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The Town of Barnstable
dp tME tb,, Permit# 7 t
Massachusetts
• Date omWtMA a
• K"& SOLID FUEL STOVE PERMIT
zes¢ .�#- Fee
D MA'S
t This constitutes an official stove permit after inspection and approval by the building inspector.
010 11(/
Owner ��-e✓�,tJ L,Q�£ Telephone no. 7 7S J.5f,3
Address of Property ��J�� �' �/�9�1�� T 'K� Village ` cog) ill'
Location and Stove Type `pi9C/c �,YVAJf?66�j (,t Dob ?)V-"d4
��ovr
Date:
Building Inspector
The solid fuel burning stove at the above location passed: failed: inspection.
, of YHE rq� • Town of Barnstable *Permit#
Pl' O Expires 6 months from 'sue date
t
Regulatory Services Fee
AIHNLTI nz, i
9� MASS Thomas F. Geiler;Director 31/&/I L
iGg9 ,� V
prED MA'1�' LOP
Building Division
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.bamstab le.ma.us
Office: 508-8 62-403 8 Fax: 508-790-623 0
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
—7/-� Not Valid withow Red X-Press Imprint
Map/parcel Number
Property Address -33 j yzL L /_
residential Value of Work�✓�-��V Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address _22 MA! at- .66M - Al APSH-AL-L— 3 SKc lAlt It 7— a''—C'AI�
o ,
G i21DiLGr N) ►
Contractor's Name ;.Z1,YU./ 1 ��/J p��,/ C�j Telephone Number $Off 7,74 --OX 3cf
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance -PRESS PERM'
Check one:
❑ I.am a sole proprietor MAR 16 Ni
am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name TOWN OF BARNSTABLE
s
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
2--Re-roof(stripping.old shingles) All construction debris will be taken to ., N1= dm 1stm
❑Re-roof.(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)#of windows 4
*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
required. -
3ICTNATURE:
):1WPFILES�FO (building permit formslEXPRESS.doe
\.evised 070110 i
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
+ d 600 Washington Street
Boston,MA 02111
www.mass.gov/dia '
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organization/Individual): / A✓AjeSlfAi-4
Address: 5^3 5KUAJk—Al f- yQ. );ikD
City/State/Zip: CE—Xf,7,Egro PLLC M Phone.#: .mod-9 776 —O
Are you an employer?Check the appropriate box: Type of project(required):.
1.❑ I am a employer with 4. ❑ I am a general contractor and I
employees(full and/or.part-time).* have hired the sub-contractors 6. Q New construction .
2. I am a sole proprietor or partner listed on the attached sheet. ` 7..❑Remodeling
ship.and have no employees These sub_contractors have 8. ,Demolition
workingfor me in an capacity. employees and have workers'
Y P h' 9. ❑Building addition
[No workers'comp.insurance comp, insurance.t
�}e uired. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
L q ] officers have exercised their 11. Plumbing repairs or additions
3. I am a homeowner doing all work.. ❑ g P •.
myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]t c. 152, §1(4),and we have no
employees.-[No workers' 13.0 Other
comp.insurance required.] f
*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
information.
Insurance Company Name: _.
Policy#or Self-ins.Lic.#: Expiration Date:
77
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 maybe forwarded.to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and pe alties o,perJury that the information provided abo"ve is true and correct. ,.
Signature: Date:" a�C�
Phone#:
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)s
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 buildings in the commonwealth for any
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
enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
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 current
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 proof that 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. ,
`y
The Department's address,telephone-and fax number:.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. #�617-727-4900 ext 406 or 1-$77 MASSAFE
Revised 11-22-06 Fax## 617-727-7749
www.mass.gov/dia
TKE Town of'Barnstable
Regulatory Services
* >anxxszaaLE, * Thomas F.Geiler,Director
y MA8s.
`bp 16,39. . Building Division
-. rFD MA'I A .
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.
Please Print
DATE:
JOB LOCATION: 736-3 SKU .K IV 6_7__rQ_0 Ge-wn P 11/LL L
number street
village
"HOMEOWNER": HAI tIA-2 SfIAL L SZ S 7 76 — U 9 3 C f
name home phone# work phone#
CURRENT MAILING ADDRESS:. �`�Prvh.P �A
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 undersigned"homeowner"certifies that he/she understands the"Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirement
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 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:forrns:homeexempt
4L
�t Town of Barnstable `" 44
Regulatory Services
svwsrea�.
