HomeMy WebLinkAbout0032 SHERYLES WAY �3� /�
2/5/2018
Request for information on tiny house proposal for 32 Sheryl's Way, MM
Caller wants to put a tiny house in backyard of mother's property.
Subsequently changed proposal to RV/pull trailer
Later asked for Accessory Dwelling Unit (ADU)
We discussed permanent unit vs. mobile/portable.
Stressed permanent over portable
Advised—no one can live in a trailer/RV unit permanently
Tiny house must meet state building& sanitary codes.
ADU must meet zoning setbacks.
Advised zoning does not allow for ADUs as a matter of right—may need ZBA for detached
family apartment unit.
Referred caller to Health for septic feasibility. She also asked about buying a separate
system on line for just the ADU. Referred that to Health as well.
Advised caller to consult with professionals once they determined what Health would
allow.
"III-
*IWE TOWN OF BARNSTABLE Permit No. ...3.W0,,,,
yid BUILDING DEPARTMENT
TOWN OFFICE BUILDING Cash
....
6)0• �'
HYANNIS,MASS.02601 Bond ...,,,X,
CERTIFICATE OF USE AND OCCUPANCY
Issued to Mr. & Mrs. Conrad Caia
Address Lot #9, 32 Sheryl ' s Way
Marstons Mills, Mass,
USE GROUP FIRE GRADING OCCUPANCY LOAD
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 AND.IN ACCORDANCE WITH SECTION 1I9.0 OF THE'MASSACHUSETTS STATE
BUILDING CODE.
October .3, 19 91
.............. .............. ..
Building nspector
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TOWN OF BARNSTABLE
BUILDING DEPARTMENT
= assaSrAa TOWN OFFICE BUILDING
rua
HYANNIS, MASS. 02601
MEMO TO: Town Clerk
FROM: Building Department
DATE: /Q
An Occupancy Permit has been issued for the building authorized by
Building Permit #...... ...�1 � „01�................ .........................................................................................._.................
.._.....
issuedto . r. ������-..:./.. '1 /R .. .r_................................................................ _... .... .......................... w_
Please release the performance bond.
TOWN OF BARNSTABLE, MASSAC,..,,.:'.-_. ���G •����''
A="f- 15-UU3
DATE �:L,c. .:v � ,{� .4
APPLICANT peter I'+lULli:d3:,��'1 �:Ll`. 1-Li,�: e't.- ,;i . _ PERMIT NO, v
• ADDRESS t ..port, 14A
t
(NO•) (STREET) .t(CONTR'S LICENSE
i PERMIT TO bUll.d DwiE!.j11;Cy .
-) ( Z I STORY `�-��'j•l-I-% L'c:Cilll�l DI�1�;j,i1]-Tl NUMBER OF
(TYPE OF IMPROVEMENT) NO. 9DWELLING UNITS
' (PROPOSED USE) -
AT (LOCATION) Lot y� 3G :Jlli: _p'! - :,i;1;;.5 "ails ZONING
IN0.) (STREET) - DISTRICT KF
BETWEEN
(CROSS STREET) AND
(CROSS STREET) '
SUBDIVISION
LOT BLOCK LOT
SIZE
BUILDING IS TO BE FT. WIDE BY j
FT, LONG BY FT,•IN HEIGHT AND SHALL CONFORM IN CONSTRUCT
TO TYPE f �
I USE GROUP BASEMENT WALLS OR FOUNDATION
REMARKS: (TYPE)'
n ,
Bond ,
AREA VOLUME 1436 sq. _t. G. ^
ESTIMATED COST ,�` 60', 000•UO PERM IT•.'OO 50
(CUBIC/SOUARE FEET) - FEE
OWNER 101r. & dims. Cunra 1 --a
ADDRESS j'1 L ' '� BUILDING.DE PT. �1
' BY
�I J
► THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY C
PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE' BUILDING CODE, MUST BE A
PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINE
OF ANY APPLICABLE SUBDIVISION RESTRICTIONS.
FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PER D NO
T O.T RELEASE THE APPLICANT FROM THE CONDITIOI
I
( MINIMUM OF THREE CALL
I INSPECTIONS REQUIRED FOR -APPROVED PLANS MUST BE RETAINED ON JQB AND THIS WHERE APPLICABLE SEPARATE
I
ALL CONSTRUCTION WORK: CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN PERMITS ARE REQUIRED FOR
j I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTUMBI TIONS.
