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HomeMy WebLinkAbout0040 BROKEN DIKE WAY k ,�? ` . :� .�EO� . : �, Hof��e�� l�i�i�. , .. d .. ., ,.. .,.: .. r, ' ,a'. � .. '. ,. ,. � - � � c I - - `. I�� - - a _ - i � :. Town of BarnstableBuilding {Post This Card So That it is Visible From the Street-Approved'Plans Must be Retained on Job and this Card Must be Kept RAM 'Posted Until Final Inspection Has Been Made. Permit i639 cup oru ° Where a Certificate of Ocancy is Required,such Building shall Not be Occupied until a Final Inspection has been.made. - �. .. ..A., ,. . �- Permit No. B-20-1505 Applicant Name: SIRHAL, HUMAM K Approvals Date Issued: 07/09/2020 Current Use: Structure Permit Type: .Building-Addition/Alteration-Residential Expiration Date: 01/09/2021 Foundation: Location: 40 BROKEN DIKE WAY,CENTERVILLE Map/Lot: 228-171 Zoning District: RC Sheathing: Owner on Record: SIRHAL, HUMAM K Contractor Name:`�HOMEOWNER IS APPLICANT Framing: 1 Address: 36 BROKEN DIKE WAY Contractor License: EXEM 11 PT 2 CENTERVILLE, MA 02632 -'tea Est. Project Cost: $ 12,000.00 Chimney: Description: Replacing windows: ufactor 0.30- 16 double hung and 2 casements. Permit Fee: $ 111.20 I Insulation: Re-siding-cedar shingles @ 145 sq ft. Replacing 5 1/4 PTDecking : Fee Paid:f $ 111.20 with composite mat'I @ 140 sq ft. Rplaceing;PT balusters with Final: Feeney T316 01/8" cable rail @ 1000 L.F.Approx. y- s Date: 7/9/2020 Project Review Req: NO STRUCTURAL CHANGES f Plumbing/Gas Rough Plumbing: g ( - Y\Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the'approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for.public inspection for the entire duration of the Final Gas: work until the completion ofthe same. Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing r J Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection). Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site � C- Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT tp � -- gyp* Application Number..: .... �.........SDs........................... BARNSTABLE, KAS& Permit Fee............ ....................Zoning District.......................: 1 39. � � � of D Total Fee Paid.... TOWN OF BARNSTABLE Permit Approval by- ................On.......�.� �._a BUILDING PERMIT Q Map...:...�.�.V..................Parcel.........j.y-�..l..lI ........................... APPLICATION Section 1 — Owner's Information,and Project Location Project Address 40 6k0VZ1J �b,ttc.c: 6AY Village CE:m-n_-,tviLLt Owners Name buni Owners Legal Address 40 4&0 UANJ 'bttc6 WAY City e_t4-.tLV1 L . State MA Zip 0t`32 Owners Cell # Sod 3's-1 E-mail 91R4AL14 @ VtJLri,aa. A3ET Section 2 —Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet Commercial Structure under 35,000 cubic feet Single/Two Family Dwelling Section 3 —Type of Permit New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment © Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar } ® Renovation ❑ Pool ❑ Foundation Only Other—Specify Section 4 - Work Description 'p QEPLActw14 W rwlY\ainS u_r-At_7L/L h In @ 16 ppuJLLE-Hui . + 2 CAcrluwl4rc CEtS� S'H..u�,us S 1D 14S SQ.F4 y y REau)Ci,JG S t�� PT )Sr=M#A!' aur,N Coymoojnt MAT,11_ fis 140 SQ Ft I /4t�caai.�L, PT ieALuy1EAS W" FEF.ycY 'T31G d1le' CA-ALA RAIL Q1P 1000 L. F+ i9,Q�ok Last updated: 1/31/2020 Application Number.................................................... Section 5 —Detail Cost of Proposed Construction 41 z,oon.oo Square Footage of Project Age of Structure Dig Safe Number # Of Bedrooms Existing Total# Of Bedrooms (proposed) 110 MPH Wind Zone Compliance Method ❑ MA Checklist'❑ WFCM Checklist ❑ Design Section 6— Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors r+ H cPlumbing ,� ' '} ❑ Gas ❑ Fire Suppression �co�Ul?Ut�b . *•.� ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply ❑ Public ❑ Private. t 1 ' Sewage Disposal ❑. Municipal ❑ On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: I am using a crane C Yes ❑ No Section 7— Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No ❑ Section 8— Zoning Information Zoning District Proposed Use Lot Area Sq. Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed r Rear Yard Required Proposed 4, Side Yard' Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ❑ No Last updated: 1/31/2020 The Commonwealth of Massachusetts Department of IndustirialAccidentv Office of Investigations 600 Washington Street - Boston,MA 02111 www.mass.gov/dia - Workers' Compensation Insurance Affidavit:Balders/Contractors/Eleetricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/individual): Aft tc. fRM*L Address: 40. 49&o t c an / City/State/Zip: ou st-- Phone M S o6= 3`o- a''3 3'7 Are you au employer?Check the appropriate box: `N. Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I. 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 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,-❑Demolition working for me in any capacity. employees and have workers' t 9. El Building addition [No workers'comp.insurance comp.insurance. 10.❑Electrical required.] . 5. ❑ We are a corporation and its repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. Plumb' repairs or additions' [� ex � ❑ � myself.[No workers comp. exemption per MGL 12.❑Roof repairs insurance required.]t �t of c. 152,§1(4)9 and we have no employees.[No workers' 13.Z Other R rluovA na� comp.insurance required.]; *Any applicant that checks box#I 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. rContractors that check this box must attached an additional sheet showing the name of the sub-coutractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees Below Is the policy and job site information. G pEPT Insurance Company Name: �Q�'N Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: AR(vS�ABLE 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 enaltxes ofperjury that the info nation provided above is true and correct Signature: Date: t/4 o1" Phone#: T69 _ Oj kid use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.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 budding 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 constrict buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificates)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 lime. 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 to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike 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 Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617 727-4900 ext 406 or 1-877-MASSAFB Revised 4-24-07 Fax#617-727-7749 • www.raaw.gov/dia Application Number........................................... Section 9— Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: mwp2AM It JiRrie� Telephone Number 508_3eo_ ,f W7 Cell or Work Number S a8- 42a_ 8 s 4 t C.oi=�'. I understand my responsibilities under the rules and regulations for Lic�tmst3vction Supervisor in accordance with 780 CMR the Massachusetts State Buildin Code. I underst construction inspection procedures,specific inspections and documentation required by 780 CMR,a the f Barnstable. Signature Date oc/to/toLo APkICANTSWjNATURE Signature Date Print Name ftmA,,,,, k . Sig*A, Telephone Number Soft_,5&0 E-mail permit to: S-14"La P vt&t7_p-j . ti r Last updated: 1/31/2020 r Section 12 — Department Sign-Offs , Health Department C Zoning Board (if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department ❑ Conservation ❑ For commercial