HomeMy WebLinkAbout0093 KELLEY ROAD ACTIVE
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 SignaturftS on this form at 200 Main St., Hyannis.
Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is
required.by law.
w 1-MDATE ~` 3 Fill in please:
� ARM APPLICANT'S YOUR NAME/S:
BUSINESS YOUR HOME ADDRESS: 4AJ
t i
MY TELEPHONE #r p -Home Telephone Number -�1
NAME OF CORPORATION:
NAME OF NEW BUSINESS i TYPE OF BUSINESS: (V *trL) /
10 ._
IS THIS gHOME OCCUPATIONS YES NO
ADDRESS OF BUSINESS Q MAP/PARCEL NUMBER (Assessing)
When starting a new business there are.several things you 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) sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING C MMI SIO R'S OF
This indiv u h n ' r eE an per t r q ire nts that pertain to this type of business. - � �' "��~ I Au iz i rant
ENT -
2. BOARD 4 HEITH
This individual ha info a pe e that pertain to this type of business.
MUST,,4MpL'Y WITH ALL
Authorized ; nature**COMMENTS: HAZARDOUS MATERIALS REGULATRJ�iS
3. CONSUMER AFFAIRS(LISII A THORITY)
This individual has b inNf a he licensing requirements that pertain to this type of business.
Authorized Signature*
COMMENTS:
j t� Regulatory Services
P� Thomas F. Geiler,Director
fi Building Division
9� 1MASS. Tom Perry,Building Commissioner
'0t a 200 Main Street, Hyannis,MA 02601
www.town:barnstable m&us
Office: 508-862-4038 Fax: .508-790-6230
Approved:-
Fee: ��
Permit#: C7C� h
HOME OCCUPATION REGISTRATION
Date, 3 3//3
Name: y /y: �4�7J!-t �r�j Phone
Address: / �e %1 V 4 Villager .0 ;y 5
Name of Business: Pg. 3 a;V�i .. b p A z/v '
Type of Business: 7FoNct. Map/Lot:
IlV'= It is die intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
viadnin single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity
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 with the Building Iinspector,.a customary home occupation shall be,permitted as of right subject to the
folloi4ing Conditions:
• The activity is carried o-i by the permanent resident of a single family residential dwelling unit,located Within
'- that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to die dwelling which are not customary in residential buildings,and there is
no outside evidence of such use.
• No traffic AU 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 otherobjectionable effects.
• 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 die same lot containing die Customary Home
Occupation,and not widen the required front yard:
There is no exterior storage or display of materials or equipment.
o There are no commercial vehicles.related to the Customary Home Occupation,other than one win 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 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
i
• If.the Customary Home Occupation is listed or,advertised as.a business,die street address shall not be
included.
• No person shall be employed in die Customary Home Occupation who is not a permanent resident of die
dwelling unit.
1, the undersigned,have read and agree with die ove restrictions for my home occupation I am registering:
Applicant �.�n-tom Date: - l
r Honieoc.doc Ree.01/3/08
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION o�
Ma Parcel is T.`' t E Permit# ��s
P ,. - ,
Health Division 1 i �„Q�w,� �• ,. s; Date Issued ? O
11CACGnservation Division �� W Application Fee
17-Tax Collector�(7 p j O �a�- l } - `�Permit Fee 9 R o 2r S
Treasurer k— i/206q OEM SYSTF.AA MUST BE
�1STAM IN t:�U1PUANCE
Planning Dept. WM TITLE 5
Date Definitive Plan Approved by Planning Board EMMMMENTAL CODE AND
TOWN REGULATIONS
Historic-OKH Preservation/Hyannis 3B-e S
Project Street Address cl s Ke-Iley (`i J kg1Q tJi S 00(o p/
r
Village 7S
Owner �R V 6N , AO Address L r�
Telephone S 0�- '7
Permit Request o Foal Doome-c ImC � 0 tf CAAQe +O cxeA-' e a
�QC ,del �ys
Square feet: 1 st floor: existing proposed 2nd floor: existing-5 7(o proposed Tao Total new 45�?
Zoning District `IP5�cfcfq Flood Plain Groundwater Overlay
Project Valuation C 000,bf Construction Type
Lot Size , G,50 Grandfathered: .❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes a'No On Old King's Highway: ❑Yes 6No
Basement Type: Q 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: existing new
Total Room Count(not including baths): existing W new First Floor Room Count 1
Heat Type and Fu e Gas ❑Oil ❑ ❑Electric Other
Central Air: :Yes ❑No Fireplaces: Existing w p g New Existing wood/coal stove: ❑Yes ❑No
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 Autthh rization ❑ Appeal# Recorded❑
Commercial ❑Yes ®'No If P
,es site Ian review#
Y
Current Used^iIM4N ke)Ae. Proposed Use
BUILDER INFORMATION J� g
Name ✓� °r ✓a l r� Telephone Number 7 (>)UZe
Address e Ile License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE o O 6�l
Y FOR OFFICIAL USE ONLY
a
a
t _
PERMIT NO:
DATE ISSUED
MAP/PARCEL NO.
