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HomeMy WebLinkAbout0018 VAN GOGH DRIVE S Van NE Town of Barnstable BARNSTABLE. Regulatory Services Y MASS. 1639. Building Division 200 Main Street,Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Location 1,5? PPW V0e6-1- OS �. Permit Number Owner a I ILI, 'srs CIAt Builder �A One notice to remain on job site, one notice on file in Building Department. The following items need correcting: 9sr6 7oo? add ►�� � /�i�uC �L�/� e--V A/l Tpi 3 s � /4a 5—.. /JC- #1�eIU6 O�t-G= aF 6 ::'�5'!�7 — / ID NFU O/V csG�PC�S� Sl/I.yOS�� Sc l��iU S !��(IES �E U/ DS7 /O At N 19'a E Tc=� f i �N6 . Alt- i I" U ( lease call: 508-862-403$for re-inspection. Inspected by ku� Date t7 //`/ f ��6 i . r� f /� �. f / i i � � „a,. 1 I .,�- � `., �--• r - �. ,. ,�.. _�., "� --;.- - z "� �� 4 - - � �. c �� t • ti i 1 jr 1 1.004 l4 x 16 OR - � � a ems!". '�s � �` •"'� ;�I'' � .. �: 4 , � c . 19 ' +� �� ?'} i :�1. r� � i c Le- ��~w �` I �. � ��rV. - _ �-�-�� •S^ -.��� n �N� _ - — _ MF4' ^ -- - � � , �- r - _. .. _.. �- �. . . . . : .. .. ...:, . .. ir _�� � � ^ »l . , . � @ lit � � _ » r� TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel `U l `�ppltivtoo Health Division / Date Issued Conservation Division \J 1�' Application Fee Planning Dept. Permit Fee 3tlf�� Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation/ Hyannis l �"' Project Street Address I IR i/A►J l�Oc''41 T--)Q 07 4os S Village C)sjPcz►1\lc Owner rANE �� t�22 i it Address Itnl l M Rios-., Telephone -1]L4-71Q8-3Cp La Permit Request Cached Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuationz -- - °a 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 ighway:�Ye8❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other E L_ Basement Finished Area (sq.ft.) Basement Unfinished Area (sq Number of Baths: Full: existing new Half: existing new. Number of Bedrooms: existing —new F a Total Room Count (not including baths): existing new First Floor Roo Count rn Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_. Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name �iAfUE JD9_6iiminrit MAiLLc)u:X Telephone Number Address License # Qj n \e_ ME D'�to& Home Improvement Contractor# Email d inne c S Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Lod v SIGINATURE ATE ! L3 0 Pa FOR OFFICIAL USE ONLY r � APPLICATION# I DATE.ISSUED r MAP/PARCEL NO. ADDRESS I VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME ��RINIt'J Z/G/r� R I INSULATION 1 I }: FIREPLACE , ELECTRICAL: ROUGH i FINAL _ 1 � PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING ti t DATE CLOSED OUT' +4 L ASSOCIATION PLAN NO. 10, , y r r 1 f - 1 . 27w Comrrmoparcceah*ofMassachaseM Deparhumt qfhaaksbialAccideltr t ce ofinvestigafiam ; 600 YYtashuagtd a:Street Bostarl!,MA 021LI ", raasmgmldi a W,ar ersCompensafianInsuranceAffidavit:BuiTders/Conf 7acinrsMectricians/Mumbers - �pl�cant^Ilo1armaf.an PleasePrinf L�ibIy N c Oipnizadonanavida4:hide) Loe-mozz,-m tAp i t, -e-%- /Z,Sr-tatr-/Zip- Areyou an employer?Check the appropri oz: T of o ect (r a contractor and 1 3l 1 e4u u edj_ 4 L❑ I am a employer with � 6_ �Nevi o,,,�.,�� employees{full and/or partAime�* have hired the sub-eontractoLs 2,❑ I am a sole proprietor or partues listed on the attached sheet F- ❑Remodeling ship and have no employees These sob-contractors have g- ❑Demolitioa working forme in any capacity_ employees and have workers' 9.- ❑DuildEng addition [Na worker'comp_mmxanre Comp_mcnranr¢ required] 5. ❑ Vile are a corporatianand its 14❑Electrical repairs or additions 3 I am a homeouu-er doing all work officers have exercised Their If-El Plumbing repairs or additions [No workers'comp- right ofe-,w 6oaper MGL 110 Roof inrranrerequired_]F c_152,§1(4),and wehavveno repairs cf -❑Other employees_[Nowod=' comp_insurance requi esl.I *Amy sppbcmtthatchedsbax-#1mastalso5noutthesecfianb9wsbmvdngflieawakesTmimpmorfi upormyink T Homeowners vita submit this affi&rviR in sdbmk a nzw a£fid3cit in,raCstin rnrh tnrs that cfieck this boot mast sttadhed as additional shed shotcine the name of the and state whether ocnot those e�fSes have emplmyees. if the s