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HomeMy WebLinkAbout0003 VALLEY AVENUE mw. 7 r' f,� -rNf.r�'.rr' t ,.. .r+.4 �t nt ,rye, .� 9 •"i',.: � �N,�,t:,�° ,y., ,,. wn. r Ju - ,t �+�' ,u. a-. k:. r ,...hr; �:.. r 46 '�J. � M1�,►r 02. x0 i,;.... `. W G T n .,,}�,!)'� ° �A` a f,.,Fry `,e a l�' ..tr ii�yp. J'''.. �i t:. 7 IFY kF Q' �1 .x6� �I � ..if GrrA, r .1 L } u fr + , th E Nov f '`mot z x', r WQWr? l t e ar ftf F: spy kil Any � vav h'SZ4 ;F 3 now , NO o tr s t" ? c TQWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel C�l4(,f Application # Health Division "IAIQU Date Issued !l—Zr Conservation Division V-01"' 7�,. Lle10 6, ��� _ Application Fee Planning Dept. toFQ � � Permit Fee q Date Definitive Plan Approved by Planning Board R�STA� Historic - OKH _ Preservation/ Hyannis ) Project Street Ad ess, 3 VA LLt-Y AV[= Village Owner _—Tu D i i 4 iMAVk` �SsEk) Address V,4LLEY �C✓ ( 1�'i�R�a�l- Telephone ' J Ic( - 73 51 Permit Request J>✓ C9\ +�f � 1L�F�q S`'D W,4��S Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new / Zoning District �%L� I� Flood Plain Groundwater Overlay Project Valuation Construction Type lV"D Lot Size Grandfathered: ❑Yes ❑,No If yes, attach supporting documentation. Dwelling Type: Single Family 16� Two Family ❑ Multi-Family(# units) Age of Existing Structure 40 S Historic House: ❑Yes Flo On Old King's Highway: ❑Yes Wlo Basement Type: ❑ Full ❑ 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: 4 existing _new Total Room Count (not including baths): existing _ new First Floor Room Count Heat Type and Fuel: a as ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes U No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use - APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name " � s Telephone Number 458-4252M Address Z V i C�zcte License# (��' o��J 7(� 2 't� Home Improvement Contractor# loOqDf' Email�S6AaV45P�VG wk)- Worker's Compensation # �^ _ ALL CONSTRUCTION DEBRIS RESULTING FROM JHIS PROJECT WILL BETAKEN TO A P-O W 1`, SIGNATURE DATE �J © � FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. r. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t DATE CLOSED OUT ASSOCIATION PLAN NO. r VIV tl�KGL . BastoY x MA dz��}}l}�I� Wmimrs' CumveIIS2fi=Insur cm Pr wi $,af*'fslzCg ,,tt A.ddse Are you an=Tl"er?Chc&flmaPprqpxiafebu= Type of project L❑ I am a employe€v 4. ❑I am a dal co twtur ad I fi. New J� I am �(fcd aMvOr gatt--lime)* bave hin dtfie 2. a sole orpadaw- fisted on the offs w sheet I ❑IFwnadefiag sh r and hwe,no employees. These svb-ccnhzct=.Fsax*e S. Demaliti= wodtia- form i a any capac�g_ employees and have s q_ ❑Bui1dmg addi�n jldo wodoras'caalp. rapiM&I ;❑ 'fie ase a and ifs 1 � i repairs nr adiaas 3_❑ I am.a hameosmer doing ag vmk af3oe:s have cmc their 11-Q Plumbragrepaim or addtiions myself[No ' a�of duperMO- msu&ance �-I t�� r-M§1{4�andwe have w �❑other [Na rourp_msmz=e=quire&] •Any Eppffamt,fiwcr5tp ffil— M m,; pMHcY; = ameoiva��zl,esahrt4t�dssf�ciae i gtmepmgrlaia�eg�w�rmi&=Y=a=ecaatru actvnlm zuewzF3dz&MfhrIFtMMCTL 'Ca ss check tL�s b==mst—d, sa.addid-2 shEd si,v�then—of the �d sffie ��ancswse ham emp9oyees.T€thema-can 4 ,�Izvz=Plvyw%fiL7�Lt pmv &ek wwkme a=p paR Er- am an evgAayer Sieispraph&g irtsaraucs fbr my- S $eEw it fits pvHq find jab sits �,jarraatiaa „_� PaficymSelf-irns IIc.