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HomeMy WebLinkAbout0236 POPONESSETT ROAD �'6 J'o6v12ersT �?J- Town of Burn �stable *Permit# p� Expires 6 months fronAjs=rdate Regulatory Services Fee 1 �� omas F.Geiler,Director AUG 12 2012 Building Division Tom Perry;CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 TOWN OF 8Af;t48TA9Ljwww.town.barnstable.ma us Office: 508-862-403 S Fax: 508-790-6230 EXPRESS PERNUT APPLICATION - RESIDENTIAL ONLY m F /1(� (" Not Valid without Red X-Press Imprint Map/parcel Number � ) I �J`� V/ Property Address 00 esidential Value of Work 0CP 0 ° Minimum fee of$35.00 for work under$6000.00 r Owner's Name&Address i�C /°1 I - 6—n .t1 � S (r . fop ant 55e /� A-r � U2 35 Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Ch�ta e:. 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 Requ (check box) f} ° Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to 5z,!1 G �! C 1� ❑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 ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. . Separate Electrical&Fire Permits required. *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: A/� ' t''� QAWMF 13STORMS\building permit forms\EXPRESS.doc Revised 053012 The Comm'onw+eah*of M'assachruseth Diparhnent o,f fndustrlot Ac cid Ofike of 1westigadorrs 6, 00 Washiagwn Str mt Boston,MA 02111 >ii"' mar govfdiuz Workers' Compensation Insurance Affidavitr Butiers/Cmt erac�kTtrk ans/Pbun rers Appficant Information Please Pint 'b Nance t / illy c�tyescz _ P 77 -- 3 Are you an employer?Check the appropriate box: T of project r ype P ] (required): 1_❑ I am a employerwith 4. ❑ I am a,general contractor and l xxction employees(fun and/or part-time)* have hired the self-c�o�nttactors + 2_❑ I ass a sole proprietor or partner listed on the attached sheet. 7_ Modeling ship and have no employees These sub-contractors have 8= ❑Demolition wg&ing for me in an employees and have wadcm' any 9_ B addition O Wnf1�C['�',comp.insurance Comp_ir,cn.vnep� ❑- ... I- ❑ We are a corporatioa and its 10_❑Electrical s ar additions . 3._ Lama homeowner doing all work officers have exercised ffieir 11_❑Plumbingiepairs or.addid. myself[No workers"comp- right of effemgtiou per MGL 12.❑Roof repairs , insurance -)"I c.152, §1{4X.and we Jurmnio. employ-[No wo&=t l3.❑Other comp insurance required.] `AnY app�cmi Pont checks box#1 mast also fill oat the sec&n below dwwiuglhea waders'wmpeasaA poJiC9 i,�,, HnmeawoRtS ALO snboait this affdavdt i&catmg they ace doing all mat and then bite outside coutractocs must submit a new affidavit indicating such iCanuactats that check this boot must stmched s n additional sheet.shavdng the name of Ike sub-cmMca s and:stste Ahedw ormot Ease entities bave empkyym.ifthe sab<natraciatsl—empltryees,they mastFWAde their W-kKe aIMP.policy mnaber. I am an empinyvr that is prauidittg workers'coarpensation 2UsaMM06 fir sty eMP1 JIMM MOW is thff policy aAd job site: informadom Insurance Company Name: Policy#or Self--ins.lic.#: Expiration Date: Job Site Address CityJ"StatelZip: - Attach a copy of the workers'compensationpolicy declaration page(showing the policy number.and e3pn-ation date). Failure to secure coverage as regtrired 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 imprisonnimit,as well as civil penalties is the form-of a STOP W©RS"ORDER and a tine of up to$250.00 a day against the i3alat3or. "Be.advised that a copy of this statement may be ftwarded,10 the Office of hrvestgad=o ofihe DIA.formsurance coverage vet firabian.. IdoherebyCewhrun&rthe its andpenal`ties ofperjury that the in fibr rafiMprvWArd abova fs true and correct Sd Bate: Phone#: 77 -"C2 3t- b o1, cial"use only- Do Hurt arrke in this:area,to be completed by city or town of frciat amity or Toawn: Perim License# Issuing Authority.(circle one): 1.Board of Health Z.Ding Department 3.City1fown Clerk d.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: phone 9: 6 • BAENBrABLE �.i6 � 'own of Barnstable 9 . fig' 3 A A a Regulatory Services Thomas F.Geiler;Director Building:Division Thomas Perry,CBO Building Commissioner 200 Main Street, .Hyannis;MA 02601 www.town.barnstable..ina.