MASS. �, Thomas F.Geiler,Director '
039.
en� 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
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize to"act on my behalf,
in all matters relative to work authorized by this building permit.
(Address of job)
Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled before fence is installed and pools are not.to be
utilized until all final inspections are performed and accepted.
Signature of Owner. Signature of Applicant
Print Name Print Name
Date
Q:FORM&OWNERPERMISSIONPOOLS
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel Permit# '
ealth Division �} x e✓'FIW Date,lssud� �2314'�°-
Conservation Division '- ,7 Fee-. `S��
,/Tax Collector
/Treasurer UNGTALLED IN COULIANCE
Planning Dept. V1,11TH TITLE 5
EN IRONWIENTAL CODE AND
Date Definitive Plan Approved by Planning Board TO PI M Rt20, SL1,ff P����W�'
Historic-OKH - Preservation/Hyannis
Project Street",Address' 53 S/C utl Rl eJ Z—,) a
Village C`EN fef-✓, /�6
Owner �� �veil! +�o �� _ ° Address'
Telephone 5D Fl 77
Permit Request 1:eAZf14 D E iS�i�c
z
Square feet: 1st floor: existing t proposed 2nd floor:existing proposed Total new
Estimated Project Cost Zoning District Flood Plain Groundwater Overlay
Construction Type oo D t '
,Lot Size /(6. / `7.2 0 Grandfathered: ❑Yes` .❑No If yes, attach supporting documentation.
Dwelling Type: Single Family. Two Family ❑ Multi-Family(#units)
"Age of Existing Structure Z Historic House, ❑Yes t6 o On Old King's Highway: ❑Yes
Basement Type: ❑Full ,❑Crawl ' ❑Walkout A.Other � .2 f
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: I Gas El Oil' El Electric ❑Other
Central Air:"•❑Yes �No Fireplaces: Existing New n g
Existin wood/coal stove: ❑Yes' ❑No
Detached garage:❑existing ❑new size Pool:❑existing. ❑new size Barn:❑existing ❑new size
Attached garage:Lrexisting 5Lnew.-size Shed:❑existing ❑new size Other: 'Op
Zoning Boa peals*Authorization ❑ Appeal# Recorde ❑
Commercial ❑Yes If yes', site plan review# - �`2� _q
Current Use Proposed Use
i
BUILDER INFORMATION
0 C' _r
Name d uK4uE � .� o% Telephone Number
Address —;;:,e)- 6e /oDS License# 5 , 7/.,2,
A�&zu /�f��s ,�� Home Improvement Contractor#
Worker's Compensation# -�
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOifJ.�'lOsc/y % o �
SIGNATURE -DATE rZ20 59
FOR OFFICIAL•-USE ONLY -
PERMIT NO.
DATE ISSUED Ir ' ' 1
r _
MAP/PARCEL NO.
ADDRESS ~' . a = t VILLAGE
OWNER
DATE OF INSPECTION
� FOUNDATION` � � - � .� _ - x _ •`. i ` , ,
'r FRAME
INSULATION
FIREPLACE t _
h ELECTRICAL: ROUGH j FINAL'
A �. ' : �, i 1, , ^ ', •-. ' . .' � ,may
PLUMBING: ROUGH ; FINAL
GAS: '-`ROUGH W,, :' FINAL
FINAL BUILDING'S �•x ;, -
DATE CLOSED.OUT
`j ASSOCIATION PLAN NO.
Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862=4038 Ralph Crossen
Fax: 508-790-6230 7 `
r Building'Commissione.
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 ofan 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:_AD/Nh;910 h) Estimated Cost ±& p, °b
Address of Work- Ile oiti iy-f Ro
Owner's Name: S-fe l ek ( D/E
Date of Application•
I hereby certify that:
Registration is not required for the following reason(s):
[3Work excluded by law
C]Job Under S1,000
[3B 'Idmg not owner-occupied
weer 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.
Date Contractor Name Registration No.