¢ 6Z� t��15 7 Job Mte A&kesm AE{ach a copy of the warkcre compeasafiaupelicp dschunfi s Par(showin the p'oRcY amber aad axphmIion&de). Faihue fo se=m ammage as reSmrcduudes Section 25A o€M(Z c.1M P=lead to 8ie imposifiau of coal peQalises of a fine up to$L50DOQ mWor case-gcarimpdso as well as civil peal iesin the f=cm �T of a STOP DKK{IMMaud a fame: o€up to WM a clap Windthe Violator. Be asizdsed 21d a copy of f3is statement Abe fmwarded to the Office of Imvestigatiaas offhe DIA for" coveMge veEEScafio,i Ido h p Off'�atf3ta a�ar�u obotw` true cm7r t Date- Phone rr --r4.S 2b Ojokiab am a nly. Do nata rite in dib mvv, be cau pleted by ritg artaim Offidar City or Tawm Ferm Lice�e Issuing An6writy Eca-de tel: L Baamd of Hsi Mv BwIffing Dgmrft t 3.6tyfrova Clm* L Electrical bspector 5.nmbing Last ecWr Ch o&W Conbct Fens= ?how P: - 6 i i 11 i t l i 1 1 i t .■n1.w�■F _.• Mt:■•it :■t/n w _I wit■n ••rF 1• •1 /• •- •••e■1r1, ►■I/■!•�!.1.1:.■•1/ l•1 [. ! �!ain ••rw '1■ _/Y.■1 t• is■a_ runt .n �•a/ • ■:7■I■�. : - ■rF•■ a p - -Ir • • :.■.i■: .■■■ at r•llll r • n■ •.tas -• nI: ) ••■/nit ■ %/ tI I •- ■anti�/ : ..I n lexalm Is-­IIl:■ ■/:iF■tea :••-•ref:la•l• ►n •n .■■•11 •1 •■/ r•J: r\Ill • •: _n' -'• ■) tt.1 • it' 7.1 •■t■• �._r•�■ ■■ •In1 �■I•i! •1■A: _I■• ■■ 1■nn• i■- �_ •) ���/■r1■•w • : • •: �■ i!e■■f •.r •1 i■- :ra ■ ■ ■ ■�- • :n u o n.r. .aai■rF•tu _e.K•«rn n■ n •i■> �: �+■1\t r.n.• ■ u: .gnu •• :■- -•r i. •-•/ ■ _ ■- 1 0 ■.t a_•n- .. n.) it r. in :u:. n■r.l� a■r -•air -.-1/ it: tin n u • r■o.m • n r• 1 u- ■•r • a■/it r -'■• rnu •• t rF u■ !■ •/ ■■:nnt�■.n r w�! .r■n. a ■./1 •■. nt n / ■- - lain_ ■.rw :n �■n •) •1! i■ •J •■l•■ n •■■ ■■■• .It■■1 ■:It_.■1 i!�!1u Y■: / ■• I�r:a• • ■ .■ �.ttr ••■t i.1 I' !�r■■�• ■. •- . •`I I�: ■:n\ w OI. • rug. i■a r rJ■ . •r_ �.vI_ a ) _ ! -• it ■• ■ i. .r a _a. a • -' t • �f ■ • ..$I ■. •.- .In- • .LYu i.Y. • n r■■ ■ .r / +a • .• y. a i. - r•enn• . i. t• :n : ■ ■ •.: . t • / - .■ / •■ .ram. - r-•r ■ -• la=:e r ■ t a ■ - ••Ii. ■..- u n - ■ r■ - -/ • ■ �• - ■•u m. 1 ►� /:� ■.0.r OI n:■�. ali\:+ n wnun n■-•�:lit •n .n • IR ■• u r: .■/ -n■a ■.I �Il■:i aipa :.■ ' ►■a■ ■ r In at- .i7Utn■..[r • r.•1 ••ai■. nna :r.�r r• - •r•. • •;■.0 a A/ - ••/It i/- n n _n►' �■■ai 1■•�■[/. • an ..:Ir nr ■ •rr. ■1 �+a■Ilrt 1. 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'"■ ' ■W A Fie I a� �c� �irci for Complmc:e ugQ MIR5301 2 1.1�I - 1.1 SCOPE- . . - • - C°'mPFr�� Wald S,pe.ed{3-mm=4 110 n ph Wmd E:q r Cal g_wj B and Expommtegor3►r..:..___--Fmeerins Requa-ed For Enffra 12 APPLICABEXIY . -Nrmuber Df Sk ies(a roof vHch a eds B in 12 siape shad be considered a sfary) Mmries 5 2*des - Rxf Plf h (Fig 2) 512:f 2 - Mean RoofHeight z (Fg 2) Budding 1Tidflt,W - . _ (Ng 3) ft Ba' BWdung Land,L (Fig 3) RrAc'ing Aspect Rahn(fJM (Fig 4} "c 3_1 Nomimi Height of Tallest Dpetimgz (Fg 4) S _ 1.3 FRAhHNG CONNEEMORS Gerera1 mmprrmmvFdh frarnirig mknecfions_ (Table,2) . 7-1 FOTJHOATIDtrI Foundaffm tabs meermg regrarernerft Df 780 CMR 5404.1 r CDnca .�...-..___ _...__....__,.,_..-- ------ -- ----•----- ----•---- ' _ Gars Masonry._.:.. - _ - - 2.2 ANCHORAGE TD FDUNDATIOhi _ 518'Anchor Boft,hnbedded Dr 5/3'Prgpriefaiy'Mad=ical Anchors as an a[fefneve in concrete of BDIt Sparing-genand ._.__ (Table 4) Bolt Spacing from engjjomt cf pt, (Fig 5) nL S 5-1Z`. f3git Embedmezrt-mrnm!ta —(Fig S)___ - h Y 7; - Solt Ernbedmenf-masonry Pfai Washer. ' CFg 5) >3`x 3'z Y 3.1 FLOORS FIDwfrw rrg member sp anG dmcfmd (peg 730 CMR CI•ranr 55) Mm rnim Floor Operrng¢imensbn (Fg 6) - Frsd Height Wall 5fuds at FiDQr Operimgs less fizan 2'irorn Extew Vifalr(Fg 6).-;---._-.