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HomeMy WebLinkAbout0036 SPRUCE STREET �3(� CS'P�vc� c5tre�f i IVI OF BA1-,h1b-TjA13JLE E C 2 CAPE SAVE I .:0-1 Weatherization 508-398-0398 December 14,2011 Town of Barnstable Thomas Perry CBO Building Commissioner 200 Main St. Hyannis,MA 02601 RE: Building Permits Dear Mr. Perry, This affidavit is to certify that all work completed for permit application#201006942, Status A, Parcel 310225 at 36 Spruce Street,Hyannis,Permit type: RADD, and issued on 12/20/2010 has been inspected by a certified Building Performance Institute (BPI) Inspector. R-30 Cellulose insulation was added to the attic. R-18 cellulose insulation was added to the slopes and floor.The walls were dense packed with R-13 cellulose insulation.The basement sill was insulated with R-19 fiberglass batts.The perimeter was wrapped with R-5 reinforced foil or vinyl faced ductwrap.All work performed meets or exceeds Federal and State Requirements. Sincerely, . � I William McCluskey TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 0 Parcel �2-� Application # 0CJ09 Health Division Date Issued ` lv Conservation Division ­,Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/Hyannis Project Street Address "S C-6 Village Owner ��b p 1 C t c._ C 1-k(Z 1ST- Address }M,5 Telephone 50� �}S Permit Request g C-oU-)K 1 - rJ `t�� i�. ,tk'i 2 c�r.� 1�-► D C���JI- C, (111t 71 ti321 �i�Tl f Square feet: 1 st floor: existing proposed - 2nd floor: existing proposed - Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 5o oo'00 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ©' Two Family ❑ Multi-Family(# units) Age of Existing Structure ( 11 , Historic House: ❑Yes I( No On Old King's Highway: ❑Yes O/No Basement Type: mull ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 19 2. l Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2- new Half: existing — new - Number of Bedrooms: 3 existing -new Total Room Count (not including baths): existing _ new First Floor Room Count � -A Heat Type and Fuel: ❑ Gas Ufbil ❑ Electric ❑ Other 1 Central Air: ❑Yes 3'No Fireplaces: Existing New Existing wood/coal stove:0 Yes 0 No Detached garage: ❑ existing ❑ new size-Pool: ❑ existing ❑ new size _ Barn: ❑ existing Linew size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name l_AP6 5 1WE Telephone Number Address C- ( uN��on1 �'} V�` License#� �Ovt'i1t I.ALW O 2_GfoY Home Improvement Contractor# Worker's Compensation # W ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Yr4 Wp utrlU SIGNATURE DATE ]A - 2 D - )O FOR OFFICIAL USE ONLY t APPLICATION# i DATE ISSUED MAP-/PARCEL N0. _ __-- 4 i ADDRESS. VILLAGE OWNER s DATE OF INSPECTION: 1 :..FOUNDATION FRAME { 'INSULATION'. FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL *4 GAS ba ROUGH!: ` iz FINAL m -`-`FINAL BUILDING _t" DATE CLOSED OUT ' a ASSOCIATION PLAN NO. i ` The Commonwealth of Massachusetts DeParOMW of InduaWdAeWdenty Office of Invesdgadons 600 Washington Street Boston,MA 02111 www was&gov/dia Workers' Compensation Insurance Affidavit: Builders!Contractors/ElectrlciansJPlumbers Applicant Information Please Print Lesi Iv Name(BusineWOromization4ndividual): C_ Address:— City/State/Zip: Are you an employer?Check the appropriate boa: �3mr I.L l am a employer with_ 4. ❑ 1 am a general contractor and I Type of project(required): emptgxe- (full l have hired the p oes 6 ❑New canstcucti A 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition wonting for me in any capacity. employees and have workers [No workers'comp.insurance comp. insurance.i 9. ❑Building addition required] 5. ❑ We ire a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs required.]t c.. 152,§1(4),and we have no 38.13 1 am a homeowner acting as a employees.