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HomeMy WebLinkAbout0026 SHELL LANE a� s�� � z� r MAR-02-2012 13:54 From:MAP INSULATION To:15087906230 Pa9e:2,12 M.A.P. INSTALLED BUILDING PRODUC7P R.O. BOX1.309 N SAGAMOR BEACH, MA. 02562 _ (509 888-359.9 (508) 888-9609 Fax r o Date jb co mpleted: 2 Zip Address of foam application: 00 ,T' MA-. Z(�' Inches spxayed in: Ceilin Walls 9:) 1. o Slopes g Overhang Bsmt Ceil Stwl Blockers &Runners Cath Ceil Cath Walls Knee Walls - AM Wells - Crawl Ceil ins iollers Signature: � T v. r - AR-02-2012 13:54 From:MAP INSULATION To15087906230 '. Pa9e:1,'2 f MAP INSULATION CO INC. P.O.BOX 1309 SA.GAMORE BEACH,MA 02562 TEL 508 888 3599 FAX 508 888 9609 : " FAX TRANSMISSION DATE TO: u r . yea o c) FROM kyr MAP INSULATION CO INC... '. NUMBER OF PAGES INCL 1N COVER:lcw s ; -- ILA m y } �� o ���� ,Pr, �e� ll� y � � s ��-- �� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map cerApplication Par Imo, " �F it o l t Health~Division Date Issued o? �I Conservation Division IL _ Application Fee Planning Dept. - Permit Fee4�06 , Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis ��Q o� cProject-Street Address ��O S e S( La A u _ Villager 3 CO 1�' Own, er Ma- lionm Address q 1 vz o w Permit Request 17 _ olive L Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Pr t,Valuation., f v Y�0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ - Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing. ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other- Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ ea Commercial ❑Yes ❑ No If yes, site plan review Current Use Proposed Use APPLICANT INFORMATION p Aa (BUILDER OR HOIVIEOW� NE3R) P - T- wo S— �Name� x, Tblephone�Number Addre�5 License #_ (` S 0;2 G 2Z Home Improvement Contractor# U� Worker's Compensation # k/(-t/® 0 �' ;7�0 0 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /iZ e.� 0V ecf '17 1 f-� FOR OFFICIAL USE ONLY •APPLICATION# DATE ISSUED MAP/PARCEL NO. . . i ADDRES,� VILLAGE OWNER DATE OF INSPECTION: °! 'FOUNDATION J,146e4-c-LP 1 4,4 FRAME M Ok =t !2 AY►a.cA-- INSULATION' ClK 3 /L FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS:, _ ROUGH _,a - FINAL r - - t - 'FINAL BUILDINQ- dr 2. 12 4 DATE CLOSED OUT rA ASSOCIATION PLAN NO. = ' f Massachusetts- Department of Public Safety ✓ °�" 'ZO 'w��t� ��� �uaet�a Board of Buildin!� Re.1ulations and Standards Office of Consumer Affairs&Business Regulation Construction Supervisor License - HOME IMPROVEMENT CONTRACTOR License: CS 85275 Registration; 151195. Expiration 5t23/2012. Tr# 294067 ' —, 4TRICK F HOBAN Type,i' PnvateCorporation BRACKL00N TILE oafflNC 33 WASHINGTON ST I PATRICK HOB AN aNroN, MA 02021 z 183 WASHINGTO`N STD CANTON, MA 02021`-,, Undersecretary Expiration: 3/13/2013 ('ummissioner Tr#: 13326 t _ n L—I X r Z > n C7 '� 10 O _ N .yf a O m e- rv /Z� DCID J V/ N C _I � O c 7J f; (D C k G m O .� c w.j � .� t' C •r. j I _ I I T6w)a.Of Barn-stable . Regulatory'96rvdces ;ixresrA�r� Tb c) as F. Geiler,Director c5p ��b Building Division r-o►, - Thomas Perry, CB O,-BLi2ding Commissioner 260 Main Street, Hyannis,MA 0260I' 4--wv.town.bart? ble.ma_us ..'Fax: 508-790=6230 'Officec 508-862-4038 PLAN REVEW #I. Z v !( b ! 77 Owner /1'IAia✓�y _ Map/Parcel: ddress Z(�5h�lfGanc G f Builder- Proiect A ' The fallowing items werB noted-on .reviewing: 'oF S -- -Z�C Z�� 30 f �s i ivy- ' ✓ �o�� /`�� s.