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HomeMy WebLinkAbout0148 KETTLEHOLE ROAD > � r • i P pi A , . U r 1�® NO. 152113 ORA MAN 00 USA• • . Ilk ACi ivc �i a a Application number...yGa'1 .� 3. . ' qI f 6 q" OCT 11201 Fee ............../...................... ............. . ... ... .......... BAEG�AM� ��i�l �-1� �N�iIV�iN�L�g Building Inspectors Initials............... ...................... 'F�lMA"I Date Issued..................101H.] ............................. Map/Parcel..../.Q..cj.......1..1.3.�......................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOW S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: �� �, �.�� W F6� NUMBER L STREET VILLAGE �y Owner's Name:� �ly /l� fC� o Phone Number_-e a/-,W—�g✓ Email Address: Cell Phone Number d06— �O ✓ Project cost � Check one Residential + / Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize RVff ro to make application for buildin permit in acc ance th 780 CMR Owner Si a ( Date: o Q TYPE F,WORK 59 Siding Windows (no header change) # /Q'��0 Insulation/Weatherization Doors (no header change)# Commercial Doors require an inspector's review ® Roof(not applying more than 1 layer of shingles) n _ Construction Debris will be going to j j�J^'� G� / � ,a�`� �V z� CONTRACTOR'S INFORMATION Contractor's name �a�� e��00,50- --o Home Improvement Contractors Registration(if applicable)# / 6 (attach copy) Construction Supervisor's License# SST��� ��o S (attach copy) �LotJ a J 4one number Email of Contractor � d , �o ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ r *For Tents Only* Date Tent(s) will be erected Removed on number of tents total Does the tent have sides?Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 201bs. or> Yes No____, if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at.your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. ' Signature Date APPLICANT'S SIGNATURE Signature- Date All permit applications are subject to a building official's approval prior to issuance. t Application number................................................ S� Fee ....................................:......................................... s � s y , s Kga Building Inspectors Initials....................................... DateIssued................................................................. Map/Parcel.............:................................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0 Siding 1:1 Windows (no header change)# 0 Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review ED Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION i Contractor's name Home Improvement Contractors Registration(if applicable).#:_:- (attach copy) Construction Supervisor's License# a h'co ( PY) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. I o�gZQ,��O1360 O\a�tiJ�`� L i i ComMonwealth of Massachusetts t f Division of profe I l nd Standards Board of Building Regulations� Construes Expires:0512412020 • Cs-039868 ;+ ROBERT J GLOVER pOBOX703 02648 MILLS MA MARSTONS -� ,;•.41•� �\�. Commissioner The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' _ 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip-A60 Ala< crzG 4/19 Phone#: <% 08 Are you an employer? Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. &Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h'• 9. ❑Building addition [No workers' comp. insurance comp. insurance.t required.] 5. ® We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I LE]Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.0 Other comp. insurance required.] "Any applicant that checks box#1 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. lContractors 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,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for m,yy employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: y7 '�I tJ �a (v� <;;-,�'`O Expiration Date: Job Site Address: /u� 7�'w 6-f, City/State/Zip cgYOeu�/W�s� � 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 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. Be advised that 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 the i e ialties o perjury that the information provided above is true and correct Signature: Date: Phone#: \� `7�e,_e-2 — &- ;7 9 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing 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#: f DATE(MM/DDKYYY) ACCORo® CERTIFICATE OF LIABILITY INSURANCE `.