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Home My WebLink About0152 BRIDLE PATH Pq ~ Lim o a 7 a P a f i Ct�kRy 21 - tFu�q�+eS �C.�w� foe- See- 3 7&� a 0 j: ' fl O G a , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map (4 9 Parcel 190 Application # d 65-7!;6 Health Division Date Issued Z . Conservation Division Application Fee ��V, 7©� Planning Dept. Permit Fee - Dy Date Definitive Plan Approved by Planning Board p X_ , i'/ Historic - OKH _ Preservation / Hyannis x/�/`' Project Street Address (Sz, Village Owner 0,rd Address Telephone_ "tom 9 Z31S o y 4 S Permit Request Ss-CA) I7-1 gh� S+ ckocML!' gcrot.S hgcc_ oi_ Vey Se�- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 10 , 00 o Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes•,U No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other :y Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing_ new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑ Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number 1 n 4-•Z'Sle- o U 1 S Address k5'L License # Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -Co w>n T ra ws�cc.� 5�•c��n h i SIGNATURE DATE Cf • S ►)� FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER ; k. DATE OF INSPECTION: FOUNDATION FRAME ;. INSULATION a / FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL is GAS: ROUGH FINAL 4 FINAL BUILDING r P DATE CLOSED OUT ASSOCIATION.PLAN NO: Towne of Barnstable Regalatory Services __ h oY roiyy Richard V.Scal4 Director Building Division Tom Perry,Biding Commissioner areas �$ 1. �� 200 Main Street; Hyannis,MA 02601 www town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EIETION Please Print DATE: a.U\. \� JOB LOCAnOK x5l,d�c. P..1'� �• M; \5 number strect village HOMEOWNER":��nr�S'to�1..•� rc.cc)► "1 y - ZSs�'0 44$' n-- borne phone# work phone it CURRENT hLkMING ADDRESS: 9- {4 H� cityhnwn statz rip 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_ DEFINMON OF HOMEOWIqER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned`.`homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations_ The undersigned"homeowner"certifies that he/she understands the Town ofBamstable Building Department minimum inspection procedures and requiremen he/she will comply with said procedures and requirements. Signatara of HomcoWIjr Approval of Bua7ding Official Note: Tbree-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constriction Cont QL HOMEOFYNER'S EIiF1!'IPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of tfiis section(S on I0971=Licensing of eons cfion upervisons) prodi3*6d t—aTXtE(i 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 responsibrlities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the Iast page of this issue is a form currently used by several towns. You may care t amend and adopt such a formfeertification for use in your community. i Q.\wPFn SIFORMS\binldmgpermitformslEURFSS.doc Revised 061313 Town of Barnstable Regulatory Services a RARNf.TAMY f y MARS �, Richard V.Scali,Director 16 Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must .Complete and Sign This Section If Using A Builder . as Owner of the subject property hereby authorize to act on my behalf, is all matters relative to work authorized by this budding permit application for. (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date . Q:FORMS:OwAIF_RPE ZAMSIONPOOIS Ile Commorriveakh of-Massachusetts Departirrent of grulzcstrid Accidents Office of 1mwsdgations 600 Washington Street Boston,CIA 92111 wFvjv.mass`gorldia Workers' Campensafien Insurance Affidavit: BOderslContractorslEIectr clans/Plumbers Applicant Infarmatron Please Print Lecg'h Name(sush3nM rganin ion&I&vidagy- C-V\t-.-Nb 4_C &tCk rCA Address �5Z1, Qa CitylState/Zip= h. ��\ R OZ&4 Phone�' 1'14 Z3`6• o y y 1 Are you an employer?Check the appropriate btaz: ' Type of project(required}. I.El am a employer with 4. ❑I am a general contractor and I employees(full atldl`or part-time).* have hired.the sub-contractors 6_ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ?_ ❑Remodeling s and have no employees These sub-contractors have 1uP8_-Ej Demolition woddrig for me in any capacity. employees and have workers' 9. B.uildiag addition [No workers comp.insurance comp_insuran{f—$ reclnired_] 5. ❑ We are a-corporation and its 1'0'❑Electrical repairs or additions 3.gam.a homeovsmer doing all work officers have exercised their 11_Q Plumbingrepairs or additions mysel€ [No workers'camp- right of exemption per MGL 12_❑Poofrepairs insurance required_]i c.152,§1(41 and we have no employees-[No worrkeers' 13•ffOther rj0t,, 4:rf_ comp.insurance required.) •clay WHcaa�(fist checks box r1 mast also fill out the section below shomng alien wa&eie compensation policy irrFurmanon. ;Any submit This aftidmgf inUcatM.K they are doing all WCak and.then hire aut ade contractors mast submit a new affidavit indicating such- ICanlracWrs that rhxY this box msst attached sa sdditinnd sheet showing the name of the sub-coat zcbo-s and state whether or not those entities hav errPloyees.If the sub-contrectnrshave employees,they marstp=nd their nrorkew comp.pormy numbu. I am an empLq er that ispro-ading workers'cot gmnsafian imniranca for my*empLoyees ffeTocv is fire policy kind job site infor►zatiom Insurance Company Name: x Policy or Self--ins.I.ic.& Expiration Date: Job Tite Addle CitylStatdzip: Attach a copy of the workers'compensationpolicy declaration page-(showing the policy number and expiration date). Failure to secure coverage as required.under Section 25A of MGL c� 1572 can lead to the imposition of criminal penalties of a fine up to$1,50a 00 andror one yearimpFisot;ment,as well as civil penalties.in flee form of a STOP WORK ORDER and a fame 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 ofthe DL4 for insurance coverage ti etifica#ion- I&hemby certify under the andpenalties ai"perimy dhatf ie information prmuded abmv is bite and correct Sitmature: Date: c!• I Phone ik "1'7 4 O Y y Ojj"acial use anTy. Do teat avrite in dais area,to be cainpTeted by city artotcn officiaL City or Town: PernritUcense# Inning Authority(circle one): L Board of Health 1 BuRding Department 3.CRyfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone-#- r. ;- 77 laformation. and Ms&ucfious Massachmr_4 Ge�aeral Laws chapta 152 req=s all employers to provide workers'compensation for their employees. `o —. Parsrantto this stag,an employee is defined as."_.every person in the service of another under any contract of hi3 e e :prew or hnplied,oral or wilt=." An ernplayer is defined as"an individ A partnership,association,corporation or other Iegal entity,or any two or more of the foregoing engaged i+n a joint entap±m,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employers. However the owner of a dwelling house having not more than th=apartments and who resides therei a,or the occupant of the - civelling house of another who employs persons to do maiut mane;contraction or repair work on such dwelling house or on.the grounds or building appmi Ihi-_reto shall not because of such employment be deemed to be,an employer." MGL chapter 152, §25C 6)also states that"every state or local Iiceusing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buldaigs in the commonwealth for any applicantwho has notprodnced acceptable evidence of compliance with the bism-ance.coverage required-" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth,nor�y of its political subdivisions shall enter into any contract for thD PMfmm=W ofpublic woik until acceptable evidence of complimcevrith the ins r a ce.. requirements of this chapter have been presented in the contracting ard'hozity." Applicaut5 - Please fill out the woifcers'compensation affidavit completely,by ehecIzig to boxes that apply to your situation and,if nmessazy,supply sub_contractor(s)name(s), addresses)and phone numbers) along with their certificates)of mm ance. Limited Liability Companies(LLC)or L>mited Liability Partnerships(LLP)with no employees outer than the members or partners,are not nquircd to caizy workers' compensation insurance. If an LLC or LLP does have employees,a policy is reguized. Be.advised that this affidavit maybe subm"find to the Department of Industrial Accidents for confirmation of insm-mce coverage. Also be sure to sign and date-he affidavit•,. The affidavit should ber-toned to the city or town that the application for the peardt or license is being requested,not the Department of had stri al A cciden ts.