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HomeMy WebLinkAbout0255 CONNERS ROAD 2 o . tHE�°� The Town. of Barnstable BAR LE.MASS. Department of Health Safety and Environmental.Services T MASS. O _ _ 1639. �0 prEOMp� Building Division. 2 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice 0 Type of Inspection 1'7) Location 2 5 C.6n rN cl v-I A� J Permit Number$' 19 4 Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: Ld !' r v K Ndl Please call: 508-862-40. 8 for re-inspe •ion. Inspected by L-A 0-44 J. Date I 0- &6 'L) ` Town of Barnstable *Permit#s 3 �� Expires 6 months fr m issue date d Regulatory Services Fee ��.a anxntsrasie, � . M"M Richard V.Scali,Director Building Division PERMIT Tom Perry,CBO,Building Commissioner JUN 2 3 2015 200 Main Street,Hyannis,MA'02601 www.town.bamstable.ma.us TOWN OF BARNSTABLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAHT APPLICATION - RESIDENTIAL ONLY / 6! Not Valid without Red X-Press Imprint Map/parcel Number Property Address- assW OVl Residential Value of Work$ JZ, dcvj Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address � fiT 14 1) Contractor's Name IV^t at.n a-66k(y Telephone Number Home Improvement Contractor License#(if applicable) `7(} 3 Z Email: t _ Construction Supervisor's License#(if applicable)CS• 07 Ll Y Z/ ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner [�I have Worker's Compensation Insurance Insurance Company Name -�G t Workman's Comp.Policy# G✓L�-Sy"S�o i ary 3 Za!'th, Copy of Insurance Compliance Certificate must accompany each permit. F Permit Request(check box) ®. Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to �Y V J �L" ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 Imprg#Wnenit Contractors License&Construction Supervisors License is. quired. ` SIGNATURE• Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 swxrisrnsra. MASS.039. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us • Office: 508-862-4038 Fax: 508,790-6230 .i Property Owner Must Complete and Sign This Section. : If Using A Builder as Owner,of the subject property hereby authorize :Yra�. to act on ray behalf, s in all matters relative;to work authorized by this building permit application for: (Address of Job) . k - 4 Signature of er Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable - Regulatory Services oF7 TWy,� Richard V.Scali,Director _ Building Division -r ;.li * :wuvszasr.F� ' Tom Perry,Building Commissioner {i " Maas. 1639. A.�� 200 Main Street, Hyannis,MA 02601 _ www.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 thap 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 otherapplicable 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. \ Ya Signature of Homeowner y 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 4 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 t amend and adopt such a form/certification for use.in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 040215 Y # WZMfih3gibYf MFrZt • fvfs�u� �v�r�a _ - � I lmTfT'"{lFT'f-Affidavit:Enfld arslcu niz���rt Nan= = _ IT • �yzFa�empIa�er?�hec�t��bcr�• ryp�agg�est� J: - i i_❑ Iamaeaplayer ¢ Ia�acrrfaZ * b ?�iztbe Vitas EL ❑New - �I°Yew�andTorga �- ' Elrrg El am a stile Qrgar€ner- Iisiz3 on $ aFied s 7- sbi£z�Isere n,Q e�Ioyees 23� ha-v� g_ ❑ dma :ffirmr-m any r_ eu layees$a$ba�*�vent s' �_IIlLCaaffi.�l El 5- Ej We:am a wtpora iamzuff iis caj=qics-cx addifims 3_❑I am a Tum pmer doia -I WOA-- I D pig=per nr ad(Elia-s �{-yam f �a Fer E�C�.. 1��]$nafiepaiis . iztnxan r�. 1 E r- +�+�PM m we hm nD ' ezn�Ivp��es_[Naffs` I�-0 4td�r - comp_kmxanm nmpired-j C xr�stch-Kkt3xL-bacmgstsftdsedra fAiti�y7 sheets bthenmm�af&e mdstaiauhe>�tcant8rnse 5-ems ax Liyers_Ifthe�,h.�-Cu� B.m eamIrees,tapg pnmlle tb,*wca�s'imp_p abet 'ttg 87z�"Jz`.rIt 7S1}t7Tf L d fFOII�PJS�GOitty ZSYrfID2I Fn ��fir ts�er�sF�y�ss B�3ary is f}tepu&g and jah�cta Inswi ce COI73P&MYN=C: :r 110 ELT ry ccS£Jf-iIIE-T.IC-4- L7}3} -16bSitaA.& ZS"� Cavw�rs rrT C��BNv� ��q. AL{zch a copy of t� comrpeusafiinn park-dzc-ration gage(siOU-;33g thlM POb£3'sram er zad+uq3a--Uon ilate); Fax�ttz�fA setazt c�image as teed u SecEmix25A of M.r- 152 cm lead to tbt imposffirra of jai perzIEes of a fine up to- LUDa DD anzdfQr of-year im ;as wen a---cila peua7Ei m ffie fcim of a STOP WORK ORDER—and a Pisa cdupto$250-DO a dsyagaimEfheviobd.cc- Be advisedt�ar-ojyofhis nragbefadedtg Dffireof Iuv,=tgmdiom of So DIA€or im*ance cummge I e eaglfiiar rr yset�urp vcdEcathm- &m-ffi&�vrxzc±i m pr al2e>?e a ond erect Pie i#= �'• -�" �7� .' ' ' - EfSS auF itQl FRYJf Ifi flzir m-ea,tuba r=nTLcW bg df m fu=of cLl . • CRyarTowm fsz>iag A-I.,G64{circle LBaardfffHexTffi 2.RmiffiagDqj Ec�� Itlfd£a?mO=k 4 �Ietfrical�xec#sr �_P�mgFs�ect�tr �c Gm=ml Laws chapter I52 requires BE mnPIQyem to prmvidD w�'cmensaiinn fDr i��plgyce� �rn���„f to this sty as pis deuned as —every pion.in tne,=Vice of Moth=under My crnor-t Dfhire, P_xT}=m fimpHc , oral ar Win.." - • . fi nT PZIi�j Idea is defm ed as'an.im�p ��-p° ' or often legal e�y,or any,two or mare ofthe fiz going engaged m aJ��P�y mad tal�Ieg of a deceased employq-cz the receives car tr•asloe of an infvi&Ma partn=bzp,asssDciafimu or other legal edY,emPlCymg emplDyees HowevM r o W=of a dWellmghousehaving mtmore than three apartnaajs and who resides t =jo,or the Dccupant Of the dwelFmg hawse of anmthe r whD employs pmsons to do ice,commom or repair work on such clweIimg hDuse or on the graunds or building agpmtnar¢thereto shall not bwm D of such m3ployment be deemed to be-an employer." oId ffi e isYa nce or M(iL chapirr 152, §25C(�also strips fiat evei"y sfaf$or Iotal ficeusmg agency steal[wrf�h . . renewal of a;'rcense or pErmitto Dperate a bnsimess or to construct budffings in the mmiuoarw"-Ith for auy applicant who has not produced xamptable evidence of coiaplzance with the insurance coverage requ>ro:ns AAd io a_Tfy,MGL cbaptra 152,§25C(7)states-Neither the=n=awealthnor any of itspDhtical subdivisions shall ,ntz into EET contract for the pcER=a .ce of public wQik until amrptsble evidence of miupliaare,with the m car ce requirements of this chapt Er have been presenird to the cant''ting a*-dhDritY.' Applicants Please fr7l out $e workers'compensation affidavit completely,by checking the boxes that BPPIY to your sitladDn and,if necessary, supply sub-contractO*)mme(s),addmmCes)andphoae mmber(s)along withiheir cer ificatt(s) of i su a=. Lb i Liability Companies(LLC)or Limited I iah2t Partneisbigs(I T P)with n o empl oyees outer man the members mr partners,are notregvhed-to cagy wmrkexS' compensation n,�m If an LLC orLLP does have employees;a policy is B c advised that this afudav>tmaY be submitted t)the Department of Industrial Accidents for confirmation ofmTce coverage. Also be sure to sign and date the affidavit. The affidavit should be mtzmled to the city or tovrn that the application for tie permit or license is being requested,not the Depa tmabf of Industrial'Accidents. Should you have any quesfiom regards tie law or 2fyou m,regnsed to obtain a *orkers' coeosahonpolicy;please call the Department atthe number listed below. Self-insn-ed companies should enter their mp self-mete fide n=Brr on tie appropriate line. _ CLtY or Town OffirsaIs : ... . �_,.. . Please be Brae flint t$e affidaft is=nplein*andgrifed legily_ TI E:Departrnent 3�ss provided a spare atffie brit m of the affidavit foryou to fm outiathe eveut the f?ffice of3nvesb •nri. has to oonfact.yonregaEdmg m-e applicant Please be sure.tD fM.is the pc it/icense number which will be Used as a reference nt.=bea. In adcLtion,an applicant that must submit multiple peamitllicanse epplir lions m my given year,need only submit one affidavit mdica current policy info=;giion(ifneressary)and under'76b Site Address"the applicant should writes as l locations ia (city or torn)."A copy of the affidavit that has been officially stamped or madced by the tarty or town may be provided tO the applicant as proof that a valid affidavit is on trTe Rz futn e permits or licenses knew affidavit must be Died out e:acb- year-Where a home en owner or citiz is obta�ioing a license or permit natreIated io'any business Dr commercial ventLue (i_e•a dDg license or permit to bran leaves etr.)said peison is NOT rec �to completes this affida�Zt The Office of hivestigatinns would lik-e to tIomk you io.advance for your cooperation and shouldyou have any.quesiions, please dD n of heshBtj--tp give ns a calL The Depart aenfs address,t--Iepb-one and txnumber_ at.-CUmm:oav?�,-ajth of was h Dcpaitmeat af7ndintialA to _ a:�Ut:�t oJC�.tianii o I&G I TeL.9 61 7-727-4 466 ur 14 7 MA SSA . . R=4 6I7-727-' 4-(� Devised 4 24 Q7 gp . Client#:35211 2MOSHERCO ACORD. CERTIFICATE OF LIABILITY INSURANCE D061182015ATE Y) 06/18/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NA E: Dowling&O'Neil A 508 77 -1620 Insurance Agency Nf ac No): 5087781218 E49WL 973 lyannough Rd., PO Box 1990 ADDRESS: Hyannis,MA 02601 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Associated Employers Insurance INSURED INSURER B: B.L.Mosher Construction,Inc. INSURER C c P.O.BOX 1131 INSURER D South Dennis,MA 02660 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INTRR TYPE OF INSURANCE IH$RADDL trWD POLICY NUMBER MPOM/DDY EFF M�DUY EXP LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY R&VIM1&J?