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HomeMy WebLinkAbout0039 PEACOCK DRIVE 3� ���coc 1� �,�.., o Town of Barnstable *Permit ac�_ Expires 6 mo s from is�dal yT Regulatory .Services Fee 1 , BAMSTABIX • MASS' � Richard V.Scali,Director i639. �FDMA�p Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office:. 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY l Not Valid without Red X-Press Imprint Map/parcel Number I Property Address 7iorAdocle Residential Value of Work$ 2 O a O Minimum fee of$35.00 for work under.$6000.00 Owner's Name&Address ffr,b 1 �jC. (7&L Contractor's Name___ '(� Telephone Number 1-0 •�j 3oa D eZoZf' Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: rm Xer PERMIT ❑ I am a sole proprietor I am the Homeowner ' I have Worker's Compensation Insurance OCT 21 2015 Insurance Company Name TOWN OF BARNSTABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. \ Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side Replacement Windows/doors/sliders.U=Value (maximum.32)#of windows A !✓1--,z>n 4©o #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note:. Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is ed. SIGNATURE: �f C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIO I DHR\EXPRESS.doc Revised 040215 The Commontwwealth of Massachusetts . Department of Ind ustr al Accidents Of lace of Investigations 600 Washington Street , A Boston,M4 02111 ' til ww.mass.go 1dira Workers' Compensation Insurance Affidavit: Builders/ContracturslEIectricianslPlumbers Applicant Information Please Print Lezibly . Name(BostnessiDrgmizaiion/Individual): Address: �' �Aao�K �/'I ✓� City/sta&z p_ Yirt``nAs Phone# �0202- Are you an employer?Check the appropriate bos: T of project 4. am a general contractor and I XIJe P ro) (required): 1.El .1 am.a employer with ❑ I g 6_'❑New construction. employees(full and/or part-time).* have.-hired the sub-contractors 2-❑ I am a sole proprietor or partner- listed on the attached sheet- 7- ApRemodeling ship and have no employees These sub-contractors have 8_ ❑Demolition w for me in an capacity- employees and have workers' ° y� t3`- i 9- ❑Building addition [No workers'comp_insurance comp-insurance. required-] 5- ❑ tole are.a corporation and its 10-❑Electrical repairs or additions 3. am a homeowner-doing all work. officers have exercised their 11.❑Plumbing repairs or additions V 1£ o workers' right:of exemption per MGL myself � camp-' 12-❑Roof repairs insurance required.]1 c- 152,§1(4),and we have mmo employees.[No workers' 13.❑Other comp.insuance required-] *Amy applicant that checks box N mmat also M out the section belay showing their workers'compensation policy infornratiaa I Homeowners who submit this aflidmat indicating they are doing all work and then hire outside contractors most submit anew affidavit indicating such. =contractors that check this box must attached an additional sheet showing the name of the sub-contraxtm and state whether or not those entities have employees. If the sub-coutrttctors have employees,the),must provide their workers'comp.policy number_ .lam an employer that is pro idng workers'comtpe unfion insurance for my emrpitryees. Blow is the policy and job site inforniadorr. Insurance Company Name: — Policy#or Self-ins-Lic_#: Expiration Date: 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cent rrder the pains andfenald o,�'pet' ty that the irtrorrn&rion provided above ' trine and,correct: Si ture* UIA _ Date: v �� Phone#: Q trial use only. Do not write in this area,to be completed by city or toom of ciat City or Town: PermitUcense Issuing Authority.(tdre a one):' 1.Board of Health 2.Building Department 3.City[Fown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person:. Phone#; 6 `� Town of Barnstable Regulatory Services DIME Richard V.Scali,Director Building Division ; BARNSTABLE, " Tom Perry,Building Commissioner 9 MASS* 1639 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: Please Print a WY.4.44105 JOB LOCATION: "�l"(/��C �� number' street �T� Q► q village "HOMEOWNER":�+ �� c�/ /��� G�C.- .J ✓ V�/� Q��9 name home phone# n work phone# CURRENT MAILING ADDRESS: . 7 Py P cX l )�q 'milY --pjti i 0 v 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 sugbt 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 procedyrys 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 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. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOI DHR\EXPRESS.doc Revised 040215 1 Z `ems• ��• s TOWN OF BP.RNSTABLR Permit No 27987 - ------------- Building Inspector �m�7.ai Cash ---------------- 'g ,eyo }° �o UP a> OCCUPANCY PERMIT Bond ------ X - Issued to Bayside Building Co. Address Box 95, Centerville Int # A 39 PP.AeorU, nriup.. W€,st Bps.nnisnort Wiring Inspector �� t� :s� / Inspection date Plumbing Inspector- iX d ('^ Inspection date Gas Inspector i, {�y � _ Inspection date .. C! ....�7 J R/la Engineering Departments' / Inspection date Board of Health t�, ,t4 -, ( � '� Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. i Building Inspector TOWN OF BARNSTABLE BUILDING DEPARTMENT 2 DA83lT�HL = TOWN OFFICE BUILDING 1039. �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: Nune 12, 1985 An. Occupancy Permit has been issued for the building'authorized by BuildingPermit #$........................7987... .._.._......._._............................................................_......._.........._........ __... _.. . . issued to Bayside Building Co. Please release the performance bond. F E1171i" SVIS—TE UST BE 0 r; Assessor's map=and lot number: .. �- .. �?.�..:.. '..� .N COMPLIANCE J � LE 5 OFTNET�� Sewa a Permit,.number ' ........ ............. ....... r TOWS`IF-C a S BAHH9TADLB. i House number .... .............��...l...(..,/.�z .. . ... ...................... t ,"b s 4' 39• �0 f TO, �N OF BARNS�TABLE rt _ BUILDING , INSPECTOR } .APPLICATION FOR PERMIT TO .. [1'>~c4.7. � ....��.II4�. a.t��-.. l�l!�!��.LL'� .�. .TYPE OF CONSTRUCTION ... Q��.... lL.!4EM ................°....... ........... .............. ........ , ...... s .....�o.......19.0 TO THE INSPECTOR OF BUILDINGS: Q . The undersigned hereby applies for-a permit arrccc�cording to-the' falllowing. information: Location . .kbf .I-). .....��CA C.11k_- ..�.� ,1 .V...� .... .................................................................... ProposedUse .....1.�S..f�C' �5. ............................... ................_................................... ............................................. Zoning District -....h\:.1 ...:. Fire District ° ..:. .GL4!)!Wti9._................................ Name of Owner .. a .l : fi1`e... .U.11t!� Addres's .........� ......................................................... Name of Builder � �r v"�.. .. ...Address ..................... `^'�,. Name of Architect ..: :-..: � ..................Address ......... -?........................................ ............... Number of Rooms ..:................... ..................... ....................Foundation .. ........... ... � ' ................... Exierior -Lc�rcTcC .. i l !."C_ ...:..............Roofing ......7� .�2"14:��..................................... Floors . ......}..�/.:t. .. ...... ............... Interior .....: /�. .�.! !a .. �� 1. .C;............................. Heating �. ...............Plumbing .....T S' � ..... ............ lT_S.'., Fireplace ..P.P.l..�. . ...... ..�.. .Q. .............................Approximate. Cost ............LR.`?..i.. ............. ' Definitive Plan Approved by Planning Board ________________________________19_______. Area`' f..:> 1...J...'P........:........... Diagram of .Lot and Building with Dimensions Fee .....j ......�.c�` .................. ' SUBJECT TO APPROVAL OF BOARD OF HEALTH CDy� •` fldu�-e F bj40 , `. OCCUPANCY PERMITS REQUIRED FOR,NEW DWELLINGS hereby .agree to conform to' all the Rules-and Regulations of the Town of Barnstable.regarding the above-- construction., ' . • Name ...: ` .. Construction Supervisor's License . ,'--J EMYSIDE BUILDING CO. 279187 One Stor - '�" No One for ' `Single Family...Dwellin...... .......... _ M1 - �; (�' ., � - • �; � �-�-� ' ........ ..................... ......... J: r } Location Lot lA, 39• Peacock, Drive Owner R4Y-5.9�1 Building CQ {"w TA a of Construction .. .k X. Iris.... '�.......... N '� - C • ♦ + ..F 1./ �. ems. ..01, .Z•• ,r • A -1 :ter ,. ;•,`C Y _ t •� >~# .......................... ............ . ... ............... #r, Plot ...................... 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CERTIFIED , PLOT.. - PLAN ,. i r N a �yG I '` 4 4 xx) � ROBERT LU T /:..7 .7 .�1 v c K D 2 i,✓E lya F�� -I cf r sv r rz 1 PS � I B t''' r l } t #r xx uJw wk P �, ry i s R " t t.ELbR1,EDGE '1/V�/-�/a4`/1//✓/S/?v�2'r r t t �xet S 4 yx i�t+r.� < e�.2 : > k`,.kia rS2 ?� 'l�.. 