work,please take your plans directly to the fire department for approval Section 13 — Owner's Authorization as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name 1 Last updated: 1/31/2020 Town of Barnstable *Permit# GExpires 6 months rom issue date Regulat®ry Services Fee snarrsTAar e nrnss' Richard V.Scali,Director ; pTEO MP'i A . Building Division X-PROh Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us JUN 05 2015 Office: 508-862-4038 �OWAI OF,ax: - 08-790-6230 EXPRESS PERMT APPLICATION - RLSIDENTIAL ONLY f ABLE ^� Not Valid without Red X-Press Imprint Map/parcel Number ,2 Q 7 t9 / Property Address 40 g&ott&NJ ,4cl�,,e,6 WAY 64rJ&XVjU .� MA oLG3t_ [Residential Value of Work$ SA DO 'Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address I*jMAr'M It. R 14A L 40 fl�tolt� �Iltt t�/i!'1► P�1/f1eltNuaC y��,d OL 3L Contractor's Name Telephone Number 508_3 L a_f'337 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if.applicable) ❑Workman's Compensation Insurance' - Check one: ❑ I am a sole proprietor ❑ I atn the Homeowner ❑ I have Worker's Compensation Insurance - Insurance Company Name _ Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit: t Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles).-All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side [�Replacement Windows/doors/sliders.U-Value 0.30 (maximum.35)#of windows 14 #of doors: 3 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:. Properly Owner must sign Property Owner Permission. F A.copy of the Home Improvemen ractors License&Construction Supervisors License is required. , SIGNATURE: ' Q:IWHILESTORMSIbuilding pe ' s\EXP S.doc Revised 061313 © http://issgl2/inti net/propdata/iookup.aspx b Bing� P -:�- ,4 r `F40 avorites Parcel=Lookup, . Parcel.Lookup ,a a.; ��.. , y`"� t , b�:. - - � - .'� � ���' .��������` .� 4�i t ���� ages�Safety Toofs- w p mom �a •!t'i '�' i — { Street , 1 Stree# 8 �`# , AO � •� i �. �# *ram ��� �a � +� � � � .�" ems•..*� �t �"�`•E VE, -� d Street Namze BROKEtI as i � v ry ' ���^ �":&`°-.' ``�:�e��, :b�����✓w,€ ���,.ape a'�`'a ,. .— • Page 1 <PrevPgext>of Rows/Page. to =4 x s ® t . • I 228- 140 BROKEN DIKE �SIRHAL, I 171 IWAY HUMAM K CEN 0188 228171 _ _ - t .�^. r a -:....'Ga ... zi'8 - tA v=;#'t "" .n, e ..... Y 4^ a; .hg'...•.+w .o-,. r" s "" 7 $t 'Sr' Aw , �.d..,. j.L�IO + x�r �S#art s , ,: Parcel�Looku,;.,. � � � �-� �., ,� _ ..f C©m uter ��,.� 'Nl• Pte�#vvai�k�Pl I �_. �, Math,System Application . .!af% Y�. 4 a8 O;AM, . staff,MA C •'� .rss Tn� a� dersft"�n*��cfrFcz�lP�ru��� • ��mr�uuzd� Nunt,� !� . .1 i��_ Pig-Y�iu.:��� . Nzj= - - Address: 4D Pho=f- $b -_ !j2p g .. AreytFa zu q3plo�g t ta�bG= r�af�ed Cam}= 'L El am a evaplaprt via d-.❑ I ansa i rtmfr�rhsr�$Z I}Fe:w eIapees{€�Il andlrir P �* h �lthe El I.na a sofa grog orparfner- Iisfed as wed shy 7- ❑ g ship axed have nz etapkgmr,' ZIP�nFa g have g- ❑DemnlfiDa woding forme m sng capacay e.�layees andha vas' - ❑�ua�titng add�aa�► [Novc�.'camp--knra= ctxnp-is 4 5_ ❑ We are a cotpaE@iiamaadifs regains of iddi ions 3_ dging alI vvar� afss have „-:zed I I[]Piambing npaits ar adrlsiians �� O WC6=' _ - xi-t afe mp alter�fCL . n� I T I5Z 1{4} and we}tea ZtD I� oa -❑�Qti= comp-ms== I "'dip aup���csbo:r;�I�.st else fiII oath`�aheIa��.S flseswo��sT mmp�auperT�- So�enatnesu nsrbl=—Lb3slffid--Y:. I-y amdamg MAE—M*eaatsickco —st5�8II2cF€�daritID�sarh Znwk. =tist rTi-rk ThL- sheet thenffineaf&e ins and ststeAhesfo�xnor�se k�fxsiv-ve they pmaift wa3ms'rwnp.policytmmbtx ' :' .�ruir-arz �t'rhatispa�•�irg�ar&ets'z�a�Q,�-„�,7c far t$•�e.�Tayees. Be�arF is fftepa&�a�d3ob sds ' ' ir�artt�tt2ita� .. n. •4• •- _ - T�r,rp Pobcp t'g cr SeEf-inr,Lim fiuII T�si . Job 1� Ciiyi S9al�g: 1�(acb a;c�pg���xken'c�x¢peur.�tiun pvIrr.�der�tian pale-(sh�nring ff�Pow'fixer$ad ezpaatinxt�s�}: Fail=fxl Sec knx 25A of ISM c. M n3 m lead to ifse imposiiioa Df rdmraal pez1fies of$ fine up to 3 LSDIGD anUcir one-yearim as wen as city pesaltim in f m fig of a STOP WORK ORD:M and$fine cd up.to,$250.00 a day agate ffie violator_ Be mvised f8mt a copy of Phis stdzmcd maybe faip�to the Qfrz of Imons of the DIA€nr;•,�n�cav�ge v�c�_ _ do.haray cattfF ffCe ptdus andpsastifar ffiatfh u ftrazuiirxa pravided abam&h zra and`currect DaE Pie#- D _ _ �3•��.. • �� s rxzai Drr trot writ ifa ffds creaf&bar CQRVBW by cdp or fa=ttf cua£ Cog nr Tom n ease LBc=-da•€Reiff 7.RuMngITar�I afyTawaO=k 4-El=tdcalELpectar --Ph=b.m E r cxh!r-r .. �����;s�nra$I Laws I52 regtrires aII r�gloyeas to pru'vide worl�rs'crmpe�safiQn for then:�IoP� - PUIsIaErE:to-dris stdz±r,an=p&Trw is dcax d as­--cv=y person in fire=vice of asofficr rides any corYtract of hire, expn=Or iMp&eCL orat CZ'Wdtb� ' An e�Trspe�is defmsd as 4an rah,parfneashin,association,coipar�i®.or o$ie�1 baI entity,nr any tyro or more ofthe fareg0ing engaged in aJuiat Mtlprlse�and icin thce legal reprmcatdves of a deceased employq-or fhe recalver ar brasier of an mdtvidmiL partaeaship,assocsaiion or other legal e0y,emplaymg=2 loyexs. 3owev�ffie own of a dweI£ngoousehavugntmr tl=fhe apartments anlw�resides hm ' Qr the occ�ant of he dwtRing o air work on such dw - house easons to do manatrnance cons�ttuction. r wo elhng l2DIISe of another whB , roP ��P or on fae gins or building apputmiarit thereto shaIl not becaase of snrh m ploymeat be deemed to be-an employ cr." 2,fGL chapter 152, §25C(t7 also sW=that'every state or local frcensing agency shall withhold ffie issuance or renewal of a lmc e.or permit to operate a business or to constrarct bnrldmgs in the commonwealth for any app$rant Who has not produced acceptable evidence of coruphaace With the insurance-coverage:requh7tcLa . Additionally,MM cbaptra 152,§25CM states=Ncifhea fhe commonwealth nor any of ifs poliiical subdivisions shall enfer mtD any cow for the ped=ance of pub Er,wow nntt1 acceptable evidence of compliance with the i„an ce r(-,q=em=ts of this chaptrr have been presented to f e,conta to anthorr y.' Applicants Please fill out the workers'compensation affidavit completely,by cher-king the boxes that apply to your sifnztion and,if necessary, supply mb-contractnr(s)miners),addresses)andphone mmmber(s)along withtheir ceaiducate(s) of in n cm-ace. Limited Liabilny Companies(LLC)or Lkaf ;&Liabi7hy Partners s(I I.P)wi no employees other man the members or partners,are not mquired to carry workers' compensation insurance- If an LLC or LLP does have employees;a policy is retlu>red_ Be advised that ibis of idavitmay be submitted D the Department of Industrial Accidents fur confirmation ofin�ce coverage Also he sure to sign and date the affidavit. The affidavit should be ret=rd to t�e city or town thaf the application for file permit or license is being requested,not the Department of Industrial'Accidents. Should you have any quesft=regarrlingm the law or'you are rrgnited to obr=in a workeis' compensation policy,please caIl the Department at the number listrd below. Self-insured companies should eater their self-i„crn-m=license ntnnber on the appropriB±e lime. City or Town Officials - " _`' Please be sure f$e affidaYrt is completE'Endpt>�d legibly_ T$e Departmenthas provided a space at,$e ba1 of the affidav�t for you to fiR ouf is the event the Office ofbavestigHtimm has fD cone you regarding!e applican't Please be snr;:tD fdl in the peamitfficansc number which will be used as a mferm=n=ber. In addition:an applicant thaf must submit multiple peaLtllicense appliralinns iil any given year,need only submit one affidavit indicating M=Mnt ' policy information(ifnecessazy)and under¢Job Site A.dffi="the applicant should write mall locations in. (city or awn)."A copy of thD affidavit that has been officially stamped or mai3ced by the city or town may be provided the applicant as proof that a valid affidavit is on file for future permits or licenses knew affidavit must be Elea out each year-Where a home owner or is obtaining a license or permit not related to-any business or commercial Ytea ze; (i.e,a dog license or permit to burn leaves et.)said person is NOT requi:md to complete this affida:vZt The Office of hives�ns would lice to thank you in a m=for your cooperation.and should you have any.questions, please do not hestatr,to give i§a call. The Departmeufs address,Wephone and f amber: as E;OMMO-E IaafMassac iu D ft at ofIn&� A=ideat ~_ ofluv4stigztionti B IAA G2I II TOU%6I 7-727-4-9W Q�±4-66 car 14 MA VkTE. . R=4 f 17-`2'- 4-4 Rovised 4-24-D7 ' . Town of Barnstable '. Regulatory Services - Py°F'VKEtotl,` Richard V.Scali,.Director Building Division MRIMABLE, ' Tom Perry,Building Commissioner 1 200 Main Street, Hyannis,MA 02601 s www.town.barnstable.ma.us Office: 508-862-4038 -Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION f Please Print DATE: 0l,�nC— 1 - AA JOB LOCATION: 40 6�t0i4�J c�� Wes. C ✓�t.�a number street village .'HOMEOWNER": , hiloam k U'de"u— 5oi8- J'of.4la_ 34) . name home phone# work phone# CURRENT MAILING ADDRESS: 4o 4,to a-t&G wM' 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) . 4 The undersigned"homeowner"assumes responsibility for compliance with the State Building,Code and other applicable codes, bylaws,rules and regulations. �•„ The undeAanuire omeowner"certi a/she understands the Town of Barnstable Building Department minimum inspection procedure that he/she will,comply with said procedures and requirements. SignAwfrofHomeo er 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 unawaie 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;'f, permit application,that the•homeownercertify 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 u_se in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 P OF THE l0� } * * f 39. ,�� Town of Barnstable rEDMp�� Regulatory Services Richard V.Scah,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 w www.town.barnstable.ma.us Office: 508-862-4038, Fax: 508-790-6230 Property Owner Must ;Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit forms\02RESS.doc Revised 061313 � vZ . As3`ssor's map and lot number g � /71� D �/ /0C a 77-� SEPTIC SYSTEM MUST BE Sewage Permit number ........f..i.. ..........................�3..... INSTALLED IN COMPLIANCEl / WITH ARTICLE If STATE *"THE r T ND TOWN.., TOWN OF BARNS - ,LE ego ♦� BdHd9TSDLE, i �oo�Mb qa`e� BUILDING INSP ' 0�pY J - ND TO,WW% APPLICATION FOR PERMIT TO ... t: l..L..k?..,,I,,,STORx.. ays�.....��G����QNs.........w�w� .,........ _. TYPE OF CONSTRUCTION x- G... ..............19......... . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location L�.T... �b ... �..�L�.1'....i D' .......C =.�/,ERd/LLB ...... . ....... P/'.................................... ... .. .. .... ...... ...... ..... .. ....... . ... . ProposedUse ............................................................................................................................................................................. ZoningDistrict .......... ... ...................................................Fire District .. ......U............................................................ Name of Owner 4 ^.:. 1 Cf7`�L .I....#!—CV�1.T 5.M.4�......Address ................................ Name of Builder pOff /QT�' C01?6....................Address A4'OUT/ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ..................................................................FoundationQ.............................................................................. Exterior .........V.W/G........... 1. !. LF—.5...................Roofing ...�(.l.$ G7 ................................................... Floors ....... ................................................................Interior ...... F T�Q o C/j.......................................... � Heating � ....7L....................................................Plumbing .... ............................................................ Fireplace k..............................................................Approximate Cost ..../.. .ad CJ........................................... Definitive Plan Approved by Planning Board --------------------------------19_______ , Area j...1.aa Diagram of Lot and Building with Dimensions Fee . c�- S .......... SUBJECT TO APPROVAL OF BOARD OF HEALTH -7/a7/77 A o '11F 5� p ZOO Z Z I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . plz .... Dr. Nihholas Retebtskie Oo .... Permit for .... ................. .....................:..... .... ............................... 0 Br oken ...Way,,Location ............... ........... CentervilIg........ ............................................ .................... Owner ........ .......... Type of Construction ....1WQo.d..Frame...-.- ............ ........................................................... ................... Plot ................. .......... Lot .......... a.. . .......... Permit Granted .......December.. .......2.2....19 77 . . ...... . .. Date of Inspection J147d...................19 Date Complet6d ... ...........19 TERMIT'REFUSED ................................................ .... 19 tj - Z.. ............................ R; Pla ............................. ...................................... ................... ............. ........... ............................ ........ ................... Approved ................... .................... 19 M ... ............ .. .......... s;or s map and lot "number ....8 1 71 �"" © x/ �0�y,�, " �jam- A `�_T. ti 67) _ 7t - /"LS`?TiC SYSTEM MUST BE Sevybge Permit number ...... f.a.. �`3 Jrl�y I''::T, LL`D IN C0.00PLIANCE `T ✓� ., .............. . / WITH A^IfC!.� 11 STATEe 1 Py��TM[T��♦ r' TOWN OF BARN' T , 9E TO DAW TSDL rb 9 ;�� .�_ -:. Y�- � B U 1 L D I N G I N S P :-f lot Y�Y 4 a t ut ;= J7 ... ......t.....,�Y!...............APPLICATION FOR PERMIT TO ... ..�'.1..4r.1�...........T�R.j,.....:.°U...:�.....��i,�,.�I14j�s:.. TYPE OF CONSTRUCTION ..........UJ r s'./�....F '�1. :..........................:......... ......................................... .......................7./ -.0........19.z./ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .G� ......... L. l. .l.......... :..........0�IL%,4�W Y/.G:t'.. ................... ............d. ...............................—� ProposedUse ........................................................................... .................................//................................................................. ZoningDistrict .......... ...(....................................................Fire District .. .....v............................................. ............ 'Name of Owner :. i CIfL�t,f Y.aTS.l(!. Address � e ,sfTrs/ram ..f%��ff�Rr ' .�/��i...................Address ��5� /14tifDUI'!� Name of Builder ...................... ..................... .................................................................................... Nameof Architect ....................................Address .................................................................................... Numberof Rooms ..............................................................Foundation .............................................................................. Exterior .........V C...........S (d! o-(.F.S...................Roofing .. . .Pry G........................................................ ..... ...... . Floors ...........�w ..............................................................Interior ..... F�T�Q Lh............: Ueating !.f:,:. .....�/L................................................Plumbing .... ..................................................................... 'Fireplace ......,. ,.,,..,................ .......................................Approximate Cost ....�(��................................. pefinitive Plan Approved by Planning Board � aY..._._.._, Area ... ................... piagram of Lot and Building with Dimensions Fee q 3, t.?"..rJ SUBJECT TO APPROVAL OF BOARD OF HEALTH 7171 1 3' Dr. Nitkholss .Reuotskie a-:- �/ s .y No ............9852......Permit for Lwel�i.: . . .:...i store. ..... -, t: .. ........•........�. Location,...44 Broken dike Wad;, ... . Ceintetyt Owner Type of`Construction ..YO'QA..I+rame t' ,. .... ................................................ Plot . .. ... Lot ......... ..8... ......... . w -F�ermit Granted'.:.:...December 22 19 77 a ` "Date of In ection Date Completed fc ' i P+RMIT*RE SE® s .. ..... f ... ...................... '1 t ....• •.• •2 ......................... • ..1 ...... ...... Y .. ...... •• ..... .... ......• V. Approved .. ......... t m...... ... �. .................. ... .... .................................................... ...... Assessor's office(1st Floor).: SEPTIC`SYSTEM] MUST T Assessor's map and lot number m Q` IN CopA o` Conservation `� _ G W" Board of Health(3rd floor): ' IMIRONMEMAIL C Sewage Permit number LTOWN ���►��� rua to Engineering Department(3rd floor): �//�� o esrs639►��� House number '`/y Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 606T A-62, )(/Z J f TYPE OF CONSTRUCTION V d�) d-�a 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ( LoT g Location d 6eQ 6 Proposed Use Zoning District / Fire District , / / �/ Name of Owner / I�t3T� l G ! Address d b6"Ole N 3V? �-- �yl// - 0 cli Al Ve, A /✓/��'Name of Builder v d��dress� Name of Architect Address Number of Rooms Foundation C6*Cb/ T OG k§ Exterior ''" 6 0b Roofing ��rSlTllwL Floors yV tad b Interior ©� Heating Q/o Plumbing o4-16/V C Fireplace /Y G/Y(� Approximate Cost a O Area d Diagram of Lot and Building with Dimensions Fee V1 L-b OCCUPANCY PERMITS REQUIRED FOR NEW DWELLING o.� I hereby agree to conform to all the Rules and Regulations of the wn of Barnstable regarding the ve construction. Name Construction Supervisor's License REVOTSKIE, NICHOLAS No 35479 permit For BUILD TOOL SHED Accessory to Dwelli�sg 1 y Location Lot #8 , 40 Broken Dike Road , Centerville Owner. 'Nicholas Revotskie ir Type of Construction Frame Plot `� Lot PermitGran!ed October 27 , 19 92 -rf Date of Inspection 19 r Date.Completed 19 - r . E R9 t�"•y`'i F' ' I - ' 1 f� / «' ,"� mac./�— �-{ / T E'- �.` � ,�--• F ;: G � r� .�" �' ,�.- ' �� C did ./Ip;k?V �--E CEciTc \ , .5 O(/ eel i / L`' "G Tom" !'! �L-- i� � rr- % � ..• i 4 �A[�� - _ 761 O " jj -r � --/ / . /!l yq..✓� cv i c�r v 1. .! % Z •. ;� � �87 i,vv �— I - i�j'�� , r` �' ,� •.mac.:. r-- � .-,". �'� 1 � �Lt ti ut �ol-.- � I RAIC Zo7' \ ���. , A3 fG! �G��' L E�i9G�!/�vC., p.•.•, %�`�/7y ��� o.4y •-� G-/ - i� � � . -`-= ;s. _- /, ``-�S',G �y�c. .= �/4 G:y wit.'C.� v�,C�i4C�?';� � i'O_`'�.'� � .�i9 y/Z O 7 7 77- r'Z';i�' /O c;,9[./� ' 2 3,,9/FA 5 Tip e3l—F 4F ' �k t � Or i nn LNAHhN M! Gam+ 4*o s- l