HomeMy WebLinkAbout0016 BROOKSHIRE ROAD 16
TOWN OF BARNSTABLE BUILDING PERMIT APP,LICAT°ION ;
Map 3z � Parcel V Application #o20� 00 CDa
Health Division Date Issued
Conservation Division BUILDING � �� Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board JAN 04
Historic - OKH _ Preservation/ Hyannis BAR�STq �
Project Street Address t6 ` aA r)('E
Village I6 -ro0K KA oiyih�S
Owner Address ��.���� �� ��
Telephone
Permit Request Q (lo> 1NIrdbwSr Wow- SfQxI� -h llNtokS nbm g bsi7qp rabib
Square feet: 1 st floor: existingrrg1c 9-proposed 2nd floor: existingUflq-% proposed Total new Q
Zoning District Flood Plain Groundwater Overlay
Project ValuatioNI bO. 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 1D5 b Historic House: ❑Yes- 2 No On Old King's Highway: ❑ 'Yes �No
Basement Type: & ull ❑ Crawl Walkout ❑ Other
Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) ke 63.10
Number of Baths: Full: existing new Half: existing 0 new e
Number of Bedrooms: 3 existing 0 new
Total Room Count (not including baths): existing 5 new First Floor Room Count
Heat Type and Fuel: ❑ Gas W Oil ❑ Electric ❑ Other
Central Air: 0 Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes a No
Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_
Attached garage: ❑ existing ❑ new size —Shed: N existing ❑ new size 101M Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
l (BUILDER OR HOMEOWNER)
Name r1.yA 1A ervift do X) Telephone Numberdn
Address ZA ak11 License #
Home Improvement Contractor#
Email �'p� — ' f 0 I1,UIn�� U)vfW orker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
L ��� ci I�cas� rn — s �lS
SIGNATURE (KO ' O
�`L DATE ()�° LIP 2Dllp
FOR OFFICIAL USE ONLY
-APPLICATION #
DATE ISSUED -
MAP/ PARCEL NO.
ADDRESS VILLAGE
t s
OWNER,
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
t..
,ti
'' Me Coni ntainvealth of Massachusetts
Department of r4draft ial Acciderais
Off-ce offnnestigations
. .600 Washington Street
ti Boston,AM 02111 -
nrviw trrass govIdia
Mr rkers' Campensation Insurance Affidavit:Builder-slContrac-tors/EIectricianslPlumbers
Applicant Infotmation Please Print LegibIy
NatlmAL
($nairtplthganiza{i4nlfn n l�_ l�ja {�
Address: -0 tat (1C.C.1 d
Ityrf Patel gC MA OZ� Phone lu 9,6
Are you an employer?Check the appropriate box: Type of project(requited):
1.❑ I am a employer urith 4. ❑:I air a general contractor and I
employees(full andfor part-time)-*.. have lured.the sub-contractors d ❑New construction
2.❑ I am a sole propne-tar or partner- listed on the attached sheet. 7. ❑Remodeling
ship and Ewe no employees. These sub-contractors have g_ ❑Demolition
working for in any c employees and have woricers'
[No Svorlcers'comp-insurance comp_insurance-1ci g. ElBuilding addition
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_❑Plumbingrepairs or adc]itiom
myself [No workers'comp_ right of exemption per MGL 12.❑Roof repairs
insurance required-]s c.132,§1(4X andwe have no
employees_[No workers' 13.2other
comp.insurance required_]
*piny appFuant Ghat checks has Fl must also fill out the section below shassiug their mashers'compensatwa policy information
I F on emvners who submit This affidavu indicating they are chin,;all wade and then hire outside contractors hmrst submit a new affidavit indicating such
fC'antrsctorsthat cbea this box mast attached=additions)suet showing the Tiara of the sub-ccatractars and state whether.or not those deshave
employees.Ifthesub-cont actors have employees,they must provide their workers'comp.policy number.
I ar t ari etrtpfo}�er thane isproxziiirrg yvarkers'conipertsaiz'art irtsurarrce for arty*enrpfo}�ees Below is file policy and job site
informadon
Insurance Company Name: �.
