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HomeMy WebLinkAbout0070 WAQUOIT ROAD • - , . s 1, 70 „ � ri .. is n ;• I • „ + , ,. G• r,i ��,. I _`;1" }+ail a 1 u n 1'. t• u .A u t' I \ t- r tiN� [ .. A . rY ^ � I' .{, � ,1 ^q"I". IiM •d r r r b �ti V .4 � +wY,�, �r , I Y•. . ,. ,, � a G Al �dln 'Y 'APy L k d... 41,., a ;�f 'N 'UY d 1 [ i . f - •• n ., u 3 rrdn: ,. ,. 1 A 1r. , Y 7A 11 Frd, �' �{ r ��l�r 1 '... n' 9 f. Town of Barnstable Building eMaw -PostTh�s CardSo That:it��sisibleFromthe Street;-A roved,Pfans`Mustbe,Reiamed on Job and,#hls Card Must be Kept PP Poste UnIFfnal fnspection Has Been Made - „x F f m • Where a Ceificate Of Occu anc s,.Re a�resucha Build�n ;shall,Not;be Occu �ed.unt�l a Final Ins'ectron,#�as been made ��1ya 1111� Permit NO. B-16-2059 Applicant Name: James OBrien Map/Lot: 018-110 Date Issued: 08/09/2016 Current Use: Zoning District: RF Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 02/09/2017 Contractor Name: Residential N Contractor License: Location: 70WAQUOIT ROAD EAST,COTUIT Est Protect Cost $25,000.00 = � � 4 R Owner on Record:. OBRIEN,JAMES&LORENA k Permit Fee „$127.50 Address: PO BOX 1984 Al . . Paid x $127.50 COTUIT, MA 02635 Date: 9/2016 Description: Kitchen.Renovation- Replace cabinets,replat6416ors move stove,,move and recesslrefrigerator. Sink and dishwasher to be replaced in current location Project Review Req : Kitchen Renovation:-Replace cabinets;i epla a floorsj o e st e,move and,r;;ecess refrigerator. Sink and dishwasher to be replaced in current location r � a Building Official This permit shall be deemed abandoned and invalid unless the work authonze&by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved applation;and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and st0ctures shall be in compliance with the local zoning by law a' t codes. This permit shall be displayed in a location clearly visible from access stre or road and shall be maintained open for publicgmspe-' on for the entire duration of the work until the completion of the same. )' 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 � T 1.Foundation or Footing 2.Sheathing Inspection xu 3.All Fireplaces must be inspected at the throat level before firest flue Immg is`'installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) . 6.Insulation 7.Final Inspection before Occupancy T . f 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. "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 All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT .............._........._......_............................_.:_...._......... ........................_.......-.- ... ................ . ............ S. .......... -. ._..:- _.. ..__ .. __.........-.. .......... ..... ..._ NEW SINK AND DISHWASHER TO _ -MA1iOGANY DECK ...................._.._........................___.... REMAIN IN SAME LOCATION AS EXISTING. ..... .- .. SCREENED PORCH ... .. RELOCATED STOVE W/NEW MICROWAVE/HOOD.NEW - - ....................... - - ................. NEW UPPER AND LOWER CABINETS. ELECTRIC OUTLETS AND EXISTING ELECTRIC OUTLETS ABOVE i COUNTERS TO REMAIN IN PLACE RELOCATED GAS LINE ...... . ...... ...... i _...........__..............._........._........__..._........._......._......_....... ...................._....._..... - r FRENCH.DOOR FRENCH DOOR IST FLOOR 1 TI O r� DISH I SINK NE I NEW 3'-0"X T-0'ISLAND - WASHER FRID� - (WOODFLOOR) —TH ROOM BA NEW PENDANT LIGHT 3 KITCHEN (NEW WOOD 3'-4" FLOOR) DINING AREA Q. 12'fie' (NEW WOOD FLOOR) x O 3 SEASON ROOM 3. NEW ELECTRIC OUTLET(TYP) 34 —L-- --J— GARAGE __... ........._ 3 14 31'-3 +s - c• " a }' R� PANTRY EXISTING BEARING WALL TO / 1 REMAIN.NOT TO BE ALTERED J 3-3q 6 CLOSET 0+ RELOCATE EXISTING REFRIGERATOR, - — LIVING ROOM 1 ELECTRIC OUTLET AND WATER LINE (NEW WOOD FLOOR) TO PANTRY/CLOSET 8' .... .....