vcautradas hope empioyees,they must pmvide their warltre comp.palicg uwnber. Iam arc empLyw that is pro}idfxg worker'comperurdion irm4rimcs far azy employees Belau is the policy artd job site inforaza- olL Insurance Company Name: Policy r'-or self-ins.llc�9: Fxp rattoIIDate: Job life Aaldmss City/Stat e/25p_ Attach a oopy of the workers'compensation policy declaration page(showing the policy member and expiration date). Failure to sem recoverage as regairedunder Section25A o€MGL c. 152 can lead to the imposition ofcriminal penalties of a fine up to$I.500.OD and/or one year imprisoumert,as well as civil peaalties in the form of a STOP WORE:ORDER.and a fine. of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Irrvestigatiom of fe DIA for insurance coverage-veriEccation_ I de.here rti rtnder tks ' s a id penalties of my fhartha ircforrrcation prmddsd abm,e is true and correct Ahone# .7 7�" ZO,g'— /n R Ca (7 fj�uial use vuI}`. Do not cvrihs in this area,fa be rarrtpieted by city or fawn af�`iciaL City or Town: PermiVLicense# Issuing Authority(drele one): 1.Board of Health. 2.Bag-ding Department I Cityfrowa Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone Ih 6 Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto this statute,an anployee 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 Iocal 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 ntmrber(s)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partaers,'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 Indus'a-ial 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 ls 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-in sttrance license number on the appropriate lime. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at th e 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 permitAlicense 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 a 5da.vit 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 fir 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 ailidaNdt The Office of Investigations would Re 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. nc$ Commaawealih of Massachusetts Depaztment of Indust dal Accidents 0#!Qe of kvestigafiGm 600 WazMnUton Stzeet Bostou,MA 02111 Tel.A 617;727-49-GO Gxt 406 Qr 1-UT MA��SAFli Revised 4-24-07 Fax#617-727-7749 - www-mas,-,,gov/dia 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 Legibly Name(Business/Organization/Individual): �G✓fi'�( �f//�//J� IU Address:- 11,7% A�k tt 1(LX C ru City/State/Zip: 1WYJ1_f n011 Phone#: Are you an employer?Check the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 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.l required.] 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work ' officers have exercised their I L E]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.] *Amy 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. $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.#: 1 1 Expiration Date: (' Job Site Address: V I City/State/Zip: h/ �. Attach a copy of the workers' compensa on 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 certify under the pains 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 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 alleemployers 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 Fax#617-727-7749 Revised 4-24-0Z . . www.mass.gav/dia. Town of Barnstable - -' Regulatory Services - pfZ Teti Richard V.Scali,Interim Director Building.Division - i ReRwcrA131 : - Tom Perry,Building Commissioner M4s14� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 HOMEOWNER LICENSE EXEMPTION - Please Print DATE: �:/ � JOBI.LOCATION 7 V/9 A) L'i0G /:'H c S'T�R Ul L� number street village I II,>EowrrEx�: 1���a.iI� La,rF2r���► PA1LA,6bx 771/-z08-3�83 508-375-1A�1�-ly name home phone# work phone# CURRENT MAILING ADDRESS: _/AJ cityltown 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` eowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection pr c"dures and r uir ments an a she will comply with said procedures and requirements. o tt�1/ Sign a of mcowo, /— Appi-oval 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 1091.1-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. I • e`tr r Town of Barnstable o� Regulatory Services •Richard V.Scab,Interim Director 039. `�� �. Building Division Tom Perry,Building Commissioner ' 200 Main Street;Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete.and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my bel alf� in all=ttets relative to work authorized by this building permit (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date L . •. 