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9/l/2009
Town of Barnstable Building
Post This Card,So That it is Visible:From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept
`� Posted Until Final Inspection Has'Been Made. -j ��y.m it
• Where a Certifi
cate of Occupancy.is Required,such Building shall Not be Occupied.until a Final Inspection has been made. Jl Jlll
Permit No. B-18-1966 Applicant Name: JAMES D TWITCHELL Approvals
Date Issued: 07/11/2018 Current Use: Structure
Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/11/2019 Foundation:
Location: 59 COTUIT COVE ROAD,COTUIT Map/Lot: 005-040 M _ Zoning District: RF Sheathing:
Owner on Record: ROWAN,RICHARD J&KATHLEEN M Contractor`Name,,JAAMES D TWITCHELL Framing: 1
Address: P 0 BOX 1060 Contractor License: CS40 2646 2
COTUIT, MA 02635 Est. Project Cost: $3,200.00 Chimney:
Description: 8x4 platform with 3 steps same footprints. Permit Fee: $85.00
f
Fee Paid:' $85.00 Insulation:
Project Review Req: - /
Date: 7/11/2018 Final:
/ Plumbing/Gas
Bui ding Official
Rough Plumbing:
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is co enced within six months after issuance. Final Plumbing:
All work authorized by this permit shall conform to the approved application and the:approved construction documents for which this permit has been granted.
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Rough Gas:
This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the
work until the completion of the same. r. J[
Final Gas:
The Certificate of Occupancy will not be issued until all applicable signatures by the Building-and-Fire Officials are provided on this permit. Electrical
Minimum of Five Call Inspections Required for All Construction Work:
1.Foundation or Footing Service:
2.Sheathing Inspection Rough:
3.All Fireplaces must be inspected at the throat level before firest flue lining is installed �l `
4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final:
S.Prior to Covering Structural Members(Frame Inspection)
6.Insulation
Low Voltage Rough:
7.Final Inspection before Occupancy
Low Voltage Final:
Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations.
Work shall not proceed until the Inspector has approved the various stages of construction. Health
"Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final:
Building plans are to be available on site Fire Department
` All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final:
6
�p�• AppIicationNumb' �.1. .....�. !6
` Permit Fee.......................................OHier Fee........................
0��A Total Fee Paid............ ��el...l....4✓..b..l..........................
TOWN OF BA�RNSTAB y,
Permit Approval by.................................01L.......................
BUILDING PERMIT
I �
APPLICATIO
N
1�......................� ..�..... ........... .. .............
Section 1 —Owners Information and Project Location
Project Address I C o tUs'f COVE 9 a a V Village C BTcJ,'t-
Owners Name "R i c U A►Zu d- 11::4T µ I G�Wa/ "Ru ul A r/
Owners Legal Address a
city C o-�U 1 .� State I`-(A d 6 ZG 3 ,►' : zip O a.4 31
Owners Cell# E-mail
F-/
Section 2—Stractaral Use
Single/Two Family Dwelling ;; . 0 C,omme'rcial Stiructure'over 35,000 cubic feet
❑ Commercial Structure under 35,000 cubic feet
Section 3—Type of Permit
❑ New Construction ❑ -Move/Relocate [] Access ory Structure ❑ Change of use
❑ Demo/(entire&uctme) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm
Rebuild ❑ Deck Apartment ❑ Sprinkler System
❑ Addition w oop eel ❑ Retaining wall ❑ Solar
Renovation �'t°Nf'����❑ Pool ❑ Insulation
Other-Specify '�iZ OAJ+ S T.E r J ?o j b�e 7L a rat,o el l ec�
�uJ UUT/G1�tJ
f
e ` •.. Section 4—Detail ti
Cost of Proposed Construction Square Footage of Project 3 A o
Age of Stricture ti Dig Safe Number
i
#Of Bedrooms Existing Total#Of Bedrooms (proposed) O
110 MPH Wmd Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design
Last updatmk I U72017
Section 5 -Work Description
Section 6—Project Specifics
❑ Wring Oil Tank Storage.: ❑ Smoke.Detectors
• i
❑ Plumbing ❑ Gas Fire Suppression
❑.Hewing System ❑ Masonry Chimney_ 0 Add/relocate bedroom i
J
-- Water Supply Public ❑__Private - "-
Sewage Disposal ❑ Municipal L+�"On Site
Historic District N ❑ Hyannis Historic District ❑ Old Rings Highway
Debris Disposal Facility- er9WV of Jd"AldfA l h 1a1VACI-M am using a crane C
Yes �No
Section 7—Flood Zone
1
Flood Zone Designation {
Within or adjacent to a wetland,coastal bank? Yes ❑ No 1
i
Section 8—Zoning Information
1
Zoning District,k 1'11�1 I- Proposed Use Lot Area Sq.Ft 7
` Total Frontage Percentage of Lot Coverage #of Dwelling Units(on site)
Setbacks Front Yard Required Proposed
r
Rear Yard` Required Proposed
Side Yard Required � Proposedf-�' ? i
Has this property had relief from the Zoning Board in the past? ❑ Yes No
r.=upab&11=17
Section 9—Construction Supervisor
C n ervisor
� o o
�wiT—1 -7 y - Y72- oyjy
Name .1 A ii ES D• I Telephone Number
Address 1' AA SFi,EI0 Ay qjty MARJfoN1 a%jState AtA Zip 07.4VdV
License Number G s-l 0 2�Y G License Type U Expiration Date 6�r-/3 a f 1 r
Contractors F-MAJI R UE I(Aft" @ PA W,Cb� Cell#
I understand my responstblities under the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections sad
docomentaton required by 780 CMR and the Town of Barnstable.Attach a copy of your license.
signaitae Date
O6120%f
Section 10—Home Improvement Contractor
Name IA N," n• �(Ul�G�Zl� Telephone Number �7`� Y-7 z- o y 7 ci
Address 4 11 Au J r e l0 ,4. HANiraw 1t111.1 state H t zip o 2 G ys'
Registration Number a 1� -� Expiration Date
I understand my responsbfiiiies under the rules and regulations for Home IFovement Contractors in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and
documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your ELLC...
Signature Date 0%'
Section 11 —Home Owners License Exemption
Home Owners Name:
4v 14 -
i �
Telephone Number Cell or Work Number
� I
I naderstand my responsibilities tinder the rules and regulations for Licensed Construction Supervisor in accordance with 780
CMR the Massachusetts State Building Code. I understand the construction inspection procediaus,specific inspections and
documentation required by 780 CMR and the Tows of Barnstable.
' Signatiue Date
APPLICANT SIGNATURE
Signature Date
J AMe,f -1 7 y cf 72 0 I
Punt Name Telephone Number
E-mail permit to: U�C'L Cat o Cow
Last updated:11n2017
Section 12—Department Sign-Offs
Health Department ❑ Zoning Board(if required) ❑
Historic District' ❑ ':Site Plan Review Cif required) ❑
Fire Department ❑
Conservation
For commercial world,please take your plmrs Arectly to the fire depwftent for approve
Section 13— Owner's Authorization
I, , as Owner of the subject property hereby
authorize to.act on my behalf, in all
matters relative to work authorized by this building permit application for:
(Address of job)
Signature of Owner date: .
Print Name
Last UPddc&11/7/2017
Page 1 of 1
fair'
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http://townofbamstable.us/propertyimages/00/10/14/27.jpg 6/14/2018
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- � �— •�/LC �GIYl7Ul71a!'LC[tCCII.I�L 0��'f%�(CCtJSC(•C1LllJCClnt
4. Office of Consumer Affairs&Business Regulation
' HOME IMPROVEMENT CONTRACTOR
TYPE:1ndividual
Registration\ Expiration a
1421i08,-;_ 03/14/2020
JAMES TW I CHTEIL ;'r.W t
D/B/A JIM TW ITCHE-LL ALUMINUM&VYNYL
�-
JAMES D.TWITCH L
16 MANSFIELD AVE'- Q✓_
4� MARSTONS MILLS;MA 02648 Undersecretary
®3 Massachusetts Department of Public Safety
Board of Building Regulations and Standards
License: CS-102646
Construction Supervisor
JAMES D TWITCHELL
16 MANSFIELD AVENUE; 4�• ` �!-.r
MARSTONS MILLS MXs02648� '
Expiration:
Commissioner 08/30/2018
t
------------
Registration valid for individual use only
i 'before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation°
}
10 Park Plaza-Suite 5170
'Boston,MA 021:16
Y
t
Not valid without signature
Construction Supervisor
Restricted to: s of any use group which contain
Unrestricted-Building 991 cubic meters)Of
less than 35,000 cubic feet
enclosed space.
ss a current edition of the Massachusetts
Failure to posse
State Building Code is cause for evocation of this license.
r
DPS Licensing information visit: 1Nww•MASS.GOVIDPS
The Conanonwealth of Massachuselft
Department of btd=1rkd Accidents
Offlce oflnvestigations
Tj 600 Washington Street
Boston,lift 02ttt
www-mw gov/dia
Workers'Compensation Insurance Affidavit:Builder@!Contractors/Electricians/Plumbers
ADDUCAnt Information Please Print Letdbh►
Name iBa&ess/O onftdMdtW):_-:J At j l--�G
Ci /Sts�te/Zi : t. M�r d AJ H/l!/ M0 Phone#.
