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0750 WAKEBY ROAD
_ 7� w� �� _ � a ,� 0 0 .._. _. .. r a. 0 4 e i a . a i e a C) December 31, 2018Cn r Town of Barnstable Attn: Building Commissioner 367 Main Street Hyannis, MA 02601 - :� M do Re: 750 Wakeby RD, Marston Mills, MA 02648 To Whom It May Concern: This letter is to advise that our client no longer has an open case pending against this homeowner as of 12/21/2018. Please remove this property from your registration records accordingly. Feel free to contact us if you have any questions. Sincerely, Steve Warren Agent on behalf of CitiMortgage ` Mortgage Contracting Services Code Compliance Department 350 Highland Dr. Ste. 100 - Lewisville, TX 75067 Codecomoliance@MCS36O.com W R Page l of 1 350 Highland Dr. • Suite 100• Lewisville,Texas• 75067 813.387.1 100• wwwACS360.corn Ow --------------- REGISTRATION AND CERTIFICATION FORM FOR FORECLOSING/FORECLOSED PROPERTY Thank you for registering in accordance with Town of Barnstable Code chapter 224 sections 224-3 and 224-4. Please complete one form for each property in foreclosure (section 224-3)or already foreclosed for which possession has been taken(section 224- 4). Please file the original with the Building Commissioner and a copy with the Chief of the Fire District in which the property is located. If you claim you are exempt from registering under Massachusetts law, please state the reason(s) and complete section 1 (property information) and the first paragraph of section 2 (foreclosing party, court, etc. and foreclosing party representative, but not other representatives and attorney) so that the Town can review the exemption and update its records: n/a Section I —Propeqy Information Property Address: 750 WAKEBY RD, Martsons Mills, MA 02648 �. Assessors Map 3001 000012 Parcel 5`jlt #: #: Block �„ Land area and description Lot Sq. Ft. 180,338 4.14 Acres Building(s) description and contents Single family w � r w rn Occupied: x Occupant(s)(if borrowers so state and include name(s)) W. J. Lopez Phone: n/a email: n/a other: n/a Vacant: n/a Date: n/a Anticipated Length of Vacancy: n/a Last occupant(s))(if borrowers so state and include name(s)) W. J. Lopez Phone: n/a email: n/a other: n/a Has possession been taken No • If so, please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing Pagy Information Foreclosing Party(full name/title) citiMortgage Foreclosure Case Court: n/a Docket# n/a i Date filed: 11/30/2016 Current Status: Pending Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name,title,): Stephanie Weicht CitiMortgage Company(if different from foreclosing party): Address: 1000 Technology Drive O'Fallon, MO 63368 Phone:877-290-3997 email: Code.violation@citi.cocbther: If an exemption is claimed, please do not complete the remainder. Other representative(s) (if foregoing representative is primarily responsible for property and/or foreclosure and is most likely to be able'to address town matters concerning the property and/or foreclosure, please so state and do not complete contact information(i. e."none"or"see above")). Name,title, other: Mortgage Contracting Services, LLC Property Manager Company(if different from foreclosing party): Address: 350 Highland Dr. Ste. 100 Lewisville, TX 75067 Phone(s): 866-563-1100 emai�(s)ecomplianceQmcs360.coother: Name, title, other: Company (if different from foreclosing party): n/a Address: Phone: email: other: Attorney representing foreclosing party n/a Firm name (if different from attorney's name): n/a Address: n/a Phone(s): n/a email(s): n/a other: n/a I acknowledge that the information provided is accurate and correct. I also understand that any inaccurate information will result in non-compliance with section 224-3 of chapter 224 of the Code of the Town of Barnstable. . Date: 2/28/2018 Name: Steve Warren Title: Agent for CitiMortgage V a I hereby certify that the above-named foreclosing party is in compliance with the provisions of section 224-3 of chapter 224 of the Code of the Town of Barnstable. Date: Building Commissioner,Town of Barnstable TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Qr—VV4-A 1 STABLE CI Map Parcel Application # :T� Health Division 2016 cry 5 « 39 Date Issued Conservation Division Application Fee Planning Dept. �p�r � � ""�" Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis Project Street Address Villages Owner �L'�fL— P,o/l� Address Telephone L57/r Z Permit Request VJO &2�� Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation 1�6 Construction Type„/�,,_;�, i �1'ot-,* .. Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(# units) i Age of Existing Structure Historic House: ❑Yes 2(.�o On Old King's Highway: ❑Yes XNo 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: ❑ existing ❑ new size_ Attached 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 APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Telephone Number LET ?� 2) Address License # // / 9 XA,e2L4 O 111;f� Home Improvement Contractor# ,/�_� 5�� Z Email �� C,FI�eG -lI)W X�� Worker's Compensation ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE ' FOR OFFICIAL USE ONLY ' l APPLICATION # DATE ISSUED MAP/ PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: ; FOUNDATION FRAME INSULATION F FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL E GAS: ROUGH FINAL FINAL BUILDING ' DATE CLOSED OUT ASSOCIATION PLAN NO. l CAPE CO® INSULATION FISII OIA57 $SAMLISS IFNAY FOAM SUSVINDIO SAM OU IIINS IN I UTAIION CIISIN01 1-800-696-6611 Town of Barnstable Regulatory Services Building Division 200 Main St Hyannis, MA 02601 1 Date: Dear Building Inspector Please accept this Affidavit as documentation that Cape Cod Insulation, Inc. performed.& completed the insulation and weatherization work at the property listed below. Cape Cod Insulation did this in accordance to the specifications listed on the building permit application. All work has been inspected by a certified Building Performance .Institute '(BPI) inspector. All work preformed meets or exceeds Federal & State Requirements. Property Owner Property Address Village Insulation Installed: .Fiberglass Cellulose R-Value Restricted Unrestricted Ceilings Slopes ( ) ( ( ) ( ) ( ) Floors ( ) ( ) ( ) ( ) ( ) Walls �a �N rof/ (VOr k FPr)ror je01 Sincerely H ry E ssi r, President pe C Ins ation, Inc. c�z i w . � The Contmonwercl tit of Af(wyachuset'ts Department of Inrlustrircl Aecitients 0 1 Congress Street, Suite 100 �.' Boston, MA 02114.2017 ' r vrvyv,(+•ores,g o v/rll rc 1}'-ul'kers' Compensation Insurance Affidavit; Btlllders/Contraetors/Electrlclnns/Plu TO BE FILED WITH THE PERMITTING AUTHORITY, tubers, Ilcant Information Name(Business/Orgenization/Individual): 1/ Please Print LeL71bly Address. G✓-J� ,� ---- City/^ State/Zlp. �,cklh;;,Qpproprlstt • zPhone #:Arc you nn employer? C box; _ l.�t am a employer with Type(full and/or pan time).' Type of project (required)�� 2.0I am a sole proprietor or partnership and have no employees working for me in 7' ❑ New construction any capacity,(No workers'comp. insurance required.) 3.�1 am a homeowner doing all work myself, 8. D Remodeling Y (No workers'comp. insurance required•)t 9• ❑ Dem011110n a I am a homeowner and will be hiring contractors to conduct all work on m ensure that all contractors either have workers'compensalion insurance or are sots I will 10 r] Building addition prop,ietors with no employees. 1 1,(] Electrical repairs or additir,r, 5_0 I am a general contractor and I hays hired the subcontractors listed on the attached sheet. 12,( j These sub•conrrac' comp, insurance.i 1prs hays employees and have workers' i--�Plumbing repairs or addtt;r;,,. 6❑We are a corporation and its officers have exercised their right of exemption per MGL c, 13.[]Roof repairs I S2,¢I(4),and we have no employees (No workers'comp• insurance(squired.) 14.[ Other ;'Any applicant that checks box NI must also fill out the section below showing their workers'compensation policy informetio . Contractors who s',bmihhls affidavit indicating(hey are doing all work end Then hers outside contractors muss submit IContraclors Ilia)check this box must attached an additional sheet showing the name of the side contractors o and slate w n F employees. If the sub•conlractors have employees,they must provide their ivorkers'com . tuft a new affidavit indicating such. whether or not those enti(ies have /rrni un enrp(oyer that(s pro vl(111rg )vorkers'co(npensatton lrrsurntice o policy number. infonnntlon ✓ my employees• Below/s the pottey an((fob sire Insurance Company Name: POlicy #or Self•ins. Lic. �Is lob Site-Address.- Expiration Date: .'•Site-Address.- Attach a copy of the workers' con1pensation policy dec�rnn page (Showing the ---_.— _City/State/Zip; •_ Failure to secure coverage as required under MGL e. I S2, §2SA is a criminal violation Policy and/or one-year imprisonment, as Well as civil penalties policy nue b afro expiration date day agairisl the violator. A copy of,tl;11 statement al s in the form of a STOP 1,yO Punishable by a fine up to$I,SOG G I coverage verification. y be forwarded to the Office of investigations of the DIA or in urER and a fine of up to a OF / iZ r(o Irereby certify rcrrr(er the pr:ins n(rr(perinitles of perftsry 111nt ltle 110rt Si nature. ,''; n�ction provtrled above rs true an correct. Phone M. _ D e; ` OfJlcirrl use only, Do•..-liot wrtee lrI tlr(s area, to be compleled by city or low n officlrrl --.--�--. City or Town: i Issuing Authorl Permlt/Llcease ��� I� rY (circle one); ++ I. Board of Health 2, Building Department 6, Other 3, City/To)vn Clerk q, Electrical Inspector — - S, Plumbing Inspector j Contact Person; i Phone#; !I i ' -----�-r^ i Massachusetts Department of Public Safety Board of Building Regulations and Standards License: OS•100988 Construction Supervisor. " HENRY E CAS•SIDY. 8 SHED ROW �, I I r." fir. WEST YARMO'U1`H Expiration; Commissioner 1111112017 ,.,,,,, �po�2�2o�vc�ear�,2 ty \ a t Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite S 170 Boston, Massachusetts 02116 Home Improvement C&.t.ractor Registration Reglstrallon; 153507 Type; Private Corporation Expiration; 12/15/2016 Tr# 259188 CAPE COD INSULATION, INC HENRY CASSIDY 18 REARDON CIRCLE SO. YARMOUTH, MA 02664 . :' Upda,ts,Addross and return card, Marlt reason for change. $CA I ti'I ?OM.05r11 Address Rellewal Employment U Lost Gals . .. . . ........................ /co arryraooirver�/G/o�'c�/l/lrWaa.�uaalri� ate\ •Cfflcc,Q.rConsumerAffnirs FC l3uslness Regalnllon Llcense or registration valld for Indivldul use only OME IMPROVEMENI'`CONTRACTOR boforo the oxplrntlon date,'If found return to; eglstrauon: -4.0567 Type, office of Consumer Affalrs and Business Rogulation j xplratloi);{:;1:21:�:51.20:1.6 Prlvate.Corporatlon 10 Park Plaza• Suite 5170 CAPE COD INSUTAf-.Q6 ;INC''..,; Roston, MA 02116 HENRY CASSIDY 18 REARDON CIRCLE' . 50: YARMOUTH,MA 02664 Undel'sccretnry —�_. N valld wl tit sign e r CAPECOD-27 CLEDDUKE CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDrrvYY) 711/2016 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 policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER NAME:CT Barbara DeLawrence Rogers&Gray Insurance Agency,Inc. PHONE A 434 Rte 134E-MAILc t ac No South Dennis,MA 02660 SS:bdolawronce@rogersgray.com INSURERS AFFORDING COVERAGE NAIC p INSURER A:Peerless Insurance Company INSURED INSURER a:Safety Insurance Company 39464 Cape Cod Insulation,Inca INSURER c:Endurance American Specialty Insurance Company 41718 16 Reardori.C:kcle INSURERD:Atlantic Charter Insurance Company 44326 South Yarmouth,MA 02664' INSURER E INSURER F: COVERAGES CeftTIFICAft':NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF.3N9URANQE-.LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY•REQUIREMENT,:YEI3fVl OR;CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PE RUIN, THE:(NSUI'tAN' 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. LTR TYPE OF INSURANCE POLICY NUMBER MMIDDIYYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE OCCUR CBP8263.063 04/0112016 04/0112017 PREMISES Ea occurrence $ 100,000 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 N'LAGGREGATELIMITAPP'I♦t8P8R:., GENERAL AGGREGATE $ 2,000,000 POLICY EI PR LOC PRODUCTS•COMP/OP AGG $ 2,000,000 <d15C4P' OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 Ea accident) B ANY AUTO 6232707 COM Of:. 