Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0140 CONNERS ROAD
r � 4 � v�' r 3y O i� �pf THE 1p�� o� Town of Barnstable MARNSensce. Building Department- 200 Main Street `? �0� Hyannis, MA 02601 $A'Eo Mai° Tel. (508) 862-4038 Certificate Of Occupancy Permit Number: B-20-446 CO Issue Date: 8/6/2020 Parcel ID: 251-014 Zoning Classification: RD-1 Location: 140 CONNERS ROAD, CENTERVILLE Proposed Use: Name of Tenant: Sprinklers Provided: Gen Contractor: BAYSIDE BUILDING INC Permit Type: Residential - Single Family Type of Construction: Design Occupant Load: 0 Comments: Building Official Date: A Certificate of Occupancy is Required Prior to Occupying Space Building Code: 780 CMR 9th Edition x ^ -re'- " k ri .. x. k k fv. t ddd Certificate of insulation install Address: 140 Conners Way,.Centerville, MA , Roof--40; Closed cell foam Exterior walls — R21; Closed cell foam Basement ceiling — R30; Fiberglass Batts 1 I Installer: Cape Cod Spra oa C MA 111 8 Signature Contractor of the projec : y de uilding Inc ZONE: a« ' RD-7 s 3haity P nd Area (min.) 87,120 Sr (RPOD) '`'I•` {- ��, ' Frontage (min) 20' Lake VVequaquet Width (min) 125' Setbacks: v Front _ Side 10'0' A Great Pond Rear 70' OogseDerry -- •� ' tobl•nd - -` Edge of Water — . _ 3 FLOOD ZONE: Zones: X(0.29 Annual Chance) 7,. Pt �.• X Area of.Minimal Flood Hazard „'�` CUS \� Ni / - Community Panel No. > Lt \ E t Edge o � �CB/DH #250007CO562J _ (Fnd)/ July 76. 2014 _ ,�.�?..`.. e- �'_• y ' ogd Pier SE-j-4755 LOCATION MAP: 7ss _ REFERENCES: 1'=2,000t' Deed Bk. 31581 Pg.'83Plan 6k. . Plan Bk.. 89?P g 6305 ASSESSORS REF.: Lot Area Plan Bk. 47 Pg. 119 Map 251 Parcel 014 17,590±SF to Lake OVERLAY DISTRICT: o'- 50 AP - Aquifer Protection District o .o NIF Randal C. Green and Wendy L. Joakim Trs. --Deck.. 27.0' 1st\ Rinse' Sty ew C5,ncrete 700' r 1 Deck Foundations\ 10.3'� / o #140 cB/oH,.� - o Ex. 1 Sty (Fnd) 7( :.8' 3 w1f Dwelling \ S� 40-W _ N ,Fla ` ...; 21.6' 22.7' _. B sa — ce/oH o' ,2 CB/DH 9FO(STI , :(rnd) .... N 2'08'20.'f (Fnd) . 384.47 E (ONAL E COf// e S Road Al (20' Wide Private Way) Existing New Foundations Plan • o The property line information shown was 2) The topographic information was obtained on9 F,p�IQPkI'IIIg$t Tim & Janet Green obtained from a Pion of Land at 140 Conners from on on the ground survey performed on � At Sullivan ConsUIft Ina 140 Canners Rd. Centerville, Rd., Baxter Nye Engineering and Surveying December 13, 2019. 140 Conners Rd. MA 02632 -. imm�maw•ea•:ms•�a Mr,m..ao.ra unoaen� dated 7/21/2008 which was compiled from 3) The datum used is based on Town of Barnstable fGB,7fB,�llre�Mass. —�- � m- As rae w,k 20 0 10 20 various recorded plops and available record Barnstable GIS Data. -a cra . - deed information. 4) The foundations were field located on 5-22-2020. Moy 26, 2020 cam 1 e,o e. rsse�or - Town of Barnstable Building n x f?ost,This Card So__pt it is.Visible"Frgm"the Street-Approved P ans Must be Retame on Jo an #his Car ust a Kept Posted Until Final Inspection Has"Been Made y. g ° t _ Permit Where a`Cer ificate'of Occupancy is Required,such Building shall:Not be Occupied=until a Final lnspectiort has been made Permit No. B-20-446 Applicant Name: BRIAN T DACEY Approvals Date Issued: 03/03/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 09/03/2020 Foundation: Location: 140 CONNERS ROAD,CENTERVILLE Map/Lot. 251-014 Zoning District: RD-1 Sheathing: 41. Owner on Record: GREEN,TIMOTHY T&1ANET S Contractor.Name:"".NBAYSIDE BUILDING INC Framing: 1 Address: 140 CONNERS ROAD Contractor License: ,113786 2 CENTERVILLE, MA 02632 � Est Project $ 150,000.00 Chimney: Description: To renovate existing structure and add a rear,addition as well as a 1 Permit Fee: $815.00 -car garage w/mudroom Insulation: Fee Paid: $815.00 x r° Final: Project Review Req: Date. ,�!� 3/3/2020 Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is_commenced within six months afite issuan icial Final Plumbing: All work authorized by this permit shall conform to the approved applicatiorrand the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws`and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures bythe Building-and-Fire.Officials are provided on this,permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing ` Service: 2.Sheathing Inspection J 3.All Fireplaces must be inspected at the throat level before firest flue,limng is installed _ Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Final: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Low Voltage Final: Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Application Number.......b........... .................. MASS. Permit Fee...... ..........................Mer Fee:....................... 059. 49 Total Fee Paid ............................................ ...... TOWN OF BARNSTABLE Permit Approval by... 31112-o ..... .........On............................. BUILDING PERMIT map.......02.'-' .................Parcel....... ......................... APPLICATION Section 1 — Owner's'Information and Project Location Project Address 1410 Village bL;ANNF17 Owners Name v.4— MAR 0 4 Owners Legal Address I . State --Zip Owners Cell# /0 E-mail Section 2 —Use of Structure Use Group5.F. F] Commercial Structure over 35,000 cubic feet El C0rhmercial StructureUnder 35,000 cubic feet Single/Two Family Dwelling Section 3 — Type of Permit F-1 New Construction ❑ Move/Relocate ❑ Accessory Structure EJ Change of use El Demo/(entire structure) ❑ Finish Basement 7 Family/Amnesty El Fire Alarm Rebuild F Deck Apartment IPJ 1.E5rMeD k?Jem Addition ❑ Retaining wall E] Solar FE") 18 Zug X'Renovation ❑ P 6`01 El insulation Other—Spebify—I TOWNIOF BARNSTABLE F7-i- Rsection 4 - Work 1pescription AJ T.P-t lindsted- 11/1 snot R Application Number..................................................... Section 5—Detail Cost of Proposed Construction (�JI Square Footage of Project Age of Structure �'/ ., Dig Safe Number # Of Bedrooms Existing �` Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics W1ring ❑ Oil Tank Storage Smoke Detectors [� Plumbing Gas c ❑ Fire Suppression Heating System ❑ Masonry Chimney fK[Add/relocate bedroom Water Supply Public ❑ Private , E" Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: &XV1.4- Lamle_ I am using a crane ❑ Yes IK No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes No ❑ i { Section 8—Zoning Information Zoning District rX i Proposed Use Lot Area Sq. Ft. v Total Frontage Percentage of Lot Coverage # of Dwelling Units (on site) Setbacks Front Yard• , Required Proposed �� .� _ Rear`Yard' . wRequired t0~� Proposed Side Yard Required I y Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 Liberty Mutual SURETY Bond 999037020 LICENSE OR PERMIT BOND KNOW ALL BY THESE PRESENTS,That we,Bayside Building,Inc. as Principal, of P.O. Box 95 (Street and Number) Centerville , Massachusetts and the The Ohio Casualty Insurance Company , (City) (State) New Hampshire corporation,as Surety, are held and firmly bound unto Town of Barnstable (State) as Obligee, at 200 Main Street,Hyannis,MA 02601 ,in the sum of Five Hundred Sixty Dollars And Zero Cents ($560.00 )for which sum,well and truly to be paid,we bind ourselves,our heirs,executors, administrators, successors and assigns,jointly and severally, firmly by these presents. Sealed with our seals, and dated this 13th day of February , 2020 THE CONDITION OF THIS OBLIGATION IS SUCH, That WHEREAS, the Principal has been or is about to be granted a license or permit to do business as Street Opening/Right of Way for the work to be performed at/for: Construct Home at 140 Conner Rd, Centerville,MA 02632. 140.'fronby the Obligee. NOW, THEREFORE, if the Principal well and truly comply with applicable local ordinances, and conduct business in conformity therewith,then this obligation to be void;otherwise to remain in full force and effect. PROVIDED,HOWEVER: 1. This bond shall continue in force: ® Until 13th day of February ,2021 , or until the date of expiration of any Continuation Certificate executed by the Surety . OR ❑ Until canceled as herein provided. 2. This bond may be canceled by the Surety by the sending of notice in writing to the Obligee, stating when, not less than thirty days thereafter, liability hereunder shall terminate as to subsequent acts or omissions of the Principal. Bayside Building,Inc. By Principal P\11( INS& The O ' asualty Insurance Company yJ �0 Poor , , 1919 0 - ° B I .