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Home My WebLink About0110 BEARSE'S WAY //o /�a��, ��,,y _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 74 Permit# 3 q I �{ Health Division Date Issued 111 _R Conservation Division Feed c),=) Tax Collector Treasurer �+71 QD Planning Dept. Date Definitive Plan Approved by Planning Board r ' Historic-OKH Preservation/Hyannis Project Street Address -_[ 2 ' X1c'A&Se 9 Village /`w1}V\A Owner MA C MAAA Address Telephone 6/7 1)-S'- �Q/ 7 617 - 7 Permit Request - 0 o 0 � f Square feet: 1 st floor: existing Proposed 2nd floor:existing proposed Total new Estimated Project Cost Zoning District Flood Plain Groundwater Overlay Construction Type LJo O r- Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family CD/ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes V4 On Old King's Highway: ❑Yes ❑No YP Basement Type: ❑Full //Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) �1 Number of Baths: Full: existing new Half:existing 2C new Number of Bedrooms: existing new _X Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑GZN as ❑Oil M'Electric ❑Other X Central Air: ❑Yes Fireplaces: Existing �� New _ Existing wood/coal stove: ❑Yes W- o Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:O existing ❑new size - Attached garage:❑existing ❑new size _ Shed:❑existing ❑new size�X Other: Zoning Board of Appeals Authorization ❑ Appeal# /X Recorded❑ Commercial ❑Yens ❑No/ If yes, site plan review# Current Use �Ps,c%rat Z;a Proposed Use &Ss 0)e�(D BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation cc# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO c�� Grope s` SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. 1 - DATE ISSUED ° MAP/PARCEL NO. ADDRESS �D"-"' 1p5 _S "y VILLAGE 'Z 6L4tI?/off OWNER l� '' %✓'(C �J.� ��1 z v. t ti DATE OF INSPECTIONF S = FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - - GAS: x ROUGH FINAL FINAL BUILDING t ° DATE CLOSED OUT ' ASSOCIATION PLAN NO. j �� of INE . .�°� The Town of Barnstable • BAMSTABLe. • 9� MASS. ,m� Department of Health Safety and Environmental Services 1 MA'Sa Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. jj�� Type of Work: e — oD Estimated Cost,? /G Address of Work: Owner's Name:�4YU� Date of Application: / U I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑B mg not owner-occupied caner 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. / R T � p Date Owner's Name q:forms:Affidav The Commonwealth of Massachusetts ;== Department of Industrial Accidents Office 01/oir85998MORS _ 600 Washington Street mac+, Boston,Mass 02111 Workers' Com ensation Insurance Affidavit name: ) UA- C � . location city hone# 79? I am a homeo performing all work myself. ❑ I am a sole proprietor and have no one working in anv capacitv 521 I am an employer providing workers' compensation for my employees working on this job. .. :..::: :::: :::::::::::::::: .. coin anv name:. ' ............ dire ss. City insurance co. . DO CV#.>: ❑ I am a sole proprietor,general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: com anv name. ;>::,;. •:.;;<;..::: :.<:. ;... a ... ............................. ........................................................................ .... .. .:::..,.....,. .... .. ...... .......................................... .......... ::: ::::::ii`':'::;:::::::i>:;:j:: ::::':: ::::::'i... �::......%:2 . ::.>:.:' st`, i%; ::::;y:::;::::::;::`:'?'::::S::i::i::::::: � phone'#: ................................................................:............................:.................................................................. oliev c anv name.. ;><»::>:<:::::»:.>:;:::<>::;:;.::::.:.;:;:::;:;•<:.;:::,:.;:•::,.: .. address: - city,.. phone.# :......... .:.. .. ............... ............. ............... insnrance�co:.. :. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a Sae up to Si,500.00 and/or one year,'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a tine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the OMce of Investigations of the DIA for coverage veriScation. 1 do hereby certi under the pains en of ury that the information provided above is true and correct Signature Date Print name G �. `�J eelPhone# .5� . 1 official use only do not write in this area to be completed by city or town official In city or town• - perndt/license# ❑Building Depar1i ❑Licensing Bourn ❑check if immediate response is required ❑Selectmen's Office (]Health Department contact person: Phone#; ❑emu Urvucd 9/95 PJA) R J�l2L 2 o�70 'Yh e own of Barn- stable �F VE t Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 BIAS . � t639. 10� �ED MA't A Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: 0 Z�C,_, r-S E'1 �-r�•4=/ f 7 vie/lYl r.S number J street village "HOMEOWNER"I)TArIC 4 I7 -3 614/ 7 name home phone# work phone# CURRENT MAILING ADDRESS: c1 city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall-be responsible for all such work performed under the building_permit, (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures quiremen- . /M�/� , Sign of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q:FORMS:EXEMPTN