co
ADDRESS t VILLAGE
OWNER
DATE OF INSPECTION: p
e1
FOUNDATION
FRAME JLt`� �•
INSULATION t• V
FIREPLACE
ELECTRICAL: ROUGH ' FINAL
PLUMBING: ROU FINAL r
er
GAS: ROU C FINAL
n S
FINAL BUILDING g
117
mA� Q � •
DATE CLOSED OUT N� 0
S
ASSOCIATION PLAN N
.1
t
I -
The Commonwealth of Massachusetts
--"-= Department of Industrial Accidents ,
- - r-J • M68 BIifirafrOff s
600 Washington Street
Boston,Mass. 02111
Workers'Com ensation Insurance Affidavit-General Businesses
name: �✓
address:
city state: zip: C%2 66 hone# 75—<>7, O I- >
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. 1 ❑Office❑Sales(including Real Estate,Autos etc.)
❑I am an employer with employees(full& art time).,®Other
I am an employer providing workers'compensation for my employees working on this job.
_ ... . .
address: ..:. :. . ._ .: ..; . ... ..
l
city: phone#: .
insurance.co:- : olio #
I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices:
comveny name•
address
city:. > phone#:
insurance co. olic" #
/
:
company name:: ad
address
insurance zo. 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$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$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 hereb under the pa' and penalties of perjury that the information provided above is true nd correct
Signature Date 6
Print name Phone#
official use only do not write in this area to be completed by city or town official 5 '
city or town: permit/license# []Building Department
❑Licensing Board
❑check if immediate response is required ❑Selectmen's Office
contact person: phone#; ❑Otherh Department
(.,bM Sept 2003)
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 confirmation of insurance coverage. Also be sure to sign and date the
affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being
requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are
required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe 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 Imms"goons
600 Washington Street
Boston,Ma. 02111
fax#: (617)727-7749
phone#: (617) 727-4900 ext.406
I
o� Eta. Town of Barnstable
Regulatory Servides
a�xxsrear.s, ► Thomas F.Geller,Director
3 k Building Division
lFD MP'�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
• Fax: 508-790-6230
Office: 508-862-0�038 •
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 adj acent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: ��
_// S�j 4m-er EstimatedCost_'161000-
• .
- Address of Work:___1_ /40 rdi-, dYI4111AI P oa G
Owner's Name:
V ,
Date of Application: 4
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
❑lob Under$1,000
[]BujWmg not owner-occupied
caner pulling own permit
Notice is hereby given that:
OWNERS PULLING'THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME EYIPROVEMENT WORKDO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A.
SIGNED UNDER PENALTIES OF PERT(JRY
permit as the agent of the owner:
I hereby apply foi a
Date Contractor Name Registration No.
R
Date 0� er ame
RESIDENTIAL BTJILDING PERMIT FEES
APPLICATION FEE ,
New Buildings,Additions $50.00
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WORKSAEET
NEW LIVING SPACE
square feet x$96/sq.foot= x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
S ' x.0031=
_Y/ e--square feet x$64/sq.foot= a
plus from below(if applicable)
ACCESSORY STRUCTURE>120 sq.1t
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf 75.00
>1000 sf-1500 sf 100.00
>1500 sf-Same as new building permit: x.0031=
square feet x$96/sq.foot=
STAND ALONE PERMITS
_x$30.00=
Open Porch
(number)
Deck x$30.00=
(number)
Fireplace/Chimney __x$25.00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable) permit Fee
projcost
f
RESIDENTIAL BUILDING PERAUT FEES
APPLICATION FEE ®'
New Buildings,Additions $50.00a P
Alterations/Renovations $25.00
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
square feet x$96/sq. foot= x.0031=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
p�squarefeetx$64/sq. foot=
x.0031= g� o ��
plus from below(if applicable)
GARAGES(attached&detached)
square feet x$32/sq.ft.= x.0031=
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.0031=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
Deck x'$30.00=
(number)
Fireplace/Chimney x$25.00=
(number)
Inground Swimming Pool $60.00
Above Ground Swimming Pool $25.00
Relocation/Moving $150.00
(plus above if applicable)
Permit Fee
projcost
Town of Barnstable
Regulatory Services
' Thomas F.Geiler,
sest�sr�srE, = ,Director
s6 9. .0� Building Division
rED MA't�
'Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
)ffice: 508-862-4038 Fax: 508-790-6230
HOMIEOWNER LICENSE EXEMPTION
Please Print
DATE:.