� 05114/2018 „ 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). PRODUCER CONTACT NAME: Marie Raymond OCEANSIDE INSURANCE GROUP PH ONE , (508)775-0500 aC No): ADDRESS: Made@oceansideinsurance.com ADDRESS: 52 WEST MAIN ST INSURERS AFFORDING COVERAGE NAIC$1 HYANNIS MA 02601 INSURERA: TRAVELERS PROPERTY CAS CO OF AM 25674 INSURED INSURER B: R GLOVER BUILDING COMPANY INC INSURERC: INSURER D: PO BOX 703 INSURER E: MARSTONS MILLS MA 02648 INSURER F: COVERAGES CERTIFICATE NUMBER: 268824 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. INSR TYPE OF INSURANCE ADDL SUER POLICPOLICY NUMBER MM/DDY EFF MPIOIIODLIC EXP LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RERTF5 CLAIMS-MADE DOCCUR PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑PRO ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COEa aMBINEDcciden SINGLE LIMIT $ t _ ANY AUTO BODILY INJURY(Per person) S ALL Or SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTYDAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA I" HOCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE N/A AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X STATUTE ER AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNER/EXECUTNE YIN E.L.EACH ACCIDENT $ 500,000 A OFFICER/MEMBEREXCLUDED? NIA N/A NIA 7PJUB2E66336418 01/15/2018 01/15/2019 (Mandatory In NH) EL.DISEASE-EA EMPLOYEE $ 500,000 If es,describe under 10ESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached B more space Is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main St AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Tni Da aniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD h �T i / i r ``h i i k I� I � p 1 r v .. � + � co�� sTO � e ==p j � ice ✓ awn i At t Yt 'r t y `I 0 I '' - _ �y�- eo J; �� ��_ - - `"� 1 - - - v�, _ Town of BarnstablePermit: �F1NE 1py, Regulatory Services ate: Thomas F.Geiler,Director EARNSTABLE, Building Division Peter F.DiMatteo Building Commissioner ��'f N1Py A 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: M V"0 r7 Phone: 50Ft. 3 7�--U 6-7 Install at: 1qf rtAfPOU lz . Village: �/1�- g A✓✓�S� lo� W. 6 oLxti le MR wbbg' Map/Parcel: Date: Stove Z nd. i(e �2 N - A. ew/Used tv► Ct or �Yev►ous ! B. ype: Radiant/Circulating '(,e C. Manufacturer: S 5 Lab. No. I Y y'tc 1oy? fi '- D. Model No.: jf(aft oS,9 Inyed Chimney L� A. New/ xistin If existing,please note date of last cleaning) aOOO B. Flue Size ©_ -4 C. Are other appliances attached to Flue? ND D. Pre-fab Type and Manufacturer —_ a E. Masonry: Lined/Unlined <' m ; o Hearth Z u A. Materials: f i'a- = W B. Sub Floor Construction: — rn Installer Name: Tdd N. NIel'kVsoYl Address: lye %L �IPLioI� /�a Phone: 5M• 3 75-- Ol h Z Location of Installation: S'arne— APPROVED BY: Please make checks payable to the Town of Barnstable *This constitutes an official stove permit after inspection, photographed, and approved by the Building Inspector Q:forms:stove Rev122801 �2 f h oc7Q JL �P'l�t"QTZ Pm2 I tu 2 � l ,CATION REPORT TIME: ,01/02/1997 11:11 r NAME: BARNSTABLE BLDG DIV FAX 1=508-790-6230 TEL 1-508-790-6227 01/02 11: 06 915084300631 00: 05:39 02 OK STANDARD i f 1 P\ The Town of Barnstable Permit# 3Si Massachusetts - - aAernaI Date KAM SOLID FUEL STOVE PERMIT 16196 Fee This constitutes an official stove permit after inspection and approval by the building inspector. Owner��yi� R. LLI S Telephone no. Address of Property -TLL ,/JULe- /ZD Village 1-3 Q A2NS7�BLL Location and Stove Type_ cs CAS�Ll� — K O At v PIzi-A Date: l`' = Building Inspector The solid fuel burning stove at the above location passed: failed: inspection. f Xt 066 , sessor's Office(lst r) Map 101 Lot 0 3Permit# � � -Z C/Conservation Office(4thlr) 2 J� Dade Issue a� J �B rd of Health(3rd floor)(8:30-9:30/1:00-2:00) 7�'-/�� 4 i n �"� 'Feed r 0 . Engineering Dept.