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0062 BAYBERRY LANE
+, - - • 4 • • ',T.T u° ° . . y 51 Town of Barnstable * erg m1t# O a. Expires 6 months from issue Regulatory Services Fee (�'-- � • s,nansrnHs, • N 9. Thomas F.Geiler,Director Building Division Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number 335/ L A-40 S� O--t le. Property Address (pa QV rr L y am. Zesidential Value of Work 1�/'€� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ,a-PAIL 0 f�,pr►n a 3 ' - Aye. 56 ���I " y iQ a��iQ as Contractor's Name Sprinkle Home Improvement Telephone Number 508 775-1778 Home Improvement Contractor License#(if applicable) 103757 Construction.Supervisor's License#(if applicable) C J gy9(0` '4' PRESSP ERM t Workman s Compensation Insurance SEP 2 1 2011 Check one: _ I: 1 am a sole proprietor TOWN N (�F BAR S I PF�L� El am the Homeowner I have Worker's Compensation Insurance Insurance Company Name AsSnCi industries of MA Workman's Comp.Policy#AWC 7004943012011 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ggpp-� (' ;'�LL'e-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to kiry.01411 (Wi der Q6 ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) , ❑ Re-side #of doors ❑ Replacement Windows/doors/sliders. U-Value (maximum.35)#of windows 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: . Property Owner must sign Property Owner Letter of Permission. A co y of the e Improvement Contractors License&Construction Supervisors License is re SIGNATURE: • C:\Users\decollik\AppData\Local\Ivticrosoft\Windows\ mporary Internet Files\Content.Outlook\DDV87AAZ\EXPRESS.doc Revised 072110 l �- .t. -rvoill ,, , , ,,Y 1 ,) , Town of Barnstable Regulatory Services Thomas F.Geller,Director Building Division Thomas Perry,CBO Budding Commisdoner 200 Main Street Hyannis.MA 02601 www.town.barastable.ma.us 0fce: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, )CatxVn2S CY LonnoQ as Owner of the subject property heoeby a„ „,e Sprinkle Home Improvementto act on my behaliy in all matters relative to work authorized by this building permit application foe rr 0. ltcd fJob) V 09-0,n4, ;„. grivx.1.4.L... 9/5-A Signature of Owner Date `)rat vvv d e...pAiiko Print Name If Property Owner is permit,p ,please complete the Homeowners License Exempdon Form on the reverse Revised 072110 Waa e Mica othWfodowdTempoaty Immo FIesTooteotAodooldDDV87 1 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION • Map 7� Parcel ©& . . Permit# Health Division oS O i ' Date Issued I —0 S' 5T . Conservation Division �) � C�g '� � � Fee ?'�/ 1 I I OTA!l D IN COMPL1ANCr Tax Collector 1 i , _ WITH TIo"L 5 grao u N v 5/ Treasurer 1C,1341 R7GULATIO vC. Planning Dept. Checked in By Date Definitive Plan Approved by Planning Board Approved By Historic-OKH Preservation/Hyannis Project Street Address 4 Z Village 46. �, /,a-,rrn5 �i--��a. Owner J/� �5 0 ��2i1 Address Go' Telephone ,�• Permit Request ,� �dGL/Z-Gr) A / /G /2- ' 22/5, L, c Square feet: 1st floor: existing 'h, (��proposed ' 2nd floor: existing " proposed ' TTtl Valuation //OP-7 Zoning District Flood Plain Gdwater(krlay Wrdl7n ' Construction Type w Op 44 Lot Size 1 3o 7 5 Grandfathered: ❑Yes 0 No If yes, attach supporting d cumentatl3n. r- c m Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure V� ', " Historic House: ❑Yes 11'1Vo On Old King's Highway: /X‘s ❑ No Basement Type: 'ull rawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 000 f.