2. PRIOR TO COVERING STRUCTURAL ELECTRICAL, PLUMBING AND
MEMBERS(REAOY TO LATH) QUIRED,SUCH BUILDING SHALL NOT BE .00CUPIED UNTIL .
3. FINAL INSPECTION BEFORE FINAL INSPECTION HAS BEEN MADE.
( OCCUPANCY. '
POST` THIS CARD SO IT IS VISIBLE FROM STREET
BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS
ELECTRICAL INSPECTION APPROVALS
A�
2..`
f I•,4 Z pis.
r n S HEATING INSPECTION APPROVALS
�p 1 ENGINEE G DEPART ENT
L
BOARD�OF HEALTH
OTHER yz,
SITE PLAN REVIEW APPROVAL
e. r
WORK SHALL NOT PROCEED UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION
TOR HAS APPROVED THE VARIODUS STAGES OF LPOER
RK I S ISISSUED
T STARTED WITHIN fJl'X MONTHS O F DATE THE INSPECTIONS INDICATED ON THIS CARD CAN B
CONSTRUCTION. MIT AS NOTED"ABOVE, ARRANGED FOR BY TELEPHONE OR WRITTEI
NOTIFICATION.
4'
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�o 77°53 36 ASEMENT to
DRAINAGE �241 72 0
20. DO ,77�53 36r E
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79-43,58„ E
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FLOOD ZONE "c"_ FO UNDA TION CERTIFICA TIONREs ZONE. "RF"
TO XV MARsToNs mias SCALE- 50 PL.REP 410118 ELEV.-
I CERTIFY THAT THE ABOVE FA
POOL IS LOCATED ON ���VH 0F Mgsf9� YANKEE SURVEY CONSULTANTS
THE GROUND AS D SHOWN, AND OESdoe P AUA. L �� 143 ROUTE 149 P. 0. BOX ,265
ITS POSITION o MERITHEW N MARSTONS MILLS, MASS. 02648
CONFORM TO THE ZONING LAW No. 32098 x TEL: 428-0055
SETBAC BARNS_TAB_LE REQUIREMENTS OF �o�F�si�A1,sTANO SJQ���o FAX 420—5553
JOB
— --��.��-- 22
PA UL A. MER THEW DATE.•V6 9�91 NUMBER 5_0_0___
oF "E lOw o Town of Barnstable, Massachusetts
: .� Department of Planning. and Development
• BAM Tnsc
.E«
Office of The Planning Board
.
tj 163 9. ,00
HIED MA'S°i 367 Main Street,Hyannis,Massachusetts 02601 --(508)775-1120 ext: 190
Ap r•i 1 2
P 29 , 1991 .
Leo' F . 'Delaney , P .E .
141 Main Street
'Falmouth , MA 02541
Bank of-Cape Cod
249 Worcester Court
East Falmouth - 'MA 02541
RE: 5USDIVTSION #616 DRAK /MAHLER SHERYLES WAY MARSTnN MI iS
At the April 22 , 1991 meeting of the Planning Board, It was
unanimously voted that lots within this incomplete subdivision, are
considered to be automatically placed back under covenant upon
expiration of the security .
The office staff have been directed not to sign-off on building' permit
applications .
Sincerely .
e/rLd 2f J
Carl Cooperrider , Vice Chairman .
Planning Board
CC: ' Building Inspector
Town Attorney
at
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Asses'sor's map and "lot number ......:.. .. ....�r.... ........
7 . INSTALLED DrI�
Board Hof Health"`(3rd floor):
Sewage Permit.. number � — 2....
WITH TITLE 5
Engineiering'Depattment (3rd.floor): ENVIRONMENT I_;CD Muni
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}` �..:�....���... .... TOW REG+4ILE�TI �r va�e0
House number .......... ....n '' ' 3
a YA
APPLTCATIONS k0CESSED '8:30-'9:30 A.M. and 1:00.2:00 P,M. only: �e `"}''•M
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TOWN OF BA RNSTABLE . • � ���:
BUILDING INSPECTOR
APPLICATION FOR "PERMIT TO GS.'. ....�.!`S.,e�L�%,,,.••,1,. /v„ 'Q l r r S' �•'
....
TYPE OF: CONSTRUCTION ,.
SI •• •.....• ................................. ......g..
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TO THE. NSPECTOR OF BUILDINGS:
. • 4if`t
r•The undersigned-hereby. applies for a permit according tothe following information: - " 41-S�Q,tj •:,'//Z
Location ...C...Q. ..#9........ .��.%.C�. .I.C?. ......1:1.r. V'.('.........0 ....cSiG'4.o.0. ..:.... 1
ProposedUse ..... ..�.�$.�!.C!. .^� 7e:..1.......... . a./!?.e.....................................................................................
