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0032 GOFF TERRACE
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'.0 J ��.(-,is :INA , Town of Barnstable BuildinPerm - P..ost+This:aCardSo That�tris V�s�ble`From„the Street ,°A ,"' rovechrPlans Must be,Retamed on Job and,this Card;Must be;Ke t • flARNf3Y°ABI'E' ' ;�,°' w a ,:;. �� r-..,,r"�' .",����`' �� adz, �;�s 1'p`�� '�.:' � '� :; �',, ,., ,�` �. � �. p���' ?:. ' • M os PtedUntlFinal laspection Has Been Made f �, �.. 1639.° .Where.:a Certif atevofO.ccu anc is Re aired such Buldm shall NotbeOccu ied untih-aRF�natanspection hasbeenmade 1� Y° ,...��4.:� ' g . �- ... , ....�.� .•.;, ,mp �.�. ra �- .,, NY . ,._ , .,. ..: Permit No. B-16-1376 Applicant Name: SHANAHAN, BRIAN W& KATHY L TRS Map/Lot: 171-106 Date Issued: 06/22/2016 Current Use: Zoning District: . RC Permit Type: Shed-Residential-200 sf and under Expiration Date: 12/22/2016 Contractor Name: Location: 32GOFF TERRACE,CENTERVILLE Est Project Cost: $0.00 Contractor License: L Owner on Record: SHANAHAN, BRIAN W& KATHY L TRS# x Permit Fee $35.00 - Address: 32 GOFF TERRACE s Fee Paid $35.00 N' CENTERVILLE, MA 02632 # ' - ' F ' Date. � 6/22/2016 Description: 12x14 Shed Project Review Req 12x14 Shed z Building Official This permit shall be deemed abandoned and invalid unless the work author�¢ed by this permit is commenced w th n iz months after issuance. All work authorized by this permit shall conform to the approved applicatioh and the approved�construct on,docume its for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be'in'compl'iance with tfie..lo,.calzoning 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 mspe5ction for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures W the Building and Fire Officials are provided on this-ppermit. Minimum of Five Call Inspections Required for All Construction Work E 1.Foundation or Footing 4� , 2.Sheathing Inspection =` 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to frame Inspections ` 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT d ce� Town of Barnstable - �"'E ,ti Regulatory Services o" Richard V. Scali,Director } k ► BMWSrABLE, MASS. Building Division 039. ,t AiEo 3.t A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-79076230 PERMIT FEE: $35.00 `,.SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less l Location of shed(address) Village r Property owner's name Telephone number. G iz x r ��� iopw�, r1� Size of Shed Map/Parcel# .. Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway Conservation Commission(signature is required) Sign f hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:040914 I NE -7 /{. • r GO/.� �tir� ✓G'�`"� JV T'2r /+ s�o'wiDC — 1 =��b I 3 � n I A +i • of i /0 7- Sp, 177 Ev`� �y S77.vG' i Z ��S• Scgnc i �I S T 7q-v►G' �_ /I r Al - r E"D• Oti/_/�SUHE2� Dl9TL�—! k • CERTI FI ED PLOT _ PLAN LOCATION 7zVi4G MASS. - 30 SCALE . . . . . . . . . . . . . DATE si r z7/479 PLAN REFERENCE T . . . . .As.. . i J/ Sh/oW N O N /� /�lA�✓ O/c �� �Fs✓D aE-D Lo T .20 I CERTIFY THAT THE QZ�S7�i/G JrD�•/LYgT/o.ci SHOWN ON THIS PLAN IS LOCATED ON THE GROUND �'oFF �,eA AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF Rirn!-srgr3L . . . . . . . . . WHEN CONSTRUCTED. 7VpZA,7'0 ,��.jP..�\/� DATE T 1 I / 0 �t►,E r Town of Barnstable *Permit# G� months rom is e Expires 6 date Regulatory Services Fee • lA I MASLE • MAC'1639. Richard V. Scali,Director ♦� Building Division PRESS Tom Perry,CBO,Building Commissioner �a 200 Main Street,Hyannis,MA 02601- SEP 23 2015 www.town.bamstable.ma.us Office: s 08-862-403 s TOWN OF S EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY I-?[ 11ol, Not Valid without Red X-Press Imprint Map/parcel Number Property Address 3 2, &o f 6&d eel Vl l(-t [O'Residential Value of Work$ vo v Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Brl4 P +- L�a� Aafla Contractor's Name �fltth AC,-a huV- Telephone Number ��� - 360 '3�(a7 Home Improvement Contractor License#(if applicable) 1S6 Z!I -Email: 4n C�mCusf-YIe�. Construction Supervisor's License#(if applicable) (IS- 60 L(r) [�J_Workman's Compensation.Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner 211 have Worker's Compensation Insurance Insurance Company Name_ �LR wl�� r faf( _bASorgetc t° Cv . Workman's Comp. Policy# I^'G 0M-6 t- g 331 _ Copy of Insurance Compliance Certificate must accompany each permit. 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) i rRe-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with othentown department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Wre y of the Home Improvement Contractors License&Construction.Supervisors License is red. SIGNATURE: Q:\WPFILES\FORMS\ uilding permit fomu\EXPRESS.doc Revised 040215 The Commonwealth of Massachusetts Print Form_ Department of Industrial Accidents -_-- ice of Investigations ' I Congress Street,Suite 100 Boston,MA 02114-2017 b www mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/O,gmiimtion/Individual):Brian W.Shanahan Address:32 Goff Terrace City/State/Zip:Centerville, MA 02632 Phone#: 508-360-3567 Are you an employer?Check the appropriate bog: Type of project(required): 1.911 am a employer with 3 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' 9. El Building addition [No workers'comp.insurance comp.insurance.t required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]fi c. 152,§1(4),and we have no siding employees. [No workers' 13.❑✓ Other 9 comp. insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the subcontractors and state whether or not those entities have employees. Uthe 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 pokcy and job site information. Insurance Company Name:Granite State Insurance Company Policy#or Self--ins.Lic.