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HomeMy WebLinkAbout0970 FALMOUTH ROAD/RTE 28 ��� � ��� 3 -- -- � �� I r a 1 L0T 30 r i L 0 T 1 ► 'y SHED ti DECK 1 i / I 10 74, 0, U�E: �28 0 57 - x 1VOT,.,. � THE tICRSE PASTL%RE CROSSES THE LOT LINE r This MORTGAGE IIvSPECTI01� Plan is For F=V == RES° ZOPiE- R,-1" T Bank Use Only T Q[ T NCE ND �t ASUR AtENTS C TNi� ? A SHOULD BE V ,'tE A ST T� To WIT _ _ REGI TRY OWNER: JOtfiV _T._ C�R_Ld0!V -_-__----__-._ __ DEED REF: _Z1fL-_lZ--------- BUYER: _ �'BF�1�LY_1�._�1 1�.4RD�'_ 9 1��1 ��--�--- DATE: F- O_9�- ----- --- - - PLAN REF: _29137' , ____--SCALE:1' � I HEREBY CERTIFY TO ..d ��� -� -� 'c. L__._------_ YANKEE SURVEY SAVIA'GS_B.9Nh' THE BUILDINGBUILDING SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS � CONSULTANTS SHOWN AND THAT ITS POSITION DOES -_-_ CONFORM � 40B (SUITE I) TO THE ZONING LAW SETBACK REQUIREMENTS OF THE melimm -1 INDUSTRY ROAD TOWN OF _.BAR.�'S_T. BL -------------AND THAT 40 3m ARSTONS MILS. MA, 02648 1T DO>S__�LQQ _ LIE WITHIN THE SPECIAL FLOOD HAZARD ;EL; t28-OO55 AREA AS SHOWN ON THE H.U.D. MAP DATED d-0_0j_ FAX 4�0-_05 3 ttg unity--Panel 'S0001-0005- THIS PLAN N0'C MADE FROM AN [. SURVEY 549 SP. I. A. f im PLS ---� NOT TO BE USED FOR '?ENCES. 8LJILDiNG PER1iiTS. ETU FiE t J � v !RIJ In � o ® C's, � c J s o a 3 L 1 -rQGG5 DEEP 7 � F- MTE9 4� g u1 po s- rr z v f � � " U ® T- O cli O C-A �9 vy x tj — ,, -r u7 o a 3 s �;' W E LL- I N Cam. N C., IZA L1 06. c-� k,� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �Map 2S,6 ' Parcel 6.1�3 Permit# Health Division ��i� Date Issued ©D Conservation Division /2� C? Fee. ®2�" O Tax Collector �. + � M,����1 60 SEPTIC SYSTEM MhUST BE Treasurer- , INSTALLED IN CCIMP1lAIlIC WITH TITLE 5 .Planning Dept. ENVIRONMENTAL CODE A � Date Definitive Plan Approved by Planning Board TOWN REGULATIONS Historic-OKH Preservation/Hyannis f` ` Project Street Address ® Village Owner Address 51111C Telephone SSE -71R CS--9 SS 0 Permit Request 5 «� Shwa t(D 1('0 oeQX t�X t�_o lL1 Square-feet: 1 st floor:existing proposed 2nd floor: existing proposed Total new Estimated Project Cost 9 00 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure I O%S Historic House: ❑Yes DkNo On Old King's Highway: ❑Yes k'No Basement Type: 1!;rF-ull ❑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 ~. L Heat Type and Fuel: 4b"as ❑Oil ❑ Electric ❑Other Central Air: ❑Yes �IrNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes Wo 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 BUILDER INFORMATION Name nW`(-\ Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE r> FOR OFFICIAL USE ONLY PERMIT NO. -D'ATE ISSUED MAP/PARCEL NO. r j t ' t` ADDRESS =. ;... VILLAGE .7 J OWNER DATE OF INSPECTION FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH - FINAL r PLUMBING: ROUGH, :'.� FINAL GAS: ROUGH: FINAL z FINAL BUILDING 1 i+ �'X � t • Il ! 1 DATE CLOSED OUT s ASSOCIATION PLAN NO. a r The Commonwealth of Massachusetts . ' Department of Industrial Accidents OWNollmrestigatioos 600 Washington Street y Boston,Mass• OZIlI Workers' COm ensation Insarance Affidavit on iranrri rii riirrr r� SRI e. name: -•J location: zeA ' hone city ❑ I am a homeowner performing all work myself I am a sole etor and have no one working,in airy �i° •'"� %%///////% ' en00 1111 sation for my employees working on this job..:.:::.:.::.::::::::::::.::::.:: :..:..:::..,:..:.:.....:..,.. din workers ::::::.......:.::::::.::::....:.:::.::::::::::..:::::::::::.<.::.:. :::::::::.::::::,:::.: ::..::::.:::::: ::. :: .,. 1 g .... :.:..:::::::.. .:,:.:::::...:.:. ::.::::..,.:.::. .:.:::...:. . :.:::.:::::::::::..::::::::::::.:::.::::::::::::::. I am an employer P�............................:.::::.::........:..: .. tl mD an vn am e.: t ............ , . ad ........................... :.::.:::..::.:... :;;.::.......................... n.:.::................r..... .......... ..... . ............ ::: . ......... ......::..:..... ................. han cites 2'I am a sole proprietor,general contractor, homeowner(cir one)and have hired the contractors listed below who have enratton following workers' comp o the g .............:•........:....::...........,.::::::::::•:::•:.yr:4:{{+•}:{•::{..4}CL{..::::.•.••Y:{•::•}h•::.}}?':'•v:-.vti.:•..v.f..•:.;:.vr ....... . moanvnam .. .. .. ..:v...:::...........•:•n.:w:x:::n:v:n::vn�v.:::.:}:•} :::v:w:::.v:.v:::,�::::::•:.�:::nv::::::::•:•::.::::::............... dress: ................... ............... ........,•.,..x+:::::::•:::....:. ..... ..... .... .. >..... ..h .... .k ...... xray.. 