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0031 EASTWOOD LANE
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(,J A Y r �% Mr7'iL � «d-J%.!'+.' 1 . 7 1 ' f�ri .i�,/ i1v11A.Of AJ E`t J i 6 I^14 P r / 4(J'i✓ii+ wc k5 rzu> 7� .- t✓ �;,:.• 13t1R�1�' t a _ v /�s,�.+h,�,+�•y' s ,�qq w F� '� � .f.t,. s �, -. e � ''' 4�I:.r!QaTrf�L,+�'�'�+•�a'.^s��'�/ ��•+w,t�f.�J' e � E �`ey� � K � t r, r< � s. t a: ` � # � I �� '"T'�`'i (✓'��� �4:rn.'Y� � s�$M1 ,.A � �f9 �k /� �I fF M1-.. � �' Y +� t Sv. MIA't J �JAi♦�§ "� �������('!��7 �x'�.i p�i t.;L:� w3 t 5�'� 3t t .., < '' to 3- d - e y a wf a T v -'}rr ,c,x+,• Ss ;Oil TOWN OF BARNSTABLE permit No. __19713 11/1/7 7 Building Inspector � rua Cash _--------__--- °"pYw OCCUPANCY PERMIT Bond ,N/A "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to Tellegen—Ferrone Address Jot .020 Eastwood Road, Cotuit Wiring Inspector f; Inspection date / Plumbing Inspector ^ '� Inspection date Gas Inspector Inspection date �1 Engineering Department Inspection date THIS`PERMIT WILL NOT BE TALID,, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED{,BY"THE BUILDING INSPECTOR``UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ................ ��Z ................, t ...... � fBuilding�Inspector �......._._..___ TOWN OF BARNSTABLE Permit No. -Y 713_11f1, 77 Building Inspector � siYrrrm Cash ----___--- AO OCCUPANCY PERMIT. Bond. _-_ [if t5 `.-N building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued.to TP.,.I.lC�',�.'en—FCrrol1e Address I_c�b 020 ftstwood Read, Cotuit Wiring Inspector Inspection.datek ,,._� _ •,,,,..- �. Mom•. �, Plumbing Inspector y L`^�� Inspection date . �.' Gas Inspector Inspection date Engineering Department Inspection date THIS'PERMIT WILL NOTE VALID,. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILD NG INSPECTOR UPON 'SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ...................�f ................. r" ...... _ ,Building Inspector ....._......._..».�... 77 Assessor's map and lot, number .... .. :.�.J....!!t<• ; KD! SEPTIC SYSTEM MUST BE INSTALLED IN COMPLIANCE e: Sewage Permit number .......................... WITH ARTICLE II STA TE 0 C0f: +' SANITARY CODE AND TOWN t: �, P��FTNET��♦ il} TOWN' 'OF ':BAD TSI�A i 13AUSTLBBB, 9° "6 9a BUILDINt'- INSPECTOR tis ' QED YPY -� c:> i �� �,�'� • APPLICATION` FOR"PERMIT TO ........... . �. 5..�`1"AI .................................. ........ ............. `ry ... ... r _ V / . TYPE OF CONSTRUCTION ..................... ........ ............... �r............................................................. .. .Pg...................19 TO-THE-INSPECTOR-OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ ....... .f,'............ U .�Q. ......X,�./........................�.e O.-740 ,7........................ .... ProposedUse .........., ( (.//. ................................................................................................................................. Zoning District Fire District ........./. 'o C) / . ........................... Sr.... .................................................. Name of Owner I e-//z-...�f .. eze-�C� /IS 4..Ad t3 2 3. /e' ),(��,�SC�/ ..... .. .......... .Address ........�,....1�..�.......................K..!':�<...4" z/e.... Name of Builder ............../... �llP ..� :::'..................Address .......................�� ....................................... Name of Architect ...:.........lT�l..f.. ?�lN.:.....................Address ..........................�,—..9:.�A'a ................................. Number of Rooms .......... .........:.........................................Foundation .........�f?�1..���r..�.....��.......�.�.v.....L�.�.. .....�, :........1:..././.. . f,?!e:.. �/Roofing ...........o.��. ., .. �J........... Exierior .... �"1 ... j . r .. !.. ....... ......:....... .��f'/ l ...:.Interior ,l .a... ..c. Floors ..... �..../ ............ ems• rC. Heating ............................. .. .CU ....... . ......Plumbing ........................... ..��.�r. G.dlP! ""'�............ Fireplace ........V�.1l.lQ ../V.j .r.6.4, A .................Approximate Cost .... .. ....... .s��J...V 0.0................... fi Definitive Plan Approved by Planning Board ---------------____-----------19________- Areal ............................. Diagram of Lot and Building with 'Dimensions Fee ................................... SUBJECT TO APPROVAL OF BOARD OF HEALTH I x • , . ��� ft'1�OQS P�/ GV� I hereby-,agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name '� �%°J:` ? .. ::.. X.......... Tellegen & Ferronel l ' 19713 No Permilzfor ...Dwelling,,,,,,,,,,,,,„ I +............t j ......... ` y 0 LocationLot 20 Eastwood lid: c" Co tu.ix ., 1 a Owner .....T..ellegen.,�.Ferroae....................... Type of Construction .........Woad..F-r-emi .......... r. if-'f< c• cz .......................................................... ................... j ,' .,•�/ / i{ +,. / J - _ f,: ..Plot......... ............. Lot ...X..ZS. .L..42...... Permit Granted......... ' Nov. 1 .19 77 - f: x rf Date of Inspection ................ ................. 19 Date Completedl. 1 .7 �19 J / ; �- - `� 4 Ti Cyr � ��T� ', ,. `.� • � � PERMIT REFUSED ... ............ .....°.. ........... . .... .. ................ .. .. ...................... .......... .. . .............. . . ......................... , -. /�.. P ^ Al .............................. ............................................................ ............{I :1 �• .. J �,s ''T' rF =� - al P ✓ Approved ............................................ 19 `. ! m ......... y, T I Assessor's map and lot number .................................. ......I Sewage Permit number .................. .. :�............................. *THE TOWN OF BARNSTABLE BJBH9TADLE, i 039. �•� BUILDING INSPECTOR ~ APPLICATION FOR. PERMIT TO /.�.. /(.. ..................,j/<;. ...................................................................... /z/d � TYPE OF CONSTRUCTION ........d4!'../....:........../��.... .......................................................... ...........�? ..... ...................19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for as permit according to the following information: ,t Location ........ .......�r. /- /9.51t� n/.�` l .............................. P ......................:...... ......v.. ................................... �/,o P d ProposedUse ........................................................................................................../...'................/................................................. All F Zoning District ............. ..............................................Fire District .........!...�/„CJ.�. .........-. ............................... /���,•rtJ �/ �.orrcv✓�' /�S s�� � /� n X 7 c Nameof Owner......... .................................................:.........Address .................,.........:....................:. . Name of Builder .............. .P/.,?��� o..............................Address .......................- ./...'!c` ....................................... Name of Architect ............ �J�/ ?� ....Address l..........:................:..................................... Number of Rooms ......... !?.....................................................Fouundation a,d./Z ..... �0.i`JGl'�� Exterior � .�/..... i1 ...)/ ��rJ A ��C��1 /�Roofn ��!1 /`�5.0 A,) . .......r ` g .......... , ........ .................... .�...... .. ....... ... Floors // '� ✓ ...r/ / " !J/��f.....Interior /,Jr�....�! .............../. ..............:....................................... ......................................... Heating , ..................... .�./. d ............ �� � .... .,f�.................. ................... .................. Fireplace ......... �. o�� �?'> .,� /.!';/�9.A..'... .................Approximate Cost /a n(J 0 ............. Definitive Plan Approved by Planning Board -------------------------------- 70 19 -- --. Area .................................... Diagram of Lot and Building with Dimensions Q Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH kvG) �& �x � - wooel Et I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name/fs .......... �o ��...............................................AA ellegen & Perrone 1 No ............9713..... Permit,fbr ....Dwelling.............. ......................................... Lot Eastwood ftd-.b Location L ........................................... Cotuit ............................................................................... Owner ...Te.1.1e1g.en.........Ferrone .... . ........ .... .................................. Type of Construction .....W604-TZOAC.............. fj ............................................................................... Plot ............................ Lot L...4.2.......... Y� Permit Granted Nov I19 77 a .......-....---- - Date of Inspection ...... ...............19 GF Date Completed .. ...................................19 7i PERMIT REFUSED ................................................................ 19 ..... ........ ...... ..... -YW .............4 .......... ...................7..... .......... .......................... ..... ............................. .... .... ....................... ............................................................................... Oi Approved ................................................ 19O 0 ................................................................................ > ............................................................................... Town of Barnstable � 'is' Shed a • s aSo That�ii:isVisible Fromthe:Street .A rovedP.,,lansMust be,,Retamed onJob:and this Card MustbeKept ►Jilela MAMMA L Pont is Card , M" jr Posted Until Final Inspection HasBeen IVlade • • _ -'bl- Reglst�'atl®Il WheaCeificateofOccupancyisRequred,suchBuimldmg shall Notbe Occupied until a Finalzlnspect�on hasbeen,made§� Registration Number: B-20-1260 Applicant Name: DEFEO, NEIL A& KAREN A Approvals Date issued: 05/21/2020 Current Use: Structure Permit Type: Building-Shed—Residential-200 sf and under Expiration Date: 11/21/2020 Foundation: Location: 31 EASTWOOD LANE,COTUIT Map/Lot: 025 042 Zoning District: RF Sheathing: Owner on Record: DEFEO,NEIL A& KAREN A �'. Contractor Name HOMEOWNER IS APPLICANT Framing: 1 Address: 31 EASTWOOD LANE gt` Contractor License's EXEMPT 2 COTUIT, MA 02635 Est`Project Cost: $0.00 Chimney : Description: 10x16 SHED Permit Fee: $35.00 Insulation: s: F bP� ids $35.00 Project Review Req: ' _ zW4Final: ®ate 5/21/2020 Plumbing/Gas Rough Plumbing: Building Official l Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authoied by.this permit is commenced within six mo the after issuance. All work authorized by this permit shall conform to the approved appl atiori;and tt, approved construction documents>for wh ht h s permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shallkbe in compliance with the local zoning bylaw3 and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. 4 Electrical The Certificate of Occupancy will not be issued until all applicable signatures by"'the 13wlding andTire Officials are provided�on this'- rmit. Minimum of five Call Inspections Required for All Construction Work z Service: 1.Foundation or Footing $< x Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Priorto Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction.. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: r Town of Barnstable oF % Building Department Services Brian Florence,CBO BUILDING p JIMMSTABIE Building Commissioner EPT 9 1659. �� 200 Main Street, Hyannis,MA 02601• ' s '18 2020 www.town.barnstablc.ma.us MAY Office: 508-862-4038 TAW1%Q:--8AflNSTABLE PERMIT# 0 - l R(ab FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet"or less Location of shed(address) Village ~ r ^ .roperty owner's name Telephone number Size of Shed Map/Parcel# E-Mail Si ature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? You must file with Old King's Highway _ ( .g. - Conservation Commission si nature is requ' - - _ fired) Sign off hours for Conservation 8:00-9:30&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 a4 PLOT PLAN Q_forms=sliiedreg REV:08/6/17 1 s, i MORTGAGE lJVSP-'CTION PLAN APPLICANT: DEFEO TOWN: COTUIT 9 LOT 21 ,yr0� SHED LOT 19 ti0 I2`SO1 \ +cam n.