HomeMy WebLinkAbout0377 MEGAN ROAD
Assessor's. map ,.and lot number ........ '
+ .t ....:
THE '
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Sewage, Permit number d
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Ho�, �, 9'8ASH9TADL8 i'
se number f `� r � y.......................... rasa '
�a MAI a'
_ .T`WN O; A rS'�GA . LE'.
BUILDING , IUSPE'.C`T 01
APPL'ICATIir `ON'� FOR' PERMIT TO ............................................- ... .,.
TYPE: OF 'CONSTRUCTION' ........ ......... ........ .. ..::..: .:.:.:::. ...:.:..: .:. ......... ......... .. .
. 19.
TO:,THE ;INSPECTOR '•OF BUILDINGS:
The undersigned hereby applies for is ipeirmit :according .to, the following information::
Location .....: .,....: .....:.. .,.:... .....:. .:...... j
Proposed', ilUse' ......... .!... ...!..:I . . ......................-......................................... ........ 1 .. ........ .....................
Zoning D'istfict : .... ......::. : .:...:: ....... ... :...... ...:,::. ......:Fire; :Distract -
i�lame of tOwner `s� 1 1F-h �I.y' ��h'I� ...:Address' ................................................................
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Name- of Buil'd`er :. ......... t ..... !C...... ... 1 .Address;
Nameo"f Architect ... ............................................................' Address ....1 ....... ....... .....................................................
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Number of ,Rdoms : ��:.:.. ,.:. .. `..:.:Founddti•o' _ PO r0 1( 1'.J �°
/ r
fxdeiior .........................................
...:...r.............. �`.:...`f.... ........:.............. Roofing' ........1.... }. . ^..il...!? :.::.`..o.....:
Floors .....0 ... ..... ..... ....f.f.... .................................Interior (��_'� �' !�'f✓�
Heating .....................................................tL Plumbing _ ..a r, .....�..::
w
Fi"replace ...:.......:..... ..:.,..:..........................................aApproximate'Cost .. - - _ _.
DefinitiveiPlan Approved ':by Planning;,Board:' _._ ___:___: 'ti ._-_.___:_1'9' Area ,::;, . , ........
Diagram of :Lot and Building with Dimensions;
- Feel
'SUBJECT 'TO. APPROVAL OF BOARD,OF HEALTH
� 1
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i
1
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I hereby agree .fa conform; to all' fher Rules' and Regulations of°the Town of Bq-rnstable "regarding ;the;aboye;
Construction.
Name
I
| Gray-Oaks Devalopj�eot Corp.
'
21��
' No -- �c—. R�mitfor —..»me..o
single family dwelling
-----.—.-------------. ---- - .
� 37? Boad '
Location ------.�'�------. —..
_______..oyauo��________'� /--.
`
Owner --.��`�Y�uu�o.. ..QAX]P..
Type of Construction ---�ram.e......................
----'---`------------------'
/
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Date Completed .........../...........................19
PERMIT REFUSE91
I I/K/U
Approved
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---'--'--'--^^~^'-------''
-----^^---'-----^'^^---^'
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TOWN OF BARNSTABLE permit No _21191- --
Building Inspector
na�rr.0 Cash - --
x /L'7�g Q
OCCUPANCY. PERMIT Bond- __ _
"No building nor structure shall be erected, and no land, building or structure shall be
used for a new, different, changed, or enlarged.. use without .a Building Permit therefor
first having been obtained from the Building Inspector. No building shall be occupied until a
certificate of occupancy has been issued by the Building Inspector."
Issued to Cray (yak Develor nent Corp. Address Box 957, Hyamis, 11'a
l nt h 177 Mr,Pan Rngd_ ilvp i g >
r
Wiring Inspector V6_1 /.,%: ;'V' Inspection date "7 �
Plumbing Inspector f_t• r ( Inspection date
V
Gas Inspector , Inspection date
Engineering Department - a (i L*r Inspection date -j J /X.
THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL
SIGNED BY THE BUILDING INSPECTOR UPON.SATISFACTORY COMPLIANCE WITH TOWN
REQUIREMENTS.
f 19
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.... ......' �. . .....�, �./' .... h .. ......Building Inspector
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Assessor's map and lot number .............. ....... —
......................
J Jr
ypi
g r.? ../.../..................`. SEPTIC S`mST�E!.� �:�LiS�' 13E
Sewage Permit number r �IA �' ,,, `..
�7 I i 3 'I'� €N vC ']lP If�NC t BaaasTsnLB,
House number .............................../..................,...................... WITH A5""a"tCLE II STATE ,f r° Mba
TOWN` OF-,, BARNS'T B' t
BUILDING` I�NSPECTOR
..,"INSPECTOR
APPLICATION FOR PERMIT TO RR.U.
