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HomeMy WebLinkAbout0031 FARM HILL ROAD .a .� J ,.� .. `,._ .� � .. �' a y...�� y, �. ..� `','r � � - `j; �� •R 9 � �. n _, .� , t. ., � ' ., y. • „�. J.... - � > y c �, .lid y. R. .x a � i o ' °Y�a ,. . r. i ,. t .. — . . .. �' r. .: �� .. ., Y . ,.. .. � 4 �:. `z '... _ °' c . ., .' c' R t�: d.. .. ... .., , ' ... .. Y: .' ., .. .. - x '... - .. f ... r: � : .. ' �; .,y � c r{ _ _P i .. ,. .. i� .. L .� .;.: ..- �. . _ . ,.. 4 _ ` . u ,, s .. .. '� ,; ", � � � yr- ... � � _ .,., «y ,� .. ,ate.. . , } ° ; -. i. .�. .. a ,e ,. .,. ,. � > -,� .�� �. n. r St �, ,.. , �„ .. 3 r �.. .. -.,-' 4 'p -. .r .. 1 � �. .. _ .. ` a ,,. u a, ,. ,. ... '� 7,. '... 'p' -r- t ..� .: � e , , z, ..� .. ,.,. .�. * ,� y . ,... 77 , � •.r�� ' ,y' r� r, A' a _ e �' t� � � '. � �.r _ a. ., - ' i .. ., .... .:� ,a :� .ice _ .: '... u � � .. � - . i . _ .. .. . r � - � .. .. �• ,�. ...- .. � 4 �- i ;. � " .. . .., � � � .... A�c „}� � ..I, 't�_ may! � � .r ;� � � o .. �� ` '.! '� -,. c� � t w '::y L a h r. .:� ... r, h •~ �.: „' � r ., .._,. .� e.. ,., v. `� a. � ,.a. ,. 'p. - .i. ., i t� ' p -�, � u � _ . �. ,. � ��..: .n .. � \) e a . , e r r •,r , r' y a ! • • r y u 9 s _ • - ter' .. f - • sr r r, , w USA ESSEM ¢; CAPE COD ow INSULATION IIY4Y GLAif ILA MlfS! {P9AT FOAM fYfP{NY4N +//+��1��'' c MRS uu TT{YS INfU"TION C1WN05 1-600-696-6611 ` 'Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 Dale: 7A/I� Dear Building inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed & completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance Institute (BP.I) inspector. All work preformed meets or exceeds Federal & State Requirements. Property wner Property Address Village a4 Y 8A 31 Ail M' Insulation Installed: Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ) ( ) ( ) ( ) Hours Walls Sincerely Fix ry L Cas y Jr, President (' e Cod .1 ulation, Inc. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application T (J Health Division Date Issued o Conservation Division Application Fee #R) w Planning Dept. Permit Fee _�� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis Project Street Address Village C?"oz, ,2 Owner r2ld �,%U.S�'� .� Address --;e Telephone L5-'�)90 Permit Request /D �� ��/�� .� �5� C//�✓`S J ��/�v/d �� f�G Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ,�7�a/�, z> Construction Typ o Ae Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of E,lsting Structure Historic House: ❑Yes LgNo On Old KinO' H ghway: 0 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 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 yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION - -- _ - - -(BUILDER OR HOMEOWNER) NameP �,,�oOY Telephone Number Address /�`� %�G�f �`//� License# `4W'a 4, C>,��- Home Improvement Contractor# Email Worker's Compensation #Idz 6")e4egs;'z ALL CONSTRUCTION DEBRIS.RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# -DATE,ISSUED MAPS/PARCEL NO. i ADDRESS VILLAGE r OWNER DATE OF INSPECTION: FOUNDATION i FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING; DATE CLOSED;OUT AS,S,_{OCIATION,PLAN NO. _ 1 t 1 OWNER AUTHORIZATION FORM I (Owner's Name) owner of the property located at (Pro rty Address) r (Pro rty Ad ress) • hereby authorize ( contractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. I x,4f* el s S re Date Massachusetts -Depattm4nt of P iblic Safety .,;Board of Buildirjg Regula#lons end Standards Construction Supervisor :.; ter. License: CS-100988 HENRY E CASSII)'Y 8 SHED.ROW WEST YARNIOU11-1, Expiration Commissioner` 11/11/2015 r - C `F: 1 / r� J �'Uyy�iCL�'LG/1P.G?;�G�.!'L Cz� .C��6�1K?WGrG- 1 GC;1•E.'