#WC009619339 Expiration Date:1/03/2016 Job Site Address: 32 Goff Terrace City/State/Zip:Centerville, MA 02632 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 Gera the sins and enaltks of edury that the information provided above is true and correct Si ature- ------ = - --------- --- Date Phone#:508-360- 567 Official use only. Do not write in this area,to be completed by city or town ofciaZ 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#: r Policy Number: Date Entered: 09/22/2015 Act® CERTIFICATE OF LIABILITY INSURANCE FD/22/NDDIY 922/2015 5 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT PASSARO, LEVERONE 6 BUCKLEY INS AGCY INC NAME: FAX 239 ROUTE 28 PHO UVC_NE .(508)398-2223 IAIC NO:(508)398-2224 E-MAIL P.O. BOX 160 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC t/ DENNISPORT, MA 02639 INSURER AsGRANITE STATE INSURANCE COMPANY INSURED BRIAN SHANAHAN CONSTRUCTION INSURER B: BRIAN W. SHANAHAN DBA INSURER 32 GOFF TERRACE INSURER D: CENTERVILLE, MA 02632 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSLTTRR TYPE OF INSURANCE ADDL SUB POLICY NUMBER POLICY EFF MPIO�LICDY EXP LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED CLAIMS MADE OCCUR PREMISES Ea occurrence S MED EXP(Any one person) S PERSONAL&ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE S POLICY❑PECT RO- ❑ J LOC PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY I COMBINED SINGLE LIMIT $ -(Ea accident) _ ANY AUTO I BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE S HIRED AUTOS AUTOS Pera'Odent $ UMBRELLA LIAO OCCUR EACH OCCURRENCE. $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER A ANY PROPRIETOR/PARTNERIEXECUTIVE E.L.FACH ACCIDENT $1 r 000 r 000 OFFICERNEMBEREXCLUDED? Y❑ NIA WC 009-61-9339 /3/2015 /3/2016 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $1 r 000 r 000 It yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached K more space Is required) CARPENTRY WORK BRIAN W. SHANAHAN IS NOT COVERED UNDER THIS WORKERS COMPENSATION INSURANCE POLICY. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 200 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS, MA 02601 AUTHORIZED REPRES 7 THE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD Produced using Forms Boss Pius software.www.FormsBoss.com;Impressive Publishing 800-208-1977 1 Massachusetts -Department of Public Satety , Board of Building Regulation's and Standards Construction Supervisor y License., CS003247o� 32 NTE�rI�I.,�E ►r cE r 6 g ilk'i rxpr;ratian . 1110312015 L.OYTlrMi4SQ0t1e[ - i !�f�e�czrc�Frarcrc.��r/�l�i, ulation:lt E office of Consume r Affairs&BusinessRegi OME IMPROVEMENT COPfiRACTOR Type; _ istration 156211 Individual n Expiration �t' 13< - BRIAN SHANAHAN BRIAN SHANAHAN 4\ 32 GOFF TERRACE _. CENTERVILLE,MA 02(�3?' U dersecretary ; r;nnNse BLF, MASS. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.tow.n.barnstable.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 Property'Owner Must Complete and Sign This Section., If Using A Builder I,T/5(1104 ������ , as Owner of the subject property, hereby authorize �(��^ Stu`'�`Gl�"� to act on my behalf, in all matters relative to work authorized by this building permit application for: l (Address of Job) AIA- �ld SAatureer Date Print Name Y If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. Q:\WPHILESTORMS\building permit forms\E)TRESS.doc - r Revised 040215 Town of Barnstable Regulatory Services �Tt1E rgyr Richard V.Scali,Director Building Division BMMSTABM ' Tom Perry;Building Commissioner " MA85 1639. 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 of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILESTORMS\building permit forms\EXPRESS.doo Revised 040215 y: YOU WISH TO OPEN A BUSINESS? I:or Your Informat:inn: (cost.$4.0.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (wfur.;h yoi_r rnust:do I3y M.G.L. -h:does not give you perrnission to operate.) You motif fir�i ohiain the nra:c. stark ;ign;iftm ;, I:n1 this r�rrni al ?00 `-lain tit., H annis- I,rki, thr c onri:rlr led 10rm 10 11-10 fr:w\'rr Clfld: 01:11c o, I sl fl., q.7 Niain tit., F-Iv�ulnis, ('0A 0'>h0l (T���wu Fialll and �e l flrcr 1:3u.�ui� s� C::r. rtifit''Ili., th;it is rr'c11.111-0d by lavv. u,. DATE: y /7 12,616, Fill in please: APPLICANT'S YOUR NAME/S: 5et an 5AA h Q.h�t n er BUSINESS YOUR HOME ADDRESS: Cra f 7-erra�e _3r67 Cln /t?rVl P r/!R TELEPHONE # Home Telephone Number s O P v A 2-7 c )y t NAME OF CORPORATION: NAME OF NEW BUSINESS Arlan "► 4,1 Gv, TYPE OF BUSINESS_ s a oil ey IS THIS A HOME OCCUPATION? YES NO ADDRESS OF BUSINESS 3 a (,-of F Te rr-cP n h r-v1 l./ ' MAP PARCEL NUMBER f I( <O G / (Assessing When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Ad. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING COMMISSIO ER'S OF CE This individual hds e i e e IV it re irements that pertain to this type of business. MUST COMPLY WITH HOME OCCUPAT Of Auk on i ** RULES .AND REGULATIONS. FAILURE 1 t._, MMENI". Py)I fir j 2. BOARD OF HE LTH This individual has been informed of the permit requirements that pertain to this type of business. - Authorized Signature* COMMENTS: 3. CONSUMER AFFAIRS(LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature* COMMENTS: it i ToWn of Barnstable. 1"E T Regutlatory. Seiic.es. o Richard V.Scali,Director ST" _ Building DivisionRARNM y� brass.g Tom Perry,Building Commissioner. 'DrEn tuul s 200 Main Street,Hyannis,MA 0260.1 www.town.barnstable.ma.us Office:' 5087862-4038 y Fax:`508-790-6230 Approved: - Fee: z Permit#: oZ�� S�.om 4 HOME OCCUPATION REGISTRATION Date: yli1 Name: Phone#: -76 Address: 32 &,-(f L rroce Village CPy1 E►'VII�P Name of Business: lYt a.