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i
oFtNME r Town of]Barnstable
Expires 6 months from issue date
Regulatory Services Fee
Thomas F. Geiler,Director
�iOTEc nntd" 11
Building Division c>L J o�26�
Tom Perry,CBO, Building Commissioner.
200 Main Street,Hyannis,MA 02601
www.town.bamstable.ma.us
Office: 5 08-862-403 8 Fax 508-700-623 0
EXPRESS PERMIT APPLICATION -. RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number
Property Address p[ sh lr DE
3 Q
❑ Residential Value of Wor Minimum fee of$35.00 for work under$6000.60
Owner's Name &Address r�c_
f a sh I*P-o(I oQ,�;3
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable)
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance X-. PRtSS PERMIT
Check one:
❑ I am a sole proprietor OCT 2 5 2011
IX I am the Homeowner
I have Worker's Compensation Insurance ` OWN OF BARNSTABLE
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof}
Re-side
' \ #of doors
❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License& Construction Supervisors License is
required.
SIGNATURE:
Q:IWPFILESTORMSIbuilding permit forrnslEXPRESS.doc .
Revised 070110
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations ` ;
600 Washington Street
Boston, MA 02II1
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
P•
�Nar-11e�/Orgatuzation/Individual)'
7-7
V ,
—City/State�Zip:-- lQ. I �`�. Phone #: 3/ ��
Are you an employer? Check the appropriate box:
Type'of project(required):
1.❑ I am a employer with 4• ❑ I am a general contractor and I
employees (full and/or part-time).* . have hired the sub-contractors 6•.„❑New"construction, .`
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'
[No workers' comp. insurance .w • comp,insurance.$ 9• ❑Building addition
required.] 5• ❑ We area corporation and:its 10.❑Electrical repairs or additions
I am a homeowner doing all work T,' officers have exercised their
C g 11.❑Plumbing repairs or additions
myself. [No workers' comp. "_ right of exemption per MGL
12.❑Roof.repairs,
insurance required.]t c. 152, §1(4), and we have no
employees.'[No workers'. 13T] Other
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 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 policy and job site
information.
Insurance Company Name: r
Policy or Self-ins.Lic. 77#:
Expiration Date: '
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy numberand 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 imprisomnent,as well as civil penalties in,the form'of a STOP WORK ORDER and a fine
of up to"$250.00 a day against the violator. Be advised`that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains alties of perjury that the information provided abo a is tru and correct ,
Phone
t �a 2 b 1
^ Official use only. Do not write in this area,to be completed by city or town ofjiciat
City or Town• Permit/License#
w Issuing Authority(circle one "ky
A.Boaid of Health 2.Building Department 3. City/Town-Clerk 4:,Electrical Inspector 5.Plumbing Inspector
6:,Other- -
•
Contact Person;• a Phone#:
' �1HE r Town of Barnstable
Regulatory Services
BARNMB[.B, * Thomas F. Geiler,Director
y Mass.
1639. ��� Building Division
,
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
,y
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
I
Please Print
TE:JOHI OCAT /A 2,r te t t/ %village
HOMEOWN
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 proced es and requirements and that he/she will comply with said procedures and
requirements
Signature.of Homeo 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 2.15) This lack of awareness often results in serious problems,particularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed
Supervisor. The homeowner acting as Supervisor is ultimately responsible.
To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,
that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
several towns. You may care t amend and adopt such a form/certification for use in your community.
Q:forms:homeexempt
Town of Barnstable
Regulatory Services
aAitrtST.ABU.
MASS. , Thomas F. Geiler,Director.
1639. 1.
16 Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862 4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
A f i
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this.building permit
(Address of job)
Pool fences and alarms are the responsibility of-the applicant. Pools
are not to be filled before fence is installed and pools are not to be
utilized until all final inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
Q:FORM&O WNERPERMISSIONPOOLS
Towle of Barnstable
�oFT►+e r ti Regula0ry Services
o�
r � Thomas F. Geiler,Director � �0Ii 9 10
+ BARNSTABLE, ' Building Division v
v�pl i639' a Tom Perry, Building Commissioner
ED MAC
200 Mairi Street, Hyannis,MA 02601 1
vww,town.barn stab 1'e.ma.us.
