HomeMy WebLinkAbout0264 TURTLEBACK ROAD Ve, e�rzAv .
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! Town ®f Barnstable Permit:
Regulatory Services Date:
°p�HE r°� Thomas F. Geiler, Director
Building Division
• BARMMBLE, • Tom Perry,. Building Commissioner
MASS.3 . ��� 200 Main Street; Hyannis, MA 02601
ATFo �A www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
TOWN OF BARNSTABLE
SOLID FUEL STOVE PERMIT
Owner: Ln Phone: —yW_-S71
Install at: ��o� f ,tn Village:
Map/Parcel: Date: o G
Sto
Ne / Use
B. ype: Radiants Circulating /
C. Manufacturer: 1-4/"CLZ 0 i f Lab. No. / 3o7^-<j O c) 4��
D. Model No.: J_.0_aCj o � ,jtt,.4 Lk L !yfj,2 1:P-, c
Chimney
A. New �Exist:iing (If existing, please note date of last cleaning)
B. Flue Size �2( L�
C. Are other appliances attached to Flue? Q
D. Pre- ab Type and Manufacturer
Masonry). Lined/Unlined
Hear
A. Materials:
B. Sub Floor Construction:
Installer - -
Name: Address: ,.
Phone: so.f- f/o1 - `579
Location of Installation: �
' ASe. �YIPn/T
—
H.I.0 Registration#
Construction Supervisor#'
OR check- Homeowner Installing, no license required
APPLICANTS SIGNATURE
APPROVED BY: a 16 09
Please make checks payable to the Town. of Barnstable.
*This constitutes an of stove permit after inspection, photographed, and approved by the
Building Inspector
Q:forms:stove
Rev 103107
t
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
' 600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/Organizationdndividual): /'1/
Address:
City/State/Zip:`��51�t�l_S ig/�S >Q Phone.#:
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
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. T. ❑Remodeling
ship and have no employees These sub-contractors have g. '❑Demolition
workingfor me in an capacity. employees and have workers'
y P t'S'• $ 9. ❑Building addition
[No workers' comp. insurance comp. insurance. 10. Electrical repairs or additions
required.] 5. ❑ We are a corporation and its ❑ P
3�I am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions
myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs
insurance required.] t c. 152, §1(4),and we have no �—
employees. [No workers' 13.❑Other C�jcG V�
comp.insurance required.]
*Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
]Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have
employees. If the sub-contractors 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:
Policy#or Self-ins. Lic.M Expiration Date:
Job Site Address: CP Y �`r�S/fir✓r//i/�S City/State/Zip: �j¢ r) � �
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 tip 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 certify u der the pains and penalties of perjury that the information provided above is true and correct.
Si afore: Ci Date: �d0
Phone#: _ T-6
Official use only. Do not write in this area,tb 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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their.employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more
of the foregoing 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 be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall .
enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if
necessary,supply sub-contiactor(s)name(s),address(es)and.phone number(s) along with their certificate(s)of
insurance. Limited Liability Companies*(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in (city or
town),".A.copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions,
please do not hesitate to give us a call.
The Department's address,telephone-and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
Fax # 617-727-7749
Revised 11-22-06
www.mass.gov/dia
. a1
'
Town of Barnstable
'THE
Regulatory Services
awxHsresr F— : Thomas F.Geiler,Director
tsws&s
Yq,,,l A.•� Building Division
Tom Perry,Building Commissioner
vtrwv.town.b arnstabl e_ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOA1MOWNER LICENSE EXEMPTION
/�
Please Print
DATE �,► 1,/�ReN—I /q , —� p
OU /
JOB LOCATION: �LD �6/�c!e 2i A�S i �
n a 1 /P street village
"HOMEOWNER": 6� f� LA df e SDI--7�//1 5-— 79�
name home phone# /1 work phone#
CURRENT MAILING ADDRESS:
cityhowo 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 fans structures. A
n person who constructs more tha 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 Barpstable,Buildin. Dr
part rent
Minimum' ection procedures and requirements and that he/she will comply with said procedures and
r e
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q.
Rides&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 unliamsed 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 fom/certifi cation-for use in your community.