&EoccurD $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&A DV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY ME O- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY Per accident $ AUTOS AUTOS ( ) NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS PROPERTY $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE AGGREGATE $ LIED RETENTION$ $ A COMPENSATION TH AND EMPLOYERS'LIABILITY WCC50050138432014A 09/11/2014 09/11/201 X T OFFICERIMEMBER�EXRCLUDEED PROPRIET YIN IER OR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $1 GOO 000 (Mandatory In NH) EL DISEASE-EA EMPLOYEE $1 00O 000 If yes,describe under DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT $1 00O 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) RE:255 Connees Road Centerville,MA 02632 Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION Town of Barnstable,Building SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Dept ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street Hyannis,MA 02601 AUTHORIZED REPRESENTATIVE C 1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 Of 1 The ACORD name and logo are registered marks of ACORD iFC4 C9rlOR/M4 C9Y07 M A W r%ler"�uiu�rrac-ir�l� r j�^ -., C[71�fr�f1�irPl�: dp Office of Consyk, r Affairs&Business Regulation �E im'ROVEIVIENT CONTRACTOR aegis#ration: 170132 Type Expmt1�Pt 9/14/2015 i . Individual BRIAN K.REBr Ci-,j... BRIAN REBELLO 76 WOODSIDS RQ g W.BARNSTABLE,MA 02668 Undersecretary r� j Massachusetts -Department of Pudic Safety Board of Building.Regulations and Standards Construction SuperNisor License: CS-074421 BRIAN K REBELO 76 WOODSEDE RB West Barnstable MA Expiration Commissioner 09/18/2016 1 f Information and Instructions Massachusetts General Laws chapter�152 section ee requires as every s to provide a son nthe serviceeof another under anytheir employees, As quoted fromth.e `law , an employee rYP , of hire, express or implied, oral or written. An employer s defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,-and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,Partnership, association or other legal entity, employing employees. However the owner.of a ... dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house.of another who employs persons to do maintenance, construction orepair edtn be as employer. ase or onthe grounds or appurtenant thereto shall not because of such employment building aPP� MGL chapter•152 section 25 also states that every state or local licensing agency shall withhold the issuance br renewal e or permit to operate a t business or to construct buildings in the commonwealth for any applicant who has of a licens not produced acceptable evidence'of eompliancewitb the insuranceIlcec act for the public table commonwealth�nor any of its political subdivisions shall enter y P table evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority ,; . .' -- . .. .. . .. .' . .;. Applicants Please fill in the workers' compensation affidavit completely,by aecking the o that Pinsurance to youras all ry be pply�g company names,address and phone numbers along with submitted the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and'114 date the affidavit. The.affidavit should'be returned to the city or town that the application for the permit or licease'is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the' ..'Pf f you ' a workers' cAmpensatioitpolioy,please call'tlie Department atthe numlierlistedbelow.: are required•to obtain City or.Towns •� ottom oY4� Please be sure that the affidavit's complete and printed legibly. The Dep rEment onta�t ho provided the ape at the plicant.Ali ard�Please affidavit for you to fill out in the event the Office of Investigations has to c y g P �',s ezmrtlliaense nuibe�whichwilLbe used a's a iefeieace number..Tlie adavits mayi'e'r �dt�?•.. be sure to fill in t}ie.p "arrangement have been Sri de ~M the Dep eiitb ` i.1,14 o FAX unless othei arrang ^.�,,.• • ;. ations would like to thank you in advance for you cooperation and should you have any�uestions, . The Office of Investig• ,•. ..,• .A.s. _! - please do not hesitate to give us a call. The Department's address,telephone and fax number: •. w The'Commonwealth Of Massachusetts Department of Industrial Accidents ; Dns lnYestl atI . a t�ce at 9 600 Washington Street , Boston,Ma. 02111 fax A. (617) 72 7-7749 . «171 727-4960 ezt. 406, 409 or 375 ' h . 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F��e to secure covera;e as ngniredttnder section25A of MGL 152 cah]ead to theimpositlon of erlminalp enaltles of a$nenp to s1,5oom and/or one years,secorc Cove of a Ls rtcl cit1 i penalties in the f form Of a 10'2 oiLK ORDV for a d SL fin �tion0o a dap against ma I tmdereEsmd that a' copy of this statementmay be forwarded to the Of9ce S - that-the-in orniatian- rovided.above-isst�-•-�_�'coirect I da hereby-certifyuruierthe�aixs-and penalties-of-perjury f P . Date PEOne ��' Print name�'✓�/�,�e'` do not write in this area to be completed by city or town ofr dal af$cialwe only - . ern -cense# [jB�dingDepartment city or town: ❑Licensing Board ❑5ale'trten's 0MCe • p:�or.�r; • contact person: a r °FINE r Town of Barnstable Regulatory Services � � 4 BARNSTABLE, f Thomas F.Geiler,Director 9 MASS. g 1e39. a Building Division TED pM't Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal,demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Wo / ,D' Estimated Cost ��J�6 6= Address of Work Owner's Name: ��.� � �— � •�` ��"��� Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 F�Ipdilding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED ACCESS COT OHF�IRATION PROGRAM O GUAR.ANTY FUND UNDER MGL c 142A. ACCESS SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: r Date Contractor Name Registration No. OR Date OF/ricr s�.arr_e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map d1` +.� Parcel ��✓ �� I Permit# �• f S 73 Health Division t Zq ' ` " "`" °'`S CA2, Date Issued /4 /7 O Conservation Division /0 ��� '', .:? - �' j �. -, Application Fee Tax Collector /0Z&L`2 Permit Fee35�, Treasurer ✓1 ;T ,7t-- Planning Dept. ✓0 Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address �-_��� C .s/,e�� mac✓ VillagedJ �-� Owner Addres Telephon(�G k ) 7 7,'—e ms Permit Request 5"�I'c_-o'• Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatior ��-tJ Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 511 Two Family ❑ Multi-Family(#units) Age of Existing Structure ,/1z)&e- /G Historic House: ❑Yes t VNo On Old King's Highway: ❑Yes VNo Basement Type: *Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new ► Number of Bedrooms: existing new Total Room Count(not including baths):existing � new First Floor Room Count Heat Type and Fuel: 'A Gas ❑Oil ❑ Electric ❑Other Central Air: ;Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:existing ❑new size �_ Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number ,5 ),k:� - 7 7 J;— 6/ Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU E DATE % ej 'z-- FOR OFFICIAL USE ONLY PER4;,T NO. DAPE ISSUED MAP/PARCEL NO. +r • r fir ADDRESS - VILLAGE ;OWNER r f r i DATE OF INSPECTION: .r T FOUNDATION r _ FRAME INSULATION ,4 FIREPLACE 'r ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE'CLOSED OUT .r ASSOCIATION PLAN NO. 1.i r j1�YLL•sro� � RE ADY TO FINISH SUPERSTORES Built To Last Standard Features & Materials Delivery Qualitycustom Built Sheds USA®stands out in both quality and service. Roof eak,extended cap korgambrel • Sheds USA will acknowledge the receipt of your Our sheds are built with your specifications in mind— • 1/2"plywood ��= I order by phone or by mail. Please provide a daytime - Sitoomaga 2"x4"construction,24"on center 1_' 1s K hone number at time of purchase. Y all made with the finest quality material and backed u p q tY p Self-sealing shingles with 20-year warranty ' with our lifetime warranty. Unlike most shed companies, available in black,white/gray or brown Peak I Delivery schedule will be established by Sheds USA. •6'wide sheds available in peak roof only �� .i You will be contacted by phone 1 to 2 weeks.in advance.Sheds USA will deliver and assemble our shed for you, -*"ar gardening •6' wide peak=8' 8 wide gambrel , y y Roof HeihtS,�, rWrY at no extra charge*. From ardenin tools to art •g wade peak=8'3" •10'wide gambrel=9'S„ Extended•Peak j volume,weather time conditions,s, etc.e based on seasonal supplies to sporting equipment, we have a shed for p g 9 r • 10'wide eak=8'11" •12'wide gambrel=9'10" your storage needs. g Deliverydate and installation date may differ. �— - P • 12'wide peak=9 6,, s Fv ., delivery/install y WalIstvo 41 Reschedulingof the delive /install date will 0 z How To Order Your Shed •2"x4"constmction,24"oncenter - - � Gambrel only occur if Sheds USA is forced to so by •. •ShePine: tongue ong re&grooveoned (horizong ntal) events; events out of our control (weather concerns, �° ,� � c �,I { � Z Sheds USA offers a uniquely flexible program for •Pine"6"ton ue& move(horizontal) illness, mechanical or other difficulties). Sheds � " t -0 •Cedar 6"or 8"tongue&groove(horizontal) customizing a shed to both your individual budget and •Wall height=71 USA crews deliver/install several sheds per day; needs—and it's easy. •vinyl siding applied over t/2"plywood therefore the status of one customer's order Floorp rsizes are approximate) affects many others.To provide the best service ry ,_, . „ ti rF " To choose a shed size and tyle,review ywood for l of our customers, once a A Pricing to determine which ssize shed will fit your needs and •2"A"construction,16"on center for 6'&8'wide units '� date Ihas been agreed to and scheduled by the budget.See Standard Features and Materials for more •2,,x6"construction,16"on center for 10'&12'wide units ` I customer and Sheds