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HomeMy WebLinkAbout0330 ELLIOTT ROAD TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION " Map I Parcel v Application'. �VJ Health Division Date Issued Conservation Division � �. Application Fee Planning Dept. , Permit Fee`, 41 Date Definitive Plan Approved by Planning Board 'k, Historic - OKH _ Preservation/ Hyannis T4& Project Street Address �.L4 0 •�' � Village GtG"kS%1V 46 • tAA , 014021 Owner FA IQ -tO 4pr.,A6 Address ' 3xp C- 0.% Rd Telephone —3W --7 to Permit Request V w*11 a A Uc.2 G PSTb o;-*-444 AQeA �6 C SiFM F4 Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio y() ,Qcn Construction Type Lot Size Q-6 Pjcrlt6 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ZrNo On Old King's Highway: ❑Yes f110 Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) O Number of Baths: Full: existing new Half: existing JX new Number of Bedrooms: �� existingo new Total Room Count (not including baths): existing _�new First Floor Room Count Heat Type and Fuel: ®'Gas ❑Oil ❑ Electric ❑ Other Central Air: . ❑Yes o Fireplaces: Existing 21Newee Existing wood/coal stove: ❑Yes Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use 5 ,9� Proposed Use eC#),GA rka APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name F Telephone Number 6108'360 Address 33,E su110+k License # rrff Gr�� yt U� Home Improvement Contractor# Email FAw) L'�' e'!9X-Ai Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4-0 'Pvn-,C�► AIJ SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED - •• M9I' t # �i MAP/ PARCEL NO. a*. -.• ,;, `. —= t, a ADDRESS VILLAGE t f OWNER - Y DATE OF INSPECTION: a FOUNDATION - 4 FRAME INSULATION i FIREPLACE ELECTRICAL: ROUGH I' FIN,\L PLUMBING: ROUGH FINALS �1 GAS: ROUGH FINAL � FINAL BUILDING �U 5 to 11� , DATE CLOSED OUT `� ASSOCIATION PLAN NO. ' y The CF!MWOI7}t2Wkh Qfmamen $ Orke VfbrPCz*dfiOM. 600 FFrrsl►mrgtm feet Buse,MA O2HI •. . wgv��ra.mas� �lia - . Workers' ComzpensationIns ce avit$mlde7dC�unb-a��c-one hers IIIform�fit Please Prixd Address: C.7,t,/SW.M,- tiYe)N-xJ% 11� Mir AZ6P iV,-- 508 -.,3f0 7400Z Are you an employer?Checkthe apprapriate = Type of project(regau edy- I.❑ I ant a tnployer vwifh 4. El I am a general coaimctos and I - 6. Ides oousoa employee;($ell an&for gad-fime).* lave Iffie soh-court 2.❑ I am a sole proprietor orpart mr tided rmthe arched sheet~ 7- ship and have no emplWees • These sah-c�ts hm. & ❑Demolition wcddng fume is any capacitg. �l andhave wod=' [NO 'camp.;T4vtrr„r� COMP.imsumnu $ • . . g' ❑ s affdiion 1 5. ❑ We are a coapomfiam and ifs Id-El Electdcal repairs or aeons 3. am a homeovmer doing all wmk 1 L Q plumbingrepaizs or ad&iaas =ysd f LNa 'gyp- right of exeaqif=per MM L7_❑RDof in a regu;*pd-1 i c.M,§l(4).and weILweno employem[No Wadoers, 13-D,Otlser cam insrance mgdu-e&] �$ap fat cber�sbos�1 mast elsn ffioa�the sectioaheLax•shc�g t'�eawodcers'��.mfi�.+poy� • l�eovrffi,�v saw iris a eney sz e1F�a�t s t[�]axe o e c�amst sv5rmitanew ffidx& fin nCTL fCa $ist c3�cYt3i5 bmc nos[affidted m:sdRdi�l�al s�gei s5aa�agtLen�of the�+-��*sc�er�:mod st�e�hethe[®rnatfEose ea�shs� E6IIQIQ]RPS.Iftil2 mhresnlrae-Frvef�y+e�jprl '�f I�F '� ��.�Q�}II�IIEL . -Tam era empLa sr f7v¢is pruuidirtg taorkets'caarp,eazsaficxra irasruatres or entp yea .Be&w is fihsprr�cy andli7b.e i�cforac�n. - i Tasaxancr�GOm•PaftY�siSe: . �' -Polky 4,,'m Self-im Zic.4.1LF�pi�iaaDafe_ Job Eta Address` C4/Statae� p: AC#2ch a copy of the warkere compensationpolicg detmrafion gage(shy the policy mower and expiration.date). Failure fn secure coverage as regnisedunder Sectian,25A of MGL c-15'7 caa lead to the imposition of csimimal peualts es of a fizfe up to$L ea t7Q sacVor ane` rx sons as as penalties m the tarot of a STOP WORK ORDER:and a fine of up to$250M a dap against the violafcr. Be advised rid a copy ofthis zbdement maybe fimvzBed fa the Office of Iuvest'sgations of the MA for i surce coverage vedffcafioa. Ida heraiiy eerAyy under the of gerfacap fhatfita ugfarwa€=prm&W abate€1s true and carreat s-oaxt„m Late: Phone V ~ 70 ' Ojokid am aanfy.'Do Wert write in wwa,to be cmnp Wed by dif+matt n gore&at Chy or Tama: Per fewe# Issuingar (Ch-de-ras): L ward of M21& ":.Buffirmg Department 3.OtyMmea Ckxk 4-Electrical I r S.Phunbing Emspedmr s.Othm CoRsct Person: Photo : 6 1 1 11 11 1 1 1 1 ! ! lJ `�= Jtiw�•r_ - •�- .•:r■(� �•IU�•. .I i3t11• ••�R i■ 11 • /- •••I.7�■. r•la■t■:!/ :(■•lt I■1 [\" + �11t1• • �- 'n ■_nl n u w. rout .n �.u . ■ •n:• :w - ••'R•■ Jr i■ - � • :n■n� m•� al ru■n :r ■ Im - . ■ �.�• • •i •ram.a : _n u n nu: •r.■ n�R•tIr :•:�•wrn•n rn ■• .n w •1 •n� -•r- :a■ut n _n• •.• • n u - • ■•- 7.1 --•u �+■_r._�a n •to .n+rr. ur�� _I/• n u nu_ is- _ - - • ■ ■ f�" • :/+ Ir U •Il •_■ ••rR•tI■ .ww•wY/■•11 •1 •■■� _J% �Inl • i+.■aia •• ■t_ halt• ••�.- i••• •� i/- ■r••� rj _ •• - 1•• ■■+ ■ t■• l• It•1 ■■:11 (11 i- .■•:t n■i�r(L :It■ •'Ita ..Y•- i■�' Ala■ n ■■ • rrI•�/11 • ■■- • 1 n• ••aw- • :n•it� ••■• +;nu •• /i.R•n n •■ n.nnl:�■.n r u• ■ t r■ua a •.n ••■•. u■ n t ■•• Iw: ■•■w • ••1■ \• 'J •r•■• a ■al •■l .■r■•I liia.I/1 7■� - 1• ■ I ■• •�l:ta • • .l �+laU •••■.n •" a��i\•:• ■• •- :■• �••1a • J� a-n t� • : • ru:. a:e � -•, r_ r ■ _t r= w Ym_ - ■ - ■ - ,• • :as . ■' u + ■• ■ •- r 1 u.Yn:.,v ■ o/ ma.Y■ 1 r a,to a ■■ _ u ■• - r■ann • ■ - it ■ .0 •• lr•la. 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' A WC Guide bn Wood Construction imHigh Wind Areas. I 10meh.Wind Zone Massachusetts CheckHst for (78UCMR63& .�y'I)1 . check ` ' ' ^ ' � 1'1 SCOPE Compliance' � Wind ' 11V VWndExpomueCa�go�___-._-_-'-___--_--_---'-.__-....................................-� -----'- -'' --- -..............................................~ 1.2 APPLICABILITY Number ofStories ` ` ^ des S-2 stories Roof Pitch Building Width,vv....................................-____-_-'--_--____- --_ BuildingLength,L _-___'_-_-_---'--__---. �uquMgA�e�Rodo .......................---- -- --- , v-� 3� Nominal He����T�ha�Opan�g^ .-___--. � �� -�--`----~-G�^ ---- .�----_ ~ ' . � 1'3 FRAMING CONNECTIONS ' ' General compliance with framing connwotions....................(Table 2)........................................................ ....... 2.1 FOUNDATION Foundation Walls meeting requirements of7BUCMR54041 uoncreue,.--._-.--.'---__-----..-__-_-_-.-.__-_______...____._. ' Concrete Masonry.................................................................... ---' - -� _'-_---. 2.3 ANCHO8AGETQFOUNDATION" ' 5/O Anchor Bolts imbedded or 5/8'Pn,phebmy Mechanical Bolt ----- ---- BonEnbeumen -concn�e_- ----- ---- 8o� ......................................... ----- ---- Plate Washer...............................................................(Fig 5)~______��x Yn� -- � - -�-- 3.1 FLOORS Floor framing member spans checked ~ � Maximum Floor Opening Dimension...................................(RQ6)............................. ft:512'orU2nrVV/2 `---- Full Height Wall Studs at Floor Openings less than 2'from Exterior Wall(Fig6)....................................... ---' Maximum Floor Joist SetbacksSupporting Loadbearing Wails m[Sheonmall................OFigr>.................................................... It dMaximum Cantilevered Floor Joists _ -- Fk�,Supporting. - Walls E��m�U ............. .. ................................�- '- ------(Fi ---' ` ����� '--- Fks� ---- Floor Thickness................... (per 780 CMR Chapter ---- *uorshmghmQFoau��Q.��-_--____---.--_.(Tablenails md ' in �e/ --- . ' 4.1 WALLS ' . Wall Height and Table _--�.--_.--�_� ��7 walls.......... and Table S>----__.-- It �2J --- Wall Stud --___--_'�--~'r.--_--- and Tob���- ' 24ro.c. --- - Wall Story Offsets ........................................................(FiQo7&u)------_-_--r--.._`--'ft :5d ---' 4.2 EXTERIOR WALLS3 Wood Studs ^ ' ` L====.,g walls.......................................................(Table o>...... ....................2x ft in., Gan�Eodvvauu�ong � �-' --- ---` Full VVSP/��Fk�rL�g�--_,� ' | ---- Gypsum VVGP 1� ' ---' 2�4- - ' / -' ` � w�onvnuouz��/u�ce@o ft.o.c'-pFig11L--_--'-_'---��.-- °""me ` . ---- Splice _ — _-_ . '-----------'-_' . . ' ` ^ ' ` ^ ' AWC Guide to Wood Construction in Nigh ff"Ind Areas:110 mph Wind Zone Massachusetts Checklist o t r Compliance(780 c�ttz s�o><.z.>i.i) Loadbearin9 Watt Connections Lateral(no.of endnailed 16d common nails)..............{Table 7).........................._............................ Non-Loadbearing Wall Connections Lateral(no.of endnaled 16d common naffs)_._-.....(Table 8)..„..............................................._... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ...................................................:...(Table 9).................................—ft_In.s 11' Sill Plate Spans ..........................................._.......(Table 9)................................._ft_m.511' — Full Height Studs (no.of studs)...............................(Table 9)........................................................ — Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) HeaderSpans.............................................................('fable 9)................................._ft—In.512' Sill Plate Spans................................... (Table 9).................................._ft_in.512' Full Height Studs(no.of studs)........ ......................(Table 9)........................................................ Exterior Wall Sheathing to Resist Uplift and Shear S1'Z&neousV Minimum Building Dimension,W Nominal Height of Tallest Opening2 ............................................................I..............._5 67 SheathingType................_............................(note 4)...................................................... Edge Nail Spacing.........................................(fable 10 or note 4 if less).......... ..............—fn. _ Field Nail Spacing..........................................(Table 10)................................................. in. _ Shear Connection(no.,of 16d common nails)(fable 10)_...................................:.................. _ Percent Full-Height Sheathing................. ....(Table 10)..................„................................_% _ 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts).............. Maximum Building Dimension,L Nominal Height of Tallest Opening2..........._...................:........................................ 5 6'8' _ SheathingType........................................_..(note 4)......................I......................... :.... _ Edge Nall Spacing...............:.........................(Table 11 or note 4 if less)........................ in. _ Field Nal Spacing..........................................(Table 11)................................................. in. Shear Connection(no.of 16d common nails)(fable 11)........................................................ _— Percent Full-Height Sheathing.......................(Table 11).........................._..._............„....... 5%Additional Sheathing for Wall with Opening>6'8'(Design Concepts)...........„. ... — Wag Cladding Ratedfor Wind Speed?.............._.......................................................................................................... 5.1 ROOFS Roof framing member spans checked?..............._......(For Rafters use AWC Span Tool,see BBRS Webs ) _ Roof Overhang .................................................. (Figure 19)........... fts smaller_ ller of 2'or L/3 Truss or Rafter Connections at Loadbearing Walls — Proprietary Connectors Uplift................................................(Table 12)............................................U= pif _ Lateral............................................(Table 12).............................................L= Of _ Shear........................_....................(Table 12)............................................S= plf _ Ridge Strap Connections,If collar ties not used per page 21.....(fable 13)...........................„Iler.of 2'T= Of _ Gabe Rake Outiooker....................................... (Figure 20)............ _ft s sma or U2 Truss or Rafter Connections at Non-Loadbearing Walls — Proprietary Connectors Uplift...............................................(Table 14).................... - Lateral(no.of 16d common nails)...(Table 14)............................... = lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 and 59).................. RoofSheathing Thickness................................_..................................„......„...........—in.a 7/16'WSP — Roof Sheathing Fastening..........................................(Table 2)........._...................................._..._.... Notes: — 1. This checklist must be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 53012.1.1 Item 1.ff 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. Comer Stud Hold Downs per Figure 18a. 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. VK AFFC Guide to Xbod Corrsfrrrrldda rr)�i Tr AkuzdAra=-IZD rvh firmd4aaz.e • Massachusetts Cheeldist for Campdmce cmD cmnsmi.7. 4. m From Tables i 9 and 11 and lotafron of wall sliefty and B fildhg Asgecf Ratio,determine Pert&rt Fcttl-Helght shmehmg and lA Spadrig Mquirenlents . b. Wood Struchn-9 Panels shall be mcftrtrt thialmess of 711 B'and be installed as fbnDws: - - _ L Panels shA be installed-oft strength arts patalled to litvic if. X horizontal jobzts shall occur over and be narled to fra¢ning. RL On single s oty mnstrmlibrr,panels shall be at#ached b botinm plates and fap.inembet of the double - .--- — p -- - - -- shaff-be .in-bd lap tnetnbernMe upper double to plate and b band joist at bob=of paneL Upper aff achrent of lower paned shall be made is band joist and lowerattadimarlt made to lowest plate at fust tidortiaming. V. Horimr&.d rag spacing at dmi&tDp plaies, band joists,and girders shall-be a double now of ad - sta nt S. Glazing pmterort a),n ouse orhDrhmrd-ataddi5p n rewired ifp?r)e k i rnr7eH o�sto shh re = Afi�ch h r3f Rfe.ZB or north of Rfe.E) (e 't south of b)vertical addffian—not requfed triless there 15 exlar rmxwdDn to tine first floor c)reptat tnerttwiridovrs—needs energy r-on=v4=carnpT C:;only(chap 93)S.Wood Frame Cormtuc&n Manual.OWCM)fhr 110 MPH, t�posum E may be obtained from the Amerir.&n WDDd C,oun=1 (AWC)vreb�. V , cat - - • FRALW=155=954 to • [I 1! tl tl • ii ii i, i a o t .•ii ii.� 1 e t o LL [ F Ir 1 i Le Pd it tl ! t REF 6iT1ai1TSX[T1= I1 L) ► t i E . ST _ i a jE L i i t ' '_�•i- F'` ,�y � jy�IFGC TJEtf RY_C' �L . .See Data ?n Next Page Yer&W-and HorimrrW NBUTMg = > i t VET5 a4 and I-forra)- I Nai�mg). for Panel Attacfunent fnr Pane!Aftrl marif _ Town of Barnstable Regulatory Services dF Richard V.Scab, Director Building Division ` KaM t Paul Roma,Building Commissioner ea. �, � 200 Main Street, Hyannis,MA 02601 www.town.barnstable.nuLus Office: 508-862-4038 Fax: 508-790-6230 n HOMEOWNER LICENSE EXEMPTION Q 1 Please Print DATE: _ 1 JOB LOCATION: 3 3Q J5 LL., Q+�"' �,L AAM.IXV(J number street village "HOMFAWNIER": ` Ae&.0 57te (�i o-'7(p ` name l r home phone# ( work/phone# CURRENT MAILING-ADDRESS: 3 3O �`'• �� L.AG cityhown 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_in ores and requirements and that he/she will comply with said procedures and r r Sign omeowner 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 EXEbI n0N The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages.a person(s)for hire to do such work,that such Homeowner shall act . as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed personas 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 to amend and adopt such a form/certification for use in your community. �.++E Town of Barnstable � ` Regulatory Services MAM Richard V.Scab,Director abs .�q �� r�659 Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maas Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must COrilp�ete�`a1113..S�i`,yI'his"'•SeG�t1021�� 4. "»�Y,', If Using A Builder. �+ I 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) t **Pool fences and alarms are the responsibilityof 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 Signature of Applicant Print Name Print Name' Date • Q:FORMS:OWNERPERMISSIONPOOLS VL J 4r 8U,lLbWd DEPT OCT 18 2016 TOWN OF BARNSTAf3L[ 10/11/2015 F-2 001.jpg e --- � [.xm —- wc. _ 3& 5 IrIJK� PIv �-�• w 311'r 9PI% 4 a V6•v Lyy.�4 L�z"µ• (p.) pl �E �� 6716 `JuE !,iG u'LLi Y r 3% 3v w: k 45 ---- y4c.}sr �v3 _io wA06 u. cz fmio —� T3 C lzrlE� yy�k �� t��lfla� 3 -TV G iF lA. tiC1 T 3 c .r m � Y Neu/FA(MILY ROW _i�It �Cbv✓ CScscEh jx, NO,raw Fb* https.:Hmail.google.com/ /scs/mail-static/ fjs/k=gmail.main.pt BR.lm4K4TyXSUQ.O/m=m_i,t,ittam=PiPeSMD8v cHsc4QoF36QNV999 vULs7MPDv3cmgGQvAP5v9v8A�2-em76Q/rt=h/d=1/t=zcros/rs=AHGW... • � y TA i' ES ABLr Z � r 1 1 "• I 1 i p 1 6• s - Z 1 Building Department Services s fTME Tp� �.y Brian Florence,CBO Building Commissioner - F zAxxsrAgr�, 200 Main Street;Hyannis,MA 02601 MAss www.town.barnstable.ma.us ®k Office: 508-862-4038 Fax:���€7�Q0-6AO Approved: ,(3!= 'Z3 Fee: Permit#: SB -/TiT-o7lodS HOMM OCCU. ATXON REGISTRATION / ILI/ i 90 Name: n+�O�_o Phone#: �06 -340 -76 6 Z T 1 � Address: 3O e c(. .v4 Village:� Name of Business: �J �a �- �� c3c S Type of Business: `�/`-C, ,7-A) $'�^—Q Map/Lot WI' : It:is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,'subj ect to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the.dwelling. there shaU be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. A$er registration with the Building Inspector,a customary home occupation shall be permitted as ofright subject to the following conditions: • -The activity is carted on by the permanent resident of a single family residential dwelling mait,located within that dwelling unit. •" Such use occupies no more than 400 square feet of space. • There are no extemal alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess ofnormal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • 'There is no exterior storage or display of materials or equipment. • There are no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton oapacity,and one trailer not to exceed 20 feat in length and not to exceed 4 tires,parked on the same lot containing-the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall bg employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the undersigned,have read and agree with tfie above restrictions for my home occupation I am'registering. Applicant; Date: HOMCDOADC Rev.0620/16 - YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does. not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is, required by law. DATE: IZ-_/ I I Fill in please: APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS: -DO - l- o ��ole r�o_766Z fin. O 2� W " TELEPHONE # Home Telephone Number EMAIL: fia�/ova .Ld NAME OF CORPORATION:. NAME OF NEW BUSINESS ^ ^ 1 L Co/"M C I TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO Z ADDRESS OF BUSINESS.33� 9 n L iAL. �MAP/PARCEL NUMBER (50-2 DFS (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFF_.I This individual has bee orm o n rmit requirements that pertain to this type of business. Author zed S' atur COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. _�..