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Home My WebLink About0126 LAKESIDE DRIVE EAST �_ r . . .y, % A .'�, iY+' �. w' r r+ 'c .. r _ ,t � n! Y .�x S} �'.... •��'• �,.rd•;.y "< e„ F n�'iw��t4 et x`td:�.,.t+.+ *'�.�� ,t .��.� r ..pp } r !.' '..°�:� �rU.. ;, '; ,gyp;;.. :. �.r. � -. � ..� .:,�.. �: ., .. .lM+' �A., {Y rA ,iyr f'•. 1 IP �:'S�A.%Y �>�` '�I .j'. q` F A 'C ��` �� c a��'P °°a,,, n :: �: a Asa".r �" u' � Y .. � �M �' • s ;, � �. ., e. . _Ya �� .. .:-.;x ,. � < .� �K"v..., < s � x.erta f 'p ��r � •,e. , �, ., o _ � � o - , Y ,. i .. ,. n .. .. � .. .` � � � d ,. •. A . . _ .� e - o - h TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map h aZi Parcel ;�ppi)li coation # Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board J �01`6 h 2- Historic - OKH _ Preservation / Hyannis Project Street Address / PRSzy Village Owner M&44-`e_e,X2 :� Address 5��,�DU� Telephone v - / ; Permit Request D I Square feet: 1 st floor: existing proposed _�2nd floor: existing Z� proposed _Total new �7 Zoning District Flood Plain Groundwater Overlay Project Valuation O� Construction Type Lot Size o YI /'IDS Grandfathered: ❑Yes )6 No If yes, attach supporting documentation. Dwelling Type: Single Family t, Two Family ❑ Multi-Family(# units) Age of Existing Structure5 Historic House: ❑Yes XNo On Old King's Highway: ❑Yes JO No Basement Type: Wr Full ❑ Crawl' ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 6,32 5' Basement Unfinished Area(sq.ft) 1 Number of Baths: Full: existing_ new 0 Half: existing new Number of Bedrooms: existing new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: A Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes JNo Fireplaces: Existing J_New Existing wood/coal stove: 4Yes ❑ No . Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: 0 existing Onew size_ Attached garage: existing ❑ new size _Shed: ;0 existing ❑ new size _ Other: a :D 73 Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes 4 No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER O Q EOWNE - -_� A Name /�lGC� e� �/'7�� Telephone Number 0� — Address `r, � lLeeke6lde, /5 License # l�ellk z,)llle J�4 4AZ 0/3.� Home Improvement Contractor#. Worker's Compensation # ALL CONSTRUCTION-DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �� DATE FOR OFFICIAL USE ONLY w, APPLICATION# s DATE ISSUED MAP/PARCEL NO. T r ; x ADDRESS VILLAGE Y OWNER DATE OF INSPECTION: e FOUNDATION FRAME I`t °t INSULATION E FIREPLACE f ELECTRICAL: ROUGH FINAL -t PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL FINAL BUILDING 11�13 ►Z t DATE CLOSED OUT ASSOCIATION PLAN NO.- 0 Department*of Industrial Accidents Office.of Investigations 600 Washington Street Boston,MA 02111 - www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plnmbers Applicant Information Please Print Le •bl Name(Business/Oro nizadon/Individual): j Address: City/State/Zip: ( Gl '�i�/-��Li � one.#: ( Are you an employer? Check the appropriate bog: Type of project'(required):- 1.❑ I am a employer with 4• ❑ I am a general contractor and I employees (full and/or part time).* have hired the sub-contractors' 6• ❑New contraction.. 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet . 7. ❑Remodeling s and have no employees These sub-contractors have. �p '8. ❑Demolition working for me in any capacity. employees,and have,workers' co insurance.# 9. ❑Building addition •[No workers' comp,insurance. comp. required.] 5• ❑ We are a corporation:and its 10.❑Electrical repairs or additions 3. I am a homeowner doingall�work officers have exercised their 11. Plumbing re❑ g pairs or additions : - myself. [No workers' comp. right 6f exemption per MGL 12.E]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 rm showing their workers'compensation policy infoation. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.. _ tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. Tam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of 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 u to$250.00 a day a p y garnet 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 ce Jy under the pains-and penalties of erjury that the information provided above is true and correct- Si ature: 7/ Date: Phone#: �� 7 Official use only. Do not write in this area, to be completed by city or town official City or'down• Permit/License# Issuing Authority(circle one): :L Board of Health 2.'Building Department 3.Cityt'Town Clerk 4.Electrical Inspector 5:Plumbing Inspector 6. Other Contact Person• . . Phone#: . THE 'own of Barnstable J pp Tp� , Regulatory Services iAartsTAsr e, t Thomas F.Geiler,Director MASS. 1b39 Building Division s rFD MA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us r' J. Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: —w_ 4.7 JOB LOCATION: ��(� �� / iO ��✓ (� /�p number street village "HOMEOWNER": —� e . 