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0185 GOSNOLD STREET
Ajozb 101NG DE PT of Barnstable D PT SINE Building Department Services SEPT 9 2019 Brian Florence,CBO T��/(/ NOFB =AMSTABM Building Commissioner ARNSMAMrAB�E . 039. �0 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 PERMIT#� I q_� I FEE: $35.00 SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less �S GoSNOL)> ST yA114NI Location of shed(address) Village MA kT-I tJ +,N I D AKA P-OR of 3 3 23 7 Property owner's name Telep one number I q ' )( ` X -7 ' 9, Size of Shed Map/Parcel# E-Mail ,K5,6-7 7QAOL. Cot � ZO f9 Signature Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Af 0 You must file with Old King's Highway Conservation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:08/6/l7 � . ....` � a ... . r Or.�••. it N 11 5 3 ilk _ *1 Acam �Xftl�� � C NQ a O D �a � • � sins � � i Date: May 3, 2018 To: Building File RE: Misdirected Tax Payment Address: 185 Gosnold St, Hy Originator: Unknown/meb784@aol.com Complaint: Seeks refund from water dept. Enforcement Process Steps ® 1. Initiate local investigation: RA ® 2. Document/enter into system Yes ® 3. Contact ® 4. Property Owner 5. Seek access to subject property 6. Seek administrative warrant(if necessary) NA LJ 7. Notify state authorities of findings NA ® 8. Document conclusion Open ® 9. Referred Building PropertV— Property is developed 05/03/2018 Caller submitted electronic payment (from out of country)for May 15t tax bill but inadvertently submitted to water dept. He seeks to reverse transaction in the amount of 907.03. He was unable to speak to water dept.staff/Hans. RA—sent off email to Hans. Town of Barnstable rmt # Expires 6 months from issue date Regulatory Services Fee t Z Thomas F.Geiler,Director Building.Division Tom Perry,CBO; Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bnrnstab l e.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY I Not Valid without Red X-Press Imprint Map/parcel Number 3 a � Property Address [i esidential Value of Work J t "t go " Minimum fee of$25.00 for work.under$6000.00 Y Owner's Name&Address 1 Y 1 U.Y 1 ' IQ arCA Contractor's Name �` S QKLf Telephone Number • Q Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) Kit ❑Workman's Compensation Insurance � WIone: .: €m a sole proprietor ❑ I am the Homeowner ` ❑ I have Worker's Compensation Insurance ,:`y;N c: „ w Insurance Company Name 1 Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) [/Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) ❑ 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. f ***Note- Property e t si ro erty Owner Letter of Permission. copy f the ome Imp ve ent Contractors License is required. . SIGNATURE: _ i Q:Fomis:expmtrg Revise061306 f The C0771/rlonwealth ofHassachusetts Deparfnrent of rndustrialAe dents Office of_ fivestigations 600 WashinAdon Street Boston,MA 02111 www.rrtass.gov/dia Workers"Compensatiol Insurance Affidavit: Builders/Contractors/�lectricians/Plumbers A n licant Informatio Please Print Le 'bi Name (Business/Organization/Individual):. rr� Address: ® �u City/State/Zip: n`s mI 0 0 I phone.#: {V- rre you an employe heck the appropriate box: ❑ I am a employer with d. ❑ I ama general contractor and IType of project(required):.�ployecs (full and/or part_time).* have hired the stib-contractors 6. New construction�/T am a'sole proprietor or partner- listed on the-attached sheet. 7. o Remodeling ship and have no employees These sub-contractors have working for me in any capacity, employees and have workers' 8' �Demolition [No workers' comp.insurance comp,insurance.#' 9. 0Building addition required.] 5. We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.[]Zfcpairs ing repairs or additions mysrIE [No workers' comp. right of exemption per MGL insurance required.] t c, 152, §1(,t),and we have no 12. employees. [No workers' 13.❑ Other ------------ comp.insurance required.] _ *Any applicant that cbccks box#1 must also frll out the section below sbowing their workers'compcnsatlon policy information. t Homeowners who submit this effdavit indicating they arc doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractm that check this box must attached an addiiionalshret showing the niunc of the sub-contractors and state whether or not those entities have employees. If the sub-contractors live cu,ployccs,they must providt their vrofkcrs'comp.policy number. 1 am arc employer that is providing workers'compensation insurance for my employees. Below isihe policy and job site information. Inmzance Company Name: Policy#/or Self=ins.Lie.#: Expiration Date: Job Site Address:Attach a copy of the workers' City/State/Zip: compensation policy declaration page(showing the policy number and e Failure a as re xpiration date),.