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HomeMy WebLinkAbout0048 KENNEDY CIRCLE �l� �'�n� C®r� a ,Q /� c I i Regulatory Services P : Thomas F. Geffer,Director `a gamvcr_^.R s Building Division r$ 16 k~�� Tom Perry,BuRding Commissioner a 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fa 50 ,790-6230 Approved-1-1ac G� Permit#: 5 3 HOME OCCUPATION REGISTRATION Date: I� y Name: ��J l Phone#: �7? Address: Name of Business: YW 0�'? Type of Business: Kents Map/Lot INTENT: It is the intent of this s w e ren to oof 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 vvitlun 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 parldng generated by such use shall be met on die 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 are 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 1, the unders' ed.;hav`e read e 'th the above restrictions for my home occupation I am registering. . Applicant _ Date: Honieoc:doc Rey.01/3/08 YOU WISH TO OPEN A BUSINESS? For Your Information: Business certificates(cost$40.00 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.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the To,:vn Clerk's Office, 1 st. FI., 367 Main St., Hyannis, MA 02601 'Town Hall) and get the Business Certificate that is required by law. DATE• Fill in please: APPLICANT'S YOUR NAME/S: lfv BUSINESS YOU9 HOME ADDRESS: Y1 i `' -7 1 L4-45i _SDIZ2 w {ate 0 TELEPHONE # Hom elephone umber �S D�� "/-7/ -7 v1 a 4 NAME OFNEWBUSINESS ` " TYPE OF BUSINESS ADDRESS OF BUSINESS 'rv — AP/PARCEL NUMBER [Assessing) i 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 M ISTSO TO SOD-Mai ms (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 a y permit requirements that pertain to this type of business. 1 �fOri.2ecl Signatur ** E COMPLY WITH HOME OCCUPATION COMMENTS: -- 6ND REGULATIONS. FAILURE MAY RESULT IN FINES: . 2. BOARD OF HEALTH This individu as be a of the peir�nts that pertain to this type of business. A Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS( CENS G AUTHORITY) This individual ha in r o the licensing requirements that pertain to this type of business. Authorized Signature** . COMMENTS: r,( v Town of Barnstable oF"'E Regulatory Services- MINNs�� - I T BIL-, Thomas F.Geiler,Director e xsresi aMAM A ' 9 Building Division °F �� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02661 www.town.barnstable.ma.us �` ----- 0IVISi0 z .y Office: 508-862-4038 Fax: 508-790-6230 PERMIT# — FEE: $ SHED REGISTRATION 200 square feet or less Location of shed(addres4 Village .Sa 8-- 7 7 I — 100 7 Property ow is name Telephone number Size of Shed Map/Parcel# Sign Date Hyannis Main Street Waterfront Historic District? Me Old King's Highway Historic District.Commission jurisdiction? o Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 000, PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:042911 / r -- i i LCP 11990A I I 1 I 50G°48'00"E 1 1 10.47' 1oT4 APN 267-056 10,90G±SF i o , N DECK O w z i 1 N N o / No. 48 , z I STY., WD. FRM. / j t:u I j s �Co. 70.00' — NOG03 1 '00"W I - KENNEDY , CIRCLE CURRENT OWNER(S): Stephen Babola j LEGAL REF: Book 232GG Page 137 I hereby certify to Mortgage Master, Inc. and Anthony Palmieri that to the best of my knowledge, and in my professional opinion, the structures) as shown hereon were i in conformance with local horizontal setback requirements when constructed, or are now '. exempt from setback requirements per MGL Title VII, CH 40A, Section 7; that the structures) are not in a Special Flood Hazard Zone as shown on F.E.M.A. Community Panel No. 250001 0008 D, dated July 2, 1992. This Plan is NOT the result of an on-the-ground instrument survey; is NOT to be used to determine property line location; is NOT to be used for construction of any kind, or for erecting of fences, and 15 NOT valid without an original stamp and signature. TOWN OF BARNSTABLE BUILDING PERMIT_APPLICATION Map 26 Parcel 0 5 (n, .Application # o)6/)90I7� Health Division �`Date Issued 2 Conservation Division ' `;`Application Fee Planningbept Permit Fee tUo Date Def nitive Plan Approved by Planning Board Historic OKH Preservation/Hyannis tX Project Street Address,�_ P �_� �/(. r rc Village f(y n II 4,a w� Owner S�-C Address 7- Cti �u Telephone S©'� '7-2 1 -'2.�i �1 Permit Request �c.���,1� �x�s�B��, as,k Square feet: 1st floor: existing /176proposed '1___1*­`2nd floor: existing—proposed,," Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 'Z O v @ Construction Type Lot Size , Z 3 /11c r I Grandfathered: ❑Yes XNo If yes, attach supporting documentation. Dwelling Type: Single Family -Two Family ❑ Multi-Family(# units) Age of Existing Structure 3c Historic House: ❑Yes 2rNo On Old King's Highway: ❑Yes to Basement Type:,,_YFull 0 Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.).