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0396 HUCKINS NECK ROAD
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COWN O1 6NMS ABU TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/'WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: _ �q(o .� K:n s deck �Q NUMBER STREET VILLAGE Owner's Name: _Ma+{6e,%/ W Phone Number SEA-7 -e[ c p 7 Email Address: rna.'-+e S-' ,r 5 ;s�o Wot Ks Cell Phone Number Project cost$ l�; 15— Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: 5 e p �-(�Q ckxa C� �c � Date: TYPE OF WOE Siding ffWindows (no header change)# _ Insulation/weatherization Doors (no header change)# ( Commercial Doors require an inspector's review Ell Roof(not applying more than 1 layer of shingles) Construction Debris will be going to GJ a s4e CONTRACTOR'S INFORMATION Contractor's name I;c an `7�n.�;so r, - So,,(�.��� de,J Fr,,(CV J'n Jow S V Home Improvement Contractors Registration(if applicable)# 17 3 Lq( (attach copy) Construction Supervisor's License#— ()J 5`7 07 (attach copy) Email of Contractor $t.,ea 9 q 6nq; (. C 6 M Phone number V0 J- Z 2 R - J X ALL PROPERTIES THAT HAVE STRUCTURES VER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X I X Additional tent dimensions can be attached on a separate piece of paper. Check one:this event is a: for profit non-profit event Check one:Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval *WOOD/COAL/PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXE YTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CM[R the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMIR and the'Town of Barnstable. Signature Date PLICANT'S SIGNATURE Signature Date / U All permit applications are subject to a building official's approval prior to issuance. ZZ Office of Consumer Affairs and .Business Regulation 1000 Washington Street- Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement Card Registration: 173245 SOUTHERN NEW ENGLAND WINDOWS LLC = Expiration: 09J18/2020 10 RESERVOIR ROAD - —.... SMITHFIELD, RI 02917 = M•OS/ iCA 1 0Update Address and Return Card. 207/7 •,�P. �•LYJ�/J1././I.1L'P,O�Gl/� /.�..G•�CGrI/l�//C1LiClG ' Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration. Expiration Office of Consumer Affairs and Business Regulation 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW:€NGLAND WINDOWS,LLC Boston,MA 0211 BRIAN DENNISON a 10 RESERVOIR ROAD' SMITHFIELD,RI 02917 Undersecretary t,-- - .a. Without signature f Y Commonwealth of Massachusetts 195 Division of Professional Licensure Board of Building. legulations and Standards Constructfbn 'Stag rvsor CS-095707 - `. Epp i res : 09/08/2020 BRIAN ® DENNISOIU 8 BLACKWELL-DRIVE 1 - CHARLTON MA 01607C J- V ;Q Commissioner The Commonwealth of Massachusetts Department of lndustrialAccidents I Congress Street,Suite 100 Boston,MA 02114-2017 www mass.gov/dia IS orkers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERVIITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): .&AAem Je4w e�54:$lam D 44,�CID UIJ Address: /Q &5er r/n1'r jR01 . City/State/Zip: 4G,_'e_/ ;?f 02_� 1 Z Phone#: 4/0 1-y2 k-9�DD Are you an employer?Check the appropriate box: Type of project(required): L U 1 am a employer with oZ 0+'employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in $_ ❑Remodeling any capacity.[No workers'comp.insurance required.] 3.E]I am a homeowner doing all work myself 9. ❑Demolition y [No workers'comp.insurance required.]T 4. I am a homeowner and will be hiring contractors to conduct all work on m 10 Building addition _ ❑ g Y Property. I will ensure that all contractors either have workers'compensation insurance or are sole 1 i.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.E]I am a general contractor and I have hired the sub-contractors listed on the attached sheet. These sub-contractors have employees and have workers'comp.insurance.' 13.E:]Roof repairs //-- / 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14. vv Other (,t/i l/�tL8*�J�ct e f' 152,§1(4),and we have no employees.