HomeMy WebLinkAbout0031 ANTHONY DRIVE �a ttr `Y'ovvn of Barnstable � *Permit#
�pZHE;y�r t?� 1� a Expires 6 months rom i sue date
l ` Regulatory Services F
i 1
Thomas F. Geiler, Director
16-59. NSTAB�� Building Division
,TO Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 5087790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number v2/� _ 20 U f/
Property Address / 7ZAi¢,I/P,
residential Value of Work 3 fI/ 00 Minimum fee of$25.00 for work under $6000.00
Owner's Name &Address t/G
Contractor's Name /l� � ( s�C%7 ���r/ Telephone Number
Home Improvement Contractor License#(if applicable) 1/ d
❑Workman's Compensation Insurance
Che k one:
am a sole proprietor
i ❑ I am the Homeowner .
❑ I have Worker's Compensation Insurance
Insurance.Company Name
Workman's Comp.Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stepping old shingles) All construction debris will be taken to
g/Re-roof(not stripping. Going over�_existing layers of roof)
❑ Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum..44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
'Note: Property Ownerrnust sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License is required.
I
SIGNATURE:
Q:\WPFILES\FORMS\building permit forms\EXPRBSS.doc
Rcvist020108
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The Comtnortwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
1 www.mass.gov/dia
Workers' Compensation Tnsnrance M$davit: Builders/Contractors/EI Please Print
Le6bMb s
Applicant Information Please Print Let?ibly
Nania(Busintss organi2ation/Individual): /
Address: (0 1 f Et A
City/State/Zip: Wux /S Phone.#: r6 P. AI00 - 3IP 6 2
Are you an employer? Check the appropriate ba-c Type of project(required):
1'❑ I am.a employer with 4- ❑ 1 am a general contractor and I 6 ❑New construction
* have hired the sbb-contractors
��loyecs(full.and/orpart.tiuic). 7. Remodelin
Z_►J i am a'sole proprietor or partner- 1i&�on the attached sheet ❑ g
ship and have no employees These snb-contractors have g, ❑D=Dlition
working for me is my capacity. employees and have workers' 9. ❑Building addition
[No workers' in�rr,ance comp.nimirance.
5. [] We,are a corporation and.its 10.❑Electrical repairs or additions
rt aired_] officers have exercised tbeir 1L❑Plumbing repairs or additions
3.❑ I am a homrawncr doing all work
myself: [No workers' comp. right of exemption per MCTL 12 ❑Roof repairs
in manco regniseA]1 r- plo §r15(.4)[,
-5. [ and or have no 13.❑Other /�5i
employees. [No workers'
camp.insurancz required.]
*hay applicant that checks box 01 Tnust also fM out the section below showing their workers'cov4xnsztion pofiay infmToati—
t Homwwnas who submit this af5davit itrdicaSiug rirCy mm doing a,work and thrn hire outside contractors must submit a new a�rlavit indiraftizrg such
Icontractors that check this box mzut atbcbcd an additional sheet showing the name of the sub-couft-4aum znd state wbetha or not thosd entities have
mnploycrs. If the sub-contractors have employees,they nmA prvvi&their workm-s'cmmp.po5cy number.
lam an employer that is providing workers'ccmpensation insurance for my employees Below is the policy and job site
information.
Incrrance Company Name:
Policy#or Sclf--ins.Lic.#: Expiration Date:
Job Site Address: City/Sta&zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to scturc coverage as required under Section 25A of MGL c. 152 can leati al to the imposition of crimii pcnaltics of a
fine Tip to S 1,500.00 and/or one-year imprisonment, as we11 as civil penalties in the form of a STOP WORK ORDER and a fi
of up to$250.00 a day against the violator. Be advised that a copy of this statcmtr t m$y be forwarded to the Officc of
Invcrtigatims of the!)IA for insuramr,covers o verification.
I do hereby certtq under the pains-and penaLdIcs of perjury that the information provided above is true dnd correct
( Dart:
Phone# -6 0 '21 S�o ' 3 je(4 2�,
I
Offickd use only. Do not write in this area, t or town offxLL
City or Town: Permit/License#
Issvfng Authority(circle one):
1.Board of Health 2.Building Dep r-tratut 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector'
6. Other
Phone#:
0
�01-VEY, Town of Barnstable
Regulatory Services
RkMNST"BLF-
MAS& Thomas F. Geiler, Director
Arfo �a Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
r !� , as Owner of the subject property
hereby authorize X41 to act on my behalf,
in all.matters relative to work authorized by this building permit application for:
(Address of J(C)
ign tore of Owne Date
I
Print Name
If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on th'c reverse side.
