Loading...
HomeMy WebLinkAbout0645 SANTUIT ROAD r. 1, �-u= i I Town of Barnstable ' _ s Building Post This Card So That it isYisible`from"the Street Approved Plans Must be Retained on Job and this Card Must be Kept sasw Posted Until Final Inspection Has Been Made Y as Where a Certificate of Occupancy is Required,such Building shalliNot be Occupied-until a Finalglnspectionhas been made " Pernllt Permit No. B-20-1226 Applicant Name: Jerry Friedman Approvals Date Issued: 05/14/2020 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/14/2020 Foundation: Location: 645 SANTUIT ROAD,COTUIT Map/Lot: 006 028 Zoning District: RF Sheathing: Owner on Record: FRIEDMAN,GERALD&CARR, DEBORAH Contractor Name:;` Framing: 1 Address: 9 ABERDEEN STREET Contractor License: 2 NEWTON, MA 02461 `°� "' Est Protect Cost: $5;000.00 Chimney: Description: Replace garage roof in kind. i Permit Fee: $35.00 Fee-paid':) $ Insulation: 35.00_ � Project Review Req: 14 2 20 Final: Date.-. 5/ / 0 J ' ✓ i�' Plumbing/Gas Roug h Plumbin : �., g Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterissuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. - Electricals The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are'provided on'this permit. Minimum of Five Call Inspections Required for All Construction Work-1 Service: 1.Foundation or Footing 2.Sheathing Inspection - Rough: ' 3.All Fireplaces must be inspected at the throat level before firest flue lining is install " 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site _ Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �/,`4, 5 � Town of Barnstable h �. Building , Post This Card Sofihat itis.Visible�Frorn the Street-i4pprovedPlans Must be Retained-on:lob,andthis Card Must be;Ke,pt ransa Posted Until Final Inspection�Has;Been Made - Where a Certificate of Occupancyis Required,such Bu,iiding shall`Not be Occupied until a'Final Inspection has been made Permit Permit NO. B-19-1241 Applicant Name:. Jerry Friedman Approvals Date Issued: 05/10/2019 Current Use: Structure TV���T 2019 10 Date:Expiration Ex 11 Foundation:o�' i*I Permit Type: Building-Addition/Alteration-Residential P / / Location: 645 SANTUIT ROAD,COTUIT Map/Lot: 006-028 Zoning District: RF Sheathing: Owner on Record: FRIEDMAN,GERALD&CARR, DEBORAH f ;Contractor Name:" Framing: 1'i Address: 9 ABERDEEN STREET i 'Contractor License. 2 NEWTON, MA 02461 _ "' Est. Project Cost: $ 150,000.00 Chimney: Description: Kitchen remodel,additional bathroom, replace electric service, } Permit Fee: $815.00WL 4 Insulation: 9; %is-hot replace heating, replace some windows and doors, replace.siding Fee Paid:f. $815.00 and roof Date: ° 5/10/2019 Final: °�1 a f Project Review Req: .NO STOVE IN BASEMENT. s Plumbing/Gas Rough Plumbing: Building Official '! = Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by thins permit is commenced within'-six months after issuance. All work authorized by this permit shall conform to the approved application and thejapproved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning'by=laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. r Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the-Building and Fire Officials are provided on thispermit. Minimum of Five Call Inspections Required for All Construction Work:l Service: 1.Foundation or Footing 2.Sheathing Inspection Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed Final: 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final' S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: - Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site ���� Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: l2-Se L -SealTite PRO f' t ptERTIFICATCE O� INSULATION .4 k ` ht fornl mt�st,b flled:out and pastedta oomply.w�th tiuildmg cRde requirements;Meets 1RC Sections N1141 3, N11 0t:41.and{ 1101;8 requirements.Consult International Building Code;,Chapter 26-Plastic and International Y Residential Code(IRC)R314`Foam Plastics for specific requirements.The spray polyurethane foam systems)has/have beeminstalled in accordance with manufacturer's processing guidelines to.provide a thermal resistance of: ProductR Value,, t T S CUe S _ Ceiling Area I Ceiling Area 2 rfr�`r a Floor Area 1 Floor Area 2 i Wall Area 1 SeakV Vt Sro C(ose to r 3.. 