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Home My WebLink About0170 FOREST HILLS ROAD �� .� � ��i� �` - - . r i a� �. T ..:.. �:�w.,...,.....,_._._ OfIKE7pt, Town of Barnstable *Permit# Expires 6 months from issue Ante ' Regulatory Services Fee BAttNSrABLE, A11AA& Thomas F. Geiler, Director plFo �& Building Division m RESS PERM Perry, CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 .SEP _ 1 .2009 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTAKE EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address kResidential Value of Work z S Minimum fee of 2S.00 r work under$6000.00 Owner's Name&Address AK Contractor's Name Telephone Number Home improvement Contractor License# if applicable) 7 Construction Supervisor's License# (if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name - Workman's Comp. Policy# Copy of Insurance Compliance Certificate must be on file, Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑ Re-roof(not stripping. Going over existing layers of room C Re-side ❑ Replacement Windows. U-Value (maximum .44) *Where required: ISSUance of this permit does not.exem t compliance with other[own department regulations,i.e. Historic,Conservation,etc. ***Note: Pro Owner us n Property Owner Letter of Permission.. om rov en, ontractors License & Construct Supervisors License is required. SIGNATURE: QAWPFILESTORNMExpres PREssPERMMDOC The Cotntnonfvealth of Massachusetts Department of Industrial Accidents Office of Investigations + d 600 Washington Street Boston, MA 02111 au i�•' www.mass.gov/dia Workers' Compensation Insurance Affidavit: Build ers/Contractors/Elee'tricians/Plumberg Applicant Information Please Print Le ibl t. Name(Business/Organization/Individual):_��0 Address J _ /�/' �(�/ l� ° City/State/Zip: Phone.#: Are you an employer? Check the appropriate box: - Type of project(required): 1.❑ I am a employer with 4. I am a general contractor and I employees(full and/or part=tim.e). * have hired the s'ub-contractors 6. []New construction 2.[� I am a.sole proprietor or partricr- listed on the attached sheet. T. 0 Remodeling ship and have no employees These sub-contractors have 8. 'Q Demolition working for me in any capacity. employees and have workers' 9 Building addition [No workers' comp. insurance comp. insurance.$ re 5. We are a corporation and its 10.❑Electrical repairs or additions quired.] 3.>� I am a homeowner doing all work officers have exercised their I I-❑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.�Other comp. insurance required-] 4 *Any appl icant.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 most submit a new affidavit indicating such. xContractors 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 andjob 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 cri_mi ial penalties of a fine tip to$1,500.00 and/or one-year imprisorarient, 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 covera e verification. I do hereby certify under he pains nd e ties ofperjuty that the information provided above is true and correct. �Si ature: �h Date: :NTPhone #: Official use only. Do not write in this area, !o be completed by city or town official City or Town: Pern-it/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other r d. Information and instructions Massachusetts General Laws chapter 152 requires all employers to provide_workers' compensation for their.employees. Pursuant to this statute, an employee is defined as "...every person in.the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual,partnership, association, corporation or other legal entity, or any two or more engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the of the foregoingever the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. How owner of a dwelling house having not more than three apartme nts and who resides therein, or the occupant of the truction or repair work on such dwelling house dwelling house of another who employs persons to do maintenance, cons or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also state's that"every state or Iocal licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall . enter into any contract for.the performance of public work dntii acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.' Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of - Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the peralit/license number which will be used as a reference number._In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessarv) and under"Job Site Address" the.applicant should write"all locations in__(city or town).".A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. , r,c4 Fr atione would like to thank you in advance for your cooperation and should you have any questions, 11A \J ltll�e Gl LiiYecitzg..L:.