HomeMy WebLinkAbout0342 WILLIMANTIC DRIVE 0
0
a
�• 1
r Town of Barnstable .*Permit#
Expires 6 months from issue date
Regulatory Services Fee
• BMWWABU. • -
MA� Richard V.Scali,Director
Building Division �j
Tom Perry,CBO,Building Commissioner X-P((d"lOESS PERMIT
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us AUG 1 9 Z01�
Office: 508-862-4038 �,n1'�p� UN0"
0
EXPRESS PERNHT APPLICATION - RESIDEN[Tiff-
D Not Valid without Red X-Press Imprint
Map/parcel Number � "
Property Address
[t]Residential Value of Work$ ��,� Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
Contractor's Name Telephone Number_�I-
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
['I am a sole proprietor
® I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Requ st(check box)
Z Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
/y
SIGNATURE:
Q:\WPFILEST0RMS\building permit forms\E)PRESS.doc
Revised 040215
77te ComumtoniveaIth of Massachusetts
Deparftment ofIndustriaf Accidews
Ofike of Investigations
' 600 Washingion Street
Boston,AIA 02111
ivmv mass govfdia
Workers' Campensatian Insurance Affidavit:Builders/Contractors/EIectricians/Plumbers
Applicant Infnrmafian n Please Print Legibly
Name�Busmess110fgaaiza�ianlladcvi�lnal}: o_ `�K-�/�SS�1 C. �i�1 �c�S
City/State/Zip: /�1 6 n
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 6. ❑New construction
employees(full and/or part-time)_* have lured the sub-contractors
2..❑ I am a sole proprietor arpartner-
listed on the attached sheet I- ❑Remodeling
ship and have no employees. These sub-cofactors have g. ❑Demolition
wad-ing far me in any capacity employees and have wodcers' 9. ❑Building addition
[No workers'comp.insurance comp.insurance-1
required-] 5. ❑ We area corporation and its 10❑Electrical repairs or additions
officers have exercised their
3.�am.a homeoumer doing all work 1LE]Plumbing repairs or'addztions
mys6f [No workers'comp- right of exemption per MGL 12. Roof repairs
insurance required]1 c.152, §1(4),and we have no
employees.(No worms' 13_0 Other
comp.insurance required.)
;Any applicantthatchecksbox AE1 nmst also fill autthe section below shmsing theirwozikers'compeasatioa policy information.
such-Homeowners who submit this ofiidat a ind+r=g they are doing all waal and then hie aatside contractors amd submit a new affidavit indicating
check This boat mast attached as additional sheet shoving the name of the sub-coatractors•and state whether or not those eatides have
employees. Ifthesulrcaaw=rshaveemployee%&eymustpmvidetheir workers'romp.policy number.
I --
I arnt art etitpLgvr thatis prniding workers'coitWaisatiaii inmaratzce for uzy eRipLojwes. Below is the policy arm job site
informadom
Insurance Company Name:
Policy 4.or Self--ins.Lie.t F-Viration Date:
Job Site Address: City/State/zip:
Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required.under.Section 25A o€MGL c 152 can lead to the imposition of criminal pt-nald s of a
fine up to$1,500.00 and/or one-year imprisonment,as well as time/penalties.in the foffi 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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification-
I do hereby certtfj,under the pains and pen atties ofpetlmy drat A information prav&&d abm g is bare and tarred
signature: Date:
Phone ii:
Official use only. Do not trrite in this area,to be completed by city ortown official.
