Loading...
HomeMy WebLinkAbout0130 SETH GOODSPEED'S WAY a 0 o �. I� e �, r 4� ' i tt �, .I i } 'r; i a t ��� o 1 d o i� << , !a _ �, S y. a Property Dereeistration ATTN: City of Barnstable r--- " RE: 130 SETH GOODSPEED WAY, Village of Barnstable, MA 02655 To Whom It May Concern: The above referenced property was previously registered with your municipality by BRON Inc on behalf of Selene Finance LP. Selene Finance LP and its respective investors and property management team have no affiliation or responsibility for this property as it is no longer under their service as of 09/27/2019 due to Property no longer qualifies for FC OR Vacant registration. If additional information is needed to ensure that this property is removed from your regism please let us know. Otherwise we are now considering this property DeRegistered and co°rr�,�pliant. Thank you, j Compliance Team „ Bron Inc 877-338-3791 27720 Jefferson Ave Ste. 230 t'871 Temecula, Ca 92590 i . I Bron Inc. 27720 Jefferson Ave Ste.230 Temecula,CA 92590 City of Barnstable 200 Main Street Hyannis,MA 02601 i o P� Town of BarnstableBuilding `a �nxxnwe� Post This Card So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept r a ,�SM& Posted Until Final In Has Been Made. i Permit eaMo•+° Where a Certificate.of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-3817 Applicant Name: Dennis Ouellette Approvals Date Issued: 11/14/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 05/14/2020 Foundation: Location: 130 SETH GOODSPEED'S WAY,OSTERVILLE Map/Lot: 122-092 Zoning District: RC Sheathing: Owner on Record: Dennis Ouellette Contractor Name: Framing: 1 Address: 550 Liberty St.Apt. 2704 Contractor License: 2 Braintree, MA 02184 Est. Project Cost: $ 12,000.00 Chimney: Description: Replace Roof& Permit Fee: $61.20 Siding(Front)dispose of debris in dumpster to go to transfer Fee Paid: $61.20 Insulation: station Date: 11/14/2019 Final: Project Review Req: 3 Plumbing/Gas Rough Plumbing: Building Official This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced withinsix months after�issuance. Final Plumbing: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspectiont for the entire duration of the Final Gas: work until the completion of the same. The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Electrical Minimum of Five Call Inspections Required for All Construction Work: Service: 1.Foundation or Footing 2.Sheathing Inspection ,- F Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed" 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Rough: 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Health "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Final: Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: � h TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION J �� Map Parcel d 9� ; Permit# S/J Health Division �.akl t, O e Z- `Gb APR 3 2001 y Date Issued y _ `' vs �Conservation;Division � Fee f (o Tax Collector' fit/0,d Treasur - -r{ 1 Planning Dept. '` Date Definitive Plan Approved by Planning Board i Historic-OKH Preservation/Hyannis Project Street Address /3 Loa Village S-��V Ur��1-e Owner in /h::-",A, Address . O cy� Vic/ Telephone - O Permit Request 740 d l/ Oo ' ow► 1,6--eZ. 1GOly � o Square feet: 1st floor: existing Proposed 7tol 2nd floor: existing proposed Total new Valuation Z 1/0�,el Zoning District Flood Plain Groundwater Overlay U Construction Type VOod 26^ to - LC7 Lot Size 11/ 912 5F Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Q yts O Historic House: ❑Yes ❑No On Old King's Highway: ❑Yes ❑ No Basement Type: X Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) 0 (�y Number of Baths: Full: existing 61A-2 new e1A a Half: existing_ 7A-2 new Number of Bedrooms: existing Aja new , Total Room Count(not including baths): existing new t WO First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑ Electric ❑Other Central Air: Cl Yes )4 No Fi°replaces: Existing (2 h e, New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:X existing ❑new size 12 Qa Shed: existing ❑new sizeOther: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use BUILDER INFORMATION Name e aile/Z Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO EqL") Ae VSIGNATURE DATE � Ft FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED MAP/PARCEL NO. . ADDRESS " VILLAGE' � OWNERS a r , DATE OF INSPECTION 7r FOUNDATION ` FRAME INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL I ` 1 f PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING vl Ib1 DATE CLOSED OUT t ASSOCIATION PLAN NO. r 4 V 4 SMOKE DE T CT Rs �aKe B NSTABLE 13ulLDfNr pp p 671/ GIPI 'V i� �� �' �o�n of �ia�► p/�ti ` d ` s y ept7 r�� W �� �� i a -F -'/oor? 11�v�-N -e Doi o l� 9 „37 7. � �x - i 1 F 1 1 f 1 I 1 " e Jcdl- lie S 1 1 f ` . Oyu ,Y l 1 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 1 —Propegy Information Property Address: 130 SETH GOODSPEED WAY, OSTERVILLE, MA, 02655 Assessors Map#: 122 / Parcel#: 092/ Land area and description Single Family Residence Building(s) description and contents N/A Uj CQ � C) Ca can Occupied: X Occupant(s)(if borrowers so state and include name(s)) GC US Bank National Association OL7 residentialpropertyviolationsousbank.com PhoneM612-973-2749 email: other: _ Vacant'IN/A Date: N/A Anticipated Length of Vacancy: N/A ��- Last occupant(s) )(if borrowers so state and include name(s)) US Bank National Association 612-973-2749 residentialpropertyviolations@ bank.com Phone: email: other: Has possession been taken N/A If so,please explain and complete and file the maintenance and security plan form(unless exempt as stated above) N/A Section 2—Foreclosing Pa Information Foreclosing Party (full name/title) us Bank National Association US BANK VS Judith Fligg 682214 Foreclosure Case Court: Docket# 6800104900-US BANK 122627 �s Date filed: 4/14/2017 Current Status: open Foreclosing Party's representative(s)for property (entry, management, repair, etc.)(name, title,): US Bank National Association Company (if different from foreclosing party): US Bank National Association Address: 200 S 6th Street, Minneapolis MN 55402 612-973-2749 residentialpropertyviolations@ sbank.com Phone: email: otyler: 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: Carrington Home Solutions Company(if different from foreclosing party): Carrington Home Solutions Address: 1600 South Douglass Road, Suite 130 B Anaheim, CA 92806 949-517-6733 codeviolations@carringtonhs.com Phone(s): email(s): other: Name,title, other: N/A Company (if different from foreclosing party): N/A Address: N/A Phone: N/A email: N/A other: N/A Attorney representing foreclosing party Unknown Firm name (if different from attorney's name): Unknown Address: Unknown Phones • Unknown email ( )• (s): Unknown other: unknown 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: 10/17/2017 Name: Title: Authorized Agent of US BANK I Xome Xome Use Only Field Services PID# 20L2§Lj April 26,2019 Hello, Xome Field Services (XFS)is working on behalf of Mr.Cooper XFS previously registered a property located at: Street Address City State Zip 175 Washington Ave Osterville MA 02655 This letter is to serve as notice that the property has either been sold to a new owner,the property is now occupied,foreclosure has been rescinded and/or borrower is no longer in default.XFS does not represent the new owner and has not been provided any further information or documents. Please de-register this property and send confirmation of de-registration to the email address listed below or by mail. Thank you for your time and attention to this matter. Xome Field Services Attn:Property Registration 9600 Great Hills Tr,Ste 15OW SIQ E Austin,TX 78759 XFSVPR@Xome.com O W ' ' Y� ' � Z 0 m .. Field Services W Field Services 9600 Great Hills Tr,Ste 150W,Austin, TX 78759 Town of Barnstable Attu:Building Division 200 Main Street Hyannis,MA 02601 } INSTALLED IN COMPLIANCE THE A ssessors offap and floor); ��� JA WITH TITLE 5 �o* >o� Asse'ssor's map and lot number 5..... ..................... o 0 EIVTe�L Board of Health (3rd floor): CODE AND-T®VVAI RE Sewage Permit number -.d�.9f•.