- Number of Baths: Full: existing v new Half: existing new Number of Bedrooms: existing ✓ new / Total Room Count(not including baths): existing new First Floor Room Count 7 Heat Type and Fuel: ❑Gas 1UiI ❑ Electric ❑Other Central Air: QXes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑exiting ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage: eisting ❑new siz lf- Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ri, iKo If yes,site plan review# Current Use W P N Proposed Use BUILDER INFORMATION - - - - Name 8cZ) �� Telephone Number j Address 2,0 ‘DX G 7 77 License# 1236 /i/ ' " `r/ °G ?/y10v Home Improvement Contractor# //40tO 46 (9)-3( Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO /�/71/1 ri -( SIGNATURE /y/ DATE /( Z� 0c ‘. • FOR OFFICIAL USE ONLY PERMIT NO. . 1 . - . . DATE ISSUED , 2 MAP/PARCEL NO. . . - . ... . ADDRESS . VILLAGE • . , 1 OWNER . • - • L ._ DATE OF INSPECTION: FOUNDATION i /4 1 /"9 e x -„ /V.,b'r pRori5-kute eio i.-.4)°""j1"- FRAME 0,-- - 44 INSULATION Or- ‘*---4V 1"-430- 9------6 c fp , ,.... FIREPLACE - - t ' , ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL -.- FINA!..BUILDING - ,r: , . . ., ,. DATE CLOSED OUT i A ASSOCIATION PLAN NO. ,..,. 1 , • , '.. . __. f RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE • New Buildings • $100.00 Residential Addition $50.00 Alterations/Renovations $50.00 Change of Contractor/Builder $25.0.0 FEE VALUE WORKSHEET NEW LIVING SPACE tr/ square feet x$96/sq.foot= x.0041= f plus from below(if applicable) ALTER& NOVATIONS OF EXISTING SPACF$47674?-- square feet x$64/sq.foot= x.0041= ( 1 �o plus from below(if applicable) . - bo GARAGES(attached&detached) square feet x$32/sq.ft.= x.0041= ACCESSORY STRUCTURE>120 sq.ft. >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf- 1500 sf 100.00 >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0041= STAND ALONE PERMITS Open Porch — x$30.00= (number) Deck — x$30.00= (number) Fireplace/Chimney .— x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) al 4 Permit Fee j Projcost Rev:063004 7i0 CUR Appendix J • Table J5.2.1b(continued) Prescriptive Packages for doe and Two-Family Residential Buildings Hated with Fossil Fuels • • • MAXIMUM MINIMUM Wall Floor Basement Slab .Heating/Cooling • Glazing Gig Coning Perimeter F,quipraetrt Etlidetsrye Area'(%) U-value' R-valu.a R•value' R-value° Wen pPackager R-value' R value 1 5701 to 6500 Heating Degree Days' Normal. Q• 12% 0.40 38 13 19 10 6 6 . • P. 12% 0.52 30 19 19 10 8S or Normal g 12%" 0.50 38 13 •19 10 6 •N/A Normal .._.0.3.6-.--._.__38 13 • 25 N/A -- --T-- --- —6-- --Normal-.-- ----- - 19 19 10 . ..v..,.,. .'iS•h � 0.46 38 13 25 Na N/A 85AFUE .:. V.;.::. ;., .:IS°/. 0.44 38 19 .. 19 10 6 83 AFUE .. W .. 15%. 0.52. 30 N/A Normal X 18% 032 38 13 25 N/A N/A Normal y 18% 0.42 38 19 25 N/A 13 19 10 6 90 AFUE Z � 18% 0.42 38 6 90 AFUE AA ' 18% 0.50 ' 30 19 19 10 I. ADDRESS OF PROPERTY: b 2- 4147, eø' A1/11/1//,ew77, /5d-- //,57;i-i,gz 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS:. 3 2S . • 3. SQUARE FOOTAGE.OF ALL GLAZING: • • 'iQ 0 - .• 4. %GLAZING AREA(#3 DIVIDED BY#2): • ‘9`S •' . • • 5. SELECT PACKAGE(Q-- AA-see chart above): X • • NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS .• ARE AVAILABLE. ASK US FOR THIS INFORMATION.