Loading...
HomeMy WebLinkAbout0051 THREAD NEEDLE LANE :. Y ..� � _ H. . r �. .� � � va t �: n - w y � .. .. '. r � ,. _ w i � .. .- FJ'� ,�. t ' � ` .. ..._.._ Win, �.i. .. - ' `� . � � .. 1 .. THE FOLLOWING IS/ARE THE BEST IMAGES FROM POOR QUALITY ORIGINALS) M ^ACC DATA i Lv TOWN OF BARNSTABLE DEPARTMENT OF HEALTH SAFETY AND ENVIRONMENTAL SERVICES BUILDING DIVISION cl C STOPWO , µs THIS STRUCTURE AND/OR PREMISES HAS BEE INSPECTED AND THE FOLLOWING VIOLATIONS I OF THE BUILDING CODE AND/OR ZONING ORDINANCE HAVE BEEN FOUND: 1) c� I y1 C C_- I (p v-\ S — 2) v\ )-( P 2, 4) - 1� YOU ARE HEREBY NOTIFIED THAT NO ADDITIONAL WORK. SHALL BE UNDERTAKEN ; ."UPON THESE PREMISES, OR THE PREMISES W OCCUPIED UNTIL THE ABOVE VIOLATIONS;:° ARE CORRECTED ANY PERSON REMOVING THIS NOTICE WITHOUT PROPER AUTHORIZATION SHALL BE LIABLE TO A FINE OF NOT LESS THAN FIFTY, NOR MORE THAN ONE ]HUNDRED DOLLARS. Address `� � 'f— V e 7,c p o Date TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map IID Parce Permit# Health Division DO- I k3l/��- �� '^3�' y�? Date Issued Conservation Division �-� 231( J Fee Tax Collector (� D Application Fee 00 Treasurer 0 ,Planning Dept. Chec3 _ STEM Date Definitive Plan Approved by Planning Board 01 OE RW ROOM _ Historic-OKH Preservation/Hyannis Project StpVt Address A b /V C- JD L k t Al, Village ke T- t t I/W Owner Cam► i`L Address w ��_ J pr Telepho O ,< R k «) Permit R§quest_ de ce Square feet: is or: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size om,3_0 6 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation, ` Dwelling Type: Single Family (U( Two Family LJ Multi-Family(#units) Age of Existing Structured Historic House: LiYes W fio On Old King's Highway: ❑Yes, r�o �/ Basement Type: o/Full ❑Crawl Cl Walkout ❑Other Basement Finished Area(sq.ft.) A10 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 Floor Room Count Heat Type and Fuel: l Gas ❑Oil ❑ Electric ❑Other Central Air: YYes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes U(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 INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATUR& DATE / .�� FOR OFFICIAL USE ONLY PERMIT N.O. DATE ISSUED r MAP/PARCEL NO. , ADDRESS } VILLAGE , OWNER } DATE OF INSPECTION: 4 FOUNDATION S U a D l<, FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH =' FINAL I ` P PLUMBING: ROUGH FINAL N I+ GAS: ROUGH ®- FINAL' _ f�7 FINAL BUILDING DATE CLOSED OUT i m in ASSOCIATION PLAN,NO. Department of Industi ial Accidents Office of Investigations' ' . 600 Washington Street Boston,MA 02111 •` www mas&gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumalbers Applicant Information Please Print Legibly Name (Business/organization/Individual): . Address: GL City/State/Zip Phone#: 9= Are you an employer? Check the-appropriate box:. Type of project(required):• 1.❑ I am a-employer with 4. ❑ I am a general contractor and I 6.'❑New construction employees(hill'and/or part time).* have hired the siib-contractors 2.[] I am a sole proprietor'or partner- listed on the attached sheet$ �� ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition worlang for me in any capacity. workers' comp.insurance. g, ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.❑ Electrical repairs or.additions • required.] • . 3. I am a homeowner doing all work right of exemption per MGL 11.7 Pbmbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers 13.❑ Other ' comp.insurance required.] '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. tContractors that check this box must attached an additional sheet showing the name of the sub-contrabtors and their workers'comp.policy informatiom 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. 152 can lead to the imposition of criminal penalties of a fine up to$1,500•.06 and/or one-year imprisonment, as well as.civil penalties in&e form of a STOPVORK 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 Investigations of the DIA for insurance coverage verification. I do hereby cer�W� under the pains and enaldes of perjury that the information provided above is true and correCt Si atur Date:. OOP • Phone Official use only. Do not write in this area,to be completed.by city,or town official City or Town: PermitUcense# 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. « , association,Furporation or other legal entity,or any two or more An employer is defined aS..arl ind%vi¢tial,;paptnerslup 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. Howvez:tlie owner of a dwelling house having not more than three apartments and who resides therein,or.the occupant of the e,construction or repair woiYbn such dwelling house dwelling house of another who employs persons to do maintenanc or on the grounds orbuilding appurtenant thereto shall not because of such employmentbe 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(')states"Neither the commonwealth not any of its'political subdivisions shall enter into any contract for the performance of public work until acceptable.•evidence of compliance with the insurance i i nto s of this chapter have been presented to the contracting authority. req Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone numbers)along with their certificates)of insurance. Limited Liabmgity Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners;tedab not required to carry workers' compensation insurance. If an I.LC or LLP does have employees, a policy is required. Be advised that this avit may be sure to sign and dabe submitted te the affi the davit Department affidav of it should Accidents for confirmation of insurance coverage. 