1110 J t S S*% Wall Area 2 9eD-k t lOro close Ceti rZ �,, 3,S 1 b0 1lor\S i Wall Area 3 SealTite PRO Products- Ignition Barrier/Intumescent Coating, ���e,.. , (1e tcA Carlisle Spray Foam Insulation—Lot Vs: T Manufacturer: Lot/Batch Thermal Barrier Coating: r Manufacturer: Lot/Batch#: _ 4 9 CERTIFICATION SIGNATURE: BUILDER AND SPRAY FOAM APPLICATOR This is to certify that the SealT'ne PRO Spray Polyurethane Insulation System F has been installed,per the manufacturer's specifications. p "AeSs; (OH Sh�"`�'` �A ' Date of Installation:. ' ' �,LO-7 33 - LA l�, wilder Name: "^ U Phone: MG. urlder Address: Ua b 0.4o ck% Lh Date: $011der signature: Applicator Name: n Phone: AN iicator Address: Date: F§ ... I � -����� Apptta~,a�forS�gtlature: i Y n 100 Enterprise Drive•Cartersville, GA,30120.844 9222355 ,rSPRaaYP=c2AA4 www.carlislesfi com ti sari►, ,���� r - d m `O o > _o lec:l o =" 61-Ar), be- L4 i M �k ' :- _ _W N do !/1 � g Cie m �O � J � o Os Milli INi CIV ado I 4 �o o � � a O cZ =" J C� f �T, - '_ ,. � ,• �� '� - �' I w L� �� ` � i �� --.�_ � � ' '� y �►, � i ' � �, � - - � ,, .� k .y - �. �� , f -� �� oD �o O + a. 2 01 F c� Rjol mom �-a, 7 ' m 00 .o O l � a 2 � � � O d �., w, G ��� _ .� :t J awl Orions i r e� �� -t r-r j•,�. b Ln Ef m CAC m 'o aL- Z � a Q c� Assessor's map and lot`number ........ .. ..... 7 7 SYSTEM MUST ®E Sewage Permit number ........... :..... iiiNS TALLER IN i CO IA E A'CLE MPL IVC ANii� U11% II STATE t flq. TOWN THE T��4 ?' TOWN' OF BAR X �° Z IMUSTADL°0 y MA86 � ``OUttDING INSPECTOR APPLICATION FOR PERMIT TO - !8 ............................................. TYPE OF. CONSTRUCTION ................ Cf:. . q°-.......... . . ............. .............. ,.. / .197,/'. 'TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies. fora permit according to the following information:. Location ......... .. ............:. ..... ...... .:.................:..:.......... .............:....:....................... Proposed .Use ........ ............ ......... ............................ ................ ......... ... ....... Zoning District .................................... ..............................Fire District Name of Owner %p�/ZFi .o/ U'r .�C Caf1�`' .... ............ .. ..?t,..Address �. .. �.. ... .. Name of Builder �i/. ..C.� ��r< ...Address ...! ..... . �''''.. Nameof Architect ...................................................:..............Address .........................................................:........................... Number of Rooms ............................................ .....Foundation ..... �,. ' .................................................................... Exterior ........... '/.......:.................................................:.Roofing ....... .5 6�irGG:...............:.............. Floors Interiord � ................. //............... ....... .................... ....: ..................................................... .......:..... :....,...... Plumbing Heating ......... o d o teFireplace ............. o!.0tr!......................................... .......Approximate Cost ...................../..r.... ......f Definitive Plan Approved by Planning Board ___________ _____________ -19 ------- . Area .. ....��. ....�........ Diagram of Lot and Building with 9 g Dimensions Fee . �.`..�!.!!....... SUBJECT TO APPROVAL OF BOARD OF HEALTH 8' I hereby agree to conform to all .the Rules and Regulations of the Town of Bar ble regarding the.above construction. Nam .... ....................... .... ���''r............. Pontifexgi James 6 28 19801 No ................. Permit for .:...Garage.................. - • Location ......6.4.J.:_.Santn3.t..Rd.. ....... ......... ...................sCatuit............................................ Owner ........Jsaes..P.onti£ex....:..................... Wood Concrete r "" Type of Construction ......................................... ,7 ............ ..... .................................................... -Plot ............................ Lot ................................ Permit Granted ........December.....1........19 77 Date of Inspection .... ....:19 Date Completed .....1:19 _ 'PERMIT REFUSED ................... . ....................... ,. 19 ................... ...F......... .................. ......!............ j 3 ....................... .................................................... y . ............................................................................... ''Approved ............. 