*\ V(, S6Wl J(" CJ Type of Business: (Volt, rN : Map/L.ot : 17 EITI ENT: It is the intent of this sectionto allow the'residents of the Town.of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be-no increase in noise or odor;no visual alteration to the premises,which would suggest anything other than a residential use;no increase in:traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the Building-.Inspector,'a customary:home`occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling'unit- • Such use occupies.no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and'there:is no outside evidence of such use: •I: No traffic will be generated in excess of normal residential volumes. • The use does not involve the.production of offensive noise,vibration,smoke,dust or other particular matter, odors,electrical.disturbance,heath glare;humidity or other objectionable effects. • -- There.is no storage or,use,of toxic or hazardous materials,or flammable-or explosive materials,in excess of normal household quantities: •' Any.need for parking generated by such use shall be meCon the same.lot containing the Customary Home Occupation,and not within the required front yard.. • There is no exterior storage or display of materials or equipment. o ' There are no`:commercial vehicles related to the Customary Home.Occupation,other than one van or<one pick-up truck not to exceed one fon capacity,and one trailer not to exceed-20 feet in length and not to, exceed 4 tires;parked`on the same lot containing the Customary Home Occupation: • No.sign shall be displayed indicating the Customary Home Occupation: If the Customary Home Occupation is listed or advertised as.a business,the street address shalt not be included No person shall be employed in the Customary Home Occupation who is not a permanent resident of the`. e g unit I,the undersigne ve(adand agree with the above restrictions for my home occupation I am registering.'., Applicant Date. Homeoc doc Rev.i113 f T"E,°�ti Town Hof Barnstable *Permit# Expires 6 months from issue late Regulatory Services Fee BABNSTABLE, ��A MASS.6,9 $ Thomas F. Geiler,Director _^ �`�%J jFD MAI Building Division Tom Perry,CBOT,Building Commissioner 200 Main Street,Hyannis,MA 02601 www,town.bamstable.ma.us Office: 508-862-4038. - Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X Press Imprint Map/parcel Number r7( D 'Property-Address P�fResidential Value of Work 'goo Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address h §l arlc hol) L -Zro f f T.errw Cen+e✓vC[G , /4M C)�(0 3 L Contractor's Name GVlr-Au►n Telephone.Number Home Improvement Contractor License#(if applicable) 15_6 2-1( Construction Supervisor's License#(if applicable) Z Workman'sCompensationInsurance APR ZOO Check one: TOWN OF BARNSTA BLE [� 'I am a sole proprietor Y 21 am the Homeowner ❑ I have Worker's Compensation Insurance �(- Insurance Company Name AfG,T��t��_�Ul(�► �" Workman's Comp.Policy# k 430 Lq 2Y 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 yQrin✓1�/v`t fhi"�f IIj ❑Re-roof(not stripping. Going over existing layers,of roof)` []/Re-side #of doors [Replacement-Windows/doors/sliders.U-Value °7I© (maximum .44)#of windows /6 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property O must sign Property Owner Letter of Permission. copy of he Home Improvement Contractors License& Construction Supervisors License is re SIGNATURE: - n.\urnrir=0VCr)_DV1 \1-,;1A;, „PT,.,;1 fnrmc\FXPRF.CS rinc The Commonwealth of Massachusetts Department of Industrial Accidents !, Office oflnvestigations f' 600 Washington Street Boston, MA 02111 www.niass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): . ��td� Slvklt~Ala✓, Address: City/State/Zip: ���r fi(II,p IPA 3L Phon(,Y e i Are you an employer? Check the appropriate box: Type of project(required): 1.-el am a with employer 4. I am a general.contractor and 1 —� 6. ❑New construction employees (full and/or part-time).* have hired the.sub-con tractors 2: I am a sole proprietor of partner— ship '. listed on the attached sheet.. 7,p[remodeling and have no employees These sub-contractors have g. Demolition workingfor me in an capacity, employees and have workers' Y9. ❑ Building addition [No workers' comp.insurance comp:insurance.l uired.] 5. 0 We.are a corporation and its I0.0 Electrical repairs or addition 3,: I am a homeowner doing all work officers have exercised their 11.�.Phtinbing repairs or addition myself. [No workers' comp: right of exemption per MGL 12:0 Roof repairs insurance required.] t C. 152, §1(4),and we have no employees: [No workers' 13.❑ Other- comp.insurance required.] *Any applicant that checks box ill 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 contractor must submit a new affidavit indicating such. tContraclors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their.workers'comp.policy number. - I am an employer that is providing workers'compensation insurance for my_employees. Below is the Ipolicy and job site information. I/ Insurance Company Name ((MtS 1. V(A(UVl Policy# or Self-ins. Lid.#: we &(;d La 7,1 Expiration Date: t G 7 1 Job Site Address: r.?.mGQ City/State/Zi : (,�� P� 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 MOL 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 maybe forwarded to the Office.of Investigations of the,DIA fiy insurance coverage verification, I do hereby c i rind r the pains and penalties ofperjury that the information proridedabove is true and correct. " Si ature: Date: 501 Phone#. ?.`f Official use only. Do not write in this area, to be completed by city or town officirl. 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 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,constriction 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 tivho 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 ic work until acceptable evidence of compliance with the insurance enter into any contract for the performance of pub] 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 certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(UP) 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 pen-nit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number,listed below. Self insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be1sure 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 givenyear,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 filture 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 buslneSS 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 lnvestigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASS.AFE Fax # 617-727-7749 Revised 4-24-07 1 www.mass.gov/dia Town of Barnstable Regulatory Services • Thomas F.Geiler,Director BARrrsreBLE, "� �m� Building Division PIED ' A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 3h-c i _ / 4 JOB LOCATION: 3t village number street 