__. MODIFY CLOSET BEDROOM#1 .... _.: PARTITIONS (WOOD FLOOR) TOWN OF BARNSTABLE,MA. Job Number 0 2'-0' 4'-0' 6'-0- 8'-0- Permit/Application:TB-16-2059 Revision Date _70 016 KITCHEN REMODEL SCALE 1/4"=V-0'AT ORIGINAL SIZE PAN OZ PROPOSED PLAN Pq Ord:31 d0y 30t6-J 00 Px .........................__........_........................._._....._.................._...................._.............._:._.....__._._....._, ...........................:....._........__........_......._ ........_..........._........._.....__......._.......__..._........._......_::.................__........._.; ..................................._.........._........_.................._..........................._........................... ................._...._......_...... ---_.._ . _...._.... .................... ..._....._...... ... _......_. __...._. . ... .. MAHOGANY PECK-.._ .__......_..._.........._.._.........................................._........._..._..................................:..................._......__........_..............—.............. , i ....... ............... _...... SCREENED PORCH ...................... ... ..:_...._. _........... ......... ......._....._............._.............__....__......__................._._...._...___.._..__.._—__.--.............. ......_........_..._............._....__ CABINETS&COUNTERS TO BE ................................:......................_...__.............._................................_...__........_........_............................... REMOVED AND REPLACED .... .... .... ._ -AZ-6 ..... ..... _....._.._...................................._.....__.........:....._.............................__........_......._......_............................. _...._... #— a STFLOOR O 1 I O O .... II BATH ROOM I I -(WOOD FLOOR) {? KITCHEN 9 (WOOD FLOOR) OO ' OO �' DINNING AREA x O — PENIN5ULA TO BE I I (WOOD FLOOR) 3 SEASON ROOM m REMOVED. ELECTRIC BOXES GARAGE _ TO BE RELOCATER GAS LINE TO BE z-0' -- j, RELOCATED. e .. 31'-3. + 3'-1q° e s — bi m __...—_... _..—T.4-0 X 6 ....... .... ....1 REFRIGERATOR TO BE T Y CLOSET '�, Tf RELOCATED °t a CLOSET +6 e _ isi.......... LIVING ROOM ` (WOOD FLOOR) , BEDROOM#1 ...:........_._.................................................................___........._............_._....___; (WOOD FLOOR) Job Number 0 2'-0' 4'-0' 6-0' V-Ir TOWN OF BARNSTABLE,MA. Revision II I Permit/Application:TB-16-2059 Date 70016 SCALE 1/4'=r-0 ATORICINALSIZE KITCHEN REMODEL PLAN �� EXISTING FLOOR PLAN - Town of BarnstableItsMicting �., mit�., , Per rdS That�ts,Visble,Fromahe Street .:A rovetl,Plans Must.3se:Retamed on Job and this-Grd Must be3Ke t PostTh�s Ca pP P � .MAC. Posted;Until I?inai ins ection Has:Been Made, g 3P ' etificate of,Oceu ancF:�s Re ii�red ;such Bultliri' shall Not'be Occu ied un#EI aFinaf Iris ection has.been.made ea.r Where_a Permit No. B-16-2059 Applicant Name: James OBrien Map/Lot: 018-110 Date Issued: 08/09/2016: Current Use: Zoning District: RF Permit Type`. Building=Alteration INTERIOR Work Only- Expiration Date: 02/09/2017 Contractor Name: Residential Contractor License: Location: 70WAQUOIT ROAD EAST,COTUIT � Est Project Cost $25,000.00 ^ Owner on Record: OBRIEN,JAMES&LORENA g Permit Fee $ 127.50 _ row. , .- Address: _:. PO BOX 1984 Fee'Pard �$ 127.50 4 , COTUIT, MA 02635 Date: 8/9/2016 Description: Kitchen Renovation-Replace cabinets,replace fl�oors,E pye stove, move and recess refs geratoi'". Sink and dishwasher to be replaced in current location Project Review Req : Kitchen Renovation,- Replace cabinet s,replacefloo�s,move stove,move ndrecess refrigerator. Sink and dishwasher to be replaced in current location r .. Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after,issuance. All work authorized by this permit shall conform to the approved application and the approved construction document for which this permit has been granted. All construction,alterations and changes of use of any building and structures,shall be in compliance with the local zoning by lavrsand codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for pu 'li6inspecti for the entire duration of the work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signaturebyhe Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work fi * s 1.Foundation or Footing } ' 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue Iin nigis installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection 5.Prior to Covering Structural Members(Frame Inspection) _ 6.Insulation 7.Final Inspection before Occupancy _ 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. 0-M "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). ENT" Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1 mot , Town of Barnstable *Permit# Expires 6 months from issue dat �7 Regulatory Services Fee BARNSTABLE, * . v� MASS.1639. Richard.V.Scali,Interim Director �� ATfD M0't a Building Division (0°1 I9 by Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 . EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address Wh v T aof{j 6A51 ['`Residential Value of Work$ �&Poo,,00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address J 41u s LY r[G( j0/I 4 0 4 2i C nJ Contractor's Name A44 Telephone Number Home Improvement Contractor License#(if applicable) A,10- Email:. I fyj Construction Supervisor's License#(if applicable) �r—no 7D,'P Workman's Compensation Insurance i Check one: SEP 16 2014 ❑ I am a sole proprietor ® I am the Homeowner TOWN OF A RNSTp BLE ❑ I have Worker's Compensation Insurance f n / I`1 �U /1 Insurance Company NamejVz Gro;j 86e. JYJ, �Ul Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Pernut Request(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to T,-M.A>ee ,QQ✓/>'r 1, ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ 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. �Q SIGNATURE: L 1�✓L� TAKEVIN D\Building Chan s\EXP S PERNIMEXPRESS.doc Revised 061313 I r 1HE tq • IARNWABLE, 9Q ' 8. ib39. Town 'of Barnstable U �0 Regulatory Services Richard V.Scali,Interim 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 ope ty Owne Must Complete and Sign This Section If Using A Builder. as Owner 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) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEWN MBuilding Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 r a: . 7,�ie Ca%�r�ionvet�,dtla +f�assa�ae��tts� . ' �; �rrei�t of Irad're.rtir,�r�l Accicle�rrs C?,f`ire of Iravestigat PA 600 WaAingtorl Sifreet. BOa`oira t 02111 . _. . . :. -: :. . •<: . tivraw� rnax�g�vlclia .Work n'{Com .0ensation Imt:Lt�c_a Affidavit: Bnffders/C6n tik'slE adnClaniM. U tiers Applicant Infmaiim :.Please Prat Lel�y Name 0 D. Jfe .d city/sta&z Are_ you an employer?Check the appropriate boa T e of xt ect t 4_ I aan a eral contractor siid I ' 3p In J , `,equued 1_❑ I affi a�empltry :unth ❑ .._ employ s(foal andl r p �Cinne}_' have hired th sub-congactasas b I�Teu{constraa axon 2.❑ I am a sale pioprietor'or partner listen-on: e attached sheet¢ 7 r❑tLe ode g ship said have Tier einplcsyees< Ides tattlD oordracto have g ❑bemolittaa woag forme.in any capacity. etrtployees and have wo�eas' : : (ATo Woai�ers comp i>Bstnce coaa�;sastiaraitr3e I 9 ❑Bualdang atitton r cl. - ❑ iVe are a co porataon- its 1{D❑ELectaical i epaias va'addations egtr 3. 1 am a hermeowier do allro offis ersercised tlte>r: 11_❑Pii�mbm ears or°addakioris gP myself[No worlueA .mmp ©f on perAfiCrL: r 12❑Itoafrepssas Insurance r "d_ F, ` . c_ 152, 1{4X aad we have no . "1 employees [N6 worker_s' .. 13❑Other comp:ms-maaoe regtiueal •Any'appE¢airt dat checks box f1 mn°3;also Ell clot the sectian bell dt& em o—pezgsa�aa�paling mfaiias�CiarL n,00mm users who,nbmu this affid-ft mdi-tiag they s e derin�sll trigrild a wa hize rn4ts de coatiactars amst subm�t.s nem ea it-Indic sack. *� .. :.