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Home My WebLink About0009 MOORING DRIVE 4/)�_ � � � �'� i 0 I� I ,d �,�,..w Ttt` ,a,M. .Z r... ,u .ry +r^t"•..>'� j�N 1 ,3e'�f+�r�?s, ,�R�,^^xy ��.C`"• .�*. r•'"�� e,PyF'� j.'" t ff tom'• .s' .1t (rk ,,,,,;.��• x.�'.a'�ji.i i�i .. C'.•3 r er a-+.;. M 14.- 4 :.x •r'k,., snf .�. .a'€ . �. •• � , s#"F ` j .a J �i r � r," t' � ..�,�•. >+'� -L r.r5� r�'awu gnh i1,r �t C�r !'ri.��` L �,y ' s(J ,(Y .+�. :' t'rv1 �� T�-'.Yi«��. s�'�.j P ti;�` F` 4v`,� ��.ssr.. �+++•� • • { ,�; „'i• A #r. {5 .;. •� -vt•• q' Y3 A•'tta Y; g fi 4i^.. i a, ` �'� E}:D � � .�-v .a - .. 4 .. f `S�'�b a rah �• Y `�i '� •t ,� •.�{$•`wn. e 23 X ZC �5 m•ai' � s i -�� Z n n � Inc n?Ll Z �4C3 c� Nix -0 r ,+t�G � Ar x m K ry m m . E V4vcJt PLAN SHOWING �+ > 8 ' m rj FOUNDATION LOCATION %01- - p T �vz 9 i -C ➢ n - - C O T UL T, MASSACHUSE T ' + .t. OWNED BY: CeC; ' 0 .9c al 0 r, Tj SCALE • DAATE' G.S, /9d4 3 NORMAN GROSSMAN------ REGISTERED LAND SURVEYOR C C 3 D I HEREBY CERTIFY THAT. THIS FOUNDATION IS LOCATED '( 'n i- *�'-tN ON TIHE LOT AS SHOWN AND CONFORMS' TO, THE TOWN OF BARNSTABLE ZONING REGULATIONS REGARDING hdRM1FN y SETBACKS FROM STREET LINES AND LOT LINES . v GROSSMAN m (� ,Q 12775, �0 p 17 0 !I NORMAN GROSSMAN ' R.L. S. DATE AND SuRV • � J 7 T R ll s4ssor's map and lot numb r ..!� .. ' �? .......... Q ,�/ , locl; ' — 7�✓� .T A THE Sewojqe Permit number ... ................:. uS .............................. INSTALLEDTIC SYSTEM M • R p IN .. I................... " COMPU SBIL i House number .................. 9 WITH TITLE 5 °o 1639. �0m� . 9 --NAB IL ENVIRONMENTAL CODE TOWN OF B A R N-S TOAM ATIONS A. BUILDING INSPECTOR APPLICATION FOR PERMIT TO ............... Y..... :... ............................ TYPE OF jCONSTRUCTION .... ...zz: I�1.�/.... . .............. • ......................................... ..........19........ r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following inf rmation: Location ..44�..//.0........ .............. ......! ....... .. ........... ..:................................... 04�� ......... y....Proposed Use ....... .................. . .................. .................................................................... .................................................. Zoning District ...............�.............................. ...................Fire District .......��ru!� ................................................... " Name of Owner ...0 � ' "'Y.... ..-...... ...`.!�. .... .... ../��.....Address ......................... ........ e�;�i�' Nameof Builder 71,eo.444............. ...............:.................................................................... .Name of Architect .................... :........ .. ..........Address .................................................................................... .......... Numberof Rooms_..................................................................Foundation ............. .... i ........................ Exterior � J ....................Roofing ...... /. ......4....14...e.........:5.7....L.....y.....4.-...................... Floors .................... .................................................Interior ....... ........ . .......... ............................. .. �� ' IJ HeatingPlumbing .... ............... .......... ................. g ................... ............................................................ Fireplace .....................e..... ...............................:................Approximate Cost .....dk 41it,:�o ................. .......... /o7 J� Definitive Plan Approved by Planning Board ___ ----19 J®. Area ................. Diagram of Lot and Building with Dimensia s Fee ......... . .......................... SUBJECT TO APPROVAL OF .BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding thq, above construction. a Name ........ ................................................... ... i. TF Cedar Acres Realty Trust e 22933 one story - :.� o ............:....`-Permit for ....................... ............ r r t �£. t single family dwelling � ................ ............9 Mooring Drive .. .. •................ . q,. Location ............................... - COtuit ............................................................................... Owner Cedar Acres Realty Trust :` X t r frame , Type-of Construction �. I''.. ............................... 13 Plot ........................ Lot .............1................. Permit Granted ............March-20.........19 $1 Date of Inspection . ..........19 t' 4 Date Completed / . 19?/ PERMIT REFUSED P r ' �... .... 19 + ' .......... ....�............................................................. .� mob, 4 , c Approved '........ ..........:................ �- Assessor's map and lot number ..ram...:.... ' 7� c%TH f` .. •P��♦� Sewage Permit number Z BASHSTAMLE, i House number ............... .....I............................................... 90 r,ua G 1679• \e�i Q TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO �'�`..r...........,. .............................................................................................................. , TYPE OF CONSTRUCTION .... .....................r. .: !r.. t ........................................... ................!..r !.......t.` ?..........19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .. �.r....... : '......... r/c r': It... ....... .. `:j !'..! .... .. ` ................................... ProposedUse ....................................................................................................................................... Zoning District .............................. ................. ,,... .....Fire District� .. .... .................................. Name of Owner ............................................................. ..... •. . ? ......Address ........................ . ..... w ................ Name of Builder ..-.'. :r?::.