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0023 CHASE STREET
�?,3. C�lh.re SY,' 1 V V_ V N r J ml D Ali � d �" Town of Barnstable *Permit# '/� aaa E�Tres 6 months rom issue date ' Regulatory Services Fee ifs — \ * RnRM"Ast.E, - MAsB. Richard V.Scali,Director 1639 Building Division a , Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 AUG Q 4 20�� www.town.barnstable.ma.us OWN OF RA�iM d O�� Of ce: 508-862-4038 Fax: 5"08=790'62ABLE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number.3:�296 14 0 . Property Address O�� CCT' ► �� T��/UGV� -4, 2esidentiat .Value of Work$- oz-n . cy,,, Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address bt-13 a(C4 ' �2 3 A;I:Cr D I Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor U'I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# . Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) - ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 2"Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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. A copy of the-Home Improvement Contractors License&Construction Supervisors License is jeq;.red. tSIGNATURE:. .. _r- - Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 i 37ze Commompeah*n,f Maysadjrtset& Depaatsrteut cr,f1ndr s&z-d tccid=tr OfTwe of dons. 600 Waslhfivi i&reet Baston,MA 02111 numcmasmgovIdia WurIvers' Cumpensa tin L==ce Affidavit]3aders/Contract6rsJEIecErician lumbers Applicant Inforniaitigg Ple ase Print Na=Masiaet0Z lazZ. 6 L Address: 3 Citgfstatef Are you•an employer?dheckthe appropriate bam Type of project{rejmir e4: L❑ I am a employes with. 4- ❑I am a general contractor and I 6. ❑New construction employees(full and br parWime * have hired f&e sob%-co�bozs -�_ 2.El am a sale proprietor orpartuer- listed ou the attached sheet: I- ❑Remodeling. ship and have no employees. . niece sob-contractors have 9. ❑Demolition wa dz ng for roe in any rapacity_ employers andhave wodma' 9. .❑Build addition. [No Wo6mrs,comp.Nance camp-men Kance 1 r -j 5. ❑ We are a caiporati m.and its 10-❑Electrical repairs or moos 3-[9<am a homeowner doing all work officers have exercised their 1L❑Plumbingrepairs or additions myself 8 wo�rlmrs'. right of eserzc d=per MGI. r � t'�F- L_❑hoofepairs rosin-mce rem&]Y c_152,g1(4),andwe have no employer[No ' 13-❑Other cam-insurance -] 6Aay app&c=tdwtcbedcsbos 1F1 mast also Moutthe sec icab9awshmdag dekwadceW cumpeass$napel"icyiU5=WFim_ Hameomners who sabmit do af3dzm zfwrem .Ley eie doing nU wcA cud&=hie outside coatmcmts�st 5flltmit a neW affida�t:mdicariag SUCI ICoaszwk=l59RchecktbFs bmc.mmst attar'h inadditimal sheet dwwh gthena of the mid stafewhether arnattflose a xtidub.n-p- employees.Iftheavh tautzadaeshace employees,theyxmstgmuide th ea worms'tamp.policy mttaher I am ata errip r flint is pr ding�t<arkers'compertsatian finurarwxfor my empLo��wex Bataan is tha paticy and jab sfte triformadam e Insurance Company Dame: Paficy 74k or Self-inn Lic:* Expiration Date: Job Site Address: CitylStg: Aftach a-copy of the warkere comzpensationpolicf declaration page(showing the policy number and expiration date). Failure to secure coverage as requued under Seztioa 25A of MGL m 157 can lead.to the imposition of criminal pe ides of a fine up to$L54aOD and.Tar otie:ytirirgpdsoumewk as well as rim penaffies in the form of a STOP WORK:BORDER and a f me of up-to$250_00 a day against the violator. Be whised'that a copy of this statement maybe forwarded to the Office of Investigations of the DIAL for ibsuraac coverage veriflc im Ida ttere6y ceNo u radar tkepains andpmaltres ofpedWy thatthe_irafbn m Yv pmt&ff ahmre h bare and carrect Side: -7 2 0,okial use only. Da not routs in This area,to be campteted by city srtbirn a,okinL Cky or Town: PerffitlLieense;9 Issuing Auflmrity(curie one): *B and of Real& r.BuffaTng Department 3.CRy rown Clerk 4.Electrical Inspector S.Plumbing Inspector *Other Conbct Person: Phone#- 6 orm�afion and Instructions _ 7 ass,acl=eft CT 'bmal Laws chVb=M Imes all=gi0y C S m PrM&WOMTO&co:1rPeMSa=fX thZ=emPlflyee5. FM=Mt to•[his Statter an=PLY=is defined as",everypersonin ffie service of another under anyCoMtaCtofhfir eM:j Tss or i railed oral or writ cam-" An errsplayer is d0fined as ran individual,partnersliP,association,corporation or other legal entity,or ray two or more of the foregoing engagEd is a Joint ertzpase,and inalndmg the legal representatives of a deceased m3ployer,or the receiver or t UStiND of an mdividu 1 pMJnMShip.assDClaf pn or ofhralegal entity,employing employees- However fhe owner of a.dwelling house having not more tip three apa dmeots and who r$sidas ffiamin,or the occupant of the - dwrE a house of another who employs persons to do maitman.cc,c^"gfrac'f'on,or repair work on such dwelling house or oa fhe grounds or bm1rag appurtenant$ereto ffi0 nDtbecause of mch=ploym ent be deemed to be an employer." Mom,cbaPtCr 152,§25C(6)also staters flat"every state or local licensing agency sha.0 withhold$ie issuance or renewal of a Iicease or permit to operate a business or to construe buildings in the c mm onwealth for any