Policy 4'or Self-ins..Lic_9: Ekpiration Date:
Job Site Address: City/State/zip:
Attach a copy of the workers'compensationpolicy declaration page(showing the policy number and respiration 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$1,50D.00 and'or one-year imprison meat;as well as ci-%ril peualties.in the formm,of a STOP WORK ORDER and.a fine .
of up to$250-00 a day against the violator. Be adiised that a copy,of this statement may be forwarded to the Office of
Irdvest gations of the DIA for insurance coverage verification_
I do Hereby certrfj,under the pains andpeiiabYes ofperjurp that the iraforrrratior>!pm cried abmv11.f.tru$acid carrect
Sienature:, l � ,J� d _• bate: o 1,0`''�° W l I
Ofja"eial use enly: ,Da not wrfte in this area,to be completed by city ortbirn officzat
City or Towu.: PermitUcense#
Issuing A utherity(circle one):
1.Board of Bealth 2.Budding Department 3.CitylTown Cleric 4.]Electrical Inspector S.Plumbing Inspector
6.Other
Contact Person: Phone#:
Iliformafiau and Tus&ucfious4 `
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees:
Pa suantto this shut.,an empfnyee is defined as.--every person in the service of another under any contract of hire,
express or implied,oral or wrifteu"
An enpfcy8•is defied as"aa mdividnal,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 sees 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 ofpublic wou3c until acceptable evidence of compliance with the iasuranCO..
requirements of this chapter have been presented fin the contracting alb-OdiY."
Applicants
Please fill out the wou<<ers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s), addresses)and phonenumber(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 affidayit may be submitted to the Department of Industrial
Accidents for conf=maiion of insurance coverage. Also be sure to sign and date Elie affidavit The affidavit should
be retuned to the city or town that the application for the permit or license is being requested,not the Deparbneat of
Ldistrial Accidents. Should you have any questions regarding the law or ifyou are required to obtain a workers'
compensation policy,please cafl the Department at the number listed below Self-insured companies should enter their
self-h1sma ce license n»ber on the appropriate line.
City or Town Officials
f "
Please be sure that the affidavit is complete and printed Iegibly. 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 pewincense number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/Ucensa applications in any given year,need only submit one affidavit i adicaiiag current
PO
i afbim.ation Cif necessary)and der"Job Site Address" 1t�e applicant sho��ld•rite"all locations in ( 'or
town)-.A copy of the-affidavit that has been officially stamped or marked by the city or town maybe 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 homeowner or citizen is obtaining a license or p=aitnot related to any business or commercial venture
(i.e. a dog license or permit to bum leaves etc.)said person is NOT regt>aed to complete this affidavit
The Office of Investigations wound 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:
Thu C�GmmonWc eft of Massachusttt�-.
Department of IndUS-iriak Ac Oidentq-
Oface of kves:dgafi.oA�i
Goa-Waslaiva,st=t
Ruston,MA Q111
T(,-L 4 617-727-4-9,GG ixt 4-06 or 1-M-MASSAFE
Fax 9 617-727 7749
Revised 4-24-07 wWW mash-gavldia
e
4WC wide to Wood Constrac iorr in Hj CIA end Areas:110 inpk MTud Zofze
Massachuseits Checklist fOF Colm-p once (78o ChTR53012:I.I)' - {
c'1 heck
Camglianca
1.1 SCOPE-
Wind Speed p-sea- 110 mph
WindExposure Gategmry_._._____.._____-__ ____._._._�._.--•-------_:•----- :._----___..__.__-B
Wmd Exposure Category..:.............Engineering Required For B-i ire Project--------------------------------------