(3rd floo House#1 PI Admip..Bldg.) -BABNSTABIE. t. D 19 1 v�67.'71 LED P WITH Tl �- TOWN OF BARNSTABL40ONMENTAL CODE 41ND Building Permit Application TOWN REGULATION Project treet Ad ess Y$ ktl ZTl_�_ POD& - (2&ID Village nnBS/�J�TgQ , Owner J 40)D l� , a'LL.1S �u�N 7 (j -►Address i 7 SO/JS t r ,C4A-d- r g 4 2A.JSVO&Z Telephone 3 (Z- 9I 76 Permit Request _'584Z -,D 6 k Ma h4ND ISA- &2/ p0�, Total 1 Story Area(include 1 story garages&decks) square feet Total 2 Story Area(total of 1st&2nd stories) square feet Estimated Project Cost $ �/ 0O, 0 ' Zoning District 0 , QWWbTMLIL Flood Plain 1J0 Water Protection AAA Lot Size .99 A CAL Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use R Ls i()ESL Proposed Use 1D&JTI AL Construction Type wooD - STICK (-/ZAM( Commercial Residential Dwelling Type: Single Family L Two Family Multi-Family Age of Existing Structure 17 y/zS Basement Type: Finished Historic House Unfinished Old King's Highway yts Number of Baths Z ZZ No. of Bedrooms 3 Total Room Count(not including baths) g First Floor S Heat Type and Fuel F14w - CqS Central Air NO Fireplaces Aoi Fog LJ000 S70v/ . Garage: Detached Other Detached Structures: Pool Attached QmQLt2 Barn — None Sheds `- Other Builder Information Name 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 B,o 2iis-ro 3Ll- SIGNATURE 1?. ZX� DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED p MAP[PARCEL NO. �a ADDRESS VILLAGE OWNER e 4 - DATE OF INSPECTION- ID FOUNDATION FRAME ',�✓�- INSULATIONrY FIREPLACE ' ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH _ FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT- ASSOCIATION PLAN NO. ® r The Commonwealth of Massachusetts Department of Industrial Accidents Office 0/10=1192110nS ; 600 Washit ton Street _ Boston.Mass. 02111 I Workers' Compensation Insurance Affidavit he nformation: Please PRINT lebtbl _, s -' name• _DQV I locitions 1` 9 7ra— oLK— 20qc) J1Y 4-J, 13/d2N 5-r,46L4 ph&i( 3 b Z. —�17b I am a homeowner performing all work myself. e " I am a sole proprietor and have no one working to any capacity I am an'emplover providing workers' compensation for my employees working on this job. company name: ' ail tl ress city: phone#: insurance co. no icy# ,. ,,:a.'-:::•. ..a,,. ,_: «,,,a.,, .��,.;t-.. ..a. c,o�.�w<.=-�-f.rn ;.e-•�s•;-•,;-q!-tom..: I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed.below who have the following workers' compensation polices: company name: address: city: phone#: insurance co policy# ^e'- r - nv�-•�_.:rvs�=?'�?'i T+ti�f?:TMa P ,T� '+xt�•7�e * ' ''= a'stis!.�a•=�,'.-^ *r company name: address- city: phone#• insurance co policy# Atiach'tAdM6 al'sheef if necessa ' 4 rt- '�+ motif ' tc�' '� ` - - _ cess_rYs:-.. :. - .tom: ..,;. �— - - - tea— Aim.F:. .: Failure to secure coverage as required under Section 25A of IVIGL 152 can lead to the imposition of criminal penalties of a fine up to$1.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herehl certnifr under the pains and penalties of perjury float the information provided above is true and correct. Signature �J�/� �• Date Print name 7190 I Q 2. U-45 Phone# (�08- 34 2—Rl 26 7Dcparfmcnt _official use only do not write in this area to be completed by city or town official city or town: permit/license# nBuilding�LiccnsingO check if immediate response is required ❑Selectme[3Health Dcontact person: phone#; nOther Re"sed 3195 P1A) tMe . ° The Town of Barnstable WAS. S65peg Department of Health Safety and'Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph Crosson Building Commusstonr Faac 508 775-3344 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,wnversion, improvement,,removal, demolition, or