TYPE OF CONSTRUCTION ...............'. .�./UA.......g................................................. ...............................
.W.......
................... . ... ..
• �
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .. ....... .. Al r G�. . . V f
�G T........ .................................... .. ............ N.�! �.!. .. ........... ......... .. . .... ..... .... ............
Proposed Use . S (��'hl
ZoningDistrict ........................................................................Fire District ...............................................................................
✓Name of Owner 4' -A ' ._.C1�/<5.... n.v...:.�C! [.........Address ......3.!.A....7 7.......uV!�#Ad..........................
Nameof Builder ................ F...................................... ....................................................................................
Name of Architect ......As�.. «/�f<i' Sk ....Address r� lV�� TWin....... .......................
......... .................................... ......... ........................ .......... .....
�. 1�c���� Lo it .
Number of Rooms ................ ................................................Foundation .... ...... .......................................
Exterior ...........�'- ...................2':..�:..5...................................Roofing ........�... 1. 1....../�:5��fi�l�. ............................
.....
Floors ............' '.. ...................................................................Interior ........... 1...........................................
Heating �f` f'L" ...Plumbing ./ 17A ...............................................:.....
..... ........................................................... .. ......
Fireplace .............................�.....�`. .�..................................Approximate Cost .... . °..........................................a.....
Definitive Plan Approved by Planning Board -------------------_-----------19_______. Area ..........�.�.........5. ....'.....
Diagram of Lot and Building with Dimensions Fee //''
JlO
................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH �® .
f ..
3 IC
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above
construction.
Name .....
.Gray-Oaks Development Corp.
21191 one story
,vo ................. Permit for ....................................
single family dwelling
...............................................................................
377 Megan- Road
Location ................................................................
Hyannis
...............................................................................
Gray-Oaks Development Corp.
Owner
Type of Construction .............frame
e...................
........... .....................................................................
Plot ........................... Lot ..........#2................
Permit Granted ..........Aprill-----1-1............19 79
Date of Inspection .................. ........19
Date Completed .... .......
PERMIT REFUSED
. ...... .. �..V. ............ ................. 19
..........................
... . ...... .................
.................. . .....................................................
...............................................................................
'Approved ...... ......................................... 19
. ............................................................................
................................................................... ...........
TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION
r 2,�
Map Parcel ' J`� i�,# -16
Health Division
Conservation Division Permit#
Tax Collector Date Issued
Treasurer Application Fee
Planning Dept. Permit Fee
Date Definitive Plan Approved by Planning Board
Historic-OKH Preservation/Hyannis
Project Street Address �j'�7 M i✓�AN /��
Village HYA-"t-,t
Owner & o iv S (`AR Address 3 7 m EG A.v
Telephone S o
Permit Request Fe R e d (Pre-
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/coal stove: ❑Yes ❑No
Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existin { ❑newsize
Attached garage:❑existing ❑new size Shed existing Sinew sized/6 Other:
Zoning Board of Appeals Authorization ❑-Appeal# - Recorded❑
Commercial ❑Yes ❑No If yes,site plan review#
Current Use Proposed Use
BUILDER INFORMATION
n.: CC
Name d� � tE Telephone Number �� n 5
}Address License#
Home Improvement Contractor#
Worker's Compensation#
ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Al D .CI`ftc�
SIGNATURE DATE Vt D'
t `c
FOR OFFICIAL USE ONLY
h
PEJRMIT NO.
DATE ISSUED r
MAP/PARCEL NO.
i
ADDRESS VILLAGE
OWNER
n
DATE OF INSPECTION: i
FOUNDATION
FRAME
INSULATION
i FIREPLACE
i
ELECTRICAL: ROUGH FINAL i
PLUMBING,- ROUGH FINAL
GAS: ROUGH FINAL
FINAL BUILDING '
DATE CLOSED OUT
4
ASSOCIATION PLAN NO.
' i
' The Commonwealth of Massachusetts
Department of Industrial Accidents
y Office of Investigations
600 Washington Street -
Boston,MA 02II1'
wrvw.mass.govldia '
Vrorkers}Compensation Insurance A..MdEivit: Builders/Coaatractors/Electricians/Plumbers
• Applicant Information Please Print LegibIV
Name(Business/Organization/ln(iividual): , 9,04
Address: 3? M E C.4 ,��•
City/State/Zip: lYyi9�.��1 . / i9. o� 6o.t Phone.#: SoBd 8oSo ?�
Are you an employer? Check the appropriate bog: :Type of project(required):.
