HomeMy WebLinkAbout0058 MEGAN ROAD ss rneg�
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TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
Map, Parcel a Application # L�f o.P o
Health�Division Date Issued
Conservation Division r Application Fee
F
Planning Dept. Permit Fee (00Date Definitive Plan Approved by Planning Board
Historic OKH _ Preservation/ Hyannis
Project Street Address ��� i)7 es?C?41 n r`5
Village Yyq oi'5 u'l l l a w 15
Owner /Oy*t D' Conn t, Address r�Gy►''"�-
Telephone /O
Permit Request
Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new
Zoning District Flood Plain Groundwater Overlay
Project Valuation Construction Type
Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation.
Dwelling Type: Single Family Two Family ❑ Multi-Family (# units)
Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No
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
Number of Bedrooms: existing _new
Total Room Count (not including baths): existing new First Floor Room Count
Heat Type and Fuel: ❑ Gas ❑Oil ❑ Electric ❑ Other
-
Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/ .:al stove;❑Yes ❑ No
S
Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ r new size _ Barn: 0 Listing new; size_
v Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other:
Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑
C
Commercial ❑Yes ❑ No If yes, site plan review#
Current Use Proposed Use
APPLICANT INFORMATION
(BUILDER OR HOMEOWNER)
Name ��r� 1ICC��i'h ,� Telephone Number
Address A 9S4v P9r Ci rc le-- License# 07 00 3
50- 9-4/6'6) Home Improvement Contractor# I q 7 '3 3
Worker's Compensation #
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO 71vl �7
C"
SIGNATURE DATE ��
1
FOR OFFICIAL USE ONLY
APPLICATION#
y ` -DATE ISSUED
,s
t MAP/PARCEL NO.
ry .
ADDRESS VILLAGE
OWNER-
7
DATE OF INSPECTION:
FOUNDATION
ti
FRAME `
'y
INSULATION
FIREPLACE
`r ELECTRICAL: ROUGH FINAL
PLUMBING: ROUGH FINAL
, t
GAS: ROUGH FINAL
t
'a FINAL BUILDING
DATE CLOSED OUT
ASSOCIATION PLAN NO.
f
4 Towne.of Barnstable
Regulatory Services
IIAMSKAS& Thomas F.Geiler,Director
°rE16.19, � Building Division
Thomas Perry, CBO,Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fa„: 508-790-6230
PLAN REVIEW
Owner:'*-[—; t C c70f�'C C -� Map/Parceh 9
Project Address Builder:
The following items were noted on reviewing:
o g 0 7
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mat S i `7-o
Reviewed by:
Date: ' ` O ?S
Q:Forms:Plnrvw' .
,
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Le 'bl
c/°
Name(Business/Organizadondndividual): L�r
Address: &,'46 5lv _eolr C.`r C.
City/State/Zip: 0l4,11,'5 M^ Phone.#: 6 a? _29 3L�
Are you an employer? Check the appropriate bog: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.raq I am a sole proprietor or partner- These sub-contractors
on the attached sheet. 7. ❑❑Remodeling
ub-contractors have g. Demolition
ship employees
and have no partner-
working for me in any capacity. employees and have workers' 9 ❑Building addition
[No workers' comp.-insurance comp•insurance.#
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.❑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 Homeowners 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 or not those entities have
employees. If the sub-contractors have employees,they must providb their workers'comp.policy nwnber:
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
. f.
Policy#or Self-ins.Lic.M Expiration Date:
Job Site Address: A'e-9 Gl 4 City/State/Zip: Milq tmi�� r"r,
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 tip 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 may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certi under the�pa�i�njs-and penalties of a.'ury that the information provided above is true and correct
Signature: �t/G d I.0 Date: �2
Phone is <6 d' -/O -7- "`7
Official use only. Do not write in this area,to be completed by city or town of xiaL
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#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees:
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hue,
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, §25C(6)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,MGL chapter 152, §25C(7)states`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 out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees, a policy is required Be advised that this affidavit 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 to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City orTowwOfficials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e. a dog license or permit to brim leaves etc.)said person is NOT required to complete this affidavit.
