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0114 PINEVIEW DRIVE
Fit piNEJi� w Aeive r � pFtNE TpN, Town of Barnstable *Permit P�)011 Expires 6 hs from issue date Regulatory Services Fee + 13MMSTA 1.4MAM • 9 % � Thomas F. Geiler,Director �'OrEa ter" _ Building Division Tom Perry, CBO, Building Commissioner g' 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �G Not Valid without Red X-Press Imprint Map/parcel Number / Property Address residential Value of Work ;�!j.5-4:57` Minimum fee of$35.00 for work under$6000.00 Owner's Name &Address e- /1-1<lo �"I�� )i�l/'r!��'y°'/c t� f�2/✓c- C o��X J?'. l'LI/7,D z G tSS Contractor's Name /4�/YV lJ 1iG.�c/ Telephone Number �� Home Improvement Contractor License#(if applicable)_= 12— 11793 Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance �� S� ��dim® IT Check one: [�J- 1!am a sole proprietor ❑ lam the Homeowner SEEP ,- 7 I have Worker's Compensation Insurance Insurance Company Name ` ' F BARJSTALE Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over` existing layers of roof) E Ke-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum .44)#of windows *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Notes Property Owner must sign Pr erty Owner Letter of Permission. A co fItheme I o ment Contractors License& Construction.Supervisors License is ed. SIGNATURE: v Q:\WPFILES\FORMS\building permit f s\EXPRESS.doc 41 Revised 070110 The Commonwealth of Massachusetts Department.of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): / �//V Address: '� � S �i✓� City/State/Zip: fio b Phone #: 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 f * have hired the sub-contractors 6.,❑New construction �ployees (full and/or part-time). 2. I am a sole.proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. employees and have workers' comp.insurance.1 9• ❑Building addition [No workers' comp:insurance � P• - - required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doingall work 'officers have exercised their l l._❑Plumbing repairs or additions myself. [No workers' comp, right of exemption per MGL 12.E]Roof repairs insurance required.] t c. 152, §1(4),and we have no 13. 3 employees. [No workers' .Ether_ comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such, $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must 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. �y Insurance Company Name: ✓�I���/� V5. &U, Policy#or Self-ins.Lic.#: YM � .Expiration Date: Job Site Address:_ l /l 1�� � City/State/Zip: eo TJ/� �`- Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance cove verification. I do hereby certi n r the s d hies of perjury that the information provided.above is true and correct Si nature. Date:. Jr 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 ector 6.Other Contact Person: Phone#: Town of Barnstable Regulatory Services MUMST"LE. MASS. �, Thomas F. Geiler,Director 1639. A. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Usin-a A Builder —, as Owner of the subject property hereby authorize ,��'lJf t� � �� to act on my behalf, in all matters relative to work authorized by this building permit. r (Address of Job) t - .Pool fences and alarms are the. responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be utilized until all final inspections are 4eend accepted. Signature of Owner Sp-Iicant Print Name Print Name Dat Q:FORM&O WNERPERMISSIONPOOLS DIME Tn, Town of Barnstable Regulatory Services BARNWABLE, Thomas F.Geiler,Director y MASS. %639. •�� Building Division lFD MA'I 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: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING 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 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 • ��80® The Town of Barnstable Department of Health, Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-190-6227 Ralph M.Crossen Fax: 508-790-6230. Building Commissioner Home Occupation Registration Date: ' 3 U"�0 Name: To) Ar» M W J� Phone#: Address: . ti l�� i nc\)�P\J'7 a— Village: Name of Business: Cap-A ye,alo r Type of Business: i ViCA carLt n V i CL7 i 6N� Map/Lot: ©q WITNT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings, subject to the provisions of Section 4-1.4 of the Zoning ordinance, provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor; no visual alteration to the premises which would suggest anything other than a residential use; no increase in traffic above normal residential volumes; and no increase in air or groundwater pollution. After registration with the.Building Inspector, a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling trait, located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings, and there is no outside evidence of such use. • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise, vibration, smoke, dust or other particular matter, odors, electrical disturbance, heat, glare, humidity or other objectionable effects. • There is no storage or use of toxic or hazardous materials, or flammable or explosive materials, in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation, and not within the required front yard. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation, other than one van or one pick-up truck not to exceed one ton capacity, and one trailer not to exceed 20 feet in length and not to exceed 4 tires, parked on the same lot containing the Customary Home Occupation. • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,.the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I, the undersigned, have read and agree with the above restrictions.for my home occupation I am registering. Applicant� � Date: 6 0 36 -6 d Homeoc.doc Assessor's map and lot number .y�— T. .:�.. *TN E Sewage Permit number .... a......� .. ..' . . .. ...... , BARNSSBTa LE, i u Z House number ................................fit-�./.:/�,Y`........................, STe��.�. 3 IN aO 1r4 ta 9�0 t63q. \0�9 IT H TITt..F G � . TOWN OF BA1�A . a1B �E TOWN RF_,CjU AT1 r . BUILDING ANSPECTOR APPLICATION FOR PERMIT'TO Construct ............................................................................................................................. TYPE OF CONSTRUCTION .......................VQQd, k'raM.......................................... ............................................. Gl,�.........................19.��!� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Lot 26 Pineview Dr. , Cotuit, Ma ProposedUse ....Residential......................................................................................... ........................................... Zoning District R�CFire District G9��atl..zu zu................................................... ....................................................................................... Name of Owner Dennis Star Construction,„Co,..„.•Address ..24..G �..�RXId,.]� ...�.. Q,.. dxlC�lUth,.. 1... ...... ................... Name of Builder .................Address ....................... Nameof Architect ...WA.......................................................Address ..................................................................................... Number of Rooms ...5............................................................Foundation .....pQI re.d..CAXACXQ�....................................... cedar shin le Roofing asha�t..shingle....................................... Exterior ............................g................................................... ........... FloorsP.l.` ........................................................Interior ...........Sheet..rock.................................................. Heating ...I................F. `Yq. ...GAS.................:........:...............:Plumbing ........ 1.1/2..bat:=................................................. Fireplace One................... pp r.Approximate Cost ...............25..25.1-000......................................... Definitive Plan Approved by Planning Board -Sept.___2-1,_-------------19__7-3__. Area ......./ .. ..5„.-..... ........ Diagram of Lot and Building with Dimensions Fee - ............ e... .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ,D 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. � �.. r Nam ........... ? .... 016681 Construction Supervisor's License .................................... ' - ^ . .;. . . DZNNIS STAR CONSTRUCTION CO. 25709 One Sinole ]�aouily Dvvelling ..~~~~~--------------------- Location .Lot...3S......ll4...I`inenie.w...Drine . . ' -----./�gt����.--------.�------.. ' - . . ' Star Construction Co^ ��vvne, .���/�!���----------------. ^ ' ^ . . , . . ' }7zc�oz� Typa�� Construction' -------------- .. ' . ----'.'� ........................................... ------ � ~ . . ^" ~ . Mct �—. '� Lot —�r ---' ----------� ' , . ' ^ ' . - - ' October 28, 83 . Permit Granted ................................ ^ ' ~ �c Do!e~of Inspection —'���..... ..................lA uo"z c� _ . � . ~ ' . ` 3" ^ ' . , . . . / . . FRONT sr TOMM OF BARNSTABLE ' l BUILDING DEPARTMENT `rands Lahteine � MAIN STREET HYANNIS, MA 02W1 Town Clerk Phone 775-120 a SUBJECT:' FOLD HERE - DATE - __ M f S-S'A G E _ Work,has-bmn-e leted-undw. Perna. # 257 39 �De .s Sir .