Loading...
HomeMy WebLinkAbout0069 BLUEBERRY HILL ROAD �/ � � i _. _ - - - - - -- ----- -r -- i- �•_ .. . x� r r j f �' I,. '� � �, I� i Town of Barnstable Building r .aaysrntEta� Post This Card So That it isUisib,leFrorntheStreet=Approved PlansMust beRetamed on Job and this Card Mustbe Kept 3 M Posted Until Final In Inspection Has Been Made. j p ym ° 'Wh'ere a Certific"ate"of Occuipancy is Required,such Building;-shall Not be Occupied until a Final.Inspection has been made Permit No. B-20-161 Applicant Name: Michael McMahon Approvals Date Issued: 01/21/2020 Current Use: Structure Permit Type: Building-Insulation-Residential Expiration Date: 07/21/2020 Foundation: Location: 69 BLUEBERRY HILL ROAD, HYANNIS Map/Lot: 249-153 Zoning District: RB Sheathing: Owner on Record: WRIGHT,JANET A&MARILDA L P Contractor,Name:'''-,,MICHAEL T MCMAHON Framing: 1 Address: 69 BLUEBERRY HILL ROAD ContractorJucense: CS=068111 2 HYANNIS, MA 02601 Est Projct Cost: $ 1,686.00 Chimney: Description: Weatherization,Air Sealing,Weather Stripping - Permit.Fee: $85.00 Insulation.: Project Review Req: Fee Paid.,= $85.00 Final: Date. 1/21/2020 _ Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized=by this permit is commenced within six months aftecssuance. All work authorized by this permit shall conform to the approved application and the'approved construction documentsfor which this permit has been granted. Rough Gas: All construction,alterations and changes'of use of any building and striuctures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for,piblic inspection for the entire duration of the Final Gas: work until the completion of the same. i ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are,provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing " 2.Sheathing Inspection , _ Rough: .< 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low.Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing;and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final; p p Y BNL:�E. F_mN=L. SE.✓r Application numb gaFee ............................................ Building Inspectors ltnitials... H 3� ..... ......................... ill I 6- q DateIssued.....8.....................1.................................... TWINMap/Parcel... .................. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDOWS/DOORSfrENTS/STOVES/WEATHtP,IZATION PROPERTY INFORMATION Address of Project: 6 ci NUMBER STREET VILLAGE Owner's Name: F61).ef- Phone Number <Z),S- 36? 67 Email Address: Cell Phone Number Check one Residential Project cost$ :ZFS0 al Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize XneS-o to make application for a building permit in accordance with 780 CMR Owner Signature: Date: U TYPE OF WORK ED Siding DWindows,(no header change)# Insulation/Weatherization 0 Doors (no header change)# Commercial Doors require an inspector's review Roof(not applying more than I layer of shingles) Construction Debris will be going to almoz> 71Z, CONTRACTOR'S INFORMATION Contractor's name-1—jo-7 Home Improvement Contractors Registration(if applicable)# . . IV,36-S3 (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor---T;&i keIY4 166(4-3 Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. ,. Town of Barnstable Building ;< Post This Card So That it is;Visilile Frorn,thc Street Approved Plans Must be Retai ed on Job and d Must�be Kept SA"gr e Posted Until Final Inspection,.as Been Made yam� Where a Certificate'of Occupancy,s Required,such Building shall Not be Occupied until a-,Final Inspection has been made �i j�jl Permit No. B-19-2637 Applicant Name: TIMOTHY KEATING DBA KEATING CONST. Approvals Date Issued: 08/15/2019 Current Use: Structure Permit Type:-'Building-Siding/Windows/Roof/Doors, Expiration Date: 02/15/2020 Foundation: Location: 69 BLUEBERRY HILL ROAD, HYANNIS Map/Lot 249-153 Zoning District: RB Sheathing:- Owner on Record: WRIGHT,JANET A&MARILDA L P Contractor Na e TIMOTHY KEATING DBA KEATING framing: 1 CONST. Address: 69,13LUEBERRY HILL ROAD i' �_ 2 i.. Contractor_�cense �143Q53 HYANNIS,MA 02601 Chimney: Description: ROOF Est Project Cost: $7,950.00 % x Permit