HomeMy WebLinkAbout0221 OLD TOWN ROAD rj .
I
(21e
0e) /S- C) a � � �,
Town of Barnstable *Permit#
Expires 6 months front issue dote
Regulatory Services X eeSS t�t��r� �
e
awar�ere�s �T U uVI VI
►�' Richard V.Scali,Director APR 25 2015
Building Division
Tom Perry,CBO,Building Commissioner TOWN OF BARN STABLE
200 Main Street,Hyannis,MA 02601
www.town.barnstable.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 a,Cll 90
Property Address 20 1 O to I C,tk;n ,, �4 lJ�,-x'I rl 15
[residential Value of Work$ (' Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address CrrV e
Contractor's Name !r4r-'ed:ra Telephone Number 520 9223
3
Home Improvement Contractor License#(if applicable) f Email:
Construction Supervisor's License#(if applicable)
[l�J�orkman's Compensation Insurance
Check one:
❑ I am a sole proprietor
❑ 1,4jn the Homeowner
' D4 have Worker's Compensation Insurance
Insurance Company Name rr w ems.h�Pc a� iS�
3� -S
Workman's Comp.Policy# ivc
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Requ t(check box)
UeRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 1r�,n . EL"MI�
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
i ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
F Separate Electrical&Fire Permits required.
i
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required..
SIGNATURE:
C:\Useas\Decollik\AppD,f L.ocal\MicrosoftlWindows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc
Revised 040215
ACC CERTIFICATE OF LIABIL17,1NSURANCE DATE`M'�2015 Y'
T'�I t;"_! n 1 (?q(�h1�.- 9 4282015
,E
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DO ES N OT AF FIRMATIVELY O R N EGATIVELY AM END, E XTEND O R ALTER T HE C OVERAGE AF FORDED B Y T HE P OLICIES
BELOW. T HIS C ERTIFICATE O F I NSURANCE D DES N OT C ONSTITUTE A C ONTRACT-B-ETWEEN`:7,11E I-SUING I NSURER(S), A UTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the
terms and conditions of the policy, certain policies may require an endorsbment. A statement on this certificate does not confer rights to the
certificate holder In lieu of such endorsements .
PRODUCER NAME: "—Berld - d.RLs r Services
Hannon Ryan Insurance H ;� h FAx
PO Box 457 AIC.No.DO: Sb0:dU 4589 (AC.No.: 866 215-8118
ADDRESS: PolicyServices(g?berkleyrisk.com
Pembroke,MA 02359 INSURERS AFFORDING COVERAGE NAIC B
INSURER A:
INSURED Jason Standish INSURER B:
dba:JBS Roofing INSURERC:
50 Grove St INSURER D:
INSURER E:
Plympton MA 02367 INSURER F:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
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 LTR TYPE OF INSURANCE NSR WVD POLICY NUMBER POLICY EFF POLICY EXP MM/DD/YYYY MM DD/YYYY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTEDPREMISES Ea occurrence $
❑ CLAIMS-MADE ❑ OCCUR ❑ ❑ MED EXP(Any one emon $
PERSONAL&ADV INJURY $
_ GENERAL AGGREGATE $
GEN'L AGGREGATE LIMIT APPLIES PER: - PRODUCTS-COMP/OP AGG $
POLICY ❑JERCT ❑ LOC $
AUTOMOBILE LIABILITY 11 ❑ M I L $
I Ee aceldent
ANY AUTO BODILY INJURY Per arson $
ALL OWNED ❑SCHEDULED AUTOS $
AUTOS BODILY INJURY Per accident
HIRED AUTOS E]-NON-OWNED _ PROPERTY DAMAGE $
AUTOS Per accident
❑ $
UMBRELLA LIAB ❑OCCUR ❑ EACH OCCURRENCE $
EXCESS LIAR ❑CLAIMS-MADE AGGREGATE $
DED RETENTION$ $
WORKERS COMPENSATION WC STATU- OTH.
AND EMPLOYERS'LIABILITY YIN X TORY LIMITS ER
ANY PROP RI ETD R/PA RTN E RIEXECUTIVE E] - E.L EACH ACCIDENT $ 1 00000,00
A OFFICE/MEMBER EXCLUDED? NIA ❑ WC-20-20-005522-00 1/92D15 1/9/2016
(Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 100000.00
It yes,describe under -
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000.00
❑ ❑
DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD'101,Additional Remarks Schedule,if more space U required)
Election Category Election Status Name All EntitiesAnsureds:
Sole Proprietor Exclude Jason Standish Jason Standish
• • P
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY.OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Town of Hyannis EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
367 Main St ACCORDANCE WITH THE POLICY PROVISIONS.
- - AUTHORIZED REPRESENTATIVE _
Hyannis MA 02601
r
The Commomdi~ealth of Massachuselft
Dgwrtnnent oflndustrial Acddents
Office of investigations
600 Washington S~
Boston,MA 02111
wernv massgo►1dia
Workers' Issuance Affidavit BmkderstContractors/Flectiridans?bnnbers
Applicant Please Print I.es�'biy
Address:
City/State(Zip: r
Arc yo,xm employer?C6esk dw appropriate box: Type of project(required):
L I am a employes with 4. ❑ I am a general contactor and I 6. ❑New Construction
employees(fidl and/or part-time).* have hired the sub-contracton
2.❑ I am a sole proprietor or partm- listed on the attached street. 7. ❑Remodeling
ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. employees and have waikers' 9. ❑Building addition
wadmrs'comp-m�uce comp.insurance.I
5. ❑ We are a corporation and its l0.❑Electrical repairs or additions
3.❑ required-] officers have exercised their 11. airs da additions
I am a hdrmeoumer doing all wtuk ❑Pluming�
myself[No worloers'comp- right of exemption msption per MGL 12.❑Roof repairs
ias� ]r c. 152,§1(4),and we have no
employees [No workers' 13.0 Other
comp.insurance requited.]
*Any qqdb=tint dadm hour#1 most also fill out the section bdrw dwwias their wakes'compenutimpacy infinummisoL
1 Hama sown wbo submit this aifidna iaftodug they are doing all work mad dwn hue onuide cooncans mast submit anew Mdwa®dreg sort.
tConuscaon that dnxk ibis boa most xmKhad as additional suet showing the name of®e sdb-ca®tractoas and stye wbobw at n t those ionise have
employer. If the sub<anuumn haw•employees,tiny—ast provide tb w wakes'comp.policy mmaber.
lam an employer than is proving m vrken'compensa&n insanrrrce for my eurployen Below is the policy arrd fob siAr
ireformwWom
Iasutsace Cry Name:
Policy#or Self-ins.11c.#: Fj*atioa Date:
Job Site Address: City/StffWZip:
Attach a copy of the workers'congmutkm policy declaratfon page(showing the policy r umber and expiration date).
