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HomeMy WebLinkAbout0304 STRAWBERRY HILL ROAD �� r;: . ...: a eta "... ,•� ,.'��,.Ir- , ,� ,.- ,, I .. tr�,�� �'�'+�Y>,�,', �;, _"v',e1� � � ���,a r4'�.. a� 9�'z�`�. w` y , Iv Ok r,.� s-r ..'4,+. -n YAfG''.: q +'d �•7r Y i ti.,' r. � yt:' �1'' r t ��`r ��;::�. �� _ ,�d,A< �y{;; � � ��!1� v ifcc .��.:'y'"� 6 " 'F•. d fir. d�a '� t t�- �''1 i e. , i i A !l �• l ' , (,r f t a ( l' 1 V. t tt 1 s i, i t t, t fr t r b r ea `r Pr' A 1 x 1 i / a i is , t it 1 )i� `tea f i' „ r` , , V S j, )A 1 '=r t f k 1 h A, r 'srr t ,1 r' y 1� t it 4 ry F 4 r.' it 7 t 1` L�r d e` ;i d: •r .r r, "1 B' t: '4 )1 y ! 1 J d i t t� 1 � f 1 P 4 / er. S 1. iry Y ( I. 1. ( t •t r Ir. 1 3 4. 1' xf?. i y.. j'. t F ,r =1 f f' 1/ r t 1 > 1 1 �t r .l ( r' w f c/ 'A ) {V Z i l f (` I, 1: 4 r( f f, t 4• 7 i t f ' } r i t&" 1, .Ia • ; x / 4 r y: } .v1 f Y "t 1 b i i} r 4 M1 f•, } (1 , t a f F` nn r to {F r Y h A ` n +j 1 r It at Y :r: .t . r, r, e.. i>, s :.:- 4 -�; •C $ 'Ir sFbe''l f r -t 'ri'a ;N�:� ',IV .{"t 'I { a r ) i, 1 "8 : c 6' A f 6 ( :f r{ 'P i 1 •1 Y: k 1 i s IA c r f r a...:::-� _ t-# f.l. i55g'c..�kd.. ..ao�.Y...if ,z.5,.zl.,{{ .w 4,, t A:n L?c )J rs-dl .+,-.:� ,f.)n� z�i�:�-5� I ,vj�pl tt�'i �r_l 1Me lY' yPl ps} �.t, Wt fh •r.a:. .J._1 ... -. ,,..�. _€_F.✓ t_:�'� .�:��3d�.4r - pia ,�5�tx�._.:ic+r_�.� .,.. •:,, ...... n-- i "'--;`—" :. t—,1+, •a �as �- - ,.,: e.r .,. Town of Barnstable Bul 1 n _ rn> IPost This Ca:'rd So That it is Visible From the Street=Approved:Plans Must'be Retaine6 on Job and this Card Must be Kept. BAIMS Posted Until Final Inspection Has Been Made. Where a Certificate of Occupancy is Required,such,Building shall Not be Occupied until a final Inspection has been made. eri _ Permit No. B-19-1213 Applicant Name: STEPHEN F MATHIAS Approvals Date Issued: 05/14/2019 Current Use: Structure 2019 Foundation: ,�14 Date:Expiration 11 Permit Type: Building-Addition/Alteration-Residential Ex p / , / Location: 304 STRAWBERRY HILL ROAD,CENTERVILLE Map/Lot: 248-240 Zoning District: RB Sheathing: Owner on Record: MORRILL, PAMELA Contractor Name'`,-,STEPHEN F MATHIAS Framing: 1 F-7Address: 177 FULLER RD Contractor License- CS-035267 2 CENTERVILLE,MA 02632 {--„ Est Project Cost: $ 10,000.00 Chimney: Description: Build 1414 Screened in Porch off Kitchen side of house. Permit Fee: $ 101.00 ( Insulation: Project Review Req: i Fee,�Paid� $101.00 Date: 5/14/2019 Final: „ - Plumbing/Gas - Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by thi 11 s permit is commenced within six months after-issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of.any building and structuresshall be in compliance with the local zoning•by-laws and codes. • i Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. - - Electrical The Certificate of Occupancy will riot be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION,,_ Map Parcel Application Health Division Date.lssued �� ` t Conservation Division ` Application•Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board `o` - 1 Historic - OKH Preservation / Hyannis JV O � Project Street Address Sr¢ AA6eQ e-Y t-k q_. ZT> Village Pb4zs2�t ll Owner '(7WftN HL&0451, HA-TW14- Address!XPA Telephone 5afb- S�oZr o3s3 Ct�rl�1�2.V V'�IA Permit Request lLb �f rkEk.8eb k C)Jk Square feet: 1 st floor: existing propose 2nd floor: existing,proposed _Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1 M Construction Type IZ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ®-" Two Family ❑ Multi-Family (# units) Age of.Existing Structure Mo Historic House: ❑Yes R-No On Old King's Highway: ❑Yes &No Basement Type: O- ull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) C) Basement Unfinished Area (sq.ft) �1'� Number of Baths: Full: existing 2.. new (5 Half: existing O new O Number of Bedrooms: existing Knew . BUILDING DER Total Room Count (not including baths): existing Co new C'�AP�irt fIQgrj99oom Count Heat Type and Fuel: &-G s ❑ Oil ❑ Electric ❑ Other_ N-OF BARN STABLE S ABLE Central Air: des ❑ No Fireplaces: Existing New 0 Existing wood/coal stove: ❑Yes 9-No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: xisting I I size Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes Flo If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number ,4509 71a-1-- 01 U3 Address C �F3LXLt�-f License # CC.? ` 011&S2-6`( 6Aa4XPIV Lux1 , 0%A9 31-- Home Improvement Contractor# ko Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT I i h E WILL, T KEN�. ��1G4� SIGNATURE z DATE I >q FOR'OFFICIAL USE ONLY APPLICATION# -DATE'-ISSUED MAPY-PARCEL NO. ADDRESS VILLAGESOWNIER�,' 4, LJ DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL Z. -D GAS: ROUGH JFINAL FINAL BUILDING al DATE-CLOSED-OUTS ASSOCIATION:PLAN NO r " Tit Corrtmonwe�tlt of. Irsssdchusetts , Deparfinent of lit du N. Office of.itvesdgarions 4 tree f i on S dsh n ., 600 FY gt . � rs�ww:mr�ss.gav/dia� , .