[No workers'comp.insurance required.] e r ep(a C FS *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 indicatine 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 isproviding workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: ,1-r re M e A 5 14 n'1 Policy#or Self-ins.Lic. I C-A .3 J �� 72_Cj Expiration Date: Job Site Address: �!(p H v G k-n S AJ roc City/,State/Zip: ✓i l fie A Attach a copy of the workers'compensation policy declaration page(showing the policy number and expire ion date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under thepai andpenalties of perjury that the information provided above is true and correct. d t Sitmatur Date: /O - 3 Phone#: qQ I -L Z.k-� Kn 0 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building(Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r— CERTIFICATE OF LIABILITY INSURANCE FDATE(MIMIDD""") 2/29/2017 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 CON-TACT CoBiz Insurance, Inc.-CO NAME: PHONE 1401 Lawrence St, Ste. 1200 •303-988-0446 VX No:303 988 0804 Denver CO 80202 nooRLss: COMaiI cobizinsurance.com INSU S AFFORDING COVERAGE NAIC 9 INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO 01 Southern New England Windows, LLC. INSURER B:Firemens Insurance Company of WA,D.C. 21784 dba Renewal by Andersen of Southem New England INSURER c:Homeland Insurance Company of New York 34452 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F COVERAGES CERTIFICATE NUMBER:1252851165 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. ADDL SUER iTR TYPE OF INSURANCE _ POLICY NUMBER MMO/LDIDI EFF MMNDEXP LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1/2018 1/120191-71 EACH OCCURRENCE $1.000,000 CLAIMS-MADE OCCUR DAMAGE TO Rr:RFFD- PREEM SES Es occurrence) $300,000 MED EXP(Any one Person) $10,0W PERSONAL&ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY❑JET LOC PRODUCTS-COMP/OP AGG $2,000.000 OTHER: $ A AUTOMOBILE LIABILITY N CPA3158728 1112018 1112019 COMBINED SINGLE LIMB Ea accident $1.00D.000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS Per accident) $ A X UMBRELLA EXCESS LIABAB X OCCUR CPA3158728 1/12018 1/1/2019 EACH OCCURRENCE $10.0D0,000 CLAIMS-MADE AGGREGATE $10,000,000 DED X I RETENTION$IA $ g WORKERS COMPENSATION WCA3158729-20 1/12018 1/12019 µ AND EMPLOYERS'LIABILITY Y I N X STA UTE ER ANY PROPRIETORIPARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? ❑ N/A EL EACH ACCIDENT $1,ODD,000 (Mandatory in NH) IF yes describe under EL DISEASE-EA EMPLOYEE $1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY UMIT $1,000,000 C Pollution Uabft 7930073340000 1/12018 1/12019 Each Occurrence $1.000.000 ClaimsMade Policy Retroactive Date 06/202013 Deductible $10 D0p 00 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE'HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELNERED IN ACCORDANCE WITH THE POLICY PROVISIONS. For Informational Purposes AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD . . ,., .I.�,I,LLI,",'1 I,1"'._r.�I:.1.:'I.�'�I..'.r..-.I.�...,rI..rI I.:.r.'..I.'..I.�1.I:4"r�....�'r;:I,,,.1I L.:.I,I.—._.1F,,.rI�.,LI1�.r.L..r1..I:.I.—,-'I,:'..I1.�r:,:+II".r�1.I.r...-.:.1.-,.—��'.!.7...:."1.t.-''—.I..L.�.;-1—..r�'."::1��1rr L�::�'.r.-�.'L..::.:II:.,.::.-,rI':,_�.�.,:r�L:-:l,_,.:1.-I.r�L 1�I.�:..L.LI._.�-.....r'r'L:+�.":1.1:....,1 1r�II..I�...�..;'l.."..r'.:�I1I..,..I—.:1 rL.L,"��I.'�.L:.'rL;.�I'—��1'r1 1.L Ir:.r'I'....-':-lI".-.-..-1.I LL..:.Z,rr-II..,:.d.rr1.,.-.,L....:I.'..1....::...:.,I r....1.1"L.,;1".rLI,�:-�..r.trI�iL-,..1 r,r"�;1.:I�,...I.7 r.L...-.,—rr.:.:��1J-.-:..�.'.,:��I r.I..I.-�.�I�r.,':r...-,:.,r."1:.,,..:.:�._�..L���r:.,r'.'..L:-'.�.�,;-:.."�_I1.L.r..�rr,.-r:'L�1I r:L.�.'.-III.r.Lrrr,r'.:,..I-'r.,1+1I rj.'.,;1-.1I.rL�,..1.�?�..Lr:.'�-r-II.I,rr-�.II:.'.1.-.Lr_ILrI,%.--,.�.rr,',�i..L.._.�I,:.I.r.I.L.rI�.'Ir:I..