HomeMy WebLinkAbout0071 POND VIEW DRIVE IrLA"
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Ma ` Parcel ��� QC 0 l '
p Application # � � 0 � S
Health Division Date Issued 1191-7,111
Conservation Division Application Fee
Planning Dept. Permit Fee
v
Date Definitive Plan Approved by Planning Board
Historic - OKH _ Preservation / Hyannis
Project Street Address 4 ve u ►��
Village
1( c Owner ( Ll C �J�°C U et(6 Address
Telephone
Permit Request r) 0O o
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation I Construction Type [11� .J
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family ] Two Family ❑ Multi-Famil (# units)
Age of Existing Structure ( � 7 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 Floors om Cou;WW'
Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other C
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wo /coal stLae: 2.Yes 0 No
Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: existin ❑ size
1 _
�.
Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Othe
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes ?(No . If yes, site plan review#
Current Use � �� � � Proposed Use
APPLICANT INFORMATION
-- -- (BUILDER OR HOMEOWNER)-
Name 67taxacA aoq Telephone Number
p
Address &l 5C� `-e� C(O C License # (T� / z//
T � 3 .
Home Improvement Contractor#
Worker's Compensation # f
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
C
SIGNATURE DATE
•1
FOR OFFICIAL USE ONLY
APPLICATION#_
DATE ISSUED - -
MAP PPARCEL NO.
tom• +M� p _ f
ADDRESS !�' VILLAGE
OWNER c. _
DATE OF INSPECTION: -
>FFQ.UNNDATIQN4_(3)s 5 t =lo 9
FRAME �.� . . .. _
INSULATION
FIREPLACE -
ELECTRICAL: ROUGH FINAL .
PLUMBING: ROUGH FINAL
GAS: ROUGH FINAL '
FINAL BUILDING g 1glls
DATE CLOSED OUT
ASSOCIATION PLAN NO.
o�TM�Ta,�,ti Town 'of Barnstable
°* Regulatory Services
> IE8 Richard V.Scali,Director
16;9. �0
'°riroMa'�16 Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.maxs
Office: 508-862-403 8 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, 0 & ,as Owner of the subject property
hereby-authorize (& v'J (2e& y, ry to act on my behalf,
in all matters relative to work authorized by this building permit application for.
CLVIJ ki-c e car:
(Address of Job)
Pool fences and alarms are the responsibility of the applicant. Pools '
are not to be filled or utilized before fence is installed'and all final
inspections are performed and accepted.
I na e o r i lit
g nature o g, p
ant
Print Name _ Print Name
We
Q:FORM&O WNERPERMISSIONPOOLS
Town of Barnstable
Regulatory Services
�oF Toiy Richard V.Scali,Director
yo Building Division
4 rt
* YeRNsrasM Tom Perry, g
Buildin Commissioner
%639- 200 Main Street, Hyannis,MA 02601
pTFOy� 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 MAMING ADDRESS:
ciWtown ..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 OFHOMEOWNER
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'"holneownee'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 Barmtable Build ng 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. = t
- ' 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 10911-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,RuIes&Regulations for Licensing Construction Supervisors,Section 2.15) This Iack 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 Iast 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:\WPFII.ES\FORMS\building permit fonns\EXPRESS.doc .
Revised 061313 ;
Bk 276-58 P's 239 , 450547
08--30--2013 a 12 Z 39P
QUITCLAIM DEED
I, HOPE C. WATKINS, an unmarried woman, 3212 Blossom Lane, Odessa, Texas,
79762,
in consideration of TWO HUNDRED SEVENTY-NINE THOUSAND DOLLARS
($279,000.00) paid,
grant to BARBARA.L. WALSH and WILLIAM B. WALSH, husband and wife as tenants.
by the entirety, Two Grandview Street, Natick, Massachusetts 01760,
the land situate in Barnstable (Centerville), Barnstable County, Massachusetts, more
x { particularly described as follows:
_
w Being Lot;4-�as shown and delineated on a plan entitled, "Subdivision of Land in
Centerville, Massachusetts as laid out for George A. Stackhouse, February 26, 1947,
Bearse & Kellogg,' Civil Engineers, Centerville".which said plan is duly filed in the
Registry of Deeds for Barnstable County, and said lot is more particularly bounded and
A described according to said plan as follows:
3
w •
H
c -Beginning at„the northeasterly corner of Lot 3, on the westerly sideline of Pond
w ` View Drive, so-called, which point represents the south-easterly corner of Lot 4
to be conveyed, all as shown on said plan;
n
Thence North 860 00' 20" west by the northerly. boundary line of Lot 3 one
hundred twenty-nine and 90/100 (129.90) feet to land now or formerly of H. L.