� •�. S orkers' Comps nsadonInsarance davit: Builders/Contractors/EIectricjarLs/Igmberg Applicant)_n.formatzoii � Pieast: Pant Lehi. Na r, (Busi.ncsglorgan tion/Lndividuel): fmc r �.�► • Address:�� � l�a,.�$�� � • • CitylStafe/Zrp� c?7sU�9! �7-6 phone #" Arc you an employer? Check"the appropriate boz; Type of�pi oject(required): ` 4 .❑ I'am a general contractor and 1 I.❑ I am a employer with 6.'tcw constru tl c 'on • �• * ,� _ ha•v�hired the sub=coniractars cm to ccs (hill and/or art-time . p y P 7. Remo deling listed on the attached sheet., • � ❑ 2"❑ I am a;colc proprietor or.partncr Theso'sub-contractors have g, [] Dctnoliiion ship and ba.yc no CMployces •: employees and have .vorkc'rs'' 9 B g addition ' working for me in any capacity. ; comp. inset ance.t a _ [No workers' comp.insuranoc •10.�]°Electrical rep airs Oj addi6U oqudred] We are a corporation and its °'` 3,L J i am a homeowner doing all„worse oEccrs bavc exercised their ; ' i"I L[]Pltunbing repairs or additio. myscLf. [No workers'.co�. - r right of'ez.emption per MGL 12•E] Roof rcpa.irs c; 152, §1(4). and'we have no ' iner,rancercgtiired]t 4 - - 1 0-. 13.❑ Other cmployte's. {No workers comp, insumnce rcgwred] t. *Any applicant that checks box{fl must also fill out the section below ahovring their workers'eompcns--4 policy inforrrratton: t 14Dmtowntr*v who cubrM this sgidavit indieahng tficy an doing all work and that hits outside conttaLtorS inusl xubtnit a nrsv a�davtt indicating sveh.' tContractnrs lint check this box mustatiaLhcd pit additional shcct shouting the name of the sub�onhactars and shin wbrthcr ur::not those m6tics l avc m-nployecs. Lfthc subontr.=torr have employccd,they muti provide thcr � workers'comp.policy number, x 1 am an errzpfoyer ticni is.providrytgworkers' compensative insuraricefor rrty employeesY BeXatV is the paCiry arid job site' ' inforrnaliort. - .. `� � �� . � r .�,. • Insuzancc Company ». Policy# or Sclf---ins, Lic.#.� {;, Exptrafion at,: Job Sitc A°ddress: City/Statc/Z>p. Attach a copy of the workers' compensation°policy decla-ration page (snowing the policy number,aril expiration date). Failure to secure covcrago as requirad under Suction 5A of MGL c.J 512 can Iead td•the imposition of criminal penalties of a fu Eno tip to S 1,500,D0 and/or ono-year 4risonment, as Well as civil penaltics in the form of a STOP WORK ORDER and 2 Of up to $ZSO.DD a day against the Violator. Be advised that a ropy-of this statcmcritmay bc�forwardcd to the Office of lavcsti atiow of the bIa for ing r mcc covers c vcrif cation. " d pertaities ofperjury dial the irrfo rmatioti provided fj der Me P;�rns--alormatioti providedaba've'is true and correct �. "Da v Si a.turc:. tcI •.�: Phone —7�� Offtclal use only. Do not write inINs area, to be completed by city or town official City or Town: Pernvt/Licenge# Jgguiog Authority(circle one): I. Board of Health 2, Building Department 3, City/Town Clerk 4. Electrical Inspector 5, Plumb'i�g Inspector 6. Other _ T Information ,and InSt 'uct Ions d Massachusetts Gcneral Laws chapter 152 requiires all employers to pro e ice ofsanoth r ndc hroa y c ntract of hi r, pursuant to this statute, an erraployee rs defined as ...every person vi express or implied, oral or written." • � corporation or other legal entity, or any two or moze Aa em'pjoyer is dffmcd as "an individual,partnership, association; up of the foregoing engaged in a joint enterprise, and including the legal representatives of a dce caslod cmplH w Ycrthe arinershi association or other Icgal entity, employing y receiver or Blister, of an individual, P P, upant of the owner of a dwelling house having not more than three apa�nanccats�onstructi neonccpa�-'o k on such dwelling house dwelling house of another who crnploys persons to do rnaun , or on the gzo�inds or building-6viijl-nant'thereto shaLI;not because of such employment be deemed to be an employer-" tcs that'*eve .,stafe'oc local licensing agency shall jrithhold the issuance or MGL cbaptcr 152, §25C(6) also sta uY for"r=eaevyal of a License or permit to operate a buslness�oo tcorni�nee�rWdthe rnsvranceco erage rtequiredY $ , . applicant who has notproduced•aeceptable evidence f p Additionally,MGL ohapter 152, §25C(7)states 'Neither the commonwblcAI tcYidc bOtn c of political �Zth the iinzu—cc enter•imto any contract for.thc performance ofpublic work��� P zcquirc;monts of this chapter have been presented to the contracting authority. Applicants the boxes that apply to your situation a-nd, if . please fill otit the workers' compensation affidd�sc )acntd y, bphonc ttccEa along with their ccrEScs.tc(s) of ncccssary, supply suub-contractors)namc(s), with insurance, Limited,Liability Companics.