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0007 WAGON TURN ROAD
Oxford® NO. 1.52 ORA ESSELTE 10% TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map.. D Parcel D�� Application # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee J� Date Definitive Plan Approved by Planning Board Historic - OKH Preservation / Hyannis — Project Street Add ss �� 2 Village 67 ha h Owner,Je-Uka JQ12 i Address Telephone-SZq 76 47 Permit Request C Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �o _Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 2--l" Two Family 0 Multi-Family (# units) Age of Existing Structuur ' C Historic House: 0 Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: O11ull ❑ 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: X existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas (210il ❑ Electric ❑ Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing 0 new size — Barn:_.0 existing. ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Othe"r_:f L "-"' 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 Telephone Number 7 �O c Address h,' License # a lkn r M 0 1/,-"-,2 Home Improvement Contractor# Worker's Compensation #U)Uz 50055q&l M4A ALL CONSTRUCTION DEBRIS RESULTING OM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE a FOR OFFICIAL USE ONLY e APPLICATION# DATE ISSUED .MAP/PARCEL NO. l - � sy ADDRESS VILLAGE OWNER DATE OF INSPECTION: it -KFOUNDA ' FRAME -- •--_. __ .,_ _._.. ._u __ :INSULATION. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING.!-' -ems= 1 DATE CLOSED OUT rf ASSOCIATION PLAN NO. r. i .� Town of Barnstable Regulatory Services > -Rich%rd'V.Scali,Uiirtcior �' ►`�� Building Division Tom Perry,Building Commissioner 200 Mom►Street,I1yumis;r2A 02601 r"viv.towe.barnstxsb nuLus Office: 508.862-4038 Fax: 508-790-5230 Property Qvner Must Complete and Sip 111s Section JLU S �d r, gSIGit as CJ per pf the- ubiea property hereby urhoiizh to act on my.behalf, in all matters relsaive to work authoiim b}=r6 building pewit application for WA&mr,1 -Cy(z4J ?-0 wL-� y2,t--s (Address 6f lob fences =d ih ate r,6e itsponsib :t,-o axe n�>`tea be.filled ter>,.td'brf ere fence�i>� t;d�d all'f> ' inspections ark pe4ormed=4 accepted. a s naof a Signature of,A,ppbaint `n Print Name Print Name .Date Q:FORM S:OXVI\T:.RPEP NUSSI.ONPOOLS i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 Congress Street,Suite 100 04� Boston,MA 02114-2017 5" y www mass.gov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization&dividual): TUPPER CONSTRUCTION Address:546A HIGGINS CROWELL RD City/State/Zip:WEST YARMOUTH MA 02673 Phone#:508-778-0111 Are you an employer? Check the appropriate box: Type of project(required): 1.NO I am a employer with 10 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 shipand have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' insurance.$ 9. ❑Building addition comp.[No workers' comp. insurance P. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑ 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.❑■ Other WEATHERIZATION comp. insurance required.] `Any applicant that checks box ftl 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. Contractors 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 my employees Below is thepolicy and job site information. Insurance Company Name:AEIC Policy#or Self-ins.Lic. #:WCC5005593012015A Expiration Date: 10/3/16 .rob site Address: 7 Wagon Turn Rd City/state/zip: barnstable MA 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 fu4nsurance coverage verification. I do hereby certify t r th pains an penalties ofperjury that the information provided above is true and correct. nat Date: Si ure: 10/13/15 Phone#: 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#: i CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 10/2/2o1s 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 CONEE