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HomeMy WebLinkAbout0015 PRINCESS PINE ROAD Y �� I� I rk TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel A�W Application# Health Division Conservation Division Permit# Tax Collector Date Issued 11311,07 Treasurer Application Fee D U Planning Dept. Permit Fee �7 Date Definitive Plan Approved by Planning Board �— Historic-OKH Preservation/Hyannis Project Street Address /.S' ���N C -ess JV e AP,s e/ Village Owner 4'"OiEs N041v-4, MJEv� 7-,e- Address Ao ,40X G9 ® . �Pxr�e�vrfl.� nos 2 Telephone �'a — 7 3 7- Sp e.5fox,r_ -fO S/,v�lc F/ ►.c a.s Permit Request .�i �, x-- L�i�L c�,�.L,r C� /�'�.�eEv�r AaMV® - s- w•rA t� Lo 4 — - y,goquare fee : 1st floor:existing proposed 2nd floor:existing proposed Total new. Zoning District Flood Plain Groundwater Overlay 4 t...a Project Valuation ;�/060 Construction Type ', Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting-documentation. � .-r Dwelling Type: Single Family 1K Two Family ❑ Multi-Family(#units) _ . r Age of Existing Structure --o Historic House: ❑Yes XNo On Old King's Highway: ❑Yes ANo Basement Type: ❑ Full ❑Crawl Walkout ❑Other Basement Finished Area(sq.ft.) 75-6 Basement Unfinished Area(sq.ft) �® 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: L'Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �9,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 BUILDER INFORMATION Name lA-o#Cs Nyx-loi �OiyAjek� Telephone Number S`�� 7 37•-`2<ra� Address eO X 6,9 License# - �'� ?��� Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE i FOR OFFICIAL USE ONLY PERMIT NO. ! DATE ISSUED s MAP/PARCEL NO. i ADDRESS, VILLAGE S e I OWNER i DATE OF INSPECTION: FOUNDATION FRAME € INSULATION 9 i FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL FINAL BUILDING ol i r i DATE CLOSED OUT I � ASSOCIATION PLAN NO. i 1 The ComnionfVeatt i of Massachusetts . Department of Industrial accidents Office of Investigations 600 Washington Street . Boston,.MA 021II' e VWw.mass.gov/dia ' Workers'Compensation Insursme Affidavit: Builders/Contractors/Electriciam/Pl A licant Information ers'Pleas a Print Le j Name(Business/orgmiiation/lndividuat):. i i s �l/ctr pal✓ • owls � Address: r, , City/Statelip: 060w44r U,44,,0 P #: Ph .737r ZS . Are you anemP. .erTCheckthe appropriate box: LEI I am a employer with 4. I am a general contra z;tor and :Type of project(required).,. 'employees(full 24d/orpait time).*• .have hired the stab-contractors 6• ❑New construction . 2. I am a sole.p'roprietor or partner- listed on the attached sheet; 7. 0 Remodeling ship and have no employees These sub-contractors have 'working for and in any capacity. employees and ha a 8. •Demolition:. v workers ' [No workers' comp,inmiance• comp, insurance,$'• 9, []Building addition required] a 5: [] �Ve are a:porporation and its 10.[]Electricalrepaas or adctions 3. I-aara homeownerdoing-a'll:work - officers-have exercised their • myself.[No,workers' comp, right df exemption per MGL 11:❑Plumbing repairs or additions insu nce,required,]t c,152, §1(4),andvrehaveno 12,0 Roof repairs. y employees, [No workers' .13.11 other ' comp,insurance requured,] *Any applicant thatchecks box1 must also-fill out the section below showing thou workers'compensation policy infannation, f Homeov,UM,who submit this affidavit indicating they are doing all Work and then hire outside oontractors must submit anew affidavitindicatin ergjo ees, that check this box must attached an additional•gheet•showing thename of the pub-contractors and state whether arnotthose entities have� empjoyees, Ifthe sub-contractors have employees,theymust provide then•workers'comp,pogo,number. lam an employer•that is providing workers'compensation insurance for my employees. Below is the policy and job site' information. Insurance Company Nat=: Policy#or Self-ins.Lic,#;. - { Expiration Date: job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showin the policy number and e Failure,to secure coveia a as re xpiratiou date),- fine quired.under Section 25A;of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500,00 and/or one-year imprisonment; as well as civil penalties in the foray of a STOP QRg pgpena PR and a fine of up to$250.00 a day against the violator, Be advised that a•c of this statement