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Home My WebLink About0069 JOAN ROAD . � .r . . _ � _ .�_ . e a y�+ P - � i .. 5 t - ip� .. 4 ! _ a u a t.. { 1. ., 4 i t 9 p o . Town of Barnstable Building : `PostiThrs Card So�T,hat rt=tsxV+s+ble From the�Street��;A roued�Plans�Must berReta+ned on Job.and this Card Must be°Ke t „ �" PsostedEUntil Final Inspection Has Been Mader '` �,R W;here a3Cert+ficate�of Occu anc'�is Re urred uch�Bu+ldrn �shall�Not be-0ccu red=unt+I=a"F+nahlns ect+onsh'as�bee`n'�`,,made Permit Permit NO. B-18-2459 Applicant Name: INSULATE 2 SAVE, INC. Approvals Date Issued: 08/01/2018 Current Use: Structure Permit Type: Building-Insulation- Residential Expiration Date: 02/01/2019 Foundation: Location: 69JOAN ROAD,CENTERVILLE Map/Lot 228 070 _ Zoning District: RC Sheathing: w 4 . Owner on Record: WHITE, ROBERT V&PAMELA P ContractorName INSULATE 2 SAVE, INC. Framing: 1 Address: 69 JOAN RD r G ntr f a or L cense 180747 2 Ski CENTERVILLE,MA 02632 Project Cost: $7,168.27 Chimney: Description: Weatherization Perm+t.Fee: Insulation: Project Review Req: Fee Paid';= $86.56 U Date 8/1/2018 Final: Plumbing/Gas t Rough Plumbing: F Building Official " Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by-Ams permit is commenced within sa months after issuance. � - � , Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which thig permit has been granted. All construction,alterations and changes of use of any building and structures shall;be in compliance with the local zoriing bylaws ad codes. Final Gas: This permit shall be displayed in a location clearly visible from access street orroad and shall be maintained open for public inspection for the entire duration of the p work until the completion of the same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Build�inganttd Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: 1.Foundation or Footing tea - Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT i .:z 3MCIa az�:s L f.Se<sa ems- ® - t-Y}.\2 S:a:[ t'l , E - n-f✓4 - f W4 i•v-.\ �:.-.Y! i 1F;Rt,- Y3 712 - i It .t a.`.!ii.�i33 � a i• � yG3 8,^.it'. O:E � - a 3i!• - � I3� .f:�t 3 a Z i i 74 tee.! ISM, 6 Tr c.•'A:.:.w� �.. _'=Z s �' S.6 ,.8::.- Oitai9. .✓_t.y- [t:.;3:.ta � �! � �Y.=at, _ � �-i �s:r. - _�;�. �'ll��cl c�aa r i 2fG` -�B T�l�e r`�a L�c�UG✓�1 s f�l i^ l � dada 144 Ip d l�f�cP �,S'�i�Pa �P✓S�<� (_.Yoor' 9L �tGt��Y SQ/�'�°�r " 4 Section 6—Proj6d 0 Wiring fail Tank Storage [1 Smoke DeWc n plumbing ❑ Gas Fire Suppression Q Heating Sys D z&wnry Chimney O'AddOelocoebodro�am j , W :Supply II Public ❑ Private SeDisposal M pal . . , Historic District (] Hyannis Historic District ❑ Old:Kings. y Debris sal Facility:.116 - 1lac SPIsm using a c Yes Q.No IaF d a r V- <C Section 7—Picwd ZA Mt Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes* No No Section 8—Zoning Zoning.District Proposed Use I Lot,Area 4 Ft. Total Frontage Pie of Lot Coverage #of Dwelling.Ups ion sue} Setbacks Front Yard Required_ Reir Yard - Requined Side Yard Required thisrogerty relief from the Z,,oning.Board ia.te past? J - Yes No section 9-COM&Mpaps-.sq .! Ate. /�.6-po U- e 5 g4 City iq C/h eop' -zip f11 9-a o Licetzs -Number / ?F�' License Type Date . CWbactols Email /fat) i? to A,, �� I mdwsopOzy, esgo tb ties under the rules and regeIsdo s for Limed - .. *: Ce SM Bmldmg cod& Idxe c sd ed by M CMR amdthe Town ofBarnsW&.A9Kh a csfy �2Date J3.0 AF Secdon 106.00 L �.v✓� Thow Addms l'�ati'� sue- City Ca 16ye'e. zip 40;'1)�_O. Ramon Nupber_ZZ 2sf7 Exphvdion Date I my-res�oa sibitities tinder ft nfles and regflatim fix e C ..._w:Bu2ft I ustod tt�n by 78O CAa Tjr :A :a 6f E.LC_. e Dale 3:o�l .� 11�-Home How.-Owners.Nme• 9� i Tdepbm N=ber �DF 9,4 Cell or Word I d,M �i .t�i toe rides and regumoos.for Lich. �;acc ?8 f CAR�eLas�acsetts Stye Buflc�g Code. i�f rem by 790 CMR and.ft Town of Barastabie. Side eeq, Date o L �� .$*Poe AI 9 ww �/ / • r t 40.. J"o n ' u c s a ue, e M Health Depktment Zoning Board(if recpjr4 M HWOric District Site P ' Review(if � Conservation ❑ ; . , For.comnwdd work,please tape ©} y 7plans d�t©,aej&e a 13 ownee - $ uo as Comer at `rL- the-subject Proms hereby to act o�� , .. �tters:reve to work atrtho ' by this b y b� inall �ca4cn for. /� e (f -14 ©d 3 ( ddress of job} t: Sig a of Owner Nme e i. a 2 t 5A' r ' r 3 aPkAll 50H ' ...... "" :" ..ate. 26,2t12t1 �$ I Epp!?,;Avenue, 'e.2 SoaifiYai�oufti;,AA,4�'lT�B64 _ . Job i3eAW.ottori' fii� WkSaAt TW6�l L R l Q RIGID SflA iWEWi LS R!9 FG BATI 12" S, t3VS0�A.7 BtJIKNEADDOOR APO ATTIC I=LAT;33-30 UIdEACEl3� Rtl ASS. ... . .:. '##42..-.. SF.. 2,192:54. S546 f�'Fill I3V1'5fiit TtiEFF ,BUILTP:,. f ... $23 G $'�,41;. AER,'SI:P; 1G: 1ti+$T11„AlON.CHUTES 78 8'ow Ct3A4�W4 V';RlG0.BQARD: SS: _ .,,.S� $3�60 _,•„ $3465._:..._ • 4 x'16" 31=#"!'t/EE+lS Ili al{LLS WC }-SIflED 4a CELLUt pSE 4�S LATt3ERS T 6QQ :. : :.: :.'.'RPJO i= ;."..I $ a qr�ota1: �,552 07 . VNE FREE HEREBY TO F[I iSRSERViCES :CQivtf' .E:tl Ik=R�#Aka N(iTH OVB a#?t4doj AT.tC3 S FOR:tkfE sum OF Ti�ouserid,fliv,e'.Nil An .. 4, MAIM UPgkfftECEIPTt Y S3RR#SEEt�GINEEf�P�re CE:' 35�p1EF3efiaREE3 Q8EIAI NTQiJE fP-1LL$d, FW,. �.t°h�1H11 BE C2EQ�#dF��`QN 1F pn+1 W(snc3S'acEry�R�fiTEf39opk`f8 sEEsiEVERSEPC#i lal3Kr, rrPoow a O1rAF3Rt��RKaiF€sC3FREf:iS}�f Bf��EDu1$�c3 {its S 3)ONoT S[GN T-MS Ct7l3iRAG� <tIEEiE Ai?E dT3Y BL ANK CL=S . c f R1 epr�serrt hye .:.. Eu�ome S a3tt x •... - S�gtt{Tafe. stcFTlilscotitif?JscrMaYBENttitlFA51'tFS"iF.iloT"EJcEc�rtrawtfF�tl rcCAC� coirrRXcr aFiEr+6oVEPR4cEssPEelFtcrc;►I ' 80 DAYS: "GQt .S gi�E�A7tSFA6Y1fiSC 501�`i+A97D ARE EIFf3E&� AfiE . Y fKUTtIQRflED F .S77U tK IHDR1t: ff1Et}i�A3!