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HomeMy WebLinkAbout0430 OLD CRAIGVILLE ROAD a n v 1-7 Town of Barnstable T"E' ti Regulatory Services • � � Richard V.Scali,Director 13 UIL®1NG DEP7 Building Division Paul Roma,Building Commissioner MAY 0 9 200 Main Street, Hyannis,MA 02601 �0�7 www.town.barnstable.ma.us TOWN 0F[3ARINST4,a E Office: 508-862-4038 Fax: 508-790-6230 PERAHT# - / yo7� FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY . 200 square feet or less C-49 A 1z I Location of shed(address) Village Property owner's name Telephone number Size of Shed . Iviap/Parcel# Z, Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old king's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:06/20/16 DULE 40 P.V.Cr VENT PIPE (®Least 24 inches tall) SECTION A -A ti! Schedule 40 Fve w/Charcoal Odor niter D-BOX cover must be PROFILE VIEW OF ADDITION TO LEACHING SYSTEA — within 6 in. of finished grade Tank - 93.00 /�—Grode over D-Box - 92.00 Tale over SAS - 92.00 3" of 1/8 - 1/2" Washed Peoslone-- / 3/4" to 1 1/2 Washed Crushed Stone 3 HOLE H-10 _ 4-PVC(CAPPED)INSPECTION PORT TO BE ST. BOX 3' Maximum Cover INSTALLED AND TO BE`"THIN 6' OF GRADE 5=0.01�=- Top OF System- El". -68.00. IS" Sa 0.01'pe, foot _ _ -10"ENealtw Depth rn O uT 20' I" an 0.83'.(10 inches) 5 Units IF 6.25' 30' co pqn o 3' I 3, m 31.25' e a0 37.25' v 4 J ` 3 yl 4' I, 'Effective Length 4•-1 1 1 t' v SOIL ABSORPTION SYSTEM (SAS) 6 In.of 3/ 2 / O 'v compacted stone Q Effective vldth 0 o INFILTATROR HIGH CAPACITY {H-20 LOADING)/ GEORGE I -o f m (OR EQUIVALENT) Not to Scale Z Bottom of Test Hole 1 Dev.=81.50 1.1 -Groundwater Observed - NONE OBSERVED NOTE: OVERALL HEIGHT OF INFILTRATOR IS 18" /EFFECTIVE HEIGHT I� i I I i I 9� TEST HOLE #1 _ ELEV.= 91.75 75.00'---a Pvc f 9�' �> � ---37.25' Vent' l Box9ifs Cy: ::1��,"' '?..' '.^(•1 r - ` 93 y — i o=_ `�2 O - -- NEW 1500 gal. O Q]eq!,Lethylene Tank O Failed 9� CESS o 9 - — 3 -r9 -- 1901, Porch EXIST. PROJECT BENCH MARK '��\ On Posts Deck 9,r TOP OF FOUNDATION ELEV. = 100.00 (Assumed) 91- EXISTING 98 3 BEDROOM HO&SE \ `96' THE SEPTIC TANK C c #430 ACHING COMPONENTT !IN 6" OF �19 r \ - FFLES OR EOUALS \\v \ 9y �=f LOT # 16A -- ° 7,500 Square Feet 75.00' -y9 --------------------- ---------1------ -- ----------------------- --------- ®LIB R OA _ (40 FOOT RIGHT OF WAY) „ PTIC TANK trge O'Brien Co Franey, Patrick From: Tricia Ferraro <pmf860@gmail.com> Sent: Thursday, May 18, 2017 12:17 PM' To:, Franey, Patrick Subject: :. Re:sheds Thank you Patrick. I was told those measurements when I applied for the permits. Tricia Ferraro Sent from my iPhone On May 18, 2017, at 10:13 AM, Franey, Patrick<Patrick.Franey@town.barnstable.ma.us>wrote: Good Morning Patricia, , This is just to confirm our phone call that the sheds at 430 and 429 old Craigville Rd need to meet 10 foot side and rear setbacks. Thanks. ?,Patrick Patrick Franey Town of Barnstable Building Inspector 508-8,62-4035 1 01 O! 06, a c3 oFt r Town of Barnstable *Permit# O Expires 6 months from issue date Regulatory Services Fee s_3,s-; � ESS PERMIT! ; 1b�' Thomas F. Geiler,Director -PRE i°rEc near Building Division AN1OV 7 2011 Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF BARNSTABLE www.town.barnstabie.ma.us. Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERAM APPLICATION - RESIDENTIAL ONLY Not Yalid without Red X-Press Imprint Map/parcel Number o) Property Address [;(Residential Value of Workf&O. Minimum fee of S35.00 for work under S6000.00 Owner's Name &AddressIla L � ) r �r Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#'(if applicable) ❑Workman's Compensation Insurance Check one: I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance nsurance Company Name dorkman's Comp. Policy# -opy of Insurance Compliance Certificate must accompany each permit -rmit Request(check box) YRe-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ 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 cop of the Home Improvement Contractors License& Construction Supervisors License is 'NATURE: ✓PFILESIFORMSIbuilding permit formslEXPRESS.doc •ised 070110 The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contracto Applicant In rmation rs/Electricians/Plumbers fo Please Print Le •bI Name (Business/Oro nization/Indiyidual): V Address: City/State/Zip: ti Phone#: � Are you an employer? Check the appropriate box: 1.❑.I am a employer with 4. [] I am a general contractor and I Type of project(require]additions employees(full and/or part-time).* have hired the sub-contractors 6• �]New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have working for me in any capacity, employees and have workers' 8. Demolition [No workers' comp.,insurance comp.:insurance.# 9. []Building addition required.] 5. We are a corporation and its 10.[]Electrical repairs or 3. I am a homeowner doing all work officers have exercised their myself. comp. right 11.❑Plumbing repairs or y [No workers' co ri t of exemption per MGL insurance required.]t c.,152, §1(4),and we have no 12 X oofrepairs employees. [No workers' 13.[]Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site in formation. 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-yeaz 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 maybe forwarded to the Office of . Investigations of the D I for insurance coverage verification. I do hereby eertify unde a pains and penalties of perjury that the information provided above is true and correct .r Si ature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town official City or To 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#: VE .Town of Barnstable Regulatory Services • rd+ss i E, Thomas F. Geiler,Director Building Division Tom?erry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us (y Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION , Please Print �+ DATE: JOB LOCATION: num r street / � J village "HOMEOWNER": r name home phone#� work phone# CURRENT MAILING ADDRESS: r rZ3 c , city/town �, g,state ,, s k ' -j .,zip code F 1 � 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 Persons)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 10b:1.1) - I The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations ; The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department �.Zeq=irem �nspe on procedures and requirements and that he/she will'comply with saidprocedures and, en Signature of Homeowner { Approval of Building Official t; Note: Three-family dwellings containing 35;000 cubic feet or larger will be required to comply with the , State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION } The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1.-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly .when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue-is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexe=t •_ HE Town of Barnstable ,�� Regulatory Services I A Thomas F. Geiler,Director fp 'i Building g Division Tom Perry,Building Commissioner 200 Main Street H anus MA,0 Y 2601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Proper Owner ust Complete acid 1gn. 's Section If Usin B ' dert 0- ` Owner of the subject property hereby authorize to act on m7 behalf in all matters.telative to work authorized by building p t (Address o Job) **Pool fences and alarms are th responsibilityof the a plicant. Pools are.not to be filled before fence i installed and pools are t to be ufflized until.all fim1 inspections are performed and accept S' afore of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS 8k . 