CT Lora FitzGerald Southeastern Insurance Agency, Inc. PHONE (508)997-6061 FAX o C No:(508)990-2731 439 State Rd. AIL ADDRESS:lfitz@ sout:heasternins.com P.O. BOX 79398 INSURE S AFFORDING COVERAGE NAIC9 North Dartmouth MA 02747 INSURER AArbella Protection Insurance 41360 INSURED INSURERS' OSton Insurance Brokeracie Inc Tupper Construction Co LLC INSURERC: 546A Higgins Crowell Road INSURER 0: INSURER E: West Yarmouth MA 02673 INSURERF: COVERAGES CERTIFICATE NUMBER:2015-16 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 AMT SUB LTR TYPE OF INSURANCEINSD WVQPOLICY NUMBER MMIDDY EFF MNUOD EXP LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000' ,000,000 A CLAIMS MADE OCCUR ENTE PREMISES Me $ 100,000 9520045208 11/1/2015 11/1/2016 MED EXP(Any one person) $ 5,000 PERSONAL BADVINJURY S 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S 2,000,000 JECTX POLICY PRO- LOC PRODUCTS-COMP/OP AGG S 2,000,000 OTHER: I S AUTOMOBILE LIABILITY C MBINED SINGLE LIMIT Eaaod e t $ 1,000,000 A ANY AUTO BODILY INJURY(Per person) S ALL OWNED X SCHEDULED 1020009389 12/1/2014 12/1/2015 BODILY INJURY Per accident $ AUTOS AUTOS ( ) X HIRED AUTOS % NON-OWNEDPROPERTY DAMAGE AUTOS Per accident S Uninsured motorist BI split limit $ 250,000 UMBRELLA LIAB OCCUR EACH OCCURRENCE g A EXCESS LIAR HCLAIMS-MADE AGGREGATE $ DED I I RETENTIONS 4600058368 11/1/2015 11/1/2016 $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE 1-1E.L.EACH ACCIDENT I S 1,000,000 OFFICERIMEBER B (Mandatory In NH)IXCLUDED7 u N/A WCC5005593012015A 10/3/2015 10/3/2016 E.L.DISEASE-EA EMPLOYEd S 1,000,000 Ups,describe under IDCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT I S 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,maybe attached if more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE For Information Purposes Only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ashley Paiva/AMP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD INS025 r2ouciii -- � C�r�2ri �I22�anz�ric���il� >��C>rG�x:�.��c�c��•e��; Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston,Massachusetts 02116 Home Improvement Contractor Registration Registration: 178434 Type: LLC Expiration: 4/16/2016 Tr# 251075 TUPPER CONSTRUCTION CO, LLC. RICHARD TUPPER 79 B MID-TECH DR. W. YARMOUTH, MA 02673 --- — Update Address and return card.Mark reason for change. Address ; Renewal F7 Employment Lost Card scA 1 a zoanosin /fir�r.��riiti�iicrn�l�r�"'a�itxir•�n�el/; ._._...-__.�_ __._.. .__ -. - - - ---._ _....._.._.... Office of Consumer Affairs&Business Regulation License or registration valid for individul use only VL04", OME IMPROVEMENT CONTRACTOR before the expi date If found return to: egistration: 178434 Type: Office of C airs and.Business Regulation plration: 4/16/2016. LLC 10 Par aza-Su'a 170 Bo ,MA.021 TUPPER CONSTRUCTION CO,LLC. RICHARD TUPPER 79 B MID-TECH DR. _ Q W.YARMOUTH,MA 02673 --- —— Undersecretary o. j ithout signature I 1 Massachusetts -Department of Public Safety BUILDING PERFORMANCE INSTITUTE, INC Board of Building Regulations and Standards 107 Hermes Road,Suite 210 Conirrucrion Super-,isor Malta,NY 12020 , License: CSi•069058 �- (877)274-1274 ra' ' ...:° rAuw.bpi.org Richard S Tupper= �, 546 A.Higgins Crdweill'a _ West Yarmouth MA Richard Tupper i, 2'' •� BPI ID#:5040M Expiration ' Commissioner 12/31/2016 - (Sff REV ERSi:SIDE FCA t�E5i6�IhiiC;:S nVn��ir=•+i=�J�iCzi Unrestricted-Buildings ofany use group which contain less than 35,000 cubic feet(991M )of CERTIFIED PROFESSIONAL DESIGNATION EXPINATION DAT= enclosed space. Building Analyst Professional 5/1512018 Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. For DPS Ucelting information visit: www-Mass.Gov/DPS - BUILDING PERFORMANCE INSTITUTE, INC 71 TOWN OF BARNSTABLE 20,139 e - Permit No. Buildti g Inspector .... Cash 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 Stephen Wilcox Address 6 Wagon Turn Rd-, , 1-%frnstable lot #61 `7 Wagon Turn Road, West Barnstable Wiring Inspector [���/ � Inspection date Plumbing hispectorl� C`> Inspection date Gras Inspector ! y Inspection date /iEngineering Department, Inspection date/ X1 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. - az��el _.............. . ..._. ......