�.��......................... GULATIOl�� t Baaa9T11DLE, ! Engineering* Department (3rd floor): moo Maso• ♦0 House number ........................t............................................... to NO A,*%APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00-2:00,, P.M. only TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...� 2..... .........�)C 1.S7?d/G �Gt/1-L G/�� . ................................................................... TYPE OF CONSTRUCTION ........ �......0!�...P.a�'.�6�4 ��`�C2LT�' �ariirPi7i477d�P/ .............. ........................ ��..-... ........._..t v . TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: S /¢y T ............................................Locatio (, iT / . ........ ......................... . ....... ..Proposed Use .,5;6cc%X!/ ..P.donr ................. . .............................................................. Zoning District ..r...............................................Fire District ......... ..�........................................................ Name of Owner ...... '?/AA/�G......K! LL�z.11�F2 ........Address ..........�5..,E?H Goo�sPQE ..4.`::'9y......................... Name of Builder ` w Iqe-d-/ Address . . ... . Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ......................I.........................................Foundation avR ✓J....`6.e/��P�� ...................................................... w/f�rN C�DA12 SN•yGG� 5' (.!�.......7-�?...M/�r2rf.....1zX� aid:'.......Roofing ..............4;J)!:NWwLl Exterior ......�.��. G ... ...........................................................Interior ��c /�r/�L L Floors K ......................................................................... g /yli/ //�O!tt �zXiST/��� Sj!ST ?l Plumbing n/ ,O Heating !'!' ../.1.................................................... Fireplace .................. ....................................................Approximate Cost �'. ......;22.I�OT� ............................. Definitive Plan Approved by Planning Board __________________________ 19 Area C ...... . ... .! Diagram of Lot and Building with Dimensions Fee" � SUBJECT TO APPROVAL OF BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .... .. ............... ...... ................................. Construction Supervisor's License ..©�. �L<!. ,, KALLENBERG, FRANK Buil/Addition No..... Permit for .................................... Sincrle Fami1v Dwellin ............................................... .........g.......... location ............... Q . .. e. .. .. ................................... Owner ...Frank„KA.1.1.e.nke.r.g..................... .. . .. . .. .. . .. Type of Construction ...FX7.AXG.P........................... ............................................................................... Plot ............................ Lot ................................ Permit Granted ..... ..................-19 88 q Date of Inspection ....................................19 Date q3)mpleted .....................�3........ 97 rbo -- I � OE Z4 { �Assessar's offioe 0st floor): Assessor's map and lot number -? (ell 0�? :. Board of Health '(3rd floor): I d 77- 9�� 1 ..Sewage Permit number .............,.... ...�..,:... 136BD9TLDLE i Engineering Department (3rd floor): °a K 9 House number 3 APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00='2:00 P.M. only TORN OF BARNSTABL�E BUILDING INSPECTOR APPLICATION FOR PERMIT TO ...�A.7.17.......7 0 �)C 15Ti iA/G I�h/!=��//vdC ......................................................................................... TYPE OF CONSTRUCTION ........u/P6l'.... ......r)r�r OAI/.. /�ce ,?r:/� �ai ;G r,;/z/2,j�7c� .. .... .................G�....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ..................... SFT�A Goot�sPFi�D u/i4Y ? .L............................................. ........................................................................................ ProposedUse ..Sri,�i.U ..Go ?rrl....................................................................,... ............................................................... �� ZoningDistrict ..::....................................................................Fire Distract ............................................................................... Name of Owner ......:. ............ ........Address ............ �c.=?N Gool�SPc v wAy ......................... �,•.;, Name of Builder 700.!t..... .t/C.........................Address ��I�GGS......... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ....................../..........................................Foundation ! u. '......l.r,.vC!��T ....................................... Exterior ..J//'!.!!/(r....TCv... .C/f . S7// ........ ..4 ar N! • .. . Roofing .................. . .................................................... Floors 6A/75...........................................................Interior �\/wit L L Heating ��!/.... ?C !44...1=Xr5?/!l/G....<)-;v ibl Plumbing.... .. ..O �J. .......................... Fireplace ..................e.4...................................................Approximate Cost ..........................................I.......................... Definitive Plan Approved by Planning Board/ `' :: 19 Area ........ . Diagram of Lot and Building with Dimensions Fee .. ................ y SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWE,LLfNGS l I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. ... .. :L"........-...`................... 4 Construction G Supervisor's License �,.. �. I KALLENBERG, FRANK 2— No. .... .. .... B..31.8.61... Permit for .Build Addition ................................... Single Family...!?�!��.incj........... Single ..... Location ...Seth...G.qo.d.s.p eOVaY O*sterville ............................................................................... Owner ........Frank...K.a.l.1.b n.b.e r.cj..,. ............ Type of Construction ...Fr.ame.......................... ............................................ ............. .................. Plot ............................ Lot ................................. Permit Granted May... . 88 ....................19 Date of Inspection ....................................19 Date Completed ......................................19 y� \ ems •, - , � v_-- ��. .o; ,- .... .. 0 . . �:. :- - ...... -r - - <. Of RICHARD yN : A. BAXTER Ma 2,,048 ,STSO4; 1 CEZTtFIEtD p'LOT ya sa LoCATIo" ScALM 1(,4 OF I C-M4ZTt i= . TNAT TNi= POU N DATI 0r l 5"ovi j Pt-AI j RS1=E2F_► IC-a 1-- SR F-=o14 W V COAAPLVS TN TN6. 5l urE_f` WE--:: L O T /�,wmly. 'SET$�CbC .