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HomeMy WebLinkAbout0099 CAP'N SAMADRUS ROAD CaP 'n Sama:dr-us �.Y i . � i, 1" i { i. 1i �. } b% t:, � j. Town of Barnstable • __ � __ . _�_ �_ .. __, Building MA Post ThisCard So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept SAMPO MAM #Posted Until Final Inspection Has Been Made. Permit 16JP � Permit mot' Where a,^,Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final inspection has been made. Permit No. B-18-3742 Applicant Name: Roland Langevin Approvals Date Issued: 12/19/2018 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 06/19/2019 Foundation: Location: 99 CAP'N SAMADRUS ROAD,COTUIT Map/Lot: 038-054 Zoning District: RF Sheathing: Owner on Record: SORCENELLI,JOHN D JR&SHARON F TRS Contractor Name: ROLAND LANGEVIN Framing: 1 Address: 99 CAP'N SAMADRUS ROAD Contractor License: CS-103861 2 COTUIT, MA 02635 Est. Project Cost: $3,804.00 Chimney : Description: Attic; R-30 fiberglass,attic hatch;seal &insulate,vent bath fan Permit Fee: $85.00 through roof,air sealing ventilation chutes,weatherstrip&add Fee Paid::' $85.00 Insulation: doorsweep. ' Date: 12/19/2018 Final: Project Review Req: L�— Plumbing/Gas Rough Plumbing: ` Building Official Final Plumbing: i Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Final Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Electrical This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Rough: Minimum of Five Call Inspections Required for All Construction Work: - 1.Foundation or Footing Final: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Low Voltage Rough: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Final: 6.Insulation 7.Final Inspection before Occupancy Health Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: °FINE, Town of Barnstable *Permit#Czn6rp 'b Expires 6 months from issrre dale Regulatory Services Fee c , t • BARNSfABLE,y," MASS. Rr Thomas F. Geiler, Director � s63q. p ♦� TF039 -PRESS PERMIT a Building Division Tom Perry,CBO, Building Commissioner JUN _ t 2009 200 Main Street, Hyannis, MA 02601 www.town.barnsiable.ma.us 'TOWN OF BARNSTABLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number_______ Property Address64-4 eed _ `n \jJReqidential Value of-Wort. 42' (/( Get Minimum fee of$25.00 for work under$6000.00 Owner's Name & Address Contractor's Name Telephone Number d � �e;) I lome Improvement Contractor License#(if applicable) C Construction Supervisor's License# (if applicable) QWapr*crrrat s Compensation Insurance Check one: -0l am a sole proprietor ❑ 1 am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy h Copy.of Insurance Compliance Certificate must-be on file. Permit Request(check box) IWe-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e. Historic,Conservation,etc. ***Note: Property Owner must si n Property Owner Letter of Permission. A cop/oft/hheom mprovement Contractors License is required. SIGNATURE:Q.`b\l'I-ll.lS\RAM.'building permi forms\E Revised 100608 i Board of Building Regulat ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 134313 Type: DBA Expiration: 10/241200P_ Tr# 259907 DAVID SAWYER CONSTRUCTION DAVID SAWYER 318 MEIGGS BACKUS RD. SANDWICH, MA 02563 -1 Update Address and return card. Mark reason for change. 'S-CA1 0 50M-05/08•PC8490 Address n Renewal ❑ Employment Lost Card • Massachusetts- Department (►t•public Safet% 9 Bnard of Buildin Re--rulations and Standards Construction Supervisor Specialty License License: CS SL 98859 Restricted to: RF,WS i DAVID SAWYER 318 MEIGGS BACKUS ROAD SANDWICH, MA 02563 Expiration: 1/27/2011 ( unuii.