-Ai:!9!! Basement Unfinished Area (sq.ft) //7-6/ Number of Baths: Full: existing new _� Half: existing new Number of Bedrooms: :3 existin _new Total Room Count (not including baths): existing new� First Floor Roo County Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes No Fireplaces: Existing New Existing woodkpal stove? ❑ o Deta arage: ❑ existing 0 new size ool. ❑existing ❑ new size ❑ex sting ®mewl-size_ Attache age: ❑existing ❑ new size ❑ existing ❑ new size _ Other: — r- rn Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes c No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �`�n ri� Tele hone N m r 0 I 1 � p u be .S� �� �-7 Address License # 5_3 19 7 1,(y h n s IL Home Improvement Contractor# Z F517) Worker's Compensation # - v 3 ? ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE A FOR OFFICIAL USE ONLY 4 r APPLICATION# DATE ISSUED .A MAP/PARCEL NO. ADDRESS VILLAGE OWNER 4 DATE OF INSPECTION: FOUNDATION FRAME s _ E INSULATION 7 FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL } FINAL BUILDING —�"� ~O a . DATE CLOSED OUT r ASSOCIATION PLAN NO. f y 0 ,per The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' a 600 Washington Street Boston, MA 02111 Q4 ;v www.mass.gov/dig Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 7 g 5 ?, ) Address: Z t/ S 4, G, G City/State/Zip: ,tea �, h �s /'78 r�T,A o 1 Phone.#: 5'059 `7-7 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 6. ❑.New construction employees(full and/or part-time).* have hired the sub-contractors .2.[oI am a sole proprietor or partner-- listed on the attached sheet. T. ❑Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• 9. ❑Building addition [No workers'co,mp.-insurance comp.insurance.$ required.] 5. ❑ We area corporation and.its 10.0 Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions - 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.❑ 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 anew.affidavit indicating such. IContractors that checkthis 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'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: —��( ti'p Policy#or Self-ins. Lic.#: lh Z'3 -b11 ` �-031 Expiration Datp: >Q L3 U Job Site Address: T— t City/State/Zip:. . X ah ri•sue���° _ 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$250.00 a day against the violator. Be advised that a copy of this statemeiit maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un r the pains and penalties of perjury that the information provided above is true and correct Signature: Date Phone#. G'$ 7 ) Official use-only. Do not write in this area,to be completed by city or town offcciaL .City or Town Permit/License# v Issuing Authority(circle one): I-'Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: �. A 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 define.d 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 vrith 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-contractors)name(s),address(es)and phone number(s) along with their certificate(s)of a ili Partnerships LLP with no employees other than the once. Limited Liability Companies LLC or Limited Lib ) incur Liability P (tY mP ( . ). 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 Officials 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 permittlicense 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 io any business or commercial venture (i.e. a dog license or permit to burn 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. # 617-7274900 ext 406 or 1-877-MASSAFE Fax# 617-727-774 Revised 11-22-06 v/dia www,mass.go Barnstable Assessing Search Results Page 2 of 2 E Stories 1 Story AC Type None = Exterior Walls Wood Shingle Bedrooms 2 Bedrooms i 1 Roof Structure Gable/Hip Bathrooms 2 Full t WDK14 0 tC Roof Cover Asph/F GIs/Cmp living area 1176 42 Replacement Cost $121851 Year Built 1974 Depreciation 20 Total Rooms 6 Rooms GAS BMT Lard i 1 t CODE 1010 42 Lot Size(Acres) 0.23 i Appraised Value $164,900 i Assessed Value $164,900 As Built Cards: t 2 t !>, - VieW Interactive Bias >> Sales History: Owner: Sale Date Book/Page: Sale Price: BABOLA, STEPHEN Nov 14 2008 12:OOAM 23266/137 $80,000 BURNS-DANA, KATHLEEN M May 24 1974 12:OOAM 2044/180 $33,900 Exitra Building Features Code Description Units/SQ ft Appraised Value Assessed Value FPL1 Fireplace 1 $2,400 $2,400 Property Sketch Legend BAS First Floor, Living Area FST Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy ' FUS Second Story Living Area UST Utility Area(Unfinished) (Finished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story (Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar=267056 4/23/2009 :Barnstable Assessing Search Results Page 1 of 2 h. n y g �F New Search New interaictWe Maps >> Owner: BABOLA, STEPHEN 48 KENNEDY CIRCLE Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $97,500 $97,500 267 /056/ Extra Features: $2,400 $2,400 Outbuildings: $0 $0 Mailing Address Land Value: $164,900 $164,900 BABOLA, STEPHEN Totals $264,800 $264,800 24 ST. FRANCIS CIRCLE Residential Exemption Received=$100,964. HYANNIS, MA.02601 2009 REAL ESTATE TE Tax!nff9m ation' Tax Rates. �- r e ti I<,3 O o v a`ua�on` i Community Preservation Act Tax $33.91. Barnstable FD-All Classes $2.37 $6.90 C.O.M.M.