HomeMy WebLinkAbout0078 LEWIS STREET A
TOWN OFtBARNSTABLE BUILDING PERMIT APP,LICATIO
1�• �l �. � it w, a C+r•
Map ' ='' Parcel m— ��w, Permit#
..
Health Divisionb) fix' ' Date Issued
Division S,^ G� cC �? _ i f �- Fee-
Conservation
Taz Collector e
Treasurer i7, t I A j
PlanningDe pi. 9 4 , _ c ,' GTlbti p�RMIT FRff'i ,To
p ^RL�iG DMSION FPJ
Date Definitive Plan Approved by Planning Board f
Historic-OKH ! Preservation/Hyannis } `�
4 j f
t._ q6 76
Project Street`Address
Village
T {
Owner Address
-t— L _ __.
TelephoneC � , — �,�e* ;
Permit Request f ,4r 0,,A
1
Roam r-�o : "?,cc1. �tjeUr�e+r11 , ��,c�i.S O ��V.�S '(Zn✓nA
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Square feet: 1st floor: exi t
g proposed 2nd floor: existing proposed Total new
Valuation �560g ZoningDistrict Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes Cl No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family- ❑ Multi-Family(#units)
Age of Existing•Structure CPU t 1,C Historic House:F-o
❑Yes 2lo On Old King's Highway: ❑Yes 2 No
Basement Type: ❑ Full ❑Crawl ❑Walkout Other �I t;y� % 1` j� C
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing �new Half: existing new
Number of Bedrooms: existing_ new I
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑Gas YOil Cl Electric ❑Other
Central Air: ❑Yes 2"No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes 2TIN'o
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:el"existing ❑new sizeaL_h(Qq Shed:011existing ❑new size_�X JZ� Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 2rN o If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE J DATE2 d�
;y FOR OFFICIAL USE ONLY -
J
PERMIT NO. ` a
DATE ISSCJED, "' ry
MAP/PARCEL NO.,
.:ADDRESS, ,01a r 7- R">:<!"°l'^K t rs VILLAGE t
OWNER
DATE OF INSPECTION
FOUNDATION,,
% • — 1
FRAME - .
INSULATION
FIR PLACE
r
ELECTRICAL: ROUGH FINAL'
PLUMBING: ROUGH FINAL
GAS: t �•? ROUGH FINAL'
1
'- FINAL BUILDING
F r •�j
DATE CCOSED 0UT
ASSOCIATIO PLAfN NO.
a
oFrME ri
The Town of Barnstable '
RMW&rABL& :
9� 1639. Regulatory Services
Thomas F. Geiler, Director
Building Division
Ralph Crossen, Building Commissioner.
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax! 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements. c I
Type of Work: le -�L� �'.���� Estimated Cost
Address of Work:
Owner's Name: CJ \
Date of Application: /0
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:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
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 Contractor Name Registration No.
` e
OI �R
Date Owner's Name
q:forms:Affidav
The Commonwealth of Massachusetts
Department of Industrial Accidents
0/ffce oflasestjgatfaas
600 Washington Street
• `-� ;yr Boston,Mass. 02111
Workers' Compensation Insurance davit / ���/��./„
//,�,/
o r t
location: '`i. r->,�"' ,;:•� ...,
City
6 � � � � phone# i
I am a homeowner performing all work myself. T
❑ I am a sole proprietor and have no one working in any ca achy ,.�,.///
%%%%% %%/%%% %/%/// /.
I am an empiover providing workers.'compensation for my employees working on this job.. .
❑ :. .
comannv name:
address:
city:
alley#. : ;..
❑ I am a sole proprietor, general contractor,'or homeowner(circle one)and have hlred the contractors listed below who
have
the following workers' compensation polices:
co
an v name:
ad
dress-
ess•
#:.
one
city
msarnnce co.
comn
v name:
address:
(tone
city:
insurance co:
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of txhaiosi penalties of a fine tip to understand
and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I undeatartd that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verincadom
j 1 do hereby certify under the pains and penalties of perjury that the information provided above is truo and correct
Date ao/0 1 - -
S„gna I �, Phone# 7C10 32Y�
Print name 1A�,'' aA✓1 Z /��
oinciat use only W do not write in this area to be completed by city or town official.
permitllicense# ❑Building Department
a city or town: ❑Licensing Board
❑Selectmen's Office
❑ check if immediate response is required C3Health Department
phone#; (]Other
contact person: a:
n, .... y ... .. ..
itCvtsea v95 PA) -
Information and Instructions
to
Massachusetts General Laws chapter 152 section 25 requires all employers to workers' compensation for their. P
employees. As quoted from the "law", an employee is defined as every person in the service of another under any contr-"
of hire, express-or implied, oral or written..
