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HomeMy WebLinkAbout0343 MARINER CIRCLE _ 4' ME r° Town of Barnstable RAE. _ Regulatory Services 9 MASS. 1659. D 1' Building Division 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection //' ����%���c. ---I � 3 3 i� Location �vZ r�--yt /e?c c. F Permit Number Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: o� u �T 1�vl(N<�- Yoor c-( t�- -/u c� 7/oit/S TC— !tl(5 410< <'�UA) JOB l�` L��J hi-W r Please call: 508-862-403$ for re-inspection. Inspected by Date 2 VCR b7z, TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f k �J, Map Parcel ® 1 Applicationa0l ® v Health Division _ Date Issued Conservation Division Application F Planning Dept. Permit Fee ' Date Definitive Plan Approved by Planning Board. Historic - OKH _ Preservation/ Hyannis QProject Street Address,.. `-f 3 a.► t o Ir('H e r C i C rVillage- NCO t�� ( wner E(I C f�G S o Gh`W t Adore S`!�. � i�e r Cc c�(�_ C,19 tat cTe_lepl one S-0 Q PPermit,Reguest-�. be Square feet: 1 st.floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation . �^0 U d 3construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No 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, _J Electric ❑ Other N t y Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woody/'coal stove ❑gs ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new' size — Barn: 0=existing ,l nev=size— Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ p rn Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use - e APPLICANT INFORMATION " Y _ (BUILDER OR HOMEOWNER) _ r-Name 5^0� ��n�� � rTelephore,N�e ^r�g �p � o2�,3S— Address � fvl4,lr l hT�, _A U-i T �'/('_ License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNdTIJRE:,4r�l `,�/0 oa DATE -3 / 1Z�/ Z FOR OFFICIAL USE ONLY APPLICATION# x ; DATE ISSUED %,iMAP/PARCEL NO.. ADDRESS VILLAGE 'i OWNER DATE OF INSPECTION: FOUNDATION Q!,T w FRAME INSULATION + FIREPLACE <c ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL :GAS: ._ ,, ROUGH FINAL �.,>EINAL BUILDING .5 of ti oK iN cs DATE CLOSED OUT ASSOCIATION PLAN NO.. ' 4 i The.Commonwealth of Massachusetts '. Deparbnent of lndust7id Accidents Office ofInvestigations 600 Washington Street Boston,MA gZIIl www.mass gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians(Plumbers A licant,information Please Print Leplbl {Bsiness/Org o anzatin/Indivi Name. dual): /� 1/a rc S L Adrhess: �3=T3 City/SgWt72:7;— l l( 2,6 3 Phone#: S T Are you an employer?Check the appropriate'box: . ,. 1.❑ lam a employer with 4.'[].I mn a general contractor and IL7E] project(required): . employees(full and/or part-time).* have hired the sub-contractorsew construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. vemodeling ship and have no employees Thesumb-contractors have emolition working for me in any capacity. employees and have work=`, [No workers'comp:firm ranee comp.msura ce,l ildingyaddition quired•] 5 [L We area corporation and its ectrical repairs or additions 3=L�"l-Za homeowner doing all work ` officers have exercised their ---�' mbing repairs or additions myself [No workers' comp: ; right of exemption per MGLm.� neerequired]t c. 152,"§1(4),and we have nod of repairs employees. [No workers' her comp.insurance required.] tAny applicant that checks box#1 must also fill out the section below showing then workors'compensation policy inform ,L Homeowners who submit this affidavit indicating they are doing an work and then hire outside contractors must submit a new affidavit indi $Contractors that check this box must attached as additional sheet showing the name of the sub-contractors and state whether or not those entihc es havoc employees If the sub-contracton have employees,they must provide the worke�s>c policy omP•P cy nmmber. .1 am an employer that is providing workers. compensation insurance for my employees. Belofv is the p"o&cy and job site IKfoT7Ka1[on 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 e. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year mnprisomnent,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 a Investigations of the DIA for incnranco coverage verification. I do hereby certify under the pains andpenandas of perjury that the information provided above is true and correct (Si titre: O r tp DC q zo Phone_#�..J!^� O� ( • O,07cial use.only. Do not write in this area, to be completed by city or town o lid City or Town: Permit/ icense# E_=I) nSpe Issuing Authority(circle one):1.Board of Health 2.Building Department 3. City/T own Clerk 4.Electrical Inspector 6. Other Contact Person: Phone#: Town of Barnstable i Regulatory Services Thomas F.Geiler, `+ swxrrsrast.E, � ,Director Mass. 1639• .