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HomeMy WebLinkAbout0217 PHINNEY'S LANE y� d t� � '• �{�i� � , �'' :,� 4a -.': ryrr ,;S.. ak r:�?k:g.�. �„ r... . �e ;.' � :;;" . � .t ,� _.• ;� � '*..: , '?h4, ,}; _�• �U:. ia,.�' (t'.' z - �di.. - ,C^._'', 'i�f b7 a. � �^,y, i�'+n•'. f s..r '�l+ ,C� :Y�', ..� ',.. ".. a :S 6.si3 y., .. - � M rA' ... � t� _ ,,s �. � it ,a i{, u�:� � �•, *r' Y',�� ,iy>� s• :�,,, < i� x�, N� 4y�',; ` _ H ra •a�� a. 'r " a (M1+I w v � � t• . a r ' , .e c t n � r , : p , a • . • x u n u M r c „ , , R ° a n F, , i' i t L3 b-e� I\n .t .::.s ^,.- "' h'$ y. .-4. +y. } .i;;w„r..aY.'.;. •'.ri::•aa,r'a;i,Re'GiJFfY'FM1;bh. tit`�' nr'.',. . ti.-•.e.dv4„2'.a-a,ti t .: r a0.^',; .a.; t>-.n ,., t, Towri of Barnstable ti Regulatory,Services Thomas F Geller; Director. w BARNSTABLE 9 MASS_: Building::Division 9 t63 . �0� `ArEo to `^ Thomas Perry, CBO, B"uildrng Commissioner 2001VIain Street, JHyannis;"MA 02601 : www.town:barnsta:ble..mams Office 508=862-4038 Fax: 508-790-6230 `EXIT'URDER DATE: - Zd � } .LOCATION; ZA " C" UNDER.THE PROVISIONS OF 780.CMR;'THE=STATE BUILD ING'CODE, SECTION,3400.5:.1, YOU ARE HEREBY ORDERED,TO-IMMEDIATELY ; ,DISCONTINUE_THE USE OF THE:CELLARBASEMENT AREA FOR SLEEPING PURPOSES. y LOCAL INSPECTOR SIGNATURE OF,,RECIPIENT : ODEM DE SAIDA_ DATA: � - LOCALIDADE DE ACORDO COM O PROVISORIO 780 CMR;:CODIGO"DE CONSTRUCAO:DO ESTADO,'PARAGRAFO 3460.5.I VOCE ESTA ORDENADO DE'DEIXAR DE USAR, IMEDIATAMENTE,.A AREA DO'TORAO/BASEIVIENT PARA O: PROPOSITO DE DORMIR. INSPETOR LOCAL ASSINATURA DO:RECIPIENTE t &-air i� f C j r �T i. l j� � b ^-� IT� \ J J J ^•, d "� i �� � � 1 � U � �J � rn -S+ �- �� '--� ,\ ,� 'i 1 iil likom i 1 A m� �h�s+a b� G,nn r� 0 -6 �� � � N 3 z; A k - T /"7yy CY O C J\ 1 C C6 i I� v_ 1 I I ' I { 1- C r C.e.n�� � a� " � � �. �1 � f Town of Barnstable Regulatory Services Richard V. Scali Interim Director �' Building Division p ►` Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT;�� S FEE: $ SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less _ yw9°t n•F 5 Gc-74'X-�1 u4/ k Location of shed(address) Village rss Property owners name Telephone number r— 0o, Size of Shed Map/Parcel# Signawje Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is req red) Sign off hours for Conservation 8:00-9:3 &3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY.A PLOT PLAN Q-forms-shedreg REV:110413 plort .R� Z �rsc% 42-.05E Location os Pe � cr p1 ANGLE .J �ti �, IRON FND. Li w .OFF o , ►' (SEE DETAIL 1e� HAY 6L155 0 N t 00O Q °, a� C�x� N E EOSS w c. a� sty SEA 77y ID N R /✓66-- . _ - 43E 17 Lu ANGLE ' IRON FND .OF'F # . T,4J *• (SEE DE - uj z N ro' � N 3 O Q N N co i � ' e u co f_ CV y (V PIK OO ? cv r �, 234.04 y C..B FND. N4 c-/5 ( 1J 52 -09- 36E x - - 40. 15 i _ —� --- - - - - 3 G7 ✓;_:. I 2) i ���. ' 6G.04 FND A 8 77 G.B. . 3 O �SB- 2.8� 384'r R= 04 OFF 74.71 FNU. f- S58 - 56- 38W ROUTE #28 J (1930 CO. L.O.) O _ r #i4-.�^ "- J'y t��- Town of Barnstable *Permit# Expires 6 months from issue e Regulatory Services ...BARMAS 1 tom, Richard V.Scali,Director i6 3P 1 , �' Building Division SEP 0 8 2015 Tom Perry,CBO,Building Commissioner To fl,p� 200 Main Street,Hyannis,MA 02601 V vt OF BA , www.town.bamstable.ma.us ABLE Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address ZQ TA6AL&kr!1,S (ter A- _ t4l 4 e7&2— [�&esidential Value of Work$ 7s22P_4=z>' Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ® Contractor's Name ��/ Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑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 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) XRe-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ 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 r uir SIGNATURE: C:\Users\Decol �\AppData\Local ierosoft\Windows\Temporary Intemet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 } Town.of Barnstable r Regulatory Services �oFnu Toiry,` Richard V.Scali,Director j Building Division sAaxsles Tom Perry;Building Commissioner MASS 1639• `0� 200 Main Street, Hyannis,MA 02601 lEn www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print .DATE: JOB LOCATION: Pe`t7f�N U [ C% � l 1 number street 1 village "HOMEOWNER": 30 name - ,home phone#. twork phone# . CURRENT MAILING ADDRESS: 7d 0)—J7,titJ�S L41+t1� OXMXi jf kLLC. A4l a 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 proce ores re ' e is and that he/she will comply with said procedures and requirements. Signatur 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc - Revised 040215 v T u Pl • =ARNSTABM • Town of Barnstable �ArFD MA't A Regulatory Services Richard V.