HomeMy WebLinkAbout0226 LONG BEACH ROAD s ✓
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�tMME r 'Town of Barnstable _ *Permit#-
Expires 6Tonthsfirom issue date
Regulatory Services Fee AU I
» snxxsras[.e. •
9� MASS. Thomas F.Geiler,Director
1659. ♦0
�TED MA't A
Building Division (E5b) i3
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Map/parcel Number Q(�)s
Not Valid without Red X-Press Imprint.�
c �
Property_Address rfv— �'Ivn—&
XResidential - Value of Work . Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
--7\D(Ax--&&
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) X.P D n o%r,
e ■ A iklt f ■1 01T
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance MAY 24 2013
Check one:
❑ I am a sole proprietor TOWN OF S ARNSTAS
I am the HomeownerLe
I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
Re-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows
❑ 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 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
4� equired.
SIGNATURE:
Q%TFILESTORMS\building permit formsTYPRESSAoc
Revised 053012
The Commonwealth of M'assaclruselts
Depamnent of Indusbial Accidents
O,,we o,f'Investgations
600 Washington Street
Boston,.MA a21.I1 .
wnwv.mass govldia
Workers' Compensation Insurance-Affidavit: Builders}Contractors/E•l licians,Plnmbers
Applicant Information Please Print Leal
Name{Business/orgauzatianlliai):
Address: aak, Lmk�
C '
City/State/Zip: Phone#:
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).
* Dave:hired the sub-contractors 6- ❑New construction
2..❑ I am a sole proprietor orpartner- listed on the attached sheet. 7. ❑Remodeling
snip.and have no employees Thy sub-contractors have g- ❑:Demolition.
working forme in any capacity_ employees and have workers'
[No c+,arkers'comp_insurance comp.insurm(m-1 9. ❑Building.addition
required.] 5- ❑ We are.a corporation audits 10.❑Electrical repairs or additions
3\ ] :I am a homeowner doing all work afficers have exercised their 11.❑Plumbing repairs or additions
myself [No workers'camp. right of exemption per MGL 12. .. Roof r
epaim
insurance required.]? c. 152, §1(4),and we have no '
employees.[No workers' 11 Other
comp.insurance required.].
•AxLy applicant that checks bo,#1 matst also fill out the section below showing heir workers'compensation policy information-
I Homeowners who submit this affidavit indicating they are doing all walk and then hire outside contractors must submit a new affidavit indicating such.
FContractors that check this boat must anacbed an additional sheet showing the nine of the sub-contractors and stare whether or not those entities have
employees. If the sub contmaors have employees;they must provide their workers'comp.policy number.
I am an employer that is prmreding works'compensadon insurance for my alrrploryeex Byelaw is thepoffq,and job site
infortvrrrdem
Insurance Company Name:
Policy#or Self-ins.Lic.4: Expiratio,n.Date:
Job Site.Address: , �� 4 �-/ City/State]Zip:
Attach a copy of the wG leers'compensa hou policy declaration page(showing the polio'number and expiration date).
Failure to secure coy-erage as required under Section 25A of MGL c. 1.52 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as chril 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 statenunt may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ce render the 'ns penaldes r f tray that the infornid ten provided above is true and correct
Si lure: Date: _
Phone 9: SOBS " L ( ` L q
Official rase only. Do not write in this area,to be completed by cio,or town of ciat
City or Tom'm: PermitfLicense 9
Issuing Authority(circle:one):
1..Board.of Health 3.Building Department 3.C ity/Tomm Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
6
°FtK r Town of Barnstable
Regulatory Services
*
* BAIMSTABLE. ` Thomas F.Geiler,Director
y Mass. g �
1639..,a`e 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
HOMEOWNER LICENSE EXEMPTION
I� Please Print
DATE: .. o ) `'
JOB LOCATION: \ kc�1 ,I
number street&Y�A L `` C, village I `r„
"HOMEOWNER": /V /�' �'1 O _ 7 V H
name �i{ home phone# work phone# $7 6 0
CURRENT MAILING ADDRESS: V
O
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
proc res nd requir ments tha he/she will omply with said procedures and requirements.
"g000le-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.
C:\Users\decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Out]ook\QRE6ZUBN\EXPRESS.doc
Revised 053012
Asses,is office(1st Floor):
Asse'sor's map and II t umber / �o�TMt toy
Conservation
�\�,.�,r --� ��Yr►�'GI�- SEPTIC SYSTEM MUST
Board of Health(3rd floor): INSTALLED IN COMPLIA
/Sewage Permit number WITH TITLE S 11AUSTUL
y rua
Engineering Department(3rd floor): �8°5tr.%r �e�o.
House number EI� IP
Definitive Plan Approved by Planning Board 1g
APPLICATIONS PROCESSED 6:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTA13LE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
TYPE OF CONSTRUCTION
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location 22
Proposed Use &EZ-QA)6
�
Zoning District Fire District `�a-P,/"6
Name of Owner✓ aP,Oi-�xl���/f�a!/�r��'�i�Address / 091.)
