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Home My WebLink About0515 WAKEBY ROAD oje TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map O P POsd Parcel Zo &C7� � • Permit# Health Division Date Issued Conservation Division 00 Fee �s�� Tax Collector CC .ilia 0le3 -./f��(d% � Treasurer t 9 �CY-) SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE wITIfTE6 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-,OKH, Preservation/Hyannis TOWN REGULATION$ Project Street Address '� (N a/1 e Village R✓J /v�! �/� c Owner P v �! Address Telephone e-ld o " R"RpoZ Permit Request P lea/ r Square feet: 1 st floor:existing Q�/0 proposed 2nd floor:existing proposed Total new a�d_ Estimated Project Cost,060. Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size ' Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family )9 Two Family ❑ Multi-Family(#units) Age of Existing Structure ? Historic House: ❑Yes OrNo On Old King's Highway: ❑Yes .ArVo Basement Type: )7Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing 7 new First Floor Room Count Heat Type and Fuel: ❑Gas AOil ❑ Electric ❑Other Central Air: ❑Yes �lo Fireplaces: Existing 0 New Existing wood/coal stove: ,2rYes ❑ 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 WNo If yes, site plan review# Current Use 4% /4 Proposed Use \ BUILLDER INFORMATION Name e — Te,� `V,' �(' Telephone Number q.) 0- ---Address U /2o X /�� License# Ag0-_J 16,qf /�� t[(f d�� Home Improvement Contractor# 6 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 00 SIGNATURE DATE FOR OFFICIAL USE ONLY 4, k� PERMIT NO. r f7l DATE ISSUED MAP/PARCEL NO. ADDRESS' VILLAGE OWNER » f DATE OF INSPECTIOLV� - • _ FOUNDATION FRAME ' INSULATION FIREPLACE T ELECTRICAL: ROUGH FINAL _ PLUMBING: ROUGH -m m FINAL h j GAS: ROUGH' m ,i 9 FINAL FINAL BUILDING m 7-Y V+ w FEE in DATE CLOSED OUT .� S � (�-2 zGU- f" 5 �.p ASSOCIATION PLAN NO. Q In 5 ' to ® F FILE # CENSUS TRACT # CL i ENT : DEED BOOK 3993 PAGE 127 OWNER:, . E izabeth eirson PLAN BOOK 246 PAGE 55 LOT APPLICANT : same ASSESSORS PLAN PLOT MIORTGAGE INSPECTION PLAN OF LAND ' I N B A R N S T A B L E SCALE : 1"= 50' MAY 29, 1986 Povice4 A D,000 s;P. . .Ao DceK 38� `Q F PA"- DeCA a6.DO 1/t/aKaab �oady . ' CERTIFY TO DONAt_D F HENDERSON,SENTRY FEDERAL SAVINGS BANK AND ITS TITI_r INSURANCE COMPANY , THAT THERE ARE NO VISIBLE E^ICROACHMENTS OR EASEMEN;TS EXCEPT AS SHOWN AND THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPE"ISION , THE ; LOCATION OF THE DWELLING AS SHOWN HEREOF! IS IN- COMPLIANCE... WITH THE LOCAL APP'_ ICAAI_E ZONING BY-LAWS WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS , THE DWELL I NG SHOWN HERE DOES NOT FALL � � �..- D ZOME AS WITHIN A SPECIAL FLOOD HAZAR The Town of Barnstable ptME Department of Health Safety and Environmental Services Building Division BARNSTABLE, ' 367 Main Street;Hyannis MA 02601 Mass. 9 039• �ArFf)�r a Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: .� ^•�� V fJ JOB LOCATION: —�(T number s village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: AA�a 'n?o a— 10 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 Persons)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 procedur d r u' e + Sign e i eowner 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 to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN I J 4�N VA i i f i i �fJ • ` � ll I __ .._. .. ........._....._.._ ............ .. _ t i .. -. ._.._..._._ ...-..._..._ _...__. ....._.� ��'r ill t,1 `_�"�`— - The Commonwealth of Massachusetts 4-�.: - = ; �1. -' Department of Industrial Accidents A ::..-.. • _= x , r= ; exce oflaseslioadeos _. _ - �. - 600 Washington Street ,. c i. Boston,Mass. 02111 . • Workers' Compensation Insurance davit li �0 �P � � ` name: •- 1 • / C /p_ f location: 1T�� cc• /�C'4� / "' ` _ city ,,i�Gt,,�J l°rn f' / "�, A-r i ,,�/ ��. phone# I ,a I am a homeowner performing all work myself . ❑ I am a sole rietor and have no one workin in achy %%%%%%% % /% %///%/%%///%%%O%%%/O/%%%%%%%%%%%%%%%///%%%%%%//////�%%%/%/%�/%�/%%%%%%%%�%// I am an em 1 roviding workers'.compensation for my employees working on this job.:: :: ::: :::.::.:::X . :.:::::':: :: : : com anv n ...... `'ares 'ol1e# ?