•..`L.an$SCtnr3 that checkthis mugattached anadditiauill sheet 6hot4ing the name dYff die sib-ODI IaCt41I5 8nd-5i8te whether or not tlla5e 2a1AtFC5 baeE hmplayees. If the s i.ti Ltm bare a play6Es,die' t�sC.pavvide their arkeas c—p,policy umber I;Qm are arripI n,W,thaat is provadtaag 1mdiets=cotaapMsvrlam+n aaasmr�erice for aaay aaa �eaes [iedna�is "PaA cy a ijo6 site irafoeraiah�*ri Insurance CO Plante: Poltc}!##orrPelff-ms Lip:i# " ExpusAioa gate: „Job Stdf Adcits CitylState�Zsp Attmh a copy of the orkcrs'cumpensaban, olffry decEmoon page(sho'tNM the pulley artatmber"',and ix -a date).' FkAure to secure coverage as retgatiierl under Section 25A of mm tw 152 caii lead to the inij6sitiou of rTIMI al pea�lties of a fine up to 1,54U fit}aafd!!or one-yeas i nM.sat»ate it,as wren as ci^% petasities in.the'f :of a S Y'L1P.oV®RIf C]RL7 anal a fine of up to$250.Dtl a day agaiij,t hhe viola tos Be advised fat a copy of this:statement atsag�be,fnrwaraed to fDffice of InveFO Lions of ffie DIA,fva•insivance coverage�e Cation I do herby certay a tdre ptriris arul aalYaas a that the iaa ai�rarata Zvi `ivttri �baa�e is irate ariF'corrst S 'Date Phone#: O,�acaeal ais minty Ilia riot write art this iirea4,tfi lie c�arplste�by city ar tntvra1 Cifiy or Town Pe e IssMuing Anthorky(Gtrcte oae): 1.•S03rd , l3raltlh I.13,nn�ding Depna�rnt 3. Cai�froym Jerk .-EJecti cal ln,&pe.c r � Plnmbig.En% i�ctot `` b.OflLer. ' Cotatact Person: Phone.#: 6 Town of Barnstable Regulatory Services OFTME Richard V.Scali,Interim Director Building Division BARNSrABLE, ' Tom Perry,Building Commissioner MASS. 039. ,�� 200 Main Street, Hyannis,MA 02601 '°�eo IAi'I° www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: C?A,4,1& D JOB LOCATION: '76 U/f (Q )0iT number rstreet village, "HOMEOWNER": JMMA S Q'A 2JGN �y fl daf 0 T 7/71!ll !70- 16 t? name home phone# work phone# CURRENT MAILING ADDRESS: �, D d /q D L 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 proce ttres a requirements and that he/she will comply with said procedures and requirements. Sig ature o omeowner 7 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,.that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. T:\KEVrN_D\Building Changes\EXPRESS PERMIT\EXPRESS.doc Revised 061313 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 4 t Map D Parcel Application # Health Division Date Issued }� l' Conservation Division Application Fee Planning Dept. Permit_Fee Date Definitive Plan Approved by Planning Board + n Historic - OKH _Preservation / Hyannis ,�hN Project Street=Add er ss 70 • ' kU!flag Owner W'& a cr jd l` ,� �.'p/lr��� Address Telephone .I L/ ` Sa f P, ermitRReauest) " x cu./ beck i7`7 !d ,o Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuati&n", 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) `3 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 wood/coal stove: ❑Yes ❑ No Detached garage: ❑existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑existing ❑ new size_ 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 # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR H MEOW Name` ��M1 r c n� Telephone Number Address 1 vo1,r- License# Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM,THIS PROJECT WILL BE TAKEN TO SIGNATURE / - C�LDAT=-E L f F FOR OFFICIAL USE ONLY APPLICATION# t DATE ISSUED F� 1 MAP/_PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: c -_ FOUNDATION.'t FRAME INSULATION.!;. FIREPLACE ELECTRICAL: ROUGH FINAL M i PLUMBING: ROUGH FINAL * GAS-' ROUGH FINAL FINAL BUILDING fc- /o ;S \ 4 r yk_ DATE CLOSED.OUT ASSOCIATION PLAN NO.. r I r Town'. of Barpstable Regulatory Serrice-s s Thomas F. Geiler, Director °rob =�,0 Bitzlding Division