'O .. - ,t '�.' NLq�f S3E7 A V t AU .,Ws S1 f"'kt,.:K`s 'k T ;` w'i,Fy,'A t /J . '� ! �C_ '(''V R'� j�I I N . _-I.,';:''it " iv .f�i; 9br R,1:.r,r , m zi T$ � ,'tyl1�'q�„�rP9t Lscaog - : �� , _ ", t SS �i f k,k li Y ,�. S ,.fs�l" �" .:.' � '.5§ x ^� as$i rs 'rF Fb' PS 1 :df a„a..�. I:', I _ ; t y N ' x F J f,. r� ,..r r ' 't`t ...��� �,. _ J .s"rC �. $CALE� . =I DATE, G/? ' P -, f ?t .4`ys-J o e I `CERTIFY THAT� THE1. t 4 ,;:crroil�TrEIRE.. *3 I3 @I.$TER r t.`r ' '""..�'t'"'.�'. PLAN IS L.00AT6� , 3N�WN ON TNt9 a r ., r�4�.f3c�3 ON THE 'GROUND A9 INDICATED Atni kw�. .i:Y1L .>.. Ano r , f MQ�.+_-._, ,` k7r > r s ar`r;� n* �' 1'I SEW®DEER t�t�RVESPOEt � x , L% �MCO14RMS" TO THE ZONIN• L.A1P �­4 ,'t>' }>. - .t '� n �# r ...� -lair ,'r: - �.'(�. �. „•'' .. T 8�` k;x ry '. ��yy �. �' `- AI�H All. MA8 I v� Y� " �M r Tt2``MA-1 N .S E T� ? ;r fir: 1 -+ j �?� ./J/ $' 4 r;+�,l f_ ' f ", HYANhIIS, .MASS,?", Y° ph ET.1,.OfI. ,.' TE' REO LAND eURVEYOA ,. ,�: r r jz ' r Assessors map 'and dot 'number ... �ct ... � yoFTHETod r I ! t`v� ' �P o d 4_ Sewage Permit number ...........................:............. .............. B i JSH9TODLE, House number .............. AS r3..J...r....J.��C/-��.i................:;,.... °Oo N & 0� 0 MAY Ar, .. TOW/N OF BARNSTABLE BUILDING INSPECTOR _ "\ APPLICATION FOR PERMIT TO C'n�. `�2vC w�l„L. `............. J ` I . TYPE OF CONSTRUCTION ... t. .Av,A .....................................................................I................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...krJ...........L ...........ae.�..c.C�.c :�... ..... D(-?,..g.. I .�.J......................................................................................... ... ProposedUse ...� .. ................................................................................................................................ Zoning District ... ....1.�.......................................................Fire District ..........!A.fkA/V.V yq.:................................................ Nameof Owner ...` {.< ... .U.! tu ..........Address .......... ......................................................... v •V' Name of Builder ........ ......... 5 .... ' ......................................Address ...............�.......`:�".:............................................... . Name of Architect Jl Address ........... �?�:.......................................................... .......................... e,9 `�.e_. ...... C_ t21..........�' ...................... Number of Rooms ......:� � .......................................................Foundation .� `2� ..... c� ...... Exterior ....... ����?..... /�, �J -`K_. g ......?1.'� Ta.........(. Floors .y .? ..�.�.�. Aj .................................Interior .......'rt<:?S.! .w?,....':...�.�..�.�-.......................... - Y l _ Heating ......................................................Plumbing ........ .................... ..... .., Fireplace .. .R..!. .��..........f...�- .l.r?C. .............................Approximate. Cost ............f...4.;z...( OT. ............................. Definitive Plan Approved by Planning Board ___:-_____-______—___________19_______. Area �. .................... \ a o� / � Diagram of Lot and Building with Dimensions , """ _ Fee ...,..�../...�.................................... \ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to.conform`to all the Rules and_ Regulations of the Town of Barnstable regarding the above construction. Y Name ... ..... ........................................ Construction Supervisor's License ... .14..� ............. BAYSIDE BUILDING CO. A=269-50 2 7 9 87 One Story No ..... .. Permit for .................................... Single Family Dwelling............ ........................................................... Location ....Lot ot....1A.........3.9....Peacock. ...D-rive .. . .... .. ....... .. .. .... West H:K���j�port ................................. .......;.................. Owner Baysid . e Buildi g .......................................... Type of Construction Fra ............................. ........me..... 7 ................................................................................ Plot ............................ Lot-............:.... ........... Permit Granted ..June e...7-, 85 . ....... .. ....................1.9 Date of Inspection ....................................19 Date Completed ....................I..................19 -7