HomeMy WebLinkAbout0685 SANTUIT ROAD � �s �a�„-,---
� �
�r
t r Town of Barnstable *Permit Jo
Expires onths from issue date
Regulatory Services F e
Thomas F.Geiler,Director
SEP 4 Building Division
Tom Perry,CBO, Building Commissioner `-
\NN OF ��� I�gL� 200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax:508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number G d Z f
p
Property Address 6�3 dun-iu 6 14" 9 lI ed�d i'f"r !7'N
4
[Residential Value of Work 106 60 Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address e Q o n G • illl0 ✓
Contractor's Name 0 y[W 4. 619 f/t P 1'1V ! Telephone Number "al Yill 5, j S
Home Improvement Contractor License#(if applicable) AP1 -7 3 7
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Cbe k one:
am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance.
Insurance Company Name
Workman's Comp.Policy# r
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box) .
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
h-eocn,.n fyJ
#of doorsNf/tY d a
.[Replacement Windows/doors/sliders.U-Value c It (maximum.44)#of windows `
*Where required: Issuance.of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
red.
SIGNATURE:
C:\Users\decollik\AppDa ocal\Microsoft\Windows\Temporary Internet Files\Content.Outlook\4STGU5QO\EXPRESS.doc
Revised 090809
a..ominopaweakh®fIc wsechuseas
dDeRaavtaeAt 0f1z&s&WAccMeajs
oflavesfigafions
Workers' Compensation Insurance Affidavit; Buis ers/Contracto
Iicant Information � jeCtricians/Plumbers
Please Print
Name(Business/Organization/Individual): d V At 6 13.0 i/i/ t n
Address: P e l e g 2 .� cc tL Jl� ev �.✓
City/State/Zip: {,
Are you an employer?Check the a ppropriate]boa: Phone#: rOl ylt 6��y
1•❑ I am a employer with 4. ❑ I am a general contractor and I hype of project(regrired):
employees(full and/or part-time).* have hired the subcontractors 6• ❑New construction 2•�I am a sole proprietor or partner- listed on the attached sheet. 7• ❑
slop and have no employees These sub-cont eve Remodeling
working for me in any capacity- employees and have workers' g- ❑Demolition
[No workers'comp-insurance comp.insurance.$ 9- ❑Building addition
3•❑ required•) 5- ❑ We are a corporation and its i0.❑Electrical repairs
,I am a homeowner doing all work officers have exercised their or additions
myself. [No workers'comp, right of exemption per MGL 11-❑Plumbing reps or additions
insurance required.]t c. 152,§1(4),and we have no 12•❑Roof repairs
employees-[No workers' 13.❑Other
comp-insurance required-]
Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all Iwo and then hire outside con
;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'co tractors must submit a new affidavit indicating such.
p mp.policy number,
formation.m an employer that is providing workers
information. COMPensadOiz insurance for my employee& Below is the policy and job site
Insurance Company Name:
Policy#or Self-ins.Lic.#:
Expiration Date:
Job Site Address:
Attach a co City/State/Zip:
py of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
do Oaeveby certify t a ns and penalties o e 'ra that the information provided above is true and correct.
./•p rJ r1'
Si ature:
Date: .
Phone#:
Ojfcial use only. Do not write in this area to be completed by city or town o�cia[
City or Town• Permit/License#
bsuing Authority(circle one): -
L Board of]Health 2.]building Department 3.CityrTown Clerk 4.RlectAcal gmspecter S. :�,,�;��„�v �
6.Other 'y
Contact Person: Phone#o
�� Boa�t�'6f0ilt�i�r � fi �to� afitY�tr +tl� g Licenrz or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. if found return to:
Board of Building Regulations and Standards
Registration: 105737 One Ashburton Place Rm 1301
- Expiration: 7/20/2010 Tr# 0 Boston,Ma.02108
Type: Individual
JOHN C.BOWDEN
John Bowden
28 Lady Slipper Lane 1< t ali out signature
Marstons Mills,MA 02648 Administrator
✓fie Vamirna�zus�of.iC�aa�acfiu�
Board of Building Regulatio s and Standards
i' Construction Supervisor License
c License: CS 14224
Expiration' 4/8/2010 Tr# 22052
Restriction: 00
JOHN C BOWDEN
BOX 26/28 LADYSLIPPER LN LI•j-'�-
MARSTONS MILLS,MA 02648 Commissioner
t
� lAEP19fAiit.
Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
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
Property Owner Must `
Complete and Sign This Section
If Using A Builder
as Owner of the subject property J
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Addresi of Job)
ature of Owne Date
Print Name ,
r
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\MY7NB4IL\EXPRESS.doc
Revised 100608
t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Z Application#
Health Divisi -3
qlConservation Division Z9 Permit#
'SEPTIC 8;*61E MUST B�
Tax Collector 'PHSTA LL D IN CORAPLIM Date Issued
Treasurer WITH T[CLE 5 Application Fee U
Planning Dept. 10M4 HIGUL AMJ ; Permit Fee t-3 07• S�o
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address
Village Caw-e
Owner C C CA�-X:: t- ,_5_Oe9 W! �► Address
�v•�S S �.-�'11 i f''r-�
Telephone .�L� � ClzC) 0 Z 0.3
Permit Request A ��� Z® � Z� 4IZZ:X &T- C
Square feet: 1 st floor:existing Cad proposed 2nd floor:existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation �-�` Construction Type %N CU
Lot Size Grandfathered: , Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure / 0 Historic House: ❑Yes IgNo On Old King's Highway: ❑Yes gNo
Basement Type: 1 ,Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) NO Basement Unfinished Area(sq.ft)
Number of Baths: Full:existing new Half:existing new v
.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:O existing ❑new size
Attached garage:❑existing ❑new size Shed:9exisfing ❑new size Other: s '
.Zoning Board of Appeals Authorization .0 Appeal#_ Recorded❑ _ _ _zr_
Commercial ❑Yes No If yes,site plan review#
Current Use . i-b 6-AiCam" Proposed Use
/` d BUILDER INFORMATION c-15 C, F5 gOCS 03 0 G
Name t� �_ c C&C&e` CAQ Ch W�� Telephone Number c� , �, ���
Address d'Q '> --�" License#
Home Improvement Contractor#
Worker's Compensation#6AV 8 Ix ur
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �d��.• G �*
ow
SIGNATURE DATE
t
FOR OFFICIAL USE ONLY -
PERMIT-"NO.
DATE ISSUED''
MAP/PARCEL NO.
ADDRESS VILLAGE
OWNER
• i r . t t
z .
DATE OF INSPECTION: -
�ONO
FOUNDATION 1496
.,FRAM
INSULATION �/�S°�o���o
FIREPLACE '
ELECTRICAL: ROUGH` FINAL + `
PLUMBING: ROUGH FINAL '
GAS: ROUGH FINAL `
FINAL BUILDING j Pir � PC/�3/0(o
f
DATE CLOSED OUT t _
ASSOCIATION PLAN NO. r Z <
}
4/26/2006 6:19 PM FROM: 781 821-0281 Lipner. TO: 1 508 339-6616 PAGE: 002 OF 002
Apr 26 1'06 06:37p Gregory A. Cauldwell SQ8-339-6616 p. l
Town of Barnstable
�rr �4j Regulatory Services
Tbornm F.Geller,Director
Building DiAsion.
Torts Perry, Building Commissioner ;
200 h'aia St-At Hyanafs,MA 07601
wttw.town.barnstabk.ma•us.
Office: SCS-861-4018 Fax: SJb %9'J c2�n
Property Owner Must
Complete and Sign This Section
If Using A builder
I, 0 ,as Owner of the sub' `ct ro
____. �" p Pew
r0rr r—OW.- v
rerebyauthcrim (404-b W tiles !Av4 -t- to act on rny behalf,
is ail matters relative to work aixborized by this binding permit application for.
