HomeMy WebLinkAbout0040 JACKSON DRIVE y0 j66 rSO A/ v c7-
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CAPE COD
1EMEROY S<>LL rON
378 Route 130 -
Sandwich,MA 02563
PH:774-205-2001•844-90-AUDIT .
Permit Affidavit .
Permit m,BLD-19-458
I,Craig Bishop,confirm that the weatherization and air sealing work completed at 40 Jackson Drive Cotuit
has been completed in accordance with 780 CMR.
Signature: 1
gn atu e: . Date: 5/23/20.19_ _.
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Town of Barnstable Building
t Post This Card So That itis,Visible From the Street ApprovedPlans Must 6e:Retalned on Job and this Card,Must be Kept
MAS& Posted Until,Final Inspection Has Been Made. yam '*
bsa p• . P Y_ oui ...� d.g.r. _ ... p pection has been made :. Permit
1
i Where.a Certificate of Occu anc, is Re uired,such Buildin shall Not be Occu ied until a Final Ins
Permit No. B-19-458 Applicant Name: Craig Bishop Approvals
Date Issued: 02/19/2019 Current Use: Structure
Permit Type: Building—Insulation-Residential Expiration Date: 08/19/2019 Foundation:
Location: 40 JACKSON DRIVE,COTUIT Map/Lot: 019-082 Zoning District: RF Sheathing:
Owner on Record: JOHNSON, RICHARD& KATHLEEN Contractor-Name—, Craig P Bishop Framing: 1
Address: 40 JACKSON DRIVE Contractor License: CS'109777 2
COTUIT, MA 02635 `" Est. Project Cost: $3,635.00 Chimney:
Description: Air Sealing&Weatherization Permit Fege: 85.00
5
P g = $ Insulation:
Fee Paid $85.00
Project Review Req: Final:
-, 'Date.. t �2/19/2019
Plumbing/Gas
Rough Plumbing:
t
g g:
--�•�--••� .Building Official
_ Final Plumbing.
This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance.
All work.authorized by this permit shall conform to the approved application and theapproved construction documentsforwhich this permit has been granted. Rough Gas:
All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws 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. y'
_ . �. Electrical
The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials-are provided on this'permit.
Minimum of Five Call Inspections Required for All Construction Work`. r Service:
1.Foundation or Footing .!
l _�• 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.Prior to 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
Final:
All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT
Parcel Detail Page 1 of 3
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Logged In As: Parcel Detail Tuesday, Marc
Parcel Lookup
Parcellnfo
Parcel ID 1019-082 Developer I LOT 2
Lot
Location�40 JACKSON DRIVE ) Pri Frontage 153
Sec Road+CHEOH ROAD Sec,or
Frontage
Village iCOTUIT Fire District`COTUIT
Sewer Acct i Road Index 0786
Asbuilt Septic Scan: Interactive a'
019082_1 p
- Owner Info
Owner 1— -- SON, RICHARD N- µ. mM_ co-owner;KATHLEEN JOHNSON
Streetl 140 JACKSON DRIVE Street2
city:.'COTUIT state'IMA zipi02635 Country yUS
- Land Info
Acres 0.50 Use ,Single Fam MDL-01 I Zoning ;RF Nghbd;0108
Topography:,Above Street I Road !,Paved
_._-------- -----.......... ..... ...... __... ._._..._... .....
Utilities 1 Public Water,Gas,Septic I Location 1
Construction Info
Building 1 of 1
Year;_ _ "_,. Roof ..__. .,_." _ Ext
Built'1970 I struct{Gable/Hip Wall Wood Shingle
Effect3689 .I Roof AC GIs/Cmp.I Ac ,None ~ u
Area- cov ier Type.