(LLC) or Limited Liability Partn rsh ps (J an)L�or0 Clp does es othcr than the vc mornbcrs or parincrs, are not required to carry workers compensahon ins employees, a policy is required Bc advised that this affidavit may o e s nd date thcttcd to the laff�dcp a�t nt`lbo affidavr Of tlshould Accidents for confirmation of insurance coverage. Also b 1;u be returned to the city or town that thc•application for the pdin it c law o cis o marrc rcq cad to obtain acwor�kocs' of Industrial Accidents. Should you have any questions regarding th y compensation policy,please call the Dcpaalm•ent at the uurgbcr listed below. SrIf-insured companies should enter their self insuranro license number on the a ropriatc Iine. Clty or'f'owR OtIlclais Please be sure thatth.o affidavit is complete and printed lcgibly.uTho Department has provudie ardi g thcappli antes of tho affidavit for you to fill out in the event therOfff which vrill bosusod as as tions rcfcrcncocnumber. Lu addition, an applicant Plcasa be suuc to fill in the permit/liccnsc number that must submit multiple permit/liccnse applications in any given year, need only submit onp affidavit indicating current policy information(if Accessary) and under"Job Site Address" tho applicant should write"all locatiionsr tovm may be � d�to this or town)."A cbpy of the affidavit that has been officially tazape :tits or hamarkcnsb s A nowity oaffidavzt mustbe Shed out each apphrant as proof that a valid affidavit is on file for fu p year.'Whero a home owner or citizen is obtaining a liccus e or pprzmt not related fo any business or commercial vcnhue (i_e, a dog�icenSC or.permit to burn leaves etc.) said perspA is NOT rcquucd to complete this affidavit operation and should you have any questions, Too Ofe Of would h1c,to thank you in advance for your co fiic pleaso do not heSitate to give us a call The Department's address, tclephone-and fax number: ► ` The Commonwf-,4th ofMassaGhI=trws pe apt of zn.dustz 4 A:cciderits Office of 11tvest.g t o•6s 600 Washim�toa Strict Boston, MA 02111 T6; # 617-727-490.0 cxt 406 pr 1-8'77-MASSAFE 4 Fax# 617-7727-7749 Revised I1-22-06 www.rnass-gov/dia Commonwealth of Massachusetts Division of Professional Licensurt Board of Building Regulations and Stzndards Constqu16111 -,fib rvisor I . CS-035267 Imo, ires: 08/26/2019 STEPHEN F MATH.IAS!'&14 t y 'xh 304 STRAWBERRY HILL,IR•,yryOAD GENTERVILLE MA 02632', N` Commissioner et i on� f Regu &BusinessTOR umays CONTRAC Of f ConseMEfice oIMPOVENT HOME ; Individual T�pE� ExEx I Re Istratio � 1210812020 n Nv-,S n t?r AND REMODELINGSTEPHENMA iNSIM,jpT10NS DIBIA GENT El ,11 MA SAD STEPHENWgERR`l^p26�2 Undersecretary 304 STRA I 111 CENTERVILLE,MA Con fiction Supervisor Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed - space. I Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For information about this license Call(617)727-3200 or visit www.mass.gov/dpl Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 1000 Washington Street-Suite 710 k Boston,M 02118 l L oNo4tlidwithout signatur r r LO 7' 6 f 100 00 1 S78 56'�0 �- 24.2' (JI 4-1- - - - ,, HSE K304 -_- _ 24.2 +gip{ LOT 4 s zv Qz co l LOT 5 s �z S89,08'20 91, 101. 87' " RFc 7,OAfE- ".RE" This MORTGAGE INSPECTION Plan 9 For FI )OD ZONE- "C" Hank lh OnI TO W N: _WEST HXA-NUI-SPA _..._ _..__ RL:C.T IST I�Y 0 WIC E � JG'171:_!'FI E6'��a,�� 1— -- --BL Z'c:R: Ti _'HF ATf �05 -- =-- -- — PLAN REF: _1�34�'-' `i - -_ _ SCALE. ?U — - — 1" - -F'I. i :r{I IZEEY CERTIFY TO 'S1h YqNKEE SURVEY THE BUILDING SHO"W'N ON THIS PLAIT IS LOC ,TED ON THE GROUND AS CONSULTANTS 'i PALL. SHOWN AND THAT ITS POSITIO'4 DOES _--- CONFORM `� A. TO THE ZONING LAW SETBACK REQUIREMENTS OIL THE � <'?I I� .:91TilE-w 11 40I3 (SUITE 1) ^O'WN OF b'9-�N.�'TAf31_E _� - __.---------._.A?�T� 'IIit1T � .l � _, i20:yii 1.,r INDUSTRY ROAD T N07 ...... LIE' WITHIN lI SPECIAL I'I L)UI� Ii 1ZAK1� i �>��: i�.�R A9ARSTONS MILLS, MA. 0:..64E3 AREA AS SHOWN ON THE H LV D MAP DATE D—Z, � � tv� .. 