-
ss of job
Snature o C?vvner Date
�•�oe:.ls.gvvriF�F.r�trtlssro�
I {�
I ,
°k1HET Town of Barnstable
Regulatory Services
� r�I'E� Thomas F.Geiler,Director
A�fo;ora�� Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
i
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: /;?��/-104 G�'°f/`I. Estimated Cost
Address of Work: 6 d 5' SAN—r� iT C
Owner's Name: _®A Al 14 L 1 10/V 06T�% '"�" C,&,, v4&^ CCA l t<
Date of Application: A em: 6
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date Contractor Name Registration No.
OR
Date'. Owner's Name
Q:formslomeaffidav
1091S Ise
r, ala+epineC do .
JldilOd?�1 9ll9Mt]1i1N0 aan;sa�ts;noq;ib pgsA
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P BtSP. s Wl- �lgkiolau49sV_aub
spaspue;�r-` � �t�l� '
1�
✓/fie-pomvnzo�za�ea� a��/�ocr�u�ka
BOARD OF WILDING It 'LATiON$ '
License: CONSTRUCTION SUPERVISOR
Number: CS 033572
BirEhdater-09/25/1.948
Exphesc'09125/2007 Tr.no: 3361:0
Restricted: 00 _ .
GREW A CAULDiNELL
880 EAST ST
MANSFIELD, MA 02048 � .
�� ` ✓� mod„ �� ,�
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number: CS 033572
Birthdate• 09/25/1948
Expires:09/25/2007, Tr.no: 3361.0
Restricted: 00.
GREGORY A CAULDINELL
880 EAST ST
MANSFIELD, MA 02048.
Commissloner
-
Board gf BuiIdiu4,..q.*#pna•' —, tandards r -
Xw
;�C .a%:aclt/ ✓One Asbburtoglace-Rm`1301'
Boston,Ms.0210W" � wuf.BuiWin g Regulations and Standards
1409 IMPROVEMENT CONTRACTOR
Registration: 105829
Elzp..i�atroli :7J21/2006 -
,_� . .--Type 13A _.
vIllN valid without signature CAUIDWEtL BLat3&CONTRACTING
vory Cauldwell
=ast Street {
—
_ 0204,E
;s
Apr, 28 06 03: 27p Gregory A. Cauldwel1 508-339-6616 P. 1
?Ai cult Appendix 0
Tjkbk J.&Llb(eoatlnumd)
Pmceipti ve Parlragta for C�a am 7'wo•Ftutdy luldentlal Boildlags F.Jmwi with Fw.sil Fuels
. ..
�dAX]<1b1[1M M11;1T11h�Pt3h! _
Gilazins3 01
aaing Cr2 n0 Wed Roo rr Balumem Sub Hes n&1Cooling
Areal(°m1 ! U.valut� €t valaic R-value° R-valued' wall pe#easarea' F�uipmsnt F.flicl�ey'
P' e-L,..__ R valueo R-value'
_ 5701 to 6500 Hearing Degree Day9'
P2•J• 0.40 31 13 19 10 b Normal
R 12% 042� 30_ 191 _ l9 l0 6 Norma!
85 AI-VE
_T 153b 0.36 R 13M
.� MIA Normal
u 13% 0.46 � 3E _19 6 NoitnaiLJV 15% 0.44 30 13 NIA E3 AFUE
W 15% 0.5 2 30 19 6 �33 AFUE
12% 032 is i3 , N/A Normal
Y 12% 0.42 39 19 WA Almrrra!Z 1S°/u 0.42 33 13 �� 6 50AFUE
AA I8"! 0 0 0 30 19i1�w 90 AFUE
I. ADDRESS OF PROPERTY: L� � '57 y�/� �l-
2. SQUARE FOOTALGE OF ALL EXTERIOR WALLS:
3. SQUARE FOOTAGE.OF ALL GLAZING:
4. %GLAZING AREA(93 DIVIDED BY 42):
5. SELEC'C PACKAGE:(Q—A.A.-see chart above):
NOTE: OTHER MORE.INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUILDNG INSPECTOR APPROVAL;
YES: NO:
!A-forms-0903033 .7
pp(NEA- The Town of Barnstable
BARNSTABLE. Department of Health Safety and Environmental Services
9 MASS.
i639• �0
p�EO MA0 a Building Division
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection
i
Location �$�S'4/V 7u/Y �o�FD Permit Number Op SJ
i
Owner Builder AL
One notice to remain on job site,one notice on file in Building Department.
