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HomeMy WebLinkAbout0008 RALYN ROAD�� i f TOWN OF BARNSTABLEIBU.ILD,ING PERMIT APPLICATION - SEP 2g 20 .. Map D�2 Parcel 4- ?Q�� Application # Health Division T OwN OF(3gRs7AB Date Issued �� Conservation Division Application Fe O Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board " Historic - OKH _ Preservation / Hyannis Project Street Address S ZALYA 2D . Village CLOTU %'T n Owner WQ1C, ,*4E- Address 4::;,.A4AC- Telephone p p Permit Request -��� w�+��b�lS �i�o�ai, �►�� - $� (2. 5 ;F LC)& . i3 14116QaC& P/�t-r °T QD Y- ,,r ; ftem'16 A11I `i3lkF_r1 -r A rA kLx -110a 1 Square feet: 1 st floor: existingi��roposed Q 2nd floor: existing 76 0 proposed 0. Total new Zoning District Flood Plain Groundwater Overlay IProject Valuation_____Ooz Construction Type 'wt�a Lot Size—;C Grandfathered: ❑Yes ;S-No If yes, attach supporting documentation. Dwelling Type: Single Family /9 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes N No On Old King's Highway: ❑Yes 2iVo Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) WcfaseD 36 2 %a Basement Unfinished Area (sq.ft) 14 oo %a Number of Baths: Full: existing new O Half: existing new 0 Number of Bedrooms: 3. existing c�!new Total Room Count not including baths): existing new d First Floor Room Count ( g ) 9 � Heat Type and Fuel: 0 Gas ❑ Oil ❑ Electric ❑ Other Central Air: Yes ❑ No Fireplaces: Existing 2 New _n Existing wood/coal stove: 811 Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) .Name "Y" :` ,,� -�' L� 14,d�SQ,+�- TelephorieTNumber fC - 3 �Z�3� YXddress 264 oL_Zi v--_Li'cense'#mA , 4 ,_5-044 :Sl C C 0%M_ MA, Oz6, S` Home Improvement Contractor I �S 1 933, E�-rnai� S-Lc,,P-f P'3 eo-A A,5i Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .SIGNATURE -- DATE- { h FOR OFFICIAL USE ONLY } APPLICATION # DATE ISSUED MAP/ PARCEL NO. t } r I� ADDRESS VILLAGE OWNER f. DATE OF INSPECTION: t: FOUNDATION :FRAME I � INSULATION r FIREPLACE ELECTRICAL_: ROUGH FINAL � PLUMBING: ROUGH FINAL GAS: ROUGH r FINAL ei FINAL BUILDING 11_ ri u#:1`—K. t3 r� DATE CLOSED OUT ASSOCIATION PLAN NO. Et VC wide to Food Carts-�-�ri bi H'- F�'rrxd�fi- :��11 arPh end Zane; S C�tu et Chic mC t far Co ia= CMD CMR53D1?L.1)t - C=3pBM= 1.1 SCOPE- .� .• - .• . . � _ Vft d Speed p-sea.g[tst) 110 mph mind ixpc=re Cah*=yFor. ed B 12 APP LABILITY ---- -- Itlriiberai Sty(a taufi Iv"cii exzeeds B iri;f2 sb -sW be=nsidm a sixy) sicdes s - Raof Pit (Fig Mean R=fHeight - (RI z) Bumng Widff,W (Fig 3) Sing Leng 4 L _ (Fig 3) -ft 5 BEr . Bu3ding Aspect RaSo(Iliad} (Fig 4) -s 3:1 - hlm 7d:rol Height of Wlest Dperfmg? (Fig 4) 55S` 13 FRAEMNG COAI Scrims General mthpd'ranEe wr�h franurig caru�ec6ans (fable 2) Z.1 FOUNDA'nDN - Foundaf;on Wails meE&g t agt m emer[t of 7BO Ch R S4041 - r ,2-2 AhtLHDRAbETD 17DUNDAZIQA-3_ _ 518'`Anchor$o�dmbedded Or b/6'Praptiefaiy Me�ianic�Andwrs as an alfemafrve in�onc�eta onfy BDIt Spacing-general. (Table 4) BDlE 5pa=g from endrdmt of plate- (Fg 5) lm s B`-1 z,. >3D Ernbedmsnt-Bona a (Fig 5)_ m-y T BDIE Embedment-masonry - - (Fig Plhh iNasher (Fig 5) 3`x 3'X VT 3.1 FL.DDRS - Ffoorfrarrurrig mwnberspans dwckDd (per M CMR Chapter 55) Maximum Haarap wing dimension (Fig 5) -f:9 1Z ' Full ljeight Wall Studs at F DX ORP mgs fess iizan 2z from Exterior Wall(Fig _..._.