----- M& ii:an FborJoMSefi7acks Suppof&u Loadbea'M' 9 Waifs nr Shmriyali (Fig 7) _ft c d Maximum Canf laym-ed FicorJc&fm Supporting Lbadbearing Waifs ar Sheanwan (Fg 8) <d .R=Brac>ng at En (Fig 9) Floor Shoring Type _(per 7B0 CMR Ghapfr r 55) FIDarSheaffimg Tt idmess '_(par7B0 CUR Chapter55) rL EmrShaaftbg Faste mg - (Table z)_ d rrailss of In edge! in freld 4f VL1r Wall Height . I DadbMMk-g waUS - (Rg 10 and Table,5) Nair-Loadbarmg walls_ _ (Fig 10 and Table 5) ft's20` Wad Stud S pcing ._ - (Fg 1(I and Table 5) _fn_c 24 czm Waft Slaty Olfse4s {igs 7 8) 42 DCi1PtOlt WAILS' WaDd 5frsds - i�dbe�og�%raIlg (i"aiale�}_ 2x_- fit in. NDn4_oadbearing walEs. {Tab}a 5) 2x - ft h - Gable End Wad BTadng f _ Ft1T1 Ike ttEndwall;'frlds (Ffg 10) _ WSP Af c FODr Lmngffi Fig t 1} ft 2W13 Ut Cerrsg LerrgSt[rf WSP not useii} -(Frg 11) - .and 2 x4 Gortfiijtmts Lateral Biaca�6 fi:o_�_(Fg 11}__�._-_____•-_-•-- :— or 1 z 3 r�Tmg fiarmg ships @ 16`spacing-rani.ter 2 x 4 big�4 f1 spacing in end or fruss bays Double Tap Piafe Sprier=Length _ (Fg 13and Table 6) g �41�r'�guide to FYo�d Carrs�uefion irz ugh �izd ftrec�= IIO tx�rfi �rrrd�rFce ' - Massachfsetts Cheekffst far COMPR Ace(nil O�ms30r_z.Z.I�i Laa��9.Waif eonnec�Dns - - Latieral (no_of 15d com (7-a,bfes�mon rams) - - Nw-,_L•aadbearrg Wag Connerffbns L abral(na:of 16d carman rmb) (Table 3) Lrad Bearing YVad,Dpen¢igs(record largest apemg but check aff openings for coin p6ance to Table 9) Header Spars (Table 9) _ft In.!;11' Sal Fiato Spans - _ FLA Iiak t Studs (na.of-sbrfd ) (Table 9) Alon-Load gearing Wag Openings(na and targesE oPmft bttt check al openings for campllanca iD Table 9) Header (Table 9) _ft- in•.S1Z silt pbdm Spam-_- - (Tables 9) _ft in. 1T Fu6 Height Studs(no.of Mods) (Table 9) - - Ex±erior ViW Shaming to list Uplit and Seat&IrM tan&msV _ wff&m T guildusg Dimension,W N=kiWHeightofTaffestDpenine ..... — Shm-:dhing Type ( '¢) Edge:NA Spacing (Tables 10 or note 4 if less) �- Feld W Sparing (Table 10) - fn_ Sf:w rConnecibn(nrL of 16d common rialls)(Table 10) _ Pert FL&-Height Shea$vng ' (Table 10) --% 5%Add]&)nal Sheafhing for Wall with Dpmbg>5'1?<'(Design Concepts) mwdmr m Sulfang Dfrnension,L - NDmkial Height of TallestOpenings ------ ---.- 5 SIT ` Sheathing l'ypa- (not-5 4) • Edge hfaul Spacing_ (Table 11 ar nail 4 if less) iiL - Feld!Marl Spacingm- Shear ConneeSDn(no_of 16d cDmm r<nab)(Table 11)�--- _ Percent FulE-!•feight Sheaffiling (Table 11) -- 5%Add Dnal Sheathing for W4 wfth Ope:ning>Wr(Design Concepts) VV4 Cladding - - Raiad for vi ind Speed? 5-1 FLOOFS - Roof framing meal5w-spans checked? (FDrF,-dfiers tsee4WC Span Tool,see BBRS Websife) t;,LnDf overhang — (Figure 19) ff:5 snoller of 2_or L13 Tntss or Railer Connections at Laadbmrbg Wafts - prvpriefa y Connecbrs - . Ups _ (Table 12) r P� 'Lateral (Table 12)_ = Pff _ Shear (Table 12) S= .Plf- ' Mcige Strap Cannec5ons,lf collar yes not filed per page 21--(Table 13) T= Plf - Gable Rake Oulboket_- _ (Figure:2D) _— fts smaller nf2`or L12 _ Tnzss or Rafter Cannec: om at NorAnacib ring Walls - . proprielarY Connecfnrs . Upy — (Table 14) 1� lb- _ Lahxaf(no-of 15d common rw'Is)-(Table 14)--------- _-._.___-_L= . lb. - Rnaf 51Se irg Type (pet7BO CMR Chapter 5l3 and 9) �Sheaftung Thicimess in_'- Ft16'Y�►5P - Roof Shaming Fastexsing -(fable 2) - Ibtes: ' Tkfm dust shaII ha met in ft enfiraLy,r=iudmg the spmffic exreptlDn noted in 2,to rxtimpfy wig ifie:[Equfretnesis Df 75D Cf,IIR$3D121.1 Itern 1. ff the ehecdrst is met in rls enfir*then thm fotivwing meW straps and hold downs are not required per fhe WFCfid i 10 mph GLAdw EL 5ted Straps per Frgure 5 - b. ' 2`1 Gage Straps per Rgt.rre 11 - - r Upfft&traps per Fxjure 14 . cL An Straps per Figure 17 m Comer Stud Hold Downs per Figure IBa