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%� � � � �� Q� � � � � o � � �� � � o o o � . o 0 0 �, . � o � � o � � � a ,. ,� o - -� � <, � ,. �� �� o ;�o. � � � � ��� o� o o .. � ,. �= ^ o o n � � .. o � - ° �. �� a �� � ," c a o �� � o` � N� � o o„ o � c m � ° �a , ,, b � , � � a ° o .. .. 0 8 a a, a u m� � � 00 o 0 o p .. o.. o ,.� , o u o a .. oP a '� , o �� O n. �6 n a u � a a o, - o ,, o o a 9 �o _ G o.� U �o 0 0 0 0 � o a c o o o d+ r. o 0 ,. .. ,. a 'a � � � � , o � 9 `o ,. � n � o o , 0 G 8 u � � _ ., a e �, „ � .a o'i a .. e �' o. ,. �, o u o ,. ., � o <, - 6` � e � a � a a a � � o � o o ., ��. ,� �� � n o`�B° _ � � � o ,. � �o .. �. � e, � � o � o � � , �, o o �a o � � � � ., - o o - a; � o: � � _ �_ � o ,. � � o � � �. � ,. o o o o ,. � � � .� �. - o o a o a o o , � o o U � e � � .� c n o , o o .. _ „' a ., o 0.�6 � � � o � o o e o� � o� c �.- ��Rn .� .. o ,. � a ., ' � � L' g,,o,. ,o � � o c 2I' o ,.. � oa � i �� o � o tl n�'o " o. a o ^ ar o .� ,' ., � ° � 0 o ., -,,. - �„ � ,. o �. � � o ,. �6 o � o � !Y o �� �,; � � .. _ 0 .. � o .. � � .. '� �, i. p �, i � � � � � � ,.. a o .� � � � � � .. o h a ,. o � o ;; o �o ,.- o a u e ;, a 9 ., , - ,. e P � o � a �n o o o ' ,� Ax„ ¢ '. � � o � , e � ,, e 0 %� a i ,. p � ,. ., o � e o .a o o a o ., o r h -o o�' � o ab ._ � � , p � � °.� , o � c o' a :, ,. o '� � � o o p ..r � i. � c �o _' o a � o - !i� .. � a o �� � o � o � � o o� o p� 0 9 ..o � a as a ,. o a o ° ��� o„ o o � o � o o b„` a o � , �, a I. - � � a . � _. o c a o ., o � � e 6 �. �� a o o b n ,. � �' " a ,� ,. ,. � � o' o a te. ,. � u o o � o n c o q a o n 5 �o e e. p.� �•w�n.a-.. ^"��,.,.ry.`h'!'%.'n.-r+�.-.�^r.r, ��+ -,++w.ov.�+�!y_!�/'.++r+i.+-.�*. �...if'�v'+...m..—..�. _...$�_� M'-�� r, t i • R 4 f� �y.l0 __Mai a i i o 9 G q# i A F -'rAS �t86v.T` QEF-f- :'T *Lzo06e2-SZ Si�E ��s °v�kY tFa (ZEfuSCD Ta lE't' rhESPF�r f¢oa:>E Fad corhPtTµ, G, o o o t a Application Number..... .... .... MAS& Permit Fee.S.i!)...Q G...............Other Fee:....................... %63 BuILDIAIG DEpT NOV 0 7 2019 Total Fee Paid................................................ TOWN OF BAM§XAB3LE Permit Approval by.. -I-&-�...............On..... .4 SrABL" BUILDING PERAHT" Map........Q..1.....................parcel.... ...... ....I �........061......... APPLICATION Section 1 - Owner's Information and Project Location �oiect Address.. village Q"ers NTme,-,'fij�pN P OvvifCr§-L6jal-Address—/Zp y11 1---5- gzk—� CitqQ O571-ez-t,-1 Stated zip Owners Cell# E-mail n e- ig� I j al -s,191e;,zlp v/P Section 2 —Use of Structure Use Group_ ❑ Commercial Structure over 35,000 cubic feet ❑ Commercial Structure under 35,060 cubic feet ❑ Single/Two Family Dwelling LSection'-37=7 Type-of Permit F1 New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use El Demo/(entire structure) .0 Finish Basement ❑ Family/Amnesty El Fire Alarm Rebuild El Deck Apartment El Sprinkler System ❑ Addition ❑ Retaining wall Solar Renovation, ❑ Pool ❑ Insulation Other—Specify ,�Seeti6C4=-W6i--k-DescnDtion Sec _ 7,r--,?I (fcx- 4- 4�A&) T.Rzt wnr1siteA- i i Iiinni R v �j qq The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street - Boston,AM 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): ©AJQ�/ Address: 16 1I5 A44`/ ss City/State/Zip: t/�S7`fa��/,L� >? JORone#: &,,9�) Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑ Building addition [No workers' comp.insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑ Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of M_9Lc. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment as well civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the vizccorve��ation. . a copy of this statement may be forwarded to the Office of Investigations of the for insuran I do here a fy under the p ' and s of pe ' that the information provided above is true and correct Si afore. Ot�+^-�rG Date: Z Z Z, �9 Phone#: Official use only. Do not rite in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more 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,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727-7749 www.maw.gov/dia i Application Number..................................................... Section 5—Detail Cost of Proposed Construction 2040 Square Footage of Project X9 1Ja SF Age of Structure yrs Dig Safe Number # Of Bedrooms Existing 3 Total#Of Bedrooms (proposed) 3 2. -`S l2 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist ❑ Design Section 6—Project Specifics ❑ Wig ❑ Oil Tank Storage ❑ Smoke Detectors Plumbing ❑ Gas ❑ Fire Suppression d ❑ Heating System ❑ Masonry Chimney ❑ Add/relocate bedroom Water Supply Public ❑ Private Sewage Disposal ❑ Municipal On Site Historic District ❑ Hyannis Historic District ❑ Old Kings Highway Debris Disposal Facility: ��Q�y,��C'_ �i?S �SI am using a crane ❑ Yes ❑ No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland, coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District G Proposed Use rf id Lot Area Sq. Ft. - '0' ,q'cre-s Total Frontage_- Percentage of Lot Coverage �G # of Dwelling Units (on site) Setbacks Front Yard 93 f Required Proposed i Rear Yard // Required Proposed Side Yard 7 Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes ® No Last undated: 11/15/2019 i Application Number........................................... Section 9= Construction Supervisor Name Telephone Number Address City State Zip License Number License Type Expiration Date Contractors Email Cell # I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. Signature Date Section 10—Home.Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11 —Home Owners License Exemption Home Owners Name: Telephone Number�Dg l Cell or Work Number I understand my responsibilities under the rules and re lions for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Buil ' ode. I �otarnstable. d the construction inspection procedures,specific inspections and documentation re d by 780 an Signature Date 07 A*ZP SIGNATURE 000 Signature Date Print Name roes Telephone Number -� /�— E-mail permit to: j a/n e.5 moa4.le r ear. Aat-4- i i/1 VIM 4 - Section 12 —Department Sign-Offs Health Department ❑ Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required) ❑ Fire Department- Conservation ❑ For commercial work,please take your plans directly to the fire department for approval 4 Section 13— Owner's Authorization I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by-this building permit application for: (Address of job) Signature of Owner date Print Name Last updated: 11/15/2018 0 1 2 3 4 5 6 i7 8 9 10 11 12 13 14 15 16 17 18 19 ■ � . oo�■�■■IN�IINe��E���p,�.oa ■ ■ 0 Q -® ®■.` ..mommom �ARRE' QQ�QQQm.aQaoa�Q.000Q©©QQCQOQQQa®mQa®sQQCQQQ Q NNE CQ■Qi I � . � C�QQQQQQQQ�CQC.Q000CC©CQCCQC.QQQ..©C.CC000QC Q iBQQQ QC:Qi QQ�C. � IiCCCQCQCQ�CQCCCCCQQQCQ©CQCCQQCQCQ�CQCCCCCQC 1 ■ i p .M■MM� H■■.■IN■ H ■■.■.INHIN.M.■.■ H■. ■■.M.IN...INHMM ■■■■ ■ ■■�QIHMO .! .■M!CIRSHUHINl� .H (CC■.■■..■■..MM■M■QME M■.■■IN■M■.■M■MQ....Q■ CCQ' H ■MCQMOMMEmm■iivC iiCQiCCCiiCVCCCCCiiiiii �2 ■.■■ I HM■M■■M.M■./. 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DATE OF BIflTH OF OFFENDER �T11E►p,_ MV OPERATOR LICENSE NUM a p7 516''576MV/MB REGISTRATION NUMBER IIAflN. I.E. ' r '^/ /J�) ,Yr /'� /r `} Q +1639• `�' OFFENSE A i' �T `i �_�tfw no 1 7 � � �I r �1,.s'� 7' 7�`�•�� C LU TIME AND.. OF VIDLAJJIO LOCATIO VIOLATION Z NOTICE OF ) = )t(AeM F P.M.)ON 20 01 1(� l rs _uJ�y (,�5 /!/112, � � SIGNATU OF ENFORCING'PERSON 1 s E flGN6 DEPT. ,1' I/ BADGE N0. y VIOLATION �, 3 1 tJ; 0 OF TOWN V ~ I HEREBY ACKNOWLEDGE RECEIPT OF CITATION X a ORDINANCE ITLInable to obtain signature of offender. �-.����� THE NONCRIMINAL FINE FOR THIS OFFENSE IS Date mailed L++ OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL Wa DISPOSITION WITH NO RESULTING CRIMINAL RECORD. W co REGULATION (1)You may elect to pay the above fine,either by appearing In person between 8:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, w before:The Barnstable Clerk,200 Main Street,Hyannis,MA 02601,or by mailing a check,money order or postal note to Barnstable Clerk,P.O.Box 24W, —i Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. d i O( ) p ringg yy yy I 9UNSTABLE DIVISION,COURT COMPOUND,noncriminal BARNSTABLE,MA 026 0,Attttn:21 request Noncriminal Hearings and enclose a copy of this citation for a hearing. (3)If you fail to pay the above offense or to request a hearing within 21 days,or N you fail to appear for the hearing or to pay any fine determined at the I hearing to be due,criminal complaint may be Issued against you. I ❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ Signature U.S. Postal Service,. r CER*r7FIE� MAIL. RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) r For delivery information visit our,website at www.usps.comg or PO Box. r � I i i PS Form 3800,June 2002 See Reverse for Instructions Certified Mail Provides: •► .• A mailing receipt (ss� )zooZ eunr'ooss uuozi sd A A unique identifier for your mailpiece • A record of delivery kept by the Postal Service for two years bnportanf Reminders: • Certified Mail may ONLY be combined with First-Class Maile or Priority Mail®. • Certified Mail is not available for any class of international mail. 11 Is NO INSURANCE COVERAGE IS PROVIDED with. Certified Mail. For valuables,please consider Insured or Registered Mail. • For an additional fee,a Return Receipt may be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return ,I Receipt(PS Form 3811�to the article and add applicable postage to cover the fee.Endorse mallpiece'Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a LISPS®postmark on your Certified Mail receipt is required. ■For an additional fee, delivery may be restricted to the addressee or addressee's authorized a ent.Advise the clerk or mark the mailpiece with the endorsement"Restdctedelivery". ■ If a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. 'IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information is not available on mail addressed to APOs and FPOs. i OT NAME OF OFFENDER 1 , BAR- 70908 ` TOWN OF ADDRESS OF OFFENDEq.� � BARNSTABLE CITY,STATE.ZIP CODE•oJ{ l; _ _ Z�j pt THE 3; �IA�S. LJ Llio -3 �I 1 , - Eor�• O�I AIS .. IM 0 DATE F VI LA %A VI ATI /T�-. }� W•� — NOTICE OF s P.M.)ON — ,20// l//J�\I�(�� ��, LU - l :VIOLATION s N fl OF�NFO IN P SON E I D Frr ��� BAOGE NO, LU rn _ OF TOWN I H Y ACKNO EDGE RECEIPT OF CITATION X ; ORDINANCE Unable to obt 'lXre o tteneer. a OR Date mailed THE NONCRIMINAL FINE FOR THIS OFFENSE IS i W Uj YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL w I REGULATION DISPOSITION WITH NO RESULTING CRIMINAL RECORD. (1)You may sled to pay the above fine,either by appearing In person beytween mailing e:30 A.M.and 4:00 P.M.,Monday through Friday,legal holidays excepted, Q iI i Hyannis,MA 0260 WITHIN I TWENTY-ONE(2)200 Main Street, DAYS OFATHE DATE or bOF THIS NOTICE. order or postal note to Barnstable Clerk,P.O.Box 2430, j 1 1 (2)If you desire to contest this matter in a noncriminal proceeding,you may do so by making written request to DISTRICT COURT DEPARTMENT,FIRST (IIII BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET 6ARNSTABLE,MA 02630,Attn:21 D Noncriminal Hearings and enclose a copy of this ,I citation for a hearing. (3)If you Fail to pay the above offense or to request a hearing within 21 days,or H you fail to appear for the hearing or to pay any fine determined at the hearing to be due,criminal complaint may be issued against you. 1 i Cl I HEREBY ELECT the first option above,confess to the offense.charged,and enclose payment in the amount of$ {n Il Signature ' 1 fl IHDIH SENDERA •MP-L,,ETE THIS SECTION COMPLETE • ON DELIVERY ■ Complete items 1,2,and 3.Also complete A � nat Item 4 if Restricted Delivery Is desired. ����13 Agent _ ■ Print your name and address on the reverse X ❑Addressee so that we can return the card to you. B. R ed by(Printed Name to f�-1iy ■ Attach this card to the back of the mailpiece; ✓ , or on the front if space permits. D. 1/delivery address diffe nt from it, 1 ❑Yes 1. Article Addressed to:. , � YES,enter delivery ad ss below: ❑No I }4. JIPA A I ''• 11 //'' �/ .L _ 3. Service T G YPe Mail ❑UpressMail ❑Registered XLEetum Receipt for Merchandise ❑Insured Mail ❑C.O.D. i a 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number', (rransfer from ser%ice labe TO 6 0610, `0 0 3i5 2'S 6 0 0 9 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STdfE USTJ4�:�E1 /I 1 ,',,e'S is °s�,a„v,•w " �~ifstlas�5�lhdi�' ?r I d 0. .cis3ag�e"q&�._ ee�,P9id I *.Sender: Please print your name, address, and ZIP+4 in this box • +I "vM OF BMMST"LB BUILDING DIVISION 200 MAIN ST. }. I i I A, iJ D S-t 'rLs0-2 oil„ 11J. III...Ii.►,.1i..il1...11.,..l�i.l � i i t; TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Application# Health Division Conservation Division Permit# Tax Collector I Date Issued Treasurer Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Project Street Address --/"S Village _ Owner � i 4 Address Telephone o? 7,��/� Permit Request < ,` U ,6 ' E r Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District c° �� - Flood Plain _Groundwater Overlay o a Project Valuation jec243 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentq'Fgi n. Ua o -v Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) w Age of Existing Structure Historic House: ❑Yes R_No On Old King's High ay: ❑Yc ANo Basement Type: QrFull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) —La() Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new ef2 Half:existing new O Number of Bedrooms: existing_ new - (�)// Total Room Count(not including baths):existing CO new_�'� First Floor Room Count Heat Type and Fuel: ❑Gas ¢ Oil ❑Electric ❑Other Central Air: ❑Yes 9LNo Fireplaces: Existing L/ New Existing wood/coal stove: Ii Ves ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing Cl new size Attached garage:*existing ❑new size ' (FZ Shed:M-existing ❑new size�Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ V �C-ommercial—O Yes- --No If yes, site plan-review#,. Current Use Proposed Use ILDER INFORMATION Name ` / l` S OLrJ/1 Telephone Number Address License# Home Improvement Contractor# Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TOz'1 Z2 z`s�aS� SIGNATURE DATE i l i FOR OFFICIAL USE ONLY 1 PERMIT NO. DATE ISSUED i MAP/PARCEL NO. I ADDRESS" VILLAGE OWNER DATE OF INSPECTION: 5 FOUNDATION i FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL' �_ r f FINAL BUILDING i ' Y DATE CLOSED OUT 4 j ASSOCIATION PLAN NO. a The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers'Compensation Insurance.Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLdbly Name(Business/Organization/Individual):� i /Gj �1"6 Address: Z(Q�Li�� City/State/Zip: �STe�di��L° Phone.#: 5&7 c /7 Are you an employer? Check the appropriate box: Type of project(required):. 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction . employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a•sole proprietor or partner- listed on the-attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity.acitY• employees and have workers' $• 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.K•Electrical repairs or additions officers have exercised their 11. .3 .� I am a homeowner doing all workh �Plumbing repairs or additions myself [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t. c. 152, §1(4),and we have no employees. [No workers' . •13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fin out the section below showing their workers'compensation policy information. t Homeowners who subrtrit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. (Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is.the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: r Job Site Address: Jle_/�!l �S ��� City/State/Zip: � Attach a copy of the workers' compe sation policy declaration page(showing the policy number and expiration date). Failure.to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce u er th ins•and penalties of perjury that the information provided above is true and correct: Signature: Date: /,� Phone# Official use only. Do not write in this area,to be completed by city or town offciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information' and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association, corporation or other legal entity, or any two.or more 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, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to'operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C()states `Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of complauce with the insurance requirements of this chapter have been presented'to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti•actor(s)name(s),address(es)and phone number(s) along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Departmeirt of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 'The affidavit should be returned to the city or town that the application for the-permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure.to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all-locations in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.where a home owner or citizen is obtaining a license or permit not related fo any business or commercial venture (i.e. a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,ielephone-and fax number:. The Commonwealth of Massachusetts Department of Industrial Arcidi=ts Office of Investigations 600 Washington Street Boson, MA 02111 Tel. #617-727-490.0 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia • �FTf1E 1pyy Town-of Barnstable v7 °� Regulatory Services h IBI Thomas F.Geiler,Director 1639' •� BuRdincr Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 509-862-4038 Fax: 508=790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, •improvement,removal,.demolition, or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adj acent to such residence or building be done by registered contractors,with certain exceptions, along with other requirements. Type of Work S/���5-�D lam— Estimated Cost laeg— ,kddress of Work 1 o YX;S &114e 42fl ��/i • Owner's Name: ;,. /� Date of A Z pplication: /2/17 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: OARS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORD DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES.OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name RegistrationNo. OR Da Owner's Name Qfm-mhomeLf8dzv fHE Town of Barnstable CF �� "o Regulatory Services STAB Thomas F.Geiler,Director 1639. .m� Building Division rFD NIA't A Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION ' r� Please Print / DATE: �191 l JOB LOCATION: !,P ',• /(_Law �S �!//lln ii/e� number - street village .HOMEOWNER": Z //Q lL ,�!'P/�Q_S name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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 procedu s and requirements and that he/she will comply with said procedures and re eme s i na e o omeowner Ut 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 person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q, Rules&Regulations for Licensing Construction 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:forms:homeexempt Town of Barnstable Regulatory Services BAMSrnate. v MASS. g Thomas F. Geiler, Director �ATFo;p. Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 July 16, 2007 Ms. Livia A. Freitas 1 Locust Street Falmouth, MA 02540 RE: 16 This Way, Osterville. Dear Ms Freitas: In response to your application to add a second kitchen to the above referenced property, be advised that unfortunately the application must be denied. This property is located in the RC zone, which limits the principal permitted uses to that of a single-family residence. Very trul y rs, Thomas Perry, CBO Building Commissioner TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel 4 : 001 Application# Health-Division""`-�. Conservation Division f s Permit# Tax Collector 'Date Issued 5 7 Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board EXISTING SEPTIC SYSTEM LIMMM TO 3 ��OF BEDROOMS Historic-OKH Preservation/Hyannis /S /��0 l C"�• (1, C(�`d�I/On �✓�'l t/Ll R/0✓�'I, Project Street Address V TIM S maul Village 04 fiVV 41 C Owner I,I VI GC TY41 Address I� Ths 04 0;terV4_ Telephone 14 (AS Permit Request a Square feet: 1 st floor:existing proposed .3 2nd floor:existing �Zo proposed Total new Zoning District e eSPrz /4-/ Flood Plain &d Groundwater Overlay Project Valuation Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes No On Old King's Highway: ❑Yes 0 No , Basement Type: Q,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 3 new 4 Total Room Count(not including baths):existing la new�� First Floor Room Count ca CD Heat Type and Fuel: ❑Gas 0 Oil ❑Electric ❑Other m i Central Air: ❑Yes �]No Fireplaces: Existing New Existing wood/coa.stove: Pr-Yes w0 No Detached garage:0 existing 0 new size Pool:❑existing ❑new size Barn:❑ezi"sting ❑new size Attached garage:Yexisting ❑new size d Shed:71existing Clnew size Other: « 3y ryl w r- Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes TLNo If yes, site plan review# / Current Use re�iq� . �` Proposed Use BUILDER INFORMATION Name-- ~ Telephone Number -�i'" Address=A6- hjl_ ad License# Home Improvement Contractor# �-- � Worker's Compensation# ALL CONSTRUC-TIOWDEBRIS:RESULTINGFROM THIS-PROJECT WILLBE TAKEN_TO—A K 4{UGC_ D� -c2r d Im ill SIGNATURE ,DATEZ-7_J glo 1Z FOR OFFICIACUSE ONLY PERMIT NO. DATE ISSUED I 1 MAP/PARCEL NO: ADDRESS '� VILLAGE OWNER DATE OF INSPECTION: I FOUNDATION A: FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL is el PLUMBING: ROUGH 1= FINAL GAS: ROUGH n FINAL S FINAL BUILDING f NTr DATE CLOSED OUT >^ Gf ASSOCIATION PLAN NO. n .. t RESIDENTIAL BUILDING PERMIT FEES APPLICATION FEE New Buildings $100.00 Residential Addition $ 50.00 Alterations/Renovations $ 50.000,/r? Change of Contractor/Builder $25.00 FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq. foot= x .0041= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACE 3 &R-0 square feet x$64/sq. foot= x .0041= plus from below(if applicable) GARAGES(attached&detached) square feet x$32/sq.ft.= x .0041= 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 .0041= 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 j Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee Projcost Rev:063004 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance davit: Builders/Contractors/Electricians/Plumbers A licant Information Please Print Le 'bl wine-(Business/Organization/Individual): Address:J' kl< JA1,111 04trolb �ty./_State/Zip: Phone M Are you an employer? Check the-appropriate box: 'Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(full and/or part-time).* have hired the sub-contracto$ 7 ❑ Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp.insurance. 9. ❑ Building addition workers' Comp.insurance 5. ❑ We are a corporation and its -.-,,[No r . 10.❑ Electrical repairs or additions officers have exercised their ,required•] f A I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions A myself.(No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] t employees.(No workers' 13.❑ Other comp.insurance required.] "Any applicant that checks box#1 must alsd fill out the section below showing their workers'compensation policy information' t Homeowners who submit this affidavit indicating they are doing all work andthen hire outside contractors must submit anew e$davit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that Is providing workers'compensation Insurance for my employees. Below is the policy and,yob site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of'up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herebyc� uridjer the pains and penalties of perjury that the information provided above is true and correct L s% skmafore: Phone#" qK • I Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority (circle one): 1.Board of Health 2.Building Department 3.Ctty/Towa Clerk 4.Electrical inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as-"an individual,partnership,association, corporation or other legal entity, or any two or more 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 bean employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their certificate(s) of insurance. Limited Liability Companies(LLQ or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Depm=ent of " Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should•eater their self-insurance license number on-the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly: The Department has provided a space at the bottom. of 1he 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 perrni0icense number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please 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 Investigations 600 Washington Street Boston, MA 02111 Tel. 617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 ww-w.mass.gov/cia • °FIME Town of Barnstable j P� ti Regulatory Services B Thomas F.Geiler,Director Eo;9�A`�� Building Division Tom Perry,Building Commissioner 200 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. I T e of W L'C rGD✓G( 1 l7y ^Estimated-Cost7,_g1%JT LT1 Addr� ess of_Work:—'� S i Owne Name: �I V)a 'i'1� Date-of o D(0 • I hereby certify that: Registration is not required for the following reason(s): QWork excluded by law ❑Job Under$1,000 ElBuilding not owner-occupied O-wner_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 C Registration No. r ; �I ® /R Date Owner's e - Q:fomu:homeaffidav M CMR Appeeda Table J31.Ib(continued) Prescriptive Packages for One and Two-Family Residential Buildings Heated with Fossil Fuels MAXIMUM MINIMUM Glazing Glazing Ceiling Wall Floor Basement Slab Heating/Cooling Arta'(%) U-value= R-value R-value' R-value' Wall Perimeter Equipment Efficiency Page R-value° R value' 5701 to 6500 Heating Degree Days' Q 12% 0.40 38 13 19 10 6 Normal R 12% 0.52 30 19 19 10 6 Normal S 12% 0.50 38 13 19 10 6 85 AFUE T 15% 0.36 38 13 25 N/A N/A Normal U 15% 0.46 38 19 19 10 6 Normal V 15% 0.44 38 13 25 N/A N/A 85 AFUE W 15% 0.52 30 19 19 10 6 85 AFUE X 18% 032 38 13 25 N/A N/A Normal Y 18% 0.42 38 19 25 N/A N/A Normal Z 18% 0.42 38 13 19 10 6 90 AFUE AA 18% 0.50 30 19 19 10 6 90 AFUE 1. ADDRESS OF PROPERTY: a-ke-I Ae- , A1174 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: 3. SQUARE FOOTAGE OF ALL GLAZING: 4. %GLAZING AREA(#3 DIVIDED BY#2): 5. SELECT PACKAGE(Q--AA-see chart above): Q NOTE: OTHER MORE INVOLVED METHODS OF DETERMINING ENERGY REQUIREMENTS , ARE AVAILABLE. ASK-US FOR THIS INFORMATION. .cam BUILDING INSPECTOR APPROVAL. / C� YES: NO: q-forms-f980303a 780 CMR Appendix J Footnotes to Table J5.2.1b: 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 ft'of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 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 R49 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 EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to 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. 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. 7 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 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 J5.2.1 a 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 - �pTHE Tp� Town of Barnstable Regulatory Services * BARNSTABLE, MASS. Thomas F. Geiler, Director �A i63q. ♦0 TE039. ° Building Division Thomas Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 March 27, 2007 Ms. Livia Freitas 16 This Way Osterville, MA 02655 Re: Illegal Apartment: 16 This Way Osterville, MA 02655 Map: 121 Parcel: 141-001 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home,which is contrary to Barnstable Zoning Ordinances. Violation of.zoning.ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to taker - Sincere! L' dson .73 Amnesty Zoning Enforcement Officer Building Department gf6rms:zoning3 Town of Barnstable I'! Building Department V eses P087� 200 Main Street � ® ,� ® Hyannis, MA. 02601yy® gTNEY BowES 021 A $ 00.390 0004606238 MAR28 2007 F MAILED FROM ZIP CODE 02601 I I f \' Ms. Livia Freitas 16 This Way Osterville, MA NI <IM O.':9 ;l 00 04•/O1:/.O`I RETURN TO SENDER NOT DELI`JERADLE AS ADDRESSED UNAst-c TO FORWARD BC: 02601.00200 *2004--02514-01-03 I - 02601@4002 I11�„..I,I�II�,II„��„II,I��III��,II.,.„I,III,►,11,��,1,1�1 0t.6S3ti s48-i+s C002 L -- .. �` / ` f� 4� � �.� �. I , ++ \ 3 �, I \�\ r' M �� ...... `} - � ; --- __.. � --- I� -., '` , t -� / � , _,-- �r � � ��F 1 �� � ��. �� �� Town of Barnstable Building Department S3PAxs PQ 200 Main Streeto„ ���® Hyannis, MA. 02601 ? 02 1A $ 00.39° 0004606238 APR03 2007 1 MAILED FROM ZIPCODE 02601 Ms. Livia Freitas 47 Lewis Pond Road Cotuit MA 02635. -- RETURN TO SENDEia NOT DELIVERABLE AS ADDRESSED UNABLE TO rORWARD ' SC: 02601400200 *0969-1 1 532-03-41 . � =�71�� •e, rp�� �00nm illlllllllili�llillllllllill lliill lllllllll�I�IIIII III111�1'll _., ..... _ ,....., i I r.�. ....... \\\� j .y. � � »• �! / w..r. \ h� ��w• au� B 1 �``. .+�.n• N`� �wrw • ' •� S `� �' �: � i // f �' '� . / 1 �-I\ 1 s i i" Barnstable District Court I CapeCodOnline.coin Page 2 of 2 ti �BEARSE,Amanda L., 34, 16 This Way, Osterville;guilty-plea'to two`c"ousts assault and'battery;-Dec-20 in Barnstable,two years probation and$50 fee;assault_and.battery_with a dangerous weapon dismissed BROWN, Kyle R.,21, 3 Arrowhead,Drive, Eastham; admitted sufficient facts to breaking and entering in the daytime to commit a felony, breaking and entering and malicious destruction of property of a value less than $250, Nov.4,2008, in Yarmouth, continued without a finding for two years, $1,560 costs and$90 fees. FORD,Adam J., 29, 600 Main St., Hyannis;guilty plea to violating a protective order, breaking and entering and assault and battery, Feb.6 in Barnstable, 30 days Barnstable County Correctional Facility(18 days pretrial credit); guilty of three counts violating a protective order, Dec. 19 and Jan. 18,and a guilty plea to larceny of a value less than $250,Jan. 29 in Barnstable, two years probation, $1,560 costs and$50 fee. GONCALVES,Valnei, 33,62 Hooper Farm, Nantucket;assault,threatening to commit a crime and a traffic violation, Dec.26 in Barnstable, dismissed. MORRIS, Deborah L.,45,28 Circuit North Road, Yarmouth; intimidating a witness,Jan.25 in Yarmouth, dismissed on payment of$200 costs. ARRAIGNMENTS (The following pleaded not guilty.) ATKINS,Jarred D.,27, 8 Cardinal Lane,Yarmouth; possession of marijuana with intent to distribute,Tuesday in Yarmouth. Pretrial hearing March 30. BODE,Josh A., 17, 12 Albion Road,Yarmouth; assault and battery of a police officer, assault and battery,carrying a dangerous weapon, resisting arrest and disorderly conduct,Tuesday in Barnstable. Pretrial hearing April 2. BRADSHAW, Nicholas S., 19,44 Yarmouth Road, Hyannis;two counts assault and battery with a dangerous weapon (knife, framed picture),assault and battery and assault with a dangerous weapon,Tuesday in Barnstable. Pretrial hearing March 25. DAVIES, Jonathan, 22, 18 Bayview St., Yarmouth; malicious destruction of property of a value more than $250, Jan. 20 in Yarmouth. Pretrial hearing March 30. EVERSON, Bradley S., 19, 71 Lakefield Road, Yarmouth; malicious destruction of property of a value more than $250,Jan. 25 in Yarmouth. Pretrial hearing March 30. HIGGINS, Shawn, 19, 28 Gleason Road, Yarmouth; intimidating a witness Jan.4 in Yarmouth. Pretrial hearing March 24. MAGOON, Ryan, 20,44 Abbott Road,Yarmouth; malicious destruction of property of a value more than $250, Jan.20 in Yarmouth. Pretrial hearing March 30. ZARATE, Matthew J.,21, 249 Old Townhouse Road, Yarmouth; possession of marijuana with intent to distribute, Tuesday in Yarmouth. Pretrial hearing March 30. Copyright©Cape Cod Media Group,a division of Ottaway Newspapers,Inc.All Rights Reserved. http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20100227/NEW S/2270324/-1/N... 3/1/2010 �iarnstable District Court CapeCodOnline.com Page 1 of 2 ` ;`T >.+ _S. /� � v ►`y,. �,Mf,ry�+�:r:^r�s�,Yf?�k� `{'C�_"�,y,�,:,..�'e �-i,._2.+-� �I►✓.-...�,-.+.'�+ri ...n .. i• k y �� Barnstable District Court February 27,2010 2:00 AM In court Tuesday: DISPOSITIONS BODE, Christopher S., 19, 12 Albion Road,Yarmouth; guilty plea to breaking and entering a boat or vehicle in the nighttime to commit a felony and receiving stolen property of a value more than $250, Sept. 9 in Yarmouth, 18 months Barnstable County Correctional Facility, 18 months probation, $1,170 costs and $90 fees; possession of a burglar's tool and breaking and entering a boat or vehicle in the nighttime to commit a felony,dismissed. MCWILLIAMS, Robert W., 30, 9 Brassie Road, Dennis;guilty plea to operating a motor vehicle while under the influence of alcohol (OUI), Jan. 9 in Yarmouth, 30 days county correctional facility; admitted sufficient facts to another traffic violation, 10 days(concurrent)county correctional facility; not responsible for another traffic violation. MEDEIROS,Jordan, 19, 106 Seatucket Road, Falmouth; guilty plea to receiving stolen property of a value more than $250, Oct. 27 in Sandwich,seven months county correctional facility; breaking and entering,dismissed. REEN, Kimberly, 35, 39 Arnold Road, Forestdale; assault and battery, Jan. 30 in Sandwich, dismissed. ARRAIGNMENTS (The following pleaded not guilty.) FREGEAU, Ronald, 70, 50 Raspberry Lane, Marstons Mills; larceny of a value more than $250 by false pretense, Oct.6, 2008, in Barnstable. Pretrial hearing March 24. GENEROSO, Philippe M., 18, 101 Longfellow Drive, Centerville; receiving or altering a motor vehicle identification number, larceny of a motor vehicle and breaking and entering in the nighttime to commit a felony Nov. 12 in Sandwich and Dec. 31 in Barnstable. Pretrial hearing March 19. JOHNSON, Craig M.,60, 148 West Main St., Hyannis; OUI, negligent driving and four other traffic violations, Monday in Barnstable. Pretrial hearing March 4. KIMBALL, David B., 30, 289 Old Townhouse Road, Yarmouth; distributing heroin, Nov. 17 in Yarmouth. Pretrial hearing March 11. MARQUES,Vitor H., 18, 18 Pawnee Court, Hyannis; larceny of a motor vehicle and breaking and entering in the nighttime to commit a felony, Nov. 12 in Sandwich, and five counts receiving stolen property of a value more than $250, four counts removing or altering a motor vehicle identification number and selling a motor vehicle with a defaced VIN, Dec. 5 and Dec. 31 and Jan. 28 in Barnstable. Pretrial hearing March 19. MOVANU, Cortney P.,26, 13 North Pond Drive, Brewster; OUI,Tuesday in Yarmouth. Pretrial hearing March 19. PLOUFFE, Normand C.,60, 7 Ferry St., Dennis; OUI, negligent driving and two other traffic violations, Monday in Yarmouth. Pretrial hearing March 17. THOMAS, Douglas A.,44, 35 Elton Road,Yarmouth; unarmed robbery and assault and battery, Feb. 19 in Yarmouth. Pretrial hearing March 25. In court Wednesday: DISPOSITIONS http://www.capecodonline.com/apps/pbcs.dll/article?AID=/20100227/NEWS/2270324/-l/N... 3/1/2010 �or �-� �oFt lops _ Town of Barnstable Regulatory Services 9 ABM MASS. Thomas F. Geiler, Director 039.�En 39�" Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arn stable.max s Office: 508-862-4024 Fax: 508-790-6230 March 27, 2007 Ms. Livia Freitas 16 This Way Osterville,MA 02655 Re: Illegal Apartment: 16 This Way Osterville, MA 02655 Map: 121 Parcel: 141-001 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning.ordinances is.a.misdemeanor, conviction for which results in a cnmmal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office.immediately to tell us what direction you wish to take; ~' Sincerel ;y .tom Li dson Amnesty Zoning .Enforcement Officer ° .. Building.Departrnent � .• •� • . . ... � : _ , , ,-_ •. - _. gforms:zoning3 Town of Barnstable Building Department 200 Main Street g Hyannis, MA. 02601 A9 ®PITNEV BOWES • 0 21 A $ 00.390 0004606238 APR09 2007 MAILED FROM ZIPCODE 02601 Ms. Livia Freitas Box Holder Cotuit, MA 02635 NIXIE 029 1 00 04lii,f07 RETURN TO SENDER ,. NOT DELIVERABLE AS ADDRESSED i UNABLE TO FORWARD ^'•J +"T r:.G•i GC: 0.2801400200 *0969-04491-09-40 L.t•'1�';• 'r 0260104002 IIII I I I I I I I I I I I I I I 1111 I fill III IIII I I I II I I I I II IIII I I II I I I I If III '7Z z °FIME 1 Town of Barnstable Regulatory Services , y 'nusOLE, Thomas F. Geiler,Director lEC►�`�A Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b am stable.ma.us Office: 508-862-4024 Fax: 508-790-6230 March 27, 2007 v Ms. Livia Freitas 16 This Way Osterville, MA 02655 Re: Illegal Apartment: 16 This Way Osterville, MA 02655 Map: 121 Parcel: 141-001 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoningt ordinances is.a misdemeanor, conviction for which results in•a criminal record" You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. R �, Please contact this office immediately to tell us what direction you wish to takeY Sincerel Li dson Amnesty Zoning.Enforcement Officer -� r .Building_Department, - �_. ,.. - . gforms:zoning3 ;I Town of Barnstable Building Department SPQ 200 Main Street o�P �F Hyannis, MA. 02601` 3 d ,, ®�® ®PITNIN BDWES 02 1 A $ 00.390 0004606238 APR09 2007 # MAILED FROM ZIPCODE 02601 PMs. Livia Freitas Box Holder � Osterville MA 02655 NIXIE 029 1 -- 00 04/11107 RETURN TO SENDER ATTEMPTED - NOT KNOWN UNABLE TO FORWARD BC: 02601400200 *0969-04492-09-40 028010400.2 rrrI,Illr,rlrr„rrl,,,,Irrlr,Irrr,,,rrl„Ilrlrri,I,it„I,ili,t -- -- , i .� _..�. `- I � ....... � r,� �. .::�: !/ ...:::: r __�. ....... � ,, r : C _: w:�: ��� _.... , :::�: � ....�. , ._.�.. � �-�� 1 .w. i ...._.. i � 4 �� t 1 ��. i 4� // J {. 