-All Classes $1.08 Hyannis FD Tax(Residential) $471.34 Cotuit FD-All Classes $1.43 $6.12 Hyannis-Residential $1.78 Town Tax(Residential) $ 1,130.47 Hyannis-Commercial $2.77 W Barnstable-All Classes $2.11 Community Total: $1,635.72 I Construction [D#etaiis f �� g � � �:tc r' 11. � � Building value $97,500 Interior Floors Carpet Style Ranch Interior Walls Drywall t Model Residential Heat Fuel Electric Grade Average Minus Heat Type Elec Baseboard http://www.town.bamstable.ma.us/assessing/2009/displayparcelO9map.asp?mappar=267056 4/23/2009 'iuFr j�:x y"� 1r;3 �_r.f 4';•F.¢` �_—� i�I '? � 3 p �� a�:vi-: '��}f yw '��$ _S' � �a9 U is i `,P� ✓fie T�omimo�zusea,� �./�/laaoac�ivaeCCa i Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: i 3 Board of Building Regulations and Standards Registration;,,158588 One Ashburton PlaceRm 1301 i Expiration 2/11/2010 Tr# 264154. PAL iType` Partnership Boston,Ma.02108 ;. MASS BUILDING SYSTEMS P STEPHEN BOBOLA' . 24 ST.FARNCIS CIRCLE o',,d/ HYANNIS, MA 02601 Administrator Not va id without signature j Board of Bwldmg Regulatioand Standards ;£ I I' y r ;, Construction Supennsor License s� Ugennse GS 58987 ` t I' 1 Expiration—:2/4/2010,t .,TTr# 16188 V I :} ;. .. 6 I � ppp t i .STEPHEN E„.,BOBOIA a 24 ST F,RANCIS 0IR a;" - ✓J '' c }� HYANNIS MA 02601 4 s Commissioner a f„ y ' 6 tT , Town of Barnstable ti Regulatory Services • iutrxsresr • - Mass $ Thomas F.Geiler,Director 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town_barnstable.ma.us Of6ce: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using AA Builder as Owner of the subject property hereby authorize ,S�c��n �a l 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. n.ar.nirc.ntrn.ranocn�rmcrnwr Town of Barnstable Regulatory Services -� Thomas F. Geiler,Director � RI RNCT•AAT� 14tA3.4 b ' � t6sp.. �$ Building Division' PrED Tom Perry,Building Commissioner 200 Mairi.Street;--Hyannis MA 02601 _.. ..... ... . _.._. . . __.._..... www.town.barnstable-ma.us Office: 509-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown state rip code The cuarent exemption for"homeowners"was extended to include owner-occupied dwellintrs 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. DEYMMON OP HOMEOWI`'ER 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 siructures 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 be/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) ibility for co�Lance with the State Building Code and other The undersigned"homeowner"assumes respons applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certifies that-be/she underst nds the Tpwn of Bar. table•Buildipg Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signati=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. HOMEOWNER'S EXEMPTION The Code states that: "Any b6rreowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1D9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall ad as supervisor." Many homeowners who use this exemption art unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Ragulations for Ucansing Construction Supervisors,Section 2.15) This lack of awareness often results.in serious problems,particularly when the horleowner hirrs unlicensed persons.. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed, Supervisor. The homeowner acting as Supavisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities rr-quire,as part of the permit application, that the homeowner certify that be/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. you may can t amend and adopt such a fomikertifrcation.for use in your community. Q:forms:homccxcmpt TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION r Map- Parcel _ App lication # Health Division 33 Date Issued Conservation Division Application Fee P PlanningDept. ' Permit Fee 16 Date Definitive Plan Approved by Planning Board ` Historic- OKH Preservation/ Hyannis Project Street Address Z 14-ehn-e VillageT� Owner Address Telephone _50 ` 7 l - Y 9 7 f Permit Request /i e le. /dC -c 1 � P•, c. It. /'r� C D. sz /2 e C t s r a_- s Square feet: 1 st floor: existing 7�proposed AAA oor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation uj 00 0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) Age of Existing Structure r Historic House: ❑Yes 61 No On Old King's Highway: ❑Yes JMo Basement Type: 'dull ❑Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /J 7 6/ Number of Baths: Full: existing new Half: existing / new Number of Bedrooms: existing Total Room Count (not including baths): existing e_new"""" First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ,.Electric ❑Other Central Air: ❑Yes -4?01,o Fireplaces: Existing l Nevy/"'— Existing wood/coal stove: ❑Yes�No Detac rage: ❑existing Lillnew size_ existing ❑ new size existing ❑ new siz11e_ Attac �arage. ❑ existing ❑ new size _Sued'❑existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes IQI'No If yes, site plan review# Current Use , Proposed Use APPLICANT INFORMATION .