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I o� .o Town of Barnstable BuiR i g -� Post,This Card So That it,is Vkible.;From the Street App'roved,Plana Must be Retained on Job and this Card Must be Kept : " Posted Until Final Inspection Has OMMMASM Been Made ' ° µor° Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final lnspectidwhas:been made Permit No. B-20-1999 Applicant Name: Vladimir Doklev Approvals Date Issued: 07/31/2020 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 01/31/2021 Foundation: Location: 351 LAKE ELIZABETH DRIVE,CENTERVILLE Map/Lot: 227-014 { 'M1^ Zoning District: RC Sheathing: Owner on Record: LIU,XISUO TR Contractor.Name'`Cape Cod Renovation LLC Framing: 1 Address: 18 THOROUGHBRED DRIVE Contractor License: 194808 2 SHERBORN, MA 01770 ( Est. Proiet Cost: $48,000.00 Chimney: h n renovation. Bathroom renovation. Re. lace two extenor Permit Fee. 294.80 Description: Kitc e o p $ doors. Replace windows. Insulation: Fee Paid: $294.80 Project Review Req: NO STRUCTURAL WORK. GLAZING REPLACED IN HAZARDOUS Date: a 7/31/2020 Final: LOCATIONS AS DEFINED IN 780 CMR MUST BE.TEMPERED OR EQUAL. � y Plumbing/Gas a Rough Plumbing: Building Official i Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized byth s permit is commenced within"six months after issuance. g 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. ' Electrical 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: Service: 1.Foundation or Footing Rough: 2.Sheathing Inspection - - �:_:-... '- g 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 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. 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). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT ON49��iE 's O_ffice C1�t ..� Map= = � # IS-3� • Ac�P��^r `Parcel .L� . Date Issued - Fee �f S• engineering DepC(3rd floor) House# r : BARNSTABLE, d 19 f 059. r rEo Ma+" - TOWN OF BARNSTABLE ; uilding Permit Application ` Project Street Address / Village Owner ddress 3 / Telephone 7 ���IA II - r CAR- Permit Request lA x,a4 A First Floor square feet Second Floor square feet Estimated Project Cost $ Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization Recorded Current Use Proposed Use r Construction Type Commercial Residential Dwelling Type: Single Family Two Family Multi-Family Age of Existing Structure Basement Type: Finished Historic House s✓¢ Unfinished Old King's Highway Number of Baths No. of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other _ Builder Information am'' e� �2� . (. �-'(�t;f'i'a�.��.�� •�,T/elephon Ne umber ,'505— 770- ?f.&(a , v"A"ddressl 97j T/Ajt-- Cot4G— '6J.. !Lice e# C)6, �5 tu yL-t C�2�9� //Home.Improvement Contractor# `Worker s'Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT) SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO A F .7 SIGNATURE DATE G BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR,OFFICIAL USE ONLY c .a 07 •PERMLfI'NO: D iSSUjD M P/PARCEL NO. ADDRESS ;, VILLAGE OWNER 1 r DATE�OF INSPECTION: Vk FOUNDATION FRAME INSULATION ' FIREPLACE - - ELECTRICAL: ROUGH FINAL a �. PLUMBING: ROUGH FINAL GAS: I ROUGH FINAL t , FINAL BUILDING DATE CLOSED OUT t ' I ASSOCIATION PLAN NO. OWN f Barnstable The Town o .c� •v f � �"�$ Departinent of Health Safety and Environmental Serve •' Building Division 367 Main Strut,Hyatmis MA M 01 . Ralph Ctos= Off ce: 509-790-6227 Big CM= F= 508-775 3344 For office use oniY • ' Permit no. Date AFFIDAVIT HOME n"ROVEMENT CO� TORIA CAZION� SUPPLEMENT TO PERMIT coon,alterations;renovation,���=co�o� MGL c. 142A mgaim that the"rt constrn ed remotial, demolition or consuuaion n, weMng units or addition to to �mijaccm ��g containing at least one but not more than fa cerQo� bong�►iQ to such residence or building�done by registered quirt mc= Type of Work: Esr. Address of Work: OR6ner.Name: iicati on: Date of Permit App ' I herct<certify that: Registration is not required for the following reason(s): Work excluded by law 'Job under SI.000 Building not own Pied Owncr Pulling own permit Notice is hereby gi%'en that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING NOT wrMEHA FOR APPLICABLE HOME ROVEMENt' VE ACCESS M THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERSIIRI' I bcreby apply for a permit as the agent of the Dated n t conuactor. ame Regisu = No. OR ' The Commonn-calth of Massachusetts srl: r _�yy Department of Industrial Accidents ;s ` �. �'1� OIIIC80//QYCSD9allOdS 600 11'ashin.;ton Strcet Boslon.Afars. 02111 �• Workers' Compensation Insurance ARdavit ____.�- Please I'1ZITVT Te tbly - An[�ii c�ni niorTnwiion U� nnme- - 6 G ohnnef I am a homeowner performing all work:myself. a sole proprietor and have no one working in any capacity ❑ I am an employer providing wori:ers' compensation for my employees worl:tng on thts�ob. co- m nddretc• - citl. phone#• in�ur�nce co police# ❑ I am a sole proprietor. general contractor, or homeowner(circle one)and have hired the contractors listed below who the following workers' compensation polices: nv n� address: cih phone#! cu n nolicv# nm inv nstne, address: city phone#, in—Tur9nr rn nolicr# :Attach additidnal'sht e!if aeeessa w:: .