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: 5.08-790-6230 Property Owner Must Complete and Sign This Section. If Using A Builder I, , as Owner of subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building ermit application for: (Address of Job Signature of Owner Date Print Name If Property Owner is appl g for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit forms=RESS.doc Revised 04M15 T7ie Commoniveafth of 1Vassachusetts , D,eparturerxt of Indu b alAcciderds - Of ke of Invmfigadens 600 Washhigion Street y Baston,MA 02111 wivat.ariasgVvfdia '"Tnrkers' Cctmpensat it Insurance Affidavit:B_mlders/Cantractars/EIectr cians/Phu nbe'rs Applicant Infarmation Please Print LezibIy Name(Business�OrganizatiaafIudieidnal}: ��b(:�� �i�(�t��, 1 �'I/�/�1tT''j' C iyfStatel ip: tt tti� Phone iu 4;��25 `Z 7(e At e}YOU an employer?Check the appropriate box:l9ZCo 2i — Type of project(required): 1.❑ I am a employer with 4, ❑I am a general contractor and I * have hired the sub-contractors 6. ❑New const nuction , employees(RM andfor part-time)_ „ 2.❑ I am a sole proprietor or partner- , listed on the attached sheet:. 7. ❑Remodeling ship and have no employees. These sub-contrac#ors have g. ❑Demolition Working for me in any capacity. employees andbave workers' " g. ❑Building addition [No ryorloecs'camp.insumnce camp-insurance-1 reT3ired] 5. ❑ We area"corporation and its 111_❑Electrical repairs or additions w 3: " 'f am.a homeoumer doing all urork officers have exercised their 11-❑Plumbing repairs or'additions t of exemption per MGL - myst=l€[No ur�orkers'comp- � p 12.[:j Roof repairs insurance required]F c.152!, §1(4h andwe have no employees-[No wod=s' 13.❑Other comp-insurance required:] ;Any ap&zntdwtcbecks box#lmast also Moutthe section below shavength&widea'compensationpolieyinfaamstim Homeowners who submit ibis affida%rit hmBc dnZ they are doing all wal=4 then brae outside contractors mast submit anew affidavit mdieaaiag satch, fCantractors that check this boa must attached sax additional skeet showtag the name"of the sub-cantractias and stale whether air not tbase eaddes bave employees.Iftbesubtoat®ctorsbave employees,theynmstpmvide dmir workers'camp.policy number. I acn art ecreplt rr that isprmdtiing x�urkers'cantperesrrtaara itcszaraccce for arcs*enrpla}�ees Below is trite policy acid job site infornzadom .f Insurance Company Nance: Policy#or Self-ins.Uc-4. Expiisation Date: _ Job Site Address: CityfStateJ.tp: ; Attach a copy of the workers'compensationpolicg declaration page(showing the policy number and respiration date). Failure to secuciv coverage as required.under Section 25A o€MGL c_152 can lead to the imposition of criminal penalties of a fine up to$UMOD and'or one-Leas imprisonment,as well as ciO penalties"in the fom of a STOP WORK ORDERand a fine, of up to$250_00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verifitatiom I Ufa Jcereby cccrtF sander is at dpenahies ofgerjury that the uafarma€h pt m ided abm a m'trus and correct CSi E" "—Date: _ Official use only. Dv n of write in this area,to be compl<etced by city or town offidaL City or T'awn: PertnitUcense if Issuing.A-utlt or ty(circle one): , L Board of$ealth y.Building Department 3.QtyJTown Clerk d:Electrical Inspector S..Plumbing Inspector" 6.Other , Contact Person: y Phone#e Information and Instructions Massachushts General Laws chapter 152 rfflm=all employers to provide workers' ompensation for their employees. P this sf:a ftrfe,an_amplayee is defined as."