�...r�,.:,.I'.:L..,I::�",;,.,r.I. r. Renewal Agreement Document and Payment Terms bY�l1C�eCSei1: dba RenewaLHyMdersep ofSonchem New.Engtand ' Matthew Wake �e� Legal Name:Southern New'England Windows.LL,t 396 Hickins Neck Rd �P®o RI#36U79,MA#173245,Cf#0634555 Lead:Ftrin#1237. Centerville MA 02632 . wreDDw;RE uCEMEM 10 Reservoir Rd t-$mnhfield;�Rl 02917 H:(50607 13-91$7 i': . Phone:.86&563-2235 I`Fax;401-6B 6602 1 salesCrenewalsne,com C:($08)360=0877 Buyer(s)'Name MdttNew'Wake: ':Contracc Date:.10/18/18 . ., . Buyer(s);StreerAddress:396 F{ickins Neck Rd; Centerville, MA'0263Z'` Prima yTelephoneNumber: (508)778 5187 -SecondaryTelephoneNumber: (508)3.60 0877 Primary Email: Matt@stu,rg6bU'a works-corf1. Secondary Em'A.,. Buyer(s).hereby jointly and severally_agrees to;purcliase the products and/or services of Sourhem;New"England'Windows,LLC,d/l/a Renewal ByAndersen.of Southern New England(Co.ntracco"r"),-in accordance with the;rerms and conditions, idkfibed inThis Agreetnenf Document and Payment,Terms,any documents fisted in the Table of Contents;;and any oilier document attached'.ro this Agreement Document,the Ttfrrs of which are,all agreed o by The:parties;and incorppora'd herci lbY,rcf6ience(collectively,ibis"Agreement");. Buyers)hereby agree to sign,,completion certifrcace after Contractor;has completed all work under this Agreement. Total Jo6:Amount 51;8315 By sigtttng this Agreement,you acknowledge that rite$,lance Due,and the Amount Financed inusf'be made by personal check,ba,4.ec , credit card,or cash: F DeposirReceived: $0 . Balance D:ue $18 315 Esuma>ed Start: Est mated Complerion Ainounc Financed:: 8 10 weeks : I, I rs $18;315 Method of Payment Financing :-We schedWe msrallanons based on die dace of the signed eontracr`.and secondarily on the.date m which we complete z ee-technical measuretlienrs.The installanon&' tliar ' re'provtdmg at tliis;;ttrne is only an esnmate.We will'cornmunicate an-ofhictal dace and-dine ar aaater date.Ralwand extreme weather are-th'e'most;common,.causes'for delay.' . Notes: permit in Barnstable ` Buyers)agrees and,understands that this Agreement consti"totes the entire understandings beaveen the parties and chat There are no verbal: understandings.changing or modifying any of the terms of this Agreement.No alterations'to of deviations'from:rhjs AgTeernent will be valid without -le;signed,writrea consent of<;boih the•Buyer(s)and Conaactor.;Buyer{s);`her6k acknowledges rliat$uyer(s) 1)has-read.this' • Agreement, understands the terms of this Agreement,and has received a cortipieced,signed;anddared copy of rhis Agreement including die'rwo attached Notices of:Cancellanon;o`n be date-first written above and 2)was,.orafly inEormed.of`Buyers right to cancel"cliffs Agreement: . . ,' NOTICE:TO BUYER -Do naL sign>rhis contraca if filank.You are"eritided to�a copy"of the"contract at the rune you sign.' . , . YOU,THE BUYER,MAY CANCEL THI5 TRANSACTION AT ANYTIME NOT;LATER THAN M�DIVIGHT OF 10/22/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE;IS LATER SEE THE ATTACHED NOTICE QF CANCELLATION FORM FUR AN EXPLANATION OF'THIS RIGHT I egg(Names Southern New England Wrndows,LLC d6a:itenet:F B: %Andersen oFSoiiihern N.ri Ed"gland finyer( :- U Signature of Sales`Person $igt tore Signature'` jirtt passanisi' Ma `hew.Wake . Princ`Name of Sales.Person'` '. Name PiincNarne UPDATED'; l'0/18118 _ - Page 2/=11 TOWN OF BARNSTABLE,BUILDING PERMIT APPLICATION ,,,,Map Parcel. Application # Health=Division - ' Date Issued to Conservation Division �J ';Application Fee Planning Dept, - Permit Fee Date Definitive Plan Approved by Planning Board 0E) Io�S�lt Historic'- OKH _ Preservation/Hyannis Project Street Address J16 44[)tKi J5 UecK Village C�W+WV 1I4C, Owner : Mkt k. tk)► 15_ 4- :J 5.l 1 i el W Address SA'1M Telephone 60 �, �� 0 07 Permit Request tk)z&-1AN� z-e and CGN Ud CORM 1 nib k!