City or Town: Permitffikense#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.Cityfrown Clerk d.Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone tt:
Information and Instructions
Mica husetts Geheral Laws chgl,a 152 requ5=all employers'Eo provide wo3i-,eas'compensation for their employees. '
Pmmiaatto.this sist<be,aa.ernployw is defined as."-.every person in the service of another under any contract of—hire,,
CZ or implied,Aral or writt�"
An Moyer is defined as"an mdividnal,partner,associafion,corporation or other legal entity,or any two or more
of the foregoing engaged in a Joint enfiagrim,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 -
dWPTTmg house of another who employs persons tD do mamtea ce,contraction or repair work on such dweling house
or on the grounds or building appT ten ant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every stain or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct burldmgs na the commonwealth for auy
applicant who has not produced acceptable evidence of compliance with the incnran ce.cove)rage required-"
Additionally,MGL chapter M, §25C(7)states'Neither the commonwealth nor icy of its political subdivisions shall
enter into any contract for the performance ofpnblic work until acceptable evidence of compliance with the iumnan ce..
rez m ern ents of this chapter have been presented to the contracting arthoaty_" :
Applicants
Please fill out the wo&='compensation affidavit completely,by checking the boxes that apply to your sitnation and,if
necessary,supply sub-contractors)name(s), address(es)and phone nnmber(s)along with their certificates) of
irmaraoce. 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 maybe st,l7�to the Department of Industrial
Accidents for confirmation of ins'nzance coverage. Also be sure to sign and date the affidavit lbe,affidavit should
be returned to the city or town that the application fur the permit or license is being requested,not the Department of
hadm3trial Accidem . 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-i R*rance license number on the appropriate line.
City or Town Officials .
r _
Please be sore that the affidavit is complete and priced legibly. The Department has provided a space at the bottom
of the affidavit for you tD fill out in the event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill in the pennit'/licerise munber which will be used as a refereuce number. In addition, an applicant
that must submit multiple pennitUcense applications in any given year,need only submit one affidavit indicating current
policy information Cif necessary)and under"Job Site Address"the applict should write"all locations is (cty or
town)-"A copy of the-affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not.related to any business or commercial venture
(Le. a dog license or permit to burn 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:
Thu Commartwealth of Massachusci#s ,
Degailment of lndmtial Accidents
Office OfXnvestfgatio.�
6Q�Q T�ashingtQn Sfz��
. �Qstx�n=I�fA E1�111
Tf,-L 617'27-4 �xt 4€16 or 1-977-MAS,SAFF
Fax#617-727-7749
Kevised 42407 .Mass-gavidia
Town of Barnstable
Regulatory Services
oFt tWlr Richard V.Scali,Director
• r
Building Division
r r
` RAEUMMASS. .E. ` Tom Perry,Building Commissioner
.� 200 Main Street; Hyannis,MA 02601
�Ep www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number nn street village
"HOMEOWNER": � T T eA,o
name (� ,e� home phone# work phone# .
CURRENT MAILING ADDRESS: / d SC/I1AZ
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-
family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section
109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection
procedures and requiremen&-wd that he/she will comply with said procedures and requirements.
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code
Section 127.0 Construction Control.
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt
from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner
engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often
results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our 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:\WPFILES\FORMS\building permit fbrms\EXPRESS.doc
Revised 040215
' ���� Town of Barnstable
Regulatory Services
Richard V.Scali,Director
Building Division
Thomas Perry,CBO
Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 5.08-790-6230
Property Owner Must
Complete and Sign This Section,
If Using A Builder
I , as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side.
Q:\WPHLESTORWbuilding permit formsUTRESS.doc
Revised 040215
i
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 10,3 Parcel Permit#
Health Division T";SLF Date Issued / y
�'® �Application Fee
Conservation Division Z Gr t..;1�;;' 4,
Tax Collector Permit Fee �.
Treasurer f ' "M"-
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address .9Y2
Village //[e�bd 4rk,4 ZW&
Owner 1� 6 ,d elL 1,61z) -Address _C,4�
Telephone \Z F-
Permit Request Id- X /VO r5h7 _0
Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain' Groundwater Overlay
*Project Valuation Construction Type
Lot Size ' Grandfathered: ❑Yes W No If yes, attach supporting documentation.