11/1Ul/20,;;1/M0N 09: 40 C-0—MM FIRE DEPT FAX No, 5087902385 P, 002 A Lill UU I I r I UDelete egg -1 I0;1920 07 1 1 091 1 2 1 11 111-0002034 11 000 ❑Change Basic fDlb * State* Incideat Pate * Station Incident Number * Exposure * ❑No Activity Cheak this box to Tndimk. Clue ek. .dd... Eot Chia incid— L.p—Ld•d an en•Nlld1•rd lac. BLocation* �Moule to a.tti.A A Wtem.tly y.t.eso.sp.tlrxoatiW. Vae only Cox Wllaland area CebeUB Tract 1_ ®Street address 16 " (THIS WY I I ❑intersection Number/Mile oat Prefix P 9tr6et or Highway Street Type Suffix ❑In fzoat of I ❑Rear of OSTERV_ ILLE IM 1 102 655 -1 ❑Adjacent to Pot./suite/Room city State Zip Code ODirectiona Croce street or directions as goalicable C Incident Type * E1 Date & Times Midn-ight is 0000 E2 Shift & Alarms 424 jCarbon monoxide incident Cbeck boxes if Month Day Year Er Min Sec Local Option the Incident Type samasaSrAlarm ALARK always required 4 01 Aid Given or Received* Date' A]arm * 07 09 2011 17.29:06 1 COM23 1 SAiit or Alarms District L Platoon 1 ❑mitual aid received ARRIVAL required, unless canceled or did not arrive II ] Arrival L 07 09 2011 I17:35:3.2 I E3 2 ❑Automatic aid recv. Their FDID Their 3 ❑Mutual aid given State CONTROLLED Optional, except for wildland Cires Special Studies 4 ❑Automatic aid given I I ❑Controlled u " 11I I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required excapt ror wilaland fires l�- I I I Incident Number Last Unit I n Special Spacial N �Nor� © Cleared �J 09 2011 I18:25.06 i study Iott study value Fi' Actions Taken* G1 Resources * G2 Estimated Dollar Losses & Values © Check this box and skip this LOSSES: Required for all fires 1f knowD, Optional section if an Apparatus or 41 (Identify, analyze I Parsoonal form is usaa. for Son fires. None Primary Action Takao (1) Apparatus Personnel Property / 000 1 000 ❑ 51 Iventilate Suppression �� Contents $1 , 000 000 ❑ I Additional action Taken (2) EMS U PRE-INCIDENT VALUE: optional I I I I Other L 0002 1 00� Property 000 000$1 ' ' El Additional Action Taken (3) ❑ Check box if resource rcounts esources. $I ,L�� 'U I include aid received rasourcns. Contents 000 000 ❑ Completed Modules al*Casual tias❑xone $3 Hazardous Materials Release I Mixed Use Property, ❑Fire-2 Deaths injuries N ❑None NN Not Mixed ❑Structure-3 Firs ' I 1 Natural Gas: .1..1..k, .....,..eion,:Y.sN.c.tole,. 10 Assembly uSe Civil Fire Car.-4 SerP1'� I� �J ❑ 20 Education use ❑ 2 ❑Propane gas: <ii ab, e.m (aa In h.sm vrsu) 33 Medical use ❑Fire Serv. Cea.-S Civilian�� �� 3 ❑Gasoline: .ebia.Eao1 tadk 40 Residential use ❑EMS-6 - ❑iterosene: 2b.1 4.quipa.ne or 51 Row of stores Detector P"CaD1a COra9' 53 Enclosed mall ❑Haft-7 Required for Confined fires. 5 ElDiosol fuel/fuel Oil:vchiWA fuel tank.a Po.tabi. 58 —Bus. b Residential ❑wildlarld size-e 1[-]Deteetor alerted 000ueaata 6 ❑Household solvents: h.-/."A— pli1, L. .p.nly 59 Office use ®Apparatue-9 7 ❑Motor oil: Win omglne or yarcable WnWnR 60 industrial use ©Personne -10 2❑Dataetop did hat al th ett w. paint: F,,m 63 Military use l B ❑ o.iat�.,� tRt.uag<ss g.11e.. 65 Farm use ❑Arson-11 UO Unknown 0 ❑Other: 2P— reaRase4 q P—>s6gai., 00 mother mixed use t Lo r a J Property Use* Structures 341❑Clinic,clinic type infirau ry rj39 ❑Household goods,sales,repairs 342❑Dootor/dentist office 579 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 361❑Prison or jail, not juvenile 571 ❑Gas or service station 161 [ Restaturant or cafeteria 419®1-or 2-family dwelling 599 ❑Business office 162 ❑Ear/Tavern or nightclub 429 E]Multi-family dwelling 615 ❑Electric generating plant 213 ❑Elementary school or kindergarten 439❑Rooming/boarding house 629 Q Laboratory/science lab 215 ❑nigh school or junior high 449❑Oommo:res,al, hotel or motel 700 ❑Manufacturing plant 241 ❑college, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 464❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑warehouse Outside 936❑vacant lot 981 ❑Construction,site 124 ❑playground or park 938 Graded/care for plot of land 984 ❑ industrial plant yexd 655 ❑Crops or orchard 946 ❑Lake, river, stream 669 ❑Forest (timberland) 951 ❑Railroad right of way youhaveDNOTachecked a Property Usee�X. if 807 ❑Outdoor storage area 960 ❑Other street Property Use 1419 919 ❑gyp or sanitary landfill. 961 [ Rigbway/divided highway 931 []Open land or field 962 ❑ es Ridential street/driveway I1 or 2 family dwelling NFIRS-1 Revision 03 il-7n :0MM Fire 01920 07/09/2011 11-0002034 II/Jr1/201J1/MON 09: 40 C-0—MM FIAE DEPT FAX No. 5087902385 P. 004 1 01920 1 U 1 71 U 2011 1 1 11-0002034 I 1 000 complete PDID * state* Incident Date .* station Incident Number Na==ative * exposure Narrative: Capt. 321 dispatched wl Engine 304 to a reported carbon monoxide detector sounding. Upon my arrival I was met by the OIC/304 who reported upon metering the incident they found elevated levels of CO, as high as 44 ppm. The home is available for summer rentals and the new occupants had just arrived with the last half hour and were warming up the kitchen gas stove when the CO detectors started sounding. Check of the rest of the home finds elevated CO levels throughout the home with the highest on the First floor. In checking the home I found a basement apartment with a small bedroom with no egress to the exterior. I was also concerned about the lack of smoke detectors in the home but specifically in the basement area. I requested a fire prevention officer to the scene and Inspector MacNeeely responded. He confirmed my suspicions and the occupants of the home were notified not to use the basement bedroom. With CO levels decreasing the gas stove was turned back on and CO levels (confirmed by using both a T-80 and TMX-412 gas meters) rose to as high as 62 ppm. The stove was shut off. The gas (propane) to the stove was turned off as well as the gas at the tanks. The house was ventilated to zero ppm of CO. The occupants were told of the actions taken and our concerns. They were told if they at any time had any further concerns not to hesitate to call 9-1-1. In returning to HQ I called the home owners and relayed my concerns. The problems found and step taken to correct them. I informed them that the basement bedroom shouldn't be used and that fire prevention would follow up with them. Mr. Mouteforte said they "didn't use it much" but it is noted on the homeway website the house is advertised on. (Copy attached) . when asked how long they had owned the home he "couldn't remember" but a check of the Town of Barnstable assessment website finds it to be 2005. Units cleared w/o incident. 07/09/2011 19:02:55 dbrogers i 4SM Fire 01920 07/09/201.1 11-0002034 ll/JUL/2011/MON 09: 40 C-0—MM FIRE DEPT FAX No. 5087902385 P. 003 IK1 Person/Entity Involved 1520 - 289 - 7465 Local option Buslheas name lit applicable) Area Code Phone Number L 1 1Marian [Manning �J ®Check Thia Box if Mr Mrs First Name MY Laat Name acme addreaa as Suffix incident location- I • Then skip the three 16 (THIS WY duplicate addreee of Prefix street or Highway Street Type Linea. Suffix 1 1J OSTERVILLE Poat o_fice Box .Apt-/Suite/Room City L 1102655 -1 State Sip Code more people involved? Check this box and attach Suppleme❑tal Voms (NEIR9-19) as necessary K2 Owner Some as person involved Then check this box and skip I I 401 - 255 - 6853 The rest Of this Section. •- Local option Buaineae name lit Applicable) Area Code Phone Number James / Livia IMouteforte I ® Check this box iL Mr.,Ma., Mra. Pirat Name MI Zest Name Bu;fyk same address as incident location, 116 �� THIS WYthe Then skip three NWDDGX Prefix Street or Bi bwa Street T Suffix duplicate address g Y Type MI I JOSTERVILLE Post office sox Apt./Suite/Room City NSA 102655 State Zip Code Z Remarks Local Option Capt. 321 dispatched w/ Engine 304 to a reported carbon monoxide detector sounding. Upon my arrival I was met by the OIC/304 who reported upon metering the incident they found elevated levels of Co, as high as 44 ppm. The home is available for summer rentals and the new occupants had just arrived with the last half hour and were warming up the kitchen gas stove when the CO detectors started sounding. Check of the rest of the home finds elevated CO levels throughout the home with the highest on the first floor. In checking. the home I found a basement apartment with a small bedroom with no egress to the exterior. I was also concerned about the lack of smoke detectors in the home but specifically in the basement area. I requested a fire prevention officer to the scene and Inspector MacNeeely responded. He confirmed my suspicions and the occupants of the home were notified not to use the basement bedroom. With CO levels decreasing the gas stove was turned back on and Co levels (confirmed by using both a T-80 and TMX-412 gas meters) rose to as high as 62 ppm. The stove was shut off. The gas (propane) to the stove was turned off as well as the gas at the tanks. The house was ventilated to zero ppm of CO. The occupants were told of the actions taken and our concerns. They were told if they at any time had any further concerns not to hesitate to call 9-1-1. In returning to HQ .I called the home owners and relayed my concerns. The problems found and step taken to correct them. I informed them that the basement bedroom shouldn't be used and that fire prevention would follow up with them. Mr. Mouteforte said they "didn't use it much" but it is noted on the homeway website the house is advertised on. (Copy attached) . Authorization 18390 1 1 R S, BRADY ICAPT I321 J 07 09 2011 Officer SD charge ID Si atu Position or rank Assignment Month Day Year bz`is® 1 8390 1 LROGERS, D. BRADY I CAPT 1 321 1 0 71 U 2011 :aMe is Officer Member making report ID Sign;ture Position or tank Aaaignmant Month Day Year .n charge. ,M Fire 01920 07/D9/2011 11-0002034 I1/JUL/2011/MON 09: 40 C-0—MM FIAE DEPT FAX No, 5087902385 P, 002 1.11.`i UU IIII UDelete Np•Igg —1 01, 920 07 09 2 1 ll I 111-0002034 1 1 000 Change Basic t tDlb * store* IncidaDt Date * Station Incident Number * Exposure * 0.6 Activity Cbeok this box to indieee. eb.e el...ddc... Eoc eyi."Ad- 1.pcovid.d o„ en.Ylldl.nd far. $ Location* �Nedule 1, s.ceian a ^alcs m.civ )o D'Sp.uiic.tloe'• Use only for nildlend tires. census Traci ®Street address 16 u I THIS WY ❑Interseation[]In :Front of Number/Wile oat Prefix P street or Nlghway Street Type Suffix ❑Rear of I 108TERVILLE I IM 1 102 655 ❑Adjacent to Apt./suite/Room city State 21p code 1 I ❑Directions Crave street or directions an applicable Incident e * Midnight is 0000 C Type E1 Date & Times �,'2 Shift & Alarms 424 (Carbon monoxide incident 1 Check boxes if Month Da Year Hr Min sec Local option Incltlent Type dates are the Y same as Alarm ALARM always required 14 1 1 01 COM23 L Aid Given or Received* Date. Alarm k1 0?1 1 091 1 2011 17:29:06 1 �— SnlIC or Alarms District Platoon 1 ❑Mitual aid reesivmd I II ARRIVAL required, unless canceled or did not arrive I 2 ❑Automatic aid recv. Q Arrival * 07 09 2011 17:35:3.2 Eta Their FDID Their 3 ❑Dlutual aid given state CONTROLLED optional, except for wildland tires Special Studies 4 ❑Automatic aid given I I ElCoritrolled I_� u I I I I Local optloo 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires ��1 I � N ONone Incident Number Last Unit Special special Cleared 07 U 2011 18:25.06 study ID# Study value £i' Actions Taken* G1 Resources * G2 Estimated Dollar Losses & Values © Check this box and skip this;action if as Apparatus or LOSSES: Required for all fires it )mown. Optional ersonnel form is uaod. for non fires. None Primary Action Taken (1)(Identify, analyze 1 Apparatus Peracnnel property $I I 000 J 0001 ElI 51 (ventilate I suppression �J �J Contents $1 .000 000 ❑ Additional Action Taken (21 EMS PRE—INCIDENT VALUE; optional I I 1 other 1 0002 1004 Property $L� 000 000 El Additional Action Taken (3) ❑ Check box if resource counts include aid received resources. Contents $I—� , 000 , 000 o Completed Modules H1*Caeualti®s❑clone gi Hazardous Materials Release Mixed Use Property ❑Fire-2 Deaths injuries N oNono NN Not Mixed Structure-3 10 ASsembiy use E•i� 20 Education use I I ' I 1 DNatural Gas: ,l.v i..k, .,.v.u.eies a:Y.sWe.eeia,,. ,-4 service I I ❑Civil Fire Cas 2 ❑Propane gas: Apr 1p, emk in home sea grin) 33 Medical use Fire serv. Caa_-3 Civilian�� �� 3 ❑ 40 Residential use Gasoline: „ebiae Eeal�a partbla��� EIIM-6 4 ❑kerosene :,.,b c„Say.yuip�c ao pareaDle ctoraye 51 Row of stores DHaaMat-7 Detector 53 L+nclosed mall il l el/f Diesel fuel/fuel o :,,.nioye fuel t.nk ar pactabi.Repaired for Confined rites. 5 ❑ 58 HUB, 6 Residential ❑wildland six®-8 ❑ 6 ❑Household solvents: bm. , pi p on)y -99 Detector alerted 000uyants / ��• ;i, ei..os Office use 5�Apparatue-9 7 ❑Motox Oil: M=engine or portable oonwfta 60 Industrial ua® .Y Personnel-10 2❑Detector did not slept the. 8 ❑Paint: Ezow pains c.oa e,k.usp<95 g.iinn. 63 biUltasy use �Atson-11 u Unknown WsWe.aye,.p.q a=va ar spin>swan., 00 []OtPa—her use ❑ 0 ❑ot21�r: 'p.`.. 00 Other mixed use e t form 1 Property Use* Strueturos 3410Clinic,clinic type infirmary 539 ❑Aoueehold goods,sales,repairs 342 Q Dootor/dentist office 579 Motor vehiale/boat sales/repair L31 ❑church, place a worship 36108riaon or jail, not juvenile 571 []Gas or service station 161 ❑Rastausant or cafeteria 419®1-or 2-family dwelling 599 ❑Business office L62 ❑Ear/Tavern or nightclub 429 Multi-famil dwellin ❑ Y g 615 ❑Electric generating plant M ❑Elamvritary school or kindergarten 439 C]Rooming/board!Lng house 629 O Laboratory/science lab ?15 DHigh school or junior high 449000MMenci,al hotel or motel 700 Cl Manufacturing plant ?41 ❑college, adult education 459❑Residential, board and care 819 []Livestock/poultry storage(barn) 311 []Care facility for the aged 464 Dormito /barracks Non-residential ❑ � 882 0 Park-ing garage 331 ❑Hospital 5190Food and beverage Sales 891 ❑warehouse Outside 936❑vacant lot 981 0 Construction.Bite 124 []Playground or park 938 ❑Graded/care for plot of land 984 ❑ ,i Tnustrial plant yard i55 []Crops or orchard 946 ❑Lake, river, stream 369 Forest timberland Lookup and enter a Property use code only if 951 ❑Railroad right of way you have NOT checked a Property Use box: 107 ❑outdoor storage area 960 []Other street Property Use 1419 119 Dump or sanitary landfill. 961 ❑Highway/divided highway )31 E]Open land or field 962 []Residential street/driveway 11 or 2 family dwelling 1 NFIRS-1 Revision 03/1/733 IMM Fire 01920 07/09/2011 11-0002034 ll/JUL/2011/M0N 09: 40 C-0—MM FIRE DEPT FAX No, 5087902385 P. 003 KI Person/Entity Involved 1520 - 289 - 7465 4 Local option Buslheaa name (if applicable) Area Code Phone Number U Marian [Manning LJ ®Cheek Thia Bon if !!r Nrs First Name !!T Lent Nome name addreaa as Suffix incident location- • Then skip the three THIS WX u L-J duplicate adtlreaa er Prefix Street or Highway Street Type Linea. Suffix ' I 10STERVILLE Poet Office Box .Apt-/Suite/Room City [N�Lj 02655 -�J $Cate Zip Code More people involved? Check this box and attach Supplemental Fo;;m9 (NFIR9-19) es necessary K2 Owner Some as peraon involved? then cheek this box and skip I 1 401 — 255 — 6853 The rest or this section. Local option Bueinean name (if Applicable) Area Code Phone Number 1James / Livia 1Mouteforte 1 ® Check this box if Mr.,Ms., Mre. First Name MI Last.Name surflx same address as Incident location. 116 THIS A7Y Then ekip the three duplicate address Number Prefix Street or Highway Street Type suffix lines_ � J 10STERVILLE Post office 9ok hpt./Suite/Room City 1� 102655 --1 State zip Code L Remarks t Local Option Capt. 321 dispatched w/ Engine 304 to a reported carbon monoxide detector sounding. Upon my arrival I was met by the OIC/304 who reported upon metering the incident they found elevated levels of Co, as high as 44 ppm. The home is available for summer rentals and the new occupants had just arrived with the last half hour and were warming up the kitchen gas stove when the CO detectors started sounding. Check of the rest of the home finds elevated CO levels throughout the home with the highest on the first floor, In checking. the home I found a basement apartment with a small bedroom with no egress to the exterior. I was also concerned about the lack of smoke detectors in the home but specifically in the basement area. I requested a fire prevention officer to the scene and Inspector MacNeeely responded. He confirmed my suspicions and the occupants of the home were notified not to use the basement bedroom. #ith CO levels decreasing the gas stove was turned back on and CO levels (confirmed by using joth a T-80 and TMX-412 gas meters) rose to as high as 62 ppm. The stove was shut off. The gas (propane) to the stove was turned off as well as the gas at the tanks. The house was Lrentilated to zero ppm of CO. Che occupants were told of the actions taken and our concerns. They were told if they at' any time had any further concerns not to hesitate to call 9-1-1. Cn returning to HQ •I called the home owners and relayed my concerns. The problems found and Step taken to correct them. I informed them that the _basement bedroom shouldn't be used and _Hat fire prevention would follow up with them. Mr. Mouteforte said they "didn't use it such" but it is noted on the homeway website the house is advertised on. (Copy attached) . Authorization 18390 1 R / BRADY 1CAPT 1321 J 07 , 09 2011 Officer LD charge ID Sig atu PosLtioa or rank Assignment Month Day Year xcir® 8390 1 IROGERS, D. BRADY 1 CAPT I 1321 1 1_71 U 2011 Ime Position or rank Aaai nmant' Officer Member making report ID Bignature 9 Month Day Year charge. R1 Fire 01920 07/09/2011 11-0002034 1'I/JUL/2011/MON 09: 40 C—O—MM FIRE DEPT FAX No, 5087902385 P. 004 I 01920 U 1 11-0002034 000e comPlote FDIU * State* Incident vela * Station Exvo6ur Incident Number Na=ative * Narrative: Capt. 321 dispatched w/ Engine 304 to a reported carbon monoxide detector sounding. Upon my arrival I was met by the OIC/304 who reported upon metering the incident they found elevated levels of CO, as high as 44 ppm. The home is available for summer rentals and the new occupants had p just arrived with the last half hour and were warming up the kitchen gas stove when the CO detectors started sounding. Check of the rest of the home finds elevated CO levels throughout the home with the highest on the first floor. In checking the home I found a basement apartment with a small bedroom with no egress to the exterior. I was also concerned about the lack of smoke detectors in the home but specifically in the basement area. I requested a fire prevention officer to the scene and Inspector MacNeeely responded. He confirmed my suspicions and the occupants of the home were notified not to use the basement bedroom. With CO levels decreasing the gas stove was turned back on and CO levels (confirmed by using both a T-80 and TMX-412 gas meters) rose to as high as 62 ppm. The stove was shut off. The gas (propane) to the stove was turned off as well as the gas at the tanks. The house was ventilated to zero ppm of CO. The occupants were told of the actions taken and our concerns. They were told if they at any time had any further concerns not to hesitate to call 9-1-1 , In returning to HQ I called the home owners and relayed my concerns. The problems found and step taken to correct them. I informed them that the basement bedroom shouldnit be used and that fire prevention would follow up with them. Mr. Mouteforte said they "didn't use it much" Dut it is noted on the homeway website the house is advertised on. (Copy attached) . When asked how long they had owned the home he "couldn't remember" but a check of the Town of 3arnstable assessment website finds it to be 2005. )nits cleared w/o incident. )7/09/2011 19:02:55 dbrogers i 4 Fire 01920 07/09/2011 11-0002034 'PR/2"'20071PI H:29 COMM FIFE DEPARTMENT FAX Ne'. 50E19""',5 P. JOJ ' X1 ° Person/Entity Involved t. LO�41 Option I Buaknaas name (if applicable) ' I .tree coda Phoae Nomaber T_I Check Ilia oa:� ii p�„MB , HSs aY-st Name MS Last Name Lj Suffix same addreaa ae , I&CIdent iccation. ' hen.skip the three '' � t L I dupllCate address i7rr -- pre-ix straat or N:ghr,ay Street Type so.irix lints. 