9� TEL 428-0055 c U. a,`. ti 50001-0008 U ;, � M�� FAX 420-5553 THIS, PLAN NOT RSADE F RGi14 AN INSTRUMENT Ym n SURVEY, NOT TO BE USED FOR. FENCES, ETC. 17255 BI�' TA tI ME RP,4�, PI - --- r P`o,t►,Ergti . e Town ®f .rnstable NW �� BARNSTABLE.MASS. Department of Health Safety and']Environmental Serviees o i679• `0m _ Building Division 367 Main Street,Hyannis,MA 02601 Mice: 508-8624038 ?ax: 508-790-6230 1 PLAN REVIEW Owner: S n QA Map/Parcel: 4 8 Z 4 Project'Address: 0 4 +'r c� !o Q;v L v) Builder: The following items were noted on reviewing: I �3 QVVt v r n o Reviewed by: Date: �' Q TKE Regulatory Services P Thomas F. Geiier,Director Building Division wur.A v� 1 a`�� Tom Perry,Building Commissioner A .200 Main Street, Hyannis,MA 02601 www.towmbarnstable.ma.ns Office: 508-8624038 Fax: 508-790-6230 Approved: Fee: 442`,s -O Permit#: I Y HOME OCCUPATION REGISTRATION Date: Name: J la'E �`l�( .�s� Phone LV Address: $ � j Village C7 —�l I Cam ' Name of Business:( 1 litS` R- 1 D S. Q�i t n9� .�.�Ste_�1•�vS $ hh �� Type of Business: INTENT: It is the intent of this section to allow the residents of the.Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance;provided that the acti<2ty shall not be discernible from outside the dwelling. there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration«ath the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: a The activity is camed.on by the permanent resident of a single family residential dwelling unit,located-vidnia that dwelling unit Such use occupies no more than 400 square feet of space. Y There.are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical disturbance,heat,glare,humidity or other objectionable"effects. u There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard: . a There is no exterior storage or display of materials or equipment. Y There are no commercial vehicles_related to the Customary Home Occupation,other than one pan or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tines,parked on the same lot containing the Customary Home Occupation. No sign shall be displayed indicating the Customary Home Occupation If the Customary Home Occupation is listed or advertised as a business,the street.address shall not be included. • No person shall be employed in the Customary Home Occupation Nvho is not a permanent resident of the dwelling um* I, the undersigned, ve c agree with e above restrictions for my home occupation I am registering. Applicant Date:Al L3 1 i Houieoc. oc Rer.01/3/08 t YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give YOU permission to operate.) You must first obtain the necessary si,grratures on this form at 200 Main St., Hyannis. Take the completed form to the To,:vn Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 ;Town Hall) and get the Business Certificate tliat is required by law. DATE: 3 Fill in please: WN t m � APPLICANT'S YOUR NAME/S: BUSINESS YOUR HOME ADDRESS:_ S d - �c YL,�t�L�3 " TELEPHONE # Home Telephone Number �� E, NAME DF CORPORATION ' � ` NAME OF.NEW'BUSINESS( 11L�' lta�5.US1?�u.?�1t��J TYPE OF BUSINESS' C'�unD�"r .3^�S�ca--�DNC, g �, IS!,THIS AHOME OCCUPATIONS YES NO 1'''�-�� g � (L�•�tOflt •A ' ADDRESS OF BUSINESS �O Sl L �'L�ILf .4:�%�' �`L cA� '�'��MAP/PARCEL NUMBER (Assessing] '. When starting a new business there are several things yob must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING C MMISSIO R'S O ICUany This indi 'dual h e n fin`fo m dr it re ui a ents that pertain to this type of business. PLY WITH HOME OCCUPATION MUST COM A on d ignatur * RULES AND REGULATIONS. FAILURE TO C MMENT MAY RESULT IN FINES. 2. BOARD OF ALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS LICENSING AUTHORITY) that pertain to this e of business. This individual has been informed of the licensing requirementsp type Authorized Signature* -COMMENTS: TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 2A00 Parcel 7 ,,,. . Permit Health Division -. 3 ��� �' �.1� .,, Lf Date Issued j C) 5 t Conservation Division fy a; 18 Application Fee Tax Collector Permit Fee a Treasurer `� VIS1 r� E KISMO SEP M SYSTEM Planning Dept. 1LIM ffW'Td` #�OF BEDROO Date Definitive Plan Approved by Planning Board 9( Historic-OKH Preservation/Hyannis Project Street Address Z-,TP_AX4 G4vu, ED Village Owner��REIA �''1t 1 AMOZ Address 15A<Yr Telephone Permit Request A-0 D 04 -U 1.�AA� PAC'( . 