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Home My WebLink About0019 BUTTERNUT CIRCLE i � �U-ff��r �+ _ C'.�� , Map Parcel 0? Permit# House# 9 Date Issued It I Boa of Health 3rd floor)(8:15 -9:30/1:0 - ) "`7,�' _ ee 5 . J7J Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) S 11 Planning Dept.(1st floor/School Admin. Bldg.) SEPTIC SYST �• Definitive Plan Approved b Planning Board 19 �' PP Y g -�STi4LLED IN E . WITH TI ="9. TOWN OF BARNSTAMEONMENTA ° rL9 Xa� Building Permit Application ' Project Str Address A? ~ Village Owner Address I Telephone Permit Request 5 First Floor square feet Second Floor square feet I Construction Type�;�/ � , Estimated Project Cost $ Zoning District R/= Flood Plain Water Protection 14, Lot Size Grandfathered ❑Yes ❑No 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 ❑Crawl alkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing_� New Half: Existing _� New No.of Bedrooms: Existing `New Total Room Count(not inc.uding baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Oil ❑Electric ❑Other Central Air ❑Yes No Fireplaces: Existing New Existing wood/coal stove ❑Yes p'NO Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ttached(size) eQ�� ❑Barn(size) ❑None hed(size) 8 ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ I Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE / DATE BUYQ ING PERMIT DENIED FOR WOLLOWING REASON(S) A A; l' ,, . \ft FOR OFFICIAL USE ONLY PERMIT NO. w DATE ISSUED MAP/PARCEL NO. +" ADDRESS 1 - VILLAGE OWNER ` DATE OF INSPECTION: FOUNDATION FRAME . I CIO INSULATION ` FIREPLACE ` ELECTRICAL: ROUGH FINAL r PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDING , DATE CLOSED OUT ' ASSOCIATION PLAN NO r The Town--of Barnstable 9�' r Department of Health Safety and Environmental Services Eo rra► Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 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 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 nts. Type of Work: Est. Cost .7 '01 ?e Address of Work: Xg Owner's Name , Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. lding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR L2�Z& Date wner's Name r-_ The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of/nlvestigstions 600 Washington Street Boston,Mass. 02111 Workers' Co m ens ation Insurance Affidavit name: location: city hone# I am a homeowner performing all work myself. ❑ 1,a sole ro rietor and have no one workin in any ca acity � � %%/, ❑ I am an employer providing workers' compensation for my employees working on this job. cmiiaany name: address.:... .. . . <...... ciW: .. .. .. . .. . insurance co. ... .. olicv# Xv ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name• ..... address:: ; phone#: msnrance:co... oliry# ;;:::::;.;:::::::,::::::.;;::::::>:;<:;:<:>:«:>:<:>;.>.......::;;;;::;:: camaanv name.... .. ..:<:;>:as:::<>::;:>::.;.;.;..:. ... :..; address: ...... ctt nfi one: Mtrance- "olicv. XX Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify r the pains and penalties of perjury that the information provided above is truo and corr ct Signature Date Print name Phone# ofiicial use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (roved 9/95 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees: As quoted from the"law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in.a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having hot more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and, date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law"or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned io the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents - - Office of Invesugaflons 600 Washington Street Boston,, Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please prim DATE f ..... , JOB. LOCATION Number Street address Section of town "HOMEOWNER" �?8 Name Home .phone Work phone - PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEF'EINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building OfficiE on a form acceptable to the Building Official, that he/she shall be resDonsib! for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Ste Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands . the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL 7- Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "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 OwnE shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of -a supervisor (see Appendix 0, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarene. often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner� acti as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/Fier responsibilities, ma: communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the 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. r` 61Cr-..�_ ... - IT 1 Ap 10 77 o I I ! � r , r , o r 1 V1 N a a i c , t y N 00 d s o - - b TOWN OF BARNSTABLE 25712 Permit No. Building Inspector la,arun. : Cash --------------------------------- °" OCCUPANCY PERMIT Bond 4 Issued to Theo Construction Co., InAddress lot #29 19 Butternut Circle, Cotuit „ Wiring Inspector l_ �/ ,r_; Inspection date 1, Plumbing Inspector Inspection date F Gas Inspector 6 i� Inspection date ywEngineering Department�.� Inspection date Board of Healthil Inspection date 7 THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119'0 OF THE MASSACHUSETTS STATE BUILDIIN ODE. .. . 14y ................. .......... .............. .......... Building Inspector FROM �- TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr: Francis Lahteine 367 MAIN STREET HYANNIS, MA 02WI Town Clerk Phone: 775-1120 L SUBJECT: FOLDHERE DATE i August 15, 1984 MESSAGE ,Work has been completed under Building Permit #25712 (Theo Construction Co.). Please release Bond. SIG ED� DATE REPLY j SIGNED I N87-RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY • PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH CARBON INTACT. 'AJ V m T /3 r4 v.t3 n Z 7 it 26 N $ q V Ln-V z1 Q z400o ± o map u� Zt6,a40 , • 2a� PLAN Sf�f WING aszQ " FOUNDATION LOCATION W_ wl C O roIT I MASS. m OWNED BY: T ro C64 ST tit Ac GRl �.ra !J . r zLl SCALE P A= —016,T DATE: QLr ZZ, 1965 o NORIVAN GROS SHAN ------REGISTERED LAND SURVEYOR l HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED ON THE LOT ASSHOWN AND CONFORMS TO THE TOWN OF ZONING REGULATIONS REGARDING doea� SETBACKS FROM STREET LINES AND LOT LINES . GR12775 Q NORMAN GROSSMAN R.L.S. DrtTE " y Assessor's map and lot number '..../...�. . . Sewpge Permit number .. .... ... Z EAR394ADLE, i House number ....................................#19................ rasa � alduvq y e� �� po,s639. 00 G ��,.Q IFO YPY a` TOWN OF A`e, r" ,TABLE Fs.kw j lYw BUILDING INSPECTOR APPLICATION FOR PERMIT TO .............Construct . ........................................................................................................ TYPE OF CONSTRUCTION ........................ ...Wood......ame.............................................. .......................................... Fr 0-"Z!�--... .......................19.1(W TO THE INSPECTOR OF BUILDINGS: J The undersigned hereby applies for a permit according to the following information: 1 Location Lot 29 Butternut Circle, Cotuit, Ma. ....................................................................................................................................................................................... Proposed Use Residential ........... ........................................................................................................................................................... Zoning District ...........Fire District .....COtuitt Ma.................... Name of Owner Theo..Construction Co. , Inc. Address 24..Great Pond Dr, r So. Yarmouth,. Ma. ................ .................................... ........................... ..... Nameof Builder .....Same ...............Address....................................... .................................................................................... Name of Architect ...N./a........................................................Address Number of Rooms 5 Foundation .....Poured concrete ............................................................. shin le ................Roofin Asphalt ....................................shingle Exierior ...................:..Cedar...................... ...................... g .............. Pl ood .Interior Sheet Rock Floors .................. ..�..................................................... .................................................................................... Heating .....FHCnI — csas ..Plumbing .........11/2.b? ,UIS................. Fireplace ...................One........................................................Approximate Cost .......... ...................................../�.... Definitive Plan Approved by Planning Board --Sept-------21-------19_Z3__. Area ..... ..f...;!....V.7"........ pd Diagram of Lot and Building with `Dimensions Fee �� ......... ....... ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH D" � o OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ................................. . ................... 016681......Construction Supervisor's License .............................. ' 'THEO CONSTRUCTION, -CO. INC. 257124 One Story ,M3 .....* .......... Permit for .................................... � Single Family Dwelling ........................................................................... Location -,LQ-f;...2-9.o......19...Buttemaut...Circ. Cotuit • ............................................................................... Owner ...Theo...Co.n.str.uq.t.io.... ....QQ..... ..... .... .. ....... .... .. . ..n Type of Construction ...Frame.......................... . .............................................. ................................. Plot ............................... Lot ................................ Permit Granted .....October 28........19 83 ...................... Date of Inspection .....................................19 Date Completed .....................19 . 7, " Assessor's map and lot number .... ...:.....�..I.. ...... { ',xq �fTHEtO Selwage Permit number O.� 7 d x / / 9 q�AB6 E. i House'"numbe'r ....................................:.................................... �O 163 0; p G �0 YPY.6• i TOWN OF BARNSTABLE BUILDING IN.&P-1CT0R APPLICATION FOR PERMIT TO Construct , TYPE OF CONSTRUCTION .....................W�..... ..................................................... .......................................... ' - ...................................19.6? .r' TO THE INSPECTOR OF BUILDINGS: The;undersigned hereby applies for a permit according to the following information: t I\ `� � :l4� I of 29 Butternut Circle, Cotuit, Ma. tLocation f.. ................................................ ...................................................................................... ................................... • ,I, Proposed Used..........ReS1.. ........................................................................................................................................... COtuit, Ma ZoningDistrict ......... ..........................................................Fi.re District .............................................................................. - o Name of Owner �o Constructinn Co. , Inc' .Address 24 Great Pond Dr. , So. Yarmuth, Ma,. „ ................................................................... ............................ ................ Sane Nameof Builder '....................................................................Address .................................................................................... Nameof Architect ..N/a........................................................Address .................................................................................... 1 Number of Rooms ...5.............................................................Foundation ....,Poured concrete MjCedar shingle Asphalt shix%qle Exterior .................:.......................... ......................................Roofing ........................................ ........................................ r � ' FloorsPl OOd...............................................Interior ...........Shee....RQCk................................................... Heating .- F ::-.:9as.:...:........:...................:.......:Plumbing ........alf2_bc3ths:.....................:............�... -*,. Fireplace on2.............................,..........................Approximate Cost ..........25,,000............................................. }............... Definitive Plan Approved by Planning Board __Seipt._____ 21_______19.7_3__. Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ` J OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. • Name :......: .....:............. ... .............. Construction Supervisor's License 016681 t� •t `. THEO CONSTRUCTION, CO. , INC. A=40-97 25712 One Story No .................. Permit for .................................... Single Family Dwelling .............. .................o............................................... Lot 29, 19 Butternut Circle Location ................................................................ Cotuit .............................................................................. Theo Construction, Co. ztOwner .................................................................. :"—T-ype of Construction ...Frame...............................;....... ................................................................................ Plot ............................ Lot ................................. October 28, 83 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19