_..__._ ._, 19_ .............. . ... -- Building Inspector _ �L) Town of Barnstable .*Permit# Expires 6 months from issue date Regulatory Services Fee `3 • snxxsrrnsrZ Richard V.Scali,Director Building Division X-PRESS PERMIT Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 AUG 12 2015 www.town.bamstable.ma.us Office: 508-862-4038 TOWN :Bs^sWatR 43LE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number (OS / 23 Property Address : Wkbol� —rV/uJ a&� 9WZAJ&IASLf-- 44A Z)��p esidential Value of Work$ (4 - Minimum fee of$35.00 for work under$6000.00 ,Owner's Name&Address _RN/L40 lljm �nJfctq o� "�1SLry 20 � — (SafL�v fsT Asa�E AAA oZ(aG8 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) orkman's Compensation Insurance Check one: ❑ I 'a sole proprietor c[ 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) Rp stde lacement Windows/doors/sliders.U-Value 0. 30 (maximum,32)#of windows #of doors: � ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE /' r QAWPFILESTORr r ildin permit �\ERES .doc Revised 040215 I � lWe Commonwealth of- assachusetts Deparhment of Industrial Accidents Office of Investigations 600 Washington Street Boston,CIA 02111 tvrvtu masmgovIdia Workers' Campensatian Insurance Affidavit:BgildersiContractarsIFIecfricians/Plumbers Applicant Infarmatian Please Print Le�My Name(B sst�gars annndividnal}. 1 E�16A- A&ess: I- L✓ACyN T a2s) f Z- LA k--� (;-7 i W-A-3 Le /htA z Z(-Co� City/Stater: Phone- !�bQ - --t-5t� -(0 1 c3 Are you an employer?Check the appropriate box: Type of project(required): 1_❑ I am a employer urith 4. ❑ I am a general contractor and I employees(full and/or part-time).* have lured the subcontractors 6_ ❑New consnuctio4 2.❑ I am a sale proprietor ors. listed on the attached sheet. 7- ❑Remodeling ship and have no employees. These sob-contractors have 8. ❑Demolition working for sue in any capacity. employees and have woricers' q_ ❑Building addition [No ' comp.insurance comp.insurances red-' _j I- ❑ We are a corporation and its 14❑Electrical repairs or additions 3. )ama homeowner doing all work officers have exercise d their 11-❑Plumbing repairs or'additioms sel€ o workers' right of exemption per MGL � � - 1?.❑Roof repairs insurance required.]i c.152, §1(4k andwe have no employees-[No workers' 13.0 Other comp.insurance required.] ;;Any apphcsTedSr checksbox r'.fl mm—a—kc Maloutthe seChonberowshowing dwir�eW campaxsatioupork-y infnna6m �H'oJmeowners who submit dus a5dmit mdic=g tbey are doing all wol and then him outside contractorsamst submit anew affidavit indicatm.-such. TConnactors that check this boat must attached as additional sheet showing the name of the sub-contmum and state whether or not those adities have employees.If the sub-am actues have employees,tfieyamst-pm dde their worker'ramp.policy number- lam an eiiipiny)er that ispror�iditg it�orkers'cortgwLsaliati ituvranceforizzycarployees. Below is the pa8cy and job.rite information. Insurance Company Name: Policy#or Self-ins.Lic-#: Expiration Date: Job Site Address- City/State/Zip: 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$1,50Q00 andfor one-year imprisonment,as well as chtil peaalties•in the form of a STOP WORK ORDERand a fine of up to$250-00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Inves4 gations of the DIA for insurance coverage verification. I do Izersby/erWfy umdar tTre pain s azzd psrralfies ofpetjury that the inforztza#ioz>prod abm�e i true and correct Si /►itJil G/t Date: v �i pih/ne ik v Ojj't 9r,zrse arzTy. Da not write in this area,to be caznpleted by city arton�n o,,Ij4ciat City or"Town: Permit/License# Issuing Authority(circle one): 1.Board of$ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: I Laformation and Instructions Mjassarhuscft Ceaeaal Laws chapter 152 regoaes all=Ploy=to provide workers'compensation for their=ploy=,,* � pm suantto this sty,an.en playee is defied as."