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HomeMy WebLinkAbout0023 HAVEN LANE a� �✓ �� - -- _ - - J � �� Engineering Dept.(3rd floor) Map oZ�o Parcel Permit# r.: House# 3 JGJS Date IsY69� c.. Board of Health(3rd floor)(8:15 - 9:30/1:00-4:30) � F.-` �� ee •c✓U � Conservation Office(4th floor)(8:30-9:30/1:00-2:00) SEPTIC SYST t BE GTALLED I "CE 19 WITI� ENVII3®IOlME I TOWN OF BARNSTABL IV,'I R��'nul.F..., Building P Application Project Street dress # Jot Village Owner Address Telephone7 7 Permit Request v2X3 First Floor sq �7 Secd or —square feet Construction Type Estimated Project Cost $ _ d-d-y Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family p Multi-Family(#units) Age of Existing Structure Historic House ❑Yes a"No On Old King's Highway (]Yes O'1VO Basement Type: ❑Full Crawl ❑Walkout ❑Other \\ Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing�_ New Half: Existing New No. of Bedrooms: Existing o;2— New Total Room Count(not including baths): Existing_ New First Floor Room Count_ Heat Type and Fuel: as ❑Oil ❑Electric ❑Other Central Air ❑Yes l Fireplaces: Existing I New Existing wood/coal stove ❑Yes p'iVO Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Byrn(size) one - Shed(size) /d X /D ❑Other(size) N Zoning Board of Appeals Authorization p Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name zl)� J2,A� 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 SIGNATURE DATE CP BUILDING PERM DENIED FOR T61OLLOWING REASON(S) FOR OFFICIAL USE ONLY 1 >= PERMIT NO. DATE ISSUE : MAP/PARCE ND j r ADDRESS VILLAGE OWNER ' r . t DATE OF INSPECTION: r ,�1 1 FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL ,> GAS:,, 'ROUGH FINAL , FINAL BUILDING. . DATE CLOSED OUT ASSOCIATION PLAN NO. ; r , i l4 • ! Town of Barnstable o� The Tow - : _ 'ronmental Services MA.g Department of Sealth Safety and Envl 4 Building Division 367 Main Sheet,Hyannis MA 02601 Ralph Crossen Building Commissione.- Office: 508-790-6227 Fax: 508-790-6230 For office•use only Permit no._ Date AFFIDAVIT HOME 1MPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION re wires that the "reconstruction, alterations, renovation, repair, modernization, MGL c. 142A q re-existing conversion, improvement, removal, demolition, or construction of an addition to any pr to cu building containing at least"one but not more than four ended lcontractors�mth owner occupied reside or building be done by registered structures which are adjacent to such res requirements. with other req cc in exceptions,along t.Cost Type of Work: Address of Work: Owner's Name Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: PERMIT OR DEALING WTTH UNREGISTERED OWNERS PULLING THEIR OWN WORK DO NOT HAVE FOR APPLICABLE HOME IIVIPRO�'EMEFU��UNDER MGL c.142A CONTRACTORS TION PROGRAM OR GUA1tAN'I'P ACCESS TO THE ARBIT� SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Repstration No. � Contractor Name Date i ner's Na n TP The Commonwealth oj111assachuscttt Department njludustrial.4ccidents ' q� O�ceol/ovestigat/ons M. 61111 ff'asltington Street Boston.Alan. 112111 Workers' Compensation Insurance Affidavit to - . . -- nam 7F -9I am a meowner pe orming all work myself. I am a sole proprietor and have no one working in any capacity e._.ta.:•• Ss- !.^ s►-"R".+..r.'+'+a!!-'^f!'AK..r�.i..,i74G7•.-�*e.er.=- .r• - - - '—`- '"y-""'"�-."'.'.�['+�-^'--••4 1 am an employer providing workers' compensation for my employees working on this job. contninv name: address: City- phone#• insurnnee co nolicv# II am a sole proprietor. general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comnnnv n•tme- midress• city nhone#• incurince co nelicv# �- _ ... _... .r...!:::.�..::}yec:--,-�•:-:-Tc�r.«f-*.?Fc:.__---;'cep•••-•.•.��?�i',rn;•J�+r�..+e�.s.::'t-''�":^..rcq*`v...--Ta+r*�!�!F^�5 -'a'--•-"—r cmmninv name: nddres�- rite• nhone#• insurance co. # _ :Attach additional sheet if necessa ;'- r; o,�,,�=„" :�,;�,;�m•;;: ^.`"-, "'".' - =ems."aue �e•;..kr::.,: Failure to secure coverage as required under Section 25A of AIGL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 andior unc rears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 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. ' 1 do herehr cerrij•un, the pa rs d etralti of perjun• hat the information provided above is true and correct. Si_natum Date o21 /9�6 Print name Phone# r-__10C1;t7:cor ial use only do not.write in this area to be completed by city or town official town: permitAicense# rlBuilding Department Licensing Board 0 check if immediate response is required [3Sclectmen's Office Otlealth Department contact person: phone#• 101her_ Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' ccmt:ia'.nsation for the employecs. As quoted from the an emploree is defined as every person in the service of another under anv contract of hire, express or implied, oral or written. An einplorcr is defined as an individual, partnership, association. corporation or other legal entity, or anv two or mdr the foregoing engaged in a joint enterprise, and including the legal representatives of deceased emplover. or the - receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However th owner of a dwelling, house having not more than three apartments and who resides therein, or the occupant of the dwcllin`g house of another who employs persons to do maintenance , construction or repair work on such dwelling, ho or oft the `,rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chapter 152 section 25 also states that ever% 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 common-wealth 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 ?. been presented to the contracting authority. 