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HomeMy WebLinkAbout0590 MAIN STREET (COTUIT) x. �- p Town of Barnstable *Permit# dZ�3� 10 0 Expires 6 months from issue date Regulatory Services Fee s�atvsr��.E. = . MAM Thomas F.Geiler,Director039. . Building Division (.PRESS PERMIT Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 J U N 2 g 2012 www.town:barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESID RNSTABLE' Not Valid without Red X-Press Imprint Map/parcel Number Property Address [Residential Value of Work J` lib Minimum fee of$35.00 for work under$6000.00 / Owner's Name&Address `Cje�; �j A4.t//ol2-1-6. x y e Contractor's Name,X //7, ,�[��I C�G�S' Telephone Number —,JCS l q�,7 V/ -7 Home Improvement Contractor License#(if applicable) A � Construction Supervisor's License#(if applicable) b orkman's Compensation Insurance Check one: ❑ I am a sole proprietor the HomeownerU4- . have Worker's Comp ensationon Insurance Insurance Company Name /a i/- if!.S Workman's Comp.Policy# 1:7_-57 tZ 1; t 7 71 g , Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side _• tf S gu�i«S / #of doors ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#.of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.- ***Note: Prgperty,Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required.. SIGNATURE: .� C:\Users\deco al\Microsoft\Windows\Temporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doe Revised 072 i 10 r , 1 _ License or registration valid for individul use only. before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation . 10 Park Plaza-Suite 5170. Boston,MA 02116 _ 1 ------------ Not valid`without signature . I . r, e i (9, e WommolmejealtX a1(D1 %r%aclzeoe6 I Office of Consumer Affairs&Business Regulation kWME IMPROVEMENT CONTRACTOR ; egistration: .156887Type: iration: .-;,8/13/2013-. Partnership p ALL CAPE PAINTING 8 CARPENTRY, JYL HENDRICKS 19 QUASHNET RDA MASHPEE,MA 02649 Undersecretary I I -' iVlassachusetts- Department of Public Safety Board of Building R , . e2ulatiOns and Standard_Construction Supervisor License License: CS 90884 JYL'M HENDRICKS PO BOX 2103 MASHPEE, MA 02649 '? 2 Expiration: 7/1412012 Commissioner Tr#: 28975 77te Commonwealth of Massachusetts Department.of Industrial Accidents Office of Investigations vi 600 Washington Street. Boston,ALA 02111 ivww.ntass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/ElectricianslPlumbers Applicant Information Please Print Legibly Name(Business/Organization&&vidual): /� n -�✓1 (.� aG A,i 4 717 7 Address: ,O . /G3 City/Stat&Zip: Phone lk 0--4 Are you an employer?Check the appropriate box: T of project(required): 4. I am a general contractor and I 3'Pe P .l ( mod)= 1.❑ I am a employer with ❑ g 6. ❑New construction full and /or part-time)-s have hired the sub-contractors employees( p ) 2.❑ I am a sole proprietor or partner- listed on the attached sheet 7. Fftmodeling ship and have no employees. These sub-contractors have S. Demolition w for me in an capacity. employees and have workers' working Y � h'- I 9. ❑Building addition [No workers'comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its ME]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.]f c.152,§1(4),and we have no employees.[No workers' 13.0 Other comp.insurance required.] ;Any applicant disc checks box#1 trras<also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all world and then hire outside contractors mast submit anew affidavit indicaung such. Contractors that check this box mug attached an additional sheet showing the name of the sub-conuacters and state whe&u or not those entities have employees. If the sub-contractors have employees,they mast their workers'comp.policy number. I am an employer that is protriditlg workers'compensation insurance for my employees. Below is the policy and job site information Insurance Company Name: ���✓'� ��t's Policy#or Self-ins-Lie.