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HomeMy WebLinkAbout0016 COVE ROAD a �F � e , o 6 m e I �s r— FSHE ip� Town of Barnstable *Permit#s9_�G Z S qo Expires 6 n it s fr is e-dnte Regulatory Services Fee ' snxtvsTnsr.r:, c w '�va 0$ Thomas F.Geiler,Director �A , TFD N1A A-"• Building Division 3.2009 Tom Perry,CBO, Building Commissioner TOWN OF g 200 Main Street,Hyannis,MA 02601 A www.town.barnstable.ma.us. Office: 508-86-038 ABL� Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Reif X-Press Imprint Map/parcel Number fV� Property Address 1 La C,C7Jr; 40, Residential Value of Work i SGG•O o Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address C AA A03 Contractor's Name IZ.�PoafC.S . �- MO w�! Telephone Number DID 424 - GI OV Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Gs 16 1-7%4 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor. ❑ I am the Homeowner ® I have Worker's Compensation Insurance Insurance Company Name 24CIAMl6%_jtba I.JS pk6ii C ►JC Workman's Comp.Policy# G I R - OO — d Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ® Re-roof(stripping old shingles).All construction debris wilh be taken to t?4kA r*1S`-A�At.Tc ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U-Value (maximum-.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License.is required. SIGNATURE: C-\Users\decollikWppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\MY7NB41L\EXPRESS.doc Revised 100608 Board of Building Regulations an' d Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Construction Supervisor License License CS: 16174 Restriction: 00 Expiration: . 5/7/2010 TO 23727 CHARLES D ROGERS �� r ► ---- ----�__ PO BOX 310 �•.� �A�1+;L OSTERVILLE, MA 02655 !.' l` �) Update.Address and return card. Mark reason for Change. r . OPS•GA1 ai $0M-01/07-PG9490 I`J Addl'CSS l iZCnC11':Ii ! .i Los( Caryl ; . ��7ao�„mo�uueal!/ o�://�aaecu,/cuee!!d Board of Building Regulations and Standards _ I ConstructioV Supervisor Ucense Licet7Seti CS' 16174 tEplrtlQj� 2g I O Tr# 23727 r n fl ee �t'o . 091 p I J CHARLES D ROGER PO E30X 310 •' ,, OSTERVILLE,MA 02655 Commissioner j Hnartor'AaIS, "'"OS� Town of Barnstable is Regulatory Services Thomas T.Geiler,Director B10ding Division Thomas Perry,CIRO Building Commissioner 200 Main Street., IdyanniS,MA 02601 www.kowlr.ba Meta ble.rrt a.us Office: 508-862- 038 Fax: 508-790-6230 Property Owner Must C 1mplete and Sign This Section If Using A Builder 1, GVen rd Sm ,as Owner of tlu subject ptopaty bel el,y nuthorvc `� c "�' / ►`�rh to let on 1,ny beh."U, 1 in ill mattW relative t work uthori ed by this building li snit apphcatioti for. JJ . (nddi fJI) re of Owner Date I�rinr Katnc IP roperty owner is.,ipillyinp f r perm t,pleftstcompIdtatlic ljomcowncrs License Exemption Forts od the rverse side, C;�?aennQccnlliklAppDntnlLe� IMietose �WInQa 1TcrPntgry lnlcmc[t'i1gslCr+n�cnk0udnnklMY�Np4l1,1EXrRFSS,dna Revised 10008 'd HU 'ON 85OHOL l9 Md l :z 60H 'E[ 'IF 677-7 4 Board of B.wilding Regula ons an �tandar s One Ashburton,Place Room 1301 Boston.-Massa husetts 02108 Home Inlprovementi Contractor*Registration :.� ,.�. Registration: 100134 Type:. Private Corporation ROGER 'r + Expiration 6/9/2010 TrN =267877. Sm& MARNEY INC. Charles Rogers " P:O BOX Oster vi le,:M'A`02655 ,.,Update Address`and return card Mark i e soil Vfoi change y PS-CAI ai SOM-07/07-PC8490• [ Address 0 Rcncryal� I�rLroployiucut Lost C' d�.. f- Board of Building Regulations and Standards License or registration valid for ilidividul use only HOME IMPROVEMENT CONTRACTOR before the in iration date. if found return to: Registration: 100.134 Board of Buildiug Regulations aril Standards i Expiration: 679/2010 Tr# 267877 One-Ashburton.Place 1301 