• - • Re -iewed by: Date r The Commonwealth of Massachusetts Department of Industrial Accidents Offzce of Investigations a ' 600 Washington Street Boston,MA 02111' . .' wtvw.mass.gov/dia Workers" Compensation Insurance Affdavit: Builders/Coiitractors/Electricians/Plumbers Applicant Information L / `..Please Print Le 'bl �---Name'�(Business/Organzation/Individual): . [�A ddress '`/' G✓Gi S `i ������ S6'_ (; t I e�t h /Icy City/State/Zip �C j/,e,,j L�� U,)L Gz Phone w: G/-71 — tyo2 9— �U•5— Are you an employer? Check the appropriate bog: ;Type of.project(required):. 1.❑ 1 am a employer with ' 4. [] I a a general contractor and I m 6. New construction . mployees(full and/or part-time).* • have hired the sub-contractors 2.L2 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 vorkin for me in an capacity. employees and have workers' g Y P P com insurance.;, 9, []Building addition. [No workers comp,insurance. required.] 5• ❑ We are a corporation and its 10.❑•Electrical repairs or additions officers have exercised their 3`� 1 am a homeowner doing all work . 11.El 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' 11 Other comp,insurance required,] *Any applicant that checks box K 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 mutt submit a new affidavit indicating such, tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornotthose 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: Tob Site Address City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains•a`ndLpenalties of perjury that the information provided above is true and correct Signature � � '�. / LGY� ,...��.Date:—._,.,// � 6 U S� Offzcial use only. Do not write in this area,to be completed by,city or to official City or Town: ' Permit/License# Issuing Authority(circle one): .1.Board of Health 2.Building Department 3. Citp/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Phone Contact Person: #: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee-of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced.acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter..152, §25C(7)states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for.the performance of public work until acceptable evidence of-compliance with*tlie 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), address(es) and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships(LLP)with no employees other than the members'or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should•'`,\ be returned to the city or town that the application for the permit.or license is being requested,not the Department of a 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 complete'and printed legibly. The Department has provided a space at the bottom of the-affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant t 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 Depaent of ldvs�al A.ecldemts Office of Zz� estgac��us , • 6Q4 Washingt6 Street C B.oston,.MA 0.2111 Te1. `61 7-727 4 5-00 e&406 or 1-8-77-MASSAFE Fax�# 617-727,7749 Revised 11-22-06 wwv.Ilmam.