Faihae to secure coverage as required tinder Section 25A of MOL c. 152 can had to the imposition of criminal nal penalties of a
Sae 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.
Ida,hereby an the pains andpenahies of perjury that the information prau¢bd a"' and correct
Date: l iJd
� f
Phone M ZV
Official aye only. Do not+urine in this area,to be completed by city or totem offlc&L
City or Town: PermitUcense 6
Issuing Authority(tdrele one):
1.Board of BW& L Building Department 3.Citylfown Clerk 4.Electrical Inspector 5.Plumbing lugwtor
6.Other
Contact Person: Phone!!:
6
�t
ROOFING
" 5 0 ��r:,R e• RE 6 > P„-Y�Y+?is T y c tfi e-,. 0 2 31 6 7
O4. e F r r. 0 2 7«
This contract, dated July 28,2014 is by and between the owner and contractor
Owner: Paul Gravel
35 Marilyn Way
Halifax,MA 02338
Property Address:
221 Old Town Rd
Hyannis,MA
Contractor: Jason Standish DBA JBS Roofmg
1.General
This contract,is.for the following work.and materials to'be,performed by Jason Standish and
crew
On the property address above.
The project.is to strip and replace all house roofs �✓� $/�r �'
2. Liability
JBS Roofmg is fully insured with liability and Workers Compensation.
JBS Roofmg has an unrestricted building licensenumberl04056, and home
improvement license number164092.
' :-During this re-roofing project the shingles will be installed to manufacturers specs and
'done by the MASSACHUSETTS STATE BUILDING CODE 8TH ADDITION.
This pro-iect is generally described as follows:
■ Hang tarps to protect house and'landscape
■ Strip off all existing roofs and dispose of debris in dumpsters provided by JBS
■ Inspect roof decking and replace any rotted or damage wood. Plywood $50 a
sheet installed boards $6 per foot
■ Re-nail loose roof decking
Provide and.Install CertainTeed Ice and water shield underlayment on all eves at
least 3ft up from the gutter so it is past the exterior wall at least 2ft. Wrap ice
shield around.all 'roof penetrations like chimneys, skylights, pipes and at. cheek
walls where there is step flashing
Provide and install felt paper on entire roof deck-
Provide and'mstall 8 inch drip edge on all edges '
Provide and install new pipe flanges for all pipes
■ Provide and install new exhaust vents where needed
■ Provide and install Shingle vent II ridge vent on entire length of ridges
• Provide and install CertainTeed shadow ridge caps
Provide and install CertainTeed landmark shingles
■ Grounds will be cleaned and raked free of nails and debris at the end of every day
■ Provide all permits
CERTAINTEED LANDMARK SHINGLES $5
JBS Roofing will provide a 10 year workmanship warranty on all work. -
JBS Roofing will provide a full roof inspection 2 years after completion date,upon your request.
No charge for this inspection.
Upon acceptance of this proposal payment shall be as follows:
50%deposit bgfore start of work,balance due upon completion of work
Ux i dv-fl 1v-L tic
,T
ACCEPTANCE OF PROPOSAL ----------------
Owner: �'Y d r/ S� 4 JBS Roofing:
� - 50 Grove Street
Plympton,MA 02367
Thank you Jason Standish
Proposal will be honored for 120 days
se or.registration valid for mdividul use only
Licen return to:
o o iration:date. If found ulatton x'
before the eap'
'= ~
office
of Consumer Affairs and Business Reg
10 Par Suite 5170
kPlaza -. -
o. . MA62116 .
Boston, r
yy
'.V O.`
Zoo tti it'll'?1 1j1.I k
'0 w �`N �4 Not valid without sign
at
"Al
CO
0CIA
z ,w O F-
'C- Dm` K U =QN = ,
O W. 'o! N
m
O` O _
j
4 ti r '73ePaf 'ie�s o
►�4i1�Safe . :
F. Bair o Qud rl " Y
RE9ufatrorrs��ncl~�fandars
a� Cohsttrcfron
.� F rs'tsDr 4: j
'cute
('S 104056
A.
a Jt1.S3N B S7v
50 GRAVE S�ANDI'S`H
r Plympton Mk
0267'
n. L „ •:w � Mti
Expiration
s GomrtnssiQr}pr
x � 06/18/2015 =i
. -`e-5u.4_ �•..:-ems t �-.. -�}:.
Urir�sricted= dings of any use glroup wluc y
r; r
t. cones less tl n IS OOU cubic feet(991m3)of
enclosed space
Failure to possess a current edition of the Massachusetts
State Building Code . cause fo{revocation.of this license.
For DPS Licensing information visit' www.Maks.G&/D.PS 5. V
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION {
Map Pare' O° OF S,ARNS`IAKE Permit#
Health Division — Date Issued > o a
7 I v u %n JUL - 1 PM f: 2�
Conservation Division < Application Fee
Tax Collector 0 ,
DIVISION .r,��T�C� ��4� e W0i L
Treasurer INSTALLED IN C0rUPI,I.UX
Planning Dept. 'TIIT'E 5
ENVIRONMENTAL CODE ANO
Date Definitive Plan Approved by Planning Board TOWN REGULATIONS
�nOu+�
Historic-OKH Preservation/Hyannis Sy
Project Street Address
Village
r
Owner Address dEF
W Oise lie
Telephone . LUI 1 0 Z
Permit Request * &�MAzw ad&�cm 1(v I 4d&
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District . Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size V. 77,�; Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family- ❑ Multi-Family(#units)
Age of Existing Structure Historic House: ❑Yes �No On Old King's Highway: ❑Yes �No
Basement Type: Full ❑Cr�10 lkout ❑Other
Basement Finishe Area(sq.ft.) A Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing ew Half:existing new
Number of Bedrooms: existing_ new
Total Room Count(not including baths): existing new First Floor Room Count_5
Heat Type and Fuel: XGas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes X No Fireplaces: Existing New Existing wood/coal stove: ❑Yes (,t(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 Authorization ❑ Appeal# Recorded❑
Commerciale--❑Yes L_o_ If yes, site plan review#
Current Use Pro osed Use
Al
{ BUILDER INFORMATION
C t
Name Telephone Number
Address L NA
4111 License#jl�A' I A�rA' ?v f(A
Home Improvement Contractor# __. ?22-
r
Worker's Compensation# �
ALL CONSTRUCTION DEBRIS RESULTING FROM HIS PROJECT WILL BE TAKEN TO
OWN Uow 0
SIGNATURE DATE __ c
FOR OFFICIAL USE ONLY
k
:PERMIT NO. -
DATE ISSUED --
MAP/PARCEL NO. '
ADDRESS VILLAGE
OWNER i M
DATE OF INSPECTION:
FOUNDATION �� �lO
FRAME
:3 4
INSULATION
FIREPLACE ,
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH J FINAL m 1
GAS: ROUGHL= j,. . FINAL
A FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
XRESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings $100.00
Residential Addition $50.00 S P® 0
Alterations/Renovations $ 50.00
Building Permit Amendment $25.00
FEE VALUE WORKSIIEET
NEW LIVING SPACE ,
square feet x$96/sq.foot 49 :2 x.0041=
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE `
square feet x$64/sq.foot= Q x.0041=
plus from below(if applicable)
GARAGES(attached&.detached)
square feet x$32/sq.ft.= x.0041=
ACCESSORY STRUCTURE>120 sq.ft.