Are you an employer?Check the appropriate bow 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 stub-contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 7. V Remodeling .f7S'
strip and have no employees These sub-corttractors have 8. Demolition
working for me in any capacity. employees and have wodws' 9. Building addition
comp.hominceJ
[No workers'comp.insurance 5. We are corporation and its 10. Electrical repairs or additions
3. I am homeowner doing al1-work Offieen�have exercised their 11. Plumbing repairs or additions
myself o workers' Of exemption per MOL
insurance required.]t�P c.152,§1(4),and we have no 12. Roof repairs
employees.[No workers' 13. Other
comp. ]
'Any applicant that eheoto;box gt iiTnut ateo ffit mtt the UQIeW s�V�t>�TuwB '.. policy tffioFa�ran.
t Homeoovners who submit this affidavit indieWing they are doing all work and then biro oum*comet s must submit arrow affidavit indieating such.
tCon trwtm tbet check ft boa must attached an additiand sheet showing the mme of the sub-watmctors and state whether or not those ems have
employees. if gw nob-conmM have employees,they musttpmvide theme ww1m9'comp,policy number.
Jam an employer that b provldng workers'compennAM insurance for my enWloyM Below is ikepolky and/oh site
informadon.
Insurance Company l
Policy#or Self " L Expirat m Date: 12125/2018
Job Site Address:
C O t y "/ °�J 2 /�O City/State/Zip: C- o7'v� H,4
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Faihme to secure coverage as required under Section 25A of MOL c.152 can lead to flie imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations ofthe DU for insurance coverage verification.
I do hereby c under the pains and penal ofped wy that the irijonnadon pnvvlded above is here and correct
U Data:t li/t/2018
Phona4hWv v-vv.V
'�. of'letal use only. Do not write in this area,to he conrlded by c1V or town q flclal
i
City or Town: PermittLicense#
Issuing Authority(circle one):
1.Board dBeelth L Building Deparbmeat 3.CitylTown Clerk 4.Eiectri ai Inspector S.Plumbing ispecbor
6.Other
Con ted Person: Phone ft
-r o
0"30 2
i .
C p�5 ti
GOT 70 o
V- .LOT 39
WAG'�-gip~
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X 2nd
DE KY J OF�WNc�'E� �
1p�'
Ids 00,
LOT 40
RES. ZONE- "RP" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.' "C"
Bank Use Only
TOWN: COMT_ — REGISTRY OWNER: JO N P. & EUZABETIL—MLAt NOONAN R.
DEED REF: 12280 _ — —BUYER: PAUL GINS`&-,L A�FD 'LDF�LVIVIS
DATE: _AZ17,_1_92_' — _ PLAN REF: 223 _ — —SCALE:i = 40___FT.
- I HEREBY CERTIFY TO PLY�fO(ITH MOTC�ICE'CO______ _THAT THE BUILDING �q�W of 4j, YANKEE SURVEY
__ _ _________________ �
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o� PAUL '� CONSULTANTS
SHOWN AND THAT ITS POSITION DOES __-_ CONFORM 1 A. ^
TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MERITHEW N 143 ROUTE 149
TOWN of BARNSTABLE______-_____-AND THAT 10 No. 32098 MARSTONS MILLS, MA. 02648
IT DOES NOT 'LIE WITHIN THE SPECIAL FLOOD HAZARD 9°Fs 9fCI5iER`�� Q,� TEL: 428-0055 .
kREA AS. SHOWN_ 614, THE .H.U.D. MAP DATED_�2�92__ ` �Nac callosJ FAX 420-5553
,01-q.iun tv=Panel 250001 0021. D.
,y e — THIS PL;+W t JOT MADE FROM AN TRUIdENT ^ -^
�I„E r Town of Barnstable
Regulatory Services
RAptNsrAimr, Richard V.Scali,Director
' ,�9 � Building Division
fQ NIA'
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.mams
Fax: 508-790-6230
Office: 508-862-4038
Property Owner Must
Complete and Sign This Section
If Usina A_Builder
I FCN037 ,j_ , as Owner of the subject property
hereby authorize '���\ to act on my behalf,
in all matters relative to work authorized by this building permit application for:
Cori F
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
i I&DeGtAons are erf rmed and accepted.
Signature of Owner Sigp Jure of Applicant
Print Name Print Name
Date
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®SCALE nmZgrn
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DECK FRAMING UP 3 0 t
12 m to
0 m
11.YL PLASTIC DEODNG i
AZE[ON RISERS,TRIM 8 STRINGER
15"T �
s l/z"R—� DUSTNGGPADETOT.O.D8X EXISTING BRICK PAVERS €9
8 h`Y o 0
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• lY CONY.flLLEO SONG TUBE H b
- SCALE S
PROPOSED REPLACEMENT DECK&STAIRS REVISED:
0 1' 5'
SCALE
SECTION @ DECK
DATE:
6/15/18
• SCALE:
SHEET:
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Z3rooin
aL+ OO
Q
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77
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I/ LED ER L K @ z"o. . I I DECK
2X8 P.T.JOISTS @ 16-O.C. 8'-4 J a
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0 t' 6' A o 3 Q
OD
®SCALE amFE ("
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DECK FRAMING UP 3 a _
5/4 X6 PLASTIC DEWNG
AZEK ON PSMS,TRIM&MMGE0.
15"T
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5 1/2"R—� DDSnNGGRADETOTO.DEa— EXISTING BRICK PAVERS >
7X17 STRINGER a E �
• 12'CONC.FlIIED SONO TUBE
•o' 0 1 58 m8 .a b
c mcm- SCALE y _66 L at
• €� �s
PROPOSED REPLACEMENT DECK&STAIRS REVISED:
0 1' 51
SCALE
SECTION @ DECK
DATE:
6/15/18
SCALE:
SHEET:
9 ,
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1/ LED ERL K@ z•o. . M(I DECK
2X8 P.T.JOISTS @ 16"O.C. $'-4
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®SCALE -8.
E6 c
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DECK FRAMING DP 3 a ,�, 2 C>
g m 2
514 M PLASTIC OEOONG
AZEK ON RISERS,TRIM 6 SMINGER
15"T —
5 1/2"R—Ez
: •� a €
EasnNGGRnoEToro.oEa— EXISTING BRICK PAVERS
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2XI2 STRINGER i S p 3 a q S•�
lr CONC.FI.FD SONO TM S$ z
5 8gvEc;88_a
SCALE
' PROPOSED REPLACEMENT DECK&STAIRS REVISED:
:B.
0 1 5'
SCALE
SECTION @ DECK
EDATE:
6/15/18
::
SCALE:
SHEET:
Town of Barnstable *Permit#
Regulatory Services Veees 6monthsjrom issue date
lARNBTABIE ` 7(
1 ,� . Richard V.Scali,Director � � �.0 U
Building D vise �!
Paul Roma,Building Comm,1ST
200 Main Street,Hyannis,MA 0 607 6 2016
www.town.baznstab'e:ma:us-
Office: 508-862-4038 k Y it9 d�BARNS)ABLE Fax: 508-790-6230
EXPRESS PERMIT APPLICATYION - RESIDENTIAL ONLY
1� 0,1�
Not Valid without Red X-Press Imprint
Map/parcel Number (� Lt�� �J {�
Property Address S� l.V �� C�ev 1�Q
residential Value of Work$ o�300 Minimum fee of$35.00 for work under$6000.00
�j
Owner's Name&Address ( Scsw b Y rtn czpw,�w
5� CdTys� Cw� � Crrcy� (rV�ss
Contractor's Name- ( - �,��Cj� 1 Telephone Number ' — '0 4
Home Improvement Contractor License#(if applicable) V ID 10W Email:_JA.)fCtCy WLQ?t (*W CQ1^^
Construction Supervisor's License#(if applicable) IDD Ll-\(
❑Workman's Compensation Insurance
!Ch ck one:
I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Re-side
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.
Separate Electrical&Fire Permits required.