�0°�A WE E BE K4A�? S Alt AUtha►dMol n Site i€3. 3420837 Ct stc�rtier;:Robert 1' hite �• 1 t � wai ark# e;prerr 1'ca at (oii i er s ,Ft{ntedD 69}oan fta6: Ceot;oNiHe,MA 026.2 ;�Pgir�ekA,ddres5f ;{irf#:Y} x ° .� ttlt�� E' SS SiS1IL' 3rf {:ti�E�S�f &St1eit3Tr0S` 41 k o? to a gn y be to and t*t ain 5 peg tau l�erftsT.M. lotdf a� za io r, wiori aa:mY Frees 1 � � I sue. J M1 Y 0 e" P .?< ko<. We:have.asgned#hefoliawingMass Saue.;Hameery Zcsartic%patiatg:Coctar tQ . MN atic�pt€ Cttcactcir' Hate Name:RISE Engineering Piscine:4t}l>?:84-37fl0 :;.:. .. . i The Commonwealth of Massachusetts a Department of Industrial Accidents > I Congress Street,Suite 100 Boston, MA 02H4-2.01.7 `r www rnass.govldla Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH.THE PERMITTING AUTHORITY. Applicant Information Please Print Legibly Name(Business/Organization/Individual): Insulate8ave Inc. Address:410 Grove Street City/State/Zip: Fall River MA 02720 Phone#: 508-567-6706 - Are you an employer?Check the appropriate box: Type of project(required): l.Mx lama employer with 20 employees(full and/or part-time).• , New construction 2.[1 am a sole proprietor or partnership and have no employees working for in . 8. Remodeling any capacity.[No workers'comp:insurance required.] 9. ❑Demolition 3.n I,a,a homeowner doing all work rtiyself:[No workers'comp,insurance required.]t 10❑Building addition 44-11 aril a homeowner and will be hiring contractors to conduct all work on my property. i will ensure that all contractors either have workers"compensation insurance or are sole 1 I.M.Electrical repairs or additions proprietors with no employees. 12.❑Flumbing.repairs or additions 5.E]1 am a general contractor and i have hired the sub-contractors listed on the attached sheet. 13. Roof repairs These sub•contiactors have employees.and have workers'comp,insurance.* 6.Q we are a corporation and its officers have exercised their right.of exemption per MGL e, 14.QOther Insulation 152„§1(4),and we have no employees.[No workers'comp,insurance required:] *Any applicant that checks box#1 must also till out the section:b0ow sl owing their workers'compensation polio-y information. P Homeowners who submit this affidavit indicating they art.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-contrtctors aud.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'cornpensatdon insurance for my employees Below is the policy and job site information. Insurance Company Name: Liberty Mutual Insurance Policy#or Self-ins.Laic.#: XWS 56418741 _ Expiration mate: 12/10/2018 �• l��/7 r _ City/State/Zip r eA v Lle d 4 Job SiteAddr�'CP� O � � o _-.- <� f1?� � 3�� Attach a copy of the workers'cOmpensat&policy declaration page(shoring the poliey�.--.-zi-una extration" ), Failure to secure coverage as required tender MGL,c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a clay against the violator,A copy of this statement may be t'nrwarded to the Office of Investigations of the DIA for insurance coverage verification: I do hereby certify under the s err e ties of perjur}>thtrZ the dnfortitstdor'provided above is true and correct . Signature: Dater Phone#: 508-567-6706 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/Lice.nse. Issuing Authority(circle one):, - I;Board of Health 2.Building Department 3.City/'Towrr.Clerk. 4.Electrical lnspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: _, I 3 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Sine 517 Boston, Ma, usetts 02116 Nome I rriprovem 7 s, tractor Registration ..:...__. p- .._-- Type. Corporation Registration: 180747 INSULATE 2 SAVE , 1NC. `sF Expiration: 12/28/2018 410 Grove St , Failriver, MA 02720 A, Update Address and return card; Mark reason for change: 'CA 9 4 20M-05/11 w_..n .,,�____r _.___ fl A f t R r gw i©:E�Ic ent O Lost Card i �� may✓ �J_..�.�.,_._,./..�._._....�,...J �._._..... , 2P. sf't3"1Yf•YXti(Yf'JCLItvQ�LfL�to'Y�dG.1CG(iJLCf .µ....,...� Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE.Gorpioration before the expiration date. if found return to: € € Office of Consu ner Affairs and Business Regulation on 12J2i3/2018 14 Park Plaza-$ulte 5170 , Boston,MA 02118 INSULATE 2 Roland langevi6,. .. 410 Grove S# Faiiriver,MA 027 Undersecretary Not Valid vifithout Signature C rtvrealth of Massachusetts Division 61 ,6tes al l.icenwre ' Board of Suilding Regulations and Standards >rt�t�r � P� rvas�r CS-€i1361 � :., res;# 24t2Ei19 A RO ANDI HiiHCIii�FtAA FALLRtVER,�" - _' Ctarrtrrll� ' . .•r r t F r 7 -.Y.;�•. �. s `a- Cs:O,. S e:.S iwb.. �-� - l�- 'YR-a _- :f`_�owl WIN 8 • eRiver 'M&Y 02720 = ,. � .,`� s.'a`, _ -a ;a:� a 'may=:�'-t>��cp-,a :_ a:. ••6. _—_ �.:�s s x-, >i.:s z .ir- .3.c-.:;��r:-'Fbi�°.-s:� -- IF WWOTOWN �e, S�Tx e' - ��ay.. �. -_a. -' _;; _- ®- os a� a a ��,x�-f• a- a=ae-- a3a.: --_-- ram Now Boom .� - _ - -ea LOT 26 A.M. 228—069 S84°O1'00'E' 83. 00' w LOT 27 p A.M. 228—070 '� 1 AREA=17 7621S.F � c� 40 oleo ` GARAGE ~�1\ ,,,,,,L,,,,,,, ` SHED ,,,,,,,,,,,,, o ,,,,,,,,,,,,, 19� N84 01'00"#r i LOT 28 100. 00' — A.M. 228-071 1 L LOT 29 A.M. 228—074 FLOOD ZONE "C" GARAGE CERTIFICATION RES' ZONE- "RC" TOWN• CENTERVILLE SCALE.• 1" 30" PLREP 30469A ELEV N/A SETBACKS. 20 10"-10" •A ►'��c� a�a, YANKEE LAND SURVEYORS & CONSULTANTS I CERTIFY THAT THE ' Z� S7EEHEN P.O. BOX 265 "GARAGE" IS SHOWN oo L J UNIT 1, 40 INDUSTRY ROAD ON THE PLAN AS IT EXISTS ; -, = �� MARSTONS MILLS, 'MA 02648 - ON THE GRO UND. ; _ V,,o yoQ a TEL' 508-428-0055 FAX 508-420-5553 SJ JOB 7- i D DATE.