Office: 508�862-4038 Fax: 508-790-6230
PERMIT# 20 .[0 FEE: $, _5—�.Se
SHED REGISTRATION
120 square feet or less
JP
f 42R-sb OZ6RDt "
!�- D�
Location of shed(address) Village
a`
W C Property owner's name Telephone number
. N
a0
-�
'( a �S
Size of Shed Map/Parcel#
co
Signature Date_
Hyannis Main Street Waterfront Historic District? -
Old King's Highway.Historic.District Commission jurisdiction? / 3 7.
Conservation Commission(signature is required)
Sign off hours for.Conservation 8:00-0:30&3:30A-3.0'
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 APPROPRIATECOMMISSION.FOR DETAILS.
THIS FORM MUST
BE-ACCOMPANIED
AN
� .. y ^
` ,. . �.i�OT-PLAN :,. . V `
Q-foims-shedreg
REV:042506
1z (a�J!E�
App4cont` Dr&f W- ,vw, • Tocat;ort of'-property: C�t�Yvr'fle
2 22 GrW Vaf5h Pond
r
• ohvel(wcy . ..
• �
222
o
17 f.
ref. 4 , iS7 *0d.pat j_Cf. 250 001 000' c OOG� ion¢: C OF MAss9
PAUL �yN
hereby certify t1at ttus mortgaqe tnspwtt"on wa5-prrpare4-for T.
GROVER W
�Iilors� atild NP.wel� �8a�2k v>'tPu�t
.p o.31311 O
Tu dwelling showtv hemean, cfall in,alspeacr�, =�oo�,� �9� ISTE��oQ
h ama with am eWea ive,daze of° 6 -19-85 anA the localtbnl &P o S v�y
tfw-dweikng Foes confcrr�m,�ro he local gonincJ 6y-iatius in�e e��
wtthe tune construction win mPectto horiiklt l dtmert siottu scaie: .. 40,
setback Or is mrtpt`from, vtolacttoa CaForeemVrle Date:
czftbm under Mass. General laws Qw(ptw 40 A Sect't'0M '7. File No. ►0 3 0 5
PLEASE 'NOTE The structures as shown on this plot plan' are approximate only.: Ari:actual survey is necessary. for a precise
.determination of the building location and'encroachments, if any exist, either way across°property lines. This plan_ must not be
used for recording purposes or for use in,prepariiig deed descriptions and must not be-' used for,.variance or, building plan
''purposes. This plan must not be used to locate property lines. Verification:of, building'locations, property line dimensions, fences '
or, lot configuration. can only be_accomplished by an,accurate instrument survey which may reflect different information than what
is shown hereon, Please note that this is "NOT A BOUNDARY SURVEY`; and is ''FOR MORTGAGE PURPOSES ONLY".,
4 , ,COLONIAL LAND SURVEYING COMPANY; INC.
269 Hanover Street:• Hanover, Mass. 02339 Phone: 781-826-7186 � Fax: 781=826-4823
0 ��
� -1lto----------- �
c -S o
IME, TOWN OF BARNSTABLEr.
ti Building .
Application Ref: 200706545 BARNSTABLE, Issue Date: 10/26/07 Permit .
9 MASS.
i639• ♦0 Applicant: WIINIKAINEN,ROSE M Permit Number: B 20072675
Proposed Use: SINGLE FAMILY HOME Expiration Date: 04/24/08
Location 222.GREAT MARSH ROAD Zoning District RC Permit Type: RESIDENTIAL ADDITION/ALTERATIO
Map Parcel 210075 Permit Fee$. 25.00 Contractor PROPERTY OWNER
Village CENTERVILLE App Fee$ 50.00 License Num OWNER
Est Construction Cost$ 50
Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND
REMOVE BEDROOM IN BASEMENT THIS CARD MUST BE KEPT POSTED UNTIL FINAL
INSPECTION HAS BEEN MADE. WHERE A
CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH .
Owner on Record: WIINIKAINEN, ROSE M BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL
Address: 222 GREAT MARSH RD INSPECTION HAS BEEN MADE.
CENTERVILLE,MA 02632
Application Entered by: JL Building Permit Issued By:
THIS PERMIT CONVEYS,NORIGHT;TO OCCUPY ANY STREET;"ALLY+OR SIDEWALK OR'AN,;PART THER HE ,TEMPORARILY OR PERMANENTLY:
ENCROACHEMENTS ONTUBLICPROPERTY NOT SPECIFICALLY PER`M! ITTED UNDER THE BUILDING CODEIvMUST BE APPROVED BY THE JURISDICTION.
STREET OR ALLY:GRADES,AS WELL AS DEPTH AND LOCATION OF`P.UBLIC SEWERS MAYBE OBTAINED FRO,M;THE DEPARTMENT ORPUBLIC..WORKS
�,r;
THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM,THECONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS
MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK:
1.FOUNDATION OR FOOTINGS.