570857 NAME SHIPTO ADDRESS ADDRESS CITY,STATE,ZIP CITY,STATE,ZIP ORDER NUMBER DEPARTMENT SALESPERSON E WHEN SHIP TERMS HOW SHIP DATE QUANTITY DESCRIPTION PRICE AMOUNT l Lr O T l V` 4C 3 h�b Life l h Iva 4 ll � ►S � v� °D yy �w 1L)rL J 1 bra BUYER: Moo KEEP THIS SLIP FOR REFERENCE L 570858 NAME SHIP TO ADDRESS ADDRESS D m CITY,STATE,ZIP CITY,STATE,ZIP ORDER NUMBER DEPARTMENT SALESPERSON WHEN SHIP TERMS HOW SHIP DATE I F I QUANTITY DESCRIPTION PRICE AMOUNT Inc; S CD R V V � -`• W CIJ ' r✓ L 1�fi a h `o� A BUYER: moo KEEP THIS SLIP FOR REFERENCE i Community Systems, Inc. Heritage Park 280A Roure 130,Suite 1 Forestdale,MA 02644 p:508-833-0945 F 508.833-0961 e:info@csi-ma.org January 30, 2014 To Whom it many concern, 91 Community Systems Inc. is a non-profit agency that is contracted through the Department of Developmental Services(DDS)to provide supports to individuals with developmental disabilities. We currently rent a home on 18 Van Gogh Drive in Osterville where one woman is provided with 24 hour staffing supports. When the homes second floor egress is inspected and approved by the Town Of Barnstable building department, another young woman will be moving into the home. There will always be a minimum of one awake staff in the home at all times with these two individuals. Each woman is ambulatory and can evacuate the home independently in the event of an emergency. The 24 hour staffing is necessary to insure safety and well being of both women. If you have any further questions or concerns,please contact me at my office at 508-833-0945. Thank you, Sarah Sampson Program Director Community Systems Inc. ------------- hZ .h «d IENFNZ Management Services by: ���������� �O ��Ol Community Systems,Inc. Division of Management/Support Services 7926 Jones Branch Drive,Suite 105 McLean,VA 22102 .� �:, i. C �. � f .. ..._ t i i i fCommunity Sarah Sampson Systems, Inc. Program Director ` Heritage Park 280 Route 130 A-1 Forestdale,MA 02644 p:508-833-0945 c:508-367-6414 _ E 508-833-0961 c:sarah.sampson@csi-ma.org i I i I i I I - I I I I i Mckechnie, Robert From: Mckechnie, Robert Sent: Thursday, January 30, 2014 8:54 AM,I To: 'sarah.sampson@csi-ma.org' Subject: 18 Van Gogh Drive, Osterville, MA Good Morning Sarah, I would like to clarify the information required by this office on the property listed below: 18 Van Gogh Drive Map: 146 Parcel: 104 Osterville, MA, 02655 Property Owner of Record: Diane M. Lorenzetti First, Under M.G.A. c. 143 and the Massachusetts State Building code, 780 CMR 51, a Building Permit is required for the work that has been done on the property. The building permit should be applied for by a Massachusetts licensed construction supervisor with proper credentials. Second, it is common practice for the agency creating a facility of this type to submit a letter on company stationary to this department that contains the following information: 1.) Who the Corporation is. 2.) What the Corporation is. 3.) How does this Corporation operate in the State of Massachusetts? 4.) A description of the program at this property. Including the number of residents, ability to self preserve, number of staff there and when the staff is there. 