edf
style;Cape Cod I Ill iDry Rooms J ms
Wall 4 Bedrooms
Model 'Residential " Int Hardwood ,I Bath `2 Full + 1 H
Floor s - Rooms i
Grade,Average Plus Heat Hot Air Total=8 Rooms
Type, Rooms
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=731 3/24/2009
Parcel Detail Page 2 of 3
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Stories 11 1/2 Stories I Heat IGas I Found- Typical
- Fuel ation
Permit History_
Issue Date Purpose Permit# Amount Insp Date Commen
02/12/2008 Out Building 200800743 $5,000 09/11/2008 00:00:00
08/01/1985 B28319 $10,000 01/15/1987 00:00:00 CO GAR/
- Visit History
Date Who Purpose
09/24/2008 00:00:00 John Greene Permit/Hold as NewGrth
09/11/2008 00:00:00 Mike Keating New Construction
03/07/2005 00:00:00 Paul Talbot Meas/Est
08/30/2002 00:00:00 Paul Talbot Meas/Listed-Interior Access
07/20/1999 00:00:00 Frederick Stepanis Meas/Listed-Interior Access
12/15/1985 00:00:00 FR
Sales History
Line Sale Date Owner Book/Page, Sale P
1 JOHNSON, RICHARD 2765/100
Assessment History
.._..... ....
Save# Year Building Value XF Value OB Value Land Value Total Parc(
1 2009 $318,300 $4,700 $0 $206,400
2 2008 $344,100 $4,700 $0 $230,400
4 2007 $381,700 $4,700 $0 $230,400
5 2006 $343,800 $4,700 $0 $218,100 ;
6 2005 $300,300 $4,500 $0 $218,100 ;
7 2004 $242,000 $4,500 $0 $167,200
8 2003 $225,600 $4,500 $0 $74,300 ;
9 2002 $225,600 $4,500 $0 $74,300
10 2001 $225,600 $4,700 $0 $74,300
11 2000 $116,400 $3,700 $0 $45,000
12 1999 $164,100 $2,700 $0 $45,000
http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=731 3/24/2009
Parcel Detail Page 3 of 3
13 1998 $164,100 $2,700 $0 $45,000
14 1997 $175,000 $0 $0 $45,000
15 1996 $175,000 $0 $0 $45,000
16 1995 $175,000 $0 $0 $45,000
17 1994 $154,700 $0 $0 $50,600
18 1993 $154,700 $0 $0 $50,600
19 1992 $175,900 $0 $0 $56,300
20 1991 $179,900 $0 $0 $60,000
21 1990 $179,900 $0 $0 $60,000
22 1989 $201,100 $0 $0 $72,000
23 1988 $143,600 $0 $0 $28,400
24 1987 $88,700 $0 $0 $28,400
25 1986 $88,700 $0 $0 $28,400
Photos
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http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=731 3/24/2009
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Town of Barnstable ermitS0
w Evpires.6 months from issue date
Regulatory Services Fee. 0 cx�
Y #
- BARNSCABLE, • - - .-.
v� ASS. Thomas F. Geiler, Director
_ AlfD MA't n '
Building.Division
Tom Perry, CBO, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barns table.ma.us
Ofi icG: 5.08-862-4038 Fax: 508-796-6230
EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY
y Not Valid without Red X-Press/mprint
M ) �ap/parcel Number _._� 1 L/U
Properly Address _" G/U�"�/� (�d�— CC)TLJcT" lNl
`
Residential Value of Work .V, _ Minimum fee ol'$25:00 for work under$6060.00
Owner's Name & Address /�(C, ,��c>
---�14 c tC�C L :7 n1 on C"p Tw( mSa
Contractor's Name --- - -' 'Telephone Number S �rT 9
I"lome Improvement Contractor License#(if applicable)-__---__ --
Construction Supervisor's License# (if applicable)
❑Workman's Compensation Insurance _ -PRESS ' " r
Check one: OCT 2 1 2008 .
❑ I am a sole proprietor
( I am the Homeowner
❑ I have Worker's Compensation Insurance TOWN OF BARNSTABLE
Insurance Company Name
Workman's Comp. Policy#
Copy.of Insurance Compliance Certificate must be on file.
Permit Request (check box)
t
Q Re-roof(stripping old shingles) All construction debris will be taken to 6/;N `j
❑ Re-roof(not stripping. Going over existing layers of roof)
e-side
Replacement Windows/doors/sliders. U-Valueav� maximum .44) �qJ
*Where required: Issuance of this pen-nit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
'Note: Property Owner must sign Property Owner Letter of Permission. PC :01 1,jv Z ��t 'IZ
A copy of the..Hdme Improvement Contractors License is required. U
SIGNATURE:
Q:`_WI'('ll.-f.•'S\FORMS\building permit forms\EXPRESS o
Revised 100608
The Commonwealth.of Massachusetts
Department of Industrial Accidents
Office of Investigations
d 600 Washington Street
Boston,MA 02111
°�. ,�•�' www.mass.gov/dia
Workers' Comp f
ensation Insurance Adavit: Builders/Contractors/Electricians/Pluloobers
Applicant Informtation .Please Print Legibly
Name(Business(Organization/Individual): )G�
Address: ?
