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i 0-, 9 t 309,„m . Town of Barnstable *Permit'# t t•w
. ,� 3-• Expires 6 m the jro issue date
e S � Regulatory Services Fee d . `)
'* BARNSTABLE. Wi l I
t 6 / Richard V. Scali,Interim Director
i639. A% '/EC
Fn ' 2013 Building Division
TOWNTom Perry,CBO,Building Commissioner -
N4�BARNSTABLE 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 351 / 059
Property Address 115 Kevene Lane &$- �1` ''�/I
1
[`Residential Value of Work$ /5\. 41'D Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address Timothy R.Halloran
2 Powder House Road,Dover,MA 02030
Contractor's Name Robert G.McCarter,dba Construction Services Telephone Number (508)420-5753
Home Improvement Contractor License#(if applicable) 177129 Email: rgmccarter@comcast.net
I
Construction Supervisor's License#(if applicable) CS-051404
❑Workman's Compensation Insurance
he�zic one:
u, I am a sole proprietor
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
Insurance Company Name
Workman's Comp. Policy# I
Copy of Insurance Compliance Certificate must accompany each permit. I
if)Permit Requ t(check box)1 Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to I 131�y`i�
❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof)
['Re-side
ErReplacement Windows/doors/sliders. U-Value 6 3 a (maximum .35)#of windows 1
#of doors:
O Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required.
Separate Electrical& Fire Permits required.
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
required. 1-4611\)
SIGNATURE: �
T:\KEVIN D\BuildingChanges •XPRE S ERMIT\EX RESS.doc
Revised 061313
l'Ai lb% . .
• BARNSTABLE, •
,, MASS.
,. • s -.' - Town of Ba'r°nstable` er ; , , ' . F .,
A i evr s
;F .f - ‘1.4 a v 2 E E x: 1,y..l L 1. e r. ' ecS '' z:c'd"[ 1
.. _. _ : . .. r Regulatory;, Services... . . u; .
:1� rrx.e-•'C: ,.t. -ri .1.1 ,s,,;_4.1.,...Y .r .. .' .. :1 ..1..1:,fi,t1 r 4.
r7 . •; s:o"'r.S.=, r'r ..—,r i, d v. I'i.,c ..•;Richard V.Scaly Interim'Director .,. _ _ •_ ,._ :.•,til .. , ;r.
Building Division .. ,, ,Y,,3,-, '. `
Thomas Perry,CBO t
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, Timothy R.Halloran , as Owner of the subject property
hereby authorize Robert G.McCarter,dba Consruction Services to act on my behalf,
in all matters relative to work authorized by this building permit application for:
115 Keveney Lane,Barnstable,MA
(Address of Job) 1
T _ .
\i° AffiV Za 26 I 5---
Signa ure of Owner . Date
' tivTimothy R.Halloran
Print Name
Robert G.McCarter
If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the
reverse side. • • ,_
_9,, }'_ II.:;.` Z_ ,
{
T:\KEVIN D\BuildingChanges\EXPRESSPERMIT\EXPRESS.doc s - fr -t - '._y
Revised 061313 1
.
oF ,, Town of Barnstable ..,•
Regulatory Services
BARNsTABLE, ' ;. , f':'.T>iornas F.Geller,Director r.
MASS
9 �-en �`�$ 14 I ,Building,Division
,,Tom•Perry,•Bnilding Commissioner
200 Main.Street,,Hyannia,MA 02601
www.town.barnstable.ma.us
Office: 508-8.•-4038 el VII ,t41 , • :rl . .,-,, ,,,„ Fax: 508-790-6230
HOMEOWNER LI M SE EXEMPTION
• Pleas •rint
DATE: —
JOB LOCATION:-
number s,r village
"HOMEOWNER": r 1 r i I :. i '. 7 i l l r`r
name , -home phone r 1 wo phone 4
1. `atZ'). fl� '
CURRENT MAILING ADDRESS: r
cityrlov.. state zip code
The current exemption for"h. eovmers"' extended to include owner-occupied dwel ngs of six units or less and to allow
homeowners to engage an dividual for hire • o does not possess a license,provided at the owner acts as supervisor.
