The URL can be used to link to this page

Home My WebLink About0059 CHURCH STREET i 4 i i f NO. 152 O'/o d -i� -�a �� `�� I ,,� - - � 4� a ;� �,: i o ,.. I .�, o , � ,, ;; <, EI r\J�pr r_` -1. W (^'1 �.1' d (�� \J O a � � m 9 4 I /. 4/7 1 t ' DLL) � . _.�... _ it y Town.of Barnstable *Permit# PERMIT Regulatory.Services Fee 6mn Susue die • •wxrrsrnst.E, - "T4 1'� 0$ ;� Richard V.Scali,Director 944/ TOWN Building Division fO . N OF S RNKA®LETom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY �S3 dO� COY; Property Valid without Red X-Press Imprint Map/parcel Number / �f /�� Property Address,, S�, !/✓ _ &reResidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 -...-----...- ---...._....- --._._..- - ....._.._...--...._........__...... _.._..- -- .............-- -- Owner's Name&Address ( iE'lTn-� Contractor's Name , kt [.1%V_0VkC4j Telephone Number �be - 360 Home Improvement Contractor License#(if applicable) 110� -7 Email: Construction Supervisor's License#(if applicable) 10260U ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑,,,l am the Homeowner ❑✓ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# V" C, 5— —-L —_Q_tl9 c `76 �© Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑,Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPM-ESTORNIMbuilding permit fo RESS.doc Revised 061313 {i .Y oFm�ram, < BAMNSTABLK 9� ' ,�� Town of Barnstable j0rfn r+�'t a Regulatory Services Richard V. Scali,Director 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 Property Owner Must Complete and Sign This Section If Using A Builder I, \ CEO �e ,as Owner of the subject property hereby authorize /Op'k r �O ✓ rJC� 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 If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. QAWPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 l J Town of Barnstable Regulatory Services P�oFT TOtyy Richard V.Scali,Director Building Division sAxNsznalE = Tom Perry,Building Commissioner MASS. s� 1619. $ 200 Main Street, Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown 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 Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Hie CommopneeaMi af'Massar_bmseffs Dep=hnent oflid-astr.i'dAccidenty - F3,�ce rr�'� figr,�iarrs 00 WT-r ington meet Bos&r%,1A 02U1 wmv.masxgrvfdia Workers' Compensatmix Insurance dam Bmlders/C-,Gut ractorsMect icianMumhers Applicant Information Rease Prmt Legibly Name(kuinewf6xga>xh3tiouanavi&4: Roo4A)C__ Q ol&)G 4S�- Case,- (Z-0, u,c, W(Ns CIw Gft (�O City/Stabel2ip: W:,Y".V0 9k l2 n Pho=;�_ W-36 6^ZN Eire you axF employer?Check the approp- -to bo Ter - ----- --- -—... -- ...__.. T. ..a o . r.. - _.._ Fee pr i e( 4mred=.._._.... I El am a employer with 4. I aoY a general ccmfiractor asB l 6- ❑New oon-stnxtica employees(full andfor part-2ime)* have hirea the sub,-eonamciors 2_❑ I am a sole proprietor or partner- Listed on the attwhed sheet 7- ❑Remodeling ship and have no employees These 5ub-contractars have g- ❑DemQlifion working for me M- arty capacitjr employees and have workers 9_ ❑Building addition [No,workers'camp:inwJ=e Comp-insaranml required-1 5- [Qte area corporatiouand its ID_C]Electrical repairs or additions 3.❑ I am a homt %mer doing all wo& of hatim exercised their 1I-0 Plumbing repairs or additions my.d [No workm'armp_ right of esmmpfion per MGL 120 Roof repairs ;,�,m xmce Leered-]1. c 154§1(4} and we have� employees_INC,worts 13❑Other i�n��f 0 comp.insurance required-] !Amy wphcmt that checks bcm Rl--m also fiIl out the section beIawshavring lheiry D&ere compensadoapp3icy t Hnmeowness vrho submit this afi]dxvif indtiicstiag they are doing sR nta$and then YmE onYside caot=actaa nmsi sMI-it a neca surh_ FCoat,sctna they checY this bmc mint stmthed sn additional dh shoteing the name of the sub-cz s and staff vrhedmr m=(hose mgifws have —play— If the svl—ontmcfots h—empre3 s the}must prtrvide their warkes'comp.policy atnabes lam HeIaty is the paUiT rutd,job site info rmadon_ Insurance Company Name: Poly 9 or Self ins Licq- n.FxgiratioDate�: q Job Sits Address- S / �.&M q CityfStaWZip: V- Aff2ch ai copy of the workers'coxnpensa6m policy declaration page(showing the police number a-nd expiration date). Failure to secure coverage as required uud'er Sedior<2 5A of MILL c. 152 can lead to the imposition of criminal p=&es of a fuze up to$I,5DD.0D and/or one-yearimpHsonment,as well as civil penalties is ffie form of a STOP WORK ORDER-and a fine of up:to$250_00 a tiny against the violator_ Be advised that a copy of this statement maybe forwarded to the Office of Investsgations of ffie DIA fDr msmmct coverage merfficatim Ida hereby crMratk.�kepairtsatid'penah esof petfurythatihe inforrruxiianpro-ki&dabavefstritealit!'correct Signature: , (VN Date: 7 �� Ph Me;ff: q_0� '-3 60 - 7((� gyki'al use only. Dar trot write fa this urea,to be t:aampL-ted by diy or town offx'ciaL City or Town- Pecndtucense If Fs=ing Authority(circle one): 1.Board of Health 2.&uRding Department 3.CitylTown Clerk 4.Electrical Inspector 5.Plambiug Easpector 6.Other Confact Person. Phone#_ c Info r* oration and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 emyloyer 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 commonw6lth 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 perormance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cer i_ficate(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 maybe 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 obtaia 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 sine 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,nezd only subunif one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations.1a (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 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 Comrmonw'eeth of Massachusetts Department of Industrial Accidwts Qffiee of lavestigatFans 600 Washirow S`t=t Roston.IAA 02111 Tel.A 617-727--4905 W 4-06 or 14 MASSAFE Revised 4-24-07 Fax# 617-727-7-749 www-ma gqv-/dia LL �Par��n�earuuealG�Office o�C aac 44de of Cons r _ Consumer Affairs&Business Regulation I License or registration valid for iridividul use TOME IMPROVEMENT CONTRACTOR ; before the expiration date. If found return to: nly, egistration; 010787 T i ri n YPe: I Office of Consumer Affairs and Business Regulation expi ratio n:,_.129TO 20.1_5 . LLC 10 Park Plaza-Suite 5170 T. ROOFING AND SIDING',-MCAPESCOD, LLC. Boston;MA 02116 -7 � DZMITRY LABKOVICH % I 68 WINSLOW GRAY RD. W.YARMOUTH, MA'02673i- Undersecretary i i Not valid without si tature 1fMassachusetts - Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: CS-102600 , DZMITRY LABK9VICII 13 Athens Way = �hi., West Yarmouth N3A 02673 1 � � Expiration 92, 03127/2015 Commissioner I LMG 3/25/2014 11 :44 : 12 AM PAGE 3/003 Fax Server A V CERTIFICATE OF LIABILITY INSURANCE y ,20 4"' THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements. PROaXXR BRYDEN & SULLIVAN INS NAME: 88 FALMOUTH RD No):HYANNIS, MA 02601 ADDf* INSM ARa0RDIN000VERAGE NAIC# INSURER A: LM Insurance Corporation 33600 INSURM INSURER B: ANDREI YARMOLOVICH DBA BEL ISLAND HOME IMPROVEMENT INSURERC: 29 MILL POND ROAD INSURERD: WEST YARMOUTH MA 02673 INMARME: INUIER F: COVERAGES CERTIFICATE NUMBER: 1957 541 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAKED ABOVE FOR THE PCLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFCRDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERJuIS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.U MTS SHOWN MAY HAVE BEEN FEDUCED BY PAID CLAIMS. TYPE OF INSURANCE ALWL POLICY NUMBER UW TS OM1W9VNAL GENERAL UAR urry EACH OCCURRENCE $ CLAIMS-WE ORETED OCCUR PRBWV Ea om wca $ MM EXP me $ PE39ONAL&ADVINJURY $ GENLAGORSCATEUpM�TAPPUESPER: GENERAL AGGREISATE $ POLICY❑j LCC PRODUCTS-CCJIvP/CPAGG $ on-ER $ AUTOMOBILE UABLITY $ aoa �a ANYAUTO BODILY INJURY $ All106 ED SCHEDULED BODILY INJURY(Paaoddart) $ HREDAUrCS AUTOS (MTl® am $ J $ IABREILA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAINGAMDE AMRSOATE $ DED FuumCN $ A WORKERS COLVeMTMN WC5-31 S-384176-024 2/25/2014 2/25/2015 -( AND EW WYEFff LIABILITY Y/N ANY PROPRIETOR/PARTNERIEXECUTTVE EL EACHACCIDENf $ 10000 OFFICER/NEWERFXCWDED? N/A (f�r�6ory In NIA EL DISEASE-EA EIW $ 10000 DF.SMIIP'nCNCFFOOPMAnCNSbdow EL DISEASE-POUCYLIMT $ 50000 DES"OF OPFRATTO6/LOCATIONS/VEHCLE3(AOOFO IM,AdMmal Renela SrheduK nsy be attached If more b required) Workers compensation insurance cover a applies only to the workers compensation laws of the state of MA. ANDREI YARMALOVICH IS COThis certilicate cancels and VE RED BYPTHE WORKERS'COMPENIssued only as SATIONt yy POLICY.relate to workers compensation coverage. CERTIFICATE HOLDER CANCELLATION TOWN OF BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BECANCELLED BEFORE 200 MAIN STREET THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. HYANNIS MA 02601 AUT}fORZ®FETPFifSBNTATIVE LM Insurance Corporation ®1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.: 19576541 CLIENT CODE: 1588030 Anne Chandler 3/25/2014 8:33:48 AM Page 1 of 1 Qz s?� 65 `� Oy' EXISTING DWELLING FIRST FLOOR EL 71.25 SHED POJ\��1 J - A6,, FOUNDATION NDATION PLOT PLAN DCE #16-127 PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE LOCATION 59 CHURCH STREET WEST BARNSTABLE,MA SCALE : 1" = 40' DATE : :3-21-2017 PREPARED FOR: REFERENCE : MAP 153 PARCEL 4-4 SCQTT LEONE DEED BOOK 26998 PAGE 57 al -� HEREBY CERTIFY THAT THE STRUCTURE ;•�/,.a- - '�� •_ SHOWN ON THIS PLAN IS LOCATED ON THE :o�DANIEL y GROUND AS SHOWN HEREON. q c off 508-362-4541 U jf+,L/{ V. faz 508-382-9880 �, I'' j downcape.eom A �� ti 1110.A0980v_ D wn cape endineerindkC. ' �o _ oc civil engineers land surveyors ------��`—r— — -----i�—�-- 939 Mo/n Street (Rte 6A) YARMOumpoRT MA 02675 DATE REG. LAND SURVEYOR T I Di N O `Y EXIS77NG DWELLING FIRST FLOOR EL. 71.25 SHED I AE- FOUNDATION PLOT PLAN ICE #16-127 PREPARED EXCLUSIVELY FOR THE PURPOSE OF OBTAINING A BUILDING PERMIT, NOT FOR ANY OTHER USE LOCATION 59 CHURCH STREET WEST BARNSTABLE,MA SCALE : 1" = 40' DATE : ,3-21-2017 PREPARED FOR: REFERENCE : MAP 153 PARCEL 4-4 SCO T LEONE DEED BOOK 26998 PAGE 57 Mk OF t✓4S I HEREBY CERTIFY THAT THE STRUCTURE SHOWN ON THIS PLAN IS LOCATED ON THE DANIEL GROUND AS SHOWN HEREON. A m� oft 118-3 4541 82— QJALA cn downcope.cam t4 �No. 40980 �P oWO cape endineerina,ine. S,,o civil engineers _-Z land surveyors �_-- 939.Main Street (Rte 6A) ------------ ----------U------ -- YARMOUMPORT Mil 02675 DATE REG. LAND SURVEYOR ' I TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel (/O (� e(j� Application #. �J Health Division `s Date Issued 21 ? fin? Conservation Division T JAAl 11 Application Fee J Planning Dept. 0 1 , Permit Fee Date Definitive Plan Approved by Planning Board r'�✓! Historic OKH Preservation/ Hyannis , Project Street Address .�g C�/Zt c f-c ne Village 748. 626a_vj�) Owner /%0_L/SS4 �Go L �-� Address ,�g (� �� . Telephone 2-03 ,I/'S--- 0/?® Permit Request AWV40`1 �Ib 4 'ILA e2_0 LA,pj, ry-ol e- ;-14,0 /ems Square feet: 1 st floor: existing/��O proposed 6W 2nd floor: existing proposed Total new 6'ZO Zoning District Flood Plain Groundwater Overlay Project Valuation O. 000 Construction Typedjd► 40y1 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Cd' Two Family ❑ Multi-Family(# units) Age of Existing Strucctt re 15 8 ). Historic House: &Nes ❑ No On Old King's Highway: ❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of'Baths: Full: existing 1� new Half: existing new Number of Bedrooms: � existing Anew Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: O"Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes 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 -1-yd-Ai _ !114-12r c<She- - Telephone-Number Address /74 v e r- License # C.S` /0,5—.9 6 15/ ,l 'l-1 i 1, Home Improvement Contractor# /7 2 el m Email Yft 2 M O L(9 v IC-4 0-KO-E (9,�A PLC v. co--tWorker's Compensation # W C 5=31 S 3g,-,//46= ' ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO Ili K t In SIGNATURE 1 DATE 2 2 ql,�� r • - —�.t q, w..nw _tc5 FOR OFFICIAL USE ONLY _ APPLICATION # DATE ISSUED L l 1 , MAP/PARCEL NO. r . t, f 5 ADDRESS I VILLAGE OWNER DATE OF INSPECTION: FOUNDATION r FRAME aet9/? 0 el L©T,XA INSULATION ��1 oK a��l�RA G'sr2r ��1 FIREPLACE r • ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT r r . ASSOCIATION PLAN NO. . r AG R I BALA N E@1 ' . Company Name Cape Cod Insulation Phone Number 508 775 1214 Applicator*Name David Souza : Anstallation Date 11/29 z a Jobsite Address. 59.Church Street A-Side Lot #'s PA86001718 w _• Permit. Number B-Side Lot #'s P3283523517 °D o r- Wails Attic 8.511R-38 740 r„ • s � 0 4. Blazelok Thermal barrier Paint Far side getting'Wood cover .1.7 mil wet_. www.Demilec.com Q@DEMILEC 2/25/2016 10:42:06 AM PST (GMT-8) FROM: 100005-TO: 15087901414 Page: 2 of 2 AC R® DATE(MMIDD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 2125/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTRUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsemen s. PRODUCER BRYDEN&SULLIVAN INS NCONTCT AME: 88 FALMOUTH RD PHONE FAX EfilA1 HYANNIS, MA02601 LExit, '� N ADDRESS: INSUR S AFFORDING COVERAGE NAIC# msuRERA: LM Insurance Corporation 33600 INSURED INSURER a: ANDREI YARMALOVICH DBA BEL ISLAND HOME IMPROVEMENT INSURER 204 CINDERELLA TERRACE MURERD: MARSTONS MILLS MA 02648 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 28713782 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LLTTRR TYPE OF INSURANCE DL SUBR POLICY NUMBER POLICY MMMMDIY FF MPOM1LICY Err LI61TTS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $DAMAGE TO RERTEIT- _ CLANS-MADE DOGGLIR PREMISES Me ocoinmirical $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JPER LOC PRODUCTS-COMP/OPAGG $ OTHER $ AUTOMOBILE LIABILITY ED I $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED AUTOS ALTOS BODILY INJURY(Per accident) $ NON-OWNED PROPERTY DAMAGE HIREDAUTOS AUTOS Peracdtlem $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION s $ A WORKERS COMPENSAnoN WC5-31 S-384176-026 2/25/2016 2/25/2017 STATUTE ER AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNERrEXECUTIVE Y/N E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E L.DISEASE-EA EMPLOY $ 100000 If yyes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,maybe etiached N more space Is required) WORKERS COMPENSATION INSURANCE COVERAGE APPLIES ONLY TO THE WORKERS COMPENSATION LAWS OF THE STATE OF MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. ANDREI YARMOLOVICH IS COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION OWN OF YARMOUTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN RT 28 THE EXPIRATION OATS THEREOF, NOTICE WILL BE DELIVERED IN 1116 SOUTH YARMOUTH MA 02661 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD 28713782 L-384176 16-17 UDC Ashish Sorgaonkar 2/25/2016 1:38:27 PM (EST) Page 1 of 1 i 4 . i onsumei irs�6�/u�� ' _ - smesl�e 10 Park Plaza - Suite 5170 6 Boston, Massachusetts 02116 Home Improvement Contractor Registral i Registration: Type: i BEL ISLANDS HOME IMPROVEMENT ' : `' Expiration: ; IVAN IVANINSHENKO 204 CINDERELLA TER. MARSTONS MILLS, MA 02648 .t..` Update Address and returi sca 1 ., 20M-05m Address U Renewal /�r��uraranrrrrt�/�n�r`l�irtanr�uac•/(.1 fliice of Consumer Affairs&Business Regulation License or registration valid for individual us ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to egistration:.--I Office of Consumer Affairs and Business Reg Expiration 772476 Type. 10 Park Plaza-Suite 5170 Supplement Card Boston,MA 0 16 BEL ISLANDS HOME!IMPR6',-'E idT IVAN IVANINSHENKO 204 CINDERELLA TER"..' MARSTONS MILLS,MA 02646 — Undersecretary Not lid o A na re i i i blass:achusetts Department of:Public.Safety Board of'Building Regulations and Standards. License: CS-105964 ton.struction Supervisor IVAN V IVANIUSHENKO 174 UPPER COUNTY ROAD--APT 1-14 DENNIS PORT MA 026.* • �� Expiration: Commissioner 01/0112018 I ! . i I I i i 00 NZ. W } � W !� SKYLIGHT LL +••� H a W o H ARCH.ASHPHALT 12 12 ARCH.ASHPHALT SHINGLES,MATCH 1� �� V SHINGLES,MATCH EXISTING EXISTING Q "� w 0 U Q 1 - H NEWANDERSEN WINDOWS/DOORS Q U Q0 WINDOWS/DOORS ON NEW FIBERCEMENT W.C.SHINGLES, TITLE: SIDING,PAINTED TO NATURAL,MATCH MATCH EXISTING EXISTING CLAPBOARD EXPOSURE EXPOS D ELEVATIONS I .I CONCRETE' 12"MAX EXPOSED 18'-D'• __, - j- � II CONCRETE I E III I I � l l EXISTING HOUSE 25 I I -'<- I 21'-(-ADDITION I I I II'll ADDITION I C 1I I I I I I I I V .o d y I I I I I I I I I I d p r :E�___________________� 4===p ti ______====ter 5 � _ _p ti ,'A Q Go-o L) LJ LJ I_J C ^ !� O t NORTH ELEVATION CHURCH ST. Q a 2 EAST ELEVATION s ,. ,/.-_ , ACT 1,2 2016 t' /•-- co o Ln tastable () L. 26 2 E Town ofIs `N,9hwaY �+ EXISTING DH WINDOW TO MOVE Old Comg Rtdtee F �.d SKYLIGHTS Z $ ARCH.ASHPHALT Qt b z SHINGLES,MATCH I e�', �EXISTING �ZARCH.ASHPHALT -r12 _ ErWSHINGLES,MATCH 1UI �0r1oy,NEWSKYLIGHTS EXISTING 't`-�''1I / )1 V 4 Lu PADORWND ff ILLjjlf �•— cargo ' NEW ANDERS �• NEW ANDERSON I K}a•f,91 12 C --- - WINDOWS/DOORS II WINDOWS 7.• W.C.SHINGLES, W.C.SHINGLES, Z I-O I- __I' NATURAL,MATCH I NATURAL,MATCH EXISTING I EXISTING EXPOSURE EXPOSURE HDC: 09.02.2016 12"MAX u II. RECEIVED EXPOSED WA CONCRETE RETAINING LL j I I I '•" ,_,.• .. �.II I EXTG HOUSE I w x..v.. ✓ y LL__F 2 GIR OWTH MANAGEN ENT I 21'-0'ADDITION I I 15.0'ADDITION I 18'O-ADDITION I I I'l EXISTING HOUSE ri tt 3.-0. 3 PLAN KEY a SOUTH ELEVATION (BACKYARD) I 5 WEST ELEVATION • NOTES r Al ■ O. 1.DIMENSIONS ARE TO CENTERLINE OF INTERIOR WALLS AND OUTSIDE FACE OF STUD OF EXTERIOR WALLS,UNLESS OTHERWISE NOTED. 2.CONTACT ARCHITECT IF THERE ARE ANY DISCREPANCIES IN THE DRAWINGS. BARNSTABLE OLD KINGS HIGHWAY HDC 09.28.2016 ' T V....v._ .11 I� 1 ) - \✓ �N v LEGEND NOTES /.DATUM 6 NAVD 88 1 —99_ WELL EIOSTING(AMNW 2 MUNICIPAL WATER IS NOT AVNLAEKE [aaa X-1 COST.SPOT El". I THE PLAN 6 FOR PROPOSED WORK ONLY AND NOT TO `\//�� -{99)— PROPOSED CONTOUR BE USED FOR LOT LINE STAKING OR ANY O7NER \ I9$4 PROPOSED SPOT 0- PURPOSE �ro r9 �71'j J DI4.SAFE(1-68 SNME 6E)AND VOW FOR HE D11 LOCATION OC�(1�ALL UNDOWROUND ANDAr THE TEST HOE PRIOR 1D C0106NCd1O/T OF WORK r� 2 &APEE OF GROIAID Rd UTILITY POLE . � TIRE NTDRANT 1r1D m Au errs ro Arrr r rrwr r h 6,7 MAP 1h PARCEL 2 ° a a G LOCUS MAP 6 NOT TO SCALE 1 ♦'O ASSESSORS MAP 153 PARCEL 4-4 11 O 1e 7g 6 11 b 76 79� o ZONING SUMMARY ZONING DISTRICT: RF RESIDENTIAL DISTRICT h DIVEILVG e ^ F)RSrFC20EW PANS pP/L£ MIN.LOT SIZE 43.560 S.F. EL2.2. 87 gh F T.T3 'y MIN.LOT FRONTAGE 150' '� yb MIN.FRONT SETBACK W. MIN. SIDE SETBACK 15' 6� 'a MIN. REAR SETBACK 15' 82 g, /{(� MAX.BUILDING HEIGHT 1. (11y 1 ) 1 /1 81 0 O OWNER OF RECORD 1Q 1 C SCOTT T. &MELISSA A.LEONE 0051)NO a 59 CHURCH STREET SEP71C WEST BARNSTABLE.MA 02668 60 11 REFERENCES 1h o 0 DEED BOOK 26998 PAGE 57 77 e e 69 PLAN BOOK 407 PAGE 26 1 1h FIRE RT 1 10 � 61 A 11 J O' �^ RECEMD 0 . A 15 ^ 1b REL4 4 .s c. ^, GROWTH M.ANAi.EIVEN'1 71 11 23.94 SITE PLAN u1♦ OF 91 ^ J u 16 jb 19 74 MA 1 ^ 59 CHURCH STREET R IWEST BARNSTABLE, MA . 11 ^ PREPARED FOR j9 0 SCOTT LEONE 1b 19 61 ^' ( ' DATE: MAY 27. 2016 re 1b 68 Scale:1•=20' 77 'ps 0 10 20 b 40 50 FEET 78 ] Il 8f 1e aN 508-3u-swo 5OB-362-6880 m 8 a l dorrlcope.0om O 79 es as 61 75 / S WAN Cap1 fAj%Art/%Aj,%qt civil engineers land surveyors 939 Ato7n Stroet(Rt. 6A) DICE #16-127 DATE DANIEL A.OJALA,P.E.,P.L.S. YARMOUTHPORT MA 02675 16-127 LEONEDWG LEGEND NOTES P 1.DATUM ISMUNICIPAL Naw 8B f/ %/ /•� j \ \�� j�I I I I I '� � � �S RV— C%ISTING CONTOlR2 NQL' t INSPLN WATER IS NOT AVIIUBLE I I X?%! EXIST.SPOT ELEV. �.MI5 PUN IS FOR PROPOSED HORN ONLY AND NOT TO RE USED r011 LOT UNE STAKING OR ANY OTHER —[VY]-- PRpPpSEO CONTOUR �^ PURPOSE. `�•�/`' \�- / I / 1 C�� cU n \\` / �/ ,11 S ' (/ I V'�j, IP4.R) PROPOSED SPOT E4 C CONTRACTOR SNAU.RE RESPONSIBLE FOR CALLING . Mi OgSAFE(1-BBB-.)"ON AR D YERIMNO ME LOCATON OF ALL"UN IINO k OVERNEM UTILITIES TEST HME PRIOR TO COJINENCENENT OF WORK. / (C " 1 /�} \. f•- SLOPE Or fEtGWD .I Saa 4 / 1` //�/� I � �.I UTILITY p1[ 1 I �' ( ) \U\ � �� - I /I� v TT .5 1 t '1 1\ `' `! �^ NEW L 1\ xTO w�uL mwnAiRE W OR/wN w cum a 4f �,. /"J/ '� MAP 753 /0S1✓ (\� 11 1 ��/ _ / � / PARCEL `4-1.2 (rJI 1\f \ \1` (• `\� l/// ��\ i \•` /� > ,� _\��1\nw�� a ` L•—Jf �W LOCUS MAP l�-_J / --i��:�:1.1.�^�4 !J •-J._-! ! ,%l/�� \` Ii !-�' G '�L�^ �. �J� ti/ 1 NOT TO SCALE ASSESSORS MAP 153 PARCEL /-/ ® r•� �` �f� 5 1 \' I ..�� r✓Revise��J(ii �I fir✓ I �'1\Yt�//// �\� E� G ?� \�j��.^C�_J J1 li✓s PARCEL4-4 ' ' } Over'/I d lay 't �t� N p ' ZONING SUMMARY EMSDNGnrI •� �. (._� ZONING DISTRICT: RF RESIDENTIAL DISTRICT� �3D• --��.�'�`" .�� .� f� !Elf I OKELLING Pms , I MIN.LOT SIZE 43,560 S.F. J✓� J r� __-�\ `-� , a5 ` �/ ' �(�` EL 71.25 YED DRnr'b• �•1� �Ya L l NIN.LOT FRONTAGE 150' PA . ij{ �\ ) MIN.FRONT SETBACK W. /' -�`•-` l r �) v\�'��`(.( % \ �_ MIN.SIDE SETBACK 15, MIN.REAR SETBACK 15, MAX.BUILDING HEIGHT 30' /15 o-� �,-./ � 7 OWNER OF RECORD 59 CHURCH STREET �/� � '� ( ,� r -•-� � / � f � �nC° m.^�� NEST BARNSTABLE,MA 02668 ( j REFERENCES DEE,1 c� ° PLAN BOOK 4079PAGEG2657 fI pl l t ///� C 1� / 1 jj ,f /� �\/r/•'�^• \ �%g •� � /J r� �l \j1 �'• (a PK J �•b '` 153, ,P RCEL 4�4 V( j j 1�—V 11 — "') 31d- SITE PLAN (-)j /; ` <� ', \/�� \s M1��/1 S ;1.0 l;t\lll�` 1; ru�� OF `� �/ j r�.j f j,e y� �I S % IMl``/lei_:, v r f7 �f , ^`MAP 115J) lI �{T1�1� 59 CHURCH STREET �,\ �\ y /� `�• ( �'. �`� f�/j-19%, '��r-f J' '� d�ARc��'�'l 1/`1�`1 WEST BARNSTABLE, MA PREPARED FOR �' — \.� s' 4 �_ti //" ,--� �,' fJ��✓/�/� ", �( 1\i�� rfS ` t{�� SCOTT LEONE ( , \_/ 1- �'•�/ �. /��t/ , _._ ) /`. L..� `\�\J,�( `m DATE: MAY 27, 2016 ,' _`� f .� (. -]] ✓ / � i��. ii/J�J /�� / <g �� l✓� ti Ion-Boa—}� IF J �` .7N _y: /j'�� 'i✓ /��_.\ Cf" 1' J Jl / - �-• 1 N we-TB2-�su 9 / �]e• ,�/��-_�_ _�•� � �E;- �j, � I f /l1(t � �) �,'� � i � Jown cope engineering,inc. r `� r civil engineers 1. �!.\AI'��"� .f ✓:^r=._ .�_..._f"..��/',., / l( 1 �:,_..�c t///Jf �'. \ \ land surveyors BJ DATE DANIEL A.OJALA,P.E.,P.L.S. rARMOu]HPORr NA 02671 DICE #16-127 ' I6-1I7 LEONE.DNC 6� a t Barnstable Old Kings Highway Historic District Committee 2001VIain Street, Hyannis,MA 02601,TEL: 50$-862=47$7 Fax 508-862-47$4 e.p`0g APPLICATION,. CERTIFICATE OF APPROPRIATENESS Applicafion is hereby trade,with four(4)complete sets,for the issuance of a Certificate of Appropriateness'under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 1. Building construction: ❑ New Addition ❑ Alteration 2. Type of Building: 'House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting. roof ❑ new.roof ❑ color/material change, of trim, siding, window, door 4. Sign : ❑ NTew Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole El Retaining wall El Tennis court El Other 6. Pool ❑ Swi.m.ming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date NOTE All applications must,be signed by the curreerd ow pneer r -7 Owner(print): ` 2(,i zlja & `� �) LZ,,Cg' Telephone#: Address of:Proposed Wock:.!�3 Village F'A�t o n Map L, Mailing Address(if diff, C ) H Owner's Signature / V l VagnPT . Zo� r Description of Proposed Work: Give particulars of work to be done:. Town of wa Old Kong's Highway Committee Agent or Contractor(print): Address: vr- - S I Contractor/Agent'signature: D For committee use only. This Certificate is here APVRO .D/ .ENIED REC'� Date l• �• Members signatures AGE GR0H Q:ARoards and CommiPsionAOtd Kings HiglnvajAOKH ApplieatlonAOM DRAFT 2011 t<ert Appropriateness DRAFT dor cook a 6,a_vv,�k lea k �� Ao� 1C, v CERTIFICATE OF APPROPFJATFNl�ESS SPEC SHEET Please submit 5 copies Foundation Type: (Max. 12"exposed)(material-brick/cement,.other) Siding Type:. Clapboard shingle T other, " ( a Ivlatcrial: red cedar wh.i e ceda'r. . oilier: Color:,.p;de� :P,TG Chimney Material: Color: Hoof Material: (make&style): Color: 1 Roof Pitch(s): (7/12.minimum) (s/�ecij�,D11.pla)is fOr.rteiA:biiildin�gs, major additions) Window and door trim material,: wood other material,, specify Size of-cornerboards size of casings(l X 4 min.) color VVn I Rakes 1:st member i � � 2°"�member ��u� Depth.of overhang Window: (make/model) . material color W4411;� (Prcn-ide windbic schedicle on plait for nem?buildings,major add fion.$) Window grills(please check,all.that.appl y,: true divided lights exterior 61tred grills_ Tr.ilfs between.glass removable interior_ :None Door sty le.and make: material. Color: MAI IT- Garage Door,Style WA Size of opening Material Color Shutter Type/Style/Material.- 1`1 Color: Gutter Type/Material: Color: Deck material: wood other material;specify Color. . V")< 4q,V Y!!; Y2.(4 Skylight, type/make/model/: VC' ' , Oq'X 4► 1pjP r: m— o;p Size: Sign size: PJ Type/Materials: M PT 9 ��6 Color: RECEIVED Fence'Type(max 6' )Style. A materi16��t�B�atrist�a�e Color: old Kings`W � Sip 2 LU it Retaining.wall:: Material: A Commmee d�jl dL15L-0 ti> ting, freestanding 4 l on building %L t� iu Q t � gTH MANAGEMENT OTHER INFORMATION: THE ATTACHED CHECKLIST MUST BE COMPLETED AND SUBMITTED please provide samples of paint colors,manufacturers brochure.of windows,doors,.garage door,fences,lampposts etc / r Signed: (plan prepares) Print.Name ) 2 2. Q�Boaids'an4 C oinmuswna101 Kingy f7iginvay�QK(1 Appticatimis\6KIi'I)RAFT 2011 CertAppropiiateness;DRAF.dor.. f Plans shall-include the following: _Name of applicant,street location,map and parcel. Name of Builder Designer,or architect;original,signature of plan preparer.and stamp; plan date;and all revision. dates. ALL NEW HOUSE OR COMMERCIAL.BUILDING PLANS MUST HAVE,AN ORIGINAL SIGNATURE AND STAMP,IF ANY,BY A.REGISTERED ARCHITECT.;MEMBER OF AIBD,OR A LICENSED MASSACHUSETTS HOME IMPROVEMENT CONTRACTOR;_UNI ESS THIS REQUIREMENT IS WAIVED 13Y THE OKH,DISTRICT COMMITTEE. A written and bar drawn scale. Elevations of all(affected)sides-of the building.with dimensions including height.from the natural grade adjacent to the building to the ton of the ridge; location and elevation of finished grade,roof pitch(s)dormer setbacks;trim style; window and door styles. Changes to existing buildings must be clouded on drawings.. Window schedule on,plans. Landscaping plan,5 copies drawn on a certified perimeter plan containing i.he following.information: _Name of applicant,street address,assessor's map and parcel number. Name, address and telephone number of the plan preparer;plan date and dates of revisions. _The location of existing and.proposed buildings and.structures,and.lot lines. _Natural features of site(e.g:.rock outcroppings,streams,wetlands,etc.). _Existing buffer areas to°.remain: Location and.species of trees:outside of buffer areas greater.than.IT'caliper to be retained.or removed. The.location,,number,size and.name of:proposed new trees and.plants. Driveway,parking areas,walkways; and patios indicating materials to be used. Existing stone walls;and proposed walls including retainitig walls for slope retention or septic systems. ('for removal of stone walls, file_Demol tion Form).. _All.:proposedoe.xtedpr:lighting and signs. Sketch or photos of adjacent properties, (1 copy only) A sketch(s)to scale or photographs of nearby adjacent:buildings, where present,along both sides of the street frontage, showing the proposed new house or commercial building in scale and in relationship to the existing buildings. Please discuss with staff if you do not think this.is relevant to your application. Photographs of all sides of existing.buildings to.remain,or being.added to I set only). Fees according to:schedule. APPROVED Please complete:the following: OCT. t"2 2016 i�`jV Town.of Barnstable K. Existing building;foot print: Old Kin 's Highway Building l 1/ 6 0 3f sq. ft. Building 2 committee Existing Building,gross floor area, including area_of ginished basement: Building l I D D S01p sq ft. Building 2 RECEIVED New building or addition,foot print: :Building 1rZ7i S sq. ft. Building 2. *` = 2 Zulu New Building.or addition, ross floor area,including,area of finished basement:. 