0410112016 '04I :/2017 BODILY INJURY(Per parson) $ • ALLOWNEO':;',: SCHEDULED X BODILY INJURY(Per accident) $ AUTOS AUTOS X ` PROPERTY HIRED AUTOS AUTOS $ED ei $ XCCUR,'O 2,000,OOOx UMBRELLA LIAB C EXCESS LIAR CLAIMS•.MADE EXC10006636001 04/0112016 04101/20.1:7:- AGGREokTfc $ DED X RETENTION$ 1.0,000 Aggregdte••.. $ 2,000,000 WORKERS COMPENSATION :' ' .' PER OTH. AND EMPLOYERS'LIABILITY STATUTE ER Y I'N' . 1,000,000 . D ANY PROPRIETORIPARTNER/EXECUTIVE ❑ NI:A' C�Q043'f902 06/3012016 0:6/3012017 '6:l;:EACHACCIDENT:i:: $ OFFICER/MEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE tm OY.-EE $ 1,000,000 II yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEA RPL L'ICY LIMI,T:: $: 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLE6 (ACORD 101,Additional Remarks Schedute,'may be,st4thed'It more space is required) Workers Compensation includes Officers or Proprietors. Additional Insured status Is provided under the General Liability and Auto Liability'.ikfibn required by written contract or agfeemeniwith the Certificate Holder. CERTIFICATE HOLDER CANCELLATION " '" �i� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 'he jI7 uliderS THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 94A Corce Park SOuh ACCORDANCE WITH THE POLICY PROVISIONS, Sou hatham,MA 0265 `'M.•, AUTHORIZED REPRESENTATIVE 7 ©1988-2014 ACORD CORPORATION, All rights reserved. ACORD 25(2014101)' The ACORD name and logo are registered marks of ACORD HOME OWNER WEATHERIZATION WORK PERMIT: i PLEASE COMPLETE AND SIGN THIS FORM AS THE APPLICANT HOMEOWNER. E Y hereby consent to and agree that weatherization work may be done by the Weatherization Program of Housing Assistance Corporation on the property located at: � 9 re, Mir C.�, e" I The weatherization work done will be based on programmatic priorities and availability of funding and it may include all or some of the following measures: Weather stripping; air sealing; attic& basement insulation; exterior wall insulation; ventilation measures In consideration of the weatherization work to be done at my home I agree to the following: 1. I give permission to Housing Assistance Corporation the property with such equipment and materials as may be'necessary to perform weatherization. 2. The Housing Assistance Corporation reserves the right to inspect the fuel or utility bill for the weatherized unit on an ongoing basis for no more than five (5) years after the weatherization work is completed. 1 have read the provisions of this agreement and give my consent. a Home Owner(Signature) Home Owner email: Date: -"")Agent:(Signature) 7Date: Weatherization Contractors: C j� ✓�� Adam T Inc Cape Save All Cape Energy Frontier Energy Solutions Alternative Weatherization Lohr Home Improvement ildmg-Scie t'at 'on Tupper Construction Cape Cod Insulation Town of Barnstable *Permit#6-1 Fxpaec 6 nw m issue date Regulatory Services Fee s�xtvsruu�. : �, MASS �,�' Richard V.Scali,Director Building Division Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.towmbarnstable.ma.us. Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Map/parcel Number [ ()61 O a Not Valid without Red X-Press InWrint ( J /n Property Address $'Iesidential Value of Work$ 0 Minimum fee of$35.00 for work under$6000.00 ry-� Owner's Name&Address ( A- en/'r` 4 t Contractor's Name /y � 6�2 end �/ Telephone Number Home Improvement Contractor License#(if applicable) �/b 1`�d `� Email: �-0. Z Pad�'I Construction Supervisor's License#(if applicable) �V U 313 QWorkman's Compensation Insurance Check one: XOPRFSS ❑ I am a sole proprietor 's ❑ I am the Homeowner AUG 2 10 I have Worker's Compensation Insurance p 2016 Insurance Company Name CS TO""�/ A N O F p Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Pennit Reallest(check box) Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) D Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *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 Contracto icense&Construction Supervisors License is required. SIGNATURE: C:\Users\DecollikWppData\Local\Microsoft\Windows\Temporary In et Files\Content.Outlook\2PIOIDHR\EXPRESS.doc Revised 040215 Ong II BAMSTAIRa "��, Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-8624038 .Fax .508-790-6230. Property Owner Must Complete and Sign This Section If Using A Builder as ner of the subject property 9 �/ hereby authorize r L��"'' z C� oy- to act on my behalf, in all matters relative to work authorized by this building permit application for: f (Address of Job.) a-cl d- 1116 Signature of Owner Da , Z. e)'-y y Print Name If Property Owner is applying.for-permit,.please complete the Homeowners License Exemption Form on the -reverse side.: C:\Users\Decollik\AppData\L.oca]\Microsoft\Windows\Temporary Intemet Files\Content Outlook\2PIOlDHR\EXPRESS.doc -Revised.040215 Hze Canurrornivedfle of Massadinmetts Deparftnerrd oflitdresftad Acdderaf dZlce o1"Irmesdgadorrs Wi- 600 Washington Sltwa Bastan,MA 02111 tibntnc:ata-mgosMia Workers'Compensation Insurance Affidavit-Bider,Rs/Contractoars/El'ecttici sIPtumhers ".taint Information Tease Print I e "b Address: �i�r C11_111 e Crc�rscarp: C ��/ P Pha 4_ Are you an emploW. Cheek the appropriate box: I am a employer with 4- I am a general contractor and I Type off project(required):1.� employees(fall and/or gattt-trine)a havv.hired the sub-contractors 6- ❑I*w construction 2-❑ I am a sale propnetar or partner- listed an the attached sheet. 7- ❑Remodeling ship and bare no employees These sab-contractars have g- ❑Demx&tion wodEing for me in any capacity. employees and hav,v worms' [No warlten'camp.insurance comp-inwrance.= 9- ❑Building addition reTtired.] 5_❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I arm a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myseW_ o workers' rat of esesrag>tian per MGM 12. repami ce r��)I c. 152,§1(4X and we Mve no employees..[No worlcefs' 13.[�Othelhe a comp-insuance required.] — •Any app&cmr that ch_-rks bane#I Mna:iso ER am the secdaa below teaming urattaas•cm�ensaaan pa�cy infanntti� H meorms wba sdb at this 1fd2=UMhC ag&ey ue daing aii react snd ohm bite aWstde conusnms>ttast submit a new wads%*�dicatirr such ?4:anuaruus mat ch-k obis box mm rmcbed an zdb auai don showing the name of she snb<cnmcsms wd state mhe&ff a r not those etvaes babe emplay— If the scab-casuma—hsce ecq tosees,>h_-y—provide tb-w-L--'c—p-panty namber lam are asrrrpfoysr tGaE 6s praafdkrr�g vt�rCrr°teugraetesatFara itt sravatce��or ntys�urpla:g� JDalaty ds ticsr pole orrd jab sits innf'oauratam Insurance CbmpanyNamre: C C Policy#or Self4 nss.Ur-# P`' 3 0 Espiratian Date: l Job Site Address: �® �'by CitylState/ZT: "'If Attach a copy of the workers'compensation pa6y declaration page(showing the policy number and expiration date). Failure to sere covwage as requtwed under Section 25A of IMQi1..c.152 can lead to the impositiaa of arimin d penalties of a fine up to S 1,%O.0d and/or arse-year imprisonamot,as well as civil penalties in the farm of a STOP WORK ORDER.and a fine of up to$250-00 a data against the violator. Be aftised that a copy of this statement may be forwarded to the Office of hm-estigations of the DU for insurance coverage verification. f do hemby a;atrtif,)+aad'er&a pairs nd a :�g�wrp tonne tlae in�arurativra prtss rdaal'Q&awe is Ortag or S tme Date- Phone Phone it -�a �� U ✓' Official case 003: Do trot write its d s area,to be camphited by a ty or total of efal, City or Timm: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department A Cityfrowm Clerk 4.Electrical IInspector S.Plumbing Inspector 6.Other Contact Person: Phone#: CERTIFICATE OF LIABILITY INSURANCE °"��'"°ole" -- - - - - 02/17/2016 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 poficy(res)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the eq policy,certain policies may require and endorsement A shiterent on trs certificate does not confer rights to the certificate holder in lieu of such endorsements. PRODUCER CONTACT McShea Insurance NAME Bertdey Assigned Risk Services - 1550 Falmouth Rd RT 28 Ste 2 KfC.to.� (800 634-4589 FAX w (866) 215-8118 Centerville,MA02632 EMAIL ADDRESS Poli ervlCeS@betklYrIsILCOM wsurtED INSURERS)AFFORDING COVERAGE NAIC N Richard Cazeault Jr WWPXRA:Acadia Insurance Co 31325 198 Five Corners Road BISUPZR B: Centerville,MA 02632 INSURERQ UISIIRER D: INSURER E . INSURER F . i COVERAGES CERTIFICATE NUMBER: REVISION NUMBER THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN INSSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH 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. MSR LTR TYPE OF INSURANCE RADD WRVD POUCY Nut�R POLICY EFF POLICY P LIMTIS . tM�wO>rYYY) (MWI)DNYYY) YWD LOPE COt ABLrpTtOA/AIND WC STATU- WLOYt3tS'LtA68 rrY 19 TORY LIMITS ❑OTHER ANY PROPRIETORIPARTIRERI E.L.EACH ACCIDENT $50Q,000 A EXECUTIVE OFRCEMEdBER Y EXCLUDED CM) NIA ❑ MAARP300M 02A)4/2016 02/04/2017 ELD -EABIPLOYEE $500,000 D}I'to, E.L.DISEASE-POLICY LIMIT $500,000 It yes,desorlbe tttft DESCRIPTION OF - OPERATIONS below. I ❑ ❑ -3ESCI&qMN of 0PEPAM0NS I L0CMM I V&IVC—L .(Atterh ACORD 101,AdffwnW Reumft.Sdredude,urrwre spape.b I. . ... . _ Erection Category Eleven SlaLis Name EtedWe Enftfian AD trrshaed EnMy Excbzftd Richwdcazeausk Rkk LooNan 198 Five Corners Road.CenterAle MA 07532 !C CERTIFICATE HOLDER- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Totem Of Barnstable EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE 367 Main Street POLICY PROVISIONS. Hyannis,MA 02601 AUTHORIZED REPRESEWATIVE - Z ignature: ACORD 25(2010/05) BRAC 3139 ment of Public Massachusetts Depa t s and Stand ads Board of Building Regulations License: CS-100393 Construction Supervisor RICHARD p.CAZEAULT JR 198 FIVE CORNERS ROAD ` CENTERVILLE MA 02632 Expiration: , COrnrnissioner 02f0312018 •6110 w((INIJIINWirrrer lr n/•�/��IrJJUCII[R3e i Office of Consumer Affairs.&Bnsibess Regulation License or registration valid for individul use only i OME IMPROVEMENT CONTRACTOR -• -before the expiration dam•If found return to:...... Registration: _ 4,68607 Type: Office of Consumer Affairs and.Business Regulation_ .6Expiration: 3/8/2017 DBA 10 Park Plaza-Suite 5170 Boston,MA 02116 CAZEAULT ROOFING&RE14AIRS RICHARD CAZIEAULT / ,p 198 FIVE CORNERS RD CENTERVILLE;MA 02632 s Undersecretary Not valid without sigdature 0 r, 4 ae AiA-recbtumrnds Outelh Training coarser"'to 61'"atiots.to oceapat'mo Hfol' *ad hesith for workers.participation is vgtuntary.worke+dst receive additioall training oa specific hazards of their job.This course+ uaa Fasd does not expire.► I t t � 1 1 „�FFoorr further information see our web site at www osha eov/outrencLt1111111 TOWN OF BARNSTABLE Board of Appeals ..........._......................_........................... ...._ ::. ..._. ...._.... Petitioner Appeal No. ....... ...:......... ' ...................... 19 FACTS and DECISION filed petition on 19 Petitioner ` � � .5 _. ._. requesting a •p p �.. .. ........................................ in the village ermtt for remises at .........:...:::..:. :4:. .,._...��. . , ... �# of _...... .............. adjoining premises of.. ......._ ._....... _............. _...._._.. ._._.._ ......._._....._. for the purpose of . - -.._ ... ........_ ... ..... A41 .... ............................................................................_..........................................................................................................._..........._............................................................ . : - W Locus is presently zoned in ........:........................................................_....................................................................................................................................._..............................................._........._............_......._ Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in.Cape Cod Standard Times, a daily newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town -of Barnstable was held at the Town APO 94-0 Office Building, Hyannis, Mass., at P.M. upon said petition under zoning by-laws. Present at the hearing were the following members: "` ......._..............................................._....................._. _.... ._...................._......................................._...... ............................... _._..... Chairman At the conclusion .of the hearing, the Board took said petition under advisement.. A view of the locus was had by the Board. On .....................................{. ................................................................................. 19 ...., the Board of Appeals Lound 8644 USUM *qW"*ft" too O uouu m . . ;. � 3rMA a ' : Soot =ws Uaftm ftw U 4out 4 1, Vey" . to-V6 ,80404 O of UM 204 UFO" vomit . at. ). at AU `mud 46 a Restrictions imposed: �Advwv-vtn d aid not toot 24 ,01,S00. Distribution:— r Board of Appeals Town Clerk Town of Barnstable Applicant Persons interested Building Inspector ; Public Information y ..;.. .................. ... ... .... Board of Appeals Chairman TOWN OF BARNSTABLE Board of Appeals _.F..r..e.d....L......and....Rutkx.....R.......W..illiam. Petitioner Appeal No. ........................... ....... 19 19 68 FACTS and DECISION Petitioner .......F. 'd....L.......8t1d...Ruth....B......M.1111am ..... filed petition on .....AP.rAl....2.. 19 68, requesting a variance-permit for premises at Wake ?y....R.Qad............................................. Street, in the village of ....MarBhons... ilia...., adjoining premises of-Lorenzo....T........Gib'f.ord Loring.....J.pne s Sr.J Ragar..s.,.....Char1e.s....E....... aznb13h.............................._......................................_...._w for the purpose of ._.._.c.au t.I'ucting.:.12.1.....5....20 sddltiQI71....t.4....gX16.1. ng...aP& kenpel ................................................................................................................................................................................................................................................................................._........ Locus is presently zoned in ........R.ezlAenC.B....Rm2......................................................................................................_. ................................._._........................................................................................................................................................................................................................................................ Notice of this hearing was given by mail, postage prepaid, to all persons deemed affected and by publishing in Cape Cod Standard Times, a daily newspaper published in Town of Barnstable a copy of which is attached to the record of these proceedings filed with Town Clerk. A public hearing by the Board of Appeals of the Town .of Barnstable was held at the Town Office Building, Hyannis, Mass., at .......3430................_ . P-M. Apr..il....24......... ... 19 68, upon said petition under zoning by-laws. Present at the hearing were the following members: Char..les....McGrath............... .......Je an....M......Aa.ar.Se.................. .........Raard....Gn.ins............... __ Chairman _.........._...................................................................... ....................._..........._...................I................I........... ......................................................_.................__ ._ At the conclusion of the hearing, the Board took said petition under advisement. A view of the locus was had by the Board. On ....................................................._..............._...._...................................................._ 19 .........., the Board of Appeals found The petitioner stated that he proposed to add a 121 x 201 addition to an existing kennel. He said that he presently had ten stalls and would add an addiitonal ten to enable him to keep 20 dogs. The petitioner stated that he owned approximately 9 acres of land and that the kennel wouldkocated near the middle of his parcel at a considerable distance from any abutter.. It was the opinion of the Board that the extension of the present use would not be more detrimental to the area. The location of the kennel near the center of the large parcel would eliminate any undue noise to the neighborhood. The Board voted unanimously to grant a Special Permit. Restrictions imposed Distribution:— Board of Appeals Town Clerk Town of B instable Applicant Persons interested Building Inspector Public Information B y ................. _.... Board of Appeals Chairman 15o Wokeb - � Giangregorio, Robin From: Houghton, David Sent: Friday, October 26, 2001 10:51 AM To: Giangregorio, Robin Cc: Smith, Robert; Horn, Dan; Lewis, Charlie Subject: RE: Re: Special K Kennels Thank you for the attached review and information. A petition was submitted to the Town Manager on July 17, 2000 signed by Twenty-five residents complaining of excessive barking noise from dogs at Special K. Kennel. The Town Manager issued an order pursuant to his regulations and state statute dated September 14, 2000 that Special K. limit the amount of time dogs were out and develop a plan to abate the nuisance. Special K. appealed that order to Barnstable District Court. The appeal was settled by SPecial K's plan to enclose the kennels which I gave to you on Wednesday over suggestions by Animal Control Officer Charles Lewis to employ barking collars, among others. Their claim that the legal department told them they did not need a permit may be an expansion of an inference they may have made that we didn't tell them to get one. I corresponded with their attorney about the pace of the enclosure process from last September to this May. The only time I ever met the Perrys was on July 10 when I visited the site along with Dan Horn, Charlie Lewis and their attorney. I recall observing a poured concrete slab and one part of one wall of a kennel enclosure. I did not observe nor ask to see a building permit nor expressly or by inference advise them to get one or not to get one: my role was to track compliance with the resolution of a District Court appeal of an order by the Town Manager. You indicated to me today that the work is almost complete: perhaps a review of the remedies for completed, unpermitted structures would be of assistance. If you or the inspectors have additional questions or need additional information, please contact me. Thank you again. -----Original Message----- From: Giangregorio,Robin Sent: Friday,October 26,2001 9:01 AM To: Houghton,David;Smith, Robert Cc: DiMatteo Peter;Trott,Mitchell Subject: Re: Special K Kennels Importance: High The owner of Special K Kennels has informed the building inspector that our legal department advised him to"...just get the work done.A building permit is not necessary". Not believing this to be true I requested the applicant to provide this to me in writing. Now the work is being done with out the benefit of the necessary permits. He does not understand why he can not pull a residential permit. I explained that this is a commercial venture in a residential area. The purpose of the work is for the commercial use hence the requirement of a commercial permit. This also necessitates a licensed contractor to apply for the permit (which he would like to avoid I assume to due to the expense). He left in a huff that day and apparently his attitude has not improved because he made threatening remarks to the inspector yesterday. The current quandary is the requirement by the building inspector to post a stop work order as no permit has been applied for or granted. I understand he has been mandated to do this work but not outside the scope of all other legal requirements. Also, it is unclear to us which authority mandated the work, the Town manager, the ZBA or the court. The owner is threatening legal action and additional spiteful harassment to the neighborhood. Also, he claims the town has been attempting to close him down for years and this is just one more tactic in our mission to get him. Before the inspector continues with the stop process, is there anything else we should know or be aware of or should we not proceed at this time? Please advise ASAP as the inspector awaits a determination. Thank-you. 'r )o• Avai-laole Assessor's Plan: TGAGE I �, I NECT I ON PLAN ;a B A R N S T A B L E r Gifford a T- 7y 1 > ,33 ,68 f Lot 3 ^� 180, 428 .S.F. f �, US' 1t e a � I Kei 1 Story , b 300 0 , x,el Building ' 5 Shed c:�6 Lot 1 of 2 Stied % Sot 00�O Lot 4 Sto ��.% O 1ildinq 2 Slory 1 . Building � Stied o No. 750 , M ' ho — 268.66' -� W A K E B Y ROAD ------_. -7/l -7//��4 l . P�0,*114ET°�° TOWN OF BAR:NSTABLE Z BARNSTOIILE, i Y BUILDING / INSPECTOR FY a . APPLICATION FOR PERMIT TO ......... U. .... ....... 1.... .. Gi/}\,! .... 17 .!..��......... ........................... TYPE OF CONSTRUCTION ...............I".( }/' ..,.......... ......../7�., ... .......................................L........ a .............. .....`;.L.6�..............19.2.13 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit >according-to the following- i�ng-informationf:( Location .R J✓•...:3..�......... ..OrKic .�...>'4. ..........[.!.J. acS. !. - .... .I.l.l��. ..:...r%i.� ..................... Proposed Use ............. ... n!�....... LR.2.F'/./ ................................................ X. ................................................// r Zoning District ............ .......C-�..................................Fire District Name of Owner �l l <t1./1... .. � C�E(.�"../...!_. ��re ..... D 318..........!T..... Name of Builder ...........:..... ..AMM. .......................Address .......� �f..... .�....1 '1..!........................................ Name of Architect ....... .fl' ...� ....(FYI. ...................Address ........M,1.t5........ ................................... 6 Jf Numberof Rooms .......................... ...j....................................Foundation ............. .......................`.....:................................... Exterior Tly.w.0.4.... !F.P..:,.....................Roofing ......a��.� (10woe-41 Floors .......................... ............... .....:................Interior ....Y/. .l .I. ,............................................. Heating ...........OJA......&0.. . .