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O7#c��#,..:•.�::.::::,:..,::::.::.:,:.:,,:.,.;:........ �� . .. tnsurance�co:��>:>;r,,:<.:;i•:;:«•>?}::.:::::•:;:,•.::...... ...... ......:.::.:..................::.......::::::.:............. vti}1i y 4:\ki':{bhv.Y.{•}:k•}:4i:{v:•.:{L,ik+�::S;}::k::ii:•:iii�ii:•i'::.:::.:iiji?ii�'I.;:y:;.'•}:�:�'::{jr�:;:i:ri}iii�i`:i::?::$::v:?::ji`:�i?i?'.�ii}:��Ri<':2�ii?::�i?:�:t�?:�`:': ............... :•::::.v:::::::::::::::::•::v.v:::::x;....:':...- vxv:::v:....n. •'v...Kvv,w:::::.v.}'^....... :... ....:::....:..-..•:• ..........................................:..:i:iv\�.ikb?:ti tivv:•rr} .:-.....:;..;... <: s ddr es ........................................... .........................................::•:..vv..... ..:v:x:::w::::::n..v..k•4 .... , ...:-.......... ltv:•i}:{•}};{.::.:v{{4:::.:{•}?}:•i:}:^i?:::.�::::.�...{.i'.:�::::.i.iLi:6i:bii}?:•:i}} .i:•}i:-}::-i:.•......v.v. "::iii?:i::::^i:::v::::•:i;•?i•::-::i<4.....-:::::.........:":'r':'•:•::-:•:-,-.-v...-v-•:..::":: ::":.....:vw.•.vJC.vvw:::k+:}:•}:•"{Sj :: ...... v.....{.,-vnw.:::.,:.::n••::.v'{.i}}.}}}}:Lie......, n......n:....:..... .....-•............ ...:............ Failure to secure coverage as regWred under Section 25A of MQ.1St can lead to the impo�of criminal penalties of a fbw up to S1.500.00 andior and a fine of$100.00 a day against me. I a one years'imprisomumt as well as civil penalties;in the form of a STOP WORK ORDER copy of this statement may be forwarded to the Omee of Investigations of the DIA for coverage vedncsd0n. I do hereby un certi der the pacts and pertahies of per*ury that the information provided above is trw•and correct _ Date -7 - I - C> _ - � � Print name ���d Phone# S�8 7c't 0 -1-1G�� official use only do not write in this area to be completed by city or town oMdal perr�t/llcense# _ ❑Building Department city or town: ❑Licensing Board ❑Selectmen's OMce ❑check if immediate responses requited ❑Health Department phone#; ❑Other contact person (revuxd 9i95 P1A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law",an employee is defined as every person in the service of another under any cony act of hire. 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, consauction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a Iicense or permit 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,neither the commonwealth nor any of its political subdivisions shall enter into arty 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. n //. Applicants Please fill in the workers compensation affidavit completely,by checking the box that applies to your situation and supplying company names,address and phone numbers along with a certificate of insurance as all affidavits may be submitted to the Department of Industrial Accidents for cmfirmation 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. City or Towns 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 mrmber. The affidavits may be retained to. the Department by mail.or FAX unless other anangements have been made. The Office of Investigations would like to thank you in advance for you 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 011lce of Investigations 600 Washington street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 °F ZHE?, ° The Town of Barnstable 9�URNSTABLL MAM ��� Department of Health Safety and Environmental Services �Eo 59.�, Building Division 367 Main Street,Hyannis MA 02601 Ralph,Crossen Office: 508-862-4038 Building Commissioner 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 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: ' ineai Estimated Cost 't Z—e><> Address of Work: Gila 1•—tMaaki, Rel Owner's Name: Te-r­=4 Date of Application: -7- I — o I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law OJob 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 ARBITRATION PROGRAM OR PROVEMENT WORK DO NOT E ACCESS TO THE A 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 Date Owner's Name q:f6mis:Affidav f -ime town. of Harnstable °FTt+e Department of Health Safety and Environmental Services Building Division BAMSTABL& ' 367 Main Street,Hyannis MA 02601 MASS. 9� 039. 1e� Aj�O�,1► Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner HOMEOWNER LICENSE EXEMPTION Please Print DATE: "7— 1 JOB LOCATION:_ 'q T l Jy�o.] ^ ��ti n i 5 M `jn�umber street village HOMEOWNER": J�l�-w�a����o�S ! ' 6&\I'790 name honte phone# woWphone# CURRENT MAILING ADDRESS: �aw•e� 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 and requirements. Signature of Vomeowner 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