� (BUILDER OR HOMEOWNER) Name _ r�, r,r, � � Telephone Number Address Z!v S.� /'� e is c, License # 8" p Home Improvement Contractor# 4 Worker's Compensation # k1C Z 317 Zit -03 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 5 FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL N0. y: 1 ADDRESS VILLAGE � I • OWNER ; k DATE OF INSPECTION: s FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH ' FINAL PLUMBING: ROUGH ,FINAL GAS: ROUGH FINAL r FINAL BUILDING �?"� �0,9, DATE CLOSED OUT , ASSOCIATION PLAN NO. ' k The Cornrnonwealth of Massachusetts. U9Departmeni of IndustrialAccidenis Office of Investigations 600 Washington Street Boston, AM 02111 www.m ass.go v/dia' Workers' Compensation. Insurance Affidavit:-Builders/Contractors/Electricians/P'lumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): ---�Q Address: _- �/ City/State/Zip: ►.o,n n ► —, a Phone.#: -�'7 l —2 `� 7 °1 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 6. ❑ New construction employees (full and/or part-tim.e).* have hired the'sub-contra ctors 2 ] I am a'sole proprietor or paxtuer- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have g• ❑ Demolition workingfor me in an capacity. employees and have workers' Y P h`• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 7.0.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 1.1.❑ Plumbing repairs or additions myself o workers' eo right of exemption per MGL y [N mp. 12.❑.Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' l3.❑ Other comp.insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeovmers who submit this affidavit indicating they arc doing all work and then.hirc outside contractors must submit anew aii'idavit indicating such.. XContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whetter or not those entities have employees. If tic sub-contractors have employees,they must provide their workers' comp.policy number. I ant an employer that is providing workers' compensation insurance for my employees. Below is the policy acid job site information. - Insurance Company Name: i d'e r V� Policy#or Self-ins. Lic,#: L - 7,5- — -3 I7 Z// Expiration Dater �B Job Site Address: y g ke aht�1 Cr r c � City/State/Zip: v A)') 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. Bc 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 er the pains and penalties of perjury that the information provided above is true and correct` Si afore: Date: / $ Phone 3' Offtcial.use only. Do not write in this area, to be completed by city or town officiaG City or Town: Permit/License# Issuing Authority(circle one): L.Board of Health 2.Building Department 3. City/Town Clerk .4.Electrical Inspector.5. Plumbing Inspector 6—Other Contact Person: Phone#: - zHET , "Town of Barnstable • Regulatory Services 9saxNAM. Thomas F.Geiler,Director i639. �� �Eny�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 Us ing A Builder as Owner of the subject property hereby authorize S' e p en d�a�� to act on my behalf, M all matters relative to work authorized by this building permit application for: U /5 C;7rl'Ce/�Y \jI o /{ (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please.corrmplete the Homeowners License Exemption Form on the'reverse side. Q:FORMS:O WNERPERMISSION t_ Town of Barnstable Epp THE Ty Regulatory Services BA SrAB Thomas F.Geiler,Director rr�.4s. 9�P 16sa a,�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 vt ww.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79.0-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 9 number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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 faun 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"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: Signature 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. 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 horricowner 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:fornzs:homeexempt .. -j } � A Board of.Bwldmg)�2egulaffo sand StAfifteds N I r'.Construction Su¢ervisot�LIcense - License CSC 58987x+ � t Eat' on 4/20 0r# 8 }. x�� -TUJ A xka Re`s action :ODt, F t STEPHEN ,, � k E BOBOLAW 24 ST FRA CIS C R 4 c, -Ai }r `� HYANNIS MA 026011 � CommissioIt ner I! - .. 