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HomeMy WebLinkAbout0063 LOOMIS LANE r r c o a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 3 O Parcel \ 0 (0 80kC7/jvG Application # Health Division q )? 'D R;Date Issued S AI Conservation Division TOINj1 op P.8 2416 Application Fee Planning Dept. eq��sT�e Permit Fee' �.��• r✓ Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis EM&r L 5 E-tJdr Project Street Address (r� L 0 0 AA S L_ P\-)Q \� Village 0— �—e� Owner ��fk rL v 1 ®� VJ r�` Address�S Telephone R Permit Request Pi (0) �\�1\�!�' �'� .�f G./V\ t '�aY Q<►'Pf 1 1�,1A. L i �(' a 4P Inc: d`� aYi �_ Lek Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation " , ®0D Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) Age of Existing Struct ure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas alcr,I ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of AppealZAu orization ❑ Appeal # Recorded ❑Commercial ❑Yes If yes, site plan review # Current Use e�5 �-1 Proposed Use APPLICANT INFORMATION - (BUILDER OR HOMEOWNER) Name� i-N- �Ifryl Telephone Number 3(Q7 `�(Dsls Address (� � ��� `e4 f VI)C�_, License # C 1 Q 1 CI (D 0-c4n,A) mikes A 0�,(,e4b Home Improvement Contractor# Email S eu,I �W 0-0 00 M CGL:S+ ('worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE ,(— Z 2—C ) FOR OFFICIAL USE ONLY Y APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION N FRAME INSULATION . FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts T _ Department of IndustrialAccide7its' Office of Investigations 6001Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plwmbers Applicant Information Please Print Legibly Name usiness/O onandividual 11 �� �: G�WIC�c, '���rrnrn�t�+ r Address: �� r f \\ City/State/Zip: Phone#: Are you an employer?.Check the appropriate bog: 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 2.15U am a sole proprietor or partner- listed on the attached sheet. 7.'Jjg.8emodeling P ship and have no employees These sub-contractors have g, Demolition , working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp.insurance. t required.] 5. F1 We are a corporation and its IO.❑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 12.0 Roof repairs c. 152, 1(4),and we have no insurance required_]t § - employees. [No workers' 13.❑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. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 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. I do hereby fy under the pains and penalties f perjury the information provided above is true and correct Si Date: Nay Phon". Official use only. Do-not write in this area,to be completed by city or town official 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#: 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,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.". MGL chapter 152, §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 who 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 enter to an contract for the performance of public work until acceptable evidence of compliance with the insurance n rm y p p p p e e contracting ors requirements of this chapter have been pies ntd to the g 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(LLP)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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate lime. 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 be sure 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 given year,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 future 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 business or commercial venture (i.e.a dog license or permit to bum 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 O$i-ee of Investigations 600 V nwmgton Street Boston,MA 02111 Tel.#617-727-4900 exit 406 or 1-977-MA SAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia Fl i Town of Barnstable 0 } f Regulatory Services XASM -Richard V.Scali,Interim Director Building Division Tom Perry,Building Commissioner , 200 Mai Street,BYa ,MA.0260I www.town.barnstable.ma.us Office: 508-862-4038 Fag 508-790-6230 Property Owner Must Complete.and Sign This. Section If Us'A Builder 2s Owner of the subject l PtOpetty heteb orize F— Y auth � t�¢� `� to,act on mp behalf, uo in all matters relative to wotk auto oozed by this btu7.ding p etmit (Addtess of Job)' **Pool fences and alarms ate the responsibility of the applicant. Pools are not to be filled of utilized before fence is installed alad all final inspections are performed and accepted. ignat ne of Owner tote of Applicant Print Nztne Ptint Name Date Town of Barnstable _ - RegWatory Services pF Toyy Richard V.Sca%Interim Director Building.Division : - aTsrexz Tom Perry,Building Commissioner 9c� % ,�� 200 Main Street, Hyanms,,MA 02601 www town.b le.ma.us Office: 508-862-4039 - Fax: 508-790-6230 HOMEOWNER LT sE UMUPTION Please t DATE: JOBLOCATIOX- - nmaber shy village "HOMEOWNER: name home pbon work phone# CURRENT MA=G ADDRESS: city/town share zip code The current ekemption for"homeawn--.was exten to clude owner-oMMied dwellings of six units or Iess and to allow homeowners to engage an individual for hire who does of ossess a license,provided that the owner acts as supervisor: D ON OF HOMEOWNER Persons)who owns a parcel of land on which he/she r or intends to reside,on which there is, or is intended to be,a one or two- family dwelling, attached or detached strictures accesso t such use and/or farm structures. A person who constructs more than one home in a two--yPe r period shall not be considered a ho eown . -8uch"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be onsa le for all such work erformed under the building Permit- (Section 109.1.1) The undersigned"homeowner"assumes response for complian with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/ understands the To of Barnstable Building Department minimum inspection Procedures and requirements and that he/she will mply with said proced and requirements. Signah=of Homeowner Appioval of Building Official Note: Three-family dweBings costa-mg 35,000 cubic feet or larger will be Mn ed to comply with the State Building Code Section 127.0 Construction ControL HOOWI�t'S EXEh>PTZON The Code states that: "Any.hom caner performingME work for which a burlding,,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 shall ac t as su ervisor. engages a person(s)for hire to do such wa k;that such Homeownerp ��, e unaware that the are assuming the r • ,onsibilities*of a supervisor homeowners who use this exemption are un w y g �P Many h 1 P 2.15) This lack of awareness often (seeAPPendixQ�Rules&Rations for Licensing Construction Supervisors,Section results in serious problems,-particularly when the homeowner hires unlicensed persons. In this case;our Board cannot unlicensed person a�it would with a licensed Supervisor. The homeowner acting s Supervisor is proceed against the unh p - ti a- P g ultimately responsible. To ensure that the homeowner'is fully aware of his/her responsilailities,many communities require,as part of the t she understands the responsibilities of a Supervisor. On the last page permit application,that the homeowner certify that he/ of this issue is a form currently used by several towns. You may can t amend and adopt such a form/certification for use in your community: Massachusetts -Department of Public Safety Board. of Bu ,aing Reguiations a a oa us i construction 5u i�iss�r " g r,;' URresvidied-Buddinp of any[use gwup which contain less than 35,OW cubic feet(991m)of License: CS-101989 enclosed qmc- JAMES S BLI�1VVyb0 ° r IL 68 FRAZIKR WADI ` s f MARSTONS MIIIS ' x p r aEt ra I I oJ� Facture to possess a curmit edition'die aehusetcs 01M 7 SP201 Commissioner i StateBuildingCodeiscauseforievoatkmofthislicense. r For M ltwWng Information visit wwwAU%.Gov/OPS �.. '�T n.`�rtuanra.ni�xtr�N n��=i��irs;arcc�zertells' . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR. before the espiration.date.. If found return to; egistration �63725 Type: Office of Consumer Affairs and Business Regulation y piration: 711'r1M17. DBA: 10 Park Plaza-Suite 5170 r. Boston,MA 02116 NORTHGROUP BUIWING A"NURE ODELING JAMES ELUNW006 s 68 FRAZIER WAY MARSTONS MILLS.:MA.664 ' .U=�ndersecretacy Not valid without signature t TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION a� �3 COC Ma 230 Parcel— o o Application Health Division Date Issued 601"ity Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address (0 c) v�%, 5 Lo_" Village 01P VA�CV k \1,e Owneraohr, Address G 2, L noLi s �.�►� r �1Z Telephone CO `+00 �g t Z� ►Avq dzca3Z PermitRequest'&Crnoge, (0 Skd-\nS 060" 4-:5 %r%.� ZS au —In sy,�_m ne_,.0 .�,n s v `u.�`. n S iWOL-r . 9% CA2_VY\&A3r 5'�:,,n�. e�Pa• o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Tofal new Zoning District Flood Plain Groundwater Overlay Project Valuation Soo , j _ Construction Type t Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished-Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: q Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ -Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes t"o If yes, site plan review # Current Use -� ` Proposed Use APPLICANT INFORMATION - - (BUILDER OR HOMEOWNER) Name J 0.vweS fit, I i.A lJ O rO A Telephone Number G Q?2 3(o:1 S(p S* 5 Address (0 e) C-(' wo"A License # C S - k o 1 q% eA. ANa,_CSA0f)5 AKM S (A (fit Oo)(0`'f J Home Improvement Contractor# t Q0 5—1 2 Email _,YS ELLI r1y0 e0L\ Qo M C 0_3 . Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C o YYI SIGNATU DATE I t) Jl v n e" 2-0 ` v FOR OFFICIAL USE ONLY =-APPLICATION# DATE ISSUED ' MAP/PARCEL NO: 1 ' ADDRESS ' VILLAGE a OWNER f s DATE OF INSPECTION: FOUNDATION FRAME Q YAW INSULATION FIREPLACE w.i ELECTRICAL: ROUGH FINAL " r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 0 J.L36 . DAT&CLOSED OUT ASSOCIATION PLAN NO. i The Camwaxmwakh of Vassachustfs Departutmt ofIn&i.sh ial Accidents Office 00mlesfigations 600 Washington Street Boston,M,4 02711 wMMynass:gavldia WorYkers' Compensation Insurance affidavit:Builders/Contra:cterslE ertriciansXlumbers Applicant Information r Please Print;Legibly Name 91ud _w10z anization&dividnal): taw►g_S s . E r.L i a �� No �,quo e 3�, , CityJStatrJZip:0&rskuvt, A&,'N M P a d�N�6 Phone 4- 3�`7 `t5 —__Aire won.an_employec?G7ieck t app apriate bar: 4- I artx s contractor and I 1_❑ I am a employer with ❑ 6- ❑New oanstuction employees(full andlorpart-time)* have hired the sub oiors. 2 I am a sole proprietor or partner- listed on the attached sheet_ I- ❑Rrmodelmg slip and have no employees These sob-contractors have 8- ❑Demolition Working for ore in any capacity_ employees and have workers' 4_ ❑Building addition [NO:WOrkr_rS'Comp_iflMUanre comp_insuramT l required-] 5..❑ We area corporation and its 14.0 Electrical repairs or additions 3.0 I am a homeowner doing all work- officers have exercised their I1_0 Plumbing repairs or additions Myself [No workers'tamp right of exemption per MGL 12.0 Roof repairs snnumncerequiired,]t c_152,§1(4} andwehaimna employ'-[No workers' 13_❑Other eSOG-�►+� comp-insurance required-1 *Piny applicant that checks boa#1 umtt also fll out the:section below shewiag the¢waodkers'compensation palm infurmatetm. T Homeowners Wbo submit this zffidavh indic such- ZCbutmctors that check this bark mast sttached an additional sheet showing,they, of toe suA�comtaa roars and state whether arnot those amities have emplayees If the sub=contmaurs hale emplUees,the}must provide their workers'comp.policy number. lam an employer that is prmidi►ig workers'con.Weruntion irmirance for my enWEoyects Below is the policy an.d}ob site. information. Insurance Company Name: Policy 9 or Self-ins. Expiration Date: Job Site Address: (o (..QQ VVI S lsx,re Qi City/StatelZip:e,yl,�W AAA 0 2(o 3-- Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiation date). Failure to secure coverage as required under Section 25A of M_GL c, 152 can Lead to the imposition ofcliminal penalties of a fine up to S 1,50Q00 andlor one pear 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 instance,coverage verification- I do hereby fy under tkspains and penattie ofpedury thatth formation prin idecd above is hue and correct c Sitma Bate.: ✓1 Phone# nq_ �n:7 s to s;5- l3,fficial use only. Do not write fn this area,to be completed by civ or town official City or Town:. PertnitUcense A Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.Cityltown Clerk 4.Electrical Inspector 5.Plumbing inspector' 6.Other Contact Person: Phone#_ 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(57 also states that"every state or Iocal 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 who 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 enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance 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-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)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. De advised that this affidavit maybe submitted to the Depaftment of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter heir 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 be sure to fill in the peradt/license number which will be used as a reference number. In add?tion,an applicant that must submit multiple permit/license applications in any given year,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 future permits or licenses. A new affidavit must be idled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NTOT required to complete this affidavit- The Office of Investigations would lice 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. ne Commonwealth of Massachusetts Ilepart=nt of Tnduslrial Accidence office of Xuvestiga.tions 6GO Washington Street Boston,MA 02111 Tel A 617-727-4900 ext 4-06 or 1-9 MASWE Revised 4-24-07 Fax#617-727-7749 Www.mass govldia Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 -Property-Owner Must - - -_ _ _ .4,------------ - ---- - - Complete and Sign This Section If Using A Builder 1 �2•r� , as,Ownex of.the.subject property �O 0 VU, k1l✓�c� hereby authorize c"r,n� c__s ��l 1 ��T,moo J to act on my bel in all