� tip' �5i'o ._ i`� S � na-�1 IJ3� trti1. Square feet: 1 st floor: existing proposed 2nd floor: existing' proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation O I UM 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 stbQe: Yes ❑ No ,Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn`Oexisting new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: F _ = Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ 6 Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name f"l�' UlJ A-��� Telephone Number Address t1� Y1S I���lC. License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �� l l I rh/ SIGNATURE s�' E WI 2 FOR OFFICIAL USE ONLY APPLICATION# F u ` DATE ISSUED MAP/PARCEL NO... . A A . ADDRESS VILLAGE 4 OWNER •a DATE OF INSPECTION: FOUNDATION_ FRAME I l I H�lt " �E INSULATIONS FIREPLACE ELECTRICAL: ROUGH FINAL } ,y PLUMBING: ROUGH FINAL t ROUGH ; FINAL GAS:�,-=x� _ . ,FINAL BUILDING°`_ CLOSED OUT. ASSOCIATION PLAN NO. ;f The Commonwealth of Massachusetts t { Department of Industrial Accidents Office of Investigations t 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0bly Name (Business/Organization/Individual): f 4—ke—, Address: 3A &,- u5 oe_(4L kA Ci /State r 'A t5' /Zi p: t MtVV1 VlQ ,IMA 6243 2- 0�n-1Phone #: �f�' ,3�t�_ Are you an employer?Check the appropriate box: Type of project(required): I.❑ lam, a employer with - 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or listed 7. Remod 'p partner- on the attache # eItn P P d sheet L'� g 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 3.[equired,] officers have exercised their 10,❑ Electrical repairs or additions l m a homeowner doingall work 'right of exemption per MGL 1 LEI Plumbing repairs or additions myself. [No workers' comp. e. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t. employees. [No workers' comp, 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 now affidavit indicating such. tContmaDrs thatcheck 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. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the,policy number and expiration date). Failure to secure'coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator,, Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby nder the pains and penalties of perjury that the information provided above is if. a and correct Si afore: . Date: Ph one#: _4_q2KR- 6 Fsr Official use only, Do not write in this area,to be completed by city or town official City or Town: Permit/License# Isst ing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5, Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct building's in the commonwealth for any Y applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enterco inio any .contract for the performance of public work until acceptable evidence P p n e of compliance with the insurance requirements ofthis chapter have been presented to the contracting authority." o ' " 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 certificates)of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured-companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating currept policy information (if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i:e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit- The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Da �ent of In partm dustrial Accidents Office of Inve ti g. & a,fions 600 Washington Street Roston,MA 02111 Tel. # 617-727-49.00 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.m,asa.gov/dia t - Town of Barnstable Regulatb'ry Services y •w L uLE, Thomas F. Geiler,Director ib59• Building Division ' CEO f�j k Tom Perry,Building Commissioner 200 Magi-Street,_Hyannis,MA_02601 RWv.to wn.b arnstab l e-ma-us Office: 508-962-403 8 Fax: 508-790-6230 Please Print DATE: JOB LOCA71ON: I V ��/� • (1 � „� ��� number stroct Village. Leo• 681-7 98- name home phone# work phone# CUP RENT MAILING ADDRESS: /7{°✓A� cityhown statz aP code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does not possess a-license,provided that the owner acts as supervisor. DEFT MON OF HOMEO!'i7\TR P erson(s)who owns a parcel of land an 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 structiaes. A person who constrgcts more than bne 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 tie 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 thathe/sho understands the Town of Barnstable Building Dcpartmcnt inspection procedures and requirements and that he/she will comply with said procedures and r nts. SiinatiXM A Homeowner Approval of Budding Of r-ial Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constructibn Control. HOMEOWNER'S EXEMPTION .The Code states that: "Any bameowncr pm-forming work for which a building permit is required shall be cxLmpt from the provisions of this section.