1 I_--J --- —J Port 01110e Box Apt./sUte/Roon city • t__J I _1-�J star Zip code More people involved? Check this boa and attach SupnlemArtal Forma (NFIRS-18) as necessaxy K2 0wr16r S44e aE parson involved? _ LJ Then check this box and skip LL_J The seat CI this aeetion. Local Cptier. Business Wane (it'Dp11CA.b1e) Area Cade Ehona Nunaez I� I u I L___j ® C)Ieck this vz' if Mr..Me.. NrS. sir:: None Hr Last Name E'-af1'ix sane ,dllr.sS as incidelic location. Phan Skip the thraa __sJ f. __.J dupli-ata addraea .NWtSer Prefis "o:rep[ 4r Nlcpway Street Type Suffix (Scat office Box Apt. Sm a/Room city State 211. Cote Z R.amarks Local Option Callex .lame PULSIrER Caller Address : 328 OIL : PULSIFER Pats. : 0 rcrosby 2007/04./26 i7:56:36 - 328 AT EVENT MANNING IS 1 rcrosby 2007/04/26 17:53:37 JOINT_ AGENCY ENFORCEMENT wmonroe ; 2007/04/26 19:39:27 CI.EAR 2 1839 C-328 responded with zoning Enforcement to 16 This way, Ost.erville. Arrived to meet BPD Officer Mike Reilley, Zoning Enforcement Robin Giagregorio, Health Inspector Donna Miorandi and Building inspector Robert MoKechnie. Structure is a two story wood frame xeside;cltial building. Vehicles -n the driveway are a Black Toyota Solara !AA req 4223XS and Tan Plymouth minivan MA reg 439EF0. Attempted notification. Of occupants -4-ia the fron1_.door w/o success. BPD Officer Reilley made contact with a resident on side C of the structure. Slight language harrier in place., but the-resident understands some english. Resident -s Sonia Quezada 508--444-8550, Zon�hg,E;lforcement Officer Giagregorio advised Toe. Quezada that the reason for the visit was to inspect a bz;semert apartment and requested permission to inspect, all agencies were identified. Pis. Quezada asked to hold the inspection while she contacted a responsible party for the property. Ms. Quezada made contact with Peggy Freitas L Authorization L9381 I I PULSZFEP,, FRANCIS LE PREV, I j 1 04 1 LL6j 2007 OPflnr la charge ID Signature Position or ran). Aaaignment Month Day Yeer Box`it© (a i81 PULSIFER, FRANCzS _� i FIRE PREY. j ' 1 0411261 I 261 1 2007� . sans Position or rank nssignmaat month lay fear a.a OF:icer Marcher nnf:in� report ID signature is cne.rge. - COMM Fire District 01920 04/26/2007 07-0001174 .0 _27i%U071 K; 0`29 COMM FIRE DEPARTMENT Fr No. 50F790'-1H5 MM DD YYYY - -01920 LJ LJ 26 20C_7 f LirJ l o7-0001174-j b Naarratioo xromp&ti= ve SLID * State* ineldenG Data * StetiO:f Il1c:.6epG NwrQber * exposure .k ' Harrative: Caller Name : PT)I,SIFPR Caller Address : 328 OIC : ?L,7LSZFER Pats. . 0 rcrosby ; 2007/04/26 17:58:36 - 328 AT EVENT MANNING IS 1. rcrosby ; 2007/04/26 1?:53:37 ..'OANT AGENCY ENFY)RCEMENT wmonroe ; 2007/04/26 18:39:27 CLEAR @ 1839 C-328 responded with Zoning 'Enforcement to 16 This Way, 07terville. Arrived to meet PPD Officer Mike Reilley, Zonir_g Enforcement Robin Giagregoric, Health. Inspector Donna Mierandi and Building Inspector Robert McKechnie. St_uctura is a two story wood .frame residential building. Vehicles in the driveway are a Black Toyota Solara MF, reg 4223XS and `Pan Plymouth minivan MA reg 439HFO. Attempted notification of occupants via the front door w/o success. BPD Officer Reilley roads contact with a resident on side C of the structure. Slight Language barrier--In place, but the resident understands some english. Resident is Sonia Quezada 508-444-8550. Zoning Enforcement Officer Giatjregorio advised Ms. Quezada that the reason for the visit was to inspect a. basement apartment and requested permission 'to inspect, all agencies were identified. Ms. Quezada asked to hold the inspection while she contacted a responsible party for the ;property. Ms. Quezada made contact with Peggy Freitas 508-457-0202, identified as the mother of the owner. Ms. Freitas stated that her daughter was out of the country. Zoning Officer Giagrecorio 'advised Ms. Fraitas the reas;.�n for the visit and. requested permission to enter. Ms. Freltas denied. enz ry and stated that she wanted to be present for the inspection. A mutually convenient date of May 8, 2007 at .13:00 flours was agreed upon by Zoning Officer. Giagregorio and Ns. Fraitas. I asked Zoning Officer Gia.gregorAo to ask permission for Fire to enter to confirm smoke detection was in place for the safety Of the occupants. Ms. Freitas agreed to have sire enter for the sawte. Ms. Fretas advised Ms. Quezada that Fire was ok to enter. I entered with permission front hoth Ms. Freitas and Ms. Quezada with BPD Officer Reilley for security purposes only. Identified myself and Officer Reilley to the other occupants- of the structure acid stated my r'eason for entry. We were escorted through the structure entering a doorway at grade level on the C side to the basement. Inside the basement, I observed a kitchen/ dining area to the left on the C side and an area set up as ;n office straight ahsad in the center of the basement. To the far left on side p at the C/D and A/D corners were two makeshift bedrooms with sleeping furniture in place. There was no secondary means of egress from the bedrooms. immediately outside the bedrooms is a smoke detector at the base of the basement stairs that operated but appeared to have no a/c power. The detector is Confirmed to be interconnected with other detectors in the residence. We were then. Led to the first floor via the interior stairwell. There was a smoke detector at the top of the stairs that operated and is con'firrted to be interconnected with other detectors in the structure. There ;were a total o' two rooms on the first floor being used as tearooms as weU. The bathroom is also located on the first floor at the tap of the stairs from the basement. The first floor is separated from the remainder of the first floor of the rest of the house by a doorway inaccessible by these tenants. No CO detectors were found in the residence. I advised Ms, Freitas of the 'following conce_ne via telephone while on scene, no CO detection, SD in the al,21 Fire Distxict r,1920 04126/NQ7 07-ODO1114 7/zIli'7i"^IR; �Ir:29 COMM FIRE DEPARTMENT FU No. 5i1�7G'i2_ P. U �5 101 DO YYYY --� 1 01920 LP — 07-00o117iJ L J L5J L _rl L 000 FWD yt state* rncxdbnr natc srarlep xneldane iq�bee ¢rosaur.., ,� L aL=alive Narrative: basement appeare to have no a/c power, and basement bedrooms do not, have secondary means of egress. I advised Ms. Fratao that I would discuss the same with the tenants and that I. am suggesting that the tenants relocate all sleeping areas to the firsr floor bedroom.. for egress reasons. IMs. Freitas agreed that that is a viable interiiii solution and I asked her to reinforce the same to the tenants. She stated that she would and stated that she would have the smoke detector- repaired and Co detection in place prior to the Nicely 8, 2007 inspection. Ms. Fretas stated that she was unaware that the terarts were using the space in the baserrmt as sleeping areas and thought it was only being used as a kit-chea and living area only. I handed the telephone to Ms. •�)uezada and Ms. Freitas advised her of our conversation. 'Upon ending the telephone conversation, I advised Ms. Quezada of the findings ane. stated the need to move all sleeping areas to the first floor for safety reasons. Ms. Que2ada acknowledged and stated that she understood the urgency and necessity of the instructzona. I tl;anl:ed tkle residents =or their understanding and cooperation, I exited the structure with Officer- Reillay without incident. Discussed my visual findings with Zoning Enforcement staff and stated the i.±rm.ediate corrections that were requested. The residents had reported to Zoning Enfor.ce.ment staff that there is a total of twelve people living at the address, six in the basartlent a_.-artment and six in the upper apartmen '. Additionally, it was observed that there. is 2- 80 gallon LPG tanks on s.Jcie C attached to a. ]regulator and enter the residence (Am-.r_.gas P00-•323-9699) and 1-86 gallon LPG tank. aide H attached to a reculator and enter+pq the bua..Lding (no contact info) . On side A of the structure observed a fitl and vent for Oil tank storage. Units c1_ared W/o incidenc. 04/26/2007 ?9:51.:47 frul.sifer t, CQM Frze [}dtriL't C1920 04/26/2007 01--9001174 PRi27i�Q0'ii yE'! 8,%8. COMM F IRE DEPARTMENT F+':1( Ids, 508?9i�'1�85 P. 00' A "! DD XXYX ❑+elate I NFTRB -i 101920 ti1A 04 261 ,0 11 1_07-0001174 f 000 6 2 change Basic rD?D .k state.* inc-,dent Pete * station Iocident Number * Exroeure * ❑lk,Aetioity Gods tale pop to Inalc.e•0-ch•.dd—toe tale Lnoiden=!•p�•vld.d en th.Vildla.d nc• _Q1L.u5 7raet I.,I 1 aLocation* ❑x,ddla lb aaetion B'Rlteraativ L...lL,n zi;—Ldleacion". Vac ooly fox aitdl.nd EA—. ®street Eld6re8a 16 " ITHIS WI ❑Intersection N r )ilepoet Prefix street of xi9hway Street sype SUEfin Din front of I LOSTERVILLE 102 655 I-I ❑Rear Of ❑Ad-jacent to Apt'/Salto/Room city 9ta.r,.e UP C'pd6 I ❑Directions cross at_eet or dlreCtiJns, as =licablt C Incident Type # L'9i 1 Date & Times Midnight is 0000 E2 Shift & Alarms 900 apeeial type of iroident, other) check bexm if Month bay You. Hr Min Sete Local Option Qatar sre the �� �� ?ncldant T e aeaa as aaam ALARM el.ays =.Tl-tad GpM23 Aid Given or Received* Date. Alarm * 0A L 26j• 2007 17:53:00 Sun or alarms cistziat D p_atUOfl RA0.TV3W requirec. tmXass canceled or did not erriva 1 (:]mutual. aid received I I -- Arrival 09 , 26 2007 I17.58.36 2 ❑Automatie aid recv. IAeir :DID Thai- ❑ rr v � �°3 3 ❑mutual aid given b IIC° 0011TROLLFC op:lonal, except for wildland fireb Spesaial Studies 4 DAutoxatic aid given ❑Conitrollod LJ L_—J I I I I Local option 5 ❑Other ai.a given Tt alp LAST UNIT CL;ARED, required except for vL1dlsna Ilme ir.cjder,t N11mber LaHt UIIit Si,ecia2 V ®NOIIe ❑ CAoarad ( ndl 4—?j I 20071 ELi!:12 I Study IN Study,Volt. i F Ast ona Taken* G1 Rea ouraes-* `G2 Estimated Dollar Losses & Values 12 rl Ghet:: t'nis box and skip this LOSS&s= Required for all fires if F=own. Optional aaetion if an ArDsra[us ez ror non tires. None 1f 0 II TnforlRation, I Personnel fom io used. � I Apparatus personnel Property $1 000 , 000 ❑ nnlmu.xy Acticr. Taken (1) 8uyprassion I �� I contents SL1 r L_0001 1 000 Rdrilt}sjnal Action Taken (2) 1 1 ._� PRE-INCIDENT VALTM: crt7.oDe1 " t -a: -i Other L_ 0001 �1. L 000J property 0001,1000 HaQ}cional Action Taka: (3) r1 Check box it resource counts L} include aid reCetved.rosources. !,pntenta '�Q � f 0-02, 000 0 Completed Modules H1•*Casual tie s❑Norse H3 Raxardous Materials Release I Mixed Uae Property ❑Eire-L Deaths Injuries N ❑Noaa NN Not Mixed ' �Strt store-3 fire 1 I!� 1 L3Natural Gas: ,l,r 1:aR,no avauatl 10 Assembly use 8orvico on ex a,szue aotsaM 20 Education U30 ❑ :r Cii.l airs caEs_-Q 2 Cjpropane gas: t.,,L td.,new sea eciu) 33 Medical use ❑Fire Se--v. Cas.-5 civili L� 3 ❑(;=soIinet vcuua real Cav) ac Pe•t.bi.`"""" 40 Residential nee 51 Rnw Of stores �$plS-6 uo DGtmCtpr 4 �KeroY4ri®: e..t a�,;ay•an:y,aot or 1ortaLlt sanvage 53 Enclosed mail ❑F?azMat-7 &egUIred for confined Firaa. 5 ❑Diesel fuel!9wu.-I oil:v.tLae E•a.l an►.:„static 58 Sus, g Residential Datactor alerted oc;wpnnte 6 ❑Household solvents: no,a',rsae..psu, cl..p(p,sly 59 office use ❑Wil_dland Tire-6 la ®Apparatus-9 7 DMotor oil: oontaintr 60 ,ratLd tz3Al usm jAlPersonael-10 2❑DeteotPx did net start them 8 Lf"tpaint: fx,b,palnt ouu t,e.lsn7<as 3.uo- 63 Military use � 65 rarm. use ❑P.reoa-11 U[Junknom 0 Qorhes: aaeo.l rosYAt acUm,req..,—.."11.>as9,r•, 00 other mixed us* n..• l.t.ttm a: j Property Use* 3t,xuctureu 341❑Ciinic,ciinic typo infirmary 539 ❑Househcld goods,sales,r"airs 342QDcator/dentist Office 579 Motor vehicle/boat sales/:•epair 131 QChureh, place of worship 361❑P=Lsox+ or jail, not juvenile 571 ❑Gas or sasvioe station 161❑Restaurant or cafeteria 419P91-or 2-family dwe,Lling 599 ❑Business office 162 CBar/Tavern or nigh'telub 429 E)HWti-family dwellirig 615 ❑Elettrio gexlazating plant 213 ME10 Mary school or kindergartOn 439❑Rooming/boardiay hours 629 ❑Laboratory/science lab 215 rlHigh school ex 'Junior high 4490Commercial hotel or motel 700 Ej Manufacturing plant 241 College, ad+ilt edueaki,or. 459❑Residential, board and care 819 ❑Livestock/poultgy storeige(barn) 311 Glcare fao:lity fnr the aged 464),❑Dormitory/barracks 882 ❑Non-residential parking _garage 331 Hospital 519❑FOOd and beverage sales 891 ❑Waroh"So Outside 936❑vacant lot 981 ❑construction site 124 ❑Playg—nd or park 938 Q6raded/oare for plot of land 984 ❑ Iaclustrial Plant yard 655 ®crops or orchard 946❑Lake, xir,gr, stream ❑�'Orest (t1riberland) Lookup and Tatar. a droparty uca coca only it 669 951Railroad right Of way you have NOT checked a Property Uqe box: 807 I;joutdour storage area 960 Other street Psopezty Use 419 319 QDump or sanitary landfill 961 ❑Highway/divided highway 931 []Open land 0): field 962 ❑ n Residetial street/drivoway I1 or 2 family dwelling N&`7x5-1 CC,Mi :ire District 01920 04/26/2007 01-0001174 1PR/27./H07i'FRI 01:27 COMM FIRE DEPARTMENT P, No. 5iJ07G02�85 P. OOI S a CENTERVILLE-OSTERVILLE—MARSTONS MILLS FIRE DISTRICT DEPARTMENT OF FIRE-RESCUE &EMERGENCY SERVICES 1875 Falmouth Road, Rte. 28 Emergency Number: Centerville, MA 02632-3117 Business:(508)790-2375 John M_ Farrington Facsimile: (508)790-2385 Fire PreventionlAdministration Chief of Department Facsimile: (508)957-8239 Dispatch Center FAX COMMUNICATION MESSAGE DATE: C)q- a-1-0-7 TO: PHONE: ATTN: -�t'�t� C�� tC c7 FROM: RAa�F- 4vt � �� rcCj�tiJ : A-,r 4X4O A." t t0 C 6N7. I'Ze Pw-t 1 —n+f 5 t.O-(� WE ARE SENDING #��j L�)PAGES, INCLUDING THIS COVER SHEET. PLEASE CALL.(508)790-2375 IF YOU DO NOT RECEIVE THE TOTAL NUMBER OF PAGES. CONFIDENTIALITY NOTICE: This fax transmission may oontaln Confidential information belonging to the sender and such information is legally privileged and is intended only`or the u6e of the Individual or entity named above, Any copying,diselosure, distribution or dissemination of this Information or the taking of any action based on the Contents of this communication is strictly prohibited. If you have received this transmission in error, please notify us immediately by telephone and return the original transmission to us by mall or delivery at our address above. We shall cover the cost of return mail. Thank yowl ;PR.!27i�00�%F?i 0'C:29 COMM FIRE DEPARTMENT FAX No, 50E79'G2::95 P. 000 ' K4j person/Entity Involved I I ICJ-I•. .^J-L --j ray, Ia;:e.i tlp:lon 3usinexe now of applicable) Azoe Cods Pboae RImber Check This bcs ii s IFirst N I M� ILast Name U suffix same addrens se nme , SpCltlent lctttion. � I 7bsn skip duplicate address V or p_C_ix 9traat or Haghr:ey Street Type SuSiix line. Port Mice Box AHt'/3%Uts,Rocr' City 9tato LIP Code �p More people involved? [heck thie boa and aktaah 5upnlemertal Forma (17FIRS-IS) as necesaa-y . K2 Owner ❑3ene es psrsen involved? ?heft C)leck. Chi s box and akip The sett of this &action. Local Cpticr. Business acne (if 1DP1Ite01B) Area Code P;x7na Nonhez QCbecY. chin bD'/. if MT.,Mb rix•s- Fizsc Nza¢ Hi' Last Name Eutiix •ows address ns I lncitlatlt Sacaclon. ) I �J I ___„ __j i U ?hen 8kl'p the thrsa - - ----- duplicnte addraes .Nwt4ar Frcfix street or Hlt+.say Street Type Suffix lines. L Pose office Box '' tt Apt•/suite/Roan City . L -J I ��i� Stott 211) eooe L R.amarks Local Option Ca11e., Name : PULSIFER Caller Address : 328 OIL t PULSIFER Pats, 0 rcrosby 2007/04./26 17:58:36 - 326 AT EVENT MANNING IS 1 rcrosby 2007/04/26 1?:53:3'1 JOW-7 AGENCY ENFORCEMENT wmonrce ; 2007/04/26 18:39:27 CLEAR 2 1839 C-328 responded with Zoning Enforcement to 16 This fna;�, Osterville. Arrived to meet BPD officer Mike Reilley, Zoning Enforcement Robin Giagregorio, Health Inspector Donna Miorandi and building 'inspector Robert McNechnie. Structure is a two story. wood frame residential building. Vehicles -n the driveway are a Black Toyota Solara MA recg 4223XS and Tan Plymouth minivan MA reg 439FFO. Attempted notification. of occupants via the front .door w/o success. BPD Officer Reilley made contact with a resident on side C of the structure. 5lsght language barrier ir. place, but the resident understands some english. Resident -s Sonia Quezada 508-444-8550• Zoning Enforcement Officer Giagregorio advised 14s. Quezada that the reason for the visit was to inspect a basement apartment and requested permission to inspect, all agencies were identified. Ms. Quezada asked to hold the inspection while she contacted a responsible party for the property. Ms. Quezada made contact with Peggy Freitas L Authorization L9381 PULSIFER., FRANCIS I tmm ?REV. I I 041 1.261e-007 Offlcar In charge ID - Signature Position or rank Aaai¢nment Mon= Day Ye= Box`ie© 1 8381 I I PULSIFER, FRFrCIa -J �FIKE PREY, I I 1 j 041 J I 2007j none co.-rember aakinp report ID Sigcnture Fositlon or rank Jos±gn.•ntat honth ley 'ear � as OFEi 1n char?a• COMB Fire Die-rict 01920 O4/2E/2007 07-0001174 r PR/27i'007iFR Oc,2'? COMM FIRE DEPARTMENT Fj; Id6. 5C!�1i 85 P. CILf MY L'D YYYY L01920 LIL; L, a� 26 2 D C 7 I 1 I 1 07-0ooii7� 000 co�le_c i Narrative MID * state* fnelflent Data * Stntioh nw-doxxt purbar Exposnze HEL=r'ative: Caller ',pane PTJLSIFPR Caller Address . 328 OIC : PULSIFIER Pats. 0 rcrosby 2007/04/26 17:58:36 - 328 AT EVENT MANNING IS I rcrosby ; 2007/04/26 1?:53:37 j0ZNT AGEBCY ENFORCEMENT wmonroe ; 2007/04/26 18:39:27 CLEAR @ 1839 C-328 responded with Zoni.nc Enforcement to 16 This Nay, Osterville. Arrived to meet PPD Officer Mike Reilley, Zonir_g Enforcement Robin Giagregoric, 3ealth. Inspector Donna Mierar;di and Building inspector Robert KcKechnie. Structure is a two story wood frame residential building. vehicles in the driveway are a Black Toyota Solara MA reg 4223XS and `Pan Plymouth minivan M reg 439HFO. Attempted notification of occupants Yip. the front door w/o success. BPD Officer Reilley made contact with. a resident on side C of the structure. Slight language barrier in place, but the resident understands some english. Resident is Sonia Quezada 508-444-5550. Zoninq Enforcement Officer Giag'regorio advised tits. Que:zada that the reason fc_r the visit was to inspect a. basement apartment and requested permi lion to inspect, all agencies were identified. Ms. Quezaca asked to hold the inspection while she contacted a responsi.lale party for the property. Ns. Quezada made contact with Peggy Freitas 508-457-0202, identified as the mother of the owner. Ms. Freitas stated that her daughter was out of the country. Zoning Officer Giagrecoric ad•✓_sed ids. Freitas the reason for the visit and. req,.;ested per'inission to enter. Ms. Freitas denied. entry and stated that she: wanted to be present for the inspection. A mutually con_vend ent date of May 8, 2D07 at 13:00 hours was agreed upon by Zoning Officer. Giagregorio and Nis. Freitas. I asked Zoning Officer Giagregorio to ask permission for Fire to enter to confirm smoke detection was in place for the safety of the occupants. A9s. Freitas agreed to have Fire enter for the sale. :4s. Fretas advised Ms. Quezada that Fire was ok to enter. I entered With permission from both Ns. Freitas and Ms. Quezada with BFD Officer Reilley for security purposes only. Identified myself and Officer Reilley to the other occupants of the structure a;id stated ny reason for entry. We were escorted through the structure entering D doorway at grade level on the C side to the basement. Inside the basement, I observed a kitchen/ dining area to the left on the C side and an area set tip as ;n office straight ahead in the center of the basement. To the far left on side D at the C/D and A/D corners were two makeshift bedrooms with sleeping furniture in place. There was no secondary means cf egress from the bedrooms. Immediately outside the bedrooms is a smoke detector: at the base of the 'asament stairs that' opera ed but appeared to have no a/c. power. The detector is Confirmed to be interconnected with other detectors in the residence, we were then red to the first floor via the interior stairwell. There was a smoke detector at the top of the stairs that operated and is confirmed to be interconnected with other detectors in the structure. There ,here a total .o two rooms on the first floor being used as tearooms <<s well. The bathroom is also iccated on the fi- rst floor at the top of the stairs from the basement. The first floor is separated from the remainder of the first floor of the rest of the hoLse by a doorway inaccessible by these tenants. No CO detectors were found in the residence. I advised Ms Freitas of the 'following concerns via telephone while on scene, no CO detection, SD in :;he CrM Firc Distxict G1920 041'2e/2o07 07-00e1ii4 ".Fk;'%7;`c1ri 7; RI -Ir: COMM FIRE rEPPRTMEP�T "A,y ivo, 5iI-71-,F � �. 