The URL can be used to link to this page

Home My WebLink About0089 AUTUMN DRIVE f.��Tl.�/Ylf" '�' .r... ,. �� ..t .-. r \(, ks ,��. ..._:.. .x.:_ .... _.... s..,, k,::y r1E;. �� i i i f'' i ! • .. . ■ - • i I �I �,r . T 0 W N 0 F BARVS" l" 13LE REGULATORY SI�,Ri'1CF.,S [3UILDINC: U11�1,S10N STOP WORK THIS STRUCTUREANWOR PREMSES HAS f3EE� INSPECTEDAND TI IE FOLLOWING VIOLATIONS OFTHE BUILDING CODE AND/OR ZONING ORDINANCE HAVE,BE EN FOUND: �� YOUARI?IH?RFBYN071FIF1)THAT NOADDITIONALWORKSHALLBGI.ADLIZ"f11:I:N -` UPONTHESE PREMISES,ORTHEPRf':111SFS OCCUPIED UNTILT11EAI OVY VIOLATIONS ARE CORRISCTGD. ANl`PIsILSON R1:�101'1,1'G TIIISNO"fICI:11171101,'"f '^ �' rROPt:IZ,�Irnlolzlr:�rloNSH:uI �I;r.lA11Lf TOAFIN1 :ti UI' 0")I,f_ss'f11.�N f 11 71,A'l)R MORETHANO V:llF':NDPRfDWwl.MR . ddrece - — �Ifurldin CUtnrnitsurrrr'r g TO OF . BARNSTABLE BARNS ABLE 163 10"111. 9. 0 N . . BUILDING . INSPECTOR APPLICATION FOR PERMIT TO ........ ................. �/... ...... ..../,.e..... ;............... TYPE OF CONSTRUCTION ........................ Q. ....... ................................................................................ ....... ........... .............1923 TO THE INSPECTOR OF BUILDINGS: The uncle plies a permit, cording to the following formation: Location ................................... ..... ................ ... .. ............................................ Proposed Use .................. ..................... ....... ................................................................................................. 7 Zoning District ..... . ........................... .. ..... Fire District ...........11 ........ ... ........... r' *I-Address 3. 7. Name of Owner ...... . .......................... .. . ............ .. ..... 4.1 .............. --</ ** Nameof Builder ...... I ........ .......... . .. ..............................Address .. .......lz-�.. ... ............................................... Nameof Architect . .. . . . ........ I.....................................Address .................................................................................... a ...................... ...........................................Number of Foundation ............ Exterior .. .. ... . . . ...... . .............................................Roofing ..... . ...... .... ..... Floors .............. . . ..............................................................Interior . ......... . .e�.V........ ZIP ............................. I g. ..............Heatin .... ..Z.?M................................................ .Plumbing .... .............................. ....................... Fireplace .......... .......................................................................Approximate Cost ......�Z:5! ................................. Definitive Plan Approved by Planning Board -------------------------------19------ Diagram of Lot and Building with Dimensions ei SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE SUBJECT TO APPROVAL OF BOARD OF HEALTH WITH ARTICLE 11 STATE SANITARY CODE AND TOWN REGULATLO-N-S•. 11 Jl- S 17, I hereby agree to conform to all the Rules and Regulations of e To n of Barnstable re ding the above construction. Name I/..........L... .a. �-r .... . ....... ......................... .... ..................... Russell E. Ginn, Inc. No ..161-88... Permit for ........orie story single family dwelling ............................................................................... Location Autumn Drive Centerville ............................................................................... Russell E. Ginn, Inc. Owner ................................................................... 1 frame Type of Construction .......................................... ..... Plot ............. .......... Lot ............ 49.............. 4 rV Permit Granted. .......;W.?......................19 73 Date of Inspection ............... .......... ........19 Date Completed .. 0 .. .... ....{.!3...19 ' I PERMIT REFUSED , ..................... ....................................... 19 ............................................................................... I ............................................................................... ............................................................................... Approved ................................................ 19 (((� ............................................................................... I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. Map Parcel Application* Health Division Date Issued Ji _ Conservation Division Application Fe 0S Tax Collector Permit Fee Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address AV 10 Ce_A44 V1& l✓�'y.. Village l Owner 4Q. l/ht� u_ d64q ?7 Address Telephone r-d _„c( Permit Request - P LS '.lfe /��,^�n �. � ✓o Av)If ram, y Square feet: 1st floor:existing` ,eM proposed J 2." 2nd floor:existing proposed ,Tptal new Zoning District Flood Plain Groundwater Overlay Project Valuation 10VO , J Construction Type Auvdal Gig < �, v: c� , Lot Size ,1'�) Grandfathered: U(Yes ❑No If yes, attach supportlig documentations Dwelling Type: Single Family W/ Two Family ❑ Multi-Family(#units) I'D rn Age of Existing Structure M17 Historic House: ❑Yes W/No On Old King's Hi hway: ❑Yes o Basement Type: ❑ Full . ❑Crawl Oi/Walkout ❑Other Basement Finished Area(sq.ft.) d6 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: dGas ❑Oil ❑Electric ❑Other ' Central Air: ❑Yes UNo Fireplaces: Existing / New Existing wood/coal stove: ❑Yes iNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:dxisting ❑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 W� �` /� ' Telephone Number Address 1)J1)--1AJ )r License# Home Improvement Contractor# Worker's Compensation# n ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO CYCO SIGNATURE DATE v2 7 FOR OFFICIAL USE ONLY - _ APPLICATION# DATE ISSUED F MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: r FOUNDATION FRAME ` INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION,PLAN NO. Mw :. 