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HomeMy WebLinkAbout1190 SANTUIT-NEWTOWN ROAD r Town'of Barnstable *Permit 6 mont from issue dat Regulatory Services Expires Fee PERMIT . . 9� MASS. Thomas F.Geiler,Director - i639. �0 P i.4 2012. _ Building.Division Tom Perry,CBO, Building Commissioner n TOWN OF BARNSTABLE 20.0 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION RESIDENTIAL,ONLY Not Valid without Red X-Press Imprint. Map/parcel Number 0d,(Q " Q' Property.Address ' / % 0 :,Cl^a W Residential Value of Work IS a 0 d Minimum fee of$35.00 for work under$6000.00. Owner's Name&Address k1u n!�_y s c7 96 It _tL/L ed u` Contractor's Name h w J 0 L f 0 N Telephone Number ^d� ` 7,?7 0/ Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) 6 D s 6 q ❑Workman's Compensation Insurance Check one: Y❑ I am a sole proprietor ❑. I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name /Y[a.H G^? S ;f j�� Ci n : . ww:k, C4.�,!/r cz, Workman's Comp.Policy.# Zoo f X 0 '10 i 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) , Re-side #of doors 1: 5 ❑ Replacement Windows/doors/sliders.U-Value 'A 7, (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: QAWPFILES\FORMSIbuilding permit f 1E 2RESS,doc Revised 053012 The Commonwealth o,f Massachusetts Department of kdustrial Acciderr&. - Or Offwe of Investigations 6t1�7-# ashingfon,street Boston,M,4 02111 nwm,mamgnr/dire Workers' Compensation Insurance Affidavit- Builders/C.+Dntractars(ElecctriciansrPlumbers Applicant Information Please Print Lej bly Name 03usine - ization/Individual): J0 4/1 JQ �/1_G1A. 1 er- Address: /'6 O C City/Stater= �.tf f a w a-�wt to 14 n s�Phone#_ sa 6 -Z 27 _ ® 1 s^I Are you an employer?Check the appropriate box: Type of project(required): . am a. contractor d racor an 1_❑ I sin a employer txritn 4 ❑ I 6_ ❑New cxinstructiou employees(frill and/or part-time)_* have hired the sub-cnmhactods 2-.® I am a sole proprietor or listed on the attached sheet. 7_ ❑Remodeling have These sub-eontractars have ship and Dave nno employees $_ E]Demolition w. for me in an i _ employees and.have wod lers' - - offing y capac tY 9_ �Building atiditian. [No workers' comp.insurance comp_insurance. re X d .5_ ❑ We area corporation and its 10.0 Electaical repairs,or additions q°sre 3.0 I am a hams doing all:wv d c officers have exercised their l L E]Plumbing repairs or.additiom myself[No workers'rainy_ light of exemption per IidGL 12.❑Roof repairs insurance r &,]i c. 152, §1(4),and wve have no o wtrrkers' • 13.❑'Other employees- comp insurattce required.] `Any app&=.that checks box#1 um sY also fill out the section betmv showing.then wodtes' alion-porky infnrmzdm I HomeowDes who submit this affulnit in&cating they aze doing all wa k and rhea h¢e outside couwwturs Est submit a new affidavit indicating sudz t1__omt[achus that check this boa must attacbed sa additiim d sheet showing the as®e of the sz*-co�and:state whe2w argot 4wse entitles have emVhryees.,Ifthenub-amftworsli aemployyees,diey-1stpmvidetheir wmke&comp.policynumb-- I am as emptay€r thous pmidiq workers'cotr pmsirdm insurance for my empli�,ees. Below is thopoticy and job site. information Insurance Company Name: Policy#or Self ins.Iic_#: Expiration Date: Job Site Address City/5tatel2;p: Attach acopy of the workere 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 onayear ijnpriso as well as civil penalties in the farm of tY STOP WORK ORDER and a fine of up to$250_D0 a day against die violator_ Be.advised that a copy of this statement may be forwarded to the Office of Investigations of1he DIA foot'mi si rance coverage verification;. I do hereby certify under thepains aadpinahUey ofpedurp that the informationproW&dabaove fs true and correct Si Date: Phone A:: 5�0 Official use only. Do not write in this area,to bs completed by city or town o,�SciaL City or Town: PermitUcense# Issuing Authority.(circle one):. 1.Board of Health 2.1Wding Department 3.City(Fown C1;ek d..Electrical Insped-or 5.Plumbing InsPector 6.Other Contact Person: Phone:#: 6 RARNSTAaLEMASS 9 se3 . Town of Barnstable ok 9 �prFD MA't Regulatory Services Thomas F. Geiler,Director Building:Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us - Office: 508-862-4038 Fax: :508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, / ss O , as.Owner of the subject property hereby authorize o l-W 6910,50A) to act on my behalf, in all matters relative to work authorized by this building permit application for: l (9 o S;-.s;v t i/nreo;ov n^o (Address of Job) Signature of 6wner Date Print Name if Property Owner is applying for permiti please complete the Homeowners License Exemption Form on the reverse side. QAWPHLESTORMS\building permit forms\EXPRESS.doc Revised 051811 . ..a. ��•T ,xY,tit'.