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0035 BEE LANE
u e a g o � r o a d 0 i Town of Barnstable *Permit#t � v a Regulatory Services 6,non .on u ��111 MAss. g , Richard V.Scali,Director �e3aro��0 Building Division Paul Roma,Building Commissioner U 200 Main Street,Hyannis,MA 02601 www.town.bamstable.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 x �1 Property Address 3 V ee I '�-P�- 1/ Q , esidential Value of Work$ cj5o0- 0® Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address e2 ' I CcrSc/-" I l.. CC,+Q-r-y 1)le Contractor's Name �/y 1 \le) Y.Y.,0-cJl I`G:-�'1 �►'�-'�.� Telephone Number 1 2—� B Home Improvement Contractor License#(if applicable) I 737�3 �' Email:'5V Z-4 2-00a h\00 C�� tt Construction Supervisor's License#(if applicable)0 '-10 -K I g Wrkman's Compensation Insurance Chec one: [Vam a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each.permit. Permit Reques eck box} c 4-'Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑ roof(hurricane nailed)(not stripping. Going over- existing layers of roof) [ Re-side �ti9r- ❑ Replacement Windows/doors/sliders.U-Value - (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner.must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPHLESTORMS\building permit forms\EXPRESS.doC 06/20/16 f : Gj The Commompeakh o,f Massadrrtsdft Depwtwmt n,f radirstrid Accid=&- 0irke,Of '600 Wass fiWort meet , Boston,MA 02111 spipiumass gop1dia Wcwlmrs' Campensa6um I ce ffidzv+. uilder_zlContractorsMec€ricianstPbmnbers Apxl�I t Inftn-mafion Please Print Y -Name 0 Addregr Uri e��tax� '�n��s t�oY-�-.Y`'►� D�63 I�n�� � �� 2�I o� � �`��' Are you an employer?Check the appropriate bom Type of project(regniredy- 1.❑FaMESaleprqprietarorpart=_ I with 4_ ❑I wn a general contractor and I ❑ . Cbr p��)* Have lvred1he sdTy-crom#a t s 6_ Ides cF�on 2. listed onthe attached sheet I ❑R=odeliAg Mese sob-condractors have ship and have no enzpla�ees $- ❑Demolition, wadding forme in any capacitg en3ploleLz_andhave workers' 9_.❑Building addition [N¢yam'comp.insurance 'CdDlp.mererarxp� . r e&] 5. ❑ Fite are a-corporafim and its 10-❑Electrical repairs or additiaas 3.❑ I am a bomeouner doing all work officers have exercised their M❑Phunbiag repairs or addifiams myseM[N8 workers' right of esempfion per Mtsl. c.1.52,§I(4�andwe baare>pa lw❑Roof repairs - ��+nm=required-]Y 13_❑0theer employees.[No' . cam-irmmmce nquired.] •Aapap N-ateatcbefsbmPImastelsaMrnrtthesectioabelmvslwwing&eaaaske&compemsafi=peTcpinFb=s6mL �I�OIDeON34i'S whD SIIbo�t ili1.S ef�d2C�ID �P they ese doio;eg WIC and H't�hiss outside[D'D�CtDLs nmst Submit a neW S�da'ePt u7dia3iCa rnrs, . i0==civatbat cbecYt d ba x Hues[attscbh as additirmal sheet dbowfng the name of the sub-cu=,ctaa•mad stile whe&e,ar art9hnze,IfId �U EMpicyees.Ifthesabta haveemplayw_%dLLTm=&ry=vide&eIr wadamecomp.poRUmm3ber I am_arr ealipi�sr flint is prvuidireg turrrliers�cotsrrtzan iaaszirarace�cr�y etrrplrr}�ee� $etoev is t7�e pv�iry arrd jeb site Fn�mrrsrrfiarz : InsuranceCompanyName: Fuficg or Self-ems Ii - RKpifationDate: Job Sifa tlddrem c4lstatete tp: Attach a-copy of the workers'comapensation.policy declaration page(shhowing the poFicy artrmber and expiration date). Failure to secure coverage as required under Section 25A of MQ,m M can lead to the imposition,of criminal penalties of a tine up to$1,54 0(}andtar one-Fear imprisonmentas well as rim penalties ime fog of a STOP�daR ORDER and ae of up to- -00 a dap agai u t the vioLdur. Be adtised'dig a copy-of this statement may be forwarded to the Office of Investigations ofthe-DIA.for insurance coverage verificafiioa I do hereby cerdy under&e pains and penalffzs,9fprdW7 that tha info aafim pro-itW abmv is bare and carrect Si*MstUM Date: / I PbMM ik 20 2� g c,' t9}gficial am only. Do not write in this area,to be campTetesd 5y city srtatt a offiziaL My or Town.: Permifficense S : Issuing Authority(drde one): L Beard of$eat I BwbEag Department 3.Cdyfrown Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Coact Person: Phone 9- 6 � ormation and ]Instructions ' A/`w=chweft CTe'aea'Bl LAWS chaff I52 regmras all boy=to WOVI&WCd='conpensHtSOII ET ffieIF empl0yaM5 Pmsa�to this stye,as�Ivyee is defined as"_everypersonin the service of aermnder nay art ofhire, =q==or implied,oral or wrh=" Aa Tay is de fined as"an bEwidual,p=f=rsb*,assoaiatia a;corporation or other legal eaiiiy,or any two or m m of the foregoing=gaged in aJ oint entcrprim.and incbidmg the legal representatives of a deceased employes,or foe reiver or trastee of an m�vidnal,parmedship,assoczafim or ofhetlegal eptity,employing employees. However fhe ec owner ofa.dweILinghousehavingnotmore than.three apartments and-who residesffiereia,orfhe occ-,¢pant ofthe - dwelling house of anger who employs persons to do maintenance,constracb on or repay Work on such dweMag house or on the grounds or buacrmg appurf=antffieret°shallnotbecause ofsoch employmeatbe,deemedto be an employer" MCsL cbaptm-152,§25C(6)also stems that"every state or local licensing agency shaII wifhhold{ire iss uan ce or renewal of a Hcense or permit to operate a by tress or to construct buildings in the commonwealth for any applic=fWho has cc notproduced aeptable evidence of cdmptian With the insurance coverage requu ed." Additionally,MCrL cbaplvr 152,§25C(7)states-Feifherthe czanntsnsyeall nor;�ny ofits poTTfiral subdivisions shall . enter into any contract for the prance 0fyublic Worm tl acceptable evidence of compliance with the insurance. rents of this chapter have been es prented to the eontradirng amdhozdY:' A pp4cants Please fry oht tha wo&ers' compensaf on affidavit completely,by g the bones apply to your z;fnaiirn, and,if necessary,supply soh-cgnixactor(s)name(s), addresses)and phone m=ber(s) along with their ce r[if cate(s) of h:=r ran.ce_ T"nn*tad Liability Compames(LLC)or Limed Liability`Pe rtnersbips(LIP)wiffi no employees other ff-an tho members or p =not required to carry wo:6= ' compensation insurance• If an LLC or LLP does have employees,apolicy isregaued. Be advisedthkfais