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Home My WebLink About0025 MARC AVENUE as MIA-re - — - - - -� 6 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel placation # Health Division ` Date Issued I Z' LGj— �/ I �' Conservation Division Application Fee ' Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address. f Nut � � v Village '�4 7 AN rJ=—S Owner " Address Telephone Permit,Request 1UiT�"�✓ GG' r . �GAl Ab tP for -� it $Ipm, Square feet 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay ,.Project Valuation ��°� Construction Type , IWW/ Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family �wo Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Baseme Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other IIZC Basenit Fin`''ished Ar (sq.ft.) Basement Unfinished Area (sq.ft) Numb of Baths: Ful existing new Half: existing new Number of Bedroom existing _new Total�Room'Count (n JE-J!pcluding baths): existing new First Floor Room Count Heat Type and Fuel:I a Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Au orization ❑ Appeal # Recorded ❑ Commercial ❑Yes o If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) = E��Z° 41 j7 7 •Z,- Name 6vu (�� Telephone Number 150 1 ! l� Address License # V q4NAA41 V�14 Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PRO T WILL BE TAKEN TO �V' goo SIGNATURE DATE `2 t C r' FOR OFFICIAL USE ONLY APPLICATION# x DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER r r ti DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL IF BUILDING DBE>CL0SED OUT { A-$-SGC KAXION PLAN NO. s Massachusetts - Department:of'Public Safety Boa rd of Building Regulations and Standards Co list I'll ctiou Supervisor License: CS-100988.; HENRY E CASSIDY' - ',. aw- 8 SHED ROW }, WEST YARMOUM B - 954, Expiration Commissioner 11/11/2015 i= Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 k Home Improvement Contractor Registration Registration: 153567 Type: Private Corporation Expiration: 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO, YARMOUTH, MA 02664 Update Address and return card.Mark reason for change. SCA 1 0 20M-05111 Address Renewal Employment- Lost Card GFI?e �par�rr�zoauuea�t�a�C/��CulJCic�u4e�J 1. .X Office of Consumer Affairs&Business Regulation License or registration valid for individul use only ,poOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: '1.53567 Type: Office of Consumer Affairs and Business Regulation xpiration: 92/:1512016 Private Corporation 10 Park Plaza-Suite 5170 Boston,MA 02116 Q CAPE COD INSULATIQN;;;INC':_ HENRY CASSIDY _ 18 REARDON CIRCLE SO.YARMOUTH,MA 02664 Undersecretary N valid wi ut sign ",tde f The Commonwealth of Massachusetts Department of IndustrialAccidents 4 W Office of Investigations w ' d 1 Congress Street, Suite 100 o Boston,MA 02114-2017, www.mass.gov/dia. f Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leizibly Name (Business/Orzv4wt n/Individual): Address: 1 V�k UMd �I — _ City/State/Zip: " w " l. M Phone#: 17 -1� Are you an employer? Check he appropriate box: ., 4. I am a eneral contractor and I Type of project(required): k' 1.�I am a employer with 'Z ❑ g employees (full and/or part-time). * have hired the sub-contractors 6. ❑ New,construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.,insurance comp. insurance. required.] 5. ❑ We are a corporation and its 10.El Electrical repairs or additions 3.El 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.Q Roof repairs insurance required.] t c. 152, §1(4),and we have no 13. Other�� employees. [No workers' '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%ffidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the subcontractors 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: awtv v Policy#or Self-ins. Lic, #; 46o 0 1 Expiration Dater l � Job Site Address: City/State/Zip: 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 statement may be forwarded to the Office of . Investigations of the DIA for insurance coverage verification. I do hereby certify n r pains and penalties of perjury that the information provided abov is tr and correct. Si nature: Date: Phone#: Official use only. Do not write in this area;to be completed by city'or town official. } City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r V� r w I CAPECOD-27 KLIGETT CERTIFICATE OF LIABILITY INSURANCE 76/1EIMM/DD/YYYY) srzola THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT; If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed, If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements), RODUCER CONTACT g NAME: Barbara DeLawrence• 14 