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1860 SANTUIT-NEWTOWN ROAD
N�6UY6 i72-D-1 Mom. ,44nr. l��a �i� , YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40,00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Vou must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the To,,vn Clerk's Office, 1st Fl., 367 Main St., Hyannis, NIA 02601 (To\,%,n Hall) and get the Business Certificate that is required by law. DATE: ,,Fill in please:�� APPLICANT'S YOUR NAME/SArthur Bence d- &erz.A L[. Pv,i r BUSINESS YOUR HOME ADDRESS:161 Harbor Hills Road 8 0 5A Tv 2� 508-776-4589 Centerville, MA 02632Carvlr, XiA 0Z63,5-' y ,. TELEPHONE # Home Telephone Number 5 0 8 8 6 2- o� �! - us NAME:OF CORPORATION: Limbi r Racrnirr-pc; . Tnr NAME OF.NEW BUSINESS.Lewis . Bay Associates TYPE OFBUSINESSMental Health Services IS THIS HOME OCCUPATION? YES NO X ADDRESS OF BUSINESS 119 Cedar. Street, Hyannis MAP/PARCEL`NUMBER 3 Z , � [Assessing) .When starting a new business.there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended 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 in this town. 1. BUILDING COMMISSIONER'S OFFIC This individual has been informe any permit requirements that pertain to this type of business. Authorized Signatu COMMENTS: 2. BOARD 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: '. Z The Town of Barnstable P Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Cros= Offtce: 508-790-6227 Building Commi F= 508=175-3344 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the-reconstruction,alterations,renovation,repair,modernizadon,eonvrssicn, improvement,.mmcn-4 demolition. or construction of an addition to any p building containing at least one but not more than four dwelling units or to sMM=cs v&ch are ad to such residence or building be done by registered contractors,with certain c=cptioM along with other �uiremeats. Type of Work: X�cu Est. Cost �iy�cJ Address of Work: /960 SAV-7—o Ii6� AZ C&7 s- � Oaaer.Name: &;"4;2 CAW • Date of Permit Application: I hereby certify that: Registration is not required for the following r=son(s): Work coduded by law _ _ob under S1,000 Building not owm-ooatpied Owner pulling own permit Notice is hereby ghren that: CONTRACTORS OWNERS PULLING THER OWN PERMIT OR DEALING WITH UNRE0I5i FOR APPLICABLE HOME IIAFROVE E34T WORK DO NOT HAVE .ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hcrcby apply for a permit as the agent of the owner. tractor name Regisuation Date Con No. OR The Cunttnun",calth of Massachusetts Department of Industrial Accidents •��-� ;;� - �, OfllceolloivestJgaUoas 600 Washington Street Burton.Mass. 02111 Workers' Compensation insurance_Affidavit Annlie��ntnrmatinn: Plestse PRi1VT',e j�ly~ - �^g'•'� n2me* /�A-/C location- YS C"4—S'T. .J- Ox 677 G 9 sits. Lc% A;q4- _ A17 4. nhone# -ram 362 8-75 1 am a homeowner performing all work myself. Eyl"'am a sole proprietor and have no one working in any capacity 1 am an emplover providing workers' compensation for my employees working on this job.. rnmp�nv name: address, citx: phone#* insurance co, op licy# I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address, Sitx: - phone#: insurance Co. pQlicv# j. '�: �,.'-:T'�� - — �'+eru�Tr'.r.71»vet="?.•i'%";'TRti�s??',iyF^.i'�4� "" iln 7, �«.�e''r`�T:f�!.f,�S�f�.a7lc^.'�'l*rY��R43±4!,fY"'»'!.�75 company name• address: city phone#: insu_rnnee nn :Atiachadditiiinal'sheetiftieeeis `Y;vire�':f`=X's, rya:-�:.,:�s}t, �ua� . �+► �y Failure to secure coverage as required under Section 25A of DIGL 152 can lead to the imposition of criminal penalties of a fine up to$1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herehr cerdfj•under the pains and penalties of peduq•float the information provided above is trae and correct Signature Date Print name a �G�/���"� Phone#ja$r. -?.-2 r official use only do not write in this area to be completed by city or town official city or town: permit/license# nBuilding Department Licensing Board 0 check if immediate response is required QSeleetmen's Office �Ilealth Department contact person: phone#;. nOther (raised J,hS PJA) Information and Instructions • y Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees: As quoted from the"law", an e►nplot(ee is defined as every person in the service of another uiadcr any :f.e< contract of hire, express or implied, oral or written. An eniplirner is defined as an individual, partnership, association. corporation or other ;cgal entity, or any two or more of the foree,oink enga cd in a joint enterprise,and,including the legal representatives of a deceased cmplover, 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 tine dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the `rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 1'52 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have. been presented to the contracting authority. 77�.�w*r-.�+.r+�•....,,w••_ ^"-"'-"�" e - _ 'i•^�" lia. .`w:• �,.... a•N:.:��^''g U.�:� ' :IAe:^�.y`Y-n•�.�!'.:i`lfr;. '!