•Should you have any gaestions regarding the law or if you are regaaed to obtain a workers' compensation policy,please call the Department at the number listed below. S_If-fimued companies should enter their self-insurance Hoene number on the appropriate line. City or Town Officials Please be sire that the affidavit is completes and prod-lcglly. The Department has provided a space of the bottom of the affidavit for you to fill out in the event the Office of Investigations has in contact you regarding the applicant Please be sure to fill in the per: it cemse number which wM be used as a reference number. In addition, an applicant that must submit multipIe,pemu en tEcse applit ations in any given year,need only submit one affidavit indicating rrrrrent policy inlfbrmation(if necessary)and under"Job Site Address"the applicant shoTld write"all locations n (city or town)-"A copy of the-affidavit that has been officially stamped or mailced by tie city or town may be provided to the applicant as proof that a valid affidavit is on file for frdnre permits or licenses_ A new affidavit must be filled out each year.Where a home owner or citizen is obtaaining a license or permit not related to any business or commercial ventlae (Le. a dog license or pemut to bum leaves etc.)said person is NOT requiced to complete this affidavit The Office of Investigati s would like to thank you in advance for your coopmation and should you have any i Mons, ---please-do not-llesitate��e�s-a The Departmmfs address,telephone and fax number. '1 e C:GnMjar► tlr of Ma ssa-chu>s ' D:egadment of liidui k Accident% C ffitce of 7xtv:egtgatio-� I FQ4�ashi�.gtan Sire Boston,MA 02111 T(,-L 4 617 -4900 Qxt 406 or 1977-MAJSSAFE Fax 4 617-727 7M Revised4-24-07 ( R -govIdia a me - -� , _ — Z O '-PoCNG,L �A��`� 9 .� �o �Z'� O Cam' SPt= I • 55 It e_ IC L r--4 c y 1 W A L� ZO UJ r was Lc 9 Zn O �Z' O G. 5Pf- �4 F MA li �LA z L' cl�1r Uj Aza t71 _ L d Ll� 1 LC,� s'��,�E c -KC Q- (Z� Z — t A oz&q�- i 0A CA C t4\ C 7,!j Lo r\ -3 7Z Town of Barnstable Regulatory Services BARNSTABLE. MASS ta,q.• Building Division p�FD MPS 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice a Type of Inspection �r2m Location 1Yn /�iz/ G6 P%'"Z/ Permit Number Z U/.-D S 7 S� Owner R14%, /C Builder S� One notice to remain on job site,one notice on file in Building Department. The following items need correcting: l0 0/C 4L/,4 Y B8IDS /y/ 1 FIRE ad9�14 1 '. D Guy 4�u-�7ro,c�S Please call: 508*240 0� 9--efte-,��spectiolt- Inspected by Date / A � a i a oFt„E Town of Barnstable *Permit CZ�15 -' Expires 6 mont r is a e Regulatory Services Fee Bnaxs'rABr.e, � MASS' Thomas F.Geiler,Director i6g9. ,0� AtED N1p`l A Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number [2n / Not Valid without Red X--Press Imprint I viC ' Nio,g i11SA (S yProperty Address `5 1 ❑Residential Value of Work$ Z �� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Ghr�S ►uQ1w(- &,rc.-rck, Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) X-P ❑Workman's Compensation Insurance 1" Check one: AUG 22 2013 ❑ I am a sole proprietor I am the Homeowner 7.0� ❑ I have Worker's Compensation Insurance N OF ggRNSTgBLE 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 i ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) _EZ'Re-sided ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#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. i ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit fo s\EXP SS.doc Revised 060513 Em a ° f �r The Cominornuealth of Massachusetts Deparfi+nent of Iird ustriol Accidents - Office of Inveshkations s 600 Washington Street Boston,MA 02111 wa- mass.govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectriciansMumbers Applicant Information Please Print Legibly Name(11 iwlndividnal): CYN r�S�o D Crr�r�l Address-. City/statrJZip: M,'0S VI4 Phone 4- Are you an employer?Check the appropriate box Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6- ❑New construction employees(full and/or part-time.).* have hired the sub-contractors. 2.❑ I am a sole proprietor or partner- listed on the attached sheet: 7• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition. w for me in an `c ci �. employees and have workers' Diking y apa. t5 9. ❑Building addition [No workers' comp_mi s,urance comp.insurance.x �) 5. ❑ We area corporation and its ME]Electrical repairs or additions I am a homeowner doing all work officers have exercised their l l.❑Plumbing repairs or additions. myself [No workers'comp. right.of exemption per MGL 12.❑Roof repairs irrstttance required.]b c.152, §1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.]: *Any applicant that checks boa#1 mast also fill out the section below showing their woTkers''compensation policy urination_ T Homeowners who submit this affidavit indicating they are doing all work and them hire outside contractor mmst submit anew affidavit indicating sash. TContracturs that check this boa mast attached an additional sheet showing the name of the sub-cim=ctors and state whether or not those Mies have employees. If the sub-contmaors have employees,they must provide their workers'comp.policy number. lam an employer that is prmiding workers'compensation insurance for my employees. Below is the policy and job site 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'requiredunder Section 25A of MGL c. 152 can lead to the imposition of trim nal penalties of a fine up to 31,500.00 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 pains and penalties ofperjuty that the information prosided above is bus and correct Si tine:- - "Date: Phone#: Qftiai use onty. Do not write in this area,to be completed by city or town officiaL City or Town: PermitUcense It Issuing Authority(circle one): 1.Board of Health 2.Budding Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone tit: 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,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 receiver or trustee of an individual,partnership,association or other legal entity,employing employees. 