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HomeMy WebLinkAbout0083 WILD WAY Q A .� �,s _. _. �� ,. �• AA Town of Barnstable Building ld� 1,,:'A?' g�.,,' '�'' �• � ,�e "��, ,ri yr.... rp`.' .; :/�xi��" ���� "�fe� .,? F 3.Xr`.` �•1�y ,�.,�� �I .�y`.✓, 2,�," ^n^sxF3.e�waw,u � •n ?Post�Tliis:CaPdSo.Th"at rt is:Uis�ble From�th�e Street-A ,;,roved:Plens,Must?be;Retamedon Job and,this"Gar':d M•ust`be Kept �z,. �fx Pp' `l y�... a M" "Posted639- LlntilFinal Inspection Has Been Made s, d y � u Where azCertificate:of Occupancyas Regwlred;;such Buildmg'shall Not.bekOccupied•until aF•inal Inspection has been made : Permit ...«5 ,... .c o. ,», :.�..:.;.-k.:r. ., .<„%. a.� ....r °w.�•...:�;... `...., „.. ,,. .:, s..,..,..:»;s�»..iw' tuT:,H :'x ,,,.,. -s F w.....<.a... ,...�,w-:3 .<<,,d ,,..ai.,_..a.....;.,�-., .Me. Permit No. B-20-1112 Applicant Name: Tim Sherry Approvals .Date Issued: 05/11/2020 Current Use: Structure . Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 11/11/2020 Foundation: Residential Map/Lot. 027-133-000 Zoning District: RF Sheathing: Location: 83 WILD WAY,COTUIT Contractor Name TIM SHERRY HOMES'INC. Framing: 1 , . Owner on Record: SONGER,JEFFREY L&PERNICK,RACHELD �y Contractor"License:" 163296 2 Address: 83 WILD WAY y" Est Project Cost: $45,000.00 Chimney: COTUIT, MA 02635 u r i- Permit Fee: $279.50 Description: Construct new master bath/closet in a first floor betlr°oom Insulation: g Fee Paid:' $279.50 Project Review Req: x � Dates 5/11/2020 Final: t& Plum mg/Gas b. Rough Plumbing: „g s . This permit shall be deemed abandoned and invalid unless the work authored by this permit is commenced within six mpnths,after issuance. Final Plumbing: All work authorized by this permit shall conform to the approved appl cation and the approved construction documentsfor whicFi this permit has been granted. All construction,alterations and changes of use of any building and structures�shalLbe in compliance with the local zoning by laws`and codes. Rough Gas: This permit shall be displayed in a location clearly visible from access street o61road and shall be maintained open for public inspection for the entire duration of the work until the completionof the same. ' Final Gas: The Certificate of Occupancy will not be issued until all applicable signatures by the Bwlding and.Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work:i' p q z a r 1.Foundation or Footing c f Service: 2.Sheathing Inspections Rough: 3.All Fireplaces must be inspected at the throat level before firest flue",lihi, >isjnstalled. 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation 7.Final Inspection before Occupancy Low Voltage Rough: Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department �- All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: Assessor's offin-e (1st floor): /�3, �� �n�. ��� FTNE Assessor's map and lot number .................. .......,1..,�;-,�.r...... Board of Health (3rd floor): Sewage Permit number ..... ................................................. Z 99Hd9TAXE, i �. Engineering Department (3rd floor): ,G,, 5 r a m' � ��O1639• �0 Housenumber ..................................... ............................ a' APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00.2:00 P.M. only TOWN 'OF BARNSTABLE BUILDING INSPECTO APPLICATION FOR PERMIT TO ....154.. ...... . ....... . ........ ............. ...................... �.. ......................... TYPE OF CONSTRUCTION ........1Xj,�2 ........ . ... J ............................... ......................... ............... ................ ........Ig..W.;7 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit actor ing to the following informat'on: Location ....... / l/�/�C/� �5l�`�V,� TUiT i ProposedUse ...................................................................................,..:......................... . . ......... ............................ Zoning District ........ .... ........r�...........................................Fire District ............. Name of Owner .:.,!f . ......... ..'. .. . ^................ ......A dress I—I)AAA. Name of Builder .......................................i. .......... ....Address ...... ................ ......................................................... fc Name of Architect ..................................................................Address .................................................................................... N mber of Rooms .... ....................................Foundation ........... ..... . Ex1e for ..... ...... ................... ... ............................Roofing ................... ....... ....:..................: r ............................... Floors ...........-,,7 ...... .�....�l..... .......Interior ..................... ....... ........................,.;......................... t 1 n Heating ........... ..t. ✓.....................................r'..............Plumbing .................../.v...�.......... .................................. r CJy ' ._......Approximate Cost Fire lace l�t.ti-.�<........ ....�......9.d..Z.k ......C'a..�.�w.'�................................... Definitive Plan Approved by Planning Board ----------- --v_----------419 Area -- .....��J Diagram of Lot and Building 'with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH 1 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS r I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r�,i.n. the above construction. _ Nam . ............... ...........................................J. .... + .. `..r Construction Supervisor's License .. . J HILARY LAUREN R. E.� TRUST A=027—;M—Tj00 —13 ' J r No A A.13+8:3.. permit for .... 'l.... . ... ........... Sin le Farl� J.N7 Dwelli 9............................................xl j.......... Location ... L s�...:r��' 83 WiId.. kVa �t.................... .. �......... ...................�l J............•....................... Owner ..H l.ary..Lauren,,.R.....E......Tr.u,st Type of Construction ..,F):. .Me.......................... .................................... ..................................... Plot .:.......................... Lot ................................ Permit Granted ....Noy, k? x,•.5..F.......19 87 Date of Inspection ....................................19 ' Date Completed ......................................19 l 30o ,- 1 Ass�eTsor's, offioe (1st floor): . / s, Gd Assessor's,In+ .ap and lot number .. ....... -9,9.r.... u 4 ..°f rNf tO�` P ' Board of Health (3rd floor): // Sewage Permit number ....V � 5� Z DAUSTABLE. i Engineering Department (3rd floor): - ��� ras ^ ��O 1639. Housenumber ......................................�...................�........ APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only TOWN OF ` BARNSTABLE BUILDING I SPECT0 APPLICATION FOR PERMIT TO .... . ...... r. ............ ...................... . .. ..:....�".`" ,.�,.... TYPEOF CONSTRUCTION ........ . . ........... . .. . ................ .............................. ......................... ................. /.._�........19..(J TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following informat'on: A�,tLLocation ...../,. .' .... . ........... ..a........ .. .... v.". ....9..... ......`�.......... .... �T��. ' . ProposedUse ............................... .................... ......................................................... ....... , Zoning District ........-.... .. c��'/�? .Fire District Al Name of Owne . ...... ress . .... .................. ............... .. S I., � z 3� Name of Builder .: '.......... ............ ......... . :... Address ........................ Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ................. ..... ..... ....................................Foundation ........... ..:.. w`.:...... ................... W.C� �% ... ...........................Roofing f L'�JR Exlerior ........ ..,..... .................................... Floors ............Z........... ..... ........ ...... .... L.!!!` (.......Interior ................. .............. ./� Heating. ........... -.4''. . .........................................o.......Plumbing ................... ,....... ....... Cl�- ............. - Fireplace ..........�. .. .. ..... . ... (. .... .'�,__.....Approximate Cost ......(;.�•.�`.� ................. ............ . PP Y 9 �If`(19 Area Definitive Plan Approved b Planning Board ___________� _ ___ _ Diagram of Lot and Building with Dimensions Fee .ls................. SUBJECT TO APPROVAL OF BOARD OF HEALTH ,5D J jOCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS ..1-z I hereby agree to conform to all the Rules and Regulations of the Town of B rnstable regardiacLthe above construction. Na .. . .. ..... ....................... ... CC.Constructi n Supervisor's Lid nse .. .v . �(:f �alp R s # Permit for .....ZW.Q... ....... _.....aingle...Fami.j. . D.W.Q. Ijn. Location .LQ.t... .7. ......0...Wild...Tn7U.y........... X r ............... CU Sul. ............................................... Hilar Lauren R H Owner ...................�?.....::....::...........................>r:1d 1 Type of Construction F.;~'.c MQ............................. Plot .......................... Lot ................................ i ,Permit'Granted .......... 8-7 November...,�......19 - - Date of Inspection .l:1.,5..'.F.�......... ....19 Date Completed' .. �..0:� .......19 LI pitMF>O. 1 ( TOWN OF'BARNSTABLE permit No. 313,$ ,,,,,, ` BUILDING DEPARTMENT �. J Cash r TOWN OFFICE BUILDING r' """7 Y� .a HYANNIS,MASS.02601. P Bond ......X..�r . CERTIFICATE OF USE AND OCCUPANCY L, Issued to Dennis Ducharme Address Lot #7, 83 Wild Way Cotuit, Massachusetts USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND.IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. September . 7 19......$9....... Buildin Inspector ..� °�. TOWN OF BARNSTABLE BUILDING DEPARTMENT 4 »rAuSa % TOWN OFFICE BUILDING tg i039' �� HYANNIS, MASS. 02601 MEMO TO: Town Clerk FROM: Building Department DATE: `�—00 An Occupancy Permit has been issued for the building authorized by Building Permit, #........._. l�»-� .. ............................... .. ....................._» .» ...»..f.... ..........»»»» issued to/'/'—/ / J�2' .. ..... /,�. `•....../ hC/;.. .......».. »..»»»»»».....»»........ .»..»»