of ickyitmaybe;snbro tindt,the Department of Industrial Accidents for confamaiion of ins ranm coverage: Also be sure to sign and date the afad a Yit The affidavit should be retnmed to!he city or town that the application for the.permit or license is being requester not the Deparmmeut of Irdastriat A cmAmts Shanld you have nay questions regzldmg the Law or ifyou Eire recpzaed to obtam a worms' compensation policy,please call fie Department at the rmmber listed below. Self-ms►nr-d companies should enter their self jas a„ce license number an the apprapriafe line City or Town Officials Please be scn-e that the affidavit is caugle#$and primed legibly. The Departinemt has provided a space of the bottom of the affidavit for you to fill out in the event the Office ofInves6gaiinns has to coact youregardiag the applicant Please b e sure to f M m the peun>t/license number whirh will be used as a mf=;nce number. In-addition,an applicant that must submit m #ple pemjWHcense applir aiions in any given year,need Only submit one affidavit indicating=Mt policy information(if necessary)and under`rJob Site Address"the applicant should write"all locations in (may or town)_"A copy of the-affidavit that has been officially stamped or mated by-&a city or tovm may be provided iD the applicant as proo-f dLat a valid affidavit is on fIe for fte permits m licenses_ Anew affidavit must be filled Olt Mach year.'Wh=a home owner or citizen is obtaining a license or pest not related to any business or commercial venture (ie_a dog se licen orpeunit to bmn leaves eta.)said person is NOT raqciredtn compldr,this affidavit The OT=of Inyestiga dos would Ike to t5snk you i a ativaace for your cooper ion and should you have any gaesticros, please do not hesitate to give us a call. The DepErtmmfs address,telephone and fax number • • � tlr of 11�1��.ssa"cliict�tts . • - . Define of hiAct dints affi=of�tio= T(,-1.4 617-727-4900 cat 406 or 1477 I§_,� Fax 617 727 7749 - R.avism 4-24-07 w m_ss p i Town of Barnstable Regulatory Services RAMMMASS.MABM Richard V.Scab,Director ►� ' Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property,Owner Must Complete and Sign This Section If Using A Builder Q � ► SSA u �� G ►--� . I. , as Owner of the subject property hereby authorize M0W'--\YYAC::.2') ►�l �f�to act on my bebA in all matters relative to work authorized by this building permit application for. (Address of Job) , f **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. r tore of Owner Signature of Applicant �AQ 1 ;ss 014 rY\ Print Name Print Name Date QTORMS:OWNERPERMISSIONPOOLS Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Paul Roma,Building Commissioner MASS i639. �� 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: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: 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 requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. _ -'HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner- engages a person(s)for hire to do such work,that such Homeowner shall-act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the*responsibilities of a supervisor (see Appendix Q,Rules&Regulations-for Licensing.Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner- acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the- permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. " Q:\WPFILES\FORMS\building permit forms EXPRESS.doe 06/20/16 r ' 9L0t/SL/6p uoge��dx� la • uoiss, 03 ,� + ?— �.6£9jo. VIV U0'r sfpp = aQ 'la Z i art SQ is PUJ99 s BLSSpL-S IOXV . OjL . �osri�a O 'aSVa3( aJpS ol�gnd/o ltuia/*M6a21 6u!Pl.h"u J Uedaa spas 8 oesSeW �e rpnarl�Ttn�r.cueal� 1/b/AcccJJCcc�[cJe�J �• Office of Consumer Affairs&Business Regulation License.or registration valid for individul use only (. OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: JP egistration 1.7349.2 Type: Office of Consumer Affairs and Business Regulation Expiration 10/9/2016 DBA ! 10 Park Plaza-Suite 5170 .._ .. `.. . :. ; Boston,MA 02116 1 ALL CAPE RENOVATION MCHHMED RAHMAN 66 CENTER ST UNIT11=2: DENNISPORT,MA 02639 Undersecretary VNot valid without signature X } � a Assessor's O£fice Q§ oor) Map; ,/ 42�1_d Lot ®� Permit# �q . Conservation Office 4th floor) �' CT, Date Issued ,/Board of Health ,3rd floor)(8:30-9:30/1:00-2:00)A%✓ ,i 4A7-,�ti,'a 4- X'ngineering Dept.( rd floor) House#1 � °• 8 BE INSTALLED Planning$De�tor/School Admin. Bldg.) � A���%E Definitiv by Planning Board A�N 19 E AND ®19$ TOWN OPBARNSTABLE Building=Permit Application ,Project S1 ( Al Q5 ('Village �2 Address mil) :Telephone '7 1— '4 U 2 Permit.Request � MAY(a����� S p ti�l ,J (�/ ee �otal 1 Story Area(include 1 sto garages decks) ( �O square feet �q ,Total 2 Story Area(total of 1st 2nd stories YYA square feet ` Astimated Project Cost $ �oOO tb Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached. Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION D R RESU ING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 2- S`q 5 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. #9968 DATE ISSUED August 28, 1995 MAP/PARCEL NO. 249 025 35 Bee Lane s + � , r ADDRESS VILLAGE Centerville, MA 02632 _ - OWNER Eugene R. Biagi DATE OF INSPECTION: ' FOUNDATION FRAME INSULATION `6 FIREPLACE ELECTRICAL: ROUff FINAL - PLUMBING: �t a "ROU13-H1 FINAL z , GAS: FINAL S. 4EJC :' 17 1 � .- 3 ,FINAL BUILDING �• _� DATE CLOSED`:OU.1i rn: ASSOCIATION PLAN NO-_�; O .fi `oFIMEr The Town .eof Barnstable BA MASS. • Department of Health$ie y and Environmental Services f MASS. o39. � Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection Location J j P. /ti r Permit Number �'q(a$� Owner ~ Builder One notice to remain on jobsite, one notice on file.'in Building Department. f The � following /(items need correcting: 1 / l AJ ll 0I//o Pe.2- / (31 it1 P PcX / / y r-(o 0 It, 4 2 4-9 Q..- .- . w. 1, i t Please all: . 508-790-6227 for re-inspection. - J Inspected by Date j _ ZG��'� A - - 1, �,� w4..F+..•.,a....,1�:w..w..yn....�....r_r.v' . �r-k , _.. - ,,.,R . . rr .. �. ra-. � .�.".�•^t.ro's,.,«-.,-....i..... ..