19 Assessor's map and lot number .......................................... Sewage Permit number �l/..0. ............................... e�Qy°*THE T TOWN OF BARNSTABLE Z 89SH9TAIILE, i 0 pYa�•� - ,r BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... ......................................./. �. ...... ........v...................................................... TYPEOF CONSTRUCTION ....................... �' � a ��..............�......... ............................................................. ........ ............................19 �M i TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...................................,.................:................................................................................................................................. ProposedUse ' .................................................................................................. Zoning District � .�/.................................Fire District .............................................................................. ................................. --� Name of Owner ..................................................... 4e?r:..Address 1... �....................................... b. '' � Name of Builder / .�av'G� Zirx.. —•*...Address .............................................................. Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms .....................................................Foundation ....�....... .................................................. Exlerior ,4//� ........Roofing ..^.................................... ........................................................................... a�Z" c7 d ,r G G Floors / .Interiors r ............._�.�..............."... ........................... Heating '!�� � Plumbing � 'v............................................................... . .......................................... ' o Fireplace � o�� Approximate Cost... ........................................................ ..................................... Definitive Plan Approved by Planning Board ________________________________19________. Area ...............F.L1....�....... Diagram of Lot and Building with Dimensions Fee ...........�1 2. ..4.... / SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 . ti r; I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........................... .....:..-• e...s-r............. r i Pontifex, James 6 28 1 No 1980........ Permit for .......Garage............... . Location .......antugt.....Rd•.............................. ......................................Co tui t........................... Owner Pf .....James......................onti.......ex................................ Type of Construction .....WQQd..Canicxete••••.•.. ................................................................................ Plot ............................ Lot ................................ Permit Granted ....December 1 19 77 .................. Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ...................................... ...................... 19 .......... .................................................................... ............................................................................... Approved ................................................ 19 ............................................................................... ............................................................................... e ' ' ~ ' ^ ' THE J INSTALIJWM t BARNSTABLE. : 40 5 1639- TOWN OF BARNISTAL BUILDING INSPECTOR APOLICATION FOR PERMIT TO ...... ..41,.r . ..... TYPE OF. CONSTRUCTION *-**-*-/19/............................... To THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Name of Owner Floors, ........G...�- .. ...............................................................Interior .........IaAna.....IK14 F................................ Diagram of Lot and Building with Dimensions Fee ..... ...... .............. SUBJECT TO APPR�VAL OF BOARD OF HEALTH or /00 ' | hereby agree to conform to all the Rubs and Regulations of the Town of Barnstable regarding the above . construction. ~ Nom� --.��..��. .. ��- .� . l ' } i » ' } ' ^ l ` ^ ' . , . . . ' . � � James Po]q.ti . ' 19 Datef Inspection ............ 