• • • BUILDING INSPECTOR APPROVAL: • . YES: NO: • q-forms4980303a 1 780 CMR Appendix J • Footnotes to Table J5.2.1b: doors, skylights, and • ' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass 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 uirement. For example,3 ft2 of decorative glass may be excluded from a buildingdesignwith 300 ft2 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 11.5.3.a. U-values are for ' whole units: center-of-glass U-values cannot be used. ' ' 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 3.8 insuyation iiiay be"stibatituted'for-R-49-insulahonr Ceiling R.'values-represeflt the sum of.ofcavity— 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 electric resistance heating use compliance approach 3;4, or 5.. If you plan to install more than one piece of heating equipment or more than one piece of cooling equipment,the equipment with the lowest .efficiency must meet.pr exceed the efficiency required by the selected package. . • • 'For Heating Degree Day requirements of the closest city or town see•Table J5.2.1a . • 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 11.5.3b. 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 different insulation levels,the component complies if the area-weighted average R-value is greater than or equal to the R-value requirement for that component.Glazing or door components comply if the area-weighted average U- . value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). . . • 43 K‘)*TH. E la,� Town of Barnstable • Regulatory Services B"R''sz"BI'E' Thomas F.Geiler,Director '01f �(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 Property Owner Must Complete and Sign This Section If Using A Builder ; r I, \Y\-YY{ 0 COTh1 _ ,as Owner of the subject property hereby authorize TD1 ' S s 4— to act on my behalf, U Cam in all matters relative to work authorized by this building permit application for. (92- 6,Vf3L-ei0 V 4,11-- (Address of Job) / (').—(9 . °C-- Signature of Owner Date VAnit-3-- 0(CO) ii Print Name Q:FORMS:OWNERPERMISSION . .---- .-- ____ •s:„ .... ( --)— -T- 1 , • I f • i, i[ __ — 1 — - --- I , •, ! • . , 4..__. . r------_. — I I . - - - - - - - --------- ______ -- - --- - —1 77 i 1 ______ ________;___..._ ., „ , 1 j_414 _ i , 1 t • . —E t— 71 1 TT V — /4 -I— T I '1 1 I ! 1111111111'1-1. t f I _j_ , /4 , — i I l• 1 I ' i : \ ! 1 1 i i I Itill ' (I 1 . 1 .. 1 I- / I I il. 1 : I 1. i . 1i 1 , 1 , . 1, I I • / )(-1/ p6 . 1 1 ._ , i 1 II i . z 1 -1 —4,Cf,E1-- —7.-1— 1 ' i I ' i til Mk I ,-- k A - fv• i : 1 I 1 - 1 ! 3•'".1['° '-' I••• -.1.11/4 110 C7 . 4 I ei/' 5 Obl) Cit/ClilYC "gra'---- 1 1- frAiOajell e-kir vi(J5 1 44 // .k2... Ni. 'rle71%-1 . - 1ril wipplpiaiaLE- 517 1-7.- -\2 \ . / . L wile etp 0/106/.5.s . /4;111. c/S/Ajs" x -iv& xi5 -/46- - ,- - ' P/'.4d ev a D D Fi g Crnrrk vCTi v7V Cu'. g7GO( s _ i /X Ale el/ XG CMS/4/6 c>n/s rs e /G ®L - o DxAl G PT see- VV'A gr� 11 eftS/rcc ir4 C'rDss secT/v v Z /54-y -/. t Ae4,, ji* lee n >1 • t.... -71 --1 •1:-:1------ t-L1\- ----- -: -------- : .._.....' 7 1 . 1 1 4 1 1 1---__ WO PO.. iD /7-;(2A.1 2Z ' 12 ! _ i F/fill.'/4Y Re/VIM ----?, 1 , i 1 i I •. - I _., ... .._ t II 1.- - -L: --- -- — ! .. i f /'_77-7-67Z.-..--4,/ ! t . 7L- i . I / N.N kj ir,fr,74/LY R470414 • N 1 QK \ Ni ____r - I' I i ! 1 1.-.- --1-------- ,,- --' kA \‘`•_ OVeietrj Ravil-- rzi-o.noc. ,D4/, .9- ,oex t• ree-4- , 41 gA7/14att Z"it e-dr#,V5-e4./. 1 . • re3 I, • C 0)e , 2 Kv le,- c rrl b tet e, rf? 1 oo Vy5 v jer /// • &" c"col I `ler att 1 I - - 5-60,1- T OormeeK 3.t.".F1.r74s; • 2 /46 0 C p ft "C • . . • • 4.-X 71A 7 • • FRill`q NG PLAN • az BAYI3ERRY • _ J II , , LOT 14 - S9 �Opy 4 F LOT 12A i LOT 11 20.307 SF± • _ S7g'�8•Sp„ rF, E ��'�� ��.PROPOSED` SOIL 24,33� 69' SYSTEM �� '��� ABSORPTION --oPosED ;,0 -FOUND ADDITION . 