�EQUiQENtci.1�'S bF -TNT Y . TO W U olr ' • ` • �.{ i',�, DATE � � 77 !�•��-���.-..-b-'C� •''1V C���-: .-N-� .: - B,4XTE2 REGISiv--KT-=r� t-AWr> SU EYo� TN Is 172_A" IS LIoT BA.SE'O o.W . Au osTEev�tt� o �t,tass = :` -JOT L4CA.I�T LOPE:: iD E V~ pT BS uSt�E To bETEQ.Mt%I� l-.aT 'LINaS - ..��• EvE :. Assessor's map and lot number �.. Sewage-Permit, number ......... ...... ............................. d Qy�FTNEt��♦ TOWN OF BARNSTABLE fob ., ow Z 33AWSTADL 9. BUILDING INSPECTOR 'F0 M tr• APPLICATION FOR PERMIT TO ... ......... ......... ........: ...... .. .............................................................. TYPEOF CONSTRUCTION ::. . ......................... .................. ....................................................................................... ................................................ TO THE INSPECTOR OF BUILDINGS: "—The undersigned hereby applies for a permit according to the following information: Location ........ ..... . ................... :......... ProposedUse .......:... ........ .........L....... ...................................................................................................................................... Zoning District .... .......................................................Fire District .. .......`. .. Name of Owner .......:. :...:.:.. ..:..:... Address ........ :.. :: ................................................... Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Numberof Rooms ..................":..:............................................Foundation ............:......................::......................................... Exterior .....................................................................................Roofing ..........:...........................,;................................................. Floors ...................................Interior ........ . ................ %. . ...... Heating ...............................Plumbing ............ . .................... :.....:.. Fireplace .............. ... .......::....................................................Approximate Cost ....................... ............................................ Definitive Plan Approved by Planning Board -------------------_-----------19________ . Area .. Diagram of Lot and Building with Dimensions Fee ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. G Name ................. . ...................................... Capewide Development A=122. O (not plotted) No 19285 Permit for ..... one...stor... . ............... m single family dwelling h ............................... Location 2(Seth Goodspeeds Way 1 .?. ....................:................................. Osterville . ............................................................................... Owner Capewide Dev.elopment ...... ...... ................. Type of Construction frame .............................................................. ..... ....:��61...... Plot ............................ Lot .... ...... June 10 77 Permit Granted ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ............................... ............................ 19 ............................................................................... .................... .......................................................... y 7 Approved ..................... . ....... ............... 19 . .......................................................... ............. ..................... .................................. ................... I • J N f 6) T2 SF.- kic 177- RICHARD T A. ". 333 RAXTER n No. CEQTIFIED peso,- ' Fn.-A J LOCATIOAi GAL. I C-tMTIr--,( THAT TI-Ir-- POU+a DA-N-k ON +50,owl.l -Q►� R�FERE�.IGE ti-IEq E o�i �orv�PLYS W I T" TWS ve-u WE� ; AhuD SETBACK JMQUIREMEuTS OF T64C- -j 0:!s7 e 9-v l LL G t-IEIG bh'�jy + I,j _"q.1..{._,.� , • REGIS't�itBD LAtJp SVeVarYo¢S'• THIS 'DLAW IS LJOT f5ASE'o 064 AN OSTE�V%LLE o MASS, ,. tlJS1"QrJMEt.IT SUQVE { �.T«F C3t=�SIETS 5laawla APPLtCA1JT . CAPE - IJpT_6Z�_.:J : Z-, _-2 ©ETEeMI6IE VDT LIMi=S AssAisor's map and lot number /e Sewage-Permit number .......................................................... °*'T"E�°� TOWN OF BARNSTAB-ifiEs, i BABB9TODLE, i ,- • .6 9 BUILDING INSPECTOR APPLICATION FOR PERMIT TO .... .`.:`'.....V.............. ............�.....'. .......... TYPE OF CONSTRUCTION ............(ji.&.j.......V ...................................................................... r l . ............................ .......19.7.� TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... ..... ........:... ?. ......... ..e:. J.l....... .. . ............. 1/................................................. ProposedUse ....... ...................................................................................................................................... Zoning District ........ � ...................................................Fire District .... ....V: .... Name of Owner ........`y... ...�e- Name ..... �1�!`.;............Address ...........! ........................................................ ofBuilder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................:.................. Number of Rooms ..................................................................Foundation ......../. c� Exterior .............................1..................................................Roofing ^.........- ..... .................................................. W !�! ..........................Interior ........../ . .... aCf.. Floors ....�-�.-............. £'.. ................. ...................................... ..............^... . .. . . Heating l..r... ...vE..l.................:....:......:Plumbing ............' .................: Fireplace ............... . . ...................................................Approximate. Cost ..... %'dd O................................7. ......... Definitive Plan Approved by Planning Board -----------____---------------19________. Area 7 Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH 1� • . I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ............... . G✓&I'al-2. .......r............................ Capewide Development • 19255 -one story zpo ................. Permit for ................................... �single family dwellihg ...................................................................... Location 1.3..0..S.e.th..G.o.odsp.eeds...Way........... .. .... .. . .... .. . ........ ........ ...... Osterville . ............................................................................... Owner ................C.apewide..D.eve.l.o.pofen.t........ ............... .. ...... . . ........ . Type of Construction ....................frame...................... .......................... ...................................................... Plot ............................ Lot ..........#61 ...................... June 10 77 Permit Granted ..... ........19 Date of Inspec'tion . ..............1.9 ..........VIX ...1.9 Date Completed ����7... ..................19 PERMIT REFUSED ........................................................ ....... 19 ............................................................................... .................. ............................................................ ............................................................................... ................................. ................... ......................... Approved ................................................ 19 ................................................................................ ................. ............................................................. �p THE 1� The Town of Barnstable • Regulatory Services MASS 9�ATE0 na't� •� Thomas F. Geiler, Director Building DivisioCo�ssioner. Peter F..DiMatteo9 Building 367 Main Street.Hyannis MA 02601 Fax: 508-790-6230 Office: 508-862-4038 HOMEOWNER LICENSE OPTION _ Please Print DATE: Q� S-P village JOB LOCATION: stret number "HOMEOWNER": / v� no IIe# work phone# name CURRENT MAILING ADDRESS: O zip code state city/town The current exemption for"home"was extended to include owner-oecuaied dwellings cense,g six units or individual for hire who does not possess a less and to allow homeowners to engage an lirovi� dew the owner acts as supervisor. DEFII�iTTION OF HOMEOWNER Or Is Person(S)who owns a parcel of land on Which helshe resides or intends �e°s ry to such use n which'there �and/or intended to be,a one or two-family dwelling,attached or detach farm structures. A person who constructs more than one home in a two-Year Pructures eriod shall not be considered a homeowner. Such"homeowner"shall submit to the Building Off cial on a form acceptable to the Building Official,that he/she shall be res onsible for all such work nerforTned under the building ermit. (Section 109.1.1) liance with the State Building Code and The undersigned"homeowner"assumes responsibility for comp Other applicable codes,bylaws,rules and regulations. ilding The undersigned"homeowner"certifies that helsheunderstands s and thaot h shewn of Bwill Comply withsaid Department mummum inspection procedures and req procedures and requirements. signature of Homeowner9 Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feetControl.e r larg will be required to comply with the State Building Code Section 127.0 Constructs HOMEOWNER'S EaZU-nON permit is required shall be exempt from the The Code states that: "Any homeowner performing`Mork for winch a building provisions of this section(Section'109.1.1-Licensing of construction Supervisors):provided that if the homeowner engages a person(s)for hire to do such work.that such Homeowner shall act as supervisor." unaware that they are assuming the responsibilities of a supervisor(see Many homeowners who use this exemption are This lack of awareness often results in Appendix Q,Rules&Regulations for Licensing Construction Supervisors•Section 215) onsible. �ainst the e.our serious problems.Particularly when the homeowner hires unlicensed persons. In t as his c serviso B s ultimately cannot respced.ao person as it-would with a licensed Supervisor. The homeowner nli hues.many communities require.as p�of the permit unlicensed p oe of this issue is a To ensure that the homeowner is fully aware of his/her rap responsibilities of a Supervisor. On the last pa= unity. that he/she understands the rap our comet application,that the homeowner certify care t amead and adopt such a form/certification for use in y form currently used by several towns. You may Q:FORMS:EXEMM N I X08)INll313 O 310d 1H9n OEF11N slossesry e{gDlswoB{°°M010001 woq penl!B!p eiass se°II Iwmd 0D1=,{yO elDx°1° dow ey,uo alms paei°lua *133!OS=H)NI I 11t dow louopoN Iaaw oI paddow eieM uollola8en puo'Aydm odol'soulaw!uold uoymoWo) spalgo lo�!sAyd oI sd!ysuoyolei lonpo Iuaseidai IOU op slyf Io saopuol$bmmry dow lououoN US SZ Q 310d A111110 DiBoloyd loI ao 6961 woq palaidialw alas uo!Iola6M puD Aydabodol•Auodwo)llamas•M puD'suog°sol awl Ion RID Aa41 %!jopunoq Apadmd{o Iaaw Aow uo dow a oos a3M01 ao d DueD wo olaidielu!eias SOM108 a Dw-Uow Sngew!uo suoplueseidenl doi6 U0DIDSGUI anode ION P I OOI=„l - • 4 I $661 4 P ( { P ) Id �53)Nn05 VIVO 4 N I I 41�310N** °)o IuewaBiDlua uo sI dow s!41 �310N* 111i NI°lm5 U11HIId ! NItlNa WNaI$ ® HO!$ S W 3 1 S A S N O 11 V W a O a N 1 �O 1 H d V b 0 0 3 0 3 1 6 V 1 S N M V a A 0 N M O 1 31od 9m1 „O ua o 11OHNO O 1AlVA 6 1NVNOAH N31d/X)oa r-e`ry GC oz L 3anllNN1S/9NIO11n8 ❑ F2i z L Q 100d 9NIWWIMS (���?+,I Z z L d Y W j S A113f 3N01S zz L dvV W Mal avow llva + , !—I �L d V W V V --------------11VM9NINItl13a .�._ � _ 3)N3d llVM 3NO1S NOIIVA31310dS b'6�� ►• 6ZOA9N uo Pasoq uORDAe13 r 3NI1 anO1NO)100d 01 —oi Ml anO1NO)1001 l L a38WnN MON---ap-Dvel# � 6 338WnN13)NVd— I (�(� L ddW 3Nil 13)HVd #dVW Du Aw 77 ** 01 lIV31/HIVd H)110 39VNItl40 OVOS 03AVd 1019NIANV( AVM3AIN0��; - ll avow Isla = _ _ = L ddW fl;�+ ON # � 6331VM 30 3903 V3NV HSHVW z z L ddW S33SI SnO33lINO)10 3903 A_A--A- AN3SNnN a0 OSVH)NO ! _ HSnSG 10 3903 991 # # S33a1 SnOnO❑30 10 3903 AVMNIVd 3Ssno)d109 � ] H L— dow o uo ioaddo II!m slogwAs II°Ion:31ON Z{:►•L d Y W z ll I z dvw 0] L # O N 1911 MOMS 1 � l :1L n G � - r �P�pF THE Tp�O The Town of Barnstable tARNSTABM MASS. g Regulatory Services 039. 0 ,,. Thomas F. Geiler, Director' Building Division Peter F. DiMatteo, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date o " 0" G 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 ntractors,with certain exceptions,along with other such residence or building be done by registered co requirements. Type of Work:— G Estimated Cost _1 r_2 0 GO Address of Work: 3 S-P va 74- 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 i AOwner 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: Registration No. Date Contractor Name OR / o ,3 / o / Date Owner's Name q:forms:Affidav:rev-070601 RESIDENTIAL: SHEDS - POOLS -DECKS-OPEN PORCHES- GAZEBOS DETACHED GARAGES FEE VALUE WORKSHEET ACCESSORY STRUCTURES >120 sq.ft.(Sheds,detached garages,gazebos,etc.) >120 sf-500 sf $35.00 $ >500 sf-750 sf 50.00 $ >750 sf- 1000 sf 75.00 $ >1000 sf- 1500 sf 100.00 $ >1500 sf—USE NEW BUILDING PERMIT APPLICATION DECKS _x$30.00= $ (Number) PORCHES x$30.00= $ (Number) IN GROUND SWIMMING POOL $60.00 $ ABOVE GROUND SWIMMING POOL $25.00 $ RELOCATION/MOVING $150.00 $ (Plus above fee if applicable) x PERMIT FEE $ e,d Q:forms:dkcost eff:082301 The Commonwealth of Massachusetts — Department of Indusdial Accidents #me&oilaer�estlaaBoos 600 Washington Street Boston,Mass. 02111 - Workers' Com ensation Insurance davit ��� i ai rr rrirrari ri ������ �� r -Iq a r a , - one# Pal �I am a homeowner performing all work myself: ❑ I am a sole mor and have no one worldn is any ,JIM ����.�%�'i///.�O/i�///�// an this•ob rovi ' workers' ensatiion for my employees working. ) :.:.::::. ana�P � ...................,:..�:::.,.::::::::??.;:':.;:.:•::.:i:::.:;.:;:.YTYY:?a�«•...:>..,<>:::.;:��,:.;:.Y:.:::.:::r....::..::..:.:....:.. ............ ::::...........::::.... ....... ... .. ........ .....r.:.......r..,.,.. :rr..,>:•:?;•:.;-•;:•:•::?::ii is:`Y:::�i:;:�:::'f•Y::•x-::::..:... ... l� e Z>� an v n am \} r .... ..... ..... ....... ... ... ..'�W C....T.. .t .a,t sea .:... ..n.• ...... .........r..........::•... .. ..J..,..,.n:..;... ....... ..:v.....tv..::nh..... ..... ..:v.....n.... .t}x•r ... .. ..... .. ....... .. ..... ................::•:: aft .•.4.r h..}+.�:::}::±:}!Y•:.a.::::-:�:-:..:•:::::.,•-r•:,.::+:s. ..... .... .. ............. ... ... ...... sea ).rr.?4. .... :,r.. .:.,. :.....,...........:. ... ... .... ...... .. .... ... .nJ. ...... ... :.... :}• ... ...............;. .::: .... :•s.,::T::a:�:.;;•:t •.:i;;{:•:.:..,+•l.;.a;.yt t�hb•Y::;na.Fi:7,:to,�'�jjca.;as:.xs�.