*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:
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
06/20/16
t .
a16 N The CPJIiiwomreaht of MaSc=dr=etts
Deparanent Of Ind-asbi Accidefl&-
fill 600 WashhWon Street
Boston,MA 02111
- - k�rvt�rrt��ov�dia
Wcwkers' Carnpensatian Insm-;nce davit BmlderslC�antractarslElectricLanr./Plumbers
Apphkant Information Please Print v
-Name
Address Rp MkOSIFeM AVLr-
Cityistata( M fl)TVs M o �(g Plono" 1`-I- q
Are you an employer?.Checktht:appropriate bom T of project r
L❑ I am a employer with 4 ❑I mn a ge: etal contractor and I Type Fray
6. ❑Nov oomsfrudion
oyees aedlOr part�tme * lrave hiredthe subcontractors
2.,K I am a sole prqprietor orpartaef- fisted onthe attached sheet: ?- ❑-em vdeHng.
sbz p and have no employees - These sub-contractors have 9- ❑Demolifioa
wodang for me in any capacity- employees and bane wadmss' 9..❑Building addition
INp Worlmrg'comp-insin-an a COMP-mertrany f
f -I 5_ ❑ We are a corpomfiim and its Id-❑Electrical repairs or ado ions
3_❑ I am a homeowner doing all work officers have exercised their 1L❑Plumbsngrepairs or additionsmyself '
o workers' _ right of exemption per MGM
it ncerequited-j7 c.152, §1(4�andwe have no L ❑Roofrepais
employees.(No woz3=1 13-0 0ther
Camp-insuranme required-)
'Any applirmT&&stchedsbox9ImastelsefiIIo t}�sechioabeTosv�easia��heawodcea'ca�peasafinupoyeyinfncrosaaa
1 Sameawners udo sub=t rd m affidau-9-Hr saCIL
ZCoul, aBszI 6ed0ibaz bax mast attic as additional sheet shovdng tie rtame of the =d stdIewhether arnattbose endtiesbam
employees.Ifthesab-co-a: have engiayea%Meym p=widethe'u wadmm imp.poliy MEMber- i .
I am an saiPIaJ�Br fltatisprmry a�ar&ets'corrgrensafiQa insrirancs f yr xcy¢mgrFu3�ees Seloty is ti�ta prrficy ru:d jeb sits
FnformadDiL
Insurance Company Name:
'PcGr.y 4-or Self-itts.Lim;` lkgiratiaa Dade:
Job Site Address_ CitylS#abdz�p:
Affach a-copy of the workere cozapensationpoRcy declaration gage(showing the policy giber and expiration date).
Failare to secum coverage as required under Section 25A of MGL m 157 can lead to the imposid=of criminal penalties of a
free up#o SUOD 00 andtor onayeir impaisommzd,as well as civil penalfies in the faua of a STOP WORK ORDER and a$me
of uplo Moo a day aggaimt"the violator. Be advised that a copy of this statement=.;aF be fnrvarded to the Office of
Investigations office DIAL€ar msmnce coverage c cm-
I do her.y cV*fy under pams and pow o pedW7 thattha info rmaifonyn nrhW abm a iss`fnm artd correct
Ale
Plane ik- `1 L `l — C) L\ `1 \:
Offid d am wily. Do trot writs to d6 area,to be completed by city artown a,0`icral
City or Ta wn: P'erraitfLicense f
Issuing AmfiorEty(drrk one):
L Board of Health 1.Buffirmg Deparbmmd 3.EityHown Clerk 4.Electrical Inspector S.Plmmbing Emspector
6.Other
Comtact Person: Phow 9:
6
Town of Barnstable
Regulatory Services
?NABS. Richard V.Scali,Director -
�1 Building Division.
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 509-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, ?1,V TN L .E /Y A) , as Owner of the subject property
hereby authorize J �Cn1eHE�\ to act on my behalf,
in all matters relative to work authorized by this building permit application for:
5c\ Co W�k CW L5 CCU M- VYl as-)o o., 3E
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
A0 ,
�ZaJ
Signature-of Owner S' e of Applicant
��Tr�L F_F/`� M• ,6�r/� �SJ�Tm��w��r 1 �`1
Print Name Print Name
Date
Q:FORMS:OWNERPERMISSIONPOOLS
I
. ;j '�=. ..-.'.- V lae�omvrr�a�zwea�o�C%aGaadac�iccaeL7a
Office of Consumer Affairs&Business Regglation 1 li
WxME
IMPROVEMENT CONTRACTORgistration: i1�21,08 TYPe: i
piration: D - DBA
i --�r
JIM TWITCHELL ALOt}' .�t�tl=Bt�Lly�
z i
:_}-
� JAMES TWITCHELL•s�
j 16 MANSFIELD AVE
MARSTONS MILLS,MA 02648 Undersecretary
Massachusetts Department of Public Safety
® Board of Building Regulations and Standards
License: CS-102646
Construction Supervisor '
JAMES D TWITCHELL
16 MANSFIELD AVENQ_
MARSTONS MILLS MA?02648�•�•
CA,, Expiration:
Commissioner 08130/2018
License or registration valid for iridividul use only
before the aspiration date. If found return to:
Off K
ice of Gorispmer Affai"rs and m.Busess-Regulation
1
0 Palk Plaza-Suite 5170
Boston,l�IA.:02116
1 Not si"
valid.wittiiiat nature
g:.
Construction Supervisor
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of
enclosed space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
DPS Licensing information visit: WWW.MASS.GOV/DPS
i
L
Town of Barnstable RECEIIt
PT,
` t eecs 200 Main Street, Hyannis MA 02601 508-862-4038
Application for Building Permit
Application No: B-16-3572 Date Recieved: 12/5/2016
Job Location: 24 PINE VALLEY ROAD,HYANNIS
Permit For: Building-Siding/Windows/Roof/Doors
Contractor's Name: PAUL M DOWNING State Lic. No: CS-074247
Address: BROCKTON, MA 02302 Applicant Phone: (508)427-6444
(Home)Owner's Name: MURPHY,SEAN D& KELLEY B Phone: (508)364-1251
(Home)Owner's Address: 24 PINE VALLEY ROAD, HYANNIS,MA 02601
Work Description: DIRECT REPLACEMENT OF REAR PATIO DOOR WITHOUT ANY STRUCTURAL CHANGE
O +�
p \-n g7
Total Value Of Work To Be Performed: $3,690.00
Structure Size: 0.00 0.00 0.00• r—
Width Depth Total Area
I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before
he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568).
I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by
filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to
accept coverage.
I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have
been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the
Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and
specifications. All information contained within is true and accurate to the best of my knowledge and belief.
All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24
hours in advance.
Signed: Davos Contracting 12/5/2016 (508)427-6444
Applicant Date Telephone No.
Estimated Construction Costs/Permit Fees
Total Project Cost : $3,690.00 Date Paid Amount Paid Check#or CC# Pay Type
Total Permit Fee: $35.00 12/5/2016 $35.00 XXXX-XXXX-XXXX- Credit Card
2082
Total Permit Fee Paid: $35.00 ..
.......................................................................................................................................................... ....................................................................................................... . ................................
HIS IS NOT A.PERMIT° `
a � Y , ,
c�tl�
,,,E Town of Barnstable *Permit 41?—
Tres 6 months from issue date
�.� Regulatory Services EFee
` snfwszastF
y� Mass Richard V.Scali,Director
039.
RFD `s' Building Division
Paul Roma,Building Commissioner !%4111
200 Main Street,Hyannis,MA 0 601 Sep�
www.town.barnstable.ma.ug 0 8 ?018
Office: 508-862-4038 / 0F8A Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIA I +
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address sc\ ''oti
Residential Value of Work$j� 3 %W Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address tz�C-tkm
Contractor's Name � �' y'C � Telephone Number �1 A"10 a- a L ')A
Home Improvement Contractor License#(if applicable) �' O Email: `�)KLV M� e CW--
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit. .
T
Permit Request(check box)
❑, Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
e-side (aZ', vca
Replacement Windows/doors/sliders.U-Value .� (maximum.32)#of windows to
#of doors: --
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
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:
QAWPFILESTORMS\buildin ermit forms\EXPRESS.doc
06/20/16
The Conzwomp►eakh ofMassradlruseft
SrN
Department er, 1nd.zrs&U Aecidercts
0irce of1MWX*Q ms.
600 WashhWion&Met
Boson,MA 02111
imquvim mgovfdia
Wnrkere Cmupensa ianTnsurance Affidavit Bid a CentractmmMectricians/Plumbers
A.PPIkant Tnfn motion Please Print F Iy
Name C
Address. I`o MdeoSif d)y Lr- eo
Cityfsta ftv �1 o.%t Phoneme
Are gnu an employer?.Checkthe appropriate bon Type of project(required):
I.❑ I am a employer with. 4. ❑I am a general contractor and I 6. ❑New oohs
oyeez(funan1br part-time).* have hired the suf-condractots oix 2.A I am a sole proprietor orpartaer- listed on. the attached sheet, I- ❑Remodeling.
sbip and have no empin5ees These sub--contractors have g- ❑Demolition.
worming for me in any capacity_ employees and have Worlress' 9..El Budding addition
[No wo tars'comp_insi-rnre comp.msuran cl
require&] 5. ❑ We are a corporation and its 16-❑Electrical repairs or additions
3.❑ I am a homeowner doing all work officers have exercised(heir ' 1L❑Plumbing repairs or$doom
right of oa er MGL
ink€��wa���F- c.I52, g1{ �dwehasreno 1�❑Roofr�epairs
employees.[Nowod=s' 13.❑Other
cam-insurance mquired.)
