HomeMy WebLinkAbout0563 OLD STRAWBERRY HILL ROAD — - — ��3 Oldcl'fr�ebe� �i'!t„�
- - — --
°F1„t r ` 'own of Barnstable *Permit#
S Expires 6 ont rom issue date
Regulatory Services Fee
t 3ARxsTnar.t;; . Thomas F. Geiler, Director
6 9 a,�� Building Division oh, l/o
rib t��
Tom Perry, CBO, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstab l e.ma.us
Office: 508-862-4038 Fax: 5087790-6230
EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY
Not Valid without Red X-Press Imprint
Map/parcel Number (�1
Property Address
c�a
Residential Value of Work ;�;Dj�r� Minimum fee of$25.00 for work under $6000.00
Owner's Name&Address
Contractor's Name (Zolh�4- C- jf'��� r�tr'1 Telephone Numbers~�
Home Improvement Contractor License# (if applicable) / b
❑Workrnan's Compensation Insurance
19"Chec
I am a sole proprietor P SS
❑ I am the Homeowner
❑ I have Worker's Compensation Insurance
P 12 2008
Insurance Company Name �f,�
n ra ° OF BARNS 1ABLE
Workman's Comp. Policy#
Copy of Insurance Compliance Certificate must be on file.
Permit Request(check box)
❑ Re-roof(stripping old shingles) All construction debris will be taken to
❑ Re-roof(not stripping. Going over existing layers of roof)
❑ Replacement Windows/doors/sliders. U-Value (maximum..44)
*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 copy of the Home Improvement Contractors License is required.
SIGNATURE:
Q:IWPFILESTOWSIbuilding permit forms\EXPRESS.doc
Revise020108
/' $Aard of Builc�il?�13..$
u ktf1ME IMPROVEMENTO7R �Q�
7= Registration`'148999 25995t1 :
Expiration =11I15/2009 t.
f
Type DBA'
il,gFiT BROWN'CUSTOMBUILDINGRENIODEIING R'
F�txe'ERT BROWi�t t -y I.
563 OLD STRAWBERRYNICLF�q; Adml�i�ah�toi
.:
CENTERVILLE,MA 02632 J
._
epse or registration Ya1id for igdividul..w only
P ur-n$o .t
're the ex iratlon dato, If found ret. >t
Beard of Building Regulat301a�Stald,ards
i.
A hburton Place Rim
i
` Q n¢a.02108 ,U
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, Mai 02111
r www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Eleetricians/Plamberg
Applicant Information Please Print Le 'bl
Namne(Business! nLatiotflndividual)
Address: d l� S 2 � Z +4 LL- t ,
City/State/Zip: y Phone.#:�5��' I '�`I �'�
Are you an employer? CbLeck the appropriate bo7c: r7. 0
oject(required):
1.0 I am a employer with 4_ [] I am a general contractor and I construction
employees(full and/or part-tune).* eve hired the shb-contractors
f, � listed an tie ai�uhed sheet odeling
Z am a-sole proprietor or partner-
ship and have m employees These ssh-conttactors have g, 0 Demolition
employees and have workers'
working for mein aay capacity. re$
anr_e S. We arc a cor 9. El addition .
[No workers' camp.-mKur , Q°�"'a c-orparoration and its 10_0 al Elect cic pairs or additions
rtqured_] . �
3.❑ 1 am a homeawnLr doing all work officers have exercised tbeir 1 L❑Plumbing repairs or addition s
nrysel£ [No workers' comp. right of exemption per MCzL 12 Q goof repairs
inmranco r t c_ 152, §1(4), and we have no
employees. [No workers' 13.❑ Other
camp.insurance required.]
*Any applicant that ehxks box#1 Must also fill out the section below showing their vmrk='mTnp=Lsztion policy infortrnration
t HwT=wnat who subnbt this of idavit iracating 6=yarlc doingaM worlcand tha hire outside mntx-actnrs must submit anew affidavit indicating such-
lcontr ebm that cbxk this box nmst attached an additional sheet showing the name of the subtontraetors and state whether or not those entities have
cmploycrs. If the sub-conttaetnrs have employcrr.,they mast provi&their workers'camp.policy number_
l am an employer that is providing workers'compensation insurance for my employees Heluw is the policy and job site
' information.