Thomas Perry, CBO,Pudding Commissioner 200'Mai:n Street, Hyannis,MA 02601' www.town.barts b le.ma.us • r Office( 508-862-4038 Fax: •508-790-6230 PLAN REVIE W Msp/Pmcl: fl l 8 Silo Project Address 70 !d f Q overr 4. �C'-r- Builder: Pt w`� The following items were noted on reviewing: �ON�E�TiDAIT -E'Q ctZ12� ' �/°A/1-�A/1 r q-'tL= �yllil,Z'�Tt�s?S T •h'�5 l s T �.t/d G!F�- S /.o. N� yk%- � 5 tYG /P�S'�D� •STD/p-�s 13r-rls z' s Reviewed by: Date: The Commonwealth of Massachusetts c I Department of Industrial Accidents Office of Investigations - ' 600 Washington Street � 61ii'is ; - �:� j Boston, MA 02111 r r www.mass. ov/dia g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers,,' Applicant Information :, Please Print Legibly Name—(Bg'si'ness/Organization/Individual): 04mej a�_v� Z­vlq,'j/� Cnddress---,�, ?U PL-4 y,vv % City/State/Zip:•-0d�—Ot r n44 od,&-, Phone #: Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ 1 am a general contractor and 1, :6: New construction employees(full and/or part-time).* - have hired the sub-contractors 2. I am a sole proprietor or artner- listed on the attached sheet. 1 7• ❑ Remodeling ❑ P P P ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp, insurance. 9. ❑ Building addition [No workers' comp:insurance= 5.-❑ We are a corporation and its quired.] officers have exercised their ]0:❑ Electrical repairs or additions I am a homeowner doing all work right of exemption per MGL• 11-El Plumbing repairs or additions myself. [No workers' comp. a 152, §1(4), and"we have no 12;0 Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] `Any applicant that checks box#I 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 their workers'•comp,policy information. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site - information. - N 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 criminal penalties of a fine up to$1,500.00 and/or.one-year imprisonment, aswell'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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalties'of perjury that the information provided above is true and correct. Si %/� �i nature: - ate �Phon�} I 77.V 7w�� - ..✓.(� f� Official Use only. Do not write in this areal to be completed by city or town off cial City:or Town: w Permit/License# ` Issuing Authority(circle one): " t L:Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other < Contact Person: Phone#: r. 0 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 in 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 receiver or trustee of an individual, partnership,association or other legal entity,employing employees. However the 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 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 until 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 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 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 burn 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 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7.749 www.mass.gov/dia p Town of Barnstable �ofYHe try Regui•atory Services tttrrsrwsie Thomas F. Geiler, Director KAS& 16S9. ,�� Building Division . PrEO µA't a , Tom Perry, Building Commissioner. 200 Main.S i-cet, Hyannis,MA.02661 R ww.town.b arnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOINUD NERECEI\'SETEXE�MPT O Please Print 1,2P 1l number ; strmt village "H.OMF.OWNERt:� c%A'nZ/ (! 3 iliG'-1 7-7 — name home phone# work phone# CURRENT MAILING-ADDRESS: Ao .A � ... 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 j Persons)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 be/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,be/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and require, ents, t Sign rc of omeowner 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 Constriction 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.