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HomeMy WebLinkAbout0171 DONEGAL CIRCLE >t �... .¢¢ } 1 �. - !i d5 ,.,.. �.. ....� ,.. _. .:. .. ..�;. _ ,:: ..; ,1,.. ..,,.. ..,.... _ ,N ,.._b sue... -s"f � �. .. { 4j � � .,: f: �.S t.1.3y,Y r tS. j rl, .F k -;:Ra,-a �e �ti7k. - t � 9r_�� r..S a��i'r(,f�p�..x•�Tl.�. �1'� �11 ,tt!3"k,+ rY('�7�..�.�� r '�.�'�';F f.. .f'iy`sir��� ,.",`t {��' a: ���, .�1- � � � � e !� � �f - , i :t' ,;;�q°#:p�2��f$i t.5d"�J1:11���trl`f#t/�t`l�.:�r� .��A.4.�1._"Y. ;.ikY�r., ,'1'tr,i- '«,'��11.',�d�{�:�Mrt.r.r.t�Il+Y.�- ,�,�� �. ,Y. e� - �� 7 1�.��; t ���t� ' K��f ',��P��i„��� �,�� �' .t��jttt���� ,iik�k�r€�. r�air�y #a.,lr��� r i g ��� i>.e � �y� y 2t�n !kt � � , ' o.. � _ wli �;S � o "k r �� � o r. .. 4 � d -. � r - .. .. - - y. :e ... e e � a a . e o e .e a d a. � � � , j .. � Q > .yam - n ,.. 0 .. �. �... 0 r7. . � .: �-. e o .,. _ � q. o � p tli a a o '^' , o o �, d e o ,. �� o � , . ;� .. . _ �_ - .� .� e a E..�. � m ,,, - .., a .,, • - .�, ;' � a , • � .� a ` 9 p .� P .. � .. a. ... n - -' Town of Barnstable Building A roved Plans"Must be Retained on Job and t is Cyr M stbe Ke t , s P„dstTfi�s�Card So Thatt isUisible Er�o�m fie Streets y�pp � � �e f p sa l�o�sted¢Until F�� a)Inspection Has B±°en IVlade ,�� � �� � s Permit, R Where a�Certificate of Occu-an�. rs•Re wired:;,such;Builclm .shall iVoybe©ccipied£until a Final Inspection'has been mad ,,.. �� •. � ���-': _ _p.. � q�<� � �zs�� .. ':.erg ;�; �� . � �,-u,. Permit No. B-17-2961 Applicant Name: Carl Rebello Approvals Date Issued: 09/05/2017 Current Use: Structure Permit Type: Building-_insulation-Residential Expiration Date: 03/05/2018 Foundation: Location:, 171 DONEGAL CIRCLE,CENTERVILLE Map/Lot 169 036 Zoning District: RC Sheathing: Owner on Record: BERGEVINE,MICHAEL f&DEBRA 1fi Contractor Name Carl J Rebello Framing: 1 Address: 171 DONEGAL CIRCLE k Contractor L nse ,CS-084358 2 CENTERVILLE,MA 02632 Este Protect Cost: $5,211.00 Chimney: Description: Insulation Permiv, tr $85:00 insulation: Protect Review Req: Insulation f ePaid: $85.00 J 'Final: a m �''L Date 9/5/2017 Plumbing/Gas Rough Plumbing- ' k �, - h , xBuilding Official final Plumbing. . . ' �sv' This permit shall be deemed abandoned and invalid unless the work auihorizedbythis permit is commenced within six=months after-issuance. I�� -; Rough Gas: All work authorized by this permit shall conform to the approved applicatio and the approved construction documents for which this permit has beengranted. All construction,alterations and changes of use of any building and structuresshall be in compliance with the local zoning:,by4aws an codes. a Final Gas: b displayed in a location clear) visible from access street or toad and shall be maintained open for public mspe tion for the entire duration of the This permit shalleY work until the completion of the same. Electrical u anc will not be issued until all applicable si naxures b the Builds and fire Officials are provided on thispermit. The Certificate of Occupancy pp g Y p Y u_ IF %' Service: Minimum of Five Call Inspections Required for All Construction Work: z 1 _ 1.Foundation or Footing R VP .