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HomeMy WebLinkAbout0432 PITCHER'S WAY y3a �iJ�Aers wzJu TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION . 61 70/ Map Parcel Application # Health Division Date Issued O Conservation Division Application F Planning Dept. Permit Fee h Q Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/Hyannis �� " , Project Street Address � i Cl' S QQ Village t ' Ownecke 15 �o�erl Qn Address LJJ4')r1 Ly� n cyr Q I'14 Telephone cri a SHLA r Sid Permit Request CC. e-C. L,-.:).i ei-AD .-A Square feet: 1 st floor: existing j1 Pproposed 2nd floor: existing proposed TgIT l Zoning District S Flood Plain thj o Groundwater Overlay Project Valuation o Construction Type Lot Size < < , Cy L4 s4 .01 Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Structure 1984 Historic House: ❑Yes & o_ On Old King's Highway: ❑Yes ❑ No Basement Type: 2ru'll ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) a Basement Unfinished Area (sq.ft) CSC J Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ZGas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes Flo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ (OttoAttached garage: ❑ existing ❑ new size _Shed: sting ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use r APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Names(6)TT a(Zke-cr Telephone Number S4L4- -1 a7S Address -1 . e�'�..qn� License # �o �D�J® 3 ' o t 1 Orqrnw= Home Improvement Contractor# 14 S0T!) /ap►6 Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT E r C,-7Z* DATE 9• 3"0 4 x FOR OFFICIAL USE ONLY -APPLICATION# DATE ISSUED MAP/PARCELNO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION Y FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL { PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 1 f r Town. of Barnstable Regulatory Services BARN ` Thomas F. Geiler, Director Building Division ran µy„ Thomas Perry, CBO,Building Commissioner tLI—ji �200 Main Street, Hyannis, MA 02601 � www.town.barnstable.ma.us Office: 508-862-403 8 Fes: 508-790-6230 PLAN REVIEW Owner: e , D tf L5 LA N Map/Parcel: �7 O 7 O / a Project AddressSuilder: '-S P �/C 2E: The following items were noted on reviewing: 0 - IRc Lo C/CS° Revi6wed by: —. PC Date: Q:Fo=:Plnrvw The CornrnonweaRh ofmassachusetts Department of lndustrial,4ccidents Office of investigations 600 Washzngton Street BoSt01t, AL4 02111 v '�• www.mass.gov/dia • Workers' Compensation Xnsarance Affidavit: Builders/Contractors/EIectricians/Plumbers A Ucant Information Please Print Le "bl N .MP_ (Business/Organizadon/Individuel): SCCOr, Address: q$ City/State/Zip: Or end M Q• d try Phone.#: g� S���,at,3 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 e ees (full and/or part_time).* have hired the stab-contractors 2. am a•sole proprietor or partner- listed on the attached sheet 7• [:1 Remodeling These sub-contractors have S. Demolition ship and have no employees and have workers' working for me in any capacity. employees � 9. [:].Building addition [No workers' comp,insurance COS' msuranca• l0, l airs or additions• required.] 5, [] We are a corporation and its ❑Electrical re p 3.❑ I am a bomeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required]t c. 152, §1(4), and we have no employees. [No workers' 13.❑ Other . comp,insurance required_) *Any applicant that checks box#1 must also M out the accdon below showing their workers' compensation policy information. t 1-lomcownerS who subroit this affidavit indicating they arc doing all work and then hire outside contractors must submit anew aiiidavitindicating such. tContmcwrs that check this box must attached an additional sheet showing the name of the sub-corntractors and state whether or not those entities havo employees. if the sub-eonh-actors have employees,thcy must pro-vidt their workers'comp.policy number. ram an empfoyer that is providing workers'compensation insurance for my employee,- BefoTv is the policy andjob site information. Insurance Company Name: Policy#or Self-i.ns. Lic.#: Expiration Date: Job Site A.ddress: 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 pcm1tins of a Eno vp to 51,500.00 and/or one-year imprisonment, as well as civil penalties in the farm of a STOP WORK ORDER and s fine of up to $250.00 a day against thr,violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of th bIA for insumucc coverage Mil cation, r do hereby certify ander the ns•an nalties of perjury that the information provided above is true and correct. Signa.turN, �- Date; CI' Phone `4�L -1 2) Offx1aj use only, Do not write in this area, to be completed by city or town officiat City or Town: Pern it/License 4 Issuing Authority(circle one): 1. Board of Health 2, Building Department 3, City/Town Clerk 4. Electrical Inspector 5. Plumbing Insp'ec{or k 6. Other Contact Person: Phone {1: Information and 111st �uctions �. Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for thera,ernployees: �� •ce of another under any contract of hire, Pursuant to this statute, an employee is defined as ...every person in the serer express or implied, oral or written_" Au 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,partncrshiP, 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 rnaintenance, construction or repair work on such dwelling house or on the grounds or building appiirlena.ai 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 of a 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." AdditionaIly,MGL obaptcr 152, §25C(7) states 'Neither the commonwealth nor any of its political subdivisions shall enter.into any contract for,the performance of public work unfit acceptable evidence of comp lizncc Rzth the insurance rcquiremcnts 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-contractors) name(s), address(cs) and phone numbers) along with their ccrtificate(s)of insurance. Limited Liability Companies'(LLC) or Limited Liability Partnerships(LI.P)with no employees other than the members or partners, arc not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit racy 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 regarding the law or if you arc required to obtain a workers' compensation policy,please call the Department at the nurgbcz listed below. Set#insured companies should enter their self-izrsuranGa license number on the appropriate line. City or Towta Offrclals Pleas be sure that the affidavit is complete and printed legibly. The Department has Provided a space at the bottom e of tho 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/l_iccnsc number which will be used as a reference number. In addition, an applicant that must submit multiple permit/licensc applications in any given year, need only submit onp affidavit indicating current policy information(if Accessary) and under"Job Site Address" tho applicant should write"all locations in (city or d toe town)."A copy of the affidavit that has been officially stamped or marked A newe city or town may.t must borovid Mled out each W applicant as proof that,a valid affidavit is on file for future permitslicenses. year. hcro a home owner or citizen is obtaining a l.iccus c or permit not related io any business or commercial venture (Le. 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 hesitato to give us a call The Dcpa.rtm.ent's address, tclephonc•and fax number: Q� MassarhU tt s ��CQL�Il10r1WP�a,�.t11 . D,pa.z =t of kd>as�0 Arcidc�nts Offxc� a�S�rvestiga�i.a>zs 600 Wash gtc)a Stet Buton, MA 0211.1 TQL # 617•-727-490.0 ext 406 pr 1-V7-MASSAFE Fax# 617-727-774.9 Revised 11-22:06 tivww.rna�S..gov/dia �0FYH.5 Town of Barnstable Regulatory Services " EARNMsLE, Thomas F. Geiler, Director -Muss. Apr 0 5m Building Division Tom Perry, Building Commissioner 200 Main Street, 14yannis, MA 02601 w�vw.toivn.barnsta ble.ma.us Office: 508-862-4038 Fax: S08-790-6230 Property Owner Must Complete and Sign. This Section If Using A Builder 7, C11t"l��Ol2.,rG1�n , as Owner of the subject property hereby authorize S C o�� to act on my behalf, in all matters relative to work authorized by this building permit application. for: �Ja C-4, (Address of Job) Signature of Ow er Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. Town of Barnstable �C) -IHE r�ti yw� Regulatory Services Thomas F. Geller, Director w BARNSTABLE, MASS. Building Division 1a3p. N PreA �a Tom Perry,)3ullding Commissioner 200 Main Street, Hyannis., MA 02601 wwtv,tow n.b2rnstable.ma,us Fax; 508-790-6230 Office: 508-862-4038 HO)JEOWNER LICENSE E,XEAIPTION Plense Print DATE: JOB LOCATION: street village number "HOMEOWNER", home phone N work phone-# name CURRENT MAILING ADDRESS: state zip code city/toven The current exemption for"home_owners"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. DET7NITION OB HOnIEOwNER 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-fa 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 homeowner11 .shall subrxut 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•trill 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. F oNaOWNER'S EXEMPTION The Code states that: sions ,Any homeownerperfcrming work for which a building permit is required l ae erson exempt f ToTn k for hie t' do�su h of this section(Section 1o9.),1-Licensing of construction Supervisors);provided that if the homeowner engagesp () work, that such Homeowner shall act as supervisor," at they are assuming the responsibilities is a supervisor(see Appendix Q, Many homeowners who use this exemption arc unaware th Rules &'Rcgula'tions for Licensing Construction supervisors,Section 2.15) phis lack of awareness often results in serious problems, when the homeownerbires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it wooulduld withh 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 sues.part 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/ccrtification for use in your community, Bo ihaf`81 ' itT ffof irn l f T License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR j before the expiration date. if found return to: Board of Building Regulations and Standards Registration, 145073 One Ashburton Place Rm 1301 ExprraUon:,,,12/7/2010 Tr# 278556 Boston,Ma.02108 ,� TYPe _DBA� ° PARKER ROOFING` -'f _ SCOTT PARKER- �� 98 BARTLETT LN ORANGE,MA 01364 4 ` %` Ad r►inistratoi: Not valid without signature 1 '`� iVlussachuscti5 - Dep a finent of Pblic Safety Board bf Building Re� "i u . . ulations and Standard:~ Construcfio..Upervisor License License: CS 66630 ` Restricted to: 00 SCOTT A PARKER 98 BARTLETTLANE. ORANGE, MA p1364 Expiration: 3/1/2011 ('ummisi„nc.r. Tr#: 13119 r„ � O 3� S 1 11 C -AILA y t — Qec1L f II CERTIFIED . PL® T L A�1 FOR : .. LOT : ice. TOWN OF E : DATE �uLy 71 198'3 . , SCAL icem 1 CERTIFY THAT WHAT IS SHOWN ON THIS PLAN IS . AS IT EXISTS ON THE GROUN.O ANO CONFORMS TO THE TOWN REGULATIONS EAIMD W BOY LE ASKS OCIAT ES a . i rl 6 eST -- ISLE 14 LA-1 a e _ Cep - ---- ck �0*114E ram, Town of Barnstable *Permit# y�P ti� Fxpires 6 monthsfrom issue Regulatory Services Fee C BARNSTABLE, � v M^� Thomas F. Geiler, Director �j 1639• �� ATf0 MPS A Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstab l e.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number__( Property Address 1_ `1��� � VA V1 1c,, VA esidential Value of"Work_ � O Minimum fee of$25.00 for work under$6000.00 Owner's Name & Address 4�a)C' Contractor's Name 'C_a I k Telephone Number 1 lome Improvement Contractor License#(if applicable) Q IrS Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance PERMIT Che one: X-PRESS a sole proprietor I am the Homeowner ,APR 1 0 Z009 ❑ I have Worker's Compensation Insurance -----� ,�--� '-OWN OF BARNSTABLE Insurance Company Name1-,-� Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) - ❑ Re-roof(stripping old shingles) All construction debris will be taken to e-roof(not stripping. Going over r existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) *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. copy of the Home Improvement Contractors License is required. SIGNATI,itE, C �i. \A l'hll.l.S\l:0lZMS\building permit forms\EXPRESS.doc Revised 100668 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 15 `d 1 Address: V �r��� City/State/Zip Phone.#: Are you an employer?Check the appropriate box: C Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a'eneral contractor and I 6. ❑New construction e,�sloyees(Rill and/or part-tine).* have hired the sub-contractors ma soleproprietor or partner-' listed on the attached sheet 7. .❑Remodeling 2: a Y'ship and have no employees These sub-contractors have g.'[]Demolition working for me in any capacity. employees and have workers' 9 ❑Building addition [No workers',comp.-insurance comp.insurance q . r ] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comb. right of exemption per MGL 12. oof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other �"�6 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 affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit'indicating such. tContractors 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 liav^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: Policy#or Self-ins.Lic.#:,ry. Expiration Date: Job Site Address: l l _ City/State/Zip: n1N1 ✓T` Attach a copy of the workers'compensation policy declara 'on page(showing the policy number and expiration date). Failure fo 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 MA for insurance coverage verification. I do hereby certify u der the ns an 'es ofperjury that the information provided above is true and correct CD Si tore: Date: Phone# 01 Z O �L4 WI Official use only. Do not write in this area,to be completed by city or.town offu iat 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 Insttuctions r Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their.employees. 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 engag in atom enferpnse;a� C--10ing tfie legal-represen�a�i� f- deceas employer,-or- e _-._-: - - -_- receiver or tiustee 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,construction 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 of a 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 oath the ins-urance 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-contractors)name(s),address(es)and phone number(s)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 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 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 ��L 7___a c______.a. all a:�aL., a at.-n4c= ..ir T....enfi nnfi n.+n 1.ec M rnnM rt vrm rPoarriinar the ann�(_]7�1t, of the affidavit fo yULL LU llil ULLL ill Ll1N VYlilll ill%.VA.LACe Vl 11—estlbuficons h-- �.