City/State/Zip: C-6 0 IT MA S<� Phone.# -j®�S 02 �
Are you an employer? Check the appropriate box: .Type of project(required):,
4. [] I am a general contractor and I
1•❑ I am a employer with
• * , have hired the sub-contractors 6. ❑New construction .
employees (full and/or part-time), 7. Remodelin
2.� I am a'sole proprietor or partner- listed on the attached sheet. ❑ g
ship and have no employees These sub-contractors have g, 0 Demolition:
employees and have workers'
working for me in any capacity. 9. .[]Building addition
[No workers comp.insurance .
comp. insurance.$
required.]
5. [] We are a corporation and its 10.❑Electrical repairs or additions
3. I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions
myself.[No workers' comp. right of exemption per MGL 12,]Roof repairs
insurance,required.]t c. 152, §1(4), and we have no
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.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provi db their workers'comp,policy number. .
1 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:
lob 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$1,500.00 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 maybe forwarded to the Office of
Investigations of the bLA.for insurance coverage verification.
I do hereby certi gy er the pai •and penalti of jury that the information provided above is true and correct.
Si afore: Date;
Phone#: 512
Official use only. Do not write in this area, to be completed by city or town official
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
Contact Person: Phone#:
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."
An employer is defined as "an individual,partnership,association,corporation or other legal entity,or any two or more
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. 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 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
ren mi
ewal of a license or pert to'operate a business or to construct buildings in the commonwealth for any
applicant who has not pro.duced,acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL ehapter.152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
'enter into any contract for,therequirementsperformance of public work until acceptable evidence of co nplisaee with the insurance
requireents 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 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 burn 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:.
o CommQnweaM of Ma&sa&usetts
DQpartmmt of lndu�al Acc deets
Off oo of la*eStigatioas
600 Wa`chingtori Street
Bosto ,MA 02111
-T . ##f 17-72"7;4900 ext 406 or 1-M-MASSAFE
Fax#617-727-774
Revised 11-22-06
www.mass.gov/dia
i .
' r
. .Town .of Barnstable
�pf YHE ray
Regulatory Services
BARNSTABL— ; Thomas F.Geileri Director - - -
NUS&
Building Division
ATFD
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.todvn.barnstable.ma.us
Office:. 508-862-4038 Fax: S08-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE: /O
JOB LOCATION:
number street e , G L/ c� s v�illlagee G-
"HOMEOWNER": ffkAj1 Zb �ToI1 n157N T��. "(d`� T�7/ C117Z ! //
name home phone# work phone#
CURRENT MAILING ADDRESS: QL1 Gl��
016
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
Pcrson(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 be/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.
igna of Homeo
Approval of Building uildin 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 hoineowner performing work for which a building permit is required shall be exempt from the provisions
of this section(Section 109.1.1-Licensing of co, struction 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/certifi cation.for use in your community.
Q:forms:homeexempt
. e
IHEr Town of Barnstable
` Regulatory Services
y' AB
KAS& IE� Thomas F. Geiler,Drirector
i639 ��
Fora Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-8624038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
as Owner of the subject property
hereby authorize to act on my behalf,
in all matters relative to work authorized by this building permit application for:
(Address of Job)
Signature of Owner Date
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
n-Pr)Pk,tc•nwuFaPF1?XAYQcinU
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Ma Parcel
�-- �
A lication#
p pp _
Health Division` ' Date Issued6.6
Conservation Division Application Fe ,
Tax Collector Permit Fee ou
Treasurer
Planning Dept. a
Date Definitive Plan Approved by Planning BoardJI l
Historic-OKH Preservation/Hyannis
p`� U
Project Street Address d J C
Village C9-Tfl)T
Owner R►cF,/.,Rp .T 3bis,-),rj Address TUiT k�
Telephone 1-0 yam;7
r tii c 11 j Z
Permit Request o y
Square feet: 1 st floor:existing proposed 2nd floor:existing proposed _Total new
Zoning District Flood Plain Groundwater Overlay c F-
Project Valuation Scram _ rz Construction Type Woob
Lot Size A Grandfathered: ❑Yes ❑No If yes, attach supporting documentation.