- ,.r w: �11"4E►° The Town of Barnstable BARE. Department of Health Safety and Environmental Services MASS. 059. �EDna+°�0 Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection v2 �•.- Location 3 S Rp Q_ 4,U Permit Number 9 �v Owner Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: © J r i re a r 6-N --Vq -a.0..- G frt-f fn 0 o n u -'JAI=2__- 14T GO 5 A)?ZS 7r •8.2 3 1 O Please call: 508-790-6227 for�r-�j-inspection. Inspected by Date DEFT L" s��w $81 i i 2i i 1z2. . } COI,un,4 InU/FiQLUL of Maaach"dead � • ��QQIilJiiliL O� � "t II �s 600 9�U��st, James..Campbeq Comrrriss�oner Workers' Compensation Msm=ce Affidavit with a prindpai place of busmess a� a(�Z/k) TIL e�nsemrzt� do hereby certify under the pains and penalties of perjury, that: O I am an employer provid'mg workers' comp:cn coverage for ivy employees this job. , Insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. O general contractor or homes (�one) and have I am a sole proprietor,eonaacrors Usced below who have the following workoeW oonnpensaaon Polidm Contractor Insurance ylPoiic Connraaor Iasucaace Company/Pofic Contr- - ' r Insurance Company/folic nun a'h med performing all the work myself. t L'nQBi:tifl6:i.3L 3 CO�'/of tf be ferw ded to tte OlffcL'of InveWpft I!at dM MA for=verMVG =d f (range a re=•-td and of tin teal to the lrnooaic'of aunt paw d a tGoe of up to S 7 ire ' t as o Ides of s STOP WORK ORO �sd a tine S t00.OD a day�pq��+—� Signed th' day of �,zr�.�see�Percnit=ee Btutldzng �epa�nt . Licfmsing Board f .c TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION Number Street address Section of town IIHOMEOWNER" ll�• C i -7-7 y0 2(0 Name 7 7 !�— 26.1? Home phone Work phone PRESENT MAILI NG ADDRESS 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 such homeowners to engage an n dividual for hire who does not possess a license, provided that the owner acts as supervisor: DEFINITION OF HOMEOWNER:. Person(sY who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 acCe�ptable to the Building Official, that he/she shall be for all such work performed under the buildingres onsible permit. (Section 109. 1. 1) The undersigned .."homeowner o assumes ,responsibility for compliance with the Stat Building Code -and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies t he/she understands the Town of Barnstable Building Department ' ' i spection procedures and requirements and that he/she will comply ith said ! cedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be re uir to comply with State Building Code Section 127. 0, Construction Control. ed b HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section log. 1. 1 - Licensing of Construction Supervisors) ; provided that. if Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q for .licensing Construction Supervisors, Section 2.15) Rules. and Regulations often results in serious problems, This lack of awarenes P , particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed. Supervisor. The. Home"diiner`actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her. responsibilities . man communities require, as part of the permit application, that the Home -Owner 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 to amend and adopt such a form/certi f ication 'for use in your community. 1-'o 1�tAG t Rate,Dam Cc El `Te_, , S tot-I — -- In1< �XtS i lnrG �w�Z.4�s G v i i �i �ooTLN G pJ 2l� ��CAB T� 6J�✓L 3 Z " CI�SKL4 N C W Sties C S ion S'tatia 3 �� �,�cu-,'lr 2-2x6" Act may. S'n,nA,N� VA co" OIC �,► o�8ta i(LS o N ac< I C 02-P l 4 2X�' �.1� CA--rV- �vs�S eoj-�CA... l�CraGk --2 RAT- I It GX ,TWG 2Xl2" G�C�stwc bW ttL(Nc I t �1a,e,2(Wc i 91 VX P, /7- �(—Ywo C) 0 c Vl �oQ �1Gew . �LpC92�I�G 2 3 2� L�X S t —T>LYwoo a � 3- 2�x1Z" X 16 ' o/e _.:. ._._---------__-_. t I i f Roo- . 2-2XVX gr _ j - plc �• h• 1 AJ 2AF 2.IC(o )C 1 V. Ca iL o 6 -ti 2_ax� t 1 Q P I 2-9 ` -3 x - eoNcQ�� 2 N, I 7'C01 ��s � 1d� C�rc ��•�'ttY • � � � . � �� D,f, D� � ?cam /'41�,e� ' •! �� �. _..__.-__ f 80 a DIY r��. f� ^ '} • it b A AA r s- �8=�� ` _ -7y P ... ............. ........... ------ 71 in Hs ................... 77 -7� ol s• ,r RANG SA7"/y + / s-P.� 7-a L t Cc- t CLOS. b2ES C2 tj i 5r0 " 9 , '044 � u 7� 18M G 10 7 i441E .tires .fit As.yi.vG Al 46 rl : C- 20rpR^ l 1 q �e :i '3 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION w , Map Parcel Q Permit# o V Health Division �'� GnC � Date Issued a _ Conservation Division . Fee a Tax Collector to o Treasurer llqI�& Planning Dept. SEX .. .5 2GY1` Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis By Project Street Address Village Owner tL i C. i Address L ��N Telephone J-6 — 0 2 Permit Request I-` ° Square feet: 1 st floor: existing proposed 2nd floor: existing proposed �1Z Total new. ,012-C00 8 Valuation : k- Zoning District Flood Plain Groundwater Overlay Construction Type L u M sc- Lot Size Grandfathered: ;.Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Or.. Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 Historic House: ❑Yes UINo On Old King's Highway: ❑Yes 4 No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing 2 new 4� Half: existing new Number of Bedrooms: existing � new _ c Total Room Count(not including baths): existing 7 new I First Floor Room Count 7 Heat Type and Fuel: P Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes &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 C° Telephone Number Address 3S BEN License# 0.� 1,�'�2 L. C Home Improvement Contractor# Worker's Compensation# ALL CONST 5IIO�N DEBRIS RES TING FR HIS PROJECT WILL BETAKEN TO � D�.�N SIGNATUR DATE ?— R ' r FOR OFFICIAL USE ONLY •`� � low.- PERMIT NO. b, DATE ISSUED a MAP/PARCEL NO. 1 T Ma. 1 r i ADDRESS ! VILLAGE OWNER%, DATE OF INSPECTION. FOUNDATION q FRAME ('�� { INSULATION FIREPLACE ~ ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT i ASSOCIATION PLAN NO. The Commonwealth of Massachusetts —..... Department of Industrial Accidents 600 Washington Street Boston,,Mass. 02111 'Workers' Com ensation Insurance Affidavit name: -� vG , \-� 1 location city I k-�,q y l-1 L..