1,000 GAL f-OPTIC TANK giiei.,.; 70• * FOUND #62 & /4)9 4 -a. `P- LOT 13A Rp• .5.97 �O J PLOT PLAN 62 BAYBERRY LN. CUMMAQUID BARNSTABLE, MASS. SCALE: 1"=40' DATE: 11/28/2005 ��P��; OF Mgss90 o= TIMOTHY t BENNETT ENGINEERING R. LP . jp� A LAND SUR EYING,ENGINEERING,&DEVELOPMENT SERVICES 8 BEN4�� -1 PLAN REF: 243-35 L`� ��I •/<,/- PO BOX 297 TEL.(508)888-4868 DEED REF: 1763/19 j� `� r� SAGAMORE BEACH,MA 02562 FAX.(508)888-4867 JOB NO: 0812 ° 4o so 20 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# g8 Health Division Conservation Division Permit# Tax Collector Date Issued Treasurer Application Fee v Planning Dept. Permit Fee 2 ,0 0 Date Definitive Plan Approved by Planning Board Historic-OKH Pr r..tion/Hyannis Project Street Address A, Village "41 ' Owner Address Telephone ck)Rj i\4\4c3 Permit Requ:. Square feet: 1st floor:existing propo%-0 2nd floor::.:t ropo Total newoning Distr -: . - • Project Valuatio' C. st ti. T pe 1K Lot Size `\, Grandfathered: ❑Ye• ■ N. ' - a ach supporting documentation. Pp 9 \‘ ) Dwelli Typ : Single mi ❑ o Family ❑ Multi-Family(• . its) Age o Existing Structure Histori ouse: ❑Yes ❑No On Old King's Highway: ❑Yes ❑No Basenent Type: ❑Full II awl ❑Walkout ❑Ot -r Base ent Finished Area(sq.ft.) •- -ment Unfinished Area(sq.ft) Number .f Baths: Fu .existing Half:existing new Number of ::• i s to:. 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 Detached garage:❑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 ❑No If yes, site plan review# Current Use Proposed Use / C BUILDER INFORMATION Name "J 1ES •�— , � � °�a r✓A/O 2 Telephone Number 6/7— �"—00,R3 Address g . L t y cr License# nix",m/91 t!i 0 r)4 4' d-2-e 3 7 Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 61, SIGNATURE �v DATE 7//,4-4 FOR OFFICIAL USE ONLY ,' PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE J - . 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. f ... TOWN OF BARNSTABLE Building ' �► Ti,. % Application Ref: 88822 , * BARNSPABLE, * Issue Date: 07/19/06 Permit MASS. �APeD NIA A�� Applicant: OCONNOR,JAMES Permit Number: B 20060669 Proposed Use: Expiration Date: 01/16/07 Location 62 BAYBERRY LANE Zoning District RF-2 Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 335062 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village BARNSTABLE App Fee$ 261.23 License Num OWNER Est Construction Cost$ 51,520 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND 12X22.5 ADDITION TO KITCHEN AND FAMILY ROOM THIS CARD MUST BE KEPT POSTED UNTIL FINAL CHANGE OF CONTRACTOR 7/14/06 TO PROPERTY OWNER INSPECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: OCONNOR,JAMES BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: P 0 BOX 67 INSPECTION HAS BEEN MAD . CUMMAQUID,MA 02637 Application Entered by: PC Building Permit Issued By: T)0.-44) , THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET,ALLY OR SIDEWALK OR ANY PART THEREOF,EITHER TEMPORARILY OR PERMANENTLY: ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE,MUST BE APPROVED BY THE JURISDICTION. STREET OR ALLY 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 CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 1 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). P ; u REOSTifa1(. : 1 HT IS iSIBLEFROMSTET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health I . • Town Of Barnstable - �cFTHE rp�, • 4 ,, „.. 