construction of an addition to any pre-cdsting 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 C=Vdons, along with other requireme- Type of work.S N Q D o Rlha q (OMai Da 2cy Est Cost ySQa. -2 Address of Work: Oaner.Name: '�)&uif) R tuiS 4- NANCTt,4 60261-21 —"�U/S Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law _Job under S1.000 Building not owner-occupied =Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH L7I7REGI3'TERED 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 ' ate Owner's name • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print.;-.. DATE JOB LOCATION ' Roo - 'Number Street address Section of town "HOMEOWNER" -D1 fl •N►4 Pblk .G0IJOM PLUS S6z- Name Home phone Work phone PRESENT MAILING ADDRESS 17 SvNsk.Y kkik lBg2�s1 E' n9A OL 6.-34C> ity/.town State Zip code The current exemption for "homeowners" was extended to include owner-o cupie 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(sl 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 Offic on a form acceptable to the Building Official, that he/she shall be responsi- for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes ..responsibility for compliance with the S 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 requirement. 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 Rome .Owner performing work for which:.:-'a.Wfiildin permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that Home Owner engages a persons) for hire to do such work, that such Home 0 shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are .assumin the responsibilities of a supervisor (see Appendix Q. Rules and Regulatio: for licensing Construction* Supervisors, Section 2.15) . This lack of aware 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 Supervisor. The Home"Owner:'ac as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities,. communities require, as part of the permit application, that the Home *Ownc certify that he/she understands the responsibilities of a supervisor. On last page of this issue is a form currently used by several towns. You me care to amend and adopt such a form/certification for use in your eommunit i r i a f i t � '��r�.4—�•c-r_�`1,��.�C3{T ��l��l���- I xf.3 µ r.� /� � / �`'��� .�. li. �t � N -.•�iS .�ti > IL x i� � ��*,� .+�x tk�r"t i 3a•rBi�.r�wr'ti'�"��'dr'��is �.'>•L'M'z•�r a i—af, .•S y a � f� t'ay.1- �e-y' tee" � t � � , ��t�I•'1�lRal�J�J� Y3 t3Y'��dc x'!fi 1't..,wy��` .r^.r r"r�.e+n'"�a?''% �' +�'� • C f i r Ul - _ LrL i rR(Wr FLEVAi7h&l A1hNT fLxyAr OJ I 1 • DOR MEt {FA4lnEQ5 pD"" ADDITID�/ Y Y •'_1%D.. • ''A a!1.SPARDU,IIAUWE-7'c4&�04 i r NLn Af FUALT RCOF STn6 04 ANCA DYER ISLE FELT b!/S.bW—C4L E4b-(G /11LIL V(.1.YT E066 Qr V"VIWI—f ADD GAO LE VtNT TD CV11T 641" 1 EArrJrlp. 14 U.-sl 31Y'A]•( Idooi�..( _ Ir irAyciA .w,cH V�IrILyDPW.G 4CEN5 / lO FF IJ fAAW V R' '!l li T. -PE 1IVT0 a-aa4.TOP PLATE 4 FRONT CIA/ -Tw Fxr L 'S,.la—M -�'.ax8 McA0E4 r-I• 3"..w OFG FLOOrC..... / NATKM -. • . x4y P IVOC_ 7-v�4- / •\ 3 yrv(y r,Ift S'nw 1 Ru 1N ylDa J+LL ..MATCH 1 1a1 IAS Cbv$ • % _ Z+IY TOE 506 FL MATCH Ex•ST A(ATCfI Y• ' w3.v (� a SA21iLE PoQ.H Y .ix ro 14 (Ar T rD IxB FAG/A._ 4°0.Es 1.4 7YRr- MA7LM SOFTIT W 4i V L.uAu.aS7• .P.T. 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A t ttL�i _ �` 1I�WIWI III I �J � I Fl ' 1 -4 ,ACT F,BVAr�ewl you gj"-l_p• REAR ELEyA-"o-j _ • S .. - Application to Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTI FICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction- ❑ New Building [Addition ❑ Alteration Indicate type of building: [House ❑ Garage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY I DATE �J ADDRESS OF PROPOSED WORK KekIe-�I� -ao it a ASSESSORS MAP NO. v OWNER Avi-o A. E'Ii-4 Avo 410g01i A. _ovsN;- ASSESSORS LOT NO. HOME ADDRESSrI Swi:0, hi: � 'Sh31 �iM3a TEL. NO. 3L' dl7- FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet.if necessary). SEt' l�TrA��I�D 5 NFL-T AGENT OR CONTRACTOR S14MC-1, AS /4Q6y-6 TEL. NO. ADDRESS DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs,,give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). ADD Do km6Q, W rrq 8RTN /�/JD fA217)L2 fop ^4TaOLs 7_0 Signed z "/, Owner ontr ctor-Agent ` Space below line for Committee use. Received by D.C. p D Date-` L`i` i The Certificate is hereby '' Date l— 0f "(s l Pifie 1 6 19.gs A' ........ R vim, y :oa ;'S ii HINAY Approved . ❑ IMPO ANT: If Certificate is approved, approval is subject to the 10 day appeal period provided in the Act. ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate of Appropriateness is required are: (application for demolition or removal is a separate form). 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered including windows, doors, siding, roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition — show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion .of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached to these applications. An application is not required when repainting existing colors, changing to white, or using colors approved by the Town Historic District Committee. 3.. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the.event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of th- premises on which they are erected or displayed in a residential zone. 4. STRUCTURE: An application is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles, hedges, gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10 day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied, application will not be accepted or acted upon. Copies of the Act establishing the Regional Historic District may be obtained at the Town Hall. 2� Town of Barnstable Old King's Highway Historic District Committee SPEC SHEET FOUNDATION AJ SIDING TYPE L/LNQ SµIlu L COLOR 'LL&01 CHIMNEY TYPE N COLOR ROOF MATERIAL 3 7A8 - ASPHALT COLOR BLAc,IG PITCH 3 112- WINDOW S aj¢& 8 P#A)L 57DQ,41 SIZE TRIM COLOR G 2gy - SAME /lS o,,j 2kSr ,y()USk DOORS — COLOR SHUTTERS N`A GUTTERS w4171- ALJM i N JM AS oN jZkS_/ DECK I A2ESS� 7r�A GARAGE DOORS / COLOR �— NOTES: Fill out completely, including measurements and materials/colors to be used. Three copies of this form- are required for submittal of an application, along with three copies each of the plot plan, landscape plan : and elevation plans, when 8 [j applicable. Plot plan need not be "Certified", D but ., should show all structures on the lot to scale. SPECSHT �a(yyvG,��1- - --------- ----- --------- "IV ------C -- ley 1-6 '?IScN'1 '�/ '`,/" gip-+ ot�,p.) •� �ITI�/ o.� Pa 9 ,.,,gr,r�s�+,f,�,� �••raj �►�'S�'� �1� -�.nFo�� •y a�.�n►'4,� �' •i„r "�1�� }+�c 4MORTGAGE INSPECTION PLAN JOB # ADDRESS A-YB A""6 77ZE /Y0.4 of /?,0 ziP VH_LAGE GL-0st TOWN L�At NS224_8L APPLICANT � ///� �• / !'f}/V�.!/�J� 49i"S/�/S DEED REF. �1W �/40 ASSESSORS MAP /09 PARCEL PLAN baw add ..'.00 LOT#�� .i i o � N 7\_ Ad x14 N db0 Zev �y SCALE: 1 INCH = 661) ��— THIS IS NOT AN INSTRUMENT SURVEY THE N COMPLIED BU INGf�' H/ _ZON NG BY—LAW TH FOR BANK USE ONLY. THE NOT FOR CONSTRUCTION, FENCING*, DEED BUILDING SETBACK REQUIREMENTS WHEN DESCRIPTIONS*, RECORDING*, PROPERTY LINE CONSTRUCTED AND THERE ARE NO VISIBLE DEFINITION*, LOT OR LOT COVERAGE AREAS*, EASEMENTS OR ENCROACHMENTS OTHER THAN OR BUILDING OFFSETS* UTILITIES OR AS NOTED ON THE PLAN. THE *requires INSTRUMENT survey DWELLING DOES NOT LIE IN A FLOOD HAZARD _._........ ZONE AS SPECIFIED ON COMMURLTy PANEL DATE L PREPARED XCLUSI LY FOR of o� ARNE �? H. T OJ LA ��SL Ni. 03� a DATE Rl=GIs? SURVEYOR ! CIVIL ENGINEERS LAND SURVEYORS Assessor's map and lot number Sewage•Permit number .......................................................... �FTNET��� TOWN OF BARNSTABLE 1i EAEHSTGDLE, i 0M a' "6 BUILDING INSPECTOR ° APPLICATION FOR PERMIT-TO .= .... �f.Cr.....r...... ......7.? :`.....a!L�,'./. .....r'?.1......s`.i,1....................... I TYPEOF CONSTRUCTION ..................................................................................................................................... ..........................................