\ phone# 7?`'YU 2C I am a homeowner performing all work myself. ❑ I am a sole proprietor and have no one worldn in any achy VIA �j /� r/i,%/WEMON, workers' ensationfor mv employees:woritingon.this:job......::::::_:;.Y;::<.;:::r:::::: am crop Dyer Prwi......................... :::..:::::::::.::..:...:.:....,,,:.::.::..:::::::::.:...:.�::::::.:......::.�::.�::::.::::..................:.:,..:...,::.,:::.....::::..::.::::.�.:�:.Y:;:.:;.;:.;Y:.::.Y:.;;;;::::::>::: . ::::}.. :: cam any Hamer.. ......::: ....: ................. .......:............................:........... stldress.>: .............. :: ::::::::>;::• s .....::»::>::>;:<:»:::>::<:<.:: > >::::::< :;:»::: ...::::.......... :.:.....:::. .::. oil �nsmnce co ////�; ❑ I am a sole proprietor,general contractor,or homeowner(circle on and have hired the contractors listed below who have coo the nvnaomwemsg w.orke 'co.. ensatio:.a.::polices: .. :.:...: ...:.:.::.:..},:.}.:::.:.:.:....:.:.:.:.:. . . .:.:.:.. } .:::.............. . .....: : . : ' ; Y :, :: ; ; ;. ...:... , .... ................ . ..Nmi MR ..:.:....:.:......:.: :v::.::•:}i}i}Yiiii'•ti+?CY:::j'-.,-::r.v} ..:...iti•}::4:ji'i'•ii:'ii:•:i•iii?i:::......:. ... ......... ........... .................. ......... :w::::.v:{d}:+.::v.v::::$?{vr'•:Y.vn•{.,•L.. •...........r.......... .....,.n• ...........:..........:::::v:w::v::r........., .........:::.. . ...:::...::.:•.Y.:•Y}Y:3}:r.�Y:{{:;}}:}:±?.........:^w.....:..........................::•: ................................................ .............:v........... ...::::::.....,.,......:v:::n..................,.........•:�.v w::......... : ..-.....:...k........•::::v:;.}w...... ::...: ............... v,.?J,}Y<'r::?:i$ii'...... .:. n..::v::v...........::?}:•.......-.<.,..,....... .-..........x.,r....-... ...: n•.v::nn n........}r?x,:?.:.:?•: ::..:.:..:.v•Ati?•}:r,::v;..}}:::::;{-': 1117 say Ham :. .. ............ :.:.:• ....:::: . .. .... address: 0 ne .......::::::................::.. ............ cl .. .............. ::::v::Y}:v}}i:4:}:}Y:4:+.�;:?4;}i:•;}:?•::{Yti^}iii:'.::.�::..:::::::.:::::::.}:w:::::.::::•r.i'::.::.::::::w::::.:;x:x:v.}'::. •..:....:'•'::8:?{ih}:?v�:w::r:...... ...... ...................::•::..,•::::.v......':;{:::::Y::::ri:•}:{•i:•}YYYY:i?{{•:?:iiiii:�i:t:isfi:{:iiiii :<i><�::?i:i'.G::,::iiii ii ii}:i:tiJ(:}iiiii:i':;:?i:{::�..:...... r:::ryy.Y vv::•::.i::.:::::::::Y:•Y,.:}...::::::..;:......... Fwb a to secure coverage as requited under Section 25A o[MGL 152 can lead to t1u imposon of erlmiasi penaitia of a sae up to understand and/or Dun ye'rs'tmprisomnmt as well as�p�ajfl tl�e form of a STOP WORK ORDER and a sne otS100.00 a day agshut me. I mtdet>tmd that a copy of this statement orwatded to the O of of the DIA for coverage vetisation. I do herc certify under the pains and pen erjurq that the utfornta ion provided above is tru.and caned Date signs # `? `7 I �--`�f��(o • Print name ` 1 1 official use only do not write in this area to be completed by city or town official permt/uranse# ' ❑Budding Department city or town: C3ucensing Board ❑Selectmen's piste ❑check if immediate response is required ❑Health Department r contact person: phone#; ❑ (tevaad 9/95 PJN Information and Instructions J r for Massachusetts General Laws chapter152 section 25 requires all employersoprovide the serviceworkers' another compensation any heir employees. As quoted from the law", an employee is defined as every person Qmnc 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 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 c l building appurtenant thereto shall not because of such employment be deemed to be an employer. that every state or locacens enev MGL chapter 152 section 25 also states l liing agency shall withhold the issuance at who of a license or permit to operate a business or to construct buildings in the commonwealth for any pp lican not produced acceptable evidence of compliance with the insurance coverage required. fo��ce Additionally, nc ier the �1 commonwealth nor any of its political subdivisions shall enter into any have been presented to the contracting acceptable evidence of compliance with the insurance requirements of this.chapter authority. si/,i-' %// JMMN oFff Applicants ' compensation affidat completely,by checiang the box that applies to your situation and Please fill in ,he workers comp + , with a certificate of insurance as all affidavits maybe supplying company games,address and phone numbers along a ,moo be sure to-sign and submitted to the Department of Industrial Accidents for confirmation of insurance coverag • or license is or town that the application for the permit date the affidavit. Ile affidavit should be returned to the city have an questions regarding the"law"or if yc big requested,not the Department of Industrial Accidents. Should Y� y are required to obtain a workers' compensation policy,please call the Department at the number listed below. City or Towns bl The Department has provided a space at the bottom of f Please be sure that the affidavit is complete and printed legibly. the applicant. Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be zetua t" or FAX unless other arrangements have been made. the Department by mail The Office of Investigations would Ile to thank you in advance for you cooperation and should you have any questions- please do not hesitate to give us a call. The Pent�ess,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce of lavesdeadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 710 QNR Appends! Table JS=b(eaadaaed) pmeriptive paeicagee for One and Two-Family Resideadai Building Sated with Fossil Fneb MAXIMUM � Glazing Glazing Ceiling Wall Flaar Baa�mt Slab �COO� �°P!°� Efficiency' (•/.) U-value= R-value' R-value' R-vaivar Wall Pt Package R-vduo' &vaiud 5701 to 6500 Heating Degree Dam Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal 9 12% 0.50 38 13 19 10 . 