`k` C"OZ. -.........Plumbing ....,. ?... !9�.!l 5..:..................................................... Fireplace ..................................... -'�................................Approximate Cost ........A��G/f/ .................................... Definitive Plan Approved by Planning Board -----------________._________19 Diagram of Lot and Building with Dimensions SEPTIC SYS INSTALLEDEM MUST BE N COMPLIANCE SUBJECT TO APPROVAL OF BOARD OF HEALTH° WITH ARTILLE II STATE SANITARY CODE AND TOWN REGULATIONS.AA 00 Est xjC, .s �- � �Eby R���• I hereby agree to conform to all the Rules and Regulations a Town. f sta regarding the above construction. N : dF. ...• ..... .................... , Frahonunnv Helton B. &: Claudette ^ 16048 . ' . � ^ ^ I1/n No —.����.�... Purmh for ---..��.�..�����—.. + ' } ----'' ` � -------=—''"'°^—'' '7 - .�` . ' ^"`".~". ---byMarstons Mills . . ............. ' , . {]vvne, .......... .R...8".. , hmanri ' ' Type of Construction .............fmm.................. ....................... ..........................................�.............. . , ` Plot ............. Lot ................................ � [ ` i . ` . ' . ^ Permit Granted --D�r���..��..—�-.—lP �� ' , Dote of |n ` l�Inspection , ; Dote Completed �K�»�� �� . . ` " . PERMIT 'REFUSED. ^ .-----...�.�.—.--..------- lV ` i ........................-----.------------' . ' ' ' . ^-------.------------------. ' . ' . . ------.—�----..`------.-----.. ` - ....................................................... � ~ ! ' Approved ,--------------- lQ ! ' , . , ' _ Vi''v* t i i ��o�' TOWN.OF BARNSTABLE BUILDING PERMIT APPLICATION Map 01aoo3on i Parcel _ke-ij Permit# :J(J Health Division km Sa_2Qc )— - 1c) I Date Issued Conservation Division / f 1cwe, Fee $ Tax Colle /� �tlPoe Treasur r._ D I l I O + 1E TIC SYSTMI 5 MA) IP�ST Q:�T�.. �LLED W COLIP ,"- Planning Dept. WITH TITLE"03 Date Definitive Plan Approved by Planning Board ENVI (0a � T � - Historic-OKH Preservation/Hyannis Project Street Address 7S� (�a,C'Q h. � /9? a 14,5_10 r,0 IMAJ Village Ma K5Y ✓2S �� J1S Owner l�%arY��o eZ� PU�/��•P,0 Address 'mod 40aL� 'phone `Permit Request-70,0 1,cpla o 1P / -n:z e _ Mh Oa t /i V AO/7 rO04 /a_ %a 4�4 cv�- o n e aT 6: ))'0 Yb f Square fee t floor: existing proposed 2nd floor: existing proposed Total new Valuation Zoning District Flood Plain Groundwater Overlay Construction Type C 1 nd0r 3/ae./( Lot Size Grandfathered: Er es ❑No If yes, attach supporting documentation. i Dwelling Type: Single Family ❑ Two Family Er Multi-Family(#units) Age of Existing Structure c,2 Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑Crawl ❑Walkout 26ther 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: ❑Gaffs tV it ❑ Electric ❑Other Central Air: ❑Yes efNo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:O existing ❑new size Barn: existing ❑new size Attached garage:❑existing O new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Q No If yes, site plan review# _ Current Use Proposed Use BUILDER INFORMATION Name Perl,(4 Telephone Number Address / rI YYlO oft L Q r5 License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE /o 4 le, / c _ r t a Z FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTIONy FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL ,r PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING., ' DATE CLOSED OUT, ASSOCIATION PLAN NO. y i RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE tr 6 D a� x.0031= I7`f J square feet x$64/sq.foot= plus from below(if applicable) ACCESSORY STRUCTURE>120 sq.ft >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-Same as new building permit: square feet x$96/sq.foot= x.0031= ; STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) ,7q SCr Permit Fee , projcost °FTME The Town of Barnstable �Ae Regulatory Services MASS,039. •0 Thomas F. Geiler, Director rEo Nw� Building Division Peter F. DiMatteo, Building' Commissioner 367 Main Street.Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-=1038 HOMEOWNER LICENSE EXXEMMON Please Print DATE: / U� O JOB LOCATION: (J z Stre/et vn,ge number _ `p r work phone# "HOMEOWNER": home phone# name CURRENT MAILING ADDRESS: state zip code city/town of six units Or The current exemption for"homeowners"was extended r rewho include does not possess a license,2rov� ids less and to allow homeowners to engage an individual for titre the owner acts as supervisor. DEFINITION OF HOMEOWNER oris Person(s)who owns a parcel of land on which helshe resides or intends t�access ry t such use and/or intended to be,a one or two-family dwelling,attached or detached 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 res onsible for all such work performed under the building ermit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner'certifies that he/she understands d that of Barnstable she wa ill comply Building said Department minimum inspection procedures and requirements procedures and require ts. gnattue of Homeowner Approval of Building Official Note: Three-family dwellings containing 35.000 cubic on Control withwill be required to comply with the State Building Code Section 127.0 Construction ON HOMEOWNER'S EXEM n ermit is required shall be exempt from the The Code states that: "Any homeowner performing work for which a building p • provisions of this section(Section 109.1.1-Licensing of construction Sup�rviosors):Provided that if the homeowner engages a person(s)for hire to do such work.that such Homeowner shall act as limey are assuming the responsibilities of a supervisor(see Many homeowners who use this exemption are unaware •�lack of awareness often results in oainstthe Appendix Q.Rules&Regulations for Licensing Construction supervisors as Section i proceed against a serious problems•particularly when the homeowner hires unlicensed persons. In�sS per°Ise S S ultimately f�peed ao e. person as it-would with a licensed Supervisor. The homeowner acting communities require.as pan of the permit unlicensed p oe of this issue is a To ensure that the homeowner is fully aware oflshe understands the responi hues of a Supervisor. On the last page unity. care t amend and adopt such a form/certification for use in your comet application.that the homeowner certify form currently used by several towns. You may Q:FORMS:EXEIviP'i1V Town of Barnstable . . : The . 9��Mg Regulatory Services %659. .•• Thomas F. Geiler,Director, �fD .+ Building Division Peter F. DiMatteo,Building Commissioner 367 Main Street,Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 Permit no. Date /o��/ AFFIDAVIT CTOR LAW HOME IMPROVEMENT CONTRA SUPPLEMENT TO PERMIT APPLICATION air.modernization,conversion. MGL c. 142A requires that the'reconstruction.alterations•renovation.rep existing owner-occupied improvement.removal.demolition.or construction of an addition r tpreuuctures which are adjacent to building containing at least one but not more than four dwelling such residence or building be done by registered contractors.with certain exceptions.along with other requirements. s //''�� r Estimated cost O / Type of Work: y Address of Work: 7�0 -�J c 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 Mdwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH GISTERED Wow DO NOT HAVE CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT FUND UNDER MGL c.142A. ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner. Registration No. contractor Name Date Owner's Name Date q:forms:Affidawrev-070601 cx fe,-;o/7 vleC.v �er7•?e/J. 2 -x d1 ........ �.�...+v_...w._..S..yn��..w.�.�+_w•TwlY+r..'�.r•.'Ra_..+..�.j�...w�w�-.r._....K_nv.+� .. e... �_ ..�........._.r^..-. . ...n.. _.-�..•....._._` ....n-.��._.'..-_-:.'.......r^..._.r• .._<' ... .r...._ .�.rw.�ar.r__....a...-. / Maws..e...�•�w..v,a y...,w.W...u..m. ....L.�a••vM...•....__,,.._�e••_..M..........r...:•,.•...•.. .. ..,...��.�._•.�:..::•, .. ..... ..•_-.n.m.. ..�J:.6:..�tl..Gw:...::..e„am_ _ ' 1 3 • 3 -- vdbr-� gyre fx.94 P t� E xe der 'o r V'e'er _ • � �t ha��� tans �f xr 01��ar1 � , i l f The Commonwealth of Massachusetts j- L Department of Industrial Accidents Office 0110BQ599890dS 600 Wasltington Street Boston,Mass. 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I two • copy of fhb atattmeat may be forwarded to the Office of Investieadoa�of the DIA for covers; rutder the sass and ofPerjury that flit eyorntatio rovided above is truce mtd correct I do hereby eeTdfy P P Date /0/i // signature ,� print name /�Y r Phone# oincw use only do not write in this area to be completed by city or town offidai perudocense 0 ❑Buiading Depardnent city or town:— ❑Licensing Board ❑selectmen's Office ❑checkitimmedwe response is n4� (]Health Deparnneat . - ❑Other contact person: phone ii; (myeo 9/9S P)A) Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide a serviceers' compensation for of another under coeir - emplovees. As quoted from the "law", an employee is defined as every person in 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 of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver trustee of an individual, partnership, association or other legal entity, emplovu�g e=nploYe� 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 an such dwelling house or on the grounds c crew shall not because of such employment be deemed to be as employer. building appurtenant threnev MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance o construct buildings is the commonwealth for any.app who h: of a license or permit to operate a business or to the not produced acceptable evidence of compliance with the insurance coveragfbr helperformance of Additionally, work until commonwealth nor any of its political subdivisions shall enter f thisntract z have been presented to the c^^^a� acceptable evidence of compliance with the insurance requirements authority. Applicants ' compensation affidavit completely,by checking the box that applies to your smur6aa and Please fill in ,he workers comp with a certificate of insurance as all affidavits may be supplying company names,address and phone numbers along a Also be sure to sign and submitted to the Deparemmt of Industrial Accidents for c on of insurance covmag or town that the application for the permit or license is date the affidavit. The affidavit should be returned nts- Should you have any qu��regardingreg the'law„or if yc being requested, not the Department of Industrial lease call the Department at the number listed below. are required to obtain a workers' compensation policy,p City or Towns The Department has provided a space at the bottom of t! Please be sure that the affidavit is complete and printed legibly. the applicant Please affidavit for you to fill out in the event the Office of Investigations has to contact you regarding ermitllicense member which will be used as a reference number. The affidavits may be retur to be sure to fill in the p have been made• the Department by mail or FAX unless other arrangements The Office of Investigations would like to thank you in advance for you 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 Industrial Accidents Me of Investigations 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 io- Available Assessor's Plan: NO:-- .— C. T G A G E I NE C T I 0 N P L A N BAKNSTABLE C�i�����M!� ` 3���"° �,�: :�. .� � �`��•fir � Gifford %' 11) 3 f Lot 3 180,428 S.F. f OS' ;y a I 1 Story b 300 OC Kennel Building Shed / Shed Lot 1 of 2 i Stied 0 5 Lot Cd Lot 4 1 Sto' ., O iildinq O 2 Rory Building r, Stied oNo. 750 I �O 268.66, ' ! W A K E B Y ROAD r1n t io0 a : i r spec i a' ] K Viso UJcA-*Ki2 by Alk , f z f -�D cor Drr6r s i ro PAril�ivl'1 � )'ti:1. r. ' '�v. .:i€•i rt+s:..1• •'/0. W�fS :�5,� � �• 1!_ �. .✓ - `-ia.,:`?ASiY3`. .U to � --.rcr ...