'Bui:l.ding 1 '5"rn sq. ft. Building 2 GROW"' nil A �t, LMENT 4 Q Words and Co.,tvofssions\bl .kings Higlnyay\OKii Appliralio&tiOKII.DRAhT201 i Ciro Appropriaieness,DRAIhT,.d u:: Town of Barnstable Geographic Information System September 8, 2016 154004 #20 164006 • 040 130017 ` 154007002 154007 #2049 #50 072 130016 9G V 1129# 4%. 164007001 080 P 164006 Jy 153004002 ® #106 �p #45 153004004 153018 #59 #122 a N 153004003 C #47 Z O = 153003 #0 163004001 #21 r 0 71 Feet '�rF� s '#°902 DISCLAIMERS:This ma is for planning Ma 153 Parcel:004004 p' p g purposes only. It is not adequate for legal p� Selected Parcel boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner:LEONE,SCOTT T&MELISSA A Total Assessed Value:$350100 W E 1"=100'may not meet established map accuracy standards. The parcel lines on this map are only graphic representations of Assessor's tax parcels. They are not true property Co-Owner: Acreage:1.58 acres Abutters -: �' boundaries and do not represent accurate relationships to physical features on the map Location:59 CHURCH STREET /r such as building locations. Buffer :� i III► � ,� rI �� 3 tjj r4"�wiP�'4 e '�%�� i'Ji- � I�a �6'.'.I _��/A� V`• /7 �� /�iO�-".�a�y f s� .Ct:p --- � ��1�Q�Pf�M.`,�-Q.��"> .CrJS � &�sr ••e�,.} ,f{�► + y AAA ` �r�.S`o:�.�® '•rr,t'ir ; �", j Npi. , ?�,fl�7l � � —� ate'��',Kati`aD..'',•��i',P+,,.,��.�•�j4�fr,:;:s�"y?)3.�`''X it�.�:�.`i'.��\ 77 Fit *t�i+y,��. ai� ' �- + }i�,. Y� ��r��U' ,.ati��i�'.�4$�� a\i�fl • Fi',�: vi�w�� 3 w�,.•l iG_` '+j`;o'^ ^,af:'"`''"".r_S.''G' � �a��f 1��y� � ~ �"'�� ._� 1 '-~r�`a( [ rt�. � yy \ ash...o/• "'',� � �. 3 w §. x;rPf' fi t WNW r � `� - .1' � 4 e�t � � •..moo'- ��7��.r f ! '� ,. ��/ r s■�� O SPA' al s ...� s .. ----fir,•- ,. � � "�;'" - _ _ -,.`....�..�.�„ .. �r• � � �� Y-.: ski. . 7 � k�, a<;r, SSiP .�+e.. �s�,,,. �„ �R. � � ,�,q ti a :y 4 ` ♦' I � $ '� ��([ �►'i1��i`#`.'w.r . y p a IA B1 , , to�• � �"' - 1� i�•°��f.�7i � �:�i�!'t a1s "i,.• * y 1 r 3 t �� '`'� at•�,;, aj-�`!e�,�j ''d�e1J_ ��{�!'� -',y. .'� e $ -��, ��♦ � :�j?� �i�< i `U P Ptk It 44 ~ '`� v �P�R f`, �� \, � �/fl�io_ k�� )+',/r �'<.+�ik�." 3•! � � ht� +. -'i �i�i' ��t�• •�'.�` e .� \t�r, •�ij� �1� '� �Y'�y �_ '•�� ti+mil�i`��5t}if�! -� '. .ij� �p4 � i�` �r�" i `' � �'� ,1�� '� �� s,'� �w �`.h,;-Far n `! •j R X rIM ov LT t -�----,--..~'r-----,---,--mot,=- ,�- 9 ;�-�+•�_...� '1�'1--.,�.._. .�c+ ��.�t��`f1' { .r Shea, Sally, From: Shea, Sally Sent: Thursday, February 02, 2017 10:32 AM To: yarmolovichandr@yahoo.com'; Mckechnie, Robert Cc: Brigham, Anna; Herrand, Karen Subject: ViewPermit, Permit No:TB-16-3713/ 59 Church Street West Barnstable Hi Ivan, Unfortunately, the maps are showing that your project is in Old King's Highway. Please contact Anna Brigham at 508-862-4682. She can assist you in regard to obtaining your approval for this project. We are unable to move forward with your review until you have obtained Old King's Highway approval. If you have any questions please call. Sincerely, Sally Shea Town of Barnstable Assistant Zoning Admin/Lead Permit Tech. 508-862-4031 i Shea, Sally, ' To: yarmolovichandr@yahoo.com Subject: ViewPermit, Permit No:TB-16-3713 Hi Ivan, Please come in and label all rooms for use. Thank you. Sally Shea -Tr)wn of Barnstable Assistant Zoning Admin/Lead Permit Tech. 508-862-4031 1 W. AWC Guide to Wood in High WhmdAxeas:110 mph Wibud' 7�� . °=uo�oau�xuu��u�� . 8��K8��7��M��GBUK��/' T- '''' ~ ~'^~`°'"°L? [M Check � Compliance 1.1 SCOPE 2017 FF-- _� � &M �� - - . --Wind Speed(�oeo QuaV-_--_-- - --_-- - --'11O mph V WindExposure Category................................................................... .............................................................B �-�- 1.2 APPLICABILITY Number of Stories(m considered astory) � g2stories RoofPitch ........... ..............................................................(Fig 2)........................................... :51212 MeanRoof Height ..............................................................(Fig 2)................................................. ft :533'Building ---- Width,VV................................................................ 3 .................................................�2_ft BuildingLength, L ..............................................................(Fig 3 .................................................. ft �VBuilding Aspect � Rmdu _'_--'---- 4�---'-----.-,- mommmna�mo»|ooeoOpemng� -----------'��g4�---------------' | ��8^ *^ 1.3 FRAMING CONNECTIONS � � � General compliance wdhframing connoubono------'Oab��-------------'----.'--' ��__ 2.1 FOUNDATION � Foundation Walls meeting requirements ofT8OCKAR54D4.1 Concrete............................................................................................................................... V ConcreteMasonry.................................................................... ----------------`----' | 2.2 ANCHORAGE TO F@0 D*TUON" ` 5/8 Anchor Bolts imbedded or5/8 Proprietary Mechanical Anchors oomn alternative kx concrete only Bolt -general----------- ........(Table 4)............................................... 44-4. ~/ Bolt Spacing from ondfjointofplate ............................(Fig 5) ................................... _��jn�s�^-1�� ' Bolt Embedment-concrete........................................(Fig S)-.-:------------. in.a7^ Bo�Embedment-masonry-------------..(F�5)------- --� � 3�� e15^ i J�-��-----� � -�^=- Plate Washer...............�-------------��g5�''-'-'��'^.Y�---k3^u3ru1/4" � 3.1 FLOORS � Floor framing member spans cnukmd ...............................(per 78OCMR Chapter 65)------------ Maximum Floor Opening Dimension � _ ft�12' Full Height Wall Studs at-Floor Openings less than Z from Exterior Wall(Fig M)........................................ Maximum Floor Joist Setbacks Supporting Loadbearing Walls mr8haanwaL----'(Fig 7)........................................................~f ft :5d -Au/_ Ma°,' ,Cantilevered Floor Joists Supporting Loadbearing Walls or8heamvaU................(Fig 8).....................................................Aft Sd Floor Bracing at.Endwalls...................................................(Fig B).....:........................................................... - Floor SheathingType ........................................................(per 70OCMRChapter 55)------.i.a)-�� Romr.ShamtingThichnomm ----------------(per7GDCMRChapter56 --' � Floor Sheathing Fastening----------------.�able2)'`P d nails mt_ bi'in edge/ Q."in field 4.1 WALLS Wall Height Loadbearing walls -'..-------------(Fig1OandTable[)--_--' ft :519 . vmllu--------------- iO and Table 5)......................... aft g29 ' VVaUEtud'Spmcing ........................................................(Fig 1O and Table 50....................1k�Lhn.':5 24"o/c. Wall Story Offsets ........................................................(Figs T&8)`-'------'---'` ft yd � 4.2 EXTERIOR WALLS' | Wood Studs � ��- ----_--' g . ............................ -_-------�`�__- ' - .--------__� ��~ _�- 3x��_ ft Gable End Wall Bracing � � Full -------`------ ��__ or 1 x 3 ceiling furring strips @ 16"spacing min.with 2 x 4 blocking @ 4 ft.spacing m end joist oxu truss bays �c_ Double Top Plate Splice Length ---- 13 and Table G)----'---_-- � ft Splice Connection(no.of 16d common nails)--''''(Table G).......................................................... - _ � Y � f AWC Guide to Wood Construction in High Wind Areas:110 mph.Wind Zone Massachusetts Checklist for Compliance(780 CM' R 5301.2.1.1)' Loadbearing Wall Connections . Lateral(no.of 16d common nails)..:............................(fables 7)...................................................... �Non-Loadbearing Wall Connections Lateral(no.of 16d common nails)...............................(Table 8)..:..................................................... Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans ............................................:...........(Table 9)..................................Jz ft Q in.5 11' Sill Plate Spans ........................................................(Table 9)..................................—ft in.s 11'. Full Height Studs (no.of studs)....................................(Table.9)......................................................... Non-Load Bearing Wall Openings(record largest opening but check all openings for compliance to Table 9) Header Spans.............................................................(fable 9)..................................�ft 0 in.s 12' ✓ Sill Plate Spans...........................................................(Table 9).................................. G ft 1� in.5 12" Full Height Studs(no.of studs)...................................:(Table 9)..................................:..................... _ Exterior Wall Sheathing to Resist Uplift and Shear Simultan usly° Minimum Building Dimension,W — 5?,pN M I%4 J Nominal Height of Tallest Opening2 .............................................:...................:..........1/ 5 6W Sheathing T note 4 4,(...................................................... VW Edge Nail Spacing.........................................(Table 10 or note 4 if less).......................�in. Field Nail Spacing.........................................(fable 10)..............:.................................. 1,, in. Shear Connection(no.of 16d common nails)(fable 10).................................................... Percent Full-Height Sheathing.......................(Table 10).................................................... /o 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Maximum Building,Dimension,L p 4 -_1 49 1 - Nominal Height of Tallest Opening2.................................... 6'8" SheathingType....... .....................................(note 4)...................................................... Edge Nail Spacing.........................................(Table 11 or note 4 if less)....................... in. Field Nail Spacing P 9.........................................(Table 11)................................................. in. Shear Connection(no.of 16d common nails)(Table 11)........................................................ Percent Full-Height Sheathing.............. (Table 11)....................................................W1, — 5%Additional Sheathing for Wall with Opening>6'8"(Design Concepts)..................... Wall Cladding Ratedfor Wind Speed?.............................................................. ................................................................ 5.1 ROOFS Roof framing member spans checked?....................:..(For Rafters use AWC Span Tool,see BBRS Website) Roof Overhang .........................................:..........(Figure 19).............124 ft<-smaller of 2'or U3 Truss or Rafter Connections at Loadbearing Walls Proprietary Connectors Uplift................................................(Table 12)............................................U=�3jplf Lateral.............................................(Table 12).............................................L= ptf — Shear.......................................... (T 1 ) _�p ff Ridge Strap Connections,if collar ties not used per page 21e.. (fable 13)...............................T ptf Gable Rake Outlooker.........................................(Figure 20).........:....p ft 5 smaller of 2'or U2 Truss or Rafter Connections at Non-Loadbearing Walls Proprietary Connectors Uplift.................................................(Table 14)...........................................:U= 4/7 lb. Lateral(no.of 16d common nails)...(fable 14).......................................L=26 lb. Roof Sheathing Type...................................................(per 780 CMR Chapters 58 ado 59) ...........7//&04)P �L Roof Sheathing Fastening...........................................(Table 2).............................�.. .. �.. rjj'!11 Notes: 1. This checklist shall be met in its entirety,excluding the specific exception noted in 2,to comply with the requirements of 780 CMR 5301.2.1.1 Item 1. If the checklist is met in its entirety then the following metal straps and hold downs are not required per the WFCM.110 mph Guide: a. Steel Straps per Figure 5 b. 20 Gage Straps per Figure 11 c. Uplift Straps per Figure 14 d. All Straps per Figure 17 e. Comer Stud Hold Downs per Figure 18a and Figure 18b 2. Exception:Opening heights of up to 8 ft.-shall be permitted when 5%is added to the percent full-height sheathing requirements shown in Tables 10 and 11. 3. The bottom sill plate in exterior walls shall be a minimum 2 in.nominal thickness pressure treated#2=grade. AWC Guide to Wood Construction in High'Wind Areas:110 mph Wind Zone Massachusetts Checklist for Compliance(''7so CMR 5301.2..t.1)r 4. a. From Tables 10 and 11 and location of wall sheathing and Building Aspect Ratio,determine Percent Full-Height Sheathing and Nail Spacing requirements b. Wood Structural Panels shall be minimum thickness of W16"and be installed as follows: i. Panels shall be installed with strength axis parallel to studs. ii. All horizontal joints shall occur over and be nailed to framing. iii. On single story construction, panels shall be attached to bottom plates and top member of the double top plate. iv. On two story construction, upper panels shall be attached to the top member of the upper double top plate and to band joist at bottom of panel. Upper attachment of lower panel shall be made to band joist and lower attachment made to lowest plate at first floor framing. v. .Horizontal nail spacing at double top plates,band joists,and girders shall be a double row of 8d staggered at 3 inches on center per figures below:Vertical and Horizontal Nailing for Panel Attachment �ATF VAISr� Urs r ON USEMNAIS n n rr n r rr rr r .. u r rr n r rl n r rr rr n rr n i M a ` ii i� • r n u r r to n < r rr �r g r 4 u u u rl r J it 11 rr rr r rr rr r d V w u rr r u � r rr rl t rr ii ii 3 r u r . n D01J8LE ` MAR8PACWG — } }`, PIAdri d S v See Detail on Next Page Vertical and Horizontal flailing for Panel Attachment AWC Guide to Wood Construction in High Wind Areas:110 mph Mind Zone Massachusetts Checklist for Compliance(780 CM.R 5301..2.1.1)1 1' EUXTE STAGEMED KAIL PATIMN P AwELL EmQ R! D a p NAIL SPA=G DErAL Detail Vertical and Horizontal Nailing for Panel Attachment i Mckechnie, Robert From: Mckechnie, Robert Sent: Wednesday, February 08, 2017 8:30 AM To: 'yarmolovichandr@yahoo.com' Subject: 59 Church Street, WB Good Morning Ivan, The existing second floor plan for 59 Church Street shows a bedroom where a bathroom is, and a bathroom where a bedroom exists. I will need you to correct this information on the copies of the plan that you gave us. Also, I have your copy of the ON approval and several extra plans to return to you. Could you please stop in the office when you are in Hyannis today or tomorrow to correct the plans and pick up the other items? That would be good. I will issue after you correct the plans. Thank you, Bob Robert McKechnie Local Inspector Building Department Town of Barnstable 200 Main Street Hyannis, MA 02601 508-862-4033 1 i I 37ze Corwealth �r-t Depa baeut afrnd=bUAcddents 600 WashiVfm shvzt Boston,MA 021I1 Warlmrs' ComteasatienInsurance AfEdzvi+-Sni le7J en AppHcmnd Infmafion Please Pr ink Env Name &Marmw A h A'42-vL i Ad&ess: u! cityfstatmr�- p6 S VF— 36 —650-9 Are YOU au employer?Check the apprapriate ba= Type of project(required): L❑ I 3M a employer wig 4. ❑I an a general confractar and I 6. ❑New ogees(fall an ifor part-lime * brave hired the saki-ems 2.[^I am a s�Ie Svpsielar orp3rfaer- fisted ontbe attwhed sheet 7- ❑Remodermg ship and have no employees These smb-c�acs have S- ❑Demolition warier; forme is any capacity. emplorw andhave workers' INC wod mcs'onmp.insumace comp- I t . . ElT. r mg pfioa -j 5. El We am a tmporatian and its ❑Elechicai repairs err ail one 3.❑ I am.a homem mer doing all wark officers have ewxmed dew IL❑Mmubing repairs or moms myself[No wafpm' - ug1t of a M436=per M'Q. ksumce required.]i c.M JIM aadwe'haveno I--'❑Roof� employees_[No worms' 1313-other COmp-insurance regmre&] #Any fiMtc1�edsbox#1mastLIMmooltheRCff=beIowAvssiagtLeirwadce=s"cpeesativupa1icginf=taraL #E@aneuwnm vidw sn6m3t dm Effidavil im g =Cb- rC'a=C9=s*9 cbedcthis boa Tmst attt=sddi6nm2 s#reei sbox tliena@eof Ibe smd stye Whether arnotthose a shsv� i ®per Tfthes�c Shares , YzaosrgsaFide& u 'ter.PG&Yabet i I am m'eriiplOw dutisprmvi`Urig-,workers'canT resaf an iasnrance jer uy emp&jwm Betaw 1s fhe pvrLcy amd job sits IasmMce Company Name: /� �'i''t �t.G!�` ✓A,(,t Policy 41 or Self-igs Lic. LV C- -3 Q L1/ 6"026 ExpirationDate: Job Tile llddre= J Iy -e-eC g15 �c rI�SD�.6'L� �1i Attach a copy of the warmers'comupensationpolicy dechwa ion page(showing the policy number and expiration date). Faibre to secam coverage as regduedunde r Section 25A o€MGL a 152 can lead to the i mpositioa of csimmai penalties of a fine up to$L50D-OQ andlor one-yewimpfisonmeff,as web;as civil penalties Jn the faaa of a STQP WORK ORDI Rand a fine of up to$250M a day aaai�t molatar. Be advised that a copy of tins stalemerd maybe forwarded to tine Office of Iavestsgatiom ofthe DIA fnr- coveter I do hereby cerhyy pains and psi' ufgediuy thattlrs u forma€vaprovi&dabore is true and correct. - Date- l2 29 Prance ik mat arse a nly. Do jot mite in ffib area,&be completed by city arfairn ajYkiat City or Ta wm Pezmiff,icense# Lmlemg Auaarity(tacle one): L Board of$eal& 1 Raffifing Dqm mcmt s.0,<rumm Clerk �L Electrical Easpectur 5.Phunbing Emspector �.Other Court Person: PhD= 6 Tuformation and lastructions M ��tD MMffaworm' furl eg� - �a�h.,�e�Ge'neaalLaws c7zapfa �� . P�to.this sf�,as�Iayee is dried as=.evPryp¢soam�.e seavi.re of err ceder auy co�xsct ofb�,• express or naphed,oral ar wrr<i=!' Aa ea�Fay�is defined as�mtRnffi sl,per,as o�"�cmpax-af n cm affim Iegai eniify,of any Or IffXM of tine bregoing is a Joint etda�i and molndmg�e legal of a deceased e¢�Ioycd, rw2 i=or tins=of an bxvidnal,pMt =ffiip,asoeialion or othm legal entity,eploymg=pmyem a3wevez the owr�of a.dwmIlmg Muse having not me ro�lh=apartine�andwho resides ,or fhe occ�t of the - dweUi ng house of m fta who m3pIays prisons to do mam •tmanoq,ctmstra Or ropes WDrk.an sach dw,!J house or on the groum or b ldmg apgzutffi�thereto ffiannotbecame of such employment be deemed to be an=:[Pluyea." MGL chaptn=152,g25C(6)also states du±aevay stain or local fireasiag agency shaII'�bold$ie is-=nct-or renewal of a&cease or permit to opmmfe m business or to constrict bmldmgs in the co—onwean for asry applic=twho has notprodnced acceptable evidence of cdmpH=m with the uzsm--an=cov=zge rmq it „ AddmonaIly,MCIL cliapt=L52,g25CM std ns¢Naffi=the ce®aMW=M nor a'uy ofibpoEbzal subdivisions shall ear info any camtrad for the prance ofpmbli c work=61 acceptable evidmm of compHgncewifh the insrumzce.. requae CMtS of this chaplra have bees prese�d to the Cntr�, anthozity." Applicants Please fill out the worb=,compensation affidavit completely,by d=Eng• e,bm=that apply,to your sftzffan and,if necessary,amply s)name(s), address(es)a ndphcnp==b=(s).alongwiththcs ceE-bilcate(s)of instaance. T,=rtf-dI mbffity Companies(LT-C)or Li=tedLiabilrtyP s.(LLP)wi6ino =aplayees°ffim than$ne m=i& s or pm tne7s,die not rbqcm:ed to cant'workns'camPmI stun nminmcr- If an LLC or IL?does have employees,apoIiey is rMgafied. Be advisedthAthis affidmvitmaybe mhmftbn;d to the Department of Indushtial AceirT for confnmzfM of iim=coverage: Also be sure to stn and dateiffie affidavit The affidaVit should be retomed to!he city or town that the application for tine pezmit or&cease:is being rmquesh4 not the D epartm=d of IuhistEml A a denim Sbouldyou have any questians regarding the law or zfyou ax-e,requiicd to obtain a worms' ccM0pesafL policy,please call timDepatm=xtatthemmmberlis�bclow: Self-msuredeoinpanicsshonldeattrtheir self-msmz celicenseamberanffie line. City or Town Officials s Please be sore fat the of davitis cample�L-®dgrmdEdlegmly. TheDepa lmemtthas provided a space af.tficbottom Of the affidavit you to fll out iathe evemt the Office ofFmyestigad��"'s has to�ctyouregaXmgthe applicant Pleas e b e sure tD f M in the pennh'/liceose nmaber which w�I be used as a mfc=m=amber In-addVt an togappl c - fat must submit multiple pe�Tceuse.apphbgh ns m aay gm=year,need only mbm±ome affidav>x indit:aTsT fag eat policy fi fi:) n n.gnecessaiy)and modes`Tob She Add cc&*fe apPhcmf shOLIdv'Itm"all loc�ti in (may or town)-"A copy ofthe•affidavitmathas berg oi3>iciaIly,sfmVed armarledbyihe city or to may beprovided to the - - = applicant as.proof t hat a valid affidavit is on f ilo for 531= pemi:s or Hc=sos A new affidavit m Ld be f Mcd oiA earl year.Where a home owner or affirm is obiai�ng a license or permit not rr.7afzd fD any, tT3isess or dal v amtcro (ie_a dog licnsa or pew to bum leaves eta.)said person is NOT rcTared to eomPlefD this affidavit Tlie Of E=of Inv =�U Moe to thank you in advance fcr yomc coopeaafion and sbo�Id you have any ques'fr°ms. please do not hate to give us a call. i The Dq�artm S address,telephone and fax rmmb= - The Co of IAssachn x - Deparfmmt of 1 A t MA CdIII T(1L.#617-' -49W=ft4€6 or Fax 617 727 7M Ravised424-07 ��r u y Town of Barnstable Regulatory Services KAM ` Richard V.Scab,Director. Building Division Paul Roma,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barustable.ma.us Office- 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder I� S('oT 6�,M o (M r I S SA- �.t�C}M� , as Owner of the subject property hereby authorize (fi t L ►S t14 r c7 S r-o-►M i h 20axrM c"i to act on my behalf in all matters relative to work authorized by this building permit application for. `j c i4v l?c.}N s T v r s T 3 N rz r.�sT I'��- J�.p, o 6 C-g (Address of Job) **Pool, fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is ins ed and in ctions are performed and accepted. n � ignature of Owner of Appli t �I M r L SS P v�CO�s� ? 1-��t i f��CrP Print Name Print Name tZ Date WORMS:OWNERPER MSIONPOOLS Town of Barnstable Regulatory Services dF "W Richard V.Scali, Director ' Building Division X ` Paul Roma,Building Commissioner Mma 03% 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE ESEMMON Please Print DATE: JOB LOCATION: number sheet village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cityhown 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 Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required . shall be exempt from the-provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a 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 to amend and adopt such a form/certification for use in your community. i ' 1 0. 0 . „ x m A n M . � r laz N —b x o� 40 z r Z • >< _ bm • Z L- E ]. o r 0- _ �Q0 m cn 0 z s _ � N F a co$ 3 � > X O 3 m 77c, D Z g m -o o e zc Nv � � . CD v a O 013 u, N a 5 3 to Z O O rr N rr 0 a to o Q � n m D m al �1 CD N y °o02 O 0 3 m m m ,p v3 v m V 3 p >v N a n �_ c amo m � v m m z O n o •* o -t) O -� .. 3' 1 C) 0 ' N C O � — m � IUD 0 N O �► C fl• y 77' ?. � I� x. �► 2 rn =r _ C 33 aitn c My o rn Z m m rn o -� AN ADDITION FOR: �n v i • 831 Main Street X -i 9— Dennis,MA 02638 1 1 c A3 arches inc 508.694.7887phone D (p MELISSA&SCOTr LEONE 0 o Residential Commercial Net Zero �artl;toetain��m Z 59 CHURCH STREET ''^^ --I N, VJ r■ ; �,r' - Np ON N�' i6r1nUG¢FLP6 oflIl7T Z WEST BARNSiABLE MA 02668 WEW V' OF'n¢ABCT]1tCl'11f3 aGtN tIItYAatDYO@IGLLr FOA mtrnWtx roa no;'IRo1CCfnr rna BEE AND6 Nar . ME 1v ac Imn wmrtart rv=TD.100MU r ovn¢ARCWECr Ol OA.EAL0WW NC2016 l 4 �o AREA CALCULATIONS: ' EXISTING AREA: 4'-0" 17'-0" • 1 ST FLOOR: 1150 SF 2ND FLOOR: 590 SF 1 ti, TOTAL: 1740 SF � ,r PROPOSED ADDITION: � MASTER BEDROOM: 620 SF z Q 1 h• 0 ;�r I REVISED TOTAL: 2360 SF q�. s. � � W -j 0U Q t LL 0 N tA ( Z _ ZZ I cd oC =Y O C o LIST OF DRAWINGS: o m W Z A1.0 FOUNDATION PLAN Q � un � All FIRST FLOOR PLAN 77 r°> ",: I v`v` ,�. A1.2 SECOND FLOOR PLAN TITLE: A A2.0 ELEVATIONS A2.1 ELEVATIONS FOUND. cn n 14 c A3.0 SECTION PLAN Q0 r, S1.1 1ST FLOOR FRAMING m -; NEW BASEMENT EXISTING S1.2 2ND FLOOR FRAMING BASEMENT EX1 EXISTING PLANS �EW ACCESS IN °fin EXISTING CONC.WALL 00 -�N E Uu $ $5 O 3 r:; ppop 201-611 (A gl �V d NMI "CONCRETE RETAINING WALL,FIELD VERIFY EXACT . LOCATION AND SIZE Date: SD: 06.01.2016 PRICING:07.15.2016 ti p A/I PERMIT: 12.21.2016 Q�'G SON A A1FiA HYANNIS A 1 .. M FOUNDATION PLAN ?NOF . 1. 311r-r-W . A3.0 NOTES 4'-0" 17'-O" T. DIMENSIONS ARE TO CENTERLINE OF INTERIOR WALLS AND OUTSIDE FACE OF STUD OF EXTERIOR WALLS,UNLESS OTHERWISE NOTED. 4'-7" 7'-10" 4'-7" 2.CONTACT ARCHITECT IF THERE ARE ANY DISCREPANCIES IN THE DRAWINGS. 3.ALL NAILING AND CONNECTIONS SHALL BE IN ACCORDANCE WITH WFCM GUIDE TO WOOD FRAME CONSTRUCTION IN110 MPH ZONE. 4.ALL HEADERS TO BE(3)2X6s UNLESS NOTED OTHERWISE/ ui Z o 5. XK,XJ=#OF KING AND JACK STUDS(d3 OPENING. USE 2K,1J UNLESS NOTED OTHERWISE. p Q � Lum 3K1J 0 O t� ar5 / Q = ED o Z LU 0� Ln 3K1J � Q 251-411 TITLE: 1 st FLR O PLAN ool Cl / M M s e OFFICE DINING 2 ooin a Q c 8'-4"x 14'-0" 12'-6"x 14'-0"CD V C L dl rr— d V V u y _III LIVING ROOM d vtz 24'-0"x 14'-0" 8 4'-7" 10'-0"c EX �s?o 20'-6". EXTG HOUSE ' Date: SD: 06.01.2016 D ARC PRICING:07.15.2016 ETAINING WALL d�6 NA.q� �� PERMIT: 12.21.2016 No.20259 HYANNIS q m6 PJy A-1 A lny 0 rl"'�.FIRST FLOOR PLAN -r i 33'-Y 10 ol 13'-8"V.I.F. t 7'-8"V.I.F. 0 R Q N D D A Q n� �A o b� =8TrrrrrTla O.� 3 D z r �m mA z� �m mo �o _ _ 0 0 D N N !A aN v� n 0 ;0 o V O O aj m m p to -n T r -n O_ 1 z -0 Z O _ = m = CD C m ( I I 1111111111111 H. IN III III IjIjI+f M!"'I'll.-INVIE --4— I I UTA0 W N � z X r Z 9 n > 0 Q ?� rcnrzcrnmcmn c- mM= >- z m c D c N �n m5z mz x I Q2 ONzDm, 0w0 I oiom Z zO I O _ I D m Q O O T O � o I v... = zm � Z Fl m 1 I D E N �_ = m om z I � y z c z o M o I i cch m z o I oai = � � 0 cn r- v m (P� z r z z -uM mo m z0 D0 0- _ .c G) m v ------------ ---------J c � , z N00 cn Dm D I Xm ncn z r------- I m Z o . I 9 _ c Cc:o I I m v cn m I z 0 � D I ( o z 0 I m cam . o o m' cn cn m O c _ L------- I m v 00 RF I I O o CAI m v ' y�► =c I I m aDz^�i v t i D m y � � I j m z y AN ADDITION FOR: ;a • • 831 Main Sweet ZmNx Ma 02638 D m c� AMarches inc S08.694.7887phone Z On MELISSA&SCOTT LEONE g o Residential Commercial Net Zero wwwa3a=hitecminc m 59 CHURCH STREET • WEST BARNSTABLE MA 02668 rrona or ooeraKa+r_ . 'v THISOMWWG 6iHE fBOPFATY 0i�Al6RRLT HAS BEEN"IVAiI®ccrtnr.UY IOI TR OWNFA i00.'RO MDAGT AT��AND 61.'Of TOEFE6EDvir=t7FWITFNCD�rr OFTHE MOMFGT W� � .OA.CAACMILRSINC 1D16 uj N Z -- LU m 0. 