � � Please call: 508-862-4038 for re-inspection:? ---- Inspected byC) —/�C, Date �j- � -6)L__ _ SMOKE DETECTORS O.K. SMOKE DETECTORS O.K. S G,+o STABLE BUILDING DEPT. BARNSTABLE BUILDING DEPT. New Addition and 2 Baths and Etdsting House and Bath Laundry ca to 9 EXISTING C -- BEDROOM BEDROOM -FAMILV LIVING N r ra.H'-9 tz3att-+ +n-ixlT-t . m 0 Y O 0 m 0 GARAGE co _ Existing House and Bath naxzra J U • LAUNDRY aa.+sa KITCHEN - - - ® O DINING r-i.xa 0 ,0 MASTER BATH , O na.ra # } x'-�' a _ SDREEN - n - PORCH co LIVING AREA C' . t�,a99 .Q MASTER SORIA - L tom. Section A-A cn ca a� Laundry - New Addition and 2 Baths and Existing House and Bath - a` , Drawn By. NAL Date:05-10.02 Scale:1/4"-V Street_ A-1 RTASIO= Date: C C LL A Of O IQ�{ ... m E C C � m • - m E m� c = _ E ca co rn 8 ..... v O ...m.,... - -; - O C O w% _ O cn • _ C N N SwUon A-A O L , a Drawn By. N& . Date:05-10-02 Seale:Ire=1' . sheet S_3 ReNsbna: Data: ' B Now Foundation Existing C t LL C m � Q Y� I _____________________________________________ c6 O ________________� i ,� __--___—__—__ 1 - Existing Foundation .Eo $ , CO) = A I a 0 Q. :nil � y Ito II" Existing Foundation - �. I I I I I I I ' • ' ------ ca ------------------------------------- f0 I 1 I 1 I I I LIVING AREA •I _J (A N New Foundation - - •0 •• L • a Dre By. NAL . Date:05-10-02 Scale:1/4'=1• Sheen• F-1 Re&lom Date: CO C C gr C m O CID (D y 0 it H coO EafeIDp 9moom 6ldva bRenmlR New Whtlwve CID m O C Proposed Left Side Elevation E 99tt co C f0 O C N MdWe a60vmeau Wkft - Ca @Mw TeerNdil S4*Roof OWerq Newmoi ^ C O P'bneE FJ.CeEa TNe tab en!ta3 Rekee tae Fastla `0 taB eoMlwiNveM n . taB FMm r Q � s. ta5 tamer EmmE9 E VlM1M Ce4mReMRMFglm eO aiEn - r New VVtritlovn ' Yhdow TNn laC O Proposed Right Side Elevation vmm.sn,ao Fo- a Drawn By. NAL Date:05.10-02 Scale:114'=T' Sheet E-3 ReAsk.M Dam: 0 U LL C • C N Q N f r CO- p v1 tmCO g CCO = _� @ 7 a V ea CO O oa oo ao T � u CO _ O Proposed AddiUm Exkpng Hoye - - Q N • Drawn By NAL .. Date:05.10-02 Scale:1/4'=T -t Sheet, E-2 Y Revt�low. Date: c c � • � m a) � � m 0m c v o o • ca . - J U- O ❑❑❑❑ ca 0 EA.Unj House .. Proposed AddlOw 'O _ 'O Q. to N N • O a . Dram By. NAL ` Date:05-10402 Sfate:1/4'-1' .r - • P Sheet E71 Assessor's .offioe"(1st floor): ,' ' # ' �� �� THE Assessor's map and lot number. � '7:. ,l 4 6,P �, � �(3 , SEPTIC SYSTEM MUST 8 Board of Health (3rd floor): # Y Sewage Permit number ..... ...... ......:.� `� INSTALLED IN C asa9Tl►DLE OMPLIAN ' B Elhgineering Department (3rd floor) / -7/ �1� _, WITH IT"g �00 1639. House number ........:....... / y ENVIRONMENTAL MO DNA', Or ......... .... .... NMENTAL CODE A . APPLICATIONS PROCESSED 8:30-9:30 .A.M. 'and 1:00.MO-'PA. only TOWN REGULATIONS ;OF "ARNS TOWN? TABLE #, BUKUN`G -.-JASPECTOR APPLICATION FOR PERMIT TO ...Ca.P.I. G..kx......Q, .. e. 4##3.....'................................... TYPE OF CONSTRUCTION ..........(� �............ i T TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies fora per it'according to the following information: CATLocation II....•.�.Ci..�i.,/'a.:e.�...:7r��....:.4„-�:/..(,�l.e�./•• ....�G>�.,.:.....(......... : #..� .`. ............................ Proposed Use .......J.. .. . 15.,..C��.M. . .................................................................. .......ok . .......... ................. f Zoning District :............Fire District f:...................... -. .... . Name of Owner C�........67. L.............Address `./.f.`... `.�'.8./1Si.i ..:.!f-1 1:.. � i✓/.` a r Name of Builder'...,�a�. Address '.7.i2..... �41 .itf.l......�.� .a....... .. Name of Architect n ".....Address' ..' ).U.?�.� Number of Rooms ..........o�!�................. ........Found ....A). .c,�....... T x .........: Exterior .....:Wood..:...........................................................Roofing ....a�/. :G�.C�.�GrG��J........ ..h.l.l�l.�.