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Home My WebLink About0041 COVENTRY LANE (2) f C 0 t 1 1 Oidbrer NO. 152113 ORA MADE IN LLSA 0 ESSELT'E �_�_ ,� �� i,: �� ,_ 4 I Town of Barnstable *Permit# f 30 A. Expires 6 months from issue date Regulatory Services Fee Al snxtas M1X � � Thomas F.Geiler,Director, 1639. �wway Building Division J� Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barmtable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTLAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address ✓ L, Residential Value of Work$ Z� Minimum fee of$35.00 for work under$6000.00 Lr c . Owner's Name&Address J 1 lo-,e -" C, a , . — 1 Contractor's Name Telephone Number �+ ago Home Improvement Contractor License#(if applicable) Email: O( Pas 7 PER Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: F BARNSTABLE I am a sole proprietor -�®\.NN 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 Request(check box) ❑ 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/slider .U-Value �� (maximum.35)#of windows #of doors:1z::) ❑ 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: QAWPFILESTORNIMbuilding permi fom \EXPRESS.dm Revised 060513 The Commonwealth of Massachusetts D�Warbnent of Indusbial A cciden& Ogre of Investigations lei 600 WashhTton Street Boston,M4172311 . ?Vn".Mfi3&go v/dia Workers' Compensation Lm rance Affidavit: Bmlders/Con#ractors/Electric ans/Plnmbers Applicant Information Please Print Lembh Name MusmessK) timlladividwl):Address: City/State/Zip: c,, Phone# -' Z Z:J 2 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 1 6- ❑New construction employees(full and/orpart-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition (No L odmrs'comp.tom' ranee Comp_rnc„ranrg 5. ❑ We area corporation and-its r 10.❑Electrical repairs of additions 3_ d]homeowner doing all wade officers have exerciseddmeir 11.0 Plumbing repairs or additions 7 myself [No worms'�p right of exemption per 1Y1CaL 1 ❑iof repairs insurance required]T c.152,§1(4),and we have no employees.(No workers' 13 0#lrer comp.insurance required.]. tJ 'Any apphcmir that reeds box#1 must nlw fill mat the section below shoving then voiceis'compensation policy infvmstiab 1 Homeowners who submit this affidavit iadicadng they am doing ail wat Lad then him outside cofactors mmsi submit a new a$dwii indicating sash tcoatractars that check this baps must attached an additional sheet showing the name of the sob-camtictass and state whether or not those entities have employees. Ifthe sub-mixtmaors have employees,tteynn ist pmaide their markers'comp.policy number. I wn an employer that is providing.worirers'compensation insuranca far niy ewphow& Mavis the poitfcy and job site informalian. . Insurance Company Name: - Policy#or.Self-ins.Lice#: Expiration Date: Job Site Adddiess: City/StatryZip: Attach a copy of the workers'compensation policy declaration page(showing the policy member and expiration date). Failure to secure coverage as required under Section.25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S"00 00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a tine 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 verifitation- I do hereby cerhiy under the pains irry that the infaraaafian provided above is bus and correct Signature-' Date: Z\ Phone Ojucfat use only. Do not wrfte in this area,to be completed by city or Mimi oiciaL . City tar Town:. PermibUcense# Issuing Authority(circle one): . 1..13oard.of Health Z.Budding Department 3.City( noun Cleric 4.Electrical Inspector S.Plumbing Inspector .6.Otht.r.. Phone#: . IAItNSrABL& ' Town of Barnstable Regulatory Services Thomas F. Geiler,Director. Building Division Thomas Perry,CBO Building Commissioner 200 Main.Street, Hyannis,MA 02601 www.town.barnstable.mi.us Office: 508-862-4038 Fax: 508-790-6230 Property'Owner Must Complete and Sign This Section If Using A Builder , 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:\WPFILESTORMS\building permit forms\02RESS.doc .J ,*'THE r � Town of Barnstable Regulatory Services ` t;aataM LF Thomas F.Geiler,Director j�AIEoYA Building Division Tom Perry,Building Commissioner 200'Main Street, Hyannis,MA 02601 www.town.barnstable.m.a.