and FqgtM 1Bb _ 2_ 'Excepfioa•t Dpmk g heights afup tD 3 It shall be petmrl when 5%is added fa fhe perrentM-height shs;dh ng requlrarnesfs sfxiwn in Tallies 10 and 11. ' S_ The:bottom sl plate in exSdDr wags shaft be a nffi* mt 2 fn_norrilrof fhfcimess prem e:kEEtD4#2-9_2'4e_ AWC Gal&to ,FlOrrd OwTs7�ircgorf irr.' ifr �yuadl4re¢s'fZO.rrtpdr f3�rad�a�ze Masaachusetfs Check for COMPI ance[MD.cKR-W12 r_I)r 4. - - a. . From Tables 1 t!and 11 and locafion cif vJall g and Sodding Aspect FW o,defetm a pent FLffl-¢ ekft- Sheathing and 14A Spacing neqLfirernert_ _ - b. Wood cfi,c u-d Panels stall be rniff um tf itch ess of T11 r mid be hsbbied as follows: - L Panels shall ba inswed Wtlr st=A-xis pm-aej to studs, _ TL All horizonW job !s sirali otair over and be tr[�tled fn framing in. Dn single scary cartshmaon,panels shall be aflached to bottom plans and top inamber of the double top plate. _ iv. Dn bm story==h c5on[upper panels shall be alfadhed to the tap member of the upper double top plate and to hand)alsf at botbm of panel.UpW affbdr=t of bwerpaned steal[be ride bn band joist and lower af#achment-n cletolowestplateatnrst:fionrbarnirrg. ' V. Horbznrbd nail spacing at double top plates,band joists,and gkdeis shA-be a double raw of 3d staogwed 2t 3 inches on mrbr per figures below:Umfmd and Hatimnbat taring kir pane!Atta:f=ent Gig proiec5arr a)'net�house orh�rrbl addrlion—required ifptnjer#s 1 trine or rdos�'in shore(gerseraliy,south>3f Rhe.;ZB or north of Ria.6) ' b)vwfical adcrmn-not:required r>-J—ffmre is extan�renwdon to$re first tiaor c}replacetnerri w¢idovrs—needs energy consetvafion compWc:i only(chap B3) - 6_Wcx:id Frame Consttvcdion Manual(W.FCM)far 110 MPH,Exposure H maybe obtainecf from theAmmic-an Wand Couna7. (AWb)v .ATE= ii rt' -1r a s �r t' rt �i or - i i IL tl If 4} Ll i 1 aQ ' )l U� .. .. 1. ■. � ,�GK „F L 47 L ° u '. [i= _ i i' •` art•, r•�'L "�. �� > d' �� r��i,,aa FSY'S�RG�r•�i L - Se—a Daly on hbext Page Verfical and Horizontal N.-Eng bit• _ for Panel Attaehrnent ' 1Trxti�al,�Nafrz�nbl hlar7rng for Pa I Atf ac: tmarit - Town of Barnstable R' 4 Regulatory,Services KAM'M'z' ` Richard'V.Scab,Director Building Division } Paul Roma,Building ComIIussioner' } ; " 200 Main Street,Hyannis,MA 02601^ n www.town.barnstable.maxs Office: 508-862-4038 Fax: .508-790-6230 ` -Property.Qw ir,Must Complete.and Sign This Section If Using A Builder I TI. I ;as Owner of the subject property' A J/S/0�(I S- — -= Y to act on in behalf` hereby authorize,, -r -�--j- y '. • in all'matters relative to work authorized by this building peimif application.for. 9 `n **Pool fences'andalarms are,6 responsibility of the applicant Pools are not to be•filled or utilized before fence is installed and all final inspections are performed and accepted f L (2 vle&49242n igna/S96e of er` �' S' of Applicant" . t . , -Print Name Name Date, F QYORM&OWNERPERMISSIONP0OLS Town of Barnstable. -Regulatory Services ox Richard V.Scali,Director Building Division - Paul Roma,Building Commissioner �� „ 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": 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�workperf'ormed 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 d Approval of Building Official }� „ Note: Three-family,dwelling s containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. ^, i . R-.4,:. 