&Qv'ldia 11V�F2KERS° COMPENSATION AND EMPLOYERS LIA9ILITY INSURANCE POLICY ` f Inforrna ion Page _..: Atlantic Charter Insurance Company VDAC NCCI Co. No.:29211 Policy Number: WCV00947700 1. INSURED: Prior Policy Number. New Brackloon Tile, LLC Producer: 183 Washington St William J. Sullivan Insurance Canton, MA 02021 Federal ID Number:218412564 Agency, Inc. Risk ID Number: 30 Central Avenue Milton, MA 02186 Business Type: Limited Liability SIC:9999 NONCLASSIFIABLE ESTABLISHMENTS Other Named Insured: Other Work Places: 2. POLICY PERIOD: The Policy Period Is From: 2/4/2011 To 2l4/2012 12:01 A.M. Standard Time at The Insured Mailing Address 3. COVERAGES: A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here: MA B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3A. The limits of our liability under Part Two are: Bodily Injury by Accident $ 500,000 each accident Bodily Injury by Disease $, 500,000 policy'limit Bodily Injury by Disease $ 500,000 each employee C. Other States insured: Part Three of the policy applies to the states, if any, listed here: COVERAGE REPLACED BY ENDORSEMENT WC 20 03 06A D. This policy includes these endorsements and schedules: See WCE105 4. COVERAGES: The premium for this policy will be determined by our Manual of Rules, Classifications, Rates & Rating Plans. All information required below is subject to verification and change byaudit. Code Premium Basis Total Rate Per Estimated Classifications No Estimated Annual $100 of Annual 'Remuneration Remuneration Premium See WC 00 00 01 Minimum Premium: Deposit Premium: $550 $2,732 Interim Adjustment: Annually Servicing Office: Total Estimated Premium $2,583 25 New Chardon Street Surcharge(s) 149 Boston, MA 02114-4721 Total Premium a Surcharge(s) $2,732 Issue Date 02l15/2011 Countersigned By: V Date Copyright 1987 National Council on Compensation Insurance Form 100mv Town of.Barnstable , Regulatory Services, HARNSTAB E'MASS. + Thomas F.Geiler,Director Mass. 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 N Property Owner Must Complete and Sign This Section If Using A Builder big as Owner p ` f of the subject property hereby authorize_ I f Ij�ja}� to'act on my behalf, in all matters relative to work authorized by this building permit. w S J �L , T (Address of b) **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., a Signature of Owner' Signature of Applicant Print Name Print Name Date Q TORM&O W NERPERMISSIONPOOLS Town of Barnstable - Regulatory Services ► ' stixxsusre Thomas F. Geiler,Director MAIRM Building Division �EDµAik Tom Perry, Building Commissioner 200 Maiu•Str=t,_Hyannis.MA_02601 R�vw.town.barnstable.trta.us Office: 508-962-403 8 Fax: 509-790-15230 HOMEOWNER LICENSE EXEMPTTOII Pleare Print DATE AV y, 'x)o r IDB LOCATIO)F:"^' fn l I'� l.1CJ i7 f number street village • ol�> � l;R -- In 4- 1'7 Y 1-0hurl3�g 3�— name h phone# I Get{.�er3Fphane# CU�RB11T?iQA1LING:4DDRFSS:"'�..._ 01" LA 1ah e erty/tawn a ©zip ake Thm current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iass and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as site::ryiso DEFI>\T ON OF HOMROwh'ER . Persons)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, atiachcd or detached siructures accessory to such use and/or farm structures. A person who constrgcts 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 forma 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"homeownet'assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that.he/sho understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and regrn*ir nTS f'`Signature,of,,,_ameovrncr °"""� . Approval of Building official Note: Three-family dwellings containing 3 5,000 cubic feet or larger will be required to comply with the Statc,Building Code Section 127.0 Construction Control.H OMEOWXER'S EXEMMbx .The Code states that "Any homeowner performing work for which a building permit is required shall be ax=' pt from the provisions of this scction.