• r
Town of Barnstable
�ofSHt:rp�y
o Regulatory Services
saxrtsrwsce Thomas F.Geiler, Director
� Mom• �
1 19. Building Division
plFD '�a Tom Perry,.Building Commissioner .
200 Main Street, Hyannis,MA 02601
Rww.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
JOB LOCATION:
number street village
"HOMEOWNER':
name ,� home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was extended to include owner-occupied dwellings of�ix,upits qr less and
to allow homeowners to engage an individual for hire who does not possess a license,pro'yided`t it 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 perforating 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 rtsponnbilitics 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.
and of
Buildi
{I y01 yF 1Mpj�p ng Regulation° 4
Re � VFMENT and Stand /
�grstratrons CANT ards
prratipp 1j6609 RACT pR t
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1CCY FCgUTy�N� 41nd, uo10 r
i I H�BFTy q�yFN ' ;r' al 26g043
l qN Nls MA 026p1�, a
_ Administrator ,ii
License or registration valid for individul use only
. before the expiration date. If found return to:
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston;Ma.02108
'i': 4otvalid without signature ,
i
r,
Assessor's office(1st Floor):•
Assessor's map and lot number
Board of Health(3rd,floor):
Sewage�Permit number
} = DAR13TA)LL i
Engineering Department(3rd floor): clue
House number `s�� r/ - vo 039.
Definitive Plan Approved by,Planning Board / 7 . 19 _9 6 o env a•
APPLICATIONS P ROC EOS�IQO:30-9:30 A.M.;and 1:00-2:00 P.M.only ' /tit,
Barns tat3i b,vation c.0.WnN OF , BXRNSTABLE -
�h-�� t iM D i N 0 INSPECTOR
Signed Date APPLICATION
FOR PERMIT TO i l'
TYPE OF CONSTRUCTION
TO THE INSPECTOR OF BUILDINGS:
The undersigned/hereby applies for aapp�ermit according to the following information:
Location
Proposed Use LC:Q--
Zoning District APB- Fire District '
Name of Owner C C/� T Address
Name of Builder Address C
Name of Architect Address �I
Number of Rooms Foundation
Exteri Zak ,&o Roofing
Floors .� �-�Y y Interior
Heating &:�o IV4,;z O Plumbing �� a
Fireplace v �h� Approximate Cost Lo G
Area
Diagram of Lot and Building with Dimensions Fee (�
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name Z2--94
Construction Supervisor's License
C. C. H. T.
No 3 4 6 5.0 ' Permit For Z,i 1 z Story
k Single Family--.Dwelling �.
Location Lot #11 , 3'1 Anthany D ive
R' Hyannis
y owner C,. C
Type of,Construction Frame
o' Plot- Lot
21`October
• Permit Granted� 0 19 91
Date of Inspection / 10
/ D e mp eted / ��/ z-- 19
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���°�•.ew TOWN OF BARNSTABLE
BUILDING DEPARTMENT
TOWN OFFICE BUILDING
rua
'g�01uY►�� HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE: q15 +9
An Occupancy Permit has
been issued for the building authorized by
BuildingPermit #$ A................................................................................._......»..........»....... »»
issuedto ......»............. .G!.....---------:.......... »..................................................................».».. ».»»..»» .....»».........»..»»..»»»»
Please release the performance bond.
TOWN OF BARNSTABLE Permit No. 4650
. BUILDING DEPARTMENT
I MATT I TOWN OFFICE BUILDING Cash
kK, �9 �"a
039•
you+� HYANNIS,MASS.02601 Bond ..... .........
i
CERTIFICATE OF USE AND OCCUPANCY
Issued to Cape Community Housing Trust
Address Lot #.11, 31 Anthony Drive
Hyannis, Mass.
USE GROUP FIRE GRADING OCCUPANCY LOAD
THIS PERMIT WILL NOT BE VALID,.AND`THE BUILDING SHALL'NOT BE OCCUPIED ;UNTIL
SIGNED BY THE :BUILDING .INSPECTOR UPON SATISFACTORY"COMPLIANCE,.WITH TOWN
REQUIREMENTS AND IN ACCORDANCE WITH SECT[ON,a119.0 OF THE MASS ACHUSETTS.STATE
BUILDING CODE:
January 3, 92 ice!
.................... .. 19.. .. ..