19053 Ps82 *'739b5 _ .�Ot9=�21= 10�1C14 a�i 02 2 34a en c M ci aQ 00 A ctAm 11-V�i U ng �-o�c a. rrr W h-d•40 co `"" o-* We, Esther T. Ritchie, of 50 Bruce Wood Street,Boston,Massachusetts and Harriet Segal, v�arloaw W ca m °� of go w& Ste'. , Massachusetts fa! C �"I y}- e A � � in consideration of TWO HUNDRED FORTY-EIGHT THOUSAND FIVE HUNDRED W W N C4 AND 00/100 DOLLARS ($248,500.00) JJ I O.Z M fA.. •. grant to Patricia M. McCarthy Ferraro and Christopher M. Ferraro husband and wife as .x�y� (V 4' tenants by,the entirety p d¢ � a $4 in of 17 Carriage House Drive, Lakeville, Plymouth County,Massachusetts with quitclaim covenants ro x a certain parcel of land with the building thereon,(single family wooden dwelling) situated in Barnstable(West Hyannisport),Barnstable County, Massachusetts, more particularly described as Lot 16A shown on a Plan of Land entitled: "Re-Subdivision of a Portion of Block"F" (Comprising Lots#2 To#32 Inclusive)at"Craigville Beach Estates" West Hyannisport— o Barnstable-Mass. Property of Alfonso Cannata Scale: 1 inch=40 feet-March 11,1952 - a Bearse&Kellogg- Civil Engineers",which plan is duly recorded with the Barnstable County Registry of Deeds in Plan Book 103,page 75. a Together with a right of way in common with others entitled thereto for all purposes for which •rq way are commonly used over the ways shown on said plan to the public highway. N v Being the same premises conveyed to Esther T..Ritchie by deed of Esther T. Ritchie and Ruth - Shulman,dated May 9, 1999,recorded with said Barnstable County Registry of Deeds in 0 Book 12392,Page 133. See life estate reserved by Harriet Segal in a deed dated May 18, 1993 Mrecorded in Book 8669,Page 117. o , Harriet Segal;grant and release all of my right, title and interest to the above mentioned property, specifically releasing a life estate reserved in a Deed recorded with the 0 arnstable Registry of Deeds at Book 8669, Page 117. 0 xecuted as a sealed instrument,this day of�J_ , , 2004 o 14 Esther T. Ritchie Harriet Segal Bk 19053 Pg 83 #73965 N 0 W x� �DGa'• NG NO a+F-d'yY OQ x W M O N PROPERTY: 430 Old Craigville Road,West Hyannisport,,Barnstable,Barnstable County,Massachusetts W�7NLYW W O WOG N COMMONWEALTH OF MASSACHUSETTS CAS`" o l SS. N J 1 C10, PC CA 0°D On this ! �'�day of September, 2004,before,me the undersigned Notary Public, aN•• •• personally appeared Esther T. Ritchie,who proved to me through satisfactory evidence of ct�x a rr.• gg C$.w identification,which was , �i ZI(I U k .to be the person w se name is signed on the preceding or attached document, and acknowledged to me that she gned it voluntarily for its stated purpose and acknowledged the same to be her free act an ed, before e. '•'•:,t�� 7� Notary �o _ GERALD F GIBUN �,. •,: NOTARY PUBLIC �^S '�► -.•. COMMONWEALTH OF MASSACHUSETTS } �'•.� f.•'`��� MY.COMMISSION.EXPIRES 11/3/2006 .•• r COMMONWEALTH O'F MASSACH(1$)ETTS SS. On this 7 day of September,2004,before me the undersigned Notary Public, personally appeared Harriet Se al who proved to me through sati actory evidence of identification, which was_ �r, L�rr to be the perso hose name is signed on the receding or attached document,and acknowledged tome th s e signed it voluntarily for its stated purpose and acknowledged the same to be her free deed,before me. 9 Notary GERALD F GIBLIN Vs NOTARY PUBLIC COMMONWEAU1.1 OF MASSACHUSETTS. co MY COMMISSION EXPIRES 11/3/2006 •ti M P1'1 RETURN TO: BARN STABLE REGISTRY OF DEEDS TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 7 Parcel 1® Permit# Health Division d 5 — A 5 ��)� ,( � Date Issued , 0-onservation Division .