0 U r` ? m p = a Q � Ln : TITLE: ELEVS. ARCH.ASHPHALT SHINGLES,MATCH EXISTING s . NEW ANDERSEN a�. WINDOWS/DOORS a � s — NEW FIBERCEMENT � � � SIDING,PAINTED TO MATCH EXISTING FM CLAPBOARD Z 2"MAX .m Fm EXPOSED • E CONCRETE C I f co . $.1 26-4"EXISTING HOUSE f 21'-O"ADDITION I I I I Date: I I I I SD: 06.01.2016 � PRICING:07,15.2016 L J L J ��\S�O A ARIol PERMIT: 12.21.2016 NORTH ELEVATION (CHURCH ST.) Q.2028.9 ' HYAN —2 ■0 o MAI Jy. . �� OF Mess 01 0X ^_' XX > � m _ � X z � � N > � z � 0) z0 mm CZD = Oz ZijD = z -40 MG) z 0 0M� -� G7 m r►1 D G) X C _ _ nN O -DID S Z = �. ZO O O I �� ---- O m II II II � II o II o I I A o II 6 �' Z II A II II � II � f M II 9 gM - r -------I-- - 9 ��, DL�-------i- -- - o Z II II I 6 - II I � I i II _ °z I I I ti �1N JF II i i A II - I I I ♦l b N - 1 1 C N • m zc p .T 3Z. g azn� a CAP �US�I'TS-L0 D ;13 co v m AN ADDITION FOR: 70 A " � • • 831 Main Street — Dennis.MA o2M M m P arc- inc "'ma' phone < MELISSA&SCOTT LEONE A , N g o Residential Commercial Net Zeroa3h � Cn 59 CHURCH STREET •V WEST BARNSTABLE MA 02668 0 0N C Nmm OFeTT . OFT/¢ABartfECl'HAS BffN PBBARED r?F17FlGulY FOSTIff OWNFd W0.TH6 PlOJBLT ATTH6 giEAND 6NOT TO M U w OUf R'AO �OF THE AtCKMMT Ol O ME AROQFwM wC zM i .mi XX -Din zm m XiA D OTC * OD � � 2 Z Cl) Z � 2 O z Z r D z rnOrZ N0 r ON (n m = D m 0 2 D = n� 0 � � II II II II II s O II � II M II II a II o z II o II o II Z v II � II I v II II II ; II { II II IIl I� w II b II � I.I II IM7- z 11 o II CA II m II II II . II II c - -� II II _ z II II o c II a II II II �owwoo�R = a �Do Z m z _ X L �aZro > o � O m Z n y K3 Cn 0 :E O = NN fir° of n M SD mD Opp +Lp. T- o - O 9. Z 00M (1) m jr Am nr L)m Znm z = my m02 mz -4 Ch v M AN ADDITION FOR: M 5 ° a 831 Main Sweet r' � K— Dennis,MA 026M DTI m D �0 `� A3 archr�ects, inc 508.694.7887phone -r MELISSA&SCOTT LEONE tV N m Residential Commercial Net Zero —a3araimminc-cm 59 CHURCH STREET WEST BARNSTABLE MA 02668 p O �' 'i}�O8AVG01G 6THE P60FF1lY OFTHEAAQQ�EGT HAS BEENAFPA1tED SIMNCSIIY W6THE OWNIX FOR iF16 F80JkLT CDAT TIQS 50YANDENOT O' 'TO PF ISFD NTfH0 M WRMI+OONSMT OF THE AA00[LCT Z T OMEAH00TEQS0iC2016 ' w c O t 1 l'-8"V.I.F. t T-8"V.I.F. 1 '-8" 1— (2) 1 J"X 11 j"LVL RIDGE BEAM O O Q (3)1 "X 14"LVL RIDGE BEAM �� 6 °� V 2'-10}�2" F j m . k;M1{ O TYPICAL ROOF CONSTRUCTION: RAO a °" � a ARCH.ASPHALT ROOF 4YL=.''' �`�'. h.. Q g 0 1/2"PLYWOOD SHEATHING, Wit' !:?�; TAPE ALL SEAMS �� "'' '*„ TITLE: 2xl0 ROOF RAFTERS, 16"OC W/2X10 COLLAR TIES, �"� 12 SECTION OPEN CELL SPRAY FOAM INSUL. (RAO) 1/2"DRYWALL 14 MASTER WEST WALL WINDOWS SHOWN ON a BEDROOM SECTION FOR HEAD HEIGHT LOCATIONS ONLY '- TYP.NEW EXT.WALL CONST:R:20 ..__ _ a NATURAL W.C.SHINGLES, 5"TW. /. " 1/2"PLYWOOD SHEATHING, t MASTER 1 BATHROOM E f � 2X6 LOAD BEARING WALL, w T-0"FLOATING WALL BATHROOM �❑ m o a 16"OC 5 1/2"SPRAY FOAM INSULATION, ° _ �lul a V ` 1/2"DRYWALL °O z •=N m --ALIGN Z T.O. 1STTCH Ex SUBFL I •u a,MATO f1 aana'� mm° ` ertu' ss � 5/8"X 8"ANCHOR ( VU e8 ".. BOLT@ 32"O.C.MIN. id TYP. NEW FLOOR CONSTRUCTION : ' 3/4 T&G ADVANTECH SUBFLR, ' 3"x3"x "PLATE WASHER. i0., GLUEDBNAILED ' 6'-0"ACCES TO I ;... LOCATE MIN.9 ° NEW 11�"TJI FLOOR JOISTS, NEW BASEMENT XISTING BASEMENT :•. FROM END OF JOINT PLATE. DROP CONC. VERIFY PROPOSED WALL HEIGHT WITH GRADE IN HE 6,_0„ " 11'-0"EXISTING HOUSE FOUNDATION AS REQ'D FIELD. EXISTING SLABS SHOULD ALIGN.EXISTING LIGN I � FIRST FLOORS SHOULD ALIGN. DROP PROPOSE WALL ` '. � � Date: _ eT.O. SLAB :. FOR DEEPER FRAMING. CS7 _ _ ELF MATCHEXTG ,, .,. , ..• ,. ^ . _ __ —. PRICING:07 15 2016 15'-0"ADDITION 18'-0"ADDITION �`g,�EaEDAR � PERMIT: 12.21.2016 33'-0" 0. 0269 v, HYANNIS M 5y �SECTIO A32 N _ ql Zi�b S�P� - b-n , L� O 0 D ,� b Z � D z Z rtJ 'n I °S m m $ 00 m I • a O ' n n A n ' I I 6- X z <71AOW vN -n z . OxDcD � nn,p0 om m ' O ` = � DzDOztn = n 00Pf0n -.4 0.z w � 0 � � 0 ;a0 (D mzOmz = O5b v Oo� Df) mx -mi zT n 0 DS'cZn = � zi 0to C � �D z mr nc �miq) m— N NOD m C O o0z � -< m —Z+ Mm � m vv, D Z v o z n 0 ZO � n 56 G� = = n Amy � gpx z9F- rn z v 0 Cl) (n � mmZ U) Zz m Zov M 0 c - = vc z = m ' Cnn m v Ch m C/) 0 sR�p p �3ZN Y G yt Z. cn a s . S Y p o -n AN ADDITION FOR: • ct�, • 831 Main Street m 3— Dennis,MA 02638 D c A3 archrte inc 508-694.7887phone „ MELISSA&SCOTT LEONE g o Residential Commercial Net Zero --a3urhitectsinc.com Z r0 59 CHURCH STREET WEST BARNSTABLE MA 02668 Q O � 'IEf6 08AwI24G 6711E FBOFfRTY OFllff AtOU7FA.T•N15 9FFN Ft0'AtFD SF[Cg1C1LLY FOR THE O'ANFA FOR lid PItOJECF ATTIfb SITE AND 6 NOT rotEusmwmlou 1`MR C3NSWT0FMAtOMICF Q1 0MEAROUTELT%W-2016 t 13'-8" V.I.F. t T-8" V.I.F. o co z n 0 2X10 SLOPED RAFTERS, 16"OC Z (2)2X10s AT SKYLIGHT OPENINGS r 0 2X10 SLOPED RAFTERS, 16"OC 00 m co I (2)2X10s AT SKYLIGHT OPENINGS _ c I A _ I < o D l J I 2X10 SLOPED RAFTERS, 16"OC 04`'' J oN I r 2X10 SLOPED RAFTERS,16"OC . I I I I ` I I Z vND . z I OxDCD � nnpO „ mo= �nr- m 0 m E m p � pZcn` m -qDzD oOFm0 (aO I m mOZ DCZ m 0 m 0 ;uvcn mZOmz = mm v m > mK0 0 -4o Z w m z n 0 Z - = per mnX Croy > r- ZZT1 C I G70Z � > Zm (P� Z r Zrz I ° Zm o0) m mm � 0 > M _ 0 m = O D ;0 D mcnzo nmcrn =Z F I � m m ' �' z -G P y 200 a aN > o ( � mc x co cn m 3 I o -D AN ADDITION FOR: m n a w • 831 Main Suva � 3 — Dennis.MA 02638 O T F3 c fi0a—rc-hqtect% inc 508.694.7887 phone 9 -n MELIssA&scoTT LEONE o Residential Commercial Net Zero- vwvw.a3ardlimminco�n, Z 59 CHURCH STREET N v • N + WEST BARNSTABLE MA 02668 IV N N NOnOE OE aOeTRIGHIF Q O � TICS URAWBIG 6TIR 7ROPERfYOF THE ARC'WTECT NAfBON RLLPARfD SPECDICALLT FOR TFD:OwNU FOR TM PROJECT ATTIBB(IE AND ONOT 01 TO BE USED Wn=f wRDTni CO?WM CS TM ARM ECT' OMEAROUTWIRu1-= . Town of Barnstable Building Post This Card,So That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept NAM Posted Until Final Inspection Has Been Made.'' '` -,%63 r M' p�ym7t eo +'' Where a Certificate of.Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made.. Permit llll Permit No. B-16-3713 Applicant Name: Ivan V Ivaniushenko Approvals Date Issued: 02/10/2017 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 08/10/2017 Foundation: Location: 59 CHURCH STREET,WEST BARNSTABLE Map/Lot: 153-004-004 _ Zoning District: RF Sheathing: Owner on Record: LEONE,SCOTT T&MELISSA A Contractor Name: BEL ISLANDS HOME Framing: 1 Address: 59 CHURCH ST �IMPROVEMENT 2 WEST BARNSTABLE, MA 02668 -Contractor License: '172476 - Chimney: Description: New Addition to Existing House with New Master Bedroom,and Est. Project Cost: $70,000.00 Master Bathroom Total 620 Sq $407.00 Feet. Permit Fee: Insulation: Upgrading Smokes. _______ ! Final: Fee Paid: $407.00 Project Review.Req: New Addition to Existing House with New Master Bedroom,and Date: 2/10/2017 Master Bathroom Total 620 Sq Feet. Plumbing/Gas Upgrading Smokes. ., � �� Rough Plumbing: Final Plumbing: ~?, Building Official Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zornng by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. '�-- Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing - 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: S.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. Fire Department "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). .Final: Building plans are to be available on site All Permit Cards are the property of the APR! ,I-ISSUED RECIPIENT TOWN OF BARNSTABLE..... t 242�0 Permit No. --------------- �� Building Inspector Cash -- - �.+►.� , r26 OCCUPANCY PERMIT Bond ___x--.___-: Issued to Howard W. Woollard'\ ,Address 59 Church Street, West Barnstable Wiring Inspector Inspection date Plumbing Inspector �,��J`� l Inspection date � ` a Gas Inspector 1 / ` Inspection dated 7Engineering�Department vz lloz Uispection date / -/,4-/ Board of Health y Inspection date///7 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 CODEr.. Q Q �_z � ...............�..................................., 19.»»_ ............................................................................ ._.... .»» Building Inspector 1 1 q 11 11 ; I 1 \ / 3 0 \ 1 4� Y, ° \\ t VtJpaa'#iO�.1 LLxco 4 o N -TH E i�LA i �.► S 7\� o�\ li -- o---DISTANCE AS CERTIFIED I HEREBY CERTIFY THAT THE BUILDING SITE PLAN SHOWN ON THIS PLAN IS LOCATED ON THE GROUND AS SHOWN HEREON &THAT IT O n -v LOCUS: ' CONFORM OF THE ZONIN BY AWS OF T � Of TQ �1 � J�i � =y j>j?jA�NSTA3LG t�IA.SS. 30 WHEN CONSTRUCTED. DATE JAMES °�.�.` �/� REF: 7 down cape engin fj owto PREPARED FOR: 1 #2,404 CIVIL EN E S LAND SUR O-f- I ` DSURVEYOR Yarmouth&Orleans,MA COSU SCALE DATE S2. YOU WISH TO OPEN A SUS11VESS9 For•Your Information: Business certificates [cost$40.00 for 4 years]. A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by.M.G.L.- it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office., 1 st FI., 367 Main St., Hyannis, MA 02601 (Town Hall) and get the Business Certificate that is required by law. DATE: 1-16 -I Fill in please: . . APPLICANT'S YOUR NAME/S: Sco L Diva �<< BUSINESS YOUR HOME ADDRESS. Sq C t+„ee -1 S T- oZ66fS TELEPHONE #k Home Telephone Number '7-7N- G qd- R377 NAME OF CORPORATION: AC7CNC%6S NAME OF NEW BUSINESS S0a� L\NrC- A,C3'Er-CiCs TYPE OF BUSINESS IS THIS A HOME OCCUPATION? X YES NO ADDRESS OF BUSINESS SS C'0\,�2CO MAP/PARCEL NUMBER 00 dd [Assessing] When starting a new business there are several things you must do In order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the.information you may need. You MUST GO TO 200 Main St. - (corner of Yarmouth Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. . 1. BUILDING COM SID R'S OFF CE This indivldu he a irrFo anfanp mit requir ments that pertain to this type of busl( sST COMPLY WITH HOME OCCUPATION RULES AND.REGULATIONS. FAILURE TO Aut or d Si to ** COMPLY MAY RESULT IN FINES. MEN / r 2. BOARD OF HEQLTH This Individual has.been informed of the'permit requirements that pertain to this type of business, r Authorized Signature** COMMENTS: 3.. CONSUMER AFFAIRS [LICENSING AUTHORITY] This Individual has been informed of.the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: f Town of Barnstable TKE Regulatory Services Richard V.Scali,Director B z Building Division 9 BUM $ Tom Perry,Building Commissioner i6;q. 'DTF µgt 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.ns Office: 508-862-4038 Fax: 50 -790-6230 Approved: Fee: 135 t Permit#: 00/ S-OY4f 6 j HOME OCCUPATION REGISTRATION Date. 7 — Name: cork K L �'t-rc Phone#: 1.-1 Lk Address: S C }i-y12 C to S7- Verge; Name of Business: SZE l,C �'��`C t 6- Type of Business: C Ot-1 S u U-0 W C Map/Lot U 0 4 0 0 q INT=: 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 residential volumes. • The use does not involve the production of offensive 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 hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parldng generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment • There are 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 the Customary Home Occupation. • No sign shall be displayed indicating the Customary 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 I,the undersigned, ve read a�id'a r"e with the above restrictions for my home occupation I am registering. l Date• Applicant= ,�, . f ' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION MapAJE`'� Parcel #Application Health Division Date Issued Conservation Division Application Fee Planning Dept. Permit Fee 7 , :X3 Date Definitive Plan Approved by Planning Board to Historic - OKH Preservation/Hyannis ' - Project Street Address ) U u C-0 l Village �,A1 tfi4- Owner Meiy(!g � CV4 5C&(f (,e—C9 �)2 Address 50( U) u CA 5T Telephone a-© -/3 9 S 5- -7 0 j Permit Request Y� '�-C�C� O aj) 44 M41? 1, OtkAed',n,2&, Square feet: 1 st floor: existing proposed �00 2nd floor: existing W?bO proposed '-P 0 Total new Zoning District Flood Plain Groundwater Overlay Project Valuatior# O 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 ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new a o Total Room Count (not including baths): existing new First Floor Roi ount m Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Q r� Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/cJ stove: RYesM No 1 -� ,-4 Detached garage: ❑ existing ❑ new size Pool: ❑ existing ❑ new size _ Barn: ❑ exist' g ❑ ne4 size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing 0 new size _ Other: �n 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 /`�`� �� e Q�e Telephone Number ✓ ff 1:5 -7 f"7 Address 15ct 6 k q4 License # Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE I5 (3 { -�,... -75; FOR OFFICIAL USE ONLY a APPLICATION# 4 DATE ISSUED t.� MAP/PARCEL NO. k. . r ADDRESS VILLAGE OWNER DATE OF INSPECTION: 4 ' FOUNDATION s 312' `Y y INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL r r PLUMBING: ROUGH FINAL , GAS: ROUGH FINAL cu— + FINAL BUILDINGSel�(Zcu s v DATE CLOSED OUT Y ASSOCIATION PLAN NO: ,' r Town of Barnstable Regulatory Services Thomas F. Geiler,Director MAM 396 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 PLAN REVIEW ?b!3 ao99� Owner: LE oae Map/Parcel: 640 /- 60 Project Address dwAc# S'r, /,)B Builder: 1W.Oqf:,o kMrep The following items were noted on reviewing: ��kE �TKTo/Ls,li¢i�-rtrn s A�yl� CO ,�F�zoi�r.,�i�Ifts - Aof 6& 2AWI?29 LLt--4 /OEl'¢ 2 6'-ooie Z s ci-L y-riO tit )PEW"-'('O2 C-b 2 etc/N 3 c S�! /GL TlcAl✓19LE .�E �£�G�9-CE� ? C tt-&Ae -r Z044-7-/ON W*S AAO T 0045�.Ar" OR, Z IDS P��T�D/•� (� �D/IK dGc�j Yt oit7/i�(�f-/C�lyO �iQ �Ili�tJdlOT h7E -i/cf°/�LIEd '6 /e i L 7; - k At a:e�- l Rc— L T /olztsY� I i Reviewed Date: 7� Q:Forms:Plnrvw ' - The Commonwealth of Massacksetts - Department of Indrlstrial Accidents Office of Investigations._ ...... 600 Washington Street Boston,MA 02111 UV www.mass.gov/dia Workers' Compensation Insurance Affidavit: Butlders/Contr-actors/Electricians/Plumbers Applicant Information / Please Print Letsibly Name(BusmesdOTanizatiowbdividn : )kddress: i City/Sta-te/Zip:--V-&+- ��`�= hone.#: � '7 d Are you an employer? Check the appropriate box: Type ofpioject(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I to ees full p ) *• have hired the snub-contractors 6• ❑New construction I �. Y ( and/or art time . 2.[] I am a'sole proprietor or'parbla-' listed on the'attached sheet 7.. 0 Remodeling s. and have no employees These sab-contractors have � mp Y� 8. ❑Demolition woding for me in any capacity. employees and-have workers' • [No WOrkeIS'•COInp.•inc�Tranrr. comp. incrn-anCe: 9. Buildin,�addition $. `�"� - ed.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3. • I am a homeowner doing all work officers have exercised their 11.❑Plumbing repass or additions myself [No workers'comp, right of exemption per MGL 12.❑Roof repair insurance required..] t c. 152, §1(4), and we have no employees. [No workers' 13.❑Other comp,insurance required] *A13Y aPPucant.that chec]Q box#1 mu ow must also fill out the section below shing their workers'cornpaz sation policy information. t Homeowners who submit this affidavit indicating they are doing all work and d=hire outside contractor;mast subrnit a new affidavit indicating such. on XChactors that check this box nnrst attached an additional sheet showing the name of the sob-contractors and state whether or not those entities have employees. If the sub-conft ctors have,earployea,they must pruvi&their workers'comp.policy number. I am an errrp'[oyer that is providing workers'compensation Insurance for my employees. Below is the polity and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/Sia.te//Zip: Attach a copy of the workers' compensation policy.declaration page(showing the policy number and expiration date). Failure to set-tae coverage.as required under Section 25A ofMGL c. 152 can lead to the'imposition of cri i a penalties of a fine tip to$1,500.00 and/or one-year i�risonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against ffk violator. Be advised that a copy of this statement may be forwarded to the Office of IuvestitTations of the DIA for rn.sm-anrp coverage vt cation. I do hereby ce th�pains pert ofperjwy that the information provided above'rs tmezand correct . Si ( Date: �✓ Phone# d'C� 9 fH' -7 1 -7 — D0zcia!use only. Do not write m this area,tb be completed by city or town offrciaC City or TovPn: Permit/License# Issah g Authority(circle one); I.Board of Elealt h I.Building Department 3.City/Town Clerk 4.Electrical Inspector S.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 horse having not mDre 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 shO not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local liceusing 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, §25(x J)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 vzth the insur-aace requirements of this chapter have been presented to the contracting authority." Applicants PIease U out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and it neccssary,supply sub-conti actors)name(s),address(es)andphone number(s) along with their certificates)of ►n „ce. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the member;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 taus affidavit may be submitted to time Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned tin,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-ins=ad companies should enter their self-insurance license number on the'appropriate line'. City,or Tows.Officials .Please be sure that the affidavit is completr'and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fiIl out in the.event the Office of Investigations has to contact you regarding the applicant Please be sure to f11 in the permit/license number which will be used as a reference number. lu 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 taws),"_A cbpy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the' applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must b'e filled out each year.Where a home owner or citizen is obtaining a license or permit not related fo any business or commm-vial venue (Le.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 arldress, telephone-and fax number. The Conrma>awealth of MassaG L=as Dq tmont of ladust dal Accidents ©-f'tec of InVestigat OnS 600 Washington Street Boston,MA 02111 ; Tel.#617-727-4400 ext 406 ar 1.-877 MASSAFE Fax#617427-7749 t GttW W.Mass.gf a v/d i a af�r 'Tum of Barnstable Reg latoty Sem' 'Ces RL ANfR'1R1 ,F : Thomas F. Gener,Director cbT9 �a Building Division QED lAl�� Tom Perry,Building Commissioner 200 Maiti-SircctLHyannis,MA 02601 R WVY.town_barastable_ma us Office: 509-862-403 8 Fax: 50 8-790-623 0 ElorrmOvmm LICM\'SE EXEM JON . ` r Plerse Print DATE r� l 1.5 JOB LOCATION: 7 -I V&Wt& W v!`I' 2 6Z�- 1 f e9 number street village xo) owN>:R~: /VI �i�✓� 1 �Y1� �03��t �S- —1 1 -7 j name i�p `home phaoe# work phone# CUARMhFr WMING ADDRESS:_ 1 j6'Q rit s>atc zip ende The cturcnt exemption for"homeowners"was extended to include 0-rimer-occupied dwelli= of siz twits or less and to aIIow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as sutperyisor_ DE73JU17ON OF HOM7,07TWER Pcrson(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 dctmhed.siructm-cs accessory to such use and/or farm sfruetttrrs. A person who constrgcts more than one home in a two-year period shall not be considered a bo=owncr. Such "homeowner"shall snbffit to the Building Official 011.a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building peffiit. (Sedon I09,1.1) The tmdcrsigncd`homeowner'acst cs responsibility for compliance with the State Building Code and other applicable.codes, bylaws,roles and regulations. The tmdcrsigued"homeowner'certifies that he/she understands the Town of Barnstable Building Department n�irrirrntm inspection pro uses and ri-_q ri*T**�mts and tbat he/she will comply with said procedures and SignaEme of Harncowncr Approval ofBu�lding OffiCW Note: Three-faintly dwc1lin gs cont�,�3 5,000.cubic feet or larger will be required tD comply with the States Building Code Section I27.0 Constrnctibn Control. HOaMowrta'S EmarzTbN .The Colo stztrs that Airy bcrrr=wnrrpafmmmgwark for which z bm-ldmgperrait is shall be of this section(Section 109.1.1-Ii�+ving of construction Supcn isors);provided that if the homcoq�na m ��t from the o do r ch gagrs a pason(s)for hire fa do such word that such Homeowner shall act ss rope-visor." i y he neownar who use this rrcmpticM are onaw=that they arr assuaning the nspannbilitia of a arper7isor(see Q Appendix i i Rules&Rcgu)ati=far Lieeosurg Coatlrvctian Supavisara,Section 21 This lack of awarrnesr hften rr sups is serious prab]cras,partir�hafy whir the haeawner hires unlicensed pawns. hi this case,oor Board cannot pmcced against the unlicarsed pcnoir as it wld ou with g b=nsed Super m visor. The homeowner acting as Stipavrs(r is ultiamte)y T sponsrb)r- To===that the hamcnwncr is fuI)y Marc of hirlba-rtsponsibilities,many comannnities r updre,as part of the pcnnit application, that the bm-n=f mcr=tiry that hekshe undasbm&the rrsponanbilitia of a Supevsor. Do the lzst page of this issue is a form amardy used by =coral towns. You may t=t amrnd and adopt such a fmnl6crtifneatioo for use in your eonmmnity. Q:formr:hom=crnpt r ti Town of Barnstable Regulatory Services � tti AIV[T'1 Ftt_,4� s MIaC �� Thomas F. Geiler;Director . �En► �'� B[rllding Divisida Tom Perry, Building Commissioner 200 Main Strce%Hya=is,MA 02601 www-town.b arnstab Ie_ma..us Officer 508-862-4038 Fax: 508-790-6230 Property Owfter Must Complete and Sign This Section If Using A Builder- as Owner of tb-snbject.property hereby authorize to act on m7 behalf, in all Tn;l rs relative to work asrhorized by ibis building permit application for. (Address of Job) .Signat= of Owner Date Print Name If Property QWner,iS applying for permit please' complete the Homeowners-License Exemption Form on the reverse side. Q:FORlrIs� .DV/NERPERMMSION r j �I i fi 11 _ f s - V) oo o Utility Room U Bath 0 Furnace IMP® T - PGRADE REQUIRED STATE BUILDING COD REQUIRES THE UPGRADING OF SMOKE DETECTORS F THE ENTIRE DWELLING WHEN ONE OR MORE SLEEPI AREAS ARE ADDED OR CREATED. O NOTE: A SEPARATE ERMIT IS REQUIRED FOR THE Closet cT ON OF SMO E DETECTORS-THE ELECTRICAL . ES NOT SA SFY THIS REQUIREMENT. SMOKE DETECTORS REVIEWED BARNSTABLE BUILT ING DEPT, DAT Closet ENT DATE BOTH SIGNATURES ARE REQUIRED FOR PERMITTING Porch 1 st Floor (Exis7ing) CARBON MONOXIDE ALARMS MUST BE INSTALLED PER MASSACHUSETTS BUILDING CODE CCo p • • 1C m m Bath J 0 O ;af v� 73 Porch f U n 4ON Kitchen 2nd Floor (Existing) ON �" P cf) `P Bath 0 h Furnace .c. Home Office Closet Bedroom Closet Porch 1 st Floor (Proposed) � l O Bath O. Porch P V 2nd Floor (Proposed) ,& 5+, &U4� �7b4vA 4 54awkmv TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel Q® --`,,'4 OF BARNSTABLE Ap � plication # + U Health Division Date Issued v J } _ Conservation Division Application Fee ?� Planning Dept. _ �. m_ Permit Fee Date Definitive Plan Approved by Planning Board LIV_1S10N 01 Historic - OKH _ Preservation/ Hyannis Project Street Address Village W)a+r� Owner ,4/�:Q�(�v�a� .P_d YV Address Sa YAP. Telephone o26 q EZ j Permit Request fA K, iA Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain 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 ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ 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 /UIa yf i eo6,0 Telephone Number a�✓`� fJ�" Address �; _ License# Home Improvement Contractor# ' q P Email i/�'11(�,�'t !I �?- ��0� a C, eayt Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE DATE (D ,� FOR OFFICIAL USE ONLY ~°APPLICATION# f t t DATE ISSUED t , s `w MAP/PARCEL NO. i t � Y, ADDRESS VILLAGE OWNER r . DATE OF INSPECTION: FOUNDATION ' t FRAME INSULATION s FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH- FINAL FINAL BUILDING DATE-CLOSED OUT AS:_SOC ATION PLAN.NO. Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division 14 Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 RFD 's a www.town.barnstable.ma.us Off-ice: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION DATE: CO Please Print .I / 5 CIA yj 4+ 5, Al JOB LOCATION- number strVet village "HOIVMOWNEW'AV�5221 Lez-ameo g63 9 j(_1j:-2 7( . name home phone# work phone# CURRENT MAILING ADDRF—SS: 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 un rAgne "ho wner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection proc d ej%certifies tshe will comply with said procedures and requirements. S/grature of Horncowne�-/ 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 persou(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. QAWPFILF_S\FORMS\bui1ding permit forms\ENPRESS.doc Revised 061313 Town of Barnstable Regulatory Services • r r ► �BARNSTABM S M . Richard V.Scali,Director i639� �� 639. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and 'Sign This Section If Usina A Builder. 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) "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 Q:FORMS:O WNERPERMISSIONTPOOLS I ,4co® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) llll. � 1/14/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER C ONTACT Cove Risk Services,LLC NE FAX No EKft PO Box 859222-9222 AIL Braintree,MA 02185 RESS: INSURERS AFFORDING COVERAGE NAIC it A: MA Retail Merchants WC Group Inc. INSURED INSURER B: Party Cape Cod,Inc. INSURERC: 660 Mac Arthur Blvd. POcasset,MA 02559 INSURER D INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 07378 REVISION NUMBER: 00000 THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ILTR TYPE OF INSURANCE ADS S BR POLICY NUMBER MM/DD/YPOLICY EYY MM/DDVYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE 5 COMMERCIAL GENERAL LIABILITY E TO RENTED PREMISES a occurrence S CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE S GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC S AUTOMOBILE LIABILITY ECOMBINEDaBI e SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY AUTOS AUTOS (Per accident) $ NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS Per accdent $ s UMBRELLA LIAB HOCCUR EACH OCCURRENCE S EXCESS LIAB CLAIMS-MADE AGGREGATE S DED I I RETENTION$ S WORKERS COMPENSATION X WCSTATU- OH- AND EMPLOYERS EMPLOYERS LIABILITY YIN O I S ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT S 100,000 AOFFICER/MEMBEREXCLUDED? ❑ NIA (Mandatory in NH) 014000500406115 1/01/2015 1/01/2016 E.L.DISEASE-EA EMPLOYEE S 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) CERTIFICATE HOLDER CANCELLATION Town of Barnstable SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ATTN:Building Department 200 Main Street THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Hyannis,MA 02601 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD f Tfw Comrno7nwah*of—UassaeliuseAs Deparkxxmt of htdusb tat Accidents - office of finves afions 600 Was-hington,reet Boston,MA 02111 wfv"wnasmgaWdia Worlcers' Compensation Iu mrauce Affidavit Builders/Contra:ctors/F-JectricianMumbers Applicant Information Please Pant Legibly Name(Budnes/0rganizaion&&vidn4: �P.AP Address ' City/Sta"Ja o=47 — (,:5 — WV Are you an employer?Check th&appropriate boz: Type project(required): 4. I aru a contractor ! 