Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0584 SKUNKNET ROAD
S�� �%��n�n� ��� _ . y y e ENS ����_� �� �l 1.��� � �,(� ,� i ' v � � ��v�12 �c7'� �i�, { t 4 i � � �� '�ves 1 2 -l"7 i � I �3► � s � ._..a.�.,_ _ _.�.._ �. BUILDER INFORMATION Name /c��AR D �Lc I Telephone Number 50& 20 - "7 2 97 Address :579 S�y N K'y i� % License# �N?C�'f/l LLC 1144 O Z 6 ZZ Home Improvement Contractor# ^'f� Worker's Compensation# Nl� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TOcKc - -� SIGNATURE - C DATE TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map es Parcel /:9- © /i Permit# Health Division N7 3 2 9/--7,5/ Date Issued Conservation Division L{ I zwt oftc Application Fee Tax Collector - Do J - Permit Fee Treasurer �� �©� � C SYSTEM MUST f ;s: I�LLED IN COMPLIAN-- Planning Dept. NTH ME 5 Date Definitive Plan Approved by Planning Board ENWRONEENT A1.CODE A ;" TOWN RE(;ULA11rJC , Historic-OKH Preservation/Hyannis ry Project Street Address 1Cyi�iKa'CT A>AD a Village C.6Jv7,6R✓/1-4C Owner fficHARP ;p /IARy Address S4."E Telephone/.50 S ) 4 Z0 72$7 f2 9 0 Sg/ Permit Request Ac.Abwi 0/ ?"=' ¢'! - s� dor^7e�e --0 A?s o,�,� / e%// �✓�� . �er-1v�e/ � /s� ��✓ �%�� 2 �e��yv�=�� / t�I/ ��'e�,�,.t Square feet: 1 st floor: existing 790 proposed 96 0 2nd floor: existing 0 proposed Total new t©£S Zoning District Flood Plain Groundwater Overlay Project Valuation 2.5.O'O Construction Type /v Lot Size 0. 6.3 A co¢G5 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family )d Two Family ❑ Multi-Family(#units) Age of Existing Structure 22 � // 5 Historic House: ❑Yes ,9No On Old King's Highway: ❑Yes 8(No Basement Type: 14 Full 50 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 4P Basement Unfinished Area(sq.ft) 21,6 Number of Baths: Full: existing / new 2 Half: existing 0 new Number of Bedrooms: existing 2 new J -l7''4f_ 3, Total Room Count(not including baths): existing L} new First Floor Room Count 3 riff) Heat Type and Fuel: 26 Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes _9 No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes, LMo `' Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑newtize Attached garage:t4 existing ❑new size Shed:❑existing ❑new size Other: — a ® o ca Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use rn BUILDER INFORMATION NameA;,./, ,/ y. 6,1U Telephone Number Address/ tj /*LOS 5� Via Ate, License# D!;�0-� f�5 �trf/iA �l� Home Improvement Contractor# //ol C1 7 7 Worker's Compensation# wcc. Soo/663olgo ,z ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A5,�c4_ �cw�y a�`crf i''��•� SIGNATURE DATE v FOR OFFICIAL USE ONLY PERMCT NO. t J DATE ISSUED ~; cs „ ti �,• - 'XI 'c r. r 61 MAP/PARCEL NO. ADDRESS -~ r VILLAGE /f OWNER i r DATE OF INSPECTION: i }' r FOUNDATION 03 FRAME 4 INSULATION FIREPLACE Aj ELECTRICAL: ROUGH FINAL'. y — PLUMBING: ROUGH FINAL, " ' �° FINAL GAS: ROUGH ; . , FINAL BUILDING DATE CLOSED OUT-` ASSOCIATION PLAN NO. � r A °FINE T°y, Town of Barnstable Regulatory Services BAMSCABLE. " Thomas F.Geiler,Director 9 MASS. g q'ArE6 o.�a`0 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: dela-zo461 lam a' 9 el0d'"mc-f Estimated Cost 2,s,, Address of Work: 5,%9 Ce-7 of 0'2 G3 Z Owner's Name:��11�f✓c� � ���` e9.e/G Date of Application: z9e" 2' 2-' "'2, I hereby certify that: 'I Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied ROwner 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 Owner's Name Q:forms:homeaffidav `J RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 RKSHEET FEE VALUE W O NEW LIVING SPACE 570 square feet x$96/sq foot= 51-t,-122o x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF ERISTING SPACE 2 5° square feet x$64/sq.foot= j 6 'goo x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.1 y , >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 Open Porch _x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney _x$25.00= - (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee �? projcost Tabia.iS.1.115 ' ReideasW Sd1�+asl�with)poss>i Fact. prwcriptfrg psc"gw foram"d Twe-Fsmi� MUM m4IUM M,UaMUM Wau HOW Snemas�t slab cicnc7� (leg . GLriaB CaIia¢ Pt� Amy(IN U-valurT R-Valt7e� R-vaiws� 1i�nlud 1 �� Padca?e STDI to 6599 IiestFatt De�rtti D=7� ' 6 Noses 19 1 D Narani Q 1Z!'s 0.40 3E l3 6 30 19 19 ' 10 E5 AFUE S 1Z:'. . 0-50 3E 13 N/A wt Ncr� T 15% U6 . ]E 13 6 Newel 19. 19 10 tl Am U• ty/• 0.46 3= u NIA � WA v Is/. 0.44 3E 13 i !S ARM W 1.5% O.SZ 30 19 19 10 NSA Noma! 13 23 NIA No=al . X 1 E'/. 03Z. 31i I� u ?YA WA cc�� Y IEY. 0.41 3t. t3 19 10 6 90AM Z ism. 0.4Z 33 6 90 AFVE. 0� IE% OSD 30 L9 S9 . 10 r. ADDRESS OF PROPERTY. 5' , LLS: Z. SQUARE FOOTAGE OF ALL EXTERIOR WA. 3. SQUARE FOOTAGE OF ALL GLAZING:' 4, %G_ LAZINGRE AA(#3 DIVIDED BY 023: ' 'SELECT PACKAGE(Q AA-see chart above): S; •- G ENERGY'REQUIREMENI S . NOTE: 0-IKE� ORE AILABLE••ASIC US OLVED METHODS O TfIIS INFORMA ARE ; BUILDING INSPECTOR APPROVAL: YES: NO; g4brr s-f380303a , Footnotes to Table'J5.2.Ib.' ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass-doors, basement windows if located in walls that enclose conditioned apace,but excluding opaque doors) gross area. expressed w a percentage. a s 1% of the total glazing area may be cxcluded.from the U-value requirement. For example;3 fti of decorative glass may be excluded from a building design with.300 R=of glazing area. = peer January 1, 1999, glazing U-values-must be tested and documented by the maaufacnrrzr 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-vaIues 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 exieriar walls without ccmp=ioot R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R=49 hsulatiot:. Ceiling R-values represent the s of cavity insulation plus insulating sheathing (if used). For.ventilated ceilings,.insulating sheatl:ag-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$heathing, and lhtericr'drywali.For example,an R-19 requirement could be met EITHER �OR R-13'caviry insulation plus R-6 insulating' sheathing. Wail requirements apply to by R-19 cavity insulation wood-frame or mass(concrete,masonry,log)wall.constructidns,but do not apply to metal-frame construction. The floor•'requirements apply to floors'over unconditioned spaces (such as unconditioned erawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. Tl c entire opaque portion of any individual basement wall with=average depth less than 50%below grade must me_t the same R-value requirement-is above-grade walls. Windows and sliding glass.doors of conditioned br..,ernents must be included with the other glazing. Basement doors must meet the door U-value requirement r d_scribed 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-morel than one pie= 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 acquirements arc for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no grea than 0.35.Door U.vaIues must be tested and documented by the manufacturer in•accordance w ter 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 0.35). . c) if a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or mare areas with different insulation levels,the•companent complies if the area-weighted average R va]ue is greater than or equal to ply if the area-weighted average U- the R-value requirement for that component. Glazing or door components com value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors)..' - 43 —- ---- _--E --_.. -- _ — ._.. r -- — - — — - -._.._ ..__..- --- . ._..... ScT 7Z a S Tw rev ti'$r SMOKE-DETECTORS O.K. BARNS — DEPT. _ � t T DI : r FE�T VEAJT /�SPNAt-T SM11UC�t�S �f'rNE Tj� M ' 51C-1 L TC 4 ` RJR 5?�nt�. - � `•'�� P�� Qlcgfe� IRA c' t_ f rc•=���5 Z�cit� �6 a t_ a E Fc-,A c ��If.A@�E7 jrpGl�lC� T2C�T14iJ tia7H lk C��Prr'�E"i�,;•it ,1- jfix'/,5 / . Cam' _- �_• r - � - _ ._.. rns7�Li- HC-ioEP r - lJ rs_ For; C"a:v��F.S•�,, f. a , Sn1urc ITr- — — IL - i - r t l , e a 1 yy E f T t — _ ....._. ----:. ..,...... �-N% WALL w t F I �` oUc 4c.L I 7�LL IS Y , i - a- +' i t Y , a � Y s ., I 1�R`rf �^a %i<t!S `��SC 1. - e I ,u w - - - �}. - Sf�F1ri2�'�. .�csrOG•vci /'•iQS� ��2 ���-"9s✓ � � ` e F _ x„ The Town of.Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 2- Z "&t, JOBLOCATION:5, 1 CBc TF_9V I U L6- number street village "HOMEOWNER": �1G1j�12P S+ICR2 �Os� `1 7-0 "]2—K'7 54;& _SZ(I 5�1 name home phone# work phone# CURRENT MAILING ADDRESS: Shy S K`i N KN 1 +7 C c�v c P,v I L,L u✓1�t o 2 6 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling 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 requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of'a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the 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:EXEMPTN � .. � _ The Commonwealth of Massachusetts . =.�_ — . `_ - Department of Industrial Accidents 600 Washington Street --=- ;, Boston,Mass. 02111 --- Workers' Com ensation Insurance Affidavit �/ /— O.� name' �' ,/, , r C! /— ,S A E G r f . location: s8s y ��," k:tie-,/- /? cf, city C�`�' le •> r I/ �c. Qo! G 3 phone# .5 e c' '-fd v- 74,'7 ,©, I am a homeowner performing all work myself ❑ I am a sole r rietor and have no one worku m' capacity acity `� /// %%% %%%%%//%%%/%%%/%//%/%%%%%%%%%%��%///%%%%%%��%/%���%/�%�%%%%/%%%%%%�%/%%%%%//�, ❑ I am an employer providing workers' compensation for my employees.working on this job. :: :::: ::: ::::::...........:::: O101p8nV <`' _::>:::.....:::::>::.... ::::::::>::::>:...... ;:.....:>::::>::;:>:::::>:::>::_>::::::::<:<<::::::::::<:<:>::::«:=:<::<:::::::::::::«:::>::>:::>: ..... :::;>:< 8t�rt! x``>d flII e' ;.. ,yc .....:::::.::.... ... ...::::. :1iiltt ltce:c� _ ... oli ❑ I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have . the following workers' compensation polices:. .::::::.:::.:::: M zflnrf,anv'namte >:><::>:::: : : :.: address..:..:. ..::.: ..... .......... .. .:. ..... ... ::ti.. .wi i:i.:::w.:.:::.,.:::: ................................... ..... ..........................::..:::......:.::::::..::::::.:.::...:.:...:.::..:::::::.::. :... ...............::::....................................:::::::::..::.........................................:'....:::::•:. •. :; >::: i 'ti .;::::::::::::::::::.. ::.:�::.:::.:::::...::..::.::....:......:...........:...........:.......:.............. % :..::................... .........:.::.:.::::....:....................................-.....I....,.:....,........... ................. . .. . .....r.............. .....................:.........:..;••:.:� ........:.....v.:�::.:::::::::::.�:.�:...•.:�:::._::v:::::._:::::::nv:Nn•n,Jn:;3:A[.i}iiii:iv:: . ::.••............::....i:::J::':i:::::•:::. :•:::::.is;i.-'.:i"iii:.*::::'i::is^ :::::::.�:::::i}:: i=:•}::!'::.iiiiii.......:i::-ii:i:ih:`::•:---_:::::. . ............................ .................................. ..............— :............... . fl� :./I::.i::%::-%.......::::::.:.::: :.::::...:.:::.i::'.'::.::.iii::::.iii.....::::Li}iii:.is<ri::Ji::i}:.....:...:... ImuranceT .......... :.:::.:::::..:._..%.:::..:............................................... . l/////I/Ii. : �1'aDIez: :::;:':::::...:;::<:::':<:-...:::>:::::::::::<.::s>;..... ::?::::>:';::>::>:::<:.%....:.................................... ...... c sa address. :.. fft 1. :::..... ...... .... . ........ ho ci ....::::::::::::::::.....:::.;:.;:. :::,:.................... ::..::::::::::::::;:.;:.;....:.::::.;;:.:;.;:;.:::....... ::...;:.;.. .. :::..::.::.:.:.:............... -.....:.:..... .......:..:.;:::.;:: ............ ....... .......................................... ::.:. .. :.............................--...................: ::::::::::::::::::::::i:::i:.