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HomeMy WebLinkAbout0119 OLD CRAIGVILLE ROAD t r) Map - 7(? Parcel 113 Permit# 1 S'q 6 Conservation Office(4th floor)(8:30-9:30/1:00-2:00 1 1 Date Issued Board of Health(3rd floor)(8:15 -'9:30/1:00-4:45) e ',� Engineering-Dept.(3rd floor) House# f r-UN AS 19 B WITH TITLE 5 LANCE TOWN OF;BARNSTAR ® NTa �� Building Permit Application % oo ®v P oject St et Address �� 9 � CRAA' 111)_4�5 ROA %7,,Y*it/0 g, 101 ®�° 66, I age Owner U N— iyo s Address S,4/M f Telephone Permit Request e4l'D®08 S-r0RA64 ; S#Z s First Floor square feet Second Floor square feet Estimated Project Cost $ O0 0,/) �G Zoning District E Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family �'�d/ Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures:, Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address j/'� ©i- f� 4j„ License# O/S IV A� aP i�* I Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUr DEBRIS SULTING FROM'THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIE OR THE FOLLOWING REASON(S) i FOR OFFICIAL USE ONLY i P. MIT NO. , f Din ISSUED MIP/PARCEL NO. ADDRESS VILLAGE f ' OWNER . f4 i i t DATE OF INSPECTION: FOUNDATION FRAME INSULATION — FIREPLACE , ELECTRICAL: ' ROUGH FINAL , . ; i a PLUMBING: ROUGH FINAL GAS: ROUGH FINAL r FINAL BUILDING {" r �i `/l�), s' ... 6:j YL9 0.� ..•A f � f s DATE CLOSED OUT rm ' ASSOCIATION PLAN NO. w • "ji]` `'_ Tltc• Cunrmann'Caltll grAtassadimetts y a Dc ptrrtnrrnt ojlitdustrial Accidcnls • 4 �. _:!� 011fceollo�sl/gallcas . `? �i' •a` 600 1hishin it)#Slrrd • x� �; �Baa7an.Ala=, 92111 Workers' Compensation_ tnsurance.A>Tdavit A m—nennt nformation Inca ion- citt III' i YVA• d+10 nhnnc f I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacityMM F Imo' - y4��"�t�1+-•-•-+a'-�ILT��+�+� , Q. 1 am an employer providing workers' compensation for my employees working on this job. cih•• phone#t cnolicy0 I am a sole proprietor, general contractor, or(homeowner circle one)and have hired the contractors listed below who havi the following i4 workers' compensation polices: comn•1ny n•1me �� ���� 1) psno address RO City: �vV Vb-6 --L/506 incurnncc ce •• relics•# • • • I"^��s':==- "",�T'�.. _-.:_..rsn�-,�...•.arw�'Q*„'�""'T�"'''p.,gi�''c� �avr�+sq�e7�f'�1'r�[;�..., s�r�+t.+-.y�. "�_ m �• e• cih phone#• -s--rn- :Attach additidesfsheet if tiee .�Y- .ram- .�++sr rssr* :.;:.'w..;. _•... — --- -- _ _ .-% Failure to secure coverage as required under Section 25A of h1GL 152 can Ind to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that s coin•of this statement may be forwarded to the OMee of Investigations of the DIA for coverage veriliesdon. I do herebr certify nit t pa s and penalties of perjury that the information provided above is true and conrct Sinnaturc MY 19% Print name � ® 5 one# �6 o;cial use only do not write in this area to be completed by city or torn oMdai city or town- permitilieense# r11Building Department 13Uccusing Board check irimmediate response is required OSelectmeWs Oflice (311nith Department contact person: phone#; nUther__ .-Information and Instructions a Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for tile-* emplgvee is defined as every person in the service of another under any employees: As quoted from the"law",an contract of hire,express or implied, oral or written. j An emplitrer is defined as an individual, partnership.association.corporation or other t."gal entity, or any two or morf in a joint enterprise.the foregoing engaged ise,and including the legal representatives of a deceased cmplover.or the receiver or trustee of an individual, partnership.association or other legal entity, employing employees. However thi owner of a dwelling house having not more than three apartments and who resides therein. or the occupant a the ot dwelling house of another who employs persons to do maintenance,construction or repair wort:on such dwelling lte or on the grounds or building appurtenant thereto shall not because of such employment.be deemed to be an employer MGL chapter i'52 section 25 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 fins not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the ble evidence of compliance with the insurance requirements of this chapter i performance of public work- until accepta been presented to the contracting authority. �. Yin. Ali: ."h^ d U�^�.:.i�tY: y`tiv....1'r^� C;;,.