4HOMEOWNER'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 he 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.pa.rttof the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a_ form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc_ 06/20/16 " lY - -- ---- �� lsh•ation valid for individual use on License or reg' f e p rs Regulation i before the expiration, If found return eg lation Office of Consumer Affaas OBusiness TOR HOME IMPROVEMENT C gffice of consumer Affairs and Business Regulation Type: 10 Park Plaza-Suite 5170 RegistrationsY' 108901 private Corporation Boston,MA 02116 E�cP i rati on�= F2018 low REVISIONS,INC. David Shastanyi - !v' Not valid without sign re 12 VISTA CIR MA 02649 Undersecretary MASHPEE, ' Massachusetts Department of Public Safety Board°of Building Regulations and Standards License: CS-058376 Construction Supervisor DAVID P SHASTANY 12 VISTA CIR MASHPEE MA 0,264P Expiration: Commissioner 08/19/2017 Construction Supervisor- Restricted to: Unrestricted-Buildings of any use group which contain less than 35,000 cubic feet(991 cubic meters)of enclosed space. y Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing information visit: WWW.MASS.GOV/DPS i' Town of Barnstable Permit# 0 Expires 6 months WOM11V Regulatory Services Fee t sn$rrsTABM 9� uasS 6 Richard V.Scali,Interim Director 4` Building Division d,,r;t�il,c��� r3� � Za,�-°'•°� Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not valid without Red X-Press Imprint Map/parcel Number 2 '�/ _��l p \ Property Address I t��. U 1 • AD Residential Value of Work$9 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address _rQ l Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Z Email: Construction Supervisors License#(if applicable) t�.�S (��"c7 U b � �` �. �a I ❑Workman's Compensation Insurance Check one: MAY Z ❑ I am a sole proprietor ❑ I the Homeowner have Worker's Compensation Insurance Told lq OF VI OTABLE M W 3rtA;rance Company Name � %/i(;�tp QQ �, 9 A Workman's Comp.Policy#r 1aQ Copy of Insurance Compliance Certificate must cc mpany ach permit. Permit Reque (check box) V Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ; ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side • ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows •#of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical Fire Permits required. *Where required: Issuance oft s permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro e Owner st sign Property Owner Letter of Permission. o y of the H me Improvement Contractors License&Construction Supervisors License is e ired. SIGNATURE: TA MN D\Building Ch ges\EXPRESS PERMITNEXPRESS.doc Revised 061313 The Cara, inonwealth of iassachusetis �- Depaphnent of Industr al Accideraits r 0,07ce of Investigations - 600 Washington Street , Boston,MA 02111 - * v.mass.goWd is ` Workers' Compensation Insurance Affidavit:Builders/C-ontracto E•iecta-ician filers Aix icant Information Pease Print Le ib Nine(B tion vidual): ems Address: Ctyftelp: Are you an employer?Check the appropriate boa.: Type of project(required): 1.E3'1-arm a employer with-2 4 ❑I am a general contractor and I * have hind the su 6- ❑New construction employees(frill and/or part-time)-* . 2.0 I am a sole proprietor or pear ner- listed on the attached sheet 7• ❑Remodeling ship and have no employees These sub-contractors have $- ❑Demolition working for;one in any capacity- employees and have wodiers' [to workers'comp-insurance cam-insuraum, 9- ❑Building addition required-] 5- ❑ ale.are.a corporabon and its 10.❑Electrical repairs or additions 3-❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp- - „ right of examoon per MGL 12-❑Roofrepsirs insurance required-]I c-152,§1(4),and we have no ` employees.