app?icantvvho has notprodnced acceptable evidence of complianm with the iasuraure.covearage requsect" AdditdonaIly,MGL chapter 152,§25C(7)states"Neh'herfbe nor a"ay ofits political subdivisions shall eut jab any o=a for the perfu= rose ofpnblic wolkUntl acceptable evidence of compliauce with fe fimmance. reqL==e is of this chapfra have been presented to the c;onfra cfihg auffl0at _" App icants Please fill act f je wod=, oompeusation affidavit completeby by g the boxes apply to your sifnatien and,if necessary,supply sub-contracr(s)name(s). addresses)andpbs= — er(s) gong wi&their certific;ate(s)of instance. Limited Liability Companies(LLC)or Limited LiabiTi-tyPminersbips(LIP)wrfh no Moyers other flan the members or p are not required to cany workare compensation insurance. If an LLC or LLP does hate employees,a policy is required. Be advised thAfhisathdryit may besnbmittedto the Deparfineatof Industrial Accidents for conftmation of in saranoe coverage. Also be sure to sign and date the affidavit The affidavit should be retied to'Le cify or town that the application for the permit or Irene is being regaestA not the Depa:tmeof of Inds_ti l Accidents_ Mum1d.you have any gnest Lms regarding the law or ifyou.are rcgmird to obtain a workers' compensationpoliey,plmsecalLf=Deparbne tattbenmnberlistedbeIow Self-fi redcompaniesshould— their scif fi sara ce license nm ber an.fhe appropriate line City or Town OJfxdaIs Pleas a be score that the affidavit is complete,and pr mtDd legibly. The Department has provided a space at the bottom of the affidavit for you to fill out is the event the Office oflnvest gafmw has to 6oz±ae you regarding the applicant Please be sure to fill in the pen�aifllicense mnuber which will be used as a reference member. In addition,an applicant that:must submit multipIe penntl ce se appht a ions m any g}ven year,need only submit one affidavit mdicafmg C:=mt p olicv inforrnatiou(if necessary)and under"lob Site A-dd ess"ffie applicant should write"all loons in (city or_ town)_"A copy of the-affidavit Beat has been officially stamped or marTurd by the city or gown maybe provided to the applicmnt as prooftbat a valid affidavit is on file for firm a paeans or licenses Anew affidavit must be filled out each Year.Where a home owner or citizen is obtaining a license or pennitnot related to any business or commercial venture (ie. a:dog license or pemtit to bra leaves eta_)said person is NOT rejairEd to complete this affidavit The Office of Investigadons wouldhke to thank you is advance for your cooperation and should you have ray qamstions, please do not hesitate to give us a call The s address,nlephone and faxzmmber -The CaMMQUTslt1E of Massarhn&,fs . Depailmmt of Izadm9dEd Accidents Ice of�fio� 6M-Waafiatm, B M&E 111 Tor.#617' -4 mt 406 Qz 1477 MASS� Fax#617` 27'74-9 Revised 4-24-07 gpV r -� Town of Barnstable Regulatory Services cOF Richard V.Scali,Director Building Division t . t Paul Roma,Building Commissioner 639. 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION L/ j_ Please Print DATE: Y� � i JOB LOCATION: OC ber Street / village "HOMEOWNER": 5-5M4 name /� �^home phone# work phone# CURRENT MAILING ADDRESS: aX 1 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. Th&oceZes dersigned"homeowner"certifies th7se_ t he/she understands the Town of Barnstable Building Department minimum inspection and r and at will comply with said procedures and requirements. Signature of an er Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 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 esults 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 responsibilities of a Supervisor. On the last page 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 06/20/16 . x Town of Barnstable Regulatory Services ` Richard V.Scafl,Director " Building Division. Paul Roma,Building Commissioner, 200 Main Street,Hyannis,MA 02601 www.town.barnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature-of Owner Signature of Applicant Print Name Print Name Date QYORMS:OWNERPERMSSIONPOOLS Town of Barnstable mit t# 3 Permit Expires 6'months from issue date Regulatory Services Fee Thomas F.Geiler,Director Building.Division, Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 Fr www.town.barnstab l e.ma.us Office: 509-862-4038 Fax: 508-790-6230` EXPRESS PERMIT APPLICATION - RESYDENTIAL ONLY Not Valid without Red X--Press Imprint Map/parcel Number o O Property Address l.'1' I e, -!9 gt n 'S Residential Value of Work �J�. 0 l.i Minimum fee of$25.00 for work.under$6000.00 Owner's Name&Address 711ILicenif, CanisContractor's Name TelephoneNumberHome Improvement Conse#(if app icable) 1Constraction Supervisor' applicable) ❑Workman's Compensation Insurance •PRESS.P E R M IT Che one: I am a sole proprietor ❑ I am the Homeowner A U G 2 7 M2 ❑ I have Worker's Compensation Insurance Insurance eompanyName TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) wae-ro.of(stripping old shingles) All construction debris will be taken ❑Re-roof,(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Values_( .44) "where required: Issuance of this permit does not exempt compliance Krith other town department regulations,i.e.Historic,Conservation,etc. ***Note- Property O er sign Pr per ner Letter of Permission. opy o the H e Improve ontractors License is required. SIGNATURE; Q:Fomu:cxpmtrg Revise061306 y' i The Commonwealth of Massachusetts r Department of Industrial Accidents Office of Investigations ' d 600 Washington Street Boston, MA 02111 wM www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Name(Business/Organization/Individual): �- Address: _ J City/State/Zip: mo I!