579 P_y� _7��y SZ F-yid 767 j "HOMEOWNER": �m work p hone#1 nae r home phone#i 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/orfarm 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,,, 09.1.1) The undersigned"homeowner"assumes responsibility for compliance with"the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned` w oner"certifies that he/she understands the Town of Barnstable Building Department mi 'mum spec n procedures and requirements and that he/she will comply With said procedures and requr + Signatur o Homeo er Approval of Building Official ' Note: Three-family dwellings containing 35,000 cubic„feet or larger wiUbe 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' ermit 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 dq 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 oftenTcsults in serious problems,particularly when.the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. eexemot.DOC - 1 ` �YHErp Town of Barnstable Regulatory Services BARNSTABLS, Thomas F..Geiler,Director eo:%..9' � Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.ma.us Office: 508-862-4038 Fax: 5087790-6230 Property Owner Must Complete and Sign This Section If Usina A Builder /� h r���ta� as Owner of the sub'ect property 7, R I G'L J P P hereby authorize to act on my behalf, ^in all matters relative to work authorized by this building permit application for. (Address of Job) qll3 d 4Signeof er D to Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. I � , '.e TOWN OF BARNSTABLE Permit No. ----------_----------- 1 UUITAU Building Inspector Cash ------------------ OCCUPANCY PERMIT Bond No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .....................................................1 19...... .................................................................._............_....................... Building Inspector Quicki4NoW Date���En►rOeIC 3 196 To" Subject J©� OQY- "ZOrke- '4 QCtoit in r16 so6dlv; iov,— e mjeoQyLk" 'f jt o o;O►-\ oo r S 2- 47-231 Poly Display Pack(50 Sets) From N 147-232 Desk Dispenser(125 Sets) �• ` NATIONAL Made in U.S.A. 1.7 �' ,- .. ' , , •;�,, - �' , r+' r { �:, r. I . ;�II IL,o7- -* 20 3� C'•a�'k�r�e� j � . . �'.` ', L x f�� ���e���5 �O� =t- �C,�T 2a =� 3Z �--���%2� C.�� � w ,Ale zT of Z 3/fEZ7 ti� lV �' GoCF AL' �7XAc6- a3'� Pev. �'wiDC �F I //o,0 0 All I P, �'u �; I A I 76 Al 9 r B0X -- EZE-vR'na,v= �t.SE"D Off/ �¢SS(INEv Df�t�'7 CERTIFIED PLOT PLAN IDCATION SCALE . /.r_ 30 DATE.SEP'T z7/979 PLAN REFERENCE . . ?. . .AS. . ' pA r S��V�N ON A R44-p/ oF . . . . . . . . . . . . . LoT .20 I CERTIFY THAT THEFG�•vA•9?7o.ci ....... .. ...... SHOWN ON THIS PLAN IS LOCATED ON THE GROUND l70`jC �,eAC� AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF ST9tjG�.. . . . . . . . . WHEN CONSTRUCTED. DATE PETITIONER: yyl4/✓IV/j REGISTERED LAND SURVVOR N59J�5 ess'ror's map and lot numb .................. /� �FTNEtO �... lJ Sewage Permit number ........................................................ S INS IN ' J?Z ABLE, i House number .......... a WITH W ' 5 9�0 1639. C-NVIRONMENTAL.COD Y a TOWN OF BARNSTIB-LBI LATIONS- BUILDING INSPECTOR APPLICATION FOR PERMIT TO .:......0 `.. ' TYPE OF CONSTRUCTION .........WALU.?2.......... ''..r. ........................J.......................................... t ............................. ............19. .� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following infoirnation: Location ........... ...........J.. :!!R.#.( ..............� .L.1,...1. .n .,.&................... ProposedUse ..... .. .!�1.t9....��`c...... I41�1.t...l.. ............................................................................................................... ki Zoning District ......:. ..........................................................Fire District ...... b......5 ...........(R✓'i .. ......................... Name of Owner .!.5..�'.��!. (.....I. Z4 t�1. ..........................Address ..............................y .�:.1.�� �......N.. .F... `�l..q . r°!.% Nameof Builder ......... l......................................................Address ............. . ................................................................... e-e s .Name of Architect ..................................................................Address .................................................................................... Numberof Rooms .......6........................................................Foundation .&...1.' cla.........40.............. .................. C2�e¢I.� Exierior .....................................................................................Roofing .5.. .�.dSt....�..... ................................................ Floors ....../✓. .kvz.................................................................Interior ......2. ....5'.[ct..C. ..�...... .C4..0 .f'�........................... Heating GTi� �. Ihd q /0_ d.$.. .............Plumbing �................... ....... . ...... ................. ........................ Fireplace ........4.. ...5............................................................Approximate Cost ............ ®.C?..................................... Definitive Plan Approved by Planning Board ________________________________19________. Area /... :........................... Diagram of Lot and Building with Dimensions Fee .. Q" .............................. SUBJECT TO APPROVAL OF BOARD OF HEALTH vb I hereby agree to conform to all the Rules and Regulations of th wn of Barnsta le regarding the above construction. Na .��� ?... f ............................. V77 Burke Homes "1706 No .............. Permit for ...... 1 1/2 story single family dwelling ............................................................................... Location ..............................................lot #20 3 2 Gof f Goff.................. .. Centerville ............................................................................... Owner .............Bur..k...e....H.omes................................... ........ ..............f r.a.me Type of Construction .................. ................................................................................ "Plot ............................. Lot .......420 ...................... Permit Granted ..........October..............19 79 • -Date of Inspection .............. .1. ... ..........19 Date Completed .....t... ........ .............. PERMIT REFUSED .......I.:....................................... 19 ti V. .......... 71.. ... . ......... ......... ...... 4 L .. .. .... ..... . .. ........ ............... east 0 M Appr .... ..4. ................................ 19 ............................................................................... ................ Z S� ,A" ktiib 7��e�9e.�- 3`V Ai2v. 9o'wiDt i //O.Oo I — All, "'77NG W i Y ¢,F 70 ¢ A1$ cob 221 7w V i5 r PST Cox -� -- �z�1/fI97O v3 S,9;56V ON �SSUHEv DfjT{✓� �Yy ° `_ `K 6( CERTIFIED PLOT PLAN a z LOCATION Cen-, Z?ZViGGC- MAss. SCALE . ,. 30�. . . . DATE sir z 7/479. PLAN REFERENCE A?A!G.. 407 SNaW N 0,V L.o r zo I CERTIFY THAT THE 14 !4r1.v.. �vu• iT�v.v G.... ....... .. ...... SHOWN ON THIS PLAN IS LOCATED ON THE GROUND �oFF T���ACE AS SHOWN HEREON AND THAT IT CONFORMS TO THE 8 // SETBACK REOUIREMENTS OF THE TOWN OF/'��-1�5 . . . . . . . . WHEN CONSTRUCTED. ..DATE 4StX7.2.7./�79 PETITIONER: .9/✓N/S /�ff1SS. # . f' Y / REGISTERED LAND SUR OR N59345 r 4'7 70 TOP OF FOUNDATION CONCRETE COVER CONCRETE COVERS 4"CAST IRON 12"MAX. 12"MAX. PIPE (OR 4"ORANGEBURG(OR EQUIV.) EQUIV.)- MIN. PIPE- MIN. LEACH ' PITCH 1/4"PER. PITCH 1/4"PER.FT. PIT . e PRECAST o' NV RT • Q LEACHING ` EL. 7.�r� ... INVERT INVERT p . e•`e PIT OR o SEPTIC TANK EL ,qt�,S� DIST. EL,�,�B >x EQUIV. , o INVERT 80X /000 GAL. INVERT �a ci � e; EL. - yrC3 INVERT w w 0: ::�. 3/4"TO I VZ EL.....,! •. WASHED STONE WDIAOIA Lo p� PROR LE OF GROUND WATER TABLE SEWAGE DISPOSAL SYSTEM NO SCALE SOIL LOG WITNESSED BY : DATE-'-z."b.•.?; i979 TIME1-'.30 " PAuL /yc„e2AY BOARD OF HEALTH TEST HOLE I TEST HOLE 2 •rl�S �, ZG P� ENGINEER ELEV. .`��7n. . . . ELEV. .. .. . 7 DESIGN DATA ' Sug-Solt- NUMBER OF BEDROOMS 3o,f TOTAL ESTIMATED FLOW �37'30. . . GALLONS/DAY t'a�zsc /B.S sar.o BOTTOM LEACHING AREA SO.FT. /PIT SIDE LEACHING AREA . .�SP�' . . . SQ.FT./ PIT GARBAGE DISPOSAL NON (50% AREA INCREASE) Z9 oa SM�D TOTAL LEACHING AREA . . . . . . . . . SQ.FT � ,. PERCOLATION RATES. Th% MIN/INCH LEACHING AREA PER PERCOLATION RATE SSa.. SQ.FT. .!Y� .WATER ENCOUNTERED NUMBER OF LEACHING PITS -1 PIT' W.177V TWo. . APPROVED BOARD OF HEALTH i?7 OF•-57blVE dN ALL SIDES• = 4$ G 7TNS � of J-)VAIC PEz P/T• .THOMAS E.'KELLEY CO: DATE. . . . . • • � ENGINEERS—SURVEYORS AGENT OR INSPECTOR 346 LONG POND DRIVE SOUTH YARMOUTH,MASS. OFM r # Zo �ZN OF pa `��E. 02664 t4P 7H PEA - Kr:tLer ELLEY .¢ No.1I260 O y s;v i4o 23i .lC/ST�p��k AIEN PETITIONER / �rtJii!/S /VfASS. y�G` p SINI-I '�rpN � �.. . � .. Assessor's map and lot number . . .......... EPTIC SYSTEM MUST �,Q of TNF to�� Sewage Permit number ................: .. r.. .� [ JkS�',��.LED 1N COMPLIA � , o� WITH TITLE 33AH39TABLE, i House number .... ?.2. ........................................................... t 1 � �"DENTAL Cl.- -� 900,e,1639- \0� t Tf)+' i ?OF 'BARNSTABLE TOWN BUILDING INSPECTOR APPLICATION FOR PERMIT`TO -V.�.... ... .... ... 4�1?Tl. ? ..................................................................... TYPE OF CONSTRUCTION ....YVD.OD.......hA!v...E................................................................................................ .............3 -� f� �.............19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ? ...Z.v..........#...r, ..............:......... ...5?- 2........... rEo�llf2V(!i1.E......................................... ProposedUse .... J�j'NA .. .............................................................. ............. � ZoningDistrict .......�................................................................Fire District ............... .:............................................................ Name of Owner �✓IIR ....S ........................................A� Address ..............(..Qr tE.n&.........�R T. -E&V-L 4.6... Name of Builder Q!?....!' .....5 ?... ........................Address .............F.. .. TEn2 Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .........#. c................................................. ....rU6'U.......................................................................... Exierior �'t`:AQ� n'��:. -...�{.�� �L�/i�dVD.......................Roofing ..A.S-Oi�LT.................y7r...pl!�WDDV .... ..... ..................... Floors e4.09-r.. ..............................................................Interior .SZ?�T....44 . .C,� .... . .................................................. }-rcarrn`rs'4sr�l.....f...............'........................-..........................-...Plumbing ...............................................................:.................. Firepp NOn/6 ..................Approximate Cost . ..... lace ................................................................ cr d............................................... Definitive Plan Approved by Planning Board ______________________19________. Area :J�.%.y...5 .�t'...... � � Diagram of Lot and Building with Dimensions Fee ............ .......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �t 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 ...Kf!:. !l ..................................... Construction Supervisor's License :L::6 ......... SHANAHAN, BRIAN A=171-106 � No ......2.z,.72,8Permit for -Addi•t on••• ...............sin.g.h....fam 1y...dwel•lin Location Lo. ... t #20. .......3. ... 2 Goff. . ....Terrace. . . ..... .. .. .... . .. .. .. .... .... .... .. ............... .................................... Owner " Br.ian. ....Shanahan. ......................... .... .. .... ............ ....... Type of Construction mQ ..................f......ra ............ ............................. I. Plot ............................ Lot ...........'................... r Permit Granted .............. .......19 85 G:jte of Inspection ....................................19 Date Completed ( A 17i -... � � Assessor's map and lot number .:................... ......... ............ CF THE t0 Sewage Permit number ................................... �.. Z 33A"STADLE, i House number ....S.. :......................................................... It NAM 1639. TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION ,FOR PERMIT TO ........ '+:: ;X7,f '...................................................................... TYPE OF CONSTRUCTION ....I vv0 ?...r�1dJ !!n. ...................................................... .............. ':::.f..:�-' ................19........ t TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......!{a .....!:. 3.......... ... a "" .........................f?.?: `.......... ...............` .:.... 17:� ....w ...... ................................... ProposedUse ...... ':1 ... . .................... .................................. r....................................................... rr � �� ....Fire District Zoning District ......./.......................................................... .............................................................................. Name of Owner , r,f'ry . � ..........�.... ...........................Address .. to r .... . �' Nameof Builder .:?f... .. ............Address........................................... ....................................................................,... ... ... Nameof Architect ...../�ru¢�/ .................................................Address .................................................................................... Number of Rooms Foundation ...1�4'V'� ��................................. .................................................................. r i 3i tl:� 3cisX �'+— t �L t/rUfiV �??.S .�ifc7 t�1t1#D1> Exterior Roofing . i' Floors !? ✓' "!? -.........................................:............Interior .: !, ? .... JF. :.................................................... Heating %aC ....Plumbing `v t- ........................... ................................. .......................................... ................................. .................. Fireplace ...NC Approximate Cost fit ...................................................... .� .. ?.c.................................................. Definitive Plan Approved by Planning Board -------------------------- .......3,7tf ?e 7-/ Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH R 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. ,A . Name ...Illy.,;� tc.?.:Ia. '.�' Construction Supervisor's License(�?().`:1 ?..%. .......... P SHANAHAN, BRIAN A=1.71-106' No ... Permit for ...Addition...to.... .......s.i.ng.l.e...f.clrgi.ly. ...dwelling.............. Location Lot...#20 32...qg;ff..T-exr.ace,. .................. ...........Cen.ter.V.i.jjQ....................................... Owner ...Bzian..Shar ......................... Type of Construction ................f rame............. ................................................................................ Plot ............................ Lot ................................ ... ........... Permit Granted ......... April 9 1985.............. ... Date of Inspection ....................................19 Date Completed ......................................19 Assessor's map and lot numbers........................................ THE Sewage Permit number A, ..................................... ... .... ... DAUSTABLE, * .32- Housenumber ........................................................................ MASM 039- 0 Mix TOWN OF BARNSTABLE BUILDING INSPECTOR "APPLICATION FOR PERMIT TO ........ ...T....... ...... ...........Le......................................... r— TYPE OF CONSTRUCTION ......... ........Q./9........... , .............................................................................................. ............................. ............I q.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: ....Location ... T ........... .............. ............ ....................... ... ..... Proposed Use ..... ......................... ................................................ ........ ..... ................................ Zoning District Fire District ...... .......... Name of Owner?� .....okf .....!!�ws Tk......OA...............................Address ... ................................... Nameof Builder ....................................................................Address ................i................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ...... ........................................................Foundation x.......... ..... ........ ................. Exterior ..... ..........................................................Roofing ......m A -!4.... -.T............................................ Floors ......0.).!i=.................................................................Interior ...... 4..r.r.. ........................... .Heating .........H.f?............ ............ .............Plumbing ............. .........;......................................................... Fireplace ........ ............................................................Approximate Cost ............ ..................................... Definitive Plan Approved by Planning Board --------------------------------19--------- Area .4r-�.../'��7.............. 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 Tpwn of Barnstable regarding the above construction. Name, ................... Burke Homes ' ' ' �~ A=I71~106 No ......... 2—l-7O..6 Permit for --,--1 —I/2 ���P��— -- � single family dwelling --------------------~----- Locohnn ...............32..8of f..Ierrac.�_____. ' . Centerville --------'------------------ Burbe Bcooeo Owner ---------------------- . Type of Construction frame ] ' � � ..........................................�)......................................... Lo Plot ............................ /C t ... .....#20..... ......... 0=�)— � Permit Granted 9 P i/MI IT REFUSED --- /v ____v _____.....________.. —``—'' '' --~----'' ...........