�i:.:::.::::::...............................................................:::i::...i:- .......... 8 > > •.`• - a�uraaco. i. . Failure to secure coverage as requited 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 S100.00 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 certify wider the pains and enaldes of a{fury that the information provided above is trrw and correct 7 Date. egg"�0 --.zo n .- Sigaa .. le . Phone# SD7-`7' -10- 7 �&7 f1 rPrint name/`�- �'`I c! i= ��'c 7 . Ccontactperson: se only do not write in this area to be completed by city or town official . town. permit/license# * CIBuilding Department ❑Licensing Board if immediate response is required ❑Selectmen's Office . OHealth Department Phone#; -- OOther_� ftavind 9195 PJA) . 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 and supplying company names,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 rebn'ned it 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 Otflce of imtos"gallons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 f rm�5\6— COMMONWEALTH OF MASSACHUSETTS EXECUTIVE OFFICE OF ENVIRONMENTAL AFFAIRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM FORM PART A CERTIFICATION Property Address: 584 Skunknet Rd. CenterviTle, MA 02632 Owner's Name: Richard Sherley Owner's Address: Date of Inspection: Name of Inspector: (please print) Wei 1 1 jam ' . Robinson Sr. Company Name: William E. Robinson Septic Service Mailing Address: P 0 Box 1089 _Centerville, MA Telephone Number: ( S 0 8) 7 7 5—8 7 76 CERTIFICATION STATEMENT 1 certify that I have personally inspected the sewage disposal system at this address and that the information reported below is true,accurate and complete as of the time of the inspection.The inspection was performed based on my training and experience in the proper function and maintenance of on site sewage disposal systems.1 am a DEP approved system inspector pursuant:toZ.Sec,'on.15.340 of Title 5(310 CMR 15.000). The system: es. Conditionally Passes Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature: Date• —O L- The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Heatih or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the appro.ving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address how the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 Page 2 of l l OFFICIAL IN FORM—NOT FOR VOLUNTARY'TION FORM ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM IN PART A CERTIFICATION (continued) Property Address: 584 Skunknet Rd. en ervi -, Owner: .Sherley Date of Inspection: Inspection Summary: Check A,B,C,D or E/ALWAYS complete all of Section D A. S�ste asses: I have not found any information which indicates that any of the failure criteria described in 310 CMR.. 15.303 or in 310 CMR 15.304 exist.Any failure criteria not evaluated are indicated below. Comments: stem Conditionally Passes: ne or more system components as described in the"Conditional Pass"section need to be replaced or repaire The system,upon completion of the replacement or repair,as approved by the Board of Health,will pass. Answer y s,no or not determined(Y,N,ND)in the for the following statements.if"not determined"please explain. The septic tank is metal and over 20 years old*or the septic tank(whether metal or not)is structurally unsound,a ibits substantial infiltration or exfiltration or tank failure is imminent.System will pass inspection if the existing is replaced with a complying septic tank as approved by the Board of Health. 'A metals tic tank will pass.inspection if it is structurally sound,not leaking and if a Certificate of Compliance indicating at the tank is less than 20 years old is available. ND explain Obs rvation of sewage backup or break out or high static water level in the distribution box due tocbroken or obstructed ipt(s)or due to a broken,settled or uneven distribution box.System will pass inspection if(with approval o Board of Health): broken pipe(s)are replaced obstruction is removed distribution box is leveled or replaced ND expla' e system required pumping more than 4&aes a year due to broken or obstructed pipe(s).The system will pass ins ection if(with approval of the Board of Health): broken pipes)are replaced obstruction is NM VW ND c 1 f Page 3 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) Property Address: 584 Skunknet Rd. centerviiie, MA UZbJZ Owner: Sherley Date of Inspection: �•-^�.`l LO �� G Further Evaluation is Required by the Board of Health: Con itions exist which require further evaluation by the Board of Health in order to determine if the system is failing to rotect public health,safety or the environment. 1. Syste will pass unless Board of Health determines in accordance with 310 CMR 15.303(1)(b)that the system is not functioning in a manner which will protect public health,safety and the environment: _ Cc spool or privy is within 50 feet of a surface water _ Cc pool or privy is within 50 feet of a bordering vegetated wetland or a salt marsh 2. System ill fail unless the Board of Health(and Public Water Supplier,if any)determines that the system is fun tioning in a manner that protects the public health,safety and environment: The s ystcm has a septic tank and soil absorption system(SAS)and the SAS is within 100 feet of a surface wi ter supply or tributary to a surface water supply. _ The stem has a septic tank and SAS and the SAS is within a Zone I of a public water supply. . - The stem has a septic tank and SAS and the SAS is within 50 feet of a private water supply well. _ The ystem has a septic tank and SAS and the SAS is less than 100 feet but 50 feet or more front a private w ter supply well**.Method used to determine distance "This s stem passes if the well water analysis,performed at a DEP certified laboratory, for coliform bacteria d volatile organic compounds