[No workers' 13_�tlrer comp•insurance required-1 'Any aopliccaaut that checks box#1 oust alsm fillnit s the section berm*sho�g thetr woAeis'coutpensation policy i�amanon- i 1.lamem miss who submit this afiida dt iadic=Z they are doigg all wcA and thm hire outside contractors mnt submit a new affidavit indicating sudL ZContraciots that chech this box mist attar an additional sheet shaw�ag the name of die sub-ctnteachm and state whether or not those entities have. employees. If the sub-contractors have employees,they must pmvide their mmrkm'comp.policy number- I am,arn employer that ispt rrg workem'comp,nisadon insuran"fox my eaqAkym& Below is thepAcy and jab shoo informatioin. Insurance Company Name- ( aoam Policy#or Self-ins-Lic•it: /L•�c ( !9 b -1 .Expiration Date: Li l M.a lS Job Site Address:1�) City/State/Zip: L �'-C b Attach a copy of the worke pensation policy declaration page(showing the policy number and expiration date).. Failure tm secure cov ge required Section.25A of MGL a-. 152 can lead to the imposition of criminal penalties of a fine up to$1,500-00 aide year' Dement,as well as civil penalties in the form of a STOP WORK ORDER and a fine. of up tD$250.00 a day a - t the van • Be advised that a copy of this statement may be fi ded to the Office of Investigations of'the D i n oirerage-unnification- I do hem bycet#ry the °n nd nalties a,f perjmy that the information proms )tere° true and Correct . Sa IDate: l U Phone#: - t3, al rr.se only. Do not grate in this area,to be completed by c3'or town officiaL , City or Town: Per jizitlLicense Issuing,Authority(circle one): 1.Board of Health 2.Building Department 3.Citg(Town Cleak 4.Electrical Inspector 5.Plumbing fit for 6.Offier Contact Person: Phone#: Rightfax C3-2 11/11./2013 6155:56 AM PAGE 3l.009 Fax Server A�& CERTIFICATE IC)F LIABILITY INSURANCE tj =2o�s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATtOW ONLY AND CONFERS NO'RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE' AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOTCONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT- If the certificate Bolder is an ADDITIONAL INSURED,the policy(ies)mustbe endorsed, If SUBROGATION IS WAIVED, subject to the terms and conditions Ofthe policy,certain policies may rcquire an endorsement. A statement on this:certificate does not confer rights to the certificato holder 16 lieu of Such endorsement(s). PRODUCER NAME:' OLDE CAPE COD I"AGCY PHONE _ 11 FAX 296 WINTER ST AK,No za?l' (A;(!.,N t, HYANNIS,MA 02601 1iA1` In SLIrtERI3)AFr;TROfNl�onv_wcr,>= nAl:e - INSURER A.THC 1RAV✓=I ERS RSM MNITY COMPANY OF AWRIC IX INSURED - _. - INSURbRI)C FAEAGHER WCHAEL..DBA INSURERC. MEAGHER BROT14ERS CONSTRUCTION 97 EMERALD STREET IN ur i 4 t1 MARSTONS MILLS,MA 026a8 iN�uRFR .. - INSURER I:.;.. .. COV RAG S rFAfiFICATE NUM R: REVISION NUMBER. TI•IIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED 11FLOW HAVE:BEEN t$St1ED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREt:1ENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT:WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT' TO ALL THE"TERMS. EXCLUtSftS: .AND CONDITIONS OF.SUCI.1 POLICIES.LIMITS SHOWN MAY HAVE DEER REDUCED BY PAID CLAIMS. fN3R sADDL SUO POLICY err POLICY EXP - LIMITS LTR. T'N'E Or .. . °INSR WVD' POLICY NUMBER. [0.l6NOD MMIDWYYYY GENERALU"ILr1Y EAGlI DCCURR NCC 2 CnithtERCL11 C�kNtc.SP1 UAE{11.1T`Y ErAbBAf E i0 ftENTEJ • PREMt$CS ESI u.:a!rru°+i� AIhR3'MAC>E OCCUR ML'F-xp(Am/artq.r+•rFnrj $ _ . PERSONAL&ADV-INJURY _..