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Home My WebLink About0051 CRAIGVILLE BEACH ROAD 14(aIL4e—�IMMMMI 0000�� Engineering Dept. (3rd floor) Map Parcel ermit# House# � �� Date Issued j© Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) jC � L j - ^7Fee � o� lift.IN IHE and - 19 SEPTIC SX 9 -INSTALLED `��CE bt 3 TOWN OF BARNSTABISmo� DE AND Building Permit Ap licatio TOWN REGULATIONS joje7t�Address '—/ /f r Village wAfoe Owner Address ✓t Telep01 hone - S'-- !1 l / Permit Request, f ° 2 •_First Floor `, square feet Second Floor square feet Construction Type ,�Pa r� (,() , i'](l n fl� / w( S'J7o�Ci Estimated Project Cost $ : , Qcao , Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family( Two Family ❑ Multi-Family(#units) Age of Existing Structure AegffQX istoric House ❑Yes fNo On Old King's Highway ❑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 No. of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count — Heat Type and Fuel: ❑Gas AOil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing _/New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) \, ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name OL,U21:g=L Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. s ALL CONSTRUCTION DEBRIS RESULTINGTROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE BUILDING PERMIT DENIED6ORT OLLOWING REASON(S) FOR OFFICIAL USE ONLY s PERMIT NO. T DATE ISSUED MAP/PARCEL:NO. ADDRES9 VILLAGE OWNER I f r � . DATE OF INSPECTION: FOUNDATION FRAME i INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ;ROUGH:,. .. FINAL GAS: FINAL A-k pax FINAL BUILDING I ' �.F 'iyag wr f 1 4- t,,,� DATE CLOSED OUT r, ASSOCIATION PLANNO. '.w i Dc parrimill of hidustrial Accidc/rtts i �` iy _'I O� fceofIffm zaaffs_ -y,=�' 6111111 aslliulaon Strret Workers' Compensation Insurance Affidavit Anniic4— .+^{^�^��'t^^ Please PRiN•T''le�ibly ��~� w nnMel C QAU� iChang0 1 am a homeovkner perfotminj all work myself. (] 1 am a sole proprietor and have no one working in any capacity ne!�-- '. _. �_-r .�- .'.'�,;r---.� ._.,err _.. .�.,... _:.. _"""T'^".�,.e•� 1 am an emplover providing workers' compensation for my employees working on this job.. r cnmnlm name...- /�• la�QZ g R Idr c city, A, Anne incnrance co. I am a sole proprietor. general contractor,or one)and have,hiredithe contractors listed below who have the following workers' compensation polices: nm anv na c• � idre it nhone#• r incurnncc co noun. - .. �.. _. .•rif!� .. .s��sT -.�!•:..�'•e1•.•i�+.....�_ -ar��-.nav��T�.J�""�i- "'-^q�.P--`'..'..^'.'..�"q.".'--,�C'. 'a.i,.ai com anv name: addre c• rin Phone#• 'Surince co nolicy#- �^ _ 'Attach additional sheet if necessa , -^*r�:•<,..*-.-..:. :'.:...-� ...,.....•.. `.''•`;-'--•• —- r ti.,_w ;-_~~ ,�.,.: Failure to secure coverage as required under Section M of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1S00.00 and «~ one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that cop) of this statement may be forwarded to the Me of Investigations or the DIA for coverage veriGeatiom ' I do ltercbr cctrift under the pants and pe tard o pedun•that the information prodded above is true and correct. q Si__natun � Date �� © Print name r /� Phone# Z,/Z � 3 'ofliciai use only do not write in this area to be completed by enty or town official city or tn��n• permit/license# r9Duilding Department Licensing Board check if immediate response is required OSeleetmen's Once �Ilcallh Department contact person: phonefl; nUther owned IV PJAI r� 7 � v - Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for employees. As quoted from the "lay+", an entpinree is defined as every person in the service of another under an\ contract of hire, express or implied. oral or written. An empinrer is defined as an individual. partnership, association. corporation or other legal entity_ or any two or r the fore�_oin�_enuaged in a joint enterprise, and including the legal representatives of a deceased employer, or the rccciver or trustee of an individual , partnership, association or other legal entiq-, employing employees. Howeve. owner of a dwellin__ house havin_ not more than three apartments and who resides therein, or the occupant of the dwcllim_ house of another who employs persons to do maintenance , construction or repair work on such dwelling_ or on the _rounds or buiiding appurtenant thereto shall not because of such employment be deemed to be an empic MGL chapter 152 section 25 also states that ever}'state or local licensing Agency shall withhold the issuance of renewal of a license or permit to operate a business or to construct buildings in the common-wealth for any applicant who has not Produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapt, been presented to the contracting.authority. 