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HomeMy WebLinkAbout0094 BARNHILL ROAD 7�31�y3� � - �►.f 1 -7 i NO. 152113 ORA MAMMUSA ESRUE � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map U Parcel D TO/N OF BARNSTABLE ApP lication # Health Division Date Issued i0 k! /� 21116 SIP ?i AMIO: gn Conservation Division Application Fee Planning Dept. _ __ Permit Fee U✓ • V Date Definitive Plan Approved by Planning Board 01VISI(.'t Historic - OKH _ Preservation/ Hyannis Project Street Address �1 l3 ffi r-N �-A rNSi.--, Village Owner Address q ( t1A Q Telephone l �b - 2 2- Permit Request(D )81k r L�-n.t,c 2 2- A k An o'i +b �C.vte C37 TN U e A_A s �Lf) Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuatio S� Oa Construction Type Lot Size Grandfathered: ❑ Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ,U,-/ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ 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 new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil - ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size ' Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name r Telephone Number Address T'�, . -�,4 License# O d- ? 7 / 6.1 7 7 Home Improvement Contractor# � Y / Email b n rr,A S 'Y y ✓,.r4 - Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO PfqC SIGNATURE DATE FOR OFFICIAL USE ONLY �. ' APPLICATION# y DATE ISSUED MAP/PARCEL N0. ADDRESS VILLAGE OWNER , s DATE OF INSPECTION: FOUNDATION FRAME INSULATION ' FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL 4 GAS: ROUGH FINAL FINAL BUILDING 1 DATE CLOSED OUT ASSOCIATLON PLAN NO. f Tay Town of Barnstable . y. Regulatory Services KIM Ricbard V.Scali,Director 1 cud• Building Division Tom perry,Building Commissioner 200 Main Street,Iiyannis,MA 02601 w-ww.town_barnstabl e_ma.us Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section If Using A Builder l,_ O "MA6 n%)LLy_ -,as Owner of the subject propen-y hereby authorize c � LA to act, on my behalf, m all matters relative to work authorized by this building permit application for: (A,daress 4Job) J Pool fences and alarmns are the responsibITYof the-applicant- Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. r S' mm of Owner S' of li � APP Print Name Print Name Date Q:FORMs:o W WEVb3U-tlSsIONPOOIS r The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street,Suite 100 Boston,MA 02114--2017 .. ' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING A11THORITY. Annlicant Information Please Print Legibly Name(Business/Organization/Individual): lZ<--%z IN S'J q c� Address: City/State/Zip: S L�:1e c�1� A Phone#: C21- � 9 2 Cr — l 01 o Are you an a ployer?Cbeck the appropriate box: Type of project(required): l a employer with employees(full and/or part-time).* 7. ❑New construction 2.❑I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling i any capacity.(No workers'comp.insurance required.] 9. ❑Demolition 3.E]I am a homeowner doing all work myself.(No workers'comp.insurance required.]t 10 Building addition 4. I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers'compensation insurance or are sole I I.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions S.Q I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.0 Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 14. Cr GJL"I`iR 6.O We are a corporation and its officers have exmised their right of exemption per MGL c. 152,§1(4),and we have no employees.[No workers'comp.insurance required.] •Any applicant that checks box g I 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 sub-contractors have employees,-hey 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: t2 TnJ c C O . Policy#or Self-ins.Lic.#:— d S Y 3,A O 10 C) Expimtion Date: 2 Job Site Address: ZAr,,,! Yf (17)/ Ao. City/State/Zip: (V, 4A/ /�2 le- fi44- Attach a copy of the workeen compensation policy declaration page(showing the policy number and expiration date'. Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under th p an penalties of perjury that the information provided above is true and correct i e: ;ra ate: 9 12-.?/1 Phone#: S ti, 4 (4 l Official use only. Do not w)'e in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): I.Board of Healt .Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,Mas 02116 Home Improvement Q' ° tor Registration :�"=.