�.... . please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Departmwt of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7749 Revised 11-22-06 www.r*34.gov/dia Yk it=t Town of Barnstable y�e-ap Regulatory Services Thomas F. Geiler,Director IL6.1 Building Division PrE° � Tom Perry,Building Commissioner . 200 Main:Street;Hyannis;MA 02501 www.town.barnstable-ma.us Office: S08-862-4039 Fax: S08-790-6230 HOAIF-OWNER LICENSE EXEMPTION q9 Please Print DATE JOB VOCATION: number strcct village �r HOMFo WNER": lJ(�/ yy ��/tr O ` " " / �� ✓ ' �v ��. name home phone# work phone# URRENT 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. DEFINMON Ol?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/ 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) ibility for compliance with the State Building Code and other The undersigned"homeowner" assumes respons applicable codes, bylaws,rules and regulations. The undersigned."homeowner•"certifies that.he/she understands the Town of Bvnstablp.Buil&g Department minimum' ection pro c es and requirements and that he/she will comply with said procedures and requircm uts. Si a ' of Homcov ncr .4prproval 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 Constriction Control. HOMEOWNER'S EXEMPTION The Code states that "Any horncowoa 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 pgson(s)for hire to do such work,that such Homcowncr shall ad as supervisor." Many homeowners who use this rxcrnptimi are unaware that they arc assurmng the responsibJ1itics of a supa-visor(scc Appendix Q, Rulcs&Regulations for Licensing Construction Supervisors,Section 2.1 ) This lack of awareness often results in serious problems,particularly when the homcowna hire unlicensed persons. In this east,our Berard cannot proceod against the unlicensed person,as it would with a licensed Supervisor. The homeowner acting is Supervisor is ultimately responsible. To ensure that the bomcowncr is fully aware of his/her rrsporugbilities,many communities require,as part of the permit application, that the homeowner certify thLt he/she understands the responsibilities of a Supervisor. On the last page of this issue is it form currently used by several towns. You may care t amend and adopt such a fom�ccrtifieation for use in your con-ununity. � r Town of Barnstable Regulatory Services t p 'ui�ssAs �, Thomas F. Geiler,Director �D�a`� )wilding Division Tom Berry, Building Commissioner 200 Main Street, Hyannis, MA 02601 MVYv .toNvn_barnstable.ma.us Office: 508-862-4038 Fax: 508-790- Propcity Owner Must Complete and Sign This S tion If U in A B uilde 2s Owner of the subject propert7 hereby authorize to act on my behalf, .La all matters relative to work autho by this building pernut application-for. (Address of job) Z er Date If PropejU Owner is applying for permit please complete the Homeowners License' Exemption Form on the reverse side. Assessor's oftice (1st floor): SEPTIC SYSTEM MUSS E' E T Assessor's map and, lot number ............../�....�`........ .. INSTALLED IN COMP Board of Health (3rd floor): ,/ H TITLE 5 C O WIT Sewage Permit number .................... ...:............'.. �a BSTABLE, ENVIRONMENTAL C® Engineering Department (3rd'floor): f Ja q Q ,SOWN REGULATI :✓ J( K� / rasa . 1 O� i639. \0� House number ......................... .. ........ .. ......... . ...... . C.! O MPY 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 TO1 .�..... ...c].. .�1 ..1......... .......................... TYPE OF'CONSTRUCTION ..............(.!1�(,'��. ..�:.....Jr.:1. ....................................................................... ......................1.0..... ...........19_. + TO THE INSPECTOR OF BUILDINGS: The undersigned hereby a permit according to the following information: Location ...... .. .............................. ....... .. .............................................. ......................... Proposed Use .......... L ......................:...... f1.U..4?r!� ...6..�� .; .............................................. Zoning District ............. r...............................................Fire District ......... .�: ..`.!.:./!."� . r Name of Owner .. . -... ..1 Address .9�.. ............ .............�1!V4.-.. Nameof Builder ....................(- ? _.—)..........................Address .............................................. Name of Architect "�— ......Address Number of Rooms ........... ..........: ..... - �.........Foundation ..... � �............. Ud.2C......0 /� (� j ... Exterior ..........4,--. oI .............G1..!/..� ...Roofing ..............�� :4..6............................................ G' �. -..1,�� ^ ......Interior �W/71z Floors ............ .. ............................................. ............. .... ........................................ Heating ....... ....................f k.&Ji.�7!.......:.,.................Plumbing ........... ..01 -TI A Fireplace ................I...........................Approximate Cost ...%q.0Q-,(000 .........:................................. Definitive Plan Approved by Planning Board ________________________________19-____-__ . Area .....�J7��. . . . ....................... Diagram of Lot and Building with Dimensions Fee ......... 7......................... SUBJECT TO APPROVAL OF BOARD OF HEALTH ` 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 r construction. 4 Qp Name . ........................... ......1. .....::....... Construction Supervisor's License .................................... 4 Phipps, Barbara & Wayne Z-8 N 0 two st ry........ . .. ........... Permit for ..................... single family dwelling .....................................:...................v..................... Location ................................................................ 1329 Santuit—Newtown Road Barbara .&..Wa ne Phipps Owner ........................ .. ..... .... Construction .................frame Type'of ......................... ......................... ......................................................... Plot ..... ..................... Lot ................ ............. November 28 86 Permit Granted ...... .............. ...... A 9-- Date of Ins-pection .......................19 -N, Date Completed /7`/*/*` -0Qi.. . '.V ....19 711A& ......... r -Z 1 4-1 A —7 Assessor's office (1st floor): -��G�� 0 0 Assessor's map and lot number Q F THE T Board of Health (3rd floor): -�=C _ /F `O� T o" Sewage Permit number .................................C.IJ ....... 2 EaassTLBLE, Engineering Department (3rd floor): 07 g �j}� �_. 900A�,1639, House number I :,!........... ..............G l.:. �O MAI a' r� 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 ......... ............... /�� ..!..............1........ ..C... 1/,(/ .......................... TYPE OF CONSTRUCTION ..............! /.!A .+........... ......................................................................... ............... .......�I...`_ .......... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies. fo a permit according to the following information: G m7tRs C. --- Location �3a l '��....0............ .......................................................... .............................. Proposed Use ..................l U/V(................................ Zoning District ..............1-..... ...............................................Fire District ......... .`..D.. .!.:.1.......................................... Name of Owner W .........�'. Q.....:�.� Address ��.�J�JtSV':IQEx-)'...C�1UP;...... tQ,�� ( ,1 (l� Nameof Builder ........................`.: .............................Address .................................................................................... Nameof Architect .........................�..^r............ ...... .:.....Address ............. _................................................................. Number of Rooms ... �..... .............. �..........Foundation ............00Iv�-YCG1 ........................... Exlerior �C, 0.0.............:. !1..� ...Roofing ................... ?"!? -./........................................... ...n.................�-�^ / J 'J� }n / Floors Ca.� � / ..c l:�.D..^..............................Interior .. W/'tC� Heating ...... 14.......................I.AM. ►!..........................Plumbirig ........... .. fT/ J /UfFireplace ✓ / -. ............................................Approximate Cost ...... 00............................................ Definitive Plan Approved by Planning Board ---__----------------------------19________ . Area ..........-'f Diagram of Lot and Building with Dimensions Fee _0"// SUBJECT TO APPROVAL OF BOARD OF HEALTH d 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. -n- Name .................................................. .............. 1 Construction Supervisor's License .................................... r / Phipps, Barbary: & Wayne A=25-061 No .....30231 Permit for ..,,, two story single family dwelling Location 1329 Santuit-Newtown Road Marstons Mills Owner Barbara & Wayne Phipps ................................................................ Type of Construction frame ............................................................................... Plot ............................ Lot ..... ..................... IPermit Granted ..... ...:.......19 86 Date of Inspection ...................I.................19 Date Completed ......................................19 L"4,.,FTE ////g 7 r F f -n--,:�,,. r..