• 12 APPLICABiL1TY
-Number of StDries(a roof which exceeds 8 in 12 siope shall be considered a sfDry) stories 5 2 sinries
_.._...._ t 2 <
I�afi Fitch ..�..___.-____.:.:...:.__..-___..�_. (Fig ) .___..___._._______�-._..____. _1212
Mean Roof Height ____. ..__._-_---_._....__ _=.�[Fig'2}__.____..___.__..._.__._._._:__-: ft 5'33'
Building Width.W,_._._._ .._----- ___. -----_--_--(Fig 3)----...�-.:.----•=----•___=--
Bulling Leng.1h:L _._.______.__----_.--_-------_-(Fig 3)--_-_-•------_-.-_-----:..____ ft BQ`
Building Aspect Rafio(LItN) _._.�:-_------ ___.__:_.______ i 4 _____ ;--------:_-.— '!9 3:1
Nominal Height of TaIlest Dpening2 5 6'8"
1-3 FRAMING CONNECTIONS _
General compliance with framing r'nnediDns__..._----:__.(Table 2)------__.__--------------•----._____.____--- _--
2-1 FOUNDATION
Foundafron Walls meeting requirements of 7BD CMR 5404.1
........................... ............•-•-•--__......---••••-•-•-__.-•---•--••-•-•--•-••-••--••-•••--••-----••-•••-••-••----
Goncrete Masonry.......--------------_- ---- --------- ---- -- -------_ -
22 ANCHORAGE TO FOUNDAT]DW-3
5/8`Anchor Bolts imbedded or 5/8`PlDprietary Mechanical Anchar's as an alternative in concrete only
Bolt Spacing-general._...................•_:_-•_-___---_.(fable4)-------._.._:.._.-------------_ in_
Bolt Spa cing from endf ofnt of plate F
Bolt Embedment- 5)------- --_--_----�_.�_�_._in.>_r
Bolt Embedment- _-_--_-_--•-__(Fig 5).._._- =---.............-_____ in_>_15`
Plate Washer_.;_-_______-._.__:-----
3.1 FLOORS
- Floorframing member spans checked 7B0 CMR Chapter SS)--------------
Maximum Floor Opening dimension_.------ ---------_-(Fig 6)-•---------_..-----_------_---•----•-•_ft<_12' .
Full Height Wall Studs at Floor Openings less than Z from Exterior Wall(Fig 6).................._.........._..........
M Lx Lirn Floor Joist Setbacks
5uppoi-ing L rm aadbeag Walrs ot•ShearwaI!_-_.__---(Fig 7)__ ___;___- ____...._--_--------- --•_ft 5 d -
Maximum Cantilevered Floor Joists ,
Supporfing Lbadbearing Walls orShearwall_-.____(Fig 8)_-- -- ------------ ff `d
•Flops-B acing at Endwails__._.................•---------._ .- -(FigY--.____---------��._-
Flraor Sheathing Type .-------•--- _----------------_.. (per 780 CMR Gfiapter 55)......Floor Sheathing Thickness --(per 780 GMR Chapter 55)---------- in_
Floor Sheathing Faster mg_.._.......-........ 2)--d nails at in edge/_in field
4.1 WALLS
Wall Height '
Lnadbearing walls.---------_-----�----._ .----.(Fig 10 and Table 5) ft 510'
(Fig 10 and Table 5)_-_
Nan-Laadbearing walls_,-___.._:._:..:__:-_-__ __.__....---_ '<ft'S 2D' -
Wall Stud Spacing �...---:---._....__..- ___.._.._:__(Fig 10 and Table 5)____.._.._�._in_ 24`o.c.
Wail Story Offsets ---__;:.:_::__�..__---.._____.(Figs 7&8)_______..._...---_--•--___-�.. ft s d
42 E KTFRIOIi;WALLSs
Wood Studs
LaadbeatingwraIls_-__-----•-•--._...._._.:....----; ........-------------
._....2x
Non-Laadbearing walls �._._�Fable S — _LrL
Gable End Walt Bracing t
Full Height Endvrall Studs.._-. -:_._ _--•--,-_-•(Fig i D)__._.__ ____._�_ __...---_-__-• -•-- --
WSP-Atfc Floor Length_---__---::__.�:___._-
Gypsum Cuing Length[if MP not used)_.......... (Fig ft 0.9W -: -
and 2 x 4 Continuous Lateral Brace 9 6 f L o_c_Fig 11 — _
or 1 x 3 ce►Trng furring strips @ 16"spacing-min.vril}r 2 x 4 bioc[cing @ 4 fI_spacing in end joist or truss bays
Double Tap Pla
Spfice Length ft
4 TVC Guide to TVood Coast wcdou irz Higk lend flreas_ II D arplr >`t'wd Zotrcl '
Massaclit setts Checklist for Compliaaee(90 civzR53ol_�
Loadbearing Wall Connections
Lateral (no-of 16d common Waifs)__..___._._._____.- (Tables 7)--_---_--_----_.____._�-•--___-:
Non-Laadbearing Wall Connections
Lateral(no-of 16d common nails)------.._.----(Table 8)-.....