�;, Registration, 1$0481 . r� Type: Pf vaW CotDmacm 2 ! r,r, Evifation: Tams dt 89'l84 RETROFIT INSULATION, INC. C�"n � +w JOSEPH REILLY P.O. BOX 105A ,rt� SEEKONK, MA 02771 Updda Addy=and rams URL MMk rwon fOr dM9L Adat= 0 Beaw d ❑UpWyMe ❑Lost Card WA t r 20"5AI -- ��,�,•,�•onaadl�o�t3�awao/uasl'i8 uue or reswafou valid for imdwdw on My OMe of Oom ff MAN tc Xxibim X0601fid= bd=dm dstL %1*=d[data tot Fi01Ewwff OON7AAsrTiOR Ogg"orb Affm ad BaalMra Xgpb tiioa 8 Priwado CotpOtgtlon wom MA OZ116 RETR M y y J c�li l y OStpH l ' 04 RODMAN GT FAUJNVM MA 02?Zt "r U Not valid wi ftat W OMOKM MasaaeAitay!!a.Dopsrttno,tt of Publk SaAlr i Board Of BWkUng Rpidso ma and SUndMds f oo>ttruch"SLPeniw,Sl.eciaifn uanso:Cq@L_1 n� # 16' roans ISS i yak WA awl V, ,' TOO ExphaWn i r A RETRINS-01 RBLACKI '4 COR0' CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) `..� 7127/2016 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. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If 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 certificate holder in lieu of such endorsement(s). CO PRODUCER License#1780862 NAME CT HUB International New England PHONE 508 676-1971 1, 222 Milliken Boulevard AIC No at:( ) A/C No):(608)678-2760 Fall River,MA 02722-99" ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC 0 INSURER A:Star Insurance Company 18023 INSURED INSURER B: RetroFR Insulation,Inc. INSURER C: PO Box 105 INSURER D: Seekonk,MA 02771 INSURER E: 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. ILTR TYPE OF INSURANCE INSO WVD POLICY NUMBER MMID MMUM LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR X PREMISES Ea occurrence E MED EXP(Anyone person) $ PERSONAL d ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JET LOC PRODUCTS-COMP/OP AGG S OTHER: $ AUTOMOBILE LIABILITY COEa acdderdMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Pera.deM E UMBRELLA LIAR HOCCUR EACH OCCURRENCE E EXCESSLJAB CtNMS-MADE AGGREGATE $ DED I I RETENTIONS $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY STATUTE ER A ANY PROPRIETOR/PARTNER/EXECUTIVE Y❑ NIA C0845201 08/02/2016 08/02/2017 E.L.EACH ACCIDENT b 1,000,000 OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE National Grid THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN N Washington Street ACCORDANCE WITH THE POLICY PROVISIONS. Westborough,MA 01581 AUTHORIZED REPRESENTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD oe 911 �oF Town of Barnstable *Permit# T C 9 Explres 6 months from issue date Regulatory Services FeeNAM 03� Thomas F.Geller,Director�ED Mpi►�0 Building Division Tom Perry, Building Commissioner X-PRESS PE ,,% '7 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 S E P 1 5 2004 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDED &W*R NSTA6i_c Not Valid without Red X-Press Imprint ap/parcel Number 142 cA D operty Address �G/ ,�3r� 1✓/�lG 12� w LS I A)+/Z hI57; 6 6 � 11 residential Value of Work%�V,&-0 Minimum fee of$25.00 for work under$6000.00 wner's Name&Address 20640(9— He-I1ld 4-L ontractor's Name Telephone Number 6�3 LI AO 1500 ome Improvement Contractor License#(if applicable) onstmction Supervisor's License#(if applicable) ®ty oz-9r - orkman's Compensation Insurance . Cheyrkene: - ©'I am a sole proprietor ❑ jAm the Homeowner . I have Worker's Compensation Insurance istaance Company Name / �•-0AZ.fl "_ 7orkman's Comp.Policy# 6S6z o V 6 99�nz 7A c 3 A to 3 'opy of Insurance Compliance Certificate must be on file. ermit Request(check box) 2"R�roof(stripping old shingles) All construction debris will be taken to PL//)1 7— P ❑Re-roof(not stripping. Going over existing layers of roof) Me-side ❑ Replacement Windows. U-Value (maximum.44) *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. Home Improvement Contractors License is required. ignature !Torms:expmtrg i Application:to: JPNE�gE�ta C�rcPOENNEP Old King's Highway Regional.His*.ic District Committee ' in the Town of Barnstable for a CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings, or photo- graphs accompanying this application. . TYPE OR PRINT LEGIBLY DATE ✓� �L' ADDRESS OF PROPOSED WORK �Ll �SI�-- ASSESSORS MAP NO. g GuL�S'T l�dL�d S L. L. OWNER.9CAI/l1C= lf Gr� 2-�- ASSESSORS LOT NO, HOME ADDRESS TEL. NO. AGENT OR CONTRACTOR ADDRESSES/ W#I7' dEdl