��,l- - ftice of Consumer Affairs and Business Regulation .r� 10 Park Plaza - Suite 5170. 1 Boston, Massachwetts 02116 Home Improvement CgAtra9tor Registration Registration: .153567 Type: Private Corporation Expiration; 12/15/2014 Tt# 233831 CAPE COD INSULATION, INC HENRY CASSIDY �_ -- -- - 18 REARDON CIRCLE -- _- {. SO. YARMOUTH, MA 02664 _- " --- _--- -: ---- ,Update Address and return cArd. Mark reason for change. t A I <, .umi ua- � Address Renewal 0,C tuploymeitt Lost Card C� lNfux of Consumer Affairs& Business Regulation License or registration valid for iudividul use only, OME IMPROVEMENT CONTRACTOR before the expiration date. If found return.to: i = egistraton:�j 153567 Type: Office of Consumer Affairs and Business 12egulatiun . expiration: 12/1-5/2014 Private Corporation 10 Park Plaza-Suite 5170 ' Boston,MA 02116 APE COD INSULAI fON,yI(JC( ENRY CASSIDY 3 REARDON CIRCLE J YARMOUI'ki, MA 02664 " Undersecretary of al, Fvifho t flat re - The Commonwealth of Massachusetts' Department of Industrial Accidents W Office of Investigations w . R d 1 Congress Street, Suite 100, Boston,MA 02114-2017 . www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: V 1/l V,G City/State/Zip: 5b l UaV&Mffk,A6 . Phone#: _J5A ` -71"2---(2 1 Are you an employer? Check the appropriate box: Type of project'(required):` 1.❑ I am a employer with 2"';2 4. ❑ I am a general contractor and 1 employees (full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner-- listed on the attached sheet.• 7..❑ Remodeling These sub-contractors have ship and have no employees.. 8. ❑ Demolition working for me in any capacity. employees and have workers' [No workers' comp. insurance _ comp. insurance.$ 9. Building addition. required.] 5.,❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised`their I LE] Plumbing repairs or additions myself. [No workers' comp. right-of exemption per MGL 12 ❑ Roof repairs insurance required.] t c. 152, §1(4),and we have no 13. Other I,, m 1workers'. �k- e p oyees. [No comp. insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. +Contractors that check this.box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their,workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. � G(/V'�'�� � t v tV / LE✓�d Insurance Company Name: ����`` •. _ Policy#or Self-ins. Lic. #: WC� �i'7 Zr) 0 ' Expiration Date: jtq Job Site Address: . V /State/Zip: , . Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cer efyIt1do5 the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Z Phone#: JD f 7 7, l 2 / `f-- Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License#. -Issuing Authority(circle one): 1.Board of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I ' I i -ter" CAPECOD-27 CVANGELDER CERTIFICATE OF LIABILITY INSURANCE DATE,MMlDDIYYYY) 411/2014 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 Ileu Of such endorsement(s). PRODUCER CONTACT NAME: Cape Cod Commercial