-t .._•*9'e„� �� Table liZlb( ) "mb s�PreriQstre ParJu;e sa for One d Twa3'amilt'RmwwudalNffum Boiidlsp Hsaead Foaail MAJQMUMm � . Slab 8�('°0°IIE (ilada8 8 Ca1fa8 Wall Floor Baaem�c &VjF== EMd=cY' paimcw Areal(•/.) u.,.,wucr It-valud R vatue� RPVWULJ &�� a pu=2e 570I to 6500 HeadaR Defeo DAW Normed Q 12"• 0.40 38 13 19 t0 6 6 Normal R 12%s 032 30 19 19 10 6 U AFUE 9 12% 030 38 13 19 10' Norte 'T 15% 036 38 13 2S WA 6 w� Nom�al U 15% 0.46 3E 19 19 10 IS AF[JE v 15% 0.44 3E 13 25 WA 6A 85 AFVE W 15% 032 30 19 19 10 Normal 18•i. 03Z X 3E 13 25 WA WA WA Narsral y 19% 0.42 3E 19 2S WA 90 MUE Z 18% 0.42 3E 13 19 10 6 90 AF[JE AA lgy. 0-SO 30 19 19 t0 6 I. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL 11 EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q—AA see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FO 'THIS INFORMATION. BUILDING INSPECTOR AP VAL: YES: NO: q-forms-080303 a IOU Footnotes to Table J5.2.1b: o doors, skylights. and ' Glazing area is the ratio of the area of the. glazing assemblies (including sliding-olaSS gross wail basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the area. expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example.3 ft of decorative glass may be excluded from a building design with 300 If of glazing area- 2 After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance whit the National Fenestration Rating Council (NFRC) test procedure, or taken from Table J1.5.3a. U-values are for whole units:center-of-glass U-values cannot be used ' The ceiling R-values do not assume a raised or oversized truss construction. If the insulation achieves the foil insulation thickness over the exterior walls without compression. R 30 insulation may be substituted for R-:8 insulation and R-38 insulation may be substituted for R-49 insulation. Ceiling R-values represent the sum of cavity insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. sheathing (if used). Do not include 'Wall R-values represent the sum of the wall cavity insulation plus insulating exterior siding,structural sheathing,and interior drywall.For example,as R 19 requirement could be met EITHER o by R-19 cavity insulation OR R l3 cavity insulation plus R-6 insulating sheathing. Wail requirements app . wood-frame or mass(concrete,masonry,log)wall constructions,but do not apply to metal-frame construction. 'The floor requirements apply to floors over unconditioned spaces(such as unconditioned Crawlspaces,basements. or garages).Floors over outside air must meet the.ceiling requirements. `T'r.e entire opaque portion of any individual basement wall with an average depth less ma Sdoorseof conditioned me: the same R-value requirement as above-grade walls. Windows and sliding glass b...,ements must be included with the other glazing. Basement doors must meet the door U-value requirement d_scribed in Note b. The R-value requirements are for unheated slabs.Add as additional R-2 for heated slabs. ' If the building utilizes electric resistance heating use compliance approach 3,4, or 5. If you plan to install more than one piece of heating equipment or more than one piece of cooling.equipment, the equipment with the lowest efficiency must meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see Table J5.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels.Insulation R values are minimum acceptable levels. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 035.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test Procedure or taken from the door U-value in Table J 1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include he glass area of the door with your windows and use the opaque door•-v ue to determine er d S)compliance of the door. One door may be excluded from this requirement(i.e,r may phavace wall comvalue gronent includes two or more areas with c) If a ceiling,wall,floor,basement wall,slab-edge, P p eighted average R value is greater than different insulation levels,the component complies if the am-w equal t the R-value requirement for that component. Glazing or door components comply if the area•weighted average U- value of all windows or doors is less than or equal to the U-value requirement(035 for doors). 43 15o Giangregorio, Robin From: Houghton, David Sent: `Friday, October 26, 2001 10:51 AM To: Giangregorio, Robin Cc: Smith, Robert; Horn, Dan; Lewis, Charlie Subject: RE: Re: Special K Kennels Thank you for the attached review and information. A petition was submitted to the Town Manager on July 17, 2000 signed by Twenty-five residents complaining of excessive barking noise from dogs at Special K. Kennel. The Town Manager issued an order pursuant to his regulations and state statute dated September 14, 2000 that Special K. limit the amount of time dogs were out and develop a plan to abate the nuisance. Special K. appealed that order to Barnstable District Court. The appeal was settled by SPecial K's plan to enclose the kennels which I gave to you on Wednesday over suggestions by Animal Control Officer Charles Lewis to employ barking collars, among others. Their claim that the legal department told them they did not need a permit may be an expansion of an inference they may have made that we didn't tell them to get one. I corresponded with their attorney about the pace of the enclosure process from last September to this May. The only time I ever met the Perrys was on July 10 when I visited the site along with Dan Horn, Charlie Lewis and their attorney. I recall observing a poured concrete slab and one part of one wall.of a kennel enclosure. I did not observe nor ask to'see a building permit nor expressly or by inference advise them to get one or not to get one: my role was to track compliance with the resolution of a District Court appeal of an order by the Town.Manager. You indicated to me today that the work is almost complete: perhaps a review of the remedies for completed, unpermitted structures would be of assistance. If you or the inspectors have additional questions or need additional information, please contact me. Thank you again. -----Original Message----- From: Giangregorio, Robin Sent: Friday,October 26,2001 9:01 AM To: Houghton, David; Smith, Robert Cc: DiMatteo Peter;Trott, Mitchell Subject: Re: Special K Kennels Importance: High The owner of Special K Kennels has informed the building inspector that our legal department advised him to"...just get the work done. A building permit is not necessary". Not believing this to be true I requested the applicant to provide this to me in writing. Now the work is being done with out the benefit of the necessary permits. He does not understand why he can not pull a residential permit. I explained that this is a commercial venture in a residential area. The purpose of the work is for the commercial use hence the requirement of a commercial permit. This also necessitates a licensed contractor to apply for the permit(which he would like to avoid I assume to due to the expense). He left in a huff that day and apparently his attitude has not improved because he made threatening remarks to the inspector yesterday. The current quandary is the requirement by the building inspector to post a stop work order as no permit has been applied for or granted.1 understand he has been mandated to do this work but not outside the scope of all other legal requirements. Also, it is unclear to us which authority mandated the work, the Town manager, the ZBA or the court. The owner is threatening legal action and additional spiteful harassment to the neighborhood. Also, he claims the town has been attempting to close him down for years and this is just one more tactic in our mission to get him. Before the inspector continues with the stop process, is there anything else we should know or be aware of or should we not proceed at this time? Please advise ASAP as the inspector awaits a determination. Thank-you. J �.�.��4'�. t `? �./�,1��.9/'�f/`jk o i 01 :N5 PM HAR8CH 7782774 P. 06 r I. Stockade fencing replacing p1 anized fence a 50 R area in back of l.omel November 2WO 2. Individmi concrete walls replacing Plvanized kermeit-- __April 2001 I RM-1f like covering over kennels upun concrete watt, **acing pI" nicxtil fencing cop,.-------- --.-----April 2001 4, lnsulativa as nccded.--------- •--:----M-�.---April 2001 I 7 DOG \ tit i- \ < - . y/\� a«r- - 4<CwmS /J . <0 412±¢6-45.17 +- ©<Vt dUu3 . yoftNF>,�. TOWN OF BARNSTABLE i BAMSTAn s Office of the Building Inspector Nut �0p 039. am k� Date March .16, 1995 Fee $50.00 Permit No. PERMIT TO ERECT SIGN IS HEREBY GRANTED TO Kevin & Lita Perry D/BIA Special K Kennels LOCATION 750 Wakeby Road Marstons Mills, MA ANY VIOLATION OF THE SIGN LAW WILL CAUSE IMMEDIATE REVOCATION OF THIS PERMIT �Buildhg Inspector PERMIT NO. : ry DATE: T01-1--N OF BARNSTABLE BUILDING DEPARTMENT • 367 MAIN STREET HYANNIS, NA 02601 APPLICATION FOR SIGN PERMIT APPLICANT: _ l Q Lam//7 �GZ- /- ,ASSESSOR'S NO.: DOING BUSINESS. AS: o-eC/ TIQn new S TELEPHONE: —95— SIGN LOCATION / Street/Road: �� �G� v � filo ,/1!2) CS ZONING DISTRICT: OLD RING'S HIGHWAY DISTRICT? yes no PROPERTY OWNER / Name:Address: City: fL77U/ �o/i%Sstate: �� `7v�� - p GL Zip: G' Tel. No.: SIGN CONTRACTOR V Name: /* Address.- E/ O /d Wity: >/G07�S�i% State: /q;�c.�.,_ Zip: Ga� Tel. No. : DESCRIPTION DIAGRAM OF LOT SHOWING LOCATION OF BUILDINGS AND EXISTING SIGNS WITH DIMENSIONS, LOCATION AND SIZE OF THE NEW SIGN TO BE DRAUM ON THE REVERSE SIDE OF THIS APPLICATION. Is the sign to be electrified? yes no v (NOTE: If yes, 'a wiring permit is required.) I hereby certify that I am the owner or that I have the authority of the owner to make application, that the information is correct and that the use a::d construction shall conform: to the provisions of section 4-3 of the Tourn of Barnstable Zoning ordinances. Date Signature of owner/Authorized Agent For office Use - - - - - - - - - - - - - - - - - - - - -• - - - - - - - - - Size Sc. Ft. s Pe_mit Fee Approved !/ Disapproved • Date Sig Ina t a of Building h1sC< Town of Barnstable ' Building Department Complaintanquiry Report - Date: L- Rec'd by: Assessor's No.: Complaint Name: SDP ClG� V` L\,e VkVl1'i1 C7 L4-M `I 7 S� Location 4E D W� ,A f`o � `n �L 1,CQ�vi v� Address: �U IW� Fav�� M/P Originator Name: hYy\V,\�. Cdc S Street: 145 Mw vy6,J Village: Mar(A I U r vJ n y`1(, State• �'�' Pf Zip:oZ 4 d G t Telephone: D/E ) 1(0 7�/) + Complaint /! l ,, Description: (,(SVGAk Vk1A0 VlS Vxy kI l/l� , V 0W6 Vlc 6�( V1Vll • ` o Avon it 1/v tAUM4 VIP a � lM �/w��•v� G ' Inquiry �V ev Description: For O/licc Use Only O`'f/ G7�y f 30 Inspector's Action/Comments Date: /--'/,z —L Inspector. c G2G� Follow-up G?���� /0 �oyJ Action Additional Info. Atta ied ,,QQ a Copy Distribution: White-Departrnent Fde/di�—/7 Yellow-Inspector Pink-Inspector(Return to Office Manager) r , TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Y SEPTIC SYSTEM MUST BE ,2 Z/ Map Parcel Permit#yo STALLED IN COMPLIANCE .3oo�� , Health Division WITH TITLE 5 Date Issued %� PN�@P®Nll►iENTAL Conservation Division CODE AND , TO N E ULATI®NS Fee Tax Collector Treasurer Planning Dept. Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address Zj�6 4C�J,(, 14 Village Z2:2 is 5-h17 S ' ) J � Owner L)OPZr'er,"/ Address Telephone 34?0_Z 7 Permit Request Ta 9 rD v/ter,/ P o l 1r, X Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Estimated Project Cost X 200 Zoning District Flood Plain Groundwater Overlay Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single.Family ❑ Two Family Ua Multi-Family(#units) Age of Existing StZu Historic House: ❑Yes �No On Old King's Highway: El Yes ®'No Basement Type: ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing , 3 new Half: existing o2 new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count ms Heat Type and Fuel: ❑Gas O Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing / New Existing wood/coal stove: ❑Yes C-lo Detached garage:❑existing Elnew size Pool:❑existing ❑new size Barn:rd'existing ❑new size Attached garage:❑existing ❑new size Shed:0existing ❑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 �D.S N L'2 S�J� s/ ` Telephone Number Address NO e lm cST. License# Zf 6 -2 kS .