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0031 WHITES LANE
000r, i t r ��l�oS S P6kE w�MP. l,Jkc� re; P� Clf for v\cw a i i Wr tt .A4W 09/2212006 2�0106 09/=006 092212006 .......... O9a2t2OG6 0912212006 Parcel Detail Page 1 of 3 dy TIR, ! . l 4Ss3x�srfntrJ .. ii :. _ltt+:7 Ids Y •� � � � � Logged In As: Parcel Detail Tuesday;October 30 2012 Parcel Lookup Parcel Info Parcel ID�0 72 0 Lot 03 'Developer.LOT A2 .,...._I ----- - -- -- Location 1 31 WHITE'S LANE ! Pri Frontage 140 � � Sec Road S9ec ;. { -- - - _ -----_ ---- f -- - - -- —J Fronta e� J Village JCOTUIT . Fire District COTUIT Town sewer exists at this address�No Road Index rl831 Asbuilt Septic Scan: Interactives' JY 027003_1, Map Owner Info Owner,WHITE, MICHAEL T , Co-Owner 1 Streetl,31 WHITES LN Street2 ' city IEAOTU-IT _ State -MA zip 02635 Country Land Info Acres 0.81 Use Single Fam MDL-01 . I zoning RF Nghbd F0105 Topography Level Road rUnpaZd utilities Septic,Gas,Public Water Location I Construction Info Building 1 of 1 M1 Year Roof Ext 1977 Gable/Hi Built ____.-- _ _.__-�struct P- wan Wood Shingle ` r 20 WD Living`1056 J Roof Asph/F GIs/Cmp Ac None ' �n Area - cover Type Style IRanch ] tnt ywall Bed 2 Bedrooms 7I ' 4°' --- Wall° --- Rooms -- ---- - 34 tp Int `"" Bath'""" Model Residential ,Hardwood 12 Full -- Floor Rooms -- q, g BMT' P 71 �.. Grade�Averag�I TyP t Hot Air. I Rooms Total Fy ROOn1S I WD. ,44 Heat 1 Story. Fuel IOil - Found- Stories ation•Pf'O�red Gross{2928 Area ----_-- Permit History— - ---� — --- - http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=1552 10/30/2012 Parcel Detail Page 2 of 3 Issue Date Purpose Permit# Amount Insp Date Comments 8/8/2005 Out Building 85934 $50,000 7/22/2006 12:00:00 AM 6/29/2005 Out Building 85154 $40,000 7/22/2006 12:00:00 AM SHED 6/29/2005 Out Building 85153 7/22/2006 12:00:00 AM GARAGE 2/10/2004 Remodel/Renov 74660 $3,500 9/20/2004 12:00:00 AM 5/15/2002 Repair Work 61157 9/5/2002 12:00:00 AM CHIMNEY 7/7/1999 Wood Deck 39573 $2,000 12/16/2000 12:00:00 AM 9/1/1980 B22545 $0 CO ADDN 5/1/1977 1 IB19194 $0 1 CO ADDN Visit History Date Who Purpose 8/11/2008 12:00:00 AM John Greene In Office Review 2/29/2008 12:00:00 AM John Greene In Office Review 9/23/2006 12:00:00 AM Martin Flynn Bldg Permit Completed 4/20/2005 12:00:00 AM Paul Talbot Meas/Est 9/20/2004 12:00:00 AM Martin Flynn Bldg Permit Completed 9/5/2002 12:00:00 AM Martin Flynn... Bldg Permit Completed 12/16/2000 12:00:00 AM Martin Flynn Bldg Permit Completed 11/13/2000 12:00:00 AM John Greene. Cycl lnsp Completed-Update 2/24/2000 12:00:00 AM Martin Flynn Bldg Permit Completed 5/22/1999 12:00:00 AM 1 Donna Dacey Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 5/5/2000 WHITE, MICHAEL T 12991/343 $0 2 1/4/1999 WHITE, MICHAEL T&HEIDI L 11966/285 $115,000 3 WHITE, RUSSELL D&JUDITH ANN 1695/297 $0 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2012 $82,200 $37,500 $113,900 $121,600 $355,200 2 2011 $117,500 $6,300 $111,600 $121,600 $357,000 3 2010 $117,400 $6,300 $114,500 $121,600 $359,800 4 2009 $112,800 $5,000 $69;300 $158,300 $345,400 5 2008 $131,400 $5,000 $15,300 $165,000 $316,700 7 2007 $130,700 $5,000 $15,300 $127,100 $278,100 8 2006 $119,600 $5,000 $15,500 $130,400 $270,500 9 2005 .$111,000 $5,000 $15,700 $122,300 $254,000 10 2004 $90,200 $5,000 $15,800 $122,300 $233,300 11 2003 $82,500 $5,000 $16,000 $49,800 $153,300 12 2002 $82,500 $5,000 $16,000 $49,800 $153,300 13 2001 $82,500 $5,000 $16,000 $49,800 $153,300 14 2000 $63,500 $5,000 $12,100 $27,200 $107,800 15 1999 $58,600 $4,600 $10,500 $27,200 $10000 16 1998 $58,600 $4,600 $10,500 $27,200 $100,900 17 1997 $66,300 $0 $0 $27,200 $107,900 18 1996 $66,300 $0 $0 $27,200 $107,900 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=1552 10/30/2012 M T White Finish Carpentry - Cotuit, Massachusetts (MA) Company Profile Page 1 of 2 35 Jj 1 m n r U.S.-Cotuit,MA- Building&Construction- Carpentry Work- Cotuit Carpenters- M T White Finish Carpentry .. Company Protile Page Reports Map Web Results ..........----. . . . - ----- --- I M T White Finish Carpentry _ " Own This Business? • 'Do You work Here 31 Whites Lane r- � R ;orhavesome other connection?, Cotuit,MA 02635-2301 map Edit Company Info ; A4 N y4 About M T White Finish Carpentry + jl ° write a`Recommendation ' I Phone:(508)420-5096 1 We'bsite Information not found I Is this your company?Claim Profile "; Top 5 Carpenters near Coti t,Massaditisens 1. Spags Finish Carpentry 2, Ranney&Remington Customm New to Manta?Join FFrWl iw Thi i�i tpany Carpentry 3. Paul K Mason Custom Build 4. Vollmer&Son Construction 5. Roger B Reid Carpentry See All Carpenters I More Details for M T Witte Finish Carpentry i M T.White Finish Carpentry in Cotuit,MA is private company categorized under Carpenters.Our records show it was 4 established in 2000 and incorporated in Massachusetts.Register forfree to see additional information suchas annual r revenue and employment figures. f Company Contacts Is this yourcornpany?Claim This ProfileM. _ - ii i Michaelhlhite a Principal ( Search for more contacts Business Categories Carpenters in Cotuit,MA;Carpentry Contractor;Framing Contractors M T White Finish Carpentry Business Information Business Information = Location Type Single Location State otlncorporation Massachusetts Animal Revenue Join Free to View SIC Code a Join Free to Vievr Estim.Ye NAICS Code 238130 Framing Employees 1 _ Contractors . i Years in Business 13 Products or Services Is this your company?Add Your Produds and Services - I Companies like M T White Finish Carpentry usually offer:Carpentry Services. -------- -----------— —..- - -- ------- .._...__..._— — .............._-... .......... -- i Explore companies like-M T white Finish Carpentry Search in U.S Related searches Other companies that match W T White Finish Carpentry" Jobs in Cotuit,MA i .,i All U.S.Carpenters Other companies on Manta Spags Finish Carpentry - Carpenters in Marstons Mills,MA Ranney&Rimington Custom Carpentry Carpenters in Sandwich,MA http://www.manta.com/c/mtmfc6s/m-t-white-finish-carpentry 10/30/2012 M T White Finish Carpentry - Cotuit, Massachusetts (MA) Company Profile Page 2 of 2 In nearby cities Carpenters in Sandwich;MA Add your company for free. 1 Marstons Mills,MA Vollmer&Son Construction Carpenters(3) Carpenters in Cotuit,MA, Sandwich.MA Carpenters(10) Roger B Reid Carpentry Carpenters in Cotuit,MA Mashpee,MA Carpenters(3) a, • Osterville,MA Carpenters(1) • Forestdale,MA - Carpenters(3) Centerville,MA Carpenters(4) West Barnstable,MA Carpenters(2) East Falmouth,MA Carpenters(15) • East Sandwich,MA - Carpenters(1) Hyannis,MA Carpenters(7) Click on the reports tab at the top of the page to research company background:detailed company profile,credit and financial reports for M T White Finish Carpentry. Reports often include a complete predictive and historical analysis with payment and financial information;information on the identity;operations,profitability and stability of M T White Finish Carpentry;Details on the company's history,the business background of its management:special events and recent company news.Download M T White Finish Carpentry financial and company reports. Companies by Location:Cotuit,MA • „" _ BualnessTopks �.,, Browaec aril8t f 3 Copyright @ Manta Media Inc.All rights reserved Note:Our Privacy Policy and Terms&Conditions have changed 5/1/12 Blog Twitter Facebook News Updates . htt ://www.manta.com/c/mtmfc6s/m-t-white-finish-ca ent 10/30/2012 P 1P rY Michael White 31 White's Lane Cotuit, MA 02635 November 7, 2007 .r To: Town of Barnstable Building Department . Re: New Garage Construction 31 White's Lane Cotuit, MA Regarding plans for new garage construction at above address, this garage will be for my own personal use and to store my vintage vehicles, motorcycles and recreational vehicles. For no reason will I be using this garage for commercial or business purposes. Michael T. White & BEATRICE E;YVHrrE �? Not-sty Comm",nvreai;;;c°fs,SS�,husE�t; My Commission Expirss June 29,2012 0q)-?)6r�A I TOWN OF BARNSTABLE Building Department - Foundation Permit Date RI? Permit # E59 3 y Name Location 31 WHT-TE's I_rJ f,/,,2, ,,—Insp. of Bldgs. � 7�,� keep 