Name of Builder _ ��s� � �.,�a Address
Name of Architect Address ,V/
Number of Rooms ,2z Az .� ���a®ter Foundation _�OA 02 V 7-
Exterior Roofing
Floors Interior
Heating Plumbing
Fireplace Approximate Cost
Area a `
Diagram of Lot and Building with Dimensions Fee
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction.
Name
Construction Supervisor's License ��
I
LgNG BEACH REALTY TRUST
c _
t'6 35086 Permit For RAISE DWELLING
With Foundation/Single Family Dw.
Location 226 Lonq Beach Road
Centerville w
' Owner Lonq Beach Realty' Trust
Type of Construction Frame
Plot 'Lot ,
.r'I
t .
Permit Granted May 2 6 , 19 92 '
Date of.Inspection 19 {
Date Completed 19 �.
F .xtT 1;j J� •� - • � .
T I
il• } I
( I1
f
4
S
TOWN OF BARNSTABLE
BUILDING DEPARTMENT
HOMEOWNER LICENSE EXEMPTION
Please print. .
DATE
JOB; LOCATION �dG
6 /
Number Street Address ; �h Section Of Town
"HOMEOWNER"�
Name ' Home Phone
Work Phone
PRESENT MAILING ADDRESS
City/Town State d �Z
Zip Code
The current exemption for "homeowners" was extended to include owner-
occ,uAied dwellings of six units or less and to allow such homeowners to
engage an individual for hire who does not possess a license, provided the;:"owner:;acts as su ervisor. p d that
DEFINITION OF HOMEOWNER:
Peroon(s) who owns a parcel of land on which he,/she resides
reside, on which there is, or is intended to be;, a one to six family
to
dwelling, attached or detached' structures accessory to such use Y
structures. A person who constructs more than one home in a two-yearand/or farm
Period shall not be considered a homeowner. Such "homeowner"
to the Building Official on a form acceptable to the BuildingOfficial,
that, he she shall be res onsible for all such work erfo shall submit
building Hermit. al,
(Section 109. 1. 1) rmed under the
The undersigned "homeowner" assumes responsibilityfor
State Building Code and other applicable codes b compliance with the
regulations. y-laws, rules and
The undersi ned "homeowner"g homeowner" certifies that he/she understands the To
Barnstable Building Department minimum inspection procedures and
Town of
HOMEOWNER'S SIGNATURE
APPRQVAL OF BUILDING OFFICIAL
f
Note: Three family dwellings 35, 000 cubic feet v
required to comply with State Building Code Section 127
Control. or larger, wil� be
•0, Construction
F
3 v -
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 - Licensing of Construction Supervisors) ; provided that if
Home Owner en
engages
Owrie g g s a person(s) for hire to do such work that such r shall act a Home
s supervisor.
Marty Home Owners who use this exemption are unaware that they are assuming
the responsibilities of a supervisor P (see Appendix Q, Rules and Regulations
for Licensing Construction Supervisors, Section 2. 15) .
awarenessThis lack of
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 withElicensed , supervisor. Tha
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.
4k
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The Town of Barnstable
.'= Conservation Department
s.un
';,Y 367 Main Street; Hyannis, MA 02601
Office 508-790-6245 Robert W. Gatewood
FAX 508-775-3344 Conservation Administrator `
TO: Joseph Daluz, Building Commissioner
FROM: Robert Gatewood
RE: Occupancy Permit/Final inspection
'i
DATE: '�(o m
}
The following project has been granted an Order of Conditions by the Conservation
Commission. '
Applicant:
• 9
Project: �q� �o�� �.,1 ,,► e�,. -�v.,.-�`��w- S��rT<z "� 1-
Location:
Map/Parcel: �k.
Our Permit #: SE 3- 09
We would kindly ask that no Occupancy Permit or Final Inspection (as may apply)
be granted by your department until a Certificate of Compliance for the project
has issued from the Conservation Commission.
Your assistance is very much appreciated.
h
gatJ, Coz 5�F_it9n ogiioetatF_i, -qne.
28/ mn Basta9fe v?oad
o/�yann.is,<-Mc4 02601
5081790-4686
Sax 5o8177148,66
June 17 , 1992
Barnstable Building Department
Barnstable Town Hall
Hyannis , MA 02601
RE: Structural Inspection Bldg . Permit 35087
Packard Residence 35086
218 & 226 Long Beach Road
Centerville , MA
Dear Sir -
On June 17 , 1992 , I inspected the structural framing related
to raising both structures . The combination use of 2 x 12 "s for
the first level framing , concrete filled tally columns and con-
crete foundation , is in accordance with the structural design
intent .
The. new construction exhibits pride in workmanship . The
foundation and floor framing will support the loads as anticipat-
ed by the Massachusetts State Building Code Fifth Edition . -
ry truly yours ,
R. . ----�
GREGORY r
TAYLOR
NO. 2777D
-cam "P ti9 • Gregor aylor P .E .
% GISTEF� ;