✓s5-1-J-01, 12e 683KV Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE �— �� FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED t' MAP/PARCEL Nb. t ADDRESS " _ VILLAGE a OWNER) DATE-OF INSPECTION FOUNDATION '.� FRAME INSULA'1:ldN. s � FIREPLACr 4 r ELECTRICAL:f' ROUGH FINAL rl ^' ; PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING t • DATE CLOSED OUT ASSOCIATION PLAN NO. , } R 1 t - �y . Census Tract No:__ Io' = Availaole Assessor's Plan: L: t'10 IGAGE I H I P E C T I0N PLAN BARNSTItBLE Gifford j'83 169 Lot 3 \ ^^ 180, 428 S.F. # 300 Or Kemiel 1 Story 3' OS 1 %Nrl Building / Shed `,fled Lot 1 .,at 2 rrinr. Stied Sot Lot 9 • 1 Stv` -��- , OQ ii Id. ng 2 SLory -� Building Mp Shed No. 750 --- _ 268. 66' - WAKEBY ROAD i AP 6 C✓AffQ L Q✓FL� ' i Q ConGfGt� �11 TI P STA NDA e o POOL D4C / "_• � /SS-, 198Z SCALE 4 AY Z _ • A " A.G. 1/ BRIGGS ON STREET` NORW 1-, MA•<< - 164 WASHINCGT I / A ------__ 6 �o� o 3. 3• y�� (/err'mi�Gc��i•te �� —� Sf Berl /�c�S c✓t E' . 3/8 ,� /7c a ale 1 y STANDARD LINER pbOL DESIGN SG4LE MAY28;/982 . � M A.C.115RIGGS 164 WAS1/INGTON STREET NORWELL MA . 1 I B vS� /46^fivfiL� Voo,,. Y. I OF 11 � Commouwean of Mamchusem No. I DEPARTMENT OF PUBLIC SAFETY �@ 1 DIVISION OF INSPECTION 8 `j 1,�,� _ _ ! .__•_�. -_:_�� tee:: `< _.e; v s- --.- - - - ' II ' ✓/ie TJanzrrrearuuea�i a�:.11tidor�c/rcaetld , I HOISTING LICENSE TO OPERATE i NG MACHINERY WHEN THE + HOn� POWER CHANT AL AND OTHER THAN STEAM I� OEPARTNENT Of PUBLIC SAtEit' S 25►�d �r' \, t� �" n+duly d'°" +s°tovidedDy`0�" I CONSTRUCTION SUPERVISOR LICENSE of ie bim so Sim59. I'6• "l r1°0aa"` �a - emus Ii . Number Expires: Restr.iacted.Jo.: 00 I This hcrn= is nw valid until hi after G JOSEPN\F '`CASNA 1 hcrnu W ber" usdorscd sipanu� in Inc Iefl marlin. D�/� /0 '0Q/ 140 PEMBROKE ST i THISLICENSEW/ILLFJ�1REOh J 6 r KINGSTON, aA 02364 67-7 HOME IMPROVEMENT CONTRACTORS REGISTRATION Board of Building Regulations and Standards One Ashbu'rton Place - Room 1301 Boston , Massachusetts 02108 HOME IMPROVEMENT CONTRACTOR Registration 106824 Expiratio 07/27/00 Type;-- PRIVATE CORPORATION CRYSTAL CONSTRUCTION CORP . Joseph A . C .^na 140 Pembroke St . .Kingston MA 02364 i r OF"E A . The Town of Barnstable Department of Health Safety and Environmental Services 1659. ��EDMA'fp10 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: po" Estimated Cost DU Address of Work: Z5 Owner's Name: �4)1 81 a t-y? / 0",0,- Z,Tol ` r� Date of Application: L/y/O d 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. 7 0� Date Contracto a Registration No. OR Date Owner's Name , q:forms:Affidav The Commonwealth of Massachusetts SiT = ` _— Department of Industrial Accidents Office 01/nse5998floQs = � 600 Washington Street ' = Boston Mass. 02111 Workers' Com ensation Insurance Affidavit name 17OSe)2 A- ( Ce-5 d/ ),.L- location: Poe/Y) city. D IL a- O `3 "1/ O phone# ZL- SF,5" 7-+4 S' [j I am a home wner performing all work myself. ' ❑ I am a sole pr rietor and have no one'workin in any ca acity %/ %%/% %%%///%/%/%%%%/���%%/%%%///G%%%%///%%%%%�%%%%%//�%%%�%%%%/�%/�%%�%///, am an em to er rovidin workers'compensation for my employees working on this job. ... . : :: ::.:::: :: OIII D any n 6. C : >> <'> ess ................................. .... ................................:::: ...............................:.. . city !'� phone#•c:><:: `: ::�.:: a;..:..:. .. insurance co.. - :, .. . ohcv:#.....::. : .. . ❑ I am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have following workers' co ensation polices: the g .............. ::<.;;:sine inD ann : : ` ?< ` ' ' 5:1::;°: n aar :::::::::::.::.:............ .......... ;p ci tr ...... ca an :.. ' iire Nx a d hone. inurance �r' oli FaIIure to secure coverage a,requited mtder Sectlon 25A otMGL 152 canlead to the imposition of criminal penalties of fine up to S1.500.00 and/or one years'imprisonment as weII s,dvII penalties in the form of a STOP WORK ORDER and s fine of 5100.00 a day against me. I understand that a • copy of this statement may be forwarded to the Office of Investigattotu o[the DIA for coverage verification. I,do hereby certify under the pains and penalties of perjury that the information provided above is true and coned Signature Date Print name Phone# official use only do not write in this area to be completed by city or town otIldal city or town: permit/license# ❑Buffding Department ❑Licensing Board check if immediate response is required ❑Selectmen's Office El _ ❑Health Department contact person: phone#; ❑Other (revised 9/95 PIA) I y 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. 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 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,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 situation 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 if 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 permit/license number which will be used as a reference number. The affidavits may be returned t^ the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you 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 Industrial Accidents gfflce of lavestigadons 600 Washington Street Boston, Ma. 021 i 1 fax#: (617) 727-7749 phone#: (617) 727-4900 eat. 406, 409 or 375 Engineering Dept. (3rd floor) Map © I Parcel 003. 00 Permit# 3 �j09 House# Date Issued _ - Board of Health(3rd floor)(8:15 -9:30/1:00-460)� ,Q`>` 2`2 Fee. X ,DG ice(4th floor)(8:30-9:30/1:00-2:00) SEPTIC S • Piarnri Y ng-Bgpt: INSTALLE ft�°,ST BE(1st floor/School Admin. Bldg.) t 6eq� �LB�iNCE Defit�ti�e-r oved by Planning Board 19 ENVIROf�1 B � TOW BiII e . , 'DE AND'�b TOWN OYBARNSTABLE s Building Permit Application Project Street Address Village /�6i�h�il25 Ali%(5 Owner /J pyi/I ,—n/ Address Telephone O-- - ,. • Permit Request AJ &c ,,VV7 Wi/'�O�/1k5 _e1_C1 o� -ex%S_/,-,n /9e.eve a7 oe4 cl tylY-A j-2ecJ Gc20Ocl First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ 0067. O U Zoning District Flood Plain Water Protection Lot Size Grandfathered Oie's ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure A407 Z&-,,Historic House ❑Yes UTo On Old King's Highway ❑Yes ❑No Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing / New No.of Bedrooms: Existing .7 . New Tota' Room Count(not including baths): Existing %,S 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 i Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ErBarn(size) c20 K d Qp E(None Shed(size) / x O ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes Et- o If yes, site plan review# Current Use Proposed Use I Builder Information Name o w/v e- Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR T OLLOWING ASON(S) � 1 • j FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED' A 6 MAP/PARCEL NO. , = + _ < ADDRESS VILLAGE OWNER + V DATE OF INSPECTION: + ' ` i F FOUNDATION + FRAME INSULATION 4 + FIREPLACE - ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL - GAS: ;y ROUGH, FINAL _ FINAL BUILDING`? DATE CLOSED OUT ASSOCIATION PLAN NO. ' U , engineering Dept.(3rd floor) Map /f 1 '� Parcel M3 Od O "" Permit# ��p House# 7SO ;)a Date Issued Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) e.A�� Conservation Office(4th floor)(8:30-9:30/1:00-2:00) I Dn, A e .va ..n,, .+ina Rnar 19 _ BARNSTABLE.P• 1639. TOWN OF BARNSTABLE i ' Building Permit Application roject Street Address Village .Ma 1�5-tip•5 /—W i //, Owner fP I//a Z).,;QP r n! Address �,SQ [�J� e 6✓ /�c✓. Telephone 51-2 R _ Pe it Request d i 9 e e x/<5 7�i )%I —1302 /� vv First Floor 'rjl�y (� square feet Second Floor square feet Construction Type GO O p Estimated Project Cost $ _7, ®®Q Zoning District 3+Ps.�e n %off/ Flood Plain Water Protection Lot Size Z,-/, 7S Grandfathered Zlres ❑No Dwelling Type: Single Family 2-' Two Family ❑ Multi-Family(#units) Age of Existing Structure i5 . Historic Hous ❑Yes 0"'No On Old King's Highway ❑Yes f�o Basement Typ'( ull ElCrawl ❑Walkou Basement Finishe ea(sq.ft.) Basement Unfinished Area(sq.ft) � Number of Baths: Full: Existin New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Exis ' gQ New First Floor Room Count Heat Type and Fuel: ❑Gas Oil Other Central Air ❑Yes RNo Fireplaces: Existing New Existing wood/coal stove ❑Yes No Garage: ❑Detached(size) Other Detached Structures: ❑A�am ze) ❑A ched(size) ize) None ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Bu' a Information Name Telephone Number Address �(e License# 03,�k it 10'-17 CS Home Improvement Contractor# Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE BUILDING PERMIT DENIED FOR THE FOLLOW G REASON(S) i FOR OFFICIAL USE ONLY .PERMIT NO. ` I DATE ISSUED MAP/PARCEL NO. C c ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ', INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 0 The Commonwealth of Massachusetts r ARCHITECTURAL ACCESS BOARD One Ashburton Place - Room 1310 / Boston, Massachusetts 02108 ARGEO PAUL CELLUCCI (617) 727-0660 GOVERNOR 1-800-828-7222 Voice and TDD JANE SWIFT Fax: (617) 727-0665 LT. GOVERNOR DEBORAH A. RYAN EXECUTIVE DIRECTOR Julie Nolan CORD 114 Enterprise Rd. Hyannis, MA 02601 COMPLAINT DISMISSAL RE: Special K Kennels, 750 Wakeby Roach)Marston Mills On 2/22/99, you filed a complaint with this office regarding the above premises. After reviewing all the information submitted, the Board must dismiss your complaint for the following reason: A site inspectionwas performed at Special K Kennels on 7/13/99 by Thomas P. -Hopkins, Compliance-Officer for the Architectural Access Board. He found that the work that was performed was on the private residence of the kennel owner, therefore, the Board has no jurisdiction. Any person aggrieved by the above decision may request an adjudicatory hearing before the Board within 30 days of receipt of this decision by filing the attached request for adjudicatory hearing form. If after 30 days, a request for an adjudicatory hearing is not received, the above decision becomes a final order and the appeal process is through Superior Court. Date: July 22, 1999 ARCHITECTURAL ACCESS BOARD Chairperson cc: "Local Building Inspector = : Indeperiderit,Living Center .,Disability Commission C.1 r The � o� of Barnstable _ . I-Service.. eg1 Department of genith Safety and EavzronmeIIfa Building Division 367 Maui Street,Hymmis MA=01 . Rains C Otlice: 503-7,90-6227 Building Cz: Fax: 508-7,90-6220 For affce-uuse only Permit no,_ Date AFFMAVIT HOME McROVEMENT CONTRACTOR LAW SUppLEMEI NT TO PERMIT APPLICA17ON MGL c. 142.E requires that the "t�ronstr ictfon, aiteradons,'renovadon, rep air, moderni=tion. conversion, improvement, removal, demolition, y= In"s n, or constracdon of an addition to any pre owner occupied building containing at least one but not more than four dwelling snits or to structures which are adjacent to such residence or building be done by registered contractors' with certain exceptions.along with other requirements Est. Cost type of Work: -,.-Address of Wont: vner's Nume / ' ate of Permit Appiication: , I hereby certify that: Registration is not required for the following renson(s): Work excluded by faw Job under 51,000. Building not owner-vccapied Owner Pulling own permit Notice is hereby given that: MIT OWN PER OR DEALING WITH UNREGTSi�RED OWNERS 'PULLING THE CDNTRAC'I'ORS FOR APPLIG�iB G HOME RAM OR��OVEMENT NOT MG' I4Z.