- h4bofttan Floor.Ioist Setbada - Suppoitng Laadbearbg Waifs ar Shean-A (trig 7) Maximum r;m-O veered Roar3oisis , " Stzpparfmg ibadb�g Walls ar5hear�a -(Fig 8) _fr`d •FICOrBraj mg it Endwallt: [Rg s) Floor Sheathing Type __(per730 CMR:Chapiar 55) Floor SheaEi g Tlikimess— —(P 730 CMR Chaps 55) �- Floor Sheaffmg Fasferimg_ (Table Z)_ at in edge L In Reid 4.1 WALLS - waff Height i madbearnng us Is (Rg In and Table 5) Nag units (Fig 10 and Tabl6 5) _ft-szcr WAN Stud Spachg - (Fg 1 D and Table 5) —in.s 24`o.¢ • - Wag S•tOrY Dff (Figs T&B) 4-2 8KTEPJDRV&L& loon Studs . L�adbeatiagl�alis (Tei?fe --.mac -_fL—in. t`lon-L.aadbeaing galls..— _-(Table 5) 2x -_$_in, Gable End Wall Bragg t Full Heightadwall Studs _ .—(Fg 10) _ - vw-, fx:Floor Lengt (Rg 11) '{ems=CaUng Ler gfh Crf WSF not um4 -(Fig 11) - _ _ft z C1.HW and 2-x4 Cwfamm Iefaal Bra @ B ft o_G_ or 1 x 3 mEng furring slips @ I s,spacing-n*L xflt Z x 4 bbcldng @ 4 fL spacing in end joist 6r hms bays Double Te)p F'Ia m 13 Table� - { Spy Len-gal and(H9 --- — c�.r n.,,.,a.-K�„inn•r,�iRri rnmmnn rsai�Es�'.- ..-_iTahle al -.._. . I �4 FCC�rrfde to FYa�d Gans-i�diorr in�fig�i t�iu;f�ea�: �I��xpii ;�'rrrd��e . . _ - Massachasetts Checklist far CompB.agce(7sn,CinzJ30r 71-1) cadb0II7g Wall COMBCOOn - - - 1 ateta! (na.of 15d common nos) [rabies 7) - - j4Mj MwE earkg Wag Connections LBrad(na.of 15d common natisf (Table B) Load Bearing V&g Openings(record largd Qperung but d r=k all openings for cojnphnce to`table B) Header Spam (Table 9) _ _in-c 1 t` SM PfafB Spans (Table 9) . Fu11 Height Studs (no.Df sivdst (Table 9)— Non .cad Sawing Wag Dpanhjs(record hu post Dpamg btit dick all Dpenings for campLom to Table 2) HeadeeSpaan a._-- (Table 9) _ft'_in.51Y Sa Plate Spans.— _ (Table 9) _ft_in_51 Z I Full Height Studs(no.of sfvds) (Table 9) 6dj�jioorWa11 S mEdbing to Resist Uplit and Shea[Si=ft[neDLWf 4 _ Wa*T=n Buitfing D-unension,W f4ard sW Height of Tallest Open& .....------ S ST ' - SbeaNng (note 41 - Edge Nall 5pacif►g (Table 10 or note 4 f less) in. _ Feld Mall Spacing.— _ (Table 1D} in- Shear Conne lion(no_of I sd common naRs)(Table 1 D)_ Percent RX-HeightSheaffing (Table 10) 5%Additional Sheathing for Wag with .peeing--- W(Design Concepts) ►,Jiwdn=Bculdng Dimension,L - Nanvnal Sheaff-dng Type (note 4)—. T • Edge lank Sp3=9 (Table 11 or nab.---4 ffless) in. Field Nall Spacing (Table 11) m- Shear Connection(na.of 15d common naffs)(Table 11) _ Percent Fut-Height 5heaftg (Table 11) _% 5%Additional Shealhing for Wall wfth-Openmg m B'B'(Design Concepts) VO4 Cladding Raiff for Wind Speed? _ 5_1 JZDOFS _ Rnaftarniiig memberspans the iced? (For Rafters use AWC Span Tool see BBRS WBh) kD6f O�adMg (Figures IS) ft 5 srraHL of?'Or L!3 Truss or Raft.-!r CwMa firins at Loadbearing Walls - Proprietary ConnectorsUPMt (table 12) U=—PIf - Ia! (Table 12) f= Pff . 'Shear (Table 12) S= .Pif Ridge Strap Connecfmns,ff coliar ties not plaid per pie 21_— (Table 13)T. T= Of Gable Rake(7ADoker (F fgur--2i3)._.�_ ft-<smaller of Z or IJ- Tnz&or Raf or Connecffons at Non -oadbeanng Wafts PrDpriefary CDrmertors - UpIIt_ (Table 14) L`= m- _ Laical(no.of 15d=mmDn narks)—(Table 14�_____._.�.___—__—..._.L= lb- Roof Sheaff Type (per7B0 ChIIR Chapters and sue}._.�.__.__ , RDofshmdhbg Thici� - _. _in.?Wi5`WSP Roof&ma:9*V Fasbxn g (Table 2) NDt� . t. • This dust shall be met in ifs anfirety,ariudmg the spec5c e�pfion noted in Z to comply vAh the requirements of 7SD CI�l,R53D12 i_1 ifsrn t, ff ifre cheddtst'rs m�in Hs en5refy then$�e it?ifawmg metal limps and paid dmwis ores not requtt-ed per fire V&r-1110 mph Guide: a: sftg4 Straps per Figtu e Ix " 20 Gage Sftags per F3gtae 1 I - - - AII�Staps sp per per 14 d. , L. Comer Stid Hold Downs per FGma 1Ba and Flgum IBb 2. 