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 employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)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 in the commonwealth for any applicant who has not:produced acceptable evidence of compliance with the insurance.coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial 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-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/bcense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been 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 (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: j The Commonwealth of Massachusetts Department of Industrial Accidents Office of kvestigatious 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASWE Revised 4-24-07 Fax#617-727-7749 www.mass_gov/dia I Town of Barnstable Regulatory Services } f } ` MASS. Thomas F.Geiler,Director 163ig. 16 Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print � �' �� JOB LOCATION: \SZ, �tLc��(i �� ArS!ens }•i it��. number street village "HOMEOWNER":C�Y�S�op�nP� �\'6'CA " -X,4- ZS-�, —U q4 f name i home phone# work phone# CURRENT MAMING ADDRESS: : Sf�M city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations.; The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc sand requiremen d'that he/she will comply with said procedures and requirements. Signature ofHom caner 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. C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content0u[look\QRE6ZUBN\EXPRESS.doc Revised 053012 E T Town of Barnstable Regulatory Services * ' M E Thomas F.Geiler,Director Building Division Tom Perry,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 ection If UsingA Buil er a d s Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work autho by this building permit ddress of Job) **Pool fences and arms are the responsibility of the applicant. Pools are not to be filled utilized before fence is installed and all final inspections are pe ormed and accepted. Signature of Own r Signature of Applicant Print Name ,. Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 62012 ` TOWN OF BARN'iTABLE BUILDING PERMIT APPLICATION Map Parcel Application # Zo 6 Health Division -�, Date Issued ( < Conservation Division '�1�� Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board d9 Historic - OKH _ Preservation / Hyannis Project Street Address e ° Z ,:;d�t t��t►1 Village t } n lA\*, Owner C 67-::xc& Address Telephone -n y - Z"5 �i - clay Permit Request _. / L/ l Z- a++ i Z. Co L �- 1% � Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Z-c CC) Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) ` Age of Existing Structure Z_% Historic House: ❑Yes �No On Old King's Highway: ❑Yes No Basement Type: J Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing /• _ new Half: existing new Number of Bedrooms: -1_ existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes /2fNo Fireplaces: Existing / New Existing wood/coal stove: ❑Yes �No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) M Name <�,.�, t;,;�v,t r,r:aA Telephone Number ? -7y - r Address /5 Z h; ; )e_. P�,-YL-A License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO j�; �ar►�c . SIGNATURE DATE e f FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED I� 1 MAP/PARCEL N0. + ADDRESS VILLAGE I I OWNER DATE OF INSPECTION: z FOUNDATION o/)OS' >7Q� r FRAME - I • INSULATION FIREPLACE I' ELECTRICAL: ROUGH FINAL;-, PLUMBING: ROUGH FINAL I� I ; GAS: ROUGH FINAL i FINAL-BUILDING r DATE CLOSED-OUT III ASSOCIATION PLAN NO: • The Commonwealth of Massach usetts Department of Industrial Accidents f. Office of Investigations t itr 0 600 Washington Street fir j Boston, MA 02111 t e www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): (.,11ri 5+0 Pv,&r Address: e r d It_ P-- City/State/Zip: 1'It�.� �vri� �1�i1.5 , �:� Phone #: —n q -2, Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. # ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp; insurance 5. ❑ We are a corporation and its officers have exercised their 3 ]0.❑ Electrical repairs or additions . 1 am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions ��``required.]myself. [No workers' comp. c. 152, §](4), and.we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13/Other c_.;—a, comp. insurance required.] *Any applicant that checks box#t 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 subm it a new affidavit indicating such. 'Contractors that check this box must attached an additional sheet showing the name of the subcontractors and their workers'comp.policy information. I am an employer that is providing workers'compensation Insurance for my employees. Below is thepolicy and job site 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$1,500.00 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 pains and,penalties of perjury that the information provided above is true and correct. Signature: Date: Phone#: '77 L4 - 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 I j Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an in partnership,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 receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 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 employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)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 in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractors)name(s), address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than.the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial 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-insured companies should enter their j self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been 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 (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, . please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass.gov/dia Town of Barnstable of YKE ray ReguI'afo•ry Services Thomas F. Geiler, Director utu isrwaL_ ' Building Division PrfDµay Tom Perry, Building Commissioner 200 Maid.Street,_Hyannis, MA.02601 x-wv.town.barnstable.ma.us . Office: 508-862-403.8 Fax: 508-790-6230 HOMEOWWER LICENSE EXEMPTION Please Print DATE: ' JOB LOCATION: \�Ti �x\cY- ) oVT h number s trcct village ,I)g0MEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption fori"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- DEFINMON OF HOMEOSVNER Person(s) who owns a parcel.of land on which be/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 constrycts 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) Tlic 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 be/sbe will comply with said procedures and requure ents. Signatbrc of Homeowner Approval of Building Official i Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to cbrruply with the State Building Code Section 127.0 Construction Control. HOAIEO W7,MR'S EXEMPTION .The Code states that "Any.homeowncr performing work for which a building permit is required shall be exempt from the provisions of this scctigq(Scction 109.1.1 -Licensing of construction Supcnfisors);provided that if the homeowner engages a persons)for hire to do such . work, that such Homeowner shall act as supavisor•" 4-any homeowners who use this exemption arc unaware that they arc assuming the responsibilities of a supervisor(sec Appendix Q, Ru)cs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness bftcn 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. 7hc homeowner acting as Supervisor is ultimately responsible. To ensure that the homcowncr is fully aware ofhisAcr rtsponnbilitics,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the respons-ibilitics of a Supervisor. On the last'pagc of this issue is a form currently used by several towns. You may care t amend and adopt such a fomr/certification for use in your community. Town of Barnstab]e Regulatory Services BARNS kH v ' MAB& $ Thomas F. Geiler, Director Building Division Tom Perry, Building Commissionet 200 Main Street, Hyannis, MA 02601 www.town.b arnstab le.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder I, , as Owner of the subject.prope.rty hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of rob) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption. Form on the reverse side. Z 1 < < ,w� i C)e�p. x c� or w o c O v-\o-N- l t-V dltA+c�f'*"a n tA- y nCA , A Study of OCD 6 References OBSESSIVE-COMPULSIVE DISORDER. (n.d.). Retrieved April 30, 2009, from Funk &Wagnalls New World Encyclopedia database. March, P. (2008, December 5). Obsessive-Compulsive Disorder. Retrieved April 30, 2009, from CINAHL Plus with Full Text database. Osgood-Hynes, Deborah. Thinking Bad Thoughts. MGH/Mclean OCD institute, Belmont, MA, published by the OCD Foundations, Milford, CT. Retrieved on May 1, 2009 Cernansky, Rachel;. 