I l ' Type• Prlvale.Corporation Boston, 'Ma.02108' i "ROGERS'&MARNEY INC, f' . � Charles Rogers . L i 445 WEST BARNSTABLE ROAl7 ,4,,,Q L Osterville,MA 02655 Administrator Not valid without A at' 03/12/2009 14:37 5083932273 NORTHWOOD INSURANCE PAGE 01 �7 - OATS IMMIDDIYYW) AORiD CERTIFICATE OF LIABILITY INSURANCE ROGER ID �1 03 12 09 D G THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION -ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Northwood ins. Ageacy, inc• HOLDER-THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 540 14ain Street, Suite 9 Hyannis MA 02601 INSURERS AFFORDING COVERAGE NAIC Phone: 508-771-1632 Eax:508-393--2955 INSURED INSURER A: AMERICAN INTERNATIONAL ' INSURER 8: Cantor Caaaalty Lnsaranw Co. - INSURER C' Rph�ers S Marney, Ina INSURER D: p.0. Box 310 OBtervillg MA 02655 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENY,TERM OR CONDITION OF ANY CONTRACT OR 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - POLICY NUMBER DATE MMID DATE LTR TYPEOPBIBURANCIS 000 000 - EACH OCCURRENCE f$1 r oiNERAL LUMLm rwum f$50 000 8 X COMMERCIAL GENERAL LIABILITY CC10395621 03/20/08 03/20/09 PREMISES Ea one person) CLAIMS MADE 7 OCCUR ... MEO ExP(any one DersOn) f $5 Q00 'CC20395621 03/20/09 03/20/10 PERSONALSADVINJURY f$1 0001000 GENERAL AGGREGATE $,$2 000,000 PRODUCTS-COMPIOPAGO S$2 000,000 GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JERCT tOC At170M081LE LIABILITY COMBINED SINGLE LIMIT f ANY AUTO — ALL OWNED ALTOS BODILY INJURY, f - (Pe(person) SCHEDULED AUTOS HIRED AUTOS - - BODILY INJURY f (Pe(vWclent) NON-OWNED AUTOS - - PROPERTY DAMAGE f (Par eadd6nt) AUTO ONLY-EA ACCIDENT i GARAGE UADWITY EA ACC 6 ANYAUTO - OTHER THAN . AUTO ONLY: AGG f- EACH OCCURRENCE f PXCENIUNERELJA UAtMLITY AGGREGATE f OCCUR El CLAIMS MADE - f --EDEDUCTIBLE f RETENTION - f . - - '. X TORv LIMITS I:R WORKERS COMPENSATION AND A EIPLOYERS'UAWLIT(, WC176-00-17 01/01/09 - 01/01/10. E.L EACH ACCIDENT $0500 000 -. ANY PROPRIETORfPARTNERIEXECUTIVE - E.L.DISEASE-EA EMPLOYEE f$500 000 OFFICERIMEMSER EXCLUDED? if yes,dasciDe 0401 E.L.015EA6E-POLICY LIMIT S$500 �00 - SPECIAL PROVISIONS halew OTHER DESCRIPTION OF OPERATIONS I LOCATK)NO I Vl4ICL.0I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVIB(ONS CERTIFICATE HOLDER CANCELLATIONA OF THE AE OVE DESCRISEO POLICI $pJRNSTA ES.EE CANCELLED SEROR!THE EXPIRA DATE THEREOP,THE ISSUING INSURER WILL ENDEAVOR TO AWL DAYS WRIT7CN k NOTICE Yo THE CERTIFICATE MOLDER NAMED TO THE LEFT,BUT FAILURE TO DO 60 SHALL Town Of Barn-stable IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIRo UPON THE wSURER,ITS AGENTS OR 367 Main Stm-"t REPRESENTATIVES. Hyannis MA 02601 AUTH RE SE7 �+v5s C-� 0 ACORD CORPORATION 1988 ACORD 25(21)01108) i Assessor's office(1st Floor): i Assessor's map and lot numb T number :' o�THE7>o`. Coervation(ath Floor): '\ .� :13tY1A*I°k9: SEPTIC SYSTEM MUST�� Board of Health(3rd floor): r INSTALLEDIN COMPL6ANC c c / t ssa13T►nct Sewage Permit number g -1 - ✓ �(� H . Engineering Department(3rd floor); oesr House number :�/nf� LSD Definitive Plan Approved by Planning Board -.Y b'_� APPLICATIONS PROCESSED.8:30;9:30 A.M.'and 1`.00-2-00 P.M.only , } r � r TOWN ' OF BARN-STABLE 'BUILDING INSPE.CTOR APPLICATION FOR PERMIT TO t.7 u 1 A V, /y A'/Z At0, 70eU i o 01n6- i TYPE OF CONSTRUCTION Z4�a©b re Fgmra, }_FoorE 2 , TM/U > r" /Q Z© tg TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Z& Alt *A,17- Proposed Use Focfj-:-fL Zoning District Fire District Name of Owner 319EC-Al JF2 00 yp Address /Co COr/r= Q;fl, E n-r-2Y/4C e Name of Builder f l3r11 ILi,;006� Address c,7/ 6,60(Z6&7s/U 4.4.)b, S, V#9r-M.0Wrh/ Name of Architect Address Number of Rooms Foundation P0141z t`b co>t1C�� Exterior 