'Etmeptiort Dpardng hekkft Dfup.6 B ft shah be pmmu'id when 5%is added to fha percent Ell-height sheathing -reguaE�,-nefft m%dm in Tables 10 and 11. 33 The bottom sN plaia in exfrior walls shall be a mmu=2 uL nominal f aimess press= PZ-gtade- - •�-ems - .. - 1 — r I4wc chide fo f'Dad Commf wcfioa irr H�fr ; uzdAreas_II©frTh FrlAd.Zorze cp Massachusetts Chediist for Compdance(n C&TRsinI.2!1.'*I a From Tables i D and 11 and lomf=of wall Waaff-Ing and Sulir�tng Aspect l�o,determine PerceAt FuII-Hefght She Wmg and NA Spacbg.Mquiremertfs - . b_ Wood Structural Panels sW be n*tmt>rsr ihick less of 7116'and be indalled as fotlows: - - L Fanels shall be insWed Wr sfrengl arms parallel to stuffs. - If. M horfz:cntal jolrrt shd occur over and be nallelj to finning. to Dn srrgle stnty ctinst uctIon,panels shaft be at#ached b bottom plates and inp.Inember of fhe double -------------_---- ----M Dn fwo.sinr3'=Wudnn.uppw panefssha -be sftached todbe top rnemberDM a zipper double#np-- ---- plale and b band joist at botbm of paneL Upperaffachment of lower pane!"be made to band joist and IDweraftacfrmarf made to lowest ptafs at first fi6arframing. ` v. Horbmrrdsl roll sparing at dm ble top phdrs,band joists,and girdam shalf-be a double raw of ad - staggered at 3 Inches on carter per%tires below:Vim)and Hortm fail Alar?rng for Panel Atachmert 5. GF�tg profecSott:a)'new house orh�nfal addifion—rerluired Ifprojer#'k i mule or cinseria shore(ge:neralfy,sorlth of Ria 28 or norffi ofFdF_- 6) b)ver(iraI add'Mon—not requlred turiless them Is a rwmr45on io the fast floor c) reeds arm gytoonservafion rampbnc::only(chap 93) ,S.Wood Frame Consl7urd;on Manual(3►i►FCM)for 110 MPH,Fxptz=-r>re B maybe ebtainedfrom fire Arnericnn WDDd Council (awc)wahsiie. - sou ' rraz�a • .ATE= _ i. at 11 ts tI II . tt It'fl 1 t • tl ' It tt I Tt it f D tf �r_ �- tt - !i 1°- ' t. �rCr - . 1 m R f I t 1- cL. t t _ d•-�� �j. Uta II tF , � I tit t�� t • K T •S jt it Li fi Z - i` •` l It, I. It II t t t Tt —a1 1 1 I 1a,�YfO'F�iSi - ZE p ' ��' Fr'[f$ rtx rca t va R s'RCt4�MAL - See DaUa cn Kew Page - - VerUME11 and HDThDrrW Offing �Q • for Pang Aftarhrn�tt ` �ernFaI and Ifor'iz�rrfaI Matting . . fnF Panel Affsrlhrrert Depar1meNt af s&'i Acddenfs Office COM-Wseuddow 600 washi7w=street Boston,MA 02M • ,Fvrvtaa.m�g��i,�ia , ' Workum' Coffin eniatim InsiII-Amice 3Vit BEEdeI's/Cun ars/ ac&kian�I ess Applicant IIIfiurmtatinu !lease Prlid Addre `1&4- 6a> Are you an emaplager?Qreckthe apprapriafe bay Type of project(regsdxe4_ I_❑ I ant a employer wifh 4. ❑I am a general=1fractar and I 6- ❑New consizuarioa employees(fallamYorparwimA* haveluredthe sub-contra rICh 2. I an a sole psaprigtm orpartnar- listed osl a arched sheet I- R�Qde g ship and have no employees. These seb-conftwAors have g- ❑Demolition iior.u�e in employees andhave wogs' WO°�bQ � �`- I 9_'❑Bnildtag additzom [NO 4vadomg'comp.;i7mu n a CQM3P-MSEWHrrrr 1 Electrical of mod-] 5. ❑ We are a corporatian and its ❑ aaldifiaas officers have eserrssed t 3.❑ I am.a bomeatis�doing all WQriC. _ 1L❑Plumbiagrepaiss or$drams [No 'camp- j d9a of es an per MGL 1?❑F.00frepais km==reed.]i C. ,§1(4)�aadwe'hvema employees.[NO WOAD rs' 13_❑Other Corp.insurance required_] ;Arpag 9,4coedsboafltestalsofMugttheseetoab9aW Iavi s'hes�i c ®pe�aupaycgi =- leoamess�o saber�s sffidava`lag tlxey ohmitanewafdav-d iadirmfin sar3L fCa�rmzstfest cbecY ads Uoct mast at�t�ss sddiff sheet shooing theme of the sah-C ann stdewheflm atnat those eatitieshsve employees.IfthemA).t „na ,.