�i an•r Tr#: 98859 David Sawyer Construction 318 Meiggs Backus Road Sandwich,MA 02563 508-539-1992 Date �5-- Proposal Submitted To Work Place 1 r 31 STRIP AND REMOVE OLD ROOF SHINGLES. SUPPLY AND INSTALL: COLOR: /b-nai P W69Ct cj-�e*,lr 0,,(v vk c[74� k-91 dz Vey CLEAN&REMOVE ALL DEBRIS FROM WORK PLACE AFTER JOB IS COMPLETED. ALL DEBRIS TO LANDFILL. & ,9.o e) TOTAL INVESTMENT FOR MATERIAL&LABOR:$ All materials guaranteed to be as specified,and work to be performed in the accordance with the specifications submitted for the above work and co leted in a substantial wor anae manned Payments to be made as follows Any alteration or deviation from the'work specifications involving extra colts will be executed o y upon written order,and will become an extra charge over and above the estimate: All agreements contingent upon strikes,accidents or delays beyond our control.Please remove and/or secure any fragile household items. Not responsible for broken or damage household items. Five-Year LABOR WARRANTY/PLUS MANUFACTURES SMNGLF W Y. We may wi fir this proposal if not accepted within 30 days. Respectfully submitted ACCEPTANCE OF PROPOSAL The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payments will be made as outlined above. j DateA S .� p Signature. 1�„ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations- ' 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation lnstrnce Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information lease Print Le 'bl Name(Business/Orgmization/Individual): , Address: CCity/State/Zip: Phone.#: Are you an employer?Check the appro carte bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2: ' I am a'sole prpprietor or partner-' listed on the attached sheet. 7. .❑Remodeling ship and have no employees These sub-contractors have employees ❑Demolition ' workingfor me in an capacity. employees and have workers'. • Y p tY t 9. ❑Building addition [No workers'-comp.-insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LEl Plumbing repairs or additions myself. [No workers' comp. right 6f exemption per MGL 12.E]Roof repairs insurance required.]t c. 152, §1(4),and we have no • employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employ=. If the subcontractors have�mployers,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure fo secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500. and/or one-year imp ' ent,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 day against the viola r. Be advised that a copy-of this statement may be forwarded to the Office of Investi ations o e DIA for ins c coverer a verification. I do hereby c ' under the p ' s• d penalties of perjury that the information provided ab ive is true and correct jSi e: Date: Phone k Official use only. Do not write in this area,to be completed by city or town offu:ial. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health '2.Building Department 3.City/Town CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone M Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,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 engag �n atom en rpnse; min-l5d�mg the legalTepresen�ati ir6f- dec as'etl-empiuyeroi-the=.------" receiver or tiustee 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, §25C(6)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,MGL chapter 152, §25C(7)states`Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public wont until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(s)name(s),address(es)andphone number(s)along with their certificate(s)of insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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. Self-insured companies should enter their i self-insurance license number on the appropriate line. City or Town Officials 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. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to.thank you in advance for your 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 Investigations 600 Washington Street Boston,MA 02111 TO. # 617-727-4900 ext-406 or 1-877-MASSAFE Fax#617-727-7749 Revised 11-22-06 www.mass.gov/dia ` Town of Barnstable *Permit# �8 a q, Expires 6 months from��ye d Regulatory Services . Fee' �C/ tsTns , : Thomas F:Geiler,Director 9 MASS. Building Division Tom Perry, CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-623 EXPRESS PERMIT APPLICATION = RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number l Property