OR
Date T Owner's Name
q:fomns:Affidav
/'7 .Y 14'41Y• K.T
t1 w1j�� ! l
Department of Industrial AccirTents
' =t a Office ORRY85tigMONS
-"� 600 Washington Street
-
- Boston,Mass 02111
Compensation Insurance" Affidavit/ /�%///Rtr,
".....
name: SInc-e^- 17 c Lam.
/ e
cation 1 Sk,,., kj-r,1
city phone#
I am a homeowner performing all work mvseif.
❑ I am a sole arovrietor and have no one working in any capacity
❑ I am an employer providing workers' compensation for my employees working on this job.
comonnv name:
address:
cites phone#•
insurance cn. niicv#
❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who
have
the folloning workers' compensation polices:
company name•
address•
dtv. ohone#-
insurance cn.
>: • .. ...
camnanv name- ....L;....:<:...::.
address:
city- phone#-
insurance co. :... :.. . oiicv#
..................
Failure to secure coverage as required under Section 15A of MGL 152 can lead to the imposition of criminal penalties of a tine up to s1.500.00 andlor
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a
copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification.
I do hereby terrify un r the pains and penalties of perjury that the information provided above is trap and correct
Sizature
Print name Phone#
Ccheck
nly do not write in this area to be completed by city or town otllcial
permitilicense 0 Mudding Department
OLtcensing Board
mmediate response u required ❑Sdeeamen'a Office
❑Health Department
on: phone 0. Mother
lrevuea 9,95 P1Ai
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the:.:
employees. As quoted from the "law", an employee is defined as every person in the service of another under any coat r.
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 rece rer
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 to persons to do maintenance construction or air work on such dwelling
employs P , rep house or oa 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 renews:
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 and
supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Departrneat 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 Departmem 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 peimit�nse number which will be used as a reference number. Tie affidavits may be re=ned is
the Department by marl or FAX unless other arrangements have beea made.
The Office of Investigations would Ile 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
0MC0 of imlestloatlons
600 Washington Street
Boston'Ma. 02111
fax#: (617) 727-7749
phone#: (617) 727-4900 ext. 406, 409 or 375
MCURAppwmftj
. Psssaipdvs Pseka;d forOna and TwaFMO*Rmdu dd Boildimp Hued with Fad Fneb
MA7IUMUM MaVIMUM
at ccuing Wall Floor 8aaemmc Stab ling
U vdua� iGvaiueJ R.vaiva' Rrvaivo� Wail PIES lgic
Pak R.valud
3701 to 6500 RndaS peaeea Dam
Q 12% OAO 39 13 19 10 6 Normal
R 12% U2 30 19 19 10 6 Normal
s 12•0A am is 13 19 10 6 U AFUE
T Is% 036 32 g 2S WA WA Nomad
U Ism% 0A6 35 19 19 10 6 Normal
V 15% 144 ae 1+' 23 WA WA 15 AFUE
W 13% am 30 19 19 to. 6 IS AFUE
x IVA 032 31 13 2S WA WA Normal
Y 13% QA2 38 19 2S WA WA Nommi
t 12% 0.42 3= 13 19 10 6 90 AFUE
AA 18% 0.50 30 19 19 10 6 W AM
1. ADDRESS OF PROPERTY:
2. SQUARE FOOTAGE OF ALL EXTERIOR W
3. SQUARE FOOTAGE OF ALL G G.
4. %GLAZING AREA(#3 DIVIDED3
S. SELECT PACKAGE(Q—AA-see an Ve):
NOTE: OTHER MORE INVOLVED ODS OF DETERMINING ENERGY REQUIREMENTS
ARE AVAILABLE. ASK US FOR THIS INFORMATION.
BUMDING INSPECTOR APPROVAL:
YES: NO:
q-fomis•t980303a '
Footnotes to Table J5Z.1b:
Glazing area is the ratio of the area of the glazing assemblies ( ding sliding-glass doors, skylights, and
basement windows if located in walls that enclose conditioned space,l: ":cluding opaque doors)to the gross wall
area,expressed as a percentage. Up to 1%of the total glazing area may excluded from the U-value roquu'=ent.
For example,3 fl of decorative glass may be excluded from a building design with 300 if of glazing area.