•Any eppKc=dmtchecksbazf1nmst also fMco1*esectioabeiowshassinHiesviulaecmmpensaff szpermyinffi=w6=
meoamers TQ}!D Sdbmgt this afSdavH ID�CStiag&ey are domg all Wa k and then bne ou6 coffin—!;t submit anew affidz&mdicabne sacb.
TCoata+cEoa*zt check this box mast atracbed as s aitirmi't sheer shoxdng the mama cf the mud state whether ar not f=e ernes brce
employees.If the bnb-caatnutat;UveemPIagee_%HtwyasustPmaidetheir WMke&CMMP.poker"I —
lam an eviPzgW flit¢isprGVidk, workers't omperLsafran inmrarte for wy empl yom Below is filepa cy and job zUe
informafinn,
Insurance Company Name:
Policy 44'or Self-im I.ic.41- ExpirationDatee:
Job Site Address: Citylstatdzip:
Attach a opy of the workers'compensationpolicy declaration page(shoving the policy number and expiration date).
Failure to secure coverage as m4uimdunder Section 25A of MC L cL 152 can lead to the imposition of criminal penalises of a
fine up to$1,50D 00 andlor one.g&irimprismmetd,as well as rigsl penalises in the fb=of a STOP WORE ORDERand a fine
of up#s _O()a day against the violator. Be advised that a copy of this sbkment maybe forwarded to the office of
Invesiegations ofthe DIA fur insurance coverage verification
I do If rBhy, tariff Under#W Fa mrs and penaNes ofpedW7 that the infanna#ian pr ovikW abmw is`trtue and correct
Simmdam- Date:
Phone i;�- �\ o� — 0 L\ `1 \
Offal are only. Do not writs in dw area,to be cvmpleted by tip arfown a,okat
City or Town: PerrmtlLicense
Lwaing Aufbaridy(circle one):
L Board of Health r.Buffai ag Dqun f nent 3.CfylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person Mom 9:
- — — - 6
Imformation and Instx aefions
msmchweft Laws chi M regoares all=Ipl0Y=ID provide wai='compensation for tlOeii emplayeCs.
pm�saantto this stye, a layee is dafined as=every person m the scrvicc of anathm tmder say coxdract ofhuP,
express or implied,oral or "
An empluym is defmcd as aaa mdividuA par[netsh�,assort oni corp°t�t°n or othe$Legal arty,or auy two or more
of the foregoing= aged in a joint eotedpuse,and inchtding the legal represeofafives of a deceased employer,or the
receivcr or trustee of an individual,per,association or offi=Iegal entity,employing employees. However the
owner of a.dwejUmg horse havingnot more tip three aped men s and who resides therein,or the octet ofthe -
dwelling house of anon who.employs persons to do majatm mce,con sf uct on or repair wmk oat such dwtMag house
or on the grotm,ds or bmZdmg app=t= ihes etu sball not because of sarh employment be deemed to be air.employer."
MGI,chapter 1ti2,§25C(6)also states that¢every stain or local liicetzsing agency shall withhold the issaance or
renewal of a Iicease or permit to operate a bus rLess or to construct buildings is the commaawealth for any
apphc=f Who has not produced acceptable evideum of cdmpn=ce with the;n mx2nce coverage regained."
Additionally; MGF-chapter 152,§25C(7)states fileitherthe commcavPealthnor ally ofitspolitical subdivisions shall
MI ter into any contract far the permmmnce ofpubhc;workunI arxeptable ev2mm of compE4 cewith ine insm--cac...
reqarcements of this chaptrr have lien presented to the contacting anthozity."
Applicants
Please fill nit the worl='compensation affidavit completely,by chmIdag the bones that apply to your sitaation and,if
necessary,�plY s)nmn*), address(es)and phone nr= er(s) along with their cestifrcate(s) of
instumzce. Lja i Liability Companies(LLC)or UmdtedLiabi7ity Partnerships(LLP)wrdmo ermployees other than the
members or partru'as,are not regtint;d to carry wot3cers'compensation i as[nmoe_ If an LLC or LLP does have
employees,a.policy isrequirt4 Be advised that this affidavit may be submitfedto the Department of Industrial
Accidents for con{mmatim of msm,mce coverage: Also be score to sign and date the afadavit The should
be retnmed to the city or town that the application for the permit or license is being requested,not the Departme d of
IndIIstrial Am identL Should you have any 4nes'tians regarding the law or if you iris rimed to obtain a workers'
compensation-Policy,plmsm call tbz Departnent at fho rinaabar list:cd below. Self-hM=dcompaniesshould" their
self filwrance license amber on the appmpriafe line.
City,ar Town Ofti ials
Please be scar,ffizt the affidavit is cou3pleb�;and printcdleginly. The Department has provided a space at the bottom
of the affidavit for you in fell out in the event the Of oflnvesdgatims has to coact you rcgardmg the applicant_
Please be sure tr,Ell,i a the pem id ccmc:number which vM be used as a refe=ce mmnber Iu-addition,an applicant
that must submit multiple p=4t/Tic=ce applitotions is any given year,need only submit one affidavt TT1�g cat
policy information(if necessary)and ended` ob She Address"the applicant should writ-"all locations in (may or-
town)."A copy of the-affidavit that has be=officially stamped or madded by the city or town may be provided tto the
applicant as�roofdet a valid affidavit is on file for future pmndp.-or licenses_ A new affidavitmust be filled out each
year.',herre a home owned or citizen is obtaining a license or pe=it not relaird fin any bn sfiv=or commmT:ial TentUre
(ie_ a dog license:or peroak to bum leaves etc.)said person is NOT required to complete this affidavit
The Office of Investigations wouIdltke to talc you m advance,for your coopedion and should you have any questions,
please do not hesitate to give us a caIL
The Depazr enfs address,telephone and fax number.
tbE of MWMc U,&MM .
. IIe �o�fiud�zialA��nt�
ice of�tia�
Boston.M&Doi II
Ter.#617 -4940 Md 446 or
Fax#617 727 7744
Revised 4-24-07 W
I .
i
Town of Barnstable
Regulatory Services
Richard V.ScaI4 Director
.zb39 ��
639 Building Division.
Paul Roma,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
L ,F-,:) / /< 6-u/f A) , as Owner of the subject property
hereby authorize J 7L mAo` to act on my bebA
in all matters relative to work authorized by this building pertnit application for.
5c), SRO C-no(t► lrn z63 o 0.)O;j
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant Pools
are not to be filled or utilized before fence is installed and all final
nspections are performed and accepted.
A�.i'
s
Signature-of Owner Sijq4ure of Applicant
/l�R'Tr/LFrF/J M• au/�.l ��f�1�1 W�C/��e�1 ��1
Print Name Print Name
Date �p
QTORMS:OWNERPERMISSIONPOOLS .
Town of Barnstable
Regulatory Services
dF Richard V.Scali,Director
Building Division
t EARTMAZLE, ` Paul Roma,Building Commissioner
MAM
��� 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 tvillage
"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
zith 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 Board cannot
proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is
ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page
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.
Q:\WPFILES\FORMS\building permit fomis\EXPRESS.doc
06/20/16
� �e tpanvrrxaruuea�o�C�ac�ucaeG7a
I Office of Consumer Affairs&Business Regulation
ME IMPROVEMENT CONTRACTORI�
"gistration: 14-�21,08 Type: h
xpiration: -3&5— DBA
JIM TWITCHELL AL6'A[.p4 VI=8��EN��
JAMES TWITCHELL''
16 MANSFIEL"D AVE
MARSTONS MILLS,MA 0261 Undersecretary
Massachusetts Departmentof Public
Standards
Board of Building Regulations
License: CS-102646 it �.
Construction Supervisor
JAMES D TWITCHELL
16 MANSFIELD AVENU ?
MARSTONS MILLS MA',,08
Expiration:
Commissioner 08/30/2018
License•or registration valid for indrvidul'.use only 4
before the expiration-date.:If.found return-to:
OfficeofConfumerkkairsan_d,BusinessR'- lati-- !
10 Park Plaza-Suite 5170
r I I Boston;MA:,02116
..Not valid without signature
Construction Supervisor
Restricted to:
Unrestricted-Buildings of any use group which contain
less than 35,000 cubic feet(991 cubic meters)of
enclosed'space.
Failure to possess a current edition of the Massachusetts
State Building Code is cause for revocation of this license.
