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HomeMy WebLinkAbout0281 MEGAN ROAD � I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Ma 4w- n _�_Parcel Permit# 6,2200 -.. ��. Health Division--- . 7 a- 02- �L-3� Date Issued . Conservation Division ®2 '���'`� Application Fee Tax Collector Permit Fee430 � Treasurer. 647 Z4_4 L SEPTIC SYSTEM AAUST BE Planning:Dept. INSTALLED IN COMPLIANCE V=TITLE B Date Definitive-Plan Approved by Planning Board ENVIRONMENTAL CODE AND Historic-OKH Preservation/Hyannis TOWN REGUL.XTIONS c_ Project Street Address U _VAA L Village Owner C3L_v_ e Address Telephone S cis : 0 =0N 0 cc�l Permit Request `` , Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay 0 e 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: ❑Y * o Basement Type: kFull ❑Crawl Walkout ❑Other = Basement Finished Area(sq.ft.) fw Basement Unfinished Area(sq.ft) u'` 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 C unt NO m Heat Type and FuelC4Gas ❑Oil ElElectric ❑Other Ce ral Air: El Yes 6 Fireplaces: Existing New Existing wood/coal stove: ❑Yes El No Deta hed garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attac ed garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name �^ �— Telephone Number ^�_ c� 790 r� Address License# - - - Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �— —0 e FOR OFFICIAL USE ONLY F. PERMIT NO. DATE ISSUED MAP/PARCEL-NO. ADDRESS VILLAGE OWNER I DATE OF INSPECTION: FOUNDATION " } FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH:-�- FINAL PLUMBING: ROUGH _ c FINAL GAS: ROUGH FINAL . FINAL BUILDING #� : DATE'CLOSED OUT ASSOCIATION PLAN NO. ; J r • a The Commonwealth of Massachusetts v < == Department of Industrial Accidents = - Office 81/11oestigations . 7 , 600 Washington Street Gil Boston,Mass. 02111 • -- Workers Compensation Insurance Affidavit it e,5, 'location: ' ci hone# �J � - I am a homed&er performing all work myself ❑ I am a sole r rietor and have no one workin in an ca aclty 'I am an em to er roviding workers compensation for myemPtoyees working on this 'ob. . . ... ........- . : . . . : . . . .............................................:..:::: con an .:n ailre "` '" ::>::::>::::::::.>::<: .:>;'>>:;ri:`>::>:>::::>:'::>:::> :>::::>.:.>'>:.>::::::> ton # :: �nsura,ce.c ❑ I.am a sole proprietor, general contractor, o omeowner( ' cl one) and have hired the contractors listed below who have the followingworkers compensation polices: ....................................................................................................................... rn,n an na,n ............�;'it�t�rCS .at :�..a.,�:.,•A•:..:.... ... :. ` 'kon Q K.Y... R ::::::ii:i:::�::,:::::: :insnratrce:co:::>:»::>::>::>::>:x::;::•;:;-;:.;;;:.;;;:;:.:.;;:.;:.>:.;:.;:.;:<::;:.;:.;;:.::.::::::::::.::::::::::::::::....................................... bl, < ::>:::><�>;>;..:;; .:.:..... lio ci ........:.:::.:.::::..;;.:::.:.;............... :::::....:::::...........::: .................::.:::. .......... ��ii±arai�sc. li 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 civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a' copy of this statement may be forwarded to the Office of estigations of the DIA for coverage verification. I do hereby.cerd nder the pains and p nald o perjury that the information provided above is true and eoirect )-6 Signature Date Print name w D Phone 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 ❑checkif immediate response is required ❑Selectmen's Office _❑Health Department contact person: phone#; ❑Other (fevieed 9/95 PW r 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. e