'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with
the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for
whole units: center-of-glass U-values cannot be used
' The exiling R values do not assume a raised or oversized taus construction. If the insulation achieves the full
insulation thickness-over the exterior walls without compression, R-30 insulation may be substituted for R-3 8
insulation and R-39 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 (tf 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-flame or mass(concrete,masonry,log)wail constructions,but do not apply to metal-flame construction.
a 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
described in Note b.
'The R-value requirements•are for unheated slabs.Add an additional R-2 for heated slabs.
' If the building utilizes electric resistance heating use compliance approach 3,4, or S. 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 J5.1la
NOTES:
a)Glazing areas and U-values are maximum acceptable levels.Insulation R-values are mmunum acceptable levels.
R-value requirements are for insulation only and do not include structural components.
b)Opaque doors in the building envelope must have a U-value no greater than 035. Door U-values must be tested
and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value
in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the
glass area of the door with your windows and use the opaque door U-value to determine compliance of the door.
One door may be excluded from this requirement(i.e.,may have a U-value greater than 035).
c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with
different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to
the R-value requirement for that component. Glazing or door components comply if the area-weighted average U-
value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors).
43
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rs• �.
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ACE
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FLOOD ZONE (-Jewj,) f6171 563 -2638
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Assessor's Office(l st floor) Map 1/70 Lot I- G Permit#
Conservation Office Oth floor) Date Issued
Board of Health Ord floor) J�—' �2 /✓r
�l Engineering Dept. Ord floor) House# } SEPTIC SY BE
Planning Dept. (1st floor/School Admin. Bldg.): INSTALLEDs ���
_- WIT
Definitive Plan Approved by Planning-Board 19 E VIRO619�41E . i6 AND
(Applications processed 8:30-9:30 a.m. &1:00-2:00 p.m.) �� 0. �
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TOWN OF BARNSTABLE
Building Permit Application
Proiect Street Address S3 Uvvkrc4 R-0. Pyy r 1/, L��
Village C-e+,4,e ,11-e Fire District G
Owner +1 v-c,i. 17 ce 1 e Address 3 23 R.17
Telephone '� o-18�_S
Permit Request: -ho ar/l-/ a C 1054 A., -pal 64fh
i
Zoning District Flood Plain C Water Protection
Lot Size Grandfathered
Zoning Board of Appeals Authorization Recorded
Current Use Proppsed Use
Construction T A ML_
i
Eaistin2 Information
Dwelling Type: Single Family_ VfS Two family Multi-family
Age of structure $ ycArs Basement tune Tz//
Historic House /1/0 Finished
Old Kings Highway /VO Unfinished �1rS
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor y a d l�dr- ,, x4r-lc_r
Heat Type and Fuel 11,,d Hr,+ a,- (res Central Air A-U Fireplaces Uet'
Garage: Detached Other Detached Structures: Pool /t-D
Attached V-.T Barn /_0
None Sheds /I/D
Other
Builder Information
Name S�'�P:v4„ D_ Cede Telephone number 4/90-/M-S'
Address3n Skw,k.,-- R.D. License# 0-5-77la
Home Improvement Contractor# !D9 7.S/
Worker's Compensation # /1/Q
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
If
Proiect Cost �� Q
Fee f
SIGNATURE22
DATE�GI S��
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
BPERM T
FOR OFFICE USE ONZ.Y
l ADDRESS 353 SK.UNKNET ROAD, VILLAGECENTERVILLE
OVER STEVEN COLE _
DATE OF INSPECTION:
FOUNDATION rl
FRAME
INSULATION 91
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL '
GAS: ROUGH FINAL t
FINAL BUILDING::; 0' ®#/9/S� �_ f
r
DATE CLOSED
ASSOCIATE PLAfiFNO. '� � ��
J 4'"3 ✓"4 ��a
DEPARTMENT OF
PUBU 1
1010 COMMONINEAI.TM AyEBAFETY /
OWVIV lei
BOSTON,MASS.02215
LIC�NgE ! a HOME IMPROVEM
Board of Build ,
I One 'Asthbu
EFFECTIVE DATE UC NO ° BOS'tOn
I
HOME IMPROVEMENT is fit'
,T � Registration '
ON
EVEN. ;i;►7L� 109751
TYPo - PARTNERSHIP
..D
HYANNI
�.` BOURQUE & COLS
I ..NOT VALID UNTIL SIGNED 8Y LICENSEE AND OFFICIALLYh i STAMPED-OR SIONATURE OF THE COMMISSIONER - `* JOHN D , BOURQI IE
I 419 FIVER RD.
