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HomeMy WebLinkAbout0027 COVE ROAD 2 . �. � � �u . .. _. ., ,. .. ,, -, �- � .�� ,. e �r.. � .t �� ,.;� e. �. � ,. .. _ - u ml Application number...y .....................J...l..... BU/LDIIVG DEPT - , ' x MAY 2 9 2020 Building Inspectors Initials... .: ... ........................... es¢ TO WN OF BgRNST Date Issued.....: ........... BLE Map/Parcel....... .... ....................... SCANNED somas/.,� TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: ME �Jro.5!;R STREET VILLAGEOwner's Name (a 1Ct6'1 Phone Number , Email Address: LeG S�eve�fL-66M mac,, LGM ' Cell Phone Number `p� Project cost$ ��j 6�11) .�® Check one Residential V Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize' to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK Siding 91 Windows (no header change)# Doors (no header change)# Insulation/Weatherization rI Roof(not applying more than 1 layer of shingles) 0 Commercial Doors require an inspector's review 1 Construction Debris will be going to Uli ltt & maLf- �Ul(e 0 Certificate of occupancy with no construction(complete below) Occupant/family relationship or business name or Existing amnesty apartment(attach a copy of recoided comprehensive permit) CONTRACTOR'S INFORMATION Contractor's name S 61C Home Improvement Contractors Registration(if applicable)# g (attach copy) t Construction Supervisor's License# CS - ((�a s5 (attach copy) Email of Contractor Phone number 5C6 -a�y ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS/N A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ F_ *For Tents Only*, , Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. ti Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:004m-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE 60 Signature Date All permit applications are subject to a building official's approval prior to issuance. y ' The Commonwealth of Massachusetts " Department of Industrial'Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly" Name(Business/Organization/Individual):m-\&e,, ns in .6. Address: CUY2.S6(Onra� City/State/Zip: (A (Xt b `15 Phone#: 50S,31 Li -q1 CICA0 Are you an employer?Check the appropriate b x: Type of project(required): 1.❑ I am a employer with 4. am a general contractor and I employees(full and/or part-time). * have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner-- listed on the attached sheet. 7. 0 Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. msurance.t required.] 5. 0 We are a corporation and its 10.E Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I I.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13:�,Othe e comp. insurance required.] r t *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation fticyinformation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �� Insurance Company Name: Policy#or Self-ins.Lie.#:� V� ®� y��13—1.�.,a(� Expiration Date: Job Site Address:�l W. l,eaClkf�U �'�� City/State/Zip: .q Attach a copy of the workers'compensation policy declaration page(showing the policy Dumber and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and corred. Si afore: ~Date:' ZX Phone#: UCiS ��y'G� �Ao Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r k, Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,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,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600 Washington Street . . Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#61.7-727-7749 www.mass.gov/dia l r - \4ri 111". leoh I Li -C LE ��� �!_ __C��_.-_�-�-'+ � tom"��t; ��� --�.��'-=�--�'�-'•-i�-�`� _.______ LLe )cb 1rj i IS, I ire oor- n .:., -s., .,-.:.�. ,. ,w,.,.-.,,.._� :i .,...... ,.+..•T-+a.-+..�. ...per.:,,,.. � - - NOTICE H NOTICE TO a TO EMPLOYEES T EMPLOYEES OqM Sv� The Cosa monwe-a•lth.-of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS LAFAYETI'E CITY CENTER, 2 AVENUE DE LAFAYETI'E, BOSTON, MA02111 (617) 727-4900 — www.mass.gov/dia As required by Massachusetts General Law, Chapter 152,Sections 21,22&30, this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 4614 BUFFALO NY 14240-4614 ADDRESS OF INSURANCE COMPANY (7PJUB-0114N13-4-20) 02-08-20 TO 02-08-21 POLICY NUMBER. EFFECTIVE DATES '-" BRYDEN & SULLIVAN INS PO BOX 1497 SOUTH DENNIS MA 02660 NAME OF INSURANCE AGENT ADDRESS PHONE# o� M.B. HOME IMPROVEMENTS, INC. 53 CONGRESSIONAL DR YARMOUTHPORT �- MA 02675 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required .in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably •— connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS ooa7i W20PIG15 TO BE POSTED BY EMPLOYER �e ��/�1�f�?i�flGG'-GCGGG���✓/�C?�' '-��?�GGrJG��r� , Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement;Contractor Registration ( I Type: Corporation M.B.HOME IMPROVEMENT, INC. ° Registration: 180881 53 CONGRESSIONAL DR ° " j Expiration: 01/22/2021 YARMOUTHPORT, MA 02675 `. M1 Update Address and Return Card. 3CA 1 0 20M-05/17 .�/w �c,�ri�zc2u,ci��llG/✓�Gu,J,J�ir,�rlrl/J Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR ' Registration valid for Individual use only TYPE..,Corooration before the expiration date. If found return to: 8e01s16$10 Expiration Office of Consumer Affairs and Business Regulation 180881_ 01/22/2021 1000 Washington Street-Suite 710 M.B.HOME IMPROVEMENT 73NC. ! 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'w�!�prE♦. t�, +1$"� L•`,'1i r ..�`'"'.:'�•^"'�$"..�°'»'n�.g4'...�,'..�e,-�-..,,...,.r+ ,,.. ..,.w».«k+,.,a . ..-.... a; ,•' * .: � ; +w, =�a.» re ,d . tr,+►' a •-.",,,• Z.,.rr�_ t ,«.wr.� ,'3:+v!K;Rix- x�+,� .:Sra� ,e�«,.x.,:' ,w,.'�R:`s-v.'4dr,..,,,.w' -- 1 , Office of.Consumer Affai s&Business Regulation HOME IMPROVEMENT CONTRACTOR -Registration valid for individual use only * TYP : Individual -: before the expiration date. R found return to: Re i i'b Expiration as Office of Consumer Affairs and Business Regulation 04/17/2022 I000.Washington Street Suite 710 * , t KARL SPAIN ,,�� , Boston, MA 0211.8 D/B/A`K.T�.,SPaI ' S � doN , - KARL SPAIN ih 46 MAIN ST. � • SANDWICH, MA Undersecretary No# acid � out signature • . 0�56 .�' . . , - . 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"`�.. •.aF.r �P Town of Barnstable Building Department Services Brian Florence,CBO NAM Building Commissioner x ° 200 Main Street,Hyannis,MA 02601 w�vw.town.ba rnstable.m a:as Fax: -508-790-6230 Office: 508-862-4038 Property,Ovmer Must Complete and Sign This Section If Using A Builder a D�/�k� �� � ,� �ron,•�a� ,as Ownedof the subject property _- to act on my behalf, hereby authorize \ ►\ L�� �� � � l�-1 in all matters relative to work authorized by this building permit_application for: 2 `.aVt' ,Q o-d Ce-n ki+vi!kL (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools. are not to be filled or utilized before fence.is installed and all final inspections are performed and accepted. 3 S' atuxe o ner Signature of Applicant71 ' Yi` OstiKciil P ' t Name Print Name 1 ,StJ�n 6rosrrnar- t i Date p WORMS:OWNERPERMISSIONPOOL$ Rev:08/16/17 Town of Barnstable • �m� Building . r g a.iE Post This Card So That it is Visible From the Street=Approved Pla,i�Mustbe Retained on'Job and this Card'Must be Kept �, , �. Permit MASK �' Posted Until Emal Inspection Has'Been,Made.`,. _ �== �y.m 1 lli Where a Cetificate of Occupancy is Required,such Building shalLNpt be Occupied until a Final Inspection hasbeen,made - Permit No. B-20-21 Applicant Name: KARLTSPAIN Approvals Date Issued: 01/03/2020 Current Use: Structure Permit Type: Building-Addition/Alteration- Residential Expiration Date: 07/03/2020 Foundation: Location: 27 COVE ROAD,CENTERVILLE Map/Lot: 186-072 Zoning District: RD-1 Sheathing: I Owner on Record: GROSSMAN,STEVEN& BARBARA W Contractor Name KARL T SPAIN Framing: 1 Address: 30 HUNTINGTON RD Contractor License: CS=102185 2 NEWTON, MA 02158 � "'� Est Project Cost: $6,000.00 Chimney: Description: Exterior Work Remove Siding and Shealthing etc Remove and Permit Fee: $85.00 Insulation: Replace any rotted or comprimsed lumber and Framing Resheath and Sidewall. { fee Paid: $85.00 Date ; ` 1/3/2020 Final: Project Review Req: Plumbing/Gas C ` Rough Plumbing: -� - \Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authori zed,bythis permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the!approved construction documents for which th§s permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. � Electrical The Certificate of Occupancy will not be issued until all applicable signatures W the Building and Fire Officials are provided on this,permit. Minimum of Five Call Inspections Required for All Construction Work: " Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: /� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Zt1E ~ Application Number....... ...0.. . ....... .... . .. .. . .. f EARNSPABLE, t . MAS& Permit Fee......................... . ...........Other Fee....................... 1639. ,0 Total Fee Paid...........♦...... ... .. . . ...................... TOWN OF BARNSTABLE Permit Approval by... ....... .. . .............On......... 1.�- .... BUILDING PERMIT 8 ....Parcel—:...