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0038 SANDALWOOD DRIVE
� �� �� c��a� �9, _ .� J y�� r i �,�,.r TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2'1 Parcel T' ';t ' KA00cation #'7'r�_v t50�V U Health Division -7h =! R Date Issued Conservation Division Application Fee ���// ar Planning Dept. � _ ����.,qq ;, _ Permit Fee 1 l i s :.� --euaa Date Definitive Plan Approved by Planning Board J43A Historic - OKH _ Preservation / Hyannis Project Street Address 3 7 3wdQ,I oc :1 'Dr ye" Village Coy Owner Address Znd0,11W()C%4 t)n Telephone_ '0-30q 0 Permit Request o2 t ZOOS- �t�l S U2;k +D YCC�• RtQL1 �I l�•l� l�k�< Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District .Flood Plain Groundwater Overlay Project Valuatio 5 Construction Type A 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 ❑ 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 Telephone Number Address License # O O I NIu(1pm Home Improvement Contractor# Email j@<So��rriSlYlQ a ��� Worker's Compensation # Us-se)o1QFJ ALL CONSTRUCTION DEBRIS RESULTING FROM T IS PROJECT WILL BE TAKEN TO ern �a�ie r SA- gbt SIGNATURE DATE S r FOR OFFICIAL USE ONLY a APPLICATION# t DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER t s r a` DATE OF INSPECTION: FOUNDATION t FRAME INSULATION s k f FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL L FINAL BUILDING o zi r. a 4 . f L DATE CLOSED OUT i ASSOCIATION PLAN NO. - --- - --- i -- -- T - -..-� �-- - .� -.�z T � - -- E C � _ _ � r Solar - R i s i n g Property Owner Consent Form Owner: Robert Miceli Address: 38 Sandalwood Drive Town: cotuit State: MA Zip: 02635 Phone: 508-776-9290 I hereby give permission to Solar Rising llc. and their representatives to pull the required permits for a solar installation on my property. E . f Property O : 'er Da e Solar Rising Date Office o Consumer Af and`Business Regina lion 10 Park Plaza: -',Suite 5.170 Boston, Massachusetts 02116 -dome Improvement Contractor Registration Registration: 175578 Type: Supplement Card SOLAR,RISING LLC. Expiration: 5l2ti121)16 759 FALMOUTH RD -,_-- --- MASHPEE;MA 0264J Update Address and.,return'card6 Mark reason for change. DPS•CA9 0 ,oM anraa oto121s L Address Renewal L:J Employment ( 1 Lost Card ��LB L?r?-'?7741tQ?LfftF,[Ll�4l• O�vbGGIXJJIlCDLGIdL'�S Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found returnto: ' a Office of Consumer Affairs and Business Regulation �4' ` Registration: 175578 Ty 4 x pe: 10 Parr Plaza-Suite 5170 ?, ?' Expiration: &28/2016 Supplement Card Boston.MA 02116 SOLAR RISING LLC. J NEAL HOMGREN P.O:BOX 2623 MASHPEE,MA 02649 -� Undersecretary Not valid --' —�- valid without signature Massachusetts Department of Public Safety \ Board of Building Regulations and Standards License: CS—M921 g Construction Su ririso, W' NEALF HOLMGREM 76 SPRING HILL RO ` PAST SANOIAIICH MA 0. �VolE No,-;. (� .Expiration: caibmissioner 09118/2017 i- �' . '� . 2 1 .:.-., � . :: .-i �1 ,�. _ � ,I ,.:i....t�. - _�.,:,- __�� �:�,.'._:,_t��.� ---� 4 . .,, .. .� t 3 K 1 .i '� 1 '. The:Conimonw alth o.Mass c .e a httsetts f Department of lndicstrtal.4ccadents 1 Congress Street,SualFe'100 f Boston, M_ O7111d 2017 ,t > tVtvtiv mass.go v/daa s ��of(.ers'Compensation insurance 4ffdavit Builders/Contractors/Electricians/P(umters TO BE F(LEI)tiV[TH TFIE t'ERbIITTING AUTHORITY t annlicant Information t..` Pleasc'Print C c6ibly arfte(Business/Organrzation/Ir.-- --ual) Solar Rising LLC _ - t'. , , Address `. `759 Falmouth Road Unit 8 ' ` C(ty/State/Zip MashpeeMf�02649` k Phone 1.# 508 Zd4 62g4 „ 4 Are you a:employer"Chec, the appropnate box Type of pl Opect(Ce(IUleetl� 1 ['am a employer wrth _employe s(full and/or part umeJ• 7. ❑I�(ew construction ' ❑Lam a sole.;proptietor or partnership and have no employees working for tpe in .: 8.❑Remodeling any.capacity [No workers comp, insurance required} : 3 I,am a homeowner doing all work myself [No workers comp insurance required)i ' 9 ❑De,mol Rion 10 0 Building addrtron d t am a homeowner and will bk hfimg contractors to conduct all work on my property,twill j ensure that'al!contractors erther'have workers campensatron insurance or:are sole , I 1 EICCtrlt al repairs or$ddttiong proprietors vrith no employees t? Plumbing repairs or additions ❑t:am a,genera{contractor and[have hired the sub contractors fisted on the attached shecL These sub contractorshave em .lo ees and;have workers coin l3 ❑Roof repairs P 5 p:;insurance 6.�We are a corporation and its officers have:exercised their nght of eKempuon per MGL c t4 ®Ot[er SOlaf r a 1!5� �I(4)'and we have no employees (No;workers comp insu ance required ,.,e_'-;:�,i�._" E `A�y apphcanf thabchecks box#1 musYalw fill out the section below showing their workers`:'compensanon pof icy mtormation +Homeowners'who submit this affidavitandicatmg they are doing tilt work and then hire outside contras tors must submit a new affidavit indicating such *Contractors that check this box must attached an additional sheet show rig the name of the sub contractors and suite whether;or not those ennties,tave employees if the sub-contractors have.employees:;they must_provrde their worker's comp policy numtier am an employer���—,�.1'L�.:h...:I�i,-�j�,�:._.i.7.,,..7_.;,.,,"1�..--.f.,,.7�:,':,,—,.--.-!..I�..i.���:,7.;_%�":,.-,that rs provrdrne w�_.,��.01I.l"�-��.�,.—.....;,::.'.-,_�.,'`��,.,_.:-..�_I..�'1,",,!"�.-"�-..�ork7-_",..��.l�i��;.",.,-i..�t'.r,,��:.�:�....,:.':,,,L".-'�-.k 4,�ers,i;":`:,'�-;,.�:"."�:!,,,,_':,%..,`�..,�...�,.�-.,�%.*-.,t,._�-_;-��.�:,�,.'coMpensa. on insurance for niy employees Below rs'the policy and�ob site niforriurtcon t.f_--,,�r.,,;�,`_.,I�,.�.,-.z7":,...,-,:,-,!--,��,,T..'_,I.1 4_:��-'.:,.�,,�_�.-'�,�,:._...,*:.�,�W_7..�_,��,;.�,..-�-;,: _L 1"',�.-A,_��,_�",-�f,.1:,'.,�.,_-:.��.-:'.,_e_.-�_,!�'-1 1,,�.,I�__��.,��.,..?,,-.!r [nstirance Company Name 'Travelers:lndemnity , M,, ny Policy'#or Self-ins Lii # UB 5B677050 15 EYpiratton Date 1`1102/16 C= Job Site Address 33 SOIhc Q v tg9W City/State/Zip l�t bgQ ..I�I--.-.t Attach`a copy of the workers 'compensation policy declaration page'(showmg the pot�cy number and eaprrahun date) Failureao secure covers a as required under MGL c I b�,§, i$-a criminal violation punishable by a fine up to$l 500 00 T , . <. andl ,.ne year imprisonment as well.... ''U penalties in the form of a STOP WORK ORDER anti a fine of up to M 00 a; day against the'violator -A copy of this statement may be forwarded ' ' the.6' "'of Investigations of the DIM for insurance fl r coverage venficahon f .. do hereby ce under the pains sail penalties,ojperjury thafthe rnjorm add n provedrrl:'above rsarue and correct ' Si nature. x . ".Date.. a 102l1,5 .. . Phone ft �D R' -1 l0 a?1 - Ojficral use only Do`not write rn thrsi area,to be completed by city or town:ojf crat City'.or Town - Permit/License# . r' Issq ng AuthoI .y(circle one) I Board of Health 2 Building Department S City/Town Glen. ;Electrical Inspector �.Plumbing Inspector 6=Other x Contact Person r f s Prone# +. Rightfax CI-1 11/11/2015 5:02:56 AM PAGE 2/002 Fax Server [DATE(MM/DD/YM CERTIFICATE OF LIABILITY INSURANCE IOV IFICATE IS ISSUED AS'A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. HIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE DUCE" ER. MPORTANT:If the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. tf SUBROGATION IS WAIVED,subject to he terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to he certificate holder In lieu of such endomemen s. PRODUCER CONTACT NAME: PAUL PETERS AGENCY INC PHONE FAX 680 FALMOUTH ROAD (A/C,No,Ext): (A/C,No): E-MAIL MASHPEE,MA 02649 ADDRESS: 28LBR INSURERS)AFFORDING COVERAGE NAIC# INSURED INSURER A: TRAVELERS INDEMNITY COMPANY OF AMERICA SOLAR RISING LLC INSURER B: INSURER C: INSURER D: PO BOX 2623 INSURER E: MASHPEE,MA 02649 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: CERTIFYWill IsTo T T P ICIES INSURANCE LISTED BELOW HAVE BEEN ISWEDTOTHE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OA 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.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAm CLAIMS. INSR AD b SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBEA (MM1DDiYYYY) (MM DDIYYVY) LIMBS GENERAL LIABILITY ACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ CLAIMS MADE ❑OCCUR. PREMISES(Ea occurrence) ED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY ❑PROJECT❑LOC PRODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAB OCCUR EACH OCCURRENCE 3 EXCESS LIAB 11 CLAIMS-MADE AGGREGATE ...�$ DEDUCTIBLE $ RETENTION$ $ A EMP 0 ER'BO�LTY N D Y/N UMB677050.15 11/02/2015 11)02/2015 LIMITS ATUTORY OTHER ANY PROPERITORIPARTNERIEXECUTIVE OFFICERJMEMBEREXCLUDED? Ip�"1 N/A E,L.EACH ACCIDENT $ 1,000,000 LEI (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 n yea,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIP71ON OF OPERATIONSILOCATIONSNEHICLES/RESTRICTIONS/SPECIAL ITEMS THIS REPLACES ANY PRIOR CERTiFICATB ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. THE INSUREDS MA WORKERS COMPENSATION POLICY AND ITS LIMITED OTHER STATES ENDORSEMENT AUTHORIZES THE PAYMENT OF BENEFITS FOR CLAIMS MADE BY THE INSURED'S MA EMPLOYEES IN STATES OTHER THAN MA. NO AUTHORIZATION IS GIVEN TO PAY CLAIMS FOR BENEFITS IN STATES OTHER THAN MA IFTHE INSURED HIRES,OR HAS HIRED EMPLOYEES OUTSIDE OF MA. THIS POLICY DOES NOT PROVIDE COVERAGE FOR ANY STATE OTHER THAN MA. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENT ,!!,. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1913E-20'10 ACORD CORPORATION. All rights reserved. Tom Petersen Arehitects Planners _ Construction Offici:a;I November 5; Qui I'd ing Departn eint for project at: 3$._Sandal:wood[toad Cotuit M f)263 . Re: Solar Panel Installation ` Miceli Residence 8 Sandalwood Road Cotuit. MA 02635 -Dear Sirs, I've reviewed the proposed solar panel,installation at this location to evaluate the existing roof structure and the connection of the panels to the roof. Criteria: Applicable codas: 8" Edition Residential Code(2009 International Residential Code with.Massachusetts Amendments) 2001 Mood Frarne Constriction Manual Design roof load: 35 psf live load, 10 psf dead load,45 psf total load Design wind load: l00 mph., 15 lief; Exposure Category `H. My findings are as follows, l. The new solar panels will imply an additional dead load pf 3 psf. The existing roof structure (2x8 roof rafters cr? 16"o.c.,with 2A collar ties and 2x 10 ridge, span =+1- 10'-6") is sufficient to bear this additional load. 2. The solar panels are attached to the roof with the SolarMt otint-1 rack system by UNIRAC. The rack system,roof connections and, connection spacing are rated for 100 mph. This project requires the larger Solar Mount 1-2.5 beam(2.5'high)and spacing of flange toot connection to roof at 48"o.c...maximum. Flange footing connections to the rail are not required;to be sra'gered. The Flange foot connections to the roof are 5116."diameter x 4" tong lag bolts. I t.hereforc.certifj l.hat this-installation complies with the applicable.codes and design loads mentioned above and is acceptable for approval. Please Iet me know if you have any questions -on this information.. Thanks': gEt) ARC Sin =rely yours, yQS f. PZr�'Qr��� q m ws- No.31621 z 3 HOWELf., w Tom Petersen �p '. N J J� .� q(Ty Op; �agLs4`" Cc: • Neal Hol;mgren,Solar Rising 41:,C 6 Gauntry Lane-Howell,iVew.lersey 07731 •Telephone 73'2-730-1763, Fix 732-730-1783 ED ARC 0, C 4 Cr31''JK�h tx' No 31621 z rarml»r A T'*io �.. ,._.._ .... H ' � r _ .._...._. °� DWELL. w oy NJ ta�tia:a.mft :' t tLFq �P4 --3+ CTy OE MP5 '� k 2d ......�..".....__......__ ..._. .Nr ..... w ,. 2x12 Tate Maxin+i of Uoi+75i si+a&Spoon IS. 14 ft. 3 1 n w ib a untlira lii tRMY- -ts lest di px 0.63 41, regI-11yed a.T iairti o1c Boma Solar Rising LLC Project, Robert MlCGlI `�` � � .. � Solar Rising, Building Permit Plans _. . 