5.) What state agency oversees the operation of the facility. This letter has commonly been signed and sent to us by the Operations Director or an officer of the corporation. If you have any questions, it may be easier to correspond by email as the phone has not been productive. Thank you in advance for addressing this. Robert McKechnie Local Inspector Town of Barnstable 508-8624033 CIY q ' . is Parcel Detail Page 1 of 3 y h1A55. a f Logged In As: Parcel Detail Monday,January 27 2014 Parcel Lookup Parcel Info Parcel ID 146-104 I Developer Loot LOT 43 Location 118 VAN GOGH DRIVE I Pri Frontage Sec Road I Sec I Frontage Village JOSTERVILLE I Fire District C-O-MM Town sewer exists at this address No I Road Index 1768 Asbuilt Septic Scan: Interactive 1461041 Map Owner Info Owner ILORENZETTI, DIANE M I Co-Owner I Streets 118 VAN GOGH DR I Street2 City OSTERVILLE ( State MA zip 02655 I Country I —� Land Info Acres 10.39 ( use ISingle Fam MDL-01 I zoning I RC Nghbd 0105 Topography Below Street ( Road I Paved Utilities I Public Water,Gas,Septic I Location Construction Info Building 1 of 1 Year 1984 I Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living 1267 I Roof Asph/F GIs/Cmp I All. Central Area Cover Type _ Style Cape Cod I weuBed Drywall I Rooms 3 Bedrooms Int _ Bath r, s Model Residential I Floor Carpet I Rooms 2 Full I w Grade jAverage I Type Hot Air I Rooms 5 Rooms Stories 11 33/4 Stories I Heat Gas I Found Poured Conc. Fuel ation Gross 2580 Area Permit History http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=9561 1/27/2014 Parcel Detail Page 2 of 3 IIIssue Date I Purpose I Permit# I Amount I Insp Date I Comments II Visit History Date Who Purpose 8/25/2011 12:00:00 AM Nancy Finch In Office Review 1/20/2011 12:00:00 AM Mike Keating Cyclical Inspection 7/2/2007 12:00:00 AM Paul Talbot Cyclical Inspection 12/23/1999 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 2/15/1985 12:00:00 AM IFR Sales History Line Sale Date Owner Book/Page Sale Price 1 4/30/1999 LORENZETTI, DIANE M C152903 $127,000 2 10/31/1997 SIROIS, SCOTT M&JENNIFER J C146389 $109,950 3 2/15/1990 CUGINI, DAVID J&KATHLEEN C119720 $96,000 4 7/15/1984 ELACQUA, FREDERICK C97622 $72,900 5 7/15/1983 1 GREENBRIER CORP THE IC92500 1 $0 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2014 $111,600 $17,300 $4,100 $106,700 $239,700 2 2013 $111,600 $17,300 $4,200 $106,700 $239,800 3 2012 $119,600 $17,300 $3,300 $133,400 $273,600 4 2011 $130,400 $0 $0 $133,400 $263,800 5 2010 $129,900 $0 $0 $135,500 $265,400 6 2009 $130,900 $0 $0 $157,900 $288,800 7 2008 $138,300 $0 $0 $169,000 $307,300 9 2007 $154,400 $0 $0 $169,000 $323,400 10 2006 $134,600 $0 $0 $173,300 $307,900 11 2005 $127,300 $0 $0 $138,300 $265,600 12 2004 $101,600 $0 $0 $83,000 $184,600 13 2003 $90,400 $0 $0 $45,900 $136,300 14 2002 $90,400 $0 $0 $45,900 $136,300 15 2001 $90,400 $0 $0 $45,900 $136,300 16 2000 $70,000 $0 $0 $31,400 $101,400 17 1999 $70,000 $0 $0 $31,400 $101,400 18 1998 $70,000 $0 $0 $31,400 $101,400 19 1997 $68,300 $0 $0 $27,900 $96,200 20 1996 $68,300 $0 $0 $27,900 $96,200 21 1995 $68,300 $0 $0 $27,900 $96,200 22 1994 $70,200 $0 $0 $28,300 $98,500 23 1993 $70,200 $0 $0 $28,300 $98,500 24 1992 $79,900 $0 $0 $31,400 $111,300 25 1991 $77,100 $0 $0 $48,900 $126,000 26 1990 $77,100 $0 $0 $48,900 $126,000 27 1989 $77,100 $0 $0 $48,900 $126,000 28 1988 $59,000 $0 $0 $18,600 $77,600 29 1987 $59,000 $0 $0 $18,600 $77,600 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=9561 1/27/2014 Detail .,g. of Photos htt �'`�+y��.� <f7�12r'A;�,,� 3>�r�"�y •� +Rhr i .r t': � '+�f,�YCMo.> �w V �t �: t..-a ,F 1�,fr�t t x.s. �t,'�t't c :a y�" i�.. t5 ,+• � 4L �'..�,�, .ice s \ i fit.- . �� s �,,.,+„�-+".,..:. • §r� ...� � Vie, J ..i� a7N?/zoo7 }�'�—i►' :..,,, ��.�i` +e�iov2w ^.�.� vl •�.+�-•^- '* • ..�.. .as,.l • • • • ••. • • • 1/27/2014 Building Detail Page 1 of 1 DF fHF Q n �' T. 9 SABKSTARLE "C`Jy i i*. .. 7 �---� .. I ter'+.,�^� �/Vt/��//��� ��ff�� e ..y.J-��.• Logged In As: Building Detail Monday,January 27 2014 Parcel Lookup Parcel Detail Building 1 of 1 14, w: gRfl' �4 j II Code Description Gross Area Effective Area Living Area BAS First Floor 768 768 768 BMT Basement Area 768 0 0 WDK Wood Deck 276 0 0 TQS I Three Quarter Story 1 7681 4991 499 Extra Features Code Description Units Unit Price Year Built Value Comments BMT Basement-Unfinished 768.00 23.00 2000 $17,300 Out Buildings Code Description Units Unit Price Year Built Value Comments WDCK Wood Decking w/railings 276.00 19.50 1999 $4,100 http://issgl2/intranet/propdata/BuildingDetail.aspx?PID=9561&BID=9946&N=1&NN=1 1/27/2014 780 CMR 421.0 GROUP RESIDENCE 421.1 Scope. Except as may otherwise be specifically provided for in 780 CMR 421.0, the requirements of 780 CMR, in its entirety, and as applicable, shall apply. 