• to secure covers g quired under Section 25A of MGL c. 152 can lead to the imposition of crjrnfiW penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as cilgl 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 1)IA ,insurance covers e verification. I do here ern er th poi s• dpenalties ofperjnry that the information provided above ' true and correct. Signature: 1 • Date: Q �0 Phone #: - — Ofj`zcial use only. 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'4... . .. .. ... .. _ ,ti - . . . ., • ... 1. , - RS . - - S ` - y r Y ��.s.- b', _ { Fit Nilassachusetts- Department of Public Safety Board of Building Regulations and Standards Construction Supervisor Specialty License License: CS SL 99138 ' Restricted.to: RF,WS R` JAMES CURLEY 287 FULLER ROAD.. j t CENTERVILLE, MA 02632 a j Expiration: 1/28/2012 + Commissioner Tr,: 99138 ' ��ze;Uoonmeav�veal� ��i��� � i Boa d of BuildiE R`` Qulanions_an.d_:St�ndards--—.- -- -.--.w l..,T �w Licebse"d`r Z,istFation Nafl for mdiji-du1 use only ~HO E IMPROVEIY NT CONTRACTOR before the a iration date. , found rteturn to: Re s_t-.at1:on =w--•Board-ofBui dingy 1.24 0 n . . ,Regulatr6 's and- and.ards E iration 8lMw29�g•,�� Tr# 1 0873 One Asbburt Place Rm 13 - ""� == Boston Ma. 0 108 -==_'.Type_andivid,al 1 .• James urley = ==:-•==a James urley 287 Full r.Rd. Qe, A 02632 - R A t yali without 'b ore ��Administrator�' i y Town of Barnstable- Regulatory Services i JW NSrABLE, + . y )"S& Thomas F. Geller,Director M9, A,� Bll11diug Division Tom Perry, Building Commissioner 200 Main Sfreet, Hyannis,MA 02601 "V-town.barnstable.ma.us Office: 508-862-403 8 Fax: 50B-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the� subject property herebyauthorize jum-g r to act on my behalf in all matters relative to work authorized by wilding permit application for: , 1�5 aoolj (Address of Job) 10 3 II signature of OWner ate M �us Print Name Q T 0 RM S:O W NERP ERMIS S ION To wn own of Barnstable *permit# 9J pExpires 6 months from issue date Regulatory Services Fee + RARNSfABLE, 9cb MASS. 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/pcel Number 0 Address bl i4/�y/t� j�dential Value of Work `7 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address "�)/v SV* 01007 Contractor's Namer I:Dse_p� dc— Telephone Number Home Improvement Contractor License#(if applicable) l j /j 9 Z ction Supervisor's License#(if applicable) 7020 man's Compensation Insurance °' S PERMIT Check one: ❑ I am a sole proprietor SEP 16 Z01 ❑/I'am the Homeowner[� I have Worker's Compensation Insurance �-� N �ARNS` ABL Insurance Company Name Workman's Comp. Policy# 3 `5 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed) (stripping old shingles) All construction debris will be taken to ❑ Re-roof(h I ricane nailed)(not stripping. Going over existing layers of rood ❑ R ide ((� #of doors Replacement Windows/doors/sliders. U-Value 4 �J (maximum .35)#of windows )�S�) "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 Supervisor's License is re u' SIGNATURE: Q:\WPFILESTORMS\building permit forms\EXPRESS.doc Revised 072110 V� the Cvrtmenw•euizit of Ivittsfachuse'-s Dep a?*Mnt of Indiast;ictl Accidents -3. 0 ffct. of Investigations 600 Wash Workers' COMP ns2t?o` 1r?±ilr�ilC2 3i�r1 :aZiT.; Ut 11L1tir�ICortfB{ t "Sll F ,}J +Z.,�. tv .�s.7.'Piiian, 1n fo rm�-,;. Nca.il:'I,glU1:i:.Sc!�.'r'�ialiZ9it'v:S. 'r• cj f�t� ff t J 1�t Address: '` 1 Phone : 1�i City/State/Zip: 'Type of project(required): F22. WI u an employer?Check the a prop 4ate b j am a general contractor and i 6 Q t construction am a employer with vp have hired the sub-contractors 7 Remodeling employees(full and/or part-time).' listed on the attached sheet. ❑ 1 am a sole proprietor or partner- 'These sub-contractors have g. []Demolition ship and have no employees employees and have workers' 9. Q Building addition working for me in any capacity. camp insurance. mp.insurance to.[]Electrical repairs or additions (No workers'co 5• Q We are a corporation and its required.] officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work tight of exemption per MGL 12.❑Root',repairs myself.[No workers'comp. c 152 51(4),and we have no 13 Q Other insurance required.]t employees.[No workers' comp•insurance required.) rs,compensation licy •Any applicant that checks box#i mustalndicrill at indicating are the t!doing all work and then hion below showing their Qe outside convectors tn�ust submit aanew affidavit indicating such. t Homeowners who submit this affidavit -contractors 'Contractors that check this box must attached n additional nal sheet show het the woname of rkerscotmpsptoli y numberand state whether or not those entities have ide employees. if the sub-contractors employees, I am an employer that is providing workers'compensation insurance fob employees. Below is the policy and job site information. !