___._.._ _ 'LICENSING AUTHORITY.. This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: s v G OFTHE Town of Barnstable Permit#( �� 72 ires 6 months from issue date Regulatory Services Fee � g Y * snxtvsznar.E, - y Richard V.Scali,Director 'E0 o�g�R�VST►���-E Building Division TOWN Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERWT APPLICATION - RESIDENTIAL ONLY r� 0 Not Valid without Red X-Press Imprint __---Map/parcel Number Property Address .3,30 G(K,1 0+T R 6qi.4v-6 iL V 1 1(C esidential Value of Work$ ,S'o� m Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address PAb! Z-10 c.AJ-K 3.� v6C,�J� /�� /� �✓l�l�f oz&/Z Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: R Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ Latfi a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# A Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ Re-roof(hurricane nailed)(not stripping: Going over existing layers of roof) ❑ Re- e Q eplacement Windows/doors/sliders.U-Value (maximum.32)#of windows �-t #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. -,A copy of the Home Improvement Contractors License&Construction Supervisors License is requir d `• SIGNATURE: Q:\WPFILES\FORMS\bull erm orms\EXPRESS.doc 06/20/16 by s �l ' the Commoratvealth of-Massachusetts Deprwirrrent v, rod-us-ftialAccrderats f _ 600 Waslrurgiton Street Boston,AMA 012111 kt Fm mas.&gdav1dia Workers' Campensafion Insurance Affidavit:i3mlders/C+antractorsJElectri,cians/PhEmbers - pp&anf Infarmai an Please Print llv b� Frame(St�es�rganaatianlF„d��nal} cam _ mess 330 G i A:Lr , Uto. city/ tuk Are you an employer?.fheckthe appropriate box: Type of project(require: I.❑ I am a employer with 4 ❑I am a general contractor and I 6. ❑New employees(fish andfor part-time).* bavehired the sub-coatzactors 2.❑ I am a sole P�� or proprietor partner- listed on the attached sheet. - odeaing p These soar-cantrac#ors have s4isp and bane as employees. ', $. ❑Demolition wadding for me in any capacity_ employees sadh"'workers' 9. .❑Build-mg addition [Na�vo�ers' camp.rra�ranr� camp_insueant,I 1 5- ❑ j,�41e are a corporation and its I O ❑'Electtical repairs or additions 3. am a fiameou*ner daigg all wow officers have w=—ised their 1L❑Plumbing repairs or additions myself[No worlrgs'comp- right of exemption per MGL try:❑R:oofrgmirs insurancere uitadj i c-152,§lM andwe have no employees-[No workers' 13_❑Other comp.insurance required.1 4ALayepplicaat&atcheft box FlnmstelmM out the section belowshowkz ffijEimwodceiecompensatiaupaTiupin5m=dmi #Fiameoutntxs vrho sabmit dais af�daru ia�rztiag they are rlaing alf�ca�and then hire auiyide coatsctars nmst sahmit a new a�ds4ii u'a'rn�sack. TCantractmiffut cherkthis bax must attaclu d=addilianal sheet shoQmgthename of the sub-comdx�m and stafe'whether.arnotfhose eafi feshn�e employees.If the sub-c=-tzct shave employee%they=tstpm4idttheir xorkEWmmp.porky number- Iart[art srripioJ�r tlsat isprouiriircg workers'canzpe�csrdiort i�isriraaca�vr�c}*engvFn}+ees ff oiv is tfigpalicy turd job srfe Insurance!Company Name: — "Policy or se mns-Lic_1pf- ExpirationI3afe: Job Site Addmm GitylStaf z4r ; Attach aropy of the workers'compensationpolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Sezfion 25A of A?GL c-157—can lead to the imposition of criminal penalties of a fine up to$1500.00 andf'or onie y6irimprisonmenta as well as rivil penalties.in the form of a STOP WORK ORDEZand a fm' e of up to 0-0,0 a day against the violator. Be a iised that a copy of this statement nsag be forwarded fo the Office of lavvesEgations of the DIAL.for insurance-coverage v erifc adon. I do Iferdy cgr6f-y amdter tlt s r .getj r?'fl�attJte infarRza#ivrsprmirl�dabm�s i g g a�td correct ;xi�ature_ Date— Phone -3b0 t)„�Ciai u.�e rsad�: ,17o slat a1"rita itY flits area,tzr be crrrnpTete�d by cite artan7t a;�al .. City or Toww. PermitUcense i# Issuing ndwrity(cirde floe): L Board of Health 2.BufTXhg Department 3.Oity1rmrn Clerk 4 Electrical Inspector S.Plumbing fiLveator 6.Other Contact Person: Phan#: -- ---- -- - - - - 6 I i} S{ Taformation and Instrnc-ions Mass-chmctts General Laws chapter 152 rego:b:es all empIoyers to provide wod-Lets'comp ensafion for their empIoyees. p m tins sue,an ernplzyee is defined as_"_.everg person in the service of another under aay cont-act of hire, express or nnplied,oral or wrhe�" l An employe is defined as-m mcPxyidal,Parfneaship.association,corporation or other Iegal entity, or any two or more of the foregoing=gaged in aJoint eotecPrlse,and including the legal=Presentatives of a deceased employer,or the receiver or tiastee of an individna�partnership,associabnn or otherlegal entity,employing emPl°yees. However the owner of a.dweIImg house havingnotmore titan three aparfineuts andwho resides therein,or the occogunt ofthe - dwelling house of another who e upIoys per sons to do maminnance,construction or repay work.on such dwelling house or on the grounds or bm mg appmte:nmt thereto shall not because of sash employment be deemed to be an employer." M- CrL chapter 152.§25C(6)also states th2t"every fE.grAlo,cil Iicearing:a i g shaII withhold the issuance ar renewal of a Iicen a or permit to operate a Durum ess or to construct blffl( gs"na the coMmonw alth for any app&cant Who has notproduced accepght ep'degRe; Tnays ce coverage re al- Additionally,MGI.chapter 152,§25C(7)states fileithrzthe common ealihnor iLybf'itis�ofifical'subdivundns shall enter fijD any contract for the perfon_oaaw of public woricunI acceptable evidence of compliaa.cevrith fhe fimnaiice._ ruplimnients of this chapter have&--enpresented�to.the co—utiuctingaufioi*-" Applic-aats _ Please fifl oht the workers'comp nsttion affidavit completely,by ch=Id a-aLe boxes,djat apply to your situation and,if necessary,supply Sob-contactor(s)name(s), addresses)and phone nomber(s) alongwiLflatir certificSte(s) of c ILwn yehinthe nTanCe. L mitD LiabU4 Compades(MC)or Li itedLiabityParneships � e members or.par(ne:p,are not required to cauy workers'compensation iagoranca- If an LLC or LLP does have employees,apolicyisrupked. Be advised that this affidayit maybe mbmiitr-+itothrDeparfinentofludustrial '-•., Accidents for contrmation of ins�-�oe coverage Also be sure to sign and daft the aim-davit- The affidavit should`-,.,,; be retimmed to the city or town that the application for the permit or license is being requested not the D epem.eat of Tnr}„ct a l Acddefs. Should you have any gnestions regarding the law or ifyou aim required to obtain a workers' compensation policy,please call the Department at the number listed below* Self-insured corpanies should enter$2eir s e1f-m srttan ce license number on the appropriate Ime. City or Town Ofacials f Please be sere that the affidavit is complete and primed legibly. The Departinent has provided a space at the bottom of the affidavit for you to till out in the event the Office oflnvesfigat ions has to contact you rega udiag the applicant. Please,be sure to fill in the pert tl crose number which will be used as a reference number. In addition,an applicant that must submit multiple penuitlIicense applieaiioms m any given year,need only submit one afffidav>t mdi�g c=eut policy information(if necessary)and under`mob Site mess"the applicant should wute'all locations in (may or • town)_"A copy of the affiday k 13iat has been officially stamped or marked by the city or town may b e provided fo the applicant as proofthat a valid affidavit is on file for fviure permits or licenses Anew affidavitmust be filled olf each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le. a dog license or pemn t to bum leaves eta.)said person is NOT required to complete this'affidavit The Office c f InveSiigatrons would like try thank you is advance for your cooperation and should you have any questions, phase do not hesitate to give us a call The I?epartmenf's address,telephone and fax number: T1e�awtli�of Massac�in�#s } g q *' mt of IadUSfdal AOO9ant e ice" fitce j)CLVk � �yh�4� �� fY'�_'MJ ��♦ Boffin=Y4 01 11I Tf,-L 4 617' -4-9OG Qmt 406 or 14 MAS Revised 424-47 -��Idia II I Town of Barnstable Regulatory'Services oFTNE�ryr Richard V.Scali,Director Building Division . t SAEIVSTAiLE. • Paul Roma Building Commissioner Mass. � g 0.59. A�m� 200 Main Street, Hyannis,MA 02601 E D MId www.town.barnstable.ma.us ; Office: 508-862-4038 L Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �,D Please Print , DATE: SJ/ / JOB LOCATION: 330 CLC 1 In� X—� number street village "HOMEOWNER": name hoe phone#,1 work phone# CURRENT MAILING ADDRESS: ; city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow. homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as su ervisor. 