Dwelling Type: Single Family,( Two Family O Multi-Family(#units)
i
Age of Existing Structure Historic House: O Yes �11 No On Old King's Highway: ❑Yes
Basement Type: ❑Full ❑Crawl O 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 new First Floor Room Count
Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other
Central Air: ❑Yes k'No Fireplaces: Existing New Existing wood/coal stove: O Yes 0('No
Detached garage:.Cl existing 0 new size Pool:O existing ❑new size Barn:0 existing ❑new size
Attached garaged existing ❑new size Shed:O existing ❑new size Other:
Zoning Board of Appeals Authorization O Appeal# Recorded 0
Commercial ❑Yes ❑No If yes, site plan review# f
rr PD1
Current Use Proposed Use
j pp BUILDER INFORMATION
Name � ��h lasf4 f///h? Telephone Number STD �- /Y 70
Address o&S d License# j,) I 2/,3Lr
Home Improvement Contractor#
7
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE
� w FOR OFFICIAL USE ONLY
} 'PERMIT NO.
s
DATE ISSUED
MAP/PARCEL NO. '
ADDRESS., VILLAGE
OWNER
'yL DATE OF INSPECTION:
�i
' FOUNDATION
` FRAME r �llU�dS p ;
If
INSULATION `
FIREPLACE
ELECTRICAL:, . ROUGH FINAL
PLUMBING: ROUGH FINAL I `
GAS: ROUGH FINAL '
` FINAL BUILDING t
DATE CLOSED OUT ,
ASSOCIATIONTLAN NO.
_ The Commonwealth of Massachusetts
r - _ Department of Industrial Accidents
600 glashington Street
Boston,Mass. 02111
' Workers' Comp-la,ensation Insurance Affidavit General Businessesno
address: ✓ - y ,
/%Y state.' zi : hone#
dt
wor a location fu address: e Retail❑Restaurant/Bar/Eating Establishment
I am a sole proprietor and have no one Business Type: 0
Zj working in any capacity. ❑Office[]Sales(including Real Estate,Antos etc,)
I am an em Toyer with em 1 es(full& art time). ❑Other / / �M/C
y/// /////////y///////%//.r���iri%/ % /'/%m%///%5 a/n/fo/r-my e/m/p/i%es workflng on this job.
I am an employer providing vwprk >,
.,.:'C.' t';7.•'Q,..:i•% 'I'fit ;•''• 1> ,;.:•,-, ,a;;•!:tr
com an name: L:.....;_ : ,..
• ...• ra :'i' ,•1;'ii 1' ..'•4' ,p.1 .f'.:Lf��,^.:i.' ..�j c i.-c•: .i'. 'L, •.,' �:1.• •' f
adds$$• L. y(p.� •9•. ? : .••;.?; •' ''•lh,• .,' :,
y.. bone .:- :,•
tnsurance.co;o ..:i .c'-.%::,:.. ..'':,•. j /// ////.19 %// ////// /
ON ////'/
I am a sole proprietor and have hired the independent contractors listed below who have the following workers
cortt�ensation polices: ;;
%L'an name: LrA "1'•.'•4: •l.•� •'• I ...,1 .. :,:. ,.y .;5... 1,•;.'
toiik
gL
insflt°-once
SOONER", •�� /� / //y //// /// //l/// / / / {':.'
OWNS
•�'•- ,•.: �::.tFe`• '�l-4.�',i,,�•" •' ..L nor: _ ••i!.' "1+..
cam'eri
address: dt
d10
Failure to secure coverage as eeq� 65
°ewe form�ffl/G�
on
of TOP'wORl{O ERto the pand a fine of 5100.Oea day egaia+tmI°ndOtand.that�r
one years'imprisonment as w P
copy of this statement may be fat syarded to the Office of Iavntigatlons of the'DIAfor coverage verification
I do hereby certi under thepains and penalties of psrju that the information provided above is true d ccorrecc/t
Date ����i/(
Signature
Phone#
Print name
ofrictal we only do not write in this area to be completed by city or town official
permit/licease#„_ ❑Building Department
Wan:city or Olicensing Board .