maybe,e forwarded to Investigations of the CIA for insurance covers a verification, aPy y fie'Office of I do hereby certify under the pains and penalties of perjury that the information prgvided above is true and colrect. Si Date; /—,3U•—o Phone#; Ofj7ctal use only. Do not write to this area,tb he 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.Plumling Inspector .6.Other P Contact Person Phone#• Massachusetts General'Laws chapter.152 squires all employers to P'Otde workers' compensation for then employees. Pursuant to this statute, an employee is defned as"...everypersonin.the service of anotherunder any.contract of bile, express or implied, oral or written." An employer is defined as"an individual,partnership,assodiation,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,construction or repair work an 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 buis%ness or to construct buildings in the commonwealth for any applicant who has not produced•aeceptable evidence of compliance with the insurance coverage required.". AdditionaIly,MGL ahapter.152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,thb.perfomia&e of publimwork until aceeptablP evidence of comp nce Withtlie insufance' 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,it necessary,supply sub-conti•actor(s)name(s),address(es)and phone number(s)along with their certificate(s) of • insurance, Limited•Liability,Comp anies(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 ibis affidavit may be submitted to the Deparment of Industrial ' Accidents for confirmation ofinsurance coverage. Alsb be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the app4cat on for the pemut.or license is being requested,not the D apartment of Industrial Accidents, Should you have any questions regarding the law-or if you are required to obtain a workers' comp ensation•policy,please call the Department at the number listed below. Self-insured companies should enter their . self-insurance license number onthe appropriate'lind _— 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 refereiice number: In addition,an applicant that must submit multiple permithicense applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)and.under"lob Site Address"the applicant should write"all locaons in j_(city'or town)."A copy of the aff davit that•has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses, A new affidavit must izll ci out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (La. a dog license or permit to bum leaves-etc.)said persb3z is-NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for.your cooperation and should youhave-anti questions, please'do not hesitate to give vs a call The Depaximent's address,telephone•andfax number:; The C=MQ�ww&ofl9 alus4tts. eat ofl aftstual Acaawa O .Co Of fnves4 donna �00 Washington,S e>+ 1 t=4 02111 TO.9 617-727-4 k ext 406 or 14 -MASS'AFB Fox#�617�.'2'�-?749 Revised I1-22:Ob. � L V TT Ai V A JJCL&AJL0 LCLLYAV Regulatory Services 9SAM4VAM Thomas Tt,Geiler,Director �"l�D► '� Building Division Tom.Perry,Building Commissioner .200 Main Street, Hyannis,MA 02601 www.towA,bzrnstable,mR.us Ezce: 508-862-4038 Fax; 508-190-6230 Permit no. Date • • ' AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW -SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,3hodernization, conversion, improvement;removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units.or to structures which'are adjacent to \ such residence or building be done by registered contractors,with certain excep eons,along y4th other requirements. ..l Estimated Cost - Type of Work: 6�® Address of Work: �e a '�- ' Oyrner's Name: Date of Application I hereby certify that: Registratign is not required for the following reason(s); Work excluded by law Job Under$1,000 Building not owner-occupied SOwner pulling own permit Notice is hereby given that: ()VNERs PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDERNSGL c.142A, SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner; Date Contractor Signature Registration No. QR Date 0 er's Signature Q.wpMes,{orms:homeaifidxv Rev 060606 r . f - 1� Town of Barnstable �oF 1'� Regulatory Services BARNSTABLE Thomas F.Geiler,Director MASS. 1 39. Building Division jED MP'1 A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstAble.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 1—30—p-7 JOB LOCATION: l S /�e/0,6,5,5 /',r fV -r— )40,4 j . number street village "HOMEOWNER": 3'A7-4P5 PO4"44--' 737— Z -60 name home phone# work phone# CURRENT MAZING ADDRESS:_ D Iffo 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 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. minimum inspection procedures and requirements and that he/she will comply with said procedures and requiremLts Signatu a 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. Q:forrmhomeexempt !4" t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 56 Nlap_ L•Parcel Permit# dqoq(j)� �-� t � � ��i�I�S i .B E Health Division - 4, n u2-� Date Issued off? 4J r Conservation Division .511 Z 03 � `°""`I? f j I j{ 1 J� Application Fee <, OD Tax Collector Permit Fee 4:a, LZ Treasurer µ ~-- r CTfC SYSTEM MUSTEE 1 .��i IMISTALLED IN COMPLIANCE Planning Dept: NTH TITLE 5 Date Definitive Plan Approved by Planning Board EWRONUENTAL CODE ANCTOW14 (REGULATIONS Historic-OKH Preservation/Hyannisl^���h� Project Street Address 5 `r i n CeZ $L�,P ue�� Village yn n C5 Owner X GA� -I Dai L en f se I Cn S Address !.Si Pv it„C-e sS P i'ri f R611 Telephone �� -'1-7 5­61 Permit Request s +CGtr n f -fie BU�'I D C��'�in ey ✓�vr� �J a PYr P Square feet: 1st floor: existing Too proposed 2nd floor: existing proposed Total new Zoning District g Flood Plain C' Groundwater Overlay Project Valuation�_ 31'9-1°•Q.> Construction Type kS Eh,2� Lot Size 91 Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 2 Historic House: ❑Yes Ao On Old King's Highway: ❑Yes 2*% Basement Type: E(Full ❑Crawl YWalkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 9100 Ff 1� Number of Baths: Full: existing new Half:existing new Number of Bedrooms: existing_ new Total Room Count(not including baths):existing 6 new First Floor Room Count Heat Type and Fuel: Of Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes 0'-No Fireplaces: Existing ✓ New Existing wood/coal stove: ❑Yes �Ao Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:lie existing ❑new size . Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ _Commercial ❑Yes ❑No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION7�f�� � Name Sylerh-o�dor AaSon Telephone Number Address Po. 11,40 License# ` d 4sU-t k 4nA- D c.6 1/ Home Improvement Contractor# Worker's Compensation# ,-U/C:i -1 1��_,?3/#S J� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO g 66e-e-4 ©()r D evwid bump SIGNATURE Ct IL DATE 1 J FOR OFFICIAL USE ONLY PERMIT NO. - DATE ISSUED MAP/'PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION - FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL z PLUMBING: ROUGH, FINAL GAS: ROUGHI i« FINAL FINAL BUILDING DATE CLOSED OUT `fi ASSOCIATION PLAN NO. _(MONTELUKAST SODIUM) 0/1 �1 g1141d 20202390(1}Oil02-SNG ' fl�ERCK P The Commonwealth of Massachusetts - - Department of Industrial Accidents ` = office ofloeestfgat�oos 600 Washington Street Boston,Mass. 02111 Workers' Com ensation Insurance Affidavit name: SPA s location (S $r(`�LC25S �hn Q ©a-�� city 1 ((- 1 o u1 rL( ,/� S. /' 1.1 (3 01cCj t phone# � 2?�—F-(�/' ❑ I am a homeowner performing all work myself. ❑ 1 am a sole rietor and have no one workizi in ca achy I am an em foyer providing workers' compensation for mY employees working on this job. . ::::::.::::::: ::::::::::::::::::::::::: ::: a om anV.yj :95< '>'::'::< ': . . ..:. .: :::>`' '::;:':"':::''::<:;:5::?is t ;? ? :'':? ;';<'i,: ::z:: :': z:: ? :' ::::;:':':': :`:::: :?? <` .... ':. _ BLIdrE ^:` ItOII '''''Ulf ��'••�.���!'CD::::;;;:>�:::::Ci:i'?�iyi;[ji.:.i ..�:,i;::,yi%Fi?;`�i>:i`; `.�i�::>:�:?'.'i:i'::�;`;:'::. CV ............ I am a sole proprietor,general contractor, r homeowne f1ccircle one)and have hired the contractors listed below who have the followin workers' compensation polices; g :.:::::: .,:::::::...::::::.::::::.::::::.::::::::::::::.:::::::.::::::::::::::::::.:.:::.:::::::.::.:::::.::::::::::..:....:, cafnasnv :. at��ess ........... ............................... ..................................... :'•'. ................ lion ..........:..... ....•ha.M•x..:r5::•::•: ranceca::z:::»:;::::.;�::.<: ::.� . >;;�.::::,•:::<:::; ::•> ...:. :c $a Warn address,. ::ttv.................... `..