Loading...
HomeMy WebLinkAbout0434 LINCOLN ROAD EXTENSION `t � � � 11�1 CO l..N �v!�� �`t.1. ,'� ,;J, � ', L - , . �. _j.�-=y-- _- _ � \� i ��� � � ` I j. . _ . : r ,.. . � 4 .�-- --_ _ .�-. --___� .�` p' .y s=`3 To Date Time WFnE YOU ERE OUT M of Phone Area Code Number Extension TELEPHONED PLEASE CALL CALLED TO SEE YOU WILL CALL AGAIN WANTS TO SEE YOU URGENT RETURNED YOUR CALL i Message f I� Operator oftAMPAD 23-021-200 SETS EFFICIENCY® 23-421 -400 SETS CARBONLESS. oft r� Town of Barnstable *Permit# 60? Expires b months rn iissu ue Regulatory Services Fee BARWrABLE, Thomas F.Geiler,Director MASS. 2639• .� Building Division �v ren��s Tom Perry,CBO, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Z-7 l Property Address V3/ /'��eolq JC f e K 7". EKesidential Value of Work rr G�00 Minimum fee of$25.00/for work under$6000.00 Owner's Name&Address ,�4 k vL . y3-1 Z eCdlf e lc 7-, Af v/iG_ Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance -PRESS PERMIT Check one: ❑1 am a sole proprietor NOV O ZOO7 Q'I am the Homeowner ❑ I have Worker's Compensation Insurance " OWN OF BARN,TABLE Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. i I Permit Request(check box) - [✓(Re-roof(stripping old shingles) All construction debris will be taken to - I ❑Re-roof(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders. U-Value (maximum.44) r"') ('a *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 op the Home vement Contractors License is required. SIGNATURE: Q:Forms:bu ildingpermits/express Revise091307 ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' wfvw.mass.gov/dia ' Workers'Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plumbers _Applicant Information / Please Print Legibly Name(Business/Organizationadividual): �9 b, h' _c4u0 Address: _1_J vz�or City/State/Zip: nf C- PhoneA: d9a63 Are you an employer?Check the appropriate bog: :Type of project(required) 4. I am a general contractor and I 1.❑ I am a employer with ❑ 6. ❑New construction . employees(full and/or part-time).* • have hired the sub-contractors 2.❑ I am a'sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition: 'working for me in an capacity. employeeg and have workers g y P tY• p $. 9. ❑Building addition (No workers' comp.insurance comp. 10. Electrical repairs or additions �/ equired.] 5. [] We are a corporation and its ❑ 3.[✓� I am a homeownez doing all work . officers have exercised their l l.[]Plumbing repairs or additions ' myself,[No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance.required.]t c. 152, §1(4),and we have no employees.[No workers' 13.❑ Other comp,insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeownera.who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating'such. tcontractors that check this box must attached an additional sheet showing the name of the Sub-contractors and state whether ornot those entities have employees. If the sub-contractors have employees,they must provide their workers'comp,policy number. compensation insurance for my employees. Below is.the policy and job site I am an employer that is providing workers' information. Insurance Company Name: Policy#or Self-ins.Lic,#: Expiration Date: - lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page'(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the bIA for insurance coverage verification I do hereby certify der a pains and enalties of perjury that the in provided above is true and correct. �C�=��� Date: l— 62 Si ature: — Phone# S_© ��5� ��63 Official use only. Da not write in this area, to be completed by.city or town off ciaL City or Town: ' 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#: A Town of Barnstable �OFIME Tp� Regulatory Services w BARNSfABLE, Thomas F.Geiler,Director 9 MASS. i639• p,0 Building Division rf0 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 ------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: ��—��"c,O 7 JOB LOCATION: number street village W !.t "HOMEONER': ^ ocf/r2 `'SAD —��•s����� �7i— �07� name home phone# work phone# CURRENT MAILING ADDRESS: Y �N�'O/K J�CX <f5Z O 2 coo/ 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 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 requir Signat o omeowner l 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 ,. rl OF THE 1p�, Town of Barnstable Regulatory Services r r an ASS.