(Scc6cin 109,1.1 -Licensing of construction Supenrisors);provided that if the homeowner engages a pmon(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners wbo use this excrtrption 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 procccd 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 pail 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/certifrcation for use in your community. Q:forms:h o mccx cmp t THE r � Town of Barnstable Regulatory Services RAMSTIELF, s v ass Thomas F. Geiler,Director A6. Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508=862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject.property hereby authorize to act on my behalf, m all matters relative to work authorized by this building permit application for. (Address of job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. 0:FORM5:0 WNERPER MT.RMN 4 P/NE R=507.86• R/ G L=278.5p• /?0 D tV C tp G EXISTING 144.3' C O CONCRETE FOUNDATION I so 0 N C 1r� a. O 63.2' 280• LOT 118 41,800sq.ft. O N 245.63' I CERTIFY THAT THE STRUCTURES ARE SHOWN ON THE PLAN AS THEY EXIST ON THE GROUND AND CONFORM TO THE ZONING BYLAWS OF THE TOWN OF COTUIT — BARNSTABLE, MA. DATE PROFESSIONAL LAND S PLOT PLAN STEPJ. N�_N PEPARED FOR: MR. & MRS. ENDICOTT DOYLE H LOCATON: LOT 118 PINE RIDGE ROAD No.37559 DATE: 06/13/94 j0 ��;►o�'��"oQ SCALE: 1" = 40' SU y FLOOD PLAIN DATA: THE STRUCTURE DOES NOT LIE IN A FLOOD HAZARD ZO PREPARED BY: STEPHEN J. DOYLE AND ASSOCIATES 42 CANTERBURY LANE, EAST FALMOUTH, MA. TELEPHONE: 508/540-2534 ~ \_--------� / ~ ` SITE PLAN OF LANDNATIONAL HERITAGE SPECIES BOUNDARY FOR. 100' BUFFER ZONE i LOTS 118 & 1119 PINE RIDGE ROAD WATE'R SERVICE lco cli Al 19. TP iNG Soo ft. 0 Lp ` ` J GARAGE EXISTING OGYELL/NG EXISTING OECK ABOIiE EXISTING 8' EXISTING S-0 FRENCH DOOR O/A CONCRETE FOOT/NG RAISE EXISTING DECK 6 REPAIR ROTTED RIM BOARD ON MAIN HOUSE BEHIND NEW MAHOGANY DECKING (TYP) PRESSURE TREATED 2X10 LEDGER (SEE SECTION NOTES) REPLACE DOUBLE 2X10" BEAM �� NEW 4'-0 X 6'-0" WITH 3-2X10" BEAM (TYP) PRESSURE TREATED SHOWER ENCLOSURE to �-r7-I-r-r-n REMOI/E EXISTING EXISTING COf/ERED PORCH / T/ G O C STRINGERS J_L1_I_LJ-LJ NEW STAIRWAY - — ---- �� LOCATION. PRESSURE PRESSURE TREATED TREATED STRINGERS. 12'-2X10 016" W/RAILING O.C. (TYP) i o '' PROPOSED DECK PROPOSED 10" DIA X 4-0" 3-2X 10 PRESSURE TREATED N DEEP CONCRETE FOOTING (TYP) i i WOOD BEAM (TYP) NEW RAILING AROUND ' 2-2X1O P.T. PERIMETER (TYP) , FOR PERIMETER (TYP) 100' BUFFER ZONE / / 5'-9" 5*-9" 5'-9. 9:o / > / 8• / / 70 WMUW PROPOSED DECK SCALE: 1/8" = 1'-0` / DATE: 5 MARCH. 2011 NEW STAIRWAY LOCATION 20'-1 1/2" EXISTING 0kYr_ZL/NG 8'-0' 91-111, PRESSURE TREATED E,Y/ST/NG dOIST 12'-2"X10 ®16" O.C. (TYP) HEIGHT NEW JOIST 36" HIGH RAILING (TYP) 3"X1/2" LAG HEIGHT (TYP BOLT ® 16" FOR ALL O.C. EACH BAY (TYP) 3'-0" 4"X4" P.T. POST (TYP) NEW MAHOGANY DECKING (TYP) EXISTING DECK ✓O/ST NEW 3-2"X10" PRESSURE 157-FLOOR ✓O/ST — _- — _ _ — — TREATED WOOD BEAM SEE NOTE 1 iv EXISTING 2-2X10"" \ BEAM 00 i E.Y/ST/NG 5,r4lR5 SEE NOTE 2� -- NEW STONE OR NEW 6" X 6" P.T. EXIST/NG FOUNDAT/ON \� / CONC. PAD POST (TYP. OF 4) /\, NEW 3-2"X10" �i\\�\ /jam\\ BASE OR EQUAL (TYP OF 4) \ \\ SIMPSON PBSV GALVANIZED POST TREATED WOPRESSUREOD / \/% � CUT EXISTING 6"X6" EXISTING 8"D/AAfETER POST TO - \� CONC. FOOT/NG <<�fLZ_z ACCOMMODATE EXISTING SURFACE NOTES: 1.) REMOVE EXISTING PRESSURE TREATED 2X10 PROPOSED 10" DIA X 4'-0" LEDGER AND REPAIR WATER DAMAGED RIM BOARD DEEP CONCRETE FOOTING (TYP) ON MAIN HOUSE. RAISE DECK HEIGHT 6" TO BE FLUSH WITH EXISTING FLOOR JOISTS ON OUTSIDE PORCH. REFLASH AND RE-ATTACH EXISTING P.T. LEDGER TO HOUSE FRAME. REPLACE 2"X10" P.T. JOISTS ON TOP OF NEW 3-2"X1O"BEAM. REPLACE EXISTTNG 5 1/4 P.T. DECKING WITH NEW MAHOGANY DECKING. 