�hzeemployees,tbey=mstpmvideter -PeTicFmmilrez I am all sriipIOPar Berrnv is tfur paucy amd jab she ' IsjurauceComgaayY�Fatae: , r Potficy r or Self-im Iic- P�giratiaa Date_ Job Oe Addre= Y ' Citl*15tafelz�p Attach a copy of tie waders'compensaiionpolicg declaration page(showing the poRcp number and expiration date). FaR=e to secum coverage as required uudes SecIMn 25A o€MM m L52 can lead to ffie imposifi m of coal petIlses of a fine up to$L,54D OQ andfor one-geariraprism=menk Es vael as eivsl p—Age s is the foua of a STOP WORK ORDERand a Time. of up to 0.114 a d3y agahu t the vio}atar. Be ad-cised fizat a copy of this Ax&=eut maybe fxvuded to flue€rke of Imves or:s of the M far nmeff c I dO&ffaby C&tyya pearcWes afp&jkq datfize izf arma€zotrpFm•i&d above ig trace mid aarrmt Phase 9.7 ok7 Z 3� 02kiid am aaafy. Do not write in dib arear,ita be cmupLeted by cftp carfaim ojorcrat City or Taww Permitll icense f Issadng 4vOwrdt'(cane tine): L Board ofIfealth y IuTdiag Department 3.CdytTosm Clerk 4.Electrical Fmpet fur S.PFommbing Emspector �.a&W Contact Person Phone 6 1 1 li , 11 11 1 11 i 11 i1: Y -■ttA�l■. - ■ _ - awt.I•{Y. :•,■r�•- .I :ifll■ ••i?R It •t • /- •••1■1�R calf/II tic :,■•n t•t ■■" , M■tlr • - 'n ■_nl n is >, rnnl -n �.n I - ■qan�. :A - - ..'.R.■ i1 i■ - r • .0■n� en■i= a■ «um :V ■ m - • %'II • r r ■ital■�■ : .it 11■■ rlaf: •I:■ •■CRY t,1. •1■wYn■■ r./ ■• .t■•/a ■1 •/.� i••J: i3.,■t • ■1 _••• ••• • I.•t - • ■■ 7■7 •t■ �■1%•�• n - ■la illni! u•1:- .11■ ■• t•■,t■ it - • a1 u/ ■n. •_I n.R uI. _A\•wrn•n •1 •■■i r ilnu �.w •• u: i;nu ••�-. :••. •� it" •- ■� • _ •- lo: l•1 a. n_ I■ nu nat to .n:Ine�u� :n• ^I• aY• ia� ifu n u • rw.■v • u • -1 a ■■aA" • :n■�,� ••■I unl• • ■iiRu• a ■• uanu.el.n« m l ■ra•■ a -r.n ••■■. •n n t l^_ Ian: ■•aA" • •1t to" J ■m■ • a It MINN .n r•1 Iil•.owl la it o-u ■- so .i✓-n a 111.01 inn■• ••■■:!n ■' 1� /a�■ O •' _n �np ••r I H, a is*Ii • ■ rug. 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I fa. •" •tnt lati■ I• a■- �•. nt ii■1 • ■■u , YJa1• ••�w •• • r • Is • r ■at1, a r•, inn J■Im • n n .0 r- ••�. ::- � • t - t■ n v . _ ■■ ■ ■- 11" n a- ■: : �■■_ ■r ■ r- -mn�• n n- ► .t u••l ne n- _n.fr_■m •1 it" rime • -+■ - •nu�/r_ •■ t• 1 ■ �: r.I u- �i.r.t m.!u _ n- ■urn■� w{�• ■" ■• - n n .0 a■ - nun•�, ua ■I- .n n ••n._u- u" ' � - ■- n i•_I u- i■■. 1 .nun ir :n• •nnei■ "J• as" ��r a tt■iul ■_ • • t iI a. _I n- ••auto • u an■. •1 t• •, n 71 In In a n a, oisr . .••+•__um .. n r.1u: ••r _.■ nn: n u. v.■ is., ■■ I `•a■Il 1 n a 1■Ia •�■II Ir ifa - :t•t .:n•11 to .tt• f'�, •�t ■��'• •■ ■nn1 nI �r■.•1 u■ r:n■• n■ at ■t fa •t•O. a■I 1�►..•�_• .It/ ■n•.�. •• ti11- /V wM ■ YIr•■r i1 ■I n.1a.•i•/ • ■, w1 •I ■•• a1 r • .• •-■ fI n" ar a av_n_ of •• o. ■ n• • 1 •r 0- to Inm - ■.1■■. ta. a ►�■ .. I • _ i■a.• 1 m ■ ial.a • 1 r - a ••■� - ■•II - •"1�' • Mn /.!6 •.Y n,ta rill� •7 •il•rI 1 I• :■�• t• .n •a Yt1�A. • ►110,•I� w •i1nr11 " �l w • •�R•t �•■n i■ t1 .■Ilan i'," ■■ is•. ■- . ■■ - • 1 `..rya•:1■■tl •'■■ ■ .• I• ■,.n ••1 1■ / -Ir r. •1 a at r•••i! .1••tt .1■a ■•■ • ••a l • .■■ •■^I.i• - •• ■• I.�Y IYar Is J• •A V M■ i I t ■n�■ :■II .� r �•■n■ .n a r.