� y° HAM? aa3 y $'14 * �,� Timothy A. Mikolajewski Attorney-in-Fact Liberty Mutual Surety Claims.P.O.Box 34526,Seattle,WA 98124•Phone:206-473-6210•Fax:866-548-6837 LMS-209e9e 03n9 Email:HOSCL@libertymutual.com•www.LibertyMutualSuretyClaims.com The Commonwealth of•Massachusetts Department of Industrial Atccidenis Office of f Investigations 600 Washington Street Boston, MA 02111 wwW.Mass.gov1dia Workers' Compensation Insurance Affidavit: Bunllde>rs/cColrnt>ractois/]Elleet>rieians/lP>(u>I>mbelrs Appflean>t Information (Please IPrinf Legibill Name(Business/Organization/Individual): Q, Address: 7 d ?-Joxqs- City/State/Zip: Cest6NLN 06 Phone#: - Are you an employer?Check the appropriate ox: Type of project(required): 1.❑ I am a employer with - 4. K I am a general contractor and I employees(full and/or part-time). ave hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. RLRemodeling ship and have no employees These sub-contractors have g• []Demolition working for me in any capacity. employees and have workers' insurance.1 _ 9 wilding addition comp.[No workers' comp,insurance P• required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.F1 Plumbing repairs or additions .m self o workers comp. right of exemption per MGL y � ' p 12,❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 131-1 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all 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'compensation insurance for my employees. Below is the policy and job site . information. /� Insurance Company Name: kadL. LM tkrdkKC.Q Policy#or Self-ins.Lic.#: �'�0'r?j�Q (Q ZQ — I Expiration Date: Job Site Address:NO orinee!> -X d City/State/Zip: Attach a copy of the workers' compensations policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250,00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certiki under the pains and penalties of perjury that the information provided above is true and correct i ature: Date: Iks Phone#: 1 Jt(C)wl 77 Official use only. Do not write in this area,to be completed by city or town official City or Town: Perinit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Commonwealth of[Massachusetts i Division of Professional Licensure ` [ ®ard of Building€�Egiat ti6ns and Standards _.,.....:_ ..,,.-�. .._ :.,.; ,.,._..-._...... -.-" _ -... :..: ...... ..... ........ .. ... ..._-•. -.. �`"r.�tP!; �.�.4Fog�res,.ilcrsr ..-. _:-.... k v CS-006645 Aires: 04/19/2020 �. BRIAN T®ACFV PO BOX95 'a CENTERVILLE 63i f Com'Missioner 1 . Construction Supervisor Unrestricted-Buildings of any use group which contain ; less than 35,000:cubic feet(991 cubic meters)of enclosed space. S e Failurb to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)721-3200 or visit www.mass.gpvldpl t/ Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home ImprovemenfiC�antractor Registration Type: Corporation r:;nz Registration: 113786 BAYSIDE BUILDING INC i PO BOX 95 ���+. �rv.-��«� Expiration: 07/15/2021 CENTERVILLE, MA 02632 ° Update Address and Return Card. SCA 1 Ca 20M-05/17 - �0e Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:,,Corooration before the expiration date. If found return to: Registratiiom Expiration Office of Consumer Affairs and Business Regulation 1;13786 = 07/15/2021 1000 Washington Street - e 710 BAYSIDE BUILIMMW NC' =: :w Boston,MA 02118 BRIAN T.DACEY< „f 3 BAYBERRYSQ CENTERVILLE,MA 02632 Undersecretary No alid w' ut signature a I - 1Bayside]Building Subcontractors2019 GeneralL'iabih W Wofkers Gom ___,_ Comments_ sub Contractor GLFStart �GL End W,,C( Star;: W.0 Ends j Villani Construction Inc 04/12/19 04/12/20 01/08/19 01/08/20 Christopher Costa,Inc. 04/13/19 04/13/20 01/09/19 01/09/20 Walpole Woodworkers 04/14/19 04/14/20 01/10/19 01/10/20 Botello Lumber,Co.,Inc. 04/15/19 04/15/20 01/11/19 01/11/20 Davids Building&Remodel Interior Trim Car en. 04/16/19 04/16/20 01/12/19 01/12/20 MacDonald Concrete Finishing Cellar/garage floors 04/17/19 04/17/20 01/13/19 01/13/20 OTihelly,Brian 04/18/19 04/18/20 01/14/19 01/14/20 American Floors Oak floor finishing 04/19/19 04/19/20 01/15/19 01/15/20 Morse's Masonry Mason Contractor 04/20/19 04/20/20 01/16/19 01/16/20 Meagher Construction(Roofer) Framer 04/21/19. 04/21/20 01/17/19 01/17/20 Pro Fence Co.,Inc. Fence 04/22/19 04/22/20 01/18/19 01/18/20 Cape Cod Insulation 04/23/19 04/23/20 01/19/19 01/19/20 Spagnuola,Anthony dba Spas 04/24/19 04/24/20 01/20/19 01/20/20 Jeffrey Lauder Bobcat 04/25/19 04/25/20 01/21/19 01/21/20 Reliance Air Systems Inc 04/26/19 04/26/20 01/22/19 01/22/20 Foam Insulation Technology 04/27/19 04/27/20 01/23/19 01/23/20 Falmouth Engineering 04/28/19 04/28/20 01/24/19 01/24/20 Coy's Brook,Inc Landscape 04/29/19 04/29/20 01/25/19 01/25/20 Hill Construction Framer 04/30/19 04/30/20 01/26/19 01/26/20 Carpet Barn Inc 05/01/19 05/01/20 01/27/19 01/27/20 L&M Glass Co,Inc Mirrors,shower doors 05/02/19 05/02/20 01/28/19 01/28/20 Kitchen Concepts of Taunton 05/03/19 05/03/20 01/29/19 01/29/20 Creswell Construction(Steve Creswell) 05/05/19 05/05/20 01/30/19 01/30/20 Toby Leary Fine W000dworking Trim Carpentry 05/06/19 05/06/20 01/31/19 01/31/20 Pastore Excavation Inc. Excavation 05/07/19 05/07/20 02/01/19 02/01/20 VMA Electric Pool Installer 05/08/19 05/08/20 02/02/19 02/02/20 Jackson Welding 05/09/19 05/09/20 02/03/19 02/03/20 Govoni Land Services Land clearing 05/10/19 05/10/20 02/04/19 02/04/20 A.F.M.Plumbing 05/11/19 05/11/20 02/05/19 02/05/20 Cape Cod Marble&Granite 05/12/19 05/12/20 02/06/19 02/06/20 ML Riley Construction Framer 05/13/19 05/13/20 02/07/19 02/07/20 Cavanaro Consulting Inc 05/14/19 05/14/20 02/08/19 02/08/20 Reed,Mel Sheetrock 05/15/19 05/15/20 02/09/19 02/09/20 Triple Crown Cabinets&Millwork Framer 05/16/19 05/16/20 02/10/19 02/10/20 Arne Excavating&Paving 05/17/19 05/17/20 02/11/19 02/11/20 Fast Glass Service 05/18/19 05/18/20 02/12/19 02/12/20 Chaves,Robert Electrician 05/19/19 05/19/20 02/13/19 02/13/20 Aluminum Products of Cape Storms screens gutters 05/20/19 05/20/20 02/14/19 02/14/20 N:\aaNICKWA—Subcontractors Insurance Master 2012 Application Number........................................... Section 9- Construction Supervisor Name Telephone Number !!Sn�S- 77(- (oiE Q Address City Jill.Q State — Zip 6Z(e3 L i License Number 005 JA! License Type Expiration Date 41utl Contractors Email 6 Y o oA (1�i �t -Cc� l Cell # 505-Z'U-W%k� I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections:-and- documentation re d by 780 CMR and the Town of Barnstable.Attach a copy of your license:;�, Signature Date , 'l Section 10-.="Hoine ImprovementContractor`.4:J:r =; '; Name , `t' Telephone Number Address City State Zip _ Registration Number Expiration Date ko 12-6 I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation require y 780 C the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 -Home O s License Exemption Home Owners Name: Telephone Number Cel Work Number I understand my responsibilities under theZ.-I es egulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Bui ,understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date r ' Print Name ICJ Telephone Number '77q LI67- D�?lj E-mail permit to: ` haoje Ut j COAA, Last updated: 11/15/2018 Section 12 ®Department Sign-Offs . Health Department El Zoning Board(if required) Historic District ® Site Plan review(if required) El Fire Department ; . 3El Conservation For commercial__W,041 please take your playas dlrecdly to the fire are depaar tment f oa°`aapprovaL y Section 13 ®Owner's Authorization � r►il, , as ®caner of the subject property hereby authorize to act on my,behalf, in all matters relative to work autho 'zed this buildin permit application for: (Address of job) Signature t date Print Nameto R . R N !! e # R j y Last updated: 11/15/2018 f f TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application Health Division Date Issued 0 f Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Str et Address,.ALA P ryino6 Village Owner c� Address lqsno ffexfs CLZ mil Telephone 0 s Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 Kings Highway: ❑Yes:-:❑ No Basement Type: �ull ❑ Crawl ❑Walkout ❑ Other r 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 XNo If yes, site plan review# Current Use Proposed Use V\Y-\g4 _ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name {� Telephone Number Address 1�lU Grrw le License # ' � 1 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� /�- �� DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. f r ADDRESS VILLAGE OWNER t, i• _ _ DATE OF INSPECTION: s� FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL 4 PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 2 •. DATE CLOSED OUT ASSOCIATION PLAN NO. h Office of Consumer Affairs and Business Regulation .