The URL can be used to link to this page

Home My WebLink About0073 OVERLOOK DRIVE t t a .. -. :: �,y. ,. .� .. ,. .�.. � < �tiY"s�r.,...°�,wwara...��...:.`........�Lv...�.._,..»...__.._._s.�...G,...t�.s�:sr...:x..,.,�ci,�...,..,_....�amv�;r�..��..W+s..k.:ue�^.�.a:�r'e .,w,.:.r',,.;::ew..,5.. ''- .. w._�......+w�"...........-.�.,.�. .�.. '°a. � ';.,s � '° war f t 1" ��, r... a..��.:,::d.....,,,,..,,.......�,..,._�».,,u,....4....,...e..r�,.:�...�..�,.,..�..�. ... ..v_ ...�.. .... ..��. MM-..�2 -m TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map t� Parcel i, Application # An/ ary -6 ! 2:.tj j pp Health Division Date Issued Conservation Division Applicati ee Planning Dept. r1V ISDt Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address ZZ bVeVwA11r, Village-- -- 'e-t-) �e Owner 7t Telephone:_ Pe`rm�it'Request- - ,�� a�or1 s =�'s �-vo w./� 14�a 6IV � �►` ��-t-� All Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Mbo.00 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: 0 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 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 HOMEOWNER) Name Q\/ /7)C /,4j%O Telephone Number 60 g J 7 76 O ZI 75 Address `7 v 0V 6e LOy Ile License # d"OJ`�6 G+e V G.L F- IV A- Home Improvement Contractor# Email 14-JM C%r)TUS 1 f P C'19,P6eOy,*,EAL-7 ' orker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I �� SIGNATURE DATE /0 / t } FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r - r GAS: ROUGH FINAL FINAL BUILDING. DATE CLOSED OUT ASSOCIATION PLAN NO. ' z a ?lie Comrnonivealth of- assachusetts Deparbrfe it of Industrial Accideras : - - Office of Invesfigations ' 600 Washbigton Street ti Boston,41A 02111 x 3mv 111as&gov/din Workers' Compensation Insurance Affidavit:Bialders/CuntraciuirsJEIeactri,cianslPlumbers Applicant Infarinatian Please Print Legibly Name 9 Busmenf orgmiratianllndividnal): i r AddFess: IDt r u�.: ,,CityJState/zig: I 0 2�. Phone G�°7 77 G``�. 6 � Are you an employer?theckthe appropriate box; ' Type of project{require : 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full andl`or part-time)-* have hired the sub-contactors 6. Q New construction. 2.❑ I am a sole proprietor orpartner- fisted on the attached sheet .7. ❑Remodeling ship and haze no employees These sub-comractcrs have 8.I❑Demolition wvo far me it,any capacity_ employees and have waxkers' y ❑Building addition [No sinkers'comp.iusumuce: Comp-msuranml 5. ❑ Mile are a corporation and its 10❑Electrical repairs or additions ' 3.•MI am�ed-j. a homeovamer doing all work officers haveexercised their 11.❑Plumbing repairs or additions sal€ o wa&ers' Tit of exemption per MGL m5' � - �12.❑Eoofrepaias - insurance required.]6 c.152, §1(41 and we have no• employees-(No workers' 13.❑Other comp.mswanci reVnred-] *Any Wlicsat dhat cbecU box 91 most also fill ovf the:section belaw skewing their workers'campensafionpolicy information. Mmemnes who submnt dais dfidwit in&xatmg they are doing all wars and aben.hire Outside conimaors mat submit a new afr3daeit indicatiq;sacIi =Coot RMM that check dds boa must attacked am addilinml sheet sho -1mg the name of the sub-comer=m and state whether or oat those en ities bzm . employees.If the sub-contmams hive employees,they mnrstpmuidetheir worken'tamp.policUnumber. -Taman eiiiplojvr that isprmz dfrig it�orkers'compensation f nwrance for arty*empda3ves Below is the policy and job site fnfornzatiori. Insurance Co>rlpany Name: � _ Policy 9 or Self-in,s.Lie.#: Iikpifation Date: Job Site Address. d City/State/ a: Attach a copy of the workers'cixmpensation policy declaration page(showisig 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 OD andlor one-year imprisonment,as w�g as civil penalties:im the-form of a SWOP WORK ORDER and a fiale of up to$250-DO a day against the violator. Be advised drat a copy of this statement may be forwarded to the Office of Investigations.of the DIA for insurance coverage verificatiorL I do IlerRd?y CBYLtify izatdm^tritepains acid pen altres o, 'parjuty that the fnforamt&w prodded abmw fs hus and correct �afirre:F -. i+—- Date: /.- ' 0A€cfal use only: Do trot write in flits area,to be-campleted by city ortoom official, City or Town.: Pere itUcense# Issuing Anthority(circle one): 1.Board of Health 2.Building Department 3.C;ty1rown Clerk L Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Ins&uctions Massachusetts Geheral Laws chapter 152 requites all employers to provide workers'compensation for their employees. ItMMIantto this statLte,an emq7InyPe is defined as."