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HomeMy WebLinkAbout0158 TROUT BROOK ROAD W !; �l !/ 1 � �l {y:� �rr ".4 Dear Sir, It has come to:my attention that the people living at 158 Troutbrook in Cotuit have been able to build a large addition to their kitchen as well as an outdoor shower and a gas grill without a building permit. These same people have also cut vegetation in front of their home to have a better view of the river. As a law-abiding citizen who applies for permit and follow the rules, I am quite upset by such flagrant disregard of due process. Sincerely, g An annoyed citizen J o -i _ O CD 1 CD CO cn F Pam)A y.rs �.� 37 VOA c �}t� a c� Far:aA,�Pik, � 30 MAR A � t"3 Building Commissioner Torn Perry - 200 Main Street Hyannis, MA 02601 a j} ]] 44 ]] / i£}Ef ii�i } i iti� E#� } ti31} i}i ii } £yt 1i is i ,q '/'f �' /�/`� ' /r "�'� / \ � ~� I I �., y�. ..,, . I �` � w -� BFIRrx r Q W:kk KL{ 5�1to w f1�OS3� irot'T1►1 ! { i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 01.0 Permit# q 7 Health Divisi �_ / ,/a°� 5�`���-- ' '��' PAii'r`�f� `; 8iJQate Issued L —a7'03 Conservation Division (J 9 '*- f OA 03a 001 ? t7� � Application Fee �'00 lam � fo4; � 24 A gyp: J3 Tax Collector ` Permit Fee Treasurer " s'JS —SEP-ZI>i�SYSTEM MAST EE Planning Dept. fir oOFi INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENMRON'MENTAL CODE ANG Historic-OKH Preservation/Hyannis TO MI REGULATI{�N5 Project Street Address Village CJ 7 Gf t - Owner _ 2�/V && a R60m Address 0L)-69X &K &AGCI t Telephone Permit Request �S' 6 Square feet: 1st floor: existing proposed /a70 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 3.D 0 0 Construction Type Lot Size A Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 0" Two Family ❑ Multi-Family(#units) Age of Existing Structure d S Historic House: ❑Yes Z No On Old King's Highway: ❑Yes Q<o Basement Type: 2�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: d Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes a o Fireplaces:Existing New Existing wood/coal stove: F-IYes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 0No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Rnq a�R t �t Q e2 Telephone Number ���' y� ���� Address License# Roul &OL Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE (D 0-3 FOR OFFICIAL USE ONLY •PERMIT NC - DATE ISSUED r MAP/PARCEL NO. ' ADDRESS VILLAGE ! - • OWNER ! DATE OF INSPECTION: FOUNDATION FRAME � � .J INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH ► FINAL GAS: ROUGH t 4 ' FINAL Iv FINAL BUILDING -DATE CLOSED OUT ASSOCIATION PLAN NO. t P.oFIHE► ti The Town of Barnstable BARNSTA ASS. E.,0a• Department of Health Safety and Environmental Services 7 NASS. �A .39. ��0 lFo Mpg Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: 2Gf1 Gf7rG(e Map/Parcel: M K 0 Project Address: g 1 ff k/ Builder: The following items were noted on reviewing: 1 / 0 �c 4j. firm ? ('tic15 t- -ex k tn'r7iiwJt+-+ of 4 6 101o c,l t • oo+i nqs 1 f 5 in c, ¢vb-s-s b fa-f b e l/ LTC �CXThh4� Gt� GGG�o}k (l -,,.^d-� hvn I +Ube- mVS+ -6 unoyf, < 0 ' -Point I cnd5. Reviewed by: Date: ( �,97 03 q:buildinglorms:review l The Commonwealth of Massachusetts - -- - ` Department of Industrial Accidents ~� = alffce affayeslf9atfans _ 600 Washington Street -_ Boston,Mass. 02111 Workers' Co m ensation Insurance Affidavit 0 name: location City.4r I am a homeowner performing all work myself. ❑ I am a solerovrietor and have no one worlds M' ca acitp co ensation for my employees working on this job. :- };•�{::ri;<;:z} :.f• ' :, ,kr ... : n 'din workers .......:..;{...:... : IOVi ..................::::::•:•::•::•::..:......;{.r};.;::•%:{•>i:•:i•:•::•{.; `•i' ... em 1 er g ..............�!::::.::•.....:.::}:::.:_...,....:.:<.::::>::::.::•.:.::�:.,......{{.:.::.:::.:-:..,L...r...}::•:}:f.:,.;.:...::...}::•:.;}..:::?L. 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Imcdersts�d a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I des hereb a fy under the pains and penalties of ped my the the information provided above is truce and totted y �� Date � �� Y-03 - Sipature Print name '>4 - Phone# bS� �a�-� 6 official use only do not write in this area to be completed by city or town official peradtliicense# -- QBuaftg Department city or town: ❑Licensing Board ❑Selectmen's Office ❑check if immediate response is required ❑Health Department contact #; _ Other' person: (devised 9/95 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 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 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,neitherthe 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 along with a certificate-of insurance as all affidavits maybe 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 pemut 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. 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 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 Pear r hcease number which will be used as a reference number. The affidavits may be retarne3io 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 Department of Industrial Accidents Once of Investigations 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 oFtHE,�, Town of Barnstable Regulatory Services 2 - � Thomas F.Geller,DirectorKASS • 9� a639 � BL11ld1II DIVISIOII pTfD MAi A g Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax:- 508-790-6230 Permit no. 