..» » » Please release the performance bond. TOWN OF BARNSTABLE,.MASSACHUSETTS B U I L•,D I I`I G PER t�111 ' A 617-133 TOO -133 Coo DATE ti 19 PERMIT —{tr'7"'�+`'lc'IiCT� t� '�-- it•`' � APPLICANT. ` ADDRESS—IF! `q•RE � '—"`-gU61t PERMIj TO h I STORV ,,,, NUMBER OF. r R eNp I R E)TNwe WELLING UNITS J1T (LOCATION) 2 �3 Nil&w , i ZONING .1 '. — NO. STD E Et E°rii �t� ' DISTRICT BETWEEN'' AND (CROSS STREET) (CROSS STREET) 'SUBDIVISION LOT LOT BLOCK—SIZE BUILDING IS TO BE FT. WIDE BY FT, LONG BY FT. IN HEIGHT AND SHALL CONFORM;IN:QONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION ' - .. r (TYPE),:.' REMARKS:' a $*t2TY3X S?7 5[t F Borid AREA OR VOLUME r ESTIMATED COST ` FEEMIT CLUB QUAR FEET) 2Zf/i o :uC Q u�_ .OWNER ADDRESS _� �flix _ BUILDING DEPT. . BY FROM THE DEPARTMENT OF PUS WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIOt, OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ASPECT INSPECTIONS REQUIREDTHREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE-SEPARATE ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQU!RED FOR ELECTRICALI. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL, INPLUMBING STALLATIONS.D 2. PRIOR TO COVERING STRUCTURAL QUIRED•SUCH BUILDING SHALLNOTBE OCCUPIED UNTIL 3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.OCCUPANCY. , POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS -- - ELECTRICAL INSPECTION APPROVALS L�JL " 6 V'JL�h.ly T l n !A Z . pL. �j-. rS- -��i • I. 1 3 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT OTHER fir? t- 2 6 _E�n BOARD OF HEALTH_ WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT tv! ---- TOR HAS APPROVED THE VARIODUS STAGES OF WOR L BECOMEULL MONTHS OfDVOID IF SDATE THE INSPECTIONS INDICATED ON THIS CARD CAN CONSTRUCTION. PERMIT IS ISSUED AS NOTED ABOVE, ARRANGED FOR BY. TELEPHONE OR WRIT11 NOTIFICATION. i i" Lo -F 8 t .2 i_0.76 d' Qd LOT r Q i Z 1 5 3'7 S•F `� • T o K li J 71 M N J _ z Z-L 3 � OPEN 5PACE PREPARED FOR SVU-FH CAPE FEALTY CER TIRED PL 0 T PL AN LOCATION- NIARSIONS JJILI- MA. SCALE "= D: DATE Oc-r 2 !q 87 REFERENCE! LOT -7 P. B. 4-33 P. 3 L.C. P. _ FLOOD ZONE aria of a I HEREBY CERTIFY THAT THE BUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GEoa GROUND AS SHOWN HEREON AND THAT IT DOES y CONFORM TO THE ZONING BY-LAWS OF THE TOWN OF 9Pbl sZ-A.B[.-E WHEN CONSTRUCTED. SUR,4 LOW d WEL"ER, INC 7/4 MAINS TREE T 0 C 7- 79 7' YARMOUTH, MASS. DATE -,g 094 V Engineepng Dept.(3rd floor) Map' Parceli!23Permit# I 33 House# `F� Date Issued 7-6 7 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30. -J0­9 Conservation Office. 4th floor 8:30- 9:30/1:00-2:00 a�aS . ( )( ) P 1�STEM MUST-BE Pi 1st7oor/ iir-fig') INSTALLED / {;E W ate_ 019 ENVIR®N DE AND TC . rfor INNS CGS TOWN OF BARNSTABLE ii Building Permit Application ;y Project Street Address , l L- ! � Village Owner n,v .� �;��.` �, i u P. Address �s n,V-A C, Telephone 0� Permit Request LA i IM O L� ' X ) (p TQM)1 y4 Y`a YIN First Floor �,. �I square feet Second Floor square feet Construction Type i Ll (0 W a(7j n Y'cDoyn Estimated Project Cost $ 4� {6E48.. Zoning.District 14 (JS ;r�e,,,, ;rl, I Flood Plain Water Protection Lot Size L r, Grandfathered ❑Yes ❑No Dwelling Type: Single Family C@ Two Family ❑ Multi-Family(#units) f . Age of Existing Structure rs Historic House ❑Yes ®No On Old King's Highway ❑Yes a No Basement Type: ❑Full ❑Crawl. ❑Walkout C&Other _bcaw, 5 o n cx Tu h?S Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths):Existing �9 New �_First Floor Room Count Ll Heat Type and Fuel: W Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes,site plan review# - Current Use Proposed Use Builder Information Name. ����r � Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE UILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) 5 t` FOR OFFICIAL USE ONLY -� (33, PERMIT NO. _ j ' DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE ' OWNER i r DATE OF INSPECTION: FOUNDATION t FRAME INSULATION FIREPLACE + ELECTRICAL: ROUGH FINAL . PLUMBING: .m '">ROUGH FINAL . GAS: TROUGH FINAL f FINAL BUIL*W P - I— low DATE