�, , . �T Town of Barnstable ` Regulatory Services MASS 1E, ' Thomas F. Geiler,Director 1659. 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 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 ag"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:\WPFILES\FORMS\building permit fonns\EXPRESS.doc wised 051811 { Massachusetts -Department of Public Safety Affilm Re ulations and Standards Board of Building 9 i. Construction Super.isor i License: CS-0054IS 09�,/ I JOBN J JOHNSOI �% y PO BOX 118 W BARNSTABLE MAC 2668 Expiration 1 06/2112014 Commissioner ` XI 7O4?"'tO97Business Q License or registration valid for individul use only �. Office of Consumer Affairs& Regulation g y 'HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration F 102149 Type: Office of Consumer Affairs and Business Regulation Expiration 6%30L2014 Individual, 10 Park Plaza-Suite 5170 w Boston,MA 02116`. JO ..•J0HNS0 W John Johnson \ i PO Box 1.18 1601Church St 4 y W.Barnstable,MA 02668 -� Undersecretary Not valid w' out signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map �o Parcel ;,r 'A Permit#1- 41 �3y5N Health Division f 3 % �T�ADate Issued Conservation Division Application Fee Tax Collector -- Permit Fee �S 0� Treasurer T L' Ic J CO«4PLIANCZ Planning Dept. Vr r H TITLE 5 Date Definitive Plan Approved by Planning Board E,-iVfi nX1rAENTAL CODE ANE TOWN REGULA'.1ONS Historic-OKH Al Preservation/Hyannis Project Street Address /� Alen kvToc,, Village �fo 7-,,7` Owner L_; /3eIz 12 vs-so Address Telephone S o S Permit Request Square feet: 1st floor: existing proposed 2nd floor:existing '7$'Y proposed Total new Zoning District Flood Plain ' Groundwater Overlay Project Valuation .5' sA,0 O Construction Type w o 61 *°,n ov-,,,,t Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ® Two Family ❑ Multi-Family(#units) Age of Existing Structure / 7 Historic House: ❑Yes ❑No On Old,King's Highway: ❑Yes ❑No Basement Type: ®Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) K/4- Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing / new Number of Bedrooms: existing new Total Room Count(not including baths): existing '7 new First Floor Room Count Heat Type and Fuel A Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ® No Fireplaces: Existing �_ New Existing wood/coal stove: ❑Yes O No Detached garage:❑existing ❑new size N4 Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size AJ A Shed:Q existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes. U�No If yes, site plan review# Current Use A-e r Proposed Use .: � v x BUILDER INFORMATION Name �� �ti L Telephone Number S U Y 3` L 2 7/ , Address Vkc L, -t License Oy �Ve `=>2SX Home ImproV6Ment Contractor# /O D z G ` d Worker's Compensation# 6 20 l ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Pet x-S44 d{'� l I SIGNATURE i DATE Af'P �7,d �'3 FOR OFFICIAL USE ONLY PERMIT NO. P DATE ISSUED MAP/PARCEL NO. ADDRF,SS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION } FRAME INSULATION ` FIREPLACE C ELECTRICAL: ROUGH FINAL F PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING s 4 rup 0 , DATE CLOSED OUT a ASSOCIATION PLAN NO. x 4 r., F r The Commonwealth of Massachusetts Department of Industrial Accidents Office offAvestigations _ T 600 Washington Street Boston,Mass. 02111 Workers' com ensation Insurance davit name: ' <,/ /V �/aLl, IL' -, ` location: /G,c+ c /vim sue . f> city G✓ c. .r-I JILI A SJ 02 L ' phone# 3c)F '3-C2 -.Z i`7/ ❑ I am a homeowner performing all work myself ® I am a sole etor and have no one wor an in ca achy %� // //G/ /%/ //G/////G//%%%/%%%/%%%%/%%%%%%%%%%��%%%%%/%%//%%//%%%////%//%%%O/�%%/G%%%/ es working on this job. I providing workers' compensatconform�'em� w:,::{ 't,::J.?h: a,:i. 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I do hereby certify under the pains andpenalties ofpedury that the information provided above is truf and correct Date ,�•�'� ��; m � - - Signature i h.n..r Phone# 13L 2. -2.76-7) Print name_ �`' �'`"• y ofncial use only do not write in this area to be completed by city or town oMdal city or town: pemdttlicense# (]Building Department ❑Licensing Board ❑Selectmen's Ofnce ❑checkif immediate response is required []Health Department eontactperson• phone#; other_ tunas 9195 rJA °FTti Town of Barnstable hP Regulatory Services S BAMSPAMM ' Thomas F.GelIer,Director Mess. 9� i639, ,�pr�39 Building Division _ Tom Perry, Building Commissioner 200 Main street, Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder j V• _ _�._..:::........