_.every Person in the service of another under any contract of bite, express or implied,oral or w ." An ewWL7ye3-is defined as"an individnal,pardnership,association,corporation or other legal entity, or any two or more of the foregoing engaged in a Joint enterprise,and including the legal representatives of a deceased employer,or the r meiver or trustee of an mdividnal,partnership,association or other legal entity,employing enPloyees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the - dwelling house of another who earrploys pessans to do maintenance,construction or repay work on such dwelling house or on the grounds or budding apprn-[rnant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(S)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings iu the commonwealth for any applicant who.has not produced accepts-ble evidence of compliance with the insurance.coverage required-" Additionally,MGL chapter 152, §25C(7)states"Neither the commanwealth nor any ofits political subdivisions shalt enter mto any contact for the performance ofpublic work until acceptable evidence of compliancewith the insmance._ requirements of this chapter have been prrsented to the contacting aufhoritY" Applicarrts Please fill oirt the workers'compensation affidavit completely,by cherkiag the boxes that apply to your sitnation and,if necessary,supply sub-contractors)name(s), address(es)anddphone number(s)along with their certi:Facafe(s)of inc mmc.e. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partaers,ate not requited to carry woikers' compensation iasorance. If an LLC or LIT does have employees, a policy is requited 13e advised that this affidayit may be subm_ittE-.d to the Department of Industrial Accidents for confnmation of insurance coverage. Also be sure to sign and date the affidavit . The affidavit should be retnned to the city or town that the application fur the permit or license is being requested,not the Department of La-dLi al Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-inslz<ed companies should enter their self-irs m=ce license number on the appropriate line. City or Town Officials . r - Please be sure that t3ie affidavit is complete and priated legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant_ Please be sure to fill in the pennit/Iicease number which will be used as a reference number. In addition,an applicant that must submit multiple pennit/Hcense applications m any givea year,need only submit one affidavit indicating current policy in��rmation if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)-"A copy of the affidavit that has be=officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (Le_ a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would at to thank you in advance for your cooperation and should you have any questions, please do not hesifata to give us a call The Department's address,telephone and fax number. The weslth of MassachuseM , Delta dmenfi cif luduizial AoridentE Office of ktve&#ffatio.. Bastou�MA 02111 Tf,-L:g 617 727-4900 Qxt 406 Q.r 1-977-MASSAFF, Fax 9 617-727-7749 Revised 4-•24-07 _ma-gQvffa- r THE r, snxxsrwsrA 1 ,�� Town of Barnstable prED µpl� Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date - Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:IWPHLESTORMS%gilding permit formslEXPRESS.doc Revised 040215 Town of Barnstable r. Regulatory Services oFsME rO Richard V. Scali,Director Building Division t &4SNSrABLF. * Tom Perry',Building Commissioner KASS. 163¢ .m� 200 