%''� .. ' -/�) <!f2 +;;✓ r) ....Address..................... .................................................................................... .Name of Architect .................. .............................................Address .................................................................................... Number of Rooms f T r +......................................Foundation - Exierior f G,� ,cf..��T......`.�..........Roofing r� 1, �sC.• i` �..... ,. ..... `:".............................. - :: t` :............Interior .......:.:.. ! :'J� .t ter. �� ...�...r�..Floors .� r ' [ e E.. :. .. .............. ............................................. �. ,, -f � r Heating _f, ....L `.................��.... .............Plumbing ....................t........ ................................................ Fireplace Approximate Cost t f ... Definitive Plan Approved by Planning Board ___ +r_c ___ _ ____19_±r_r%_. Area Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH r 1 f . f I ` f I 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 =23-55 r J one story........No :.....22933 Permit for .................... ................... `single family dwelling ............................................................................... Location .... 9 Mooring Drive . ................................................ Cotuit ............................................................................... Owner ........Cedar..Acres. ...Realty. . ..Truest........... ......... . ...... . .... .. .............. Type of Construction ...............fr . ame....................... /I.........: .............. Plot ....................`........ at ...........1......13............... Permit Granted ........ .NaXch 2 . .........19 81 Date of Inspection ...................... .............19 Date Completed ..................... .................19 PERMIT RIFUSED ........................ ........ 19 .............. Q. ' yf�. .:..... ......... ............................................................................... ............................................................................... ............................................................................... Approved ......:...........:............................. 19 ............................................................................... ............................................................................... r TOWN OF BARNSTABLE � Permit No. ---- ----------------- 1 ; Building Inspector cash 7 •Yl A OCCUPANCY PERMIT Bond ------------ "No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to 4.0-L-j :`;~diLy �rkA6 Address Wiring Inspector /j f Inspection date Plumbing Inspector �' Inspection date Gas Inspector Inspection date Engineering Department 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. ...................................................... 19..._. _ .................................................................._............_..................._..-•-- Building Inspector L— P) a- 17 - MAi Town of Barnstable " 200 Main Street, Hyannis MA 02601 508-862-4038 Application for Building Permit Application No: TB-17-1555 Date Recieved: 5/19/2017 Job Location: 9 MOORING DRIVE,COTUIT Permit For: Building-Insulation-Residential Contractor's Name: TODD LEDUC State Lic. No: CSSL-106019 Address: East Greenwich, RI 02818 Applicant Phone: (401) 965-8578 (Home)Owner's Name: SHAW,JAQUELYN&MURRAY,DAVID Phone: (508)294-8427 M (Home)Owner's Address: 9 MOORING DR, COTUIT,MA 02635 Work Description: Air sealing and insulation of attic flat and attic floor. Total Value Of Work To Be Performed: $3,000.00 r � Structure Size: 0.00 0.00 0.06 m Width Depth Total Area I hereby swear and attest that I will require proof of workers'compensation insurance for every contractor,subcontractor,or other worker before he/she engages in work on the above property in accordance with the Workers' Compensation Act(Chapter 568). I understand that pursuant to 31-275 C.G.S.,officers of a corporation and partners in a partnership may elect to be excluded from coverage by filing a waiver with the appropriate District Office;and that a sole proprietor of a business is not required to have coverage unless he files his intent to accept coverage. I hereby certify that I am the owner of the property which is the subject of this application or the authorized agent of the property owner and have been authorized to make this application. I understand that when a permit is issued,it is a permit to proceed and grants no right to violate the Massachusetts State Building Code or any other code,ordinance or statute,regardless of what might be shown or omitted on the submitted plans and specifications. All information contained within is true and accurate to the best of my knowledge and belief. All permits approved are subject to inspections performed by a representative of this office. Requests for inspections must be made at least 24 hours in advance. Signed: todd leduc 5/19/2017 (401)965-8578 Applicant Date Telephone No. Estimated Construction Costs/Permit Fees . Total Project Cost : $3,000.00 Date Paid Amount Paid Check#or CC# Pay Type Total Permit Fee: $85.00 5/19/2017 $85.00 XXXX-XXXX-XXXX- Credit Card ......... .............................. . Total Permit Fee Paid: $85.00 a ak �l�l�s OF THE Tp� Town of Barnstable *Permit#a d l 5"0 P� Exp' 6 months from issue date Regulatory Services Fe w snuvs`rnsrs, I MAM Richard V.Scali,Director 1639. a� R 012015 TFD MP'1 Building Division TOWN OF BARINSTABLfum Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 02 Not valid without Red X-Press Imprint Map/parcel Number (} Property Address / fyl002tN6 De. t, 0 z(a S 5— Residential Value of Work$ I Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address R /mil�.R" V e Piz . Contractor's Name 5&1C TelephoneNumber._�5k Zpy gyz-:�- Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ® I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# 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) oQ Re-sided /rraF Replacement Windows/doors/sliders.U-Value - (maximum .35)#of windows 3 Isom.o:t� A 3 4 #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. K. *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&Construction Supervisors License is required. SIGNATURE: , -�J Y►'1 !