The following items need correcting:
O
Please call: 508-8624OWfor-r-e=irrr spcectiorr.-
Inspected by
Date 4 G D (0
The Town of Barnstable
BARMASS.S.NSTABLE.D! Department of Health Safety and Environmental Services
MAS0
PIED MP'�a Building Division
200 Main Street,Hyannis,MA 02601
Office: 508-862-4038
Fax: 508-790-6230
Inspection Correction Notice
Type of Inspection 1 /214--r'x C
elLocation 62�S ,(' /)W"ermit Number 2u,0( 00 S-s'
C,-r '
Owner Builder
One notice to remain on job site,one notice on file in Building Department.
The following items need correcting:
1,,41 c- /'imi c N&C—�--i6
n2_ JJ (C_n rt�--S- -(f 7-4 E-Y5
r�
Please call: 508-862-4 forTe-i speetion.
Inspected by
Date e-
3 f O
,
a
OIC
i I k`
� j 1
T
i
' RUN PIPE LEVEL. 2' DOUBLE WASHE
IS PROPOSED1500 FOR FIRST 2'
GALLON SEPTIC
TANK (H-- 10
GAS
MIN BAFFLE 22.49' pow 22.32l l� Cl CJ C7 t
< 2 % SLOPE) a :! . 0 0 m a C
CRUSHED STONE OR MECHANICAL o 0 0 [] C] C
COMPACTION. (15.221 C23) $$ �'. (� C
DEPTH OF-FLOW = 4
ry. rTEE SIZES < % SLOPE) } ( 1 % SLOPE) 3/4" T
°
a.
INLET DEPTH 10" Y
. DauB
-
0
14
• .4
OUTLET DEPTH "
OUNDATIaN-- 16'
r SEPTIC TANK sJ' D' BaX 7 13'
` ,. + N N v '+ 28.4
IEXIST- WELL
+.24.5 Aft� w
+ 5.9'
194,78' o.o
LOT 32A. Ir
33,228t SQ, FT. + 27.4 \ + 28.6
\. 0,76±° ACRES 26.3
o \
+c 1 ED
+ 2 f �'
•8 27.9 •0� TOWN `,WATE
27.8
. 26.6 C NC. 27.6 PATIO
PROP. 1500 GAL 5'1+ 6.7 SID ALKS \
' SEPTIC ,
5EP C TANK N
CES
-w(NOTE,-
SPOOL
--- -- \ -
-" OC i0 '
3 _
'N
` \ UNKNOW 5/
, . N� . [n
u F N' �•
rD .0,EXIST. a
7 DWELL. 7.6+ 27.7
TF = : 0 27.8 �
8 4.8 �. 6.4 28.0 - \ N
+ 28.1
TH S �1
2� 4. 7. 27.1 2 -1C
a. + 28.4
$.3 8.5 p
Ip• r . 24.2 a .0 ��Q ORS 8.4
i
26.6 + 2
TOWN WATER. 26.6 �I-2s.4 29
6 O + 27. � i
26.4
2 b.4 27.0
i
. 26.7
�:� '26 2,:a 2j
BENCH MARK - TOP OF CONC. `BOUND f
ELEV. - 25.5' / �s
-25.4
--------------
TOWN WATER
0 1 •--2'8�3
4 '
SMOKE_DETECTO S ,n
JE ED
BARNSTABLE BUILDING DEPT. o�'
FIRE DEPARTMENT
BOTH SIGMA FOR
TURES ARE RE U/RED DATE
Q PERM/TTiNG
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