Main Street, Hyannis,MA 02601 �lEb � www:town.barnstable.ma.us i Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION DATE: - /`D Please Print / JOB LOCATION: �✓�6 OA) _TVeiN— 2--E>A-C�> I/LC-___V bl_,a, jZ_- number r street village "HOMEOWNER": L NA) - R63 �'b� - T��_8S Z3 name o e phone# work phone# . CURRENT MAILING ADDRESS: hA&-0N TU/Z.ti1 24D city/town a 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"homeowne?'certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and r quirements and that he/she will comply with said procedures and requirements. -4 Sign e of wn r Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to.comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules &Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. . To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Parcel Detail Page 1 of 3 r Jan 9. 1659. 1. Ba[iNS FABLE ll <- `y __ Logged In As: Pa rce I Detail Wednesday,August 12 2015 Parcel Lookup Parcel Info Parcel ID j�108-023 Developer Lot ILOT 61 Location,7 WAGON TURN ROAD] Pri Frontage i,266 Sec Road ---—�c3) Sec Frontage wI Village �WEST BARNSTABLE I Fire District iW BARNSTABLEI Town sewer exists at this address No I Road Index 1772_ G",3 ���Y it !✓ _,."_-.,,-.:�. Asbuilt Septic Scan: Interactive Map 108023 1 w Owner Info Owner(MARK,JOHN J&KATHII co- o %JANNEY,STEVEN G£I wner streetl 7 WAGON TURN RD I street2 F I city I WEST BARNSTABLE I state MA SY�= I Zip 02668 -Y M� I Country I Land Info _..._.._......._..........-.............._.............................._....................................................................................___..................._......... ........_......................._...__..._..._.........................__._.................................................................................................._............................._..................._-_... Acres 1 1 0.81 (Use ingle Fam MDL-01 I Zoning RF I Nghbd 0106 Topography Level �I Road Paved Utilities ,G s ell,Septi I Location - Construction Info Building 1 of 1 Year rry19-7T p 9 - Roof Gable/Hi Ext Wood Shin le Built If I Struct ^ —I WallLiving g ,2026 Cover _J Roof Asph/F GIs/Cmp Type Area None Area � - t. 1 Style Colonial wall Drywall �� Rooms 4 Bedrooms s 12 Model ;Residential I Floor Carpet ) R oms 2 Full-0 HalfI CAS ___ OUT 14 Grade Average Plus I ype Hot Air I RoomsTota �8 Rooms I ii stories 2 Stories Fuel Heat Oil F eiion Poured Conc. Dross Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 1/1/1979 Dwelling B20969 $0 1/15/1980 12:00:00 AM WB 2 STOR Visit History Date Who Purpose http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6131 8/12/2015 I Parcel Detail Page 2 of 3 7/24/2006 12:00:00 AM Paul Talbot Meas/Est 8/29/2003 12:00:00 AM Paul Talbot Meas/Est 2/22/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 6/25/2007 MARK, JOHN J & KATHLEEN M 22138/331 $0 2 6/11/1986 MARK, JOHN J & KATHLEEN M 5126/31.7 $1 3 6/11/1986 MARK, JOHN J & KATHLEEN M 5126/312 $1 4 4/29/1981. MARK, KATHLEEN M 3276/186 $0 5 7/23/2015 JANNEY, STEVEN G & JESSICA P 29029/306 $375,000 Assessment History Save Year Building XF Value OB Value Land Value Total Parcel # Value Value 1 2015 $179,700 $28,500 $3,800 $152,100 $364,100 2 2014 $179,700 $28,500 $3,900 $152,100 $364,200 3 2013 $179,700 $28,500 $4,000 $158,100 $370,300 4 2012_ $183,800 $28,700 $3,100 $152,100 $367,700 5 2011 $207,700 $6,000 $0 $152,100 $365,800 6 2010 $208,200 $6,000 $0 $154,500 $368,700 7 2009 $240,400 $6,100 $0 $174,100 $420,600 8 2008 $240,400 $6,100 $0 $186,500 $433,000 10 2007 $239,400 $6,100 $0 $186,500 $432,000 11 2006 $211,100 $6,100 $0 $203,800 $421,000 12 2005 $192,000 $6,100 $0 $163,000 $361,100 13 2004 $156,600 $6,100 $0 $138,600 $301,300 14 2003 $138,200 $6,100 $0 $54,300 $198,600 15 2002 $138,200 $6,100 $0 $54,300 $198,600 I 16 2001 $138,200 $6,300 $0 $54,300 $198,800 17. 