CLOSE `r t ASSOCIATIOIfi David And Julie Myett 83 Wild Way Cotuit, MA 02635 Map # 027 ' Parcel # 133 LcG .a i f �j�✓' .UNd�r�Ry S. cDX / J 1! David And Julie Myett 83 Wild Way Cotuit, MA 02635 Map # 027 _ Parcel # 133 CIC ettAnd Julie M s David Y 83 Wild Way , Cotuit, MA 02635 Map # 027 Parcel # 133 j G II David And Julie Myett 83 Wild Way t Cotuit, MA 02635 Map # 027 Parcel # 133 3� �mcyc Skyi,ftiF �x,$),� l N I gKy I•ft,F `\NVI Y V THE The Town of Barnstable MAS. • �xrrsrnBt.E. 1Q�. `0�' Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date 4 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: ( on SjYU G 00deh YDO'VNEst. Cost�� 0 ; Coo Address of Work: Ln� J W/ Owner's Name T)a v i (A GL Date of Permit 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 x,s g 2-- Date Owner's Name 1 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE -EXEMPTION Please print. DATE JOB. LOCATION Number Street Address Section of town "HOMEOWNER" V dl M u e.-C L (Y 0�� ���a�-`1 1,90 S ' �}•L�:�l�� - Name Home phone Work phone . - fir• PRESENT MAILING ADDRESS ^ � W City town State Zip code The current exemption for "homeowners" was extended to include owner-occupied dwellings of six units or less and to allow such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one 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 Officia on a form acceptable to the Building Official, that he/she shall be responsibl for all such work performed under the building permit. (Section 109.1. 1) The undersigned "homeowner" assumes _responsibility for compliance with the Sta Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE ��� � yl APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109. 1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for . licensing Construction Supervisors, Section 2.15) . This lack of awarenes often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home 'bwner-' actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her responsibilities, man communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. TheCUI11111f11114'culdll lJfMassachusea Department of Industrial Accidents office 51190=921150S r \ i :_'r 600 ff uAin-ron Street •� � ,�� Boston. Ma.u. OZIII Workers' Compensation lnsurancc Affidavit ,- -._.a..- ..._...�. --- �lpplicint information• ^- ..__..._ _ Plc�se PRINT lebi il� , locition• 1 A) t A W 4 k4 city L t 1 /,AA phone ��) ��a i' I am a homeowner performing all work mvself. 'C] I am a sole proprietor and have no one working in any capacity •'.M��.-_.��I_.w.......-_w�.+'.7Msr...f�t�RT•"w�wi'.;1.7�'��'.�Tv _ .. _ I am an a tplover providing cvorkers*compensation for my emplovees working on this job. cninyinv name• address- cin•• nhnne�!• incurnncc cn nnticv# A"WI am a sole proprietor. ;eneral contractor. or homeowner(circle otte) and have hired the contractors listed below who ha% the following workers' compensation polices: cmmn•Inv n•tmc• adrlresr city! phone#- policy insurance co # .�..,. cmmr)nnt' name• addressc rite phone�#• insuranc co "olio•# Attachadditio 7 _naisheetifneceisaryy.�- lave'—• r~•.YN•wrJL Failure tti secure covernec as required under beetion:5A of 1►1GL 152 can lead to the imposition of criminal penalties ol"a lineup io S1.500.00 andior unc.cars•imprisonment:is well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Once of lnvestig2tions of the D1A for coverage verification. i tlo herehr certif-guider ih•punts and penalties of pei jury that the information provided above is true and correct. Signature Datc Print name /)C( Phone# .