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0008 TROTTERS LANE
X 0 �l v�"9 J ^/-IV Conzarvwon ` 1 11/14/14 Thomas Perry, CBO Town of Barnstable Building Division 200 Main St Hyannis, MA 02601 RE: Insulation Permits Dear Mr.Perry, This affidavit is to certify that all work completed for insulation work at 8 Trotters Lane (application#201302030) has been inspected by a certified Building Performance Institute (BPI) Inspector. All work performed meets or exceeds Federal and State requirements. Sincerely, M—� Conor McInerney ConserVision Energy =_a 376 ROUTE 130,SUITE C SANDWICH,MA 02563 508-833-8384 WWW.CONSERVTODAY.COM TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O�a Parcel Application ��� Health Division Date Issued Conservation Division Application Fee CID Planning Dept. Permit Fee oo Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address S L N Village AA,P,?_59_.W 15 /NA 1. IILS Owner 1L W' N Cy M M i Nf('S Address Telephone Permit Request w EfTUL`If' 'I-Z . Oh! Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1200 Construction Type o d o Lot Size Grandfathered: ❑Yes ❑ No If yes, attach sur rting do'umer tion. cn Dwelling Type: Single Family ❑ Two Family 0 Multi-Family (# units) o Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Hi hway: 0 Yes ] No-_ Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other t" r Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) ry Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type,and Fuel: ❑ Gas ❑ Oil ❑ Electric 0 Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 0 No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing 0 new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use i APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name CBYV Bi(L M_( NT7Z Telephone Number Zg'L3 Address '3"1 b 0-0 yro-S 0 License# 102--1-1 6 5pfl\p wqc 6 IN" oZS b 3 Home Improvement Contractor# Worker's Compensation # C -° 6 r, ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO `arjvTL� r SIGNATURENYV\,AYDk DATE r FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ' 'DATE OF INSPECTION: FOUNDATION ' FRAME INSULATION FIREPLACE `ELECTRICAL: ROUGH FINAL - PLUMBING: ROUGH ` FINAL = GAS: ROUGH FINAL r j FINAL BUILDING —- ; _ .--•-- --- _ - ', DATE CLOSED OUT, ' ASSOCIATION PLAN NO. ���?�'�o� 1� ��• 4 n* 41 OWNER AUTHORIZATION FORM / Liz (Owner's Name) owner f the roelocated o e property rty at (Property Address) (Property Address) hereby authorize 1 S d Tv , (Subcontractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. 04vne s Signature 1 .. Date D A`f 2 5 2012 CONSENE-01 MVAUGHAN '`'`� CERTIFICATE OF LIABILITY INSURANCE °"312010 3' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. VAPORTANT: N the certificate holder is an ADDITIONAL INSURED,the pollcypes)must be endorsed. H SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certMeate holder In lieu of such andorsomen a PROD NAME:• Strata Ic Business Unit ��ers 6 Gray Ins.-Dennis Branch PHONE 606 398-7980 434'Rte 134 N : 877 $16.2166 South Dennis,MA 02060 EM INSURER AFFORDING COVERAGE NAIL Y INSURER A:Selective Ins.Co.of the Southeast INSURED USURER e• _ Con-Serve Energy,Inc. C dba ConserVkbn Energy 607 Main St INSURER0: Hyannis,MA 02601 INSURER a: INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICYNWBBi vP LIMITS GEMS LLORL" MHOCCURRENCE S 1'080.0 A X CDUMERCIRL GENERAL UAR ITV 2011299 WM013 3A412014 0� 1 Ea 3 10 MEOExP on. S 0.00 PERSONAL aADvINJURY S 1,000,0 GENERAL AGGREGATE $ 3,000,00 GQfL AGGREGATE LIMIT APPUESPER' PRODUCTS-CCMPIOPAGG S 3,000, X PO= F-lLoc S AUT01900WIJASLITY � If S ANYAUTO a00ILY INJURY awpmm) 3 _ SCHIMULEG AUTOS AUTOS AU tI000YINJURY(Pereod0ent) 3 HIREDAUTOS �BAD P R S $ UY61t�lA lJAB OCC1R EACH OCCURRENCE S ExcEssWe C1Ae,1 AGGREGATE S IGEDI IRErENTXIN S WORNMM" YP6teAl10N ATU O A ANYPROPwEroRa�Aa FJrlal�arrvEYINUMff AM smart"WeLm C7866639 3N4)2013 311412014 E.L EACH ACCIDENT 3 600,00 OFFICERIMFIA>9tEC UDED'J NIA II QeTo�� E.L DISEASE-EAEUPLOYE i 600,00 oFaPEw►norrswlor ELDLSEASE•PaJ(wuurc i 500,00 I oeaeRlPtIDN OP aPERAtmtts rtJlaTltlnsJ vettars tAsw,ACGRD rat,AddYlootl Rutrtcs B�MGu11 r omn sPw Is naar.al , EXCLUDED OFFICERS UNDER WORKERS COMPENSATION:CONOR 3 COURTLY MCINERNEY"NOTE THAT BLANKET ADDITIONAL.INSURED OVERAGE APPLIES TO THE COMMERCIAL GENERAL LIABILITY(IF A WRITTEN CONTRACT IS IN PLACE). CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 13EFORE Rise Engineering THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Rise Elmwood Ave. ACCORDANCE WITH THE POLICY PROVISIONS. Cranston,RI 02910 AUTHORMD REPRESENTATIVE 01988.2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD f The Commonwealth of Massachusetts Print Form .- Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 Boston, MA 02114-2017 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibly Name(Business/Organization/individual):Con-Serve Energy,Inc dba ConserVision Energy Address:376 Route 130 City/State/Zip:Sandwich, Ma 02563 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1.21 I am a employer with 8 4. ❑ I am a general contractor and t employees(full and/or part-time). have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ?. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' 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 I.❑Plumbing repairs or additions myself ' right of exemption per MGL Y (No workers comp. 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers 13.2]Other Weatherization 2013 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors have employees,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:Selective Insurance Co.of the SouthEast Policy#or Self-ins. Lic.#:WC7956539 Expiration Date:3/14/2014 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$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of investigations of the DIA for insurance coverage verification. I do hereby I certi under the pains and penalties o er'u that the information provided above is true and correct: Si azure: 71Date ?J 2 2013 Phone#:505-833-8384 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#: CSSL-102778: CONOR D MCINERNEY - 30 SIASCONSET.DRIVE SAGAMORE BEACH MA 02562 08/19/2014 Office'f't~onsuiner Affairs&Business Regulation' _ HOME IMPROVEMENT CONTRACTOR Registration: 171251 Type: Expiration: 3/1/2014 Partnership CONSERVE ENERGY CONOR MCINERNEY 376 ROUTE 130 SUITE C SANDWICH.MA 02563 Undersecretart• License or registration valid.for.individul use only before the expiration date. 1f found return to: Office of Consumer.Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA02116 I ' Not valid without signature 7 � rp 8- F� 3 3 - �38L j t oFtNE Town of Barnstable Regulatory Services B"NSTABg Y i E Thomas F.Geiler,Director i639. 039. 0. Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Feb. 28, 2013 Conservision Energy Phone on Trucks: 508-833-8384 376 Route 130 Sandwich, MA 02563 It has come to our attention that your trucks are working on a residence at: 8 Trotters Lane Marstons Mills, MA 02648 Please be advised that if any work requiring a permit is being conducted, or has been completed by you, then you are in violation of the Massachsetts Building Code 780 CMR and the IECC and subject to additional charges and/or fines. Permits are required for most weatherization and energy conservation improvements involving insulation. Please contact me at 508-862-4033 as soon as possible to discuss this matter. Robert McKechnie Local Inspector Building Department Conservision Energy in MA I MA Conservision Energy - YP.com Page 1 of 1 Loazlir T8 it... 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Sign In Join Conservision Energy near I MA ' � I Conservision Energy in MA Results 1 of 1 I Filters List View Map View 1 Conservision Energy 376 Route 130,Sandwich,MA 02563 »Map Be the first to review (774)413.5797 •>More Info -Add Photos If we're missing a business and you'd like to make a suggestion,please do!Add a business u MA Yellow Pages» I ' I Sponsored Links Get Energy Efficient I www.worldenergy.com/efficiency/ Save Energy and Lower Your Business's Energy Bill-Act Nowl t Q N TIC �� S Mass Energy Conservation www,homeadvisor.com/ Get an Energy Audit For Your 3 I / Home.Free Auditor Listings.Search Nowl /`�' Find an Energy Audit Contractor Energy Tax Credits wvnv.engineeredlaxservices.com/ Tax Deductions For / Property Owners with Energy Efficient Buildings ABOUT SITE DIRECTORY CITY GUIDES noroutioa•• YP FAMILY About YP Home Atlanta Detroit Miami Corporate Site Contact Us Find a Business Austin Houston Milwaukee Advertising Solutions Advertise with Us Maps&Directions Baltimore Indianapolis New York AnyWho Careers-WE'RE HIRINGI Find a Person Boston Kansas City Oklahoma City Ingenlo Yellow Pages Engineering Blog WMke Pages Charlotte Las Vegas Orlando Keen Legal I Terms of Service and Use Restaurants Chicago Los Angeles Philadelphia AT&T FAMILY Privacy Policy•Updated Mobile Apps Dallas Louisville Phoenix Small Business Advertising Reverse Phone Lookup Denver Memphis Saint Louis AT&T Advertising Choices Site Map AT&T wireless Mobile YP Find Us on Facebook 0 2013 YP Intellectual Property I.I.C.All rights reserved. YP.the YP logo and all other YP marks contained herein are trademarks of YP Intellectual Property LLC and/or YP affiliated companies. AT&T,the AT&T Logo and all AT8T related marks are trademarks of AT&T Inc,or AT&T affiliated companies.All other marks contained herein are the property of their respective owners. I �TRUSTe• CERTt-�-O F3Fv'AC1° http://anywhoyp.yellowpages.com/massachusetts/conservision-energy?g=Massachusetts&... 