67 CO M CO ';PERMIT REFUSED / | } / . ~ . ^ ^ ^ . . . . ' /�� . . . / x~� - ........ ' .-.. / . . -'- i ' -- .-.. Jr .. -^ Approved ................................................. lQ .^ ' ' - ~ . ' ------- --------...--.-,...--.. ' � ................................................... K + Assessor's map and lot numbers.............. ..:.,............... THE �QypF Tp�O Sewage Permit number ? - ?. w ��' I Z BARNSTABLE, House number "� ' ............................................. 9�0 Mb 9 00 3 �0 i°TE'p May a• TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....`! ` tCi- *- t%a., tC /rfr- ,i.fsr' .... �-% TYPE OF CONSTRUCTION ..... ?� ................ ..... f.........../ .....:... ..l. ........................... `.. ........... .ef.. '... ..................19.. `..:. 1 - TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .....l.. ......... ' .. .�..p,V rt. ... :: :� ............ r? ......................................................... ProposedUse ......... ..s'c.t*3 J. ....................................................................................................................................:...... ZoningDistrict ..................................................................�..........Fire District ............................................................................... Name of Owner ... r ': �� :'... !!,�< f,'�.✓ . ...Address .... ..'! �.........: ... 4%. r r " Name of Builder .!� r h�-z: ..Address ..'..!:. ✓ l r, Ct ....'� ...r . :` ?.. j _ ...../ ........ t ....... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms �.- ............................................Foundation ` ='.< ��/ ............... ..................... ................... v Exterior ..... ✓. ztM: n ..............`/ rt..... ^.....: .:., Roofing ..... C. f 7�+ ................................................. Floors c. t v .................................................Interior .................,................................... Heating .....................................:.........................Plumbing ........................................................................ - f b Fireplace .K + - �-� ' � :�!... Approximate Cost �'t> C% U 7 J...... ._ ....... ................ .1....................... Definitive Plan Approved b Planning Board -------------------------- `✓� pp Y 9 ------19--------. Area .......:.:1.::�....... .?`............ Diagram of Lot and Building with Dimensions Fee /f --'" - SUBJECT TO APPROVAL OF BOARD OF HEALTH ; f a I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............................................... . . ............................. PONTIFER, JAMES A=6-28 No 2.2.6.0.5.... Permit for ..ADD IT ION Single.Family..Dwellin�.......... . LocatiaW4.. .5.antu i t...Road .......................R.tA t........tt................................. Owner ....J,4mes...Pontiy�er ..................................... Type of Construction ....F[A]Ae......................... Plot ............................ L 1.1.t ................................ i a I� N Permit Granted ......October 2 2, 19 80 Date of Inspection ...........!........................19 Date Completed .............¢..........................19 S PERMIT�REFUSED E .............................. ... 19 i L, .. �................ .................................. F ........ .............................. .... .............. ..... i .................................. . .... . . ..........�. .�.. .. Approved ............................................................................... TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map_ Parcel Application Health.Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 9 Village Owner IRv6 r P- Pam, �e )c Address LIS S An led, Telephone 5�0 27 — YA -3 ® � Permit Request _.ems :�; Y/yf Y CD�G i9 I�/ e n Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 0,0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.)