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HomeMy WebLinkAbout0009,0011 SOUTHWINDS CIR i i wPTi F v c. y , n r , r i e e. ;k i T Barnstable aBuilding Town of ' ':. 'v " ' `•`', ",':. ` :';�•. :• ', a Yam, .. Post-This Card,So"That isible'From the Street A �ovedPlansMust iie:Retairtied,on J;oband this Car Must be;Ke,'t n 1a3 i Posted Una#rl Final Inspection Has=Been MadAl" Ml e � ' T TQ �o Where a Certificate of-Occupaniy�s,Required;such Building shall Not be Occupied until a'Final Inspection has been made mit Permit-No. B-19-3640 Applicant Name: Enda Garry Approvals Date Issued: 10/30/2019 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 04/30/2020 Foundation: Location: 9 STAGE COACH ROAD,CENTERVILLE Map/Lot 172-111 Zoning District: RC Sheathing: Owner on Record: FULP, MATTHEW 8 ' Contractor Name:'='.GREATER BOSTON ROOFING Framing: 1 CORP 2 Address: 9 STAGECOACH RD F ?�- � •- Co�ntractor'License 191498 CENTERVILLE, MA 02632 Chimney _ Est Project Cost: $6,000.00 Description: strip and re-roof " Permit Fee* $85:00 Insulation: Project Review Req: IF Fee Paid: $85.00 Final: Date: 10/30/2019 Plumbing/Gas . : ugh Plumbing: .Ro` Plubi Final Plumbing: g' RoughGas: this permit shall be deemed abandoned and invalid unless the workauthorized by this permit commenced within six months afterissuance. All work authorized by this permit shall conform to the approved application and theme=approved construction documents:for which th s permit has been granted. All construction alterations and changes of use of any building and structures shall be in compliance with the local zoning byaaws and codes. Firial Gas: This permit shall be displayed in a location clearly visible from access s reet o ,o and shall be maintained open for pubic inspection for the entire duration of the work until the completion of the same. Electrical ��:. The Certificate of Occupancy will not be issued until all applicable signatures by the Budding and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work: ? Rough: 1.foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. 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" (asset 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 9 50 LJ 1 d1 Q FLOOD ZONE: ASSESSORS REF.: Zone B & A10(el=11) see plan Map 226, Parcel 158 Community Panel No. #250001 0008 D OVERLAY DISTRICT July 2, 1992 AP — Aquifer Protection District As Shown on Plan Entitled "Revised Groundwater Protection Overlay Districts" — April, 1993 / ZONE: RC / Setbacks: Fron t 20' / Side 10' Rear 10' / °oio .yam`t •9 yq / 0.62' 34.4' 0), c4 . k 6 8 F Go�Q ti�ry\ 0.40' ^ oh w Lot 2 6,670tSF \ �' %i 6 �ry New Top of Block �/ O � \ ;� ++� ,� 0 Foundation Elev = 12.0'(NM) 90 A / o o 410 4 9 eP%811 ` I' Za1\ FEMP FEMA Zone line as shown on / FIRM Panel #250001 0008 0 Lot 11 V O w�(H Of M�4 RlCiiARil G61�, P1 U LHEU4ux N 00. 12 ., PLOT PLAN IN BARNSTABLE Zo/OGr-D f (Centerville) NOTES: MASS, DATE: 201OCT104 SCALE: 1"=20' 1.) The structures shown were located on the ground 0 5 10 15 20 30 40 FEET by conventional survey methods on (or between) July 21, 2004 and October 15, 2004. PREPARED FOR: 2.) The property information shown hereon was Angelo Petrosino compiled from available record information and 29 Westward Circle does not represent an actual on the ground survey. No Reading MA 01864 3.) This plan is not for recording and is not PREPARED BY: to be used for construction layout or deed CapeSurv ' description purposes. 7 Parker Road Osterville MA 02655 DWG #: C629gl FIELD BY WHK/JPM (508) 420-3994 / 420-3995fox Assessor's office(1st Floor): niw �l5`0Q ` Assessor's map and lot number Conservation(4th Floor): Board of Health(3rd floor): , Sewage Permit number ! DAUM= ��ngineering Department(3rd floor): �'�`` '' y °o,,��byo•`\�a° House number De9PPLICATION y Planning Board 19 APSED 6:30 9:30 A.M;and 1:00-2:00 P.M.only I .TOWN OF BARNSTABLE ?BUILDING . INSPECTOR FOR PERMIT TO f ' TYPE OF CONSTRUCTION � - . . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Proposed Use Zoning District Fire District r Name of Owner A I A 0 Address' Name of Builder Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost L /r6U•CIO Area Diagram of Lot and Building with Dimensions Fee 05 d'C/?-) OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ()J-C-� Name — )A Construction Supervisor's License } • No 4886 Permit For 22 6". 