HomeMy WebLinkAbout3096 MAIN STREET % //719,%✓ „Cr- vo
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August 19, 2013
Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA.02601
To whom it may concern:
This letter is to inform you that I, Gabriel Hall,owner of 3096 Main Street, Barnstable, MA 02630 have
changed electricians. Eric Stuart will no longer be working on Permit#201303701,we are now working
with Tim Willman.
If you have any questions or concerns please call me at(508) 362-6307.
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Thank you,
cp-n,46/.„,
Gabriel Hall
3096 Main Street
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Barnstable, MA 02630b
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W1/6 c )
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**r Town of Barnstable *Permit#
ti Expires 6 nth from issue date
�i,\°� Regulatory Services Fee
BABNSTABLE, % Thomas F. Geiler, Director
Mass.
9�P 1639. a,�� Building Division /p
TF1)�y�
Tom Perry, CBO, Building Commissioner
200 Main Street,Hyannis, MA 02601
www.town.bamstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
EXPRESS PERMIT APPLICATION - RESIDENTlAEY
Not Valid without Red X-Press Imprint A r ri c PEWIT
Map/parcel Number 0)),' ® V MAY ', h 1 f 1,I
Property Address 30 y 6 ft)qln sir, 15 il 5-0,19tt 1414 TOWN OF BARNSTAB( F
• 2 Residential Value of Work At Minimum fee of$25.00 for work under$6000.00
Owner's Name&Address G AQR,I e.L 444 4 LI,
3oga . n14.11,1 sr. 4 151"r94k{ AA
Contractor's Name K,/n 6 SS etve Telephone Number 507-. 6).6/1/
Home Improvement Contractor License/# (if applicable) * /547 oG G i IStLVL1Io'l LiCe1)S e 4 q qq d6
❑Workman's Compensation Insurance
Check one: .
Evl am a sole proprietor
❑ I am the Homeowner •
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❑ I have Worker's Compensation Insurance � ,/'
Insurance Company Name f)4 f/O4* // `(i
�• 6040 '. fit rJ L ,Ln,SUtlin ce 6' ,o#94 '
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box) •
Q/Et.e-roof(stripping old shingles a11 construction debris will be taken to 684r(Y Sr LC L b"ie) F( /1
A,epl4cl/7q iS/2M ./r 1Ql7h Aui Ce094_6 #47k,
❑ Re-roof(not stripping. Going over existing layers of roof)
Lam" Re-side
❑ Replacement Windows/doors/sliders. U-Value (maximum.44)
*Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Owner must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License is required.
� I �SIGNATURE: -�' x L
Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc '
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02om�,wouuea ✓�aa
oa�ueCla €� " a, s a.. .- . .. y, .,.� � t?� .. g ac' d ofice ofxConsum�rAffarrs&$trsrne�'Regulation j rceh4e oera li rid aly ,�; before theaprrton' te Iffound return to=i iFdgME IWIPROVEMEN` CONTRACTOR
° .r.� anon � 59 0 !: Office of Consumer Affairs and=Businegille IA t n s
Expiration 5L19f2012 I 10 Park Plaza-Suite;5170
Try, 293982 ! g �!4
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TYpe{' IVrt,)d drjEVW.5 Boston,MA02116
KIM M ASSETT`f. •
K(hA BSSE. ;s = i .
i 3775 mAIN ST ,_ =-. \--2G-'/)...i..0,C' ... .
CUMMAQUID,MA 02637.2
Undersecretary
Not valid without signature i
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jF�-- x. rt.ichusett�- pep rrnrnt ut• n,Rubi S.tre.t•i ,
Board of Buildings Rc tulatiou' and Standards I,
VC-cnstr'uctio.n Supervisor•Specr {1 license
Lt ' ={� SL 99406 • �. ,
Resrr eted to RF,INS,DM Y r
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KIM BASSETT ati kr '',
3775+;MAIN STREET • �` ..
GUMMAQUIO, MA 02637 t:1
,• - -� - 9 Expiration:- 12/1'2/2011
'L (Un1111i .Hitler. • -Tr#� 99406
t
- _. The Commonwealth of Massachusetts .