®Map........... �: ....... .... .............. . .. . . .... ... ... ... APPLICATION Section 1 —Owner's Information and Project Location Project Address a- Cv e- Kood Village CQ I `L- Owners Name 'S 4n a) , &Co5scDon ,t Owners Legal Address__ City e State Zip Owners Cell # 61-7-q3 q• 5 51„ E-mail e- 5 Section 2 -Use of Structure Use Group ❑ Commercial Structure over 35, 00 cuba`eet W k ❑ Commercial Structure under 35 000 cub6feet Single/Two Family Dwelling Section 3 -Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑. Deck. Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify EX�(-'O�- Q �S Section 4 - Work Description ge.,5h26Accin� 5,Aelj_�011 q ' Last updated: 11/15/2018 Application Number........... Section 5—Detail Cost of Proposed Construction Square Footage of Project SG Age of Structure o S. Dig Safe Number # Of Bedrooms Existing 3 Total#Of Bedrooms (proposed) -{ 110 MPH Wind Zone Compliance Method FMA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway ❑ Yes �No Debris Disposal Facility: �X�—Qx tmt sa1C2, I am using a crane Section 7—Flood Zone a Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑. No ❑ Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units on site) Setbacks Front Yard Required Proposed a Rear Yard Required Proposed Side Yard Required Proposed- Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No r Last updated: 11/15/2018 The Commonwealth of Massachusetl+s Department of lndusidd Accidents Office of Invadgadons 600 Washington Street Boston,MA 02111 www.mass gov1&a Workers' Compensation Insurance Affidavit:Bnffders/Contractors/Electricians/Plumber's Applicant Information Please Print Lggib �C� " . Name(Business/Organiration4ndividual)• h Address: City/State/Zip:Y C(v Phone#: 1�0S Are you an employer?Check the appropriate bow Type of project(required): 1.❑ I am a employer with 4. 91 am a general contractor and I 6. ❑N construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no employees These sub-contractors have g; ❑Demolition workingfor me in an aci employees and have workers' Y capacity. ; 9. ❑Building addition [No workers'comp.insurance comp.insurance• 5. ❑ We are a corporation.and its 10.❑Electrical repairs or additions required.] officers have exercised their I L Plumb' airs or additions 3.❑ I am a homeowner doing all work ❑ �reP • myself[No workers'comp. right of exemption per MOL 12.❑Roof repairs insurance ]t C. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] •Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infiomIatioa t Homeowners who submit this affidavit indicating they art doing all work and then hire outside contractors mast submit a new affidavit indicating such. rContractors that check this box must attached an additional shed showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contracbms have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: t P�11�'(�\`���J -"1' Expiration Date: Job Site Address:a-1 (al t? lA . l�AR V_C1 J_t�f MO, City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MOL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofpediL7 that the information provided above is true and correct: Date: I Cl Phone#' ���i l � 13 Oj k d use only. Do not write in this area,to be completed by city or town oflkiai City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.EIectrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r Office of Consurnier.-Affairs and Business Regulation 1000 Washington Street'- Suite 710 ; - Boston, Massachusetts 02118 Home Improvement.,Con#ractor Registration Type: Corporation Registration: 180881 M.B.HOME IMPROVEMENT,INC: Expiration: 01/22/2021 53 CONGRESSIONAL DR r` YARMOUTHPORT,MA 02675 . - Update Address and Return Card. SCA 1 0 20M-05/17 Office of Consumer Affairs&Business Regulation. HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE,Corporation before the expiration date. N found return to Registttion Expiration Office of Consumer Affairs and Business Regulation 18088� 01/=021 1000 Washington Street`-Suite..710 M.B.HOME IMPJ Tl=1�l6AVINC. Boston,MA 02118 • i MICHAEL BERNSTE=1N 53 CONGRESSIONAL DF2 YARMOUTHPORT,MA=02G75 Not valid without signature Undersecretary ' �. f(I JaaeL Ep.rn,4-e n of -CoZA-krne :rmr--, jDA n- -rj- c. I ed—na rhi I CA r C _�v �C 7 A- be—cl ndA. - t ._ Nc-beiel Ror sk� cj fw. Ass-a y, censure Op ! i d102 # ►�L T SPAT AN dwic r . t ��ie�tnaaastt c�2��a.�ura/ittt¢ll1 ' OMce of ConmmwAfMks& RequWw HOME IMPROVEMEW COMMACTOR Realdraftm vabd for butAdual tw only TYPE: befto to=pMMddk B foeeed rebeeee tm Ot6oe of ConsumwAffelm and BudroBs Ramon 1.77Tb7-_- 0?102. One AshburiOn Rye-S1eRe 1�1 DJWA KT.SPola rt7CENST1 710N 46 MAIN 67. SANDWICt1.MA valid Wfibfut SlgndM • NOTICE G NOTICE TO 0 TO _ EMPLOYEES �� EMPLOYEES 9M S� The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100,Boston,Massachusetts 02114 — 2017 617-727-4900 — http://www.state.ma.us/dia As required by Massachusetts General Law,Chapter 152,Sections 21,22&30,this will give you notice that I(we) have provided for payment to our inured employees under the above mentioned chapter by msunng with.• THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 _- MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (7PVUB-0114N13-4-19) 02-08-19 TO 02-08-20 POLICY NUMBER EFFECTIVE DATES BRYDEN & SULLIVAN INS PO BOX 1497 r� 0W SOUTH DENNIS MA 02660 NAME OF INSURANCE AGENT ADDRESS PHONE# M.B. HOME IMPROVEMENTS, INC. 53 CONGRESSIONAL DR . YARMOUTHPORT MA 02675 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal in_. �1 pe juries arising out of and in the course of employment to furnish adequate and. reasonable hospital and medical services m accordance with the provisions of the Workers' Compensation Ac-L A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician.h ician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and masonably connected to the work related injury. In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS G;s" Vr"IG15 TO BE POSTED BY EMPLOYER �Im Town of Barnstable Building Department Services ` BARNSrABI.F. Brian Florence,CBO 39.0 $ Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.rna.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder W pi!/�14 ter•( ?T�vc� f r/'vs3r,.�a�► ,as Ownerrof the subject property hereby authorize 1 t\i, L Vi ee� to act on my behalf, j in all matters relative to work authorized by this building permit application for: 1 27- 6yt f-00-W� 6-1 k-►vi Ile— (Address of job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Si ature o . tier Signature of Applicant . P ' t Name Print Name S 'cJc,� roStr+�ar� nlntNin 6'L/ �Q Date Q:FORMS:OWNERPERMISS IONPOOLS Rev:08/16117 The Commonwealth of Massachusetts Department of IndustrkdAccidents Of ice of Invesdgatiolns 600 Washington Street, Boston,MA 02111 ww►v.mass.gov/diti t 4 Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information 71 Please Print Legibly - Name(Business/Organization/Individual): \ C- Address: C),:� C CmQf P c f)5lri� City/State/Zip: 0 Phone#: Are you an employer?Check the Appropriate bob c. Type of project(required): 4. � m a genr contractor and I 1.0I am a employer with- I b. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2.El I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no,-employees These sub-contractors have 8. ❑Demolition working for mein any capacity. employees and have workers'. - $ 9. ❑Building addition [No workers'comp.insurance' comp.inc,,,z,nce. _ •. _ required.] . 5. ElWe are a corporation and its= 10.E].Electricil repai s,or additions 3.0 1 am a homeowner doing all work officers have,exercised their 1 L❑Plumbing repairs or additions right of exeption per MGL myself[No workers'comp.- 12.❑Roof repairs t, c..1529§1(4),and we have no insurance required.] _ 13.�Other employees..[No workers' comp,msurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. y $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not tliose entities have employees. If the sub-contractors have employees,they must provide their workers'.comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees Below is thepolicy and job site A information. , Insurance Company Name: Policy#or,Self-ins.Lie,# LA Iq Expiration Date: rr n 1� - Job Site Address:a� l Ae— \`G �QY11P,��\ �� City/State/Zip: Attach i copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties"of a fine up to$1,500.00 and/or one-year iniprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above is 7e and correct Si. Date: Phone#• Official use only. Do not write in this area,to be completed by city or town.official City or Town: Pernrit/License# .._ Issuing Authority(circle one): ; 1.Board of Health 2.Building Department 3.City/Town Clerk a4..EIectrical Inspector 5.Plumbing.Inspector 6.Other Contact Person: ;" Phone#• Information and. Instructions . Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,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 groimds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone numbers)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit(license number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The CommonwWth of Massachusetts Department of Industrial Accidents , Office of Investigations 600 Washington Street Briton,MA 02111 Tel.