DEFINITION OF HOMEOWNER
Person(s)who owns a parcel of land on which he .1 a resides or intends to reside,on ich there is,or is intended to be,a one or two-
family dwelling,attached or detached structures ace=.sory to such.use and/or farm • ctures. A person who constructs more than one
home in a two-year period shall not be considered a h• eowner. Such"homeown shall submit to the Building Official on a form
acceptable to the Building Official,that he/she shall be ponsible for all such wo performed under the building permit. (Section
109.1.1)
The undersigned"homeowner"ass .• s responsibility for cot liance with the..tate Building Code and other applicable codes,
bylaws,rules and regulations.
The undersigned"homeovv, er"certifies that he/she understands th Town o'Barnstable Building Department minimum inspection
procedures and requires.-nts and that he/she will comply with said p .ced':es and requirements.
s ,�l ,c' ,13 ..
Signature ofHomeo er
Approval of.:. ']ding Official ; = i
Note: Three-family dwellings containing 35,000 cubic fee or larger will a required to comply with the State Building Code
Section 127.0 Construction Control. •
HOMEOWI\ •'SEXEMPTION
The Code states that: "Any homeowner performing ork for which a b ' ding permit is required shall be exempt
from the provisions of this section (Section 109.1.1-Licens'1 g of construction Supe ' ors);provided that if the homeowner
engages a person(s)for hire to do such work,that such H.11 eowner shall act as supe\iisor."
Many homeowners who use this exemption are 'naware that they are assuming`the responsibilities of a supervisor
(see Appendix Q,Rules&Regulations for Licensing",nstt ucton Supervisors,Section 2.IS") This lack of awareness often
results in serious problems,particularly when the ho•.eowner hires unlicensed persons. In this case,our Board cannot ,
proceed against the unlicensed person as it would h a licensed Supervisor. The homeowner-acting as Supervisor is
ultimately responsible. \\
To ensure that the homeowner is fully a• are of his/her responsibilities,many communities require,as part of the
permit application,that the homeowner certify 'at he/she understands the responsibilities of a Supervisor. On the Iast page
of this issue is a form currently used by sever• towns. You may care t amend and adopt such a form/certification for use in
your community.
C:\Users\decolliik\AppData\LocallMicrosoft\Windows\Temporary Internet Files\ConttentOutlook\QRE6ZUBiNT\1 RESS.doc
Revised 053012
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map J 5 ) Parcel 0 Permit# 04-9-I
2-0
Health Divisiontio:6 � Date Issued 1 �L `®
Conservation Division ` t O///Of9 ' _ Fee �5,y, SG
Tax Collector • ge-- _:77:, CYST 7 6 .
�D E ; `C bLLED IN CO M-IP:KC I
Treasurer ( v j o O WITH TITLE 5
Planning Dept. :ENVIRONMENTAL CODE AND
TOWN REGULATIONS
Date Definitive Plan Approved by Planning Board /Lei -'
Historic-OKti Preservation/Hyannis
Project Street Address . I 1 5 K EVE KA E 11 t__ ram►E 13f'�-R N STTA:s3 L_�. .
Village -6A'2.1.,i 5TA-6>✓E . .
Owner Ti i't I-tA% L—LORAN . Address 1 1^1 K P5 C.t 14 " C T . gl9 5'1-73 0
Telephone 6 ► -7 3 4 s 3 8 0 3 °
Permit Request RE-71—‘41 CE. K t T c , iY U t L 0 1..k e.w D L K.