2.) RELOCATE STAIRWAY. REPAIR OR REPLACE Q NOW ROAD SECTION 1-1 STRINGERS TO CODE. SCALE: 1/4" = V-0" �y DATE: 5 MARCH, 2011 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION ' Map D` Parcel Permit.# Health Division ' Date Issued Conservation Division Fee / 07� Tax Collector OK— Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address W X GL'4— Village 4 t� Owner Address Telephone Permit Request Square feet: 1st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost �� Zoning District Flood Plain Groundwater Overlay 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 O Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool: ❑existing ❑new size Barn:❑existing ❑new size 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# Current Use Proposed Use BUILDER INFORMATION Name_ FRASER CONSTRUCTION Telephone Number Address 71 TARAGON CIR. License# , iQTUIrtA 02635 Home Improvement Contractor# Worker's Compensation# 6UC I3/SYfc ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO._ SIGNATURE DATE 3 �7 ll FOR OFFICIAL USE ONLY PERJJT NO. DATE ISSUED MAP,/PARCEL NO. ADDRESS 3 VILLAGE 'n ! OWNERk r t , trr S cv DATE OF INSPECT FOUNDATION ' FRAME F INSULATION FIREPLACE _ t E ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: - ROUGH FINAL FINAL BUILDING . - - x. z? ; DATE CLOSED OUT ASSOCIATION PLAN NO. R , fi The Commonwealth of Massachusetts MI .. Department z' Department of Inthatii d Accidents , 600 Washington Street Boston,Mass 02111 —' Workers' Com cessation Lssarance davit name: FRASER CONSTRUCTION ocat,on. 71 TARAGON CIR. — CGIUII MA 02635 phone ASS':1 ❑ I am a homeown9 ptxi`ormmg aVoik myself. ❑ I am a sole rietor and have no oneworldne in anv ca acity .", 'Ml'c' ////,%//%//////%/,;': a� I am an emplov4r p g,��tpq�� l�s��ion for my employees working on this job. tomanv name: rrttii 71 AGGRAGvN CIIIQ���tIIJJNN ; address: .: COT MA 02635 : .:.;; > : .:. ::< :;... . .. ::;:<.:;:. >.... > ::.. �tv: '(508) 428.2292 ;.. .. phone* Insurance ca. olicv# M VAIMMA W.4- 14 16rmQS ZU '3 ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comoanv name: address- Mr. phone# cpmpanv name. ...:...:.:... •. :,: :.� . address: city: phone M. prance Co. • •:..::,.a,.s.:... ..,.t.>;.:.:.;...:,. .. . .:: . . . .. •• • itev# FaOnre to aeeate coverage as eegnired under Section 25A of NIGL 152 can lead to the imposition of crhn ual penalties of a flne up to S1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification, 1 do hereby cord the airs an emattics of perjury that the information provided above is tru.and correct Si'atm— Date Priest name Phone# QX-- BQ 5 7or nly do not write in this area to be completed by city or town offi ial p"Initmeeme 0 OBdlding Department OLb:ensing Board mmediate response 6 required ❑Selectmen'sOffice OSeaftDepartment n• phone Mt ❑Other 0gVJ"d 9/95 P1A1 IThe own of Barnstable • .�.�rrsrw� • 9 ' AM Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building'Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT 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: p� Estimated Cost ZJ® �`Cr� Address of Work: J)0y Owner's Name: Date of Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under S1,000 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 IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav HOME IMPROVEMENT CONTRACTORS,`REGISTRATION Board of Building lding Regulations and `Standards Ashburton place '- Room , Bost on,• Massachusetts. 02108 4 HOME.`IMPROVEMENT CONTRACTOR j Regis_tration-11253 _ _ �s . � -;-�� - F-------------- ' TYP@. — DB 6 :r., " Expiration=..04/.06/99t<, NDIR:' INPROVEMENT CONT RACTOR . FRASER CONSTRUCTION Registration 112536 DEAN C. FRASER << 5 ' : '. .� Type._ 71 TARRAGON C I R "� a '�' ' M E plratio� "€44/06I99 COTUIT MA 02635 ► ' ��. .. ' .. .Y' .._;�; FRASER CONSTRUCTION e o}� C. FRASER tw j 1 TARRAGON CIR COTUIT NA 026L S