AJ 4E--d f' GLL�jT— gZI TEL. NO. This application is for exemption of proposed exterior construction on the ground that: ❑ It will not be visible-from any way or public place. —(2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work, showing location on lot,and, if an addition is involved,show ing location of existing building. SIGNED Space below line for Committee use. . Owner-Contra gent Received by H.D.C. The Certificate is hereby Date — Time By Date Approved The categories of work entitled to exemption are listed on M 72. of Baildin Reg lat�ons and u�ae NOME IMPROVEMENT CO Standards Re gist CONTACTOR gttc.: 105252 — f 6/2006 JOHN W.RODR� John Rodrigues v i PO Box 641,151 f - p Y W.Bamstabie,MA 0266 Administrator , 3 - 1 v AnchorLBuilding Services BUILDER INSPECTIONS RENOVATIONS CONSULTATIONS September 5,-2004 Ms Bonnie McNally 94 Barnhill Rd. West Barnstable,Ma. 02668 508-362-6012 PROPOSAL. Job Location: 94 Barnhill Rd.,West Barnstable We hereby submit specifications and estimates to: 1) Strip approximately 2500 sq. ft. of roof shingles 2) Install ridge vents 3)Install drip edge vents 4)Make necessary roof surface repairs 5) Apply Triflex roofing underlayment 6)Install approximately 2500 sq. ft. of new asphalt shingles with a 30 year warrantee 7) Remove roof debris and dispose all waste material We propose hereby to furnish materials and labor, complete and in accordance with the above specifications for the sum of................................................... $7875.00 $1,800 deposit; Balance on completion All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements are contingent upon strikes,accidents or delays beyond our control. The builder warrants that he is fully insured, and will supply insurance certificates upon request. Authorized Signature Note: This proposal may be withdrawn by us if not accepte within 30 days. Acceptance of Proposal: The above prices, specifications and conditions are j satisfactory and are hereby accepted. You are authorized to do the work specified. Payment will be made as outlined above. Date of acceptance /,3 0 ` Signature c P.O. Box 641 WEST BARNSTABLE, MA 02668 (508) 428-1 500 • 1-888-428=1 500 A5 Assessor's Office(1st floor) Map IQ 9 OQ.O LD,o� Permit# t Conservation Office(4th floor) bz&5LDate Issued 7 Board of Health(3rd floor)(8:30-9:30/1 -2:00) "7 7 . 3 \'h Fee 1 - Engineering Dept.(3rd floor) House# Rq 4Z6�, Planning Dept.(1st floor/School Admin. Bldg.) �41 BARNSTABIE. Definitive Plan AP oved b Planning Board 19 ®.`•^ '� ®e� yfo 19. *3 TOWN OF BARNSTA `��� Building PermitApplication �. Project Street Address Village �n�aST�F51 Owner 'Rnmm� nC+(ftL_1_y Address Telephone 15003(o0.-6>01D_ Permit Request }RSpLftC;g EMS=t�(6 D�GIC ( ir01 tSC 1-1 (uj�� Total 1 Story Area(include 1 story garages&decks) oZ. square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure g Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel 61 VR_nL Central Air Fireplaces Garage: Detached, Other Detached Structures: Pool Attached x $mil Barn None Sheds Other Builder Information Name L4EUeM4MQJ21 cj�r I V "_ Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO .&PfR STP>fl lIF FT:LL SIGNATURE G DATE BUILDING PERMIT DENIED FOR THE FOL14WING REASON(S) FOR OFFICIAL USE ONLY , PERMIT NO. 9196 _ 95 - •' DATE ISSUED 7/20/• MAP/PARCEL NO. 108 .020 94 Barnhill Road - W. Barnstable + ADDRESS ` VILLAGE ! ` ,.Bonnie McNally , OWNER , DATE-OF INSPECTION: FOUNDATION FRAME u+ i - r INSULATION ' FIREPLACE, r ELECTRICAL: ROUGH FINAL - PLUMBING:. ROUGH'. FINAL f GAS: ROUGH FINAL r FINAL BUILDING r , DATE CLOSED OUT t ASSOCIATION PLAN NO. 7 3L S 11:02194 17:02 -U61 7 727 7 122 DF.PT IATD ACCID .. . _ —�;, C0I3unoiuvealtlt of 7Wajjac1zu4et ' �Uapa�fine�tf o���f,�ia[�ccrdaw 600 �'t, at James J.Campbell iUosfoa, //laaacAwslh 02f f f Commissioner Workers' Compensation Insurance Affidavit c with a principal place of business at: (c+trisra�zfa� do hereby certify under the pains and penalties of perjury, that: () I am an employer providing workers' compensation coverage for Wiry employees working of this lob. Insurance Company Polity Humber I () I am a sole proprietor and have no one working for me in any capacity. O I am a sole proprietor, general contractor or homeowner (cirde 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/Poiicy Number, )( I am a homeowner performing ail the work myself. 