9.0 • Regulatory Services • . • II stAB7. Thomas F.Geiler,Director • 79. �m Building Division• r�ArFD �s Perry,BuildingCommissioner Tom 2e y, - . 200 Main Street, Hyannis,MA.02601 www.town.b arnstable.ma.us • Office: 508-862-4038 Fax: 508-790-6230 • HOMEOWNER LICENSE EXEMPTION • • Please Print DATE: .7//3/°4 . • JOB LOCATION: 6 a 73 .3()2i'L-y I-4'✓E C u m►V►�tQu) o, y i . number street village "HOMEOWNER": /Erm 6S l— . 6GrIWu 6!7-028-/-008-3 .• -name home phone# • work phone# I CURRENT MAILING ADDRESS: 'Pa k 6 G err'm/a-q arm r79ia- o ? 6 3 7 . 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 of 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 regt» nts. Signa a-of Horneowner---""'"'"' • - -- -- • 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 perfomung 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 i 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 be/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 6.1HEr Town of Barnstable ti Regulatory Services sn f Thomas F.Geiler,Director "0 t : L Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 -��,:�... lf�ri Office: 508-862-4038 Fax: 508-790-6230 NOTICE TO THE BUILDING DIVISION OF CHANGE OF LICENSED CONSTRUCTION SUPERVISOR I, �I A--" ' . 0 ! Cd rr A,a i , owner of property located at 6 g 01#%4 c. 2- A/� Cc1 )21/-00 , hereby certify that I�LN Big e I J' is no longer Construction Supervisor listed on the application for the project under construction as authorized by building permit# ec9 D- , issued on RFC , 200 I understand that the project under construction must cease until a successor licensed Construction Supervisor, is submitted on the records of the Building Division. 7/ / 3 C PROPERTY OWNER DATE q/forms/newcontr reference R-5 780 CMR rev:080102 -4,rotio; -, 9: . Town of Barnstable .., ,,,-,,-..._ • Expires 6 nionths Irons issue date I BARNSTABLE. ; Regulatory Serviqes ' Fee /,, Q25e) • Thomas F.Geller,Director Ib_es e39. , —1.b PAO k . • Building Division . • . Tom Perry, Building Commissioner 200 Main Street, Hrrnis,MA 02601 X-PRESS PFP""-- Office: 508-862-4038 Fax: 508-790-6230 • • • EXPRESS PERMIT APPLICATION - RESrDENTW,,vvi v NLjutit_VL:AR N2:T5Ak;s. r_g Not Maid without Roe 1 X-.Press Imprint . - • lap/parcel Number f 5 o roperty Address (e 2, SAyRifegy 2.a.-- ght-gis-I-A_\0 ip • i Residential Value of Work?e.,2602) Minimum fee of$25.00 for work under$6000.00 / )wner's Name&Address ,V/7117t"3 (203)1./22-4-' • le Z 4/.4-Y6gEZ Y ,---- " • 7.ontractoes_Name geh k S •l-c ett- Telephone Number S72, . /7 2- 7,246. dome Improvement Contractor License#(if applicable) //06 Vil e-X . //• 3 •06, 2onstruction Supervisor's License#(if applicable) (936,3& • ,.. . . DWorkman's Compensation Insurance •• Chec0 ne: • . • I am a sole proprietor • 8 I am the Homeowner . . • 0 I have Workers Compensation Insurance . • . Insurance Company Name 145/t6 2.&v,er of," r Workman's Ccimp.Policy# Copy of Insurance Compliance Certificate'must be on file. • - • • Permit Request(check box) • • • E"Re-roof(stripping old shingles) All construction debris will be taken to &EA/s-fr.4.4„).- leie,t /--1( El Re-roof(not stripping. Going over existing layers of roof) - ' • • • Kte-side . OP 10 A. 1\ • El Replacement Windows. U-Value (maximum.44). - , • *Where mquired: Issuance of this permit does not exempt compliance with other town den( — i Ae -e—eath of,Azaaackaea • ***Note: Prop-. Owner must sign Property Owner Letter of* t,-,,-__1,-___- 1 Board of Building Regulations and Standards Ho;47 isi. oven:Lent Contractors License is required. , ! litif__- HOME IMf-R7 EMENT CONTRACTOR • ' CX-V9 ift Si Rectiotid --10644 gaature .:4 ,4100"r ,,,..,_ • ' -- --TEPI-61'7-71p/2006 ~ --=-----'----f., 7. —f Q:Forrns:expmtrg ' :.., . Revise063004 BENJAMIN AS :,- . BENJAMIN BASB --- .s„? _ • 64 River Street ''"-, z. ,''' -6.