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HomeMy WebLinkAbout0021 HARRINGTON WAY I-IYAuN/S �: . ' Town of Barnstable Building rRntv�ra> Post This Card So That it is Visible`From the Street Approved'Plans Must 6'e Retained on 1'ob and;th�s Card Must be Kept R __ Posted Until Final Inspection HasBeen Made. t _ y�g� Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.` ��1 lil�� Permit No. B-19-3142 Applicant Name: MAGEE, RICHARD A Approvals Date Issued: 09/23/2019 Current Use: Structure Permit Type: Building-Shed-Residential-200 sf and under Expiration Date: 03/23/2020 Foundation: Location: 21 HARRINGTON WAY, HYANNIS Map/Lot: 288-091 Zoning District: RB Sheathing: Owner on Record: MAGEE, RICHARD A Contractor Name: Framing: 1 Contractor License , X Address: 21 GODDARD ST �..-- ._ •. _ ---.- � - 2 QUINCY, MA 02169 ` Est. Project Cost: $0.00 = Chimney: Description: 10x20 shed Permit Fee: $35.00 Insulation: Fee Paid:. $35.00 Project Review Req: 10'x20'one story shed located as show on property plan Date: 9/23/2019 Final: ( / Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after'Yissuance. x > All work authorized by this permit shall conform to the approved application and the;approved construction documents for'which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street.or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. ' Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the BLAIding and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing ' 2.Sheathing Inspection F r .�`l Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site JY? Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT 1 ?" Final: Town of Barnstable 81jIL p1 ok Eras, $nildin.g Department Services NG DEpT ti Brian Florence,CEO EP 2 3 2019 � f RAENMU X&M .�� Building Commissioner T OwN OF eA is39. �� 200 Main Street, Hyannis,MA 02601 RNST orED y www.town.barnstable.ma.us ABLE Office: 509-862-403 8 Fax: 508-790-6230 PERAM4 ` - l� E: $35.00. SHED REGISTRATION RESIDENTIAL ONLY 200 square feet or less a rr%n A17 Nulam n lS Location of shed( ess) e rd / yV a-w g56- 51 &2 Property owner's name Telephone number jog aO Size of Shed Map/Parcel# 3 s / s Si Date Hyannis Main Street Waterfront Historic District? h 0 , Old King's Highway Historic District Commission jurisdiction? n o You must Me with Old King's Highway Consetvation Commission(signature is required) Sign off hours for Conservation 8:00-9:30&3:30-4:30 PLEASE NOTE: IF YOU ARE WITHIN THE JURISDICTION OF ANY OF THE ABOVE COMMISSIONS,TBERE MAY BE A REVIEW PROCESS AND APPLICATION FEE. PLEASE SEE THE APPROPRIATE COMMISSION FOR DETAILS. THIS FORM MUST BE ACCOMPANIED 13Y A PLOYPLAN i Q-forms-sbedteg . R$V:08/6/17 ��1�-!�.(.L ` �U iY1 mGZ eta Fleming & McCarthy MORTGAGE INSPECTION PLAN LAND SURVEYORS This plan was not done with an instrument survey 38 POND STREET FAX and is to be used for mortgage purposes only. (617)438-0136 STONEHAM,MASS. (617) 279-0725 DATE: Z- S- 9c�r SCALE: / -' 3D ' 1 certify that this dwelling is located approximately as shown and conformed to n m the zoning bylaws of the town/city of P)6#A1A115PoA0'F 0 U 0 when constructed and is not located in a flood plain hazard zone. 3 °- � w N Deed&Plan Reference o 0 N � A941?/V5TA161-E County Reg.of Deeds a m A (D N i L) 7y29 /0 3. 3 2- CD CD 1 ✓ / a L-� 5- 0 �j � i sT�y � � r'iARffG-E � r3 CiJ I BIT I 't I CDT/C,, I I I F f /0Y. 1�3 1 1 y os 00 /fAf IV(S--Ta Of Mq�s E yf N l - O / ENO `URA r �n v , Application number Fee ................. :... : .................................... KAse. DEC Q J 2013 Building Inspectors Initials .. ................................ tb�g. � TOWN ��H�u����� Date Issued........ .���/. ........................................ Map/Parcel......o � 1 ............................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: i ROOF/SIDING/WINDO WS/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: �A40_6 NUTvBEP, JET VILLAGE Owner's Name: S' Phone Number Email Address:- A-m IAAG-&,::� \'P • Ull Phone Numberc�(l s� O Project cost$ Check one Residential V1/ Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0 Siding 0 Windows (no header change)# © Insulation/Weatherization koors no header change)# Commercial Doors require an inspector's review Roof(not applying more than 1 layer of s gles) Construction Debris will be goingto CONTRACTOR'S INFORMATION Contractor's name U\� t!