•,07-03-07 NUMBER 54242 //l � �� fie, ��S -� �� $� � S F mOW'� OF BARNSTABLE BUILDING PERMIT PARCEL ID 228 070 GEOBASE ID 13941 ADDRESS 69 JOAN ROAD PHONE CENTERVILLE ZIP - LOT 27 BLOCK LOT SIZE DBA '`r DEVELOPMENT DISTRICT CO PERMIT TYPE SILDA DFTCIPTION2UILDINGEPERMITGACCES CONTRACTORS.: CAUTHEN, ,BILLY E. De artment of ARCHITECTS: P Regulatory Services TOTAL FEES: $175:57 BOND $.00 CONSTRUCTION COSTS $18,432.00 328 OTHER NONRESIDENTIAL BLDG 1 PRIVATE * MAW 16g9.. A1� t �D MA'S BU DI�NGt l fMON BY I' DATE ISSUED 02/18/2005 EXPIRATION DATE .-.-. R TOW OF BARNSTABLE BUILDING PERMIT PARCEL fD` 228 670• GEOBASE ID 13941 ADDRESS 69 JOAN ROAD PHONE z CENTERVILLE ZIP - i LOT 27 BLOCK LOT SIZE DBA DEVELOPMENT -.DISTRICT CO. RR gg 3�g DESCRIPTION 2A.�24 DE AC ED ARAG RRR TYPE. . .B�ILDA TITLE NE;W BUTL�ZN� PE�MT;T �CCES CONTRACTORS: CAUTHEN,- BILLY E. ARCHITECTS: Department-of TOTAL FEES: �. Regulatory Services BOt3D : $ 00 CONSTRUCTION COSTS $18,432.00 328 OTHER NONRESIDENTIAL BLDG 1 PRIVATE MAM .1639' A, FD.MA BU INGI SION f' t NATE. ISSUED 02j18/2008 EXPIRATION DATE'".- `� -: THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY,OR.PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,'NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED.BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS,THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS: MINIMUM OF FOUR CALL INSPECTIONS REQUIRED I FOR ALL CONSTRUCTION WORK: 'APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE FOR 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION'-. PERMITS ARE REQUIRED 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND M CH- FOR (READY TO LATH). PANCY IS REQUIRED,'SUCH BUILDING SHALL NOT BE tANICAL INSTALLATIONS. 3rINSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. 4.FINAL INSPECTION BEFORE OCCUPANCY. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 • 1 I '. 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. 'I I I I I I I I I j j I I I I I j I i ( I I I I I , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map r �� Parcel 67D Permit# 2 .� Health Division to/0 s R'g--4� Date Issued / (;�Ps - o Conservation Division f"': J, ;>1/7 6L5— ``= ' FE 17 Application Fee Tax Collector Permit Fee Treasurer C� �- SEPTIC SYSTEM-L Planning Dept. INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board WITH TITLE 5 ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address 12 Village Owner �a�c�/�9 `� r��Q 4: �frZ�� Address A&771 Telephone S0, 77P— ,2 Permit Request A111 Square feet: 1st floor: existing /!& proposed 2nd floor: existing ' � proposed Total new J� Zoning District Flood Plain Groundwater Overlay Project Valuation ;2-6 CM,00 Construction Type 06 lrQlc?60-1 Lot Size 7f Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family El/ Two Family ❑ Multi-Family(#units) Age of Existing Structure �/� 4„ow t-S Historic House: ❑Yes O' o On Old King's Highway: ❑Yes CAN -b Basement Type: M<U11 0-6rawl ❑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: O Gas ❑Oil ❑ Electric ❑Other Central Air: . ❑Yes arNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes E o Detached garage:❑existing 9new size �y�l�4�� Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing 0 new size Shed:dxisting ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name11y Telephone Number 3�G�— 7%0 OP Address PC License# G° ()CJ9p7,$— 944,✓ I/S P40 eC4 0/ Home Improvement Contractor# Worker's Compensation# Ve r- ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �(S (7s44 e-A , SIGNATURE P dct DATE zl(o ezr V FOR OFFICIAL USE ONLY r' PERMIT NO. DATE ISSUED MAP/PARCEL NO. III ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION C51� FRAME —fir INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH C, =Z FINAL xr. t a 2 FINAL BUILDING CA) 1 C T! r m Q rn o p DATE CLOSED OUT M 0 '3 ♦ S c') .w. ASSOCIATION PLAN NO. cy —' C- ` tom co MM ® . The Commonivealth of Massachusetts — =3�6 , Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit-General Businesses name: address: city-, state: ziy: Oa Q/ vhone# y c P,7 N) work,site location full address): I am a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBar/Bating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I an em to er with tan loyees(full& art time). ❑Other am I am an employer providing workers' compensation for my employees worlds&on this job. city phone#•'. instirance.cb:- I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: C011lpeny name• -- --- - - -' address.: ... : . city phone#° insurance co. j. `olic'':# / . / %/ %////%/i COmDenV pants••_'� ". ; ., - - - address city phone#`i Failure to secure coverage as required ender Section 25A of MGL 152 csa lead to the imposition of criminal penalties of a fine up to$1,500.00 andlor one years'imprisonment as well as civil penalties is the form of it 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 c der th ins enaltie fperjury that the information provided above is true and correct Signature ' �� Date 2 l Print name l GC Phone# official use only do not write in this area to be completed by city or town official city or town; permittlicense# ❑Building Department • ❑Licensing Board ❑check if immediate response is required ❑selectmen's Office E []Health Department contact person: phone#; ❑Other (mvaed Sept M03) 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 produced acceptable evidence of compliance with the insurance coverage required. Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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 d ueste , not requested, the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are ep 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 pernit/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 gMto of Imsflgadons 600 Washington Street Boston,Ma. 02111 fag#: (617)727-774.9 phone#: (617)7274900 ext. 406 I� 4 i Town of Barnstable ' f Regulatory Services Geiler,Director � s nsLs, Thomas F. , Building Division_ rFo r�►'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-40 8 Permit no. Date AFFIDAVIT , HOME LMyROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION - MGL c. 142Arequires that the"reconstruction,alterations,renovation,repair,moderno canerrsion, improvement,removal,demolition,or construction of an addition to any pre-existingowner-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:L�n�JZ,�rrt'� .Z`` � 4 Estimated Cost dZ� `d� �' Ile Address of Work: Owner's Name. Date of Application: ��/�/ I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law y []7ob Under$1,000 []Building not owner=occupied 00wner pulling own permit Notice is hereby given that, OWNERS PULLING THEIR OWN PERMIT ORDR NG WITH VEMENT WORK DONOT HAVE CONTRACTORS FOR APPLICABLE HOME IMY ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A.' SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: /l 0 _ Contractor Name Registration No. ate 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 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x,0041= plus from below(if applicable) GARAGES(attached&detached) Lo square feet x$32/sq.ft._ 3Z 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-Same 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 SwimmingPool $25.00 Relocation/Moving S150.00 (plus above if applicable) Permit Fee Proicost Rev:063004 cpTMe' ti Town of Barnstable °�. Regulatory Services v $ Thomas F.GeUer,Director Building Division Tom Perry, Building Commissioner 200 Main Street, $yannis,MA 02601 www.town.barustable.ma.us Office: 5'08-862-4038 Fax: 508-790-6230 Property Owner Must P Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize:'-'e,' to act on my behalf, in all matters relative to work aueeeLd by this building permit application for: (Address fJob) A7 iAo er Date 7 Print T'd�me r BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR ' Number: CS 009975 t Expires::,08/13J2:005 Tr.no: 2188 Restricted: 00 BILLY E CAUTHEN �jA. 86 BETH LN HYANNIS, MA 0260i Administrator i 1; T� lugBoard of Buildingo� Ons and Standards`' HOME IMPROVEMENT CONTRACTOR -y Regist". 116609 00 Fsa ian9/2006 _? BILLY E CAUTHEN � '> BILLY CAUTHEN 86 BETH LANE _ HYANNIS,MA 02601 -'� �' f Administrator r i re r Ce 1 IDf5 -fir IlLt ,vo�ysU�� I r�► vo � C G,Lc t ��r C'aN�, v�hQIG�► ,eC 24' 12' 12' I (V 4" poured concrete w/6mil poly under i :N 2442 N 24' x 24' Detached garage 3068 - ------------------------------------ � N CD ' i i i TO"x 9'0"garage door TO"x 9'0"garage door ----------- ----------------------- - ------------------ ----------------- 67 i 10110 67 24' 24' . f II Drop 3'6" TT Concrete wall Drop 3'6" 8" poured concrete walls N with 20" footings N Drop 12" 24' Drop 12" Drop 12" I oFt lo,,, Town of Barnstable ~ ' Regulatory Services v Mnss. Thomas F. Geiler,Director �p 039. 0 lFCMor° Biilding Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 „ 4 Fax: 508-790-6230 RE: 69 JOAN RD. CENTERVILLE OUR RECORDS THE FOLLOWING ELECTRICAL PERMITS DOES NOT HAVE A FINAL INSPECTION #84904 ELECTRICAL PERMIT EXPIRED FOR WIRING OF THE SUB PANEL LIGHTS AND OUTLETS IN DETATCHED GARAGE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mao a2d' Parcel L3 7 Q Permit# � � `I car"tr{9!��Rs��1 E � '� Health Division — 7 < . � o Date Issued Z - U S 0 �✓ 1 �' 0 11', I E } Application Fee / � Conservation Division o 3f s ; i ppi Tax Collector Permit Fee U Treasurer Ur t 1 (jmd— Planning Dept. �s1 MUbT BE Date Definitive Plan Approved by Planning Board IN $lr1Af�CE VmTffwHistoric-OKH Preservation/Hyannis ENTALCMEAM mm oleomn ANONS Project Street Address �'/ Jo 41tl Village rr'�,�,7i1�'V/ lie l� Owner T Address :: lo4w fi�al ash&X cl Ile Telephone X-GP- 77,?-o2I/ Permit Request k*ot1— tv Square feet: 1st floor: existing 14-J'U proposed 2nd floor: existing—Ag proposed —0 — Total new -- G Zoning District Flood Plain Groundwater Overlay Project Valuation 0 100 0FO Construction Type Ul or a Lot Size 0. 40' kde:.s Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family O Multi-Family(#units) Age of Existing Structure 4Q !k X Historic House: 0 Yes 0'No On Old King's Highway: ❑Yes @,No Basement Type: 2full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing y new Half:existing new Number of Bedrooms: existing 3 new G Total Room Count(not including baths): existing if new - G— First Floor Room Count Heat Type and Fuel: Gd"Gas ❑Oil ❑ Electric 0 Other Central Air: 0 Yes @'�o Fireplaces: Existing / New— 0 , Existing wood/coal stove: ❑Yes ffl o Detached garage:❑existing ❑new size Pool: ❑existing 0 new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:O existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0 Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Number Address License# (10 r ?d' 5 G�G 0 / Home Improvement Contractor# Worker's Compensation# 4ie f- 0;V-J-�73 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO mown/ Vt,sIoSV SIGNATURE DATE z�Z�0e/ FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS• VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH .rR, FINAL GAS: ROUGH Z F NAL FINAL BUILDING U_ g DATE CLOSED OUTrn C N ir ASSOCIATION PLAN NO. 'a .9 Ogg ,< The Commonwealth of Massachusetts - Department of Industrial Accidents* 600 Washington Street ' Boston,Mass. 02111 Workers'.Com ensation.Insurance Affidavit-General Businesses `; 4 4- 1-4 adaress �' 'P �G • S state R 2i . Uo2 6 0 I hone# D�'71b'd y wor site location full address I am a sole proprietor and have no one Business Type: Ej Retail�Restaurant/M/Eating Establishment worldng in any capacity. 