Rogers&Gray Insurance Agency,Inc. PHONE —� — FAX ^— — 434 Rte 134 IAIC,No Exit: I(A/c No):(877)-816-2156 South Dennis,MA 02660 EMAIL . ADDRESS: INSURERS)AFFORDING COVERAGE NAIC A INSURER A:Peerless Insurance Company INSURED INSURER B:COMMERCE INSURANCE COMPANY ______ Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle INSURER D:ATLANTIC CHARTER INSURANCE GROUP South Yarmouth,MA 02664 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: I 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. _ ^� INSR I-"'-"�'___._..___..,_..__.__.___-_—_ �� l76 POLICY EFF POLICY EXP LTR I TYPE OF INSURANCE INSQ WVD POLICY NUMBER IMM/DDIYYYYJ JMMIDDIYYYYILIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,00 _-I CLAIMS-MADE (�OCCUR CBP8263063 04/01/2014 04/01/2015 -DAM�GETOl2ENTElS —^ 100,000 PREMISES Ea occurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE_ $ 2,000,000 X POLICY L.- I jECT LOC PRODUCTS-COMPIOP AGG _$ 2,000,00 I OTHER: $ T AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident B j ANY AUTO _ 14MMBCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ 1,000,00 X X NON-OWNED PROPERTY DAMAGE — $ HIRED AUTOS AUTOS Per accident) X UMBRELLA LIAB X OCCUR - - EACH OCCURRENCE $ 1,000,000 C EXCESS LIAB CLAIMS-MADE R/O XONJ453512 04/01/2014 04/0112015 AGGREGATE $ DED I X RETENTION$ 10,000 Aggregate $ 1,000,00 WORKERS COMPENSATION AND EMPLOYERS'LIABILITY .STATUTE D ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N WCA00525904 - 06/30/2013 06/30/2014 E.L.EACH ACCIDENT $` 1,000,000 OFFICER/MEMBER EXCLUDED? E NIA - --' —"— (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 It yes,aescnoe unaer DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers Compensation includes Officers or Proprietors. Additional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE EVIDENCE OF INSURANCE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD TOWN OF BARNSTABLE CERTIFICATE OF OCCUPANCY 1PARCEL 247 065 CEOBASE ID 15214 ADDRESS 31 FARM HILL ROAD PHONE p' W HYANNISPORT ZIP - LOT 5 BLOCS LOT SIZE DBA DEVELOPMENT DISTRICT CO I, PERMIT 53512 DESCRIPTION CERTIFICATE OF .00CUPANCY---BLDC_PMT.#50595 PERMIT TYPE BCOO TITLE CERTIFICATE OF OCCUPANCY CONTRACTORS: Department of Health, Safety ARCHITECTS: . and Environmental Services TOTAL FEES: 4 . Im BOND $_00 Ox CONSTRUCTION COSTS $.00 �. 756 CERTIFICATE OF OCCUPANCY 1 PRIVATE ETV BARMABLE, f MASS. �-039. EC � IIA� - _ BUILDING DIVISION BY, DATE ISSUED 05/22/2001 EXPIRATION DATE k TC74N1 OF BARNSiABI�E BUILDING PERMIT PAP'C'EL ID 247 065 GEOBASE ID 15214 AODRESS 31 reARM HILL ROAD PHONE �� HYANNISPORT - ZIP — LOT 5 BLOCK LOT SIZE DBA DEVELOPMENT DISTRICT CO -'' PERMIT 50595 DESCRIPTION ADD 20X45, TO EXISTING HOME SEWPT#2000-73i PERMIT TYPE BADDI TITLE BUILDING PERMIT ADDITION CONTRACTORS: MELLOR, STEVE ARCHITECTS: Department of Health, Safety and Exivironmental Services TOTAL FEES: $549.01 - BOND $.