IOB LOCATION:. /`3 C e V09�ItU�
number street VAage ,
xOrgowN>;x^ ?A`'( �0, /JA (i 4 �509'-'7 75-02 015 i
names home phone# work phone#
CURRENT MAILING ADDRESS: •v 1t,
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 indiNridual 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,structuies. 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—
minirrmm inspection procedures and requirements and that he/she will comply with said procedures and
Teq=ernents.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger.will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This ladk 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 suph a form/certification for use in your community.
vc.CHrAlE3�i(i<JK;,t:JL- 607974 .. .. .
F777
CeriLi_f ed to:
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MORTGAGE COMPANY
Teti
JAMM
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NOTE:THIS PLANWASORAWNFOR NORTC.AGGE PURPOSES ONLY AND IS NOTTO BE
RECORDED,OR COKSTRuep As AN INSTRUMENT SURVEY MORTGAGE LOAN INSPECTION
NOT TO BE USED FOR ERECTING FENCES OR ISSUING 13UFLDFNO PERMITS.
t3 'ro�39+�Sa PUW R'EFEREniCE: r�—;s�" P6:�,s� 4N
1 CERTIFY THATTHE STRUCTURE ON THIS'PLAN IS LOCATED APPROXIMATELY AS SHOVYN N s�� $L (#Y447rl's MASS.AND THE LOCATION OOWORME M THE ZMW LAWS OFTHE CFTY OR TOWN OF
13`C
REMENTS-
OAFLYj OR FS EXeAPT OAOki VIOLATION ENFOnCEMEMT /
ACTION UNDEO 1MASS.G.L.TITLE V11,CHAP.40A.SEC.7,UNLESS OTHERWISE NOTF.0 OR SFtOw1u HEREON. SlCALE: 1" $'p F H>=REElY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN DOES NOT LIE WITHIN
THE SPECIAL FLOOD HAZAAO AREA AS SHOWN ON THE F.I.S.MAPS FOR THE CITY OR
TOWN OF iB A R ti+s 7'r4 g t E ,
-TOM O J_AM ES C. VAFIAD ES--R EG. LAND SU-RVEY_O R . .....__
256 WORCESTER LANE, WALT.HAM, MASS
CXO'� mpj Sul q:f-,c-^
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NEW SMOKE DETFE=Gfb Dc:nUIREMENTS
ARE NOW LAW EN T ADDITION OF A /b cox
NEW BEDRO ILL TRIGGER AN g;- Se 4-
UPGRADE OF PIE SMOKE DETECTORS Ay: �e Ir'
FOR THE WHOLE HOUSE. YOU MUST
PLAN ACCORDINGLY AND HAVE YOUR
ELECTRICIAN TAKE OUT THE APPROPRIATE,
PERMIT AT THE FIRE DEPARTMENT.
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BEAM A
Businm RIDGE BEAM
TJ-Beamt 6.20 Serial Number:7005122634
User:1 12/20120059:12:59AM 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 1 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
Member Slope:OM2 Roof Slope9M2 Overall Dimension:36'
RI' 0
5 12• b 12' 6 12' 1
All dimensions are horizontal. Product Diagram is Conceptual.
LOADS:
Analysis is for a Header(Flush Beam)Member. Tributary Load Width:8'1"
Primary Load Group-Snow(psf):25.0 Live at 115%duration, 10.0 Dead
Vertical Loads:
Type Class Live Dead Location Application Comment
Uniform(plf) Snow(1.15) 203.0 82.0 0 To 36' Replaces
SUPPORTS:
Input Bearing Vertical Reactions(Ibs) Detail Other
Width Length Live/Dead/UpliftlTotal
1 Stud wall 3.50" 1.99" 1054/423/0/1477 L1:Blocking 1 Ply 1 3/4"x 9 1/2"1.9E Microllam@ LVL
2 Stud wall 3.50" 5.27" 2781 /1136/0/3916 R7 None
3 Stud wall 3.50" 5.27" 2781 /1136/0/3916 R7 None
4 Stud wall 3.50" 1.99" 1054/423/0/1477 L1:Blocking 1 Ply 1 3/4"x 9 1/2"1.9E Microllam@ LVL
-See TJ SPECIFIER'S/BUILDERS GUIDE for detail(s):L1:Blocking,R7
-Bearing length requirement exceeds input at support(s)2,3.Supplemental hardware is required to satisfy bearing requirements.
DESIGN CONTROLS:
Maximum Design Control Control Location
Shear(Ibs) 2081 1809 3633 Passed(50%) Lt.end Span 3 under Snow ADJACENT span loading
Moment(Ft-Lbs) -4344 -4344 6771 Passed(64%) Bearing 3 under Snow ADJACENT span loading
Live Load Defl(in) 0.261 0.592 Passed(1-1545) MID Span 3 under Snow ALTERNATE span loading
Total Load Defl(in) 0.351 '0.789 Passed(U404) MID Span 3 under Snow ALTERNATE span loading
-Deflection Criteria:STANDARD(LL:U240,TL:U180)..