•'.?$Q.;::;:;.};�:'�t a �r dre s s a N r . d a b ;a>}>... .'h •.++xata>,:•}f:::?ii::i:;{i:{:}Y rii}YY::;:;;:}�:.}•:;a .i•}#?hi...:i::+ wJ.'• ;Yx• Y• vfx ... ....... ...:.................:::...:::::.v:.v:•......... :::::::::::.v::::::.vh:,i':v:.v}:. .Y. 'Oa'. n.. .... .....v:n•. ::nt..:..v ........ ........ ............. ............................:n::::::::::•...............................v.....x Y.t`�r,Q;;r>?...2,..•]±.tu};xh„a-f ... ...... ...... ............ ...............................::;•........r:...• ... f v....vn;;•:;;iiv}±}.\\.: ±:•}Yi'.}?;:•h:}�'-i: ...... ...... ......... .... ......................... r n. na•tax.;•{::?.Y...<••.•;;::;::::::..-::.: ..... ..... .......... ............. ................. ............r............ v..}Cat n ,v...w;... \..+- .... .... ......................................::::::::::::::.,.........::.v;. .... ...... .,,:::•:,v.i:';':::}:}:J±Y:•::::Y...vnY:vYT:?�;Y:;-.v:::::ni:Yi:C.:::{:::iv:.v ......... ........... ..........................::::::::•�::.�::n:w::............::::::::n:v:.now:v:::::.... ...v:::a:J:b:;::;v:..\}. '•}::;a:•:, ri .:{:.,.-::..:...:Y.±w::.}v::::::... `T:;::?;•:;:.;:rye:JhYi:;{;4::.:i:;x$YYY±:4Y:h}±:'xiiiiiii'riiiiiiYTYi}Y:;4::::::::hi}}YiiYXiiiiihi}T:;•ii±±:Y:..........::...:{`;:.;:r.;.:y.;;?{{:;:{{{:•::::.... ❑ I am a sole proprietor,general contractor,or homeowner(tdrele one)and have hired actots listed below the i- who have • workers: ensatioa olives: ' ..... '-.}}'v...^ !\".\`>U1;7}?M}}:i.Y`:-i:}:.}}}:n;::n}•f.{..v..:;h1.Y?+;n:^^W..4\ai•}:;}}lY:^}.... following � ..............,v .....................................:::::...::::..:::::.�:......t.....:::.;.::::::.. .+..:::..,.::::.a..::{.:{.tc•:-:±x•.t•;Y±:-;T};::::::::::::n•:::.::::::::...:::.;Jx•:>#�Q••a•:...........a.....:. the g.................::::..::.:.................................:..:::............... .......::::::.::::n:....:.�:::::::::.:.:.:. ...t. ..... . .... .... .....................:�:::::•:::::::n•::::::.:�:::::::::::::::.}}:.:::;;-:::::•.::.:::.. ......h:..:..••::•:t:•�..:••:t?-:n•:::;::Y-�; ....... .. ... as+.;:-:;�:�>:C:�>:>:: ....................... ..............................:............:::::::::::::::::::::::::::...............::•.�:::::.... ..:..., ... .. •.•:.;--x.}:.}}'.sea•.}:+:-:.:.::�:.....;. .... ..............................................................................................................................:::::...:......... ....................................... ......................................,....... ......t..:. ,c r.•.a...+.:C. ..Yr .n.....n..r..h.n........ .::................................ anvnam ...... ................:::::::::::::�:::;•;•x'•TY;•.}wx x ,cJT ':.'tt;."•+:S:Yaa):bh{.,}:•}:a •;::.�{:::;:}•:.}••::::p:....'�?:if'•>ri#:;:Yf�r``:;�#:�:�';#: ............... .............................. .:: ......:. ....... v. a}%.\h.ttn..:..: .a....... >. .....,..- r•..,. ...J.:.t.:tw{:.�••;�;:•;;i+::`•.a`.'•:±Y<•• ;;tij>:.::.}•p}xJ:•}rY:•±Y::�Y:•Y:: ................. ,........:•::.�-•.......... .:.:.,:•:::::::::n•::::....tt....n..a:;}h•-:.a-::±}::}}....:....,::••,....t.:.,c :•:n, 2,.. ,. ,,,...\. :Y•;.}. .,..n•..•.,w:;•r:f:<:t . :w::::::.••.w::::.v'::::;v;hw:::::{v::......v.::w:n•,v,•.:.:n.v...............::::hnv:n•:.:....rw:::::-:x::.vv:::'.•..? , .,:?? .+p .........:•r..........+:n•............::............................::::n:w.v.�;:•:.t...,... ....-....... .r.......... .}n•..t na.......J,."'+'.v { , W. .t#k+�x .{Q y...%. :•.....:.lv}%-- .,•.4 :{:2y;:,:;:'':.'. ..:a.k.... £�fa• ...M a-.Y•S£t'M:a '•:a,;:;j;.{j:±.:,,..:.:::. nw:::n:........."' .......... v...............mnwn:;•i'i:aY:-}:•YY}Yinvh4:x:::v:Fia:nx:J�::v:::. ...............:::::.�n•::::.T:•......... .....:......... ;........... ..r::::::^t.�::�::::::....;...}� {a:.�:., ..........::•.:..........:•:...........:.:.:•::�:::::::::::::.:.............................................. .r...sex?:.:.t;•r::T+:;••::.,;h-."}£} :.,,-• {+`'> .na•.:• .n• .......... :...........................a.....:::•.tw::::w::::::n•:v:w::n.... t..r ..:;....... •Yr£.±x..}�..+:\.xr...a..x Tt.. .h:•:h:.}i}t}}}}}}.t::w::: tlddfess t 'fi:a .x............ .............................:::::::::::::::::::::::::::::::.Y':n•::}••:'-::;••Y'.T;•:.,x.t.-rr..vht•..rtrn.>. n....a F ..r. - ,:. .s�.,•{:h ..�;��. .........:.::...........:•:......-....:..............................t:..n•.,,.r.s....:.. .... ..f. %{Y~.�M'.. .. .}{-.- - p$>.k��t;.:a .};?.. N.kA�K.,3if•-+30<�+#,Q,`..'�,•�•{`,•,•�.;:i"v.,.:\<;Y.:>C^: r.•.......r..t• .t.... ..,n...h.Yfv.... .. ...............r ..... :.:::•r:{F t.vr +.\£•.a9rx kn>s.,,±c4\... t•. .: .t-± 'Q>}r::•:+ ti;±d.'+k"Q::;;?. •.vr ...n..w:<?.....}.:-•9#..............:::...a+at n. .. .....nm.....x...n..a..3%F.v...:#,.;/.•{3 .... .:•....... r.., a„�f .} :Q.;:;,...t.ii:{+-"-"a:.' ...kY:?::. ....x).............l..v.-....v....:rr.....{........a..r}.n r{:n::vw::::::::n.., ..... .},t � n.. .... .. ...+.v...............v...n...Y...................... J±..v......... ..n.v:h•.,.::•::::-era:h•.rx3. .+r , .v•.... ..> .. r :... 4 •�?•�?Y:a+:{}n{' -QM:�,,�,'±�i:<}\\�3.r�.•.:_.::.. .vij:>'r'4$>V��w:± n..rr..>r.•? ... ................. ...................t.. .......}}t......... ..,.rra {.{.:.ukV.}}?�`�Cab.�a.�# t#c nAfdax.�h•�4... ..an}'.• ...n -'�'{Q. } a,• I.I. Y�Q x: r}:•t .v .t... a .. }rn .... rti.::::::::::::isTYY:v::::::;::Y::::..v n......................ry ... r.........:........t -r-.tQ•+r..n ....... ...... ..... ... .... .,.....t.,... ... .r .,t. {�.(.'�>. ,fit. ...,. .............. .r:...-.>.;•::,.•..w..;..,..t.r}h.:Y:•..::•:•::::n.:..............,...... 'd r}•av :b. A?`?g{+; F}x.::::::::.`::::"..:-.•:::.�:n:.n:v:,;iY•r:a>.r:.>.an•:•:c'::;;::w•.::':,t;:::::a+.::Y+x:r+,:<;r.4ri:}".`>:�•.'<+�:�9 # +-�MY:. {-#}' A lisur•artceseoz:�:�><:z::«�:<:;YY:?•±:a:•}:;>.}:.Y:•Y;xti3:.:::::::•: ,rthaa••n.:::•:::::zt, •.v::.ti.;.x�:i•.>t't;;:;;:a.;% ::;�#:#{r. .................................... ......................:n•:::•.x.:•r.•.; ....t.,.,:... {.... .!era. • >t:;• '\•:r:.:.. .,,.+•.k.\>..,•...,t.;,},;,ter:•->:t;J•:::;'.:�:::.%;`•`;;#:';:�: .... .. ..............::::::::w.........-:::w:::::::::::::::::::::.... ......r:•w:......•+•.x: :�+.•:. hn:,..;t,..•,?a. .,v.. v .;t ....::.............::...........:::.................:::::..............................:.±.a:-:.•:::...x.....:....a.C..�.......J,:x:•...:.:•n.}..Ya..n -T ±' :••'�•�.a'.cS'.r6f`-,'c>'ta;.:.�.:�,}{;aY.'.+:a'S?-S:J4vo-Q? t;{:�£YaY•;;•}:}."�r�:::;:::: ...f$•r.a•. ....>:.v::••'}:}:.. h4 \ ..- ..v3� �t.. .r{�'..}.}.t:T ..�•.v.a 4a•T\,1nvv.'-:i} xr:}.::::.v.n.:.:.. ........... ..............:::::::::n.r.....::::::::::::::::::::::':'::::::::::`::...�.:n::.i:::::...:•:::... ..Y7...v<}.+Y•v:v.., t.x.....a:ry r.,; ....n•...n..nh... ....... ..::...vF.F. vv...........w:.........•:nv............•v::.:.....................nn..••:v::a...........................{... ....:v..x.,..... rn•.v.,v.. r.�.+tii�{•}.•.. .'•. - Y:. +v•:nv.:J} -: ... :.........::•:..........w...............::n..................•:•:v::nv::::.n........................... }$,r..•\•.{n...........Yt•.-....}..+y+Y, v..w:•: .:..}} .. .. .......:............::.............::::.................:::::::..:...........................n....-::.�::::::n•::•}:::.�:...............•:an .,.:+:, �:,{ •:: ,fia.,a t>:.