� � ACCESS TO THE ARBITRATION PRO SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as agent of:the 'r.e C �� The Contntomecalth of Afassachuscttt ;:J DepartmeW of Industrial Accidents Office ff"11Yestf9211ons 600 !f aWdu tun• � Street Mass. (12111 Workers' Compensation Insurance Affidavit f/ C. / r/ c1t�•_ '//�/Y-�17/ (/'7�S l/f/j/�/�S nhnnr� LIdS I am a homeowner performing all work myself. I am a sole proprietor and have no one working: in any capacity • 'v.. —.s- ..... A�.•v..i.a++tres�.w�l+/.7!�r+�".A.t!�•..!_.w..�l��..��,..�,.�..r.�....�•�+w�........—......'r.^_....��.. ... .......�. •". r . ..� -- - � - - -'�" '=r. ..ter- - ,.r.t_�.. ..x. - -- — .— _—._�� [j I am an emplover providing workers' compensation for my employees working on this job. cornnam• name: address: city: nhnnr#- insurance en. polio•# C] I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comnam natne: address• city: phone#• insurance co. nnliev tt cmmpan.• nntnc: aticiress: rite phone i#- insurance co, noiic� iY Attach additional sheet if nccesiaty_ _•r '_ _ I -�� '•� ,y.- i•�w'�r+`+++.•_+.. �vs Failure to secure covernac as required under Section 25A of 111GL 152 can lead to the imposition of criminal penalties of a tine up 1 S1.500.UU ndiur one Years'imprisonment:is well as civil penalties in the form of a STOP NVORK ORDER and a fine of S100.00 a day against me. I understand that a copy of this statement may be forwarded to the ORcc of Investigations of the DIA for coverage verification. 1 do hereht cerrif11 tit the Wits and penalties of perju . J at the information prodded above is true and correct. �^ Sienature Date Print name Phone me 9 79Y 3_5 official use unly do not write in this area to be completed by tiny or to%vn official city or tna n: permit/iicense# rnlluilding Department a Licensing Huard a check if immediate response is required C35eiectmen's Office ►•' contact person: phone#: ❑OIhc fh Department Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all em lovers to provide workers' compensation for r p _ p employees. As quoted from the "law". an e»>pinree is defined as every person in the service of another under any contract of hire. express or implied. oral or written. - An c-mpharer is defined as an individual. partnership, association. corporation or other legal entity. or an• two or iri the foregoin�� cnLa_cd in a joint enterprise. and including the le=al representatives of a deccasc,d employer, or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dw-cllin�, house of another who employs persons to do maintenance , construction or repair work on such divellin�, h or on the `:rounds or building appurtenant thereto shall not because of such employment be deemed to be an empioy MGL chapter 152 section 25 also states that even 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. 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 been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation anc supplying company naunes. address and phone numbers 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 if you are requirL to obtain a workers* compensation policy. please call the Department at the number listed below. - I City or'fowns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. PI be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returnee the Department by mail or FAX unless other arrangements have been made. i Tlie Office of investigations would like to thank you in advance for you cooperation and should you have any questi( please do not hesitate to give us a c-^ll. Tlie Department's address. telephone and fax number: The Commonwealth Of Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washinaton Street Boston, Ma. 02111 fax #: (617) 727-7749 phone 4: (617) 727-4900 ext. 406, 409 or 375 • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION P ease print. • DATE , ./JOB. LOCATION S j %S Number Stre address Section of town " Z. HOMEOWNER 0-0 v D Ly gYS 7 V0?8- y :� Name Home phone Work phone PRESENT MAILING ADDRESS City town State Zip cod. The current exemption for "homeowners" was extended to include owner-occur ,dwellings of six units or less and to allow such homeowners to engage an ,dividual for hire who does not possess a license, provided that the owner facts as supervisor. ' EFINITION OF HOMEOWNER: erson (sy who owns a parcel of land on which he/she resides or intends to ide, on which there is , or is intended to be, a one or two family dwell4 ;-, ttached or detached structures accessory to such use and/or farm struct:L person who constructs more than one home in a two-year period shall not r onsidered a homeowner. Such "homeowner" shall submit to the Building Of-f: n a form acceptable to the Building Official, that he/she shall be resrer.s or all such work performed under the building hermit. (Section 109 . 1. 1) 'he undersi4gned "homeowner" assumes . responsibility for compliance with the Building Code and other applicable codes, by-laws , rules and regulations. he unders_gn`d "homeowner" certifies that he/she understands the Town of arnstable Building Departunent mi imam inspection o edures and requireWer- nd that he/she will compl wit said procedures requirements. Ob'-EOWNER' S SIGNATURE PPROVAL OF BUILDING OFFICIAL ate: Three family dwellings 35 , 000 cubic feet, or larger, will be requirec 0 comply with State Building Code Section 127. 0 , Construction Control. i HOME OWNER'S EXEMPTION -= the code state .that: "Any Home Owner performing work for which-_avhuildinc pe=it is required shall be exempt from the provisions of this section (Section 109.1. 1 - Licensing of Construction Supervisors) ; provided that is lame Owner engages a person (s) for hire to do such work, that such Home Ok:. shall act as supervisor. " [any Home Owners who use this exemption are unaware that they are assuming le responsibilities of a supervisor (see Appendix Q, Rules , and Reguliticis .or . licensing 'Construetion Superviiors, Section 2.15) . This lack of awaren ften results in serious problems, particularly when the Home Owner hires nlicensed persons. In this case our Board cannot proceed against the nlicensed person as it 1would with, licensed Supervisor. The Some "dwner. act. s supervisor is ultimately responsible. % .,. o ensure that the Home Owner is fully aware of, his/her responsibilities, m Dmmunities require, as part of. the permit application, that the Home Owner :rtify that he/she understands the responsibilities of a supervisor. On t: ist page of this issue is a form currently used by several towns. You may Lre to amend and adopt such a form/certification for use in your community: . s ,�` X PLAN bF LAND IN BARNSTALE BSC/Ca a Cod'�Sur �y p .Consultants,: Surveyors ' ,� :. . June 18, 1986 j eye t Na, y° Wsq der l Bntt ,S o. �g� 1.7a Gro ft. 9�y E �,6.0 . . .,,. • ,db. C9' Q'7 ' sr' em }� R v c� Or41 . 77 ,..r Lod- Cp i r �ass_ •ice ��• I Ai 'i 0 I 1j L:� itt 0 00' sso o�C> 00 l- , 40� I 0 0 �• Co '� Subdivision of Land ! I ' Shown on Plan 37518A Filed with Cert. of Title No., 63915 Registry District of Barnstable County _ Abutters are shown as on w, :Separate certificatep of title maybe issued or.?-and' , ; origina 1 de- cree..Oian. I shown hereon as I Lots Ehru 5 By the Court. �L.:-� Al -'Copy of part of plan -filed in LA ND1EGISTRATIONOFFICE _ / --T- MAIPCH 9,!987 - March '9� /987 i Redord.6, (j i,�:1 Scale of this plan 100 feet to an inch Louis A. Moore,Engineer for Court � � Form LCE-S-I.3mfi-88 • SUBDIVISION PLAN OF IAND IN BARNSTABLE D _ j BSC/Cape Cod Survey .Consultant;s;• SurveY.ors 375/)V'' I F o 0, June 18, 1986 �a A Way�A Cert N0•6�3� r�* d'" �e v o� 9yo c o yy 15 f7a'S55Coda dh.in�B �s)Zy,A7�a<?)cZ Gompde t fe�e9r p gyp; �- ,�. la• %\�a „ One 0,0d Sao h ! h' � N pe; t b �' N C d ►� N b eB En9� , 0 e �3 CP • "oo v \r � \v •sm F \O` tti o 0 0 tQ Qj om C N t y 3 Ory, V , o I ° 9 X. y rreu I. ••�' 9 Subdivision of Land I *Shown on Plan 375.18A Filed with Cart, of Title No'. 63915 y• Registry District of Barnstable County t: Abutters are shown as on Separate certificates of title inaybeissued orland original decree••plan. .shown hereon as Gycs Ehry,5, j By the Court.. /L. J I Copy ofparlofplan ! filed In LAND REGISTRATION OFFICE March ""' { / MARCN9,/997 Recordf�•. Scale of this plan 100 feet to an Inch C.✓•e. 4 Louis A.Moore.Engineer for Court P.LCa•94.Sm4aA . �,KG '� /4 Pam• I � � ! � I A�PI1°-1�1' Sy ;nCk Ib %6 \6 "OC � I 'I � I � �x` '�a�•\tr v \4 1 O. O.G ( f Toy StS ` 1 e n-to eX'S+;r�q road r / tWnesorrt 30 >5ro��+ �'oced ��� inbVln-{ oti -19 - Co 5 of), � ou-i-e;d e 0- -I is nQoc.]s P lace. Q(o,.ie q lass a1- 2'r�'- ,. LAJ 1y,000� ./a x TyViceK � Sttel�oo!' n I �f l WOOd 3��«Fly"'0°� '4 holy �/oPor orriQrS --- — — -- --- e1 -ce. s: l ,G .1'i b�Ir19 , �9 C7/ �46 m ,E Xi Jai nr l:� 4tAaWa�^g-�dW SMopv c' -vo•+-o(nav! 7 pr, 0) x v /M aovld r p ° 1p -- £ >✓ 3 anowa io v 6' r ---- d n_ 0 I (»opv�ol 9 a 1f°- bu'!+91 IIm.�6v Fc��y o Q� 3 c f c I O R Q 3�� r 7 c n �- Hoosc �- Sns Jo 11 w;ndou) , � x � Mea�sv.cmer-f i S-re P- ei r 3 � X ' Tile CummIIrunrrca 1 t u . assac lusctls ' ,j t' ' Dep arinrent of Industrial Accidents office offmVsdaffeas t 1- �?;\` 600 Masbitt1,7on Street Bua7on.Afars. 02111 �-' Workers, Compensation insurance ARtlavit FM111 ^2r15—t6r•,aI:^^name! lee Ple:t�e i'R/NT bl_____v location- 75-ev vihone it GtJa 6d I am a homeowner performing all work myself. ❑ 1 am a sole proprietor and have no one working in any capacity ❑ 1 am an employer providing workers' compensation for my employees working on this job. phone##: ' Holier f! insur'.Ince co ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hued the contractors listed below who the following workers' compensation polices: _. comr-Inv phone#-* Helier#! surnnee co T * m inv name, phone#• ;Attach addlti0nal sheet I r�'r'��"�. • •ice` •�+ rr_ �� SZ Failure to secure coverage as required under Section 3A at hlGL I no lead to the itapasitioa aterimiaal peaaides ota tine up to 51300.U0 as une}ears'imprisonment as well as civil penalties in the fora of a STOP WORK ORDER and a trite ofS100.00 a day apinst me. I anderrumd th. copy of this statement may be forwarded to the Olnce of Investigations of the DIA for coverage vailleadon. I do herebr cmifp under the pains and penalties of periurr that th iajor nwo pnv►y aboveis Vise and corrom Sienmure J Print name paw one# OMCial•use only do not write in this area to be completed by city or town otlicial permitilieeme t! nBuilding Department city or town- pUaasiag Hoard . �Sdeetmea's ORitx cheek if immediate response is required allezith Department phone ft contact person: sl0ther revnea;?7 P!AI information and Instructions Massachusetts General Laws chapter IS?section 25 requires all employers to provide workers' compensation for employees. As quoted from the "law", an enrpletyce is defined as every person in the service of another under am contract of hire, express or implied. oral or written. An c niplurcfr is defined as an individual. partnership, association. corporation or other legal entity. or any two or the fordaoin-engnowd 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. Howeve owner of a dwciling house having not more than three apartments and who resides therein, or the occupant of tite dwclling house of another who employs persons to do maintenance, construction or repair wort:on such dwelling or on the ;,_rounds or building appurtenant thereto shall not because of such employment be deemed to be an empic MGL chapter i S? Section 25 also states that everystate or local licensing agency shall withhold the issuance or mnewal 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 chap: been presented to the contracting authority. Applicants Please II in the workers' compensation affidavit completely, by checking the box that applies to your situation ar. supplying company names, address and phone numbers 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. Tire 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 requi to obtain a workers' compensation policy, please call the Department at the number listed below. �- +.'