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. Q Type.of Work: �c2eP NRd Estimated Cost 06 0l Address of Work: - Owner's Name: Date of Application:_ P� " I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law []lob Under$1,000 []Building not owner-occupied Ro"wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE OVENINT WORK DO NOT GUARANTY FUND UNDER M HAVE 142A• ACCESS TO THE ARBITRATION PROGRAM OR G SIGNED UNDER PENALTIES OF PERTURY I hereby apply for a permit as the agent of the owner: 1 Date Contractor Name RegistrationNo. i0>=flef , Owner's Name The Town of Barnstable Regulatory Services Thomas F. Geiler, Director' Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION [L Please Print DATE: JOB LOCATION: I�SC �iC©U_ z67 o0't number street vMage "HOMEOWNER": b-Q0 0 _%aez ,0"�(r� � o p 74 work phone name home phone# P CURRENT Iv1Aa1NG ADDRESS: p."0 • 60 � l city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or fazm.structures. A person who constructs more.than one home in a two-year period shall not be considered a homeowner. Such"homeowner"'shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) - ibility for compliance with the State Building Code and The undersigned"homeowner"assumes respons other applicable.codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of B arnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said pr dares and requirements. Signature of Homeowner Approval of Building.Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply withthe 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. Tn u oi, th%r the hnmenwner is fully aware of his/her responsibilities,many communities require,as part of the permit . APO. O� HE- �71 --------------- -- __.__._____- _ ---___.__-_ ___ _. __ PNAI= J x _ A Or 43 4ow j4r Zv.V., P414� Ile A4,0 J,o(//,to oolpjo-c,v OT:a I .......... .......... N$ .......... ------------------------- ........... I NII 1V .......... 77 OL 1r7 ................. 51 Xo �e _i7T _:. ._ __ ____.__.__._______ ___..____.,__,_..._______ _-_-_.-__._____._____ .______ ._..___.._._._____ _._.___, _,____ ____ .__. ._.__�._.______ ____ _ ._�.._ .___. . _ ___._ ____ - _ _ _ _________________._.._ _.____-_.-_-__--_-._.- _.__________ _____ ______- _ -- ---------------- .......... ------ .... ....... .............. 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( 9 1 - _. i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE l2'C-'� 1 square feet x$96/sq.foot= 11 �oZC7 x.0031= 3 S- � plus from below(if applicable) —LTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) 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= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 �r� Relocation/Moving $150.00 6"4 (plus above if applicable) 1 Permit Fee ��� ( TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mai CAB' Parcel o/o Permit#� Vl' Health Division �� - '�' I °a� d oG. a rs Date Issue ((J� Conservation Division ) I"�00 ; ' "'' 31� E^� �eeay Tax CollectoZI S � Treasurer Planning Dept J Date Definitive Plan Approved by Planning Board 1 Historic-OKH Preservation/Hyannis i Project StrAet Address /3- 0 U% 3200/G Q C� Village C O Owner n'? , Z3QV/�GF Address Telephone OV D( ""' yad Permit Request RE/OCM c" k/TC"RAJ 7-0 6"K S Tl,,V G 7-i'f2 f-c seAson ' oorr) CAya Qge4 c'Hf}--yaer) y ;Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new fFstimated Project Cost tOt CM Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Lto0 Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Family tA Two Family ❑ Multi-Family(#units) Age of Existing Structure o�Jca Historic House: ❑Yes W No On Old King's Highway: ❑Yes V No o Basement Type: ❑Full ❑Crawl a alkout ❑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 S First Floor Room Count r Heat Type and Fuel: YGaas. ❑Oil ❑Electric ❑Other Central Air: ❑ a Yes • o Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size• Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE` FOR OFFICIAL USE ONLY PERMIT NO. - t DATE ISSUED MAP/PARCEL NO. ADDRESS f VILLAGE OWNER- DATE OF INSPECTION - FOUNDATION '+ k r • i t FRAME INSULATION R - FIREPLACE w ;` •« ELECTRICAL: ROUGH FINAL f , i PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL ~ FINAL•BUILDING � t Jh . DATE CLOSEDOUT ASSOCIATION!PLAN NO. • r F - ' Department of Inca aWai Accidents OflICCOI/OYCSIIABMOS - 600 Washington Street ' - - Boston,Mass 02111 ,. Workers' Com ensanon Insurance davit name: e YAX7H It) M SOU 12.G C'�- location: 159- /ROo {' e9w1c-R d t city c'Ifo/-i' ; m n phone# ❑ I am a homeowner performing all work myself i w i I I u,pct Ck. gun-ht,pi--y�_ ❑ I am a sole etor and have no one worldn in aw achy a I%/ P %/011ie %///%� r/ ding workers'compensation for my employees woddng on this job. me F :' ;' ' 2 `> <'j f2 '<': '`)% '?''''` ? 3 "�'' ' ?5 '•}� +%SO n addres ::::::......................:... :}•#'t''d'c'ra' ia ...::.....:....::::.....:.:..:...........:..:::::.:.............:...:::.:::....:.... atvs ..........:.::......:. iesnrance co. ............ :.}:.}::::.:::::.. .:.:..:::::::: ................ tv MEMBEEMMEMMM ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the c onitactors listed below who have ' the following workers'compensation polices: ::.::..:::::.: ..........................:...:.....:....::..........:.:......:::..:..:::::::.::::::::. ::.r:,.::,............. .::::.:::::......................................... ..........................:: ::•.:�:.�:.:v:::::::::::::::::.::::•::::::::::::::::::::::.�.�::::.�::::::n::v::n: ,:......:..::::::::::r::r.n..4•:r vr.... ....:�.