__...;as..0w.nex..of the.subject property- ._......._... .: hereby authorize ._.to_act on my.behalf,. in all matters relative to work authorized•by this building.permit.application for: (Address of Job) $tea e of Own ate 146 Psiat Name oETME,�. Town of Barnstable Regulatory Services 913 s�LE,$ Thomas F.Geiler,Director 2639• �,� Building Division TfD►,AP'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 • Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMMT 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: Estimated Cost E ® O C W c+..Z�,�,.. Q�-k C'F,Z�`` t ft-t�c s Address of Work: /�f I 1 © • Owner's Name: 1`4)hc,..-I' �t.r Date of Application: I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law []Job Under$1,000 []Building not owner-occupied []Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME E1UROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERTCTRY I hereby apply fora permit as the agent of the owner: 10r— o '2 I `t q Date ontractorN `e RegistrationNo. OR Date Owner's Name ✓fze T�arrunzaruve¢ a�.�aaaat�ucael7a BOARD OF BUILDING,IIQU.LATIONS. tense CONSTRUCTION SUPERVISOR I Numbem 005409 Brd6�afe �fi1�33119y�6 �xpires� 0¢l1004 Tr.no:' 25873 :anstFuctton- - Re rGt JOHN J JOHN'S _ m 1 160 CHURCH.ST W BARNSTABLE MA�� Administrator r ��re-�o�zonuiea� o�✓vcua°ucluibrlta I ense or registration valid for indi Board of Building Regulations and Standards Liceul use only t r before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Board of Building Regulations and Standards Registration 102149 One Ashburton Place Rm 1301 Exptrahon 6%30�2004 Boston,Ma.02108 lugType tndiyidual j JOHNJOHNSON John Johnson PO Box 118 160 Ckireh Sf ' Not va d without signature I. W.Barnstable,MA 02668 Administrator y l rd: _ a Ar sir 6,5 A. 14 £� T z` 7 _ SlG 4 E.GE.V !� T 48041 41�, 'G 0 7-- oL A A,/.- J r PLAN, t2E F QENC '; ;tA ` 3 ,� ,C, A3 DA"iO&/ G4CAT/OV !+"�t *x -�• 1 • • Aa5 �f�Oh�N.Qx%L7: _CDN , iy i'�+'/Th/ r ,` D. •T,41E•7 420WN Of 43 nl l 07 / 7"M.4. �es_�sor's map and lot num er ....... .:./....�................... '�� / . ' ' SEPTIC SYSTEM MUST BE M 7 t �. ............................ 1 INSTALLED ED IN U)i'A�" IANCE Sewc�gg Permit,number . k WI I'I `a. i IC,i..E H 'ST 4 E •, v ! �I TV?Y CQIJ- A,110 TOWN �. °`j"Er° a TOWN OFF BARNSTABLE A i BA"STADLE, : BUI.LDIHG INSPECTOR CV APPLICATION FOR PERMIT TO . TYPE OF CONSTRUCTION .Gf .S .�l...;C..{�!L.�...!. ...... ... ........................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according,to the following information: .e c .. .� c' (: ;'�1'.....gA....��.... ��............................................... 1 n Location "` .................................... Proposed Uses... ... .. 1 1.... . Zoning District ... ........ Fire District ........................... ....................................... Name of Owner Address � ... d�! sV.... ................��7 r / Nameof Builder ...... ... .. ... ... ..'.....Address .......................................!........... ............................... Nameof Architect ... ... ................................Address ...................................� ..........................: Number of Rooms ill / .................................Foundation .. ... ....E ...................................... Exierior(i!. . [..!.v . 41.. /..�, lf`G. .Roofing � ... R. .�. .. .......................Interior Floors lul . .�.. .. ................. ..............:................................ .....,.... Heoting 5. .... .. ......................................Plumbing ... Fireplace ..1,....)jK. ... .................................................Approximate Cost ...... Definitive Plan Approved by Planning Board __ 9___-____. �, a ........... ..... Diagram of Lot and Building with Dimensions Fee .../ C .6L .................. SUBJECT TO APPROVAL OF BOARD OF HEALTH .f • V V N s, I hereby agree to conform to all the Rules and Regulations of the of B n le re the a o construction. , LName ..... .... ....................................... .............................. /7 Mid Cap e-Re1q: rus t 18.315 1 112 story, ..e 'Permit for .................................... single family di4elling ........................................-..F................................... 5an�e;/- ,- I i . Newtown Road Location ...........................I........................................ Marstons Mills .......... .... Owner ...................Mid .Cape..