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Inspection Report— Building Department
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Addresses
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Purposeof CaMns ection Ls
Reported to Site with me
Observations & Notes
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Town of Barnstable, MA Search: RB ZONE
ADMINISTRATIVE CODE>Multiple-Member Appointive Organization
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Ch 241 241a Attachment A
Water Pollution Control Board Waterways Committee Water Quality
Commission Zoning Board of Appeals Individual Officers Inspector of
Affairs Hearing...
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ADMINISTRATIVE CODE -
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§360-44 Deadlines to repair failed septic systems.
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SAS,cesspool,or privy below high groundwater elevation;or Any poi
Zone i to a public well;or Any portion of a cesspool within 50 feet of a
with...
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ON-SITE SEWAGE DISPOSAL SYSTEMS>Additional Regulations
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§407-17 Southside harvest restrictions.
Harvest restrictions in the intertidal zones.The commercial harvest o
on the Southside of the Town of...
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Assessor's Office(1st floor) Map Lot O b Q k Permit# 27�,3 �
Conservation Office 4th floor Date Issued 2 9
Board of Health 3rd floor
APPLICANTIMMMASEWEB
Engineering Dept. Ord floor House
Planning Dept. (1st floor/School Admin.Bldg.): _
MAR&
Definitive Plan Approved by Planning Board 19
(Applications processed 8:30-9:30 a.m. & 1:00-2:00 p.m:)
TOWN OF BARNSTABLE
Building Permit Application
Proiect Street Address ?
Village kv H i-e Fire District "t-S
Owner -2�e �✓ ;r-�B��S Address
Telephone
Permit Request: �O �_ ��encr �c�s ��� T /�%uS� �inr tF
Zoning District Flood Plain Water Protection
Lot Size -%O O X-/D Grandfathered
Zoning Board of Appeals Authorization Recorded
Current Used w. Proposed Use ,4.r•-G'
Construction Type 411,19 19 d
Existing Information
Dwelling Type: Single Family Two family Multi-family
Age of structure e C, Basement type
Historic House Finished
Old King's Hi h�way Unfinished
Number of Baths No.of Bedrooms j
Total Room Count(not including baths) 7 First Floor -7
Heat Type and Fuel C..;71 4 Central Air % ' Fireplaces
Garage: Detached Other Detached Structures: Pool
Attached L,--' Barn
None Sheds -`
Other
Builder Information
Name L I44-9 G( if 5 Telephone numbersN--'-?-,
Address ? ;Z—G K q+vim License# d 01--%6
Home Improvement Contractor#
Worker's Compensation # 3/1-
NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS
PROPOSED STRUCTURES ON THE LOT.
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS ROJECT I L BE TA. EN TO J'V"d
Proiectt Cost
Fee 4,3z5• d-6
SIGNATURE DATE—
BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S)
BPERM T
s 4/12/95 37630 FOR OFFICE USE ONLY
310.260
ADDRESS
78 Linden Street VILLAGE Hyannis
� -
r ,
J. Craig Medeiros
OWNER
DATE OF INSPECTION:
FOUNDATION -
FRAME ( i
INSULATION t
FIREPLACE —
e
ELECT ROUGH FINAL
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PI, ROUGH FINAL
GAS: ROUGH FINAL
FINAL G: '
DATE CLOSED OUT:
ASSOCIATE PLAN NO.
e e .
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TOWN OF BARNSTABLE 4.
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE
JOB. LOCATION
Number Street address Section of town
"HOMEOWNER" �... ..
Name Home phone Work phone .
PRESENT MAILING ADDRESS
�� � .ma's _• ;,�,�, v�d�� �. -
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 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(sy 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 Sta
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 comply with said procedures and requirements.
HOMEOWNER'S SIGNATURE J
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.
HOME OWNER'S EXEMPTION
The code state that: "Any Home Owner 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
Home Owner engages a person(s) for hire to do such work, that such Home Owner-
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 awarenes
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 " caner- actin
as supervisor is ultimately responsible.
To ensure that the Home Owner is fully aware of his/her responsibilities,. man
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.
ttts ,
: . The Town of Barnstable
MAS& �e� Department of Health Safety and Environmental Services
16j;9. Building Division
367 Main Street,Hyannis MA 02601
Office: 508-790-6227 Ralph Crossen
Fax: 508-775-3344 Building Commissioner
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,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.
Type of Work: S r+1 A C,P"Z` X/0 ✓ S �` Est.Cost /I co
�� a G L L✓^ V L"s i1/l
Address of Work: -7 �^ E �f /�� v �► 5
� r
Owner Name: /
Date of Permit Application: /��l ,
I herebv certifv that:
Registration is not required for the following reason(s):
Work excluded by law
Job under S1,000
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:
e Contractor name Registration No.
OR
Date !�' er's name
11/02'94 17:02 'C$177277122 DEPT IND ACCID Ql001
11Z Conunoiuvea&L o f )WaJJaclr udettJ
�JaPartme�o�J'•ndu�Eria�✓dcccdan,�i .
600 Wwknyloa..Sht l
/� V " 02ff>
J ell L�oaames J.Campbton, a�ac
Commissi6mr
Workers' Compensation Insurance Affidavit
(inan:ee/Qermatee)
with a principal place of business at:
(earistne�z�v3
do hereby certify under the pains and penalties of perjury, that:
() I am an employer providing workers' compensation coverage for my employees working on
this job.
Insurance Company Policy Number
() I am a sole proprietor and have no one working for me in any capacity.
(� I am a sole proprietor, general contractor or homeowner (circle one) and have hired the
contractors listed below who have the following workers' compensation policies:
Contractor Insurance Company/Polity Number
Contractor Insurance Company/Policy Number
Contractor Insurance Company/Policy Number
;tI am a homeowner performing all the work myself.
und that a copy of Ehis sratement will be forwarded to the Office of Investigations of the DIA for coverage verification and that failure to secure
coverage as ret:.ired under Section 25A of MGL 152 can lead to the Imposition of criminal penalties consisdn¢of a fine of up to s 1,500.00 and/or cne
years' impri<orment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S 100.00 a day against me.
Signed thi � day of /l �„�y,� ,
Q
Licensee/Permittee Building Department
Licensing Board
Selectmens Office
Health Department
TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375
TOWN OF BARNSTABLE BUILDING PERMIT # �7��0