158 Location ' 9 Southwinds Circle , r , Centerville, MA 02632� Owner Angelo Petrosino & Lillian Petrosino Type of Construction Plot Lot I + Permit Granted 19 Date of Inspection: Frame 19 ~ Insulation 19 Fireplace 19 Date Completed 19 11/02'94 17,02 V617 727 7122 DEPT IND ACCID (aoo- Jr. Cotiunojutleaftlt o &IJac{r.uJeffi �t3PRrtiltelu.o�JnQ.U�ErLLLt„/VCciQBILLI 600 bVawh ton.S'h+ t .lames J.Campbell &ton, // mac" 02111 Commissioner Workers' Compensation Insurance Affidavit with a principal place of business at: «rstm,zip, do hereby certify under the pains and penalties of perjury, that: ') 1 am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Humber O 1 am a sole proprietor and have no one working for me in any capacity. () I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself. I ur!derscznd tat a copy of&is statement will be forwarded to d:e Office of Invesdr.2rions of the DIA for coverage verification and that failure to secure cove-age s ree:i;ed under Sccuon 25A of MGL 152 can lead to the Imposition of criminal penalties consisting of a fine of up to S 1,500.00 and/or cr. years' impriscrr.,ent.m well as civil penalties in the form of 3 STOP WORK ORDER) and a fine of S 100.00 a day against me. Signed this `�`'rY`�"" r "�`�- day of lam( ICJ 19 Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409; 375 .. .. r, 11-m nT I r.T11, -T•Tt14T1r 4 _.. ""- TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE /7' lq S-- JOB LOCATION cj Number Street address Section of town rp"HOMEOWNER" e l ., S r Vly Nam Home phone Work phone PRESENT MAILING ADDRESS 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 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: Persons) 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 Officia. on a form acceptable to the Building Official, that he/she shall be responsibl: for all such work performed under the building permit. (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Sta- 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 requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet; or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. snxxsTwBtE. • The Town of Barnstable KAS& �0 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. 01 Type of Work: Q—q- "'��r Est.Cost q Address of Work: n U��. ll e Owner Name: Date of Permit Application: I herebv certifv that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied �Owr`cr pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. - OR Date Owner's name Assessor's office(1st Floor):• i. f s.r �� s �� Assessor's map and lot number Conservation(4th Floor): I ? - t"r - ram, •� Board of Health(3rd floor),C rt. VA1I3T►8L = Sewage Permit number �3 5� �1?'. ■a• Engiheering Department $EFMCSySTE&j MU (3rd floor) I i t 4 � �AL`ED OMPLIA g �r House number s Definitive Plan;Approved by Planning Board t9 WITH MTV.E APELICATION-FOR CESSED'8:30-9:30 A.M;and 1':00-2:00 P.M.only TOWN OF BARNSTABLE , 'BUILDING INSPECTOR PERMIT TO 4zo `. �D rc ' �iyF�'�Sh �J 7-01mc c a^ty TYPE OF CONSTRUCTION t I 19 TO THE INSPECTOR OF BUILDINGS: The undersig ereby applies for a�permit according to the following information: Location Proposed Use C Zoning District Fire District Name of Owner r Address / �� /L/w C.1 �•.� � j Name of Builder Address Name of Architect Address Number of Rooms Foundation Exterior Roofing Floors Interior Heating Plumbing Fireplace Approximate Cost Area C Diagram of Lot and Building with Dimensions Fee i t i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name _ o Construction Supervisors License /� I 4 Permit # 7302 q Map/Parcel 226. 158 Date Issued =- June 27, 1995 9 Southwinds Circle - Craigville Beach, MA Owner = Angelo & Lillian Petrosino — f b 11/02'94 17 t 02 V617727 7122 DEPT IND ACCID Q 00- anunviuveafilL 0/ I&Jaclyu-MU6 ' alJaparfinenf o�..J'nc�u�fria�,�iccic>!enf� 600 Wa ton., h' l James J.Campbell &IFon, ///aaagujA 02 f f f Commissioner W ers' Compensation Insurance Affidavit a 1, (�odtsecipetmatee) with a principal place of business at: /n ) (awistaizly) do hereby certify under the pains and penalties of perjury, that: () I am an employer provid'mg workers' compensation coverage for my employees working on this job. insurance Company Policy Number () I am a sole proprietor and have no one working for me in any capacity. () i am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Plumber Contractor Insurance Company/Policy Humber Contractor Insurance Company/Policy Number { am a homeowner performing all the work myself. I u�dersurid t'--t-;copy of&,is statement will be fom-zrded to cite Office of Invesrir.2rions of the DTA for coverage verification and that failure to secure coverage:s rec:ir ed under Secdon 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to s 1,500.00 and/or cr- years' imprisonment is Well as civil pen hies in the of a STOP WORK ORDER and a fine of$100.00 a day against me. Signed this day of 19 Licensee/Permittee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAGE INFORMATION CALL: 617-727-4900 X403, 404, 405, 409, 375 . Tni%TN nTF RARNSTART.F RTTTT.TITM(, PFRMTT # 1� McKean Thomas From: McKean Thomas To: Barry Ed; Dunning Jerry; Miorandi Donna; Kuchinski Christina Cc: Sullivan Barbara; Saad Dale; Sargent