501a) r .:50$ 7 284 38 Sandalwood Road Revision 10/9/15 PO Box 2623 Scale _ None �Mashpee, Ma 02649 Cotuit, MA 02635 Neal Hol .:Drawn By mgren (a) LU0• 0 " " Life's Good es : LG Ne®N2 LG's new module,LG NeONI 2,adopts Cello technology. Cello technology replaces 3 busbars with 12 thin wires BB APPROVED PRODUCT to enhance power output and reliability.LG NeONTNeONI"2 V 60 cell demonstrates LG's efforts to increase customer's values E cc AR fJ beyond �- efficiency.It enhanced warranty,durability, Intertek IQvI664573 . Bs EN 61216 performance under real environment,and aesthetic Phomwltaic Modules design suitable for roofs. Enhanced Performance Warranty 00 High Power Output LG NEON'""2 has an enhanced performance warranty. ie ' Compared with previous models,the LG NeONI 2 The annual degradation has fallen from-0.7%/yr to has been designed to significantly enhance its output 0.6%/yr.Even after 25 years,the cell guarantees 2.4%p efficiency,thereby making it efficient even in limited space. more output than the previous LG NeONI modules. Aesthetic Roof U& Outstanding Durability LG NeON'"'2 has been designed with aesthetics in mind; With its newly reinforced frame design,LG has extended thinner wires that appear all black at a distance. the warranty of the LG NeONI 2 for an additional The product may help increase the value of 2 years.Additionally,LG NeONI 2 can endure a front a property with its modern design. load up to 6000 Pa,and a rear load up to 5400 Pa. Yllk L0Y • Better Performance on a Sunny Day 0 Double-Sided Cell Structure LG NeONrM 2 now performs better on sunny days thanks The rear of the sett used in LG NeON`rM 2 will contribute to to its improved temperature coefficiericy generation,just like the front;the light beam reflected from the rear of the module is reabsorbed to generate a great amount of additional power. About LG Electronics LG Electronics is a global player who has been committed to expanding its capacity,based on solar energy business as its future growth engine.We embarked on a solar energy source research program in 1985,supported by LG Group's rich experience in semi-conductor,LCD,chemistry,and materials industry.We successfully released the first Mono Xa series to the market in 2010,which were exported to 32 countries in the following 2 years,thereafter.In 2013,LG NeONTM(previously known as Mono XO NeON)won"Intersolar Award';which proved LG is the leader of innovation in the industry. LG NeON'M z Mechanical Properties Electrical Properties(STC*) Cells _ 6 x 10 Module Type 315 W Celt Vendor LG, MPP Voltage(Vmpp) 33.2 Cell Type _ Monocr'talline/N-type MPP Current(Impp) 9.50 Ceti Dimensions _156.75 x 156.75 mm/6 inches Open Circuit Voltage(Voc) 40.6 u of Busbar _ 12(Multi Wire Busbar) Short Circuit Current(Isc) 10.02 Dimensions(L x W x H) 1640 x 1000 x 40 mm_ Module Efficiency(%) 19.2 64.57 x 39.37 x 1.57 inch Operating Temperature(*C) -40-+90 Front Load _ _ 6000 Pa/125 psf ¢ _ Maximum System Voltage(V) 1000 Rear Load 5400 Pa/113 psf{ Maximum Series Fuse Rating(A) 20 Weight 17.0 t 0.5 kg/37.48 t 1.1 lbs Power Tolerance(%) 0-+3 Connector Type MC4,MC4 Compatible,IP67 'STC(Standard Test Condition):Irradiance 1000 W/me,Module Temperature 25°C,AM 1.5 Junction Box IP67 with 3 Bypass Diodes The nameplate power output is measured and determined by LG Electronics at its sole and absolute discretion. •The Typical change in module efficiency at 200 W/rnz in relation to 1000 W/mz is-2.0%. Length of Cables 2 x 1000 mm/2139 39.37 inch Glass High Transmission Tempered Glass Y Frame Anodized Aluminum Electrical Properties(NOCT*) ModuteType 315W Certifications and Warranty Maximum Power(Pmax) _ 230 Certifications IEC 61215,IEC_61730-1/-2 MPP Voltage(Vmpp) 30.4 IEC 62716(Ammonia Test) MPP Current(Impp) 7.58 IEC 61701(Salt Mist Corrosion Test) Open Circuit Voltage(Voc) 37.6 IS0 9001 Short Circuit Current(Isc) 8.08 UL 1703 *NOCT(Nominal Operating Cell Temperature):Irradiance 800 W/m',ambient temperature 20°C,wind speed.1 m/s Module Fire Performance(USA) Type 2(UL 1703) _ Fire Rating(for CANADA) Class C(ULC/ORD C1703) - Dimensions(mm/in) Product Warranty 12 years Output Warranty of Pmax Linear warranty*. *1)1 st year 9891,2)After 2nd year...0.6%p annual degradation,3)83.6%for 25 years _ Temperature Characteristics s NOCT _ 46 t 3°C Pmpp__ -0.38%/°C f ---- . �a onav 0°.ix °yAaen� s e ad Voc -0.28%/°C Isc 0.03%/°C Characteristic Curves s 1000w 10.00 800%, 4mweea d,a 1 7 I.7 8.00 R��1 6.00 600W u�m aW�l 400W 4A0 s 0.00 5.00 10.00 15.00 20.00 25.00 30.00 3500 40.00 4500 v N d g J a e ` s ..........--. 80 ---------------- ------ ----- ---------- ----------- - -- -------- .......... ------- 140 O o x .0 e 5 T F o m -25 0 25 s0 75 00 The distance between the center of the mounting/grounding holes. North America Solar Business Team Product specifications are subject to change without notice.® LG LG Electronics USA.Inc DS-N2-60-C-G-F-EN-50427 . Ufes Good1 1000 Sylvan Ave,Englewood Cliffs,NJ 07632 Copyright©2015 LG Electronics.All rights reserved. Innovation for a Better Ufe Contact:lg.solar@Ige.com 01/04/2015 www.lgsolarusacom Grid Tied Photovoltaic System DC Rating 6.615 kW Robert Miceli 38 Sandalwood Road Site Details: All Work To be in Compliance with: Solar Rising Shall install a 6.615 kW Grid-tied 2011 National Electrical Code (NEC) Photovoltaic system comprised of (21) LG 315 21C- 2009 International Residentail Code (IRC) B3 Modules with (21) Enphase Energy M250-60-2LL 2009 International Building Code (IBC) Micro-Inverters. The Modules will be flush mounted to the 2012 International Fire Code (IFC) Asphalt roof. MA 780 CMR 8"' Edition ASCEiANSI 7-05 Minimum Design Loads for Buildings and other Structures. Equipment Specifications: Modules: (21) LG Solar 315N1C-A3 Inverters: (21) Enphase Energy M250-60-2LL Racking: Unirac Solar Mount Attachments: EcoFasten Flashing with 4" Stainless Steel Lag Bolts Roof Specifications: R° Roof Asphalt 2X8 Rafters 16" OC Pitch: 15,30" Azimuth: 90, 1800 Site Specifications: Occupancy: 11 Design Wind Speed: 110 MPH Mean Roof Height: 18ft Ground Snow Load: 35 PSF +` - Solar Rising LLC Project: Robert MICeII Solar Rising Building Permit Plans Solar 508-744-6284 d Revision: _10/9/15 PO Box 2623 38 Sandalwood Road sale: None Mashpee, Ma 02649 COtult, MA 02635 Drawn By: Neal Holmgren a I ; 1 I - 4 ELI -Quantity of attachments 38 @ 48" O.C. 1 -Maximum. UniRac Rail"span:.- 48"O,C.= •Maximum.Allowable-Cantilever = 16" ' -Racking and Attachment: UniRac Solar Mount with s ¢ Snap and Rack Corrugated Saddle Block with . -lag screw, Hex Head, 18-8 SS 5/1'6" x.4" Length -Array Installed According to the UniRac Solar Mount, Code-Compliant Installation Manual. i Solar Rising LLC ! - hroieCt: Robert Miceli ' Solar Rising Building Permit Plan j �' S08-744-�6284 ( Revision: 10/9/1 5 Isda38 Sandalwood Road — I PO Box 2628 1 Scale: None 15' r" i cj Mash pee, Ma 02649 p GotU lt, MA 02635 Drawn By: Neal Holmgren ..,,.,�_.._«—.s.-...:::�-..-,.,. _.ww.yia-'6�"-+fi'ab�gw7*r,�n��.m•4,vamt.�xrm.A^'m�A'+"�'aa�' w}-�-�-��--- _ I i �apanng (inl F—T 1 �,•_..•• t tt tt sCtxyn�eacfdrtao*��v� � I I Fi7ctsczt�i�ruk�s� I ��'�� non Loaci:{Rst� ,'�" -Dead::-,Load�:fps4� 2x12 IThe N-4,aximutu Horszon61 S'Part;isi i 14 f . 3 1fte I i with a inuIIPWOIII hearin�is np gth.of 0.67 W. i required red at catch enrf:Qf the member species S}a#uec Terre Fu . ;Crrade f i5r S<1od'uMs��csr astActty4 Dti�trtt Psr , 7,7 ...-:w_:...,..w..,...-, .+...-«mow m.,n... r•". ,..-.,......... «.�...:a.. .. Solar Rising Building Permit Plans Solar Rising LLC Project: Robert MICell � 9 9 i 508-744'-6284 Revision: 1079%15 0� r 38 Sandalwood Road _ _ — / PO Box 2623 I Scale: None Mashpee; Ma 026491 Gotuit MA 0.263cJ � , ` • Drawn By-:Neal•Molmgren __._ z, s Y �,1 IfYJ 99 Y t I t �I Al fWIN , >t , f SECTION A �° .„ � er 85aY..sr'.Cu^xgs,ed,yq�_5wxa,^.tsm.aaNcea.Rk ax,�etKr.,scJ,:Afro�t rtbral.ract.ede+crq!iel�ixtnq'orKe.�9d*I.Y! .___..i, Solar Modules to be flush mounted to existing roof structure and set above shingles 4" } I { solar Rising L.L_ c . ! Project: Robert Miceli i Solar Rising Building Permit Plans i Sc: lr` . 508-744-62$4 1 Revision; 10/9/15 33 Sandalwood Road } PO Box 2623 - Scale: None Mashpee; Ma 02649 _ COt€.IIt, MR 02635 prawn By: Neal Holmgren OR Grid Tied Photovoltaic System DC Rating 6.615 kW Robert Miceli 38 Sandalwood Road Site Details: All Work To be in Compliance with: Solar Rising Shall install a 6.615 kW Grid-tied 2011 National Electrical Code (NEC) Photovoltaic system comprised of (21) LG 315 21C- 2009 International Residentail Code (IRC) B3 Modules with (21) Enphase Energy M250-60-2LL 2009 International Building Code (IBC) Micro-Inverters. The Modules will be flush mounted to the 2012 International Fire Code (IFC) Asphalt roof. MA 780 CMR 8"' Edition ASCE/ANSI 7-05 Minimum Design Loads for Buildings and other Structures. Equipment Specifications: Modules: (21) LG Solar 315N 1 C-A3 Inverters: (21) Enphase Energy M250-60-2LL t Racking: Unirac Solar Mount Attachments: EcoFasten Flashing with 4" Stainless Steel Lag Bolts `a Roof Specifications: „ Roof Asphalt y 2X8 Rafters 16" OCR. Pitch: 15,30' Azimuth: 90, 180° Site Specifications: Occupancy: II Design Wind Speed: 110 MPH Mean Roof Height: 18ft Ground Snow Load: 35 PSFZ. +` Solar Rising LLC Project: Robert Miceli Solar Rising Building Permit Plans Solar 508-744-6284 38 Sandalwood Road --Revision:- --10/-9/15 PO Box 2623 Scale: None Mashpee, Ma 02649 Cotuit, MA 02635 Drawn By: Neal Holmgren V 8 KA yy 1'fi R - Yr• 1 1 • • a • -Quantityof attachments'.- '-38 48" .C. x<< -Maximum UniRac Rail span -:48 O;C. - AT -Maximum Allowable Cantilever = 16"` -Racking and Attachment: UniRac Solar Mount with I Snap and Rack Corrugated'`Saddle Block ck with-lag screw, Hex Head, 18-8 SS 5/16" x 4" Length -Array Installed According to the UniRac Solar Mount : Code-Compliant,Installation Manual. a Solar Rising Building Permit Plan Soler Rising LLC Project: Robert Miceli �__ Splar508-744-�6284 ; Revision: . 10/9/15 PO Box 2623 ; 38 Sandalwood Road scale. None ----- Mashpee, Ma 02649 C,Ot�.1it, MA 02635 [?raven By; mgren Neal'Hol s _— — — - -- — _ I_--- — —.� ._.. Specter Spttz PcfF+r ..,k." 40, Deflection taasttll$tl SpacingOnJ txm v; .._N.. Elt stratte rnf ucn3 ;� Cxterior:Esposurer tn�sett lta�Ge� I r� i Snnzr t aAd(pSt) ...�.i,...k.,,...w5.•.r'...�.w.$1GIdlill$.� �!Xtil1�`�4S�ZP86�Rt4I� .�w'w. ..,.,Ya.w.,a,. ,%`' ! .�� t.'� �^�„ I T6i +b.tl�rtlnt 1°crr4c+ Y4sn,s I f 14 f.: 3 in. a.Vjth';a ry�uiUIIJ3111 biz~tric%'jetj2fj f*.Gj in., i sequined atzsch end.4ft te tnetu er- �P1'Aptt'Yt _ <.�1v�sdBttQ, j i pe,,ies __ M S�c Pee F7�-r^ r , s �t� lasttcz tY t crxttng Strengt}t(Fk) I �Bcartit�Stteue'�6�F _ S� t5hear 5uetasttb(j'r)...�._.,.._..•.,,.,._...._.�*,..........,.....r.,.... .. S t Solar Rising !-LCi PrOjeot: Robert Miceli I Solar Rising Building,Permit Plans 50$-744-62s4 3�8,Sandalwood load I Revision: 1'079/15 PO Box 2623 i i Scale: / ' i r� None Mashpeel Ma 02649 Cotu-it, MA o26 5 y .. 9 Drawn B Neal Holm ren - k Giit5#�e rGF3 ; cs yt }' 44 au an I A A, • � .!;'P x. §n"f'c � "�^•� a ,:} 3 x„.>R' .,',gpfi+�,A,+�* �' ?"w a � A - .. _ _ - e 14, SECTION A-A - I a � b• F f; -� �,§ra;,o-�'`;t'+�w��"•.x.' :.' - .. �.. - ..- � W:- "a`r ,�S'C§.S'vt f�^<:} a,�;�...p.1r o�'G`h a dee^�r3n�E.�et„:,.?§.e r��ra.eer�••sxl,rnx�cFy�"'.k!}'ate2^x�i Y�'�c' - i j Solar Modules to be flush mounted to existing roof structure and set above shingles 4" I Solar Rising,!-LC ! .Project;` Robert 'Miceli Solar Rising Ii3uilding Perrrpit Plans I 508-744-6284 ! i_ Revision- 10(9/15 r Po Box 2623 33 Sandalwood Road sure. None « o f� a rl GYMashpee, Ma 02649 Cotuit, MA 026 Drawn By: !Veal Holmgren . r II `��a k_ v r :. �� �' e • .. i ' f '''���� ..mow. ..- ...w� vr• _. _ ' �� i _ � Vr+9Q l..r.. � ,...... 1:' ��' ''I —r � .... ,� Town of Barnstable Permit: 0 i�©� Regulatory Services Date: oFt"E � Richard V. Scali,Interim Director - # F'ee: Building DivisioneJ " &UMSTABM Tom Perry, Building Commissioner �639. ♦ ` v V 200 Main Street, Hyannis,MA 02601 �'FD MA'S A y ` www.town.barnitable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: IV LI Phone: ' ri Install at: �` (lip��`� a Village:Rn .'f� Map/Parcel:--- Date , Stov . A. l Used B. Type: Radia Circ lating C. Manufacturer:,ile.e Lab.No. 4111 D. Model No.: r Chimney A. Ne /Exi l existing,'please note date of last cleaning B. Flue Size .,. . C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer' S7A:✓ti! S � ,� �' zv E. Masonry: t/ Line Unlined Hearth ; El f A. Materials: B. Sub Floor Construction: ,f Installer ►'i'1 C Name: Address: 1� `G Phone: _ - ""V4 4, Location of Installation: j �> H.I.0 Registration Construction Supervisor# L5JA Il nk--1plPnuir ink' , no' LICENSED INSTALLERS SIGNATURE: 1� 1Y i I VY, APPLICANTS SNpaqvable'lo URE: /` APPROVED BY Please make ehec the Town o Barnstable *This constitutes an official stove permit after inspection,photographed,-and approved'by the Building M§pector Q:forms:stove Rev 11/4/13 o,EIHETown of Barnstable Regulatory Services seansrAWZ. f Puss Thomas F.Geiler,Director 163¢ Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, `�—� � "f`�'�` ,as Owner of the subject ptoperty herebyauthonze w i to act on ray behalf; in all matters relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are performed and accepted. Signature of Owner attire o plicant Print Name Print Name Date Q:FORM&OWNERPERNSSIONPOOLS The Cottttnonwealth of Massachusetts Print Farm - Department of"IndustrialAccidents Office of Investigations • 1 Congress Street,Suite 100 y Boston,MA 02114-2017 s www.mass.gov/dia Workers' Compensation.Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information "'Please Print Le ibl Name(Business/Organization/Individual)., 1 S' ap Address: Y.Q,&,l go - City/State/Zip: 104 rni M5U,5 Phone#: ; _I` Ar�yor�employer?.Check the appropriate box: " Type of project(required):employer with 4, ❑ I am a:general contractor.and I employees(full and/or part-time).* have hired the sub contractors 6: ❑New construction t 2.❑ I am a sole proprietor or listed.on the attached sheet. 7. ❑ Remodeling - ship and.have no employees These sub-contractors.have 8. []Demolition employees_and have workers working forme in any capacity' ' ..' 9. ❑ Building addition _ [No workers'comp.insurance comp.insurance.{ required.] '5. ❑ We are ❑a corporation and.its 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work officers:have exercised.their 1.1.❑Plumbing repairs or additions myself. [No workers':coiap. right of exemption.per MGL "+ 12.❑ of repairs . insurance required:]t c. 152,§1(4);and we have,no ; employees.[No workers' 1S. Other ^' comp.insurance required.] *Any applicant that checks box.