► um • 1•�I■.t rat til i ■■Iji.V■/� 1 ■�t ti Town of Barnstable Regulatory Services dF Richard V.Scali, Director Building Division Paul Roma,Building Commissioner 63 M�� 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 F . V "HOMEOWNIER": name home phone# work phone# CURRENT MAILING ADDRESS:' cityhown 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 whp 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 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. Town of Barnstable Regulatory Services ` MAM Richard V.Scali,Director. ► Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder L ,as Owner of the subject property hereby authorize to act on my behalf; in all matters relative to work authorized by this building permit application for. (Address of Job) ** applicant Pools responsibility of e Pool fences and alarms are the respons b tY the are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name l Date Q:FORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services M 4 Richard V.Sca%Director . a�nsa � ,. . 6m¢ *`� Building Division ►red Paul Roma,Building Commissioner ' 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Offi6e: 508-862-4038 t Fax: 508 790 6230 Property Owner Must r ' Complete and Sign This Section If Using A Builder ' r-,U , as Owner of the subject property hereby.authorize i> to act on my behalf, in all matters relative to worm authorized by this building permit application for: (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 . �r inspections ate performed and accepted. Signature of Owner. Signature of Applicant AL Print Name ! Print Name Date, <. . �' _ +f XL QTORMS:OVNERPERMISSIONPOOLS i Town of Barnstable _ Regulatory Services dF Richard V.Scab, Director Building Division -z • IDIAZINGTIAMM Paul Roma,Building CommissionerMAW 6ss• �� 200 Main Street, Hyannis,MA 02601 ! f.,. www.town.barnstable.maus Office: 508-862-4038 y F=x . 08=790-6230 HOMEOWNER LICENSE EXEMPTTON Please Print ' DATE: JOB LOCATION: number street ,"HOMEOWNER"• __._ _ .,_ ___._ :sr•— -- — ,. - �v _ ;J s name home phone# work phone# f CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six_units orgless and*;, to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner:acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be,considered a homeowner. Such "homeowner"shall submit to the.Building Official on.a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner."assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that,he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said jrocedures and requirements. ,u ' . _ Signature of Homeowner ,� J-1• '"`:' Approval of Building Official Note: Three-family dwellings containing 35,006 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXYMPTTON 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 responsibilitietof a, Supervisor. On the last page of this issue is a form currently used by several towns. You may care to anmend and adopt such a form/certification for use in your community. ° Massachusetts -Department of Public Safety Board of Building Regulations and Standards ^---- ' I.VL�LrI.11 L1V 11 sU}/CI/iJV1 License: CS-W395 DAVID F KERR 364 OLD OYSTER R11 i$ COTUIT MA 026-35 - Expiration Commissioner 11/17/2016 -- Office f Co m¢ ffaiB sines✓v R gulation HOME IMPROVEMENT CONTRACTOR ,Type: . WD Registration: ,43.,1833Individual Expiration: W26=16 RR DAVID KERR17, r 364.OLD OYSTER RD 3r COTUIT,MA 02635 Undersecretary Unrestricted-Buildings of any use group which -contain less than 35,000 cubic feet(991M)of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DP5 Licensing infoemation visit: www.Mass.Gov/DPS i �Li^ense or registration valid for indwidio use only before the expiration 52iie., If found return to. Office of Consumer Affairs and