#617-727-4900 ext 446 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 www;maw.gov/dia Application Number........................................... Section 9-Construction Supervisor Name Ka Telephone Number 7�y - H 5 H - yq (0 3 Address 410 mri�h 5�7 City .State Zip Q— rj(o_?j License Numb e � aft License Type Expiration Date�I'D C) Contractors Email Cell I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 t` CMR the Massachusetts State Building Code.,,I understand the construction inspection procedures,specific inspections and documentation required by 80 C and the Town of Barnstable.Attach a copy of your license. Signature Date a Section 10—Home Improvement Contractor m;On CA e. .er ns1e� Name Telephone Number _5bR - (2_�y — 6(Cj(oco AddressS3 ( City State Mp Zip ppwP_1 Registration Numb Expiration Date �� ' ,�na� I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date (� Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Ia a Print Name Telephone Number E-mail permit to: MM E©.z H (o @ A OL . COM Last updated: 11/15/2018 Section 12-Department Sign-Offs Health Department F Zoning Board(if required) .M Historic District ❑ Site Plan Review.(if required) ❑ Fire Department ' 0. Conservation M For commercial work,please take your plans directly to the fire department for approval Section 13 - Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name k 4 Last updated: 11/15/2018 Town of.Barnstable Building Post This Card So That it is.Visible;From the Street Approved Plans Must be Retained on lob and this Card Musf be Kept # vu 633 �$ Posted Until Final Inspection Has Been Made ,^ ;T; 1 ti 3 gWhere a Certificate;of Occu anc is Re faired,such Bwldm shallbNot"rbe Occu fed untila Final Ins ection has been made Permit No. B-19-4033 Applicant Name: M.B. HOME IMPROVEMENT INC. Ap provals Date Issued: 12/19/2019 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 06/19/2020 Foundation: Residential Map/Lot: 186-072 Zoning District: RD-1 Sheathing: Location: 27 COVE ROAD,CENTERVILLE Contractor Name: KARL T SPAIN Framing: 1 Owner on Record: GROSSMAN STEVEN& BARBARA W _ Contractor License:; CS 102185 2 Address: 30 HUNTINGTON RD Est Project Cost: $30,000.00 Chimney: NEWTON, MA 02158 f Permit Fee: $203.00 Description: kitchen renovation-install new cabinets&fixtures within tl existing Insulation: Fee Paid� $203.00 layoutremove sheetrock&insulation from exterior wall behind sink Final: area. reinsulate&install sheetrock. Remove sheetrockfrom,ceiling_ Date 12/19/2019 &install new. replace counters&fixtures in the batli:off kitchen Plumbing/Gas Project Review Req: NO STRUCTURAL CHANGES. EXISTING KITCHEN.IN SINGLE Rough Plumbing: FAMILY HOME.. - _ Building Official �� Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within sixm`'onths after.issuance. All work authorized by this permit shall conform to the approved application and the�approved construction documents for wM61h s permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning;by laws`and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. " ,2 q . Electrical i' n this.'permit. The Certificate of Occupancy will not be issued until all applicable signatures b,the Bwidrng and 0 Officials,are prov ded o p Minimum of Five Call Inspections Required for All Construction Work:. Service: '. 1trFoundation or Footing 2� Rough: 2.SheathingInspection ection ti g � installed 3.All FireplacesP must be inspected at the throat level before firest flue liningi s 4.�Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Application Number........ ............ MAS& Permit Fee...... .................Other Fee........................ . 1639. TotalFee Paid............................................................... ...... TOWN OF BARNSTABLE Permit Approval by... .........................On...1 .....................On....1zhiAl..... BUILDING PERMIT Map.......... ...............Parcel.......61. ...7c;)L..................... ... ....... APPLICATION Section 1 — Owner's Information and Project Location Project Address CL Je QQ6 Village Cen tes Owners Nam e-- co5 Snn-On(4 Owners Legal Address_ coo e , 1 n n r' City. l l State —Cn, Owners Cell �3q - 5456 E-mail e- FSection 2 —Use of Structure Use GroupE] Commercial Structure over 35 fSt — '00 cubic f❑ 1 Commercial Structure under 35,000 cubic feet , 15r-Single Two Family Dwelling Section 3 - Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure E] Change of use E] Demo/(entire structure) . ❑ Finish Basement El Famfly/Amne' sty ❑ Tirie Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition ❑ Retaining wall EJ Solar renovation ❑ Pool D Insulation Other-Spec Section 4.- Work Description Emoia on n o I-,ej- hg e7 L �F, If S lot 61 E-1 (A 4 V 0 rn 0 )C& ei' o iAnLe 4 E <,L�o,6LL J11 Q J L Last updated: 11/15/2018 i Application Number.................................................... Section 5—Detail Cost of Proposed Construction U CQb, 06 Square Footage of Project Age of Structure 5�or5Dig Safe Number # Of Bedrooms Existing i Total#Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage' ❑ Smoke Detectors FJ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility:&ry V�5 CrA�11iti� � I am using a crane ❑ Yes KNO Section 7—Flood Zone a 3 Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8—Zoning Information • a ZoningDistrict Proposed Use Lot Area S . Ft. P q Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 11/15/2018 1 1N i ndvc� Sir, v cn - v y Door i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations w 600 Washington Street Boston,MA 02111 wwM.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print L 'b Name(Business/Organization/Individual): h Address: 5 5 City/State/Zip:Y CCC� Phone M. Are you an employer?Check the appropriate boar. Type of project(required): 1.❑ I am a employer with� 4. W am a general contractor and I • employees(full and/or part-time).* have hired the sub-contractors 6. V'wron 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. od ship and have no employees These sub-contractors have - g, ❑Demolition working for mein any capacity. employees and have workers' 9. ❑Building addition [No workers'comp.insurance comp.insurance t 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.], officers have exercised their 11. repairs or additions 3.El I am a homeowner doing all work ffi h id h ❑Plumbing a P myself[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance ram,]t c. 152,§1(4),and we have no employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their worker'compensation policy information. t Homeowner who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. cContractor that check this box must attached an additional sheet showing the name of the sub-contractor and state whether or not those entities have employees. If the sub-contractor have employees,they must provide their worker'comp.policy number. y I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#:�� `1����1`'111�1J '�' Expiration Date: Job Site Address:o�1 11V P lLQ • l�P�? \i 1 Q. 0� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c..152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine" of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true correct Signature Date: Phone#• ��� T 6 0(0 Ojftial use only. Do not write in this area,to be completed by city or town ojjiciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person iri 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 inchuding 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,constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone nu nber(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation inst,n,nce. If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Qffi'tce of Investigations 600 Washington Street Boston,MA 021.11 Tel.#617-727-4400 ext 406 or 1-877-MASSAM Revised 4-24-07 Fax#617-727-7749 WwwMaw.gvvfdia Office of Consumer Affairs and Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement,Co:ntractor Registration _..... 