- Home Improvement Contractors Registration(if applicable)# (attach copy) Construction Supervisor's License# 0��(L7 -(attachcopy) Email of ContractorV_u�,, � pja"e_nlumobet-l�a .5)� 1/ ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTYIS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER............................................................ • 9 *For Tents Only* Date Tent(s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X X Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s)of each tent Fuel source being used LP tank 201bs. or>Yes No • ,if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3.30 pm-4.30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLIC S GNATURE Sign Date l_2 ` All permit applications are subject to a building of icial's approval prior to issuance. The Commonwealth of Massachusetts Department oflndustrialAccidents I Congress Street, Suite 100 Boston, MA 02114-20I7 �� ��•'� www.mass.gov/dia 11_orkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information // PIease Print LeQibI Name (Business/Organization/Individual): `I Address: uw.�v City/State/Zip: MA 0,1 $ Phone #: � 1 $ r Are you an employer?Check the appropriate box: Type of project(required): I.171[am a employer with employees(full and/or part-time).* 7. ❑New construction 2 i am a sole proprietor or partnership and have no employees working for me in ar:y capaci y.[No workers'comp.insurance required.] 8. Remodeling I ! homeowner doffs all work myself. 9. ❑ Demolition J a` - - y [No workers'comp.insurance required.]` 1 am a homeowner and will be hiring contractors to conduct all work on TnY property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.Q Electrical repairs or additions proprietors with no employees. ❑6. I am a general contractor and I have hired the sub-contractors listed on the attached sheet 12. Plumbing These sub-contractors have employees and have workers'comp.msurance.t 13.�oof repai repairs or additions rs 6.F1 We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees. [No workers'comp.insurance required.] *Any applicant that checks box R 1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such_ }Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: I ` 9 Policy=or Self-ins.Lic.t: 15; �5 Expiration Date: Job Site Address: A-QzIw� City/State/Zip: 1 1S vA abO Attach a copy of th�eorkers' compensation policy declaration page(showing the policy nu er and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi der the pains and pena ri o perjury that the information provided above is true and correct. Suture: C Date: L L! rFOffzcialonly. Do not write in this area, to be completed by city or town official n: Permit/License Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone 4: KELLY ROOFING PH. 508 509 4640 8 Rhine Road MA C.S.L. #099167 Yarmouthport MA H.I.C.R. # 128957 MA 02675 August 20 2018 Proposal submitted to Alyssa McGee of 21 Harrington Way Hyannis MA. We propose to supply all materials and labor required to remove and replace the existing double layered asphalt roof on the front of the roof at the address Protect all walls,.Windows, shrubs, plants etc. during roof strip. Alt' ebris to be removed to town transfer. 