0 Office[� Sales (including Real Estate,Autos etc.) ❑I am an em to er with e n to ees(full& art time: ❑Other /% /�/%/ I am an employer providing viorkers' compensation for my employees working on this job. com"an ,nerve• ' •`ate .. . sd"dress: p'hoiie city .�•. .. y. ••t. j .insurance.co O11C, #" ❑ I am a sole proprietor and have hired the independent contractors listed belowMhove the following workers' compensation polices: coin'en n'a'iiiec 7777 address:. city " phone#s'� insurance co.'...': ... ,.. ,.. .,.....,.,.. •::.:.;• . r":•: coin an. name: address:. • .. ; :nkone#c r 1.c:: Failure to secure coverage ss required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 in& I understand that s copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce ifry er the ins an enalties of perjury that the information provided above is true and correct Signature �-d,_ Date Print name �AG-rf-rel • Phone# r1�77a-o�yl official use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department T ❑Licensing Board (]check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; []Other (revived Sept 2003) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their-. employees. As quoted from the f`lavd', 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 ajoint enferprise, 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 produced acceptable evidence of compliance with the insurance coverage required: Additionally,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 in the workers' compensation affidavit completely,by checking the box that applies to your situation.. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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. . 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 Imsd atlons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 CA Erg. 'down of Barnstable Regulatory Services a�xrisTeer. Thomas F.Geller,Director 16s k.�� Building Division FFD Mp't ' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,ccu ier Ion, improvement,removal,demolition,or construction of an addition to any pre-existing ovrA p building containing a 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: �ti7e�f6 t hump'el Estimated Cost Address of Work: (9 1011 Owner's Name:_ Date of Application: I hereby cerff9 that: Registration is not required for the following reason(s): DWork excluded by law ❑lob Under$1,000 []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 ENUROVEMENT WORKDO 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: 166 Contractor Name Registration No. Date OR Date Owner's Name TZa Qr{Ft Ash! Table.t5.2.,Ib(raatiRstes3} acted with FosxueL tzye paeksgct far aaa actd Ttra-F'ssaitJ'Assideatli18ni1dGsp H Prese�F . trffM mum. —----- Uld slab S Ce{11ng Wdt FScar Az= Equipmcnc Mcicacy' CbminA V�4) U.yalue� R-vuIu� R-value{ R-Yatue! r &relae� R-yalLc pac�agt 31Q1 to 65gQ Hestiag Ae�m Aa� 6 Nacmal MG 38 13 I9 10 60.32 Natural Q IZ/ 30 19 19 10 6 15 AFUE R 12/4 010 13 19 IQ NtA Narmgl 8 1Z/. 31 13 v N1A 6 No 11 T I5(. G 19 19 10 NIA 15 AFUE 15/. 38 Cf I3 25 N/A ' f5 AFUE v 15Yi Q.44 33 19 10 6 15'!. o.i2 30 19 z5 NIA NIA xomsal W Natural 13 111% a3Z 31 S9 25 NIA NIA g0 AFU1r Y 19% 0.d3. 31 13 t9 to 6 AFU x 11% 0.42 31 19 19 f0 AA 6 9o. E 18/� 30 ADD RE5S OF PROPERTY: 1. Z. SQUA RRE FOO'rAGE OF ALL EXTEIaR WALLS, - g• SQUARE FOOTAGE OF ALL GLAZING, . % GLAZING AREA(#3 DNIDED BY 02): See chart aboYo): ' 5. SELECT PACKAGE{Q--AA• t 4o be r �ed Lu t4-L 3 / 1 G ENERGY REQUIREMENTS 1a ; OTHERIviORE INVOLVED ORTHIS LNFORiviA ARE AVAILABLE. ASK V BU,DING INSPECTOR APPROVAL. N0: YES; q.facrns-fl80303s °Fr Town of Barnstable Regulatory Services 3 s,►Kxsrat Thomas F.Geller,Director '16as�ss. 9�p>Ec 3 61 Building Division - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508 790-6230 t Property Owner Must Complete and Sign This Section If Using A Builder .,•as.O..wnet..of the.subject p.±opettp- hereby authotize ►,�l?� f?`�'�! to,act on tny..behalf,. in all matters relative to Work authoiizetl hy.this building permit-application=for. L-5'0+A) CIA)�J; (Address of Job) , Signature of Owner Date Priat Narn.e - T t �� d Standards. us Board of B nilding MENT CONTRACTOR HOME IIIaV _ 6609 Re$istcan rt20p4at I r� a { i1iYidual BILLY E CAUTHE fa{EN \ BILLY CAU NE 0 � Sfi' ?�H�+� R D2s�y9 ✓fie�i arniawozurea��i a� � b €` BOARD OF BUILDING REGULATIONS i' License CONSTRUCTION SUPERVISOR Number: CS 009975 Expires:08113/',905 Tr.no: 2186 Restricted 0 BILLY E CAUTHEN 86 BETH LN (rEs» j HYANNIS, MA 02601 Administrator_ TOWN OF BARNSTABLE BUILDING 3'ET.MI T PARCEL ID 228 070 (TEOBAS.E ID . I394-1_ ADDRESS +69 --JOAN PHONE CE 'T'ERVILLE ZIP tl�OT�' `�'7 �3►�;CuE *�p7, i r Ttp�Y hY 1 LOT Sl-Z ° {epy D i`A. Lad»,if,�s�R.fi. PME.:i�T DISTRICT 1.+O P'ER M.f:T 70651 F.kRSCRIPT'ION T.4X,1.6 BED BATH ADDITION PERMIT TYPE BADDI rI 7-3 L E BUI ERMIT ADDITION t,0 d`J.RA "'LtTR ': ��ACST'R 19 1.LLY E. ARCHITECTS: Department of t e Regulatory Services TOTAL FEES: $L2.6.66 CONSTRUCTION COSTS $21,504.00 434 RE'S+S D £'iDr),,''t7.d.t'.1./C0N'V 1. PRIVATE A TyE V).+ iF +► BARMABLE,. �D MA'S BUbIlNG ISION BY ' DA"T H ISSUED 08/0 7,/4 003 4M)IRATION DATE L�-f t S7(v4 �ebfee-� -N/L ' 1 Teo�e1 S I 35" 25-1 24" i" 33'' 361 ;�= 24" as r� 36" 24" 30" 24„ M, VV3330 VV2430B o N ID 3 �o BD24 1 24.DISHW N� N.I ------ .. ( �0 W�� }} M M M I OI t� M �I B36.2FWT BW615 1 I s \ � l m ifl p') R v 28"-- 8" ' 24' —/I IZ' j —36 �r fl All dimensions size designations given are This is an original design and must not be Designed:7/3/2003 subject to verification on job site and released or copied unless applicable fee has Printed: 12/8/2003 adjustment to fit job conditions. been paid or job order placed. WHITE CAUMEN Fp 1 Drawing#: I f 56 12' MI 14' { N � t{j+Ft 1 .