77 Type: Corporation Registration: 180881 M.B.HOME IMPROVEMENT,INC. Expiration: 01/22/2021 53 CONGRESSIONAL DR YARMOUTHPORT,MA 02675 , Update Address and Return Card. SCA 1 0 2CM-05/17 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYP.E:.Corporation before the expiration date. If found return to: Registration Expiration Office of Consumer Affairs and Business Regulation t808$1 01/22/2021 1000 Washington Street-Suite.710 M.B.HOME IMFROVE-Ni L INC. Boston,MA 02118 MICHAEL BERNSTEIN _ 53 CONGRESSIONAL YARMOUTHPORT,MA=03(i75 Undersecretary: Not valid without signature I elf- � E L � _ uncire 5,fL-tc rn e-I aci- PC,! y {2 . I l - " Z t 3 �ad bf Bui g a € AM b.n VARKI took VA" 44 � 1,2 � . a Aktt � r£ ARLTS ki k - SWVHBO • ��e�ca vu�sa�iumul/fi c�2i��a�uic�aifetY1 - -—'- Office of ConsumerAffaIrs&8wdrwwRe9uIaftn HOME MPROVBMEN CONTRACTOR Re aUon valid for buivMM use afdy TYPE:tfl&rduai before the molration date. B found rdurn to: Bs"mm- ambfim OfficeofCorsunwAffairswWBLmru Regulation a_77-76-_ One Ashburtan Pia a-Shiba i30i KAAL SPAIN Boman,MA 021 D/B/A KT.SPAIN CONSTRUCTION KARLSPAIN 46 MAIN ST. -_- SANDWICH,MA 02M= otv moo" t NOTICE N NOTICE TO o TO EMPLOYEES EMPLOYEES / y\ oqM SV� The Commonwealth of Massachusetts DEPARTMENT OF INDUSTRIAL ACCIDENTS 1 Congress Street, Suite 100, Boston, Massachusetts 02114 — 2017 617-727-4900 — http://www.state.ma.us/dia As required by Massachusetts General Law,Chapter 152,Sections 21,22&30,this will give you notice that I(we) have provided for payment to our injured employees under the above mentioned chapter by insuring with: THE TRAVELERS INSURANCE COMPANIES NAME OF INSURANCE COMPANY P.O. BOX 1450 MIDDLEBORO MA 02344-1450 ADDRESS OF INSURANCE COMPANY (7PJUB-0114N13-4-19) 02-08-19 TO 02-08-20 POLICY NUMBER EFFECTIVE DATES a BRYDEN & SULLIVAN INS PO BOX 1497 SOUTH DENNIS MA 02660 NAME OF INSURANCE AGENT ADDRESS PHONE# M.B. HOME IMPROVEMENTS, INC. 53 CONGRESSIONAL DR YARMOUTHPORT MA 02675 EMPLOYER ADDRESS EMPLOYER'S WORKERS COMPENSATION OFFICER(IF ANY) DATE MEDICAL TREATMENT The above named insurer is required in cases of personal injuries arising out of and in the course of employment to furnish adequate and reasonable hospital and medical services in accordance with the provisions of the Workers' Compensation Act. A copy of the First Report of Injury must be given to the injured employee. The employee may select his or her own physician. The reasonable cost of the services provided by the treating physician will be paid by the insurer, if the treatment is necessary and reasonably e� connected to the work related injury_ In cases requiring hospital attention, employees are hereby notified that the insurer has arranged for such attention at the NAME OF HOSPITAL ADDRESS 001848 W20PJGIS TO BE POSTED BY EMPLOYER L pME rq Town of Barnstable Building Department Services Y � Y BA MASS. Brian « Brian Florence CBO y Ass. �.er ib39' p10 Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder >ft n 6/2"E "t" ,as Ownerfof the subject property hereby authorize Y 't\i, 6, t-P—� 6LEa�t n to act on my behalf, in all matters relative to work authorized by this building permit application for: Z7- k,^vi tl,- (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. S _ afore o u�iner Signature of Applicant P t Name Print Name sXVet.. �'raSt�nar� /U,, Date Q:FORMS:OWNERPERMISS IONPOOLS Rev:08/16/17 Application Number.... " ....... ...... ...... ........... Section 9- Construction Supervisor Name Telephone Number m LA -5 H H q(p 3 Address��rn(a (� City State _Zip a License Number-(,Oa $5 License Type Expiration Date Contractors Email Cell # —MY — 454 Ll�(p I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780- CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 78Q CMR and the wn!7arnstable.Attach a copy of your license. Signature - Date ILL Section 10—Home Improvement Contractor - Name Telephone Number -q q(.O(O Address53 6&(-.e51- ondk be City .YU(o �4 State Ma Zip (n� Registration Number 01�59( Expiration Date � o� I QCQ I I understand my responsibilities under.the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and 'documentation required by 780 CMR and the Town of Barnstable.Attach.a copy of your H.LC..: Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT SIGNATURE Signature Date Print Name l( ��,�\ &DSL Telephone Number -%o(p E-mail permit to: m M E. 0 I�A (y ( n c U m 'Last updated: 11/15/2018 } Section 12—Department Sign-Offs Health Department ❑ Zoning Board(if required) Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ ` Conservation For commercial work,please take your plans directly to the fire department for approval Section 13 - Owner's Authorization qq. as Owner of the subject property hereby it authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) Signature of Owner date Print Name 1 Last updated: 11/15/2018 Y Town of Barnstable Building Post This Card So That it is Visible°From the Stree"t Approved Rlans Must be Retauied on Job and this Cartl Must be Kept v aARNSTASM 1630, `�� Posted Until Final Inspection Has Been Made �` wiPermit a Where a Certificate of Occupancy is Requ`red,such Buildmg shall Not beOccupied until a Final Inspect�on'has been made Permit NO. B-19-3889 Applicant Name: Joel Zimmerman Approvals Date Issued: 11/25/2019 Current Use: Structure Permit Type: Building-Smoke Detector-Fire Alarm Dection Expiration Date: 05/25/2020 Foundation: System Map/Lot: 186-072 Zoning District: RD-1 Sheathing: Location: 27 COVE ROAD,CENTERVILLE Contractor Name: BRIAN REZENDES Framing: 1 Owner on Record: GROSSMAN,STEVEN&BARBARA W Contractor License; 22213 2 Address: 30 HUNTINGTON RD Est:Project Cost: $2,838.00 Chimney : NEW TON, MA 02158 - Permit Fee: $35.00 Description: Instal l security and fire alarmsystem. Insulation: Y p ;Fee Paid: $35.00 Final: Project _ , Date: 11/25/2019 of Review Re q x,. � , l � Plumbing/Gas Gas CJIs-��crv�. g/ 3 � Rough Plumbing: i i This P ermitshall be deemed abandoned and invalid unless the work authonzed byth s permit is commenced within six months after issuance. Final Plumbing: : All work authorized by this permit shall conform to the approved appl c tion and the'approved construction documents-for which this permit has been granted. r' Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. g This permit shall be displayed in a location clearly visible from access street o,r--road and shall be maintained open for public mspection for the entire duration of the Final Gas: work until the completion of the same. 4, The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided ohA is permit. Electrical s Minimum of Five Call Inspections Required for All Construction Work:iService: 1.Foundation or Footing 2.Sheathing Inspection ection 1. Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is,installed aA, - - . 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: TOWN OF BARNSTABLE ` BUILDING PERMIT PARCEL ID 186 072 GEOBASE ID 10735 ' ADDRESS 27 COVE ROAD A PHONE CENTERVILLE ZIP - .� I LOT A-4 LCJ BLOCK LOT SIZE DBA .7lx DEVELOPMENT DISTRICT CO PERMIT 87249 DEOCRIPTION ADD 2BDRMS/2BATHS/DECK PERMIT TYPE BADDI TITLE BUILDING PERMIT ADDITION i CONTRACTORS: ROGERS AND MARNEY Department of ARCHLTECTS: Regulatory Services TOTAL FEES: $1,075.00 BOND $.00 CONSTRUCTION COSTS $250,000.00 "nb 434 RESID ADD/ALT/CONV 1 PRIVATE * a RMABLE, ED NIp►�A BU((IL-DIN DIVISION `"' DATE ISSUED 09/30/2005 EXPIRATION DATE C , TOWN OF BARNSTABLE e 7 �, BUILDING PERMIT PARCEL ID 1d6 0721' 6v GEOBASE ID 10735 ; f'. ADDRESS 27 COME ROAD PHONE CENTERVILLE a f ZIP - ;{ LOT. A-�4 LC9 �1CK LOT SI?E M -e DBA ,. DEVELOPMENT DISTRICT 'CO PERMIT 87245 DE9CRTPTION ADD 26T3RMS�26ATkIS/DEGE r�'�" . PERIIIJ T TYPE BADDI TITLE BUILDING P OMIT ADDITION CONTRACTORS. "P.3ERS AND MARNEY Department of AR4' T ' Regulatory Services ,---.TOTAL FEES: 3I,076.00 ; BOND $.00 CQgSTRUCTION;,- COSTS $250,000.00 434 RESID .ADD/ALT/CONY . 1 PRIMATE 0 K *"13.4JMS BLE, f'I �. MASS. 039. 1� ol 7 BUIL-H,IN ISION r' DATE''- ISSUED 00/30/2005 .EXPZRA°.CTON DATE 41 THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK,OR ANY PART THEREOF,•EITHER TEMPORARILY OR PERMANENTLY.e EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS ePERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE PERMITS ARE REQUIRED FOR HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU- 2. PRIOR TO COVERING STRUCTURAL MEMBERS (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. �I e ® o IN! ® e ® e BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPR A LECTRICAL INSPECTION APPROVALS 2 2 2 1 �) 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT I 2 C BOARD OF HEALTH OTHER: SITE PLAN REVIEW"APPROVAL I =1 �I tI WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA— TION. NOTED ABOVE. TION. BOII. DING PEKimvmilT t gtThe Town of Barnstable Department of Health Safety and Environmental Services � r S"s.�,� Building Division .�- 367 Main Street,Hyannis,MA 02601 Offices 508-8624038 Fax: 508-790-6230 PLAN REVIEW c Owner: � s� ✓5 �1� MaptParcel:_ C (�� D 7 2 n.f�� _ M Q Project Address: 2 �� Builder:-7 The following items were noted on reviewing: f 42 Q - n Reviewed by ty r 1 • '��tox pa.�aw tv>Mrtftf �d 11 cw svnx R�to 1 - EXISTING .,Na..aa,... �en .......... W J® H O U S E ® 3S-rnx wcma• .r'• ._ 9 I an�� Lnxtw N-.w. +t 0. R SO iw6vw EXISTING .,.a.... i-w•.a.o....ve n I HOUSE ".iII TT- J i'.�1. inn kv wt varvN• �Lt EAO Y'e•n� 4 r I R-tl int T 1 •M.+se uo w .iro.vaao SMOKETE . . rxr-v N ILDI ELEV LEFT ELEVATION .wv.t wu• - ' .v.ci us,X FIRE DEPARTMENT TE BOTH SIGNATURES ARE REQUIRED FOR ®1 !NO ® ci iL �'+••ww. ••�� fi 1 ,R•19 jNRM1Mna I. ® EXISTING .haw•..,.+,w T }�i...... ..( ... .Er I' ll HOUSE .,p...Lsa. EXISTING'. FIOUSE r . � .. w er}•.r, n�wx.t Li P' IMPORTANT - UP _ .t.. - a•w.miwn mm wwa STATE - - SMOKE DETECTORS FOR THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPING AREAS ARE ADDED OR CREATED. SECT/O N uA LE_.3•!' .- L_tt ca.K NOTE: A SEPARATE PERMIT IS REQUIRED FOR THE ..._ INSTALLATION OF SMOKE DETECTORS-THE EL€GTRIGAL ••• •• GROSSMAN RESIDENCE PERMIT DOES NOT SATISFY THIS REQUIREMENT. RIGHT ELEVATION FRONT —ELEVATION ELEVATIONS .�. _ 27 COVE R0. A-I GARAGE DIMING - RM. BATH 1 D ` , DN BEDROOM I LIVING RM FAMILY RN EXISTING HOUSE KITCHEN ir.i'x a BREAKFAST 88 a BATH WOOD DECK , 2 PROPOSED O ADD/TlON ti - BEDROOM 2 "q S W N O Q � - O cc Q PROPOSED DECK GROSSMAN RESIDENCE sou tti•ot ¢L •i PROPOSED ADDITION 27 COVE AD A 2 UNFINISHED STORAGE POP i BEDROOM 0. EXIST NG HOUSE 1 W t C. BATH � , BEDA00IA 6 ^ BATH ..