=" ough: 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" (asset forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Q. Town of Barnstable 200 Main Street; Hyannis MA 02601 508-862-4038 6 Application for Building Permit Application No: TB-17-2961 Date Recieved; 8/29/2017 Job Location: 171 DONEGAL CIRCLE,CENTERVILLE Permit For: Building-Insulation-Residential Contractor's Name: Carl J Rebello State Lic. No: CS-084358 Address: Swansea, MA 02777 Applicant Phone: (508) 567-4109 (Home)Owner's Name: BERGEVINE,MICHAEL E&DEBRA I Phone: (508)243-8665 (Home)Owner's Address: 171 DONEGAL-CIRCLE, CENTERVILLE,MA 02632 Work Description: InsulationCD ? f 0 �1 Total Value Of Work To Be Performed: $5,211.00 Structure Size: 0.00 0.00 0.00 Width Depth Total Area . I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: Carl Rebello 8/29/2017 (508)567-4109 Applicant Date Telephone No. Estimated Construction"Costs/Permit Fees Total Project Cost : $5,211.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee:' $85.00 8/29/2017 $35.00 Paypal Paypal ` Total Permit Fee Paid: $85.00 8/29/2017 $50.00 �PaypahPaypal i V� Town of Barnstable Building � ..,�5- .. ,:--: „� ,n w. r r��� . "i apb�y'*a+� i r ..i�;• t.. �. t Q s Post=This Card SoThat it is Virk,ble From' he Street ApprovedPlanslVlust be Retained on'Job and."this Card Must be Kept41 P'ostedaUntil Final'Ins naction Has Been Made "{ F. Where a,Certificate of Occu anc is Re uJred,,such Bujldm shall Not�be Occu red unt�lartF:inal Ins, echo has b,"een�made Permit p y,. L 4... - •ram g, p p ., Permit No. B-16-3160 Applicant Name: BERGEVINE, MICHAEL E&DEBRA I Approvals, Date issued: 10/27/2016 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 04/27/2017 Foundation: Location: .171 DONEGAL CIRCLE,CENTERVILLE Map/Lot: 169-036 Zoning District: RC Sheathing: Owner on Record: BERGEVINE, MICHAEL E&DEBRA I zrContractor Name: framing: 1 Address: 224 PROSPECT STREET § 'Contractor Dense . -,2 FRANKLIN, MA 02038 Est Protect Cost: $0.00 Chimney: Description: Shed 10x16 #f� 4 rc E Rermrt Fee: $35.00 Insulation: Project Review Req: Shed 10x16 wFee Paid: $35.00 £} Date } 10/27/2016 Final: N1Plumbing/Gas Rough Plumbing: g ,Building Official � Final Plumbing: - g This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance. 1 Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structuressi be in compliance with the local zoning by laws and codes. w _ _�:, ,";.. �rr Final Gas: 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 work until the completion of the same. Electrical will not be issued until all a licable si naturesb` the Buildin ,and Fire Officials:are- rovidedaon;this ermit. The Certificate of Occupancy pp g y _g P P P Y a x Service: Minimum of Five Call Inspections Required for All Construction Work: g 1.Foundation or Footing Rough: 2.SSeeathing 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.Rwor 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 Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT � 7 Town of Barnstable Regulatory Services Richard V.Scali,Interim Director BUILDING DEPT Building Division b a` Tom Perry,Building Commissioner OCT 2 5 2016 200 Main Street, Hyannis,MA 02601 - www.town.barnstable.ma.us TOWN OF BARNSTASLE Office: 508-862-4038 Fax: 508-790-6230 PERMIT# ���" FEE: $J J V SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less /7t C�,v, Location of shed(address) Village Property owner's name Telephone number � CJ (' l _ lJ✓� Size of Shed Map/Parcel# Si Date Hyannis Main Street Waterfront Historic District? . 