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HomeMy WebLinkAbout0170 TROUT BROOK ROAD 0-70 l 007Z9/?00/ it d anIIp mot Yxe rok� TOWS Of Barz1S$able Permit# P Ecpires 6 months from issue date. �� oT RegillatOry ,Services Fee, 3 <, � HARNSTABLE, MASS. a y$ Thomas E. Geiler;Director 1639. plfD�� Building Division -PRESS PERMIT Tom Perry, CBO, Building Commissioner IfAPR 2011 1' 200 Main Street, Hyannis,MA 02601. www.town.barnstable.ma.us TOWN OF L = Office: 508-862-4038 : Fax: 5 30 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY iYot.Yalidavithout Reel X-Press Imprint- Map/parcel Number (`) 1 Property Address f 90 �7AVKK A& residential Value of Work 3��Qd Minimum fee of$25.00.for work under$6000.00 Owner's Name&Address /q}�12 '+ l�lir��� 1 �"��ZZl-5' Contractor's Name Telephone Number Home Improvement Contractor License# (if applicable) Construction Supervisor's License# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am`a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping.old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side #of doors ❑ Replacement Windows/doors/siiders.`U-Value - (maximum .44)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. *"*Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: .. . &441L� The Commonwealth of Massach usetts . , -� Department of IndustrialAccidents , d� Office of Investigations Jt 600 Washington Street 5 , 1 Boston, 1MA .02111 w}vw.riznss.gav%dia. Workers' Corripe.nsatfon Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organi2ation/Individual): V �� V'tFL LVS Address: L niA- 1` �✓�d 4�- I�1�" Y City/State/Zip �'(�� l /1u1 4 '� Phone#: � Are you an employer?.Check the appropriate box: Type of project(required): 1.❑ lam a employer with 4.'❑ I am a general contractor and I 6 ❑New construction have hired the sub-contractors employees (full and/or part-time).* 2.0 I am a.sole proprietor.or partnei listed on the attached sheet. 7. ❑Remodeling 8 ship and have no,employees °These sub-contractors have . ❑ Demolition working for mein anycapacity..f employees and ' have workers 9 ❑ Building addition comp, msurance.$ required.] _ S.J❑ We are a corporation and its ❑ Electrical repairs or additi [No workers' comp. insurance 10. ons 3 I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions right of exemption per MGL srryself,.[No yvorkl5._cQZnP;. g... P .._ p _. - 12.❑.Roof.repairs . insurance required.] t, c. 152, §1(4), and we have no 13:❑ Other employees: [No workers'' comp, insurance required] *Any applicant that checks box#t must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state,whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. - I am an employer that is providing workers"c.ompensation insurance for my employees. Below is the policy and job site information. < Insurance Company Name:: } Policy#or Self-ins. Lic.#: :� _ Expiration Date: Job:Site Address: 7 ��$�� 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 De advised that a copy of this statement may be forwarded to the Office of of up to$250,00 a day against the violator. Investigations of the DIA`for insurance coverage verification. I do hereby certify ;,- pains and e alti ofperjury that the information provided above is true and correct. Signature: Date: --�LOr/ Phone# �® Official use only. Do not write in this area, to be completer)by city or town official. City or Town: # Issuing Authority (circle one): 1. Board of Health 2:Building,Departrnent 1—City/Town Clerk d.Electrical Inspector 5. Plumbing inspector T7- Inform tion and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,m 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 an 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 coin'pliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance With the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary, supply sub-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 ^- 'r.s`---- -_ members or partners,are not required to carry workers compensation msurance.`If an L�C or 11;P 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 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 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 P Y ( town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the affidavit is on file for future permits or licenses. A new affidavit must be filled out each applicant as proof that a valid aff v P ial venture r citizen is obtaining a license or permit not related to any business or com mercial v Y ear.Where a home owner o g (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit, The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Xnyestigations 600 Washington Street Boston,MA 02111 Tel. 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727 7749 Revised 4-24-07 ,,,,,,,t,mace ar)-k/MIA Town of Barnstable 0 Regulatory Services �. " Thomas F. Geiler,Director w BARNsrnst:E, . MASS. Building Division p�EO µAS d Tom Perry,.Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 R HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: -7 k0,2/ 4ker number street village "HOMEOWNER name home phone#I work phone#1 CURRENT MAILING ADDRESS: city/town state zip code rs"was extended to include owner-occupied dwellings of six units or less and The current exemption for"homeowne 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 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,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 require ts. Signature of Homeo Iner , Approval of Building Official F 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 hisfher responsibilities,many communities require,as part of the permit application, that the homeowner certify that.he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amcnd and adopt such a form/certification for use in your community. Q:\WTFILES\FORjMS\homcextmpt.DOC 00HEr� Town of Barnstable Regulatory Services HA&NsrABLE, ' Thomas F. Geiler, Director y htAss. $ 1639_ Building Division Ito MAC Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Fax: 508-790-6230 Office: 508-862-4038 Property Owner Must Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereb authorize to act on mybehalf, Y in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Prop _ Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Assessor's map and lot'snumber ............................ ......... :2 S-/ Sewage.-Permit number, ,'.: ........................:................. ypF TH E T�� TOWN OF BARNSTABLE r Z 33MUSTODLE, 0 6 " 9 DUILDING INSPECTOR t: APPLICATION� FOR PERMIT TO U ? �` .......................... .... ..!'.v. Z �. �..."'. TYPE OF CONSTRUCTION ............. 1.C...n . ........................................................................ ... . r L / U .................. )6: ..:�..............19�is TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `�- (/ ?U :.... 1! K....... ...................eC�' 1 ....:.: . ................. u ....... . ..........�.... ProposedUse C. .......................................................................................I......................... Zoning District R. ..Fire District <'c."t'U....... ........................ ............................................. ............... .................................................... Name of Owner NG.....464!4 k.Address (=�X �D Name of Builder �� � ,; .......�VAla. ............Address ................`. ..............................................+.. ................ Name of Architect�....?!JN G r X,/ .1;/•t� .......Address ................C? .. .t%.................................................. ............... ..................... Numberof Rooms .......��.........................................................Foundation ....... ►�J• ' =.................................... Exterior f .............Roofing .........................? ........... Floors /N. .-..... PtQb '` (lX?�� ......Interior Si` � .... '�k" .................. ... ........................:............... .................... ......................................................... Z A T 4r r +a 6-9 Heating .......... (... 01 t W f'c"€...............�- t.'..PIumbin ... !6'............................................... Fireplace .....�.O.b�........... 1)VF 5 .........................Approximate Cost ...........�-�..r.bU J......................'.!........ Definitive Plan Approved by Planning Board --------------------------------19--------• Area b .Si . ............ Diagram of Lot and Building with Dimensions Fee ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .� , ,�, Gallus, Barry & Johanne A=8-11 18459 1 1/2 story No ................. Permit for ...:"***""**"**'*"****'*'****** single family dwelling ............................................................................... Location /JO Trout Brook Road ................................................................ Cotuit ............................................................................... Owner ..............Barry. . ... J.�hann.e..Gallus. . . .... . ...... . ........ .. .... . . .... �' Type of Construction .........,ftame.... ........................... .............................................. ....... ....................... Plot ............................. Lot #9 • Permit Granted /J......un....e ....15................19 76 ....... ,Date of Inspection ....................................19 Date Completed ........................... ...........19 PERMIT R/FUSED ................................... ...................... 19 ............................... ........................................... ErAf X.......................... ......... ..................................................................... ............................................................................... Approved ............................................. 19 ............................................................................... ............................................................................... f Assessor's map and lot number .... ................ r` ' / ,�• ypi T N E Tp�1r Sewage Permit number .... ...+ �.. �..... .. .........� Z BAUSTADLE, i Housenumber ...................................................... .................. 'O� W q. 0� p� �0 RFD NAY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ��..