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0380 HUCKINS NECK ROAD
_t i TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map:vim. Parcel Permit# V603 Health Divisio r> 3-Qv� III 115 ate Issued I'1-0 " SEPTIC SYSTEM MUST B� - Conservation Division . P $ ; �� INSTALLED IN COMPLIANCr WITH TITLE 5 Tax Collector ENVIRONMENTAL CODE AAMlication Fee J y' Treasurer TOWN REGULATIONS Planning Dept. Checked in B Date Definitive Plan Approved by Planning Board Approved By - i Historic-OKH Preservation/Hyannis Project Street Address �� Village Owner Address- T9 (0 VA/ e" Telephone Permit Request& bwAlod,i61S Square feet: 1st floor: existing ;2-10 proposed ® 2nd floor: existing O proposed 15 Total new 0 Valuation �� Zoning District Flood:Plain Groundwater Overlay Construction Type &,J060 Lot Size 6-"3r Grandfathered: ❑Yes ❑ No If yes, attach supporting d cumentn. ; Dwelling Type: Single Family 6 Two Family ❑ Multi-Family(#units) ac, i Age of Existing Structure Historic House: ❑Yes 1@ No On Old King's way: 94es No Basement Type: ❑ Full ❑Crawl OLWalkout ❑Other ~� Basement Finished Area(sq.ft.) !-�o 410-;w 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 0 First Floor Room Count Heat Type and Fuel: ❑Gas 0 Oil ❑Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes �i(No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn: ❑existing ❑new size Attached garage:;Lexisting ❑new size _� Shed: existing ❑new size ele)Q Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes A No If yes, site plan review# - Current Use�/egi=,F Ake Proposed Use BUILDER INFORMATION �' e Name Telephone Number ®� ✓ �� _ Address -e� _2e License# a�� 14941r-e�le IM Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THISPROJECT WILL BETAKEN TO (/ SIGNATURE DATE FOR OFFICIAL USE ONLY ' 'PERM T NO. DATE ISSUED' MAP/PARCEUN0. t ADDRESS VILLAGE OWNER t DATE OF INSPECTION: FOUNDATION. FRAME INSULATIOI I +1`= cr cc, i-� t— Ham•• �j ' FIREPLACEW t- Q -? ' _ ELECTRICAL:i f ROUGH FINAL PLUMBING:n 0 ROUGH FINALcj ' GAS: ROUGH FINAL r 'f. r FINAL BUILDING j)� /��` a-� 0 go-Cie DATE CLOSED�OUT ASSOCIATION PLAN NO. f � ^1 y °FEa, Town of Barnstable Regulatory Services ` Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 _ Fax: 508-790-6230 Permit no. Date n 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. —' .. - pp Me '�) _ Type of Work./� `,�'��' J � Estimated Cost /LJ it9���. Address of Work: ` iUc Owner's Name: /—�C�/�.11'��j✓Gt ` ��.��� ` Date of Application: I hereby certify that: Registration is not required for the following reason(s): 7Work excluded by ❑Job Under$1,000 QBuilding 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 OFTERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name Q:forms:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Change of Contractor/Builder $25.00 FEE VALUE WORKSHEET •NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONSMENOVATIONS OF EXISTING SPACE ` / 20 s e feet x$64/sq.foot= 7/ �9 x.0041= plus from below(if applicable) . QAR.AGES-(attached&detached) square feet x$32/sq.fL= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Some as new building permit: square feet x$96/sq,foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 RelocadowMoving $150.00 (plus above if applicable) Permit Fee Projcost T._..I.fN/,/1 A a t Town of Barnstable Regulatory Services ' BAItd!IW Thomas F.Geiler,Director ..buss. 9''°�fct•`e� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Ommer Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize . � ' to act on my behalf in all matters relative to work authorized by this building permit application for: IL /--V 3H2 -- - A * (Address of Job) e7�A//Z"00// 14 iiggaawire of Owner Date P ' t Name Q:FORMS:OWNERFERMIS SION i ne."mmonweairn of inassacnusetts Department of Industrial Accidents Office of Investigations ' d 600 Washington Street. Boston,MA 02111 www.mass.gov/dia Workers' Compensation In Affidavit: Builders/Contractors/Electricians/Plunibers Applicant Information Please Print Legibly Name (Business/Organization/Individual): CZ-6 (J ✓�/ Address: City/State/Zip: 114 Phone#: .�� �� (� 41i Are you an employer? Check the-appropriate box:. 1.❑ I am a employer with 4. I am a general contractor and I Type of project(required): 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 ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or.additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees.[No workers' . camp.insurance required.] 13.❑ Other. *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information + t Homeowners.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tcontractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. �d Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: A. A, City/State/Zip: >�P ,J�IS 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 ip to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of [nvestigations of the DIA for insurance coverage verification. T do hereby certify under the pa' and pena perjury that the information provided above is true and correct: Si afore. 45;_ � Date:_ Phone#: L QJf1cial use only. Do not write in this area,to be completed by city.or town official k , City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2..Building Department 3.City/Town Clerk 4.:Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions _ Massachusetts General Laws chapter 152,requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an imclividual,: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 association or other legal entity, employing employees. However:t>le rece iver or trustee of an individual,partnership, of the an three apartments and who resides therein,or.the occupant owner of a dwelling house having not more than p sons to do maintenance, construction or repair workvn such dwelling house r who persons in house of another employsP „ dwelling or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or uct buildings in the commonwealth for any or to construct g renewal of a license or permit to operate a business �� hems insurance coverage re uired. table evidence of compliance with t g 9 app licant who has not produced acceptable P , Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if. necessary,supply sub-contractors)name(s), address(es) and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below.. Self-insured companies should enter their number on the appropriate line. license numb app p self-insurance City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to.fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the officially affidavit that has been ocially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for.future permits or kenses..A new affidavit must be filled out.each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and.fax number: ' The Commonwealth of Massachusetts " Department of Industrial.Accidents s Office of Investigations 600 Washingion.$tr-pet - `"' Boston, MA 0211 L. Tel. #617-727-4900 ext 406 or-1-•877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/-- j . ) t►ons and. taridar ,per Board of Bu►i `*7cff►la t �\ VL Y iyT'CONTP.ACTOR . 1` NOiJNE ii .. 11157, Re ist 'l 2006.. _. t Y R.GLOVER ROBERT OiO RD: p0_61OX 703`f 13;CU gun. or _ RSTONFS MICA B ,t r 6:OAIR�D©F+6UI1LD'I!�N �§ ;GUiLAtTIONS UIcense: C N:5'TRUCI ION S-UPERVISOR Tliurtn�beC 039868 EI Tr,no: 24715 ROBERT J GLOU y PO BOX 703 MARSTONS MILLS, �0 ' Commissioner MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # I MAScheck Software Version 2.01 Release 3 I I I Checked by/Date I I CITY: Barnstable STATE: Massachusetts HDD: 6137 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 10-28-2005 PROJECT INFORMATION: 380 HUCKINS NECK RD HYANNIS MA COMPLIANCE: Passes Maximum UA = 238 Your. Home = 233 Area or. Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1120 30.0 0.0 39 WALLS: Wood Frame, 16" O.C. 1088 13.0 0.0 89 GLAZING: Windows or Doors 153 0.340 52 FLOORS: Over Unconditioned Space 1120 19.0 0.0 53 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design o as specified in Sections 780CMR 1310 and J Ze_ Builder/Designer Date