USA, postponement or — •Concrete block supports4 corners,front& ' information about standard sheds. back center of outside frame Heavy Duty Fr 2x4 or cancellation by the customer will result in B Pick the roof style and shingle color. If preparing your own foundation/footing,please call 2x6 Floor Construction a 20% restocking fee. y a Sheds USA for exact outside floor dimensions. t �, C Customize the placement of your doors&windows. s ,. xg2faesMed. i peak Too Windows I �, } D If you have specific requirements,see Options&Upgrades for details. •All windows come with flower boxes and shutters Sheds USA takes pride in its E Read Site Requirements carefully. •6x6,6x8,8x8,8xio and i0xlo units include :n 1 f IF Read our Delivery information carefully for certain requirements. one window—all others include two :� experienced staff of builders. • ` G See a store associate to fill out the Sheds USA Order Form. Wooden sheds come standard with functional windows. (optional screen) •vinyl sheds come standard with non-functional windows Most sheds are built within (functional windows available as an option) Doors 3 hours of arrival—backed by our " . t• t,� D 9 •40"double door standard � y outstanding LIFETIME warranty. � • $ • � � & °• ` (6x6 sheds come with 26"single door standard) (� Standard 40"Double Door i For�'lmolre inforllnatioln visit ourWeb°site �p��p/�p� 'nm_ /� � en /gyp �4 tlH l7�.CllfaShedsUSA -0- -M • .y ,+a � t r►" A _.m • o� tall;-US At•800.441�.g4$�.� _. Nn � - � . , ., n ..� $.. .» a»n,+s. a .a r . ^e •• - .r g R »s .�6. .s■ m ;t ., r§- .� A >ff 3 r F 'e �' ,+. •m �" .m �.., �.;�� `s A�.. a e + '!/IT"rY �YY 5i1''�'t�a�t'" _{ ..e,\ „p ✓$ x 'rw,..4° F da'v" -,'kA me^J""u'f • ° • ►Mwa►./ `�/./x/ o- s .> m F , M .; .. „,,:y^ ^ ".: •, ..'; .,..... .. f�� �,¢. o _ �f«.BN'.' ,F` � � ya• a�p;1t. r �� � µco• i a to 4�4 r. . gip"'� �� a .! *e Lit.. •t!���'��'3 _`+cot 57— r M5 North • C7Q (rd sh iids 2,02 p i Customize your shed . 0 0 Options & Upgrades Site Requirements P Pg G Note:Options and upgrades are an additional cost to the standard pricing. I . , P Pg P g l Clearance Shed site needs to be located at ---- Floor Upgrades(AII_Sheds). • � � : .� � � � # } least 3' from any fences, trees, etc. Please remove 100%mamteriance free " •Pleasant aroma naturally repels • •Most popular material •Vertical exterior sheathing Pressure treated plywood floor $ 1.20/sq It Variety of colors available s insects and resists rotting Withstands all types of weather a • •Durable and economical 2"x6"floor joists upgrade for 6'x8'wide units $ .92/sq ft tree branches, brush Or other obstacles 3' around •PractIs ical $ s Ages beautifully �`Classic tongue-and groove s •Pre-primed surface makes an (upgradedjozsrsarepressuretreated) perimeter of shed and 12' above ground. •Durable , •Excellent base for stain and paint construction a excellent base for paint Vinyl •Economical �; s •Very stable-resists warping :Affomabl riced i `x •Upgraded and improved Colors v r � . '0 0. _ and buckling YP ' '` *m7WureT--IH) • n from m y y�$ Y s25.00 ' es es l with n protruding rocks or Lan Grade Must a less than 6" slope r white 6x6 $ 10x14 stumps in o the area.o . • m._ v ^s: €� <" 6x8 $ 30.00 10x16 $ 75.00 P y 6@ v -- a 8x8 $ 30.00 10x18 $100.00 . ^ .t • �'-a .n • 1 - " Access Shed is delivered in prefab panels; clear cream: - -+ •, 8z12 size shed shoves exE.peak roof x_lbshed-size4own a brel roof r8x12 sheds¢eshawn pe of 8x10 shed size shown peak ro 30.00 10X20 $125.00 access O e Inecessary-stairs, rOW W y- _ ac sit s narrow walk l _ , • . 8x12 $ 40.00 12x12 $ 76.00 fences, gates, shrubs, carports, awnings, arbors,wa lkways, 40.00 °12x14, .00- etc. may present difficulties and should be brought - � • 8x16 $ 50.00 126 $100.00 to the attention of Sheds USA prior to delivery. ; 7 sIl `j II � '��""s ..-. ^-. � ram= ' �,' *• t pt* '� g ,a l• i � � 10x10 „$,55.00, _ „12x18 $125.00 x1 . Land Quality Consider all factors when ', 10x12 $ 60.00 12x20 $150.00 choosing your site, including proper drainage, G 6x6 `$1,319.00 -v-' $1,179.00 ,fur�$ 999.00 _ Door Upgrades • ;:,�•, y firmness of earth, etc. - $ 895.00 a a , ,v Note:Larger door sizes may not fit on all shed walls. ,� $1,429 00 ^ m $1",299.00 _ . $1,049 00*, A. ..,� $,955.00 � µ Siz ce Vinyl Price • Permits are the sole responsibility of the homeowner. gxg •>=$1,529 00„,. $1,379.00 $1,089 00= $ 999.00 ExchanQestandard 40"double door for 54" $ 50.00 $ 79.00 Please contact your local town office soon after b 8x10 4 $1,699 00 6 _ ^" • a 1 g Exchange standard 40 oub e o - 7�bZ1-- $ 99.00 y y $1,529.00, µ x, • $1 329 000 y $1,229.00 orderingour shed to determine an restrictions o. • „ , � �.• „,z � � � P.� � =- �-== Exchange standard 40"double door for 78" $ 125.00 $ 129.00 ' _ 8x12 $199900 $1,829.00 • 1. $153900%J t $1,469.00 • or setback requirements. N '5 . � � � 6Y6 sbed size only r �'`8x1144' `, $2 299 00 k 'yl $2,089.00 � s � t $1,869.00o � �.< $1,739.00 . � Exchange 26"single door for 40"double door $ 40.00 $ 60.00 L� • •, I Shed site must be 150'or less from where 8x16 "'' 1$2 569 00• a •. $2,339.00 a w., $2;149 OOg° $1,999.00 • Other Optionsw �. �t N, yr o a v J, tom _ •,,..„, o lerca a -300 10x10 Ft, $2,079 00 y,• $1,929.00 ' v • " ° Item Wood Price Vin I Price from t I awl r sites 150' $1,669 00 " $1,525.00" • y large tractor-trailer r tra ark S �rN ,t x . 0, _ ar ^ m • f m truck parking area ill incur a$50.00 fee 4'pressure-treated ramp FREE FREE P g 10x12 w, B$2,439 00 $2,279.00 a ' $21139 00 1 $1,889.00 ___ A 0 ;� .� 0". Additional 26"single door $ 79.00 $ 99.00 payable to the delivery crew. If your site is farther t„ „. 10x14 rt $2,739 00 $2,569.00 • ' 4 ' „ $2;299.00. A £ • $2,149.00 • Additional 40"double door $ 108.00 $ 14g.00 than 300' please contact our main office. f ^ • Additional 54"double door $ 120.00 $ 179.00 : e r $2 579 00 ;, t $2,375.00 10x16 n k $3149 00� • $2,939.00 m e ®, o 4 • Additional 78"double door $ 16o.00 $ 229 00 I The above site requirements allow us to build a safe,sturdy shed for our 10x18 .$3,479.00. $3,325.06 a $2,799 00 ,„ ,$2,599.00 Additional 78"double door 160.00 $ 229.00 w'°a' .'V;% 6 customers.If any of these requirements are not met,your shed may 10x20 • tk • $3,799 00 t. $3,635.00 $3,159 00 "` v ` $2,899.00 Additional window $ 6o.o0 $ 69.00 l not be built and a fee of$150.00 will be charged for our crew to return . '• s x (includes flower box ands utters) and construct your shed once conditions are met.If this occurs,delivery 12x12 .$2799 00' w t$2,649.00 ` $2359.00 F = $2;139.00 Y upgrade(! Y P P Y property,in sr 0 Vinyl shed window u rade(functional) n/a $ 49.00 of our shed materials must be completed and laced on our 2, 12x14 v f $3`129 000 'g, $2,999.00 a $2,589 00 g" v, .€ $2,399.00 Window screen(each) $ 15.00 $ 15.00 a location accessible to the final shed site to avoid a 20%re-delivery fee. N a"° �a �O-N v Aluminum gable vents(pair) It is the customers responsibility to cover the materials with a non-transparent, 12x16 $3;65900-1. s $3,389.00 rr $2,949.00 r , $2,699.00, a $ $ 3000 waterproof material to prevent weathering and or discoloration. .• 0 _• a A'e'o • ^} 12"x 8'Shelf $ 0 $ 45.00 rP P unnecessary g 12x f8 4 °�"° r13,949 00 i � $3,749.00 OF 75 00 $3,049.00 4'storage loft for 8'wide sheds $ 65.00 $ 65.00 All fees are due at time of notification. 5M 4'storage loft for 10'wide sheds $ 80.00 $ 80.00 0 12x20^ � Na �$4;549 00� : .�4 $4,229.00 $3,649 00 Z' - - " "'w " "' '� - •- 4'storage loft for 12'wide sheds $ 95.00 $ 95.00 t (loft storage space will vary wilb roof style) I Standard Program Custom Design Options DELIVERED and BUILT ON u E y , 77 • Door&Window Layouts • Shingle Color • Options & Upgrades SITE, FREE OF CHARGE • ShedsUSA offers a uniquely flexible program forte R# combination of roof,style„shingle color,aATkng material ti (Positioning) (Black,white/gray,brown) (Window Screens,Ramps, customizing a shed to both.your individual budget and g a that besffits'yo6r needs?'Also6,at no extra charge:you can m Door Enlargements,and more) . . - - - � ti 4 • Roof Style • Several Siding Options needs-aldit's eas . Our' ro" ram allows' ou to an design,the layout andry ositionof our windows and doors.F • ; ; LIFETIME WARRANTY Y. P g Ym i y - Y . Y r (Gambrel,Peak,Extended Peak) (See above chart for samples) Note:Options and upgrades are an a,g ; -%h y s s . '° 4 e ff e g a r additional cost to the standard pricing. a �, � 5. � *� � � # � � OCT-08-2002 15:27 SHEDS USA 6034367808 P.06i08 Sheds USA Inc. Delivered - Built - Guaranteed Roof.Construction Roof Hcieht A9k 7/16"OSB/1/2"5-ply plywood 6ft wide peak-8' 2x4 construction 2x4 construction,24"on center 8ft wide peak-8'3" Siding Types: 3ft,3-tab,self-sealing asphalt shingles 8ft wide gambrel-9' Primed shed panel loft wide peak-8'11" Pine(tongue&groove) loft wide gambrel-9'5" Cedar(tongue&groove) 12ft wide peak-9'6" Maintenance Free Vinyl on Yz"plywood 12ft wide gambrel-9'10" Peak/Gambrel wall height-71"(approx) . Ext front gable wall height-75"(approx) lr _ �.� K.sv Windows Doors �2 Size: 18"wide x 22"tall(approx) Standard 40"double door (except 6'x6') 5/8"plywood/OSB Includes flower box&shutters Optional 54",66",&78"double door Floor joists- 16"on center Optional window screens Optional 26"single door 2x4-6'&8'wide sheds Wooden Sheds-functional windows 2x6- 10'& 12'wide sheds Vinyl Sheds-non-functional windows Concrete block supports Optional functional windows Note:Options may not be available for all sheds.Call your Distributor or Sheds USA for more information. XATECHNICAL\SHEDS\Shed-cut away Diagram.doc Version: 3/04102 r OCT-08-2002 15:27 SHEDS USA 6034367808 P.07i08 80ARD¢tP.au"ING RSOU�,gT10Ns 1.