usinpss"Regulation 40 Park.Plaza-Suite 5170 Boston 2116 Not va id without signature r f / .I 41 Town of Barnstable *Permit# ^ �� 4" Regulatory Services wee 6monthsfrom issue date BARNEMABLE, MASS. Richard_Vi Scali,Director 1639. Building Division Paul Roma,Building Commissioner 11u 01 2L,13 200 Main Street,Hyannis,MA.ORa6 0 I 1 / � www.town.bamstable.ma.us IJI ►U �F 8AHi Officer 508 862 4038 FOB08-790-6230 EXPRESS PERMIT APPLICATION — RESIDENTIAL ONLY oN Not Valid without Red X-Press Imprint Map/parcel Number Property Address iku ® d [Residential Value of Work$ ']�QQ, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address IL Contractor's Name Q (,,��r Telephone Number Home Improvement Contractor License#(if applicable)��� *� Email: VL;M POaLA69I CCOJO o Cal r Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ am the Homeowner II have Worker's Compensation Insurance Insurance Company Name &x AmF,&A*J Workman's Comp.Policy# 2d 8 2—C 30 13 7116 Copy of Insurance Compliance Certificate must accompany each permit. . - Permit Requ (check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to IYI CL� wiR p_&R ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is t r wired. SIGNATURE: - QAWPFILESTORMS\building permit forms\EXPRESS.doc 06/20/16 The Commonwealth of Massachusetts Department of IndustrialAccidents I Congress Street, Suite 100 �< Boston, MA 02114-20I7 °4 www mass.gov/dia «'orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name (Business/Organization/Individual): i LL G l� Address: City/State/Zip: ft0=l)vY4VW9- 0.4 02-0$ Phone#: -56 IE� S0 �16 4/1) Are you an employer?Check the appropriate box: Type of project(required): 1.6 am a employer with � employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8. ❑ Remodeling 3. I am a homeowner doing all work myself t 9. ❑Demolition ❑ y [No workers'comp.insurance required.] 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑ Electrical repairs or additions proprietors with no employees. 12.[]Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.t I3•.[f—Roof repairs 6.Q We are a corporation and its officers have exercised their right of exemption per MGL c. 14.Q Other 152,§1(4),and we have no employees. [No workers'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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 4��- Policy#or Self-ins:Lie.#: Expiration Date: 5-6- P y Job Site Address: City/State/Zip: _14 Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. - I do hereby certify under the pains and p ties of perjury that the information provided above is true an correct Si afar Z 1 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): I.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: Town of Barnstable Regulatory Services , ' MARL Richard V.SCO4 IDirector Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstabILMR.as Office: 508-862-4038 Fax: 508-790-6230 'ro a 0wrer..lO�Yust P rty Complete and Sign This Section If Usirw A Builder T• r{ Lti � ,as Owner of the subject property hereby authorize J 1� vg&�4 to.act on my behal� in all matters relative to work authorized by this bu lding permit application for (Address of Job) t **Pool fences and alarm are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final Inspections e.performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name 717.E a r� ; Date QTORM&OWNERPERMISSIONMI S ` t I Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 128957 Type: Individual Expiration: 6/14/2017 Tr#. 