HomeMy WebLinkAbout0183 BUCKWOOD DRIVE�3 OkbD
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' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map Parcel 09
Permit# Cry
Health Division __l & " (p5Q UI24 63 QN DEEP Date Issued
conservation Division1 z�l r 3 ' ' Application Fee
Tax Collector Permit Fee
TreasurerSErTIC SYSTEM 1�161ST 6E
Ilk ALLED IN COMPLIANCE
Planning Dept. VM THE 5
Date Definitive Plan Approved by Planning Board EWRONMENTAL CODE AN[,
TOWN REGULATIONS
Historic-OKH Preservation/Hyannis
Project Street Address -_� c�z)t� and
4
Village 4u A&W i S
f-
Owner d d Address �!} MC
Telephone 1 - 50H _ I w —d-S
4-1
Permit Request 2& 5 idC' W+(( 00 koUS6-
' Square feet: 1st floor:existing Q50 proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type ,
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family M Two Family Cl Multi-Family(#units)
Age of Existing Structure_ ? Historic House: ❑Yes eNo On Old King's Highway: ❑Yes B' o
Basement Type: MFull ❑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 41 new First Floor Room Count JAF't C
i /
Heat Type and Fuel: MGas ❑Oil ❑ Electric ❑Other
Central Air: V1',�r es ❑No Fireplaces: Existing r New Existing wood/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size'
Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other:.
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name ' LOLA Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
R
SIGNATURE t DATE
FOR OFFICIAL USE ONLY
I
. PERMIT NO.
DATE ISSUED
r
MAP/PARCEL NO.
k '
ct . 1 ,
t ADDRESS VILLAGE
OWNER
y •
`r
DATE OF INSPECTION:
FOUNDATION
ti FRAME
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL "
4
. 4
s GAS: ROUGH FINAL
FINAL BUILDING =
DATE CLOSED OUT r 4
�.� ASSOCIATION PLAN NO-
r
1Y 1
G
r
J„E,° Town of Barn.stab.le
Regulatory Services
tL SAxresr�sr�, + Thomas F.Geiler,Director
Building Division
•lfD MAj
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
• Fax: 508-790-6230
Permit no. ,
Date
AFFIDAVIT
HOME EYUROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERNIIT 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: o r li �g��vC l�? dM41� Estimated Cost _
Address of Work: 1 f,}`i rr R e bL
Owner's Name: '
cy
Date of Application: (0'9S'®3
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
26wner pulling own permit
Notice is hereby given that:
OyMRS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PRO GAAM OR GUARANTY FUND UNDER MGL c. 14ZA..
TIES OF PERJURY
SIGNED UNDER PENAL
I hereby apply for a permit as the agent of the owner:
i
Date Contractor Name Registration No.
9 Q • OR
,� }e Owner's Name
The Commonwealth of Massachusetts -
�- -
_� — Department of Industrial Accidents
- — Office 0110YOs000ns
_ 600 Washington Street
-_ Boston,Mass. 02111
Workers' Compensation effInsurance Affidavit
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NA
location: �
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am a homeowner performing all work myself.
Q I am a so wrietor and have no one worlds in ca ac,
ers' co ensation din
r my e
fomployees working on this job. }vvV`.k,,.r}v`}*_...:work mp }>:>
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❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who
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coverageFEEN
011
as aired ender Section 25A of MGL 152 can lead to the iMPIDA"don of enimirnal penalties of a fine up to si,So0.60 and/or
one ye to secure mpri imprisonment
penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I anderAmd that a
one years'�prisonmeat as well a,duff p '
copy of this statement maybe forwarded to the Of ice of Investigations of the DIA for coverage verification
e p ' penalties of perjury that the information provided above is truce
I dv hereby certify under th and correct
Date 2=0 -
Signature
Phone#
Print name
r
oMc al 1y4e only do not write in this area to be completed by city or town official
perndtflicense# C] �Bg Department
city or town: []Licensing Bow
C)Sdectrnen's Offtce
C]d,.e }sifi,nmedtaterespomeisrequired ❑Health Department
phone#;
contact person:
❑Other
(fevised 9/95 PJtU
Information and Instructions
Massachusetts General Laws chapter 152 section 25 to requires all employers to provide workers' compensation for their
employees.s. As. quoted from the "law", an employee is defined as every person in the service of another under any contract
Pee
of hire, express or implied, oral or written.
partnership, association, corporation or other legal entity, or any two or more of
An employer is defined as an individual, partn p, � rP
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 maintenance, of
another who employs persons to do 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 section25 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,neitherthe
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 in the workers' compensation affidavit completely,by checking the box that applies to your situadonand
supplying company names,*address and phone numbers along with a certificate of insurance as all affidavits may be
submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and
the city or town that the application for the permit or license is
date the affidavit. The affidavit should be returned to
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.
i
City 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. Please
be sure to fill in the permit/license number which will be used as a reference number. The affidavits maybe returned to
other arrangements have been made.
Department b mail or FAX unlessaarang
D Y
the ep
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 give us.a call.
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Office of lavestlgatlons
600 Washington Street
Boston, Ma. 02111
fax#: (617) 727-7749
nhone#: (617) 727-4900 ext. 406, 409 or 375
1•
The Town of Barnstable
Regulatory Services
Thomas F. Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
HOMMOWNER LICENSE EXEMPTION
!!^^ l Please Print
DATE:
70B LOCATION: f��
x�r,�x�yd ix-, tLAALA24S
number street Ivillage
"HOMEOWNER
name home phone# -work phone#
CUp, ENTNWLINGADDRESS:
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 yermit.
