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HomeMy WebLinkAbout0096 PLEASANT PINES AVENUE SIM�x � _y r .a .[., k't.A}• ,- -.,..' C✓ '6 ;. sl i" ;�r� X S r 7 a. r« '_ - r; } 1 Town of Barnstable *Permit# LO ISO. Expires 6 rotp ys4ue date d Regulatory Services Fee— �UU w BARNSPABIE MAS&ASS. �' SS 1639. Richard V.Scali,Director u PER Building Division n Tom Perry,CBO,Building Commissioner JU 04 2015 200 Main Street,Hyannis,MA 02601 TO mi' www.town.barnstable.ma.us OF BA RIVS Office: 508-862-4038 Fax EXPRESS PERMIT APPLICATION, RESIDENTIAL ONLY Not Valid without Red X-Press.Imprint Va Map/parcel Number V w7 Property Address S 1�J.K �' V F b + •l� I ""`�� 1'i T and � ❑Residential Value of Work$ 2 6 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address Contraptor's Name_,�h i Cb b Telephone Number gg --7 67C Home Improvement Contractor License#(if applicable) �`o 3 Email: ' Construction Supervisor's License#(if applicable) " © � 6 ❑Workman's Compensation Insurance Check one: �I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance ' Insurance Company Name Workman's Comp.Policy# Copy of Insurance Complianee Certificate must accompany each permit. Permit Request(check box)MlRe-roof(hurricane nailed)(stripping old shingles) All u construction debris will be taken to I wt7�+ 17 C jO ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors:' ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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: C:\Users�Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.OutlookVPIOIDHR\EXPRESS.doc Revised 040215 BAIUMMM MAM A,� Town of Barnstable Regulatory.Services Richard V.Scali,Director Building Division Thomas Perry,CBO 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, t C n \G, (3 e, C\ ,as Owner of the subject property hereby authorize P _ C to act on my behalf, in all matters relative to work authorized by this building permit application for: Vr is (Address of Job) ' I S e of Owner Date Print Name ' If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. - C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Intemet Files\Content.O'utlook\2PIOIDHR\EXPRESS.doc Revised 040215 m r ��R 22 2015 Town of Ba nstable A VA OS1 OM, Regulatory Se ®� Fee seatvsrnBU& M"M i6j� A Richard V.Scali,Interim Director �OMAr Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790=6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number o? 7 2 Woo 1�n' n Property Address �__ t - t Residential Value of Work$ D���. V o Minimum fee of$35.00 for work under$60000 c a;"'.� ;,•ate Owner's Name&Address (� i ( 1' K -0 P C\I S Contractor's Name C `s 6 \ 04- Telephone Number t- 7 3 7, 26 76 Home Improvement Contractor License#(if applicable) 0 3 Email: Construction Supervisor's License#(if applicable) 0 y 1 b ❑Workman's Compensation Insurance Chec ne: I am a sole proprietor ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman'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) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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: T:\KEVIN_D\Building Changes\EXPRESS PERMITIEXPRESS.doc Revised 061313 saaxeTAOM p,� Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO 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 I n ( Cc_ s Owner of the subject property c hereby authorize rS -V1 to act on my behalf, in all matters relative to work authorized by this building permit application for: �fe rs Ale (Address of Job) 4t2 c 0 f Sign e of Owner Date Print Nam If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. TAKEVIN_D\Building Changes\EXPRESS PERWTIEXPRESS.doc Revised 061313 Commonwealth of Massachusetts Sheet Metal Permit Map)� � Parcel !d 7 e&, - 6 Date: '� �-lS� , FPERMIV Permit#� �, G vRESS .Permit Fee: Estimated Job Cost: rLB 27 20,15 Plans Submitted: YES _NQ K. ® SA�NS�Ab Reviewed: YES., NO v< Business License# Applicant License# � Business Information: Property Owner/Job Location Information: Name: Name: V 1(f(Cs l N !41 Street: Y6 Street. ! �1�?�JS4-,j+ Pm� 4�, Ci /Town: ►a PJ A- - City/Town: ty � Telephone: .? 