14i4/Tr. C r-b4Q- Roofing IJSPH1914Lr sMiwvo-i � Floors Interior � o� Heating Maw s r� Plumbing W'151EEy- Fireplace Approximate Cost �/J zO© Area D SQ F Diagram of Lot and Building with Dimensions Fee 'A r7 D'i�i Y7 C♦�v �� Co. 1� lip `1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above. onstruction. Name Construction Supervisor's License 0/0 "7/x BOYD, BEECHER No 36720 Permit For ADD TO DWELLING Location 16 Cove Rd. Centerville , Owner. Beecher Boyd Type of Construction ? r , Plot � Lot Permit Granted May 23 19 94 Y Date of Inspection: Frame 19 Insulation 19� - � Fireplace 191 Date`Completed 19 ? r t r I' I EK�STNCr HOIti1l: - 2Ui GT. _ I ,p?SPN�'p �CI.`vil¢S� qPD 1�"IOIV EXISTING FLL i I L 1 I no 6o V E R D N-C2 vIL c� p fi4P irevvi rtv ZG I v • � � / V '�y GRRIZ'/INV �GRI//'1 1,�0~ peyca.. �(o Coves Q� CE/Vy E�V 19DD ITjBn) IaJ F� r6a Rb 4 i2a revvz wkac.,, wr+S/ 2 a� f5xis i S, 70 C� ti 1/16, VO AM" 5.0 ; 7 -_rn�s 'Zit ti ,t�a,��.,• Zk �' 2A F4'FRS V4wJT �— aAcLr T iLltitii _ . r ,� Ea1CISTINlr , ,r o e. k is O�cfa L N aw qo o" ow a' a /N 4 N - aatb ib' a/c- - GgOv.ti1 t-r- Iw.Npv�a Ir RY IJTIN G. �C l�ro 70K2ttD CEme.a4- �I.octL c.or,c�t�t-r —� COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY g� OF I ONE ASHBORTON PLACE dsacA.avnofolf.o ref! s ±jo ®lacaacagorr�grgA!i"" jT, MASSACHUSETfS 60SiON,MA IJ2108 cfthiaflce+rtr�_ i_ T E N S E CAUTION EXPIRATION DATE Co v 5 T R. SLIPERVISOP s F' rT EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB 'J 0 N F: 1: `•� f?6/3 0 hl ')n 3 910714 ¢ PRINT IN APPROPRIATE BOX ON LICENSE. tiEM`JE,TH F COWGILL ?'1 G F O R G T O W`1 L a •"�D I F{G BLASTING OPERATORS SS P' 02'a—.34-8550 A ziA S RIV77R FA t:2664 z MUST INCLUDE PHOTO. PHOTO)BLASTMI(?OPR ONLY) FEE; - 1 ),) • L�(� I NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER DOB: ol - THIS DOCUMENT MUST BE « SIGN NAME IN FULL ABOVB91GNATUPE LInIE la �i'{ .CARRIED ON THE PERSON OF SIB TURF OF LICENSEE. i/'• K; THE HOLDER.WHEN EN- OTHERSI �IGHT THUMB PRINT- GAGED IN THIS OCCUPATION NER i.� �\ ✓�o �onrnu',rwra�/�n/ /�na.;nc�u.lr��fi l.-y. {;71E Ii'p40ltE'`:Ei{T lPiITRi}CTOR �+ }'Gc - T11 i(!UTAL .. i ErP> 3 rat:on 04/2� T KPIKTH F C0n'GICL t KEWIETH F C0 GI!LLl yj `Ciu" flll! %11 t SI%T - { - ADMINISTRATOR - 5 YAFi'OTH "A 026~4 - `� } ,COMMO TH OFfiAsCHUS 'I'S v Le 2= Y cc iM: _<... -< ..c'�_ ..F. ...•..4i^'f',R,.-C..,n:K-,s'Rl"';"�tl., ,-t�1 ti x;'. 's*c DErA} ''T OF LNDUSTRIAIf►ACCIDF.NIs ' 600 WASHINGTONStEET *y' BOSTON, MASSACHUSEM 02111K f .{ fames- Canooei: _} .pr;n:ss+one: r t :. r WORKERS' COMPENSATION INSURANCE AFFIDAVIT w -P R: S f �N4;NTH �Gtit�fir/L L I. r (licensee/permittee) with a principal place of business/residence a •S 3 4r - Z I C F-0 4 0910/wG . . (Gcy/StaulzlZip) - �• - �� ' .;. ` do hereby certify,under the pains and pcnalaes perjury,that:of perju F k ` j] 1 am an employer providing the following workers' compensation coverage for my employees working on this job. y _ Insurance Company 'Policy Number r J 1 am a sole proprietor and have no one working for me. _ (J 1 am a sole proprietor,general contractor or homeowner(circle one)and1ave hired the contractors Kited below who have the following workers' compensation insurance polidcr - y �� ja•,.rr> EXc�,tinv�s� rRE��.IcKsr Ca.' U,st-ee✓icy: Name of Contractor - R = Insurance Company/PolicyNumber • l�'-�- l ems - , ,:'� � �'. � ��: - '' . ` , Woe.rzm+a,,,l• �o.,�p, _ Dame of Contactor . _ x Insurance Company/Policy Number ' Name of Contractor ,, � , s s• -g Insurance Companv/Policy Number „ . lam a homeowner performing all nce wort:mvsdf NOTE.Please be aware that wbilc bomeo%-+eczs who employ persocs to do maiatcasnce:eonstructioo or repair wort on a dwcliing of not r�orc than t rcc units in�icb the borco••acr use resiccs or on tic grounds appurtenant thereto are not ceaeralh• considered to be cmalowrs u.adcr the aorkcrs: Corcvcrsation Ae;(G1_C 152.sec- 1(5)).application by a homeowner for a license -or permit may evidcccc the Ict;al sutus of an emalover under the' orlcers'Corz:pepsation Act. ' i f c t s: Y ..