. .s..�.:.e�
Zoning District .. �..e*4`... .. .................Fire District . ..... .... .... -
Name of Owner .PQ.U..I....P.. .!�'e.. .t``. < ...4..........Address .7......Cv. UI.!�.1v�^r......... //..U.�;. .
Name of Builder Off. f\.�..!4.`� ....../.�..h'{.77....Address ./�. ...a. ....CZ.. .` Aj
Nome of A•rchitect ..................................................................Address
r......v ../.........
. ..... . ._
Number of Rooms '' Foundation ... .�... ..
Exterior CCGrS/1�..'J�1.�.�. .C2Gff%...... ./li bS....Roofing .. /�¢
,5 . c��i r✓q
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Floors ti.Y �N d.Q..G`........................ Interior Q�� /� �� �' .�/Q /
j{ �p„wOo� ..
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Pleating ... ... .... .. �1`f .(...... f� J (x�...........Plumbing ....�`.�:.: v�� FF '}a�ae� -• °� .f .r
,ft 6,
p e ..!4�. .....�..lc....................... �..7.
(�'Fire.lac :...................�Approximote Cost ........... I ��,.. d.a...�.... ................
Definitive Plan Approved by Planning Board � _ _ ____19 (p Area ! (
..
\ Diagram of Lot and Building with Dimensions
Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
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MA Lie A Ctcc)'S' T6 OF BMNSTABLE
Building Inspection Department
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Assessor's`offioe' (1st floor): Ai > �t FTME
Assessor's map and lot number ........AL17.-./.. ........:`
Board of Health 43rd floor):
96
Sewage Permit number ..........................:.............................. Z BeaasrwtE. J
Engineering' Department (3rd floor): 'oc M639�
House number ... o�.::.YYi... ::........ '°� 6`e
0 YAY
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00 2:00 P.M. only
TORN OF ,BARNSTABLE
B. UILPING, INSPECTOR
APPLICATION FOR PERMIT TO .. �.�..................�....... .........................�....e. ....................................... a
TYPE OF CONSTRUCTION .... .. •.`!.l''.`!..!.. ... ....��./rU�':.�.!.......... .............................................
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TO THE INSPECTOR OF,BUILDINGS:
The undersigned hereby applies fgr• a permit according to the following information: 1)14�5�orl/ /lit
Location ..(..:: a. .........�..........��/ A c�:. ....... ..C..lU�.........af.{...... C-..!�. Ca../........
Tl G.e: ....
f� I r i.............
Proposed Use ..... .........../j0 ?yN P...
Zoning District ... ... .�!. l!..1'..:►.....ia.../..................Fire District ..........:...................................................................
Name of Owner �U../..1.... .. a: "` '....4-.........Address ..7.. U /uG
p �.......-...................�.................................
� - Name of Builder / 1. .. f5�� /� T g....Q l iUt .t ( � �.�
D 1.. l� ,...................Address
Nameof Architect ..................................................................Address ................ ........................./............................:..........
Number of Rooms .......:.. ..................................................Foundation ... ..(a..../`.. .. ............................................
Exterior C•.C.,<_G r,S/ "A.)C1 b/ Roofing /!�lf1/,¢ s�1 . NG le
.......................................... �.�..C..a............ g .. ... . .... ........ .v .................................. P
Floors ..!�-... ................. .Q. ...:........................... Interior
Heatingf R� .... . ...........................................................Plbig ...... le c ,.�..��.........
......... .........
Fireplace ........................... C...................................................Approximate Cost ...........�%-6...(D.;4-0... J..........................
Definitive Plan Approved by Planning Board Z -6_all______19___- Area .../...... ��o.... .....
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
I •
OCCUPANCY PERMITS,-REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of--�Barnstabl/regarding the above
construction.
Name ........... ......... ..
Construction Supervisor's License ......:....../ ........
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No -----' Permit for ------------ ^'
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------------------------..
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Location ---------------------'
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--------------------------.
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Owner ---------------------'
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Type of Construction ..................................
--------------------------. ~'
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P|c» ............................ Lot ................................ ' .
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Pannh G,onne6 ........................................}V - ^
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Date of Inspection --------'�--.T0
Date Completed .......................................
