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HomeMy WebLinkAbout0016 ISALENE STREET �� -ZS`�C C�v� ST - - - - it • j — t3 .— l�f -�.�' . Town of Barnstable *Permit# ZFiEQ Expires 6 months from issue date Regulatory Services Fee KAM Thomas F.Geiler,Director i6g9- �0 - Building Division Tom Perry,CBO, Building Commissioner .200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma us I 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 k)• qma0Y11,,5PDr [�Residential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address t Contractor's Name Telephone Number.5D9' Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 1IT ❑Workman's Compensation Insurance Check one: APR 18 2014 ❑ I am a sole proprietor ® I am the Homeowner '❑ I have Worker's Compensation Insurance .',.®WN OF ARNSTABL1= -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�� !:/Y� ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows ❑ 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 depmtment 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 required. SIGNATURE: The Cola work wswalth of Massachusetts Dep,arhnent of Industrial Acddenft ,— Office of Ii vestigations bt7�IYtrshing 3`treet Boston,M4#211.1 rvic�►v.l nasmgmfdia Workers' Compensation Lmsurance Affidavit Budders/Contractors/ElectrieianstP]tubers Applicant Information Please Print Lem Iv Na=(BudnessKhyanizau: 1Y.L u 1 r Add ress:1 140 Z5 IznP S Cit3r/Statetzip: "mLSbb it PhD. P13 Are you an employer?Che appropriate;bon Type of project(required): 1.❑ I are a employer with #- ❑ I am a general,contractor and i employees(full andJarpart-ti )- * have hired the sub-contractors6- ❑Ide°�.*mmstr�cfran e 2.❑ I am a sole pro{rtie3zri orpartuer- listed on the attached sheet y- ❑Remodeling ship and hoc*e no employees These sub-contractors have g_ ❑Demolition w ina for me in any capacity. e�Floyees and have mo�cers' 9. ❑Budding addition IN.o IiJIQdom.camp.-insurance comp-ensuranrr—I 5. ❑ We are a corporation and its 10.❑Electric ai repairs or additions required I fW I am a homeowner doing all work officers have exercised feir 1 LEJ Plumbing repairs or additions ngh#o exemption per I41GL nryset€[No workers'comp. if tin 17-_�Roof repairs e c.152,§1(20,and.we have no 9 insurance r d F employes h[No worken' 13, Ot , n A c /ubT comp-insurance required_}. Any applicsoi that checks box#1 mast also fM net the section below showing th&wodeis'campensa#iQn P F i tiob i Houernwners wbo submit this aM"Vxt iM&,cxt Mg they are doing all wat=d th en hue outsides contracmrs mast submit a new affidavit mdicsting such tt+omactm that check this box mast attached as addition-e sheet showing the name of the suit-amtrxto-ss and state whether or aott"hose entities have employees. If the solrron�atus have employees,theynximpmvide their worker ramp_policy number. I run ate eraplt sr t3irrt is pra�vidirig xrortrers'coaepsresrrtt'srt itzr�tty ce for t?iy eazplagt Bedotr is tilt:poUcy and job site ia,forrstrti�M. . in nance Company Frame: Policy 9 or.Self-ins-Lic.# Expiration Date: Job Site Address: Cityista�. ' Attach a cagy of the workers'compensation policy declaration page(showing the policy member and expiration date)- Failure to sec am coverage as required under Section 25A of MGL c- 15P2 can lead to the imposition of criminal penalties of a tine up to$1,500 OD atWor one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250-DO a day against the violator. Be advised that a copy of this sbtement may be forwarded to the Office of Investgatiom of the DIA for msur-ance ccnmrage tlhveriH�cn I do hereby cerfa;&under th.epaiins and pelt r*fperjury at the info mia#ion proWded above is buC/s anPd cam 51 Date: ©LI Phone#: ©,dart me only: Do not writs in this arty la be ctrrnptete+d by city or tmwj official . or Town• FermitUcense 9 )suing Anthority(tack one): . L.Board.of Health 2.Bu l&mg Department 3.Ci.gff-own Clerk d.Electrical Inspector 5.Phunbigg Inspect©r 6.Other.. j.j _ _ °FzSKE Town of Barnstable Regulatory Services * 11MMSTAHEX ' Thomas F. Geiler,Director 039. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office:. 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: OL4-I '- I'� _ JOB LOCATION: I (CJ �'I"`— 1uAnn' nu ber street village "HOMEOWNER": l\ — %�� / ✓ name F home/phoune# J work phone# CURRENT MAILING ADDRESS: 1 r� l1�G MA cityAbwn state z p 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 structvres.+'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 suchworkperformed 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 in -inspection procedures and.requirements d thathe/she will comply with said procedures and requirements. Signature of Hoper 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." t t ] t 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,tharthe 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 C amend and adopt such a form/certification for use in your community. , ' n.\mm�n no\ran♦/c\L..:7J:_..-e....::�Fn......ICVDACCC'Anr , . . . . .. .. .• - . * ]MRNSfABL.E, + 039. ,�� Town of Barnstable pTbb MP't A _Regulatory Services ' Thomas F. Geiler,Director. Building Division Thomas Perry, CBO Building Commissioner 200 Main.Street,- Hyannis,MA 02601 j ' www.town.ba rnsta ble.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Co plete acid Sign This Secti If Using A Builder I C ;as O er of the subject property hereby authorize dlf 1 to act on my behalf, in all matters relative to work autho .ed b b ding permit applicad a _T ( Addr ss f Job a Signature of net Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on;the -- - reverse side. Q:IWPFILESTORMS\building permit forms\EXPRESS.doC TOWN OF BARNSTABLE mum 1639- in?ful BUILDONG , INSPECTOR APPLICATION FOR PERMIT TO ... ................................. TYPE OF CONSTRUCTION ....... A.2ty........... .........2u�n .............................................. G✓.........4.7..............19. ti TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ........... .............. ........ ............................................................................................... 1-0 ProposedUse ..... ................................................................................................................................................ <- r Zoning District ........ ....xe' ....................Fire District ....WX.�......'...�® .......I.................................. Name of Owner ... ....... ....Address ....... .......................... Nameof Builder ..........Sa?.1n..4�. .....................................Address .................. ............................................................... Nameof Architect ......... ........................................................Address .............:...................................................................... . Number of Rooms ...................................................................Foundation ........... ............................................... Exterior ............ 7...............................................Roofing ........... ............................................... Floors ...... .........................................................Interior ........................................................ ............................. Heating ..................................................................................Plumbing ....... . ..... ................................................. Fireplace ......:7777=.............:.............................................Approximate Cost .......................................... Definitive Plan Approved by Planning Board ---------------—-—-----------19---—-- Diagram of Lot and Building with e, S2 SUBJECT TO APPROVA L OF BOARD OF HEALTH O cjs ITI V) 47, "f—r7— V-i 0 C) -TI c- t frrm 0, Zz cn I hereby agree to conform to all tKe- Rules and Regulations of the Town of Barnstable regarding the above construction. .... ... ........Name ....... ...... � Jenkins, Edward 15822 garage ��-' saiene Street Edward Jerildns frame de PERMIT REFUSEIJ -------------.------------- ^—_—.—.—.....—..------.--~---.—. . � .,..--..--------.,...,....—.—.-,---. ) ^ .—.--.----.----------.—.—.---.. ' . ' , . ` Approved ............................................... lQ --------.------.....--..----.— \ . , ----.---------------.—..---.. . ^ .� .� l � ]L _ �