*ea.i.t.y...T.r.u.s t......... ........ ....... . . .A Type,of Construction .....................frame..................... ............ ................................................................. Plot ............................. Lot ............#28.................... April 15 76 Permit Granted ......... ..........:19 Inspection Date of Ins .............. 19 Date Completed 19 PERMIT'REFUSED ................................................................ 19 ............................................................................. . ........................................ ......................... A. .................................................................................. ............................................................. jApproved ................... ........... 19 .... ......... . ............................................................................... Assessor's map'and lot number ............. � .. �............. Pc IS -76 Sewage. Permit number ....... ... ...... .......................`.... P�0*TNE.r TOWN OF BARNSTABLE 89SB9TADLE, i - - °° M 9 :•� 6'UILDING ; INSPECTOR APPLICATION FOR PERMIT T�O . .. .. . . .......................... TYPE OF CONSTRUCTION / !,.Y`' ... Y� '. ............................................................................... )2, • y' TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for,a� permit according to the following information: 1� Location artl�........;C L , t l> �C f1�1�s 1 r Proposed Use�� t Q �., ,;..;L. VI � l�( ,!. 1 �%................................_.................................................. p .. � . Zoning District ..............................................................f Fire District ................................... - ....................................... Name of Owner Address :. Nameof Builder ........'—��.! �? :!!..a .............................Address .................................................................................... Name of Architect .............................Address t h -.�.................................Foundation ��-j Number of Rooms :..................... ........;,,...............,.... .............................................. ExteriortlfJ ,,�YC� .-. 1 � C3�k .:f`.�� ...Roofing �} 1 .......................... J Floors 1 11 i /)n!NIf?.. -�- \{. � �. Interior "` I �.1- ..... .......... Lf / _,....................... Heating ) .......... .....................................Plumbing ....... _ .........,... ,............................................... Fireplace .. �. Approximate Cost 2 tu(..��................................... ....... .„ Definitive Plan Approved by Planning Board 9--------. Area ...."...`.. Diagram of Lot and Building with Dimensions Fee .... .f2 rti .................. SUBJECT.TO APPROVAL OF BOARD OF HEALTH 1 a , i 4 1 ' I hereby agree to conform to all the Rules and Regulations of the Town of Barable regarding. the above C°. construction. Name ............................................:... ............................... Mid Cape Realty Trust A=26-21 1831.5 1 1/2 story, No ....... Permit for ............. ... single family dwelling ......................................................... ew.to'wn Road Location ..................................................I............ 14ar-rte4w,-XLLLr.- �V;e ............................................................................... Mid Cape RXXXY Realty Trust Owner ...................................................... Type of Construction ......................frame........... Plot ............................................................Lot ............. #28) .......... ..... 11................... Apri/15 76. Permit Granted .. .....19 0 Date of Inspection ...........i Z. ......19 Date Completed ........1 ...........19 110.0111000., PERMIT R'EFUS PERMIT 0 ................... ................... ................ 19 ............. . . .................. ....... ........ ........ ........... ............. ...........................a........... .............. ti t .................... .......................................................... ................................................................................ Approved ........... ....... ......I................. 19 ............. ... .. ....... ............................................ ............... ...........41.8.. jr c - •: '. .i..w. ... ....... #- :.4n kit. .4. n , A 4 - r 4 :r • i • - a , 1 v ti. Y { : r G� f" r. . ��y v rl ........... 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