—�-- • Depm hnent of Industrial Accidents
1 .. 41t - Office of Investigations
t "till— P - 600 Washington Street -
1.e. 1a= a• Boston, MA 02111
y' � www_mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/El ectricians/Plum'bers
Applicant Informationhi Please Print Let=zbly
Nam e(Businessiorganizatioa11ndividuaI): 14i AI 6 4 55t1
• Address: 3�� /'/ ('4 t ,S r .
City/State/Zip: 3,4t.4 3 T,96 Li , i4. Phone.#: JscF--3C)-"$ 'L
Are you an employer? Check the appropriate boys: Type of proje-ct(required):
1.❑ I am a employer with 4- D I am a general contractor and I 6 New construction
. employees(full and/or part-time).* have hired the srilr contractprs
2.K I am a-sole proprietor or partner-
listed on the atlarhed sheet 7. [1 Remodeling
' ship and have no employees These sub contractors have 8. ❑Demolition .
employees and have workers'
working for me in any capacity. 9. ❑ Building addition
[No workers' couip.-msmance comp.insurance'$
5. We are a corporation awl its 10.❑Electrical repairs or arlrlitior
required.]
3.El I am a homeowner doing all work officers have exercised their 11.EI Plumbing repairs or addition
myself [No workers' comp. right Of exemption per MGL 12 ❑Roof repairs
insurance r t C. 152, §1(4), and we have no
• u�] employees. [No workers' 13.❑ Other
comp.insurance required]
*Any applicant that checks box#1 must also fill out the section blow showing their workers'compensation policy information_
t}lomeawnerc who submit this affidavit indicating they are doing all work and then hire outside contractors must subuut anew affidavit indicating such.
tCuntraetots that check this box must attathol an additional sheet showing the name of the subcontractors and slate whether or not those entities have
unq,loycrs. lithe sub-contractors have rsnployces,they roust provide their woricrrs'wimp.policy nurnber. .
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
' information.
Insnranco Company Narnr_ .
Policy#or Self-ins.Lie.#: . Expiration Date:
lob 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 mule."Section 25A of MGL c. 152 can lead to the imposition of criminal.penalties of
fine Up to$1,500.00 and/or one-year iroprisonmmt, as well as civil penalties in the form of a STOP WORK ORDER and a I
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 wider a pains•and penrlrfre of pedury that the information provided above is true and correct.
%t¼ •Si natrrc: 1 Date: /ll
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Phonc#: `, ` 7 PCs 3 2_,-. (,(�'(
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Official use only. Do not write in this area, tb be completed by city or town officiaL
• • ...City or Town: • Permit/License#
Issuing Authority(circle one): -
1..Board of Health 2.Building Depai tiuent 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6. Other • '
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(6-4--ThEro, Town of Barnstable •
Regulatory Services
...xtArtrAsty Thomas F. Getter,Director
"E'D 1,01,1 t` ' 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
le\siits,_
I, af\latla, k , as Owner of the subject property
hereby authorize ti614/14 rt OLNSittr, to act on my behalf,
in all matters relative to work authorized by this building permit application for:
?10 C. d.
(Address ofJob)
_ s_ ,
Sig7 e of Owner ' Da •
fabg.lc.. 4 A-0, •
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Print Name
. . .
- ' If Property Owner is applying for permit please complete the Homeowners License
Exemption Form on the reverse side.
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• Town of Barnstable
rest' .
1----,,pi..-04E
Ala, o Regulatory Services
.,..t.
"`°' Th Building pTfDs a Tom Perry,Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
\`
Office: 508-862-4038 \ F 5.08-790-6230, - ,, \ -
HOMEOWNER LICENSE EXEMPTION
l Please Print
DATE: .
JOB LOCATION:
number street village
"HOMEOWNER":
name 'r, home phone# work phone#
„G
CURRENT MAILING ADDRESS:
city/X,, stat - zip code
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The current exemption for"homeowners" ` as extended to include owne occupied dwellings of six units or less and
to allow homeowners to engage an individua' for hire who does not possess a license,provided that the owner acts as
supervisor.
