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HomeMy WebLinkAbout0010 FULLERS MARSH ROAD i� � _ � ` �� ��. �� c� ti / ♦ -fir y 7P TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. 2 . DATE JOB LOCATION O A"- ek_ AV<-ZC 0 7LVr�T Number /Street Address Section Of Town �d_HOMEOWNER" �-le S /✓U,�` �-Dlit/ 4/2 2-?7.5`$- 7 7/_ �/70 O Name Ddx Home Phone Work Phone PRESENT MAILING ADDRESr 9 #b 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 such 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 to six 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, by-laws, rules and regulations. The undersigned "homeowner" rti ies that he/she understands the Town of Barnstable Building Depa men ni inspe on procedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.-.0, Construction `h HOME OWNER'S EXEMPTION The code states that: "Any Home Owner 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' Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assumi the responsibilities of a supervisor (see Appendix Q, •Rules and Regulations ng for Licensing Construction Supervisors, Section 215) . This lack of awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. To* ensure that the Home Owner is fully aware of his/her responsibilities, many communities require, as part of the permit application, that the Home Owner 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. may caste to amend and adopt such a form/certification for use in your community. ^1 Assessor's office(1st Floor): . Assessor's map and lot number \ 0 30 AAV- - p�QSEPT➢c SYSTal Conservation(4th Floor): 1N COM Board of Health(3rd floor) l/ Vj � T1Tt,�S Sewage Permit number V ' yo rua Engineering Department(3rd so floor) N � .Coy r�`�� House number IEa�,gTt0N.. Definitive Plan Approved by Planning Board '1 j 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.'and 1:00-2:00 P.M.only r TOWN OF " ,BARNSTABLE BUILDING ' INSPECTOR 1 APPLICATION FOR PERMIT TO ; r TYPE OF CONSTRUCTION �— 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according ®to the following information: Location f f`'� �(�° /e�c /lyi [ r� �vrr Proposed Use Zoning District Fire District (.©To 1T Name of Owner /i S �• Uy- �ON� Address 169 it r G1`B-a- / &,,r 1 xJ Name of Builder - Address Name of Architect _— Address Number.of Rooms Foundation ! 4( /t Exterior S�/�zaS�� ! t-U Roofing QsP k X Y' Floors � Interior Heating Plumbing Fireplace '' Approximate Cost Area Diagram of Lot and Building with Dimensions Fee ACC D--Zb� Y OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnst a re rding t bove co j . N e Construction Si ipervisor's License r BURTON, CHARLES D. �4 No 36293 Permit For BUILD GARAGE Single Family Dwelling - r` Location 10 Fuller Marsh Road r y Cotuit� Owner -'Charles, D. Burton / Type-of,Construction F r a m e } Plot r / %' Lot November 5 93 - ' Permit Granted 19 :, - -- j Date'of Inspection: ` Frame. 19ti Insulation 19 Fireplace 19' Date Completed a 19 + a • �.�y.mow . + } v e 1 r 1 1 1 ' p ���� ,d � . ti. TOWN.OF BARNSTABLE BUILDING PERMIT APPLICATION- Map Parcel SEP-r _- Permit# �` 'I Health Division �° ��AL�Eo 1 EM A (� Date Issued Conservation Division -5 I clq pv EIVI/tin®'ThT171 "PL'ANCiFee �6., d_ Tax Coll E,,, o tl , � ���AID Treasurl e V� . Planning Dept. Date Definitive Plan Approved by Planning Board Historic.-OKH Preservation/Hyannis Project Street-Address �!� I—L,lled5 'Village 'Owner I'Gi- Address t d A,,//,� /f- Telephon �70 Y Z Permit Request C� 12 Square feet: 1st floor: existing proposed 2nd floor:existing proposed TTotal new Estimated Project Cost 10©0, Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes,attach supporting documentation. Dwelling Type: Single Fa ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes ❑No On Old Kin ' ghway: ❑Yes ❑No Basement Type: ❑Full 0 Crawl ut ❑Other Basement Finished Area(sq.ft.) • Basement nished 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, m Count Heat Type and Fuel: ❑Gas O Oil ❑ ctric ❑Other Central Air: ❑Yes ❑No Firepl s: Existing New Existing wood/coal st e: ❑Yes ❑No Detached garage:❑existing ❑ne size Pool:❑existing ❑new size Barn: isting ❑new size - Attached garage:0 existing ❑ne size Shed:0 existing ,O new size ther: Zoning Board of Appeals Authorization I Appeal# Recorded 0 Commercial 0 Yes 0 No If yes,site pla Current Use Proposed Use BUILDER INFORMATION Name Telephone Number . Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTIO S' SULTING FROM THIS PROJECT WILL BETAKEN TO x SIG NA DATE Cf �l a FOR OFFICIAL-USE-ONLY PERMIT NO. ' DATE ISSUED •�-, _ ' ..' .. ,, .. • " - . - ! q - • Y .7 . MAP/PARCEL NO.;. a • 'F ADDRESS, r,._VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ..w, INSULATION, FIREPLACE�'� � ° ', 4 _ .' . : � ` '� _ _ - •^;r . 1 ELECTRICAL' ^RROUGH. FINAL< PLUMBING: r ROUGH' FINAL .J GAS: ROUGH FINAL' = < FINAL BUILDING DATE CLOSED OUT _ F ASSOCIATION PLAN NO. �` � w' •� � .: L .� 1 . ..f� I ' I The Town of Barnstable Department of Health Safety and Environmental Services;- Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 i Ralph Cressen Fax: 508-790-6230 Building'Commissioner 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: Estimated Cost Address of Work: Owner's Name:��.A_­� . 