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location . Proposed Use -...7�.......................................... ZoningDistrict ........................................................................Fire District .............................................................................. Name of Owner ........ .......... ►~ // `17/AJ7 1�Y....Address �?.!?�.. !�� ��...�t�..../i�i3..::..:........................ Name of Builder ///>j/ ^J-:'YY. �7{- / �,�t J 1 �.............................. ...................................................................Address .......................................... ............ LFt Name of Architec ............................. ..........r. ... ...................:...... . r r Number of Rooms rr .................................................Foundation /./.),...,fC:. Exterior FC�:"�!:�...`r'/�t. �/1 ..Roofing '? F- `':r ✓r...+. `.:............................................. _ ............... Floors .............................................Interior .................................................................................... Heating ................:.................................................................Plumbing .................................................................................. Fireplace :.:.''........ ............:e:%..f. 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 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .................................................................................. ` Moriarty, Michael J. A=109 6 � ^, | 20174 l 1/2 story ' i No ................. Permit for .................................... ' m�o�lw �auu1lv �wmll1oo - � ���~ ' dwelling ' ( 148 Kettlmhmle Road ' � Location . .. . ` , ~=�° arnstable ` . � Owner Type of Constr(ction frame� � ' Plot ..................../ 21A ` May 5. 78 � � Permit Granted � ^ ~~.~ of Inspection. ' Dote Completed PERMIT REFUSED \ ~ ........................... lV � | ' � ^'^--'T'7a'—'T---- .�r'—~^--'---.— / ' ^—~-........---^..—.—.-----.------ \ ' � . .............................................. � � | '----'—'—'---^—'~—'---'' � ------------.---. l9 � � . . -------------,...-------.---. / � ........................................... � � > � ` " •e TOWN OF BARNSTABLE Permit No. _______ _----- Building Inspector Cash yJq �O t079. 'r9YPY�\ OCCUPANCY PERMIT Bond ----------- "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Michael J. Moriarty Address R.F.D. #1, f1ashpee, 1,11A 02649 lot i et�,-l.e liol' nc� 1 11F: Wiring Inspector i Inspection date � ��� Plumbing Inspector Inspection date ' Gas Inspector // Inspection date Engineering Department Y� 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. !-// i .....................................................1 19...... .........................................................................................._._...._....._...... Building Inspector .•+ - `.fie' _n 1 b iN iNG RNt. (Y0 Klj� o xrz G N pd to oxq-6 ,u' j ltVIG 0.M tl' t�=4 0, il' 8 x 22-4 N i eR V P ` l L e«:..f F 1, � ' !4 Cl, ip, 1 'St i cne ' �►qo xi. 47 i KIT Et_-V- IN4";_..x,. MR. _ MR5 MJCHAtL _J. N1.CI1UNP_T)/ � :� =G 4 tq4 4—�� . Nt +� ��rr� 9TORn4t. t 000 1 . -- -- - -i i } i c , r � , + \ 4 L 2.11 ` 1�. .1 •. 1 + "M } r4 ( t vh - G, MP C L M V A T R � GtiI � _ � NU E l. Edl� T C. n1 -_ k I. V! 177 a Q0 r�� ' 000 ± X 00 0 u Rd. ROBERT 1 Of, nt dff �p EU R.r CERTIFIED PLOT PLAN LOT ZIA 1<e7'TLENOLE Dr4,b 1 NEW CONSTRUCTION ONLY = -- wT I3Ai4�/5Ti43c.€ TOPS&r... UNDATION IS ( FEET W POINT OF ADJACENT ROAD. SCALE: ` - q-O+ DATE _ . : 1178 LDREDGE EN I CERTIFY THAT THE Fo=J/VVAriat1 CLIENT . SHOWN ON THIS PLAN 13 LOCATEDEGISTERED REt31STERED J08 N0. 