Dwelling Type: Single Family 2( Two Family ❑ Multi-Family(#units)
Age of Existing Structure /920 Historic House: ❑Yes ® No On Old King's Highway: ❑Yes dN o
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: ❑Gas ❑Oil ❑ Electric ❑Other
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size
Attached garage:❑existing ❑new size Shed:❑existing id new size O er:
Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑
Commercial ❑Yes ❑No If yes, site plan review#
Current Use Proposed Use y
BUILDER INFORMATION
N e_ /11(L. �(v ,h,ti Telephone Number t�O `f pZ S%'9
Address. D 0r, License#
�J_ ald5s< Home Improvement Contractor#
Worker's Compensation#
ALL CO STRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO
VIGNATURE
(
/ FOR OFFICIAL USE ONLY
R
/ APPLICATION#
\
DATE ISSUED
} . MAP/PARCEL NO.
ADDRESS VILLAGE .
\OWNER
/
} cf
> -
/ . . .
� .
DATE OF INSPECTION:
3 .
� FOUNDATION
FRAME
ƒ INSULATION `
$ .
\ FIREPLACE
\ ,
¥ ELECTRICAL: ROUGH FINAL '
; .
\ PLUMBING: ROUGH . FINAL
$ GAS: ROUGH FINAL
( .
\ FINAL BUILDING
t . . . . .
{ DATE CLOSED OUT
\ ASSOCIATION PLAN NO. -
: ` ►
( / • \ �`
2 .
` a The Commonwealth of Massachusetts
Department of Industrial accidents f
Of of Investigations
600 Washington Street
Boston,MA 02111'
www.mass.gov1dia '
Workers`Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le ibl
Name CBusiness/organization/Individual): 4 217 <D `7J\/
Address:
City/State/Zip: CD7 90
Phone.#:
Are you an employer?Check the appropriate bog: :Type of project(required):.
1•❑ I am a employer with 4• ❑ I am a general contractor and I
* have hired the sub-contractors
6 (]New construction .
employees(full and/or part-time). 7• Remodelin
2;❑ I am a•sole proprietor or partner- listed on the'attached sheet ❑ g
ship and have no employees These sub-contractors have g• F]Demolition
employees and have workers'
'working for me in any capacity. 9. ❑Building addition
[No workers' comp.insurance comp.insurance.t
5. [] We are a corporation and its 10.0•Blectrical repairs or additions
equir h officers have exercised their 11.❑Plumbing repairs or additions '
3. I am a homeowner doing all-work .
myself [No workers'comp. right 6f exemption per MGL 12.❑Roof repairs
insurance.required.]t ' . c. 152, §1(4), and we have no 13.❑ Other
employees, [No workers'
comp,insurance regiured j
*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-contractors and state whether ornat those entities have
employees. If the sub-contractors have employees,they must providt their workers'comp.polidy number.
I am an employer that is providing workers'compensation insurance far my employees. Below is.the policy and job site,
information.
Insurance Company Name:
Policy#or Self-ins.Lic,M Expiration Date:
lob 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$1,500.00 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 be forwarded to the Office of
Investi ations of the INA for insui ce covera a verification.
I• o he by certify under the pains•and pe alties of perjury that the information provided above is true and correct.
Si ature: Date:
Phone#: - s
Fial use only. Do not write in this area, to be completed by.city or town offciaL
or Town: ' Permit0cense#
Issuing Authority(circle one):
1.Board of Health 2•Building Department 3•City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other
Phone#:
Contact Person:
'THE Town of Barnstable
�OF Tp��
Regulatory Services
* BARNSTABLE, Thomas F.Geiler,Director
y MASS. g
Q� 1639. .0 Building Division
ArEp ,ts 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:
JOB LOCATION: L f Q (Q
number street village
"HOMEOWNER': l?/,_-h :+(Zl7 Al f7/g- `j 6
name home phone# work phone#
CURRENT MAILING ADDRESS: -/6 G—A<-k SJ r-1 Gl
CoT<ir i Q?�c� D M 3S
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 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.
gnature f Homeowne
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/certification for use in your community.
