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Home My WebLink About0175 OXFORD DRIVE i J 7 I Town of Barnstable *Permit#,672M76� Expires 6 months fran issr Regulatory Services Fee act�,. BARNSTABLE, Thomas F.Geiler,Director 94� MASS. Building Division r✓✓� Tom Perry,CBO, Building Commissioner• Cr . Cl 200 Main Street,Hyannis,MA 02601 % www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 62( -037 �ys� Property Address 17,< QxFeib DR t of 06 I a l"r � �� Q 26 36 (�Residential Value of Work 7i-Si?y Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address �D$ i�l— '� / '161Y164 _Q/AIXI! p- Contractor's Name �� Telephone Number Z63 Home Improvement Contractor License#(if applicable) '. Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one:❑ i�-PRESS PERMIT I am a sole proprietor. I am the Homeowner NOV 2 9 Zool I have Worker's Compensation Insurance Insurance Company Name TOWN OF 5ARR TABLE Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will betaken to ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side . Replacement Windows/doors/sliders. U-Value -30 (maximum.44). *Where required: Issuance of this permit does not.exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Prop per mus ign Property Owner Letter of,Permission. . A o t mprovement Contractors License`is required. . SIGNATURE: ;Q:Forms:buildingpetmits/express' Revise091307 The Commonwealth of Massachusetts Department oflndustrial Accidents Office of Investigations i t ' 600 Washington Street r , Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contract(irs/Electricians/Plumbers Applicant Information Please Print Le0bly Name (Business/Organization/Individual): �� /4 , i!5 Yom -,ek_ Address: 176— 4'�Xlrept) D21 UC City/State/Zip: 00 I O 11— & Q26 Phone#: Of5--4Z�-D7.3 Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition workingfor me in an capacity. employees and have workers' y p �'• 9. ❑ Building addition [No workers' comp. insurance comp. insurance.$- required.] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their I L❑ Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.[o Other UJOYDOUJ comp. insurance required.] P ANT *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA or urance co rage verification. I do hereby certify u er p enalties ofperjury that the information provided true and correct. Si nature: Date: ��706 u 7 Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 1. f Town of Barnstable Regulatory Services t nAxtvsrnet a Thomas F.Geiler,Director MASS. %634. �.� Building Division ,olEo ,tA 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: I) -7 JOB LOCATION: 1 7S-_ (!51X '�DaP bQ/(/ t ^/V/ number street village "HOMEOWNER": wg .SaMM02 2e3-435-`741e zo 3---13!�-26 a 1 name home phone# work phone# CURRENT MAILING ADDRESS:LQ 7 /PD P 214gg7 e l^ QE1`�77 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigneggneowner"certifies that he/she understands the Town of Barnstable Building Department minimum ins ct' rocedu an equirements and that he/she will comply with said procedures and requireme s. Signatu e 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 I I Asse4so4 map and lot number ...:..... ..[. 93. THE tp1` Sewage Permit number Cf... ' ,V. ,. (f ,�/� EARNSTULE, i House number ......................f.... �f�......!U.". ..... +� �.�� \ �1'�S 9O MA86 ......... �. ... } , y' t639 TOWN OF BARNSTABLE BUILDING INSPECTOR -� APPLICATION', FOR PERMIT TO ...�� f ' CL� TYPE OF CONSTRUCTION .....:.`... . ........ ...................................................................................... ...................................... i9Y3 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a ipermit according to the following information: Location ......LCT.'::f 2.3. ......... .. ............ Calvlr ,.. .............................. ProposedUse ....:. J.n1601 .......;�t!!1.1.L.Y... . eh.e�...................................................... . ........................................... Zoning District .......! .%�E....................................................:..Fire District .....1�!.` Y7......................................... 0 6A 1 L i�Y O 1•1S Name of Owner .......... } Address Name of Builder" .. 'Sl ...VPLI. (�.10.................Address 1.VA CUG .:..MAD... .. �Ghr1!,5,�..MA. �/ Name of Architect ...„11 ................................................Address ................................;. - ` CbP�C d2La Number of Rooms ......... ...........Foundation Exterior .. d i....CLAPMAC.0... ..S#a0.4. 4� .Roofing ....... AT�... 1. 16L.0............................... Floors 1!ut�i .......... .........�..��: .. ...Li/J6� 1 ...Interior .......,� . ................. Heating ....(5r.Fa..&..............................................................Plumbing ...lYe I Y...` � .�. ....p/.tc. ........ Fireplace ....64A&KL ............ ............................................Approximate Cost .......�. �.. ..... ............... - - e. Definitive Plan Approved by Planning' Board __,i'1 -----19_ Area d.. ' .....'...... Dia ram of Lot and Building with Dimensions �G g 9 Fee .............. ....... ..................... SUBJECT TO APPROVAL OF BOARD OF HEALTH �� /�V I, �A `xlill . t 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. • ! 4 Name ...... ............... .. .... . :MA9TIS, JOHN & GAIL 1 / F 25913 12 Story ` . Permit for aI ^o Single Family Dwelling d Location Lot 22, 175 Oxford Drive : Cotuit rr ................................................................ ........... a , rr � .. F ' John & Gail Martis Owner _ Frame - Type of Construction .......................................... _ ............................................... PlotA......................... Lot ................................ 7 i r 1 • Permit,Granted ... ................ 83 w Date of Inspection ...........................�.........-19 - j ' n .....:. j Date;,Complete 7.�, �. '............. .. l 9 r Assessor's map and lot number ........ .. ..{ ...... c Yee o r / SeweEje Permit number .... ... ...•`::`?' '... ... ��Q �+► +� l hJ Z BAHH9TAELE, i Housenumber ....................... ..........,..............:............. rasa .. ...... 94p 2 6 9. /r 'E0 Mpr k\�� TOWN OF BARNSTABLE BUILDING INSPECTOR ' APPLICATION FOR PERMIT TO �1t S IU�aI L� ... V. TYPE OF CONSTRUCTION ......4!` x? rr .................... ..................... ...................................... ................................................19.�.. . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a -permit accoedi}g to the following information: Iry Location ..... ........................... C I rY I ,?1.. .f !".Igor... .. ........................................................ ProposedUse ..... ..... .. . A ..........................................................................I......................... �� ZoningDistrict ...... .......................................................\ Fire District ......:....................................................................... Name of Owner .............. �C ........Address -1 ..........................tom. �..... '..�.„...................... Name of Builder; ! ',)1. -...�1tJ ;tih1l #" ;..................Address J13....r�{AII}! t? �.....of�`. . RQr4nnI„t� f'lA . . . Nameof Architect lF= .............................................Address .................................................................................... Number of Rooms ''` ` Foundation CQ?h.d�t2x"I". ........!.....................1................................ ..... ............................................... i Exlerior t #ill:....!tL1ar'I ,{7 -1„ Aa )n "i.Roofing ...... ;�a%! !',r tnCat": .+ /=� k"� tfitI1F^r'1...Interior ....... ....... Floors ......................................................................,............. '3rTk'_c�L1L_. . ................................................................... Heating :.,.... Plumbing ..1:.�7t'?I,.Tc: ...r�...>y " Fireplacevo ..................................................................................Approximate Cost ..................:...........�..................................... Definitive Plan Approved by Plarining Board __AIA_V 7 _ !� ....... 'f — - -- 19 --- .,. Area . .......-'...................... 11 Diagram of Lot and Building with Dimensions Fee )� SUBJECT TO APPROVAL OF BOARD OF HEALTH �l� r 1 r14 r � r a ' I 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. Name ...`._wx�,e � � Y o MARTIS, JOHN & GAIL A=21-37 25913 12 Story No ...4........... Permit for .................................... Single Family Dwelling w Location .....Lot 22, 175 Oxford Drive ........................................................... Cotuit ................................................................................ Owner John & Gail Marti.s .................................................................. Type of Construction Frame ................................................................................ Plot ......................... . Lot ................................ Dec. 22, 83 Permit Granted ............I...........................19 Date of Inspection 19 + Date Completed ......................................19 o„o•,i ., TOWN OF-BARNSTABLE Permit No. ____25913 Building Inspector cash rwn — - �0 YPY . OCCtJP�►NCY• PERMIT Bond ----------- - -- Issued to john & Coil SUS Address fpt 22, 75-Caford Dri�re, CcrNui.t Wiring Inspector ' Inspection date �+�L el Plumbing Inspector �/A . c -� Inspection date r Gas Inspector r Inspection date Engineering Department_ � �'� { � Inspection date-,Y' ' Board of Health s�t�T. z. �,�-� Inspection date THIS PERMIT WILL NOT BE VALID, AND E� ILDING 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. qw ,4............... . / 19 ./ /..�;.; Bu'ildin Inspector I_ FROM TOWN GP BARNSTABLE W. Francis i BOLDING DEPARTMENT1 G11.1 �"�".,.r ..�• M.. - ', Town Clerk . . . . fi° G7 MAIN STREET HYANNIS- MA 02601 h t .,., k 4 Phone: 775-1120 SUBJECT: FOLD HERE DATE r July 13 i, 1984 MESSAGE Work has bedn.cmp eted under Pe.. �rmit #25913.(Jahn &"Gail Mattis) � , ..�. .ems. Please release-Bmd , >n • .. f'iY O F'iR f.Y V':if'N.:$ib H6/k drY acra{ 01 SIGNED DATE - - REPLY ' _ t - RK •• N87•RMI - - �1 - RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY • - • PRINTED IN U.S.A. SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE.AND PINK COPIES WITH CARBON INTACT. , . Y 4 0 1 z-ss. o v 4 2,2 , \ V }� }� Lsz ' .Y SPL'c, 2Es�kc cPlw) ,« CERTIFIED PLOT PLANT :.�/�-ss dn.L�� tom,?" p..Go��►o-,.✓ F�7'4- F,,V��1 l f M ,, ' ,L...t7 7` 2 2• C.�,�r'=r,� �D IZ P i , /h, IT' Sez1 NEWCOMTRUCTI OIdL'P 4_ROBERT," ?� t� 7 L� 1 "�-" , (TRUCE .,-TOP. .OF FOUNDATION 19 FEET � E�oH �f tRl � ABOVE .1,10W POINT OF_ ADJACENT N' lA STe �► �Ho su �y SCALE,' DATE V G6 / �z • ;,r / utlKl�4Yp N I CERTIFYTHAT THE y SHOW N . ON THIS PLAN IJ LOCAT194,1 ECtSTERED REF NSTERED r * , 400 t �, Flo ®N' ,THE`-GROUND AS INDICATED, CIVIL LAND OONFORMR TO THE ZONING •1»/� ENGINEER RUIlIEYON ,� +b1f� Of tAARKSTABLE , MAS ,. Y 712 AAA1 tJ STREET ; HvArvRIs, �ssa �� FE. � �.... DATE I®. 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