❑selectmeu's Office
❑cheek if immediztzrespowe is required ❑Health Department ,
phonen; ❑other
tontaet person:
ttevfied 9ept.1CO3) Oil : - .
-er-:x
Information and Instructions
Massachusetts General Laws chapter152 section 25 requires an 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 deaed 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 empooydr.
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
corrnnonwealth nor ate+ of its political subdivisions shall enter into any contract for the performance of public work until
compliance with the insurance requirements of this chapter have been presented to the contracting
acceptable evidence
authority.
Pop V/
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 conf>zrnation of insurance coverage. .Also be sure to sign and date the
affidavit. The affidavit shouldbe returned to the city or town that the application for the permit or license is being
Industrial Accidents. Should you have any questions regarding the-"laysr" or if you are
requested, not the Department of
onpolicy,please call the Deparhnent at the number listetdbelow.
required to obtain a workers' compensati
00
City or Towns
Pleasebe snre.thatthe affidavit is complete and printed legibly. The Depar�ent bas 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 p lit/license number which wM Ve used as a reference number. The affidavits maybe returned to
-Y mail or FAX unless other arrangements have been made.
the Deparfineat b
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
Of�cra o(Ievesngatlons
600 Washington Street
' Boston,Ma. 02111
fax#; (617)727-7749
phone#. (617) 727-4900 ext.406
Town of Barnstable
h Regulatory Services
A"STAB Thomas F.Geiler,Director
019. b Building Division
o
lfD MP'�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Fax: 508-790-6230
Office: 508-862-4038
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.
Type of Work: qLL Estimated Cost
Address of Work:
Owner's Name:
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
TQQwner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIIt OWN PERMIT OR DEALING
WORK DO NOT HAVE
CONTRACTORS FOR APPLICABLE HOME.
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERMGL c.142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner:
Date r
Contractor Name Registration No.
OR
Date Owner's Name
Q:forms:homeaffidav
RESIDENTIAL:
SHEDS -POOLS—DECKS-OPEN PORCHES- GAZEBOS
FEE VALUE WORKSHEET
APPLICATION FEE: $50.00
BUILDING PERMIT FEES:
ACCESSORY STRUCTURES >120 sq.ft.(Sheds,gazebos,etc.)
>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—USE NEW BUILDING PERMIT APPLICATION
DECKS x$30.00= $
(Number)
PORCHES x$30.00= $
(Number)
IN GROUND SWIMMING POOL $60.00 $
ABOVE GROUND SWIMMING POOL $25.00 $
RELOCATION/MOVING $150.00 $
(Plus above fee if applicable)
PERMIT FEE
Q:forms:dkcost
REV:063004
Town of Barnstable
"o Regulatory .Services
BARNSTABUF. Thomas F.Geiler,Director
9039. .•� Building Division
j �AIFc �a Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: /�' n�
JOB LOCATION:_ ,3V G{ d //{���
numbers ' / �J A , street �J /y )�, village) f
.HOMEOWNER": 6w-w E C.� Y/��li (/7• (_ /6� ✓'�F y0`�'o2S�S� 7P
name /, /home phone# work phone#
Q
CURRENT MAILING ADDRESS: p—6, ja7t�
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
suRervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to
be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A
person who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be
responsible for all such work performed under the building permit. (Section 109.1.1)
The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department
minimum inspection procedures and requirements and that he/she will comply with said procedures and
requirements.
9—
Signature of Homeowner
Approval of Building Official
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the
State Building Code Section 127.0 Construction Control. .
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such
work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our 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:fornwhomeexempt
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Assessor's map and lot number ..... . ..... .......................... ...