DPS Licensing information visit: WWW.MASS.GOV/DPS
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 0Parcel Application
'!-" 23 t� �; 2� Date Issued o7 1
Health Division - ; ;
Conservation Division Application Feed
Planning Dept. j f - .�� Permit Fee
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address 5 �'r y I-r CvL:-- R D
Village eory ►'i
Owner 9-% 20 Gov/---►-/J Address 5S C rut? Cve Ro arvj;rMA
Telephone 5 G - —
-r
=Permit Request o IFAL-, eC-%C-5 N 5L Coa D r-Lov9, /3L-C g6
?� 3 ' i� opt. (-'125,- ;Yl l3�syw,rt-k- S�►QS Oruu 6-� xS�w,tSsr+t(ZS
CoG— L iL, 0►�/ — �� asZ ONE 13tc t,� 3 0 �v— au iNl2rr
•=44 5G1 VWIL SftOOQ
Square feet: 1 st floor: existing proposed 0 2nd floor: existing proposed Total new O
Zoning District Flood Plain e— Groundwater Overlay
Project Valuation o' Construction Type t/ i Nbco/5tibm- U VW(s O,30
-Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family `1 Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes A(No On Old King's Highway: ❑Yes ❑ No
Basement Type: Afull ❑ Crawl l ❑Walkout ❑ Other
Basement Finished Area (sq.ft.) P/ A- Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new C3 Half: existing new
Number of Bedrooms: 3 existing 0 new
Total Room Count (not including baths): existing 0 new First Floor Room Count
Heat Type and Fuel: ❑ Gas kOil ❑ Electric ❑ Other
Central Air: ., ❑Yes pdUo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes > No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION _
(BUILDER OR HOMEOWNER)
Name wrycmC1 Telephone Number
Address «ck �&ThM �XLFlq\M i�� License # I CA(.12%V
Home Improvement Contractor#
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
®u
SIGNATURE DATE
FOR OFFICIAL USE ONLY
'APPLICATION#
DATE ISSUED
'r MAP/PARCEL NO. '
I
I
ADDRESS ' VILLAGE
s
OWNER
z DATE OF INSPECTION:
-:FOUNDATION N)Sor%s alp 1431
FRAME
ShAa A3 RAW- -
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL '
r
r ,
FINAL BUILDING v )4 13
o
F
S ,
5
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t
r
s �
t
The Commonwealth of Massachusetts -
De
artment of'Industrial Accidents
Office of Investigations
600 Washing on Street
Boston,HA U2111
i www.mas&gvv1dia
Workers' Compensation Insurance Affidavit Biilders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Bt /p�tion&dividual):
Address: 1 Sc 4f' ( � Kb al
City/State/zip: Phone#: C
Are you an employer?check the appropriate box: Type of project(required):
4- ❑ I am a general contractor and i
1_El I am a employer with 5_ ❑of
construction
Ioyees(full and/or part^timme).* liave:hired the sub-contractors
listed an the attached sheet, 7- E]Remodeling
2. I am a sole proprietor or garb .ham sub-contractors have
ship and have no employees 8_ ❑Demolition
woddna for me many capacity_ employees and.hwm wodcess' 4_- ❑Building addition
(No wodams'comp.insurance comp_+++smram> X
-)
5. ❑ We are a corporation.and its 10.❑Electrical repairs or additions
required
o�l
3_❑ I am a homeowner doing all work cers have exercised their 11_❑Plumbing repairs aaddi#ions
myself (No workers'comp_ right of exemption per NIGL 12❑Roof repairs
insurance required.]r c. 152,§1(4),and we have no
to 13.❑Other
employees-[No workers'
comp.insurance required.)
*Any applicant that coeds box#1=W also fill out t ae section below shaving their weikeie compensation policy inhrm tiara
I Homeowners who submit tbis affid2VTt infcating they are&=g aU woalt amd then hire outside convacturs unit submit a new affidavit indicating such
tCon=cxors that cheek this boat must attached an additinnal she showing the nmne of the boa and state whether ar not those entities have
employees. Ifthe sub-c ubmd-ors have employees,they must provide thm warkeW comp.policy number-
lain air emplo3,ei tliat is prx wjff rg workm;coitrpertsation inmmnce for rriy ouTloyens, Beioly is the pohgi acid job site
informidion.
Insurance Company Name:
Policy#or.Self-ins-Lic.# Expiration Date:
Job Site Address- City/StatelZip:
Attach a copy of the workers'compensation n policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 157 can lead to the imposition of czim*nal penalties of a
fine up to S 1,500.00 and/or one-year imprisonmeat,as well as civil penalties in the fore of a STOP WORK ORDER and a fine
of up to$250-00 a day against the violddor. Be advised that a cosy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance cmm age verffifistiam-
I do hereby cerd under thee_ ns a nd pe-lnlb•8s ofFedj ty drat the irrforwzat6m provided above is bus.and correct
Signature: Date:
Phone# QL,el v`
U,,jcial use only. Do not writs in tl:is area to be muipleted by do or tmwj a f 5cict
City or Town: Permit/IAcense# i
i
issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Tow n Clerkd_Electrical Inspector rs.Plumbing Inspector
6.Other
pl-fb
+ BABNSrABLE,
"�: ,�� Town of Barnstable
'0lfo rna�°i '
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street,' Hyannis,MA 02601
www.town.ba rnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder ,
1, fi �04 ; as Owner of the subject property
^ l P P r'
hereby authorize JAMl'J .. 1 W\A CA'F—,� to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
r '
Sign.IR4e�Or Date
PoGcJ/Q�V
Print'Name
If Property Owner is applying for permit,please.complete the Homeowners License Exemption Form on,the
reverse side.
i
QAAWILESTORMS\building permit forms\EXPRESS.doc
°FIVKE r°tti Town of Barnstable
Regulatory Services
s �
BAMSTABLE, ' Thomas F. Geiler, Director
039. a � Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.m.a.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 15,000 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 Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately
responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner
certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and
adopt such a form/certification for use in your community.
• neamrn TcwnnLAc�L..:1.1:......e....:�F......\AYARPCC rtnc •
I
of me tqy, '.
Town of Barnstable
Regulatory Services
• SARNSPABLB, t
MA es. Thomas F..Geiler,Director-
��„Mr .Building.Division
Tom Perry,Building.Commissioner
200 Main Street,jiy_ami;,N[A_Q201
www.town.barnstable.ma.u.s
Office: 508-862-4038 Fax: .508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize J�fN� �G:r ('(��� to act on my behalf,
in all matters relative to work authorized by this building permit.
co-V U V� LOI)F- QGPb
(Address of Job)
**Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of er S tuxe of Applicant
Print Name Print Name
Date
Q:F0RMS:0WNERPEFMISSI0NP00IS 62012
Town of Barnstable
?t1E tp� . ' ..
P� "�. Regulatory Services
rs Thomas F.Geiler,Director
MASS
16$9. .��s Bu Division
Divi
.
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 MAILNG 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 buildinz 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 ordarger 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 Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may caret amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt.
i
T �,Tf� fi
a�iness egu at,on
Office of C of mry airs
?�
HOME IMPROVEMENT CONTRACTOR Type.
Registration:. 5��j42108 DgA : sg
Expiration: .31;]5J2014
LL A � _--= YL
TITJICHE y - .
I
C� I
JAMES TWITCH�..t a
139.CAPTAIN CAR'ETS
' ..� ersecretary
COT
Massachusetts MA 02635 ,;y,�
Und l
Massachusetts -Department of Public Safety
Board of Building Regulations and Standards
Construction Supervisor
License: CS-102646
JAMES D TWITCftLL
139 CAPTAIN CARL O S
COTUIT MA 026:35 I
Expiration
Commissioner 08/30/2014
i
y Fty
r.51
License o>f're�ist.�`�$t�dhfi�atitl�for r��• vrdai:usE otsly
9 �
befere 4he eni�4r;t¢i�tti��� l�`f�11�N�e7drr4 to�t�4�tion �
Oifito 0 Cots iti e4 C 3� lit�d. ��il►¢sS]EF.e '
10 Parkl'Isa9 'ui�e Sfl�iO
Boston,MA 02116
I � 1
of valid without signature
•S
Massachusetts-Department of public Safety "r.5
Board of Building Regulations and Standards
Construction Supervisor
License: C.S-102646
JAMS D TWITCJ-#ELL
139 CAPTAIN CA. L, S
COTUIT MA 026-35 1 "{
Ex pi ratio n
08/30/2014
Commissioner
30'S0
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STORY
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RES. ZONE.- 'RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE- "C"
Bank Use Only
TOWN: C0MT: — REGISTRY OWNER: ✓OHN F. & ELIZABETH WALLACE NOONAN. JR
DEED REF: __s312Z280 _ _ —BUYER: PAUG_._KIN�&_F_. ADELLE DEAUVIS _
DATE: --BZ171-92_ — — PLAN REF: z2V-39 _ _ _SCALE:1"= 40_...FT. —
I HEREBY CERTIFY TO FLYM00H MORTGAGE CQ_---.