indicates that the well is free from pollution from that facility and the prese cc of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure c iteria are triggered.A copy of the analysis must be attached to this form. 3. Other t 3 tl Page 4 of I 1 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART A CERTIFICATION(continued) t Property Address: 584 Skunknet Rd. Centerville. MA 02632 . Owner: Date of inspection: D. System Failure Criteria applicable to all systems:. You must indicate"yes"or"no"to each of the following for all inspections: Yes No _ Backup of sewage into facility or system component due to overloaded or clogged SAS or cesspool _ Discharge or ponding of effluent to the surface of the ground or surface waters due to an overloaded or clogged SAS or cesspool _ Static liquid level in the distribution box above outlet invert due to an overloaded or clogged SAS or cesspool _ Liquid depth in cesspool is less than 6"below invert or available volume is less than'/3 p p j _ Required pumping more than 4 times in the last year NOT due to clog ed or obstructed i e s .Number of times pumped Any portion of the SAS,cesspool or privy is below high ground water elevation. _ Any portion of cesspool or privy is within 100 feet of a surface water supply or tributary to a surface water supply. Any portion of a cesspool or privy is within a Zone I of a public well. Any portion of a cesspool or privy is within 50 feet of a private water supply well. _ Any portion of a cesspool or privy is less than 100.feet but greater than 50 feet from a private wain supply well with no acceptable water quality analysis.[This system passes if the well water analysis, performed at a DEP certified laboratory,for coliform bacteria and volatile organic compounds indicates that the well is tree from pollution from that facility and the presence of ammonia nitrogen and nitrate nitrogen is equal to or less than 5 ppm,provided that no other failure criteria are triggered.A copy of the analysis must be attached to this form.) (Yes/No)The system fails.l have determined that one or more of the above failure criteria exist as described in 310 CMR 15.303,therefore the system fails.The system owner should contact the Board of Health to determine what will be necessary to correct the failure. E. rge Systems: To be onsidercd a large system the system must serve a facility with a design now of 10,000 gpd to 15,000 gPd• You in st indicate either"yes"or"no"to each of the following: (The fo lowing criteria apply to large systems in addition to the criteria above) yes n _ the system is within 400 feet of a surface drinking water supply _ the system is within 200 feet of a tributary to a sm-face drinking water supply _ the system is located in a nitrogen sensitive area(interim Wellhead Protection Area—IWPA)or a mapped Zone II of a public water supply well significant threat,or answered - If you ave answered"yes"to any question in Section E the system is cunsulered a 1a�e system considered a "yes" n Section D above the large system has failed.The owner or operata of any g Y signi cant threat under Section E or failed under Section D shall upgrade the system in accordance with 310 CMR 15.3U system owner should contact the appropriate regional office of the Department. 4 Page S of 1 f OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART B CHECKLIST Prop"Address: 584 Skunknet rd. en ervi , 2632 Owner: Sherley Date of Inspection: Check if the following have been done.You must indicate"yes"or"no"as to each of the following: Yes No/ :/ Pumping information was provided by the owner,occupant,or Board of Health t: Werc any of the system components pumped out in the previous two weeks? Has the system received normal flows in the previous two week period? _ lave large volumes of water been introduced to the system recently or as part of this inspection? L/_ Were as built plans of the system obtained and examined?(If they were not available note as N/A) Was the facility or dwelling inspected for signs of sewage back up? Was the site inspected for signs of break out? ✓_ Were all system components,excluding the SAS,located on site? Were the septic tank manholes uncovered,opened,and the interior of the tank inspected for the condition of the baffles or tees,material of construction,dimensions,depth of liquid,depth of sludge and depth of scum? _ Was the facility owner(and occupants if different from owner)provided with information on the proper maintenance of subsurface sewage disposal systems? The size and location of the Soil Absorption System(SAS)on the site has been determined based on: Yes 'no Existing information.For example,a plan at the Board of Health. _ Determined in the field(if any of the failure criteria related to Part C is at issue approximation of distance is unacceptable)(310 CIAR 15.302(3)(b)) 5 Page 6 of I 1 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION Property Address: 584 . Skunknet Rd. Owner: Sherlerenterville, M71 02632 Date of Inspection: L d FLOW CONDITIONS RESIDENTIAL Number of bedrooms(design): Number of bedrooms(actual): DESIGN flow based on 3I0 CMR 15.203(for example: 110 gpd x N of bedrooms): 36 o Number of current residents: /� Does residence have a garbage gander(yes or no):&p Is laundry on a separate sewage system(yes or no):,,.,& [if yes separate inspection required] Laundry system inspected(yes or no):/Lv Seasonal use:(yes or no):L.'p Water meter readings,if available(last 2 years usage(gpd)): ' 0 1 — 12 7,0 0 0 Sump pump(yes or no):A/ U 0 0 96, 000 Last date of occupancy: j-o-1,,Y-o�- COM RCIAIANDUSTRIAL Type of a tablishment: Design fl w(based on 310 CMR 15.203): Qpd Basis of d sign flow(seats/persons/sgft,etc.): Grease tr present(yes or no):_ Industrial waste holding tank present(yes or no):_ Non-sani waste