Fee: $40.55 Insulation: Project Review Req: - g Final: . i a Fee Pa d' 40.55 S i Date,-,, 8/15/2019 I , ( Plumbing/Gas Rou g hPlumbin : g g 4,_,: - Final Plumbing: Buildmg Official - This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the°approved construction documents=for which this permit has been granted. i Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning UV laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained.open for.pu, inspection for the entire duration of the work until the completion of the same. t� Electrical The Certificate of Occupancy will not be issued until all applicable sign atures.by`the Building and:'Fire Officials arelprovided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing L � 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.final Inspection before Occupancy r Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund"(as set forth in MGL c.142A). Fire Department Building plans are to be available on site final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT APPLICATION.NUMBER........................................................ *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X fi Additional tent dimensions can be-attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 20 lbs. or> Yes No ,if yes, a gas permit is required. Natural Gas Yes No ,.if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number- . I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date / All permit applications are subject to a building official's approval prior to issuance. Application number................................................ Fee..................................................... ..................... MteBuilding Inspectors Initials....................................... e. $ DateIssued................................................................. Map/Parcel.............:................................................... TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SID1NG/WINDO W S/DOORS/TENTS/STO VES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUMBER STREET VILLAGE Owner's Name: Phone Number Email Address: Cell Phone Number Project cost$ Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK o- Q Siding Windows (no header change) # ❑ Insulation/Weatherization ❑ Doors(no header change)# Commercial Doors require an inspector's review ❑ Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# (attach copy) Email of Contractor Phone number ALL PROPERTIES THAT HAVE STRUCTURES OVER 7S YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Constructiq r Specialty CSSL-099351 fires d5/11/2020 TIM B KEATINWG .^r 54 LOWER BR�OK SOUTH YARMO,f4TT M Commissioner �✓"' q �c//1,�,aaac�uiae%Ja Office of ConsumerAff i s&BuSlness Regulation HOME,IMPROVEMENT CONTRACTOR TYPE:Individual 143053 - 06/13/2020 s TIMOTHY KEATIN =t7� D/B/A.KEATING GONSTi t zr TIMOTHY B.KE 41tJG 54 LOWER BROOK�RD io! SO.YARMOUTH,MA 02664 Undersecretary; ITheCommonwealth of-Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information � Please Print Legibly Name (Business/Organization/Individual):/�1 ir-7 l�.O fr't?,�'j e, Address: City/State/Zip: ygrm +'-) tMAO Z6l-/ Phone#: SO 76c) 2-D Are you an employer?Check the appropriate box: Type of project(required): 1. I am a employer with l 4. I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors b. New construction 2. I am a sole proprietor or partner- listed on the<attached sheet. 7. RvjKodefingg 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 comp.insurance. � 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 11. Plumbing repairs or additions myself([No workers"comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no employees.[No workers' 13. Other comp.insurance required.] *Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContracturs that.check this lynx rmust attached.an additional sheet show. the name of the sub contractoyc chether qr at?t thoce enttttesrh vg 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: C17/4 - Policy#or Self-ins.Lic.#:KS S!2 U 22!;e W77 Z/% Expiration Date: Job Site Address: S v �// /�1 City/State/Zip: ii4n17,'r P? 