�. . t Applicants Please fill in the workers' compensation affidavit completely,"by checking the box that applies to your situation and supplying-company names. address and phone numbers 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 if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. r-a.*.w..�+wr�enss.��•c!R.n,. ,•.u,�.ew��!�.v ..yA...4 - 1- e -::.. '�La.�,.rlw - .. �.� �Y- �� 3c:'':•7�, �;;.•. -.. .. •i -3i .if A•.�{::7'_ 1 .::a•.; rttl�t "r..Pwi,Jd! ,li! rt++R�•,r!i. ` Citv or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please l be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. Tine Office of Investi=ations 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. 7:« ,e = :. .. :ate: :::�':•:" > ,.r.Vi�.i� .—� .. !.Y �...✓'✓ i .. •. . . ..Y..Y 71...,..J.•: Y.M•LiM, 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 fax#: (617) 727-7749 -. phone#: (617) 7274900 ext. 406, 409 or 375 218 j'8' � N82 32'55 X EEO+- O �7!0 0 cn 50t HS1; 0 1868 �' I o ASS. LOT 24 0 o 0 0 y N � o � � 0 0 218.18' ' S82 3255"W b - ASS. LOT 25 RES. ZONE "RB" This MORTGAGE INSPECTION Plan is For Bank Use 0 ! FLOOD ZONE- "C" `TOWN: REF: U_ST - ------------- REGISTRY OWNER: D t1VE_,'- Jj,�I�� ------------------ DEED REF: _�915 22-�_--__-----_BUYER: _F�'89L,0_P__ELQYZ�____ DATE: _9�20IA5 _______________ PLAN REF: _ 73 51__-- -------- --- I HEREBY CERTIFY TO FLEEf_fiLA L_4�5ydlE ELJLVD lv_C_ 40---FT. _/S_AA,A_T/MA ITS TlTL_E_IN_SCO_& JE_FF_R_EY_A._STERN_THAT THE BUILDING p��HOF,� SHOWN ON__THIS PLAN IS LOCATED ON THE GROUND AS 9 YANKEE SURVEY SHOWN AND THAT ITS' POSITION DOES CONFORM MERT`A CONSULTANT TO THE ZONING LAW SETBACK REQUIREMENTS OF THE EMT3 98 y S OWN OF _ B4�?IUSTABLE _ "____AND THAT , 40B INDUSTRY ROAD T DOES_ 1VOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD sb,`FssioNP� MARSTONS MILLS, MA. 02648 REA AS SHOWN ON THE H.U.D. MAP DATED_�/Q?��_ <qNp ,IpP TEL: 428-0055 o it — an,o 250001 0021 D �1HdE FAX 420-5553 PA AER[�HEW—pL --- PHIS PLAN NOT MADE FROM AN INSTRUMENT SURVEY NOT TO BE USED FOR FENCES ETC. 17618 ✓DR ' 4 HOME OWNER' S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Ownez shall act as supervisor. " Many Home Owners who use this exemption - are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our' Board "cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home 'bwner actin as supervisor is ultimately responsible. r To ensure that the Home Owner is fully aware of his/tier responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the lazt 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. M r TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION P .ease print. DATE so 14 ,, JOB LOCATION c� . ��'y 1!- )J&V Td 1. A), ? Number Street address Section of town OMEOWNER" �-�teq L.� `Z_ �j20 -c]©3'Z �]S - ; ., Name Home phone Work phone � PRESENT MAILING ADDRESS kA 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 such homeowners to engage an in- dividual 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 re- side, 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 acgaptable 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 Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands .the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply w' sai pr ce ur s and requirements. HOMEOWNER'S SIGNATURE/ � . APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 354cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. c • information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' ccfrnpensation for the employees. As quoted from the "lacy an einpluree is defined as every person in the service of another under any contract of hire, express or implied. oral or written. An enrpinrer is dcf incd as an individual. partnership, association, corporation or other legal entity, or ally two or mor the foregoim� 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 th 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 ho or on the ,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that even-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 i-w•ho has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter h been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers 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 if you are requires to obtain a workers* compensation policy, please call the Department at the number listed below. • City or,towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o- the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pie. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to give us a call. . The Department's address. telephone and fax number: The Commonwealth Of Massachusetts •a ;, .,. Department of Industrial Accidents _ Office of investigations 600 Washington Street Boston,Ma. 02111 fax #: (617).727-7749 , phone #: (617) 727-4900 ext. 406, 409 or 37S r i The Commonwealth of Massachuseas _. t,_ Department nt of Industrial Accidents 1 Oflice019MV9211/7os 600 11'ashiul;tun Strut Burton. A1uss. (12111 Workers' Compensation Insurance Affidavit AJiPlicant information: ___..... .._..._..