(Seetirin 1D9.1.1-U=nsing of eanstruetion Supenisors);provided that if the homeowner engages a person(s)for hiro to do such work,that such Hameowna shall act as supervisor.", 1r�anry horrreowners who use this excurptioa are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Caastructicn Supervisars,Section 2.15) This lack of awaruress bfi=results in serious problems,particularly when the homeowner hires unli=nsed persons. In,this case,our Board cannot proceed against the unliemsed person as it Would with a licensed 5 ervisor The hotnoown er actin Supervisor is uttima vp . g as up responsible. To croon:that the bam=mmrr is fully aware of his/her rzsponsibilitioa,many communities require,,as part of permit application, that the homeowner certify that he/she understands the nmponsrbrlities of a Supervisor. On the last page of this issue is a form currently used by several tow are towns. You may caret amend and adopt such a f6nnlcertifiax6cn for use in your community. Q:forms:hom=mrnpt 1 , T` Town of Barnstable P Re gnIatory Services 1MAEL `�� Thomas F. Geiler,Director `1. g 'Buildin Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.to w n.b arns tab l e.ma,us OfFice: 508-862-403 8 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 Matteis relative to work authorized by this binding permit application for. (Address of Job) Signature of Owner Date Print Name If PropLM Owner is applying for permit please complete the Homeowners License Exemption Form on 'the reverse side. Q:FORMS:0V NERPERMISSION I a Boise Cascade Double 1-3/4" x 7-1/4" VERSA-LAM® 2.0 3100 SP Wall HeaderT1302 BC CALC®3.0 Design Report-US 1 span I No cantilevers 1 0/12 slope Wednesday, September 14, 2011 Build 517 01-04-00 OCS File Name: S Richman Neck Ln Job Name: Description: HEADER AT HOUSE Address: 396 Huckings Neck Road Specifier: Joe Madera City, State, Zip: Centerville, MA Designer: Customer: Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: 6 `2i Isl ! ! I l ! ! I I I 3 ! ! ! Al ,. 08-00-00 BO,3-1/2" B1,3-1/2" LL 320 Ibs LL 320 Ibs DL 941 Ibs DL 1,405 Ibs SL 628 Ibs SL 1,325 Ibs Total Horizontal Product Length=08-00-00 Live Dead Snow Wind Roof Live OCS Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area (psf) L 00-00-00 08-00-00 40 10 01-04-00 2 Unf. Lin. (plf) L 00-00-00 08-00-00 80 - n/a 3 Unf. Area(psf) L 00-00-00 08-00-00 20 10 01-04-00 4 ,.Trapezoidal (plf) L 00-00-00 20 n/a 08-00-00 80 n/a 5 Unf. Area (psf) L 00-00-00 08-00-00 15 30 02-08-00 6 Conc. Pt. (Ibs) L 06-00-00 06-00-00 715 1,313 n/a Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 4,714 ft-Ibs 48.9% 115% 2 1 - Internal Completeness and accuracy of input must End Shear -2,700 Ibs 48.7% 115% 2 1 - Right be verified by.anyone who would rely on Total Load Defl. U427 (0.212") 56.2% 2 1 output as evidence of suitability for u particular application.Output here based Live Load Defl. U805 (0.112 ) 44.7/0 2 1 on building code-accepted design Max Defl. 0.212" 21.2% 2 1 properties and analysis methods. Span/Depth 12.5 , n/a 1 Installation of BOISE engineered wood products must be in accordance with %Allow %Allow current Installation Guide and applicable Bearin Su building codes.To obtain Installation Guide 9 pporlS Dim.(L x W) Value Support Member Material or ask questions;please call BO Post 3-1/2"x 3-1/2" 1,889 Ibs n/a 20.6% Unspecified or ask quests 8 before installation. B1 Post 3-1/2"x 3-1/2" 3,049 Ibs n/a 33.2% Unspecified BC CALC®,BC FRAMER®,AJSTm,. Notes ALLJOISTO,BC RIM BOARD- BCIO, BOISE GLULAM rm SIMPLE FRAMING Design meets Code minimum (U240)Total load deflection criteria. SYSTEM®,VERSA-LAM®,VERSA-RIM Design meets Code minimum (U360) Live load deflection criteria. PLUS®,VERSA-RIM®, . Design meets arbitrary(1") Maximum load deflection criteria. VERSA-STRAND®,VERSA-STUD®are.. trademarks of Boise Cascade Wood Products L.L.C. Page 1 of 2 ®Boise Cascade Double 1-3/4" x 7-1/4" VERSA-LAM® 2.0 3100 SP Wall HeaderT1302 BC CALC®3.0 Design Report- US 1 span No cantilevers 1 