Address Q Residential Value of Work Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address 1 CA Contractor's Name Q (' Telephone Number abz- Home Improvement Contractor License# if applicable) /workman's Compensation Insurance X.PRESS PERMIT Check one: ❑ I am a sole proprietor JUN 17 2008 1 am the Homeowner I have Worker's Compensati n Insurance TOWN OF BARNSTABLE Insurance Company Name Workman's Comp. Policy# q Copy of Insurance Compliance Certific ite must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingl s) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of roof) WRe-side s ❑ Replacement Windows/doo s/sliders.U-Value (maximum.35) 7 r r L._ *Where required: Issuance of this penni does not exempt compliance with other town department regulations,i.e.Hiatt c,ConserLaff etc,.` ***Note: Property Own r must sign Property Owner Letter of Permission. ?- v A copy of the ome Improvement Contractors License is required. : &V '-O� SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPF ESS.doc Revise020108 `" r ui in�ge�gulaVons an an ar s91te Boa o One Ashburton Place - Room 1301 Boston, Ma,!�salchusetts 02108 Home Improvement Contractor Registration Registration: 118494 Type: Supplement Card x Expiration: 2/1/2009- BAKER CUSTOM ALUM & VINYLkNC BRETT BUSSIERE < ' 521 SHOOTFLYING HILL RD. ' CENTERVILLE, MA 02632 �-- n, Update Address and return card Mark'reason for change. J Address E. Renewal C Elmployment D Lost Card DPS-CA1 0 5OM-07/07-PC8490 Tie e mmaoouue� �Ga raac/zecaPtYa 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: Board of Building Regulations and Standards Registration: 118494 One Ashburton Place Rm 1301 on: 2/1/2009 Boston,Ma.02108 Type: ment Card BAKER CUSTOM ALUM&VINYL I NPETT BUSSIERE r 521 SHOOTFLYING HILL RD. / CENTERVILLE, MA 02632 Administrator Not vali without signature 110JI-d of'Iluildiiig Regulations and Standards ivellse Uy I'cgiNt'"At to'I %a I id Io I i Id I%III,, use unl� HOME IMPROVEMENT CONTRACTOR before the expiration date. l(found return to; Registration: 118494 Board of Building Regulations and Standards Expiration: 2/1/2009 Tr# 126302 lane Ashburton Place Rin 1301 Type: DBA Boston, ma.02108 BAKER CUS I()M ALUM&VINYL INC. MARK BAKER 521 SHOOTF'LYING HILL RD. CENTERVILLE. MA 02632 Administrator Not valid without Siplljltll-e Hoard lit'Rijil I,,Regulations and Standard, Constru on Supervisor License icense- CS 74477 Birthdate: 1/6fI973 E irition: 1/6/2009 Tr# 8139 Res fiction: 00 FT J BUSSIERE ill i-1VAREHAM LAKE SHO E '_AST WAREHAN41.MA 02538 Commissioner 061,110/1-00> TUB 10'. 33 FAX print IF-xit U y PUIRRIPRE BRft-T T INV Uk 1 `3 ... .. T1 :Date: 5,75/2008 Time, 10003 AN To: ® 9,5063626115 Page: 002 Client#:9742 2 ACORM CERTIFICATE OF LIABILITY INSURAN E 05/05/0088 "' PRIER THIS CERTIFICATE IS ISSUE13 AS A MATTER OF INFORMATION Dowling&O'Neil Insurance ONLY AND CONFERS NO RIG ITS UPON THE CERTIFICATE Agency HOLDER.THIS CERTIFICATE ES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFC RDED BY THE POLICIES BELOW. 973 lyanough Rd., PO Box 1990 Hyannis,MA 02601 INSURERS AFFORDING COVER kGE NAIC# INSURED INSURERA: Harleysville Wor ter Insurance Co. Baker o Associates,Inc. INSURER B: Associated Employ rw Insurance Compa P.O.Box 923 INSURER C: Centerville,MA 02632-0071 INSURERD: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY RIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS ERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EX USIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE-OF-INSURANCE POLICY NUMBER IN t CSTION DATE(MMI'DilfM LIMITS A GAL LIABILITY CB831 T48 04/19108 04119/09 tRSONAL CURRENCE $1 000 000 X COMMERCIAL GENERAL LIABILITY GE TO a muff $10O OOO CLAIMS MADE a OCCUR one Pe+sdn $5 000 X PD Ded:250 s AIN INJURY $1 000 000 ENERALAGGREGATE s2.000.000 GENL AGGREGATE LIMIT APPLIES PER: I RODUCTS-COMPIOP AGG s2,000,000 POLICY JE LOC AUTOMOBILE LWBIM OMBINED SINGLE LIMIT ANY AUTO a acciderd) $ ALL OWNED AUTOS fJLY INJUR/ 0.:Y lED AUTOS HIRED AUTOS OILY INJURY NON-oVVfNEO AUTOS