2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE F T E LINING IS INSTALLED.
3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETE IN ECT N.
4.PRIOR TO COVERING STRU TURAL-M BER TO-L T
5.INSULATION.
6.FINAL INSPEC ION FORE 0 UP Y.
WHERE APPLICA SEPARATE PE ITS ARE U1 FOR LECTRICAL,PLUMBING AND MECHANICAL INSTALLATIONS.
WORK SHALL 0 PRO ED UNTI T PEC OR HAS APPROVED THE VARIOUS STAGES OF CONSTRUCTION.
PERMIT WILL CO M U L AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF
DATE THE PE IT ISSU D AS NOTED ABOVE.
PERSONS CONTR C G WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A).
INI
221,
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS
2 2 2
3 1 Heating Inspection Approvals Engineering Dept
Fire Dept 2 Board of Health
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map 2,b Parcel o-7S Application#6?d � 'y
Health Division o 07 L`17 �ec�n�a^1 Date Issued ( 0.o
Conservation Division Application Fe
Tax Collector Permit Fee was
Treasurer
C f 2l� 07
Planning Dept. h
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
)��
Project Street Address
Village
Owner Address
Telephone
<—Permit.Request �.ttid��2;
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new :
Zoning District Flood Plain Groundwater Overlay T.Project Valuatiory Construction Type ;; x
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting.,ocumentation. F-
Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units)
Age of Existing Structure 311 14 r Historic House: ❑Yes O'`o On Old King's Highw y: ❑Yes O<o
Basement Type: �d`Full ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0
)
'Number of Baths: Full:existing new Half:existing I new
Number of Bedrooms: existing new t � rt r11eM w �1nn
avh
Total Room Count(not including baths):existing ne irs o om Count
Heat Type and Fuel: ❑Gas Moil ❑Electric ❑Other
Central Air: ❑Yes ®"No Fireplaces: Existing New Existing wood/coal stove: ❑Yes 2*�o
Detached garage:❑J�existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:d'existing ❑new size Shed:❑existing ❑new size Other:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes 9/No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATION
Name '44h1ralTelephone Number
Address Gl P.a. ffi&mU License#
�rQ�YL 4r y it TYAA n�1 3 Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE An DATE �. O
' FOR OFFICIAL USE ONLY
APPLICATION#
n
DATE ISSUED 1
MAP/PARCEL NO.
' M
ADDRESS VILLAGE
tN
OWNER
DATE OF INSPECTION:
FOUNDATION
FRAME
INSULATION
FIREPLACE
YS r
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL '
FINAL BUILDING
DATE CLOSED OUT
ir ASSOCIATION PLAN NO. {
fi
t`
i
1.
r
' r ' The Commonwealth ofMassaehusetts
Department of Industrial Aecidents ,
Office of Investigations
_ d 600 Washington Street
Boston, MA 02111
www.mass,gov/die
Workers"Compensation Insurance Affidavit;,Builders/Contractors/EIectricians/Plumbers
Applicant Information �° Please Print Le •b.t
I`Tame-(Business/organization/Individual): 5 � h,1y ,�'' ;`e�
•Ad_dressa2" GIi
City/State/ .ip• ee'dz-r-UU IQ A Phone-#: � 5
Are you an employer? Check the appropriate box: -Type of project(required):.
1.❑ I am a employer with 4. 0 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. 0 Remodeling
ship and have no employees These sub-contractors have S. Demolition
workin for me in an capacity. employees and have workers'
g Y P tY• $• 9. []Building addition
o workers' comp.insurance comp.insurance.
equired.] 5. We are a corporation and its 10.0 Electrical repairs or additions
FL3' Tam hameowner'doing°a11 work officers have exercised their 11.[]Plumbing repaws.or additions
rnysel£,[No-workers'comp right of exemption per MGL 12.0 Roof repairs
insurance se iced t c. 152, §1(4),and we have no
J ... employees. [No workers' 13.[]Other
comp, insurance required.]
''Any applicant that checks box A must also fill out the section below showing their warkas'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.
tContractors 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 trave employees,they must providb their workers'comp.policy nurnbcn
Iam an employer that isproviding workers'compensation insurance for my employees Below islhepolicy andoo,site
information s
Insurance Company Name:
Policy#or Self-ins,Lic.#: Expiration Date:
Job Site Address: City/State/Zip-
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date),.