#::''•`ri:i:j�:�:;ii:y}, ::::ij:;<.4{;::}::.........:......{}i`:?;:::^>iij:?:i:: .;:j.>J.Qy.i: ��riatnn Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one yearn imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a COPY of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby certify under the pains and penalties of perjury that the information provided above is taro and correct si Date ! «/g gnature_ .��. - ` Print name Phone "C# Sig M 771 ��, �-,' �2Vt , official use only do not write in this area to be completed by city or town official dty or town: permit/license# ❑Building Department ❑Licensing Board ❑check if immediate response is required ❑Selectinen's Office ❑Health Department contact peiaon: Phone#; -- ❑Other (FwaW 9/95 PJA) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", 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, 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 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 has 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 performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. MAMMiN Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and '' supplying company names, address and phone numbers along with a certificate of insurance as all affidavits may be r submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign an &.. 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. City or Towns 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 pernnt/license number which will be used as a reference number. The affidavits may be retxnned in 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 questions. please do not hesitate to give us a call. IThe Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of IoYestloadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 I °f1HE rgsy Town of Barnstable Regulatory Services '' MBLF� ' Thomas F.Geller,Director MASS 9�prED .Phil Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal, demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type.of Wo;k: W a U 9 j tt Estimated Cost •�- -'ISM�-r— ff Address of Work: m f P sc iP � ,AA Owner's Name: lP r\S Date of Application: b I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME E14TROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Date Owner's Name vi /\ p 6: I Af 11 • Y 0 .. - T i The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: I �� 1 V 1y1 C C 5S f, '`4 l t1�C!/I tit number street I village "HOMEOWNER!': /k e-i SP�('✓1 5bW--7-7/ P5`7� S`a� -1-000- S`;P:3 m name home phone# work phone# CURRENT MAU_]NG ADDRESS:�/S Pl'in C~? .5S' f i1 P e va d hk 1 Q vl o S /yy7-- 0 a 0/ ity/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 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 B aim table Building Department minimum inspection procedures and requirements and that he/she will comply with said proced es and requirements. ZZ G 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. - 07 01/25/2007 15:04 5087786448 HYANNIS FIRE PAGE 01 HVANNIS FIB DEPARIMENT 95 HIGH SCHOOL Rd, SXT, HYANNIS; Mrs.02601 iA HAROLD S. BRUNELLE, CHIEF PIKE PREVENTION BUREAU BUSINESS PHONE:(Wa)77-c;.1300 FACSIMILE PHONE;(508)"8,6448 LT.DOT ALD H.CRA.S]B,JR.,Cam[ LT.EMC F.FULMIJIM,CFI F'![Ii E PRE VEAP1 ON OMCM ICE PREMMON OFFICER AGENCY NOTIFICATION Building Health Wiring Gas J Consumer Affairs Pursuant.to Mess:=joeneral Law, Chapter 148:28A and 527 C-MR 1.00, the above agency is hereby.. notified-that a hazard or violation is believed to existzelating tGthe above agency's jurisd"Iction. The hazard or,vioiabon noted is not within the.inspectors oode:of.'enforcement or.judWiation. The following has bow reported-in peer on (ir'by oho on.this�:date: for the:property looted at. � in.Hyanrlis: 1} 3) 4) --- -_ — Owner of record: " -- phone: Fire Prevention Offloo cc:street file ' ay rev, 1l2000 r C3 C ) C M 01/25/2007 15:04 5087786448 HYANNIS FIRE PAGE 02 s FP40(rev 1109) �� '�C1G4SY '0,�5, � za�' ta&'t'.G&aa. APPLICATION FOR CERTIFICATE OF COMPLIANCE FOR ;SMOKE DETECTORS AND CARBON MONOXIDE ALARMS M.G.L.CHAPTER 148,SECTIONS 26F,26F1/2 /� "� City or Town.