--e,„--47‘,1•-‘44- Plymouth,MA 02366 Administrator --= Town of Barnstable Regulatory Services 9'"'u' 'E. 'o Thomas F.Geiler,Director �'4rfp;�rA�` Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, (�'i I`i�3 00.7)/4 P ,as Owner of the subject property hereby authorize 36-4.) ` (4530 7 to act on my behalf, in all matters relative to work authorized by this building permit application for. 2 4i &— ,ey L/r (Address of Job 7. 2o Signature of Owner Date f'11E5 °Connor Print Name • Q:FORMS:OWNERPERMISSION The Commonwealth of Massachusetts .__._--- Department of Industrial Accidents i Office of Investigations __; �=.� 600 Washington Street _"_ z Boston,MA 02111 Wit'' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly . Name (Business/Organization/Individual): /5C/1 8 it __ Address: ç7. &7,t /7?7 City/State/Zip:��l (d 2 2Phone#: / g 0_Z Are you an employer? Check the appropriate box: Type of project(required): .- 1.❑ I am a employer with . 4. 0 I am a general contractor and I 6. ❑New construction 1oyees(full and/or part-time).* have hired the sub-contractors 2. ill I am a sole proprietor or partner- listed on the attached sheet t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9, ❑ Building addition [No workers' comp. insurance 5. ❑ We area corporation and its • officers have exercised their 10.0 Electrical repairs or additions required.] officers Pl repairs or additions 3.❑ I am a homeowner doing all work right bing ep of exemption per MGL • myself[No workers' comp. - c. 152,§1(4),and we have no 12. Roof repairs - -- - - t employees. [No workers' insurance required.] 13.❑ Other comp.insurance required.] _ *Any applicant that checks lion#1 must also fill out the section below showing their workers'compensation policy information ' t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp pnliry.Jnformation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify nder the •ns and penalties of pedury that the information provided above istrue and correct Signature: Date: 7'2 ' Phone#: C�P Vi 22 6. • Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' o underther i anyn their contact of hire Pursuant to this statute, an employee is defined as ...every person in the service 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 hous e or on the grounds or building appurtenant thereto shall not because of such employment be deeii7ndrhe i o t Y MGL chapter 152, §25C(6)also states that"every.stat&or local licensing agency shall withhold the issuance or renewal of a license or p ermit 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,MGL chapter 152, §25C(7)states"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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es) and phone number(s)along with their certificate(s).of. insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit 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,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials 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. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in • (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your 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 Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia � � Application to ' pOVpp��pO�NOV�N .. - . SpNO �PPNN�S 0p in _ A* E_` ��! Old Kings Highway Regional Historic District Committee Ii_ _:‘, d-0 in the Town of Barnstable for a 1 . CERTIFICATION.OF EXEMPTION Application is hereby made, in triplicate,for the issuance of a certificate of exemption under Section 6 and 7 of Chapter 470, Acts and Resolves o1 Massachusetts, 1973, as amended for proposed work as described below and on plans, drawings,or photo- 1 graphs accompanying this application. 1 TYPE OR PRINT LEGIBLY DATE 7' 26. ,o64 ADDRESS OF PROPOSED WORK 2 Ic.Gl ,6fIY La- • ASSESSORS MAP NO. 335(SG 2 OWNER J4 1eS C& ASSESSORS LOT NO. /24 HOME ADDRESS 50-C--- TEL. NO. AGENT OR CONTRACTOR 8 ,ti g/I ---77.-- ADDRESS 7•°' /. 90//r /77 7f_ /1 f v,rlf , i7 TEL. NO. .�oF 172- 702.1,,E 023l02_ This application is for exemption of proposed exterior construction on the ground that: ❑ (1) It will not be visible from any way or public place. (r (2) It is within a category declared entitled to exemption by Old King's Highway Regional Historic District Commission. (Check applicable box) PROPOSED WORK: Describe and furnish plan of proposed work,showing location on lot, and, if an addition is involved, show. ing location of existing building. lielo/4c e .t,(5/7/g woo . S i,e, root w I7L4 so m `e Os'e cei'` reio/ac‘c ex T! wood s� / side toci((' w s�`x wAdf ceargAl • r a.. QY (S. t yak h cx (St) Iv SIGNED Space below line for Committee use. Owner-Contractor-Agent. Received by H.D.C. The Certificate is hereby. . Date 14 \ °C Time ' By W Date . . Approved The categories of work entitled to exemption are listed on Disapproved ❑ the back of this form. j Assessor's office(1st Floor): 2��4 Assessor's map and lot number J� SEPTIC IC SYSTEM t�J$; , Mit to Conservation di 7 ] 2 — 9 3 INSTALLED IN COMP: /�'r, � �.w Board of Health(3rd floor): WITH TITLE 5(fl? Sewage Permit number :/ ' -fr V� ENVIRONMENTAL CO tti; `t:•;) , LE ;D Engineering Department(3rd floor): TOWN REGULATI• i6j0. .•4. House number o asr►• Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only . . ,_..• "'" "" TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO A MD e,,;)�{ J-77/.1-f 6.47a' 1 -,et,," il tr(''s ,c- TYPE OF CONSTRUCTION _ Ft,,,,L, r, 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies forra permit according to the following information: Location ra 2 3 ,ybervy t/ 2 c'c c' (c> u-1 IA-1's E. ( r Proposed Use ✓,-tie l f1 K Zoning District �P aJ Fire District Aidgr Le_ Name of Owner ^ 2 14.es C,tCd, a.,- Address /74-,_ ,cc,-, St 8�,,,L K H"I f o Name of Builder 4,911 yr are14 1.u Address / ''L,KLArLy St 6r. 1,.,.1.les Name of Architect Address Number of Rooms ^ , Foundation ^ Exterior /(9:41.61S I4VG� 'V 16 Roofing ✓d Floors Interior VO r 1/&1 14L 6- Heating Plumbing AO /L 'T, Fireplace Approximate Cost /'0-7,7, Area / Ve71d- CA LC. Diagram of Lot and Building with Dimensions Fee i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Q.,=-1-- Construction Supervisor's License 030 (9 5 �`� . O 'CONNOR, JAMES . z ~'" No 36034 Permit For BUILD DORMER «i ' - Single Family dwelling . Location 62 Bayberry Lane - - Cad rbOt1-1nS,( Ie , - ' • Owner James O' Connor _ Type of Construction Frame 3, ; Plot Lot r Permit Granted July 16 ,. 19 93 r. Date of Inspection 19 ` Date Completed /VA,3 19 . r f) y vyn4� -9 �- e T . , i♦ ne-n Kiss t•/ e d In -1 `- i.:,e Fr w„j ar' r. `ter_' ---.-r^s - i �" s . a•r ., • y .