2009 Obsessive Compulsive Sufferers May Find Relief With a "Brain Pacemaker" Discover Magazine. (p. 1) WHAT IS OCD. (2006-2009) Retrieved May 1, 2009, from The OCD Foundation http:t/www.ocfoundzit-ion...org./what,-is-ocd.htmI I ' I I i � ° 36 '49Y Z oo /I/4 ; 7-6 �y� S36 ouµ1K1S 4" - . � 53804,9 ' 30 � goe� �o �r PLOT. p L E ,... IFI � . CiER? /vL� PATN..,,. ,r y c L07' i4 _r_o ru.S CONSTRUCTION ONLY ' �-►-NEW IS �FEET � • FOUNDATION ` TOP. OF ADJACENT SCALE = 4o DATE° I ABOVE LOW Ai P01 NT O F il/DA7 ' ' ROAD. _ Mort i CERTIFY THAT THE IS Lo.CX IwF THIS PLAN ----E NG Q. IN CLIENT ...r SN0�6dN ON AS INDICATEID;' 1ND:. GROUND �,A1N9`i` --�Dsr ��a R-s ON THE TO THE ZONINd 1..: REGISTERED JOB NO CONFORMS, MASS• EOISTERED LAND A. OF' BAR' ' I 12 �t� �— CIVIL` SURVEYOR ENOINEER SURVE• CH. REG. LAND 712 MAIN ST. D)l ' N ST MASS. SHEET�Of TE�-.: , . 33 NO. MAIN MASS. HYANNIS, 0.. rARMOUTH, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map i Parcel \ud Application # r �Z l0 Health Division Date IssuedJ� Conservation Division Application Fee " Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board l Historic - OKH Preservation./Hyannis Project Street Address \s Z 3��.�•.- �� Village %,v, Owner Address k s z Telephone Zs-9 -c,\4 I5 Permit Request o'It A�QT-uj_ cosO sY- Sir C%Sr 6:rsj ��k\ th^ $ s.+ sz\ooS . Q.to\o.ce_ �� tA9incao S ,.^A 3 A0005.. 24—r--Q60 u:�cr•�n a &.�+^�6AA cJlownst�ai�S 1v�il.�ucr�. Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation , • .odo Construction Type Lot Size `IL emu` Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family OL Two Family ❑ Multi-Family (# units) Age of Existing Structure 3 Z- Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: I(Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) © Basement Unfinished Area(sq.ft) Number of Baths: Full: existing I new Half: existing new Number of Bedrooms: •3 existing _new Total Room Count (not including baths): existing G new First Floor Room Count Heat Type and Fuel: ❑ Gas JXOil ❑ Electric ❑ Other Central Air: ❑Yes 5tNo Fireplaces: Existing a p g New Existing wood/coal stove;❑`e a ❑ No ZE Detached garage: ❑existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: OOeXisting 0 new size_ Attached garage: ❑ existing ❑ new size _Shed: Lkexisting ❑ new size _ Other: .Z Zoning Board of Appeals Authorization 0 Appeal # Recorded ❑ `n NO Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name Telephone Number Address License# K1C1Tsk r,s VkJ\\%, K, 0Z's'e-49 Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE S y i o FOR.OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER i DATE OF INSPECTION: i ' FOUNDATION FRAME _ f _ _ INSULATION - FIREPLACE ELECTRICAL: ROUGH FINAL f< PLUMBING: ROUGH FINAL' GAS: ROUGH FINAL FINAL BUILDING /2 a /4 /f k1Ae-.W_ dk y uK! qt� , DATE CLOSED OUT ASSOCIATION P'LAN NO. :y r The Commonwealth of Massachusetts Department of Industrial Accidents l Office of Investigations I' 600 Washington Street .Boston, MA 02111 �j yy www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lel?ibly Name (Business/OrganizationAndivi dual): Gent�s�ug�ex` SAo� Address: kSt, %.s:Ass-- Seo•-M, City/State/Zip: Ks Phone #: -� lrp-z3cj,o�1N� 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 einploy'ees (full and/or part-time).* have hired the sub-contractors _ _ _._.._ ___.__-........ . . .. . 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. gRemodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers'comp. ❑ Building addition No workers' comp. insurance comp. insurance. y� right of exemption per MGL required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions 3.)( .I�,� ' `myself. [No workers' comp. 12.❑ Roof repairs insurance required.] t C. 152, §1(4), and we have no 13.❑ Other employees. [No workers' 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: 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$1,500.00 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. 1 do hereby certify under the pains and penalties of perjury that the information provided above is trice and correct. Signature: Date: /U Phone#: �1 o 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 S. Plumbing Inspector 6. Other Contact Person: Phone#: { information and. Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an enrplo�ee is defined as "...every person.'in The service of another under any contract of hire, express or implied, oral or written.' An employer is defined as "an individual,partnership, 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 receiver or trustee of an individual, partnership, association or other legal entity, employing employees, However the cupant of the owner of a dwelling house having not more than three apartments and who resides therein,.or the oc dwelling house of another who employs persons to do maintenance, constriction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employmentbe deemed to be an employer." MGL chapter 152, §25C(6)also slates 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 in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." •Additionally,MGL chapter 152, §25C(7) states"Neither the conunonwealth nor any of its political subdivisions shall enter into any contract for the performance of pub)ic-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that.apply to your situation and, if necessary,supply sub-contractor(s) name(s), address(es)and phone number(s)along with their certifrcate(s)of insurance, Limited Liability Companies (LLC)or Limited-Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. if an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town That the application for the pen-nit or license is being requested,not the Department of Industrial Accidents. Should-you have any questions regarding the law or if you are required to obtain a workers' ir compensation policy,please call the Department at the number listed below. Self-insr.rred companies should enter the self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed 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. Pleasebe sure to fill in the permit/license number which will be used as a.reference number. In addition, an applicant that must submit multiple permiUlicense nt applications in any given year, need only submit one affidavit indicating(city or policy information()if necessary) and under"Job Site Address" the applicant should write"all locations in town),"-A copy of the affidavit that has been 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 fixture 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 (i•e. a dog license or permit to bum leave$etc.) said.person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and'fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. 4 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax 4 617-727-7749 Revised 4-24-07 viw maQQ crnv/ilia Town of Barnstable �oFz�Teti . a„ Regulatory Services i > xszna Thomas F. Geller,Director Mass. 039. 