a 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"ren6val 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 situatkn'and 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. you are required.to obtain.a workers' compensation policy,please call`the 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 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,permitllicense number which will be used as a reference number..T1ie affidavits maybe rehuaed ti the Departrn by mail or FAXrunless other arrangements have been made .. The Office o not hesitategto Oe would us a calle�thank you m advance for you cooperation and should you have any questions. - please d gi The Department's address,telephone and fax number: The Commonwealth Of Massachusetts ...Department of Industrial Accidents Orrice of Inues"gatlons 600 Washington Street -. Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 727-4900 ext. 406, 409 or 375 INE�° Town of Barnstable Regulatory Services �B CBI e� Thomas F.Geiler,Director 039.�A�` 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. Type of Work: . r Estimated Cos b Address of Work: �`V `�` 44 �QL Owner's Name: 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 ❑Owner 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. D to Owner's Name Q:forms:homeaffidav The Town of Barnstable Regulatory Services Thomas F. Geiler, Director Building Division 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: \K% L� V" number street village a "HOMEOWNER!'.. L�� name home �phon # 'work phone# CURRENT.MAILING ADDRESS: ` ,/ � �- city/tolo 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"homeoVer" rtifies that he/she understands the Town of Barnstable Building Depa nt minimum inrocedures and requirements and that he/she will comply with said proce es and quirem i ature 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:EXEMPTN _ 9 r." 40 y $ O r " ERT IFIE ® PL ® T P LAN w; A L E: DATE ✓c�iyE- /! ✓y'7S '- ERE .NCE : 6 —. s ' RESy CE RT1 FY T H Alf T H-'E BU1 L DING _ N— " 5UR..v..E_YO f�..._ ffEG LA ii G O W N O N T H l 5 . p .L--A ri 1,_5_ L. C A: 7—E [> Ora G ROUND AS SHOWN HEREON AND '1 T A: T t r 2-:�)oS _. C O N F O R M r G T.H E .,,•:, Z 0 I N G BY — L A W 5 O F T H E T O w O F N •"`� 72f w H E N C O AJ STRU CTE D ABLE SURVEY C_., '`' 0Na..U.-Li"ANTS4 INC sJ T "YARM .OUT. H KAA5S . �,� yU TOWN OF'$ARNSTABLE r� LOCATION�,� i�/r� N.��• !'�! SEWAGE # 3s C VILLAGE ASSESSOR'S MAP & LOT INSTALLER'S NAME & PHONE NO. i SEPTIC TANK CAPACITY / $ LEACHING FACILITYAtype) (size) NO. OF BEDROOMS 3 PRIVATE WELL OR PUBLIC WATER BUILDER OR OWNER 4 t - DATE PERMIT ISSUED: 0 DATE COMPLIANCE ISSUED: 252 2— 9�- VARIANCE GRANTED: Yes No v S � 4d' i to W 2 SO �I z id H F h v Y � z _ lu o . lit W � x C w � JA i r CH/M N� i t - d opt!RRYtNG. BEgn� _ FlRRYING B EA f i ' �I 11/ l X Ip BENCH -SEAT � i I { 2-2X1p Mallet CARRYING___ 7 3 -?Recur R tS E 3RECt�1�R15Es- --_ - SonfgTUBE _— �� F s map and lot`;number ....... tj Sewage`,Permit.number ...............: i!1. ..... .. ..... ! 5' �Qc° TOWN OFYBARN:STABLE i. BASB9TAD LE. i vl 7t 1 B'UILDIING ` IN'SPECT'0R. ,o�'fb 9: •, i 'EOYPY a` APPLICATION-FOR PERMIT TO I. A ... ....................... TYPE OF. CONSTRUCTION .. . ... ••• .............................. ••••••• - s ,- 1 117* .. 1410 V �. TO THE INSPECTOR' OF BUILDINGS: The 'undersigned;hereby applies'fora permit according/'to the following mformdtion: Location ..... .Y...... !/!r /`G/� L;fd .......� �: .....................`........ .. .. . . Proposed 'Use C�Tit/ J F, �-z f � �':�L X ..:: ........................................................... .. Zoning' District :.......Fire 'Disinct /. ! � ;Name of Owner f%/�/ii��,' 1'i! l......... t... Address. (tJ �?/.-Eit�r.. //4!/ Cse�, d' Name of Builder. . r ` ............................. Address / f �. ..............�..... . , Name of Architect' I+. ��..... .. .. �. ..: Ad dress .....................I � . . Number of Rooms' .. ........ .... ......... Found ........................................................................ .Fo /� G�}�L Exterior t, /.(/ �4L;� i(�' . Roofing" (... „ , ................ t Floors %'I ,. �f�dldh�lJT�,, l.. J.:.........InteriorZ !... ................ Heatin 1 1 �I/, �'/� x .. .Plumbing .................................. g ,. Fkreplace ........... `. . 1 .. .......Approximate..Cost .. .�i .... .. .. . .. Definitive Plan A roved'.b Planning Board ___ ��. �+_ � 19'� �... 'Area ...................................� ��r / A Diagram of, Lot'and Building with Dimensions Fee •,•••• ........ ..... SUBJECT 'TO.APPROVAL,' OF BOARD OF 'HEALTH I hereby, agree-to conform:to all- the Rules 'and Regulations. of the Town of Barnstable.,regarding the above construction. Name...... .. ... ...... 4 SF 1 'L - d1�.-:.S' �f 1 -1 - ,c: -.r '� .a — � r s 1 s. ~,;; a a 9 _.. 0. r 9 m E r A-2 1 5 - r � Y.,: �r' C _ e _ , r' Ls..•` S?•.-,. - .:1. 2 •:t• l I Fes, . 177'S•7, one =stor CI ,. �„1 Y,� - '� t - ,- Permittfor ...... �. - �= - u- ,. r• �`z-I.• �.. ,,f i5,.''t=', <c 1 .v' N., l .. .- ,. - •'C.. .Z,t F _ '.`Fs "7,; �, _ 1" d' . sink1 T,-am l dwe l l n --- z `T _ r r- _' ,... l e Y °... ... .... . ...::. , - - _ _-ra..: ... -.r `- A`' .c ` M an 'Road - r- _ - t: r �, ,:�.-.I�,�(.)_I--J.,...�—..-I.'�.,..�W�.l_;.­1",1�,-4,I 1..�,.1� LocotionI` ^'"!J l 'I. _ 'i �i ' � ' Sri I �1' Il, r4, - r I.,W1;l lam Z D ce Jr: _ - - .Owner a Y r ,, :.... .. . ;;: r 7-. e , . _ _ - t I .. . - t. I -Y -L` i s Type of.'Construction 7frame r I > r f' . I; 1- — .. .. — <-' s . , . Plot f t �. �` t ; #14_ ........ _ .-s --- - . .� '• ��,;• ?.. - - t :June,,.18 � •7 5 i, ;' - a' t• ` f s }x; ; Permit,:Granted :1,9. F, y } =h. ',r> - _ s Date of_Inspecti n T9- 4; 4 4 ;< A '" — f bate Completed ` ... 19_ �. _ ;1 7 {,:: J !. - - �' .- Imo: - ¢: � '7 , a.P. ,..`!_. - '__ 'tis'. {;, 1—. 'JI.• it �I _ - _— .C• :L , . . �`!. I - • t•. i 'y _ - ,. c' L^ • . 1 1 r i _, " 6. '' ., M II - - r :Is - oa PERMIT`REFUSEDi y 1 _ y' t: %. 1 a� ,4. , , ; _ n t _, - -- a ; r _ . J Y - k' ..J. f - 11' - .I:. �' _9. _ V. u- Fo L .; f — t _ _mil_ .__ -, _ _ - ti r v _. ...::.:.... •.••... . ;. .. ". .. _ a t. k y,. '. ,1 I. _ -,1 .t i 1 F '1. n .. , - 'i' ,,.I S r r� - ., ,IT. ` Z_ ,' f - fsl s ., Y• _ , ',.._­,;`-":�..'.�.�.,),t.0.*"":�-1,­,....��,'-.,,,,_..o,.�>,�I I.­­.II,.�p.�,.i..1'--..I"I�:�,.*..e",'0.,f:-.1.,-...-.�—­-.�_.��-�.',�<.-r.,.!'I�I-­�,*"1I.-1.I.,--,.,:,� :'c.l 2 3 : :1.' 4 / �/ -. - r _ "lid. ` - of " .I . - ,. _ c'. - . a -�1 - - 7 - - Ik .rr. - - I 5- Y'" . ,l; ;, - ,61 . 1 .. - .- r r' I. - .: , cy y -c. - ,:r ar- t ','. tee d s - �. _ }- '.�..- :y i r; �i• ,_ „ r. I I.1, ..,, .< f u, c 6 Assess ,'s map and lot.nu ber0./...� p �..... @ - C/% -' (� ���7 SEPTIC 6YS' T gt 7S MSTALL Its Cdal $'9.I�i Sewage Permit number ....... .......� ................:........ WITH AI�MCLE ST�bT� d f9 SANITARY Y CON 1 QyO*?N E tp�y TOWN OF B A R IVWt-E .. • BABH9TABLE, i "6 BUILDING INSPECTOR APPLICATION FOR PERMIT TO ................. .. ..... ..... ..... .......... ..............................:..................... TYPE OF CONSTRUCTION ...............W.... .. 