[No workers' 13. O7ther general contractor(refer to#4) comp.insurance required,] 'Any apptit m that checks box ill.must aW.fill out the section below stowing their wodm,co t Homeowners who submit this affidavit indicating they are doing all work and then hire outside c �hcy inf nutim doctors must submit a new affidavit indiCBttti such tContractors that check m e ate d as itia�at shM showsing tlu DOM of do sub•condsctots and state whether or not those l� Kk.> employees.itie sub-condactwa have employees,they must provide their worketa'comb.policy number: enentitiesnve I an an employer that is providing workers'compensation insurance for sty employee& Below i4 the infornmdon. Pesky and fob site Insurance Company Name t `a�l .`T IVf lAl� t= Policy#or Self-ins. Lie.#: - Expiration Date_j ol LW� Jt00 gilt As-A:---3 4;� ° I .; City/StatelZip:_( �A :�S C>2.-�,Cy 1 Attach s copy of the workers'compensation policy declaration page(showing the po Cy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 1.52 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 fotzn of a STOP WORK ORDER and aft of up to$250.�a day,against the violator. Be advised that a copy of this statement may be forwarded to the Office f Investigations of the DIA for insurance coverage verification. o I do hereby certijjr under the and pe of pedi uy that the Informado�e piavided abav+r b trove and correct Signature: ; [6. tclal rise® 41pi� (tt tt+tw co kted by etty or-town o,j etat y or Town: Permit/License# ing Authority(circle one): bard of Health 2• Building Department 3.Clty/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector thertact Person: Phone#: ✓ r. - l ® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F 11/1/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED kEPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Shannon Sperrazza Risk Strategies Company PHCN o (781)986-4400 aC No:(781)963-4420 15 Pacella Park Drive E-MAIL ADDRESS: errazza@risk-strata ies.com ADDRESS: P g Suite 240 CUSTOMER ID ER D0018476 Randolph MA 02368 INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURERA:Seneca Specialty Insurance Co INSURER B:Keating Group Ins Services Michael McCluskey, DBA: Cape Save INSURERC:Chartis Insurance 7 C Huntington Ave INSURER D: INSURER E: South Yarmouth MA 02644 INSURERF: COVERAGES CERTIFICATE NUMBER:CL1011132675 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR IN SR WVD POLICY NUMBER MM/DD/YYYY MM/DD/YYYY GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE ( RENTED PREMISESS Ea occurrence) $ 50,000 A CLAIMS-MADE X❑OCCUR BAG1002608 10/16/2010 10/16/2011 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 1,000,000 GENT AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 1,000,000 X POLICY JE� LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ X UMBRELLA LIAB OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAB HCLAIMS-MADE AGGREGATE $ 1,000,000 DEDUCTIBLE $ B RETENTION $ 1023578601 10/16/2010 10/16/2011 $ C WORKERS COMPENSATION Aichael McCluskey X WC STA IT- OTH- AND EMPLOYERS'LIABILITY Y/NANY PROPRIETOR/PARTNER/EXECUTIVE --- is excluded from coverage E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) 9930951 10/21/2010 10/21/2011 E.L.DISEASE-EA EMPLOYE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101;Additional Remarks Schedule,if more space is required) Issued as evidence of insurance. Contractors-Executive Supervisors or Executive Superintendents. CERTIFICATE HOLDER CANCELLATION (508)790-2425 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Housing Assistance Corp ACCORDANCE WITH THE POLICY PROVISIONS. Attn: Ruth 460 West Main Street AUTHORIZED REPRESENTATIVE Hyannis, MA 02601-3698 Michael Christian/SMS ACORD 25(2009/09) ©1988-2009 ACORD CORPORATION. All rights reserved. INS025(200909) The ACORD name and logo are registered marks of ACORD of IWE r Town of Barnstable Regulatory Services BARNSTAeLF. ' Thomas F.Geiler,Director 1619. 1` Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 wwvy.town.barnstable.ma.us Office: 508-862-4038 _ Tax: 508-790-6230 r , Property Owner Must W Complete and Sign This Section If Using A Builder - • ,I, `3'0�1 .� � �,� h,r1:S t•-, , � �;►as Owner of the._subject property. hereby authorize "® __, � • y t� o act on m behalf, a1� Y _ in all matters relative to work authorized by this building permit application for: or: (Address of Job) r. S` afore o er Date Print Name If Property Owner is applying.for permit please complete the ,Homeowners License Exemption Form on the.reverse side. Q;FO RM S:0 WNERPERM IS S I ON 5 . u _62 4 W. Office of Consumer Affai s and Business.Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement"Contractor Registration Registration: 164432 _- - Type: Supplement Card 3�M.- Expiration: 10/6/2011 CAPE SAVE _? . WILLIAM MUCCLUSLEY -- --��-� 8201 S. HO U R D CT ----- --------------- CHAPEL HILL, NC 27516 i, Update Address and return card.Mark reason for change. ops-cA1 at 50M-04104-G101216 `_J Address j 1 Renewal 171 Employment (J Lost Card -- Office of Consumer Affairs&Business Regulation License or registration valid for mdividul use only F;!L-- before the expiration date. 1f found return to: �= s HOME IMPROVEMENT CONTRACTOR = Office of Consumer Affairs and Business Regulation r Registration-- Type, 10 Park Plaza-Suite 5170 Expiration tt)/6/2011 Supplement Card Boston MA 02116 CAPE SAVE WILLIAM MUCCLUSLEY' 7C HUNTING AVE S.YARMOUTH,MA 02664" Undersecretary Not valid wit ou signature Massachuse s- Department of Public Safety' Bogard of Buildin;; Re-uiations and Standard Construction Supervisor Specialty License License: CS SL 102776` Restricted to IC WILLIAM MC CLUSKY 37 NAUSET:ROAD ` WEST YARMOUTH,..MA 02673 Expiration: 6/28/2013' Commissioner TrF#: 102776 _ _....___ .1. _ __ __ .._... .... _......... ___ _ • .. .. . _ _ .... ....._. ...... _... ....... .__._.._.. ....... ._.....__............ ...... _... �,., . ... . .. .. .. _ _. _ _.. . .. .. _.. ... _.. : 1.__ .. .. _...- _. . �'�:-::--i';:��::.I:r:,"­::q,.:::1-%-1�.�:-"'.;,:1 -I�-:'l l--'�..�:�'.�..:.:. ,I",-:�: g ` � '<� � ',P- _ ,, 3 ., II1, - , �.:�.::..:..:.�:.:I�'�,..:I:..1:.,,.::-::-1"I ...: ,� d ...`: ...:: ...... '3 p ... .' . .. ... ... __ _.. 1. :. .. .. ... r ., . . .. . . : To 11am ! may Ccaraerr�. a William-A...:1. c�� skey is an'em l­711ovel:ee'.1.r f Ca Sage a is1.:a atI. ;orwzed t �t� to ccantrad '. d b ,� ing per;: its for . co 1.paa . ,: :.�I ft:.:.M.--1.....'.....::::.:::: �p ::::, .::::q:::::�::: ::::: :::,, : -:;, ..., ,. . .....----...---...-.-...... .....:::.....::::��-:,:, ; -- :.1: - --..:-l.:�:19 .: ':�; 11 -....- I-,.... .-�.....� -...-.::-':::::::::':: �::: _:::���::::-::' ':::: ': ''.:::::::':::' :: - 1iic aet . .:..:::I::I.,:.. e ' . : Capp Saue Onr 19-593- 9 ce _. .. .. :: .. _ .. .. _ ,: .. . . . 7C Fiu�ntsr g. n'AV.enu'C SEIt moot , Q2654 12-11 • TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map / Parcel _ Permit# G Health Division 4k Date Issued :Old- Conservation Division Application Fee xl' `0 Tax Collector (7D3 b !y L- Permit Fee 3 7. Treasurer (7 ?� - APPLICANT MUST OBTAIN A SEWER PlanningDept. CONNECTION PERMIT FROM THE p ENGINEERING DNISION PRIOR TO Date Definitive Plan Approved by Planning Board CONSTRUCTION. Historic-OKH Preservation/Hyannis Project Street Address 26 S ,a ,e-cT Village Hy 'A n n I!S Owner D 41 f c� Ila e It- a-#dress ✓c Telephone ® `7 7, 5t 6 9 07 Permit Request r m o r g4a L 4?