2/28/2013 r P. 1 Communication Result Report ( Feb. 28. 2013 4: 09PM ) u 2) Date/Time : Feb, 28, 2013 4: 09PM File Page No. Mode Destination Pg (s) Result Not Sent --------------------------------------------------------------------------7------------------------- 3117 Memory TX 915088338384 P. 1 OK - ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang up or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—mail size Town of Barnstable ! Regulatory Services neon 7Lumas P.Gr9er,Dins= ' 0j¢r Building Division Tom Perry,Ituthling Co Wsslaacr 200 Mdn SU.,;.lly—w4 MA 02607 Offiao:509-862-4m8 Far,503-790-6230 Feb 29,2013 Conservislon Eacw Phone on Truss 50"33-8384 376 Route 130 Sandwich.MA 02563 It has come to our attention that yourtrucks ate worming on a residence at . 8]Yottera Ise . Manstons Mills,MA 02648 Pieaso be advised that if any wwk requiring a permit is being conducted,or Las been comploted by you,Otan you are in violation ofthe bUssaehsotts Building Code 780 CMR and the IECC and subject to additional cimsgm and/or fines.Permits are mquhvd for ' most weathann ion and energy conservation improvrmeats involving insulation. - Please contact me at SM862-4033 as anon as possible to diawsa this matta. Robe+t McRechnie . Imcal Inspector - Building Department C)Lk VIZAT10 A-N Mq�. 3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Q T Parcel 2— _ Permit# 7 9 I b l Health Division aC q __-3 ry, Date Issued Conservation Division re v `" Application Fee Tax Collector Permit Fee Treasurer SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plah Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGULATIONS Project Street Address m"k-�c°�-s 1--cwt. Village i'Y)ahs Y+s M i l)s Owner RbeJ- A. Ill d- Karer\ 4-- Curn✓ ',qk S Address 8 Trr A-r,s (_ahe , NO-s4hs films Telephone 508 q�O -57 89 Permit Request Auld,fron op Ci_ 'Ewo &A)1 GcAeA Gf rcLQe `24X zy) an j W1 rooni a60ve 4-o &X(sIKA SlhJr 'Ei,r111 lnovne- Square feet: 1 st floor: existing 74�,S proposed MR 2nd floor: existing SOW proposed Total new !37 Z Zoning District Flood Plain Ado Groundwater Overlay Project Valuation 94,848 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. ' Dwelling Type: Single Family ] Two Family O Multi-Family(#units) Age of Existing Structure Historic House: O Yes No On Old King's Highway: ❑Yes No Basement Type: ;4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 769 Number of Baths: Full: existing Z new Half:existing new Number of Bedrooms: existing 3 new _)L( Total Room Count(not including baths): existing new_ First Floor Room Count 3 Heat Type and Fuel: ❑Gas ;4 Oil ❑ Electric ❑Other Central Air: 0 Yes X No Fireplaces: Existing New Existing wood/coal stove: O Yes No Detached garage:0 existing 0 new size Pool: 0 existing ❑new size Barn:0 existing Cl new size Attached garage:0 existing %new size 2 x L Shed:0 existing 0 new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded❑ Commercial O Yes %No If yes,site plan review# Current Use Sinnie_ r,es4e xJ r., Proposed Use 5Sn4_ fam0& I-.11j"111 BUILDER INFORMATION Name_Brc 0-or-k BuAin+ •- Ipernodel►. !�, Telephone Number 509 534-`700 Address Poo fQ-1_mo uA r?d. 5u%le 303 License# 61 Z I A G nlus�pr� ,/CIA D�6 45 Home Improvement Contractor# 1'3 3 LI q 8 Worker's Compensation# ALL CONSTRUCTION DEB ULTING FROM THIS PROJECT WILL BE TAKEN TO 3o ee n & SIGNATURE DATE 'O ' FOR OFFICIAL USE ONLY i t PERMIT NO. DATE RUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER DATE OF INSPECTION: ' FOUNDATION FRAME -b.�IQ Sir eh.- •7 Ir ®K.?.�'�� J INSULATION -7-6'-p a eK1001, ' FIREPLACE ELECTRICAL ROUGH FINAL PLUMBING: ROU( S FINAL'- f3C o GAS: ROUC _ FINAL - ` FINAL BUILDING -i- m racy - DATE CLOSED OUT' co < m s a ASSOCIATION PLAN NO M f � e 00 cb lb IQ LOT 1 1 LOT 2 gy RES. ZONE- "RF" This MORTGAGE INSPECTION Plan is For FLOOD ZONE.- "C" Bank Use Only TOWN: _______ REGISTRY OWNER: STEPHEIV _T._I�AVIID ______________ DEED REF: _9Z7Q,�e ____—___BUYER: JOEE)2T--A IL Ir9RF,N_�_CU�IMILv2S_____ ___ DATE: —9�3�93 ____________ FLAN REF: _271�9r _ _--___SCALE:I"= 30 ___FT. I HEREBY CERTIFY TO AVOf?