�; M 02v Phone#: Are you an employer. Check the appropriate box:1.El I am a employer with Type of project(required):. 4. I am a genera contractor and d I 6. ❑New construction e�'hployees(full and/or part-time).* have hired the sub-contractors 2.L�.-/I am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling 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 q 3.❑ I am a homeowner doing all work officers have.exercised their 11.EI P >F6bing repairs or additions myself. [No workers'comp. right of exemption per MGL 12. oof repairs insurance required.]t c. 152, §1(4),and we have no 13.0 Other employees. [No workers' comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information. t Homeowners who submit this affidavit indicating they are doing all work and.then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I'am an employer that is providing.workers'"co'mpensotia►t irnuranee for,my:employegs :Below.is:the policy and information. Insurance Company Name Policy#or Self-ins.Lic.#: _ Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the.policy number and expiration date). Failure to secure coverage as required under:Section 25A of MGL e. 152 can lead to the.imposition of criminal penalties of a fine up to11;500 00 and/or one.=year utnpr sonmeilt;as.well as civil-penalties in the,form of:a$TOPiWORK-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 Investi ations of the DIA msur nc .,• ove ae verification:: I do he(ely certify and the utma a ties of perjury that the information provided.a ove is lue `and correct. Si ature: Date: Phone#: 9 a Official use only. Do not write.in this area,..tobe completed,by city�or town offrciaL. ' City or Town: Permit/License# Issuing Authority(circle one) 1.Board of Health 2.:Buildin De ''artmerit�=3...Ci "/Town Clerk 4:Eleetrtcal:Izks ecto:r.S:PI'umbin :Ins eEtor g p. ty p g p 6. Other Contact Person: Phone#: r - 3`=i)x�,:. -•J. �� '4 1_`yr y fin,_r' C=, h� itv'.'. z •3: � !. I�" F t'y. `�a ,:>.;sg'- .�d�,ta. 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M, an �;..F.: ;;4 .Y `a t �4;` "ie ,.'. „::, w.,.r, ,, ., _ ..a. .; ,. ?HF� ., o Town of Barnstable RARNS AXLX, ; Regulafory Services WASS Thomas F. Geiler,Director °lFD MphA BWIding DI-vision Tom Perry, Building Commissioner 200 Main Street; -Hyannis,Na 02601 "'W-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 as Owner of the subject property. herebyauthoriz CU y to act on my behalf, in all matters relative to work authorized building permit application for: (Address of Job) Si atu of Owner �� D to J Print Name . W011-I S:OWNERPI RMISSION TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel I'lo Application # Health Division Date IssuedZ- Conservation Division . Application Fee J Planning Dept. Permit Fee o �., Date Definitive Plan Approved by Planning Board Historic - OKH _Preservation / Hyannis Project Street Address .13 Village l f6,q Is Owner /��`�� G7`' G 7J� Address Jol Telephone 6 `791,-- LIAe q b` b �ems, 4 6966c, hermit Request %a A-D-P A r��{� x S�� IOAess Lro-e 794v j. EVIL Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay o —� Project Valuation d o 0 Construction Type 7 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docfineri ation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's ighway:`.':©Yes,,,' ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 1GK G�7� yoXG'C Telephone Numbe� Address �?3 License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �l/ ��2_® � l FOR.OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE OWNER DATE OF INSPECTION: '7 FOUNDATION a _ FRAME INSULATION FIREPLACE m ELECTRICAL: ROUGH FINAL f PLUMBING: ROUGH FINAL 'j { GAS: ROUGH FINAL FINAL BUILDING r x DATE CLOSED OUT ASSOCIATION PLAN NO. r� Town of Barnstable Regalatory Services Thomas F. Geiler, Director =big, ~� Building Division Thomas Perry, CBO, Building Commissioner 200 Main Sheet, Hya=s,MA 0260I' www.town.b arnsta b l e.ma.us 'Officcc 508=862-4'038 Fax: 508-790-623C PLAN RF W r- Owner: 1-0.1 C Map/Parcel: (' Project Address `� `3 C f-I�SG Builder: d`C DL The following ite=' were noted on reviewing: © L'�5 L O PCS L LT.S 3- . P ...• . • � �a�-� �� � �� �.-�.� �4-.c_� � �C 4. � Jos D a N o T- : pi 09-f[- Reviewed by: Date: i The Commonwealth of Massachusetts Department of Industrial Accidents Office j�ce oflnvestigations 600 Washington Street Boston,MA 6,211.1 Wwwmassgravldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electric'A licant Information ians/Plumbers _ Please Print Le 'bl Name (Business/organization4ndNidnai): `C'K ` d G 4e ( Address: QC<2 �13_j1' City/State/Zip: SC , �>�,2 f s <A44 ®°?Ph Phone#: 7sl an employer? Check the appropriate box: a employer with 4. �] Iam a general contractor andI Type of project(required):loyees(full and/or part-time).