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 bom 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 permit/hcense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license 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 Vwn)."A copy of!he.-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 bum leaves etc.)said person is NOT required to complete this affidavit 7se to thank you in advance for your cooperation and should you have any questions, The Office of Investigations would lm please do not hesitate to give us a call. The Deparhneut's address,telephone and.fax number: The Commonwealth of Massachusetts . Department of Industrial.Accidents ..®five 9.fJnvestaga#0ns . ,. 600 Washington•$ eet� . Boston,MA 02111, Tel.#617-727-4900 ext 406 or-1-877-MASSAFE Fax#617-7274749 Revised 5-26-05 www.ma'ss.gov/dia _El Town of Barnstable Regulatory Services Thomas F.Geiler,Director mum Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IlVIPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT 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. of Work. Estimate Costt�®� Type. , Address of Work: Owner's Nam ' Date of Application: / I hereby certify that: Registration is not required for the following reason(s): []'Work excluded by law ❑lob Under$1,000 KBuilding 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 MROVEMENT 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. Date Owner's Name Qlb ms:homeaffidav oFTH�t Town of Barnstable Regulatory Services BARNSrABLE, : Thomas F.Geiler,Director v t�►ss. $ �A 1639. .�6. Building Division tF0 MA'1 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 Please Print DATE: �� L�14,5 JOB LOCATION: 5 number street village , "HOMEOWNER": dC.�' �. / — O J V✓�. — name ho phone# work phone# CURRENT MAILING ADDRESS: o ✓e r aja k1a 14_�Vlvwl , A a city/town f 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 procedures and requirements and that he/she will comply with said procedures and requ' s. 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 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/certificarion for use in your community. Q:forms:homeexempt X8 PT po rt I� °i r �� p IHE The Town of Barnstable BA AA' LE,I Department of Health Safety and Environmental Services �s�. ptEDMA+p Building Division 367 Main Street,Hyannis,MA 02601 )ffice: 508-862-4038 lax: 508-790-6230 PLAN REVIEW Owner: a nr d Map/Parcel: 2 1 o Q 7 Project Address: Builder: tUh p.�C i The following items were noted on reviewing: 2, 2 X S���, J�` o c o'- wl u Gvt�Q r IJ Reviewed by: Date: q:building:forms:review TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map /-1l6 Parcel Permit# & ( Q O c Health Division ' Date Issued Conservation Division � Fee l� Tax Collector �Z_ ��S S� /eQ Treasurer Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By EXISTING SEPTIC STEM Historic-OKH Preservation/Hyannis LIMITED TO #OF BEDRooms Project Stre Address , 52 ZW44� ,O 11=L� Z Z 4 4'` Village 1V ;d Owner ddress tXYA A Telephone ° ®� u/2 eI - Zea ledo Permit Request .� 6,1 l/D ii o,N Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation� Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size o Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. T ul cr Dwelling Type: Single Family V/ Two Family ❑ Multi-Family(#units) r _ r Age of Existing Structure 9 Historic House: ❑Yes Of//No On Old King's High ay: ❑`Yes e0 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 Floor Room Count Heat Type and Fuel: VGas ❑Oil ❑ Electric ❑Other Central Air: W/Yes ❑No Fireplaces: Existing _� New Existing wood/coal stove: Cl Yes WeNo Detached garage:❑existing ❑new size Pool:Cl 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 LI/No If yes, site plan review# Current Use ,_ . .�, Proposed-Use -- - - - BUILDER INFORMATION Telephone Number -�Z_ ,;nI , , R& —al :roll" ess #�/1 �o Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNAT AtA DATE FOR OFFICIAL USE ONLY s P RMIt NO. DATE ISSUED - MAP/PARCEL'NO. T i ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION �y6 FIREPLACE % ELECTRICAL: ROUGH "1 FINAL PLUMBING: ROUGH r + FINAL GAS: ROUGH - ©, FINAL FINAL BUILDING Lr 0 DATE CLOSED OUT ASSOCIATION PLAN NO. — tv The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 1 d ti 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information' Please Print Legibly f . Name (Business/Organization/Individu Address: ?01- TlJ,0 City/State/Zip: Phone#: � Are you an employer? Check the-appropriate box:. Type of project(required): 1.El I am a e to er with 4. ❑ I am a general contractor and Iy f 6. ❑ New construction employees(full and/or part-time).*, have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet. $ ?• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me many capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] , officers have exercised their 10.❑ Electrical repairs or.additions 3. I am a homeowner doing all work' right of exemption per MGL 11- Plumbing repairs or additions myself.[No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.] t employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#I 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 tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. 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. 152 cari 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 forwarded to the Office of . Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains an enalties of perjury that the information prov ed above is true and correct Si Dat Phone#: 'r Official use only. Do not write in this area,to be completed by city.or town officiat 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 t Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their eiWloyees. 