�Plcase PRIIVT'lebjjy�— - '� ckv - hon•a I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an emplover providin=workers' compensation for my employees working on this job. comnam• name: address: city: rhone#• insurance co. Policy# I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnam• name: address: city: ahonc#: insurance co. nolicv# comnanv name- address: city: phone#: insurance co. # Attach additional sheet if neccssatj;; ...' •t r.,�l' Y .J..�',../.. It. I..tel: �.M.t.\,T'1.M!/.�iY.�GJw..rr.�i:��� 4 -��..����..lrr.or.:�.:hl.Sa'AYr�., ..•a.a_-a-...-.....,.. .•:_-_,,.......-._..fir -__'=..�-'_1!..i�.Jb11L'iol��iR•.Luh wri+�. Faiiurc to secure coverage as required under Section 25A of NIGL 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andior unc y cars' imprisonment as well as civil penalties in the form of a STOP NyORI:ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statcutcut ma} be forwarded to the Office of Investigations of the DIA for coverage verification. 1 ilo hereht•certif•under a pains and penalties of perjury that the information prorided above is true anld c rrect. Sisnatum Date L ' Z� Print name Phone# Official use only do not write in this area to be completed by city or town official Y� city or town: permit/license# riBuilding Department Licensing Huard CD check if immediate response is required selectmen's Office ► C3Ilc2lth Department contact person: phone#; rJ01her y. i. r : . . : The Town of Barnstable snaivsTn L&MAM • 16 ,��' Department of Health Safety and Environmental Services 59 ArEO Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only . l 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: Sh,,c-c)*V vy Dc -c-K Est.Cost Address of Work: 113L.0 SAuTv IT - ��✓'�wA3 �wner's Name ��L� � p ^L o c✓ ?� Date of Permit Application: 7Z k c, I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date ZOwner'sName E1gineering Dept. (3rd floor) Map 61:)3 Parcel Permit# _.Z I House# Date Is ued �. V/Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) 9S"/ S Fee -�,� /Onservation Office.(4th floor)(8:30-9:30/1:00-2:00) -lG 1 THE 19 ' BARNSTABLE. A MAR& TOWN OPBARN5TABLE Building Permit Application - Project Street Address - -t y wk-, r2-D Village c o fV 1 Owner (A-z 14Y1 Lrl,oV f 2- Address Telephone Permit Request a First Floor square feet Second Floor 300 square feet Construction Type Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size C /,A C_ft e, Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 0'� w�j Historic House ❑Yes IW6 On Old King's Highway ❑Yes Q'Ko__ Basement Type: ❑Full ❑Crawl ❑Walkout peer 42t!, r d' e_..P'tL)L� Basement Finished Area(sq.ft.) r-9 Basement Unfinished Area(sq.ft) )0 0 !�tp�, Number of Baths: Full: Existing 1 a, New�_ Half: Existing New No.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 VIO Fireplaces: Existing New Existing weeIVQAbstove p'Yes ❑No - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) WA-one ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# r, Recorded❑ Commercial ❑Yes UKo If yes, site plan review# - Current Use S /r UL Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE B LLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL N f ti' ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME s INSULATION FIREPLACE f ELECTRICAL: ROUGH FINAL . PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL,BUILDING ✓� �� DATE CLOSED OUT ASSOCIATION PLAN NO. N ' Assessor's Office(1st floor) Map 2�' Lot ��' ,Permit# Conservation Office(4th floor) Date Issued Board of Health 6 47 a,(3rd floor)(8:30-9:30/1:00- 2:00 A Engineering Dept.(3rd floor) House#1 _ (�,� F-� Plamnin a L_R1 cln_t__ v _ , '� Q•4 Dent (�ct±lnnr/Qrhnnl �_' SEPTIC S �.BE _ 19 INSTALLED LIANCE WTH .�.� TOWN OF BARNSTABI vsno,% EiMTAL 60DE AND Buuilldd na Permit Application --' Project Stree d s ! 8G /L Zc�'7�,> /(n Village -_C n& Owner (c d,9 L Address ZAS AK-z0Y�,t/ Telephone -7 1`�O d f;?,C Permit Request �ax�� S�CDi1,�1 �nd2 �� �dnJ t�j 7!9 ;Total 1 Story Area(include 1 story.garages&decks) square feet Total 2 Story Area(total of lst&2nd stories) square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Pu Unfinished Old King's Highway 461/l� Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel b-)*Yn AJA-j C/JS'Central Air . Fireplaces /U0 Garage: Detached. Other Detached Structures: Pool `V D Attached Barn AJQ None �^ Sheds Other Builder Information Name / n�? /P�l `� Telephone Number Address License# OO 9IRLT Home Improvement Contractor# Jr 9 Worker's Compensation# IIV-A NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY r PERMIT NO. DATE`ISSUED ' , MAP/PARCEL NO. ' ADDRESS, VILLAGE r OWNER t ' DATE OF INSPECTION: �: r FOUNDATION I ` FRAME r INSULATION ; FIREPLACE - + ELECTRICAL:• ROUGH ! FINAL • _ PLUMBING:;" ROUGH FINAL GAS: ROUGH FINAL 4 I �t sip i • , � _ ': FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN r The Commonwealth of 4fassachusettc 7�� Depart►nent of Industrial Accidents Off/ceof/nveslfyatlons 600 Washing-ton Street Boston,Alas. 0 111 Workers' Compensation Insurance Affidavit Applicant tnformation: _ _ _ 7 _•7 name: (.,)1/uN/� �o/ �[/►GL•��IY! location: -Cr' A City 41kc r- Z& /r114 a. (51' Phone#t S08 29-2 9181- I am a homeowner performing all work myself. F-1 am a sole proprietor and have no one working in any capacity E ^•rrs+��- .,n--�•'.