2000 $94,100 $5,900 $0 $36,300 $136,300 18 1999 $94,100 $5,900 $0 $36,300 $136,300 19 1998 $94,100 $6,700 $0 $36,300 $137,100 20 1997 $93,400 $0 $0 $31,800 $125,200 21 1996 $93,400 $0 $0 $31,800 $125,200 22 1995 $93,400 $0 $0 $31,800 $125,200 23 1994 $91,600 $0 $0 $36,700 $128,300 24 1993 $91,600 $0 $0 $36,700 $128,300 25 1992 $104,300 $0 $0 $40,800. $145,100 26 1991 $127,400 $0 $0 $63,500 $190,900 27 1990 $127,400 $0 $0 $63,500 $190,900 28 1989 $127,400 $0 $0 $63,500 $190,900 29 1988 $102,300 $0 $0 $24,700 $127,000 30 1987 $102,300 $0 $0 $24,700 $127,000 31 1986 $102,300 $0 $0 $24,700 $127,000 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6131 8/12/2015 Assessors map and lot num ec ...D�...�`3. .. ... ........ TMETp�O Sewage Permit number 7 SEPTIC SYSTEM MUST ° o . INSTALLED IN COMPLIA AUSTADLE, House number ......... . .........:....:........:......................... II1�ITi-I ARTIC LE 11 STATE 'oo M639 (, VIVITARY CODE AND TOIN �0M41 a� - �b � r,Ul_ T� �:S TOWN OF BA`RNSTXffUE ° BUILDING •INSPECTOR APPLICATION-FOR PERMIT TO . � �� �� TYPEOF CONSTRUCTION .....................Jf.-Ql........ ....................................................................................... 1l. . ...... ..............192 TO THE INSPECTOR OF BUILDINGS: The undersigned here��byy applies for �a,/permit according to the following information: Location ............�..........�. ........�Ll. ..7... . ..... ........ .1/.:.. 1C �.s / .................. ProposedUse ............ !!.mil//.i'Z ....................................................................................................................................... Zoning District ............... (................................................Fire District W'���?�' ............ .. .............................................................. rr Name of Owner ....n5.* n 1 ..................Address ......!:�7... .....��........ .. Name of Builder �5 .e. ..............................................Address ................................... .. .......................................... .Name of Architect ...................Q.............................................Address ......................................:.:........................................... Numberof Rooms ..................o..........................................`...Foundation .......... G .................................. Exierior ...... .. Shia /�S ......Roofing QsQ�� ............................................ ....................../. ........... ............................................... Floors ............................. .... ............... . Lf P.Q ......Interior IilgwAkA ... g <r� 4&: ..Plumbing .. �tTs Heating ................................. . ... .............................................. Fireplace ................QY..er._.........................................................Approximate Cost ......... ............. ................. . Definitive Plan Approved by Planning Board -----------_______--------___19________. Area, ..../.�b ...5: .:................. ... . Diagram of Lot and Building with Dimensions Feed 75 SUBJECT TO APPROVAL OF BOARD OF HEALTH w.D . aft b� g� b. C/ i-� I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. r Name /iI ...... .................. ^ ?,Wilcox, Stephen A108 23 ~" 20969 � No ................. Permit for ..2..s.tQ��.IwKe-1]J-Ag ' --------------------------' . � ' . Location .�Pt..61.....7..Wagon..TurD..Rd............ � West Barnstable � ---------------'----------- . � Dvvnor 3tP' ,,Q.` ..wj]cox................................... Typjaof Construction .......Frame........................ ` —''`------------------------ plot ............................ Lot ................................ . ' � Permit Granted ......4ngAry'1?...--.-lQ7g -_ _ Date of Inspection ......—.. .........lg � °� Dote Completed —'.���..��.