discharged to the Title S system(yes or no):— Water m ter readings,if available: Last di of occupancy/use: OTHER(describe): GENERAL INFORMATION Pumping Records Source of information: Was system pumped as par_t,6f the inspection(yes or no):/1:L d If yes,volume pumped:_gallons--How was quantity pumped determined? Reason for pumping: TYP"F SYSTEM Septic tank,distribution box,soil absorption system • _Single cesspool Overflow cesspool _Privy _Shared system(yes or no)(if yes,attach previous inspection records,if any) _Innovative/Altemative technology.Attach a copy of the current operation and maintenance contract(to be obtained from system owner) _Tight tank Attach a copy of the DEP approval Other(describe): Approximate age of all components,date installed(if known)and sour c [information: Were sewage odors detected when arrivin at the site es or no :�0 g g (Y ) 6 Page 7 of 11 OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 584 Skunknet rd. en ervi e, A 02632 Owner: Shere ey Date of Inspection: — ��-0'�L BUILDIN SEWER(locate on site plan) Depth belo grade: Materials of onstruction:_cast iron _40 PVC_other(explain): Distance fr private water supply well or suction line: Comments on condition of joints,venting,evidence of leakage,etc.): SEPTIC TANK:/(locate on site plan) Depth below grade: Material of construction:_✓concrete_metal fiberglass_polyethylene — other(explain)-If tank is metal list age:---� Is age confirmed-by med•by a Certificate of Compliance(yes or no):_(attach a copy of certificate) I y Dimensions:--_:r� �,!! s er Sludge depth:_ /.- Distance from top of sludge to bottom of outlet tee or baffle: Scum thickness: ,.,3 Distance from top of scum to top of outlet tee or baffle: Distance from bottom of scum to bottom of outlet tee or baffle: How were dimensions determined:_ O ew je rt, Comments(on pumping recommendations,inlet an outlet tee or baffle condition,structural integrity,liquid levels as related to outlet invert,evidence of.leakage,etc.): ` o o dam/ t'e GREAJEP:_(locate on site plan) Depth bade:_ Materiatruction:_concrete metal fiberglass_polyethylene_other (explain Dimensions: Scum thickn ss: Distance fro top of scrim to top of outlet tee or baffle: Distance fro bottom of scum to bottom of outlet tee or baffle: Date of last tamping: Comments n pumping recommendations, inlet and outlet tee or baffle condition,structural integrity,liquid levels as related t outlet invert,evidence of leakage,etc.): 7 . 1 . Page 8 of 11 OFFICIAL INSPECTION FORM--NOT FOR VOLUN ARY"PIOSESSMENN FORM TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INS SYSTEM INFORMATION(continued) Property Address: 584 Skun1netMAd02632 C n e Owner: — Dale of Inspection: — �must be pumped at time of inspection)(locate on site plan) TIGHT or OLDiNG TANK: ( Depth below ade: — concrete metal fiberglass polyethylene other(explain): Material of c struction: Dimensions: allons Capacity: gallonslday Design Flo . Alarm Ares t(yes or no): — g es or no Alarm love : — Alarm in workin order(y ). — Date of las pumping: Comment (condition of alarm and float switches,etc.): DISTRIBUT ION BOX: (if present must be opened)(locate on site plan) Depth of liquid level above outlet invert: evidence of solids carryover,any evidence of Comments(note if box is level and distribut on to outlets equal,any leaka ge a into or out of box,etc.): PUMP CHA DER:_._._(locate on site plan) Pumps in worl,ing order(yes or no): Alarms in wor•ing order(yes or no): appurtenances,etc.): Comments(n to condition of pump chamber,condition of pumps and 8 Page 9 of I 1 OFFICIAL INSPECTION.FORM—NOT..FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued). Property Address: 584 Skunknet Rd. Centerville, MA .02632 Owner: Sherle Date of Inspection: SOIL ABSORPTION SYSTEM(SAS):�ocate on site plan,excavation'not required) If SAS not located explain why: Type leaching pits,number: f leaching chambers,number: leaching galleries,number: leaching trenches,number,length: leaching fields,number,dimensions: overflow cesspool,number: innovative/alternative system Type/name of technology: Comments(note condition of soil,signs of hydraulic failure,level of ponding,damp soil,condition of vegetation, etc.): 46 a a o v- 60 e- )L, CESSP OLS: (cesspool must be pumped as part of inspect ion)(locate on site plan Number a configuration: Depth—to of liquid to inlet invert: Depth of so ds layer: Depth of scu layer: Dimensions f cesspool: Materials of nstruction: Indication of oundwater inflow(yes or no): Comments(n a condition of soil,signs of hydraulic failure,level of ponding,condition of vegetation,etc.): PRIVY: ocate on site plan) Materials of co struction: Dimensions: Depth of solids: Comments(nott condition of soil,signs of hydraulic failure, level of ponding,condition of vegetation,etc.): 9 Page 10 of I 1 ' OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 584 Skunknet Rd. Centerville, MA 02632 Owner: Sherle _ Date of Inspection: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks.Locate all wells within 100 feet.Locate where public water supply enters the building. � G r r 10 Page 11 of i l , OFFICIAL INSPECTION FORM—NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION(continued) Property Address: 584 Skunkne Rd. _Centerville, MA 02632 Owner: Sherlgy Date of inspection: SITE EXAM Slope Surface water Check cellar Shallow wells Estimated depth to ground water�'�feet Please indicate(check)all methods used to determine the high ground water elevation: Obtained from system design plans on record-If checked,date of design plan reviewed: Observed site(abutting property/observation hole withi�e�of AS)hecked with local Board of Health-explainChecked with local excavators, installers-(attac documn �~ Accessed USGS database-explain: You must describe how you a tablished the hi h ground water elevation: 6 w 11 f ` TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION -oil L Map "J6 '7 Parcel 015 e Permit# Health Division �2 Date Issu d 7, Conservation Division vo Fee -� Tax Collector n r' SEPTIC SYSTEM MUST BE Treasurer Or-cuwvo-t. La Z r INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 ENVIRONMENTAL CODE AND Date Definitive Plan Approved by Planning Board TORN REQULA 6 N� Historic-OKH' Preservation/Hyannis Project Street Address . 