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HomeMy WebLinkAbout0186 GOSNOLD STREET C-osno i Town of Barnstable BuIl��Il e e MTneu Post This Card So That it'is Visible'From the Street `Approved Plans Must be Retained on'!ob:a' this Card.Mustbe Kept PostediUntil,,Final Ins ectiowHas Been Made , , ,� a ,,, ° � r . ,v ,. �^^ dam" .� �.;�,�,� ��» u �� Pe r'II it Where,a Certificate:of Occupancy is Required,such Building shall Not<be Occupied until a Final.lnspection has been made —cup y = Permit No. B-20-2144 Applicant Name: Joseph Burgum Ap rovals Date Issued: 08/11/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/11/2021 Foundation: Location: 186 GOSNOLD STREET, HYANNIS Map/Lot::306-120 Zoning District: RB Sheathing: Owner on Record: MEECE, KATHLEEN E Contractor Name',Joseph R Burgum Framing: 1 Address: 22 PUTTER LANE Contractor License: CS1-104847 2 HYANNIS, MA 02601 ,. Est. Project Cost: $7,000.00 Chimney: Description: Remove existing asphalt roof covering and install architectural Permit Fee: $35.70 asphalt shingles. Insulation: � .Fee Paid) $35.70 Project Review Req: Date: 8/11/2020 Final: Plumbing/Gas Rough Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permitis commenced within six months aft4�i�Y en&. Cia Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough 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. I Final Gas: J The Certificate of Occupancy will not be issued until all applicable signatures by the Building_and_Fire_Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: + 1.Foundation or Footing Service: 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is iristalled` r_ 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: I � - ' � lTown of Barnstable 'Permit# Regulatory Services e Richard V.Scab,Interim Director Btt1fdmg DIVISIUII Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www town banstablem$.ns Office: 508-862-4038 Fax:508 790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid wMoatPad%PressImprint M4/parcel Number ap 6. 126 P.ropertyAddress 196 (2 05potA, ST. XRcsidential Value of Work$ (3 Q7s Annimum fee of$35.00 for work under$6000.00 Owner's Name&Address K,4Tfftf-F� E-��0- 1 fb G6sPd ST toi4 o,>-z6 Contractor's Name 6 tt@rtk— - Telephone Number -7�� 3 Home Improvement Contractor License#(if applicable) tlaZ(o �"Q,3 Email Construction Supervisor's License#(if applicable) 6,570077 WIA CiI9 Workman's Compensation Insurance KIM ��\\ Check one: MAR 28 2016 ❑ I am a sole proprietor ❑ I am the Homeowner TOWN OF gA R�STggLE I have Worker's dCompennfm Insurance Insurance Company Name Sl/ � ARVj0,Sh1f-1Rf- l/ Co ' Workrnan's Comp.Policy# W L 7-� � 41/� Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) - ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris w01 be taken to ❑Re-roof(hurricane nailed)(not stripping. Gomg over existing layers of roof) ❑ Re-side Replacement Windows/doors/sfiders,.0 Value (maximum 35)#ofwin s #of doo (49 ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand inspections required. Separate Electrical&Fire Permits required. *whera ngmced: Lssaanceof ftpem&does not mempt wmpfi mcew*other town departnm ieg bbons.i e.Ehwric,Conservation,etc. Note: Property er Property Owner Letter of Permission. A copy of H ;--gn mpr Contractors License&Construction Supervisors License is required. SIGNATURE: MWEM D)Bnildmg ChangeslEXP RBSS doc Revised 061313 , HOME i APROVEMENT CONTRACT PLEASE READ THIS Sold,Furnished and Installed by- Branch Name:New England Date: THD At-Home Services,Inc. d/b/a The Home Depot At-Home Service.¢ !drench Number;31 908 Boston Turnpike,Unit I,Shrewsbury,MA 01545 Toll Free 877-901-3768 Federal 1D#75-2699460;MF.Lic#C 02439,Ri COnt.I.ic#16427 CT Lic#HIC.0565522;MA Home Improvement m/prjovement Contractor Reg.#126893 6 installation Address: G lU0�',/�GS�� K cit2A/1/�j L Q City U_ State Zip Purchaser(6). work Phone: Rome Plane: Cell Phone: Hume Address: (If different from Installation Address) City State "Lip E-mail Address(to receive project communications and Home Depot updates): []I DO NOT wish to receive any marketing emails from The Home Depot Project information: Undersigned("Customer"),the owners of the property located at the above installation address,agrees to huy; and THD At-Home Services,inc_("The Home Depot')agrees to furnish,deliver and arrange for the installation("installation")of all materials.described on the below and on the referenced Spec:Shect(s),all of which are incorporated into this Contract by this reference,along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively, "Contract"): Job#: (nd—o R.Rm c) Pivd Sw