�a Q:\WPFILES\FORMS\building permit fbrms\EXPRWS.doc Revised 061313 The CoTinnorrivealth of Massachusetts 11 De artwent€t fitdrrstrialAccidents f { Office oflrtaywstigtztions { [mayy s 600 Washington Street Yw t. a BoStvnf 3M.0211I ri.;mv.ntass govlrlia '"Torkers' Compensation Insurance Af Fidavit: Builrlers/Conti-actur--JE--1ectticians/Phunbers Applicant Information Please Print Legibly I*Tamz- a Grgaz�,iizationfindiv dual)- LavIn Murr1c,. Address—. 9 .noow n OQ. CitytState1Zipc Cdrv,7- H4 O Z(O3 s Phone#_ Spa- 2 ry y- e5iz-4 Are you an employer?L7ieck the appropriate bus contractor and Tproject. nt gal d.I ` ��of (required): 1.El I am a employer with 4 ❑ l am 6_ ❑New construction employees{full and.nor part-time).* have hired the sub-contractors 2-❑ l am a sole proprietor arpartnes- listed on the attached sheet. 7- ❑R emodeing These stub-contractors hme, slop and have no employees $_ ❑Demolition Work-ing c employees and have workers for xue in any capacity- $ 9_ ❑Building addition. [No tvmicrers'comp-iasux-Enre comp-immurancl— _ required-] - ❑ We are a corporation and its. 10_❑Electrical repairs or additions I n7hameouner doing all work officers.have exercised ther 11. Plumbing re:pairs or additions nyyel£ [No workers'comp_ rust of exemption per iviGL . 12.❑Roof repairs insurance required.]E c-1.52, §1(4),and we have no enTloyees.[No Markers' 13.❑Other comp-.insurance required.] *Any spplicmi that checks box#1 Est also fill out the section b6m,showing their ss+odies.'compensation policy in5rnmdoi- F=omeoWners Who submit This,RML-V indicsting they are doing all vicar and 4hea hire oatsidecontactors oast submit a new affidavit iod ca#iq_,such- Contractors that check this box must suached au addu-iooai sheet shotcing the mine of the a sub-contiactGrs and state whether or not those entities have empioyeu. Ifthe sub-contractors have employees,theyImstFruvide their workers'romp.policy nUMber. I am art emptotrer Mat is prm idi ng ivorkers'corngmisation intsurnutce for nttya empIo�ees 13etot is titepoTiry*and,job,site informatiom Insurance Company Name: Policy�or el�ins.Lie 41. ExTiratio Date: Job Site Address: city/State/zip: ,kttach a copy of the workers'compensation.policy declaration page(shoeing the policy number.and expiration date). Failure to secure.coverage as required under Section 25A of NfGL c_ 152 can lead to the imposition of criminal inal penalties of a. fine up to$1,500-00 and for one-Fear imprisonment,as well as civil penalties in the faixn 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 fonvarded to the Office of Irrvestigatiom ofthe DIA for insurance coverage verification_ I do hereby c.grttfjr under the paints and pennal6es of pergitty.thatthe infornttntionprmridedabove is trite and correct tture` ,�. �� Date: [ Phone Offirial use onl[ . Do not ivrite in this area,to be completed by:city or toitm of cwL City or T'ovin: PermitfUcense 9 Issuing Authority(circle one): 1.Board of Health ?.Building Department 3.C ityf Town.Clerk 4-Electrical Inspector S.Plumbing;Inspector 6.Other Contact Person: t- Phone#: - _ 6 P�DFTHE Tp�� . _ * _ * BARNgrABM MASS. i639'. �' Town of Barnstable �� Regulatory Services Richard V. Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 026. ' www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must CompleteandS. This Section If Using/A Builder as Owner of the subject property herebyauthorize � Se(r to act on my behalf, �� in all matters relative to work authorized4 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. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable .� Regulatory Services °FTHE ra Richard V.Scali,Director Building Division BARNSTABLE, ' Tom Perry,Building Commissioner y MASS. �+ 1639. 200 Main Street, Hyannis,MA 02601 AIFD �a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION S Please Print DATE: Z JOB LOCATION: n P_ 7 1- ,C number street village ..HOMEOWNER": —8 AQ m u r r'a i Sa ia- 2 9 ' eY 2T name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The cent 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. 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.,, h 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:\WF-FILES\FORMS\building permit forms\EXPRESS.doe Revised 061313 r c; f 5C {{°�' Town of BarnstA ble.. "Pernilt# ,E 0 N RegulatoryServices t dare, sets, � Thomas Ir. Geller., Director Building Division b� Tom Parry,CEO, Building Commissioner ^� 'OWN OF BARNSTAI LL 200 Main Stree4 Hyannis, MA 02601 �C www.town,barns table,ma.us Office: 308-8624038 Fax, 508.790-6230 INPRESS PERMIT APELICATION - IE.SI ENT'A ON ,vim NYoi Yalld tdk'Gaat Red X-Puss lnrpriri V� N,ep/peroal rlulsber 6 Z Property Add rest ///7—_.___ ,,,f' Itealdantial Value or Work 'Minimum fee of S3100-for work undrr S6004.00 Owner's Name dt Addtus �1/J�'It? iit?�? ?y Conttector'e Idante � iG'//ICJ;' D Telephone iVumber _ Home Improve mew Contractor Llcense#(if applicable) Xja 'o Construction Supervisor's Licensed(if applicable) 4(0� QWorkman's Compensattloa Insurance Check one: I arts a sole proprletor , I ass the Homeowner I have Worker's C®mpensation Insurance Insumnce Company Name- 1�fi91_,ll?l Workman's Corr►p, Policy N //,��lie_�z � Copy atdtuurands Compliance Cardfic2te must accompany etch permit,: Permil Request(check box) j/Re-roof(hu.rricans nelled) (stripping old shingles) All construction debris will bo taken to �? (�Re-roaf(dsurrlcane naked) (not stripping; Going Over .existing layers orroo C3 tta-side #ordoors (] Replacement Windowl/door0liders U-Va)ue (n�azimt,m .3S)a of windows �*Mere rtqulnad: kwanes of Was permli duds nit exempt oomplience wuh other town.depann,ent regulations.f.s. f{iNotr ,ConselYation,etc... ++•Note; Property Owner must sign Property Owner Letter of Permission. A Copy of the Home Improvement Contractors License& Construction superviso, �s Liecl►so is r alt�edr �SIGNATtlR6: . W1tFlLfig+pQ�pSibt,ltdinaportnl(fonetsiSXPRGSS.Cae - �' 77m C°OMnaornpe(dtla oflkferssarehus as ,�tpm��ra�rnt ara�'dndartli°itiP.