>120 sf-500 sf $35.00
>500 sf-750 sf 50.00
>750 sf- 1000 sf. 75.00
>1000 sf=1500 sf 100.00
>1500 sf-Same as new building permit:
square feet x$96/sq.foot= x.0041=
STAND ALONE PERMITS
Open Porch x$30.00=
(number)
f 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 TS - d
Projcost
Rev:063004
The Com�niinveath of Massachusetts .
-- ccidents'
• - � 'atA
u shz
nt
o
nd
t ea
rtm e
f
_ 60g Washington,Street _
Boston;Maas. .02111
workers,,,.0 m ensation,InsuranceAffidavit-GeneralBusines`ses
•/// y � '`3',,:, � •\,.;ytaL SN.ram — L,. • , I S '� r ... •,
address:
state:
1000.
work site locati fu11 address : Retail R aF/�at ug E.tabh hmeut
rietor and have no one ' Bpsiness Type: at Antos etc.
❑ 1 apa.a sole prop ' • []pgce❑Safes(inc ding REal Est e,
Ikin in an:y capacity p}her '
�''`o g "eJn to ees full&' art time : ❑ R/////10,,j///�
am an em 10 /%/%// � �%%/%%/%% %%/%�//%%////%%/ gs rob., ,
Ngr
1%�%%/%%%%//////M easation for my employees working 0 9 J '
an,employer providing vlArkers'cb �r< < L. . r• '
r.. IMP
'9n• net .1 st, ti;p- `+?.�{+F'. .r ,ry, J^,f•,,�I,,l + v. ",ltt: •t'' 1S ,• �(I,.fi •+r• 'r.
COrh' it ��' '• 0, r 'y d. ti.rS ry fr�S'Nti.,:tr.;i .rt"�k'.:ir•';\ :S e•
, '( •" :+,�'I�: •p;' •ti4;' •�i+t�,�!.L+:;+.if,.t.:�.t,`.,,.5:�;,'.'':. as:.,.. :�,•S+ rt•� y'• 'Ftr i''"'- - '
• t, -t. 1 .,Kr ',,' :Jr;'Gr � ,.r '�UliO. •,:• _ ''i . �1. '' .•�
.: :r,';:+�•.°' •'•L d•• ~«• .ftt.'. �•1f, •{• _i.r+,,'.1• }}�� .5.�= (... �. ;�'. :;5�• r.tt• 5 •d
tirisiiYa�ce.cosu, • VYorlCelS'
//
' a sole proprietor aIId'have hired the indep dent contractors listed below'who have the following
p polices: '
tionli •: `•''ti
nl
.�;• y., r �,�t. t ,tiy.L ,t•';t1:
•CO a ,.ti.• •, ., . , ;Err, 9.t^,},�:-'v�'t•?:• 's:*•:��',4t„r��•�rl; �iti:::•�'..:., 't
a L.,. < 1. , �r.•..
••��: `t:.(:S. '}'
'•i:C:L�::ir".�.• 'S\hy.« a :•F'' r •,f�. .yr •% •1, !:. " ^f.'rea. +'.'•,�•, ••••i•r;'�e�°:�' ..
rile,1 L. .t y .r.. .: ' .+,r :'t.••'' yyt r, i .f.
' 613 I78n1�,,. i. 't.• n';.,,..r ::. ' S 1 Y Srr '. _ �jr (5tit t,
� .t• .:'.•••a,1�'l;i i•'itl'.�,�.J•:4•. .Ji,.'•• 7 ?r•' 1• S ..� i• t:-'•;' t• v::i��. ai• -•�.• '.-.t .. rr'r: v '
t.•I,rjw'• rL r �,; ,5�1.,r t,l.• 'r 1�•. (��. ,, t ,��, At' ',r `,•,: .,.•' '.
' ••• ;ii-••Li r.••r r� I', .1 ti•r� Y.. / 1 ..l :r, •,
ad1 ,: 4'. .':•r "' . .tr•t:,r,,r;r •: .•'• • r . .t , t�.':.t . ••Ir-0r::....t ,rL` t:
ress,. '" .r ,r,.,.• � •i ,., ', •, •e�;: �,;• �;��' :: •c .:•zw-: ,r. ••,
�, •,. L• Y.•.a'' t •` '':7?r,, �,7r't';�t'Yt.•.�F�;{:l �G 1'• r eLi , ?i. �••1.i.r •r'•. , .. !•'1"f''
•' . 'C'' ' •.;'•i•... •ti,.;+�, :f t• •,;'' a t,L,.t•.1. j� U'dne�.. r•.,..- •' - .: 4, r,
ti• 5 i .� ''' �• J :i r 1 ',•. Lr�."tiyl 1.::: to.a'r••:1:% ,.:�}mod:is�:•i ?'. , t'r}��il
Cl t N.t: .': J 1 ..�: } 'i 3, rtrtQ:Fjr'(+,`t•:i: 1 ,� ::'•:: ,rt t. t,� ;' (' tiy•,• �f' S' L'
., ;Kr.�'.,L, •.�„r rS 1 y,,r: +1,. i L .+ r. �. + 'S.. !. ,�r: t: ;Y:'�.a•+
'r�• e;.•
• /r;:,. :1 5 t1'• a ry a`S r . t
l r:t;t�• �1 „ . !";'. U ,t p^, •x A •s`:.=a?Y/1}�'}. 'Y:. ,r::'•�0'i1C 7J:' .r,?1:2 t:..�:,2{'.•: .r�:''.•�.a ��/����/%
��.•';,, � •i•IJ,�':�Fy3',,.T_`�'4y�(�i• t;..Tr.,•.. 4•q �••".: :Ir!'::,. :"1:' ••• ,
1IIS11ra11Ce'CO. � , •�• . '�•' •',� •1 'y t I"''""'` '.r T.i't r••• 'j i•I'•;•:�,'"•'
/ ,: � .•,.r y.t�ti •, ,t.; •t :, r 1: ::•0•:Y•it .r J,;,t.'4.�r:,.,+5 d`•: t.7 M.•,+'•"i-� tt•.•'
,r ;; "'.fir: ,r• ;;'. 't1,.•i I e:: '' •+ r':;' It..tijtLs;'r••y Y r y,•:�.I.......•t' tJ... .r:raSrt
i ijttfi"1r•:�t'+ .Sr jr�:ti,y*,y.1r,t•4+ 1 •..•t:•:y''' rr Yfu e•fm.tiidi�,,• •'t t' •,�'t•�t r,t• ;t'Jt r:i:'a. {T y, a c .C•'
'rrL.s'j"y�tY`^;�YI.C� t'�n;.�l t.r�:•'�t' ti:'':`..it�'•�;.<�•',•(+r....t.• rya t.. r ,�r;•• .. .!� t'• •'.l:• 't
ColnA.