Norris, all as shown on said plan;
t f' Thence turning and running north 40 46' 20" east by land now or formerly of said
w Norris one hundred eighty-five (185) feet to a point for a corner, as shown on
o said plan. Thence turning and running south 850 51' 40" east one hundred
a twenty-three and 83/100 (123.83) feet and south 450 26' 25" east eighty-two and•
73/100 (82.73)feet, all by land of Stackhouse et ux and not numbered, all as
shown on said plan to the northwesterly sideline of said Pond View Drive;
Thence turning and running in a.southwesterly direction.along Pond View Drive
by an arc having a radius of three hundred nine and 61/100 (309.61) feet for a
distance of one hundred forty-five (145)feet to the first mentioned bound and the
point of beginning; containing an area of 25,730 square feet of land, be the same
more or less.
Grantor hereby certifies under the pains and penalties of perjury that the premises
herein conveyed •are not homestead property. This Deed releases any and all
homestead rights created either automatically by operation of law ,or by a written
declaration that is recorded.
Atl
Bk 27658 Pg240 #50547
Said premises are conveyed subject to and with the benefit of any and all rights,
easements, reservations, restrictions or other conditions of record insofar as the same
may be in force and applicable.
For title, see deed dated September 17, 2009, and recorded at Barnstable County
Registry of Deeds in Book 24043, Page 277: ,
Property address: 71 Pond View Drive, Centerville, Massachusetts 02632
Witness my hand and seal this 231d day of August 2013..
H pe . Watkins
k
r Commonwealth of Massachusetts ,-
Barnstable, ss.
On this 231d day of August 2013, the above-named Hope C. Watkins personally
appeared before me, proved to me through evidence of identification was her-driver's
license to be the person whose name appears on the foregoing instrument and
acknowledged to me that he signed it voluntarily for its stated purpose.
"ASSACHUSETTS STATE EXCISE TAX
BARNSTABLE COUNTY REGISTRY OF DEEDS 4 -2e
Date: 08-30-2013 a 12:39am Carrie kins, Nota Public
Ctlr: 686 Dod: 50547 rY
Fee: $954.18 Cons: $2797000.00 ' commission expires April 2, 2015
No"Pdit
BARNSTABLE COUNTY EXCISE TAXI
BARNSTABLE COUNTY REGISTRY OF,DEEDS 2•�
Date: 08-30-2013 a 12::39am
CtIA: 686 Doi_': 50547
Fee: $753.30 Cons: $27MOM10
BARNSTABLE REGISTRY OF DEEDS
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
- �II 61 S S -
Map Parcel ?ppoh
Health Division . Date Issued
Conservation Division Application Fee . "D
Planning Dept. Permit Fee �UIIG
Date Definitive Plan Approved by Planning Board 031
Historic - OKH _ Preservation / Hyannis n�
Project Street Address
Village
Owner cZ (4ig Address maf4el
Telephone
Permit Reg
- c- IeLrwo tlj
Square feet:1 st floor: existing�z proposed 2nd floor: existing pr posed L Tot1Fh ew4.
C�
Zoning District Flood Plain Groundwater Over � /U
Project Valuation 0C'G Construction Type Al Div
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Z� Two Family ❑ Multi-Family (# units)
Age of Existing Structure yeb Historic House: ❑Yes d No On Old King's Highway: ❑Yes
Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other T 1 =
Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft)
Number of Baths: Full: existing new 0 Half: existing new
Number of Bedrooms: _ existing whew
Total Room Count (not including baths). existing new First FloorfRoom Co ;
Heat Type and Fuel: 216as ❑ Oil ❑ Electric ❑Other
Central Air: 9'�es ❑ No Fireplaces: Existing New _ Existing wood%co stove: as ❑ No
Detachgarage: ❑ existing ❑ new sized ob C] existing ❑ new size �arh 0 fisting neWT size_
Attac,Jbedgarage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
Commercial ❑Yes Z No If yes, site plan review #
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER) �.