Anemployer is defined as an individual,partnership, association,corporation'or other Legal entity, or any two or more of
in a ourt ente rise, and including the legal representaum of a deceased employer, or the receive:
the foregoing engagedJ rP ,� emp employing employees: However the owner of a
trustee of an individual,partnership, association or other 1 to or the occupant of the dwelling house of
dwelling house having not more than three apartments and who resides.th=in, P
e, construcfim or repair work on such dwelling house or on the grounds c
another who employs persons to do maintenanc
building appurtenant thereto shall not because of such employment be deemed to bean employer.
MGL chap shall withhold the issuance or renef
ter 152 section 25 also states that every state or local licinsing agency
of a license or permit to operate a business or to construct buildings in the commonwealth for�pp r�° h'
not produced acceptable evidence of compliance with the insurance coverage required. Y�
contract for the performance of public work until
commonwealth nor any of its political subdivisions shall enter into a been presented to the co**�*� 'nc
acceptable evidence of compliance with the insurance requirementsr have
authoritymy
Applicants
Please fill in. the workers' compensation affidavit completely,by checIang
the box that applies to your situation and
supplying company names, address and phone numbers along with a certificate of insurance 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 you have any questions regal the'law"or if c
are required to obtain a workers' compensation policy,please call the Departaul t at the mmiber listed below..
//
City or Towns
rioted 1 bl The D w meat has provided a space at the bottom of t
Please be sure that the affidavit is complete and p Y• the licant. Please
be sure to fill in the per
affidavit for you to fill out in the event the Office of has to contact you regarding aPP
-.mit/li
... cense number which. . ch will be used as a refcrence
-. ,number. The affi m
davits ay be rctmiid t^
the Department by mail or FAX unless other arrangm have been made.
The Office of Investigations would Idle to thank you in advance for you cooperation and should you have any questions-
please do not hesitate to give us a Co.
The Department's address,telephone and fax number.
The Commonwealth Of Massachusetts
Department of Industrial Accidents
Me of InY8stl0auces
600 Washington Street _
Boston;Ma. 02111
far#: (617) 727-7749
phone#: (617) 7274900 eat. 406, 409 or 375
The Town of Barnstable
Regulatory Services
'°lFn N►n+" Thomas F. Geiler, Director
Building Division
Elbert Ulshoeffer, Building Commissioner
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
l Please Print
DATE: !P-O/o I
JOB LOCATION: `67
number street village//�y
"HOMEOWNER": �tl, l,.kl.�.i �ID —3al 7 ��� ko' w
name / home phone# work phone#
CURRENT MAILING ADDRESS:�7G6 _
®'7bo�
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.
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�,irements.
Signature of Ho owner
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 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:EXEMPTN
bedroom bedroom bedroom bedroom
g
bolhroom ballroom I ,�
S
living room �• r;
new bedroom
dining mom •`� dining room
kitchen .... kitchen
basement \\/l basement;
stairs - stairs
_____ _ ______ cbser
Cbxf uzw ___ -------- Gose .
•
GereOe Dear
new living room _ ..
O
W81am I J0ya Y Wi N.Yce
78 Lewtc St 78 Law(e St
aleia MA 02601
S.b 11MA OZB01 Sc
Scale 1/a•=T Scab 1/1'•7'
shed shed
a rrt
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7.-a. p.-f. 7..r
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bedroom � bedroom ,. R bedroom bedroan ..
bad,roan m i u�, _ .1. bathfeom
new bedroomR 4
y
Asa• ,k—aa- ,
1
7 dining roan dining77
hWtchen a W'fchen
Y7.7 §
I-2'-N
basemgM) I v base f�7k'
\ § cost a,.ar y ipnwrter
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-'� .�`-ra•. .. axis' y coas- r-0•.
za.
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Darpa Door
new living room
t:
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wwnr.bl+n - - wwn I Joy a
78 Ln*St - 78 Lax"St
Myanab MA 0M hY—'b MA 02801
Stab IN".1' - Scab I/.•-f'
] .shed _ h shed 1 �•
�B'-/•� .�—Bye
crawl space crawl space
27-1r - -
N
!�—ra full basement full basement
ti
basement - - G� basement
1 stairs �,J stairs - '
24'
concreat slab concreat slab
4'r
wKSM I joyce 7shed
I Joyce7e L-i.S2 79 L.M.StMy—Y MA 02601 Hy—isMA 02901
Scab IWA' Scab 1//••1' shed
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Assessor's map and lot number .........`.. ......."�.... ..............
-.� 7—77,,
� Q�Of a Toffy
Sewage Pr, iit number ........