* have hired the sub-contractors 6. .New construction a sole proprietor or partner- listed on the attached sheet7. 0 Remodelingand have no employees These sub-contractors haveing for me in any capacity. employees and have workers' 8. ❑Demolitionworkers' comp; insurance comp,insurance,# 9. ❑Building addition .ired) 5. We are a corporation and its 10.❑Electrical repairs or additions'a homeowner doing all work officers have exercised theirlf. [No workers' comp, right of exemption per MGL 11 �]Plumbing repairs or additionsance required.] t C. 152, §1(4), and we have no 12•❑Roofrepairs employees. [No workers' 13.[]Other * comp,insurance required.]*Anyapplicant that checks box#1 must also fill out the section below showing their workers'compensation oli t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit taaan w affidavit indic tContracwrs that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities s kavec� employees if the sub contractors have employees,they must provide their workers'comp.policy number, I am an employer that is providing workers'compensadon in fsurance or information my employees. Below is the policy and job site Insurance Company Name: Policy#or Self-ins;Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the impositionof criminal penalti aof 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 the pains and penalties of perjury that the information provided above is true and correct Si ature: Date: Phone Official use only. Do not write in this area to be completed by city or town official City or Town: PermitUcense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Ins ector 6. Other, p Contact Person: Phone#: j ign Pro TM Deck Des �. Joist Layout View 'r X " u ir✓ Q u �CACV� Ql pptf `�i ry l(� n �►^ 3 a-p0. �'t' ®far I��d Cancre{� �Sed. N N N N N N N N W A Ae jr 5 -- - l(�At R W A A A A A A A W ° w - 0 (7 n (7 [7 n (7 n (7 (7 Q O O D\ Q D\ Q Qi Qi Q 1 �' a a ❑ 5 a' o' �' S' 5' a' a' 5' I i I W A A A A A A A A a a a �7 S* �' �' C 0 0 0 0 0 0 0 0 0 0 0 0 0 swo�ube _ W I 4��': �T �65� � � ��• II o � woe_ wl 3 s+> Notes: f All joist and stringer spacing dimensions are measured in OC. ��1 { Warning and Important Instructions: This is not a final design plan or estimate. EDGENET, INC.assumes no responsibility for the correct use or output of this program. All information contained on this page is subject to the terms in the disclaimer located at the end of this document. Advertencia a instrcciones importantes: Esto no es un plan ni una estimaci6n final del diseho. EDGENET, INC. no asume ninguna responsibilidad del use o de la salida correcto de este programa.Toda la informaci6n contenida en esta pagina est6 conforme a los terminos en la negaci6n,situada en el extremo de este documento. Copyright©1989-2011 Edgenet, Inc. Page 8 of 24 Doc ID 8981e293-3faa-4823-be03-a4bb8a17679a TM Pro Deck Design Railing Details View FF i I I I I I I I 1 11 S. U„ Ll4n1 33,5Railing style 3 Warning and Important Instructions: This is not a final design plan or estimate. EDGENET, INC.assumes no responsibility for the correct use or output of this program. All information contained on this page is subject to the terms in the disclaimer located at the end of this document. Advertencia a instrcciones importantes: Esto no es un plan ni una estimaci6n final del disefio. EDGENET, INC. no asume ninguna responsibilidad del use o de la salida correcto de este programa.Toda la informati6n contenida en esta pegina este conforme a los terminos en la negaci6n,situada en el extremo de este documento. Copyright©1989-2011 Edgenet, Inc. Page 9 of 24 Doc ID 8981e293-3faa-4823-be03-a4bb8a17679a f NEW ENGLAND LAND SURVEY MORTGAGE INSPECTION PLAN Professional Land Surveyors NAME PATRICK & ROBERTA JOYCE 5 Wheelock Street 23 CHASE STREET Oxford, MA 01540 LOCATION PHONE: (508) 987-0025 HYANNIS, MA FAX: (508) 234-7723 SCALE 1"=40' DATE 3/2/2011 REGISTRY BARNSTABLE BASED UPON DOCUMENTATION PROVIDED,REQUIRED MEASUREMENTS WERE LENDER: WFI I S FARM MADE OF THE FRONTAGE AND BUILDING(5)SHOWN ON THIS MORTGAGE SN OF DEED BODK/PACE: Z4ESZ 132 ' INSPECTION PLAN.IN OUR JUDGEMENT,\LL VISIBLE EASEMENTS ARE / SHOWN AND THERE ARE NO VIOLATIONS OF ZONING REQUIREMENTS JA REGARDING STRUCTURES To PROPERTY LINE OFFSETS(UNLESS OTHERWISE PA CK PLAN BOOK/PLAN N/A NOTED DI DRAMING BELOW). NOTE: NOT DEFINED ARE ABOVEGROUND M POOLS,DRIVEWAYS,OR SHEDS WITH NO FOUNDATIONS.THIS IS A WE CERTIFY THAT THE BUILDING(S)ARE NOT WITHIN THE SPECW. MORTGAGE INSPECTION PUN:NOT AN INSTRUMENT SURVEY.DO NOT USE NO. 6151 TO ERECT FENCES,OTHER BOUNDARY STRUCTURES,OR TO PUNT ROOD HAZARD AREA SEE HUD MAP: SHRUBS. LOCATION OF THE STRUCTURE(S)SHOWN HEREON IS ERHER M E(tE� COMPLIANCE WITH LOCAL ZONING FOR PROPERTY LINE OFFSET PP�S7 2500010006D Dm: 07/02/1992 REQUIREMENTS,OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION L LAND FLOOD WM ZONE W6 BEEN DETERMINED BY SCKE AND IS UNDER MASS.G.L.TfrLE VII.CHAP.40A,SEC. 7,UNLESS OTHERWISE NOT NECESSARILY ACCURATE UNTIL DEFINNTVE PLANS ARE ISSUED NOTED.THIS CERTIFICATION IS NON—TRANSFERABLE.THE ABOVE D OR A VERTICAL CONTROL SURJEY 6 PERFORMED, C� Fl. CATp BY HUD AN NS ARE MADE WITH THE PROVISION THAT THE INFORMATX)N PREC!SE ELEVATION'S f MNCT BE RIEINSMED. PROVIDED IS ACCURATE AND THAT THE MEASUREMENTS USED ARE , ACCURATELY LOCATED IN RELATION TO THE PROPERTY LANES.' 