16 Building Division rfD MAt Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 -_— --------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: q `/ /0 JOB LOCATION: /SZ 4Srt'J)e_ ?,k44n onS �`111�5 number street village "HOMEOWNER": C)nt:S\-oe\&t r G� fC" -1-1 -1 — I'$-0W.J name home phone N work phone# CURRENT MAILING ADDRESS: Vkt vs4-uns mills Hef o�CotPK city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner 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\FORMSVromcexempt.DOC r .. "per �pIKE 1p� Town of Barnstable O " Regulatory Services RARNSfABLJE, Thomas F. Geiler,Director y Huss. g 16.39.., wilding Division . Tom Perry,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 wilder 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;FORMS:OWNERPERMISSION i 6 ��c� t I 4 °°� i i I 1 I Anderson, Robin From: Miorandi, Donna Sent: Wednesday, April 14, 2010 4:43 PM To: Heath DeptMailbox Cc: Building Dept Subject: 152 Bridle Path, Marstons Mills An FYI that I have received a fax from Clean Harbors regarding the HAZMAT clean-up of this property. It looks OK. The file and the report are in the middle of my desk. I also called Craig Crocker, Superintendent of the COMM Water Dept. regarding the clearance for them to go into the house for a water meeting reading for the closing on Thusday, 4/15/10. There is MUCH mold inside the house and have stated that to all concerned. Pictures were taken. 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application #02� ® /yc�4 6 Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee a Date Definitive Plan Approved by Planning Board 0 Historic OKH Preservation / Hyannis Project Street Address & Village Owner �� r^ �!'�/� Address Telephone 7 < " 39 S 2 Permit Request _ R2�-1.3u.2 �!a�f',r� a9/ c >.,ic� di y,Ab PLe a;., d n=49li vY. h-W Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 25DO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House:, ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: &(Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas &/iI ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size — Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size — Other:_ o r ZE Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ c.='� 0 � � o Commercial ❑Yes ❑ No If yes, site plan review # .co Current Use T� Proposed Use UJ APPLICANT INFORMATION / (BUILDER OR HOMEOWNER).___ Name /`�l��J � '`fa S Telephone Number Address License# 6 .:5 / Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO D0 &44, �� SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED - MAP/PARCEL NO. ADDRESS VILLAGE ;OWNER - DATE OF INSPECTION: _ FOUNDATION ` FRAME NSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH t FINAL ' GAS: ROUGH FINAL -FINAL BUILDING .i�rsloKA4.9y` ' r DATE CLOSED OUT ASSOCIATION PLAN NO. rM r The Commonwealth of Massach usetts Department of Industrial Accidents Office of Investigations 600 Washington Street c Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name (Business/Organization/Indivi dual): Address: �,�'� �T 1,R City/State/Zip: o Phone M 1�-L* b� I ciao Are you an employer? Check the appropriate box: Type of piroject(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction emphoyees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor.or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑ Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition No workers' comp. insurance com surance.# . 5. a are a corporation and its 10.0 Electrical repairs or additions required.] 3.❑ I 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 13.0 Other employees. [No workers' 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those cntities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site 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$1,500.00 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. 1 do hereby certify under the pains and, alt'es perjury that the information provided above is true and correct. Signature: Date: O Phone#: U' 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#: •r:r.•.•.rcnusctts - Ochar-tmCnl nl'Publicufri� [3o:ud rr"41ildin.0 Re-uhilinn. ;rnd tit;rnd;rrrl.: Construction Supervisor License License: CS 65318 Restricted to: 00 MICHAEL A SANTOSoi { 4830 RT 28.. COTUIT; MA 02635 Exprration: 1/28/2012 (lrwni.xinnrr - . Tr#' .18416 .t� ciT p il Board of B�oo�Lmc��uuFal�1 " \ udin t;Regulations anJ Standards HOME IMPROVEMENT CONTRACTOR T Registratio • Incense or r n 143064 registration valid for individul use only Expiation: , before the expiration date. If found return to: 6/15/2010 Tr# 276305 - Board of Building Regulations and Standards Type: Private Corporation. One Ashburton Place Rm 1301 APCON, INC. Boston,Ma.02108 MICHAEL SANTOS 4830 RT 28 I COTUIT,MA 02635 "`'�-�^�� Adminish•ator I / ! Not valid without signature ti HomeSteps- AFreddieMacUnit March 18,2010 RE: FHLMC Asset#: 716040 Property Address: 152 Bridle Path,Marston Mills,MA 02648 To Whom It May Concern:: Please be advised that CENTURY 21 HUGHES &CAREY, Greg Russell (listing agent)whose business address is 2277 State Road, Suite K,Plymouth,MA 02360,is acting as an agent for Federal Home Loan Mortgage Corporation, also known as Freddie Mac, (Seller). Per Seller's request,Broker has permission to turn on all utilities,order any inspections or permits and handle any affairs such as violations, liens and/or fines for the above referenced property on behalf of Seller. Please contact me if you have any questions or need additional information. Sincerely, Stephenie D. Miller, VRM Property Coordinator Homesteps, a Freddie Mac Unit 972.395.2803 Phone �,,,,..•„ ERICA JONES t Stephenie Miller@freddiemac.com ??e. Notary Public,State of Texas L ?�•: My Commission Expires '�•?„;;� August 14,2013 f i 5000 Plano Pkwy LA Carrollton,TX 75010 1&Phone(972) 395-4000 Fax 972-395-4050 Hughes & Carey 2277 State Road, Suite K Plymouth, Massachusetts 02360 Business (508)888-3704 Fax (508) 888-5778 Toll Free (866) 400-SOLD Website www.c21 hughesandcarey.com April 8, 2010 To Whom It May Concern: . This letter will serve as authorization under authority granted to me by Freddie Mac, the owner of 152 Bridle Path, Marstons Mills, MA for: Michael A Santos, President APCON, INC. 4830 Rt. 28 Cotuit, MA 02635 To apply for any building permits as he deems necessary for repair as described for you by him in said applications for same. reg Russell Chairman/CEO CENTURY 21 Hughes & Carey Y/� nris Each Office Is Independently Owned And Operated Phone:508-420-9200 Fax:508-420-9201 ©` 10) INC. All Yhase Contivuctiun of Vew F.n�lxnd MICHAEL A..SANTOS, President- 4830 Rt. 28, Cotuit, MA 02635 www.apconinc.com mike@apconinc.com i GregRussell ssell � CBR i Chairman/CEO HUGHE$&CAREY 2277 State,Road,Suite K Plymouth, Massachusetts 02360 Cell 508-889.4093 . Office 508.888.3704 Fax 508.888.5778 E-Mail GRussell@CENTURY21.com 0 Each ottke b 4Wepenaentty owned and operates I r FRIEDLINE&CARTER ADJUSTMENT, INC. 436 Main Street, P. O. Box 338 Hyannis, Massachusetts 02601 Tel. (508) 771-3232 FAX (508) 790-2344 TO: Kf Building Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen. ( ) Fire Department TOWN OF Barnstable TOWN HALL Hyannis, MA RE: Insured: SANSOLICIE, Michelle E. Property Address: 152 Bridle Path Marstons Mills, MA Policy Number: H00306058 Type of Loss: Fire Date of Loss: 1/28/2009 File#: 108860 Claim has been made involving loss,-damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the.captioned insured, location, policy number, date of loss and file number. On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by First Class Mail. P. J. PARECE Adjuster m -- -v 4/28/2009 Ti < w w cn o D o -o ca cn r— W m r Citizen Web Request Page 1 of 4 y iA MASS r M; . x. Logged In As: _ Citizen Request Management 4Monday, Febru TOWN\OWN\miorandd Route to Users Search Requests Create Requests Request Information Request ID: 24185 Created: 1/28/2009 4:22:01 PM Status: Assigned To Staff Assigned To: Miorandi, Donna Health Office Anonymous: No Request Category: Article X - Food : Foodborne Illness Routine work: No Estimate: No Date scheduled: Estimated 2/11/2009 Change Estimated )an February 2009 Mar Completion Completion Date: Date: Sun Mon Tue Wed Thu Fri Sat 25 26 27 28 29 30 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1 2 3 4 5 6 7 Created By: Parvin, Lindsay Priority: Medium Health Office Citation Numbers: Requestor Information Requestor COMM Fire . Request DETAILS: 000 Click Road List LOCATION: 152 BRIDLE PATH Click Road List Ma 02632 Marstons Mills, Ma 02648 Request Parcel Number � COMM Fire Department Map: 149......... Block: 140 Lot: Imo' requesting a health inspector at above location/structure fire Parcel Lookup Email: http://issql/intemalwrs/WRequest.aspx?ID=24185 2/2/2009 r Citizen Web Request Page 2 of 4 Edit Requestor Information Track Request Progress Request Work History: Internal Note History: Entered on 2/2/2009 10:01:00 AM System entry on 1/28/2009 4:22:01 PM: by Miorandi, Donna Last modified on 2/2/2009 10:29:49 AM Assigned to Miorandi, Donna DZM responded to the call from the COMM Fire System entry on 2/2/2009 10:32:49 AM: Dept. Capt. Field was on site initially and then Capt. Byron Eldredge took over Dept. was called Estimated completion changed from not because of the fire because of the 2/11/2009 to 02/11/2009 sanitary condition of the house. There was much debris throughout the house-trash bags full, Christmas tree still up and very dry along with many other decorations. Much clothes, paper and other clutter all around. Living in the house is the mother, Michelle Sansoucie, a 14 yo niece (Alex Sansoucie- Watt), her 20 yo daughter (Ashley Sansoucie) and her boyfriend, Dan. There are also two other daughters in house, ages 10 & 11. The boyfriend, Dan, is allegedly a bad diabetic and has to urinate every 20 minutes so he urinates in soda bottles and half gallon juice bottles. For whatever reason there was a collection of these urine bottles in the bedroom and upstairs bathroom. Hi sharps were not properly handled as they were carelessly strewn around house. DZM has given him a sharps container which was obtained from the Comm Fire Dept-gave him instructions on how to use it. Ordered the mother to go out and buy smoke detectors and CO detectors. She bought three combination smoke/CO detectors and installed them. DZM tested all three. The tree was disposed of and the house cleaned up to a minimum of standards. Educated the smokers in house on proper cigarette disposal and gave them info on sources of combustion related to carbon monoxide. The trash disposal could end up to be a problem because the mother's JEEP is not running and that has the landfill sticker on it and there was a worry abouth the cost of a new sticker when time comes. Mother complained about costs of detectors. Informed family that they could dispose of trash as I they go (pay per bag as you go). Mother works in Woburn nights/early am and is not home alot. Allegedly she is home during the day after 9 AM. MOther's sister is in a shelter somewhere with three of her four children. The fourth child (14 y.o. niece) http://issql/intemalwrs/WRequest.aspx?ID=24185 2/2/2009 Citizen Web Request Page 3 of 4 is living at this address. The Red Cross was able to put the family up at the Holiday Inn in Hyannis for two nights after the fire. The fire was caused by a faulty timer in the dryer. The basement had two illegal bedrooms (mattresses in place) and had no proper egress windows. The mother states she no longer sleeps down there because of the mold so she sleeps on the sofa in the main living room. Insurance adjusters were on the scene the next day (Oceanside Insurance) and the plan was to gut out and repair (finish off) the basement. Informed the family that they are in a ZOC and can't have any more than the three bedrooms that they already have. Mother's cell (Michelle) is 508-572-9004 and the daughter Ashley's cell is 774-274-2347. DZM took pictures and printed them out and will be in the residential file. update delete Enter work progress: Enter internal note: (Viewed by everybody) (Viewed internally only) l i i Spell Check Spell Check Add document or image link: _Browse * You can also type in a folder name to see everything in the folder Current Links: I_\Health donna\152 Bridle Path, Marstons Mills 023.ipg. Remote Time worked on request: 6.00 Response time: 0.50 *Time entries are in hours..Examples of time entries: 1.25, 0.5, 0.75, 1, 3.5, 0.25, 0.10 * Response time: Measured from the creation date to your first actions on the request. * Do not include nights, weekends, and holidays in response time for most departments. Save changes r Check to notify town employee below to review this request. r_, Save changes and notify http://issgl/intemalwrs/VvRequest.aspx?ID=24185 2/2/2009 i ,•� i ,_.: �: ��e�?��, i .� �� o< a �q�, ti� a..' _ :. ,p. c �. �� _ �S k �� ' S ? �_ 3 s s�z„ ? 7 � 7T err, Page 1 of 1 Marstons Mills fire forces family from home By Karen Jeffrey STAFF WRITER January 29, 2009 7:35 AM MARSTONS MILLS - A family was forced out of its home Wednesday night after a dryer fire spread to walls and ceiling in a basement. Firefighters from the Centerville-Osterville-Marstons Mills fire department found heavy fire in the basement and spreading to the upstairs of the house when they first arrived at 152 Bridle Path, according to a press release from the department. No injuries were reported, but the Cape Cod Chapter of the American Red Cross was called to assist the family in finding shelter for the night. Firefighters removed the dryer from the home. http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20090129/NEWS 11/90129006... 1/29/2009 Assessor's map and lot number ...' .��..'..� ��........... �� C`' �J THE z OF TDIr tGew ge Permit number ..... ...... ....... , SEPTIC SYSTEM MUST'BE ev- . INSTALLED IN COMPLIANC .. BAHa9TGDLE, House number ..-�.�-�..�............................................ WITH ARTICLE II STATE� v rasa rry SANITARY CODE AND TO °°,�oypY•a�00� TOWN OF, B,AR�Na9AB�E BUILDING, A-S:PECTOR 01- APPLICATION FOR PERMIT TO �� ,f,; TYPE OF CONSTRUCTION ...... 7/f ....................................................................................................... 19........ TO THE INSPECTOR .OF BUILDINGS: The undersigned hereby applies for a permit according to the folowing information: Location .....f,.G� l ....... � / Ile... .. .A.:;,K,.........:....(.. ..4...�; ProposedUse .. e:. ..................................................................... ...................................... ZoningDistrict ........................................................................Fire District ,.p............................../..'...................................:.....: Name of Owner .. o .�..�.�..f�/�. '►o. Address ....�.1..OX..Yzl ......±.r..S.�"1. Ce Name of Builder .-Veo. ... ... ... ddress ....� ..... . .... 0...... .�... Name of Architect ... e.�..r�.e.......'.. ® dress .......d .. 7. ....... '........ .....•... Number of Rooms .....................Foundations. C.a/9��'.�'.. ..................... AExterior .. P �� g ......... ......... ..... Floors y?.r .. ...........................................................Interior .......-5. .p�.......:.............. Ci Heating :.. .. .f.�.. ................................................Plumbing , � �� Fireplace ........!.....................................................................Approximate Cost ........1.?....�,t.to..*................................ Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ��o ............... ........................... 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 ......... ............... ........../CJ............ ......... \ ' � Wetmore, George Jr. No 20 Permit for .......l...I/2... ..... aiugI�� ' ------..~.. .�e�++�..��+++e�-----. � ^ ' Location l52 I�\tb ' ---_—:::��+�.. -------.. � � ( Mar top -------' ' Owner ..........99gCZg..X#t1P0t]Q.^..�X................. ' ' Typo of Construction ............jrsaoaa................... ^ --'.--~--------------------'' i ~ / Plot ............................ Lot .......