���...... _ a Y Floors .....C-O-Ac .el ................................................Interior .....(' . ...�����9�....�....1.1.11.(z......................... Heating .....1E.L (a./ .........................................................Plumbing //Q1.2..if..................................................... ......................................r....................A Fireplace ......//O/je pproximate Cost ...... %.1 P.0............................................. Definitive Plan Approved by Planning Board --------------------------------19-------- . Area 1. .4.4.. .... .......... Diagram of Lot and Building with Dimensions Fee O SUBJECT TO APPROVAL OF BOARD OF HEALTH � � . • `� X.2 2 � • a y • OCCUPANCY PERMITS-REQUIRED FOR NEW DWELLINGS I hereby agree to conform to_ all the Rules and Regulations of theJown of Barnstable regarding the above construction. O- Nam ........ ........ `.. ... ....... Construction Supervisor's License /.. Q:..`'.. NN GULL, RICHARD No .29:852' ,`Permit for ,Build Addition ` ... ................ .......... ...................Family.. ................... ( == z S. Location 171t Mariner Circle it...... ...................... .......,......... 4� _ ,•,J` a '"3 6-� < i i, -Richard Gull " Owner ........ .. ................. .... Type`of Construction ..,Frame.... Plot .... ..... .. Lot.................................... - AUgUu - z Permit G_ ra ed .... `t 28�..... fJ Date of-Inspection /! .f.0. '. ,9 At 1( y 81 Date rCompleted .:.........19 -vt ry ' r� mra `;`rQ E. .� ,f s M • e` y n �^ "��� - �. t s _ � . � t. _ CV)ag 'hw,CC'+7'S'' w4�rMA y� 1 "_ n. �i ' w a.. 1 Pam. '•4^' • « ". +.. +n., . .w,.....' r ' ' s - K, �• �YI �,{ r y }•a i�{ • ,. ^ 5 w�H' �_r ~�`o a .-.........s...- r ..a.- � • - ri ;.a r IM .� I! f .mot. Y1 . �+- T � � • � - , _ ty. F Assessors offioe (1st floor): � ��� �. oFTNETo r �. Assessor's map and lot number ................. .......... ............... Board of Health (3rd floor): a�P Q T (� Sewage Permit number ...................aQ..-...�.�.�...... � ! 339Hd9TAME, i engineering Department (3rd floor): # / -7/ �1,s' °o M o• Housenumber ..................................................:..........:........... o Mav a APPLICATIONS PROCESSED 8:30-9:30 A-M, and 1:00-2:00 P.M. on ly.$-�.-.: r^"� TOWN OF BARNS, TABLE BUILDING/'INSPECTOR :4 �APPLICATION FOR PERMIT TO ...C..r-:�'.,�d..S.�...c.c,...:�......�,..�....... 4 ,...<�; .a.:�..__..� .:...,......................................... TYPE OF CONSTRUCTION .......... .a 0'...�................................................................................................... qq Y 1......... ...............19...�r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a per it according to the following information: Location 1.91 //1 �. � a. .J • ,m.4.............t...L07........ ............................. 41-0- 1 Proposed Use ............?...C..:2.a 1....... F. .!"!' ...............:.....f..;..........................................,............ ....... ........ ZoningDistrict .............Fire District.......... .. . ......C.....................� ....... .............. .. .--. ................................ Nome of Owner .. .! ........1.3..1. ... .............Address .../..! lG. .E..r4. .1......t.! Name of Builder ... ,u.!. .. .C��1..1�!.t f'.clC! Address ..7..7..��.[a,!!�. P...VI. ...L.�A..�....... .!.-T. Nameof Architect ..................................................................Address ......................................../............................................ Number of Rooms .........®k.l.4.�e............................................. .... ......0 ..G.�1..<......1��", T .......... Exlerior ......... - / C'h;�.���................................................................Roofing ........!..�.r'�.�..,.(.�-:.��.......4..�..�..