Building Inspector
i �•,.+`. �... w•.�'i.�rv--.,-.r�-.^w.-.,.i...-.}Y.i^�+"`ry"d`'•f- 'r"ayf.^A,.-. -lti.++t..:n-�y+va'"�y"`d�.Tyy"'"' i.-,r..y�,'yr..�v y-:w-..-.-v-r •ve,'•" *'
ti TOWN OF BARNSTABLE Permit No.34650 -oFrw[�a i 1
...............
`BUILDING DEPARTMENT
I V ~' TOWN OFFICE BUILDING.. Cash ................
ten.. _
HYANNIS.MASS.:02601 ' Bond `1�
CERTIFICATE OF USE AND O&UPANCY
Issued to Cape Community dousing T4ust
I Address Lot #11, 31 Anthony Drive
Hyannis, Mass.
r
d' USE GROUP FIRE GRADING OCCUPANCY,LOAD
THIS PERMIT WILL NOT BE�,VALID., AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED''BY`THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN A
REQUIREMENTS AND.IN ACCORDANCE WITH"SECTION 119.0 OF THE MASSACHUSETTS STATE
BUILDING CODE. _.
.....3anuary. t3 f..... I9....9 ..... .... �'�L'... .....
Building Inspector
r
F
i4'y~ tr.k7" 'J r 1°I•mot t a�y t:Kt' rp ;•� �'t a t t �." ;
k TOWN4OF6$ARNSTABLE;•MASSACHUSETTS` y s BUILDING `PERM:IT
:. � 'psx Z~ ` -'kit t5 tj s$,ki x 'i� ,r<. 6Yr"f _.E. �, .y t � s
s�o'Am272 t ; October 21 91
zi � � tr ATE 19 PLR IS N -_
$ay-,;6 Building G'Go'. .'G�en"�erv� 5
APPLICANT ) `•ADDRESS': -
(NO ). (STREET). ICONT R•S. LICENSE) 1'
k r Build dwellin 1 h Singh ifamily ;dwelling, tNUM13ER, OF 1
l+•cPERMIT TO ) STORY DWELLING UNITS a,..
IMPROVEMENTI' 4NO to -rt (PROPOSEO':U,SE) : _
�f x {i lot' 11 w <� Y ANt ony DRive, Hyannis ZONING RC
AT (LOCATION) DISTRICT
�r
BETWEEN
,(CAOSS STREET) ° (CROSS STREET)
T
LOT'
SUBDIVISIONI LOT e .BLOCK SIZE
-••BUILDING IS Y0:BE FT. W IDE BY ' F.T.-LONG,BY'- FT, IN HEIGHT AND SHALL CONFORM IN',CONSTRUCTION -
TO TYPE USE GROUP_ BASEMENT WALLS OR FOUNDATION
- - ITYPE) _
REMARKS Town '$ewer 0536
t
a�
c
ND
r• w, r t ti BO
AREA 'OR t 816 f3{�• :�t� i3 C
} - 60,000 MIT65.50-
VOLUME r ESTIMATED COST FEE PER
ICUBIC/SOUAREtFE ET)
Y 4
C FC �1 T r
OWNER. y
t" -a BUILDING DE PT
"s ADDRESS..
t
4
' r�•jt q � t.( 6r )<4 S SJ�.t^f•,,.i,.� �` f � - ��, 4 � {. t! _
sa; a Sis 74,�i,..0 ,�r .,. pc v ,� .r¢.,{ I•..�.r.i� . . .-..; } +,..,. „rs '+fi .a k .f.\,r�..,,. •-r � .a::,.,., ,,r.eZ tea•
PERMIT DOES NOT RELEASE THE AP PLIC ANT,.FROM THE CONDITIONS
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
MINIMUM OF THREE CALL _ -APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE
INSPECTIONS REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
ALL CONSTRUCTION WORK: ._ ELECTRICAL, PLUMBING AND
1. FOUNDATIONS OR FOOTINGS. MADE. WHERE .A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS.
g 2:PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL
3 MEMBERS(READY TO LATH).3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
-�
OCCUPANCY. - -
POST THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
Ale/
i
i
2 2 pe1'/4 2
3 i HEATING INSPECTION APPROVALS EN NEERI D PARTM T
00
.�
2. BOARD OF HEALTH
OTHER SITE PLAN REVIEW APPROVAL I.;
WORK SHALL NOT PROCEED UNTIL-THE INSPEC= PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE
I WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN
a TOR.HAs APPROVED THE VARIODUS STAGES OF .I
f, CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION.