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0009 MILLSTONE WAY
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E , f� k Hl 'A , , ,.,',,�i,,,,�4�,� 1�,""k,"'V,�, " . , ��"r,,,�4�-.,E�,,'o,4,_e,,,,� '��4 , 'A _ , -�,,,',,.4g,q,fWN"t ..q, , �,11 ,, Of �'11'111'� 1 '4� , �, :�-�-,q,,--,,,�, ,,4'i",40V,V�:M IN PHNOU.- gf"WRON OR MW W Q_ , _,,,X�4.�,�,'�",:,�. ,�jq ,4 :1 7, I—- -, , � - - I, ,." - - 1. 11.1 IV', 4, ', 4'W"" � `I ,�,� , " I . , .f. ,�. - , z - 12-1��J�-�j%I,,,jp,l,,�,z I ,4i Ii U V, ,k ,", k. "X , 1111"111:_�*'111,11 "-1, , . ,.'Ili It W 7,�, ����",�-*�,�,i,.,���,,r;��i�4f'I, �1, , Z,-i. I , , " ,,4 ,I i -�,"Ill, �"4' "11... 11 fP�� I I , ���. �I . 1 & . II , - I... , 11 I , I... �1501'1111+ I go 4 .1 I..- r iiiii;; � � ::::, , I � ::::: , ,I , 1�1!:i �� 11 11 I Wki f _ �oFrr r Town of Barnstable *Pere 't ti c ' O l.rp `!-Yn r m-is9T(r r/nre $ ^3 � Regulatory SeI'vlces Fee ",�+�a �B�AI3 srtiet,S, ur 61m Thomas F. Geiler, Director _ .! ca 10 2.6%f1 To Building Division Tom Perry, CBO, Building COITImissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nt Va1N ivtt/ran!Re(I X-Preys linprint Map/parcel Nurnber d Property Address L L v -{- Cc �A J� Residential Value of Work q 41 `f !TOC 7 Minimum fee of$35,00 for-work under$6000.00 Owner's Name & Addresst�}- Contractor's Name _. Telephone Number Home Improvement Contractor License #(if applicable) Construction Supervisor's License#(ifapplicable)_ ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accornpany 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 roo.o Re-side �N�Frs n #ofdoors NY• Nl Replacement indotivs oors/sliders. U-Value `1/Q 0 (maximum . ) o wndows �l �1 .'35 # fi jfAl•SU i'2:� Zj G t��a:D Oiy3 2n *Where required: Issuance of this permit does not exempt compliance wish cYher town depiriment 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 required. License is STGNATUIZEI: QA WPI-ILESIFORMSIbuilding permit f6rms\8XPRCSS.doc t The Co7rrrrroirwen.lth ofllfassachitsetis -- -- Depart nerr.t of 171 ditstrial Accideutz �--� Office of lr7vestrgatiorrs (�, J 600 Washington Street t Bostorr, :�1�.02111 ��tiy r•t.�tsnt�.rirnss.got��'rlirr 'Workers' Compensation hisux-ance ai.ffi:davit: Builders/Cnii:ti-actors/Llectiicians/Pl:iunbe.rs Applicant Information Please Print Le giblti 4U�Ma121e�(Rus ne"rgauiz,tion ndivldaaI).- L.y yo1�,� Z. . City/Mate/_Zip: Phone #: Are you an employer? Check the approprinte 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 orpariner- fisted on.the attached sheet. 7. ❑.Remodeling ship.and have no employees These sob-contractors have. g. ❑.Demolition working :for me in any capacity. employees and have wvockers' [No workers' comp.insurance comp.insurance..? �. []Building addition required.] 5. ❑ We. are.a corporation.aud:its 10.0 Electrical repairs or additions :I am a.hotneoutaer doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exeruption per iMGL 1 ❑'Roof rep.a.irs insurance:required.] i c- 152, §1(4), and.we have no n employees.[No workers' 13..❑'O:tber �,p ca=� "�' comp_:insurance requir-ed.] tv&t>,Ao 'Any applicant thstchecls box#].Wort also BROW_the section beloa•'sbacving((heitworlters'compensation policy infonasrtiacL - W I Homeowners who submit this affidavit indicating they are doing all work and then hire autside contractors must submit.a mw affidavit indicating such- =Cautrac.tnrs that check this box must attached an sdditioost:she.ef showing the:nsme of the sub-cantraetars and stale whether or not those entities.have employees. Ifthe sub-•contaactors:hsve employees,theymust provide their workers'comp.policy number. I asr au errrploy trr(drat is prvrr'dirrg rtrorkers'corrrperrsrrh`on r ts>rmrrcefor rrry errrpla�ees. Belotr is the policy and job site it forrrraliort. Insurance Company Nance: Policy#or Mf--ins.L;ic.