___- - B ED•AOOM"; EXTERIOR DOOR� WINDOW SCHEDULE - - 'Ti PROPOSED - ADDITION eae - WWI QNIq5- ' O Uury ltf OE �u06¢FHN¢c 46^ ^� + \\ w erit 6�%'eC10�, ONC rt a, L a7 BALCONY GROSSMAN� RESIDENCE PROPOSED ADDITION PROPOSED ADDITION 27 COVE AD A_3 1 1" O•�rmw<, pCQ4 ev 24�� c Wari t0 QE bA6 � � ' Pp-a.rper�e0 Ronv4 Ov 6' v'C eu �Kouu A04L W2r wAE w��-56 is-02 ttSK�K¢ eo: 6- '4 w. ao - •-�' � OECK oeunegm+�oL�oM'vw/ "m ® ® 1191�11,. .vmm.w4 Lu +a BEDROOM 2 ___—.—�—_ I•�. ._ - �.-�_20 a.ee��- — 446 .�en.sa waoo..ma.ve � .paA n m.owenno 0 v �''AM+2 '•© ®M1 U ,BATH I -----'-- m o T"t ................. ..............__.._......: auKe .i © O ® a _....._ ...... ......._......_._..._... o eve" is7i z6'-o FOUNDATION PLAN FIRST FLOOR PLAN SECOND FLOOR PLAN LABT. C. P. ... E /STING EXISTING '� EXISTING id-vk �a•a� (—s=—{' ROOF -. HOUSE HOUSE _ . 4• Q E i:i o RS 16 P, j . d _w 9 A N ({ TYmK/•l Mgt:3�h'r et'l . QA An a � ti 424 -FIRST FLOOR FRAME SECOND FLOOR FRAME ROOF PLAN GROSSMAN RESIDENCE FLOOR� FRAMING PLANS • 27 COVE A0. A7 r- my ov vuoR ao�L+': 8�•iY+• , r wuY D¢GWNb - -,roP or Jre+�: B'•o%• xv M.»ob Reo �' W B x 28 STe[t O[nn � .two mr�no mrr¢4 vuy+rub Tnve oee4 aao-RP Gorton oP To+sr �•b• ' .4 X"mN� t+4 ..T�ve¢eD OAO oN To1cT n M*�on W Sn tp0 OR HEST FLW4 SUp D pwn ' 6v.n .FtooR• .....ow O _�.3o susawnou ' .h P.D _... Lvx yn"Pvi»b �t aL 2vB 3D�etS 1ZOC. . O BCeta'.3•�� .. • �.'{'1•T/b q.vweeo 4w¢oL un��¢D iZ 11'nor,. »e•o eP+eL . w BR YB wn , eta4Al, r / + exB TOAST Lx0 Li ao�ST ear JJI I �tss v'.v'x'ti•c —�rr R�3 / /' B..ce rt•re col'�i+�o � DECK a- �. B,• al v.ir...•cvr 3Lr6 ue+DE O I Q', .d 1 . aornr.. .._ e'b.r.• W�Ye'Pa+v¢4 _ I'4 r.ea.eoe,o tv,.vJ wr. T¢,n ^^T.` »T _ �• _ ib"n »wo cr+c4 —. r•¢a¢S4N FwR aoeO 'k•ber�s d'o.c. ...b. 2v 0 JOIST a+0 JOIST i�" � - _BIOCC •e ReB. LQC[ ,'t• ROOF Ome ce.o.�Nb a a" � i ease: +p•, aV maa .eer+ ' 8C9t¢' J�sl or EA.n vt,wa. O GROSSMAN RESIDENCE ee+u•AS NonD �� JC &+ta: 3••i �� DETAILS 27 COVE RD. A,,r ' l "HE The Town of Barnstable , BA NVA LE.p Department of Health Safety and Envir®nmerital Services S639 BuildinLy Division PrEc►Aa+a 367 Main Street,Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 PLAN REVIEW Owner: Map/Parcel: u Project Address: 2� 0 C-V�' Bilder: The following items were noted on reviewing: c • Q I 'gyp 1lY, to can c� QC � c n. rig\9t Reviewed by: ���9- Date: 9' — 2 L- �� f .the C01nnwnwea& o Vad.4ac4weffi ' a(Jeeartment 01 Jiro .service3 03oard of J"ire prevention !`Eo yalatiorh, MITT ROMNEY P.O. 46OX f 025 -State koo / V.CARLISLE SMITH GOVERNORa� CKAIRMAN EDWARD A.FLYNN st �f TELEPHONE(978)567-3181 ow SECRETARY ll , ���ll'Id JacLietti 0 f 775 FACSIMILE(978)567-3199 �dv /�iJOPY Committee on the kama4woffi e4dricalCoL TO: Licensed Construction Supervisors in Massachusetts FROM:William Laidler and Donald Giombetti, Co-Chairmen SUBJECT: Concrete encased electrodes and the 2005 Massachusetts EIectrical Code Date:November 4,2004 A forthcoming change in the Massachusetts Electrical Code will,in many cases, dramatically change the way general contractors sequence the order of trades with respect to electrical work in particular.We believe that timely communication to this effect is crucial to the orderly completion of any work that will involve the placement of reinforcing steel in a concrete footing. The 2005 NEC as adopted in July of this year by the National Fire Protection Association now ;equines that all qualifying concrete-encased grounding electrodes be connected to the grounding system for the building, unless the building is an already existing structure.A qualifying concrete- encased,reinforcing-steel electrode is • At least'/-in.in diameter(corresponding to a No.4 bar,or larger); • At least 20 ft in length(this measurement includes multiple pieces of steel if they are tied together);and • Placed"within and near the bottom of a concrete foundation or footing that is in direct contact with the earth."' This means,in turn,that for new construction,a connection must be made to such steel electrodes (where they exist)using a 4 AWG or larger copper grounding electrode conductor,with the other end of the wire arranged to leave the concrete at some convenient point.The means for connection must be listed by a qualified testing laboratory(such as UL)both with respect to suitability for embedment in the concrete as well as for use with reinforcing steel.Many electricians use wire long enough to reach from the foundation to the intended electrical service location,avoiding the need for a subsequent connection.Another approach involves bringing a segment of reinforcing steel out of the pour that is tightly tied to the segments)making up the qualified electrode. The electrical connections are covered under MGL Chapter 141 and Chapter 143 Section 3L. Therefore the connection to the electrode must be done by a licensed electrician,which need not rm responsible for the other work i be the same person or fin the building.Further,this work, including verification of the suitability of the tie wiring on the components of the electrode,must be inspected by a municipal Inspector of Wires prior to the completion of the concrete pour.If this process is not followed,the consequences could be severe,potentially resulting in a requirement to dismantle and rebuild the foundation. -page 2- A similar letter is being sent to the Building Commissioners in Massachusetts,because we are aware that often,building pennits for foundations issue separately from those for the building proper,and at times to those who are not so licensed..We want to do everything in our power to make sure that everyone potentially affected by this change is well informed in advance. This provision of the 2005 National Electrical Code is not being amended in Massachusetts.It, along with all other provisions of the 2005 Massachusetts Electrical Code,will apply to-all electrical work in Massachusetts for which an electrical permit issues on or after January 1,2005. We hope that you will assist us in making a smooth transition to the new requirement.You may want to consider establishing a relationship with a licensed electrical contractor well in advance,at least with respect to being available to apply for the required electrical permits and having the required stock and personnel available so your construction schedules are not impeded. Please note that this is not a requirement to install a concrete-encased electrode at any building (although it is always permitted).This is a requirement to connect to such an electrode if it will exist because of engineering design.This work qualifies under Rule 10 of the Massachusetts Electrical Code for inspection within 24 hours(weekends and holidays excluded)following notice to the municipal Inspector of Wires,so construction should not be delayed for that reason. In fact, if the inspection does not take place within this time,the concrete pour can proceed without the completion of the inspection. In a nutshell,IF THERE WILL BE REINFORCING STEEL IN THE FOOTING OR BOTTOM OF A FOUNDATION IN ANY BUILDING you erect after the new year,then THERE MUST BE AN ELECTRICAL CONNECTION MADE(or arranged for if the steel will extend out of the concrete)AND AN ELECTRICAL INSPECTION PERFORMED PRIOR TO THE CONCRETE POUR. Concrete-encased electrodes have a long history(over a half-century)of superior performance with respect to creating an effective ground reference.In New England soils,they are far superior to the any likely alternative,particularly with the increasing use of nonmetallic water piping systems. This change is squarely in the interest of public safety,so we want to do what we can make its implementation as smooth as possible. Very truly yours, William Laidler Donald Giombetti Iment relocated) METER DISCONNECT NOT SERVICE EQUIPMENT IVtdy'df ;ertirrt ViiiiPFieftE fiferri -tti`. ratirrgs:anOield marf4fngs st[ilpt>tiiitti"i�;wtTj�tpt e!d§uai:service W.Ii ji#:prncedures"i#ii t' rily. aWad4f.a qual d's;ij bedis oniti ct:Aj iliea`� lion no longer depehdant I rn P.i lte; •1 PRACTICAL EXAMPLE. Ahvall nbk susperssbn,kr. field . 24wtable4rom canopy.part of graded le Cord ID aeoormwd�mbfton,Insu3pensioon k F * apata r 1 1(After consideration,unamended In Mass.) I Ei:: -All qulardying I elecUndas: must now be used it' sent",-1 whether or not'availabI 'as in'. e 2002 NEC.A concrete encased electrode must now be Included" on new construction W it wf exist t� by engineering designMajor ./ Jmpe on bade pro ct/ce, Rebdoroing Steel ekctrode quali8cadonS• At4east 20 R(can be Joined with V"rey, work sequencing. Nnt er.