-Bracing(Lu):All compression edges(top and bottom)must.be braced at 7'4"o/c.unless detailed otherwise..Proper attachment and positioning of
lateral bracing is required to achieve member stability.
-The load conditions considered in this design analysis include alternate and adjacent member pattern loading.
-Design assumes adequate continuous lateral support of the compression edge.
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser Business
Microllam® is a registered trademark of Trus Joist.
ti
Yp Ai0, BEAM A
_Rum, RIDGE BEAM
User:1 12/020059N2:59AM005122634 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 2 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
ADDITIONAL NOTES:
-IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will
be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,
and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate.
-Not all products are readily available. Check with your supplier or TJ technical representative for product availability.
-THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Allowable Stress Design methodology was used for Building Code BOCA analyzing the TJ Distribution product listed above.
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser Business
Microllam® is a registered trademark of Trus Joist.
BEAM A
®�
f/AB,u;nm RIDGE BEAM
TJ-Beam@)6.20 Serial Number:7005122634
User:1 12/20/2005 9:12:59 AM 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 3 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
Load Group: Primary Load Group
11' 10.00" ^ 12' 0.00" ^ 11' 10.00" ^
Max. Vertical Reaction Total (lbs) 1477 3916 3916 1477
Max. Vertical Reaction Live (lbs) 1054 2781 2781 1054
Required Bearing Length in 1.99(W) 5.27(W) 5.27(W) 1.99(W)
Max. Unbraced Length (in) 88 88 88 88 88
Loading on all spans, LDF = 0.90 , 1.0 Dead
Shear at Support (lbs) 329 -535 438 -438 535 -329
Max Shear at Support (lbs) 409 -616 520 -520 616 -409
Member Reaction (lbs) 409 1136 1136 409
Support Reaction (lbs) 423 1136 1136 423
Moment (Ft-Lbs) 964 -1228 331 -1228 964
Loading on all spans, LDF = 1.15 , 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 1101 -1789 1466 -1466 1789 -1101
Max Shear at Support (lbs) 1366 -2061 1738 -1738 2061 -1366
Member Reaction (lbs) 1366 3798 3798 1366
Support Reaction (lbs) 1415 3798 3798 1415
Moment (Ft-Lbs) 3223 -4107 1105 -4107 3223
Live Deflection (in) 0.213 0.027 0.213
Total Deflection (in) 0.304 0.039 0.304
ALTERNATE span loading on odd # spans, LDF = 1.15 , 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 1163 -1727 952 -952 1727 -1163
Max Shear at Support (lbs) 1428 -1998 1129 -1129 1998 -1428
Member Reaction (lbs) 1428 3127 3127 1428
Support Reaction (lbs) 1477 3127 3127 1477
Moment (Ft-Lbs) 3523 -3372 13 -3372 3523
Live Deflection (in) 0.261 -0.084 0.261
Total Deflection (in) 0.351 -0.072 0.351
ALTERNATE span loading on even # spans, LDF = 1.15 , 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 653 -1224 1466 -1466 1224 -653
Max Shear at Support (lbs) 825 -1400 1738 -1738 1400 -825
Member Reaction (lbs) 825 3138 3138 825
Support Reaction (lbs) 856 3138 3138 856
Moment (Ft-Lbs) 1811 -3403 1810 -3403 1811 -
Live Deflection (in) 0.062 0.125 0.062
Total Deflection (in) 0.152 0.136 0.152
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
I Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser Business
Microllam# is a registered trademark of Trus Joist.
f
/ / f BEAM A
(/,,, Bu';_ RIDGE BEAM
TJ-Beam@ 6.20 Serial Number:7005122634
User:1 12/20/2005 9:12:59 AM 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 4 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
ADJACENT span loading over support # 2, LDF = 1.15, 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 1081 -1809 1564 -1368 1204 -673
Max Shear at Support (lbs) 1346 -2081 1836 -1639 1380 -845
Member Reaction (lbs) 1346 3916 3020 845
Support Reaction (lbs) 1395. 3916 3020 876
Moment (Ft-Lbs) 3129 -4344 1474 -3165 1900
Live Deflection (in) 0.198 0.077 0.076
Total Deflection (in) 0.289 0.089 0.166
ADJACENT span loading over support # 3, LDF = 1.15, 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 673 -1204 1368 -1564 1809 -1081
Max Shear at Support (lbs) 845 -1380 1639 -1836 2081 -1346
Member Reaction (lbs) 845 3020 3916 1346
Support Reaction (lbs) 876 3020 3916 1395
Moment (Ft-Lbs) 1900 -3165 1474 -4344 3129
Live Deflection (in) 0.076 0.077 0.198
Total Deflection (in) 0.166 0.089 0.289
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser Business
Microllam® is a registered trademark of Trus Joist.