�% 10 Park Plaza - Suite 5170 Boston, Massach4setts 02116 Home Improvement Contractor Registration Registration: 180747 % - Type: Corporation Expiration: 12/29/2016 Tr# 261507 INSULATE 2 SAVE , INC. ROLAND LANGEVIN 410 GROVE ST - ...... FALLRIVER, MA 02720 a.. _ Update Address and return card.Mark reason for change. - Address " " Renewal E scA+ 0 zoM osm mployment ; Lost Card r-•.:F'�!/.i.iC/(.Y[/l.ir.'��i Office of Consumer Affairs&Business Regulation License or registration valid for individul use only IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ° . ' tegistration: 180747 Type:. Office of Consumer Affairs and Business Regulation Expiration: 12/29/2t)1,f Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 INSULATE 2 SAVE ROLAND LANGEVIN.: 410 GROVE ST y� FALLRIVER,MA 02720 Undersecretary - _....._..._._.__._.._.... , Not valid without signature Massachusetts Department of p ® ubiic Safety Board of Building Regulations and Standards License: C8.103861 Construction Supervisor ROLANO LANGEVIN 56 HIGHCREST ROAG FALL RIVER MA 027 s s5 Ccmmissloner cXpiration: 08/24/2017 afo� CERTIFICATE�,...�: RTIFICATE OF- LIABILITY INSURANCE °� ( °°^^�) i TNT Cat11FICATE M 18S1lED AS A MATTER OF FORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIRCATE HOLDER;/9 4 CBwiFICJ17E DOBB NOT A 1ATlVELY OR NEGATIVELY AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE BELOW.: THS CMF'0AT: OF M XtAI DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSU REl�BENTA11VE OR PROOt ER AND 7K CERTIFICATE HOLDER. RER(S), AUTHORIZE P013C1t 5 D ofth ADD the policyl—I must De endorsed. If S the UI and eendffma of the pohcI4 eartabl policies ma A O IS W subjeot to cmdkII h0it�in F*u of Such w dW*@Wn y require an endorsement. A sta/iemerR on this certificate does not tooter rigflts:to the PROGUM �' CONTA T j Anthcaar F. COrd6ir0 Insurance NAME:_ __ PHONE - 171 Plimsant Street (508) 677-0407 �X N (5 88) 677.-0609 Fall River, MA 02721 ADDEss: hsouza@co rdeiroinsurance.tom --- INS UPBRIS)A>=FORDING COyemm -- NAIC x S� INsuRERa:_ berty Mutual Insurance -- -�— Insulate 2 Save, Inc. INSURER 6: -- - -- 410 Grove St. INSURER C: Fall Rivet, MA 02720 INsuRERo:- - - I NSURER E: S INSURERF: COtTIFICATENUMBER: REVISION NUTABER: THIS IS tD CERTIFY THAT DIN POLICES OF INSURANCE LISTED BELOW HAVE BEEN iSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD CERT T®, NOTWITHSTANDING ANY REQUIREMENT TERN{OR CONDtT!ON OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTlcIMTE.MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESORIBED HEREIN IS SUBJECT 'fG ALL WHICH icRHIS i E)II",ANDCONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. THE TtrPEOFM1fYRAIICE I ...PouCINUMBER -. ..,N .M/ )Y - i P _ -. A I LIABdtiY Y + Y IBKS 56418741 uMr>S j� 2/10/14i 12/10/15� EACH OCCURRENCE 5' 1,000 OOO PLO ;C�/NERCINL GENERAL LIABILITY{��^ )_ i s 30 000 cwrlsawnoE X occuR neo E�(A 0_pwsa�) S_y 5,000 PERSONAL&ADV INJURY S 1.0o).000 I GENERAL AGGREGATE_i S 2.QO'J.000 ..j 0@ LI�OGREGATE LFiT/WP S•PER. PRODUCTS-oow1oP AGG i S 2,0 O OO.Q II 1 ICY , LOC . i Ig A auToi�oaaELla i !BAA 56418741 12/10/141 12/10/15; a R g ANY AUTO ;BODILY INJURY(Per.pemarq S ZLOWNED sc►I�uuaD X TOS AUTO$ i BODILY NYIURY(Per accdwn)1 S X H11ftEDAUTOS X EOM SWNED GE g- tPer aaridnkt A UPBRILLA UAs II occUR Y i Y iUSO 56418741 12/10/14' EACH OCCURRENCE _S 2,OQ0,000 F]OC86S LFAB i CLANA644 0E i - AGGREGATE 5 YO,000 IRE IRAN$ -- -� A AND �TM YIN ITS 56418741 12/10/14 12/10/15 X woc ,_ --- )®GSLRYMLDED?IEXECUTW 1 N!A' El EICH ACODENi.._---. 000 1 in . :-E.L O44EASE-EA ENPLO_v TEE S 500.006 Rh k NV RATIONS bela- .0ISeA9E-PQWCYLII 5-SOD,000 i CIE SCRWfIQIIOFOPfiRATION51LOC1710NSIVBNC.IS (Attaeh ACORD 101,Ad *onaFR.rmrkssch-We,if sFacL.bragdred) Proof of Insurance. I I I TE MOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEPORIE I . THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. i A/ AUTHORIZED RE PAES1lJTAT1VE�/�' '1 ©19w.2o10'ACORD CORPORATION- All rightoreserved. ACORD,2S(2010/05) The ACORD name and logo are registered marks of ACORD PhnnP Fax: E-Maim a.. ro Federal10#05.0405629. RISE Engineering RI Contractor Registration No 8186 MA Contractor Registration No 120979 A division or Thielseh Engineering CT Contractor Registration No.620120 III ont Avenue,South Yarmouth,NIA 11_(if1-1 CONTRACT SO8.5G8-192h X-661t1 FAN'5118. 68-1933 Page 1 R I S E 7 Hi;i CONTRACT IS ENTERED INTO BETWEEN RISC CT C-Rcs ENGINEERING AND THE.CUSTOMER FOR WORK AS ENGINEERING DESCRIBED BELOW CUSTOMER .. PHONE - 1)ATF. CLIENI s NonK ORDE'n Moll A (ircell (50R)775"0`iti 3 0�12 711015 19S'8 37 000W :,Ei{VICE;;tnf:Et BILLING STREET I'll)Canners Ro;ld P.0,13v.e 321 SERVICE C4lY.61ATE.71P •aILLING CITY,STATE,71P ("cnicrvillr.'NI)V02632 Cenicrville MA02(,32 JOB UESC;TtIP'i ON All,SI'-AI.IN(i:i`rovidc labor and materials(i,seal areas of yunr holnc lleainst,+asti:hll,excess;tir Icakape. This work Will be I)dr1af111dU III CfRieeI1 with the USC Ali SpUcltd tools and diagnostic tests to assure that your bole will he left Willi PI hceillnul level of " air e\chanCe;Ind indoor air quality.Materials to be Used it)scif your home can include caulks,foair)S.Wc-11111C1,16P1110p:unl Other prT•ilucls. Prijria ;Ircas for sE:ahinE include air leakage wallies.basements,attached garm.LsCoin OtlICY uD11CM12d are;;::to indatvs are not ite-ncralh•addressed.) (8)working houra. A rciluction in cobit feet per nlintile(C1'111)of air iuliltranon will occur-but dH::wtual number of cflu 6 not guaranteed. :S616.00 CRAWISPACI":Provide labor and InIncrials to install(120S)squnru test of 6 nil pulvelhvicni!over oPen grO n d in d"iLlmw'll ratwlspace/eardicn lmsenienl ami:s. iNCic:VTIVE:RISE Eingincering will apply all applicable,eligible inr:cntivis lii this ennlrtcl, Yoll will he hilicd only the Net amount. CUn'ently.for eligible measures,the Cape Li'ht Compel offers 73rif incentive,lint to exceed 50 )tier Calendar year,and an inc,illiec of iI')0' 6ir the Air Scaling.Incasun:.N. - Flit dic safety and he:llth of Your home's indoor air quality,we will he conducting aI blower door diaignomic of the:naiiad,ic air flow in your hank i,iRh licibie the.work is begun.aad dl9 after the wcarizillivn work is complete.We wJll also conduct a full:ISCc mail rig. the cnmbuainn sakav of your heading systnn and water hcaer.'1 his h;ls t1 value of$90 imd is at no c"st nl voli. S90,00 Total: $1,636.16 Program Incentive: $1,636.16 Customer Total: $0.00 WE AGREE HEREBY TO FURNISH SERVICES-COMPLETE IN ACCORDANCE WITH ABOVE SPECIFICATIONS.FOR THE SUM OF "'00'/Dollars $0.00 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING•CUS1O6lER AGREES TO REMn AtAOUN t DUE IN FULL..INTEIKSi OF I%WILL BE CHAHGEU MONTHLY ON ANY UNPAID 13ALANCE 'R JO DAYS.SEE nE SE FOR WPORTAAT IRFORMATtON Or,DUAR&/ EES.RIGHTS OF RECISION.SCHEODUt$G,AND CONTnACTOn nEG{STnA-r10N. "_*�q T SIGN THIS CONTRACT IF THERE ARE A 11 LANK SPACES rN RI SIGNATURUR CUSTOM A CEP NLL•II O '1zNOTE:IN S CONTRACT TED Wn"/tali OATF.OF AC:CEPA. CE ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE.HEREBY ACCEPTED.YOU ARE AUTNOniZEO TO DO THE WORK DAYS- AS SPECIFIED,PAYMENT WILL BE MADE AS OUTLINED ABOVE Town. Of Barmastable "` .^ �2iichar�'V''.Sc3[iAikeclog. . -Di'vislon Toni.Yerr9, nijdfn .Camirndssioner 200 mhi n Street;Hyannis;Ai}1.026171 es`�Yiv'towxtiariu�icat�ia.gs Fax_ 508-79�1-62 :} 548=8524038 Owner Must p e g a$at Sx This Section B Us, C%M--:r'ofthe.: bjecGProperly rnybp. - . aj1 ers.2e�atze-to tvorn:ath�zrc%by ems:btilclin�,permit application f or. 06SA y o ire: cani.. .oc s izu�ctioz�s��xe:.pea��rri�c�.a,:rtcl'aG�:ep�ed. S' om Mcr :Si at re o :AppL 't Pint Na,aie Daze QiFORNtS:Uw�v'�}LP3�4ISS1'b'N�AOi:�' The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia . NYorkers'Compensation Insurance Affidavit:Builders/Contmcters/Ekctricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. A-mbcaut.Information Pkl Print 1 , Name(Business/Organization/Individual):Insulate 2 Save, Inc Address:410 Grove Street City/State/Zip:Fall River,MA 02720 Phone#:508-567-6706 Are you an employer?Cbeek the appropriate box: Type Of project(required): LQ I am a employer with 20 employees(full and/or part-time).