—every person in the service of another under airy contact of hie, express or implied,oral or " An ernproyer is defined as"an individual,partnership,association,corporation or other legal eztdy,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 dwellm.g house having not more than three apartmeais and who resides therein,or the occupant of tine dwelling house of another who employs persons to do maintenance,contraction or repair work-on such dwelling house or on the grounds or building appi rt�thereto shall not because of such employment be deemed to be an employer." MCrL 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 not the commonwealth for any applicant who has not produced acceptable evidence of c6mph=ce with the insurance.coverage required." AdditionaIIy.MGL chapter 152,§25CM states"Neither the commonwealth nor aziy of its political subdivisions shall enter into any contract for the perf uM3nce ofpublic wozk-unff acceptable evidence of compliance with thf,-fi u-ancc6._ requirements of this chapter have been presented in the contracting authoiRyf - Applicants orkers'compensation affidavit completely,b checIdag the boxes that apply to your situation and,if Please fill out thew rap Y necessary,supply sub-coutractnr(s)name(s), address(es)and phone numbers) along with their certlficafe(s)of in n-ance. Lmmited.LiabziI4 Companies(LLC)or Limited Liabz7ity Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation ins¢rance If an LLC or LLP does have employees,a policy is rmp a-ed. Be advised that this affidayrt maybe submitted to the Department of Industrial Accidents for confirmation ofinurance coverage. Also be sure to sign and date the affidavit. The affidavit should be rEtrrmed to the city or town that the application for the permit or license is being requested,not the Department of Tndil- 'al Accidents. Should you have any questions regrading the law or if you are requred to obtain a workers' compensation policy,please caIl tine Department at the number li_-b�:d below Self-insured companies should enter thew self-film-xmce license number on the appropriate lime. City or Town Officials t Please be sure that the affidavit is complete and printed legz11y. The Department has provided a space at the bottom of tine affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please-be sure tD full in the pent Iicense mnnber which will be used as a reference number. In addition, an applicant that must submit multiple penanit/hcanse applications in any given year,need only submit one affidavit mdicafmg current p olicy information(if necessary)and under"Job Ste Address"the applicant should v;ute"a]i locations is (ctY or town)_"A copy of the-affidavit that has been officially stamped or marked by Ahe city or town may be provided to the - applirant as proof that a valid affidavit is on file for fut are 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 rclated to any business or commercial venture (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Iave,56g-alions would at to thank you in advance for your cooperation and should you have any questions- P Lease do not hesitate to give us a call The Deparhneut's address,telephone and fax number. Tht Ca=jQnWcatth-of Massach�tts Depar mmt of ladustzal AccUen:L- �e r��ivga<f1o� Bosun.,MA Q2111 Tf,-L 4 617 727-4 Q�- 06 or 1-9 IAASSSAAFE Fax 9 617-727-774 Revised 42¢-0 7 mas, go�f din Town of Barnstable Regulatory Services . cIF Richard V.Scali,Director Building Division • s�rtaraars, •i� Paul Roma,Building Commissioner , 639« �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION i Please Print DATE:_ JOB LOCATION: "J i3 O number street '1 c village "HOMEOWNER: name home phone# work phone# CURRENT MAILING ADDRESS: —7 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 - The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, ,rules and bylaw s, regulations. ,. �r y , The undersigned"homeowner"certifies tbat he/she understands the Town of Barnstable Building Department minimum inspection pro ores and requirements and that he/she will comply with said procedures and requirements. C , S' f 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 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 per sons.`-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 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. Q:IWPFILESIFORMSIbuilding permit forms\EXPRESS.doc 06/20/16 i ToWn of Barnstable Regulatory Services. NAMRichard V.Sca14 Director. - ►� Building Division. Paul Roma,Scolding Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable-mans. Office: 508-862-4038 Fax: 508-790-6230 Property Own!Rsowner Complete and Signcti If Using A B ,.J e_ 4— , of the subject property hereby authorize d 1 U to act on my behal f in all shatters relative to work authorized by ' budding permit application for. 3 eve K Jbl2. e_V1LI-r., In 4 (Addr ss of Job) **Pool fences and alarms a the responsibility of the applicant Pools are not to be filled or u ed before fence is installed and all final inspections are perfo ed and accepted. C 61a6le of owner Signature of Applicant Print Name Print Name D /0 Da Q:BORMS:OWNERPERMMONPOOLS 'i�°i•`r �_� `'"�° ,�t R' tf—a .?a �"��'".��,.�2v?'rw �'.o..er 1i-� -`� ; " b { d I ►!1 �: „ �G► r► ,RNSTOit lip- 1-1 I i l — -- - I. �3 _ m s" lYd i� .. Ly .I ka {Z jCjCWAtj 13 / - . La I