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): . + Address: City/State/Zip: Phone.#: Are you�an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. 0 I am a general contractor and I . employees(full and/or part-.time). have hired the sub-contractors 6. El New construction . 2.❑ I am a-sole proprietor or partner- listed on the-attached sheet. 7. [ Remodeling ship and have no employees These sub-contractors have g. EJ Demolition working for me in any capacity. employees and have workers' 9.. []Building addition o workers' comp.insurance comp.insurance.$• , required.] 5. We are a corporation and its I0.❑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 insurance required.]t c. 152, §1(4),and we have no employees. [No workers' . .13.R Other 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. ,.xContractors 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 have employees,they must provide their workers'comp.policy number. lam 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-inns,Lic.#: Expiration Date: Job Site Address: City/State/Zip- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).. Failure_to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification, I do hereby certify under the pains and pen ties of perjury that the information provided above is true and correct: Sitmatore; / Date: Phone#• JL ! — Official use only. Do not write in this area,to be completed by city or town ofjlciaL 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 Instructions 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 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, §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." states "Neither the commonwealth nor an of its political subdivisions shall GL chapter 152 25 N 'Additionally,M. p , § C('n y enter into any contract foz the performance of public work until acceptable evidence of compliance with the insu ante 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-confractor(s)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 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 reference number. In addition, an applicant that must submit multiple permit/license 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 fo 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 like 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 Inctrial AGaitlents Offce of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 11-22-06 • wvvw.rnass.g oar/dia ' j Jr THE l°y Town-of Barnstable yP� 'Y Regulatory Services * snxr�eresi.E, Thomas F.Geller,Director y Mass $ . 639' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 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 mots or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. nf � • Type of Work P "M Estimated Cost Address of Work: Owner's Name: �� 1�� '�G��' ✓ Date of Application: �,�✓121rd I hereby certify that: Registration is not required for the following reason(s): MWork excluded by law ❑Job Under$1,000 Duilding 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 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. Date Owner's Name . Q:fmmuhcmeaffldav r oFTHE ram, Town of Barnstable Regulatory Services BAMSUBI.E, : Thomas F.Geiler, Director gb,,l039. 16 Building Division fD AAA'1 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: 7 �tzb:7 JJ JOB LOCATION: V A, Z_A/ (.�y�/�I/► �`�' num er )J street village Q "HOMEOWNER": dlJ% 6/)ya�ro _lJ4" 13 17'0 name home phone# work phone# CURRENT MAILING ADDRESS: 126 r Aa- OZC 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 underiigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable col1 s,bylaws,rules and regulations. The undersigned" meown "certifies that he/she understands the Town of Barnstable Building Department. minimum inspection oced s and requirements and that he/she will comply with said procedures and require 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. Q:forms:homeexempt SP . ... ...... .... vi I Y /(D* oe r ol 44 i o^ � s � I yp ' 6 �^ f .. � r � ' . i , � ,- • ... i � ��' �' � � ' 1 � . i � .y O _ �,+" M {+J • - .._ S. .i .. -+ f � .� � _ I , . i �'- � - j , / . � � , � i ,, �•,� ,, t 4. .. � .. I �,. r � '~ ,� __...�.._ _ ._,_ t ..�. .4 _ � • I �.f X • i • 1 �.y `_ 1 rrtA- - P7, ki., 4D dW U► 4 Y-o axes u. LvL- -x, Cl Imo► Ul w, ajt6(" It X ��. • r :. f �, � t � r t � • ti� � �, �� ., y � ` �•� 1 , '� � i � � , 1 _ � ;� � ' . -� - ..._ i - � � • ' y J � - � � .., j mot` ' '* �, ' ; - � •/ +' .i � 1 � � � � { � . - � � � � � . .•_.-� - - ..f r LLB , y\� xo �?�' "fix 1 ,v+� �►� ; _ , t T .ate yam. --y,,�, �j� 1 {ar�� . -5�1 Ir,JC_�.• ��t� i-1"r.it - �11`+�r .. - . . t':4 , ' IE—ION :� �r, �t;'� t I • t b. 311 I 1 1� CIANii ' j . `I � � ,� ` -•G'°-- to c ra.��.00�•.t ?'' � 1 \/ � # - � , FO11r— �� G7At' r(� (I ✓ — TuK M ti A. 4 E_I3 CK. x h 1 t � e�c71� t 1 s Q� r J ) i O " 1 { s y �G � i, 3 x'- : t it� c , �Fm _ ;,,-ter T. y/ 7 _ { 1 `� I ""'-------_...__ ,•---,—�.,ar.-.. ,- I'i' _ �tD m�� 'y FF _SL4 T F SDI Te411r t�. , n•.. j� • : _ _ :3 i .,. �. 47