� . O Insurance CompajName.: . © � Expiration Date: Policy#or Self-in ' F City/State�Zip: Job Site Address: ex Attach a copy of the workers' compensation policy declaration Pag52 canjlead totthe�imposition of and penalties of a Failure to secure coverage as required under Section 25A of line tt to$1,500.00 and/or one-year imprisonment,as well asCiv'tl of thipenals!statetnent may be forwardedes in the jorm of a STOP ao th office of d a tine p against the violator. Be advised that a copy of up to$250.00 a day Investigations of the DIA for insurance coverage verification. provide aba is true and coryert 1 do hereby certify u pains and penalties erjury that flee information p Dace: Si nature: Phone#: in this area,to be completed by city or town official Official use only. Do not write Permit/License# City or Town: Issuing Authority(circle one): Health 2.Building Department 3.CityfTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 1,Board of 6.Other Phone#: Contact Person: 1 ��ie -�o,�r�no�nu.P,alt/i o�✓�oaaacl.�aeCs`a ' Office of Consumer Affairs&Business Regulation I License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. if found return to: j Office of Consumer Affairs and Business Regulation Registration 126893 Type:. 10 Park Plaza-Suite 5170 Expiration 8!3/.3012... Supplement Card Boston,MA 02116 I The Home Depot?At=Nome Sennces DARREN DEMERS 2690 CUMBERLAND,PARKINAY S — A'f��At ,GA 30334�1=::_, Undersecretary Not valid without signature i The iCairrmoiriveal/h of.Afassachuselts tw --- DeprirtrnenI of Industrial Accidents 1{ Office ofInvesti,,aa ions 600 Washington S/reet Boston, Al-I 0211-1 �C. l rt 1wir.inass.govvldia 'Worke>i-s' Compensation Insurance Mficla-6t-: Btxilrlers/Con:ti-,octorsJElectrici enslPl:umbers Applicant Information _ Please h-int Legibly Name (Btisines,Drgauizatiou.'Individnai): 6 e Address: Sd✓✓ l/v City/stc1'tc/Z1.p: A4. 3 I lone #: V—g Are you an employer?Check the a propr late boa.: [1100tber f project(requiivd)- 1..❑ I a employer with mil. ❑ I am a general contractor and I loyees(full and/or part-time).* have.hired th.e sub-contractorse onsttaic.tion 2 a�n a sole proprietor or partner- listed on the attached sheet. esnodeling ship and have no employees These sub-contractors have Petnolitiou working :for me in any capacity, ernployeas and have tvo kegs' cote insuraure,I uildtng addition ,[No workers' comp-insurance P retluired.] 5. ❑ lVe are a corporation.andi.is ectrical repairs or additions 3.❑ .1.am a.homeowner doing.a11 work affi.cers have exercised their umbing repairs or.additions myself. [No workers'comp, right of exemption per NMGL of repairs irasurance:requireci.]T o• 152, §1(4)„ands;<<ehave-no employees-[No'workers' comp-:insurance required.] •Any spplicamt that checks box#I nuLv also fill-0ow the section below showing their workers'conrpevsa:tion policy infornzatian- Y Homeowners who submit this affidavit indicating:they are doing all-worts and then hire outside contractors must sub-mit a new sffidavit indicating s:tclL rCmalractors that cbeck this box must attacbed an sdditiDnal sheet shminlg the name of the sub-contractors so.d stare whethir or not'those entities bave emplDyees. If the sub--conh:actars:have employees,they,mast provide their workers'comp.policy number. I alas an employer that isprovidiilg n orkers':conrFellsah It 111514rance for nty'employeies. Belot;,is thepoliCy rnr:d,lob site info rmat3oiL Insurance Company name: Policy-or Self--ins.Lic.#: ) Expiration Date: Job Site.Addres_s: q'5- 6)aslvay V. City/State/Zip: Attach a copy of the workers' compensation policy declaration page(shoxrdng the policy number and eapii•ation date). Failure to secure coverage as required under Section 2.5A of MGL c. 152 can lead to the itzxpoxition of criminal penalties of a fine up to$1.,500.00 and/or one-year imprisonment,as well was 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 Once of Investigations of the DIA for insurance coverage verification. .I ado hvre6V certify, n-Irder thepa is ctltd pel 'gs ofpe�n.ry f fat Of inform a ion provided a tva is trope and correct. /1 —ke Signature: C. Date: Phone#: L only. Da not tt'rite ill this area, to be cauipltltlyd by cif or tota�tt geiat vn: Permit/License# hority(cii-cle one): Health 2. Building Department 3. Wylroi n Clerk 4,Electrical Inspector 5.Plumbing Inspector son: Phone R. fi tdadv.cct3u?cet?- FaCts:a:-M101s .d public N:r4Ci• Bo;rd oaf 3r:i!dirt� Rrgflt!:et::n:+and `t::ndar(b- Construction Superv;ser License License: CS 70077 _.�. Restricted to: 00 i JOSEPH C OUARTE i 15 FAIL ST WAREHAM, MA 02571 r I �.•�— ./��.� Expiration: 12/30l2010 t .meni��i.uu r Tra: 7662 a"aa. f1or+N of R�iW�e�fte�aaoa�i saa.`.taeJ:rl• ;.ict+esr o�n�itt;N�n valid Gar int��9d+a0 vae�1S` Uejoli►the r vira�drelc. If found ni��A ta: 110111E tJMNLMPRdYEM{ENj CaN�'C7Ai+ {tgArd OF ftibli-t f fVNtinati*ud Jtewdarda i9tr�Aiott' 13?X9 tiur:cshburtna P1:u+�' t�� Fatpontbn: 1f1 R2011 itt 1?d91 too,a'4a.1121'� ype: paslnersbip ; J J Ren)otte .lost► Duarte {�• ,y t5 Sa!I S1 !�_rr'�''`i ` _ vati4 willWt�sioawrt VMatt+htam•ma 02571 trmtni•tr:� + r 5 ER)ME IMPROVEMENT CONTRACT PLEASE READ THIS Suld,Furnished and Installed by: 1 • Branch Name: Boston Date: /�/ 0 THD At-Home Services,Inc. d/b/a The Home Despot.At-Home Services 345A Greenwood Street,Unit 2,Worcvtcr,.MA 01607. Branch Number:31 Toll free(800)657-5182: Fax(508)756-8823 . Federal TD#75-2698460;ME Lac#C 02439;ltt Cont.Lic#16427 Cr 13c#565 'MA Him a IIm/p�rovement Contrrwt'orr Reegg..