Lynda;McFadd Christina; Kelleher.Maureen; Geiler Tom; Crossen Ralph Subject: Changes in Board of Health Regulations and Policies Date: Thursday, April 06, 1995 9:47AM On Tuesday April 4, 1995,the Board of Health voted to delete the following: - PART Vill: SECTION 5.00- Upgrading of Substandard Onsite Sewage Disposal Systems dated 10/18/82 which required cesspool systems to be upgraded. - NOTICE TO BUILDERS AND INSTALLERS dated 8/31/77 which details the size of septic tanks and number of leaching pits etc. for the number of bedrooms proposed. Please remove these from your files. SHINGLING, SHEDS AND DECKS The Board of Health voted to allow applicants to obtain approvals of building permit applications for the construction of storage sheds and for the construction of decks at the Health Division Office if there is an as-built card on file at the Health Division showing a converted cesspool (with inlet and outlet tees)which is connected to a leaching facility and the proposed construction will not infringe on the septic system setback requirements. A single cesspool may be allowed also. However, the shed or deck cannot be constructed within the setback requirements described within Title 5. If thereis no as-built plan on file,the Board of Health requires the applicant to obtain a sketch of the septic system component locations by a licensed installer or licensed septage hauler, not the homeowner. OTHER ADDITIONS TO SINGLE FAMILY DWELLINGS (excluding bedrooms) Other additions, such as a family room addition, additional space to a kitchen, new garage, or swimming pool, may be approved after the health inspector thoroughly reviews the records for compliance with the 1978 Code. This includes a review of the as-built card. This policy also requires a review of engineered plans on file if the property is located in an area potentially close to wetlands, private wells and/or high groundwater table. The system must consist of a septic tank and leaching facility or a converted cesspool connected to a leaching facility, it must be at least 4 feet above the groundwater table, at least 100 feet from the edge of wetlands, 150 feet from private wells, and all the 1978 Title 5 Code requirements. If there are no records on file at the Health Division Office or Town Hall attic, a septic system inspection is required by a certified private inspector. If the system passes the inspection.and the septic system meets all 1978 Code requirements, approval can be granted. The health inspector must also review the application to ensure that the proposed addition will not be constructed within the setback requirements described within Title 5. ---------------------------------- ADDITIONAL BEDROOM (S) The septic system must be inspected by a certified inspector at the applicant's expense. If the system passes the inspection and the septic system meets all 1978 Code requirements, approval can be granted. The health inspector must also review the application to ensure that the proposed addition will not be constructed within the setback requirements described within Title 5. Pagel The Town of Barnstable BARMAMZ KAM �,� Department of Health Safety and Environmental Services %659.5� Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-775-3344 Building Commissioner For office use only Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement, removal, demolition, or construction of an addition to any preexisting owner occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work: Est- Cost Address of Work: Owner.Name: Date of Permit Application: I hereby certifv that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000 Building not owner-occupied -:: tiVmer pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor name Registration No. OR Date Owner's name • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB LOCATION J ��`^'��� tj).. !u A -Number Street address Section of town "HOMEOWNER" C 2030 Name Y Home phone Work. phone . PRESENT MAILING ADDRESS 21 W r gfvffl�°1-b� 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as su ervisor. DEFINITION OF HOMEOWNER: Persons) 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 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 Stat 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 requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. . c 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 Owner 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 iwarenes 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 "dwner- actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her. responsibilities,. man 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. 4 t ; �. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION y ^ rs Map ' Parcel Permit# _ �4/� Gar ► `�ti F ; fai ` k. ate Issued �® f3ALI Health Division /�y B 6 CV Conservation Division Application Fee Tax Collector Permit Fee � v leyTreasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address C::.UJb",JN -45 e-CA2 Village Cel',Nk-e� V Owner FIQ_�SiNO Address � ��e,S�v✓r�•- (✓� e N.Q¢,A�3 10 Telephone 9-7�`'G 6 9 - C�, at�6 9 Permit Request _-o \-a�5-R- 'Cv- e Square feet: 1st floor: existing 192d proposed c,� 2nd floor:existing X proposed Y_ Total new Zoning District Flood Plain Groundwater Overlay Project Valuation . 0a o Construction Type N-,44< 4�,,,,,�,-�► Lot Size�O� 70 0 Grandfathered: O/Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family Multi-Family(#units) Age of Existing Structure 1 q H C\ Historic House: ❑Yes X No On Old King's Highway: ❑Yes ❑No Basement Type: ❑Full 51 Crawl Cl Walkout ❑Other Basement Finished Area(sq.ft.) n 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 6 First Floor Room Count 6 Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other No Central Air: Cl Yes XNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes )20 No Detached garage:❑existing ❑new size -- Pool: ❑existing ❑new size — Barn:❑existing ❑new size Attached garage:❑existing ❑new size — Shed:Xexisting ❑new size 6X Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes No If yes, site plan review# �Curre nt Use -- mow,k 'Proposed Use BUILDER INFORMATION - Name- POty-s,'/J0 Telephone Number. - Address aLc\ License# CS e9 1 % L4 q d /j p �-R e�� ► \a Y�1. 19 016,0'1 Home Improvement Contractor# �3 1 5 0H Worker's Compensation# �J C S315 O a ^7 3 LJ ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO �Jb SIGNATURE �J�""` DATE FOR OFFICIAL USE ONLY PERMMIT NO. DATE ISSUED a -s MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION 1612410 t o�A!#—. FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ` GAS: ROUGH FINAL 's 1 FINAL BUILDING �! aS DATE CLOSED OUT ASSOCIATION PLAN NO. �F1HIE Tom, Town of Barnstable y Regulatory Services - A BMWTABLE, Thomas F.Geiler,Director F 3;�a i Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization, conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. T �Ye of Work: ') ( 5 1►n q ©�z Q. foar)jr�tt��) Estimated Cost Glf� 0 J � Address of Work: 7 \la, h Owner's Name: N 1,0 1�Tg 0 [ Np Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied J&Owner pulling own permit Notice is.hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the ownuepr�f Date Contractor Name Registration No. OR ✓"�.� <h 0 Date Owner's Name Q:fon-mhomeaffidav The Commonwealth of Massachusetts Department of Industrial Accidents' MOO OfIRMSM9M 600 Washington Street Boston,Mass. 02111 . "may Workers', Com ensation.Insurance Affidavit-General Businesses ' "� � �..�Rujy � •,7d,•_•, ' y •1/yO},1SRr ,f. ��L,,., "VM • '` . ,. i riw'1t�$1 . NV til address: a "" o f C e Co 'f► AF p N N( state I''I A �'�' zip: 4 Lt . phone# 6G 42 03'0 lwork site location(full address)' O,aT.h W I ill 0 U z,t hA d•&- ,-i A JX I am.a sole proprietor and have no one Business Type: []Retail El RestaurantBar/EatYng Establishment { working in any capacity. ❑Office E] Sales(mcluding_Real Estate,Autos etc.)' ' ❑I am an em lover with em toyees (full& art time). 0 Other I am an employer providing workers, compensation for my employees working on this job. coID^ari'•riaine• "'' .ti ..:r: aaare8s ..p.r.. .inisiiTari l%/� / • I am a sole proprietor and have hired the independent contractors listed below who have fife following workers' .compensation polices: com an' 'nam'es eddressd. i tilioae.#: •ir:..•• .. cifv rr iiisursnce co. -rv*`' ti 1117117111 INAMM c' address: - • . .. ,a '.r. ..:i, : aihoriE#fie•. i• .fit. n Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the fdim of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains.and penalties of perjury that the information provided above is true and correct 11v ature - - Sign Date. . •. .. , . .. - Print name Phone#. official use only do not write la.this area to be completed by city or town official city or town: permit(license# ❑Building Department _ [licensing Board `❑check if immediate response is required- ❑Selectmen's Office ❑Health Department contact person phone#; Other (revised Sept 2003) n Information and Instructions Iviassachusetts General Laws chapter�152 section 25.requires all employers to provide workers' compensation for their. employees: As quoted from the law', an employee is.defined as every person in the service of another under any contract of hire, express or implied; oral or written. An employer is defined as an individual,partnership, association, corporation or other legal entity, or any two or mare of d in a�joint enterprise, and including the legal representatives of a deceased,employer, or the receiver or the foregoing engage trustee of n individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the.occupant_of