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HomeMy WebLinkAbout0115 GROVE STREET 1 TOWN,OF BARNSTABLE BUILDING PERMIT APPLICATION r Map a Parcel �� Permit# `( � ealth ision Date Issued _ zs 2Y �000 E Genservatton ivision - Fee Tax Collect N�•z.? Treasurer _ M . apt. () Date Definitive,Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Village C.6 Tv, / T- t , Owner .S/;�9/Vr l'`� ��� Address /5: Telephone Permit Request /C p le:100 Square fe 1st floor: existing proposed 2nd floor: existing proposed Total new Valuati6n �' �' Zoning District Flood Plain Groundwater Overlay �� g Y Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. ` Dwelling Type: Single Family Two Family ❑. Multi-Family(#units) Age of Existing Structures C? Historic House: ❑Yes ❑No On Old King's Highway: O Yes ❑No Basement Type: O-ftII aCrawl 0 Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) t Number of Baths: Full: existing 7 new Half: existing ��-_ new Number of Bedrooms: existing3__�� new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas Q Oil O Elec-ric 0 Other Central Air: ❑Yes ❑No Fireplaces: Existing` New Existing wood/coal stove: ❑Yes ❑ No Detached garage:0 existing ❑new size Pool: 0 existing ❑new size Barn: 0 existing ❑new size Attached garage:Ming ❑new size 4r ,Shed:U 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 ©w Itlez Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO c SIGNATURE �r- DATE 310y .. i r FOR OFFICIAL USE ONLY L_ PERMIT NO. DATE ISSUED MAP/PARCEL NO. t ADDRESS L' VILLAGE OWNER" '` > Y r • � t i DATE OF INSPECTION- FOUNDATION `•- ':" "" � 4 FOUNDATION r• ,mil , - _ - FRAME INSULATION r FIREPLACE ' ELECTRICAL: ROUGH FINAL • '_tom • - a � f . PLUMBING: ROUGH FILIAL GAS: ROUGH G FINAL', L FINAL BUILDING DATE CLOSED OUT ,. ASSOCIATIOMPLAN NO. ' . t 600 Washington trel te r= Boston,Mass. 0211 ce davit / �,,,•. 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Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-862-4038 Building Commissio::e- pax: 508-790-6230 Permit no. Date AFFIDAVIT HOME HUROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION I. MGL c. 142A requires that the"reconstruction,alterations.renovation,repair,modernization,conversion, led improvement,removal,demolition,or construction of an addition to any pre-wdstmg per-occu p building containing at least one but not more than font dwelling units or to structures w are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: F Estimated Cost 2, J"v Address of Work- Owner's Name: 1:rm" Date of Application• Z. I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 pBuilding not owner-occupied, ;Owner pig own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT ORDEALING UNREGISTERED WORg NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT 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. OR Z" Da a Owner's Name q:forms:Affidav °FIME 1p Department of Health Safety and Environmental Services Building Division .� tree Hyannis MA 02601 s aMttvsrwet.e. 367 Main S b Y MASS. v 1639. 10�' 4',,�Eo aw't' • Ralph Crossen Office: 508-862-4038 Building Commissioner Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION p- r� Plem Print DATE: 0 �3/0 JOB LOCATION: �� village number street "HOMEOWNER": borne phone# work phone# name CURRENT MAILING ADDRESS: i® town/ state zip code city 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 OFROMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends toresi m'on which there is,or is intended to be,a one or two-family dwelling,attached or detached struciu m 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 Budding official,on a form acceptable to the Building Official,that he/she shall be responsible for a ll such work performed under the building (Section 109.1.1) The undersigned"homeowner"assumes resports><brlity for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. th The undersigned"homeowner"certifies that he/she smderstan e Town of Barnstable Building and that he/she