< LIcsnse: tg�aS'FPtUC-rION SUPERVISOR ' mber ir91 i Nu•.. : ,.. 071717 8hi :r{�96l3��1 ! ia Tr.no: 5892 JOSEPH R :. 50 PIFGH RD r LEE, WH 03924 , Afdministratbr Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston, Mr setts 02108 Home Improvemed- tractor Registration Registration: 123921 Type: Private Corporation „'rr Expiration: 04/24/2003. Sheds USA, Inc. Joseph Baroni 655 Portsmouth Ave/P.O. BOX PORTSMOTH, NH 03802 ' �''• Update Address and return card.Mark reason for change ❑ Address Renewal Q EMploytneot ❑ Lost Card ,_,��: '._.. �i a�nosys�ovNuxa��►o�./�aaeaa�israaQ3 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: et Board of Building Regulations and Standards i?3921 One Ashburton Place Rm 1301. F fl4L/aA/2003 Boston,Ma.02109 }�r►C(8t0 Corporation Sheds USA,Inc, ''. j- a Joseph_Baroni 398 RT4 BARRINGTON.NH 03825 Administrator of vali wuhout signature t The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: A J JOB LOCATION: ra.2l.eJ Eves t number street Jvillage "HOMEOWNER �G3.ChZ— name home phone# �' work phone# CURRENT MAILING ADDRESS�_5 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) 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 `-pr- es and requirements. Si re 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 perfomring 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 t amend and adopt such a form/certification for use in your community. O:FORMS:EXEMPTN OCT-08-2002 15:28 SHEDS USA 6034367808 P.08i08 ProducerThis certificate iS issued as a [natter of information j only and confers no rights upon the certificate Sigma- one holder. This certificate does nut amend. extend o- ;. a °.worl:ars-Compcttsanon ra_ct( alter the co�era;e afforded by the policies belom% PO Box 1387 Companies Affording Coverage Concord. New Hampshire 03303-13S7 co;HrnN`t L7rIMM A Grzni(c State Work!:S' CClmoensation Manufacturers Tru,a CoNeANY LE'rMR R =mpioyc:s Reinsuranc!Corp. Shc& LS.k - — -' -99 Route 4, Suitc This policy is efiO-et.ive at 12:01 a.m. or) 1/1i2002 :`•it"J N H C3S23 expire at miQnioht on 1?131/?00?. This policy v,ili autorrat.icaii� i renewed unless notified by either oar iv by October 31 of any ;!11 C trv3- 1 _..... COVERAGES .'_n�' narr.a? ai.f.t�. .. .._ f _ ...,...,, .. ._ .. =:•.;i-dC: C: :ii;1Cf :.QC'.'.^.,'.'li �t�;l'; rCSDE: .. ��;;1;be Isc,ucc er . .:� _-zl(. I _ insurzn_^ _fc:cej [�- poii- sc ,: e'• - ... .. .,..:iu:a ;�o,_ir. , , crc ;o y1 t^� ....-as ��r: ..,.._..:c,:.. D'' cue;. ��.._,._, -• . .-.,.._.,,,,... Tvpe Of ...su:ance/Carrie.► Policy Num�ner Policy Policy _ _IMI' -IS i:'1 (,G= 1_ -.J.200 _.._,... hCSCrt)1[IOrI I11 (IDC'�(i�=.l�: Additional insui-L•d: I ' LnTIr?C _TL H0'_,Ur CAC LI Ar10N Sheers U SA ...,Should,any of..n.e above-dtscribec policies oe canccico betort i c expiration Date taereof,the issuing company will endeat'cr�,o:rail 30 '�i �'3S'� 3a)'s w'riuen.'noacc.to the. cerri,=te holder named to tnc ;/:t,•tw! :ailLre :o mail such notice shall imocse no obliga;io❑ or !i�biiir�' c shy i ind'upoa [hc company, its'agMS a;reorese>:Icati:c;. •_r;t-�, Cate ...... ........_........... ., TOTAL P.08 y . f LOc)r<.S 40 .Q S F Flo (�M NE 41`49 16c( NAIL 5 dr A- IV PLY - a PNl1A�i�I u r � r 17 \ �Jl PLY INA 111Z(,1oz 14 511.2 2�r5- 4o44,O¢s. R D gip. JAN1E E. c 7 EG:.ti r� 1 STP AP TiessTRi!CTU . Nr zass, (� A1NAI. Mal S I<- 1 �) C®4MI) 2s 5 C����� � �� �� � � � 1�� 2�J `�►�s� r� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION o. Map Q- �o Parcel Permit# Health Division �'23 DZ 7m -29 e7 Date Issued Conservation Division � rev"�. Application Fd Tax Collector Permit Fee' 6 Treasurer (��� �� /� SEM SYSTEM MUST BE - INSTALLED SI COMPLIANCE Planning Dept. Date Definitive Plan Approved by Planning Board RO( ITAI.CODE ANIL / TOWN REGULA9.10NS Historic-OKH Preservation/Hyannis Project Street Address 162s- z 6,y y gF zs 2ao n Village �'cvrr2v�LL� Owner "/ T7_--_2 /,(rf Loc ,�L Address / �i�,�sf/ ,si�� �z v y • ri�, ,� Telephone C5081 3 757- 3,�,7 V Permit Request NEW 19m i r ibnL Su y &o kit /q l ` Square feet: 1st floor: existing_ proposed _ 2nd floor: existing proposed Total newer /� Zoning District Flood Plain Groundwater Overlay Project Valuation/(r�2 Construction Type _Goon r� Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family UK Two Family ❑ Multi-Family(#units) Age of Existing Structure 1pyc Historic House: ❑Yes Vo On Old King's Highway: ❑Yes UI-Wo Basement Type: ❑Full bawl Q Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing -rWn new Half:existing new Number of Bedrooms: existing Tam new Total Room Count(not including baths): existing Wig: new our First Floor Room Count vE Heat Type and Fuel: 'Gas ❑Oil ❑ Electric ❑Other Central Air: E(Yes ❑ No Fireplaces: Existing New — Existing wood/coal stove: ❑Yes Emoo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage:Wlelisting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes W-lo If yes, site plan review#- Current Use Proposed Use J BUILDER INFORMATION Name 1�� ,� /�.����. �,;ll,;,� �'/ .Telephone Number ,5-d ._375����.2 Addres /2 License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM,THIS PROJECT WILL BE TAKEN TO 411 srr¢r,� r,�srE SIGNATURE A DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED 1' MAP/PARCEL NO. ADDRESS" • -r - VILLAGE • - r • OWNER + ' DATE OF INSPECTION: FOUNDATION j — FRAME INSULATION w � FIREPLACE r - ELECTRICAL: ROUGH FINAL PLUMBING: ROUQIZ FINAL GAS: RO11G FINAL FINAL BUILDING >0 01 DATE'CLOSED OUT. , t-1, a� ASSOCIATION,PLAN N , . i. - "" _�' The Commonwealth of Massachusetts . . a- • - Department of Industrial Accidents Office of/nreSHAR ONS 600 Washington Street . --.=•c,�, Boston,Mass. 02111 Workers' Com ensation Insurance davit i location: �i hone# l�� 77�-6 '2"e — I am a homeowner performing all work myself. . ❑ I am a sole r rietor and have no one workin m' acity %%/%%/%%%%O% %/%/%%%%%%%%/%%%%%%���//��%%%%%%%/% % %%%//%%%%%/%%%%%%/%%//%%%%%%/%%/%%�%�%%%%%%/�/%/%%%%%%/�%%%%O%/ ❑ I am an employer providing workers' compensation for my employees working on this job. ::;.>:>: $:`i:; i`i£%:>3?i 3: asi ::`:'ii : :3c3 ?: <3 3 S i:i`ii:>%?: `:`_ '% ::i.y : i'isisi;:!....?:;:isi'i;:;:isi: :;:i?i is 2': 2:E?s i: `;isii<z:it:i:i::i t:i:i:i:i::is :I.....:i i Y i i :i i i;i i i i? i Yt1mQeQY n IIt ..;.: :AE��CsS... ... .. ;:::::::::.:i::::::..::::::.::....:::...:. ..::::::::::. .:.. ....... . QtV' phone .: 'i,...:...:: ,....:...... ::: ...... iln9ll?81FCG':CD:::: �i::::.;::.. :o;;::.:;....;.;:. ;> :;o.::::?:. ::: .. V/// ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have .. . . .. the following workeI.rs' compensation polices: . . ....:is ':iiii'':::;:;::;ist?•:::::i:;i......-:',.-:;ir?:': ::.:is ii::::':':'iii:i':is '...;;. '�':::k:iii::iii ?ii:fi?i:ii:i:i: i:ii%�`�i:iY:::':i:f:::iL;:;:;::i:;:;i:;:ji::is:i:iii`:+;}}i:i!ii:iC::i?:iii:i an 'name. ::.; :.:..::>;::.::.>:: ::: ::>:>':;::: :>:::>;;::>::»::>:.::::::::::>:>::::><;::;.:::.;:.:; - -M v .:.::::: acres >;:. .. :::::::::::........................................ .............................. ............ .....................................::..;;;;:;:::•::........................................:............:.:.:....::•....:.................................:...............:. ................ .................................................................. .•::::..:.:::...... ' i.. ..........................:.........:..... .::..... :: ;;,.;;.;:.:....:::::,.;:::: ...:............r. ....::.::. i:':i:'t` i :: ::' :%C. .:::::: :::::::.:�:%:�i:�i;';::;:::o%�t:':=;�::�:?5�:��i��i�ii:f:�i i'�5: �:�` �:<i:�:�:: :;:� :�:�'% ??';::::�;i::�:�:�i:��:s? :�is 2 .i:.r�:�:�:�:� .i:�i:,'i: %�:i.. . . ......................................... ........................:.........::..... :::.:;;:;:::.;;.�:.�:.;:.:.:.;.;:.;:..::.;;:: ............................................................................ ...........:::::..:.:......:...:..............:.......:::::::.....�±..... .....:::._-,:,::::::::._::.�:.�,�:::::::::::::::::::::•:::::.. ....:..................................:..:....................................................... ..... .................. ..........................................................................._.... ............;.M1:.::::::.�::w:::::::.�::::.�:::v:::::::::::::.:::::.v/.v.•n,J.w:�•.Y.•nv:::::::i ..........:..........:.........................::.:::..:::::.:::::.:::::: Otl .#:>::i>ti:z:::;;:.::;:;.;i;isi;::<.::.;:;>i;; :<.::;.;;;::::.::.;:.;:a:;::a:;c:c;rc;;:J>:...i....:........... # rapt¢e.ca:<.;;:.::.>,::::.:,::::::.::::::.:::::.:::.:::::::::::::.:..:.............................. ............ /M�r//%////l%///� :c sn;name::;:;;:: :.:.;:;;.;;:.:::::><:::::; adslress4.;... .:::. `tithe ................................................ . h -0...:::::::.........:::.::..: ::::................ .. . ........ r::................. :::.:..::................ . :....;i: : ............................................................................................................. .............................................................,:::::......,.::..:.:.......:: ._::._:....,........::::.... .............. ...................................::.... ...._:::..:.........:::.::.:::•....:.:: .... :::::::::•::::::.................................................. ............. .......................:::::.............. .... .......................................................... Q1DTAnG :�U.:,;:,::;:::;::...;;...;:::;;:::.....