#l.4.................. ^ , . Perm ' | it Granted __.Sootamber_29__]g 78 ` . Date of Inspection .^ ....�_......................./° ' Date Completed . 0,o- ° ' -�� d^�� ' -��.�� ~=~ PERMIT REFUSED . / _----_—.------------- lV . � - ^� | ---- t / / ' ---- . . - ............... —�du.n .,�c�/a�� .............................. ---------------- l� Approved . ' . . ^ - . -------.-------~~..----.--.— ` . . . . . � ' --------------------.—.......— � . ^ . - Assessor's map and lot number-.. .' .` �: �'" %'�--� o� mac° — CF THE t0 1 " f Sewage Permit number ........................................................... _ Z BAHB9TADLE, i House number .............:.�........................................................ 9� MMa p 039. \00 Q mi% y. r TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....... .........t.......................... TYPEOF CONSTRUCTION ..............z ".t: ......................................................................................................... .............. . ............................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .............^. ..�r�.............'..�....f! l...`.::....... c'' #.!..!.. " t. !..:........1�. t4 !`... .....%s�`°.....�.�►.�......... ProposedUse ..............................f......................... ZoningDistrict ..........................................................................Fire District .............................................................................. Name of Owner ..................................................................' .. ` r?Address ...!` dX..y ry. .......:..:. .'.!:.....r.'". !!. r........, Name of Builder ......... ..........+..: .:: ,� f"�..'r.� '{`Address ....../-'Wl'� ....: ........ ......`.....:...... ........ .. ..................................... i Name of Architect Ae 11 -�C` C' �1�� : ......'.Address f.A..'"...... 7 - ........................................................... ............. ..... ........................ ` .......................................Number of Rooms � Foundation X Ale— Exterior .......... r........................Y...l.r.................:.... f:'4Roofing ..... .. �r R. .............:. . ... .... .... Floors .............J�... .. .. ...........................................................Interior .......:S�r' a^ e-..`! .. ..?.� ... .`............................... ...... . . .....Y Heating Plumbing ,f. Fireplace ......... .....................................................................Approximate Cost .........:..<1 ....d.d.0................................ Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ?r?..0............................. Diagram of Lot and Building with Dimensions Fee .. SUBJECT TO APPROVAL OF BOARD OF HEALTH L - I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............... ........................................... o Wetmore, George Jr. `A=149-140 20630 1 112 story No ................. Permit for .................................... single family dwelling ............................................................................... Location ........152 Bridle Path ......................................................... Marstons Mills ............................................................................... Owner George Wetmore, Jr. .......................... '............................ Type of Construction ...............Le........................... ................ Plot ............................ Lot .......t 14 ......................... deptmber 29 78 Permit Granted .......% e �....................... ...19 Date of Inspection ...... Lo ..................19 Date Completed ......... ............................19 PE MIT REFUSED ........................../I............................. 19 ........... ................ ..... .... .. ................. . ........ ..... ............. ..... ..... X) ................. .................. . .. ................... ...........! ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... TOWN OF BARNSTABLE Permit No c "sc . 1 smn,n, Building Inspector Cash _-- — � rua 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 George 'letnore, Jr, Address lot 114 11i? Rridle Path. Mnrgfions ';i_11s Wiring Inspector �� /� �._ Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date , AN t• Engineering Department,,-, `f7i ��fr� , / Inspection dated 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. .... ..........._, 19 ................... .......... _ r Building Inspector V - T li 13R PA v- 00 6' ul N ice.' � `t, •I Ll 4 ., .S'D H � �� RbEERT 4„, ,N. ,•., .s 38 g 9 ar P. r„ .. t r 1� r 'Peen 0.0�. �. •E• s CERTIFIED PLOT PLANN L07- /4 )3R/Z>4- PA TN NEW CONSTRUCTION ONLY : /' .4RSTONS 14 /'C_1_S TOP OF FOUNDATION IS Z FEET - IN -ABOVE LOW POINT OF ADJACENT BA&M -S'1'AWA14NA ROAD. SCALE: / = 40 DATE - LEDGE ENGINEERING CO. IN WE7MoA CLIENT 1 CERTIFY THAT THE Fbv 4770 IVKati ._ E01 TERED� REGISTERED SHOWN ON THIS PLAN IS LOCAT90; JOB N0.?g'0 rrT ON THE GROUND AS INDICATED `AND:. l CIVIL LAND ENGINEER SURVEYOR DR. BY: 4,'4. CONFORMS• TO THE ZONING LAWt'* OF BARNSTABLE , MASS. ' 33 NO. MAIN ST 712 MAIN ST CH. BY', SO, YARMOUTH, MASS. HYANNIS, MASS. SHEET_L OF � TD E DREG. LAND SURVEY R O ..f, r f+=2 1 �.� M W ��_ _ - �, :,` '"'�" �05 �" i e�P\ao-se mom te"`' eery -'gi\\ ed,p o% "d ma.. J\\y' e,E�. t%pvo de\` s des�<my a e�. 2n.nQ �od�see �e�\�. ad je5exc °FIKE?, Town of Barnstable r Regulatory Services v B"MSTA MAM. Thomas F.Geiler,Director , �p t639. ♦0 rEOMAyA Building Division Elbert C Ulshoeffer,Jr. Building Commissioner 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Building code Violation and Order.to Cease, Desist and Abate: Mr.Freedman Watson and all persons having notice of this order. As owner/occupant of the premises/structure located at 152 Bridle Path,Marstons Mills,MA,Assessor's Map 149 Parcel 140 you are hereby notified that you are in violation of the Massachusetts State building code 780 CMR Chapter 1 Section 110.1 and are ORDERED this date June 6,2001 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: 780 CMR Chapter 1 Section 110.1 Permit Application 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: Apply for building permit for construction And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the State Building Code Appeals Board(as specified in Chapter 1,Section 122 of 780 CMR State Building Code) within forty-five(45)days after the service of this notice. By orde , `� v 0 Mitchell A.Trott Local Inspector enclosure Certified Mail 7000 0520 0024 8281 3650 R.R.R. Q/FORMS/violatel&violate2 r U*SPoslal Service (Domestic Mail Only; No Insurance Coverage Provided) CERTIFIED MAIL RECEIPT Ln 7 ✓ l—0 M rPostage $ 0266N ruCertified Fee Return Receipt Fee m Posf (Endorsement Required) Y H ru C3 Restricted Delivery Fee p (Endorsement Required) O Total Postage S Fees Is v5 rU LP) Recipient's Name (Please Print Clearly)(To be completed by mailer) O reef,Apt. o.;or PO Box N . r` l is O2-,6 PS Form 3800,February 2000 See Reverse for Instructions Certified Mail Provides: ■A mailing receipt i ■A unique identifier for your mailpiece i ■A signature upon delivery ■A record of delivery kept by the Postal Service for two years Important Reminders: ■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. ■Certified Mail is not available for any class of international mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. •'%' ■For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage'to cover the fee.Endorse mailpiece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS postmark on your Certified Mail receipt is required. ■For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement"Restricted Delivery". ■If a postmark;on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,February 