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un he pains and penalties of perjury that the information provided above is true and correct. Signature: Date: I �/ Z6 Phone#: ' 26l _e2g�Z Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r - TIF err a - , '� �CEFRIMFIcaTE IS IS$IlEQ AS A AOATTEkZ O .6ERTfF16/4TE DOES NOT AFFMi!l�ATNIELY OR 1�EEAtTFtEtY � ! Q , .C.�`� 3fI911 BELOW. TtflS CERTIRCATE OF INSURANCE DOES EILTE0 -OR.ALTER TIC COVERAGE AFF T:: >.. : RE tnTAiwt v i irRt3� �r TIME.A.CONTRACT THE POUCES �K.'Ete,En3 lii> CitC1t7 :HOtILR:' 'WEEM THE'ISSUING IMSURER(gR .A1J[t{OIiIZED P IMPORTANT: If the ce cafe holder Is an ADDITIONAL.INSURED,Ere ' tic es . a''aarrrrsi�ro vuiruivvns orals 1� YG I must be endorsed SUWiOGAiION IS WIUVED certificate holder in tteu of such eR( Iro ties may Mwir®an a .6114 sat6 ect: ,� ,.. lei. . ant.:A staien►eM;cn this certificate doea not confar ! to Nat¢ �s m the S�hl�gel & Schlegel Ins Broker R4 b4z. ! Q±r fa PNOHE .7C7LI M—CDMLI. 508') .77 -8381 (508). 771r0663 } West Yarmouth, 02673 echle 11n uranGe@ 1. IPISURED INSURE SAFFORIM COVERAL3E` CO>a i NABB 1NB4lRGI :'NAV TILUS --'-`- 1'11+p"}ThiINSURERS:CNA . nt+F►11 PLC's L- CONSTRUCTION +NsuRER C, Jai' 'Lti 1litU(J!C LK + RER 0 _._ SOUTH YARMOUTH, MA 076b4 ImMURER NSURER ER71FtCATE NURABER F• THIS IS TO CERTIFY TFWT THE pa(CES,OF 1 REVISION NtleA��. rniLtl%dy riiuiwllrwJAlvulrtc ply NSURANCE LISTED BaOW,HAVE BEEN ISSUED TO THE!NS CERTlF(C4TI:N4►Y ISSUED:OR MAY TALI TFQ�MENHE INS OR Ct1N�Tgtil OF URED NAME A80VE ...FQR THE POMY FEll EXt.'LU'49N4 AND CONDITIONS OF SUCH . ' CONTRACT OR.C?THER'DQCUNIEIVT WITH RESPECT TO iflMi�H:THIS ftftSURANCE AFFORDED BY THE POLIES DESCRfiD HEREW I5.SUBJECT TO FILL Lt PQL{GES:lJNl1TS.SH0141�1;:tuIAYlIA11EEf,C, Or IIu Adr ao _ -1 SY PAxil THE TERMS . A , CrEP+ERALtlA81LITY POUCY'NUlBER � L`Y �.T nzy` vial ?fz.c[� I. LtE1T8 X :COhRiERCIALGEPEFyLIWBRJTY ', vw+tvw.i?eirai�G a _" s-vk �a+�e s. ,s� Vic,, I i; RTANkGE TO'RREMISktENTEO , [Ea gwitmoel $ 500 00a uttiryane persm ,. I J PERSONAL&AOV.INJURY $ 1 000 000 GEN'LAGGREGATELQutTAPPUESPER --2 - QENERAL AGGREGATE I'$ 2 ►°ULttiY �69fL. (—l00 Luc PRODUCrs_ODMIl roPAG�. S. 2 _000 000<. AUTOg061LEL1A MM, ;. „$ ANYAUTO Ceflxidaft N IT ALLO Mo SCHEDULEb: $ AUTOS I. Flom l INJURY(Pei perm) E AUTOS. HIREOAUTOS S �', I' �: BODILY INJURYIIPeiaaJdern 3.. UIYBRELLA LIAR -: . . 4 I'. ..- ERCESS UA8 CLAIMS MADE I I"rLACH OCCUilf3ENCE; $ 1 OED RET8iTI0f,} Hs WORKERS L AGGGATE.COMPEN6ATIOq` , °V=="°""'= 6S59,UD0224N372:14 3/9/s9 3/9/20 we srATU oTH_ APO'PROPR!ElIORIIPARTWReMWTIIIE`: YfN 4 5 OFRM RA EMMR EXCLUDED? �.. (Manda"in NHL, N/A E:L.EACHAC DENT — untlef i I00 0 f . 00 iHZE!dARl OFOPERATIOFIS'6elow. � � Isi , oAcQsc ep e�en�" o, — ?c_LLS tl b3: _ �t EL.DISEASE-POLtCYlIM1T .i. J�O�' ��{� OESCR�TIONOF OPERATION$/LOCILTIOHB r VEHICLEg _ .. . T LMn_T: (A+tidi ACOR0 ,;Addltlaial ReeafltF SfAtefl .irmm&MCC is ngdred) KT�'bTTt�t�`. iiaC TLLi<'t�Tt.�Tf., n}C1.13 G.. . ' w/'rw. v ..Vv-... :.:�i✓�'�.:�+.�..LAC.LY�i I�Li�L�F�' :�'�'�1TE�n{!.i .-. .- �CaL��7 v.Vi'JC�6CIOM11� e.w�:, ... T. CANCELLATION o+wuu Ani vr'!Me sincivt utM,KIL3ED:PtM 1CBS-BE CANCELLED BEFORE E THE EXPIRATION ORE DALE THEtiEOF,; NOTICE WILL. BE: Dtuw9ED. I' ACCORDANCE WITH THE POLMCY PROVISIONS: !1UTHORLWO RE T ACORD 25(2011NO ) ACORD CORPOWq TION. All III Meeved.Phone: The ACORD.name and 10(to are.resredrnalrks>a.of.AUOR� Fix: €4l it: �j Shed' ° TOWN- OF BARNSTABLE Permit * BARNSTASLE, MASS 16 9��F0 MA'S A, Permit Number: Application Ref; 201505677 20152450 Issue Date: 09/10/15 Applicant: BEARD, ANDREW J Proposed Use: Accessory Structure Permit Type: SHEDS 200 SQ FT & UNDER Permit Fee $ 35.00 n Location 69 BLUEBERRY-HILL ROAD Map Parcel 249153 Town HYANNIS Zoning District RB Contractor PROPERTY OWNER _ Remarks 8X12 SHED Owner: BEARD, ANDREW J Address: 69 BLUEBERRY HILL RD HYANNIS, MA 02601 R _ Issued By: PF POST THIS CARD SO THAT IS VISIBLE FROM THE STREET Town,of Barnstable �r�TME' ti Regulatory Services Richard V.Scali,Director t BA NSTABLE •' MAM Building Division 1639. �0 'OIFp Mpl A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.nia.