8"White Aluminum Drip Edge to be installed on all eaves. Ice and Water damage protection membrane to be installed on first Six feet of all eaves and around all protrusions. Remainder of roof deck to be covered with synthetic underlayment. Install limited lifetime warranty Architect style Shingles, color to be Owens Corning Weathered Wood toMatch Back Roof All shingles to be storm nailed (6) Replace plumbing vent pipe boots with new. Repair/Replace all flashings as necessary including Chimney. Install Shingle Vent II ridge vent with hand nailed caps. Complete Clean up off all areas including all gutters and all nails after project complete At a total cost of$6900 Payment Schedule; Balance upon Completion Proposal Submitted by: Oliver Kelly Proposal accepted by: �� 7 Date / 2018 This proposal is valid for 45 days from date above, please call to verify thereafter. L�, 8 �/ y vve. ��� ai�2��fi' �iZ''vvy�i (� ✓ Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement,Contractor Registration Type: Individual OLIVER KELLY Registration: 128957 8 RHINE RD Expiration: 06/13/2019 YARMOLITHPORT,MA 02675 Update Address and return card. Mark reason for change. SCA 1 :} 2INv1-05111 CI Addr"a 171 P—niournant Cl Lr,¢t Card ��irYc:>nr(nt:/rurecrl/�c�-. �(.rr�.:r(cf/(JCl/ Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only _ TYPE:Individual before the expiration date. If found return to: ` R istration Expiration. P � Office of Consumer Affairs and Business Regulation =' 128957 06/13/2019 10 Park Plaza-Suite 5170 O .VER KELLY Boston;MA 02116 OLIVER M.KELLY �jLCc� 8 RHINE RD. YARMOUTHPORT,MA`02675 Undersecre Not valid without signature tart' Commonwealth of Massachusetts Division of Professional Licensure Board of Building Regulations and Standards Construction•Sdpervisor Specialty CSSL-099167 EXpires: 09/28/2019 OLIVER M KELLY 8 RHINE ROAD,, YARMOUTH PORT MA 02675 Commissioner f DATE(MM/DD/YYY1) AC'oR& CERTIFICATE OF LIABILITY INSURANCE i*.� 1 09/20/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; Linda Sullivan DOWLING &O'NEIL INSURANCE AGENCY PHONE 508 775-1620 a No): E-MAIL ADDRESS: lsullivan@doins.com 9731YANNOUGH RD INSURERS AFFORDING COVERAGE NAIC& HYANNIS MA 02601 INSURERA: ACE AMERICAN INSURANCE CO 22667 INSURED INSURER B: KELLY ROOFING INC INSURERC: INSURER D: 8 RHINE RD INSURER E: YARMOUTHPORT MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 316737 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICPOLICY NUMBER MM/DDY EFF M EXP LT MA)DI LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS MADE 1 OCCUR DAMAGETO RENTED PREMISES Ea occurrence $ MED EXP(Any one person) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRCT O ❑ LOC PRODUCTS-COMP/OP AGG $ JE OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS AUTOS WA BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE N/A AGGREGATE $ DED I I RETENTION$ $ WORKERS COMPENSATION /� STATUTE ERH AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE WA ) E.L.EACH ACCIDENT $ 500,000 A OFFICER/M EMBER EXCLUDED? WA WA 'WA 6S62UB8H08580918 05/10/2018 05/10/2019 (Mandatory in NH) FEL_ DISEASE-EA EMPLOYEE $ 500,000 ff yes,describe under IPTION OF OPERATIONS below DISEASE-POLICY LIMIT 1$ 500,000 N/A DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay Claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE'DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN David Bernstein Builders ACCORDANCE WITH THE POLICY PROVISIONS. 139 Nantucket Drive AUTHORIZED REPRESENTATIVE Chatham MA 02633 Daniel M.Cr y,CPCU,Vice President—Residual Market—WCRIBMA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Town of Barnstable Building ems, $=,'' i's� 3x' i"K x, gym, ': �`' ..'t ' ` �.•: Y `C:..,. ^•'r?, '� j4,. ' .. -.: - g PostThis Card SoT.hat�t.is Visible;From the5treet-.Approved Plans Must be Retained gn,Job:and,this Card Must,beKept ' ' :� ✓ �'�,..,�,�, 'ir "', :�r ��,.`"6� � :C, d"' �' %�' �.r.. �, � ,`;� x��� :x ���.�- �� ,� Permit M Posted Until Final Inspection Has,Been Made X - ° Where'a Ce"rt�fica�te of Oceuanc;ass Required,s h Bu�ild�ngashall Not be;0 upped until a Final.lnspection has been made Y: _�.,,�.