-00 Ox CONSTRUCTION COSTS $177,100.00 9 - 434 RESID ADD/ALT/CONY 1 PRIVATE P. * HAItNSTABLE, • ' FD NAIL o BUILDING DI ON BY DATE ISSUED 12/14/2000 EXPIRATION DATE TH;ti PERM T'30NVEY3 NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORAHILY OR PERMANENTLY.EN-, CR04CHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALL F-A'GRADT-S AS WELL AS DEPTH AND LOCATION OF PULiLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE OF THIS PERk.'I'DOE:;:NOT HEL.EASE THE.APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. j MIN r;M OF 3UR CALL INSPECTIONS REQUIRED _ FJR ALL CONSTRUE IJN WORK: T BE RETAINED ON JOB AND I APPROVED PLANS MUST WHERE APPLICABLE, SEPARATE R 0TINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2 PRIOR ,O( `C1 RiNG STRUCTURAL MEMBE-ia HAE; c ENI n kOE !NIHERE A CERTIFICATE OF OCCU- („E.Ru4 H). PANCY IS Rt,'uIRL'J,SUCH BUILDING SHALL NOT of ELECTRICAL,PLUMBING AND MEC!I- 3.iNS'.;L:WION OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL iiv3 T.,L!JkTIONS. 4.FINAL INS"`:!'ION BEFORE OCCUPANCY. a i LDI^:!z -INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALSev 12 _ P, 2 2 r�-lam r/N/I�iC �y` . � 1S® 0✓07/iv s+leTi� � 1 HEATIN7`,NSIa TION APPROVALS ENGINEERING DEPARTMENT 2 ,d BOARD OF HEALTH OTH R: SITE PLAN REVIEW APPROVAL . � _ WORK SHALL NOT PROCEED ATIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION\'/ORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOH BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- I 1 ION. NOTED ABOVE. TION. \- r;,: y • ''^: yF 9 R�@`� _..i:fie � _ Y' 1 . t i ' t 100 00 o 36.4�*, _? LOT 5 11.1,4.1 k 7,500 s.f. ` CONCR FOUNOq o ,�� nON o �, nks 100.0 C�K -00I' 00-200 CER TIFIED FO UNDA TION PLAN FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT LOCATION ; #31 FARM HILL ROAD HYANNISPORT, MASS PREPARED FOR: SCALE : 1" = 20' DATE : FEBRUARY 1, 2001 GARY BRUSTAS REFERENCE : PB 118 PG 133 ASSESS. MAP 247 PCL 65 { I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON. N Of off. 50e-3e2-4541 o�` ARNE �yG I fax WB-382—OM H. F OJALA p down cape engineering, inc. A No.2 CIVIL ENGINEERS Q LAND SURVEYORS DATE REG 939 main st. yormouth, ma 02675 . SURVEYOR TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# =IET Health Division 000'' / Date Issued a— 2 Conservation Division Feed Tax Collector j a�(3 ( o c.P a IC SYSTEM MUST BE !P Treasurer ( I4 remcP�ALLED IN COMPLIANCE . WITH TITLE 5 Planning Dept. ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address �I Rom. Village r T� /�0 1 Owner ��i�.. N/� ��;C/ Bat "w Address �JJYL 4h Telephone �T"l ?c Permit Request Square feet: 1 st floor:existing proposed® 2nd floor: existing C') proposed �� Total nevu_ S' f� �7 ./ Estimated Project Cost oning District Flood Plain Groundwater Overlay Construction Type Lot Size —? S Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 1" Two Family ❑ Multi-Family(#units) Age of Existing Structure 30 Ww0 Historic House: ❑Yes LXM On Old King's Highway: ❑Yes bl-o Basement Type: ❑Full U'Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) ® Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new 1 Half: existing new Number of Bedrooms: existing new C2 _ Total Room Count(not including baths): existing -new _ First Floor Room Count Heat Type and Fuel: U1 laas ❑Oil- ❑ Electric ❑Other ` Central Air: ❑Yes U°No Fireplaces: Existing _ New 0 Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size 61 Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use ` r BUILDER INFORMATION 9 Name Telephone Number SUS Car- Address / C� c�7C ���`� License#A�i 9i9 Home Improvement Contractor# �6 1 o Worker's Compensation# Q!