-s �l 6�' Application Fee Tax.Collector BF 4 reasurer INBTAURD IN�COMM ANC VM TITLE 5 Planning Dept. EWRO a EAW Date Definitive Plan Approved by Planning Board ` Historic-OKH Preservation/Hyannis 4n � Project Street Address 3® ®1.�© GR-Ai►f�ll� Village co c*ti Owner 4r ewr a4pt i2",t Q Address t7 cAA04AkEou A. LAqWMZ. Telephone ,sos ?q6- 2- 6 2 7 Permit Request Rf TrFno�,� -— �Tzl n R�MoAx.. (l&Pt.Abr-Z .5-444Aacl't ?g,4r w 4k%. S. SAA/J f Z4,e©wc Square feet: 1st floor: existing `7S 7 proposed 6AM� 2nd floor: existing AX proposed AA. Total new 0 Zoning District Flood Plain Groundwater Overlay A6 cW M&Z S� Pro' t aluatio'n Construction Type '� iV� = Ral;&&,rcAL S'A6F.2 7 1� Yp 1, 3 � ize 'TS )C 1®® Grandfathered: Cl Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes >(NNo On Old King's Highway: ❑Yes >00 Basement Type: ❑ Full /"'Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) A A Basement Unfinished Area(sq.ft) 4 aAwl. 5_ 757 Number of Baths: Full: existing _ new M - Half: existing RA • new AA . Number of Bedrooms: existing S new CNA TMa Total Room Count(not including baths): existing j6- new First Floor Room Count z Heat Type and Fuel:XGas ❑Oil ❑ Electric ❑Other �} Central Air: ❑Yes �40 Fireplaces: Existing New ® Existing wood/coal stove: ❑Yes ,�qo Detached garage:❑existing ❑new size AA Pool: ❑existing ❑new size AA Barn:❑existing Cl new size _ Attached garage:❑existing ❑new size CA Shed:❑existing ❑new size A Other: A 4 , Zoning Board of Appeals Authorization ❑ Appeal# .- Recorded❑ Commercial ❑Yes )<o If yes, site plan review# 64. Current Use 'SiA6rLZ 'FAr ic.Y .}}otAg Proposed Use 57A6i.,Z �i4Mic.Y h4psi1g BUILDER INFORMATION Name Ci4ts lTc44Aowo Telephone Number ( SO$1 33a—%6 66 Address ZS i fgAYvK AVf. License# 0 -.6v �Rex � i MA . oZ.3'a) Home Improvement Contractor# Worker's Compensation#VOL 6ol®i5'Iol Z*p5( 69LITA40-0) ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A&A- TABI�� SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. 3 i DATE'ISSUED MAP/PARCEL NO. ADDRESS 'OLLAGE �- OWNER DATE OF INSPECTION: ; FOUNDATION ' FRAME fd INSULATION FIRF.PI.ACF r ELECTRICAL: ROUGH FINAL PLUMBING: RO�U&I FINAL r GAS: R( r FINAL: f .� FINAL BUILDING Itre �.•, ., DATE CLOSED OUT 9- 114. off to t ASSOCIATION PLAIONVa r �/ OMI !A The Commonwealth of Massachusetts �� Department of Industrial Accidents 600 R'ashin;ton Street Boston,Mass. 02111 ' Workers' Com ensatian Insurance Aff.idaV VAvit'-General Businesses / h / � ,'...nT•msm+="Tay_�c m.+ 'Te.'T•r .;� ,� >.� \ .. _ . '�• ~ . atxte' I" Ai address: ­ AY�1 ,Ave ' j c.M�tA/1 state: M A ::�. �Z O h e GV�s i Jf��ir� S work site location fu address rietor and have no one Business I), [�Retail[]Restaurant/Bar�EatingEstablishment am a sole prop 0 05ce❑Sales(including Real Estate,Autos etc,) .,king in any C'&Padty R01! I am an ea to er with eta 1 ees(full& art time. ❑Other / / ///////M i ���i��i�//,/,y iP�//i, ����i�/.�i i��/��y�e /ees worm on this job. . e �Ian employer providing vtArkerst compensation for-lay oy . g am '- +,',. .:. +(M •1'V�' C:. t•" 'r -t, .t :T• ,. t•• :,:•\';;.r`.+' •Cf'IY'•r•,�.5; •. •' + •" : �`•',C't:•, .+: :� •'•t �t{ .r ,!t ,a h�,�. 6iN •'r:�`i.j:',..i' ''i • ..... �i t•{ ,.��. .h� .%',1�'�S.'f}i�a.•1.• „Y Jam... r•;, T.'. .J•'.:.�t�' 'j+ addTe3S• .iC ! T ^, iT. '� � +'.•"�\' •A` 'r� " '��.v..�•'r'•,•! �' i�'• �,. .• ,; hone i>+..' '� '' ,: •:j,. rfns<tiance eod". :•�; ..'�;:.'... �.,.' j �' ,t9'/ ////• .•.,.: . .•%, .. . workers'} . . , ; or ` d h ve hired the independent contractors listed below who have the following am a sole proprietor an a r com ens M polices: E: ,, •ilyji�,:'af.•�::,,,• i,rr:.:••:.>y�.f•'1���'.i'1 '•; '�:' +• ••':::. ,+.+:a: , '• 9ildre�3:1 .4'' •j•j •, ,,.4,•n � 1-• ,j .. ,� y:,,+•• v. �i,� Cl •v �fir,.J ''.��.{\'S '1�`':� •''}•r' •. ' � y�.