* 7. New construction 2.E]1 am a sole proprietor or partnership and have no employees working'for me in $. Remodeling any capacity.(No workers'comp.insurance required.) 3.01 am a homeowner do all work myself 9. ❑Demolition mg y [No workers'comp.insurance required.]t 4.n I am a homeowner and will be hiring contractors to conduct all work on my 10 0 Building addition property. twill eamure that all contractors either have workers'compensation insurance or are sole I I.Q Electrical repairs or additions proprietors with no employees. 12.0 Plumbing repairs or additions 5,❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.t 13-Roof repairs 6.❑ 14. Qth�,� Insulation We are a corporation and its officers have exercised their right of exemption per MGL a er 152,§1(4),and we have no employees.1No'workers'comp.insurance required.] 'Arty applicant that checks box#1 must also fill out the section below showing their.workers'compensation policy,information. t Homeowners who submit this affidavit indicating they are doing all 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 providp their workers'comp.policy number.., I am an employer that is provf ng workers'compensation insurance for my enrtrloyees. Below is the policy and job site ieirntadx Insurance Company Name:Liberty Mutual Insurance 'Policy#or Self-ins,Lic.#:XWS 56418741 •' Expiration Date..12110_115 'Job Site Address: City/StatelZip: n r'V I Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration�date). V V lY Failure to secure coverage as required under MGL c..152,§25A is a criminal violation punishable by a fine up to$1,500.00 :and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a ;day against the violator.A copy ofthis statement may be forwarded to the Office of Investigations of the DIA,for insurance :coverage verification. I do hereby certify under the pains and penahki of penury that the information provided above u* &me�and correct Si e: Date: 'Phone#:508-567-6706 Ofildal use only. Do not write in Asir area,to be completed by city or town official City or Town: - Permit/Liceuse# Issuing Authority(circle one s I.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 'Z- I Parcel 0�`'� ''; Application # , Health Division Date Issued v Conservation Division Application Fee Planning Dept. Permit Fee �C7 Date Definitive Plan Approved by Planning Board f Historic - OKH Preservation/ Hyannis S Project Street Address `�� ���►� S �� Village C-e*.%vz_uv i It-2 Owner S�M � ktAM Address Qo' S Oki MN ti It�,r �, _ F64 Telephone Permit Request Square feet: 1 st floor: existing 1040 proposed 1'rA 2nd floor: existingoi proposed �.p p N��6tal new ca . Zoning District fk Flood Plain Groundwater Overlaycy Project Valuatio �v Construction Type zA Lot Size 3l Grandfathered: 0 Yes WNo If yes, attaIsupting qQpur>Wntation. r Dwelling Type: Single Family Qr- Two Family ❑ Multi-Family(# units) Age of Existing Structure Historic House: ❑Yes U-Md On Old King's Highway: ❑Yes Flo Basement Type:' ❑ Full �Tawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) N-0 N A Basement Unfinished Area(sq.ft) "am A Number of Baths: Full: existing new N Half: existing (4 new 141 A Number of Bedrooms: `;k— existing ,l new i`lcsa ► Total Room Count (not including baths): existing _5 new %6N4 First Floor Room Count Heat Type and Fuel: 016as ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes UNtlo Fireplaces: Existing New Existing wood/coal stove: ❑Yes rA-M Detached garage: ❑existing ❑ new size -❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: ❑ existing ❑ new sizw?W. ❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use - '- - ` ' _ T Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number I CXJ Address f 6W 14'1t1N Ni-s (1A License# b 15 Home Improvement Contractor# 1. 0-0 G G cl Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l Ck 1. 193 Ad vA,-2-LJ SIGNATURE DATE FOR OFFICIAL USE ONLY PPLICATION# IJAT51ISSUED • , 'MAP1/PARCEL NO. - ADDRESS VILLAGEf E OWNER z , F DATE OF INSPECTION: .� FOUNDATION /oil /orit FRAME AFNI" 6��o�oy INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING RF1A10;) �O�-'�w9 e1UC1= r . DATE CLOSED OUT ASSOCIATION PLAN'NO:- ,Department of Lndustrial flccidents Office of Xnvestigation9 600 Washington Street Boston, ALL 02111 www.mass.gov/dia Workers' Compc xmation insurance Affidavit: Builders/Contractors(EIectri"ans/P.lu.mbers ;lIcanLt Informatioxl Please Print LeNe (Business/Organi_z bnflnc; dual): Address: A1V 1�4k S �� City/State/Zip: Qj �1RNS APhone.#: you an employer? Cheek the appropriate box: Type of pz'oject(required): ,A-re 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I 6 ❑Hew construction employees (full and/or part-tame).* havc hired the�nb-contractors listed on the attached shcpt 7. ❑ Remodeling 2_P111-am a'sole proprietor or partner- These sub contractors havc ' ship and bavc:pn employees 8. [] Demolition . employees and have workM' Buildin addition working for Mn in'MY capacity. t 9• ❑ , o workers' ins,urancc CDmP insurance. [N crnnp•'— 10.❑Elcctricalrcpairs or additions VT r�uir�] 5 ❑ c are a corporation and its 3.❑ I am a homeowner doing all work offirc'rs havc exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12 ❑Roof repairs t c. 152, §1(4), and vie havc no incnranc-rcqu rcd.] .13.❑ OthcT C r, PA.G . employees. [No workers' comp.insurance required.] *Auy applicant that chcclx box#1 must also 90 out the sccbon below sbowing their work=-s'coropcn .mI policy inforn-mtioa- t l-lomcowncri who submit this ef5davit indicating tbcy art doing 0 work and then h rL outside contrnetnrs must eubrnit anew affidavit indicating such. #Contractors that ebeckthis box must ittachcd an additional sbect tbowi g the name of the 5ub-cmtraclur3 and ttaln wbctha arnot those mtitits have ccnp}oyecs. Tf the sub eantraetorc havc a�loycts,they must provi df their workers'comp.policy:timber. I am an employer that is providing workers' compensation Insurance for my employees. Below is the policy and job site infbrrriativn Iosltranc6 Company Name: Policy#or Sclf--ins. Lic. #: Expiration Date: Job Sitc Address: City/StatcIzip: Attach a copy of the workers' compensaidon policy declaration page(showing the policy number and expLratiou dat.e). Failure to s=rc covcragc as required under Section 25A of MGL c. 152 can lead t�the imposition of r rimiral penalties of a Eno up to 51,500.00 and/or one-year impnsonmtut, as well as evil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Bc advised that a copy-of this statement may bo forwarded to the Office of Investigations of the AIA. for innaancc coves c verification. I do hereby certify under the,pains•and.penaLa.es of perjury that the irnformadon provided a-iove is true andcorrect Si e=fuz : _�� Date: Offze�use only. Do not write in this area, tb be completed by city or town officlaL City or Town:.,Permit/License# Issuing Authority(circle one); 1. Board of Health 2.Tiiulding L�epartratnt 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6, Other Contact Person: •Phone#: Massachusetts General Laws cbaptcr 152 requires all employers to provide workers' compensation for their crmployccs: ' Pursuant to this statate, an employee is defined as ":_.every person in the service of another under any contract of hire, express or implied, oral or written." t An employer is defined as "an u?dividual,partnership, association corporation or other legal entity, or any two or'mcrre of the forcgoing_cagagcd in a joint enterprise, and including the legal representatives of a dcccascd cmploycr, ar the receiver or trusfec of aniudividual,partnership, association or other legal entity, employing employees. However the owner of a dwcIling horse having not more than three apartments and who resides therein, or the occupant of the iwclling house of another who employs persons to do maintenallcL, construction or repair work on such dwclling housc. )r on tic grounds or building appurtenant thereto shall not because of such cmploymcat be d=rocd to be an employer." viGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or -enewal 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," �dditional[y,MGL ohapter 152, §25C(� states `Neither the commonwealth nor any of its polipcal subdivisions shall rater into any eoniZact for.rhe periormanco of public work until acceptable