Q:forms:homcexempt
trti Town of Barn-stable
Regulatory Services
yaAaMAS& Thomas F.Geiler,Director
s639-
16 Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
\ Property erMust
Complete an ign This Section
If U n A Builder
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative work authorized b this building permit application for.
(Address of Job)
Signature of Owner Date
Print Name
If PropeLty Owner is.applying for permit pleas com I\e
Homeowners License Exemption Form on a reverse side.
Q:FORMS:O WNEF-PERMISSION
m
4 .mzn
�I. :i T
k
a e'
A
jTT 4 �7
— _ ?8_p„ NEW 8"THIGK CONCRETE
FOUNDATION NEW ADDITION EXISTIP
... .......... _
_ .. ... .•.. ...
J .. . .
J J NEW 8"X16° .... /
CONCRETE FOOTING WITH
GONTINUOU5 REFINF.BAR
J J NEW 8"X16"
/ CONCRETE FOOTING WITH
CONTINUOU5 REFINF.BAR
J / APPROXIMATE LINE OF STEP J /
/ ... /
IN FOUNDATION-(SEE LEFT — — — — — — — — — — — — —
SIDE ELEVATION) J .•:�:•.• ���� .... .. ..
— — — — — — - - - - - -
J J NEW 8"X16" i
J 6"THICK 3500 P51 CONCRETE SLAB / J CONCRETE FOOTING
ON GRADE WITH 6 X 6-W2.0 X W2.0 / J
J J WELDED WIRE FABRIC REINFORCING
CRAWL SPACE
1 ::• Boa
_ _ _ _ _
J..1 .. .. .... ..
13'-7'/„
J / Ln
Q0 J J 3,_9„ 4,_ 2 4'-V„
.. — . -r J
28-0 10"DIAMETER CONCRETE
4_p FOOTINGS FORMED WITH
1 SONOTUBE (TYPICAL)
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION lga%
Map ;3' Parcel I Permit# / W7/
f G
Health Division 3� V —308- i �Y if - B A f f S T A B LE Date Issued _ D T/61—B1501-
� �
Conservation Division � •• ;.U�y �(,i� _3 ��; $. 2.� Application Fee
Tax Collector Permit Fee
OF OEWMW
Treasurer
E�GSTMiO OMM SYSTM
--��-�----_...�j��+#SIOf� LI�11'E�T��
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address o24% 7u ,o_%L 64 at
Village A R S M O G
Owner �/ �ol� f �/Ce Address
Telephone � f
Permit Request —/'e C
4 t
e" b�eeic�a
Square feet: 1 st floor: existing r proposed 2nd floor: existing proposed Total new g
Zoning District Flood Plain C Groundwater Overlay
Project Valuation zd,DOo. Construction Type
Lot Size Grandfathered: Yes ❑ No If yes, attach supporting documentation. ,
Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Q
Age of Existing Structure c -kt� Historic House: ❑Yes ;i�'No On Old King's Highway: ❑Yes VNo
Basement Type: Full ❑Crawl Walkout ❑Other Ulna
Basement Finished Area(sq.ft.) y/ O/if Basement Unfinished Area(sq.ft) _4 3 6 0
Number of Baths: Full: existing new U Half:existing O new
Number of Bedrooms: existing\7 new 0
Total Room Count(not including baths): existing new _ First Floor Room Count ,3
'feat Type and Fuel: X(Gas ❑Oil ❑ Electric ❑Other r CIALA
Central Air: , ,,Yes ❑No Fireplaces: Existing _� New 0 Existing wood/coal stove: XYes ❑No
Detached garage:❑existing ❑new size Pool:❑existing Cl new size Barn:❑existing ❑new size
Attached garage:❑existing new size-09X-2�Shed:Xexisting ❑new size Other:_A X/O
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes bNo If yes, site plan review#
Current Use .�n�i�� �,� _ Proposed Use , Af
BUILDER INFORMATION
Name Telephone Number
Address c�L/ ��, , .� ��� License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESU TING FROM THIS PROJECT WILL BETAKEN TO �cCil,,.., �.