4 , I w-I SHED j23 _ 1 iTF 0' 20' 40' 80' BO' 120' REQUESTED LA RThE File: 1IMIP688 DRAWN BY: lAS CHECKED BY BY: GES SCALE: 1'=40' .................._..................._..._._.:..............._..__..._......._..._...........__._...._...._....._......_..........-........._........._._._..—.......—.__—,..----"__'---...._..__. ------ I i e Page 1 of 1 ' # °` s +'g ,` C _ L 1 filet/\\isvisions\gis\sketchesl2\25059_25974.jpg 12/A/2011 THE T Town of Barnstable Regulatory,Services s,�xwsreBIA • Thomas F. Geiler,Director i639 ��� Building Division ATfD�A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE:- MO.; JOB LOCATION:— nu-mler street _d p cq village .HOMEOWNER name home phone# work phone# ' CURRENT MAILING ADDRESS:_ C���f�' CX-42u city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides.or intends to reside, on which there is,or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section l09.1.1) 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 mum inspection procedures and requirements and that he/she will comply with said procedures and requirem Si re of Homeo er Approval of Building Official y 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 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 responsibilities 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. Q:forms:homeexempt I"E ,,, Town of Barnstable Regulatory Services * * g ry >Axxsrm�, + MASS Thomas F. Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Street Hyannis,MA 02601 'www,town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-623 0 Property er Must - C rnptete and 4 ign This Section LJs' A Builder , Owner wner of the subject . l property hereby authorize to act on my behalf, in all matters.relative to work au orized by this building p t (Address of Job) f **Pool fences and alarms are the ons res ibili of the responsibility applicant. Pools are not to be filled before fence is installed and pools are not to be. utilized until all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOLS I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 O Parcel O Application # 6/ Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address + (� 1AS Village /V Yf�/�G��-S Owner ��� � � 67 - 07oyee. JA, Address Telephone oaf- `f— Y01 h Permit Request 2577 fZe 7a S/eC C p Mt&X Aelen2coms, yeOC®9z'a tc?w I.y/"Dows /X541tt Lbw /.s/LXe'le-14, /Wr84YN 7011-eTs4 vA1Afc;�eT, 73 Sc-44ocmtivs /u*4L r,ca,.3 cAs Square feet: 1 st floor: existing proposed /yfd 2nd floor: existing — proposed s— Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �600 Construction Type Lot Size 0-3- 4 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ;Rr- Two Family ❑ Multi-Family (# units) Age of Existing Structure YOOAS Historic House: ❑Yes Flo On Old King's Highway: ❑Yes �(No Basement Type: Wull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new d Half: existing new C-!r Number of Bedrooms: 3 existing 6 new Total Room Count (not including baths): existing _ new 0 First Floor Room Count Heat Type and Fuel: ) Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes gNo Fireplaces: Existing L New d Existing wood/coal stove: ❑Yes X No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ —a Attached garage:Xexisting ❑ new size _Shed: t�Nexisting ❑ new size _ Other: e C K a ,",a C7 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ I Ina Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name 4�1 /� c�a CGS J_° Telephone Number c_5 ��-�3 r a�G ! Address 3a CH1414«t6 C 4241 A(b License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO � /ISi7l�Gto SIGNATURE DATE `�C ACC i r. FOR OFFICIAL USE ONLY APPLICATION# r DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f DATE OF INSPECTION: FOUNDATION i FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING F S F DATE CLOSED OUT ASSOCIATION PLAN NO. i t The Commonwealth 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 NaIne(Business/Organization/Individual): �� LG� , JdYC�� U- Address: �2 C /fl✓?6 Cl1o�f1 ,�o.�� City/State/Zip: _S /�l/� Og!�6 g Phone.#: Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I * have hired the sub-contractors 6. 0 New construction employees(full and/or part-time). , .2.0 I am a sole proprietor or partner listed on the attached sheet. 7.. 0;Remodeling ship and have no employees These sub-contractors have g, 0 Demolition working for mein any capacity. employees and have workers' 9 0 Building addition [No workers'comp. insurance comp.insurance.# required.] 5. 