0" A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �'�M-12 ti Map 0 1 Parcel Permit# 3� _Health Division ��� Date Issued Conservation Division Application Fee 0 Tax Collector n _ Permit Fee y eT7 *V`� Treasurer Planning Dept. EXISTING SEPTIC SYST Ef�l Date Definitive Plan Approved by Planning Board LIMITED T0� �S) #0 EEDRQOMS- Historic Preservation/Hyannis • r� cn Project Street Address 3 °'t e� �. pi co Village C dT 1A Owner /14 ) C 6 S 1 1 , W 4;Y P Address 31 W ti4& � ( . Y! Telephone Permit Request re inolle .e Y44Py 2 79'aGIJ�t gttha 1e bU;1Gti hem/ Square feet: 1st floor: existing proposed 2nd floor: existing proposed /°�' Total new 2ff Zoning District Flood Plain Groundwater Overlay Project Valuation 50, U 00, ®0 Construction Type LV 006t Lot Size so Grandfathered: 0 Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure 3 Historic House: ❑Yes 4No On Old King's Highway: ❑Yes IO No Basement Type: ❑Full ❑Crawl ❑Walkout YJ Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0 dumber of Baths: Full: existing 0 new 0 Half:existing new 0 Number of Bedrooms: existing_ new 0 Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric O Other Central Air: ❑Yes W No Fireplaces: Existing New Existing wood/coal stove: 5d Yes ❑No i Detached garage: 0 existing @J new size .Z Pool:❑existing ❑new size Barn:0 existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization 0 Appeal# Recorded❑ Commercial ❑Ye s ❑No If es site Ian review# Y p e Current Use Proposed Use v BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ou#1/?4.,,1Pr SIGNATURE DATE g/ S� O P FOR OFFICIAL USE ONLY PERMIT NO. =s' *DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE , OWNER DATE OF INSPECTION:- t FOUNDATION /C yZ-9 9 c*y► b:d3.�, C�y'� FRAME 1 l . INSULATION FIREPLACE III. ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL • L3 GAS: ROUGH FINAL FINAL BUILDING V+ rr ' M DATE CLOSED OUT s ASSOCIATION PLAN NO. a The Commonwealth of Massachusetts Department of Industrial Accidents' < 600 Washington Street . � Boston,Mass. .02111 , Workers' Com ensation.•Insurance Affidavit-General Businesses "/►�J(l#C� i 't:3.:`�,°��w��/t���ti:., - -- .o�i.t.`.hn9ei naIne: address: 3.l w llf re S city C•O TGB/ State:" 44 ziv �.Z.(y'�5 phone work site location(full address): [� I am a sole proprietor and have no one Business Type: Retail Restaurant/Bar/Eating Establishment working in any capacity. ❑Office❑ Sales(including Real Estate,Autos etc.) ❑I am an employer with em to ees(full 8-gar,time).. Other /%/%%%%/%//////%/%%%%%////////�i���i. ill/%/% %/%%% I am an employer providing workers' compensation for my employees worlcng on this job.. address: ;:. _ msurance.co: ❑ I am a sole proprietor and have hired the independent contractors listed below who have the following workers' - compensation polices: com�any name: •` ' '•' "� _ address:. city. > ne - •. s insurance co. . :,.:. .:.. :.;4 • ... . , .:';::':� ::�olic'::.# ,"s•• " ..r ' . oinU- nV`n ni eadress:. tnsu a -r.a nce o' Wig a as required under Section 25A of MGL 152 can lead to the' �/Failure to secure coverage eq �mpositioa of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of$100.00 a day against me. I understand that P copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under h pains perjury that the information provided above is true and correct Signature Date 2 06 Print name A t C 4&e I tAl vi e Phone# 4^20 official use only . do not write in 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) 1 Information and Instructions cha ,ter 152 section 25 re uires all to ers to provide workers' compensation for their. Laws mP Massachusetts General p . . q � . Y P .. . employees: As quoted from the 4`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 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 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 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 in the commonwealth 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 regardine'the"law"or if you are required to obtain a:workers.'compensation policy,please call the Department at the number listed below. City or Tow ns .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 fill.:in the permit/license number.which will b�e used as a reference number. The.affidavits may be.returned to the Departinetit 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 gin"of ftes wftnz 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 exL 406 f : Town of Barnstable °�. Regulatory Services snnxsr Thomas F.Geller,Director 9bum `b 1 ���� BuBding Division TomPerry, Building Commissioner 200 Main Street, IJyamis,MA 02601 www.town barnstable:maxs Office: 508-862-4038 Fax: 508 790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder Whit?t? ,as Owner of the subject property hereby authorize:'.' /�i'e .Qe"l Lv h/fi''e to act on mybeiA, in all rmaxters relative to work authorized by this building permit application for. 31 e`f (Address of Job) 7/7/®s" Signature of Owner Date Print Name RESIDENTIAL BUILDING PERNIIT 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) AI,TERATIONSMENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) Z,91 square feet x$32/sq.ft. x.0041= 3��• � , ACCESSORY$TRVCTURE>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: x.0041= square feet x$96/sq.foot= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= Fireplace/Chlmney 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 " 4� Town of Barnstable Regulatory Services Thomas F.Geiler,Director BARNSTABM ` Building Division TfD a Tom Perry,Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION r 1 Please Print DATE: / 6-/ D JOB LOCATION: 31 141 h t'r-e�5 L.ti CO""U" number street village .HOMEOWNER": Al"r-�i« e 1 w4'`T e 5 D S- V-)_0 -5096 1(1/4 name home phone# work phone# CURRENT MAMING ADDRESS: /1i1 r'G�� l ?•'? 31 tA,'71 e3 Lti 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 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. - The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. 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 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,.our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the pernrit application, , that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt r ■/1�i5 ,� KeySpan Energy Delivery Psi 127 Whites Path Energy Delivery South Yarmouth, MA 02664 August 2, 2005 Mr. Mike White 31 Whites Lane Cotuit, MA 02635 Re: 31 Whites Lane, Cotuit To Whom It May Concern: This letter is to confirm that there is no natural gas service to the above referenced property. If you.have any questions, please call 508-760-7530. Sincerely, Steve Jacobson Field Supervisor r L_ S.A. SOUZA ELECTRICAL CONTRACTOR 28 NORTH MAIN STREET. SO.YARMOUTH MASS , 02664 508-648-6758 LIC. #E39768 To the Barnstable Building Inspector: R.E. The demolition of the the garage located at 31 Whites Lane Cotuit Ma 02635 I Shawn A . Souza removed all exsisting power to the garage and disconnected the wiring from the electrical panel and removed all of the old cables. I also notified Bill Amara on 8/l/05 of my actions and he told me that it was all set. Any questions or comments feel free to call any time. REJ. PECTFULLY SUBMITTED X"� a d SHAWN A. SOUZA i °�jHeT Town of Barnstable °* Regulatory Services annNszesi.E, ' Thomas F.Geiler,Director g Buildin Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us 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 adj acent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: Aj e i/V q eroj e Estimated Cost d., 0 a d, Address of Work: 31 W 4l t o�Cj k Ne of t Owner's Name: �[ d P Date of Application: �S 0 5� I hereby certify that: Registration is not required for the following reason(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied [ZOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDERPENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Date Owner's Name Q:fbn=:homeaffidav LOT A3 `° G� 0 UNDATION 6� 0 1 I s�o LOT A2 #31;.... [� , LOT Al 0 FLOOD ZONE "C" FO UNDA TIO.N C RTIFICA TION RES ZONE. "RF" TO WY COTUIT SCALE: 1"-40' PL.REF 930-31 ELEV N/A SETBACKS: 30'-15'-15' I CERTIFY THAT THE ABOVE ,�AA YANKEE SURVEY CONSULTANTS FOUNDATION IS LOCATED ON s� OF"JA e° Ss� P. 0. BOX 265 THE GROUND AS SHOWN, AND S-ER cy ° F� UNIT 1, 40B INDUSTRY ROAD IT'S POSITION DOES ° PSTEPh-N CONFORM TO THE ZONING LAW J. f MARSTONS MILLS, MASS. 02648 J'E TEL: 428—0055 SETBACK REQUIREMENTS , OF �7wq FAX 420—5553 STABLE ND S` ®/o JOB STEPHEN J DOYLE, R.P.L.S. ®w° DATE 09-08-05 NUMBER 53949FND ' TOT-IN ;OF j.3 ST �T,; r t" FJII,bINr F$h' i3`L' . ` ,� 41 PARU ID ll�. 