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House number
1M s639:.,\0
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X)ffyINTAL CO ...- ?�
- .TOWN OF BARNST
UUI'LDING INSPECTOR
APPLICATION FOR PERMIT TO . . ...............................
r
TYPE OF CONSTRUCTION .. .11.. . .... ...... ....................�...........:g....................................
. .......... .. ........19-2.
THE.INSPECTOR OF BUILDINGS:
The undersigned
hereby applies for a permit according to the following information:
Location .... .............. ... ...........................................................
ProposedUse ....................................................................................................:........................................................................
ZoningDistrict ......J....... ........................... Fire District ..............................................................................
Name of Owner ./............. ...X. ............Address ...�.. .....Lc� .. r�.....................................
Name of Builder .....144v►11:►��...........................................Address ..:: .......................................
.....................
Nameof Architect ..A-yi .............................................Address ... ..........................................................:.....................
Numberof Rooms ..................................................................Foundation ..............................................................................
kl000' Swisj az, q
Exierior ....................................................................................Roofing ......-4111 ............1..............................................
el
Floors ............... � .zzc..
...............................Interior ....................................................................................
.......... .
Heating ..................... ......................................................Plumbing ................................ ....... ....
- � � 'moo . ;
Fireplace Approximate Cost ......................... ....................... . ...............
...........................:..................
Definitive Plan Approved by Planning Board -----------__________--------19--------. Area l..`�!...5. ....................
Diagram of Lot and Building with Dimensions Fee 7 .
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I -
yam
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f9�a
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction. /
Name ..! ..... . .. .. ......................
\&stcber^ Henry J\ . .
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�l�O2
No -----.. Permit for\'~�------..������e ^ .
---''—~—'----^------'----'''---' � !
78 IewiaTteige
Location ............................................5iL......
--------.u�a����------------..
Owner ---- ---------
Type of Construction ..........................frame
---------~----------~----- . `
Plot _--------. Lot ------��---.
~^ ' .
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(
May 17 79
Permit Granted --- .............................. ;
» .
\ '
~_- of Inspection ................. --'
^ .
1.g�^�
-
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_ PERMIT REFUSED
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~pp ~ 19
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Assessor's r_Vrap and lot number ......... ......... ........... '00k
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a ....... T 0i T E T0�
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Sewage eQmit'3number .........����,G� ,, ,rIL;�9?.
Z BA"STADLE, i
House number NAM
9�O t 6 3 9 \e�0
am a'
TOWN �OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ....
�
TYPE OF CONSTRUCTION
...........................................................
�-
....M..:.:?-:�.:'...�t n-`:�:,..:....�:*a'.-1z-,�r�-,r.�-.P- ��-
z 19...
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .......7.. ....
X ...................... ......�3.•a� va..................................................................................
... ............................. � ,.
ProposedUse ...................................................................................................................................................I.........................
ZoningDistrict ........................................................................Fire District ..............................................................................
Name of Owner l-� y . . ...............Address ( .�c.......-.
.� � /!�
Name of Builder .......R.:r ^:�.:r.............................................Address .....::h. ';:.:?:^.- ............................................................
Name,of Architect ... ..............................................Address .....,a..r . ..r.
........................................................................
Numberof Rooms ..................................................................Foundation ..............................................................................
_ _ f
s-��. "
E x l e r i o r ........'.'...............................�`?.. ,C, `. ..................
......................................Roofing _........p,?`�..,.....:::...t.....:...............................
t 3 ?. {µ:^ .....Interior
Floors ........::...:..:....,,........................... ....................................................................................
Heating .................................................................:................Plumbing ..........................f+.
Fireplace ..................................................................................Approximate Cost ..................w..
......... ..........................................
r
Definitive Plan Approved by Planning Board ________________________________19________, Area
r
Diagram of Lot and Building with Dimensions Fee � ......
SUBJECT TO APPROVAL OF BOARD OF HEALTH
1"
r,�-
r r
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Vatcher,.Henry A. A7-310-123
No ....... 302 Permit-for ......a4!Lt9..&AK49e,.
.-f-Lo, 78 Lewis Location Road
caon ................................................................
.......................... .....................................
Owner .............Henry. A. V�tcher..................
Type of Construction ..........L1.49....................
...................................../................... .........t� -
Plot .................... Lot .... .. .....
May 17
Permit Granted .,\�..............0...............19 79
.............
Date of Inspection ....................................19
Date Completed .......................... ........19
PERMIT REFUSED
..................................... ...... ..... ....... 19
...................................... 7.
to........................
........... .................................................
..............0...............0.. .......0..................
......................................................o........................
Approved ................................................ 19
............0..........................
....................................0.........................................