evidence of compliznee with.the ins uzance equircracnts of this chapter have bccn presented to the contracting authority. ,pplicarits lease fill out the workers' compensation afFidavit completely, by checking the boxes that apply to.your situation and, ii` ecessa y, supply slab eonhaLtor(s)name(s), address(es) and phone numbers) along with their ccrtificate(s)of isurancc. Limitr-d Liability Convanics CLLC) or Li_mitcd Liability Partnerships (LLP)with no�craPloyccs other than the wcmbers or partners, arc not required to carry workers' compensationc� 7nrr-ancc. If an 7I C Or l.i i dOCs 11aYC nployecs, a policy is required. $c advised that this affidavit may be submitted to the Dcpartmcat of Industrial ceidcnts for confirmation of insurance coverage. Also b. sure to sign and date the affidavit. The affdaYit should returned to the city or town that the application for the pc�it or license is being zcqucstcd, not the Department of . tdustrial Aecidenls. Should you have any questions regarding tbb law or if you arc required to obtain a workers' ,zopensaEon policy,please call the Department at the nurgber listed below. Self-insured companies should cntcz thciz :if inccrranGO liccnsc number on the appropriate line. ity or Tow-P Offiicisls cast be sure that the affidavit is complctc and printed Icgibly. The Department has provided a space at the bottom ,the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding tho applicant case be sure to fill in the permiVhccnse number which will be used as a reference number. In.addition, an applicant it must submit multiple permitlliccmc applica-tions in any given year, need only submit onp affidavit indicating cucrcnt 4 y inforzoation(if ncccssary) and under"Job Site Address" the applicant should write"all locations in (city or Nn),"A copy of the afFdavit that has bccn officially stamped or marked by the city or town may be provided to the plic ant as proof that a valid affidavit is on file for fiLtuc permits or licenses. A new affidavit,must be 511ed out each Ir.whcrc a home owner or citizen is obtaining a license or permit not related to any business or commercial venture a dog license ox peffiit to bum leaves etc.) said persou is NOT required to complete this affidavit e Office of fnvcstigations would hkc to thank you in advance for your cooperation and should you have any questions, asc do not hesitate to give us a call. Department's address, tcicphonc•and fax number: Thy Gammonw� th of Massachusetts Dq:�,rtment of ludustial AccIdeIlts Ofn" of Investigations fiQ4 Wasl�in�n Street Bos'tan, MA 02111 Tel. # 617-727-4c�0.0 ext 406 ar 1-8-77-MASSAFB Fax# 617-727-7749 11-22-M WWW.m aSS.gov/di a f ' °0-VEr ti Town of Barnstable Regulatory Services ! i gsaxxMasrEWUS � Thomas F. Geiler, Director rFo�.ta Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us _ Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, /ari /T (Tre�%r� , as Owner of the subject property hereby authorize !;kn% / to act on my behalf, in all.matters relative to work authorized by this building permit application for: (Address of job) V_3e) DF Signature of Owner Date - 42 A Pant Name „ If Property Owner is applying for permit please complete the. Homeowners License Exemption Form on.th:e reverse side. n Town of Barnstable Regulatory Services Thomas F.Geller, Director satuasrwnrt:, MASS. _ Building Division �PTfD �A Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 R'ww.town.b arnstabl e.ma.us Office: SOS 86 2-4038 Fax: 5.08-790-623.0 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER 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. AEFINTTION 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 "horneowner`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 buildin> 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. S.ignaturc of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,060 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.L I -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 Hith 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 hcAbc 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 amend and adopt such a form/ceRification for use in your community. •. � t ` .�� ✓lie �ariv�raaoaiueall/ a�✓T/`a,�%�tac�ucaell,`t . :t 6 b xt I Board of g,Regulati ns and St Buildinandards {� : Constructio"n. Sup ervi§or License ' I * I Cicenss''e, CS 5190 _ I. Expiration t: 3/21/2010 Tr# 2007.1 ., �� S{�2estrict n 90j j DAMES K SMITH r Pb BOX 124 BARNSTABLE,MA 02fi30'_.•- r C"oinmissioner 'I a p� ✓lie �anirrcaaxcuecz�Cli a��/�aaaaclucae�Ca \ Board of Building Regulations and Standards License of up.Aft!on vAlUfox�ndividul u§e only . HOME IMPROVEMENT CONTRACTOR before the exlxfaio3l& e wq ¢ t fo Board of 13.uildjiFse$ tj�g nAt1 ndafds Registration 100699 One Ashburton 19laee30T Expiration W3/2010 I •.�•.Tr# 268790 is Boston,Ma.02108 r" rETYpe Individual JAMESK.SMITH' James Smith �` F 1695 HYANNIS RD` /��t .�Q a..` (�rv�-�'• `J .. r \j— — BARNSTABLE,MA 02630 re Not valid,Wt# Administrator.' ffe1 "s u 5 t l ' �trINE rqy� Town of.Barnstable D S E p i md d � Conservation Commission D BARNSTABLE, 200 Main Street y MASS. BARNSTABLE CONSERVATION i639 Hyannis Massachusetts 02601 Office: 508-862-4093 FAX: 508-778-2412 Permit No. Statement of Applicant/Applicant's Agent upon Obtaining a Building Permit Application Signoff from the Barnstable Conservation Division I fully understand that although I have obtained a signoff on the Building Permit Application for my project,site work may not begin under the Order of Conditions until the following requirements(from Section II of the Order of Conditions)have been met: Not Met -Met 1. Within one month of receipt of this Order of Conditions and prior to the commencement of any work approved herein, General Condition number 8(recording requirement)on page 3 shall be complied with. ---Must be met prior to sign-off.. ❑ [� 2. It is the responsibility of the applicant,the owner and/or successor(s)and the project contractors to ensure that all conditions of this Order are complied with. The applicant shall provide copies of the Order of Conditions and approved plans(and any approved revisions thereof)to project contractors-prior to the start of work. Barnstable Conservation Commission_Forms A and B shall be completed and returned to the Commission prior to the start of work. k, e pt3. General Condition 9 on page 3 (sign requirement)shall be complied with. ❑ [ 4. The Conservation Commission shall receive written notice 1 week in advance of the start of work. �. The work limit line shown on the approved plan shall be staked in the field by the project surveyor/engineer. ❑ 96, �shall nched-m siltation�encing shall be set along the approved work limit line. Effective sediment cntil the site is stabilized with vegetation. ❑ 7. A sequence of color photographs showing the undisturbed buffer zone shall be submitted to the Conservation Commission. Note:the strawbales and siltation fence must show in the foreground(or bottom of the photographs. G Applicant or Applicant's Agent Signature Date I Company Name Phone# � a Y: PPframe q:forms:bldsignoff TOWN OFBARNSTABLE BUILDING PERMIT APPLICATION a r 00 � - Map Parcel- 0 i Application# o Health Division "'Date Issued Oc� Conservation Division .:Application Fe U Planning,Dept-.' 'Pe rmit Fee Date Definitive>Plan Approved by Planning Board F i Historic OKH Preservation / Hyannis Project Street Address 14:0 (e)N",RS Village C Wrp_(kV Owner AL�N d.-SN�R i G�2LI�t� Address ci9 CEN 11�7 N LAAE C'WPy;11e 03(.31. Telephone rll�S -09131 Permit Request OF W)bf_1L fSAi A+ 4 K i ire.H0hl R e --&o C4- to Square feet: 1 st floor: existing ICAO proposed IChOL 2nd floor: existing NIA proposed tJ A Total new N A Zoning District NSi,,A,,Wii PA` Flood Plain Groundwater Overlay Project ValuatiA U,000 Construction Type -RPI�E Lot Size s 400 AC8,R-. Grandfathered: ❑Yes ❑ No If`yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (#,units) Age of Existing Structure °1` y X Historic House: ❑Yes ®-ft On Old King's Highway: ❑Yes 91'o• Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Jz. .