�:.: ...................................::............................... .................. ................................................... .:::: .::::•::............::::....... ..............................F...:.....::::::..... .. ......£:;:::::::::;:::::::;::::> :::: i;.....;:::;:; f :-:t?;:;•T::;;:<:::::}:T:}:•}:;t•}:•::::::: :::;4T:-:}TT:- :.:.�:::::..,•: 'ad�dres�s� « ::<::<:><;;:.::.:>:<:::::;::::;::;«<:>:>:<:::::»::;;;:;;:;:<:>:::>:.>.:::::::::>::>::>::>::>::»::»:�:<::�>::::::::a>::s:<::#�i: ::`•?is�::>SS`:i:><.:>::>::>:::::'.....:............::.....:.......................,....... _....:..... ...............:.:.:.::::.::.:.:::...:..... :.::._:::::.::::::.::.. : -'y:;:: .. .............................................:::::::::::::::::::::::::........................n...........r.......:::w:::: .v:::::.v:-v:::::w...........::::::n:v:;....r.........,.?:r1.4Y.F}w.f;.}-4;rM.w..^.:!Y:,.\: .. : :{::::::::}}:??^is•:::.v::::::::::•..............::::::t•.4:�s.T}w:::Tv:}::v::.::;-:}::}:::.:.:....v::........ ...r..>.r} .. ....:..:..... ........:...........................................::..:::.v..�:::.,..................:............n%,:tv:::n?•::::::. �d-}:.}:•}:�:::w::::n•:::::::::::..:r.. :.r........... 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Y,>::: .::r-,•�{ ..l.F.?5...:::.4:;�;.4• .:)4���:. }r<�:�i�i::`vJ%.' .............._......................:.................................................. ................................................................................................ _... .. :........:........................:...:::......... ::::.::.::.::::::.::.:.:::.::::.:::::::::..... ::.:: eaeinanv.name:;.. ..::::.:::;:,..;}•?::::::::::::.:::::...:::::,,,:.:::.:.:.:::::.::::::•::::::::.::::::v>:.,:::?•.,:.:::,:,:.:::::::?..::.::,..::.,.,.....:.:?.}:-:}TT:;•T: ':..........r•::.:::?.:::.:s?.::}::r.4.v... ......I ,...;:::.;.;:.;;:.;: .............................................................:.................. ...................:.. ..............:.:.....,................................:..:.�.�::::::::.,•::M...,.•.::. ,w. -r.,•:::::::.......T..o. :,.r.•:..:...,..r.....:.?•T:.;..�::::•.. .:::::::{............r:•:::::::.:.r.,.:.. ..:•.:.:::::•:::::::.: ............ r.,,,...:r...w. :.....rr..,.,...........:...y. .�,,..wy..,.,.. ti s:' .....::::. ::.: .::::.:. ............. :.:...:. :.}:::.:::::.:.......::.... ...:.:........ r..t... v......................... ..... i:.v:::......:......:.-i.. '..n.......n. .:.:.r .vn- .,v Triv:::c^:: }:.:.:-:o:;.}'?•::}:cT:,:..:'::::.�:::.:toytt•;•T}TT:�;::�r-::::::aT:.:?•:••t?•::t.::-}:-::-}>}}:::;•T:-:.::?.::�>:�::.>:::::::::::::.....:::..:.::::.�::•:::::::........... r.. f�...::<. :...:::•::.:';.::.;•.-'?•}}}}:'.}:r,.:•.:T:.:-::::::�::::::::�. .:::..::t-r:.,.r>..•::.�:......?-a.3:?t•T;}:->:-:' :r::�::t?.}••::: r ... ... ...e:•T:::Y..4c�T:?•:::a..4�-�;:i.;: CCU'CO:J:;,.?.;?<?.;::::�>;>t:':::i�:;>.:>;:::;>}::::::;;:;;:;;;;}:.:<;:>:::;';::�:::::,<�}:�}}:�>�:::�:�>:::::<::::;.:::::::::..:::::::::::::::•::::::::::::.:�:::: �:.s:r.;..•.:.. nsnran _ ... ._ ,,:,...,.:,:.,;Y..YY:TF:T:}R...T..r.rr../rr/:• Fafime to scene coverage-required order Section 25A of MGI.152 cm lad to the imposition of estmind pemitlea of a fim ap to S1.50 w and/or one years'imprisonment as wen as civa penalties in the form of a STOP WORK ORDER and a floe of S100.00 a day against me. I mdeestmd that a copy of this statement may be forwarded to the OMee of Investigations of the DIA for coverage ve ineadom. I do hereby certify under the pains and penalder of perjury that the information provided above is Grua.and coned Signature e&C-t4 Date Cam,�G Af 9 Print name Yi') 7 h t Ct, n� • a y !� G L Ph.I o fficial do not write in fhb area to be completed by city or fawn ollsdal petmti/llcaue o (]B�dfag Department ediate rsaponae b repaired �Lieamdng Board❑Selectman's 00_ Oneam Department P #: ❑Other (Arad 9/9S PW Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the:.r employees. As quoted from the"law",an employee is defined as every person in the service of another under any cc=--r. 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 c r the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the re=ve. 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 an the grounds cr 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 shalt withhold the issuance or renews: 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 eater 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 checidng the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insuz=r 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 member 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 affidavit for you to fill am in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permitllicense number which will be used as a reference number. The affidavits may be rc=ned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would lice 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 Department of Industrial Accidents Imce of Ives uadons 600 Washington street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 '. � The Town of Barnstable ��� Department of Health Safety and Environmental Services 16'biro . Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date !o AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,.demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost Address of Work: Owner's Name: C 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 1%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. �A OR Date Owner's Name q:forms:Affidav • • aIftl ' o Department of Health Safety and Environmental Services ' Building Division STAB 367 Main Street,Hyannis MA 02601 _ MASS. 9A 1639. '�prFD MA'I& Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: -3 S e' JOB LOCATION: /0-P /r9d�t A4 d number _l street village "HOMEOWNER": Aj0'0 k6aX--__' - name home phone# work phone# CURRENT MAILING ADDRESS: 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 su ep rvisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. I, Sifi6ature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems, particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXF"T 03/11/99 05:05 FAX 5085482524 BOURGETUMNNEY 1z01 Fee Number. 40481 UNREGISTERED LAND D�B00k 4631 pQQe: 28 Farrell 6 Duff Ko y A. Rotstein & pwnbook; 268 L per: 4 L01(sZ e ow,ec Tiny G Aronson Cynthia M. Bourget 6 Ran No: cr Appleent �rK D_ Gac�on__ None Available REGISTERED LAND nw Ces True?Number . geplstratbn Book pope: RevV..: Ase : 4/20/89 Mop: Block PorCet _ cerrifices Of Me: Dote- 3/29/89 %nNo_ rot(sj MORTGAGE � ARNSTABLE PLAN IN Lot 8 I 20,400 S.F.± + r, 1� Lot 9 �~ j r Lot 7 ) r Eck 10,. 4* a 0 n Iron Pipe 125.00 T R 0 U T B R 0 0 K ROAD THIS IS THE RESULT OF TAPE MEASUREMENTS. NOT THE RESULT OF AN INSTRUMENT SURVEY. I CERTIFY TO FARRELL & DUFFY, PLYMOUTH MORTGAGE COMPANY. AND THE TITLE INSURANCE COMPANY, THAT THERE ARE NO EASEMENTS OR ENCROACHMENTS WITH RESPECT TO BUILDINGS SITUATED ON THIS LOT EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION. THE LOCATION OF THE DWELLING AS SHOWN DES LAURIERS&ASSOCIATES,INC. HEREON IS IN COMPLIANCE WITH THE LOCAL Ws Poe $amar Wft 102 Sf*,VM MA 02M(e17)3e1-4000 ZONING BY—LAWS WHEN CONSTRUCTED WITH P,o liar set e3o Main St.03,AW4dd,MA ours•osm(soe)an•22u RESPECT TO ALL THE YARD REQUIREMENTS. 1400.ss'b555 Lt:THE DWELLING SHOWN HEREON DOES NOTfo'-t'�nF d•'"�;'1 Y/fit FALL WITHIN• A SPECIAL FLOOD HAZARD aar.r.:: ZONE AS SHOWN ON A MAP OF COMMUNITY a NUMBER 250001C DATED 8/19/85 BY THE F.E.M.A. i,. . . 3ANX USE: ON1.1 9;1A.�. , GENERAL NOTES(t)Thedecla►atiom modeabowareoMthe b0S1sof rnVknowledge.information.and belief asthe resuitof o mo tgoge plot plan tape survey Imspectlon mode 10the nom of standara of care of registered land surveyors P=tking In mouachusem(2)Declarations are made to the above named Client oral as of this date.(3)this pion was not made for recording mmoo es for use in preparing deed descripflons or for constructions(4)Veri ications of property fine dimensions, bulldinp offsem fences,or lot con%Nmtlon may be oocomplLshed anIV bV do aoctxate instrument survey. Mill ME M Mow - --- -- - - - -- - , A is pow - -- — _ — -- i --- - - -` --- R Jr - -- --- - -- W U _ - - - - - - MEE AA&�Q Pe L � - t i MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2.0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-6-1999 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 48 Your Home = 46 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 128 30.0 0.0 5 WALLS: Wood Frame, 16" O.C. 256 15.0 3.0 17 GLAZING: Windows or Doors 27 0.400 11 DOORS 20 0.350 7 FLOORS: Over Unconditioned Space 128 19.0 6 ------------------------------------------------------------------------------- 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 125% of the design load as specified in sections 780CMR 1310 and J4.4. Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.0 DATE: 5-6-1999 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ) 1. Wood Frame, 16" O.C. , R-15 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ J 1. U-value: 0.40 For windows without. labeled U-values, describe features: # Panes Frame Type Thermal Break? [ J Yes [ ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location FLOORS: [ ) 1. Over Unconditioned Space, R-19 Comments/Location AIR LEAKAGE: [ J Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type IC rated and installed with no penetrations or installed inside an appropriate air-tight assembly with a 0.5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ ] Ducts in unconditioned spaces must be insulated to R-5. Ducts outside the building must be insulated to R-8.0. DUCT CONSTRUCTION: [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems. TEMPERATURE CONTROLS: [ ]. Thermostats are required for each separate HVAC-system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output capacity of the heating/cooling system is not greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only) ------------------------- " TOWN OF•BARNSTABLE BUILDING PERMIT APPLICATION - Y,W _ 3g2o o � Map �� Parcel � Permit# . Health Division Date Issued "q__ n . Conservation Division ' Fee- o2S ©® Tax Colle ' Treasur Planning Dept. ; Date Definitive"Plan Approved by Planning Board Historic=OKH Preservation/Hyannis l Project Street Address b 2) Z� Village so � Owner C Address. S Telephone Permit Request Square feet: 1st floor: existing " I7 proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling-Type; Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil - ` ❑Electric ❑Other Central Air:. ❑Yes ❑No Fireplaces:-Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ; Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name C?Q?