Inm anc:Company Nam
Policy#or ScLf--ins.Lie.#: Expiration Date:
Job Sita address: City/statc/Zip:
Attach a copy of theworkers' 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 lean to the imposition of criminal pcnaltics of a
lino iip to $1,500.00 and/or one-year imprisonrnsnt,as well as civil penalties in the form of a STOP WORK ORDER and a fi
of up to$250.00 a day agzinct the violator. Be advised that a copy of this statcmcrit maybe forwarded to the Office of
Investi bons of the DIA for inctirance coverer c verification.
Ida hereby certify under the pains-and penalde cf perjury that the information provided above is true and.correct.
Si c Datc:
Phone
11 OfTchd use only. Do not write in this area, tb be completed by city or town of xiaL
City or Town: Permit/License#
ITquing Authority(circle one):
1.Board of Health 2.Building Department 3. City/Tolvn Clerk 4.Elecfrical Inspector S.Plntnbing Inspectur
6. Other
Phone#:
�pVEr Town of Barnstable .
Regulatory Services
±�SAHrr AHLF- Thomas F. Geiler, Director
MASI
-Ljp i63q• ��
rfo �a Building Division
Tom Perry, Building Commissioner
200 Main Street, Hyannis, MA 02601
www.town.barnstable.ma.us
Office: 508-862-403 8 Fax: 508-790-6230
I
Property Owner Must
Complete and Sign This Section
If Using A Builder
Y I�� L— '� �A-'� , as Owner of the subject property
O alf,
authorize
r� "7" t-�--yl to act on m beh
hereby Y
Y
in all.matters relative to work authorized by this building permit application for:
(Address of Job)
I
o �
Signature of Owner Date
Print Name
If Property Own6r is applying for permit please complete the Homeowners License
Exemption Form on th'e reverse side.
Town of Barnstable
�01p SHE)ply
o Regulatory Services
saxtvsrwsre Thomas F. Geiler,Director
y MAS&
16yg. a m Building Division
Tom Perry,Building Commissioner .
200 Main Street, Hyannis, MA 02601
K ww.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
HOMEOWNER LICENSE EXEMPTION
Please Print
DATE:
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)
ibility for compliance with the State Building Code and other
The undersigned"homeowner"assumes respons
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 parson(s)for hire to do such
work,that such Homeowner shall act as supervisgr."
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 hdshe 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 forrn/certification for use in your community.
f
Town of Barnstable
Regulatory Services
p... •,1. Thomas F.Geiler,Director
Building Division -
va MASS Tom Perry,Building Commissioner
rfp Mpg*� 200 Main Street, Hyannis,MA 02601
www.town.barnstable.ma.us
Office: 508-862-4038 Fax: 508-790-6230
Approved:
Permit#: as �{
HOME OCCUPATION REGISTRATION
Date: t l d�
Name.��+ � � �r 1 Phone#• S �7 c�
Address: J ® � y`LgA,)6rX4V 41/ fliage:
Name of Business: c' P mac-"�
Type of Business: ��`� Map/Lot: —2 3 6DO4�
IN'=: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation
within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity
shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the
premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;
and no increase in air or groundwater pollution.
After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the
following conditions:
• The activity is carried on by the permanent resident of a single family residential dwelling unit,located within
that dwelling unit.
• Such use occupies no more than 400 square feet of space.
• There are no external alterations to the dwelling which are not customary in residential buildings,and there is
no outside evidence of such use.
• No traffic will be generated in excess of normal residential volumes.
• The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,
odors,electrical disturbance,heat,glare,humidity or other objectionable effects.
• There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of
normal household quantities.
• Any need for parking generated by such use shall be met on the same lot containing the Customary Home
Occupation,and not within the required front yard.
• There is no exterior storage or display of materials or equipment.
• There is no commercial vehicles related to the Customary Home Occupation,other than one van or one
pickup truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to
exceed 4 tires,parked on the same lot containing the Customary Home Occupation.
• No sign shall be displayed indicating the Customary Home Occupation.