__ ___ __________ ________THAT THE BUILDING'' ;3 ``N1oFb�asVv 't'tY'ANKEE SURVEY
SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS CONSULTANTS
SHOWN AND THAT ITS POSITION DOES _ — CONFORM PAUL ��
TO THE ZONING LAW SETBACK REQUIREMENTS OF THE MER THEW 143 ROUTE 149
TOWN OF _ BAR11/STABLE-------------AND THAT -o No. 32098 . e MARSTONS MILLS, MA. 02648
IT DOES_ NOT_ LIE WITHIN THE SPECIAL FLOOD HAZARD , �ECrSr �,���� TEL: 428-0055 .
AREirmun tHO p ON TH H.U.D. 0021. DTED_�2Z�2 —_ 2gI '��yak��yia os�Q ,y ^� FAX: 420-5553
_ .
THIS PLAIs�NOT.,MAE!rFRO , BJSED , 'r9218PAUL A. ?AERITH PLS SURVEY,,N T TO BED'US .FFS
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{ . a 1
t 15' i"IEr,1 u F r. Town of Barnstable *Permit#
Eylres 6 issue(late
Regulatory Services Fee "
t16 .ARN IST.AWit`.I �
�r Thomas F.Geiler,Director
CEO MA'I A
Building Division
Tom Perry,CBO, Building Commissioner Y/
200 Main Street,Hyannis,MA 02601
www.towit.barnstabl e.ma.,us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number CX)S w
Property Address sq
XResidential Value of Work 10 J C 6 D 0 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
Contractor's Name_ �(yY� \ �} C L t Telephone Number f�' a a_0 1-1 ?C�
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable) ` �J!14 (p
❑Workman's Compensation Insurance
Che k one:
I am a sole proprietor
❑❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request-(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
XReplacement Windows/doors/sliders.U-Value 6 U3-5 (maximum.35)#of windows �
*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:\Users\decollikWppData\t,ocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110 l
a s
• BABNSPAM.E, •
. Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize \ C1� to act on my behalf,
in all matters relative to work authorized by this building permit application for:
0\ �U% Cove
(Address of Job)
/IZZAK� 1112 i!
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollik\AppDataV,ocal\Microsoft\Windows\Temporary Intemet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
i
77te Ooninionivealth of Massachusetts
Depo*neat of Industrial Accidents
Office of Investigations
600 Washington Sbwet
Boston,MA 02111
invav niass.gov/dia
Workers' Compensation Insurance AfEdavit: Builtleis/Contiactors/lElee.triciansiPlumbers
AiMicant Information Please Print Legibly
Name musines/Organimtiongndividuao: 1 alb \wft,"&t
Add,ess: 60� CiVO CK�UFU W,3 00W
City/State/Zip:Cz 6 Nk, dac,36- Drone# ?� 4_ '_?J a_o y 7�
Aree you an employer?Check the appropriate box: Typee of project(required):
1_❑ I am a employer with 4- ❑ I am a general contractor and I 6. ❑New construction
employees(fall and/or part-lime).* have hared the sub-contractors
7.
2J I am a sole proprietor or partner- listed on the attached sheet modeling
c ship and have no employees These sub-contractors have S. ❑Demolition
working for me in any capacity. employees and have wogs'
[No workers'comp.insurance comp-insurance-1
9. Building addition
zequired] 5_ ❑ We are a corporation and its 10_❑Electrical repairs or additions
3-❑ I am a homeowner doing all work officers have exemcased their I LE]Plumbing repairs or additions
myself(No workers'comp. sight of exemption per MGL 12-❑Roof repairs
insurance required.]I c.152,§1(4) and we have no
employees.[No workers' 1.3-❑Other
comp-insurance required.]
'Any apptit=chat checks box ml nw t also fM out the section below showing their worke►s'comp Wasationpolicy irdonmtion_
1 Someowness wbn submit this affidavit indicating they are doing all work and then hire ownde contractors amst submit a new affidavit indicating such-
'Contactors that check this box must attached an additional showing the name of the sub-ccaw tors and state whether or not those Qa -have
employee;. if the sub-contmaors ham employees,they unist provide their workers'comp.policy at ET.
I am an ernplo.avr that is prouddWg trorkers'coa gmusation insurance for tray employees. Below is tine policy and job site
h1foraaaadint
Insurance Company Name:
Policy 4 or Self-ins.Lie.#: 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).
D:ailuse to secure coverage as required under Section 2.5A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to lS 1,500.00 and/or one-year ismprisonment,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 adtdsed that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ida hereby cer*aander ae paai s d penalties rrf peduty that the h1forina ion proWded above is
//true-aand correct
Signature: t - Date:
Phone if-
OBFcial ass only. Do not write in this area,to be completed by cry or town o, .cial
City or Town- PermitUcense#
Issuing Authority(circle a one):
1.Board of Health Z.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
4
. .'. Y.• '
ly
License or registration valid for individul use on
IUD
' "viti,a ui auiiuui�; keaulutions and Mand`ti�� before the expiration date. If found return Regulation
Construction Supervisor License office of Consumer Affairs
and Business Reg
______-_ = 10 Park Plaza-Suite
License: CS 102646 Boston,MA 02116
Restricted.to:...00
JAMES TWITCHELL r
139 CAPTAIN CARLTONS RD _
COTUIT, MA 0205
Not valid without signature
Expiration: 8/30/2012 _ ._.. ...._
Tr##: 102646
• ('unui,issiuncr ,
s
• &
Office of p
Consumer Affairs
r.,
Ho iwE IMpRO:�/E &Business Re f•
Registrations MEONT CONTpCTpR gulation
Expiration- —_ 8
' - X2012 1
JIM TYPea� g `
ov
Ml.
//� DBq: Try 294557
TWITCHELLrR` 1l;
JAMES �AAIUIyI R r:
TWITCHELL_ WNYL
APT 1� � f•139 C AIN CARLETpNS,Rp;
COTUIT,�MA 02635
ilndersecreta
g
f
Town of Barnstable *Permit#
Expires 6 months from issue dp e
�f'Regulatory Services 6 , : 0
II aaxrrsTas�. �' ,�y�z
. 39. ,�' Thomas F.Geiler,Director As��a.
Building Division
' Tom Perry,CBO, Building Commissioner Ow/v
200 Main Street,Hyannis,MA 0260 R
www.town.barnstable.ma.us `S/'fit L
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERACT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number 06 5 U-6 —1 0
Property Address �—Ot U u
Residential Value of Wor )—I / G Od Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
s°\ C�-��y Coy �ZD� Cv
Contractor's Name �/��t I\ ` `L� \C1�1 Telephone Number l rl� LA ?-
Home Improvement Contractor License#(if applicable) \a ` 07
Construction Supervisor's License#(if applicable) 0 (D L1 62
❑Workman's Compensation Insurance.
Check one:
I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
X Replacement Windows/doors/sliders.U-Value o�J (maximum.35)#of window_
*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:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
License or registration valid for individul use only
before the expiration date. If found return to:
Office of Consumer Affairs and Business Regulation
10 Park Plaza-.Suite 5170
Boston,MA 02116
Not valid without signature
tion
nsiness Regula
ConsumEMENTrC�NTRACTOR
— Office of V
HOME IMP R1,42108 Tr# 294557 is
tration
Regis -�'-"3/�ti512012 ..