Namej a Telephone Number ,
Address � / License # f
v
Home Improvement Contractor# f
Email T ' /ki - Worker's Compensation # �,Sfw N y
ALL CONSTRUCTION DEBRIS SULTING FROM THIS PROJECT WILL BETAKEN TO �✓h. ,� ,,�
s P6s C/
SIGNATURE /60xv� DATE IJ /V .
FOR OFFICIAL USE ONLY
r
APPLICATION# -
DATE ISSUED
MAP/PARCEL NO.
ADDRESS VILLAGE
-OWNER
r
DATE OF INSPECTION:
FOUNDATION
FRAME
v
INSULATION
FIREPLACE
ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
PAS: ROUGH FINAL '
Ic
FINAL BUILDING
D'AM?CLOSED OUT
AS6CIATION PLAN NO.
'G
s ,
t'
I g '
Town of Barnstable
RegIdatory Services
s -:Richard V.ScaIi,Interim Director
16 Building Division
Tom Perry,13WIdmg Commissioner
200 Main Street;Hyauais,MA 02601
www.town.barnstable.ma.us H
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete.and Sign This Section
If Using A Builder
as Owner of the subject property
heteby,authorize Q a CQ to act on my behalf
in all mattets relative to wotk autho=ed by this building permit
JI"tin Vifol U- 'C CNA:M 0& VA A
(Address of Job)
Pool fences and alarms ate the responsibility of the applicant. Pools
are not to be filled or.utilized before fence is installed and all final
inspections are performed and accepted.
Sb aline 6Y er Signatute of Applicant
Print Name Print 4aine
Date
Town of Barnstable - -.
Regulatory Services
Richard V.Scab,Interim Director
Building.Division
* MUMMAE M t Tom Perry,Building Commissioner
9 11 ��� 200 Main Street, Hyannis,MA 02601
ED µpi F www.town.barnstable. a.us
Office: 508-862-4038 Fax: 508-790•-62-40
HOMEOWNERLICENSE MPTTON
Please Print
DATE.
JOB LOCATIQN -
number street YMage
"HOMEOWNER":
name home phone# work phone#
CURRENT MAILING ADD S:
city/town state zip code
The current exemption for"home ers"was extended t include owner-occupied dwellings of six units or less and to allow
homeowners to engage an individu r hire who does t possess a license,provided that the owner acts as supervisor.
DE ON OF HOMEOWNER
Person(s)who owns a parcel of land on w heshe elides or intends to reside,on which there is, or is intended to be,a one or two-
family dwelling,attached or detached structure acc ssory to such use and/or farm structures. A person who constructs more than one
home in a two-year period shall not be considere homeowner. -Such"homeowner"shall submit to the Building Official on a form
acceptable to the Building Official,that he/she s e responsible for all such work performed under the building ermit. (Section
109.1.1)
The undersigned"homeowner"assumes r onsibility for c plane with the State Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeowner"c es that he/she understands the own ofBamstable Building Department minimum inspection
proc6dures and requirements and at he/she will comply with said p cedures and requirements.
Signature of Homeowner
Appioval of Building OfEcial
Note: Three-family dwellings containing 35,000 cubic feet or larger will a required to comply with the State Building Code
Section 127.0 Construction Control
HOMEOWNER'S EIE TON ,
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 1091.1-Licensing of construction Supe ors); 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 A eudix Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness.often
( PP � �a
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/ceri fication for use in
your commuinity.
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�Boise Cascade Triple 1-3/4" x 9-1/2" VERSA-LAM® 2.0 3100 SP Floor Beam\F1301
�r Dry 1 1 span cantilevers 1 0/12 slope Wednesday, March 12, 2014
` BC CALCO Design Report- US
Build M27 File Name: R Byam_Walsh
Job Name: Walsh Description: Designs\FB01
Address: 71 Pond View Specifier' J Madera
City, State, Zip: Centerville, MA Designer:
Customer: R Byam Company: Shepley Wood Products
Code reports: ESR-1040 Misc:
y F
1 o-00-00
BO B1
Total Horizontal Product Length=10-00-00
Reaction Summary(Down/Uplift) (lbs)
Bearing Live. ,Dead, .. Snow Wind Roof Live. .
BO,,3=1%2" 1,000/0' 1,322/0 1,500/0
B1, 3-1/2" 1,000/0 1,322/0 1,500/0
Live Dead Snow Wind Roof Live Trib.