Sheets #: P ect Amount ❑Roofing ❑Sidins 25Wmdows ❑Insulation b g� ❑Gullets/Covers ❑Entry Drxrn ❑ 0 3 ao/�, $ "� [,]Rooting ❑Siding Windows ❑Insulation g ❑Gutters/covets ❑Entry Doors ❑ Roofing❑Siding ❑windows ❑insulation ❑Gutters/Covers ❑Entry Doors❑ $ ❑ROOFng USitfing 0 Windows ❑Insulation $ ❑Gutters/Covers ❑Entry Doors ❑ Minimum 25%Deposit of Contract Amount due tpan lion otthis contract. Total Contract Amount $ Maine Purchasers may not deposit more that one-third orthe Conrad Amount Customer.agrees that,immediately upon completion of the work for each Product,Customer will execute a Completion Certificate (one for each Pmduct as defined by an individual Spec'Sheet)and pay any balance due. As applicable,each Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Home Depot or its authorized service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold,asbestos or.lead paint,other safety concerns,pricing errors or because work required to complete the job was not included in the Contract. Payment Summates; The Payment Summary# included as part of this Contract, sets forth the total Contract amount and payments required for the deposits and final payments by Product(as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets)before work on that Product is complete. In the event of terininatiion of this Contract,Customer agrees to pay The Home Depot the costs of materials,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED 1'0 THE HOME DEPOT FROM THF: DEPOSIT PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING•THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the products and installation services and supersedes all prior discussions and agreements,either oral or written,relating to said Products and luslallation.'this Agreement cannot be assigned or amended cxccpt by a writing signed by Customer and The Home Depot.Customer acknowledges and agrees that Customer has read,understands,voluotarily accepts the, terms of and has received a copy of this Agreement. Acce t d by: / Submi by: �C �fi x h 91/� x I,L . a Customer's Signature Date Sales Con lanl's Signature Date C I Telephone No. Customer's Signature Date Sales Consultant License No_ , COCELLATTON: CUSTOMER MAY CANCEL THIS (as applicuble) AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS �- DAY AFTER SIGNING THIS AGREEMENT. THE 1_ G STATE SUPPLEMENT ATTACHED HERETO CONTAINS A FORM TO USE IF ONE IS SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATF,. NOTICE:ADDITIONAL TERMS AND CONDITIONS ARE STATED ON THE REVERSE:SIDE AND ARE.PART OF THIS CONTRACT 10-05.15 White—Branch File Yellow—Customer Td. Wd6£:i T ET03 OE 'daS TLi E 9£80S: 'ON XUA Pe6uref: WJ219 � x 1 P The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations h I Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly The Home Depot At-Home Services Name (Business/Organizatiom'Individual): — Address:908 Boston Tpk Shrewsbury,MA 01545 Phone#:508-962-6942 City/State/Zip: Are you an employer?Check the appropriate box: Type of project(required): 1.X I am a employer with 200+ 4. 1 am a general contractor and 1 6. ❑New construction employees(full and/or part-time)." have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or partner- These sub-contractors have ship and have no employees 8. Demolition employees and have workers' working for me in any capacity. 9. ❑Building addition [No workers' comp. insurance comp. insurance.* �5' We are a corporation and its 10.❑Electrical repairs or additions required.] 3.❑ I am a homeowner doing all work officers have exercised their 11. ' Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no WINDOW REPLACEMENT employees. [No workers' 13101 Other comp.insurance required.] 'Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:New Hampshire Insurance Company Policy#or Self-ins. Lic. M WC 015519215 Expiration Date.3/1/2017 Job Site Address: Coos No s/ — City/State/Zip: rjq'C'z S Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the plA f surance coverage verification. I do hereby certify eder a pains and penalties of perjury that the information provided ove i true and correct Si mature: Date: 3 Phone#: 401- -6 9 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r _ The Commonwealth of Massachusetts a:Sl`iwr Department of Industrial Accidents Office of Investigations 7 1 Congress Street, Suite 100 Boston, MA 02114-2017 y' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): / _ Address: City/State/Zip: l kLOfvor d -d Phone #: 7 7- 764—Z3 Z5- Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. 0 I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2 I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. 