(Scction 1D9.1.1 -Licensing of con=mr-bon Supervisors);provided that if the homoo`vacr engages a gag peson(s)for biro to do such worr,that such Homcowna shall act as supervisor."' )J-any homeownma who use this rxcmptioa are unaware that they are assuming the msponsibilitics of a supervisor(see Appendix Q. Rules&Regulations for Licensing Cmdruction Supervism,Section 2.15) This lack of awareness bft=results in sm-ious problems,particularly when the homcownq hires unlicensed persons. In,this case,our Board cannot proceed against the unlieenscd person as it'would with a licansed Supervi> w or, Tbc honc�:oncr acting as Supervisor is u)dTmtc)y responsrb)e. To ensure that the homeowner is fuDy rwarc of his/her responsibilities,many communities mquire,as part of the parrot application, that the homeowner certify that hrJshe understands the responsibilities of a Supervisor. Dn the last page of this issue is a form currsnt)y used by several towns. You may care t amend and adopt sucb a fom-)=Ttificatioo for use in your community. 2:formes:homccxcmp1 I r Proposal Brackloon Tile LLC 183 Washington Street,Canton,MA 02021 1-781-562-1325 9 Date 07-25-2011 To: Mr Paul Maloney 26 Shell Lane, Cotuit Ma. Description Amount Removal of existing porch&disposing of waste,. Brackloon tile will then rebuild new porch as shown on drawings. Home owner will be responsible for fixtures,tile,&painting Total 30,550 Signature Date ------- -------------------------------- --Zo-io__ ® / Signature Date THE Towti Town of Barnstable Regulatory Services ` s�� Thomas F. Geiler, Director �prFdµq `a� 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 PLEASE FORWARD THE ATTACHED PAGE(S) TO: TO: ATTN: r Zl o f3 H�fJ a FAX NO: C) � RE: FROM: o2T DATE: PAGEN: (INCLUDING COVER SHEET) 508-862-4033 ,io urn•eP FAX 508-790-6230 ROBERT MCKECHNIE BUILDING INSPECTOR TOWN OF BARNSTABLE REGULATORY SERVICES BUILDING DIVISION TOWN OFFICE BUILDING 200 MAIN STREET,HYANNIS,MA 02601 email:robert.mckechnieCtown•barnsteble.ma.us Rer)21901 A To,wTj of B ar nstable Regulatory Services ;�xxsrA�r� =• Thomas Geiler,Director • ksass , � =bs� wilding Diyi.sion Thomas Perry, CB 0,Building Coi-nmissioner 2oD Main Street, Hyannis,MA:D2601 www.town.bams-table.ma_vs Fax: 509-790-623D f Officer 508-862-4035 PLAN • � Nfap/Parcel: 0 6 g Owner- �Ga> ProJject Address 2( L ,.C'� Builder The faIIowing items were noted.on reviewing. nc P i cE • le) /0 aPr S iQoOt o — 0 � ire E: mo �i.� �o��• �E-,c9kls-/Rorr�cTio� . . N� �t�IV-�ioi✓ ®F d ar S-WvwAi 09 )"4- g 4)fV 41 lvlpli�f- -,E7 tex(E-ns Ar : ® o�Yn E'tR/G S1 E .r )f�-t C.i I��o 1C�o2' Sbfc3/c)•. Of /1li$•� RegieWed by: Date: // l� P, 1 r Communication Result Report ( Nov. 21. 2011 4:06PM 1 Dat e/T i me; Nov, 21. 2011 . 4: 05PM File Page No. Mode Destination Pg (s) " Result Not Sent 4455 Memory TX 917815620048 P. 2 OK ---------------------------------=------------------------------------------------------------------ Reason for error E. 1) Hang ui) or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—mail size Town of Barnstable Regulatory Serv-reef. Thomas B.GAB ,Director . BDildirig Dl'4ISIOb - 7 homac Pu7y,CB0,BWIdtnLrCemmiW=er - . 2M Maio Sow.Hy—ic,MA 0260t - www./own.6viomDlemo.m . Ogee:508-962 4038 Fax:501-190-6230 - PLEASE FORWARD THE ATTACHED PAGE(S)TO: TM PAX NO: -10 i. 67b 2. 000 y R$:AI,RLo A96-e� 6DENL$r.7� raJ!