� 1-- 5 6 F{vr ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 4 0 t FOR OFFICIAL USE ONLY , t s PERMIT NO. DATE ISSUED MAP/PARCEL NO. x 1 d• r ADDRESS . VILLAGE _ OWNER . DATE OF INSPECTION"- FOUNDATION FRAME C /Z n INSULATION 2C7 Z� 7 FIREPLACE ELECTRICAL: ROUGH FINAL , ,3 PLUMBING: ROUGH, FINAL ' GAS: ROUGH FINAL ' ? FINAL BUILDING ylf•, s X DATE CLOSED OUT r:2 , rot � r ASSOCIATION PLAN NO.CI - dw �i�e�o�+ma�ru�eal!/c��aaaru,�uraetea4 BOARD OF BUILDING REGULATIONS ' �+ License:'CONSTRUCTION SUPERVISOR Number:>a 049879 _ Blrexh1 e;,WM1957 _t Expires 05122R002 Tr.no: 25093 Restricted To. 00. STEVEN L ME LLOR PO BOX 334 W BARNSTABLE, MA 02668 AdminL4trat—or � Tle levc =�. .,..-. Board of Building Regulations anStandards HOME IMPROVEMENT CONTRACTOR Registration: 117610 Expiration: 10/25/2002 TYPO: INDIVIDUAL STEVEN L.MELLOR STEVEN MELLOR 199 PERCIVAL DR/PO BOX 334 W BARNSTABLE,MA 02668 ``` ' Administrator i of IHE The Town of Barnstable MASS. Department of Health Safety and Environmental Services E16 ptA Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building 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:U�,�1��A�.r� �- fL�[1,Y Estimated Cost Address of Work:^ 31 lQ Q Owner's Name: t <,I— 4ACT� Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law OJob Under S1,000 ❑Building not owner-occupied ❑Owner 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. U. � ► G 6 Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav . :a,-`. —.�.._ The Commonwealth of Massachusetts — ._ . ` .. ' Department of Industrial Accidents . X = ON=911HY8st 989Oos . _- S 600 Washington Sheet 4, ,` Boston,Mass. 02111 Workers' Compensation Insurance Affidavit . name: C location: ' Ao" � � ``A : . city t) k6,:: � phone# ❑ I am a homeowner performing all work myself ' ❑ I am a sole r rietor and have no one worki>i in ca achy ❑ I am an employer providing workers'compensation for my employees working on this job.: :: ...: : :::: ::::::::::: ::: cam an<name.:: :.:>; X.-I -.. . ....-I I ...-,I ::> :;::::::>::::;:.>:::: :.>:;r;::>::>. ;;:..: address catty 4 &iy° ,: �i °` :phone# : Mi. . ` .:::. [fisnrance co. 1 r. i ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: :;: comdanv name:' 1. 1. . . address...: :;:;;:»: ;::::»>,:;.;;:::.:::;>;:. ;»:::::::>:: :.::::,<::,. ::.;::.::::::;:::::....:.::......:.......... ... ...:....:...:...... :.. ....::>:;::: <;::;::::><:::::>:;»::::::i::>»:::: .+...:::::'•:..:>>::'.:;>:<::':»?::> >:>::::;<:>::::::::,..:..:::;»:»:_>::> ::::»;:::::-:::>:::<:::::;<"::>:<::<::<:::>:;;<> >:::: t ltv :;:.;;:;•::::::::::::::::::::::::::::... % :....:....::::::::::::"..........:....:: ...:,::::::::.::.:.::::::::.:.;:.;:.;:<;;.;:.;:.: . ...... rnsntanceco ..;,:..... ..::.::..:.........::.:::::.:..:.:: :. .,'///%%////i . :.>::::>::;::>:::;.;.:;:::...;:.;:.;: :::.;::.:::..:::..:. ....... »:.. :ca an name:... .:;.;:::>:-..-+;::<::.:,.......I.. .....;::;. . :;.:.... . _ _... address .. >:::::;::..... ::»i. r C yt%''??> ?:isof-:: y2 > ` .. ..........t ne . clt�- :: nsnrance co.: :. <, :..._ ... _ . �/. Fafinre to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of ctfininal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. . I do hereby certify under the pains and penalties of perjury ury that the information provided above is trio maid correct Date 1 3--1 t- ey Signature _ - Print name ! 