Rte&Gray Insurance Agency,Inc. PHONE FAX No): (877)816-2156 Duth Dennis,MA 02660 A6 RRss: bdelawrence@rogersgray.com INSURERS AFFORDING COVERAGE NAIC N INSURER A:Peerless Insurance company sugED INSURERB:COMMERCE INSURANCE COMPANY ` Cape Cod Insulation Inc INSURER C:Evanston Insurance Company 18 Reardon Circle South Yarmouth,MA 02664 INSURERD:ATLANTIC CHARTER INSURANCE GROUP: ` INSURER E: INSURER F 0 ERAGES CERTIFICATE NUMBER; REVISION NUMBER: TF IS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD IN ACATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS.SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, R TYPE OF INSURANCE POLICY EFF POLICY EXP WVQPOLICY NUMBER MM/DDIYY Y) (MMIDD[Yyyyl LIMITS X COMMERCIAL GENERAL LIABILITY , EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR CBP8263063 _ 04/01/2014 04/01/2015 PREMISES Ea occurrence) $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,00 X POLICY a PRO• ❑ JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ (AU OMOBILE LIABILITY COMBINED SINGLE LIMIT K . .. ,. - t Ea accident $ 1,000,000 ANY AUTO 14MMSCKVMK 04/01/2014 04/01/2015 BODILY INJURY(Per person) .$ ALL OWNED X SCHEDULED _ AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS X AUTOS NON-OWNED 4 PROPERTY DAMAGE AUTOS $ Per accident $ X UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE XONJ463614 04/01/2014 04/01/2015 AGGREGATE $ DE D X RETENTION 10,000 Aggregate $ 1,000,000 ORKERSCOMPENSATION PER OTH- ND EMPLOYERS'LIABILITY STATUTE ER NY PROPRIETOR/PARTNERIEXECUTIVE`Y/N WCA00525904' 06/3012014 06/30/2015 E.L.EACH ACCIDENT $ 1,000,000 r FFICERIMEMBER EXCLUDED? a N I A M andatory In and s,describ under E.L.DISEASE•EA EMPLOYEE $ 1,000,000 °'OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 SCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additlonal Remarks Schedule,may be attached If more space Is required) rkers Compensation Includes Officers or Proprietors. iitional Insured status is provided under the General Liability and Auto Liability when required by written contract or agreement with the Certificate Holder. P .R IFICATE HOLDER CANCELLATION I r OWNER AUTHORIZATION FORM I, L v; (Owner's Na Me) owner of the property located at 25- ��G✓cyc _.- (Property Address) ai'l-6,V1 Ile 111/� v z G 3 2. (Property Address) hereby authorize 0. P ro d ol�10 VN , (Subco tractor) an authorized subcontractor for RISE Engineering, to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature 5 Date i —Z-7 Town of Barnstable TOWN QF _ iTARl �11HE ti Regulatory Services Thomas F.Geiler,Director 2013 N1 }1 18 AM '9: 2 b + BARNSTABLE, « „�. Building Division. ATF1639. � Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT# I FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less Location of shed(address) Village IV ��L �yrY'►S h �� Z� '� � 27 Property owner's name Telephone number Size of Shed Map/Parcel# lc l T � f., 3 Signatur Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 30 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:052813 Town of Barnstable Geographic Information System Novem6,. r t..,.y. . f 252055 252058, •,,,,.. #14 "- #108 273014\, yt ... #89 tF MARC AVE x 252062 #13 e., A2521 A • �, 252060 #25 252059 K #86 r Mm My 252065 a #44 252066 } #50 r ' 262067� 3 252068 C i #78 ST k f f^ 2730115 #73 0 16 Fe - DISCLAIMERS:This map Is far tannin u Map:252 Parcel:060 p planning purposes only. It is not adequate for legal P Selected Parcel o N boundary determination or regulatory Interpretation. Enlargements beyond a scale of owner:POTASH,NEAL Z&LUIGINA Total Assessed Value:$178800 FA 1 -t00 may not meet established mapaccuracystandards.The parcel lines on this map T dar F4 + fare only graphic representations of Assessor's tax parcels.They are not true property Co-Owner: Acreage:0.17 acres Abutters W y E boundanes and do not represent accurate relatioriships to physical features on the map Location:25 MARC AVENUE such;as b6i g;locahons K° k Buffer e Al TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcely aNOD +Application # ray Health Division Date Issued u l Conservation Division Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ' z9 3/y//o Historic - OKH _ Preservation/ Hyannis Project Street Address 'h5 HACC AWL-VuC`. Village rrS Owner Address 1-�r 11AYCC AST - G U,-Illmrt0)L,Lt= Telephone 5'D lb� 2ao '. �4-7� Permit Request S Kit L t Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay .Project Valuation $ toy 0J 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 Historic House: ❑Yes ❑ No On Old King'ss H ighway� ,❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Yp