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Home My WebLink About0076 HOLLY LANE 7Zta A-0 t -Town of Barnstable ( y 03 b?3 oFr►tF tpky "Permit# ` Regulatory Services FPees6m°"`hsj°-„S` °1e ' sAR,YsTABLE, t OASS' Thomas F. Geiler, Director' 059• Arl�D A�P'�A " Building Division n Tom Perry,CBO, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable,ma.us Office: 508-862-4038; i Fax: 508-790-6230 :EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number p Property Address D 67 Go .1 �Q ❑ Residential Value of Work �a Minimum fee of$35.00 for work under$6000.00 Owner's Name & Address T ` it p �� ✓1 Contractor's Name S t � Telephone umber TO Home Improvement Contractor License#(if applicable). . Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑�I am a sole proprietor -PRESS PER, MIT . �J<l am the Homeowner ❑ I have Worker's Compensation Insurance �� i� 2 Zola Insurance Company Name F BARNSTA13L Workman's.Comp• Policy# Copy of Insurance Compliance Certificate must accompany each permit. a Permit Request(check box) , Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken.to S .� ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) 5LRe-side t #of doors_ K Replacement Windows/doors/sliders. U-Value its aj (maximum .35)#of windows + *Where required: Issuance of this permit does not exempt compliance with'other town department regulations,i.e. Historic,Conservation,etc. t' ***Note: R Property Owner must sign Property Owner Letterof Permission. " y.of the Home Improvement Contractors License& Construction Supervisors License is fired. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.d6c Revised 072110 l The Common wealth of Alarssachusetts Departmeatt of Industrial Accidents - Office of Investigations 600 Waslrington.'Street Boston, MA 0.2111 * Wnmt.mossg ovIdia cp*ers' Compensation Insurance Mfidavit: Builders/Contractors/Electric ins/Plumbers Appfi.cmt Information Please Print Lcbh Name (EsmssfOrganizabondudividuaD: V.- � Address: CitylaZip: Phone#_ $ ? Are Sou axemployer?Check the appropriate box.: Type of project(required): 1.❑ I alai.aelnployei with 4. ❑ I am a general contractor and I eusplgees(full and/or part-time). * have hired the sub-contractors 6- ❑New construction 1❑ I asn.asole proprietor orpartner- listed on the attached sheet T ❑Remodeling ship and have no to s These sub-contractors have employees h $.,❑Demolition , ur rking :for me in any capacity- employees and have workers' (No n;urkers'comp.insurance comp_insurance. I 9. [],Building addition reclui rtd-] 5 ❑ We are a corporation and its. 10.❑Electrical repairs or additions 1� officers have exercised their.I.aru a homeowner doing all work 1 l.❑Plumbing repairs or additions myself[No workers'comp_ right of exemption per I4feiL 12.❑koof repairs insu raw required.]' c. 152, §1(4} and we have no employees-[No workers' 11❑Other comp.insurance required_] •Arty apphraw that checks box#1 must also fill out the section below showing their workers'compensation policy informs®an. I HomeoWners who 9obMit this affidavit indicating they are doing all wed aiLd then hire outside contractors mast submit a new afdaeit indicating such bcontracrors that:check this b m must attached an additional sheet showing the game of the sub-contractors and statue whether or not those entities hn e employees. If the sub-contractors have employees,they bust provide their workers'comp..policy nu mbar_ lam an enip4vr that is proiit&g rtrorkcrs'colrrp rlsa olt insrrrarccxr for wrz� errrplayee Below is the polic y and job site ii�oYrrlatl016 . Insurance Company Name: Policy#or Self-ins.Lic_4: Expiration Date: Job Site Address: . City/State/Zip:' Attach a copy of the workers'compensation policy declaration page(shoving the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 1.52 cau.lead to the imposition of criminal penalties of a fine up to$1,500.00 andfor one-year imprisonment,as well as civil penalties in the form of STOP�VORK 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 hemby cer'#`n—n)ff0tDKins and penalhes ofpeduty that Cite informaatian protdded abow is true and correct Si Date- Phone#E: official is se only. Do not write in this area,to be-completed by city or totwi official City or Town: Permit/License# y r Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other r Contact Person: Phone#: 6 i B of lOwti Town of Barnstable, Regulatory Services " UA ass.B�' Thomas F. Geiler, Director b79• ,0� ''ren+n't°i Building Division Tom Perry, Building Commissioner_, 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 518-862-4038 - - Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION 'Please Print DATE: C�L JOB LOCATION: � V 1 number street vi.age {�. --� p HOMEOWNER h G_� 4lC,L�10 5 o O 77 71 name !! home phone# work phone# CURRENT MAILNG ADDRESS: (� 1 �� city/town state zip code The current exenption 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 unders ned"homeowner"certifies that he/she understands the Town.of Barnstable Building Department minimum inspection procedu es an requiremen d that he/she will comply with said procedures and requirements. atur o n.er � Approval of Building official j f . 