#.n-. t
BEAM B
'ABEAM
B,,q ROOF BEAM AT CEILING LINE
TJ-Beam 6.20 Serial Number:7005122634
User:1 12/20/2005 9:15:46 AM 2 Pcs of 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 1 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
Member Slope:OM2 Roof Slope9M2
F
R P1 PEI
d _ 72'
All dimensions are horizontal. Product Diagram is Conceptual.
LOADS:
Analysis is for a Drop Beam Member. Tributary Load Width:6'1"
Primary Load Group-Snow(psf):25.0 Live at 115%duration, 10.0 Dead
Vertical Loads:
Type Class Live Dead Location Application Comment
Uniform(plf) Snow(1.15) 215.0 123.0 0 To 12' Replaces
SUPPORTS:
Input Bearing Vertical Reactions(Ibs) Detail Other
Width Length Live/Dead/Uplift/Total
1 Stud wall 3.50" 1.50" 1290/793/0/2083 L1:Blocking 1 Ply 1 3/4"x 9 1/2"1.9E Microllam@ LVL
2 Stud wall 3.50" 1.50" 1290/793/0/2083 L1:Blocking 1 Ply 1 3/4"x 9 1/2"1.9E Microllam@ LVL
-See TJ SPECIFIER'S/BUILDERS GUIDE for detail(s):L1:Blocking
DESIGN CONTROLS:
Maximum Design Control Control Location
Shear(Ibs) 2025 -1707 7265 Passed(23%) Rt.end Span 1 under Snow loading
Moment(Ft-Lbs) 5907 5907 13541 Passed(44%) MID Span 1 under Snow loading
Live Load Defl(in) 0.202 0.583 Passed(U693) MID Span 1 under Snow loading
Total Load Defl(in) 0.326 0.778 Passed(U429) MID Span 1 under Snow loading
-Deflection Criteria:STANDARD(LL:U240,TL:U180).
-Bracing(Lu):All compression edges(top and bottom)must be braced at 9'2"o/c unless detailed otherwise. Proper attachment and positioning of
lateral bracing is required to achieve member stability.
-Design assumes adequate continuous lateral support of the compression edge.
ADDITIONAL NOTES:
-IMPORTANT! The analysis presented is output from software developed by Trus Joist(TJ). TJ warrants the sizing of its products by this software will
be accomplished in accordance with TJ product design criteria and code accepted design values. The specific product application,input design loads,
and stated dimensions have been provided by the software user. This output has not been reviewed by a TJ Associate.
-Not all products are readily available. Check with your supplier or TJ technical representative for product availability.
-THIS ANALYSIS FOR TRUS JOIST PRODUCTS ONLY! PRODUCT SUBSTITUTION VOIDS THIS ANALYSIS.
-Allowable Stress Design methodology was used for Building Code BOCA analyzing the TJ Distribution product listed above.
-Note:See TJ SPECIFIER'S/BUILDER'S GUIDES for multiple ply connection.
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser BU3iness
Microllam® is a registered trademark of Trus Jois=.
BEAM B
YA Bisi ROOF BEAM AT CEILING LINE
TJ-Beam 6.20 Serial Number:7005122634
User:1 12/20/2005 9:15:46 AM 2 Pcs of 1 3/4" x 9 1/2" 1.9E Microllam@ LVL
Page 2 Engine Version:6.20.16
THIS PRODUCT MEETS OR EXCEEDS THE SET DESIGN
CONTROLS FOR THE APPLICATION AND LOADS LISTED
Load Group: Primary Load Group
11' 8.00" ^
Max. Vertical Reaction Total (lbs) 2083 2083
Max. Vertical Reaction Live (lbs) 1290 1290
Required Bearing Length in 1.50(W) 1.50(W)
Max. Unbraced Length (in) 110
Loading on all spans, LDF = 0.90 , 1.0 Dead
Shear at Support (lbs) 650 -650
Max Shear at Support (lbs) 771 -771
Member Reaction (lbs) 771 771
Support Reaction (lbs) 793 793
Moment (Ft-Lbs) 2249
Loading on all spans, LDF = 1.15 1.0 Dead + 1.0 Floor + 1.0 Snow
Shear at Support (lbs) 1707 -1707
Max Shear at Support (lbs) 2025 -2025
Member Reaction (lbs) 2025 2025
Support Reaction (lbs) 2083 2083
Moment (Ft-Lbs) 5907
Live Deflection (in) 0.202
Total Deflection (in) 0.326
PROJECT INFORMATION: OPERATOR INFORMATION:
PAUL BONGIGLIO Bill Rubel
93 KELLEY RD Mid-Cape Home Centers
HYANNIS MA PO Box 1418
465 RTE 134
South Dennis,MA 02660
Phone:508-398-6071
Fax :508-398-4559
brubel@midcape.net
Copyright ® 2005 by Trus Joist, a Weyerhaeuser Business
Microllam® is a registered trademark of Trus Joist.