matters relative to work authorized by this building permit application for: Lc)bv-,-i (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFI Y_MRMS\building permit forms\smokecarbondetectots.doc. , Revised 050412 IOWH 01 DUFUNUtVIC. Regulatory Services .. iby Richard V.Scali, Director " Building DivisioII 10 >ASxsTA MA Tom Perry,Building Commissioner arA.ga. 163q. ��� 200 Main Street, Hyannis,MA 02601 ArEQ � 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 dwellinss 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 hermit._(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. -- G OM,,of Cons®me.Affairs&Business Rego lait a License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: gistration: 163725 TyW: " Office of Consumer Affairs and Business Regulation Ekpiration• 7/1712015 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 :NORTHGROUP BUILDING AND REMODELING JAMES ELLINWOOD ' 68 FRAZIER WAY " F MAR3TON5 MILLS,MA 02648 Undersec"ry. Not valid without signature • Nia�t usetts -Department of Public Safety , Soard'of Building Regulations and Standards Construrtiiin Sgen isur Lddense: CS401989 DAMES S ELI.tN OO. 68 FRAZIERWA1l s MARSTOI�IS ME�1S s , �'nmm�ssconer 6111312015 Unrestricted Buildings Of any,use g=P VVhich eoi►taiin less than 35,000�cubic feet(g91in3)of , 4 enclosed space. ,, y Jw 'ssess a cutreM edition of the Massachusetts Failure to Po lion of this license- + state Building Code is cause forrevoca t i s www.Mass,Gov1DPS _ n'00n DPS licensing infW visit. w for , + TOWN OF BARNSTABLE Permit No. _ _-----------------------------Y�� w _ 711+7T Building Inspector 1YL + 'oo Cash ------------------------------ �OY►Y+` 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 John Peirce Address !An Hill Rd. ,Sherborn, MA nnp, Centerville Wiring Inspector fl r 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. ...................................................... 19......_» ........._...................................».................................................................. Building Inspector r_ Q LOCATIo>`t CEN-rEQ�.►I*C,. �: GAL h*a -GOF•r >aTt= Ih C!zR T t F Y T H A T T H E FU U N D AT I0 Nj 5t`l>AJ►.t Pt A�.l IZ F ctZ ►.1 c+E t t��t��a GQN\P��(S W ITN Tta6 �i o�E.�.i�.t� L •G• 3�'t � �{• /�. A1.IL SETBACK �E4vi¢EM�+�TS of "r wc— DATE � Y..t v� 't � �,;����"".c_.._- g,4XTE�Z. �.. u�� I+►.1G_ REG1S[ -RED 1A1.tC:> - SUv�=�lok'S r '- - OSTEfLV1Lt.E O /4taSSr „ G, " �'!-•1.t S •�C p:F=r�.3 I S i.l o'T P.s,n.5�:D O►.��"IA�..J 1+ ' J4415-'QUMEkJT �jiJG`�JC�( ,T�aE: c�F�;a rS 5f�o�+./ta APRLI cA."- " JG !-i N , t�� �C� i I•C>T EB'E U S C u To D C:T G e M I►J E- L-O-r LI I,Wia riI (EE JV- 7 . Ases7sor's map and lot number ..:=Z•••••.•••••'•• ••• SEPTIC SYSTEM MUST BE -� ' - INSTALLED IN COMPLIANCE M 4 / .. WITH A;ZTICLE II,'STATE( n Sewage "Permit number r" SANITARY..GOOF-aND TOWN. T"E " TOWN OF B°A11"TIBLE �of roe , SUBJECT TO APPROVAL OF i B,HBSTIIDLS i ' in , `a BARNSTABLE CONSERVATION. " ` D U Ir L O I N GT3=� hH S P E C T 0 R M1 COMMISSION . 'Ep�pY c`; s „y tw APPLICATION FOR PERMIT TO ...:.......................... .. -......R ....... ......................................r...... . .... / TYPE OF CONSTRUCTION .....:4V.Q -... ............................................. ................r.. c ...... .. ..j...............................19?0. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......................................... .........`... U.4r�............... e/s�1 � .`—............................................... ProposedUse ....40 4en.�'...................................................................................... .. ....... ......................... Zoning District . I.................................................Fire District ....Cr C.*.o............................................................ Name of Owner &9.416.......................Address ........� ......1....� ,�.r.............. .��..1� .. .1......... .... Name o Builder i'�IfY / ./�4 .44e r� �•T/�A�.G�../ 4ddress .. U. �......®.S1'OD e Nameof Architect ..................................................................Address .................................................................................... ......................................Foundation .......Number of Rooms ......��.�....... ' S����iL?.....�r�✓..ev weei� Exterior . 4'5.r.....4,z. °a.ev? ..5VIV V........................Roofing ..:. e. .. ��'f! /„�. ............ ......... .......... ... . Floors ..........c. ................................................Interior .. .yI ��. ..... .... .......................................................... Heating ��,� .....1 .7�.........14'� .........................Plumbing .............. ............................................................. 2 , ter ' Fireplace ..........0!1.rz............................................... .........Approximate Cost ......: ©„U...d �.:......... 1: Definitive Plan Approved by Planning Board ---------------------------------19________. Area ..... / .. .......... i .�. ......... ... .. .......... Diagram of Lot and Building with Dimensions Fee 35 as ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTHo�.t� 1 I`I I hereby agree to conform to all the Rules and Regulations of the To 2nof arnstable regarding the above construction. Name .. . `. ...................... : ................................... Peirce, John ` . 9 one story �o ................. rnrn`n for .................................... ' ^ `__.o '���� ..M�m�.111ng_______. ( � Location ---63— .............Lmmm1m.—La�m—.-.^—.--.----.. Centerville ^ ---------'----`~~—~^--^'----- Owner —.--John Peirce ----.--.—.----.--.—.-- Type of Construction ---..f?;@���------.. —..,.~--._..—.--.--..--,—~—.---.. Plot ............................ Lot ................. . - ...............Permit Granted ^ ` Date of |nopaction—'-------.---]V ""'= C" ' p^" ' � ~ . `~.p ��*� . ' '~. . ������ ����0� ^ ' ` ~ ,-^..~�.--..-.._.-,-...-..,.....��_, 19 ........................... � . � ` ...-- ' ^ � -'«�. ................................................... - - - _ .----. � --.^�l°�[ --.~.. .' ' ' ^ lq ' ' Approved/ . ~ ' .............................. ............................................ ' � ................................. ............................................. | ^ tl Assessor's map and lot number ....`...i-.:..... `` Sewage Permit number /S TOWN OF BARNSTABLE Z BARNSTABLE, • • 9° 1639 BUILDING INSPECTOR 'F0 MPY a' 1 APPLICATION FOR PERMIT TO c�-s f -li C Sin ! r - ........... :�.............. .� ...:.......... .y ............ . ..................................... Gu Q D -4-a� • TYPEOF CONSTRUCTION ................................:.................................................................................................... ..... �. ...............................19? . TO THE INSPECTOR OF BUILDINGS: # 3 The undersigned hereby applies for a permit according to the�following information: Location �C 6 f�, �� ICJ e� l .... ProposedUse ..... r ..... .... .................................................................................................................................. ZoningDistrict ........:..'..0......................................................Fire District ... .' ........................................................... Name of Owner ...��.:... . .. ... A.F.I. ......................Address ! /�7 SC1etl„ ...(4,/a....`:.ff;C` 'C°3rs..�►.., ...'��J1, Name of Builder r 1 t1 L=1'<t O, lift/S11'.!�!r^ as ./ a`„r�Address ..s/�G L!, fl .... ............................................ .. ...... .. .. Nameof Architect ..................................................................Address .................................................................................... Number of Rooms / !.. ..............................................Foundation �(! ................... -:................. y Exterior ..�...................... ........................Roofing... . .............................. r. Floors . .. .Interior L Y LtJ A L e- ..................................................................................... .................................................................................... Heating .......... f' lit............................Plumbing . .....`e. ,qT f—............................................ : .. ....... .... y _ Fireplace " r ..Approximate Cost ........................... ............................... r Definitive Plan Approved by Planning Board ________________________________19________- Area .../54-7 5' r'....................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTHv' r r f f •'I r+ SI 4. i I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .......... ....................................................................... � l " ^�O239 oftm story �^ No .�, ........ Permit for .................................... ' single family dwelling ' -' ----'------^--------'—' — ' 63 Loomis Lane Location ..--.--.---.--.--.------. Centerville ,.—,-.---...—,—.—.—...'.--..------.. - Jmbo �e�rom "w"= ` !\r , '. Construction -----' ` ' ............................. ' ~' ~~' Permit Granted Date of mxpeq/nn � uo/e Completed � � , PERMIT EFUSED ^ 19 --- —'—'--' ` ' _-- . _.—.-- � f �8 � } ~--'--'' .'!°' . .......................... � .—.---.----_--,--.—.—.—...-.......' Approved| - ---------------- lA N ' . ----.----.-----~.......—..—~--.,' ` ----.--------...-------.:.--.—.. ( � �