#: Expira6on Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(sholldng the policy number and expiration:date). Failure to secure coverage as required under Section;;2.5A of MGL c. 152 can lead to the imposition of criminal penalties.of a fine up to$1.,500..00 and/or one-year imiprisoun en.t,as well as 6Tril penalties in the form of a STOP'WORK°ORDER and a fine of up to$250M a day against the`violator. Be advised that a copy of this s atement may be:fbmarded to the Office of Iuvestig<ttions of the D.IA for insurance coverage verification. I do hmby cerh tritder tlra paiirs:aild parraliies nfp�rjairy tlrat tare it fortti Ttiolt pro idid.aboite is trtre.aiid correct. 5i tu-rem n!tD•`are a U� v FOflier R.orrl>'. Do not tirite!rr farts area, to be corriphrted by cif or town official . . Cityil: Permit/License# hority(circle one): Health ?. Buildin.g Department 3,City/Town Clerk 4. Electr}cal Inspector S.P}umbing Inspector son: Phone#; 15 �FTHE rpkO + EARNSPADLE, • - MASS.1639., Town of Barnstable plFD MP'�A . Regulatory Services Thomas I'. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner. 200 Main Street,- Hyannis, MA 0.2601 iwww.town.barnstable.mn.us . V4 0Mcc: 508-862-4038 Fax: 508-790=6230 z^ Propelrty Owner ust , .4 Complete and Sign T is.Section If Using A 1B ilder. K -- I, s Owner of the subJect property hereby authorize to act on my behalf in all matters relative to work authorized by t wilding permit application-for: - (Address job) a . Signature of Owner Date _ Print Name If property Owner is applying for permit,please complete the Homeowners License Exemption Forma on the reverse side. QAWPFILESIF0RMSlbuilding permit formslEXPRESS.doc � rf P�o[KE Town of Barnstable Regulatory Services jq�AvIIIassg $x Thomas F. Geiler,Director $A , r10 61979•r Aim Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 98-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 1 Please Print DATE r=�/ 7-1 / (b <JOB-L0CA'rroN: IAv L�-5kv e CA A-1/ �' (�( P-u i�.C� Ili�l o-L-(, 13`Z number n street a — �1 village r 1=fOM60WNEROL—, _1 �fL B �ry a "7 �090 —`�me home phone N CURRENT MA[LNG ADDRESS: o Vr, 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 helshe shall be responsible for all such work performed under the building permit (Section 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 pro s and requirements d that he/she will comply with said procedures and requirements. Slgna 1re-o,_o.meowne =_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.]27.0 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 ofawareness 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:IWPFILESIFORMSIbuilding permit formsTXPRESS.doc Revised 0721 10 Assessor's Office.(lst floor) Mau 2- i Lot Permit# �F7.5`6 �— Conservation Office(4th floor) Date Issued 10 $oard of Health(3rd floor)A 250..E<eat-op t, y�>rodt�rL �� Engineering Dept. Ord floor) House# &Aloe Planning Dept. (1st floor/School Admin.Bldg.): Sl��..,�� :Definitive Plan A roved b Plannin B 19 �?0� `��te0 111 C IAFA lications rocessed 8:30-9:30 . .& 1:0 2:00 .m. � ir�� e CODS AND OF BARNSTABLE riding Permit Application Protect Street Address ( S,O 0 E: A �QT S Villa e V t Fire District �' CjQ77E&v L (,Ltd Owner L— i4v',-) Address Q . Telc honc w Permit Rcquest: 71 Zoning District /l<// Flood Plain / O Water Protection Q Lot Size O ® Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type Existing Information Dwelling Type: Single Family Two family Multi-family Age of structure '2.2 `? Basement type (9 U R c-c> c--' n k) Historic House Finished Old Kin 's Highway Unfinished Number of Baths I A,, No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel 1�A5 YA 6 Central Air t--� b Fireplaces (0 1� Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO_-("�PY�I� '�)UrV\� Project Cost Fee SIGNATURE DATE 7J Z BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) ��2.