•, AN-NIS FIRE DLU YGT__„ _ Date: � � �y O ` 1 Application is.hereby made for inspection of smoke detectors and carbon monoxide alarms as required t)y Massachusetts General Law, Chapter 148, Sections 25F,26F'/x and 527 CMR 31, et seq. NOTE:SU B MTT AP 71CAITI 0 N TO LOCAL E DFPARTME HEAD PTERS Location of Property ' CLOSING DATE: l� Owner of Prcpsrty A-J Number of.Dweliing Units l _Signaturoof Applicant Inspectionfresting completed on: By: — ------ trnsp9ckar Fee:(M.G_L'&i pter148 Sec, 1OA) $25.00—cg,:k.Fire Chief_IiaxQ,ld S• ,�xune _le. Mote:Any certificate issusd in accordance with provisions of M.G.L. Chapter 148,Sections 26P,215R/z expires scdy(60) days after issuance by head of the Fire Department. FIRE DEPARTMENT'S CQpl z- — I/ 40 POIN' DATE & TIME WITE SPECIFIC 110O TEI,. CONTACT i� ER.T —_...— ——— REVERSE SIDE —_ .,r —_.---_r.— > FP (rem Trost r cup+, CERTIFICATE OF COMA' NCE M.G.L. CHAPTER 148, SECTI 26F,26F'/x City or Town, IIYANNIS FIRE DIST�_.__ ate: This Certifies that the property located at �„,� has been equipped with approved smoke dot e rs, and ca.rb�rn de ala and was found to be in compriance with Massachusetts General Law, Ghapter 1 ectio 2 and 527 31,et seq. lnspectionnesting completed on: $y; M � lnapactor lef Harold S. Br- -ellp Fea Paid; Head of Fire Departn3 t: Un Hate:This certift expires sixty(60) days after d of issue. 07163 . . SELLER'S GOP - PERMIT # �� 01/25/2007 15:04 5087786448 HYANNIS FIRE PAGE 03 P �t �4(5- E-cft.-V-�p e- WoOD q < 01/25/2007 15:04 5067786448 HYANNIS FIRE PAGE 04 �_Rarnpable Assessing Search Results 01123/2007 02:14 PM ;iI I I 9 6 r rAU New Search I, i§�New Interartimm Ma Owner: 2006 Assessed Values: CALVACANTI, DIEGO A& 15 PRINCESS PINE ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $110,200 $130.200 2669 I D88I Extra Features: $2,600 $2.600 Outbuildings: $500 $600 Mailing Address Land Value: $164,800 $164,300 CALVACANTI, DIP-GO A& ABRANTES, JOSELITO Totals $2996.100 $298,100 %NORTON,JAMES TR CENTERVILLE. MA, 02632 2006 REAL ESTATE Tax Information. Tax RateS: (fir $1;000 of valw2ktian) Community Preservation Act Tax $37.48 Fire District Bates Town Barnstable-Residential $1,90 $6.31 Barnstable-Commercial $2.51 Commercial Hyannis FD Tax(Residential) $479.94 G.O.M.M.-All Classes $1,06 $6.54 Cotuit FD-All Classes $1.33 Personal Property. Town Tax(Residential) $1,249.38 Hyannis=Residential $1,61 $6.49 Hyannis-Commercial $2.50 Other Bates W Barnstable-Residential $1.60 Community Preservation Act 3%of Town Tax W Barnstable-Commercial $2.46 Total: $1,766,80 Construction Details Property sktti;ll Legend Building Building value $130,200 Interior Floors Hardwood hap:!rwww,own.bamstab!e.ma.usJassessing/assessp6/disvlayvar'celp6map.asv;mepparbaak�ad3ress&maPpfi =269088 Page I of 2 f 01/25/2007 15:04 5087786448 HYANNIS FIRE PAGE 05 z , Barnstable AsieSsrg Search Results 01/2312007 02:14 PM "1,� �+4r.4 vvu vvwivv •vPvP MJvrp„ i - Model Residenti3! Heat Fuel Gas 1 Grade Average Heat Type Typical 1` Stories 1 1/2 Stories AC Type None Exterior Walls Wood Shingle Bedrooms 3 Bedrooms Roof Structure Gable/Hip Bathrooms 1 Full+ 1 H Roof Cover AsphlF GIs/Cmp living area 1428 Replacement Cost $153223 Year Built 1970 Depreciation 15 Total Rooms 9 Rooms Land CODE 1010 Lot Site(Acres) 0.28 Appraised Value $164,800 Assessed Value $164,800 t View Interactive Maas >> Sales History: Owner: Sale Date Book/Page: Sale Price: CALVACANTI, DIE GO A& Sep 1 2003 12:00AM C170576 $282,000 SELENS, DARLYNNE D&KEITH A Sep 19 2001 12;OOAM C162313 $1 SELENS, DARLYNNE D May 15 1991 12:00AM C123413 $0 HOLIGA.N, DONALD J Oct 15 1985 12:00AM C103910 $70,000 ZARATE,PAUL A & PAMELA J Mar 15 1983 12:OOAM C91240 $46,006 SELENS. DARLYNNE D'MRG CTF 14J8l97 $0 Extra Building Features Code Description Unitsf$Q ft Appraised Value Assessed Value FPL2 Fireplace 1 $2,600 $2;800 SHED Shad 30 $500 $500 Property Sketch Legend BAS First Floor,Living Area FST, Utility Area(Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story (Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area(Unfinished) FAT Attio Area(Finished) GAR Garage UTQ Three Quarters Story (Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio' UUS Full Upper 2nd Story (Unfinished) FHS Half Story (Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TO$ Three Quarters Story(Finished) httf,,/lwww.tpwn.bamstable.ma.us/assessing/assess06/displayparce106map.asp?mapparbaek-address&mappar=269088 page 2 of 2