0 '� ' ./ Telephoner Photo I.D. required/Copy ofPhoto I.D. attached: YES , NO staff Initial d-1unrestricted.license J-2/M-2-restricted to dwellings 3-,,stories or less and commercial up to 10)000 sq. ft./2-stories or less Residential:,1-2 family Multi-family Condo/Townhouses Other i Commercial: := Office Retail Industrial„ ,.-Educational Fire Dept. Approval Institutional_ ; Other Square Footage: under 10,000 sq. ft � over 10,000 sq.ft. Number of Stories: Sheet metalwork to be completed: New Work: Renovation: HVAC V� Metal Watershed Roofing. Kitchen Exhaust System Metal Chimney/Vents Air Balancing' Provide detailed description of work to be done: L s i . i , INSURANCE COVERAGE: I have'a current liability insurance policy or its equivalent which meets the requirements of M,G.L.Ch.112 Yes/No ❑ �I If you have checked indicate the type of coverage by checking the appropriate box below: A liability insurance policy [R/ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the � Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this boxW,,I hereby certify that all of the details and Information I have submitted(or entered)regarding this application are true and accurate to the best of my knowledge and that all sheet metal work and installations performed under the permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: YES NO Progress Inspections Date Comments Final.Inspection Date Comments I 1 I i Type of License: 3y Master I title ❑Master-Restricted 'ity/Town ❑Joumeyperso'n . Signature of Licensee 'errs t# ❑Joumeyperson-Restricted r License Number.' `t =ee$ ❑ Check at www,mass.aov/dn{ nspector Signature of Permit Approval i i D8parftnPnt afla ustjid-lccidemts - - 0 ce ofrmlestaoans 600 Washington&reet Bastan,MA 02 WKW anurs.ga-ldia Work-ers' Campensatiani Insurance tdavit_Bi:tildersfC;`onfi a_ct-oxslElechicians/Plumbers Applicant Information Please Brut LegiMy Name{BushaeOrganizationlfndividnaQ_ Alress_ t AD 4. &,AZ Cityrstatcrp. w ��S AA oZ&o/ po,, -Are you an employer?Check the appropriate box: Tn>e of et ._ aria conracor and i �� �r et}uired}: _❑ I am a employer witbL 4 I tt 6- ❑New constuctioa employees{fait andlorpatt-time).* have hired.the sub-contr&dors. I�I am a sole proprietor or partner- listed on the attached sheet_ 7- ❑I�enrodeltng ship and have no employees These soh-oontractors have $_ ❑Demolition. vorlii ng forme in any capacitlr employees and have workers' p_ Building addition [-N,7o workers' comp_Sngranre comp_msuraaot I - - --faired-] S_❑ We are a cmporation aad its IG. ]Electrical repairs or additions 3.❑ I am a homem mes doing all work ofEccers halm exercised.their 1I_g Plumbing repairs or additions myself [No workers,czmp_ right.of exemption.perMOL. 12-❑R!30frepai[s inmamnrerequired-]1 c-152, §1(4} and wehgveno employees-[No workers' 13_0 other comp-insurance required-1 - -Aay ap pUcmt that sheds box f1 omit slso fal o=tha section b9aw shawb34 tea woken*romnensa4ion goiirT t Ttn,,,cr-aj„�r rc urn s�m�sut this�dsvif inmcstsg they H1Z fining s1T tro>ic�tb2a hire o�dzide cOgtIaCrr7CS omit scab�rit a m�a,�d�it m�r�:ina.snrli tCtninctors that check this box must xt ached au additionsI sheet shnuir-the name of the and state whethe mnat those zsities have -9MPSvyee5_ If the stab-<MAMCt s home empIgyet%the3'must Pia,ide the r worl�'comp.pahcy ILMn - Iam an Bmglby�F thatzsprtsx tduig ttbrke-rs'LOrr>pefirrhntt azirttraiice far tt�I emg£myc�es Bslarc is f3te�7ic} rutd�ob sites b2zurance CompianyNanie: Poltep fr or Self-ins- ExpiratsonDate: Soh Site_A-ddiess: sit-Rstatelzip- Attach a coFy of the workers'compeu=tion polio-deztzration page(showing the:policy number and expiation date). Failure to secure-coverage as requirt dunder Sectica 25 fir of MGL c_ 152 can lead to the imposition ofcr mfi al peIIalhes of a fine up to$1,56D.00 andlor one year imprl5 t,as.cell as civil penalties in the form of a STOP WORK ORDER-and a fine of up.to$250M a day against the violator_ Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIft for fins-- =4 coverage verification_ I dd hereby c alder tke pia. ric£pe ,as of ury d iatfhe informafi7a prcn idRd abfn a is b ue and correct Signature: }date: 0A5w a£use ari[y. Eta trot ivrite in this area,to ba completed by cit}:ar town o i'ciaL City or Town: Perw itUceflse ig fs-u Antharity(circle one): 1.Board of Health Btug'ding Department I Gitidraxm Clerk 4.Electrical Inspector S.Plumhmg Inspector 6.Other Contact Person: Phone td: 6 f Information and structions v Massachusetts General Laws chapter 152 requires all employers provide workers'compensation for their employees. Pursuantto this statute, an ernployee is defined as"...every perso in the service of another under any contract of hire, express or' lied, oral or written_" An employer is fined as"an individual,,partnership,associ - n,corporation or other legal entity, or any two or more of the foregoing e aged in a Joint enterprise,and including th legal representatives of a deceased employer;or the receiver or trustee o an individual,partnership,association or Cher legal entity,employing employees_ However the owner of a dwelling h use having not more than three apartm is and who resides therein,or the occupant of the - dwelling house of anotiz r who employs persons to do mainten ce,construction or repair work on such dwelling house or on the grounds or but - g appurtenant thereto shall not b use of such employment be deemed to be an employer." MGL chapter 152, §25C(6) o stiles that"every state or Io 1 licensing agency shall withhold the issuance or renewal of a license or permi to operate a business or to c nstruct buildings in the common-�i;easth for alay applicant who has not produce acceptable evidence of co pliance witbi the insurance.coverage required." Additionally, MGL chapter 152, § C(7)states"Neither the ommoawealth nor any of its political subdivisions shall enter into any contract for the perfo_ ante of public work til acceptable evidence of compli.-iice,.�,iL the ins=e,nc.e requirements of this chapter have been resented to the con ding authority." Applicants — Please fill out the workers'compensation al$ vit comple ly,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), ad ss(es) d phone number(s) along with their cercificate(s) of insurance. Limited Liability Companies(L LC) or ted iabilify Partnerships(LLP)wYu7no em loye7cs other than the members or partners,are not required to cant'worke ' co pensation insurance. If an LLC or LLP does have employees, a policy is required. Pc advised that this a t may be submitted to the Depa�ent of industrial Accidents for confirmation of ias ur-ance coverage. Also sure to sign and date the affidavit. '11e afEdavit should be retuned to the city or town that the application for the pe t or license is being requested,not the Department of Industrial Accidents. Should you have any questions rega ling e I--w or if you are required io obt:.ia a workers' compensation policy,please call the Department at the number below. Self-insured companies should enter heir self-insurance license number on the appropriate line. City or Town Officials Please be see that the affidavit is complete and printed It bly_ The Dep ent has pro«ded a space at`the bottom of the affidavit for you to fill out in the event the Office of vestgations has t contact you regarding the applicant Please be sure to fill in the permiJlicense number which be used as a referen number. In addition,an.applicant that must submit multiple permi/limnse applications in an given year;need only s nit:one a$davit indicating current policy information(ii necessary) and under"Job Site Addr ss'the applicant should w `e"all locations in (city or town)."A copy of the affidavit that has been officially ed or marked by the city or L wn may be provided to the applicant as proof that a valid affidavit is on file for future ermits or licenses. A new affi t m,--t be filled out each year.Where a home owner or citizen is obtaining a license r permit not related to any busines or co;Mmercial venture (i.e.a dog license or permit to bum leaves etc.)said person NOT required to