gn. ii&nLe.•+�:r �* _ .',, :,• , t^ :y'i: .rk e `
a(LTeSS: t• .. •^ •• L, ' t•• '+l.if'."L.!;. ' �i,.,'1 :•s:
8 '1: , ,r , !• �. .r0..r .r:. i;�tliN.jj :t��'i;:' l,ti;+,•, •r r...':'ti.:. �• • {,
. (, ''•. ` ''�' :-.• } ;•i,' r :'. 11•L '�.,,•If••'..s�l t:• ''t''�'ty•.:'i�;•• ':R�}:t .i,.
r• G••• •.i, y t.«ri. , th•.(„�..w: ,1.. ,'•,.+1,1:.,('•'• 'y't: }, r•;s:y�.;y.',_ •,1 aA. ,.
' •; r'::r:•�i•t •ki;}. :,:•�}�•;;�• t rt ,ts,•' 1. s a:,,..iL t ,4:.t ,�•,.�L, :,l'''1�at K.i r;l•.tix-•.'1.',L 5$• '�t. t
' (•���':}�'•;'! ,;, •>.';p.. ` rr,,,''�� .. { 4;`:; +11.�','iL'.I.S.Y O'11C1•:tFr• :t�'.i:v..i�.•. ,� :S •.s: .:
pye a as required Hader Section z5A of MCrL 152 can lead to the Imposition of crimfnal penaYties of a fine up to$1,500,40 an or
Failure to secure c 8 enalti the form of a STOP WORK ORDER and a fine of$100.00 a'day against me, I understand that}t
one years'imprbonment as well as ctvilp
copy olthis statement maybe forevaxded to ffice of Investigations of the minor coverage verification
I do hereby certify u t pains d aldes bf perjury that the inform provided above is free and eG orle ✓ '
Data -
5�ignature s phone#
Mint name ,
official use only do not write In area to be completed by city or town aTicial
permit/license# []Building I)epartment
[}Licensing Board
city or town:
❑selectmen's Office
0-check if{mmeawe response is required ClEcalthDeparlment ,
'[]Other
phone#;
contact person:
{I6Y1sed Sept,7003)
__,,..•-.r_v,•a,•ra,cYti.-� .r7.'= Ye n' f�+-Isva,Mc.s+r..�. `
' Information'and Instructions
r ' eral Layvs ch�pter 152 section 25 requires all employers to providc•warkers' eompensatidn far their.
Massachusetts G j "`
the `law" an employee is.defined as every person m the.er of another under any, act
=vloyees; s quoted from p
of hire;expres s or implied; oral or written.
' partnership, corporation or other legal entity,'or any fwo or mgre of
An employer is defined as an individual,p hip xP
the foregoi gag ea in djoint enterprise,and including the legal' 'resentatives of a deceased,employer;or the'receiver or
trustee of an indind'�'partnerslnp,•association or other legal entity, employing�loyees.'Howevei••the owner of a
dw g house hang.-not'inore than three aparbnents and•who resides therein, or the oeeupant;o the:dwelling hous a bf
another v ho emplbyspersbris to a i nu intcnance, constriction or repair work on such dwelling fiouaedir on the grounds Orbbuilding,appenantthereto shall not because of such:erisploymeut.be'deemed'tobe air pnployer,•. ,. .
r' t licensing-agency shall withhold the issuance or renewal
MGL chapter.152 sectibn 25 also's�Eates that'every state leeal h g Y .
too crate a business or to construct building's in the,conmriwealth for any applicant who has
Of a license or perm?f p
not produced accepfable•evidence•of coimplian with the shall enter int any eotdtr'acgfar the performancee of'publictwork unto
coixraa�v'balthnor•any•of its political subdivisionsY
c e of.compliance with t�e insurance requirements of this chapter have been presented:to the contracting
acceptable eviden •.
authority.
Applicants
Pleaseeyyork�s� eompensatiorr 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 maybe submitted
to the Depariment'of Industrial A60dents•for confirmation of insurance coverage. Alsobe sure to sign and date the
affidavit. The aff davit should be returned to the city or town that the application for the permit or licens a is being
requested, not the pepartment 6�hadustrial kccideuts. Should you have any questions regar&gr the•"Iaw"or if you are
obtain 1) grkers'•compensatidmpplicy,please call the Department at the ninnber liste,cl,lielow.
required to, , . .
City or Towns .
pleasebe sure that the affidavit is complete anclprinted 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 fillip the per number which wM be used as a reference number. •The.affidayits maybe returnedtq
mail •F•AX unless othe'r'arrangemmts have been made,•
the DepartmentbY. ,
The Office of liavestigafions would hike to thank you in advance for you cooperation and slionld you have airy questions,
esitate to give us a caTL '
please do noth
/
' address,telephone and:fax number.
The Depts
The Commonwealth Of Massachusetts
Deparbnent-of Industrial Accidents
. Bl�GB Oi(HY88T15 '
60o Washington Street
Boston,Ma. 02111
fax#: (617)7z7-7749
.n_ f"MN "IwT.Annn __1 'AAC
i
Town of Barnstable
o� Regulatory Services
Thomas F.Geller,Director
v� sbg9• $ufldiug DM810I1
�lFo MPS k Tom Perry,Building Commissioner
' 200 Main Street, Hyannis,MA 02601
• Fax: 508-790-6230
Offsce: 508-862-4038
permit no.
pate '
A�AvzT _CT OR �
� OVF,INUNT CO
SOTJPMEPLEMERN O PERMIT APB CkTION
an additionto any pre-existing ow4er-occupied
L c•142A requires that the"reconstruction,altela£ons,renovation,repair,modernization,conversion,
MG
improvement,removal,demolition,or construchan
buA�g cantainmg at Least one but not more than fora'dwelling units or to structures which are adj scent to
such residence or build'mg be done by registered contractors,with certain exceptions,along with other
requilements•
� � Estimated Cos
Type of Work:._—
Address of Work --------------
Owner,s Na �
Date of Application:
I hereby certify that:
gegistration is not required for the following reason(s):
[]Work excluded by law '
[]lob Under$1,000 ,
(]Building not owner-occupied
[]Owner pulling own permit
Notice is hereby given that: OWIj ftRM�T OR DEALING WITII UNREGISTERED
OWNMRS pDLLING TERM
oxT UXTORS FOR A PIACAB.'I,E HOME FOR GUARANTY CP UND U NDER NI,GL r 142A.