-r -'::�?rRS"+�K2aa?... t �,�"'*».,,�,,...� .F9"-:. .rg���-s�••-.��•.•...nl,•te•.•r^.Mr+aoszeyyr.- t::.::<+..:�...._.. I am an employer providing workers' compensation for my employees working on this job. L company name: oddress• city: phone#• insurance co. Policy# �. ... .-..; .., ....•.a„rrv. ..Y�,.s;.p-,w .!viwM.m^+.nsnrwvavrwln►'M+9^Tsn�A4Ds,; «..w.�.wY!-•..+........Rwo....r.e.... I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address: city: phone#• insurance co. Policy# -.. ..`.... , _ FI'i:,-• -T+1wn a-_-a:�-•.:^r�tLt�af .� •.c•^. <wu 7 2"tiin'.^''' S�..�..•�� .,,, .. ._, .... Yr' .:r.,:.. �"�' rr3•°. r _ _ ;'3g_ company name: address: city: phone#• insurance co. icy# Attach Iadditional'she.et if necessary Fa(ilurc to secure corcragc as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one N•cars•imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 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. 1 do berehr certifj•and le pains nd penalties o Wrjurl•that the information provided above is true and correct. Si=nature Date /l4-5--A-5 Print name A..vie �_ 41 cAV/Cr!A x--'N Phone# _5-ox- 6 9-2�2 *official use only do not write in this area to be completed by city or town official city or town: permit/liccnse# nBuilding Department oLicensing Board ❑check if immediate response is required [3Scicctmcn's Office ; 011ealth Department ' contact person: phone#; MOthcr (rep"used I"PJA( 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 e►npl(tvee is defined as every person in the t:vrvice ofanother under any contract of hire, express or implied, oral or written. An enrplat,er is defined as an individual, partnership, association, corporation or other Icgal 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 dwellin�a, 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the 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 in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers 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 if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. MOM IT ,---•--„��.,.- �. .�-�,--� �:., .�,• ter...-.� Cite or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of lnvestioations would like to thank you in advance for you cooperation and should you have any questions, piease do not hesitate to give us a call. .o... .�.. , +.. TT n. Tile Department's address, telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 The Town of Barnstable g Department of Health Safety and Environmental Services ° •`' P Building Division 367 Main Street,Hyannis MA 02601 Off ce: 508 790-6227 Ralph Crosser Building Commission: Fax: 508 775-3344 For office use only Permit no. Date AFFIDAVIT HOME ZwROVEMENT 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-odsting owner opted building containing at least one but not more than four dwelling units or to structures which are adja=t to such residence or building be done by registered contractors,with certain exceptions+ along with other requirements. �l Type of Work: ai Est Cost �� Address of Work: 196`0 Oaner.Name: --k/ Date of Permit Application: /7 �S I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _ . ob under S1,000 Building not owner-occupied _Owner pulling own permit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNRECI3'TE1UD 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 hcrcby apply for a permit as the agent of the owner: �P Registration No. Date Contractor name OR Owner's-name i 218.18 N82'32'55"E i r 50t N5E � � 0 1868 �i ASS. # LOT 24 1 o . 0 0 0 218.18' S82 32'55"W ASS. Jf LOT 25 RES.. ZONE` "RE" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only- TOWN: _BAff1V6S1M1d4:------------- REGISTRY OWNER: DEED REF: _ —-----------BUYER: -� 89L1?_P_ELQYLT,�-------------------------- DATE: _9/20/95 --------------- PLAN REF: _ 73 51 __SCALE: 1"= 40___FT. I HEREBY CERTIFY TO FLr REa� S�AIE F�ILVDIIVC_ �NOr _!S_AA,AT/MA ITS_TITLE_IN_SCO_&_!E_FF_R_E__A S_Te_RYTHAT THE BUILDING / � 0 Y_ ANKEE SURVEY SHOWN ON THIS PLAN® IS LOCATED' ON THE GROUND AS PAULA ��� .CONSULTANTS SHOWN AND THAT ITS POSITION DOES _ _ CONFORM MERITHEW TO THE ZONING LAW SETBACK REQUIREMENTS OF THE No.32o98 - 40B INDUSTRY ROAD TOWN OF _ BARNSTABLE __________AND THAT A MARSTONS MILLS, MA. 02648 IT DOES— NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD e SS1oNPP TEL: 428-0055 AREA AS SHOWN ON THE H.U.D. MAP DATED_Z/_0W2 _ OSUFN FAX 420-5553 Co t —Pane �?50001 00.21 D 1 �hQ�•y_ __ THIS PLAN NOT MADE FROM AN INSTRUMENT 17618 JDR PA A.7viE_RI_PH_EW PL SURVEY NOT TO BE USED FOR FENCES ETC. COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY 7j OF ONE ASHBORTON PLACE MASSACHUSETTS BOSTON,MA 02108 LI EN S E EXPIRATION DATE C'O A S T R. S U P E R V.I S O R CAUTION i4�4JL �J j/1 9/1`�9 5 EFFECTIVE DATE LIC-NO. � FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB tJUrVE .a 06/30/1993 0096R5 0 � PRINT IN APPROPRIATE 6 . BOX ON L 3 DENNIS M MCWILLIAI~S o � d 45 -CEDAR ST t �RNSTABLE MA 02668 2 Bi TING SS m ii INCLUDE PHOTO. PHOTO(BLASTING OPR ONLY) FEE: r M1 I I I, / I) NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER L �c ^ D THIS DOCUMENT MUST BE ...