6 Old King's Highway Historic District Commission jurisdiction? /N/o If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:304:30 PLEASE NOTE: 'IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg p C REV:110413 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �� Parcel 0316 r Permit# Health Division 2—�'�' Date Issued 2-1= Conservation Division I% Fee,, �'"�'�ir. Tax Collector- SEPTIC'SYSTEM MUST BE Treasurer INSTALLED IN COMPLIANCE r Planning Dept. r ENVIRONMENTALMiTITLE 5 Date Definitive Plan Approved b Planning Board CODE AND pp y g TOWN REGULATIONS Historic-OKH Preservation/Hyannis Project Street Address ,Village C_>G✓1�r_Y"V/ Owner P1141qej, AddressC2,2 cpweG . Telephone O — S�2 F-5' —c;2 87 d� 3 Permit Request 4 &1) -c n g Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total,new Estimated Project Cost 5-00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size 3 .Sr �S t Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure eey r� Historic House: ❑Yes No On Old King's Highway: ❑Yes No Basement Type: XFull ❑Crawl ❑Walkout ❑Other - Basement Finished Area(sq.ft.) 5 Basement Unfinished Area(sq.ft) Number of Baths: Full: existing. new 6 'Half:existing new Number of Bedrooms: existing .3 new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: i1 Gas ❑Oil ❑Electric ❑Other, Central Air: ❑,Yes XNo Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes l No Detached garage:❑existing ❑new size Pool:0 existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existingA new size Z 22 Shed:❑existing ❑new size ' Other: ' l y x ZYD Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑.Yes ANo If yes,site plan review# ' Current Use ya cc"410rl A Or"-r_, Proposed Use L�100 nen 2`'a..! j BUILDER INFORMATION Name_ a w w �_ �o Telephone Number, Address License# t Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO ` SIGNATURE- DATE Z FOR OFFICIAL USE ONLY , < t ^. ,a PERMIT NO. DATE IS g; r y MAP/PARCEL NO., +h - + ADDRESS : VILLAGE. i a s OWNER' < ' ' � ♦ � Mi�"1 ' • � • _ •r - • au;. P .. 1 - - • a �.. " � � ... a 7 ` s . DATE OF INSPECTION` FOUNDATION.. FRAME INSULATION S� aCel9� r '# t q µ • FIREPLACE ELECTRICAL: . ROUGH FINAL 1 �- PLUMBING: ROUGH FINAL GAS: , ROUGH- E FINAL' F ., FINAL BUILDING DATE CLOSED'OUT Vic ri, u F ASSOCIATION PLAN NO. Existing home Proposed Addition 0303 miff Micheal Bergevine 171 Donegal Circle Centerville, Ma. 24' 0" 24' 0" existing kicthen Proposed Sunroom existing bedrooms �� Proposed existing 2/Car garage livingroom ❑� 28' 0-3/4" 14' 011-7 Micheal Bergevine 171 Donegal Circle Centerville, Ma. 02632 Gable End (of proposed 2/car garage) Existing chim asphalt shingles to match house 1x8 collar t' 2x8 rafte 1/2"CDX \ 3/4"CDX continuous soffit vent 2x10 joist 16"on center W12x27 steel beam 31/2"tally column 5/8' Fire Code inside garage 16'Overhead siding to match 2"x4"construction- 16"ee R-13 insulation in all walls 2x6 sill 4"concrete slab-2"pitch --y -- Dnvewa ------------------------------------------------------- 8"foundation 16"x10"ftg Micheal Bergevine 171 Donegal Circle Centerville, MA 02632 e own rin�� �ie 9 M �' Department of Health Safety and Environmental Services Fo► ' Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner 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: a _/ ,-A 74,0 1irie" # 1 �QrnEstimated Cost Address of Work: N 3 Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 Building not owner-occupied AOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date 1 's Name q:fomu:Affidav . . =t3QAOPe ftj ' ' Tiblo./SZ.111(eeedn0/d) � • p.ipdv.Paekna for One and Twafan*RmddemW Boildtnp Hated with Fa-ar3 Fuda MAXVAUM MRNIMUM Glazing OItaag Cep Wail Floor Ba-emerat slab HaDriumdcoolia8 Wail pftb m Foci p�� Rrvaluat B,•vdud 6701 to 6300 HeadaR Degeee Days' Q 12% 0.40 31 13 19 10 1 6 Normal R 12% 032 30 19 19 10 6 Normal s 12•A 0.30 31 13 19 10 6 15 AFUE T 13% 036 31 13 25 WA NIA Normal U i3% OA6 31 19 19 10 6 Normal v 154%. 0.44 31 13 23 WA WA 13 AFUE W 13% am 30 19 19 10 6 25 AF[JE X 12% 032 31 13 23 WA WA Normal Y 12% 0.42 31 19 25 WA WA Normal Z 18% 0.42 31 13 19 10 6 "AFUE AA IVA 030 30 19 19 10 6 "AFUE 1. ADDRESS OF PROPERTY: / 7 ( � 6 d! P 6 04 L / &4. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: / 3 o 3. SQUARE FOOTAGE OF ALL GLAZING: 3 ? 4. %GLAZING AREA(#3 DIVIDED BY#2): tb o O 6 6-7 S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: q-fomrd-080303a a 780 CMR Appendix J Footnotes to Table J52-1b: 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 o total area may be excluded from the U-value requirement. a percentage.U to 1/o of the glazing y area,expressed as p � P For example,3 fl of decorative glass may be excluded from a building design with 300 IV of glazing area. y 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 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. `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 requiremenm apply to wood-fame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-fame construction: 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned arawispaces,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:am 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 J52.la ROTES: 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 035.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 035). 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(035 for doors). 43 FILE # CLIENT : CENSUS TRACT # t OWNER : r _ L Co of Ca a Cod DEED BOOM 266 PAGE . 102 b A�urtyhv =r MaraaroL PLAN BOOK PAGE L OT APPLC CANT : revs ASSESSORS PL N PLOT h0RT 'GAGE INSPECT1 .0N PLAN OF LAND I N B A R N S T A B L E SCALE : 1 "= 40` JUNE I4, 1984 �c ()-O- Lo — (o N/F CROSBY 250.651 LOT 18 23, 590 s ,F ± gib. o@ 00 s Focclv n \ I STORY 281+ 103 . 78` D 0 N E G A L CIRCLE I CERTIFY TO MERCHANTS BANK. & TRUST COB OF CAPE COD, RICH ARD P . MORSE , JR „ ESQ . --AND ITS TITLE" INSURANCE COMPANY, THAT � THERf ARE NO VISIBLE ENCROACHMENTS OR EASEMENTS EXCEPT AS SHOWN AND 'THAT THIS PLAN WAS PREPARED UNDER MY IMMEDIATE SUPERVISION , THE . LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY-LALWS WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS +,y KENFJETH THE DWELLING SHOWN HERE DOES NOT FALL --- -_ -- The Commonwealth of Massachusetts _�- Department of Industrial Accidents _-:_P f Office oflnrestigatians �i4 - , M '=�'� 600 Washington Street � Boston,Mass. 02111 Workers' Compensation Insurance Affidavit name: location f 7 ✓J d t? F city Cra C 2 e y f �( F /� nhone i! v - Ya -a 3 PR I am a homeowner performing all work myself. ❑ I am a sole ro rietor and have no one workin in any capacity ❑ I am an employer providing workers compensation for my employees working on this job. company name: address: _. . . city: phone#- insurance co. Vn1icV# r ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the folloning workers' compensation polices: companv name: address: city: phone#: ... . insurnnce ca. . ........ company name: address. - cit%: phone#' ;,:;:.._.... ... ..:.: ... insurance co. olicv,# Fadure to secure coverage as required under 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 dva penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a COPY of this statement may be forwarded to the OMce of Investigations of the DIA for coverage verification. I do hereby certif nder t and penalties of perjury that the information provided above is true and eorreex Signature G� Date Print name �l 1 e h 4C I g�C. f.0i n Phone# `�O�— y ass — O 1`7 Fcontact ly do not write in this area to be completed by city or town otneial permit/license# P ❑Building Department ❑Licensing Board mediate mponse is required ❑Selectmen's Office❑Health Departmentn: phone#; ❑Other w::..........; ::::: .. (tevuea W93 PJAI 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 cote, 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 c. 