1:❑ I am a employer with 4• 7 I am a general contractor and I
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, F1 Demolition
w 9, CI Building addition
-;working for me in any capacity. employees and have workers'
[No workers' comp,ires»nce comp,insurance,
.$
required.] 5. ❑ We are a corporation and its 10.[]•Blectrical repairs or additions
3.� I am a homeowner doing ill-work . officers have exercised their 11,❑Plumbing repairs or additions
myself, [No workers'comp: right of exemption per MGL 12.E Roof repairs
insurance.required.]t c. 152, §1(4), and we have no
employees. [No' workers' 13.X Others YEQ Pte Fib&
comp,insurance required,]
*Any applicant that checks boi#1 must also fill out the section below showing their workers'compensation policyinforrnation.
t Homeowners•who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the dub-contractors and state whether or not those entities have
employees, L 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 Naive:
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 requred under Section 25A of MGL c. 152 can lead to the imposition of cr=� al penal es of a
ine up to$1,500.00 and/or one-year imprisonment,as wel as&il penalties in the form of a STOP 7'ORK,ORDER and a tine
of up to$250.00 a day against tht violator. Be advised that a copy of this statemerit maybe forwarded to the Office of
L,yestizatiom of the DLA for insurance coverage verification.
Ido hereby certify under the pains•andpenalties ofperjury that the information provided above is true and correct.
Staaturz 4`//a/!d ' `�✓y� Date: /
Fv
Ofzcial use only. Da not write in this area; to.be completed by.ciy. or town ofjiciaL '
City or Town., .Perm_t/License t
IIi
Issuing Authority(circle one): it
1.Board of Health 2,BuildingDepartment City/Town3. City/Ton Clerk 4.Electrical Inspector 5,Plumbing Inspector
6. Other
'.
Contact Pens on, Phone#;
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to t is statute, an employee is defined as"...every person in the service of another under any contract ofhire,
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
Q.,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 mare 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 commonweal`�.h nor any of its political subdivisions shall
enter into any contract for,the performance of public work until acceptable evidence af�compl once frith the insLarce'
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-conti;actor(s)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 onthe appropriate-line.
City or Town Officials
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 imformation(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 maybe provided to the
applicant.as proof that'a valid affidavit is on file for future permits or licenses. Anew 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 burn 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 clo not hesitate to give us a call.
The Department's address,telephone•and fax number:.
mar �fna Aeents
Qftloe of Inyestigaftolls
6.00 Washine-toii Street
TO.#617-727 4900 ext 406 or 1-377 MASSAFE
Fax#6.17--727-7749
Revised 11-22.06 WWW.ma;sS.8QV/dia
n�
RESIDENTIAL: '
SHEDS -POOLS-DECKS-OPEN PORCHES-GAZEBOS
FEE VALUE WORKSBIET
APPLICATION FEE: $50.00
BUILDING PERMIT FEES'-
ACCESSORY STRUCTURES >120 sq.It,(Sbeds,gazeboss etc.)
>120 sf-500 sf $35,00
>500 sf-750 sf 50.00 $
>750 sf-1000 sf 75.00 $
>1000 sf-1500 sf 100.00 $
>1500 sf USE NEW BUILDING PERMIT APPLICATION
DECKS x$30.00 $
(Number)
TORCHES x830.00= '•S
IN GROUND SSG POOL 560,00 $
ABOYE GROUND SWINIlI�TG POOL $25,00 $
MOCATION/MOVING 5150,00 $
(plus above fee if applicable)
FEE
PumaPuma $
Q;forms:dkcost
gpy;M004
�oFTME t, Town of Barnstable
Regulatory Services
BARNSTABLE, ' Thomas F.Geiler,Director
MASS.
0
iOPEDMP'�", Building Division
Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
Office: 509-862-4038 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: AR F (S YFd Estimated Cost 3,170 O
Address of Work: 7 6i c 6,d,, X, f d"',it
Owner's Name: A..r d TAR Re.
Date of Application:
I hereby certify that:
Registration is not required for the following reason(s):
FWork excluded by law
❑Job Under$1,000
MBuilding 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 WORD 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.
l OR
Da e Owner's Name
Q:fomnslomeaffidav
Town ®f Barnstable
pp THE Tp�
• Regulatory Services
*Y BARNSfABLE, = Thomas F. Geiler,Director.