�.. �m AG�.. �i��i9L �q TYPEOF CONSTRUCTION ..................... DO .............................................................................................. ............ .........`� '`1......� .............19...... 3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 0 / /Zo�7 /��loo �iV. �o iZ / 2 6 Location ............/.70............................................................................................................. ProposedUse ......... '7).r'7?flG�.......................................................................................................................................... Zoning District ` ' ...................................Fire District ..... ���� . ..................................... .................................................................. Name of Owner J Cie y .. .�..�.L. ...............Address ..../20.....�✓ ".0 6y—'00«...............................' Il/I/ S Nameof Builder .......................m.............I...........................Address .................................................................................... Name of Architect S� �G` ... ...............................................Address ..................'�fj�'YlC�................................................. pN C i(1]U�tJb C(W(C S f1 Number of Rooms C ........................................................:........Foundation .............................................................................. Exterior ......... .dQ. ..........................................................Roofing ...............&. ....r ..�7................................................ Floors ®N.212G'T ........Interior ..............5/ ........................................................... ............ ........................................................ ec �crn, B+rsC �4' //}� iHeating ................ .....................`...............................Plumbing .................... !....................................................... PUIFireplace ........: � ..................................App Approximate Cost ................................................... ................ ..... ................... - � Definitive Plan Approved by Planning Board --------------------------------19--------• Area ..�=!:.7..�.......................... Diagram of Lot and Building with Dimensions Fee ...©�f.. ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH v OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...11..........7 .& , Construction Supervisor's License /��a"" f. y XGALLUS, BARRY W. A=8-11 t 24701 Build Garage No ................. Permit for .................................... Accessory to Dwelling ............................................................................... Location 170 Troutbrook Road Cotuit l ..................................................... Owner Barry W. Gallus Frame -- -- ------- ----- —_.� _ -- - - -- --_ ---- - -- ..TYpe of-Construction ......................................... Plot ............................ Lot ................................ Permit Granted .....January 6, 19 83 r f Date of Inspection ....................................19 Date Completed 19 ccr i t t , r i i Engineering Dept.(3rd floor) Map /V Parcel 4,- Permit# House#- / 7� f Date Issued f� " Board of Health(3rd floor)(8:15 =9:30[1:00-4:36)24-;?t Fee, Conservation Office(4th floor)(8:30-9:30/1:00-2:00) +_'�i 51/7)d6' SE TIC SYSTEM MUST BE -,3s'3o PiAarry Planning Dept. (1st floor/School Admin. Bldg.) 9 INSTALLED IN NCE Definitive Plan Approved by Planning Board I f/; 19 VM . 5� 7? PAT AND ORE S TOWN OF�BARNSTABL Building Permit Application Project Street Address /17 o -r72-0u i Ap"Coe- Village Owner 9 A-;Lai t-TD 0bUAJ 6-, 6A L GLI C Address Telephone SQ f4 . 4�z t 3 -Permit Request A,U I( b /4 5 y>>y270-zs; °70 Cd7Vitlb�- % ??) COW4' '& i First Floor I U square feet Second Floor ���} square feet Construction Type C.Q.A,60 7sM JqJ-iJJu i tJ0 al Gi2.A-,I 6 �10Jh4-t,T RAfl F Estimated Project Cost $ A,000 �'— Zoning District P F- Flood Plain Water Protection Lot Size 3'�, �Lo0 Grandfathered AYes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure O'IX W s Historic House ❑Yes 'No On Old King's Highway ❑Yes ANo Basement Type: ❑Full ❑Crawl Q Walk/out ❑Other Basement Finished Area(sq.ft.) 11-1 1 Basement Unfinished Area(sq.ft) A11A t Number of Baths: Full: Existing - New Half: Existing New No.of Bedrooms: Existing_ '7� New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil 3'Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove Yes ❑No Garage:XDetached(size) Other Detached Structures:. ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization X Appeal# 0 Recorded❑ Commercial ❑Yes k No If yes, site plan review# Current Use tz"A Proposed Use 12�1�t c-ou c_z� Builder Information Name � Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L ;LL SIGNATURE DATE BUILDING PERMIT DENI D FOR THE FOLL WING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO: DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE T' t - eel, OWNER G ' DATE OF-INSPECTION: FOUNDATION rp • I FRAME INSULATION = FIREPLACE E ELECTRICAL:':" _ROUGH FINAL 4 ms aS{i x PLUMBING�'� OU FINAL ' GAS: 0 MtmJ FINAL . FINAL BUILD 2 2 m _ • 4 t DATE CLOSED 00[', 0 P r ASSOCIATION PLAN ND I LA�-- G� -�,�t> Gam' 5 IS D.G. Hpl�IZ, OUT FIZOM +AOUSE �, ��I t,��•D � Gl�o►,rr�fl I-kous� WALL lL T a +4' Ar3ovc. , ,o V z'�0-C • — vjcKT —..........