0.)5 14M DC) YYYY 1 01920 _� [nj l a I 1 261 2007 1 1 1 07-0001174 J 1 000 1 comFaete State Tuclden. n:tc sta.t_en irc]dant Pmbez i 1Cazzative 71r �' 7t Narrative: basement appears to have no a/c rower, and basement .oedruoms do not k,ave secondary means of egress. I advised .Ms. Fr=taa that I would discuss the same with the tenants and th,nt Z am suggesting that the 'ter?ants relocate all sleepimg areas to the first floor bedrooms for egress reasons. IN15. Freitas agreed that that is a viable interim solutien and I asked her to reinforce the same to the tenants. She stated that she wo.111d and stated that she woulc! lave the smoke detector repaired and co detection in place prior_ to the kLiay B, 2007 ins ection, Ms. Fretas stated that she w*as unaware that the terra-its were using the space in thee basennt as sleeping areas and thought it was only being used as a kitchen and living area only. I handed the telephone to Ms. ;;uezada and Ms. Freitas advised her of our :=veJ=sation. upon ending the telephone conversation, I advised Ks. Quezada of the findings and stated the nee:.; to move all sleeping areas to the first floor for safety xeasons. Ms. Quezada acknov:ledced and stated that she -kin.derstood the urg my and necessity of the inst__uctions. I tbe_,,l;ed t):be residents -'or their understanding and cooperat::or:;, I ezited the structure vrith Officer Reilley without incident. Discussed my visual tindi.ogs with Zonin q Enforcement staff and stated thie imiledlate. corrections that ware requested. The resi�aents 'lad renorted to Zoning Eniorcea:ent ta.ff" that there Ls a total of twelve people living at the address, six in the ba.setnent- a_artment and six in the upper apartment. Additionally, it was observed that there is 2- 80 gallon LPG, tanks on side C attached to a. regulator and enter the residence (Amer-'--gas �00-•323-9699) and 1-90 vallon LPG tank side r attached to a recula`_or and enterinq .:;he buildiTig (no contact 'Info) . -On side A of the structure observed a ii,l,l and vent for oil tank storage. Units cleared i,/o incide-nz. 04/2G/2007 19:r,i:�7 fvu].:ifea i CORM Firs District C192G �9!2h/2UU7 U?-ODU1:74 s a A + MM DD yyyy ❑Delete NFIRS -1 101920 ` I .0 051 1 091 1 2007 U I07-0001310 I 1 000 ❑change Basic FDID * State* Incident Date * Station Incident Number * Exposure ❑No Activity Check. this boy.. to Indicate that the address for this incident is provided on the Nildland Fire Census Tract BLocation* Module In Section B "Alternative Location Specification". Use only for Wildland fires. ®Street address 6 �J��THIS'WY ❑Intersection Number/Mile ost Prefix P Street or Highway Street Type Suffix ❑In front of U ❑Rear of [US TERVILLE � IMA 1 102655 �-1J Apt./Suite/Room City State Zip Code ❑Adjacent to I I , ❑Directions Cross street or directions, as applicable C Incident Type El Date & Times Midnight is 0000 ,+2 Shift & Alarms 900 ISpecial type of incident, Otherl Check boxes if Month Day Year Hr Min Sec Local option dates are the Incident Type same as Alarm ALARM always required 10 1 I I COM2 3 Aid Given or Received* Date. Alarm * 05 09 2007 I13:58: 08 I shift olr Alarms District DPlatoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received JI LJI ❑ Arrival 1 051 1 091 1 20071 I13:59:14 I E3 2 ❑Automatic aid recv. Their FDID Their Special Studies 3 ❑Mutual aid given State CONTROLLED Optional, Except for wildland fires 4 ❑Automatic aid given I I ❑Controlled " " I I I I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires I N ❑ Incident Number ❑ Last Unit ,,�, 1 n91 1 20071 EL.18:00 I Special special None ��J 1 _- ( L l Cleared F Actions Taken * G1 Resources.* G2 Estimated Dollar Losses & Values ❑ Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or Personnel form is used. for non fires. None 80 (Information, I $I I � 0001 ❑ � Apparatus Personnel property �_1 , 000 � Primary Action Taken (1) IUI Suppression U Contents $1 000 ,1 000 ❑ Additional Action Taken (2) I EMS l�J PRE-INCIDENT VALUE: optional I I I Other 1 0002 1 0001 Property 000 000$1 ❑ Additional Action Taken (3) ❑ include box if resource counts $1 - I ' LUG '�� include aid received resources. Contents 000 000 ❑ Completed Modules HI*Casual tie s❑None H 3 Hazardous Materials Release I Mixed Use Property ❑ 11 Fire-.2 Deaths Injuries NNone NN Not Mixed 10 Assembly use F—Istructure-3 Fire 1 Natural Gas: slow leak, no ovaUaticn or xarMac action: .2Q Education use Service U ❑Civil Fire Cas.-4 2 ❑Propane gas: <n lb. tank (as in hares BBQ grill) 33 Medical use ❑Fire Serv. Cas.-5 Civilian 1 3 ❑Gasoline: vehicle fuel tank or portable container 40 Residential use ❑EMS-6 4 ❑Kerosene: feel km=ia 51 Row of stores H2 Detector g equipment or portable storage 53 Enclosed mall ❑HazMat-7 Required for Confined Fires. 5 []Diesel fuel/fuel oil:vehicle fuel tank or portable 58 Bus. & Residential Wildland Fire-8 1 Detector alerted occupants 6 ❑Household solvents: home/office spill, cleanup only 59 Office use❑ QApparatus-9 7 [-]Motor oil: frog,engine or portable container 60 Industrial use ❑}{Personnel-10 2❑Detector did not alert them 63 Military use 8 ❑Paint: from paint enna totaling< SS gallons 65 Farm use ❑Arson-11 UEDUnknown 0 ❑Other: Special HarMat action:requimd or,spill> ssgal., 00 Other mixed use plea —let. the xauaat form J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 57 9 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 361❑Prison or jail, not juvenile 571 [:)Gas or service station 161 ❑Restaurant or cafeteria 419®1-or 2-family dwelling 599 ❑ Business office 162 ❑Bar/Tavern or nightclub 42 9❑Multi-family dwelling 615 [:]Electric generating plant 213 ❑Elementary school or kindergarten 4 3 9❑Rooming/boarding house 62 9 [:)Laboratory/science lab 215 ❑High school or junior high 449❑Commercial hotel or motel 700 ❑Manufacturing plant 241 ❑College, adult education 459[:)Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 ❑Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 [:]Warehouse Outside 936 ❑Vacant lot 981 [:)Construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑crops or orchard 946 ❑Lake, river, stream Lookup and enter a Property Use code only if 669 ❑Forest (timberland) 951 ❑Railroad right of way you have NOT checked a Property Use box: 807 ❑Outdoor storage area 960 [:)Other street Property Use 1419 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land or field 962 ❑Residential street/driveway I1 or 2 family dwelling I NFIRS-1 Revision 03 11 99 (nniM Fir.. District 01920 05/09/2007 07-0001310 S K1 Person/Entity Involved Local Option Business name (if applicable) Area Code Phone Number I_� I I u I I u Check This Box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as incident location. Then sY.ip the three u u duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I U I Post Office Box Apt./Suite/Room City " I -I State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-1S) as necessary R2 Owner Same as person involved? Then check this box and skip The rest of this section. Local Option Business name (if Applicable) Area Code Phone Number I I I " I Iu ❑ Chec): this box if Mr.,Ms., Mrs. First Name MI Last Name Suffix same address as I I incident location. Then skip the three duplicate address Number Prefix Street or Highway I Street Type Suffix lines. I I I I Post Office Box Apt./Suite/Room City " I I-I State Zip Code I, Remarks Local Option Caller Name : FPO PULSIFER OIC : PULSIFER Pats. 0 cadams 2007/05/09 13:59:14 - 328 AT EVENT MANNING IS 1 cadams 2007/05/09 14 :00:12 328 REQUESTED CARD FOR HOUSING ENFORCEMENT Responded to 16 This Way, Osterville for a scheduled follow up to the inspection at thi saddress on May 8, 2007. Arrived to meet with Jeff Lauzon Building Inspector and Peggy Freitas Property Representative. Ms. Freitas allowed entry to the structure. Checked the following violations noted on the previous report: 1. Basement bedrooms: Due to no secondary egress for the makeshift basement bedrooms, all bedroom materials were removed and the wall partitions have been dismantled. Tenants have been relocated, at their choice, to a different address. 2. Basement Smoke Detector: This detector has been repaired to be interconnected with both a/c and battery power. 3. CO Detection: CO detection has been installed and is operating in all areas of the house in accordance with 527 CMR 31.00 4 . Intervening Door: The intervening door separating the two apartments that originally had L Authorization 18381 I IPULSIFER, FRANCIS IIFIRE PREV. I I I 1 0 5 1LL9j 2007 Officer in charge ID Signature Position or rani: Assignment Month Day Year Check © 18381 I I PULSIFER, FRANCIS I I FIRE PREV. I I I �1 I� I 20071 Box if same Position or rank Assignment Month Day Year as Officer Member making report ID Signature in charge. (nMM Fira D.i5tr5.ct 01920 05/09/2007 07-0001310 MM DD YYYY 01920 U 1 51 U 2007 1 1 1 1 07-0001310- 000 Complete FDID State Incident Date Station Incident Number Narrative * * Exposure Narrative: Caller Name FPO PULSIFER OIC : PULSIFER Pats. 0 cadams 2007/05/09 13:59:14 - 328 AT EVENT MANNING IS 1 cadams 2007/05/09 14 :00:12 328 REQUESTED CARD FOR HOUSING ENFORCEMENT Responded to 16 This Way, Osterville for a scheduled follow up to the inspection at thi saddress on May 8, 2007. Arrived to meet with Jeff Lauzon Building Inspector and Peggy Freitas Property Representative. Ms. Freitas allowed entry to the structure. Checked the following violations noted on the previous report: 1. Basement bedrooms: Due to no secondary egress for the makeshift basement bedrooms, all bedroom materials were removed and the wall partitions have been dismantled. Tenants have been relocated, at their choice, to a different address. 2. Basement Smoke Detector: This detector has been repaired to be interconnected with both a/c and battery power. 3. CO Detection: CO detection has been installed and is operating in all areas of the house in accordance with 527 CMR 31.00 4. Intervening Door: The intervening door separating the two apartments that originally had a locking door knob preventing secondary egress from the basement apartment, has been replaced with a non-locking door knob. While on this inspection, noticed combustibles within close proximity to the heating appliances and vent pipes. Also noted the vent pipe from the furnace with a negative pitch from. the furnace to the flue. Advised Ms. Freitas to have corrected as soon as possible indicating both fire and CO hazard if not attended to. She stated that she would mitigate a solution. Units cleared w/o incident. 05/09/2007 16:04 :44 fpulsifer COMM Fire District 01920 05/09/2007 07-0001310 A MM DD yyyy ❑Delete NFIRS -1 101920 I• U 1 05 1 1 081 1 2007 11 I07-0001298 1 1 000 ❑Change Basic FDID * state* Incident Date * Station Incident Number * Exposure ❑NO Activity Check this box to Indicate that the address for this incident is provided on the wildland Fire Census Tract BLocation* ❑Module in Section B "Alternative Location specification". Use only for Wildland fires. ®street address 16 " I THIS WY ❑Intersection Number/Milepost Prefix Street or Highway Street Type Suffix ❑In front of ( I I OSTERVILLE �� 10265.5 I-1 ❑Rear of state zip code Apt./Suite/Room City ❑Adjacent to I [:)Directions Cross street or directions, as a0olicable C Incident Type * El Date & Times Midnight is 0000 E2 Shift & Alarms 900 ISpecial type of incident, Othe Check boxes if Month Day Year Hr Min Sec Local option dates are the Incident Type same as Alarm ALARM always required 10 I 1 I I CQM2 3 Date. Alarm * 05 08 2007 I13:07:27 I I 1� Aid Given Or Received* Shift or Alarms District D Platoon ARRIVAL required, unless canceled or did not arrive 1 ❑Mutual aid received � JU ❑ Arrival 1 051 1 081 1 20071 I13:08:26 I E3 2 ❑Automatic aid recv. Their FDID Their State CONTROLLED Optional, Except for wildland fires Special Studies 3 ❑Mutual aid given 4 ❑Automatic aid given I I ❑Controlled " " 11 I I Local option 5 ❑Other aid given Their LAST UNIT CLEARED, required except for wildland fires N ❑ Incident Number ❑ Last Unit U �08J 1 2�I14.02:04 I StudyaIDl Special tudy aValue None F Actions Taken* G1 Resources,* G2 Estimated Dollar Losses & Values ❑ Check this box and skip this LOSSES: Required for all fires if known. Optional section if an Apparatus or for non fires. $0 (Information, I Personnel form is used. None Apparatus Personnel Property $11 , 000 , 000 ❑ Primary Action Taken.(1) U Suppression Contents $1 , 1 000 ,1 000 ❑ Additional Action Taken (2) I EMS u PRE-INCIDENT VALUE: Optional I I I Other � 0001 0001 Property .$U , 000 , 000 ❑ Additional Action Taken (3) ❑ Check box if resource counts include aid received resources. Contents $1 , 000 , 000 ❑ Completed Modules H1.*Casualties❑None H 3 Hazardous Materials Release I Mixed Use Property ❑Fire-2 Deaths Injuries N [:]None NN Not Mixed 10 Assembly use ❑Structure-3 Fire U U 1 Natural Gas: slow leak, no evaeation or xa=Mat actions 2 Q Education use Service❑Civil Fire Cas.-4 2 [:)Propane gas: <u lb. tank gas in none eeQ grill) 33 Medical use ❑Fire Serv. Cas.-5 3 Gasoline: vehime fuel tank or portable container 40 Residential use CivilianU U ❑ ❑EMS-6 4 Kerosene: fens burning equipment or portable storage 51 Row of stores Detector 53 Enclosed mall ❑HazMat-7 H Required for Confined Fires. 5 []Diesel .fuel/fuel oil:venicle feel tank or portable 58 Bus. & Residential ❑ ❑Detector alerted occupants Wildland Fire-8 6 ❑ omy Household solvents: h /office spill, cleanup only 59 Office use ]. OApparatus-9 7 ❑Motor oil: from engine or portable container 60 Industrial use 63 OPersonnel-10 2❑Detector did not alert them 8 ❑paint: from paint Dana totaling<55 gallons 65 Military rm use use ❑Arson-11 (J❑Unknown 0 ❑Other: spaeial xa=Mat amtiona rngai:ea or spill > ssgal., 00 Other mixed use elect lore the xa=Mat fozm J Property Use* Structures 341❑Clinic,clinic type infirmary 539 ❑Household goods,sales,repairs 342❑Doctor/dentist office 579 ❑Motor vehicle/boat sales/repair 131 ❑Church, place of worship 3 61❑Prison or jail, not juvenile 571 [:]Gas or service station .161 ❑Restaurant or cafeteria 41 9®1-or 2-family dwelling 599 ❑ Business office .162 ❑Bar/Tavern or nightclub 42 9❑Multi-family dwelling 615 [-]Electric generating plant 213 ❑Elementary school or kindergarten 43 9❑Rooming/boarding house 629 ❑Laboratory/science lab 215 ❑High school or junior high 44 9❑Commercial hotel or motel 700 ❑Manufacturing plant 241 []College, adult education 459❑Residential, board and care 819 ❑Livestock/poultry storage(barn) 311 ❑Care facility for the aged 4 64❑Dormitory/barracks 882 []Non-residential parking garage 331 ❑Hospital 519❑Food and beverage sales 891 ❑Warehouse Outside 936 ❑vacant lot 981 [:]construction site 124 ❑Playground or park 938 ❑Graded/care for plot of land 984 ❑ Industrial plant yard 655 ❑Crops or orchard 946 ❑Lake, river, stream 669 ❑Forest (timberland) 951 ❑Railroad ri ht of wa Lookup and enter a Property Use code only if g y you have NOT checked a Property Use box: i 807 ❑Outdoor storage area 960 ❑Other street Property Use 1419 919 ❑Dump or sanitary landfill 961 ❑Highway/divided highway 931 ❑Open land or field 962 ❑Residential street/driveway 11 or 2 family dwelling NFIRS-1 Revision 03 11 99 muWn Or,/na/Wnm rn_nnn1,)QA r R1 Person/Entity Involved Local Option Business name (if applicable) I I Area Code Phone Number U I I I I I U OCheck This Box if Mr Ms Mrs First Name MI Last Name suffix same address as incident location. I I u u Then skip the three U duplicate address Number Prefix Street or Highway Street Type suffix lines. I I U I I Post Office Box Apt./Suite/Room City State Zip Code More people involved? Check this box and attach Supplemental Forms (NFIRS-lS) as necessary R2 Owner Same as person involved? Then check, this box and skip The rest of this section. u Local Option I Business name (if Applicable) I I Area Code Phone Number U I I U I I U ❑ Chec): this box if Mr.,Ms., Mrs. First Name I MI Last Name I I ISuffix I same address as I I U I I U U ncident location. Then skip the three duplicate address Number Prefix Street or Highway Street Type Suffix lines. I I I I I I Post Office Box Apt./Suite/Room City U I I-I State Zip Code L Remarks Local Option Caller Name : 328 OIC : PULSIFER lmotte 2007/05/08 13:08:26 - 328 AT EVENT MANNING IS 1 lmotte 2007/05/08 13:08:14 INSPECTION W/TOWN INSPECTORS Responded to 16 This Way, Osterville on a follow up to Incident 07-1174 . Arrived with Robin Giangregorio- Zoning Enforcement and Jeff Lauzon- Town of Barnstable Building Department. Met with Ms. Peggy Freitas, mother of the owner Livia Freitas. Ms. Freitas stated that she is accepting responsibility for the property in the absence of her daughter. Ms. Freitas allowed entry via the entrance on Side A of the structure. This area is separated from the basement apartment found during the last incident, by an intervening door centrally located in the house. The main unit has no smoke detector issues. The second floor of the unit has two rooms being used as bedrooms, one on the B side of the structure has egress windows of insufficient size. Ms. Freitas stated that that room is not a legal bedroom and is classified as an office, although there was a made bed, dresser and associated personal belongings concurrent with a sleeping area use in the room. There were no CO detectors found in this unit. The intervening door on the first floor separating the two units is the second means of egress for the basement apartment and is locked to prevent entry from the basement side. There were no corrections made to the violations noted to Ms. Freitas relative to the basement apartment, bedrooms, smoke and Co detection since the inspection on 04-26-07. I L Authorization 18381 1 IPULSIFER, FRANCIS IIFIRE PREV.