the dwelling house of another who employs persons to do.maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such.employment.be deemed to be an employer. :. MGL chapter 152 section 25 also*states thatevery state'or local licensing agency shall withhold the issuance or renewal of a license or pernut to operate a business or to construct buildings in the.conunonwealth for any 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 chapter have been presented to the contracting . authority- . . / Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation..Please supply company name, address and phone numbers along with a certificate of insurance 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 the 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 regardin41he"law"or if you are required to obtain a:workers.' compensation policy,please call the Department at the number listed below. . City or Towns . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fillin the permit/license number which will be used as a reference number. The.affidavits.may.be.returned to 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 questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Inn of Wfflsngawns 600 Washington Street ' Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617) 727-4900 ext.406 RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $ 50.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 1 Zg square feet x$64/sq. foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) _. square feet x$32/sq. ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch. x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) - Permit Fee Projcost Rev:063004 f 5 � I Board of Building Regulations and Standards i HOME IMOVEM ONTRACTOR straPf On- 31504 006 I + -- idual Angelo Petrosin Angelo Petrosino, -_ 29 Westward Circle°5 c North Reading,ma 01864 `` Administrator r Y Arthur P.Tragzyk Principal Ptanner :, tau• d nr ilding Keg aGo d Standal Lis ' OME PRO EN TRACTOR Town of Barnstable strilon , 1 , I xpi tl Ro Ptanning Divisiop. - pe: i ual 200 Main Street,Hyannis,MA 02601 (508)862-4685 Angelo P tr o Fax(508)862-4725 Angelo ro in art.traczyk®town•barnstable.ma.tjs 29\N sward it North Reading, a o» Adminis ator f T (suit)86:-403a BOARD OF BUILDING REGULATIONS FAX(508)790-6230 License: CONSTRUCTION SUPERVISOR Mw MMiTAYIE • -•��� i� . II ";P ,Y Number: CS 018440 JEFFREY LAUZON Blrthdate: 12111)193 BUILDING INSPECTOR (� ' TOWN OF BARNSTABLE � y" �� EXplr6i; 12/11/2005 7r.no: 11050 REGULATORY SERVICES BUILDING DIVISION Restricted: 00 TOWN OFFICEANGELO P BUILDING 29 WESTWARD CIR 200 Main Street.Hyannis,MA 02601 N READING, AAA 01864 Administrator "a FLOOD ZONE: ASSESSORS REF.: Zone 8 & A10(el=11) see plan Map 226, Parcel 158 Community Panel No. #250001 0008 D OVERLAY DISTRICT: July 2, 1992 AP — Aquifer Protection District As Shown on Plan Entitled "Revised Groundwater Protection Overlay Districts" - April, 1993 ZONE: RC / Setbacks: Front 20' / Side 10' Rear 10' %� ! q 0.62' . 34.4' A Go�Q q,� 0.40' / \ ohw Lot 2 / 6,6 70f SF 2` 90 q� i a001- o � /B P Zae FEMA Zone line as shown on FIRM Panel i 250001 0008 D Lot 11 O of C6 RICHARD LHEUREUX o' Ate PLOT PLAN IN y BARNSTABLE (Centerville) `NOTES: MASS. DATE: 131AUG104 SCALE: 1"=20' 1.) The structures shown were located on the ground 05 10 15 20 30 40 FEET by conventional survey methods on (or between) July 21, 2004 and August 12 2004. PREPARED FOR: 2.) The property information shown hereon was Angelo.Petrosino, compiled from available record information and 29 Westward Circle does not represent an actual on the ground survey. No Reading MA 01864 3.) This plan is not for recording and is not PREPARED BY: to be used for construction layout or deed CapeSury description purposes. 7 Parker Road Osterville MA 02655 DWG #: C629gl FIELD BY. WHK/JPM (508) 420-3994 / 420-3995f6x oFt� Town of Barnstable Regulatory Services Thomas F.Geiler,Director -E pm� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 wwwAown.barnstable.ma:us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION q p� Please Print DATE: — 2 J — 2 ©c 14 JOB LOCATION: J d o V�I�. U/� tat�. C, Q•y� ��'L'1I.'f/i number street village "HOMEOWNER!': / 3 o y 7 _ r6 (1 2 3 D name home phone d#v work phone# CURRENT MAnJ NG ADDRESS: (Vt old (y , cityhown 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,Rrovided 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 i09.1.1) 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 requirements. D 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 for which a building permit is required shall be exempt from the provisions of this section(Section i09.1.1-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. 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