^.. ,._. ,��r�>. . �._ Permit NO. B-18-3729 Applicant Name: Stephen Dickinson Approvals Date Issued: 11/28/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 05/28/2019 Foundation: Location: 21 HARRINGTON WAY,HYANNIS Map/Lot: 288-091 Zoning District: RB Sheathing: Owner on Record: MAGEE,RICHARD A Contractor Name STEPHEN T DICKINSON Framing: 1 z Address: 21 GODDARD ST s 8� Contractor Licensey CS-081843 2 QUINCY,MA 02169 Est Project Cost: $9,198.00 Chimney: Description: Replacing 11 existing windows, Like for Like replacement No Permit Fee: $46.91 change to Header Insulation: fee Paid:` $46.91 Project Review Req: Date 11/28/2018 Final Plumbing/Gas Rough Plumbing: �> Building Official Final Plumbing: x Rough Gas: This permit shall be deemed abandoned and invalid unless the work authonzed'by this permit is commenced within six,months after issuance. All work authorized by this permit shall conform to the approved application�and 1 hhe approved construction documentsfor'which`this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and st uctures shall be in compliance with the local zon ng'by Iawsand codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the X Electrical work until the completion of the same. ti Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Buil ding an :,Fire Officals are provided�on�this permit. p q Rough: Minimum of Five Call Inspections Required for All Construction Work 1.Foundation or Footing _+ "? 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons ntracting th unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department �^ Final: .� Building plans are to be available on site ��� All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Fleming & McCarthy MORTGAGE INSPECTION PLAN LAND SURVEYORS This plan was not done with an instrument survey 38 POND STREET FAX and is to be used for mortgage purposes only. (617)438-0136 STONEHAM,MASS. (617) 279-0725 DATE: Z- S- 95r SCALE: / "- 36) ' I certify that this dwelling is located approximately as shown and conformed to n m the zoning bylaws of the town/sing of / /1 0 a when constructed and is not located in a flood plain hazard zone. c = =3 W n Deed&Plan Reference o a CO 0 ti C �4R/VSTABGE County Reg.of Deeds a 8K 0 5K �3z l,aU I,, C CD CD n N J i 75•�8 Z /03.3 2- < m a LOT 4 `-� S / 57-o,Qy ,� GtJ DU p GAk,4vE � 3 w M ; y 2 / I BiT I I D,QivE. I I I /041. 5j3 a ios o0 NG-ToP- w A y /��P�SN MAJS C \ 1'K E N 1 a 0^Q cLi T1 -Tl Of T321-TISt2bIC 367 Main Streci,Hyannis MA 02601 Office: 508 790-6227 Ralph Crosseu Fax 508?75 3344 Bmlding Commissioner For office use only Permit no. Date AFFIDAVrT HOME IM0`ROVEME1tITCONTRACPORLIW SUPPLEMENT TO PERMITAPPLICATTON MGL c.I42A requires that the"recorz_struction,alterations,remstion,rcp=4 modernization,conversion improwment, removal, demolition, or construction of an addition to any pre tadsdng owner oocapied 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. Co e-f Type of A'ori:: -11cr��l 60 9 S Est_Cost �$S ���n' Z ca jpb �, �l2 Address of Work:Al jj9.9*) N4nN VJ9L4 A14 t NdIS 0 �o Chwner Name: h1 n L ct oL w xs Date of Pernik Application: I hereby certifv that: Registration is not required for the folloAing rcason(s)-. Work excluded bn•law Job under S 1,000 Building not oaacr-oavpicd O\\ncr pulling ov%m permit Notice is hereby given that: O NTERS PULLING THEIR OwN PER!-OT OR DEId-T:G':TI-H UT'REGISTERED CON7TRACTORS FOR APPLICABLE HOME 1NTRO%t'•``.1`i N:'OFJK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAi�t OR GUAR,4jM-FLT'D UNDER biGL c. 142A SIGNED UNDER PENALTIES OF PERMRI' 1 hcrcb\-2pp1\-for 2 permit 2s the 22cnt c,L:x ok cr: D2tc Contactor name Registration No. OR Date OIKKC 's name TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE E=*PTION Please print. DATE I1h�Q JOB. LOCATION l 1Y is Number Street a dress Section of:-town':= "HOMEOWNER" Name Home phone Work phone PRESENT MAILING ADDRESS 0 City town State Zip code The current exemption for "homeowners" was extended to include owner-o dwellings of six units or less and to allow such homeowners to en a e —an dividual for hire who does not possess a license h g n in acts as supervisor provided that the owner DEFINITION OF HOMEOWNER: Person(sj who owns a parcel of land on which he/she resides or intends to re- side, on which there is, or is intended to be, a one to six 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 buildinc permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, 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 rocedures and requirements. HOMEOWNER'S SIGNATURE ✓FI($JO.. APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. IIOME O1^7NER' c EXE'iPTION The code state that: "Any Home Owner per-forming work for which ay^building permit is required shall be exempt from the provisions of this section (Section 109. 