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HomeMy WebLinkAbout0028 DEER JUMP ROAD o . � . ) . ] � l ] � \ ) . / \ ] r _ CL6 % . � ] . � , � ! CC j . � � O � \ ] \ � � � : ���r �.; .i .� .� �,j; �� ,� i `� is (I i� ,; 'i� �' i f �, ��,I X.PR RIT Town of Barnstable *Permit# �. pies 6 mon hs from iss date F 2 Regulatory Services ee BARNSPABLE, : Thomas F. Geiler,Director TOW � � � ABLE Building Division . rFp tApi A Tom Perry, CBO, Building Commissioner v l' 200 Main Street,Hyannis, MA 02601 www:town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not valid without Red X-Press Imprint Map/parcel Number l V q6 Property Address residential Value of Work �1 f OD tKD Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address /v C C6� t Contractor's Name � Q. <;�inn t�� Telephone Number 5y 6 3(2 3 rQd Home Improvement Contractor License#(if applicable) ❑Workman's Compensation Insurance Ch�qk,one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name l—1 bezCt OtU/f( Workman's Comp. Policy#WC 2 - 3 t S- 31 6 2-0 " 0 �U7 Copy of insurance Compliance Certificate must be on file. Permit Request check box) �. Re-roof(stripping old shingles) All construction debris will be taken to / Akrh IJ A)" ❑ Re-roof(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders. 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. A copy of the Home Improvement Contractors License is required. . SIGNATURE: Q:\WPhLES\FORMMuilding permit forms EXPRESS.doc Revise020108 a - ✓lie Coo�nmamcuea o�yaaaac�zuaeli~a Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: ��ti Board of Building Regulations and Standards Regist[ati9n; 150950 i One Ashburton Place Rm 1301 Expiration:_578/2010 Tr# 267093 Boston i1 j���TypDBA ,Ma:02108 `. PETER J.SMITHIHOME-IMPROVEMENT PETER SMITH =F' 3925 MAIN ST. CUMMAQUID, MA 02637-' Administrator Not Wid without.signature The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 • wwwanass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors[Electricians/Plumbers Applicant Information Please Print Le 'bl Dame(Business/Organization/Individuan: • Ad�re55 3,��S V �/� s" . City/Statdzip: C +f n'1<►'l4 y i Q hone.#: c�6 •3�2 ' 3 552 Q 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 loy (full and/or part-tint).* have hired the sbb-contrato crs 2 +� I am a soees le proprietor or partner- listed on the attached sbtet 7. [ modeling ship and have no employees These sub-contractors have g• F1 Demolition working for me in any capacity. employees and have workers' 9 0 Building addition [No workers' comp.-insurance, comp.msunance• regaired..] 5. 0 We are a corporation and its 10.0 Electrical repairs or additions I❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself [No workers' corms. right 6f exemption per MGL 12.0 goof repairs insurance require&]t c. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp,insurance,required..] *Any applicant that chmim box#1 must also fill out the section below showing their workers'coTnpcnsztion policy information- t Homeowners who submit this affidavit indicating they an doing all work and then hire outside contractors must suhrrnt a new affidavit indicating such- tContrnctnrs that chcck this box must attached an additional sheet showing the name of the sub-cantractors and state whether or not those entities have unployas If the svb eonhactars have�loyeer,tlrcy must prm idb thc� workers'comp.policy mmnba. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: t b�/L- M•J U A Policy#or Self-ins.Lie.#: WG2^ S ' 2 — ©Z.0 Expiration Date: J 2 f a 0 �� � �I City/St,&zip: � 6,12AJ Sf�"�(2 Job Site Address: y • Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this stattmcrit may be forwarded to the Office of Investigations of the DIA for insurance coverage ycrification. I do hereby FgFqfy under the pains•and penalties of perjury that the information provided ove true.and correct Si c: Date: Z _ Phone,:# SU `Z^ 3S k Official use only. Do not write in this area,tb be completed by city or town official City or Town: Permit/License# Issidng Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: L °FZHErti Town of Barnstable Regulatory Services HARNSTAEM MASS. $ Thomas F. Geiler,Director fo;9 � Building Division. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder Y �ee as Owner of the subject property herebyauthorize �� -e�. b1't i to act on in behalf, � � Y in all.matters relative to work authorized by this building permit application for: (Address of job) Signa of Owner Date Print Nime If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. THE Town'of Barnstable �pF Tp�� Regulatory Services Thomas F.Geiler,Director sAmsrwat.s, MASS, v� 019. ��� Building Division PlEo I��a Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 wym.town,barnstabl e.ma.us Office: 508-86211038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: b_. JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS- city/town state zip code The current.exemption for"homeowners"was extended to include owner-occupied dwellings of six units otless and to allow homeowners to engage an individual for hire who does not possess a license,provided that the ownericts as supervisor. DEFINITION OF ROMEON'VNER 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 iwo-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 resQonsible 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. Signature of Homeowner Approval of Building Official I' 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 Ucensing.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 fonn/certification for use in your community. ' _ _ �„`.^a:•.+;r.r-:: _ .... ,_,...n- :.1--.. ,::a" ..._., _�•..v - - � "s '- c±.c"`.-.1'y."�''�.c-"a. _"y^+..r"•"^_T� '� s i s TOWN OF BABNSTABLE Permit •No`' 27803 C � _ . -----------------•------ Building;Inspector, cast, 1 sauce i ------ °'"' OCCUPANCY PERMIT Bond Issued to B. W. C. Ellis Address fR !` lot Deer ;Jump P.oad, ,Test Barnstable Wiring Inspector �. Inspection"date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department '"�i�r,f/ F, „>�� ,�/--y Inspection date`/ Board of Health \���y ��� Inspection date A— 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. .. ..... ..._., is Building Inspector J`.�.'`- -";rj} :'•.s.' ,i,t:;..p'..`n 't.3,43, 1-~- A 4 0�0..��� '°•mow TOWN OF BARNSTABLE BUILDING DEPARTMENT t se8aer TOWN OFFICE BUILDING HAS& HYANNIS, MASS. 0260i �o lur►• MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #._. .. �.9._© ....._.........................................................._.._......_...._... _� __... ��......_. issued .to ...J�. ! '. �_ 4..........._..................................................................... _ Please release the performance bond. �U SwF 43,848 s•f•� ��� - vp1 artc� LL co Q O 5 Sod 3 i It 2- 2 52 004 # g2- 098 CENT/F/�� #4DL OT AL AA./ P\2N ST P�15 L.C M f� � .eEFE,ee•.c/CE: BBC. E L L ! 2 i-/EeEBY CEBT/FY T/-/FiT T/-/E 6V/LD/.VF SHON/.V O.V TI-//S PL AN /S LOC.gTEZ> OA/ Ti/E yeouva fi5 S'NO wN f,IEBBo�/./ • ��P��N OF Mgff9 ARNE Cys wry cam en9in�eerir,9 o H. O ALA NI cI�I� E.VGLVEBc3 �0 634 `ol gFCI y 20cJTE 6A^-YAeMOC/Ti�-/� MgSS. afarr ,eEy. L ' ,� T Assessor's map and lot number W...1.3 . ...LOT...Aq, THE _ oK �L �..... SEPTIC SYSTEM L+Ul` Sewage Permit number .......... ..0 nnINSTALLED IN ' - BABHSTADLE, i • House number ....DEER .JUMP..HILL..RD �� T!T{" 9014= ENVIRONMENTAL CC0 �639• 0� 0 Mix TOWN: OF BARISTAB"LrE BUILDING INSPECTOR 3 APPLICATION FOR PERMIT TO ....GQN.5T. ,LIST..VIEW...S.INUE..F.AMILY...RES.IDENCE...................... TYPE OF CONSTRUCTION .......WOOD FRAME .................................................................................................................... ..�%................19�.�... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location $...DEER...J.V.MIP...RILIA....RD.........W......BARNSTABLE.....I'm................................................................................ Proposed Use .....S.1NQU...FAMILY...RESIDENCE........................................................................................................... Zoning District R..F.....EES.IDENTIAI:..............................Fire District WES-t...BARNSTABLJE..................................... Name of Owner .....................................Address 247.1...MAI.N... T.—r-1... ).,....BARN...7...MA............. Name of Builder B... ...C..... Address ..!!..............!!......................................... K. JEFFRY/ALAN DODGE P.O. BOX 720, BARNSTABLE, MA Nameof Architect .................................................................Address .................................................................................... Number of Rooms 8 Foundation POURED CONCRETE Exterior .CEDAR.•CLAPBOARDS...&...SH•INGLES...........Roofing ....ASP•HALT.............................................................. Floors ......WOOD.....................................................................Interior ...DRYWALL/WOOD TRIM ...............................................:.......:...... g OIL FORCED HOT WATER Plumbing COPPER/PVC Heating .......................................... ............................................................ Fireplace 1 MASONRY Approximate. Cost ...$12 0, 0 0 0 . 0 0 Definitive Plan Approved by Planning Board _NOVEMBER_ 5 19 8 5 . Area ed ...........cQd......... . ... Diagram of Lot and Building with Dimensions Fee ©`� . ................ ....,..�.................... SUBJECT TO APPROVAL OF BOARD OF HEALTH � r . r �- OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town o arnstable rreabove construction. Name .... .. .. .................. Construction Supervisor's License 4' 020 13 ELLIS, B. W. C. No 2 7 8 3.... Permit for §:toKY.............. SinglSingle Family,,, pKq;�jin e.................. .. ......9......... Location .......8 Deer Jump Road ...........................Jump., West Barnstable ............................................................................... Owner ....... ... ... ......................... .. .. .... .. Type of Construction ....Frame,,,..„.................. ................................................................................ Plot ......................I Lot ................................ Apirl, 25, 85 Permit Granted .... ....................................19 Date of Inspection ................19 Date Completed Zq711e..—(: .............19 Assessor's map and lot numberMAP....1.3!.3......�!q ...4.4­1� *THE C Sewage Permit number ...... O DA"94AD E, House number*q...DE.ER...JU.MP...HILL...RA.1,16,�.r.......... MAS& ..... ..... t639- 0 TOWN OF BARNSTABLE INSPECTOR APPLICATION FOR PERMIT TO .....C05T.R114.77..N W...q.-T NG%T­..P.....r?KM.1 T ....................... WOOD FRAME TYPEOF CONSTRUCTION ..................................................................................................................................... ................ TO THE INSPECTOR OF BUILDINGS: ,The undersigned hereby applies for a permit according to the following information: Location jvKp HILL W......13 ARN S.T.A.R.L.E......MA................................................................................... ProposedUse .....5.1 XQL EFFAKT DENCE,........................................................................................................... Zoning District ......RES.I.D.FNITI.T.&TA.............................Fire District ...................................... Name of Owner L.1 IS.....................................Address 20.7.1 ..... . T. E .............. Nameof Builder B.-NX......FL1.1 S......................................Address .........................R.............. ........................................... K. JEFFRY/ALAN DODGE P.O. BOX 720, BARNSTABLE, MA Nameof Architect ...................................................................Address .................................................................................... 8 POURED CONCRETE Numberof Rooms....................................................................Foundation .............................................................................. Exterior ....S..F�:E N.C-.L. P_C...........Roofing ...A.SRFUNLT.............................................................. Floors ......WOOD DRYWALL/WOOD TRIM ......................I.........................................................Interior ...... .... ...............................,......................................... ..................................Plum ing ............... ...................................................................1L r-ORCED :7," "VER COPPERPVC }seating ............................................. bi Fireplace 1....MASONRY............................................................Approximate Cost ...�!.?0, 000 . 00 . ....... ....... .. -C %. -9 Ann- Definitive Plan Approved by Planning Board _NOVEMBER 5 d --- ...19 Area ... ..............16BI,.t............ Diagram of Lot and Building with Dimensions Fee ............... ......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town ofBarnstable reg r ing th"e7above construction. Name ................................. Construction Supervisor's License .......................... ELLIS, B. W. C. A= 13 3-4%�� 13 3 :"4 J�2 No ....?.78P Permit f ..Story............. ..........S.i.nq.l.e...F.am.i.ly...PKqj�.in.g........... .. .... .. . .... Location Lot...2.,...2.8...D.ee.r. ...J.umR...Hill Road . .. .. .... .. .. ..... .... .. .. ............ .....West...Ba.rns.tab.le..................... ..... . .. ..... ....... .... .. ... B. W. C. Ellis Owner .................................................................. Type of Construction .....Frame.......................... .... .. .. ............................................................................... Plot .................. . Lot ................................ .......... Permit Granted AP.ri1..25.o................19 85 Date of Inspection ........................... ......19 Date Completed ......................................19 AL