Load Summary,
Tag Description Load.Type,,. ..Ref. Start End 100% ; 90% 116% 160%_125%
1 Standard Load Unf. Area(lb/ft^2) L 00-00-00 10-00-00 20 10 10-00-00
2 Unf: Area(lb/ft^2) L 00-00-00 10-00-00 15 30 10-00-00
Disclosure
Controls.Summary". Value °/.Allowable.Duration Case Location Completeness and accuracy of input must
Pos. Moment 7;277 ft=1bs - 30.2% 115% 3 05'-00-00; 'be verified by anyone who would rely on
End Shear .2,504 Ibs 23% 115% 3 01-01-00, .output as evidence of suitability for
Total Load Defl.` U720 (0159.")` ' 33.3%-- n/a 3 05-00-00 'particular application.Output here based
Live Load on building code-accepted design,
Defl. U999 (0.093") n/a n/a 6 05-00-00 properties and analysis methods.
Max Defl. 0.1591, 15.9%_UeT/ n/a 3 05-00-00 Installation of BOISE engineered wood
Span/,Depth, 12.1 -n/a n/a 0.. 00-00-00 Products must be in accordance with
4 current Installation Guide and applicable
%Allow %Allow building codes.To obtain Installation Guide
Bearing Supports Dim:(L x W) Value. Support,. Member M or ask questions,please call
aterial (800)232-0788 before installation.\n\nBC
BO Post 3-1/2"x 5-1/4" 3,197 Ibs n/a 23.2% Unspecified. CALC@,BC FRAMER@,AJSTM,
B1 Post 3-1/2"'x 5-1/4`'. 31197 Ibs n/a 23.2% Unspecified :- ALLJOIST®,BC RIM BOARDTM BCI@,
BOISE GLULAMTM",SIMPLE FRAMING
SYSTEM@,VERSA-LAM@,VERSA-RIM
NOt@S # PLUS@,VERSA-RIM@,
Design meets Code minimum (U240)'T6tal load deflection criteria. VERSA-STRAND@,VERSA-STUD@ are
Design meets Code minimum (U360) Live load deflection criteria. trademarks of Boise Cascade wood
Design meets arbitrary(1") Maximarn total load deflection criteria: Products L.L.C.
Calculations assume Member is Fully Braced.
Design based on Dry Service Condition.
Deflections less than 1/8"were ignored in the results. `.
Fastener Manufacturer: Tru'ssLok(fm)
Page 1 of 2
. r 4. ..
Boise Cascade a Triple 1-3/4'` x 9-1/2" VERSA-LAM® 2.0 3100 SP Floor Beam\FB01
Dry 1 span No cantilevers 1 0/12 slope Wednesday, March 12, 2014
BC CALCO Design Report: US
Build 2627 File Name: R Byam_Walsh
Job Name: Walsh Description: Designs\FB01'
Address: 71 Pond View Specifier: J Madera
City, State, Zip: Ceriterville, MA Designer:
Customer: R Byam Company: Shepley Wood Products
Code reports: ESR-1040 Misc:
Connection-Diagram .
b d —
a
• r• •
c
• • •
e
i
a minimum =2" c= 5-1/2"
i b minimum =4" d=24"
e minimum = 1
All TrussLok screws,may be installed from one side of multiple ply VERSA-LAM beams.
All Trus'sLok screws-maybe installed from one side of multiply Versa-Lam beams.
Member has no side loads.
Connectors are: FMTSL005
F
Y • iy k G x ,fir.� ...
Page 2 of 2
115' \ PV
30" 2' 30, \i
32„ 1 32" C� d� I
32" 25"' 18' 158„
-
iv 04 W3030BUTT
N WR3012BUWF A
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10 40'" . AN{- ,�
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�. Customer Measure
Ceiling Height 90"
Alignment Height 84"
_ t Cabinet Consturction APC, ,
Cabinet.,Door Style Hayward
Cabinet Finish Dove White
Customer Accepts Design
a
Signature
Date
24COM6 .WD, {
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U181284RJ181284L
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10 4 105 4'
—41
t; 120"
� - All dimensions_size designations This is an original design and must Designed: 1/5/2014 -
given are subject to verification on not be released or copied unless Printed: 1/5/2014
job site and adjustment to fit job
1 J j applicable fee has been paid or job ,
conditions. order placed.
.'
10502a55 All' Drawing#: 1 No Scale.
,
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'tMOKE DE' ECTOR .R� lEY�ED . .
k �� ` a�r' rn ',E UILDING . DATE.