- _............... VZKUU C> o_ L� Oh 1 OF CONC. ZV,&t7l5 AT � rj -- q-�-D�� 13C .. s�cr lory s u. I 0 \�------s^— IOU ---- + .: -;-x:• . �- II �(vAtz�t w�c�aa�E� _ T�Y�OEz SIGtt4 - l� a -rA H Nh, r�A 02601(�8) 790-4G36 (. 1-7r� -nKour 1E�,KcoK 1zoA p r "----- ----- foWr?t� 2>e-4 WALI-S — -... .._._. --------- -------? 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I 4 , 7-7 I� _ l ... __- 1 f-- _ L�Ll.V/,T I0t`a 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: 5-17-2000 DATE OF PLANS: TITLE: COMPLIANCE: PASSES Required UA = 80 Your Home = 69 Area or Insul Sheath Glazing/Door Perimeter R-Value R-Value U-Value _ __UA CEILINGS 289 30.0 0.0 -- 10 WALLS: Wood Frame, 16° , O.C. , ., 426 13..0 3.0 30 GLAZING: Windows or Doors 38 0.400 15 FLOORS: Over Unconditioned Space 289 19.0 14 ----------------------------------------------------------------- ------- = -- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other p calculations submitted with the permit application. The proposed building :r has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4 . Builder/Designer Date MAScheck INSPECTION CHECKLIST Massachusetts Energy Code °-MAScheck Software Version 2.0 DATE: 5-17-2000 Bldg. Dept. Use CEILINGS: [ ] 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 16" O.C. , R-13 + R-3 Comments/Location WINDOWS AND GLASS DOORS: [ ] 1. U-value: 0.40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location- 'tl� i , z; FLOORS: [ ] 1. Over Unconditioned Space,- R-19 ,. 'Comments/Location ,i AIR LEAKAGE: [i,>] 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)------------------------ J ELE[!= 47.11(N.G:VD.) LOT 8 A.M. 8110 4vP��C� HOUSE / lb 237' CONC l / I 120' �j / PROPOSED 0 MONOLITHIC 60 �°,E a o it SLA9 J�,,.� p 17( t0 :�170.:. LIMP... cv LOT 9 `J ! l I , ,;' ' — coNc M 8�11 0 /� �`i 1 4�w w RET \ --------- ' AREA=35,2121 SF \ l l - WALL 40 i Iz I P /TREEHOUSE / /�j� i�/ 2 � ^per/ �/ /�!� ���� � ��• � �',•�a�,�,tir � . i 0 \ -- ` LOT'10 _ > > A.M. 8/12 I 20 o i�ozrr beat K3,s 38 40 42 44 /TREEHOUSP _ i • i 61 ,yl x € I . LP 1 CERTIFY THAT THIS SURVEY AND PLAN WERE MADE 1 1 IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL STANDARDS FOR THE PR ACTICE OF LAND SURVEYING 1 1 , 4� faao�. THE COMMONWEALTH OF MASSACHUSETTS. IN PA UL A. MERITHEW, P.L S. AT w � ' The Conrmontvcull/r of.�ltassuclrusctts Department of Industrial Accidents fix VMCCat/095f/ga1/ons 600 !f'asi'tirt(;turr Street 4 Boston.A1uss. 02111 Workcrs' Compcnsati0n Insurance Affidavit dpphc•tnt inff�ormation'• — _Please PRINT Z-ML .— r , name• 9 AiUL. /W 6A 1.Z, i i S Incition tin. eo-n ) 1' 1 nhnnc I am a homeowner performing all work myself. I am a sole proprietor and have no one workin__ in any capacity Q 1 am an employer providing workers compensation for my employees working on this job. coutnnm•name; ad d revs-• city. Rhone 4: insurance co. noliry 0 [) 1 am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: compnnv nnrne, adtlresc� cin Rhone 0J• insurance co. nniiev 0 cenirmo ' name* atl[Iressr tin nhnne Of- insurance ce nnlicy*1 Attach additio_nai sheet ifnecessa -:.."'.-i r' ._.•r --Ji'.':.��.. •ate.i� '+—=.; ^::+'•`r.^ Failure to secure coverage as required under Section:SA of NIGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 andiur unc scars'imprisonment ms well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a dag against me. 1 understand that a cope of this statement may be forwarded to the Once of Investigations of the DIA for coverage verification. 1 r10 herehr cerrij't•it cr the pains and peiialti• jperjun•that the information pro Ivided above is true and correct. Si=nature Date Print name / �} L L US Phone>* Z g `S39 .u+..`wrnrr '�ofTcial use unly do not write in this area to be completed by cin•or town official �+ city or town: permit/license 0 r111uilding Department C3Liccnsinr Board check if immediate response is required C5cicctmcn's Office ' (:JfIcatth Department contact pcnon• phone#; rJOther F. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for:h employees. As quoted from the "law". an entphtree is defined as every person in the service of another under any contract of hire, express or implied. oral or Nvrincn. •� •s s an individual, partnership. association. corporation or other legal entity, or any two or inc An cntpint cr t. defined a. the foregoing enuaged in a joint enterprise,and including the legal representatives of a deceased emplover. or the receiver or tntstce of an individual . partnership. association or other legal entity, employing employees. However owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwcllimg house of another who employs persons to do maintenance, construction or repair work on such dwelling ii( or oft the __rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioy: MGL chapter 152 section 25 also states that even state