_Q._U A/ P Telephone_ Number ya� — �� -7 7 Address o License# (/ /O.SZSTCL► �/� /�i¢ Home Improvement Contractor# Oo9(D VP Worker's Compensation# 700 ZS 90 ALL CONSTRUCTIO RIS RESULTING FROM THIS PROJECT WILL BE-TAKEN TO SIGNATURE DATE 13 Z9 • s FOR OFFICIAL USE ONLY PERMIT NO. _ DATE ISSUED led MAP/PARCEL NO. A ADDRESS . h VILLAGE . OWNERS DATE OF INSPECTION: 't r FOUNDATION _ :• ., FRAME - INSULATION i, '.- r - - , t .• �: =• - FIREPLACE , ELECTRICAL: ROUGH FINAL ; r. PLUMBING:- ROUGH FINAL ' • ? j L 11 a GAS: ROUGH FINAL al FINAL BUILDING , DATE C LOSED OUT ASSOCIATION,PLAN NO. + t \\�1rV'•- LulAYiia.o AOVa-iavaa 367 Maui Street,Hyannis MA 02601 ` )ffice: 508-862-4038, Ralph Crossez pax: 508-790-6230-- Building'Commissia::e- Permit no. Date r 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 contr =ors,with certain exceptions,along with other requirements. Type of Work: Estimated Cost Address of Work: owner's Name: ��p Date of Application: I 1`� I hereby certify that: Registration is not required for the following reason(s): Work excluded by law C]1ob Under$1,000 [38uilding not owner-occupied C]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. IGNED UNDER PENALTIES OF PERJURY I hereby apply for a pe t=ast of th er: --7114919 wc'/ Date Con Name Registration No. OR Date Owner's Name q:fbims Affidav r— J - .. °�'� O�crO�hestlgatloQs 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit VIP name. location city y•� phone# (42'8 Q I am a homeowner performing all work myself. ❑ I am���a���s��ole%��a/r//o%A/o///r�i/e/t�o�r�/a��/n�d�have no//�/of'/�n�e//�ti�v�orki�n�///in a��m���ca acim j//j/j/�iIG%N/i�i4G(/i��RR RNVNi�NV//N/I��ifNViGfifAi(bWN��j���i�%//.(//���•///���%N/N//�iG%N// %��N//I//«. I am an employer providing workers' compensation for my employees working on this job. comonnv name: address: ??O ��7� ��c:) n .... city: phone* insurance cn. �r���� �1`�5�� niicv ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have , .the folloi�ing workers' compensation polices: comoanv name: city: _ oh one#t •`� r .. . n--------- - .. .. ley . •.S'✓ •I•..: ..i: '•w'Hn'H.:• insurance cmpricy#:: 17 :,;;.:M3i ...''... :. .ti:i�•.... .::. .. ..,;i.y::xiti:y i::�n H`vvvr: }( camnanv name- }7q. address- city: p Insurance co. i;&re eo secure coverage as required under Section ZSA of MGL 1S2 can lead to the imposition of c t dnd penalties of a tine up to suouo and/or one years'imprisonment as well as civil penalties in the form of a STOP IVORK ORDER and a tine of SIOo.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DL►for Coverage veeiBeatkuL I do herehy cerrijy the p ' and �taWes of puyu a infornsmon provided ahove is true.mid correct Signature Date Print name r�J� J O� C� \� riit7iic# ���C� — �V- 1 Ccontactrerson: do not write in this area to he completed by city or town ofMkW Vern itmeense# QBudding Department [3lAcensing Board dLWe response is required ❑Selectmen's Ofiice ❑Health Department phone#,, ❑Other�� (nww 9,95 PJAI 1 Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation.for the'•:: employees..As quoted from the "law", an employee is defined as every person in the service of another under an,;✓ 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 c; the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver a stee of as 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 themin, 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 c: 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 renew, 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,nederthe . commonwealth nor any of its political subdivisions shall eater into any contract forte performance of public work umii acceptable evidence of compliance with the insurance requirements ofthis chapter have been presented to the contact authority. , Applicants • Please fill in the workers' compensation affidavit completely, by checking the boat that applies to your situation and supplying company, names, address and phone numbers along with a artffk=of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation ofiasnronce coverage. Also be sure to sign and, _ date the affidavit. The affidavit should be returned to the city or tows 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. ---------------------------- 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 affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicaurt. Please be sure to fill in the peimitll use number which will be used as a rcfhz a number. Tye affidavits may be rcKmraed is the Department by mail or FAX unless other arrangements leave been,made. The Office of Investigations would hire 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 Department of Industrial Accidents Me of imrestloatlon= 600 Washington street Boston,Ma. 02111 :• fax#: (617) 727-7749 phone #: (617) 727-4900 eats. 406, 409 or 375 1t f w C t js 1� F K r t r Z+�d; f I o Cr t,,,1 1dw♦yY s 4 > +,` l'^`. S~•\,,��d t `�✓ •lL/ f r �i��r(�G/V t.�I{'w�w� r P.IARG'�• f i Y? d t a (,,� �• }"'s__--is :tq +I+'♦ t .••"r�, it+ 's r(<'9d` a ��i���%%�i�� I r"?Sl yp rr ,�•-'rA�'t 1 1p t}�fi1F ����+YW f ��Z"�a. ..r IU YS.,:t.J���,1•t�d �,Iw .i� � �sr('l r �t'�c'k�\"a t`a ;,! r � ,. 3�i� I+ se r,�,2i ">,�1 Iyt,hi`r""� I I• t x x 4.J e� ++H��3)' ,M ! ,�,J � ' a�' . Jv, .. ,� 1T{:rt t t •. n •• � ':' t 1-'C.ff/'.-r�..$.AMr i:!'J••e51� fly '•r l: t�-a 1+t1a tRt I ,� � -r� }a( M Is��I��le � , ,,r t-lI ,HOME, IMPR ENTOVEM CONTRACT' w:REGISTRAT , 1;;: ORS .r .� ,Y' Ut . �` , iy tl��y1♦ 1'«.,ri+ s � f:w�vY ;� �rtis��,ht�1'���st�Si's r s r f !' 1 �t i u vY' tint ♦ J �Z- :I_ .;,Board of uild>.ng Regulations X.b' 7'1 I 't '1 'r.5. I t v f ne` Ashburton P1'ace Roomt��T1;30xrW-x+"k n' +1 .,f ,. s\n yj!;�8� q -'•R,,..... ..