--- 't--NERAt n(;GNf3GA"I'E OCN'LACCREG'AJ'E LIMIT.APP05;PER: I - FrtQl9ttF1S COMP11wAG±G S.. ... PoLtCY- J 0. LLOCH A,V]OMOBILE LIABILITY '� - - - t�3MBINED'S)Nr"e LIMIT ANY A.;O .. q Y_....._.� 7 80t71I,Y'1NJURY IIytfN4PSGi7 u Aiy L""SRlt=.f7.- AOTO]LtL D:: AtHEO - OWL INJURY Yat fin+ NON.rJyil R) OP%% AIAAGE $ �HIREDAuTDs AUTO$ ea+t UMBRELLA LIAt_3.. OCCUR E-AWOCCURRENCC ;• EXCESS UAa CLAMS-IADF... - GED ItETP.aTION;t _ c WORI{ERSCOMPENSATION A u\L jTATu wiI. AND C}gPLOYCRS'LIABILITY _ * l'ORY LIMITS EN - ANY PROPRI-MR'i'ARF.CNI.XCCLTIV - R.t.EhCiwAi�:CIDr�J7 S100.004 Orra:r_A1MCS1aCRexcw0to'? NiA SKUD 1149-2013 11-M2014 If yVg aaa9a?a$A ¢alery. an NHp. C L.DISEASE-EA EMPLOYEE S500,000 n�x��.�+���es D€scRt&rin D-opE":rtONsr , F-L-olsf�.sr.PCX lay L1MIT $100,000 DCSCRtDTIDN OP OPCRATIONS 1 LOCATIONS I VEHICLES tAilach ACORA.161,Addtffanal Remarks 3ChodUle,It more APlace Is NgUlredl MEAG HER,MICI AEL IS:COVERED BY THE.ItiORKERS'COPOPENSATION POLICY; 98TIFIGATE HOLDER CANCELLATION TOWN OF BARNSTABLE BUILDING DEPT SHOULD :ANY OF THE ABOVE, DESCRIBED POLICIES BE 230 SOUTH STREET CANCELLED BEFORE THE EXPIRATION DATE THEREOF', t1YANNIS;MA02601 - NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY:PROVISIONS, AUTNORMED REPRESENTATIVE C 1988.2010ACORD CORPORATION.All rights reserved. ACORD 25(2040105) The ACORD name and logo are feglstered marks of ACORD 1 Massachusetts-Department of Public S&)fety Board of Building Regulations and Standards Construction Stapervis1)r License:CS-102266 MICHA'EL S MEA,6KER JR 97 EMERALD Marstons Mills MA 02648: 5 J:•�.... J1JSt ai.i 4�' i x iration Co nmissioner 11/05/2014 ^� Office of Consumer Affairs&Business Regulation r OME.IMPROVEMENT CONTRACTOR X9'stration: 162938 T ` P ration YPe. . 4127/2015..: DSA ME9GWER BROTHERS CONSTRUCTION MICHAEL MEAGHERJR.,.::'..`' 97 EMERALD LN MARSTONSMILL, MA 02848 a Undersecretary . l j Unrestricted=Buildings of any itse group which contain less than 35,000 cubic feet(991 M of enclosed space. Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DIPS Ucensing information visit; wwrw.Mass.Gov/DPS License or`registration valid for igidividul use only before the expiration date. If fouind return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suit 170 ' Boston,MA 021 No slid ithout signature .+ Town of Barnstable Regulatory Services . Richard V.Scali,Interim Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize Q' ' ! -4/ to act on my behalf, in all matters relative to work authorized by this building permit application for: ( ddress of fob) �2. Si ture of Owner Date Print Name r c If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. T:\KEVIN D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 I;. Eng4fi ering Dept. (3rd floor) Map 2Z6 - Parcel 06.6 .. Permit# _ House# �� Date Issued ,-_�ard of Health(3rd floor)(8:15 -9:30/1:00-4:30).��� .�T+,.► �' ee C-a erii—e Office(4th floor)(8:30-9:30/1:00-2:00) P d IC SYSTEM MUST BE Manfting4)4t.(1st floor/School Admin. Bldg.) 1�9STiiLLED IN IANCE WIT � Defiffftiv4-F;Aress proved by Planning Board 19 ENVIRONME AND TOWN R . S TOWN OF'BARNSTABLE Building Permit Application ProjectStre 3 V4 V _ eo�, ?