_ 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 new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing woocf7toal stove:'❑Yg ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0`existing O:newz&ze_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: . � Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# .Ai Current Use _. - __ Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �yr7 P` "f" Q®V • 2 o Telephone Number _Address G �S ,S�ar� �r � A) TeX)License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �-? ® / .2® // i t FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS i VILLAGE y OWNER DATE OF INSPECTION: ' f .FOUNDATION "' a Lc i FRAME INSULATION;' - - FIREPLACE ELECTRICAL: ROUGH FINAL ti PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL ;FINAL BUILDING rj G. K DATE CLOSED OUT I . ASSOCIATION PLANINO.--, r ,4 b Town. of Barnstable . Re galatory Sen4ces " resrA� Thomas F. Geiler,Director Building Mylsion Thomas Perry, CB O,BuiIding Commissioner. 200 Main Street, Hyannis,MA 02-601- www.to wn.b arnsta b l e.w a.us 'Office( 508-862-4038 Fax: 508-790-6230 PLAN REVMW Owner: Map/Parcel: �o Project Address ��� ��AM&r BuiIdcr ME The fallowing iferns were noted-on reviewing: UZc,i2O'r—, SZ ReYlewed by: Date: I ' The Commonwealth of Massachusetts Department oflndustrialAccidents W Office of Investigations a ' 600 Washington Street Boston,M14 02111 www.mass.gov/dia Workers` Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information ..Please Print Le 'bl Name(Business/OrganizatiowUdividuai): . ® ` Address: iG LI S =S r1 u T City/State/Zip: . C® v a iQ ©dl 6 3 Phone.#:� `y' 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 6. ❑New construction . employees(full and/or part-time).* • have hired the stab-contractors 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 vorkin for me in an capacity. employees and have workers' g Y P ty. 9. ❑Building addition [No workers' comp,insurance comp. insurance.$' required.] .. 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions officers have exercised their 11. Plumbic re airs or additions 3. I am a homeowner doing all work . ❑ g P .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.] *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-contractorshave employees,they mustprovidt their workers'comp.policy number. I arri an employer that is providing workers'compensation insurance for ray employees. Below is.thepolicy and job site' information Insurance Company Naive: Policy#or Self-ins.Lic. #: Expiration Date: ,ob 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 for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature:, C Date: aa Phone#: 6 ® 8 Official use only. Do not write in this area, to be completed by,city or towmt 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#: Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as "_ever 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 of the foregoing engaged in a joint enterprise, and including the legal representatives of a-deceased employer, or the employing employees. However the partnership, association or other legal entity, m o receiver or trustee-of an individual . ,P P� g tY, P Ymg owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house 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 states that"every state or local licensing agency shall withhold the issuance or renewal of a license dr-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 until-acceptable evidence of�coinpliarice with the insurance requirements of this chapter have been presented'to the contracting authority." APPll6mts Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contiactor(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 permit/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 necessary) 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 proofthat 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 fo 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. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number:. ` :A '- 7.e C06m, 6nweal ofMassachusPtts Off1-oe of 1z�vestlgatzons • -6Q4�ashin�tari �.treet d.. ' ' . Bostom,.1 TA 02111 TO--. ## 617-727 45QQ ext 406 u 1-M-MASSAFE Fax##617-727-7749 Revised 11-22-06 w.mass.gov/(�a Town -of Barnstable ti RegnIatory Services sAxxsrAsr Thomas F. Geller,Director .