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Assessor's offioe (1st floor): ' /� �• S.EpTjC SYSTEM M �"�
Assessor's map and lot number ......:.%71.....:-............ INSTALLED IN D®M�
Board•of Health (3rd floor): WITH TITLE 5 �
Sewage Permit number ...... .............�..... .. ' B ?11DtE, S
f ENVIRONMENTAL CD r„a
Engineering Department (3rd floor): �• /� a -TOWN ®CG � gyp® �o2639
House number .......................... . ,...... .. 1'Yl�.................. oYara'
APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00�P.M.-only'
TOWN :OF BARNSTABLE
BUILDING INSPECTOR
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APPLICATION FOR PERMIT TO ... ULS. .... .�L�....... .. ......e.�. ...................................S..
. .......
TYPE OF CONSTRUCTION ....AiS.t......: ......:...Gt..L.... 1W.l'-L!..�..M.. .......................:....................
U q�/
.......... �.7.---19.
TO THE INSPECTOR OF BUILDINGS:
-The undersigned hereby applies for a permit according to the following information: �4PS�0�
Location ... 4i /. . % G`d... ...C?. ......k1.C.A.V.el........® ....c .C: 9.C3./....... T.✓ .C.. ...
/•.........,/
ProposedUse ...../..\..te. ..�..C�. .^) T .. ............Ao ...........................................................................
/Zoning District ... .................Fire District
�...��.-.:.�..[...(J(..:P...B�...�a../ ..............................................................................
Name of Owner fiU l ! .!1�:/(�Qa"���'�..4. ........Address � .7.....Cd �(f,�7� Jc�Cc �j .. .�.,U. .....
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Name of Builder . . ..D.... ......�.r[. ..................Address W .... .�
Name of Architect ..................................................................Address
Number of Rooms ........... ............... .... .•.Foundation .... .. ...D.............................................
Exterior CC�C� C<�5 �+`... . . ..+�e.QF0:/...c./a:��.......Roofing ...C..—51P.f`c...�..........5�.. .!.. .....
.' Eye! ..1...... ...... ..P.0.t .� ....T/� �� ��a�c✓wo�
Floors .... ... ........... ........................Interior .. .�..
Heating f ^ �� �` Plumbing �`f v �� nn 4.....L............................................................... ............`.�.... .�. ... ...... .....f [............ s
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Fireplace ........ ............... ............................................... Approximate Cost ............�4?... ...i......................
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Definitive Plan Approved by Planning Board � ' _____19____ Area ....1..... . . .....1 !.....
Diagram of Lot and Building with Dimensions Fee
SUBJECT TO APPROVAL OF BOARD OF HEALTH
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town o ornstab regarding the above
construction.
Nam ........... ....................... ...................................
Construction Supervisor's License 4�.s ....C.l.. .../...
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No —.— Permit for ....................................
------------------------.. `^�-
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Locohnn ---------------------
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Owner ---------------------- ^
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Type of Construction --------------
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Plot —'-------^ Lot _----- .............. �
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Permit Granted -------------]P
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Dom* of |n —_--------'�-lP
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Date Completed -----.------'lVI JAL-
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Assessor?s o, a(1st Floor):
Assessor's map and lot number +� U��-O/�5� OD -3 ��. SEPTIC SYSTEM MUST BE u�-TWE�to
F INSTALLED IN
Board of Health(3rd_floor): - � f o
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�Sewa e'Permit number -` '-'
Engineering Department(3rd floor): ,� .�� jS a,i - r, ENVIRONMENTAL CODE A c AXI6 s y
House number i/ �o� �r .TOWN REGULATIONS
Definitive Plan Approved by Planning Board,i 19 s � 1
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
a
TOWN , OF : BARNSTABLE
. tBUI INGLD ,'INSPECTOR 4E:
APPLICATION FOR PERMIT TO Co�S^Kke�• Qs..� �Oaw� --`
TYPE OF CONSTRUCTION W p O @ �&mk- '
19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information:
Location I q She -5 5 6 A-
Proposed Use res 1 IG7.&! A MU,
Zoning District /5 Fire District - � t ' /.-
Name of Owner/('ns * MrS . Co,nc-4A Ca--c. Address6 �c^�15on ��y ��e•,�:.5 M4
Name of Builder ���C/' % ��J "Afidress U
Name of Architect .-t.W 11 Sa,6V1,,e Address
/'� p I
Number of Rooms '7 fi� Foundation Q c`L,<J
i
Exterior � � Roofing
d
Floors l DUY Interior
/ /�-
Heating U QS Plumbing
Fireplace Ue S [A� Approximate Cost d Do 0
Area q 5 Z tom.
Diagram of Lot and Building with Dimensions y Fee f/ao. \,J O
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re arding the above construction.