� 1i'�VF ___THAT THE BUILDING �,��,�ZH Ma YANKEE SURVEY SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS o�'y PAUI CONSULTANTS AND THAT ITS POSITION DOES _- CONFORM A. `� rO THE ZONING LAW SETBACK REQUIREMENTS OF THE MER1rHEW N 40B INDUSTRY ROAD rOWN of _EARNSTABLE_____ ____ A No. 32098 _._AND THAT o ,o' MARSTONS MILLS, MA. 02640 IT DOES_ NOT _ LIE WITHIN THE SPECIAL FLOOD HAZARD "s '��CiSiER �y``;• TEL: 428-0055 AREA AS SHOWN ON THE H.U.D. MAP DATED_V19,��5s�oN;, LXIT;S° FAX 420-5553 -o unit —Panel # 250001-0015—C v. _ s/]Q __ _ �____ THIS PLAN NOT MADE FROM AN INSTRUMENT �7 /+/+�/ � F, a L1N'Ni7T-T GTC CTiA\7T V i�i(1'f m P TTQt n Lno crT,irvc vrr 123,92 V111V1 Town of Barnstable Regulatory Services s BA MM L ' Thomas F.Geller,Director 9q, s679. .0� Building on Divisi - Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 office: 508-862-4038 Fax: 509-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I .;as.Ownex-.of the.subject property ._....._._.. ._ hereby authorize l3ro�er�T -.13c��j��;ic,: +- Rem.ode j".j::._. ... .:. .to°act On=Tb.eb.4. in all matters relative to work authorized•bp this building•permit-apphcation for: S rre �-, !�?�►-5s /�l�'��S , CIA (Address of Job) ` p Signature of Owner Date (� A tiffs G` t Name RESIDENTIAL BUILDING PERINUT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 i FEE VALUE WORKSHEET NEW LIVIN S PACE g9 o square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTF,RATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus-from below(if applicable) GARAGES(attached&detached) 57(o square feet x$32/sq.ft.= j g y 3 Z x.0031= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 _ >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30,00= . (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) - Permit Fee projcost na ctrtR Agpex�&! . Tibia J3.Ub(coatiaucd? with gcsxfl Timistrye F':cksge7 for Qan zad TwaFx�slly Aesldeaiitil Hnildia�ge tted Prrse�P . ', hQMML7M 'flcating/Coaling h'iAXfMtlhl a Clling Will FS -Y�slueoar s 9=s�?� gquigrcuitICiei1c Blazing Qlaang Will Arcs'(INIJ•yalu� R-Yaluc� R-Yaltle R ��YxlsrC� &YullmT Prr�3e 5701 to 6500 Hesting Dim D11� 6 Nonaal 31 13 19 10 6 Nonnxl Gm 30 19 19 10 6 15 APVE R i2/• 10 0 13 19 10 N/A Nannal 3E 13 y NIA 6 Nemu1 13% 0.36 10 T . 0.44 38 19 15 WA 15 AFUE U 15/. 31 13 25 NIA 6 {5 AF JE Y IS'h 0.4# 19 19 10 Nomsal 15'/8 042 30 N/A N/A X 18'/. 032 31 13 25 19 � N/A N/A 4 AF�VE Y i8'/. 0,42 3E 13 19 10 6 31 6 g0•AFLTE � Ig•/. 0.42 i9 14 10 ' 0.30 30 1, ADD RES5 OF PROPERTY: ae-s�otin.s 5 MA 2- SQUARE FOOTAGE OF ALL EXTERIOR WALLS; ' 3. SQUARE FOOTAGE OF ALL GLAZING: Il(o 4. a/a GLAZING AREA(#3 DNIDED BY 12): 0 5, SELECT PACKAGE(Q--AA.see chart abcyc); ,RMINING ENERGY REQUIREMENTS �0 ; OTHER MORE INVOLVED 0R'O WORMA71011 ARE AVAILABLE, ASK TJ BUILDING INSPECTOR APPROVAL: N0; YES q.fecrns-fl80303a f o�TME Town of Barnstable Regulatory Services Thomas F.Geller,Director 1639• �,�� Building Division rFD MA't ' Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. AFFIDAVIT HOME IMPR0VEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the"reconstruction,alterations,renovation,repair,moderniza ioni ier ion, occup i -improvement,removal,demolition,or construction of an addition to any pre-existing owr� bujlding containing at least one but not more than four dwelling units or to structures which are adj scent to such residence or building be done.by registered contractors,with certain exceptions,along with other requirements. Type of Work �� l°C-='" Estimated Cost Address of Work: 'a �e�e�'e�s �^�''� ma�s�-ohs Owner's Name: i�b e��- �►. a.r� l., uMPM"Io'C,S - Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under S 1,000 []Building not owner-occupied ❑Owner pulling own permit Notice is hereby given that: OWNERS PULLING'TECEIR OWN PERMIT OR DEALING WITH UNREGISTERED NOT CONTRACTORS F�ITRATION PROGRAM OR GUARANTY FFUND UNDER MGL c 142A. ACCESS TO , SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as eR o e o er: Q �qr" I Date Contractor Name Registrationl�Io. OR Date - Owner's Name } The Commonwealth of Massachusetts Department of Industrial Accidents El $J O�Il�e1/�f�S sdi�s 600 Washington Street Boston,Mass. 02111 Workers' Co� �ensation Insurance Affidavit-General Businesses name: � �GIB 1 C. ._ .. t-•'u + --�� address: I Y UIIJ %C Tl�'� City_ state: `Y,I rV ziU:O LIogq phone# work site location(full address): f Y 1 d 6C�_ ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑Sales(including Real Estate,Autos etc.) ❑I am an em I with em loyees(full& art time). ❑Other LJ I am an employer providing workers' compensation for my employees working on this job. company name: address: city phone# .insurance.cb:-• I am a sole propriaCr and have hired the independent contractors listed below who have the following workers' compensation polic C Coln anV name: insurance co. ME o1ic' :# _. company name: address 2. city::•' : .:. •. . :.:. .