1 q-V�h L, M t`.1 I U1( Phone# �6� U 1 ?� official use only do not write in this area to be completed by city or town official . . 11 city or town. permit/llcense# ❑Building Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone _ ❑Other Owned 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees: However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not acceptable table evidence of compliance with the insurance coverage required. Additionally,neither the P P commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be co Also be sure to sign and submitted to the Department of Industrial Accidents for confirmation of insurance verage. � date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 r M CMR App=xft J Table JS.Llb(continued) Praeriptive Paelcages for One and Two-Family Residential Buildings Anted with Fossil Furls 1V1AXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Healing/Cooling Ara'(%) U-value= R-value' 1t vaiue' R value' Wall Perimeter EgWpmem Efficiency Package I I R value' R value' 5701 to 6500 Hating Degree Days' Q 125'a 1 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 036 38 13, 23 N/A N/A Normal U IS% 0.46 38 19 19 10 6 Normal V i S% 0.44 38 13 25 N/A N/A 85 AFUE W IS% 0.52 30 19 19 10 6 85 AF[JE X 18% 032 38 13 25 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 19% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: Q 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: "a-o b �4 4. %GLAZING AREA(#3 DIVIDED BY#2): (`;� c �7 ( t• 5. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J6.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft2 of decorative glass may be excluded from a building design with 300 ft of glazing area. Z After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 'Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. 'T:e entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement &-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. " If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and,documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded.from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component.Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 r ESTIMATED PROJECT COST WORKSHEET Value LIVING SPACE square feet X-.Ssq. foot= GARAGE (UNFINISHED) square feet X$25/sq. foot= PORCH square feet X S20/sq. foot= DECK square feet X S15/sq. foot= OTHER square feet X S??/sq. foot= Total Estimated Project Cost W� l;1�7 Z99091'b t ! / CC/U T-/U U O tJ S fr'/DGE. UE /7- t• COPJ7-I A)UO US RIDGE VEN T ASPNTL-T sH GLES. <.. .. �. �3042... 3o�i•2._ 3.A I . . 2.042 6AAAE' CEDAR SH/ni6LEs_ REA8 ELEVATION • 4 W O' �i. f ,l i m � m f, r o Z w o . 41 N T`I . G �. f,r Ik C> r o� a I. Ca O N I _ IIk, FF� n a ell Zn = I oto I f I w o • N N j 4 - u" y ' 0 w O -A N W N • a 3'-2 ' n � o m (A o v ° — a is k Q oo T { . o a J , ---------------------- IV `a t (no - = a c„ y u' i tO 1 S. 7_ a� FO ciio ra AZL W j;v POWs., AAD .?A-r/.D A Db085 A N D ER SEA.) 136or P/TGN TD l%lATc g, Ex sT/NG AXW sl -AX W,3t - ct-:DA cLAF$0AlTV-5 ETTT 2042 3oa12 _ I S DHP3092-►83 042 3c6tZ FRONT ELEVpcT)O� - SGAGE r „ 70P FNDN. AT EL. 31.7' SYSTEM PROFILE TEST HOLE LOGS s ACCESS COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE) M. FARIA, SE