1 l undersund that 2 coif of this smte.�nent will be fo:v:2rded to tte Office of Investicarions of the 0IA for coverage verification and that failure to sec cove- :s rEe-;,red under Section 2SA of MGL 152 can feats to the Imposition of criminal penalties cotnatine of a fine of up to S 1,500.00 andlc years' impraonn.,ent m well as civil penalties in the fore:of a STOP WORK ORDER and a fine of$100.00 a day apinst me. Signed this day of J-0 LM t 9 Lm�2h-c-r-nAL. / LicenseelPermittee Building Department Licensing Board Selectmen Office Stealth Department rn vl`otcv r•nv1=17AGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 r TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please '`print. DATE �J V LJ 199-s _ r.. :....:;:�'. :.. .. I9� JOB. LOCATION 1 Number Street address Section of town "HOMEOWNER" Di�- C) Name Aaome phone Work phone PRESENT MAILING ADDRESS 94 Clty .town State 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(sj 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 Officia on a form acceptable to the Building Official, that he/she shall be responsibl, for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes ,responsibility for compliance with the Sta- Building. Code -aad 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 comply with said procedures and requirements. HOMEOWNER'S SIGNATURE 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. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which-.&�J%ilding permit is required shall be exempt .from the provisions of this section (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 Owne shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor .(see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarene 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 TheHome er acti as supervisor is ultimately responsible. To ensure that the Home Owner is fully .aware of his/her responsibilities,. ma communities require, as part of' the permit application, that the 'Home *'Owner certify that he/she understands the responsibilities of a supervisor. On th 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. y The Town of Barnstable S.,g Department of Health Safety and Environmental Services 116 Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Cwssen Fax: 508 775-33" Building Commission 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, 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- iso( tJd Type of Work: NWPl.PrcfTY 6 &,1:aT—Ti! l6 Cost LO�L ��6 ' Address of Work: I W 0.26(O l Owner-Name. �^ Date of Permit Application: U u Lti 19 _ 19 1, 5 I hereby certify that: Registration is not required for the follo%ing reason(s): Work excluded by law Job under S1,000 Building not owner-0ocopied — Owner pulling own permit Notice is h given that: �Y� 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 ' Ic Date Owner's name C.) C9=p.0ELL�At46924S J o ' O t4 PI-A t J 'TbTA�. /Z• u X �p�� Go N C?c-T�-. 'f ppTi 1�fo S SET .4'T is�� az�T} PT PosT --- '1� -ro -- r�► Z 8 P T M -t- cEa�iZ- Sr�Ac,�tJ 6 r - .. -T.- -..---••-•-•----.- T�.-'�_ Rom•!-Vw^.T'va-.w�.a r ^^'N.�'-�.�-- � ..-....� .� .« _. .�. r.,y,y. .1.e+ir�.'\•.�. E Application to ir a00f., 9 5 -135 Old King's Highway Regional Historic District Committee in the Town of Barnstable for a ?• CERTIFICATION OF EXEMPTION . Application is hereby made, in triplicate,-for the issuance of a certificate of exemption under Section 6 and 7 of1Chapter 470, Acts and Resolves of Massachusetts, 1973, as amended for proposed work as described below and on plans,drawings- or photo- graphs accompanying this application. TYPE OR PRINT LEGIBLY WIZT= . DATE S ADDRESS OF PROPOSED WORK,' EF�1-� RF?2� S�T'R�I ESSORS MAP N0. 14O�( [2111&1 OWNER �P[IrCL� `�_ ' ASSESSORS LOT NO, HOME AD_DRESS lPIRlvmt+ u .T� • TEL.NO �- AGENT OR CONTRACTOR ` ADDRESS ` TEL.NO. ` This application is for exemption of proposed exterior construction on the ground that- (1) It will not be visible from any way or public place. (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission._ (Check applicable box) CPROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot and if an addition I 9 add o s involved,show• ing location of existing building. 