71i _ !�o `'J L��/di�}, O SE��� /u.v� o�THE
Sewage Permit number ........................................................ d
Z 2 STADLE, i
House number ...................... o PAS&
TOWN OF BARNSTA044MUU
REG ��E AIVp
BUILDING INSPECTOR TOWN �
"S
APPLICATION FOR PERMIT TO .... ...........i f.>;C.. O.V...Atr!,d.. iA �4c-,.....10....�.Y!aT.:r�v( .
TYPEOF CONSTRUCTION .......... .............................................................:............................................
.� ...jo Y...........2.y..............19.7./..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies fora permit according to the following information:
Location ......... !!(M .,..........AEA. !. ........... YhA. y A.s..................................
E2t4 Proposed Use ......!. ..............{:...':.....: ....i2.... n.................................................................................................................
Zoning District ........................................................................Fire District ...�c,�-?
Name of Owner .....Address .... ........�^.tV
Name of Builder I...............Address .... •.li.=.!'.... �.,...}Y?da! S �a��....�'�'�:.�.�.5..,...t!!I.p.
Name of Architect � '�m 2 .................Address .......................... � �-
.................................................. .............................................................
Z I ...c?............................Foundation ....NP.1�. .c::v. x......A;-o.eJ4.S..............................
Number of Rooms ...........C....,�...............
Exterior .....:4:,:0:AA...............................................................Roofing .......AS.JD.�AkS ........................................................
Floors ......C.9.N. ...........................................................Interior ........5!-!�. ..Q :re+.t:x ...................................:.
Heating .....................� A............:..........................................Plumbing .............. ...........................................................
Fireplace ..:................y .......................................................Approximate Cost ........9r.Uf90...............
........ ......................
Definitive Plan Approved by Planning Board -----------______-----------19_______. Area ...�.G.. ... ......................
Diagram of Lot and Building with Dimensions Fee ! �' (]
. ...... ....... ....................... . .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
ll
Name .. .........
Childs, Robert A=103-85
No .21352..... Permit for Add....breezewa-Y...
.......&.garage:.to..dwe.Uing...........................
Location wi.j.jjrpant.jc..Dr..j..............................
.........................Mars tons-Ni-l-Is.......................
Owner .....Robert.-Childs................................
Type of Construction ............Wo()d....................
..............................................................................
Plot ............................ Lot ................................
Permit Granted ............JUne.... 1979
Date of Inspection ....................................19
jj
Date Completed ...................
19
PERMIT REFUSED
................................................................ 19
................... ......Kn
.............. C. ..
................ 0. ........................................
In1
................. ....................................
Approved ....... 19
0..............
%
In
.............. . ...
..........................................................................
Assessor's map and lot number ..... .. .: ..d.. �...... ° ,,,. �,eGc•: f
A� H
Sewage Permit number ................................ ........................
Z H9HBSTADLE, i
House number .............. vo raea
..........................................................
4 1639• �0
YAY A,
TOWN - :-OF BARNSTABLE
BUILDING . INSPECTOR
APPLICATION FOR PERMIT TO ....ADD...........!'3.c �?J....A �...�E1��.�.�:.... T�...�x„t�::�r :��u:z�✓Cs�
TYPE OF CONSTRUCTION ...........l,-,y,4•t.C?:(r,y,0.0.d............................................................................................................
..............�....7..............19'7 9. ., v
TO THE INSPECTOR. OF BUILDINGS: f,
_ The undersigned hereby applies for a permit according to the following information:
Location .........l..+J..>.�.,. M..fNA1 �.(...............b.�%.�.g................,�.!?.!..0.n,;v.S....yy..,3.A.s..; YY\.!A.:..................................
Propr 2 0 5 b . (.-.v n., /`e 1�1 (i* n�d t) !1 d`G rJ
osed Use ............................................ ............................................. ......S . ..:.....G....................................................
Zoning District Fire District ...f� -��tr..!c:./.IG ;(?S !!.!v: I�� M
Name of Owner °.K..?x:.►.14,,s A....�FJ 6.°e.;n+...Ek.:A 4.5..........Address ....W..IL :x:........�r. ��.�..;.M n✓c foti,�„IY1,1 is
Name of Builder .. 1�,A....n..r...�1 Q. t✓..�c� l.�a._ 1 .............Address ....7 :.?.!.....1�..A...... ...!!!!.4?