__j 1 1 L 1 1 081 2007 Officer in charge ID Signature Position or rant: Assignment Month Day Year check ® 18381 1 I PULSIFER, FRANCIS I I FIRE PREV. 1 1 I I�J I� I 20071 Box if same Position or rank Assignment Month Day Year as Officer Member malting report ID Signature in charge. _ ._. nio9n ns/nR/?nn7 m-nnnl?QA • . : MM DD YYYY 1 01920 U 15 1 u 2007 L 1 J 1 07-0001298 000 Complete FDID * State* Incident Date * Station Incident Number * Exposure Narrative Narrative: Caller Name 328 OIC : PULSIFER lmotte 2007/05/08 13:08:26 - 328 AT EVENT MANNING IS 1 lmotte 2007/05/08 13:08:14 INSPECTION W/TOWN INSPECTORS Responded to 16 This Way, Osterville on a follow up to Incident 07-1174 . Arrived with Robin Giangregorio- Zoning Enforcement and Jeff Lauzon- Town of Barnstable Building Department. Met with Ms. Peggy Freitas, mother of the owner Livia Freitas. Ms. Freitas stated that she is accepting responsibility for the property in the absence of her daughter. Ms. Freitas allowed entry via the entrance on Side A of the structure. This area is separated from the basement apartment found during the last incident, by an intervening door centrally located in the house. The main unit has no smoke detector issues. The second floor of the unit has two rooms being used as bedrooms, one on the B side of the structure has egress windows of insufficient size. Ms. Freitas stated that that room is not a legal bedroom and is classified as an office, although there was a made bed, dresser and associated personal belongings concurrent with a sleeping area use in the room. There were no CO detectors found in this unit. The intervening door on the first floor separating the two units is the second means of egress for the basement apartment and is locked to prevent entry from the basement side. There were no corrections made to the violations noted to Ms. Freitas relative to the basement apartment, bedrooms, smoke and Co detection since the inspection on 04-26-07. I stated to Ms. Freitas that I had made it very clear to both her and the tenant Ms. Quezada, that there were serious life safety issues about lack of egress, smoke detector violations, CO detector violations and that we had agreed on immediate action being needed to correct the issues. I reinforced the immediate need for correction and stated that an acceptable course of action relative to life safety violations were as follows: 1. Repair the basement smoke detector, no a/c power 2. Install CO detection in the residence 3. Remove the locking hardware on the intervening door to provide secondary means of egress 4 . Relocate all tenants from the basement bedrooms to the approved bedrooms on the upper floors to provide adequate egress I reviewed the four items in great detail with Ms. Freitas and stated that I would allow 24 hours for correction. I set up a follow up appointment with Ms. Freitas for 05-09-07 at 14 :00 hours. I informed Ms. Freitas that if the four violations noted above were not corrected within 24 hours, that I would be forced to issue a non-criminal fire code violation and notification to Child Services would be made for knowingly endangering a child with exposure to an environment with unsafe egress conditions. She stated that the items would be corrected this evening and ready for re-inspection tomorrow. Ms. Giagregorio and Mr. Lauzon discussed additional requirements with time constraints with Ms. Freitas. All units cleared w/o incident. Ms. Freitas gave the following address/ contact information for the owner: HOME: /`nMM Fir. nictrirt ' - - 01920' '. 05/08/2007 07-0001298 MM DD YYYY 1 01920 U L 5J u 2007 � 1 07-0001298 000 Complete Narrative FDID * State* Incident Date * Station Incident Number * Exposure Narrative: Ms. Livia Freitas 36 Sherman Street Wickford, RI OFFICE: Ms. Livia Freitas 1 Locust Street Falmouth, MA 02540 05/08/2007 16:57:16 fpulsifer nnnnw o; o n;�r r 01920 05/08/2007 07-0001298 U.S. Postal ServiceTM CERTIFIED MAILTM RECEIPT (Domestic Mail Only;No Insurance Xoverage Provided) For delivery information visit our website at www.usps.com® Willy M. ��N� - or . - PS Form 3800,June 2002 See Reverse for Instructions Certified Mail Provides: esenea)zopZ eunr'OOSE uuoj sd • A mailing receipt ■ A unique Identifier for your r#fallplece • A record of delivery kept by the Postal Service for two years Important Reminders: ■ Certified Mail may ONLY be combined with First-Class Mail®or Priority Mail® ■ Certified Mail Is notavailable for any class of International mail. ■ NO INSURANCE COVERAGE IS PROVIDED with Certified Mail. For valuables,please consider Insured or Registered Mail. ■ For an additional fee,a Return Receipt m%be requested to provide proof of delivery.To obtain Return Receipt service,please complete and attach a Return Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailplece"Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPS®postmark on your Certified Mail receipt is required. •For an additional fee, delivery may be restricted to the addressee or addressee's authorized agent.Advise the clerk or mark the mailpiece with the endorsement'Restrictedelivery" • It a postmark on the Certified Mail receipt is desired,please present the arti- cle at the post office for postmarking. If a postmark on the Certified Mail receipt is not needed,detach and affix label with postage and mail. IMPORTANT:Save this receipt and present it when making an inquiry. Internet access to delivery information Is not available on mail addressed to APOs and FPOs. SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signatu item.4-if.Restricted Delivery is desired. � -may, g ent. ,, ■ Print your.name and address on.the reverse / / '� \ ❑Addressee so that we can return the card to you. B. Req6lved by(Printe,(�, amp) rC�Dat of Delivery ■ Attach this card to the back of the mailpiece, C(/(� " � Lr 6 Ij O or on the front if space permits. - D. Is delivery address drfferent fro 1? ❑Yes 1, Article Addressed to: FIf YES,enter delivgS�`dsdress bel : f�'I�O 3. Service Type. f _ ;El-2ertified Mail ❑Express Mail 71L�l ❑Registered ;21,Retum Receipt for Merchandise ❑ Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number (rmnsfer from se►vice labeo 7006 0 810 0000 3521 7994 PS Form 3811;August 2001 f 1 ; Domestic Return Receipt 102595.02-M-1540 UNITED STATES POSTAL SERVICE First- a ppair� Did it No.Gwe0 M j • Sender: Plea print your name, address, and ZIP+4 inath's 0x• I 5 I & TN OF BARNSTABLE A o- B LDING DIVISION 200 MAIN ST. S,MA 02601 s- cy A __ , sir►�«,r� �rr�,rr�,,,«rr,r,►nr��,rr�t„�rrr�r�=��ir,��r�r i Town of Barnstable r a Regulatory Services f s BAMSTABLE, y n�Ass. g, Thomas F.Geiler,Director �ArEo i a+°tee Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 June 4 , 2007 Livia Freitas 1 Locust St. Falmouth, MA 02540 RE: 16 This Way, Osterville, MA, Map121 Parcel 141 001 Dear Property Owner: This letter is to follow up letters dating May 9, 2007 and May 11, 2007 sent to you by this office directing you to discontinue use of the basement for sleeping purposes and to obtain a building permit to restore the home to its permitted configuration. To date there has been no application for a building permit. In accordance with CMR 780 118.4 this office may pursue criminal prosecution beginning June 11, 2007 unless the violation is brought into compliance. Each day the property remains in violation shall constitute a separate offense and punishable by a fine of$1,000.00 or by imprisonment for not more than one year, or both for each such violation. By Order, 4 ey L Lauzon Local Inspector Q:zoning5 Town of Barnstable Regulatory Services s r • BAMSfABLE niAss. �, Thomas F.Geiler,Director AtFOMA�A,� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 11, 2007 Livia Freitas 1 Locust St. Falmouth, MA 02540 RE: 16 This Way, Osterville, MA, Map121 Parcel 141 001 Dear Property Owner: A review of our records, including the permitting history of 16 This Way, Centerville, as well as Zoning Board of Appeals.records, indicate that the use of that address as anything other that a single family home is illegal. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You are hereby ordered to discontinue the use of the above-referenced property as it is now being used and restore it to a single-family home. You have until May 21, 2007 to comply or fines will be levied for each day you remain in non-compliance. A building permit must be applied for to restore the layout to accommodate the conversion. You must do this before you make any changes. For any questions, call (508) 862-4034. By Order, *d G� eauzon..#, Local Inspector Q:zoning5 F1ME ram, Town of Barnstable Regulatory Services anxx S M Thomas F.Geiler,Director 1639. p A�FOMP. e� Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 May 9, 2007 Owner/Occupant 16 This Way Osterville, MA 02655 RE: EXIT ORDER 16 This Way Map : 121 Parcel :141 001 Dear Owner/Occupants : The basement at the above referenced address contains bedrooms with insufficient emergency means of egress as required by 780 CMR 3603.10.4.1. In accordance with 780 CMR 121.0 and 780 CMR 3400.5 you are notified that the basement bedrooms are declared dangerous and unsafe and their use must cease immediately. You may call this office at(508) 862-4034 with any questions. Thank you for your anticipated cooperation in this matter. By Order, r e L. Lauzon Local Inspector Q:zoning5 Town of Barnstable Regulatory Services snxwsrnace, 9 MASS. � Thomas F. Geiler, Director 039. 3�° Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 March 27, 2007 Ms. Livia Freitas 16 This Way Osterville, MA 02655 Re: Illegal Apartment: 16 This Way Osterville, MA 02655 Map: 121 Parcel: 141-001 Our records indicate that your house at the above-referenced location is currently being used as a multi-family home, which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. Sincerel emu-- a Edson Amnesty Zoning Enforcement Officer Building Department gforms:zoning3 Parcel Detail Page 1 of 3 THE` 0 "m OVA q�Ita�9 ��r M1`4�li Logged In As: Parcel D eta I I -- - - --- Tuesday, Marc Parcel Lookup Parcellnfo .............................................................................................._...................................................................................................................................... ............................................................................................................... Parcel ID 1 121-141-001 I Developer Lot s I LOT 2 : Location 116 THIS WAY I Pri Frontage!45 Sec Road J Sec I Frontage c.......-..._--.............._..._..._....._......_........_.._ _._..._.._._.........._......_.._........................._.._..._.__._.._..._.._....................... .................._.._........................__..............................__._.._........................_.........---_._...._........... Village 10STERVILLE Fire District jC-O-MM ------------..._.........................._........----._................................._.....- - .......... _._................. ....__.._........................ ....... .............. ......._....._..........................:.__.._.... Sewer Acct j I Road Index 1712 V Interactive p {{ Owner Info —_._.....__.._...................:......_....................__..._...__.._.........._.._.:......_.............- ._.......:..............._...._._._............................._......._. ...................... Owner I FREITAS, LIVIA Co Owner .............._................-----_.._........__....__._....__._._........._._... _.._.._..._..._.__........._...._..._..._......_......... _................ ...._.........._..._............._..._:. Streetl 16 THIS WAY I Street2 City�OSTERVILLE State F. MA j Zip 02630 Country Land Info ...:..........................:........................:...........:.._............................................................................................................................................................._............................................._.............................................................._....._....... Acres .44 fuse Single Fam MDL-01 I zoning ER Nghbd 0107 Topography Below Street. � Road j Paved Utilities Septic,Gas,Public Water I Location IRear Location Construction Info Building 1 of 1 Year 1978 I Roof IGable/Hip Ext Wood Shingle Built .- Struct Wall Effect 1935 I .Roof AC GIs/Cm p Ac None Area Cover I'" Type _............................. .. Style ICape Cod I int 1-D wall Bed 3 Bedrooms WallInt ry I Rooms I Model Residential _ ) Floor r[ I Bat Roomss 2 Full -_-- ---- -.- I 1 Grade Average I Heat Hot Air ^I Total 6 Type Rooms Rooms http://issql/intrane't/propdata/ParcelDetail.aspx?ID=7617 3/27/2007 Parcel Detail Page 2 of 3 Y 8L 6AR` yy- 9MrT� '� Heat I I Found-I ( J ) Stories 1 1/2 Stories Fuel Oil -- ation TypicalLj , LK`S ? FOP Permit History Issue Date Purpose Permit# Amount Insp Date Comm( 2/7/2001 Addn+Renovate 51534 $20,000 10/29/2001 12:00:00 AM 3/29/1996 Remodel 14172 $1,000 6/29/1997 12:00:00 AM BasemE . 8/1/1990 B33921 $5,000 1/15/1991 12:00:00 AM OS DO[ 15/1/1978 620255 $0 1/15/1979 12:00:00 AM OS 11/1� Visit History Date Who Purpose 1/3/2007 12:00:00 AM Paul Talbot Cyclical Inspection 1/27/2006 12:00:00 AM Jason Streebel Measured Only 10/29/2001 12:00:00 AM Martin Flynn Mea./List Bldg Permit Only 12/31/1998 12:00:00 AM Donna Dacey Meas/Listed 6/20/1997 12:00:00 AM Lloyd Kurtz Meas/Est Sales History Line Sale Date Owner Book/Page Sale P 1 10/25/2005 FREITAS, LIVIA 20397/265 2 FRAGOSA,ROBERT J & PAMELA 2692/338 Assessment History Save# Year Building Value" XF Value OB Value Land Value Total Parc( 1 2007 $186,700 $1,900 $600 $190,800 2 2006 $164,300 $1,900 $700 $198,400 3 2005 $150,200 $1,900 $700 $141,500 4 2004 $120,200 $1,900 $700 $176,900 5 2003 $107,300 $1,900 $700 $47,200 6 2002 $86,200 $1,800 $0 $47,200 7 2001 $86,200 $1,800 $0 $47,200 8 2000 $67,500 $1,800 $0 $28,900 9 1999 $62,100 $2,000 $0 $28,900 http://issgl/intranet/propdata/ParcelDetail.aspx?ID=7617 3/27/2007 •• : :le ,1 ,1 .le ••. :11 'r1 'rl .11 ••� '�• 111 'rl '�1 '� • 111 •• ',• 111 'rl 'rl '� • 111 • •�. ',• 11 'rl 'r1 '�� • •11 1 •:: •11 ,1 ,1 • :11 •: � � •11 ,1 ,1 • :11 •:• ,� � •11 ,1 ,1 • :11 �• � ,.. � �r«9�a�,�i'• 4Y� '�C ^`L` �SLt ��]Z }'tY,� g�i( 'iSJ, 5��`��� a'".`�' ����3. h ��a�4 !^ s- � ✓f T ���' xpA t ti tiq iz,. -ta�, � 1K -�'tc�x � i vP, '�, �• � .gyy� a�r',,,�c �i iF� one � �. �',�ar�- ,, �t 3�} � s� q Tip _ _ ' '.._." .e,(}`k 4Y A"��sY �jS N C����� ��♦ +� �� w s,s Mill fi a. .. � `.... <�.`nx��'�'K. ..&.i• � P�.��t"�-s`'�,°n.�e�,�,.,. �.t ..t°i.' r_.�.Ks� ���`.���w .It''�'�"C'.��l,�y}as��Y.��'.sksx +'�, I INN 20255 .TOWN OF BARNSTABLE permit No. ____________________ .• � , l 11,Un,� t.�Building Inspect.°r `'cash ...< < , 3 OCCUPANCY PERMIT Bond No building noi structure shall be erected, and no land, building or structure shall be .used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by he Building Inspector." Issued to Robert J. Fragosa Address 18 Cozy Home Terrace, West Yarmo ;h lot 02 16 This Way, Osterville '• i Wiring Inspector 1��� Inspection date Plumbing Inspec�to U'C ' �� � Inspection date 'f Gras Inspector r � � � Inspection date ✓Engineering Department "7 Inspection date j Q j p� G THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. .......................1. /a3..... i9f? ....... :....... .......................... �� Building Inspector >. /9 4 1 .. f 19 174-S F- A` ' 7• 20 v _ O .__..�,. O otsr8-'.:W/I"3.ToHs O _i000'cSr- LA NHS" - 1 lip 4 1 �. w j Co i $ / i Scale Horiz./vert. 1"-40t PROPOSED PLAN OF LAND IN BARNSTABLE MASS. S 1 or ¢ KEMPTON NICKERSON, BUILDER f Being .lot # 2 as shown on •a plan for George D. Fardy, Jr. by King & Reekie- Assoc. , Surveyors -Scituate, Mass. Elevations shown are in feet above an .assumed datum. t .• i ------------------------------------------------------- DateS Agent: Barnstable Board of Health i I Certify that the foundation shown on this plan is located on the ground as shown thereon and that it conforms to the zoning and building laws of the � . . Town of BARNSTABLE when constructed and to the restrictions on record. f Date, 5-29-78 I • Sub ° Soil . Medium to Course 1 j Sand i & op PIP ,��,�;� Gravel E sJ Thomas A. N Thomas A. N', o JACY,SON c JACK 1N ` No:•8931 ti ` 1;o.8 09 - 9 ` p !9 FO/STO "STr.- �. S�RVEy •"—NAL Test made 5-4-78 No water encountered zerC�test more than - 11. do p per one minute. rn �� ..�. r Assessor's map and lot number L.J SEPTIC SYSTEM MUST BE w ® 72 1� WITH ARTDIC E I IN OSTA STATE Sewage`cPermit number ........:................................................. .,r -+ SANITARY CODE AND TOWN o`tHETo�° � C TOWN OF ,-BAR `T LE �Q - BARISTeDLEi i "39 BU LDIHG.��� INSPECTOR* A'tFOY°r�' 1i tz N APPLICATIOy'FORPERMIT,TO .. .,.X . 7. /... (.Z.�G � 1�.............:................................ m I 3/� 6.P >, TYPE OF.CONSTRUCTION ............ ..... ....... .......................................................................................... ....... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ........ .Q. r... Pil.'...AMY..... 5 (Z V. . ................................................................... '.... ......... ..... .... Proposed Use ...P.WlEa-`1v4� .....EPIL.....OW/l�.Q r..............nn........ .............................................................. b l./ Zoning District ........ .................................................Fire District ......... . Name of Owner ....1. 06.e.N�...V ......�ra..f ...ck...Address ....11.!....0O2r..,Y.....HQ.M.. ....Tf . ....lN...... Name of Builder ...m!-K.....,l)ic. � 0tv............Address a....TfV1.5. 4 /m.y QAT��v,1Le—E ...... ............ ....... .... Name of Architect ...��:...F��..d4. ........................Address fJ.....aZn4 .....lN Number of Rooms ......kJ.........................................................Foundation ...Iq.1....z0o. a . ...������� ............. j L fir, �./ / Exterior ... /...'�I..... II.E T`/.d. ................................Roofing ....APNY9L7 ..... .................... Floors .Il ell. SASAde.CI.....764. .........Interior ..�. y..�AC,CSj... ....��aY.�!�?�. ............... Heating ...F.....��/.—A...........................................................Plumbing .................................................................................. i Fireplace .......l.....GN. ........................................................Approximate Cost ....... or. t ...................................... Definitive Plan Approved by Planning Board -----------_-------------------19_______ . Area a�.......�.......... Diagram of Lot and Building with Dimensions Fee 1� .1. �................... . ............. ...... 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. Name ...... .................... Frammma, Robert J. No ' �� � � � 2O � ---2�5--� Permit for ---.�—..� . �--- � ^"� � mimglm family dwelling --------_-----------.-----. � ` Location ---l6..Thim..Wsy----------. , Oo lle ----'---------------------- �m��rt J Owner ° ^^�����. > --------'^---' -----'' � Type of Cons,r'uc ion ...............f.r.ame................ ` ----.—.--------------------.. ' � . #2 Plot ............................ Lot ................................ ' � � �a� �� '' � �� Permit Granted --------..