will comply with said Department minimum inspection procedures and requirements procedures and requirements. ignature of Ho eo ` 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 abuilding provided it is thatif the homeowner shall be exempt engages from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);r" ln0 person(s)for hire to do such work,that such Homeowner shall act as supern n the responsibilities of a supervisor(see Many homeowners who use this exemption are unaware that theyao S) This lack of awareness often results in Appendix Q,Rules&Regulations for Licensing Construction Supervi ,. : In this case,our Board cannot proceed against the serious problems,particularly when the homeowner hires unlicensed p g as Supervisor is ultimately responsible. unlicensed person as it would with o licensed Supervisor. The homeoer wner many communities require,as part of the permit To ensure that the homeowner is fully aware rs ands the responsibilities of a Supervisor.. On the last page of this issue is a application.that the homeowner certify that he/she understands the responsibilities form currently used by several towns. You may care to amend and adopt such a fortrt/certification for use in your community. Q:F0M1S:EXEMPTN f Engineering Dept. (3rd oor) Map (�� l Parcel 0 o� �J�, Permit#" House# JS Date Issurld .� k B :15 -`9:30/1:00-4:30 Fee [ ~ (8:30- 9:30/1:00-2:00) in. Bldg.) 1HE n Board 19 ' _ RARNSTARLE. 6 9 TOWN OYBARNSTABLE, ' Building Permit Application c~1 Project S'ree ress Village l 0 � V/7— i Owner �'/�/t/,�l 1 . /K//'r► /S L=2 Address //.f'G ?, o v E.:,,f I— Telephone 1/a 4 - 5- Permit Request 12 , First Floor S 7' square feet Second Floor c 'D G S T— square feet Construction Type A/lam t Estimated Project Cost $ 3,S`a 0 Zoning District Flood Plain ti U Water Protection Lot Size a 9j�' 4 Grandfathered ❑Yes ❑No Dwelling Type: Single Family Lff Two Family ❑ Multi-Family(#units) Age of Existing Structure yd yev/U Historic House ❑Yes allo On Old King's Highway ❑Yes ❑No Basement Type: W Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) //- 0 O Number of Baths: Full: Existing 3 New_ Half: Existing % New LGarage oms: Existing 3 New Count(not including baths): Existing New First Floor Room Count d Fuel: ❑Gas J@ Oil ❑ Electric ❑Other' ❑Yes XNo Fireplaces: Existing 1 New Existing wood/coal stove ❑Yes a No etached(size) Other Detached Structures: ❑Pool(size) ttached(size) 1/NpE/? .2OU ❑Barn(size) one ❑Shed(size) ❑Other(size) 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# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE` DATE 'j 7 BUILDING PERMIT DENIED KOR THE g..OLLOWING REON(S) dd f FOR OFFICIAL USE ONLY ..PERMIT DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE *' - OWNER41 " DATE OF INSPECTION: • } FOUNDATION FRAME INSULATION 9C`" �J / FIREPLACE ELECTRICAL:. ROUGH = FINAL PLUMBING: ROUGH FINAL j GAS• ROUGH FINAL FINAL BUILDING f , DATE CLOSED OUT 4 j ASSOCIATION PLAN NO. , Ire • �� wn of Barustable The To fi Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crosser. Office: 508-7,90-6227 ` Building Cora.--: Fax: 508-,90-6230 For office use only Permit no. I 1 r Dale ' r AFFIDAVIT HOME WROVEMENT CONTRACTOR LAW SUPPLEMENT-TO PERMIT APPLICATION MGL a. 142A requires that the "reconstruction, alterations, renovation, repair, modernization. conversion, improvement, removal, demolition, or construction of aaddition o a g on1��1ng owner occupied building containing at test one but not more contractors, with structures which are adjacent to such residence or building be done by registered certain exceptions,along with other requirements / Est.Cost 3•�`� ,/ Type of Work: L/Address of Work• �wnerls Name ate of Permit App I hereby certify that: ` Registration is not required for the following resson(s): L Work excluded by law _Job under S1,000. ding not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEAEJNG WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME GRAM OR G�iTR� FUND UNDER MGLOvEMENT WORK DO O 14Zri� ACCESS TO THE aRgITRAZ'ION PRO SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner-. e / 7 �r Registration No. Date f - TIIL' C1111111JU1111'eall/r of.