42 �� Date of Application: ' 2 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. ontractor Name Registration No. Date Owner's Name q:forms:Affidav - The Commonwealth of Massachusetts V Department of Industrial Accidents � _ n Olfrce of/nyestigations _ 600 Washington Street Boston,Mass. OZIII Workers' Compensation Insurance Affidavit %��%%/%%%%%%%%//////%�%%%%�/%,,, .:,,..... name: location: city phone# ❑ I am a homeowner performing all work myself. ❑ I am a sole proDrictor and have no one workin in anv capactty Wwz ❑ I am an employer providing workers* compensation l for my employees working on this job. compnnv name: ��t:r'y disc�./ /OG o l (�`6 � )D"0-s address: city! o / /41 dT nhane#:9 insurance CO. Cir eit —Y2-41,,✓!r cv nlicv# L41C 7 0 0 ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comoanv name, address city phone#r . . . ..... ...... insarnnce cn. alicv#.. :•.;:...,,;...:,...,:... /////////////// /////////////////%////,%//////////,lC,.'MMUMMI comnanv name: ' address: city- ... phone M :... ;... .:. ;insarnnce co. oliv# Failure to secure coverage-required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of 5100.00 a day against me. I understand that a copv of tltfs statement may b forwarded to the OlUce of Investigations of the DIA for coverage verification. I do hereby certijy der the pains and pe ies of perjury that the information provided above it true cpCt Sigature Date / _ Print name Phone N F.ntact y do not write in this area to be completed by city or town ofIItdal permit/llcense q ❑Building Department ❑Licensing Board mediate mponse is required ❑Selectmen's OMce❑Health Department: phone t/; ❑Other (rrvum 9,95 P1A) r Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for th= employees. As quoted from the "law", an employee is defined as every person in the service of another under any cor—= 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 more c: the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the rece:z e: trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more 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 c: 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 Iocal licensing agency shall withhold the issuance or renew 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 con=cdng authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of insurance as all affidavits 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. 70/11 City or Towns 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. The affidavits may be returned io the Department by mail 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. 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 Office of lavesugaffens 600 Washington Street Boston; Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 TME Department of Health Safety and Environmental Services Building Division ra sa L& ' 367 Main Street,Hyannis MA 02601 _ 1659. ArEO MA'I�' Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION �j Please Print DATE: ` JOB LOCATION: number f / street village / village "HOMEOWNER": a4 c^l Bf c,`('�!/� l 7 O�S C( 2Zf 3 7 SIr name �home phone# work phone# CURRENT MAILING ADDRESS: ro `4-- D26 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the buildingpermit. (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"ce es that he/she understands the Town of Barnstable Building Department in inspection procedul: requirements and that he/she will comply with said procedures and requi is 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 to amend and adopt such a form/certification for use in your community. QTORMSIXEMPT -7l,�l©� THE Tom,, Town of Barnstable *Permit# `1 b 9 Expires 6 months from tissue date • = Regulatory Services Fee * 3ARNSTABLE, • 'n v K►ss' 0� Thomas F.Geiler,Director 039• Building Division Tom Perry, Building Commissioner y.PRESS PERMIT 200 Main Street, Hyannis,MA 02601 A Office: 508-862-4038 JUL 14 2003 Fax: 508-790-6230 - EXPRESS PERAUT APPLICATION - RESIDENTIAh BARNSTABLE Not Valid without Red X-Press Imprint Map/parcel Number / Property Address na-es-i-di—ential Value of Wo � U v a Owner's Name&Address Contractor's Name Telephone Number " S � 2 9 Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I ajXL a sole proprietor I am the Homeowner ❑ 1have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Permit Request(check box) Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) e-side 2 eplacement Windows. U-Value (maximum.44) *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Pro y Owner must si perty Owner Letter of Permission. o I ov ent ctors �ttired-� Signature Q:Forms:expmtrg Revise053003 \\ STANDARD LEGEND note:PUT Dll symbols Yell appea,on U map GOLF COURSE FAIRWAY DECIDUOUS TREES Ei /% EDGE OF BRUSH 1 `l 1ti �\ �'' \ `\ ORCHARD OR NURSERY CONIFEROUS TREES MARSH AREA y i EDGE OF WATER GIRT ROAD DRIVEWAYS / •"', '� `�j PARKING LOT ` PAVED ROAD 1 DITCHES J F' -"`!'••..,, / \ 7 7 i� PATH/TRAIL PROPERTYUNES PMAP# ARCEL NUMBER `,,\A ,\ ti •\, ',1 ` ,, HOUSE NUMBER // 1 j ,' '\ 7• \` f; ,`t 'i 1 FOOT CONTOUR LINE \ �' !i ,� -�. 10 FOOT CONTOUR LINC Mir6\ 1,..-, I I ! .. 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