54"P ®lit AP-0K(,I VdAy, ., 92' �CL �" Square feet: 1 st floor: existing ( proposed 110-00nd floor:existing �540 proposed b Total new lbo Zoning District Flood Plain Groundwater Overlay Project Valuation �tT Construction Type D Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family 9" Two Family ❑ Multi-Family(#units) ` Age of Existing Structure Historic House: ❑Yes *116 On Old King's Highway: ❑Yes Q-ftr ' Basement Type: &<11 O Crawl O Walkout ❑Other Basement Finished Area(sq.ft.) O Basement Unfinished Area(sq.ft) L�o Number of Baths: Full: existing new 0 Half:existing new Number of Bedrooms: existing_- new Total Room Count(not including baths): existing new O First Floor Room Count Heat Type and Fuel: f9-G`as O Oil O Electric ❑Other Central Air: ❑Yes BlNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes.' 3146 Detached garage:O existing ❑new size Pool: ❑existing ❑new size Barn:O existing O new size Attached garage:❑existing ❑new size Shed:O existing O new size Other: Zoning Board of Appeals thorization ❑ Appeal# Recorded O Commercial ❑Yes No If yes, site plan review# Current Use i 14, tli6 Proposed Use �A Q(4,4 4a Q-Cb l ( f BUILDER INFORMATION Nam it_ Telephone Number Address �30 Y License# - — I (L�� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO r SIGNATUR - DATE FOR OFFICIAL USE ONLY 1 � PERMIT NO. , `DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: l FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ^ PLUMBING: ROUG FINAL' GAS: ROUGH FINAL , FINAL BUILDING 0 03 tr DATE CLOSED OUT V2 C3 t ASSOCIATION PLAN NO. n; 1 �r 4 _ The Common)vealth of Massachusetts Department of Industrial Accidents 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit-General Businesses name address _ }-11��� city�� U i Lj state: 1 , ziv: ��_v-tone# � work site location(full address): ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an em to er with e i loyees(full& art time). ❑Other LJ I am an employer providing workers' compensation for my employees worldng on this job. company name• --- address: •< . a. . phone#: . insurance.cot I am a sole proprietor and have hired the independent contractors listed below who have the following workers' compensation polices: company name• `` '' address c1ty' phone insurance co. company name•: : - --- -- address phone#' insurance eo. :: .:. olicv Failure to secure coverage as required under Sectioa 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 civilpenalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify der a sins and penaltie f perjury that the information provided above is true and correct Signature - Date l AA •� Print n ' 9 Phone# F.•- officiA use only do not write in this area to be completed by city or town official city or town: permit(license# ❑Building Department ` ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office t ❑Health Department contact person: phone#; ❑Other (revised Sept 2003) F. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association,corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confimnation 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 pernrit/license number which will b�e used as a reference number. The affidavits.may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents BMW of Im msugadons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext.406 opstie roy, Town of Barnstable Regulatory Services Thomas F.Geller,Director MAN� saxr�srnsr�s, , A 1 . a��� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-86Z-4038 Permitno. Date AFFIDAVIT HOME JMPROVEMNT 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 oth with er requirements. Estimated Cost 15 070 Type of Work: Address of Work: Owner's Name: `7l Date of Application: I hereby cerfify that: Registration is not required for the following reason(s): []"Work excluded by law []Job Under$1,000 ❑ uilding not owner-occupied EgOwner pulling own permit Notice is hereby given that: OWl`TERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMP G GUARANTY FUND F�BERM 142A. ACCESS TO THE ARBITRATION PROGRAM SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration-.o. OR Date Owner's Name Q:forms:homeaf ftv ' 78b CMR Appendix J • , Table JS=b(eantiuued) presetlp &e Packages for One and Two-Family Residential Buildings Bested with Fossi!Fuels MAXIMUM MINIMUM Wall Floor Bsscaeat 31ab 'Heating/Cooling Glazing Glaring ceiling perimeter gquipment Efficiency, Area'('/e) U R v -value= R-vaiuel R-value` alue° Rwa s R y�ete Pacica3e 5701 to 6500 Heating Degree Days' Nomta! 6 Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 l9 10 6 85 AFUE s 12% 0.50 38 13 19 10 Normal N/A 38 13 25 N/A .— --_-6 _._._...—Normal U 15% 0.46 38 19 19 10 NIA 85 AFUE Q 15% 0.44 38 13 25 N/A 6 85 AFUE W 15% om 30 19 19 10 Normal N/A X 18% 0.32 38 13 25 NIA ____NIA Normal y 18% 0.42 38 19 25 N/A 6 90 AF UE y 18% 0.42 38 13 19 10 �AFUE AA 18% 0.50 30 19 19 10 6 1. ADDRES S OF PROPERTY: 1 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: ` 4, %GLAZING AREA(#3 DIVIDED BY#2)' Q11L) 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table AIM I Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value requirement. ft=of decorative glass may be excluded from a building design with 300 if of glazing area. For example,3 =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 ceiftg.