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" o ner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures uirts am /fie-will-comply with said procedures and requirements. V7. _ Sign o e wner Approval of Building Official e Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing.Construction Supervisors,Section 2.15) :This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with.a licensed Supervisor. The homeowner acting as Supervisor is ` ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On'the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 Town of Barnstable Regulatory Services ` s MASS.w ` Richard V. Scali,Director. 1639. ►�� Building Division.Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us —Office: 508-862-4038--- ---- ---- Fax: 508-790-6230-..- ...__- Property Owner Must Complete and Sign This Section If Using A Builder I , 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) **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 Signature of Applicant Print Name Print Name Date Q:FORMS:OWNE"ERMISSIONPWI S t , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma Parcel T ��d 41 O F � Application #� � �r�v r7 p �����STABLE pP Health Division .� r� Date Issued 6 , v r 10= 17 Conservation Division Application Fe nn Planning Dept. Permit Fee ay Date Definitive Plan Approved by Planning Board l it' 10, Historic - OKH _ Preservation/ Hyannis Project Street Address 3 3 O V Wi v i R O, V`1 A 6 2 r. ,?Z Village Owner A Q l c 2 o(,,4 Address Telephone_ 7 6 L Permit Request m AA r C) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 7 o o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑-Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If es site Ian review # Y P Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 5Qc4p ' ��N��c-r Telephone Number Address P, O P--?0 1 o S� License # r/ b a- 7 vc- Vv a God 1 Home Improvement Contractor# /* Y G/ Email OC re- , l 4 vvA �6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /+8 c (I SIGNATURE DATE �/2� r FOR OFFICIAL USE ONLY t APPLICATION# DATEISSUED z MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION t FRAME t INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f ` I • 4 4 ••a• w.• ,�y a S ..w.....�<�... s•i1i,WMIi.�.�a41•�W..��...ry,.�I.4��i�/,iMrlrYir y . r .Fi. •✓�•IMT.+'t�,��..�VVY�w���rr .�...".. . NSA •Y".Y•7 .'•. try'"<"'� "Mm N .44 * V I Y .III ` + i 19 ! tea ; 4 ` i • 9 I The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114--2017 www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Analicant Information Please Print Legibly Name (Business/Organization/Individual): Ia T,:N S'J A'1 Address: City/State/Zip: S ��1C oti1� Phone#: C-Z f 7 2 Y y Are you an employer?Check the appropriate box: 0.1717 Type of project(required): 1 a employer with employees(full and/or part-time).' 7. ❑New construction 2.❑1 am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] 9. ❑Demolition 3.❑1 am a homeowner doing all work myself.[No workers'comp.insurance mquired.]t 10 ❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I L❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a gennal contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insimm.t 14. er wL�/ R • L 6.❑We are a corporation arui its officers have exercised their right of exemption per MGL c. 152,$1(4),and we have no employees.[No workers'comp.insurance required.] *Arty applicant that checks box k1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating airy are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that chxk this box must attached an additional sheet showing the name of the sub-contractors and state whether or not dim entities have employew& if the sub-contractors have employees,they mist 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:_. f J-)qt2 Policy#or Self-ins.Lic.#: � (� S�� d O e) . Expiration Date: CT 2 Job Site Address: 32 6 011 d T City/State/Zip: Ce^-*,-�l le M 4 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DiA for insurance coverage verification. I do hereby certify under th 1p an penalties of perjury that the information provided above is true and correct i e: ate: Ph ne#: - �S — b y l Official use only. Don ot w 'e in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health—.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Off ce of cros=elr Affairs and Business Regulation 10 Park pLua- Suite 5170 Boston,Mas 02116 liome improvement . ,r, Registration Replstradon, low, ��'� ��___ --1• ; Type: Private Coraommon Expiration: TraW TYti ?B9'!84 RETROFIT INSULATION, INC. JOSEPH REILLY P.O. BOX 105 ` __'*' ., N'a� Update Addraim ma t+Mm WL Mark rum for WMP AddM �)li I UpwMe9t Lost Card SW 0 ZOWMI -- ���irxaxoruueal� tadaceo�waslA Lieeaee or reallbadoss Vaud for indly!"no p&a of CEasemaer At4in k balm se E�oa dut& bused rol s m Us� NOW COMMOM orm oicSo='mm Asl am emd Dubme Ba6dadou 5. `uo4s1 TYW. 10perkpk a-SMeS17o 8 Pdvw t:o wmdon 1ost4 MA 02116 RETROFIT y JOSEPH RERLY i I FALLMVM MA OYIZ� s-,• U Wat VAN without eipAwn Mamackmang-Deparbnerd of Publk an" ` Board of BuNdlno Mpalso m and BtNWWrds t n„Etrvc ,n SLi,enisr.►Sj.eciahy L+cann:cse -+�q�n� �daslat,� .�:, •,y PON=IN i 8leereah M4 IMI dP !� !F • � „•�r�' Escpiratbn i 0l�ASlfl17 III RETRINS-01 RBLACKI .4CORO" CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) `.� 7/27/2016 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 License#1780862 CONTACT HUB International New England PHONE Fax 222 Milliken Boulevard AICo El:(508)676-1971 ac Ne:(508)678-2750 Fall River,MA 02722-9946 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC i INSURER A:Star Insurance Company 18023 INSURED INSURER B: RetroFit Insulation,Inc. INSURER C: PO BOX IDS INSURER D: Seekonk,MA 02771 INSURERE: 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 CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILA TYPE OF INSURANCE INSD YV1ID POLICY NUMBER MMMIIDDD CY E POLICY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE 1-1 OCCUR x DAMAGE TO RENTED— PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY a JET LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE UABILITY COMBINED SINGLE LIMIT $ Es aociderd ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESSLULB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION - AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Ya NIA 0846201 08/0212016 08/02/2017 E.L.EACH ACCIDENT $ 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS!LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF,. NOTICE WILL BE DELIVERED IN 50 Washington Street ACCORDANCE WITH THE POLICY PROVISIONS. Westborough,MA 01581 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD I - December 14, 2015 To Whom Concern, Insulation was done by RS Spray Foam-insulation Inc at The 330 Elliot Rd Centerville Ma Location. The Gable Walls Ha Faced Fiberglass R15 and Closed Cell Insulation.The slopes Where Also Done with Closed Cell Insulation 5.5 inches R38. Cathedral Wall Roofing Was Done With Craft Faced Fiberglass R21. If you have any questions or concerns please feel free to contact us at Rsspi-ayfoam@gmail_com or (339) 469-1905. n Thank You TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map o-T Parcel— per, Application # � Health Division Date Issued Conservation Division Application FJ ii Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address -��� e Cut 45 T Village Z\ I -� Owner bO CA A _ 'Address C (Telephone 08 0 6 2/ Permit Request �'�,h ,L AJ A l.1 ti �� LO ' - �-.►�� r�--� tip- S `Square feet: 1 st floor: existing_\1roposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0-Q=0 Construction Type Lot Size Og(o A-CZET Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Y Two Family ❑ Multi-Family (#-units) Age of Existing Structure ' r1-1 Historic House: ❑Yes 'dl o On Old King's Highway: ❑Yes ❑ No Basement Type: mull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) i 8,Q Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —pew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: 3<as ❑ Oil ❑ Electric ❑ Other 3entral Air: ❑Yes Fireplaces: Existing Z New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: xisting ❑ new size _Shed: ❑ existing ❑ new size _ Other: ' Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use w e APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name. FfAb Z.V( A Telephone Number �5 -3�20 Address `� �G� �-�`rG License # S � Home Improvement Contractor# Email 4 - Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT-WILL BE TAKEN TO SIGNATURE DATE 1 � - - FOR OFFICIAL USE ONLY a APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER a DATE OF INSPECTION: FOUNDATION FRAME( j"- l:rllr0L INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ?Tie Cormmarrivealth of-Vassachusetts D4parameiit cr,f IrrdrrstrzalAcciderrts far— O„�il'e O•f.£FI1�fft1.g/71L07rS . 