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. am iudiv*al,,partnership;.association, corporation or other legal entity,or any two or more s of a deceased employer,or the and including the legal representatives of the foregoing engaged in a joint enterprise, g g �p association or other legal entity, employing employees. However the receiver or trustee of an individual,partnership, owner of a dwelling house having not more than three apartments and who resides therein, or,the occupant of the dwelling of another employs er who to s persons to do maintenance, construction or repair woikvn 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-contractor(s)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 permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license 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:fixture 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 bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like 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 ,r office of investigations -. r. 600 Washingfon Street Boston,MA 02111. Tel. #617-727-4900 ext 406 or 1-.877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia a -� Town of Barnstalble °* Regulatory Services sesNSTABiE, + Thomas F.Geiler,Director Th , 9�j°?ED 39. a`0� 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 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT 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: Or Estimated Cost Address of Work: �- (/+�(5 J /--- Owner's Name: e ��i�i� Date of Application:��L I hereby certify that: Registration is not required for the following reason(s): Work excluded by law ❑Job Under$1,000 []Building 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 IMPROVEMENT 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: r Date Contractor Name Registration No. OR Date Owner's Name Q:farms:homeaffidav oFt►�,� Town of Barnstable Regulatory Services tanxarsrear.E Thomas F.Geller,Director ' . ,�� Building Division AT fog a Tom Perry,Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 6�/ JOB LOCATION: number street g street —` village (� "HOMEOWNER": /`„%C / �1�/C— (2z/ , ,_ (JQ`' /ge�d name home phone# wor phone# r� CURRENT MAILING ADDRESS: a Q lefD cityhown 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 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 perfomvng 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:forms:homeexempt -��; �CONSUIVMERINFO ORM'4!SUNRO.OMS ' � <„<. i .r_�. aches 3State uil'din Co e• 80� > `" ' en ' echo L :23d wn The Massachusetts State Building Code(780 CAM) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental .CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructinglinstalling a house addition with very large percentage of glass to opaque wall,seeks to utilize a special energy conservation exemption option for "sunroom" additions to,an existing house (780 CMR, Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size, configuration, orientation,form of construction or percent glazing,but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and construction/installation of"sunrooms", included below is a non-required, open-ended list of product and design considerations that _a homeowner may wish to consider before actually constructing/installing a "sunroom".It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential--energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/seal durability and/or weather tightness of the sunroom • Adequate ventilation Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.123.1,..requires that the actual property owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document corLcernmg sunroom comfort and energy conservation. Af - Signature of Actual Bui Owner Print Name Address of Permitted Project Owner Address(if different than project location) Owner's telephone number f V� r� j __ ��rc f y - �FTMETp,,� The Town of Barnstable P` NW �� BARNSTABLE. ` Department of Health Safety and Environmental Services . MASS. a pTfDMA�a, Building Division 367 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: CJ I :C SKr Map/Parcel:_ 1 h U 7 7 Project Address: (-+�VCCR Builder: l Jl,-),n The following items were noted on reviewing: 1 Vc0V 1 0 ti' vim- Q�- e'v�2- Q V- o S ? 1- r r) S 4-vo-E-� — o �e- .2�, rn;n •2 C 1 V 12 m lr s � o S --7—,, /7 Reviewed by: Date q:building:forms:review c N OR Lv , ' (A `Y _ E " .' ' ` yr, O / - a.• �� t - �Loi a t B.t.: 9/16/03 . . EDM ND & FRANCES CLIFFORD „ D-ume Number:. Scale: - PLOT _ PLAN _ f 1"' = 20'-0" 51 THREAD NEEDLE ROAD CENTERVILLE, MA - BAA\ - Sketch Number ' 5-101 3 i 1 f i O r Y , a�.1.. `r A L=> �< Bete:- 9/16 03 - EDMOND & FRANCES CLIFFORD Document Number: PLOT PLAN ��e. 51 -THREAD NEEDLE ROAD CENTERVILLE, MA BMA _ Sketch Number: 'S•101 f• E . s- 7 0 J�-✓ ez WALL If I L O•0�"�/ 5 !I tY .' FOOT 6LV I Gt -- i FL pro 19 1-4 -1�;? Wr—Vrf ' l z w Vilto.t n f --------------- is f 8 0 F 3$ br L O 3tl"k¢ 'SLID fl 5 KY L►<4T-- v+t p d Z M. $ 1 r—• �xt�`rtt.3�is """,�� t -c .. � u •�8`�..i e - i a �r > xtfs tQ =x` i U a J - tGt c IGGl{ t1 � Q r a a 1 ..Y , i �l 1 - 22 � © b �l, j r ,r . t\,j G- i b� B.a: 9/16/03 s°°'°: EDMOND A; PLOT PLAN FRANCES CLIFFORD Document Number: 1" = 20'-0" 51 THREAD NEEDLE ROAD CENTERVILLE, MA BM\ - Sketch Number: S•101 AA 01 115 L.06 "re L"t° Zte x - _ ------------ IL 41 aaEa�B o y -S j S/t-5T!, 6 WA,L_L W A..L L '55 .°i