^n�y� LOT 25 Y 4:. 44 _ D 'YLE � A LOT 26 �L r f FLOOD PANEL: 250001 0021 D FLOOD ZONE: "C" DATE MAP REVISED: 7/2/1992 I HEREBY CERTIFY THAT THIS MORTGAGE INSPECTION PLAN HAS BEEN PREPARED FOR: DATE: 1/22/13 SCALE: 1" 40' PIONEER MORTGAGE COMPANY DEED REF: 25523-300 PLAN REF: t 284-42 THE LOCATION OF THE DWELLING SHOWN DOES NOT FALL WITHIN A SPECIAL FLOOD HAZARD ZONE, PER TAPED INSPECTION THE DWELLING APPEARS TO CONFORM TO THE LOCAL ZONING BYLAWS IN EFFECT THE STRUCTURES SHOWN ON THIS MORTGAGE INSPECTION PLAN ARE LOCATED BY TAPE SURVEY AT THE TIME OF CONSTRUCTION WITH RESPECT TO HORIZONTAL DIMENSIONAL SETBACK REQUIREMENTS _ ONLY.NO INSTRUMENT SURVEY WAS PERFORMED AND LOCATIONS SHOWN ARE APPROXIMATE OR IS EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MA GENERAL LAWS CHAPTER 40A AN INSTRUMENT SURVEY IS NECESSARY FOR PRECISE DETERMINATION OF BUILDING LOCATIONS SECTION 7. REFERENCE DEED SUBJECT TO AND WITH THE BENEFIT OF ALL RIGHTS, RIGHTS OF WAY, AND ENCROACHMENTS, IF ANY EXIST,EITHER WAY ACROSS PROPERTY LINES.YANKEE LAND EASEMENTS, RESERVATIONS AND RESTRICTIONS OF RECORD, IF ANY THERE SHALL BE, AND INSOFAR SURVEY COMPANY INC. SHALL NOT BE HELD LIABLE FOR DAMAGES RESULTING FROM ANY USE LC T"r CAu;r AAC nun'txtcnT nr 4u .n,•u rn. nn..n. ..,... ...... ......��.�.....r....��..... Town of Barnstable Bpi THE)� ' Ptio Regulatory Services uxrrs•reaL.e, Thomas F. Geiler,Director M"i639. Building Division �� prFp ,y Tom Perry,Building Commissioner . 200 Main Street, Hyannis,MA 02601 www,town.barnstable.m a.us Office: 508-862-403 8 Fax: 508-790-623( PERMIT# ' 00 U-,5V 'V FEE: $ S a 00 SHED REGISTRATION 120 square feet or less Location of shed (address) Village - Bo /<ae !owner's name Telephone number -b Size of Shed Map/Parcel# 7 Z k Signature Date Hyannis Main Street Waterfront Historic District?' Old King's Highway Historic District Commission jurisdiction? ��j� Conservation Commission(signature is required) vf/ Sign off hours for Conservation 8:00-9:30 &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 COMIYIISSION FOR DETAILS. THIS FORM. MUST BE ACCOMPANIED BY A PLOT PLAN . � E Q-forms-shedreg REV:042506 I, kA'•3'i,. .;,.'r.� s 'y''prty;dY ?x t�^k?.o-<- .L},••y�"SF# "1"�df 'i`}3' ''y;�s rsvw.: x rrfi, hssg�x�"^+..,�,,,' '€ ':9''t''� °"',F'K; s'f,k�'g;vt Y,�y ,•,.;v"�a' •��c: '�, -.y ,p':`b .�"'=:' �?( Rf AIMr �r Z, No 15 f- �, i� x2 � i � �.• ��' s � _ <.i i F 'e it }A t 7 {r a �1 S , 3 :i 4t r � 5 f ' d P.'a� t �� �{• !'ta"Fb�' sy,�� 4 c I �� r`.�a::.� � #K� ti'� i is� k^ x ,t , �1 1 l :b ff8 lao' {� .RIVE ' 4o WtA. `. L0 r f` j) ivy(! • mar ; 6 T4,1 � ?>� TELL // {� �/��fj'� In`Fr _ fps f�y�—ter/� �f^'� . .1_.'t LL tom- LJ f� f�lj1 !�'�/��.p.l..-Fig�F t 0 ? ; ,: 6 IF- GO /Li!'' tt/t:Tt/ /; P WA IH Of' P` �f BAP—N�T.AUZ- o cy may. GeoR -7 k/ . LC3 ". F 1CF-Gw ✓'S-_.'�1/D 1'.;: � 7 T -A Svw r' �- d� � � s , � 1 � ��� � a 8 a' - . 0 6 OF THE.TOE Town of Barnstable *Permit�U�l d Expires 6 months from issue to Regulatory Services Fee RARNMEue, Thomas F. Geiler, Director V^ 16 9 ,$� Building Division `�prfb MAy a - Tom Perry, CBO, Building Commissioner D 200 Main Street, Hyannis, MA 02601 www.town.barnstab I c.ma.us 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 :� 73 /;W(,VZ,6r'L)e-r D i2_ CO/UI! 1W 6- ('Residential Value of Work /'/.UU,— Minimum fee of$25.00 for work under$6000.00 Owner's Name &Address 5'd7 /'Y1L✓(9i/L�r'tJG /�irL CJ / CJ�'%�' /V1 T Contractor's Name Telephone Number Home Improvement Contractor License# (if applicable) ❑Workman's Compensation Insurance Check one: -PRE S MI ❑ I am a sole proprietor 5?1 am the Homeowner SLP � � 200� ❑ I have Worker's Compensation Insurance Insurance Company Name TOWN OF BARNSTABLE . Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) e-roof(stripping old shingles) All construction debris will betaken toTfjg,2�UJd ❑ Re-roof(not stripping..Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum..44) r c 9 71 *Where required: Issuance of this permit does not exempt compliance with other town department regulations,% istoric,GoasmaJ ,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. (` A copy of the Dome Improvement Contractors License is required. ' cry W — F_ _j rn SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revise020108 r The COMInOnweaXth of Massachusetts Department of Industrial Accidents Office of fnvestigatians 600 Washington Street Boston, MA 02111 ` wwtv.mass.gov/dia Workers' CompewationYnsnranceA£fidavit: Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Leyibi Name(Business!Organization/Individual): �j • Address: � ®�ry G� J � - . City/StatdZip: C3,jVV6Tr 1/ ' el- OZIo3j Phone*: *g-o 3,bo 1 Are you an employer? Check the appropriate boic Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sbb-contractors 2-❑ I am a sole prDprietDr or partacr- listed on the afiached sheet 7. ❑Remodeling ship andhavc n0 employees These sub-contractors have g, �Demolition employees and have workers' working for me is any capacity. t 9. ❑Building addition [No workers' czrap.-rann-amc °°�'rncL2LanGe. 10.❑Electrical re airs Or additions rtgtured] 5. [� We arc a corporation and its p 3'.RrI am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers' comp. rigbt df exemption per MCL 12 ❑goof repairs i„�rnanGc requirui]t in. 152, §1(4), and we have no - employees. [No workers" 13.❑ Othcr comp.Tnsurancc required.] '`Any agptimnt that e;I=ks box#I must also fM out the section blow,:bowing their workers'comparsation poBcY inf°Tamtion t HmT=wrxn who submit this affidavit indicating they are doing all workand then hire outside contractors mustsubnit anew affidzvitindic 9 such tCantractnrs that cbxk this box must attached an additional sheet showing the name of the sub-contraclnrs and state whether or not tlrosb artitia have rarrployecs. If the sub--ontract»rs have enrplvycts,they moat pT vi&their wort,='cmnp.policy number. I am an employer that is providing workers'compensal on insurance for my amproyees B'eraw is the polity and job site information. In n-an=Company Name: Policy#or Self-ins.Lie.#: Expiration Date: 7Db Site Address: City/St&jzip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to sccmr,coverage ed as requir undLr Section 25A of MGL c. 152 can!cart to the imposition of criminal.pcnaltic r of a Sue tip to S 1,S00.00 and/or ono-year imprisonment,as well as civiil penalties in the form of a STOP WORK ORDER and a fi of up to$250.00-a day against the violator. Be advised that a copy of this stattmarit may be forwarded to the Ofl?ca of InVC&tigiLtiqrs of the DIA for inerimncc coot ra. o verification. I do hereby c nder the pains-and penalties cf perjury thud the information provided above is true and correct. ' Datc: — Phone# S ` 2 C' l OfficLal use only. Do not write in this area, to be completed by city or town offcciaL :'City or Town: Permit/License# Isofag Authority(circle one): 1.Board of Health 2.Building Department 3. City/To,?m Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other r<..—" va R , •Phone#: the rp Town of Barnstable mop _ 01 Regulatory Services Z BARNSTABLE Thomas F.Geiler, Director q MASS. Building Division PTfD `�a 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: �je jo—, I JOB LOCATION: 15,75 /?�I,�j c9r�Li6V Cr 22 �l(J L% number street village HOMEOWNER": �T)L lr10s 5LW *2c' 001 -774- 3q7- 2-76! name home phone# work phone# CURRENT MAILING ADDRESS: /S73 uL 7 jVlf4 ZCo 3 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 Persons) 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 resQonsible 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 ents. ggfr'ature of Homeowner IV V 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 rcquirrd 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 supervisar(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. �i 0*114E 7, Town of Barnstable Regulatory Services +ySARNSrABLE, Thomas F. Geiler, Director �Op i639. �m rEo►u.�a Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Pax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder r , as Owner of the subject property hereby authorize to act on my behalf, in altmatters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Ovm&r is applying for permit please complete the Homeowners License Exemption Form on tb:e reverse side. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �t Map Parcel TO Vlpi Ctt - Permit# 7� Health Division 3 0 '7 -6� © Flssued Conservation Division 3 Piklication Fee Tax Collector 9�r� & ao �� Permit Fee �S Treasurer 'i Pj i-pp; 8EM SYSTEM Planning Dept. UMMTo-.,3.#OF=ROOMS Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village Owner II Address Telephone l Permit Request ckxk � t� OC ��nS i 1 C " tl` Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain I VI b Groundwater Overlay YJ Project Valuation IWO Construction Type Lot Size,®�l� Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. DwellingType: Single Family l/ Two Family ❑ Multi-Family #units YP 9 Y Y Y( � �) Age of Existing Structure �,r d� Historic House: `❑Yes Lit No On Old King's Highway: ❑Yes �Ao Basement Type: [B'Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) 0 Basement Unfinished Area(sq.ft) Number of Bath s:s Full. existing a� new Half:existing new Number of Bedrooms: existing h new Total Room Count(not including baths): existing new ® First Floor Room Count Heat Type and fuel: ❑Gas Val ❑ Electric ❑Other Central Air: ❑Yes O No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes O No Detached garage:❑existing 0 new size Pool: 0 existing ❑new size Barn:0 existing 0 new size Attached garage:D existing ❑new. size Shed:❑existing ❑new size Other: Zoning Board of AppealVNO orization ❑ Appeal# Recorded❑ Commercial ❑Yes If yes,site plan review# r Current Use `` Proposed Use ��,1r�t BUILDER INFORMATION Name _ ATelephone Number �7— /Q g — OS � Address t L License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO s V� b rn Uwe. V\S VS SIGNATURE DATE FOR OFFICIAL USE ONLY r ' _ a PERMIT NO. F DATE ISSUED ; MAP/PARCEL NO. - ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION ' t' FRAME ? INSULATION FIREPLACE ,� ELECTRICAL: ROUGH M FINAL PLUMBING: ROUC I FINAL i s � ' GAS: ROU -I , FINAL s FINAL BUILDING r DATE CLOSED OUT 0 ASSOCIATION PLAN NO. " • The Commonwealth of Massachusetts --� -- Department of Industrial Accidents' _ WC801MMIF09M - 600 Washington Street i Boston,Mass. 02111. V Workers' Com ensation Insurance Affidavit-General Businesses ��'�. �- V •a,. .y�.er.,..�yY•.•p„t,.. .. �•; .'_tom �— .:�.",..StdUi t address V%'`� ! of state: zi :o "hone work site fioff(full address)' [] I am•a sole proprietor and have no one Business Type: ❑Retail❑RestaurantBar/Eating Establishment working in any capacity. El Office El Sales(mcluding-Real Estate,Autos etc.) I am an em to er with on to ees(full& art time. © Other I am an•eWloyer•providing workers compensation for my employees working on this job. J. :\. :.1i t'tltrl:l; '�'�,::�'. .5"•••'' 1:11 1v. �.• _Y.�•; .:1'•:,: . comJ. di • L.•{`�'' is• .ti i ins•Iirarice.cd:, :�:.'�'•" '°• I am a sole proprietor and have hired the independent contractors listed below who have the following workers' .compensation polices: P.7•..S' � .L t-' ••Y f, .4:r ..ly..k,�•� ..R.V{.!•� ..�l:.tii ::fi•:.1: COn] •.,... .ai: „'e-: '!�: ... ' 't .;.' .;C-r:+.iti�'. '.r r.. - ecldress:. 13 on c insiirance' o. / coin! addressi. ., CI' ,!r- '( .:fs:'••' -:•C.. �.� •a: '.i., •�v.;:i,• •a'+•' _py:,t: ,i'^A.'•• ..:'� .t'✓�'.•l�s. • •' •' !'�': t: ::i:� lc'.:ej..i• ,:.:` �S;{w:!• •O�IC: ,�� i'.,ra.: - Failure to secure coverage s9 required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the foim of a STOP WORK OPMER and a fine of$100.00 a day against me. I understand that it copy of this statement mayb forwarded to the . ue of Investigations of the DIA for coverage verification I dolhereby ify and r e ins d penalties of perjury that the information provided above is true and colrect _ Signature Date Print na n Phone# me I► \ 5 _ Y official use only do not write in this area to be completed by city or,town official city or town: permit/license# ❑Building Department.. . • . _ ❑Licensing Board .' ❑-check if immediate response is required ❑Selectmen's Office Health Department contact person: phone#; _ Other _ (revised Sept Z03) + Information and Instructions Massachusetts Ge eral Laws chapter�152 section 25 requires all employers to provide workers' compensation for their. employees: As quoted from the law', an employee is.defined as,every person in the service'of another under any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or mare of the foregoing engaged in a:joint enferprise, and including trustee of an individual,P �P• the legal representatives of a deeeased,employer, or the receiver or partner ship,, association or other legal entity, employing employees. 