Q:forms:homeexempt
�1HEl Town of Barnstable
d ,
• �. Department of Health,Safety,and Environmental Services
Btasrnat,E,
MASS.039. Conservation Division
200 Main Street,Hyannis MA 02601 s`
Office: 508-862-4093 Robert W.Gatewood
FAX: 508-778-2412 Conservation Administrator
MINOR ACTIVITY REGISTRATION
Pq
Property Owner Telephone number
Da-
Mailing address
Project location .' Map/Parcel#
Project description
The following minor activities will be reviewed,under Art.27,by Conservation staff instead of the .
Conservation Commission,as long as they are constructed at least 60' from a wetland resource area or to '
of.a coastal bank.
* Pathways 4' in width
* Fencing that does not create`a barrier to wildlife movement,6"above grade:
* Conversion of lawns to decks,sheds,or patios that are accessory to single family homes,as long as:
=house existed prior to August 7,1996
alteration within the buffer zone is less then 250 sg:feet.
sedimentation and erosion controls are used during construction
* Stonewalls(this does not include stonewalls for retaining wall purposes,grading and/or fill)
Signature ate
61
4/
'Revie b Dat
wed '
_GIS Plan Attached(fee`charged for plan)
Q/VdPFiles/Form/MinorAct
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NOTE:PARCEL LINES MAY NOT BE ACCURATE. The DISCLAIMER:This map is for planning purposes only. It #6 Ir #3n
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parcel lines on this map are only graphic representations of may not be adequate for legal boundary deternwination or _ _ ,
Assessor's tax parcels. They are not true property regulatory i merpretation.This map does not represent an - 0 5 10 20 Feet
boundaries and do not represent accurate relationships to on-the-ground survey. - - -
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V Assessors map and lot number. .............................................
TWE
SEPTIC SYSTEM MUST ropy
Sewage Permit number ........:.......................
INSTALLED IN COMPLIAN
WITH TITLE 5 AUs E, •
-aAouse number a T4DL
tY.............................:.................... ,, .�c MABa
/Jc ENVIRONMENTAL COD Ay °`moo 39
AI
TOWN OF BARNAB E N ,�
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO .................... ... .................. ... .................... ..............
• � v C
TYPE OF CONSTRUCTION ................. �.qn. .......................................................... ....................................
..................... `�J................19 .
TO THE INSPECTOR OF BUILDINGS:
e
The undersigned -hereb
y
-applies for a permit according
., to the following information:
Location ......................... T�. ................... �...5�1 b .,. .....! `.�+.�............. {M}..........................................................
ProposedUse .................. �..� Q ........................................ .......... ..............:.. . o
Zoning District ...................Fire District ................... 1>..................
Name of Owner .... .1. '`)S L' (.................Address
Nameof Builder ......... .. .. .: .....Address ......................................................................... ........
r� h .so✓J
Nameof Architect ........................................................'........Address .....................................................................................
Numberof Rooms ...........:...........................................:.*........Foundation ..............................................................................
Exierior t 1
......... .�...... >.. ��.........................................Roofing ................ . ........ ... .1�,..................................
Floors ................... ........ .....................................................Interior .............:.......................................................................
Heating' ..........................................................................:.......Plumbing ...............:.::-::.........................................................
Fireplace ..................................................................................Approximate. Cost ......./,ZOJ.�.....................................
Definitive Plan Approved by Planning Board ________________________________19________ . Area ......���..6.0:..... .............
........
Diagram of Lot and Building with Dimensions '" Fee Q..... .. ....................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
pro
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1 `
9
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OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Bgrnstable regarding the above
construction.
Name . .. ... . . .......
Construction Supervisor's License ....................................
f
JOHNSON, RICHARD P.
28319 Build A ch Garage
No ................. Permit for ...................t..�.�:....�d...
Sin.$ ...
le Fami... ....l Dwellin. . . 5...... .... ........ . . ......
Location ......40 Jackson Drye,,,,,,,,,•,,,,,,,,,•
N
Cotuit #-+ �-
. ............................................................. . ............... , r
Richard P Johns
Owner •..............C??1..................
..............................
Type of Construction ......FX.ame.........................