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print 4 DATE: A Z • - ` JOB LOCATION: number treet village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/to� 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 require sand that e will comply with said procedures and requirements. Signature of Approval of Building Official Note: Three-family dwellings containing 15,000 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 farm currently used by several towns. You may care t amend and adopt such a form/cenification for use in your community. . Anr .. .. .. - . A. _ r •TM TOWN OF BARNSTABLE Permit No. Building Inspector cash - — -- �0"'Y Bond `ezalp OCCUPANCY PERMIT Z Issued to S L S Trust Address Lot #34, , 16 Currycomb Qtrcle, West Barnstable . Wiring Inspector Inspection date �� 1 Plumbing Easpecto� �- Inspection date Gas Inspector Inspection date / C�fZ`i.Q�[.Cbm�/A7'� •c��.m.d O r 19( ) Engineering Department" , " '//�l Inspection date Board of Health Inspection dateV2 _ � _� 6 V THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. C ...................................d 19 � �w..................................__....�_......r_.. Building Inspector 4 �. __. .: „\?� ..._s; .Ys t��.�;, _ .:..r Tri' m 5r�'�.r=� ,� rl.;'.�' .%a ,ti��V�.��r..rN.fit..:�✓ '.r ..i y: .r a.n .. .. '-ir� �t c h Lj • TOWN OF BARNSTABLE _ BUILDING DEPARTMENT _ DARN°T = TOWN OFFICE BUILDING rut HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: ' Building Department DATE: An Occupancy Permit has' been issued for the building authorized by $�........�D,�,, -3..._.........Building Permit ..................................................................._.................._. _.»... _ .. ....�. ... _. issued to5..._.y�.._... � _._3�._ f.._�v......C::..vl' '�Co�� Please release the performance bond. LOT J(o S-11 IrSF �., SS -215 CE,eT/F/�D P.G oT ILL iUN PREPARED Fo R: ccLWuC.,C_i'm,_: c, O.L/ T.y/S• PL.oi../ IS L O,•o9 TE D OA TSNE y.BOc%t/D AS SNO N/.V HEQEO�/. o�. AP.NE wn canoe en yir�ecrir�9 � I o A 0 c-/�.c. E�c/G/.t/EEG3 S DL� •� r'V Q - G 4.VD SC/eV6YOB�-_, �/ /✓ __- pow '� ,EOc/TE 6�4^-`�.eMOCJTs-I, MASS, a�arc- e��. L. 1uo_,sv Yoe 1 SZ . D 41 SEPTIC SYSTEM � INSTALLED�IN COMPLIANCE -�- Assessor's ma and'lot number . ... �..�L�-./.,3�... p WITH TITLE 5 pf THE ;, - ? �� d � Si ........wage Permit number .. ........................... ENVIRONMENTAL C TOWN R RE >a s ,House number .................`... ....F-�� ....................:...... 9ooAsa sncs,ST MM6 O'N ryt ,o,i63 * ♦� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...... . E!/.. ....�yz S�O .............................................................. TYPE OF CONSTRUCTION ......... rlfJ�1.4. ... 2�.!f.7Ge.--.............................................................................. ................�.. ..... ..r�.....19.rW TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for r t a cor i to(t fo 4 win information: 9 Y Pp ` // g Location ... P. :..' �� k .c... C4!4.�� ...................................... ProposedUse ..... ............................................................................................................................................. Zoning District le, ' .................................................Fire District Name of Owner SLS... v ............................Address �><e �L7../.p..................................... ........................... Name of Builder Pal—... vc e� ..... '" !:......Address ............J�..i...rn ................................................... ,/� .�c� 2S /�h.......Address Name of Architect i Number of Rooms .............. ...............................................Foundation .��s!�! e ..... S,.r Exterior ........ �? Y�Ir2 5..................................................Roofing ...........�v,,/;f........................................................ Floors ...... ?/If.QJ00?�,.......................................................Interior ........��/�.egT` ....................................... Heating Plumbing .................. ..... ./�f.�.............. ......:..�".........-5...... Fireplace ..........,..�..............................................................Approximate. Cost ................��I.Q��.............................. Definitive Plan Approved by Planning Board -----------_______-----------19_______. Area ... > .... :.. Building with Dimensions Diagram of Lot and Bu g Fee ............ .. . ......................... SUBJECT TO APPROVAL OF BOARD OF. HEALTH. / �� S o� OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the ow•n of Bar'stabl regarding the above construction. Name . !....... .: . ........................................ Construction Supervisor's License .......... .... ........... ..... S L S TRUST .._. No .. ... Permit for ....1. ...StQrY............... Single„Family Dwell,, g....................... Location ......Lot 4 ......j�...G.u>;zyC.omb...GircI e ....................... ....................... Owner ........S..L..5....Tru;; .....................:.......... Type of Construction ......Frame......................... ............................................................................... Plot ........... ............. Lot ................................ R} \ Permit Granted November 13, ....19 85. > Date of Inspection ..............19W Ddte Compl ted r. 9 I�.................19/, Y M A, _ Assessor's map and lot numberi":� /�_ �. ..��{. , t P�' F 1 E T�` G` ft Sewage Permit number'r,'...............:.......... ..' y 33AWSTAMLL i House number .... r ....�.. .. . ...................................- M63 e� 6 c'r7� TOWN . OF BARNSTABLE BUILDING; INSPECTOR APPLICATION FOR PERMIT,TO .....> �! �'�,L S �UZG1...................................................:. TYPE OF CONSTRUCTION ........ `/Uri ,..... ................................................................................... ............... .... ....19.....r TO THE INSPECTOR OF, BUILDINGS: The undersigned hereby applies for•` 7per 't afor4i,ryg to th ' folllowing information: Location ...-1�:. ... .3s �6........................ ........................................... �4- ��. ............................ . ... ProposedUse ...... 4 Z,�»."F......................................................................................... ................................................ C ZoningDistrict ............ �-............................7?..................Fire District ................. 0..................................................... ✓LSE' � Name of Owner ..... /SL�S..... ��.v. .......'....................Address _ZO.Zp..................:.................................................. Name-of_ der ,,��!fCF'1.-... u�?�,5.....�PvL�/....Address ............5 wil ly...... .................................................. Name of Architect ., /?-�`"!�.S.�Qt........Jes h Address � �.' U Ty.Q02T Number of Rooms .............. ...............................................Foundation .wkkeee�, .................. Exterior .......:7/1iY�,�> e.. ..................................................Roofing ............� ......................................................... Floors .....v .....................................................Interior ......... e!,G/�........................................ Heating .. .......... .....................................................:........Plumbing ......./� �/�,GIP✓�eiZ....... Fireplace .......:..�25..................................................... ........Approximate Cost ................ ,... ...... Definitive Plan Approved by Planning Board ---------------_—-----------19_______ . Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH o F , OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS i I hereby agree to conform to all the Rules and Regulations of the Town of Bar"stable r' eg rding the above 4 construction. i K Name ................{..... ..... ................................................... r �. Construction Supervisor's License O�/..�/... S L S TRUST h. 7 28663 11 No ................. Permit for ..........Sto...... ................ Single Family..Dwelli ..................................... . .................... Location ........Lot.....3.4...,.. 16. u Circle . ..... ... y.c.o.mb........... --Y( West Barnstable ............................................................................... Owner ........S.....L....S...........Tru..s.t................................... Type of Construction .....Frame.......... ................................................................................ Plot ............................ Lot ................................ Permit, Granted ..... 13..........19 85 Date of Inspection .............................:......19 Date Completed ................... ..................119 ///97 TOWN OF BARNSTABLE Permit No. 28663___-_--- Building Inspector au�sr.0 Cash � qua � ------------..-- °' OCCUPANCY PERMIT Bond Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. ..................................I.................... ].9......_.._ Building Inspector