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R 38 in of cavi insulation and R-38 insulation-may be substituted� 'or-R-49-vnsulahon: Ceiling R-values-represent-the sum ry----- -- insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between e ventilated portion of the roof. � the conditioned space and the v p �• insulating sheathin if used . Do not include cavity insulation plus ins g g( ) 'Wall R-values represent the sum.of the wall c ty exterior siding, structural sheathing,and interior drywall.For example,an R-19 requirement could be met EITHER R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to by ry - wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal frame construction. 5 The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must mcez 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 5.• If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest .efficiency must meet or exceed the efficiency required by the selected package.. For Heating Degree Day requirements of the closest city or town see•Table J51Ia NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 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 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 I RESIDENTIAL BUILDING PERIVIIT FEES APPLICATION FEE , New Buildings $100.00 Residential Addition $50.00 3Q, Alterations/Renovations $50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE lQo square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x:0041= ACCESSORY STRUCTURE>120.sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch x$30.00= (number) . Deck x$30.00= (number) Fireplace/Chimney' x$25.00= (number) Inground Swimming Pool $60.00 - Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee i Z` 122 Proicost. ,ev:063004 1NE t 'down of Barnstable P 1, ]regulatory Services _....._.. v .. �.r_... .:..,..T.h . . . .. ..... »• saxntsTna�, » .. -.." ..., . .• .. _o�t�,s..-F;-:�.eiler,•Dir•.ector. : -. ....�__..__ .. �... _. . _-._ -,.. .... nsass. - . Building Division "-Toriu Perry;B"uilding"C-otninissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us - Office: 508-862-4038 ::....... • � - � - ' - � -' � - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 2 Please Print DATE: JOB LOCATION: 5Q�L o�p_w �hy (2.rD numb6 street village "HOMBOWNER": �1R-I AJ Z'D �� �( J S name ^home phone# work phone# CURRENT MAILING ADDRESS:, �I.DCtarrPjGY� kLt-, ez 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 pot be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building•Official,thathe/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 Tomm of Bamstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir n igna 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 persons)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:homeexempt f L.F.GIAMPIETRO ARCHITECT, P.0 Registration# 220 Main Street, Falmouth, MA 02540 7124- 1030 Mathias Res.,304 strawbry.Hill Rd., Living Room Cieling Beam 131 MA Date:3/04/05 BeamChek 2.3 Choice W 10x 33 A36 Wide Flange Steel Lateral Support at: Lc=8.4 ft max. Conditions in., Min Bearing Length R1= 1.1 in. R2= 1.1 in. Data Beam Span 18.5 ft Reaction 1 4190# Beam Wt per ft 33.0# Reaction 2 4190# Beam Weight 611 # Maximum V 4190# Max Moment 19380'# Max V(Reduced) N/A TL Max Defl L/240 TL Actual Defl L/918 Attributes Section(W) Shear(in') TL Defl (in) Actual 35.00 2.82 0.24 Critical 9.79 0.29 0.93 Status OK OK OK Ratio 28% 10% 26% Fb(psi) Fv(psi) E(psi x mil Values Base Value Fy 36000 36000 29.0 Base Adjusted 23760 14400 29.0 Adjustments YP Factor, Lc 0.66 0.40 J Loads Uniform TL: 420 =A q. .z No 29 1 NA OF V Uniform Load A 0 0 RI =4190 R2=4190 SPAN= 18.5 FT Uniform and partial uniform loads are lbs per lineal ft. BeamChek automatically added the beam self-weight into the calculations. �� 0 � �� �� �� � � �� E _ ? ,� ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel ;-7- y© Permit# ' 69 7 1 ` 3 03 Health Division to S SLtDe tw ' Date Issued Conservation Division i�� �T Application Fee `7 UD Tax Collector�i'C�� Permit Fee a Treasurer SEPTIC SYSTEM LUST B Planning Dept, INSTALLED IN COMPLIAM WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AM Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address d I h _" 4A ti7 Village V I UL Owner ��--t--[ I Ac3 Address I-112-1 Telephone Permit Request-� �� lS it�1�, x � I `��1» .�`�Ld h� Sf � �C L—� 1 I a,L L ;B.