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" , 127% TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 5 Parcel �0 Permit# 789*3 1 Health Division 300''S Date Issued 13b o y - Conservation Division ?/W/, Application Fee k Tax Collector Permit Fee Treasurer SEPTIC SYSTEM MUST BE Planning Dept. INSTALLED IN COMPLIANCE WITH TITLE 5 Date Definitive Plan Approved by Planning Board ` ENVIRONMENTAL CODE AND TOWN REGULATIONS Historic_-OKH Preservation/Hyannis Project Street Address �/ )7Q R R_l SO/w Village �'PN�c°NlIle AZi Owner / ,*AS Address Q2lJd'N � Telephone rd k 79Q ]Os S Permit Request 0JR e) OCk ov-erk�k1 < e:k p- Square feet: 1 st floor: existing proposed s—" 2nd floor: existing �`� proposed ti Total new A14 Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Y(0�q iS Historic House: ❑Yes ,WNo On Old King's Highway: ❑Yes No Basement Type: ❑Full ❑Crawl ?�Walkout ❑Other Basement Finished Area(sq.ft.) o1/A Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new IV A . Half: existing N A i new Number of Bedrooms: existing new Total Room Count(not including baths): existing S new/i A First Floor Ro"'Count to Heat Type'and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes �ffNo Fireplaces: Existing _ New tiA Existing wood/co I stove:—❑Ye§ �d No w Detached garage:❑existing ❑new ;size AUTA Pool:❑existing ❑new size II��N Barn:Clxisting dnewpize Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Yl Y Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes . ❑No If yes,-site plan review# Current Use Proposed Use BUILDER INFORMATION /_ Name Telephone hone NumberVA � dJV Address 61 ��Ice/Ste/ Licensees C( �Vdl1P M11 2Q-6�_ Home Improve'mb Contracto Worker's Compensation# ALL CONSTRUCTIO RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY x ,G. PERMIT NO. DATE ISSUED i s MAP/PARCEL NO. Y t ADDRESS VILLAGE. ti OWNER «. . .t a DATE OF INSPECTION: FOUNDATION r FRAME , INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUG ;;Z FINAL GAS: ROUGE FINAL BUILDING f m 0 -1 l f -� ° ru0 • DATE CLOSED OUT, fit; � t7 c) w Q 00 1 ASSOCIATION-PLAN NOT M 4, -y Town of Barnstable of cxE toffy ' ' ' o� gegul.atory Services • Thomas F.Geiler,Director �H s& Building Division Tom Perry,Building Commissioner • 200 Main Street, Hyannis,MA 02601 • Fax: 508-790-6230 Office: 508.S62-4038 . permit no• Date AVTT PtOME ZIPROYEMENT CONTRACTOR LA'W SUpp�MENT TO PERMIT APPLICATION. 42A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, MGL c.1 re-existing ov"Aer-occupied ' roveraent,removal,demolition,or construction of an addition any p th other building containing atleast one but not more than four dwelling units or to structures v+'hich are of,cent to such residence or building be done by registered contractor,,with certain exceptigns,along v�n requirement,. Estimated Cost .211 . Type of wark: Address of Wow "IA Res/ . `��Y114 C_X• Owner's Nam hcatioro Date of App I hereby certify that: gegistration is not required for the following reason(s): DWork excluded by law ' []lob Under S 1,000 , Building not owner-occupied 'Ownex pulling own permit Notice is hereby given that: GISTERED pUI,LTNG THEIR OWN PERMIT 0�R VEEMENTT-WOpjr DO NOT�A C0�CTORS FORA PIACAB,•LE pIOME ERMGL c.142A ACCESS TO THE ITP,&TION PRO GRAM OR GUARANTY FUND LTND SIGNED UNDERPENALTIES OF PERTURY�/is�� for a ermit the agent the oy4er: l drfl Y � Thereby apply P / l Date OR ;_. ,, +�''' :'., • .:.,;`Th }comnwnive4lthqMassdchusetts • '  Department of Industriat-Accidents' . 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"'1.•a.4 ♦a,: • •j'+�4'.;t''r;.rr'!:t.•a:, i, t.0.l' :1,• t;' r: i 7. s i.