� Cons�,�rrxcfi Please re a-Bond v_1�-�:�.4»w;. y! IGNED - - DATE REPLY x - y SIGNED Ne7:RmI • _RECIPIENT:RETAIN WHITE COPY,RETURN PINK COPY ' . PRINTED IN U.S.A. r K SENDER: SNAP OUT YELLOW COPY ONLY.SEND WHITE AND PINK COPIES WITH.CARBON INTACT. i f TOWN OF BARNSTABLE Permit No. _._ �� Building Inspector IL"STAU cash ,63 @ OCCUPANCY PERMIT Bond ----------__.___ Issued to Address C_'Lis Stir ksistnkcti_on C 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. 19............ .................................................................. _ .. ... __......... Building Inspector . r f ! -�y,F i' r a tiiL r ,t t iter r yt.ti .f - r Qk, M.�.s n t _ z �v 5 : r+ t i q '!•` �t SA iV - +.r !. . �,#tw+.M r//� t,t.•,r }A''r i 1 vh;"y } S M Y, ,s ...r.{ j i 1 f•SF i+' ! +•c ,! 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C, r 5 11 Y ; r f�:F. 4 J as-~ " .:� } : .. ty� 3'1L' �; '�s°MQRAIANt r flR 'SSA�AfI�+ r R L'$ 'r ` DATE T f�> ;, . t�. : F , - , r. ! ,lid i' t t r lri f„ �� 6 J i• i t 7 a +'+ F F ♦t..'n z' {�,. ., F I e:c �! it- J", y#' 1" - t 4 ,r 1 F, r r ? ,s., _ #e4 rtr. v t . t !, Y .S: �• ':s� ° I. '- z a r �! !''S' P +.�{ j f v ,1 ! *? 9 ! r y Y?j}, e X rr y .��-.__.�„'- _i,•• L"- •_U,, , as" � yf ..* 7� 71 I- t $:.;s 1' 4 '.44 : c .- _...I— r ..•��_ 4 11-fk'Fc+"-1ry MAi IL Assessor's map and lot number ... 1'. -1, / �pF 7H E Sewage Permit number ( ZOO ARN�ABLE. i House number ................................ 9.l..l..Y............... r MAea 16 \00 0 YA'(p. TOWN OF BARNSTABLE BUILDING I`NSPECTOR APPLICATION FOR PERMIT TO Construct " TYPE OF CONSTRUCTION ......................NWwd.F:rim......................................... ..........................19�! TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locution Lot 26 Pineview Dr.r..Cotuit•..r'k?...................... .... P�rbpdsed! Use ......... ReSid�rlt131........... „ ...... ............ .... ............................................................. :� A, Zoning- District ........... ......... ..............................Fire District .... CL?tP tr..�:.................................................. C. Name of Owner D �eriixis Star Construction Co. 24 Great nd Dr X Name of Builder S Address ............................................................... .................................................................................... Name of Architect ...N '..................:....................................Address .................................................................. Number of Rooms ....................................................................Foundation .....P�? 4.CX�? �T' ....................:.................. cedar shi le . ......................... ................................... Exterior ..........................?? ..... .....................Roofing ...........aa`' a� :. �P.....: Floors .......................I?l ...............................................Interior ...........Sb(et.T'Xk.................................................. Heating ....RFiW •: Gas t .Plumbing .........1... /.2.Jl hs................................................. Fireplace .me......::...........................I.....................Approximate Cost ...............25.;.0.00........................................ Definitive Plan Approved by Planning Board -Sept—21_____________19_73__. Area .......................................... Diagram of Lot and Building with Dimensions Fee .... SUBJECT TO APPROVAL OF BOARD OF HEALTH f' i• OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ti + I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Nam ............`::r. . ......................:... ............ s 016681 Construction Supervisor's License .•• DENNIS STAR CO STRUCTION A=40-94 7 14s.4,9-gq No .... Permit for .. One Story,,,,,,..., ........... Single Family Dwel,�, nq ................. Location .....Lot...6.........114...Ziaemiew...Drive Cotuit ............................................................................... Owner ....PjqR1.4i.F?....$.tar...C.Qn�tr.Uatipn Type of Construction ...Frame......................... ................................................................................ Plot ............................ Lot ................................ Permit Granted ........October,, 2.8......19 83 Date of Inspection ....................................19 Date Completed ......................................19 19