SIGNATURE % a. DATE
3
w
FOR OFFICIAL USE ONLY
1
PERMIT NO.
�a
DATE ISSUED
MAP/PARCEL;NO. ;
ADDRESS VILLAGE
OWNER
DATE OF INSPECTION:
FOUNDATIONA.,6 O �
E FRAM O S ` �los
ew v
:• INSULATION _ e,,�„
r '
FIREPLACE
ELECTRICAL: ROUGHfj FINAL
w
PLUMBING:. ROKC FINAL
1 <
GAS: ROISI-6. FINAL
FINAL BUILDING
J..
DATE CLOSED OUT
ASSOCIATION PLAN N
l� r
I
• 6
The Commonwealth of Massachusetts
u� Department of Industrial Accidents
600 Washington Sire et
Boston,Mass. 02111
Workers' Comiensation Insurance Affidavit-General Businesses
name:
address: 1/ , /2%1 ie I
city y�✓%�P BLS. `n11 i/s state: alp: tl- ,,2 4&hone
work site location(full address):
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 Toyer with em koyees(full& art time). ❑Other
% / /%%%%%/O/�%% �/O//%/%%%/////%%�%%%%%/%/
I am an employer providing workers' compensation for my employees working on this job.
company name:
address: ..:.
city: phone#:
.Insurance.co: - pofic. # .° •
I am a sole proprietor and have hired the independent contractors listed below who have the following workers'
compensation polices:
comriany name:
addressE :. -.:•
city:. phone#:
insurance co. " " olie':#
compenyname:.,;.::
address
Z.
city:: • : Phone#i ..
insurance zo. : .:..: :..::: :• olicv
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
t I do hereby certi er the pap s and penalties o perjury that the information provided above is true and correct.
Signature �f � R E iLt�oe-L Date
Print name A14 Phone#S1J Q — I ,2 .S 7 9-(/
official use only do not write in this area to be completed by city or town official
city or town: permit/license# [)Building Department
check if immediate response is required ❑Licensing Board
❑ P 9 ❑Selectmen's Office i
❑Health Department
contact person: phone#; ❑Other
(revised Sept 2003)
4
Information and Instructions
Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their
employees. As quoted from the"law", an employee is defined as every person in the service'of another under any contract
of hire, express or implied, oral or written.
An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of
the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or
trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a
dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of
another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or
building appurtenant thereto shall not because of such.employment be deemed to be an employer.
MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal
of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has
not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the
commonwealth nor any.of its political subdivisions shall enter into any contract for the performance of public work until
acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting
authority.
Applicants
Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation. 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 permit or license is being
requested, not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are
required to obtain a workers' compensation policy,please call the Department at the number listed below.
City or Towns
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the
affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please
be sure to fill in the permit/license number which will b�e 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
WIN of inl 9098dons
600 Washington Street
Boston,Ma. 02111
fag#: (617)727-7749
phone#: (617) 727-4900 ext.406
T
RESIDENTIAL BUILDING PERMIT FEES
APPLICATION FEE
New Buildings $100.00
Residential Addition $ 50.00 ,�Q
Alterations/Renovations $50.00
Building Permit Amendment $25.00
FEE VALUE WORKSHEET
NEW LIVING SPACE
00
3 square feet x$96/sq.foot=�� , �� x.0041= S�
plus from below(if applicable)
ALTERATIONS/RENOVATIONS OF EXISTING SPACE
3 9� square feet x$64/sq.foot= x.0041=
plus from below(if applicable)
GARAGES(attached&detached)
B�
7 square feet x$32/sq.ft.= 37, 0f_ x.0041=
ACCESSORY STRUCTURE.>120 sq.ft.
>120 sf-500 sf $35.00
>500 sf-750 sf - 50.00
>750 sf- 1000 sf. 75.00
>1000 sf= 1500 sf 100.00
>15 00 sf-Same as new building permit:
square feet x$96/sq.foot= x.0041=
STAND ALONE PERMITS
00
Open Porch �_x$30.00= 3
(number)
Deck.._. ... ... :_ x$30.00=
(number)
Fireplace/Chimney . x$25.00=
(number).