0 We are a corporation and its '10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.0 Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other l comp.insurance required] *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. f Homeowners who submit this affidavit indicating they are doing all work and.then hire outside contractors must submit a new affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the subcontractors 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: Policy#or Self-ins, Lic.#: Expiration Date: Job Site Address: City/State/Zip: 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.1,52 can lead to the imposition of criminal penalties of a fine tip 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 the pains and ena l ' o f p erjury that the information provided/above is true and correct Si ature: Date: Phone#: 1-5—OS— 3 r 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. Pursuant to this statute,an employee is defined as".:.every person in,the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership,'association,corporation or other legal entity,or any.two or-more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house 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 states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." „ Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies.(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the 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. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Offcials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current ' policy information(if necessary)and under"Job Site Address" the applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do 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 Investigations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617427-7740 Revised 11-22-06 www.mass.gov/dia 1'IAR-23—R011 11:43A FROM:SCHLEGEL EXHILEGEL _ d 7"0:15"3855636 CERTIFICATE.OF LIABILITY INSURANCE .�GA[E 0641;130"Ya _ 03/23/2011 TWIG CERTIFCATE IS ISSUED AS A MATTER OF INFORMATION WILY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS TWIG DOES NOT AFFIRMATIVELY OR NEGATi4'614Y ANIEI4e7, FXTCHD OR ALTER THE COVERAGE AFFDRTED BY THE POLICIES BELOW THIS CERTIFICATE OF 1NSUrRAWCE DOES NOT CLIKISTITUTE A CONTRACT B2TWEEN THE 1390N0 INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE WXMER. IMPORTANT: If the certificate INSURED, the ppticy(ies) mu;;t Fa endorsad. 11 SLIUR GATT N ;S YU I D, subjaC :o ! the, terms and condltiOna of thtl policy. GwUln potcieS niay. require an endorearnert. A statement an this cerUficate do" rwi contar Tights to the certificate Wdev in liaa of su.h tandorsemont(s). DgOCUGER - - NAW &ahl®qs3. A Schlaaq®1 saaurarc® arnkaass laic F""L F; (508) 771 - 0391� 1506} `n - 06f fAr..NOtfut.hm: 34 MAIN STREET ,AODRfAD9: ' West YmMouth, Mh 02E73 _ E _ - W-JAER(S)AFFOADNGCOVERX,a jy wuCs ----- - ----------•------•--•',may - �.. 6'USURE9 1 wyLREA ANa�K '�YgCFo-R71D)C.�s Jelin L>a.Rtaidim D" Mid. Cape vainting..icpd pemode,14 - -�- ---_ IRSL'RER 6A3M M[TlUAL �.. i Hyannis, YA 02601 _ mcUReac F; COVERAGES CERTFICATE NUMBER: -A ^� REVISION NumbER: ?N!S 19 'Ic cepm-Y TNAT THE PGLICIES OP IN5UR41SfE i.i F7 F3EL0'-' Ht+t SEEN •SSUED TP5 fINSU,E��D UAW 48 a X THE POLICY PER:1_10 INDrCATE7, NC7'V.TM9TANDrva ANY REGUIREAENT.; 7ekhf, OR 1,,,0N'ji7I0P4 0; r'NY GONYRACT DR OTHeR DOCUMENT AITH RESPEc TO `,VMIt,H 7141E 1 CERTIc!CATE tAR,Y Be ISSj,,D JR h1AY FER'TNN. THE IldaUiRAP,C.E AFFCRDED BY THE POLICIES DESCRIBED HEREIN IS SLEUEGT T Ad TmE TERMS. EYCL;115:0NS AND,^ jIC1.ONXt:a v.=SUC^i P1L[CI_$.LIMITS b'1-10itrN MAY HAk1:CLGN REL,LCE0 B,,PAID CLAIM& �y LIT E GF m14RliatiCc PGJ':T NVNOER 1MNipV/YTYT) {MaA'a 1iYYYY) + Lt TB T A �cENEAnLLuatLi. —f - i r✓,eyoceOnr£eyce s2 0A0 OAa7 1 IM.?x'879z A3/22l1i :03%22J1L r a j y cOMrrERc:AL C�rrr<�AL L:AsILIr,• ! � rDAaa�To�wr�------+— -- Il PREUVES Ma rWWT@Amv) 14 500,000 I"CI AILiR.MALIELa i Occxl i MsoexFtayonoNrearl $20,000 I � � F£RSQN?7.aAOV IrL'L7iv a 1,000,000 \• c>FN=--RAL' A,&SKEOATP z2,000,QO�1 i alDucra•.oMaASNA s 2,u00,BCC Pcucr r �Ka L,LDcAUTOV I i - i � I tavr3lNf°QeavaLsuMlr i y I ANVAUTO ! + (Ea aacadanl) i . ,_.... , I I ALL 7.VNED AUTOS ! 18t?D4r IMJUiir Ci�at tFIYADB) S i I i SOOLY MURV laa%mc'xrt} {y SCHEDULED RirfUa I ( R"F.RT•V OAMAIM �.f.... HREDAUTOS i f (Pat aeG4aaC j.f N�rJd`Nr:ED AUT09 j j i I � ' •��-'•...���: UI,�RSLLA U" f` OCCUR ' I EA rDCCB88 UAH c:n OCCURRENCE .y_ WAWATE is —_OEDUCTII3LF: j ! i A RFrENTION s g won-aft cowENSAncx ?----I-., bQi 38�Co12fl10 j05'/D3/10 09/J3/Il X AND EMPLOYERS,UR91UM 'i C:R'( ANY FFQPRIET4RFART.P:Ea eCiP'Ia 6,-EACH ACG�DENT 7F:t4!MJAEVe2A 0C.LL01401 11'6 I N!.A .iminMmry L.SIN) I ----- :1 Vas.ftecilIm ued¢r j j E.L.VS AUL-EA EMPLOYM s 100,000 OESCrYPTpN OF OPENATIGNe�nL2i �..__._..,�--��T...,.....ve E.L,O:'. 3. e-POLICY Lim"r r.L3CRIPT;ON Of OPERAflON9!LOGiT,]kg,V=HTCLaS CAttneh ACtORa 191,Aadid-al R[njW"SMdo a,If Ina,,PAW I4 mWeadt CERTIFICATE110LIlLii CANCELLATION •••.•� _ .-300 $TP 1,34 �N ' SNOULO ANY OF THe AROU,$ DESCRMal) POUCIS,'- BE CANC@Li.4w EXPORE "NE BXWR,ATION PATE THEUOP, h't)WS. W:LL Of VELIVEREC IN SOUTH DEMIS, W, 02E,60 AC:C0R0AKCfi NTH 111HEPCLICYPRANSIONB. Au- +uceeiu KWAmarm Ve 9'AR#d 500-3s3-f563ti A 4' ! ®lEaa 80U!ACAR!