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Home My WebLink About1996 MAIN ST./RTE 6A(W.BARN.) P e UPC 12543 ,a No. 53LOR HASTINGS MN TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ( Map f Parcel & `p Application #2�I Z ZCp Health Division Date Issued S (co r Conservation Division Application Fee Sb Planning Dept. Permit Fee 3 I Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis 1` ProojectlS;treet Address Z/ / [ U 1�� W/ /4 vim Ilage� ,�Q r n s t0.h I e (owner AIAjb C . � R I J L ��X 0/J-dress rep one Permit Request Ch/ir Y f- Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District _0 orFlood Plain Groundwater Overlay Project Valuation--- - l Oo 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 ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: 'q Yes ❑ No 4J Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: 0 existing, ❑ �w size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:1 �r Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Names 4�;. d4XTa Af /Telephone.,Number Address / 9 q�f le A License # Home Improvement Contractor# Worker's Compensation # BALL CONSTRUCTION DEBRIS RESULTING`FROM'THIS PROJECT WILL-BE TAKEN TO" •A, �Ild SIGNATURE- c D TE 34 // �w FOR OFFICIAL USE ONLY `APPLICATION# ' r g DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT p ASSOCIATION PLAN f The Commonwealth of Massachusetts Department of Industrial Accidents h � Off ce of Investigations 600 Washington Street 7 Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/PIumbers Applicant Information Please Print Lelxibly faille Business/Organization/individual): bQ/Unn,,Ak A 6 , T A ass.:— q 6 City/_State/Zip: • hAS� Ie Phone #: Are you an employer? Check the appropriate boxes Type of project(required): 1.❑ I am a employer with e41-0'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' [No workers' comp. insurance comp. insurance. t 9. ❑ Building addition required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions ��3% I am a homeowner doing all work officers have exercised their I LE] Plumbing repairs or additions .m self. k ' right of exemption per MGL y �o workers' comp. 12.❑ Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other comp. insurance required.] °Any applicant that cheeks 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. xContractors 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. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job.cite information. Insurance Company Name: Policy#or Self=ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensati&n 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 S 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 S250.00 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 coveragt�yerification. I do hereby certify under the pains and penalties of perjury that-the information provided above is true and correct_ Si�ature Phone#: LOther only. Do not write in this area, to be completed hy'city or town official n: Permit/License hority(circle one): Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: Phone#: 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 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 baving 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-contractor(s)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'pe mit 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 sbould 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/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 d6g 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'rkot hesitate to give us a call. The Department's address, telephone and fax number: The Coimnonwealtb of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Te4;.#.617-727-4900 ext 406 or.1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 wwwrrias.s.gov/dia ' N Town of Barnstab-Ie G�SHE rry_ Regulatory Services akrtrtsTAst a Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.t6wn.barnstable.ma.us Office: 508-862-4038 Fax: .508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print L�1.OB IAGA-T-fON:� Z /P 4 A,-;;7 �"`�� e � G numbers street n �f village // HOMEOWNER': �r1��U C� �P7/r7 �d T9�� nam home phone# work phone# CURRENT MAIL-f11 ADDRESS: D A�3G�Y �r/ 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 wit.lrsaid procedures and requirements. ` $ omeownc�— 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]09.1.1 -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 ofa supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack ofawareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this me,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 ofhis/hcr responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshc understands the responsibilities ofa 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:forms:homccxcmpt N � rC. of TFIF TD{y : EMRN9rkEff-F- MASS. Town of Barnstable Regulatory Services Thomas F. Geiler,Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 .,e www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230. Property Owner Mu.