'li ♦'Iit. A _ _ t - r is � • - r S Gt� LOT 1MOPMENTa _ d �.n � ,.vt N •j' , . L 5 LIT TrI t -�,x-da.6h � w 3 '[ rr,S�' .�, `� .,..:.:- x �' ' r'•'. Y �^ .Si i' �. .,��')+1?.-: 's rf..= �. ..•` ..::� EVIOL1 Department of j.{1 r.�f t Yi -.t"l y . tMy � t•-j -. I ', � yA..�yt x .f.. �j \_� � � e e 3 tS Slrt � ♦t � ��(ki / � �� _- n { y [ t�Pf LY'•J L U {' - yJ T � t i ''' -y .� ', ' ° 'L �Y. 1• � .. i yV t� i c •c„i 1i^ f;' 4 1 T t f •!'�'. ' 4,--T 'Y .3r4' � ` L E x e, 'NABS 6 4 `' `4 >: i # �� e # .t t y j A i .• f z Ic BUILDING DIVISION r BY 4 . EXPI'RATIC'"t �+ a TOWN OF BARNSTAB.LE BUILDING PERMIT i PARCEL ID 027 '003 GEOBASE ID 1447 ADDRESS 31 WHITE'S LANE PHONE COTUIT . . a ZIP _ LOT BLOCK LOT SIZE _ . DBA DEVELOPMENT DISTRICT CT PERMIT 86933 DESCRIPTION DEMOLITION OF EX STING GARAGE PERMIT TYPE BDEMO TITLE DEMOLITION PERMIT } bONTRACTORS: PROPERTY OWNER De artment Of ARCHITECTS: P Regulatory Services TOTAL FEES. $35.00 BOND $,00 CONSTRUCTION COSTS $.00 645 SFH DETACHED DEMOLITION 1 PRIVATE0:�� * BARNSTABLE, • MASS. �D NAB BUILDING DIVISION BY .OATH ISSUED 08/08/2005 EXPIRATION PATE THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLEY.OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. EN- CROACHMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE;MUST BE APPROVED BY THE JURISDICTION.STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF-PUBLIC WORKS.THE ISSUANCE.OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND WHERE APPLICABLE, SEPARATE 1.FOUNDATIONS OR FOOTINGS C THIS CARD KEPT POSTED UNTIL FINAL INSPECTION HAS 2. PRIOR TO COVERING STRUCTURAL MEMBERS BEEN MADE.WHERE A CERTIFICATE OF OCCU- PERMITS ARE REQUIRED FOR (READY TO LATH). PANCY IS REQUIRED,:SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND MECH- 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS-BEEN-MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. VISIBLEPOST THIS CARD SO IT IS BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 I 2 2. 2 1 1 I 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT ' I I 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. I ,.� ,r a 3 f�T f F TOWN OF BARNSTABLE BUI ING PERMIT APPLICATION ' ap ® c;? Parcel, -, O®3 x Permit# f Healt flivision �� fo�'a- ®3 _ Date Issued Conservation Division"- d Tax Collector '1Lj' : (z Application Fee Treasurer Planning Dept. i0f^ -E1ies 1 in By Date Definitive Plan Approved by Planning Board Approved By ' Historic-OKH Preservation/Hyannis Project Street Address 31 W L Y7 ' Village C v-r tk r t Owner e G h cte I T W h%T e Address 11 V J1 Telephone 5 O F �L © `" 3'0176 Permit Request re -build o.nd add on to -?- 5tio� toG1tea( a re Square feet: 1 st floor: existing p posed 1�' 2nd for; sting d propo d 1 y'�° to Zon 'strict Floo Plain Groundwate ve Valuation ,g Construction Type w'004t F rame Lot Size 35, �� 9 randfathered: ❑Yes ❑No If yes, at ch klin�gg docum ntati n. I Dwelling Type: Single Family 9 Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes 96 No On Old King's Highway: ❑Yes ®'No I Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new b Half; existing new Number of Bedrooms: existing new 0 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:29 existing 26 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 M No If yes, site plan review# Current Use — -- - Proposed Use worlrsl o� q�Tcr� e- BUILDER INFORMATION ,(� > _ Name y►i C 44e l W h,,1-e Telephone Number �U ��Q—�5D9 Address License# Home Improvement Contractor# Worker's rCompensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE __ Y ,�I �. DATE IG �+ FOR OFFICIAL USE ONLY / 3 PERMIT Nd. DATE ISSUED � MAP1 PARCEL NO. N � ADDRESS VILLAGE OWNER DATE-OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING • DATE CLOSED OUT ASSOCIATION PLAN NO. ;� -- -- The Commonwealtlz of Massachusetts -� — _ _ - Department of Industrial Accidents — Office of Investigations 600 Washington Street, a Floor ,. Boston,Mass. 02111 Workers'Com ensation Insurance Affidavit:Buildin /Plumbin /Electrical Contractors Wearti :� t '•* g'' MY �` x ' ) .'e 'l �y a t ` �A,,"'' ` name: / V1 i L �GC Z �, ti✓�1/'f e address: I �t y C,� L V) city ®t Gl t state: 1414zio• vX 6 3L phone# b�'�� i}oZ 0 'SD 9hl. work site location full address): 3 t W tii t eel I am a homeowner performing all work myself. Project Type: ❑New Construction®Remodel ❑ I am a sole proprietor and have no one workin in an capacity. f Buildin Addition SN!"i;•F (;=,ui;., < T. ePi r, rrm•.w.. : ,:• x . .: - .f>..¢_w.. 3 ?�is. r3us# P;sifi?±#1, is,T..5�s 'r �rd•raa:•a:, xtn .u9a an employer providing workers'compensation for my employees working on this job. company name: address:' city phone#: insurance co. Doliev# �i•Pd��i�t�asbt`-. :'.'a7::::ftv'�"e5�i1�"v7G�J'�.'-s�E K76.1r.5J�"®�:s.°��:;i:L�"•1t:AT�.5 3i d `r`w'':3."i'«:i:�::.:. 1da:..R,,,..i�- '¢v••¢: i. r i�i: '����>e^.�::5, .b��a`:.:r•_x_ '.sz.•-'�`4•....:•tilorw.ars:�:r:I�t: :`:.�h-:-:�:�,ir3,•b��:w', ,..�."��r.� %, ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: i company name: t address city phone#• insurance co. policy# fin`•.;�;�s�-':f;•r�t�...`'.�1'i'�':�a!ia�s:'Z�:�:erl`.,c;v��y_ �`�p; yr��¢I '•r c x.i� _ ::6 i.',._ '•i".sT. . . r`iV`6��;:'t "',�SYg,4•':. :oi+ci•Yil 1.=>` t ..�w ..•� 'r' .t� �..l.y...... :.. °Ni."'. i`.n�'.-�)'.. 4. .?>;b:. %�''.i�. .ti.P;'.`,a�`.:.»`ram.-;.' ::�;�'d;i ':•:'•y':'i' it r''•t& 'company name: address: city: phone#: insurance co. • o tc :F►a"..,.,._..... : ReQJLEe2.rs a,- S`` ' �' pr..-����j�-�, �:. , � 10MM �-� +r :•..alx' ..'i Failure to secure coverage as required under Section 25A of MGL 152 can lead to the impositionit a of criminalt. penalties`ib- of a fine up to$1,500.00'and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a- copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under th pains and penalties of perjury that the Information provided above is true and correct. Signature 'OG % Ol/ -Date b �.,Z 0 �J Prini name M i c h a pe I ! W h l�f t Phone# E10nly do not write in this area to be completed by city or town official : permit/license# ❑Building Department ❑Licensing Board Immediate response is required ❑Selectmen's Office ❑Health Department on: phone#; ❑Other03) Information and Instructions Massachusetts General Laws chapter 1.52 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 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 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 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 in the commonwealth 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. �"? , .,. , '��,`l;''�:'•'' :r,+:x,�g n. �.ai� .�;. ..�,,.�. ��5� "�3,�t •.�.:: :C`n�.�,a�'_"�":.•.�12�..pi�i�,µ,,�,',� .,,.y' i ,�:nnr,':`. ,�� k �. ��.a5' �F+��"�w�" �• Via' a` �' J• d',it:r' �,`�y'� , ,:f}.�:.�• .` :N� -'i .Vier. '•`�k•�•ci.��.�At#��1 '�. .3 �'ins:'ft:�fe?�:d�i.^v.'F:�i`i:,�"�."�. '.•.7L;��t7.r..xa��0.-Z•.':`:�:� v"K 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 pennit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the"law"or if you are required to obtain a workers' compensation policy,please call the Department at the number listed.below. r +i 4� :••g41;�7�.gg«.� ,f;^+',i$7yrr"' '�i�%., aT,�`+�"?'+ ,r•�4:, ,$� ;�#:�P:.:4. it+,;.;�ar:r�;s:�. tom.,:r(T.ti'!' ss.r a .�,F, h �.7,g,+i:-�t � :•v;�a. °? - _ f,u:+�y� �.f... �. �+ •��c,Ad"s.�x' �r's•;8'?t�R„"+`4.Si.Fr v "`,,��y'C';•r�� try. vS ^.4E r ��.,tr'N��'� waixs.S�'�. i.'#.R�,`•S."�••*3iFa�� � �,:a�i•w,±�h�'9C•:�''�' ^+fin r �'a.�:�5� r.P.:''� ; �Y+..:6.r n,'.r.f.�' 'u;t�3�` '�c�f.':� r'.nar a 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 fill in 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. .:;--.J,• :r• •.�• :+^,: 4 ..J •;as;. �Y�. ` � ..�....�`'',�.rrir�t�r.:t: •.a� �y �. sn; ,,( y }C' �. ski q.. 8�' '�'.,.5 � ar�� �"•"l"•.