er accident) $ OPERTY DAMAGE $ e:accident) GARAGE LIABILITY O ONLY-EA ACCIDENT $ ANY AUTO THC-R THAN EA ACC $ O ONLY: AGG $ EXCESSAIMBRELLALIABMY kCH OCCURRENCE $ OCCUR CLAIMS MADE kGGREGATE $ DEDUCTIBLE $ RETENTION $ $ B woRKERs COMPENSATION AND WCCSW2454012008 04/23/08 04/23/09 K I T`ffgcysTATu- OTH- EMPLOYELS'LIABILITY .L.EACH ACCIDENT $100 000 ANY PROPRIETOR/PAR NERIEXECUT WE OFRCERIMCiMBER EXCLUDED? NO .L.DISEASE-EA EMPLOYEE $100 000 IL y8e describe OUlderE.L.DISEASE-POLICY LIMIT $SOD O00 SPECIAL PROVISIONS OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Officers are included under the workers compensation policy. Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of insurance shall be deemed to have altered,waived,or extended the (See Attached Descriptions) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBE POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of Barnstable DATE THEREOF,THE ISSUING INSURER ENDEAVOR TO MAL I_ DAYS WRITTEN Thomas Perry NOTICE TOTHE CERTIFICATE HOLDER PAMEDTOTHE LEFT,BUT FAILURE TO DO SO SHALL 200 Main Street rAp=NO OBLIGATION OR LIABILITY C F ANY KM UPON THE INSURER,ITS AGENTS OR Hyannis,MA 02601 REIPRESENTATMES- AUnOR1ZEBPRESENTATTVE ACORD 25(2001108)1 of 3 #S51922/1M51911 I.S1 m ACORD CORPORATION 1988 The Commonwealth'of Massachusetts Department of Industrial Accidents Office.of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pli tubers Applicant Information Please Print Legibly Name (Business/Orpnization/Individual):_�aQye�- N)'�ZnG 1 Q.'te=;1 Address: �� City/State/Zip:0 g ►11� �11� as"3a Phone 3G vQ-. a AA S Are u an employer? Check the-appropriate box:. Type of project(required): 1.[ ! am-a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part time).* have hired the sub-contractors listed on.the attached sheet I ? ❑ Remodeling 2.❑ I am a sole proprietor or partner- . ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers comp. insurance- 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.[3 Electrical repairs or.additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL ll.❑ Phlmbing repairs or additions myself.-[No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp.insurance required.] ,Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: `. Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such. Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy infor rrration. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site nformation. y assurance Company Name: S I Q- M l0 ?olicy#or Self-ins.Lic. #:k)�co_-Sm aA S,q 0 1 .ao-0 Expiration Date:- iob Site Address: CQ��YI DG nn0. D City/StatelZip: kttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to.secure-coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine up to$.1,500•.00 and/or one-year imprisonment, as well as,civil penalties in the form of a STOPWORK ORDER and a.fine )f up to$250.00 a day against the violator. Be advised that a copy of this statement may lie forwarded to the Office of nvestigations of the DIA for insurance coverage verification. 'do hereby 'Wfy 'ass d pe aloes of perjury that the information provided above is true and correct: ii afore:. Date: , Q ?hone#• S�C�' ���' ��"�� Official use only. Do not write in this area,to be completed by city.or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: oFI"HE Town of Barnstable Regulatory Services BARNSTABMMASS. Thomas F.Geiler,Director- i639. iDlFp Mpl a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us I Office: 508-862-4038 Fax: 508-790-6230 i Property Owner Must mplete and Sign This Section If Using A Builder C 1I, 16)n Jo(— G�� ` I , as Owner of the subject property herebyauthorize a ('A ('�`—JCjOGIQI Ti(-IC . to act on my behalf, in all matters relative to rk authorized by this building permit application for. GQ ',n ai- Co+ , i-- (Address of Job) Signature of Owner Date 0 Print Name If Propedy Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. I 0:FORMS:0WNERPERMISSION i Town of Barnstable tJF THE Tp� Regulatory'Services, tiARNSTABLEp Thomas F. Geiler,Director p MASS. 0 1 39. Building Division TfO �A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such 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. 