#126893 Installation Addr•ecs: l D �7 STlllt —� City State Zip Purchaser(s): Work Pbune: Hume Phone: Cell Phone: 1 a N/317 OIL Horne Address: 2`"1 IdA"5 C Sf A FLefiM 4(x0 st J MA io t y 0- (If different from Installation-Address) City l + State zip E-mail Address(to receive project communications and Home Dcpot updates): �� 3 3—Qr ❑I DO NOT wish to receive any madoeiing emails from The Home Depot J) Proiect Information: Undersigned("Customer"),the owners of the property located at the above inst writion address,agrees w'buy and THD At-Home Sta-vices,Inc.C'I'he home Depot)agrees to furnish,deliver and arrange for the installation(`•Installation")o all materials described on the below and on Use referenced.Spec Sheet(s),all of which are incorporated into this Contract by this- reference.along with any applicable State Supplement and Payment Summary attached hereto and any Change Orders(collectively; "Contract"): ]oh#: ontm o a�,tea ndy; S eet(s # PryJect Amount r Roofing Si&n Wmdows 0 Insulation10 $ [f ❑Gutters/Covers QEntry 1)nors ❑ 0 ❑Roofing OSiding Wiodows 0 Insulation $ pGutters/Covers DEntry Doors ❑ Roobw Windows ❑Insulation $ ❑Cutters/Covers ❑Autry Doors n Roofing OSiding El Windows ❑Insulatiou $ ❑Cutters/Covers ❑Entry Doors E Minmaun25%MpaaitefContraadAmuwat due upon esrxa-tAttoscaotaad. Total Contract Amount $ Maine Purchasers may not depot more than one4hud ofthe t oubmetAnwouL Customer agrees that,immediately upon completion of the work for_each Product,Customer`iWdl execute a Completion Certificate (one for each Product as defined by an individual Spec Sheet)and pay any balance due. As applicable,eaell Customer under this Contract agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s)included herein,at its discretion,if The Homc Dcpul or its authorized Service provider determines that it cannot perform its obligations due to a structural problem with the home,environmental hazards such as mold.asbestos or lead paint,other safety concerns,pricing ctzurs or pause work required to complete the job was not included in the Contwt. t'y/ Payment Summary- The Payment Summary##d � L .. included,its part of this Contract, Sets forth the total Contract amount and payments requirod for the deposits and final payments by Product applicable). NOTICE TO CUST()MF:R You are entitled to a completely filled-in copy of the Contract at the time you sign. Do not sign a Completion Certificate(note: there is one Completion Certircate for emb listed Product as defined by Individual Spec Sheets)before work on that Product is complete. In the event of termination of this Contract Customer agrees to pay The home Depot the costs of material.•,labor,expenses and services provided by The Home Depot or Authorized Service Provider through the date of termination,plus any other amounts set forth in this Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNTS OWED TO THE HOME DEPOT FROM THE DEPOSff PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE IIOME DEPOT'S OTHER REMEDIES FOR RF COV ERY OF SUCH AMOUNTS: Acceptance and Authorization: Customer agrees and understands that this Agreement is the entire agrecm ve unt bet en Customer and The Home Depot with regard to the products and installation sa[viers and supersedes all prior discussions and agreements,either oral or written,relating to said Products and Installation-This Agreement cannot be assigned or amended except by a writing signed b Customer and The Horne Depot,Customer acknowledges and agrees that Customer has read,understands,voluntarily accepts the term,of and has received a copy of this Agreement. A by: G Sub ed by: 11 Date Sales nsultant's Si azure Date ` Customer'sSignat e X Telephone No. �- Customer's Signature Date: Sales Consultant License No. CANCELLATION. CUSTOMER MAY CANCEL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSINESS DAY AFTER SIGNING THIS AGREEMENT. THE STATE SUPPLEMENT ATTACHED HERETO is CONTAINS A FORM TO USE IF ONE SPECIFICALLY PRESCRIBED BY LAW IN CUSTOMER'S STATE NOTICE:ADDITIONAL TERMS AND CONI)MONS ARE STATED ON THE REVERSE SIDE AND ARE PART pF TH15 CONTRACT 11,30 09 C SG White-Branch r1l a Yellow'Customer Pink-Sales Consultant Ed Wd£S:4 2-OW i-E 'upf >L Z?9£875: 'ON XUJ 71261117 W063 f'•� vt0 /4Zi � TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map lX Parcel ' ''y' r C,F D ,ii,.S PerTAOLE mit# Health Division -_LA /b`1. Date Issued 7 AA Q fa Conservation Division �s 02® { " 3' 14 3 Application Fee , Tax Collector Permit Fee Treasurer Planning Dept. CMCtW180MAO0OUNT Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address 1 66 L= Village1��� Owner ' RCS ress Telephone Permit Request 4 Square feet: 1st floor: existin�_ proposed 2nd floor: existing proposed