` _ :c..:will be forwa ced:ro cnc>✓ega c.t or I:cus: 'Accidents' Ofncr of Insurance for:coYcra c :- i,,c ::1:::10 .Tc.;; :o Steers co"t:-rc s rccul t'• under 'z.ccaon 5:Of.MG_ _c r icad to the unpoiition of crir.:i.'Ial p IS aIU*• �� c cons'st-£of.i::c et ec`tc 5':00:0G .-ic�or rdc: irrprLorrr .t of ua to one v=:ne c:vu acn=:icz Ln the form of Stop Word:O cent a fine of S 100.00 a cav a€ains:me. Sicned this CO 0 day of , 19 Woo 0010. Lie_: :_:P.:;;�::cc :.icc::sor;F:rrri:,a: Y F TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ��� - Parcel �� Permit# 0 Health Division � ?'� � ~ Q k Date Issued p 1-00 Conservation Division ?IZ�Jao Fee- Tax Collector Treasurer -THC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. . `� WITHTITLE6 + Date Definitive Plan Approved by Planning Board a ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address llv Village Owner 4/3/1 G�n/� l^iio®J� C Address Telephone �B� 7790•_1151 Permit Request .,JW1770A1 © ?uf Wr zayzzern ' Y Square feet: 1st floor: existing G'�4' proposed ✓�7. 2nd floor: existing '� proposed �; ey Total new {5 Valuation —1 q.-3`7 to Zoning District Flood Plain A10 Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure .3 f Historic House: ❑Yes B o On Old King's Highway: ❑Yes 2 o Basement Type: af'U'll ErCrawl s ❑Walkout ❑Other �592771f, CV0,4P4&— Basement Finished Area(sq.ft.) st0/% Basement Unfinished Area(sq.ft) Number of Baths: Full: existing I new °� Half:existing 0 new v Number of Bedrooms: existing - new S /v riYt� Total Room Count(not including baths): existing new G- First Floor Room Count 6 Heat Type and Fuel: 21"Gas ❑Oil ❑ Electric ❑Other 4—i Central Air: ❑Yes �lo Fireplaces: Existing �s New / Existing wood/coal stove: ❑Yes Cr No r y Detached garage:❑existing 811 new size'' Pool:❑existing ❑new size 49 Barn:❑existing ❑new size o Attached garage:❑existing ❑new size _,� Shed:Gglexisting ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4 No If yes, site plan review# Current Use R., Proposed Use /c S i fJi /a2 BUILDER INFORMATION Name L�riy:t/�Y7Z Telephone Number Address �'� ��'�� � j`�NiZ�2��:/lam= ✓�lfi License# G�Cf� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATUR rGr1- DATE �� /C FOR OFFICIAL USE ONLY, PEEMMIT NO. a, DATE ISSUED MAP/PARCEL NO, # ` ADDRESS - �-x`' VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ` FRAME INSULATION b FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL * GAS: ROUGH" FINAL FINAL BUILDING DATE CLOSED'OUT, *r , ASSOCIATION PLAN NO. . N s �1 The Town of Barnstable BmwsrABLL • MAS& �mg Regulatory Services 1°rE1 59. Thomas F. Geiler, Director - Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 a 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: A22d,OaZ- e-des -7.i;�� �Vwcz--(-c-fq Estimated Cost (JO, Address of Work: /!o L°o(16r- 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$1,000 ❑Building not owner-occupied 26wner pulling own permit Notice is hereby given-that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR r /2 �as Date Owner's Name g1orms:Affidav r %!r�/;t�/{any„� ���z:. '�%�:%- .