��..••w+ee..r•..S...r� � :.•..�..r,--�-�. �. :- .:. ... ., .... _j�� ...y.._T��.:....ate.. •_ .. ••�w";.j. .'_. y,,;:•.r,.;i.?LC S� ��i•.`•TI,ti:.�Ty"':ti t'.° \rim:.•t:.Sfi..'•• CARS,• City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottor. the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. F be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be rettun the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any quest please do not h l.hesitate to to give us a call. ►.+raw�w�..-..+•.�.+. • _. 77;�. . �i:.w r.:�:•�'�.i,. .i.i:•:�; .awe'.'• :�T:. r•3' �' .. .. ..ice .. ' .s• ..,.. '•:et»• jfr. The Department's address. telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents Office of invesdgadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone #: (617) "::7-4900 e 'n6. 409 or 375, aF�Tgtyi► The Town of Barnstable • sniuvsTnB�. • � Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Ralph Crossen Fax: 508-790-6230 Building Commissioner 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: COn,5 fi ,'on— Estimated Cost_ d ao, o c Address of Work: �7SQ Owner's Name: Ae„, r A, 41- , l Date of Application: 9�w23�y I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job Under$1,000 [uilding 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. 7,�. OR Date Owner's N q:fortm:Affidav TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. . DATE «Z3�^ JOB. LOCATION Number Street address Section of town "HOMEOWNER" i%7 ci e_rraj -7 � O-AX5`r7 5���7'L'.�' l' S, Name Home phone Work phone . . PRESENT MAILING ADDRESS Sp c� /� �• - . 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 such homeowners to engage an in- dividual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER: Person(sy who owns a parcel of land on which he/she resides or intends to re- side, 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 res onsible for all such work Performed under the buildingpermit. p (Section 109. 1. 1) The undersigned "homeowner" assumes . responsibility for compliance with the Stat Building Code and other applicable codes, by-laws, 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 proce s and requirements. HOMEOWNER'S SIGNATURE 1k APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic feet, or larger, will be required to comply with State Building Code Section 127. 0, Construction Control. HOME OWNER'S EXEMPTION The code state that: "Any Home Owner 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 Home Owner engages a person(s) for hire to do such work, that such Home Owne_ shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix ations for licensing Construction Supervisors, Section 2.15) .Ru This les alack nd eOflawarene_ often results in serious problems, particularly when the Home Owner hires unlicensed persons. In this case our Board cannot proceed against the inlicensed person as it would with licensed Supervisor. The Home "Owner* actir as supervisor is ultimately responsible. To ensure that the Home Owner is fully aware of his/tier responsibilities, man communities require, as part of the permit application, that the Home Owner 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 to amend and adopt such a form/certification for use in your community. p VE The Town of Barnstable • sssiverns�, • Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-8624038 Ralph Crossen Fax: 508-790-6230 Building Commissioner PLAN REVIEW Owner: Map/Parcel: Project Address:_ ��C Builder: The following items were noted on reviewing: l osS Ca>\—�U LPrT( o Pj i Please call 508 8624038 for re-inspection. 10 by: S Date: Z '� q:building:formsseview Accredited .�. ...�. s -..:.•.. __ certification i • i National Fenestration Program Rating CouncilNUMM Incorporated. #411 Pella Corporation .� Manufacturer stipulates that these ratings were determined In accordance with applicable NFRC procedures. r/ Energy Rating Ratio s Product I. 00'ey't"'s .S Factors Residential Nonresidential Description 1 U—Factor Proune m ; 7j Dotor In accordance 0.56 0.55 DouOb-hoop C / q with WRc NiRC 100 Will Solar Heat Gai CIO rto i f C o e f f i c i e n t 0.61 0.5 9 Atr Flllea De1ormined 1n accordance with NFRC 3200 Ir 3 V Vi si bl a Light TransmittanceDete 0.63 0.64 i with rNFRC 309 in accordance . i 40 NFRC.ratings are determined for a fixed set of environmental conditions and specific 0 � � �! � product sizes and may not be appropriate for directly determining seasonal energy /f } !/2 N, a 1L /2 1 performance.For additional information contact:NW WDA,1400 E,Touhy Avenue, f Suite 470,Des Plaines,IL 60018(847)299-5200.FAX(947)299-1286. Meets or exceeds C.E.C. Air Infiltration Standards is j I I BWEW NO.22US r L' I ' I '. II7,w �P� a I . I I I I I 11 I �� � � � � � � � � ii �� �� I'I I', � i � � � � � � � � � � u ii Assessor's mop and lof.'number ..� ........:.�... ..... -fp- . y Sewage Permit number .......:.................................................. C/vL 1'A01^1- Qy�fTNEr��` TO 1:1 N OF BARNSTABLE Z 89HBSTODLE, i "b BUILDING INSPECTOR e ...... ........:.................................... APPLICATION FOR PERMIT TO .Q.� f.(�.�R.. J.�g�..��...��... .. .•..•••�•®•� �� TYPE OF CONSTRUCTION � .�OC� �......C.9,.D.S. ... .....!..h��►1 tS .. t�.�...................... ...................................... ......19 . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit Iaccording to the following information: Location W�Kid6y...RA. in.rf,as.4-om's..at-its.................................. ... ProposedUse ..........1•.R. :ci...... '.. . ......�eft,,.....`c..m.�5....................................................................... Q ............Fire District ..S.di...{.!�....... .4.t.��-, Zoning District .......................................................... ... .... 4 Name of Ownel!!.'r1. ?. .0/ V�1�F.JI ��Ph4ddress �.s31`i'` I?Name of Builder m.dtp...1?..... , .....Address .......� Name of Architect . ET.1. ��i11Y�.IMA.N.V4..........Address ......�:��..I.v�.....���..�� Number of Rooms .................... .........�4."..04.kt�ing ...............................Foundation �O!~? .!. �5. $....'"iJ� .`�.�.,..............:........ ExIerior U f4? clF. �� Jlj... .......d...3. .. ....Q L..�. .C` ..°......... Floors ..e,p,'.AG..................................................Interior ................................................. Heating ..............................Plumbing . ........................................................... 11 � Fireplace lam-' ..........................................Approximate Cost A9.5.0c). Definitive Plan Approved by Planning Board ________________________________19________. Area 15,00........................... Diagram of Lot and Building with Dimensions Fee .....�I...1..s. . SUBJECT TO APPROVAL OF BOARD OF .HEALTH I hereby agree to conform to all 'the Rules and Regulati 1 s of t e To n nsta ardi the above construction. Nam .. .. frabmao, Melton R. & Claudette ' No — .. Permit for ......dog.. — ( r .............. --.�------------.. ' Location ���~... ..Road_,_______. _ . ' - . ...........................MAK§.ton0.milla_______ Owner �el��� B. & C . _ ----- --------------_ . . � Type of Construction ----..���9���---.. ' ^ --^-----------------------' Plot ............................ Lot ................................ ' . ' Jn�a 18 75 ' Permit Granted — g Date of Inspection Date Completed ..n. [ .,7...--.....--..]P . � } PERMIT REFUSED -----_-------_---'.—._ 1p � -------------------------.— . . ' � ^ . ^---------~---------------- ! ------'-------.'-----^'------ / - . . |/ ----~-------''^-------'----`�'' . ` Approye6 ................................................. 19 .---------------.---------,— ^ -----------.--------------. - ' Assessor's map and lot number, ..:0 ...... -^.... ............. ,'f a,,,`-,//4-1• f' ��{�9h' . � �/'e/ it / 1"!,• r�f /l"�'t�.�G Sewage Permit number .........! ............................................... L Py�F?NEt��` TOWN OF BAR STABLE BARN TAIME. i "6 BUILDING INSPECTOR �'E YPY Ar APPLICATION FOR PERMIT TO ................... � , TYPE OF CONSTRUCTION n /1�Ac ...................... ................... .. ..Tt t► c'T TO rTHE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Locationq , MA.".5c� .,��c M � I ( c ....................................................................................... ,...,........�.---�^�,. ............... .►.... .. ProposedUse ....... ............... ... ..........+... ................................................................ U` r-- Fire District .. G�t ) .o.i 1, G r';C��!?f Zoning District ................................ .. ....:.......................,. Name of Ownert .............%.......... ...�......... ins„�n I.ILAddress n,�L1...1.1Y>�,c ,s.�� ..�� uc I.. .. .J.�fc�c+c. I' i��1. ., t� L�nie I. ... ,. : Address ...... jjj.&(/e (I�Pc�lnr..................I1rc./'{'��s Name of Builder ,.V.............. ............................................ ... ... ............ MA Name of Architect .......... +. ...........► ..Lr.. ..........Address .......h 1•.,..2...t...., �... .....rn...vlgL.�,� ......r�c...... g Number of Rooms ..................................................................Foundation l:":.... ,,L��r. ..{ .. .... ... r Exierior I"njAnOL>i-. � �,.rnU. a,- L, 1. Ai �3 M FRoofi g ........•� `�ri i�i' P- �� `�� l I�sC/.s� - . _ ... .. ;. .. .................Interior / !AM.JIFloors ................................. �• _ - ..�. Heating .' < < \f� c7 I.A n ;.i7 Plumbing 1n r' Fireplace .....� ...5.-� - ...Approximate Cost ..........a-� Definitive Plan Approved by Planning Board --------------------------------19--------. Area 1,500. ............. ...................... Diagram of Lot and Building with Dimensions Feet -:?R- 7 SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations--of Town of / Barr stable_regarding the above 4111(Ikl�-construction. 14�0// _ 4 & lif I A � 6� .v /. .�. ter............. Frahmann, Melton R. & Alaudette A=12-3 , 17754 dog graining building .................... . .. ................ ..... Wakeby Road � Location ................................................................ Marstons Mills ............................................................................... Owner Melton R. & Claudette Frahmann .................................................................. masonry Type of Construction ......... }}............................. ............ ............................ Plot ............................ Lot ................................ Permit Granted ..�..`'..`.'ne 18 ....19 75 Date of Inspection ........0...........................19 Date Completed ........................... .........19 PERMIT REFUSED ...................................... ............. 19 .................................... ./................................. .................................../....... ............................ , ........................... .I............................................. ......................... ................................................ Approved .. ... .... .... .......... . ..:............ .. - ..................... ......................................................... • a N, t`,V _ •L. C. No'37�93'Q Cent z 0Al, , r'•: co 'y ��: �- - ti 71,51 . 3 N tD '~ op 99 C> .90 o :dam 6 -. � �, • 0ti co � 15 cle Co ' o • V