ACCESS TO THE
ARBITRATION PRO
GpAM SIGNED UNDER PBNALTIES OF PEPTjF'Y
Thereby apply foi apermit as the agent of the ow4er:
Contractor Name
• Registr 'onNo.
pate
R
Owner's Name
March 18, 2004
Town of Barnstable
Building Department
F Hyannis, MA•02601
I hereby give Gary A. Ellis of Northside Building Consultants authorization/7to apply for a
building permit for construction of a handicapped accessible bathroom and for the
replacement of some windows.
The property is located at 221 Old Town Road, Hyannis. ..
The parcel ID #268-190.
If any further information is needed, please call me at(413)967-6558.
Res fully,
ohn S. Lasek
Barbara J. L sek
f '
F
c'm air' rp }!.
a.
f
I
MAScheck COMPLIANCE REPORT
Massachusetts Energy Code ( Permit #
MAScheck software version 2.01 Release 2 I
I
checked by/Date
I
CITY: Barnstable 'JAW
D .
STATE: Massachusetts r1 L-ar—�
CONSTRUCTION TYPE: 1 or 2 Family, Detachedf/
HEATING SYSTEM TYPE: Other (Non-Electric Resistance)
DATE: 7-1-2004
COMPLIANCE: PASSES
Required UA = 36
Your Home = 16
Area or Cavity Cont. Glazing/Door
Perimeter R-value R-value U-Value UA
-----------------------. -------------------------------------------------------
CEILINGS 96 30.0 30.0 2
WALLS: wood Frame, 16" O.C. 224 15.0 15.0 10
GLAZING: windows or Doors 7 1 0.340 2
FLOORS: Over unconditioned space 96 19.0 19.0 2
-------------------------------------------------------------------------------
COMPLIANCE STATEMENT: The proposed building design described here is
consistent with the building plans, specifications, and other calculations
submitted with the permit application. The proposed building has been
designed to meet the requirements of the Massachusetts Energy Code.
The heating load for this building, and the cooling load if appropriate,
has been determined using the applicable Standard Design Conditions found
in the code. The HVAC equipment selected to heat or cool the building
shall be no greater than 125% of the design load as specified in
Sections 780CMR 13100 and 14.4.
Builder/Designer A: IVw j f:: Date
Massachusetts Energy code
MAscheck software version 2.01 Release 2
DATE: 7-1-2004
Bldg. l
Dept. 1
Use I
I
CEILINGS:
[ ] I 1. R-30 + R-30
Comments/Location
I `
WALLS:
[ ] I 1. Wood Frame, 16" O.C. , R-15 + R-15
Comments/Location
WINDOWS AND GLASS DOORS:
[ ] I 1. U-value: 0.34
I For windows without labeled u-values, describe features:
I # Panes Frame Type_ Thermal Break? [ ] Yes [ ] No
I Comments/Location
I
I FLOORS:
[ ] I 1. over unconditioned Space, R-19
Comments/Location
AIR LEAKAGE:
[ ] I joints, penetrations, and all other such openings in the building
I envelope that are sources of air leakage must be sealed, when
I installed in the building envelope, recessed lighting fixtures
shall meet one of the following requirements:
I 1. Type iC rated, manufactured with no penetrations between the
I inside of the recessed fixture and ceiling cavity and sealed or
I gasketed to prevent air leakage into the unconditioned space.
I 2. Type IC rated, in accordance with Standard ASTM E 283, with no
I more than 2.0 cfm (0.944 L/s) air movement from the the
I conditioned space to the ceiling cavity. The lighting fixture
I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure
I difference and shall be labeled.
VAPOR RETARDER:
[ ] ► Required on the warm-in-winter side of all non-vented framed
ceilings, walls, and floors.
I
I MATERIALS IDENTIFICATION:
[ ] I Materials and equipment must be identified so that compliance can
I be determined. Manufacturer manuals for all installed heating
and cooling equipment and service water heating equipment must be
provided. Insulation R-values and glazing u-values must be clearly
EI marked on the building plans or specifications.
I DUCT INSULATION:
[ ] I Ducts shall be insulated per Table 14.4.7.1.
I
I DUCT CONSTRUCTION:
[ ] I All accessible joints, seams, and connections of supply and return
f
.,a .
I ductwork located outside conditioned space, including stud bays or
I joist cavities/spaces used to transport air, shall be sealed
I using mastic and fibrous backing tape installed according to the
manufacturer's installation instructions. Mesh tape may be
I omitted where gaps are less than 1/8 inch. Duct tape is not
I permitted. The HVAC system must provide a means for balancing
I air and water systems.
I
TEMPERATURE CONTROLS:
[ ] I Thermostats are required for each separate HVAC system. A manual
or automatic means to partially restrict or shut off the heating
I and/or cooling input to each zone or floor shall be provided.
I
HVAC EQUIPMENT SIZING:
[ ] I Rated output capacity of the heating/cooling system is
I not greater than 125% of the design load as specified
I in sections 780CMR 1310 and 34.4.
I SWIMMING POOLS:
[ ] I All heated swimming pools must have an on/off heater switch and
I require a cover unless over 20% of the heating energy is from
I non-depletable sources. Pool pumps require a time clock.
I
HVAC PIPING INSULATION:
[ ] I HVAC piping conveying fluids above 120 F or chilled fluids
I below 55 F must be insulated to the following levels (in.):
I PIPE SIZES (in.)
HEATING SYSTEMS: TEMP (F) 2" RUNOUTS 0-1" 1.25-2" 2.5-4"
I , LOW pressure/temp. 201-250 1.0 1.5 1.5 2.0
I LOW temperature 120-200 0.5 1.0 1.0 1.5
Steam condensate any 1.0 1.0 1.5 2.0
COOLING SYSTEMS:
Chilled water or 40-55 0.5 0.5 0.75 1.0
I refrigerant below 40 1.0 1.0 1.5 1.5
i
CIRCULATING HOT WATER SYSTEMS:
[ ] I Insulate circulating hot water pipes to the following levels (in.) :
I
I PIPE SIZES (in.)