0/12 slope Wednesday, September 14, 2011 Build 517 01-04-00 OCS File Name: S Richman Neck Ln Job Name: Description: HEADER AT HOUSE Address: 396 Huckings Neck Road Specifier: Joe Madera City, State, Zip: Centerville, MA Designer: Customer: Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: Connection Diagram Disclosure Completeness and accuracy of input must b —d be verified by anyone who would rely on a output as evidence of suitability for • r• • particular application.Output here based on building code-accepted design c properties and analysis methods. Installation of BOISE engineered wood • • products must be in accordance with current Installation Guide and applicable building codes.To obtain Installation Guide or ask questions,please call a minimum =2" c= 3-1/4" (800)232-0788 before installation. b minimum = 3" d =24" BC CALC®,BC FRAMER®,AJSTM, Connection design assumes point load is'top-loaded'. For connection design of'side-loaded' ALLJOIST®,BC RIM BOARD-,BCI®, point loads, please consult a technical representative or professional of Record. BOISE GLULAMTM SIMPLE FRAMING Member has no side loads. SYSTEM®,VERSA-LAM®,VERSA-RIM Concentrated loads are not considered in side load analysis. PLUS®,VERSA-RIM®,VERSA-STRAND®,VERSA-STUD®are Connectors are: 16d Sinker Nails trademarks of Boise Cascade Wood Products L.L.C. ®Boise Cascade Double 1-3/4" x 7-1/4"VERSA-LAM® 2.0 3100 SP Wall HeaderT1301 BC CALC®3.0 Design Report- US 1 span No cantilevers 1 0/12 slope Wednesday, September 14, 2011 Build 517 06-00-00 OCS File Name: S Richman Neck Ln Job Name: Description: HEADER (S) IN CONNECTOR Address: 396 Huckings Neck Road Specifier: Joe Madera City, State, Zip: Centerville, MA Designer: Customer: Company: Shepley Wood Products, Inc. Code reports: ESR-1040 Misc: 08-00-00 BO,3-1/2" B1,3-1/2" LL 240 Ibs LL 240 Ibs DL 689 Ibs DL 689 Ibs SL 840 Ibs SL 840 Ibs Total Horizontal Product Length=08-00-00 Live Dead Snow Wind Roof Live OCS Load Summary Tag Description Load Type Ref. Start End 100% 90% 115% 133% 125% 1 Standard Load Unf.Area (psf) L 00-00-00 08-00-00 10 10 06-00-00 2 Unf.Area (psf) L 00-00-00 08-00-00 15 30 07-00-00 Controls Summary Value %Allowable Duration Case Span Disclosure Pos. Moment 3,143 ft-Ibs 32.6% 115% 2 1 - Internal Completeness and accuracy of input must End Shear 1,372 Ibs 24.8% 115% 2 1 - Left be verified by anyone who would rely on Total Load Defl. U625 (0.145") 38.4% 2 1 output as evidence of suitability for Live Load Defl. U1,024 0.088" 35.2% particular application.Output here based ( ) 2 1 on building code-accepted design Max Defl. 0.145" 14.5% 2 1 properties and analysis methods. Span/Depth 12.5 n/a 1 Installation of BOISE engineered wood::' products must be in accordance with %Allow %Allow current Installation Guide and applicable .(L x W) Value Support Member Material building codes.To obtain Installation Guide Bearing Supports Dim - or ask questions,please call BO Post 3-1/2"x 3-1/2" 1,769 Ibs n/a 19.2% Unspecified (800)232-0788 before installation. B1 Post 3-1/2"x 3-1/2" 1,769 Ibs n/a 19.2% Unspecified BC CALC®,BC FRAMER®,AJSTM, Notes ALLJOISTO,BC RIM BOARD-,BCI®, BOISE GLULAM- SIMPLE FRAMING Design meets Code minimum (L/240)Total load deflection criteria. SYSTEM®,VERSA-LAM®,VERSA-RIM Design meets Code minimum (U360) Live load deflection criteria. PLUS®,VERSA-RIM®, Design meets arbitrary(1") Maximum load deflection criteria. VERSA-STRAND®,VERSA-STUD®are trademarks of Boise Cascade Wood Products L.L.C. Connection Diagram b d a c a minimum= 2" c= 3-1/4" b minimum = 3" d = 12" Member has no side loads. Connectors are: 16d Common Nails Page 1 of 1 IIL p Town ®f Barnstable *Permit# Kxpires 6 rnonthon 'su to °� s.r Regulatory.Services Fee a s + BARNSTABLE, • - - - - 6;9. a�`� Thomas F.Geiler,Director /.3/i o Ep a II Building Division Tom Perry,CBO, Building Commissioner ' 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY jj Not Valid without Red X-Press Imprint Map/parcel Number. �J 63 Property Address_c' kk e- .14e a&I-Ieryi/A� residential Value of Wlj_j_ Minimum fee of$35.00 for work under.