421.1.1 Department of Mental Retardation (DMR) .Group Homes. 780 CMR 421.0 shall not apply to premises operated or•licensed by the Department of Mental Retardation (DMR) pursuant to 115 CMR 7.00 and 8.00, upon the completion of a DMR safety assessment for each individual and an approved safety plan for each location where services and supports are provided. Such premises shall be treated as conventional R-4, R-3, R- 2 and R-1 use as applicable. LnCA � � I 03 rn 8/22/08 (Effective 9/1/08) 780 CMR- Seventh Edition 103 i Community Systems, Inc. :: Contact Page 2 of 3 "...Diana met a number of CSI Massachusetts: staff and chose Shari to work with her.Shari's high energy and Guri L. Davis, Executive Director zest for life encouraged Diana to try new activities.Diana started Community Systems, Inc. Phone: (508)833-0945 working at TJMaxx, joined 280 Route 130, Bldg A Unit 1 &2 Fax: (508)833-0961 both the health club and Weight Forestdale, MA 02644 E-mail: info aecsi-ma.oro Watchers,and began volunteering..." Read more about Diana r Click here for more stories on Virginia: LIVING LIFE WELL Robin Bell,Executive Director Community Systems, Inc. Phone: (703)913-3150 8136 Old Keene Mill Road,Suite B300 Fax: (703)913-0200 Springfield,VA 22152 E-mail: info aecsi-va.or4 Community Systems,Inc., Division of Management and Support Services: Richard Buckey Chesley, Ph.D., President/CEO Janet Butler, Senior Vice PresidendC0O Cyndy Davison, CFO Community Systems, Inc. Phone: (703)448-0606 7926 Jones Branch Drive, Suite 105 Fax. (703)448-0609 McLean,VA 22102 E-mail: info oncommunitysystems.org Community Systems, Inc., Board of Directors: Harold L.Thomas, Chair Community Systems, Inc. Division of Management and Support Services 7926 Jones Branch Drive Suite 105 McLean,VA 22102 Governance of Community Systems(CSI)is overseen by a nine person Board of Directors which serves in common the three corporations within the r CSI family(Connecticut, Delaware,and Massachusetts). http://www.communitysystems.org/contact.html 1/27/2014 i Community Systems, Inc. :: Contact Page 3 of 3 The Board is actively engaged in corporate oversight and fulfillment of its fiduciary responsibilities, meeting three times per year in person for a total of five to six days. Meetings are held in rotation among the CSI states of operation. In addition,the Board also engages in frequent teleconferences to remain abreast of clinical,program,operational, and financial matters. The professional backgrounds of Board members are: • Amy Yenyo,JD,Chair(Law and Public Administration) • Simon Auster, MD,JD(medicine and public administration) • Kevin Beecher(banking) • Amy Yenyo,JD(Law and Public Administration) • Linda Marsh(education) • Donald Shapiro, MD(medicine and health care administration) • Janet Butler(services administration) • Richard B.Chesley, Ph.D. (psychology and public administration) • Mary Jane Theilhelm • Ellen Einstein The Division of Management and Support Services(DMSS)serves as liaison, staff, and secretariat to the Board.The Board may be contacted through DMSS. Persons interested in reviewing key CSI corporate policies,e.g.,avoiding conflicts of interest and reporting corporate wrong-doing, may obtain copies through DMSS. Persons interested in reviewing CSI's IRS 990 Forms may do so on GuideStar(www.guidestar.org). Accessibility Privacy Policy WEBSITE DESIGNED BY DESIGN PRINCIPLES http://www.communitysystems.org/contact.html 1/27/2014 Community Systems, Inc. :: Contact Page 1 of 3 Supports We Provide We Support People with... Living Life Well FAQs&Resources ABOUT DIVISIONS EMPLOYMENT PARTNERING CONTACT Search: Connecticut Virginia Delaware Management&Support Services Massachusetts CSI Board of Directors Connecticut: Catharina Ohm,Executive Director i Community Systems, Inc. Phone:(860)482-2887 295 Alvord Park Road Fax: (860)482-2678 Y Torrington, CT 06790 E-mail: info cDcsi-ct.orq a Delaware: David Paige,Executive Director Community Systems, Inc. Phone:(302)325-1500 New Castle Corporate Commons Fax: (302)325-1505 2 Penns Way, Suite 301 E-mail: infoe-csi-de.org New Castle, DE 19720 http://www.communitysystems.org/contact.html 1/27/2014 i Community Systems, Inc. CC Heritage Park,280 Route 130 A-1 Forescdale,MA 02644 .