� e � S.ra::.FYh•a. ..��.,. 'rv..+tr.i�ro 5VS•)'ks*�rk���iv��Sa�k.ac+ (c�Sres���'�'.' $t3t�' ,.a+ 'l}.hP.er X."v.i�`••yH n.��' `..F r...�^F it'r�s a�' x� .�: F;.rM^ ..seQ',*a=. ar.�.1•t.i�. its" ,•r�',:, vw.r-..F n 'rMS The Department's address,telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street,7 h Floor Boston,Ma. 02111 fax#: (617)727-7749 phone#: (617)727-4900 ext.406 . �. �FTHE Tpy, Town of Barnstable Regulatory Services BnRxsTABLE. MASS. g Thomas F.Geiler,Director s6gq. �0 prFOMA'�A 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 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. Type of Work: a Wy a h 7 4 ����� Estimated Cost I�e U�U•®� Address of Work: 31 �v t1 IL4 5 L. g Owner's Name: Cr7 ffi (iV'�j,•y` .� _ - 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 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 owner: Date Contractor Name Registration No. Date Owner's Name r Q:forms:homeaffidav RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE 25� New Buildings $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Change of Contractor/Builder $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE Y square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE square feet x$64/sq.foot= x.0041= plus from below(if applicable) GARAGES(attached&detached) p 7� 1 l61 square feet x$32/sq.ft.= . �0 2� x.0041 1 11 y 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= s (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) L, h Permit Fee �7 4 r8'� Projcost - � - Rev:063004 n0 CMR Appaxft! • Table JS=b(condoned) f` prescriptive Packages for due and Two-Family Residential Buildings Hated with Foait Fuels M )dmuM MINIMUM Glazing Glazing Ceiling Well Floor Basement iwc Heatint M inGlazingArea'(%) U-valuc= R-value' R-value' R-vaiuc . Wall Phesit�i eta Equipment EII3sisnsy� f R value' it-value' Package 5701 to 6500 Heating Degm Days' Q 12% 0.40 38 13 19 . LO 6 Norm e al 6 Nmma1 R 12% 0.52 30 19 19 10 85 AFUE S 129/6 0.50 38 13 19 10 6 -38 13 25 NIA N/A Normal —--=6 -----—Normal-- --- ----_ U -15% 0.46 38 19 19 10 85 AFUE V 15% 0.44 38 13 25 N/A NIA W 15% 0.32 30 19 19 10 6 SS AFUE x IS% 032 38 13 25 N/A NIA Normal y 18% 0.42 38 19 25 N/A NIA Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 1! O.SO 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: 31 W hi t�I� 1- 11 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: ,t GLAZING AREA(#3 DIVIDED.BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES. NO. • g4bnns-1980303 a 780 CMR Appendix J Footnotes to Table A2.1b: I Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage.Up to 1%of the total glazing area may be excluded from the U-value.requirement. For example,3 ft of decorative glass may be excluded from a building design with 300 if of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U=values cannot be used. S The ceiling.R-values do not assume a raised or oversized truss construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R 30 insulation may be substituted for R 38 -- _ insulation and R-38 insulation"niay be substituted for-R-49 insulation: Ceiling Rvalues-represent the sum of cavity---..--.. insulation plus insulating sheathing(if used). For ventilated ceilings, insulating sheathing must.be placed between the conditioned space and the ventilated portion of the roof. Wall R values represent the sum.of the wall cavity insulation plus insulating sheathing(if used). Do not include exterior siding, structural sheathing,and interior drywall.For example,an R 19 requirement could be met EITHER by R-19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces,basements, or garages).Floors over outside air must meet the ceiling requirements. The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. `The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes`el0tric resistance heating use compliance approach 3;4, or 5.. If you plan to install more piece of coolie equipment,the a ui equipment with the lowest than one piece of heating equipment or more than one pi g q P . P . the selectedpackage... use meet or exceed the efficiency required by .efficiency m y For Heating Degree Day requirements of the closest city or town see.Table J5.2:1 a NOTES: a)Glazing areas and-U-values are maximum acceptable levels.Insulation R values are minimum acceptable-levels. R-value requirements are for insulation only and do not include structural components. b)Opaque doors in the building envelope must have a U-value no greater than 0.35. Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with ted average R-value is eater than or equal to ies if the area-wee �' different insulation levels,the component complies, area-weighted the lZ-value requirement for that component. Glazing or door components comply if the area-weighted average U- L value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). 43 Town of Barnstable �F SHE Tp� Regulatory Services sAxxsaasi$ Thomas F.Geiler,Director MAss. pr1639. A��� Building Division fp�. Tom Perry,Building Commissioner 200 Main Street, Hyannis,Na 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: _ ! w ilV r ej C of ul't number street village "HOMEOWNER": AAic.%,e) T wyr ,e �eF- f,2o -5pyF6 4 name home phone# work phone# CURRENT MAILING ADDRESS: 31 Leif t?'' L- A? 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 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements Signature of Homeowner 4 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 persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisoi. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, `that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt 4 Town of Barnstable FTHE Regulatory Services Thomas F.Geiler,Director ► 1AMSTABIX 9$ 63 �0� Building Division ATF p 39n. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 ` Ex: 8-790-6230 low' PERMIT# - FEE: $ co Ln SHED REGISTRATION _ .120 square feet or less N sv rn Location of shed(address) Village T . wh;t e SU 8- 9-2© --5-5 9 Property owner's name Telephone number 2 � 003 0 k Size of Shed Map/Parcel# ` Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? p Conservation Commission(signature is required) 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 ; REV:121901 T TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION A. Map oll Parcel 0o3 .,. Permit# 6 Health Division® Date Issued 10q Conservation Division .2J�L_o 113 Application Fe .Tax Collector - /} Per ' ee Treasurer s;;' FC�;_; ' SEI TtC SYSTEM MUST BE ' Planning Dept. -_ PUANCE Date Definitive Plan Approved by Planning Board WITH TITLE 5 Historic-OKH Preservation/Hyannis ENVIRONMENTAL CODE AND -- TOWN REGULATIONS Project Street Address W 6 i Lan e Village or U.i t Owner A ► C 4 CL e, T U/h it Address Sd !n p Telephone ---, Jo'' C� iS y 2 6 g 6 ' Permit Request T o b o a r lf� 0_ ,�J Fa r 5 ©rC i1 o®f Square feet: 1st floor: existing 165 proposed 0 2nd floor: existing 0 proposed Total new Q Zoning District Flood Plain Groundwater Overlay Project Valuation Construction Type i/V oQ Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 30 Lleor Historic House: ❑Yes Af No On Old King's Highway: ❑Yes Li No Basement Type: Full O Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing _ new 0 Half:existing new Number of Bedrooms: existing new 0 Total Room Count(not including oaths): existing 6 new ® First Floor Room Count 6 Heat Type and Fuel: ❑Gas 54 Oil ❑ Electric ❑Other Central Air: ❑Yes 0 No Fireplaces: Existing New 0 Existing wood/coal stove: 0 Yes ❑No Detached garage:4 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 0 No If yes,site plan review# Current Use Proposed Use BUILDER INFORMATION Name /14 ie kQe 1 w 4ij c — owner Telephone Number Address License#. Home Improvement Contractor# Worker's Compensation# __// ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO Gnu MR 5T'C'r ---SIGNATURE DATE Feb Z 00�L FOR OFFICIAL USE ONLY b PERMIT NO. DATE ISSUED ' _MlkP/PARCEL NO. ADDRESS VILLAGE , OWNER DATE OF INSPECTION: / FOUNDATION a FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r, GAS: ROUGH , FINAL . Z FINAL BUILDING j S � i r. r DATEmCLOSEDrOUT Q► �tr as 0 ASSOCIATION PLAN NO. '� G mm The Commonwealth o Massachusetts , _ - Department of Industrial Accidents' ' 600 Washington.Street _ Boston,Mass. 02111 Workers,.Com ensation.7nsnrance Affidavit-General Businesses // 'Sra�'' •T•`,grTA�'T""' ., � ., :•t. � ;;-,*a�tl / 1 I name: :°: (, _ �hh ' .. ,••' address 3 f v�/�l _ zi d hone state; n v work site location full address): ' ❑ I am.a sole proprietor and have no one Bpsiness Type: []Retail[I RestaurantBai/Eating Establishment worldng in any capacity. E] of [] Sales(mcluding Real Estate,Autos etc.)' I am an em to er with . etn to ees full& art time) Other %% // %�%///�%%//%///%%//�%////O�%%/ I am an.employer providing workers compensation for my employees working on this job. ,. co • 2{ at'Ff:,•• �q. .tr.a:.:.'s :;�•i..:. .. ..5:• 'f.. a..,. :1'• � ' __ .' - •t: •.r .Wsurarice.ca Iam a sole proprietor and•have hired the independent contractors listed below who have the following workers' ,Compensation polices: ; • }•�,.