��c2t n Square feet: 1st floor: existing proposed 2nd floor: existing ,proposed d' Total 4-c01- Zoning District Flood Plain Groundwater Overlay Project Valuation 00 0 Construction Type " Lot Size Grandfathered: P(Yes' ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure . Historic House: ❑Yes . Vfho On Old King's Highway: ❑Yes 4Ao Basement ype: ❑Full 9 rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Me Basement Unfinished Area(sq.ft) 2 00 5! -.1`T Number of Baths: Full: existing Dn� new , ®h•e- Half: existing XDU Sb 6E-new Nein_ Number of Bedrooms: existing w r> newo -� Total Room Count(not including baths): existing Al f/'C new A!P7-e First Floor Room Count f1V-e- Heat Type and Fuel: 0 Gas 410i[ El Electric ❑Other r Central Air: ❑Yes ❑ No Fireplaces: Existing Ivyn t New Deli Existing wood/coal stove: ®Yes ❑No Detached garage: existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size o Shed:Vexisting ❑new size Other: t !J Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# Current Use-- WWYJ t I&A Proposed Use .BUILDER INFORMATION Name He b t;--T K g-A e I m Telephone Number y Z �- 6--1/ Address 3 6 P aid Psi A An •-P License# es ��feT��� M, Home Improvement Contractor# Q ,L 6 Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE V06 I S��i�(/!il DATE A-- O FOR OFFICIAL USE ONLY 4 PERMIT NO. c DATE PSSUED MAP/PARCEL NO. ADDRESS - VILLAGE ' OWNER - DATE OF INSPECTION: FOUNDATION ` c1r FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUG% t FINAL ` FINAL BUILDING DATE CLOSED,OUT - - na : o " ASSOCIATION PLAN NO. t "Z'h Coiri�non vea th ofMassachusetts e • ', _= Department of.XndustriatAeeidents' . — •' • 6�yypshin�� - Boston;Mass.:b2�1I -Workers',.C m ensation.usurance AffidaQit-General Businesses _ ME rtda t.. .,stets v ' C dress: ,, • 5' •- •��6J •h 'e#• �_S a �S 6_.7 j •� •/ state• ` • FstabliShmeat e location fall address : sxne$s 1{t,Me. []Retail[�RestaurantBaF/Ea o work sit etor and have no one $R Q Ce Sales('including Rwal Uat�Antos etc.) ❑ Xain.asole�r*ri '' ''' . • . working in any capacity. 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'+.`Jr,�,r''•• ,S q,(5•'iL,.}t,}:, `:;d;Sr t.,. .,.d?. •t OO.00 Sn Dr SnsLirari� aF critics of criminal}icnaltirs of a fine tg�to$1,5 Failure to secure cavcrage as required ender Section ZiA of MGL TO can lead tq the lwp. ent tss s r e to ctytBP der s es�the foYm of a STOP WORK ORDER and a fino of$100.OQ e'day against mar I understand tlsat X oTte years'imprL+onnl statement maybe f°ceded to the Office of Investlgations of the DlAfor coverage verification. copy o f this that the information provided above is frue and Correct un thep,i -s`an nal 'esbfperJury I do hereby ce Date t 5i�nature i hone# Print name ' officialese only d0 II°tt0 in this arm to be eompletedby city or town official [IBuilding Department permit/iicansa# ❑Licensing Board city or town: ❑Selectman's Off'ioe [�HealthDcpaztmen� ' [}eheckif immediate response is req ed phone#; �- contact person: ' (:ev$edsept7m3) s • • . luforxbiation and Xnsfxuctions' ' �� chapter 152 section 25 xegtiires all employers to provid rworkers' eompengtiott fcr their. WS sac1:4§.Ptts G' loyees; As quote f d:fromthe ggV', an employe is.defined as every person in the service of another under any eorzfract of hire,exP ress or irrol dd;oral or written. er is defiled individual,partnership' association, corporation or other legal entity, or any fwo or rngre of .An MAY ed�a;]oint�� rise,and including the legal ieePresentatives of a deceasedymployer, or the receiver or the foregoes engag artnershi association or other legal entity, employing�oployees. 'Howevei.the owner of a trustee of an individual,P P,. . not'fnor,than three apartments and who resides therein or the occupantto toe;dwelling house bf g house having•.,. _ •• ctibn or repair work on such dwelling fiouse csx on the grounds or `,iho 1bySpersbris to, maintenance,constrg eP , another �ant thereto shall not use pf sucherrployment.be deemed to be Ai prrployer. 