-»--O--a— —rr Please be sure to fill in the permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permittlicense 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 io any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice 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: the Commonwealth of Massachusetts , Department of lndustrial Accidents } 4f ee of Investigatfo>xs 600 Washington Street Boston, MA 02111 TO, # 617-727-4900 ext-406 or 1-977-MASSAFE Fax# 617=727-7749 Revised 1 i-22-06 www.mass.gov/dia • M1 L Town of Barnstable . T H�E Regulatory Services Thomas F. Geiler,Director sAxxsrxs>_.e. . � 16.1 Building Division PlFD a Tom Perry,Building Commissioner .200 Mairi=Street;--Hyannis;MA-026D 1 _.. ..... ... . _.._. . . --._..... www.town-barristable-ma.us Office: 508-862-4038 Fax: 508-790-6230 HOAEEOWNER LICENSE EXEMPTION Please Print DATE JOB LOCATION: number^ street p 'r --� village "HOMEOWNER": �[ or I k T�eter 978 SN4-^T� ` > op S LAI1 ,S)b I name home phone# ( work phone# CURRENT MAILING ADDRESS: C��r�n see M� • of�,y city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellino 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 Persons)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 be/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"bomeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned."homeowner"certifies thathe/she uoderstPnds the Tpwn of Barnstable,Buildiug Department minim minimurr L inspection procedures and requirements and that he/sbe will comply with said procedures and re.quir nts. c Srgna 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 boh=vmer performing work for which a building permit is required shall be exempt from the provisions of this section(Section ID9.1.1 -Licensing of construction Supervisors);provided that if the homeowner mgagcs a pa sons)for bire to do such work,that such Homeowner shall ad.as supervisor. Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rrilcs&Regulations for Licerssing 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. 7be homeowner acting as Supervisor is ultimately responsible. To ensure that the bomcownar is fully aware of his/her rzspon ibrilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may caret amend and adopt such a fmm/certifica ion.for use in your community. Q:forms:hamccxcmpt • 4Z t T � Town of Barn-stable . Regulatory Services 9uIM 'B $, Thomas F.Geller,Director n 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstabl e.ma.us Office: 508-862-403 8 Fax: 509-790-6230 r s s Property Owner.Must 'Complete and Sign This Section If Using ABuilder I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeoumers License Exemption Form on the reverse side. 11.Cn13 l l0_nll MTV DCD%rTDOlnld Assessor's map and lot number ................ ... ........7:......... THE Sewage Permit number ..................r....... ......... MAR39TABLE, 2, MAO& ..................... ..........................House number.. 4 t639* TOWN , OF BARNSTABLE BUILDING INSPECTOR r APPLICATION FOR PERMIT TO ........... ...................................................... .. .. ........ .... TYPE OF CONSTRUCTION ......... ....... ...................A.. ........ ................. TO THE INSPECTOR OF BUILDINGS: The undersigned he—reb/y%pplies for a permit according to the following information: X- Location ............ .................. ........ .......... ..... ......................... ................................................. ProposedUse ......S::!-�sA .....................:. .........a..................................................... Zoning District ......... ..................................................Fire District ..... ........................ Nameof Owner ... �4=..... ..........................Address...... ........... ..........I ......... Nameof Builder ........... ..........................................Address ...................... ........................................ ,Name of Architect ..................... ........................................Address .................................................................................. Number of Room ................. ...................................................... .................................................Foundation Exterior .........Roofing ... Floors ..... ......................................Interior ... ................................................ Heating .. . ................Plumbing .................... .............. .... .......... ... .............................................. .... Fireplace ..................................................................................Approximate Cost .................................................................... Definitive Plan Approved by Planning Board - ----------- 19------ Area ..... .............?.................... 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. Name •....................................................... ................. Construction Supervisor's License ..')3 5— 70 Ll................................ R. W. J. CONSTRUCTION A=2 9 25300 1�2- Story No ................. Permit for ............................... .... Single Family Dwelling ................................................................... ........... ..e..S Dw elling 1 n y g Pjt Location ..Lot...L2.......4.1Z..PAt ers Way I ........... ............. ................. s............... ..... ...................... t Owner . R- W. J. Cons ruction ...................................... ruction ..X,.............:............. Type of Construction XX4MP............................ ................................................................................ Plot ............................ Lot ................................ Permit Granted ......July 11, ............19 83 ...................... Date of Inspection ....................................19 Date Completed ................ .....................19 67.r S %C Asa ssor s map and lot number ................ ...... . . .... ... L �� �t Q�OF THE t0�� Q' r S / Sewage Permit number ..(1.`3....1....d..,?. iJVI -fITL�(�r,,3E g • �� ��yp al lyO>��� � IYI�!1S9 V r� House number a ........ .. ................................. t639- TO A. OF BARNSTABLE � t r •. BUILDING INSPECTOR ' . . r r' APPLICATION FOR PERMIT TO .......... .5 .......................... ..................... . ....:..................................................... TYPE OF CONSTRUCTION ......... �: �.. 1 ? ,.....�^" i ..� ....... .... ...................,....................19S."a TO THE INSPECTOR OF BUILDINGS: The undersigned a applies for ppermit according to #ol wing information: Location ! .. .. .. XL... .. ...... ....`•r a ... Proposed Use .......: ......J�.`....cw;v..-:�Av�3, ........ . Zoning District .......... !..................................................Fire District ..... u .............................................. Name of Owner ..... .... . ..............Address ..j :....:X `L.. ... -c ? ,?......... Nameof Builder ............ fit..........................................Address ............................. ........:..................................... Nameof Architect .................... `.......................................Address .......`....................`—................................................... Number of Rooms ................. ............................................Foundation �...................................................... . .�/1 �Exterior ........... ................. .........Roofing .....C--�.� Floors .... .... t......................................Interior .... .._........................:...................... Heating ? 1%C�z ... �C....C�. /. ...:..............Plumbing ............. ...� -K. ................................................ Fireplace ...............................�-.-.........................................Approximate Cost ...... .....©........................................... Definitive Plan Approved by. Planning Board __________/--Y ___________193 . Area .... � .. .................. Diagram of Lot and Building with Dimensions Fee ...�--w .............. .... , / ....... SUBJECT TO APPROVAL OF BOARD OF HEALTH t tl' 1 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. Name ....................................................... ............... Construction Supervisor's License ........................ .......... R. WrA, J. CONSTRUCTION 25300 l�_ Stor Permit for z Single Family Dwelling ............................................................................ , Location .... ...4.32 Pitchers, Way; ................... ............................................ Owner-...R. W.- J..•••Construction•, n Type,of Construction ...ZrAMe..............:........... ....... ................................. ........................... - Plot n*�................r ..... Lot' ................................ *►� /i r t ., - •� - Permit Granted ..J......................... l ..........19 83 Date'of Inspection .. . ...... ...................19 } Daterompletted '.. �..................19. r i h 'r i t , } • *alb'=�� Y �yF,Yt= y •ta � � � a Q U Ik O �7.'t . N � y INC CC m -jo ap d U. 29 y C W ��•c,�ll . �� Q ~ O 0 z O d 11: 3Q le, HCcH ® p 1 y W Cm< �... INC tp Z a um •211 � '"�q 1 �� � � W �... - . ._ A � Osm sm — .. = J r Q v O O v y O O ` ..TOWN OF--BARNSTABLE Permit No. ----2 5 30 -- --------------------- Building, Inspector a.aan — Cash OCCUPANCY .PERMIT Bond --______X____�!-__ 9� 1 ja Issued to R 1 W. J. ' COl:.tstruCtion - Address L9pp � w t; 12'r 4432''Pitchers Way Rvannis Wiring Inspector � �� r .- Inspection date Plumbing Inspector f o�'e� Inspection date Gas Inspector., �!� �, Inspection date XEngineering Department Inspection date/ Board of Health 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. ti .. � ' Building Inspector i i . FROM TOWN OF BARNSTABLE . BUILDING DEPARTMENT Mr. Francis. Lahtet-qq. :F. , 167 AIN STREET HY';ANNIS, MA 4 Town Clerk .� .�..Y , Phone, 775-1120 SUBJECT: FOLD HERE DATE MESSAGE Work has beeAgggjp. ete4 ..qqC��� .�?��mi,t � 253Q�L� .�:�1•� ,�7,� Construction), Please release Bond. SIGNED \ -v r -3.t DATE, } REPLY [jE ^'