�• . .< .. i> 'r S`'••iv,.ayi-'• ..�<;ft�',"it.i h'�i,`� 'fi;}a�. coin an 'a-ame: address:. L.-L. _ .., •:' :.. .;y:fit 1.;.. ;•t �;,'. insurance'co. •.a e.coin an• n .. .. •• 't. ,. s7dressi. - . • ,. .r, liti3iu #c CI iIISUr�811C°•'Sb:� i" :;: Mammilix Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of aline u p to$1,500.00 and/or one years'imprisonment as well as ctvil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p copy of'this statement maybe forwarded to the Office of Investigations of the DIAfor coverage verification. I do hereby certify u r e pain / d penalties of perjury that the information provided above is true and correct G� 2 Date O y .4 Tr x . $ignatvre JJ--' tname1 e�lQ e� �s I/{✓�[l -Q Phone# ��� Pan official use only do not write in this area to be completed by city or Town official permit/license# []Building Department INNOM city or town: ❑Licensing Board • []Selectmen's Office []checkif immediate response is required ❑Health Department . phone#; ❑Other contact person: (revised Sept 2003) " i Information and Instructions Massachusetts General Laws chapter�152 section 25•requiires all employers to provide workers' coinpensatidn 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 iwo or more of the foregoing engaged in ajoint 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. •Howevei.the owner of a dwelling house baying.-not more than three apartrnents 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 liouse or on the grounds or building appurtenant thereto shall not because of such employment.be deemedtobe.a'employer...,. : : ... MGL chapter 152 section 25 also•states thaf every state or local licensing agency shah withhold the issuance or renewal of a license or permit.to operate a business or to construct buildings in the.commonwealth 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 unto' acceptable evidence of compliance with tie insurance requirements of this chapter have been presented to the contracting . authority. Applicants ' e ensation affidavit completely,b checkin the box that applies to your situation.•Please Please ti is the workers orr Y� Y g ]?P .. .. .. supply company name, address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Departrnent-of Industrial Accidents-for confirmation of insurance coverage. - lso be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pemnit or license is being requested, not the Department of Industrial Accidents. Shouuld you have any questions regarding* the"law"or if you are required to obtain a:workers.'compensationpolicy,please call the Department at the number liste4below. . 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 fill in 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 ybu 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 Once of feiledwfiens 600 Washington Street Boston,Ma. 02111 fax#: (617)727-7749 nhnnP#! 16171 727-4900 ext:406 �NEr Town of Barnstable of °�y • o� Regulatory Services Thomas F.Geller,Director 163 k,�� Builffing Division rFD MAI • Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Fax: 508-790-6230 Office,: 508-862-4038 Permit ao. Date APMAVIT ]SOME 71YIPROVEIYIENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c.142A requires that the`ton or construction nstructioaalteo an addition toon,repair,any Pre-existing o�wr�e�occupied conversion: • •improvement,removal,demolition, biding cootainizig at least one but not more than four dwelling units or to structures which are adi agent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. 3 Q 0.6 0 rk Type of Wo ro"r Fa rm er'l ©r'C A Estimated Cost �S Address of Work, . . iJV h;f e Owner's Name: 1,C fit. �' I ation: F Date of Applice b 10 0 I hereby certify that: Registration is not required for the following reason(s): 0Work excluded by law []Job Under$1,000 Building not owner-occupied gowner pulling own permit Notice is hereby given that: pERMT OWNERS PULLING THEIR OWN LEME UNREGISTEREDOR DEALING WITH IMPROVEMENT WORKDO NOT HAVE -Fop APPLICABLE, ACCESS TO THE ARBITRATION PRO GRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PER7URY Ihereby apply for apermit as the agent of the owner: Contractor Name Registration No. Date Owner's Name Town of Barnstable oFt�'�ti Regulatory Services BAMSTABM ; Thomas F.Geiler,Director 9 MASS. 1639. A Building Division rED tr1A'1 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 �y, Please Print DATE: Feb T �.o o Lk L JOB LOCATION: 31 uy ht f e+ / Ln, C 07aw°T number street village "HOMEOWNER!': I14;c�de1 T WAI-e 5 ()T-03.0 -TeA name home phone# work phone# CURRENT MA M-;G ADDRESS: /Gy Q /'* 31 w4/wI I—�7 AM 0,j t 35- 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 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requiremen s. gap 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 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. a , Q:forms:homeexempt • l.W TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION "Map 6 Z / Parcel 003 Permit# Health Division q Date IssuedA� Conservation Division Fee Tax oll ctor 4-0 014 C e Treasurer a, c�v Planning Dept. �!1/® li Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address L �! Village C6_r1 7 Owner Mr G�d e T w4ty Address Telephone 6-a- Y.,)_a —57-0 6 Permit Request b udd gxl-rtiti C 41`i II-e 1y6 tt d air o r f err e boIr Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type Re 5 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure C? Historic House: ❑Yes ONo On Old King's Highway: ❑Yes J 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 4- new First Floor Room Count Heat Type and Fuel: ❑Gas 00il ❑ Electric ❑Other Central Air: ❑Yes 4rNo Fireplaces: Existing I New Existing wood/coal stove: &Yes ❑No Detached garage:;6 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 9 No If yes,site plan review# Current Use Proposed Use - - BUILDER INFORMATION Name 1141(1 +,1 Telephone Number Address 3 r W 4"t, 5 Z,h License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE 00j, . 1 FOR OFFICIAL USE ONLY r R PERMIT NO. DATE ISSUED MAP/PARCEL NO. - F ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL s b _ FINAL BUILDING t DATE CLOSED OUT Y z ASSOCIATION PLAN NO. a r q . The Town of Barnstable - Regulatory Services Thomas F. Geiler,Director -Building Division Peter F. DiMatteo, 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. Type.of Work: r e C6o 5 t'tu c 7*y of C Ww.h.Q Estimated Cost a 00 Address of Work: I VV b Owner's Name:' /�� (, � I W 4/1 42 Date of Application: I hereby certify that: Registration is not required for the following reasou(s): []Work excluded by law ❑Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME EVIPROVEMENT 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 q:forms:Affidav :rev-122001 THE The Town of Barnstable BAR`1STA BLE. Department of Health Safety and Environmental Services 7 MASS. m 039• �0 �pTEDMP' a' Building Division 367 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 PLAN REVIEW Owner: N r I)# Map/Parcel: a 2-7 a 3 Project Address: 4#A1,,r Car, Builder: -The following items were noted on reviewing: .D y r'e i�6 x3 u• T 't>o J4 o fi 7W/Z i 4 l t Reviewed by: Date: q:building:forms:review t = r Department of Industrial Accidents affre oflfty,95 19MRs _ — 600 Washington Street -= t Boston, Mass. 02111 Workers' Cow ensation Insurance Affidavit Af hone# �1® I am a homeowner performing all work myself. 