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Home My WebLink About0084 MONOMOY CIRCLE r i7 0 ,t .. .r'S k� Y:`L t ', � •: .-,a & ...' . a,.. -M c' ss. ,�4� ,�, cv, .�' m ..�� },. +'- q d '� Rr•.; y v { i _ u Lauzon, Jeffrey From: Lauzon,Jeffrey Sent: Wednesday,August 15, 2018 1:36 PM To: 'SUSAN.MURRAY65@YAHOO.COM' Cc: Lauzon,Jeffrey Subject: ViewPermit, Permit No:TB-18-2355 Applicant, Please be advised that the Building Department has reviewed the above application and noted the following: 1) The existing chimney serves as exhaust for the gas appliance(s) in basement. 2) You must demonstrate proper exhaust for existing appliance(s).A permit will be needed for any new appliance or duct work. Item two must be addressed before a building permit may be issued as it would create an unsafe condition in violation of the State Building Code. Please do not hesitate to contact this office with any questions.Thank you for your immediate attention in this matter. Respectfully, Jeffrey Lauzon Chief Local Inspector (508) 862-4034 jeffrey.lauzon@town.barnstable.ma.us 1 , Application Number..;........8 .......... f i t � ♦g TOWN OF BARNSTABLE � Permit Fee.........................:....:.......OtherFee...............:.:...... MASS. 708 JUL 23 Pit 3* 4 2- Total Fee Paid..................................................................... TOWNOF BAIINSTABLE Pm7aft Approval by.................................on.........:................. BUILDING`1P V'WIT mo........�... ...............Pa�............. .....C_�. .............. .. APPLICATION Section 1- Owner's Information and Project.Location Project Address D `T r- �cc- Vffiage ei-Jh,-1"Z wt 1 L-- Owners Name G(N-) f V r'r'A C� Owners Legal Address oro cyyi Ot'/ 1.� �✓�� t.. City. � NU�c`( State zip Owners Cello 9 7 0 176 7��5 E-mail 5 co a)4,1 Section 2—Use of Structure Use Group ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,000 cubic feet Rf/Single/Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ,Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild ❑ Deck Apartment Sprinkler System ❑ Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other-Specify Section 4 -Work Description a 4 o tics T Act nndsrted:2/92018 Application Number.................................................... Section 5—Detail Cost of Proposed Construction L � Square Footage of Project Age of Structure Dig Safe Number_ 6J � # Of Bedrooms Existing 3 Total#Of Bedrooms(proposed) 110 MPH Wmd Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas "❑ Fire Suppression ❑ Heating System Masonry Chimney ❑Add/relocate bedroom Water supply ❑ Public ❑ Private Sewage Disposal ❑ Municipal ❑ On Site Historic District ❑. Hyannis Historic District ❑ Old Kings Highway 1 Debris Disposal Facility: I am using a crane ❑ Yes ErNo Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No 21 11/ Section 8—Zoning Information Zoning District .Proposed Use Lot Area Sq.Ft. Total Frontage . Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed ; Has this property.had relief from the Zoning Board in the past? ❑ Yes ❑ No Last undated 2/92019 r Application Number........................................... Section 9—Construction Supervisor I ' Name Telephone Number Address City State zip License Number License Type Expiration Date k Contractors Email Cell I understand my responsibilities under the roles and regulations for Licensed Construction Supervisor in accordance with 780' CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section.10—Home Improvement Contractor Name Telephone Number Address City State Tap Registration Number Expiration Date I understand my responsibilities under the roles and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and docimmentadon required by 780 CMR and the Town of Barnstable.Attach a copy of your ELLC... Signature Date Section 11—Home Owners License Exemption Home Owners Name: -- �s a- /V U rr-A C Telephone Number27'W-- 7S'�- /7 G3Cell or Work Number I understand my responsibilities under the tales and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation by 780 CMR and the Town of Barnstable. Signature Date " ( (2 —1 APPLICANT SIGNATURE Signature Su6cA) .fliU✓' 4 Date — (2 r • Print N Telephone Number 9 7 F— �.� ��?G E-mail permit to: -J5 UcSCt f1s) orr q�/ �- `� L100-- e-O/!-j T-..a n moor 0 i Section 12—Department Sign-Offs Health Department ❑ Zoning Board Cif required) ❑ Historic District ❑ Site Plan Review Cif required) ❑ Fire Department ❑ ` _ Conservation For commercial work,please take your plans directly to the f re department for approval, Section 13 Owner's Authorization h , as Owner of the-subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of j ob) 1 Signature of Owner date Print Name f , x n y . Last mdatc&2/92018 ON IL c, , i i I FRAME pr. CERTIF IED PLOT cc. A:LE 3 74s LOT a P�. Z 7 z P� 7-' Bax T NYE I mac. , { ZolvlIV6 1 {, `: Gf�" Tf'� 7" <✓Gv'!Y °•it R <�I T'L. RlE - t:- D LAND SUS v';~\�r.rt;,;w C) S S,S ;7 TER.VIt..�E � _ .