2 ._................................................................... ........... ......................19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location Location .......... %,,....... ! ...:.. ....... f!`�aS' ' ............................................ ..... Proposed Use ......."54 .. ... ... ...... .:.. ',d'� ......................... ee Zoning District ....... .....:........ ...........:......................Fire District ...:.....:f� � fs� r Name of Owner C ..........Address ..l�........` ................. ........... Mel. 1� .' r / y s /r Name. of Builder ...................`. ...........!`. .............� ...:.........Address ..................1... ........ .... ...... Name of Architect ..................................................................Address .....�..,.....................,.................................................. ..... Number of Rooms ..........:.. ....................:...........................Foundation ......./o s�� �-1.. 1� Exterior ....... ..........................:..Roofing ....CsC !. ... .... ..... .. .......:.......................................... Floors ...........Interior .......Z.... .................... .................................. Heating ..........................Plumbing .........1..:..................................... J .......... / Fireplace ......................... ......................................................Approximate Cost ........ �?�l.V 4�..:..... ......................................... Definitive Plan Approved by Planning Board -----I- 6 - -----19�-Z. Area .......................................... Diagram of Lot and Building with Dimensions Fee ..... �f�0,.4�......... SUBJECT TO APPROVAL OF BOARD OF HEALTH 1111C XAjeCl l X14If k I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ..�..� � .. Dacey, William E. Jr. N;, 17757 one story, o ................. Permit for .................................... i sin le famil dwellin ....................................g................ Location ..........MeeSan Road .............................. H annis ...........................Y................................................. Owner ............... illiam E. Dacey, Jr. ............................. ................ Type of Construction frame ............................... . ................................................................................ P. Plot ............................ Lot ............ ............. Permit Granted .......June 18 : 19 75 Date of Inspection ..... ....... ......................19 Date Completed .C ..�.... .. ... ...........:.19 PERMIT REFUSED ' ................................................................ Y19 r ............................................................ .................. .......................... FI ............................................................................... ' ................................................... ....................... Approved ................................................ 19 ............................................................................... - ............................................................................... tl a a t C 7- } XCE R T ! FIE ® PLOT PLAN L O C A T 1 0 N •`/f��iy�t/is S A L E: / D A T E ✓�/v�- // /97s R .E P E R E N C E : e �7o77a p n D A T E ll'E 8 Y C E R T I F Y 'r H A * T' H€ 8 U I L D f N G ' R E G:•. LAND S U R V E Y O R S rI O W N O N 'T H 1 5 . P L._A N- 1,-5 L.O C_ A T E [).. O`N THE GROUND AS S HOWN HEREON AND 'F AT 1ro��` CONFORM 7O THE rj f:A r(+.G LS ZON( NG BY — LAWS OF THE T0w ..N') 0F �P�Slio ( .\ r. W H E N C ON 5 T R U f C T E 0 17) '. iNST.A8LE SURVEY CONSUL -fAN, TS, 1NC . WEST Y A R M O U_ T-ii M A S�3 .