6 95 AFUE T 15% 036 38 13 23 WA Wf Normal U 15% 0.46 38 19 19 10 6 Normal V 15Y0 0.44 38 13 25 WA WA 83 AFUE W 15% 0.52 30 19 19 10 6 83 AFUE X 18% 032 38 13 25 WA WA Normal Y 18% 0.42 38 19 1 23 1 WA WA Norval Z 19% 0.42 38 13 19 10 6 90 AFUE AA 18•/. OSO 30 19 19 10 6 A1�[JE t 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: c. Z 4. %GLAZING AREA(#3 DIVIDED BY#2): i9 SELECT PACKAGE --AA-see chart above): M 5. (Q NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and, basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented.by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. `Waal R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `7) a entire opaque portion of any individual basement wall with an average depth less than 50%below grade must Me--,. the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned br,..ements must be included with the other glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4,or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efftciency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c) If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- e equal to the U-value requirement(0.35 for doors). value of all windows or doors is less than or q 43 CF IHE Tp� The Town of Barnstable &6"SzABLL S& ���* Regulatory Services 4',,rEn 59. Thomas F. Geiler, Director, Building Division Peter F. DiMatteo, Building Commissioner 367 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 Work: NJ's D k N(, 2 6_1' _ Estimated Cost E k Address of Work: Owner's Name: N `G �G Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law FlJob Under$1,000 []Building not owner-occupied Vwner 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 E Date Contract ame Registration No: Date Owner's Name q:forms:Affidav:rev-070601 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 =- 'Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE kuare feet x$96/sq.foot= 7 t V x.0031= a- plus from below(if applicable) gat r1^ ' ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0031= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft i >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq. foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) GOP / Permit Fee 1 ` projcost �1Ld�oSy VT\vr-• 3 r� Lp.w 2 tic(—0 ZS rc�1ST1�6 Uwcu.tN� 1 i i i 'i 2x G N + 6 F X feX�a tip. 'w au Ott- 4 Co x •' tx6 cG au� �cr�tic. &V F 3/�t Z.x6 X �`t` �'s�►L��N'� �1s�-tn,6 1 � N �tnce ----------------- t � �4a�o►w� !'�O��4ti.o I � os S�ZQc 4 � rt _ I o t�s�T q4 D 1TI0A, N o -r IA��.t� W�vcA�5' o r o Tv A �t.�,v A►r�o� a tact 20 0 u�'h lb a ADD tTtnN 2No � �'►Frttit Y �`Lbs2 W C�.frINC. li WgLW tNArLLA, • tN C e s T ock 4 D CT t o A j A) o Z LA e-A i-b4x tN 1 v(,A-►a.A vD JG7L 1Li 13 A C ! LQV AT1d ti I RANGE /y ; ..S le;( 7-$' Li 1 1 �•' y _s /���`x /3-fir � • � M tq) 0\ ,�Op THE Tq� The Town of Barnstable • BAMSrAet.e. - MASS g Regulatory Services Q, 1659• �.� Thomas F. Geiler, Director '°rEo na't Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE EXEMPTION Please Print DATE: l ,� JOB LOCATION: street village number "HOMEOWNER": GZ'k-, work phone# name home phone# CURRENT MAILING ADDRESS: O 2 63Z. state rip code city/town 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,nrovi�at the owner acts as supervisor. DEFINITION OF HOMEOWNER a parcel of land on yihich he/she Person(s)who owns he resides or intends to reside,on which there is,or is hed or detached structures accessory to such use and/or intended to be,a one or two-family dwelling,attac farm structures. A person who constructs more than one home in a two-yearperiod o shall not be the considered a homeowner. Such"homeowner"shall submit to the Building official Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeow er"assumes responsibility for compliance with the State Building Code and other applicable codes,byi s,rules and regulations. e undersigned"h*!es he/she understands the Town of Barnstable Building Department minim and requirements and that he/she will comply with said procedures and req 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." P the responsibilities of a supervisor(see Many homeowners who use this exemption are unaware that they are assuming 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 i pities re ultirely responsible.s part f the permit To ensure that the homeowner is fully aware of his/her responsibilities,many application.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a d and adopt such a form/certification for use in your community. form currently used by several towns. You may care t amen Q:FORMS:EXEMPTN 3. J Ezi8neerin =De t.' 3rd floor g g � ( ) Map o��� Parcel Permit# House# ,�� Date Issued Board of Health(3rd floor)(8:15 -9:30/1:OQ'-4:30), 9-1-71 q r Fee Conservation Office(4th floor)(8:30-9:30/1:00 2:00) SYSTEMS - Idg.) STALL PL6ANCE D "19 5 r• ='ENVIR0 ODE AND TOWN OF�BARNSTABLE TOw TsoNs Building-Permit Application , Project Street Address Village UL v Owner oG Q-�') \ G 1 Address Telephone 1-7 '1 0 2.�o ` Permit Re uest 6 G � Q� � ��2� N-(::�D 1Ti o b _ ��` S-j-1ki G `First Floor v square feet Second Floor , square feet Construction Type ' Estimated Project Cost $ 00c) "_ Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family I Two Family ❑ Multi-Family(#units) Age of Existing Structure 2-71 42 S Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: W�Full ❑Crawl ❑Walkout ❑Other LJ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0'0 8 Number of Baths: Full: Existing 2— New Half: Existing New No.of Bedrooms: Existing 3 New —Q- Total Room Count(not including baths): Existing New �. First Floor Room Count G Heat Type and Fuel: CYGas ❑Oil ❑Electric ❑Other , Central Air ❑Yes R No Fireplaces: Existing New Existing wood/coal stove ❑Yes 00 -, Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) €, ❑Attached(size) 2 Qi 1 ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes L.No If yes, site plan review# Current Use Proposed Use Builder Information Name �G � '� Telephone Number 7 G 2 -C Address (dvN' License# W�J V� Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRI TING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU E DATE ! (1 BUILDING ERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY _ PERMIT NO. J d ` DATE ISSUED T MAP/PARCEL NO !t F , '• ''r y ADDRESS: a VIL"`LAGE P ! t a t OWNER DATE OF INSPECTION: `o FOUNDATION FRAME INSULATION D/ �►�SL� •1 �'� ��'9I c ' M `" FIREPLACE ELECTRICAL: ROUGH FINAL- ' PLUMBING: ROUGH FINAL GAS:, ROUGH -. FINAL FINAL BUILDING-? Z�- m DATE CLOSED OUT' ASSOCIATION PLAN NO.� ! cu zz a D, o,?oo � h .7 11 r . I 32 i 27� '''� .. .�-. 17' ,Qr I s 4e 17 .SM .e i . D 1 T1uti • - - - - - : i i i 4 I 1 Cie I 276 , Td` V\rclN 70 r.- Pti�I 10^I 1 . f 1, -}poTlNi 7-Z.7-R8 r u ... 2 2-LX� �t P�a�► r2,-Nei( 'bw 2 0t_ ZE; AU 2 - Lx`l•x 8` a ►.► ABC. Co�roaa,3 Lf X S K'�2 SIDING 2x� t�Z�s71�c 5ug rc'��.N• 2.)( 1 I TOP U�Gw G 4 -7—17—Qi i Oxo g• i S,o t } ?_t? -At. Vp KiTcXL--, • 1 2 2xlo`x7 S7.5,,CX eA o 2 v w ` � � 1 4;;b(2AL dh e 7_0-8 O - O r� k- t , 2 : O � f S „ �Dt 10 11 - _. 11/NAw JN CLOS- �b2ES se? � fib ''! L L ��•.�� _ .�-f� 1 � �E O i � f �f V IBM G 101 The Town of Barnstable NAM �' Department of Health Safety.and Environmental Services iismo Building Division 367 Main Street,Hyannis MA 02601 Ralph Ctossen Office: 309.790-M7 Building Camtaissio::: Fax: 309-790-6230 For office use only Permit ao. Date AFFIDAVIT HOME IMPROVEMENT*CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c I42A requires that the "nmustrucdon, alterations, renovation, rzor, modernirstion. conversion. improvement, removal, demolition, or construction of as addition to any pre-ezistin9 g units owner occupied buit2idj2c containing Sh t�least one or butilding be done by registered cot not more than four ntractors,or h structures which are_ 1 certain exceptions.along with other requirements. 7000 7 Type of Work: ' `-• ` Sc� f-�,'j0i 1v^ Est.Cost Address of Work: Owner's Name L�LADate of Permit Applleation: 6 I hereby certify that: Registration is not required for the following renson(s): Work excluded by taw _ _ ob under SI.000. Building not owner-occupied Owner puiUag own permit Notice is hereby gives that•. OWNM PULLING 'HE OWN PERMIT OR DEALING WITH ONREG� IR CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE AC t SS TO THE,RBITRATION PROG:tAM OR GUARAf=FUND UNDER MGL c. 142A SIGNED UNDER PENALTS OF PER.IIJRY I hereby apply for n.permit as the agent of the owner. Date Entmamori'lamme Registration No. OR Owners Name Date The Commonwealth of Massachusetts Department of Industriirl Accidents ;� � :, ; __ _�� Olfice ntlnsestigations -' £= 600 Washington Street ;+."r Boston,Mass. 02111 Workers' Com i0sation Insurance Affidavit / name: G �� location' =Z— V ` "J hone# I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 7 1/ ❑ I am an employer providing workers compensation for my employees working on this job. com anv name: address: city phone#• insurance co. 201icv# ////%/////////////////////Gi, ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: . .... .. company name, address- :::.. dtw phone#� insurnnce cn. cam anv name- address- phone phone#• insurance co. Failure to secure coverage as required under Section 25A of NIGL 152 can lead to the Imposition of criminal penalties of a One up to s1.500.00 and/or one years'imprisonment as well as civil enalties in the form of a STOP WORK ORDER and a One of$100.00 a day against me. I understand that a copy of this statement may be forward o the Office of Investigations of the DIA for coverage verincation. I do hereby cerd der the pains a es of Perjury that the information provided above is true and coned XSignature Print name Phone# official use only _ do not write in this area to be completed by city or town official city or town: permit/license a ❑Building Department ❑Ltcensing Board ❑check if immediate response is required ❑Selectmen's rtm❑Health Department contact person: phone k; ❑Other (revues 9/95 P1A) 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 contraac 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 . 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 to tin maintenance , construction or repair work on such dwelling house or on the grounds o: aGM- ..,..,....r.v�.. t•v.r..-- 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 renew business or to construct buildings in the commonwealth for any applicant who h of a license or permit to operate a a 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. No Applicants W ns 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 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. 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 permit/license number which will be used as a reference number. The affidavits may be redimed io 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,io not hesitate to give us a call. W ei% The Deperunent's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents 11mce of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) 7274900 eat. 406, 409 or 375 WC34RAppmjdk, Table J&Ub(eondauaQ Fmcriptive Paekaga for One and Two-Fan*Residential Buildlage Anted with FaW Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab He WnWCooling Anal(Ve) U value= lt value' R-value' R value) Wall perimeter E wpmm E den pie it-value, it-value! 5"1 to 6500 Hndag Degree Days' 12•/. 0.40 38 13 1 19 10 6 Nomud R 12% 0.52 30 19 19 10 6 Nomml S 1251* 0.50 38 13 19 10 6 83 AFUE T 15% 036 38 13 23 N/A N/A Norma! U 15% 0.46 38 19 19 10 6 Normal V IP•/. 0.44 38 13 25 N/A N/A IS ARM W 15% 0.52 30 19 19 10 6 IS AFUE X 18% 032 38 13 23 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 12% 0.42 38 13 19 10 6 90 AFUE AA Ir/. 0.50 1 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 0, 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: r 4. %GLAZING AREA(#3 DIVIDED BY#2): S. SELECT PACKAGE(Q--AA see chart above): 11 NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. r BUILDING INSPECTOR APPROVAL: YES: NO: q-forms-080303a 780 CMR Appendix J Footnotes to Table J5.2.1b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space, but excluding opaque doors)to the gross wall area, expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used. ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 insulation and R-38 insulation may be substituted for R49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion^fthe roof `Wall R-values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example, an R-19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned cmwlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements-are for unheated slabs.Add an additional R-2 for heated slabs. ` If the building utilizes electric resistance heating use compliance approach 3, 4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1 a NOTES: a)Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable levels. R-value requirements are'for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component. Glazing or door components comply if the area-weighted average U- value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE �� i�U 0 JOB. LOCATION Number Street address Section of town "HOMEOWNER" � C7� Name Home phone Work phone - PRESENT MAILING ADDRESS �L 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sl who owns a parcel of land on which he/she resides or intends to re- side, 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 accaptable 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 Stat Building. Code and other applicab4co by-laws, rules and regulations. The undersigned "homeowner" cert he/she understands the Town of Barnstable Building Departs t mspection procedures and requirements and that he/she will com y with dures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home ' Owner actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/ner responsibilities, man communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. f MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Onlv(800)392-6108,FAX(800)851-8424 41312010 Form of Notice of Casualty Loss to Building Under Mass.Gen.Laws,Ch.139,Sec.3B BARNSTABLE BUILDING COMMISSIONER 367 MAIN STREET 367 MAIN STREET HYANNIS MA 02601 Re: Insured: EUGENE R.AND LINDA BIAGI Property Address: 35 BEE LN,CENTERVILLE, MA 02632 Policy Number: 0906190 Type Loss: Water Damage:All Other Damage Loss Date of Loss: 03/29/2010 Claim Number: 275086 Claim has been made involving loss,damage or destruction of the above captioned propert,which may either exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any notice under Massachusetts General Laws,Chapter 139,Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured,location,policy number,date of loss and claim or file number. MPIUA Claims Division CMA00021 — n - pFIME T Town of Barnstable M Regulatory Services i 11 r BARNMBLE. y MASS. g Thomas F.Geiler,Director �A 1639.rFouno'�6. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 July 22, 2004 i Eugene Biaci 35 Bee Ln. Centerville, MA 02632 RE: 35 Bee Ln., Centerville, MA, Map249 Parcel 625 Dear Eugene Biaci: It has come to the attention of this office that an existing shed on the above property is under renovations. The shed is existing non-conforming and by itself is not in violation. The work being performed; however; is in violation of local zoning ordinance as well the building code. The shed must be restored to its original footprint or a variance obtained with the proper permit to perform the work. A stop work order has been issued and you must contact this office to resolve this issue and have the order removed. For any questions, call (508) 862-4034. By Order, Yee y Lauzon Local Inspector Q:zoning5 16-26-2000 01:59PM CENT OST FYREDEPT 5087902335 P.02 Bugd*Dear y5e Coffipl�tq' 'Y � _ - i fie•__.l© C�G C a, Itw'd bp: Aumces No... j Pit i hivpl i �rigY�tator Nam W� f comptaw Dv dLC i ► f , �f Ej s o CwY Usa r. ,r�• I�spcctoz� f { Action a i , • i 4 f AddWoraJ Into.A�tdted Ot+'gAvibudw: $vie•De F* TOTAL P.02 Crai � ville � eac g - ,_ - -- Cape, Olil C 86ePe urn`, s�11 Crag a Beach,Centerville z Cape Cod,Massachusetts An aerial view of popular Craigville Beach. ;y2 S miY �,, � 7 Ph o by Jim Abtsprep r �� CO N 6LI 1 .L x , E p t L� 61OV/VIVA r ✓ `VVV '_ ISE s \ � !i try.-'�- A• � _ _ ._ a 5 'A)WN OF BARNSTABLE BUILDING PERMIT APPLICATION , ,r F� Map' Parcel yZ Permit# Health Division AS u r /Gi 7/ c-;'_71-0Y Date Issued 2112401 Conservation Division 7 Z� �� , k, Application Fee Tax Collector Permit Fee d� A55.6P4 Treasurer SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE Planning Dept. WITH TITLE 5 Date Definitive Plan Approved by Planning Board ENVIRONMENTAL CODE AND' TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address ��N Village � t 2V kc Owner IN U(k l{ G I Address Telephone f`CR — 2 ? 1 "' If 02J� Permit Request Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 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 33 YC4 Historic House: ❑Yes Colo On Old King's Highway: ❑Yes © No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 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: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ 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 Cl Yes ❑ No If yes, site plan review# Current Use Proposed Use --------------- BUILDER INFORMATION l- Name �vG` Telephone Numberb G Y Address 3 �S R �— "' License# � v ` L Home Improvement Contractor# Worker's Compensation# ALL CONSTRU DEBRIS RESULTI G FROM THIS PR ECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY i PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS " VILLAGE OWNER _ DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUCgH FINAL GAS: ROUGH -ti tJ FINAL FINAL BUILDING m rnC = �� DATE CLOSED OUT An 's, ASSOCIATION PLAN NO.M t� oFt Town of Barnstable - °� Regulatory Services BARNs'rABL6.MAM Thomas F.Geiler,Director 1639. p Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-8624038 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. r Type of Work: �cz� 9 X Estimated Cost Syo Address of Work: 3 Owner's Name: l A- PC i Date of Application: _ Z 7 —p y I hereby certify that: Registration is not required for the following reason(s): [:]Work excluded by law. ; E [}Job Under$1,000 Qguilding not owner-occupied ROwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby a r a permit as e a at-e a�er: Date Con or Name Registration No. OR Owner's Name Q4orms:homeaffidav The Commonwealth of Massachusetts Department of Industrial Accidents" 660 Washington Street Y Boston,Mass. 02111 . Workers'-. Coin ensation.Insurance Affidavit-General Businesses - ///� •�',.. •.