0 Demolition working for me in any capacity. employees and have workers' r insurance.* 9. [� Building addition [No workers' comp.insurance comp. required.] 5. [] We are a corporation and its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other comp. insurance required.] *Any applicant that checks box#t must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is thepolicy'andjob site information. Insurance Company Name: 777AU Udk S //)S' . o _ Policy#or Self-ins.Lic.* Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required tinder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the pes and en ies of perjua that the information provided above is true and correct Signature: 0 Date• Phone#: -7 77'— 746` L 92-5 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: �_" \ n J Office of Consumer affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Iiproverenf Contractor Registration -_ Registration: 126893 — - Type: Supplement Card THD AT HOME SERVICES, INC. - Expiration: MUM 6 ANDREW SWEET - 2690 CUMBE.RLAND PARKWAY SUITE---3. - -- ATLANTA, GA 30339 - = -- --- -- Update Address and return cart-Mark reason for change- aca 1 zor�asni Address Q Renewal :_ Employment rI Lost Card ��`ie Locmr�2c�zc�calfli a�:�/�laJQacl2cUeI�S Office of Consumer Affairs&Business Regulation License or registration valid for individul use only COME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: k _ Office of Consumer Affairs and Business Regulation l , Registration }4 893, Type: 10 Park Plaza Suite 5170 �' Expira'0itrrr-. Supplement Card Boston,MA 02116 THD AT HOME SERVIS1 THE HOME DEPOT: TfiOl_SERVICES ANDREW SWEET'',r _ tiff: 2690 CUMBERLAND PRRKUl?`(S � � — XfLL5.IM,GA 30339 Undersecretary N41wit ut signature ® DATE(MMIDD/YYYY) AC40 O CERTIFICATE OF LIABILITY INSURANCE 02/18/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 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 NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED;subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER NAME: MARSH USA,INC. PHONrE FAX TWO ALLIANCE CENTER A/C No 3560 LENOX ROAD,SUITE 2400 MAIL ADDRESS: ATLANTA,GA 30326 INSURE S AFFORDING COVERAGE NAIC# 100492-HomeD-GAW'-16-17 INSURER A:Steadfast Insurance Company 26387 INSURED INSURER B:Zurich American Insurance Co 16535 THD AT-HOME SERVICES,INC. INSURER C:New Hampshire Ins Co 23841 DBA THE HOME DEPOT AT-HOME SERVICES 2690 CUMBERLAND PARKWAY,SUITE 300 INSURER D:Illinois Nabonal Insurance Company 23817 ATLANTA,GA 30339 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: ATL-003746646-14 REVISION NUMBER:8 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LTRR TYPE OF INSURANCE POLICY NUMBER MM/DD MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY GLO4887714-06 03/01/2016 03/01/2017 EACH OCCURRENCE $ 9,000,000 DAMAGE TO RENTED 1,000,000 CLAIMS-MADE M OCCUR PREMISES a occurrence $ LIMITS OF POLICY XS MED EXP(Any one person) $ EXCLUDED OF SIR:$1M PER OCC PERSONAL&ADV INJURY $ 9,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 9,000,000 X POLICY❑jE O- LOC PRODUCTS-COMP/OP AGG $ 9,000,000 OTHER: B AUTOMOBILE LIABILITY BAP 2938863-13 03/01/2016 OM accident BINED 03/0112017 C SINGLE LIMIT $ 1,000,000 a X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED SELF INSURED AUTO PHY DMG BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS I AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ C WORKERS COMPENSATION WC015519215(AOS) 03/01/2016 03/01/2017 X STATUTE ER AND EMPLOYERS LIABILITY Y/N ( )WC015519217 AK,KY,NH,NJ,VT 03101/2016 03/01/2017 1,000,000 C ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ D OFFICER/MEMBER EXCLUDED? N/A WC015519216(FL) 03/01/2016 03/01/2017 1,000,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under Conitnued on Additional Page E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION THD AT-HOME SERVICES,INC. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE DBA THE HOME DEPOT AT-HOME SERVICES THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2455 PACES FERRY ROAD ACCORDANCE WITH THE POLICY PROVISIONS. ATLANTA,GA 30339 AUTHORIZED REPRESENTATIVE of Marsh USA Inc. Manashi Mukherjee �'LQ�.aooti► ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD •,,r T �' l Map '0 6 Paicel ZO Permit 11 House# ' �O �O _ Date Issued Board of Health(3rd floor)(8:15 9 30 1:00-43�) `' a� c'7J ee Conservation Office(4th floor) 8:30-9:30/1:00-2:00) Planning Dept.