-P--a PI— cC-E ,X1S 1.T11-., Ls- wtrsChow 1 N L^1ti ► w ( 2 A,1 W ►TR-4-
E Ki C, D O'O P 5 . RE 13U t L- 17 PI, ff,.VL-tPre.-E ° o reloon, I
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Valuation 7 9t51C�.3D Zoning District Flood Plain Groundwater Overlay
Construction Type .
Lot Size 542Sct.a s • P • Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Nit/ Two Family ❑ , Multi-Family(#units) .
Age of Existing Structure Historic House: ❑Yes d'il'&o On Old King's Highway: i± 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 Half: existing new
Number of Bedrooms: existing new
Total Room Count(not including baths): existing new First Floor Room Count
Heat Type and Fuel: CGas ❑Oil ❑ Electric ❑Other
Central Air: 0 Yes tNo Fireplaces: Existing 1 New Existing wood/coal stove: 0 Yes C '�lo
Detached garage:0 existing ❑new size Pool; 0 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 ' I N (L E PA V i t--k- 1 Proposed Use 5 Pt M t~ . '
1 BUILDER INFORMATION
Name (D� S 1 L-V I Telephone Number "7'7 5 1 4-4:-
Address 1 G M_A't tr‘A S T License# Or&M
LE► I—re IZ V I L.L.E. 1\/i lam-- Home Improvement Contractor# 64</pa�
0 2.40 3 Worker's Compensation# TC09- 8314/9
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO -6- - • or O iXf- r
.11/' AcT O Ks T'i 214 C'�lj ,
SIGNATUR ,� DATE 7c:>/34c).
1 • FOR OFFICIAL USE ONLY _
• - 5 • p* }
PERMIT NO. -
DATE ISSUED 1xg r
a . . , . .... . _ , .. . . . ,
MAP,PARCEL NO. �, - . c: �.
,ADDRESS: ° VILLAGE
OWNER, • F - ,
j -
:r _
''
k DATE•OF INSPECTION • - N. - E
FOUNDATION
FRAME 1 1 fri ?
INSULATION -
FIREPLACE 1 0 ' `
ELECTRICAL: ROUGH x FINAL `° _ _- # :'
PLUMBING: ROUGH FINAL %`
GAS: ROUGH - FINAL =
i.
FINAL BUILDING -. _ - , - ,�
H
1 I,I - / i lt
DATE.CLOSED OUT - t - ,
f• .,
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ASSOCIATION PLAN NO. - C.-
•-
.• it
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1
roc,THE Ip�
' ' 'j* •' °� The Town of Barns
table
• Bnxrrsrnai.e. .
�� " �' Regulatory Services
ArEDA'ta Thomas F. Geiler, Director
Building Division
Ralph Crossen, Building Commissioner
367 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 notmore 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: lei i,a`h 0/U: "`-, -- - -Estimated Cost
Address of Work:---//5 Vt'il`�/ f lJ`e—, a ri 411,,1`e-
Owner's Name: //fY1 79q/f0 rq j1
Date of Application: 9 a� .
I hereby certify that:
Registration is not required for the following reason(s): -
❑Work excluded by law
-- l - ❑Job Under_$1,000_f. _.. - -. _ _
['Building not owner-occupied
DOwner 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: / /
. . J(
Date Conti or Name Registration No.
OR
Date Owner's Name
q:forms:Affidav
ESTIMATED PROJECT COST WORKSHEET
LIVING SPACE
Value
(high end construction) square feet X$115/sq. foot=
(above average construction) square feet X$96/sq. foot=
(average construction) square feet X$57/sq. foot=
GARAGE (UNFINISHED) square feet X.$25/sq. foot=
PORCH square feet X$20/sq. foot=
DECK 35 o square feet X$15/sq. foot= 515 CD
OTHER square feet X$??/sq. foot=
Total Estimated Project Value
For Office. Use Only
----dnclos,onery Affordable-Housing► Fee
Residential - . - Commercial**
Property Owner's Name -
Project Location
Project Value Permit Number
**Existing Sq. Ft. **Proposed New Sq.Ft.
Fee $
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