�� Building Division rED MA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE- _`.,4✓l /1 d O ' Z JOB_,LOCATION-3-9.3 M a rc A e r C©4(��- nu�m�ber street village 7 hgi-92 5J !i�'� Ll 77-117 0'0 name home phone# work phone# .CURRENT MAILING-ADDRESS:, . 3 �Gti V r p_i� C; r_Auu 4- 3 5— 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 ownsa 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. CSignature_of Homeowner � C7ApproJal'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 Constriction 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:fomu:homeexempt � a s• pFVe-ram Town of Barnstable ti Regulatory'Servi.ces 9 ". $ Thomas F.Geiler,Director E1659. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.b arnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subjectproperty I J . hereby authorize to act on my behalf, in all matters relative to work authorized bythis building permit application for. (Address of Job) Signature of Owner Date Print Name If Prove Proverty Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. ' Q:FORMS:OWNERPERMISSION �oTAdr 3 4 ; 4 3 o v. Vl c o. n. a� Fn s 7 Y' r �} tTt Nii ., �- p : To -MA.5 06 Aa b DATE -: Se �s SC�tLE - 3 REGISTERED lANA SC/RVE Y4 GROSSht�ll� �. u fVQATJON 1S.LOCATE D " • ti � s� THAT T) l s FO U - HE��EBY- a"RT fF Y THE t' aft irNE LOT AS SNOWAI AN 'CONQ Cs REGAfIIZltt�i ZONING REGUL p0' .BgRNSTABLE. i LlNE,s Am -.LOT. LINES _� = A"GKS FROM. STREET l." SET,H. TV V f i 7LI 'ter S 0 w o � Ll� �`9Jo rY Z^Nam �f i � 5 I.:nr f i—PC4( 5} . ------------- ►� ` s Po�'��QH M TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I Parcel ( Application# Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee Planning Dept. Permit Fee .� Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 313 Mariner [iji�Llr? Village r/t)+u I Owner ' ,_Ua v 1,,4-0 Ame.da, Address (573 Telephone Permit RequesttWhSir&AA+i Y �r Square feet: 1 st floor:existing proposed 2nd floor:existing proposed TotElk ew Zoning District Flood Plain Groundwater Overlay Project Valuation 0 D Construction Type form-r, Lot Size 20b( Grandfathered: ❑Yes ❑ No If yes, attach supportin cumen�tion. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) ��' r / Age of Existing Structure r Historic House: Li Yes No On Old King's ghway: O Yes"' Basement Type: Cif Full ❑Crawl &</alkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing I new Half:existing I new Number of Bedrooms: existing�� new Total Room Count(not including baths):existing 1-6 new First Floor Room Count Heat Type and Fuel: Zas ❑Oil ❑Electric ❑Other Central Air: ❑Yes Cho Fireplaces: Existing New Existing wood/coal stove: ❑Yes &f4o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:W46isting ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes f�No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name Telephone Numbers _ 6 Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. f. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION id �( FRAME 0 �� � �?/Eg, � INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL jr FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. i Department oflndustrialAccidents _ Office of Investigations ;i 600 Washington Street Boston,MA 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/]Electridans/Plumbers Apt)licant Information Please Print Lezib y Name(Business/Orgmization/Individual): Address: 3 I 40� 01 f_GI C City/State/Zip: Q)R_ I I MFt 0 (03'hone:#: Are you an employer? Checkthe'appropriate box: Type of project(required); 1.❑ I am a em _Io er with 4. [] I am a general contractor and I P Y 6..❑New construction . employees (fall and/or part,time),* have hired the stab-contractors 2.[] I am&'sole proprietor or partner- listed on the-attached sheet, 7. ❑Remodeling Partner- ship mdhave no employees These sub-contractors have g, ❑Demolition' workin for me in au capacity. employees and have workers' .$. . 9;•• u�I.ding addition [No workers' comp.insurance comp,insurance. Apnre&] 5. ❑ We are a corporationand its 10.❑Electrical repairs or additions officers have exercised their ll. p b re airs or additionsm ahomeowner doing.ell work ❑ ? P myself[No workers' com9. right�f exemption per MGL` 12.❑Roof repairs insurance required.]t c, 152,§1(4), and we have no employees.[No workers' 13.[ er comp,insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidaf itindicating they are doing all work and then hire outside contractors must submit anew affidavitindicating such. tContractors that cheek this box must attached an additional sheet showing the name of the'sub-contractors and state whether ornot those entities have employees. rf the sub-contractors have emploYees,they must providtr their workers'comp,polidynumber. I sin an employer that is pro-vidng workers'cornpensativx insurance far my employees.