600 Washington Street Baston,41A 02111 ' b4'fVt?sr11t3S�•�DY/�l�lll Workers' Compensation Insurance Affidavit Budlders/ContractursMectricianslP'himbers Applicant InfGrmat ign Please.Print Legibly \,Na ie 3asinessl r anQatianlInd z3na1}. ��1 v0 '_C'ity/Statf Zip W" U WV\ Phan.x1r' .�b O —J 6-1 /6 6 2 Are you an employer?Checkthe appropriate box: Tya- F red)c 1.❑ I am a employer ixith 4- ❑ I am a general contractor and I 6. n emzplayees(fish.andfor part-time)-* Have hired.the sub-contractors 2.❑ I am a sole proprietor• or partner listed on the attached sheet. 7. ship and bane no eruplayees. These sub-contractors have g ❑Demolition wading far me in any capacity.- employees•and have workers', 9. ❑Building addition [No-w-orimrs'comp.insutance comp.insura ce.1 5.,❑ We.are a corporation and its 10 ❑Electrical repairs,or additions 3. r a homeowner doing all work officers have exercised their 11-❑Plumbingrepairs or additions ` _ txiysel€[No workers' _ rigbt of exemption per MGL 12_[:1irs Roof repa incat►arare required]i c.152,§1(4),and we have no employees-[No workers' 13.❑ Other comp.insurance required-] *Amy applicatxtthatchecksbox#1 mast also falcutthe:sectiaabelawshawing fluakwaakere compensat onpolicyinfbrmauaa Homeowners who submit this arhdardt ingffratiag they are doing all wcflk sad d5ffi hire outside contractors mast submit a new affidavit indicating sari FC'aniractn6 that eheck This bast mast attached as additional sheet shoaiag the num of the sub-ccn=ct&m and state whether or not fhase entities ham employees.If the mtrb-coatnactorshaveemmptoyea%dieymnstpmtddetheir worlres'comp.policy number. I arts an efffplopff tlerrt is prm.,idirfg it�orkers'compensalian inmirance for wy entph;yees $etoav is$tepoticy and job site i�f�ormafion. ' Iitsurance Company Nam: , Policy or Self-ins-Lie. ExpifationDate. Job Site Address: City/Statel�: t Attach a copy of the workers-"comzpensatianpolicy declaration page(showing the policy number andexpiration date). Failure to secure coverage as required.under Section 25A of MGL c 152 can lead to the imposition of criminal penalises of a fine up to$1,500:00 and'ar one-yearimprisonmueak as well as civil penalties.in the form of a STOP WORK ORDERand a fine of up to$250.00 a clay against the violator. Be advised that a copy of this statement may,be forwarded to the Office of Imrestigalions of$ie DIA for insurance•coverage yecification. I do Ifereby cal fy ander tF pants tuidpenabies ofperlwy that dig infortvta6aa prmi&d abm,g is bars and correct r Date- a tree 5 -3d O 2 OBkiat use anfy. D47 not&write in this area,ter be campleted by city ortolvil offidat City or Town: PermitUcense,#' - Issuing A.utho,r€ty(circle one): 1.Board of ff-e9th 2.Budding Department 3.C ity{rmrn Clerk 4.Electc Teal Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: -— --- - --- -- - .6 -Information anon and lnstructious Massachusetts Geheaal Laws chapfsr 152 requires all employers fo provide workers'eourpensati(M far their employees. PmMrantto this stye,an��y�is defined as_"-.every person in the service of another under any cant-act ofhae, express or implied,oral or written." An empkye-is defined as"an individual,par(nerh4,association,corporation or other Iegal entity,or airy two or more of the foregoing=agagcd is 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 mamfenan ce,consfructi.on or repair work on such dwcDiag house " e to shall not of sack to entbe deemedto be an employer. or on,the grounds or building appzaten�th re �.p yin MGL chapter 152, §25C(6)also states that"everp 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 applicantwho has not produce:d acceptable evidence of compliance with the insurance_coverage required.' Additionally,MGL chapter 152,§25C(7)states-Neither the commonwealth nor Eby of its political subdivisions shall enter into any contract for thepaformance ofpublic work mitil acceptable evidence of complian.cewith the indicant@._ ref j=Meats of this chapter have been presented to the contracting airthodt" Applicants , Phase fill out the workers'compensation affidavit completely,by chec. $e boxes that apply to your situation and,if necessary,supply sub-eoniractor{s)names), addresses)and phone numbers) along with ti�eir ceriificafe(s) of rndrrance. Limited.Liability Companies(LLC)or Limited Liability-Partneashrps(LLP)widino euployees other than the members or partners,are not required to carry workers' compensation insurance. If au LLC or LLP does haye. employees,a policy is regnired. Be advised that this affida:vR may be submitted to the;Department of Industrial Accidents for confrmation ofmsm7ente coverage. Also be sure to sigu and date the affidavit The affidavit should be retomed to$e city or town that the application for the peunit or lic en re se is being quested,not the Department:of lnd T curial A ccidmfs. Should you have my gaestions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below Self-ins�red.companies should enter their self-ins� ce license number on the appropriate line. City or Town Of adz]s Please be see that the affidavit is complete and prhted legibly. Tie Department has provided a space at the bottom of the affidavit for you to fM out is the event the Office ofInvestigations has to contactyou regarding the applicant Please be m=to f71 in the permitlli.cense number which wM be used as a refarence n=ber. In addition,an applicant that must submit mullipIe,permitllicerse applications in any given year,need only submit one affidavit indices c urea policy information Cif necessary)and under"Job Site Address"the applicant should write"all locations in (criy or town)--A copy of the-affidavit that has been officially stumped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for futa e penniis or licenses A new affidavit must be filled out e:a rh year.Where a home owner or citi=is obtaining a license or permit not related to any business or commercial veuttse (i e. a dog license or permit to bum leaves etc.)said person is NOT to complete this affidavit The Office of Investigation s 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 Departmenf's address,telephone and fax number: Tb�L-f.GMan tthL of Massachusctts , Department of 1ndk Accidents flee of livedigatiwa,% ���ashingtan t ' � n211'ft4 E�111 �� T(,-L 4 617 727-4g00 406 or 1-a77 M AYE Fax#f 17 727 7M Revised 4-24-0 7 .I'm 2z gaTldia A f1IC Guide to Wood Constructiou in Hight Fl,77nd rheas: 11 D,niplr !Find Zone Massachusetts Checklist for COMP arnce(780 cKIZ5301.2.1.1)i LoadUearing Wall Connections - Lateral(no.of 16d common nails)-_--------------------- (Tables T0.....:-.--------------------------------------- Non-Lmadbeadng Wall Connections Lateral(no.of 16d common Waits)......__.._.--.--.•-.--.__(Table 8)._-.-..._-----...----.._._-------------------_.. r Load Bearing Wall Openings(record largest opening but check all openings for compfiance to Table 9) Header Spans ....._......._......._._._..._.._:......:.. (fable 9)..............----------_...._It in.511' SioPlate Spans ._........._...._..._......-...._.. ._....... .(Table 9)...............:.................. Full Height Studs (no.of-studs)..........._._._...__.:._......(fable$)......................................... ...._.. Non-Load Bearing Wall Openings(record largest opening bUt check all openings for compliance to Table 9) Header Spans.:........................... .........:_....._...._...(Table 9)......._I......................._ft_in.s 12' Sill Plate Spans......................_........................__-..(fable 9)........_:..._._..............._ft_in.s 12' Full Height Studs(no.of studs).: ._...-..._._..........(Table 9).................................__._...... .... Exterior Wall Sheathing to Resist Uplift and Shear Simultaneously4. _ Minimum Bulding Dimension,W Nominal Height of Tallest Opening2. ........................_................................................�:.__s 6`Er Sheathing Type------------------------------------ (note 4):e,_...............................................•Edge Nail Spacing-------------------------- --•-----(Table 10 or note 4 if less)....................... in. . ' ' Field Nail Spacing....................._: .._..._.....(Table 10)...................... ----- Shear Connection(no.of 16d common nails)(fable 10).... -------...................................... _. Percent Full-Height Sheathing..................:...(Table 10).................................................... % 5%Addifional Sheathing for Wall with Opening>6'B'(Design Concepts)....._............. Maximum Building Dimension,L , Nominal Height of Tallest Opening2..._.......__.....................................:................... s 6'8' SheathingType.................................._......(note 4)......................__:............_....._.... Edge Nag Spacing.........-...... —__-(Table 11 or note 4 if less)....... _........ in. Feld Nall Spacing...._. _........_.,..._....-.(Table 11).........._._..,------- ._._,... in. Shear Connection(no.of 16d common nags)(Table 11)........... .........._... . ......._ Percent Full-Height Sheathing..__.;_....._.._.-.(Table 11)..._.._._...._..._.....�_____.���...__ % 5%Additional Sheathing for Wall with'Opening>6'8'(Design Concepts)_.......... Wall Cladding , Ratedfor Wind Speed? _. ..... .._.�.__._...._....._ .... .....__.......