HomeMy WebLinkAbout0184 NOTTINGHAM DRIVE J
( � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map % Parcel Dot_ Permit# �A!9�O
Health Division Date Issued
Conservation Division Feei� O O
Tax Collector
Treasurer
Planning Dept.
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address
Village
Owner o Address &I 42me
Telephone
Permit Request PcA EW-2 ,&
Square feet: 1st floor:existing proposed 2nd floor: existing proposed Total new
Estimated Project Co Zoning District Flood Plain Groundwater Overlay
Construction Type
Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family I Two Family ❑ Multi-Family(#units)
Age of Existing Structure 02 Historic House: ❑Yes ffNo On Old King's Highway: ❑Yes 0,11b
Basement Type: Hfull ❑Crawl ❑Walkout ❑Other
Basement Finished Area(sq.ft.) 0016 Basement Unfinished Area(sq.ft)
Number of Baths: Full: existing new Half: existing / new
Number of Bedrooms: existing J new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: �6 Gas ❑Oil -❑ Electric ❑Other
Central Air: `6 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 No If yes, site plan review#
Current Use Proposed Use
BUILDER INFORMATIO
N
Name- ca J}ALK _ Telephone Number
Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
SIGNATURE DATE 21
FOR OFFICIAL USE ONLY
P&MIT NO.
DATE ISSUED
f
t �
MAP/PARCEL NO. ` � ~
ICJ � � ` Y♦ ,, •{ -.7 ( — - ! . .of
r. ADDRESS ' VILLAGE
OWNER.
DATE OF INSPECTION
FOUNDATION
FRAME
INSULATION -
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL -`
GAS: ROUGH FINAL
FINAL BUILDING
r -
DATE�CLOSED OUT
ASSOCIATION PLAN NO.
_= al Accidents
172i W. ; Department of Industri
xF:�,��,��� Olffct atilwatfaatfoirs
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{ �.' 600 Washington Street
c Boston,Mass. 02111
Workers' COMP en cation Insurance davit
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Faaare to secure coverage as required raider Section 2SA of MQ.152 can lead to the n of erhmoai penalties of a Hue nil to S1,SU0.00 awdlor
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one yam,imprisonment as well as civil penalties in the corm of a STOP WORK ORDER and a Hue of S10Q00 a dad against me. I
copy of this statement may be forwarded to the OMce of Investigations of the DU for coverage vedHeadm
1 do hereby certify raider the p ' and penalties ofpalWy that the information provntled ove is trw.mud coned
ateIsigna"UZ G
Print name
oincW use only do not write in this area to be completed by city or town ofaciA
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permitliicense f< adding Department
city or town: Qlteensmg Board
❑Sdectmews Omcc
❑check if immediate response is required ❑Health Department
❑Other_
' contact person: phone
UrA"Q 9195 PJA1
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The Town of Barnstable
� • warrsrea�. -
�� s �e� Department of Health Safety and Environmental Services
Building Division
367 Main Street,Hyannis MA 02601
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
Permit no.
Date
AFFIDAVIT
HOME IMPROVEMENT CONTRACTOR LAW
SUPPLEMENT TO PERKM APPLICATION
MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion,
improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied
building containing at least one but not more than four dwelling units or to structures which are adjacent to
such residence or building be done by registered contractors,with certain exceptions,along with other
requirements.
Type of Work: d F—pl �i' ) "'I�Gt1�i /�iT/� u s ed Cost
Address of Work:ZJE N[14%AI611121�
Owner's Name: (212
Date of Application: L2
I hereby certify that:
Registration is not required for the following reason(s):
Work excluded by law
Job Under$1,000
pBuilding not owner-occupied
®Owner pulling own permit
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IIVIPROVEMENr WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A.
SIGNED UNDER PENALTIES OF PERJURY
I hereby apply for a permit as the agent of the owner.
Date Contractor Name Registration No.
S 66 i; OR
D e Owner's Name
q:forms:Affidav
` DffHE rp Department of Health Safety and Environmental Services
1 + Building Division
CAB . ' 367 Main Street,Hyannis MA 02601
MASS.
9 1639n.
�ATED tr1A'i� ,
Office: 508-862-4038 Ralph Crossen
Fax: 508-790-6230 Building Commissioner
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: —
JOB LOCATION:
nu er street village
"HOMEOWNER": 8 A zo~ =L
name I hoke phone# work phone#
CURRENT MAILING ADDRESS:
city/town state ZIP code
l
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 procedures and requirements and that he/she will comply with said
procedures and re ements.
Si slur of H 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
p
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 to amend and adopt such a form/certification for use in your community.
Q:FORMS:EXEMPTN