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I understsad that a :opy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification do hereby certify under the pains andpenalliq4pelurY that the information provided above is ow.an correct � 1� o 5igoatWe P, Print name AI'c 4a e� �, lN'�t��f Phoned ®C�� omcial use only do not write in this area to be completed by city•or town bfflcial peiaiit/lieasse# _ ❑Bmldini Department city or tows: ❑Licensing Board response is required ❑selectnews Office ' [Icheckif imaediste q ❑Health Depatiznent contact person: phone#; '- ❑Other � . Oviaad 9195 PJA) Information and Instructions sachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their lovees. As quoted from the 'law", an employee is defined as every person in the service of another under any corfract re, express or implied, oral or written. wmployer is defined as an individual;partnership, association, corporation or other legal entity, or any two or more of bregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or Lee of an individual, partnership, association or other legal entity, employing-employees. However the owner of a. lling house having not more than three apartments and who resides therein; or the occupant of the dwelling house of her who employs persons to do maintenance, constriction or repair work on such dwelling house or on the.grounds or ding appurtenant thereto shall not because-of such employment be deemed to bean employer. 'L chapter 152 section 25 also states that every state or local licensing agency shall withhold the,issuance or renewal license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has produced.acceptable evidence of compliance with the insurance coverage required. Additionally,.neither the unonwealth nor,any of its political subdivisions shall enter into any contract for the performance of public work until eptable,evidence of compliance with the ins;»nce requirements of this chapter have been presented to the;contracting aority. plicants ase fill in the workers'. compens4t'LM affidavit completely,by checking the box that applies:to your situation and . )plying.compun -with a•certificate of ms=' ce as all affidavits may be y?tames, address and phone numbers along )miffed to the Depar went of Industrial Accidents for confirmation of insurance coverage: Also be sure to sign and. fe the affidavit. 'The affidavit should be returned to the city or town that the application for the permit or license is ng requested, notthe Department of Industrial Accidents. Should you have any questions regarding the"law"or if you required to obtain a-workers' compensation policy,.please call the Department at the number listed below. ty or,Towns +ase be'sure that the affidavit is*complete and printed legibly. The Department.has provided a space at the bottom of the adavit for you tb fill out in the event the Office of Investigations has to contact you regarding the applicant. Please sure to fill iri the peimit/licecse number which will be used as a reference number. The affidavits-may be reburied in Department by mail or FAX*unllesg"other-ta agetaents have'been.made:-•-`-- ie Office of Investigations would like to thank you in advance for you cooperation and should you have any questions• ease do not hesitate to give us a call. he Departrnent's address,telephone and fax number: The Commonwealth .Of Massachusetts Department of Industrial Accidents Office of loxestluatlons 600 Washington Street Boston,Ma. 02111. fax#: (617) 7274749 phone#t(617) 72774900 ext. 406,'409..or.. 375. The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division Tom Perry, Building Commissioner 200 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION nn ] q Please Print DATE: �f`�II I f% �a0� y JOB LOCATION: number)�" ) p street village "HOMEOWNER": ��G'[tit ( 14/1 f y name home phone# work phone# CURRENT MAILING ADDRESS: �/y(�P'o G Coty1T '444- o�l3S 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 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said proce ores and equirements. 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 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a ' form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION T Maps Parcel 003 Permit# Health Division r 4, Date Issued ? Conservation D 'v+son C_ Feev`�� Tax Collector. SEPTIC SYSTEM MUST BE 'i J Treasurer aJ (,c) 9 . INSTALLED IN COMPLIANCE WITH TITLE 5 Planning Dept. ENVIRONMENTAL CGD,�."-. AND, Date Definitive Plan Approved by Planning Board TOWN RECULAT.IONS Historic-OKH Preservation/Hyannis Project Street Address ?7 1 W T Village Owner Al�G�ta�l t ��i t Q Address 3 WOO C I Telephone o + �d ' nn e c )9 e Permit Request r- 3 I� �i p r _ 6 .X 10 e6 .x �_k Square feet: 1 st floor: existing proposed 2nd floor:existing proposed Total new Estimated Project Cost �1- 00 Zoning District fleJ&gryAA`lFlood Plain Groundwater Overlay Construction Type Q,C Lot Size 4proX Paz b Grandfathered: ❑Yes ❑No If yes, attach supporting'documentation. Dwelling Type: Single Family W( Two Family ❑ Multi-Family(#units) Age of Existing Structure ,17- -e4 Historic House: ❑Yes O 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 19 - r Heat Type and Fuel: ❑Gas Oil 0 Electric 0 Other Central Air: ❑Yes jONo Fireplaces: Existing New Existing wood/coal stove: J4Yes 0 No Detached garage:0 existing ❑new size Pool:0 existing ❑new size Barn:0 existing ❑new size Attached garage:0 existing ❑new size Shed:0 existing 0 new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION G� Name I C h a-e l w 4 T Telephone Number Address 3 ���� �- License# Home Improvement Contractor# d w y Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE U��i DATE r FOR OFFICIAL USE ONLY PERMLT NO. w DATE ISSUED MAP/PARCEL NO. � ADDRESS . VILLAGE �r OWNER 4 f DATE OF INSPECTIOI` ' , FOUNDATION FRAME - - - INSULATION _ FIREPLACE z ELECTRICAL: ROUGH') FINAL ' F PLUMBING: ROU644 -s ` FINALrl GAS: ROUGH- == {- FINAL FINAL BUILDING 'y r DATE CLOSED OUT } ASSOCIATION PLAN NO. i ti , The Town of Barnstable • a�►aivsr,►si,E, • 9 � Department of Health Safety and Environmental Services Argo �" Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. t 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 btilding 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: Estimated Cost a Address of Work: W by t L Owner's Name: 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 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 owner: Date Contractor Name Registration No. OR Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts Department of Industrial Accidents -��� �� =�� Office ol/nsestigations .. :. ,: 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance davit worl in�icanv^rr/tf�`arura(�no r1, )��//�///,%%%'�"'� p' ' name: /V` C l 6t� 6 t/V / \ location. 1 `�/n t L city Lo 1-14l * /V1 14 hone# 7 U 7 I am a homeowner performing all work myself.. 17 1 am a sole proprietor and have no one 11111,113 'kill'!I,! 7acity Ex ❑ I am an employer providing workers' compensation for my employees working on this job. comonnv name: address: ::;:•.. ... . :.::.,; ::. AN: phone#• insurance co. oi/iicv# ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have w , the follo«ing workers' compensation polices: comonnv name: address: .<...:..::..;.:; dtv: phone#- insurance en. oitev# //m/// // eamnanv name: :..::::..,.. address- city- phone#� iruarancc co. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a tine up to 51,500.00 and/or one yearV imptisonment-as well as civil penalties in the form of a STOP NVORK ORDER'and w ine of 5100.00 a day against me: I understand that a copy of this statement may be forwarded to the OlUce of Investigations of the DIA for coverage verification. I do hereby certify under th pains and en(alld ojperjury that the information provided above is tru,-and correct Signature G "C--� Date -U 4 Print name / " "1 G�a el w 4 t f � Phone# I 7 o y� [contact use only do not write to this area to be completed by city or town otIIdai own: permit/Itcense tl ❑Building Department ❑Licensing Board kif immediate mponse is required ❑Selectmen's Offlee❑Health Departmentperson: phone#; ❑Other w. .:......:.:.; (mvea 945 P1A) Information and Instructions j Massachusetts 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 cow z: 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 more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receive:c: trustee of an 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 that every state or local licensing agency shall withhold the issuance or renewa: of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not pSoduced acceptable evidence of compliance with the insurance coverage required. Additionally,neitherthe.. 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. i Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers along with a certificate of inctn-,nce 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 regarding the"law"or if you are required to obtain a workers' compensation policy,pleas e call the Departcaeat at the munber listed below. FINFRIF 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 fill in the permit/license number which will be used as a reference munber. The affidavits may be returned io 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 nay T=Stions. 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 Offlce of Invesdoadons 600 Washington street Boston'Ma. 02111 fax#: (617) 727-7749 ...phone #: (617) 727-4900 eat. 406, 409 or 375 I stone .Pat i n ----- I L- - - 7 7 `v Cat -- ------ --- --- __--- 6 sr t 10 - I ! _ -71 T ` s ho we,, er��lo4, Deter: 1 X�t Daek for i w l/ P.T, Po s rS } t - Larry rt _ r rigg /rs Y r X� PourPd i co—acr—ems Soho t Dec c 1-0 fcz-LOn fI ,,hG 1 b ., 0 Graf P ��T �X4- PoSt't �rrr �= ....._...._._._.._._...._.._,.........._ P.T. )- 1 c Nxg P.T, 47 IA Se 5 71 Assessor's map and-lot •number_ /p • � � 1�� Q��f TOE♦ ��pp�� THE Sewage Permit,. number 'Soft STEM M o„ ,� SYSTEM ......... ... . . ............ '"VAL'& 04 COMP,House number .......:.... � . . STABLE. :ILE, i R wtTM TITLE 6 EAMRONMENTAL COO yar a. TOWN OF �BARNSr. .ITACB'� NTI-�� r. BVILDIN�G INSPECTOR APPLICATION •FOR PERMIT TO ........ R,Cl......,Q,?......e4................. q E' . ......................... j,J , TYPEOF CONSTRUCTION ...........................4, l4n. et'/............................................................................................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ......zat,...#.... (.✓....A.............1'Y�f.z !.:5.......11,7............c,],4cp4zr.......................................................... Proposed Use .......... ............................................ Zoning District .............4„6 `l�l. "..:........................................Fire District ...............� ................ Name of Owner ... U...f�' �....�:....�� t. .........Address .d.��..../1 ! ...: C�:........J..�.!/. �l�i .... Nameof Builder ....................................................................Address ....................... ..................r....................................... H ....Address .........' Name of Architect � ..................................... .......�......... ..........:....�.....................��............... ......................... Number of Rooms ......................0/,,.f°..................................Foundation .....���........... c'��l F'17 ......kl&ll................ Exlerior ............... ...Roofin�.......//1 g ..........Ap4 /z............ f��� �s Floors ...........C G"//.P.. . .........................................................Interior .................. � .................................................. ...... /�� M• Heating ...... .'.0,00/..........Sreye.. ...................Plumbing ......................A..J....................................................... Fireplace �4 .............Approximate Cost 7.4?®'0J Definitive Plan Approved by Planning Board _________________________ ------�9--------. Area . .....rr............ ........... .. Diagram of Lot and Building with Dimensions Fee � .1� SUBJECT TO APPROVAL OF BOARD OF HEALTH r 2JT� 73 CIL 1 N I la 1� F� 4_ • ts. �cr �_��• 1 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ....... .. ........ ..%?'V. ...................... ' WHITE, RUSSELL D. No Permit-for ...ADDITION ...................... ....AG. 9 P 1;Y tO Dwelling .......................... Location ...L.Qt.AL.Whi.te..'..s....Lan.e...#.3 1. White' s.. ....... .. .. .... r ,, s ................................................ t D Whit 10 611� -.0 Owner ......................!��..................... Type of Construction JEK.Z_AMf�.......................... .. ......... ................................................................................ Plot ............................ Lot ................................ Permit Granted ............Sept6mber__�29...19 80 ........................ Date of Inspection ....I................... 9 Date Completed ............. ,.00'.7A_F_5..........19 PERMIT REFUSED 19..................................... -0� ............. .................. ar 12.1 ............................... ................... r t A, P-4.................................................... . . ......................................................... Cr Approved , ............................................... 19 ........... ............................................................................... ............ ............................................................. Assessor's map and lot number .: R.,k................... t C�THE Sewage Permit number .......�!�.4,,K. ... . ��,�nar/•......... BARNSTABLE, i House number #�?......................................... 9�C M639 e0�........................... ,sue 'F0 N Ar, TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO 66� ft............. TYPE OF CONSTRUCTION ...........................if.�t� r ......................................................................................... .... ..................... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ...... .`...... ....%?�J .. .......1�....to.. ..... �� /i'.......... �...... ................... ................................... ProposedUse .......... ............................. . ............................................................................................................ Zoning District ? '« .....................................Fire Distric ............... - .............................................................. Name of Owner .!?,":l� ./,)......?! ✓!.:.s ?".........Address .................I......... ...............!...../>:.........�3r%.<�?'�:�...... Nameof Builder ............:.......................................................Address .......1..,........................................................................... Name of Architect .............Address Number of Rooms .....................:c'?� !� ..................................Foundation .....X ........ u✓c// Exterior f..:..:�.' ' !- ........&/ Roofing !"1,..5P/. .lry" S �t.J.� R' .............. ....................... .J.... ...................... Floors ` /�1. �� .......................................................Interior ...zCi2;,a' ....... f , Heating :.....? ?r s.............................Plumbing .................. : .:................................................. Fireplace ..........................�1r�..................................................Approximate Cost ................... .......... ... !!Y?.:. lJ .................J.�.ij ........... Definitive Plan Approved by Planning Board -------------------_-----------19--------. Area 3.:>...............i!......... Diagram of Lot and Building with Dimensions Fee ......... 1..4. ~.............. .1.. SUBJECT TO APPROVAL OF BOARD OF HEALTH "' �• in �� �. � t 7a y I � I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...9.{/ .... .../�.. ^.:`.................. � WHITE, RUSSELL D. A=27-3 / ^ ADDITION No225.45.... Permit for ................................... � Accessory to IpIveIIimJ . ............. .------.'--.—.--.-----.. ' Lot A2 Whites Lane #]l ' Location ................................................................. Soutuit ` ............''