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 lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Boaid 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 such a form/certification for use in your community. Q:fotrns:homeexempt ssessor's map and lot number ................ TH E Sewage Permit number .................................................. 33AWSTABLE, House number ............5;..........(yo...................................... NAM ......... 1639. 0 MAI TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ........ . ...... ............... ...................................................... TYPE OF CONSTRUCTION ..../ - . ........... ............................................................ ................................................19A TO THE INSPECTOR OF BUILDINGS: The undersigned. hereby applies for a permit according to the following information- 3 Location ... .. .,;4................ . ........ ...................... Proposed Use ............................�/j, 47f4� ......................................................................................................................I......................... ZoningDistrict .......... ....... .................:...Fire District .............................................................................. ,,;? -4... Name of Owner . . ......... . .............................................Address ........... Name of Builder Address 316.3.......... llalul�................... ... ..... .. .....***"*'**............ .................... Nameof Architect ... ................Address .................................................................................... Foundation ........................................................ Number of Rooms ................. Exterior ........X/ .....................................Roofing ..... /��............ ............ ..................................... .....................................................Floors ...................?.............. ...................Interior Heating ......... ...............................................................Plumbing ......... Fireplace ...........4,4A— J ;� 3,f eL-V, ....................................................................Approximate Cost .............................................................. Definitive Plan Approved by Planning Board ----------------------------- Area ............. . ./ f. ......................... Diagram of Lot and Building with Dimensions Fee ............... ............; ............... SUBJECT TO APPROVAL OF BOARD OF HEALTH Iv'o I hereby agree to conform to all the Rules and Regulations of the Town/of" Barnstable regarding the above construction. Name .......................... ....................... D'&vaua, Joseph L. =38-54 ° / No _2U9g9_. Permit _..\ j�n�. __. i ---'� ---'� ---- � ^ single family` ~ .. . ' C7�y ' � i Location — . ' Cotuit � � . -----------------.--------.. � i Joa L D' Owner ���� ^ �Y��� .,,- of Construction__ � � rm. / ! ^ \ Permit Granted g . � ' Date ofInspection / Date completed ERMIT REFUSED � ` � / ---- � ) i ---- —''*'--~�—' . . ' ........................................................... ------.. � ` � .-----.—.---.~—...--�'..~---~--... / � . // ---.—..—...----.—.— ---------..' ... . � ___------------- lg Approved --------------..-----~----- / -----------.------------.