__ ------ ---_--.---_._._.--
Load Bearing Wall Openings(record largest opening but check all openings for carr►p(iance to Table 9}
Header Spans -----------------(Table 9) fit_in._<If,
Sin Plate Spans ---------____ ___�_._._.(Table 9)_..�--._ ._-------•-_-_ff_in._<1 S'
Fun Height Studs (no_ of sivds)-- ---------_- ---(fable 9)--------------------.__..__ _--
Non-Load Bearing Wan Openings(record largest opening bilt check an openings for compliance to Table 9)
Header'Spans..-• (Table f3)___-------------_----- ft_in_512,
Sill Plate Spans. _--_(fable 9).._--- _----__-•_fit_in s 12`
Full Height Studs(no.of studs)__, _ —___--_-(fable 9)___.__-____-.-----
ederior Wall Sheathing to Resist Upldt and Shear Simuftaneousiy{
Minimum Building Dimension,W
Nominal Height of Tallest Opening Z ...................---- - --- - ------ _-_ _ —�6'8'
Sheathing TYPe- --- _—---- - - _(note 4)- ---------- - -_-__--- - -
Edge Nail Spacing---------_------ - -_-.(fable 10 or note 4 if less)---_--------__-_- In-
Field Nail Sparing-......__...__------.__-.-_•(Table 1D)__-__-_-_:___--___.___-. in.
Shear Connection(no-of 16d common nails)(Table 1 D)---•--_-_--_-------------------------------- _
Percent Full-Height Sheathing.___._' ___-----(Table 1D)-------_---_----_--------,---------•-_-._°�
5%Additional Sheathing for Wall with Opening>V&7(Design Concepts)-_-_-_---__.---"-
Maximum Buifding Dimension,L
Nominal Height ofTatlest OpeningZ_---.----------.-----"----------------------------------------_:__5 BIB"
` SheathingEdge Nail Sparing able 11 or note 4 Mess ------------------ in.
g P g----•-------- ---------(T )
Feld Nail Spacing--------- -------- ---•__=-(Table 11)_________.,._----------_-------•__ in.
Shear Connection(no. of 16d common nails)(Table 11)---...___:_
Percent Fun-Height Sheathing (Table 11) %
5%Additional Sheathing for Wall with-Opening>BIB*(Design Concepts)__._-__u�._
Wall Cladding
Rated for Wind Speed?- - - ---_---- --- --- -------_— ----- - ----- -- -
5.1 ROOFS
Roof framing member-spans checked?------.---.(For Rafters use AWC Span To_ol,see BBRS Websifs)
Roof Overhang ------------------------------------------------(Figure 19)___-___--. ft s smaller of 2`or U3
Truss or Rafter Connections at Loadbearing Walls
Proprietary Connectors
Uplift-_-_---.____.._ _.---_—_.(Table 12)--.___ U= plf
Lateral--------.---.__-.---------.__.__.----(Table 12)____--------------.---•-_----_-_L= plf
Shear-_-_------•-.___. '_—.----(Table
cti
Ridge Strap Connections,if collar ties not used per page 21._. (Table T= plf
Gable Rake Otttlooker----------------:-..__.__..____.-_(Figure 20) .____..___ ft s smaller of 2'or U2 '
Truss or Rafter Connections at Non-Loadbearing Walls
Proprietary Connectors -
Uplift __(Table 14)_-__---•----------•__--U= lb.
Lateral(no.of 16d common nails)_..(fable 14)......................................L= . lb.
Roof Sheathing Type ---__--;- --__--_---(per 78D CMR Chapters 58 and 59) ...........
_
Roof`Sheaihfng Thickness in_?711S'WSP
Roof Sheathing Fastening-_.__-._:_ _._:_-_._._.___.(Table 2)
Notes_
•1. This checklist shag be met in its entirety,excluding the specific exception noted in 2, to comply with the requirements of
78D CMR5301.21.1 item 1.If the checklist is met in its entirety then the following metal straps and hold dbwns are.not
required per the WFCM 110 mph Guide:
a_ Steel Straps per Figure 5
b. 20 Gage Straps per Figure 11
c. UpFff Straps per Figure 14
d_ All Straps per Figure 17
e. Comer Stud Hold Downs per Figure 1 as and Figure 18b
2 'Exception:Opening heights ofup to 8 ft_shall be permitted when 5%is added to the percent full-height sheathing
requirements shown in Tables 1 D and 11.