...............................................................'. / R000eII D. White ` Owner ---------.---------� ---. / | . Type of Construction�u��ion -------------- ^ ` ` --------------------------' ' | � Plot ............................ Lot ----------'' � Permit G,onte6 -- �9.!l9' 80 � Dote of Inspection ------------lV � � Dote Con`o��a6 lg � . ------------.. � ` . . ���&�U� ������� v- ........................ —. —.. 19 ` f �q 1----'------. / � � � ----.—.—.—.—~~----------.----- ' ................................... ` ---------^~----^--^^--~~--~—' � ` Approved. ................................................ lA -------------`---^'--~^—'---'' . ' � -----'`----^-------~'—^—^^^'—^' | � s. .. y.:.... ,,, ,�1.t-.�:�,�. �., "*. .i- '`�'.4w ''M1r.'+ � .p�'„(y;�'�+j^K+n.'N/"��. fir'...-....s,D..`. ,�,,. _ �.r�.. .^.r•a.,�...r:cY"`,�.. Assessor's map and lot number r Sewage Permit number .......................................................... 'It"E.r°�o TOWN OF BARNSTABLE i BAHHSTAnLE, ° "6 9.Ar BUILDING INSPECTOR n wnr , APPLICAT1 N FOR PERMIT TO ..... ,,,Mt..s...r... 4k...................... ��,................................................ ..... TYPEOF CONSTRUCTION .........1„i) s -. ............................................................................................................ �- Via . l 9. .7 r. ....... ........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: rLocation .....3.1......... � 1.! ...'.........:............................... .....:....:................................................................................... ProposedUse ..........�....�...........:�...........................�.......�.........�................................................................................................ 1 ` „� l�. T Zoning District ..............................................(....,......................Fire District .......;........................................................................ Name of Owner `� :.�.�...... Address '31 ��,+`�es 1AnV SCLV,tu-;+ ...........................�................................. .................... Nameof Builder, :..............................Address ..................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .Foundation b Ci ......................................................... ��V INS d� 1�- ) Roofin C1S��al �......Jtl►Ytl'eS....................... Exterior ...................�....�V.LA ........ .......a...................,........... g ................................ Floors ....................... � 1 .......................................Interior .................................................................................... ........ Heatin 1,u ? ......5 4 t�--!t?_ Plumbing 'Vl :... g ..................... ............................................ , a-ts-t. zr-o FireplaceApproximate Cost .................................................................... Definitive Plan Approved by Planning Board ________________________________19________. Area �.�....................... Diagram of Lot and Building with Dimensions Fee ..!..C?.as� SUBJECT TO APPROVAL OF BOARD OF HEALTH r � e • 91 T1r�i IL d� s' ieb I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. � p� �,/' ` !�%�F�� Name .... f�...... ................... White, BmaoellD° A=27~3^ � No —l9l94 .. Permit for � ���-----..---- � ' � . ' -----------..------.--.----- ' ' v � 31 �b1tm m Lane . - Location ---------------------. - Saotu�c . '--------'----- ' - � � Owner . Russe D. White . .. Type of � � � � R � � Date oInspectf ""'= Comp let . . . ' . _ ~ ' . ' . . � PERMI REFUSED 19 .---. --. —` .-------... . v ....................... .............. —^---'''^--''---- � . � ............. ............... ......................................... ....... � � Approved .......................... lg ' ' --.............. ............. ..........'................................. ----------------------_--.. Assessor's map and lot+number ....... .../....�... ............' 7 SEPTIC SYSTEM MUST BE vl �'� INSTALLED IN C MUST NC v f Sewage Permit number ......... . . ...'................... _ WITH ARTICLE II E : SANITARY CODE STATE OWN OF7NE T�� TOWN O F B A 1N"TP`A � Z 3 STeDLE, "AB" 9 BUILDING I INSPECTOR �p 163 �0� 3 r APPLICATION FOR PERMIT TO .....CM*1: Tf�.!lS,! .... t a-g. .......................................................... TYPE OF CONSTRUCTION ..........W.A.P4....... + .......... ........r..........19,7.7 4► . TO THE INSPECTOR OF.BUILDINGS:The undersigned hereby applies for a permit according to the following information: ii f I , , II ,l Location .....3.(.........W.E�.tT ,.......L.( .11. ................... �.Y�. . ..I....................................................................... ProposedUse ........ .�?Z< �r.1 .....-..S .° J�. . a!�¢5.................................................................................... w.t.l............................... Zoning District ................................................ Fire District ....cof..... r ........................... Name of Owner . �ISSS',%. .1...... ,.......`�v.Cl.l.f..�.......Address 3! s L� S ...... W�, e ............n.�............. C n.:LL1 Nameof Builder ....................5(:k. .-..............................Address ...............:.................................................................... Name of Architect .................Address Numberof Rooms .........................)........................................Foundation ..... ...................................................... Exterior .................. ) ...... - i �.............Roofing ...........G.C..S...11P..�...0",1+ .................................. Floors .......................�Q/,Y")!1 ........................................Interior .................................................................................... .. .. PP " d� ...........Plumbing ........... 0. Heating .............W...R�..Q..........5.....e'41e.-.................... ..... ....nn......................0............................ .......................................Approximate Cost .... .. `/............................... Fireplace ......................�.�......... pp ...................: Definitive Plan Approved by Planning Board ________________________________19________. Area ��� . ... .................................... asp Diagram of Lot and Building with Dimensions Fee ..J. .................................... SUBJECT TO APPROVAL OF, BOARD OF HEALTH _ 3 S, z � � S� F • r , 578' z9, Na L S I rs'L•, a� ' 1 flp 0 of /I V PIA I hereby agree to conform to all-the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... ... ...... ........ ....................... PPP' White, Russell D. 19194 age No .................. Permit for ...garage....................... ....................................I........................................... Location ..............3.1...Wh.i.te a***Lane....... .......... A ............................ Owner ...............Russell....I...... .. .. . .........D. White.e...*............... Type of Construction ...............ffame........................... 4 4. ................................................................................ Plot ............................ Lot ........... ................... z 151 Permit Granted ...........MA . .....:�jq 77 y.. ......... Date of Inspection ...........................- 19 Date.,Completed ......... ..... .......... ...ig � :v REFUSEDr", PERMIT 4 .................................. ..... 19................;4 ....................... ............................................... ...... ........................................................................... ............. ................................................................... 14 1 . . ......................... ..................................................... Approved ................................................ 19 ................................................................................ .................... .......................................................... ' " � _.OSAI-IDLY.C41tuSt.ES � - -r ¢IoGE VFi,lr ... 1. :. . —I-1— 243•L..(.3�. 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