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 section 25 also states that every state or local licensing agency shall withhold the issuance or renewa 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 performancetof 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 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 returned 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 do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Ofifce of Investigatlons 600 Washington Street Boston;Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext 406, 409 or 375 Building Division t�►er�tsresttr. ' 367 Main Street,Hyannis MA 02601 es�sa 1"9• �0$' Office: 508-862-4038 ; Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE•.7 --/ ` R JOB LOCATION: 17 C l/�lI Y C o�`i' C f k� ce/I/2K number) I street village "HOMEOWNER": O 1'(1 _ O 2;- '?a;l' '� S�L/0 name M Rhome phone# work phone# CURRENT MAILING ADDRESS: I f'c Y 7 e,e-c-i g�u vL C 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 undersi ed"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum'' sp tion procedures and requirements and that he/she will comply with said procedures and require iie /Sign of Homeowner i r 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.M 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 to amend and adopt such a form/certification for use in your community. i Q:FORMS:[7EMPT b , THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINAL (S) m E DATA f ,,. z t;'r r #.�.lae`,'Y' Jlt`'^�t.l�s,f .rs ,: +°6t` nit+ €iH a } )v. v,Etr# I.I.,.roar ah..l;1 k r .';v,xtrtytd m {f.,',4'1`�+3 ' ,�y e�,t• f �•'' r b,iv , t +•*.. ±t'rr .,}di I i�lkry it �;d'1�{t�}ks...�d'�?�J' �a,� r'�.li�:}.rit'r ear,; { rvd: •,k#, ar`a P�....5+�`i Mij;ir�t "'?.`G A+rt.i„� "1 r. t 4 +r 1.-rt Iwo t , h {t'>�t I eP""t' a '� h # .tf:. 4S rM t.. 'r rrJ Pr,,.an, 1 .yJ{t 1.+t rr• . tr+�'tr- {'' tr'1 ip 7 v ;r# r{La >a .rh h'. 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' � ,�.. r:;.. ,�'�r`"� ,1^ ..•_F ,,,.,.. ... .,_ , J' n�. <.t:.._ 'mot �t,.....:.i,Aa Ar•". i. a...(r Xu r. drr I. tf«•�.,.i 1 ` AUG - 7200-0 a *r Department of Health, Safety and Environmental Services -`- .. .. - AS& 16g9• �E� A BUILDING DIVISION BY THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY.EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY,PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL-AS DEPTH AND LOCATION OF'PUBLIC SEWERS MAY-BL OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.'THE'ISSUANCE OFTHIS PEROhT DOES NOT RELEASE THE APPLICANT FROWTHE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS'REQUIRED d9 . FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION PERMITS ARE REQUIRED FOR 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU ELECTRICAL,PLUMBING AND MECH- (READYTO LATH). PANCY IS REQUIRED,�SUCH BUILDING SHALL NOT BE ANICAL INSTALLATIONS. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. . . 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLE.POST THIS CARD SO IT IS FROM STREET. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSP CTION APPROVALS / 7-0G>v d�csl r 2 ' I , 2 O0 2 1V �` v 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW.APPROVAL ::r... WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. BUILDI NG ��FTHEtp�� TOWN OF BARNST ABLE SAUSTULE, i 90 M6 BUILDING INSPECTOR O `.G Y �,�0 AY a APPLICATION FOR PERMIT TO ... .. .......... .. ......... .. .... ........ .. ....... .................................... TYPE OF CONSTRUCTION .. .. .... .......... .� ... .... y�'.................................. ...............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: �b Locationkc'T...j6......�'.!- C!�.C'.6......................................................................................................... Proposed Use ... .... . .. . .......................................... Zoning District ... �1...........................................................Fire District .. .. .. ........ ....... ............ Name of Owner .. . .... .:`.1........Address .....�.�.......(�,.... ......... d9 :a'�.. Nameof Builder ....................................................................Address .................................................................................... l ( r� Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....... . ..L.................................................Foundation .... •��,�� Exterior ..�frLt �(he`....•`r'�r ... ............Roofing .L� �:y?, ................................................ Floors . .............................................................Interior ....L:.. .. ....���1-iro .................................. ....... Heating C.a,....E wA...............................................:Plumbing Fireplace ..........f.....................................................................Approximate Cost .......1.�J`.O.d. .................. ........ .. ......... 7� Difinitive Plan Approved by Planning Board ________________________________19________ . Diagram of Lot and Building with Dimensions / =e e.. THE PROPOSED MEETHOD 0T- P-0V',i- f 1G-FOR SANITARY WATER SUPPLY,'SEWAGE DISPOSAL 0 AND DRAIN GE IS HEREBY A P�' 70 TOWN OF BARRNSTAFILE, BOARD OF HEALTH - A LICENSED INSTALLER MUST OBTAI SEWAGE 4 r PERMIT, 4ND INSTALL S'YSTEiVf. "I c. ?�� 3 hereby agree to conform to all the Rules and Regulations of`the Town of Barnstable regarding the above construction. Name �� Dacey, William E. Jr. DEC 31 1970 No ...1 06... Permit for .build one sto]7- ................ .........dwelling.................................. .................. Location :.,Daneal Circle ................... Centerville . .................................... Owner .Y �??,sz21?.E.,,Dag®fir Jr...................... Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ......Qctohar....9.............19 70 Date of Inspection v.. .. .............19 70 Date Completed ......................................19 PERMIT REFUSED ................................................................ 19 ............................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... 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'+f'°.rrUr.xtMj1#44 '•ti /^ �w,'."*�'1� tff ff,,+/tl d.F/ i X Ar ff 'Irr �t/ fa°x► �lqa�". < ia^t'�iJp k4SAl�M at%#l�'A"°""...■.. x ,+�'� f*maA Wk + _ . krf M s is ZoAC 1r i Y:. f >fi1�� .r�lG�.lt7po' [I".,4i� `"�tity"`y-+.'�!, rf�,f�;.* _ r♦r'fJf/JrlOP1!ffA fFIf ffIIl/J/'rafrrr rf/J-fArJfrff ff/ff Ar✓ t �r'kr.A.r rf°'r.,. ., +K iA'+'�✓A.l'q�+ �`�;�4�'ip.yi r a*Wy / dS R4:1 ♦ , J . aw . 1 1 -. xv' 30 /' 71"7r' "1J1:` r= StrR►,3`r J#" ftv #T,91" a?' lie r �7,� !y ryf era 7 .5 ^f7wu�,,r• ,{i* °e '4 r. „rrMr /' ,S'9 I M V rW PRAM-K Or LkVV 01MIAl�t'rW IV T- �"'•+��, �'"`,x -'''' �� � x) CMAS"N PLAA' OP LAND rope . .Pk�„J G�` " 'R�'DT�L�.�.ly7 ''J IWZ* fD A fit" CHIP 1:' * 1110 . ON , + 'R '`HCG SCALE 40 1ATZ STR r ROAD MARSTONS HILLS, MASS. 02648 _...+....'�.rlia,^.,w.,,a..-.swa«wa.wmua+nu.,®r.vwamnm.�„m:wm+.wrcr, m., .., -.. wow.,.,.:i..:»:w•xa.o-rL . .r/ 54510 sill y;.