3- The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated t2-grade.
r� .4F)''C Guide to F3`bad COILi771rCtlOfl ur I ijIc 141*rzdAre,2t_ 110 tapir 1r7ndZcne
Massachusetts Checkdfst for Compliance(790 CNIR S30L J'1)'
4
a. From Tables 11)and 11 and location of wall sheathing and Building Aspect Rafio,determine Perot qt Full-Height
Sheathing and hail Spacing requirements
b. Wood Structural Panels shall be minimum thickness of 7116'and be installed as follows
1. Panels shall be installed with strength ass parallel to studs.
I All horizontal joints shall occur over and be nailed to framing.
-ui. On single straiy construction,panels shall be attached to bottom plates and top inembar of the double
top plate-
iv. On two story construction,upper panels shall be attached to the top member of the upper double top
plate and to band joist at bottom of panel.Upper attachment of lower panel shall be made to band joist
and lower attachment made to lowest plate at first ftoor framing.
V. Horizontal nail sparing at double top plates, band joists,and girders shall-be a double row of 8d
staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment
5. Glazing proiaLton:a)•new house or horimnW addition-required if ppled'is 1 mile or closer to shore(generally,south of
Rte.28 or north of Rte.6)
b)vertical addrhbn-not required unless there is extensive renovation to the first fioflr
c)replacement iviridows-needs energy conservation compliance onty(chap 93)
S.Wood Frame Construction Manual (WFCM).for 110 MPH,Fxpnsure B may be obtained from the AmericEin Wood Council
(AWt)websita
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Vertical and Horizontal Hailing Detail
Vertical and Horizontal Hailing
far Panel Attachment fbt Panel Atfaahrnant
SHE a
toffy Town of Barnstable
Regulatory Services
' E g.srxcraur� E
r EC'ACM $ Richard P.Smli Direct=
4.
Btuldmg Division a
Tomrerry,BmZiing Commissioner
200 Main Sheet Hymijs,MA 02601 .
www fownbarnstable ma_us,
Office: 508-862-4038 Fag: :508-790-6230 ry
Property Owner Must{
Complete and Sign This Section:
If Us ing A Builder
as Owner of the subject property-
hem by autbLo irz to act on. ^ bebA
in all matters relative to work authorized bythis binding Permit application for. ,
(Address of Job)
-'Poolfences anl,alatms are the responsibilit rof the applicant Pools.
are not to be filled or d before fence is installed and all final
inspections_are pedonmed a_nd accepted.
S;gnat•m of Owner 4 JL Sipature of Applicant
PlintName- _ PrinxNamP
t f : 4t
tl
Date
QFaAMS:O WXEUERMMMDIeOOL5
A
Town of Barnstable
Regulatory Services
�-ME r � Richard V.Scafi,Director
BuIding WvMonE
t
t 86�'aatasxr4 f Tom Ferry,Eur7ddg CoMASS
mmiceieap,.�
pcb Z tia� 200 Mad.Stmet, Hyannis,MA 02601
W w towILbarasta_�lr
Office: 50 8-862 403 8 Fag: 509-790-6230
• HOMEOWNER rrr�rr_E�'ITON
��•A`2 n p 1. 'Plerso Pr nt
0 NO
JOB LOC 411dbL-
_ cant_ bam phono# workphono#r
7 -Y)C�.QWU-" rnn baste
CURRENTMAIL.�IGADDRESS: CJ4_JT 1 �
city/fuFra sty Zip cock
The current exemption for`homeowners"was extended to include owner-occapied dweIImgs of sa units or Iess and to alloy
homeowners to engage an individual for hire who does notpossess 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, an which there is,or is intended to be,a one or two-
f achy dwelling, aftanhbd or detarhed strict ores accessory to such use and/or farm stuctnTes. A peson who constructs more than one
home in a two-year period shall notbe cam�.ahomeowner. Such`homeowner".shall submitto t$e BTn Official on a form
acceptable to the Bm1�Official,that he/she sh0 be responsible for all such wodc Rerf=ed under the bm7dina permit (Seciian
109.L 1)
The undersigned`homeowner-asses responsibility for comuphanm witb.the Stain Building Coda and other applicable codes,
bylaws,rules and=9U- htians_ -
The uadrmgned`$omeowncz"rectifies thathe/she uadcutmcls the Town ofBa nsbble Bi diag Departm=tminkm inspection
promdmes and regni rc=nts andthat he/she will comply with said procedmrs and regmaemeufs.