-t"' Complete and Sign T 's Section If Using A B der as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized this building permit application for: ( dress of job) Q i Signature of Owner Date Print Marne I If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\dccollik\AppData\Local\Microsofr\Windows\Tempomry Internet Filcs\Contcnt.OutlOOkiDDV87Ap2\EXPRF-SS.doc Revised 0721 10 I _. TOWN CLERK BARNSTABLE, MASS. Application to TOWS; or 4 ®Y!'J fTC.q'o �f gbbmp Regional �IsStDrfc Miotrftt (EDTI' mit�PI' fy-TABLE 2M JUN 12 Psi 2: 0 42003 KA Y -7 PM 2: 4 g In the Town of Barnstable CERTIFICATE OF APPROPRIATENESS DIVISION lication is hereby made, with four complete sets, for the issuance of a Certificate of Appropriateness under Section Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described.below and on plans, vings, or photographs accompanying this application for: ECK CATEGORIES THAT APPLY: :xterior building construction: ❑ New ❑ Addition ❑ Alteration ndicate type of building: ❑ House ❑ Garage ❑ Commercial Other xterior Painting: ❑ Signs or Billboards: ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other PE OR PRINT LEGIBLY: �A� /� DATE Jr 7 3 DRESS OF PROPOSED WORK �.� �� /7 ASSESSOR'S MAP NO. _ fNER beAlA ha d Ao/ Tff /'294JC7_6AJ ASSESSOR'S LOT NO. ME ADDRESS /5 ?�o A22 VIA f 1,-3arn)4 �r_ Xa, TELEPHONE NO.S_b? 3S z- 913 LL NAMES AND ADDRESSES OF ABUTTING OWNERS, including those of adjacent property owners across any flic street orway. (Attach additional sheet if necessary.) 5 elko Co' r-sa /J9 90 0& rile � D ?66g- eGl� 0L I� IAI 4 oZlo6�" P a /P.S a P Q 42 668 ;ENT OR CONTRACTOR TELEPHONE NO. DRESS :SCRIPTION OF PROPOSED WORK: Give particulars of work to be done, including materials to be used. Please :lude locations of proposed signs. 47� ,C'��ace_ 6move Chi/mAle- Signed �- ner-Co a or-A it )r Committee Use Only This Certificate is hereby APP " ' Date pproved Committee Members' Signatures: Assessor's offioe (1st floor): Assessor's map,and lot number ..... .......:........:.....t. SEPTIC SYSTEM MUST B �oFTnE>o`` Board of Health (3rd floor): 3 BR. lMr4x C., CNSTALLED IN COMPLIA Sev*ge Permit number ........... .. WITH TITLES Z 139H39TADLE, i Engineering Department (3rd floor): S � /9 y(: P ENVIRONMENTAL CODE "b 9. Hquse number ................................................. ...................... TOWN REGULATIONS '�0 v a. t YP APPLICATIONS PROCESSED 8:30-9:30 A.M, andt 1:00-2:00 P.M. only' i TOWN OF BARNSTABLE i BUILDINGINSPECTOR APPLICATIONFOR PERMIT TO ..!.......................................................................................................................... TYPE OF.CONSTRUCTION t t cG Ltk�tJ ��Jc/Vl I .. ....,.......... ............................. .................... ................................. .......................... .. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: i Location ....0 4.�........R.1....6.A............ .:.. n.2 t............................................................................................................ s Proposed Use .......F'orntL.�....!h°.0.Qm'1................. ? ..YQoa vr)............. ................................................ Zoning District ............. ...7................................................Fire District ..�Il�....IcJJ�2 '—. .b.l.. ............................ Name of Owner ?J ........P(..?',t.0...............Address f� -- � 11 11,,,,+�� _� a '1452 Name of Builder . .. �.1't �... c!`�R .....................Address ... .Z,C?...P�lG�`�1Y'S.S....V�.�Fa Nameof Architect ..................................................................Address ...................................................:................................ .... ....................... ...... .... ... .� .+�._ ....... ! ZI-T"E................. Number of Rooms t_ ..................................Foundation �J�. Exterior ....... .rVCu.1..Q ..........................Roofing ......... S.�Q .L- ............................................ Floors t r ......��.�-...��.�.Y.1l�I�--�..Interior .....>, ..................... Heating ................Plumbing1........ Fireplace ..................................................................................Approximate Cost .... ............................................ Definitive Plan Approved by Planning Board ___________________ ______19________ . Are Z/ 5 Diagram of Lot and Building,with Dimensions Fee�5v'............................................. : SUBJECT TO APPROVAL OF BOARD OF HEALTH 0 0 1 So 6 - � 5 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. / Name . J.... . ... 4� .......................... Construction Supervisor's license .�1. .3. .......... PAKTON, DONALD 3�ft 9 8 BUILD ADDITI No ................. Permit for ...................................01 Single Family Dwelling ..................................Mic A .. .......... .... Location 1996 Rt-tr-6A .............................................. ..... ....... West Barnstable, ............................................................................... Owner Donald Paxton ................................................................. Type of Construction ..................Frame........................ ............................................................................... Plot" ............................. Lot ................................ Permit Granted ...................................November 18 ,..19 86 Date of ]nspection ............19 ...................... Date Completed ......... 19 '71 -7............. M G; 5 ell 'Assessor's off,oe (1st floor): 1^ o-r THE Assessor's map.and lot number ...�..I.1......................�: .. P Board of Health Ord floor): 3,j�R' A-)L �,�:� fO •• Sewae Permit number .................. .......8 ......................... i 13aaa9reDLE, i Engineering Department (3rd floor): / / rma `e C� �JS 'gyp f 6 9. Houlenumber ..................................................................:.:... .a�0MAI APPLICATIONS PROCESSED 8:30-9:30 A.M. 'and 1:00-2::00�P.M. Oro f�; TOWN ' OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO .....................:....................................................................................................... TYPE OF CONSTRUCTION ..... .(1. .!...1....r. =?K, ..................w Cgvf......�� !e.'�cN\I+:.................................. ......................... .------.-19 < TO THE INSPECTOR OF BUILDINGS: ; ... ... .. .._ ..b,..a .. -. �... _ .. .. -.. _ The undersigned hereby applies for a permit according to the following information: Location 1.9.`tA1:1-.!....�4.�............lt.). C�� rz ��i Proposed Use P ............. Zoning District .............R...F.................................................Fire District .��.).:... `f!�>� U. .. .K1._..f ............................. Name of -O nC3; �.fl.�•, ` ��.y, C� ,:1 Address �� f'i ! �'i.fl�•, .�1. .... i"J l�„%l„e ,�l;u;Wit; l I� . , caner i >✓ 1 5 2 l ,`a Name of Builder Z�.�.:.,'.h•.!'. ...SC Address ...�1�).... °.Tc>;�i'ati d ............. . ...................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..... ..............:.......................................:...Foundation ......( 0n\. ...... Gn R'�.�?`3"t.................. ExteriorRoofing ....... t��' l :...._:........ .......... .. .... ..:... .. .. .............................................. Floors ...... :: ��-...4:1•`,1�.�.:.�...Interior ....>..... :!.E`��:<. ... '.. T?.,.,i«,<).!�.1..�......................... Heating " ..I..:....::... ......:Plumbing ..... .... . 'Fireplace ..................................................................................Approximate Cost ..... .. .i.nr��,................................................ Definitive Plan Approved by Planning Board ________________________________19________ , Area !.:.................... Diagram of Lot and Building with Dimensions Fee ' D� ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 9 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name h.).....�.J4. ..... Construction Supervisor's License .�). .. .SCE.......... 7AXTON�, 1 01NALD A=217-16 No for J3j il(! Additid'a ............................ .........Sin. le..Family..Dwelling....... Location ..... ....�...qov In ................ West .................... ..................Owner ...... ...P.axt.on............................ ....... .... Type of Construction .......FX.4 M 9....................... .......... ................................................................ Plot ............................ Lot ................................ , Permit Granted .... November 18 ,....................................19 86 Date of Inspection ......I.............................19 Date Completed ......................................19 N6 T- 4 T6 D �l� lr;7 .. erl