« SIGN NAME IN FULL ABOVE SIGNATURE LINE ,.. CARRIED ON THE PERSON OF SIGNATURE OF LICENSEE-. THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATION. - ,� j�+ C�OMMISSIONER IC ��' DEPARrnENr CONSTRUCTION PU8LSUPERVISOR IC SAFETY IICEnSE . CS'' ,0096E5 Expires: 08/09/1991 x DFNNIS n N UIttIAMS 45 CEDAR ST U 84RNSTAatE, NA 02668 e Town of Bar nstable Approved Regulatory Services Fee 025 -D-D Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Home Occupation Registration Date: Name: G-A-U_ CQv�Jury Phone#: Sa8 L{aO —C9c132 Address: t45cn o �A rvTv�r—r�cw��N�o�� Village: CPZ_1JLT Name of Business: A+4> TypeofBusiness: "JCwgLP. 4 C.,P_,hC—T t7�s«J1 — �2�cft-�s�Map/Lot: Oa302 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 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. After registration with the Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • 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,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. • 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 Occupation,other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and 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. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. , I,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applica Date: 2 Homeoc.doc tea, 4ps •or's.Office(1st floor) Map., 0,� Parcel (S Permit# Conservation Office(4th floor)(8.30-9:30/ 1:00-.2:00) /I 7 Date Issued / J Board of Health(3rd floor)(8:15 -9:30/'1:00-4:4 Fee. 0� y Engineering Dept.,(3rd floor) House# d1NE,,,, BARNSTABLE. . 19 M 3 .9 - e$ • - � CEO MAC� TOWN OF BARNSTABLE Building Permit Application Projec Street Add r ss /8!O } Village Address :Telephone 007 Z Permit Request ��y AZC2)1_r1_a>U 1,C^1,Z6_mV "O'"' ' e) , a First Floors square feet Second Floor Al 6 square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type 4,o&,0 14Z 16- Commercial - Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths 1 No. of Bedrooms / Total Room Count(not including baths) First Floor Heat Type and Fuel - Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number 36;2 93 83 Address GIJ_ a�2it, /YIr4 02 6�� License# Home Improvement Contractor# Z/6 129 Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO n L SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY € rPERMIT NO. DATE ISSUED _ MAP/PARCEL NO, S - ADDRESS VILLAGE OWNER , ! - DATE OF INSPN:TION: _ r FOUNDATION FRAME4 9� 1�9.,7 INSULATION T' FIREPLACE - - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ;- s GAS: ROUGH FINAL FINAL BUILDING ; DATE CLOSED OUT ASSOCIATION PLAN NO. i s , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map OZ F Parcel D Z Permit# � L7 Health Division ,mil 995- h/off Date Issued Conservation Division 1 Fee _ - Tax Collector -,�OQl '—� llgl sq*10 rS1F*rd1YA f BE Treasurer INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address Village Owner ZeAn j � 4! ,411 Address Telephone %00-00-3 Z Permit Request 1 y��3�� ��� t2��� 2SIa,qY 1-41,//o-r/ w 1-*AX-fey 1o.ecl? 7 1-4c eof 2 /ao cle- tit z-,,, Z,* ✓ �o��pf'J2 rggZ c✓ *��q•e Square feet: 1 st floor: existing proposed 2nd floor: existing proposed l3 Total new a�� Valuation R ` ��Zo in ng District Flood Plain Groundwater Overlay Construction Type woo Lot Size y3G3�sF Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family N Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes YNo On Old King's Highway: ❑Yes A(No Basement Type: )(Full C1 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing f new Number of Bedrooms: existing A® new 3 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ZGas ❑Oil ❑ Electric ❑Other Central Air: 9Yes ❑ No Fireplaces: Existing New -IBI Existing wood/coal stove: ❑Yes .*No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Mnew sized XZ Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4�16i o If yes,site plan review# Current Use Q��i� /,�4 Proposed Used /��DD ,' BUILDER INFORMATION Name �tJ4 IV � t� Telephone Number �8 3 fy -W-! Address . `k� S L�Ly n� License# C S 0(P SO Z Home Improvement Contractor# 116 y/q Worker's Compensation# 0i9C,QU822- (00 �I ALL CONSTRUCTION DEBRIS ESULTING FROM THIS PROJECT WILL BE TAKEN TO ,u-d' SIGNATURE DATE I FOR OFFICIAL USE ONLY PERMITiNO. �j -2- T 7o DATE ISSUED ; MAP/PARCEL NO. l ` ADDRESS VILLAGE OWNER DATE OF INSPECTION": r 44. FOUNDATIONLe FRAME Yl -INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 's PLUMBING: ROUGH- FINAL GAS: ROUG� 0 FINAL ` L FINAL BUILDING , _, -y t DATE CLOSED OUT a ' rzir ASSOCIATION PLAN NO;-, ,e t.3 3.! 5Z rl i , The Commonwealth of Massachusetts • = . Department of Industrial Accidents Meg 611MRS/ 8980s 600 Washington Sheet Boston,Mass 02111 Workers' Com ensation Insurance Affidavit r CC name: ,\e ft"l �� <LO V I T Z . location: 0 AJ - A)�eL. \©u)k city \ n-i%x .T T . 