<::::::.::. :..::._,::: ....:::::: ::::::-,:.,...:.,:::::::,,:::::::::::::::::::: OIL ,. .:.::::,:,,.::::.:::... :.::.:::::::::::::: ::............__...........:.........:.....:...:: i. Fafim to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement maybe forwarded to the Office of Investigations of th DIA for coverage verification. I do hereby certify t e pains and pe_n_a)ll des of ury that a 'formation provided above is tr►w and correct Sigtiature v Date. /5//a' � - - I Print name .�1.��- ,, � ,Co ��.0 Phone k Tom— 7 7, - elzle 2. official use only do not write in this area to be completed by city or town official • city or town: .permit/license# rIBnfiding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office (]Health Department . contact person: phone#; -- ❑Other ovind 9/95 PIA) . Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire,express or implied, oral or written. An employer is defined as an individual,partnership;association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for.any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may lie retired n- the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call: The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of ImlesdVauens 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 RESIDENTIAL BUILDING PERMfr FEES . APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIV NG SPACE —I square feet x$96/sq.foot x•�3 i- "Ia plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>12.0 sq.1� , >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 ' >150 sf- 1000 sf 75.00 >1000 sf-1500 sf .100.00 >1500 sf-Same as new building permit square feet x$961sq.foot= x.0031= STAND ALONE PERMITS , Open Porch x$30.00= (number) Deck _x$30.00= (number) FireplacetChimney _x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee proicost pt.iy�pt}re park.:;•cc faraAa aadT�*�'j�Y ' MINIMUM ' ri �nit�g' • p1a�nMg� Glaxia8 Cc�La� Wall r •��� ' Asu�(%.) U-slue= A-Ya1ue� It-value R� jtva� P��II 87a1 to 654a Heatl�SUa1�Ds� Nate 3 i 13' 19 10 . 6 Ncr=l Q 12:4 C.40 19 10 95 AFM i9 12`/: 03Z 3a 10 • 6 A 13 19 Norma f 13 ZS �T h— Noisasl T 1S'/, tub . 3i 19. l9 to B t!AFVE U .15Y• 0.4b 3i 13 21 IVA iA sS AFVE y Is/, a.44 33 30 19 l4 Norrasi w 15Y, a3Z 13 25 WA WA S x .13% a 7z . 31 � ?VA ?VA 3= 19 i 90 AFtJE :. Y 111/4 ' 0.42 13 1 g 10 94 AFUE Z 11% 0:4Z 32 f 14 19 10 AA 11Y, DRES 5 OF PROPERTY' �, � P�,.r,n�c1� S %�d ✓� Z, S:QTIAR£FOOTAGE OF ALL FOR WALLS: 1 3, SQCTARE FOOTAGE OF ALL GLAZING. 4, °/a GLAZING AREA(#3 DNIDED By#2): SELECT PACKAGE(Q_ AA-see chart wave):' OLVED METHODS OF D G ENERGYQEMEN'CS NOTE: 'OTHER MORE INV . ARE AyAIr,ASLE.•ASK VS FOR THIS INFORMA'IIDN• i ---- IVA gtnLDING INSPECTOR APPROVAL: YES: Oar=4980303a ' t 1 . Footnoies to Table'J5.2.Ib: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skyligli5,n d basement windows if located In walls that enclose conditioned space,4nit exeludirig opaque doors) to the grn area, expressed as a percentage, Up-to 1% of the total glazing aria ma)t be excluded.fram the U-value requirement' For example;3 fi gf decorative glass may be excluded from a building design with.300 ftz of glazing = After January 1, 1999, glazing U-values'must be tested and documented by the manufacturer in accordance with the National' Fenestration Rating Council (NFRC) test proccd =, or takes-from Table 11.5.3a. U-values arc for whole units:,center-of-glass U-values cannot be used. ° The ceiling R-values do not assume a raised or oversized taus con�truetion. If the'insulation achieves the fu•11 bstituted for insulation thickness, over the exterior walls without compassion; R 30 insulation may be su cavity of insulation and R-3a insulation may be substituted•far R49 insulation.nag-e nues g t the plat d betwe n insulation plus insulating sheathing (if.used). For.veadlatcd ceilings• the conditioned space aad'tile ventilated portion of the roof. sheathing (i{used). Do not include Wall R-values represent the sum of the wall eavity InSUlatiea plus insulating exterior siding, structural sheathing, and intcriar'drywall,For example, an R-19 requimnient could be met EITHER by R-19 cavity insulation OR R-13'eavity insulation plus M insulating Sh W& �� requirements apply to wood=frame or mass (concrete,masonry,log)wall.eonstrucddas.,but do net apply to metal=franc construction. •°The floor''requirements apply to floors-over uneonditioried spacts(such as unconditioned crawispaces, basements, or garages). leers over outside air must meet the ceiling requir=e=- low grade must -rhe entire opaque portion of any individual basement wall with as average dd sliding 1 lidsa g gl=than sdcotse of conditioned me_t the same R-value requirement-as above-grade walls. Windows sa b"ements must be included ,'ith the other glazing. Basesneat doors must nicer the door V-value requirement d-scribed in Note b. ' The R-value requirements are for unheated slabs,Add an additional R?for heated slabs. ' l more if the building utilizes eletttric rtsistance heating use compliance approach 3; , r 5. If you with theto llowest than one piece-of heating equipment or.more'•than one pieta of coaling equipment, equipment e ceed the cf5ciency required by the selected package• efficiency must meet or x e ee Da re ui. mdats of the closest city or town see Table 35-7.1a. For'Hcating D g y q• NOTES: alues are minimum acceptable lev els. a) Glazing areas m and U-values are maximum, acceptable.lev eIs lati .Insuon R-v ents R-value requirements are for insulation only and de not include strurtzsal eat 035.Door U-values must be tested b) Opaque doors in the building envelope must have a U-value no � ced0Te or taken from the door U-Value and docuinewed'by the manufacturer in•accordance with the NFRC test pre in Table 11.5.3b. If a door contains glass and an aggregate U-value radag for that door is not available, include the • door with our windows and use the opaque door U-value to determine compliance of the door. area of the Y glass ar door. with door may be excluded from this regitirement'(i.e.,may have a V-value greater than 03 ) o or more areas with c) if a ceiling,wall, floor,basement wall,slab-edge,or bawl space wall component includes different insulation levels, the component complies if the at average R value is greater than or equal t- •components comply if the area-weighted U- Glazing or door comp P Y the R-value requirement for that catnponent. g . i value of all windows or doors is less than or equal to the U-value requirement(0,35 for doors)..' . •• III - 43 ,q�'OFZME To,�, Town of Barnstable Regulatory Services BA N&rABLE, ' Thomas F.Geiler,Director MASS lEv 39.E a Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: AUl'(al Estimated Cost ` Address of Work: CbNNF?S 2;:1-© c`�N?7�1Z(�r`llLt Owner's Name: ,Uq[.7`FZ It 70—N Date of Application: I hereby certify that: Registration is not required for the following F-lWork excluded by law ❑Job Under$1,000 ❑B g not owner-occupied LoOwner 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: ate C ntractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: ra%{7� number street village name home phone# Ar Aephone 772f�— 6 y� CURRENT MAILING ADDRESS: / �,�c� f���C/a�./c� �-L— /�/J�.�i-.�/� cSi 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 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 pr cedurey and requirements and that he/she will comply with said procedures a4d requiremen . 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 pernut 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 t amend and adopt such a form/certification for use in your community. O:FORMS:EXEMPTN 'f TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY : PARCEL ID 251 060 001 GEOBASE ID ADDRESS 255- CONNERS ROAD - PHONE -- -- CENTERVILLE ZIP i LOT 6 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT PERMIT 64078 DESCRIPTION SINGLE FAMILY HOME 456096 PERMIT TYPE BC00 TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of ARCHITECTS: Regulatory Services TOTAL FEES: BOND $.00 p�F CONSTRUCTION COSTS $.00 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE * BAMSTABM Mass. 039. RFD MA'S A BUIL-DINO -' ISION DATE ISSUED 09/30/2002 EXPIRATION DATE-/ 7 4 TOWN OY,BAR.N STABL . (extension granted 3/23/02) PARCEL 'I D 251 0q_ / 001 GEOBASR Ili ADDRESS 2Jt) �_1ERG ROAD, PHONE CENTER JLE ZIP - .LJOT. 3 BLOCK .. � LOT SIZE; ,..,_..._� t,BA DEVELOPMENT DISTRICT _HERMIT 56096 DESCRIPTION NEW SEH ?ERMIT TYPE BUILD' TITLE RESIDENTIAL BLDG PMT . i,QNTRACTORS:, BAYSIDE BUILDING, INC - ARCHITECTS- Department of Health, Safety RCHITECTS- PERMIT EXT•ENS ON GRANTED r and Environmental Services TOTAL FEES: _ $563� 30 BOND $.00 �Tlt� r ONSTRUCTION COSTS $147,840.00 101 SINGLE E'AM HOME DETACHED 1 PRIVATE P;, `IYT'", • * EARNSTABM + MASS. 1639. - _ 1 BUILDIN ` . ,V . ON ..,..-- . BY 65- j DATE ISSUED 09 28 2001 EXPIRATION D T DATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,/' =Y OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PEF TED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC E ERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDI INS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPR D PLANS MUST BE RETAINED ON JOB AND WHERE.,APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS D KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS I; 'J MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- I (READY TO LATH). PANC REQUIRED,SUCH BUILDING SHALL NOT BE 3.INSULATION. OCCU- UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. IIPOST THIS CARD (. s o ® e BUILDING INSPECTION APPROVALS PLUMk, '`JG INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS I I 1 ' Todd I 2, �I•T"' c� v� 2 ffJv 9IY20 .) 