° Y4 Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing l new O Half: existing 0 new Number of Bedrooms: existing Qnew Total Room Count (not including baths): existing new 0 First Floor Room Count ._ Heat Type and Fuel: QGas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes 20I10 Fireplaces: Existing_I New 0 Existing wood/ al stoves ❑-Yes �o Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑e isting <0 ne\R size d _ -1� Attached garage: ❑ existing ❑ new. size _Shed: ❑ existing ❑ new size _ Other: ch _ Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ C Commercial ❑Yes ❑ No If yes, site plan review# Ln .Current-.Use. Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name J A1`4 as ,S'mt 7_1{ Telephone Number Sbi- ,Address r' ci S (�I`fAn►i�l'r P\8 License# e S 919 c) �l1RNSt �—� Home Improvement Contractor# �GF�Sv Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE-_ Cx. a DATE �a`t /(jI s _ FOR OFFICIAL USE ONLY it$ rt APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: I � i FOUNDATION f FRAME Y INSULATION t FIREPLACE :•;'' ELECTRICAL: ROUGH FINAL s PLUMBING: ROUGH FINAL ry; GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i I ,;; zh-e GorrcmortweriZth of.lV.tassdchiiseirs . ,Deprrrtrrterit of Irxdustri.aL,�ccidents Office of Investigations. 600 Washington Street Boston, MA 02.1II . ` � www.mass.gov/dice Workers' Compeowat�ion Insurance AfEdavit: Build ers/Contractors[Electricians/P.luzubers A_� Beam Information please Print LaE bly �allle (Business/OrganizaiionlLndividuaI): �A r'1t=S c�� i�t'4' • — Address: (� t�1 S Ara you an employar7 Check the appropriate boz: Type of project(required): 1.❑ I am a employer with 4. ❑ l am a general contractor and l 6, ❑Kew construction em loyces (full and/or part-time).* have hired the shb-contractors ) � ,� listed on the attached sheet 7. remodeling K ► -F N 2_ILA�a sole proprietor or partner- Thcse sub-contractors have 8. [❑ Dcmoliti,on, ship and have no employees t employees and have workers' working for me in aay capacity. 9. ❑ Building addition • . [No workc"' c mp.•inmuaneG comp-insuramc. . 5. [� We arc a corporation and its 10.❑ Electrical repairs or additions rmr�] officers bave exercised their 1L❑Plumbing repairs or additions. 3.❑ I am a homcownnx doing all work myself[No workers' comp_ right of exemption per MGL 12 ❑Roof 1epai,-s incnranrc required_] t P. 152, §1(4), and we bayt no eroployces. [No workers' 13.❑ Other comp.insurance required.] *Iwy zpplieant that cheela box#1 roust also fjU out the section below abovring thcu workcza'cDnTc;salon Policy infotrrmtaon- t I-lomeovmere who eubrmt ilia affidavit indicating they arc doing all work and then I iM outside contractors must submit a new affidavit indicat>ng wueh. XContzactors ibat check this box must atSaebcd an additional ebect showing the name of the sub-czmh ctrna and staff vrhether or not thosti rntities have tanploycrs. If the sub-contractors have rmploy=s,they must provi6b tbeir workers'comp,policy n=ber. fain an employer that is prcvidirig workers'camprnsatwn insurance for my employees. RU1UYv rs rftepoUcy and jab site ' inform-atinrt . lnsurancc Company Name: Policy#or Sclf--ins. Lic. #: Expiration D atc: Job Site Address: City/Statr./Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration da-te). Failure to secure eovcrage as rcT ircd under 5c e imposition of crm ctiou 25A of MGL G. 152 can lead to thiinal penalties of a 5nz tip to $1,500,00 and/or one-year imprisonment, as well as czs2l Penalties in the.form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advisod that a copy-of this statcmcrit may be forwarded to the Office of JUVCSti ations of the DTA for insurance coves c verification. Ida hereby certify under lhepains-and penaLdis of perjury th.af the inform.adon provided above Es tYue and correct Si attire: DatL: — Phone Offuinl use only. Do not write to this area, to be eompLete-d by city or town officia.L City or Town: Permit/Liceasa# Issuing Authority (circle one): I. Board of Health 2.Buildi.ng.Departmeut 3. CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees: pul-guant to this statute, an employee is dcfmrd as "._.every person in the service of another under any contract of hire, express or implicd, oral or written_" An emp[nyer is defined,as "an ipdividual, 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 ccccivet or trustee of an individual,partnership, association or other legal entity, employing employees. Howevcr the Dwner of a dwelling hour e having not more than thrcc apartments and who resides thcrcia, or the occupant of the iwelling house of mofl=who employs persons to do maintenance, construction or repair work an such dwelling house �z on the grounds or building appurtcnant_thcrcto shall not because of such employment be deemed to be an employer." viGL chapter 152, §25Q6) also states that"every state or IDcaI licensing agency shaII withhold the issuance or ,eaewal of a license or permit to operate a business or to construct buildings in the'cornrnonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." �dditionaIly,MGL ohaptcr 152, §25C() states `Neither the commonwealth nor any of its political subdivisions shall e ormaacc of public work until accc table cvidcacc of compliance R ith the in.�nce • to an contract for nc�p rz p P :rater into y equirements of this chapter have been presented to the contracting authority.' ,pplicants lease fill out the workers' compensation affidavit completely, by checking the boxes that apply to Your situation and if ccessary,supply vib-crontractor(s)wme(s), address(es) and phone numbers) along with their ccrtificatc(s)of Mjrancc. Limited Liability Companies(LLC) or Limited Liability Partnmships (LLP)with no-cmployccs other than the ,embers or partncz-s, arc not rcquircd to carry workcn' compensation in n ance. If an LLC or LLP d ocs have nployees, a policy is required. Be advised that this affidavit may be submitted to the Dcpartmcat of Industrial ccidcats for confirmation of.insurancc coverage. Also be sure to sign and date the affidavit. 'Ihe affidavit should returned to the city or town that the application for the pr ait or liccnsc is being rcqucstrA not tho Dcparbnent of idustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' )mpcnsation policy,plcasc call the Department at the number listed below. Self-insured companies should cntsr their If-insurmw liccnsc number on the appropriate line. ity or Tow-P Officials case be sure that tho affidavit is complete and printed legibly. The Dcpartm.cnt has provided a space at the bottom the affidavit for you to fill out in the cvcnt the Office of Investigations has to contact you regarding the applicant case be sure to 511 in the permit/licensc number which will be used as a reference IL cr. In addition, an applicant it must submit multiple permit/liccnsc applications in any given year, nccd only submit onp affidavit indicating cmcnt I cy information(ifnccessary) and under"Job Site Address" the applicant should write"all locations in (city or wri),"A copy of the a$davit that has bccn officially stamped or marked by the city or town may be provided to the plicant as proof that a valid affidavit is on file for fixture permits or liccuses. A new affidavit,must be filled out each ar.Whero a bDme owner or citizen is obtminin a license or permjt not related 6 any business or cormncrcial venture s etc.) said persou is NOT required to complctc this affidavit a dog license or pemoit to burn leave e Office of Investigations would hkc to thank you in advance for your cooperation and should you have any questions, aso do not hcsitata to give us a call Department's address, telcphonc•and fax number. Tha Commonwealth of Ma_sacbuse-t.t Dq),u e_nt of ladustdal Ac-cidonts Gffce of Investigations GGG,Washington st =:t Boston, MA 02111 TO. # 617-727-490_0 ext 4.06 or 1-M-MASSAFB Fax# 617-727-7749, i 11-22-06 wwt�.mass.gov/dia �oF Vie r � Town of B arrnstable ` Regulatory Services y Mass �+ Thomas F. Geiler,Director. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable_ma.us Office: 508-862 4038 Fax: 508-790-6230 Property Owner Must Complete and Sign 'Phis Section ff Using A Builder yY 3.as Owner of the'subject property hereby.aufhorize �/Y S S'iY)/ TJf to act on ray behalf in al,rnatters relative to work authorized,by this building perrnit application fox `{ 14 (Address of Job) Signatute of Owner Date l n 14 , 6:1-r e--K ' Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form'on the reverse side. Town of BarnstablefHE - , Regulatory Services Thomas F. Geiler,Director BARltSTABt.