%:_:••'.s? ,�� � �� � �������� b r „ _ • it - i 1 rr 000 . - •r.n -------- offwal use only do,not vrrftt in dds arm to be completed by city or tolm Officid ■ i. Department city or town* [3Licensmg Board ■C3SdwbneW$OMW ■ checl,ifimmediste response ■C3HgaIthDepwftMwt phone#1 contact person: ■ • :::: 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 apartnieats and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, camstructim 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,neith . the commonwealth nor any of its political subdivisions shall eater into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting airthority. ,.;. y_ '—Applicants `-;Please fill in the workers' compensation affidavit completely,by checldng the box that applies to your situation and .plying 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 coon of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuimied 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. workers' compensation policy,Please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and prided 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 periit!license number which will be used as a reference number. The affidavits may be=tnmed*fo the Department by mail or FAX unless other arrangements have been made. The Office of investigations mould Me to thank you in advance for you cooperation and should you have any.questions. please do not hesitate to give us a call. =7171=111711171117111, ym/n/ ME VA The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Offloe of Investloauans 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 eat 406, 409 or 375 7=CZMAqpmmft j • Tab1a-'ram(ooamlaoed) • • FrandpOve fukga for daa asd Twa-FaeadY KMdmdal Buffilh gt Seated with Foam Fads MAXIMUM MENIM 1M Wou Flow mi., zab �C°°uag U-rdoa; Rry dmi &-Wawa• R.vaimi Wall Pls�m md=w). pipe R.vaism� J1,vaImtr. 5"1 ro taDO Meade;Degeea Dam Q 12% 0.40 31i 13 19 10 6 Nonce! it 12% am 30 19 19 A0 6 N=W S. 12% am 311 13 19 10 � 6 UAFUE T 15% 036 311 13 25 WA -WA Noem l 1U IS'Xi 0r16 33 19 19 10 6 Naml r is% u►.ai 3: 13 �' WA !s AF[1E w 13% osz 30 19 19 !0• 6 11S AME x x 111Y. o32 311 13 29 WA WA Norval T tl 19E 0r42 31 19 25 WA WA Norma! i 9E o+t2 J11 13 19 10 6 90 AFZJE M On 850 30 19 19 10 6 90 AFUE � 1. ADDRESS OF PROPERTY: 2.. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: . ; 3. SQUARE FOOTAGE OF ALL GLAZING. `I 4. %GLAZING AREA(#3 DIVIDED BY#Z): S. SELECT PACKAGE(Q AA-see chart above): NOTE. OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: f q-f0n=-f980303a r - 780 CMR Appendix J Footnotes to Table J3.7-1b: o ass doors, skyIIghts, az�d ' Glaring area is the ratio of the area of the glazing assemblies (including sliding-glass basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glaring area may be excluded from the U•value requirement. For example.3 &of decorative glass may be excluded from a building design with 300&of glazing area. =After January 1, 1999,glazing U-vahtes must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Cotmcil (NFRC) test Procedure, or taken from Table J1S3a U-values are for whole units.center-of-glass U-values cannot be used. 3 The exiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full .im thickness.over the exterior walls without compression, R-30 insulation may be substituted for R 3 8 insulation and R-3S insulation may be substituted for R-49 insulation. Ceiling R values represent the sum of Cavity insulation plus laminating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space sun uic veat;and Paden of then rm—f. - 4 Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include oaerior siding,structural sheathing,and interior drywall.For example,an R-19*requirement could be met ETHER by R-19 cavity insulation OR R-13 cavity insulation Plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(conen�ete,masonrY,lop,)wall constructions,but do not apply to metal-frame constrnaion. 