HomeMy WebLinkAbout0080 PINE TREE DRIVE f,.
,;
�.
i
� y
.,_ '. � -
f
.. ,. � ..
,. .* � ..
X
1 ..
i
� `
,.
4 �lgl«
� > Town of Barnstable *Permit#�
Regulatory Services Expires 6 mondrsfrom issue date
Fee
i s i
s F. s
Richard V.Scali,Interim Director
A
Building Division
Tom Perry,CBO,Building Commissioner
200 Main Street,Hyannis,MA 02601 0 -
www.town.bamstable.ma.us
Office: 508-862-4038 MAY90-6230
` _EXPRESS PERMIT APPLICATION - RESIDT+N i '
Not Valid without Red X-Press Imprint -�1 U S 1 A�L
Map/parcel Number � � ��� -
Property'Address Fn
residential Value of Work S /g 3 Minimum fee of S35.00 for work under$6000.00
Owner's Name&Address o �D(�R,�GF' /
/12 r Z 'D� Z 2, 2
l3RiR,v --
Contractor's Name N Telephone Number 40!-1Zr—y't
Home Improvement Contractor License#(if applicable) Email:
Construction Supervisor's License#(if applicable) a`S7a 7
AWorkman's Compensation Insurance
Check one:
❑ I-am a sole proprietor
I am the Homeowner
I have Worker's Compensation Insurance
Insurance Company Name
W orkman's Comp.Policy,
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box)
❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to
❑Re-roof(hurricane nailed)(not stripping. Going over, existing layers of roof) 1
:].Re-side
Q eplacement Windows/doors/sliders.U-Value. 3�•0 35 r of maximum
( ) windows
#of doors: I --
❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical&Fire Permits required.
sWhere required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
**---Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required.
SIGNATURE:
Q:1WPF1LESTORMStbuilding permit formMEXPRESS.doc x;
Revised 061313
05f12128r16 09:68 57875315 a2 sLi^l 4 RACE 05d05
� .. Xn,(Wd 4� � r ERSEi 7 ;0�exse�ry a tsoa���` -- CT 37ti \f95!!!
w�a.ass etst++xrrr.r nAedrecayaa, �I'h.:'s96'toss..what.'.Lii¢i�n174,. I 'J BS urd.F,m-1v.
Phan.8661363-2235-'F-r 40 1.01 6502
ESft9Nt r`dt[@'.'1:Sn•MrgR 'ry
Sm dhl Tw NEw Englaaat•Madewr,_LLC d/b/a
PAnewo A."derwri of^sa�tl6aa� I t sad
CUSTOM W-MD6}W.MD DOOR R$_h�CtDE,Lli']AGREEMENT
, ., t
0cy63'ti a=•at .ess. *�w -.xo G_ar F ROAer, ..
4 .
- -�
nqk
au
31ztc*)her.byicinily{aad snvra97 agree&to purchase:}*e products areal/ai rtft ccs�(Sourherrt itiew l glaasd 11,10oftT,Ut d afa 1.nY,+a t
by Aaderwz of Sobthern Nevr;E.-q;]dnd C-Ccvntss(XGe;L is atA".#mna u ikh kkc ac, y and amd4iom devrl�4ed ors tits&crLt�d jhe r".Gase`c ',
tkis agreemcn,'a and on the anadietl flCwU04t sheet)(p Ul nF el};IWA,-rT.Mrrecnr). L7 AFatp�=Cl,Coa o,Q 00A7
TMi;cb/1-mmme: 6wvu.ed kanl 04m M40 66& ent d Check. .0 C63t9 WIC116
Pepasis keel de C31., `�hl
Cee- t:Cards era spud far if"ic o*--wdmum uj irf thy
°ar�ge ac&tare j poke(33%)r Fat M wd.Cc n Y!,wd&Dz.= pmjeint east Mec-sea 6jdk cced p4mmt RW►q er jijrg this
I-_kfi_,ed,P that;"lialmce as 3sart aaf eb WO ere
haimc on Uq6arlw $. ' 390ce oer,Sv+ Mndxl CewtFtelun of fob rannet bo rrrudd t+y a'ecic
Cafn* m aflo6(33 a rd er d nnrat lx rrm !Pprs l ctisck Ei irk de.c� arescH_
Hayer(a)•agriee and andeysits4as tJutb aj, djce�ent c�didtetstt the xradcretaua[Yng gy2i4i6eN4 11 8 gatKfley tbnt
t7tere w no verbal understandings ebaoging5 any of die terukw of two Agi�q+yrtteet.H.ti' (a)acimo+eledgee th$e Huyee{9y'
(1 reted.this AgrccmCW4 na�,ticr tln the terrtea of d t"Agt.t,.m�t,txtd_pate aaseCviad a i:umpieted,etgxaeti,attd tine_
copy of th ig A grime lavii,ioldt'ding the two i Racist No;rm uE aa�e1ls�ras a�ati�d�6 fYtgk wtieum a�and (�rk�s et�
ivaiEOrraet of 1$ttg e'a right to cimcei tea Atge�ceraeat t DO NOT SIGN THU CA}NTRA Gil IF Ti ANf€)3(.tl�iiC SpAC�.B.