—.. � ) ' . . � TOWN OF BARNSTABLE Permit No. 20999 Building'Inspector cash -- 7 �YL OCCUPANCY PERMIT Bona "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Joseph L. IPAvena Address Wareham, MA lot #34 80 Captain Carleton's 1.7ay, Cotuit Wiring Inspector /� Inspection date Ae Plumbing nPl ector ; ( �, �,y Inspection date f, - Gas Inspector Inspection date 1/E1gineering DepartmentJ�j/f� ���f���� Inspection date//, 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. w ._, _ 'Building Inspector NOTE ; �oR LOT DI k\EEt`t51 0rt5 12E1�- -5ubD IV lSioN ILAr1 UATV-TD -7• 10•73 . ?jY 6HARLE5 H. OAVWYINC; SURVEYORS L. G. rL'Ar1 34�23 b /3 2 of 4 -7 � Z 0A � g' �ix p�\ CA?, LU 3 LOT 3 4 0 °�, �° `N of �\ CHARLES yG LINCOLN , v ROWLEYMAN n No. 27701 S�tC N 85°27-.o55"\V ` Gb L.o T FLOT FLA" 'OF- .Lo i 34 6ERTIFY -THAT roc- Fo uHVATia-{ 6HOW1 15 LOC/ATC-0 oN TNT GKOut-try A5 mf-i OT&D AND TNAT- ITS LDGAT(OH 1�;, H G O N TO U G T ® iN 00t(FOKAAHCC- wT-H c-xlhTit-( r , SET�Avt< f'EQUi{�Fr\l�t`�'T� of::-THE-- (-Af-N /5AI.1A[DK0l-.J- r\oAD . TDVVN�. .. BARN 5T A ALE- , N\,q,�7�. sI : � k� �cALF I" =4v JA0, 1`3, 1918 Ll GHALEt) L, {�O kP-," �, MIVO(A TEr AA, Ja,� . )9, I9 ? 1 G(VIL PM(:rlr` C-E-K5 .i, '5URVFYoRS Assessciv s number map and lot num ....................................... . F THE T P Sewage Permit number ' . .. ....... � ......................... IS►VS A1C SYSTEM MUST fO� ��� LLED IN COMPLIA ='BAUSTODLE. : 9 MAO& House number ............ . © WITH ARTICLE............................................ SANITARY CODE STATE °� i639 0� ............... ODE AND TOW oMAIa� ° PFONULA ��� TOWN OF "BARNSTAIME , r BUILDING, 'INSPECTOR APPLICATION FOR PERMIT TOe..................... 9.4............... TYPE OF CONSTRUCTION .... .............................................. ................................................ .. TO THE INSPECTOR OF BUILDINGS: The undersigns hereby .applies for a permit accor ' g to the following information: > 3 /' Location .... .. ................................. ........ ........s. ..............t ................ ....... . Proposed Use ....... ....................................................................................................................:...... -�L!1/..!..... .......... Zoning District .......... . ....... ..................... .......✓.£NA....Fire District ........... .......... ...... .............. ............................ Name of Owner .. ...... ..... ......:...../.ak: .........Address ................0 Name of Builder ...... .........' ........ ..`.......................Address v/`'�1` . b ...........` �L� .!O'�...`4............... Nameof Architect ........'.�,1.. .. t............................................Address .....................................:................................................. Number of Rooms ....... ......................................................Foundation Pr.... . ..... ... .. Exterior .........&,. ..... ....................................Roofing ....... .... ................................ ..................................... Floors /4�. ...........Interior .....1!. ... ................................................ Heating � G�!..... .................. .......................Plumbing ✓_' Fireplace p ..:.......�G�i��.:-....1........................................................Approximate Cost .................,............................................. . Definitive Plan Approved by Planning Board ------------__—___________19_______. Area Q�.....s ............. . . Diagram of Lot and Building with Dimensions Fee 1 7 a� SUBJECT TO APPROVAL OF BOARD OF HEALTH -1�0/VO �X"11 10 �6 I hereby agree to conform to all the Rules and Regulations of the Tow o Barnstable r rding he above construction. ' Name ... ..... ............. .... .................. ...................... . D'Aveua, Joseph L. ' ^ ~ ^ ~~ � - � single family ' —r--'---' ' . Locuhoq ....... Elotuit ----.---------------------.. - . - Owner ----- ^.L°_D,&v���..____ . ~ . . Tv� of Construction -----'f��m�----. . � / ....................... ' ` # 4 ' . P|oi .---------. Lot ------3.r--- ^ Permit Granted ..............i ar.y' 24. lV 79 . "".= of " sp=` =' f� - CompletedDate ` . ' PERMIT REFUSED ' ' __---'_-------------�—.. lA ' . . - . . -- -- . . . . ~ -- / ' . . . . . ....... ~ -_--------'--. . ' . . --..������ -----�-.-----' . _ .. Approved ................................................. lq ' -----------------.---.—.--- . ' ---'-------'----------^^'—^~—' ^ '