_.everypersonin fhe service of other under any contact ofbire, express or mnpliec�oral or women." An allpk5 is defined as"an individual,parfnershrp,association,c caporafion r other legal entity,or any two or more of the for nz a oint e,and includ ng the legal repres es of a deceased employer,or the ��engaged 3 receiver or ti aA=of an individual,partnership,association or other Iegal ty,employing employees- However the owner of a II g house having not more than three apadments and who des therein,or the occapant of the - dwelliag horse f anomer who employs persons to do maintenance,co -on or repair work on such dwelling house or on the groan or budding appurtenant thereto shall not because of h employmentbe deemed to be an employer." MGL chapter 152,§ G(�also sues that"every state or local lice agency shall withhold the issuance or renewal of a license o ermit to operate a business or to co buildings in the commonwealth for any a licant who has not oduced acce table evidence of compli ce with th-e insnran ce.coverage required." PP p Additionally,MGL chap, 152, §25C(7)states"Neither the aowmn nor any of ifs political subdivisions shall enter into any contract for performance ofpablic work unt table evidence of compli.ancewith the inc�ttanC@: requirements of this chapter ` ve been presented to the aothoity--" Applicants 'a Please f l out the workers'comp on affidavit comp,l Iy,by checI�g&e boxes that apply to your situation and,if ec nessary,supply snb�ontractor(s) e(s), address(es) d phone number(s)along with their cmtificate(s) of hasura„ce. LmmitEd Liability Comp ' (LLC) or L" ' Liability-Partnerships(LLP)with no employees other than the members or partners,are not r carry workers' ensation insurance. If an LLC or LLP does have employees, a policy is required Bead ed that this dayit maybe anhmrHPri to the Department of Industrial Accidents mr confirmation of insurance erage o be sure to sign and date-he affidavit The affidavit should ` be retummed to the city or town that the app on fb the permit or license is being requested,not the Department of Liductrial A ccidenis. Should you have any regarding the law or ifyou are rup±-ed to obtain a workers' compensation policy,please call the Departm at e number listed below. Self-insured companies should enter their self-insur ce license number on the app e. City or Town Officials . Please be sore that the affidavit is complete an p legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event e Offi f Investigations has to contact you regarding the applicant. Please be sure to fill in the pennWliceme n ber whi be used as a reference number. In addition,an applicant that must submit multiple permit/Iicense ap "rations in en year,need only submit one affidavit indiratmg current policy information Cif necessary)and under `Job Sit-Add -the applicant should,,-en "all locations is (city or town)_"A copy of the-affidavit that has b officially stamp or maimed by the city or town maybe provided to the applicant as proof that a valid affidavit is a file for future p or licenses- A new affidavit must be filled oit each year.Where a home owner or citizen is o fairing a license or p not related to any business or commercial venture (i-e. a dog license or permit to bum Ieav etc.)said person is NO _ to complete this affidavit: The Of of Investigations would like thank you in advance for yo cooperation and should you have any questions, please do not hesitate to give us a call. The Departments address,telephone d fax number: . The CaMMnWeabh of Marssach- Dtpaitment ' cif hid�ial �o' en Office of TiVegU&tzo= Goa,washivou S Baste MA G2111 TT1.: 617'27-4900 cxt 4-06 or i-9 7-MAS F Fax#617 727-7749 Revised 4-24--07 m e gckg1dia r' e TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 1 Parcel J�\ plicatil P A C-- Health Division Date Issued t Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board p i 1►�1? Historic - OKH Preservation / Hyannis Project Street Address 'i I+i6CAf ell Village, C..