- . ._:� :,��:__ .�-,...-� :- ,, .,sue --Y T�:,,,.�•.;�: .� �. r 3't" '� `+p,.f�. �" ��. �y"""' '.�.""-s""'""�" 312{t"'•1tA"fir">£"�*�+""'°"ti'rr^: +i. -.-^..0 --=p'�j--�•,F 4 TOWN OF BARNSTABLE —�51 • Permit No. ................ 4 BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash rare . HYANNIS,MASS.02601 Bond .....X......... CERTIFICATE OF USE AND OCCUPANCY Issued to Barbara & Wayne Phipps Address 1329 Santuit-Newtown Road Cotuit, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD 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 INWACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. January 11, Building Inspector • � t TOWN OF BARNSTABLE BUILDING DEPARTMENT t 11ARISTAIM TOWN OFFICE BUILDING Mt. HYANNIS, MASS. 02601 �o r�r►• MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has beenissued for the building authorized by BuildingPermit # /I\"3 � � ./..........................i._.................................. ..................... ........_................................ ... issued to ..... / ...... _ /,� / ......... Please release the performance bond. DATE CONTINUATION OF ROAD BOND BUILDING PE IT # The undersigned owner/contractor hereby agree to maintain the' bond in force until the following work items are completed to the satisfaction of the Engineering Section of the Department of Public Works. Y/ loam and seeishoulders as soon as weather permits. • other (explain) LOCATION ; 3 a /( / �� i �ZZ,/l 4-1 GLN ED ner/Contac�r- -DRIZATION I'll, INEERING UTH �l THE FOLLOWING I.S/ARETHE BEST -.* IMAGES FROM POOR QUALITY ORIGINALS) ' , I m DATA . t� s„ ARNSTABLEy ASSACHUSETTS � x y I WING PE Rm��. r sa�' ow rz:ti i 1 .✓'DATE 19 PERMITNO�� / / CANT / ADDRESS �f� - - - (NO.) (STREET) e- (CONTR'S LICENSE) }. - . PERMIT TO NUMBER OF f'* (_) STORY DWELLING UNITS .4 ITKPE OF IMPROVEMENT) N0. nn^^ ('PROPOSED USE) ZONING 'f AT (LOCATION) ` ! /Uc�7?A4oU AeD Con&n DISTRICT N0 (STREET) ' BETWEEN - AND - (CROSS STREET) (CROSS STREET). . r LOT SUBDIVISION- LOT BLOCK SIZE - . y BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (TYPE) REMARKS:' AREA OR PERMIT r' VOLUME ESTIMATED COST .$ •.Jts (CUBIC/SOU E FEET FEE OWNER �/ (it lC !l W� BUILDING DEPT. ADDRESS. BY - .; THIS PER,.IT,CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY' PART THEREOF.. EITHER TEMPORARILY OR ' .PERMA.NEIIi ,LY. .ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- ®.PROVED BY,�.THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS: DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED,• - FROM THE DEPARTMENT OF PUBLIC WORKS.a,ZH•E ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF 'ANY APPLICABLE SUBDIVISION RESTRICTIONS. _ ,MINIMUM OF:ar REQUIRED 'CFOR APPROVED PLANS MUST BE RETAINED ON JOB AN-D'�'T-H.IS..WHERE APPLICABLE SEPARATE PERMITS'REQUIRED FOR y PERMITS'"ARE REQUIRED FOR ACL;CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING""'`AND'^�-y"--r I. FOUNDATIONS OR'FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY-IS RE- MECHANICAL INSTALLATIONS. . - 2. PRIOR TO COVERING STRUCTURAL QUIRE.D,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TO LATHE FINAL INSPECTION HAS BEEN MADE. - ;• '3. FINAL INSPECTION BEFORE .�� OCCUPANCY..-'. - .yr POST THIS -CAR® SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS Gam. 3 H ATINCANSPECTION APPROVALS E NEERIN RTMENT OTHER BOARD FHEALTH 4 IL . •/• t .WORK SHALL NOT PROCEED(UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED-ON THIS CARD CAN BE TOR HAS APPROVED.;rHE VARIOUOS STAGES OF WORK IS NOT STARTED WITHIN SI, MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN ! CONSTRUCTION: PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. %-`HEREBYCERTIFY THAT.Irr/S LOT/S NOT LOCATED /N F,L00P HAZARP ZONE 46 SAOWN ON THE FEPERAk F1,00P INSURANCE RATE RAP FOR THE TOWN OF .COMmUNITY PANE, NO, EFFECT/YE DATE ROBERT E. RAYMONP, !f I,.S PATE NOTE: NORTH ARROW NOT TO y BE USED FOR SOUR PURPOSES. y m 188.27 O OQ � L-0T� � a y y N oa � s � oC CID > y N a > O I k 14.00 �Q tiJ(JT�1OU o 40.00 ` y y n CZy y (n O) No t' C3 "N ° %- ee> L-114.69 50.14 P� R-974.66 a LINE BEARING DISTANCE n i S 89.111061E 6.00 � Co H/S PLOT PkAN WAS NAPE FROti T 1 FOUNDATION 1v00ATION P1,AN AN INSTRUMENT SURVEY ANP /S FOR THE I USE OF THE BANK ONZ Y. UNDER NO CIRCUMSTANCES ARE OFFSETS TO BE USED FOR FENCES, WAILS., HEDGES, 2�,1 � - },,�71T, , ETC. OMNEP c 12rAeB4eoN' Fi+ l PP5 P�jH OF MAss' 4/f'ROW ENGINEERING INC.. 60 EAST FALMOLITH HIGHWAY f R08ERT o�F� E,45T FALMOUNf . MA. OZ536 RAYMOND CAGE: + PATE SHEET A 0.N21583 o P'=�O e`lUV 26� 198 �O,c � o L OR,4WN,BY. GHECKEDBY APPR BY Pk,4N NO. a� hip V771 RED lV A4