• t�-_ -Mass yf �� .. _. ..:.. ..�, ,t(;J'�. � r(�' (�^'y� s.�� 'y x.,^ '4 .°sro�y,��, :�„� .Ci ff d'(. r� ..;. 1t f +' �:.•Bosto.n ll,'a Ss Achusett-6': \/ �R 1"i,t t 5>ti.t'�{II �• 74 i 7 " > �•+1 -✓!y,�y'' c.,rt7� '4':> ''SyPt{ { Tn, .,�,�Ry�" .�k.��r� t���� v 1'�y.ekl ,+�'('i•1?`tls.A}�a z't3's.` - .ski/ta.°+:�A� >S6i 'HOMUITMPRO.VEMENTI CONTRACTOR Ei,�i �'4 w F # I � +� LYiL:s s ti '1'• P .1� WiW' �'w or4 te1 , xplrat ont ,0 SJ 7 1 Rgt ,, t5 '7"t"+,,+w�",.*J{m',7�""'�WA t'�r"',-�1'..,•t r t�a t �,..'-Y' f +' `"1YPey� ~:PARTNERSHIP 4ss,,v,1,5141311 kN +;� I ;.lt t A �i. ►uneal�o�.�aeeaa�tueel� `s,�y�1.".Sl9� i v't�!d,Y I ,r-r• ., l� '. a (rC n 17, rl sl > } r' tNPROVENENT,CONTRACTOR +� �' t wr dux�, 'NP�a""1t , f , t r: �+1 �, •a,e'�i•, iY,4 ,. I u � , tI.k ?��ie�i lCr+C�4 PhA'q.'_IiJ t'k�I�.1n 7 t$,4(J'f.' .CAZEAU+ L T &I 'S'•"OxN S � J...`�1�i'�r r#x<1 Kq},°1i 3v ty„'1�.f i�•�s.,�"�.e 1.,s e�y Jti•]r Y+ � !-}v;` rFr:�,'t.t,i yp9 ais«'tfit t atl0nI�{�:Ky'103 ROOFING ARTNERSH1IP145 , r alrt tt�i. 5, .�: 'i` l,' � 1` t , *r� Paul J cazeault ` r=� I t�; Ezplratlon r 01I09/00 f i .is �C'3y<t't Gi.ddia l t Rd :. P Q Box 2781 f a�F{,; t� �,! I, �,' :,;br=,�c ;. r`��;�G t`Or;learls MA 026,53 ti 3 :.N,�>�� ;�5?. �♦;, R IIt'�,; ;,Y` PAUL:J wCAIEAULT,tISONS ROOF. <.F ! :r {• ,} ,�+"J ' y �s!lt�.lx".. �If Rq{. .tF 1 ). t���s !s}� a�` i.''''.i +r ,fxSt ut.,Nyd.•. / I i ,V'4�i �+ rNh�` , �,1 i. i+ ( � ,j�'�? �;{1 t4�a •' Pau1J:J�'.Cazeaul��+'s F,�- -k 0 Box 278 ;I ` ;tlt }ti•. y v*YYu h�( ' I ISVRggR ADMIN,. !, OrleansNAB r riPll f;`;IMU100N I'I0,C1. , Idl 1:;G91 ftO!;TOM1I, fill) 021.08 ...1f:1_ l:0IT;1 1Jtti. IJf)N `;111 r {3'•✓.I:i01? L. f (�ILunI1F'r•: � ( •:(:,:i:r•r . . W • 1 , t r! nn (t - � ,T 1 1_ ;7 t 1 1'f4Ul I [ r 1 (ttil° I.. i311O C:IialIclfJ '61 r-ddl"i t:_ w - - — . 3t:,- •:,,. tC O�JLIJLOOtIr/C v lllJ� ..I + DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nualhen: Expires: Y Restric'Ced'To: 00 i r,.?ef4 ,AL J •CAIEAULT ' 1585 MAIN ST OSTERVILEE, NA•,O2655 :� TOWN OF BARNSTABLE } � OFFICE Or i D}�A�9T4tll i ' Na33. BOARD OF HEALTH 59 397 MAIN STREET HYANNIS, MASS. ozsot To 3u i 13iz1g T 1secto F .-.. From: Heal�h Deio�rt:lent Sua7ect Test- ho :e Grd. Pe- -cola- Test ti _ tr exa:lwnat on= o_ the- s __...( ot) (?�ddr ess) Vil_lace) was made on �- _ _ and -found to be (date) suitable for sub-su,face se.,raget at site of test hole. Building Permit will not b ap roved o.t: sew ✓e parmi issued until Health DeDa_'tment receives tl-,o copies of Man showing building, set,age systems and all other details :Li Si.ed in Board o� Health ins trllct ions to sewage a;?�?licar_ts. This approval does no.t Constitute a i ri!1 decision . concerning the installation oil G on 4111 State and local Health regu1a ions ap.p y t o 'ipa1 approval . v r i 6/20/75 CHARLES D. SPOHR, PE CONSULTING ENGINEER TEL. 548-0623 REG. PROFESSIONAL ENGINEER 45 FELLS ROAD MASS. No. 7468 FALMOUTH, MASS. 02540 R. I. No. 2146 5 June 1977 ASHRAE Mr. Joseph DeLuzj Bldg. Commissioner Barnstable Building Department Town Offices Main Street Hyannis, Mass. 02601 Re: Foundation Check Lot #8 Trout Brook Rd. Hillcrest Subdivision, Cotuit, Mass. Mr. Dean Boger Dear Mr. DeLuz: I wish to certify that we have this date checked the recently installed foundation on the above referenced lot. I find the size of the foundation and its location to be exactly as shown on our attached dwg. #457, revision "A",P dated 23 May 1977. Very truly yours, Charles D. Spohr, F.E. CDS:ms Enc., 1 cc: Barnstable Board of Health Town Offices Hyannis, Mass. 02601 Mr. & Mrs. Dean Boger Crocker Neck Rd. Cotuit, Mass. 02635 Assessor's ma and lot-number .... .:� .....4,.. .�:�.•:c p oc G-G SEPTIC SYSTEM MUST BE s INSTALLED IN COMPLIANCE Sewage Permit number :.................. N 1 WITH ARTICLE II STATE , 74 4, FTNE ropy �0 C v TOWN O F B A R N S '�T `' � it 'ANb TOWN Z 89$B9TSIILE. • , 3 ' NUILDING INSPECTOR � O MPS a`e0 1 1 ERMIT-TO . ... .�.�.�J.,-....�1.. .....-?7Q ..... !. .4:......./� ../../.�.................. r--. APPLICATION FOR P ,�- ....�.�..�'1 .� .��y TYPE OF CONSTRUCTION .............. ................................................. ............... k ................................................19...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies. for a permit according to the following i tnformation: LocationT° ....Avg'. .44"40....... p U/ ....f/1WS.... .................... ................................... ProposedUse ....... 1. .a�!. ..... /.4- .......+1 .. '. ................................................................................... Zoning: District ........ '.►...` ......................................................Fire District ...... 0A; .................................................. 10* , ter � � fc 4 Name of Owner � ........Address �.' Address ?'tl .... Name of Builder . ................ ... ... ........................ Name of Architect ................. ................Address .................................. ...................................................................................... . ' . �r .. Number of Rooms ...... ......................................................Foundation .. vpe .` ..... wvw......................... Exierior 77.'.14 ...Roofing ..Ar ,0*1, � 040 er...................... TI/wr .................... Floors P/�.