a Walkout ❑ Other -'l Basement Finished Area(sq.ft.) Basement Unfinished Area (sqt Number of Baths: Full: existing new Half: existing i new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Rol Count- - w Heat Type and Fuel: ❑ Gas ; ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# • Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) p Name 'Po fvy I Telephone Number S�a�' Z fdO Address 2 69o<(c Auk License # Gb X LaJhciG Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO S�i S to DLMP SIGNATURE DATE_7-(7,3 jy FOR OFFICIAL USE ONLY s APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL :R PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING h H 9 i DATE CLOSED OUT a ASSOCIATION PLAN NO. t f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ►y 600 Washington Street Boston, MA 02111 � y! www.mass.gov/dia ' Workers' Compensation Insurance Affidavit:. Builders/Contractors/Electricians/Plumbers .Applicant Information Please Print ]Je ibl �a Business/Organization/Individual): L L tfld-d Ss: L.� �, 1` - AUL, jeiity/Sta et %Zip: L_LdTt 2y Ll,r y2� _ phone #: 6U--G 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.❑ I am a sole proprietor or partner— ship and have no employees These sub-cogtractors have g. ❑ Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp. insurance comp. insurance.t. /required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additi �-3. -1am a homeowner doing all work officers have exercised their 11.❑ Plumbing repairs or additi myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs c. 152,§1(4);and we have no insurance required.] t -------�-p-"r't -employees. [No workers'. comp, insurance required] *Any applicant that checks box tl1 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 a new affidavit indicating such. lContractors that check this 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. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information: Insurance Company Name: . Policy#or Self-ins, Lie,#: Expiration Date: ` Job Site Address: City/State/Zip: Attach.a copy of the workers' compensation policy declaration page(showing the policy number and expiration datf Failure to secure coverage as required under Section 25A of MGL c. 152 can lead.to the imposition of criminal penalties of 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 advised that a copy of this statement may be forwarded to the Office of of up to$250.00 a day against the violator. Be Investigations of the DIA for insurance coverage verification, 1 do hereby certify un e pains d penalties of perjury that the info rniation provided above is trice and correct. Si nature: f Date:—'k `z L l Phone.#: ' Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one 1. Board of health 2. Building Department 3. City/Town Clerk 4, Electrical Inspector 5, Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions m e compensation for their eployees. Massachusetts General Laws chapter 152 requires all employers to provide workers' com p 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 defined 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, constriction 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 ofa'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.with.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!-contractor(s)name(s),address(es) and phone numbers) along with their certificate(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships (LLP) with no employees other than the 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 retumed to the city or town that the application for the pen-nit 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 permit/license 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 to 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: t ` The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 4-24-07 www.mass.gov/dia Town of Barustable of tt�r� Regulatory Services Thomas F. Geiler,Director � WAS& Building Division Preo IMl Tom Perr-y,Building Commissioner. 200 1vMaid•Streetti H annis,MA 02601 Rwsw.town.barnstable.ma.us Office: 508-862 4038 Fax: 509-790-6230 90)frOWWER LICF-NSE EXEMPTION. Plcasc Print DATE: JOB LOCAT]ON: l, AVLS GL�n�U� LC number street • village —HOMEOWNER": - # name t� home work.phone# Pbone CURRENTMAILING ADDRESS: a oil C 1%- r,nkA H 9 tJ 2. 