complete this a� it The Office of lavestigations would like to thank you in adv ce for your cooperation and should you b ve any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commn.nwi-- of Massachu -ei(s Department of I i ustial Acciden Offim of Ia:-�estigatjaus 600 WashingtGa Stc e B ostuu-MA G21 11 Tr--I.9 6I 7-"27-A�90G W 4-06 or l-&71-MAS FE Revised 4-24-07 Fax 9 617-727-7-749 �. �IRE Town of Barnstable Regulatory Services • aaBrta AWZi MASS �, Thomas F.Geiler,Director Building Division Tom Perry,Building Commissioner 200 Main Sheet,Hyannis,MA 02601 www.tawn.ba rnstable.ma.us Office: 508-862-403 8 Fax: 508-790-Q30 Property Owner bust Complete and Sign This Section If Using A Builder x as Owner of the subject property hereby authorize to act on my behalf in all matters relati e to work authorized by this building permit ' Pk--AzMfJf—P;W� v�- c III (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled before fence is installed and pools are not to be . utilized until all final inspections are performed and accepted. Sign e of Owner Signature of Applicant J M Print N e print Name Date Q:FORMS:0V,rNERPERMIS S10NP00L5 OMMOIV1Al` L'fH',�QM .'d US9.7n 0,T07-7 P A d' £ `fi r.s F'OLLt11+X1 IGhtL=(CIFNS� MA� SF AMACHAOQ ` k , i d 4 ✓,'}i�M1`�'� 6� � gyp t 5 r . r r.`i�i� � �a� �`�3"9'� ��'.k�s�.f S c�1�.�.,�u�' .F.. '• 1t...�F�„' � _�7 wx - - t'�Y#NN�SM�'` MASSACHUSE �S/ �i�� DRINER/S, (���LACENS 11 , e 46 ADRENA AVENUE l l r s ; - sir /� HYANNIS MA 02601 3504 r t 6/OD 1047 3014 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel O Application # b Health Division Date Issued AAA 11 T\ P a- Conservation Division 0) Application Fee v Planning Dept. Permit Fee rV d Z Date Definitive Plan Approved by Planning Board , Historic - OKH _ Preservation/ Hyannis Project Street Address 9. L ( FiA514d1 P% n £S A O�. Village -tea n c �-,n n i c C 2jl T cr'V�111 e Owner U (Z_Cr N `( R 1. 2 1 f J Address 9� � �g A S fwl Telephone_ 3:7 a 75 5 Q Permit Request 9-enX G\J E_- 2 of (<r f c V)£Y% 1,2,;—b J''i Square feet: 1 st floor: existing 7 bproposed d 2nd floor: existing O proposed Total new 0 Zoning District Flood Plain Groundwater Overlay Project Valuation 00 Construction Type L'4 o 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: ❑Yes LKlo On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full Y-C- rawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 0 . Basement Unfinished Area (sq.ft) y 0 54, Number of Baths: Full: existing 1 new Cl> Half: existing new Q Number of Bedrooms: ,� existing -0 new Total Room Count (not including baths): existing _�new © First Floor Room Count 3 Heat Type and Fuel: CYGas ❑ Oil ❑ Electric ❑Other _.� w`a y CD Central Air: ❑Yes O'No Fireplaces: Existing New Existing wo�Ycoal stove: ❑Yos ❑ No Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: existing 'l7 nev, size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ m 4 Commercial ❑Yes ❑ No If yes, site plan review # Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) ~ V� mJ Name �. �"7 2�S cX,� � 2 �`h� Telephone Number T�7— SW7 Address ��C �'� c l 1 License # C S DkA `j 69 b 4 O a S7s�_ Home Improvement Contractor# Email Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO AU M SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED- MAP/PARCEL NO. ADDRESS VILLAGE r, OWNER DATE OF INSPECTION: FOUNDATION 3 FRAME 4s i; INSULATION FIREPLACE s ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL t GAS: ROUGH FINAL FtNAL BUILDING G t o1-9115- r DATE CLOSED OUT ASSOCIATION PLAN NO. 4 10-23-'14 14:08 FROM-Ferreira Engineering 15089923374 T-530 P0004/0005 F-789 �A k.l a ai;,�:; ltstaiJ`.i 71(RL"1 ' i2� i LLtM r:VUN(vA i,ICiItMME,MCNICHOLS&GARNER LLP DEED BOOK 23187 PAGE 335 . OWNM EIDMOND I.FESHIN TRUST, PLAN BOOK PAGE LO -- - ,,, -.: APPLICANT,.At3T•<Rgl:YAtf n r nctwr _ ca *. ^. :,:,a.35Vno a Y.rull"-t (-LV 4 num tou t MORTGAGE INSPECTION' PLAN OF LAND I �aED All 96 PLEASANT PINES AVENUE BARNSTABLE,M.A,SS.A,CHUSETTS 4"®i2Amr ., V6aa➢dffia b.II,bVA`?,I I � ` �\ SCR \ at���. • cluC .ybt S! a A.a%waa a tv a.svtvavuvtT�[wl[CYi;E!!Vb',lYli..1V ut us a,i!