�tcc�daaads Ojke of'r"Pa°dealioru tr 600 Wns7dilrair �. Bowen,M4 02111 p,mw.rraa=gvW fa iK�arleoa�' lP g tsa�ssee : Buadeers/ ontractos�E�'tai�ans/I'lutaabe Wat brs �, an i4Xow Cheek do 4""Prlata bm Type atpref vat(t•ese wrad), C! ras aI 7d!f 1, I atam oeaaaaptoyae � sera bhtrd the s�olaNaw eoaxstettstie>m � ° ou the dmd 7.Z❑ I rataolmptopeiei+mta>r p - T h me subs e&sUp and hn-a so ersaple'aet eu ployeeeee=a hav *t m hn MY ct Y 9, ❑l�nilatia�se�4i�e � tm 3. ❑ Waump $wqm6cc and,its i 0.®Elasscaei repaira cr additioaot 3.❑ I an a boat all wo* uffl=n have ee mvin d tbmir I I. Pi>aaasbb a epairs or mdeii& = mgq►"{No W= d&of *n Pea iV OL t a 132.11(41 aad ve havi no 13Z Gldw esmWtoym.Pto wodCaerc' camp.#asamom raalak,4 .�,��tloert i�t�baae e3 aeeeeae eeaee dt3enetemR aadas a�oereaYearlao eild8rwaasam'aem,�.oie�loo�lstbra.dms. 1 7atM wiledt tilt st411mm+R �9'sts+bmto�eQ!>�eeeeat alum tab oe�lageessne4er eeeeest a�aa�d�n°ae�qag nuh JCMWWwrt dW C%02*91% a Mw aeete&of to set U*mmt eases desst*e•aseemm offs swNcamwan sad sexes who*"a<moe&a tomko knee alma W*"WwmWU"Asa�eree.r teevieler do*wu mem*ps&7 msembaernow I All ax Ilt�il a!slael'6 ptwa rree�°�orx�pesrtdore f ®e�'oragy � et n'a+polioy ArutfoL a+Era kmome fiat sa mm up—0, Iob�Sto A,ddrtnt' GrtprStet+elZip: AM&ae m?°at&r v►o **n' OwAtI"PO 7&ac4mk6s JmV(216 ywlms the peeK&I -Beer ml eaO'etion aft►). pWh n 10 tamajAteaa wvemp as a qmW wWw Se aEicaa ate"r!.*tUG .c. 152 cm land to the ieaespaeWom of e6wieml met of a &sup to$1,500.00 aoedJor came-yore ampsasoeommot,se waI!os oival es iss tlta form of s g'I�OP WOO-03 mad s&t o4ttp to$230.00 a say sphM do vefolatar. Be aedvfead dw s copy of dib ekatea w t my be lamed to dw 091ce of hnmwpdm aaf tba MA hr humam.s covasap vaiscasm, Jel v 404Y a&.#* App+dws creed of ry Neat dw i�/treurd�fow pso+�da$�bmrw to a�mid o�xe now p teol wt mo-, Do not avrdN too ft or#%to be axonepUte+d by cio or tatwt affidad Chy or T'owa: Pert>gitlL.lceatt d Iastda�AughotIty(exlydoonem)a 1e Sosrd*(:W*et& 3.HaiMa g Department 3. e" C'Icr1c d.Vaetrkaxl I upfttor S.Ph=btx:t Ya>rePeotor f Town of Barnstable Regulatory Services Tbomss F. Geller, Director Building Division Thomas Perry, CRO Building Commissioner 200 Main Saeet, Hyannis, WA 02601 www.town.be rnstable.me.us Office; $08-862-4038 Fax: 508-790.6230 Property Owner Must Complete and Sign TWs Section If Vsing A Builder zlg=.� , sus Owner of the subject property hereby authorize___ �'1»,�/� to act on my behalf, in sV mattoa relative to work authotised by this building pe=it application for: -ZZL2 � 1-1, (Address of Job) 5ivatute of otmer ace Friatt Ndtne If Property Owner to epply$ng For psrn�r,please complete the Homeowners+License Exemption Forta'on the reverse side. I DAVID-2 OP 10:KG CAM 0M=WWVl ttisd�1t49PE>�AlE 18 ISSUGM AE A MAMTt OF INFOtRMArOM ONLY AND CCN04 Z R$ NO 9R OWM UPON T149 CERMPICATE HOLD".T#13 MU P.Et►T iCATE 110T A6P4'R9$ATjVgLV aftNEATtlJt"LY AMEND, EXMD OR ALTER THE COVMAW, AFFORM0 NY a'aat=P POL1C1E1 f efto . TIGG C"nmcATE OP IMURA0.NCE DOU NOT CORN"S A COMTRA= 64TWM THE M UING JMMRG6(4l AUTHORMID R A fWK Oft PIMOUM,ANO Tog CERTIEICATIE 14OLilW wMaramr. if Ina co ® or Is an ADI7I ED,the polwi(mp mktat oe endarslact. tt SUBROGATION 14 WAIVED,sJ*M M the toy"grad concot6tti'tii of tha aofty)cameo policies MOO require An endarsen9ent A"ement an thts certmesto does not Confer rights to the hodschlou Of such an"MMOMM riaRntt�it +�t18.78't-4 M�WieI$aNn Aga-a+, on � . wolve caws Ins.cc 9RYtit'ait®tit4trMbA _._.. lamp! — � gas— 2MOCATE OIR: ! Ef-W`Tg--CgRyVyTHAT'lWE PM011111 OF INaURAtIC`E LIED®ELOVJ SAVE SUN MWO TO THE INSURED ON=AWNE FOR THE POLICY P@RIGd gl� ,eTBA, Nj.0jW IfH$rAM=Q�9tltOLNIMMENT,TZRIN OR 001401TION OF ANY C OT OR OTHER DOQLi�9�NT WIMM 46SPECT TO VY140-'THlS a CATS MAY II &MM OR tM Y PERTAW,THE INSURANCE AFFORD10 BY THE POL10194 DESCRIIM HIREM 19 SUBACT TO ALL THE TERMA. UvLus'me M1D COMM Of SLi M POLICIES LIMITS SHOWN WAY 4AVE SUN REDUCED BY PAID CLANGS, 7'�!!19F H1019 Po�ro'r l�oe9ER _..._ � isnrt'® ZAP,w ux��aEv�3 s 1100,40 A GGMMtpA6i9RtvptR ALU.IT'r 6El9168lM708 08!'B4?�Z S31t�/49 3 ;ee+'—��ti--�— a X N E94Arat0rs ' 11 REti$pNAL E Ali tllJl�i !s 1.Q00, ! 1 MERAI.AG REOATF hoons_ate'"J�tl-APPLIV3 PS' I p�-� 1 1 ( MV AV-o jOS�RT 9-S 1 0Ai9R10 GAA8/t3 ^�A �n antes ena.Y 1�uair IFa- s 6i30, a1MiECALTv® i 4UT0°WN� ,; 6 occur" ; C�a'►�,o,.YJx;Ev;a s ' � CLVhiL5lNkdr I l i t AG°dR�?+TE ;�.— J ££ .......�.. S5 -- AN�,rar�swel�'a10.Wtt1Y 7 r 1 I 4 I 1 r v J 1 AgEEgowAI i �I f EL l'ACr q JrT g t� f KUADIOX742212 ®3146/43 07A 6113 Q 11RreNM (1 E.L.e DI:i.EAyE"SkA ° l 109 aN NP E TfOM/6001WW.vN" Sa tA,a.c,AGGAP M1°Asftom q&aft Io rwoftQ David Coot Is rAt cov4wed by tw rP arkurs° CoM. policy TOWMSAIt Town of ftmwAble AECOADA t Wft lNe PoLIQY PIIt"Waft 280 Main SWW RRIS,MA IMM Aun mm IroN rATAm ®IN64WO ACC f-50 ATION. AdPrig Me raservod: ACORRD 26 90106) The ACOM0 name and tlga are re@Wdwod!omerM of ACORD 071. la.0waW. " License or registration valid for individul use only Office of Consumer Affairs&R siness Regulation i before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR j Office of Consumer Affairs and Business Regulation ' Regtstmtion:,:',:100497 Type• 10 Park Plaza-Suite 5170 - Expiration: -3/25/2014 private Corporatio Boston,MA 02116 V!DAPC10X,JNC , David Cox � . :..........._ - �19 LAVENDER LN -_-- ��,� _— �b��1 W.YARMOUTH,MA 026Z3 . .;:. Undersecretary ! Not valid without signatur tilasva�hlQsetts- iDepallment of Public safe- Board of Building Rquulations and Standards Construction Supervisor License License: CS 63537 - DAVID R COX x ; PO BOX 401 S YARMOUTH MA 02664 i Expiration: 10/15=13 C uirnnissif,ncr Tr#: 4314 - f ` • Engineering Dept. (3rd floor) Map Parcel .Permit# 2-0House# - s Date Issued Board of health(3rd floor)-(8:15 -9:30/1:00-4:30) Fee d C) conservation Office.(4th floor)(8:30-9:30/1:00-2:00) / ^ Planning Dept.