266936 Oliver Kelly , Oliver Kelly if 8 Rhine Rd �.A Yarmouthport, MA 02675 � ' vUpdate Address and return card.Mark reason for change. SCA 1 0 20M-05/11 Address ❑ Renewal Employment Lost Card C>��e Cea�i�cua�tcaercll�o�C�/Il�cad�cc�ure/ld .—._._ __ Office of Consumer Affairs&Business Regulation License or registration valid for individul use only COME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: 1Registration 12_8957 Type: Office of Consumer Affairs and Business Regulation ::'Expiration�6/14/201T Individual 10 Park Plaza-Suite 5170 l~— = , Boston,MA 02116 Oliver Kelly 1 P Oliver Kelly 8 Rhine Rd. Yarmouthport,MA 02675 - Undersecretary Not valid without signature Massachusetts Department of Public Safety. Board of BuUdmg Regulations"-and Standards License: CSSL-099167 . ._1_. Construction-Sup visor Specialty ,ej OLIVER.M KELLY-�- 8 RHINE ROAD O i, YARMOUTH PORT MU''0216761' Expiration F_ Commissioner 09/28/2017f.,,,.• T � t. .. � n � f ACo® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DWYYY 16. � 05/27/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. TH CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICII BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZE REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to t certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Christine Davies DOWLING& O'NEIL INSURANCE AGENCY PHONE 508 775-1620 FAX NC. /C No): E-MAIL ADDRESS: odavies@doins.com 973 IYANNOUGH RD. INSURERS AFFORDING COVERAGE NAIC a HYANNIS MA 02601 INSURER A: ACE AMERICAN INSURANCE CO 2266' INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE ROAD INSURER E: YARMOUTHPORT MA 02675 INSURERF: COVERAGES CERTIFICATE NUMBER: 56798 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIL INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TF CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERN EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ' ADDL SUER . LTR TYPE OF INSURANCE POLICY NUMBER PNODUCY EFF tPNOLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS-MADE OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY PJECTRO ❑LOC PRODUCTS-COMP/OP AGG $ . OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS N/A BODILY INJURY(Per accident) $ HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS Per accident $ $ UMBRELLA LIAS OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION X SPER AND EMPLOYERS'LIABILITY Y/N TUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVE E.L EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? WA WA NIA 6S62UB2E9013711fi 05/06/2016 05/06/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwdAvorkers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFOI THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED POLICY PROVISIONS. ACCORDANCE WITH THE PO Hastings Meadow Condominiums _ 135 West Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 —)` C`S Daniel M.Crowl'ey,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights resen ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD c� EO c E,ITC N i2§4 I: T �AS�Aat�. as.ts+a� �esa��1 7� iwAg� � c L E> I L.Iwei� �omtq . i t-1Ct'T'�ms > t;¢Ftea�sti � r~>?�c,Ae.� $;F►S"C'►al�• �t�t�� w)t:'►� � t k t?4.'�-S"S'i�lt•9t� >P•0t,CCL L'.�'.a7��$. 30e�ti�..WP:.aL S�1�er,�s. . . . :.:.::.: ....... ...... ..:..;, .::. :,i' -• C�1?b16f9t',-tom �It�S�" F'��P_ 4'�.J'�T� tAd Sd'H 9�9�Md q 1tGlLs4�5� F°AIa.r, AL 9�45"�fZtoQ 'TG'►ta0 1WR1d(S � �tx?►L:t�4�. 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