#.l must also fill,out the section below showing their workers'competsation pulicymfotmation. _ t Homeowners who submit this affidavit indicating,they are doing all work,and:then hire outside contractors must:submi-anew affidavit indicating such. *Contractors that check this boz 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. lain an employer that is providing►vrkers'compensation insurance for my employees. Below is the policy andiob site information. Insurance Campany,Name; 1� ���rY�c�ee Expiration Date:Ex . Policy#or Self-.in #•s.Lic; L�(I���``��� p� / p 1"t1 � I�`tT"�t ^"" J• Job Site Address:;, � ���6 Ci ry State/Zi : r � Attach'a copy.of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section25A of MGL c:.152 can lead.to the imposition of criminal penalties of a fine up to$1500.00 and/oi one-.yeaiimprisonnient,as well.as civil penalties in the fotii of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be:advised that a:copy of this statement may be forwarded to,the Office of Investigations of the DIA for insurance coverage verification. A I do hereby certify u r Wpains and. enalties qfper'u2.that the in ormation provided above is true and correct i nature:- Date. U—IL_ r _ •,. Phone#.:. Official.use.only. Do not write in this area to be completed by city or town.o&ia1- City or Town: Permit/License f Issuing Authority.(circle one): ' 1.Board of Health 2.Building Department 3.Clty/Town Clerk 4.Electrical Inspector 5..Plumbing Inspector' b.Other A I i Contact Person: Phone#: ' LtLi,, L• LUI`F l:`tJriIVI nNRI INOURMNUC t IV II, Itaj r. . CEIRTIFICATE F L' , ILA 1 varElmMfoor 12/02I201414 THIS CER71FICATEAS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THe COVERAGE AFFORDED BY THE POLICIES SELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,ANQ THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an andor$aMent. A statamont on this certificate,does not confer rights to the certificate holder in Kau of such endorsement(s). RODUCER NNE- r Laura J Murphy HART INSURANCE AGENCY,INC. PHONE 503-759-7326 x?.07 5q8=759-7386 243 MAIN STREET , N,, PO BOX 700 -"AAI- BUZZARDS BAY,MA D25320700 INSURERS AFFORDING COVERAGE NAIC R INSURER A: ESSEX INSURANCE 00 $9020 ISURW Sandwich Chimney Sweep - - 1r+suRER a: ATLANTIC CHARTER INSURANCE COMPANY 4432E PO Sox 90 INSURER C Sandwich,MA 02553 INSURER D: . INSURERS; . OVERAGES CERTIFICATE NUMBER: REVISION h1UAlI8ER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUr<D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY RAID CLAIMS, In TYPE OF INSURANr POLICY N1JMaFR .MtDQY EFF PM DB EAF LIMITS GEN@RAL LIABILITY 31)V0379 10/09/2014 10/0912015 EAGHOGGVRR.Ncz 5 1,000,000 COMMERCIAL GENERAL LIA01L;yY AAW E T a 100,000 CLAIMS-MADE OCCUR' MED EXP(An on6 raan) 8 5,000 -- - PER$ONALS,ADVINJURY S 1,000,000 GENERALAGGRFGATE S 2,000,000 GERL AGGREGATE LIMIT APPLIESPER, PRODUCTS-GOIdP1OPAGO S 1,000,000 POLICY FRO- [—] LOC 5 AUTOMO&LE LIABILITY COPA6tNED SINGLE LIMIT Es accide I ANY AM BODILY INJURY(Fee pmon) $ ALL AUTOS OWNED AUTO-S BODILY INJURY(For accidanl) S HIRED AVTQS NON-OWNED ' PROPERTYDAMAG _ AUMS - Par ' ,dT,' S ' UMBRELLALIA9 OCCUR EACH OCCURRENCE S EXCESS LIAa �—H- QLAIMS-MADE AGGREGATE S OEO RETENTIONS - ( WORKERSCOMPENSATION AND Erd'LpYETLA6ILITY WCV61153100 05/13/2014 05/13/2015 WTTATU YIN • orM. ANY pROPRIE /EXECUTIVE OEEIOERR/EMerR EXCLUDED? ❑ A E.L.EACHACCIDENT § 500,000_ (Mandatory In NA) E.L.DISEASE.EA EMPLOYEE S 500.000 If ya- da:cn4o under 3 DESCRIPTION OF OPERATIONS p910%v , t E.L,DISEASE-POLICY LIMIT Is . 500,000 ISCRIPTION OF OPERATIONS r LOCATIONS!VEHICLES(Atuch ACORD 101,Addltloral Rernerka Schedule,If more apacd Ia nNlulfnd). Ierations as performd by Terms&Conditions in the policy :;RTIFICATE HOLDER CANCELLATION ' SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAN05LLED BEFORE TOWN OF BARNSTABLE THE, EXPIRATION DATE THEREOF, NOTICE WILL' BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. BARNSTABLE,MA AUTHORIZED RUPRESENTAftF Q 1988-2010 ACORD CORPORATION. All rights re:$orvcd_. -ORD 25(2010105) The ACORD name and logo are registered marks of ACORD . Consumer Affairs&Business Regulation Oil e o"So I rt, a OME IMPROVEMENT CONTRACTOR Construction supersko I r &-2 F11111i1v egistration: 120859 Type: F. CSFA Expiration: 31/12/2016 Private Corporati( -058557 SANDWICH CHIMNEY SWEEP, INC. KEITI-I A CLIFF PO BOX'90,. KEITH CLIFF SANDW 112,11 MA-.02:563 28 EMERALD WAY FORESTDALE, MA 02644 Undersecretary 02/27/2015 COMMONWEALTH OF -e SHEET METAL WORKERS ': "ALYZLIJ A S T E R-U N R ES TRI qTE D'. ISSUES THE ABOVE LICENSE TO: A CCIA111FIED #2722 CHIMNEY SWEEP A T .,C C1 F F __T Valid Tliw �,.EMERALD WAY June FORESTDALE t-1A 0 2,6 4(1 1530 2015 02/28/15 5330094 S,-..1i1dwIc11 ChImiley Sweep &--m(.1wich, MA Restricted -.One-and irr,i"T accessol-li, budding tl'ierLto, irrespective of size. lz Lie-license or registration ll fol*individ,Ul use 0111), 1)e'Ol*e the exl)iratiou elate. 11�1'oujjcl return to: ' Office 01"C011SUmer Affairs and Business Regulation 1 10 Part:plaza-Suite 5170 Boston,NIA.02116 Failure to possess a current edition of the Massachusetts State Building Code is cause forLicense.'' revocation ofjhi� For D.PS Licetisitig information visit: www-Mass Gov/DPS Not va4wl I liout signature CSIA Code of Ethics 3 0 4 1 IS(Wny that Caltification 1)y the Cnomey "'cly Inslli.le of Anledita tCSIA)Ca7ies�%itn it certain responslhllitsie,,and owigations militt)may now me.., .(�Yad, 110tify y_()ur*Boa;-_i ai�l ii-le: to a 131 Laial Of performance and professional losi. 01 dc.s I I, lmnivioi man apoicabia aws,rates cis raillwatioiii 76 v z;It o i l .J o .,4_ -Nl 'JOEW i,x&, 1;1 this rectad I pledge; to Islam and 1161,16 all cnimney and renting safety iii]A 32-i il- - practices ana t"nniques PrOillollsOl by CSIA. '2.j.'a"aa,illy services in an no last and A -If "S your Di,,d., and to r6b.isi Isom engaging in unfav o.d"epike S iown Is ljualij pr.aotls,es o'olahmg any imlli,Q,_dacepli,e state. or acldfass is in�Lffc�.' pj_Gp@i il-lailif-Ig Eli 1-leX 1116111%inClUaing 1)�.t 1101 liffillea 10 Will regard to Ulely[VI L at Ill.CS[Alogos, ull, /-klways ;ck:1 10 your kerlse iidllliji�V. 3.To comply will all aj)1311(7abls�Wilding lodes In 10e _'-�Ubjact tc., ilial provit�iqlls C4 the Gonaml L. svvs 11 1 5—lCe.Man tile lllanLllacwrs s instaitation in't"Idion.Ws ill.1—ddels I Inflall,and'All i-FsOild pilvilog, and i)fust-j,l()*L lj,� —ognued cninin.i,and ybnlmp p"'clicies 01 cissigli06 .J,jy I ' ' 10 pnawle and cal,,eals,consAle's allool$ml. 0 'Ammisy and'enlinu practices' P&I or L j;I-e Cr by lo iino to contmomy twifait my'noMeasill.11olis" and l6mliqussl tvjljl dijaid to c'Irre'll accepted chi )ey and venling safety p,aafices, it To conatic(myself in a decent,fc3j)ectui,and l)jofei,,iooai manner V,ten sefolst in illy cattacily 't is a cilinme)sweep,al imen attending a hinclion - as event of ao organization in file enanney as ovattin ill.01103 vid"31,yo ." I 7 TO t,o,i)j)jy.iall loe plol)61,save of file CSIA Rciiistwal 1,advalad,33 deleted 41 tile CSIA lz�ID Y T,adama-,,Use Guideline docLillann: Revised 5,61il I P, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map a�Parcel UO3 Permit# 2 3,38 7 Health Division 6 Date Issued Y � 02— Conservation Division ,13, 1 tm 2 oil— Application Fee Tax Collector 3l Permit Fee �a Treasurer '3 SEPTIC SYSTEM MUST D q�' INSTALLED IN COMPLIANCE Planning Dept. V=TITLE 5 Date Definitive Plan Approved by Planning Board EWRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUL:TION i Project Street Address 5Xi2li'/�61_g r 2A Village Owner ��'� �� % ,�i�� Address C�a6w:c Telephone 12 fi- Permit Request 3d 2eca��c Square feet: 1st floor: existing proposed 2nd floor: exis ing proposed Total new_ Zoning District Flood Plain Groundwater Overlay Project Valuation / ?) Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,� Two Family ❑ Multi-Family(#units) Age of Existing Structure f' v S Historic House: ❑Yes A No On Old King's Highwsay: ❑Yes No BasemeN Type: X Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new T . Number of Bedrooms: existing .3 new w Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: OGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes ;dNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes XNo Detached garage:❑existing J9 new size 760 Pool: ❑existing ❑new size Barn:❑existing ❑new size ZT Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: .honing Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# �&rrent-Use = Proposed Use BUILDER INFORMATION Name yf�2s-;r 7' /�'/�C`� /*> Telephone Number Address .�� _ i� ��rp� ��' License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /417 SIGNATURE rDATE Z— 3/— a FOR OFFICIAL USE ONLY 4 PERMIT NO. DATE ISSUED .` MAP/PARCEL NO. ADDRESS VILLAGE L , OWNER DATE OF INSPECTION: ` FOUNDATION } FRAME - INSULATION , V-7 FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL" GAS: ROUGHS_ FINAL FINAL BUILDING ` ' ' DATE CLOSED OUT ASSOCIATION PLAN-NO. ' �J�6� gj-►�w. rf f (N,5�rF cos Y p 1aY) i fd o� 1 ` LOCATI N P O i-v L NSTANDARD LEGEND 'E• " NOTE:not all symbols will appear on a map ?j/J GOLF COURSE FAIRWAY EDGE OF DECIDUOUS TREES EDGE OF BRUSH ORCHARD OR NURSERY EDGE OF CONIFEROUS TREES MARSH AREA I l i "--_ - EDGE OF WATER DIRT ROAD 13 DRIVEWAY 71 PARKING LOT PAVED ROAD N t I� _ .- — DRAINAGE DITCH a ' as —__ t PATH/TRAIL I l 1 PARCEL LINE AkA21 t PARCEL NUMBER O - #1160 —HOUSE NUMBER I 2 FOOT CONTOUR LINE I Y —i-®— 10 FOOT CONTOUR LINE s Elevation based on NGVD29 4.9 SPOT ELEVATION STONE WALL FENCE RETAINING WALL RAIL ROAD TRACK 1 _ STONE JETTY Poo" . SWIMMING POOL PORCH/DECK C� ❑ BUILDING/STRUCTURE DOCK/PIER HYDRANT e VALVE O MANHOLE 0 POST 0'P FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M A T 1 O N S Y S T E M S U N 1 T .o SIGN ® STORM DRAIN N PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a *#NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD o UTILITY POLE ❑ TOWER w ° 0 20 40 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards LIGHT POLE O. ELECTRIC BOX : 1 INCH=40 FEET* enlarged scale. on the map. at a scale of 1"=100'. Parcel lines were digitized from FY2002 Town of Barnstable Assessors tax maps. °FTHE T° Town of Barnstable Regulatory Services 9saxcnB?E'$ Thomas F.Geiler,Director Es6 p.�a Building Division Tom Perry;Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: ) Estimated Cost %4n ) Address of Work: Owner's Name: �O Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied VOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contr ctor.Name Registration No. OR /�- Date Owner's e Q:forms:homeaffidav The Commonwealth of Massachusetts Aq :• ='- Department of Industrial Accidents offfee On 600 Washington Street -'.... Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: /f—[���h,� i C lili location city /'.!�'��C/ � �� phone# U`UU �4Y� ''•�� . I am a homeowner performing all work myself. N/a/m/n, Iamasole r rietor and have no one worldn in ca acity % %%/ 1xv�/%/%%/%///////%%///%%/%%/%%/%%%/%%//%////%%%%%////%%%%/%%%%%/��//%%%%//%%�/%%%/%/%%%%%%%%/%%%%/ ❑ I am an employer.providing workers' compensationfor my,employees working,on this job.: ��os;:sa n�nr xx A a t c>` :iic► /117 ❑ I.am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following > ': >':. o3npatir'n :::.:r:::.:.,:::::::........................... ::. ;::. :........:...:......:.::.:::::::.:::::::.::...:::.:..:....:•::.,::.._,:...:::........::...:..}:.:......................................:..._:...::.::.:}::-:::.......:......:..:......::.:. , s•�:.v::::.,•:::::::-�::::.t.?::i:•>::::.v:;•:::.v.v::::: ::r:::::::::•:::.�:::•::•:::}:.::.,::-:.;. -v••:.,•::i::Sj;:::;:}>:•:is?:::•}:.::�>}}}:t:?SS.v.}.};::: ..lt.. .•.�... :.. ii:}:iiii:�::;::%}%+:v'iii}}ri:+Tiii::yr::'r'}yv�;;i:';::iti:i:j�;i:�:i'%::v��':ii:�ii:'vi?:i'•ii:: :::�i:;��:.iiti j :ji>:'.'::h:::i:{i}':?:i�?iiii; m�i:fyii'r:�:fi:S�`i'ri{iiii^•< {%:iY:�iii??ii'iiii: :••:;•::?�:p:S}:L}}}?}ii:!Si•r::%}:i:%:,t;ij•3%;�:z-.v:-:.v::•i}:;h •...... r...,....:::.n....... .. ..: :.. v.:•:::..t.........i.•.n:.:v:.:s•.v:::::.::::.:.::v:S}::=•ti•Y f--}:;�..;•}.v;:.:::ii"• .....u::L::.x:::::::.v:::::....-.-•vn..e..:sv::v.v::.v:.v::::::::.:s....:.::.v::nv:r•:::.}':{i:C.••.Fv.S•.^:u.4•}:::�:::.v:::::::::::................ ..3... ...........:.•. .....:...... ......:..�:::::w?.:S•:uw::.:r::::::::}.1-:.�::::r..r e.h v: ••1:•?:::::t. ..:w::•::......n........::...:.. ...................:....�::::.v::.v:v::::.v:tv::.::....:....Z:...:r:£ww:?r..�.w:::::::.::::::::::::.... ::••: :::::::::::nv::::C.............,......: ����:+<':;'�:: .: %%�<{:��'�<::? ::%� :=:��:•:'•s�:� :�:�:�:�: < r:'::::i':%.?;.}:��:'S>•'•:r:���rr: %%<S:::Gig%f:�:'%+:?':�:':;x5:�::: ;: . i::::•:}::.'-::<;;:'•%%%}:;::;••:ti}g; Gov<.';•;=:::::}>:::: :; '`•'t:�::�'+�%�:% 'i'�; ';' ;:;: :;:�:;`:��:�:t::5:�::ii:`•7:;:;::%:is�:::%�:%;:;��;:; �:;:::::.:;;;;:;�::;: :::::''%�::?:t?:�:;`:::<:`::�:`%:�::;:;5:`:':';:?+;:%;;:;�:`.;;:`�:;:;:�:� :::':`':i`'::5:�':`�:?�::'':':'';�:��:�:''�:''::;`:'��� ,•.i�r3:":+::is��' :::':;:�`-:::�r:�:'•:2�<::.�:::::.:r•:::::.:. .............................................::::::::::.::::..:............................................. i•.'R•:%%i4i:vYii:ii}iii::::•.'?:i}:::;:Y.4:%::i:::?':::`i:::}.S:':i'ri:i':}Y•ii$i: .v:??;.}'{::::::::::.:.:i4::.;,;:..::::•{.}•.v:::::::::::. ..................:::w::is•.v:::::•:w::::::::::v:::{::;i}:.;vv::::....r..+: ...........•}}:v:::::?•}?}:•i}:;;SO;.;......:•.:.v.:.; ............... ,:,:--:.4^:::v:::::is i::.........................:...... ......................q,,,...................s..................................:...................... ... }};:::••;v::::::::::vv;irf;::;•}:•}:.......:.v::::.:...., :....... x:::w::sv.v.v:%v:•.v!:••.