1 . 1 - Licensing of Construction Supervisors) ; provided that,:if Home Owner engages a person(s) for hire to do such work, that such Home Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and 'Regulations for licensing Construction Supervisors, Section 2. 15) This .lack of.• awarenes often results in serious problems particularly when 'the Home Owner hires unlicensed persons. In this case our Board cannot proceed against, the--. . inlicensed person as it would with licensed Supervisor. The, Home6wiier'actin as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/her. responsibilities,,- man communities require, as part of the permit application, that the Zome _Owner 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. S`y 11/02/94 17:02 $6177277122 DEPT IND ACCID z001 _I ( ornnWitwealM o f Maijacltajetb ' a.L�a�artmenE n�.�•ndu�Eria,l�cci�n� 600 Wwky&n Sh...1 .lames J.Campbell 12osl`on, /f/addachccJ416 02111 Commissioner Workers' Compensation Insurance Affidavit (lksusWper zkw) with a principal place of business at: (city/staw in) do hereby certify under the pains and penalties of perjury, that: () 1 am an employer providing workers' compensation coverage for my employees working on this job. Insurance Company Policy Number O I am a sole proprietor and have no one working for me in any capacity. O I am a sole proprietor, general contractor or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation policies: Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number Contractor Insurance Company/Policy Number I am a homeowner performing all the work myself. I understand that a copy of this statement will be forwarded to the Office of investigations of the DTA for coverage verification.and that failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties consisting of a fine of up to$1,500.00 and/or one years' imprisonment as well as civil penalties in the form offjja STOP WORK ORDER and a fine of$100.00 a day against men. Signed this d/ day of 19 Q 7 Licensee/fArfifluee Building Department Licensing Board Selectmens Office Health Department TO VERIFY COVERAG FORMATION C LL: b 17-727-4900 X403, 404, 405, 409, 375 6C � �I a5 r I L � ` ' l I III i i,�- . 1� +. � VAsscssor's Office 1st floor Ma Lot 1 C(.M Permit# Conservation Office 4th floor _ Date Issued l qlq Board of Health Ord floor � � a Engineering Dept. (Ord floor) House# Planning Dept., 1st floor/School Admin.Bldg.): RrAsmi Definitive Plan Approved by Planning Board 19 (Applications processed 8:30-9:30 a.m.& 1:00-2:00 p.m.) 4 TOWN OF BARNSTABLE Building Permit Application Protect Street Address Ha lyp 1 Village Fire District (hvncr e i S Address k O Nl 4 94"- Telephone 56 g ^ Permit Request: O Z-2 1J3 ' Trl YC . Zoning District Flood Plain Water Protection Lot Size Grandfathered Zoning Board of Appeals Authorization Recorded Current Use Proposed Use Construction Type / Eaistinp Information Dwelling Type: Single Family ✓ Two family Multi-family Age of structure Basement FULL �5� Historic House Finished Old Kings Highway Unfinished Number of Baths , No of Bedrooms Total Room Count not including baths First Floor Heat Type and Fuel Central Air Fire laces Garage: Detached Other Detached Structures': Pool Attached Bam None Sheds Other Builder Information Name Telephone number Address License# Home Improvement Contractor# Worker's Compensation # NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN (AS BUILT) SHOWING EXISTING, AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO VPro ect Cost 00, d 0 Fee dv SIGNATURE DATE � Sr BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) BPERM T i FOR OFFICE USE ONLY ' ' ADDRESS 21 Harrington Way VILLAGE Hyannis OWNER Mr. Malcolm Freitas ! 4 DATE OF INSPECTION: t ° FOUNDATION. T FRAME r ' INSULATION I FIREPLACE ELECTRICAL: ROUGH FINAL _ PLUMBING:---', ROUGH FINAL GAS: ROUGH FINAL f FINAL BUILDING... DATE CLOSED OUT: a_4 ASSOCIATE PLAN NO. , . 1 r t i