4 5k IWEl— 206D Village &N7L�y1L-L-i✓ Owner i4•J-M X5 ��Azb 5'h0 1-i Address S 4in,C� Telephone Permit Request F*Tayb )r4-1C -r A:M 61149 Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new 00 Estimated Project Cost D Zoning District L Flood Plain Groundwater Overlay Construction Type fwo c7Arry `' Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I.-S,-r Historic House: ❑Yes 4\N0 On Old King's Highway: ❑Yes kNNo Basement Type: Vull ❑Crawl . ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) `Number of Baths: Full: existing new Half:existing C2 new 0 Number of Bedrooms: existing_�� new —L. Total Room Count(not including baths):existing new 14 T First Floor Room Count Heat Type and Fuel: ❑Gas 'dOil ❑Electric ❑Other Central Air: ❑Yes �lo Fireplaces: Existing `/L ) New A4 Existing wood/coal stove: ❑Yes �o Detached garage: - T� Attached garage:❑existing $new size f0 Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use 5 BU''IiLDER INFORMATION' Name r�c.� S Cc,s�rn �kiirt Telephone Number ?`?5—(500 Address W i�6 3 License# or to QB &TWU 6-2-6 3 Home Improvement Contractor# 10 � Worker's Compensation# U) �L OW P-5 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 6-r 5iE"P— VS� SIGNATURE ��T" �.1t}- DATE FOR OFFICIAL USE ONLY `PERMIT NO. DATE ISSUED MAP/PARCEL NO: ADDRESS r VILLAGE 1 OWNER #. DATE OF INSPECTION: FOUNDATION . 7 ` FRAME qf C, ®^� - INSULATION ' FIREPLACE W ELECTRICAL: ROUGH" FINAL i' PLUMBING:- ROU,G :.. FINAL GAS: ROUdr, '- FINAL , ` ` • �: t ! ra FINAL BUILDING, x . DATE CLOSED OUT t ASSOCIATION PLAN NO. t- r Syyf c. .1 ESTIMATED PROJECT COST WORKSHEET e Value ,r LIVING SPACE ) O square feet X $55/sq. foot= 66 GARAGE (UNFINISHED), square feet X $25/sq. foot PORCH square feet X$20/sq. foot= DECK square feet X $15/sq. foot OTHER square feet X $??/sq. foot= Total Estimated Project Cost �2/, g990915b leo - V w y i t o L07* 10 , .4 f0T 12 X. PlUI2 CS zL OVI) Gf l"vj:' 71047`:° e This IN� FEC mI0N yl UU'! Bank Ts, nov �~ hEG!>'I'I{Y OWNER: — ,•rla: REFJ .�:�;y _ — ,-f".aT,r-1' 50 --- IERE9Y CYI3Tll"i V) b ,1s�1 'F'It'�I�.. -------- ___- �r �� Y��NKEE Stif?'VT THE RUII.DE � ��, CW5 1.1I,TANT IS I.00A 'J) ON TITF. GI-.Ul`vG :'�� v PAUI` A. 4013 (SUIT T) rHE 'OPTING LAW SETBACK. RIt:Q IRFAIEN'rS OF THE 1A No. CAB I`.I)(.STftl ROAD �I ., t� 7 E ORTHIti TIT[ HAZARll MAJP: 74F: 1'C F , f OF THE Tp� : . .~ The Town of Barnstable w BAMSTABM 9q, M�; �0� Department of Health Safety and Environmental Services A,Eo�r a Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 50&790-6230 Building Commissioner 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: Htldf`Fc Estimated Cost Address of Work:f%! F sic-om iC_W&-7 Re ) L Owner's Name: L. Date of Application: 12—23—51 Q 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 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: 12— ` _3 S •�o ��, S lC�®?�,t7 Date Contractor Name Registration No. OR Date Owner's Name I q:forms:Affidav- s I The Commonwealth of Massachusetts r — Department of Industrial Accidents Office 91/oreSM811819s 600 Washington Street Boston,Mass 02111 Workers Com ensation Insurance Affidavit name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worku is a� act I am an em I roviding workers' compensation for my employees working,on this job... XXX :............ _ :.:..................... .....:::::::.::::.:.:.........,..:::::..:::.: ::::::::::...:.: ::: .......:.::::::::::::::...........:::::.:.: company name tfi L- x ... :.:.::.:::...::::..:. ...:.:::.....:....:::::. .................:.:. :.. ..... 9ddress `I +SG � `" ""` p flame#'''>```''' ) :':. :';' _<.>><;? <' < ................. ptV• � �1 .......:::::. : insurance c0.: . ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: coal anvnameX. address:' :::..::........:..:::.:.:..........:..::..::.:::..::.::..::.:.......:..::::.::.:.......::::::::: 4 R...s. ............ :........................:................................................................:::................... �,..... d ......::::::::......::::.:.::: ::..::.;.. ............................................................................................................................... .................................................................................................................................................... ...................................................................... c any'name•. :...,;>:>::::>::<.;::.;;;:.;:.;;::.;:..;::.;::;;;;:«. _ address: X. vi hone tP 64 +r:rr: r::;: :: :is i::: :;;>i si::.................................. ;y:;.::i::. ..........�::..... r•%; `'•:;:. f� •`•. � : nsurance:Co.. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition;[criminal penaWes of a fine to S1,500.00 and/or one yam,imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of sloo oo 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 1 do hereby certify under the pains and penalties of perjury that the information provided above is trup and correct signature=rl Date /Z- ZJ' f _ Print name `ate �--c�1 l.- Phone# ! 7,15--" 06 - official use only do not write in this area to be completed by city or town official city or town: perndtilicense# E3Buiiding Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: Phone#; _ ❑der OrAsed 9195 P1A) MAScheck COMPLIANCE REPORT Massachusetts Energy Code Permit # MAScheck Software Version 2 . 