=il e.1 �l ►�1�L t�[,C� u—s[? A--% ram„ Hgt, n_ o ►mot gDo tLi ul mete "f KLIoiv-1 Square feet: 1st floor: existing- `�C- proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay �~ Project Valuation 'tam Construction Type k, 9 b Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting,documentaf en. t , I `,, ca > Dwelling Type: Single Family �wo Family ❑ Multi-Family(#units) o 70 Age of Existing Structure Historic House: ❑Yes B-Nu-- On Old King's High ay: ❑Yes Pde-- .. CO Basement Type: -R l Ll Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) ' _ Number of Baths: Full: existing new Half: existing new Number of.Bedrooms: existing 3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: W-6`a`s'--❑Oil ❑ Electric ❑Other Central Air: ❑Yes EH 5 - Fireplaces: Existing New Existing wood/coal stove: ❑Yes 644e--, Detached garage: ❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size- Shed: ❑new size 2.0 Other: Zoning Board of Appeals Authorization ❑ Appeal# .. Recorded❑ 9 Commercial ❑Yes . t'Zo—If yes, site plan review# Current-Use _ R - _ = - -_- Proposed Use BUILDER INFORMATION Name Die Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 4.1 SIGNATURE DATE ' S FOR OFFICIAL USE ONLY 9 PERMIT NO. DATE ISSUED MAP/PARCEL NO. ' z ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION/ FRAME INSULATION J FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH; FINAL FINAL BUILDING DATE CLOSED OUT « c ASSOCIATION PLAN NO.- i The Commonwealth of Massachusetts Department of Industrial Accidents office ofinWestfolions 600 Washington Street Boston,Mass. 02111 Workers' Compensation.Insurance Affidavit name location ci sit A phone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity [] I am an employer providing workers' compensation for my employees working on this job {�. c s-mt'�.�� E�7+!� ..-`�';�;l�.C"" •krT6'd E,�'T�•. ,E.,:: fit ;,;L,Fw�sa'a rlf. -,�`�'ry M�+ c -..y`�L� �L. r - f'y''g`-�w�3.;;C,t'���,^'��"�����-:`' G. S:r S 1S�'lI- .a c�-, ..c uwC +a loin`an tF�U.Z. iw r s. y^°*.�• ��.tc.. :,,,': nc:��E"9>a R e. (. 4 y;...r +,: ..s. �_t+.isl�f:+.P-th r j `U,. e"'r"Ff:b=-.r� �.� ✓ 1 tv` r�a:;�'Y•r1V P ti''rr' )�, �.S '�txi..f4't a}-Y"rf { z - t�t•*q}.s fc•"4'� :�f e.iv,�E.Di'�''z'4..7i.' ,�,'�tl. E '��s� .�•zr.�.r! x•F�..�"'A.r` � �r,.gw l..- 7 -:h,a '?S ��.31.. -r �y 'r '' t 7..�'�t?,r*r��.� � ����''��. (address :�.�•.�� ,�a� � �� l F rya �� iMug 2 s 5i4 �.- s�`..,`• j�• °7': r', ' ,�,i 3 fi$ 4 f' f� rt r itir!,c=,.?,rxS `.ri -k.S. tt A.C`^•t i ' 7 Y ��.++. �'.`._. x or "� §' t•T .�..:y 4 s a„ ^��x ,M �y.. ,p � �''k �.' [] 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: 1 c } x.f "u?F' y - tY.rn• a!n o ,t, f"4Tvni t r y. U2_.. 'Y i n a ld h- y' ,`r..a}�,p"tiS��7..�;"xc l.+y'l.�s ry�. ! 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H�+�' s"r•'�`t*�.� �a..° ivY,-v'4tl' Er'�i2 9 i'„'' d' tr^ taddT�ss. �� �� � t• —ve r` L-i„:Y' aY t r V '.',nlp x}h F" •a.a rN' l.s'.+.M f �".s r.-t iS'd �S°t°^'Y'�tea' .'+: S.!S F 'e a."�.' ,y• ,rz„, Ar.,!i't' �+. 1„+�t, , x '"Acv ..ts M xJ'.g •f'fiwi �.t,:,t, -+,'ft`P� �/. n ,a p ..n x�•$. T"aF >! 4 ., y -} A I':Y t y '-y 7-•s A-x•-u' .'+,t y r. k1's §�;'�S „ a ..,-�2�t�, i .r+ r a:. y s! ,. ._ e:w,:�t ^&sra �kff by w S��"J�,L+ ,`' � 2xr'�`a `^a7. '. a `y <;?. ..!::.. dllQr 3,�.#•...M'..S-:.,+fir, i .c:.. 'ry 4.�'t'x'��;r'r.4"h',`�� r 1�3.'._4-"...+«'3 9�:�:' .ti Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against 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 u de a ains and penalde f perjury that the information provided above is true and correct CS Signature Date LDS Print nam Phone# official use only do not write in this area to be completed by city or town official city or town: permit/license# FIBuilding Department [)Licensing Board n check if immediate response is required []Selectmen's Office []Health Department contact person: phone#; rl0ther f (revised 9/95 P!A) 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 names address and hone numbers along with a certificate of insurance as all affidavits may be supplying company p g 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. WE Eli E City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406 Town of Barnstable ti Regulatory Services L BAaxsrUM ' Thomas F.Geiler,Director KAM 9`bpr16 1;. A � 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: &V_,_ALL-L_ W l Olk f 5"- Dv-Z— Estimated Cost ' 2.xxz Address of Work: u.. �� Owner's Name:_-< �/ 1-i Date of Application: �L _ 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 MUROVEMENT 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. O �` Date Owner's Name c 7 0 CMR App..U.J Table JS3.lb(continued) prescriptive Packages for One and Two-Family Residential Buildinga Heated wins Fossil Fuels MAXIMUM MINIMUM GlazingGlazers Coiling Wail Floor Bawment slab Heating/Cooling Arcs'(•/.) U-valsus R-value' R-value' R-values wall mewEquipment EfEcirncy' ing ffi R-value R--value package I � 5701 to 6500 Heating Degrte Day-0 6 Normal Q I2% 0.40 3S 13 19 10 Nomal R 12% 0.52 30 19 19 10 6 g 12•/. 