DE'9 ITION OF HOMED `ER
Person(s) who owns a parcel of land on which lat he resides or int' ds to reside, on which there is,or is intended to
be, a one or two-family dwelling,attached or deta `-d structures :ccessory to such use and/or farm structures. A
person who constructs More than one home in a ar perior shall not be considered a homeowner. Such
"homeowner"shall submit to the Building Official • .orm :cceptable to the Building Official, that he,/she shall be
responsible for all such work performed under the bu, , •ermst. (Section.109.1.1) '
The undersigned"homeowner"assumes responsibility t.r co I,liance with the State Building Code and other
applicable codes, bylaws,rules and regulations. .
The undersigned"homeowner"certifies that he/sh- nderstan, the •wn of Barnstable Building Department
minimum inspection procedures and requiremen and that he/s' - will •amply with said procedures and
requirements. - -
Signature of Homeowner
Approval of Building Official •
Note: Three-family dwellings co e taining 35,000 cubic feet or larger \'ll be required to comply with the
State Building Code Section 127.0 Construction Control. \.
I 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 constii ction Supervisors);provided that if the homeowner engages a persons)for hire to do such
work,that such Homeowner shall act as supervisor."11
Many homeowners who use this exemption are unaware that they arc 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.undcrstands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by
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several towns. You may caret amend and adopt such a form/certification for use in your community. .
'« 4KI-I afprovec 7-1 R
Assessor's office (1st floor): 7 -/cam/
Assessor's map and lot number � V ,�., 'LJ(J.:NE
TO4�.„
Board of Health (3rd floor):
Sewage Permit number �Z
n __ Z D9D.J9TALDLE,
Engineering Department (3rd .floor): y �. - - +moo "639 s.
House number !/ 1.G �n -
�o NO a•
i Definitive Plan Approved,.by Planning Board • 19
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• APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00 P.M. only _ '
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TOWN OF . BARNSTABLE ' .
BUILDING INSPECTOR •
\\
APPLICATION FOR PERMIT TO s j�,J.Uti;..la -
. TYPE OF CONSTRUCTION ?ems± CkA ti k :e,,,( Y1G1 b(342 •
' Q5a. 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: .
Location 3..Q. .L...... .Q1r, S.1--, -8.cUL.nSt- ),1 _f la J_ t2 2...a • .
Proposed. Use . tl:(�S. .r91 P O'ir I . Q.,A c.5:41, - .'„,.,
Zoning. District R F c2 Fire District B.ml.h.. t t..,,
\I_ y�
'(F" �`�" �t�•k Address .8... f.1� C DUCA lLlake, b2, �� D
Name of Own . .l .. . .... ... '�1�,
Name of Builde�/i7 A] CcU Y�.t �a . J
Number of Rooms ...1. .o-- 3 - Foundation C .e'.Y.t ...
Exterior ....0 ........ S (n �\ . . Roofing G ....a 02)Rnh A�..:. (.�1!'�. !I�,$S
•Floors Pm?.... Interior Y.\ `.M.k.•3/1t.d .
Heating .L1(Ve Plumbing .
Fireplace AA xv...... Approximate Cost - — lc .o.O 0
• Are I*7s' li •
Diagrarn of Lot and Buildin orth Dimensions 7 • Fe ` , .e6 '
49 <
pT
, y CO
` • k,' J
Ex iyi-c._ GI . .
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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. - •
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• r as6,,,A, c...
- Construction Supervisor's License
WEAVER, ELIZABETH & NEVIN
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32110 '.:permit for Build Barn
o :Perm t ,
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Accessory to Dwelling s :
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Location 3096 Main Street �,
r - Barnstable T • t �• T _
OwnerElizabeth & Nevin Weaver
'- Type of Construction Frame - . ? F
Sf • 4, `-
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Plot ; Lot t 9 f• j ✓ ,,
t Jul 12 4" `,; - -\ _
Permit Gran ed Y 5, 1-9 8 8 , • - `�
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` Date of Inspection ' 9 —. - • ti f�� _r;
Date Coonif pleted ............ 19 _ •
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