1 Ar1 I (�0�� ! 7e // �rX name home phonee# work phone# CURRENT MAILNG ADDRESS: 4,0 /0Z — 1e?51d_ 12/ city/town state zip code t 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 procedures and requirements and that he/she will comply with said procedures and req ' ements. Signature of Homeowner 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 f6r 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. Q:forms:homeexempt N' FTHE Town of Barnstable Regulatory Services * snxivsrws 1 v MASS. Thomas F.Geiler,Director �p 1639• TEo Mai" Building.Division Tom Perry,Building.Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Offi ee: 508-862-403 8 Fax: 508-790-623 0 operty Owner Mus Complet and Sign This S ction If 'n A Builder h , as wner of the subject property hereby authorize . to act on my behalf, in all matters relative to work authorized by this buildin permit (Address of Job) **Pool fences and alarms are the responsi ility of t e applicant. Pools are not to be filled or utilized before.fence i installed and all final inspections are performed and accepted. Signature of Owner Signa e of Applicant Print Name Print ame Date QTORM&OWNERPERMISSIONPOOLS 6/2012 .� a Now S V '::! Fee .� ��,��,... Regulatory Services Thorns F.Geller,Direstor, f PTfO'A°'y'v Building Divisions �- Peter.F.DIMatteo, Building Commissioner 36 i M. aim Strem Hyannis.MA 02601w ' Office: 508-862--038 Fax: 508 90-62:0 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid wirhoiu FUd X-Prm JmFrW Aap:parcel N=ber ' ropemr Address.. �,� Value ofwork cool �3 zl"Residential . Owner's Name&Address �rt�mber ° — - 613,9 Contractor's I�'ame Telephone. - Home improvernent Contractor license 4(if applicable) I I D 6 00 l(-'�- Construction Supervisor's License= if applicable ❑Worimran's Compensation Insurance Qreck one: ata a sole proprietor ❑ I am the Homeonmer ❑ I have Woriccr s Cosensation Insurance insurance Company\Tame Workman's Comp.Policy Permit Request(check box) )(.PRESS PERM` ❑ Re-roof(stripping old shingles) ofroo ARRI 2002 ❑Re-roof(not sttippin_ Going over existing layers f) TO\NN OF 13ARNST ❑ Replacement Windows. U-Value ( •�) ❑ Other(specif}) •Where required: lssu=ce of this permit does not exempt conviiatt=with ether town department regulations.i.e Historic.Conservation-e:c. Sima ture O:Fomu:caprnng:rcv{l 7060l ✓/ze �aminzariui .�` iicltuaelta BOARD OF BUILDING 12EXCLATIONS, ' License CONSTRUCTIONS RVISOR Number CS 023333 Btrttidatett)l03/1939 Exprres-101.03/2003 t p, Tr.no: 6616 l , 1 Restricted'�0l} � '"� JOHN P KOV&CH 135 C. I ,IMG'STOk♦?D MARS 0 101ILLS, NIA 02648 it _ GTE Po . Board of Building Regulations and Standards. HOME4MPROVEMENT:CONTRACTOR' Registration:: 110600 } 417 Fa,Con 11/03/2002 . ! TYPe INDIVIflUAL JOHN P KOVACH JOHN.IOVACH -� 135 CtiIPP. GSTONE RD MARSTONS:MILLS,MA 0264.8 ~ .Administrator . . Town of Barnstable ermit: ce FTM T Regulatory Services ate: Thomas F.Geiler,Director 4 Fee: lJ 1AMSTABLE, : Building Division 9 MASS. 1639. Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner:. as f-eell �lE' Phone: Liz 7�� pC, Install at:faS�C/� I� Village: U Map/Parcel: Date: 9, (o 7 Stove A. New Used B. Type: Radiant/Circulating C. Manufacturer: (lef m o,—,) 11ar 9 Lab. No. -, D. Model No.: s C Chi A._ ew/ Xis ��(If existing,please note date of last cleaning) o TIPB. vie size C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer S // 7, //T E. Masonry: Lined/Unlined Hearth �} /� ,D A. Materials: 14,, r �i (� c�� A9�- B. Sub Floor Construction: -%- Installer � ' Name: J Address: �,�� D � ��/� Phone: v0 e Location o Installation: APPROVED BY: Please make checks payable.to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 122801 ---------------- 746 Permit Da �/ D/ ® 53-7107/2113 Date: Order Of $ Dollars Cape ' COd 51 P.O.BO%f0,OR LEANS,MA 02668 Fax: 508-790-6230 Memo + 8�� 0746 a Owner: am reel,) Phone: 77c5% Install at:�a 6L'` �dC�E.//IZ Village: PV/Ile Map/Parcel:k-1,17)-- 51d,41W�W Aab�_ Date: -dci Stove A. OUsed B. Type: Radiant/ Circulating C. Manufacturer: (l�°f^m�1 f7<i�r�i Lab.No. D. Model No.: -71 ChiT=Yl �- ' A. ew/ xistin �(If existing,please note date of last cleaning ✓ u' z� vx B. ue Size C. Are other appliances attached to Flue? D. Pre-fab Type and Manufacturer m E. Masonry: Lined/Unlined Hearth ` p f� A. Materials: yIY4-n- -�� ¢ mot, �/� `Y 14. B. Sub Floor Construction: Installer Name: Address:.& d)( Phone: r U15V Location o Installation: /V,G APPROVED BY: Please make checks payable.to the Town of Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:formsatove Rev 122801 Uaa �GD.t G• '.a dtba� �— A LLB 301 - �A% j � � L.��"IL.ITY �®�Ar1 �D �2� � P�•�� o�� T`ta7db�L.. , til VD`IVP.315�� 14M „ .71 I) j t i i I j DIV d D� U r i oo .6-rs;a t_. i Z!' L.L>t,4 W 6 TV'7t� L i V�1FVA.�1S�� 11 i I i _ N _ isen rr 90) Cl Fi / r ,f y F c