-,r,..:::•s .:::::.::.... .....r?............. ., ....:.::..........:-::.:• ,:mar-.;;;:?•:t•:?•}:•:•3:t•:;•}•:;?::A�:�:`•3Y.;•::::::•:c?•;:•}}:?•r.:t;•}:•:`. #<::%::•>:•;::<<:::�:::.}::?}:•:;>.;%:;•}:%•-:•<>...}'.r:.�:::::::•:::.:�.:::::::::::::.�:::.::..�:::::::.�:.�;:>.. ... •8 e•CX1�::#�:::�:<:�:''::',^;.;�::; :err't'�?'•::;';:�;:?�:�:�..>.:� y;;:;::::, :;:::�:c�>�`'':�;:>::�`:;�R:;::%:::;;;::.:;:;::;:;;�;:;;:,::;•;;:.,;.:?.?:;<.?:}:<: ........... ..... ...... .................................. Fafiure to secure coverage is required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up.to$1,500.00 and/or one years'imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification A. - I do hereby certifyu - hepoins-andpe es-of-perjury-that-the-informationpr-ovided-above-islrue.and-coirecL=�_ _... Signature Date Print name ��6... �� / /CPI PHone# Fo�ffldalnly do not write in this area to be completed by city or town oMdal : permit%license# • oBuilding Department ❑Licensing Board mmediate response is required ❑Selectmen's Office _ Health Department ; contact person: phone#; ❑Other O vised 9/95 NA) Information and Instructions Massachusetts General Laws.chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any crnitract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,-and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner.of a .. . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of- another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer: MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or"renewal of a license or permit to operate a business or to construct buildings in the commonwealth for.any applicant who has not produce p p d acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe' commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until i acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. y Applicants Please fill in the workers' compensation affidavit completely,by checldng,the box that appliesto your situation"and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law":or_..you - - :. are,required,tb obtain a workers compensation policy,please call`the Departirient at the number listed below City or Towns - Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. tfie affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please.. _ a: be sure to fill in the.perautlhcense number which willbe used as a reference number..The affidavits may�ie'retn the Departmeirt b 'mail'6'r FAX unless other arrangements have been oracle: :r ,. , yam. ... S. . . . _._.,, The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. . Please,do not hesitate to give us a call. � The Department's address,telephone and fax number: - TheCommonwealth Of Massachusetts _Department of Industrial Accidents Office of Investlgatlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4960 egt. 406, 409 or 375 it . .. 7 The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: / JOB LOCATION: �O c +�'' %C�� 0/— number street village "HOMEOWNER": name home phone## work phone# CURRENT MAII,ING ADDRESS: S�C�/I GIG!✓G'7 � 2V— 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspe, procedures and requirements and that he/she will comply with said procedur Vuli t Signature of Homeo 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 t amend and adopt such a form/certifrcation for use in your community. Q:FORMS:EXEMPTN PLATS -------------- _ __ � _ _ _--/7-/ --00 00 � . Ab/04 a /-1ci 000 _ -Gress �� 014 -- r 31* Real learning. Real results. PLATS �iS�Ls C;�xd;� /zo _ s. __ —- -- ------- —_ /x IX3RealYearning 1 reedits.: T 2x(2 1 i ---- - ---- 2 x iL Zx )U — - hE I tv�ki�y is M S/DiN(� (J w-►I i % - (, 1 14 f i i Co,jct4e , j Z . � d , c 33 a H i3; � y � , d �n 3' � � �� C L �'•i` � � <� r N k Y S V �• V/14 han A SIP x r77 if z 97`z , - Igoh, 1 Tf , ov! - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 44>)2 SLAB MI or) AA& - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -I - - - - --- - - - - - - - - - - - - - — 21 7W sq ft - � A d 2> . m . . . . : . . . s.- a ^i y, 'o r n x f ry �r v �x i F ra 3^. 20 - - - - - - - - - - - - - - - I -F I � I � I " I . I I � CM I 00 I , I I I _ I I I I I I I - I I GARAGE _ I _ OM — — — — — — - — — — — — — — — - — — — — — — — — — ce) I I I I I I I � I I B' I I I I I � � I I I I l u I I I I I I I •� i I I I I I I I I I 3 / 2 i 3 - - - - - - - - Y- - - - - - - - € - - - - - - - - � - !- - 24' 064�� - 1 V4 _*4�� a1657 1� - S V 3 i t 'N r. 3 3 i 3 � q ,"� ;T Y. ��� ✓ � bra �= Z '4 a 8 r � f „ , R 02-41 MA Alm I IA 4 0`'�� � \•, a � �' -�„����.'q �,�: �\\\� `....a3 mod.. �,,. s n. Y > l x. �y 20 z lag *�3 a k .: \• ' \ �-,r- .3�...._A: �:. ... .. ......... < ,.::.. .�.,..... .,n d” ....., .. ., d,. �L °tea ,,, Cliff - AIR NEW 136 n 0 IS Cot�C_. Jt a C� 41 Co-To 1T Mfg`'`' PFZE.PAfz-ED FOfz.� � i 1 za aArc: 13 1 E3AP-tOZTABL.: ASSES=oF r�AF� 24 LO 3 2' s�EL'EBY CeA-7- . T/•✓AT 7-",g 45!1/4-.01A a- S"<l >WAJ CPA./ 71/-//S L,OC,09 TE`L) O� } LFa vL> sc/AFVAR 0.W3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION lY �. Map 7 /Parcel—__e0 � �� � L= ,,' ��€- Application# Health Division s°` -` j t r7 j, f�U Conservation Division Permit# Tax Collector - Date Issued /,0 Treasurer Application Fee lot C)o Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address -goal- Village OwnerD �z/�/�/ /� /�i "li Address L Telephone 0 Rerrnit-Request ois � s Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .'!�->OZIO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family L" Two Family ❑ Multi-Family(#units) Age of Existing Structure oat Historic House: ❑Yes O'�lo 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: E Gas ❑Oil ❑ Electric ❑Other r Central Air: ❑Yes &No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:UY'existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:&existing ❑new size Other: v Zoning Board of Appeals Authorization a0 Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# ` R Current Use Proposed Use BUILDER INFORMATION Nam ,C> Telephone.Number Address 7 License# v Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS—RESU[TING FROM I&P.R%ECTWILL BETAKEN TO P.L� SIGN RE r - ATE c FOR OFFICIAL USE ONLY jl P,FRMIT NO. DATE ISSUED ' MAP/PARCEL NO. ADDRESS' VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ?S INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROLW=JJ FINAL FINAL BUILDIN DATE CLOSED OUT , 9 ASSOCIATION PLAN NO. The Commonwealth ofMassachusetts Department of Industrial Accidents Office of Investigations 600Washington Street ' Boston, MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Pluamlbers Applicant Information Please Print Legibly Name (Business/organizationm&vidu4: %�. %(�Z Address: � _l�/�'�� ✓ 21� v City/State/Zip: • 0..?6/Z Phone#: Are you as employer? Check the appropriate bog: Type of project(required): 1,❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees (fall and/or part tone).'" have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 7. ❑ Remodeling ship and have no employees These sub-contractors have s: ❑ Demolition worldng for me in any capacity. workers' comp,insurance. g, ❑ Building addition [No workers' comp,insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repaizs o$ additions I am a homeowner doing all work right of exemption per MGL l l.❑ Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t , employees.(No workers' 13.❑ Other warp.insurance required.] *Any applicant that checks box#1 mast also fill out the section below ahowing their workers'oompensation policy information: ` t Homeowners who subarit this affidavit indicating they are doing all work and then hire outside c =motors must submit anew affidavit mdicatfxig such- iCon h actors that check this boa must attached an additional sheet showing the name of the subcontractors and(heir workers'comp.policy information. ram an employer that Is providing workers'compensation Insurance for-my employees. Below is the policy and job s& - informadox Insurance Company Name: Policy#or Self-ni.Lic.#: Expiration Date: Job Site Address: City/Statetz* Attach a copy of the workers' compensation paticy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL a 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.90 and/or one-year inrpriso�ent,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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify ,� t pains nd 'es of perjury that the information provided above is true and correct Si ature: Date: Phone#: Offlcial use only. Do notgUt ie in ihb area,to be completed by city or town ofciat City or Town: PermitMeense# Issuing Authority(circle one): 1.Board of Health 3.Building Department. 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector•- 6. Mer. Contact Person: Phone#: Iuformation and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. t pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,.6i-A 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 bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or permit to operate a business or to construct buildings in the commonwealth for any of a license or nit renewalP applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additianally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work unto acceptable evidence of conz�liance 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-contractors)name(s),addresses)and phone=nber(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 Depariment 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 member listed below. Self-insured companies diaCd enter their self-insurance license number on-the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of lale affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sine to fill in the permit/license number which will be used as a reference number. In addition,an applicant That most submit multiple pmmitllicense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job.Site Address"the applicant should write"all locations in. - (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that.a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit notrelated 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 Brine of InvfAlgatms 600 Washington Street Boston, MA 02111 Tel. t#617-727-4900 ext 406 or 1 o77-MASSAFL ' Far.:#617-727-7749 Revised 5-26-05 WW-w.M&s5.aov/dia a Town of Barnstable Regulatory Services BAMMass I'E'g' Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-8624038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ,� r Type of Work: �X/C/ i /Z Estimated Cost Address of Work:_ Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied c❑6wner pulling ownpermit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registratio o. OR Date Owner's Name Qhmis.homeaffidav v�F tHE royy Town of Barnstable Regulatory Services vMASS..I'E� Thomas F.Geiler,Director 1,639. APED MA� Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Mier Must Complete and Sign This Section If Using A Builder 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) Signature of er Date Print Name Q TORM&OWNERPERMISSION DFTHE 1p� Town of Barnstable Regulatory Services BAMSTABLE. Thomas F.Geiler,Director 9 MASS. g 039• Building Division �prfD MA'1 A Tom Perry,Building Commissioner 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: �4 1✓' 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable-Building Department minimum ins ection procedur s and requirements and that he/she will comply with said procedures and require Signature of Homeown Approval of Buil ing 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 t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt `1!X/`rCT� Vj � c c vt ' 1 S �r fir, f-1 i 0 Lif ,t q C or • � 1�1) 44 7I-Or,IVL VL J � � AZ PARCEL 3 SLOT` PP.EF'.AP ED FOP-' L0004 1T' Mf)SS• 4 2 A tom! Il2EFE,e -A.ICEs ' BFtt�N NTA BLE AS.�.ES:�o�S ' M:A E� # 24 f6�Rti' ,v ./4.p p4 S/ 2' /-1G`GESy CEGT/FY. T/-N�4T T.�JE, alJ/La/.VG S•ANON/.C/ O.V 40GO47-Ga CW- "WI. 4ca may`:* �Y: +; -•,� r _ SMMA� Great ideas. Great results. G�EaYeat 3415 t 4� 1615oe � 4 ---- - - 1 f f1� r 4 t: 3''�/ ; s Vie. i I r 1 I .. i 1 i 4 i i 1 .. + i I� I{J l I -- - - — I , [ !, / --4 — — — — — ---- _ — — — — - 1000 Massachusetts Avenue,Cal Massachusetts 02138 Tel 617.547.5400 Fax 354,5758 wwwsmma.COM n Town of Barnstable Regulatory Services e'M _ Thomas F.Geiler,Director p s639. �,e Building Division Thomas Perry,CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: M C C—L Map/Parcel- 02 '1 003 Project Address 38 S4P4)'9(-.WdCA A Builder: r/nA C-r. The following items were noted on reviewing: r1E�vc �bope u 5 E _ � II 3WIA)C- Of Zooms Cop- 'b06"Z's, Reviewed by: Date: • r Q:Forms:Plnrvw �s Town of Barnstable *Permit# Expires 6 months front issue date 3' Regulatory Services - Fee 00 * BAIMSrABLE.. v�A 1 ESS PERMITIomas F. Geiler,Director lEU INA'� NOV 2 1 `200B Bultlding Division Tom Perry,CBO, Building Commissioner TOWN OF BARNST O 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 s .. residential Value of Work Minimum fee of$25.00 for work under,$6000.00 Owner's Name&Address ems 4 - Contractor's Name Sk✓t- elephone Number 6S"Jj Home Improvement Contractor License#(if applicable) A;� Construction Supervisor's License#(if applicable) ro S ❑Workman's Compensation Insurance . Check one: 2�1 am a sole proprietor,. 