� ,. ... phone# -- o7i Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a flue of$100.00 a day against me. I understand that p copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the ain enalties of perjury that the information provided above is true and correct Signature Date Print name i, —15P Phone# v official use only do not write in this area to be completed by city or town official L permit/license# ❑Building Department ❑Licensing Board e response is required ❑selectmen's Office ❑Health Department phone#; ❑Other r _ $, Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all einployers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service-of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has _not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract tar the p ormance o pu c work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pernit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the perrnit/license number which will be used as a reference number. The affidavits.may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 8lflce of Inlresugatlons 600 Washington Street ' Boston,Ma.. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext.406 Results. Page 1 of 1 Licensed Contractor Look Up Select the search method: License ' Maximum number of matches: 25 j Enter Search terms separated by spaces.172126 Select Search type: G AND r OR Search Search Results City/Town Name Type Lic. # Restriction Expiration Street State Zip BRODERICK, 800 MASHPEE BRADLEY E CS 72126 1 G 02/06/2006 FALMOUTH MA 02649 RD SUITE 303 Total of 1 Records matched. Back to Home Page BBRS Privacy Statement I Results. Page 1 of 1 Home Improvement Contractor Look Up Enter Search terms separated by spaces. Search terms can be Town/City,Name, or License number Select Search type: (v- AND r OR ILSearch , Search Results Reg. No. Applicant 11 Street City State Zip Name 7Title Expiration 800 BRAD FALMOUTH BRODERICK, 133498 BRODERICK RD. SUITE MASHPEE MA 02649 BRAD OWNER 6/29/2005 303 Total of 1 Records . matched. Back to Home Page BBRS Privacy Statement ..The Town of Barnstable Department of Health Safety and Bnvironinental.Services Building-'Division y 367 Main Street,Hyannis,MA 02601 , 8.8624038 ' 18.790-6230 PLAN REVIEW ' ►caner. s Map/Parcel: 7 f Z 2 rojcct Addrtss: Builder•. I Me following items were noted on reviewing: ( 1 ' 6- eA C.4 3 W Yt�� S ter. e1 \k we�v�C 2-4/by S o elz 2 7/oy 1 J �y v ax d 1 • Z r►oOR JOIST I lCGWT1,I= x.oCxn+a 1 L-1/p-P1 I I .I I I II I I l I M cwcc •. 2. ,4 a �iTAGGCAm) Gw PL 0�7 . I I I 1 I CAP PLATF TIFTATI To raurpo I OR WNTDAX= VALL rWTL%4 LW GFNERAI NOT C AND F;ATERIA � CP iFI ATIO 'C� I. Structural Steep ASTM A5.7�ahop painted w/ rust Inhlbltive paint 2. Anchor Bolts, ASTM A510(Galy,>r .3( din., expansion - t � �6� ���` 3. All workmanship to conform with American Instltute of Steel Co�'structlon embedment. and Massachusetts State.. Building Code Latest Edition requirements. a. All welds to be E70xx electrodes columns. Shop weld cop and base plates to 5..Coordlnate oil dimensions with Architectural: 'Drawings, field verify •a !, whey.a required. �HOF Mass MICHELEC. G TUD CR o No.34774 i cn U STRUC(URAI- STEEL BEAM CONNECTIONS MICHELE C. TUDOR, P . E u TO TIMBER FRAMING Consulting Structural Engineer �' 23 Cottonwood lone Centerville, Wks3ochusetts 02632 G I►� � s -------------- �;-O Ko � � Drawn By: VdT Dole: 0¢ Figure /4 Checked By; Scale: none File Nome. Pro ect No.; _ I SMOKE DETECTORS O.K. 7b� ... aI16aVf:4c S1 .L dX C ���'. ..� f• a' LN NEW SMOKE DETECTOR RE QUIRE ENTS ARE NOW LAW. EVEN THE DDITIO, OF A NEW BEDROOM WILL -TRIGGOR A N t.: UPGRADE OF THE SMOKE DETE FOR THE WHOLE HOUSE . YOU MUST WPm""f eNncX'd w1nL ¢FA0.�F1 EJAnCN PLAN ACCORDINGLY AN HAVE YOUR F¢cNr Ei.EVRMN ELECTRICIAN TAKE OUT THE APPROPRIATE PERMIT AT THE FIRE DEPAR WENT. � .... ..... :'iie•a[..:icb�t+.^�s'd4:'�-`'�.•�' �m�P.Irw4e N. • "dPM ww Md++aLr♦cwsy' Oeeaac a.L u�edd.' •..... .. � � �- II I n.414f[ mf W n.w.frG aYacly tll iwJM'� IabdNdaos /S6 a0 M � , '� @fi ivalns+: SIOE EIEVAnoN n .. 'SEGnON � "-••:y'a f o' ma.. ..NeH . � OIOOWOICUOYC.RFwOomLL 1/.L IIV p�jd/p1FWe"1'�SDY.�WIeUR� .e,Rae.[ddtaf GunN.4U . X�4a mXu a rmrrru u4c , - �fNNfaua N Na •l�v3m 'sa . 'dAM ' cfD• _ ' L'd't.4 . � _ � MAMIG0.�I1fOSmH c I li y I 4r. fflwYl., '.Y11LI[M ..4, I I I Revas.NMY.I r.l 4 LNwARN4f' :.,61ib Nl..L �rf�t!, dd . FAGDLY,'DbpjA'�'. S, I�_ -_ 11'.:1'•O''gi', �,�;�^7/� l'G 1Q�w�aN ' GARAGE. ADOInaN D[mFA410NtOolD LGHIMpD1F [cW[:I/y'•1-1mw. F)RSr FLooa, , Frr.rw. 1fvwEQw mDu AaQ•.wtw Lu+wmw ' NGtfMf w . u 1 eG yw[o , 1 v Sr Y.. a' 1 ' " A r I i 4 E r,ra d t - Y f r i Y. �F L �� lab Fimt vo:tra 12.04 X YtOUO AmP FW1,w6 0.A/J''I I I`• I r 7J:-0. I Em�.a a i 1+R flmasrur,:�at •`I UN[.cw�,m �.OeRew»�;,uw N[:wr 14 I FWRGNaI I I •;1 I :I I p I. P,R,i F1NR. FIIM,W H.11,d GRRaLG RODmeIJ FORIrDeTIOu nerd rrau:'/+'v p.a• n, ' wRo�nw�® aoa•nrau e,aa,rra.f ' /MUrauf M Kyw• wawa;•m '����"iiiifr°� The Town of Barnstable BARNSfABLE. ' Department of Health Safety and Environmental Services MASS. O "fEOMp�° Building Division 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection -711 Location g 7/7.0?77N6 , �9 Permit Number Owner Builder K P-4b 13 D e�( C One notice to remain on job site, one notice on file in Building Department. The following items need correcting: AID haa—P jl0 01 O 'e�2 C4 a �7c"-C t i 14 . 