�C RIDOHATtON,All ri"m reserved: AC040 25(200MO) Tne ACORD name and iogo are!eglaieaed traft of ACCRD I Town of Barnstable Regulatory Services RARxsrLsi_ Thomas F. Geiler,Director MASS. Los¢� Building Division�r'D �s Tom Perry,Building Commissioner 200 Main.Street,_Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 509-790-6230 HOir�OWNER LICENSE EXEMPTION / Please Print DATE: `o I'34?o I JOB LOCATION: number street((� q viilllagee / "HOMEOWNER":_�,( L�K C1O Yee, JIQ, cSad'�6T!' name /f y� home phone# work phone# CURRENT MAILING ADDRESS: ,3a <''�` • c,*-cr /o-1, _b 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. DEFWMON 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 constrgcts 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. atiire 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. HOAMOWNER'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.(Scction 1 D9.1.1-Licensing of construction Supervsors);provided that if the homeowner engages a pmon(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they arc assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awaen ress 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 Supervisar. The homoowncr acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her rrsponsibilities,many communities require,as part of the permit application, that the home-owncr certify that ha/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 t amend and adopt such a form/rcrtification for use in your community. Q:fomis:homccxempt Y �YTti Towne of Barnstable - r r Regulatory Services MRNbTABLE, r HAss. g Thomas F. Geiler,Director 1619- 16�� Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign ThisSection If Using A Builder ` e as Owner of the subject property hereby authorize to act on my behalf, m all matters relative to work authorized by this building permit application for. (Address of Job) Signature of Owner. Date Print Name If Property Owner is applying for permit please complete the Homeowners °License Exemption Form on the reverse side.- Q:FORMS:O WNERPERMISS1011 ,f De PlInc vrc�jT c cart k �T�r� �1,Gnriti �pe�-v►. /�✓IiJ� sec � a S�iZ i 0 �fZor•T ty13"K{M��P . v -------------- r 14 /RA 096 c W w c rn DATE May 31, 2011 TO Building File " FROM R Anderson RE 23-Chase-Street,-Hyannis Received complaint regarding work without a permit: Caller stated that the basement apartment was being restored. Responded to call with Bob McK Found worker sitting in car upon arrival. Worker admitted us. Found kitchen on first floor removed, all rooms being painted. First floor lav had fixtures removed and tub wall opened. Basement had an apartment—kitchen removed. Full bath intact and two bedrooms lacking proper egress. Advised worker to have new owner call ASAP. Advised that cosmetic work can continue but plumbing and electrical permits are required. Advised that owner must discuss former basement apartment with me. New owner just purchased at auction. Town of Barnstable of Vs Regulatory Services ti�P� ti* g Y Thomas F.Geiler,Director r HA MASS. Building Division 9 MASS. 4 nMPS a Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINVIN UIRY REPO T Date: I ( Rec'd by: Complaint Name: Map/Parcel Location Address: jA Originator Name: -� Street: Village: State: Zip: ' Ln Telephone: ' Complaint Description: FOR OFFICE USE ONLY Inspector's Action/Comments Date: Inspector: Additional Info.Attached (�2c'If?rr�e�� Olv � ��' �-�G���z,�� � ���,�r�z��� . ocument: Building Permit Application proved, Agreement for Family ommissioner. Agreement must be ds, and returned to Building Division by ents, no construction: $25. �v Town of Barnstable Regulatory Services do Thomas F.Geiler,Director Building Division BAMSTABLE, ` R �' 4v MASS. Tom Perry,Building Commissioner ? �, �iOrEo .t a, 200 Main Street, Hyannis,MA 02601 u P' www.town.barnstable.ma.us Office: 508-862-4038 Fax•`>''508 790=623.0.E Approved: Fee: Permit#: U (p HOME OCCUPATION REGISTRATION Date: Name: VeZ Ze--_ )n if• d >`i L(/l`9 Phone#:50 9 g Address:o23 014A5e 5-T 'A'Y)Yti5 m a6dl Village: Name of Business: G -M `Type of Business:nUose- Map/Lot: 309 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 pernritted 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 undersign ,have read an ee with. e above restrictions for my home occupation I am registering. Applicant• o2Q "t& Date: 17J- •9- 00� 'j Homeoc.doc Rev.5/30/03 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates[cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1�FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) '�� o. P" DATE: 9 M O 6 � ,�low� Fill in please: �PXM__ffi I APPLICANT'S YOUR NAME: BUSINES YOUR HOME ADDRESS: �3 C/,��45� .ST. y ... . ..