152 sectibn 25 also''states that'every state or local licensing•agenoy shall withhold the fssuancb dr renewal MC�L chapter. Y PP. , of a licea?se or pe3'm?f to operate a business or to construct buildings in the.conimonweaIth for an applicant who has acceptable•e'vidence'of complian6e with the insurance coverage regtili a A.tlditianally;nbithex'the' ' not producedof its political subdivisions shall enter into any eot�tract for theperformance of public work until cozxrrn�x'balth nor.�y P , acceptable evidence of corrg�lionce w tli t�e msurance requirements of t his chapter have bebn presentetT to the contracting•. , _ authority: . A;pF]ieants .• •. t a lies to our situation.,Please • $rewo�ers'• enyafm affidavit corr&tely,by checking the box tha PP : Y, lease address and bone numbers along with a certificate of insurance as all affidavits may b e submitted supply coITBny name, P to the pia �{'°f d Adaidents•for confu-mation of insurance coverage. Also be sure to sign and date the o the le The affidavit should be xetamedustial to the city or town that the application for the permit or licens a is being not the pep it shoi t obendustrial�,ccideuts. Should you have any questions regard the'"Iavd'or if you ai'e requested, li lease call the Ia axtrnent at the niu}rber listed�ielow. t a•vror.1C0!•compensationpQ Cy,p, eP required t0. . , , . , • . . lei, ell, rmbl FIVE// NINE City or Towns . easebe sure that the affidavit is complete and.printed legibly: The Aepaitrnmt has provided a space at the bottom•of the Pl affiillavxt f�.you to fill ot7t in-the event the Office of Investigations has to contact you xegardiug the applicant Please ermit%licens a nu�ntier v5rhich WM be used as a reference number. The•affidavits mayUyetmned tq• b e,sure to fillip e P -,..• . ,. thepepentb}. azPAXunlessother'ariangementshavebeenrnadq• ..' u1d lfice tii thank bu in advance for you cooperation and should you have any questions, The Office of Investigations wti Y please do nothesitate to glue us The Aepa ends add r. address,telephone and fax number. • - The Commonwealth Of Massachusetts- Department.of-ndustrial Accidents . . �hce of la�esena • 600 Washington Street Boston,Ma. 02111 fax#; (617)7z7-7749 Town of Barnstable Regulatory Services BARNST g Y t MASSA, � Thomas F.Geiler,Director 9�pTfDnnA'�°,�� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-8624038 Fax: 568-790-6230 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 Work: Fr m J.e. Koe?kn Estimated CostIF (s�� l Address of Work: e. 51 Owner's Name: J® itt Date of Application: A at—d I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 PoBuilding not owner-occupied wner pulling own permit Notice is hereby given that: OWNERS 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 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. &R Y Date Owner's Name Q:forms:homeaffidav 11'3 Closet 1�, Vanity sinkShower N Existing Room Tailet � F Back door - Hall 8'1 Door Remove Closet { 15'3 3 6'5n Existing House Plan for Jodie Gilchrist 36 Spruce Street MA Hyannis MA I c - _ Wood Shingles Existing House Existing House Wood Shingles Wood Shingles 26-O" _I North elevation Existing house elevation Jodie Gilchrist 36 Spruce Street . Hyannis MA 02601 L nsuation 2x6 R 30 j Insulation l - R13 existing walls ` 2x4 New remodel i Kitchen KltCh@ c0 exsisting 2x10 poured concrete ,� k Foundation !nsulation R19 }a _---7-O Jodie Gilchrist Spruce Street Hyannis MA Town of Barnstable Regulatory Services BARNSTABLE, Thomas F.Geiler,Director Mass. 1639. a Building Division rED MA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:.508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: Ap - 27 / oe'I JOB LOCATION: 36 _S�_QiyC: �� p .,j� number street village "HOMEOwNER" - name home phone# work phone# CURRENT MAILING ADDRESS: 36 SUt-u6 e S_rh-0-e=,,y� 1 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. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirergents a Si ature of .omeowner 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:forms:homeexempt