>�Lt� fs� `.T, . - DATL: I1A,/11 - 1. PAGERS 2— (INCLUDING COVGRSHEM 1 �4ni2i0 . J RO MCKECHM - II eWinsrn naoir E P. 1 Communication Result Report ( Nov. 23. 2011 8. 57AM ) 2) Date/Time . Nov, 23. 2011 6 56AM File Page No. Mode Destination Pg (s) Result Not Sent 4489 Memory TX 917815620048 P. 2 OK Reason for error E. 1) Hang UP or• -li'ne fail E: 2) Busv E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E-mail size Town of Barnstable Regulatory Services i10�s 7-P.Calm,Dlredor �S°•' Buildingbivisio4. �Th.—Array,M),Building r—inimer - 200 Maim Strcak Hymne,MA 02601 . .. ww�vlmrn"barnehablame.m OtTice:508-862.002[ Fa:509-790-WO PLEASE FORWARD THE ATTACHED PAGES)TO: T0: c A.•CrN: f il-f {{ 3A.� .. r FAXNO: ' RE:ACRLoaeY'�L aAc-w>-c�r L6 �aH><tt- �� �L FROMo�E127 �-'1� l E. DATE f�2 L/f . - PAGW: Z- ¢NCIADINGCOVFRSH6L+'[') ' f i 106862.gpta _ ' �6�r9�16230 EOBEB7Aq�fCk . M. I R-12190J 0 E/bf Roof v'fP7�'rf 't/naTfrPt fC�c fs IMPORTANT i ��- �� 7 RE ANY CONSTRUCTION THAT INCREASES REQUIRE PACE,�'1�fa7_�d�l!r�j/- BEYOND 1200 SQ. FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE TORS. NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE e INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL PERMIT DOES NOT SATISFY THIS REQUIREMENT. I _ 7. 12 I I 8 ,�'; _ 6'o•( I - i it - i rid i N�V F(XeP v(n/DOV (DauEL� -2b TO �2dI7� CLIT 0 -- -------------- 0 0. ' _o1zcG:in�L__ LdAL .Ez l3U1LQs'2_ �cT 49,2D ( oF• c� I r 16Et4Wfwo�M,G'�2.6D 1—1 10 _ O / i. .� - .. � � S O I S•O., 6.0.' a.U_ n '¢a O• ra LEr T FLEVATIo,�I lo LEDC,.EK — , i - ud- .rdX�o coNT . �4,= 1.O• '� - � �- --VEIz��—"YaC_'Domt�S_�iQf9.DoN.._a�.___�!_a\Qz1 E'er=-. VL Ale Cl; - ��t1:F222��.M€T2:L-t7R5c��lb�•G c. 1 � _.5��_ T 1/c A/J- _ • P"-`1_fL/S�(f�cl:(�t SHG:[GLES�=IS�'2�CC�. —_ —L-S1liSzp_C 7N:Ct — S�D�•��i Oxi IGE,/.\VdT»L3H[�LR5a �X(.__ � �zxtz �u�iLtn o�R.Stru zf°c c <v L lie t r �T Em _0 --- — • J. ;n _` � - ,------•ZXz,�<r2 2i.�r�-risr- 2�C�— J.�Cu�i Et2 �.r r'�/I7C'2i�16•� + f 1'�: - �� p" kio /rutr rr ✓ ;ia✓ L �J Mrs05r 5�se CkrsriNG rt©F _rp;w I — aETAIL i"` � � � �' ^' lZ'.S9fvo_iUSE wAu_ekr yL ..hl.l= L-O?R�Y�IY_�QyCl�dli�1=�z�Rz�DC /'.,p 2x167 � L - -7'2Tf a ,4� 1029 Vv '7✓� f/Ir,•( NIA o � jr CCjj a � F Lot`- L cs 1/lY/oq i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel - Permit# Health Division �D o e��i� �.c�ti =' OF Issued 03153 ell ou Co6ervation Division ! ® ® ,� 9 " f , , Application Fee t uwi 0CT 29 ,i�r ! Tax Collector Permit Feed Treasurers /0/ �0 - __ SEPTIC SYSTEflA MUST BE �r 5!J. INC01111 ANCE Planning Dept. MTh;7ME 5 Date Definitive Plan Approved by Planning Board E'NV3Ra NIMENTAL CODE AND T0119N REGULk,!FORqS Historic-OKH Preservation/Hyannis Project Street Address p A A1P Village- CDr'u " 1 Owner YAddress i2�?11�� ff e�d r� A Telephone ° r " i 7q 1,-.D 0 ui� - �! - y � LI DK/ 0.11 el ?Za Permit Request X, rC(V 0 Al* f,d AJ P�0M✓ C,4 5cm e j f- 62v f egs &dC/i GjLOLfC tivi 42WOKAdov3 4- joy "Ptil w 6v7- ty&-4- c4n o N tvt I-P.ace >-L1,.o it c/o o k.. W1 P* Square feet: 1 st floor: existing Ov proposed n 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay \ ' Project Valuation `�W Construction Type Lot Size Grandfathered: ❑Yes 0 No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure SO c6,i Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes O No Basement Type: uII O Crawl O 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: UGas ❑Oil ❑ Electric O Other Central Air: ❑Yes ©'No