•1E{1V!]iC,LLt',cA.sH, AND rrs Tm.R iA1Ei(R ANf')?- ViVi!'N Y, I-t I'THERE ARF l TO VLSMI EENCROACII OM OREASEPulEN'TSEXCEn AS SHOQJIJAP� THAT THIS PLAN WAS PREPARED UNDER MY ABIEDIATE SUPERVISION, t �W err�y-tnT.-.—a=--,•,�i-> ,,,.;�. F�,� .� -_ ___� g - -- - — - <..a, va a:.•"- >r ev.a•:a,aauv it..t1.9 .3ilai iFi is i��tl1V it. 1 - 16 IN vC0_WLMNCh Wrffi THE LOCAL APPLICABLE` ZON NCT BY-LAWS WITH RESPECT TO HORIZONTAL '°F tttrasr•►rcrntt.v e,.r..,�,w.rn._--_�... �?��'9, ! i il9l R xymlt i FERREfRA THE DWELLING SHOWN HERE DOES NOT FALL WITHIN N 287tib A SPECIAL.FLOOD HAZARD ZONE AS DELINEATED ON A ---'t - !� •;i• �=`— .,' - •r:m r a _._ __-�_ _ .. _ ,. �.:.. yr s•-r, u i i !'. �L`_'�E����fa i .. N()TF.:TKO FXACT i emu'A' A,i is THE nr_ p iriivivisa tir iZ.11c-x k-9 WHHOU•T AN ACCURATE ! j >1`rsTRUriIENT SURVEY (Keinineth R.FeTre �.i AVC 1v RE-f�-Nlil A-P-M TC Atn*t'at'vmnr,nn.�r Rr ....•�-, —:I 4v i'wiGi J-t - ... ..,w.v. .,ar+.�uv+aa�autia rau.i.�ii\nac �New i3Cff97-d,AAA 02740 , e�e 508-992-0020 Pax:992-3374 L _- i5irc tA(.Nums:(t)the deelKa ions Mft?tbms am on the basis of my imawteu'ge,ir6iz:aairnj�and take£as;ft cesa va a jAat pia-ta*4 r4:ey inspe on made to the aormal.stazt3a(d of oft ad land surve}ro�Qta einR is i sach�uelts.f2)Dcc[e =ae made(o the e.al v ..elms._« '�j'P.U(ls::t l nia2 Cu-�11`..fi3i. ',auTi^c*;nYi�S.= ,_..n7;.d�`...,;>ri�•',w�..M";t ..:r,. �.'.�+`s,+rtr - _ - --. -- .___� _._ - -- . _ i. 6 - z 4,.Y 'Sanetut-T. Srawartt P 9 41Zasws �V A t� i the � newt P9 t fP i 1 - a as A,avaVHb poa. $cute ffw.s 30 R7 A;iii4eM 1952 BAB ima"a xg, a CIVIO. EMOM4z&e a .�"'i'QtY 4AESiS -� • .3 t� •ar,-mom . - Y Town of Barnstable t Regulatory Services *�&ARNSTABMg+ Richard V.Scali,Director �ATE1639. 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 - L U 16Zc, ( N el f'I L - IDS 2)K) , as Owner of the subject property hereby authorize Ck f2F(L • Yj F}- -� to act on my behalf, in all matters relative to work authorized by this building permit application for: P (Address of Job) "Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. � A J Igna e of Own r FSignature of Applicant Cr 10 ' 6 0,ts�(02 K Z-- C9 Print Name Print Name a01 � Date Q:FORMS:O WNTERPERMISSIONPOOLS Town of Barnstable Regulatory Services ' ��°Fixe r°ity Richard V.Scali,Director Building Division t su�rrsrnsc s Tom Perry,Building Commissioner AUS2. & \a�' 200 Main Street, Hyannis,MA 02601 pTED �a www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: /" JOB LOCATION: number street village "HOMEOWNER": :/f name home phone# work phone r e CURRENT MAILING ADDRFSS: / r city/town state zip code The current exemption for"homeowners"was extended to include owner-occu i dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,prdyided that the owner acts as supervisor- DEFINITION OF Hfsuceh ER Person(s)who owns a parcel of land on which he/she resides or in e,on which there is,or is intended to be, a one or two- family dwelling, attached or detached structures accessory to such use rm structures. Aperson who constructs more than one home in a two ear period shall not be considered a homeowner. Suchwner" shall submit to the Building Official on a form acceptable to the mg Official,that he/she shall be responsible forwork performed under the buildingpermit. (Section 109.1.1) The undersigned"homeowner"assume sponsibiEty for compli cc with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she un tan the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she",rill comply wi aid procedures and requirements- Signature of Homeowner Approval of Building Official Note: Three-family dwellings con 35,000 cubic feet or larger will be re ' ed to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any hom wner performing work for which a building per it is required shall be exempt from the provisions of this section(Secti 109.1.1-Licensing of construction Supervisors); pr ided that if the homeowner engages a persons)for hire to do such ork,that such Homeowner shall act as