\\•V,t•, sex... ......::.::..........::............:.:...............::::.�............................................ r ... � .aws,.,.sr�K:.....::.;>R?rt}y,;{w{.}a✓;;:s`.ab.,':Y::.¢.::.}':�:•-vnJ..:,::.::......'..'.;}}:}h:{•::•}Y:•Y::• •.v:v.......w:::::.......:::w:.........•v::::::........................:::::nv:w:::::n•::::v:;:f•:;•:LT:{.v,:'--. ,.n::x•...;,y:?JQ...-.v}xac±±:a:IK�K� ... ..i:v::::::.............. t::•.v:.vnv:.,.. :vn.}h:�iaax::n....M..:,,.}.�x....... ...... ..:..:............ ei.. ......:iy:::::{:v;..' .:.:{'\v{. hJ�kYn;..t.,x ai', Uv Y?;{;)^,:•�<::i�J:iii:v�iii:�ii: $nvnrrta ...................:::,T„•';a:•>�"`:}�+. .'Q•,;;Y:}:';��4:}.>}...;x}.,}> S,Vr4,4:•:i.";t:;.'.r:,�4t;??.{�. ... ........ . .......:.:::.:::.......:i i>Y:Y+::�:'•YYY:aT•n,v;mnv,;:;�t•v...:. x:•'' v:n•.v-nY±:. ......... .:::.�::::::::::::::::::..............:•:::::.:........,....,,•.--::.t•:n•:::.t•::.t£•...c};..x. h..;...}\f'\.h� ..,'}•.atw�" t�;•..a.,. V;•;th.;:.-:.•.• \t:., .... ..... .............:.::•:...............:�::::..................................�n•:...................::...............:n-:::::..,... ..t. .,.xy '♦ .�•n•• :•r:.;�>}Xki;:r'+'can:{•Y��:•Y;r.:{.{.}Y.,was�?1;;.}}±±.�}r;...:.�..•... ...... ...... ........ .r........................... ";... ...Jh.: ...{.xyT:n'h::{{r::nt}}xh;:}:;.x.•ii'...v,.:...:.v;•:Q:i:>.::•.n:-:•'•:,.... ........ ....... ........ ........ ..........................::v:::::::.:�::::w::::T:v.�: .::v.,•.t..... .w:::::...•- ..V •v.•. ... .hti;.J..:v:::n+v.•:n. ................................ ..................................................... ........ ...... ..'.Sk..B.Y•:n•:}.Y>r.-..:n............../.v:}a:.;a::::::.+.•::}:J.�:x:•..::.:+ •vna-.:}i}:tY}::. .............. .:...:.:�.:::.••::Y::YY-x•YY:sY:�:�:T:'•:x:Y:;:;:;n'i:::�;ia:Ti:F:6>f:Yv:F.' ... .................................................................,.::.... ::..........:::............:.::.....................:::::.:::r. ::±::::............................;;.�::...... Y:::i:::.;:...:....... ...................................... .. ... :.....:: ..... ...... :v..;..Y';;:-:;x•'-x•.,.�...r.:gt':g3:Yx;;-T:;?;•:;•: .. ......... ..........:::... ... .. .n•:w:.an r v:nvv:::i;'>.tv>.'C.Y:•�i:l::i Y:-' .... .. ................................ .- .:v..... v Qa....... ...{{{..:.va>:::{{{?'an.r•v,t v:;;;:vf;n•::::•: ..............::.........:......:•:::.�:................................................m.r:•Yr.. ..t...{v-.}rAr\.,vGnaY4.,,...v;}; a. - .. ... ..}•v., ... ...... ........ ......... X....... ....................... ..,a..:......r..r .. ..r.>.?v..:Y,.}'+:•:.++:'+}:+!:'::;r:;.Yx-:;;Y::.;;;{•T:-n.:.:.;4�'::.;:+ ..r.....:::............:............:::.n...............v.v:.n.................................................-...-..:..v va\'h:•:h ....}t err.::n�n•......... .......... ......... .............. ..........................................vn•. .t..n... \:?h:ai:.•h•:�+.M1"..�. �' a:::•' i:avv.xv{.:•nl}}. ..:. ,.rr....:. ...... ...... .......... ........................ .$}r.n.......• .,.........,l n....vv. ..�F`S. ..rr�r. :r h•:n?}{ay.^.vY.yi::t,.'r..:::...a:•:n.;...- .-..... ......... ........................... ............................:..................n......................•...• ....... ...v r: .....ix. .r.r:.:'{r.;+.:+'-.-.. \..:.:>'::3;:'j}:•Ji'::ii;::. ......................................:•.......n.a.................................................w::::::::::. .x•:r....+-•.. W:nv nvn{l k.. J.:r.Y+., J:nv:�:i••.Y:..':..;.J}.vv::Nh3'•:.'r.:v't:'.. ........... ..............:...:v• ....r:.vvv:n....................r................. a':?:.??!.,.v:vx: ...:'4:•. /.......^::.:.. ' ......:r:•::.v.v:::.:::::.......,,..mxr..,.n....n........................................................::. n....vn-r•\.. r":... ,•....... YhJ...-.�,-$•...r. }�........::... .. ....,:..;..:: :v::•:::::• N.-.v{.a},J.:•i:;a4h::±::w::Y::n,....}}}Y:;Y'::::.v:•.v::nvx.}:??i>J}x..- :Nx•±}n•.Y;vhY:at' .. ....................:. i penalties of n gs�e to seems coverage as req�ed®der Section 25A of MGL 152 an lead to the impo�tian of esimdaa doe ug to 51�00 00 and/or and a due of 5100.00 a day against a one yam,imprisonment as well as civil penalties in the form of a STOP WORK ORDER me. I nade:>tsad that copy of this statement may be forwarded to the Odlce of Investigations of the DIA for eolvesage vaidation. I do hereby verb under the pairs and pwalder ofperlml'thatdw*#bmsgdon provided above is&w mid coned ` )?t Date Signature Print name � all // Phtme# oincw are only do not write in this area to be completed by city or town of ftW icease Q� go�� ctyortown: cenvnB ❑Selectmen's Oidee ❑checkif immediate response is required ❑Health Department ' contact person: phoned, — ❑Other ONE 19 Or mad 9iO NA) 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 coact 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 an 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 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 ce ff=dte of insurance as all affidavits may be _ submitted to the Depart of Industrial Accidents for confirm ace of fiww coverage. Also be sore to sign and ment or town that the ication for the permit ar license is date the affidavit The affidavit should be retuuaed tording the city the mow„or if you being requested,not the Department of Industrial Accidents• Should you have any questions re 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 primed legibly. The Department has provided a space at the bon of the affidavit for you to fill out in the event the Office of 'has to contact you regarding the applicant. Please be sure to fill in the peimitllicense 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. 22 The Deparunent's address,telephone and fax number. The Commonwealth Of Massachusetts Department of Industrial Accidents 0mce 011Wesduadons ' 600 Washington street Boston,Ma 02111 fax#: (617)727-7749 phone #: (617) 7274900 eat 406, 409 or 375 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 9y ` L C A _IJ P�� Permit#� _ i �r Health Division S )0 3 I/zc/o I 7 7 a�� I i I Date Issued � 1 � OCT 3 1 2001 Conservation Division 310c:bl 4 IJ� �: s� Fee0. Tax Collector 1, Treasur LFE SEP71C SYSTEM MUST 5E Planning Dept. ' INSTALLED IN COMPLIANCE WITH I TITLE 5 Date Definitive Plan Approved by Planning Board ENIARDNMENTAL CODE AND Historic-OKH Preservation/Hyannis Project Street Address 2 00 Village D S fzer(,j I k 'Owner ak lrq Address Telephone 9 0 Permit Request aec COh.S��UC f/I Gh f Square feet: 1st floor: existing proposed 2nd floor: existing proposed Total new Valuation:!E��O CI Zoning District Flood Plain Groundwater Overlay Construction Type C` Lot Size Grandfathered: Cl Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: O Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing new Total Room Count(not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing Cl new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑ No If yes,site plan review# - Current Use Proposed Use / / BUILDER INFORMATION p Name d�-P6/ ���Q Telephone Number Address ,O, dx License# r Home Improvement Contractor# Worker's Compensation# / ALL CONSTRUCTION DEBRIS RESULTING FROM THIS.PROJECT WILL BE TAKEN TO �O(�✓�'I �qG� o� /r�� SIGNATURE i6ATE G } FOR OFFICIAL USE ONLY PERMIT NO. h i DATE ISSUED MAP/PARCEL NO. • uS � ' ADDRESS VILLAGE OWNER I , r DATE OF INSPECTION FOUNDATION FRAME f INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING s— DATE CLOSED OUT a ASSOCIATION PLAN NO. i 7800MAp noftl • pesmiptire Pukaps tar Oaa lad Twa■Fau*Reddmda,13aildhW BmW with FOW Fade L MAXIDAUM hium 1M Wall Floor 11 a m Slab C B Ann' V valaJ R vd&O' &vaina' itrvalu2 Wall Faimcccr 001 F�a� P &value' &vabror SI01 to 6600 Hntfaq D Dar' Q 12% 0.40 3E 13 19 10 6 Now tt 12% 032 30 19 19 10 6 Normal S 129A 030 3E 13 19 t0 6 25 AFUE T 15% 036 38 13 25 WA WA Normal U 15% OA6 1 38 19 19 10 6 Normal V 13% 0.44 38 13 1 25 WA WA 1S AFUE w 13% omV38 19 19 t0 6 13 AFUE x 18%. 