�j . Y .�:' � .. L' l it f r � i Parcel Detail i Iz� 06-1 LoK ��A �-�C 416 t-61,,,,^ ,� ge 1 o�f� I Vucr'r' ��, � •yy Y i i '1' J�Itr Y )�t LXaf 0&+W) Ck+4V— K)6 Axle ✓�X /c v'�•� Logged In As: Parcel Detail Thursday,January 23 2014 Parcel Lookup -01 ^'W J Parcel Info o. Parcel ID 146-104 Developeor LOT 43 Location 118 VAN GOGH DRIVE Pri Frontage luu� Sec Sec Road Frontage V t^N L Village JOSTERVILLE Fire District C-O-MM k-. Town sewer exists at this address No Road Index 11768 1 / o i Asbuilt Septic Scan: ` p Interactive Map 1461041 - Owner Info Owner LORENZETTI, DIANE M Co-owner Streetl 118 VAN GOGH DR street2 City JOSTERVILLE State FM—A-­l zip 02655 Country Land Info �Q Acres 10.39 use Single Fam MDL-01 zoning RC I Nghbd 10105 Topography Below Street Road IPaved Utilities Public Water,Gas,Septic Location Construction Info , " Building 1 of 1 Year 1984 l Struct Wall Roof Ext Built Gable/Hip all Wood Shingle \VD Living 1267 Roof Asph/F GIs/Crap Type l Ac Area Cover Central —I �J Style Cape Cod In BedDrywall I Rooms 3 Bedrooms Model lResidential l Floo Carpet l Rooms Bh 2 Full w 1/ Grade lAverage Type Hot Air tal Rooms 15 Rooms stories 11 3/4 Stories Fuel Gas F etion Poured Conc. l t�� Gross 2580 "i U Area Permit History http://issgl2/intranet/propdata/ParceIDetail.aspx?ID=9561 1/23/2014 Parcel Detail Page 2 of 3 IIIssue Date I Purpose I Permit# IAmount I Insp Date I Comments II - Visit History Date Who Purpose 8/25/2011 12:00:00 AM Nancy Finch In Office Review 1/20/2011 12:00:00 AM Mike Keating Cyclical Inspection 7/2/2007 12:00:00 AM Paul Talbot Cyclical Inspection 12/23/1999 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 2/1 5/1 985 12:00:00 AM FR r - Sales History Line Sale Date Owner Book/Page Sale Price 1 4/30/1999 LORENZETTI, DIANE M C152903 $127,000 2 10/31/1997 SIROIS, SCOTT M&JENNIFER J C146389 $109,950 3 2/15/1990 CUGINI, DAVID J&KATHLEEN C119720 $96,000 4 7/15/1984 ELACQUA, FREDERICK C97622 $72,900 5 7/15/1983 1 GREENBRIER CORP THE IC92500 1 $0 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2014 $111,600 $17,300 $4,100 $106,700 $239,700 2 2013 $111,600 $17,300 $4,200 $106,700 $239,800 3 2012 $119,600 $17,300 $3,300 $133,400 $273,600 4 2011 $130,400 $0 $0 $133,400 $263,800 5 2010 $129,900 $0 $0 $135,500 $265,400 6 2009 $130,900 $0 $0 $157,900 $288,800 7 2008 $138,300 $0 $0 $169,000 $307,300 9 2007 $154,400 $0 $0 $169,000 $323,400 10 2006 $134,600 $0 $0 $173,300 $307,900 11 2005 $127,300 $0 $0 $138,300 $265,600 12 2004 $101,600 $0 $0 $83,000 $184,600 13 2003 $90,400 $0 $0 $45,900 $136,300 14 2002 $90,400 $0 $0 $45,900 $136,300 15 2001 $90,400 $0 $0 $45,900 $136,300 16 2000 $70,000 $0 $0 $31,400 $101,400 17 1999 $70,000 $0 $0 $31,400 $101,400 18 1998 $70,000 $0 $0 $31,400 $101,400 19 1997 $68,300 $0 $0 $27,900 $96,200 20 1996 $68,300 $0 $0 $27,900 $96,200 21 1995 $68,300 $0 $0 $27,900 $96,200 22 1994 $70,200 $0 $0 $28,300 $98,500 23 1993 $70,200 $0 $0 $28,300 $98,500 24 1992 $79,900 $0 $0 $31,400 $111,300 25 1991 $77,100 $0 $0 $48,900 $126,000 26 1990 $77,100 $0 $0 $48,900 $126,000 27 1989 $77,100 $0 $0 $48,900 $126,000 28 1988 $59,000 $0 $0 $18,600 $77,600 29 1987 $59,000 $0 $0 $18,600 $77,600 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=9561 1/23/2014 DetailParcel Page of 3 11 1 •'• •• 111 1 1 611 611 � �- � •� r r ,t� �. �*ry . xr$� ys ,3R5 v j., + �',~� a a, S� r 4 _ y ',r1^'�•ram L _.� �..TS.wr�!['°w"�s � + � y 1. y y� i E iYp � N RY-:K PN '2. M �' .+� �'a.•.c 1— .M'� +w�F'N'. �"� V"'��i � Av^ III ii i 1 rn161411:51p Michelle Cartocci I Q Massa a lrsti fax # (s Tax Tracts To : DRENDA FROM : MI ii£: swilbi"s inspection Phone: (Svs) fAX # (508)790-6230 £r latl:mich schooLcom Vr-5c"t Date sent Ja for Review. Time sent 12:4 ?'lease Cop"t"c"t Ntrw+b cif a Assessor%,map and lot number �................ � �� llll.. Q Sewage Permit number .......................................... DkWSTSDLE • Housenumber ........................ ................................ CFO YPY Ar. TOWN OF BARNSTABLE BUILDING INSPECTO APPLICATION FOR PERMIT TO G` ill�1.( ...... �%�1lf "�• / TYPE OF CONSTRUCTION ............................................. ................./Al...............19. TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: rrr Location ..............................................�:.0-x. ........... ..........4,1.!( ....G� �......... ........... ProposedUse ..................................//..!t. l..� ................. ................................................................................ Zoning District A...,........................................Fire District ................. Name of Owner ............... .1%F`'�.. L.S .....�0 ..l�.Address ........... ...0A....T......... ........ Nameof Builder ................... ................................Address ..................................................................................... Nameof Architect .........................../........................................Address .................................................................................... Number of Rooms ........................ ......................................Foundation � ...... vre.4 ..... Exterior ............. ....... Z. . .`P�.?�....G... .�D„5.....Roofing ......................... �. 4 ,..:.. .3.. ............ Floors 1. 1 ........... ��'-`a..�..........Interior ............... �.Y ' !. .0.Cr.&....................... Heating ................. . !1 ....x.....6.!�51..................Plumbing ........................! ....1?Q l...l.................................... .... Fireplace ..................................................................................Ap roximate. Cost ...............�,i... ...�r......v.U......... ............... Definitive Plan Approved by Planning Board ----------4'-u 19- 3 Area !!..C�...... ................ Diagram of Lot and Building with Dimensions Fee 694-1 SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS 1 hereby agree to conform to all the Rules and Regulations of the Town of Bornst9bITregarding the above construction. Name ......... ..... .................. Construction Supervisor's License ....... .(�.(..L1.� ...... � � ` GREENBRIER CORP. ' ' ` . +�Single Family DwelIi . .. .......................................................~................ ' � Location —�ot-4.34__l8_Vao. �oob_I��. , .` - ____._. Oo le___________.. � Owner .....G.r ob i��...COro .______. _ Type of Construction .....F.r���......................... ' --------------------------. � � ` Plot ............................ Lot ................................. ' . ' � � � ^Mkarolz 21 84 Permit Granted ---------��---]A � - . , Date of |nopechon ------------lQ . . � ' Date Completed � � . � . � � ` � , . ~ . � � ' ` ^ . . . . � ' . . � . � � ` . ~^ ' � | ' .1 �a 7" o 6N N , Oo r \ 07, S1 T a o T y3 �V �M w a 9- 3a s 8 Y,00/oo I I T a ?- qZ 0 , lY �- CERTIFIED PLOT PLAN N� �3 ROB€RT 9G �3 VA A/ kQ VF VIDRE 1N 3TE Ey�j Hfl su SCALES 1/0' DATE - 3 S :;D�y Q_GE El1IGl/VEEA/NQ Ca- !N� 2� N�R�E,¢ 1 CERTIFY THAT THE F l' --�- -- D yN bA /aN EGISTERED REGISTERED �2206 SHOWN ON THIS PLAN 19 LOCATED CIVIL LAND JOB NO. ...._.._,.,,,.. ON THE GROUND AS INDICATED AND ENGINEER SURVEYOR May: fit/ CONFORMS TO THE ZONING LAWS OF BARNSTABLE , MAS 712 MAIN STREET CH»NY� Lai. H YA N N I S, MASS. BHEET:�OF�_„ 3.1�y ;z DATE RED. L ANh SURVEYOR FROM TOWN OF BARNSTABLE BUILDING DEPARTMENT Mr. Francis Lahteine 367 MAIN STREET HYANNIS, MA OM Town Clerk Phone: 775-1120 L SUBJECT: FOLD MERE DATE June 13, 1984 MESSAGE Work has been completed under Building Permit #26181 (Greenbrier Corp. ) . Please release Bond. 1 i DATE (57 REPLY i SIGNED i I i N87-RMI RECIPIENT: RETAIN WHITE COPY,RETURN PINK COPY - -- - PRINTED IN U.S.A. r. • 1. _'.r i• i"^! 4i —;itf �' :,.r•,i^'S'a't i,.4�/• 'ti :J' 1 .I . Si+!!1?.� %v�.4'�'I `C'-'s.r�'�`^ljR.✓ k a .4: •�,� � -E:L. -,�it :'1� , i,.�+:�:', ^.� , ti }'j`'�. �3 � i+ � f;,� � sM�e.,%�3:.�.• s 1 { � J �„�•;` . TOWN OF BARNSTABLE _126181,________ . � . . Permit No. ` •Building Inspector MA"ITm 1 Cash -------__---- "`~� OCCUPANCY PERMIT Bond x______.