a�t
• sigaa�s�o o�aua ' •
ApproPdl QfBm7dmgOf ficYa1
Note- n=-fErmZy dwellings containing 35,000 cubic feet or larger will be required to con:rpIy with the State Bm7ding Code
Section 127.0 C .CLf thou C'o„tml-
HGMZDWNER'S SON w
The Code stairs that: 'Any homeowner performing work for which a baiT�permit is required shall be exempt
Emm the provisions of this section(Section 109-1.1-Licensing of construction Supervisors);providers that if the homeowner
engages a persons)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are naaware that they are assuming the respoasMMties of a supervisor
(see Appendix Q,Rules&Regulations for Licensing Construction S¢pei visors,Section 2.15) This lark of awareness oft:--a
results in Serious problems,parficularly when the homeowner hires mhceused persons. In this case,our Board cannot
or_ The homeowner as Supervisor is
used person as if would with a licensed ervis acting up
.Proceed against the umIice p �P
ultimately responsiibIe
To ensure'tTxat the homeowner is fully aware of his/her respoasctirTitles,many coamamifres require,as part of the
permit application,that the homeowner cerfrfy that he/she understands the responsIbM es of a Supervisor. On fhe Iast gage
of this issue is a form currently ited by.several towns. You may caret amend and adopt such a formleerfifr-dina for use is
your community.
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Assessor's office(1st Floor):
Assessor's map In ot number
Conservation'"" �,�''''t 161S CONNECTED
't4.�ll't'ri!'Y �
Board of Health(3rd floor): r(; TOWN S VW PRIOR TO MY i ssa»ranLE
Sewage Permit number
Engineering Department(3rd floor): 'o teyo.
House number ��Yr'Y►`
Definitive Plan Approved by Planning Board 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION
6 Z S 19 `l 2—
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location
Proposed Use
Zoning District /�J/" Fire District
Name of Owner Address
Name of Builder Address
Name of Architect Address
Number of Rooms Foundation
Exterior Roofing
Floors Interior
Heating Plumbing
Fireplace Approximate Cost �- J�o
Area
Diagram of Lot and Building with Dimensions Fee 5 r
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
C struction Supervisor's License
R
J. MCGORTY _
No 35161 Permit For Re—ROOF
Single Family Dwelling
Location 14 Brookshire Road
Hyannis
Owner J. McGorty
Type of Construction Frame
r
Plot Lot
Permit Granted :s'June 25, 19 92
I
Date of Inspection 19
Date Completed 1112 6 /T 19
A s
Gi � 'I �• • 3
i
oft r 'Town of Barnstable *Permif# 0
Expires 6 months from issue date
mmszAms, : Regulatory Services Fee A03,:5
MAM
9 s639. Thomas F.Geiler,Director
rED MP't.�'
Building Division PRESS pE
Tom Perry, Building Commissioner AEG �"�"
200 Main Street, Hyannis,MA 02601 1 ?Q
Office: 508-862-4038 TOV�N or
�3
Fax: 508-790-6230 ARNSTA i-E
EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Numbet�a U
Property Address R
❑residential Value Woork
(/Owner's Name&Address �C l
J f ,
Contractor's Name e!f f%94 /�o� Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
s�
❑Workman's Compensation Insurance
Chec" one: ►�
I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit Reques (check box)
7Re-roof(stripping old shingles) All construction debris will be taken to �A ZA-,1j
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
❑ Replacement Windows. 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 Owner must sign Property Owner Letter of Permission.
Home Improvement ntractors ense is re uired. 1
Signature
Q:Forms:expmtrg
Revise053003
°FtME r° Town of Barnstable
Regulatory Services
vBAMSTABMKA-Mg* Thomas F.Geiler,Director
n 39. Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
c
I, a��� / ' ����� ,as Owner of the subject e ro
p prty
hereby authorize -��w /" to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner D ate
Print Name
Q:FORMS:OWNERPERMISSION
o - I
71.-6 �
Board of Building Regufations and Staedartls
HOME IMPROVEMENT CONTRACTOR
Registration ti 1.10230
Eg�ra6 on 1I,9h,2004
pe
' ; Individual
iF
CRAIG FARRENKF
CRAIG.FARRENKQPE
95 ACRE HILL RD
BARNSTABLE,MA 02630 Administrator
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