032 13 2S WA WA Normal Y 13% OA2 19 2S WA WA Normal Z la•/. 0.42 13 19 10 6 90 AF1JE AA 130A 0.S0 19 19 10 6 90 AFUE ' I 1. ADDRESS OF PROPERTY: I J 0 5-(?�-h I 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: /1' (p 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): � S. SELECT PACKAGE(Q—AA-see chart above): NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS ARE AVAILABLE. ASK US FOR THIS INFORMATION. BUILDING INSPECTOR APPROVAL: YES: NO: 1 • q-forms-f980303a i 780 CMR Appendix J Footnotes to Table J5.1l b: Glazing area is the ratio of the area of the glazing assemblies (including sliding-glass doors, skylights, and basement windows if located in walls that enclose conditioned space,but excluding opaque doors)to the gross wall area,expressed as a percentage. Up to 1%of the total glazing area may be excluded from the U-value requirement. For example,3 fl of decorative glass may be excluded.from a building design with 300 ft of glazing area. 'After January 1, 1999, glazing U-values must be tested and documented by the manufacturer in accordance with 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 full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-38 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.' 'Wall R values represent the sum of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall. For example,an R;19 requirement could be met ETI7iER by R 19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to wood-fiance or mass(concrete,masonry,log)wall constructions,but do not apply to metal-name 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. `The entire opaque portion of any individual basement wall with an average depth less than 50%below grade must meet the same R-value requirement as above-grade walls. Windows and sliding glass doors of.conditioned basements must be included with the other glazing. Basement doors must meet the door U-value requirement described in Note b. 'The R-value requirements are for unheated slabs.Add an 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 w ` 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 0.35. 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 J1.5.3b. If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall, floor,basement wall,slab-edge,or crawl space wall component includes two or more areas with different insulation levels, the component complies if the area-weighted average R-value is greater than or equal to 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(0.35 for doors). 43 g 4 STANDARD LEGEND 22 MAP NOTE:not all symbols will appear on a map # 150 MAR � COIF COURSE FAIRWAY 757 4 C] mmo EDGE OF DECIDUOUS TREES # 154 # 166 EDGE OF BRUSH r i ORCHARD OR NURSERY V—V-7—V EDGE OF CONIFEROUS TREES MAP 122 n l MARSH AREA 93 EDGE OF WATER 140 ►�to MAP 1 = _ _ = DIRT ROAD t ! r 1 7 _-__ DRIVEWAY PARKING LOT # 1 Q U I �PAVED ROAD DRAINAGE DITCH — — — — - PATH/TRAIL OPARCEL LINE MAP 122 ' I�tto-a-MAP#E--21 PARCEL NUMBER g 2 atesa E HOUSE NUMBER # 1 2 FOOT CONTOUR LINE —LIB— 10 FOOT CONTOUR LINE !•' Elevation based on NGVD29 4.9 SPOT ELEVATION 00o STONE WALL W� -X—X— FENCE RETAINING WAIL ------------- MAP 14 RAIL ROAD TRACK v MAP 122 n © STONE JETTY �� 77 SWIMMING POOL 85 MAP 12 Q 1 �.� # 206 PORCH/DECK # 17 1 � U 13 BUILDING/STRUCTURE 120 77 1 DOCK/PIER a HYDRANT e VALVE O MANHOLE � ----------- 0 POST p' FLAG POLE T O W N O F B A R N S T A B 'L E O E O O R A P N 1 C .1 N F O R M A T 1 O N S Y S T E M S U N I T o,? SIGN ® STORMORAIN N PRINTED SEALS:IN FEET *NOTE:This map is an enlargement of a **NOTE:The parcel lines are only graphic representations DATA SOURCES: Planimetria(man-made features)were interpreted from 1995 aerial photographs by The James' 1"=I00'scole mop and may NOT meet of property boundaries.They are not true locations,and W.Sewall Company.Topography and vegetation were interpreted from 1989 aerial photographs by GEOD 0 UTILITY POLE m TOWER ' " ` 0 25 50 National Map Accuracy Standards at this do not represent actual relationships to physical objects Corporation. Planimetria,topography,and vegetation were mopped to meet National Map Accuracy Standards s 1 INEH=50 FEET* enlarged scale. on the map. at a scale of I"=100'. Parcel lines were digitized from 2000 Town of Barnstable Assessor's tax maps, C LIGHT POLE O ELECTRIC BOX The Town of Barnstable BARNSTABLE. Department of Health Safety and Environmental Services 9 NASS. 0a • �p +639• �0 rFU MPp• Building Division 367 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection V� CJ Location 136 6 4er it Number Owner - Builder One notice to remain on job site, one notice on file in'Building Department. The following items need correcting: � I cy fzt:�>2 w-L, Please call: 508-862-4038 for re-inspection. Inspected by Date The Commonwealth of Massachusetts Department of Industrial Accidents Office o!/mrestloatloos 600 Washington Sheet Boston,Mass 02111 Insu%�%rkers' Co�%%/%��%%% � � ������������������������������������������% ce AM name: location: 'Pi city ©lihn_ /V -e phone# I am a homeowner performing all work myself. I am a sole rietor and have no one worlds in anv fpacity /O/%////O%%�////.�///%Oi'�/,. I am an employez providing workers' compensation for my employees worldng on this job.:: :: ::: :.:::: ::::::::::::::::::: COIDQBQY K. x. 'fltY�Ce 3..�......::'::%: ::: .::. `D h ;'�> <> ' ���'�of icv issues ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the followin workers' compensation polices: roan an ::na ............ ......:::...:...:.:...:....:.::.:....::..:.....:.................... t a ...................................................................................... d tV' •}}ii:{•:Ji:titi4i}}:}}}}:titib}::•::}}::::•:}:}}:•:•.�::::::v::.�:n:�::v.:�:::::::::::::n�...........................y....�:w.�.�::. v:w::v.::�::.�.�::.�:.�.�::::•.�:::::w:::::•:i::.�:v:.�.�::.�.�:::::•.�: 1:L}}:CiA}}}:C•}}}}:•}::i4i}}}}i:•}:{4:•:::wx...;" x....... .n.. ..........................:•::::::::•:::::::w::::::v:::::.:}}YC4:iiC4;JT}}::v.v::::v.:�:.:�.�:.}'.;:w: •:.....................�::::............................�:::::t..:...................................,y........... ✓,..� :XY::. ..}:{..... ..........} ..:t..: ... y............ :'x'::;:s�::::�::: :%�':��s:?:'�: ::: isri:: :?:::::::::%`. :t::::;: :::::::e:2$::=: ?::::i::::isa3::f::::ii :::?:;::r::':<::::��:::2:;:;•>::•;::•};:•> :<:: ::>:»:<::::>:;<::.......... ........................... ...:........... .................. .................... ................ .................................. 9IIY ........ ..... .::..:.. :s Yi s tit en ::h»� ...>�.�> >< '.