Total new c_ Zoning District Flood Plain Co Groundwater Overlay Project Valuation U Construction Type LaE04�uf Y&. --C, _ Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family. Two Family ❑ Multi-Family(#units) Age of Existing Structure `"� storic House: ❑Yes X No On Old King's Highway: ❑Yes MNo II Basement Type: ❑Full Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) _ Number of Baths: Full: existing I 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:-,*AGas ❑Oil ❑Electric ❑Other Central Air: ❑Yes Vo Fireplaces: Existing _� New Existing wood/coal stove: ❑Yes No Detached garage:❑existing Cl new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garag xisting ❑new siz hedX.existing ❑new size�Wrbther: "I I I Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes'*"XNo F . If yes, site plan review# Current Use Proposed Use BUILDER INFO MATION Name ka phnone number XOk Address License#6&2m Home Improvement Contractor# Worker's Compensation# 1 ALL CONSTRUCTION DEBRI RE ULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED % MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION n i FRAME l 3 is �. U INSULATION //�/ S d / 02o G_t ,D• n FIREPLACE ELECTRICAL: ROUGH FINAL C PLUMBING: ROUGH - FINAL GAS: ROUGH FINAL FINAL BUILDING 2i�1 d A y DATE CLOSED OUT ASSOCIATION PLAN NO. 1 r RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations. $50.00 . Q'� G d Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 2 � 3 square feet x$64/sq.foot= T x.004-1= plus from below(if applicable) 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) Permit Fee (r� Projcost Rev:063004 'k T KE Town of Barnstable ' Regulatory Services. • -�" Thomas F.Getler,birector Buildiug,Dxvisian a'A�ab MA�k Tom Perry,Building Commissioner ' 200 Main Street, Hyannis,MA 02601 , Fax: 508-790-6230 pffice; 508-g62.4038 permit no , Date AFb7nAvtT . ' }3O11xEry2pOVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPI.,ICATION MGL c.142A requires that&0°reconstruction,alterations,renovation,repair,modernize ex olceu led ion, •iutprovement,removaali demolition,but not more thhan four dwelling units or orstr ict-exis�which aze adjacent to bt4 g containing such residence at building be done by registered contractors,with certain exceptions,along with at her requirements. . _Eatiraatea.cost Type of Work II Address of Work., l , CG�� Owner's Name, . licition: Dste of App Thereby certify that: geistration is not requited for the following reason(s): , []Work excluded bylaw []lob Under$1,000 , []Building not o4naer-occupied []Owner pulling ova permit Notice J�hereby given that: ORpEALII�tG WITH U GIS RED OWNERS P-riLLING THEIR OWId PERMIT COn'MiCTORS FOR APPUC4)I R ROR AM OR GUARANTY wk'[TND CTHDER MGL c 142A. ACCLtSS x0 THE ARIiITRATIOl�(PRO SIGNED UNDERPEN,ALTIBS OF PERMY Ihereby apply foi aperrnit as the agept of the ow4er: Contractor Name Regishation o. Date OR The Commonwealth of Massachusetts _ ._ ^ — Department of Industrial Accidents' 600 Washington- - Ston Street Boston,Mass. 02111 Workers' Com ensation.'Insurance Affidavit-General Businesses IIflIlle: . .. !; address ��/+ LJ �. fJCJ Ill C cityCeJ .�' � work site location(full address). ❑ I am a sole proprietor and have no one Business Type: ❑Retail❑Restaurant/B*/Eating Establishment working in any capacity. ❑Office❑ Sales(mcluding.Real Estate,Autos etc.) I am an em ]over with etn 10 es(full& art tim): ❑Other I am an employer providing workers' compensation for my employees working on this job.. com"ari •iiaiiie•P 7 -.60b -ri :' :':S •• <<i re hone' UlI6 i isiirarice.cart # I am a sole proprietor and have hired the in ependent contrac s listed below who have the following workers' .' . compensation polices: company narirec e li&one . insurance co. � #�• "�' ` :•t� � '•:f.. - .:. 'mot. ^.6. _ :i• comp ny n - CitY•' '• y�•3. : O ICY: irisurence%eb: e: Tf Fallure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'Imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that p. copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. • I do here certi under e e alties of perjury that the information provided above is trueand correct Signature Date y Print name !lU fbll A�1 �f=y �/ Phone# D YP official use only do not write in this area to be completed by city or town official city or town: permittlicense# Building Department OLicensing Board ❑-check if immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other^ (revised Sept 2003) sl I t r • 1 Town. of Barnstable Regulatory Services $ sr,RttsrAsz.�, Thomas F.Geller,Director 9�AtF .A"� Building Division TomPerry, Building Commissfoner 200 Main Street, Hyaanfs,MA 02601 . WWW,taWn.b arnstable.ma.us office: 509462-4038 Fax: 508-790-6230 Property Owner-Must - - ; ..Complete and Sign This Section _. if,using A.Builder X, �� rr�a A i r'►r����A�� , as Owner of the subject property ��(- 6-c77,ca- 6 � o aCt on mybehalf; . herebyauthorizeC��; . , . in all matters relative to work authorized bythis building permit application for, (Address of job) . ` ' �j C-00 1 e S' afore of Owner Date � vow iU print Name •fit•Y:1R•4' •�^• :; :!'