•Below is.thepo;licy and jab.site information, Insurance Company Name: Policy#•or Self-ins..Lic,#: Expiration Date: ;ob Site Address:- City7State/Zip: Attach a•copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as iequired under Sectien 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 t)IA•for irSUrance coverage verification, I-do hereby certify under the ains•and pena 'es of p fury that the informatian provided above,is true and.co.rrect.- /PJV_1L11_11V 6 -,r7I Date: Phone official use only.--Do not write.in this area, to be completert 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 b.Other Contact Person: Phone#: Inforina io any In tructi®ns Massachusetts General Laws chapter 152 requires all employers to profide 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 :recebmt nr&as ee•of an individual,partners ',association or other legal entity, einploying-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•dwellin&house or on the grounds or building appurtenant thereto shall notbecause 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 renewal.of a license or permit to*operate a business or to construct buildings in the commonwealth for any applicant•Who has trot produced acceptable evidence of compliance with the insurance coverage required!' Additiom4y,MGL ohapter 152,•§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for••theyerformance of public work until-acceptable evidence-of compliance with the insurance rec,umements of_this chapter have beenpresented'to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and, if nezessary,supply sub-contractor(s)name(s),addresses)and phone numbers)along wish their cer ificate'(s) of insurance. Limited Liability Companies'(LLC)of Limited Liability Partnershipa(LLP)with no employees other than the members orpartners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. B.e 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.orlicense 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-6nter 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 fi71 in the permit/license number which will be used as a reference number. -In.addition, an applicant. that must submit mnitiple 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"alllocations•iu (city-or town)."A•cbpy of the affidavit that has been officially stamped or marked bylhe 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 mot related to any business or commercial venture dog license or permit to bum leaves etc.)said person is NOT required to.complete this affidavit Tme Office of Investigations would like to thank you in advance for your co operation and should you have any questio.a,- please do not hesitate to give us a call, The Depaz nient's address,telephone-and fax number:: • �t✓a�0nu�alt�c�Adassatrtb,��t€s ' Dgputmmt of Wasinal Age d=ts Office Qf kmdptlow. • . fi����shin�t�Stre� B•0�ton,ILIA U-111 TeL 617-727-49GO ext 446.or 1-01 MASSAFE Revised 11-22.06 W. w,mass. 0Wdi °*IHETo Town of Barnstable Regulatory Services 'g Thomas F.Geiler,Director rEnnna+a Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 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 adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. oo Type of Work: 0 ino i n U f _e�rcA/�. Estimated Cost Address of Work:_(3 � Mat—, ner— (1-1 cc �P Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 uilding not owner-occupied P@wner 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. OR „J Date Owner's Name Q:fomwhomeaffidav TADle is-LID teuxuaned) Preseriptive Packages for dire and Two-F=W RaidentW Baildiags'Hestsd v►iY>t'F`es*0�'pels HMAXf11 bm 11iII+IIiViUlV[ Glazing Glazing Ceiling Wail Floor Ba_trrarat Stab HeatinglCooling A='rlaJ U-value= R-value) ' R-values Revalues Wail paime3tr Egwpment Emdeacyr Pachge R-values R Ysluer 570I to 6500 Seatlag Dcgm D@ya' 0.40 38 13 19 10 E Normal FL12% 032 30 19 19 10. 6 2+lorrssa! "s 12% .50 39 13 19 10 6 'S7�P{JE T 15va b 38 13 25 NIA NIA. Plormai U 15% 0.46 38 19 19 10 b Nor W Y 13% 0.44 38 I3 25 NIA NIA 85 AFUE W` 15% 0.52 30 19 19 10 SS AFUE X 13% 032 38 • 13 25. NIA NIA Nonsial i �°' 19 . 0.42 38 19 23 NIA NIA Normal '= Z 13% b.4Z 38. 13 39 l0 g 90 AFUE i __d ,A I sm 0.30 30 19 19 i9 L 6 90 ARM 1, ADDRESS OF PROPERTY: 2, SQ UARE FOOTAGE OF ALL EXTERIOR WALLS: U 3 GE OF ALL GL G 4, %GLAZING AREA(#3 DIVIDED BY#2): NOTEc OTHER MORE INVOLVED METHODS OF DE'IE�NG ENERGY REQUIREMENTS ARE AVAILABLE, ASK.TJS FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES:. N0; q-forns•f�Sa3Q3a . 