MARSTONS MILLS 'M `
. S �F LICENSEE
BOURQUE & COLE
CUSTOM HOMES&REMODELING
419 RIVER ROAD MARSTONS MILLS, MA 02648
(508)428-4620 420-1865
tag
ISO�$ % a V-1
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D;r
ad$ to, Gdd.i:�- 3'
D,,llc, LVL
BOURQUE & COLS .
CUSTOM HOMES&REMODELING
419 RIVER'ROAD MARSTONS MILLS,.MA 02648
(508)428-4620 420-1865 -
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�1 AMA
BOURQUE & COL_ E
CUSTOM HOMES&REMODELING
419 RIVER ROAD MARSTONS MILLS;MA 02648
(508)428-4620 420-1865 .
C,;N.edlecl.
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BOURQUE, & COLE
CUSTOM HOMES&REMODELING
419 RIVER ROAD MARSTONS MILLS, MA 02648
(508)428-4620 420-1865
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o� �> TOWN OF BARNSTABLE Permit No.
• . Building Inspector
»oaa i Cash
ego C
OCCUPANCY PERM Bond _ X__'
Issued to Address
3 L S TRUST
of 648 353 Skwiz,::,�!t Roa, �s_�t_ - i 1
Wiring Inspector v� Inspection date
Plumbing Inspector L� 1
Inspection date f /�.A�// �•°
Gas Inspector Inspection date
Engineering Department /r .1 - Inspection date `
Fi 9/ «' / v
Board of Health �� Inspection date — f
U
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING //CODE.
_ ..,... .
Building Inspector
� i � ,�a'� ._ ...3 <�'y�"• r .� 5 i �,yl �,.: ��..r, ,��� t�.` :.�.... fii .. .,.apti�.i .f^�.{,.f�g'�"� ��. +�4..� `^4
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
2 BARIS : TOWN OFFICE BUILDING
�� 6 9• �� HYANNIS, MASS. 02601
n'Fo root�
MEMO 0 `Town Clerk
FRONT': Buildina, Department
01
DATE:
l I �v
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An Occupancy Permit has 'beenis'sued for the building authorized by
BuildingPermit ................ .._........ ..�r .. ....... ......... .............................. .......... _. .
issued to ................................. ..l............. .... .............................................................................._............
....
Please release the performance bond.
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WILLIAM yG�
M. -
U WARVVICK -
4' 4 - No. 19771 a�
GI TV
I'01-11VIDAT/UN (f ART/F/CATION
On the basis of my knowledge, information and
belief, I certify to The Town of Barnstable, 07 �98 J`�KUNK/1/ET /l OAI�
The Boston Pive' Cents Savings Bank and Ticor
Title Insurance, Co. that as a .result of a
survey made on the Around on S Z4 Bs; I find CE/V TE5! V/LLC / 1A 5
that: .
The structure (s) are located on the site as
shown. 14
The title lines and lines of occupation of the
site. are as shown hereon.
The site is situated in Flood Zone mars-N�ca�/c"
Community. Panel llo. Date: �✓M./"/. 141,MW/6K A550C. �iVG,
Date: 1 Q
William M. I4arwick,RLS I
' I
I
SEPTIC SySTFrVj "UST
_ P ' TA a
Assessor's ma and lot number ....... � ...... � e/f � � o
Sewage Permit numberZ..�- � g^�AL { y
a UL ^g 2n9TAI�LE, i
, � � 9 8a
House number ��..... .................................................. as 1e
39• �0
CEO MPX d'
TOWN OF BARNSTABLE
BUILDI IN PECTO j
p
APPLICATION FOR PERMIT TO . .�... �1.... ../..........................
TYPE OF CONSTRUCTION � ............. ..............................................
TO THE INSPECTOR OF BUILDINGS: y
The undersigned hereby app •es for ermit according to the following informatio �_
Location t•.�'...1.... .......��.U �.*�.� .., ...:. - ..:..� /. j
ProposedUse ................., L..(..�^�'l' .................................................. . ............. ...........................................