� Building Division plFn Tom Perry,Building Commissioner 2D0 Main-Street,_$yannis,MA_02601 www-to wn.b arnstab I e_ma.us Office: 509-962-403 8 Fax: 509-790-6230 . HOl!'IEOwN*E$LICTsJ�SL EXEMPTION' • Please Print JOB LOCATION: 14 I1 T�i 1 ,�' S ./ C e I c y i numbery street u p village name hmne'phone# work phone# CURRp-ENT MAILING ADDRESS: P C) c) \/ ./ ( a("36 crtyhowa 1 states rip code T c 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. DEFI71r.I'I N OF HOMEOwN'E12 Person(s)who owns a parcel of land on which he/she residers or intends to reside, on which thrre 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 Of5cial on.A form acceptable to the Building Official, that he/she shall be responstblc for au such work pt rFarmed tinder the building vermit (Section 109.1.1) The tmdersigncd"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The tmdcrsigned"homeowner"certifies thathe/shc understands the Town of Barnstable Building Dcpntmcnt rmnirmrm inspection procedures and requirements and that he/she will comply with said procedures and rerzrrTirements. AL Q Signat:E L of H cowner Approval of Budding Official Nota: Thrce-fam0y dwellings mnt�,�35,OD0 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Constructian Control. HOmmowNER'S.Exy-mrnbx The Code states that "Any bomeownc performing work far which a building perimt is required shall be exempt from the provisions of thin section.(Section 1 D9.1.1-1 =rasing of wnstrvction Supervsors);provided that if the homootyner engages a person(s)for hire to do such work,that such Homeowner shall ad as supervisor.^' !rl'any homeowners wbo use this exempti®are unaware that they are assuming the responsibilities of a stipervisor(see Appendix Q. Rvlcs&R rgblations for l raising Ceustruction Supervisors,Section 2.15) This lack of awarrnoss Mine results in serious problems,particularly wher7 the homeowner hues unlicensed persons. In.this case,our Board cannot proceed against the unlicensed person as it Would with a licensed Supervisar. Tbo horircowncr acting as Supervisor is ultimately responsible. To ensure that the bomwvener is fully aware of his&crrespmmbilitics,marry communities require,as part of the permit application, that the homeowner ratify that hdshe undcrstan&the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may emu t amend and adopt sorb a formlcertifir_t=for use in your corrmrunity. Q:forrns:homcn cmpt Town of Barnstable o� F _ Regulatory Services MAELt to kxsr.ur p � * Thomas F. Geiler,Director 'BuRding Division Tom Ferry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.to w n.b arnstab I e_ma.us Office: 508-962 -403 8 Fax: 508-790-6230 1 Property. Owner Musjf i Complete and Sign Thrs ection If Usi ng A B uiId r s as Owner of tb.e subject.pmperty hereby authorize to act on my behalf, I.n all matters relative to work autho . b 'ttbis bu$ding permit a Iication for- PP (Ad ss Of Jo Signature of Owner Da - ~ l Print Name If Property er is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Q:FORMS.O wNERP ERMIS510N hit l� � Ca�►1v ,n�i�.s �r -�cc�vn�r�� aL s/y x Cg prey 4reIA'e qx $ Gt alv L%3s % )( .5Y2 , tt1ho, �o�St✓ etse� l�o°` F s Je�as�"�r+arJc e� n Al is �a,)f 8 Z.-an AA ��seSt�rtt���� ce P ni'l a 4 X Ltpas"f y X y �o��' X Pb-4 CY 141 f2, 5+'r►nj QLc eeM"+ �A ►o 1-- 1r5 a"QVL Old C14.C-k NJ ,� sfv t�'5e,rs Pry e� 1 ���k-�nss o �,� 1 ��S^�td tar S n c�`'PS J�C y eon S�cvci' xr a� T `�1 '?�a. - rn� 1, every P o s"�' �I e•o�c`�Q�I > 14L Art Town of Barnstable *Perrnit R THE l\ Expires 6 tnontlts from issue date Fee f,S ; c&-7 s619• Reg MA ulatory Services . a� -C& i"Wt;� J�f� 6ss Thomas F.Geller,Dhvdor 1 G l w G( `W c� 9� �0�� o Building Division X-PRESS PERMIT Peter F.DiDiatteo, Building Commissioner 3671Qain Street, Hyannis,MA 02601w Q C j 1 5 2001 Office: 508-862-=038 Fax: 508-790-6230 TOWN OF BARNSTABLE EXPRESS PERiti1IT tPPLICATION RESIDENTIAL ONLY Not Valid without Rcd X prat Imprint vtap,parcel Number O� � � o T v 1 T Property Address 431 Value of Work (1�Residenrial o 3-d� L` rrT Owner's Name R Address wt ES 0 �6 6' � f9 N IT � Low J 1 7 hone Number Contractor's Name Telep Improvement Contractor License 4(if applicable) Home Imp t, Construction Supervisor's License_(if applicable) i r ❑Worktnan's Compensation Insurance Check one: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensarion Insurance' t Insurance Company Name Workrnan's Comp.Policy permit Request(check box) r—/Re-roof(stripping,old shingled 1 ❑ Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side. . , 44 , ❑ Replacement Windows. U-Value ( ) ❑ Other(specify) e of this ertnii does not exempt compiiance with other town department