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT#O�ril � I� FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less_. uc,b(uv j) Location of shed(address) Village { �.�TA me 1 040 H'T 5 o8 - 777 Property owner's name Telephone number Size of Shed Map/Parcel# 5 ature Date " Hyannis Main Street Waterfront Historic District? - Old King's Highway Historic District Commission jurisdiction? _You must file with Old King's Highway _ Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3c304:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE.A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:040914 f 1` 500 -� 9S, OG AN 1-9° l o Ex , .57" L o T /S, 88� i - _ CERTIFIED PL0T. PLAN .�3a„ELEROA �` - - :'� � Ar/ Oni: HS�AN/V�S ` FRONT/ niG LOT.. ALE. / • = 4 D ' D A T E• Al o V. 14, /180 R/-`FERENCE: BEING L07- 16*A A'S 5',., OWN ON A PLAN RECORDED � � /9W THE" 8ARN5TA'13LE CO UNTy DATE RE v /STRY OF DErED5 PL-AIV -80OK 3D3 PAGE / 2 REG. L A/Z) S UP YOR r r E :5' EBY' CERTIFY THAT THE FOUNDATION SHOWN ON -rA4 /.5 • PL.AN / S LOCATED ON If; E 6R0 Un/ D As SHOWN 14ERE" 0N AND. r0 THE 7 Jf P� '• D! NG 5Ef' BACK" RE RE'A4EA'T_5 OF �r . F T o wN 0 _ 1 E: f? J c7 F L'O W AND , �� F'M oUrfipcRr � MA55, i `�„o•"" .e TOWN OF BARNSTABLE Permit No. 22869 t Building Inspector cash 7 /YL OO�PYPY/�� J x 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 Lee Jackson Address 35 Westgate Rd. g Harwich lot 015P. 69 Blueberry Hill Road, Hya.nni.s- Wiring Inspector f Inspection date Plumbing Inspector t Inspection date Gas Inspectors k Inspection date Vingineering Department !Inspection`date/- ��7` �-- 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 z y - .................. ' w�.......... J `Building Inspector l ,f r I! Assessors map and lot number THE . - 4 Sewage Permit number ......::........................................... ir' t BARNSTADLE, i ,/House number ............ 'I r�63q. nsa............................................. 90 p 9� pMAYa� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ........................................................................................:............................................ ................../CJ.................19 1„ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according ,to the following information: Location` ... ...........................................................................='1 ........... ..... l Ge t/.............................. Proposed Use .... ../ �-1 c .' ....:... .%� X?'......... ....... !......r......... .. ......... ZoningDistrict ........................................................................Fire District .............................................................................. ( . E' J/ G f`S r%.� ..................Address ._ 7 .�t Name of Owner .............................................. ..........................:........................................................ Nameof Builder .. .'•..................Address...................................:.......... .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..........`........................................................Foundation ,1....?.. ...... �''L '�—. �. Exteriork/ f2&1;114 % —, Roofing .. ..�>.......................... ............................................ ............................................................. Floors .............. .............................................................. Interior .................................................................................... f .,% l j Heating .......... / ...........................................................Plumbing ........ �.....� t�9 +I.A................................................. Fireplace ............. .................................................................Approximate Cost .......1 .:.................................................. Definitive Plan Approved by Planning Board ----------------------_---------19--------. Area ........ ........ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I� ,p- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f' Name. ..:`r .