1.El I am a employer with actor and I Flee of�'o 6- ❑New comstnscfiion employees(full and/or part-time)* V e hired the sub` s 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- ❑Demolitioa wodang for me in any capa ci t5r employees and have wozicers' - _ 9_ [-]Building addition j [No workers' conip_iusurance comp_tncivarvrg requiredr] 5-❑ We are a corporation and its l0f� Electrical repairs or additions 3_❑ I am a homeowner doing all work officers have exercised their 11_0 Plumbing repairs or additions Myself [No x,.orkers'gip- right.of eazemption per MGL 12_El Roof repairs iusuran ce regntred_]I c_152, §1(4} and we have no employees_[Nvwwkers' 13XOthe��P comp_insurance required-] *Airy BapHcxat tact checks boa n1 most also I1 out the section below showing fhea vradcea'compensadon policy iufntmztiob T Homeawners who submit this atddsvif indk they are doing sR wc$[and dies hie oxhide contractors mass submit anew afdwit iarbra in such. tContcactors that rbe ct this box mast stteched sa additional sheet showing the name of the WIF-ca&3dot5 and state whether ornnt 1ffia5Ie eadfws have Employees- if the sub-contmaors hose employees,they must provide tier workers'comp.Policy'Lumber I am arz employer that is protdditrg ttrorkers'con.Wusah'on insurance for my enipfnyem BeJatr is Ste paUcy and job site information. n - Insurance Company Name. / 1// ,- / — Poky 4 or self ins_Lim ` Q cl d o D 6 6 C'�r-C Q�0 (1 S Expiration Date: r l l0 Job Site Address: &- Citylstateizip: Attach a copy of the workers'compensati m policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required.under Sea6ora 25A o€MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.Oa and/or one-yearituprlsonment,as well as civil penalties in the foam of a SWOP WORK ORDER and a fine ofup.to$250.00 a.day against the violator_ Be advised that a copy of this statement may be forwarded to tine Office of Investigations of the DIA for insurance coverage vierification- I dd hereby IM hapains t0 rt penalties ofped.ury that Ste information prouidsd abosye is. and correct S.irrnatrsre: *� }date: (' Phone 9: a I ( / — 1 -7 l Offuial use on[y. Do trot write in this area,to be compie+ted by Grfy or town ofteiaL City or Town: PerraitUcense# Em i g Authority(circle one): 1.Board of Health 2.Budding Department I Cityfl'own Cleric 4.EIectrical Inspector 5.Plumbing Inspector .6.Other Contact Person: Phone 9: 6 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 arty 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 checld ag the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone numbers)along with their ceri_ncatc-(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other-ban 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 Indus'Lrial Accidents for confirmation.of insurance coverage. Also be sure to sign and date the affidavit 11-e 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 permitthoense 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 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: 'moo Commonwealth of Massachusetts Depai meat of Industrial Aacid mts Q�xee of�ves��atEans 600 Washinuuton St=t $ostou,M&G21 I I Tel. 617-727-49-04 ext4Q6 or 1-977-MASSAFE Revised 4-24-07 Fax#617-727-7149 w _mass-govldr'a I I IMPORTANT DOCUMENT Certificate of Flame &sistance ISSUED BY Date of Shipment 06/04/10 i Registration Number INDUSTRIES INC.® Tent Identification F-12110 14870560 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable)and were supplied to: PARTY CAPE COD 660 MACARTHUR BLVD POCASSET, MA 025592230 i ♦STE Z F RE'rQ' Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701, CPAI 84. Serial# 8106200(8) Description of item certified: 40'x50'White Frame Tent Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric TRIVANTAGE STATESVILLE NC Name of Applicator of Flame Resistant Finish Signed: ilk AN HOR INDUSTRIES INC i IMPORTANT DOCUMENT Certificate of Flame 1ssistance ISSUED BY Date of Shipment F122.02 Registration Number IND CHOR 03/25/13 USTRIES INC. Tent Identification F 1 15153653 EVANSVILLE, INDIANA 47725 MANUFACTURERS OF THE FINISHED TENT PRODUCTS DESCRIBED HEREIN This is to certify that the materials described are inherently flame retardant and were supplied to: PARTY CAPE COD 660 MACARTHUR BLVD POCASSET, MA 025592230 Gt T F ueTp�` Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant approved chemical and that the application of said chemical was done in conformance with California Fire Marshall Code. All fabric has been tested and passes NFPA 701-04, ULC 109. Serial# 8106200(5) Description of item certified: 20'x20'White Frame Tent Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric HERCULITE YORK PA Name of Applicator of Flame Resistant Finish Signed: ANCHOR INDUSTRIES INC �I { Parcel Detail Page 1 of 3 Of to C;, BARNSTABLE !d MASSoKe 41:� . ED �-: Logged In As: Parcel Detail Wednesday,July 25 2012 Parcel Lookup Parce[Info Parcel ID y 153-004-004 �_ _I Developer LOT �Y— Lot Location 159 CHURCH STREET e� I Pri FrontageSec �— l Sec Road 1THE PLAINS ROAD NORTH I Frontage 186 s village iWEST BARNSTABLE I Fire District(W BARNSTABLE I Town sewer exists at this addressNO—� I Road Index 0308 Asbuilt Septic Scan: Interactive 153004004 1 Map Owner Info___ Owner IREYNAR, GEORGE J & RUTH E I Co-Owner Streetl 59 CHURCH ST I Street2 City WEST BARNSTABLE I State MA zip 102668 Country Land Info Acres�r 1.58 use Multi Hses MDL-01 �I zoning RF Nghbd 0107 Topography pLevel o^ I Road Paved Utilities IGas,Well,Septic Location( i Construction Info Building 1 of 2 Year 1982 I Roof Gable/Hip I all Built Struct Wall Wood Shingle I Living r577 I Roof Asph/F GIs/Cmp I AC None Area Cover Type r-- _—_-- Int I`�_s�� Bed — 115 style iCape Cod I wall!Drywall I Rooms IL Bedrooms I �'`Pra9 Model esl Floor dential I or R (Hardwood �I Bath 1—FLII + 1 H e e Bath INI 1,, qs Grade Average Plus I Heat(Hot Air Total I6 Rooms _I 1 sMf Type Rooms 1 ((� Stories 1 1/2 Stories Heat Found- I Fuel I"as I ation Poured ConC. Gross 2918 Area Building 2 of 2 Year 989 R� Roof Gambrel u I all Wood Shingle Built Struct Wall http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 7/25/2012 Parcel Detail Page 2 of 3 Living 885 -) Roof Asph/F GIs/Cmp I AC None Area Cover Type Int Bed style Gambrel I wall Drywall I Rooms 2 Bedrooms Bath Model Residential I Floor Carpet IIn - Rooms 1 Full + 1 H Grade Heat IAverage I Type Hot Water ( Rooms Total 1 4 Rooms I M V Stories 12 Stories I Fuel Oil I Foation Conc. Slab Gross 1020 Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 10/3/1996 Addition 18332 $350 2/15/1997 12:00:00 AM Reroof 9/1/1989 B33240 $8,000 1/15/1992 12:00:00 AM WB ADD'N Visit History Date Who Purpose 3/28/2012 12:00:00 AM Denise Radley In Office Review 1/17/2008 12:00:00 AM Paul Talbot Cyclical Inspection 11/1/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 2/15/1990 12:00:00 AM ML Sales History Line Sale Date Owner Book/Page Sale Price 1 9/3/2004 REYNAR, GEORGE J& RUTH E 19003/237 $1 2 2/15/1993 REYNAR, GEORGE J 8440/108 $1 3 1/15/1986 REYNAR, GEORGE J &RUTH E 4889/253 $169,500 4 5/15/1982 1 WOOLLARD, HOWARD W 3475/180 $59,500 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2012 $232,200 $28,100 $3,800 $213,600 $477,700 2 2011 $288,700 $3,600 $2,700 $213,600 $508,600 3 2010 $288,200 $3,600 $2,900 $206,700 $501,400 4 2009 $305,100 $2,700 $1,400 $187,600 $496,800 5 2008 $283,500 $2,700 $2,100 $195,600 $483,900 7 2007 $315,900 $2,700 $2,100 $195,600 $516,300 8 2006 $265,100 $2,700 $2,100 $211,800 $481,700 9 2005 $252,700 $2,700 $2,100 $192,600 $450,100 10 2004 $203,700 $2,700 $2,100 $221,400 $429,900 11 2003 $180,700 $2,700 $2,100 $68,700 $254,200 12 2002 $180,700 $2,700 $2,100 $68,700 $254,200 13 2001 $180,700 $2,800 $2,100 $68,700 $254,300 14 2000 $130,000 $2,700 $1,100 $52,200 $186,000 15 1999 $130,000 $2,700 $1,100 $52,200 $186,000 16 1998 $130,000 $2,700 $1,100 $52,200 $186,000 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 0316 7/25/2012 Parcel Detail Page 3 of 3 17 1997 $131,900 $0 $0 $40,500 $174,900 18 1996 $131,900 $0 $0 $40,500 $174,900 19 1995 $131,900 $0 $0 $40,500 $174,900 20 1994 $123,300 $0 $0 $57,300 $183,100 21 1993 $123,300 $0 $0 $58,200 $184,000 22 1992 $115,300 $0 $0 $63,700 $181,900 23 1991 $109,700 $0 $0 $92,600 $205,100 24 1990 $95,800 $0 $0 $92,600 $196,800 25 1989 $95,800 $0 $0 $92,600 $196,800 26 1988 $76,000 $0 $0 $34,600 $118,100 27 1987 $76,000 $0 $0 $34,600 $118,100 28 1 1986 1 $76,000 $0 $0 $23,6001 $107,100 Photos �k Ks r tY ano Olin - , q Y 4 t i http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 7/25/2012 Parcel Detail Page 1 of 3 �0 -_ 44 v: BAFL�'ST,UII. �,,; yE- k,,.i a . FDz y G' :- } Logged In As: Parcel D e la(I Friday,June 14 2013 Parcel Lookup Parcel Info Parcel ID[153-004-004 I Developer LOT 8 Lo Location 159 CHURCH STREET I Pri Frontage Sec Sec Road ITHE PLAINS ROAD NORTH I Frontage 186 Village!WEST BARNSTABLE Fire District JW BARNSTABLE Town sewer exists at this address I No I Road Index 0308 Asbuilt Septic Scan: Interactive i 153004004 1 Map I ~ w Owner Info Owner ILEONE, SCOTT T&MELISSA A I Co-owner Streets 150 BEAR PATH ROAD I Street2 City I HAMDEN I State CT Zip 06514 I Country Land Info _ Acres —_J use Multi Hses MDL-01 I zoning RF Nghbd 0105 , 51,8 Topography ILevel` I Road[Paved Utilities IGas,Well,Septic� I Location [ Construction Info Building 1 of 2 Year uc 1982 Gable/Hip wan Wood Shingle I Living 1389 I RoofAsph/F GIs/Cmp I AC None Area Coverover Type i _ 4 ,"l Style Cape Cod I Wallnt Bed 2[Drywall I Rooms Bedrooms I Q„ FPToe , In lBath Model jResidential I Floor Hardwood I Rooms 11 Full+ 1H I e _ rs Total Grade Average I Type Hot Air I Rooms 16 Rooms I erNT stories 1 1/2 Stories I Heat[Gas I Found- Poured Conc. Fuel ation I Gross 2918 I Area Building 2 of 2 Year 11989 I Roof Gambrel ( Wood Shin le Built' I Struct Wall all g I http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 6/14/2013 Parc'el Detail Page 2 of 3 Living 831 I Roof Asph/F GIs/Cmp I None I Area� Cover Typepe Bed Style Gambrel I Wall Drywall I Rooms 2 Bedrooms Model Residential Floor Carpet I Rooms 1 Full+ 1 H Grade Below Average I Heat Hot Water I Total Type Rooms 4 Rooms I Yam' i Stories 2 Stories I Fuel Oil I HeatF ation Conc. Slab und- Gross Area i 1020 Permit History Issue Date Purpose Permit# Amount Insp Date Comments RESTORE TO 1 FAM-CREATE 3/4/2013 Remodel 201300994 $7,300 OFFICE IN ACCESSORY UNIT- REPAIR ROOF 10/3/1996 Addition 18332 $350 2/15/1997 Reroof 12:00:00 AM 9/1/1989 Addition B33240 $8,000 1/15/1992 WB ADD'N 12:00:00 AM Visit History Date Who Purpose 3/7/2013 12:00:00 AM Jeff Rudziak In Office Review 3/28/2012 12:00:00 AM Denise Radley In Office Review 1/17/2008 12:00:00 AM Paul Talbot Cyclical Inspection 11/1/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 2/15/1990 12:00:00 AM IML I Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 12/28/2012 LEONE, SCOTT T&MELISSA A 26998/57 $315,000 2 9/3/2004 REYNAR, GEORGE J& RUTH E 19003/237 $1 3 2/15/1993 REYNAR, GEORGE J 8440/108 $1 4 1/15/1986 REYNAR, GEORGE J&RUTH E 4889/253 $169,500 5 5/15/1982 1 WOOLLARD, HOWARD W 3475/180 1 $59,500 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2013 $217,300 $29,100 $4,500 $217,100 $468,000 2 2012 $232,200 $28,100 $3,800 $213,600 $477,700 3 2011 $288,700 $3,600 $2,700 $213,600 $508,600 4 2010 $288,200 $3,600 $2,900 $206,700 $501,400 5 2009 $305,100 $2,700 $1,400 $187,600 $496,800 6 2008 $283,500 $2,700 $2,100 $195,600 $483,900 8 2007 $315,900 $2,700 $2,100 $195,600 $516,300 9 2006 $265,100 $2,700 $2,100 $211,800 $481,700 10 2005 $252,700 $2,700 $2,100 $192,600 $450,100 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 6/14/2013 i Parcel Detail Page 3 of 3 r w•� 11 2004 $203,700 $2,700 $2,100 $221,400 $429,900 12 2003 $180,700 $2,700 $2,100 $68,700 $254,200 13 2002 $180,700 $2,700 $2,100 $68,700 $254,200 14 2001 $180,700 $2,800 $2,100 $68,700 $254,300 15 2000 $130,000 $2,700 $1,100 $52,200 $186,000 16 1999 $130,000 $2,700 $1,100 $52,200 $186,000 17 1998 $130,000 $2,700 $1,100 $52,200 $186,000 18 1997 $131,900 $0 $0 $40,500 $174,900 19 1996 $131,900 $0 $0 $40,500 $174,900 20 1995 $131,900 $0 $0 $40,500 $174,900 21 1994 $123,300 $0 $0 $57,300 $183,100 22 1993 $123,300 $0 $0 $58,200 $184,000 23 1992 $115,300 $0 $0 $63,700 $181,900 24 1991 $109,700 $0 $0 $92,600 $205,100 25 1990 $95,800 $0 $0 $92,600 $196,800 26 1989 $95,800 $0 $0 $92,600 $196,800 27 1988 $76,000 $0 $0 $34,600 $118,100 28 1987 $76,000 $0 $0 $34,600 $118,100 29 11986 1 $76,000 $0 $0 $23,6001 $107,100 Photos •F Q 1 A http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 6/14/2013 Bk 2699E P:R57 -7723B _X4 1.2-2B-2012 & 03 - �6v QUITCLAIM DEED PROPERTY ADDRESS: 59 Church Street,West Barnstable,MA We,George J. Reynar and Ruth E. Reynar,both of 59 Church Street,Barnstable,MA for consideration paid in full of Three Hundred Fifteen Thousand and 00/100 ($315,000.00) dollars Grant to Scott T. Leone and Melissa A.Leone,husband and wife as tenants by the entirety both of 150 Bear Path Road,Hamden,CT 06514. With quitclaim covenants The land with the buildings thereon located in Barnstable,Barnstable County, Massachusetts and being bounded and described as follows: NORTHEASERLY by the Plans Road, One Hundred Eighty-Six and 83/100 (186.83)feet; i SOUTHEASTERLY by Lot 9 as shown on a plan hereinafter mentioned,Four Hundred Thirty-Nine and 14/100(439.14)feet; SOUTHWESTERLY by the Mid-Cape Highway,Eleven and 02/100 (11.02)feet; WESTELRY by said Mid-Cape Highway, One Hundred Eighty-One and 32/100 (181.32)feet; NORTHERLY by Lot 7 as shown on said plan,Twenty-Three and 94/100 (23.94)feet; NORTHEASTERLY by said Lot 7,Three Hundred Sixty-Five and 501100 (365.50)feet. Containing 68,994 square feet more or less and being shown as Lbt 8 on a plan of land Entitled"Plan of Land in West Barnstable,MA being a re-division of Lots 3, 5, 6 as shown on Plan Book 393,Page 48,preparaed for Howard W. Woolard, Scale: 1"=60' Date: Oct. 31, 1985 Ref P.B. 393/48"Down Cape Engineering,Arna H. Ojala,R.L.S. said plan is duly recorded in the Barnstable County Registry of Deeds in Plan Book 407, Page 26. For our title see deed recorded in Book 19003,Page 237. We, George J. Reynar and Ruth E. Reynar, grantor,do release all homestead rights in the subject property and further certify that no other individual has homestead rights in the subject property. s� ILC) Bk 26998 Pg 58 #77238 f Witness our hands and sealsthis / day of ,2012 eorge VReypfalr Ruth U. oynar / ` STATE OF FLORIDA County of (n 2012 Then personally appeared before me, the undersigned notary public, the above- named George J. Reynar and Ruth E. Reynar dwho proved to me through satisfactory evidence of identification, which were j U e t�� , 0 who are known by me and to me known to be,the person whose name is signed on the preceding or attached document, and acknowledged to me that they signed it voluntarily for its stated purpose. LA URA MCA DAMSqaAt�,� Hrr Colo trAS:j s .2013 60 so Notary Public r� pR�� fl. Auoa C0. My commission expires:G-a'�-(?J BARNSTABLETCOUNTYTREGISTRY OFXDEEDS Date: 12-28-2012 a 03:56Pm Ctl': 2007 Doc:: 77238 Fee: $1r077.30 Cons: $315,000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 12-28-2012 a 03:56am Ct].': 2007 Doc': 77238 Fee: $850.50 Cons: $3150-100.00 BARNSTABLE REGISTRY OF DEEDS i V Z 0 TM I VN , 1 i I O �9 Z a 3 1 Q Q . . ;� �. �� .W _._.._. . . _ ��^ors � G � .. '� , n . o � � � . � � �= _� . Application to nP`'ram "�� , Old King's Highway Regional Historic District Committee L in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under.Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ❑ New Building ❑ Addition 52-"Alteration .� ReAlo r1)7 'oA( t eeP.�i� . Indicate type of building: ❑ House arage ❑ Commercial ❑ Other 2. Exterior Painting: ❑ 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY / II DATE AV ADDRESS OF PROPOSED WORKS ChU t? h 5? ASSESSORS MAP N0. .3 OWNER �C'ot2Gc- K °c/N�►? � g S—r----- i'77 ASSESSOR/S� LOT NO. NO'is. ADDRESS ,�-a �s9u t2e L, ST k�Q1UC�P�a,�4T (� 1►r1q.TEL. NO. .j(n9 FULL_ NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). -� 4,P Oo7�Clo� �1I9_E�1yR 47rn �� /q4d 69 C AGENT OR CONTRACTOR aeorCc�e_ lQeC/ �i2 TEL. NO. -(09 &0c" ADDRESS S� C��C� ST• [� /3�e%rsr ale • �'79 ©a(PG&-- 3toa- 1131 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done (see No. 8, other side), including materials to be used, if specifications do not accompany plans. In the case of signs, give locations of existing signs and proposed locations of new signs. (Attach additional sheet, if necessary). WeN)ove. ODD pooF' i _ /(ST/1Ak hIet.v 6/"Mel?e �oOF Re �.r�ee 0 K D w inldoLo 5 4)�e IQP Mee le d,, A4 p/w r J?oo r 5Li/W6�P s Tb !'J.5►TC�r Dose S qA 4 Signed ems` S jfce be:o,.v line for committee use. wner-cont for-Agent Ov R N�c I by H.D.C_� Date �he Certificate is herebyc Date 3— Time17 approved IMPORTANT: If Certificate is approved, approval is subject to the e 10 day appeal period Disapproved ❑ provided in the Act. RECORD-IN REGISTRY OF DEEDS TOWN OF BARNSTABLE i Oil v IN COMPLIANCE WITH SEC. 11 OF ZONING BOARD OF APPEALS CHAPTER 40A, M.G.I. � _ SPECIAL PERMIT .89 JUL -6 P3 .27 DECISION AND NOTICE APPLICATION: ##1989-52 APPLICANT: GEORGE REYNAR At the regularly scheduled hearing of the Barnstable Zoning Board of Appeals, held June 22 , 1989, notice of which was duly published in the Barnstable° Patriot, and notice . of which was forwarded to all interested parties pursuant to Chapter40A of the General Laws of Massachusetts, George Reynar applied for a Special Permit pursuant to- the. Town of' .Barnstable Zoning By1-aw, Section 3=1 . 1 (3) (D) , Family Apartments . The applicant's property is located at 59 Church Street, West Barnstable and is shown on Assessors' Map 153 , lot 4-4. The property is i.n the Residential ` F (RF) zoning district. The applicant, George Reynar, presented the'. following information: The family apartment will be constructed- in an existing barn and will be occupied year-round by the applicant' s daughter and her husband. The lower half of the barn has been, and will continue to be, the applicant's workshop. FINDINGS OF FACT: Based upon the information submitted, the Zoning Board of Appeals found that the applicant's plan complies with all criteria for. the grant of a Special Permit pursuant to Section 3- 1 . 1 (3 ) (D) of the Barnstable Zoning Bylaw. The vote on the findings of fact was as follows : AYES: BOY, JANSSON, LALLY, NIGHTINGALE, WIRTANEN NAYES: NONE - I DECISION: Based upon the .information .submitted and the findings of fact, at a hearing held on June 22, 1989, by. a motion duly made and seconded, the Zoning Board of Appeals voted to grant. the Special Permit subject to the terms and conditions of' the Barnsteb l,e Zoning By l.aw Section 3- 1.. 1 (3) (D) . Any , violation of such terms and conditions shall constitute a basis for revocation of the Special Permit. The vote was as follows: AYES: BOY, JANSSON, LALLY, NIGHTINGALE, WIRTANEN NAYES: NONE I ' f Jor AOy person aggrieved by this decision may appeal to the Barnstable Superior Court , as described in Sectlon 17 of Chapter 40A , of the General Laws v:lf the Commonwealth of Massachusetts by filing a complaint In said. Court as well as notice of action with the Barnstable Town Clerk , within twenty (20) days after the filing of this decisioh 'In the office of the Town Clerk. .Chairman, CG Zoning Board of Appeals / Town of Barnstable J I �y4) �/� -0 o.✓ Clerk of the Town of Barnstable, Barnstable County, Massachusetts , hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decision In the above entitled petition :and that no appeal of said decision has been filed in the Office of the Town Clerk. Signed and sealed this ST_ day of 4 u 19 L-j_under the pains of perjury. Town Clerk DISTRIBUTIONS Town Clerk Property Owner Applicant Persons Interested Building Commissioner Public Information Board of Appeals i PARTIES OF INTEREST APPEAL NO. 1989-52 GEORGE J. REYNAR MEETING OF JUNE 22 , 1989 Earle Merritt/Jane Starr Church ST, W Barnstable, MA Thomas Dewire 40 Church St , W Barnstable, MA Kenneth Jukes 72 Church St , W Barnstable, MA Warren & Arlene Dyson 29 Church St , W Barnstable, MA Betty Allen PO Box 427 ,E Sandwich, MA Yarmouth Planning - Board Sandwich Planning Board ----MaShpee P3'anning Board � s Assessor's office(1 st Floor): `! ^ "`'"��: �� v F THE T Assessor's map and lot number J�.3'� B y' d 0 j a d�Q�� w Board of Health(3rd floor): I.LED IN COPJPUMCE `` , p *� " Sewage Permit number VAT"TME S 0NMEWAL CODE Engineering Department(3rd floor): �-I J C E;t �, N�E��O� AND �oo�tb 9 6 m° House number 1 -I J `® Definitive Plan Approved by Planning Board 19 0 Apr APPLICATIONS PROCESSED 8:30-9:30 A.M.and 1:00-2:00 P.M.only TOWN . OF BARNSTABLE ' BUILDING INSPECTOR I APPLICATION FOR PERMIT TO nedY 1 TYPE OF CONSTRUCTION ' V l�9 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location .5a/ C��,vt2!, S r l-oT �� — �►2M5 T79�3 4 Proposed Use aA-2 i L [ �� fin/ Zoning District t" Fire District Name of Owner 6 eo vz(�.e 12P Vj�4 tz Address Name of Builder e Address Name of Architect Address Number of Rooms a Foundation I / , Exterior 0-e- (4 z- S h i N[4,f` Roofing ils'b /44 f Floors Do Interior Heating A t Vz— r Plumbing Fireplace /k/-n • Approximate Cost D � Area /Vo ��! ��✓�C Diagram of Lot and Building with Dime s Fee �0 � b6 OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable r arding the above c truction. Name Construction Supervisor's License rREYNAR, GEORGE P �p go 33240 Permit For REMODEL PORTION OF DWELLING yY Family Apartment Location 59 Church Street West Barnstable Owner George Reynar Type of Construction Frame i Plot Lot 2 September 26 , 19 89 >�• . Permit Granted '0_• Date of Inspection. 19 Date Completgd 19 17.1 17 � � � �� °gin § 240-47.1.',-it.x1 j: aj t`S eh s..[Added 11-18-2004 t The intent of this section is to allow within all residentis apartment unit occupied only by a member(s) of the pr owner-occupied single-family residence. A family apace compliance with all conditions and procedural requiren A. Conditions. A family apartment shall comply with ai of the following conditions: (1)- The apartment unit shall not exceed 800 squa existing single-family dwelling, whichever is le allow up to 1,200 square feet by a special per shall be limited to no more than two bedroom; (2) Occupancy of the apartment shall not exceed (3) The apartment shall be located within a single family dwelling in such a manner as to allow f apartment must comply with all current setba( which it is located. (4) At no time shall the single-family dwelling or t by either the owner or family member(s). The apartment shall only be occupied by those pe (5) When the family apartment is vacated, or upc representation made including but not-limited apartment.shall be terminated. A building pei cabinets, countertops, kitchen sinks and app p 2 regaraiess of wnere yuu Duy i uunei. AP Airlines Writer Samantha Bomkamp contributed to this repo Scott Mayerowitz can be reached at http://twitter.com/GlobeTrot Copyright©Cape Cod Media Group,a division of Ottaway News http://www.capecodonline.com/apps/pbcs.dll/article?AI p � � � � � � � � �� o � o � e �1 Tow Reg �OFTME Tp�� Thon Publi( * BARNSTABLE, MASS,039. �0� Thor ATEo 200 Main Office: 508-862-4644 November 1, 2004 AIRPORT MOBIL 156 IYANOUGH RD. HYANNIS, MA 02601 ATTENTION: BRIAN PERRY Your food service/retail permit(s) will be i ESTABLISHMENTS FOOD SERVICE RETAIL FROZEN DESSERT MOBILE FOOD BED & BREAKFAST �1��-- _ _ _ _ �� _ _ �' � ��- � ��, �� ,� �� : �� n� I L _.._ Town.of Barnstable *Permit Expires 6 monthsdrom issue date Regulatory Services Fee &ARNsTAaM v� iisass.039. Richard V.Scali,Director 10 ArFO��A Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 DEC 16 2014 www.town.barnstable.ma.us office: 508-862-4038 TOWN OF19A STIAOU EXPRESS PERMIT APPLICATION - RESIDENTIAL_ ONLY I AI) /. Valid without Red X-Press Imprint Map/parcel Number V Properly Address 14 Residential Value of Work$ Av_Oy Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address EC-0 4 �Q.C>V\Q p Contractor's Name !VA N J V fl N I C,?S S-t2 N((-O Tele hone Number Home Improvement Contractor License#(if applicable) 44 lcf 4 6 Email: Construction Supervisor's License#(if applicable) S " 1.0 S q G 4 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) [� Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to \,_VvI.S I U_ ❑ Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Im ovement Contractors License&Construction Supervisors License is r uired. SIGNATURE: Q:\WPFILES\FORMS\bui it formsA_P S.do Revised 061313 f . � ) � DATE(MM/DD/1'YW) A�Y7/�ir7®� CERTIFICATE OF LIABILITY ITY IAI�IIta@16tCE a�'o " 1 4/1/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If,SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT _— BRYDEN &SULLIVAN INS NAME: 88 FALMOUTH RD PHONE FAX A C'No WC, No): HYANNIS, MA 02601 E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 9 INSURER A: LM Insurance Corporation 33600__ INSURED INSURER B: —__._---- ANDREI YARMOLOVICH DBA BEL ISLAND HOME IMPROVEMENT INSURERC: 29 MILL POND ROAD INSURERD: WEST YARMOUTH MA 02673 INSURER E: I.INSURER F COVERAGES -- CERTIFICATE-NUMBER: 19702934--• REVISION NUMBER: - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS-OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE imqn wyn POLICY NUMBER MM/DD/YYYY MM/DD/YYYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE S DA A T R NT D $ CLAIMS-MADE OCCUR PREMISES Ea occurrence MED EXP(Any one person) S PERSONAL&ADV INJURY $ LG_EN'L AGGREGATE LIMIT APPLIES PER, GENERAL AGGREGATE S _ POLICY PRO- I I LOC PRODUCTS-COMP/OP AGG S JECT U $ OTHER: COMBINED SINGLE LIMIT y AUTOMOBILE LIABILITY Ea accident) BODILY INJURY(Per person) $ _ ANY AUTO ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS AUTOS $ PROPERTY DAMAGE — NON-OWNED Per accident (_11 HIRED AUTOS AUTOS $ I UMBRELLA LIAB OCCUR EACH OCCURRENCE is EXCESS LIAR HCLAIMS-MADE AGGREGATE S S DED RETENTION S A WORKERS COMPENSATION WC5-31S-384176-024 2/25/2014 2/25/2015 �/ STATUTE OERH AND EMPLOYERS'LIABILITY Y/N 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH EACH ACCIDENT S OFFICERIMEMBER EXCLUDEDT N/A 100000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYE S If yes,describe under ,E.L.DISEASE-POLICY LIMIT S 500000 DESCRIPTION OF OPERATIONS below I i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. ANDREI YARMALOVICH IS COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE.ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE TOWN OF YARMOUTH - THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 1146 ROUTE 28 ACCORDANCE WITH THE POLICY PROVISIONS. SOUTH YARMOUTH MA 02664 AUTHORIZED REPRESENtATIVE LM Insurance Corporation ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD CERT NO.- 19702-114 CLIENT CODE: 1588030 Anne Chandler 4/1/2014 2:18:46 PN Page 1 or 1 /� ._. �DO"�"LO?Cj� L ✓/. eG Board of•Building Regulations and Standards fi � Office of Consumtr Affairs&Busine - egula'tion� ..:�1� Construction Supervisor OME•IMPROVEMENT C { f RACTOR. i License: CS-105964 'p �! egistratlon` 76 l'.TypeE. `\`fir: _: Ex1 /�p�4 gPPlement;. . i . . TVAN V IVANIUSENKO } .1' 174 Upper Coun d BEL ISLAN I r.E UN PP ;� l� LS Apt 1-14 + e - :- r,� I Dennis Port MA 03,639!� I IVANIUSHEN' <r ��-1i i . , ; I ,fi Ic 9 MILL FOND Expiration. . ,I W.Y'RMOUTH, MA'O 6 3`:"'' 01/01/2015 ! Undersecretary ii. Commissioner ::all • aJeac%udeClL.l &Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Office of.Consumer Affairs and Business Regulation RrrgisEration,.;'1724Z6 Typt.1 1.0 Park Plaza-Suite 5170'' :...._ . F__xpiratio,n:�712/20;1.6 �uaplemei t' ~� IiL, ton,MA 02116 BEL ISLANDS HOME=INjPRQVEMENT. I IVAN IVANIUSH.EW`O=Pt= '!''.`. ^A 02673 Under'sec:retery �, Not valid wi out signature 6 i Ct�rnlrxcr�arc�ai of if&S-Y ;chus e r�rtmer�t of, far&utrkd Accidents 600 Wr2s'h rwgfoY%Mreef Bostar�,MA 0 HI wtt-w r asmggaWdia W,orkea-s' Compensat€axtInmmuceAfffidavit:BeafderslConbc-actorsMectriciansMumbers AppEcant Information Please Prnnf Leeibly Na=gkjsj rO%wii-,afioa&&vidnan: &- 1 s 6a16 S R O m(2- Z mp cz . A dress: �t�ce PO,vb vvL�:—UT�4 t 026 a 3 City/S�.atz/Zip: _ Phone� 5 a8 3 6�f 6 q . Are you an employer?Check the appropriate bow T , of o'ec-t (r 4. I atn a eoe-ral omfmctor and I Tj , I = 1?_NDI am a employer with 6- ❑New consfrucaa employees(fall ao-dlorpait--time)* have hiredtbe sub-coabmcfors. 2_❑ I ain a sofe proprietor ar partner- listed on the attached sh5et: Y- ❑Remodeliag ship and home no employees These snb-contractors have g- ❑Dem,olitioa working for mein anycapacity! employees and have workers' t 9_ ❑Building addition Wb,workers' comp:inmranre m comp_ surance_! 