>•±. • MASS- Building Division Y� 1659- ♦�� • 'TEa µAtn Tom Perry,Building Connnlissioner 200 Main Street, Hyannis,MA 02601 Y"nY.town.b arnsta b l e.tna.us 508-862 4038 Fax: 508'790-6230 HoNfEOwNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: villa c number Street g "HOMEOWNER": name home phone# work phone# '• i CURRENT MAILING ADDRESS- city/town state ap 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. nEMrrloN oF 1aoMEo)VNaJR , 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 espons-big for all such work performed under the building permit. (SectionF 109.1.1) [be undersigned"homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. er"certifies thathe/she understands the Town of Barnstable Building Department .-be,undersigned "homeown ❑inimu inspection procedures and requirements and that he/she will comply with said procedures and m equirements. ignaturn of Homeowner oproyal of Building Official Note: •Thxee-family dwellings containing 35,000 cubic feet or IaYger will be required to comply with the ate Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowner perfomung work for which a building permit is Tcquir-d shall be exempt from the provisions this section (Section 1 o9.1. -Cle 1 ansing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such rk,that such Hom vi Homeowner shall act as supersor:" Many homeowners who use this exemption arc unaware that they arc assuming the responstbilitics of a super visor(see Appendix Q, lcs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awarcncss often results in srsious problems,particularly cn the homeowner hires unlicensed persons. In this ease,our Board cannot proceed against the unlicensed person as it would with a licensed )crvisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is:Cully aware of his/her responsibilities,many communities require,as part of the parrrit application, the homeowner certify that hdshc understands the responstbilitics of a Supervisor. On the last page of this issue is a form currently used by :raj towns. you may care t amend and adopt such a fomr/ccrtification for use in your community. ' 1 J 1 R f • T ;�w. ,}� � ., .. � �,, `. #.:• a i, ��l3fs? C�OlId!!G<JI7II.zC,CY.Lt✓t (� �.'I7,ll:kltf'f2ldzFr?�c- '<_o� r.• Board of Building Regulatidns and Standards Construction"Supervisor License + :.. ^it'd•' t^x. ' .a :. +. - - ... ' : �' .'4 4.: .. - �' .. a r 0 License: C$ 519 Expiration:' T i i •A Restriction'.. 00 E 2010 - JAMES K SMITH''. 24 PO BOX 1 BARNSTABLE,MA 02630 Commissioner e + . z i • Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR, before the expiration date. If found return to: Board of Building Regulations and Standards Registration:. 100699 One Ashburton Place Rm 1301 Expiration;=',6123/2010 Tr# 268790 Boston,Ma.02108 Type;:'IrldiVidual JAMES K.SMITH AA A James Smith5t„ ✓ J ��"^ — 1695 HYANNIS RD "1``:.;,:F �"°""' T Not valid without signature BARNSTABLE,MA 02630 Administrator 1 S -d i - -i PROPOSE 3D NEW STAIRS y. AND PLATFORMS- -;- DESIGNED WITHOUT --SURVEY-INFORMATION _.._. 1 f -- � T - ITT, W0170BED HER DECK 4 it f nk" oiEH Foots 1 u 8 � I �� Tw 1a46 1 a•-0' \ LION&N,:2EAat i li v /iyj° oF1l r Town of Barnstable *Permit 04�� { IT Expires 6 months from issue date X-PR Regulatory Services Fe < . � Thomas F.Geiler, Director Building Division rFb � `` 0STABLE Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis, MA 02601 www.tow.n.barnstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not {valid without Red X-Press Imprint Map/parcel Number �Jr t ( Lk Property Address 11-1.0 6dn1NOP,S P, K tF_v s I(-Q residential Value of Work -f a,,oaa Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address Ldltt4 I. $ e.rkk. Contractor's Name Telephone Number w 9 G'il�-1 acr y Home Improvement Contractor License# (if applicable) [CC) 10 y. 1 Rom- ���� � ❑Workman's Compensation.Insurance Chec e: 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 be on file. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to C141 I �a� cq_I-Fie ktt h,.,f Wit` ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side , ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) *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 is required. SIGNATURE: [/L Q:\WPFILESTORMMuilding permit forms\EXPRESS.doc zzA .1'n,)nino 1 The Commonwealth of Massachusetts Department of Industrial Accidents /71 Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation%surance Affidavit: Builders/Contractors/Electricians/Plumberg A Ucant fnfOrMation Please Print Letsib� Narac(Business/Otganizationflndividual): &M ITM • Address: l� N N.i S �� City/State/Zip: rA Phone.#: �JO� <9t1�� Are you an employer? Check the appropriate bar: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I 6. ❑New construction have hired the s'ob-contractors loyees(full and/or port-time).* 4J l M ; � � Listed on the attached sheet 7. ❑Remodeling 2.l a-sole proprietor or partner- ship and have no employees These sub-contractors have g. Demolition employees and have workers' working for mein any capacity. $ 9. ❑Building addition . [No workers' c ymp.-ins ranr_e C°� tnersrance' ME]-Electrical reP airs or additions rbq iirNIj 5. [] We arc a corporation and its have exercised their 11.❑Plumbing repairs or addition 3.❑ 1 am a hommwncr doing all work officerss myself [No workers' comp. right of exemption per MGL 12 'i f repairs insurance r c. 152, §1(4), and we have no t croployees:,[No workers' 13.[]•Other cow,insurance required] "Any applicant that cheeks box#1 must also fin out the suction below&bowing their wmi=s'cmnpmisafion poficy informatiOn- t Hm=wnczs who submit this affidavit indi�ng they uc doing all work and then hirz outside contractors must submit anew affirS t indicating such t-_Mtracfors drat check this box n%mt atfached an additional sheet showing the name of the sub-ranfracton and start whether or not thost entitle have myloye s. If the sub-conhactms have employees,they must providt tbcir woYk=-S,cmnp.policy mmnbcr. lam an employer that isprovWing workers'cornperrsation insurance for my employees Below is the policy and jab site information. Insurance Company N;,Tnm_ Policy#or Self-ins.Lie.#: Expiration Date: roll Sitc Address: Cityistatc/zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requited under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fins iip to$1,500.00 and/or one-year imprisonment;as well as civil penaltin in the form of a STOP WORK ORDER and a fo of up to$250.00 a day against the violator. Be advised that a copy of this statcracrit may be forwarded to the Office of. InycstigiLtions of the bIA for isurance cov e VCliftcation.. I do hereby certify under the pains•and penalties cf perjury that the information provided above is true and correct Datn: Si c: — Phone# O j7c&l use only. Do not write in this area, tb be completed by city or town offtciaL City or Town: PermitUcense# j IsoringAuthority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other (-nnfn t FPr cnrf- Phone#• °FTHEt, Towri of Barnstable Regulatory Services RARMAS&NSTABLE. Thomas F. Geiler,Director 163 9,. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section if Using .A Builder I, (ah.';4i,t GrQLQQ6, , as Owner of the subject property hereby authorize 1A M=S sNJ i'TI to act on my behalf, in all.matters relative to work authorized by this building permit application for: [4d C0t.1r►ux3 R l C lC . (Address of rob) Signature of Owner Date not Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. � t Town. of Barnstable �of 1HE tp�� y�, o Regulatory Services • .. Thomas F.Geiler,Director snsrtsrwsr�e. MASS i639. Building Division Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 R ww.town.barnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB•LOCATION: number street village "HOMEOWNER": 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 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) ility for compliance with the State Building Code and other The undersigned"homeowner'assumes responsib 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. 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 perfomung work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1,I-Licensing of construction Supe rvisors);provided that if the homeowner engages a pIarson(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 heishe 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 amend and adopt such a form/certification for use in your community. t s ' G7 �' License or registration valid for individul use only Board of Building Regulations and Standards before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration: 100699 One Ashburton Place Rm 1301 Expiration:=_6/23/2010 Tr# 268790 Boston,Ma.02108 lug Type Individual JAMES K.SMITH t i James mithS , .