$6000.00 Owner's Name&Address 1"► 14A�_ i Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) r X-PRESS FhKMI, Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Jul_: ... L010 Check one:VI OF BARI4STABL Elam a sole proprietor am the Homeowner ❑ I have Worker's•Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) - ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over' existing layers of roof) EU/Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows *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 SIGNATURE:. C:\Users\decollik\AppData\Lo R rosoft\Windows\Temporary Internet Files\Content.Outlook\QKIH7J6E\EXPRESS.doc Revised 070110 The Comuronnwaltle of Massackuseft D49arhamt of Industrial Accidents Office of Inmfigations 600 Wmkington Street Boston,1 A 02111 nww.masmgm1dia Workers'Compensation Insurance AEE&vzt Bud&rs/Conn act wslEkctnc anslPimmbers Apiplkant Information Please Pent 1,Mb Name - ,: MAk 1AAet,- Address: u lr� l k- Ocl City/State/Zip-. i Ile— LI Z&32 Phone#k —C2)45 3&0 68-7-7 Are you an employer?Check the appropriate box: L❑ I atn a employer with 4- I arm a gen ral contractor and 1 Type of project(required): employees{fail atad/orrpnct-time). s have hired the su Amniractois 6- ❑New construction 2_❑ I am a sole proprietor or partner listed an 1 e attached sheet_ a- 0 slap and have no employees These ors have g- ❑Demolition ' woddng for me in any capacity. employees and have wadrers' 9. ❑Building addition (No workers'comp.insurance comp-insurance t t 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.MI am a homeowner doing all work officers have exercised their l l-❑Plumbing repairs or additions myself o workers' right of exemption per MGL 12.❑RoofImo]g c-152,§1(4),and we have.no repairs employem-[No wodams' 13.�OtLer comp.insurance required.] •Any apptic�d fat checks boa#1 nmst also M Out the SOMM bebw showing then wutff'ru®pemsadnn policy infnrmatiotL Hnmeawffis Who suhmrt this atHdam indicating they am doing an woo}and then hire outs&cam==mnLq mbmit a new afdavh indirsain sorb. t<artms that check this box mast attached an additional sheet showing the name of ibe avid state whe*er or not those emims ham employees. if the wb-rocs Last'employees,they mmm-p¢xide*&—kets'camp.paltry amber. I am an angdo)er that is providfirg tankers'conpeiasadoan insurance for gray sus. Below is the policy and job site informahoas Insurance Company Name: Policy#or Self-ins.Lic.#: Dgfi atiosu Bake: Job Site Address: City/State/zip: Attach a copy of the workers'compeffiation"policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Sech m 25A of MGL c, 152 can lead to the imposition of crimrial penalties of a fine up to S 1,500.00 andlor 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 diat a copy of this statement may be forwarded to t e Office of Investigations of the DIA for mnsiaance covopp verifioation- I do hereby the pains and of perfat,ry that the iraformidion provided a is and correct Date: Phone#: ~� G Q,yrcitrl use only. Do not wr&o innr this area,to be•cmpleted by edy or totem official City or Town: Permitffikense# Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.Gityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#• 6 �t Town of Barnstable Regulatory Services � Mz ss iEg Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION c Please Print DATE: - b 1® �,, c JOB LOCATION: �r Q-L eA C`^/�I/'" � number street village /� HOMEOWNER": 1'\AA� V_) f5bfs 3&0 007) ,bS 77�s 511 t1 nameTo Ite, U)k U,. home phone# 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 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 ersigned"homeo rtifie that he/she understands the Town of Barnstable Building Department minimum inspection p e n r quire s and e/ e will comply with said procedures and requirements. Signature Homeowner 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 nlicensed 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\QK 1 H7J6E\EXPRESS.doc Revised 070110 DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH OF 1010 COMMONWEALTH AVE. MASSACHUSETTS BOSTON,MASS.02215a ENCLOSE CHECCKl OR M NEY RRER LICENSE FOR ReQU11EDjFj - EXPIRATIONDATE CONSTR. SUPERVISOR 06/30/19936200 MADE PAYABLE TO EFFECTIVE DATE LIC NO. i RESTRICTIONS "COMMIS I R�IPLI� TY" NONE ' 06/30/1991 014221 AARTHUR R WILLIAN4S' (DO NOT SENDCAS�A). 