° Existing bedroom CCa�^^bW=m EnAmg U-v Room g N j 7 eds"Family Room N 4 I i { •- Existing Kdohen& 1 T EWing Bedroom Dining i i 13S 11 1T1 14'2 LiVINt5�6�—REA F 14228&q vi TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 0,70 Permit# 72078 Health Division �?Q-��7 1 �'/��( .'Date Issued 071V Conservation Division'. �Ii Ir, lC.- .;, Application Fee Tax Collector . Permit Fee Treasurer TT Planning Dept. - SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board 4 WITH TITLE 5 ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address la 9 ro"gtl 'i 0,4.? Village exI &Zf// ' hw, Owner ,z° s� /�� Address kw*ei- Telephone 3r6100- 77ps 1�51el y19 Permit Request 27-> )X a sy.r�7�c lc C'4�yc�c�r ?'77l Square feet: 1st floor: existing 40 proposed — 6-- 2nd floor: existing —7�"— proposed = — Total new Zoning District Flood Plain Groundwater Overlay Project Valuation `3 y p ,00 Construction Type G iC2 o 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 ff'No On Old King's Highway: ❑Yes &400 Basement Type: 2lull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) d Basement Unfinished Area(sq.ft) /ea CPO Number of Baths: Full: existing new Half: existing d new Number of Bedrooms: existing _3 new -- U Total Room Count(not including baths): existing new — e9 First Floor Room Count Heat Type and Fuel: WGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 2'6 Fireplaces: Existing New Existing wood/coal stove: ❑Yes EKo Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn: ❑existing ❑new size Attached garage:❑existing ❑new size Shed:0 existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded 0. Commercial ❑Yes ❑No If yes,site plan review# Current Use` -` — �- - Proposed Use, BUILDER INFORMATION Name a114 e- /U Ile&i%-t Telephone Number o(fy/ Address License# 069F7J" DoL(o 0 f Home Improvement Contractor# 2 Worker's Compensation# aa SS 0o2. f-l7.3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE r �`L- DATE a - FOR OFFICIAL USE ONLY PERMIT NO. w • DATE ISSUED < MAP/PARCEL NO. 4 ADDRESS VILLAGE OWNER 1 DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL co GAS: ROUGH-M c23 f.. FINAL FINAL BUILDING oz �-- S F- �- CJ ' m0 }� 4D Mo a DATE CLOSED OUT m 0 ` O m5 ASSOCIATION PLAN.NO. ,.. N 1 ;� `'• . COMM�.The'COM eabth of 1Vlass chuses DepartmentOf JndusHatAccidents . ' 660'Washingtan SireeE _ • Boston;Mass. . -�? 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I understand that� one yeas'ImPruonmEnt as Wan as Clvilp . be forerarded to the Office of Investigation+of the plAfor coverage verification copy of this a}atEment mar ' the d penalties pf perjury that the inf ormad on provided above is true a��e I do hereby certi un � � Date , Si&nature z9Q�P/s� ' • � � / tGf � ��L yr/ print name < ' oftieial use only do not write in this area to be Completed by city or town QMcial []Building Department permitlllcanse# �]LicensingBoard city or town: ❑SeIectmen's Office OE[ealthDepartment , [}•Check if immed� r�Ponse is requtrod []Other phone contact person: • frevpedScpt?A03) <:�ar.. s_ - ' • uctlons' forxria ixoia and Znstar ha Ater ection 25 requires all employers to provi$c•workers, compensation f�r'thear. ezieral L'aws-c p 152 s .. r r .• . Iviassa.cliusett$. person m the service oi'another under any contract oted'fromthe t`law",, an employe rs.defined as every employees: ,As qu of hire;express or irnlied;oral or written, • wa ers ' , association, corporation or other legal eni:ity, or any two or mare of employer is defiled as an indintlual,p �p tAn he foregoing is C ged'in a�oint,en�ferprise,and including the legal representatives of a deceased,employer, or the'xeceiver or association or other legal entity, employing employees. 'However•the owner of a Estee of an individual,partnership, dwelling liouse having not'fnore thau three apartments and who resides therein, or the;occupantso the:dwelling douse bf s ersbns to do zmainkeu?ncr, constrkiction or repair work on such dwelling Iiou�e Or on the grounds or another who,emplby p , thereto shall not because of such;employment be deemed to be atinoployer. ,. •bu>7ding.�pp�•tenant ., • . •.. • . ;, ,� . .. , ;�; •, ' GL chapter 152 s ecb.bu 25 also"s�Eates fhat'every state-or legal licensing agency sh��fo anywas�licant who has renewal p t too operate a business or to construct buildin s in the.convnO applicant erxnr p, g ' of a license or p . not produced acceptable'eviclence of-comp liance��n��o any eohtracgfar theperforman e of public workunt�� co,.O onwbalth.nor.any,of its political subdrnsl acceptable evidence of complitAde with the insurance requirements of this chapter have been presented:to the contracting., authority. • . i A;pplieants . ' . • 'r ' � - t a Lies to our sitaalion.,Please • please€ ,in t,e w,k,,,.sensate affidavit completely,by checlang the box tha ,pp . ., y, supply company name, address and phone numbers along with a certificate of insurance as all affidavits maybe submitted to the comp any industrial Adcidents•for confirmation of insurance coverage. Also'be sure to sign and date the affadavit. The a davit should be returned the city or town that the application for the permit or license is being not the pepai trnent 6f 1 dustrial Aecideuts. Should you have any questions regarding the'"W'or if you are requested, li lease call the Aepartinent at the number listecl;beloW , -requiredto obtain a workersr•compensationpp cy,p, , City or Towns • • . Pleas e be sure that the affidavit is cbmplete Md-printed legibly. The.Department has provided a space at the liottoni of the affidavit for you to fill ortt?Il'tbe event the Office of Investigations hs.s to contact you xegardimg the applicant Please 'tllicens a number which whl b'e used as a reference number, ' e.affidavits maybe xetuzned tQ, the �. � ' •••,.. .. e to fi11in P . be-sure.artmentby, orPAXunlessother'arrangemeritshavebeenwade. , the Dep • you have estions The office of lavestig ations would like t,tbmn cyou in advance for you cooperafion and Gould y any qu , hesitate to give u8 a•calL... ` please do notbes " . i i / e pepaent's address,telephone and:fax number: . The Commonwealth of Massachusetts D epartment. f Ind ustrial Accidents , r Brice of la�esens . 