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder kt e yh e? t7 as.Owner of the subject property /�� l P p�Y herebyauthorize /U` �`e f to act on m behalf y in all matters relative to work authorized by this building permit application for: 3(� eso&ol? (Address of Job) Signature of Owner Date An/h�_ -e Print Name If Property Owner is applying for permit,'please complete the Homeowners'License Exemption Form on the reverse side. Q:\WUMESTORMS\building permit forms=RESS.doc Revised 051811 �s > Town of Barnstable Regulatory Services 9»rrMAM $' Thomas F.Geller,Director o i 9.,+0. Building Division. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA.02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax:. 508-790-6230 / HOMEOWNER LICENSE EXEMPTION i J .3 `2 Please Print DATE: ///f/` c �, JOB LOCATION: 3 V' . Q O�1 s J e / number street village "HOMEOWNER": //�e e r'6t 4 name home phone# work phone# CURRENT MAILING ADDRESS: . 'e cityttown 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' proce s d r • ements a'hd 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 BUding 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:IWPFU,ES\FORMS\building permit formsUMIZESS.doc Revised.051811 , i Assessor's office(1 st Floor): / ® C SY M N@ 118 1 SE Assessor's map and lot number D/ 7 `�� Co ��� THE t Board of Health(3rd floor): 0 '7 INcTAL EID IN C0NPL6P K*P d'"Q�O o`#� Sewage Permit number .� / r1t,`o�Tff LE 15�Q„ ,,„� • Engineering Department(3rd floor): E @R®l� MENTAL�' it "i� = BeaasTsnrc House number . TOWN iREGULAXM21,13 �°o.�tb3o• d Definitive Plan Approved by Planning Board 19 o YAY APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN ' OF BARNSTABLE BUILDING INSPECTO APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTIONW(9j SID, 19 �— TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the following infor ation: Location �� < m .. Proposed Use Jai,-1L Zoning District _ Fire District � l Name of Owner Address lop Name of Builder Address O (,3 si Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors A Interior 1 ` Heating Plumbing-".— IV Fireplace ( yIA �, s,�_ Approximate Cost Area ' 90 Diagram of Lot and Building with Dimensions ` �-.� Fe , !� t To 19' T . . �s ('Po N ass C_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. Name OU. Construction Supervisor's License ��4 MAHON, GEORGE & ANN 3i No 3 3 3 0 5 Permit For ADDITION Single Family Dwelling : Location 236 Poppon S Pt#Road - Cotuit Owner George & -Ann Mahon ., Type of Construction Frame Plot Lot 4 %• �" - ' :, _g.• f ,.., .^tip _- � .Y� • Permit Granted October 2Q., 19 `gq .� Date of Inspection - 'L 19 DatrXomW. ed 19 ' ti Y -•w �•aam �1 ire Air} _a .L w • - - ''i ' •ti i F _rY�..'t..��.+rf'�V'..-,:•a�y� •'gS+}�1,^'�.��r�fi"rS�w, f��„r±,�.E�.{��.:,.f"ail,�'A.f'Al�. i,•.+i<F� ._ .. .i ,. .. Assessor's office(1st Floor): / �T Assessor's map and lot number Board of Health(3rd floor): Sewage Permit number 7 7 3 / J�) • B Z AB39TODLL i ryl Engineering Department(3rd floor): .y ,, wz %� -� �o rhea House number c17 �-� °.�j��639• d Definitive Plan Approved by Planning Board 19 c rav 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 v TYPE OF CONSTRUCTION V p. 1bZ 1 19 Q TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: LocationPa4df'. l `.� I I ` !,,J J Proposed Use Zoning District / ' _ Fire District 1 ..- .. C_.7"_,Q cr Address;�o I CY !�-ar Name of Owner _ � .--F t u, M4 0 . Name of Builder Q�I.0 1 C-�C.L,' -�.7 Address as4 r i �3 Name of Architect -vv`-e-- Address Number of Rooms. Foundation U Exterior Roofing Floors i_�- `* 1. _ -4 A InteriorLf t Heating LaL—L-1' Plumbing _ Fireplace (-IA X Approximate Cost Area 17( A Diagram of Lot and Building with.Dimensions Fe l 2- 0 f fl 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. F Name �, LO C` ' Construction Supervisor's License 0 MAHON, GEORGE & ANN A=019-066 .s r 010t-O(o(� No 33305 Permit For ADDITION Single Family Dwelling Location 236 Popponessett Road Cotuit Owner George & Ann Mahon Type of Construction Frame Plot Lot Permit Granted October 20 , 19 89 Date of Inspection 19 Date Completed 19 PERMIT COMPLETED 1/1/ 91 14� +� .r 1 � l.7 1A u IJ Cy -0fL .o E 4- VIA l IA ' y 4 O P 0 4 0 l 3 S CV M � %Y /s i �E�� E—L 9o� UJ S kaA X4-j VV -` X G:u v v Ll I 1 �F . I ► � Yin i3 �� � >� XI�- r _ 1 04 it I r— id , �� -----.._ ----- -- -------- _ I � Y I - � t d