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I understand&d a can of thb abdenunt may be forwarded to the Ofte of Invesdgadons of the DIA for coverage vetlfienlon. I do ha*cerli under the p ' Patalties ofperpq that the wfomsadon provided above is trw and coned Signature , Date ®l -o Pant name Phan# .06 CoMdalam do notwrite m this area to be completed by city or town ofildal pie# pepuftent l�gMdIng Boardediate respome b regodrad pseleetmen'a OfiiapHed&Departm®t phone#, pother (nzW 9195 PJA) 1 - . �/q / . 1 •(1 �. 1 1 -. 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APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVIIVG SPACE i f $ q square feet x 96/s .foot= x.0031= l`P� plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq. >120 sf-500 sf $35.00 r >500 sf-750 sf 50.00 `D� >150 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= ` (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projcost The Town of.Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Peter F. DiMatteo, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 r r 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. f� //-- Type of Work: �1 0 n) Estimated Cost Address of Work: Owner's Name: �z��Y ��r Jlav l 1 L Date of Application: a I— 0 y —.0 Z. I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under.$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given.that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: ep/-oy-o�:_ Date Contractor Name Registration No. OR Date Owner's Name q:for=:Affidav:rev-122001 �f HUB 611 THE MCCARTHY COMPANIES ►ntemati®ncl September-25,2001 Densmore Building &Remodeling P O Box 659 South Yarmouth,MA 02664 Re: Policy Number: XACRUB2266W99 Coverage: Workers Compensation Term: 09111/2001 .to 09/11/2002 Dear Wayne: Enclosed please find your new Worker's Compensation Policy written with the Travelers Insurance Company. Also enclosed is the notice to employees(which should be posted)and the claims reporting procedures. Employer's Liability is included with this policy at the following limits, Bodily Injury by Accident 100,000 each accident Bodily Injury by Disease 500,000 policy limit Bodily Injury by Disease 100,000 each employee Please review the policy and payroll levels to be sure that they reflect accurate projections of what you expect for the upcoming year. Thank you for allowing our agency the opportunity to service your insurance needs. Should you have any questions or if I may be of any assistance, please do not hesitate to contact our office. a/e f'binrwcua:.r�!/r �'..f�nw.•c1.uu�lt ✓�e � � :.,jl� 4:�, oricinonufea l� �� �zJ:urc ruaelz~. BOARD OF BUILDING REGULATIONS NOBS INPROUEHENT CONTRACTOR License: CONSTRUCTION SUPERVISOR Registration: 116494 Number. CS 065025 Expiration: u6i"tt12602 Type: Individual Expires:08/06/2003 Tr.no: 1935 �, . OENSitO4E P,EIt40ELIHC Restricted: '00 ENE DENSflOR[ WAYNE R DENSMORE , a.orl�ntisit�azaR PO BOX 659/ LILY POND DR, PO BOX 659 SO. YARNOUT S YARMOUTH, MA 02664 Administrator _.___— MAScheck COMPLIANCE REPORT Massachusetts Energy Code ( 'Permit # MAScheck Software Version 2.0 I I I Checked by/Date I I CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 . family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 1-3-2002 DATE OF PLANS: 01-03-02 TITLE: Addition of rooms & garage PROJECT INFORMATION: Jerry & Gail Elovitz 1860 Santuit - Newtown Rd. Cotuit, Ma. COMPLIANCE: PASSES Required UA = 305 Your Home = 281 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ----------------------- -------------------------------------------------- CEILINGS 816 30.0 0.0 29 WALLS: Wood Frame, 16" O.C. 1600 19.0 3.0 86 GLAZING: Windows or Doors 250 0.400 100 DOORS 78 0.350 27 FLOORS: Over Unconditioned Space 816 19 .0 39 COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 131/0 and J4.4. ��'y�-0Z Builder/Designer V'� Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 Addition of rooms & garage DATE: 1-3-2002 Bldg. 1 Dept. 1 Use 1 1 CEILINGS: [ ] I 1 . R-30 1 Comments/Location i 1 WALLS: [ ] 1 1. Wood Frame, 16" O.C. , R-19 + R-3 1, Comments/Location 1 WINDOWS AND GLASS DOORS- [ ] 1 1 . U-value: 0.40 1 For windows without labeled U-values, describe features: i # Panes Frame Type Thermal Break? [ ] Yes [ ] No I Comments/Location DOORS: [ ] i 1. U-value: 0.35 Comments/Location FLOORS: [ ] 1 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ ] 1 Joints, penetrations, and all other such openings in the building 1 envelope that are sources of air leakage must be sealed. Recessed 1 lights must be type IC rated and installed with no penetrations 1 or installed inside an appropriate air-tight assembly with a 0.511 1 clearance from combustible materials and 3" clearance from insulation. 1 VAPOR RETARDER: [ l I Required on the warm-in-winter side of all non-vented framed 1 ceilings, walls, and floors. 1 1 MATERIALS IDENTIFICATION: [ ] 1 Materials and equipment must be identified so that compliance can 1 be determined. Manufacturer manuals for all installed heating 1 and cooling equipment and service water heating equipment must be 1 provided. Insulation R-values and glazing U-values must be clearly 1 marked on the building plans or specifications. DUCT INSULATION: [ ] 1 Ducts in unconditioned spaces must be .insulated to R-5. Ducts outside the building must be insulated to R-8.0. 