2 0 6�;q I / J•S � I I ° C6 0!'�'T1.j '21v 0 vzGiv�, I 3 1 HEA- INSPECTION APPROVALS ENGINEERING DEPARTMENT. 4SITELA' OF HEALTH ZOa/_2`7 I OTHER: -EVIEW APPROVAL WORK SHALL NOT PROCEED U IL PERMIT WILI 3ECOME NULL AND OID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED STRUCTION -)RK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS 0� ;:ATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABO' ?� TION. t � {�. I f I �i f ti r' r t i r I Bayside Building, Inc. P.O. Box 95 • 3 Bayberry Square • Centerville, Massachusetts 02632 Phone: 508-771-1040 FAX: 508-775-0155 January 29, 2002 Mr. Peter DeMateo Building Commisioner Town of Barnstable 367 Main Street Hyannis, Ma. 02601 Dear Sir: I am writing to request that your office extend our building permit for #255 Conners_Road,—Cent erville.. The permit, which was issued on Sept . 11, 2001, expires on March 11 2002 . We would like to exercise our option and extend the permit for 6 months through August 2, 2002 . I thank you for your anticipated cooperation in this matter. Sincerely, Brian T. Dacey Bayside Building, Inc. EXp' S . P. 5606 IQU,1,RY PERMITS : QUERY END QUERY PERMITS PENTAMATION----------------------------------------------------------- 02/04/02 PERMIT NUMBER 56096 PARCEL ID 251 060 001 . .255 CONNERS ROAD PERMIT TYPE BUILD NEW RESIDENTIAL BLDG PMT DESCRIPTION NEW SFH CONTRACTOR PERMIT FEE 538 . 30 VARIANCE STATUS A ACTIVE CONSTRUCTION TYPE 101 GROUP TYPE 1 APPLICATION 09/28/2001 EXPIRATION VALUATION 147840 . 00 DATE ISSUED 09/28/2001. COMPLETED DEPARTMENT-----STATUS---DATE-----DEPARTMENT-----STATUS---DATE---- (N) EXT/ (P) REVIOUS/ (C) ONTRACTORS/ PR(0) PERTY/ (I)NSPECTIONS/ (H) ISTORY/ (F) EES/ (A) RCHITECTS/ .(V) IOLATION/ (E)XIT This value is not among the valid possibilities 02/04/1995 23:07 918028624926 PAGE 02 Draft 8/14101 Affidavit of Substantial Financial Interest I, a R/f!x/ -7, t1C Y of �>4�s /J� 3v /N'C- , on oath depose and state as follows: located at Mal) Parcel J. I am an applicant for a building permit for the property �� �' . The address of the property is, 2. l have /0d % legal or equitable interest in the real property h 1ich above. 3.subject of the building permit application which is identified in paragraph 3. Within in the last twelve months from today's date, which is G7 5 rest In following individuals or entities have had a 1% or greater legal or equitable ante the real property which is the subject of the building permit application which is identified in paragraph 1 above: Name Address /3 /0/9el/' %- DACFEY 4. Within the last twelve months, from today's date, which Is J GT I�; OOr, I have had e following properties which have been a 1% or greater legal or equitable interest in th the subject of a building permit application: Map/Parcel Address 6A PVT&ff4,: A 5. Within this calendar year, I have submitted 3 building permit applications for property In which I have a 1% or greater legal or equitable interest. 6. Within the last ten days, I have submitted _ 0 building permit applications for property in which I have a 1% or greater legal or equitable interest. 7. Within this month, I have submitted 0 building permit applications for property in which I have a 1% legal or equitable interest. 8. Within this month, I have received 3. building permits for property in which I have a 1% legal or equitable interest. Signed under the pains and penalties of perju this ay of LT- , 200 f r� 1 2001-0050/aff n afLOTTERY/AFFIDAVIT i BAYSIDE BUILDING PERMITS OBTAINED SINCE 10/15/2000 UPDATED 10/15/2001 HOUSE # LOT # STREET TOWN MAP PARCEL 1 150 65 KILKORE DR HYANNIS 2721 193 . 023 2 8 55 STARBEAM LN HYANNIS 272 193 . 013 3 7 61 STARBEAM LN HYANNIS 272 193 . 019 4 116 74 KILKORE DR HYANNIS 272 004 . 001 5 215 54 KILKORE DR HYANNIS 272 193 . 012 6 27 72 FLOODTIDE LN HYANNIS 272 006 . 006 7 110 4 FLUME AVE M MILLS 611 010 . 004 8 50 10 ACADIA DR M MILLS 581 013 . 010 PERMITS OBTAINED SINCE 1/1/2001 1 18 29 SEAFARER LN HYANNIS 273 246 2 16 56 STARBEAM LN HYANNIS 272 193 . 014 3 140 66 KILKORE DR HYANNIS 272 193 . 024 4 26 70 FLOODTIDE LN HYANNIS 272 006 . 004 5 31 5 HARVEST LN C'VILLE 209 P of 67 6 80 1 FLUME AVE M MILLS 611 010 . 001 7 14 68 FLOODTIDE LN HYANNIS 2721 006 . 002 8 19 73 FLOODTIDE LN HYANNIS 272 006 . 007 9 22 69 FLOODTIDE LN HYANNIS 272 006 . 003 10 90 1 2 FLUME AVE M MILLS 61 010 . 002 11 102 75 KILKORE DR HYANNIS 272 010 . 008 12 161 14 FLUME AVE M MILLS 61 006 . 001 13 6 67 FLOODTIDE LN HYANNIS 272 013 . 005 14 185 12 FLUME AVE M MILLS 61 013 . 007 15 81 6 ACADIA DR M MILLS 58 193 . 015 16 47 1 4 ACADIA DR M MILLS 58 193 . 016 17 24 1 57 STARBEAM LN HYANNIS 272 013 . 012 18 27 58 STARBEAM LN HYANNIS 272 11 19 12 12 ACADIA DR M MILLS 58 013 . 009 20 240 7 CONNERS RD C'VILLE 251 013 . 004 21 70 9 ACADIA DR M MILLS 58 013 . 006 22 31 3 ACADIA DR M MILLS 58 013 . 013 23 63 5A ACADIA DR M MILLS 58 013 . 006 24 19 2 ACADIA DR M MILLS 58 010 . 011 25 255 6 CONNERS RD C'VILLE 251 P of 169 26 121 17 FLUME AVE M MILLS 61 010 . 011 27 151 15 FLUME AVE M MILLS 61 010 . 009 OC40 �- TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION , Ma ail Parcel � � i 4 v p Permit# Health Division f ®( -DZM Date Issued Conservation Division ( 1 '• Fee Tax Collector Treasur - olo -�- SEPTIC SYSTEM Planning D � PL �CE�►Dept. INSTALLr-[) IN � , WITH`f ITL.5 Date Definitive Plan Approved by Planning Board �QG Historic-OKH Preservat WVannisc ` f'J 0 ��e� `'� ` '� TOW w'GULATI.MENTAL W S Project Street Address d�J.S led Village 2001 Owner �c Address _.`_5.6_ „ Telephone °17/— CJ cl0 �/ p --------_^^^^^^.. Permit Request �� q 3 L L Ag /�L 4L- Cv�, Square feet: 1st floor: existing /�prrooposed /50 2nd floor: existing proposed Total new �5 Valuations Nang District ' Flood Plain Groundwater Overlay P Construction Type 7-q&,XLA_ Lot Size 55. ck4o6 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family I(" Two Family ❑ I Multi-Family(#units) Age of Existing Structure /yam Historic House: D Yes &*No On Old King's Highway: ❑Yes Basement Type: mull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new�_ First Floor Room Count �v Heat Type and Fuel: Ul Gas ❑Oil ❑ Electric ❑Other Central Air: M es ❑ No Fireplaces: Existing New / Existing wood/coal stove: ❑Yes W<O' Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:Cl existing ❑new size Attached garage:❑existing O new siz4443 Shed:❑existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes C(Nc If yes, site plan review# Current Use Vazo Proposed Use _ UILDER INFORMATION Name _A Ad�LC Telephone Number 771 - ®4� Address ✓ Q S // License# &4 24 3z Home Improvement Contractor# Worker's Compensation# TQ 41 Q 116411 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4,yw" SIGNATURE DATE Q�D / FOR OFFICIAL USE ONLY PERMIT_NO. ` DATE ISSUED.• -' • MAP/PARCEL NO. ADDRESS „ — VILLAGE ' OWNER r-• � �.. • ;l III DATE OF INSPECTION:. 4 ' FOUNDATION FRAME r INSULATION ' FIREPLACE . 7 ELECTRICAL: ROUGH FINAL. PLUMBING: , ROUGH FINAL GAS: ROUGH FINAL ` a FINAL BUILDING C' / 9 Z ii 2, ' DATE CLOSED'OUT .. ASSOCIATION PLAN NO. ? r' / RESIDENTIAL BUILDING PERMIT FEES APPLICATION New Buildings,Additions 50.00 Alterations/Renovations $25. Building Permit ndment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE / I t C� vx:0031= square feet x$96/sq.foot= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft.1 >120 sf-500 sf $35.00 >500 sf-750 sf 50. S� >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck �_x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) 3 Permit Fee. projcost ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq. foot= (above average constructions�Q square feet X$96/sq. foot= /���• (abo g ) (average construction) square feet X$57/sq. foot= GARAGE FINISHED b square feet X$25/sq. foot G (UNFINISHED) PORCH square feet X$20/sq. foot= " DECK a �. square feet X$15/sq. foot= 7� OTHER square feet X$??/sq. foot Total Estimated Project Value a MAScheck COMPLIANCE REPORT I v� Massachusetts Energy Code Permit # MAScheck Software Version 2.01 Checked by/Date CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 5-9-2001 DATE OF PLANS: 5/01/01 TITLE: LOT 6 CONNERS RD., CENTERVILLE PROJECT INFORMATION: WEQUAQUET PINES COMPANY INFORMATION: BAYSIDE BUILDING, INC. COMPLIANCE: PASSES ~ Required UA = 604 Your Home = 524 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 2052 30.0 0.0 72 WALLS: Wood Frame, 24" O.C. 3108 19.0 0.0 182 GLAZING: Windows or Doors 489 0.350 171 GLAZING: Skylights 54 0.450 24 DOORS 21 0.350 7 FLOORS: Over Unconditioned Space 2052 30.0 0.0 67 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit,application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in Sections 780CMR 1310 and J4.4. Builder/Designer Date 4 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 LOT 6 CONNERS RD. , CENTERVILLE DATE: 5-9-2001 Bldg. Dept. 1 Use CEILINGS: [ l 1. R-30 Comments/Location WALLS: [ ] 1. Wood Frame, 24" O.C., R-19 Comments/Location WINDOWS AND GLASS DOORS: [ ] ' 1. U-value: 0.35 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes [ ] No Comments/Location I SKYLIGHTS: [ ] I 1. U-value: 0.4.5 For skylights without labeled U-values, describe features: # Panes Frame Type Thermal Break? [ ] Yes ( ] No Comments/Location DOORS: [ ] 1. U-value: 0.35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space, R-30 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. When installed in the building envelope, recessed lighting fixtures shall meet one of the following requirements: 1. Type IC rated, manufactured with no penetrations between the inside of the recessed fixture and ceiling cavity and sealed or gasketed to prevent air leakage into the unconditioned space. 