-Spain;zw in emxy or aqu:vrcr, See MEC Rule 10; Placed within and new the bottom of a MGL C. 141;c.143 s 3L• foundation structure in direct soli oont:& (c)Frederic P.Hartwell,2004 t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /$(p Parcel a 82 // Permit# 9 7Q2- 4 q Health Division �G�D cj � 7 l 1 -- Date Issued Conservation Division Application Feel Tax Collector Permit Fee Treasurer SEP o Planning Dept. `� �'YSTE 8 �. . "'"'" '(NIS ALLF® 114 COMPLIX4,CS Date Definitive Plan Approved by Planning Board WITH TITLE 5 : Historic-OKH Preservation/Hyannis NAIMONMENTAL COIDE AiI OWN a 7GULAT i0�1aw Project Street Address a 7 Cd ve fZo.itt> Village 6,.i 7-G L V t I- - Owner .4AP_ 577-7 Address 30 *o,r r l-,�JG root 4rve 'Telephone C�'�� l ac_�00 Permit Request 2 6�_EDg041,-i Square feet: 1 st floor: existing AG-3 proposed 22PQ 2nd floor: existing zo proposed /6 a y Total new 3fn>_; Zoning District Flood Plain Groundwater Overlay 5 Project Valuation aSo/0t9O­010 Construction Type Lot Size 4c pu Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ,"&. Two Family ❑ Multi-Family(#units) Age of Existing Structure &v&- /9" Y7 Historic House: ❑Yes 62QD_ On Old King's Highway: ❑Yves G AIN Basement Type: OFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) y Number of Baths: Full: existing o new Half:existing new a Number of Bedrooms: existing_ new a Total Room Count(not including baths): existing !:3 new First Floor Room Count 7 Heat Type and Fuel: ❑Gas AkOil ❑ Electric ❑Other Central Air: 'es ❑No Fireplaces: Existing / New e!5L Existing wood/coal stove: ❑Yes No Detached garage:❑existing ❑new size Pool: Cl existing ❑new size��arn:❑existing ❑new size Attached garage• xisting ❑new size z6 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 4144o_ If yes,site plan review# Current Use ,QF 5 o�N��-, _ :. _�.:.� _ -< Proposed Use-. i2�S�t�. C� __:. BUILDER INFORMATION Name 12oe, --- z Telephone Number Address 134 a•v�-,wbe< 1g?-4!D License# e� Z/ ?�S�'�.aZv�t,�-� ✓Ll� O�G Home Improvement Contractor# on ! 3 � Worker's Compensation# WG. 7 29a 3 � ALL CONSTRUCTION D SULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �— FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED ' MAP/PARCEL NO. ' c ADDRESS VILLAGE OWNER DATE OF INSPECTION: l FOUNDATION r, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t x �J!hyf c�1�'J j.VJ. lb JC.•O-t fi F�JJJV --�-..- • • t. Town of Barnstable 0 ` Regulatory Services ASIn.$ Thomas F.Ceiler,Director Buildiag Divisions Tom perr), Building Commjssipnar 200 it.iaia Street, Hyantis,NLA'0260 l i Office: 303-563-�tO�S Fax: 705.7�0-6�30 Properq- O"nbrMust Complete and Sign This Section If Using A Builder iRs & as ORmProf the subject ro e1 P Q �Y her yaucl•,ocyae Ft AA"IZEY, 7RC. to act on tnybehalf, irl a l) :Lners rela,tid•e ro work-aut,horzed by-thi building parmit application for(address of job) J�4 gnamre of 071- OFate Fruit Hare a 158Z 'Gh� P S 0 H 9L19 NVry :O[ SOOZ �FISE,pk `own of Barnstable Regulatory Services saa.Nsrxscs. ' Thomas F.Geiler,Director v HAM. g 1639. Buildinor Division �AlfD MA{� b Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME EMTROVEMENT CONTRACTOR LAW SUPPLENIENT TO PERNUT 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 cohtainin:g 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. T e of Work: X 00 )n'o� Estimated Colt s�0�o� YP Address of Work: u�E Owner's Name: 44 RZ Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under S 1,000 []Building not owner-occupied ❑Owner puling own permit Notice is hereby given that: OWi ERS PULLING THEIR OWNPERtiIIT OR DE. G��ZTH L1-REGISTERED CONTRACTORS FOR APPLICABLE HONIE LtiIPROVEME\-T WORK DO NOT H-k'Y-E ACCESS TO THE ARBITRATIO`i PROGRAtil OR GUARANTY FLTIND L--DER NIGL c.142A. SIGI-ED TJNDER PENAL=, S OE PERJURY I hereby apply for a pe:-mit as agent of tr_e owner: D a`e Contactor ?. ,e Registration - OR Dale Owner's Name Q:fcros:hcmea 5dav Board of Building Regula ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 100134 Type: Private Corporation Expiration: 6/9/2006 ROGERS & MARNEY, INC. Charles Rogers P.O. BOX 310 Osterville, MA 02655 _ Update Address and return card.Mark reason for chang Address Renewal Employment Lost Card DPS-CA1 0 SOM•04/04-G101216 lie >°JoorvnumurealC�i a�./�r!aaadc%uaeliit 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-. Registration: 100134 Board of Building Regulations and Standards One Ashburton ce Rm 1301 Expiration:.:_619/2006 Boston,h1a.0 =.Typei`_Private Corporation ROGERS&MARNEY;INC. " . Charles Rogers - 445 WEST BARNSTABLE ROAD ..ee�lz= 1sterville,MA 02655 Administrator Not valid wi out signature License: CONSTRUCTION SUPERVISOR - Number: CS 016174 l`. Ex s.'€Y5/07/20 Tr.no: 2379 :Restrtcted 00 ChiARL D ROG PO BOX 310 OSTERVILLE, MA 02655 ti Acting C mis one Oo%018:"2005 03:42 50:37781789 PAGE 01 AcoRD_ CERTIFICATE OF LIABILITY INSURANCE CSR xG DATE(Mrl'DO!YYYY) ROGER-1 08 06 05 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Northwood E ahbaugh Ins. Agancy HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OP. 80 r- West Fair. Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. H. sie MA. 02601 Pi—ne: 508-771-1632 Fax: 508-778-1789 INSURERS AFFORDING COVERAGE I NA1C* INSURED •Y INSURERA. Fh I$WEST IN3UP_kNCE I !NSURER B: AMRICA-N INTERDIATIONAL Roggera s Marney, Inc. INSURER OstQrvville1MA 02655 i ;NsLRERD I INSURER E: j COVERAGES THS POLICIES OF INS!RANCE LISTED BELOW HA`V=BEEN 133UEO TO TiE INSURED NAMED ABOVE FOR THE POLICY PERiOD'NCICATEO.NOTWTHSTANOING AN-REQU'RE`AENT,"ERM C.R CONJIT4N O°ANY CONTRACT OR OTHER DO.IINENT WITH RESPECT TO`AHICH THIS CERTIFICATE MAY BE Ig3UEO OR MAY CERTAIN.ThE IN_JR.4NCE AFFCFDED UY'HE 901 VE5 OESCAIIBEO HEREIN!S SIJ&ECT TO ALL T:�E TERM6.EXCIVoiONS AND CONDI-IGNS CF SUCH POLICIES.AGGREGATZ LIMITS SHCWN MAY HIA-vS 8EJV REDUCED BY PAID CLAIMS --J` LTR INSRD TYPE OP 14lSUR.;NCB I roIICY NUMBER OAS E WDorrr I ATi DQ L WITS GENERAL L"ILITY I I j I I EACH OCCURRENCE I i 1000000 A XTCO?XY.:ACIAL GENERAL LIA91.ITY CPP071026504L I 03/20/05 l 03/20/06 PREM16E5(E9oc:va oe) ; s 50000 i I CI•AI.MS MADE I.�( i OCCUR M:O GXP wn one l ( r P w"�) $5000 PERSONAL s ADV uuURY i s 1000000 _ GENERAL AGGREGATE f 2� OQQQ00 GEI`f:A3G12EGATe LIALT AP?U eS PE.i.I _ I I I PROS DUCTS•COMPIOPAGG 12000000 j I I PCLIC"I i JET I�LOC I i AUT i OMOYII. LIAYILFTY I--� I COM31NED SINGLE LIMT A\Y A.)TO ! (Ea aadCenl) i I ALL CwritU AU I O& BODILY IN:URY i SCHEC OLEO AUTOS I (Per parson) �I MIA EC,A,JTOS !{ t f I BOO LY IN.URY NON•CWY33,ALITOS IIII� I (FeraocEent) i I � PROPERTY DAMAGE ! I i I I I(FHr secdono f GARAGE LLkINLrrY I I I AUTO ONLY. a ACi:MENT I f LII ANY AWTO ! I I ) OTHER THAN ACC i f t I I I AUTO ONLY: A130 j f i EXCESB/UM BRE'_LA LIABILITY I t — I�i i I IEACH OCCURRENCE If C•CCL'rl I CLAM:MADE I I AGGREGATE I f j ! L If OWL'.TIBLE s RETE•TION f - ! s WORKERS COMPENSATION ANO 1 I I 170RY L118T5 X, ER NY,PEMPL OPRIETwuuT WC7482356 I 01/01/05 0:/01/06 E.LEACH ACC IOENT s500000 ANV PROPRIcTv^F/?ARTrIEi�.'l;7LCJTIVe � •_� C.FF:`CERIMEM4;!:E11CLUQEO7 E.L.DISEASE•EA ELIPLOYE"e i 500030 J SPECADecrltq PROVISI,) � I CL.OIEEA3E•POLICY LIMri f 500D00 SPECIAL oROv!SI�7N5�.i!ow . i OT1r4ER A � Comne=ciul Applica iCP2071026504 1 03/20/04 03/20/05I I I I i De94RIPTIC14 CF OPEA k 0r131 LOCATIONS/'VEHICLES I EXCLUSIONS ADDED BY E!IDCR_9GLGNT I SR%CIAL PROVISIONS Carpiantzy - ccnst. 1 family dwellings i I� I i I CERTIFICATE HOLDER CANCELLATION j T0WN-_m ,R 931OU_D AA'Y CF THIG ABOVE DE$CR;HED POLr—M3,E CANCELLED BEFORE Tl!i EXPIRATCH I DATE THERSOF,rxi ISSUM/O"URERWLL INDlA'VOR TO"L 20 DAYS WRITE!/ I NOTICE TC Tti:E CERnF--ATE HOLDER►"ED TL TN:Li TT,OUT►►ILURE TO DO,O SHALL TJAN 07 R,%RN3TA3i,r T TY OF ANY KIND UPON T}E VSURER,R9 AOIHTf CA 57 "A_h Sl FEE WPCSf NO 09LOA PI H.YAN N I S MA 02601 REP1tE3ENTATIYi3 AUTMOR220 RfPREXEA7ATTyi A. 1D 25(2OJ110 ly t ACORD CCR.°OftATION 1933 The Commonwealth of Massachusetts Department of Industrial Accidents N Offlce Oflvvestfgatloas 600 Washington Street Boston,Mass. 02111 `- Workers' Compensation Insurance Affidavit F gltan:t.in aeon:-- - lease PR N 7.1-lb loc=t,^n ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one working in any capacity Lt I am an employer providing workers' compensation for my employees working on this job. ::'ROGERS &- MARNEY, INC: company name: � address: P.O. BOX 310 . riR.. OSTERVILLE, : MA .02655 phone (508) 428-6106 insurance co. 1.Jo,2r-r,K r-�gf'^-3-ey6 w /-QS 'polio'e Lue�--d/ . I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who nave the following workers compensation polices: compa v name' SEE ATTACHED SHEETS 'ddres5' cirv: phone=: insurance co policy Cnmpnn%, name: address' - city.' phone=: - insuranr co yolicv"- •'Attach sdditionsI sheet if n%issa�. .- �a..:=;`:. • ::_ ,-, "t=c-._.u''l -T_ --T.: i" :�;;_ failure to secure coyera-e as required under Section 25A of:NICL 152 can lead to the imposinon of ertetinal penalties of tine up to SI-500.00 and/or one years imprisonment as M ell as civil penalties in the form of a STOP WORK ORDER and a fine orS100.00 a day against me. I understand that a cope or this statement may be for-.a-rded to the Orrice or Investigations of the DIA for coveng:veririeadots. l do hereb ter,:f;under -"`cirs~crtd pert-!ties of perjur,•that the irforrralot-pro:•ided aboti•e is t;1e cr.d correct. Sie aturc S & MARNEY •- P-._t p-cr.c = (508) 428-6106 .' orcial use onl% do not rig: in this ar':a to be eompictcd by eir:or town orricial ein or row n: Permirlic:nse= ;building Depar,pent i C Lic:nsin; board 1 che.�if imm:dint. respogs: is rquir:d [S<(c:t'ei's Orr<- [Health D:partr,.:n: eon:act person: ph an, 9; r-0ther t ALAN W. JONES & ASSOCIATES -CONSULTING ENGINEERS 6 CARLETON DRIVE WEST EAST SANDWICH, MAss.02537 FIELD INSPLCTION. REPORT TELEPHONE 888-3154 Project; �!i't 'LYICt i7TC- �!/l Architect; Contractor; I Date ;/Q '� Time; Weather; ----" - .