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0258 COMPASS CIRCLE
Camp II h �T r Town of Barnstable *Permit# C� Expires 6 mo sjrom issue ate ERMIT, Regulatory Services Fee a t Thomas F.Geiler,Director iOjFc n+�" aRI�STABI�E Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.fown.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X:Press Imprint Map/parcel Number Property Address Z.5 - C—©,!,In E4 s 5 C-7 rc,� ):-I ace n rt�' -A [�f Residential Value of Work f 3,.O ,00 Minimum fee of$35.00 for work under$6000.00 Owner's Name& Address �rttirr,� l.lF �-rctcp__ Z,5 e-o.-rjkSS C—ircfg '� �Gin.LrS ^, C)�2,�2(�.� Contractor's Name T Telephone Number Home Improvement Contractor License#(if applicable). 'Aj/ Construction Supervisor's License#(if applicable) to LA ❑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# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to +7"S C ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side #of doors Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows "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 Pr perty Owner Letter of Permission. A copy of the o e Impr ment Contractors License & Construction Supervisors License is re red, SIGNATURE: Q:\WPFILES\FORMS\building permi orms\EXPRESS.doc Revised 070110 I SHE Town of Barnstable Tp�� y�P Regulatory Services w BARNSrABLE, Thomas F.Geiler,Director p MASS. 039• ,0 Building Division Alf°fly ri Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 wwvv.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: S-3 I - l JOB LOCATION: 2 5-i~! C.o v.P"-3-9 C—Z 1-C.1 number /t street village .,HOMEOWNER": _`Cr'�rr,/ o@_ &race__ —7 7`f name home phone# work phone# CURRENT MAILING ADDRESS: 2��d C.0,^40.55 C,a r tj P__ Oi 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 Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two-family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"cer • es that he/she understands the Town of Barnstable Building Department minim inspection Pfoce ures a requirements and that-he/she will comply with said procedures and requir S' ature of am wner - Approval of k6ilding 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 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:fomts:homeexempt r t. °F1HErOy'b Town of Barnstable Regulatory Services • anxrrsTnstE, M y nss. �, Thomas F.Geiler,Director �p 1639. �� TEo,wa�A 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 This Section If Usinz A Builder 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) 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:FORM&O WNERPERM ISSION I y 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 Le ibl Name.(Business/Organization/Individual): C V` or Address: C wl:i�>wS S City/State/Zip: Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.El am a employer with 4. ❑ I am a general contractor and I have hired the sub-contractors 6. ❑ New construction • 2.❑ employees(full and/or part-time).*I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' comp.insurance.# 9. ❑ Building addition [No workers comp.insurance P• ' . required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.[ I am a homeowner doing all work officers have exercised their i 1.❑Plumbing repairs or additions I myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.0 Other 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 isproviding workers'compensation insurance for my employees. Below is thepolicy 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. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify i nd r the pains p alties that the information provided above is true and correct. Si ature: of per ry Date: — l Phone#: 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. Ci ty/Town Clerk 4.Electrical Inspector 5. Plumbing Ins pector 6.Other Contact.Person: Phone#: 7 2 9� gAssNssar's map and lot number ....311D-3 ......................... G�,Qp 0 7 D' SEPTIC SYSTEM �;,o � � EET m S age Permit number ......:. INSTALLED INaE� ...... ............................... ..... WITH ARTICLE _ S; s` • House number ........ .. ' ... ............:.......................... . SANITARY COD • REGULATIONS. ° i639'a�00 �YFY TOWN 'OF BARNSTABLE BUILDING =I11PECTOR S �i�u L� APPLICATIONFOR PERMIT TO ....................................................................................................................:........ TYPE OF CONSTRUCTION .. C.... IF.......................................... K"..�.v.............?....................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...g..A...CP.A 33...... C_Z.£..........:. .. .. ../ .N�✓/5......................:............ ProposedUse .. ............................................................................................................................................. Zoning District ........ . .£.................. ... ............... . ...Fire District ... a �s5 0. ' �. ....................... v Name of Owner ..........Address ..... (.................................�O.�.c� Name of Builder ...:... .... . . .. . . 4 ............Address ........S�J.?. .......................................................... Nameof Architect ........ ....................................... .................................................................................... / o.......Number of Rooms � .........:.....................................Exterior ...........................................Roofing ../..7.. ....c3��/�'' i................................. Floors .(-4Iaa..ILO..( ...............................................Interior .................................................................................... Heating . !''��' � ........................Plumbing .....d!��.............�................:...............^'.::.: p ..Approximate Cost ZZ OOa Fireplace ...t,�.N....�................................................................ ......:..............................................:..........�j... Definitive Plan Approved by Planning Board ________________________________19________. Area :... .,../0.;F6 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH ��'� �. A V ✓' 6 � ILA L$ � i —� So 20� �5 I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name, ..................... ................... . � . . ' ` Dennis Star ^ � . . onCo 911 story—�� m ��� '--. single family dwelling ----_--------.---------.---. ' � 258 Circle Location -----.�����.��----------- . ...................... .......................................... Owner —^--- Star �g Co. .. . Type of Conotruciion ----. —...--- ----'—^--------------------' Plot ............................ Lot ----- ---. ' � ' � . December 15 78 Permit Granted ----------.---lV Dote of inspection . — .. --lgDate Completed ... / � ~v������ � . . . ' ^ PERMIT REFUSED . . � ___---__----.-----_—.. 19 . ' -------~^^—'-------^-------- . , . . ^ ~—~...--.~.--.--.—..---..�-------. . . . ' -----'—.-..--.----...—.--..---- � . . ^ i .--~—.~—.,--^.—.........--..~—..---... . - Approved ................................................. l9 � -------------.--~....--.—.----. . . --.---------.---------...-...... , | -` . Assessor's map and lot number ...........................!................ TN E .,,,,-wage.Permit Permit number ........................................................ qJ i� Z BAWSTADLE, i House number ....................... ... s� "^ea 0 p 1639. 9� 0 MFy a� TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ...................................................................................................................:......... TYPE OF CONSTRUCTION ..''. ?e?- '..................f� ..............................................................................:....... -7 .v............ ?....................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... !.!......................c................... r. . .................. ................................... .......................... r Proposed Use ... :.! 1..r,. .::.::::+............................................................................................................................................... /.� ,�/ + Zoning District ......'..�............. ......................................Fire District f.. .. .. ....... Name of Owner - n-- ..?*�:.... ........ ! '"--.......Address .....�... ...............<.;:�J .......��.....v ?ir?. ::.: Name of Builder :�?� .. A,�.: ...... Address v '......... ..... .................. .............................................................. Nameof Architect �'�" �.....................................Address......../................... .................................................................................... Number of Rooms ( Foundation.............................................. ::.......... ............................................... Exterior ^�� ' t toy.,.......... �;....'f�:::..........................................Roofing ('-! ....... ..... ................................. Floors 2 } f'J� ...................Interior ................................................................... .................................................................................... Heating { �... ..............................Plumbing f7��4 1�f: �. ........ ....................................... ................................................................................... ' i Fireplace .. .?...... ...................................................................Approximate Cost ....`........ Qv:.......................................... r• Definitive Plan Approved by Planning Board ---------------_---------------19--------. Area .....f r) :. ' .. Diagram of Lot and Building with Dimensions Fee .................................. ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH I er I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . ............. ...............:'...:............:..................... Dennis Star Construction Co. A=310-394 . No .... 2094ermit for ...,,,,,one story single family dwelling ............................................................................... Location .......�5.8 Compass Circle. . . ................... .................. ...... . . .. Hyannis ............................................................................... Owner .........Dennis Star Construction Co. ................ ...................................... Type of Construction frame ............ ............................ ............................................. ................................. Plot ............................ of ....... December 15 9 78 Permit Granted ... ........1 Date of Inspection . ...............................19 Date Completed .......... ............................19 PERMIT REFUSED ............................................. ............. 19 ..... ......... ... ....j. -.►. ........ ,1 vi iAi ....................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... Ri „�•'"`'• TOWN OF BARNSTABLE 20911 � e Permit No. ______ _ ` Building Inspector 1 VAUSTAX Cash rg. -- ,ego• OCCUPANCY PERMIT Bond _ x J 2 No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Ileums Star ConSt' Co' Address treat Pond Dr.,So.Yatriouth lot(-93A 258 "Cwmss Circle. 14yannis Wiring Inspector PJP j��� 1 Inspection date ] Plumbing Easpector Inspection date Gas Inspector t fiJ Inspection date ol°Engineering Department 1 � f �i � / Inspection det6—c,-, �5- �� THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. Building Inspector "ERrSY-,CERTIFY`tl4AT THIS FOUNDAT16N EV:ON TAk L6T-A$ SHOWN AND i - C�IYFts}�SAS T4 THE "fIL'V OE B%;g�, 779fl16 - i { 2 �C3?ilr:Cy R'EGUE.ATiCX+I$ RfJ1}tf3lf�ii"u��$ ` L(NEF� AP� tb�' 1tNirS. F - .� tom - • ,.. ... A Af 4.6 _ y a - . �. `fit �y � , '.y a• t � ..• ' - - �\/��'