9 MASS. B y
in-u Division
PfD � Tom Perry,Building Commissioner
200 Main Street, Hyannis,MA 02601
vvww.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOME01VNER LICENSE EXFN1PTION
Please Print
DATE: ?* l/
JOB LOCATION: / �a 6►r / ✓`i S
number street village A
"HOMEONWER": I Z D" 'n-/q�.�A it ro 80 ;1,0 4)1� So Ci p 7> 19.) ly
name home phone# work phone#
CURRENT MAILING ADDRESS: 3
ev ev Il .�• ed �.,m� t
k.tyho-v,,n state zip co��
The current exemption for"homeovaners".`vas extended to include otwrier-occupied d-wellings of six units or less and
to allow homeowners to engage an individual for hire-Nxho does not possess a license,provided that the ov,Tier acts as
supervisor.
DEFINITION OF HOMEOwN'ER
Person(s)-who owns a parcel of land on which he/she resides or intends to reside; on-,a,hich there is; or is intended to
be, a one or two-family dwelling, attached or detached structures accessory to such use andlor farm structures. A
person,who constructs more than one home in a two-year period shall not be considered a homeowner. Such
"homeo- Tier" 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 pemut. (Section 109.1.1)
The undersigned"homeo vner" assumes responsibility for compliance writh the State Building Code and other
applicable codes; bylaws,rules and regulations.
The undersigned-"homeowner" certifies that he/she understands the Tmvn of Barnstable Building Department
minimum inspection procedures and requirements and that he/she v,U comply with said procedures and
requirements.
Signature of Homeov<^ter
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 ExEAITTION
The Code states that: "Any homeowner perfomung work for which a building pemut is required shall be exempt from the provisions
of this section(Section 1109.1.1 -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-Supenisors,Section 2.15) This lack of awareness often,results in serious problems,particula-ly _
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 reouire,as part of the permit application,
that the homeovmer certify that he/she understands the responsibilities of a Supenisor. On the last page of this issue is a form cur,ently used by
several towns. You may care t amend and adopt such a forrrn,/certification for use in your community.
Q:forms:homeexempt
MORTGAGE INSPECTION PLAN
OWNER/BORROWER: RESOLUTION TRUST +� ZK of Rf� y
BUYER: RONALD STARR a
P.
ADDRESS: 377 ME'GAN ROAD s B
s. IJYANNIS, MA. 02601 — ND.
DEED REFERENCE: �Gc u�
PLAN REFERENCE: LAND COURT PLAN 27099—B (Sheet lof4)
ASSESSOR REFERENCE:
CLIENT FILE NO. 94-290-04 DATE: DECEMBER 1, 1994
OFFICE FILE NO. CI 1194-273 SCALE: 1" = 30'
RFC
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38.84'
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ROAD
THE LOCATION OF THE ORIGINAL.DWELLING SHOWN NEREON._EITHER,WAS IN COMPLIANCE WITH THE'LOCAL APPLICABLE
-` ZONING BYLAWS IN EFFECT WHEN CONSTRUCTED ROTH RESPECT TO HORIZONTAL DIMENSIONAL.REQUIREMENTS ONLY).OR---
MAY BE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER M.G.L TITLE V14 CHAPTER 40A,SECTION 7,UNLESS
OTHERWISE NOTED OR SHOWN HEREON.
A REVIEW OF FLOOD INSURANCE RATE MAP COMMUNITY PANEL NUMBER 250001 0005C & 0006C
DATED MMY 2. .1992 HAS BEEN CONDUCTED AND TO THE BEST OF MY INTERPRETATION,THIS DWELLING IS IN
FLOOD ZONE _ AND IS NOT LOCATED WITHIN A SPECIAL FLOOD HAZARD ZONE
1 HEREBY CERTIFY THAT THE ABOVE MORTGAGE INSPECTION PLAN WAS PREPARED FOR CALENDA and IACOI
IN CONNECTION WITH A NEW MORTGAGE AND IS NOT INTENDED TO REPRESENT A PROPERTY LINE SURVEY. IT CANNOT BE
USED FOR ESTABLISHING FENCE OR BUILDING LINES. THE LAND AS SHOWN HEREON IS BASED ON CUNT FURNISHED
INFORMATION AND MAY BE SUBJECT TO FURTHER OUT.SAL.ES.TAKINGS,EASEMENTS AND RWHTS OF WAY. NO
RESPONSIBILITY IS EXTENDED HEREIN TO THE LAND OWNER OR OCCUPANT. THIS INSPECTION PLAN WAS PREPARED BY USING
CURRENT DEED INFORMATION,ASSESSOR PLANS AND RECORDED PLANS WHERE AVAILABLE Fp-LD DATA WAS COMPILED BY
USING EXISTING MONUMENTATION FOUND,LINES OF OCCUPATION AND EXISTING STREET LINES. IT IS NOT THE RESULT OF AN
INSTRUMENT SURVEY.
CADtech Systems, P.C. 66 Samoset St,Plymouth,Ma.02360 (608)746-33091747-2201
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