1 DUCT CONSTRUCTION: [ ] 1 All ducts must be sealed with mastic and fibrous backing tape. . 1 Pressure-sensitive tape may be used for fibrous ducts. The HVAC 1 system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ] 1 Thermostats are required for each separate HVAC system. A manual 1 or automatic means to partially restrict or shut off the heating [ ] I Rated output capacity of the heating/cooling system is -- -� I not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. I MISC REQUIREMENTS: [ ] I Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids I below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only)------------------------- NO2 3255,.E a o � N 3� o r 50 f RS o �, 186. �i C SS. � OT 24 ro 0 c o 218.18 , ' ASS. ,# LOT 25 ZONE.' "RB" This MORTGAGE INSPECTION Plan is For FLOOD ZONE. "C" N: _BAB1l�ST Bank Use Only--�22,7 __----_- REGISTRY OWNER D REF: 5�1�5l��'.3__ -BUYER: 2,ERALp P `N_ - '_-HARE Z?-------- 'E:BY!M 01A9 E --------- PLAN REF: 73 51._EL�I.YLT�--- _ _ 1„------------ *,"""------SCALE: ------- RE CERTIFY TO '- --- ____ FT F�� Z � 5�9ZL'E�1NI11N _ 177AMA nS 77rLE/NS. CO & ZEFFREY�._s_rERVTHAT THE BUILDING , SHOr,yq ON THIS PLAN IS LOCATED ON THE GROUND AS YANI<EE SURVEY rN AND THAT ITS POSITION DOES -_-- CONFORM MEHITHEW CONSULTANTS HE ZONING LAW SETBACK REQUIREMENTS OF THE No.3209a OF ---$AL?LVS'ZABZLE'-------------- AND THAT ,, y 40B INDUSTRY ROAD ►ES_ AVOT_ LIE WITHIN THE SPECIAL' FLOOD HAZARD SI�o� MARSTONS MILLS, MA. 02648 AS SHQWN ON THE H.U.D. MAP DATED_z/_Qb2 _ gyp E,,p� TEL: 428-0055 _. t - ane ,250001 00121 D FAX 420-5553 MA Lie. p.Lic.311 Estimate Densmore Building&Remodeling Home Imp.Lic.3 t t6494 P.O.Box 659 S. Yarmouth,MA 02664 DATE Estimate 1-508-394-7249 12/11/'01 200176 fax 1-508-394-2226 — NAME/ADDRESS Jerry&Gail Elovitz 1860 Santuit-Newtown Rd. PHONE PROJECT TERMS Cotuit,Ma. — --- 508-420-0032 508-420-0032 item list — DESCRIPTION TOTAL_ -� garage door left over with opener 7'6"tall x 17'wide gray$1375.00+tax installed gray New appox.$500.00 more 0.00 i 2 slylites front of garage Velux Venilating Skylight 30x46 2ea., 1 Pole,Screen,Flashing$1040.00 ; 0.00 remove existing living room roof-straighten the roof line&re shingle$2,000.00 0.00 Total other cost as of 12-18-01 not in total cost of contract$4,415.00 three above items i A. Start date will be 2 to 3 weeks after building permit has been issued.As of 12-8-01 start date Feb.2002 Completion 4-5 months depending on weather,material,sub contractors,inpections,&holidays I B. Pressure Treated frame&deck material is a wood material.Densmore Building&Remodeling IS NOT RESPONSIBLE FOR ANY P.T.WOOD THAT MAY SPLIT,CRACK,CUP,TWIST,RAISED GRAIN,LUMBER GRADE STAMPS C. All work done to or above state&focal codes&standards,site to be clean&safe at all times,work done in a timely&professional manner,crews to work daily,delays do to storms,special ordered items,emergency,may interrupt dailey working time. D. NOT INCLUDED IN PROPOSAL-septic upgrades-survey&engineering-problems that may arise due to existing plumbing& electrical-plumbing work:-cabinets-flooring-fixtures-hidden rot-painting or staining only as written E. All work out of scope of work,written or verbal,will be fixed at the rate of$50.00 per man hour, plus the cost of added material.This i hourly cost is for Densmore Building&Remodeling only!This does not include any other trade cost. F. Payment is only a guild line.If payments are not paid,work:will not go forward till payment is made.In the case of legal action owner of property to pay for all legal&collection fees. I I total cost of project 13 6,098.00 Deposit to hire.Densmore Building&Remodeling,for-plans to be drawn&permits$200.00 0:00 j payment start of project$12,009.00 , 0.00 II payment finish of addition concrete form work$12,009.00 0.00 payment finish of 2nd floor walls$12,009.00 0.00 payment after garage is framed$12,009.00 0.00 payment after roof is shingled$12,009.00 0.00 payment after windows are installed$12,009.00 0.00 { payment-after-sideing is 801/6 done$12,009:00 0.00 1 payment after electrical rough$12,009.00 0.00 payment after plumbing rough$12,009.00 0.00 payment after sheetrock$12,009.00 0.00 payment after interior trim is finished$12,008.00 0.00 FINAL PAYMENT-UPON COMPLETION&PUNCH LIST,I LIST ONLY.$2,000.00 0.00 This proposal/contract is binding on all parties who lawfully succeed to the rights or take the place of the Owner or Contractor.This 0.0 contract may not be assigned by either party without written consent of the other.This contract is acceptable and 1 hereby authorize Wayne 1 R.Densmore to act as builder/agent and to proceed with the terms of this contact. 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Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 24' 6' 2' basement wnwIgws 15Ki3 I _ { { I { 4' 24' triple 200 canted beam footing 23)Q3-girder column max { span 6 3'OM 2.3.3b) t'+l� + Sea-2'x4' footing basement windows 157 , _ { { garage I'I addition 8" concrete slab �___-_ 34' I ( 24 I UP � I g I ►rint ii ' basement winftws 15542" 161 — Front porch — 14' scale 1/8" = 1 ' ea VA' b footings 1+) I I I 1 f 11 � 1 I foundation 1/81 i owner Elovitz NewtownRd. Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 24' T f 6' 2' 4x6 pt post Wopt deck frame' 2x12 of stair frame 4' 24' 18- 1 __ 1st&2nd floor frame 2x1 0 Hioist 16"o- IM - —� - garage I addition 24, 3 4 garage floor frame 1 st&2nd floor_ I 14"I joist 16"oc stair frame 2x12 g int ----- -----Front porch — 4, _. " a front porch frame 2x10 w/44 post for W beam&roof I I I I owner Elovitz N_ewtownRd. Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 i 3 tab roof shingle/15 lb felt!�1� �� /� 2x10 ridge&hip beams 2.8 rafters 16'. r30 ceiling insulation \\ r30 insulation _ 1z6 fasic 'yiM till It it Milt IMMAN M ceiling joist 16• 2x6 r-1g c N 112 cdx plywood zo 26 8 studs 16•oc WO window 8 door headers 4A pt post 2x10 pt.joist!5f4x6 lrax 1=1 Hh -18 floor insulation full basement r4• 8•oonaete watt f�%�oundation�j 7 concrete floor 16•footi addition cross view 1/8" = 1' owner Elovitz NewtownRd. Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth I phone 394-7249 fax 394-2226 _ 4x4 pt posts, 2-2xl0 roof beam/header, W roof rafter, 1/2 cdx roof plywood,3 tab roof shingle over 15#felt paper 2x10 pt deck frame-16"oc, 5/4x6 trex decking, min. 1"air/water space @ house, 1/2"lags&bolts as needed, simpsonj!?List hangers &post anchors. / 5 l 12"A!soni tube concrete filled footing ---- Vi front porch t,-a,, scale 1/411 = 1 ' �. 00 c�a 1 1 ! O11 II / Garage footing/slab 2' footing with 12" soni tube 4' deep &8" concrete floor, I scale 1/2 " = 1 ' owner Elovitz NewtownRd. Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 --48'-1 F_— 23'-10 5/8" -0 24' " -11' 71/8" Q 12'-0"— FIZA"-- - - lot v - ,n •- zo J — , IN r dM 400 GARAGE 2Y•.Ua 1 +I Oj CM 1 M (0 I I — ►— — 1 N O �I I n PORCH , — n LIVING AREA St floor 1729 sq ft I 24'-3 5/8" �\ 23'-11 11/16"— -11'=11 5/1 —"— --- I N / 11'-9 7/16" bedroom b114100T IWrt18b0YC Q312tj2 Jj i 1 1 o 1 ------ N t.0 \` Iv' ' 1 '°ftOD �- i open 1 scale 2nd floor �� owner Elovitz NewtownRd. Cotuit 11 -8-2001 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth. phone 394-7249 fax 394-2226 i A complete TJ-Xpert framing plan includes the Trus Joist Builder's Guide or Pocket Guide TJAXpert. 34, CREATED BY Mid-Cape Home-Centers 465 Route 134 PO Box 1418 So. Dennis, MA02660 11 508-398-6071 ' c FAX: 508-398-4559 q - - JOB COMMENTS 1 - - - DENSMORE.BUILDING d REMODELING ELOVITZ RES - - NEW TOWN RD MARSTONS MILLS " LEVEL NOTES y File Name: Elovitz.job • Level Name: FIRST FLOOR - _. • y, t Plot Date. 11/28/01 09.53 r Design Date: 11/28/01 09:46 - Drawing Scale: 1/8" = 1' j Job Status: pl r Foundation....Foundation - FIRST FLOOR...Plotted Pcl 11/28/01 09:46 - <n .� NOTE: Level design times indicated above ' provide assurance for proper level stacking. Upper levels must have earlier design times. t - Design Methodology:. ASD . - - Floor Area Loading Is: - 40 psf Live Load .., 12 psf Dead Load Maximum Joist Deflection: L/360 Live Load L/240 Total Load -TJ-Pro Rating Information: - ,� Weighted Average: 46 Lowest Rating: 46 Highest 46 Glued6 Nailed•Decking is Assumed Direct Applied Ceiling is Assumed .. Floor Decking:-3/4" Plywood • . Normal O.C. Spacing = 1211* Default Wall / Beam Width: 5.5"* TJ-Xpert 6.11 (#675) A t C6.11 D6.11 56.11 P6.11 *Unless noted otherwise SYMBOL LEGEND 1 r 1 1 J TJI Joist Type ' M Rectangular Product Type, ® 24' _ — Bearing Wall . — Beam PC Parallel Closure Type O "Point Load - Line Load O Area Load JOIST AND BEAM LIST - _ ACCESSORIES LIST O Detail Callout Label Plot Unit # of Net Plot Unit # of Net (See Builder's Guide or Pocket Guide) ID Length Product t Plies t ID Length Product Qty Plies Qty O Bearing Width Label g 4 Qty Y r J1 24' 14" TJI/Pro-350 joist 24 1 24 Rml 16' 111/4" x 14" 1.3E TimberStrand LSL 4 1 4 ► Joist Layout Symbol Pcl 24' 14" TJI/Pro-350 joist 1 1 1 " TIPr - joist ' „J2 20' 14 J / 0 350 7 st 1 1 1 / Plywood • Shl 4' x 8' 3F4 y ood 19 1 19 TRUS JOIST FOR THE TJ-XPERT WARRANTY SEE BUILDER'S GUIDE OR POCKET GUIDE (�v J r ■ overview , — — 3068 3068 3068 — — — — — open \ o . O 0O O 10-07 bathroom owner Elovitz NewtownRd. Cotuit 3-27-02 Densmore . Remodelin g P.O. O Box 659 S. Yarmouth phone 394-7249 fax 394-2226 PPI f 24' �47— gq�29.5 G f 4' 24 18 1 ro roses w garage addition If e)dsUng I I footprint ,e Front porch V 32,3. ,_..._, plot owner Elovitz NewtownRd.- Cotuit 3-27-02 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 y 1111i MIN ------------ 15#felt paper shingle to match fit :J1t11E1d1:1 !r-30 roof insulation - dbl 2x10,s for- /2" cdx plywood 2x10 rafter 16" oc i dbl2x6 top plate tripel 2x8 header 6 --6068 slider 13' 2x6 wall constructi, 3/4" plywood floo 2x10 floor joist 16 T grade new block wall = q 5" concrete dust cover existing block wall-� o Cross section footing 1 /4 1 ' 1810[ 2'4 owner Elovitz NewtownRd. Cotuit 3-27-02 Densmore Building & Remodeling P.O. Box 659 S. Yarmouth phone 394-7249 fax 394-2226 • • . • • • • • � . 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