Failure.to secure coverage as required under Section 25A 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.
.(•do hereby certify-nder the pains•and po�naldes of perjury that the information provided above is true and correct.
' Sienat�tre"" Gam+ •`�`--'�-- �Date�' n� G+� v
Phone#: �7 S /5✓
Official use only. Do not write in this area,Y5 be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3:City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Contact Person: Phone#:
QSNElp Town of Barnstable
Regulatory Services
STAB
Thomas F.Geiler,Director
Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 508-862-4038 Fax: 508-790-6230
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERMIT APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions, along with other
requirements.
'Type-of Wor-k
Address of Wok o2;?�L � .%~�fd'j le' 004,!Cz2zt c'z� W
e=era sTName::---.-,,., )C® $eGt✓j/ �J%J�-�//ir'!f�tir
Date of Application:-
���A.
I hereby certify that:
Registration is not required for the following reason(s):
❑Work excluded by law
❑Job Under$1,000
❑Building-not-owner-occupied
��Ywnei pulling own perinrt
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:i
Date Contractor Name ' Registration No.
OR .
GO ii
/6-7
Date o ;Owner's.Name
Q:foims:homeaffidav
f
oFTHt l Town of Barnstable
Regulatory Services
tsresce Thomas F. Geiler, Director
MASS.
�Ar 1639• a.�� Building Division
FD MA'1
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print ca
CDATE �/6 tr 0
^� 11 j
JOBJOB t5aZ- ,G(i1 9 �/L�i/
nu r street village
®
name home phone# work phone#
CURRENT MAILING-ADDRES~S
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
yrequirents.
f-Hom owner—`/
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.
oF1HE T Town of Barnstable
Regulatory Services
9snxxSTABM$► Thomas F.Geiler,Director
�p 16g9. ♦0
° Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
Officer 508-862-4038 Fax: 508-790-6230
October 3, 2007
Rose Wiinikainen
('222 Great Marsh Rd.
Centerville, MA 02632
RE: EXIT ORDER 222 Great Marsh Rd., Centerville Map : 210 Parcel: 675
Dear Property Owner/Occupant
This letter shall serve as notice that the building department has become aware of a
building code violation at the above address. In accordance with 780 CMR 121.0 and
780 CMR 3400.5 you are notified that the basement bedroom is declared dangerous
and unsafe and its use must cease immediately. The property must be brought into
compliance or be subject to criminal prosecution as provided for by 780 CMR 118.4. A
building permit is required to bring the property into compliance and must be applied for
by October 17, 2007. You may call this office at (508) 862-4034 with any questions.
Thank you for your anticipated cooperation in this matter.
By Order,
k
re L. Lauzon
Local Inspector
Qzoning5 `
CENTERVILLE-OSTERVILLE-MARSTONS MILLS FIRE DISTRICT
DEPARTMENT OF FIRE-RESCUE&EMERGENCY SERVICES
1875 Route 28•Centerville, MA 02632-3117
1926 508-790-2375 x1 •FAX: 508-790-2385
John M.Farrington,Chief Martin O'L.MacNeely, Fire Prevention Officer
Craig E.Whiteley,Deputy Chief Francis M. Pulsifer, Fire Prevention Officer
September 18, 2007
r
Mr. Thomas Perry
Building Commissioner,Town of Barnstable
200 Main Street
Hyannis, MA 02601
Dear Commissioner Perry:
Pursuant to MGL Chapter 148 Section 28A, I am making you aware and request
your interpretation of a suspected un-permitted basement bedroom without secondary
egress at: f
f
222 Great Marsh Road
Centerville, MA
During all oil burner inspection at this address, I observed a partially finished area'
in a remote part of the basement next to the oil burning equipment. Whi?e evaluating for
CO detection,I observed the area to be a bedroom with associated furnishings and no
secondary means of egress. In addition, there is no separation or isolation of the
ccu;pment from the living space.
Please call the fire prevention office with any questions relative to this incident at
08-790-2375. Thank you for your anticipated attention to this issue.
- C z Q
Francis M. Pulsifer
Fire Prevention Officer
7.
NOZ l
�t
"Commitment to Our Community" t
FloA�
A
o � �
t
Jw—
PyofTHE T TOWN OF BARNSTABLE
S EARNSTADLE, i
"6 9 BUILDING INSPECTOR
�E11 MAY a•
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION , 1�!��..... i1�/! ............. !!!{.4. �/✓ .....!�.... /�t .t.......