^.:k.. :.%cr.afd..,"T'w. •• «..v'•.. �.+.i.: •+:i: tdU), / , name: � •_ �?: •. X l A.G-��� , . . ;;. ._. - :•�- address: 'L 2 state: / __'_ ziix , O�Z.�I hone# work site location full address): ❑ jam.a sole proprietor and have no one Business'Type: []Retail❑RestaurantBar/Eating•Establishment working in any capacity. Office[] Sales(mcluding.Real Estate,Autos etc.) ❑I am an em [over with em to es(fall& art time Other �I am an employer providing viorkCrs' compensation for my employees working on this,fob. :\t :.il tit::l:t: •. •!:• p•' .S:'';: it:l' i+ 4 i .:'i.•..5. i:�'{'+ •C.t . coin •iidme: - t.: ..:ear• 'i.. 'a •••• ':: '.t '!!,'.••'t• ..S '•� ..S::.t'. .,ter. `+f i .<•t'� i• i f:i.,i:,u.: ;•�,: .t>jt�, '�°t. .. ed$ress: _ r...•: :!' s ' ::,.. :i'. K+ ',4• 'rR i rpre'' ••4.••' Z' ..l`. .. �'t': SAY: .1� ,.� ... hone# \' ly• + . ..1: •l t.•i,y :y ii'ie:•.e �� .irisiiarice.cars •�: I 4. am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: tV com an 'narire: aildresse. :`: ci "a;,.•; , ..;t:ri .'i'• .'`r'..,a1 •r'•f_',:' .. ::I'• -,Z'''Ac,i,. �'.T•. ::�r+ 'i�::�.t..'ff.. ::.c' - "�4 i.:."' ;� YU'11C :#�'. •;i�,Q+:.��Y• :r::"•(''t..:�.i insm•ance'co.. ,•r••.,_,.;.._;.:. , e.W. +., fit:.•.. _ j�/�����j� —•!:•.•;; :•J:^. .,tiy:: _ ��. .n..i9. :.1-i :fir.:f:s .:.i. c�m�eri riaa�e war ,.••,: - iddressi .. . .: %. .c..•, .:ice •:�:; i.' ;��tt i7t1� . •.1:,'f. .tr;,•::. .k.t N. �.� i>,.•.r is ::` :1:;'.�1 .:j„~: Insurance•cb:•J Failure to secure coverage as uired an reqd Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civfi pe as In the foim of a STOP WORK OVER and a fine of$100.00 it day against me. I understand that tz copy this statement maybe forwar e o vestigations of the DIA,for coverage verification. I do hereb ify under the pains.and penury that the information provided above is true and correct Signature Date •✓ 7—�� Phone# P < official use only do not write in this area to be completed by city or town official city or town: permit/Reense# ❑Building Department . _ LILicensing Board ❑check if immediate response is required . ❑Selectmen's Office ❑$ealthDepartment , contact person: phone#; —❑Other (evi+ed Sept 2003) . Information and Instructions. Massachusetts General Laws ch*pter�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 rngre 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 employspersons 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 bean employer, MGL chapter 152 section 25 also•states thatevery 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. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation Please supply company name, address and phone numbers along with a certificate of insurance as all affidavits 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 ofindustrial Accidents. Should you have any questions regardin4•the 'law"or if you are required to obtain a:workers'.cornpensationpoliq,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 permit/license number.which will be used as a reference number. The.affidavits•may.be.returned to the Department by.mail or'FAX.unless other'arrangements have been made. The Office of Investigations would like to thank ybu in advance for you cooperation and should you have any questions, .Please do not hesitate to give us a-call.. The Departmenfs address,telephone and fax number: , The Commonwealth Of Massachusetts Department of Industrial Accidents erg"of Wesnptfens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 phone#: (6I7) 7274900 exL 406 oFI„E r Town of Barnstable Regulatory Services aAMffABM : Thomas F.Geiler,Director �b 1639. 16 Building Division AT�O f�Ar Tom Perry, g Buildin Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION A ' Please Print DATE: � I JOB LOCATION: — — C ,�N�" `�L C number street village "HOMEOWNER": name (� home phone# work phone# CURRENT MAILING ADDRESS: 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 ws rules and regulations. The undersign d omeow r"certifie at he/she understands the Town of Barnstable Building Department minimum inspe roced requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. . HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt yri.f ' ,{ - k i C, �'"{'f Y(s':•���d'1k g,."`nhS _'T�,;�'�ar. -:y�9. }.�;uCrfxy� � '�yy�, �}4.�.��s}'�} Y.3.7E.. 'M1I... h "s�9�i.i +.m`3•+ i � .y mi c „"'�-,�, "+�iy_3, '.'�' - .. .F �. •, :�,v''•�'� �t k"IF:"a A.. .s��'rr., ��^'�i o:�!,`�S (�."�.� "'a�x �Y.e� +�°/��♦r'-�'�n _ . .. - '� - c :� :b�� �"s•�C r `` a.. V c� � ? 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PATH/TRAIL i — - - PARCEL LINE** 1 249 I MAP 326 E- MAP# 021-< PARCEL NUMBER 1 #367 ; HOUSENUMBER C, 2 FOOT CONTOUR LINE io 025 10 FOOT CONTOUR LINE I Elevation based on NGVD29 1 ' ---------- j' f X 4.9 SPOT ELEVATION J c:x-x-3 STONE WALL - X X FENCE -_ I ___. / _� RETAINING WALL — RAIL ROAD TRACK STONE JETTY f X� - ---- ----- - --- - ---- - rooL SWIMMING POOL •,' ,� \ _.._.... -. . -. ...... _.._........_.. ii\` r �, PORCH/DECK � ] ❑ BUILDING/STRUCTURE DOCK/PIER r Q HYDRANT e VALVE O MANHOLE ............................._..._....._..........__. 0 POST 0'P FLAG POLE T O W N O F B A R N S T A B L E G E O G R A P H I C 1 N F O R M A T 1 O N S Y S T E M S U N I T .o- SIGN ® STORM DRAIN M PRINTED SCALE:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetrics(man-made features)were interpreted from 1995 aerial photographs by The James 1"=100'scale map and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD o UTILITY POLE ❑4- TOWER e 0 )0 20 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. 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