� _ 1695 HYANNIS RD `...;. Not valid without signature BARNSTABLE,MA 02630 Administrator ,I w f i T ti 3d1 � ,rem..sa 2Y-0` I ,p'CMCONG.tOxORK I I I I I .. Ml�l .00f���MRh PROPOSED NEW DECK - e ------pW------ --J2+2- -- I DlkW \ GREAT ROOM B C7 - ------------------------------ FRAMING/50NO TUBE LAYOUT DETAIL =4 SCALE: 1/4 = V-0" 17-0" .. P.T.2X12 LEDGER BOLT THRU TO BAND JST.®16° . RAILING SYSTEM MIN.66' O.C.WISPACERS-2X10 JST HT.ABOVE FIN.DECK HN6R®16"D.C.(FILLALL FLOOR PLAN SCALE: 1/4" = 1'-0" NAIL HOLES) - - - � 1)%MAH.DECKING NOTE:TOP OF BALCONYBE - O EQUAL TER DEMINE IN THE Flew R- SPACED MIN.B' P.T.2X10®16'O.O. - - (2)P.T.2X12 BOLT OLID BLK® - - THRU MIN.PT 4X6 POSTS - - - - NOTE:C B IN6 V RT IMP.114 CLIPS 'R \. - - POSTS Rea..OVER V WT. IV oc, . MIN.4X6 PT POS :TOP OF BONG TO BE PB44 OR LIKE RMINED IN E FIELD - - � v - - 10'DV.rC.ONC.BONG TUBE . M16 FOOT FTC.9YSTEM - MIN.46'BELOW 6R - .p MIN.'B16 FOOT'DIA 21' - - . REVISEPLAUC7UST 25, 2008 SECTION AA DECK DETAIL N`.T.S. .. Dom ® MR ANG MR6.NANA 6RmN FLAN5NOTE:The pun-.hnw Of Iheae plerm Is responaMe for conwHowe uft a8 5TATE Bid LOCAL Buh*V codes and and rmnces" ��,J ALLEN B.Os6OOD c.P.B D ►acma VAM a18rANRc�eL'o1� N NeWw ALLEN B.OS6WO Or be hdd RESIDENTIAL DE616NER. JUNE2008 p�dP�Y De��� for lha use of these. 0i I dra t4nps dud"consh odion. The purchaser Is maponalft to ve ft gill Olement8 of these plans for dcgig I, auutacy and shies,u i@I tlmlr bundm piWr to dart of Corabuctlon.NOTE PLANS ARE PROTECTED BY COPYRIGHT C 2WO f xQ om �u E i W � ----------- ---=-------------------- ® ® ® ® - - - - --- --- --------- la -711 PROPOSED FRONT ELEVATION . 66 6 - - waTa Roar raEnmvs _ 3'-9"' 2'-3' 2'-3• 9-103/4' f17'-101/4' 3-6' 2-62-63'-6' 3-6 3'-6' EM r. I EXPANDED K ASTER SUITE t 1a vmmu wrz>t maven mNro cans r —————————————— . Q 6 U _I I PROPOSED RIGHT ELEVATION __. - - O LLLJ na.i-o Q 0 co '4 ¢ I r r -------------- z RELOCATED IUTCHEN I II I I Lu ui N M 0 e w I ❑ IF- ch _——__ E—_ 36.. _-------------- tE oc vaxT[o c[oirc----- 1 [ME FEE711 WING ROOM TO REMAN 2668 2468 NEW MASTER EATR . 4066 NEW 1-CAR GNiAE. .. v � e ?'-33/4' 4- 1/4' ® -¢ ¢AB]OnulfAOx IXxatS . Z. a'-z va• a•- 1iz' 3'-m• _ DRAWN BY.E.T.E. 2668 V - 81 -------- RELGCATED6EDROOM EN,'R� oR�, SMOKE DETECTORS REVIEWED J HALL ur .. CHECKED BY:E.T.E. MUUROONI� I I� DATE: "� I I 8 rxisf ale O d A S BUIL I DEPT. DATE EATR,LAypIDRY I - - ' Dept. L%10 20 ----- L, Approvec� llbr iif#�;__._ ^yy6 FIRE DEPARTMENT DATE SCALE: BOTH SIGNATURES ARE REQUIRED FOR PERMITTING 6 6e- 4'-611/16' ]'-55/16' 7'-5' 4'-]' 3'-101/4'_ 4 1/2�-3'-101/4' 3'-7I/a' 3'-43/4" 6'-9' AS VOTED R A "per - NN PROPOSED FIRST FLOOR PLAN - - �AR 0 4 2020 SHEET: 114'=1'-0" A-1 ow xN �o -------------- — -- _ --------------- -- — — ® ® ® ® ® ❑ ® eo E --------- - ---- PROPOSED REAR ELEVATION -————————————— r I I . WANDED RRST FLOOR ABOVE - q -=----------- ----J -------------------- 1 ------- - r-—————————————————————————————————————- -———— -- .6w9nNc FouNDATroN wAtL I I "�° I I -._.. A,° � w U co r1 I I LU I I EXISTING FOUNDATION I I W W I' Q e I I � �a I I I ,� I I ;•; I � ____ I . r ------------------------- I;I I I I I :. I `per I I I GARA.E SL4R ON GRADE I I I I I C I � I 1 I ��• I I I I ---------.:--------__ --—ID'POUREDCO EIEIpUNDAONWA--..A -�.5 I— _ -.-._. ..I- '�•._I— 12'.24•FODRdD cbNGR T FOOnNc - l. DRAWN BY:E.T.E. I L---------J I I I LL _ J I I I CHECKED BY:E.T.E. -------- I I I I II e • DATE: 2'-6 -6-6 ? 2/10/20 12'- 24 12' ]' _ SCALE: PROPOSED FOUNDATION PLAN - , 1/4'�t._D. p AS NOTED SHEET: A-2 N V. 09—AWTCH FLOOR JOIST SIZE AND TYPE= O� r -- - - -� ---------------- I I L------J, I EXISTING FLOOR—M TO RE— — — I r ----------------------------- III I G4FNGE S�ON GR4oE ._ I f I I I L------------ • I I I Ir I' I II I I I I I I I I I I I I f I I I I = = I I III I I I C I L--- -----J I I FLOOR FRAMING PLAN - V4._F_D. I ----------------J --------------� .. - —MATCH CM G JOIST SIZE AND TYPE— L - W Q � U c/) - LU -- eEm..•�ri W W 0 2 W II DRAWN BY:E.T.E. III CHECKED BY:E.T.E. I g 8 DATE: 2/10/20 I I SCALE. CEILING FRAMING PLAN jAS NOTED SHEET: A-3 81 2'.10'@ 16'o.c ROOF RAFTERS c/) F Q W o� OVERLAY FRAME 1 2-x 10-@ 16-o.c ROOF RAFTERS- - w - --- ------ --------------------- ----- ----- moo I -----r----r I I OVERIAY FRAME EXI NG ROOF RAFT RS TT REM NIN A-0 I I I I EXI NG ROOF RA T REM /' I I I S I x, I I I II I I 1 . II I I I T>. I I I7. - I I I I - ----- ———— 2"r 10'@ 16"o.c.ROOF RAFTERS , ROOF FRAMING PLAN 2"x 12" RIDGE BOARD 2" x 10" ROOF RAFTERS @ 16" D.C. Q w Lu CJ w ~Q Q ATTIC-NO STORAGE (2) 2" x 6"TOP PLATE I U w MATCH RAKE TRIM DETAIL - .. O � - - d . NEW 1-CAR GARAGE - DRAWN BY:E.T.E. NEW WORK WALLS TO BE 2'' x 6 @ 16" C.C. w/ R-21 INSULATION CHECKED BY:E.T.E. 4" GARAGE SLAB ON GRADE DATE: --------------------------------------- 2/10/20 PROPOSED CROSS SECTION SCALE: AS NOTED 10" POURED CONCRETE FOUNDATION WALLS ----- 12" x 24" POURED CONCRETE FOOTING SHEET: A-4 u t i �9 CoNt. �4 Q�7 P _ _ Ams N da y S� Ter tS ' �51go r , r r r . "[OP r £L= LD A,T 99¢ 104 7-00 ov'rLeT AT WiWgeYS LAWS ` 20 y- MEET EXKTIW& Pko PO, am --= 3S•t ' ro Al Vt/EQ. L.AkE E'Lv 3I 2 611718o ova0 8 �i �x �.1 �r�. f c T � � � P-IT-a IL M Af. w 106 GT X� f -bw�t�oP� ���t LET��UI� a L�G2t✓T 'LLD c I L VC/A 1....C._ A Qw. to 1a8o dST�'�.�I�.l.d • /V�.AS S DIRECTIONS: ZONE: From Hyannis - From Main Street to the West RD-1 '' g End Rotary, Take second exit onto West Main Area (min.) 87,120 SF (RPOD) St. continue to Strawberry Hill Rd. turn right Frontage (min) 20' continue over Rt. 28 to Wequoquet Lane to Width (min) 125' Setbacks: M 0' _� , '•§; Phinney's Ln. and turn right and take an Front 3 side 1 immediate left onto Conners Rd #140 is on the Rear 10' � •n< left. s FLOOD ZONE: Zones: X (0.29 Annual Chance) X Area of Minimal Flood Hazard $• Community Panel No. #250001C0562J . ; ' July 16, 2014 LOCATION MAP: REFERENCES: 1"=2,000t' Deed Bk. 31581 Pg. 83 ``�►_` cB Plan Bk. 142 Pg. ASSESSORS REF.: (Fnd)nd) Plan Bk. 89 Pg, 63 Qo�a Plan Bk. 47 Pg. 119 Map 251 Parcel 014 . i j OVERLAY DISTRICT. l / Gte - 9• `S8 r" P / � � �} ,. - '% r �. r AP — Aquifer Protection District �*6 NIF 'b V / / Randal C. Green and o Wend L. Joakim Trs. Edge of y / Flagged Wetland �O.Ce/d �� r, Per SE3-4755 i. Existing Pier �i' / i ,/ - SE3-4755 %„ii Proposed P \ , l �r �oot Drainage '/�� u�jk1/ 6�lkk5�k0 1 p��_,l�Q r — -66\ i O/i � " '�/ i / ��w�0 c Existing Septic per Lot�I��ar y / / / % Town As Built Card i r �' Exis ' Trees Dated 912912008 / L / / i w --to be Removed, TYP j / ' NA VD 88 BM EI=68 84 T J'r9po ed y0`nfn. / � CBntlH Top of CB/DH i/ /- /'� ,Gar age/" o ( o . v � �( #140 QF, Proposed 1500 Gallon ,� �i // / �, / Ex. 1 Sty. r} , �> Septic Tank / "01 / / / w1f Dwelling , Existing Septic Tank j Oe e Proposed ,; ` to be relocated. En tron ce 20. sis. •O . Proposed Paved Drive 019.2', r t 1 p BUffe �.6� �°p 5 5 ONa LEGEND: 100' � ', 24� a 1 l O CDT Cedar Tree 1, i �l o HT Holly Tree Virginia B. Pharn �I �e� J Qt\�o Xv�a DT Deciduous Tree CT Coniferous Tree ` } ,+' ( o 41a Utility Pole ` / �'� (F dI �Z 1�{0 APq —E— Electricfgf + En 0.1 Ssgc —G— Gas O, Bu{� / Q L S T01 Wetland' Flag 1% / Z o R :;+ Light Post El CB/DH OHW— Overhead Wires 25 Elevation Contour GOO Gas Service Shutoff TI TLE: Site Plan PREPARED BY. PREPARED FOR: NOTES: � . • 1) The property line information shown was � SCANNEDProposed Improvements Engineering & Tim & Janet Green obtained from a Plan of Land at ury Conners = Rd., Baxter Nye Engineering and Surveying � ivaiiconsuiting, Inc 140 Conners Rd. dated 712112008 which was compiled from MAR 0 4 2020 At Centerville, MA 02632 various recorded plans and available record 140 Conners Rd. (508)428-3344 • P.O. Box 659 . 711 Main Street, Osterville, MA 02655 deed information. 2) The topographic information was obtained Barnstable (Centerville) Mass SeCi�sullivanengin.com • www.sullivanengin.Com from on on the ground survey performed on O) December 13, 2019. Draft: ASL/CTR Field: WHK/JOD/CTR 20 0 10 20 40 80 �L 3) The datum used is based on Town of DATE: December 26, 2019 1 20 SCALE: ' Review: CTR Comp.: CTR Barnstable GIS Data. = Project: Green Project #: 19980101_Dacey