I NON-CIRCULATING I CIRCULATING MAINS & RUNOUTS
HEATED WATER TEMP (F): RUNOUTS 0-1" I 0-1.25" 1.5-2.0" 2.0+"
I 170-180 0.5 I 1.0 1.5 2.0
I 140-160 0.5 I 0.5 1.0 1.5
100-130 0.5 I 0.5 0.5 1.0
I
----NOTES TO FIELD (Building Department Use Only)-------------------------
e
—: v/
Board of Building Regulations and Standards
-- One Ashburton Place - Room 1301
Boston. Massachusetts 02108
Home Improvement Contractor Registration
Registration: 136832
Type: Private Corporation
Expiration: 9/4/2004
NORTHSIDE BUILDING CONSULTANTS IN
GARY ELLIS - - - -
141 MAIN STREET - ----- --- - --- -----
YARMOUTHPORT, MA 02675 - -- - -
Update Address and return card.Mark reason for change.
— Address i 1 Renewal I! Employment F"I Lost Card
✓fie vanv�nan�uP,ctlC� d�i�Ooac/auaelta
s- Board of Building Regulations and Standards
License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to:
Registration: 136832 Board of Building Regulations and Standards
Expiration: 9/4/2004 One Ashburton Place Rm 1301
Type: Private Corporation Boston,Ma.02108
NORTHSIDE BUILDING CONSULT C-
1;�1� ��LLIS
141 MAIN STREET
YARMOUTHPORT. MA 02675 _._._.. ...._....... _.---___._--- ---------------.---
Administrator N valid with t signature
'A
_ Board of Building egulations
One Ashburton Prace, Rm 1301
Boston, Ma=02108-1618
License: CONSTRUCTION SUPERVISOR LICENSE Birthdate: 02/07/1955
Number: CS 015833 Expires: 02/07/2006 Restricted To: 00
GARY A ELLIS
141 MAIN ST +
YARMOUTH, MA 02675 r Sr
Y
./Tr. no: 87358
3'"`` Keep top for receipt and change of address notification.
✓l:e 1�omYnwruuea`l� o�/�aaoacLuavtta
BOARD OF BUILDING REGULATIONS
License: CONSTRUCTION SUPERVISOR
Number�� 015833
Birthdate 021.0711-:955
Expire '02/D7/2006 Tr.no: 87358
Restric cJ s 00
GARY A ELLIS
141 MAIN ST
YARMOUTH, MA 02675 t Acting C mis over
r
Assessor's Office(1st floor) Map.-., r Lot - Permit# "
Conservation Office(4th floor) ) / Date Issu' d- 06 —
Board of Health(3rd floor)(8:30-9:30/1:00-2:00) ® `�
nt vca
�4 uY U
Engineering Dept._(3rd floor) House#Y IN TALLE®01ANC
Planning Dept.(1st floor/School Admin.Bldg.) [���A�p WITAN®
Definitive P ved by Planning Board 19 'TOWN R
TOWN OF.-BARNSTABLE
Building Permit Application - "
Project S eet ress „t-Z/ 64Z>
Village
Owner ^/d 7W s -Z7,4 Address
,Telephone
.Permit Request �ir� �l;� '` k/
-Total 1 Story Area(include 1 story garages&decks) square feet
Total 2 Story Area(total of 1st•&2nd stories) # square feet
c
Estimated Project Cost $ f D 0 --
Zoning District ` Flood Plain Water Protection
Lot Size Grandfathered ?
Zoning Board of Appeals Authorization Recorded
Current Use Proposed Use
Construction Type
Commercial Residential
Dwelling Type: Single Family Two Family Multi-Family .
Age of Existing Structure Basement Type: Finished
Historic House Unfinished
Old King's Highway
Number of Baths No.of Bedrooms
Total Room Count(not including baths) First Floor
Heat Type and Fuel Central Air Fireplaces
Garage: Detached. Other Detached Structures: Pool
Attached Barn
None Sheds
Other
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 DATE c
BUILDING PERMIT D ED FOR THE FOLLOWING REASON(S)
FOR OFFICIAL USE ONLY -
PERMIT NO. #8015
r
r
DATE'ISSUED June 29, 1995 -
A
MAP/PARCEL NO. 269. 190 -
ADDRESS 215 Old Town Road VILLAGE Hyannis, MA 02601
OWNER John .& Barbara Lasekee
y }
ff .
DATE OF INSPECTION: ► w
FOUNDATION
FRAME
INSULATION ! -
FIREPLACE -
ELECTRICAL: ROUGH 'FINAL I
PLUMBING: ROUGH FINAL - _
ell-
GAS: FINAL ! r
FINAL BUILDING: E
4 DATE CLOSED:bU7 , r
•yam
ASSOCIATION PLANfNO. i -
w.
I1%02,94 17:02 'C61 7 727 7 122 DEPT IND ACCID Cm00:
Y
l/ -
Catiu ojuueaLti
ll``IIL O/ I nnlI 1VaJJaCii..uJettJ
' aUaparfinenf o�.�nd�trial,�1cci�ents
600 W u44Vton Stmel
James J.Campbell 02111
Commissioner
Workers' Compensation Insurance Affidavit
with a principal place of business at:
(awisrwizip)
do hereby certify under the pains and penalties of perjury, that:
I am an employer proviclmg workers' compensation coverage for my employees working on
this job.
AlIkIS4 ter./ 5=
Insur Company Policy Number
() 1 a sole proprietor and have no one working for me in any capacity.
I am a sole proprietor, general contraao or homeown circle one) and have hired the
contractors listed below who have the fol wo compensation policies:
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
O I am a homeowner performing all the work myself.
I endErs[ir,d t`at copy of dais S,ttement will be fone.zrded to d:e Office of lnvestirztions of[he DIA for coverage verification and that failure to secure
cc•,•erage s rec.ired under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisting of a fine of up to s 1,s00.00 and/or cr.=
years' imprisscr.r-ent as well as civil penalties in the fom:of a STOP WORK ORDER and a fine of$I00.00 a day against me.
Signed this 7t day off
Licensee/ ermittee Building Department
Licensing Board
Selectmens Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
mnTn' Ar__n_An7QIlT_AnS r_. I7=7r-nT_!.T(I nrnMTT 11_ _-
r
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE ....
JOB. LOCATION
-Number Street address Aection of town
"HOMEOWNER"
.� ✓
Name Home phone Work phone
PRESENT MAILING ADDRESS 01,,0/ d 4
ity/townstate . 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(sj 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 to six 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 Officia
on a form acceptable to the Building Official, that he/she shall be responsibl
for all such work performed under the building permit. (Section 109. 1. 1)
The undersigned "homeowner" assumes .responsibility for compliance with the Sta
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 comply with d procedu es requirements.