__...._ .._._ ._._......._ 5.1 ROOFS , Roof framing member spans checked?..........:-..__:....(For Rafters use AWC Span Tool,see BBRS Website) . Roof overhang ...........(Figure 19) _ft s smaller of 2'-or L13 Truss or Rafter Connections at Loadbearing Wags ; Proprietary Connettois Uprdt..----..._._........-........._. ....(Table 12)...........................................U= plf Lateral ..............._.....__..._.-........(Table 12)...__..._.__..._._. _..._._.......L= plf ..-. _. . Shear._.:._......-.-._........:...__..........(Table 12).............._......._....__....._._S= plf Ridge Strap Connections,If collar ties not µsed per page 21... (Table 13).._..__.....................T= pif Gable Rake OudODker...... .......:..........._.__.._.(Figure 20) ..... =ft s smaller of 2'or Lf1 - Truss or RafterConnertlons at Non-Loadbearing Walls' Prropdetary Connectors Uplift_....._..:..........::........._..__-.....(fable 14).........._._......------_.._.....__U= Ib. Lateral(no.of 16d common nags)_.(fable 14).......................................L= . 1b. , Roof Sheathing Type..._.._._._........_r:..._.-.____..(per T80 CMR Chapters 58 and 59) ........... Roof Sheathing Thickness................ ......_._.... _..........._................_.._.. _:in.>_7116'WSP Roof Sheathing Fastening........._..... _......_:(Table 2)_................................_................... Notes: 1. • This dwzkUst shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 7B0 CMRS301 a 1.1 Item 1.if the checklist is met in its entire fy then the following metal straps and hold downs arm not required per the WFCM.110 mph Guide: a. Steel Straps per Figure 5. b. 20 Gage Straps per Figure 11 _ r- Uprift Straps per Figure 14 d All Straps per Figure 17 , e. Comer Stud Hold Downs per Figure 18a and Figune,18b „ 2 'Exception:Opening heights of up to B ft shad be permitted when 5%is added to the percent full-height sheathing requirerrimb shown in Tables 10 and 11. ` 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated 92-grade; ' .ry . A WC-Guide to Wood Construction u1 High. Wnd Areas:110 nzpL Trind Zone Massachusetts Checklist for Compliance(7so clr�rRs�ot?.r.l)' E�1 Ch'=k Compfianca 1.1 SCOPE WindSpeed(3-ser.gust).._...__._._..._...........-........_......._..............-...._........_.............._........_...110 mph Wind Exposure Category....--.......... _....... -_--••-__.---_._._............_._.............. ............. ................ :......_..---.......B Wind Exposure Category................Engineering,Required For Entire Project........................................C • 12 APPLiCABILi7Y Number of Stories(a roof which exceeds 8 In 12 slope shall be considered a story) stories s 2 stories RoofPitch.........__.._..:__......._......_..._...........__.:.... . _(Fig 2) ...... ....................... 512:12 Mean Roof Height _..._..._.._..... ....._(Fig 2)...................._.__... ......__....__ft <_•33' Building Width,W....................................................• 2..(Fig 3)_............._.._.................._.._ _ft 5 80, Building Length,L .:............_-_----__---. ---- ------------ --...........(Fig 3) --._....._......:......_......_............:._.. ft 5 BO' Building Aspect Ratio(LAW) .........................................._...(Fig 4)---------_-----------------_-----_:... _._.. _<3:1 Nominal Height of Tallest O enin Z Fi 4 < ' ' 9 p 9 ............... ::��.- - ( 9 )..._........__................_......:_.. _6 B 1.3 FRAMING CONNECTIONS General compliance with ftamirig minnections.....__............ (Table 2).................................................._........ 21 FOUNDATION Foundation Walls meeting requirements of 780 CMR 5404.1 Conctinte...........................:.......................:.......... .._............................................................... ' l;oncr Masonry...._....._._._.:._..__._....-...._................. _......_......_....__.........---..__:_....._.. ..... 22 ANCHORAGE TO FOUNDATION" - 5/8'Anchor Boltsdmbedded or 5/8'Proprietary Mechanical Anchors as an alternative in concrete only Bolt Spacing-general....................................(fable 4)...........-...-......_....---._._.-._ in. - Bolt Spacing from endroint of plate..__....._....___.-(Fig 5)._-._..._..-.:................. In.:5 6'-12'. Bolt Embedment-concrete._.............._.._..._..._.......(Fig 5)..._.. in.z 7" Bolt Embedment-masonry...._.............................._(Fig 5) ....................... in.2:15' PlateWasher..-..--..........._..------•-•—.....__._......._...(Fig 5)....... .................z 3"x 3-x'/.' . 3.1 FLOORS Floorframing member spans checked .___.._._..___._.....(per 780 CMR Chapter 55)..._...._._...__..._:�._ Maximum Floor Opening pimension................... .(Fig 6)....._.. ................................ ft:5 12' Full Height Wall Studs at Floor Openings less than 2'from Exterior Wail(Fig 6)..:....................... ......... Mtadmrim Floor Joist Setbacks Supporting Loadbearing Wallis or Shearwati..._..__..._(Fig 7).................._....-_...................... ft 5 d Maximum Cantilevered Floor Joists T Supporting Loadbearing Walts•or Shearwall...._._______(Fig 8)_.................. .....:....._ft 5 d FloorBracingat Endwafls__......_.....0...._..__...._.....-.-.._..(Fig 9)_..__._.._.__._......_._.... .......................... Floor Sheathing Thickness ......._._._..-......._......_...._:.._..(per 780 CMR Chapter 55)....................... in. Floor Sheathing Fastening......................_......................(1 able 2)__d nals at in edge/_in field 4.1 WALLS - Wail Height Loadbearing wails....._....� ...... ..................._.....(Fig 10 and Table 5)...........__.........._._ft 510' Non-Lom bearing walls.._..._...:.....:__. ......._.(Fig 10 and Table 5).-.--..............._. ft'S 21r Wall Stud Spacing r 10 and Table 5 _In._<24'a.c• Wall Story offsets .........._.._.... ......._:..__.........._�Figs 7 r£8) ..__..�....�-......_...._.... _ft 5 d 42 E7aMOR•WALLS Wood Studs Loadbeariag virafls...._._..._................_........_._.._._...(Table ..„._.-........._.._-_.2x -_ft Non-Loadbearing walls ._..(Table 5)•_..._...::..........__..2x - ft in. • Gable End Wall Bracing' _..._-.-._..____....__... FLA Height Endwall tilt rds..__...._.______...._......_...(Fig 10)_......._--- WSPAtfieFloorLength.__..._._......... _:.._.....�.�(Fig 11)__..�........ _...........:....�___ •ftzW/3 'Gypsum Calling Length(rf WSP not used)....:.....-.....»(Fig 11)...______. -._.........._._ _ft z 0.9W - - and 2 x 4 Cbntinuous Lateral Brace @ 6%mm_Fig 11).___:.....r............................ . or 1 x 3 reTmg liming strips 16'spacing min.with 2 x 4 blocking @ 4 ft spacing in end Joist or truss bays Double Top Plate Splice Length ........----Fig 13 and Table 6)................_........_._._ft Splice Connection(no.of 15d common nar'ls).-_..-_....(Table 6)--.._-.........................._..�._.__.... . AWC Guide to Wood Cortsfrtictlon Ill High Nfind Xreas: 110 inph frsd Zone Massachusetts Checklist for Compliance (790 CIAR 5301 21:1)r 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: L . Panels shall be Installed with strength axis parallel to studs. 1. All horizontal joints shall occur over and be nailed to framing. GL 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 botbm of panel.Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first fioorframing. V. Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of ed staggered at 3 inches on center per figures below.Vertical and Horizontal Nailing for Panel Attachment 5. Glazing protection:a)new house or horizontal addition—required if project Is'1 mile or closer to shore(generally,south of Rte.28 or north of Rte.6) b)vertical addition—not required unless there is extenslve renovation to the first-floor c)replacement windows—needs energy conservation compliance only(chap 93) 6.Wood Frame Construction Manual(WFCM)for 110 MPH, Exposure B may be obtained from the American Wood Council (AWC)webske. YAiMT=EDGEFdNM DN Fi3Ak=USEW NAILS 'AT6" c • it ii r � �o� i II II i N• + r if s s I t s it tl o I. {.. i it i o iy it F C s s t !r Is IF Q s Ed r d t t m is II s •t tr r t t d[ ' '1 it 9 r IL o ,I u t t r F RAMM M9.� I I1 J is t I GEidTSWSXCTE I Ifl ti IF kp I 1 ID r - if ii rU t a Is ss p it dim Y I- LIt if [� r I t t pOd19r Et'�GE T• STAB 3`MM1 'j N�4 SF'�t%hVr F'AirE� _ W.U.P14T7M 3 PARM • �-� • RWNELIDGE ppUHLFty40_IEDGES?ACi'IC DIAL*. • See Detail on Next Page - Vertical and HorIWnW Nailing Detail for Panel AttachmentVertical and Hotizontal Nailing for Panel Attachment i z . ' • � � :, - - ..F �maro Town of Barnstable oT t Regulatory Services t itettx�reF[r� � r crass $, Richard V.ScaI4 Director s639. �m Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.barnstableana.