'j - i . ✓fie "C�Omn2oouue2�{�iac�tudeb - . Board of Building Regulations and Standards License or registration valid for individul,use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If:found return to: 41 Registration;,158588 Board of Building Regulations and Standards Expiiaation 2/11j2010 Tr# 264154 One Ashburton Place Rm 1301 Boston Ma.02108 i iiType Partnership MASS BUILDING�SYSTEMS_ t' STEPHEN BOBOL"P 24 ST. FARNCIS CIhCLE ',✓ � ,� i HYANNIS, MA 02601~ � Administrator Not va id without signature { r 1 M � � C� o bp Assessors map and lot number .................. ................. SEPTIC SYSTEM MUST' BE I NS T ALI-ED I1�I COMPLIANCE II STATE Sewage Permit number ....... ...............................:....... SAT' ITARY CODE AND TOWN R /� REGULATIONS. yOFTNETp�I TOWN Oj BARNSTA" E P i E9flH9T"LE, i 1639- ��YPY a• DUILD.IANG IISPECTOR APPLICATION FOR PERMIT TO .... Ll ../..�A S. ................................................................ TYPE OF CONSTRUCTION ....... A•`J?100.e............................................. ✓..ftj ..1. ...............19. ... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. ............................................... .............•. ....... . ............... ... .................................................... ProposedUse ...........*6 1 . ............................................................................................................................................. 9 Zoning District ............... . .............................................Fire District ......................... 4— Name of Owner .....Address ....'O1 .;<.�... ............ l Nameof Builder ........................................ ...............Address .................................................................................... Nameof Architect ..................................................................Address ............................................/....................................... 1-00,�O W 2 Number of Rooms ........�...................................:.............Foundation /a..... Exterior .....................................................................................Roofing .....43. 5........04st ..!1, ......................................... Floors ;/ '.., f �...�(. t/ . �G/t f ..� .. ........Interior .. .2...... /� 1��..!/................................... p C,�as1� eo �jea s u�� Heating /..�.�/ .,..... ...........................................Plumbing ..�[. /�/. y r Fireplace ... � .........................Approximate Cost .......�...� .Q 6 ......... ! `.. � .. .......................................:..... J �/ Definitive Plan Approved by Planning Board ________________________________19________. Area /......!..�. Diagram of Lot and Building with Dimensions Fee // ....(0 .......ce .............. SUBJECT TO APPROVAL OF BOARD OF HEALTH 7` � — s 26 I hereby agree to confo—fm­fo-'al the Rules and Regulations of the Town f Barnstable regarding the above construction. Name ...... .......................... .... ................................. Spencer, Arthur W. No 16860.... Permit for ......one...story tory ..... ........... ...... . ......... .. single family dwelling ............................................................ Kennedy Circle Locatio'n�$.�: Kennedy................................................. Welig;Ily-anni sport ............................................................................... Owner Arthur W. Spencer .................................................................. Type of Construction .........frame........................ ........ ................................................................................ Plot ............................ Lot .......... ............... Permit Granted .........19 74 Date of Inspection .... ..............................19 Date Completed PERMIT REFUSED ................................................................ 19 ............................................................................... ................................................................................ ............................................................................... ti ............................................................................ Approved ................................................ 19 ......................................................................... ................. .......... .................................................. INE r° Town of B ar-nstableNSTA BAR A--li- E, ` Regulatory Services 7 MASS. tb,q. Building Division prFO MP'�?. , 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location e+C� Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. 4. i The following items need correcting: ® 6— y �5 AtA i L 'T"D �-L R p- i Please call: 508-862-4038 for re-inspection. Inspected by Date