�� IL CP V 1 o - � s �° 1� 3. Q In zi N - � U' O o�� � o �� � o IS rev � � °a � tio yid _ a �; �� gv . a ' .. bti ^ aaip ham^ v '± z ` rn "'` �ecom � ss � ` ? o -Teo = �' �' ^i � �ti {y � � •" ���'� ilk .� o�' '� r.a IZ it A 00 f3 IV- �. ��. )c I� 6j\ CY 43 M (A CP ' J°�! � I ! i d�An""�".,,,,,,,,,,j ,,� i`�— � i � 1�4" j I..r �- � ; � � � j ! ! ! t ' , 7N � I <t 77, 7 07�ue� a �OARo of eulLp►NG �dd �NSTRUCTI ''1GULAT1pN Number I QN SUP.. R S d -Z � 626g�2ate��1105�y9 6 Rettic� "' Tr..no. ' i WILLIAIIi! a `J- j � HAR�ICIiPpRt: Mq � 4- ---_. � Aden nistrator r- .._... Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR License or registration valid for individul use only c Registrations, 142519 Board of Building Regulations and Standards Etxptrayt 7/2006 One Ashburton Place Rm 1301 - TVp'e_Ltd;Eiability Partnership Boston,Ma.02108 Grater Harwich Co`nstr c iori=o. LLC �4. William Shelley, Jr I Y 565A Route 28F Harwichport,MA 02646 Administrator Not valid witfio t signature TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 134 Map-- 3 d (o Parcel we Permit# y 3 Health Division 5W G W1 0Z 57 7 7 n � Date Issued Conservation Division ��3c�h�oz � "Application Fee �� Tax Collector d2 P it FeeFS 0. 0 Treasurer ® ktj 9 0 11ZApPL?CA" OBTAIlNASEwER CONNECTION FROM THE Planning Dept. C� SOX ONFFJORTO Date Definitive Plan Approved by Plan ' g Board Historic-OKH Preservation/Hyannis </ Project Street Address I �' G o s m d L-J) s R L'T I Village 14 Y A N t 5 lk�_ Owner Lov oS 1" Qift/Aw o + MAR` 1,10, G , STo E5 dress o lS 14 C!3 o 7/9&G 1-4AIG Telephone 7 g i ' 1 " �f S AR K - 7 81 - S N C( -,,g-5'39 Permit Re est GvNviRi 42,PP/36,t< Too COMPLE1ts (b 'f14Aov L.PVMD `f \\\AC- F1 - 5TvDY 02 11AM1 L.i Room - Square eet: 1 s loor: existing a J ed A M�' floor: existing p posed Total new 5 AM Zoning istri Flood Plai 1�1 47 -- Groundwater Overl y Project aluation 1510 0 Construc 'on Type w ©CID t-R A ML- mM C Lot Size ' 14 a dfathered: Yes ❑No If s, attach supporting documentation. Dwelling Type. Single Fa 'ly o Family ❑ Multi-Family nits) Age of Existing Stru re 37YM Historic Hous Yes to On Old King's Highway: ❑Yes � o Basement Type: ❑Full ❑Other J Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing ` new — Half: existing new Number of Bedrooms: existing 3 new Total Room Count(not including baths): existing new 7 First Floor Room Count C Heat Type and Fuel: )Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes XNo 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, hed:Keexisting ❑new size !R X1 Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ®,No If yes,site plan review# Current Use Proposed Use N 1; BUILDER INFORMATION Name Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION D I RESU NG FROM THIS PROJECT WILL BETAKEN TO SIGNATURE 7 DATE ppppp- .y - FOR OFFICIAL USE ONLY 4' PERMIT NO. tP f DATE ISSUED MAP/PARCEL NO. Ll u ADDRESS^ V_ILLAGE ,y r + OWNER '- •., tit -•, DATE OF INSPECTION: 7 r FOUNDATION t r FRAME y r INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL; PLUMBING: ROUGH FINAL, _ F GAS: ROUGH FINAL- FINAL BUILDING,- DATE ' rl c DATE CLOSED OUT ASSOCIATION PLAN NO. � l J r r . i •;l it S The Commonwealth of Massachusetts pK = Department of Industrial Accidents . _ 600 Washington Street ` t Boston,Mass. 02111 Workers' C sation Insurance Affidavit name: Lvoi $ + AI (ARLie.➢tj to 5T© el< S location: & D 5 0 D i D S T , L ,,pB � hone# ci 1`� I am a homeowner performing all work myself. tv O R 14"7 6-i-SS qq" I am a sole r rietor and have no one workin in ca achy I am an em to er roviding workers' compensation for my employees working on this job. 0.... ................P...y....P...........:.:::.::::::::..::.::..::::.:.:::...::.::.... .... a'ililFes :. €e>:: �rtv : :�cex(F.': i''i j:'i tii;: :iii y''``•3?':''::ii:;2 ?i:::;.a '1hstran ❑ lamas ole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have thefoliow in workers' kers co ensaho n polices: .. •- . ................ {4++" aitr t ; > »:: v9 !F ;as..........:..:::.....:.::::.?......,...................... «>nh j.� is h'.n:•:iL4 .....'iJ'+!.`Y:':::ii:ii`(:ii;:i':i:i::('f,.; i:;l;i::.;:::::::Y::v::::i:i:ij:::`ii �ii;v<;:::i'::: - +<`ii':::':;:i::iii: ;:::ii:: i':?ii ; ,+.;:j;�i:;:i;::2:y:•:::::;.`;i: 5t......................:.::::.;:;;,�::;_;;;v::?i::ri:i:•iii:;i:i:vJ:i':iiii:::i:!4i.>.<:iv:;J:v::iJi:i:i:i:v:x::is ii:}}•:iJi:i:. ........................................................................ 3!•3. .... >< »... c as nasn >: h t ;.:>•: X. Em X. c ................... :;;::::.:::..:::. .....;:-............ y1 - ^':.:• .l'JII�l�a�titl.::CbY;�i::i`i:'�ii'F.�i:::�i:�i:{•i:;;•iiii;;.:;:.i::�i:::::/:::::::�•:::::•::::�::::::::::::............................. Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civfi penalties in the form of a.STOF WORK ORDER and a fine of$100.0o a day against me. I understand that a' copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification I do hereby.certify under a pains and penalties of perjury that the information provided above is.true and correct ` Signature ate s 0� r Print name . `tJ 0➢ s e i A t-J O M A R K➢-o d 1�' S T O 1C t f2 ' Plione# I fl l -Sf U' official use only do not write in this area to be completed by city or town official city or town: permit%license# OBuilding Department ❑Licensing Board O check it immediate response is required ❑Selectmen's Office _❑Health Department contact person: phone#; ❑Other Oviaed 9195 PJA) 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 contract 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, construction 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 license 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 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 in the workers' compensation affidavit completely,by checking the box that applies to your situation', 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 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 fo obtain a workers' compensation policy,please call`ilie 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 foie 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 permrtllicense number winch will be used as a reference numler. The affidavits may be r t the Departmen bymail or FAX unless other arrangements 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 Office of Investlgadons 600 Washington Street Boston,Ma. 02111 fax#: (617.) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 • TAW JS=b(�� �ssd with Fossil Fads promptfre Psekxgn forDas sadTws•F&-*RsaWlsas BWW .W huxi .MIIY1�14SUM ' . Q1aris MUG Cdsliag w.0 , Flow H+m � d� Areal(•/6) uwalur' R-duce R-vslua R�r"� �or Padca?r 5"1 to 460500 Resting Degm DRW 19 10 6 PForosal Q I2!4 0.40 3f 13 6 Normal 30 19 19 IO 93 AFM g 12Y, 032 6 13 19 1D Nermd g iZ:�. . O30 3= WA Wf T 15% Q36. 39 13 6 Normal 3= 19 19 10 Its AFVE V' 15'/. 0.46 . WA WA y 1SY. 0.44 3E 13 as AFM 30 19 19 10 Normal W 15'h 032 WA WA R 18% 0.32 31t 13 73 Nor=! ' 19 ?S PYA WA Y 11% 0.42 3= 6 90 AFiTE y !E-/. 0:42 32 13 .19 10 ' 90 AFtJE ,� t E•/. O30 30 19 19 10 6 . 1'. ADD RE OF PROPERTY: l.8 cP 0 Ss V 0 & Pa O S� �o 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS' 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): S.'SELECT PACKAGE(Q—AA-see chart move): G ENERGY-REQUIREMENTS NOTE: OTHER MORE INVOLVED METHODS OF DETERNIININ - ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: -NO: g4o=4980303 a Footnote's to Table J5.2.1b:' Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights. and basement windows if located in walls that enclose conditioned space,but exeludirig 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 requirement. For example;3 ftz of decorative glass may be excluded from a building design with.300 ft of glazing area. = 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 J1.5.3a. U-values are for whole units: center-of-,lass U-values cannot be used. 3 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-38 insulation may be substituted'for R49 insulation- Ceiling R-values represent the sum of cavity 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.-sulation plus insulating sheathing (if used). Do not include exam I • exterior siding, stu trucral sheathing, and interior�drywalL For p 0.an R-19 requirement.could be met EITHER she,.tha Wall re uirements apply to -6 insulating' .& q - 9 cavity insulation'OR*R 13•cavity insulation plusR S . byRl ry construction. wood=frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame 5 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. ' T a entire opaque portion of any individual basement wail with an average depth less than 50%below grade must. mcit the same R-value requirement.as above-grade wails. Windows and sliding glass.doors of conditioned basements must be included with ,the other glazing. Basement doors must meet the door U-value requirement d-scribed in Note b. 'The R-value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes�elettric resistance heating use compliance approach 3;4, or S. 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 or exceed the efficiency required by the selected package. For Heating Degree Day requirements of the closest city or town see Table 35.2.1a. NOTES: a) Glazing areas and U-values are maximum acceptable.ievels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural eamponeau• b) Opaque doors in the building envelope must have.a U-value no greater than 0-15.Door U-values must be tested and documented by the manufacturer is.accordance with the NFRC test procedure or taken from the door U-value in Table J1.5.3b. If a door contains glass and as 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'(Le.,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 I , °EIHE� ^Town of Barnstable °^ Regulatory