1�9-PLP(cs el);C�TVIq_G ID WCAIr— W_ZCh+_:,I4_FSS fejo-r) l.L zvnl xbt r `�� N ; 014W �STah? - €.Ui3YPrT"�Dnr • 10 M + tJ>v c,�c�rr(Cp, $8�� Pt6 C,LFrt'1a�P,Rp 801 ,d� ��UKV R.PtJ ,r SIGNED ' Space below line for Committee use.' Own •Contr ctor-Agft Received _�._RR T ie Certifi is reby 117 y Dte qJ Approved ❑ The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. i � � �.t- AREA• �► _ ,vow au_ac D t x18 ' S ;Z;Z' ANC 14,3 SAVERY COMPANY INC. RESIDENTIAL HOMES AND BUSINESSES P:O. BOX 899 SANDWICH, MASSACHUSETTS REVISIONS: SCALE: - , DRWG NO. DATE DRAWN: - DRAWN BY: 'CHKD Y. ~ { 6 i f t iA 44, AEI / 7 \Y s� All r' Assessor's map and I7G umber �........1!..:...............: SEPTIC MUST C SYSTEM T BE , INSTALLED N COMPLIANCE �,- Sewage. Permit number ..... ..8.............................................. WITH'ARTICLE II STATE SANITARY CODE AND �Q�o�:TNETogo : TOWN OF BARNS T' ,".E -rowN Z 33 AR33TADL_E, "AB`NOR BUILDING INSPECTOR c Y'' 1 APPLICATION,FOR PERMIT ;TO 4 ........ .............................................. �6k TYPE OF: CONSTRUCTION ......6!.VP!;. .... ./ 1..................................................................................... .1.�.............19 �. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies �,foorr a permit according to thefollowing information- Location Location ...0�. .......Y.r`fP: 1�7��....!C`�'........../..r! ( 1.7�W.......... :... . � ` ........ ProposedUse ........rb.�tly ......................................................................................................................................... ZoningDistrict ..................................................../...................Fire District ............................................................................... Name of Owner .... .6 +lte/e,.....:.:.:<. ...........Address ...��1...�Yit � /o/ Name of Builder .V ..4!9.........Address Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .......7......................................................Foundation ..Z?v ..... t�1-�1................................... Exterior d4W. . 'G� bai9h. .5............................Roofing ... � Floors ......CFI.4.6F/..V/!k;r/................................................Interior lL2QK Heating !e/k...��l- ..... ... \ .........��t�.S............Plumbing .........�..... .......�:.��/....�..................... =S — �/�; e,G/c� �J Fireplace .......` ................................... 0.4.'........................Approximate. Cost ¢........ ............................. . ............ Definitive Plan Approved by Planning Board -----------_------_-----------19 . /16Y o t...... Diagram of Lot and Building with Dimensions �/ .. . Fee Fee ............ SUBJECT TP APPROVAL OF BOARD OF HEALTH �s i I hereby.agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 51,1 Uege j � ._/J� /C Name .. / :. . ............ .../......... McNally, Bonnie 18713 1 1/2 story, N-0 ................. Permit for .................................... single family dwelling ................................................................................ Barnhill Road Location ................................................................ West Barnstable ............................................................................... Owner ..........Bonnie McNally ........................................................ Type of Construction ........frame........................... ...... ................................................................................. Plot ............................ Lot .........A58 .................. October 12 76 Permit Granted ...... ..........19 Date.of Inspection ...19 Date Completed ...;77. .................19 "Z PERMIT REFUSED ............................................................... 19 VCi641KI( 4- ............... ........ tjoi f 7.,J ................................................................................. ............................................................................. ............................................................................... • Approved ................................................ 19 .................................................................... .......... ............... ............................................................