1 FE . � �gay • .; i �»�":°r� N � !� dam" �' ,.: ,rY`".�,.s...da�tP`'�` �yt -��•>.+•^i""'"s' ._ .'w. ..� ,. c'". ,.-*„'"`. �r i; i1 ►i D t, -- I 74- �a►2Cbcldt - _��x � eTM f 77 F f I { ` � 1� E 70 1 _ r"r 9 � 1 ............ a l j gR {L 6 / JijJij 1 pi- I i ' 1 / 1 I ` 1 r i f .. � �� .` ` f .. w`t .�. .r .y J �---- . �� �� 't�' f - '' .. ,.. , . t� ' f Y _... ....__ .. _.. _ � � .._ '., 1 4 r I ♦ A k. i I - I - ' CON iF0 ORNt SIIl!7I1;0OMS" i 7 .. r. WE aches ,State uridin Coe 80r '"` ' en echo L 23:1 The Massachusetts State Building Code (780 CMM includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental .CONSUMER INFORMATION FORM is to be filed as part of the building permit application when a builder/contractor or homeowner, constructing/installing a house addition with very large percentage of glass to opaque wall,seeks to utilize a special energy conservation exemption option for "sunroom" additions to,an existing house (780 CMR, Appendix J, Section J1.1.23.1). This FORM is not intended to prevent a homeowner from selecting a "sunroom"of any size,configuration, orientation,form of construction or percent glazing,but rather is only intended to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of "sunroom" structures to residential buildings may create comfort and energy consumption issues due to uncontrolled solar. gain or uncontrolled radiation cooling of.the main house. In the selection and coastruction/installation of"sunrooms", included below is a non-required, open-ended list of product and design donsiderations that a homeowner may.*wish to consider before actually constructing/mstalling a"sunroom".It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize- potential.-energy consumption and/or house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT AND DESIGN CONSIDERATIONS RELATED TO"SUNROOMS" • Solar Orientation and Natural Shading - • Type of Glazing • Insulating value • Solar heat gain • Frame materials • Glazing to frame sealing and gasketing materials/.seal durability and/or weather tightness of the sunroom • Adequate ventilation Operable windows and fans • Applied Shading Systems • Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Eff'ieiency,Zoning and Controls Homeowner Acknowledgment The Massachusetts State Building Code, Section J1.123.1,..requires that the actual vroverty owner(not the owner's agent or representative)acknowledge receipt of this CONSUMER INFORMATION FORM prior to issuance of a Building Permit for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges that she/he has read the information in this document concerning sunroom comfort and energy conservation. Signature of Actual Building Owner ' Date h R i 5'Ta 3 'f3 M 0 Z 6 5/3 Print Name Address of Permitted Project Owner Address(if different than project location) Owner's telephone number f CF THE 1p� Town of Barnstable Regulatory Services * Thomas F.Geiler,Director BARNSTABLE, � , 9 MASS. 1639• A,0 Building Division rE0 MA'I 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 y� Please Print DATE: J I y JOB LOCATION:_ 3 r� e rc.l c CAL number // / e street /� (�J/�l/ village /`/� "HOMEOWNER": ,S/� 0 l J � �Yl rjq �1140V l�/�� 77 q 7V V name � �� O 1 L(J y�^ home phone# ` work phone# ' CURRENT MAILING ADDRESS: ) n ner Ct I'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 ep 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 re irements ature 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 t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 007�Town Of Barnstable *Permit# 4 3S � Expires 6 months from issue date Regulatory Services Fee � �s 6 �' Thomas F.Geiler,Director j�/� q/0 / Building Division 7 Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us 508-862-4038 Fax: 508-790-6230 O� EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X--Press Imprint :1 Number kddress ;ntial Value of Work Minimum fee of$25.00 for work under $6000.00 flame&Address Telephone Number , or's Name , nprovement Contractor License#(if applicable) �1�5�soY's-LicEnse-n-{`i�aFP�eable-) � � � ® V� ., RT kman's Compensation Insurance APR 2007 Check one: ❑ I am a sole proprietor 5,f`am the Homeowner TOWN OF BARNSTABLE ❑ I have Worker's Compensation Insurance tce C�)mpany Name ian's pomp.-Policy# A Insurance Compliance Certificate must be on file. Request(check box) in old shin les All construction debris will be taken to [�Re-roof(stripping g ) ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement,Contractors License is required. NTATITRE: -ms:exprntrg .e061306 • Oq • �\. i/YY vv�.r..rv.Y,IvwrY.n � �, Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,VITA 02111 www.mass.gov/dia ' Workers' Compensation Iaisuvmce Afdayit: Builders/Contractors/Eldctricians/Plumbers Applicant Information Please Print Legibly Name(Business/Ogmization/Individual): rl/w d Address: CIA r 1 Yr City/State/Zip: CL—Aft 9, 1-I- h/1 lot- 031b35 Phone:#: Are you an employer? Check the'appropriate boa: -Ty of project(required):•. . 