HOMEOWNER'S SIGNATURE
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 co`d`e state that: "Any Home Owner 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 Owner
shall act as supervisor. "
Many Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisors (see Appendix Q, Rules and Regulations
for licensing Construction Supervisors, Section 2. 15) . This lack of awarenes
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 actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities, man
communities require, as part of the permit application, that the Home Owner
certify° that -he she -understands :he responvibilit es'of 'a supervi5% : On the
last 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.
Y
% t
The Town of Barnstable
anexsrABM
KAM peg Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-775-3344 Building Commissioner
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 arr: 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: �X/,11 Est. Cost
Address of Work: J,z/ 0Le3?
Owner Name: ,�rgs
�/a,�i�i� S. ,�
Date of Permit Application:_ -�S�
I hereby certifv that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000
Building not owner-occupied
i✓ 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. er's name
r
SHEDS BY EVELANll
209 IYANOUGH ROAD
HYANNIS, MA 02601
(508) 778-5667
POS'!' & BEAM GARDEN SHED
THE CLASSIC
FRAME - ALL LUMBER IS FULL DIMENSIONAL PINE
2 X 6 FLOOR JOISTS; RAFTERS, COLLAR TIES @ 24" O.C.
4 X 4 CORNER POSTS
2 X .4 STUDS AND PURLINS
1 X VARIOUS WIDTH DECK, ROOF BOARDS & SIDI'NG
ALL VERTICAL SIDING TO HAVE 1/2 X 2" BATTENS @ SEAMS
(ALSO AVAILABLE WITH CLAPBOARD SIDING . )
OTHER SPECIFICATIONS
PRESSURE TREATED PILE FOOTINGS WITH TERMITE SHIELDS .
6" TEE HINGES., METAL HANDLE AND LOCKING HASP
ASPHALT ROOF SHINGLES
NON-VENTING WINDOW WITH SHUTTERS AND FLOWER BOX.
ENTRANCE RAMP..
i
ALL HEIGHT DIMENSIONS APPROXIMATE
i --16
Ft�
73
{
0
vtC---
�= 4 3,:5—;
�nl F
0
ncA sj 7
.m
IWO
t9
The Y,iowI) 0,'i 7'16,cs p,Ers7
/s /h:�'� .117 f/fe f/aocf hVIg4-W ZoiJe
S �
tJ �� c� OEORGE
�i'vD1 Comm. Pa11e/'}` 2,5a /-o4DBC- � L : J.
LANIDES y
No. 22723 e
ClSTER��
��191i M�SJ
7'11C
CD�•f orn�ec/ �� 7`�ie Lo �i��q .�r✓5 a �:�`� e
�►�n o � Barnsfa6/e k�he<, c�o�sfruc�e�(,
,A'D IN K/, NYANti'/S PLO jC T ,!,4
P?/ 04D TOWN fort D LaT '��
Q� �e re-hc e ' TU H Al S. g,4 RBA 84 j- ZA S.�E--K
D ced SG s} t.i l i 3 a Ac•� 8, /9�6
17cccl 6k 4794 , 5/ Goo: 7• Z 4A/✓DFs 2EG: E^!G',ey�Su,evt yn,e
P/ar, g;/C 2e-8 t90 4.B 7,eZUSt. A LAI, Wly'AA2A14007N Mh,
..h ...tGh-.>•cv m.,aa,Q ::,,c.:^^,...,., .:4'✓w , .. .. a 1�'i wney..i. .t:::j.'!`�.r�rr"2'a'fC.�..4w''rx.'�',�:=rix�,... "`� _
The Town of Barnstable
Department of Health, Safety and Environmental Services
NAMBuilding Division
367 Main Street,Hyannis MA 02601 - {
Offices ,500 77V�227 r , ;4.1ltalph Crossen
' Fax. . 568=790-6230 R e Bwldmg Commissioner
Building Permit Procedures for Sheds&Decks
E
µ rF 4 1 Plot plan or mortgage survey required for zoning compliance Placement of structure
;. r
roust be 4ketched in. and distance from boundary lines indicated Hai IecafiYan r;_tl:e
sewage disposal system should be shown as well.
W
O 's wa st Di 'ct Co . .a .. p o p , t
t n/d lit o for prop es 1 ed in t c no;;�� e
r= Ivfi a
3. Apkato sigcoffmustbe op bWnrd re el:
<; Assessors Office(1st floor Town Hall) -
Conservation Department(3rd floor Town Hall)
Health Department(3rd floor Town Hall-8:30-9:30 am& 1:00-2:00 p.m.)
Engineering Department(3rd floor Town Hall)
4. One set of plans 8.5"X 11"or 8.5"X 14"(cross section and framing schedule) must
be provided. -Pre-fab sheds require factory brochures and,specifications.
' 5. Construction Supervisor's License&Home Improvement Specialists License copies
are required for a shed to be built on site or for a deck. A copy of the Home Improvement
Specialist's License is required for a pre-fab shed. (Unless the homeowners are applying
fob the remit in their o3 xm—nee).
i.
6. Home Improvement Contractor Affidavit must be submitted. (Unless the homeowners
are applying for the permit in their own name).
7. Workers Compensation Insurance Affidavit form must be submitted if construction is
to be done on site. I
8. Homeowner's License Exemption form must be submitted if the homeowners are acting
as the general contractor or doing the construction themselves. i
9. Permit Fee to be paid before permit is issued.
PERMIT
' _ • ,. . is . :.:
a D
12
•' � •'
9
\V,HTA/
�� -
LeW &t4 va-r on
-7e--- rd
► 0��
r7
r ,
GARY A. ELLIS
_ NORTHSIDE
BUILDING
CONSULTANTS, INC. �.
FINE HOME BUILDING & RENOVATION .
141 MAIN STREET •YARMOUTHPORT • MA 02675
(508) 362-2210 • (508) 362-9802 • Fax: (508) 362-5269
r
•r ; OfONE
/
WON + •
r
10- l
J14
iON
�'� ��■■ _ / 7
W
411, ►� .JA
i
r
0�1 i'1
I ! tl 1
el
ar
AMA
�' wl dewlu
ON, I D�IC 1lot�- 10
ve �Zt 11
alb ` .
e-y-
O 1
GARY A. ELLIS
O � g
NORTHSIDE
1 , BUILDING
COI�SULTAI`ITS, INC.
l
FINE HOME BUILDING & RENOVATION
141 MAIN STREET •YARMOUTHPORT • MA 02675
(508) 362-2210 • (508) 362-9802 • Fax: (508) 362-5269 14� 70
ACCESS COVERS MUST BE WITHIN 9 ' MINIMUM. INVERT ELEVATIONS : DESIGN CRITERIA : GENERAL NOTES :
6 ' OF FINISH GRADE 3 ' MAXIMUM COVER
INVERT AT BUILDING: 100. 22 DESIGN FLOW:
102. 39 FIRST 2 ' TO
.--- --
BE LEVEL MIN 2" OF PEASTONE INVERT IN SEPTIC TANK: 99. 5 3 BEDROOMS AT I10 G.P.D. PER 1 . THIS PLAN IS FOR THE DESIGN AND CONSTRUCTION
INVERT OUT SEPTIC TANK: 99 25 BEDROOM EQUAL S 330 G.P.D. OF THE SEWAGE D1 SPOSAL SYSTEM ONLY.