42'p e f1^ 7 NS V1-/1'T 'r'AQrO ?0 r/ L''•. w S/'ecT�v oUfyD �OUBL O !'kR, c,e ,eddy l,✓ipow�. �+f�TieR�' L )'G I D©2 leG T Please call: 508-8�6/2-44038 for re-inspection. Inspected by Date �2 dU Assessor's map and lot number .......................................... Sewage Permit number .......................................................... QaF?HETO�♦ TOWN OF BARNSTABLE • Z 33AHH9TSDLE, i "b BUILDING INSPECTOR O•E�MPY Ar APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ..................................................................................................................................... ................................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................................................................................................................................................................................... ProposedUse ............................................................................................................................................................................. ZoningDistrict ........................................................................Fire District .............................................................................. Nameof Owner ......................................................................Address .................................................................................... Nameof Builder .......... .........................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................................................................Foundation .............................................................................. Exlerior ....................................................................................Roofing .................................................................................... Floors ......................................................................................Interior .................................................................................... Heating .................................................Plumbing ................. Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board ___________________________19________ . Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. Fitchen; Margaret A=:+l 22 j No ..2211.4.... Permit for ...I..112...s.tQry......... .........single.1wi l. ..dwelling..................... } Location ...........$..TrAtter.'.S..Lane................. s . ........Mars.tans..Mit11s...................... Owner ...........Margaret-Filchen................... f Type of Construction .... .... frame.................... � .......................................................... s - Plot ............................ Lot ....#1........................ tt Permit Granted ........April 15..............19 80 ' Date of Inspection .............. ' Date Completed ..................../..............1.91 z t PERMIT. EFUSED t i > ....................................................... . 19 . .................. A.... ../. +r ..... .; .........T. ...................... ................................: \............................. _ Approved .......................................... essor,,s map and lot number .... 7............................. o/� . -/11 . G - ` - 79 /9 son W COgMP1�tANCE Sewage Permit numbef ........................ .......................... � 1Mf!!TI'T'LE 6 CF THE TOWN 0FdBAR1==t,o.Es ND t0 roe" O� BABBSTABLE, 16 q .e� BUILDI#G. INSPECTOR Mac a• APPLICATION FOR PERMIT TO ' G V N . 4 4..... ............................... TYPE OF CONSTRUCTION .... ..... .......C. .........................................................:......................... 1 ....7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: I J- k r n ( Mn p Location k l.� o .......... Proposed Use ..cJ.;./!!. .�...�Qf`^...... ...k-10Ljoce,.................................................. Zoning District ....... �'� , �..1. . .!Tc�F Fire District .. ` �I L�1.` r ............... Name of Owner . . ... . ! . - .. Address ... ......... L'... . .... .c.i......... ... ..M�1.'.. ........... .. .. . . .. ... ... Name of Builder .... ............ . .e. .......... ........Address ..� t/r!' --... R405 Name of Architect . .. .'