1.❑ I am a employer with 4. I am a general contractor and I employees (full and/or part-,time),* have hired the mb-contractors 6,.❑New construction . 2.[] I am a'sole proprietor or partner- listed on the,attached sheet. 7, ❑Remodeling ship and have no employees T'htse sub-contractors have g, Demolition' working for me in any capacity. employees and have workers' [No workeis' comp.insurance • comp,insurance$ 9. Building addition r quired] 5, 'Ye are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 3. am a homeowner doing work l l.❑P , bing repairs or additions myself [No workers' comp, right of exemption per MGL' 12. oof 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 a$davitindicating such. $Contractors that che*this box must attached an additional sheet showing the name of the'sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,polidynumber. lain an employer that is providing workers'compensation insurance for.my employees.-Below is.thepolicy and jab.site information Insurance Company Name: Policy#or Self-ins,Lic,#: Expiration Date: ;ob Site Address: CitylState/Zip• Attach a:copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as zequired under Section 25A of MGL a 152 cau 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 statemerit may be forwarded to the Office of - - Investigations of the!)Lk-for insurance coverage verification. I do hereby certify under thepains•and penalties of perjury that the information prgvided above is true and correct.. Si afore:. -1 1I Date: .4. iF Id Phone# ���' tao o g :51)8- a-? L o FIL� only,.Do not write.in this area, fo be carnpleted by city or town ociaL n: PermitUcense# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone : InforM' ati®n and- Instructions Massachusetts General Laws chapter 152 requires all employdrs 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 hiie, 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 Tee PT�*t„�Ste of an individual,partnerslio.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 surhtlwzlEng-howe or on the grounds or building appurtenant thereto shallnotbecause of suchemploymentbe deemedto be an employer." MOL chapter 152, §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 ,ho has no produced-acceptable evidence of compliance with the insurance coverage required!' Additionally,MGL chapter 152,•§25C(7)staies"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,•the perfbrrnance of public work until-Acceptable evidence-of cumpliauce with the iusur nce 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-confractor(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 orpartners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy-is required, R. 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 4nter 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"lob Site Address"the applicant should write"all•locations'in . (city-or town)."A.cbpy'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 frtture permits or licenses, A new affidavit must be filled out each year.V&ere a home owner or citizen is obtaining a license or permit riot related io any business or commercial venture (i.e.a&g license or permit to bum leaves•etc.)said person is NOT required to.complete this affidavit. :The Office of Investigations would like to thank you in advance for your co operation and should you have any questions �- pleas a do not hesitate to give us a can. The Department's address,telephone:-and fax number;- ' �rrvz>�c��.�aJ.t�o�Adassaeb,�s�t�s • Dqputmmt of ln,duWal Anxi.d nts Rastan,MA U111 TfI 4 617-727-490.0 ext 406 or 1-077 MA.SSAFE Fax Wr 617-727-1749 Revised 11-22-06 �.iaaSs• adl . . Town ®f Barnstable. y, Y Regulatory SerNaces Bax�vsraB Thomas F.Geiler,Director rv�nss. Building Division 9�AT fD MA'S 3., Tom Perry, Building Commissioner 200 Main Street; Hyannis,MA 02601 www-town,b arnstable.ma.us Office; 508-862-4038 Fax: 50.8-790-62.30 Property vner Dust CQrnplete and Sign This Section If Using A Builder I, 20CQ(� S�c���.. � mu ' , as Owner of the subject property hereby authorize \q Q l f to act on my behalf, , /f in a1 matters relative to-work authorized by this building permit application for: , .s 4 ► .r�e r• Ci C , � i f M p}- U (Addres's of Job) Signature of Owner Afrw P�i-WoG G� , Print Name ;• Q•rORN S:O vT!4TEI�P ,F.Iv��SIGA' �1HE 1p� Town of Barnstable Regulatory Services • r « BARNSTABLE, Thomas F.Geiler,Director MASS. g �b i639• A,• Building Division AjFp�,t Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Y Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATIO : r— LI rcl-e_ CCU H- number street village "HOMEOWNER": 55fric%� � Irnei1da ���y2� l� (S� V 77 y2U b name �j rn home phone# work phone# CURRENT MAILING ADDRESS: �_)"[ ► ' 16�{'I(,Q r' G+ I f'G��' YYl 0- 6 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwelling 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. 