Name ` Aj
Construction Supervisor's License'' 0 10
'�7-'CAIA, C+ONRAD MR. & MRS .
No 34400 permit For 1 Story
Single Family Dwelling
Location Lot #9 , 32 Sheryl ' s Way
Marstons Mills
Owner. Mr.. & Mrs. Conrad Caia
' e e
d
Type of,Construction - Frame
Plot Lot
Permit Granted June 18 91
Date of Inspection, -19
a o Ito l 6 �G 19 -
0
R.J. Margetta Adjustment
PROFESSIONAL ADJUSTERS AND PROPERTY APPRAISERS
4
•� �� 82 Granite Street
® Fall River,MA 02720
(508)675-5330 (508)675-5326
personal Fax(508)675-4660
commercial
inland marine
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS . GENERAL LAWS, CHAPTER 139, SECTION 3B
6/3/15
Attn: Building Inspector
Marstons Mills Building Department
367 Main Street, Floor 4 ,
Hyannis, MA 02601
RE: INSURED: Conrad & Denise A. Caia
MAIL LOCA: 32 Sheryle ' s Way, Marston Mills, MA 02648
LOSS LOCA: 32 Sheryle ' s Way, Marston Mills, MA 02648
;rt
POLICY NO: 68088400002
CLAIM �-NO: 033593061
DATE/LOS'S';- 5/27/2015
ca
.. cs3
`,.-TYPE/LOSS: Water s
FILE NO: M15-26533-W/D
Claim has been made involving loss, damage, or destruction of the above
captioned property, which may. either .. exceed . $l, 000 . 00 or cause Mass .
General Laws, Chapter 143, Section 6 to be applicable. If any notice under
Mass . General Laws,' Chapter 139, Section 3B is appropriate please direct it
to the attention "of the- writer -and include a reference to the captioned
insured; location, policy number, date of loss, type of loss., and. file
number.
Sincerely,
A •.N
James A:' Heaney -
On tYi s date; �� . (, .' .: `i I caused copies of this notice to be sent to t e
persons , named above at the addresses indicated above first class mail.
Please note. this is not a request for a copy of a report.
oFTM� Town of Barnstable *Permit (p-�
Regulatory Services �" f 6ni° f miscued
sxaNsrast.� Fee
MASS
j, 1639. e� Thomas F.Geiler,Director
Building Division
Tom Perry,CBO, Building Commissioner
200 Main Street,Hyannis,MA 02601
Office; 508-862-4038 www.town.barnstable.ma us
EXPRESS PERMIT APPLICATION - RESID Fax; 508-790-6230
Not Valid without Red X-Press Imprint AL ONLY
Map/parcel Number d%�p�roo
Property AddressOVA �! o
residential Value of Work_ Minimum fee of$35.00 for work under$6000.00
Owner's Name&Address
-ontractor'sName y
�, Telephone Number_
Some Improvement Contractor License#(if applicable)
-onstruction Supervisor's License#(if applicable) 4�7/
y'workman's Compensation Insurance
Check one:
,j;.i L
❑ I am a sole proprietor
(;❑ I am the Homeowner TOWN OF BARNSTAE3LE
—I-have Worker's Compensation Insurance
3urance Company Name �
:)rkrnan's Comp. Policy#_Q1M// t„_,6 fro
•py of Insurance Compliance Certificate must accompany each permit.
mit Request(check box)
a� oof(stripping old shingles) All construction debris will be taken to la
❑Re-roof(not stripping. Going over existing layers of roofl
❑ Re-side ,
❑ Replacement Windows/doors/sliders. U-Value #of doors
(maximum.44)#of windows
!Where required: Lssuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc.
***Note: Property Ownei must sign Property Owner Letter of Permission.
A copy of the Home Improvement Contractors License&Construction Supervisors License is
re ired.
fATURE:
I
=ILESTORMSIbuilding permit fbrmslEXPRESS.doc i
.d 070110
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Board of Building Re�-uul;ttions and Standards
' Construction P P y Sp ervisor S i-6'jt >L'icense
:.