-resent at Site ; 4 4- Lty"o- k � . 0 � . ALA Y W. ® WNE3 Ag O ll Submitted by; CA Date; CU 2 Page of Pages r Permit Number REScheck Compliance Certificate Checked By/Date Massachusetts Energy Code REScheckSoftware Version 3.6 Release 1 Data filename:C:\Program Files\Check\REScheck\#5081.rck PROJECT TITLE:New Custom Addition CITY:Centerville(Barnstable) STATE:Massachusetts HDD:6137 CONSTRUCTION TYPE: 1 or 2 Family,Detached HEATING SYSTEM TYPE:Other(Non-Electric Resistance) WINDOW/WALL RATIO:0.20 DATE:08/31/05 DATE OF PLANS:02/21/2005 PROJECT DESCRIPTION: The Grossman Addition 27 Cove Road E Centerville,Ma. 02632 DESIGNER/CONTRACTOR: Rogers&Mamey Builders P.O.Box 310 Osterville,Ma. 02655 PROJECT NOTES: REScheck by Cape Cod Insulation,Inc. 455 Yarmouth Road Hyannis,Ma. 02601 #5081 COMPLIANCE:Passes Maximum UA=356 Your Home UA=330 7.3%Better Than Code(UA) , Gross Glazing Area or Cavity Cont. or Door Perimeter R,Value -V lue U-Factor UA Ceiling 1:Cathedral Ceiling(no attic) 596 - 30.0 0.0 20 Wall 1:Wood Frame, 16"o.c. . 1926 _ 13.0 0.0 127 Window 1:Wood Frame:Double Pane with Low-E 256` 0.340 87 Door 1:Glass .120, 0.330 40 Floor 1: Slab-On-Grade:Unheated 82 10.0 56 Insulation depth:4.0' Furnace 1:Forced Hot Air,87.2 AFUE 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 Massachusetts Energy Code requirements in RES checkVersion 3.6 Release 1 (formerly MECchec.� and to comply with the mandatory requirements listed in the RES checkInspection Checklist. 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 AA Builder/Designer Date a i RESekeck Inspection Checklist Massachusetts Energy Code REScheckSoftware Version 3.6 Release 1 DATE:08/31/05 PROJECT TITLE:New Custom Addition Bldg. Dept. Use Ceilings: [ ] I 1. Ceiling 1:Cathedral Ceiling(no attic),R-30.0 cavity insulation I Comments: Above-Grade Walls: [ ] I 1. Wall 1:Wood Frame, 16"o.c.,R-13.0 cavity insulation I Comments: Windows: [ ] I 1. Window 1:Wood Frame:Double Pane with Low-E,U-factor:0.340 For windows without labeled U-factors,describe features: I #Panes Frame Type Thermal Break? [ ]Yes[. ]No I ,Comments: Doors: ( ] I 1. Door 1:Glass,U-factor:0.330 Comments: I Floors: [ ] I 1. Floor 1: Slab-On-Grade:Unheated,4.0'insulation depth, R-10.0 continuous insulation Comments: Slab insulation to extend down from the top of the slab to at least 4.0 ft.OR down to at least the bottom of the slab then horizontally for a total distance of 4.0 ft. I Heating and Cooling Equipment: [ ] I 1. Furnace 1:Forced Hot Air,87.2 AFUE or higher Make and Model Number I Air Leakage: [ ] I Joints,penetrations,and all other such openings in the building envelope that are sources of air I leakage must be sealed. [ ] I 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. I 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 I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure difference and shall be labeled. I di Vapor Retarder: ] Required on the warm-in-winter!side of all non-vented framed ceilings,walls,and floors. Materials Identification: [ ] Materials and equipment must be identified so that compliance can be determined. [ ] Manufacturer manuals for all installed heating and cooling equipment and service water heating. equipment must be provided. [ ] Insulation R-values,glazing U-factors,and heating equipment efficiency must be'clearly marked on the building plans or specifications., Duct Insulation: _ [ ] Ducts shall be insulated per Table J4.4.7.1 s w Duct Construction: y [ ] 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. Heating and Cooling 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. Circulating Hot Water.Systems: [ ] Insulate circulating hot water pipes to the levels in Table i:: Swimming Pools: - [' ] All heated swimming pools must have an on/off heater switch and require a cover unless over,20% of the heating energy is from non-depletable,sources. Pool pumps require,a time,clock.' Heating and Cooling Piping Insulation: [ ] HVAC piping conveying fluids above 120 °R or chilled fluids below 55 T must be insulated to the levels in Table 2. ti , Table 1: Minimum Insulation ThicknessI or Circulating Hot Water Pipes. Insulation Thickness in Inches by Pipe Sizes Heated Water Non-Circulating Runouts Circulatinp-Mains and Runouts Temperature(Fl lb to V VD to 1.25" 1.5"to 2.0" Over 2„ 170-180 0.5 1.0 1.5 2.0 140-160 0.5 0.5 1.0 1.5 100-130 0.5 0.5 0.5 1.0 Table 2: Minimum Insulation Thickness for HVAC Pipes. Fluid Temp. Insulation Thickness in Inches by Pipe Sizes Piping System Types Range Fj 2"Runouts 1"and Less 1,25"to 2" 2•5'to 4" Heating Systems Low Pressure/Temperature 201-250 1.0 1.5 1.5 2.0 Low Temperature 120-200 0.5 1.0 1.0 1.5 Steam Condensate(for feed water) Any 1.0 1.0 1.5 2.0 Cooling Systems Chilled Water,Refrigerant, 40-55 0.5 - 0.5 0.75 1 A and Brine Below 40 1.0 1.0 •1.5 1.5. NOTES TO FIELD (Building Department Use Only) .. ..-7f " 1 f r '-;;,! r:Y >'«. :x.g � ,g f?-�:"D +-x, - , r.;'^'+< - � '.r.r....:..y o..-,..-::�.'n: _x�• �'l� a +. # ^ r s Assessors mapl'and .lot number...,...:, Sewage Permit'number ....... I BARNSTADLE, i House :number .........a..y ......CGyC 4L //' iv "6 a eta O 79 ' i p Qm a` TOWN OF: BARNSTABLE ' BUILDING -1NSPECTO.R 3 .APPLICATION FOR PERMIT TO .... ....�� CAD ' TYPE OF CONSTRUCTION .........avid .:.....:./.... ''/�F.............................................:........................:....:....... .. ................. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit ccordingtoto theeffollowin information: Location ..p�.., ............G..?.//E..... ..... 4.��'a vl. ..... .�Q .... � /'s/.......... /� L-E �0/YI -Proposed Use ..... .............. ...G. .................. ......... ........ .......... Zoning District ../ .. ..............................................,.Fire District ..... .. ............... Name of Owner .1.�5 `r. . Address ......�4J!�!/.E ..... ,h/ ?. Name of Builder . .....r . .✓/� ......Address ..........f. ..............Jlli/i� . Name .of Architect .......:... .....Address,. ll Number of Rooms ..6....5 >...... ... ..y6`'� ...........Foundatior �4NC:C aY..�..�'C: ..� � c cbi} <;•iLEw Exterior . ...............C���... .��. 6 f Roofing q Floors .4.P............. ....................................................Interior ..:S.�f.�i.�1t.... . A...�`��,�•�?.�.�..G,!'�..:b,�. . Heating a%".....�..� ............. ....................Plumbing ...... ........................................................ ' Fireplace ..... �G ......G idi/�.. 4�zA./ ..............Approximate Co/st �>�•e,.?�.r!?�/..6.!?!<C�.�F...... � �� .. Definitive Plan Approved by'Planning Board ---------------_-__------------19 __-___- Area ....... ...'#'!.............. ... Diagram of Lot and Building with Dimensions - Fee °�� SUBJECT TO APPROVAL OF BOARD OF HEALTH r: goo OCCUPANCY.PERMITS REQUIRED FOR NEW�DWEELI-NGS�1— hereby agree to conform .to ,all the Rules and Regulations of the Town_ of Barnstable regarding the above Y construction. t Name ....... .. ...... .......... o .... �... .... � Q,J OZ ' Construction Supervisor's License :........... TRE11UMM, ROSS K No 2CO83 Permit for ...............ADDITION/REMODEL Single FarrLLy wellin f. 27 Cove Road Location ................................................................ Centerville Y: ... ...... ..................^..... ..... .......... .. C. Owner Ross:Trenholm.............F .... ........ Type of Construction' ...Frame...... .. f r^ ' Plot f f •...............�.,... Lot s ...... .................. Permit•Granted .... FebruaYy 16� 19. 84 4= Date of-Inspection :-. .................. ....1.q 9 �*fit. .. - .� n ; ♦. t+^ { - - t '• ` +, 4 Date Completed yt7�' . .....::,( ...T9 �R G .' `..�—. _��Leh ,•, ~ . .. . � L - �, YYYY j l�� - G ��- Assessor's map`and lot number ......r............. �.......� it FT E to ti,.. �♦ t N Sewage Permit number ....... J. Z BAWSTA LE, i House number ........ '.. .......: r!.'. ......�......:...... :':....::.� '' ro Mae& O 1639 00� �0 MA-4 a\ T TOWN OF BARNSTABLE BUILDING INSPECTOR ,APPLICATION FOR PERMIT TO, z .. ' jj, r�::...... :.�,..... :.... ...................................................................... TYPE OF CONSTRUCTION .f'�o4�1 t ................ 4.?:....19$ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..! .. C R./ ............. r .:! C�C�✓/Eo�jt�r�, /a /• •G-�/'F .......... w.........� y. �..................... 1 ProposedUse ..... ''�'q ... ......./i0/I9�... ...................................................................................................................... Zoning District ... �; ;;.. . .................................................. ....... ........./. ..................Fire District ....I........ < .. r . ............... Name of Owner ./,I• „ �>�!��. ............ .............Address ....... D /!/i .:�...... ��J<i ............. r � ... Name of Builder �� •`.5............... ...� �/t/F;/.y✓......Address ......... n!i/✓ s . C <i� '/i.!c�`. Nameof Architect .....•...........................................................Address ......j...........................................))................................... ��.. Lam// / �/ /V6/� CU�VG..vc r�G`;�% Number of Rooms .. 1......... ........ ..........,,...............Foundation ...............,.............:.... ........... �rli /v h� CF�/.o� S z ; IhF7 J� c G / �A' r Exterior ,................, ....Roofin ! ::........... : g � f Z f P !wo,o�^. Interior ..�.:.�<�!... �r......:�'�.. r... .....%�.: ?:.>.:... ................................�............. ............ r f Heating Qi.......lJp �........;h ;, ,jai ..........................Plumbing ......r4- Z n.......................................................... Fireplace ..... /c/r'.........1.;�!! ...... !t!a...............Approximate Cost l?.?.... :fi. ........... ............. Definitive Plan Approved by Planning Board ---------------_---------------19_______. Area '+' Diagram of Lot and Building with Dimensions Fee 33'0- 1................ ........................ SUBJECT TO .APPROVAL OF BOARD OF HEALTH FX I t` { a i l '`� � •3 r2 _ VVV ' Lam`^•-�� r � �3'�.. ,�41 � ,�k d L i OCCUPANCY PERMITS REQUIRED FOR •NEW DWELLINGS- ...I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. , Name :) ........ ................... t Construction Supervisor 's License .................. ... TRENHOIM, ROSS 186-0=A72 1 6-0 -4- 26083 ADDITION/ D X No ................. Permit for ..................... .............. Single Family Dwell' g ..................................................... .. ...................... Location ....2.7-Cove-.........Road ..... ......................I........... . .. .... Centerville ............................................................................... Owner ......Ross Trenhohn ............................................................ Type of Construction ....Frame........I..................... .......... ................................................................................ Plot ............................ Lot .................................. .'February� 16, 84 Permit Granted ........................................1 9 Date of Inspection, ....................................19 Date Completed ....*............... ................19 P�oFt tOwti Town of Barnstable *Permit# q Z 5 Expires 6 months from issue date ■APMrABLE. = Regulatory Services Fee �c3� • y bt cb ib39.9. Thomas F.Geiler,Director AlE0 Building Division Tom Perry, Building Commissioner - 200 Main Street H annis MA 02601 w� ' y X-PRESS PE F! Office: 508-862-4038 - Fax: 508-790-6230 OCT :y 1 2003 EXPRESS PERTMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint TOWN OF BARNS Map/parcel Number 186 017 Z Property Address . Z"I Coy r_ eD C0_X-V �esidential Value of Work -500 00 d Owner's Name&Address STE\/E N 0_QX.&M A W .30 Nuu-�t� tell '�z1� � l�l�cwT�N M►-1 D2lS'8 Contractor's Name Telephone Number Sp - NZ a Home Improvement Contractor License#(if applicable) 100 lay Construction Supervisor's License#(if applicable) GS O t G t7 y II', .Vorkman's Compensation Insurance ? Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ' []-fhave Worker's Compensation Insurance Insurance Company Name ArAS tZ.IC.A" A•1_ Workman's Comp.Policy# "Y J C 7 2..5-a30 9 Permit Request(check box) , [�e-roof(stripping old shingles) All construction debris will be takenXZY Wt1l40mgs¢. iz ESL Co. ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side [RR+eplacement Windows. U-Value ,3 (maximum.44) ❑ Other(specify) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. �ature J 1M13,ltH£ ANC* Q:Forms:expmtrg Revised 121901 OCT-30-2003 16:24 MASS ENUELOPE PLUS 16176238058 P.01i01 Steven Grossman 30 Cobble Hill Rd. Sommerville, MA 02143 To Whom it May Concern; I Steven Grossman, owner of property located at 27 Cove Rd. in the village of Centerville, grant Rogers & Marney, Inc.the authority to act on my behalf to obtain all necessary permits to install replacement windows and re-roof, Steven Grossman .j �• 1 I ! 4,r TOTAL P.01 Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 100134 Type: Private Corporation Expiration: 6/9/2004 j ROGERS & MARNEY, INC. Charles Rogers P.O. BOX 310 Osterville, MA 02655 — i i Update Address and return card.Mark reason for change. Address Renewal Employment ❑ Lost Card ✓fze Lromvmanwea�i a�✓l�ac�ivaelta . m Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: -100134 One Ashburton Place Rm 1301 Expiration: 6/9/2004 Boston,Ma.02108 Type: Private Corporation ROGERS&MARNEY,INC. 0harles Rogers t 445 WEST BARNSTABLE ROAD � , Osterville,MA 02655 Administrator Not valid without sijdature j t i i i i S j ; E 71. BOARD OF BUILDING REGULATIONS .License: CONSTRUCTION SUPERVISOR Number:CS 016174 Expires .05/07=04 Tr.no: 24057 [ -- Restricted 00 CHARLES D ROGERS • PO BOX 310 �.�.«. OSTERVILLE, MA 02655 Administrator f I- _ I �oFt To,,ti Town of Barnstable *Permit# os `g Expires 6 months from issue date r7 0_3 /. D .62 Regulatory Services Fee 9�A NAM ����' Thomas F.Geller,Director s Eo 39. Building Division _S�/s- f1�1 P E � tl M , r tY ^Gr __a� a o Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 •i 8,Ni. 7 2004 Office: 508-862-4038 Fax: 508 790-6230 TOWN �� �����5����-� EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY Not Valid without Red%Press Imprint Map/parcel Number Property Address Residential Value of Work Owner's Name&Address _/IUD Lo Contractor's Name Telephone Number % Home Improvement Contractor License#(if applicable) A Construction Supervisor's License#(if applicable) Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name. Workman's Comp.Policy# / �1� y�- Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to !' ��✓ �1���-`'�� Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. 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. Home Improvement Contractors License is required. Signature Q:Forms:expmtrg Revise053003 Town of Barnstable Regulatory Services s s�rrsx�I.E. 'suss. Thomas F.Geller,Director 9�plFD ru�r►�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-862-403 s Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder the.subject propeltp._ ._......._... .: hereby authorize ��zj Z4 Z J to:act on my.behalf,. in all matters relative to work authoiizetl•bg this building•pe==t-applicstionfot: (Address of Job) sign.atute of Owner a Print Name i •.-v-----�-� �✓J2C-VOOI7/rILOIL[IIEClI(1L __ ' Board o[,Building Regulations and"Standards HOME IMP!2PVEMENIT CONTRACTOR Re ratiT3p;�,j 00497 Expica�iQn_6L8{2004 . • « '.��' 1udt�'F,dual F q �t *ID COX INC i b vid 06x LAVENDER LN \ % GGi rfu;i 1 ,1'ARMOUTH,MA 02673 " Adinipistrator o 1 t 01 / � � / cat \ \\ Q...• \ Bit ohwEA9e Drive \ \ ohW — S�44'2 •E �• \\ \\\ • • V. a«�•to • . p• ••„• l' 03 a, Nil V / _Z \ f . ,O \ Lawn \ lord \ \ • • • ..: /9 \ Lawn \ _ tk Pogo 1{r:e'6 Location Map 1 =2,000E o .15 FF=19.9 �� StoneDriveway OVERLAY DISTRICT: '� I , ; `.\\ \\ \ AP — Aquifer Protection District Ii Lawn or 1 \ \ \ \ \ As Shown on Plan Entitled f' / \ \ `•\ 'Revised Groundwater Protection I I =zz. \l 1 \ \' \\ Overlay Districts — April, 1993 i '+ \ <s \ 2 /i Ea q .. ...._ ........ . Dwelling (0 I erve 1 �\ �. \ FLOOD ZONE. I J �!` Zones A10 e111 B,/ / I `. ( ). & C (see plan) nd Fl / �� I I � I \ Community Panel No. C � oc I / Deck #250001 0016 D/ `_.' / Zone i I MA \g 3x o Wood s 1y FE ' July 2, 1992 I od Deck _ 2,000 gal �fJ O I� Septic Tan \ \ i O e p / i \ CS t z P o 3 0 _ _ 15� - \\\\ AS REF.: i N Adder► o � — � f'/ 4 \ Map 186, Parcel 072 _ Lawn Q � / /' s s6 ZONE: RD-1 - - Area (min.) 43,560 SF i7 J /� / 5•�°`%`' / Frontage (min) 20' I — ! - - - - - _ concrete _ _ — _ Block wall - � i / � ,-.--- / Width (min) 125' / Setbacks: Front 30' Side 10' / -' Rear 10' Flood Zone Lines Ias Shown on FIRM Panel # 250001 16 D / _ - - Septic Design Analysis. - �� // 26.21'2�"E / Residential Flow: 110 gal per Bedroom F M Zone Al o(E N�o / _ (110 gal x 7 bedrooms) 770 gal 22D.3' from Edge-of Salt M co^f;^ Ton k Requirements: lit iI Z ' River Fro 770 gal x 200 % = 1,540 gal I $ °i 222.5 from' MHW Setbacks �� \ / Use 2,000 gal Tank H-20 2 sty w\f I / Dwelling / woad / Leaching Chamber Requirement: -�1de �o Qy I Deck / 770 al : 0. 74 = 1,041 SF `.5 M wed?at / —de W ' / / Leaching Chambers Provided: / Legend: Bottom Area: 59'x12.83' = 757 SF AL � �`\ \ / ® Catch Basin Sidewall Area: 59'+12.83' x4 = 287 SF O CB/DH O Water Gate (round) Total Area Provided. 1044 SF Utility Pole Gas Gate O Iron Pipe \ L \a) ' `ing Pier \ \. `♦ o & Float �/ ) ° ` AL IL OF RICHARD \` LHEUREUXAy r3J312 / q9 v�,e NO.29733 CIVIL Notes/Revision: PREPARED FOR: PREPARED jY Title: r line information shown was •v n Engineering , I nc. Site Plan1.) The grope ty Steven 8c Barbaro Grossman a e � ry it �� I I I �. compiled from available record information. Proposed Improvements At 30 Huntington Rood 7 Parker Road 7 Parker Road 2.) The structures shown hereon were obtained Newton MA 02158 Osterville MA 02655 Osterville MA 02655 27 Cove Road In from an on the ground survey performed on 508 420-3994 420-3995fax or between 20/AUG/04 and 25/AUG/04. ( ) � Tel: (508) 428-3344 Fax: (508) 428-3115 PSullPE@aol.com Bamstable (Cen tervill e) Mass. a� 3.) The datum used is NGVD '29, a fixed mean Field: Review: RRL Draft: DWB Job #: 24021 sea level datum. 20 0 10 20 40 80 RRL WHK Comp.: RRL/WHK Job #: C-615.1 Comp.: DWB & JOD Dro win q #: Date: MAR 22, 2005 Scale: 1 =20 Draft: RRL/WHK Drawing #: C615-1gl Review: PS Revision: SEP 23, 2005 — Add dimension PL t0 Addition