Name of Architect S .. en e..............................Address C-
Number of Rooms ..........kZ,1........��.t.o............................Fouridation ....! ...... l0.t..11..5..............................
Exierior ......LNo.A�................................................................Roofing ........A.S..O&I,. ........................................................
Floors .....Co. 5. ! `...........................................................Interior . cx
Heating ^-.�� ................Plumbing ........... . Mi f"'
....................................... . ...I. ............................................................
Firepp N1°V14......................................................Approximate Cost ........ .DSO
lace ..:...................
........................................................
Definitive Plan Approved by Planning Board -----------—_-_--_-----------
9 —--. Area ...........T1 ...................
Diagram of Lot and Building with Dimensions Fee �' �. 1.
• ............. ..... ........................\
SUBJECT TO APPROVAL OF BOARD OF HEALTH /
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
.raName . . .. .i a•a;Via,.;i .•r,,.,z�,{I. _.__ _. ........
. . `
Childs, Robert A=iO3-85
t
�
No2���2....... Permit for -. n���' �
.......&.�PraQe..tQ. --------- ' �
_
'
Location ............Willimantic.'�rv------'
`
,
x
Owner .Robert-Childs �
'
Type of Construction .
[ ^
-
rm, �
. - .
�
.
.'
Permit— Granted— '---
`
-_- of Inspection ----
'
.
PER IT REFUSED
�
.............................. - lA
........................... ........
--------.
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-'--' ........' -�--------'—
'---' --~----~-'----'-----
'
-------,-----~----.-----~-...
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-
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Approved
lQ
----------------
` ^ �
_______._______~_,--__-..---. i
, . ,
' .
-----_--------------...---_
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TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please 'print.
DATE '/9
JOB LOCATION
Number Street Address
Sect on,.Of i',Town
HOMEOWNER � b
Name
Home Phone Work Phone
PRESENT, MAILING ADDRESS
C, t Town ��`S � .• • • .�,_. 4s .'F
y State Zip- Code
The current exemption for "homeowners" was extended to include owner-
enga229age dwellings of six units or less and to allow such 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 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 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, by-laws, rules and
regulations.
The undersigned "homeowner" certifies that he/she understands the Town of
Barnstable Building Department minimum inspection procedures and
requirements /
HOMEOWNER'S SIGNATURE t/
APPROVAL 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.
NIScS _ E
HOME OWNER'S EXEMPTION
The code states that: Any Home O
permit is required s wner performing work for which a building
hall be exempt from. the provisions of this section
(Section 109. 1. 1 - Licensing of Construction Supervisors) •
Home Owner engages a person(s) for, hire to do such work, tha dtosuchHomet if
Owner shall act as supervisor. "
Many .Home Owners who use this exemption are unaware that they are assumin
the responsibilities of a supervisor
( see Afor Licensing Construction Supervisors, Sectiond2XlQj •RuThiles salackeoulations
awareness often results in serious problems, particularly when the Home
Owner hires unlicensed persons. In this .case our Board cannot
against the unlicensed person as it would with licensed supervisor,.
Home Owner acting as supervisor is ultimately responsible. The
To ensure that the Home Owner is fully aware of his/her responsibilities
many communities require, as part of the permit application, that the Hom'e '
Owner certify that he/she understands the responsibilities of a su ervisor.
On the last page of this issue is a form currently used b s P
l .
You may care to amend and adopt such a form/certification vus.elinoyour
community.
a
Assessor's office(1st Floor): �-
Assessor's map and lot number t�10 3
Conservation Board of Health(3rd floor): sea»r�t
Sewage Permit number a
rua
Engineering Department(3rd floor): �° 039,
House number �o err 6.