ExPirat'ion<�' 9I1
e � DI3 1�,{NYL
• (LPL"--OMINUM=&
�ITCHEL1j=� � �1
r !IM ITCHEt-t` � l
+a JPMES nNk -pNS'RP Undersecretary
139 CAPTAIN CAS 'Y
r i
MA 02.635
uu.0 d ul uu�iwu� tcc(;uluhons .uu1 Standards
Construction Supervisor License
License: CS 102646
Restricted to: 00• ,
JAMES TWITCHELL
139 CAPTAIN CARLI-ONS RD tip'
COTUIT, MA 02635
Expiration; 8/301.012
Trtt: 102646
('ummissiuncr
y
• .naxsru�, ,
639. Town of Barnstable
Regulatory Services
Thomas F.Geder,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I,-- 2?1 a 1} �/' p'��' ,as Owner of the subject property
hereby authorize �� ���C to act on my behalf,
in all matters relative to work authorized by this building permit application for:
�(Y'\u �% by Z f�* C MU�
(Address of Job)
Signature of Owner Xate
126-14Z-�s- d
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollikWppData\Local\Microsoft\Windows\Temporary Intemet Files\Content Oudook\DDV87AAZ\EXPRESS.doe
Revised 072110
G
424 The Commonwealth of Massadiusetts
Departinezit of Ind usbial Acddenis
Office of Investigations
600 Washington Street
Boston,MA 02111
b1yDN nHIaS&gVs,1,dk
Workers' Compensation Insmranze Affidavit: udders/Contractors/Electlicians/]Plumbers
.applicant Infetmnation --{� Please Print]Le ''bly
Name(Busiaeworganiationandividuaty 5 vt\
Address:��� CPO QMLTTA 2M NNM, V
City/St WZip: CCMJ kt,01 G-a(9 ]Pion# /`lr '� (�A-Q 4'?A
Are you an employer?Check ihe appropriate box: Type of project i(reguh-ed):
1_❑ I am a employer with 4. ❑ I am a general contractor and I
�,��Ployees(full and/or part-time).* have hired the sub-contractors 6• ❑New construction
2X I am a sole proprietor or partner- ��on the attached sheet 7• ❑Remodeling
ship and have no employees These sorb-contractors have 8. ❑Demolition
w for me in capacity- employees and have workers'
m'� any apa ty 9. ❑Building addition
[No wodwrs'comp.insurance comp-inselrz uml
required.] 5_ ❑ We are a corporation and its 110_❑Electrical repairs or additions
3_❑ I am a homeowner doing all work officers have exercised their 11_❑]Plumbing repairs or additions
myself [No workers'comp. rightt of exemption per MGL 12_❑Roof repairs
insurance required]t c_152,§1(4)and we have no
employees.[No workers' 13_0 Other
comp_insurance required.]
•Any appticiait that checks box Rl mug also fM out the section below showing theirwor$ers'compensationpolicy inhonation.
Homeowns s whzi submit this affidm iuddtating they are doing all waik aid then Bite outu&contractors mint submit anew Afc]avit milicatin;such
FContractors that check this box mast attached an additional sheet showing the mare of the mib-c� rs and state whether of nit those enthip have
empioyem. Mthe sub-coatractots t are employees,they untst provide their worker'comp.policy number.
lam an enrpiojvr that is pros Mug ivorkers'coe gmusadon hisaaavrnce for gray enTlotpees. Below is the policy and job site
information.
insurance Company Name..
Policy;9 or Self--ins.Lic.4: Expiration Date:
Job Site Address: City/Statelzip:
Attach a copy of thee workers'compensation policy declaration page(showing thee policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c, 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imsprisonmient,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 aandsed that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
$do Hereby certi,fy nr¢d the roes and penalties ofpedu y that the information provided abm�e is tnie`and correct.
Si tune: i c Date:
Phone 9- C) Ln
0fflcia,rm only. Do not write in this area,to.be compWeid by city or town official
City or Town: PermitUcense 0
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfl'own Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
i
Town of Barnstable *Permit# c)
Expires 6 monNrs front issue Me
r
Regulatory Services Fee
r
+ BAMSTABLK • .
ri;..
P Er� �y��7 Thomas F.Geiler,Director
Building Division
01
;v.. .v !< ... Tom Perry,CBO, Building Commissioner
�� �� OF BARNS�"A;5L'E 200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
0 (
Map/parcel Number
Property Address -5(;,\ lam(} \U� cuJ L. (�C),_K
Residential Value of WoA i g00%00 Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address_ Rm� kiA\i vow L\)
�� Um Cw Pon Co-vvr!� ,
Contractor's Name J� l(� Q Lr4`1 Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
�Che k one:
J� I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must accompany each permit..
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors,
exReplacement Windows/doors/sliders.U-Value �c J (maximum.35)#of windows
'Where required: Issuance ofthis 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:\Users\decollik\AppData\L \Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc
Revised 072110
registration valid or m iv u use only
before the expiration date. If found return to:
Office of Consumer Affairs.and Business Regulation
10 Park Plaza-Suite 5170
Boston,MA 02116
Not valid without signature
_•'r� 'III
III
4
— Office of Consumer Affairs&Business Regulation
HOME IMPROVEMENT CONTRACTOR
- - if :� {,
Registrationa�s�42108
Expir�ation:-37U5%2012 Tr# 294557
JIM TWITCH ELL++(0)ACFJI M_&VYNYL
,7.
JAMES TWITCHE`L- /
139 CAPTAIN CARL-ETONS'RD�
F COTUIT, MA 02635 ��` Undersecretary f}
• I f
.,vurti ul uuii(Aui Kerutations and *)tatidards
Construction Supervisor License
License: CS 102646
Restricted to: 00
JAMES TWITCHELL f
139 CAPTAIN CARLTONS RD
COTUIT, MA 02635
Expiration: 8/30/2012
Commissioner Tr#: 102646
a
BARNSPABM
, Town of Barnstable
Regulatory Services
Thomas F.Geiler,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, R-""tw T V` ,as Owner of the subject property
--,� C--
hereby authorize J szvne s- 142/7&1 Z5CX-- to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
/l 201�
Signature of caner Y5ate
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content Outlook�DDV87AAZ\EXPRFSS.doc
Revised 072110
I
i
the Commonwealth of Massachuseft
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
imvtuniass gov/din
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electiicians/Plumbers
Applicant Information ` Please Print Legibly
Name(Business/Organization/tndividuai): i�(� C)A r 1�
Address:1Y-k 000 0 Q f�LCTQ\JS (�7 )
Cityistate1Zip: v Ill oA U SS Phone 9- `1 1 LV- AA 014 `1 C�
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I
`, loyees(full and/or part-time)-• have hired the sub-contractors 6_ ❑New construction
2`�J I am a sole proprietor ar partner- ��on the attached sheet, 7. odeling
//�� shrp and have no employees Thy sub-contractors have g lition
working for me in any capacity. employees and have workers' 9. ❑Building addition
[No workers'comp.insurance comp-insurance-1
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 LE]Plumbing repairs or additions
myself[No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.]I c. 152,§1(4),and we have no
employees.[No workers' 13-❑Other
comp.insurance required]
•Any applicant that checks box Rl mast also fall out the section below*showing their workers'compensation policy information.
1 Homeowners who submit this afhd indicating they are doitig all wow and then hire outside contractors most submit a new aff darn indicating such
FContractors that check this has must attached an additional sheet showing g the name of the sib-comtractots and state wbe*er or not those entities have
employees. If the subcontractors have employees,they must provide their workers'comp.policy ntmtber-
I am an employer that is providing workers'conipe►isadon irrsrrrance for my employees. Belotv is the policy and job site
inforrnatiorr.
Insurance Company Name:
Policy 4 or Self--ins.Lic.4: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to S1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify ender the pain it nalties of pediary that the information provided above is trite and correct
Si tune: Date: l` — 1 d
Phone##:
Official use only. Do not write in this area,to be completed by city or to►m officiat
City or Town: PermitUcense# '---
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#:
6
Assessor's map and lot numb .. ...J ....y11 .:/(_....... ��� *THE
T
SEPTIC SYSTEM MUST
Sewage Permit number .... .......................... 'f
NSTALLEp IN COMP ;
STULL" •
House number ... ... ..I...... WITH TITLE 5rnea
ENVIRONMENTAL COI? o,,�O 39-Ar e�
TOWN OF BA,RNSfjAB"LE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ... G Yl S Y U C_� (� Lv 2 &t)�.C............. T........................................... ..................
TYPE OF CONSTRUCTION W0 O . E^'t -�
.....................................................................................................................................
1'}�.�✓i!: -.... ..S.............19..d�
TO THE INSPECTOR OF BUILDINGS:
The undersigned herebyapplies for an permit according to the following information:
Location /6 / • 3 7 Co ✓, ►),e v- Co -tL.1� CO✓f P �..... t- Crel UJCV r d
.................................................... I. ........ .............................................. ................... ...................................
Proposed Use � b L) S `e- ....:.............................................................................................
................ .........................................................
ZoningDistrict ........�............ ..................................................Fire District ...,...........................................................................
Name of Owner ... ..... . ..... ... ..............t7P7 ... ... b.�G.!!l..Address ..�.. ... .................
............. ................. ....................
Name of Builder ST t d�Ck-.vvl ............Address .... .��.1 S r. 4.........&I.......W.�...Qu rH
Name of Architect ............... (�.` .'?.`e_-.............................Address ..............................`.......�..........................................
Number of Rooms ..................................Foundation ....�U `/ ` .� C
............................ .. ..... ............ ..............................................
Exierior ..................................................Roofing .........
Floors ...............ht.r.0�LC/QQ.Cl..................................Interior ......4: �.`� LlJ G(
r
G. .................. .. ... .... .. .....................Plumbing......::... ...Heating � .............................
Fireplace �............................................................Approximate Cost ... ..7.Y...�. r
.................. ............................................
Definitive Plan Approved by Planning Board -----------_-------------------19 . Area .......1.. Q.. .� .............
Diagram of Lot and Building with Dimensions Feeti?.1.. .- ............. .... .
SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 Md
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .... .................... .......................
NOONAN, JOHN & ELIZABETH
4�No 2 3 0 51 permit for One l 2 S for
1...............Y
. Single Family Dwelling
Location ....Lot.,,,',•$,39 59 CQt,111.t...QQ.V.e.. ;2d:
Cotuit
...............................................................................
Owner Jo�Zn._.& Elizab.th...W.Oon.aa....
Type of Construction F C.dMe............................
................................................................................
Plot ............................ Lot ................................
�r
April 29
Permit Granted ........................................19 81
Date of Inspection ....................................19
Date Completed ........ ......... :-. �..19
PERMIT REFUSED
....... .... .:. ........................... �.. 19
. ..... ................ .... . ............
a� .... ........................................................
r7 er`
Approve::..............................:................. 19
...............................................................................
, r;\�
Assessor's ma ." ,•�'' /- C r p and! lot numb .r,.-,. a...""'.��..y��... i:� ....... �,. 2
Q
�pF THE
4r �� O
Sewage "'Permit number ......
d ,,. �
� � Z BARN STABLE,
House number ..�....I...../ ..............................:.............. NAM
0
pow t639. 00
'EO YPY 6'
TOWN OF BARN`STABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .......`.G.y..5 T Y.U..C. ....... U,w,e,11 �. w
TYPE OF CONSTRUCTION �D D �
. .................................. ..................................................................................................
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following-information:
Location G 3 CO ✓ 4 �- co T u,�' CO✓ e .. ..CrawF0�.�............................
................... ........ .................................................
Proposed Use / ..._..
..................................................................... ..........
Zoning District .Fire District '`......�..-. ..... /
J� 1 Y1 �' t�a i,)i M.( vl Address .. 1 a- CO�{ I
Name of Owner .................... . ....................... .. ....................
Name of Builder I ...PQST�tQ ...........Address ....L A! .d.S ............g-L4.......U)�.... �.u....N.l..
Name of Architect c_..............................Address ........................S.r'° ...........................................
Number of Rooms ............................. ..................................Foundation FU <� Ow. . C / P Te-
............... ............. ... ............................................
Exterior ..`...1.��.. .hT�t..!-. _.......I..............................`............Roofing ....../ . cc..l.. .....................................................
//6 i lcJO 0 .........................Interior .....�' [,v G�
Floors �......:.......�......... .�"..!!f.............../�............................................
Heating ................./...............................................:................Plumbing
..:.........a.............�.. �.... .. _ .........
... ..........................................
Fireplace ........... .......:....................................................Approximate Cost ...f?'.... Y , G
.............................................
Definitive Plan Approved by Planning Board ________________________________19________. Area .......J.. ?...................
Diagram of Lot and Building with Dimensions Fee . �4?..!. ......
SUBJECT TO APPROVAL OF BOARD OF HEALTH
i
4
I hereby agree to conform-to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
..�� . ... ......................�.�.. .............. ..Name....... .. . . . .. .. �
r -
NOONAN, JOHN & ELIZABETH A�5- 40
No 23Q 1._. Permit for PMe...1/2 St9ry,
.....Single..Fam .1y..AWej jng.................
Location .....Z,Aa...#.39....59...CotUit...C.OVe. RJ.'
.................. Otuit..............................................
Owner .....JOhxl...
Type of Construction .F.ra.mom................:..........
... ........................................ ..:-9.......................
Plot ............. Lbi ... ........................
Permit Granted .:.............19 81
Date of Inspection, 1 ..........................19
Date Completed .................. ....19
PERMIT REFUSED
................................................................ 19
...............................................................................
................. �. 1. ..............................
...............................................................................
Approved ................................................ 19
................................................................................
c .
Ld-,
. m n
tv
Ix.
m
\L�•�17
Xl
vy o-''�
' caw ti EYE
OF 614
S,�ry ��►i w1 �� �4ta 0 At JS.o.+l
WALTER G�
P. 3Z .ti.twl ST C. �.itl!Tr•
OL-OHAM'
,p No. 292D7 O Ve,R• f?.SSoc. �+c. �Ai �.►�aA.A,
S�A� ••= �O' "
... 7-
TOWN OF BARNSTABLE 23051
Permit No.
11 --.Building-Inspector cash�. ---___---
rua
OCCUPANCY, PERMIT. Bond
"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` John & Elizabeth N6MfaiJ_Address:
A �
lot-#39, 59 Cotuit Cove Road, Cotuit
Wiring Inspector i �2. 1, Inspection date
Plumbing Inspector Inspection date
G-as Inspector + Inspection date
J Engineering Department %y . Inspection date /
r �
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTORrUPON SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
............�......................_............, ..�...........Building/,�'Inspector _.._._._.__...�....
Assessor's map and lot number .... ... ..... .. ... . ......... ... STHE
TOE
Sewage Permit number .. .K............. ...... . .. ...... ... ..0
33AUSTABLE.
House number ............................:........................................... NAB&
0
r, 1639.
kau
TOWN OF . BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ............ .....................................................................
TYPEOF CONSTRUCTION ........... .................................................................................!.....................
........A... ............19n
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location ..................67... .7 �O IF,-0 I r. . ..........................................(.O.L/....................................................................................................
.....................P. !....
Proposed Use ....... ...... ...................................................................................................
Zoning V—
District ...............R ..........................................Fire District .1.............................................................................
Nameof Owner ... ..................................Address .......0...... ...P-L........................
Nameof Builder ....................................................................Address ....................................................................................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ..................................................................Foundation ..............................................................................
Exterior .....................................................................................Roofing ............. .......................................................................
Floors .:...............................................:...Interior .....................................................................................
Heating ...................................;...............................................Plumbing ..................................................................................
-�Z, d--b
Fireplace ...........................................:......................................Approximate. Cost .116.................................................. .. .........
•
Definitive Plan Approved by Planning Board -----------------------------19---,------ Area ......../a.-7110 ...........
Diagram of Lot and Building with Dimensions Fee ........ ..........................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
. c
COVE RD
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the T'wn of Barnstable regarding the above
a
construction. Name .. .................................................... .....................................
r)
Constr ction Supervisor's License ....................................
71
N000A0, JOB0
'
35390 Build Deck
No ................. Permit for .................................... `
'
Single Family Dwelling
.----,.---.--.,--..-----------. `
. . .
59 Cotoit Cove Boad
Locohon ----.----------------..
C toit ~
-----./��----.--.------------
John Noonan
Owner —.--------.-------._---.
. .
'
Ir�
Type of Construction --������.---^---..
. 'j, ~ '
—.—.------.------.------.----
..
Plot ............................ Lot ----------'
' -
July 8
Permit .----�.--� 8]
Parm —_---lA
Dateof | .....................................l9
' ~ -
� - . '
Oote Completed ............. ���X�� ...........lA
`
.
^
�
�
. .
` ~ _
- ' ~
,~` ^
'
' ^
,
�
- �
~ ~
'
'
^
^ ~
Assessor's map and_lot number/ !iy� /: :.,./� F T
C THE
Sewage Permit number ..��r��.'.......................
11AWSTOnr,e. i
House number ...............................................................:..:.....� ro rhea
r
O i639
TOWN . OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION ..............I fY d:........................`....................................................................
la �
.-...J. .. .. .. ..... ..................19....:3
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location . /'��d�
................:�;?......?......... U ..........`...... ......................................................................................................
ProposedUse ............................. J. L4A.................. . ........+. . C.,d*...................................................................................................
�.
Zoning District ......................?.................................................Fire District .........................
rf c...................................
Nameof Owner ...................Y............ Address .....t, ... .....:. -................................................................
Nameof Builder ....................................................................Address .....................................................:..............................
Nameof Architect ..................................................................Address ....................................................................................
Numberof Rooms ..................................................................Foundation ..............................................................................
Exterior ......................................................................:.............Roofing ....................................................................................
Floors Interior
Heating. ...................................:..............................................Plumbing ..................................................................................
Fireplace ..................................................................................Approximate Cost .:1.6 L'C„...`...............................
Definitive Plan Approved by Planning Board -----------______—-----------19_______. Area ........�1!/v ../...,.............
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
NN �!
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 ... Arm.—
Construction Supervisor's License ....................................
NOONAN, JOHN A=5-40
No .... Permit for B! ild Deck
..............................
Sinc '
............. ...F.ami.ly. ....Dwe.1 1A n g................. ....... .... ....... .... .......
Location ...5.9...C.o.tu.i.t...Cove. ...Road. ............. .. .. .. .... .. .. ....... .. .. .... ..
cotuit
...............................................................................
Owner ....John Noonan
.............................................
Type of Construction ....Frame
......................................
................................................................................
Plot ............................ Lot ................................
Permit Granted ......j:g!-Y...g.'r................19 83
Date of Inspection ....................................19
Date Completed ......................................19