• If the Customary Home Occupation is listed or advertised as a business,the street address shall not be
included.
• No person shall be employed in the Customary Home Occupation who is not a permanent resident of the
dwelling unit.
1,the undersigned,have read and agree with the above restrictions for my home occupation I am registering.
Applicant K Date: < < 0
Homeoc.doc Rev.5/30/03
YOU WISH TO OPEN A BUSINESS?
For Your Information: Business certificates(cost$30.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you
must do by M.G.L. - it does not give you permission to operate.) Business Certificates are available at the Town Clerk's Office, 1st FL., 367 Main
Street, Hyannis, MA 02601 (Town Hall)
DATE: I
Fill in lease: _
_ APPLICANT'S YOUR NAME:
BUSINESS. YOUR HOME ADDRESS1V 1
surf'•s1?.t4? � f 'Est, 11 1 CL
TELEPHONE # Home Telephone,Number S'-®� "2'?�c .
� ►vi Ui(d�
NAME OF NEW BUSINESS<0 TYPE OF BUSINESS S ( U+�
IS THIS A HOME OCCUPATION? YES NO
Have you been given approval from the building division? YES NO OV/
ADDRESS OF BUSINESS MAP/PARCEL N.UMS.ER
When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable.
This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. —(corner of Yarmouth Rd. & Main
Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town.
1. BUILDING COMMISSIONER'S OFF
t
This individual has informeny permit requirements that pertain to this type of business.
Authorized gnature**
COMMENTS:-
VV
2. BOARD OF HEALTH
This individual, s b n inf rmed of.tt}e perm r uirements that pertain to this type of business.
A orized Signature**"r
COMMENTS:
3. CONSUMER AFFAIRS (LICENSING AU HORITY)
This individual has b5 pr inform d of� c sing requirements that pertain to this type of business.
uth rized Sig ure**
COMMENTS:
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�•„••"" • TOWN OF BARNSTABLE Permit No. _20016- �h�
i Building. Inspector $464.00 (Capewid
rua Cash - -—
��OYPY r' Develop '.ent)
OCCUPANCY PERMIT Bona ._
"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 Lleviellyn Realty Trust Address
Lot 17 561'Q-1d Strawberry Hill Road, Hyan-nis
Wiring Inspector /�' � Inspection date
Plumbing Inspector y ' Inspection date
Gas Inspector Inspection date
Engineering Department.,° ,,. �-- . �• � t Inspection date
_. f'!> ,f/fly. 1/1�. ,�/ !eft!'►
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.
ff
....................�!...s:l..... 19. (.... i?
Building Inspectory
LLEWELLYN REALTY TRUST
' WESTFORD, MASSACHUSETTS 01886
C. L. GILDROY
I TRUSTEE- >
Assessor's map' and lot number .. ..
SEPTIC SYSTEM MUST BE
as
. C; �� t'� INSTALLED IN COMPLIANCE_
Sewage`Perrrq.number 'H............. 1 Vt'lTt! PARTICLE II STATE
4 n fa: SANITARY CODE AND TOWN
11PF7NETp�yow M1 TORN OF P-ARNS '< �EBLE .
Gi BASH§RADLEr.� I c
9 .9
i6' BU1 DING = IN.:SPECTOR
�p 79 `0®
" 4 AP FOR4ERMIT TO N -T'..... �T . ...�� 'l'.�.........................................................
• TYPE OF CO`N'STRUCTION ... o®.........."! h......... ............................... ........ ..................
P F .: ,.. :...................97.3
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according the
ffallo ing infor on:
Location .. P.�...�. �.... ... �1C -�, .C.....: . .�u� ..'.....................................................�
ProposedUse ...� ............................................................................:...............................................
Zoning District ,Eire District ................................................
Name of Owne .. .Address. ..! h?bv�.t ... . �...... .... .........
Nameof Builder .... "I....................................................` Address ............. ........ ............... ......................................
Name of Architect ......... .....Address ......... ......................:..................................................
Number `of Rooms ..... t........... ...........................................Foundation � .hG..........................� - ............ ...........