�j d bS PA2G�Z a Village (L {Owner 14,cmq 4aryQ 6-Ir Address Telephone 8.7 S l Permit Request h, 'LJ r.,r f fl& 5/ Yl o® 1 � .First Floor Tr a Ak us o square feet Second Floor square feet -Construction Type 4-o oS Estimated Project Cost $ /UGy oning District Flood Plain Water Protection Lot Size 3 y X 40 Grandfathered ❑Yes ❑No Dwelling Type: Single Family el Two Family ❑ Multi-Family(#units) Age of Existing Structure 1 20 Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other VaNe, Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing / New Half: Existing New No. of Bedrooms: Existing __- New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other /VO V e, Central Air ❑Yes ❑No Fireplaces: Existing , New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) N°N`R' Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 01 If yes, site plan review# Current Use Proposed Use / Builder Information Name tZ G Co A.),-.,c_L.L. . - `Telephone Number 41 Z,,O, -SS-7 j Address 36 3i P � License# ot? 60 3 vn A r-Q�j lfb a 1M, 1st kyl A- Home Improvement Contractor# y`t 987 Worker's Compensation# ��¢ NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) T� FOR OFFICIAL USE ONLY _ 74 PERMIT NO. 4 - DATE ISSUED MAP/PARCEL NO. < 1 ADDRESS VILLAGE OWNER DATE OF.INSPECTION: • ' '� yt • - . .' to � - -. . " - 1 . F . 1 j S FOUNDATION- FRAME w INSULATION FIREPLACE ' ELECTRICAL: ROUGH ' FINAL _ 1 PLUMBING: ; ;��ROUGH FINAL ' GAS: -,ROUGH FINAL . FINAL BUILDING, : - .. rf,, ► DATE CLOSED OUT' t , ASSOCIATION PLAN NO. The Commonwealth of Massachusetts �; Department of Industrial Accidents Office ofiayestiffs offs F "rl 600 Washington Street Boston Mass. 02111 Workers' Compensation Insurance Affidavit name: location: city phone# ❑ I�ln a homeowner performing all work myself. I am a sole ro rietor and have no one workin in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. n / company name: L' /C 0 l�0►tl�C address: city: Yn A-tom, 3 t 1. f insurance co. 50 L�e- fig �l (� olicv# r I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who ave the following workers' compensation polices: company name: I address: - city: phone#: insurnnce co. , olicv# : company name. address: I - city - i : phone#r insurance co ... : olicv# 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 S 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 OMce 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 true and correct Signature Date 7,:,Il l Y,,i Print name L e�c v r G� !.`� �Cc)ri)�s lJ'l� Phone# y L MERIN official use only do not write m this area to be completed by city or town official city or town: t' permit/license# ❑Building DJe j ❑Licensing ❑check if imrnediate response is required ❑Selectmen❑health De contact person: {L . phone#; ❑Other (r ed 9/95 PJA) Information and Instructions o s 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 contr- 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 or the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive: 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 o: 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 renew, of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who ha.- 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. Ile affidavit should be retuned 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 sire 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 Imtestl0atlons 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 378 °F iF1E t� { The Town of Barnstable • a�►aivsr�re. • 9059. MAM �0 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 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: P,e 13., Estimated Cost 00 0 Address of Work: 3 U A L L" p c,c_ Owner's Name: z,,�.�! Q R t Te- Date of Application: D C_ _ •� f 1,;.g I hereby certify that: Registration is not required for the following reason(s): C2]W xcluded by law ob Under S1,000 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: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav