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0277 BUCKSKIN PATH
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'.t:. a, a r. a r v .� .��• r «x Y N F a' •. n ... , 4•"ti" �z. y « a a z :a a. 51 u Town of Barnstable *Permit it Regulatory Services Eee 6 months from issue date • BAMBUTABM • MAM Richard V.Scali,Director �� .-7 6 639. �, Building Dias Paul Roma,Building Com ins rg 200 Main Street,Hyannis,MA 0 www.town.barnstable.mM9Y ' Office: 508-862-4038 r�� 16 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION = 0IAL ONLY Not Valid without Red X-Press Impn V6�� Map/parcel Number (/ Property AddressJ 2 eg: :V XResidential Value of Work$ 2 M Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 0' L) fAk� Contractor's Name l �i/ � T Telephone Number �V g 7 7 S ^� Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ,-4 I am 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 Re uest(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 rooD ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: *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: QAWPFILESTORMS\building permit forms\EXPRESS.doC 01/25/17 x I ' y 27w CowmomreaWt q,fMarsadrusetts Dep artiff nt 6 f lud-usin- Accid-e7ds J - Offike o,f.Tits-w-*afie= .. . ' 600 Washingtom.9treet Boston,41A 02111 -- }vrmm=govldia Wurlmrs' Cumpensatimr.Insn-mceAMdavi-Bmlders/Canfrachu-sMecte 'ins fibers Applicant..Infarma n Please pr hd Na=Cgnsme mh—,d lndfs�- Address: ►� 7 , �it�fSfatef�i� Y Fbos��' Are you an employer?Check- the appropriate bow ' Type of project(required}: I.❑ I arm a em 1 wi& 4 ❑I am a general contractor.and I emlloyees(fiali ar�dfor par time * Bove hited.the subcontractors 6. New cans ag 2. I am a sole propaietar orpartner Tisted onthe attached sheet. F. El Remodeling ship and have as employees These scb-contractors have 8. Q Demolition a fofMM in employees and have workers' a�ab ��Y # 9. ❑Building addition INO�[.Sr' Camp.insumnce comp.imur atrp required j 5. El �i e are a corparafiou and its 1 T:ip�-tx;r�1 or addition . ofcers have exercised their. 3.� Ia m.a 5omerXvmerdairsg all work iL0 P3umbsagreparrs or adcghons. myself o makers' F- age of esem L..O r pfion per MGL � gmin insurance egvred j 1 c.15Z§I(4k andwe have no &e employees-[NO WO�s' 13_❑o#]Bier comp_hose znw required-) •�arapg�cm4�sccbedshas91 mastalsamauttheswfianbel wshurvngfiieswuAexs'compmotiaupo1iCyiUorms6orL fi Hameowaeiswho snbo�t dtis�c]a�u in g they uedaiag autca�satitfieahixe outsidgcoatmctarsnmtt.whoa tanemaffida iadicafiao ss,cTi fCamzacinsffist chx$this box must stmche,d ffiadditimil shea showingtLemmneof&a sub-coutwbamsad st,Rewheflm arnotfase eidties]um empimes.Ifthesab-caatmdneskwe e=gtoSea%theymnstgmr�de#heu warkers'camp•FaTic�a,ambez law are &=rajwxfbrmyaupLoyze& Setow is the policy and jalr site inf ormatiom Ins=ance ConipauyXame: PO-ficy 45 or Self-i Iic. �pi�tiosD : ' Job Site Address Cifpl5 .tp: Attach a copy of the workers'compensatioapolic r declaration page(showing the poficy number and eipi-Ann.date). ° FaRnre to secum coverage as requtredunde r Section 25A o€MGI.to 157 can lead to the imposition of criminal penaities of a fine up to,$l,SQa Oa awYor one-year imprisonmeA as welt as civil peaalti es is the form of a STOP WORK IORDE1Rand a fhe of up to$251(I.DO a Clay abgainst the violator. Be sdlised fiiat a copy of this statement.maybe warded to the Office of Investigations of the MA for insurance coverage,6mdff .I do ifergby c raaddar the and p8ruMs ofpa jrY hafarma#i aR mrfed abm,s is berg and tarred Simatcxrf: Bate: Phone 00eial use'wdy. Do not wrke in tFi ur€a,&be cmrsp&W by diy Qrtonu VJ0L-2L City or Taw n.: Perzriffr,icense g Tnuing?i aflwr€ty(oche one): L Board of Health '.•.Building Depm mmt 3.fifylTowa Clerk 4.Electrical Inspector 5.Phmbing Fnspertor 6.Other Contact Person: Phone#: laformation au' d Instructions ' M���e�s Geheaal Laws 152 req�es all e�Ioye�s'fn Pr�•de workers'�e�aa for their employees. gms�tn fi3is ,an m pbyr=is defined as¢:CPmy peason m�.e sravice of mother any co�xar of3iire, 1 express or mmplied,oral Cr Wn=." An ensployer is defined as"an incbYidval,poet .assD�ivn,airporajion or other legal enfhy,or aaY two or more e legal*rprese yes of a deceased eurpIoyer,ar the of fhe foregoing=gaged im a3omf fir rMeiyq or trustee:of an kffVjCTnaL per.assochfion or ofiierIegal entify,employing employees- However the owner of a dwelling h=m having not more tban three apa¢frnenis andwho resides ti ro,or the occ¢p�of the- dw eIIinghouse of anotheg employs Perms to do mice,cansL-ac;an or repair woik an.such dweIlmg h=D fheaefo sbaRnAbecause ofsaoh employmentbe d=nedto be an employer." or on.the gro�mds or bnzldmg • MGL chapter ISZ,§25C(6 also states�¢eve ry staf�or to cal Tier,is agency sl£alI whhh Ih issuance ar renewal of a ficense or permit tooperade a business or to construct bwIdings p¢the�mmDnwealth for any apglicant'�ho has notprodnm�d acceptable evidence of compliance with flx�issuaance coverage requirecL" Adaionally,MCrL chapter 152,§25C(7)stars=Neitarf ee nor'7yy off political subavisians shall enter into any contcact for the performmm ofpubhr,waricuntl acceptable evidence of campliancewilh the insurance.. reg�enreMfs of this chapterhave been preser±ed to the con[ractmg.a3ffi0IJt." Applicants •, Please fillout the worked'comrpeamtion affidavft completely,by g the boxes$�aPPIY your stfnafton and,if necessazy,mpply snb�cEar(s)name(s), addresses)andphonenumber(s)alongwiflithcir cmtfficate(s)of arLimftEdjaabflitypar�shiPs( P)'�hno e�loy=otherf�the hl=, nce. LmaitDdLiability Cameawes(LLC) members or par[ners,are not rimed tD cauy wori=e compensafion filw1mcm If an LLC-or LLP dDes have =ployees,apolicyisrequired. Be advisedt'hAtbisaffidaykmaybesnhmjtb�;dtntireDepadmentofTndusfrial dents for con£�rmati m of insurance coverage Also Be sure to sign and date the affidavit. The affidavit should Acci beretnmed to$e city ortDwntilatthe applicafi.on forthepe�It or Iicease is beingregnesi notfile Department of�. Ldustiial A_czid=3ftL MaDI&yau have any gnesCians regardmg the haw or ifyou are recpied to obtain a wormers' compemsarion poficL please call the Dep mtnen±at the rmmbma listed belowelf-i. S osmed c ompanies should enter their s elf-fnsorance license number on the appivpaato Iine: City or Tow.a Offid2b . Please be sore ffiat the afbtiavit is complete and prided legffily. 'Ibe Departmenthas provided a space at the bottom of tine affidavit for you to fill out i a the event the Office ofTmyesdgat<mm has to cordactyou regardmg the applicant: cant Pleasebesuretof171inthepeamit/IiceascmmlberwhichwMbe used asare�cenBmbes In addition,saaPPh f�must subno ft mubiple p�ceas e app litgions is my given ye*r.need only sahmit one affidavit indicating cat policy infoxnation (if n=--my)and aacier°Tob�e,4—.A tie applicsof should write-all locaiicns in (may or town)»A copy of tale affidavittiiaY has bea officially sfa�ed or romio�by fie�}'or town may be provided to tize applicant as proof that a valid affidavit is on f1e for B:dm 'per or Hc=m Anew affidaVkTMxst be filled oiot caa year.Where a home owner or ci ti=is obtai i m a license or permit not Mated�D my business or comm eacial ydabze a dog license or permit to b=Imym etc.)said pm-son is HOT reed to complete this affidavit 'Ibe Office oflnVcsfigzfi=wm3ld likmto:dmakyonfnadvance for your coope z&maad shouldyouhave my gaesi=, please do not hesiintE to gcve w a call The Departs s mddre*r-,telephone and fax number: . • . � 5�af11 ��#s - - Departmmt c&li Ao�Zmta . �4�a�hm�an Stream 1MA Oil II • Fax#6��`���� ' Kevisexl4-24--0 T ,tea._ggVA R. Town of Barnstable r Regulatory Services of Richard V:Scali,Director Building Division `* y Pan!Roma,Building Commissioner 03g6 ���� 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.doc 06/20/16 R L Town of Barnstable Regulatory Services IULW ' Richard V.Scali,Director. - ►`� Building Division. Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 509-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder n, �LQ, 6k, , as Owner of the subject property hereby authorize Z° a 9"` to act on.my behalf in all matters relative to work authorized by this building permit application for. 02.E �u��S � CAI (Address t�✓I:�c_ 0-2-6 3� (Address of Job) **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. 1$4gazture of Own " Signature o A plicant f � Print Name Print Name Date Q:FORMS:OWNERPERMISSIONPOOIS Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSFA-047505 Construction Supervisor 1 & 2 Family BRIAN G MCCAR-16 _ 32 CARVER RD ; WEST YARMOUgH =. • n�1 .-�1.j41\. Expiration: Commissioner 09/11/2017 ^ i V/ze' rpanvmariurea�o�C�aac�uaeG� i Office of Consumer.Affairs&Business Regulation. HOME IMPROVEMENT CONTRACTOR " Registration:;,-:'"°107723 Type: Expiration:.-_-8f5/2018 DBA MCCARTHY BUILDERS;'!, Briar! McCarthy r 32 CARVER RD TH 02fi73-'� W.YARMOU ,MA .Undersecretary Construction Supervisor 1&y Restricted to i Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. DPS Licensing-information visit: WWW.MASS.GOV/DPS License or registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 0 / ` Not valid witho signature r'' 1. Town of Barnstable�oF�lOty, *Permit# Expires 6 months from issue date SARNSTABM : Regulatory Services Fee C5,5 MASS16 Thomas F.Geiler,Director Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 x'PRESS PERMIT )ffice: 508-862-403 8 - ,ax: 508-790-6230 SUN 12002 EXPRESS PERNHT APPLICATION - RESIDEFib L,l� X /� 'Not Valid without Red X-Press Imprint RNSTA13LE /parcel Number m �`" , erty Address .a 1 B"• s r-4 1 PaR CQ, *—fV 1 residential Value of Work 1 CP Ov vo er's Name&Address ,`�✓�-' �U / MOO, =actor's Name v aw.�; Telephone Number�— 1 q o— ie Improvement Contractor License#(if applicable) aruction Supervisor's License#(if applicable) rorkman's Compensation Insurance ^' gVck one: N I am a sole proprietor <. " -n ❑ I am the Homeowner 0 tv co ❑ I have Worker's Compensation Insurance o cn ance Company Name tis 00 cman's Comp.Policy# X- rn ut Request(check box) �� I E�Re-roof(stripping old shingles) All l construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. tture ns:expmtrg ��ee `j�rymauuea/,/,�i �.�aoczc/zuaelt� Board of Building Regulations and Standards HOME IMPi3�VEMENT CONTRACTOR License or registration valid for individul use only before the expiration date. If found return to: Re913tration _ J_?4310 Board of Building Regulations and Standards slraibn 9T0I/2003 One Ashburton Place Rm 1301 1 t It lh ividual Boston,Ma.02108 James Curley James Curley PO Box 231/98 Sy Iv — Osterville,MA 02655 Administrator Not valid without signa e �� `�t I LOT 36 EAJO OJT' �✓✓ _ ZOAD d> Cla © � 1 i 0 oV S/LG EG 6✓..� fea r A04r-) 4 ,MOAZ) , >G AN 407' `+ T 4' A y`` I AiZ-A OY' C��7%F?�"'T,�f.�17 /NG F'oUNDA 7'/OA/ 4OC,4710,v is OVZe,& DOE S c Assessor,s map. and lot number .1. �.`' GAG Ep CC S ^ 7�/ c— r. A, TEM MUST BE I INSTALLED IN COMPLIANCE ti Sewage'Permit numbe ...9 ( 7.:............................... WITH ARTICLE II STATE SANITARY CODE AND TOWN um Q�ofT"ETo�y = TOWN OF BARN TW'BLE S BA"-STSDLE, i r p 1 0 BUILDING INSPECTOR Apo,i63q. - ,� r__0 ai a ..... -�!'. ` ............... ...... .. ^per . . . APPLICATION FOR'' PERMIT TO .........� ... .•. ... ..,.. aTYPE OF CONSTRUCTION ..... G . ........................................................................................... ................ .............19.. � TO THE INSPECTOR OF BUILDINGS: hereby applies for permit according to the following information: The undersigned he 9 9 Y pP P 9 Location /� `J • ........... .. . ................ u................................................................... Proposed Use . .,�� 5 .' '`'..?z p ...................:...................................................................................... i ZoningDistrict ...... C.. ..... ...... .. .. . . .....................Fire District ................................... ...............................Address ............................................ Name of Owner ...... ....... ........ .......... ..................,........... j Name of Builder Cs "` `•..•..•....Address �.� ................................................ ......... ...................... .. .............................................. Nameof Architect .........�.t5�.ts............................................. ................................... .............................. Numberof Rooms ......../.....................................................Foundation ... ......................... ........................... Exterior ..............(,{/4jJ1f..... ..............:.......................Roofing ......... ..... ........................:.............................. ............ Floors .........................................Interior .......... C1..�5�>... ........................................... Heating [.�a-✓i ..........Plumbing ........................................ Fireplace ........ ..A Approximate Cost pp ........... ... Definitive Plan Approved by Planning Board _______________________________19________. Area ....... . ... .................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name (C........................................................ Green, Barbara (Ap 18367 one story, No ......... Permit for .................................... single, family -dwelling ....................................................................... VT PuckskiwPath Location .......... ...................................... Centerville ............................................................................... Barbara Green Owner .................................................................. frame Type of Construction ............................. ........... ................................................................................. Plot............................. Lot ...........#15...................... Permit Granted .......... ............ .....19 76 Date of Inspectio -51-ob Date Completed ....... ........19 .............. PERMIT REFUSED ......................................... ...................... 19 ............................................................................... ....................................... ..................... ..................................................... ............................................................ ....... ......... Sv Approved ................................................ 19 ............................................................................. • .......................................................................... Assessor's map and lot -number .: ..�.::.r::.."....:.�............... Sewage -Permit numbe��:r...........r... 2'.... .............................. `T"ET°�� TOWN OF BARNSTABLE P i � r i BJBBSTABLE, i ' - BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...........n..................................` :.::.........................:::...........?...:.......::............"....... TYPE OF CONSTRUCTION ...... ......"..................................................................................................................... ...................... .....................19...... :. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....................�:: ......................................................................................................................................................... ProposedUse ..........................{"................................................................................................................................................ Zoning District ` ................Fire District `� i7 �f Name of Owner ..........:....:.:....................................................Address ............ r -s f / Name of Builder i ` r .. . ............................... • r Nameof Architect ................Address / `.................................................. ................................................................................... Number of Rooms �' Foundation ....'L... ............. .................................................. ............ Exterior .............................................. f� 7 ..............i.:...........:...'.:.................................................Roofing ..............................:.:..... i s t ' x1 .Interior -� . Floors •.::................................................. ............:....................................................................... .............................:... Heating ..................................................................................Plumbing .................................................................................. Fireplace ...+........................................................Approximate. Cost Definitive Plan Approved by Planning Board - ------ - 19 ---• Area ........t..��...r.:...............:...... Diagram of Lot and Building with Dimensions Fee ...... J a ........................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . (,_✓ r.....r� ..... ,,.: 1............................... Green, Barbara A=171-24 � -�~ - 183§7 ' one otoryw ' � No ---�-- Permhfor ------------ ^ ' | a1oole fam1ly Il . ' �- ---.�.—.-----..--.�—�----.-----. ' ' ' Buckskin . Location - ` . ~=.~~^~^^i ` .---.---------.-- ~ . —^^~~^~ - r en � ^ Type of Construction ..... � . .rame � ` Plot ............................ ot ' ' May 76 . . Permit. Granted ' . wo/e of mupec/u"/ ' Dote Completed . ' . . . ' PERMIT 46USED - ............................................ ' � ^ . --.------.---�--------------. , ........... `�77 L� +//'r---'—'~—''xy----'--------'' ` x � ' -^''---'---'`---^^^'^~---^—^----''' ` ^ . . . �����^�'�''�,�����,,�',,�'�,���'� ' ' Approved .----.--- .......... lg ` ^ —.. ,------.�. ' —' ..................... ' ' U � Assessor's office(1st Floor): a SEPTIC SYSTEM U, j � ! D Assessor's map and.lot number INSTALLED IN COMP Board of Health(3rd.floor): ��T�TITLE Sewage Permit number !�4 / �' Engineering Department(3rd floor): ENVIRONMENTAL Cad a House number ® N RE ULUI�`6 ad 639. Definitive Plan Approved by Planning Board 19 $rest 7o A ;, A c yrr s� APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only ;:�r^ p Z 0 TOWN TA rv��jo OF BARNS j � BUILDING INSPECTO APPLICATION FOR PERMIT TO t(.'7 4 I Ly O�aj,U't DO&JI D3 t TYPE OF CONSTRUCTION (gips mtqy 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location cM AU"IiJ P' Proposed Use PIS(oft CsM 1C . Zoning District Fire District 0-0 -/bm Name of Owner 1`Yla'CNEW MI tf-V Address SAcAIiE Pc'3 Ac&)-UL Name of Builder Ji'Yl r°I'T'CE-FQ,) laL1 Address SAMC- hS &60\)F— Name of Architect 5R'kfQ0 MA S PbL Address SThk)6&2R1f (41LL PJ, UN74eV14c E v � Number of Rooms 1 Foundation FOOT 1K)& Exterior Cr- t �P-d��Sf-b�✓C�LE Roofing ASiOHAL7 Floors T/L", Interior 5ff15F_T 400K Heating FO P-0 H07—Alk&AS Plumbing _ 11LU Fireplace /c /9'M VE Approximate Cost OC221, Ono Area Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ie o Construction Supervisor's License BAILEY, MATTHEW Y top, No—f 34361 -.permit For Build Addition ` Single Family Dwelling 277 Buckskin Path ' - Location Centerville 4~ ~ Owner. Matthew Bailey Frame Type of Construction a �z Plot �J=z�+ J Lot • ^ - � ` � Permit Granted May 30., 19 91 4 , Date of Inspection 19 Date Completed 19 � Cif > a . .. 1 a �r :5 S. I C 6 h0/, 3 l _ y 1 S,0 38 S 9 kn i deck I �gla��y bt, I6 Room .t,-Po !4 � I g, _. . azt 1�a,oa /oi,�5 �u Path 40 wide qU Cape (r� _ Ica& 1 "-30 49: RaZo t goad - sae 5-27-87 ' id yamid., Ma. 02601 9hi4.,to& -vs. not with in the stood haptd prze. Ce�,UJ4.d Ptott ptan gke-buitdimq. ahown on &E4 ptan .cam. tocated on .the und as Uwwn heheorz, and me td. the 13einF tot I S a& ahown on a ptan 4.Qt-back ' e,yu ►ce�. of the, gown of gazna.tab&. .teco�ded ,in book 244 page 67. ne/t�: �. � OF4�,N rSa eq�attheu, �: � �.anet .t?.; 277 6uckak i n a,th LNE H Cen te�w,i. &j Ma. 026 32 . - .32490 Q• , _ fCISTERE� Q� , � 1 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION ------------------------ 1==----== Please print,,--,- DATE '�. . s J . JOB'.•LOCATION -jkACXS � PAN • Number Street address Section of towns` •; ; _ w "HOMEOWNER" 0061C UEA a -� ¢�e7r -16A(Ly 7-71-k 101 _aTC1q r Name Home phone Work phone ` PRESENT MAILING ADDRESSCa 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(sY who owns a parcel of land on which he/she resides or intends to r.e-,.. 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 acceptable to the Building Official, that he/she shall be responsible for a'll - such work performed under the buildinpermit. (Section 109. 1. 1) ". The undersigned °homeowner" assumes .responsibility for compliance with the Stat Building Codeand other applicable codes, by-laws., 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 w' th said ocedures 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 a 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 Constr c uction Supervisors; . Section 2. 15) . This lak of aiwarenes often= results•"inserious 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 SuP ervisor. The Home"Owner `actin ,:.. as supervisor is ultimately" responsible. To ensure that the Home Owner is fully aware of his/her. responsibili.ties, ,•man communities require, as part of the permit application, that the 'Home -Owrier 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. J� r i I P) _ i Y Ii j ❑ NOTE CHANGES �- Mpg i Building Inspection Deparintent —� � j x� !t 1 l� 1 I l Il ENT i 1 1 I � 1 � I ZEG<- -T-o P i �a _._ax..►a.._r_z_Lp-cam. _-FLv�E _t --- ax S �tTE.►z 5 �.: 1 5k I F20J._T___Po_A C..rF. o V&m C-^kA6E . V-5 In x � -- O _A5 N � - �rJSUt�.TE Lill. PEA wood Sv/3 11 II IIald H P.T. ILL _ P.r 5/1-L 152EE2E WAS on�l� ' BPS G�awl. RAGS ADOVST .._67NZAC.E ._u00k LEVGL G'-D"H/G H LO.t.)4 . V U5r. GAP �,4- f. wl /G"x8•• FOOT!AJG { • ; �PAM /A�Lr �iEGT7C�ly .d".^rT +:,,..,e�"' ..p.^ ina a: ...,�. .:, .., r+•-sr,.vdvrR""di'}-'. •: ,".`,^.,t�.+.Y? _ - ., si. �, i..s.•':r+ .'�'i^v4y :. y . ..J..^`i..ry. -c-"t i..:..«a,�„=, 4 Assessor's office(1 st Floor): Assessor's map and lot number Q1.oi THE Board of Health(3rd floor): Sewage Permit number /��, -�� ?, V 11AR11'-ROLL i Engineering Department(3rd floor): r/%�J� r.T House number 'a 7r``�/ t' .00t639. 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 TYPE OF CONSTRUCTION i TO THE INSPECTOR OF BUILDINGS: The undersigned herebapplies for a permit according to the following information: Location �? ��L r�S/fir?/ /'C�PG7 C�iL/ (A'f�i(/(-' / JYr 01� Proposed Use � ��� ��0101 Zoning District Fire District _0 I-tm Name of Owner Q1` �Cfj �G r l e�1 Address QS aA-0 e , s Name of Builder 14ecv 0 r P Address r Name of Architect (7Jr) J' fi�L��J✓ICE Address ��tt Number of Rooms 3 Foundation ' Exterior to d e 6-( CWK 5-44/6 5 Roofing Q / 1 Floors Interior Heating f:lF c_• { Plumbing bal,h Fireplace AIn411f'_ Approximate Cost oc� ev Area X-)O )4 P"'e fi-t- rt g;e. Diagram of Lot and Building with Dimensions Fee - 1 c } t 1 L, OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the.Rules and Regulations of the Town of Barnstable regarding the above construction. { Name Construction Supervisor's License u _ . BAILEY, MATTHEW D. A=171-t1 2 4 i 7I as1/ Y No 33882 Permit For Add Dormer Single Family Dwelling Location 277 Buckskin Path Centerville Owner Matthew D. Bailey Type of Construction Frame Plot Lot Permit Granted j ulY 27 , 19 90 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1!11ji Assessor's office(1st Floor): SEPTIC SYSTEM MUST BE® INSTALLED IN COMPLIANCE THE Assessor's map and lot number p tp Board of Health(3rd floor): , WITH TITLE 5 d � Sewage Permit number --_2 A�d ENVIRONMENTAL CODE AN .., Engineering Department(3rd floor): TOWN REGULATIONS t Dsaa9f11DLL .House number �'/ °,►�1b 9.6`�+' Definitive Plan Approved by Planning Board 19 °air 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 do rm tG i TYPE OF CONSTRUCTION - ., / ` bow-A19 I TO THE INSPECTOR OF BUILDINGS: The undersigned hereby,applies for a permit according to the following information. /J Location 9 77 �/tsL�s�r��/ �/X GC'sa/ l�l�il1� 01�c� Proposed Use Ae_oc�boor€ ! !M jC OQ Zoning District Fire District Name of Owner One C.) A r ky Address eq/i e GI5 0 0 t ell, Name of Builder i�./�� Address !1 I, Name of Architect��roY) /'/►��CUQl,e_ Address C-e_&eyyid e Number of Rooms 3 Foundation �. Exterior w l d �r 'c�K S�///y�i/tom 5 Roofing Floors K Interior Heating �' - Plumbing 8C Fireplace /' Approximate Cost �� ®® Area &6 Are.f-1- C 4 A-&�q G Diagram of Lot and Building with Dimensions Fee :S ;i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding th above construction. -Name `+ Y Construction Supervisor's License AM)VA BAILEY, MA'�TREW D. No 33882 ' Permit For ADD DORMER V Single Family Dwelling Location 277 Buckskin Path Centerville I' Owner, r Matthew •D. Bailey Type of Construction Frame Plot Lot Permit Granted July 2 7 , 19 90 Date of Inspection 19 Date Completed 19 3 fav f i Co > , o J. Et` - tr tC3 f"F v iAJ "" ,f } M 0 • TOWN OF BARNSTABLE BUILDING DEPARTMENT .f HOMEOWNER LICENSE EXEMPTION Please print. DATE :7-/0 70 JOB LOCATION '7 u J5 tiJ eti V o Lle- um er Street address Section of town "HOMEOWNER" w • c ` —a clo ame Home p one WorR p one PRESENT MAILING ADDRESS Ce ) d City/town State Lip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or Tess 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. (State Building Code Section DEFINITION OF HOMEOWNER: Persons) 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 acceptable to the Building Official , that he/she shall be responsible for all ,such work performed under the building permit. (Section . The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, 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.AI 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 . V • 1 8 a • • D ` 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 (Section 109.1 .1 - Licensing of Construction Supervisors) ; ..pro vi this section If a Home Owner engages a person(s) for hire to do such work, that suchdHometOwner shall act as supervisor . " Many Home Owners who use this exemption are unaware that they are assuming f the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for Licensing Construction Supervisors, Section 2.15) . This lack of awareness Often results In serious problems, particularly when the Home Owner hir unlicensed persons. In this case our Board cannot es dthe unlicensed person as It would with licensed Supervisor.. The rHome ownernacting .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/certificatlon for use in your community. • s f . l y t - i 1 t i f a I � , t I V . 1 P"\ — ��it7 D C 4 1 i I !1 i y { I i I ` c��v7 7,F �7,g as �� ice&A) C 1 I f � f 1 7 f f f 9 8 - cc�iy 3 62 cNa35 O D LI Ll - 0 TO 1 G l' 3f' LZ�XL7-1 G3 4 I L � i Y�ti�c `4 P�ti.L { of � 't ► i i I i ; i • f -k—I U'' rZ4t�vE VE CD axra e-►Dl� t< �a x p I I� WIA3 oH,a � 3 j ►a ax rO 5 C' i&"o C. ae 2 r4 AArA) 1 c3� E I S f-- I AXS NEA-T,>E2. �1a �•� � � C. Jlt"O C , i f i I; i x�5 ,-) G-- 5EA4f5A)i i I V E b C> G. WIA� PHA L- 3 r� i ►d aY oo 5 �. /� O C. _ \ o+e - AXR HEUF-K OUtK DOo�j/1 v.�n�T j 7' w" �7vn. rvfat C J� OC , J �,D u el �7 7-/ G ..-X_ _c_. ..._..... - 21 EX� 5, �vcr is FCocP 71 x�5 7A) JFA )T r s G L-Ac lk, , Ll lei _----- n Gay _- C->J0, a s� 7 t � �ofTHE ram, Town of Barnstable *Permit# pExpires 6 .. iu front issue date ` Regulatory Services Fee LIRNSTABLE, + 9cb MASS., . ,$� Thomas F. Geiler,Director Building Division Tom Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arns to b 16.Ma.u s Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valirl without Red.X--Press Imprint Map/parcel Number Property Address 0-lef'!-G%j ,,(.`FA C',e ' I�!/ s le— kyl Cc- - U Z (.Residential Value of Work Minimum fee of$35.00 for work under$6000:00 Owner's `f�t .� r w s Name & Address 7�A- •C � 3'/� j, .4 02 l/�' y a U Z-6 3 t Contractor's Name 13 '4 J Telephone Number So �G "- yad CI Home Improvement Contractor License#(if applicable) l Construction Supervisor's License#(if applicable) Zl 7 rill) ❑Workman's Compensation Insurance j f3 -heck one; _ „ v 1..,- <r '.,Awt4 ti ENI am a sole proprietor am the.Homeowner JAN ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit.Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of rood Re-side #of doors ❑ Replacement Windows/doors/sliders..U-Value (maximum .44)#of windows *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 Nome Improvement Contractors License & Construction Supervisors License is _ required. iIGNATURE: y' 7 The Commonwealth of Massachusetts t I Department of Industrial Accidents ^ � r' Office of Investigations .600 Washington Street Boston AM 02111 a1 www.mass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone 7 �� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ lam a em to er with 4. 0 I am a general contractor and I ploy * have hued the sub-contractors 6. New construction ' kship employees(full and/or part-time). _ 2. 