�a Mass. Thomas F.Geiler,Director M i639• � iOTfn3.a Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I, as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. QTORMS:OWNERPERMISSION Engineering Dept. (3rd floor) Map Z 71 Parcel 31 Permit# �$ House# 14 C_ Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) "I,/ �J cr� A— Conservation Office (4th floor)(8:30- 9:30/1:00-2:00) hil , , QUA SCE Planning pw floor/School Admin. Bldg.) _ VOOR7 Defi ' ive Plan pp' ved by Planning Board P' P� 4 �a E AND s639• TOWN OF BARNSTABLE F09. Building Permit Application Pro 1 t t Address y3 y h n co l a JR!ej Village _AeA my r A M Owner 110 n ('cam✓c//le. Address h/3 y r c c/m 12 el C:.x 7" Telephone 7 7�= 0?!o G 3 Permit Request R Id SG►^Ce n. JJo c.9s 2 First Floor /7�� )C JZ = HY square feet Second Floor square feet Construction Type LA)p p/•'�) tp,a.441 "S, Estimated Project Cost $ yDa Zoning District jL C I Flood Plain Water Protection Lot Size /D x' %O ' Grandfathered ❑Yes @110 Dwelling Type: Single Family 0 " Two Family ❑ Multi-Family(#units) Age of Existing Structure 33 Historic House ❑Yes To On Old King's Highway ❑Yes S�Ne Basement Type: of ull ❑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 3 New Total Room Count(not including baths): Existing New First Floor Room_Count Heat Type and Fuel: ❑Gas 2 r06il ❑Electric ❑Other Central Air ❑Yes 2O Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) 1 ° ❑None ❑Shed(size) 10 ' )C 1 Z ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 10 If yes, site plan review# Current Use Proposed Use Builder Information Name g4(e Telephone Number 15-0 e66 3 Address ���y__&A eAc License# Ty h/.S h�l 4_ 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 SIGNATUR DATE BUILDING P IT DENIED FOR THE FOLLOWING REASON(S) \ , . a � a t � i "� `�� f ` �`.� .�..> J � }�` "�e -- _ "� . �,.� p, . - - � .� -;. �I ' - - „ � f r �� - !- � _ �, ' c. .. �f � f � .. f �_ � f • � � . � f i � f � 1 i! +, .. f r r�i - �__ �rr �! J .^ �� f .. _ I. .Q'rf ( � +! f `' � (t do ` � � f �' r;- f � .� f� „ y •s lble The Town of Barnsta;s Department of Health Safety and Environmental Services Building Division r 367 Main Street,Hyannis MA 02601 Ralph Crosses Office: SCEM0.6227 Bing Commis F= 508-775-3344 For office use only Permit no. Dais AFFMAVIT HOME MOROVEMENT CONTRACTOR LAW SDPPLEMENT TO PERwr APPLICATION ctio alterations;tmavation'�mode i=don'Conversion, MGL c. 14ZA requires that the"rt;oonstru n. � improveme�.removal, demolition. or construction of an addition tom �a occupi at least one but not more than four dwelling units = building widen containing registered oo�a=M with eaMin oM along with other to such residence or building be done by rcqWrcmcnM �cl c K c P.i4 ®vse- Est Cost Lzee Type of Worts: S Address of Worts: OR-ner.Namc i� Date of Permit Application i I hence certify that: Registration is not required for the following rcason(s): Work cmduded by law ob under S1,000 Building not owner-oocupied Owncrpuftgownpwmit Notice is hereby given that: CONTRACTORS OWNERS PULLING THEIR OWN PERMIT OR DEALING WITIiDNIiEGIS ACCESS TO THE FOR AppUCABLE HOME IMPROVEMENT WORK DO NOT HAVE AR131TRATION PROGRAM OR GUARANTY FOND UNDER MGL c 142A SIGNED UNDER PENALTIES OF PERJiIRY I hereby apply for a permit as the agent of the ovL'nw Date ntractor name Registration No. "`.