�� W-qg -1050 TELEPHONE '# Home Telephone Number wog- 5 NAME OF`NEIMBUS.INESS Gl'n C. p / 7 /'n6 TYPE OF:BUSINESS o IS THIS A HDME OCCUPATION? .,:. YES.: X . ..NO...' _ _.._._.. Have you been given approval#fo ' e bulldang.divislo � ` ES- NOS' 1 ADDRESS OI= BUSINESS �' MAP/PARCEL NUMB R f7 When starting.a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally,operate your business in this town. 1. BUILDING COMMISSIONER'S OFFIC This individual has b informed f ny permit requirements that pertain to this type of business. Authorized Signature** FOLLOW 'HOME COMMENTS: OCCUPATION RULES 2. BOARD OF HEALTH This individual has b nfprurl d oft e permit requirements that pertain to this type of business. /�- uthorized Signature" COMMENTS: _4N� !iv► 'z� 3. CONSUMER AFFAIRS (LICENSING AUTHORIT ) This individual ha en infbn d of the li�si re uirements that pertain to this type of business. Authorized,Signature** . COMMENTS: 1Y6 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 [Town Hall) I � DATE: Lsx� f Fill in please: # y �rag APPLICANT'S YOUR NAME: BU SINE SS YOUR yHOME 1 ADDRESS ����"�'��"� �c � � a,«f�Lti e�� �a•�.)' h'��l i'��,r-s:.a �`5"i�/'I�%1�r�5 b�/l!"'i S✓fifs:,,t'.1 i : # TELEPHONE # Home Telephone Number (,--c2 �`44 S 5z,9 NAME OF NEW BUSINESS: 1:� C� r'/ r r 1 'i e/ .:i t�.. TYPE1 OF BUSINESS - i IS THIS A HOME OCCUPATION? YES, NO Have you been given approval from tie building divisi n?,'YES., NO: ADDRESS OF BUSINESS r 3 `'A MAP/PARCEL NUMBER >F <' I D n When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the To2of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIONER'S OFFICE / This individual has been informed of any permit requirements that pertain to this type of business. .. %l Authprized Signature** COMMENTS: '. 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: . 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: :Y^ YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates (cost$30.00 for 4 yeafis). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1"FL., 367 Main Street, Hyannis, MA 02601 (Town Hall) DATE: 9 210 O x rAl a@ 00 7� Fill in please: : APPLICANT'S YOUR NAME:I(/(iGGt�YJ BUSINESS YOUR HOME ADDRESS: Ni3 � 95e _ T ROT®a2 SO ff $q`f-76 SC) TELEPHONE # Home Telephone Number /}ate 1 NAME:OF NEW BUSINESS C &jwi�6 TYPE OF BUSINESS /rIT/*,-,VG rf7t-z e,4n �G IS THIS A HOME OCCUPATION? YES NO. . een givep a. .. ran ADDRESS OF BUSINESS a3 Gy e / 02 4 n M./g. MAP/PARCEL NUMBER 300 When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 20-0 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate y�roul 0udn-ess in this town. 1. BUILDING COMMISSIONER'S OFFICE This individual has been informed of any permit requirements that pertain to this type of business. Authorized Signature* COMMENTS: 2. BOARD OF HEALTH This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS:.. 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) . This individual has �for f� I1 r quirements that pertain to this type of business. Authorized Signature* COMMENTS: ---A - Town of Barnstable THE Regulatory Services altF Tp� 'Do Thomas F.Geiler,Director sn�vsrnsi.E, Building Division v� ss. ,0 Tom Perry,Building Commissioner 6 )9. a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 F : 5D8-790-6230 Approved: Fee: Permit#: HOME OCCUPATION REGISTRATION Date: Name: CLAU_Q1*IV ail M PU464 Phone#:S� Address:� f3,se S'>'` MA 02601 Village: Name of Business:,1, C8�Q PU K,kP,w(t f S Type of Business:E uxo� ,1u e�)4 w l auo-, CWA, 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. i • 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 awe m unit. I,the undersigne a read and a ee with the above restrictions for my home occupation I am registering. Applicant: Date: 7 Q� 'Homeoc.doc Re .5/30/03 TO ��USINESS OWNERS DATE: ' Fill in please: " a APPLICANT'S YOUR NAME: ����\ 'r r�AW }; ke YOUR HOME ADDRESS: BUSINESS qy y ^ 1 .. TELEPHONE W1Tele hone Number Home NAME OF NEW BUSINESS A Q TYPE OF BUSINESS IS THIS A HOME OCCUPATION? YES NO LE—Aw 1 A) Have you been given approval from the building division? YE NO ; ER ADDRESS OF BUSINESS \ MAP/PARCEL NUMB When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. Once you have obtained the required signatures, listed below,you may apply for a business certificate at the Town Clerk's Office(Ist floor-Town Hall). You MUST go to the following office to make sure you have all the required permits and licenses.. GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street)and you will find the following offices: 1. BUILDING COMMISSIONER'S O E This individual has nfarmed o permit requirements that pertain to this type of business. eorized S ture* COMMENTS: 149 �J� >--i.� `� "�.� Qf' ✓ �9I 2. BOARD OF HEALTH This individual has been ' formed of the per equireyhents that pertain to this type of business. uthorized Signature* COMMENTS: 3. CONSUMER AFFAIRS.(LICENSING AUTHORITY) i This individual hgj � ��Q ��e6Vq�uirements that pertain to this type of business. Authorized Signature" � { COMMENTS: Business certificates (cogt1$30.00 fir 4 years). A business certificate ONLY REGISTERS YOUR NAME in the town (which you must do by M.G.L. -it does not give you permissioh-te erate-you must get that through completion of the processes from the various departments involved. **S/GNITZESAPPROVAL FORA BUSINESS CERTIFICATE ONLY. N ,.,..