`.....`�....... ......t'.(r'...... ....................... JACKSON, LEE A=249-153 No §.5.9.. Permit for „One StorX Single Family Dwelling ..................................... Location ...Lot #.15A 69 Blueberry, Hi Ll Rd. Hyannis Owner LEE Jackson ............................................................ Type of Construction ... rame ................................................................................ Plot ............................ Lot ................................ Permit Granted FebruarX 24,..19 81 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFySED � ....................................... ................. 19 ...� ............................ ............................................ ..........©en .........z-t.-fw ......................... I Approved ................................................ 19 ............................................................................... ............................................................................... 1 ' t Assessors map and lot numb .. .. .... J.. .. �,(//oG/ �/— a — THE r 1 of o� SEPTIC SYSTEM MU " Sewage Permit number �...... -,,,,, °,► ,a ,,y .................................... INSTALLED IN COMP • Z SARIS ABLE. 9. ouse number .. .'`....��:.. ? .......................: WITH TITLE 5 9 Mnea ENVIRONMENTAL COGS °'siFoaYa�e� TOWN OF BARNSTABLE BUILDING : INSPECTOR APPLICATIONFOR PERMIT TO ....................... '.....................................................................................................:{ TYPE OF CONSTRUCTION ..................................................................................................................................... ................a:1z.1.................194..,1.. TO THE INSPECTOR OF BUILDINGS: k The undersigned hereby applies for a permit according 11 the following information: / y r Location .... ��..................� u . . l..G..................=... ........... 1.1y ...:5...................... ProposedUse .... .t.. f/ '... f'?��.f, �......... ........................1rI................................................................. ZoningDistrict .....................................................:..................Fire District ................................................................................ Name of Owner �� J/�Ci/C.S� � �GST,�,�7e- ,�GYi �� Address ............... ..... . Nameof Builder ..............................�.......�... .................Address ..................../.f........................................................... Nameof Architect .........................................:........................Address .................................................................................... Number of Rooms ...........6 ..................................................Foundation ...:............. ............... ............................. Exterior ...(/`�... 4A. ./ ./..`�:.'..........................................Roofing ... .��.l�.••............................................................. Floors e 4-1. -' !.....................................................Interior .............. Heating' ... i. .. ' :, ...............................Plumbing ............................................. /.............. ....... .. = ..�. .... Fireplace :.:......... ...............................:................................Approximate Cost .......� .: .v..v.......................T", Definitive Plan Approved by Planning Board ________________________________19________. Area ........�. .l..V..S. ... co Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH �Q 1 1 Y4 I hereby agree to conform to all the Rules and Regulations of the Town ofLarnstable regarding the above construction. No .. ......... ......................................... � . . . / � . � \ ^ ! JACKSON, LEE One Story | Single - Welling - ` ---.��------.------.-------.-.- ` ^ � ' ' Lot #I5A 69 Blueberry Hill � ^ ^ 'Road - Location -----.--.-------------.- Hyannis ................'r---------'---------- ' ` rfee Jackson Owner ..��...-------------.