Fireplaces:Existing New _ Existing wood/coal stove: ®Yes 2-I'To ,,Detached garage:O existing O new size Pool:0 existing O new size Barn:0 existing ®new size Attached garage:existing O new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Proposed`Use- BUILDER INFORMATION -Name 0 Telephone Number �O Can —Address A 2 R 0 41 if License# h'1 1-0 P1 rq d J_ 1 19 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO J SIGNATURE ATE __ /d 3 02 FOR OFFICIAL USE ONLY - PERMIT NO. DATE ISSUED _ w, MAP/PARCEL NO. ADDRESS~ VILLAGE OWNER - DATE OF INSPECTION: FOUNDATION rr�� FRAME `,9f/{n? Qfc � t / �/ INSULATION FIREPLACE. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t - The Commonwealth of Massachusetts Department of Industrial Accidents =-- oxce ofmyesaff offs _ 600 Washington Street Boston,Mass. 02111 i3 Workers'•com ensation Insurance Affidavit name �1! I A- location. T v TCoU c i phone city � I am a homeowner performing all work myself. ❑ I am a sole rietor and have no one worli///%i 7 ca acitp - -%%%%�G------//-----/////////�%%%%��%%�%�%%%/�//%��%%%%/ em I rovidin workers'compensation for e I es working on this job. 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'a 0� ' ..v.h ••, •.rF.Sva.{•.:::\¢:..+.w:.t•:::}..n?•r._•.r;:..::r.. Zi]arattce:tC>:�3::}'.,]:.:::+):a:•:.`;.:};%. .::}}+:;..•3•>,.$.,. . Fai>ure to secure coverage as required under Section 35A of MGL 152 can lead to the imposition of cttminal penaitia of a fine up to 5 understand and/or one yem,imprisonment as wen as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against tae: I mtderJtmmd that a copy of this statement may be forwarded to the Ofce of Investigations of the DU for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date Print name Phone# official use only do not write in this area to be completed by city or town official city or town: peradtillcense# ❑Building Department '. ❑Licensing Board (]Selectmen's Office ❑checkitimmedlate response is required []Health Department contactperson: phone#; _ ❑Other (Umc d 9195 PIS Information and Instructions t 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 cgntract 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 in the commonwealth for any of a license or permit to operate a business or to construct buildings Y 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. ' 'r Applicants licants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and 4 supplying company names,'address and phone numbers along with a certificate of insurance as all affidavits may be signand . submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure o t; 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' compensatioa 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 of the Office of Investigations has to contact you regarding the applicant. Please out in the event the O _ _ _ affidavit for you to fill _ _ be sure to fill in the permitlhcense number which will be used as a reference number. The affidavits may be returfiR t_ 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 questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Depa rtment of Industrial Accidents OMce of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 . Town of Barnstable Regulatory Services BARNSUBM Thomas F.Geller,Director 9`b16.19. ��� Building Division prfD MP't�' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME MROVEMENT 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: K t V't;Le 16 Lk P d Q. l Estimated Cost Address of Work Owner's Name � ,Lf d (P� 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 KOwner 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: s Date Contractor Name y Registration No. Date Owner's Name RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00o�� Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq. foot= x.0031= f p from below(if applicable) /ALTERATION NOVATIONS OF EXISTING SPACE s$ —' square feef x$64/sq. foot= x.0031= plus from below(if applicable) tq GARAGES(attached&detached) square feet x$32/sq.ft.= x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq. foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= v (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee projeost Town of Barnstable CF THE T� 0 Regulatory Services SAWMAsir. ; Thomas F.Geller,Director MASS Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 ice: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION:. l i k ,4 t1 V— W rU number t rent 3 O `162 8 N village . "HOMEOWNER" M V v\P an name home phone# work phone# CURRENTMA=G ADDRBSS: 0 e a d ,C 4 h t 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 andlor farm,structuies. 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 Buildirig Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work tierformed under'the building pemnit. (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"testifies that he/she understands.the Town.of Barnstable Building Department— mini�im inspection procedures and requirements and that he/she will comply with said procedures and require ents. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the State Building Code Section 127.0 Construction Control _ HOMEOWNER'S EXEMPTION .The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many conummities 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. Iron may care t amend and adopt suph a form/certificaton for use in your community. 4o { I . o i k LD ct s� __�-- � ���.3�,, _ --_____ .--_ ins 2-� ��- `��''" _ ,�� � �v� �� �• � i - _ ��>-; .. f . � � rni _ '.. ....� .. � \ '. Y V _ � :\, �y� r N \ r `i The Town of Barnstable Department of Health Safety and Environmental.Services Buildin Division 367 Main Street,Hyannis,MA 02601 ,8-862-4038 ' 18.790.6230 PLAN REVIEW - 0.1 Owt— Ma-/Parcel• 019 O Q l owner: Y P S �� well (CO'+� roject Address: Builder' 15 W O OK • Che following items were noted on reviewing: • I + ,:, ik •- ANY CONSTRUCTION THAT INCREASES LIVING SPACE . " BEYOND 1200 SQ• FT. PER LEVEL MAY REQUIRE THE INSTALLATION OF ADDITIONAL SMOKE DETECTORS, 4 --�.,,�•�� A SEPARATE PERMIT IS REQUIRED FOR THE INSTALLATION OF SMOKE DETECTORS-THE ELECTRICAL ,� � ���"`'•� �.. '�"�"" __-.. _.._ _.......�_� _._ . _,_,...._.___,«„__. � PERMIT DOES NOT SATISFY THIS REQUIREMENT. 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C_ -,.,,.,,ro ,Y 'm sg.'.�� Nc�Aw�^�` +uY'b`� � ,fKf,•�, ,! wy+",�R.�,Y�,�a.v_ + a� �iCe '4 l i / r' t , 7 _ . sl 4 ' 4 5 t 4 qb l4d i% a r. 3 m _ T< _ _ A ; ti r^ w, , 1 ,�� 7, _.,.