2. Type IC rated, in accordance with Standard ASTM E 283, with no more than 2.0 cfm (0.944 L/s) air movement from the the conditioned space to the ceiling cavity. The lighting fixture shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. .l 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 shall be insulated per Table J4.4.7.1. DUCT CONSTRUCTION: [ ] All accessible joints, seams, and connections of supply and return ductwork located outside conditioned space, including stud bays or joist cavities/spaces used to transport air, shall be sealed using mastic and fibrous backing tape installed according to the manufacturer's installation instructions. Mesh tape may be omitted where gaps are less than 1/8 inch. Duct tape is not permitted. 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. [ ] I SWIMMING POOLS: All heated swimming pools must have an on/off heater switch and require a cover unless over 2011 of the heating energy is from non-depletable sources. Pool pumps require a time clock. [ ] HVAC PIPING INSULATION: HVAC piping conveying fluids above 120 F or chilled fluids below 55 F must be insulated to the following levels (in.) : PIPE SIZES (in.) HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4" Low pressure/temp. 201-250 1.0 1.5 1.5 2.0 Low temperature 120-200 0.5 1.0 1.0 1.5 Steam condensate any 1.0 1.0 1.5 2.0 COOLING SYSTEMS: Chilled water or 40-55 0.5 0.5 0.75 1.0 refrigerant below 40 1.0 1.0 1.5 1.5 [ ] I CIRCULATING HOT WATER SYSTEMS: Insulate circulating hot water pipes to the following levels (in.) : PIPE SIZES (in.) NON-CIRCULATING CIRCULATING MAINS & RUNOUTS HEATED WATER TEMP (F)-: RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+" 170-180 0.5 1.0 1.5 2.0 V 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 ----NOTES TO FIELD (Building Department Use Only) ------------------------- Y �• ,.��r' �'Ir//I/........ � rr BOARD OF BUILDING REGULATIONS 1License: CONSTRUCTION SUPERVISOR A Number: CS 005645 B i rthdate: 04/19/1956 Expires: 04/19/2002 Tr.no: 18679 Restricted To:,,-00 BRIAN T DACEY _� 62 FERNBROOK LN Tit411 CENTERVILLE, MA 02632 Administrator 00-35,000 cf enclosed space (MGL C.112_S.60L) 1A-Masonry only I-1 R 2 Farnily Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DIG SAFE CALL CENTER: (888)344-7233 1 ' I� K _ F COMMONNVEALT E M I OF ASSACIIUSETTS -- `— DErAFC17viENT OF INDUSTRIAL ACCIDFNTS 600 WASHINGTON STREET ames Camzceu BOSTON, MASSACHUSETTS 02111 :,-or---n:ss,cne• WORKERS' CONvfPLENSATION INSURANCE AFFIDAVIT (lice nsee/permirtcc) With a principal place of business/residcncc ac (City/Sntc/Zip) do hereby certify, under the pains and pcnaltics of perjury, dur: Iq 1 2M an employe: providing tic following--workers' compcns:;ion covcragc for my employees working on this job. 4100Q71162A/ ZNs 0 tiY. TC l `1 Insurance Company Policy Number [ ] I am a sole proprietor and havc no onc working for me. [ ] 1 am a sole proprieror, general contractor or homeowner (circle onc) and havc hired the contrctors listed bee« who havc the following workers' compensation insurance polio Narnc of Conmctor Insurancc Company/Policy Nutnbc: Name of Contractor lnsunnce Company/Policy Numbe: Mme of ContmcTor Insunncc Cornpany/Policy Nurnbc: [] 1 am a homcownc. performing all tic work myself. NOTE Pleuc be aware that while homeowners who employ persons to do maintenance,construction or repair work on d.v c:Iing of not more tba-a three units in wbich•.the homeowner also resides or on the grounds appurunant thereto arc not geoeml}• considered to be em.plove;s under the Workers` Compensation fir,(GL C 152,sect- 10)), application by a homeowner for : liceesc or permit may evidence the legal tutus of an empl6ytr'uoder the Workers'Compensation Act- 1 unde:-sund that a copy of this statement will 6e forwarded to the Depar-,mcr::of Industrial Accidents' Office of Insurance for cove.q- veriiic::ion and th:t failure to secure enve:-age as required undo Section 25A of MGL 152 can lead to the imposition of criminal consisting of a fine of up to S1 500.00 and/or imprisonment of up to one ye::rtd civil pcnaltics in the form of a Stop Work Order r.--: firs of 5100.00 a d:v a€gins: me. Signcd this day of , 19 , 13X IJAI � / �- Licc scc'Pcrmiricr Lic::rsor/Pcrrniuor SUBCONTRACTOR' S INSURANCE BAYSIDE BUILDINNG: (L)- ZURICH - SCPM31195788 (W) NORTHERN INS N.Y. - TC1 91911041 ENGINEEER: BAXTER & NYE ENG: (L)., KEMPER - 7CQ27676000 (W) EVANSTON INS - AE802232 WELLER & ASSOC: (L) NAT' L GRANGE MUT. - MSP45246 LAND CLEARING: PETER GOVONI : (L) CNA INS CO - C179997230 (W) CNA INS CO - WC179997244 EXCAVATION & SEPTIC: ROBERT J. OUR (L) U S F & G - 1MP30109550901 (W) U S F & G - 771521695 NORTHERN SEALCOAT (L) TRAVELERS - 660364K8342 (W) LIBERTY MUTUAL - 312446298044 FOUNDATION: GARDNER CONCRETE FORMS : (L) ST. PAUL - BFS00000169269 (W) ST. PAUL - 7717171998 WELLS : DENNIS SCANNELL (L) TRAVELERS - 660873E5627COF92 (W) WAUSAU - 151300062926 CELLAR/GARAGE FLOORS : MASON WORKS : (L) TRAVELERS - 1680204Y4465TCT FRAMERS : ROBERT DORRER: (L) TRAVELERS - 680526K991A (W) ST. PAUL FIRE &MARINE INS CO. - 6S16UB-510X322-3-99 MIKE DUFFLEY: (L) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 DAVID HILL: (L`) COMMERCIAL UNION - NBF821356 (W) LIBERTY MUTUAL - WC1312492127024 MASON: SHERMAN, WAYNE: (L) COMMERCE INS CO - N60689 (W) WAUSAU INS - TO BE ASSIGNED FERNANDES WAYNE : (L)' HINGHAM MUTUAL - ART9800896 DANNY TORTORA: (L) ZURICH - SCP. 31874051 (W) WAUSAU INS - TO BE ASSIGNED f Y yu GAS PIPING: BAYSTATE PIPING: (L) CRUM & FORSTER - 5031766863 (W) CRUM & FORSTER - 4086081999 ELECTRICIAN: CHAVES ELECTRIC: (L) MISC. INS . - ZDN5245913 (W) MISCELLANEOUS INS CO. - WCP0006299 AMES ELECTRIC: (L) NORTHERN INS . - NBF418165 (W) AMERICAN EMPLOYERS- QBH2O8297 BAYSIDE ELECTRIC : (L) ST PAUL INS. - BFS00000400422 (W) EASTERN CASUALTY - WC98695063 PLUMB & HEAT: WHITELY PLUMBING: (W TRAVELERS - 660365K1782COF9 (W).. EASTERN CASUALTY - POLICY IN MAIL ALARM SYSTEM: BALTIC SECURITY: L ' HANOVER INS - PAC105393 (W) WORKERS RISK - WCS-80414040 INTERCITY ALARM: (L) FIRST FINANCIAL - FF0131 G400831 (W� COMMERCIAL UNION - CB0743379 CENTRAL VAC: VACUUM HOUSE: MERRIMACK MUTUAL - SBP1608045 INSULATION: MAP INSULATION:- (L) AMERICAN STATES - 02CC326435-3 (W) U S F & G - 7711099932 SHEETROCK: MEL REED: (L) WORCESTER INS - CB817530 (W) COMMERCIAL UNION - CBH557387 INTERIOR TRIM: DAVID' S REMODELING: (L) CGU - NBFB40738 M & R CARPENTRY (L) MARYLAND INS . GRP- SCP30235965 (W) CIGNA PROP & CAS. - .C80049997 K FITZPARRICK: (L) MARYLAND INS . GRP- SCP30235965 (W) CIGNA PROP & CAS . - C80049997 OAK INSTALLER: ROBERT BUDDEN: (L) COMMERCIAL UNION - NBF824090 (W) LEGION INS . - WC30024039 PAINTING: CAMPBELL PAINTING: (L) TRAVELERS - 1680251K4083COF (W) ASSOC INDUSTRIES OF MA. MUTUAL - AWC 7000126-01-99 GARAGE DOORS: ALL CAPE GARAGE DOOR.: (L) U S F & G - BFS000000348188 ° (W) TRAVELERS INS CO - 1810336H8138T1A99 STORMS & GUTTERS: ALUMINUM PRODUCTS : (L) CNA INSURANCE - 1074079839 (W) CNA INSURANCE - WCC174080411 OAK FINISHER: AMERICAN FLOORS: (W) EASTERN CASUALTY - WCV3001745 CARPET, VINYL & TILE: CARPET BARN: (L) TRAVELERS - 1680625Y1691TILOOS (W) MA. RETAIL MERCHANTS - 8100-06 TILE INSTALLER: TONY AVERINOS: (L) ASSURRANCE CO. - CFP26528977 (W) HARTFORD FIRE - 77WZCY2409 WIRE SHELVING: CAPE COD CLOSETS : (L) ARBELLA - NBF8410782 (W) TRAVELERS - 7PJUB-521X529-4-99 APPLIANCES: KITCHEN APPL MART: (L) FIREMENS FUND - AZC80453098 (W) HARTFORD INS CO - 77WZNB1603 MIRRORS & SHOWER DOORS : L & M GLASS : (L) COMMERCIAL UNION - CBR409003 (W) U S F & G - 0071439933 LANDSCAPE & SPRINKLER: COY' S BROOK: (L) TRAVELERS 6880937DO453 (W) RENNAISSANCE INS - TBD DRIVEWAYS : NORTHERN SEALCOAT: (L) MARYLAND CASUALTY- EPA18716945 (W) THE PHOENIX - UB387K530 SUSPENDED CEILINGS: ATC CEILINGS : (L) TRUST INS CO - TMP1005666 (W) SAVERS PROPERTY - WC0000873 RUBBER ROOFS: CAZEAULT CO. (L) AMERICAN EQUITY - ACC 060106R-1 SIDEWALLER: STEPHEN CRESSWELL: (L) MARYLAND INS - SCP29031342 .3 8K 12813 P0330 Quitclaim Deed I,Ruth F.Hallett of Centerville,Barnstable County,MA, for consideration of Four Hundred Seventy Thousand and 00/100 (470,000.00)Dollars paid grants to Brian T.Dacey Trustee of Wequaquet Heights Development Trust,u/d/t dated a boo recorded with Barnstable Deeds in Book I li 3 Page;3a of P.O. Box 95, Centerville,Na 01632, ,with Quitclaim covenants, the land in Centerville, Barnstable County,MA shown as Lots 2,3,4,5, 6 and 7 on the Plan entitled "Plan of F Land at Conners Road-Phinney's Lane, Centerville, MA, for Mrs. James Hallett" dated September 27, 1999, recorded with Barnstable County Registry of Deeds in Plan Book 552, Page 92. Subject to easements, restrictions and reservations of record. Additionally,Lots 5 and 6 are subject to the access restriction noted on said Plan. For title,reference is made to Deed from Connors dated November 1, 1963 and recorded with Barnstable County Registry of Deeds Book 1225,Page 9;-13eed 49 , 1994, H46�YLr Deeds from William C. Lam, Jr. dated.November 6, 1954, and recorded Ft4btr�.r . with Barnstable Deeds Book 890,Page.313; and Deed from William,Maq�m dated November 6, 1954 and recorded with Barnstable Deeds Book 890,Page 312, and Estate of James Hallett, Barnstable Probate No. 93P 1145 El. WITNESS my hand and seal this 19 day of January,2000. aRi F. Hallett STATE OF FLORIDA WRoW (�t� SS Januarylq,2000 Then personally appeared Ruth F.Hallett and acknowledged the foregoing instrument to be her free act and deed,before in Notary Public My commission expires: 10 1'3 OFFICIAL NOTARY SEAL Joan/Hallett deed.doc BRUCE SESLOWNOTARY PUBLIC STATE OF FLORIDA COMMISSION NO.CC592913 vtV c �.