�!...............................' `........... .....................Interior ..... `..... Heating �'� .....................................Plumbing / ,� - — -- - Fireplace ...... .... .......................................... .........A roximate Cost ...... ..........: . Definitive Plan Approved by Planning Board -----------—--------------------19--------. Area ............... Diagram of Lot and Building with Dimensions Fee ........: ....... :............ -SUBJECT TO APPROVAL OF BOARD OF HEALTH r `AROVAL OF 87�R1yST "CONSERVATION COMMISSION r��r ��v� I S'p .t . • +t • `s /-O'At! 4oT st GoT 7 �1��vT �Roak wren I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... .. ................. .. ................ Boger, Dean 19272 1 1/2 story N .............. .Permit for .................................... single" family diwelling ... ...................................................... ;- Trout Bro"ok Lane Location, ..................................................I................ cotuit .............................................................I.................. Dean Boger Owner ................................................................... frame Typelof Construction ........................................... ................................................................................ #8 Plot ............................. Lot ................................ Permit Granted June 6...............:.19 77 .................�.; Date of Inspection ..... . ....... ........19 Date-Completed ... ........19 PERMIT REFUSED ...................................:.............................. 19 ......................................................I.......................... ................................................................................ ........................................................... ................... w 0 ............................................................................... N Y rr Approved ...............................................—19 ............................................................................ .......................................................... ................... •'r.r - .-..-• , .�_ _.'. � -�. .:.';,:.t�. -*.• -� T -•,r.....-v.1..4,�.., •.�. . 'f:,�t� J,.n�SX+n...:iM.. �.�:..�,ty1-S� ""Ey,•.'�-+�,.•..d.':.u-"SwMil'-.". Assessor's map and lot number ................... ..�:.:.. �. ..l... Q C li.• 7 Sewage Permit riumber ........................... .....7.:............:........ •-`.�... yoFt"El°�� TOWN OF BARNSTA.BLE EiRNSTADLE, • -�" 9�C 16 9 .•�� WILDING INSPECTOR � APPLICATIONS FOR PERMIT TO ...................... ........... .... ................................................. ..... ... .....j }...... .... ........ TYPE OF CONSTRUCTION .............. ..:.?...•.'I..i..... ..........!..r.....f'............... ..........C. 1.++U.`....................... �.. ............................ ................19......:. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby:applies for a permit according to 'the following information: r T Location .�s"! ... ✓...p. !tt . ... ...:`"...!.`.. ....... fJl :....... .................................... ................................... ProposedUse •......... eEt .:�.... ` ar•%f.�%.......� � ;- tCa!F: .................................................................................. ZoningDistrict .........! ... ......................................................Fire District .............c...��f .................................................. f"� ,�^ ! i Name of Owner f. /`' ir:a.....Re -° 14: Address ..C�: Gl+kt'�E'/�..... r_f� `c. ..... Y`"r `''i /iota Name of Builder. /�::!......� s.:NP:;. t '...........................Address .........................................!l ' 'f '.it r7.,�'.f f.............. Nameof`Architect ..................................................................Address ................_.................................................................... Number of Rooms ...........................�....►.................. Foundation ................................................++4r' :.'.= w Exterior .......................................................Roofing ...:............�......:............................................................ •" Floors '�"' �. Interior .... ..... Heating .....'f: .:?r.. �c'..: ip .....................................Plumbing ...............:...... . 714.:............:............................. Fireplace ........ .f ..... ...........Approximate Cost .: :"-'... ...!... ...... ...... Definitive Plan Approved by Planning Board ----------------' --- - ---19 - -• ' Area ...... ....... . ......... Diagram of Lot and Building with Dimensions Fee ......... ' ....... �'.. ...................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ,l j 1 { +1 .�.; 40T 'G UT ✓ 3ROCA RQr9, ? I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f �. .. t..!„. ................... Name ................................. r � Boger, Dean Deao A=8~10 19272 . l 1/2 story . . No ---.--. Permit for .................................... - a1oole family dwelling ' '~--^'—~'--'---^--------'---' ~— 'Trout Brook �oz �..� " �� /`� Location --'--.—.------___6�'�7 ^_____. � . Cotolt .---..-----..—.--.--..--------.. � � , x , Dean Boger ` ' \ Owner .................................................... _ frame � Type of Construction .......................................... / Plot ~'' ^ J,/n e 6 77 Permit Granted .................