Zoning District .............. ..........................................Fire District ...................... ................................
................
Name of Owner .... tfr .....................Address (�1.. z/ ..... ............../. ....
/,�. '.`..............t� z r
Name of Builder '�YY � b �U.�✓.:�.....................Address .......... ....................
1
Cif �f ...Address .��.. ..../!.. �1..` `. .. ��/..........
Name of Architect f
Foundation .....
Number of Rooms ..............�.......................................... .... ..... ......
Exterior ...Roofing ....... ..'AA. ...................................................
..
Floors ...........ei/V �-� .......................................Interior ...... . .1°�.i�� ..ram......
��., ,.,.,�„�Heatin 1�.. .. .................... .....................:..Plumbin ..... ... . ......... ...... :
g... ....... ,J.. g
Fireplace ............... ................................................Approximate Cost ..........
Definitive Plan Approved b Planning Board _ /
pP Y g -l- --------19 Area 04.......................
Diagram of Lot.and Building with Dimension ` Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH .
Vo\
�j
ti
i
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of th Town of arnsto e r garding the above
construction.
Name �. ..................................................
Constructio Supervisor's License
TRUST
-'127944 112 Story
ANo ................. Permit for. ....................................
Single Family Dwelling
. . ..................
Lot 648, 353 Skunknet Road
Location ................:...............................................
...................Centerville.............................. f.. .... ....... .. . .. ....
Owner .S L
.............S......Trust..............................................
Type of Construction Frame
..........................................
................................................................................
Plot ............................ Lot ................................
Permit Granted ...ZUy...3.1......... 9 3 5
Date of Inspection .................................:in 9
Loo
4- ..........1 9
Date Completed .......
L
7
"eel
.-Assessor's map and lot number: ......... ........t ................ .. / SoS
P CF THE t0
Sewage Permit. number ..............�................................�......
-2 "" f RAG/ A/ MA"STME, i
House number ........::. 4............. . rhea
r.P......_,..... 9�po�i639. e00
ro TOWN OF BARNSTABLE
BUILDINS INSPECTOR
APPLICATION FOR PERMIT TO ..L..in.....:...... - .....................
TYPE OF CONSTRUCTION ............... /..` .... .:! ................. C..�aIA...............................................
................r?..... 19..�./....
f /
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby apppllies!)for a_ppermit -according to the following information.
Location ........................... ./,•�2z.....(--*' /�.......... /�(,.�E! l i.l...... . ....
ProposedUse .................` w! � ..L.: � ................................................................... ...........................................
ZoningDistrict ................,(........................................................Fire District ................ ...........................................
Name of Owner .... :�? .......... � ...................Address ..... ..�.�..2..:....../..I ,/�/`�/`f
... ..
Nameof Builder:--e.............. .....................Address ....................................................................................
1
Name of Architect /� �� ��'.� �� ..... '�l /Y .. /l / � 11
. ............. .......... ........Address .v. ............ . . .� ... ...... l.. -��..... .....
r � t '
Number of Rooms ............... ..........................................Foundation /�.1 !i�i � s�G': !�L�
........... ........ ..............................................
Exterior f-�
:::,... y............ ......1.�� .:..e ...Roofing ......r /.�� ► ..............................
/ t
Floors ............N I/`.'L4--4i'V ......................................Interior .. .�, .e-7- x .............................
Heating Heating ..i. : ......................:Plumbing . ...y . �
.. Y.?V,............................................. ,
Fireplace ................�//'. -.................................................Approximate Cost ........................ ,.
Definitive Plan Approved by Planning Board __-1_!111('1/__ _______19 ___. p Area ..........................................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
s
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
ti
I hereby agree to conform to all the Rules and Regulations of the Town of Barnsta,le regarding the above
construction.
Name .... ,
Construction Supervisor's License .................................... �I
S L S TRUST A=170-114
No 27944
permit for 1 ., S tort
................. .
e...Fami.lY..Dwe.11in.V.........
location „Lot 648, 353 Skunknet Road
.........................................
- Centerville
...............................................................................
Owner .,,,S L S Trust
.............................................
Type of Construction Frame
................................................................................
Plot ............................ Lot ................................
May 31, 85
Permit Granted ........................................19
Date of Inspection ....................................19
Date Completed ......................................19
3