repiations.i.e.Historic.Conservation. *Where required: Issuanc p Signature Q:Forms:esprntrc:r-,v-k17060 l ��z ';' -,,� ✓1ze 10amvinaiuuea�i a����avaac�euaetd; BOARD OF BUILDING REGULATIONS 11.1cense: CONSTRUCTION SUPERVISOR Number. CS 052325 Birthdate: 06/05/1947 Expires:06/05/2003 Tr.no: 11723 Restricted To: 00 PAUL K ROMA _ POB 653/90 CHERRY TREE RD { COTUIT, MA 02635 Administrator t; ;i �~ r ��Omvrnonweald a�./LfiaHsc/uael HOME IMPMEMENT CONTRACTOR _ � .. ,a- Reaistratian�. ip59ta K tf,* 5/1/02 Type: Individual n-. PAUL K.ROMA PAUL ZMA 653/ 90 CHERRY HE[ .. r ADMINISTRATOR COTUIT MA 02136 y g the name of the sub-contractors and state whether or not those entities havc 'r workers'comp.policy number. : insarance for my employees. Below is the policy and job site Expiration`Date. " City/State/Zip: —.-I ration page (showing the policy number and expiration date). MOL c. 152 can lead.to.the imposition,.of-criminal penalties of a as civil penalties in the form of a STOP WORK ORDER and a fine a copy of:this statement may be forwarded to the Office of that the information provided above is,rrue,and correct. Date; IN Lby or_townofficiaLicense# 4. Electrical Inspector 5. Plumbing Inspector Phone #: r Town of Barnstable Geographic Information System July 15, 2011 ,� ll x�,rna I� .f I ry q t qq � r r o y�. rl �Tl V r f n Y 9 � W "°` DISCLAIMERS.This map is for planning purposes only. It is not adequate for legal Map:006 Parcel:028 N boundary determination or regulatory interpretation Enlargements beyond a scale of Selected Parcel Owner:PONTIFEX.R08ERT A TR Total Assessed Value 8357600 1 1'=100 may not meet established map accuracy standards. The parcel Imes on this map are only graphic representations of Assessor's tax parcels They are not true property Co-Owner.645 SANTUIT ROAD TRUST Acreage.0.68 acres Abutters W`- -E boundaries and do not represent accurate relationships to phys lcal features on the map Location:645 SANTUIT ROAD such as building locations Buffer Aerial Photos Taken July 10,2009 I I P`pp1HE Tp Town of Barnstable ' RARNSTABLE. Regulatory Services ' 9 MASS. �prFDMP�N, Building Division 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection ®�'h' �i T�pct-� �i�/�'/X r 7'� Location SCR/Tu r r Cr Permit Number /V C Owner Builder One notice to remain on job site, one notice on file in Building Department. The following items need correcting: Via c.►q 7'rox) y f A&'O City,K. 5—I Please call: 508-862-4-0-3-8 for re-inspection. Inspected by�� lk Date f >> �� �. , T-� t� � � - � _ � �� �� � �� _ r � '�� o � �I � �� _� Room r Sketcher 645 Santuit 1st floor 2. Floor 41'10" h t � F 8 5 3'8 � r k,z' Y µ N N � W Q 9 0 r 73 sq `" 33 ft a, 4 e. r .'6 '.2 N o � 10 4 °D r AW- 41'10' 1 Room Sketcher 645 Santuit 1st floor 1 . Floor 42'3' RIB 1 i aI -sq -x 12sgft A , t' 68 sq Cf a q, 6'6° -7'10 m N .48 sq ft' 656 sq ft Px 76sgft 6sgft h ILc 15'5° 129 s 5i sq 42'3° G Assessor's office(1st Floor): Assessor's map and lot number G cis 2 X �'✓ SEPTiC SYSTEM MUST i THE to`` Conservation -, 3 INSTALLED 1N COMPLI Board of Health(3rd floor): Sewage Permit number WITH TITLE 5 ses�iaIsr�nt t Engineering Department(3rd floor): EM IRONMENTAL COD House number TOWN REGULATION '�0yxY Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2W. P.M.only TOWN OF BARNSTABLE BUI DING INSPECTOR APPLICATION FOR PERMIT TO L!/6 O TYPE OF CONSTRUCTION T 19� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location `7�� � J� /l T/�C�. �4 7r//7- Proposed Use J7 Zoning District lie, Fire District Name of Owner/'19 S POA)TI FE Address 6 J Jf iv/u/r49 CQT(!// Name of Builder K Address Name of Architect Address 110 Number of Rooms / Foundation 6 6Ae, l�i2S Exterior C ` / PIAI L Roofings� � Floors. Interior Heating Plumbing '�— Fireplace Approximate Cost ex �Q Area ` O� Diagram of Lot and Building with Dimensions Fee � a2 Cj OCCUPANCY PERMITS REQUIRED FO NE WELLINGS I hereby agr a to conform to all the Rules and R ulations of the Town of Barnstable regarding the above con ction. o � b Name V L/ Constr ion Supervisor's License PONTIFEX, JAMES No '-a5742 Permit For BUILD SHED - Accessory- to Dwelling Location 645 'Santuit Road ;. cotuit ' I Owner. James' Ponti'fe"x Type of Construction`. Frame E , Plot; Lot Permit Granted ;Apr;i 1 2 ; 19; 93 E t' Date of Inspection a 19 Date Completed ^~ 19 ir tMd ro '.1 a ( Ci { / 1