License: CS•SL 99913
Restricted to: RF,WS
TROY THOMAS
499 NOTTINGHAM DRIVE
CENTERV.ILLE, MA 02632 '
'Expiration: 4/13/201.2
('nnmis�i mcr Tr#: 99913
i
92-'�o�»nna�uvealC� o�/�craaacctir aetla
Office of Consumer Affairs&Business Regulation License or registration valid for individul use only
HOME;LMPROVEMENTOONTRACTOR before the expiration date. If found return to:
Re
Office Type: Office of Consumer.Affairsand Business Regulation
10 Park Plaza-Suite 5170
Expiration_._`3L1�5�10_l3 Private Corporation Boston,MA 02116
rw�== ='
DOYLE+THOMASt�ONST INS;I:
4
TROY THOMAS
499 NOTTINGHAM DR'ti _=
CENTERVILLE,MA 02A32=" `= Undersecretary Not v id w' outsignature
The Commonwealth of Massachusetts
Department oflndustrinlAccidents
1
i Office of Investigations
600 Washington Street
Boston, MA 02111
t 1- www.massgov/rdid
Workers' Compensation Insurance Affidavit: Builders/ContractorsAElectricians/PIumbers
Applicant Information Please Print Legibly
iName (Business/organization/Individual):
Address: 'z/90, 641- /6a
City/Sta.te/Zip: & iOV- Phone #:
[ED1
an employer?Check the appropriate box:
F2r
project(required):
a employer with-- 4. ❑ I am a general contractor and I
loyees(full and/or part-time).* have hired the sub-contractorsew construction
a sole proprietor or partner- listed on the attached sheet 1emodeling
and have no employees These sub-contractors have molition
ing forme in any capacity. workers' comp, insurance. ilding addition
workers' comp. insurance 5. ❑ We are a corporation and its
red.] officers have exercised their ctrical repairs or additions
a homeowner doing all work right of exemption per MGL mbing repairs or additions
lf. [No workers'comp. c. 152, §l(4), and we have no of repairs .nce required.] t employees.[No workers'
comp. insurance required.] er
*Any applicant that checks box t1I must also fill out the section below showing their workers'compensation policy information.I Homeowners who submit this affidavit indicating they are doing all work and then hue outside contractors must submit a new affidavit indicating such lCon tractors that check this box must attached an additional sheet shoving the nee of the sub-contraeton and their workers'comp,policy information.
1 am an anployer that is providing workers'compensation insurance for my employees. Below is the policy and job site
inforrnadom /
Insurance Company Name: Iillllll rwt, Cam: 1,a�
Policy#or Self-ins.'Lic.#: 3'lJ 1 Expiration Dater .�� / 'a00,2-
Job Site Address: z-:, City/State/Zip: ,/ 0( X44
Attach a copy of the workers'compensation policy declaration page (showing the policy number and expire),
Failure to secure coverage as required under Section 25A'of MGL c. 152 can lead to the imposition of criminal penalties of a
foe 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 foe
of up to S250.00 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 irunmce coverage verification.
I do hereby certify unde the pains and pe Hies of perjury that the information provided above is true and correct
DateIV
'hone#:
Official use only. Do not write tin this area;to be completed by city or lawn bffw1al
City or Town: Permit/License#
Issuing Authority (circle one):
1. Board of Health 2.Building Department 3. City/Town Clerk 4. Electrical Inspector S.Plumbing Inspector
6. Other
• J
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 hire,
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
a
of the foregoing engaged in'a joint enterprise, nd 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 bean 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(')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 a:Mdavit 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 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 ih the event the Office of Investigations has to contact you regarding the applicant
Please be sure to fill gii the permit/license number which will be used as a reference number. In addition, an applicant
that must submit multiple permitAicense 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 maybe provided to.the
applicant as proof that a valid affidavit is on file for future permits or Iicenses. 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
(Le."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 do not hesitate to give us a call.
The Department's address,telephone and fax number.
The Commonwealth of Massachusetts
Department of lndust ial Accidents
Office-of Investigations' '
600 Washington Street
Boston,-MA 02111
Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE
r— 4 41'7 '7 ) 7 '7�7 J n
07/06/2011 15:40 5084209227 MARK W SYLVIA PAGE 01
A CERTIFICATE QF LIABILITY INSURANCE °A�' 61201MMDN1
0710ti12011
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE: DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the pollcy(Iee)must be endorsed. H SUBROt3ATION IS WAIVED,subject to
the terms and conditions of the policy,certain policies may require an endorsement A statement an this Certificate does not confer rights to the
certificate holder In Ileu of such endorsem s.
PRODUCER TA
Mark Sylvia Insurance Agency LLC PIM ME PAX
771 Mein Street ( ,) •(508)426-0AAO iwg,Ne;
Ostervifle,MA02655 PRODUCERp� �T
INSURER(SIAFFORDING COVERAGE _._.. NAIC 4
INSURED WWRERA. farm Fa"CaeueRy Ineumnoe
-- -
Doyle& Thomas Construction,Inc —
PO Box 1 e6 INSURER B; ___,_••,
Centerville,MA 02632-0168 INSURER C;
INSURER D
INSURER E
IMBURER F.