5_❑ We are a corporation and its 10�F�ctrical repairs or additions officers have exercised their 1 Plumbing airs or additions. 3.❑ I;3rn a homeowner doing all worki�_.❑ lum g myself [No wccclmrs'comp- c- 1.52At fe1(4 pa orzperlvfGL 12-.❑Roof repaas i.,c,�ra.,rereToired_]I c_ 152,gI(4�andu�eTrsti`eIIa employees-[No wurkels' 13_0 other comp.msaran-cerequire>d.j -Any sppUca3 trot ched:s box rl nmst a15o 511 out tha srxfiaa helo sh a meu co3c¢s'compevss5oa pvirv�fia{�u rni t Homwwnc s nrdo sabmft i m aafidsva Beat w.—they are d❑n g aIlCroak a3xd then hire ostsidecontraams mx:h- =Cbntc.cmrs ihst deck this box mast sttarljed as additinnsl sheet shocciny t1L asm of sT10 crams xad stale vrhethe<Deno:hnstr amities Iuve enmtvyers- If tb°so7-coatcactun h ve empIo}-ees,they must pimide ih—�r wrorkeEs'coma polio ninabes axr art e.atgPayzr l Trot is prm idit xvor.leers'c-arlrperurhvn irlrrtrance for trzyr etirp£flyee� 3lelotr is Cite policy and job sifg €nfotmalio:n �2 Ins;u=ce Company Flame: fJ -y p q N Policy 41 cr Expiration Date: Job Site A.t : Sc? cif-p s taw2ap: Attacllt a copy of the workers'compensation polio-ded;aratiou page(shoxain„the policy-number anal expiration date). Failure to secate•coverage as required under Section 25 k o€MGL c. 152 can lead to the imposition of criminal peua Pies of a fine up to S 1,500.OD andlor one-yearimpriso ,as well as civil penalties in ibe,faffi of a STOP WORK ORDERZ and a fine of up to S-250-09 a.day against the violator_ Be advised that a copy of this stsdzment maybe fhrwarded to the Office of Im esfigatiom of the DIA fur insurance coverage-vmrificafion- I do hereby c fp thegains and aWies ofper w y fhatt ie inforrautianprmidgelabm,a iss true anet carrsct Siahatace: Date: Phone 0- 5-08 361( 609 O,fj- ia[use only. Iaa rrot sprits in this area,:v be ca.mpiet-ed by cii3:or town offi'ciaL City or T owu: _Pemmiff-acease i# Issuing Authority(circle one),: 1.Baard of Health .2.Binding Department &GitpT-Gy-rn Clerk 4_Electric al Inspector S.Plumbing rji ctor .6.Other COLLtact Person.- Phone 9- 6 I Information and Instruefions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 Iegal 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 sued 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 a»y applicautwho has not produced acceptable evidence of compliance with the insurance.coverage required. Additionally, MGL chapter 152, §25C(7)states`Neither the comnonwealt nor any of its political subdivisions shall enter into any contract for the peeiormance of public work until acceptable evidence of compliance vzth the insurance requirements of this chapter have been presented to the contracting authon_ty-" Applicants Please fill our the workers' compensation a-nda-Mt completely,by chec.'cing the boxes that apply io yo-or situation and,i.f necessary,supply sub-contractors)name(s), address(es)and phone n•,.nnbe.,-(s) along with their cerb:ncate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Pau-uerships(LLP)veAh no employees other than the members or partners,are not requi_ed to carry workers' compensation insi?once_ if LLC or LLP does have employees, a policy is required_ Be advised that this affidavit may be s::bmitted to the Department of indusuc al Accidents for confirmation of insLr'canoe nver ge_ Also be sure to sign and date the a,ffida5 t- '111e a. davit shoulld be retumed 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 obt;�-r a orken compensation policy,please call the Department at the number listed below. Sell insul e:d companies should enter. their self in�ancc license number on the Pmpropriate 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 permi`JLcense number which will be used as a reference number_ in addition,an applicant that must submit multiple pernah/hcense applications in any given year,need only submit one alffidavit indicating current policy information (if necessary) amid 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 burn leaves etc.)said person is NOT required to complete this aihdavit The Office of Investigations would Mice 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 tax number_ T'-h.��e0II2monwt,-a &of Massachus-(�-, Dr--partcaeat of IndustrW Accidents GiTiQe of Zuv(�stigati lia 5��ashir�to�Size . Baston_MA 0�III 1�L-4 617 727-49-GU cxt 406 or I-R77_NU SSAFE Revised 4-24-07 Fax:A 617-727- .c9 I � ETti Town of Barnstable � r Regulatory Services 9 RARNSrARr a MASS.M� Richard V.Scali,Director � .�e3y �m � 639 Building Division Tom Per--yBuildin -Comnussioner .. . _. _ re . -.. -- g - -- _ 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section _If Using A Builder I, JC��I�t)ts� ,as Owner of the subject property hereby authorize g E L-i S L4 N D 5 i�n ki:� to act on my behalf, in all matters relative to work authorized by this building permit application for. 5_5 C ttv fQ C N ST iv . 3 r�e_rV STftR LA'-- (Address of Job) ' Pool fences and alarrns 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 accept Signature of Owner ature of App Lt-v S cm �G Print Name Print Name Date Q:FORMS:O WNERPERMISSIONPOOLS Town of Barnstable Regulatory Services �oF Toryy Richard V.Scali,Director Building Division 4 � BARNS`r"M ` Tom Perry,Building Commissioner t.9. �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: cit3 t wn 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 oa 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 Homeowner Approval of BuildingOfficial 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. QA1,WFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 r , 01 6`lQ01 � pFt Town of Barnstable *Permit 1 p Expires 6 month om issue date Regulatory Services Fee O • • • BARN3TABI.E,MASS • 1 ,0� Richard V.Scali, Director ArfD �p Building Division XPRESsp,,,e Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 S www.town.bamstable.ma.us Office: 508-862-4038 1 r ax: 508-790-6230 "A PSI EXPRESS PERMIT APPLICATION - RESIDENTIA ' �� NNot Valid without Red X-Press Imprint Map/parcel Number_ t �-Q Property Address J-9 `i."C Rc n �� 1 Nxp-rj s 1w ,�Q- ❑Residential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address S to I I. o v\. Contractor's Name I\)A(e) I QAL `LXSNl20 ILO Telephone Number 3(-( 6'11/0Q Home Improvement Contractor License#(if applicable) 4q oZ Y-76 Email: Construction Supervisor's License#(if applicable) S ` 4c)S-q ro C( ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's C(o�mpensation Insurance �{ Insurance Company Name I JftQ .Y� JcA.1�:S l4 fV Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked-with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Pr erty Owner Letter of Permission. A c the Home Impro a ent Contractors License&Construction Supervisors License is r ui SIGNATURE: f Q:\WPFILES\FORMS\building pe s\EXPRESS.doc O Revised 061313 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 Legiblv Name(Business/Organization/Individual): ��i 1 J[O�t/�C, O011VIP— I wto Q.00"Ai_01 Address: Aq KA U py p c� K0 City/State/Zip: Phone#: nT 6 Q U9 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 workingfor me in an aci employees and have workers' y capacity.�• comp.insurance.x 9. ❑Building addition [No workers'comp.insurance p - required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I 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.[1 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. $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. --II Insurance Company Name: Yy Policy#or Self-ins.Lic.#: ' t Expiration Date: 2 Job Site Address: IS-9 � �i/l g o�� &,Q_%.5-401kCity/State/Zip: N4 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 hereby certi nder the pains an penalties ofperjury that the information provided above is true and correct Si ature: �n I _ Date: 01�+. d- - 2IA Phone#: 6 OF OR 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 all employers to provide workers' compensation for their employees. ti 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 cant'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 permittlicense 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 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 Revised 4-24-07 Fax# 617-727-7749 www.mass.gov/dia Q] _ II _ • sAMMAELF, • Town of Barnstable Regulatory Services Richard Scali,Director Building Division Thomas Perry,CBO 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 I C� 1 l�'� a L�(�� s Owner of the subject property hereby authorize(_ i S LA t-s V,>S to act on my behalf, in all matters relative to work authorized by this building permit application for: S-9 Ct1+ zC �k Si '�FZi �A2t� STn � (Address of Job) Signature of Owner Date Sco LILZ-2N- Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. i QAWPHLESTORMS\building permit fonnAsmokecarbondetectors.doc. Revised 050412 Town of Barnstable ' Regulatory Services - ox Richard V.Scali, Director Building Division s�txer�s�. Tom Perry,Building Commissioner MAM 05 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": 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 Rermit. (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 Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required'to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: ."Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a 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. A`oRoDATE(MM/DD/YYYY) ® CERTIFICATE OF LIABILITY INSURANCE 4n/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. WSUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTACT PRODUCER BRYDEN & SULLIVAN INS NAME: 88 FALMOUTH RD PHONE FAX HYANNIS, MA 02601 c o A/C No E-MAIL ADDRESS: INSURERS AFFORDING COVERAGE NAIC 9 INSURER A: LM Insurance Corporation 33600 INSURED INSURER B: ANDREI YARMOLOVICH ---- DBA BEL ISLAND HOME IMPROVEMENT INSURERC: 29 MILL POND ROAD INSURERD: WEST YARMOUTH MA 02673 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: 19702934 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS-OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DD/YYYY MMIDD/YYYY COMMERCIAL GENERAL UABIUTY EACH OCCURRENCE $ -DAMAGE RENTED CLAIMS-MADE 0 OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) E PERSONAL&ADV INJURY $ LGEN'L AGGREGATE LIMIT APPLIES PER' GENERAL AGGREGATE S__ r—I PRO- POLICY LOC L_1 JECT PRODUCTS-COMP/OPAGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) S _ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ I_ HIRED AUTOS AUTOS raccident) I $ UMBRELLA LIAR OCCUR EACH OCCURRENCE is EXCESS LIAB HCLAIMS-MADE AGGREGATE S DIED RETENTION$ $ A WORKERS COMPENSATION WC5-31S-384176-024 2/25/2014 2/25/2015 �/ SPr TATUTE _ �RH AND EMPLOYERS'LIABILITY ANY PROPRIETORIPARTNER/EXECUTIVE YIN N E.L.EACH ACCIDENT $ 100000 OFFICER/MEMBER EXCLUDED? ❑ N/A N (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ 100000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500000 I DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space Is required) Workers compensation insurance coverage applies only to the workers compensation laws of the state of MA. This certificate cancels and supersedes all previously issued certificates,only as they relate to workers compensation coverage. ANDREI YARMALOVICH IS COVERED BY THE WORKERS'COMPENSATION POLICY. CERTIFICATE HOLDER CANCELLATION TOWN OF YARMOUTH SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEUVERED IN 1146 ROUTE 28 ACCORDANCE WITH THE POLICY PROVISIONS. SOUTH YARMOUTH MA 02664 AUTHORIZED REPRESENTATIVE LM Insurance Corporation VVVV ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD CERT NO.- t9702914 CLIENT CODE: 1588030 Anne Chandler 4/1/2014 2:18:46 PR Page 1 or 1 ,..I: .//}� IIJG.p2�YtOOtUJECGLG/L oy,/lZCZ06 _ p 4�� _ ,g1ti iviaaaa�.r Wu CLLa -�c Nar.u�ici.iL u{ i-wuiii. .aniciy Office of Consumer Affairs&Bus{ne egul'ation $t 4�Cl�f/A1 Board of-Building Regulations and Standards Cunsh-action Supervisor OME IMPROVEMENT C RACTOR. � ;i != Lice nse:'CS-105964 ii egistratlon ~4.,76 Typ:eiE, cl, \- '772720j4 Sopplement �. IVAN V 1VANIU NKU'' BEL ISLAN wME_I, . MENT 174 Upper CountjC . Rd i Apt 1-14 I f I IV ANIUSHE(J�I`EQ ski I'+i ; Dennis Port MA 07639` 29 MILL POND •. aK �=7�i 1,� .! Y. W.YARMOUTH;MA'U263>="� Expiration . Undersecretary p^ 01/0.112016 Commissioner -....-.. -_. "._...-...-._..-_•-_-_-..... - rsrclC�•a�C��l/lae�ac/curetl�,I .. .. ... .. .. &Business Regulation License or registration valid for individul use only ME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: office-of Consumer Affairs and Business Regulation _�aRegisEration =1'Z2476=, . TvF u'.i 10 Park Plaza-Suite 5170 F_xpiratio n:�7[2&201'6' va ! � > zoaplemPfi• I Bf;-9tan,MA 02116 BEL ISLANDS HOMEIMPROVEMENT. IVAN.IVANIUSH.ENKO��!�7,""-' ^A 02673 Undersecretary 1'r Y I. Not valid wi out signature License or registration valid for individul.use only' 'before the expiration.date. If found return to: Office of Consumer Affairs and Business.Regulation3'. ;'I 10'.Park Plaza-Suite 5170 11"' ard Boston,MA 02116 t .',� Not,vdlid with.outrgj�r_ikur _ R I V r IHME t0t`� Barnstable Old Dings Highway Historic District Committee D,,ST,AB,$ p 200 Main Street,Hyannis,MA 02601,TEL: 508-862-4787 Fax 508-862-4784 �p 16 `00 APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 2014 PI; `,3 r, r,ST 1. Building construction: ❑ New El Addition El Alteration :��? r: ;;; � 2. Type of Building: ❑ House ❑ Garagelbarn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting ❑ new roof ❑ color/material change,of trim, siding,window,door 4. Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date NOTE All app&xtdons must be signed by the current owner Owner(print): A (p ' ) i C-19 ��e Telephone#: ©�f -7 Address of Proposed Work: J<Gj Qk S 114riVillage a ap Lot# Mailing Address(if diffe 'nt Owner's Signature t r Description of Proposed Work: Give particulars of work to be done: 12,sZV36�V� oh-;C�(u.c; E,A 11 O O k'k �-Vv T 2'.Ip SUM C°c�l tZ 12. r z wV PUS AZA, TR:ty VSo l Agent or Contractor(print): V A-P :TVA ti tLICS 1-eeAJIC O Telephone#: SP S W Y 64 0 _ Address: ' (.� �2 n Contractor/Agent'signature: �- ji- �l 02 669 / For committee us o l;;��Members This Certificate is hereby APPROVED/DENIED Date , 0 sign RECEW, M 212014 GROWTH MANAGENtE!*iT APPROVED �F- jj,c t�►�I � � DG+�c�� 11��2 f� �1e�c�P�� Ind k�N 'k `A4Qd Ckkk� Oak A��k AUG 13 2014 Town ot barnsiduir, Old King's Highway Committee 1 Q.18oards and Conunissions101d Kings HighwaylOKHAppliaationslOKH2O11 Cert Approprialeness.doc y CERTIFICATE OF APPROPRIATENESS SPEC SHEET Please submit 5 Copies Foundation Type: (Max. 12"exposed)(material-brick/cement,other) iding Type: Clapboard_ shingle_ other n.e.UVI ck- 6O-Zb Material: red cedar white cedar other Color. 1211 �{ ^ r --Gl��ey Material: �� i+"L-p-iL Color: Roof Material: (make&style) Color: Roof Pitch(s): (7/12 minimum) (specify on plans for new buildings, major additions) Window and door trim material: wood other material,specify Size of cornerboards size of casings(1 X 4 min.) color Rakes Ist member 2°d member Depth of overhang Window: (make/model) material color (Provide window schedule on plan for new buildings, major additions) Window grills(please check all that apply_. true divided lights_ exterior glued grills_ grills between glass_removable interior None Door style and make: material Color: Garage Door,Style Size of opening Material n ®Color_ Shutter Type/Style/Material: Color: A11� P�0 Gutter Type/Material: Color: �,I I C 1 3 Z014 Town of Barnstable Deck material: wood other material,specify Color: g's Highway Committee Skylight,type/make/model/: material Color: Size: Sign size: Type/Materials: Color: Fence Type(max 6')Style. material: Color: ,IUL 2 1 Retaining wall: Material: MANAGEN " Lighting,freestanding on building illu �t i OTHER INFORMATION: THE ATTACHED CHECK LIST MUST BE COMPLETED AND SUBMITTED Please provide samples of t colors,manu turers brochure of windows,doors,garage.door,fences,lamp posts etc i fr Signed: (plan preparer) Print Name /y'4.f J J V 4(J1 Q SgeWte c7 2 Q:%Boards and Commissions101d Kings HighwaylOKHApplicationslOKH 2011 Cert Appropriateness.doc f Town of Barnstable Geographic Information System July 28,2014 164004 #20 164005 #40 130017 164007002 164007 , #2049 #r50 40 #72 130016 tiG ^¢� # sue, 1640 001 goo Abb ® 164006 Jh 15300 P ® #106 p #45 V� A�� h 163004004 = 10 122 #59 m 4 a9 V p z 153004003 0 #47 z D = 153003 #0 i i 153004001 021 dT. F 0 71 Feet 09 c DISCLAIMERS:This map Is for planning purposes only. It is not adequate for legal Map:153 Parcel:004004 a boundary determination or regulatory interpretation. Enlargements beyond a scale of Owner.LEONE,SCOTT T&MELISSAA Total. Selected Parcel Assessed Value:$340500 i 1'=100'may net meet established map accuracy standards. The parcel lines on this map ,'•'i-;7; are only graphic representations of Assesso(s tax parcels.They ere not true property Co-owner: Acreage:1.58 acres Abutters .i:i;:;y �`.�s}a E boundaries and do not represent accurate relationships to physical features on the map Location:59 CHURCH STREET such as building locations. Buffer ' �✓ I t,$ U .a *yJC r err +sue /9� rvytl}t` � ot— Zgx 1,�� dab. ,F"'(�� ri({{�(1(>!}�'�' :'f11 'Z n .. :•�! v� ,: f / P Ry ,a=j -sue � ' •~ - -F' ��S S vZ a �' � K: �:�� , r jk I `�".'� - ...,w- r+�i .: •fir] i• �{ ;f• w ' a� T 781-871-8252 F: 781-857-1977 July 2, 2014 .s Thomas Perry,CBO Town of Barnstable Building Division 200 Main Street Hyannis,MA 02601 RE: Insulation permits 201400761 Dear Mr.Perry, This affidavit is to certify that all work completed for insulation work at 59 Church St, West Barnstable, has been inspected by a certified Building Performance Institute(BPI)Inspector. All work performed meets or exceeds Federal& State requirement. 0: ZE ea '` O ; - - Z Victor Cimino C X- N ►r'. 267 N. Quincy Street 'Abington, 'MA 02351 www.insul-proinc.com a n Town.of Barnstable *Permit# O 1 to 411 �0 Expires 6 months from issue date rT Regulatory Services Fee + s�artsrnsc�, v mass.i639. Richard V.Scali,Director ♦0 QED MA'S p � Building Division . Tom Perry,CBO,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us Office: 508-862-403 8 EXPRESS PERMIT APPLICATION - RESIDENTIX _ ,A YEE 6G L) (t t Valid without Red X-Press Imprint Map/parcel Number�� V_I Property Address 1A v 2 C N S� y.+ �i 13 p-Qrc S�aid ki l� oL 66S Residential Value of Work$ u S D Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address ';:"I d L66& Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) Z Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to LAN p Pjt L ❑Re-roof(hurricane nailed)(not stripping. Going.over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.35)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 Town of Barnstable Regulatory Services P�oFiru:To Richard V.Scali,Director Building Division sAxxsrnsre Tom Perry,Building Commissioner nrasS. 9� �e39. �� 200 Main Street, Hyannis,MA 02601 AIEO I'��A www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: 6—ZD JOB LOCATION: S°l C Nv QC p ST `-41i r 3 LZ NSTA7,LC- number street village .HOMEOWNER": L 6.>► e 17N-q9 U��571 name home phone# work phone# CURRENT MAILING ADDRESS: C NkU e Gk1 g'r �,.sL'S+ �A2r�STP-i3� cT o Z(oGd' 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 proced s an r q ents and that he/she will comply with said procedures and requirements. Signature of Homeowiler 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:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 061313 oF�ram, • M • BARNSTABLE. f 1639. ,�� Town of Barnstable plf0 MP't A Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.`ma.us Of\ 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Se tion If Using A Builder I I, , as O er of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this b ding permit application for: a C t{v QC w ' A-¢ S c (Address -'f Job) �--2 Cc> Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Fo m on the reverse side. QAWPHLESWORMS\building permit forms\EXPMS.doc Revised 061313 The C'ommonnfealth of Massachusetts Deparhnent of liddmstrial Accidents Office of fmestigations 600 Washington Street Boston,MA 02M1 wn m inass.gov/dia Workers' Compensation InsnranceAffidavit:BuildersfContractorslEiectri.ciansXlumbers Applicant Infarmation Please Print,Legibly Name(BusmeaslOxganizationllh&vidnal): Address S°, C,-t`e G N S. e:�K.T pz�Per4 S i- Cue MA CitylStat,-Mp: Phone 47 Are you an.employer?Check the appropriate box: Type,of project ,r mre 1..❑ I am a employer with 4. N I atn a general contfractcr and I 6- ❑New construction employees(full andlorpart-hme).* have hied the sub-contractors. 2-❑ I am a sole proprietor or partner- listed on the attached sheet: y- ❑Re=deling ship and have no employees These sub-contractors have g- ❑Demolition working for me in any capacity employes and have workers' 9. ❑Building addition [Ivo workers' coffip_insurance comp.insuaancx I 5..❑ Vile area corporation and its 10-❑Electrical repairs or additions ��ed 3.❑ I am a homeowner doing all work officers have exercised their 1I_.Q Plumbing repairs ar additions myself.[No workers'comp- right of exemption per MGL 12-.❑Roof repairs insurance ]1 c-152, §1(4} and wehneno 13_0 Other employees- o workers' mF oy�-Ll`r comp-insurance required.J: *Any applicmt that che&s boa ttl=A also 5R out the:section below showing rhea woAers'mmpensati on policy infurmatiar T Homeowners who submit this affidavit in&c.�g they are doing all work and then hire outride contractors mast submit anew affidavit mdirsda sach tCantnctoa test check this boot mast attached an additional sheet shoving the name of the sob-caaft-actors and state trhether ornot these eufities have mmph5mes. If the sue-coat actors have mplogees,the}must provide t vek workers'comp.policy awaber. I am an empZoyer drat is prm idirig it7orkers'corupen idon irrsurarrce for my empZvyelm Beloty is the po8cp anal job site informaliom Insurance Company Name: Policy a or Self-ins-Uc-4: ExpirationDate: 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 requiredunder Section 25A o€MGL c 152 can lead to the impositi m ofcriminal 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 ORDM 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 Investigations of the DIA for insurance coverage verification- Ida hereby certrfy tinder the s and penatlies ofperjury that the information pravi&d above is true and correct S.itmature: Date: O Phone 9: ZG a1 S" '-1 t 1( M f L 15 C40'L- 7Li -9114- u E F,rti t2,,Ucral u se only. Do not write in this area,to be completed by city or town official City or Town: PermitUcense ff Issning Authority(circle one): 1.Board of Health 2.Building Department 3.City/Fown Clerk 4.Electrical Inspector 6.Plumbing Inspector 6.Other Contact Person: Phone 9: 6 r Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuantto 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 IocaI 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 aizy 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 compli.arce with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their cer Lificate(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 cant'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 in unnce 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/licease 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,Tilled 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 lice 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 Commonweal&of Massachusetts Depaitmeat of Industrial Accidents office of kwst-igatfons 600 Wash boa StreeT; Boston,IAA 02111 Tel.A 617-727-49-OG ext 4.06 or 1-977-MA.SS.AFE Revised 4-24-07 Fax# 617-727-7749 w W.Eaa�ss-gnvfdia 06/19/2014 01:45 5084286875 NLCONSTRUCTION PAGE 01/01 5/13/2014 R l THIS CER71IaCA fE IS ISSIJEb Ag A(NATTER OF INFORMA1tOI0 ONLY AND CONmt8 NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFI IA71tl�Y OR NErsATNELY ASR7rb, EXTE>YD OR ALTER T1tE COVERAGE AFFORDED BY THE POUCIE3 nEI.OW-THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT aETW THE ISSUING INSUR£R(Sj,AUTHORID REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT R fhe bottler t8 an ADDITIONAL INSIJR�,fhe peaeyllcsj mmet be endorsed. It SUWtDGA71ON IS WAIVFA,Subject to the terms�condnions Of the pellet',certeln polidgo nm requite an andpSerngPll; A sd temeet an 1S cote does not confer ngllffi to the certNi Wte Rohter In lieu of such nmdonsernentsp PRODUCER CONTAM Ri.*Stratcgio Company �PWON'a�k (781)961-0303 FAX(AC t 160.Federal SftU,2nd Floor AEM BOSton,MA 02.110 PAtItAirFR INSURERS AFFORDING COVERAGE NAIL p asum.:0 INSURER A Adantic Charter Ims)manm Company VDAC 44326 ML Construd ion Co.,Tnc. INSURERS: INSURER Q 651 River Road tNSURst Q Maratons Mills,MA 02W INaum E: INSURER FI COVERAGES: CERTIFICATE NUMBER: REVISION NUMBrm. Tths m TO cEittlFr THAT THE POLICIES OF INSURANCE LMM13$ELM HAVE BEEN IssuM TO THE INSLM NAMM At CVE PoR THE POLICY PLTtipp INb1C *M NORM(tftFANOuq ANY REOUIREMENI-,1tStIN OR CWMMOt4 OF ANY CoNnzAGT cm OTtER DOCUMENT M' TO Mnnpt THIS CERRp1CATE MAY t3E tSEUM OR MAY PL3rTA90,THE INSURANCE iwFcm DED aY THE pg4.lcm s DeBmmm WMN►S SUBMGT TD ALL THE Ti3M, WnUSIONS AND CONDITIONS OF SuCN PoLico , LlMITa SHOWN MAY HAVE B!'Ett REDO W BY PAlb CLAN& { TYMOFffWRAVW AWL AkuM POLICYNUNBEq POUCYEFFECTaIE PCUCvpnMIAY1W1• Lolms LTn sm eND GATE M1R(IMIDDIW) on T1i BENERAL MAD IM WH OOIAIRM�PICE S CaVM i{C9AL atT8 uwny ❑❑ TO cLA RB7fED PREM BEE $ IUSNAbE ❑ cCG1R EIDS(Mgmepenee) S aADMAW $ AaaRECATS s OENL AGwFAATt UMTt APPLIES PFR �I�77 A s POLICY ❑cRO,�T 1 1 LOC AUTOYDBeeUAgl►}ry ccmnap$WtEUWr $ ANY AM PA~ _�- S ALL OWN WE AiJYos BODILY NWUnY ❑D SCHEOULEDAVW. RWLY INRlRYPRUPFJM S T{stnAAUTW {LO AcdaaA) NOR'OMR-LFbAuf08 QAMAGE 9 (ED Aeddwq UAMMY OOCI EACH OCCURRINNE S EXCEBR UAO❑ MANS MAtf AGMT. XtE s OEDUCMX. $ s A u"WUAMUN AND WCV01001902 03/19=14 03/19/2015 X any A}rypRoppiETnRnAgl ryvE Y/H Gl`McmN04=0(mUOEtR 1,,1 Hu Policy Cov mgc State:MA `MACMACCMEW s 100,000 Mlo0.daaolenunrYaBPLdALPRDMe1aH96alnr DIWA6E-FoucyUMR $ SRm,000 OrBEA&-EACH FMNAM S 100,000 OTHER �❑ OEaCRaTON OFOPEARrldNlaDGmaNSlVglsp,�l:�(Iprll AC-0R4 g1,AddMomr ke®luac»A.a.ln�gnmb�WMq < .. ^=a•.:.. , . . .:a>1�:k. ..�R'e..:.' M:.`�t'.5%, .it:-:: ...,,:..-...:z..J.:!_:= = -. •q I I� SHOULD ANY OF THE ABOVE 6EBCRpj®pOUCM B€&jj691jj6 BEFORE THE , PmammAtion of Affordable Housing eMRATON DATE THEREOF.THR ISSUING COMPANY WILL ENDEAVOR TO MAIL 101 Harmony Hill Road 12 DAYS WIWIM NDTuM TO THE CEtTIFICAlt W DER NAMED TO THE LE1T. 13numc,MA W32 BUT FAILURE TO 00 So SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. INEPREBBRA7NC ACORD2S(2pO8N9) r/ Pagr.1 of 1 CERTMCATIJ TTOT.DrLR COPY 0 T96s 1088 ACORO CORPORATION.An rIgIft reserveA. i. TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Parcel �tlon # Health Division Date Issued 1'� Conservation Division Application Fee J Planning Dept. Permit Fee J Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address 5 c C, U/Ch Village 1/16 13 gr17S 1-g b1 e Owner SCotf ,, f&ItZsol L co>t Address S`7 chw-ch Telephone Z d3 —?