0 I am the Homeowner ❑ I have Worker's Compensation.Insurance Insurance Company Name Workman's Comp.Policy# Copy of.Insurance Compliance Certificate must accompany each permit. Permit Request(check box) El Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re=roof(not stripping. Going over existing layers of.roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value. (maximum .44); tWhere required: Issuance of this permit does not exempt compliance with other town department.regulations,i,e,Historic,Conservation,etc. ***Note: Property Owner,must sign Property.Owner Letter of Permission: A.eopy of the Home Improvement Contractors License is required: SIGNATURE: QAWPFILESTORNIMbuilding permit formsTXPRESS.doc Revised 100608 4 CONTRACTORS INVOICE 41 WORK PERFORMED AT: -ro nd DATE:' YOUR WORK ORDER,NO, OUR 81D..N0. t• 00 All Material is guaranteed to be as specified;and the above work was performed in accordance with the drawings:and specifications provided for the above work and was completed in a substantial workmanlike manner for the agreed sum.of Dollars.($ This is a ❑ Partial ❑ Full invoice due and payable by: Month Day Year in accordance with our ❑Agreement ❑Proposal No. Dated Month Day Year - ICI\a ■��+w /V�4vA i'Y?� BSa C //YO/'a B"` - istration valid for individul use only License or reg date. if found retarn to: • �(alio1a i fAerds e � ,ng egu a before the expiration'' ❑jations and Standards Boar o T CONTRACTOR Board of Building Reg loci HOME IMpROVEMEN One Ashburton Place Rm Tr# 275279Boston,.Ma.02108 Registration; 109728 Expiration 912412010 Br e p ' ••'. r �TYP BAD ;t g REMOD•ELING SHAPIRO BUILDING , j ;. �thout signature N SHAPIRO`- I. J Not valid w STEVE.. 4 Deer Ridge Rd l '. Administrator MASHPEE,MA 02649 o wl . P � anv�o�,wecslt! a��i2�ga�� '_ r' Board of Bwlding Regulations and Standards` 3 j i:Construction Supervisor License I License GCS`' 'S6965 l Birthdate 12/29/1955 s � ^ IExpiration 12/29%2008 Tit 6899 [ 1 Restriction' STEVEN M SHAPIRppO Y 4 DEER RIDGE r MASH OE' E,'MA 02649 i j, Commissioner fqq' i s Y y I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations a 600 Washington Street Boston, MA_02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumb, Applicant Information Please Print LeIibly Name (Business/Organization/Individual): Sle.v,�, ,��� if c �/P_7J� �dir�i <v ,i� o �! Address: /V .emsi�%G City/State/Zip:; ��h®�� /nGe Phone.#: ram ' 7�s- 3— Are you an employer? Check the appropriate box: Type of project(required): 1.ElI am a employer with 4. ❑ I am a general contractor.and I 6. New construction employees(full and/or part=tim.e).* have hired the sub-contractors 221 I am a sole proprietor or`partner listed on the attached sheet. '7_0 Remodeling ship and have no employees: These sub-contractors have g• ❑Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers-comp.msurance comp. utsurance. - ❑ g . required.] 5. ❑` We are a corporation and its 10.❑.Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs ._ insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.[IrOther G�iH/c ems/.cG�o comp, insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating`such. lContractors 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: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date)., Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of.a fine up to$1,500.00 and/or one-year 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 statemerit maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify under the pains and penalties ofperjury that the information provided above is true and correct~ Signature ��'��—� � `--->` Date: 1l Jz o�m� Phone#• 7 Official use only.-Do not write in this area,to be completed by.city or town officiaG Cit 'or'Town: Permit/License# y Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector .5.Plumbing Inspector 6.Other . Contact Person: Phone#: Information and Instrncton 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." . ed as"an individual,partnership,association,corporation or other legal entity, or any two.or more An employer is defin of the foregoing engaged in a.joint enterprise,.and including the legal representatives of a deceased employer;or tlie- 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 9lr_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 overage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of ,.,. Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line: City or.Town Officials. Please be sure that the affidavit is completezand printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in__(city or town)."..A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the. applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA.02111 Tel. #617-727-4 OQ ext°406 or 1-977-M�1SSAEE Fax#_617-727-774 Revised 11-22-06 www.mass.gov/dia Town of Barnstable Regulatory Services Thomas F.Geiler,Director • Building Division • saiwsrwBte y sswes. �* Tom Perry,Building Commissioner �i°rEp s tee 200 Main Street, Hyannis,MA 02601 Office: 508-.862-4038 Fax: 508-79076230 Approved: Pee: , Permit#: U SS i(2 HOME OCCUPATION REGISTRATION Date Name: �/� //G%LC N /� Phone#: Address: /)4 Name of Business: Type of Business: �/ G = Map/Lot: O?V/,-�yp � /r i� �\ INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual.alteration to the R premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. 1 After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: V1 • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space: • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. \ " • No traffic will be generated in excess of normal residential volumes. \� (\ • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,' 111 1 odors,electrical disturbance,heat,glare,humidity or other objectionable effects. o There is no"storage•or:use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. a Any need for parking generated by such use shall be met.on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • .There is no commercial vehicles related to the Customary Home Occult L,,Athgr than one van or one pickup-tmek-not-=to,exceed,oue ton capacity,and one trailer n"`to o e --e�`et`-in le�agth d not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. . 4 � �r shall not be • If the Customary Home Occupation is fisted or advertised as a�'b'�si{es�.,the wtr�e�Jff r1'U� included. • No person shall be employed the Customary Home Occup i� 1}o is oft a permanent resident of the dwelling uni '` tj► 1 1,. t .. I,the undersigned,ha and the above restrictions for my home occupation I am registering. Applicant' Date: /d YOU WISH TO OPEN A BUSINESS? For Your Information: Business Certificates (cost $30.00 for 4 years.) A Business Certificate ONLY.REGISTERS YOUR NAME in town which u - --( you must do by M.G.I. it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1st FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required.by law. Fill in please: Date: ,> APPLICANT'S NAME: YOUR HOME /ADDRESS : %/J�• fC �� �.,,, .s �� �, ICJ/riLL/ i���L �j �.�_�,✓i/�� _ LLC�� i BUSINESS TELEPHONE # HOME TELELPHONE #: NAME OF NEW BUSINESS` ' '`'` TYPE OF BUSINESS �:c� f— ,� ✓ IS THIS A.HOME OCCUPATION? YES NO ADDRESS OF BUSINESS �i7�/ MAP/PARCEL NUMBER �qX--) (Assessing) When starting a new business there are several things you must do to be in compliance with the rules and regulations of the Town of Barnstable_ This form is to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth Rd. _ & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business injown. MUST COMPLY WITH HOME OCCUPATION 1. BUILDING Crual SS' ER'S OFFICE RULES AND REGULATIONS.. FAILURE TO r This indivi e�A i f r d f y permit requirements that pertain to this type of busine MPLY MAY RESULT IN FINES. >` Authorizeil Sig ure** COMMENTS:. � L. a k4ou rkA — 2. OARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: PERMIT PAYMENT RECEIPT 0/1 TOWN OF BARNS1 F t BUILDING DEPARTM1,� ' 2C0' MAIN STREE' HYANNIS, MA 01L*b!j OAT 10/20/08 TIM 09:21 - __ -------------TOTALS------- PER,IT $ PAID 25.00 AM JTENOERED: 25.00 AMT APPLIED: 25.00 CHA E: s 00 "APP ICATION NUMBER: 200805816 PAYINT METH: CASH PAYM.NT REF: Town of Barnstable *Permit# _�56 0-7 V7(P Expires 6 months from issue date. Regulatory Services Fee i �U Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner ^^ 200 Main Street,Hyannis,MA 02601 rH" 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 '-' ® � 4 Property Address �-/Q r� -C' l'I �"j 6 3 [Residential Value of Work V Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address v�l -� f�- cJ -Q- Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) CS. T 4 6l0 Oworkman's Compensation Insurance �� sS PERMIT Cheel one: ❑ I am a sole proprietor DEC _ 3 2007 ❑ I am the Homeowner ZI have Worker's Compensation Insurance TOWN OF BARNSi'AFjLE ` Insurance Company Name T 6- q_,11 MO Workman's Comp.Policy# O S J O L 3,5 6 Copy of Insurance Compliance Certificate must be on file. i Permit Request(check box) g-Re-roof(stripping old shingles) All construction debris will be taken to y ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town deparftnt-regulations;i e:;Idistoric,Conservation,etc. $ ***Note: Property Owner must sign Property Owner Letter of Permission, A copy of the Home Improvement Contractors License is required SIGNATURE: Q:Forms:expmtrg Revise061306 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): FRf}sEc �10/y-,-,T LU_L' t I Q A) Address: *_P0 26 City/State/Zip: (2 d�,U � -� / � OZ3_. Phone #: Are you an employer? Check the appropriate box: Type of project(required): 1.E3"I am a employer with__7> _ 4. ❑ I am a general contractor and I * have hired the sub-contractors 6. ❑New construction employees(full and/or part-time). . 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance. 9. ❑ Building addition re required.] 5. ❑ 10.We are a corporation and its ❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additions myself. o work ' right of exemption per MGL y � workers' comp. 12.4Roof repairs insurance required.] t c. 152, §1(4), and we have no 13.❑ Other employees. [No workers' comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit 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: N 74-PTL�F—y (� Policy#or Self-ins. Lic.#: Q g 5 0 L 3 S 50�- Expiration Date: Job Site Address: C��c h� ` City/State/Zip: C<)t .A l9' ' 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 25N 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 certi er the ains and hies of perjury that the information provided above is true and correct. Si /Signature: Date: - 3 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#: Board R� �a�®� One AshbOf '®n dace ® Standards 13®��®n4 Mas ac Place Room 1301 � Moms hnpr®v� en , hu�et� 0210g � o °actor Registration ERASER CONS Ragis�ation: 11253s ER CT C o DEAN®�� �� ��� ®. Expira#�ran: 3� C®T[.ldl' 9��� � Zoos 727szo � 9 MA 02636 . DP&CA7 to 50M-OS/pB-PC8490 ` - - G� ll - -- - r Update Address and return a� —• ❑ Ad dress Q Renewal arIL Afark re -Hoard®f lsUpdg�eg�elati®ns and _ -__ - ❑ mpflo3'�ent m®n for change. AIIIE HO 111A� Standards [].]Lost Card _ MEflI'T ._ C®flfCT®R License or regis�ti ��istratdaee: 3'12536 before the d for jul ftpiatic in: � muc mm date. use®u 09 hoard of RaU� •Zffound retuM to: op Te# 927s2o One Ashb g p-�ations and ERASER COIVSTRI► ]6osto mm omm Race�ffi 1301Standards* ,. CT IOiIV�o.y .j� Z Pa,02108 DEAN FRASER 4556 RT 28 COTUIT,MA 02635-. - Not d .out eignat m - i .........::.�:::.:�::::.:;::�:.:�.�:::::•::::::.�:::::�:..:::.:.:::.::: .:.:�'::::.�::.:.::•>::::::::>:;<•;:.:�::::.:;;->::-;:.:::::.�::::;:::•::;:->:.:':::.�:;.::::;-:. DATE M .::. onucER THIS CERTIFICATE:I ISSU10-15-07 ED AS A MATER OF INFORMATION WISE & QUINN INS AGCY ONLY AND CONFERS NO RIGHTS T UPON THE CERTIFICATE 449 PLEASANT ST HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 24 CWC B MA 02301 COMPANY COMPANIES AFFORDING COVERAGE INSURED A HARTFORD UNDERWRITERS INSURANCE COMPANY FRASER CONSTRUCTION LLC COMPANY PO BOX 1845 B COTUIT MA 02635 COMPANY C COMPANY THISIS TO CERTIFY :.:.::.::::::;;•.::.::_::;::..:>;:;.;:::::. .::::::;:.;::.;':::.:; ::.:.:.;;':::::::;:.:.;:•:.:.;>:::::::.:::.:::::::::::::.......... THAT THE PO .........::.:;:.:.:.;;•;:.:;;-:;;.;;-;:-,;•>:;:-:;:.....::.:.:::::.:...::.::::-::.:;.:;; :.:;:.:.;;;:.;;•;;:;.::.;;:::;:.::.>:.:.::.:.:;:::.;:.::::.:.::::::. INDICATED, LICIES OF INSURANCE ::................:.::.:.......:::.....;:::>::::»>::>;::>;::»::.;; NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCU D. CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BYE HE POLICIES DESCRN ISSUED TO THE SBED HEREIN ABOVE FORRESPECT POLICY PERIOD EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,DOCUMENT WITH RESPECT TO WHICH THIS EIN IS SUBJECT TO ALL THE TERMS, CO TYPE OF INSURANCE LTR POUCi NUMBER POLICY EFFECTIVE POUCY EXPIRATION GENERAL LIABILITY DATE(MMWDX" DATE(MMWD\yY) LIMITS COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ CLAIMS MADE OCCUR. PRODUCTS-COMP/OP AGG. $ OWNER'S&CONTRACTOR'S PROT. PERSONAL&ADV.INJURY $ EACH OCCURRENCE $ FIRE DAMAGE(Any one fire) $ LIABIUT AUTOMOBILE y MED.EXPENSE(Any one Person) $ ANY AUTO COMBINED SINGLE ALL OWNED AUTOS LIMIT $ SCHEDULED AUTOS BODILY INJURY HIRED AUTOS (Per Person) $ NON-OWNED AUTOS BODILY INJURY (PerAccldent) , $ GARAGE LIABILITY PROPERTY DAMAGE $ ANY AUTO AUTO ONLY-EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ EXCESS LIABILITY AGGREGATE $ UMBRELLA FORM EACH OCCURRENCE $ OTHER THAN UMBRELLA FORM AGGREGATE $ A WORKER'S COMPENSATION AND EMPLOVER'SL"IUnr (6S60UB-0850L35-5-07 "• THEPROPRIEfOR/ ) 09-26-07 09-26-08 3TATUTORYUMITSPAR s ""'" OFFICERS TIVE INCL EACH ACCIDENT $ OFFICERS ARE: )( EXCL DISEASE-POLCY LIMIT OTHER $ DISEASE-EACH EMPLOYEE $ 50 000 )ESCRIPTIOPo OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS THLS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CER ,... - „ .