��fTwo�i:� Owner Address Z41 Telephone (See) -7-hp -3-70Z- PermitRequest _D4C;e1_ 5-6 r�riJ �c�-r���ft-�tr-z•�rT- -- Z �••l �rvq�e. `31��-wt l e �i th'1'tf n l t�f iL �� J�(�Zy -- PS T rya b ra l rti11. LF� r-yQ A-1_ &A&JInA aAm Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 00 Project Valuation Z6 -®Construction Type 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 mac. Total Room Count (not including baths): existing new First Fl0000m Co[�ht Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other z, -e CD �Z) + Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wooyd/coal stone: (TYes ❑ No Detached garage: ❑ existing' ❑ new size—Pool: ❑ existing ❑ new size _ Barn: existingy❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: 0� Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use AP--PLICANT INFORMATION (BUILDER OR HOMEOWNER) -- - - Name J014AL_Wc-r—tey�*_S5 Telephone Number `7-7(0 ` 37o 2- Address 'Z41 f'iAf C-'`l 5 (_ ir License # M& . o ZGo 3 Z Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AA,,t->T2Z- SIIGNATUk!!!� DATE It)12 4- i 3 FOR OFFICIAL USE ONLY IN APPLICATION# til DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER f DATE OF INSPECTION: A.?FOUNDATION 2 5a►ae) K12-3IIK FRAME t INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING 277 bYhA!� DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massac kusaKs Department of IndustYid Accide;r& Office of Investigations ' .600 Washington&reef Boston,MA 02HI wnnt:mass.gV dia Worlce& CmWensatianIumwance Allidavit BaderdContractoraTUectricianMumbers Amp&cant Informafian Please Print Izzibly Name musinessroiganb$ti si)_ 3 07P.A y c le-f1fL SIS City/statrdzip: / .' A l d 01.E #-- "7-7 Co "37©Z- Are you an employer? Check the appropriate box: I am$general contractor and I Type of project(required): 4 1.❑ I am a employer with ❑ S 6. ❑New construction employees(full andlorpxt-dme)_* have hired the sub-contractom 2.❑ I am a sole proprietor orpariuer listed on the attached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have g- ❑Demolition for mein employees and have wogs' '°�'�� �y��`- _ � 9_ ❑Building addition [No tvodmrs'comp.roam m e Comp-msuraDe d.] 5. ❑ We ate a corporation and its 14❑Electrical repass or additions 3_ �amhomeowner doing all work officers have exercised their 1I-E]Plumbing repairs or additions myself [No workers'ccmp- right of ememption per MGL ME]Rnaf repairs insurance required.]I c.152,§1(4),and we ham no employees [Nowod=' 13_❑Other comp.msoraaoe required.], *Any appl c�R flat chedmboa W'l mast also fill out the secfioa6rIomsLnwiaS the¢wacke�s'compensatiampolicp infbnwti� I Hameoames wbo sabmit this affidavit iaefiesting they axe doing vEwo km d then bae outside cantrmtorsmast submit anew afidzAt indicatm9 sa& ZCoatr1 ra, A t check this b=mmst attached m additinual sleet rhea the nee of the sah camdzactocs met elate trhetber mrnat those entities have employees. If the sub-a mtactorsUm employee-%they nnutpmvide didr workers'comp.policya>mber. lain art ezzrptoyer tliatisprovW&g nvrkers'compe.n rtwn izzsziraace far my ontpIDyem Beiorr is 8repu&7 turd jvh sits hirorstadoiL Insurance Company Name: Policy 4 or Self-ins.Lie.# Fxpiratian Date: Job Site Address: city/State/zip: Affach 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 31,500.00 andlor one-year imprisonment,as well as civil penalties in the form of a STOP WORg ORDER and a fine of up to WO-00 a day against the violator_ Be advised that a copy of this statement maybe knvarded to the Office of Investigations of the DIA for inmzrance coverage verification. I do dzereby ce!r ' a a "ns rtpezzaiYies ofpetjnty diet the irorzrirdrmzpratgderFabtsys is bus azzzP currant Date: Phone t€ 06 7 7 C� 0,�}iciat um an£.g Do not wrhr in this area,to be wmpteted by city orh7m vffw t City or Town: PermitMicense# Issuing Authority(circle one): 1..Board of Heaith 2.Bu ding Department 3.QWrown Clerk 4.Electrical Inspector S.Finmbing Inspector 6.Other Contact I''ersan.: Phone 9: 6 Town of Barnstable Regulatory Services "" M ' Thomas F.Geiler,Director 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 DATE: 1 V l 741( Please Print JOB LOCATION: _N7ALA L"1 S L-* ie number street village "HO1vMWNER7: J0404 ��Gi �35 (Sop,) 7W, —37e7- name home phone# work phone# CURRENT MAILING ADDRESS: 74-7 la f 2 IJ .V YS LAAkrE city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellines 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- f unily 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) i The undersigned"homeowner"assumes responsibility for compliance