='• Tile Comnironmealt/n of Afassaclnusetts Department of Industrial Accidents s ; ;" -=�� . . OfllcEa/IayesD9at/oas ' '; � 6011 1f kwhit.M H Street Bimlotn.Alarm 02111 �--' Workers' Compensation Insurance A1�d2vit Ise =917 , �- U�3Id l am a h eowner performing all work myself. ❑ I am a sole proprietor and have no one woTkin_in any capacity ❑ I am an emplover providing workers' compensation for my empioyees working on this Job. m iri • city phone#t . nailer!! ' Incur•ince co , ❑ I am a sole proprietor.general contractor, or homeowner(circle one)and have hued the contractors listed below the following workers' compensation polices: C"flim,n addre"- city! phone 0! C11rn11CP rn -J7R« •:�iT,�•►r.J7F? ,.�'•'TA'*RT=` m im•"Time! address- cin-- phone 0 co- cu "� :A_ttach additionafshee[ffaeeessar •�' '�"� +'��r�}���-• •��• r u�t•�.�`�`, — - Failure to secure cot eragc as require.d under Seetion 3A of AIGL 152 no tend to the imposition oicritoiaai ptaaitin of s Gae op to S1.500.1 un ear e VMS'imprisonment as well as civil pensities in the form of a STOP WORK ORDER and a lint ofSIDDAD a day against mt. I naderstu- copy of this statement mad•be forwarded to the Ontce of investigations s of the DIA for coverage verilleatioa. I d ,erchr cent •une • die pains penalties of perjure that the infornmrion pttarided above is netts and conns2 Dam -3 Signature ;,A4t,-' Print name ofricial use oniv do not♦Trite in this area to be completed by City or town ofIItial perms ICense# _nBu lding Departmem. city or town: OUcensint;Board aired aseleetmen's Ofner Q check if immediate response is rev (3tienith Department Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers:' compensation etr.ployccs. As quoted from the "law". an empl(tyce is defined as every person,in the service ofanother under contract of Hire. express or implied. oral or%%Titter. An enrplt rer is defined as an individual. partnership. association. corporation or other legal entity, or any two tltc foregoing engaged in a joint enterprise, and including the legal re 'resenmtivcs of a deceased employer, or receiver or trustee of an individual , partnership. association or other legal entity, employing employees. How, owner of a dwei ling, house having not more than three apartments and who resides therein, or the occupant of t dwc1ling house of another who employs persons to do maintenance, construction or repair work on such dwell or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an en r' MGL chapter 152 section 25 also states that even'state or local licensing agency shall withhold the issuanct rene"'al of a license or permit to operate a business or to construct buildings in the commonwealth for ar applicant who lies not produced acceptable evidence of compliance with the insurance coverage required Additional!•, neither the commonwealth nor any of its political subdivisions shall enter into any contract for th( performance of public work until acceptable evidence of compliance with the insurance requirements of this chs been presented to the contracting authority. ( .r�.�..�r�. ... •.»�.�w .. '1�1,..• . .�:-y. . .• ','..`..;Hr';IK;;:•,..:..�'a�:J..!. .�S•:..t.:.•Y.'..:►�Y1.�;��'.7�a"'...•:.i Applicants Please `,'I in the workers' compensation affidavit completely, by checking the boa that applies to your situatior 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. 711( 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 re: to obtain a workers' compensation policy, please cal; the Department at the number listed below. �.. 1r.�.. .'/A�.17.• � � .l'.1PMI-..��� � .w .x/.. .. .�..y!)__.{� .�.....�IC�.. 't7 ' .. .. r.. +�.i :.:�' �.. :ji.:.r«:...:71�r •��r�.:�!�.+_�.S".:1i.'� .�ARt.11►..ia:..,!.3t•Ir ... Cin• or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bor the affidavit for you to rill'out in the event the Office of Investigations has to contact you regarding the applicant. be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be retu. the Department by mail or FAX unless other arrangements have been made. A The Office of Investigations would like to thank you in advance for you cooperation and should you have any qui please do not hesitate to adve us a call. r .. .. v .ice ,. _.rq...,.w•..