0 Checked by/Date CITY: Hyannis STATE: Massachusetts HDD: 5973 CONSTRUCTION TYPE: 1 or 2 family, detached u HEATING SYSTEM TYPE: Other (Non-Electric .Resistance) , DATE: 1-6-2000 DATE OF PLANS: TITLE: COMPLIANCE PASSES Required UA = 49 Your Home =. 38 Area or Insul Sheath Glazing/Door Perimeter R-Value' R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS: Raised Truss 228 38.0 0.0 6 WALLS: Wood Frame, 16" O.C. 272 15 .0 3 .0 18 GLAZING: Windows or Doors 12 . 0 .400 5 DOORS 9 0 .350 3 FLOORS: Over Unconditioned Space , 120 • 19. 0 6 COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building,- and the cooling load if appropriate has been determined using the applicabTe `Sta.ndard Design-Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4. Builder/Designer Date 4 MAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2 .0 ]SATE: 1-6-2000 ;. Bldg. Dept . Use CEILINGS: [ ] 1. Raised Truss, R-38 Comments/Location Insulation must achieve full height over the exterior wall. WALLS: [ ] 1. Wood Frame, 16" O.C. , R-'15 R-3 Comments/Location WINDOWS AND GLASS DOORS: [ } 1 . U-value: 0 .40 For windows without labeled U-values, describe features: # Panes Frame Type Thermal Break?, [ I Yes [ ] No Comments/Location DOORS: ] 1: U-value: 0 .35 Comments/Location FLOORS: [ ] 1. Over Unconditioned Space; R�-19 Comments/Location AIR LEAKAGE: [ ] Joints, penetrations, and all other such openings in the building envelope that are sources of air leakage must be sealed. Recessed lights must be type. IC' rated and installed with no penetrations or installed inside an .appropriate air-tight assembly with a 0 .5" clearance from combustible materials and 3" clearance from insulation. VAPOR RETARDER: [ ] Required on the warm-in-winter side of all non-vented framed ceilings, walls, and floors. MATERIALS IDENTIFICATION: [ ] Materials and equipment must be identified so that compliance can be determined. Manufacturer manuals for all installed heating and cooling equipment and service water heating equipment must be provided. Insulation R-values and glazing U-values must be clearly marked on the building plans or specifications. DUCT INSULATION: [ l Ducts in unconditioned spaces must be insulated to R-5 . Ducts outside the building must be insulated to R-8 .0 . . DUCT CONSTRUCTION: j [ ] All ducts must be sealed with mastic and fibrous backing tape. Pressure-sensitive tape may be used for fibrous ducts. The HVAC system must provide a means for balancing air and water systems: TEMPERATURE CONTROLS: [ ] Thermostats are required for each separate HVAC system. A manual or automatic means to partially restrict or shut off the heating and/or cooling input to each zone or floor shall be provided. HVAC EQUIPMENT SIZING: [ ] Rated output 'capacity of the heating/cooling system is not greater than 1250 of the design load as specified in sections 780CMR 1310 and J4 .4.. MISC REQUIREMENTS: [ ] Refer to 780 CMR, Appendix J for requirements relating to swimming pools, HVAC piping conveying fluids above 120 F or chilled fluids below 55 F, and circulating hot water systems. ----NOTES TO FIELD (Building Department Use Only) ------------------------- •.� six �� � �� .. :.a�,u.is.'•&S.M�dSAKYtcYwsC314'..., .. ... ., ., ... ... �" ' gmgm jWA am"^` EE a.. rr4��X (,S+,�y s X��ky'h r.. l t t `i�, y,�. ✓� "� a F L r }. only we give a lite/ime warranty on our workmanship 1 F DOUG WILLIAMS CUSTOM BUILDING BUILDING&REMODELING SINCE 1972 P.O.Box 1069,Centerville,Mass.02632-1069 Hyannis 508-775-1500 Osterville 508-02&0318 Mass 8WS64-0345 fax508-4E&0347 e-mail homebiMa@aol I i o � SIG J►,.,�Io, s" 7� IT- to d� w6eG Pam Q,� J� 2�' --,.- GDP o. 2� (. , ,5f r-etl r �,�c � s,9les IX3 �.- I�p�der ► z II �Iaors 2R IO/� �G•0•//L I�-13 Uagl `� I I 3-0 1, existing deck 12' new Garage 30' removs this existing wall new kitche:,extension (3-0 6' new covered - porch 3-0 F�, existing house overhead door 16' Addition to Shearley Residence 584 Skunknet Rd Centerville, Mass. Doug Williams Custom Building Co. 12-17-99 m i ' i �.. j I .A I ' I _ I I � � ��` � � �. - s . - -� -- ___ - � j �`�� � �P i �� �� �o I I � � I � ' ��x�� � ! i �`� - ---- -- - - - - I �` \V ' I � � � � i � � � � � z� I � � - �� - � _ - --. � ��+��„ Q e S 1�ad� Its r �l - l 2 I ._ - _ :s.'. .ur- .. �. �n ,�- _....,say._ .y,-. i • - - � .�'.� � _� _ h y - �� All I Assessor's map and lot number I *r ................................ THETO Sewage Permit number .:..............::...... ............................... �r Z BARNSTADLE, i < •( ..// House number .....: ?............ ....... ..................................... ...... V rasa / ..$ Op i639" TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .. �"�V°J r—M + rN............. .............................................................................. TYPE OF CONSTRUCTION . } ?c ( ;X�'ri ................................................................ ............. .i. ............... � ,£G........ `................19. �. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..............................................k \\..........� .�!....,�;e...................... ..o c..�........ ... c7��.. ............................ . . ProposedUse ....................................................................................................... ........ ... .Fire District ..p ? �` y f_ '� ZoningDistrict ........ .. .. ................................. ...... ......... . Name of Owner .... `' := .......Y-:..............e,A.�:......Address ...............1.aA n'a -V cs ............................................................. Name of Builder" .......