/5-Z M Permit Request Cf I�f / cr�'fYC gn e %l? i// I1 aT C4 HY2--- trlufc,H 2-'Ye Inf /:d eJ FJ/f -Jq7Cv-J P', 1�i✓ �bei_5 Ae_/_i►t_4k AO Oil (^Airl h ovJC . Square feet: 1 st floor: existing proposed 2nd floor: existing proposed j TON net Zoning District Flood Plain Groundwater Overlay L .. _ o e Project Valuation 2i /.f S— Construction Type v Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting.documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family (# units) �o r Age of Existing Structure Historic House: ❑Yes ❑ No On Old King's Highway 1❑Yet ❑ No Basement Type: ❑ Full ❑ Crawl ❑ Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing —new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size—Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review # Current Use TCl/�enGC Proposed Use S ci J'�►{ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name _LAJ'�-1 ,-a l yfc �r �h,ihG Telephone Number 7l-0 Address ZG 7 /- OW4C-X License #OP7'16 9 Ab IrIl ��n, /�5 NZ 3U Home Improvement Contractor# `17 a2 Io 5`ea n QQ f V vl jpiU in c�Caih Worker's Compensation # )(/t a ro cI72g5.413 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO C4cima`'off SIGNATURE DATE Z�S FOR OFFICIAL USE ONLY APPLICATION# _DRTE ISSUED.. -- MAP/PARCEL NO. t ADDRESS VILLAGE 1 OWNER k DATE OF INSPECTION: WfQUNDA1,10N>DO_U s FRAME :'INSULATIONI' FIREPLACE F f ELECTRICAL; ROUGH. FINAL f PLUMBING: ROUGH FINAL f GAS: ROUGH FINAL FINAL BUILDING=, DATE CLOSED.:OUT. ASSOCIATION PLAN NO.' r RISE ENGINEERING Federal ID#06-MS629 ' _ RI Contractor Registration No$186 A division ofThielsch Engineering MA Contractor Registration No.120979 CT Contractor Registration No 620120 1341 Elmwood Avenue.Cranston,RI 02910 (401)784-3700 FAX(401)784-3710 CONTRACT Page 1 RI S E PROGRAM-. THIS CONTRACT IS ENTERED INTO BETWEEN RISE ' CLC-RCS ENGINEERING AND THE CUSTOMER FOR WORK AS, ENGINEERING DESCRIBEDBELGW } CUSTOMER PHONE DATE CIIeM i Melissa Leone (203)915-7171 10/23/2013 151808 SERVICE STREET -BILLING STREET 59 Church Street 59 Church Street SERVICE Cm,STATE•ZIP BILLING CITY,STATE,ZIP West Barnstable,MA 02668 West Barnstable,MA 02668 JOB DESCRIPTION Provide labor and materials to seal areas of your home against wasteful,excess air leakage. This work will be performed in concert with the use of special tools and diagnostic tests to assure that your home will be left with a healthful level of air exchange and indoor air quality.Materials to be used to seal your home can include caulks,foams,weatherstripping and other products. Primary areas for sealing include air leakage to attics,basements,attached garages and other unheated areas(windows are not generally addressed.) (8)working hours. At the completion of the weatherization work,and at no additional cost to the homeowner,a final blower door and/or combustion safety analysis will be conducted by the sub-contractor to ensure the safety of the indoor air quality. t $616.60 Provide labor and materials to install 2"FSK faced semi-rigid fiberglass board insulation to(348)square feet of kneewall rafter area. $1,151.88 Provide labor and materials to install a 15"layer of R-52 Class 1 Cellulose added to(432)square feet of open attic space. $686.88 Provide labor and materials to insulate the back of(1)attic hatch with 2"rigid Thcrmax board.Weatherstrip the perimeter. $35.12 Provide labor and materials to install ventilation chutes in(36)rafter bays to maintain air flow. -$125.64 INS) t 1 V Total: $2,615.52 �- Program Incentive: $2,116.64 Customer Total: $499.88 WE AGREE HEREBY TO FURNISH SERVICES•COMPLETE IN ACCORDANCE wr H ABOVE SPECIFICATIONS.FOR THE SUM OF 1 / "'Four Hundred Ninety-Nine&881100 Dollars $499.88 UPON FINAL INSPECTION AND APPROVAL BY RISE ENGINEERING.CUSTOMER AGREES TO REMIT AMOUNT DUE IN FULL INTEREST OF 1%WILL BE CHARGED MONTHLY ON ANY UNPAID BALANCE AFTER 30 DAYS.SEE REVERSE FOR IMPORTANT INFORMATION ON GUARANTEES,RIGHTS OF RECISION,SCHEDULING,AND CONTRACTOR REGISTRATION. CO CT IF THERE ARE ANY BLANK S CE lJTT10 NAYURE-RISE ENGINEERIN CUSTOMER MICE NOTE:.THIS CONTRACT MAY BE WITHDRAWN BY US IF NOT EXECUTED WITHIN 1 f DATE OF ACCEPTANCE �1� _13 //�/ ACCEPTANCE OF CONTRACT-THE ABOVE PRICES,SPECIFICATIONS AND CONDITIONS ARE SATISFACTORY TO US AND ARE HEREBY ACCEPTED.YOU ARE AUTHORIZED TO DO THE WORK DAYS. AS SPECIFIED.PAYMENT WILL BE MADE AS OUTLINED ABOVE r OWNER AUTHORIZATION FORM (Owner's Name) owner of the property located at (Property Address) P26'W40L1r- (Property Address) hereby authorize Pfo (Subcontractor) an authorized subcontractor for RISE Engineering,to act on my behalf to obtain a building permit and to perform work on my property. Owner's Signature Date Massachusetts -Department of Public Safety Board of Building Regulations and Standards Construction Supervisor License: d"89969 VICTOR CIlVIIIVO= 267 N.QUINCY ST F + s ABINGTON MA=0235 .F Expiration Commissioner 05/11/2016 g Office of Coasumer A�ffairsr&(B,/n/�1&1, c/%n1C((J — ME IMPROVE Business Regulatioa ,_: 9 IMPROVEMENT CONTRACTOR License or registration valid for individul use only ^^ e istretion: .149123 before the expiration date. �r xPiration:. :1 j/2k015 Type: p If found return to: Office of Consumer Affairs and Business Regulation INSUL-P Private Corporation 10 Park Plaza_Suite 5170 R0, INC. Boston,MA 02116 VICTOR CIMINO 267 N.QUINC.Y STREET- ABINGTON,MA 02351 Undersecretary Not valid without signature The Commonwealth ofMassaehusetts Print Form;Department of Industrial Accidents Office of Invesdgadons 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.mass,gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Anolicant Information Please Print Leeibly Name(Business/OtganizadonMdividual): T hJz, 'P/-O Address: f 7' City/State/Zip: b i"/► v,l /f4 S/ Phone#: 7 1- Z- AFlarn u an employer?Check the appropriate box: Type of project(required): 1. a employer with 2- D 4. ❑ I am a general contractor and I employees(full and/or part-time).' have hired the sub-contractors 6. El New construction 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' [No workers'comp.insurance comp.msurance.t 9. ❑ Building addition 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 LE]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 i employees. [No workers' 13.['Other /�t/ar1 comp.insurance required.] •Arty 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. zContractors 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 pmvide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: TPc4 y e l e rJ T n d e P 1 n i"L/ Policy#or Self-ins.Lic.M X�(�/� 6 072 Y?.S.A I Expiration Date: 2�� '71 Job Site Address: S'7 CyldrC`l f City/State/Zip:L//A/4 -7ble-lAcf 02(p�dl� 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. C I do hereb certi under the pains and penalties ofperjury that the information provided above is true and correct a Date Z 1 y Phone#:_711 Ojjicial use only. Do not write in this area,to be completed by city or town qf,jricial City or Town: Permit/License# I 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#: r '4 CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 5/6/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CER,TINCATLS DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Denise Butcher Strategic Insurance Solutions, Inc. PHONE -71O0 X122 No: 1?81)659-8282( ) 2000 Commonwealth Avenue EMAIL AbDRESS.db@strategicinstlre.com INSURERS AFFORDING COVERAGE NAIC# Newton mA 02466 INSURERA:Scottsdale Insurance Company INSURED INSURER B:Commerce Insurance Company 4754 Insul-Pro Insulation Co. , Inc. INSURERC:Torus National Insurance Co 267 N. Quincy St INSURERD:Travelers Casualty 6r Surety Co INSURER E: Abington MA 02351 INSURER F: COVERAGES CERTIFICATE NUMBERCL145602872 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR I A SUBIR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MWD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENIFLI PREMISES Ea occurrence) $ 50,000 A CLAIMS-MADE a OCCUR PS1914781 /13/2014 /13/2015 MED EXP(Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE b 2,000,000 GE N'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,OOO,000 XPOLICY PRO- AUTOMOBILE $ AUTOMOBILE LIABILITY (Ea accident) SINGLE LIMIT 1,000,000 B ANY AUTO BODILY INJURY(Per person) $ ALL OWNED X SCHEDULED S563 /5/2014 /5/2015 AUTOS AUTOS BODILY INJURY(Per accident) $ X HIRED AUTOS }� NON-OWNED PROPERTYZ DAMAGE AUTOS Peraai $ b UMBRELLA LIAB X OCCUR EACH OCCURRENCE $ 5,000,000 C J{ EXCESS LU18 CLAIMS-MADE AGGREGATE $ 5,000,000 DED I X I RETENTIONS C 7942SF141ALI /5/2014 /5/2015 $ D WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN X ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT E 1,000,000 OFFICER/MEMBER EXCLUDED? N/A (Mandatory In NH) UB6626Y35214 /6/2014 /6/2015 E.L.DISEASE-EA EMPLOYEE $ 1, 00,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT b 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS 1 VEHICLES (Attach ACORD 101,Additional Remarks Schedule.If nu�m ware Is reoulredl r CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATNE Denise Butcher/DMB ACORD 25(2010105) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 r9n1nn.Fl m Thn anopn nmma 2nr1 innn 2m►nnicMrorl m2rkc of A(non Town of Barnstable-:., - Regulatory gervices ` ` �' ""` Thomas R.Geiler, Dzrector. - B I.Iff din.g IJivisi0I1 Thomas Perry,-C130, $aiiding Commissioner. 200 Main Street, H)amis, MA 02601 vA".toWn.harnstahle.ma.us . Office: 508-862-403 8 Fax: 50$-790-6230 PLEA-SE FORWARD-THE ATTACHED PAGE(S) TO: TO: ATrI`N: FAX NO: RE: �e'on �a�� i PAGE(S�: . (INCLUDING COVER SHEET) Lam, v� 40 -des 'K-L 0�_ cit OLES Rm-1214Dl TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION, Map Parcel (f (90 Application # / Health Division Date Issued Conservation Division Application.Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board V Historic - OKH Preservation/Hyannis Project Street Address , r c'eel-+ Village Owner /Y l�iS t5 Gv4 jc&( Address � - Telephone Permit Request 51 Square feet: 1 st floor:existing 06 proposed `'d 2nd floor: existing Q proposed� 0 Total new Zoning District Flood Plain Groundwater Overlay Project Valuatiorl 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 ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new_ Half: existing new Number of Bedrooms: existing —new o a w Total Room Count (not including baths): existing new -r, First Floor RoA ount w Heat Type and Fuel: Cl Gas ❑ Oil ❑ Electric ❑ Other �' �' Central Air: ❑Yes ❑ No Fireplaces: ExistingNew Existing wood/coa stove: a?Yes3� No Detached garage: ❑existing ❑ new size_Pool: ❑existing ❑ new size _ Barn: ❑ existr g ❑ ntvtt si e Attached garage: ❑existing Ellnew size _Shed: ❑ existing Elnew size _ Other: v rr; Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ❑ No If yes, site plan review# Current Use Proposed Use I 0 Parcel Detail � Page 1 of 3 �RAP1'STARLE 1% s , . Ass. \QED MO j,. . C'i/!//GE�I•i�i{/ Logged In As: .o w. Parcel Detail Friday,June 14 2013 Parcel Lookup Parcel Info Parcel ID:153-004-004 --� -'—`� Developer l LOT B Lot Location 159 CHURCH STREET -I Pri Frontage I Sec Road;THE PLAINS ROAD NORTH Sec 1 Frontage 186 village:WEST BARNSTABLE I Fire District W BARNSTABLE Town sewer exists at this address::No Road Index 10308 Asbuilt Septic Scan: Interactive 153004004_1 Map Owner Info Owner;LEONE, SCOTT T& MELISSA A - ----� �- I Co-Owner l Streetl'150 BEAR PATH ROAD I Street2 F_ City HAMDEN —� State CT Zip�06514 Country Land Info Acres.1.58 _ �1 use;Mu H es MDL-01 1 Zoning RIRF N hbd 0105 9 Topography;Level Road I Paved �1 Utilities?Gas,Well,Septic �^ ^ - 1 Location Construction Info Building 1 of 2 _ Year; Roof Ext Built i 1982 1 struct.Gable/Hip ( Wall iWood Shingle Living - — Roof fAs h/ sCm Cover p p Type No Area I ne Style!Cape Cod^ Int.p Bed; -I 1 wan: Wv all Rooms,2 Bedrooms ' Model Residential 1 Int Hardwood Bath�1 Full+ 1 H 1 Floor' Rooms Grade-Average 1 Heat' Total Air Total ` orn ' Type' Rooms 16 ROOfT1S 1 Stories:1 1/2 StOrleS - Heat; Found- 1 Fuel;Gas I anon•Poured Conc. Gross Arealj2918 Building 2 of 2 Year Roof Built 11989 1 strums Gambrel ( Ext Wall!W oo Shingle I i http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 etail F= " a Page 2 of 3 Uving 831 Roof' Asph/F Gls/Cmp AC None Area Cover Type Int Bed Style!Gambrel wail Drywall Rooms 2 Bedrooms Model(Residentint Bath al Floor Carpet R oms 1 Full+ 1 H Grade Total i Below Average Type Hot Water Rooms 14 Rooms Heat Stories 2 Stories '� Fuel.Oil Found- ation Conc. Slab Gross!1020 Area V Permit History, Issue Date Purpose Permit# Amount Insp Date Comments -�j RESTORE TO 1 FAM-CREATE 3/4/2013 Remodel 201300994 $7,300 ( OFFICE IN ACCESSORY UNIT- REPAIR ROOF 10l3/1996 Addition 18332 $350 2/15/1997 Reroof 12:00:00 AM 9/1/1989 Addition B33240 $8,000 1/15/1992 WB ADD'N 12:00:00 AM Visit History Date Who Purpose 3/7/2013 12:00:00 AM Jeff Rudziak In Office Review 3/28/2012 12:00:00 AM Denise Radley In Office Review 1/17/2008 12:00:00 AM Paul Talbot. Cyclical Inspection 11/1/2000 12:00:00 AM Paul Talbot Meas/Listed-Interior Access 2/15/1990 12:00:00 AM IML IMeas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price --� 1 12/28/2012 LEONE, SCOTT T&MELISSA A 26998/57 $315,000 2 9/3/2004 REYNAR,GEORGE J &RUTH E 19003/237 $1 3 2/15/1993 REYNAR,GEORGE J 8440/108 $1 4 1/15/1986 REYNAR,GEORGE J &RUTH E 4889/253. $169,500 5 5/15/1982 IWOOLLARD, HOWARD W 3475/180 1 $59,500 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2013 $217,300 $29,100 $4,500 $217,100 $468,000 2 2012 $232,200 $28,100 $3,800 $213,600 $477,700 3 2011 $288,700 $3,600 $2,700 $213,600 $508,600 4 2010 $288,200 - $3,600 $2,900 $206,700 $501,400 5 2009 $305,100 $2,700 $1,400 $187,600 $496,800 6 2008 $283,500 $2,700 $2,100 $195,600 $483,900 8 2007 $315,900 $2,700 $2,100 $195,600 $516,300 9 2006 $265,100 $2,700 $2,100 $211,800 $481,700 10 2005 $252,700 $2,700 $2,100 $192,600 $450,100. http://issgl2/intranet/propddta/ParcelDetail.aspx?ID=10316 6/14/2013 P. 1 Communication Result Report ( Jun, 14. 2013 2:36PM ) 2) Date/Time : Jun, 14, 2013 2: 35PM File Page No. Mode Destination Pg (s) Result Not Sent ------------------------------------------------------------------------------------7--------------- 5366 Memory TX 912032872824 P. 4 OK -----------------------------------------------------------------------------=---------------------- Reason for error E. ,) Hang up or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E—mail size Towx of Barnsfabhv-., . , Rtgulatnry Servi= .ese�. Bu7diuglJivis®D —.. .. lit—Perrp,C80,8m7Ane, c - . - 20D tda6 Strd,HY+m�i MA 0769t PLEASE FORWARD THE ATTACBED PAGNS)TO: . TO: PAR NO: >�: Leone , 5`i Chr�rzA U).6-f" .6-e..,;/414 PAGB(b�.. (INCLUDINGcommRT) -QeSAeJt 4L 1 1`�q" rT7o/n,;r \TI ROUGH PLUMBING INSPECTION NOTES BELOW FO; THIS APPLICATION SERVE FEE: $ PLAN •ter r i j� a ■ � -r' �-ram► _ �.a. I Pa I � 71 MQ� t ` r i11r^."'`�et,�*7 - ��' }hi••'A�'" $ �Y.4 r r. La Ik lfi' ; "r Presented 1 ♦ Manley Kriss Stevens i I i e . . � I NORTHSMEe-- STORY BOOK SETUNG ! � r LLJ co CC__j y Ln1 r 59 Church St, 9 We Barnstable MA Charming Home on 1.58 acres on a cul-de-sac. - A quaint Country Retreat located in desirable W. Barnstable. 2 Homes are on this impressive property. The main house has Nan- tucket charm which offers spacious family room with Vermont Pine Floors and gas fireplace. Updated kitchen with island and breakfast nook w/cathedral ceilings. Living room boast Cape ♦ r 4 Cod Charm throughout, fantastic built-ins. With 1st floor office or r ( studio. Upstairs has 2 large bedrooms & full bath with claw footed tub. Light & Bright sunroom w/skylights w/door out to sunny •.,�,,,` private patio overlooking a lovely yard. There is a detached carriage h. house with 1200 sq ft offering 2 bedrooms & 2 baths with a deck. Could be income producing or family compound. Close to the - village, sandy cape cod beaches, shopping, golf and great dining. IF YOU LOVE PRIVACY & NATURE R ' You have found your Cape Cod Dream Home on 1.58 acres. Call Now to Schedule a Private Showing! Presented By Century2l Cobb Real Estate Team Stevens & Manley Real Estate � Kriss Stevens 508-648-0013 - Scott Manley 508-360-1771 Alex Peter 251-689-4988 "Your Local Real Estate Experts" To see Cod Cape Homes for sale&homes that sold visit us at: www.CapeHomesUnlimited.com ..._......_........._ Meal estate listings Page 1 of 6 REALToRAc*" Official Site of the IE National Association of REALTORS°. Ad blocked by RY Ao0w - --- -- - 59 Church Street Barnstable, MA 02668 Great Property on Church Street-1.58 acres $339,900 ($1,212/month) 2 Beds 3 Baths 1 1,750 Sq Ft 1 1.58 Acres Presented by Brokered by Stevens&Manley Real EstatetY Century 21 Cobb Real Estate Stevens&Manley Cape Cod Real , Agents of Change ✓ Estate Experts Toll Free: Mobile: (800) 564-8082 (508) 360-1771 Office: Office: (508) 775-2121 (508) 648-0013 Fax: (508) 771-8089 01!iz a...-LA- r 7 ..+- http://www.realtor.com/print/Default.aspx?mprid=4486597851&isPhotoPrint=true&prevre... 9/26/2012 'Real estate listings Page 2 of 6 � c I4 L-T&e- Ld A http://www.realtor.conVprint/Default.aspx?mprid=4486597851&isPhotoPrint=true&prevre... 9/26/2012 i Real estate listings Page 3 of 6 •"'°" \ r1k&�j rf Aa J'11 }+�. y r •., � :.. http://www.realtor.com/print/Default.aspx?mprid=448659785 I&isPhotoPrint=true&prevre... 9/26/2012 estate listings Page 4 of • Rini htt { C F _ ,.r- •. a StA' 1 • / • • • , I • • • , I • • • • • • • 9/26/2012 Real estate listings Page of • tr.�.. Y,• +�-;�X, i. irk :) _ http://www.realtor.com/print/Default.aspx?mprid=448659785 I&i • • ' • 9/26/2012 -Real estate listings Page 6 of 6 Sit raitAbS&Harbor. 4- s - .. ... _ - +►�. i . Ik UP Formatted for easy printing so you can take this with you. Remember to say you found it on REALTOR.com®. This information has been secured from sources we believe to be reliable, but we make no representations or warranties, expressed or implied, as to the accuracy of the information. You must verify the information and bear all risk for inaccuracies. RE r ■ Scan this QR code to see this listing online. 59 Church Street,Barnstable,MA 02668 http://www.realtor.com/realestateandhomes-detail/59-Church-St—West- Barnstable-MA-02668-M44865-97851?source=web a y http://www.realtor.com/print/Default.aspx?mprid=4486597851&isPhotoPrint=true&prevre... 9/26/2012 .. ... :- .._., .,:�.-..�.y.�•..L.L'i cl:t!t" �i, :dY'i ';i- .i_t:_ ter... ;.'.t'•:. .� �:: lJ:i�.:t ::.in .. . .�.. ' I 77 77- :Id033AN3—1V3S'01 NV1133d 3SV31d3dOl311N3 lV3S`013dV1:133d 3SV3ld cc t FOR • cc m 8 Lu Ui LU U tF� o co W W O �m2 O p C. m 4 LL O Vim _, s p w e - m w o ;iL is > Cn ? cc z: o go wC7- f CD cc z z . 8 pg L LL W C i Q 5E a G ,C C a• W = 7 U O 2 V '--• O/r ,-J U ( 1 � o Vr Z. cc mJ k o Ff� Z O: p P� �}Q� @ ELL t0�!� v o Z �/J1 C Jul"' m Ui ff H rn� cLLJ aZ m m' t.-ILA O.t LETE THIS SECTION ON DELIVERY Zi SEN9.ER:-COMPLETE THIS SECTION Z, A. Signet '2� m A F Complete items 1,2,and 3.Also complete g ❑Agent item 4 if Restricted Delivery is desired. - x °'r. �� w �• a ■ Print your name and address on the reverse X Addressee ?� Z- g E o so that we can return the card to you. B. eiv by PWtI, me) C. Da a ofDelivery /'` rnTT �■ Attach this card to the back of the mail iece, A , o "' 2 W V�p jl•O t .3 ova c� �3 C��" 3.¢: m3_ :or on the front if space permits. _ '� o o N D. Is delivery address d' erent from Item 17 ❑ s o>cc 1. Article dressed to: Y ° x 0 0 If YES,enter delivery address below: ❑ No I o J a •� S3. 5, 4 o y o o > m'E �-z: 'Cm �vj��/w/�/ M,LA .O_. WO �r ��~-.�' 7�. W. _,.W 2 Cc a.o 'M/� 3. Se Ice Type �.. m �,, � � .Z w C) -;ertified Mail ❑Express Mail O p Z :Z ►_ ❑Registered >Betum Receipt for Merchandise Z: N. r o' r.u. U' J ►- Z ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes H ' m z...]• p .�_,LU: << ' 2. Article Number - --- - _ (transfer from service label) 7006 0 810 0000 3524 6345 PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 pD �� os� 1� � � ', C�'•�"" ' ` SEN. �R: COMPLETE-THIS SECTIOW. COMPLETE THIS SECTION ON DELIVERY ■ Complete items 1,2,and 3.Also complete A. Signat item 4 if Restricted Delivery is desired. X ❑Agent .■ Print your name and address on the reverse ❑Addressee so that we Can return the card to you. B. eiv by P' e) C. D e of Delivery ■ Attach this card to the back of the mailpiece, or on the front if space permits. �C' D. Is delivery address dhferent from item 17 ❑ s 1. Article Addressed to: s.%,.�. If YES,enter delivery address below: ❑No cy 61 3.`Se Ice Type Ct rtlf7ed Mail ❑Express Mail �C>e ❑Registered >Retum Receipt for Merchandise ❑Insured Mail ❑C.O.D. 4. Restricted Delivery?(Extra Fee) ❑Yes 2. Article Number 1 F 526 3 1.'! !*J 3 I (Aansfer from service labeq _ , 7 0 0 6 0 810 0 0 0 0 3 4 3`4 5 PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 UNITED STATES POSTAL SERVICE n ,� "t~IpSt Class Mail E. Y-: ;.,, r.•. , . `" <• �;,'.^PQs a$'FBes Paid ut t ,t: Cai.;i %3 w.. ,+ FRsRn!:4rfo,MC,?0 tg • Sender: Please print your name, ad6res andalP in thislic ' I I I i TOWN OF BARNSTABLE BWLDINO DIVISION r . 200 MAIN ST. ,7�:�; NYANN1%MA 02601 ' r s , U.S. Postal ServiceTM CERTIFIED MAILTM RECEIPT (Domestic Mail Only;No Insurance Coverage Provided) For delivery information visit our website at www.usps.como r !w WN I 1 _GG PS Form 3800,June 2002 See Reverse for Instructions i Certified Mail Provides:Amailing receipt (eweAea)aaoaeunr'oose�odsd • A unique identifier for your mailpiece ■ A record of delivery kept by the Postal Service for two years ' ImE)ortant 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. ■ 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 Receipt(PS Form 3811)to the article and add applicable postage to cover the fee.Endorse mailpieoe Return Receipt Requested".To receive a fee waiver for a duplicate return receipt,a USPSe 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 mailpiace with the endorsement°Restricted'Delivery°. ■ 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. Into access to delivery Information is not available on mail addressed to APOs and FPOs. NAME OF OFFENDER BAR 73948 TOWN OF ADDRESS OF OFFENDER BARNSTABLE CITY,STATE,ZIP CODE 1 ( J/ / r 4�� D E f�BIRTH OF lFFENDEjt> �t11E►o._ MV OPERATOR LLCENSEN MB5Rf j t + /•-/(~'[/J_ + (J /L.J�CJX MV/M(BJREGIS1TRAyTION NUMBER� V er OFFEN •1'L�\\1] (f`�a ..0 LJ :Fa, kf e,4c (e S4-u 1-c 4o S i n_ I�- (p.n: I f,F(�kpUj TIME ANTI DATE VIOLATION LQUa DF VpLATION Z Uj NOTICE OF ) i(A. )/ P.A.)ON r]-1 r� ,201 T-� � �t��L� SIGNATU-REp F ENFORCING PERSON ENFO laNG D �' `. / BADGE No. N VIOLATION `T�(�U►�.i� '�y^•..._..— I 1 ✓ c OF TOWN I H EBY ACKNOWLEDGE RECEIPT OF CITATION X a ORDINANCE Unable to obtai sign re of-offender. �1 �._l rt—t �_ THE NONCRIMINAL FINE FOR THIS OFFENSE IS t U U Date mailed W OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL a DISPOSITION WITH No RESULTING CRIMINAL RECORD. W REGULATION (1)You may elect to pay thCise above fine,either by appe nnj In person b or beetweenng8:30 A.M.and 4:00 P.M.,Monday through Friday,legal excepted, Q Hyannis MA 02G01 WITHIN TWENTY- LLJ ONE(21 DAYS OF T0HEDATE OF THIS a check, NOTICE. �r or postal note to Bemstable Clerk,P. .Box 2430, CL (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 UNSTABLE DIVISION,COURT COMPOUND,MAIN STREET au ABLE,MA 02630,Attn:21 D 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 hearing to be due,criminal complaint may be Issued against you. ❑ 1 HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of S Signature I NAME OF OFFENDER � _ TOWN of nor BAR 7 3 94 8 ADDRESS OF OFFEN —5k6l BARNSTABLE 0 E F BIRTH OF FFENDE LJ I Cltt,STATE.ZIP CODE 1 +�, OAS 8- cA 1NF rCM MY OPERATOR LI SE M M /MB REGISTRATION NUMBER HAHNSIAR LLJ TIM ND DATE OF�i(IOLAT �j— LOCAT OF ION ✓ LU ; NOTICE OF �� A M / P.M.)ON �' p 20 2_ "U VIOLATION VHERBEBY Ef1FORC1 RS �— ENFO G P Q BADGE N0. ly I CD .� I OF TOWN � � IACKNOWL GE RECEIPT OF CITATION X LU ORDINANCE If—Unable to obtai signs re of offender. < — Date mailed — — �_ THE NONCRIMINAL FINE FOR THIS OFFENSE IS =I w f , OR YOU HAVE THE FOLLOWING ALTERNATIVES WITH REGARD TO DISPOSITION OF THIS MATTER.EITHER OPTION(1)OR OPTION(2)WILL OPERATE AS A FINAL oL ;DISPOSITION WITH NO.RESULTING CRIMINAL RECORD. LU REGULATION (1)You may elect to pay the above fine,either by appearing In < 1 Orson between 8:30 A.M.and 4:00 PM.,Monday through Friday,legal holl P...excepted,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.Ebx 2430, a Hyannis,MA 02601,WITHIN TWENTY-ONE(21)DAYS OF THE DATE OF THIS NOTICE. ((2))If you desire to contest this matter in a noncriminal proceeding,yydu MA ay do so by making written request to DISTRICT COURT DEPARTMENT,FIRST l f BARNSTABLE DIVISION,COURT COMPOUND,MAIN STREET BARNS ABLE,MA 02E;90,Attn:21D Noncriminal Hearings and enclose a copy of this citation for a hearing. 1 _ (3)If you fail to pay the above offense or to request a hearing within 21 days,or if 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. I ❑ I HEREBY ELECT the first option above,confess to the offense charged,and enclose payment in the amount of$ _ ! V� 1 Signature — `i F, `3 �1 y ��f i Town of Barnstable Health Inspector Office Hours �oFtHe r�� Regulatory Services 8:30—9:30 yvP o,� Thomas F.Geiler,Director 3:30—4:30 BABNSPABM « Public Health Division MASS, 1639• ,0� Thomas McKean,Director PIED MA'I a 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE . Date:October 6,2011 1. General Information: Size of Property: 1.58 acres Address: 59 Church Street west Barnstable,MA Map/Parcel 153/004/004 Name: George J. and Ruth E.Reynar Phone#: 508-360-0796 2a.. How many bedrooms exist at your property now?3 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 .2c. How many bedrooms total are proposed at this property(including the amnesty unit)?3 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip questions#4 through#9 below. 4. Location of dwelling is OUTSIDE a Saltwater Estuary Protection Zone 5 . Location of dwelling is INSIDE a Zone of Contribution to public supply wells WP 6. The dwelling is connected to an ONSITE WELL. 7. Is a disposal works construction permit on file? YES or NO U-1 j 8. If.yes,I'pow many bedrooms were approved according to this permit? 2 in main house and 1 in detached structure. 9. Were.-any building permits obtained for construction of additional bedrooms? YES or NO 10. Is th re an engineered septic system plan on file at the Health Division? YES or NO G ^� 11. Has the sept c'system been'`inspected by a DEP certified inspector within the last two years? YES or NO ------------------- C`—': FOR OFFICE USE ONLY G�—S►� The Public Health Division has no objection to bedrooms at this prop_ e Special Conditions: i �`'o cam'`S ii J n V r�i-5 �,� �2- p -�r r ..�I oo. �2 �� /- a S, .. Signe 'Date: ;'L ............ -`" 1- __! i THE COMMONWEALTH OF MASSACHUSETTS D� BOARD QF HEALTH I� ...............OF.... .. .... .,Appliratiou for Disposal Works Toawtratrtiou Permit Application is hereby made for a Permit to Construct ( ko-110'r Repair ( ) an Individual Sewage Disposal System at / s -^ %�' ... do -Addres r .or Lot No. .... --••-••--•-••__• •••--•.._..._____ ------ •--•- ••-• ••--••.--•-... O r Addre In alter '—Address T� of Building Size Lot............................Sq. feet U Dwelling.—` No. of Bedrooms__________�-, g— _______________________________Expansion Attic ( ) Garbage Grinder ( ) a a Other—Type of Building _______________ No. of ersons__:_________________________ Showers Cafeteria g ----•--------•----•---•--•---•---------•--•P--•- ( ) — ( ) Other fixtures W Design Flow---------------------------------------------gallons per person per day. Total daily flow............................................gallons. WSeptic Tank—Liquid'capacitylQO0._gallons Length................ Width---------------- Diameter---------------- Depth................ x Disposal Trench—No_ ____________________ Width.................... Total Length.................... Total leaching area...................sq. ft. Seepage Pit No--------------------- Diameter----__6--------- Depth below inlet________________ Total leaching area..................sq. ft. z Other Distribution box ( ) Dosing tank ( ) Percolation Test Results Performed by.......................................................................... Date......................................... a Test Pit No. 1................minutes per inch Depth of Test Pit.................... Depth to ground water_._____._______________. G14 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................ ----------- - -- ODescription of Soil - - - •••----••- �._.Q' ---•---------•---•------------------------------•-------------------------------------•-••••-••-----•-•--- x _:. U •-•-•---•-•-----------•-------------------•-•----------------.......------•-----------------------------------•---------------------------------------....._-•••--•-•-•----•-- W U Nature of Repairs or Alterations—Answer when applicable............................................................................................... ..---••------••------•---••-••----•-•--•-•-••----•-••---•---•--•-•-•-----•••--------•----••••----•--•-•-•---•-----'-•-------•----•--•••--------•-----------------------•--------•------•••-•-•---------• Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with the provisions of TITI.4� 5 of the State Sanitary Code—The undersigned further agrees not to place the system in operation until a Certificate of Compliance has be issued y the boa of liealt.. Signed �� eg Application Approved BY- -�=-----<�-..-. �- � -- ---- - =�----------------------------•- ........................................Date Date Application Disapproved for the following reasons-------- -----••-•---••-•--•-•-----•----------•--------•-•-•-•--•-----------•-••-•---•-•-------•-•----•-•-..._._ --•-•---•-•----------•----...----•-----------------------------------------------=---------••-•---••-•••-.---•----•-----•--•--•---•--•-••---•-••--•--•-------•---•-----•-•------•--•-•-------•--•--•••-•- �� Date D t Permit No........: ........ • / �� 5__._ Issued - - a Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH _....-�.._.Fes.,. .:._.:.__.. ... :. � _...f. .l.;rl..................OF....Yi.`.fkpf� .. '!,-:N"':................._......_....._. Trrtifirair of T 'outpliFatirr THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( r) or Repaired ( ) by..................................................................................................................................................................................................... 2 Installer at = has been installed in accordance with the .provisions of T-r- -...5 of The State Sanitary Code as described in the application for Disposal Works Construction Permit No------, ..,2_________ ___............ dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE................................................................................ Inspector..................................................................................... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ....... ' :.::.............OF..../�. L.:�<.f. . ... ........_......_............ .,f O� ` NO.s......._.. FEE.- ...................... r Disposal Works Toatotrttrtioat rrmit Permission is hereby granted...... -=''---• =='s== `=== to Construct (� ) or Repair ( ), an,Indga.,divil: Sewage Disposal System at No........ Street as shown on the application for Disposal Works Construction-y-7mit No,Fr �:'_.:_ :: ''Dated_:r lS F u� Board o ealth DATE . -•---•-------•-------••-•-•-•-•--•---••-••-'- FORM 1255 HOBBS & WARREN, INC., PUBLISHERS Fxs.............................. THE COMMONWEALTH OF MASSACI-dU ETETT$ BOARD OF HEALTH .........�t3.IA ..........OF.. .1Z1�1. .7 8 t ............................................ . Q 5 Applira#ion for Wopos al Worko Tows rurtton rermt# Application is hereby made for a Permit to Construct (,><) or Repair ( ) an Individual Sewage Disposal System at: .Tlllx---P-La .....P,d'..I......('_k'ta.......SI f-p-t..... .................................................................................................. 1 ' Location-Address -� Lot No. t sz_► y rt�.......... .................................... --�t �.Nc. �= "�'. Via:,�c i t .�C�. M&............. 4. er d Address d `X ��--........................----------------- •---------------...--------- Installer Address UType of Building Size Lot............................Sq. feet Dwelling—No. of Bedrooms---------------a.......................Expansion Attic ( ) Garbage Grinder ( ) aOther—Type of Building ............................ No. of persons---------------------------- Showers ( ) — Cafeteria ( ) P-1 Other fixtures ------------------------------- W Design Flow............1_0........................gallons per person per day. Total daily flow-----------._za-tD-.....................gallons. WSeptic Tank—Liquid capacity_1.0 -gallons Length_.'............. Width................ Diameter________________ Depth_-:--_____--__._ x Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area-_____-___.-__---_--sq. ft. Seepage Pit No-----------l......... Diameter____________________ Depth below inlet.................... Total leaching area..................sq. ft. Z Other Distribution box ( ) Dosing tank ( ) '~ Percolation Test Results Performed ................ Date.... ........... aTest Pit No. 1______ ________minutes per inch Depth of Test Pit.................... Depth to ground water___-_-_______-__--_---.. fi, Test Pit No. 2......... ......minutes per inch Depth of Test Pit.................... Depth to ground water........................ a . ............................................................................................................................................................. 0 Description of Soil.............. ----------------•-----------••--•-••-•--•-•-------------------------------------...-•----------------------------------------------------•••--• W ----------------------------••-•----------------••------------•••••••-••-••••-------•------•--••-•••••••••••••••-------......__...---------------------------------------------------------------•---••- U Nature of Repairs or Alterations—Answer when applicable............................................................................................... Agreement: The undersigned agrees to install the aforedescribed Individual.Sewage Disposal System in accordance with the provisions of TITLE 5 of the State Sanitary Code— The undersigned further agrees not to place the system in operation until a Certificate of Compliance has been issued by the board of hea Signed-.�7. E �. J� D to f Application Approved By. ..r_.t�i.._.. �........� ate u�. �r` ............... Date Application Disapproved for the following reasons:................................................................................................................ .....------•-•---•-•--•---------------•---•--•-•-•----------•----------•--------------•---......-•-------------------------------•-•---•-•-------•--------------------------•---••-•-••--••---- Date PermitNo......................................................... Issued-------------------------------•----------------_----- Date THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH ..........................................OF............................................................................... Trrfifirate of TomptiFana THIS IS TO CERTIFY, That the Individual Sewage Disposal System constructed ( ) or Repaired ( ) by-----_----------- -a............................................................................................................................................................ IInstal�l ` ;� at.......... .... . ...tt...x�`��.� y,l..- - �`'.....•'��" ''---------••-•---------•--•-------•-----------•--------•----- has been installed in accordance with the provisions of TITLE 5 of The State Sanitary Code as described in the application for Disposal Works`Construction Permit No..__..c'�. ............... dated................................................ THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM WILL FUNCTION SATISFACTORY. DATE..............................----............................................... Inspector.....------------------------------------------------..........------------......... THE COMMONWEALTH OF MASSACHUSETTS BOARD OF HEALTH c ...........................................OF....................................................:................................ `� N00---- +-•--- FEE....l.r.............. Bispos al Vorks Toner ion erani# Permission is�ereby gra granted............ '-S---•---g••---.•••..•••••••-•-y--••----•--•••••-••---••----------•••----••••••......•---•-•-------.....•--- to Construct �J o Re air an Individual vt�a a Disposal System at No...... '�''� y------ ...... --------'" - �.5 '�-~�------------------ Street as shown on the application for Disposal Works Construction Permit No..................... Dated.......................................... —of Health ---------------------------------------------------•- DATE--------------------------------------- G l/ Board FORM 1255 HOBBS & WARREN. INC.. PUBLISHERS RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET Old Cotuit Rd. West Barnstable mow WB -73 LAND 153 4 BLDGS. -' OWNER Xp-Gvs-. TOTAL /8 q 5 U (/ LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS: (10-2 W71A) Parce 1 A BLDGS. 01 Philli s. John & na1.1 66 Lot I TOTAL LAND A Ro W.AR: BLDGS. ✓�C/�/y' �i e/ " TOTAL 019 ' j►uRch S'r: W aAR►vsr�b+.�e,�l _ LAND OZ6(o BLDGS. TOTAL O I LAND K BLDGS. ew Plan of land. . . (10-2 T-1) TOTAL LAND Timothyo a ay - - A o L)E Z_� T FoE o. .- - _ Of BLDGS. TOTAL LAND BLDGS. TOTAL LAND INTERIOR INSPECTED: rn BLDGS. Tonal DATE: LAND ACREAGE COMPUTATIONS OI BLDGS. LAND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOUSE LOT , O z a O 0 f�ifG G U 0 LAND CLEARED FRONT BLDGS. REAR TOTAL WOODS&SPROUT FRONT LAND REAR v 0 BLDGS. WASTE FRONT TOTAL REAR LAND 1 BLDGS. TOTAL '7 LAND 3, z / pf o i !�> I BLDGS. LOT COMPUTATIONS LAND FACTORS TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND '0 t j' ROUGH TOWN WATER o rn BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY O BLDGS. ' F'1211..11'Vla b LAND COST nc.Wails Fin.Bsmt.Area Bath Room Base BANG. COST :one.Blk.Walls Bsmt. Rec.Room St.Shower Bath Bsmt. PURCH. DATE onc.Slab Bsmt.Garage St. Shower Est. yWallssPURGH. PRICE. Irick Walls Attic Fl.&Stairs Toilet Room Roof RENT ;tone Walls Fin.Attic Two Fist. Beth Floors iers INTERIOR FINISH Lavatory Extra :smt.' F 1' 2 3 Sink 6 1/2 1/4 Plaster Water Clo. Extra Attic EXTERIOR WALLS Knotty Pine Water Only ouble Siding Plywood No Plumbing Bsmt.Fin. ingle Siding Plasterboard Int.Fin. Shingles TILING 2nc.Blk. . ' AG F P Bath Fl. Heat ace Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit Veneer Int.Cond. Beth Fl.&Walls Fireplace om.Brk.On HEATING Toilet Rm.Fl. Plumbing olid Com.Brk. Hot Air Toilet Rm.Fl.&Weins. ' Tiling _ Steam Toilet Rm.Fl.&Wells lanket Ini Hot Water St.Shower GO Ins. Air Cond.. Tub Area Total Floor Furn. ROOFING COMPUTATIONS ' sph.Shingle Pipeless Furn. S.F. Vood Shingle No Heat S.F. abs.Shingle Oil Burner S.F. late Coal Stoker S.F. ile Gas S.F. OUTBUILDINGS ROOF TYPE Electric able Flat S.F. 1 2 3 4 5 6 7 8 9 10 112131415 6 7 819110 MEASURED lip Mansard FIREPLACES S.F, Pier Found. Floor iembrel Fireplace Stack Well Found. 0.H.Door LISTED FLOORS Fireplace Sills.Sdg. Roll Roofing :onc. LIGHTING Dble.Sdg. Shingle Roof :arth No Elect. DATE Shingle Walls Plumbing line lardwood ROOMS Cement Blk. Electric isph.Tile Bsmt. 1st TOTAL Brick Int.Finish PRICED lingie 2nd 3rd FACTOR REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL. VAL. Phy.Dep. PHYS. VALUE Funct.DeP. ACTUAL VAL. )WLG. 1 I 2 3 4 5 8 - 7 8 9 10 TOTAL I [ ] [R153 004 . 004 ] LOC] 0059 CHURCH STREET CTY] 05 TDS] 500 WB KEY] 355,715 ` ----MAILING ADDRESS------- PCA11091 PCS100 YR186 PARENT] 87970 REYNAR, GEORGE J MAP] AREA1 80AC JV] 377835 MTG] 1003 59 CHURCH ST SP1] SP21 SP31 UT11 UT21 1 . 58 SQ FT] 1716 W BARNSTABLE MA 02668 AYB] 1982 EYB] 1982 OBS] CONST] 0000 LAND 40500 IMP 131900 OTHER 2500 ----LEGAL DESCRIPTION---- TRUE MKT 174900 REA CLASSIFIED #LAND 1 40, 500 ASD LND 40500 ASD IMP 131900 ASD OTH 2500 #BLDG (S) -CARD-1 1 90, 200 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 2 , 500 TAX EXEMPT #BLDG(S) -CARD-2 1 41, 700 RESIDENT'L 174900 174900 174900 #PL 59 CHURCH ST W BARNS OPEN SPACE #DL LOT 8 COMMERCIAL #RR 0308 INDUSTRIAL SPLIT102986 EXEMPTIONS SALE] 02/93 PRICE] 1 ORB] 8440/108 AFD] I F LAST ACTIVITY104/08/93 PCR] N 1 i R153 004 . 004 A P P R A I S A L D A T A KEY 355715 REYNAR, GEORGE J LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RF 40, 500 2, 500 131, 900 2 A-COST 174, 900 B-MKT 118, 100 BY 00/ BY ML 2/90 C-INCOME PCA=1091 PCS=00 SIZE= 1716 JUST-VAL 174, 900 LEV=500 CONST-C 0 ----COMPARISON TO CONTROL AREA 80AC -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 80AC WEST BARNSTABLE PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 405001 LAND-MEAN +Oo 1749001 99229 IMPROVED-MEAN +330 250 ] FRONT-FT 11 100 DEPTH/ACRES TABLE 02 1001 LOCATION-ADJ APPLY-VAL-STAT LNR] LAND LFT/IMP] ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R153 004 . 004 P E R M I T [PMT] ACTION [R] CARD [000] KEY 355715 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT [B33240] [09] [89] [AD] A 80001 [LK] [01] [92] [100] [NEW ] [WB ADD'N ] SEngineenng Dept.(3rd floor) Map l S3 Parcel — Y Permit# House# Date Issued d " 3 floor)(8:15 -9:30/1:00-4:30) Fee s� C th floor)(8:30-9:30/1:00•-2:00) Pl oor/School Admin. Bldg.) ` �I►E'a`q De b Planning Board 19 ' BARNSTABLE. rFI 19 TOWN OF BARNSTABLE Building Permit Application Proje treet Address LOT Village , Owners A_ Address Telephone' �� Permit Request First Floor square feet Second Floor square feet Construction Type Estimated Project Cost $ J�Q . dy Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure ?" Historic House ❑Yes ❑No On Old King's HighwaCUY Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing�_ New Half: Existing Y New No. of Bedrooms: Existing New Total Room Count(not includin : Existing, New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Other Central Air ❑Yes - io Fireplaces: Existing New Existing wood/coal stove ❑Yes Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) C? ❑Att ed(size) ❑Ba e) one e 02 /S ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name_ 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 UDATE BUILDING PERMIT DE IED FOR TWE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. t G 7 : DATE ISSUED"` r MAP/PARCEL'NO c ADDRESS VILLAGE . OWNER DATE OF INSPECTION: 4 FOUNDATION FRAME ! f INSULATION FIREPLACE + I } ELECTRICAL: ROUGH ' FINAL ' PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING i DATE CLOSED OUT ASSOCIATION PLAN NO. The Commonwealth ajAtassachuscttti __. hz Departniellf of Industrial Accidents � t y - 011fce-9110 119,70AS 6110 H•ashitt.;ton Street Boston.Alas. 02111 ' Workers' Compensation Insurance Affidavit _ __ ... c 40hone — 3 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity _ lam an employer providing workers' compensation for my employees working on this job. compim• name: -- city: phone#• incurince co poliev# I am a sole proprietor. general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: comn•tnv nime• n•ldress• ch•. phone#• incur-ince co nolicv# �• •,a .•. - —•. ,.rn<:.- 'n�oc--rs•::-�+R•r.c-,:�rr.n__--•cart++wa��.1i'7'�`�!.R^"�'ny,.�s+._-: ,....�i1�a..r-Ra.�•�Y•�,;-�C- cnm any name• address- city• phone#• } cur•tnce co policy# _ Attach additional'sheetifnecessary, i�� :!:9p`t��.�!�•_ "' ''z"{'�,?�'�•" °`•..'�`•.�• y •�y �,�.�zi+o: Fuilure to secure coverage as required under Scetion ZSA of l%ICL 152 can lead to the imposition of criminal penalties of a fine up to SI.500.00 and/ur one •cars'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of SI00.00 a day against me. I understand that a copy of this statement may be funs-nrded to the Office of Investigations of the DIA for coverage verirication. ' 1 do herebr certij it er the pains and pe alt es ojpeduty that the information pro►•ided above is true and correct. Si=nature Date •� Print name Phone# J Z 13 official use only do not write in this area to be completed by city or town official city or town• permit/license q nBuilding Department Licensing Board check if immediate response is required OSclectmen's Office ' C311calth Department contact person: phone#• rlOther (n„sed;:os PJA) information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers''ampensation for the employccs. As quoted from the "law", an etnploree is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An eynp/orer is defined as an individual. partnership, association. corporation or other legal entity, or any two or nor the fore�_oin�� enLa�_ed in a joint enterprise, and including the legal representatives of a deceased employer, or the recciver or trustee of an individual , partnership, association or other legal entity, employing employees. Ho veyer tli owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwcllin"i, house of another who employs persons to do maintenance , construction or repair work on such dwelling lic or on the _rounds or building appurtenant thereto shall not because of such employment be deemed to be an employe MGL chanter 152 section 25 also states that even state or local licensing agency shall withhold title issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. 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 requires to obtain a workers' compensation policy, please call the Department at the number listed below. I . City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom o: the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Ple: be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any question... 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 fax #: (617) 727-7749 _. nhnnr ii- (617) 727-4900 evt_ 406. 409 or 375 s . . L, of Barnstable � _ : The .Town ntal Services " � Department of Health Safety and Environme Building Division 367 Main Street,Hyannis MA 02601 Ralph Crossen - Building Commissioner Office: 508-790-6227 Fax: 508-790-6230 For office use only Permit no._ Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUppLEMEn TO PERMIT APPLICATION that the "reconstraction, alterations, renovation, repair, modernization, MGL c. 142A requiresre-existing units or to conversion, improvement, removal, demolition, one but construction �° four dwelling with owner occupied building containing a registered contractors, structures which are adjacent to such reside nts r building be done by certain exceptions,all g with other req Est.Cost_tz �� Type of Work: Address of Work: Owner's Name / Date of Permit Application: /D v , �o I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under S1.,000. Building not owner-accupied Owner pulling own permit Notice is hereby given that: OR DEALING WITH UNREGISTERED THEIR OWN pERT WORK DO NOT HAVE OWNERS PULLINGHOME IMPROVEMENT CONTRACTORS FOR APPLICABLE FUND UNDER MGL c- 142A ACCESS TO THE ARBrITtATION PROGRAM OR GUARANTY SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Registration No. Contractor Name Date OR. — Owne nntP i • TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please print. DATE /D JOB. LOCATION S9 S � Number Street address Section of town "HOMEOWNER" Cam' e o�"��40 Name Home phone Work phone . - PRESENT MAILING ADDRESS Od 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(s)' 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 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 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 Departm t minimum insp tion procedures and requirements and that he/she will compl ith said pro requirements. HOMEOWNER'S 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. r. 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 Ownei shall act as supervisor. " Many Home Owners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q, Rules and Regulations for licensing Construction' Supervisors, Section 2. 15) . This lack of awarene_ 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. with:�'licensed Supervisor. ' The Home Owner-*'actir as supervisor is ultimately responsible.. To ensure that the Home Owner is fully aware of his/her responsinilities,. mar. 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. ook / •ME IJTjjMM9A—A&--'T /� l � W-k '.MI- P-m IWIRIM"Orn mm, �,O . WE I !� / 1_ �' �. Town of Barnstable Regulatory Services i r r • BARNSCABLE, "�: � Thomas F. Geiler, Director A'FpA°�`p Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax: 508-790-6230 April 12, 2007 George Reynar 59 Church Street West Barnstable, MA 02668 Attention: Charlene Reynar Re: Family Apartment Affidavit Dear Mr. Reynar: Our records indicate that you have not responded to our letter of January 10, 2007, requesting you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment, please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home Apply to the Amnesty Program If you have any questions, please call Lois Barry, Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner J030403b i oFt rQ,,, Town of Barnstable do Regulatory Services � BARNSfABLE, r MASS. g Thomas F. Geiler, Director 2639. A�FONa�" 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 March 31, 2010 Charlene Reynar 59 Church Street W. Barnstable, MA 02668 Re: Family Apartment Dear Ms. Reynar: Please complete the enclosed Family Apartment Affidavit and return it to the Building Commissioner's Office by April 15, 2010. You are required under Section 240-47.I.B(2) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of your Family Apartment approval and may result in the loss of your rights. If you have any questions, please call Lois Barry, Principal Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner Enclosure jfamaptaff Foyle, Brenda From: Dabkowski, Cindy Sent: Wednesday, May 30, 2012 11:32 AM To: Coyle, Brenda; Cadrin, Arden; Dabkowski, Cindy Subject: RE: 59 Church Street W. Barnstable, Hello Brenda 59 Church street has resubmitted an application to the Accessory Apartment Program. The application is in a 30 day review period. There is no information to share at this time. Attached you will find the link AAAP Unit addresses you requested. T:\GMD\AAAP Please note that we have a process in place to assure that all Accessory Apartments are rented on an open and fair basis to income eligible renters. In order for this process to work it is imperative that persons interested in renting AAAP units contact either this office or the Cape Cod Commission. Thank you -----Original Message----- From: Coyle, Brenda Sent: Tuesday,May 29, 2012 2:49 PM To: Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Hi Cindy, I just received a Family Apartment Affidavit regarding this address mentioned above. They have written on the affidavit you are working with them (Amnesty Program). If I could have a copy of the denial letter you sent them regarding the Health Department decision it would be greatly appreciated. Thank you, Brenda Coyle -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday,May 16,2012 1:52 PM To: Coyle, Brenda Subject: RE: 59 Church Street W. Barnstable, Hello Brenda A site visit was performed on October 6, 2011. Health Department Denied the property for the Accessory Apartment Program on October 24, 2011. Thank you, Cindy Dabkowski -----Original Message----- From: Coyle, Brenda Sent: Tuesday,May 15, 2012 2:21 PM To: Dabkowski,Cindy Subject: 59 Church Street W. Barnstable, Hi Cindy, I sent an email to you on October 3, 2011 stating the owner was interested in the Amnesty Program, your reply back stated you were going to contact the owner and schedule an initial site visit. Do you have a status on this property?The current owners are George and Ruth Reynar. I Thank you, i 1 VBrencla Coyle 2 i Coyle, Brenda From: Coyle, Brenda Sent: Wednesday, May 30, 2012 11:45 AM To: Dabkowski, Cindy Subject: RE: 59 Church Street W. Barnstable, Hi Cindy, Thank you for the information. The file for AAAP says Achieve and there is nothing the file. Brenda -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday, May 30,2012 11:32 AM To: Coyle, Brenda; Cadrin,Arden; Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Hello Brenda 59 Church street has resubmitted an application to the Accessory Apartment Program. The application is in a 30 day review period. There is no information to share at this time. Attached you will find the link AAAP Unit addresses you requested. T:\GMD\AAAP Please note that we have a process-in place to assure that all Accessory Apartments are rented on an open and fair basis to income eligible renters. In order for this process to work it is imperative that persons interested in renting AAAP units contact either this office or the Cape Cod Commission. Thank you -----Original Message----- From: Coyle, Brenda Sent: Tuesday,May 29,2012 2:49 PM To: Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Hi Cindy, I just received a Family Apartment Affidavit regarding this address mentioned above. They have written on the affidavit you are working with them (Amnesty Program). If I could have a copy of the denial letter you sent them regarding the Health Department decision it would be greatly appreciated. Thank you, Brenda Coyle -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday,May 16,2012 1:52 PM To: Coyle, Brenda Subject: RE: 59 Church Street W. Barnstable, Hello Brenda A site visit was performed on October 6, 2011. Health Department Denied the property for the Accessory Apartment Program on October 24, 2011. Thank you, Cindy Dabkowski -----Original Message----- 1 i f From: Coyle,Brenda Sent: Tuesday,.May 15,2012 2:21 PM To: Dabkowski,Cindy Subject: 59 Church Street W. Barnstable, Hi Cindy, I sent an email to you on October 3, 2011 stating the owner was interested in the Amnesty Program, your reply back stated you were going to contact the owner and schedule an initial site visit. Do you have a status on this property?The current owners are George and Ruth Reynar. Thank you, Brenda Coyle 2 r Coyle, Brenda . From: Coyle, Brenda Sent: Thursday, June 28, 2012 8:40 AM To: Dabkowski, Cindy Subject: RE:.59 Church Street, W. Barnstable Hi Cindy, Are the homeowners in the process of rescinding this decision? In my previous email to you, you stated that the on May 30, 2012 the Health Dept. was reviewing and they had 30 days to respond. Thank you, Brenda -----Original Message--- From: Dabkowski,Cindy Sent: Wednesday,June 27,2012 3:31 PM To: Coyle;Brenda Subject: RE: 59 Church Street,W. Barnstable Health Department denied property for AAAP process on 10/24/11 - Homeowners have not requested second review for.eligibility into the AAAP program. -----Original Message----- From: Coyle,Brenda -Sent: Wednesday,June 27,2012 10:44 AM To: Dabkowski,Cindy Subject: 59 Church Street,W. Barnstable Hi Cindy, I know this is your first day back. I would like to follow-up on the above referenced address, I know you were waiting for the Health Dept. Decision on the septic, do have anymore information from the Health Dept. on the above property(Amnesty Program)?When you get a chance could you please let me know. Thank you, Brenda Coyle 1 i Coyle, Brenda From: Coyle, Brenda Sent: Wednesday, June 27, 2012 10:44 AM To: Dabkowski,.Cindy. Subject: 59 Church Street, W. Barnstable Hi Cindy, I know this is your first day back. I would like to follow-up on the above referenced address, I know you were waiting for the Health Dept. Decision on the septic, do have anymore information from the Health Dept. on the above property(Amnesty Program)?When you get a chance could you please let me know. Thank you, Brenda Coyle 1 Loyle, Brenda From: Dabkowski, Cindy Sent: Wednesday, May 30, 2012 11:59 AM To: Coyle, Brenda Subject: RE: 59 Church Street W. Barnstable, Open the pdf Master inventory 1112 which is the current list-the archive folder is old lists -----Original Message----- From: Coyle, Brenda Sent: Wednesday,May 30,2012 11:45 AM To: Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Hi Cindy, Thank you for the information. The file for AAAP says Achieve and there is nothing the file. Brenda -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday,May 30,2012 11:32 AM To: Coyle, Brenda; Cadrin,Arden; Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Hello Brenda 59 Church street has resubmitted an application to the Accessory Apartment Program. The application is in a 30 day review period. There is no information to share at this time. Attached you will find the link AAAP Unit addresses you requested. T:\GMD\AAAP Please note that we have a process in place to assure that all Accessory Apartments are rented on an open and fair basis to income eligible renters. In order for this process to work it is imperative that persons interested in renting AAAP units contact either this office or the Cape Cod Commission. Thank you -----Original Message----- 004v4 Iwl crzZ)n From: Coyle, Brenda Sent: Tuesday,May 29,2012 2:49 PM To: Dabkowski,Cindy Subject: RE: 59 Church Street W. Barnstable, Cfr) Hi Cindy, I just received a Family Apartment Affidavit regarding this address mentioned above. They have written on the affidavit you are working with them (Amnesty Program). If I could have a copy of the denial letter you sent them regarding the Health Department decision it would be greatly appreciated. Thank you, Brenda Coyle -----Original Message----- From: Dabkowski,Cindy Sent: Wednesday, May 16,2012 1:52 PM To: Coyle,Brenda Subject: RE: 59 Church Street W. Barnstable, Hello Brenda A site visit was performed on October 6, 2011. Health Department Denied the property for the Accessory Apartment Program on October 24, 2011. 