... . .................................Address .. .. .......... ...... .........35 Number of Rooms ........r U.`.'e-.........................................Foundation .� ......C,'.dV.� ✓...�. . Exterior �. l lt4 l `1�.� 'L!DX L.f�1�...Roofing a.................... .R' .... 9,�1�` ..V!� ..✓.�: �s 114... . . ....... .. ��.. l,�v � l Floors .? t'G:.0........��.' v::.. .....�l.0 '.. ...Ir�erior .......... 0..."`�Gl!4.... .�.1 ! :.... /�Z�Ji!I"'`.o�(� Heating �V..-:..�...1-'.......................................Plumbing ..� �'t.r-C�,.1. �... .. . .... Fireplace ... .. ....................................................Approximate Cost .............1.... Definitive Plan Approved by Planning Board ----------------------------- Area 499!.�'.. ...I...... : . ..... O Diagram of Lot and Building with Dimensions Fee '�—............................................. SUBJE TO APPROVAL OF BOARD OF HEALTH. 'Ho--jb i \ h1 Jc � s.f 1 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding t above construction. 04e- AName ....far ... ......... ...:............. .. ¢�w��C Fitchen, Margaret 0 22114.. Permit for .........l..l./.2..s.to.ry... .......... .. .. . .. .. ... .... sYn le family dwelling ................................................................... 8 Trotter's Lane Location ................................................................ Marstons Mills ' ............................................................................... Owner ............Margaret...Fit.........chen.................. ...... Type of Construction ................frame .......................... ................................................................................ Plot ............................ Lot ............#.L .................... April 15 80 .Permit Granted ........................................19 -Date of Inspection ....................................19 -Date Carnpleted7. .........19 C /•a ills A?v PERMIT REFUSED .... .....4M........................................ 19 .1.5.................................................... ...... . ..fir. . ... ......................... .. .................. ........ ....--------- - -- ----- .................................................. ci 0 CW Ap ..... 19 -t�................................. M !Z ..........M......f-5........................................................ ............................................................................... _II► -i __ _ __ .. _..,.....T#, ,!•�air Vj .t • �._ �,c,-• �. -•-c O �/33 -r ,9 Q (, 41 13, 407 4 - 2- 2 {,� '��' ��• � �`tH 0 r iw a '� �. 't '• ` I or ROBERT 'BUNIKIS w J e1 j CERTIFIED PLOT FL At kEW CONSTRUCTION ONLY. ,� 111A/?5TL9 /S � � a TO.P OF FOUNDATION IS . ; FEET IN fI,' ABOV�VJ OW POINT OF ADJACENT .�A ��1S'1'AS �+ � A t�`' r ROAD ; ^� i _" SCALE IIr 40� DATE r.' 'E`QREDGE .ENQINfER1NG_CO/N , �Ac�y I CERTIFY THAT THE ;w s}-UNDTly .* -� =•- -_-•_ CLIENT _ ..�__._.__._ 1� t61STERED�; REGISTER SHOWN ON THIS PLAN !S . LOC: I �D 'CIVIL LAND J08 N0.7.�pz7 'ON -THE GROUND AS iNDICATEC ?,ND ` si CONFORMS TO THE ZOWNO LAWS EN4_INEERi �SURVEYOiZ DR. BY: A-�t�-N��_ OF BARNSti B E , M cH. eY `-4` tits MAINST 7'2 MAIN ST Y/ YARMOUTH, MASS HYANNIS, MASS SHEET__[_OF - - -" ATE REG. LAND SURvF'f-aR ; .e TOWN OF BARNSTABLE Permit No, ----------—_____________ { NA"n.n, Building Inspector a • Cash _____ _-_______- ���•FY 6, __ ____ 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 Address Wiring Inspector eii" ,, _� Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department 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. 19......__ ................................I................................................_.........._..__._. ._ Building Inspector t ��S� Assessor's Office~lst floor Map _ C�� �- Permit#_ :Conservation Office 4th floc ' k—\ a Y810 ti - Date Issued Z Board of Health Ord floor Engineering Enginecring Dept. Ord floor House# SUIT - UST�E LIANCt; Planning Dept. (1st floor/School Admin.Bldg.): INSTA Definitive Plan Approved by Planning Board 19 ENVIR® 26 (Applications processed 8:30-9:30 a.m.&•'1.00-2.00 m) A aA ODE AND ATIONS W` ? TOWN OF BARNSTABLE Building Permit Application Protect Street Address kotzk S yU Villa e 'slo s S Fire District . Owncrik6620 �1 US Address Telephone • Permit Rcauest: tMe( r 2�I^> Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Tvve: Ingle Family Two family Multi-family Age of structure /L/ Basement i Skcoa Historic House Finished Old King's'fHighway Unfinished Number of Baths / No. of Bedrooms L� Total Room Count(not including baths) 61 First Floor Heat Type and Fuel n i Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Namc Telephone number Address License# Home Improvement Contractor# Worker's Compensation # T NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS r PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Project Cost ?i Fee O, Co SIGNATURE DATE a7 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T � :1 FOR OFFICE USE ONLY 2/28/95 �q*ibf 047. 