(lPhride&lead�alea brit j yl6dtta5r to 8-ye-A)M sot sigh tWeAgreementif'irm.of the spaces ixteaidad for the ogmed tmlj
to the e:teut air d1 u ay ahlq 11worm2ttou,sJ Iei�cbiamit. Your sme erilletrd k4 a y o£thin s set tine done peru sfgp;
iL(3)You may ae�time pay off the m uripa.d E,a�iaoe ux ck*oiv sleds A kree'M� afA its to daiag yM"ar'Y be ants&d to,
e eeca*e a partial apdtace of the fivic.and+�...p a cltargea•(4)The 8 do right to ui a a x+yqkw poiweas
or tammit any breach of the peace to repossess gn'ds pursb sed seder thle Agree=&"(a)gb niay caa i ihiaAgre e
if it kas set been siSned of t mainhe ain office ar a bt r ofh of the seU n P.rov d"yeti]Modf�e'At Sell4rr at ilia or her azain
�+�a+P braaefi af6.ec ahasva►in Klee Aigr+ecmenr lay ae�pis�red ar efet,;�ieif mat3,Leh slxmli lid gr�att"6.dot.Totsrr ibpo,�ifdulg$E.
of the tb Z4 caleaefar day.aRer the dtoy 9i Wbicb tlk biayertsigns the Apeemsot exchuting gan4sy aid any hafi"y qa,wW,4,;
rtesatro"tin da50oAo>�oigPsayidBttotace'o£eanoEliation[orittl��`,ri�laeat:o®aEbaycr#sa:gf"'_'
�'uYT��'rcoei a cn,st. e education.e�iataruLs pruv�lcd.ti}r die`L�f�Qide Lalamt{:�^an4ttsr+]R,cgi�n- ha.,rYi,° :r•I� �,v
Ren wmi o$ ern New Englsnd S
0}: •
e c ogee t�atttrc $iertahuae:.
Fhint ins¢srE Ptod a M.Anwe prfgac,Nzune Pkne Nariic t:.`7
YOq THE:BUYBl49). NUY CANCEL"1M9 T ISArMON AT.'ANY T MK PRIM.To`,Na
H [ALWfICrRF.C)�'1i�
_WUSI I�at Ari'$A?HE DATE UE'TMS TRriy�$iyC'EWN.SM Ti E�ATTA6WV NOT7 OF GdZhT£11�I 1f.AiT16N EE1PMS
FO1$.�►N.EXFI.AFNA tiox Qr Tin RIGHT.
�'- - = - - - - - F
fi
date of t ansacdon - + Ytaa c�ee .Ty4tr
4 is Mft of� Ybu rat dated'
this trammion.-writhoeut any"penalty'o�obriydetfi",vwithh i this b+na[tion}wl�taut�y pets or oBiig�S a;withdn
tbrea betxiitsss d irQm t#ce alSare data.if jrax s e:�l• thr"busine m d b om ttie above dace&if you cmel,'atyr
pp P®TeY'Vade 4 mt am OM minty rii by you under°efir 1 piroperty treded Ent,.iny psffft.dsade u uador they
Confaact or Baia;and stay 0 10 Wt. mlont d 1 titrset or Sale.end Yo .