~=^' ........ --'T''T----------- ---------------------~----' � A ---------------- 19 ---------------~^'~~------- --------------------''-----'' C-()F F TE f 2 /v o a � 3 2. c-o F F TERR- it r j z� EXSrSrIN� HovSE I I EOSTIN - 5WE6 i i I P(��SEP 2aYZ4 ,S- 2a. -jkPv �._ Zo`.x2 GhRAc- -_. -OWN ATr TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please .print DATE 12- /q_ F 3 JOB LOCATION - �P�� P v �2r v Number Street Address Section Of Town "HOMEOWNER" Name Home Phone Work Phone PRESENT 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 such homeowners to engage an individual. for hire who does not possess ,a. license, provided that ` . the owner acts as supervisor. . ` DEFINITION OF HOMEOWNER: `= E 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 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 109.1.1) The undersigned "homeowner" assumes responsibility for compliance,with the State Building Code and other applicable codes 'by-laws, rules and' regulations'. _ s _ ; The undersigned "homeower"`:certifies tha he%sheywundetstands the Town, of n Barnstable Building,.:Dep minimum spection procedures and requirements r.., HOMEOWNER'S, SIGNATURE ` _ APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be 3 required to comply with State Building Code Section 127.0, Construction ,µ HOME OWNER'S EXEMPTION The code states 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 - Licen singn of g Construction Supervisors) ; provided that if' Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for Licensing Construction Supervisors, Section 2.15) . This lack of awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. To' ensure that the Home Owner is fully aware of his/her responsibilities,many communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. F P! P !SQ 0 ✓�/ClU i7 Assessor's office(1st Floor): 4• ' II ,* Assessor's map and lot number v V l(1 SEPTIC SYSTEM MUST i HE>o`` Conservation(4th Floor): �'-- mil.!' / '� I STALLE0 IN COMPLI Board of Health(3rd floor): - FAITH'T I TL._5 ; ' h srAact Sewage Permit number . ,. �c RRC.m ."-1 'AL COD o ` .a o. � Engineering Department(3rd floor)::" { ��c��Cf s ��, s�. L �i House number j i Definitive Plan,Approved by Planning Board T ; 19 , APPLICATIONS PROCESSEDf8:30:9:30 A.M.and 1.00- :00 P.M.only , TOWN ; Of ABLE 'BUILDI=NG INSPECTOR ' APPLICATION FOR PERMIT TO f>Vt1d On e -(qd difached TYPE OF:CONSTRUCTION + JAI"C "7 f-r-a- -t i ' Z 19 / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ��f T�(d CPyt, 1-Cr V(1( Proposed Use 6-are, 5,,K Zoning District r,, Fire District Name of Owner hf(UV1 U�6 ;)�G��'`�✓� Address C t�a 6-o 7 TRIrr Ce✓L 1 z(Vt Name of Builder Address Name of Architect Address Number of Rooms l Foundation fIVQ � CiLv S ��fh f I Exterior f Roofing ��r Floors Interior Heating Plumbing Fireplace Approximate CostCdU Area 76 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 qibeve construction. Name Construction Si ipervisor's License �P�-� SHANAHAN, BRIAN W. ti 'Fos' No -3,6318-8— Permit For BUILD GARAGE Accessory to Dwellin" 1 Location - 32 Goff Terrace { Centerville Owner Brian W. Shanahan �- Type of Construction Frame - : t j r Plot < Lot 1 ,1 • � � t F r 1 Permit Granted ,December 14, 19 9 3 Date of I pection: Frame 19 Insulation 19 Fireplace 19' Date Completed 19 ' 1 4 w - 1 1 Assessor's Office 1st floor Ma 1 Lot :1, Permit# Conservation Office Oth floor Date Issued Board of Health Ord floor h Engineering Dept. (Ord floor) House# _ � Planning Dept. (Ist floor/School Admin.Bldg.):.-. - :4 SEA MUSTDefinitive Plan Approved by Planning Board 19 ���N� I OMPLIANCE (Applications processed 8:30-9:30 a.m.&•1:00-2:00 p.m.) WITH TOTLE 5 TOWN OF BARNSTABLE Building Permit Application Project Street Address 3 X 6-'ffi Ter•r"t ; Villag Fire District 0'i'KW\ Owner jSrt�n S h�� Address 3J— 6-0,f Telephone 1420 - 7(0q Permii Request: -to on veo r .P X f(5 Mtn a-#4Ch eq S a-a u 7h, kA:JI-e h / remove ex-O 'Tfv%t k(�-ct,eh Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Eaistina Information Dwelling Type: mgle Famii Two family Multi-family Age of structure Iq vo'1. Basement type .4✓el Un f(^ Jtics� Historic House - Finished Old Kings Highway Unfinished Number of Baths / k2- No.of Bedrooms 3 Total Room Count(not including baths) 7 First Floor 3 Heat Type and Fuel -4' e✓� h�1 L-(x e��o�� Central Air Fireplaces Garage: Detached ✓ Other Detached Structures: Pool Attached Barn None Sheds F x to Other Builder Information Name V(aV) S-k4 A 11 G+N- Telephone number 7(-7� Address 3� 6-off TQ<l,- License# Des L q 7 C .Qul fer �� Home Improvement Contractor# /o 2 y 2z Worker's Com nsation # f S/$ - go - of fO 5-7 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO l3arn r 6 Project Cost $/ /loud Fee jS 0,Uz) �9 SIGNATURE DATE /0-.SS-S y BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 09/ BPERM T SHANAHAN, BRIAN FOR OFFICE USE ONLY 1.! ADDRESS 32 GOFF TERRACE, CENTERVILLE VILLAGE ENTER TTT,T,R , OWNER BRIAN SHANAHAN - DATE OF INSPECTION: , FOUNDATION j FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING: DATE CLOSED OUT: ASSOCIATE PLAN NO: r --I n. COMMONTWEALTH OF MASSACHUSETTS iDEI' ,,, —T\ ; OF YNMUSTRIAL ACCIDENTS 600 BOSTON, ',.-:',�SS.hri-'sUS>TTS 02111 fames Gam[)Del o-nrss��ne WORKERS' COMPENSATION INSURANCE AFFIDAVIT 1, rrGr s7 Y �� �G (licensee/permiacc) with a principal place of business/residence at: Y _ ' - CTof f �BrrClc,Q 1 �r1 . OA �- (City/Statc/ ip) do hereby certify, under the pains and penalties of perjury,that: am an employer providing the following workers' compensation coverage for my employees working on this . job. Insurance Company Policy Number [] 1 am a solrproprietor and have no onc working for mc. A [ ] lam a sole proprietor, general contraaor or homcowncr(circle onc) and have hired the eoncractors listcd•bclow who have the following workers' compensation insurancc policies: Dame of Contractor Insurance Company/Policy Number Namc of Contractor lnsumncc Company/Policy Number Namc of Contractor Insurance Company/Policy dumber [] 1 am a homcowncr performing all the wort:myself. TOTE- Plcasc be zw.