supervisor." Many homeowners who use is exemption are unaware that they are assuming the responsibt 'ties of a supervisor (see Appendix Q,Rules &ReguIati ns for Licensing Construction Supervisors,Section 2.1S) This lack o wareness often results in serious problems, parti larly when the homeowner hires unlicensed persons. In this case,our B rd cannot proceed against the unlicensed p rson as it would with a licensed Supervisor_ The homeowner acting as Supe isor is ultimately responsible. To ensure that the h eowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the omeowaer certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form curr tly used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit formslEXPRESS.doc Revised 061313 SMOKE DETEcToRS REVIEVIIEb TOWN Of BARNSUBLE *B4s-FT3-L -E BUILDCPT. DATE' 1 i w n l ' FIRE DEPARTMENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING 9 . f J7­ Is LF 1) G b ito C � n� r z - o .... _.. _._.._ _ N . . . 96 PIq�s� �� � � ��'� • �.- Y .r r j �m • � � I 3� y C a , » a r - k a t ' e .�.........�.,.o-w.av.rv..,..+—.+.w��� t+- ..w.rvn.n«..w. -.......:,rr-+a.. ,.:��.� u ,. d• ....0•yrn. .�»... r.... .. .x v w.+..:yyr,..-:A. ,�+ �� Town of Barnstable Regulatory Services ;�eeires 6 m°, m u ;te � HARNSfABIE, � �MASS Richard V.Scali,Interim Director Ep Mtl� Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02.601 www.town.bamstable.ma.us Office: 508-862-4038 Fax:508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number IIj -7 8O o ,fop Property Address [9*iesidential Value of Work$ 3 S d6 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address V 1 p L /� IZ A 2 L Ira ;gn-� Q iIn 5. v Contractor's Name l� \ (S �(� F Telephone Number-_S-ba _ / S 7"� 674, Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) C . Pmpz ❑Workman's Compensation Insurance Chef am a sole proprietor JAN 022015 ❑ I am the haveWoomeowner ElT®WN ®F BARNSTABLE I have Worker's Compensation Insurance- , Insurance Company Name Workman'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) ❑ R ide lacement Windows/doors/sliders:U-Value' (maximum 35)#of windows #of doors:_J_ ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. '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: T:UCEVIN D1Buildi1 hanges\EXPRESS PERM TMPLESS.doc Revised 061313 s • Aft Town of Barnstable Regulatory Services Richard V.Scali,Interim Director Building Division Thomas Perry,CBO 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 02 = ,as Owner of the subject property • . ' 1 ` . �Cl l hereby authorize (S P(Z', �c� \ �' to act on my behalf", in all matters relative to work authorized by this building permit application for: (Address of Job) ` Sign a of Owner ate Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. ' TAKEVIN MBuilding Changes\EXPRESS PERMMEXPRESS.doc Revised 061313 Town of Barnstable VE Regulatory Services f ; . c . 4 Richard V.Scali,Director v .l ' Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA www.town.ba rn sta ble.ma.u s Office: 508-862-4038 Fax: 508-790-6230 G PERMIT# FEE: $35.00 L40G b3� SHED REGISTRATION RESIDENTIAL ONLY 200 square feet_or less l � rC p �l Mesa J�- p Location of shed(address) Village Property o er's ame Telephone number Size of Shed Map/Parcel# �� Sign Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? fa If over 120 square feet,you must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservationn 8:00-9:30&330-4 30-_-> PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg y REV:040914 APPLICANT:VIRGINIA L.BEIN Absimu"PLAN"L34 MLY1 UUM 1UU MORTGAGE INSPECTION PLAN OF LAND LOCATED AT %PLEASANT PINES AVENUE, BARNSTABLE,MASSACHUSETTS t SCALE: 1"=IW October 23,2014 1 tt a CI `xI Q� 4 % N� JAR - 0 v c� ` p `\\ � 1 iH�l•SI Al.