#: ,,,A / / Expiration Date: / A) ,3 Job Site Address: c�yt7 `� -A fT �d Aril City/Stat&Zip: (_/�y�i�t+ 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby rti under the pains,andpenalties of perjury that the information provided above is true and correct Si to re: r 0 t Date: t S�0 r 3 e// Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: 6 FROM:WAWOIT INSUKANCE TO:16084101740 06/28/2012 00.00:42 4103.34 P.001/001 AC R& CERTIFICATE OF LIABILITY INSURANCE DAT[IMM DDIYYYY, Iaw. -- 6/28/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS i CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THI$ CERTIFICATE OF INSURANCE DOES NOT, CONSTITUTE A CONTRACT BETWEEN THE ISSUING ?NSURER($', AUTHORIPED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, IMPORTANT: If the certificate holder is an ADDITIONAL INSURED.the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to tho toems and conditions of the policy,certain policies may require an endorsement. A,statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). _ PRODUCER TACT NAME, Nosh $tecormick Naquoit Insurance Agency PHONE cull {508)540-191916&so iF bai Isue{asr ues 516 Waguoit Highway E.M L rlmccozmicAtdmcCozmickinauratac®.eOm RERlS)AFFORDING COVERAOE NAIC Iva4u oit ...MA 02536 INSURER A:IQtlTf01_. k & Dedham Mutual 123965 INSURED iwsvjFRyB:The Travelers Indemnity colmman 25682 All Cape Painting & Carpentry, LLC INSURER ^ 19 Quashnat Road N9URERD INSURER E Mash as KA 02649 1 INSURER F: COVERAGES CERTIFICATE NUMBER:CL1262801550 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF iNSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CER1IPICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE.FOLICIFJ DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONOITIONS OF SUCH PCLICIES.LIMITS SHO:NN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IHSR uw..+TYPE OF INBURANGE _ p 1 Y UMBER POLICY EfF POLICm i ...M•�� LIMITS GENERAL LIABILITY FACHOCCURREN'LE t 1.000.000 $ Y;MMERGALGENERAI.s.IAHIU7Y !, SiERcocymn.@ $...-.-:.:...•..,.. $0,000. A f CLAIMSMAOE OCCUN �1174331A /a/solo a/Sl2E18 �N,EI)4x/(A.vmePeson, S _ 101000 PERSONAL d AM INAMY S 11000,000 _.....,_,:.,.....� ........ i GENERAL AO0NE6,41F S 2,000.000 �3E.N1 AGOREQAiE Llnut,.P`Pu_LS V[P.: ' PRODUCTS-CUMF'/OP AGwr $ a.000,000 X fKLICY? Fr,T 3— I f.f)f: S AUTOMONILE LIABILITY t�. EO,iINGLC LIMIT ANY A{,1TO BODILY!NJURY IF4w person) t - } ALL OWNED SljrlilCllifU HODILY iNJURY(Pew a^_aidenl) S —. AUTOS All CIN* NON-OWNED I j PRO:o-1 DP.MAGE S NfiiEti A:)TO:i A;l'r/7tiIPRr RGGIa0n11 :_.:............... _._. UMBRELLA LIAR pCCOR I ,FbdH.00CIiRRENCE S _ EXCESS LIAO, CLAIMS•MAL;E` ACi(iN4CATE $ i LIED RETENTION S S ` B WORK06 COMPENSATION - nT:57A7U• 0T11- ANP EMPLOYER$`LIAp{CITY YIN I •,•.•� AN4 FROPN ETOR'PARTNERIEXEC'JT'N/E(-- N)A, I C L EACH ACCIDENT S •100,000 FFICERn�F.. 01;R FxCIIR)5L`? (` .r fi,'.d/a 01a Si B/2013 ,._• (Mandatory In NH) IBUBiA77.90212 EL f.71SEdSF F..A EMPLOYEE s 100,coo I if Vat,da--be under tA,'(V RIPTION OF OPERATIONS W!vw El DISEASE.•POili:r i,.1411T 6 500,000 I DE5CRIP1ION OF OPERATIONS I LOCATIONS/VEHICLES(AttecP ACORD 101,Addluonal Remarks SchedNlo,ii more apace is re4ulred) �R CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF T HE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERE-OF, NOTICE WILL BE UELIVERED IN Essex Builders Corp ACCORDANCE WITH THE POLICY PROVISIONS. 400 Blue Rill Drive Westwood; MA AUTHORIZED REPRESENTATIVE ACORD 25(2010105) u' 1989-2010 ACORD CORPORATION, All rights reserved. INS025,,wicosl oo The ACORD name and logo are registered marks of ACORD All Cape Painting& Carpentry, LLC P.O. Box 2103 Mashpee,MA 02649 5.08-509-2107.,/ 508-509-3417./Fax: 508-419-1749 M/WBE- DBE Certified Firm June 29, 2012 Sarah Harrington 590 Main Street Cotuit,MA 02635 ESTIMATE FOR WORK TO BE PERFORMED AT: 590,Main Street, Cotuit,MA 02635 Scope of carpentry work: Replace approximately(4) squares of white cedar shingles, 52'lineal feet of rotted trim in various areas (around windows, corner boards and rotted gable tail ends).The areas of siding to be replaced are:the wall to the left of the side entrance.to the house,the upper gable above front entrance and the right side cheek of the upper dormer at the driveway.The shingles will be replaced with white cedar shingles:Xtra R&R's. Once the existing shingles are removed'and exterior sheathing cleaned of old fasteners a vapor barrier will be applied and shingles will be installed with galv. siding fasteners to match existing coursing. GENERAL CONDITIONS: Customer will assume responsibility to remove from any and all work areas, all household and personal items (with the exception of large furniture such as sofas and beds), and store those items away from work area during the duration of the.job.Due to insurance regulations and safety procedure,the customer,other