(1st floor/School Admin. Bldg.) ��ME Defiryitty -=an A p d by Planning Board 19 ` MASS. '�� TOWN OF BARNSTABLE �a Building Permit Application Project Street Address__r �;� Dy, u.e-- Village 6 1 h f Owner V'' (.r J Address '. � .. Telephone `)Ct \,Z/U ; Permit Request Cj} C�j cq(-D uol, ! c)b\.,r k,.2� ~ ` o S First Floor ' square feet Second Floor square feet Construction Type Estimated Project Cost $ a Uri Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes 4No On Old King's Highway ❑Yes ❑No Basement Type: )4 Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing New Total Room Count(not including baths): Existing 7 New First Floor Room Count Heat Type and Fuel: ,, Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes J4 No Fireplaces: Existing New Existing wood/coal stove ❑Yes 4 No CArage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) 14None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 14 No If yes, site plan review# 10 - Current Use Proposed Use Builder Information Name [AAA-QA Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. 2- 3 2-04 µ DATE ISSUED ` , MAP/PARCEL NO. ADDRESS. VILLAGE f ` OWNER DATE OF INSPECTION: FOUNDATION+ _ •^ t • r .. ', � ' dems'..: FRAME I4 SU'1 ATION , FIREPLACEr �- ELECTRICAL: ROUGH FINAL • 1 PLUMBING: ROUGH FINAL - I i GAS: ROUGH FINAL s ,FINAL BUILDING T ! DATE CLOSED OUT f - ASSOCIATION PLAN NO. t k , vY ' :ia '��i s+ a, 1, �• e Fr � ar} : ""� a r tr ' �. �r q �}'`t n.l�,'4VY �4 �,a,3�i.ar'�y. �,.st��..a - �. aPi 5.- e a •� Y' IQ� m1Zr �3 �o a pmir r� 016 � , •,� ra air ' _ ° � � -, � ccz S L Lp � O ; � ' K, +Q /6 J. 76 Y � PLAN SHOWING �+ b FOUNDATION LOCATION - T 7_ G3 C ➢ n C O T UI T, MASSACHUSE T T S OIYNEO BY: C6L7,A� AC G (il r r �ASYS Tl SCALE : 44 DATE NORMAN GROSSMAN------ REGISTERED LAND SURVEYOR I HEREBY CERTIFY THAT THIS FOUNDATION IS LOCATED Til ON THE LOT AS SHOWN AND CONFORMS TO THE TOWN D 0 ' y OF BARNSTABLE ZONING REGULATIONS REGARDING NORMO SETBACKS FROM STREET LINES AND LOT LINES . GROSSM'AN ,A 12775 NORMAN GROSSMAN R. L. S. DATE su SHED REGISTRATION location of shed(address) property owner's name size of shed sign r Vdate Old King's Highway Historic District Commission jurisdiction? THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN shed _ The Town of Barnstable Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen Office: 508-790-6227 Building Comr Fax: 508-790-6230 For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. Type of Work: ' 1 �� ; 0 - iD Est. Cost Address of Work: Owner's Name Date of Permit Application: �r I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under SI,000. BuiIdiag not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGLSTERED 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 ap a pe, it as e a nt of the owner. cz Date Contractor Name Registration No. • �` The Conrrnonwealth of:ltrrssachuscttt Dcpartnu•n1 ojlnrlirstriulAccidc•nts 3 �` ,Y O�cEafffiYO 9211orts •�� iiw r ON 11'a.vNit, Briton.Alas. (12111 workers' Compensation Insurance Affidavit 1fli7iiTt int rm ion: lac�tinn 1�✓�GQ1�� '�."1 �� //�, J \' � u hfln•f1 �r b Ll I am a homeowner performing all work myself. I am a sole proprietor and have no one working_ in any capacity [I I am an employer providing workers' compensation for my employees working on this job. ennitinn • n• nne: •ttldreca• -- city- -phone#• incurnncc cn �tniicv tY M 1 am a sole proprietor, general contractor,jo 1 e rcle otrej and have hired the contractors listed below who n: the following workers' compensation polic cornminv n•ttnc• - addresc- cin nhnnc+t• nniicv i3 incnr�nrc rn ._._ cnm inv name: addre�c� rite nhnne#• incur•tncc Co. nofic�•# Attach additional sheet if necessary, :..."'. • -- !%' :..y:S:�r- --.".'._=- `.��.;' ''^-"" ..'a' ""'�.: '::'�._:_�_.•„_._...� .. ' Faiiurc to secure cuveraee as required under Section 3A of I►IGL 151 can lead to the imposition of criminal penalties of a line up to S1S00.1111 andiu unc cars' imprisonment ax TT•efl as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that: Cops of this st:ucntcnt maI be furn.•nrded to the Ofrice of Investigations of the DIA for coverage verification. 1 do hercht•corn Eder r pains id p, allies of pedurr that the information provided above is trae uu eo ct. G rJ C Si^nature �'�' Date Printnamc 4ZIcl- r " C 1,MJ66RA01 -Phone>r �r T Official use only_ do not it•rite in this area to be completed by city or town official city or tmw n• permit/license# r'folding Department ❑Licensing Huard check if imtncdiate response is required ❑ Selectmen's Office ►_ �•. ❑11caith Department ` contactperson: phone 0. rnOther. rnrormation ano instrucrtons Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "lax%". an emplo.ree is defined as every person in the service of another under an%, contract express or implied. oral or written. An emph rer is defined as an individual. partnership, association. corporation or other legal entity. or any t%%,o or more . the foreaoin�, engaged in a,joint enterprise. and including the legal representatives of a deceased employer. or the receiver or trustee of an individual , pannership. association or other legal entity, employing employees. Ho%%.ever tl? : owner of a dwelling house haying not more than three apartments and who resides therein. or the occupant of the dwellim- house of another who employs persons to do maintenance , construction or repair work on such dwelling, hour or on the _urounds or building appurtenant thereto shall not because of such employment be deemed to be an empioyer. -MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold tlic• issuance or :•eneAyal of a license or permit to operate a business or to construct buildings in the commonwealth for any ihplicant who has not produced acceptable evidence of compliance with the insurance coverage required -%dditionall neither the commonwealth nor any of its political subdivisions shall enter into any contract for the ;erformanee of public work until acceptable evidence of compliance with the insurance requirements of this chapter ha ,een presented to the contracting authority. ..pplicants lease fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and ipplyin__ company names. address and phone numbers as all affidavits may be submitted to the Department of ;dustrial Accidents for confirmation of insurance coverage. Also be sure to si-n and date the affidavit. The 'tidavit should be returned to the city or town that the application for the permit or license is being requested. it tite Department of Industrial Accidents. Should you have any questions regarding the "law' or if you are required obtain a workers* compensation; policy. please call the Department at the number listed below. . in• or Towns ease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of 2 affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Pleas sure to fill in the permit/license number which will be used as a reference number. The affidavits may be re:urned to Department by mail or FAX unless other arrangements have been made. :e Office of Investigations would like to thank _you in advance for you cooperation and should you have an, questions. :ase do not hesitate to uive us a =11. e Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents _ r r jr Office of Investigations 600 Washington Street Boston,Ma. 02111 fax #: (617) 727-7749 phone #: (6I7) 727-4900 e.xt. 406, 409 or 375 f TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE JOB, LOCATION Number Stre address Section of town "HOMEOWNER" 1 � �C-� 1 Ja� u�D e Home phone Work phone PRESENT MAILING ADDRESS ' City town State Zip code The current exemption for "homeowners" was extended to include owner-occupie dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re side, 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 Offic: on a form acceptable to the Building Official, that he/she shall be responsi: for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the S21 Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" -certifies that he/she understands the -Town of Barnstable Building Department minimum inspection 'procedures and requirementE and that he/she will comply w'; s ' d p - c dures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER" S EXEMPTION The code state that: "Any Home Owner performing work for which a building Permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person (s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction' Supervisors, Section 2. 15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home 'bwner actin as supervisor is ultimately responsible. ro ensure that the Home Owner is fully aware of his/bier responsibilities, man communities require, as part of the permit application, that the Home Owner 7ertify that he/she understands the responsibilities of a supervisor. On the ?azt page of this issue is a form currently used by several towns. You may :are to amend and adopt such a form/certification for use in your community. i Assessor's office(1st Floor): S—S t —r SEPTIC SYSTEM MUST BE Twc Assessor's map and.lot numb pi >o t er INSTALLED IN COMPLIANCE Board of Oealth(3rd floor): : C WITH TITLE,5 •Sewage'Permit number '- e Dsaa99'11DLL Engin . ring Department(3rd floor)': ` ENVIRONMENTAL CODE AND t ♦o rua House umber � JOWN REGULATIONS t639- Definitive Plan Approved by Planning Bo d 19 . APPLICATIONS PR6CESSED 8:30-9:30 A.M.and 1:00-2:00 P.M'only i f TOWN : OF BARNSTABLE ; BUILDING - INSPECTOR APPLICATION FOR PERMIT TO C 0_444 t; (54" �� / TYPE OF CONSTRUCTION (,l,G ` /hA Sty /t/� e2 � 19 �- 4 TO THE INSPECTOR OF BUILDINGS: The undersigned herebyapplies for a permit according to the following information: Location Proposed Use Zoning District Fire District `Z�TJ C'JTl1/7® Name of Own 'k��//C/ Address r Name of Builder �.¢L/Sic G'► Address le-3 or�vi�4v C e��r is✓v��,® Name of Architect Address Number of Rooms Foundationl�/^/�9�i Exterior Roofing FIoorqC2 2(/6 /6`a-e SKI t�0o r �y 6'f'� Interior SIX z-r 710 c,, Heating Plumbing Fireplace Approximate Cost f�o 000. Area �-- Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regardi the above construc' N e Construction Supervisor's License n(oa 5.3 `r ' SULLIVAN, KAREN S. f * r -REMODEL GARAGE TO - R No_ 34434%,_ permit For FAMILY ROOM s Single Family Dwelling' + r Location- 9, Mooring DriveCotuit u ", 'Karen S. Sullivan Ownertt t ,., .t V n Wood Frame Type of'Cpnstieuetion Plot c"` Lot 1 er r a .a m 'July 3 ' r^ > 91 Permit Granted; 19 ` Date of Inspection Date;Comted '.19 Cu ��pp tea+ !jr7 t w� bf ro r/ 0 rn - y ' r ,rry14�:7r�.ri' s�.....F-,. r.'NtYrlth^til�yy-.�.r.-,,p r,*,•r." r-...��^Y"d1'-•'7` -vr�-...,r..on `""�4,N.y`"��Siw*y:r.,,...r4'f"r..Y'"..+�.,� Assessor's office(1st.Floor): Assessor's map and,lot number Board of Realth(3rd floor):Sewage.-Permit number Lee Eng ne ring Department(3rd floor): t DASMAS& L �j � rua House number 14 1639• Definitive Plan Approved by Planning Board - 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00'P.M:only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO t �4 cl TYPE OF CONSTRUCTION d" 19 / TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: -ru/ y.. .� J Location �®/i�� , Proposed UseA .� k � r Zoning District Fire.District 67V t Name of Ownp44.IT�c 1 a �/.! ✓! Address a 74r f Name of Builder k`_f 5 re> �� Address <�.3Q�91��vJ Name of Architect Address Number of Rooms Foundation te Exterior f4TI V� U)f Roofing CY/L /yf ,Z&OA J Floors �E�G /6 �(Co r � Interior ',t��' fs�15 �'xe.T/0 C,K Heating ' Plumbing Fireplace Approximate Cost coo, Area �— \ e �D Diagram of Lot and Building with Dimensions Fee r r) 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„ Na e Construction Supervisor's License2��S S SULLIVAN, KAREN S. - A= 023-055 REMODEL GARAGE TO No 34434, Permit For FAMILY ROOM Single Family Dwelling Location 9 Mooring Drive Cotuit Owner. Karen S. Sullivan Type of Construction Wood Frame ; Plot Lot Permit Granted July 3 19 91 Date of Inspection 19 Date Completed 19 Town of Barpstable '❑,itC°�� Expires 6 moutlu'from issue dale Regulatory Services Fee * ggRVSrABU, + "SASS. . Thomas F. .Geiler, Director �ATFJ t,W`i A _ f1, Building Division Tom Pcrry, CBO, Bui1ding4Cornrnissioner 200 Main Street, Hyannis, MA 02601- www.town.barnstable,ma.us Office: 508-862-403 8 r Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Nol Valid wilhout Red X-Press I'rtprint Map/parcel Number Z 0 1_3_5 Property Address _ 1�4 ccrt n Residential Value of Work. 2 `: Minimum fee of$35.00 for work under S6000.00 Owner's Nam e & Address 1 Contractor's Name S 0_\ Telephone Number Home Improvement Contractor License #(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's-Compensation InsuranceAMIT Check one: 1.