�.r�..ii..w wr�:ia •i.u�� ' :.1ir'. . T7te Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents r' Office of investigations 600 Washington Street !Boston,Ma. 02111 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE JOB, LOCATION y.3 y n c o I n f� cQeW 7.- Number Street address Section of town "HOMEOWNER" oIn 04,Vd! 7 Z - 8&(o Name Home phone Work phone- PRESENT MAILING ADDRESS y3-y �i.�rco% �Cc.Q .4 S �� o City town State Zip coi The current exemption for "homeowners" was extended to include owner-occur dwellings of six units or less and to allow such homeowners to engage an dividual for hire who does not possess a license, provided that the owner acts as supervisor*. DEFINITION OF HOMEOWNER: Person(sy who owns a parcel of land on which he/she resides or intends to side, on which there is, or is intended to be, a one to six family dwellii attached or detached structures accessory to such use . and/or farm structuz A person who constructs more than one home in a two-year period shall not considered a homeowner. Such "homeowner" shall submit to the Building Off on a form acceptable to the Building Official, that he/she shall be respor. for all such work performed under the building permit. . (Section 109.1.1) The undersigned "homeowner" assumes ,responsibility for compliance with the 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 re i.reme:. and that he/she will com 1 it said �. P Y procedures and requirements. HOMEOWNER Is SIGNATURE �az.4� APPROVAL OF BUILDING OFF IAL Note: Three family dwellings 35,000 cubic feet, or larger, will be reuirE to comply with State Building Code Section 127. 01 Construction Controlq SOME OWNER'S EXEMPTION The code state that: "Any Home Owner performing work for which-4- build permit is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided tha Home Owner engages a persons) for hire to do such work, that such Home shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assum the responsibilities of a supervisor (see Appendix Q, Mules and Regulat for .licensing� Construction* Supervisors, Section 2.15) . This lack of aw often results in serious problems, particularly when the Home Owner hir unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it-,would with licensed Supervisor. The Home"Owner as supervisor is ultimately' iesponsible.4 �. ... To ensure that the Home Owner is fully. .aware of his/her responsibilitie: communities require; as •part *of •the permit application, that the Home *01 certify that he/she understands the responsibilities of a supervisor. t last ,page of this issue is a form currently used by several. towns. You care to amend and adopt such a form/certification for use in your commur . 271 ABSO. RS M. AP T L E . .AS, SES f �` �� • ���� � �►1 . ���=��♦ � i!� Imo. a i�•1/ .� ,/ , � ;�r , • ;��'`� � wry, ; • , ► ` !ice►�I�:��r`� ��� `�' J1� I:�S � •=-,,4_ TYPICAL ROOF CONSTRUCTION ASPHALT ROOF SHINGLES �- 'q-PLY-OOD SHE 2'X8'RIDGE BOARD 2'X6'RAFTERS I6'O.C. 12 ASPHALT SHINGLES 5F_ 2'XG'c 16'O.C. SEE DETAIL 'A' SCREENS ITYPICALI N u+ TYPICAL EXTERIOR WALL CONSTRUCTION SCREEN SCREEN PORCH 2•X4-STUDS 16'OC 'PLYWOOD SHEATHING l'X6'CLAPBOARD 36'X80'ALUMINUM STORM DOOR 'X6'CLAPBOARD m i'X6'DECKING BRICK c CENTER SPAN UNDER JOIST 4'X8'LEVELING BRICKS fiYP.l 2'X6'PT c I6'AC �-EXISTING CONC.PAD REAR ELEVATION 3'-6 B'-B 3'-B' SCALE, •=,'-K• ,r-e' - CROSS SECTION FLOOR PLAN DRIP EDGE ASPHALT SHINGLES I'X2'TRIM 1•X8•FACIA PX6'PLANCHER SCREEN SCREEN SCREEN ZONE:RC-1 SETBACKS: FRONT:30' DETAIL "A" REAR 15' scALE,I •=r-e• REAR:15' 'X6'CLAPBOARO 'XG'CLAPBOARD PLAN SHOWING PROPOSED SCREENED IN PORCH AT 434 LINCOLN ROAD EXT. RIGHT & LEFT ELEVATION FRONT ELEVATION HYANNIS,MA. SCALE,I$••V-e• SCALE,Ij--V e DATE:JUNE 3.1996 SCALE:%"=1'-0"