—.--.]9 � � � Date of |no�ection ------------.l9 ` / �] Dote —...: ..��.0-- A ' � - PERMIT REFUSED ' ..----_—.---.--.----.--. 19 � . , -------~.~.....'.--.—.—.—..—.—..—. ` -----~ .. .-----~--.----. ^' � �--.—..~. � ^ � � . Approved .---------------' lg | � ^ ' � --------.-----.---.---------. . � --------------------......—.�... � � ^ I TOWN.OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Permit# ' Mealth Division Vy Date Issued Z-�''o 1/' �� 0 onservation Division z��/ � f�L� �. Fee Q d:r Collector PTIC SYSTEM MUST BE �.� INSTALLED IN COMPLIANCE Treasurer -e. d-fL11i i WITH TITLE 5 Planning Dept. RONMENTAL CODE AND WN REGULATIONS Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis Project Street Address ttO -VAN% t/J h-U _ Village N-mm y LLL`-- Owner _ 'Zosi--ax S, :E"(rD3A Address IIL1-c Telephone Permit Request �101 fA �,G�. �' �i�3� ,$ r' P, 1 . 1A4 VVA ,fit �•� ,�. Square feet: 1st floor: existing 0 proposed 210 2nd floor: existing proposed a66 Total new 4130 Valuation ao,0(0 Zoning District Flood Plain Groundwater Overlay Construction Type t4b-0�. Lot Size d 0-6@ S4 Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure 'nJF_A t, Historic House: ❑Yes &No On Old King's Highway: ❑Yes 12(No Basement Type: O Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: existing -TW6 new n Half:existing © new 0 Number of Bedrooms: existing TM0D. new 0 Total Room Count(not including baths): existing LD new O First Floor Room Count Heat Type and Fuel: ❑Gas dOil ❑ Electric ❑Other / Central Air: ❑Yes &No Fireplaces: Existing I New_0 Existing wood/coal stove: ®Yes ❑ No Detached garage:❑existing ❑knew size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing 0 new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization O Appeal# Recorded Or Commercial ❑Yes dNo If yes, site plan review# Current Use =a, di we'll I Proposed Use F*Q,w�A4 Q1 W-t V14 BUILDER INFORMATION Name Home- owNL-(L Telephone Number Address License# 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 MAP/PARCEL•NO,. r f� ' ADDRESS- VILLAGE OWNER 1 ,.. f DATE OF INSPECTION i FOUNDATION FRAME ,r INSULATION y FIREPLACE - `- .. ELECTRICAL: ROUGIV C` FINAL PLUMBING: ROUGH' ' : FINAL GAS: ROUGI3 i= S » FINAL FINAL BUILDING r. ^7 U-s DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth of Massachusetts Department of Industrial Accidents �,` , ,�-�=- , '•- Olflce o1/arest/Aatloos _ Y 600 Washington Street v Boston,Mass 02111 Workers' Compensation Insurance Affidavit FIENNEIIME �a R e:�''t" J �R•AGoS A � location 16 -*i�,citV L--tLV i I.L., VtiA. hone�! og -J11 I am a homeowner performing all work myself ❑ I am a sole etor and have no one InIaay capacitv ❑ I am an employer providing workers' compensation for:my employees working on this job. ...... ...... .............}C..... ....... v.......n..... .:.....::::$•.v-•}:v}:::?-i:•:4:{:{??:.;{??•::?-}}i:::v:?•Y::;J:?4;4}}}:•i:???•:}:{?{?v:i•:{:•:•::{.v: ....�•:::'::{!??vi::isi:::ii:i::i:$'::{::�iiif;$;i?i?iiii}j::::mn'::';ii:v:;}i:;:;?isii:!:�j:::::.4t:;i':`:;:::;iii'v,:ti�i:'.!:{{;:}:::.;::;.;;::.:•:i:;+r:::':i::�::is�v:•{.ti???•i}'i}::}:}:}:•i:;:;:<;i:C};i:ti{?:i}}}:;:i;�}::ii:?}?i.�:{.$i::i::Li>i;:;?jiy'j::;:i;ti:;:ti:ti!i::::<•::' e�omoanv':risen .. ................. ..:•:v:..n................-- ......,... ......x.v:.v:r.v:::.. ::::::::::::::?C}:4:::::::::::;v::.:}i:}}:5•:J::.?}::•}::v.:>:{{t::•::... ................... •}:-;;:}:::::::..:.{•::}}:••}r}>:;•}:;:ter.,.;.:.:....:..::::•:::•:..�:::::•::::.v::::. •tt•}}:•fi-•::.,.::::::::.Y.;Y:.}}'•»>::r.,;;. ........v.v::w::-.:..y.,.;..v::..vv;.:.::::.::........::....m::::nv:::::•......4.. ............. ..�..x::.v::::•:........-.....:::?:::::•:--.:v,.. .. :...::w:{::..:...:.... ......... .........................., �v.v::::•:w.?:v:tivv}::::::}}:.:..:-v-.}..^.:n;Y-•ti:}:'-.}v:.}v:.v?.;:ti:.:.}';:;Yr;v:{{:::n;::}::n}v•.ti::ti:;}:;:•i}}:;}:t;}:j3}:�iii:�i:?•::?v` v.Y......... ...................::v:.v;}....... ..v::::::::.:.:...::•..v..... ..x::•:•:.v:},{{'}:'}:v..M.......v.'.{•+:4:{+.-}};-}}},v,.:ry,::::.v:..:4v.v::.v::::.�.}:?{•:}v;}}:i:•iiiY:$isy;::}:::;:�j.?;i.j{{:ijvti:J:;i}::,{>:v:{::;}::}.}+{}.}}}:?:}}:{•ii:?{•::�?:•>' •:i::C^?Y?$$:?::iL:$$:i:{'�$:i:$:+:$$::i:;i::vy;:;:} :;i:ti?$$$$i:�$$:!::v$}:�: .........:.. 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Faga a to seea=s coverage ns wired—der Secdon 25A of MQ.152 can lead to the/mpodllasr of criminal penalties of a One up to SI.Mo0 and/or one yam,haprisomoent as well as dvQ penaWes in the form of a STOP WORK ORDER and n fine of SIo0.o0 a day against me. I understand 6"a copy of this stat—rest may be forwarded to the OMce of Investigations of the DIA for coverage verMation. I do hereby certif3P under thepmu and pmalties of pffjwry that the information provided above it tru.and coned Sigant= Data Past name b�, fTY 7:5, Pbane# So`6) 102 omcial use.only do not write in this area to be completed by city or town omeisl . 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ADDRESS OF PROPERTY. 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: S `1 3. SQUARE FOOTAGE OF ALL GLAZING. L4 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. BUM DING INSPECTOR APPROVAL: t YES: _ NO: . q-fomn-t980303a 780 CMR Appendix J Footnotes to Table J5.2.lb: Glaring 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 ft of decorative glass may be excluded from a building design with 300 fl of glazing area. 2 After January 1, 1999, glazing U-values must be tested and documented b� 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 thus construction. If the insulation achieves the full insulation thickness over the exterior walls without compression, R-30 insulation may be substituted for R-39 insulation and R 38 insulation may be substituted for R49 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 EITHER by R 19 cavity insulation OR R 13 cavity insulation plus R-6 insulating sheathing. Wall requirements apply to 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. `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 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 J5.2.1 a 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(035 for doors). 4w 11 � L EsTIMA TED PROJECT COST wows IEET LNG SPACE Value LIVING (high end construction) square feet X$115/sq. foot= i (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$15/sq. foot= OTHER square feet X$??/sq. foot= Total Estimated Project Value i The ' �Sz" a Town of Barnstable F e�'9: ��0 Regulatory Services 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: cl' ic I 11V 2^1Estimated Cost Address of Work: WAAA Owner's Name: , " Date of Application: (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 2wner 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. r� Q , OR Date Owner's Name q: 6mis:A ffidav BOOK Town of Barnstable Zoning Board of Appeals • Decision and Notice 'Appeal 2000-92 - Fragosa Variance-Section 3-1.3 (5) Bulk Regulations-Side Yard Setback Summary: Granted With Conditions Applicant: Robert Fragosa Property Address: 16 This Way, Osterville,MA Assessor's Map/Parcel: Map 121 Parcel 141-001 Zoning: RC Residential C Zoning District Groundwater Overlay: GP Groundwater Protection District Background: The petitioner is seeking a variance from Section 3-1.3 (5) - Bulk Regulations, Minimum Side Yard Setback to allow for an attached garage to infringe into the required 20 foot setback by 14 feet. The subject property is 0.44 acres located at 16 This Way, Osterville. It is developed with a 1&1/2 story 1,224 sq.ft. (living area) single-family dwelling built in 1978. Procedural& Hearing Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on August 22, 2000. A public hearing before the Zoning Board of Appeals was duly advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on October 11, 2000 and continued to November 15, 2000 at which time the Board granted the petition with conditions. Board Members hearing this appeal were; Dan Creedon, Ralph Copeland, Gail Nightingale, Richard Boy, and Chairman Ron Jansson. The petitioner, Robert Fragosa represented himself at the hearing. At the opening of.the hearing, it was determined by the Board that additional information was needed in terms of a proposed layout plan and elevations of the structure. That hearing was continued to allow the applicant time to supply the information that was presented at the continuance of November 29, 2000. Mr. Fragosa stated that the shed and deck are to'be removed and the addition would house a garage, an expanded kitchen and a study on the second floor. He cited that the closest neighboring home to the addition is some 50 plus or minus feet from his sideline. The public was invited to speak and no one spoke in favor or in opposition to the petition. Findings of Fact: 1. Appeal 2000-92 is the petition of Robert Fragosa for a Variance to Section 3-1.3'(5) Bulk Regulations- minimum side yard setback for the property at 16 This Way, Osterville, shown on Assessor's Map 121 Parcel 141-001 and zoned Residential C and GP Groundwater Protection Overlay. . 2. The petitioner is seeking a Variance from Section 3-1.3 (5)- Bulk Regulations, Minimum Side Yard Setback for the Residential C Zoning District. The request is to infringe into the required.20 foot setback by 14 feet with an attached garage. A proposed site plan of the garage was submitted illustrating the location with reference to the existing dwelling. 3. The subject lot is 0.44 areas in size, located at This Way, Osterville. It is developed with a 1&1/2 story 1,224 sq.ft. (living area)single-family dwelling built in 1978. The home is situated on the lot, 53 feet from the end of This Way, 20 feet from the northern property line and 27 feet from the southern property line. The proposed garage is to be attached to the dwelling's north side, where the 20 foot setback exists today. U.- 4. It would pose a hardship to place the addition in any other location given that he desires to use part of the addition to expand the kitchen and to use the second floor as part of the home for a study. 5. No variance findings were establish as to the unique conditions that affect the locus, but not the zoning district in which it is located. 6. The relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the Zoning Ordinance. Decision: Based upon the findings of fact, a motion was duly made and seconded to grant the variance with the following conditions: 1. The addition shall not encroach more than 14 feet into the required 20 foot side yard setback. 2. The addition shall be built as represented in a proposed plans submitted by the applicant entitled: Plot Plan of Land prepared for Robert Fragosa located#16 This Way Osterville(Barnstable), MA" dated October 20, 2000 by Yankee Survey Consultants, scale 1"=20'and, An Addition for Robert Fragosa , 16 This Way Ostrerville Mass- Plans& Elevations" dated Novembr 20, 2000, drawn by Terry Luff Architect. Both of the plans are hand marked "received 11/29/00 gcn" 3. The existing deck and shed are to be removed i 4. The development shall conform to all regulations of the Board of Health. The Vote was as follows: AYE: Dan Creedon, Ralph Copeland, Gail Nightingale, Richard Boy, and Chairman Ron S. Jansson NAY: None Ordered: Appeal 2000-92 has been granted with conditions_ . This decision must be recorded at the Registry of Deeds for it to be in effect. The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision. A copy of which must be filed in the office of the Town Clerk. 12 1► Ron S. J sson, airman Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20) days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this day of under the pains and penalties of perjury. Linda Hutchenrider, Mown Clerk 2 r CF THE Tp The Town of Barnstable r sssNsr.A. H $ Regulatory Services Eo;p,�`,` Building Division 367 Main Street,Hyannis MA 02601 Office: 508-862-4038 Fax: 508-790-6230 a HOMEOWNER LICENSE EXEMPTION Please Print DATE: q (g m I JOB LOCATION: IS Kj g:, number street village "HOMEOWNER": - m r S f-RP�� (bog) �W S 3118 CSi g) -41-7s name home phone# work phone# CURRENT MAILING ADDRESS: I m WAY VGA• 0A -- 13K-- city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) 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. Signature of H Vownd 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 person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assurning 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 pemtit 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/certifrcation for use in your community. Q:FOAMS:EXEMPTN i Town of Barnstable i.` r. Zoning Board of Appeals " ' - 12� Decision and Notice Appeal 2000-92 - Fragosa Variance-Section 3-1.3 (5) Bulk Regulations-Side Yard Setback Summary: Granted With Conditions Applicant: Robert Fragosa Property Address: 16 This Way,Osterville, MA Assessors Map/Parcel: Map 121 Parcel 141-001 Zoning: RC Residential C Zoning District Groundwater Overlay: GP Groundwater Protection District Background: The petitioner is seeking a variance from Section 3-1.3 (5)- Bulk Regulations, Minimum Side Yard Setback to allow for an attached garage to infringe into the required 20 foot setback by 14 feet. The subject property is 0.44 acres located at 16 This Way, Osterville. It is developed with a 1&1/2 story 1,224 sq.ft. (living area) single-family dwelling built in 1978. Procedural & Hearing Summary: This appeal was filed at the Town Clerk's Office and at the Office of the Zoning Board of Appeals on August 22, 2000. A public hearing before the Zoning 13oard of Appeals was duty advertised and notices sent to all abutters in accordance with MGL Chapter 40A. The hearing was opened on October 11, 2000 and continued to November 15, 2000 at which time the Board granted the petition with conditions. Board Members hearing this appeal were; Dan Creedon, Ralph Copeland, Gail Nightingale, Richard Boy, and Chairman Ron Jansson. The petitioner, Robert Fragosa represented himself at the hearing. At the opening of the hearing, it was determined by the Board that additional information was needed in terms of a proposed layout plan and elevations of the structure. That hearing was continued to allow the applicant time to supply the information that was presented at the continuance of November 29, 2000. Mr. Fragosa stated that the shed and deck are to be removed and the addition would house a garage, an expanded kitchen and a study on the second floor. He cited that the closest neighboring home to the addition is some 50 plus or minus feet from his sideline. The public was invited to speak and no one spoke in favor or in opposition to the petition. { Findings of Fact: 1. Appeal 2000-92 is the petition of Robert Fragosa for a Variance to Section 3-1.3 (5) Bulk Regulations- minimum side yard setback for the property at 16 This Way, Osterville, shown on Assessor's Map 121 Parcel 141-001 and zoned Residential C and GP Groundwater Protection Overlay. 2. The petitioner is seeking a Variance from Section 3-1.3 (5)- Bulk Regulations, Minimum Side Yard Setback for the Residential C Zoning District. The request is to infringe into the required 20 foot setback by 14 feet with an attached garage. A proposed site plan of the garage was submitted illustrating the location with reference to the existing dwelling. 3. The subject lot is 0.44 areas in size, located at This Way, Osterville. It is.developed with a W/2 story 1,224 sq.ft. (living.area) single-family dwelling built in 1978. The home is situated on the lot, 53 feet from the end of This Way, 20 feet from the northern property line and 27 feet from the southern property line. The proposed garage-is to be attached to the dwelling's north side, where the 20 foot setback exists today. f a 4. It would pose a hardship to place the addition in any other location given that he desires to use part of the addition to expand the kitchen and to use the second floor as part of the home for a study. 5. No variance findings were establish as to the unique conditions that affect the locus, but not the zoning district in which it is located. 6. The relief may be granted without substantial detriment to the public good and without nullifying or substantially derogating from the intent or purpose of the Zoning Ordinance. Decision: Based upon the findings of fact, a motion was duly made and seconded to grant the variance with the following conditions: 1. The addition shall not encroach more than 14 feet into the required 20 foot side yard setback. 2. The addition shall be built as represented in a proposed plans submitted by the applicant entitled: "Plot Plan of Land prepared for Robert Fragosa located#16 This Way Osterville(Barnstable), MA" dated October 20, 2000 by Yankee Survey Consultants, scale 1"=20'and, An Addition for Robert Fragosa , 16 This Way Ostrerville Mass- Plans& Elevations" dated Novembr 20, 2000, drawn by Terry Luff Architect. Both of the plans are hand marked"received 11/29/00 gcn" 3. The existing deck and shed are to be removed 4. The development shall conform to all regulations of the Board of Health. The Vote was as follows: AYE: Dan Creedon, Ralph Copeland, Gail Nightingale, Richard Boy, and Chairman Ron S. Jansson NAY: None Ordered: Appeal 2000-92 has been granted with conditions. This decision must be recorded at the Registry of Deeds for it to be in effect The relief authorized by this decision must be exercised in one year. Appeals of this decision, if any, shall be made pursuant to MGL Chapter 40A, Section 17, within twenty (20) days after the date of the filing of this decision. A copy of which must be filed in the office of the Town Clerk. cC�QJ � an Ron S. Jansso Ch ' man Date Signed I Linda Hutchenrider, Clerk of the Town of Barnstable, Barnstable County, Massachusetts, hereby certify that twenty (20)days have elapsed since the Zoning Board of Appeals filed this decision and that no appeal of the decision has been filed in the office of the Town Clerk. Signed and sealed this _ day o =, /—' der the pains and penalties of perjury. Linda Hutchenrider, Town Clerk 2 The Town of Barnstable Department of Health, Safety and Environmental Services 's t�srtsrrettt.E,t�►ss. Building Division �► 1659. 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph NtCrossen Fax: 508-790-6230 Building Commissioner 3 )-I Ltj Home Occupation Registration ,,26, ,9 Date: \�ca Name . Phone �#: �0 � Address: �� F ���✓'� Village: ( ► t inn l v Type of Business: M I i' Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling there shall be no increase in noise or odor,no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • Such use occupies no more than 400 square feet of space. • There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use. • No traffic will be generated in excess of normal residenial volumes. • The use does not involve the production of otrensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance, heat. glare,humidity or other objectionable effects. • There is no storage or use of toxic or liazardotts materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front N:•u-d. • There is no exterior storage or display of materials or equipment. • There is no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not to exceed 4 tires,parked on the same lot containing clue Customary Home Occupation. • No sign shall be displayed indicating the Custotm..try Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. 