'However the owner of a . dwelling house having'not'inore than three apartments and-who resides therein, or the.occupant of the dwelling house of another who employs persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment.be deemed.to be an employer. .: MGL chapter 152 section,25 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,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 in the workers' compensation affidavit completely,by checking the box that applies to your 5itiiation :Please ddress and bone numbers along with a certificate of insurance as all affidavits may be submitted mine, a P an . supply comp y to the Deparrtment.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 15 being not the Dep atbent of Industrial Accidents. Should you have any questions regardinglhei"law"or if you ar6 requested, required to obtain a;workers'•compensation policy,please call the Departr*nt at the number'listed.below. City or Towns . Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottonn 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 pernitllicense number.which will b'e used as a reference number. The.affidavits may.be.retumed to the Department bymai or FAX unless other:arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, ' pleas a do not to give us a call. hesitate MEMMM tel hone and fax number: . ddress , . artnient s a � eP _ . The Dep _ . . The Commonwealth Of Massachusetts' Department of Industrial Accidents fltffee of hivesUpdons 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 - phone#: (617) 727=4900 ext:406 oti(HE rot, 'Town of Barnstable Regulatory Services 1 e STAM # Thomas X Geller,Director q�b,� �639• k��� $uilffln Division ran r,,A� g • Tom Perry,Building Commissioner • 200 Main Street, Hyannis,MA 02601 Office: 508.862-4038 Fax: 508-790-6230 Permit no. Data . AF�DA'YZT E[OME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERM T APPLICATION MGL 0.142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, -improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied bta'Iding containing at least one but not more than four dwelling units or to structures which are adjacent to • such residence or building b e done by registered contractors,with certain exceptions,along with other requirements, �p • Type of Work: ��1�ncJ lt% �0�1S� �b�sc- Estimated Cost Address of Work; LN Owner's ®1,g_ Date ofApplication: ��' � ` 1 •• - I hereby certify that: Registration is not required for the following reason(s); []Work excluded bylaw []Job Under S 1,000 ' [�],B ding not owner-occupied Leer pulling oven permit , Notice is hereby given that; OWNERS PULLING TECEIR OWN PERMIT OR DEALING WITH UNREGISTERED COIF TPUCTORS FOR APPLICABLE HOME IMPROVEMENT WORK D O NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY P'M UNDER MGL c.142A, SIGNED UNDERPENAL,TIES OF PERJURY Ihereby apply for apermit as the agent of the owner: Dale Contractor Name Registration.No. OR , Owner's Name opt► , Town of Barnstable regulatory Services Thomas F. sAuvsrAars, Geller,Director MASS A 039. .•� Building Division f rED MA't A 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: —2 JOB LOCATION: ` number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: CC r0z 196 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 intendedto 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 miRimurn inspectibri proce es and requirements and that he/she will comply with said procedures and reAAirements. Signature of Homeowner Approval of Building Official t 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. I Q1orms:homeexempt