��C ❑ I am a sole proprietor 1 3 l_01C ❑ I am the Homeowner TOWN OF BARNSTABI.� I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request (check box) ❑ Re-roof(hurricatic nailed) (stripping old shingles) All construction debris will betaken to ❑ Re-roof(hurricane nailed) (not stripping, Going over existing layers of roof) Re-side #of doors Replacement Windows/doors/sliders. U-Value '(maximum .35) #of windows _ 'Where required: Issuance of this permit does not exempt compliance wilt other town deparunenl regulations,,i.e. Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner- Letter of Permission. A copy of the Home Improvement Contractors License & Construction Supervisors License is required. SIGNATURE: QAWPFILEST0RMSlbuildingpermit forms\EXPRESS.do Revised 0721 10 Y Il 5 The CcrilruoiriveaItlr of-Massachusetts _ .....___ Department ofIndrrstrial.4ccidents !— {; Office of Investigafions 600 Washrra Corr Street Bosion, AL4 02111 a g s nww.rnass.gotvdia NVorkers' Campensation Insax:ance Aff.da'6t: Builders/Con:tr--tctorSTIL-ctiicians/Plumbers Applicant Information Please Print Legiblti Na7ue (&1SinesssAOrganiza6on.gndividrial): C' Address.- � � DG2iNCl CitylSfate/Zi: --rL, ;-C +4 0-2- Phone # Are you an employer?Check the appropriate boa.: [11 pe of project(required). 1.❑ I am a employer with 4. ❑ I win a general contractor and I eaaployees(fu11 and/or part-time).* have hired.the sub-contractors [].New construction 1❑ I am a sole proprietor orpartnes- listed on.the attached sheet- ❑Remodeling shipand have no employees. These sub-contractors have Demolition working :for me in any capacity, employees and have.workers' 9. D Buitdin,g addition [No workers' comp,insurance comp-insurance.. 5. We are a corporation.and its ❑Electrical repairs or additions required-] ❑ . � 3CK:I am a.homeowner doing all work af95.cets have e�cercised their Plumbing repairs or additions myself. [No workers'comp. riglit of exemption per NMGLIZt�afrepairs insurance required,]t c_ 152, 1{ ),,and we have no . ezmp.loyee.s. [No workers' l Other comp-:insurance required.] 'Any appticaut thatchecks box#1-must also fill out the seftion below sho-mng theirwurken'compensa:tian policy inforvrstian- I Homeowners who submit this.afiidwir indicating they are doing sll wmt and then hire outside Contractors mast cubuut'a riew affidavit indicating such rContraciurs that cbeck this lam(must attached an sddidoml sheet showing the:name of thi2 sub-cmrtrntws and afar?whether or not chose entities ha;'e employees. If the sub-c.ontractorshwe employees,they.muEt provide their workers'comp.part'number. I alit rrrr v►plof�r tl�atis prot idirrg rirork�rs't'ortrp rtsation irrsatrn.rrce for rf�y ertrplaJ ens. Below is the policy and,job site ir!forwado& Insurance Company Name: Policy#or Self-ins.Lsic.#; Expiration Date: Job Site Address: City/State/zip: Attach a copy of the wDrkers'.compensation policy declaration page(showing thr policy flLumber and expiration date). Failure to secure coverage as required under Sect ou 25A of MGL c. 152 can lead fo the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as citril penalties in the form of a STOP IVORP ORDER and a fine of up to$250.DO a day against the violator. Be advised that a copy of this statement may be forwarded to the Once of Investigations of the D.IA for insurance coverage verification. I do ltvby certify under thi?pains and penalties ofpedury that tare info rmah,on,protriderinbove is trere and correct. Sienatore.; t , Date: /2 1 Phone#: EBoardof only. Do not rr,rite in this area,to be completed by citt or town;o�ria1 zt: Permit/License.#: ority(circle one): ealth 2. Building Department 3.C*Ityffown Cleric 4, Electrical Inspector 5.Plumbing Inspectorson: Phone# F i Town of Barnstable -Regulatory Services �psansuE, Tho masF. G� Sys, $, eiler;Director � 6J9' '�rontat" Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta b1e.m IL us x Office: 5i8-862-4038 - Fax: 508-790-6230 —----------------___________—_ HOMEOWNER LICENSE EXEMPTION ii Please Print DATE: l Z t3 11� JOB LOCATION: number street. " " villa e g "HOMEOWNER" Mt/r� name come phone N work phone#- ' CURRENT MAILNO ADDRESS: 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 v'vhich 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 mit iinum inspection procedures anal^ 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 ofconstruction Supervisors);providedahat.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 ofawareness often'results in serious problems,_particu]ady 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 Supervisor. On the last page of this issue is a form currently tised by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit formslEXPRESS.doc Revised 072110 ` L of THE rp� HARNSTADLE, MASS. s6�9: Town of Barnstable �� rFD MA't a Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.its Office: 508-862-4038 Fax: 508-790-6230 Property ®wrier .Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this biulding 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. QAWPF1LEsT0RMSlbuilding permit formslEXPRESS.doc Revised 072110 U.S. Postal Service CERTIFIED MAIL RECEIPT (Domestic Mail Only; No Inswance Coverage Provided) m cc S m F F C 1, A L 171-- Postage $ 3 as n ErCertified Fee m Return Receipt Fee C3 (Endorsement Required) Restricted Delivery Fee O (Endorsement Required) p Total Postage&Fees E' Sent To - - -- ----- -- r9 Street Apt No.; c3 or PO Box No. Q a �, ��,State,z 4 vd 35 Certified Mail Provides: 1 ■A mailing receipt ■A unique identifier for your mailpiece 0 A signature upon delivery ■A record of delivery kept by the Postal Service for two years Important Reminders: ■Certified Mail may ONLY be combined with First-Class Mail or Priority Mail. ■Certified Mail is not available for any class of international mail. 0 NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ti ■For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 38.11),to the article and add applicable postage to cover the fee.Endorse mailpiece"'Return Receipt Requested".To receive afee waiver for a duplicate return receipt,a USPS postmark on your,Certified,Mail receipt is required. J ■For an additional fee, delivery may be restricted'to the addressee or addressee's authorized agent.Advise the clerk or mark the,mailpiece with the endorsement"Restricted Delivery'. ■If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office Pfor postmarking. If a postmark on the.Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. PS Form 3800,January 2001 (Reverse) 102595-M-01-2425 Assessor's office(1st Floor): P� C SY M PI S7 FI� F THE T Assessor's map and lot number `' z `�VZZ YiAUED I C0MFLIIU!Z;ZPam° °`• Board of Health(3rd floor): VM MUE J Sewage.Permit number (5, ( • • _ teot��j�ROMM NTAL CODE t Besa9TsnLL i Engineering Department(3rd floor): / rnsa House number 19 -FOWNMuLM NS °o 1639. \®0� Definitive Plan Approved by Planning Board �Fa Yar d APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE BUILDING INSPECTOR , APPLICATION FOR PERMIT TO , n� a TYPE OF CONSTRUCTION 19 i TO THE INSPECTOR OF BUILDINGS: ' The undersigned hereby applies for a permit according to the following information: Location Proposed Use 1 -2 C Zoning District Fire District ? � ,� �, �� 7:G Z as tom 3 3� Name of Owner I< 2 re n t� L L, L,/e—•� Address b o. yv+ e 66 n 3 Name of Builder 11)7 m e J-�2- 4/1 � Gam, �-� Address c e2, e) 22, Lg�7L." Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior I, 1 Heating Plumbing Fireplace Approximate Cost JIl1.001^on Area n2.3 6 Diagram of Lot and Building with Dimensions 1 Fee 1 `a, 3° �s 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. 1 Name Construction Supervisor's License 0`�� 2 2 SULLIVAN, KAREN 4 r No-' 3 3 2 99 Permit For ADD DECK Single Family dwelling Location 9 Mooring Drive ;a COtuit 9 Owner. Karen Sullivan Type of Construction Frame Plot Lot Permit Granted October 18, 19 89 Date of Inspection -� 19 DateComo%ted 19 . w €� c , K.. t e 44 '* 8 Y: i } } Assessor's office(1st Floor): Assessor's map and lot number �� o�Y"E Boardlof Health(3rd floor): p Sewage Permit number t3 Z BABD9TABLL, i Engineering Department(3rd floor): / NAB& , House number 's �( /�^` �° i639• 0� Definitive Plan Approved by Planning Board ! 19 �oypY d� APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF BARNSTABLE y' BUILDING INSPECTOR APPLICATION FOR PERMIT TO _" L ON— TYPE OF CONSTRUCTION U-) 19 TO THE INSPECTOR OF BUILDINGS: �! The undersigned hereby applies for a permit according to the following information: ;-� Location YY1 el en 1 q ! Proposed Use E Zoning District Fire District 61a5 Bu/� Name of Owner k n zc- ki 1 J L f I t/ a ✓f Address �7 /o (�J �, vy, �r.t, / ` -/54 n 3 3 Name of Builder ��,I n Address C ,,?P.� n. ��`I��, , v✓t Cam. Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost ea C�f r n Area Diagram of Lot and Building with Dimensions/ Fee 10 ,;2 7 L 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. a � Name i✓�Z�/% �/�� Construction Supervisor's License SULLIVAN, KAREN A=023-055 y. -No. 's 3299 Permit For ADD DECK Single Family Dwelling Location 9 Mooring Drive Cotuit Owner Karen Sullivan Type of Construction Frame Plot Lot Permit Granted October 18, 19 89 Date of Inspection 19 Date Completed 19 SENDER: C :Complete items 1 and/or 2 for additional services. I also wish to receive the a ■Complete items 3;aa,.and ab. following services(for an ■Print your name and addr'ess-on the reverse of this form-so that we carrretum this extra fee): card to you. a ■Attach this form to the front of the mailpieoe,or on the back if space does not 1. O Addressee's Address permit. d ■Write'Retum Receipt Requested'on the mailpiece below the article number. 2. ❑ Restricted Delivery W r ■The Return Receipt will show to whom the article was delivered and the date a delivered. Consult postmaster for fee. 3.Article Addressed to: 4a.Article Number d �.f7�fl],�1940 00,03M 9647y 3383, £ z 41J.Service I ype c°+ / �' ❑ Registered p'Certified W ✓?S��' ❑ Express Mail ❑ Insured S 0,Retum Receipt for Merchandise ❑ COD c 7.Date of Delivery, z —Oct 20 5. ceived @y:(Print Na r. 8.Addressee's Address(Only if requested e W and fee is paid) W ¢ - _ C -:6.vv t- �.r� c i rf4?; �z v ;, ietK ;ii (( [ " t6 7 f � ;a fit•t * F+1'%��-c f PSI ,tz. �eceiptI UNITED STATES POSTAL SERVICE First-Class MailPostage&Fees Paid USPS Permit No.G-10 • Print your name, address,and ZIP Code in this box• 1,��1F1,1►►1:,1�,�Iflid 1„.,111„l,if,1►111 Town of Barnstable Regulatory Services P�ppTME lok� Thomas F.Geiler,Director Building Division t BARNSMBLE, « Peter F.DiMatteo, Building Commissioner 9Qp 1e . �0� 367 Main Street, Hyannis,MA 02601 AlEO MP'i A Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Mr./Ms. DIANE LONGOBARDI name address and all persons having notice of this order. As owner/occupant of the premises/structure located at: 9 MOORING DRIVE,COTUIT Map 023,Parcel 055,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,DECEMBER 17,2001 to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: VIOLATION OF SECTION 3-1.4 SECTION 5: BULK REGULATIONS,I.E.MINIMUM SETBACK REQUIREMENTS. 2. COMMENCE within seven(7)days,action to abate this violation. SUMMARY OF ACTION TO ABATE: MOVE EXISTING STRUCTURE WHICH ENCROACHES INTO 30'FRONT YARD SETBACK REQUIREMENT. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable,a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed,action to abate this violation has not commenced,further action as the law requires will be taken. Richard Stevens Local Inspector Certified Mail #7001 1940 0003 9647 3383 Q/FORMS/viozonel >:::>:<«<:««:<::;:::> <::.;:.;>:.;;:.;:.;:.;::.;:.;:.;:.;:.;:.::.;:.;:.;:.;:.;:.;::........ ....._.. ........:.;:.;:.;:.;:.;:.;:.;::.::;:.;:::.;;:.; .;:.::......................... ..... 'V`:: ::: »<:<:>::»::>:::::<::<:::> Cfr: ::<::::: .:::::::::::::::.:.. ......:.:.:.:........:.:.:.:.:.:...........:::::::::::::::..:::::::::.:::::::::::::::::::::::::::.:.::.:::::::::::::::::::::::::::..:...::::::::::::.:::::::::::::::::.::. ::Ieerr :t»> >`' :1�::1:::`:%' :: :: : :: : < ><<<< «««««<:.....:<? > <<<><> : <<««« �.. : < ` <. 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