DEPT
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FIRE DE ARTMENT DATE. �.
.som SIGRATOE ,ARE REOUIRED Fak PERMITTING :
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Commonwea tli A HIV HI'Mchusetts
22� 192 2 S%�tX%14 Permit
Map Parcel
TOWN (� L ®' Z00
Date: 3)3 21 OF BARNSTABLE Permit# 2
Estimated Job Cost: $ 70��' Permit Fee: $
Plans Submitted: YES NO Plans Reviewed: YES NO
r
Business License# ;00'7 418 109(0 Applicant License# 9132
Business Information: Property Owner/Job Location Information:
Name: ��,��1-►mac. I cA�c (��s_ Name ,B))1 1�►��s�
Street: ?z . Roy, Street: 7J Po.,d y.•¢w '
City/Town: LQ- '9a r M YbAr 01(,73 City/Town: av, {M*-
Telephone: Sod Y31i- �Iy'�q Telephone-,
Photo I.D. required Copy of PhotoI.D.•attached• YE NO �
Staff Initial
J-1 -1-unrestricted license
J-2/M-2-restricted to dwellings 3-stories or less and commercial up to 10,000 sq. ft. /2-stories or less
Residential: 1-2 family `� Multi-family Condo/Townhouses Other
Commercial: Office Retail Industrial Educational
Fire Dept. Approval Institutional_ Other
Square Footage: under 10,000 sq. ft. over 10,000 sq. ft. Number of Stories:
Sheet metal work to be completed: New.Work: Renovation:
HVAC ✓ Metal Watershed Roofing Kitchen Exhaust System
Metal Chimney/Vents Air Balancing
Provide detailed description of work to be done:
53-T 0
NSURANCE COVERAGE:
have a current liability insurance policy or its equivalent which meets the requirements of M.G.L.Ch. 112 Yes M"'No ❑
f you have checked Y=, indicate th type of coverage by checking the appropriate box below:
k liability insurance policy Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER:1 am aware that the licensee does not have the insurance coverage required by Chapter 112 of the
4assachusetts General that m signature on this
e eral Laws, and y g s permit application waives this requirement.
Check One Only
r Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
3y checking this box[],I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and
iccurate to the best of.my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be
n compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws.
Duct inspection required prior to insulation installation: YES NO
Progress Inspections
Date 'Comments
Final Inspection „
Date Comments
Type of License:
y 2Master
itle
❑ Master-Restricted
4/Town ❑Journeyperson
Signature of Licensee
ermit#
❑Joumeyperson-Restricted License Number. 90
Check at www.mass.gov/dnl
ispector Signature of Permit Approval
THE f Town of Barnstable
Regulatory Services -
f t
S Thomas F. Geiler,Director
16;q.
o ram'' Building Division
Tom Periy,Building Commissioner
200 Mann Street,Hyannis,MA 02601
www.town.barnstable.maxs
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
if Using A.Builder
> tN UVeIS�
as Owner of the subject property'
hereby authorize A Z► t) MI C+V) to act on mp behalf,
in all,mattets relative to work authorized by this building permit
U! C', yJ a
(Address-of Job)
**Pool fences and alarms are.the responsibility of the applicant. Pools
are not to be filled.before fence is installed and pools are not to be
ufflmilzedun all final inspections are performed and accepted.
Signature o Nnet Signature of Applicant
GO `,G 11�_N cd Sk
Print Name Print Name
31/9
Date
Q:F0RMS:0VR ERPERMISSI0NP00IS
• Ir
Town of Barnstable
x� Regulatory Services
t
r�xtvsTwarE, *` Thomas F.Geiler,Director
cress.
4Q, 1639. ��� Building Division
'oTfD MA't�
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.b arnstabl e.maxs
Office: 508-862-4038 ' Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTIO
\ Please Print
DATE: 3
l�
JOB LOCATION: I '
number street
village
"HOMEOWNER": W t ► W 0. S�
name home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was exten to ' clude owner-occupied dwellings of six units or less and
to allow homeowners to engage an individual for hire w does not possess a license,provided that the owner acts as
supervisor.
DEFINITI0 OF MEOWNER
Person(s)who owns a parcel of land on which he/sh resides o intends to reside,on which there is, or is intended to
be, a one or two-family dwelling,attached or detac ed structures ccessory to such use and/or farm structures. A
person who constructs more than one home in a o-year period s ll not be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a form accepta le to the Building Official,that he/she shall be
responsible for all such work performed under e buildin emit (S tion 109.1.1)
The undersigned"homeowner"assumes re onsibility for compliance with e State Building Code and other
applicable codes,bylaws,rules and regula.ons.