3 2 statn zip code ci ty/town . The current cxeruption for"homeowners" was extended to include owner-occupied dwellings of six units or less and allow bpXrreowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. bEYNMON OF BOmmmE FR Persons)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is .tended to be, a one or two-farbily dwelling, attached or detached structures accessory to such use,and/or farm structures, A person who constructs more than one homen a r p i two-yeaeriod shall not be considered a homeowner. Such "homeowner"shall submit to the B u-ldiug Official on a form acccptablc to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) Thp undersigned"homeowner"assumes responsibility for compliance with the State Building Codc and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that rn he/she understands the Town of Bastable Building Dcpartrpcnt minimum inspection procedures and requirements and that he/she will comply with said procedures and rcrniircmcuts _ S:tgnaEtrcof Homcownar. Approval of Building Official Notc: Three-family dwellings containing 3 5,000 cubic feet or larger will be rcquircd to comply with the St$te Building Code Section 127.0 Construction Control. . '' .HOhfEO4vKER'S EXEMPTION The Codc slates that "Any homeowner pcxfoiming work for which a building permit is required shall be exempt from the provisions of this seeliobc Codc.5 ]cs to9jh -Licensing of construction Supervisors);provided that if the homcowncr rngages a pason(s)for hire to do such work, that such Homeowner shall act as supervisor." Q. 's rx tian arc unaware that they arc assuming the responnbilities of n supervisor(sec Appendix a use this wnas who crnp Many homco arl M 'cul Y Rules&IZngulations forLiccnsing Conshuction Supervisors,Section 2.1.5) This lack of awarrncss often resulu in scnous prnblcros,parts Y when the homeowner hues unliernscd 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 responsrbilitics,many communities require,as part of the po mit application, that the homcovmer certify that hryshe understands the responnbilitics of a Supervisor. On the last page of this issue is A.form cumcn}ly used by several towns. 'You may cacti t arnmd and adopt such a fonr)ccrtification for use in your community. THE Tawn of Barn'stab-Ze M t Regulatory Services at�xHsust� Thomas F_ Geiler, Director fdta� h`�` _Buff.ding x• v xsion Toni Perry, Building Commissioner 200 Main Strcct, Hyannis, MA 02601 wwFv.tovvn.barnstab(e.ma.vs Office: 508-862-403.8 Pax: 508--7 Property awrierMust Complete and Sign This Sectioa I Using .A.Builder as Owner of the subject.property hereby authorize to act oa my behalf, is all matters relative to work authot7zed by this building permit application for (Address of Job) Signature of Owner Date Print Name if Proms Owner is,applying for permit please Complete the Homeowners License Exemption Form on -the reverse -s•ide. i 71 — — I f Id r I i a k ; f c E r , I I � i ! i � � L s I I �(J L I i�l i I I r - -- - -•--�- __-r - - ------- �- -- - _.. Imo. ^n I ISO 1 4 t 4 ? I ,rn 9 � ? { j i I T I i I i r I A � 1 f \ I I 1 Y I t r r r CA 1 r 1 ' t f �GJ f +- i . I ' r � 1 _ Q . r I t r I f j C-1 E � I f Town of Barnstable �oFt"E'°wti Regulatory Services O„ ` Thomas F. Geiler,Director STABLE, Y Building Division . MA39. 9$ArEo:9. � Tom Perry, Building Commissioner 200 Main Street, Hyannis;MA 02601 www.town.barnstable.ma.us Office: -508-862-4038 ' Fax: 508-790-6230 PERMIT# FEE: SHED REGISTRATION 120 square feet'or less Location of shed(address) Village N t a L, So a 1 ; Property owner's name Telephone number o6c� Size of Shed Map/Parcel#, . 0- Sign e Date , Hyannis Main Street Waterfront Historic District? Old Kings Highway Historic District Commission jurisdiction?. Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30=4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THEABOVE 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 w Q-forms-shedreg REV:042506 Town of Barnstable Geographic Information System November 2, 2010 a 252058-�"-`4""—.�.,.`^.,�-rt.,. ,� 252055 #14 F #108 r' w 273014x #89 MARC AVM P 252062 #19 R �.. J x 252069 r} kj #86 t b t y r 252065 252066262067 I #s8 } e 252068To . 78 i c� 9r 4 F } 273015 € .., #73 0 .161 : DISCLAIMERS:This map is for planning purposes only. It is not adequate for legal map:252 Parcel:060 - Selected Pafoel boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:POTASH,NEAL Z&LUIGINA Total Assessed Value:$1 78800 1"=100'may not meet established map accuracy standards. The parcel lines on this map. ,:, .., are onlygraphic representations of Assessor's tax parcels. They are not true property Co-Owner: �'Acreage:0.17 acres Abutters - .� , such as building locations Buffer boundaries and do not represent accurate relationships to physical features on the map Location:25 MARC AVENUE! ' - � - - ' SSS