with the State B_wilding 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 dures dzeqpirements and that he/she will comply with said procedures and requirements. Sign 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 persons)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\decollilc\AppData\Local\Microsoft\windows\Tempomry Internet Files\ContenLOutlook\QRB6ZUBNOTRESS.doe Revised 053012 t �IME Town of Barnstable * Regulatory Services s"� Thomas F.Geiler,Director 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 Property Owner Must Complete and Sign This Section If Using A Builder I, , as Ownet of the ject property hereby authorizes to act on my behalf, in 0 matters relari a to work authorized by this b ' g permit (Addres of Job) **Pool fences and ala s e the responsibility of the applicant. Pools are not to be filled o utilized b ore fence is installed and all final inspections are pe owned and acc ted. Signature of er Signature o pplicant Print Name Print Name Date QTORMS:OWNERPERMESIONPOOLS 62012 74-7 2q1,3 GCf 25 A 19: 06 .�`rr -✓�tee:- r�t�9 �z.�3� k S p i c Cf ,u 'THE Town of Barnstable *Permit# Regulatory Services Expires 6monrhsfromusu�e * anxxsTaaM 9cb MASS.16 9. � Richard V.Scali,Interim Director QED MA't A Building Division 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 O`'<SOT Not Valid without Red X-Press Imprint (,� 1 Property Address 1�tf-/A;t. -5 & Pesidential Value of Work Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �� rs 241 lMA Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: 90zr t4crers5eq Gom z-45T-- Je- - Construction Supervisor's License#(if applicable) P ❑Workman's Compensation Insurance X'P PERMIT Check one: ❑ I am a sole proprietor O C T 2 4 2013 am the Homeowner I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE 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 ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ 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 required. SIGNATURE: Q:\WPFILES\F S\buildi g permit forms\EXPRESS.doe Revised 061313 TIze Commartrsteakh ofMassachusefts Depizrftnen#o,f bulmstnal Accidents Office of invest gallon s 600 Washington&reet f Boston,ALI 02111 YVnig rnass govIdia Workers' Compensation Insurance 41 idavit:Builders/Can#ractors/F-Jectricians(Plumhers Applicant Information Please Print Legibly Name qh inesslthganizationandhidnat7_ N-Is �1�e�1ry�S Address: -Z(:7 City/Stat&Zip_ �L i7>Y l! MO- ouD?'one 4- 5-06 77Co Are you an employer:'Check the appropriate box: Tape of project(required): 1..❑ I am a employer with 4. ❑ I am a general contractor and I 6_ New won employees(full and/or part-time)* have hire the sub-contractors. ❑ ❑ I am a sole proprietor or partner- listed on the attached sheet +7- ❑Remodeling ship and have no employees Thy sub-contractors have g- ❑Demolition w for me in an capacity. employees and have workers' working y [No,workers' comp.insurance comp.insurance_I 4_ ❑Building addition rrc �' 5. ❑ We are a corporation and its 10..❑Electrical repairs or additions -] 3. am m a a homeauvner doing all work officers hire exercised their 11..❑Plumbing repairs or additions myself [No workers'comp- right:of exemption per MGL 12_❑!,Zmofrepairs insurance rid_]b c-152, §1(4),and we have no employees-[No workers' 131-1 Other comp-tnsorance-required.]; *Any appBcmt that checks boa#1 must also fill out the:section below slowing rhea woxkers'compensadion policy inf nmatioa_ T Homeowners who submit this.affidavit indic g dLey are doing all waur and then hire outside contractors nm submit a new of davit mrlirstiog suclf !Coutracinrs that check this boa must attached an additional sheet showing the name of dLe sob-coatractais and state whether ornat those entities bane employees. If the snlrcontractors have employees,they must provide their workers'comp.policy number. I am an Rmployer iltat is prmidutg it�orkers'coml7,ensation invirance for my*employees. Belotr is the policy and,job site in,formaiiO . Insurance Company flame: Policy 9 or-Self-ins-Lit-4: 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 n 152 can lead to the imposition of"criminal penalties of a .fine up to 31,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STRIP WORK ORDER and a fine. of up to$250.00 a day against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Imrestigations of the DIA fDr insurance coverage verification_ I do hereby c rti y render:the pains andpenaltiss nfpetjuty that the information prinided above is bw and correct Si Bate: D 1 7 7v Z- 0,,�ci.aI use only. Do not write in this area,to be completed by city or town official City or Town: PermitUcense# Issuing Authwity(circle one): 1.Boatel of Health. 