777777.7 Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to;your situation ar suiplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that,the application for the permit or license is being requested. not the Department of Industrial Accidents. Should ydil have any questions regarding the "law"or if you are recui to obtain a workers' compensation policy, please call the Department at the number listed below. Cin• or,towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottorr the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. P be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returne the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questi please do not hesitate to give us a call. I The Department address. telephone and fax number. The Commonwealth Of Massachusetts Dgpartment of Industrial Accidents Office of Investigations 600 Washington Street Boston,Ma. 02111 o�TME rq�yy The Town of Barnstable m m a�.E.$ Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Commissioner Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, ion an addition to any conversion, improvement, removal, demolition,least one but nottmoref than four dwelling unitsng to owner occupied building containing at structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Est.Cost oho Type of Work: Address of Work: 1 r Owner' s Name tJ ' Date of Permit Application: 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 :;�—Owner pulling own permit Notice is hereby given that: WITH UNREGISTERED OWNERS PULLING APPLICABL DEALINGIR O PERMIT OR E HOME II"ROVEMENT WORK DO NOT HAVE CONTRACTORS FOR " ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c- 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: .Date � , Contractoc e Nam Registration No. OR � P Y • • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE _ O JOB. LOCATION Number Street address Oction of town "HOMEOWNER" . Name ome phone Work phone . PRESENT MAILING ADDRESS SN �7 (/t City town tate Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(s)' who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"- shall submit to the Building Officia- on a form acceptable to the Building Official, that he/she shall be responsibl- for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, 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 co ply with said pr a ures and requirements. HOMEOWNER'S SIGNATURE < APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. y HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which 'a luilding permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Ownei shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarene; often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as\ it would with licensed Supervisor. The Home "dwner,' actir as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities,. mar. communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page .of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. r :...................... :::9.•23.�. .:............:::.::..:.:::::........ ...... ..... ...:. . L w .. ? pPii y::: :::::::EDWARD CUNNINGHAM '<> �«•.••.. <::C G ILLE••BEACH•..RD••• ................... HYANNISF .................... ......::::.....::.. .:::::::.::.:::• ...... .... V AL >: .. I SU >:.. . c.. ................................................................................................ ...................... :..:.x COMPLETE RE-MODEL— WINDOWS—SHINGLES ET {kyy{ C r ::q}:: � W::: BY SITE—<'< ENT S DIDCHECK M1•—REFER .T.. R. S. BLDG IN P. S is l , V T u L eP >:::> *� ] [R267 113 . ] LOC10051 CRAIGVILLE BEACH R CTY109 TDS] 400 HY KEY] 169356 ----MAILING ADDRESS------- PCA11321 PCS100 YR100 PARENT] 0 CUNNINGHAM, EDWARD A MAP] AREA155CC JV] MTG12010 CUNNINGHAM, ELISA D SPl] SP21 SP31 22 IVY ROAD UT11 UT21 . 27 SQ FT] WELLESLEY MA 02181 AYB] EYB] OBS] CONST] 0000 LAND 7000 IMP OTHER ----LEGAL DESCRIPTION---- TRUE MKT 7000 REA CLASSIFIED #LAND 1 7, 000 ASD LND 7000 ASD IMP ASD OTH #PL 51 CRAIGVILLE RD HYANNS DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #RR 0369 0004 TAX EXEMPT RESIDENT'L 7000 7000 7000 OPEN SPACE COMMERCIAL INDUSTRIAL EXEMPTIONS SALE102/82 PRICE] 52550 ORB13433/18 AFD] V N LAST ACTIVITY] 10/26/90 PCR] Y Ct/�e�e W267 113 . P E R M I T [PMT] ACTION [R] CARD [000] KEY 169356 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR .CMP NEW/DEMO COMMENT R2'67 113 . A P P R A I S A L D A T A KEY 169356 CUNNINGHAM, EDWARD A LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF- 1 7, 000 A-COST 7, 000 B-MKT 6, 300 BY 00/ BY /00 C-INCOME PCA=1321 PCS=00 SIZE= JUST-VAL 7, 000 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 55CC ----------------------------- NEIGHBORHOOD 55CC HYANNIS PARCEL CONTROL AREA TREND STANDARD 131 10 LAND-TYPE 70001 LAND-MEAN +0 70001 78256 IMPROVED-MEAN +Oo 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 100061 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?]