-----.. / I7zanze � Type of Co' `---------.,---. �. . � � . --------------------------. � . Plot ............................ �� ----------.. ' ' ' . . - Febroazy 24 , 8l Permit Granted ........................................lV . - / Date of |nspection..-----------.]A Date Completed .. ...............................lq ' . + � PERMIT REFUSED ~ .~ ..�- ....... ....................................... lq ^ Cr rX .-.. -..��-.----------------. ' - . w" -''' ���%`�'--''-------------'-^' ' ' - ~~ ......................................................... � ---��' ' ` ' ' .---------------' l� � zn ` ' ' .-------.----------..----.----. , ^ - ........................................................... ` a : 001 _ oo 30 o Efit x1 LoTT� ` . ice; . J5, 880� _ , • .CERTIFIED PL.. OT• PLA / l A 5oVE R0.4p L DCATI ON: VA.) " FRONTING _ LOT, -14, 118-0 F?¢'FER°ENCE`• B E / NG LOT l5A AS SOWN .ON A PLAN RECORDED Q•, T� f �0 TNE• BA,RNS� A"BLE COUNTY DATE RE /ST/? Y OF DEEDS PLAN .BOOK 303 , PA G E •/Z . REG. L ND 5 Uq V,�/y OR " / HEREBY• CERT/ FY THAT THE FOUNDATION : SHOWN ON T/-l/S PLAN / S L- OCA -rED 0,cv 7-/-.� E .6_• RO UND AS SHOWN HEREON. AND 7'14A T / 7" .ACES C ONF.QRM TD. THE 8U, c DING SETBA C K REQ U/ REA4ENTS OF •T © WN OF F �C/"«�' „ �+EOR E LO.W 'AA/ D CO . fibC; �' ARMoVrF-tPoRT � MA55, • �� 3 � ,f'� } i Engineering Dept. (3rd floor) Map a Parcel [ Permit# (619 House# Ct Date Issued Board of Health(3rd floor)(8:15 -9:30/1 0Q-4 30) 5;lC - Free 9 ;2 C ` P Bldg.) SEP710$YS� U$T BE INSTAU" C;E 19 LNV1Ro AND TOWN OF BARNSTABLE T49MN R oP . NS Build'ng Permit Application sect Street Address C6?1 -D j I� Village Owner c:�v . ), Address CO LW ci: Telephone Permit Request h t t < i First Floor square feet Second Floor d 5-0 square feet ,? Construction Type_ ,/) ,1 0 Estimated Project Cost $ 1 Zoning District Flood Plain Water Protection Lot Size /.!5i:970 Grandfathered ❑Yes ❑No i Dwelling Type: Single Family (n/ Two Family ❑ Multi-Family(#units) , Age of Existing Structure 15 Historic House ❑Yes ONo On Old King's Highway ❑Yes to Basement Type: ,Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) I Number of Baths: Full: Existing New Half: Existing New ( No. of Bedrooms: Existing New ITotal Room Count(not including baths): Existing New First Floor Room Count i Heat Type and Fuel: )Gas ❑Oil ❑Electric ❑Other f Central Air ❑Yes dNo Fireplaces: Existing 0 New Existing wood/coal stove ❑Yes 2fNo - Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) `Attached(size) ❑Barn(size) ❑None Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# - Current Use Z dei22Y=,r Proposed Use r Builder Information ci Name en eAtog-P� Telephone Number U(> Address & iZ( 5 2 License# ( 5 0L I �6 L Y E U h 0a.3 co U Home Improvement Contractor# 1 Worker's Compensation# W G2, O I t 9-S y q NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE AA ail DATE _ ��x' /—Cl 7 BUILDING PERMIT DE IED FOR THE FOLLOWING REASON(S) ,. FOR OFFICIAL USE ONLY ' r 7 Z Cq t, PERMIT NO. � - DATE ISSUED; ; MAP/PARCEL NO. ADDRESS i VILLAGE OWNER u DATE OF INSPECTION: FOUNDATION FRAME INSULATION r _ FIREPLACE r ELECTRICAL: ROUGH FINAL PLUMBING: U fi FINAL ' GAS: • w' FINAL •FINAL BUILDIl DATE CLOSED ASSOCIATION e. NO N% The Conlnlollwctlltll of Afassachuscliv , x! Department of Industrial,9cridents - ` oficea//nveSM171lans 6110 !1 uAin,�tun Slrcct Bmvwn- Ma.s. 02111 Workers' Compensation Insurance Afftd. it _ '�A linliFW infortnatitin• - Plcise PRINT j�.. ` _.... ..._..._.. _ . r- - Inc lion AAAA/,,-,S 'L ht, .0 I am a homeowkicr performing all work myself. FI I am a sole proprietor and have no one workinu in any capacity • �-w. . r,�— �.7ti.r....f'w�.rC T-�+w•.^11►'!^�-i"r.w .. .�.++�•�.n.�Y.�w.`•��"'.r..'.'•_�—�.w..n.—.•••�--•... 7 1 am an emplover providing workers* compensation for.my employees working on this job. cnnrnnm n•tme• C-r2_A► NI q;C 1 - CU N SrlZ U C.i 1 <, tddress• u lZ C] T:�5 <.' Iz V ►" - cy � J f I #! f'&_G io ey .L N� nolic� !! i/�1C yr I C1 3"1 1-1 insurance co am a sole proprietor. beneral contractor; omeosvner ircle one) and have hired the contractors listed below who have the following workers* compensation police`:- comnanv name: addrMs• • city• nhone#• - incurnncc co nniicv _ � ~ •r.::•+. vim,,..'