- AFFECTING WORKER COMP COVERAGE. SHOULD ANy OF T}IE AgpyE DESCRIBED POLICIES BE.CANCELLED BEFORE THE �IIIATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ERASER ENTERPRISES LLC 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE i PO BOX 1845 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SMALL IMPOSE NO OBLIGATION OR OTU I T MA 02635 LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTA !d/ M�M�::��}g1¢.ii::ii::i::::sitii::::iryii:::ism?:iii::::i}}:ii:i::{iiii??;?is isis�:iY.�:isi:::?i:�:`iiiii:.iiiii:::::::.•:n�:.......... .•�.......•`.::::.�::.ii:.iiiiiiii}i i:ti�ii•i::i•i:�i}ii i_:.ii:^:•ii::j':ti•i:{.:viii':<•i::.i:::iiiiiii::•:4i:ii:.iii:iiii::i i:Jr::.:i:::iJ:'riiiiii.i:::::::::.:.::............ r.........::::::.�.�:is}i:;Li{:�i::i::iji�:::i::::i::::::::::i:::::i:::::i�:?':::::::i::::::::i:;i::::i::;::?���.?�{::i:{��::::y^�"is�:':�� .::::.�;::>:::::::i'��:::�i::��;��.���%..•�.������.�::�i(..i:i�?:�:�..::.��.:}���'�.��'•.'::"'i'!.:�i:i}�ti`::.:::.�ii::i:.:::::{.+i::.:.vi:n?iiii::i: - Q6ONSTRUCTION Fraser C®nIJtruct0no 0:4111 Roofing & Siding Specialists • P.O. Box 1845, Cotuit MA. 02635 508-428-2292 Email: fraser construction@verizon.net www.fraserroofing.com Phone 1-508-428-2292 & FAX 1-508-428-0123 RE-ROOFING PROPOSAL PARTIAL MAIN & SHIED DATE: September 14, 2007 PHONE: H 508-428-5914 NAME: Robert Miceli PHONE: C 508-776-9290 MAIL ADDRESS: same JOB ADDRESS: 38 Sandlewood Dr. Cotuit, MA 02635 FRASER CONSTRUCTION hereby proposes to perform the following services in a neat and professional like manner and in accordance with the manufacturer's specifications and local building code. -Remove and Haul away all of the old roofing material -Re-nail all plywood sheathing as needed. Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE AR 30: 30 - Year Warranty, 5 year Sure Start Protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10 Year Warranty against ALGAE Containment. 5 year 70 mph wind= resistance warranty or 5 year 80 mph wind-resistance warranty available with six nails in common bond area, for an additional cost. See actual wary or specific details and limitations. Color: Weathered Wood PRICE- $6,825 Initi 1 Color for main & shed to match garage CertainTeed Landmark Weathere Supply and Install - CERTAINTEED LANDMARK /WOODSCAPE PREMIUM: Lifetime Warranty, 10 year sure start protection, CLASS A FIRE RATED, ALGAE Resistant, Extra Heavy Weight, Self Sealing, Multi-Layered, Laminated Architectural Style, Fiberglass Based Asphalt Shingle with New England's Exclusive COPPER/CERAMIC Stones with a Full 10-year Warranty against ALGAE Containment. 10 year 90 mph wind-resistance warranty or 10 year 110 mph wind -resistance warranty available with six nails in common bond area. See actual warranty for specific details and limitations. Color: Weathered Wood PRICE- $8,085 Initial Color for main & shed to match garage CertainTeed Landmark Weathered Wood i 9upp1Y & Install - CertainTeed Winter Guard: (ice 8v water shield) Waterproof Underlayment System (3ft. on eves and valleys, 18" on rakes, walls, and skylights) Supply & Install - Roofer's Select Underlayment Paper (as recommended by CertainTeed) Supply & Install - Kick's Ventilated Drip Edge or 8" Aluminum Drip Edge Supply & Install - Aluminum & Neoprene Soil Pipe Flashing Supply & Install-Air Vent Ridge Vent (as recommended by CertainTeed) Clean & Remove - Debris from work area daily. TOTAL INVESTMENT: Price is for main & shed LANDMARK/WOODSCAPE AR 30 - $6,825 LANDMARK/WOODSCAPE PREMIUM - $8,085 Replace Fascia on main (not addition) with Koma 1x6 PRICE- $995 Initial All other trim work will be billed at time & material. We bill out @ $50 per man hour and with a 20% markup on materials. Initial I have asked Glenn from Gutter Pro to contact you about your gutter work. *4 Star Warranty Upgrade will be applied if proposal is signed and returned within 10 days. (see enclosed brochure) Payable immediately upon completion --low NO MONEY DOWN-_NO Payment at the start or part way thru Payments accepted are: CASH - CHECK- MASTERCARD -VISA-AMERICAN EXPRESS *Any payments not made within 30 days of completion will be charged 18%for every 30 days the payment is late. Possible Extra -After the shingles are removed from the roof, we will lift one sheet of plywood to make sure that the insulation is not up against the plywood sheathing preventing ventilation from the eaves to the ridge. If it is, ventilation panels will be installed by; removing the plywood sheathing, installing the panels, turning the plywood over and then re-installing the plywood. If needed, this would be charged for as an extra at the rate of$4.00 per panel including Materials & Labor. There are 6 Panels per sheet of plywood. I i f i Possible Extra -Any rotted or otherwise deteriorated trim boards, plywood sheathing, lead flashing, or other carpentry needing replacement will be done and charged for as an extra at the rate of$50.00 per hour, plus materials, plus 20% overhead mark-up on total extras. FRASER CONSTRUCTION Warranties the labor for 12 years FRASER CONSTRUCTION Warranties the shingles against Blow-Offs for 10 years. CERTAINTEED Warranties the shingles and labor 100% through the Sure Start Warranty duration. CERTAINTEED Warranties the shingles to be ALGAE resistant for the duration of the Sure Start Warranty depending on the shingle that was purchased. Any deviation or alteration from above specification will be executed upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays are beyond our control. Owner should carry fire, tornado and other necessary insurance upon the above work. We, if not accepted within thirty days may withdraw this proposal. FRASER CONSTRUCTION: Carries Workman's Compensation and Public Liability Insurance on the above work, certificate available upon request. DATE OF ACCEPTANCE: omeo er Fraser Construction r . 1. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# .. Health Division + _ Date Issued —b hat Conservation,Division ���/t�C� Fee 0 0 Tax Collector Treasurer , SEPTIC SYSTEM MUST BE t INSTALLED IN CO ItiPLIAI Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE A140 TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address .�a� l�; ,� �� J �Ii�.or/���n' d' Village eezL f Owner �c��-7` _%r�✓� i Address Telephone '-:�Vk— SI,2- �621� Permit Request /I6, Fr.� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation ( •� Zoning District Flood Plain Groundwater Overlay 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 kNo On Old King's Highway: O Yes O No Basement Type: XFull ❑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 O Other Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: &JYes ❑ No Detached garage:O 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 kNo If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License,#. Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE Q� • FOR OFFICIAL USE ONLY - PERMIT NO. DATE ISSUED-' « ram= MAP/PARCEL NO. r y ADDRESS VILLAGE OWNER 1 r DATE OF INSPECTION; FOUNDATION r ` FRAME / .. •` i r � � � �' . : r~, INSULATION. FIREPLACEy ' s' ,Yt c r ELECTRICAL: ROUGH« FINAL I PLUMBING: ROUGH, ``: . -= FINAL GAS: `. ROUGH, ` ` ` .» FINAL y "sue :"� f,'�-, � _ ,. • 4 - - '. FINAL BUILDING DATE CLOSED"OUT ASSOCIATION PLAN NO. ' GF 1HE Tp� ti The Town of Barnstable„ S."�. , able "ASS 9. ���' Regulatory Services rEo �° Thomas F. Geiler, Director ' ' Building Division Ralph Crossen, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Faxf 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION w MGL c. 142A requires that the`reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied building containing at_least one but not more-than-four dwelling.units or to structures which are adjacent to - - uch residence;or..building be done-by registered contractors,with certain exceptions,along with other requirements. _._. Type of Work: _ �� Estimated Cost Address of Work: �41 A/w, 11/0Wj� Owner's Name: / deb Z,l- d Date of Application: r.EJf JdTU s I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 ❑Bui ing not owner-occupied L-46wner pulling own permit Notice is hereby given that: �.n.. _..:-_OWNERS,P,ULLING.THEIR_OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME-IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Da a Owner's q:forms:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents r'r -" == Olfrce oflmrestigatloos 11� _-_�_== 600 Washington Street F—=ftF Boston,Mass. 02111 Workers Compensation insurance Affidavit name locan= city &I ',` atone I am a homeowner performing all work myself. I am a sole proprietor and have no one-working'in-an<► acity _.. , I am an emplover providing workers' compensation for my employees working on this job. comnnnv name: address:a -- city insurance cn. I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below v,no have the iolloning workers' compensation polices: :::•.::.:... ...: name: - comvanv - .....;:::::... .. ..:...:: ::... ...:: ...::. . . ........:.... . ..... ........:. . :.: . hone: ;.::::;;:.;:::>;:: :>:.::.;::::..:;.; .... .::.:: icy :<oI' insur-Tice co. .::.............:..:, ............... camnanv name: ::... :;:;•:::::. address: -- : .: d tv .. atone#c::- ::: :... nsttrgncc ctt — :., Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine Tip to SI,500.00 and/or one years'imprisonment as well as civil penalties is the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded.to the OMce of Investigations of theDIA for coverage verification I do hercnv certify un paints an 'peImserjury that the information provided above is trnu and correct Si_cnature Date - Print name Adz � Phone# Sl „l1lcial use only do not write in this area to be completed by city or town official permit/license# ❑Building Department cite or town: ❑I,lcensing Board ❑Selectmen's Office 7 check if immedisu response is required E3Heaith Department Other_ contact person: phone#• ❑ 3' ."e A Information and Instructions . 25 requires all employers to provide workers' compensation for their Massachusetts General Laws chapter 152 section employees. As quoted from the"law",an ernpl°Yw is defined as every person in the service of another under any corto:�-of hire, express or implied, oral or written- An employer is defined as as individual,partnership, association, corporation or other legal entity, or any two or more of is a joint enterprise,and including the legal representatives of a deceased employer, or the reserve= the foregoing engagedj to to ees. However the owner of a trustee of an individual,partnership, association or other legal entity, emp yip�P Y dwelling house having not more than three ap ar=cnts and who resides;therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction.or repair work an such dwelling house or on the grounds building appurtenant thereto shall not because of such employment be deemed to be an employer. 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renev MGL chapter in - y p.p of a license or permit to operate a business onto=construct btaildi49 F-4- commonwealth for.an -.a n1kcnnn the- not produced acceptable evidence of compliance with the insurance coverage required. Additionally, p ._. saber into,aay contract for the performance afpublrc wonc. commonwealth nor any of its political subdivisions Have.been presented to the co^ acceptable evidence of compliance with the insurance of this chapter. authority. Applicants box that applies to.your.situation and.. ` Please fill in the workers' compensation aff lavit;coma�pl telY,by chec nog .,h, _. address and phone numbers ang�vath--a-cestificate,0 :insurance as all affidavrts:maY e supplying company names, - e: :-Also-be sure to sip,and gA' submitted to the Department of-Industaai � op Hof insurance co"erag - -t be rc=ned to the city.or_town that_tl�e_aPPhcation for the pe*arst or license is date the affidavit. The affidavitshould - _._..- Should have any_,quesaans regarding being requested,not the Departrneat aIndustoal•Ac -Y - �, the.claw"or yc- -artment:attl e:m•berlist. b are required to obtain`a workers' cow �PolicS',Pleaso- the`DeQ SEA NS _ .. ...... City or Towns ... ` legibly. .. i The Department has provided a space at the bottom of t Please be sure that the affidavit is complete and printed leggy y. . the 1*cant. Please affidavit for you to fill out in the event the Office of Imesti :has-to.cow°You ', ' member The affiidavits maybe zeturned t- en�cense member which will be used as.a refeienc_e, - _ - be sore to fill in the p have been made• the Department by mail or FAX unless other ons would ble to thank you in advance for you cooperation and should you have any questions- The Office of Investigati please do not hesitate to give us a crWL W// FIN FNNIIKEEEER�, The Department's address,telephone and fax member. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of lavesugatlons 600 Washington Street - Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 ISM S �r P9 d u) 49 / v i � G` '71.o r irj 3 S 1 !I 4>7 CcoTc�1T M�c� PP.EPAP-FD Fo P-: -L oc.4Tio.cf.'_ L M A k H O 4.AfzQ TAENLS AS MAF # a4 ! ' LoT, 3 fok9 ti a6w.L.-/49 Py. S/ y • SHO^141 Oil/ 7 A-I/S PLXi /S LOCofTLaZ> OTC/ THE "f.�,�g . E i z Ig « i , i s P/ « t I I 4 id � I �_._ __._. _. _. V` _ . s___ --as'-a�..a�n � -_.v.. Y-c-_.�- _,.�.��-t ..._-ter m __ � .-_. �-� _ __ • - 1 s -._._-.-�;....-.—.._�,�- .�-- �.�.____�c-sQ--a_.n---_._s._:.�._.�.�__._.:•�._ �� __ __ - ._- .-_� _ rs:t__a.i_.. �- -. - ��r—c-:: _._.. : ��---- _---_.ti�,��. - --•-�_4-� _v+�ss t.�-__ - �.r.+e�.�i---asp �.r-s.. __. _ a-�•.- �.�c � -^ ____..__---�__..�r-.ar_-�.__�_�a::_.� � --^-. __rya_. _ ..- _-._�=-•:..- -_ ®s..�=-s:--^�- _.� The Town of Barnstable 1HE r, do Department of Health Safety and Environmental Services Building Division BAENSPABLE. * 367 Main Street,Hyannis MA 02601 mass. 1639. ArFp MPS a Y Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: �� �Ct�2Gz2�G�'� L�cJT�s1s numm&r $ street village "HOMEOWNER": /IC1 , ✓ name home phone# ` work phone# CURRENT MAILING ADDRESS: irl1!'7 P 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,provide d 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 ---=fatt-strtctures:=A person who_coristruets-more-than one=home m=a wo-year_periodshall.not_be_considered - a homeowner. Such h"homeowner"shall-ifib riit-fo 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 - Departmen urt spection procedures grid requirements and that he/she will comply with said proce and r ements. Signature of m owner k , 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. Q:FORMS:EXEMPTN -ab'V"-ik""IV A"! .. � Assessor's office Ost floor): D ® j�.. tt• pF T11E T� Assessor's map-and lot number '...... ..49.1. ..................... Q� �♦ Board of Health (3rd floor): Sewage Permit number ........ ` 5 Y...................... .............. Z BAfld4T11DLE. i Engineering Department (3rd floor): /� 'oo 03}9 ♦� House number .......TL:?..°� a` .............................. ....... ...... p YFY Definitive Plan Approved by Planning Board ________________________________19________ . APPLICATIONS PROCESSED 8:30-9:30 A.M, and 1:00-2:00 P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR , =�- APPLICATION FOR PERMIT TO � � .� �PGI.......... •..1.-. ......./.- ... ........................................................................... TYPEOF CONSTRUCTION ............... . ...... .1. .f..................................................................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: / Location ........... /�...... ...... .................................................... ...... ProposedUse S "1��.t.....................................::.................................................L................................................ ZoningDistrict ................��.........................................Fire District .................. l. ...................................... Name of Owner .. Pf .....r ................Address ..........3.7........ ...... ..... Nameof Builder .............................Address .......................1 -��.`'�1 ........................................ Nameof Architect ..................../v ...............................Address .......................f/ . ' .................................................... Numberof Rooms ......................'-:....../.................................Foundation .....................4//7............................................ ............... -C-CfGyG ................................................Roofin / j,C1. �'r Exterior g ........... .......................................�, Floors ..,..............e/r/{Jll�.....................................................Interior .................4. �................................................. Heating .........................:--1-/ .........................................Plumbing ..................... Fireplace .......................... .......................................Approximate Cost Area ... / �....•..�..X4 �T Diagram of Lot and Building with Dimensions Fee �.Z...W.................. /; i t , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby"agree to conform to all the Rules and Regulations of the Town o 7Barnstable rg/drding the above construction. Name ..�...o.. /..:. . ..... ............................... Construction Su ervisor's License .................................... r MICELI , ROBERT A=024-003 ` ,l/_ z -f - 063 No .,,32210 Permit for ...Build Shed Accessory to Dwelling Location 38 Sandalwood Drive .............................................................. Cotuit ............................................................................... Owner ....Robe.rt Miceli ............................................................. Type of Construction Frame ............................ Plot ............................ Lot ................................ Permit Granted ...August ...........19 88 Date of Inspection ....................................19 Date Completed ......................................19 F 1 , Assessor's office(1st Floor):' Assessor's map and lot number ��/ d O s �'� oT TH E rod o Board of Health(3rd floor): �l 2 d Sewage Permit number O� 1 Z Bsaa9rsnLL S Engineering Department(3rd floor): rnsa House number '639' \�0°j Definitive Plan Approved by Planning Board 19 °VAI APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE R BUILDING INSPECTOR APPLICATION FOR PERMIT TO eOt?,$riQ UC7— ¢ /S X�`� A olT•/OA/ ^ TYPE OF CONSTRUCTION Wo() ) T-/? sY/� /�k--7-0 8ZW- /,Z 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location - S,-,WZ7AV-- WZtD 1)Q .SbU TU/7— � 40- 36 Proposed Use /775D TU Zoning District ►• / Fire District CDT y/7— Name of Owner RD Af R.T M1 C e-f i Address .3.i ,W/cal D id• 31fA,,7-U17-ur..f, Z Name of Builder �e77" OAt// T2 Address Z30XZ9 S��ewms � Name of Architect Address Number of Rooms /6b-b .SPV04-- ZD 7WO Foundation Exteriorf C/� k'lY, h.irrl ,fie c✓r ,f�'MARoofing e���� Floors ZX/O 301l�7, �C'r Sara le-LUa•C Interior SNIT i��cr�G r Heating �' ��� W ?V h/z- Plumbing NI- Fireplace !1/4 Approximate Cost .5;Odv Area. Diagram of Lot and Building with Dimensions Fee (/i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. /J Name Construction Supervisor's License ��� MICELI , ROBERT A=024-003 No 33295 Permit For ADDITION Single Family Dwelling Location Lot #3 6, 38 Sandalwood Drive Santuit Owner Robert Miceli Type of Construction Frame Plot Lot Permit Granted October 18 , 19 8`3 Date of Inspection 19 Date Completed 19 Assessors map and lot number .'�r�� ...... ................... ` f Q�of THE T0� Sewage Permit number ........................................................ Z DAUSTAELE, i Housenumber ...:..................................................................... 90 rasa Oa�1639• ♦� 'E0M d TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO �L� L S1� �L C....................... ......... ........ ........... ! '............................................. TYPEOF CONSTRUCTION ..................................................................................................................................... .................. c .f�...........19...KY a � l TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............................:..........,................................................................................................................................................ ProposedUse .................................................................................................................................... Zoning District ........................�....................................... ...........Fire District ................................................ .. ...........................:.. Name of Owner .......................... ° ...`�.... �6419�Address .................................................................................... � Q, (;��9./. �� r.r Address ................................ . ..'.......:S:l.r.......Name of Builder ........... S ......... . :.. Nameof Architect ..................................................................Address ..............:........................................... Numberof Rooms ........:.........................................................Foundation ............................................................................... ......Roofin .......................... Floors ......................:................:..............................................Interior .................................................................................... Heating .......................Plumbing ...............................:. Fireplace ......................................................Approximate. Cost .................................................................... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area .................:........................ Diagram of Lot and .Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the To n of Barnstable egarding the above construction. / d A � . Name ............. ...... ............................................ Construction Supervisor's License .. .'. .. .... J. DALTON & C. Hr A=24-3 No .26502................ Permit for ..DEMOLISH DWELLING ..................... Sin gle.............. ....................... Location Lo.t..�§z.....Sandlewod-Drv(p........ .... .. ................... ....... Santuit ............................................................................... Owner .....Jt...Dalton...&...C-...H6ran................. Type of Construction ...FrE.VPP............................ ................................................................................ Plot ............................ Lot ........................ Permit Granted ....M.ay..2 9.1........................19 84 .. .... .... Date of Inspection .....................................1 9 Date Completed ......................................10 4zv lr +. Assessor's map and lot number ....� .. ......... .........a THE y Q�o Sewage Permit number ..J,.,T:,:.......::...:............. '� ..5`!.� i BARNSTABLE,�L 1i i House number - MAO& / O 1639• 9� a MPY a, { TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO e��Si1/SC.................. .....„ ..... s i < fl ( (�P �.�...........................TYPE OF CONSTRUCTION ................�.............................�......-.................. � ......................... ............... .�...........19... . o •, TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........./ `o /(�,. u o 0� . C 1 (... :. ....... ..... ................ ?............................................................ .................................................... ProposedUse ..........?Y,. ..•...................................................................................................................................................... ZoningDistrict ...........................................:............................Fire District .............................................................................. Name of. Owner r�l ...(./( P.A,rn ........Address �' �In <� Name of Builder � � .....Address ............V ........ ....::. Name of Architect C U �j� �- S L�`��,.' E ` ' �. ...............................Address ........... - ...... .................... .�............. �y /o o v I Numberof Rooms ..........:.......................:...............................Foundation ............. I............i/.:!....................:.............,......... P� t �rl h,,.�t l <P �J 4/-..Roofing .......f�..5��.'l/J.�.Z:•.................. Exterior :...............f �.!9........... ................... ...................: Floors2 '................/................................./......Islnterior ..... /"1w. .1..................................................... " Heating f /� �, .......: ........Plumbing ................................................................. ..... Fireplace ............. ..............................Approximate. Cost ................/1-1 .....................................—"7 r Definitive Plan Approved by Planning Board _______________________________19________. Area ...................................�1... Diagram of.Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ,A . 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS v I hereby agree to conform tojall the Rules and Regulations of the Town of B rnstable regarding the above construction. Name ..... .:. ..�. �. . ... ... ,......tip,. .. Construction Supervisor's License 6 .. � � cotuit Mark Horan Type of Construction ..Fr--aous---.'-----..—.. . � ----'------^--------^------'' ^ Plot ............................ Lot ......................... ' � ' July IO, 84 Permit Granted ........................................lg - ' � Date of Inspection ....................................lg ` Date Completed ------------'l9 ^ ' - . -- -�, / . ` ' ` ^ . ' ' . ^ . . . . , | | t """Assessor's map and lot numberA.............F...... .. 0/- 0`7N ero Sewage, Permit numberLL �P� �o IC SYSTbo House number. IN G f........................ TAT i, ; r r R �E 5 war TOWN OF BARNSTAzB, t � � � IONS -BUILDING INSPECTOR APPLICATION FOR PERMIT TO Q�I(Sf}lsG � , „ ; /„V,� i k I-�a�✓ 1�J....... ....... ............ .. ,•. TYPE OF CONSTRUCTION....... ..!.'?,S� C f! ..... '. ............. .�...........19....f.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to th(e following information: Location .........C.....1........�:....�.... ......5 P...!:.�. .Q:a.f�.......