�i4sA�NT Pau€S ABC-. CERTff Y TO DUNNINti,KIILKANI:,MCNICHOL3 G�KKIVEK,LLP,0.45 ND f I TT AIT E II�ISVRANCf OWANY, THATTHEItEARENOVISIBLEENCROACEWNTSOREASEMENTSEXCEPTASSHOWN ANE T THIS PLAN WAS PREPARED UNDER MY MAEDIATE SUPERVISION. THE LOCATION OF THE DWELLING AS SHOWN HEREON IS IN COMPLIANCE WITH THE LOCAL APPLICABLE ZONING BY-LAWS WrM RESPECT TO HORIZONTAL �� iH°F MAssq DMNSIONAL REQUIREMENTS. g KENRNETH m . FERREIRA THE DWELLING SHOWN HERE DOES NOT FALL WITHIN No.28716 A SPECIAL FLOOD HAZARD ZONE AS DELINEATED ON A MAP OF COMMUNITY#250001-0562J DATED7/16/14 BY AL LPN THE F.I.A. NOTE:THE EXACT LOCATION OF THE BUILDING SHOWN CANNOT BE DETERMINED WITHOUT AN ACCURATE INSTRUMENT SURVEY Kenneth R.Ferreira NOTE: LOT CONFIGURATION TAKEN FROM ASSESSORS Engineering 46 Foster St MAPS OF RECORD AND IS NOT NECESSARILY ACCURATE New Bedford,MA 02740 509-992-0020 Fax:M-3374 ENERAI NOTES:(1)The deciaretions made above arc on the basis of my knowledge,iotorroation,and belief as the result of a mortgage plot plan tW ey inspection made to the normal standard of care of registered land surveyors pmcdcWg in Massacbusetts• (2)Declarations are made to the stove nmm to only as of this date.(3)This plan was not made for recording purposes,for use in preparing deed descriptions or for constructions. (4)Veribcatioos o rapedy line dimensions,building offsets,fence&,or lot configuration may be aworopfted only by an accurate instrument survey- I r `' Ey,.3` , j �4z' -,v i? Y~ .�,•'''^•'�-••-"�A �5�7 �� �'- �� �"�ky t-: ,-raw' 1. a -i� ' � .1y'? '� },.,§ •+,- ��, 1 r 111r :x !� c . +,`i ,_ is Ll i � Tsi 1 t 41* iY � ( ._/ 'L. r e^! � r! L�� � 1� nxi � •^1� is o-� �� _. THE r � `Town of Barnstable Regulatory Services �' iE�" Richard V.Scali,Director �A 1639 rfn►u,+" Building Division i Tom Perry,Building Commissioner 20.0 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862 4038 Fax: 508-790-6230 Property Owner Must- F Complete and Sign This Section If Using_A Builder I, V�ra I,n I CA } , as Owner of the subject property ' hereby authorize�� LLB ��/C-`A4 0(.-_ to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed:and accepted: Si ature of Owner . 5 afore of Applicant 5i 91 Prin .Name Print Name Date Q TORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services °ftt+E Tp�y Richard V.Scali,Director Building Division * anxxsz'asM Tom Perry,Building Commissioner r� 16 ��� 200 Main Street, Hyannis,MA 02601 iOrED �a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 1' 6 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town /eand/or e zip code The current exemption for"homeowners"was exten ed to includccu ied dwellings of six units or less and to allow homeowners to engage an individual for hire who doe of possee,provided that the owner acts as supervisor. DE ION OWNER Person(s)who owns a parcel of land on which he/she resi or ieside,on which there is,or is intended to be,a one or two- family dwelling,attached or detached structures accessory to uch farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeown meowner" shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be res onsiuch work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for co plian with the State Building Code and other applicable codes, bylaws,rules and regulations. _ The undersigned"homeowner"certifies that he/she under tands the To of Barnstable Building Department minimum inspection procedures and requirements and that he/she will compl with said proce es and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings con g 35,000 cubic feet or larger will be re aired to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any ho owner performing work for which a buildin permit is required shall be exempt from the provisions of this section(Sec ' n 109.1.1-Licensing of construction Superviso s);provided that if the homeowner engages a persons)for hire to do suc ork,that such Homeowner shall act as superviso 21 Many homeowners who use this exemption are unaware that they are assuming theVesponsibilities 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 th ilcase,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner 1ding as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities3require,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/el fication for use in your community. `� QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 I