><af�[2[[rt :> ?t``' '?[?:22< as%: tit: : ? : [ `[ i '' Cl ::Q h "`tikicv :iasuranc ❑ I am a sole proprietor,general'contractor,or homeowner(circle one)and have hired the contractors listed below who have • , , I . _ thee following workers' co ensation polices: compensation .:::..'-*".::::::::.:::..:.;:.;;;;:.;;:.;:.::;.;:.;;;;;::.:.;;:.;:.;;:.r.::.;;;;::.;:<.;:.:;;:.;:.::.;;:.;;;;:.:::::>::-.'?.::::»'>:;:::::>:;:<:::; :>:::::»: g..........................::::::::. .:::::::::.::::..:""'::::::.:::.......:::..:.::.:::::::::::....:::::::::::::::::::::::::......:..:::::::.::::::::.,.:...........::::::::::::::.:.::.::::.::::::::::::::::::::::::::::::.:.:::.:: :iii :. nam com anv ::. addr ................::.::::.:::::::...:::.::... ...................::::::::. " "one ci;. h 11tY b _....<'»:'•Ceres';::.....: >:<:<>::>::<:<:::>:: :>:::`>:<<<::s:::<::'>:>:'::'::::<:::<;::>«?:<:::>?;:;>:>;::::::;.:::•;:;;:;:;:>; ::::::;<::::;:<:<:::::: i inHnran /,/l//%%/%%/% :::>::>::: :::<::>::;:;:>:; ca anv nam .::.:....:..., .. r//Z////Z//Z///////Z,//////////,///",////Zz//,M=mm;=:::- :.:.:.:.:. ........ .....*"....'..*..-�...."..*.**.....**.....* .-- ddre a . ?': i8n ci b - ::�:.:z:»>::»> tP' innrance c :'>"oli �/ Failure to secure coverage a,required mtder Seaton 25A of MGL 152 can lead to the imposttton of erhninal penalties of a Hue nP to 51,500.00 and/or one years'imprisomnent a,weH a,civil penslttes in the form of a STOP WORK ORDER end a Sae o[S100.00 s day against me I m�derstand that a copy of this statement maybe forwarded to the Office of Investigations o[the DIA for coverage verification. , I do hereby certify the ' and p�Tties of .ury that the information provided above is truo and eorred . . Signature Date �- l?-O - . Priest name --I P�7``f �/ . d�' Phone# 4a4 ' Y�2 t7 -a1 P v2 official use only do not write in this area to be completed by city or town official - ' ' city or,town: - permit/Hcense# ❑Building Department . ❑Licensing Board ❑check if immediate response is required ❑Selectmen's Office . ❑Health Department contact person: phone#; ❑Other__ UrAsed 9195 PIA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers'.compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged jn 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 eater into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns Please be sure that the affidavit is,complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retuned-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 Olnce of inveodgations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 pF THE The Town of Barnstable t , . ILARNSTAar.r:. • MAS& $ Department.of Health Safety and Environmental Services 4'A,F039;.tp`0 Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW. ` SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion. improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. ,( �ae;t Apr, �<,rfe (° Ar�� Estimated Cost Type of Work: Address of Work: Owner's Name Date of Application: S� 9 ' 0 0 I hereby certify that: Registration is not required for the.following reason(s): []Work excluded by law []Job Under S1,000 ❑, B ilding not owner-occupied wner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICaBLE HOME IMPROVEMENT GU RANTY FUND UNDER M�142a. ACCESS TO THE ARBITRATION PROGRAM t SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Town of Barnstable Department of Health, Safety and Environmental Services • . = Building Division �,►se. i659. �.� 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Home Occupation Registration Date: - �G Name: el, 6v 7 f Address: ��-�` i�' e ICY Village: '4 Type of Business: a�1�I cun��' 4 Map/Lot: O INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor, no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigned,have rea d agree with the above restrictions for my home occupation I am registering. 4"—d"K"' Applicant: ` Date: ��p