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE USTEP BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT VMTH RESPECT TO VIMICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I SR TYPE OF INSURANCE POLICY NUMBER POLICY
o D 141FD
m LI �P
_ LIMITS
A OENERALuAmLrrY 20OIX0485 7/21/2011 7/21/2012 EACHOCCURRBNCE ! 11000.000_
X COMMERCIAL GENERAL LIABILITY P T RE
( 0 _gCwrenee ! 60,000
CLAIMS-MADE I ^ I OCCUR MED ExP one pareon)
_ PERSONAL A ADV INJURY E
GENERALAOOREGATE i 2,000,000
C,EICL AGGREGATE LIMIT APPLIES PER PRODUCTS-COMPIOP AQG_ S 2,000 000
X POLICY PRO LDC $
AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S
(Ea eatldord)
ANY AUTO 900ILY INJURY(Per pem-.
ALL OWNEDAUTOS --
BODB.Y INJURY(Per eeeleald) 3
SCHEDULED AUTOS —'
PHIRED AUTOS (Rar P D/AMAGE
NON-OWNED AUTOS ! --
UMaRELLA LIAR OCCUR EACH OCCURRENCE !
Excess LIAe cwms-wix AGGREGATE S
OEOUCTIBLE S
A AMoE Pao sLUTAet 2001VAf6390 7/1/2011 7/1Q012 vVC M X oET114-
ANY PROPMCTORIPARTNERIEXECUTIVE YIN EL EACH ACCIDENT ! 500,0p0
OFFICERIMEMBER EXCLUDED? Y❑
M f A
(Mandatory In NM) E.L.DISEASE.EA EMPLOYEd S W0 000
Nyea decor under _
DESCRIPTION OF OPERATIONS tegb y E.L.DISEASE-POLICY LIMB S 500,000
DOMPMN OP OPERATIONS/LOCATIONS 1 VEHICLIrS(AHetD ACORP 101,Add(ttonal Reefr lice 9sheA1le,N mon.pace b rogtrred)
:srpentry
CERTIFICATE HOLDER CANCELLATION
(508)420-7989
Doyle&Thomas Construction Inc SHOULD ANY OF THE ABOVE DESCRIISEO POLICIES BE CANCELLED BEFORE
PO Box 168 THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
Centerville,MA 02632 ACCORDANCE WrrH THE POLICY PROVISIONS.
AUTHOR®REPRENNTAIM
(S 1980-2009 ACORD CORPORATION. All rights reserved.
4001RD 25(2009109) The ACORD name and logo am registered rnart(s of ACORD
506-326-1635
SPECIALIZING IN ALL FORMS OF ROOFING & SIDING
doyleandthomasconstruction.com
P.O. BOX 168 BBB
CENTERVILLE, MA 02632 Fully Licensed & Insured
Construction Supervisor Lic# 99913
Doyle and Thomas Inc. Proposes to perform the following work:
Location of proposed work:
Mr. Conrad Caia
32 Sheryles Way
Marstons Mills, MA 02648
Date on which construction should begin: Late Spring 2011
The homeowner hereby acknowledges and agrees that the scheduling dates are approximate
and that such delays that cannot be avoided by the contractor shall not be considered as a violation of
this contract.
The contractor agrees that when such delays become known to the contractor, the contractor
will advise the homeowner as soon as possible.
The homeowner hereby acknowledges that in certain remodeling work,the demolition process
may reveal defects in the existing structure which must be repaired, creating additional work which may
need to be carried out in order to complete the work described in this contract. In such case the
homeowner agrees that the duration of the work and the schedule date of completion may differ, and
that such variation is not to be considered a violation of this contract.
The total cost for labor and materials under this contract:
30 yr.GAF/Elk Timberline HD Architectural shingle $5,978.73
Install of rake ends would be an additional Gam''` $150.00 X400
Install of two Velux skylights (Operating) $1,745.15 No
� o
Install of two Velux skylights (Fixed) $1,503.41
Tk--I, V- Ci.r U..I. V.... I .... . \/.... U..
In the event that while stripping the roof we find rot that needs to be replaced,the homeowner
then has to agree and authorize any replacement or restoration. Then in addition to the above contract
price,the homeowner agrees to compensate the contractor for any repairs or restoration at the hourly
rate of$45.00 for a carpenter and$30.00 for a carpenters laborer, plus the cost of materials.