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 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 requirec` to obtain a workers* compensation policy, please call the Department at the number listed below. 777 .. .. .... ..... '•.. ..: r!..._..._.. ;.;.-. - :^.dM:•• .. r.�:e9+`r:rid -. �..C�:1._ •:5. City or 'roivns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o- the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Plea be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t the Department by mail or FAX unless other arrangements have been made. The Office of Ltyestigations would like to thank you in advance for you cooperation and should you have any question.. 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 Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 i6i• (Al 7) 777-4900 p.r_ 406- 409 or 375 r SITE PLAN x� I ' v` SCR J / 1 ' r 1 - AVEN LANE .5 1 - `� Property lines shown on this peak � r _ -are for assessir?g purposes ora4y i 1 and do no!represent actual Teiationships to physical 011,NV l ,. A P- .� 9. 9.1 - i At 34.7 X 17.2Ar I _ 99 4.1 , r�29.8 _,`•�7.6 f� 14.3 10.9 �� 10.7 /� 10.9 3 .1 a /1O 11. 31.2 -- 116 29.4 i 31.0 r � ;, � � i 'i / •8 - � l r i IliM a , � � ► , � I (- � VU ' S Fee`r" OoTI I i iMal. r .a III i � i I � �III is i f `` . ........... .::.:......:. ...............:......:. . .....:::.:.:. :. . x-x .mix:::::: � ..max.... 0 .::.:::.:.:::::.:.:::.::: ..�::..v..�:::::.:..::::.:::::.:.:vvv.:::::::::::.:::.:::.:::: X. .......::.:::::::::.:.::.:::.v.::::::::::::..::..:..::.::::::.v....::::::::::::.::.::.:::::::::.:::::::::::.:::::::::::::::::::::. oftp ...i: E LANE~`• x ' ' M. HYANNISPORT T.0 NEIGHBOR ...........:.:........ .. .. >> PUTTING U G ON ADDITION—NO P ERMIT.PL EA E CHECK.S 3` :'r iii:$:::::•:�i`i`ii;;t`{: :y::� m<>} y<::;:>:;:'+$;:i>.i v::::••::•. v:v:::::::::v:::::::::.......................................v ::i4:[2<a:J:4>:;•i:{;•:�:vvvviii4i:vvviiiiiv:iii.';v:>.:::i::i:::i::i::i::i::>:iii: •::•;••..:• v::::•:•::}::::v:^::••••••::::v:::::••isii::•is8'S:v:Y8'^:?•:•iiivvvi;}v::vii:•i:{•:^:•i:?•i'^::^:^?:iivi`ii'•visvvi:3:•i}}":'iii::::ii::i}Yiii: "kt.v:.i:.::.WENT BY—BL DG. ON-GOING WILL REFER O R.S. r6 S S D O � a S' C�fL12�t•(, Q- 4 tw '' «<> Assessor's office(1st Floor): I r^ Assessor's map and lot n tuber n�.�' f / 0 3 *t�C,G �- �oS THE to` conservation(4th Floor): 11.- ' 23 �gy���ULLED IN COO fifi(k�L- `���� 4. Ord of Health(3rd floor): q I WITH TITLE 6 4 ssassr�nt Sewage Permit number ', /, J- !/ 1 . ENVIRONMENY�1l.������® 'oo MAAI d° t-Engineering Department(3rd floor):,` TOWN REGULATIONS House number ��0� ��d®�� air Definitive Plan'Approved by Planning Board 19 P APPLICATIONS PROCESSED 8:30-9:30 A.M4and 1:00-2:00 P.M.only r. TOWN OF BARNSTABLE -BUILDING INSPECTOR 'APPLICATION FOR PERMIT TO C GDf TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: , The undersigned hereby applies for a permit according to the following information: Location20 Proposed Use %4 Zoning District 1 t Fire District Name of Owner ?A)L (� Address' Name of Builder Owoe Address Name of Architect 1� Address Number of Rooms Foundation lbv Exterior !�� Roofing Floors J&D n \ Interior qLLkock Heating � Plumbing ©� Fireplace Approximate Cost Area /�D �°./+ Diagram of Lot and Building with Dimensions Fee OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regar ' the above construction. Name r V <j Construction Si ipervisor's License c/ ����� STEWART, PAUL G. rF , %�� No 36500 Permit For Change Roof Line/Add slider _ Single Family Dwelling Location°R3 46f Haven Lane S J Hyannisport F Owner Paul G. Stewart r Type of Construction Frame -r Plot Lot Permit Granted February 23 , 19 94 Date of Inspection: Frame /h' 19: Insulat 6n 19 s Fiteplacei-, 19 Date yCoM7 etefd , 19 ' F 1 t � z I`A iE „ i 2 o wy TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please- print. DATE JOB LOCATION f p� Number Street Address ction Of Town "HOMEOWNER" L Name Home Phone Work Phone PRESENT MAILING ADDRESS 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 such 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 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 building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State 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 HOMEOW14ER I S SIGNATURE 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 I Y re* HOME OWNER'S EXEMPI')I�ON The code states that: "Any Home Owner performing work for which a buildin Permit is required shall be exempt from the provisions of this section g (Section 109.1.1 - Licensingof Construction Home Owner engages a coon Supervisors) ; provided that if, person(s) for hire to do such work, that such Home Owner shall act as supervisor." Many Roue Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q for Licensing Construction Supervisors, Section 2.15) .RuThislesand lack eoflations awareness often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the unlicensed person as it would with licensed supervisor. The Home Owner acting as supervisor is ultimately responsible. To' ensure that the Home Owner is fully aware of his/her responsibilitie many communities require, as part of the permit application, that the Homs,e 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. ,� i /' � � � 1 � fF ..r'.x- -.--�- -- � ,� lam-f` l� y__,.�___T.�-� �. _---- � �r'' _