�,.... ��� Floors .....C191►?rkP...1..' :.................................................Interior .....:`fi e./,/rC>G .... ....d.f ✓I ..g......................... Heating ..... .........................................................Plumbing ............A .0.,K..�'`.'...................................................... Fireplace ���/tE' ........................................Approximate Cost ...... .. .0 C� Definitive Plan Approved by Planning Board ---------------------_----------19-------- . Area .��.y.... ........... Diagram of Lot and Building with Dimensions Fee �` SUBJECT TO APPROVAL OF BOARD OF HEALTH a9 a 1�2 X.�2 56n Poun a r ne( L n OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 2 Construction Supervisor's License ....0/559..Z.7....... 1 GULL, RICHARD A=024-141 i No ..29852.... Permit for .....Build Addition Single Family Dwelling Location .......171 Mariner Circle Cotuit ............................................................................... Owner Richard Gull Type of Construction ......Frame ............................................................................... Plot ............................ Lot ................................ Permit Granted ..:......August..2.8...........19 86 Date of Inspection ....................................19 Date Completed ......................................19 TOWN OF BARNSTABLE Permit No. ----------_--------- I »nA ; Building Inspector cash 7 ww/YL • _--_-_______________- 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 ._.__ ................................................................................._............_._._._�, Building Inspector r — — �a -r4�3 jq 4 a •-} 7 .. fq sny 17 { L nm PLAN SHOWING L r FOUNDATION LOCATION T C 0 T UI To MASSACHUSE T T Srn OWNED BY T+f+r'crrd yGr��!/a1TT.� • Cs�A ( IT � p 24 lJ SCALE : i �v ' DATE: 'D4C• I �D Z NORMAN GROSSMAN----- - REGISTERED LAND SURVEYOR NFREBY CERTIFY THAT* THIS FOUNDATION IS LOCATED 11 %7,v THE LOT AS SHOWN AND CONFORMS TO THE TOWN OF BARAISTABLE ZONING REGULATIONS REGARDING ' SETBACKS FROM STREET LINES AND LOT LINES . .sn7 , _ i (T� m NORMAN GROSSMAN R. L. S. DATE � �' F��Sul?"���� Aessor"s' map and lot numb �..../.C�...... ... GTHET �o o� $ewage Permit number ......��..5..ez............................... ST �.ED IN STEM MUST Q y� / ��// COMPLI 9TAXE, • ;House number ........................Z`..J............:. ....::. V�Rp WITN TITLE 5 9, MM& w„J EN1639. 9 LAMENT o D ypY�►�� AL CODE A TOWN OF BARNSr 2IrlE `T'ONS BUILDING IkSPECTOR APPLICATION FOR PERMIT TO �A ` .. >............................. TYPE OF CONSTRUCTION ...........e ..........:......... ................................ ...........1./ .. .J� ..............19.g� TO THE INSPECTOR OF BUILDINGS: The undersigned herebyapplies for a permit according to the following information: Location . . , �0:�..... .. r .....oaaAl .... .. .... .. .y.. .. ProposedUse ....... .i............. ... ................................ .............................. Zoning District /�� ....Fire District �............ ........ ........ ... ................ Name of Owner ... ` .4�� .... Address .... ....... Nameof Builder . ... . . ... ........................Address ...................................................................................... Name of Architect ....................................... . ..................................................... ............................. Number of Rooms ......:...........................................................Foundation ..... ......... �� �� Exterior ,G:�C.L�.W...4C...... .?�%�C �........ ..........................Roofing ..,.:� �!. ....... .......,.,.�...... ............................... Floors .... `.b// ..............................................Interior ... . . . ... .......................................................... Heating ..... �L/......Z .....:'�.............................Plumbing ....:......... . . ........................................................ Fireplace ................. .. ..........................................................Approximate Cost .... .�� :�a..ovO.................................. Definitive Plan Approved by Planning Board _____ _ _ __l___ _____19 Area .......................................... \ Diagram of Lot and Building with Dimensio Fees ...........2.a5.............. SUBJECT TO APPROVAL OF BOARD OF HEALTH l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ......... ........................ \ THEO CONSTRUCTION CO. � mm.....S1oql!�..I� ..DvveIIin9............... Location ....ligt...#49... .71...nY�� ' ��..<�iro 'b ' ................... -----------.`--.. ` . Owner -- ....... ^ ` Type of Construction �F2:=.e---------. ~ --------------------------' ' P|oi --------- Lot ................................ ' . ^ ' ' Permit Granted .......I]ece»��!���-3lz—lp 80 Dotoof |nopochon .................................... Date Completed ------��lfe�;?z...l9 my . - PERMIT REFUSED ' y . . . . lA ' �» ---- - IE rn CIL' - . ---- . - ................................................ ' ................................................... - ' '— .��.------------ lV . . ~ ' . . . , . . ----..^----------~----.----- . ^ ................................ --------..........—�. - ' U ' U ~ ' . Assessors map and lot number ...... ........ ......... �7d lQ�pG?H E .. sewage Permit number .......................................................... /f Z BAUSTADLE, i 1House number ......................../. .t......................................., 9O MABa 1639- \00 �E0 MAY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ........................... ...........:....,..............................................:............................... TYPE OF CONSTRUCTION ............. ...... ........... ...... _ ..............19. .:,_- TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for afy'pyyerrmit according to the following information: ,7 Location ...._ l`�..... �/-Z......... .//J l,,'2C. Proposed Use ....... �G.;"?"' ... ........................................./....................... _Zoning District ............. ............Fire District Name of Owner .. i.L Q.I;f`h��./,. /,Glc! Cf''t ... ................(.7...... 1i �A! Name of Builder %!,..1? ;%/�„� , ),K � , ?...........Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...................` ...................Foundation ......, ( ................ .......N' % 44 Exterior .,:. Roofing ..... Floors -� P Interior A�4 - . ................................................... Heating......... ......................lff,i� .:� ... � .............................Plumbing /, !� Fireplae ..... ... �• Approximate Cost ............................. .............. .............,....... ........ p ... .. f ..... Definitive Plan Approved by Planning Board ------ f__✓ _____19%�. Area .......................................... Diagram of Lot and Building with .Dimensions �✓ Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ly V r hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , .r y Name �. ? f -'':: .. r r!�'' ::....! /,� � ..�. r ... { THEO CONSTRUCTION CO. 24-141 No ..� �.$6.. Permit for One,,,Story .... Single,,,Family,.,Dwgllinq............... Location .Lat...#. 8......1.7..1...'lar.ijaer...C.ircle ................CO.tui.t............................................... Owner ...T..11.Oo..C /..r tio.n...C.Q.......... Type of Constructiom....................... Plot ....................... ................................ Permit Granted ..December 31 19 80 ...... Date of Inspection .................. .................19 , Date Completed ................... ..................19 PERMIT REFUSED ................ ......... ......................... 9 ...... .................................................................... . ............APProved ... ......O....� . 9 ...................................... g...................