�� ........... n. :.. ...... ProposedUse .......... L.�.......................:..................:................................:...........................:.....:..:............................:.......... Zoning District ......,4FeFire District ...... .................. . ......... Name of Owner ..t ..9 A........//A!-�4-rn...................Address .. .�.... Q� ..... .�..1.......!7... . V . .4��f.......�Name of Builder ....�.�.. .C'.r........., �►g':/ .................Address .A.C,lr. U.➢F.. ,�fnrti U Name`of Architect ... .k.....fl't..>°: .!i /...:....................Address ..0...& ...... ............... ............. ..4 Number of Rooms ..................................................................Foundation t�A. n .. /� rr .: .v......... Exiei or a,(v....Ll.f��. j. %@�(�.;....�n�hC <:..C20 9 .Roofing ...... .. .. , • Gil e,,g�s - 2 f •. Floors ..................:.:.................................................................Interior .....�..`.?.�.�.�.(............. .................... 4 o:Heating, eL.. �j f,......... .. .. ..4?t�.! �.................Plumbing ...... ".. y.: :? .......:............ Fireplace ...y. S.................................................................:...Approximate. Cost ................`.. .v. .................... Definitive Plan Approved by Planning Board ---------------_---------------19________. Area �/ ..:.� . Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH J 1, t OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS' I hereby agree .to conform to all the Rules and Regulations oktheTow4nB bl r arding the above construction. Nam . Construction Supervisor's License ..1.. .. ...!..(d......... = � MARK r No ..2670.1.... Permit for ..12 Story................ - . Single Family Dwelling =� Location dot 36, „38„ andlewood Drive M ............................................................................... Owner Mark Horan - r ] _Type Construction Construction ..Frame............................. _ LF ............................................................. Pot J...................... Lot...... .... .......... -�-Permit-Granted ,July••16,•.•••..•••.••••••..�,19 84 Date of-Inspection /� 19 Date Completed >. :1 ..S�.S J.. ;........t9 / �r'• v"•d ! - --,ate- ` _ /A•-ti r�� l�.. r. -_,,..-. ',r• � >f Grp ..'._ �'• f.. .y k �-r e. TOWN OF BARNSTABLE Permit No. Building Inspector cash OCCUPANCY PERMIT Bond Issued to Crr. -)ran Address T -,4- 1 ?r d Driv� Wiring Inspector Inspection date Plumbing Inspector f"- �' ,1 r Inspection date Gas Inspector Inspection date Engineering DepartmentJ. Inspection dates. v Board of Health 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 AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. .................................. 19........... ..................................... ...................................................................... s Building Inspector TOWN OF BARNSTABLE f" BUILDING DEPARTMENT w- ssaarr _NAM TOWN OFFICE BUILDING -' t639. HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department �� DATE: �f . 1 An Occupancy Termit has been issued for the building authorized by ; Building Permit .. issued to __.!_ Gt✓ r�,,.» , , ..._ . ... Please release the performance bond. N Lo o to Gonc. o Zb ' �:Qs Co rui r f`/! S5• P2.EPAF' E.D Fop 1 _ 730' a rc: w- 4 ' M A P- K H O F- .L EFEieC,cic�: ' B/A tJ: TABLE (ASSESSc>p—S MAP # 2-4 L©T fot9 Aa,knit. /4 9 P4 8/ ®T/V s 2"/-/EC-EBY GECT/FY Tip-/i4T T�:/E_!3V/LJ'��.V�i• -7? .C-A/ 7W/S PL A*" ',S LOCATEa ON TAVE yeco%siza' 'IFs .Iwo w.v wO.sec v, OF f ARNE 4 348 E'OCvTE G�4^- i-.it�%1C4c/T<-f, �t1A53: afire s49196 i�oe SLOP T1r, 'RV F" M_U QQrr � � :F Assessor's office (lst floor): ' K• tt+ u t Assessor's map and lot number ......Q.s ... ®,,,,, ,,,,,,,,, aAL�CO ¢y �Q�pFTNETo�` Board of Health (3rd floor): ;' Sewage Permit number .............. 5.`'` �. .......::..... TOWN REGULATIONS Z 33AUSTABLE, Engineering.Department, (3rd `floor): rt 'mac rb 9• House number ,............................... .,......dG...... ??'I..P �Fo r a� YA Definitive Plan-Approved,by Planning Board -----------------------------_----1.9-------- APPLICATIONS 'PROCESSED 8:30 9:30 A.M.- and 1:00.2:00'P.M. only TOWN "OF ;BARNSTABLE BU] LDING, ., INSPECTOR [ APPLICATION FOR PERMIT. TO ..:........... /1V.....&t: .��.�...: :.. ...................................................... TYPE OF CONSTRUCTION . . ......:... �IjrleZda t... e.. ............. ...... ..... ...... ........... .... .l 19 TO' THE INSPECTOR OF BUILDINGS: : The. undersigned hereby applies for a permit according; to the following information: Location .......&,Yl�.... IZYZZInG ......AD ... ...... ....... ........ .. /..�.... . ProposedUse ................ ...... ...e............... ........................ / ............ .. ...... .................... - Zoning District .':............. /� ......... .. .............:.......... Fire District ................. l.. .................................. ,005 Name of Owner .. 0£�f' ....// ..............Address .......3e.... .........a,4 Name of Builder ............. .....Address .......... ..>°......... ............. ni.-e .................... .............. L1 Name :of Architect ..................... .............. .......Address Number of Rooms ........... ....... .... ............. ...... ..........Foundation' ......:.....iC i9........... Exterior :....�i�G ........................ ...... ........:.......Roofing �,40�/, 4 ' - '� Floors, ............... .`................... .................... ........Interior ......... "... ............ rieating '00 7. .....Plumbing ................... :.. Z�. ..................... Fireplace ..... :..:...... �....... . ...... ................Approximate Cost ............ . ........ ........................ Area . Diagram of Lot:and Bt6Idir�g with Dimensions Fee .. .. `1 .. ............... VP OCCUPANCY PERMITS REQUIRED FOR NEW_DWELLINGS 1 hereby agree .to conform to all the Rules `and .Regulations of the'Town arnstable re rding the above construction. Name ... .. Construction Su rvisor's License MICELI , ROBERT No '32210•• -Permit for ...Build Sheds ` Accessory....to . Dwelling...... .... ...... ..... ...................... location 38. Sandalwood Drive - - ............Y..... , ............. w4, �. •fir - , ' Cotuit' I .+ .+. ........................................................ Owner Robert Miceli.•...••.•• f Type of ,Construction Frame...................: - t ................... l .. ....................,.............. .......... 1 fn �. / ' �•' Dy ;�, 5�� y Plot ....:.....:................. Lot ................................ z Permit Granted ...Auqus t..2 j:q ' 88 ........... Date of Inspection ................,..........:�:: I' � Date Completed ...... C¢/... 1..... .1i9 Z. . i El k j mot. 1� w � t Assessor's.map'and lot number .... j ...,:., *THE N Sewage Permit number .................................. ......... .......... .° s Z PARISTADLE, i House number .............. . ... ............ MA :.... NAM r t �f0 VO A' TOWN OF BARNSTABLE • BUILDING INSPECTOR APPLICATIONS FOR PERMIT TO .............................................S= � . % ....... TYPEOF CONSTRUCTION . . .................................................................................................................................. .... ��............19...V.' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby.,applies Jfor a permit according to the following information: c;/<o 3 s9 n l„�4�o o .......:Q1 �:.!/ .... �`1 ?��1.% ...... ... ..... ........ Location ..... .. ....... ......... r: .:. ProposedUse .......... ...: ....... ........ ......... ....... ... .......................................................... Zoning' ..District ... `f . ....... ......... .............: ..... .Fire District ....... .......... .............................................. Name of Owner .J :� �N g ....r/..v/?!?!Address ..... ......... ................ ......... Name-of Budder '�/ . 1.�e�.r. .�.. !. Address ...°2.� 1 /..c.: �..: at ...V.���...`,1�wk a 2 Name of Architect ..... `...... ......... ...Address ................................................................................. .$ ,":Number.of Rooms .... ....... ........Foundation. :... .:.:................................................... .. Exterior ......Roofing ........................................ Floors `....:.........:. ,.:......:. .......Interior. ..........................:.w...... .. ..:::.................:...................... Heating ........ ........ .................... ......._ .:......Plumbing .......................:............. ........................................ Fireplace ... .............. .............. ... ...................... ........Approximate. Cost. ................................................................ , Definitive Plan Approved by ,Planning Board __ ____ _ __________19__:_____: "' Area ,...:............ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD ,OF HEALTH. P OCCUPANCY PERMITS REQUIRED'.FOR NEW DWELLINGS ;- - I hereby agree to conform to all the Rules and Regulations of the To of Barnstable egarding the above construction. < « . l ..Name :. ...... .....�... ........ Construction Supervisor's License °o f V c ! v. J -P2)L ON & C. HORAN 26502 DEMOLISH D I G ................. Permit for .........................�-��,r..� � = •. :_ Single FamilY..Dwelling....................... Location .W ..5......S.=d1e QQa.J)r1Vi~....... ................ ............................................. r Owner .J.-... ?�ir4.Zl...&..G,...I�OX 11.......::........... Type of Construction' ...k'.bane........................... • �d............................................................ :.................. Jd Plot .............................. Lot ........ Permit Granted '..29 .......1984 -NDate of Inspection ............... .. .....�. .19 •Date Completed .........: . ....:'! ......19 s For ,^ Assessor's office(1 st Floor): 4/ Assessor's map and lot number ��/ U 3 ��� � *THE Board of Health(3rd floor): , r� Sewage Permit number 9T Engineering Department(3rd floor): - � o3 d House number �m r©W Definitive Plan Approved by Planning Board 19 M APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE , BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO L^!�/9S�Q UGT r¢ TYPE OF CONSTRUCTION WOOD F7/Z t?--m6 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location 3 S#t/©Az- WWD ;v- SW Tu/7 ( 40- .36 Proposed Use /76l7 TU Zoning District Fire District CO7-0/7— Name of Owner RD t R ��C�l i P Address 38 So> "D Ae-- 6,00 Name of Builder H ✓ Pe77 yA/ J9 Address ,CX 2.9 S 17�VNt.r /?il Name of Architect' Address Number of Rooms eft✓b 72 7WO Foundation v,QED Exterior/ C✓ O�y, K•pry/ 141/ , Ile-4- J,��'�,l�Roofing �A s CP Floors ZX/o ��I�� S C��.0 Sr/� <Loa� Interior �5n� 12°Gk Heating W Fy niL Plumbing Fireplace Approximate Cost d otl Area Diagram of Lot and Building with Dimensions Fee F I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License rf2Q 9 J MICELI, ROBERT No 33295 Permit For ADDITION Single Family Dwelling t `. Location Lot #3 6, 38 Sandalwood. Drive Cotuit Owner- Robert Miceli Type of Construction Frame Plot Lot Permit Granted October- 18, 19 89 Date of Inspection 19 Date Completed 19 • r r. 5- i ,� �r N U) � J o - � 'fi 1 o lf) \ hARCeL # 3 f APA-/. P R E.P A Fz-E[D FOP-* Loc.vT/0A CdTc�}-1- .MIf�S v� 4 MAEzi� HOle �� h! cE�: ; 4ARt� TA�,l.:E ASESoF''S MAF� # 24 I LoT, 3 ; 2 N�eEBY CE'CT/FY T-AV4T TNF 14 l i t f /f1_ L_ in is r i ✓: 2EAT, ELEVATION 4 12� 5 L$Fifc�t rw-5-7tN6Lf= G J � 9 � - .4 � � �I I � � III I�I �L• SnIN I' � I I , jE I - .. NON HEgfED I Eurny" I 1 f I J ?5 .L. {,�' �ArFD DLCK� .. y.'(uJDSEJ nDDI'/oN- - FxI5TiN6. u✓SC. - _ _ � Ex�SriHs ..Iv� �� —IrE CEDR�z SMIAi6trs I I ' I I L NDD ItIpN eYI;-,T INC MDJS_ _ _FJn-10iJ _ seas: _ — •cnRoveo er olurm er t r t i i S' P,L 2NS-.ALL FAK At-TEIZ - F--ANaiN6. Sfl6�PORMER �4 - fo l o of IV E � I - . C7DE t7E5CR1 oN � 'J,OJ9M O \�6 T.. • C00.A VENT 0.10(E VENT AND IR.S.W Nr7. L'X LI1q,x Wo Yj 2 .� 2x10 RIO6E AN P•s"—r-.. C-35 %1' cCx P YW �SMOQN,H6.' Alb 71.-W6 CT 3 I " as.we .aia a AS?HALT RLUF-SFIINGL6. E 2 SZ I Z-K7V RAI Ens • -Z�LK 8 W rtii%J."SP. ER H E•NDER I-R-36. 1"+usuEd�.ou 4x8 CO"AR n;S 3'U'O.C. ; VENrEj -DRIP ED6E - -; 2xq FIZA-ME ,m NItE CELn2.cMiH[!E _ ' Fo UN17 PTI oN• PLPtA a r 5/8' Cr PLY.5uz--L R - I I - ��zx ro' cJ�� so•srs.16"o c.. F z6- - '�` � _'t�_-�{ �}t —' E. S xi'6" g°X 16° I pJR E�fpNC. 1�� 1 �' I W/1-1L- rwRtlJ CONC'" J1.. I. I I I. Foor,rv6� qq 5/53' Cax PLy. SV3 FL.owk { Zxio GL P, �,sl$ 16'O.0 I I tt! ZxG ?T.- SILL —rt 5—sE71L WALL �' I. I �"JZ�14 SNS�LAT1oN I I .' y" FRAMr 0,055 ScC'P.oN R105ER7 T 7p:NU MICEL2 ' .3e SFNDALVJIPA az. RI��ELEVA+�•JNJ i�liYTtr FGUNL�Ri�LN PLA/•f _ - NSF - ' ft 41f n SECAND FLoo2 �L ANI _ I o I SG .� II JII II( � y r �e •") i I I o �2EMn SLIr_C� i m c c Y 1 1 ti - T.4. 3�ix10 HEIIEEZ ' j — 0 � s O II 4 ' ZenavF� it t — � • j C<aSEr. RErwvf eYuiwe R—H 7Wni j. RhER wAlL �Np DOPUAER'v • foA GVr4AF.i I I i amlce eebs or � %L'awrN� I Mo�St INS;RLL NEW L_ I � HECRpoM 7L '- - 3b BFFJLD s. 3eLuNy _ F. 4 RiriEb2RL CEI4+•16 E lu L R STaicA6e " r I_. . 1. - - PRD POSED FRMLL•/RDfM1� � F�.� � � � I � fIF .. •. ExIgT)N6 .FIRST.FjyoR. -1.114 � � - - I�I�I�.�RF(DUTEI��f I( J 43. - MA5rEk 3EDR'x�i I I°'i ROo+'F f i' E F .. i II O O b,o_ coo of a COVAFrPy KlrcrlEN/ D/N/A/G " ,(27, v- d s'o B�Fw-D jjr CEN n 1,l VyAJ6 Room - [t b Z £ >S