Services s"xrrAW. M6 Thomas F.Geiler,Director 1.pw A 9. ,0$ rf6.19. Building Division Tom Perry,Building Commissioner 200 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 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. e fo 6`ICi R T TA C H C O 6,14(z a&L ootM Type of Work: 7-0 f3 A re k tim i-AU v_D R`ff �- f RH I Ll Estimated Cost 1 l 00® — 1�I ��_D Address of Work: Cp O S �J 0 LJ) t i Lf'9 NAJ 1 S M O R(�01 Owner's Name: Ltd y t.S 1 , PI F'I PIJ O " Al R A 7 W AJ L1, 6 TO 4-f Date of Application: I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 Building 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. OR Date Owner's Nam-eQ� Q:forms:homeaffidav I RESIDENTIAL BUILDING PERMIT FEES . APPLICATION FEE • Via, o .d New Buildings,Additions $50.00 Alterations/Renovations ' - $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING•SPACE square feet x$96/sq.foot= x.0031= plus from below-(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE S� /(pj .� L x.003 1= square feet x$64/sq. foot= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft , >120 sf-500 sf S 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 bw'lding permit: _ square feet x$961sq.foot= x.003 STAND ALONE PERMITS Open Porch __x$30.00= (number) Deck _x$30.00= (number) ) Fireplacelehimney (number) x$25.00= Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) permit Fee projcost - _ I .......... Xz� xy, Pr,4 1jr 7:6 lb I UN CP -�;,62�9t' IT (31 Zj `t tS is '� O r � l I fj 4 3 3qq 8 J w s � 1 I Town of Barnstable THE Tp�� yP o� Regulatory Services Thomas F.Geiler,Director » BMWS'TABLE, * ' MASS. 1e39. Building Division rEn �s Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: _ JOB LOCATION:. I c I)& k'o fSi N Y A AJ V number bK�� street village M ARtf Lip p �7 a -19, - !W -,CS 39 „HOMEOWNER': i-®V i 5 F, pie e- i A &J 0 -7O 1- -3 3 1 — /0�5 name home phone# work phone#, CURRENT MAILING ADDRESS: i L R i T A&0 L A lJ L , WEYMOVTif A4 A- © off 0 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 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 t amend and adopt such a form/certification for use in your community. Q:forms:homeexempt TOWN OF B STABLE N i i p PARCEL M 306 136 GEQI3ASE III r DD 'SS 185 GOSN LD STREET, 111 ANN I S PH-0 zip - 1 BLOCK LO Tf Li i}..3A ah DEVELOPMENT D I STR I PERb4TT H 4318 DE&M.IPTION FINISH GAURA-M,B:LTH � RY,S��L�Y OR "AMILY I PERMIT TYPE 3f� Di B[JILL ING PE�:IT d CONTRAC ORS: PROPERTY ARCHITECTS., � Department of TOTAL FEES $10 40 Regulatory Seme s .00 CON811RUCTI:ON COSTS ;1€ , 2.00 434 RESI ADD/Ai,T/C0 PRIVATE B .�� UIL i�D �I:QN�,i BY DATE IS ED 10/0 / 002 E'PIPATION DAT THIS PERMIT CONVEYS NO RIGHT T STREET,ALLEY OR SIDEWALK O Y PART THEREOF,CROACHMENTS ON PUBLIC EITHER TEMPORARILY OR PERMANENTLY..EN- .PROPERTY,NOT CIFICALLY PERMITTED UNDER T ILDING CODE,MUST F, APPROVED BY THE JURISDICTION.STREET OR ALA FY GRADES AS WELL AS DEPTH AND LOCATIO BLIG SEWE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.THE ISSUANCE.OF THIS F 'T DOES NOT RELEASE THE APPLICANT FROM.THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. `'M6 IMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONSTRUCTION WORK: APPROVED PLANS MUST BE RETAINED ON JOB AND 1.FOUNDATIONS OR FOOTINGS THIS CARD KEPT POSTED UNTIL FINAL INSPECTION WHERE APPLICABLE, SEPARATE E 2. PRIOR TO COVERING STRUCTURAL MEMBERS HAS BEEN MADE.WHERE A CERTIFICATE OF OCCU PERMITS ARE REQUIRED FOR. (READY TO LATH). PANCY IS REQUIRED,SUCH BUILDING SHALL NOT BE ELECTRICAL,PLUMBING AND"MECH. 3.INSULATION. OCCUPIED UNTIL FINAL INSPECTION HAS BEEN MADE. ANICAL INSTALLATIONS. 4.FINAL INSPECTION BEFORE OCCUPANCY. ■ BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 1 2 2 2 3 1 HEATING INSPECTION APPROVALS ENGINEERING DEPARTMENT 2 BOARD OF HEALTH OTHER: SITE PLAN REVIEW APPROVAL WORK SHALL NOT.PROCEED UNTIL PERMIT WILL BECOME NULL AND VOID IF CON- INSPECTIONS.INDICATED ON THIS THE INSPECTOR HAS APPROVED THE STRUCTION WORK IS NOT STARTED WITHIN SIX CARD CAN BE ARRANGED FOR BY VARIOUS STAGES OF CONSTRUC- MONTHS OF DATE THE PERMIT IS ISSUED AS TELEPHONE OR WRITTEN NOTIFICA- TION. NOTED ABOVE. TION. r Town of Barnstable do Regulatory Services . Thomas F.Geiler,Director BARNSTABLE. ' 9� MASS. Building Division '0t s FD MP'� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 P ERMIT# FEE: $ oZ f3� SHED REGISTRATION 120 square feet or less 1 �S 06S,4/01- D S O ilVAAlry I S Location of shed(address) Village l�`0►�4� 78i- 39 NiARYLI�J S-roZiF5 --77 ( - C Property owner's name Telephone number �Y7(1V 3C9 l`34 Size of Shed Map/Parcel# S� IS-D Z Signatu� Date Hyannis Main Street Waterfront Historic District? Old King's Highway Historic District Commission jurisdiction? Conservation Commission(signature required) 5124 toot = PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,THERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED BY A PLOT PLAN Q-forms-shedreg REV:121901 r _ w r i V Q —All ON Obi � �~ �