-Roof to be stripped and cleaned of all old shingles and debris
-Roof to be papered with weather watch leak barrier,Synthetic underlayment, and installed
with asphalt shingle using galvanized nails. (Storm nailed)
-All new 8 inch vented drip edge and pipe flanges to be installed
-Cobra ridge vent to be installed on all ridges
-Timberetex premium ridge cap to be installed
-Gutters will be cleaned of all debris and leaves at completion of the job
-10 yard dump trailer will be needed on site; and will be removed at completion of the job
-Contractor will be responsible for all building permits needed at the property
NOTICE REQUIRED BY LAW
With the agreement of the contract$500.00 of estimate is due.
Further payments under this contract are as follows:
1/2 of the estimate due at the start; and remainder due at completion of the job.
Balance of all-materials and labor shall be payable in full upon completion of work described in
this contract. Payment as agreed upon shall be made when due. Any payments which are
delayed shall be subject to a finance charge of 1.5% per month.
The contractor warranties the work completed under this contract for a period of ten
year from the date of completion.
During the stated warranty period the contractor shall be responsible for the service of
the repair or adjustment, but the contractor shall not be responsible for the normal maintenance, repair
due to abuse, misuse, and or normal wear and tear,which shall be the responsibility of the homeowner.
All warranties for the materials supplied by the contractor shall be passed directly to the
homeowner. The homeowner may be required to register or mail in such warranty card or evidence of
ownership in order to activate such warranties. Homeowner failure shall not create any responsibility
for the contractor under the warranty provisions;the choice of repair of replacement shall be at the
discretion of the contractor.
The homeowner acknowledges that the form, content,and notices contained in this
contract are intended to comply with the applicable portions of the Mass. General Law Chapter 142A,
and regulations promulgated there under. In the event of any instance of non-compliance,only such
portion shall be invalid and the remainder of this contract shall be in full force effect. In addition,any
such portion not in compliance shall be read and interpreted so as to have its intended meaning to the
maximum extent allowed under such law and regulation.
Signed as a sealed instrument on this date:
Date: 1 t Homeowner
1 ,� Contractor
6' CC. r
�'i-- ra,. �,rT��.. F- _ � U 2 rt ,.w_,i`.I �,1`h"t�"�.Si°�Y°H✓'�<rvi,:r".n-�d';"�-�y}�lva:r"v.�.-;+,..il�J�..:
Assessor's office(1st Floor): / h,,�`//
Assessor's map and,lot number U T b - 9/.S 3 �` of fM E TO
Board of Health(3rd floor):
Sewage Permit number VFYZ
t DAHd970DLL i
Engineering Department(3rd"floor) _ S, a
House number ✓_.�/� oo9-
Definitive Plan Approved by Planning Board/ 19
APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only
TOWN OF BARNSTABLE
BUILDING INSPECTOR
APPLICATION FOR PERMIT TO
z
TYPE OF CONSTRUCTION CC e.Mt
I2C1 19
TO THE INSPECTOR OF BUILDINGS:
The undersigned hereby applies for a permit according to the following information: A,
Location � /— i She -5 �V
Proposed Use
"Zoning District r��� �� Fire District
5;;NName of OwnerArw. McS . Corc�C�. C0..C. AddressU zc Asoc% LJay 1�2•,�.5 M�
Name of Builder �C:TL� /"/6l2&2 l 4121 0Z4PIdd ess L, a k ao-1 /
Name of Architect SCl/'YL�(/sCf,6/�h Address
Number of Rooms L -}� n�Sh e� Foundation C3nuc czk CorC-�e-�f-
Exterior'� � y(�/ vl11Jh5 Roofing Ye
Floors //Q�IA U24 �j�Y 11,ItP 11�h Interior
Heating !` (rl S Plumbingrf1.�Gf �
Fireplace L1�' S �"�`' �r/A� ApproximateCost l r00.' pov� ,
Area%Z4
`�040.ee Diagram of Lot and Building with Dimensions F
r. _
r
e
r
i
OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS
I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable re ar ing the above construction.
Name y
_
Construction Supervisor's License's O k CD O
CAIA, CONRAD MR. & MRS.
.A=046-015-003
No 34400 Permit For U Story.
Single Family Dwelling
Location Lot #9, . 32 Sheryl' s./Way
Marstons Mills
Owner Conrad Caia f
I
Type of.Construction Frame
Plot Lot
Permit Granted June 18.E 19 91
Date of Inspection 19
Date Completed 19
4
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