(......................19 | " � / ^ � ^ ' --- of Inspection_ ----' 19 ""'e Completed ' .PERMIT REFUSED lA^----'-r`—'---~—^'^-----'' ^ ...... . ' - ' 7Y � � '----+''^—'-*—'l' .'~ —'' / \r'r �� .---.—.------..—..^—..--.��.—..--... -------....---.--~.-----.----'. ' - ' Approved ---------------- lg ' ^ - -------.------.--.~.--------- ' ----'—'---^'^---------^^^'—'—^' \ , ' | AREA PLAN SCALE : I "= LOT TR,OU T 6R� 0i< D Fy LEGEND «� NOTE, DIVISION PLAN "HiLLG 2(b 9 PG ,4 OCT. OWNERS: x, MR, 4 MRS DEAN 80 G ER CGI '� i LOT* 9 .� i L 0 T 7 00,04�, a,. - - - _...... tat: _ r.: •t 3 .�-i; 'i "�:.,�,,1"' �� e� + � � �..� 1 0 4 P . .r`z x.• + ` a �' �,� .,x:. 5 LOC`ATION G�' �O�a1Cl.E 1=�1i'I�t�� l Ft�1§Etd� t tea ICE r f { 9 G PIT 30' FR Q E� !`.` f STREET EET CATCH r ._..� i. 1 5: ^iwnaea�t.:u�w,a•. r - ��- �:;. �...M S I NS 2 0' FkC)M. PROPOSED ` I-E)Q i 95 AND �€O M".�C�M ACC f ..... �.. PIT; a y c �L+ 32+ I � •�Q �-� ICO e:7 pls ttP; f'tnl.V �:�,_ E tOtl& ^SSUMM DATUM �:. TROUT BROCK ROAD - SECT I O N `B.- ,;� h7-7 J J K j An PROPOSED FH-L, SECT1ON A -A .• W 1 �1/ Kr'a.S 4 M ip+ R:5! ' , W LEFT 'OFF H V Y M Y.._ Tc r.�i�.i Ohi 5,. .. �r�+.t��•'} 99. AN 'A F-CT( : y �q • "i .,..:....:.e-gin•-.. ._..._ ..-..s.._.._ ., h. _ i / s e ' 1to°Y lam-.••\��, \L� 114 - •' '. C 1 00 S bl GP c1' lJ J O DECK \ 12.0' 32.1'oz \ W / Lo__ % 231 ��� / Y'D/ic-•T� h�D / -- PLAN OF EXISTING CONDITIONS ' rO rb r ' LOCATED IN rb 'p COTUIT MASS. x of �, PREPARED FOR CHDAVID AR ES ti DEAN & PATRICIA BOGER SANICKI 28 DATE:NOV.. 14,2002 SCALE: 1 = 20' L LANDS FILE: 173BA Troutbrook158 Ell CAPE & ISLANDS ENGINEERING zo o Zo 40 bo 800 FALMOUTH ROAD,SUITE 301C MASHPEE,MASS.02649 [508]477-7272 T-YPICAS.- SYSTEM PROFILE AREA PLAN , FINISH GRADE=1r _ NOT TO SCALE \ FDN TOP FINISH t SCALE : ! _ FINISH GRADE OVER TANK GRADE OVER PIT-_,_, w f LT # U T E�3�'.^� i� �• '� rl T ?<; ' , I rr T 1 1V1 RESIDENCE O BAFFLES OR O O • .e .,,. .�. • -e.. •. .o..•... 9 (� C'... T i�i i 1�ifa�' .: . g C. I TEESto 1_: ` o • o . `� . e • • oo : L�GEHD BSMT 194 � o' ,:, r • . • • • ( • e e e • FLR 114 GAL, 4 !— l,_ t . o 0 0 • • • e e • 0 1 c• y - ? + ��• _ _ _3C?'- PROPONEO CONTO� )k - REINFORCEDCONCRETE DIST BOX CONCRETE _8 TO BE �'NSTALLED ON o ' + • • + • o 0 _ NOTE k � � ��� ' o ✓,, A LEVEL STABLE BASE • 1 • o • • � �f � Ala� PLAN N�'.I���*►kEf) ;-Vo d st��'.`• - e . e o • . • + • o o + o t DIVISION t1AN "NILLC:RFST-P ..AN 13K , SEPTIC TANK `' • , , ;=b_13:-; 4 OCT' i Q, i � -7' 6 TO BE INSTALLED ON A • f • • + + • LEVEL STABLE BASE o • • o • • • t OVINE 2 -I/8 - I/2 WASHED PEASTONE ALL BRICK 81 MORTAR COURSES AS RRS AROUND FREE OF IRONS FINES ' ' ' + + e i • • o 0 0 • REQUIRED TO BRING COVER TO GRADE 1 - ., i AND OUST IN PLACE j��,.�L'' �i�. 6 MRS �°EaN ��r� I � `` I LEACHING PIT ckoCKER ;titLGt< FORK' 24 C.I . MANHOLE COVER a 3/4 TO 1 -1/2 � WASH ED CRUSHED FRAME - SEE DETAIL STONE ALL AROUND FREE OF BASE TO BE LEVEL t!� ��GIFLAT �'+r•'�A, )S, \�, IRONS, FINES AND DUST IN =` } PLACE FOR FIN. GRADE �\ L � \` SEE SYSTEM PROFILE LOT 7 III SOIL AND PERCOLATION r...-.,.., _u 14 DATA F: - fi M .N d �,, k ---�----.----�-- P E C. RATE * 1 4 " ; - FOR INV. ELEV SEE r INLET _ ° i SYSTEM PROFILE �o , TAKEN BY . C. D. SPOHR LINE ° o --�6 WITNESSED BY . a; 0 OPENINGS Wi"4-I/8" , OUTER DIA. B� I -3/4" _ o DATE : !Qf r �% .�. �_� o !N SID DIA . 0 ° TEST PIT GND ELEV. ' 1 O p p ., _ OP POSSIBLE i L,i-Z1, L-EACNINC:r 1 FRS.m �1 T�`c:F_1' SA 3 t _ = ,:.'_-,--_ __ SINS fir' �k. 16�t PR�PO E E3wi�� D D o D D o '. - , ' - t4F �aRAv : 1\fG k~U:7T � `-D AND 4C0' F►.AGM A T'i1, _ L_F_A� " t ,aCj � � ° � ,� o o �1 EL) L�RA ti- _ EFFECTIVE DIA. I :, k--.F�� v' _ -----. _---------__.__— �3o-C-� "t' t�`S� BOTTOM OF TPOUT BROOK ROAD � LEACHING PIT - SECTION I TEST H0'L.E `;; NO SCALE DESIGN DATA : • - 'NOTE: DO NOT RUN HEAVY EQUIPMENT OVER SYSTEMIEV NO. OF BEDROOMS ! HCT ION B - B LEACHING PIT NOTES: DISPOSAL �� 4 EST. TOTAL DAILY EFFLUENT GALS. rop, t�C?L3� fi �' SCAt._E I' IP,` 1 . CONC. TO BE 4000 P.S.I a 28 DAYS . SEPTIC TANK GAL. �� LEACHING AREA I. 2_1 SQ FT GAL. SQ-FT. 2 . REINF W 6 x 6 6 GA. W W. M. / 3. 2 'AND 4 ' SECTIONS ARE AVAILABLE FOR GREATER DEPTH REQUIREMENTS GENERAL NOTES 1 . ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN NOTE : ACCORDANCE WITH ART. XI OF THE STATE SANITARY CODE Lot "` EXCAVATE TO ELEV. - OR LOWER AS DATED AUG. 15 1966 Fk ANY LOCAL RULES APPLICABLE. REQUIRED TO REMOVE ALL LOAM AND CLAY CONTAINING 2. ANY CHANGE TO THIS PLAN MUST+ BE APPRD. BY THE MATERIAL BENEATH PIT. REPLACE EXCAVATED MATERIAL BD- OF HEALTH. �Ei WITH CLEAN CLAY FREE GRAVEL MECHANICALLY COMPACTED IN PLACE. 3. WHEN CONSTRUCTION IS COMPLETED, PRIOR TO BACKFiLL1NG, � NOTIFY BD. OF HEALTH FOR INSPECTION. I.� -`,: 4. FOUNDATION ELEV. MUST BE CHECKED WHEN COMPLETED, 5. THESE ELEVS. MUST NOT BE CHANGED WITHOUT BOARD OF HEALTH APPROVAL, LEGEND 6 BOARD OF HEALTH INSPECTION READ. WHEN EXCAVATED -I- 50.0` EXIST. GROUND ELEV. GRN)Ec (-T !, A A, 75' FT 01 50.0 FINISH GROUND ELEV.- UNDERLINED i 23MAY`T'sr.FlvIcI tr d'a ; i� _ p' PIPE INVERT CLEV - , ,)V7F'c?'Jhl is a.? i L 4 7 5 1 a F v DATE D E S C R i P Y :", ry 7 ''� '" � �'� `�'� I Q TEST PIT LOCATION 1., _ SEWAGE DI S P O S A L SYSTEM SEPTIC TANK FOR 1 s !� T-At, � , M ; aLArJ BC,GE - t ���y -� ❑ DISTRIBUTION BOX LOT TkOUT F4�' L _ _..._ . 4 " C l � I . PIPE - �x � � 1� l C,��:�T uUE��I 'i/ I � iGN `-- ifiittf 1 F�- 4"BIT, FIBER PIPE - TIGHT JOINTS S COTU I T PROPERTY LINE DFSIGNED C D SPOHR DATE:,,; DRAWING NO. DRAWN: SCALE:ASSHOWN MIN. CODE DISTANCE - -- L_ CHECKED: C. D. S � --