'The floor requirements apply to floors over tmconditio nu, aed spaces(such as unconditioned crawlspaces,baseme or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 30%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glaring. Basement doors must meet the door U-value requirement described in Note b.. 'The R-value requirements;are for unheated slabs.Add an additional R-Z for heated slabs. '` "`" • If the building utilizes electric wee heating me compliance approach 3, 4, or S. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. For Heating Degree Day requn arts of the closest city or town see Table JSM la NOTES: a)Glazing areas and U-values are maximum acceptable levels.Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not includ n structural greater than 0.35. oor U•values must be tested b)Opaque doors in the building envelope must have and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.S.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 035). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R value is greater than or equal to that con onem. Glazing or door components comply if the area-weighted average U- the R-value requirement for p less than or to the U-value requirement(0.35 for doors). value of all windows or doors is . equal EST/MA TED PROJECT COST WORKSHEET LIVING SPACE Value (high end construction) square feet X$115/sq. foot (above average construction) C s s� square feet X$96/sq. foot= (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= j PORCH square feet X$20/sq. foot= DECK. square feet X$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value The Town of Barnstable • EA NgrAELL , MASS. $ Regulatory Services �'�Eo;;�►1� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print JOB LOCATION: / C1�UL` 40 ''�l/e number street village r� "HOMEOWNER": / w name home phone# work phone# CURRENT MAILING ADDRESS: Cer"rz-,?rz/ Ile— � 2 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 procedures and req ' eats. Signature of Homeowner l Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FOAMS:EXEMPTN STANDARD LEGEND NOTE:not all symbols will appear on a map GOLF COURSE FAIRWAY mn�o EDGE OF DECIDUOUS TREES EDGE OF BRUSH i ORCHARD OR NURSERY V—YY-V EDGE OF CONIFEROUS TREES � \ � MAP 18 6 MARSH AREA, 7 EDGE OF WATER JO DIRT ROAD ; # 125PARKING LOT DRIVEWAY �l t, { I��—PAVED ROAD — '� DRAINAGE DITCH r — — — — PATH/TRAIL PARCEL LINE** I\ \ MAPito<—MAP# M P 18 6 #18a---PARCEL —HOUSE NUMBER 2 FOOT CONTOUR LINE 10 10 FOOT CONTOUR LINE Elevation based on NGVD29 >/4.9 SPOT ELEVATION MAP 186 A P 1 � STONE WALL 7 � —X—X— FENCE J 71 RETAINING WALL 6 o I I I RAIL ROAD TRACK STONE JETTY SWIMMING POOL • ` PORCH/DECK i ] ❑ BUILDING/STRUCTURE DOCK/PIER HYDRANT e VALVE O MANHOLE O POST 0" FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H 1 C 1 N F O R M _A T I O N S Y S T E M S U N 1 T o SIGN a :STORM DRAIN IN PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'scale mop and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE n TOWER w e National Me Accuracy Standards at this p p physical ptopography, 9 PP P y 0 � c 20 40 p ry do not represent actual relationships to h icol objects Corporation. Panimetrics, and vegetation were mopped to meet National Ma Accuracy Standards • s I INCH=40 FEET* enlarged scale. on the map. at u scale of 1"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps. LIGHT POLE O ELECTRIC BOX ' I CN n/ \ 4 Cove e nTy _ �/�I t - _,^.f�� = - _.,c-. .—_--- i o`��,Y_:_ —._____—//— � \ tan www� • ElDEf " y l_FT�__i nT 101� RiegT )q' SMOKE DETECTORS O.K. I Z *'o c') ®ARNS-TA LDING DEPT �4} i 'i � sos�sat�siw:4 r. Cduson �? esigns r s' ;1 V' siT ELkynT+ON n.y pr.nf a iarewr Oy oca..rr for In t.a tMrr< enry.Any O:M. 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