2.Budding Department 3.City(Town Clerk 4.Electrical Inspector 5.Plumbing.Inspector 6.Other Contact Person: Phone#: 6 a Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'corn ensation for their employees. Pursuantt�this statute,an employee is defined as"...every person in the service of aaoth r under any contract of hire, express or'implied, oral or written." i An employer' defined as"an individual,partnership,association,corporation or oth legal entity, or any two or more of the foregoing gaged in a joint enterprise,and including the legal representative of a deceased employcr,-or the receiver or trustee f an individual,partnership,association or other legal entity,e loying employees. However the owner of a dwelling ouse having not more than three apartments and who resides erein,or the occupant of the - dwelling house of ano er who employs persons to do maintenance,construction repair work on such dwelling house or on the grounds orb g appurtenant thereto shall not because of such empl ent be deemed to be an.employer." MGL chapter 152, §25C(6) stales that"every state or IocaI licensing age y shall withhold the issuance or renewal of a license or permit operate a business or to construct build' s in the commonwealth for Pay applicant who has not produced a eptable evidence of compliance with e insurance.coverage requ.ired." Additionally,MGL chapter 152, §25C states"Neither the commonwealth or any of its political aibdivisions shall enter into any contract for the performan of public work until acceptable vidence of compliance with the insurance requirements of this chapter have been prese ted to the contracting autho Applicants Please fill out the workers' compensation affidavit mpletely,by the g the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address( and phone n ber(s)along with their certtificate(s) of insurance. Limited Liability Companies(LLC)or Limi Liability artnerships(LLP)with no employees other than the members or partners,are not required to carry workers' co pensati n insurance. If an LLC or LLl'does have employees, a policy is required. Be advised that this aflida may e submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be s e o sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit r license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding aw or if you are required to obtain a workers' compensation policy,please call the Department at the number ist 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 pr/ni ly. The Dep ent has provided a space at the bottom of the affidavit for you to fill out in the event the Investigations has o contact you regarding the applicant- Please be sure to fill in the permit/license number be used as a refer cc number. In addition,an applicant that must submit multiple permit/lieease applicati given year,need onl submit one affidavit indicating current policy information(ifnecessary)and under"Job Sess"the applicantshoul write"all locations in (city or town)."A copy ofthe affidavit that has been officped or marked by the ci or town may be provided to the applicant as proof that a valid affidavit is on file fopermits or licenses. Anew ffidavitmust be idled out each year.Where a home owner or citizen is obtaining or permit not related to any usinessor commercial venture (i.e. a dog license or permit to bum leaves etc.)sai is NOT required to complete affidavit. The Office of Investigations would like to thank ou in advance for your cooperation and ould you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax n r The Commonwealth of Ma-ssachuso Departnent of Industrial Accidents Office of hLyestigations 600 wash gtan Street Boston,IAA 02111 Tel A 617-727-4900 at 406 or 1-977-MASSAFE Fax# 617-727-7749 Revised 4-24-07 w .mass,gnvIdia . • L p �SME� Town of Barnstable ~° Regulatory Services 4 •F 9 MASS.