2000(Reverse) 102595-00-M-1489 i OF1HE r Town of Barnstable Regulatory Services s s 9BARNSTABLE,g Thomas F.Geiler,Director �Fp 19. A Building Division Elbert C Ulshoeffer,Jr. Building Commissioner r 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Notice of Building code Violation and Order to Cease, Desist and Abate: Mr.Freedman Watson and all persons having notice of this order. As owner/occupant of the premises/structure located at 152 Bridle Path,Marstons Mills,MA,Assessor's Map 149 Parcel 140 you are hereby notified that you are in violation of the Massachusetts State building code 780 CMR Chapter 1 Section 110.1 and are ORDERED this,date June 6.2001 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: 780 CMR Chapter 1 Section 110.1 Permit Application' 2. COMMENCE immediately,action to abate this violation. SUMMARY OF ACTION TO ABATE: Apply for building permit for construction And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the State Building Code Appeals Board(as specified in Chapter 1,Section 122 of 780 CMR State Building Code) within forty-five(45)days after the service of this notice. Mitchell A.Trott Local Inspector enclosure Certified Mail 7000 0520 0021 8281 3650 R.R.R. Q/FORMS/violatel&violate2 i 780 CMR: STATE BOARD OF BUELDING REGULATIONS AND STANDARDS ADMINISTRATION 780 CMR 109A APPROVAL 780 CMR 110.0 APPLICA'ITON FOR PERMIT 109.1 Approved materials and equipment: All 110.1 Permit application: It shall be unlawful to materials,equipment and devices approved by the construct, reconstruct, alter, repair, remove or . building official shall be constructed and installed in demolish a building or structure;or to change the accordance with such approval. use or occupancy of a building or structure; or to install or alter any equipment for which provision is 109.2 Used materials and equipment: Used made or the installation of which is regulated by materials, equipment and devices which meet the 780 CMR without first filing a written application minimum requirements of 780 CMR for new with the building official and obtaining the required materials,equipment and devices shall be permitted; permit therefor. however, the building official may require satisfactory proof that such materials,equipment and 110.2 Temporary Structures: devices have been reconditioned, tested, and/or 1101.1 General: A building permit shall be placed in good and proper working condition prior to approval. required for temporary structures, unless exempted by 780 CMR 110.3. Such permits shall 1093 Alternative materials and equipment: be limited as to time of service, but such temporary construction shall not be permitted for 1093.1 General: The provisions of 780 CMR more than one year. are not intended to limit the appropriate use or 110= Special approval: All temporary installation of materials,appliances,equipment or construction shall conform to the structural methods of design or construction not specifically strength, fire safety, means of.egress, light, prescribed by 780 CMR,provided that any such ventilation, energy conservation and sanitary alternative has been approved. Alternative requirements of 780 CMR as necessary to insure materials, appliances,equipment or methods of the public health,safety and general welfare. design or construction shall be approved when the building official is provided acceptable proof and 110.23 Termination of approval:The building has determined that said alternative is satisfactory official may terminate such special approval and and complies with the intent of the provisions of order the demolition of any such construction at 780 CMR, and that said alternative is, for the the discretion of the building official. purpose intended,at least the equivalent of that prescribed in 780 CMR in quality, strength, 1103 Exemptions: A building permit is not effectiveness, fire resistance, durability and required for the following activities, such exemp- safety. Compliance with specific performance tion,however,shall not exempt the activity from any based provisions of 780 CMR, in lieu of a review or permit which may be required pursuant to prescriptive requirement shall also be permitted as other laws,by-laws,rules and regulations of other an alternate. jurisdictions(e.g.zoning,conservation,etc.). 1. One story detached accessory buildings used 1093.2 Evidence submitted: The building as tool or storage sheds,playhouses and similar official may require that evidence or proof be uses,provided the floor area does not exceed 120 submitted to substantiate any claims that may be square feet. made regarding the proposed alternate. 2. Fences six feet in height or less. 10933 Tests: Determination of acceptance shall 3. Retaining walls which,in the opinion of the be based on design or test methods or other such building official, are not a threat to the public standards approved by the BBRS. In the safety health or.weifare and which rei u*it iess than alternative, four feet of unbalanced fill.where the BBRS has not provided 4. Ordinary repairs as defined in 780 CMR 2. � • specific approvals,` the building official may Ordinary repairs shall not include the cutting accept, as supporting data to assist in this away of any wall,partition or portion thereof,the determination, duly authenticated engineering removal or cutting of any structural beam,column reports, formal reports from nationally or other loadbearing support, or the removal or acknowledged testing/listing laboratories,reports change of any required means of egress, or from other accredited sources. The costs of all rearrangement of parts of a structure affecting the tests, reports and investigations required under egress requirements; nor shall ordinary repairs these provisions shall be bome by the applicant. include addition to,alteration of,replacement or 109.3.4 Approval by the Construction relocation of any standpipe, water supply, Materials Safety Board: The building official mechanical system,fire protection system,energy may refer such matters to the Construction conservation system or other work affecting Materials Safety Board in accordance with public health or general safety. 780 CMR 123.0 for approval. Note: Also see 780 CMR 903.1(Exceptions 1. and 2.). 11/27/98 780 CMR-Sixth Edition 19 ti. CERTIFIED MAIL Town of Barnstable Building Division P` « 367 Main Street g r Ey 5 QI % L S•PGSTAC �. Hyannis,MA 02601 > i �' ' 6138443. U3 6 520 0021- 281 3650 w ► --- _ _ _ WS Freedma Watson fame �- E� : •r '� ' 152 dle Path l St Marston lls, MA _ 2(1d N :.ti� �'t3tUi n :' , jI D. - _ Ili,,,,, ,i,ii„ii,,,,,,ii„li;l,i„°ii►„1,„i,,i,11 SENDER: I also wish-'66�eceiveft■Complete items 1 and/or 2 for additional services. w ■Complete items 3,4a,and 4b. followind,,SverviceS at ■Print your name and address on the reverse of this form so that we can return this extra fe Attach this form to the front of the mailpiece or on the back if card to you. ■ , e ac space does not 1.❑ Adtlres"see's Address` permit. \. �S 2_1_ / ■Write"Return Receipt Requested"on the mailpiece below the article number. 2.❑ R6stribted Delivery � r III The Return Receipt will show to whom the article was delivered and the date delivered. Consult postmaster for fee. o o 3.Article Addressed to: 4a.Article Number 01 71:'-00 OS20 C42t 3�26/365O IM � 4b.Service Type �°, ElRe Registered �Coll ,�2— ?2!��fe-- �``a`'` 9 C,k�ertified �S �� A f ❑ Express Mail ❑ Insured O1 Yf c 1 ❑ Return Receipt for Merchandise ❑ COD V I 7. Date of Delivery 0 � s 5. Received By: (Print Name) 8.Addressee's Address(Only if requested and fee is paid) I � 6.Signature:-(, ddressee or Agent) i i i 1i i 11. j 1 y( PS Form 3811 December 1994 t t 102595-98-13-0229 Domestic Return Recei t