7_T.! ON THE GROUND AS INDICATED AND CIVIL LAND CONFORMS TO THE ZONING LAWS ENGINEER SURVEYOR DR. BY: •A-.M• OF BARNST BL , MASS. 33 NO MAIN ST 712 MAIN ST. CH.BY: /�,7', Z3 S- S UTH, MASS MASSSHO YARMO , EET1 OF DATE REG. LAND SURVEYOR 7,9 Asses or's and lot number .. D.1........... .......'map Vet SEPTIC SYSTEM MUST DE -7 INSTALLED IN COMPLIANCE Sewag ' ...�, �.... erPermir, number ............ ................:............. Vd9Tli ARTICLE II STATE SANITARY CODE AND TOWN FTMEt�� CJ BARNS' TOWN OF BARl2 �vy '"LE Q Z is STABLE, c 'IN 63Y \ 0 BU1LDINAG' INSPECTOR Yi► r tj rj �" to •={ � oa C APPLICATION FOR, PERMIT 'PTO ��.. �C '1 � �nY SIN l` 4/�71LY / _f(J y7�E < r w: . aTYPE OF CONSTRJUCTION ..........................................................................................:......................................... N V U�/ co . ....�....7............19�0... TO THE INSPECTOR OF BUILDINGS: The undersigned .hhereby applies for a permit according to the ,following information: Location "'r/...:` ..,......hv7T ... ........l�L� .«J.� ... ? 4?................................................ ProposedUse ....`..peIC.vtoK..? A.C51. 417v*r. .............................................................:........................................ ZoningDistrict ................n.......................................................Fire District ............y.............................M.................................... Name of Owner ,� ����C� L.. ��..�� � tY...Address .z /.. .#�.r.//.! � .f. o -?`1'% Name of Builder ...........................Address co.&.".t............................. Name of Architect 4".9mY..Ow'..a�............................Address S.��T;olVZ Number of Rooms ........../...................................................:...Foundation �,d.�!fU/�, D u/!T.f� � �?................... .... ..... . Exterior L� � 1�. �NI�!T ..GFR.. '}�N�? FS.RoofingC �.. . .. . Floors .mil. w....... ...................................Interior ................6XI/Wa ....... .............,.............................................. 9,47`10- Heatingf �.........................................................Plumbing ................ ................................................................ Fireplace ) ...Approximate Cost i Definitive Plan Approved by Planning Board -----------______-----------19________. Area T.O s Diagram of Lot and Building with Dimensions Fee sr?l ' SUBJECT TO APPROVAL OF BOARD OF HEALTH 3'a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. A Name ./ ... .................. Moriarty, Michael J. . ^ 1 1/2 story ' �o ................. Permit for .................................... single family dwelling ' � -----------.--------------- ' 148 Kmttlmhole Road iocohon ------.--------------- . , . . - ' Fest Barnstable —'----------------^--------' Michael J. ��r�ar�� - Owner . — —�-- � —..-----------.----.—.—.. ' frame _ Type ofConstruction -------------- _ .............. . ' ���& Plot -----.----. �» -------.---. ' ��v 5 �8 Permit Granted ----..�,—....................lV � ' ` . �����, . ' Date of �/—x—.``—.�..���.—.]g ' ' Date 19 . � ^ Completed .... . qjq ZV . _ PERMIT REFUSED . . . ' ' ..------_'..-'—_--._---_.—.. 19 ^ . ~ ^ ' .--------.....--.....—.—.—..---.--. //.---.--..—.--.--.-----..'---~-.—. . . .' . ..~-----.-,-------...—...'..—..--...�., . —.—~..---......~......—...r.^.....—.. ' . . . " ^ ' ---------------- lV Approved . ' -------------.._....—,-----.,— � . ^ -------------.------..--~~... -/ ` . ' I _ kD It 74 -TE Y-. l_ - } D;'�(' Mi� I�. � ,�.:\IC'.M E�.�, i iF:�!-.? ,� i� !^? 1 "f ►L>A.I SCALE: ` !�- Q ., APPROVED BY: DRAWN BY DATE: N+" !r REVISED DRAWING NUMBER � l _ 19 X 24 PRINTED ON NO.1000N CLURPRINT• • • , N;iu.) A5F -[ YLco 7 H EX L; - a r. IvrE tv-1, 0 - it`-� I y- 5 - /� p d�►2 - Rx 4 TC i� FL,A i a dam. ► E "�- i I F�iarST CI�P y,,� �. Per,/ 1-ID try [ w s'7eJ f , 1 , � 11 „ - _ ,. GOpe- N � EL1 C_ �x�o� rV"©< fir, -r A 40bi E-s! I w.r--- ,l dyrto� r-•-- --- �... P^ATE�d J G 1 T �v y QOi 1 P _,LW T j5 Tf. I J i II ,// ll� tW K.Jr,fr 11 __III i { A t o P max 8 I (c. 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