� Official use only do not write in this area to be completed by city or town official city or town: permit/license tY r911uilding Department [ C3ucensing Huard tC3 check if immediate response is required 0Sclectmen s Office t.. :. C3tleaith Department phone#: nUther�— contact person: .. Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' ec)ntpensation fot employees. As quoted loom the an etnpinree is defined as every person in the service of another under an contract of hire, express or implied. oral or-tvrinen. An rmplt rcr is defined as an individual. partnership. association. corporation or other legal entity. or any two or the foregoin�u, enLaged in ajoint enterprise,and including the le-al representatives of deceased employer. or the receiver or trustee of an individual . partnership. association or other legal entity, employing employees. Howevc 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 dwellin, or oft the ;,wounds or building appurtenant thereto shall not because of such employment be deemed to be an emp: MGL chapter 152 section 25 also states that everystate or local licensing agenc,% shall withhold the issuance e renewal of a license or permit to operate a business or to construct buildings in the commonwealth for an• 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 pertormance of public work until acceptable evidence of compliance with the insurance requirements of this chap been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation c Supplying company names. address and phone numbers 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 requ to obtain a workers' compensation policy. please call the Department at the number listed below. City or'rown5 Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the botto the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returr 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 quef please do not hesitate to avive us a =11. ►^•7V...�.+..�. ...._ _.•-v.w... ..�+....rr.r...•r_»�r.�.v�-.s��.r...�..—....�.r�w��.+�w ..._ Tv..��.�» The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washinaton Street Boston,Ma. 02111 fax R: 617 727-7749 i 1 .,� ° o� The Town of Barnstable �. r BAE.Q Department of Health Safety and Environmental Services 9 MASS. 0 Q> tass .0 QED MPS a Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner Inspection Correction Notice Type of Inspection —� r� k Location 9'3 W, �� Permit "Number Owner ' Builder One notice to remain on jobsite, one notice on file in Building Department. The following items need correcting: r r "-C_ 6)/1 y p-:P 2 /V f ( -j A( •v o '7' 11 cX9 rt%A� mJ R 00 r -T c S f r . i, -r-t .y y�►�� rz� i-�s e- e-✓ cu 2 3 — fine 2 e c - W A n, JVIVTJ r r V4P2"6 ..tom o y.P A) ?f i 11d.-t-!c n A l hLT' T7� 0 73 c�, S Please call: 508-790-6227 for re-inspection. Inspected by Date �� � l l Engineehag Dept.(3rd floor) Map 0 0?'�_ Parcel/��- �d�4_ ermit# House# Date Issued 49 -.20 —2? Board of Health'(3rd floor)(8:15 -9:30/1:00-4:30) a 7 ��� ( Fee Lt,S,00 ' G Conservation Office (4th floor)(8:30-9 30/1:00=2:00) c- !S Riolannin Board 19 ' p : BARNSTABLE, MASS rFO M9. PS e` �! TOWN OF,BARNSTABLE Building Permit Application Project a meet Address ��i r!cl b c�.. ` Village!'- Cc, / i Owner o[ , J- L.f £ JM\ Address Telephone F J Permit Request )- z ' First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 10 C� •o� Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Ne"). Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other )A ej Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑'Oil ❑Electric ❑Other { Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ty ❑Attached(size) ❑`Barn(size) ❑None 'shed(size) �X /❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes //1110 If yes, site plan review# Current Use Proposed Use SI Builder Information Name `� Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE o'_-ZJ 4'4 % 01 —DATE �t A PERMIT DENIED FO HE FO G REASON(S) e n+ f FOR OFFICIAL USE ONLY PERMIT NO. � � l�/� ' i . • , _ 4' r _ � � . ` _ ` • 1 ,,.,�=� ' DATE ISSUED .' - MAP/PARCEL NO. I ADDRESS VILLAGER OWNER _ _r DATE OF INSPECTION:. r �` FOUNDATION FRAME INSULATION FIREPLACE _ - f ELECTRICAL: , ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH � FINAL ' FINAL,BUILDING `a 1 F F DATE CLOSED OUT. ASSOCIATION PLAN NO. f € ' ) ti t M t ccloft azanrt Ju k A. Km ie 4 David A. M yeti jloc4dm0fPvvPertYtAUr3tMS Mills : lof-8 + 2. Set a _t - `deck.- .. ; lot • y`.. ssy' fi,.. Y d n .ht.� 'Ar i37� - z opm `spa ee_ . Y } C' `s.^'e.+ M�)s' � < `.�.• J y- F F-Sy ! I �� .ems• T v , is a l -{...- ; • Yn x 1 i -`" i X.: `z'C'" w7� 4 fi �., yy • ^ ''' C, N of+ S r'...� a J... "� F .�., ...... � X tttf: 3 f�Oo .pan¢C 250 Oat �0/5C flO fortes 2 ftere6y certify tfat'tf is pCari,fhu deew r' - �N Of �I� V Y it A o PAUL ¢ shtown f�er6 down t falC u�•a.s T azarCAr wii.AtL a ct'ive cfaz 8=1 A.S5� Lnr COC�ArLOYV CROVER tie oCwe rrn,to Cacal' 6 -Caws: u-v z •� No.313 1 of -.GO ° y cr ar dit tune construction, wak respe�r twnri TE ram to Cy re»ienrs. i Cart,w�a�s nor macCe o su �'' .' . .. _... . . .p for nuor ng p C,s or for use tr�pr parul9 feed'o scrtpttons Ueri.�icazz°n t 6 �Ce�catwtvs,property firw dimes ions,fewces or Cotes COYLfLtratLO 1rlAy 6e acco fi QQ&f An A,CCUraro-'" l9 --' iniWto -kri rve w`ucfim,ayre Cecr r>rn� rrnatiort� b ',E: �2-to-9� fh4W Wk4r ts,skorawt, ereow. • or a�orrgage purposes on Fie too=' c1,o 1 � 52 11; COCl2 1rZC. O 269f2XWVM SCPEeC, I lamw a.,+I -,zme• phor 2E 6t7 t326.11M. PX Q S26 462'5. z - x 1 s i j �i t4l JL AA ;t 1 i l i , \ y A ! r7 V o� 1 V i ,j , 1 f �e � .. { � is i \ ' .:j 'a � �F �'A 3, Y t. �� � r * .jam r _ t S .. ,,..b. .:�, k a 'a . : .: 1 , . , fi � z d : ���,� - .. q i i i � r � � i �� I s � . � r { •,. I . � ` I • a • TOWN OF BARNSTABLE ' . • BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION _____________=-__-- Please print. DATE JOB LOCATION Number Street address Section of town "HOMEOWNER" a v d k ?,ss- i�6. Name Home phone Work phone . PRESENT MAILING ADDRESS S'/ ` -` City town State Zip code The current exemption for "homeowners" was extended to include owner-occunie dwellings of six units or less and to allow such homeowners to engage an in- divid`u`al for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Persons) who owns a parcel of land on which he/she resides or intends to re side, on which there is, or is intended to be, a one 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 Offic. ' on a form acceptable to the Building Official, that he/she shall be resnonsi:. for all such work performed under the building permit. (Section 109. 1. 1) s The undersigned "homeowner" assumes . responsibility for compliance with the S Building Code a c nd other applicable odes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands ..the Town of arnstable Building Department minimum inspection procedures and requirements nd that he/she will comply with said procedures and requirements. OM.EOWNER'S SIGNATURE LPPROVAL OF BUILDING OFFICIAL ote: Three family dwellings 35 , 000 cubic feet, or larger., will be required 0 comply with State Building Code Section 127. 