600 Washlagton Street Boston,Ma. 02111 fax#: (617)727••7749 I SHE r Town of Barnstable o� regulatory Services Thomas F.Geller,Director s539, Building Div1S10]1 g',,l�b MAC k Toth ferry,Building Commissioner • 200 Main Street, Hyannis,MA 02601 , Fax; 508-790-6230 Office: 508.862-4038 . Permit no. Dato . AFFIDAVIT_ ROME NMNT T PERMIT APB CATIONw StJP Mr c.142A requires that the"reconstructiott,tion of an aadd ti n toany preexisting owr�ezn,repair, occupied lon, improvement,removal,demolition,or constru bu0ding containin'S at least one but bo Im'steore ed contractors,with ertain ex ptions,alongan fOur d-wel"ng units or to stnlctures with other'-lit to such residence or building be don . y e requirements, A/l/V f/N C fG Estimated Cost �' Type of Wozk: C Address of Work; k Owner's Name; �✓�'/p �� ' Date of Application: w/ L /a -- I hereby certify than Registration is not required for the following reason(s); []Work excluded bylaw []Sob Under$1,000 , ❑Building not owner-occupied []Owner pulling own permit Notice 1�hereby given that; Oyri`ID' pULLTNG TSETR OWN T' R DEALING WIT11 UNREGISTERED ERMI IlROYEMENT W ORK D 0 NOT CONTRkCTORS FOR APPLICAELE H ACCESS TO THE ARBITRATION PRO GRANT OR GUARANTY FUND UNDER MGL c.142A SIGNED M DERPENALTIES OF PERJURY I aeleby apply for a permit as the agept of the oyr4er; ' Contractor Name Registrationl�Io. Date OR Owner's Name i OFZHE Tp� Town of Barnstable Regulatory Services STABLE. x Thomas F.Geller,Director Mass. $ 9 s639. Building Division �AlED µP'I a Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma-us Fax: 508-790-6230 Office: 508-962-4038 Property Owner Must Complete and Sign This Section If Using ABuilder a I ,as Owner of the subject property to act on my behalf, hereby authorize % in all matters relative to work au orized by this building permit application for. (Address of Job) Date Signature of Owner f Print Name Q:FORM S:0 W NEU F-RMIS S I0N BOARD OF BUILDING REGULATIONS License: ;C,ONSTRUCTION SUPERVISOR Number: CS 009975 Ezpires:.08/13/2005 Tr.no: 2186 i Restrtctedc :00 BILLY E CAUTHEN 86 BETH LN HYANNIS, MA 02601 Administrator ,yam 71. � e �\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registto 116609 Expiraticrl 9/2006 a BILLY E CAUTHEN Iffl.j _q BILLY CAUTHEN� r 86 BETH LANE HYANNIS,MA 02601 Administrator. t a ° `311 0" Oka F 4 - ------------ cif 3 r,- e° i '^ Too r: k' - i� m--�= OWN All IN, 4` i � 5 s r x* - i �31- S t t lot Zap AS , _ �xv v e y f ftm I N c E1 ,,�;w,, �1C,�.,,. 1a C y2r 14 'o? j 4�1� N �ool�r�9- 3`�i`� y��P�eTany 5Disr -t��'v�Er S �,<lc�t E'u0 a� $~uIST TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map ;L v20C, s� Parcel (J, Permit# !26 (0 l Health Division 7 Q 'A Date Issued _ . 03 ?� -rtl it ^: () Conservation Division U ' Ail 9: 0 7 Application Fee Tax Collector Permit Fee Treasurer '�' !L —N — SYSTM YS ,Q Planning Dept. LED IN �� a _ VB�TH THE 8L W Date Definitive Plan Approved by Planning Board ENWRO NTAL C Q Historic-OKH Preservation/Hyannis TGN REGUL07-joNs Project Street Address f -To4 rJ �oA-0 Village v/Ile 10, Owner f Cott A-2� g-°P71 W W If/�G� Address �;3 61 tloa TV ��,Ooy d0"1 B&1vJ> Telephone 0- �0 t( es Permit Request Ccwsyec e4 .4 Ic( /�/G o4 lluvfe' ea',rlJi(, 41,l/ Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new v f Zoning District Flood Plain Groundwater Overlay Project Valuation y?aff61 00 Construction Type (VOOP Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. / 1 Dwelling Type: Single Family l� Two Family ❑ Multi-Family(#units) Age of Existing Structure y U VXJ Historic House: ❑Yes M Ko On Old King's Highway: ❑Yes 0'I�o Basement Type: B'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /0 4,10 Number of Baths: Full: existing ` new /� Half: existing new Number of Bedrooms: existing new — -O Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel MIGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 2 ko Fireplaces: Existing / New Existing wood/coal stove: ❑Yes UkMb- 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 BUILDER INFORMATION Name ;8 A Telephone Number &J044 Address �'&;'T f/ 44 License# _ 06 9V 7S' zk:�� OO 0 Home Improvement Contractor# Worker's Compensation# M L = O 3 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ZOc(IdZ aie ' SIGNATURE `/'� :� v DATE 7 ` FOR OFFICIAL USE ONLY PERMIT NO. , DATEISSUED MAP/PARCEL NO. S �l ADDRESS VILLAGE '3 OWNER DATE OF INSPECTION: FOUNDATION ` FRAME 1211 INSULATION 0LC )2._ 4-U3 ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL `t FINAL BUILDING (�;('S'," :f}(-;( "U-4 _ M DATE CLOSED OUT ASSOCIATION PLAN NO. IL ' ; n The Town of Barnstable OLL ° Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis,MA 02601 -862-4038 790-6230 PLAN REVIEW , I ,ner: .� Map/Parcel: iect Address: C� ! V o etyl k c . Builder:-9 ac,-.'