-uc that while homeowners wbo cruploy persons to do maintenance,construction or repair Work on a dwelling of not more than three unit, in which Lhe homcowncr also resides or on the grounds appurtenant thereto arc not generally considered to be employers under the Workcrs'Compensation Act(GL C. 152,sect- 1(5)),application by a homcowncr for a license or permit may evidence the legal sratus of 3n employer undcr the Workcrs'Compensation Act. l undcrst:nd thae a copy of&is statement will be forwz:&d to the Dcra'tment of Industrial Aeadenu'Office of lnsurane=for.eovergc ycrification and that failure to secure covcragc ss required undcr Sccuon 25A of NSGL 152 can lead to the imposition ofS6minal penalties consisunp of a finc of up to S1500.00 and/or impr1. cnt of up to onc year and civil pcnalues in the form of a Stop Work Order and s finc of S 100.00 a day against inc. S is S day of 66fj�e� , l9 -7 Liccn cc/Pcrmirtcc Licensor/Pcrmittor t ----__ � StSTINC._._. ZK43. }ZTT�RS (aj Ib OG' i --- �SISTINC,_ 2VQ ceIL,Im - �O1STS o.G, h II - Xs(sTINL_ _. vc�U ._-Jo�srS Ib_`o C' --14-0-- -W-4V �E�LSC�-y`-�,'F l.�U V? JOI ST S O I(,OL• I 1c_E►2 � _:"�XSISTiN� 2.xlo _ .J6�STS-.B I� 0•C• 4. 5UPpvlZT WALL 8° 36 • _EXsrsr_Nc-`Mo WO-5LAB _ 1'��REb=S_�NI LI==�EK51.5T1N� P �►Ew ` 1 4I—GAGE (�T NEVV E-VVrN Du w EJ Dw o aP O p 1 PANTRv. �cCo -XS_C5'T-t1�CL ' t u - -)ATE=stESL O N�w.2Q zy�G�-A55=DOup��E lAuNc- i —C£.N-_cµANL—�� \Al 9j r-t St+awN a ' ���-�� • �_tLcr-BEN-�__ _ p iA-D- Nl s Q N j -TH— r GLc-. TV/vcR =t - i � k � • k 9-0x 7=v 1+ tl2 i k - ��5.�� SNSZ`T vF Z .S/HE27 All ? f k Gap F SAL 011 p¢iv. 4c'w.DG All F � o . •t,r ,. e i q I � �` � 47 Lo 7-�i 9 N r , ,. .:,ti r •y} , ' �1• Fes'.; , ,, r22' �e �''4 !• �7ZPE 7w P/r +113 `. Ea�v�-iioA.s C�St� o•v �}Ssu�vE� D.g�.7 ''`` '� CERTIFIED PLOT PLAN IDCATIOro �zv.L«- MASs.... ... SCALE . . =.ao . . . ®ATE.SEAT Z7 >7y FLAW REFERENCE Lor"Zo i?s W!1/ QN A /�G4 aF ..' '`�>. `'": • ", SST/o•tJ ,.2 ,Lv!�9���T?-�" /JiGG..S . . . _ ZoT' .20 ; I CERTIFY THAT THE 1Csrl•vc A,0y�o�v /� SHOWN ON THIS PLAN IS LOCATED ON THE GPOUND AS SHOWN HEREON AND THAT IT CONFORMS TO THE SETBACK REQUIREMENTS OF THE TOWN OF Rom!-s?�Yt3 .. ... . . . WHEN CONSTRUCTED. ,P�vT:�ti �/� DAME 'Z-P7 J 7 /,f E7ITIONER: y�,gn/ovrS iGn REGISTERED LAND SUR' OR 345 . J = 32 C-0 F F TEkP. ,a H�us� I .I 1 I � I • � I N �xS�sT�Kc- SNt✓0 I � � I I - i �S CA PA-(--E GARAGE O�THE Tp� �- The Town of Barnstable ;� "^� - ` 1)c (�a1-1nte11t of, I1(,:11111 1v and l;n"•ironrnental ser--vIces Building Division 367 Main Street,Hyannis MA 02601 Office: 508 790-6227 Ralph CrOssen Fax: 508 M-3344 Building Commissioner For office use only 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:_ etn o Est.Cost �{�ou v Address of Work: �r�- trd rfQrr-dce C��-aeon Owner Name: Fl u rn (1a Date of Permit Application: /y -5- —q U I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S 1,000 Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERNUT OR DEALING NL'I7I-i UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IRVIPROVEt,ENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER 1,1GL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hercby apple for a permit as the agent of the.owncr. /0 d Date Contractor name Registration No. OR Date Owner's name t 3b1 - I L 837 j s t Y �,pY .. _, ��t �� �.. •..' �-.''- ,�-� :Y��= x at`Yy.. r'^' "a*`�. .;F's°.:y.eF-{ .�.w �"� ,.a a�.v .<:, ra �/W •� MPR0 � . HOME I ,VEMENT CONTRACTOR S 'REGISTRATION S`.. Yam,-, F ' t §.*...:� v:;�. >a3&"++'',":Y, v.:,yk..a�:a�'`.o`-;g$yx +';y�c � a .,ys '„�'�) -:;�k `tv�• -n�{�:.`4'� a•-`""': "� ti c'�i' oard of ats( �Id rn�Regulat q ancl��Standard { _ �a Er. FA Way � d 1�8.ISE�Gt'tt,l ��'R,`c't9 X����4 '��i e.. r4_ •,43� :.y .,y�{}� 'I�Y'C. q 'Y11 aa u=T y �.z - s'i'+.�� �>.+a+wu-»f.�; .era.. ,�• � i:. .,. .` ;y�� �_•. �, .Q 2 � -� x a��1 ..�,• -i- r y�9 ___.�+Y x vt Cent xuYlNY MA O b32 riaA r �� �.� ,. �, � � �, �- � �.•� 3�2�off r aces �= e "�-3 Centervil`la I(A 02632 iv ADMINIS'[RATOR l - v-s I COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY s a :GIs a current OF ONE ASHBORTON PLACE � @ds mw�t�;tBteBaildin® rAASSACHUSETTS - BOSTON,MA 02106 _ T3 �t-'ecftrlovOtauov LICENSE t`s��ca�a. EXPIRATION DATE CONSTR. SUPERVISOR CAUTION 11 /03/1 99.5 EFFECTIVE DATE LIC-NO. FOR PROTECTION AGAINST RESTRICTIONS THEFT, PUT RIGHT THUMB NONE 06/30/1993 CC?247 PRINT IN APPROPRIATE �'< o 0 BOX ON LICENSE. o BRIAR! W SHANAHAR � 32 G O F F T E R R BLASTING OPERATORS . z CENTERVILL PA 02632 Z MUST INCLUDE PHOTO. m m PHOTO(BLASTING OPR ONLY) P NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER THIS DOCUMENT MUST BE IG ATURE OF LICENSEE « SIGN NAME IN FULL ABOVE SIGNATURE LINE CARRIEDON THE PERSON OF THE HOLDER WHEN EN- OTHERS-RIGHT THUMB PRINT GAGEDINTHISOCCUPATION. ISSIONER .. �. �.. ' • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. ` DATE . JJ JOB. LOCATION Number Street address Section.; of;aown "HOMEOWNER" /l Sn Gc.vi G�u 7-` 7 T Name Home phone Work phone w - PRESENT—MAILING—ADDRESS o Qrr 6 o� e r tr � � 3Z 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 acts as supervisor possess a license, provided that the owner DEFINITION OF HOMEOWNER: ` Person(sY who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"- shall submit to the Building Official on a form 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 Stat Building Code -and other applicable codes-, by-laws, rules and reaulations.— The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building De artment mini m inspection procedures and requirements and that he/she will compl wi , id rocedures and requirements. i 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 a_ nd Regulations for . licensing Construction Supervisors, Section 2. 15) . This ,lack -f awarenes often results in 'serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed_ Supervisor. The Home"Owner-`actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/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/certification use in your community. i - e i