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0135 ELLIOTT ROAD
I d ` - r z , e : t d1 ( l L ¢ Y � � : • n qq a/ a 7 ' 'TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel : Application Health Division PARINSTABLE4 Date Issued Conservation Division r , �. . , Application FAP f. �': Planning, Dept. 'Permit Fee Date Definitive Plan Approved by Planning Board Historic ; OKH Preservation/ Hyannis Project Street Address d in ( ° Village C�iN j'P i/f �/►�►'A. ' Owner , S C.f ��, of h�y� Address 449 (QJTr rr/1 Telephone 9 T_ ` H 6 `? Permit Request r.CJ^J k_ �F_M . K 6 ry &m , VLJV A-&.. 1LJJL4- ►) Square feet: 1 st floor: existing )�f proposed �� 2nd floor: existing d UU proposed Total new 3(51� Zoning District Flood Plain No Groundwater Overlay � Project Valuation J 66 Construction Type Lot Size ke�5 Grandfathered: ❑Yes ZNo If yes, attach supporting documentation. Dwelling Type: Single Family dr' Two Family ❑� ❑Multi-Family ((# ❑# units) � Age of Existing Structure I ei Historic House: Yes Colo On Old King's Highway: Yes kN-o Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other U�&? A 4 do J,) i,IR nU� 50 -Ffw Basement Finished Area (sq.ft.) () Basement Unfinished Area (sq.ft) 0 Number of Baths: Full: existing` new _1 Half: existing new Number of Bedrooms: existing 6 new Total Room Count (not including baths): e21ectric . _new First Floor Room Count Heat Type and Fu ❑ Gas ❑ Oil ❑ Other Central Air: es ❑ No Fireplaces: Existing [ New (J Existing wood/coal stove: ❑Yes &, to Detached garage: ❑ exis ' g ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use tz I V1 Proposed Use Ies►YT e"1 n y APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number 6— 666 0 Address _ �,U l�h�i l �T License# acnct q3 (0TV 6 WM. 0Z4 3s Home Improvement Contractor# I Worker's Compensation # ��CS�o�U�i I�tiZ0t,6�A ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO &6 G tS � Wluq _ m4ss SIGNATURE DATE �7 I11 1 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r' DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE t ELECTRICAL: ROUGH FINAL r " PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. J f L IT CA AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CMR 5301.2.1A)1 Q Check Compliance 1.1 SCOPE WindSpeed(3-sec. gust).................................................................. ................................................ 110 mph WindExposure Category................................................................... .............................................................B 1.2 APPLICABILITY Number of'Stories(a roof which exceeds 8 in 12 slope shall be considered a story) 1 stories <_2 stories RoofPitch ...........................................................................(Fig 2) ..........................................._J <_ 12:12 MeanRoof Height...............................................................(Fig 2).........................:.......................-ja ft 5 33' BuildingWidth,W ...............................................................(Fig 3).....................:..,................c...... 4,5 ft 5 80' BuildingLength, L .....................................:..................:......(Fig 3)................................................. ft 5 80' Building Aspect Ratio(L/W) ................................................(Fig 4)................................................ I.-W 5 3:1 Nominal Height of Tallest Opening2....................................(Fig 4)...............................................P-g 5 6,8,E 1.3 FRAMING CONNECTIONS . General compliance with framing connections....................(Table 2)............................................................... 2.1 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Concrete.....................................................................2 .. C .................................................................... ............................................................... �( 2.2 ANCHORAGE TO FOUNDATION1.3 5/8"Anchor Bolts imbedded or 5/8"Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing—general ..........................................(Table 4)............................:.................. in. , Bolt Spacing from endfloint of plate ................ ............(Fig 5).................................... in. <_6"-12" ►✓}� Bolt Embedment—concrete..........................................(Fig 5)...... '7 in._>71' Bolt Embedment—masonry.........................................(Fig 5)........................................... in.>_ 15" i A Plate Washer.................................. .....(Fig 5)........................................ >3"x 3"x W 3.1 FLOORS Floor framing member spans checked ...............................(per 780 CMR Chapter 55).........:......................... Maximum Floor Opening Dimension...........................:.......(Fig 6)..................................................Q ft:5 12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig 6)....................................... Maximum Floor Joist Setbacks Supporting Loadbearing Walls or Shearwal1 ................(Fig 7).................................................... 0 ft <_d V Maximum Cantilevered Floor Joists Supporting Loadbearing Walls or Shearwall................(Fig 8)................................................... 6 ft 5 d Ll FloorBracing at Endwalls....................................................(Fig 9)................................. ............................... Floor Sheathing Type .........................................................(per 780 CMR Chapter 55)....................... .. 1/ Floor Sheathing Thickness .................................................(per 780 CMR Chapter 55)...................... q in. Floor Sheathing Fastening;.................................................(Table 2).. d nails at in edge/ in field 4.1 WALLS Wall Height Loadbearing walls...................................................:....(Fig 10 and Table 5).......................... L ft <_ 10, Non-Loadbearing walls.................................................(Fig 10 and Table 5).:.......................7`�1�'ft :520' Wall Stud Spacing .......•.................................................(Fig 10 and Table 5)...................16 in.'<_24"o.c. Wall Story Offsets ................:............:...........:...............(Figs 7&8)........................................... !� ft <_d 4.2 EXTERIOR WALLS3 Wood Studs ; Loadbearing walls........................................................(Table 5)..............................2x - ft-L in. Non-Loadbearing walls...................................r.............(Table 5)..............................2x__(� -_ `l ft r in. f/ Gable End Wall Bracing' Full Height Endwall Studs....... ........ ....................(Fig 10).................................................................. WSP Attic Floor Length........... .................................(Fig 11).................. . .. . ft>_W/3 Gypsum Ceiling Length (if WSP not used)...................(Fig 11).............1=�I)...(,WA... ........._ft 2..0.9W V and 2 x 4 Continuous Lateral Brace @ 6 ft.o.c. .. (Fig 11)....................................I........................ _v� or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft. spacing in end joist or truss bays i/ Double Top Plate w Splice Length ...............................:......................(Fig 13 and Table 6).................................... 2--ft Splice Connection(no.of 16d common nails)..............(Table 6)......._`,............................................. (� r AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance(780 CMR 5301..2.1.1.)l Loadbearing Wall Connections Lateral (no. of 16d common nails)........:.......................(Tables 7)...............;.................................Q_ Non-Loadbearing Wall Connections Lateral(no. of 16d common nails)................................(Table 8)....................................................a- t/ Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans .........................................................(Table 9)..................................-�ft 4 in. <_ 11' Sill Plate Spans .........................................................(Table 9).........................:........ ft Oin. s 11' Full Height Studs (no. of studs)....................................(Table 9)..................................�...2r k c Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans...... .......................................................(Table 9).................................. ft_in. <_ 12' '( Sill Plate Spans............................................................(Table 9)......... ) ft_in.s 12" A//} Full Height Studs(no.of studs)....................................(Table 9)....................... ........ ............... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4 AAP Minimum Building Dimension,W Nominal Height of Tallest Opening2 ......:......:.........:.....................A1.4..dO��Jblfa......... s 68" SheathingType................:.............................(note 4)..................................................��/b OCP� Edge Nail Spacing.........................................(Table 10 or note 4 if less)....................... G in. Field Nail Spacing..........................................(Table 10)........................., . �_in. ...................... Shear Connection (no. of 16d common nails)(Table 10).........................................I.............. 3 Percent Full-Height Sheathing.......................(Table 10)....................: ° 5%Additional Sheathing for Wall with Opening>68"(Design Concepts).................... A R Maximum Building Dimension, L Nominal Height of Tallest Opening2...................................................................C.17�_<68" Sheathing Type..............................................(note 4)................. 7J. dfa Edge Nail Spacing .........................................(Table 11.or note 4 if less).......................�in. —� Field Nail Spacing....................................... ..(Table 11 .................... ............................a Shear Connection (no.of 16d common nails)(Table 11).:....................................... ....... Percent Full-Height Sheathing.......................(Table 11).................................................... ° 5%Additional Sheathing for Wall with Opening>68"(Design Concepts).................... Lt/LiZ Wall Cladding Rated for Wind Speed?.................................................:............ //0 5.1 ROOFS Roof framing member spans checked?........................(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang ................................................... (Figure 19).:.........f!j#, ft s smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift.....................;...........:..............(Table 12)............................................U=-2Q.r3 plf t/ Lateral..............................................(Table 12)............................................ L= � �2o plf Shear............................:.....:............(Table 12)............................................S= Y1 plf Ridge Strap Connections, if collar ties not used per page 21... (Table 13)....1,IjP plf 21T Gable Rake Outlooker......... ............................... (Figure 20)..:.......... 0 ft<_smaller of or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift................................................(Table 14)............................................U= It) ib. Lateral (no. of 16d common nails)...(Table 14).........................................L=_A!i0b. Roof Sheathing Type....................................................(per 780 CMR Chapters 58 and 59) ............ Roof Sheathing Thickness........................................... ............................................ 314L in. z 7/16"WSP . Roof Sheathing Fastening............................................(Table 2)....,.......... . . :. . (� ... ...6��dl�i e.....�... Notes: 1. This checklist shall be met in its entirety, excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM 110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Corner Stud Hold Downs per Figure 18a and Figure 18b 2. Exception: Opening heights of up to 8 ft. shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2-grade. s AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (780 CNM 5301.2.1.1)1 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of 7/16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. Horizontal nail spacing at double top plates, band joists, and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment -MEN THIS EDGE RESTS ON FRAMING USE&!NAGS AT fib.1C. 11 11 1 11 11 1 ' 11 II 11 II 11 11 1 11 11 - 11 1 N 11.1 I t `S 11 t _ N O 1'1 1-1 I l 1 1 I Q 1 - IL ;1 11 11 11 1 IJ 1 DO MAILSPACING PANEt d � See Detail on Next Page Vertical and Horizontal Nailing for Panel Attachment l � AWC Guide to Wood Construction in High Wind Areas: 110 mph Wind Zone Massachusetts Checklist for Compliance (7so CMR 5301.2.1.1)1 1 t FI 1 1 1 1 1 , j 1 (1 II v m 1 1 da 0 + FRAMING MEMBERS i EDGE14T'ERMEMUE 1 1 1 [._.3M4 1 / 2 1 1 18" STAGGERED 3"Mw ML PATTERN � PANEL PANV EDGE DOUBLE NAIL EDGE SPAONG MTAL Detail Vertical and Horizontal Nailing for Panel Attachment i AK Office of Consumer Affairs and Business Regulation r°c 10 Park Plaza - Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration " -- Registration: 131841 Type: Private Corporation Expiration: 9/26/2018 Tr# 419291 CENTRAL CAPE CONSTRUCTI01�'IdC�O STEPHEN DEVLIN 820 MAIN ST. COTUIT, MA 02635 Update Address and return card.Mark reason for change. �r Address Renewal Employment Lost Card SCA 1 0 20M-05/11 t Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-047993 Construction Supervisor STEPHEN J DEVLIN 820 MAIN STREET > COTUIT MA 02635 Expiration; Commissioner 02I0412018 1 r f Client#:38438 2CENTRALCA .