................................................19........
TO THE INSPECTOR OF BUILDINbS:
The undersigned hereby applies for a permit according to the following information:
Location ................ 'C,�:..:........../I!o" .... ,� �//�� /af/ r,�"•
ProposedUse ..........Q N..:.:..`/I**,.........................................................................................................................................
ZoningDistrict ........................................................................Fire District ..............................................................................
I
Name of Owner s� .._.Address �`/ �r
t:
Name of Builder ....'®P......!: 1,4.cr.rz...........................Address .....``!......
`S/ ........ y��C;.....
Name of Architect -'� !!�,�i! ....... f�.� �r��✓„••Address ....................................................................................
Number of Rooms ..... /` .........................................Foundation ........1..��'r.f ...... /"l/r•./. �/
Exterior .. gym . ...... / ./../!..Q. ...1...........................Roofin ...........
Floors ....® i;..: ...�rJ.r•!••��f� �!�.. +1!•f1!Interior .........S/ f.�../... �� "!.................
Heating Q�/!!.!":° ... .......
♦ LC/ .��'�1 .........Plumbing ......... ope.- ..�J-....................J .
Fireplace /✓iY
.....
....�.'�1......... ...... .........................Approximate Cost ......i. �.d♦r ...'..................:.
Difinitive Plari `Approved by Planning Board ________________________________19________ .
Diagram of Lot and Building with Dimensions
e
-law
� r
, 0. .. 144 1 ' D�
+ y� ' ; 3f� '
rt
Ca O
�� Cr
. �
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ........&� ...............................
__ I
-
No -----.. Permit for ------------
° .
—'------------------^------'
Location ---------------------.
—,------------------------..
Owner ---___________________. `
�
Type of Construction .......................................... '
-----^--------------------''
Plot ---------' Lot ................................
-
Permit Granted ........................................
'
Dote of Inspection ------------lA
Dote Completed ......................................
�
PERMIT REFUSED
-----_—.--.---------,. lV
^ /
'
'----~---''-----------------'
'---------------------'—^--''
/ .
--'—~--------'~--^-----~---^^
� . .
� .-----------------~.—~—.----. / ^
Approved ........................................ lg
�
^
-------------------------'—
,
-------------------.....----.. .
� ^ '
A ow—
THE
TOWN OF BARNSTABL
MAUST' LE,
MAM
1639-
0 MAI Av BUILDING INSPECTOR
APPLICATION FOR PERMIT TO ...101-4...... ............
C/ .................
TYPE OF CONSTRUCTION ...... ........;.F1�4,0
..........lil/. /- .........................................
.... ........ ........ Oe.
..... ..
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to th& following information:
Location ... . ...-6. �,e,4 7� Al. A Ar do'
X 4 v
.....................I......................................................................... l....................................
Proposed Use
111�v........................................................................................................................................
.......1064/.............
Zoning District ............I/ ..........Fire District
.....................................................
Nameof Owner ....... ......................Address ....................................................................................
Name of Builder .... ............ . ......................Addres e, �51 �1Y'f.1A011 e. 4S/
S ..................................7................................. . . ...........
Name of Architecte- Address ............. .......
Number of Rooms ....... P d/ CO- 4VCI-,e 7Z�
...................................................
.......... ...............................Foundation....... ...... .......A00A
Exierior ........A4.0...... .......4W-/AKc.0# A.S.......................Roofing ............ A'
...... . .....Ix
. .............................. .
Floors
.......................................................... Interior ........ Ile-411
Heating .......A. T...,g.............o.00 .....Plumbing .......C.. .,0oV.. .................................................
Fireplace -e-j!....:n7:� ....................................Approximatt- Cost ......
..... ... .... .✓................................................
..........
Difinitive Plan Approved by Planning Board --------------------------------19-------- -
Diagram of Lot and Building with Dimensions
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I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name ... ...C,-.(........... . .... ..................................
Stackhouse, George
I'
DLU 1 19701
No ....12939.. Permit for .......one...story9.......
,t
Locatior;;�...... Marsh Road
..... ..................................
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Ce MX.Villq '
Owner GeQge...Stackhouse...
Type of Construction ...............frame................ {
1.
................................................................................ t
Plot Lot .........il-7.................
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Permit Granted .......March 20 70 i
............ ............... 1919
Date of Inspection . .V.�A..: ...... 70
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Date Completed ......................................19
PERMIT REFUSED
................................................................ 19
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.................................................. ........................
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Approved ................................................. 19
...............................................................................
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