122 ADDRESS 8 Trotters Lane VILLAGE - Marstons Mills OWNER Robert A. Cummings, DATE OF LNSPECTION: ; FOUNDATION FRAME 7� - INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: J�-5 .T DATE CLOSED OUT: ��; ASSOCIATE PLAN NO: _l 11;02.94 17:02 '$6177277122 DEPT IND ACCID 001 loom-wncUeaft{i. of Ma1Jac1ztt6etb °UaParfrrtenf o��nc�uafria�✓ticcic�enfe 600 Wukyton Shb t James J.Campbell &ton, 02111 Commissioner V Workers' Compensation Insurance Affidavit with a principal place of business at: (QW/5tawizip) do hereby certify under the pains and penalties of perjury, that: () I am an employer provid rig workers' compensation coverage for my employees working on this job. Insurance Company Policy Humber () I am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself. 1 undtrsund: :t;:copy of&is slternent will be forvrarded to the Office of Investigations of the D1A for co%Trage verification and that failure to secure coverage as reG.!ired under Section 25A of MGL 152 can lead to the Imposition of criminal penalties eonsisdn¢of a fine of up to S 1,500.00 and/or or.-- years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.06 a day against me. Signed this C2 hL day of 19 S Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 TOWN OF BARNSTABLE BUILDING PERMIT ill 3 7 yG,, TOWN OF BARNSTABLE BUILDING' DEPART; EIvT HOMEOWNER LICFNS� _-.-_-=ION Please print. DATE a a,/t�?, JOB LOCATION fro, 2�fS �h7. Number Street address Section -of:- _town` "HOMEOWNER' t C'm S Name Home phone Work phone .:-7 PRESENT MAILING ADDRESS CO rS" L City town State q8 Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor DEFINITION OF HOMEOWNER: Person(sy who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling,, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered 'a homeowner. Such "homeowner" - shall submit to the Building Official on a form aceaptable 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 Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will compl i h aid procedures and requirements. HOMEOWNER'S SIGNATURE APPROV;L OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. !MME Oi•:\??' c EXE9IPTION ,The code state iiome C.::_Gr performing work for which a building t from the provisions of this section permit is required shall be exemp (Section 109. 1 . 1 - Licensing of Construction Supervisors) ; provided that,.if Home Owner engages a person(s) for hire to do such* work, ,that .such Home Owner shall act as supervisor. " . . Many Home Owners who use this exemption are. unaware- that they..are,,4ssmaing the responsibilities of a supervisor (see Appendix Q Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of iwarehes often results in serious, problems, particularly when the Home Owner hires unlicensed persons. 'In this case our Board cannot proceed against..the inlicensed person as it would with licensed Supervisor. The. Home �bwiier`actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware 'of his/her. responsibilities,'. man communities require, as part of the permit application, that the M6ke -04ner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue -is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. I �-MMSTABLZ The Town of Barnstable � Department of Health Safety and Environmental Services ram'' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, remo-ml, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: 611 I I-X Me P Est. Coss�s Address of Work: BMA-Qc l N • Owner Name:2' Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S 1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR c Date Own is name I , \1 ITS :.' �;•��QC� ,;;��' 'vim ---_.....__..__ .... - --.. _.. . _. . .. _.. `' � -� ! i .. � o Spa:<i:`o �n ( > 0� a I I I i • i • I OF 7. VARNUM PHILBROOK I MECHANICAL y ---- _.-._..... .......----- 10 ' ASS/ONAL 1 II . j ' Qo lN IT"vri. 1Li f V 1 LS=V P ltJrm;ut W� SOL1)� L�wc�c1NC-1 1j I i I - I • u I I r I . . ... ....... ....... :...:... _:.... .. . o����N of Mgss9cyG,_ ...�i I.•. T. VA_RRUM cam, �'1 ':•Jig "! I MECFfANHCAL I vi : - - --- ' --- SSIOIVAL ENG\ I 212..1c� w1 P, f MOUGLIIELM If i , 4 I j ' Jooc, �i 2 i i : Imo\ E � • I Z )2•4 I b c,, I I CDK i 'Tc i I I � i cy �^ w T. VARNUM i PHILBROOK MECHANIICAL G61► No. 30E90 ; 'f SIONAt Cow-nwvovs RJDC'15- 1�tnr-�Tv" J tad 1.6 �y l�tav�� ` Lti I. �h �007 s g d W�� S 1�2_5 U P�� � Y'I �•i C'fQJ�r , d� Uk I Souv C Su '13woz-1 i I j ry7 n , i N-