Definitive Plan Approved by Planning Board 19.
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-i00 P.M.only '
TOWN . OF , BA:RNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ,�.y L/�r�e
� Z7e dec,/L
TYPE OF CONSTRUCTION — Coo 06 F4 Ali zo t
19 y'Z
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location/ 2�� e2zg-/1 ]!L/ L° j,
Proposed Use cw L)a eGit
Zoning District F Fire District C,d O xz/,o
Name of Owner 4,-"' h/ Address —331�7 Doe.
Name of Builder 4rw ve f— Address e
Name of Architect �l�' Address
Number of Rooms / Foundation
Exterior AXI�- Roofing
Floors �� r Interior
Heating ��l/4 Plumbing .CJDe
Fireplace /V/�", Approximate Cost// a'�t��
Area
l 93�
00
Diagram of Lot and Building with Dimensions Fee
.33
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name
Construction Supervisor's License
CHILDS, ROBERT E.
No 3 5 5 0 4 Permit For ENLARGE & REBUILD DECK.
Single Family Dwelling
Location 342 Willimantic Drive
Marstons Mills
Owner Robert E. Childs
Type of Construction Frame t
r
• t
Plot Lot
Permit Granted November 13 ; 19 9-2
Date of Inspection 19:; ,
Date Completed 19' A
1
.. ,• F Tit, `` ' ' t , . ( 1 R � 1
TOP FNDN. AT EL. 91 .1' SYSTEM PROFILE
ACCESS.COVER TO WITHIN 6" OF FIN. GRADE (NOT TO SCALE)
ACCESS COVER (WATERTIGHT) TO
MINIMUM .75' OF COVER OVER PRECAST /� WITHIN 6" OF FIN. GRADE 2% SLOPE REQUIRED OVER SYSTEM
,'~• $7.05' RUN PIPE LEVEL 2" DOUBLE WASHED PEASONE\
FOR FIRST 2'
EXISTING 1000
GALLON SEPTIC 85.6'f
TANK (H- 10 ) GAS 84.99' Q Q [� O Q C
AFL g5.JC .. 0 84.90' C] I= 0 O CDC] 0. C
6 CRUSHED STONE OR MECHANICAL o 0 a a o c
COMPACTION. (15.221 [2]) $ 2' CD a a a C] C] C] C
DEPTH OF FLOW = 4 ( 1 % SLOPE) ( 1 % SLOPE) 3/4" TO 1 1/2" DOUBLE WASHE
TEE SIZES:
INLET DEPTH 10"
OUTLET DEPTH = 14"
FOUNDATION— EXIST. SEPTIC TANK 45' D' BOX 11 LEA(
FAC I
*THE INSTALLER SHALL VERIFY THE
LOCATIONS OF ALL UTILITIES AND ALL .
BUILDING SEWER OUTLETS AND ELEVATIONS
PRIOR TO INSTALLING ANY PORTION OF
SEPTIC SYSTEM
+,90.9
+ 91.0 \
2SA\\ o if
90.0
+ 90.7 + 90.8
F R
Roq�
+ 9.3
V tK
GARDEN \> \\
9.1 I
� + 89.8 AVEL 6
f LOT AREA 9 I DR v s,3
.39,833t SQ. FT.
90.8 \
1 \89.0 90.7 \
89.2 90.1 90.7 y> G \
/ 0\
6" TREE (\ 90.5 /
S�
y DECK
8.6 F 0 + 89.2 `N FLAG. EXIST. \A. GP
(Y; 9 PAi10 DWELL. / G
I\ "r 8.6 89 \ TFVV%§i.I'
TH GARDEN .2
ry , •
DEC 90.2
,Q + 9
7 + 89.6 16" TREE
_ F
7.6 FISH PONDS
8.4
LP 8. o
7.9
S •p
/'00 22" TREE
8.9
BENCH MARK — TOP OF CONC.
BOUND ELEVATION = 88.7
03-364