•; Itl}15,:3'»/.f,. O'L1C.'rfYiMIN t r w e to s17500.00 an or '`"'•'•••• •`" ( ;, '' al enaYties of a fin up ositioII of Crimfn insur�ri�-•'� afnst ma, I understand that lt Failure to secure coverage Is required under Section?5fo of MGL TO can lead to the imp. t ent as well as ctxiip."altles is the foY m of S STOP WORK OItDF''R and a Yerifmation.00 a day ag one years'impry°�' rvrarded to the Office of Investigations of the moor coverag r copy at fi is statement r u der pa and penalties b 1rry that the inform ation provided above is{��coned rdo'hereby c 1fy Datr3 7 1 ate .�o g• ��� ���• Sign hone# ' Print name official�e only do not write in this area to be completed by city or iown ofticiai oBuilding Department permitllfcense# (]Licensing Board city or town: ❑Selectmel$s Office is re used []HealthDcpaxtment [}'cheekif mediate response4 '(]Other phone#1 contact pers 3) o (tevista sipe.7A°, • • , Informi a66 and Ji St ructions• G eral L-s*911apter 152 section 25 requires all employers to provid:r .. rs' eom' %1 1. fir .their. Massa cliusett$, e� ,•`:' quoted'fromthe f`law"1 an employe is.defined as every person in the service of another under any contract CnVIOY press or it le4; oral or written, i of hire; , An eMploy er is defuied as an individual,partnership, association,corporation or other legal entity, or any two or rngre of the foregoing engaged'u''a•0ouit enterprise,and including the legal zepresentatives of a deeeased,employer, or the•receiver or artnershi association or other legal entity, employing employees. 'However-the owner of a trustee of an individual,p . F� . dwelling house laving. ot'more.than three apartments and-who resides therein, or the,occupant;of tb.e dwelling house bf another who.Mplbrspersons to do rnainkenance,constriction or repair work on such cfwelImg hou e.csr on the grounds or hall not beaus Pent thereto s budingD rr .. e of such;employment be deenneci to be an employer, ,•, . :, •► :;. ..'• ' , MOL chapter'152 section 25 also'siates fhat'every. s°tate'or Iocal licensing'agendy shall withhold the 3ssuanc6 dr renewaI Of a license or p •unit to operate a business or to construct buildings in the.cornmonwealth for any applicant who bas not produced acceptable evidence'of compliant a enter into athe Ins n a coveracot�tracgf°r th performance off pyublic work uptf coirmoonwbalthnor.any of its political subdreisrons 8 y acceptable evidence of compliance with t� e insurance requirements of this chapter have b een presented to the contracting.. authority: . Applicants Please f tare w as'.eo ensa af€tdavit cornpletely,by checking the box that applies to your situation., Please su company name, address and phone numbers along with a certificate of insurance as all affidavits may be subnitted to the Dep arEnnerit of pndus �,6 dmts.for confiTmation of insurance coverage. Also:be sure to sign and date the affidavit. Thedavit should be retajEaurned to file city or town that the application for the permit or license is being re nested, not the pepart rent 6�7ndustrial A.eeideuts, Should you have any questions regar&ga the qaw"or if'you are q FQ cY�F• tat then' er listeA..b low- requiredto�o Lain a worker�!.compensation li lease call theI)epartmen u�b . WN City or Towns P lease be sure that the affidavit complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fi11 out in-the event the Office of Investigations f�as to contact you regarding the applicant. Please e to fillip.the perrnit/licens e,number which wM be used as a referencb number. The.ajlk4 is maybe•returned tq, b e;sur emeiits have been made, theDeparkmentby, or F.AX.unYess other awing . .:: ..:� ti ations world lie to thank y'ou in advance for you cooperation and sliould you have any questions, The Office of Inves g ; please do nothesitate to give w a 00 /l�'he Department's address,telephone and:fax number: . : , • The Commonwealth Of Massachusetts Department.of Yn.dustrialAcdclents . Bye Di l�eseris . 