any rteP041e Pnstrument ammbtad
by you will be rett,rreed w2ditn met betttnessdajr s Milmwing I 69'you will.ba eotunel:d Withm,tit business d4s:fellioi fiebg
ren crpt by the Setrder of youir.eaneeil ikftn hooke,and any, I re byeite
t r Bader oaf')tur e�iueilatioe itodee, add any
see" interest artmig but of"H�c, transaettan:wili be sac Y tnCt}t;st arfsP(tg out of rthe tnMatdbh wrTf be
caacdod K eancel.you Must Make i lvailawe to the Seller I cancaled.Ifyoueance9.laou roust 1eAaa!arrsifalila saki EfrA Seller,
ya r m0d.9nnce-In substantially as•',0od cmditlon as when I at y oir ritdesnee,flab substantially as f eCtMofgli al sp vrhe r
re"IV any gra;Z�derrnrid to yod under tlhis ootriet or I mceived;any. deldvdrod eti yatr ender skis�nretrect or
Saleq ar.'yav A i{you with,euateplf 9rith then instructions of•I Sale;sr you lttagi,if You WiOt,compty with the Insemc6olis
sltie Seller regardi1�the return sFipnttnt afthe goods at the the Seller r�eaardtn dmte i egret shfprtteitc of edte goods at the
eiier'g eat nse and risk.if you dm ertaloa deo gaorlg a .Soflleers cost risk Ify..do
maltm treegOp elh able
to the Seller and the!Seller:dots not picit them up•tretfdn i tm tfbi`lee and the Solkir dries rant pick then*ups withiia:
'twenty do"of tire',dam of catseraliasdot4 you M4 r�fn or I rPentyi d'a of.the dam qj c&mkgadian,yasl fna r la nr
d of-the"goods M�t4tat.t ietr f irther obfig.tiaiT,If you i ,lis so at the goods Svkhout�r lumber obligation.if yu
fa�niake the'g s ilable to the Salrtar,or if yrr�tr spree I fsi!to:maim tare goods araileble to the Scllcgr or iryv�-agree;
14 return the ads to the Seller Aid€ir`I to do sp.,theft you �, to return the' a iEer trle Seiler and fail to da ser.liter you
remain liable.Crp rmanco erf*r of'ull ollf pitons ads the remain liable Apr perforM2MCG of air o6ligatioits under the
COntrt,&To satteol this trkrisacllonr lrtall or deliticr A slgnad Cantraet.Te CMKCI this trane;aetion,rwall or dalivear a stood
artd dam"00fFj Of thtS earneallatiarl noose or Wq other and dared salty of this eanceilad4in notit;e or any_ other;
written notice,orseanti;tdezear.t to Re+te rat lyrpttdwrsen of I Awitcen notic eior""d a tele toRenaewra hy*W'ersan 19C
Southern New eras at Tb Aiblan Road,Lincoln,RI Il7Hb5. t �sisuttlern l lever Errtt��liassd at$diAibiott iioad l.lmcor+a,1>tl 428b5r.
Darr BATF.R THAN MIDNiGHT Of -- NOT LATER THAN fNIONaUHT'OF
f HEg€BY.CANCELT HI,STRANSACTtOtd: fl HER—BY CANCKTHISTRANSACTION.
&�ntraa ,� .Plinc liana 0sicr " ;� p�rysry-S��y-
RbA COO:yAk-t :3"1v Cspy:Yellow %y--r Copyr.Mk
ra 1�15L/ CD Cx�OSO
rqy,
Town of Barnstable *Permit#
OpIKE
Expires 6 months from issue ALI
" Regulatory Services Fee
+ 1ARNSrABLE, * -
9� Mass.1639. Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
"w.town.b arnstab le.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
i Not Valid without Red X-Press Imprint .
Map/parcel Number 1 �TJ �V�J
Property Address 'em pi roc 1 fP r Dr CP tV.Ter.l O P "4
KResidential Value of WorJ13, OC?O ,La Minimum-fee of$25.00 for work under$6000.00
Owner's Name&Address �J O t0. Cjory<v
I�
Plk)P '1tY,> IJ� Cr°fV T 1 r,t l.tl j 'P � �'1,{
Contractor's Name PG r I�.�� C O rd z r v 7!U ry -Telephone Number
Home Improvement Contractor License#(if applicable) .
Construction Supervisor's License#(if applicable) I(0,?C13,kaf'ix X , prYa 4� y�yo5� -ram
KWorkman's Compensation Insurance � � a
Check one: J Ail 6
❑ I am a sole proprietor Y
❑ I am the Homeowner ~ ��RNSTABLE
I have Worker's Compensation Insurance �owP,� OF
Insurance Company Name h r-a ry l 1 f
Workman's Comp.Policy# :qS0 610 0
Copy of Insurance Compliance Certificate must accompany each permit.
Permit Request(check box) r
Re-roof,(stripping old shingles) All construction debris will be taken to
❑Re-roof(not stripping. Going over existing layers of roof)
❑ Re-side
#of doors
❑ Replacement Windows/doors/sliders.U-Value (maximum .44)#of windows
*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.
SIGNATURE:
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc
Revised 090809
_T
THE row Town of Barnstable
Regulatory Services
9 MA $ Thomas F. Geiler,Director
1 Fug A�0 Building Division
Tom Perry,Building Commissioner
200 Main Street,Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Property Owner Must
Complete and Sign This Section
If Using A Builder
I, Q Ip e Je N , as Owner of the subject property
herebyauthorize VAP!�s t.-.- 1:0AJ5 [ r-uc.(10 N to act on my behalf,
in all matters relative to work authorized by this building permit application for.
dd 0o)
(Address of Job)
G� 10
Ignature o r Date
Print Name
If Property Owner is applying for permit please complete the
Homeowners License Exemption Form on the reverse side.
Q:FORMS:OWN EP.PERMISSION
,�,,
Town of Barnstable
of zt�
o Regulatory Services
awxxsTas Thomas F. Geiler,Director
MASS 16 . Building Division
ATFD�,t a
Tom Perry,Building Commissioner
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:
number street village
"HOMEOWNER":
name `ti home phone# work phone#
CURRENT MAILING ADDRESS:
city/town state zip code
The current exemption for"homeowners"was ext ded to in lude o er-occu ied dwellings of six units or less and
to allow homeowners to engage an individual for hi who do not ossess.a license,provided that the owner acts as
supervisor.
DEFINiTIO OF HOM WNER
Person(s)who owns a parcel of land on which he/she resi s or i nds to reside,on which there is,or is intended to
be, a one or two-family dwelling,attached or detached struc re ac ssory to such use and/or farm structures. A
person who constructs more than one home in a two-year peri shall of be considered a homeowner. Such
"homeowner"shall submit to the Building Official on a forma tabl to the Building Official,that he/she shall be
responsible for all such work performed under the buildin it. Sec 'on 109.1.1)
The undersigned"homeowner"assumes responsibility for c mpliance 'th e State Building Code and other
applicable codes,bylaws,rules and regulations.
The undersigned"homeowner"certifies that he/she unde tands the Town of B table Building Department
minimum inspection procedures and requirements and t he/she will comply with aid procedures and
requirements. �a
4
Signature of Homeowner
0.
l ,A
Approval of Building Official
Note: Three-family dwellings contai ' g 35,000 cubic feet or larger will be requiredA comply with the
State Building Code Section 127.0 Constructi Control.
OMEOWNER'S EXEMPTION `A
The Code states that: "Any homeowner pe orming work for which a building permit is required shall be exempt\(rom 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`4��pert 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 1;censed
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 applicat, ,
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 caret amend and adopt such a form/certification for use in your community.
Q:\WPFILESTORM S\homeex empt.DOC
Assessor's map and lot number .. ...... ................. ..
SEPTIC SYSTEM MUST BE
INSTALLED IN COMPLIANCE
Sewage Permit number ......... 7............... ................................. WITH ARTICLE II STATE
SANITARY CODE AND TOWN
TOWN OF BARNSTAfft"
S r
i BAHBSTABLL r
"6 9 IOU IMDING I N 3 UT® R
�'0
' r1
r.
APPLICATION FOR PERMIT TO .......�......�....�.....�..�....@..�..........A..( � .--re S............................... . .. ..... ... . .......... .... .TYPE OF CONSTRUCTION ..... ...............................................................................................
..............................192.
TO THE INSPECTOR OF BUILDINGS: _
The under ' ned hereby applies for a permit according to the followinngw information:
G%xO/fit/Y�-r may- `
Locationu.... !r'u� ..........:...........:..............:....................................
ProposedUse .. ............... .... ...... ............... .....................................................................................................................
Fire District ................... .
Zoning District ............................................... ......................
r A /7. " Address .........................................
v.... . . .
Name of Owner ..!`.� !....... ... ..��. ................ iy`.::.......1ti. ............. .
Name of Builder ................. ...............................................Address .C� .,.. ................ .
�--� ...................................
. 2f� rc itect ... ...............)...................Address .. .....................................................,...................
Number of Roo s ...�........0� .•....... .......................Foundation ........�`.'�"1,..............
� V •
Exterior . .............. ..................................................................Roofing ........... ........................:............... .....................
Floors ...-''...............Interior ... ..
.... .............. .. ................... . ............................ .............................................
Heating �1 ....a-/ .........................Plumbing ..... ... .................................................
. ..............
Fireplace �L` -�.................................................Approximate Cost .................2.�...�1..................................
.................................
Definitive Plan Approved by Planning Board --------------------------------19--------. Area ..........................................
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
C
� 1
eby agree to conform II_the Rules and Regulations of the Town of Bar stab rding the above
constru -
���JJJ
Name ..................................................................................
McDonald, Robert
16812 ad to n le , t
Permit for ..:.......... .
No ............ ... ............
family dwelling
D....Pine Tree Drive r �► + _„
Locatio ...................... }
Centerville
Robert McDonald }
Owner ....... ..........................
Type of Construction
frame
f
Plot ............................ Lot ................................
Permit Granted Dpp.mbor—a4 19 73 __ ` • >r < ' - , <,
Date of Inspection ..Q��' .7�/."•:.�'����"\
Date Completed
. i
PERMIT REFUSED •� I , �^ , r" �/ r'
,y
........................1/.......... .......................... 19
......... Jd'..... ...............�.....................' I yi
........................................................ .......... ' M� LCC��yy/ � . ti^ I I •• 'S w �A y w -.�n+. '" '" y..
1.. ............................................................................
l A
n i t f I
' ................. ......................................................
-
Approved ................................................. 19 _
� .............. . ..........................................................
...............................................................................