r
7
4 TOWN OF BARNSTABLE BUILDINGPERMIT APPLICATION•
Map o1 Parcel A-111W DO Permit# 2-
Health Division � � Date Issued
Conservation Division (ri Z ZUO i Fee 6
Tax Collector
Treasurer,
reasurer nP R _
�B," SYST010 MUST Eye.
Planning Dept. INSTALLED IN COMPLIANCE l
Date Definitive Plan Approved by Planning Board 'WITH TITLES
—ENMONMENTAL CODE AND
Historic-OKH Preservation/Hyannis TOWN REGULATIONS
Project Street Address 3 kie Ile d _
Village 14V A/V�V i
Owner l4-v /,` i`d Address 7 s 4 l(e 6 yo9fV A/�SF
Telephone -567- 775—/ 0/S
Permit Request s�j�G"- Rox 20
Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new
Valuation 1500 Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathere& ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family a Two Family ❑ Multi-Family #units
Y( )
Age of Existing StZFull
Historic House: ❑Yes No On Old King's Highway: ❑Yes 6 No
Basement Type: ❑Crawl 0 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 new
Total Room Count(not including baths): existing new First Floor Room Count </
Heat Type and Fuel: d Gas ❑Oil ❑ Electric ❑Other
C@ntral Air: ❑Yes 0 No Fireplaces: Existing I New Existing wood/coal stove: ❑Yes M No
Detached garage:❑existing ❑new size Pool:❑Zing
ng ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed: ❑new size Other:
Zoning Board of Appeals Aut rization ❑ Appeal# Recorded❑
Commercial ❑Yes No If yes,site plan review#
Current Use Proposed Use
/ BUILDER INFORMATION
Name Id/�J-r `� Telephone Number
Address f1d Xi to U^W A) License#
Home Improvement Contractor#
Worker's Compensation# O
ALL CONSTRUCTION DEBRIS RESULTIOFROM THIS PROJECT WILL BE TAKEN TO
0
r
SIGNATURE CL DATE
FOR OFFICIAL USE ONLY `
PERMIT NO. _
DA'rI'E ISSUED -
: '
MAP/PARCEL NO. a:
ADDRESS: = ;- - _ E-VILLAGE
OWNER,
t
DATE OF INSPECTIOA`
FOUNDATION
FRAME
INSULATION
FIREPLACE cw _
ELECTRICAL: ROUGH ad " ' FINAL 9 -
PLUMBING: ROUGH FINAL
GAS: Y? ROUGH FINAL
FINAL BUILDING Fi�✓ 1 'C N
DATE CLOSED OUT
ASSOCIATION PLAN NO. i +
F •� • _
a =_
!? 6 SO Sr.,
�eri;if ed tb...
Vig M
L a T 8 6 04 T NATIONAL CITY MORTGAGE COMPANY
JAMM
C.
tA OF
cg
-o<—,
Z>;
NOTE:THIS PLAN WAS DRAWN FOR MORTGAGE PURPOSES ONLY AND IS MOTTO BE ■w p /�/�
RecOl;aEn,OR CONSTRUED As AN 1AISTRUMENT SURVEY. rf1►I aRTGAGE LOAN INSPECTION
NOT TO BE USED FOR ERECTING FENCES OR ISSUING BUILDING PERMITS.
61D�39 S�S'a PUVJ'REFEI2EKCE: rt.-;siG%P6.%s/ ��1
DEED
I CERTIFY THATTHE STRUCTURE ON THIS PLAN IS LOCATEQ A?prM MATELY AS SHOWN 814 R N s-TA 8 LJEC �a An J S MASS.
WAND THE tOCAT10N CONFOR�DT THE ZONING LAWS OF THE CfTY OR TOWN OF
id tUENTS OMYJ OR IS EXEMPT FROM W ION ENFOnCEMENT 09 fi&-�'� ��"$`�� � Culurf Tly
ACTION UNOEA MASS.G.L_TITLE VII,CHAP.40A.SEC.7,UNLESS OTHERWISE NOTED OR
sII HEREON. SICALE: 1•• S"O '
�I HEREBY CERTIFY THA7 THE STRUCTURE SHOWN ON THIS PLAN DOES NOT LIE WITHIN
THE SPECIAL ROOD HAZARO AREA AS SHOWN ON THE F.I.S MAPS FOR 1'NE CITY OR
TOwNOF �t►aNs7-. gcE _ JAMES C. YAFIADES---REq--LAND SUR-Y_EYOR..:.. ..____..- ...m
-- "'GATED:'-FT�:rC-l9;`-t 7-85-�•-COMbtIJNITI'-PAI�IEL NO, •Z S�o o i- eg a.S.-G. _ - .____.