+_ Y
.....................................................I.......................... .ti
. yr^ •f fI
Plot ............................ Lot ................................ .;
August 13, 1
Permit Granted 19 85
Date of Inspection ....................................19 - y
' f �
Date Completed .................'},:f;..19 : J}
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Assessor's map and lot number ........................................... �oF TNs Toy
P �
Sewage Permit number ..............................................1.....
N Z BARNSTADLE,
i
��House_num'ber..............LAQ..... oo i639 �m
................................................ y,sue MARL o�
'F0MAv a.
f TORN OF BARNSTABLE
{inusT
M N7A I N z�
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO. .................... . ...................... ........................................................
TYPE OF CONSTRUCTION ................. Sl . ......................................................... ..................................
.....................5. � ?................19.K.
TO THE INSPECTOR'OF~BUILDINGS:
The undersigned hereby applies for a permit according tthe following information:
�_—
Location �. ...��, C§011'. ` `�..................... ............. ... ..................._..................
ProposedUse ..................a9fp%�'P........................................................................................... .............................................
......................................Fire District .................... .
Zoning District .................. .y�........................ a
Nameof Owner,ChS�..�-....-�C`Jf�� .................Address ....................................................................................
Nameof Builder ... .......... ....Address .................................................................... .. z
rich f' 7�h Nsa✓J '
Name of Architect ................ Address ..............................................................................:.....
.............
Number. of Rooms ..................................................................Foundation .....................................................................
Exterior .......... kX',. ....` .. .1 ..........................................Roofing ............ ,a'*'...... �.Q..............................:.....
Floors ... .....................................................Interior ...............
Heating ".- Plumbing
...............................Approximate. Cost ....... ....Fireplace ...... ................ .: .... ...:.1. ... PP � :.............. .....................
Definitive Plan Approved`by Planning Board ________________________________19________. Area .... .... ......................
j
Diagram of Lot and Building with Dimensions Fee Q .�r7....
,SUBJECT TO APPROVAL OF BOARD OF HEALTH
1
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree ree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
9 9
construction. L
i
Name .. ..... .... ._. ....--
Construction Supervisor's. License ........:..........................
JOHNSON, 'RICHARD P. j A=019-'082
q
No Permit for ....dui ld...Attached. Garage
............SingLZ...EaMilv..Dw.elling..................
Location ....4.Q..J B,--kg.Q i L..D r j-v.e.........................
.....................C.Qtjlut..............................................
Owner .....R.:kqh.4.r.d..FA...jQhj1$.QT1.....................
Type of Construction ......Framp..........................
................................................................................
Plot ............ Lot ................................
Permit Granted ....August....13, 19 85
Date of Inspection .....................................19
Date Completed ......................................19
QUERY •PROPERTY: QUERY END
QUERY PROPERTY
PENTAMATION----------------------------------------------------------- 08/15/00
PARCEL ID 019 082 GEO ID 676
LOT/BLOCK 2 DBA
PROPERTY ADDRESS OWNER JOHNSON
40 JACKSON DRIVE RICHARD
KATHLEEN JOHNSON
COTUIT 40 JACKSON DRIVE
COTUIT � MA 02635
PHONE DISTRICT CT
DEVELOPMENT STATUS C ASSESSOR' S CODE
CAPACITY(NOTES)
ZONING DIST/ZOC RF SEWER SYSTEM
FLOOD PLN/ELEV. WATER SYSTEM
OKH? # BEDROOMS
ZBA DECISION FAMILY APT
LOT SIZE 21780 OPER/MGR NAME
WET LANDS MULT ADDRESS
USE 101 PROTECT DIST AP
(N) EXT / (P)REVIOUS / NO(T) ES / PER(M) ITS /
(V) IOLATIONS / (G)EOBASE / (E)XIT
NO MORE RECORDS IN THIS DIRECTION
V �
i,
�r nv.
�.- TEL Jul 25 '00 12 :52 No .005 P .01
One Centre Street MqPafthy- ss McPafth,y.' .
Wakefield, Massachusetts 01880
Phone: (781)246-4647
Fax: (781)245-1416
Fax
Kathy Maloney From: McCarthy& McCarthy
�� Mike McCarthy
iFaw 508- C 1 Date: 7/25/0012:08 PM
Cc: Pages: 4, including cover sheet
Urgent x For Re vlow< O Please Comment O Please Reply ❑Please Recycle
Re: Attached are letters ftrn Attorney Murphy to Mr. Crossen and from Mr, Crossen to
Attorney Murphy, Can your office confirm that Mr, Crossen's opinion on Lot 1 is
unchanged?