� .•fir '+,,+ '1:� .r� t' ,�.t\•,f�• 't r::••t1 •r '1.• i'r.i' ';:'' �i, .•�.� .'•' .• ;'. 'a:' `;v.':1•,• •`••" r•'�} ''�,q�//�//�y��� . inatuance co. . .• /1/ f - "s:•;;; /�/ r.- /��. ,.J, :..'•:j'.:+.1'1 or S' ,2',• •'i •.,i r�'i•{•. ,,,, .r ,p''. •r•\: N r'+• 41�: ;',�,,. j..' •'�'• ,., !•.. J!.}h,.� 11:T„4:'.•tl+'�' , �,,� T, ;I-f•4r. ,t. +,' • • .� ���,•,ir��• tiv In address: , ' :,,` ''„'•.\; ' , ' ''' ,: •• � ' •tr�\` •• � 'hone#i• ':,' ., ' ��� Ition Of P to Sl 00.00 and/or. d to Fallure to secul a coverage as required Hader Sec on theform�af as STOP-WORK Ocan,estIZDEAhe pand a fine ors 00.00 a day agaia+t�me. I understand.that one yenta'impr1ionment as wen as civil penaltiesIn copy of this statememtmay be forwarded to the OLFicc of Investigation+of the iAfor coverage verl[ication e nformation provided above is true and correct I do hereby certify and Date Phone print name do not trrtte 1n this area to be completed by city or town official oireial use only permltllicense# ❑Building Department city or town: []I,iceasin0 Board ❑Seleetmea'ps Office ❑check if mediate response v required C]RcalthDe Department , > ❑other phone ; contaet person: tfevned Sept 1403) t Information and Instructions LaWs chapter 152 section 25 requires all employers to provide workers'compensation for their Massachusetts General � employees. As quoted from the"law',an employee is defined as eve person in the service of another under any contract14 of hire,express or implied, or�l or written. An employer is defifted as an mdu ual,partnership, associati corporation or other legal entity, or any two or more of the foregoing engaged' a joint entise, and including the le al representatives of a deceased employer,or the receiver or{ ; ers ' association or other'legal entity,employing employees,*However't, owner of a trustee of an individual, p artn �P� dwelling house having not more than thr�apartrnents and wh' resides therein,or the occupant of the dwelling house of r to s ersons.to do mamt ice,constructr or repair work on such dwelling house or on the grounds or another who ermp, y P es�an 1 �, i dtobean use of su ch. to eut be deeme emp oy budding app urtenant thereto shall not beta emp , I, ter 152 section 25 also states that eve state o!local licensing agency shall withhold the issuance dr renewal of a license or permit to operate video a of compliance wits ct buildings in the cbm;nonweslth for any applicant who has MG tr P not produced acceptab a insurance coverage required. Additionally,neither the con=onwealth nor any of its political subdivisions shall, ter into any contract for the performance of public work until acceptable evidence of compliance with the insurance re uir eats of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the bo that applies to your situation. Please supply company name, address and phone numbers along with a certificate of incur ce as all affidavits maybe submitted to.the Department of industrial Accidents for con lion of insurance coverage. . o be sure to sign and date the affidavit. The affidavit should'be returned to the ity or town that the application for th ermit or license is being requested,not the Department of Industrial Acci ts, Should you have any questions reg. dingy the-"law" or if you are required to obtain a wo=kers' eampensationpoli ,please call the Department at the number tedbelow. City or Towns Please be surc.that the affidavit is complete d printed legibly. The Departmentbas provided a space at m ottom of the affidavit for you to fill out in the event the 0 ce of Investigations has to contact you regarding the applicant: ease... be sure to fill in the pamit/license number W 'ch will b'e used as a reference number. The affidavits maybe r