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This S ction If Using A Build as Owner of the subject property hereby authon"M to act on ray behalf, in all matters relative to work authorized ythis building permit application for: ( ss of Job) "Pool,fences and alarms the responsibility of the applicant. Pools . are not to be filled or " ' d before fence is installed and all final inspections.are pert ed and accepted. Signature of Owner Signature of Applicant R Print Name Print Name Date w A Q:FORMS:O WNERPERMJSSIONPOOLS Town.of Barnstable } Regulatory Services oFTHE rd Richard V.ScaIi,Director 4 Building Division w RLANL�7ART^R Tom Perry,Building Commissioner asas� p�pT 5 ���� 200 Main Street Hyannis,MA 02601 www.town.barnstable maus Office: 508-862-4038 Fax: 508-790-6230 9` � HOMEOwNM UC NM EXEIr ION DATE: o `4 I t� // Please Print !l 70B LOCATION: I village �) ,� HOIvlEowrIEx:,: 1A b t' � J'�nJ C-� 360—76 t.- name home phone# /; wo&phone# CURR�I I MAIL lNG ADDRESS: 1 O� l C Z —t ----- - ---- GEA �y� . city/town statz ap code The current exemption for"homeowners"was extended to include owner-occpied 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. DEFINMON OF HOMFAwNER 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 undersi ed`.`homeowner"assumes responsibility for compliance wrththe State Building Code and other applicable codes, � �P mP bylaws,rules and regulations. - The undersigns omeownee'certifies that he/she understands the Town of Barnstable Building Department minim�inspection p Uzes and that he/she will comply with said procedures and requirements. a Sigpature wrier 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 I27.0 Construction Control ' . HOMEowNER'S EXEMTTON The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.11-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 rise 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 Iast page of this issue is a form currently used by several towns. You may rare t amend and adopt such a form/certification for use in your community. Q:\wPFaM\FORMS\buUdmg permit famul£)=S.doc Revised 061313 i T �31 S71, t 1 l 9 � 1' n ell1 , S ` s� f 1 10/11/2015 F-1 0G9.jpg ► Lam. ` , f` d ` Sr — u' ub 777 • a 04 r ® y W .� �OKFji�'�/�(;, �X QCt`1I110�Ylffif�N7 �•��f4'��' LA � , - # p s�" ++ yJt N�buv �� s -� �x1 S(• 'I z . � �� r rOQI � S ` https://mail,google.com/ /scs/mail-static/ /js/k=gmail.main.pt l3R.Im4K4TyXSUQ.O/m=m_i,t,iVam=PiPeSMD8v—cHse4QoF36QIW999 vULs7MPDv3cmgGOvAP5v9v8A_-q—em76Q/rt=:h/d=1/t=zcros/rs=AHGW... 10/11/2015 F-2 001.jpg �r 21u -pQ t � '; *- y Hr x 3�liN /�J-J _•! _ �V NG 1 u}� J�'.1/Z,l,� ors. AWN+ LetSci•�.,.•�!- i � � i xnl lM tlt�/l 5 VAA,;�� gY✓A `mob $ t I `'• tkHuly -Pius�c��sa,� V ; A�A+1r11�,,1 t FtE. TV �s E _ tR N Mlt'1(?0 t11 • . ' w,�,.�,,�Alt / �ax,E1,�b,(t r ��.. d�li� ln�i'Sqa�✓' tx � � } � ;psi. row �.7'2-� https,://mail.google.com/ /scs/mail-staUC/ Ijs/k=gmail.m,ain.pt BR.Im4K4TyXSUQ.O/m=m_i,t,it/am=P!PeSMD8v cHsc4QoF36QIW999 vULs7MPDv3cmgGQvAP5v9v8A--q—em76Q/rt=h/d=1/t=zcros/rs=AHGW... #' r �, i ��. h tt y�a.,.',a t,€fit � es7 S° ,.a�t��; �rY�✓•. ��`�7Fio t I � .J -�: '.: • ♦♦ yr .:..,..�..._..,� t 4 j tag 4 1 - •. a £a $e 1( t l ((t 777 UZ LLJ 4 o:+ a '. � k 77 f t Town of Barnstable Permit# ;�, Expires 6 months from issue date `Regulatory Services -Fee.MAM , 1 u P 1 ,�$ =Richard V.Scali,Director' Building Division' Y Tom Perry„CBO,Building Commissioner- 12ES�_,P 200 Main Street,Hyannis,MA 02601 ����� www.town.bani.stable.ma.us. L Office: 508-862-4038 2 01�750-6230. EXPRESS PERMIT'APPLICATION RESIDENTTI�n W RN' STABLE Not Valid without Red X-Press Imprint Map/parcel Number G � Property Address ry esi ential Value of Work$ Minimum fee of$35.00 for work under$6000.00 b �O Owner's Name&Address a 4 C��l_ F LL -z6 Contractor's Name Telephone Number Home Improvement Contractor License"#(if applicable) n Email: Construction Supervisor's License#(if applicable), ❑Workman's Compensation Insurance, - Check one: : ElI am a sole proprietor am the Homeowner ❑ I have Worker's Compensation Insurance, Insurance Company Name g �' Workman's Comp.Policy# '`e Copy of Insurance Compliance Certificate must accompany.each permit. a Permit Req st(check box) * ': Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken toA. Y�IU ►u �/Le M� ❑Re-roof(hurricane nailed)(not stripping., Going over: existing layers of roof) ❑ Re-side w , ❑ Replacement Windows/doors/sliders.U-Value '_(maximum.32),#of windows #:of doors ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. w *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 c py of the Home Improvement Contractors License&-Construction Supervisors License is' reqvir SIGNATURE: Q:\WPFILES\F01FMS\building pent forms\EXPRE_S_S.doc Revised 040215 f:; f✓ '; »t .. r £,i: i ,, f I -T. .Z ° ."a 4 air .' : ' ,• t Ile Comrrrorrfrealth o,f Massachusetts - De aranevit of ln-dustrial Accidews , - 0, ce of1mwstigations ' a - Smeet Baston' MA 02111 f wiv nvia7mg4avIdia Warkers' Campensation Insurance Affidavit:Builders/Contracturs/EIectricians`JPlumhers Applicant Iufarmatian Please Print 1,m. MIX NarYiP Nb Address: U. ..C) Ci /State! - _`Ge h-e z V It' -Iz� Phone� ��+��—��� �:�_7 Are you an employer?Check the appropriate box: Type of project(required) I.❑ I am a employer with. ❑I ate a general contractor and I 6. ❑New construction employees(full and/or part-time)-* have hired the sub-contractors t 2.❑ I am a sole proprietor orparEner° 'liked on the attached sheet 7_ ❑Remodeling ' ship and have no employees. " These sir-condractars have, 8.,❑Demolition wow fiat nee in any capacity.' � ' employees and hate wodcers' q."❑Building addition [No a-nrlaeis' camp-ir�ssurance camp-insurant]e ; required_] 5 ❑,We are a corporation and its 10 ElElectrical repairs or additions officers have exercised their 3 .a hameou�:er doing allworl� � 11.0 Plumbmgrepairs or additions. :. myself [No workers'camp- right of exemption per MGL insurance required.]-s � e.152, §1(4�and we have no' O 1. of repairs - } employees.[No orlcers' 13,❑ Cher �or comp_insurance required.] ;Any app€icaatthat checks box 91 mast also fMout the sectionbelowshusingtheirworkerecompensationpolicyinformation I ameoaners trho satmut tftis afiidatJt imdixating they are darn,;all w ak=-&&en hie outside contractors mast submit a new afdavk ffiicabag such- /Cant actors that ehwlr This box m=attached au additional sheet showing the nsme of the sub-coutrxctnrs and state whether or oat tbese entities hsae . employees.Ifthesubtmitca ushave employees,theyn=pruvw their workers'comp.policy number. lam are employer€lent is prnVing workers'congwisadan insurance for arey employees,s Below is fliepa cy and job rite.; infotmahan. 7 _ Insurance Company Name: Policy rr or elf Srl$.Uc_9: t 11iCp]tatiDnDate � 4 v Job Site Address: City/StateMp_ Attach a copy of the tiworkers'compensation:policy declaration page(showing the policy number and expiration date),'. Failure to secme coverage as required under Section 25A of MGL c 152 can lead to the imposition of criminal penalties of a , fine up to$1,504 OD and/or one-yearimprisonuteut,as well as chil penalties.in the foam of a STOP WORK ORDI !Rand a fine r of up to$250-00 a day against the v olator Be adi+ised that a copy of this statement maybe forwarded to the Office of° r Investigations of the DJA for instu auce coverage cation I do here c its aced e�at/iazs o u. t diatthe in ormatirne fded abmv is true aced correct b3' Pe'. fF � .� P� Sitoature: c M �^ Pltarte - �j�D 76 roa Ofcial use only. Do not iwite hi flies area,to be cainplete� by city or town ofj`iccat r ' City or Ton n: s Perigit/Lueaase# .w Issuing Authority(di eleone). 1.Board of Iffealth.12.Building Department£3.Qtyffown Clem 4.Electrical Inspector S.Phnrnbing Tnsprectoi 6.Other k contact Person: a Phone#: , Information and lastrnctions f. Macsar-husets Geheral Laws chapter 152 requires all employ=to provide workers'compensation for their cmplcy=,-- PursuaattD this sfatuft-,an.e7ZPIayee is defmed as."-.every person in the service of another under any contract of hire, express or implied,oral or wriftem" An VIP10yEr is defined as"an mdividna.I,pa tacrship,association,corporation or other legal entity, or any two or more of the foregoing engaged in a3oint en baTrise,and including the legal representatives of a deceased employer,or the to to ees. However the ee of an individual, artn ' ;association or other legal entity,employing e>zrp y ' er or frost � erch,P racery P of the - o er of a dwelling house having not more than three apartments and who resides therein,or the occupant wn IIrng dwelling house of another who employs persons to do ma-mte ante,construction or repair work on such dwelling house or on the grounds or building appurtenartthereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also stars fiat"every stata3 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,MCM chapter 152, §25C(7)states"Neiffier the rnmm mmf--alth nor arty of its political subdivisions shall ce o ublic work unit table evidence of compliance•with the irc�rr8nce.. eater m� an contract for the erfoffian Of-Public �p . Y P , reguireni ent s of this chapter have been presented to the contracting authority." Applicants Please fill out thf--workers'compensation affidavit completely,by che+'king the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s) along with Brea certificates)of incTrr�nce. Limited Liability Companies(LLC)or Limited Liability-Partnerships(LLP)with no employees other than the members or partners,are not required to carry work(--rs'compensation insarmce. If an LLC or LLP does have employees, a policy is regoired. Be advised that tihis affidayit maybe snbrm_iiii-i to the Department of Industrial Accidents for confrrm.ation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be retvmed to the city or town that the application for the permit or license is being requested,not the Department'.of „ ,strial 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-mete license number on t ae appropriate Iiae. City or Town Officials i t _ Please be sure that the affidavit is complete and pried 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 e Iications in an en ear,need only submit one affidavit Indicating current that must submit m Ie ennitllicens app Y 1�` Y � _ �P P policy hjfb station Cif necessary)and under"Job Site Address"the applicant shoT1Id•rite"all locations in 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 fiaftam 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 venue (ie. a dog license or permit to bum leaves etc.)said person is NOT requited to complete this affidavit The Office of Investigations would at to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Departm=fs address,telephone and fax number Thy Canmarx tth of Massachmatts Degazbntnt of lladustial Aocidents Qfii ce of jves igatiaw 604.Thin tQuiz Bests MA G211I Tf,-L 4 617 727-49QO i�oft 4€6 or i--9 MASSAFF, Fax 617-727-7749 Revised 4-24-07 maw g avldia f t s c : snaxsrAst.E f 1 ,.� Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner I 200 Main Street, Hyannis,MA 02601 't www.town.barnstable.ina.us ' Office: 508-862-4038 Fax: 508 790-6230 Property'Owner Must ` Complete and Sign This Section. If Using A Builder. g ' r, I ZP�',A/L. as Owner of the subjectproperty . l hereby authorize to act on mp behalf, in all matters relative to work authorized by this'building pertnit'application for: 1-5 (Address of Job) _ 7 A / o wner b Date jPrint Name , If Property Owner-is applying for permit,please complete the Homeowners License Exemption Form on the• reverse side. ,y 4 e ' QAWHILESTORMS\building permit formsTYPRESS.doc , Revised 040215 fi ti Town of Barnstable Regulatory Services �'ME rQ Richard V.Scali,Director Building Division Bnarasrasr.E •' Tom Perry;Building Commissioner Mass 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1 I Z JOB LOCATION: �� G �Crs 4 1 U number street @ 7 village ..HOMEOWNER": 1045� ZGAA;TTi j�G7 13610 name home ph # work phone# . CURRENT MAILING ADDRESS: 4: L t/1 - 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 jEdopsigrreV eo er"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pro s an r that he/she will comply with said procedures and requirements. ature of Honleeer Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q%WPFILESTORMS\building permit forms\EXPRESS.doe Revised 040215 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION j Map � Parcel a Permit# 3Z� Health Division Date Issued 0-9 Conservation Division Fee �- TaxCollector; ..: TA c Treasurerrcl 1!✓ Planning Dept. , r Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address C.l,l d-'T t > • ' Village � G' b T—E?o( L G 0- Owner �J ywk) ,106 Kme�— Address Telephone LO 1 LPG Ce 3-1 9 t�-r I 'j—D ou "A Permit Request f ----- �!�- Square feet: 1 st floor:existing proposed 2nd floor; existing proposed ota new Estimated Project Cost #d, a Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family`` Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other \Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas O Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use b 05 C 9--F T�I K,1b►n-t- BUILDER INFORMATION Name D U9 nu f)KI L- d2 a f (!?--Telephone Number 0 67,i—_) Address 1 �� � tCt� '2_""ieense# f Ce Home Improvement Contractor# Worker's Compensation* ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE r " FOR OFFICIAL USE ONLY 'Y a ; PERMIT NO. DATE ISSUED - MAP/PARCEL NO. � q� • 't � •' .. s .ems; ev^` '• -ADDRESS �^�_ ty f . � VILLAGE r =, •y e ,.t .. OWNER DATE OF INSPECTION , ' it : r , FOUNDATION FRAME , r:•- INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL - - PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL r=. ► v.. s FINAL BUILDING' DATE CLOSED,OUT ASSOCIATION PLAN NO. • , V 4. The own of Barnstame • � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 BuiIding'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other , requirements. Type of Work: S-T� � P- t- Estimated Cost �+ Address of Work: '5 5 0 C IL-I 0 T"'I Oreg-L) 4 . Owner's Name: �0� IV Poe�.D 01 nr Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 Building not owner-occupied [30wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. 1-K71 /9? 1 r Coo 60 Date Contractor Name Registration No. • OR Date Owner's Name ti q:fortns:Affidav RWEMENT� NNTTRRAOr[[ssf�Q`�FWG{IO/A�S _ � 4 _ 1KNAM '.f11• H i�� t rt y sll'It. j � i�. •'csiL _I/'-s1�%.%%'�/ ////�//�j/ //// �j��j l � / / ■ 11 1 • 11 . N .G • 11 1 1 1 - ///////�/�/�/// i r � I ME WM -�-� -- iioiiiai/iiii/iaiiiiiia//i//i/�i�ri 11 • • •• • 1 1 1 1 • 1 1 II 1 ' 1 Y I 1 1 1 1 it 1 • I • • �• / • 1 . •1 1 '. //////�M/1�/////////////////////////////////////////////////////////////////////////////�////////////////�////��////, 1 1 1 1 � _ • • • 1 JI' i 1 1 I t • i 1 1 .1 111 / ✓ ' 1.II ywcw�ec6wi.iv2aa»>VnW:.'F:.:c:.:/n -::;:...•.•rJ.:.;.•:..o..o.»:>.cS..va,.ovr:b:n�•rc.):o.w"�/'iax•..w'>"".� (i I - � 1 nv�,.�.y.;.mY,�O�???aoa.?%"'''oox^p°=.;...,•.�...,...-. r.<�<.w.�,...".:>: aCnY9'x"o -M�O,O.pG4V/^f.. 4.•i•iv\Y.�C,?i,'�`�`b'%\�'0xn.N�lWn.i.:.'�.v'..,:.:}'..::. A dr z93 O� y Y HETp�y TOWN.1 \ O B.milR1 \ S 1 ABLE i • i EJE 3TAELE, i 9� 0AM BUILDING INSPECTOR APPLICATION,FOR PERMIT TO .........&m./A.......R.P.-S.(.c�..�. ..0 ................................................................. TYPE OF CONSTRUCTION ........I/ .V m..4........ .r...3.9tic.: ...........................................................:....................... r �. ..:.. ......................�9.7..a. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inforrratio-6: Location ...1©. ....... .Y.............../ //.R.f.... . ...........�.Q.xi.. .Q.x..Y..�.��9........................................................... ProposedUse ...../ .e.5. ..................................................................................................................................... ZoningDistrict ........................................................................Fire District ............................................................ CC ', Name of Owner .I Y.c��l '...�!�IQ.S. .e.l'� ¢................Address .y. !. .. .....���61.?1. .. !f....... o:..N<�.!✓7.�P'i/: Name of Builder .6AX.j.....1!���'.S.fi.'e.Y..�i�.. .. ............Address .......................:S,.A.xx.�S...................... ........:........... Name of Architect J.-O .h...da.r A -1..........Address ..... 5.. .e.2'.?1.1...�... ........... Numberof Rooms ..................................................................Foundation .�o.2t.�..7� .�..�..�.............................................. Exterior ..WA.01......5 .1.................... ..................Roofing ......A. Floors .....WQ..q.d..................................................................Interior ........5—b- K!.l^.G.. ../ ................................................ Heatingt.. .......................................................................Plumbing ....%......�. .. 1?.5...................................................... Fireplace ......t ...................................................................Approximate Cost ...J.��.?.�?<. .......................... Difinitiv.f,,,~Plan Approved by Planning Board -------------------------- Diagram of Lot and Building with Dimensions La o slz -e . .w w ,27 1/33 S• � ` ; y � m as Cam. ._ . �� cn N 3C] p wo R O > 2 , i 7G e s. d 00 L►. In-tE a ` ' w:CL o n a , �y �- <LL ,G Q+ ,a0 CCL . J _ ' � t�u~i �Z Ito W ' [l 1— ►� w z < Q N <- a Q LU 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .��.. ........................... Westerhoff, Frank t� 15432.. Permit for one story � No ............... .................................... ,a single family dwelling ............................................................................... �G Elliott Road Location ............................................................... i Centerville ............................................................................... Frank Westerhoff Owner .................................... ......................... ' frame Type of Construction .......................................... ..... 14 Plot ........................ .. Lot ............+ ............. r°� Permit Granted ..... . ... .... 7 ...............19 2 i Date of Inspection . . .....F41 ..199 ` Date Completed PERMIT REFUSED ................................................................ 19 ! ............................. .............................................. ................................................... ........................ .......... ................................................................. ...................... ..................................................... Approved i ............................................................................... t t . �. f T 5 Nk Ca CF- ti UPI n.