�1. •_ Applicants Please fill in the workers' compensation affidavit completely,by checking the boa that applies to your situation and supplying-company names. address and phone numbers 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. Tice 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 requires to obtain a workers' compensation policy,please call the Department at the,number listed below. : .. �...�. . .. .i.:. w..•9 .. _ � (Y: o•.;;'..:ti.:"„ins•�i-J�iih�' ��Ii:vr ��r��t��v City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple: be sure to fill in the permittlicense number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to give us a call. .,�_..."Y•R�,�r.:r..w.w±!*"�!!R.�+ :.T,•.•�,,.r.!? :�i.i r..�i..s.;s.:s� •'++�'«��.i:�•.w�i.. �tif.si :.'�.::•wn :'r"i'r"` ' • • The Deparan,ent's address.telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents - Office of imlestigations � 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 7274900 ext. 406, 409 or 375 i : The Town of Barnstable NAM e$ Department of Health Safety and Environmental Services ` Building Division 367 Main Street,Hyannis MA 02601 Ralph Crow= Office: 508-790-6n7 Building Coma Fax 508 775-3344 For office:use only , Permit no. Date AFFMAVI T HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A rewires that the mn=nstmaron,altemtioM renavation,twit;modernization,CONve 0n, improvement,.ze nmtial, demolition. or construction Of an addition to any PM'=isdng owner 0=1pied building containing at least one but not more than four dwelling units or to structures which are adja=t to such residence or building be done by registered eo=auors,with certain exceptions,along with other requirements Type of Work: -Cast Address of Work- i Oaner.Name: Date of Permit Application: I hereby certify that: Registration is not required for the following rrason(s): Work excluded by law Job under S1,000 —K Building not mmer-Occupied T—_Owner Pig am pernat Notice is hereby given that: CONTRACMRS OWNERS PULLING THEIR OWN ROMIT OR DEALING WITH FOR APPLICABLE DO NOT EHAVE ACCESS TO 'Ia ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PEFJURY I hereby apply for a permit as the agent of the o%%w- Date Contractor name Registration No. OR ' n^.- Owner's name T r • :o#AmoNWEALTH DEPARTMENT OF PtJBUC SAFETY OF ONE ASHBORTON PUKE A(%".SACHUSETTS BOSTON,MA 02108 LIC:Ely = EXPIRN 50 S EFFECTIVE DATE 1JC-NO. RESTP, 03/31./i.9y4 046135 JAMES O MCC-RATH : `at p0 80K 706 I _ jST,�:�OFtr= 4f*Q,Ln FEE:. ;..,• D By E A►D oFRCYLLT HEIGHT: • flRE OF THE�a THIS DOCL**NT MUST BBECAMEOONTHEpE�SONTHE HOLDEN WHEN CH.EN- /' R Wiwi IOWTWSOCCUPATION. • HOME IMPROVEMENT CONTRACTOR ; RegiStTatiOR 109374 Type - INDIVIDUAL ElpitatiOn 09/11/96 PINE HARBOR BUILDING CO. INC. JAMES D. MtGRATH ,aO BOX 708/120 6T WESTERN RD ADMNGTRATOR pERRI3 ii 416601 J'J a� , r' TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. P . ., DATE ,�� JOB LOCATION / 0,4t) CRA1(9 y11_j,6 N), N AAMIS A.r Number Street address Section of town "HOMEOWNER" T .r�4A/1 -TANos Name Home phone Work phone PRESENT MAILING ADDRESS PAJIL -;TANZ)S , ®dadrx • 16F13°s 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: Persons) 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 strucUires. 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 buildin permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" - homeowner certifi s that he/she understands sof Barnstable Building Departme mini m inspection the Town em and that he/she will comply i a ' procedures and requirements.nd HOMEOWNER'S SIGNATURE 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. I it _•. HOME OWNER' S EXEMPT ION 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 "Owner 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. s h I J ' c f PLOT PLAN FOR LOT 11 Indicate location of garage or accessory building Additions with dashed lines --------------- sewerage disposal (cesspool) Well EN I I (Lot....................ft. rear) - -�! AbutoaJs � Abuttor's N I — Name ame Lot 11 Lot Rear Yard ........ ...ft. a , �y If this is a If this comer� - corner lot, write in write in w name of name of - other street. Sideyard HOUSE Sideyard other street. ft. ft. I Set Back .................ft. I I _ (Lot....................ft. frontage) (Name of street) Information Supplied by Mark North Point 1