256 YVQRCESTER LANE, WALTHAM, MASS_
Jar The' Tow of Barnstable
M,ABS $ Regulatory Services
Thomas F. Geiler,Director
Building Division
Elbert Ulshoeffer, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
t
Permit no.Date J h l /0
AFFIDAVIT
HOME IMPROVEmEN'I'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.
o
Type of Work: Xdbd 6A)SW 0QT 1'Q?J Estimated Cost P
Address of Work: nl ,3
Owner's Name: ?A U .,o
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
[:]3krk excluded by law
�," ob n er T,U00
rIding not owner-occupied
ner 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.
s l q e( 4.i a.
Date 0 er' ame
g1orms:Affidav
" The Town of Barnstable
tasants-reet.�
94, E �.� Regulatory Services
°' Thomas F. Geller, Director
Building Division
Elbert Ulshoeffer, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-62=0
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:_?3 7`L-/le y rd L YAWN;-
number street
village
"HOMEOWNER": f l�V ` �� �DN�1 � 1 1 U �0$Z7�—o�0/S �-���"wo
• name home hone
n P work phone a
• CURRENT MAILING ADDRESS: 7 KP of L°y
oat!v el t
chi'/town state rip 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 suuRervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is
intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or
farm structures. A person who constructs more than one home in a two-year period shall not be considered
a homeowner. Such"homeowner'shall submit to the Building Official on a form acceptable to the
Building Official,that he/she shall be responsible for all such work performed under the building permit
(Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code.and
other applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
procedures and requirements,
ce ,
T ,,
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing,35.000 cubic feet or larger will be required to comply
with the StA Building Code Section 127.0 Construction Control,.
HOMEOWNER'S EXEMPTION
The Code states that "Any homeowner performing*3vork 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.
p Tire 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:FO R M S:EXEM FM
0
17ze Commonwealth of illassacnuse=
_�� r„
Wa - �r Department o�'Indtuvial Accidents
#A7C.a offs YOS&U MVIUS
600 Washington Street
Boston,M=S. 02111
Workers' Camnensation Insurance davit
mac• v( &AIrfcf
C)
t0=6� �@
NNi Da 64
I ata a h4m an work layseif
� I am a sole amariaor acid have no one wo�aae is an9 c�atit9
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Faflsat w seems eo+QaLe as re4oaed ceder SeettmtZSA ofMGL ISZ C=j=d to tise ingwm iest of jai panides of a flits ap to SI-500 QX
o���� as�mt as weir s:dtit penaittea is the form of a sin wom oM=and a fae of S100.00 a day afaiast=r- i=detsmo
o�py of ab statmzaey be forwarded to the Otaee oflaresdgxdam of the DlAfor coraat e
I do hereby crrtify tender the pans artd potaitirs of perjury that the infommtion provided abom is tr.=d corm
s
Date
Plot name Ph=
FL
do not writs in this area to be compisted by city or town oMdA
peiadt/llcease ft ❑Buai Dep=�
- pilcea:m;Board
ediate responas is required H eal t Devczz's O�Health Deosr=m'phone fh
(�'Others
Information and. Instructions
�1
,�lassa.:�us G=.:r d Laws chapter 152 section 25 requires aU emniovers to provide workers' comn=saaon fc:
e,=ioy=s. As quoted frc=the 'Iaw",an empze vex is defined as erery P=son in the senzce of another lmd.•:zm, zz
o f nire, dress or implied, oral or written.
,An M DIOV&.iS d`Encd 3s an icufividua, P , associzda . cc=orzd=
thr fozr_oiue in orothsle_:af �; oraaytwo or.-�
eagagcd doiat cmerprise,and incivamg the f egal z Pr=F=M Ives of a e.. cd=pioyer, or ttW
trusL�of an iadiviaual,parttirrri-W-. association or other feQai entity, CmPloymg®loyacs. Howerer tL- :.:.
dwciffng house having not more than th=apart and who r=d=th.--mot, orth oceuaam of th-dwe?liaz ic,__
ancthr who emnfoys Pons to do ma;rrrrr,a,.M -
m•rcP=vM&on such dwelling house or on t�_- .:
building apPurtenaat tberzto shall not because of such employment ba deemed to be an®foyer.