or local licensing abenc} shall withhold the issuance or renewal of:a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perforniance of public work until acceptable evidence of compliance with the insurance requirements of this chapter 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 compan names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coyera`e. Also be sure to sibs and date the affidavit. Tire 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 require 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 the affidavit for you to fill out in the event the Office of Investi-ations has to contact you regarding the applicant. P1 be sure to fill in the permit/iicense number which will be used as a reference number. The affidavits may be returnee 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 questic please do not hesitate to _give us a call. . The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents _.. Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone T: (617) 727-4900 ext. 406, 409 or 375 ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE ,�'" -- (high end construction) j G i square feet X $115/sq. foot l (above average construction)-__-., square feet X $96/sq. foot (average construction) square feet X $57/sq. foot= GARAGE (UNFINISHED) -- square feet X $25/sq. foot= PORCH square feet X $20/sq. foot = DECK square feet X $15/sq. foot= OTHER square feet X $??/sq. foot= Total Estimated Project Cost IAHFORM 1/3/00 The Town of Barnstable �OF1HE Tp�,O Department of Health Safety and Environmental Services Building Division BAMSrABLB. ' 367 Main Street,Hyannis MA 02601 MASS. 9 i639. �A�ED MA'I a Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE.. JOB LOCATION: Z/Z/ V �©D �C /v 1 ! number street �1 /� street village "HOMEOWNER": 9/er'! 1(n- Lti �Y *6&y�' �. 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 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 ---'fafm 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 proce es and/r'elquire ts. 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 communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN y CF SME Tp��O � j . The Townrbf Barnstable 9� MAM059�- �0�' Department of Health Safety and Environmental Services pTFDt�� Building Division 367 Main+Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. i Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION r 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: t 7Tl Bd7 Est.Cost0 C7 1 Address of Work: �e_a©t JIF Owner's Name AGZ y S Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ,lob under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Ul0 Date Owner's Name .-Assessor's` map and lot number ....... . ............... y T E Tp� Sewage Permit number ....... .. .......� 6 a--� d�P� ♦� Z BAHdSTADLE, i House number ....................................................... .:.............. r WARR 0 • - pp 1639. 0 F �MPY Ar TOWN OF . BARNSTABLE BVILDIHG INSPECTOR APPLICATION FOR PERMIT TO .�C� ` C i9 C� f-/.....�. ............. . t ......... ........ .... L � TYPE OF CONSTRUCTION G...©0. .................. ...........................................................:............... °t'`j...... .............>I9: .3 TO THE INSPECTOR, OF BUILDINGS:. The undersigned hereby applies for a permit*according to the following information: Location ...........l.�v.........71�v v?;�j,.cOO.�.......�...... ....� 0�........................... �: .............................. � .9 A ProposedUse ............................... ......................................................................:;...................................................................... ,Zoning District ... !..':.. Fire,District .............. ............................................................... Name of Owner .!`'R 2} ..w:.. .�. ."L. .............. ....� Q70.... 4o.Lj7.�i?vaic.....: .....�0 !% Address Nameof Builder ............ . .................... ............... .�.... ...................................................... Nameof Architect ....:........... ............:...................................Address .................. %................................................. Number of Rooms ............. l..l ...........:.....Foundation ... V�VD�C-NfC SLR .......... Exterior ©� ...........................................................Roofing ............. � L �A!V . ..Interior /p Floors ............... ..................:"..........................:.......:........... ...............�j..`.../�,............................................................ c � I A-S � l Heating ................ -. . .. ......... ...........................................Plumbing . . . ............. .. ... ........... ... ...................................... Fireplace ........................l.. ..................................................Approximate Cost ................. .............................. Definitive Plan Approved by Planning Board ------------------------------19--------. Area ........................... Diagram of-Lot and Building with Dimensions Fee '®D ' SUBJECT TO APPROVAL OF BOARD OF HEALTH Z_5� . Y - OCCUPANCY .PERMITS REQUIRED FOR NEW DWELLINGS I hereby -agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.. Name ...........