� •�/�C�IO�,S� BPERM T IT /p 0 'a-) 3/2 8/9 5 6 2 FOR OFFICE USE ONLY r 251. 160 9 Millstone Way Centerville ADDRESS t VILLAGE Paul H. & Linda L. Leeman ) OWNER DATE OF INSPECTION: FOUNDATION - FRAME _ ro '�� `• '' ... v_ _ �` - � - . INSULATION FIREPLACE f" ELECTRICAL: ROUGH FINAL f - PLUMBING: ROUGH FINAL " GAS: ROUGH FINAL ` FINAL BUILDING: - . DATE CLOSED OUT: ". ASSOCIATE PLAN NO:4 .f ' l Sv N N N N 1 EX(5 77 Iao %d /U x DOC)TZ z ��- T Gvit-ADOw a po o 0- CYJ J � o C3 F-0 C Lvrvs G N�50-25-lOE-�' C8 c Ar r¢ (I'+.73 M 4 O _ cr 0,9 400 L O+ 5 M 20,goo S.F:. 2: Z � M H u 0 +--- E 3q' Hq O 4- tn J 90.00 fz cB CS, a 549-31-30W SDK. Ph I tAt-4c s LAN E PLot PLAN �Al, S�9C / JOHN G 0. PAUL , H. LI ckA, L. LE:CMAc� NY � HEIVRIKSEN N IA 5ca.LE 1°a30' lgaD SURVEY J. O. RF_KPlk.sEN R.L.S. NotF- Thii housE coNfop-wts to the bui Ldimq seTbAC-ks As LA1a out IN +h6 ZONI ag BY- LAWS fogy the- TOWN of BAP.Ns-rabLr-. TOWN OF BARNSTABLE • MASL o 039. DU-ILDING INSPECTOR 0 M Ar, APPLICATION FOR PERMIT TO ...&-4..zd..... 4 .......// ....................................... TYPE OF CONSTRUCTION ....... . ............ ...46.1Z.4;. 0:��........................... ........ . ..... .. .. ....... 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according. to the following information: Location ..... ....... . ...... 0; ...........C ?.0 ProposedUse ........0.��.... ................................................................................................................. Zoning District .... ,cc Fire District .................................... Name of Owner ...pe�-.4�4... 31... 4.-.. Name of Builder .... ......Address .... ......... .......... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ...........1.7...............................................Foundation .......... ......................... Exterior ................. .............7*-----Roofing ...... ...... Floors ................ ..................................Interior ....... Heating .......GAIS......../-/P. �e,,...................Plumbing ....Y.-4.1t4t ... Fireplace ................ Approximate Cost ... ................................................. V-1--l-1111-1-.................... .......... Definitive Plan Approved by Planning Board -Z�Aj I------------19 Diagram of Lot and Building with Dimensions d d2 SUBJECT TO APPROVAL OF BOARD OF HEALTH > LLJ W (-) i-, C13 t9.37 0 tw_ 77= 6 9, 940 Ir n a. :E C) j oC' u 5 -) OZ 4 >� O — 0 qo--- cowl'- >- P �b Cr ,51 CL Z U '34 19 7 0 60 14- 0 3 5. 36 9.77 C5 76,00 �=-q 0 -00 -06 (5z21 Iq -tzl5-37-.? --2-5�00 1 hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' , D Name ... .�..:� I.... ! �. .......... Leeman, Paul H. & Linda L. �5986.: Permit for two story No ........... .................................... single family dwelling , ............................................................................... Millstone Way Location .......................................:....................... � Centerville ............................................................................... Owner Paul H. & Linda L. Leeman ................................................................. Type of Construction frame .......................................... Plot ............................ Lot ........#5........................ Permit Granted ¢ ,?...h ..5..............19 73 Date of Inspection ....::. .:........................19 Date Completed ....... /41 '�C/' . ....19 w PERMIT .REFUSED ...................................... ..... 19 ...................................... ..................................... ........................................ .................................... .� ................ . ........................................................... ® , Approved ................................................ 19 ............................................................................. . f