contractors,workers,children,pets and individuals will not enter the work area unless agreed upon by both the Contractor and Customer.All debris will be removed and the work area will be kept clean. Cost of clean-up and disposal of debris is included in the estimate. ESTIMATE: This estimate includes permit fees,labor and material for the above said work to be performed.All material is guaranteed to be specified,and above work to be performed in accordance with the. specifications submitted for above work and completed in a substantial workmanlike manner for the sum of: $4.200.00 with payments.as follows: A deposit of: $ 2,100.00 is required,the remainder due upon completion. - Work to begin: Duration of job: 3 Days Completion dater Respectfully submitted: Vicki L. Elias and jyl M. Hendricks Any alteration or deviation from the above specifications involving extra cost will be executed only upon written order,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents,weather or:delays are beyond'our control.This proposal may be withdrawn by us if not accepted.within 14 days. All Cape Painting.& C-arpentry, U.0 ACCEPTANCE OF PROPOSAL The above prices,specifications Arid conditions are satisfactory and are hereby accepted. All Cape Painting&Carpentry,LLC is authorized to do.the work as specified above.;Payments will be made as outlined above.All Cape Painting&Carpentry,LLC is fully licensed and insured in the Commonwealth of Massachusetts: CSL: 90884`/ HIC: 156887.,Insurer:'Waquiot Ins. 508=457-1087 Please make check payable to All Cape Pain ting&..Car ent ` LLC Signature Si ature. Sarah Harrington., to ` Date \, 4 Signature: 4.� � , Signature: L Z1 �_ g- Vicki-L.Elias Date ..Jyl .Hendricks ; Date �P TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �� U Map Parcel Permit# RS31"A0 Fi Health Division l `� 419 7�F{��'j�`"�"` 8141RN;;I nBL6 Date Issued 1 2Jd _ Conservation Division 7T`�j ) 0 � 4 j — Fee 436.o 0 A Z ri 9 i Tax Collector 1��' G G4{C— Fe-e-f� Treasurer '°I S f Oft Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address I, Village `T C1 Owner ��b 1�1�1�—� &G_P-PUtn1-7_�Address 76 FOX 0-1-3q Telep �hone � P.(a 1�^0 Permit Req est �� j� Square feet: 1 st floor: existing SO proposed 2nd floor: existing proposed Total new Valuation .Zoning District P,0 Flood Plain Groundwater Overlay Construction Type Lot Size W..$2— Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family L?e' Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes &Iqlo*, On Old King's Highway: Cl Yes Q-M Basement Type: U*11�iull drawl 0 Walkout ❑Other +� Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) J, 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: U1'Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes Mb"'_ Fireplaces: Existing New Existing wood/coal stove: ❑Yes .19<0 Detached garage:h2 existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size Attached garage: ❑existing 4.❑new' size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# V Current Use _ Proposed Use BUILDER INFORMATION Name (ZLwC Telephone Number , Address X License# Oa Home Improvement Contractor'# Worker's.Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 7 a� FOR OFFICIAL USE ONLY , PERMIT NO. ' ')DATE ISSUED � � ' ` ` • � ,r MAP/PARCEL NO. , ADDRESS VILLAGE OWNER r _1 DATE OF INSPECTION: FOUNDATION FRAME INSULATION r FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL . GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. ; Town of Barnstable Regulatory Services UXNsTMLEv ' Thomas F.Geller,Director MAM �* ��Drp`m Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction, alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:;? Estimated Cost �!04 ®� Address of Work: ��7C, Owner's Name: Ted Date of Application: I hereby certify that: Registration is not required for the following reason(s): OWork excluded by law ❑Job Under$1,000 ❑B g not owner-occupied caner 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: Date Contractor Name Registration No. G J OR D to Owner's Name Q:forms:homeaffidav The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations d 600 Washington Street f Boston,MA 02111 y www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'bl Name (Business/Organization/Individual): Address: City/State/Zip: Gvs 3P ione#: D7 Are you an employer? Check the-appropriate box:. Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet $ ❑ Remodeling ship and have no employees These sub-contractors have 8.-❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or.additions Xquued] officers have exercised their 3.EY1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. C. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp..policy.information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 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 Investigations of the DIA for insurance coverage verification. I do hereby certify u er the pains and penalties of perjury that the information provided above is true and correct Signature: Dater G Phone#: — 7•-O 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." 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 deemedto be an employer." MGL chapter 1152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' Department at the number listed below. Self-insured companies should enter their 'on policy, lease call the ep compensation ,p � P Y the ro riate lin self-insuranc e license number on app e.p City or Town Officials legibly. The D Department has provided a space at the bottom Please be sure that the affidavit is complete and pantedep P 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. Anew 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 for our The Office of Investigations would like to thank you in advance y cooperation and should you have any questions, t hesitate to give as a call. please do no � The Department's address,telephone and fax number: a The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia Town of Barnstable o„ Regulatory Services sAxslns Thomas F.Geller,Director NABS. 039• ,0� Building Division rf nr 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 . //'T/,/ DATE: 7 JOB LOC ON: ��p �UT(ll�/ /!��(�/� �^ �Gh2I number - /� —street �q village .HOMEOWNER": F,��cm� V L.t. JL'9J l U?/L� name home phone## L ' work phone# CURRENT MAILING ADDRESS: 7d -602G_d� 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 su eQ rvisor. 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. !i4ure 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 perfomung 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. 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SEPTIC SYSTEM M f C%THETO 6NSTALLED IN COMPLIANC ��Q`' Sewage Permit, number ................ ...................... ••••••••••••• WITH TITLE 5 �r .ENVIRONMENTAL CODE ZA"STIELE, House number ,.:........:....... O �C TOWN REGULATION oyAYd TOWN OF ,, BARNSTABLE N 741 BUILDING,.!' INSPECTOR ho�-- r A APPLICATION FOR PERMIT TO / �� ..... :P...........:. TYPE OF CONSTRUCTION OQ � ..7./' iZP..:..................................................................................... .SP........................................19.,?J• TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .......................N �.f......� t...........:.4 .'.••: .................................,......:.,.........,............................. Proposed Use .. !�?�/ ..... C /a/ .... �.... P/7.C—P........................................................................ Zoning District Fire District .`'����r ..................�. .............................. .................................................. Name of Owner ...... Address ... ..... Name of Builder .................................../...............................Addresses.-r-7. 7.... ... Name of Architect / i �IIYJ�l�tr�..... ............ . ......................Address ............................................ Number of Rooms ..... ..............................:.....................Foundation Ct° 7-P12 . Exterior ��� ��.�% / .....Roofing � `�............... ......... ........................... ........................................ ...................................... o .A *! G�c a Floors1..." ....:......... .....................................................Interior ............................. .................:. Heating 000 �e/ P Plumbing� ................. Fireplace s�f� r �...............A Approximate Cost ....00 ®��..............................f./ p pp /............. . Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area D ........... .. ................ .. . Diagram of Lot and Building with Dimensions Fee a ........................