-Ilia SQchusc11.S• Dep rtlyzelrt of ludurrrial Accidents 6(1(1 !f'ushingtulr Street ,4• �,�-�-• � �: •, Bustulr< 11111as: 03111 «'urk-em' Compensation Insurance AlTidavit Allph" nt inforniarinrt PlczSe f'RfNT led�i2jy"��— �nc^•inn• � � �v � • sits I am a homeowner performing_ all work mvself, 1 am a sole proprietor and have no one working in an} capaciry I am an empiover•providing^workers' compensation forms employees on this job. rnmwinv n•rmt•• 'wirier<c• yin mhnnc d- incnr^nrr rn nntiev 11 r am a Sole rroDrletor. et:ncrai contractor, or homeowner(circle mic) and have hired the conamctors llste- beto '1•cc the bilowin_ workc.s• compensation police: cnmr•mv n•trnr- ltirlrr«• rt n�1nnC d• -- in—ir--nrr rn nn6ev ii Cnn.^^�, n�rnr• nridrr— rir�•• � nhnnc>d' nniic�•+t incnr-irr rn Atlzchadditlo_naishcrfiftl[ec!snr,% —.4'�.,��•�• � ri.— -•••,•�ei�••.'r. ''••. ._..��NNe�.��__"."`-.� ••..�.�•�•� F.;,iurc to,ccurc cm cr t c as required u tier�ectton=cA of AIG:. 152 can Iead to the imposition of crtmtnat penaiues o1 a line up to S1�OU.UU anurc: tine .cars imprisonment :i. %%cil :ts cisil penattics in the form of a STOP WORK ORDER and a fine of 5100.00 a dad•against me. I understand ttl:.t cop, of Ihia ,wicntcttt ntat be furs arded to the Oltce of Im•estissttons of the DIA for covert;:c verification. /uo herc.^r c ,:n,warier the prints ctrn pelraiues of perjun•rhat the information provided above is trur rt td correct. c•,...�tu:� Date � �� 71, !'l B�L Phone ,)t incizi usc vniv Jo not writc in this arcs to be completed by city or town oRciai I t tits•or tnss n• permitiliecttse r;tiuildin,Department L ClUcensintf Board t.. _ cnech if imtncuiatc respunsc is required (:!icleetmen•s Urlier f. - Ctllcatlh Department phone 4: r"Vthcr Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all emplovers to provide workers' compensation for thei 1 employees. As quoted fin the "law*% an emph ree is defined as every person in the service of ane y �the under an P contract of hire. express or implied. oral or written. . 1 An -inj& rer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more 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. However the owner of a d%%•elling house having not more than three apartments and who resides therein. or the occupant of the dwcllin- house of another who employs persons to do maintenance , construction or repair work on such dwellin�a, hou or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL cha'ptcr 152 section 25 also states that even, state or local licensing agency shall withhold the issuance or renev-•al of 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. Additionallv. 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 hz been presented to the contracting authority. Applicants Please fill in tiie %vorkers' compensation affidavit completely, by checking the box that applies to your situation and sup-31yin;_ company names. address and phone numbers 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 affi5avit 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. . C►tv or towns Please be sore 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 tite event the Office of Investigations has to contact you regarding the applicant. Plea: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned tc the Department by mail or FAX unless other arrangements have been made. Tile Office of Investigations would like to thank you in advance for you cooperation and should you have any questionf please do not hesitate to give us a call. ' ...m,..�c•...._.... _..._.....-..:....•. �....,o•..r+..... - -ter. .....+= w—+..ww.•...�.•r-+v!oa►.rr_1r••^rvn�•�v..��.r- Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents "'„ Office of Investigations 600 NVashinaton Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375