+ntrSaON EYP.OCT.11,2000 TONN'N OF BARN-STABLE FIRE DISTRICTS PERMITTING PROCEDURE FOR HOUSEHOLD FIRE WARNING SYSTEMS IN ONE AND TWO FAMILY DWELLINGS PRIOR TO BEGINNING INSTALLATION, THE ELECTRICIAN OR FIRE ALARM INSTALLER MUST BRING TWO SETS OF FLOOR PLANS REVIEWED AND STAMPED BY THE BUILDING DEPARTMENT TO THE APPROPRIATE FIRE DISTRICT LISTED BELOW FOR REVIEW AND PERINiITTING BARNSTABLE FIRE DEPARTMENT 3246 Main Street (Route bA) Barnstable 508-362-3 312 CENTERVILLE-OSTERVILLE-MARSTONS MIILS FIRE DEPARTMENT 1875 Route 28, Centerville 508-790-2380 COTUIT FIRE DEPARnIENT 64 High Street, Cotuit 508-428-2210 HYANNIS FIRE DEPARTMENT 95 High School.Road Extension, Hyannis 508-775-1301 WEST BAR.'VSTABLE FIRE DEPARTMENT 2160 Route 149, West Barnstable 508-362-3241 PLAN REVIEW AND PERMITTING TIMES ARE MONDAY- FRIIDAY SAM TO 9:30AM UNLESS OTHER ARRANGEMENTS HAVE BEEN MADE IN ADVANCE WITH A DEPARTMENT. 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Plan Book 552 Page 92 812 Main Street Deed Reference: Ostervilfe, MA, 02655 Phone - (508) 428-9131 Fax - (508)-428-3750 Owner Boyside Builders Job Number 99-125-6 Scale: i" = 50' Date: 05-10-2002 z w c.� z J O Z ' W r Z w I— I Q C11 r m O ro co p X N V m LOT 3 in 000 LOT 4 m � (NOT CONSTRUCTED) �,�,�. E 20'—ROADWAY m a 314.73' m N m O �,J' 6�JJT 7! a u-► h u m a0 Ir9 55,966 S. F. t ±' LOT 5 •p. 1.28 Acres t ;ehope la 15.4 all �S N o i j. C1 ; a4l Av133,44, >r~►4 e1' Ra-1249.71' S 3V27W W PRNEY 5 1ANE 4. I CERTIFY 'THAT Jo THE BEST OF MY KNOWLEDGE THE FOUNDATION SHOWN HEREON IS �ytN Of � IN COMPLIANCE WITH THE APPLICABLE BARNSTABLE ZONING DISTRICT SIDELINE AND SETBACK REQUIREMENTS, IS LOCATED IN RELATION -TO THE MONUMENTS SHOWN, AND 1F^ IS NOT LOCATED WITHIN A SPECIAL. FLOOD HAZARD AREA o N 02 GI 1` u�ipp ( AL LAND_ U 0 DAT�— m Foundation Certification in Centerville Ma . Ld ere pared For BQyside Builders Q Assessor's Mop : Mop 251 Parcel 60-? �. Lot: 6 Baxter, Nye & Hdmgren, Inc. Community Panel Number 250001 0005 C Regislered Professional R.R.M. Map Zone: Zone C Engineers and Land Surveyors ' Plan Reference .Plan Book 552 Page 92 872 Main Street Deed Reference: Osterv;lle, MA, 02655 Phone - (508) 428-9131 Fox - (508)-428-3750 Owner Boyside Builders Job Number 99-125-6 Scale: 1" 50' Dale: 05-10-2002 z w O z oa w z w I- x 4 W m � L0 . r- y M 01) X N m LOT 3 in 4000 LO 4 N .. (NOT CONSTRUCTED) p 3T3o,2s' E 20'-ROADWAY N a 314.7s' m m _ lvN m LOT 7 u) ap IV - a 3a 55,966 S. F. f aLOT 5, TO 1.28 Acres t _ _ .. .,...- �- ---"�'^.-.--�-,�y � _ .� _ _ . �.c._ m��.. �� _ T _ Shan .1� .I�.r:=. 1 o A.R. �,,a-r, � � - _---•- - �..._ . �S N 1 I I&W 13Z.41 C2 1 1 v A•133.44, R•1269.71' s 3ir27W 1V PHINNEY'S LANE ............. I CERTIFY THAT TO THE BEST OF MY KNOWLEDGE THE FOUNDATION SHOWN HEREON IS tM Of A6 IN COMPLIANCE WITH THE APPLICABLE BARNSTABLE ZONING DISTRICT SIDELINE AND 4 �y SETBACK REQUIREMENTS, IS LOCATED IN RELATION TO THE MONUMENTS SHOWN, AND IS NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD AREA o U S - Io-orL. LAM GI ( NAL LAND U V OR DAff — r 95- - - -- :. .: ..._.,_ EXISTING LEGEND PROPOSED LOT NOTES ZONES Design Schedule ELEVATION Leaching Area Requirements ----------- - ----- -p Edge of Pavement, • - 0' ALLOWA 70P OF FOUNDATION 71. 8LE DAILY FLOW ON THIS LOT ZONING DISTRICT RD-1 3 BEDROOMS AT 110 GPD/BEDROOM = 330 GPD Sewer Pipe 330 GPD/AC X 1.25 AC = 412 GPD FINISHED BASEMENT FLOOR 63.3' __...._. � _._. __....__.._.. Water Pipe w - ZONING DISTRICT GP , FINISHED GARAGE FLOOR 70.0, ADDITIONAL 50% FOR GARBAGE DISPOSAL N.A. Leach Pit O MINIMUMS SEWER INVERT AT FOUNDATION 67.9, wEQUAcwET s�'LOCUSAREA = 43 560 S,F. SEWER INVERT INTO SEPTIC TANK 67.7 PERC RATE 2 /1 MIN. / INCH (CLASS 1 ) c,; Catch Basins Q FRONTAGE = 20 s p Seti Tank LAKE J o r,,E O O SEWER INVERT OUT OF SEPTIC TANK 67.4 WIDTH = 125 LIAR 0.74 GPD/S.F. Distribution Box o SEWER INVERT INTO DISTRIBUTION BOX 67.2' z FRONT SETBACK = 30 Water Gate N SEWER INVERT OUT OF DISTRIBUTION BOX 67.0' MIN. LEACHING AREA OF S.A.S. �P Light Pole SIDE SETBACKS = 10 SEINER INVERT INTO LEACHING SYSTEM 66.8' Utility Pole -�- REAR SETBACK = 10' BOTTOM OF LEACHING SYSTEM 64.8' 330 GPD/ 0.74 GPD/S.F. = 446 S.F. MIN. u E 2 s r _ ' J_...._..- Contours 200 Spot Grade 200.o WATER TABLE WEST TP Test Pit PROPOSED SYSTEM SIDEWALL (12+26)(2)(2) = 152 S.F. N LONG POND/ ST BOTTOM 12' X 26' = 312 S.F. �FFT TOTAL = 464 S.F. LOCATION MAP HYANNIS QUADRANGLE SCALE: 1:2597000 ASSESSORS GENERAL NOTES : MAP 251 PARCELS 60 ALL SYSTEM COMPONENTS SHALL BE INSTALLED IN ACCORDANCE WITH TITLE V OF THE STATE SANITARY CODE DATED MARCH 31, 1995 & ANY LOCAL RULES APPLICABLE. i-1.5" WASHED STONE ANY BY THE CHANGE T THIS ENGINEER.PLAN UST BE APPROVED IN WRITING DES' 12 �. ETED, PRIOR TO BACKFILLING,WHEN CONSTRUCTION IS COMPL 2ui.55 ,-� -- NOTIFY THE ENGINEER & BOARD OF HEALTH AGENT L=20.76 �,, __.._ Y -� `--- L ,..( r �26' FOR INSPECTION. R=15.00' l 20 - FOOT -•► � r 9 N 3 5" E PLAN OF LEACH CHAMBERS FOUNDATION ELEVATION MUST BE CHECKED WHEN COMPLETED. C LEN=19.13' I _ 60 o � o 314.76 i BRG=N b2'06'55 '" W z z / w..,...... NO SCALE w THESE ELEVATIONS MUST NOT BE CHANGED WITHOUT WRITTEN i PROPOSED PROPOSED' APPROVAL BY THE DESIGNING ENGINEER. I , DRIVEWAY GARAGE z ti ALL SANITARY DISPOSAL SYSTEM PIPING TO BE 4" PVC. 20' MIN FINISHED GRADE r 10'MIN PROPOSED `` $5.1 " „� HOUSE w \ \\j\\j\\j\\j\\j\j\ \\j\\j\\j\j\\j COMPACTED FILL EXCAVATE AND REPLACE ALL UNSUITABLE MATERIAL SURROUNDING - r - x ( i 36 MAX.- 12 MIN. // // // // // // o // // // // // /j//\/ SURROUNDING THE LEACHING FIELD FOR A DISTANCE OF 5 mTP#1 ° LOT 6 ' t . \\ \\ \\ \\ \\ \\ \\ \ !- t 2-: �_..,_.._ J .............4........ P T NE PER 310 CMR 15.255. m o �w i " 4 • ° .: . •'.' 3/4" TO 1 1/2 " ` / w w w U 55,966 S. ,r> t wLOT 30.5 O' •. ' • .Q . DOUBLE PRIMARY BENCHMARK N.G.V.D. 1 2 8 A c r4s f N PROJECT BENCHMARK SEE PLAN i • WASHED STONE �' I_=78.28' ° . shape\``f � o _ 19.48 U! LOCATION OF UNDERGROUND UTILITIES ARE APPROXIMATE AND C LEN=77.50' __.. __ `�.. •:,fi``rY SHOULD BE VERIFIED IN THE FIELD BY THE APPROPRIATE eRG=s 2T43'16" E `. i `--____.--- w `. � SECTION UTILITY COMPANY PRIOR r0 ANY CONSTRUCTION. "•. r NO SCALE � v , 1. BOUNDARY INFORMATION FROM PLAN TITLED R=15.o0' �, "PLAIN OF-LAND AT _000NORS `ROAD -PHINNEY'S LANE - - / j =t23'48'S5" �'� ;. CENTERVILLE, MASS. FOR MRS. JAMES HALLET° C LEN=26.47' °s `,., BY BAXTER & NYE, INC. DATED SEPTEMBER 27, 1999. BRG=N 75'36'45" W T2 54.6 \ t.e S 36°27'30" W cRB FND 3 51 .5 6 TD - LEACH SYSTEM vvrrH INa.TRATOR nEsicx /DH TOPOGRAPHIC2. E ON G.I.S. 'Q` FROM HE TOWN OF BARNS?BEES D L PIPES r0 BE SCHEDULE 40- PVC _ -- - USE 1 - 4" DISTRIBUTION LINE IN 3 RECHARGER UNITS - - - - - - -- - - - - = - - -- -- -` 71.5 IN A 12'X 26' WASHED STONE TRENCH AS SHOWN -z- PHINNEY'S LANE N TEFHEN G -� CID ., ` �, � N�o.30216 SS�ON,AL CERTIFY r0 THE BEST OF MY KNOWLEDGE THAT THE PROPOSED FOUNDATION SHOW 7 OI Septic Design IN COMPLIANCE WITH LOCAL ZONING BY-LAWS (WITH RESPECT TO SETBACK REQUIREMENTS ONLY) AND DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD AREA. LOT 6, CONNORS ROAD SCALE: "= 30' CENTERVILLE MASSACHUSETTS 0' 30 60' 90' THIS P IS NOT TO BE RECORDED OR USED TO ESTABLISH PROPERTY LINES. � S - I"7 -� 'o c' ► PREPARED FOR EGISTERED ROFESSIONAL LAND SURVEYOR DATE BAYSIDE BUILDERS TITLE SANITARY DISPOSAL SYSTEM TYPICAL SYSTEM PROFILE JX HOLMGREN &ASSOCIATES INC. SOIL LOGS P-9599 DATE:1118199 9:OOAM NOT TO SCALE ENGINEER : BOARD OF�ALTH DENT Proposed CONSTRUCT ACCESS Stephen A. Willson,P.E. Edward Barry, i ar!><s. .>lealth Dept. BAXTER, NYE & HOLMGREN INC. Top of MANHOLE OVER INLET WI TANK To AT LEAST TEST PIT 1 TEST PIT 2 TEST PIT 3 Registered Professional Foundation = 71.0' WITHIN 6" FINISH GRADE ' / • FINISHED GRADE OVER TANK = 70't G.S.E. =71.3 G.S.E. = 69.8 - G.!S.E. _ FINISHED GRADE OVER D. BOX = 70'f Engineers and Land Surveyors " FINISHED GRADE OVER LEACHING TRENCH = 70'f 812 Main Street, Osterville, Ma. 02655 3 A SANDY LOAM 4 A SANDY LOAM 4" scH. 40 PVC FIRST z' (To BE LEVEL) " IOYR 4 4 Phone = 508 428-9131 Fax - 508 428-3750 6 10YR 4/6 10 TYPICAL) min.. 4' SCH. 40 PVC 12" (min) Cover B B ` 6"(min.) . . PVC or OL2' (min} 36" (max) Cover ! Proposed �o" Cl tees GAS BAFFLE s"gum 4" SC .40 PVC _ SAND LOAMSANDY LOAM SANDY Finished v 1OYR 7/2 1OYR 5/6 Basement 2"Layer 1/8"to1/2" " " 2$ 24 Floor = 63.3' Peastone LEACHING CHAMBERS C1 Slope = 0,005 (min ) C i MEDIUM-FINE Reinforced Concrete 6" CRUSHED MEDIUM E FOOTING STONE BASE SAND SAND 4" PVC O • O O O • O co 70" "2.5YR 7/2 60 . 1 oYR 6/6 DATE: 0111012000 O O O • O O O O O O O 0101 O O O O O O O O C2 SAND, GRAVEL C2 SAND, GRAVEL & COBBLES & COBBLES REV. DATE: REMARKS BOTTOM ELEV. = 64.8' 132" 1OYR 5/6 120" 7.5YR 5/8 / S•�7•oi ?��sc hlevrc <k. NO WATER ENCOUNTERED Cal 1500 GALLON SEPTIC TANK DISTRIBUTION BOX 5' PERC © 50" TO BE INSTALLED ON A LEVEL STABLE BASE TO BE INSTALLED ON A LEVEL STABLE BASE RATE= >2 MIN/IN DRAWING NUMBER SEPTIC TANK TO BE INSPECTED do CLEANED ANNUALLY _ - No Groundwater at Elevation 59.8' f', LEACHING SYSTEM HADrawings on 'Ho1mgren2_nt'\ 1997\97012\ 97012CSP-4A w