�ACORDTM CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/Y 11/15/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(ies)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Dowling&O'Neil Insurance Ag PHONE 508 775-1620 F 5 A/C No Ext: AIC,No: 087781218 973 lyannough Rd, PO Box 1990 E-MAIL Hyannis,MA 02601 ADDRESS: 5O6 775-1620 INSURER(S)AFFORDING COVERAGE NAIC N INSURER A:National Grange Mutual Insuranc INSURED INSURER 8:Associated Employers Insurance Central Cape Construction Company,Inc. INsuRERc:Commerce Insurance Company 820 Main Street Cotuit,MA 02635 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER ADDLISUBR MM/DDIMY MM/DDNYYYY LIMITS A GENERAL LIABILITY MP197640 11/14/2016 11/14/201 EACH OCCURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY DAMAGE T RENTED PREMISES a occurrence $50O OOO CLAIMS-MADE FXI OCCUR MED EXP(Any one person) $1 O 000 PERSONAL&ADV INJURY $1,000,000 GENERALAGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2,000,000 POLICY PRCO- LOC $ C AUTOMOBILE LIABILITY 16MMBBWC54 09/06/2016 09/06/201 (CEO,ecccd.r SINGLE LIMIT $1,000,000 ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE $ AUTOS Per acc dent UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ B WORKERS COMPENSATION WCC50050091992016A 05/14/2016 05/1412017 X WC STATU- 0TH- AND EMPLOYERS'LIABILITYER I ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N E.L.EACH ACCIDENT $500 000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEEI$500 000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) **Workers Comp Information** Voluntary Compensation Proprietors/Partners/Executive Officers/Members Excluded: Steve Devlin,Pres./Treas. (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION Mashpee Commons LP SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE, THEREOF, NOTICE WILL BE DELIVERED IN PO BOX 1530 ACCORDANCE WITH THE POLICY PROVISIONS. Mashpee, MA 02649 AUTHORIZED REPRESENTATIVE s ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010105) 1 of 2 The ACORD name and logo are registered marks of ACORD #S180353/M180352 LS1 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): ��h/ Gl, (;.Ave,, Cd/j `� unoO Address: ZU AV Gn rS City/State/Zip: Q ,/vyftS3 62_G3�_ Phone#: 0'-2 � (6/' Are you an employer?Check the appropriate box: Type of project(required):. 1. I am a employer with �'- 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. New construction 2. 1 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 capacity. employees and have workers' y p �'• 9. Building addition [No workers' comp. insurance comp. insurance.t required.] 5. We are a corporation and its 10. Electrical repairs,or additions 3. I am a homeowner doing all work officers have exercised their 11. 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. Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: �� d C(Gt ��� M -- /I( v i ,r) Policy#or Self-ins.Lic.#: (l)CL U d U C1 2 ( H Expiration Date: Job Site Address: �-L 4 01T (_t j - City/State/Zip: CY�t l 1� (C. M, 612:�Q 2- 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 t e pains and penalties of perjury ti he information provided above is true and correct. Sip-nature: _ Date: Lln ------------ Phone#: .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#: THE ' Town of Barnstable Y Y Regulatory Services MBNBTA=, MA & Richard V.Scali,Director td39 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder C1 J —� ,as Owner of the subject property hereby authorize S � /J �iVLI IJ to act on my behalf, in all matters relative to work authorized by this building permit application for: 3 T, EL-L-(tl - C - Nlej (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. Signature of Owner Signa4Z oApplicant -5 1 CIO ftv:, A&VUD, Print Name Print Nam Date Gmail-Permit/Application: TB-17-1191 at 135 ELLIOTT ROAD,C... https://mail.google.com/maiVu/O/?ui=2&ik=38af556971&view=pt&se... Gmail Steve Devlin<centralconstructionco@gmail.com> Perm it/Application: TB-17-1191 at 135 ELLIOTT ROAD,. CENTERVILLE for Building - Insulation - Residential 1 message Barrows, Debi <Debi.Barrows@town.barnstable.ma.us> Tue,Apr 25, 2017 at 11:13 AM To: centralconstructionco@gmaiLcom Good Morning the above permitlapp!ication has been denied: The description requires a full paper bulldmg permit. Any questions please call 508-862-4038. 1 will process your refund shortly. Thank-you, Debi L } . 1 of 1 4/25/17,9:46 PM TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION., r r 4 t Map Application 5 Health Division Date Issued Conservation Division ! y Application Fee Planning Dept. Permit Fee (DO Date Definitive Plan Approved by Planning Board J►G G�3fat' Historic- OKH _ Preservation/ Hyannis Project Street Address /3 s !F"Lt.a7T R� Village C�1Vrc V/1_ 44= Owner �J_ A'%I w w /3 6rX Address rsrr/4J C'e-,v 7- Telephone SoF 77 s"- a7Y,'-7 :- Permit Request (2 Square feet: 1 st floor: existing proposed 2nd floor: existing propose Total new Zoning District Flood Plain Groundwater Overlay Project Valuation.Zoov.oo Construction Type woo 0 Lot Size /71 677 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure RS Historic House: ❑Yes No ,On Old King's Highway: ❑Yes No Basement Type: ;d Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) &A1p,ai*sy�o Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new d Half: existing new Number of Bedrooms: .3 existing o new Total Room Count (not including baths): existing new O First Floor Room Count- Heat Type and Fuel: ❑ Gas XOil ❑ Electric ❑ Other Central Air: ❑Yes >I(No Fireplaces: Existing / New O Existing wood/coal stove: XYes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ Attached garage:Xexisting ❑ new size AShed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes )No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name - lVo e`/!/el Telephone Number 7 7 J a Y�,7 Address /.?5 cvarr A0 �' �%. License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L 9N0 ��`� L. SIGNATURE :/(1 -- DATE i FOR OFFICIAL USE ONLY .I 3 APPLICATION# I� DATE ISSUED .Y MAP/PARCEL N0. - t ADDRESS VILLAGE OWNER � f DATE OF INSPECTION: a FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT: _ ASSOCIATION PLAN NO. . The Commonwealth of Massachusetts Department of Industrial Accidents 0. 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 Ledbly Name(BusinessiOrganization/Individual): .3"��.�.YA,d /��C7'GE� + S�/C=iCi¢ /sGcTLF�aQ Address: /3!5Z- ELL��77 fl City/State/Zip: CE.y�Elil�iUcE" M DZ�3 Z Phone.#: ?bF— `77-t-,7 446 Are you an employer? Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling • ship and have no employees `These sub=contractors have g, E]Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp..insurance comp•insurance.# required.] 5. ❑ We are a corporation and its 10.❑-Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I LFI 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.;U Other_aA�/t QF�ca4�e.� comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing then workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. . 'Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-conbuctm have employees,they must providt 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.M Expiration Date: Job Site Address: 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 WA for insurance coverage verification. I do hereby certify under the pains•and penalties of perjury that the information provided above is true and correct Signature: Date: G a _ Phone# .S"GS'- 7 7•5- - 2 7 Official use only. Do not write in this area,to he 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#: 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-contractor(s)aame(s),address(es)and phone number(s) along with their cerdficate(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 anLLC 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 drat 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 Tower 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 io 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 Office of Investigations 600 Washington Street Boston,MA 02 111 TO. #617-727-490.0 ext 4.06 or 1-977-IvIASSAFE Fax# 617-727-774R Revised 11-22-06 www.mass.gov/dia i Town of Barnstable �OFiHE Tp�� Regulatory Services �LE, xtvsre Thomas F.Geiler,Director sna + . y Mass. $ 1639. Building Division PTED �A Tom Perry,Building Commissioner . 200 Main Street, Hyannis, MA 02601 wvvvv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION" Please Print DATE: JOB LOCATION: - 35 number street village "HOMEOWNER': A /3ce7—/L S�Dp-975-3f� 7 Sad'-5 5=/tea name home phone# work phone# CURRENT MAILING ADDRESS: �,' EL Z`a r"-1,9 Chi✓ avii �� rW.Q. Z: 3 2 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Si ature of 11orneowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION . The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1om..1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, - Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board.cannot proceed against the unlicensed person as it would With a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner.certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Y t a oFIKE rq� Town of Barnstable Regulatory Services ` MASS. Thomas F. Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder 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 If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. r).Pr)R MQ•lIWAfFR PPR M1.QQ1l1N , _ : I I : t , I i ! " I f' i ,l a T a6 � _ - - - t : I r � I I j +• ` i t i i ' � I , _ r . i e 1 i , � l , f k 1 1 t !_ ! , 1 i ' b...... ........0 / L t —iwnu Qsn0H � d' EI :........ - _ _— Jagwnu l .. _ / �agwnu u d 3 6 to o a - , ossass►,. It I Til IL T. 3 A e _ _ /7; 67.7 �. •� tea. • j4//4)7N. n , w sst 4 + A �/ P i M -�31' 2b 777 -7v"//y l 1 . +! J?" kAl L_L 10.T77 r g, F .:\ CERTIFIED PLOT PLAN! �r ROBER IE RL EEFirt'�GE Nt c .. No.:t9367 ? IN VAAL MAS L �E SCALES 9'o' DATE , /2/ ¢ !fps C22C ffWjffj N� 00JA %//ck'0,/A 5 1 CERTIFY THAT THE/rfv vWO'7 7t vw CLIENT � SHOWN ON THIS PLAN IS -LOCATED �I$tER )y �111:01STER_ED �00 ' 653( ON . THE GROUND AS, INDICATED A 0CIVIL_ ILAND:. . _r _... '.n :.a.:_ i►n. CONFO.RMS."..TO THE .ZONING LAW& Town of Barnstable *Permit �. Expires 6 months from issue date Regulatory Services Fee 6 saxtasraBm : Thomas F.Geiler,Director � 7 Mass, 94, 039. ,0�' Building Division ArEo fir Tom Perry,CBO, Building Commissioner ° ®� 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-8624038 Fax: 508-790-6230 EXPRESS PERMIT.APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address J 5' j esidential Value of Work L�, psd Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /���rM - -- S 1 tL+ ✓�`�Poy ZCZ 1 In 1 , LI76`� Contractor's Name Telephone Number S § Q � 6 0 0 Home Improvement Contractor License#(if applicable) �?a EDW/orkmanIs Compensation Insurance Check one: ❑ I am a sole.proprietor vPRESS PERMIT ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance APR 2 9 2008 Insurance Company Name Q ARNBTABLE Workman's Comp.Policy# / 2- Copy of Insurance Compliance Certificate must be on file. Permit Request t((check box) Dine-roof(stripping old shingles) All construction debris will be taken to e91V&\D iP✓L_ ❑Re /-roof(not stripping. Going over. existing layers of roof) D-Ite-side [Replacement Windows/doors/sliders.U-Value 30 (maximu ix . *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors Li a S-e-is-irequired.! SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 . f 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): l•> Address: I nv�k-V c - , �F � S" City/State/Zip: �� t'1'i�- Phone.#: o 3 Areu an employer? Check the appropriate bog: Type of project(required): 1.L"1 I am a employer with _ 4. ❑ I am a general contractor and I 6. ❑ uc New constrtion employees(full and/or part-time).* have hired the stab-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. _ emodeling ' ship and have no employees These sub-contractors have g, ❑Demolition ' working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers' comp.•insurance comp.insurance.t required.] 5. ❑ We area,corporation and its 10.❑-Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myselL[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §.1(4),and we have no 13.❑Other employees. [No workers' comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensafion policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. TC=tractort: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 subcontractors 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. , hisu ance Company Name: �l — Policy#or Self-ins.Lic.M IAJC— -701 � �!5 Z fib? Expiration Date: 4-L Job Site Address: I , �I�j 2L- City/State/Zip: epi 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 crimirial penalties of a fine 4 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 a/b'ove is true and correct Simmature: lam Date: Phone -1"6Qc;,,7., 6� Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: PermitlLicense# 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 in the service of another under any contract of hue, 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 foreg oing-engaged in a joint enterprise, and including the legal representative's 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 com tmonwealth 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 regi&od 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 permit/license applications yin 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 copyof the,aff davit that has been officially stamped or marked by the city or town maybe 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.Whore a home owner or citizen is obtaining a license or permit not related io any business or commercial venture (Le. a dog license or permit to btirn 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. i - The C6mmonwWth of Massachusetts _ Department of Iadustdal Accidents' office of Investigations`- 604 Wmhington Street Boston,MA 02111 W. #617-727-4900 ext 4.06 or 1-977-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia I - New England Rerriodeling Doctors, LLC Federal ID#04-3456008 10 Kendrick Road #3 Wareham, MA 02571 MA Reg.# 130627 Phone (508) 273-0100 — Fax (508) 273-0155 Email:nerdoffice@yahoo.com S ear between New England Remodeling Doctors, L LC and THIS CONTRACT made the day of in they i3 Home Owners: Qf _ Home Phone: Work Phone: Address: Cit : f It State: Zip: 6 d"Z Cell Phone: We agree to furnish all labor and material necessary to install the followin described windows Window Color: Ca in N Color: r" Total Contract: Grids Sales Tax: Total Units: ' Double Hung Units: 1^042 A-" Total Price: Down Pa ment: Picture Units: Balance Due: Cro Hopper Units _ Ci Sliding Units: ' ;' �- 2 li 3 life De -it w/Order:Cash/Ck.