Exterior ...... enw.... ) g �'f..�-L.-[—'
..............................................Roofing
Floors ...... ...........................::......................Interior �Crd ..........:.................................
L� . ............. PlumbingHeating ........ CPPRAF9�?....................................................
Fireplace .....lu. .............. ..................................... ...Approximate Cost .� �.. ? 'C'.:.........................
.... ..... . ....
KY-
4
Definitive Plan Approved by, Planning Board -----------_-------------------19_______. Area ........... ...............
Diagram of Lot and Building with Dimensions Fee . ............
....�G. �.
SUBJECT TO APPROVAL OF BOARD OF HEALTH
AI
r ,
I hereby agree to conform to all the Rules and Regulations o )the Town Barnst le regardin
construction.
ame .......... ....................... ............................
Llewellyn -Realty Trust
t No .....20016 Permit for con t
single familY...dwelling............................
Location ....... '
HX$nl< rS.......................
- ' -
R- -u T. - f
o Type of. Construction waacl Areme
.............................................................................
Plot ............................. Lot ...: .#1.7 .........
-Permit Granted Aarcb..13............. 19 78 `` }
—Date of Inspection ....................................19
Date Completed .... ....... ... .19 ¢'
PERMIT REFUSED }
i .......................... .................................. 19
..... ...... .... .........�.. ......... ................
............................... •..............................................
( .............................................................. ......
[ ............
.. ............................................................
i Approved
..........................................................................
r ................. .. ............................ ..
Assessor's map and lot number
Sewage Permit number -� /
°*T"ET° TOWN OF BARNSTABLE
Z BARNSTABLE,
° a11M BUILDING INSPECTOR —
> .. . ,
APPLICATION;FOR PERMIT TO �`�' �' ' � � `�" '
1 I TYPE OF CONSTRUCTION ........�:?.J.ofa.P..........................................................................................................
j3 ..:.....................:....................19........
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location .. .:..C.'. .... ..� ....`.rli �' ...: .!::.. .1\gs J ,i: �..". .`'. ... �. ..'.�-.L...... it` f ....:...................................................
.. ....
Proposed Use ... I?F-�1� ) 1-1- !--..............................................................................................................................
..........................
,Zoning District ...........-...........................................................Fire District ..........`.................................... ......... .............
Name of Owner(,.: I ZA ::r < )c:�= �' . !{......................... .........
Nameof Builder .......:. ��� Address. ......... ......... ........ ......... ......... ......... .........................................
Name of Architect .... \ ................Address ..........................................................................:..........
..................................
Numberof Rooms .....:"............................: ...Foundation .........................+^'�' '_......................... ...... .................................................
f,
Exterior 11= T- ...Roofing .# `?.N` �+ 7'"
........................................................
Floors + (� T Interior ...�.?..i l� '� . t Vic' i
.......................................................................... .::..................................................
Heating r}....!.!..........'.......................:.......!.........................Plumbing . ......................................................::................
Fireplace pp Q
......:��:.....r.?................'..............................................Approximate Cost .�.. ....�.�'.....�............................ ..............
Definitive Plan Approved by Planning Board ________________________________19________. Area .......... .1....:..................
Diagram of Lot and Building with Dimensions Fee �--
.............................................
SUBJECT TO APPROVAL OF BOARD OF HEALTH
4
x
I hereby agree to conform to all the Rules and Regulations of the Town of. Barnstable regarding the above
construction.
Name r�!L .. ............ .tS. •-1............................
�
Capewide Deuelopement Corp.
M-273 L-4
too .... Permit for ...cunstructiRZ......
` 11in
r
Location ...563...01d..S.1^1^aiibelwry„Hi11 Rd.
Hy.anni s................................................
Owner ..Capewi'3- ev lageme>zIG..C4 P......
Type of Construction ... d..frame................
....................................... ........................................
Plot ........................ .. Lot1,7..........................
t
Permit Grant-d ............March..1.3...........19 78
Date of Insp ction ......:,..............................19
Date Completed ........... ..................19
PERMIT EFUSED
............" ...... . ..... 19
t
. . ....... .V.............. .................
f
................... ..... .... .. .� ............
Approved ................................................ 19
..................... .
..........................................................................