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 t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 1 4 'A'siesOo s map and lot number S • CF THE T0� SEPTIC SYSTEM. MUST y j Sewage Permit number ................ ...... ........................ ' INSTALLED IN COMPLIA Z 9EH4 E i �1 � WITH TITLE 5 B Tenr, House number ...... .7..3....:........................ e r Mnsa , ENVIRONMENTAL CODE A i639• . w TowN TIONS °ypYa TOWN OF BA`RN.STABI-J r BURDIHG IKSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION .. /v�.......1... !!aG�-... .��,,�.. .......... .............................. .......... �(....................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby' applies for a permit9ccording to, the following information: Location .... . .LJ.. ..:...... ! "/W Y... .................................................. ............................ " ... Proposed Use ..... .............. ...................... Zoning District ...............rp—.. ....... ........._.....Fire District ..................................................... Name of Owner ... ................................ .....T.../5......Address ..........S.- ....... ....................... ........................... .Name of Builder ..?-GC).. .........Address ....::.............................................................................. Name of Architect .................. .....................Address. ........... Number of Rooms ................5..�............... .................. Foundation.... ... . ................................. �...g74....................... Exterior ..1����`�`'�.....��¢ Roofing .....sy 4 Floors ...... .... ...................... .. .......:....... .................Interior .... . . ..... ............................................. ' Heating A .............Plumbing /. �.................. .... .... ...................................................... Fireplace ...................................Approximate Cost .....0 C(0 ...................... f........................................ .... Definitive Plan Approved by Planning Board ___ _____ �_ 19_ Area ... J................ Diagram of Lot and Building with Dimensions Fee 3�- SUBJECT TO APPROVAL OF BOARD OF HEALTH L. 4:)/J40 70 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. - Name ... .... ... ..... ...... __��CEDAR ACRES REALTY TRUST V wo*�o .2.3.3.6.3... permit for ....9Be..S=IZY........ Single Fami�_v...pKq.j.jiTjg.............. . .................................... Location ,.Lot......#.6.3....3.4.3... Cotuit, ............................................................................... Owner ..tCedar Acres ................... ........... ..Truat Type,'of Construction ....FXame......................... ................................................................................ Plot ............................ Lot ................................. Permit Granted .......August..12,...'.19 31 Date of Inspection ......................... ..........19 Date Completed ................19 Ole M PERMIT REFUSED .. ................................... 19 2iA ................... ................................ A .................................. ............... .. .................................................. r) - ro C) t M........................................................ rM Approved ................................................ 19 ............................................................................... Assessor's map and lot number,........' " " f ............ ' c.__. G Q�OF THE.TOE `. ... �r� s Sewage Permit number ..... ♦� BARNSTABLE, i . House number ...... .•3! . .................................................. 90 rnea O 2639- `e0 0 YFY a• TOWN OF BARNSTABLE BUILDING INSPECTOR � �� <j a, APPLICATION FOR PERMIT TO ....................................../........ ................................................. TYPE OF CONSTRUCTION .....1,,K-e771' ,...... .- ! ' ' ':.. `..:°t F . . !. ........................................ %....: t.,p..................19.: . TO THE INSPECTOR OF BUILDINGS: 1 The undersigned hereby applies for a /permit according �to the following information: Location ....Gl% ... .5..:. .......... �/�(C j....!.:{. ....... ................................................... ................................... -� � _. ProposedUse --....G,�i�-� G' '..�` ..........................................�............,:........................................... Zoning District .................1.r�...................................................Fire District � .,...Address ......................,.................................f......................... ...................................................... Name of Owner ....(.... .t t L a' 1 '�/?%'�:.....�� Name of Builder .r ::`."� y.....�..` ..Address ............ . Name of Architect .............`...... .._.._...--.___ ........................Address .................................................................................... Numberof Rooms ,� ........................Foundation ' --........................................... .............................................................................. Exterior ..f �'.' '�`` { �.�. r.C.' /c..... C`x A�94,,-z................................................... ..... ..............::............Roofing .... .... Floors 1, r.0/ .......................................Interior ..../-A, ... ��1....u'-�-'�.,.............................................. .................•......... L/ / i , , HeatingJl �......... ............. .............Plumbing ..............f.... ::......................................................... .l Fireplace ..................... ...............f........................................Approximate Cost ...... ...................................................... Definitive Plan Approved by Planning Board, -" 19__ _ '. Area .......................................... Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 � i 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. f Name ....... iCEDAR ACRES REALTY TRUST ( A=39-15 2 3 3 6 3 permit for One Story,,,,,,,,, Single Family Dwellin1..................................................... ....................... Location .,,,Lot #63 343 Mar 1��V,,,Circle ...3 ............. Cotui.t ............................................................................... t Owner Cedar Acres Realiry,,,,�xus.t .............. ................... Type of Construction ...F.ra1e.......................... Plot ............................ Lot ................................ Permit Granted ...... ...ugust 12......................t.......19 81 Date of Inspection .. .................................19 Date Completed ................ .....................19 PERMIT EF1SED ................................... ........................ 19 �� ............ � .......................... N ............................................................................... ............................................................................... Approved. ................................................ 19 ............................................................................... ............................................................................... -`:�,� 'r ,x•: `• w y -� r L '+ W3 r 5 �1� ;%s' E �_��, "`, ;4" a �1 L v� a`}i���A t•4., '*'y n -4 r�1 r••A .�.K S a 'J"' `-;'1, ��.kys'. e 3 � � ' 3a, V . � y _ ::s, ,Y '� f r ���Tu �;�b� •*!:�f.f e. ..,�+1 pr•Y - •• .Y =�• �` f ' 4 Ig- {�. s fir`a �.'^' a � � ... + .,�,. f��'tf7�VV_ _ e� ! ti • v .. K "t �L' } �, t'tiftr �.. qz. q .}• a.�I .Y f � ^.� �. ram. y.A. �ai".t.. `�. Mx�" - • .. i -L "'t" - i .. «} •,p t,.•�^_ f f r• !-, Yy + �. ♦! �F i 6 ZA yx N-- -SHOWING. . r J �., - V.�.�.I/t� ti .1, T• t Y' ".`f• �L + y `i."••.,w r�Y U ,Ak D LOCATION , .. �.• Z„-'� it �� ,e �-;,,, m S "-G- 0 �LASS HM'TTI . ri 0 V a Tutl,* ti I z t OWNED BY. +�► SGAtEOA7£ 0�� �/ RAMN 6R'O�SSmAM _-�-_-°REGIS;FEREO IAAIO StJ�dEYOit l NrRE$Y- GERTIF TNIII' THIS FOUNDAT4111 IS,LOCEQ Oar , ' QN T(ME'.LO7 AS SHOW AIVD.CONFORMS To 'rHE QF E�kRRlSTABL ZONING RfGULATIQN:S` REGAR�1lKG N. t $ ORO ETBA- K,S . fiROM SIRE 't LINES AN0 LOT. L1�lES . izr�s A }} r HORti1AN GROSS tit tN A L.S. DATE Y. ND.SURD" 1 �„�•„'�,� TOWN OF BARNSTABLE Permit No. Building Inspector cash OCCUPANCY PERMIT Bond Issued to Address Wiring Inspector Inspection date Plumbing Inspector Inspection date Gas Inspector Inspection date Engineering Department Inspection date Board of Health Inspection date THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Aw ......................................................1 19......_._ ................................................................................................................. Buildin(, Inspector