- Ingrodnd Swimming Pool $60.00
Above Ground Swimming Pool $25.00
j Relocation/Moving $150.00
(plus above if applicable) Z1
Permit Fee 7 ?
Projcost
Rev:063004
oF�HEr Town of Barnstable
Regulatory Servi.des
$ ear.E, s Thomas F.Geiler,Director
9�A s6391 ���� Building Division
jFD µP't
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
• Fax: 5O8-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adj scent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements,
Type of Work: Esti
t� - mated Cost.
-•� .-�Q n � l C
Address of Work
Owner's Name: l�/�/i4 1� L_ aJ�f�r✓C P
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
[]Work excluded by law
[]Job Under$1,000
[]Building not owner-occupied
0-0,7er 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.
Date Owner's Name
r
oFtK r Town of Barnstable
Regulatory Services
� a
BARNSTASM » Thomas F.Geiler,Director
MASS.
94,A 1639. �. Building Division
SEC Mp`t p
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: e)
JOB LOCATIO o2to � ���p�
nurribm street village
"HOMEOWNER":
n m; home phone OF work phone
CURRENT MAILING ADDRESS: //
�4
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' ction procedures and requirements and that he/she will comply with said procedures and
require n . 4 ::--�
�K-
Signature of Homem e
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our 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.
Q:forms:homeexempt
r
LOT ,380
LOT 382
LOT 347
LOT 348
l-
10 0,
zP d �.
LOT 349
FLOOD ZONE "C"_ FO UNDA TION CERTIFICA TION RES ZONE. "RF"
TO WN.•BARNSTABLE SCALE.•1"=40 PL.REF.-30 751 F SH 1 ELE V
I CERTIFY THAT THE ABOVE YANKEE SURVEY CONSULTANTS
FOUNDATION IS LOCATED ON OF P. 0. BOX 265
THE GROUND AS SHOWN, AND �`�"
IT'S POSITION �.�_____ � ��dat, cy� UNIT 1, 40B .INDUSTRY ROAD.
CONFORM TO THE ZONING LA W n�ER�Ew
MARSTONS MILLS MASS. 02648
SETBACK REQUIREMENTS OF No. TEL- 428—0055
_ BA
_ EARN-STABLE '�EGIST: FAX 420-5553
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PA UL A. MERITHEW DATE. 6Z24-- JOBNUMBER 50487
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FRONT ELEVATION LAFRANCE RESIDENCE
LEFT5IDEELEVATION wu'w'aa 2"MRnE6ADNRD. nuRSTONS--ZS.W
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The Town of Barnstable
VA OLL Department of Health Safety and EnAromnen tal Services
Building Division
�t0 MPy .
367 Main Street,Hyannis,MA 02601
e: 508.862-4038
508.790.6230
PLAN REVIEW. .
Owner: R-4-41•"y Z9 l�QAyC e Map/Parcel:
Project Address: —y 7- -e AL,i. Builder: _ �0 A/
The1ollowing items were noted on reviewing:
Reviewed by: 44
Date:
28,-0,, NEW 8"THIGK GONGRETE NEW ADD1710N
FOUNDATION EXISTING HOL
.. .. . .....
........... .
...............
..............
... .......
NEW 8"X Irol.
6 GONGRETE FOOTING WITH
GONTINUOU5 REFINF.BAR
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GONGRETE FOOTING WITH
GONTINUOU5 REFINF.BAR
IT-10"
APPROXIMATE LINE OF STEP
IN FOUNDATION-(SEE LEFT — — — — — — — — — — — — — -
............
...............
SIDE ELEVATION) ......
- - - - - - - - - - - - -
NEW 8"X lro'
6"THIGK 3500 P51 GONGRETE SLAB J J GONGRETE FOOTING
ON GRADE WITH 6 X ro-W2.0 X W2 0
WELDED WIRE FABRIC REINFORCING
CRAWL SPACE —
- - - - - - - - - - - - - - -
ry
— — — — — — — — — — ---
13-4/2"
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...... 4--5/ 4'-V2 F
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FOOTINGS FORMED WITH
50NOTUBE (TYPICAL)
NEW ADDITION EX15TI
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