< ? >?: ::>: ' >��><>�<<��>� ?:» »�>:<><::: ;>;:�>: .................................................. .................................................................................. ............... o gee to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a eae up to s1,"moo and/or one years'imprisonment as well as dva penalties in the form of a STOP WORK ORDER and a line of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Once of Investigations of the DU for coverage ve:iIIation. 1 do hereby certify under the pains and penalties of perjury that the information provided above is tries mad correct signature•^ /,Z..; PncU Date, Print name 1�1 ill i�Af /"I ° tC/f/.� �—��h'�l�G PhoIIe# ����" ��f (:C3 :: o not write in this area to be completed by city or town official town: perndtNcense 0 Building Department ❑Idcensing Board + response is required ❑Selectmen's Office ❑Health Department Phone tt; - ❑Other i 0evued 9/95 PIA) Information and Instructions •1 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 c 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 renewf of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who hat 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 maybe submitted to the Department of Industrial Accidents for confirmation of inst,rance coverage. Also be sure to sign and,A date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license .4INS being requested,not the Department of Industrial Accidents. Should you have any questions regarding the`law"or ifou t� 3N •9_ are required to obtain. workers' cornpensatioia 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 icenie number which will be used as a reference number. The affidavits may be mturi d io 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 Office of Iuyesduadons 600 Washington Street Boston,Ma. 02111 fax#: (617) 727-7749 phone#: (617) 7274900 eat. 406, 409 or 375 ESTIMA TED PROJECT COST WORKSHEET Value LIVING SPACE (high end construction) square feet X$115/sq. foot= (above average construction) square feet X$96/sq. foot (average construction) square feet X$57/sq. foot= GARAGE (UNFINISHED) square feet X-,$25/sq. foot= PORCH square feet X$20/sq. foot= DECK square feet X$151sq. foot= OTHER e Ad QI —CL PC* square feet X$??/sq. foot= Total Estimated Project Value `� CF THE T� The T ,, �,��. own of Barnstable M„ss. 0599- Regulatory Services 10rED MP'� Thomas F. Geiler, Director Building Division Elbert Ulshoeffer, Building Commissioner 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work: i�ir/h Estimated Cost 4,/ 00 Address of Work: Owner's Name: V /� , Date of Application: —��— dQ I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law E)Job Under$1,000 []Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Z, OR k Date Owner's Name q:fonns:Affidav r 9F THE rC The Town of BarnstableBARN r�= ig Regulatory Services 1659. 1 Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ' Print - DATE.• JOB LOCATION: 13e5i number street p / village "HOMEOWNER": Vr�V/e;A name h e phone# work phone# CURRENT MAILING ADDRESS: G 1-?a V0), e r �em % _Li/ /�� city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached strictures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. ' eL Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1 -Licensing of construction Supervisors);provided that if the homeowner engages a persons)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is-a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:FGRMS:EXEMPTN I i I REGISTRATION AND CERTIFICATION FORM FOR FORECLOSNG/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: Section 1 —Property Information Property Address:130 SETH GOODSPEED WAY, Village of Barnstable, MA 02655 � Assessors Map #: Parcel #: 122_092, M_292981_82 Land area and description Building(s)description and contents Occupied: X Occupant(s)(if borrowers so state and include name(s)) Phone: email: other: Vacant: Date: Anticipated Length of Vacancy: Last occupant(s) )(if borrowers so state and include name(s)) Phone: email: other: Has possession been taken If so, please explain and complete and file the maintenance and security plan form(unless exempt as stated above) Section 2—Foreclosing Party Information Foreclosing Party (full name/title)Selene Finance Foreclosure Case Court: Docket # ��� lox Date filed: 4/14/2017 Current Status: Foreclosing Party's representative(s) for property (entry, management, repair, etc.)(name, title,):Code Compliance Company(if different from foreclosing party):Mortgage Contracting Services, LLC Address: 350 Highland Dr. Ste. 100, Lewisville, TX 75067 Phone: 813-387-1100 email codecompliance@mcs360.com other: 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:Eric Moore Company (if different from foreclosing party):BRON Inc—Registrant on behalf of Selene Finance Address:27720 Jefferson Ave. Suite 210, Temecula, CA 92590 ( ) 877 338-3791 ( ) propertyregistrations@broninc.com Phones . ) email s other: Name,title, other: Company (if different from foreclosing party): Address: Phone: email: other: Attorney representing foreclosing party Firm name(if different from attorney's name): Address: Phone(s): email(s): other: 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: Name: Title: J L 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 i RESIDENTIAL ADDITIONS OR ALTERATIONS If located: ❑ North of Route 6- any work visible from outside needs approval from OKH ❑ In Hyannis - If work visible from outside - Check to see if it's included in the ❑ Hyannis Historic Waterfront District - if so it needs approval from them APPLICATION PACKAGE MUST INCLUDE: Q� Map/parcel number Approval Sign-offs from: QI Health Conservation (if exterior work) Tax Collector [] Treasurer ❑ If ZBA relief(Special Permit or.Variance is required for project: ❑Copy of ZBA Decision ❑Documentation proving that decision was recorded at the Registry of Deeds w/in one year of ZBA decision date. Street address Owner's name & address Permit request - full description of proposed project(u-value of replacement windows if applicable) ( ' Square footage - proposed project Estimated project cost Complete Dwelling information for Assessor's Office ❑ Builder's information —S-i`�natuce , Plot--plan Plans—�1 sets measuring 11" x 17" fully dimensionlized with foundation, floor plan, cross ~section. framing schedule & smokes, with a Red S (SB or SH) Hume Improvement Contractor's Affidavit (� Worker's Comp form must include: Insurance company's name &Worker's Comp policy numher `-� ❑�—Encri*-v-C-o plJce Form A-6L-7 ❑ Cope of Construction Supervisor's License & Home Improvement Specialist's License — Oft ❑Ho-meowner'-s_License-Exemption_Form. ❑ Need Hume Improvement License ❑ No plot plan required 1111:116 & DOCKS ❑Need Construction Super license AND Home Improvement License Owner cannot pull own permit U w� q lonm.pcnnil.l -ti �, •t K�.� f ` , r , i ..--___�_.. -. -. .__�_ ....La»was+-4>.'3v'1+•'�3�9E?iEi�".. ..rub.�!�� 7wi�+�:`.�7°�iTi���i"�r.���t'`,�Y..Y�Ia`i•:n'Ry�`` vE fE �p�! tA7� .`.a t r)` i'iL� .2 E)Er°itjl',t3..L:'@taes i ✓ WrWa .. ..................... ............ ........... I 4 X8 1 ` I I j i I I 1 � / I 1 I 1 P t 1 � i f i f If _ i _ - I On f10h lode v 1',e Otto N lol- Iv INk doll x �-Xfx-ly hp sob 7Y lac f � 1 � r, frs 7 f 9 r F J _..•-._--�.�...e. -- - -- ......�:,o.n.+.N.....1.ewe....e•N.war..u..d+erJdirudsMnar�b�..,i,�vta.,.l��/,h`e,�Odr � f•. tt��•�'I+ !�•�.—�...�.��J.s-'^l�•K". j j i j I� c i I. h f i i f � A ,