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 26 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 22� Name .. >WAY.. � .......................... Construction Supervisor's License .............:. HECHT, DONALD flo ... ... Permit for APPIX.N.N/RZKOEL 4 Sin le Famil Dwell ........................ 590 Location ....... P-t........................ ............ ......... ............................................. Owner ......Donald ................................. ...... . .. .. Type of Construction .......Frame........................ • Plot ............................ Lot .�.............................. Permit Granted ......Sept. 17. .... .....19 85 ........................ Date of Inspection . .......... Date Completed ............. ........119. % Cc' 101' Cr �-�y�0 odd ���� .�I �, �,a � ,o .s o� �� Assessor's map and lot number ...................... . ........ STHE jo Sew ne, age Permit number ......................................................... 11AB113TAIME, House number ....................!V... 73. ...... MAG& MPY Or. TOWN OF BARNSTABLE BUILDING INSPECTOR 0� N FOR PERMIT TO APPLICATI,AQ ............................. ........... TYPE OF CONSTRUCTION .... ........................................ ...................... ........................ /.7.......................192F TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: 74 Location .......I.......... ...117 ............................................................................................ . . ....... ...... ProposedUse ..Cl. le..... ..................................I......................... .............Zoning District ...... ...................................................Fire District .............................................. ............................... Name of Owner Z���.....& .............Address ebb,4? "f- ...................... ............... Name of Builder ..................................... ........................Address ress Ido Name of Architect ................ ...... Number of Rooms ..... ............................................................Foundation 6p"245-1 /..........r... 145�.:.14—........................... Exterior ...............................Roofing .......................................... Floors ....................... ........................... r ....... ..... Interior ............... ........ .................................................... Heating .................. ...................Plumbing ..................................t.......... .................... F P-) ............................. Fireplace ......................r.......... ...............Approximate Cost ....SP Definitive Plan Approved —byl Planning Board ---------------------------------19--------- AreaA ...1. .. ..Diagram of Lot and Building with Dimensions Fee ............ .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ti OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. as r Name ...A/ .......................... Construction Supervisor's License .................................... /HECHT, DONALD A=36-25 J No .28434 permit for .... DITIONrREMODEL Single Family Dwelling .... Location .... 590 Main Street,,,,;, Cotuit ............................................................................... Owner ..... onald Hecht .................................................. Type of Construction .........F. a we...................... ................................................................................ Plot ............................ Lot ................................ Permit Granted September 17, 19 85 Date-of Inspection ....................................19 Date Completed ......................................19 �a 7p- �le y._ COT UIT s - r LOCUS MOSSWOOD CEMETERY LOWED QJ • 1 . . COTUIT oES LOIyLc A.M• 36-24 _ �d � CD D COTUIT KBAY q6��1`��0 - , , rn LOCUS MAP .�, P�1• �:2 ,�,1 cA PLAN REF. 78-43-F2 & 213-87 YL pyP GAR DEED REF• 11382-307 ASSESSORS MAR. 36-25 15• DECK ZONING: »R�,» SETBACKS. 30'-15'-15' JAI' PLOT PLAN OF LA ND #590,,,,,69, LOCATED AT 590 MAIN STREET 3 �,,,,,, - � COTUIT, MA. PREPARED FOR: AREAI? =602ofS:F. 1 � _ EDMOND J. -. CLERMONT rn A.M. 36-25 /✓Kr, w SCALE 1 ' 20 ' B V ����.e ` a JUNE 28, 2005 �' .i ( '�• ® av,J�'GG -ci��(i Ch`n: REV PS-EF-0 �l ® REV coY�` ,° REV YANKEE SURVEY CONSULTANTS .• , k v�®Q� UNIT 1, 40B INDUSTRY ROAD P. 0. BOX 265 MARSTONS MILLSMA SS 02648 TEL 428—0055 FAX 420-5553. s. SHEET I OF 1 JOB �,- ,539�21JF