� c.n• t. ..... ...... ?:. ....Address ................. ............................................................. Nameof Architect ..........................Address .................................................................................... Number of Rooms ....................................Foundation ..........1. ............... LA Exterior Roofing ' R Floors ........................................Interior \ " Heating t"tt X ................................Plumbing O Fireplace ............(6 ..........Approximate Cost ........ ,O'D c> ................................. Definitive Plan Approved by Planning Board ________________________________19________. Area ........:...�y��<?............... . ... . Diagram of Lot and Building with Dimensions Fee .. ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...... 1 ..........1!:,:`:�..e^................. r' SMITH, JAMES K. A=169-15-11 No .23716... Permit for .one„& 1l2 Story Single...Familv...Dwell nq................ Location Lot ,#,11,, 584,_,S}ctAnlcnet„ad. Centerville ............................................................................... Owner James K. Smith .................................................................. Type of Construction ........Frame .................................. Plot ............................ Lot ................................ Dece "er 21, 81 Permit Granted ............... ........... .....19 Date of Inspection ........../.......................19 Date Completed ....... .....�....................19 J,_ y_ THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) I I - m /r" ' "- IL DATA f � ., TOWN OF BARNSTABLE Permit No. ---------------'-------- 1 .AUn„< Building Inspector Cash ------------- OCCUPANCY PERMIT Bond ------- No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date 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. f ........................_............................, 19......_ ............................................................................................................ Building Inspector S i , }X.l,i ►� S9 YC •.-- -ti H 1'1 .1'.c�`1 =�h N� 71 Cl �1. a rl u'J • S ; ` -Lr7v51"lr�c�V mr<»r�y •.-1�:.��n =ar�1 t•_v\:snri .1r�_�wr:�ISrol ' a i ••,S�YY �]-1'11/�i!•31i0 �5-v cl Lori $ I t'iV-a y S11'1.1. 't 2fol•='I��C1y �1"1`,�'1 Q�21=11.51!9aa I> "Zt=j�)tvz YO J-� ;" •!� 1 �, • ' : :ei 3�i �0 511�aYY��ln���y ��v�'i.L�S cirtd f'f I�••��"�lil 1� � ��1�1; � .._. I , :.,� 3�V 7� �~ s �i, �� Ti MLPAA Ila t� 1 . I ... ..r ' ' ., j A �-., ,• �.I V { ' i; Q.�H3S��Y� CI�� _ .... 5 7 5CIL 6 .�m. MI ' �lQ �,� � '4 •�d'��NN1 �.. _.. I ///\\\vim// dtC�.t^St •.�\ ✓1�]!!L .07 i � + .�lI,6 I .. �(j. � _ ., trtj .i•,. iJ f ( '�-C � --Y`� �ij���.ir'�-; ar`�;i. ' I } �roa� • ' S�r�"� zto n�vsr7, r�„� . �.�.vz� r+op�.v,oV�r . JCL om N915a CL -i�V Lc)-L -� f . . ; ..� . . .. . N _• : . . ,ad'� Sty • 7.1 • '-1qS �0a1 =�5f� 7.6 � bre L17 { -nd•9 SEsv • oil �o�� 7+r .L �i �; OT i Assessor's map and lot number :.Ll./..../K?. . s. •� . Js '._ OF THE s C SEPTIC v SYSTEM Sewage Permit �iuinber ��:.. �5.1..�.............................. � �f A PoftE�ST s�:., INSTALLED IN dO_MPL4As � AR33TULE, House number ...... ........ a-•, ...rs'1J. WITH TITLE 5 9°0,,�1639.a�0i' ,.� ENVIRONMENTAL CODE �� °"pY TOWN OF BA#NS�Ag ����TI��t0. BUILDING ' INSPECTOR APPLICATION FOR PERMIT TO ............ �UGk... .......V'� `.�.n `\ ........................:.. TYPE OF CONSTRUCTION ..................�`°c7. .... C��MQ-............................................................... �. ............. TO THE INSPECTOR OF BUILDINGS: 4;t The undersigned hereby applies for a permit according to .the following inforamation: ` Location ...................�!-. .: ......... . .......:...5 t- .n .r1. .............\\...................... `�.............. ProposedUse .... .n ......... ......... ......................................... ...................................... Zoning District q.,�. ...................Fire District ........Can ...:..: .................................... Name of Owner .....���m. -a........ . .... ..J.�!5�........Address ...............� �/1{1.�1.................................................... Nameof Builder. ....... .). .................... .....Address .................................................................................... Name of Architect ..................................................................Address ..............: Number of Rooms ....................Foundation ............ qw e� Exterior ..... .........k..... ............ .Roofing ................��`� Floors A..Clln 5 .4?.�.�. Interior ..... Heatin .C .uS. .�'-_'...............................Plumbing ••..........�I�.J . ..�. :......................../......... r Fireplace ... ........C9 . .........................................................APProximate Cost . . ............................. Definitive Plan Approved by Planning Board __________________________19________. Area. .:....:{47. p. .......... ....� Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH / ' 4 I 4 1 , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and .Regulations of the Town of Barnstable regarding the above construction. Name . x .,......... ......... n^^. ................. SMITH, JAMES K. No'.2371.6... Permit for .... & 1/2 Story .......... .. ........................ Single .,Family Dwellin.V ..................... ...................................... ................ Location Lo.t...#.l1.,....5.8.4—.Skunj net Rd. ..... .. .. .... . ........... ................ Centerville ............................................................................... James Smith Owner ....................K............................................... Type of Construction ............................................................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ....D.P—Qembtex...2.1.......19 81 Date of 1pspection .....................................19 Date Completed /...../.........—tFz-/Z-- 9 9'?