1 am a sole proprietor or partner- listed on the attached sheet. $ ? ❑Remodeling and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance. 5.. 0 We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.ElI am a homeowner doing all work . right of exemption per MGL 1 Ln Plumbing repairs or additions myself. [No workers' comp. c. 152, §](4),and we have no 12. Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13. Other W. *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City,/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A ofMGL 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 p and penalties of perjury at the information provided above is true and correct. Sipature: Dater Phone#` Official use only. Do not write in this area,to be completed by city or town offciaL 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 s, f{ Information and Instructions Massach use tts'General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." 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-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the-bottom 1 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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number:The Commonwealth of Massachusetts . Department of Industrial Accidents Office of.Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revicerl5-2fi-(15 ... _ Town of Barnstable Regulatory Services 3A.RNSTABLE, v MAas $ Thornas-F. Geiler,Director ►. Building Division Tom Perry, Building Commissioner 200 Main`Street, Hyannis,MA 02601.. www.town.barnstable.ma.us, Office: 508-862-4038: Fax: SOS 790-6230 Property Owaier'Mu.st Complete and Sign This Section If Using A Builder as Owner of the sub.J ect ro 'e .P P ?t5 .. hereby authorize m c x fti to act on my behalf, in all matters relativel.to work authorized by this building permit application for. (Addres•s of job ignature of Owner Date t f Print Name If Property Owner is,applying' for permitplease complete: the -Homeowners License Exe�rnptio Form on the reverse side: A I k , Town of Barnstable Regulatory Services Thomas F. Geiler,Director t639.HAS& Building Division prFO j`F'�a Tom Perry,Building Commissioner 200 Mairi.Street, Hyannis, MA 02601 wwwAown-b arnstab le-ma.us Office: 508-862-403 8 . Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DA TE: 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 slip erylsor. DEFINITION OF HOMEOWINER Persons) 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.constrgcts more than one home in a two-year period shall not be considered a homeowner, Such "homeowner"shall submit to the Building Official ou a form acceptable to the Building Official, that he/she shall be responsible for all such work performed imder the building permit. (Section 109,L 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,be/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 sccdon.(Sccdon lo9.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hint to do such woik,that such Homeowner shall act as supervisor," Many homeowners who use this exemption arc unaware that they arc assuring the responsibilities of a supervisor(see Appendix Q Rules&Rcgbladons for Licensing Construction Supervisors,Scction 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 helshe understands the responsibilities of a Supervisor. On the last page of this issue is a.form'cutrcntly used by several towns. You may care t amend and adopt such a forrrAcr-tiftcation for use in your community. d Y Office of Con umer A airs dsiness� T License or registration g on g on valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration ?,107,723 Type: Office of Consumer Affairs and Business Regulation Expiration �6/5/2Q12 DBA 10 Park Plaza-Suite 5170 Boston;MA 02116 M "RTHY BUILDERS Brian,McCarthy 32 Carver Road i W.Yarmouth,MA 02673 Undersecretary Not valid without signatur .__ Massachusetts- Departrn nt.of Public Safety Board of Buildin- Regulations and Standards Construction Supervisor-License License: CS 47505 Restricted.to: 1 G BRIAN~G LMCCARTHY 80 STRANDISH WAY W YARMOUTH, MA 02673 Expiration: 9/11/2011 ('vnun issiuncr Tr#: 3664, J