(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 B arnstable Building
Department minimum inspection procedures and requirements and that he/she will comply with said
prated n�• ,
Signature of Homeowners
Approval of Building.Officiat
Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply
with the State Building Code Section 127.0 Construction Control. -
HOMEOWNER'S EXEMPTION
The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the
provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a
person(s)for hire to do such work,that such Homeowner shall act as supervisor."
Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see
Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in
serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the
unlicensed person as it would with a licensed-Sup ervisor. The homeowner acting as Supervisor is ultimately responsible.
Tn n1,C11Tp flmt flip hmeowner is fully aware of his/her responsibilities,many communities require,as part of the permit .
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BE A CURATE I STANDARD LEGEND
NOTE:not all symbols will appear on a map
GOLF COURSE FAIRWAY
1
1 1 ry-y-"y-\ EDGE OF DECIDUOUS TREES
1 7 — T
——— ""~ `^ EDGE OF BRUSH
ORCHARD OR NURSERY
V— -T—V EDGE OF CONIFEROUS TREES
'""^�•,,4 �— , MARSH AREA
EDGE OF WATER
-
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DRAINAGE DITCH
————— PATH/TRAI L
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21 E PARCEL NUMBER
#lend HOUSE NUMBER
2 FOOT CONTOUR LINE
1
—10 10 FOOT CONTOUR LINE
Elevation based on NGVD29
j�4.9 SPOT ELEVATION
STONE WALL
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RAIL ROAD TRACK
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T O W N O F B A R N S T A B L E 6 E O G R A P H 1 C I N F O R M A T 1 O N S Y S T E M S U N I T o SIGN ® STORM DRAIN
N_ PRINTED SCMJE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representation DATA SOURCES: Planimehics(man-made features)were interpreted from 1995 aerial photographs by The James UTILITY POLE c TOWER
1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD
" ° Q 10 20 National Ma�Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetrics,topography,and vegetation were mapped to meet National Map Accuracy Standards
"s 1 INCII=20 FCLT* enlarged sce e. on the map. at o scale of 1"=100'. Parcel lines were digitized from FY2003 Town of Barnstable Asseswfs tax maps. O LIGHT POLE O ELECTRIC BOX
F:\dgn\conservation.dgn 06/26/03 08:47:30 AM
TOWN OF BARNSTABLE BAR-w 4075
Ordinance or Regulation
WARNING NOTICE
Name of Offender/Manager)('/C //,"/I tv f 1///V 47
Address of Offender / 'f'-3 16 40 C A I^"Of, MV/MB Reg.#
Village/State/Zip IlVyqA".AIIS
Business Name 171( /119,41) 1'tA11A, 9 //U'A/ C> r, 6'*0&am/p)n, on 611.- 20CIZ
Business Address C
Signature of Enforcing Officer
Village/State/Zip S,9 1? C -
Location of Offense 1 C ,fir- 0
Enforcing Dept/Division
Offense 441S.r- 7 f6 C,-v7/? f 1 . 171911 ,, 4 71cFV
Facts All'i'l) 1 , /flu,e i" Y
7c t6 ,nA1- Y t,,� t 41f
This will serve only as a warning. At this time 'no legal action has been taken.
It' is the goal of Town agencies to achieve voluntary compliance of Town
Ordinances, Rules and Regulations. Education efforts and warning notices are
attempts to gain voluntary compliance. Subsequent violations will result in
appropriate legal action by the Town.
WHITE-OFFENDER CANARY-ORD./REG.-PROG. PINK-ENFORCING OFFICER GOLD-ENFORCING DEPT.
The Town of Barnstable
Department of Health , Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph M.Crossen
Fax: 508-790-6230 Building Commissioner
Home Occupation Registration
Date: / f�✓ O�
Name: ePhone 77/
Address: �✓C.L(J��C� a�v • Village:
Name of Business: C WWI �G
Type of Business: C4Q6 5r_AD"- Map/Lot:.
INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home
occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance,
provided that the activity shall not be discernible from outside_the_dwelling: there shall be no increase in noise or
odor; no visual alteration to the premises which would suggest anything other than a residential use; no increase in
traffic above normal residential volumes; and no increase in air or groundwater pollution.
After registration with the Building Inspector, a customary home occupation shall be permitted as of right-subject-to
the following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit, located
within that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings, and
there is no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise, vibration, smoke, dust or other particular
matter, odors, electrical disturbance, heat, glare, humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in
excess of normal household quantities. - -'
• Any need for parking generated by such use shall be met on the same lot containing the Customary
Home Occupation, and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation, other than one van or one
pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to
exceed 4 tires, parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business, the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
I, the undersigned have readqnd a ree with the above restrictions for my home occupation I am registering. ,�11
(Yo
Applicant: -
Date: V
Homeoc.doc
f
/la C V
Town of Barnstable *Permit# 2 ` zC3
Fxp' e 6 months from issue date
Regulatory Services Ft e Q s,a o
9 MAW Thomas F.Geiler,Director
1639• �0
ArED �6 Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038
Fax: 508 790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIALN4
Not Valid without Red%Press Imprint t ��! �'
Map/parcel Number TOWN OF BARNsTABLE
Property Address jC) -�/ ri,-t m d L
Residential
Value of Work v2 �O 0
Owner's Name&Address
Contractor's Name Telephone Number �D6- 77l diS 16
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
Check one:
❑ I am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp.Policy#
Permit Request(check box)
❑'Re-roof(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
® Re-side' 22 Z
Replacement Windows. U-Value aJ / (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.
ovement Contractors License is required.
Signature
Q:Fonns:expmtrg
R P,,;�Pns�n23