# 9 ` 2 lite 3 lite Balance Due: CASH FINANCE Awning Units: ��U� " �� e`_ We do not do any painting or staining.We are not ` Casement Units: 2 rite 3 lite responsible for conditions or circumstances beyond our control including condensation resulting from or Bay/Bow Units: DH/CS due to pre-existing conditions.Our limited warranty is herein incorporated by reference. Garden Windows: Additional Notes: ft,w z - c D; re _CAU in A t �rr C'. R `iMR �9l�r/' �► '` G1y Buyer's Right to Cancel time Buyer may cancel this contract by notdelivering w written n notice to the seller at any"I hereby cancel"at the bottom and radd a to dding buyerrsht of tname he 'and address. rd business aThe notice er the dmust bate of ed 1 ver d to the Buyer may use this contract as that y 9 seller at the address shown above. Mn b i�rJ y ,�u1 and � ' P It is understood by you that the following The installation will begin on or about •(G�„�. and we will be substantially completed on or about contingencies could materially change the estimated completion date stated above:customer's inability to obtain or qualify for financing:inclement weather:strikes or other labor disruption:non-availability of materials:acts of God. , We represent that we carry Worker's Compensation and Public Liability Insurance. RED TO BE REGISTERED WITH THE MASSACHUSETTS BOARD OF ALL RESIDENTIAL CONTRACTORS AND SUB SPECIIFICONTRACTORS ARE ALLLY EXEMPTQFROM REGISTRATION. INQUIRIES CONCERNING REGISTRAT ON SHOU DIN E REGULATIONS AND STANDARDS, UNLESS DIRECTED TO: DIRECTOR, HOME IMPROVEMENT CONTRACTOR REGISTRATION, ONE ASHBIJRTON PLACE, ROOM 1301, BOSTON, MA 02018 (617) 727-8598. . IF WE DO CONTRACTOR OR SUBCONTRACTOR IS OBLIGED.TO OBTAIN THE FOLLOWING PERMITS: YOU WILL NOT ENTITLED TO OBTIOBTAIN ANY BOENEOFITSIFROM�THE GU RANTEE FOT REGISTERED�qITH THE BOARD UND ESTABLISHED UNDER BUILDING EGULATONS BE ENTETTS GENERAL LAWS CHAPTER NOT BE EN 142A. HE ANY DEPOSIT REQUIRED UNDER THE TOTIS AGREEMENT TO BE PAID IN AL CONTRACT PRICE OR THE ACTDUAL COST OF ANY MATERIAL OR EQUIPMEVANCE OF THE COMMENCEMENT OF NT WHICH HAS TO BE SPK SHALL NOT DEC AL GREATER OF ONE THIRD OF ORDERED OR CUSTOM MADE, WHICH MUST BE ORDERED IN ADVANCE OF THE COMMENCEMENT OF THE WORK, IN ORDER TO ASSURE THE PROJECT WILLPROCEED ON SCHEDULE. NO FINAL PAYMENT MAY BE DEMANDED UNTIL THE AGREEMENT IS COMPLETED TO THE SATISFACTION OF BOTH OF US. 00,. G ��`� w En an R deligg Doctors Buys s.$�ignature ' 4 J. New England Remodeling Doctors Buyer's Signature �\ 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 BuildingRe ulations and Standa:.rds Registration� 130627 g • . Expiration 414%2010 Tr# 266023 One Ashburton Place Rm 1301 ,E tr,, Boston,Ma.02108 t T.ype Ltii"Liability Corpor NEW ENGLAND�rREM DELtNG DOCTORS LLC TIMOTHY SZYNAL` ` 10 KENDRICK RD#v0 '"_ ,,,�a,,,� 77 f„ WARHAM,MA 02571 Administrator Not valid without signature { \ 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: 'Registrationio6, 130627 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration 4%4/2010 Tr# 266023 lr Boston,Ma.02108 Type Iditiability Corpor IVEW ENGLANDREMODEUN9 DOCTORS LLC rz� TIMOTHY SZYNAE' w 10 KENDRICK RD#1. � 77 - Sr WARHAM,MA 02571 Administrator Not valid without signature r APR-28-2008 12:30 M M ASSURANCE 603 356 9290 P.02 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE r" Associated Industries of Massachusetts Mutual Insurance Company J,' VqY i4 Burlington,Massachusetts NCCINc�z9i58 ' "an ..,r POLICY NO. I AWC 701 4160i2007 FRIOR NO. AWC 701 41601200b .q', i ITEM 1. The Insured Tim Srynal dba New England Remopeling Doctors Malting Address' 1a Randal)Road Rochester MA 02770 ;p>a pk. sweet . ti- Town or Cb colmty s'als zip code y l , R Individual ❑ Partnership L.J Corporation "❑.Other FEIN 04.34MS Other workplaces not ftwn above: 12J1812007 1y1e/2008 2. The policy period Is from to __ 12,01 a.m,standard time at the Insured's malling address 3. A. Workers Co npensation Insurance: PBM One of the policy applies to the Workers Compensellon Law of the states Wed here; l; MA S. E players LtablMy tnsmrite: Pan Two o1 the pnNcy apples to work In each state 113104 in Item 3A,. The llmitsof out liabilityunder Pad Two are: Bodily Injury by Accident S 100,000 eachamiden Bodily Injury by Disease S 500,000 policy limit Bodily Injury bydlseaee $ 100,000 eachemployee C, Other States Insurance_CoveteP Replaced BY Endorsement WC 20 03 08A TA D, This policy Includes these OndOrSomenls and schedules: SEE SCHEDULE CN 4. TN premium for this oonay W R be deters ntned by out Manuals at Rules,Classifications,Rates and Rating plans, All Inforn i lon required below is subject to verification and change by audit, st Clacseioalions Premium Basis Rates s FaUm�tad Porsiou �tirneted l';', j, Code Total Annual d MM W ry5 s� i l Na Ranuneregon %munerfo r�remMrtn il: ?R,y�,I+, j INTRA 462914 SEE EXTI NWON OF INFQRI IATION PAGE Minimum premium$ 500-00 Total Eetimstad Annual Premlwn 5 Ae indicated.Interim mQustmenta of premium shall be made: Oepoau Premium [� Annually ❑ Sem1 Annually ❑ Quarledy ❑ Monthly ' 1 °6` MA Assessment Chg. ;? i" '' F I yN I" h4S This Polley.lndudlno All endorsements Is hereby countersl ned by 11/01/2007 . A ftrbmd ftnaluro _ 6DlG •'q, GOV I cpv KlNO.. PLACING CLAIM NAMS SAFE1Y STATE I CLASS I AUD17 I OFFICE I OFFICE CHECK GROUP Mason&Masson Insurance Agency MA 5&tti 104 1 ]Inc WC 00 00 01 a(11.88) 458 South Avenue, Ir�udo�coprrlgNtedmarederotd�eNurenyCAUne�lonColnpYn6eJanlnwranoo, Whitman,Tv1A023$2 usod vMh its potedt ron. i, ti � - 3 // The Town of Barnstable 636 Permit# Massachusetts •_ Date /' 30 �� AM SAILWABUL w • SOLID FUEL STOVE PERMIT oes. 16396 p MA'S Fee This constitutes an official stove permit after inspection and approval by the building inspector. Owner T,/t, 13U T�� Telephone no. 2�7 Address of Property /emsu-� �� Village Location and Stove Type Date: Building Inspector The solid fuel burning stove at the above location passed: failed: inspection. The Town of Barnstable dam Permit# o2R6 3 / Massachusetts tn&MABUL = Date IKAS& SOLID FUEL STOVE PERMIT ds¢ �.� Fee This constitutes an official stove permit after inspection and approval by the building inspector. Owner Telephone no. Address of Property /3s` 6Gc«r:r `� Village �FN7 Location and Stove Tv7e Date: Building Inspector The solid-fuel burning stove at the above location passed: failed: inspection. • o i r� ,,, :.:, _r. 3,? Assessor's map lot number, Irl-96&LI�—.. ov— I IV %THE Sewage Permit number .............. q. ................ SEP77C SrEAwl ; BARNSTABLE. A1 MAM House number ...... ...................................... "St.4Q. 039. CO r T TOWN OF BARNft�,mEV s ',AT®®NSIwo BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....14.4;�.11!41...... ............. ........... TYPEOF CONSTRUCTION ............. .......... ..................................................................................... ........................../X0......19...f TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information. ,,,......... ............... .......4 Location ............................ ......... ............106....................... ........ ........................ ......................................... ProposedUse ......... ............ ............ ........... ............................ . ................................................................ ZoningDistrict ........ .............. ...... ...... ............4.................... . ....................................................Fire Fire District ................. I Name of Owner . dAAq- -- r 9........ ... .... .... ........Address .... ....... ........ . Nameof Builder ....................................................................Address .:.................................................................................. Nameof Architect ...................................:..............................Address ...........:........................................................................ Number of Rooms ......................... ........ Foundation .................. ....................!.... .............................. ... Exterior .............. e....... ...........Roofing ................ . ..... .................... ............................ ............................................................ Floors .......................... .........................................In'tlerior ....... Heating ..Plulbing ............................ -............&1D...................Fireplace ......... ..... ... ..... .. . . . .. ...AppLimate C0St . . . ...... . Definitive Plan Approved by Planning Board Z� ------------- Area .......................................... 7 117d 0 Diagram of Lot and Building with Dimensio Fee ................... ....................... SUBJECT TO APPROVAL OF B ARD 0 HEALTH 1,0 7 *6, I too �q( lev OD ,e�— IcI7 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of BarnstabI egar i g thf above REQUIRED FOR NEW DWELLINGS construction. el" Name .................. ...... .... . . ............. ..... ....... . ... ........ Construction Supervisor e n s?e6.. . ..........� �NICKULAS, LARRY 2 -1 0 ... 8772....a... Permit for .... ...Story ........ ............... ..........Si.ngle...Fam.i.l.y..dw.e.11.ij��...................... . ...... . ...... . . .. .... . .... . Location Lot' 5, 135 Elliott Road ................................................................ ..................Cen..t.......erv..i..l.le........................................... .... ''--Owner .....Lar.r.y..N.i.c.ku.l.a.s.........I.......... Type of Construction ...Frame............................. ................................................................................ Plot ............................ ........Lot ..................... December 16, 05 Permit-Granted ........................................19 Date of-Inspection ....................................19 Date-Completed ... ....1 9r-19 _440 Cr k-7 V1 vn Assessors map and lot number . . ..... --�, e THE o yam.... _ Q Sewage Permit number ............ ...........�.�......9............. BAUSTABLE, i House number .... ...� l — M"" �p t639. TOWN OF BARNSTABLE i BUILDING P IN. SEGTRO APPLICATION FOR PERMIT TO .. .1�.... .......................... TYPE OF CONSTRUCTION 1. f, • ram' • ....................... f'-:........ 19:. '..'` TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location s ................ ` C E, ... Proposed Use ......`. ..........zy' . .-- .. u:.....Y. ! err .............................................................. Zoning District ....... '/ .......... Fire District ........... ..i. ...................... .f.............. Name of .Owner ......: �" ....� P-' .. .....Address .......`. 47X.. Name of Builder :: ...................: ....Address // Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....:................... / ..........Foundation Exterior ..........:`` 'r .� ............Roofin .........�✓"Z '... / ............................ a a Floors' ........................................Interior . -G .' �i. :................. .............................................. rieafi'ng't'`............ s�.:..... !''r 'T� -- • .....Plumbing ...........................= .... .. ..........' ? ?. Fireplace .................................f... ... s ... . ..... ...............,Approximate. Cost .......................................... ...... . Definitive Plan Approved by Planning Board :�__� ___ ___________19 Area ....................!....' Diagram of Lot and Building with Dimensions Fee "' .�a............. SUBJECT TO APPROVAL Of BOARD OF HEALTH ` d 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS, _I hereby agree to conform to all-the Rules and Regulations of the Town of`,Bgristab ega ding the above construction. ` Name ..... :... .... ............... ... �• �) Construction Supervisor tense .....4�.�.�.......:�... NICKULAS, L-#a-RY A--m-2-8—+-3-9-60-27 ' No ..............28772... Permit for ....A..Story.............. . ..........Single...F a m.i.1.Y..D w e.1 l.i.n.2..................... ...... . . ...... .... . . Location .,.lot 5,.....1.35...Elll.o.t.t..R.o.ad........ Centerville ............................................................................... Owner .......LaTjry..Nickulas ........................................... Type of Construction .....F9.4.MP............................ ................................................................................. Plot ............................ Lot .............................. Permit Granted . December 16,...............I.....................19 85 Date of Inspection ....................................19 Date Completed ......................................19 ,y TOWN OF BARNSTABLE Permit No- _____2 8 7 7 2----------__ ` Bantling Inspector Burr Cash -------------- - OCCUPANCY PERMIT Bond __________x_ _/ �d Issued to Larry Nickulas Address lot #5 f35 Elliott�Road, Centerville Wiring Inspector 's ,/� Inspection date G/4 Plumbing Inspector � - Inspection date Gas Inspector 'v � f r Inspection date Engineering Department--�- y f �r� Inspection date Board of Health �tit�r,.a.t d•��% �--gym_ Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. E • ��f `� Buildin Ins ector TOWN OF BARNSTABLE BUILDING DEPARTMENT Z BA"S : TOWN OFFICE BUILDING i639' �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department//10 `- DATE: Alr An Occupancy Permit has been issued for the building authorized by BuildingPermit #........ � ........... ...............................:....................:::............ ...... .... ........... . issuedto ..r�'�..... ' ,„ �C 1C...;•,��.„!...a'".............................. ............................................................................_.........» Please release the performance bond. r 1 , b � d T S ice; 77 s, 00 VDU Z>TH. oil N M toi N®r M d . jp/cv T' C T/!J/d FEe, ART..11�, m yy N 1 /6v'U 0. zr z—z- v A CERTIFIED. PLOT PLAN . c� �iSERT . y�, U .T 07 o4 r , B. TEr�V/�L E E6eU�i1-GE IN RCALEs /"=-9'o' DATE , lol 4 ./8. s 1 CERTIFY "THAT. THE�0 Ew/)'17/ CLIgNT,,;,..._, ..._ Sa01Nld -ON THIS PLAN 19 LOCATED �t TEREO R 019TERE0 J013 ' 85 /3 6 ON . THE OROUND AS INDICATED AMU CIVIL LAND , ;A;M ..CONFORMS TO THE .ZONING LAWS EN®INFER SURVEYOR .ICY, .,�.. r..... Of ®ARNSTA'R , MASS. CN � '112' MAIN STREET 111. / HYA N A I S, MASS; - SH99T..LOF '/ TE REB. LAND SURVEYOR Assessor's map-and lot number . ..RP.