Thank you for your Its$a�e.
Very yours,
1
4
THIS DOCUMENT IS INTENDED ONLY FOR THE USE OF THE PERSON TO
WHOM IT IS ADDRESSED. . IT MAY CONTAIN INFORMATION WHICH IS
PRIVILEGED, CONFIDENTIAL AND EXEMPT FROM DISCLOSURE UNDER
APPLICABLE LAW. If you are not the intended recipient,, any dissemination,
distribution,copying or use of this document is strictly prohibited. If you have received
this communication In error,please notify us by telephone(781-246-4647)to arrange for
the destruction or return-of the original document to us.
F
I
TEL : 3u l 25 '00 12 :53 No .005 P .02
.,•- -•- rw...l.l� ,•rdv fll len tNut J1
" 'he Town of Barnstsible
a, Dopottiment of Health Sotbty and Environmeotol Services
Dauding DIVmOn
S67 Mehl 8tt K Ryamis MA 02601
UMC 30&790-6227 1talpli Crnseett
Pex: S09-790.6230 Buildies ConunWumr
Maroh 10,1998
Laster•71 Mutpiry,.ir.
Attorney at Low.
P.0.BOX 1338
Bast Dennis,MA 02641
Deer Attotuo�Mutyby::
Aber mlow uryaivrlffM COMMIng LOU#1&Q On Jackson St**a p&I=that bosh
am bulldablx Gatti a ZOPO Urttdpobt
BiM1Ccr6ly,
Mph COMOo
Building CmMbsiaaer
RC-lb
7/ / fi 'Q ld OD FRI 1B 1 lTX/t3I 1v0 70721 .fb0U1 i
f
�. TEL : Ju l 2"5 '00 12 :53 N9 .005 P .03
jLEST'ER J, MURPHY, A .
ATTORNEY AT LAW
P.O. Box 1388 I380 Rjz. T& 134
F!'LEA"014 (50a) 385-8313 EAST DEWN1S, MA 02641
FAX(Rna) 385-7033 Mara 16,fW&TO PILE 1-40,
WA FAX-79"2M
Tmn of Barnstable
Off"of(ho Beuldkllg U%m"o
Town Hall
367 Main Street
HyNWB,MA 02601
Ammo:Ralph Crosue
RX:14h 1 and 2 Jael+~o.A Strest• Owner Margaret a Campbell
Doer Mr,Crosson:
Please be edvl"d that 1 repx"t Fit'W.(kavens Who has omtracted to 1lrchase the above re
parcels of laud.
P faerrced
rx two lots are shorn on a 1919.AM Flan and onh lot is said to ca*it11,04 saxes. Both lots are
cltmu*owned by Margaret&Cm*11.
WiU You kindly advise as wheitliar each of those lots(i.e.lob I and 2)is a separate legally buildable lot for a
sipgo- iy residence Candor dw Town Of Barnstable&OW By-Laws premelltly m exic erne or under
Consideratim for a ueudineaat,
The closing is clrrremily SAWed f0t March 23, 1998,so your inroediate assistance in this matter will be
ON appimiated.
T'hwk you for ym aatid pod Coopmation in this matter and ahmild yak have my qualio=pleaoe do not
hesitate to ooatect me,
Cordially,
Lester j.M y,Jr.,
AWmay At Law
IJM/Oaa
TEL Jul 25 '00 12 :54 No .005 P .04
IM46
/IL L E BEACH RD
som*041t
I
I
� o ao ao so
.45.316 SF
i t
f-- 04.A.Cs t l
W e6
cr I W
loom
I t
o ' . N99.10'04"w v I
w A ; CERTIFY THAT THS PLAN CONFORMS TO
�2 1 THE RULES AND REGULATIONS OF THE
3 I REGISTERS OF DEEDS.
> 14
45.317 SF t
1.04 AC. I I
S.N.17.33 .
Z • ► I BARNSTABLE PLANNING BOARD
n APPROVAL NOT REQUIRED UNDER
I I SUBDIVISION CONTROL LAW.
OAT
E: —��'• a 1�f�''
I t