The Office of Investigations would like to thank you in advance for your 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 lndustrial Accidents
Office of Investigations
600 Washington Street #
Boston,MA 02111
Te1. #617-727-4900 ext 4-06 or 1-877-MASSAFE
Fax# 617-727-7749
Revised 11-22-06
www.mass.gov/dia
. r
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°F1HE l° Town of Barnstable
Regulatory Services
HAMSTABv MASS. LKg Thomas F. Geiler,Director
Fo;Aga`` 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
0U."j.-Q- , as Owner of the subject property
hereby authorize /'M cCgv -J9� to act on my behalf,
in all matters relative to work authorized by this building'permit application for:
56- /7?e9 g/L /00y11'40 ,'s 1;7--L
(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:
h�'!lR AAC•l1WNFR PFR MTCCIf1N
I
v±
Town of Barnstable
c VHE Tp��
Regulatory Services
t
Thomas F. Geiler,Director
BARNS TABLE,
j. MASS.
g, 16,9. Building Division
PlfD �A 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
DATF:
JOB LOCATION:
number street village
"HOMEOWNER":
name home phone# work phone#
CURRENT 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 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.
r;_ �/e �anr�naru o�./�aooac%ucCld ..
Board of Building Regulations and Standards
` Construction Supervisor.License
Licenec CS 70036 r
� � � ,�. Birthdate 4a/3/1961 -
E Tr# 8829
l
ROBERT C MCCA I
9 KINGSWEAR CIR � f �-'�-
S DENNIS,MA 02660 Commissioner
�/ee �io�ovmoncuera,� o���aaoaa�suoefd6
Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
RsgistratWAF 147933
U 10 '.*23/2009 Tr# 133109
.Type. li lividual
ROBERT C MCC JR
ROBERT MCCARTHY JR
9 KINGSWEAR CIRGL!l:,: -•`
SO DENNIS,MA 02660 Administrator
4
V
McCarthyCarpentry Services
Rob McCarthy
9 kingswear cir. c.s.lic#070036 h.i.c. Reg#147933
So.Dennis,MA,02660 phone #: 508-982-7936 Fax # 508-385-3299
.o
Contract Proposal
Tom Oconnell
58 Megan rd, Hyannis ,Mass
JOB DESCRIPTION
Construct New Deck Approx Size 14' x 16'
2x 10 Pressure Treated Frame w/2x8 beam
pressure treated Decking Boards
Hand Railings w/ 4 x 4 post 2 x 6 top rail - 2x4 bottom rail - 2x2
square ballisters "at 38 inchs in Height & spaced at 31/2 inchs apart
8 inch Cement Footings approx ,depth 4 ' deep
1 @ 4 ft wide set of stairs @ 2steps down to to groun
* Remove All DEBRIS from Job Site
Total Job Cost : $ 3,000.00
Contractors Signature
Date : 5- .2 S-o y
Homeowners Signature :
...
Date : (-j
THANK YOU : ROB M CCARTHY
P
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- CER'T' 1 ` E l' E D PLOT PLAN
LOCATION �./)" .,� /5 '"...9
SCALE: / DATE — Ll-
R E F E R E N C E;
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ooigG 3.7 QD AST E
HEREBY CERTIFY THAT THE BUILDING RE LAND SURVFY4YR
SHOWN ON THIS FLAN IS LOCATED 0 N
tHE G R• O U N0 AS S HOV91N HEREON AND
T HAT i T O o GS CONFORM r O THE OF Mks
I ONI N G BY - LAWS OF THE TOWN OF f 4T s�cy
t -fQle �s�`��L YY H E N C 0 N S T P, U C T E D i��- �•� i
f3 JOSEPH M, a
BARNSTABLE SURVEY CONSULTANTS, INC .
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TisIAT IT Oos CONFORM TO THE t�OF�
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r--'a, C2?d� — � OEPTIC SYSTEM MUST BE
Assessors map and lot number .. .... .................... ...... ... INSTALLED IN COMPLIANCE
/ WITH A"71CI_E II STATE
Sewage Permit number �` $ANITA�tY CODE AND TOWN
...... ...................................................
REGULATIONS.
Pyo*TNETo�♦ TOWN OF BAR.NSTABLE
• 0
BABB9TSDLE, i
N
16q. BUILDING INSPECTOR
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APPLICATIONFOR PERMIT TO ..................... ............................................................. .r ...........................
TYPE OF CONSTRUCTION ...... ........ ...............................................................
.......... �........19. .
TO-THE-INSPECTOR OF BUILDINGS:-
The undersigned here y applies for a permit according to the following information:
Location � ........% / ... � . ................... ..............................
t
4
ProposedUse ...... ..... ...... ..�4/. . .... ... ............................. ................................
Zoning District ..... 'e- ....................................................Fire District ........ ..fir d l ..............
Name of Owner ..CJ.../�% .....v/ f�.:1�!r...Address ...d..7 .... .....7R4X .. .................
Name of Builder ...........................................��. rt................�t
................ .....Address ........................ ................
............................. I
Name of Architect '� 1�..................l� 1� t
i
....................................... ......Address ....................�.........................................................:......
.i / A! �f
Number of Rooms ...... ..r..........................................Foundation .1..®.. �4.......... ............... ... ..............
� //.
Exterior ... ........ ... ... .......... . .r la... .... ....../............Roofing .., ���.... h.. ..........................................
Floors � ��-�.% ®/�/� .Interior ........ ....,r ����1!r...........................
C� ...............................
HeatingT...CO`� Y.............../—--... ........................Plumbing ......./....................................................................
.
Fireplace ................... ..........................................................Approximate Cost ....5jx...?...ap-e................
�.� ..�:. .'
Definitive Plan Approved by Planning Board _____ ________ __ ______19_ .. Area ..... .. ."®'.... .......... ...
Diagram of Lot and Building with Dimensions Fee Ste'—'
SUBJECT TO APPROVAL OF BOARD OF HEALTH
rl—bl?
1 c,
,Lb
I hereby agree to conform to all the Rules and Regulations of the Town of B nstable garding the above
construction.
Name .. ..... . � ` . ...................
Dacey, William Jr.
163 16 one story
No ........ ...... Permit for...... ...............
single family dwelling
...............................................................................
Location U g Megan Road .
.............. ..............................................
Hyannis !
...............................................................................
Owner
William Dacey, Jr.
Type of Construction
frame
..........................................
................................................................................ '
#112
Plot ............................ Lot ................................
Permit Granted ..............................18 ....19 73 r
.... .
n
Date of Inspection ...... .......... ...............19
�2 3 73 M
Date Completed '
(=D*PG&-74 + `
i
PERMIT REFUSED
................................................................ 19
........ . +:
...............................................................................
i f
...............................................................................
...............................................................................
J
Approved ................................................ 19
...............................................................................
...............................................................................
Assessor's map and lot number ......P` /.. .. . v.. 'T IC SYSTEM MUST BE
L 9- 1- 13 F �r.h r 'r
Q,e. �� �i;.,���A.LED f,l CO .iPLIANC,
.Ld �'�. 16/w �'I'TH A`-TIC', II STATE
Sewage Permit number ..................... ............. ....Q!~'.:.... �ZW SVITAV CODE AND TOWN
FEC.ULAT110 S.
yofTNEro�1 T iN OF BARNSTABLE
i BJHBSTSDLE. S
=o, QY.a�O� BUILDING INSPECTOR
daAd......6�,j
APPLICATION FOR PERMIT TO .... d ....... . . ............. ....................
TYPE OF CONSTRUCTION .......(„1...... ....
...... 19-23
_. -TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby, applies for a permit a 'ccor ng to the following information: o
Location ... ... .................1. ............. /G? .Or`?/!...... ................................... .. . A
Proposed Use ..
a
Zoning District ...... �.................... .. ............Fire District ...... �1 ........... o
Name of Owner .. .:... .... ............ .Address .....dKx
P/ ............. ........ li fr..............(`............`..f
a�
Name of Builder ........................................ ....Address ..................:.....
f/ fi `t `- rr
Name of Architect ....Address
Number of Rooms ...................°/... /f6t_.-.,c4............
.......................................Foundation ...... ..........F.
Exterior ... ........L.... .....................Roofing ... ..............................................
Floors .,�2� �1•< 0Dr-.V 6.6 G ................Interior ., .,F/ -z tolnc,_/................................
Heating1/ ... ...............Plumbing ..........:o................................
.................................
I_Iefz� oew -�
Fireplace ............�,)..............................................................Approximate Cos .��� ..........................................
Definitive Plan Approved by Planning Board �'- 19 � Area
. '
..........
SE -,S yfr�� si � - 5Diagram of Lot and Building with Dimen Fee ...........................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
SV
�N tou) l�r
t I hereby agree to confor to all the Rules and Regulations of the Town of Ba stable regarding above
construction. ��
Name ... . ....... ................................. ................ ..... ....:....
Dacey, William E.Jr.
i
No ..16r���....Permit for .....aaa........Sae
......a�...Y. awel7 i? .........................................
Locationv� Me an Road
g.................................................
......................
YaX4 .;3....
......................................
Owner ..........Y4J]C...........
Type of Construction ................frame..............
................................................................................
Plot ............................ Lot ....... a 1.2....✓...........
Permit Granted S.eptember. . . .....5........19 73
. . .......... . .. ,
Date of Inspection .......................... ........19
nn
Date Completed ...� .��. '/.. ...19
PERMIT .REFUSED
................................................................ 19
...............................................................................
...............................................................................
.......................................................................... .. .
i
Approved ................................................ 19 f !
............................................................................... r
...............................................................................
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