-V\.AA e following items were noted on reviewing: e ��- t 19 C. () ur t:1 (�1r'V l ev-' �V\ Q-V- 1 G F iewed by: The Commonwealth of Massachusetts Department of Industrial Accidents Office 01flyestf9atlons _ S 600 Washington Street --_ Boston,Mass: 02111 c—r •�, Workers' Com ensation Insurance Affidavit .'tee: location I—r4 t R 6 c' am a meowner performing all work myself am a sole rietor and have no one worldn in ca acitp m a so // /%%%%%%%/��%/G%%%%/%///%%%/%%%%/%%/%% %%/%/%G/%% %%/ / ///////------ workers co ensation for em loyees working on this job. 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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 produced acceptable evidence of compliance with the insurance coverage required. Additionally,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. or 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 inc,t-arce as all affidavits maybe submitted to the Department of Industrial Accidents for confirmation of fimnance coverage. Also be sure to sign and IL date the affidavit. The affidavit should be returned to the city or town that the application for the pemmt 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 u to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please- affidavit for you _ -- r which will be used as a reference number. The affidavits maybe e retarhRl n ' the ermit/license number . be sure to fill m p 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 Invest1gatlons 600 Washington Street Boston,Ma. 02,111 fax#: (617) 727-7749 nhone#: (617) 727-4900 ext. 406, 409 or 375 °FWE T�y�+ Town of Barnstable Regulatory Services B"Ns'MLF. " Thomas F.Geiler,Director �►ss. %639. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 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: WVF I-t t(I t/ Estimated Cost ifll&111� Address of Work: / SD 4.tl GAyti�J ° Owner's Name: /l tl dJ�� . q" �� d' A `7 ee Date of Application: 712-PA ?i I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 ❑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: L>", (,Jw2,AC1.,/ �6 ®� Date Contractor Name Registration No. OR Date Owner's Name Q:formslomeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE o� New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEw LIMG SPACE square feet x 596/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EMTING SPACE square feet x W/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.f� >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-Same as new building permit: x.0031= square feet x$96/sq.foot= STAND ALONE PERMITS x$30.00= Open Porch (number) • x$30.00= . Deck (number) x$25.00= Fireplace/Chimney (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving• $150.00 =, (,O (plus above if applicable) Permit Fee 0 Tio CMK Appendix J Table J5.2.Ib(eootinued) prescriptive Padmgrs for due and Two.Fam4 Residential Buildings Hated with Fossil Fuels MAXIMUM MINIMUM Slab Heating/Cooling CilaZing Glaring Ceiling Wall Floor Basement perimeter res Equipment Eiliciencyg A '('/•) U-value, R-value] R-valuer R-valuer Wall A�uei • R value package 5701 to 6500 Heating Degree Da Normal Q 12% 0.40 38 13 19 10 6 6 Normal R 12'/e 6 0.52 30 l9 19 10 85 AFUE S 12•/0 0.50 38 13 19 10 N/A NOm131 T 15% 0.36 38 13 25 N/A 6 Normal U 15% 0.46 38 19 19 10 N/A 85 AFLTE y 15% 0.44 38 13 ZS N/A 6 85 AFUE w 15% 0.52 30 19 19 10 Normal N/A X 18% 012 78 13 25 N/A N/A Normal y 19% 0.42 38 19 25 N/A 6 90 AFUE Z 18% 0.42 .38 13 19 10 AA 18% 0.50 ]0 19 14 I O 6 90 AFUE 1. ADDRESS OF PROPERTY: �9 fM V/ 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): n 5. SELECT PACKAGE(Q--AA-see chart above): ( f NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: NO: YES: q4orms-090303a ' 780 CMR appendix J Footnotes to Table J$.2.Ib: 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 ft 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 tesfed and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. 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. 5 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. The 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 d--scribed in Note b. The R vafue requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes elebtric 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 envel ope a must have a U-value no grea ter 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 11.5.3b. 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). °FTHE ra,, Town of Barnstable Regulatory Services M � z i3ARNsrAELF.$ Thomas F.Geller,Director 'pre 6.19. ` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I ,as Owner of the subject property hereby autho to act on my behalf,. in all matters relative to work authorized by this building permit application for: Vo (Address of Job) Signature of Owner Date Print Name y Q:FORMS:OWNMERMISSION s c a BOAR© BUI,L v License CONSfRLtIO Number ES', 009975 expires ®;�X�Izap Tr.no,. 2479 - • i BILLY E CAUTHEN /. 86 BETH LN LilANNtS, �4A D2601 istatgr . =A , • - ��e i�omvnzom,�oea� a�,�aaaacl uaek2 . Board of Building Regulations and Standards HOME O�EMENT CONTRACTOR Regi>tSalNort 6609 j rn flies t�rt V 004 ;.1. = ic{ty;dual BILLY E CAUTME F- `— BILLY CAOTNEN 8620ETH LANE IS WA 02601 tr�ar . L 56' 11'1 12' 18'11 14' ' N Existing bedroom Existing bedroom Existing Living Room io io N N Existing Family Room N Existing Kitchen& Existing Bedroom Dining, Existing Bath 13'9 11' —1T1 14'2 LIVINCAREA 142a sq ft con ;0 0 � m WINE, lol v % Ate. /VO L a'. o MOO Y't�Igr may ; `.. N a TAtL FIv ( IS � 41AST 1 . — � S wit , Af 6. �y'Qy a� x 1 - b0 X'� - �'1 � 03 o , REOw e ' f fi w ` 4 -4 H rL IDlm�'J'LlJ�JT. SGFFJ7 (/tNT ALUM. 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