0 50 38 13 19 10 6 85 AFUEN/A Normal T 15% 036 38 13 25 WA 6 Normal U 15% 0.46 38 19 19 14 85 AFUE y 15% 0.44 38 13 25 N/A NIA 6 95 AFUE w 15% 0.52 30 19 19 10 Normal x 18% 0.32 38 13 25 NIA NIA Normal y 19% 0.42 38 19 25 NIA 6A 90 Normal Z �86% 0.42 38 13 19 10 AA 0 50 30 19AFLIE 19 I0 6 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 16t)A 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA,-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ORGY REQUIREMENTS ARE AVAILABLE. ASK US FOR TIES BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table ALM a Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 f of decorative glass may be excluded from a building design with 300 f of glazing area. Z 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 ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation.thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. Wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an A 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 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 elebtric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see-Table J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 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 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 CFTHE Town of Barnstable Regulatory Services aAxxsTns . ; Thomas F.Geiler,Director MASS, Building Division rEor a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 0-3 JOB LOCATION: . numb& street village "HOMEOWNER": H&y�jjed name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm,structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The 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 require e igna 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:fomms:homeexempt �oFINE lo Town of Barnstable *Permit# 59 9 Expires 6 months from issue date BAMSTABM * Regulatory Services Fee �S yQ MASS. U 1639. �� Thomas F.Geiler,Director Arf-"A°�a Building Division Peter F.DiMatteo, Building Commissioner 200 Main Street, Hyannis,MA 02601 . Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number G Property Address G7 W Ac S, EF<e_�sidential Value of Work Owner's Name&Address � �1��� t—tA 1I"A F 5 Contractor's Name Telephone Number��--��2— d��`'� r` Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance , Check one: ❑ I am a sole proprietor C . am the Homeowner � 100,E ❑ I have Worker's Compensation InsuranceoQ C 6 Insurance Company Name 6P Workman's Comp.Policy# Permit Request(check box) ❑ Re-roof(stripping old shingles) ❑Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Re ement Windows. 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DORMERS—NO PERMIT REFER ,•• « : . >' • �«>. � �._> E TO R.S. S_ f- Ce,.ti• D `T7 e 4 e G �� G h, ram. .— r L U v t r[' 0 ,0 SHED REGISTRATION location of shed(address) property owner's name 112� size of shed gna a date Old King's Highway Historic District Commission jurisdiction? 1� THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN shed LOT 6 9 00 00 S7g°56 0 24.2 -_-_--_---- o ca -HSE c #304 p 4. — — — - 2 - — - LOT 4 39+ DEcx LOT 5 b S89°08 20"W 101, 87' ZONE- "RB" This MORTGAGE INSPECTION plan is For FLOOD ZONE.- "C Bank Use Only TOWN: ffE= HUNU 'QE1 —_ REGISTRY OWNER: !D1&—L. BOAC!— [TEED REF -_-66,24Z41, .— --BUYER: PLAN REF: -13,1 59 _ _ _SCALE:1"= _20____FT. f HEREBY:' CERTIFY TO ��LYlf�11V�TJZ.QF_I' _ ,�^ �, ,N YANKEE SURVEY ___THAT THE BUILDING: .>HOWN ON THIS PLAN IS LOCATED ON THE GROUND AS ' Paui `�: CONSULTANTS, SOWN AND THAT ITS POSITION DOES _- _ CONFORM R. -" 0 THE ZONING LAW SETBACK REQUIRFMENT'S OF THE " 4OB (SUITE 1) �EPi 2098 INDUSTRY ROAD )WN OF"�--RJL?-YSTA,BLE_________--_-- --_-__AND T'f-IAT ^+ i2Q9tl �� 'j ` a " MARSTONS MILLS, MA. 026y48 1 i' DOES_ IV�OT ._ LIE. WITHIN '1'11k; SPECIAL F'1001) }-1:1ZARD � ;r�T< <��..;� REA AS SHOWN ON THE H.U.D. MAP DA'Fla_�;Mf ____ 1y�;! ;`�Jr TEL: 428-0055 m . i. a eI 250001 ODOff D • `�`�- a"` FAX 420-5553 THIS PLAN NOT MADE FROM AN INSTRUMENT 17?55 BJS' F'AUL 4 UIFRiTHEV PLS — S l;t'FY NOT TO BE USED FOR FENCES, ETC. �T 6 i tc ' .. � � ��� ��}�E'� � M,•.,x�,, ,1++XR' 7x�:.'^ti..'-m.:?. w1' �rt.•.e'�c'''"' BUILDING DEPT APR 1 1 2019 . 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