(1st floor/School Admin. Bldg.) ` *IN HIN A SEWER D mi 've Plan Approved by Planning Board t,�r: 19 T FROM THE ON PRIOR TO TOWN OF°BARNSTABLE, Building Permit A lication Project Street ddress Village Owner r Address , Telephone - `Permit Request + r , + 'First Floor square feet Second Floor square feet Construction Type ' Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Am —t" Historic House es ❑No On Old King's Highway ❑Yes ❑No 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 No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count r Heat Type and Fuel: as r ❑Oil ❑Electric ❑Other Central Air ❑Yes � 10 Fireplaces:Existing New Existing wood/coal stove -❑Yes No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑2Attne ed(size) ❑Barn(size) ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# 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 ��/K dce�cv,�c� a CQ��i��ATE n2a c25/ BUILDING PERMIT DENIED FOR THE FOLLOWI REASON(S) 0 M- », FOR OFFICIAL USE ONLYell _ PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER 71 DATE OF:4NSPECTION: t 4 FOUNDATION+ � � 't '°, • , } ~`1 ' "'; ., - � f :: -_ -' • _ ,, ' FRAME INSULATION FIREPLACE ELECTRICAL:I ROUGH i FINAL- PLUMBING:..' ROUGH — FINALR GAS:— ROUGH FINAL"' FINAL BUILDING55 ' DATE CLOSED OUTS z } ASSOCIATION PLAN Np,. ; �Z5 e O- 21 !2- 9 o- -S-- -1.- 2 -o-2co S- f a I � •-i�d N ® Z J_ r LA I - Lr 2 t ��✓tr�� Z.`®v�..i _1..S�11 ���_ i It� I -'T t\ _ '\ i �._�. H i -__..__.._...__.___.._._.___....____._..._ I � / I � I /, 1 i i I i i I ` d ..__.-_.__..............._._-._ _ Windows/Doors- for 186 Gosnold Rough Qpeninn Price Ext. Description 60"x 49" 296.38 592.76 Mullion 30"x 49" 145.96 291.92 Double Hung 26"x 41" 128.58 257.16 Double Hung 40"x 41" 312.56 312.56 Casement for Kitchen 36"x 80" 164.00 164.00 Front Door 97"x 49" 434.34 434.34 Picture Window 72"x 80" 476.11 476.11 Slider (No Grill) 24"x 24" 62.00 62.00 Octogon Window for Pantry 48"x 30" Older window being restored M CMR Apt j Table AL1b(continued) "criptive Packages for ane and Two-Family Resideadal Buiidiags IfeaW witb Fang Fneis MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Arm'(%) U-value= R-value' R-value' R-value' Wall Ptfimeta Equipment Efficiency' Package I R value' R value' $701 to 6500 Headug Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 l0 6 Normal S 12% 0.30 38 13 19 10 6 83 AFUE T L 15% 036 38 13 2S N/A WA Normal U 15% 1 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 2S. WA WA IS AFUE LZAA 15% 0.52 30 19 19 10 6 AS AFUE 18% 032 38 13 23 WA WA Normal 18•/. 0.42 38 19 23 WA WA Normal 18% 0.42 38 13 19 to 6 90 AFUE 18•/0 0.50 30 19 19 10 66 90 AFUE 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 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-formsd980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: 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 0 area, expressed as a percentage. Up to 1/o of the total glazing area may be excluded from the U-value requirement. For example,3 ft'of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 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 R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-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 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 J5.2.1 a 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 Description of remodeling at 186 Gosnold Street Hyannis - Original construction -1933 - Structure is 20' x 28'-9" - On town sewer - Crawl space ranging from 18" to 36" All windows/doors are replacements of older window dating back to the approx. early 1950's with the exclusion of the removal..of the corner window in the Southwest corner with a new Mullion 60"W x 49"H and the removal of two small kitchen windows to be replaced by one casement window(see drawing) Exterior siding will be necessary (314 Plywood_& Cedar_Shingles.B grade)to fill in old windows and replace rotted or mildewed ones. Framing around slider and adjacent window will be replaced because to weak constuction and mildew damage Framing around windows will be rebuilt due to lack of proper construction (i.e. Jacks, sills, headers, etc.) The exterior wall of the structure will be "padded" out to 31/2" by means of new studs and padding of older wood. This is to accept 31/2 Insulation There will be a ridge vent added with soffet vent. 2 Skylights will be added to the living room. Rafters will be padded out to 2x6's to except higher R value insulation in the livingroom kitchen/loft area., Floor joists in attic will also be padded out to accept 8" insulation above the Hallway, bathroom, and both bedrooms Interior NON-LOAD Bearing walls are being replaced because of old construction and. adding closet space. . . . .. c — ,... . 