�. 9 u ai P�pF?HE tp�Ii Sewage Permit number .............................................I..........� 1, BARNSTABLE, i House number ... r rasa TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... . G ........................................................................�y TYPEOF CONSTRUCTION ..... ............................................................................................................... .............: ......../z............... 19.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....�OV•••........5.......... !.!". .. 0 ............�r4✓r1�.rG Z. ....................... ProposedUse ..... h .........!y:vpie.................................................................................................................................. ZoningDistrict ........... .. ................................................Fire District .............................................:........................ ��r Y l/ Name of Owner /. {�c'1+P�"........... ...........Address ... :(.!..f�....... ....�................................................... Name of Builder .7`r� /. . y ..e�?+:O'd�f .0.....................Address ........-�.� ?.... / ���I. ... .....M... ... ... ..j Name of Architect .......................Address .....&f,.�O.eAs.............................................................. Number of Rooms ............. ............... ...................................Foundation A,,r�Ki.......................................................... Exlerior ..... .C.► ...... 4.........................:..........................Roofing .... sp.XA.17 ........:................................................ Floors L.s�.s ° .............................................,........Interior v� �' � ............................. .... ..................................... Heating �� x?. a.:.........................:.......................................Plumbing ...... .... ........................................................... Fireplace ..................................................................................Approximate. Cost .............. .. p............................ Definitive Plan Approved by Planning Board ________________________________19________. Area ......02/�. ......................... Diagram of Lot and Building with Dimensions Fee ®O SUBJECT TO APPROVAL OF BOARD OF HEALTH 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 ...e ...................... Construction Supervisor's License .... ... 3 ............ ° BUCKLER, CH&DLES � . ^ ^ 28528� ' No — -- Permit h for --8oild— Addit—ion--- ---- — ' . . . Sio le DwelIio . . ---..��B�—�������----���------- . ` Location ..... .....l35...ClIiot... .�d........ .^ ' .......--.--.C����rviIle___________.. _ , ~ . ` Owner .....Cbarl��.Buckler_________. _ ` ` Type ofConstruction ...F.r.ame............................ ' ---.---------- ................................... Plot Lot _ ' October ll, 85 Permit Gron|e6 -------------]P ^ � Date of Inspection .....................................lV ' � Dote Completed ........... --lg ~ ' ~ - . ,- - . ' . ~ ` - - ^ ' . . . ~ ^ _ . . ' . ` � � . �~ � Assessor's map and lot number . ........ g � y�F 7N E tp�♦ Sewage Permits number ........................................................ Z EARSSTODLE, i House number ....1�/....... ........................................... ro Mb a 39• �0 CFO YPY a• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ..... .. �'i TYPE OF CONSTRUCTION ......V..:'.:�:.................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned 'hereby applies for a permit according to the following information: Location ....... .: .! .......... .........4 � `..!".t..e�:�.f��..............4�.�,'° .'.` .I................................................................... ProposedUse .... ....I ..............�e.........................................................................:..................................................... ZoningDistrict ........f.:.6, 1....................................................Fire District .............................................................................. J Name of Owner 1/YrS....../t .f"' j"`�'.......................Address ...Cr.,!rt' '°'.ls ? /'r. . r Name of Builder .7,�`.'v,�... ....:................Address l "*,� ............................. :...............r?r Name of Architect 1 � (� ! / i '.......................Address .....f� ..... Number of Rooms ..................................................................Foundation ..Q%: a ................................................ Exterior .....we�f .......�.......................................................Roofing ... A ........................................................ �F Floors ..... l.p:. i ..................... ............Interior ��'`..��..eG. r ........... ..................................I................. Heating .......Plumbing ` Fireplace ............................................................_.....................Approximate. Cost P� ..................... 119 Definitive Plan Approved b Planning Board ________________________________19--------. Area � pp Y 9 Diagram of Lot and Building with Dimensions Fee l SUBJECT TO APPROVAL OF BOARD OF HEALTH 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. Name1.., °.�-r��.•.�. 1 yia. e,. .1...................... ' Construction Supervisor's License ...d ......... BUCKLER, CHARLES A=228-139-2 ��� No ..:28528... Permit for .. Addition ............... ..... Single Family Dwelling ............................................................ ....... .......... Location '..:Lot 5, 135 Elliot o d ................................... ... .............. Centerville Owner Char.....es...Buckler. . . ......... . .. . . ...... . ............................. Type of Construction ,Frame .............................. ................................................................................ Plot ............................ Lot ................................ Permit Granted .... October 11. 85 Date of Inspection ....................................19 Date Completed ......................................19 i i - i {r--tt- •1} - - - - i. 1. f-- / i `�' 'j_ .. r3•Fl s 1 - , s � rr--• ar, �� P , o- ai` JrY4 'Prl I ��. � •,��, � V / � ,� I � }' �it +.,.. (+ �.r,: ' r ,.4 �� �,1 r L@@Lpp ff I 1 � LJ i + Y •" sr yi 1 1 , • � I •� h,,, :� �f =y ,jr Assessor's Office'(1st floor) Map L-f 00 Lot *3 IMermit# P - t1 Conservation Office(4th floor) Al 3 d�o��� Date Issued I� - 3 a / �4ngine'ering oard of Heakh(3rd floor)(8:30 9:30/1:00-2:00) �- /1-� ./� Fee Dept.(3rd floor) House W .