-... _ �.-Y..._:•-roy_- _- _�•_•--v.-�.���:rv:.�s,tr ^T4.:.-_ i..w•��. ..�...i��� emmpnn.• n•tmc• - a d d r"-v rity• nhnne#• insurnnee co noliyy it Attach addiiio_nal sheet ifneccsia -�.."" •i�- .�:":"..;L'•„ .=--'=.',_:=-_�'t'::'— Failure to secure coverage:-Is required under Section 25A of N I G L 152 can lead to the imposition of criminal penalties of a line up to S1.500.00 andiur one years*imprisonment ms,well as civil penalties in the form of a STOP WORK:ORDER and a fine of S100.00 a dayagainst me. I understand that a cop} of this.statement may be fur,varded to the Office of investigations of the DIA for coverage verification. l rlo herebt•certift•tutder tltc punts and penalties of perjure•titar the information provided above is true and t 'ccorrec Sitnature ir\_ Date 3 _ / 7 / Print named i Phone ..t�nlTicial use only_ do not,write in this arcs to be completed by citg or town oRcial , . city or town: permit/license# rlBuilding Department E C3Uccnsing Board ` check if immediate response is required aseleetmen's Mee ► '. [311c2lth Department ' contact person: phone rnUther. s. 'i- Information and Instructions Massachuscits General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employee s., As quoted from the "last-. an empinree is defined as every person in the service of another under an\• contract o6h re, express or implied. oral or written. An emplorer is defined as an individual. partnership, association. corporation or other legal entity:or any twee or more . the fon�_oin�_ cm�agcd in a joint enterprise. and including the legal representatives of a deceased employer. or the rccciver 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 dwcllim-, house of another who employs persons to do maintenance , construction or repair work on such dwelling hous or o» the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or rencival 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. 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 lta been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits 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. . Cin• or Towns 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. Pleas be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate to uiye us a call. The Department's address. telephone and fax number: The Commonwealth Of Massachusetts - Department of Industrial Accidents rr Office eI Investigations f 600 NVashington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (617) 7274900 ett. 406, 409 or 375 ` w THE . : . . ; The Town of Barnstable • nnRxsrnst,E. • 9e� 16 9. 10�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than,four.dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: a �� S 6� Est.Cost Address of Work: >aQ :gal) 1 I Owner's Name ��A� &0 e U Date of Permit Application: ` h-' I hereby certify that: �. Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied _,Z!!�,_ Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: -� 11 -? 1 LneA P, ,ee, 6S atiS Sees Date Contr ctor Name Registration No. OR 4-7 - Date Owner's Nam a TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Lt 6. -S Number Streef address dection of town "HOMEOWNER" ► ►� lY he 0 Name \ Home phone/ Work phone - - `✓ l��.�L�C/�/`.'�� // r PRESENT MAILING ADDRESS � hh 43 ' - ity town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one 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 Officia on a form acceptable to the Building Official, that he/she shall be responsibl for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes ..responsibility for compliance with the Sta- Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands .-the Town of Barnstable Building Departanent minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 01 Construction Control. • f HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations for •licensing Construction* Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our. Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home " caner' actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community.