01 Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which a building permit is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that if Home Owner engages a person (s) for hire to do such work, that such`-Home OwnE shall act as supervisor. " ' Many Home Owners who use this exemption are unaware that. they are assuming the responsibilities of a supervisor (see Appendix 0, Rules and Regulations fcr . licensing Construction' Supervisors I Section 2. 15) . This lack of awarene often results in serious problems, particularly-when the, Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home ''Owner.' act=. as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware o I f his/her responsibilities, ma: communities require, as part of the permit application, that the Home Owner certify that he/she understands the responsibilities of a supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. ' fi THE A The Town of Barnstable UMMAMa ""M& Department of Health Safety and Environmental Services "9. Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crosses Fax: 508-790-6230 Building Commissio: For office use only Permit no. Date O 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: S h e C Est.Cost d D Address of Work: 3 L-)'�Cc t",`` Owner's Name U d �- t Date of Permit Application: q I hereby certify that: Registration is not required for the following reason(s): _ Work excluded by law Job under S1,000. Building not owner-occupied Owner puffing 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 a 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Date Contractor Name Registration No. OR /i X i o gg i s a E 177 cm �QO l AS i N a ado W 111 p o < < !„ 3 e- o W .°° c `w' so fyo� •�. Igo< s �» z J 3 z o z z \ G O g Io- �� G�i/, � Ov �' O W Z oOe d O � eve � \ � � N •C O � 3Z V O O Q LL 2 O O d y NMI O Big! Syl ! �... �ooH _ W ; �� Sall o,., Q , r'✓I i� 1 1 x �'\ ., lit { X i .. U m im z a< �z OPGet N 6 qspg will / O ly k' x r' �y� i W ; W , , , r ;J . .( i \I / r 1,' /;' ' �••• �n I Y' / ; CO CID 0 Ln if 'i I a t / r , f1 00 \ `r • 1p O l , j , ;•\ ;( /\ j/ •it�1.._'^`. .tom , 82 op Or C2 . .Oc. p G � I .tea n I �o•Z3 f ... I ND Ta . E)CTE�I%b ALL APPL/Cr4 f3LE F L- -- — — -- q q r7 al .-o,�"i/e G •• e x/sfi r rou � G F-1 E . / /o ---�---- � G ,C -� � � N _ 1/E �' T, S G�1 L E- : /� � /O' „ /`7ANf-lOG.E. COVC=A25 '10 W/TH/A.l /2 O _ F � i I • r»inimum % '! Er �c�o-f 2- layer o.f` peas ne I SHHED 40 P. '✓.C. 0/2 E'�' P { I EQUr9G. TO SEP'�c P/P� Yo BE 3.ryrAl• 1'`a" —IAJ,� LEvEC. Fo2 i NT , ., 4/Qu/D D/57 B Ox LEVEL 1 314 /ZZ" T 0 O GAL. 5 E PTI G . . TA�.l l�C s�: tiIF , I 3' old 82 g2 EACH P/T { / 2 /0, 76 4-1 1 t nd \ f { V' � tjElir`JGG/-I HG /SE � A%��= 7- - 51. 7�EST 4ti/ LOWS! �.✓ELL6 � . !/NG rho- dis o5�r FTC GA S. 1FAY. A - w Z 000 r ,o• J 7•07-o`9 G. 4 i ( G.P.D. -AG+� PIT i.(I 3 CC >UF NI D1Vh 2 2 2.4 6 /t/O sr` I THAT T/- E FEU/L !JVG W "i- E R P2©p0$E D OA/ THE G12 7CJNU AS CNCOUN rb7RE-0 i Sy' OWN tON TH/5 PLAAJ D06-5 cc�A/Fo, M -ro Tf--rE gv/Lz�ll�lG sir- S/ T E 5 E 1AJ1q G E PL?e; l,J - ,E'E oo1A2`EMEA-176 OF THE T�. GJ/V 0P :FOR : o T `� /7 B, 7�G'i *u �✓I L, D \, /A y TO NS - MILLS �o ceoRce \ PREPARED FOR: .,S0(A'r,P G AP EE R FA L TY ' t.ow. v 2i8 c SCALE: AS AIOTED op-rc— u L.Y yl f A. �i11 yG pL A N C 2a,z I! C x rs4-1 rn q C /e va.-fi on B L D G. S E 70 A C/G o•oo _ pr'-oposcd e /@vatlo» f2EaL) QEMEAj76 AP. ROVED . L O�,J L` 4o%)E L L E2 x c r74 o vr•s �'r-o n f' f'f. B O F� D O F HE A L I"f--,f S 9 0 51 de. l5 4 MA/N 5Ti2EET I s—..o_tee_. e _ Pr•OpOSE'd COr-��-OUrS � ,_ Mf=1 Ste• YA,2h'lOU?'H PDl2T, MASS.,. I ---- PRo�E55loNAG CAJGINEEf25 L?gAJD SUQVEYUPS _ _ n