ed to .. the Deparirrieht by mail or FAX unless othe>�arrangements havebeen made. let thank you in.advance for you cooperation and should you have any questions, The Office of Investigations would 1 please do not hesitate to give us a"call:'- �j/ �/ '%� /%i The Department's address,telephone and a�x number •. . t�.._ The Commonwealth Of Massachusetts Department of Industrial Accidents [tea of levestlgRians 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext.406 .,oFTME'O'�ti Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division '�6D MAGI A ' Tom Perry, Building Commissioner 200 Main Street, IJyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder 4A �g,G�cq,t o ,as Owner of the subject property herebyauthorize G�l�-1$ to act on mybehalf; in all rriatters relative to work authorized by this building permit application for: (Address of Job) �gna Date PFFTA.k+A Print Nmae n.v�lotvTc•nWNARPF.RMTC SiON He,� Town of Barnstable Regulatory Services l s srasrs, Thomas F.Geller,Director WAss. 039. Building Division 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. 142Arequires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied buildin containing at least one but not more than four dwelling units or to structures which are adjacent to g exceptions,along with other building be done b registered contractors,with certain exceptio g such residence orb g Y requirements. 6oaeTo— Type of Work: 1R aMo oa-lr K i T •t I TN . R Inc.-��Estimated Cost Zd cpe>o. Address of Work: GO i u_le X—D Owner's Name G tf�-7 S ��i •��E' J®�iiLi�,i� �� � Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HONE®g G� Ty WORKUNDER NIHGAL 142A. ACCESS TO THE ARBITRATION PROGRAM SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR 57— Date Owner's Name Q:famms:homeaffidav r G Permit Number REScheck Compliance Certificate Checked By/Date 1995 MEC REScheck Software Version 3.5 Release 1 Data filename:C:\Program Files\Check\REScheck\barnstable.rck TITLE:Remodel 430 Old Craigvile Road,West Hyannisport CITY:Barnstable STATE:Massachusetts HDD:6137 CONSTRUCTION TYPE:Single Family DATE:05/25/05 DATE OF PLANS:5/10/05 COMPANY INFORMATION: Ridgemont Contracting,Inc. 25 Thayer Avenue Brockton,MA 02301 COMPLIANCE:Passes Maximum UA=175 Your Home UA=172 1.7% Better Than Code(UA) Gross Glazing Area or Cavity Cont. or Door Perimeter R-Value R-Value U-FactorUA Ceiling 1:Flat Ceiling or Scissor Truss 500 . 38.0 0.0 15 Ceiling 2:Cathedral Ceiling(no attic) 300 21.0 0.0 13 Skylight 1:Wood Frame:D,ouble Pane with Low-E 20 0.350 7 Wall 1:Wood Frame,16"o.c. 860 13.0 0.0- 61 Window 1:Vinyl Frame:Double Pane with Low-E 115 0.350 40 Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 768 19.0 0.0 36 Furnace 1:Forced Hot Air,82 AFUE COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications,and other calculations submitted with the permit application. The proposed building has been designed to meet the 1995 MEC requirements in REScheck Version 3.5 Release 1 (formerly MECcheck)and to comply with the mandatory requirements , listed in the REScheck Inspection Checklist. 0 O O � J . LLJ C CL j W CL ' Z _ Uo, orrrirreoruuP a ,aavcz ucde(,�6 O ) \ Board of Building Regulations and Standards p 1= o ,r, _ License or registration valid for individul use only M N — HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: °D F- f� Registration:, 110243 Board of Building Regulations and Standards L` t' o W'! ` One Ashburton Place Rm 1301 O z ,c;$'z' 'h'o Expiration: 10/9/2006 Boston,Ma.02108 p O U q-o o rr'�T P a +„ w w M Type: P�idate Corporation m d ' �, X �'� O o RIDGEMONT INC `; Z to w W g CHRIS FERRARO a Q J 25 THAYER AVE.SUITE 104 ,' G�� O BROCKTON, MA 02401 ""- Q> Administrator t valid without signature) C-) �g f fY} -