MGL chanter 152 sectfia 25 also states that every state or.local Iicrnsff agency shall withhold the issuance o r rt
of a ficease or permit to operate a business or to construct bafidings in the commonwealth for any appficaar wn
•not produced acceptable evidence of compliance with the insurance coverage q . may,n .,;,
c�aaR'calthnar nay of its polifirnT subdivisiaas shall etrreriato ea�art far •
aCC-=b1e.."'V1Q��of Cam_ i==y�j&the gyp •,��ri'rrr'ar'.�r of pIIb�2C R'otb
of his chapter have b=prz =cd to tL-c =
.�ppft:�nts
'f.iSe YY in the ' caMP"Tsadn"affidavit a by tL-b=
'?� 8 Y��s add;Lss and phone==b=alatgwaa errata cfb I:rs to your a1,
to the Depa ==of mth�iaiA=ij==for _....�as aII affidavits may be
�coverage. Also be sure to sign an;
atr:tlte afudavit. davitshotdcibemtnmedtothe yarto�vathatthe application for th,-p=it orR=e is.
=g rah ==d,not the Departrarat • ShmIA� �rrgardingthe "law" if.
.quiz-.:d m obtaizt a wow'mmg oaP�,P '' 'e Cal the D
atth.,aumbe listed below. .
ry or Towns
x be surr thatch:aix=" cis and legffly aaaz==has •
• • �D proviaed a spar~atthr,aottam of
azvk far you to fill autinth ev tho Ofaa
_ f has to ca�ar
� th'apliatnt. PL--se"IIisth- m wZ=to n
as a_ Gr. '�,-affidavits may be z to
D.—jarm=by mail or I:AMaril other hm beeamade.
OT= of. rsamti®s would Ii'lor 20 thank you inadn=fnr you cocpnm=,Md should you have say au—micas.
se do nut hsaatr to give us a,rall•
Dom, --ma's ado. ,tes-pares.-anti faxmm�aer:
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Oilteo of tmrestfpa�ons
600 Washington Street
Boston,Ma 02111
fax it: (617) 727--7749
LiLl I - CKl w r
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ao
sus.- COS
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4 �P AarE.
Nor S k"D w N
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. : C sgofj e t\A
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444.' TOP PLA;'t=S 4WD2 y P �-�.r
pasts 6' 3�F ern �Uu'�t2S
f
t 'c MeN� st%L Floor
�r
or - Ioor i Nc
for S(A� w i
bolis i or
()rOVNd.
ab P
�� I�;c� 5 a� CPI"� ►�
�etc), c
�� 3...............
Assessor's map and lot number .. ........................
SEPTIC SYSTEGVt MUST BE , `.
Sewage Permit number .. . .. . .... ..................................... ' ,STALLED lid COMPLIANCE z
4 A ?TICLE 11 STATE
�PyoFTNETo�o TOWN ®F BAR.N' �, � �L 4 .
ii •
i 33MUST"LE, i
"6 q BUILDING INSPECTOR
o war a'
APPLICATION FOR PERMIT TO ........................ W..................................................................
TYPE OF CONSTRUCTION .................................�rC��G 'ol..... ? ...........................................................
........................gV.. ...,t?....19.!ItF
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit accordin//g to the following information:
Location .............................��.3......./(9/ i.. ......../..)Ff:..........................................................................................................
ProposedUse ............/... ... . G.....................................................................................................................................
Zoning District ...................... L/........................................Fire District .....
/-//- ...................................
Name of Owner . ... ........
•... ...........Address .D.. . � ... �......................................
Nameof Builder ................ ................................Address ....................................................................................
Nameof Architect ..................................................................Address ................. ..................................................................
Number of Rooms ................0.-A cc......................................Foundation ...........2E.S.1��F.....................................................
Exierior ....................................................................................Roofing ....................................................................................
Floors ...............................�s( g .......................................Interior ...................`lea.��...................................................
.
Y
Heating .............................:/.f�!?.!,t'.C�......................................Plumbing ............/....��C;.....................................................
Fireplace ..................................................................................Approximate Cost .......................... ...nu.a O
........ . ...........
Definitive Plan Approved by Planning Board ___-_-____________________-__19________. Area �j/ S'
pp ,
Diagram of Lot and Building with Dimensions.....1....�.Fee ..............................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
f7D
o�
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... .....&~ z..................
°Clough, Glenn B. o
No ... ... Permit for .........16360 tool .. .......
shed {
........... ......... .........
d
............................. . �.� �
Location ..........93-ali7 ad
........................
Hyannis
.........................G...................................................
Owner lean B, Clough
...........................................:....:.................
Type of Construction frame
................
..........................
................................................................................
Plot ............................ Lot ................................
Permit Granted .......J ..3...................19 73
Date of Inspection ...................... .............19
1TV,
Date Completed .I .3.......19
C hP �
PERMIT REFUSED
................................................................ 19 #
...............................................................................
................................................................................
...............................................................................
...............................................................................
Approved ................................................ 19 -�
....: .........................................................................