ACCESS COVER (WA?ERTIGHT) TO ENGINEER: 31.4' MINIMUM .75' OF COVER OVER PRECAST WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM DONNA MIORANDI, RS 31.0' WITNESS: LOCUS 2" DOUBLE WASHED PEASTON€ AUG. 21, 2000 1 ? DATE: H r RUN PIPE LEVEL OR \29.7 * FOR FIRST 2' H-20 HIGH CAPACITY INFILTRATORS 28.0' pERG. RATE = < 2 MIN INCH PROPOSED 1500 MINA NCH SEPTIC 28,25' a `� 2' ® SIDES CLASS I SOILS Pu 2$.50 TANK (H- 10 ) GAS 27.5' # BAFFLE 27.67' ooco Z7.5 1.5' 0 ENDS MIN 2' Q ELEV: ( 7 �: SLOPE) �6' CRUSHED STONE OR MECHANICAL » COMPACTION. (15.221 t2J) 13e �8 14 �8 0 25.5 O,r A 32.0' DEPTH OF FLOW 4 0 caac' / VILLE BEACH RD. ( *EXIST. INVERT TO TEE SIZES: 3 % SLOPE) 3/4» TO 1 1/2» DOUBLE WASHED STONE SL BE RE-ROUTED TO INLET DEPTH - 10" 10» 10YR 3/1 COME OUT FRONT 14'. OF DWELLING OUTLET DEPTH B LOCATION MAP NTS 2 LEACHING LS I FOUNDATION-- 11 SEPTIC TANK 17' D BOX ' FACILITY 5.5 ASSESSORS MAP 247 PARCEL 65 36„ 10YR 5/8 29.0'_ ZONING DISTRICT: RB YARD SETBACKS: C FRONT = 20' SIDE = 10' 20.0' MS REAR = 10' 10YR 7/6 PLAN REF. - 118/133 FLOOD ZONE: C AP DISTRICT i 32.8 CONTRACTOR TO CONFIRM SUITABLE SOILS IN AREA OF i LEACH FACILITY PRIOR TO CONSTRUCTION OF ANY PORTION OF SEPTIC SYSTEM 144» 20.0' 2.1 100 NO WATER ENCOUNTERED �o NOTES 2.3 TH 32.0 4A 3231.8 R,�DsCgp 29.7 32 31.a ten,*_ , , .,_., �q44 n£ SFPTIC DESIGN: APPROXIMATED FROM QUAD I 32 31.7 7,500 S.f. 31 4 (GARBAGE DISPOSER IS NOT ALLOWEb ) 1. DATUM IS ` N DE.'IGN FLOW. .__ BEDROOMS ( 110 GPD) _ 440 GPD l: rrli�r.; .ii'AL -`Ai TER' !S EXISTING I 32 31':a .., ^ . / USE A 440 GPD DESIGN FLOW 3. MINIMUM PIPE PITCH 70 BE 1/8" PER FOOT. i � 4. DESIGN LOADING FOR ALL PRECAST UNITS TO BE AASHO H- 10' ^cry !- , EXISTING ?0' / SEPTIC TANK: 440 GPD (2) 880 5. PIPE JOINTS TO BE MADE WATERTIGHT. P / o DWELLING USE A 1500_ GALLON SEPTIC TANK 6. CONSTRUCTION DETAILS TO BE IN ACCORDANCE WITH MASS. TOP FNDN LEACH ENVIRONMENTAL CODE TITLE V. PROP, / 31.7 t0 29. O� 2(53 + 6.83) 2 (.74) = 177 7. THIS PLAN IS FOR PROPOSED SEPTIC SYSTEM ONLY AND IS NOT ADD'N/ 31. SIDES: TO BE USED FOR ANY OTHER PURPOSE. B�JTTOM: 53 x 6.83 (.74) 267 8, PIPE FOR SEPTIC SYSTEM TO SCH. 40-4" PVC. r 31. 31 31.3 © TOTAL: 600 S.F. 444 GPD 9. COMPONENTS NOT TO BE BACKFILLED OR CONCEALED WITHOUT 31.E INSPECTION BY BOARD OF HEALTH AND PERMISSION OBTAINED 31.6 �. .1 `� ''� USE (8) H-20 HIGH CAPACITY INFILTRATORS WITH 2' _��• •�,,, 31.3 -- FROM BOARD OF HEALTH. 1 co y STONE AT SIDES, 1.5' AT ENDS AND 14» UNDER 10. PUMP & REMOVE OR FILL W CLEAN SAND EXISTING SEPTIC SYSTEM -31 rp0 29. LEG 77 71.E 5 SITE PLAN 3d.1 0.031 -� / 100.011 PROPOSED SPOT ELEVATION OF 30 y 31 FARM HILL ROAD 10Ox0 EXISTING SPOT ELEVATION 100 IN THE TOWN OF: PROPOSED CONTOUR H YA N N I S ( PORT) . 29.8/ RE-ROUTE WATER LINE SO AS BENCHMARK - NAIL SET IN TO BE >10' FROM SEPTIC U TIL. POLE EL. = 31.54 SYSTEM COMPONENTS (OR "- 100 EXISTING CONTOUR PREPARED FOR: G A R Y & N A N C Y B R U S TA S SLEEVE WHERE WITHIN 10' OF COMPONENTS) RE-ROUTE GASLINE AS 20 0 20 40 60 NECESSARY BOARD OF HEALTH APPROVED DATE MA SCALE: 1» = 20' DATE: DECEMBER 4, 2000 off NO-362-4541 fox 5w 362-"w down cape en eering, Inc. ��S��A OF ARNE H. �, �o�' ARNE CIVIL ENGINEERS o ou+LA o H. niA CIVIL �► LAND SURVEYORS A N .30792 o.2ssas 00--200 939 main st, yarmouth, ma 02675 JALA, .S. DATE