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 corrimunities'require,as part of the permit application,that the homeowner certifythat he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form current) used b several[owns. adopt such a form/certification for use m your community. y y You may care t amend and Q:\WPFILES\FORMS\building permit forms\EXPRESS.doC Revised 072110 i cF IKE TQ� anxrvsrnBLE, MASS. Town of Barnstable i639. �0 pIFD MAC A Regulatory Services Thomas F. Geiler, Director Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.ba rnsta ble.ma.us Dfflce: 508-862-4038 r ' � 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, 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 qn the reverse side. QAWPHLESTORMMbuilding permit forms\EXPRESS.doc Revised 072110 Town of Barnstable *Permit# 78 q Expir s 6 0�f.�l./is ue ate r • BARNSTABLE . Regulatory Services Fe 9cb i69. �� Thomas F.Geiler,Director p'E0 Building Division' Tom Perry, Building Commissioner ®PRE F..._, L 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 - S E P 1 3 2005. Fax: 508-790-6230 TOW EXPRESS PERT IIT APPLICATION - RESIDENT g NSTABL E Not Valid without Red X-Press Imprint Vlap/parcel Number o�o� 9149 Property Address 2L /710 LL.y e_1 � Residential Value of Work Owner's Name&Address 151Zc>wzl� Contractor's Name 12c,6 r,z.S Telephone Number 3-D S_ 'Y;?$ —to/oL Home Improvement Contractor License#(if applicable) /o o ! 3 'Y Construction Supervisor's License#(if applicable) 1 Norkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name /-Jo PZ*tr LC 9opn Lj C H ►s. Workman's Comp. Policy# LAJ Permit Request(check box) Zze-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) 0,Re-side ❑ Replacement Windows. U-Value (maximum.44) ❑ Other(specify) *Where retluired: Issuance of this permit does not exempt compliance with other town depar=ent regulations,i.e.Historic,Conservation,etc. ,,natur Q:Forms:expmtrg Revised 121901 SHE T r ;.,j °�ti Town of Barnstable c N�PI O v Regulatory Services BARVSTAB(E. v ; MASS.- o Thomas F.Geiler,Director t63q. `gym17 Building Division ` Tom Perry, Building Commissioner ` 200 Main Street, Hyannis, ALA 02601 Office: 50S-S62-403S Fax: 50S-790-6230 Property, 0,;vnerMust Complete and Sign This Section If Using A Builder I, e 2 /20cW , as QRner of the subject property- hereby authorize ROGERS & MARNEY, INC. to act on my behalf, in a1 matters relative to work authorized by this building permit application for(address of job) 6 h�LL y LSE Si. ture of Omer at; PrL_r_ Name . -�� Board of Building Regula ons and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Reqistration: 100134 Type: Private Corporation Expiration: 6/9/2006 ROGERS & MARNEY, INC. Charles Rogers P.O. BOX 310 Osterville, MA 02655 Update Address and return card.Mark reason for chang Address F1 Renewal ❑ Employment D Lost Card 0PS-CA1 50M-04/04-GG�101216Q .:/itC L/6'riLYif4l2C�P�GCiL 6�✓I�GQ�J�C/LCL6rttif Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 100134 Board of Building Regulations and Standards One Ashburton ce Rm 1301 Expiration:-(6/92006 Boston,Nla.0 -Type Private Corporation ROGERS&MARNEYJNC. Charles Rogers 445 WEST BARNSTABLE ROAD _ — ,i 1sterville,MA 02655 Administrator Not valid wi out signature 0z�CaFi(b�iE(ii PfO1�S License: CONSTRUCTION SUPERVISOR l: Number: CS 016174 Bi rthdate`_05/07/1939 Ex s.05/07/20 Tr. no: 23796 __ Restrtc}ed: 00 . CHARL D ROG PO BOX 310 � OSTERVILLE, MA 02655 Acting Commis oner IL _ Assesf r's:mqp'and lot number ... ........................... FT NET Sewage Permit number l BAUSTADLE. i Housenumber ..................................'....................................... r MAM ppo�1639. a MAY a' TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ... e. U J........w is c .............................................. TYPE OF CONSTRUCTION 4.... ....... !Z Q .K ::.................................................................................. .............. .. .........................19.. . TO THE INSPECTOR OF BUILDINGS: I The undersigned hereby a plies for a permit according to the following information: r Location ...... /VV, J12 / i ! Gt ✓�.�............... ... ............................................................................ ProposedUse ..... ..................................................................................................................................... ZoningDistrict ........................................................................Fire District ..... ..................................................... • Name of Owner .I ............ ....................Address ....761.....:��!�/.Y......��..11.'Q........ /il ,........ Nameof Builder ... . ........... ..........................' Address ....�.............,......................I.................................... Nameof 'Architect .........}�.:'n.�........................................Address .................................................................................... Number of Rooms ............/...................................................Foundation C'e) vt 4l3.. .�-1..........' .�U GA. Exterior ... ................................................................Roofing ... ........ .......................................... :✓1 ..! .. a............................. Interior �La.. wc.�.L. ..............................................t Floors ............... ........... ... ,......U ........ l , . f Heating �c1.: f.... Q cs.r? .......Plumbing ............. Fireplace .................Approximate Cost ........... ...................................................... Definitive Plan Approved by Planning Board ________________________________19_______ Area ...�.0..�.................... Diagram of Lot- and Building with Dimensions Fee ......—W SUBJECT TO APPROVAL OF BOARD OF HEALTH r> 3 1 r rc c t d vi a5-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 construction. Name ......... ...... ,�J.,/ �� ............. Construction Supervisor's License .................................. 1 BROWN, MINA ) A=229-018 . No 30553 permit for ,, Rebuild Exist'., Porch Single )Family Dwelling ............................................................................... r ' �� 76 Holly Lane Location ................................................................ Centerville ............................................................................... Owner Mina Brown ................................................................ r Type of Construction Frame , .. ...e.............. ............................................................................... Plot ............................ Lot ................................ Permit Granted ..... March .25 , 19 87 '. Date of Inspection ....................................19 Date Completed ......................................19 11/ M 69'? 6zCUDff Asses rs m and lot number ...303.7.01 aK. 1-- N . TE Sewage Permit number 53-A5-,AEPTIC SYSTEM MU ... .. 4STALLED IN COMPLI STABLL?, House number ....... .............. WITH TITLE 5 V, MAG& ONMENTA'LL COD E 0 V TOWN OF BARNSTAUMAT's39. BUILDING INSPECTOR APPLICATION FOR PERMIT TO ....R.e_.8.pj'.j.b..... 1!1........po.&S-J ................................................. TYPE OF CONSTRUCTION ....C-tr.O!.�.......FA.A.A.WYA-.�.................................................................................. ...............3.......(91..................I q.. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby oy plies for a permit according to the following information: � P7 /VV, e en.. ............................................................................ 4 /. ...........:..(Ccee...............C Location ...... .........rX.D.1 / ProposedUse ....S.Q.A.....P f...................................................................................................................................... ZoningDistrict ...............................................J�! .........................Fire District ......Q ....................................................... Name of Owner ...... ....................Address ....7.6...64 14r....../a,.,o......... . ........ Name of Builder ... .......... ........... ................Address ........................:........................................................... .... Nameof Architect ....... .......................................................Address .................................................................................... Number of Rooms ............/...................................................Foundation ..... ......... ............. Exterior ...C4./�a................................................................Roofing ...0, ..0.1 P.A/I e �.................................................... Floors ... .....................................................Interior .........r. -�r. ... .. ............................................. HeatingRC .......Plumbing ............. ... . . ................................................... Fireplace ........ l . .................................................. Approximate Cost ........k�. ... ... .......................................... - F1, -------------------------------19--------- k9 ............................... Definitive Plan Approved by Planning Board Area .... ..0 Diagram of Lot and Building with Dimensions Fee ...... ............................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 -7 t4n K< C) OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS- I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ........... .................... Construction Supervisor's License ..`...D. ......... BROWN, MINA No ......30553 permit for ..,Rebuild Exist. � Porch Single Family Dwellin Location ne ....................................:................... i Centerville ............................................................................... Owner .Mina...Brown...................................... -. Frame Type of Construction .......................................... .............................................. ....... .................. t Y Plot ............................ Lot ................................ March .25 - 87 Permit Granted ............I...........................19 Date of. Inspection ..................................r.19 ` -Date Completed .....................19 'TY CR ,