2 OAK STREET - CENTERVILLE MA 02632 PIiEAS�E NOTE FEE INCREASE. j PHOTO(BLASTING OPR ONLY) FEE: 100.00 EFFECTIVE FEB. 1, 1489 HEIGHT NOT VALID UNTIL SIGNED SY LICENSEE AND OFFICIALLY j STAMPED- R-SIGNATURE OF THE COMMISSIONER i �. �� i D NOT DETACH LICENSE STUB THIS DOCUMENT MUST --w; SIGNAT RE OF LKENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON F- THE HOLDER WHEN ENGA OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPAT.IN, COMMISSIONER 20OM-2-87-81429 r ✓1.{oam�nmuuea/l/i o�/t�naaac/u�aetta HOME IMPROVEMENT CONTRACTOR Registration 101377 Type - PRIVATE CORPORATION .I Expiration 06./15/94 1 R. Arthur Williams, Inc. Arthur Williams 2 Oak St. ADMINISTRATOR Centerville MA 82632 1 r V l { > • I fir-. c. Irc +': }.'Si t_ U 1.. I p 1 ua�n in C f j' i � � U all i I A mild �N N off. u r I— { ( rt b S 1!✓ I,Dr {r .19 i; '71 L ii_S SLR - _tl.5�. �o• .: � ..� I J _ 'i i , I I wi I � L'1 N c z t•.�c � I { \ 71 {• r l' r nri 1 • , . � >M=� , s�:k'� ,ice �.;g - � .� •� � d1:��� , i. I , r ._,. :zin l- I�III Pi 05i [77 �, ,-" -�t wui pfi➢ * fb � Assessor's office 1 st Floor): Assessor's map and lot number f7C� 'E3"9 ay3� �uv yoF tNE toy Board of Health(3rd floor): jq I'MSTALLE® IN COMPLIANCE i Sewage Permit number wITI'I TITLE 5 i DeDa9TODLL Engineering Department(3rd floor): // ENVIRONMENTAL CODE AND 039, House number ��to �J-S T^WNI REGULATIONS �0 6. Definitive Plan Approved by Planning Board 19' APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only APMOW , TOWN OF BARNSTABLE 0":=8'UILDING INSPECTOR --L L�ICATION FOR PERM TJTOJ W.Xc?/ TYPE OF CONSTRUCTION 1 ,���,/ /�`,-®r,�•, �.. 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inf rmation: 1. Location Proposed Use -cl A/ Zoning District Fire District Name of Owne t-4/'� J, 14=S Aj Address �Q-iyilr *� Name of Builder s'' �- � 'I/,��►+� lJ Address t �� � / f Name of Architect a ca/sd� c�Y /.S�(e°J' Address Yp1&4 t Number of Rooms p� " �d/ Foundation ��p &t? rd : / Exterior e ...�/� v s Roofing - � � �✓n �� Floors Interior Heating 9 r-, r'��"���' Plumbing - Fireplace ` V»A,) C— Approximate Cost ©61.W Area "v a Diagram of Lot and Building with Dimensions Fee ©� e OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name Construction Supervisor's License d���d ALSNER, .EDWARD J.. - No U Permit Fo BU +LD ADDITION y { Single Famil Dw_ Linq - Location 396 HucKin�`s N�'�,ck Road %L M ,z Centervi ale - F ® - 1_ ' Owner. Edward J. 41snr ` Type of Construction r , I Plot Lot , Permit Granted August 2 4,' : 19 93 Date of Inspection 19 � . . p Date Completdd 19 ' E ` ('t) s`.,J Hwy 1 1 My - ` Co F. - I - 0 � 12'• ut" u NEW STAIR 36 I'm" 2'a" 3'• 1/2" j f- W/RAIL --_ - ---------- j -INSTALL NEW RIb6E INTO EXIST. c 2868 WINbCWs Tsb a,op ROOF FRAMING. REFER TO MNFTR M NY OWNER •NEW PT 2xt SLEEPER FLOOR - &M 6MM POLY UNOERLAYMIENT _ CALCS FOR SIZING • „�," � � � ! -INSTALL NEW 2xa RAFTER 16"OC • rw t■i. W/3 LAYERS Of 2" FOIL FACE (0-36.4) EXIST I lULATtON BETWEEN JO! Ts SISTEREO INTO EXIST. 2x4's 2'OC b co NEW KITC *N •'� " AbVANTECH SUtf OOt ` -INSTALL 3 LAYERS OF 2" FOIL N bIMJ3PJi / FACE INSULATION BETWEEN 1 Ili. 5 ANh NAILEb� T/ i RAFTERS (R-36.4)W/RAFEI MATE � p) -#E MIME EXIST. RL t WA S FOR NEW WIDOW/DOOR a VENTING AT UNDERSIDE OF EXIST. STEP lx8 ROOF BOARDING W/NEW VENT boom ' I AT RIDGE 26" -3N. Au t LAYER EACH OF 2" E � � ' •am ANC FOIL FACE INSULATION _... -INSTALL lx3 STRAPPING AT - UNDERSIDE OF RAFTERS 16"OC O INS AtAY3 (R-19.3) __....__. ___ . .. _____ ____---_.. ._._ __ _._. . ' -INSTALL NEW 2x4 COLLAR TIES Ai i -AEfII! TO NFTR CAICs FOR NEW ! I 16"OC AT UNDERSIDE OF NEW RIME 2'!t" 3'41" HEAMS OVER WINDOW/BOOR -INSTALL NEW 1/2" GYPSUM AT L#4Ts AND NEW OPENING FROM # WALLS AND CEILING " KITQ*N TO DD4" l 12 4 FLOOR LAYOUT CROSS SECTION o IS � � 'e - - _ a aao - Al 0 .0 4- O FRONT ELEVATION REAR ELEVATION date: scale: 1/4" = 1'0"