The undersigned"homeowner"certifies t he/she understands the Town of Bams ble Building Department
minimum inspection procedures and re uirements and that he/she will comply with s 'd procedures and
requirements.
Signature of Homeowner ,
Approval of Building Official
Note: Three-famil dwellings containing 35,000 cubic feet or larger will be required to co ly with the
State Building Code Sec ' 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 a provisions
of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hir 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 App dix Q,
Rules&Regulations for Licensing Construction Supervisors,Section 2.15)_This lack of awareness often results in serious problems,pa 'cularly
when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a lice sed
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:forms:homeexempt
-
� 1 �� ° it 1�,.� Cep � �s� ➢,� .. � � �.
G ^�
qvl rrge
NA
Town of Barnstable �*Perm #
O Expires 6 month from issue date
Regulatory Services Fee GJV
MASS.3 ,�' Richard V.Scali,Interim Director o'13
i0lfn 39. P sk 12��
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number l
Property Address_ 1 l�'`�p o�� �/l e�,J � � • C fir,fit-�.�� M ►�_
rOTR6-kdential Value°of Work.$ — Z t?i O oU Minimum fee of$35.00 for work under$6000.00
Owner's Name&A`ddfess�
Contractor's Name Telephone Number
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable)
❑Workman's Compensation Insurance
MIT
Check one:
❑ I am a sole proprietor DEC O 6 2013
Cm�n the Homeowner
❑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- oof(hurricane nailed)(not stripping. Going over existing layers of roof)
C[ --?to-side
'Replacement Windows/doors/sliders.U-Value n 2-'1 (maximum.35)#of windows 1 (o
#of doors:
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red Sand 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:
QAWPFILESTORNIMbuilding permit forms\EXPRESS.doc
Revised 061313
Town of Barnstable
Regulatory Services
OF1HE it� Richard V.Scali,Interim Director
Building Division
sw UMABL% Tom Perry,Building Commissioner
Mass.
9 1639., � 200 Main Street, Hyannis,MA 02601
��Ee Moy www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION ;
�„ Please Print
CDATE:—
JOB.LOCATION-
number - street" � village.
"HOMEOWNER":=W_t,r. ,- Pa,,-b « n w sL. co j t9c1( SD 4 735 - d 7 L/
named.s home pho�nee# ry work phone#----y
CURRENT MAILING ADDRESS: i �cck V-%A 14 e�.� C
�—,J A
city/6t wn a r f r state zip code
The current exemption for"homeo mers"was extended to include ow er-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 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 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.
Q:\WPFILES\FORMS\building permit forms=RESS.doe
Revised 061313
t.
� E Town of Barnstable
Regulatory Services
* snMQsts. Richard V.Scali,Interim Director
'D�i�o N,pr► 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 ust
Complete and Sign his Section
If Using A uilder
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work autho ed by this building permit
y(Address of Job)
*Pool fences and alarms are the responsibility of the applicant. Pools
are not to be filled or utilized before fence is installed and all final
inspections are performed and accepted.
Signature of Owner Signature of Applicant
Print Name Print Name
Date
n.rnn�.ra.rniniconaoart�ornwmnnTeiniir
i
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SUBDIV/S101V OF LA. /va WE,THE UNDERSIGNED BOARD OF SURVEY,
IN APPROVE THIS PLAN AND CERTIFY THAT IT
C E N l"E RV 1 L LE , MASS. � COMPLIES WITH ALL APPLICABLE LAWS
AND:REGULATIONS. ,,�
AS LAID Our F02 BOARD OF SURVEYI.r.� ""}' -e-
BARNSTABLE
REGISTRY OF DEWS
Ho § IA�M�®���
TOWN OF BARN STAB LE._: l_� G '�
F E If) 195", c7x
Scale: flvcNm 80FEET - FEBRI/ARY 26, 1947 `u
_11.H.5_0M._CLM
Beerse Kellogg .r Civil Engineers RECORDED DATED..Mn!ccii
REVISION NO.i - LOTS 8,9 6 10 REVISED-41114&
8
14&
^ No.2. 3.4,5,1oan 91
1 o 8 l666