___.___ Issued to P Corn.; Address "r T^-6 A I 1 Q_*Tf,— P+s. 1- r�,..-0...• (lcircarcai 1 l ra WiringInspector • �• Inspection date .+. •^ _ • Plumbing Inspector � + Inspection date Gas Inspector ( � �. Inspection date Engineering Department Inspection date%G'�" Board of Health Inspection date �/d?L w THIS PERMIT WILL;NOT BE VALID;AND THE BUILDING SHALL NOT _BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. Built a Inspector Assessor's ma and lot number ' p; L......(....... ........... c�THE ro Sewage Permit number .... .................................. ..,..:...... c; /y ybR r 9 BA"STABLE, i Housenumber ..........................................................:............... * b a �O 39• �0 OR a. TOWN OF BARNSTABLE BUILDING INSPECTOR_ APPLICATION �6� f� LIC TION FOR PERMIT TO ...................................................................................................................:......:.. 1AA,-t-. , TYPE�:OF CONSTRUCTION ............................................!�.,�'��..T�.,....................................................................... ................. ..�..7................19.SCf TO THE INSPECTOR OF BUILDINGS: The-'undersigned hereby applies for a permit according to the following information: G /�© Location ..............................................Lo r.....................?...3.............(•�%gt .........�. .....t......... .... .........;�a°'.-... ProposedUse .................................. ...................F!�I�°^r.� ...............................:........ .........I......................... Zoning District ......................e.. . ........................................Fire-District .................C...�....................................�....... Name of Owner ...............r. ticr�.:� •r!�.....�QQk' A,Address ...........XJ.(). .... 5 .... ...(?.......1.2t, Nameof Builder ............... .� ..................................Address .................................................................................... Nameof Architect ..................................................................Address .....................................:.............................................. .Number of Rooms ........................v ......�.......................................Foundation ....................�..!�.��- �,.....n �.0 Exterior �:.f.......5.!�: �; (�1'�.... .A/�,S.....Roofing ......................../.'4S�?�j :�..7.:....... ��S............ �. ........... / z Floors ..........v� ............Interior ...................... N-o-� ��L 6<, ....................... Heating ............:.....................:.:.:..:........................:................Plumbing .................................. . - . Fireplace ........................ r. ...............................................Approximate. Cost .............. C ..V.... ............ . .... .. Definitive Plan Approved by Planning Board -------__ ! ��_19_ _� Area . F..................... Diagram of Lot and Building with Dimensions Fee ........ �.................................... ©a SUBJECT TO APPROVAL OF BOARD OF HEALTH Fl/0 UiL ,T H i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. 'Name ....... :............. Construction Supervisor's License a i 1, "; � GREENBRIER CORP. A=146-6 No ..... Permit for ..12 Story ................................ ........Single....F a.m.i.1 y...D.we.l.li...n.g............. .. .... .... .... .. . .... .. .... .. .... .. Location ... .........18...Va.�I...GRV.h... .. . .... ..... Osterville ................................................................. Owner -...G.re.e.nb.r.ierop...Cr .... ...Greenbrier.... .. ........ ........ .................... Type of Construction ..Frame .......................... .. .... ..... ................................................................................ Plot ............................ Lot. ................................. Permit Granted .,March....2.I.!...............19 84 ..... .. .... Date of Inspection ....................................19 Date Completed ....................... ....... ........19