- - f _ LISN The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations M 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LegibIv Name(Business/Organization/Individual): 1�s 1l'5-C."ro r—r(-1 1 Address: 6 0110/0'o 1A,10 L 0111/`f City/State/Zip: (J-,,AJ L10►d` �- Phone#: 9 7 F- 7S- F— 7(o`j Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. F]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 workingfor me in an capacity. employees and have workers' Y P tY• $ 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.RI 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.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.EKOther JZW1tWQ1IA N t� comp.insurance required.] ,ti L�U, C-1 4'4 WrAe Lrt - *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: 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. 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 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 ' d p of perjury that the information provided above is true and correct: Si afore: Date: 7 ® � Phone#: 9 7 Official use only. Do not write in this area,to 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#: 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 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. Be advised that this affidavit may be 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 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 permittlicense number which will be used as a reference number. In addition,an applicant that must submit multiple permitllicense 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 burn leaves etc.)said person is NOT 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: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.mass.gov/dia Asse;" lip, ssor's map and lot number ....l.. .......1All 3 ,7 / o� Sewaged.Permit number .............l.�f..J�................................. SEPTIC 4., SYSTEM MUST 13E 'GPyO�YTME TOWN Y rl -, k I 1� L CE ts; 4 d� "SOi� ri Lt4 SANITARY I c, RANITA OCODE AND TOWN Z BABFSTODGE, i — 639 U' 11 I G INSPECT .R_ 00 �1439. ,\00 �'YPY a' cv n e APPLICATION FOR PERMIT TO ........... .. ............................................................................................................. TYPEOF CONSTRUCTION.... ..... ,.�z.�e .................... .................................................................. ` ..rG ..............2....19Zr- TO THE INSPECTOR OF BUILDINGS: The undersigned h reby applies for a permit according to the following information: Location ...... .................................................................. ProposedUse ......... ... ......... . . ........ ........................................................................................... ZoningDistrict ................. ....................................Fire District ... LLB................. .......................................... Nameof Owner. ..... . .... .... ............................Address ....................... ............................. Nameof Builder ....................................................................Address ...................................................:................................ Nameof Architect ..................................................................Address ..............................................:................................. ...................................... Number of Ro s .............................:....................................Foundation ......................... ExleriorRoofing . ........ ...... . ..... ... .. . ............... ... .................. Interior ...��' .... L Floors ...................................�.,............. ..................... Heating ...........................Plumbing .......�.... . ...... ... .. .......................... ... .- Fireplace ............................................... ....:............................Approximate Cost .............4.j..p........................... Definitive Plan Approved by Planning Board -------------------_-----------19________. Area Diagram of Lot and Building with Dimensions Fee ...� .. ............. SUBJECT TO APPROVAL OF BOARD OF HEALTH ` 9 � hereby agree to conform to, all the Rules and Regulations of the,Town of Barnstable regarding the above construction. Name..... ... .................................... �.. ~ Small, Alan E. ' ' �- 18494-' . onm atory* No Permit for --------- . ` fauuily dwelling --�.------..------.�---------.Monomoy ' . .^ . Cir«lm Location ......................... ' Centerville ---.----------------------- Alan E. Small Owner ................................................. �______ frame Type,'of Construction —.--------.�---.. ~~- .. ` . . . ----.-----------------.. ` . ^�~ ' . ' Plot -----..--.r Lot ---.'�'��--. l8 PermitGranted ^ ' ' ^ ' " Dote of Dote Comp| ]� ' �� -' ^ ' . ^ -- /- . . , PERMIT REFUSED ^ ---''�^_----.---------- 19 .................................................. --------.. ' ' --,--`�.^....—.----^--.--..------.. '`----r---.---^--------^---'''/' ` . .—.---.��---,..---------.-----., Approved ............................................... YV , ' -----------------..----..—_ - ----------------------.--.... « �_�1 c. M 0 N 0 M 0 i z►. zy•, - t a coo , 37 �1 0 a o h . 0 7a t -15_ �,f woav F1�,aME �y -DcJEI-LI Q ` �U ZIP i)! E �. O • C�!� -. 1 { CERTEF iED PLOT PLAPA L OGATsOt,4 CE►TRN.'fLLE IAASS �" 3 0' (�A-r E 4/Zo/r1- � yt L0T 3'7 PL 2, 1< Z 7 Z pro 5 ZGN/ivG 419W< Gfi7-hx� REGi -5reR.ED LAND SVRVE\(aL".s A LA,►4 DMA