'e r �� � a c .1. ., � � • � r - �y. � " . Exsisting floor boards (1" Thick) will be padded up 1.12".for smoother floor to accept carpeting and linoleum in the kitchen and bathroom There is a sencond floor storage space loft �12'xIZ that will be reconstructed with M's and 3/4" flooring as opposed to the orginal 2x4's and toungue and groove flooring. All wiring to be replaced with the upgrade to 100 amp service by Raymond LaFleur Electric of Hyannis r All plumbing to be replaced by Winslow plumbing and heating Forced Hot air gas fired to be installed by Bayside Energy Systems of Dennis t . 6j r-o c t � CERTIFICATION I. David B. Cole, Attorney-at-law, with offices at 420 South Street, Hyannis, Massachusetts, certify that EUNICE H. IRELAND is still alive and that the Durable Power of Attorney which she granted to her daughter, KATHLEEN E. MEECE, dated October 30, 1986, is still in full force and effect and has not been revoked. August 19, 1997Y Yid B. Cole Notary Public My Commission Expires: April 7. 2000 The Commonwealth of Massachusetts 1;M Department of Industrial Accidents ' � - Olficeoflnaesdgalions - 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insuraace Affidavit HOW Xx� 'name: .,,"'location# city � � hone# I am omeowner performing all work myself. ❑ I am a sole. roprieior and have no one working in any capacity ❑ I am an emplover providing workers compensation for my employees working on this job. company name:' .. address: city phone#: insurance co. oiicv# Cl 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: ...... • com any name: address: dtv phone#r oiii:v# insurance co. company name: ...:: address: city- phone olicv# Insurance co. Failure to secure coverage a+required under Section 15A of MGL 152 can lead to the imposition of crLninsl Qenaltln of a Qne up to S1,500.00 and/or one years'imprisonment well as dull penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copy o[thb statement may be forwarded to the Office of Invatigadotts o[the DIA for coverage veriflcadoa 1 do herebv certify under `th�e pains and p enaltie s of perjury that the information provided above is tru.-and correct p Signature �zp��ru e .fCL»d�' y�CQJ food Date --' 1-(25- L _ Print name kg rh le m -Z(ge)rP N.D 1-11G E I-r POP Phone#.YJd 77 L 5 a2"y official use only do not write in this area to be completed by city or town official city or town: permit/llcense# Q erasing BoD.pard Department ❑Sdeet:rten's Otsce ❑check if immediate response is required C3Hadth DeQarisaent contact person: phone# ❑Other�� (tevsem W95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a . dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pernut/license number which will be used as a reference number. The affidavits may be return.d-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 Ottice of lovesuganous 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 The Town of Barnstable • �►aivsreat� • 9 � �,�' Department of Health Safety and Environmental Services • Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commission: For office use only 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: Est.Cost SA` Address of Work: U9 Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000- BuiRling 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 Na f TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE r - JOB LOCATION �lv Number Street address ection of town "HOMEOWNER"_LLda;; 7 7 �a _ Name Home phone Work phone PRESENT 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sy who owns a parcel of land on which he/she resides or intends to re- side, 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 OfficiE on a form acceptable to the Building Official, that he/she shall be responsib: for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the StE Building Code and other applicable codes, by-laws, 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 comp y with said procedures and requirements. HOMEOWNER'S SIGNATURE �'Y1�'��Gp/�C "Zia"J14 y2 ice, PQ') APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION ' The code state that: "An Home Owner "m y 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 Home Owner engages a person (s) for hire to do such work, that such Home OwnE shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarene often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home '•Owner acts as supervisor is ultimately responsible. To ensure that the �Home Owner is fully aware of his/Fier responsibilities, ma: communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the .fast page of 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.