1,the undersigned,have read and agree with the above restrictions for my home occupation I am registering. Applicant: (� Date:I — - -+ Homeoc.doc f'C/ rG Q SA - JZ Parcel /d//-oo/ Permit# "T d'L �t nnl� Date Issued v �- Board of Health(3rd floor)(8:15 -9:30 0:00-4:45) �•- -�'.��,+ ee a'��. d?J Engineering Dept.(3rd floor) House# 14_4 /1e�:, SEPTIC SYS �-BE Plwi - INSTALLE®B a E 171rTni I, @ff" IINDO TOWN OF BARNSTABLE ` Building Permit Application �` Street Address WaL4 Village 05 i 6RV l (F— Owner 1Zob0—y- - Address \k 5 VVayl OST rV\1/ L 'Telephone (20$ "Permit Request 1htSL 7.14FiC J&I'* - �First Floor square feet Second Floor square feet <� Estimated Project Cost $ Apx-'�\; ord.— Zoning District Flood Plain Water Protection Lot Size Grandfathered ? Zoning Board of Appeals Authorization . Recorded ,--Current Use d{C,Q V6 M �yrK 4l 4 K.y", SL6)L�42 Proposed Use S1a4,mt,- Copstruction Type Commercial Residential f Dwelling Type: Single Family `�— Two Family Multi-Family Age of Existing Structure �S Basement Type: Finished 5 Historic House Unfinished Old King's Highway Number of Baths No.of Bedrooms Total Room Count(not including baths) First Floor Heat Type and Fuel Central Air Fireplaces Garage: Detached Other Detached Structures: Pool Attached Barn None Sheds Other Builder Information Name �� y�21� 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 'V16�J DATE BUILDING PERMIT DENIED A THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PE MIsI NO. V ` Dµ ISSUED M P/ ARCEL NO. RESSi VILLAGE o OWNER 1 DATE OF INSPECTION: FOUNDATION FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: TROUGH FINAL GAS: d RrOUGH FINAL FINAL BUILDING DATE CLOSED OUT' P ASSOCIATION PLAN NO. 1 � i I � _ �� I I � ,� f � � I � � �� � � ; t t �,/ �o CC � � � . �. d , �' � � � � �/ � 1 o N 7 � � � •� � a � � N � Z.y � � � � � 0 �' ,Q ` � �� � - �} � � N '� i I i I i - i 1 I i x I \ I o7 m e.. `•`+�'�� �r�'�y��7y�y Y en r, W�..c v41 -.r 1V 3,�.: ), ...... E - :. '' '��� �'�x`�1 `.4r.Li ty"{r�e S1t'•�. Jt Y1'('yj '' ,ll{ },•��'., J rnst'1 �.c�ifl fter,vrjl .L 1 ' N t Ji • x y 4 ' J�4i Y < i . r .,..Y y. �y Y„S$ j ✓ '.-Vi:;`;r F r r -t 4.J •+ - { Jv o s, c, _ . ,, r, , ,� -.` h•t^,t ' ,x, y 7 Ct�NT k .1' L4".r�, '�,sra 1� s /�-J;L , 1 t }',ycr. y r r,�r>•4h t r r_Z.: N. i 5'�,�, 7y,4 "ti;x q :.Jr x {.!• +r 1 4 1 OWN t t�.tJf J �ju • ! r j 1 �J ,.. r ��� ,:.: •OF�BARNSTABLE . 4 .3 a 3 A� C , t�•. � r � 6UILDING DEPA TM I'a 4" �I! .l�sL7�` ,,t`:,,• �!{, Ft�,�1 , ,�uv� .r ''t• R 11'IF.NT • 4 r,•k. I.y ..'i._ I DK.. ., Tstix r HOMEO R: LICEN ,' ' „ •?. y .t>`yr+Tx nta•� r t',: i. 'EXEMPTION ab �V.� a j�ttrt . Y, s tint i kTs i jl--t x7{�`! 'r •Tr ,! sFl.;Vk, E, 4 yy i -a..•.- r. .♦.. J r t se C?j, �. , �..1 t i: � , .N� i, 4Y jl t t YR ij . , ,J3�1� i 1t'• 44Jrot ,� 6� � Fi��t`!'_. �;..{�,'j, 3 L� I 1 r t v.. � ,fix• < ititCr";. " ' { � - S Y r .�r Ir i- �1.. •dj / i� .�- u,/ ;ijj�� �p y�� vt Z 1 1 i s� / 0 / 1 �`(t�t i.C,,�"�T: �v7' � t a'" C;' •Y ` .J.s1f ,,}4 r- y l �tl ,�T, . • .� t'i � ,.y i e �4�p"'t s 4 `�?r'{,..pl!'S r, i 1 i r r I ♦�•i 0' try , '' t, �,j!' i t G a t.SF . '•a S L.. -" �7bJ.fiiy .'�i.. t`:;���, (,::�, tit: S"' i y r ri ° x i� s� t i. %4r••3� v '�� - �1-j l P-Rv G 1 .� � t i'T. �1) 3 x :5 , f, e i tit aLOCgTIbN 10 vY 1t� f 1 a >ti ..3y,',' o. tTYr)! CC > erCli4° � ) tee c1 -/ ,a':i' St��•°h , f�9 �t,<1L ress ec ,s} Y ± 11�3b ER" fJ �' y' ,z { 1 on o own r f� aa , , , » S 5 ii 'V M -7�tl VJ`. •.t'� t t9�rfir 1"1 r ' t i •Y1 ame 7 ���yyy y df K ,v5 n Y vjj}v Vv 1 ,.lw �"Y j •Y / ,t•'/ .= x'' ` t ;. rsYt ome-P one s, },{P „ �, tAILINQ�°ADORESS` r,� t'� fc l; or P one At�,L w-On' 'y *'' G ��!wf,�111 /H'Isp !� tl,•y�,1-j.ri�I, t d�✓ k S',1� �'11:1 li i 1n� e'. ' {'r ac•4•..!7,�/y' hY }'� {� e . +a ryy t f a r. + '+S'IIl't'Sf'1•r;�.. ]r} , `a11WY:t !•.Gxempti ,�1 QIj F a ngs.-.of"six;uh °S�'o .04" :homeowners'!r'.wa$`extended` o�2T� t�,ri;r` ,., act `" a Qr hird'i,' o dot ' ,rhos :,an, o allow` sucfi 'fiomeow ncIude�Awner;occupied� 'a` g' ery *;�t:t @ L'. t�possess a` r'p nei's.,:to..,,en a isor: (Sta 6 license, rov e 9 ge, an.. • OF wilding Code Section Io id d that'the ow w w. Se net • �F;NIT • :., . ' P�rsQ` IONS HOMEOWNER. on.......9. • • „ siden�s�'who: owns a:parcel ..of...:. on�wfitcti:';there:` Land:on which he/she resides or x rattached or��detached structuresI intends to re_ ^' is, o ; is intended to be A'person " ccessor a one to six family dwelling, {;who constructs more than one home- a ,considered 'a homeowner , Y to to and/or farm structures• ;form acceptable to the Building"homeowner" Year period shall not be'' � ��for all such work shall submit to the Building Officiel, . . Performed. underithe0buNdin' that he/she shall be 'respons ` Buildndersigned "homeow er 9 perms ec ion able .W ing`'Code and other n assumes responsib li • er applicable cod i tY for compliance w undl' ned ° es, by-laws, rules and regulatih the State `: .BgxastAblegU9ldin homeowner" c�e.rtifies that he/she under tons. ';�a.nd.,tha he/she ding De �hinimum inspection stands the Town of 1 ' Comply with said procedures and requirements :HOMEOWNER!S SIGN procedures and requirements;t3. ; .: •s ATURE APPROVAL OF BUILDING OFFICIAL �xl tAl s . 3•' 1 J '�ote: Three{fami 1 .�d • e .comply:with State Y wui l ings 35,000•- Co f /•'or� B Iding de.Section 127t0 larger, will be Construction ControIQuired h t # 8 r 0001.10 HOME OWNER'S •EXEMPT ION i The `6da state thatz permit Is required. „Any Home Owner performing work for wh'Ich a bulidlhg ':.'(Sedtlon 109.1 .1 _ shall be exempt from the Llcensing of Construction Superv•Iso�s)slons ot' th(s section `Home'Owner engages a .person(s) for here to do such shaII act as sups „ ch wotk provided •that. ft;a rvlsor. that such Home Owner Many'. HOme. OWhers who, use this exemption are unaware the.=.-:•responsibl l sties �' p e that ` the :tor,. Llcensln ot-a supervisor (see A Y are assuming. 9 Constru;ctlon Supervlsors, Sectione2tl15 Q� Rules and Rep.lat►ons• often;resu I is In aer I;oua.ptob lams. un[Icensed particularl � ' ' This lack. of awareness' ::unl lcensed Persons: .�;.Y.-^ - Y when the ' Home Owner h'1res In• this case our Board ' cannot , roceed, a aI • �; - Person .as I t� wou I d With_ erv.l.sor I s u l t�,mje ly.. Capp l b l ensed Supervisor The'""Home Owner ns t:' the e. ...... act.ln 'ensurethat. th ,.• e Ala . OI�1 Owner s e .. .coimnun l f'les Q r er+ i fully l y away h i e' ' s part of the erm I t eot s�her•,respons I b I i I t I'e cert.lfy that he/she understands,.the responsl PPIIcatlon c'�,m�nY• last`' a th'at;.'•4f�e.Noma:''.Owner'.'.: p,ge of..this: IssUe�,18'a:foam`current.) bI l It les'°ot a su erv'lsor. ; care:::to`amend .and'•�a'dopt'`-such ' Y used by' severa i tow .,, r;. a :form%certi towns...,! You ;ma. . Ication for use iri'your.. commun,Ity.. :Y..: �t fo Assessor's office(1st Floor): P d�C S�STEiiC brae i(i.SE 1ASIALLED TIIf Assessors map and lot number .. IN COMPLIANCE Board of Health(3rd floor): `?� _ t WITH TITLE 5 Sewage Permit number 7 , i • -T ;ENVIRONMENTAL CODE AND : Deaa9TGDCL Engineering Department(3rd floor): r MU& House number TOWN REGULATIONS °o 2630. Definitive Plan Approved by Planning Board 19 APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN OF , BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION t A 9'O©G Lr—Pr v,.c e, O/ /-7 19 77 Cl TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location & ��/I.S Proposed Use jIZA46-2 Unl t�Z-D Ta EEC, ANC MP40 M Zoning District C- Fire District C� ® /zp, I n Name of Owner �jD�t�-Q?-�T �,ex1(rC�/� Address /6 o WAiJ Dy -&R tllat' Name of Builder Address 5AA4 L Name of Architect AIIA Address N/4 Number of Rooms 5Z)PA -1) E�'1fi/N�' �? Foundation Exterior Roofing cE®An. S14 /JG-i_c ASeAA(,T SN/NG-u: Floors �^XlS-IlV� Interior 20[,K Heating Plumbing / 4�- Fireplace 414 Approximate Cost �(�D/� 'Area A r eZola Diagram of Lot and Building with Dimensions Fee L5 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 e FRAGOSA, ROBERT J. - j No 33921 PermitFor Build Dormer . Single Family Dwelling r Location 16 This Way f Osterville Own-or 1 Robert J. Fragosa Type of Construction Frame Plot Lot A Permit Granted August 17, 19 9 0 Date of Inspection /i�3 19 Date Co pleted Y; I � yf"zI '-'"'`[�t�ir-'{:k,.,r-3.'-"^�....1.-.. �„f=u Q,sy'<1'7!..r+Vr'^tiS+.�..3�:�,i'e..-+<va.r,;.y;,.,•-.r��:7.�»i+St'11�'�f'`�F'v'.•,rf.,:.„r.+l,�,i:"�'•,r•4'y;'a';_-rf%w-, -t.h...{;. �1:4;,gyp.:�^:Y,,•ry.. ,..,..;� .. . ....•. .•:.Y. Assessor's office(1st Floor): Assessor's map and lot number y J Q ( �� Q�oiTN:rto� (Health 3rd floor): e Board of ) Sewage Permit number 7 1� ' �J V Z DAHII9T_4LL Engineering Department(3rd floor): r�ia House number 039, Definitive Plan Approved by Planning Board r i 19 �o rr,Y a• t APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:60 P.M.only TOWN OF BARNSTABLE ri BUILDING INSPECTOR �= APPLICATION FOR PERMIT TO TYPE OF CONSTRUCTION 1A9 ©®Gl h^ -7 19 ICJ TO THE INSPECTOR OF BUILDINGS: ' The undersigned //hereby yy-applies for a permit according to the following information: Location L!� �HI.0 WHV Proposed Use �2i/2/uG 2 0/� To E xl Nl� �d0 M Zoning District 4 Fire District Name of Owner RaSUL% , T F2,471r05,4 Address I Al WA 1/ DJ PER V I&Ul Name of Builder 91 r)&—izz Address Sty i'� it Name of Architect �/ Address A/4 Number of Rooms FX8122) 612T/N �� Foundation 0/5TIA) i Exterior eE9�AR S�(A) Roofing �aA c T Sfll N if`L Floors e-X)SI mA— Interior. SMJ ,e T 20 L(C I Heating /p I ��'�s1iNG- �. 0;6 APT AIXI Plumbing Fireplace N14 Approximate Cost Area /" Are CI�� e� Diagram of Lot and Building with Dimensions Fee 5_2>oa 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 FRAGOSA, ROBERT J. A=121-141-001 �No 33921 Permit For Build. Dormer Single Family dwelling Location 16 This Way Osterville Owner. Robert J. Fragosa Type of Construction Frame Plot Lot Permit Granted August 17, 19 90 Date of Inspection 19 .r Date Completed 19 ' y t I 1{ F e PERMIT COMPLETED 1,1/ /9 .4, N A 174 5 P t i f ZSA f 1 All ' O :• , -.. r P O DUST Iio><' •W� 1'S ToH£ i 9 e rE5rvIT' • A l - r aCD IUC AL i / � O P � N j•O P. Scale -Horiz:/very.- 1"-40� �i.9b - _ PROPOSED PLAN 'OF LAND IN BARNSTABLE ,MASS. F for KEMPTO,N NICKERSON, BUILDER Being lot m 2 as shbwn on a plan for George D. Fardy, Jr. + by King & Reekie Assoc. , Surveyors Scituate, Mass. Elevations shown are in feet above an-".assumed datum. s ------------------------------------ Date Agent,. Barnstable Board of Health t , i Sub s _ Soil 24 iMedium ` to i Course Sand & t F' 4 Gravel iI ' �ZN OF Thomas A. ys Thom--A. JACKSON No.8937 ; B `�, ^N0.l;=J9 y �ECIStEP�opQ „t_`� �i 144 �4o Test made 5-4-7 SUFV No water encountere Perc.test more than 2" drop per one minute. .._.._._............ L.�..'.....� AAe cor's map and lot number .. :...!......t-:........ Sewage Permit number .....................7Z.............................. + f FTNET��y TOWN OF BARNSTABLE • 3AHH9TdDLS; i ° IIA". BUI-LDING INSPECTOR wry APPLICATION FOR PERMIT TO ........ n....ti...�. ..... .... ILC)G�a. .........'�................................................. TYPE OF CONSTRUCTION :7��r �F1 Pl�.......................................................................................... .... ............t. ..... ..°Z.........19. r TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: r i Location1 o.r...� , T'�1r5 ,�1f� 1/ STr-2 c,'.I ...:. ............................................................................................... ....................... Proposed Use ... 1�.! // A ��, Fa YZ ()W&) P /. Zoning District ....... ..�.......�........................................Fire District ....�........ ................................................. Name of Owner ... /?�? '1` \ .... '/"'C,� ,/'r!":,....Address ....�.r1 j.... ( 7 Y' f-a/!! 62 ! ...T�:../�.. ....�.!...'. .. Name of Builder ..: !. ........ / .�� 1�\ .............Address r�{/�....1!v �y.... 5�=�(/1L:.....:.... ....•:........•... .... ..•..%Y ............... Name of Architect • - (r-6. .........................Address I (47-,_I / 7 / r.......6 t�,. 1� / ' J �1 rrr Number of Rooms f�.......................................................Foundation � J �"P/.I l�'1.. !`f` ,C' Exterior ............................ ....................................................Roofing .........:.... ................,................................................. Floors 3// . � t -:..:e...V5Ae'TP�I ��/�.........Interior .1,7/. q„. ./1CC�.... . ..�fLY.4tiGl .................. - Heating ... ... .... .................................................. .....Plumbing .................................................................................. J Fireplace ....................................................`......Approximate Cost ................r................................................... Definitive Plan Approved by Planning Board -----------_------_-----------19_______ . Area :.....` a.U....... '.......... Diagram of Lot and Building with Dimensions Fee C> '............................................. iSUBJECT TO APPROVAL OF BOARD OF HEALTH f-'1 1 I - 1 I I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. X'64-rName ...... ,. .�...r.....��1LA-41s.rt....:.�...................... Fraomma, Robert J. A=12 N� ..20255_. Permit ..`_l .l �_.m�mry _. ^ ---.. - -. ----' single family..��ell ------------^----.—.~—.----- � Location ---l8..�bla..Wav_.^. ....................... � � Osterville ----.---------------------- Robart J. Fr � Owner --------.�--. .......................... - ' . � . ' /ype n" Cpnv/rvp/pn . � ----------------- Plotot � � Permit Granted ' - Date of | . . ` uo,= Completed PE I REFUSED � � . / ��i�r'—' 19 ' .'..T��' ~—.—..—... ........ —..--.--..—... � ' ^ ~ --,—..._^.......---.--....—..,—..—. � � ' � ~^—'—^^^—`~—'--^^^^^'—'--^--'--^—~' ----~--'—'—~---'--''---'—'—'—^~—' Approved ................................................ lA � --------------...,....--~...—..— � . � -----------------.-------.~ � � h K The' Town of Barns le tab g Department of Health Safety and Environmental Services 5 Building Division 367 Main Strut,Hyannis MA 02601 Office: 508 790-6227 Ralph Ct0sWn Fax: 508 775-3344 Building Commissio: For office use only Permit no. Date • . AFFIDAVIT ROME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair;modernization,conveyo n, improvement,.removal, demolition, or construction of an addition to any precasting owner occupied building containing at least one but not more than four dwelling units or to structures which am adjacent to such residence or building be done by registered contractors,with certain exertions, along with other requirements.Y!e T of Work: ��Sl� �IaSt�►'�Ey� Est Cost ��,d(�6,f Address of Work: kaVIWS Z ne, i✓(LV j I I e' O%mer.Name: -PiYr Date of Permit Application;^ 3 I hereby certify that:. ` Registration is not required for the following reason(s): Work Gcduded by law _ _ob under S1,000 Building not ow ner-oecttpied Owner pulling own permit Notice is hereby green that: CONTRACTORS TFI OWNERS PULLING THEIR OWN PERMIT OR DEALING WI [ iEGi3'iF�ED FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MG'L c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contietor name Registration No. OR ` The Coniniottff'ealt/t of Atassaehusetty -- •n: _... r-:��� Department of Industrial Accidents =� OlAceaf/Btt8MIZ1/oos W.;1. 600 11 aching;tun Street '4 }-•; � Bonon.Mass. 02111 Workers' Compensation Insurance.ARdavit --ie_nnnt ntormationi- �fi �...... CA_ name• 1 `,,) location- l I�1. 1�W?Vl e MA pho -37 I am a homeowner performing all work myself. ❑ 11wam.assole proprietor and have no one working in any capacity ❑ I am an employer providing workers' compensation for my employees working on this job. cam any nnme- ad d refs• - cih•• n one#• - ineurnn��en polity# ❑ 1 am a sole proprietor,general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company n•nte• address: cotx• phone#• incurnnce co polio•# L ..:u: :«--:-r::-• :_ - :.,..v,r cr.�•,.-••�•.R�s -, •TJRFFO�4l�' r�iS+.W:r. ..... ----�5 �mRanv name: address- caty: phone#: �wt.. !nee co off•# . :Atiach additioiial'sheet if tii eR1 1,7 _•.�Y.: .•.r%�: .;_t'_�^H"'_� _dy,+�_`'`".=.., ,.. '. "'` :':+:`� Failure to secure coverage as required under Section 25A of 111GL 152 an lead to the imposition of esimival penalties of a fine up to$1.500.00 and/or one.•ears'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day apainst me. 1 understand that s copy of this statement may be forwarded to the Office of Investigations of the D1A for coverage veriftation. I do herebr certify under rite pains and penalties of perjuq•that the infornmdon pmided above is true and correct '� eSinature ate _ I �LP Print name 0 b a one#T 1 377� official use only do not write in this area to be completed by city or town official city or town: permittlicense# rnlluilding Department oUcensing Board ' check if immediate response is required QSeleetmen°s Once (311mltb Department contact person• phone iY; nUther (MISedaro4 PJAI r • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE • ,...... . .. . . JOB. LOCATION Number Street address Section of town "HOMEOWNER" Name Home .phone Work phone - - PRESENT MAILING ADDRESS 1 1h S W_0_\�6 '.f 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 to six 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 acre-ptable 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 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 procedures and requirements. YOMEOWNERIS SIGNATURE 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 Owner shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming 1 the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for .licensing Construction' Supervisors, Section 2. 15) . This lack of awarenes 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 " weer- actin, as supervisor is ultimately responsible. To ensure. that the Home Owner is fully aware of his/her 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. i ZONING. RC" w AS MAP.' 121 ROUTE 2e �o PLAN REF• 321133 N S Ao• y o "C" � sFLOOD ZONE: SUBSKETCH DEED LA F• C Q NOT TO SCALE d ' 1``' ., WATER O VERLA°Y PROTECTION AREA: "WP" ' '��P.t• ,O 20.00 c� ,$A �y o sse AS LOT 15—4 �� TYIIS ' 9� gU�ps � � o AS LOT 15-5 SHED TO .� LOCUS MAP BE REMO VED 6, 0 AS LOT 141-1 PLOT PLAN OF LAND 0 � AREA= 17661 f sq/ft PREPARED FOR 00.00 HSE o a` �'� ROBERT FRA GOSA L 5 � LOCA TED —C> #16 THIS WA Y AA OSTER VILLE (BARNSTABLE), MA. 0' �1 OCTOBE'R 20, 2000 8' ' (b �b C d' )"ANKEE SUR VE Y CONSUL TAN TS P. O. BOX 265 _ UNIT 5, 408 INDUSTRY ROAD MARSTONS MILLS, MA. 02648 S84 51'40'E , PH.(508)428—0055 — FAX(508)420—5553 � AS LOT 141-2 500, GRAPHIC SCALE 11-G w Oi 20 0 10 20 40 80 I CERTIFY THAT THIS SURVEY AND PLAN WERE MADE IN ACCORDANCE WITH THE PROCEDURAL AND TECHNICAL N STANDARDS FOR THE PRACTICE OF LAND SURVEYING IN tea 32M IN FEET ) TjfL�'OMMONWEALT OF MASSACHUSETTS. C� 'OpQ �ypt- 1 inch = 20 ft. /DZ3 �6 �9ss�o Q PA UL A. MERITHEW, P.L S. 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