600'Washington Street Boston,MR. 02111 fax#: (617)7z7-7749 . s rid€ Town of Barnstable Regulatory Services '* " Thomas F.Geiler,Director BARNSTABIX 9 MASS $ 1639. Building Division ��FD MA'lp Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 # www.town.barnstable.ma.us Office: 508-8624038 Fax: 508-790-6230 / HOMEOWNER LICENSE EXEMPTION Please Print DATE: V r JOB LOCATION: C, /t/ 2 !�/S h/ �`" "' � �✓� number -� street J village "HOMEOWNER':. - name home phone# work phone# CURRENT MAILING ADDRESS: �Q�2 GL S Ala state zip p 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 i s_pervisor. + 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 100.1'.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 in ocedures and requirements and that he/she will comply with said procedures and require n Signature U eo�� 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 uA1. eC � -� C797F)t PRDFIIF eta/.•r�rT � ,� ? 7 � �� 3 HOLE N-fin Ol��urlTlO" BO% ��°a+m 1ya --.._ LOCUS MAP ai � 'm Ina nxstwvrua� �I£TZLI�s? Aams.e h. e.n�� 7nfn h want quDEl suao ag a0 kaAbba6)(sut+xR a o nsAN ,-GENERAL NOTES O __—_ (dl 1nlxaaEta7 W h.f b_4r h I.baY�la}m Rpyda r Wbo;oa \ .Yaqui halGrr of aa0.er.tae a>s A�FrCa.E rarorr�zr mre p.+reaon.a aH ugdegmurrE utaaAS t. O - VARWNCE REf]UESTEO_ a ma d . �/�,6•_ Bon oar stna rb r�E po Y eamae°i sn i eke"aeeal aaa>O grm \ saoaa YA.no Redce,�bbnce PraR T.N.t.Faueha.n iron l0 reot w r Fast mane over s'lo,.�• m eaA rw � 1V A�Vtitr i_rhb ayaem 8 abl.ar W aaPaahraa Dal of",m, 1 cmlb 8 9w1•-aawonmartd sm.lc"casM S"" O a.gp�ane v"llr gerss uo.t:a,r„b aea.rea'p O } NJI b v°r nm Abe.ape a.aa aroAonmr wauacae.. aaar.ma approrne plan W j LOT�'1liA 8 e, mrAlual°°r.�0i ta.oontraamr«xaunhre a O pan lh R.rr We call by_"t Bol are arpra�,t•.rq nmsa m.als Na at sac•uor, d.rn faooe @ro�R m «h a.v eangi .s-e1 osamv raa ANI reAmwm mavaar (^�I .. rs®ems waRmra M ill.Rubber mar --1 c.rm.° a ,ea,° °p - CT1 seer.nntoe®Rbav aaat z qi as..na FROM wv vrRcs of taus ll 7_N°wl�me or lr.ul m°Wawy ef�eb awa 9a.ne PLAN VIEW w.aam.a oas E Eac1l9EM ofaSAS.93,00 or l6 10 Feet .coat.ho1w unb.a rate.m N-9d..ate a*aveaaA.. �o'•ma9a. ~ e,ur.ew Ae-stm as may ar aY??+n w aRuMl ho / I ®� j a.ra zu(owaa uaa mil m r�.ser sdrmah la 115F'we mu.B.dfao a°4-maaamr WPea T �»G: F h r.uwwvm eater L eo<+oee to'fie ladear' a.am r m.n 4`• r �y r _nr seal Er r0^E �Igo waaaun.mhor am'F a. Al. . N car M (n & ;tsoa r a `•_� r ' ,a _,_y8 ==8Fr"ra 1�ReT Pr wvtRAr1[Jtmr20 C - o ' of Mlyp i wltoR aF tars ce+TERVU£E%WLLOGG Oo oO%1z7.PAOE azURtCr Plot%/� Co aipV9E o7hQR nowTYPICAL 1r_+S_m cal L nNSEP71G TAMICt.� Nor m SM,E � r3fiv20 LRADTNG PEBQQQL6TION TEST L i. ° :' � LWAedPw..idiar Trt a4y7.Yaa7NOTES PROPMEOT GRADEy NOTES EIIISTNGNatc lcv lam 2 NW a♦{ Ba.rr Land 9af.x r 104.{6OT•GRADE. p4. PROPERLY LINE H ° s.�r �' JJ• �• / G ! •\ — PROPOSED CONTOUR ------97 EMST1ND CONTOUR I-'l c_a jr fk for its �� i5 z St®.ter f". figb .(1 DEEP TEST NOTE do rr r l f m A,Y PERCOLg7roN TEST LOCATION ray e'_u• a e xs.' r rr F• CD 0 CD = � +1 i �•� •:` �. 8 FOOT sToc7uOE FENCE 0 REV.:A/4/oa -per Cwt - ab�6• s�a,S� ,q, �, i� PLOT PLAN Pqa Bala=Lea Am Y A64 S 8 d7 1 ;` �O' 3 l aomR.ner Nat mer.p Na aa.a..a 500Q, �g' e OF PROPOSED SEPTIC SYS T E'NI UPGRADE .� _ AD.kh91m Item vs.:a Nme ,,m S{ PREPARED TOR y} MS. SUSIE CHASE PROJECT f3ENCN MARtt . 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