-0 FW INSTALLED IVATH�� j pN ABLE. t a . - 19 IRON ND TOWN ®F BARNSTAB N �E � � Building Permit Application 1 Project ss 4�3 EGG/�D T�r> JQ� I) Lar J� Village C,417F t V%Caz 6=- Owner �,dm 13y E'er Address I Telephone Tat- a ,q7 � � 7S- '956"o - �Armit Request Doug' 'aV5y ifA01r7eY t Total 1 Story Area(include 1 stoi garages decks) 1�50 square feet 7 Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished T�1 Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air _ Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) I FOR OFFICIAL USE ONLY PERMIT NO. - _ t DATE ISSUED MAP/PARCEL NO.g a F SRC. ADDRESS VILLAGE OWNER IK 4 DATE OF INSPECTIOrqy FOUNDATION FRAME INSULATION FIREPLACE . ELECTRICAL: ROUGH, FINAL E PLUMBING: RQUGI_ FINAL , GAS: :ROTJGiI FINAL FINAL BUILDING (03 DATE CLOSED OUT ASSOCIATION PLAN:NO The Commonwealth of Alassachusetts Department of Industrial Accidents 600 H aNhin ton Street Boston,Alas. 02111 Workers' Compensation Insurance Affidavit , �pltcant tnformationc Please Pi2ilVT legl�l�a„y /ame* --J-51ff/V /location: /�S� ��� All 6� I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity E ...ea+� xn•••..aa• •.r .�.:-��!'c+'�.xaea+�••ee,�aw�{etc7'�"+.�scv�'�wrr +•• �s�35", w'r*?^_r,�w'�+'r"_"""ka �ey;w,sey�.-�-,.m m...�� I am an emplover providing workers' compensation for my employees working on this job. company name: address: J city: phone#• insurance co. policy# I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name ail d ress cim: phone#• insurance co. policy# �.,.: y, �. ,.._,^ .. . urarr:s;;p -Ty`ce�--a+y .;'"'1'".,Hx^? +ua�'r'*s�7?a.t?.•",'s,:G "fA"`.-�"'S�R4• 4�:r".�'.rr: �^+�-' sy..�:�1.�.....:...�r3......wa......— _.:ia.+n• ...:i-_— - - ..�''yrSr�'.T''�l'x-t" +�" - company name: address- city: phone#• insurance co, Qolicy.# ;Attach addihonal'sheet if necessa ''r' >f-•-- �..-'t.� n"' ¢', ._ ^.r :;' e, `"•�'. `.�' ,• :tom' ^ ? . '" `''' Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to S1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a cope of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herefi certifl tinder the pains and penalties of perjun'that the information provided above is true anfd correct. �enature Date /J/ Z'��� Print name ./ •M/ /� ��E� Phone# 7 71 L�'c' �offCi21 use only do not write in this area to be completed by city or town official city or town: permit/license# r iBuilding Department OLicensing Board 0 check if immediate response is required pselectmen's Office r OHcalth Department contact person: phone#; nOther} x - ��P»'-re4 . l w r s,,ww•-.a+•_.•r.w..r^rer�nc.�!!`r un,scd giros P1A) . The Town of Barnstable M Department of Health Safety and Environmental Services 16-39. `e Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crosses Fax» 508 775-33" Building Commission For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,moderaiTation,convemon, improvement,.removal, demolition, or construction of an addition to any pre-existing owner 00cupied building containing at least one but not more than four dwelling units or to suactores which ate adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements- ./ Type of Work: ��i¢ f Est Cost ddressofWork: er.Name: �te of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under S1,000 .ng not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING SO Nt7f tEGI3T�7rltFADCCCONTRACTORS ACCESS TO FOR APPLICABLE HOME IMPROVEMENT WORK D ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor name Registration No. OR ' Z Date Owners name TOWN OF BARNSTABLE BUILDING DEPARTMENT y, HOMEOWNER LICENSE EXEMPTION Please print. - . ::. . ... DATE JOB LOCATION /c. a P'T �� l&z �k- GL - C ,ot! ' 'Number Street address Section of town �OWNER" �. , T�c�C ?T-Z -7 TTS'-�'S` ' Name Home phone Work phone RESENT MAILING ADDRESS �Gc C' iiYRr�i Ge 3 , — City .town State Zip code The current exemption for "homeowners" was extended to include owner-occupi dwellings of six units or less and to -allow such homeowners to engage an in dividual for hire who does not possess a license, provided that the owner acts as supervisor.'. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to r side, on which there is, or is intended to be, a one to six family dwelling attached or detached structures accessory to such use and/or farm structure A person who constructs more than one home in a two-year period shall not b considered a homeowner. Such "homeowner" shall submit to the Building Offi on a form acceptable to the Building Official, that he/she shall be respons, for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes ..responsibility for compliance with the Building. Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requiremen. and that he/she will comp with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be requires to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for whic,a--IFUldir permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that Home Owner engages a person(s) for hire to do such work, that such Home C shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assumin the responsibilities of a supervisor (see Appendix Q. Rules and Regulatic for .licensi.ng Construction' Supervisors, Section 2. 15) . This lack of awar often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed. Supervisor. The Home "Oir6er,'a as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, . communities require, as part of the permit application, that the Home *Ownt certify that he/she understands the responsibilities of a supervisor. On last page of this issue is a form currently used by several towns. You mz care to amend and adopt such a form/certification for use in your communit i L0 T 3 7\�� 73, zS' 0) V ).0 7 5 - /70677 5-,'Fr, k! Zo,,V R28rh to , N//DTH .p 1 L'r. M \ /MOTE- : A ss 7- M -e--31 �- 26 S 'Rv rECTivni Pee AR .iU) .71, �'E. 7u,,vn.,gY�.h N 34.� - rf M / )O,00 I �LLL/ OT 'UA ID • (PV�3e.tG of � CERTIFIED PLOT PLAN o�sa ROBERT 7-�rJ�lTe�Lc�-i Vv T/LT LEev I+ o s ELDREDGE ^ No. 1030719 w SCALES /"=90' DATEOE CAMNEERINS I CERTIFY THAT THE/059 uW0 4 71 vn' GLIENT_,_.,,.� SHOWN ON THIS PLAN IS LOCATED AtSTERED REGISTERED JOB NO. BSG CIVIL ,LAND ON . THE GROUND AS INDICATED ? ENGINEER SURVEYOR DR,By A, M_, CONFORMS TO THE ZONING LAWS Of PARNSTAB �. 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APPROX.LOCATION OF SEPTIC SYSTEM FROM RECORD w z 30.9 14.(Y Fosopc�!,T i2 #135 i6oll10" 12.9 oagnt4G 203 REV. DATE DESCRIPTION BY APPR OWNER OF RECORD: NORMAN & KATHLEEN BUTLER \—BRICK STEP 135 ELLIOTT ROAD &LANDING CENTERVILLE, MA 02632 APPLICANT: NORMAN & KATHLEEN BUTLER 135 ELLIOTT ROAD ioo-w PROJECT: CENTERVILLE, MA 02632 S 510 21'ir W CERTIFIED PLOT PLAN 135 ELLIOTT ROAD ROAD IN ELLIOTT (PUBLIC VARIABLE WIDTH) CENTERVILLE, MA tits OF AIA SHEET NO.: I OF 1 DATE: 4/13/17 LEGEND MATTHVEW C. DRAWING FILE NAME: ELLIOTT-1 35—BUTLER—CPPI COSTA DRAWN BY: JB No 52282 ICHECKED BY:MC EXISTING DESCRIPTION PREPARED BY: �4 (3 CONCRETE BOUND Ave's I HEREBY CERTIFY THAT THE IS LOCATED ON THE CAPE & ISLANDS ENGINEERING CIVIL ENGINEERING-LAND SURVEYING-ENVIRONMENTAL PERMITTING 0 STONE BOUND GROUND AS SHOWN. THIS PLAN WAS PREPARED FOR THE SOLE PURPOSE OF DEFINING AN ACCURATE ON THE GROUND LOCATION OF THE SUMMERREW PARK lF4CCMU3CWA7w 1 Q 0 IRON ROD STRUCTURES SHOWN HEREON.ALL OFFSET DIMENSIONS ARE BASED ON AN ow FALmouTm RoADsunrE 3oic 508.477.7272 PHONE info CapeEng.ctxn 0 20 50 100 "ON THE GROUND"INSTRUMENT SURVEY. MASHPEE,MA 02649 508.477.9072 FAX www.CapeFng.com 0 IRON PIPE - DRAWING TITLE: • IRON ROD W/ CAP SCALE: 1 20' CERTIFIED PLOT PLAN MATTHEW C. COSTA P.L.S. DATE PROPERTY LINE ASSESSORS INFORMATION: 248-311 ------------