�....... ..... ..... ................................ Construction Supervisor's License .1.....*30J.......... �f ' GALLUS , BARRY W. r 24.701 Build Garage ' ................. Permit for ..................................... 7 'r Accessory to Dwellin -.n) ................... .............................................. ":.. . !_I Location .. ...70........Troutbrook Road- ................................................. ~ ................. .............................................. Barry W. Gallus Owner ' - '............................... Frame Type.of Construction .......................................... r ` `' .'......j .................................................................. �- I r •' ,' 's. rPlot ........................ Lots................................ '! 1 N. Q. 83 Permit Granted January , ' Date of Inspection ! Date Completed ..................��` ....:::19 12 X" 0 -.t I � �''' •�`�� -� �br,r� 4 ;urn-��•�ruow�s ti�t•�A�' r R� . 41 Er�Nfc 7b l� N Mfg. Is f IA r j , 13 �/1c�1°DS6L� } ,,. ofsFtw-�q¢ rT + +. 9` »,. t!7p2AG E `USA i IVAI tolns�G7 To q'I 4r - ter _ TuYr �• :, 47rurr, Wt_ ira� �r PAS OF MqS, AL Jc�M /3,9Rey lv. C-ALc. s /'7© 7;20 07191e of< lti � _ c�,_vZr" I' A esso ,'map and lot number .......1J............ ........... . f .2S Seviiage•�Permit number ... GEPTIC .SYSTEM MUST bgINSTALLED IN COMPLIANO C, WIT A��2�'IQ a: P�f7NEr0� TOWN OF BA r YT� E I BLTN . w y '" • �`� '� ti GULATIONS. Z BASH-9TeI1LE, i �� � 9 aP39- RUI' .D1HG INSPECTOR c•� OD t63q, O.ypY a': s C ry APPLICATION FOi2' PERMIT TO: ............. g.... .. .. ............ ...... ........ .. .. TYPEOF CONSTRUCTION ...................... oC. .. ............................................................................................ :> C- ................................................ I TO THE INSPECTOR OF BUILDINGS:- The undersigned hereby applies for pa�,permit according to the ,following information: ^tom �/� Location ...... .!•(i' 6 ..A�..........�/`;t/C>7... `�!�lJ�.�........1....1................... �'� �.�..`.....�..:."..`.A................. ProposedUse ..................... : .. .. 'N ................................................................................................................. Zoning District �. ..Fire District ...:....`o-'u t .. :... ............................. .................... .. . 1 Name of Owner ...st1 '. �14A!G........L�.S.Address ��.. .............�® :1�.. .oZS9:. Name' of Builder ...... ....... ( LL.�1.S............Address ................s. rnL ......... r Name of Architect .... r. F1�t�NLLU .`....Address ............ cJ .L..................... Number of Rooms ....... .. . ........ :.... ?............................Foundation s., Exterior ....CLfi••'''�...: .. f/C1L .............Roofing ........... /?5. ...... �........... s Floors C.....A BC (A.) _ T .......................::...p v � Heating C G.(C ;"L .T�l WAr1L—�— lumbing ............�t(:...,.0 .. .6' ............................. Fireplace ..... ..�.bb...........�1 Q.V.. .........:.:....:.........Approximate Cost .:............ 0� ............................. Definitive Plan Approved by Planning Board__-__________ ----------t 9-------• ..Area ................. s Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH OL Owl i I hereby agree to conform to all the' Rules and Regulations of the Town of Barnstable regarding the above construction. k Name ..� .......... ....... .............. Gallus, Barry & Johanne 18459 1 1/2 story, . ................. Permit for .................................... single family dwelling ............................................................................... /76 -Trout Brook Road Location. ................................................................ Cotuit ............................................................................... Barry & Johanne gallus Owner ................................................................... fl frame* Type of'Construction .......................................... ................................................................................. Plot Lot ........... ................. June 15 76 _,Permit Granted ........ Date of Inspection .......... ....../...................19 76 Date Completed ... ........ ......... ­19 PERMIT REFUSED ............................. ...... 19 ..............................................I ...................... ................................................ .................... ................................................................... ............ ...................................................... Approved ................................................ 19 ........................................................ ' � �_ � • �• .`\ D� off{T�i i' Rt•(�-- �7 �rl n k _� _ - +�J'fr(fir.�1d�4�C,�� \� g, • C. mnT + ' .. ?•. �" ! ), it a 2 rlr- 3' TO I'/2 - I �C1AsN,�t�S'rbNE d t � Oait/T` � YC 1 f - 1 / � i11-11 ".rf �r V� � ' �� r 1��' �.f�. r�'• t J t '• � 1 ! 1�. a ; � "lUNA��`� ' �`br I%•c��,'" ;'� i