` Thomas F.Geiler,Director 16;;,. &61 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 f' -- Please Print DATE: J!� f � � ��- JOB LOCATION: 7i17 ( /jeR�t'�, ��fit l�3 �✓1��' number street village "HOMEOWNER": O 774G 70 Zr name home phone# work phone# CURRENT MAILING ADDRESS: 7,47 --Ctsrhz�2 t/]]rtit' ✓H 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. DEFINTITON 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 dare qu' ements and that he/she will comply with said.procedures and requirements. Signa re 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 persou(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\d=Hik\AppData\Loca]\Microsoft\Windows\Temporary Intemet Files\ContentOutiook\QRE6ZUBNIEXPRESS.doc Revised 053012 FVE r Town of Barnstable ti °k Regulatory Services IIAMSTAMIE� Thomas F. Geiler,Director 1639..�A Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-40 Fax: 508-790-6230 Property Owner Must Complete and Sign This S tion If Using A Builder I, Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work au orized by th/biding permit (Addres of J b) **Pool fences and alarms are a res onsibility of the applicant. Pools are not to be filled or utilized efore fen e is installed and all final inspections are performed a d accepted. Signature of Owner Signature of A licant Print Name Print Name Date " QTORM&OWNERPERMISSIONPOOM 62012 NOT FOR PUBLIC VIEW r Page l of 3 Anderson, Robin From: MacNeely, Martin [mmacneely@commfiredistrict.com] Sent: Friday, April 21, 2017 8:09 AM To: Anderson, Robin; Mckechnie, Robert Subject: Fwd: Phinneys Lane a Sent from my iPhone Begin forwarded message: From: "Burchell, Thomas" <tburchell(u�commtiredistrict.com> Date: April 21, 2017 at 6:07:09 AM EDT = To: "MacNeely, Martin" <mmacneely cni commtiredistrict com> Subject: FW: Phinneys Lane Hello Inspector MacNeely, Attached are the photograph's and narrative from Run Al7-1192, 217 Phinney's Ln., Centerville Ma., which we spoke about several times yesterday. If any further information. or explanation is required please contact me. Capt. Burchell { Responded.in 321 from Sta#1- with traffic at the request of.325 for basement bedrooms' with a single means of egress. 325 was on scene at the request of the BPD to transport a pt. to CCH, however the request was cancelled after pt. refused transport and was taken into custody. Upon arrival at the single story, single family, two bedroom home I met with Lt. Sassone who led me to the basement where three bedrooms and a living room had been built. No bulked, exterior access or secondary interior means of egress was available. All three bedrooms had windows, however two of the three bedroom windows were blocked ' with plywood that was secured with screws and adhesive. All three windows were too small to be.considered means of egress.. Inspector MacNeely was notified via cell phone, however he was attending a meeting at town hall and unable to respond. I took several pictures while inside the home (see attached photo's) and spoke`with the homeowner-John Rockners, DOB 5/03/67, Cell Phone # 508-, 776-3702. Mr. Rockner was advised that the basement bedrooms were a life hazard and did not conform to the building code. Further, Mr. Rockner was informed that Fire Inspector h MacNeely and the TOB Code Enforcement Team would be following up later in the day. Mr. Rockner was cooperative and stated the need to address family issues were his priority at the current time. 325 and 321 cleared the scene. Information was verbally passed to Inspector MacNeely, who stated he planned to`visit the home later in the day. Photo's and statement forwarded to Inspector MacNeely. tjb 04/21/2017 05:46:24 tburchell 4/21/2017 XN 6 '1 0 O 0 o o \ O O c 0 0 o `Z`• � o � Q GQy 3 QLoQ•�JG �p�\��1 ��\ \��O�O � . P C4, GO'y1• G .`O �J�'<\O� OQF1 0 �O41 �• RF}-'o P�o,,,y 6 Q - - 41 00 / . + 0 1 8S + +j� �.�pSSACH�/S�i ti O i O 5 z ilk _ MpSSACHUSF �a. 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