--x�~....... ' � ^ | | ' PERMIT REFUSED � . ' ^---- .—.. ---.. ---------� l� . . .. . ` ....................................... � = ........................... � � ...................... ~ ' ' .......~.~~.~ --------------.. � ' ' Approved ................................................ lq . � ------.--------_,..---------. � ' . . ' -----------.---------~--.`.`. . . Assessor's mop and lot nu .............................................. T HE Sewage Permit number ........................................................ �� ^ ^ House number . .'�� . � NAM --' —'�----------------` 039. TOWN OF ���� �� � �� ���� �� � ��-� �� ^ , �� �� �� �� � �]� BARN STABLE �� ���� ���� BUILDING � 0N 0 @ �� N ���� INSPECTOR ��0N 0 0—�� N ���� �~ =� � �~�~ � �= �� �� ^y APPLICATION FOR PERMIT TO --...�-�� .t --w�. .���....>*--------.------..----.— ' TYPE OF CONSTRUCTION ------ -------.--.—.---.---.-.--.-------_—___ ....�- .��.....'.�.~.~..l9....� | � TO THE INSPECTOR OF BUILDINGS: The undersigned 6ena6y applies for o permit according to the following information: Location ----.-.�--~ ...�--. �.�—�/ ,l,��—..� --.!�'��-�� .}/�p�..���/ /��.�--~----.. | ' _ Use ----£L������l��.-�--------------------------------------------- Pro� � � Zoning District .............. ...-----------..Rne District .......... -.�—���m/"� ---------____ ^ ~ �Nome of Owner —^—.�_ '� 'A66res— ..'—�� ..'~'..-/'r�—&—�p——'���'........ —*—�----- | | � Nona of Builder --'~��� Address ---------------------------- ' Nome of Architect ----------------------A6J,ex --------------------_------- � Number of Rooms ------��.............................................Foun6ohon ---. -�J/. .. -----------. ` � ' Emehor -----''�' .�.�/�.—_-------------'Roofing ----'�/, ���------------_—,' ' / ^ � Floors ................................. '� »f!&����� |n�hor ` _ ' | ----'^—'--7^----� -- --------'--� ----^-----------' | � Mcohng -----'�z-.�.�--..����.�-----------'F1um6ng -------..---_---..------.—___. 'Fireplace _____. L.'��___________________Approximooe Cos .......... Definitive Plan Approved by Planning Board lg----. Area .......................................... Diagram of Lot and Building with Dimensions Fee .............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ^^ ^ ' . . ^ ' � ^ | hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nome .......................................'.......................................... | � | Wilcox, St8p�e' * 23 �� �� D�=l ��No '2� ��— �� . Permit for —n .��.� '=,���� f� 11g --'`--.---------------.----- ' ' + . LocationlOt..G1'..7.. .TurD.�d~___. ����� ������ . Owner .�tggh�O . ' Type of Construction !! ` Lot Plot ' ............................ ^ ' Permit _-nt»6 —""° of Date Completed /PERMIT REFUSED / ' � / ` _. , __. ------' lg �� � ( '-- ---' ........... --- � -- .�`-----. ` ` ---.—~--.----------.------~. | --------.--.—.---.—.---.-----. ` � � / � Approved ................................................ lV ` --------------'-----^^—~'---' i ' ----------^----------^^'--^^'' / 7 ' / ^ � L—or 6 At•� 3 5) Z 5$F �� to o� 0 S73a7o=32 �°,�1 \^/46-70AJ ti R FLLV A'fl0N OF TOP OF FOUNDATION... I CERTIFY THAT THE FOUNDATION SHOWN DOES NOT VIOLATE ANk TING ZONING REGULATION OF '_ �I�j j�g 'I'OiiVN OF ��P+i'tl�ST�L.c � " ` — - -- � �U'/J D A'i"I ON etM TER Pp— r Tv R N R t ��.ti15TP�F SPA.iH. ,.� -1 �Iri'17,7 v�. 9S Nt`aR >�g5oc, INc. � `I&b4+� Complaint Number: 1757 Taken bv: U.LD-ING SERVICES Date: 5 00 00 Map/parcel:- Referred to: UJLD�1G SUBJECT OF COMPLAINT I Business/Occupant'Name: Number Street:;WAGONTURN-RD.-- Village: ,S�11 BARNST&B_L.E COMPLAINT INFORMATION Complainant's Name: NEIGHBOR Address: Telephone Number: Complaint Description: FLAT BED TRUCK PARKED ON STREE— VERY UNSIGHTLY AND SHOULD BE REMOVED. Actions Taken/Results: YES—TRUCK THERE--ONLY 2 HOUSES ON STREET.....WILL GO BACK OR HAVE T,P. CHECK INTO. Date'Closed: F a-9 7 93