��c^ --+' �'r�t •+••+.:: Failure to secure coverage as required under Section:SA of 516L 152 an lad to the imposition of erimiaat penalties of a fine up to 51300.U0 ao� une veary imprisonment as ivell as civil penalties in the form of a STOP WORK ORDER and a line of S100.00 a day against ma 1 understand thz copy of this statement may be forwarded to the Omcc of Investigations of the D1A for coverage verification. 1 do hereht•cerrifj•u der the pains aPf penalties rjurr that the information pntndded above is true and co .0 �Sianatute� 2 PC.f�� L fS �t es+ Print name-� _on ofticiai rn use only do not write is this area to be completed by city or to aMcial ein or town: permiUlicense# ri8uilding Department (3t.iccmdug Board check if immediate response is required (311mi thews rtmce �tiaith Department contact person: phone#: mother. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for employcrs. As quoted from the "la.+", an emplityee is defined as every person in the service ofanother under am, contract of(tire, express or implied. oral or written. An rnrplur r is defined as an indi�ideal, partnership, association..corporation or other legal entity, or any two or n the foreaoin engaged its a joint enterprise, and including tite legal representatives of a deceased employer, or the recci%,er or trustee of an individual , partnership, association or other legal entity, employing employees. However `'owner of a dweilinL house having not more than three apartments and who resides therein. or•the occupant of the dwc1ling house of another who employs persons to do maintenance, construction or repair work on such dwelling or on.the r,rounds or building appurtenant thereto shall not because of such employment be deemed•to.,be an empic MGL chapter 152 section 25 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 anv applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, 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 chaps: been presented to the contracting authority. ­77- r 'i. .. 'rt::;•ti , _ . .•.. jFr keTN;y,.:17'r�:J.'.cjlL��•�•�-'•:auw.'n:::•a���•�.�..77r .•. .. Applicants Please `;1l in the workers' compensation affidavit completely, by checking the box that applies to your situation an supplying company names, address and phone numbers as all affidavits 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 tite 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 requi: to obtain a workers' compensation policy, please call the Department at the number listed below. �. .�-�• .w.+.!ss.. - � .v..1w....-�... '.S"'_.:L: _. . . •:'.:�::..:.L'C i�..-...... ......,�.'/r ♦� �•_y�c.�.7.•.•ate•• City or"towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottorr the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. F be sure to fill in the permit/license number which will be used as a reference number. 17te affidavits may be ret=L the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any quest please do not hesitate to give us a call. , 77 7. The Departments address. telephone and fax numbei. The Commonwealth Of Massachusetts ¢„ Department of Industrial Accidents Office of Investigations F" ' 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 nhnne -0- (617) 727-4900 cxt. 406, 409 or 375 .' . TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE ...:... JOB. LOCATION Number Street address Section of town "HOMEOWNER" L 7 �► cC; 5 7 /-z �"3 G 7 �%/ ,/�. ..' .. Name Home phone Work phone - - PRESENT MAILING ADDRESS City town State Zip code The current exemption for "homeowners" was extended to include owner-occupie dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person (sj who owns a parcel of land on which he/she resides or intends to re side, on which there is, or is intended to be, a one to six 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 Offic. on a form acceptable to the Building Official, that he/she shall be responsi' for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes responsibility for compliance with the Si Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirement_ and that he/she will comply with said roc u es and requirements. HOMEOWNER'S SIGNATURE W . ' APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35 , 000 cubic feet, or larger, will be required Ito comply with State Building Code Section 127. 0, Construction Control. I HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person (s) for hire to do such work, that such Home Owne shall act as supervisor." Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for • licensing Construction Supervisors, Section 2. 15) . This lack of awarene often results in serious problems, particularly"°when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home '*Owner act- as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, ma communities- require, as part of the permit application, that- the Home Owner 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 to amend and adopt such a form/certification for use in your community. • I � aLO(-K TI '3-UN Roots -1 4 l"ILL A E-M fl� EMENT TO z_ P\-A. rkc- 3/4 SCALE: APPROVED BY: DRAWN BY At-4,� DATE: 15 REVISED FL00YK R-AN ',5LALZ- DRAWING NUMBER