4' DIAM Pi PE INVERT IN DIST. BOX: 97. 57
�- ° DOUBLE WASHED STONE INVERT OUT DIST, BOX: 97. 4 NO GARBAGE GRINDER 2. VERTICAL DATUM IS ASSUMED. FOR BENCH MARKS
T==/
99.25 97. 4 IO" ]IV.%
SET. SEE S I TE PLAN,
GAS 97. 57 97. 33 96. 5 INVERT IN LEACH CHAMBER: 97. 33
99 BAFFLE SEPTIC TANK REQUIRED
4 HIGH CAPACITY INFILTRATOR BOTTOM OF LEACH CHAMBER: 96. 5 3. ALL CONSTRUCTION METHODS AND MATERIALS AND
/3 OUTLET -
D-BOX CHAMBERS W/3. 5 '' 330 G.P.D. X 200% 660 GAL .
STONE AROUND ADJUSTED GROUND WATER: N/A SEPTIC TANK PROVIDED: 1500 GAL . MIN. MAINTENANCE OF THE SEPTIC SYSTEM SHALL
1500 GAL 2- 10 'r x 19 ' 1 x 10"d OBSERVED GROUND WATER: N/A CONFORM TO MASS. D.E. P. TITLE 5 AND LOCAL
SEPTIC TANK V6' CRUSHED STONE OR BOTTOM OF TEST HOLE •1 : 90. 0 SOIL ABSORPTION SYSTEM REQUIRED: BOARD OF HEALTH REGULATIONS.
COMPACTED BASE
DESIGN PERC RATE C 5 MIN/INCH
PROF I L E .' NOT TO SCALE SOIL TEXTURAL CLASS - I ALL SEPTIC SYSTEM COMPONENTS LOCATED UNDER
EFFLUENT LOADING RATE - 0. 74 GPD/SF AREAS SUBJECT TO VEHICULAR TRAFFIC OR GREATER
330 GPD / 0. 74 GPD/SF - 446 S.F. REQUIRED THAN 3 ' IN DEPTH SHALL BE CAPABLE OF WITH-
STANDING H-20 WHEEL LOADS.
PROVIDED: 4 HIGH CAPACITY INFILTRATOR
CHAMBERS W/3. 5 '= STONE AROUND. A-460 S.F. 5. ALL SEWER PIPE SHALL BE SCHEDULE 40 OR
460 S.F, x 0. 74 - 340 GPD APPROVED EQUAL .
N O 6. SEPTIC TANK AND D-BOX SHALL BE REINFORCED
SO I L TES T P I T DA TA PRECAST CONCRETE AND WATERTIGHT. D BOX SHALL
I ND I CA TES !NO I CA TES BE WATER TESTED TO CHECK FOR LEVEL WHEN THERE
LOT 2 IQd PERCOLATION =- OBSERVED IS MORE THAN ONE OUTLET.
1�499 TEST GROUNDWATER
7. BEFORE CONSTRUCTION CALL 'DIG-SAFE
I l . 723+ S. F TP s! 1 -888-DIG-SAFE AND THE LOCAL WATER DEPT.
FOR LOCATION OF UNDERGROUND UTILITIES.
p p oo f j 0_ HORIZON TEXTURE COLOR 100. 0
LOAMY IOYR
e A 8. SEPTIC SYSTEM INSTALLER SHALL NOTIFY THE
SAND 3/3 DESIGN ENGINEER TWO DAYS PRIOR TO CONSTRUCTION
6' 99. 5
p LOAMY /OYR OF THE SYSTEM TO ALLOW FOR SCHEDULING OF THE
D SAND 4/6 CONSTRUCTION INSPECTIONS.
F 30" 97. 5
MEDIUM 10YR 9 EXISTING CESSPOOL TO BE PUMPED DRY AND
ti !c0 7 BACKFILLED.
SAND AND 6/8
GRA VEL
�o \ l0. NO DETERMINATION HAS BEEN MADE AS TO
COMPLIANCE WITH DEED RESTRICTIONS OR ZONING
i Lh• Z veK Qp��4pr 50" REGUL A T I ONS. I T SHALL REMAIN THE CLIENTS
CESSPOOL pP\r RESPONSIBILITY TO OBTAIN ALL PERMITS. SPECIAL
IS00 GALLON PERMITS. VARIANCES ETC. FOR THIS PROJECT.
SEPTIC TANK
_ ' BM. CORNER BH
I l . IT SHALL REMAIN THE CLIENT 'S RESPONSIBILITY
i p 112 DAK EL-_102.39 I20 NO WATER 90.0 TO HAVE THE PROPOSED BUILDING FOUNDATION
,_OAK 1J DESIGNED TO ACCOUNT FOR THE EXISTING GRADE
DA TE: APR I L 15. 2004 AND SOIL COND I T I ONS AT THE LOCATION OF THE
/ Ib OAK TEST BY: STEPHEN HAAS PROPOSED BUILDING.
�q NIGH CAPACITY ��� 3 .20 PERC RATE: l 2 MIN/INCH
L EACH I NG CHAMBERS °(J QQ
W/3.5'1 STONE AROUND
�TP'1 5
oO.e�ccEARI.Nv
S
yFo ^0 3
"� B3°35 '40 'w
94
S EP T / C S YS TE M DES / G/V
22 OLO TOWN R0,40 MAP 268 P,4RCEL i 90
WEs r HYA /V/V / SPQR r . "A
PREPA REO
EFr
SO MOR5'E .4 VEWL/UE W,4RE . M, 0 / 082
5C,4L E / - 20 M.4 Y 24 . 2004
L OCUS `
41
f�E
ACH RD�� j Nn+ t!w �,. . i 923 R o u t e_ 6 A
/ CPA 1 GV I L --�'_-
(�` 3 �� r;!'A�"> ice • . �. '� d
"T' a r mo Lit r, p o r t M A 02675
t -r-- !,
i .h`r,, +� T �•�ti ` _ �j �1��� � 5O8 � 362-8 1
1
S
0 10 20 40 JOB NO : 03-087 FIELD: CFW/EEK I CAL C: SAH/CFW CHECK: CFW I DRN: SAH