- a s ALL t . - --e _- { WALLS R-i 9 e` 16 ,OL +bJ l Nn k1,b-5J-! la�l RRt�:Rs— R(�{oYc� � �• , V R t 9 1 dU..r F � � -:5rMpsoN L.ITr to2 roft ""wt wiz, ei �14� �o�ef (l�,r. { C;)x.1 ot= SCHOOL ST co LEGEND EXISTING PROPOSED ------- ____._____ Edge of Pavement EOP S w__s __ Sewer Pipe s S --- w— -'w Water Pipe w w Drain Pipe = 12"= EoCUq o O Gas Pipe O c POpO��ss 0 DI OE , Manhole Cover Os DO(V QQ Catch Basin ® o D @ W0 Water Gate owe SHELL L Z Light Pole -�� Utility Pole -0 - Contours HULL Cn < Spot Grade 20000 77- %L z cRoss S11�� � � STREET 3 W �\ OAK ST j LOCUS MAP SCALE 1'=1000' GENERAL NOTES N;F 1) OWNERS OF RECORD: Rill , J. L iNET & MAP 34 PARCEL 007 KIP,1 1. ,���11ETF�F P M E C REALTY TRUST MAP �1 i« F Al��:E L 176• '1FED BOOK 23,727 PACE 226 L. PAUL & LINDA M. MALONEY TRUSTEES N/F DEED BOOK 3567 PAGE 200 ELI2.:'BE H k ORRESIAL 0'BO YLE MAP 19 PARCEL 091 MAP 034 PARCEL 009 CHELMA REALTY TRUST DEED BOOK 12343 PAGE 107 LEO PAUL & LINDA M. MALONEY TRUSTEES DEED BOOK 7309 PAGE 352 193.00 23.43 — 2) ZONING DISTRICT : RF-SINGLE FAMILY RESIDENTIAL S 65'12'40' E BUILDING SETBACKS FRONT=30' SIDE=15' REAR=15' 149.78' MINIMUM LOT AREA = 43560 SF IP F ND ENCASED IN CONC 3) PLAN REFERENCE: BOOK 172 PAGE 69 ` ) AND EXISTING 3 ' f` .;W `" SEASON ROOM . _ - T Y CONSTRUCTION.APPROPRIATE _ _.-_ SHOULD BE VERIFIED IN THE FIELD BY THE APPR APPROXIMATE A .. ,� . TO BE RAZED UTILITY COMPANY PRIOR 0 AN _.., ,/ 05 5) COMMUNITY PANEL NUMBER : 250001 C07521 ZONE X, AREAS DETERMINED TO BE OUTSIDE 0.2% ANNUAL CHANCE 1 ... f r` FLOODPLAIN DEFINES THIS LOT AND DWELLING 53.0' 6) VERTICAL DATUM: ASSUMED: MAG NAIL #1 ELEV=100.00' 48.0 94.0' ti !_ __°'' 'a ADD 1 BENCHMARK BM-A : SPIKE SET IN U-POLE ELEV=108.07' r SED �i f l€ TING �� QROpO .j EXIS j \ T BENCHMARK BM-B BACK CONCRETE STEPS ELEV=107 72 r ;�� BOTTOM OUTSIDE CORNER OF BOTTOM 77 MA fllf, x �� 4 I OF Tb TCF•I f ;�;r t/;f. / �l,/ 1 ',! ^F- �S— i { 'y �� , - ° �•• _ N; r" Q 2' 1t 1} a-n { , Z Dd�F�R P. uG 1 /�"•°/% :. 1 A `? MAR LOUC. NE:A�::Lt r t FIRST :, 1 , n K o MAP 034 PARC' 00€i „`, c C1S1;taG if 1 tit �� > w DEED BOOK 14730 PACE 060 OVERFLOW k;ESSPOJL / � �� �� -� ! CESSPOOL U N/F f/ F: 106.4 EM i. _ oo & srfiRLEY A, C'RE'EDON co f /1 - r rn o MAP 019 PARCE! 14$ LA V, DEED BOOK 1982 PACE 162 N ��, I' J ;` �f / ,f�:�-�/�` ' j 1�� , �., v � �� v wo �// _ t ; ' ` ` ' W l Btvi A 72 18'00" �J p?r ,: ., n,R7?T7'nS777r�-l7Tinnt77TTTl7fi ` x � `� '� . i TI ,J E 7 4 \ ,Liv�tu l � :•^c•-OHW---- - �r .._ ,, '°,,SHED PI #4 4A1 p' fAF3LE I D 1H) Yt \t7H# f-. '• l,_f w J U/ th e ='`, 011W OHUF b OH ,:ttul�<t =c;.fsccu��uu�uLu�t ti. � PAVED �r r, • 4 t [� � L r . 1 �` � -"�-•�r�;-�,.--y,-..�r-,�,ti -� `1 U"---' -___ i j f�.�..,��.��.:J�-1 r�_f-, L..�v�_.�� �I `� i '"J oo, - _ H � - �-..\ `""�"'.,r•-..�...ti„'.1^Y"v"V--'V'-Y_`�r"._�v'—.y;-1,;-.Y�'�„�,..'Y`.,`, -. 'r".'__�._�......_-__...-- »__._._,_, ��____.__.._...� ._.!-_____.-... �._i✓"'~,_...'�` Y ,:,,., -"„,j..��='F'.�-<_•'.�,G,;.,.1�M-^�,•,,,�p-_.._` e�`vr Y _. l `, _'ti/.."l''""v"1v i✓—u^.w. , !'�v'.. f Y "vY'✓Yj v _. € k of 200.00' 17 k r^' ;, La N 69119'00' W ;sBjOH R111" 91900 � tND N/F a ALAN R. DA'JIES t`d /f" to MAP 019 FAIR('-',*L 092 DEED BOOK 102-1-7 PAGE 293 PrAPA€0,34- PARCEL. 006 DEED BOOK 5362 PAGE `54 rn W CA 26 Shell Lane Cotuit, Massachusetts 02635 PREPARED FOR Paul Maloney TITLE Building Permit Plot Plan J.K. HOLMGREN ENGINEERING INC. Registered Professional Engineers and Land Surveyors 942 West Chestnut Street, Brockton, MA 02301 Phone - (508) 583-2595 Fax - (508)-588-7518 20 0 20 40 SCALE IN FEET SCALE: 1"=20' DATE: 10/26/11 Of Y�SS 6 �c 4 t:DWARD P. 3 JACOBS 2 CM1 NO.-4607 1 i NO BY DATE REMARKS 6 �� so AN d �1 / DRAWN BY: ADP DESIGNED BY: JKH ECKED BY: EPJ ,KH DRAWING NUMBER , �C�G eeelll """""`"' / i I( H:/201 1 /201 1 .31 /CIVIL/PLOT/201 1 .031 BPPP.DWG 2011 -031