1 Thank you, • Cindy Dabkowski -----Original Message----- From: Coyle, Brenda Sent: Tuesday, May 15,2012 2:21 PM To: Dabkowski,Cindy Subject: 59 Church Street W.Barnstable, Hi Cindy, I sent an email to you on October 3, 2011 stating the owner was interested in the Amnesty Program, your reply back stated you were going to contact the owner and schedule an initial site visit. Do you have a status on this property?The current owners are George and Ruth Reynar. Thank you, Brenda Coyle 2 Coyle, Brenda From: Dabkowski, Cindy Sent: Wednesday, July 11, 2012 3:46 PM To: Coyle, Brenda; Cadrin, Arden; Dabkowski, Cindy Subject: RE: 59 Church Street, W. Barnstable Brenda 59 Church St W. Barnstable - site visit performed October 7, 201Y- Mr. and Mrs: Reynar were unable to complete AAAP Process -.Contact information on file is no longer accurate. Mr. and Mrs. Reynar must reapply. Cindy -----Original Message----- From: Coyle, Brenda Sent: Wednesday,June 27,2012 10:44 AM To: Dabkowski,Cindy Subject: 59 Church Street,W. Barnstable Hi Cindy, I know this is your first day back. I would like to follow-up on the above referenced address, I know you were waiting for the Health Dept. Decision on the septic, do have anymore information from the Health Dept. on the above property (Amnesty Program)?When.you get a chance could you please let me know. Thank you, Brenda Coyle i 1 wn of Barnstable ( Health Inspector oFt"e rorti Regulatory Services Office Hours 8:30—9:30 �.� Thomas F. Geiler,Director 3:30—4:30 Public Health Division Thomas McKean,Director QED MA'S 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT — SEPTIC QUESTIONNAIRE Date: October 6,2011 1. General Information: Size of Property: 1.58 acres Address: 59 Church Street west Barnstable,MA Map/Parcel 153/004/004 Name: George J. and Ruth E.Reynar Phone#: 508-360-0796 2a. How many bedrooms exist at your property now?4 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?4 2d.Please include a copy of the floor plans for the entire property..Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public.sewer,.skip'questions#4 through#9 below. .. . p 4. Location of dwelling is OUTSIDE a Saltwater Estuary Protection Zone 00 5 . Location of dwelling is INSIDE a Zone of Contribution to public supply wells WP 6. Is the dwelling connected to an ONSITE WELL __- 7. Is a disposal works construction permit on file? YES or ` NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system.been inspected by a DEP certified inspector within the last two years? YES or NO --- I ----------------- FOR OFFICE USE ONLY The Public Health Division has no objection to bedrooms at this property. Special Conditions: A10 Signed: Date: Q1t� �►o� 1loo. Coyle, Brenda From: Coyle, Brenda Sent: Tuesday, May 15, 2012 2:21 PM To: Dabkowski, Cindy Subject: 59 Church Street W. Barnstable, Hi Cindy, I sent an email to you on October 3, 2011 stating the owner was interested in the Amnesty Program, your reply back stated you were going to contact the owner and schedule an initial site visit. Do you have a status on this property?The current owners are George and Ruth Reynar. Thank you, Brenda Coyle I - 1 _ I r Coyle, Brenda From: Dabkowski, Cindy Sent: Monday, October 03, 2011 1:24 PM To: Coyle, Brenda Subject: RE: Amnesty Program I Brenda Thank you I will schedule an initial site visit. Cindy -----Original Message----- ' From: Coyle,Brenda Sent: Monday,October 03, 2011 1:16 PM To: Dabkowski,Cindy Subject: Amnesty Program Good Afternoon Cindy, We received a call this morning from the owner of 59 Church Street W. Barnstable that she wishes to go into the Amnesty Program. Thank you, Brenda Coyle . 1 1 I Town of Barnstable Regulatory Services i � Thomas F. Geiler, Director anaxsr"LE. Building Division MAR&K Thomas Perry, CBO,Building Commissioner . s63p �0 A'Ec 39 .200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 May 18, 2012 George Reynar 59 Church Street W. Barnstable, MA 02668 -- Re: Family Apartment Dear Reynar: On October 6, 2011, Growth Management Department Coordinator Cindy Dabkowski had a site visit to determine your eligibility for the Amnesty Program, at the same time the Health Department denied your request for the Accessory Apartment(Amnesty Program). Since you've been denied the Amnesty Program, your only option is to restore your property to a single family home. You have until June 8, 2012,to resolve this issue, or you could be fined up to $100.00 per day, per violation. I've enclosed for your review the Family Apartment Ordinance and the letters.sent to you on April 20, 2012, March 8, 2012 and January 1, 2012,regarding the Family Apartment Affidavit. Also, please find the Restore to a Single Family Application/Building Permit for your convenience. Please call me at 508-862-4039 to discuss the necessary steps towards compliance with the Zoning Ordinance. Sincerely, Brenda Coyle Division Assistant cc:Robin Anderson Zoning Enforcement Officer Enclosure: fasnd I l: $ 240-47.1. Family apartments. [Added 11-18-2004 by Order No. 2005-026; amended 10-7-2010 by Order No. 2011-010] The intent of this section is to allow within all residential zoning districts one temporary family apartment unit occupied only by the property owner or a member(s) of the property owner's family as accessory to an owner- occupied single-family residence.A family apartment may be permitted, provided there is compliance with all conditions and procedural requirements herein. A. Conditions. A family apartment shall comply with and be maintained in full compliance with all of the following conditions: (1) The apartment unit shall not exceed 800 square feet or 50% of the square footage of the existing single- family dwelling, whichever.is less. The Zoning Board of Appeals may allow up to 1,200 square feet by a special permit finding. In any case, the apartment shall be limited to no more than two bedrooms; (2) Occupancy of the apartment shall not exceed two family members; (3) The apartment shall be located within a single-family dwelling or connected to the single-family dwelling in such a manner as to allow for internal access between the units. The apartment must comply with all current setback requirements for the zoning district in which it is located. (4)At no time shall the single-family dwelling or the family apartment be sublet or subleased by either the owner or family member(s). The single-family dwelling and family apartment shall only be occupied by those persons listed on the recorded affidavit. (5) When the family apartment is vacated, or upon noncompliance with any condition or representation made including but not limited to occupancy or ownership, the use as an apartment shall be terminated. A building permit must be applied for to remove all cabinets, countertops, kitchen sinks and appliances from the family apartment, and the water and gas service utilities must be capped and placed behind a finished wall surface. B. Procedural requirements. Prior to the creation of a family apartment, the owner of the property shall make application for a building permit with the Building Commissioner providing any and all information deemed necessary to assure compliance with this section including, but not limited to, scaled plans of any proposed remodeling or addition to accommodate the apartment, signed and recorded affidavits reciting the names and family relationship among the parties, and a signed family apartment accessory use restriction document. (1) Certificate of occupancy. Prior to occupancy of the family apartment, a certificate of occupancy shall be obtained from the Building Commissioner. No certificate of occupancy shall be issued until the Building Commissioner has made a final inspection of the apartment unit and the single-family dwelling for compliance and a copy of the family apartment accessory use restriction document recorded at the Barnstable Registry of Deeds is submitted to the Building Division. (2)Annual affidavit.Annually thereafter, a family apartment affidavit, reciting the names and family relationship among the parties and attesting that the property is the year-round primary residence of the property owner and family member(s), shall'be signed and submitted to the Building Division. t t Town of Barnstable Regulatory Services AUAILBAHNSMLE. ' Thomas F. Geiler, Director i6 a�10� F16 Building Division Tom Perry Building Commissioner 200 Main Street, Hyannis, MA 02601 Office: 508-862-4038 Fax:508-790-6230 January 1,2012 George Reynar 59 Church Street West Barnstable, MA 02668 i Re: Family Apartment Dear Property Owner, Please complete the enclosed Family Apartment Affidavit and return it to the Building Commissioner's Office by February 18,2012. You are required under Section 240-47.1 of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the Family Apartment. Failure to submit the affidavit is a violation of your Family Apartment approval and may result in the loss of your rights. If you have any questions, please call Brenda Coyle, Principal Division Assistant, at 508-862-4039. Sincerely, Tom Perry Building Commissioner Enclosure I I Town of Barnstable Regulatory Services Thomas F. Geiler,Director • swuvsr�sLE, , Building Division MAS& Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 SECOND NOTICE March 8,2012 George and Ruth Reynar 59 Church Street W. Barnstable, MA 02668 Re: 59 Church Street Dear Mr. and Mrs. Reynar: Our records indicate that you have not responded to our letter of January 3, 2012 asking you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment,please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home, or Apply to the Amnesty Program If you have any questions,please call Brenda Coyle, Principal Division Assistant, at 508- 862-403 9. Sincerely, Tom Perry Building Commissioner Enclosure fasnd I Town of Barnstable • ' Regulatory Services Thomas F. Geiler,Director Building Division B+uvsrARC4 s g Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601. www.town.barnstable.ma.us Office: 508-862-4038. Fax: 508-790-6230 THIRD NOTICE April 20,2012 George Reynar 59 Church Street W. Barnstable, MA 02668 Re: 59 Church Street Dear Reynar: Our records indicate that you have not responded to our letters of January 3, 2012 and March 5,2012 asking you to complete and return the Family Apartment Affidavit. You are required under Section 3-1.1(3)(D)(1) of the Town of Barnstable Zoning Ordinances to submit an affidavit annually indicating the status of the family apartment. Failure to submit the affidavit is a violation of the Family Apartment Rules and Regulations and may cause the Family Apartment approval to be rescinded. Please return the enclosed affidavit as soon as possible. If you no longer have a family member residing in the family apartment,please contact this office as soon as possible to: Apply for a building permit to restore the property to a single-family home, or Apply to the Amnesty Program If you have any questions, please call Brenda Coyle, Principal Division Assistant, at 508- 862-4039. Sincerely, v 10K Tom Perry Building Commissioner. Enclosure fasnd 1 ti---._... -Ass ... essor's map and lot number ........................ .... ............... • ; piles./L,�I - ��s/8Y, Q�°F THE t0�♦ Sewage Permit number .......'. ......................... SEPTIC SYSTEM MUST BE - INSTALLED III COMPLIANCE 9TABLE If House number ......J�-`......................................................... NAM s t i WITH TITLE 5 �" °°tea 9 ENVIRONMENTAL CODE Aid® - TOWN OF BARN!S4W2F k*s BUIL HG ' INSPECTOR APPLICATION FOR` PERMIT TO . ...................... ............................ TYPEOF CONSTRUCTION ......... ...... . . ..... .. . ... ... ... ...... .. ..... ....... .. .... .............................. ............ T..........19 Z TO THE INSPECTOR OF-BUILDINGS: r The undersigned hereby applies for a permit according to the following information: Location .......`......................................................... ............ .........t 1..:?? ................................................................. . i Proposed Use .....��.� G LCs.....l !s?�� ....../�C'Y.�CjCLt .6...........................................................:.......................... ZoningDistrict ..........................:.............................................Fire District ....................... .. "...................... Nameof Owner .../7Llf ...................... Lu ..Address ....................... .............. ............................ Nameof Builder � ��i'......... 5..... c�iZ Address .............. .................. . .... ................ ....................................................................... Nameof Architect ..................................................................Address ............!!...�..................::.................................................. Number of Rooms �v�=....................................... Foundation / UCi/l�l� ( �r....'7�o.!``j"?�Cs 4............... ... ... ........................... ................ ..... Exterior .4!� .....:r... Roofing ...... 7..... ....................... .Interior ......S�fG C�T�Z�C Floors .........�.oaf........................................................... ........................................................................ L —I?- fs'�7'gs Heatirig '..E.fOT... �' /3y.11.....::..:.:.:::::.::::: :Plumbing Fireplace ..... ? G..................................................................Approximate Cost .!30 As ep......... ............................. Definitive Plan Approved by Planning Board -----------_______-----------19______. Area Zhh Diagram of Lot and Building with Dimensions Fee .............. . . ................ SUBJECT TO APPROVAL OF BOARD OF HEALTH OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ` Name . ` ` -".... ........................................................................... ,t WOOLLARD, HOWARD W. 24270 131 Story o ................. Permit for .................................... Single Family Dwelling ............................................................................... Location 59 Church Street ................................................................ West Barnstable ............................................................................... Owner Howard W. Wollard .................................................................. Type of Construction Frame Plot ............................ Lot ................................ Permit Granted ..August 9i..............19 821 Date of Inspection ....... ........ ..:...�1 g" Date Completed .:.......19 /�3 /,�/ OK O&H ,81D,4 Assessor's map and lot number ..................... —5/.............. THE Sewage Permit number ........ ........................ ss SARIST LE House number ...... ...................................................... NAG& 039 M TOWN OF " , BARNSTABLE BUILDING INS,-PECTOR APPLICATION FOR PERMIT TO ........................ ....Vy... ............................................................ TYPE OF CONSTRUCTION ............ ........... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ....... !ec ly........57 .................:. - .. .............................................................................................................. ............... .. — 4�Proposed Use ..... 6! ....................................................................................... Zoning District ........................................................................Fire District ................................. Nome of Owner .....*A->.,0.qaZ'>.. Address . ........................................A Kz ..................... Name of Builder. ......: ? ...... ...... ......Address .......................................I.............................................. Nameof Architect ..................................................................Address ..................................................................................... Number of Rooms .......... ...........................................Foundation .... r Exterior Roofing ...... ..................... . e ................ ........................... Floors ........ .............................................................Interior ...... ...................................................... Heating .....................................Plumbing .... . .... . .. .................................................................... Fireplace ..... ....................................................................Approximate Cost ......�Q .. ........................................... Definitive Plan Approved by Planning Board ---------------—----------- Area .......................................... Diagram of Lot and Building with Dimensions Fee I ............................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH �� 1r� ---.0-CCUPANCY 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 ....7............................................................................ WOLLARD, HOWARD W. A=153-4 �4270 V 2 Story No ................. Permit for .................................... Single Family Dwelling ............................................................................... Location ...5.9...Church....Street ................... .. .. .. ....... .... .... .. .... .. West Barnstable ...............................t............................................... HQward W. Wollard Owner .................................................................. Type of Construction .......Fr...ame............................. .. ................................................. .............................. Plot ............................ Lot ................................ Permit Granted ... ...............19 82 Date of Inspection ....................................19 Date Completed ......................................19 lly r Parcel Detail Page 1 of 3 z, Ok SHE011 )fir- y��► htA55, y�0 163 9• �hbl r /%//,may 9y/yam/� j-�rJfp//,//�- - 'ya.:yH 'ZfD hl aV A' .`. _ _ ........r...Y 1��/ (fC/G/I(/ls/�fli(/G/-(/C/ _.. . •��p�hg. "�;.�A,". - Logged In As: Parcel Detail Friday,August 24 2012 Parcel Lookup Parcel Info Parcel ID 153-004-004 l Developer LOT 8Lot l Location 159 CHURCH STREET l Pri Frontage F— l Sec Road ITHE PLAINS ROAD NORTH Sec Frontage 186 l Village WEST BARNSTABLE l Fire District JW BARNSTABLE l Town sewer exists at this address I Nol Road Index 0308 l L may` Asbullt Septic Scan: Interactive 153004004_1 Mapyl�i ram. ,}t< Owner Info Owner IREYNAR, GEORGE J&RUTH E l Co-owner Il Streets 159 CHURCH ST l Street2 l City IWEST BARNSTABLE l State MA zip F6-26681 Country�J Land Info Acres 11.58 use IMulti Hses MDL-01 l zoning I RF Nghbd 0107J Topography Level !l Road Paved l Utilities I Gas,Wel1,Septic l Location " Construction Info Building 1 of 2 Year 1982 Roof[able/Hip l Ext Wood Shingle Built Struct Wall Living 1502 _l Roof Asph/F GIs/Cmp l AC None Area Cover Type Style Icapecod l Int ,Drywall Tl Bed 2 Bedrooms �l RTd. _ ' ys. Wall Rooms @' Model lResidential l I Floor or Hardwood l Bath 1 Full+ 1 H `l r Rooms 13 B8 Txs' Grade Average Plus l Type Hot Air l Rooms 6 Rooms l s 2 1 'ee�T Stories 11 1/2 Stories I Fuel Gas 1 F ation Poured Conc. Gross 2918 I Area Building 2 of 2 Year 1989 Roof Gambrel _I Ext rWood Shingle Built Struct Wall http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 8/24/2012 Parcel Detail Page 2 of 3 Living 831 I Roof Asph/F GIs/Cmp I AC None Area Cover Type Bed 1 Style Gambrel I wall Drywall I Rooms 2 Bedrooms Bath 1 Model Residential I Floor Carpet I Rooms 1 Full+ 1 H s Grade jAverage �I Heat H Rooms ot Water I Total Type 4 Rooms I T U Stories 12 Stories I und- Fuel ea Oil I F ation Conc. Slab I Gross 1020 -I Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 10/03/1996 Addition 18332 $350 02/15/1997 00:00:00 Reroof 09/01/1989 B33240 $8,000 01/15/1992 00:00:00 WB ADD'N - Visit History Date Who Purpose 03/28/2012 00:00:00 Denise Radley In Office Review 01/17/2008 00:00:00 Paul Talbot Cyclical Inspection 11/01/2000 00:00:00 Paul Talbot Meas/Listed-Interior Access 02/15/1990 00:00:00 IML - Sales History Line Sale Date Owner Book/Page Sale Price 1 09/03/2004 REYNAR,GEORGE J & RUTH E 19003/237 $1 2 02/15/1993 REYNAR, GEORGE J 8440/108 $1 3 01/15/1986 REYNAR, GEORGE J&RUTH E 4889/253 $169,500 4 05/15/1982 WOOLLARD, HOWARD W 3475/180 $59,500 - Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2012 $232,200 $28,100 $3,800 $213,600 $477,700 2 2011 $288,700 $3,600 $2,700 $213,600 $508,600 3 2010 $288,200 $3,600 $2,900 $206,700 $501,400 4 2009 $305,100 $2,700 $1,400 $187,600 $496,800 5 2008 $283,500 $2,700 $2,100 $195,600 $483,900 7 2007 $315,900 $2,700 $2,100 $195,600 $516,300 8 2006 $265,100 $2,700 $2,100 $211,800 $481,700 9 2005 $252,700 $2,700 $2,100 $192,600 $450,100 10 2004 $203,700 $2,700 $2,100 $221,400 $429,900 11 2003 $180,700 $2,700 $2,100 $68,700 $254,200 12 2002 $180,700 $2,700 $2,100 $68,700 $254,200 13 2001 $180,700 $2,800 $2,100 $68,700 $254,300 14 2000 $130,000 $2,700 $1,100 $52,200 $186,000 15 1999 $130,000 $2,700 $1,100 $52,200 $186,000 16 1998 $130,000 $2,700 $1,100 $52,200 $186,000 http://issgl2/intranet/propdata/PareelDetail.aspx?ID=l 0316 8/24/2012 Parcel Detail Page 3 of Photos a F,• q'�<k�F.,b�Y"�t• °;;` a�� ! xr� y,K�"''. a ba .p . �", htt '��a�gvrooa�• � - ovnizoas • • • • ••. • 03168/24/2012 0 .00 ir `Vy 0 . 00 /p� t6� 0 ►.0i0 0 . 0'0 0<.ti0_0 5 , 91:7 . 00 + 5 + 58,0 . GO + 5 , 448 . 00 + 2 - 7,16 • 0-0 + 1°.9 ,-64 1 010 * Parcel Detail j Page 1 of 3 8AR.1STAaLE. Qh GdpT fD N 1hd 'z J; 4 r+ ✓. `� !/� ,ry - Logged In As: w� Tuesday,July 24 2012 Parcel Detai '��?�liz �V arcel _ �� .� _F .•,.,-"� =.--:J � �17i _►�!l—I- k- d_s-fa vP 1 ve �A — s v Parcel Info l Q Parcel ID 153-004-004 I DeveloLoot LOT 8 Location 159 CHURCH STREET I Pri Frontage Sec 1 Sec Road ITHE PLAINS ROAD NORTH Frontage 186 Village IWEST BARNSTABLE I Fire District JW BARNSTABLE Town sewer exists at this address I No I Road Index 0308 Asbuilt Septic Scan: Interactive w Ma 1530040041 p � s�f s - Owner Info Owner I REYNAR, GEORGE J& RUTH E I Co-owner Streetl 59 CHURCH ST Street2 City WEST BARNSTABLE State MA Zip 02668 Country f _� - Land Info — 'O Acres 11.58 use IMulti Hses MDL-01 I zoning rRF Nghbd 0107 Topography Level I Road Paved I Utilities lGas,Well,Septic I Location Construction Info Building 1 of 2 Year 1982 I Roof Gable/Hip I Ext Wood Shingle Built Struct Wall Living 1577 Roof Ash/F GIs/Cm AC None Area I Cover' P p Type I �BedAS 1: Style Cape Cod �I wall Drywall — I Rooms 2 Bedrooms Model Residential I I Floor or Rooms Hardwood I Bath 1 Full+ 1 H I ' r 1 eat Total Grade jAverage Plus I TYPe Hot Air I Rooms 6 Rooms Stories 1 1/2 Stories�I Heat Gas (Found- Poured Conc. I Fuel i ation Gross 2918 I Area Building 2 of 2 Year 1989 I Roof Gambrel I Ext Wood Shingle I Built Struct Wall http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=l 0316 7/24/2012 Parcel Detail Page 2 of 3 v . Living 885 I Roof Asph/F GIs/Cmp I AC None Area cover Type Int Bed style Gambrel I wan Drywall I Rooms 2 Bedrooms Int Bath Model Residential ( Floor Carpet I Rooms 1 Full+ 1 H Grade jAverage I Heat Hot Water I Total 4 Rooms Type Rooms Stories 12 Stories I Heat Fuel Oil (Foation Conc. Slab Gross 1020 Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 10/03/1996 Addition 18332 $350 02/15/1997 00:00:00 Reroof 09/01/1989 B33240 $8,000 01/15/1992 00:00:00 WB ADD'N Visit History Date Who Purpose 03/28/2012 00:00:00 Denise Radley In Office Review 01/17/2008 00:00:00 Paul Talbot Cyclical Inspection 11/01/2000 00:00:00 Paul Talbot Meas/Listed-Interior Access 02/15/1990 00:00:00 -ML m Sales History Line Sale Date Owner Book/Page Sale Price 1 09/03/2004 REYNAR,GEORGE J&RUTH E 19003/237 $1 2 02/15/1993 REYNAR, GEORGE J 8440/108 $1 3 01/15/1986 REYNAR, GEORGE J & RUTH E 4889/253 $169,500 4 05/15/1982 WOOLLARD, HOWARD W 3475/180 $59,500 Assessment History Save# Year Building Value XF Value OB Value Land Value Total Parcel Value 1 2012 $232,200 $28,100 $3,800 $213,600 $477,700 2 2011 $288,700 $3,600 $2,700 $213,600 $508,600 3 2010 $288,200 $3,600 $2,900 $206,700 $501,400 4 2009 $305,100 $2,700 $1,400 $187,600 $496,800 5 2008 $283,500 $2,700 $2,100 $195,600 $483,900 7 2007 $315,900 $2,700 $2,100 $195,600 $516,300 8 2006 $265,100 $2,700 $2,100 $211,800 $481,700 9 2005 $252,700 $2,700 $2,100 $192,600 $450,100 10 2004 $203,700 $2,700 $2,100 $221,400 $429,900 11 2003 $180,700 $2,700 $2,100 $68,700 $254,200 12 2002 $180,700 $2,700 $2,100 $68,700 $254,200 13 2001 $180,700 $2,800 $2,100 $68,700 $254,300 14 2000 $130,000 $2,700 $1,100 $52,200 $186,000 15 1999 $130,000 $2,700 $1,100 $52,200 $186,000 16 1998 $130,000 $2,700 $1,100 $52,200 $186,000 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=10316 . 7/24/2012 DetailParcel Page 3 of • 1994 $123,300 • $0 $57,300 $183,100 Photos q .t ! �•4,!IGt v�0°iti a i f ads A$+ �� i �+�i�� 7Mj t - !,%; htt �!. ,v�t� .t, C+y Z n' 'i '"tir 4 i u�J Pfj'6f�iye• i - 1, rk{� n S�11 9y ��„ y , ii .�erg +. n t ,t Sr 1} '�,•�.-� �i ft/� d �i �,ci �� 4{�, tom. i�Y ��i may- ,,w 3+�iJ`c�aw F .•. �,3�il.'� r� 7a`r� ity� P � to rx�*,:f °�Z i�o r��3� •�� p �?��^�'-��1�'6r,��b � !1Ay�e.Pi' �1 i5 ♦ (may{'�G a� '' Niiy 19yk�� if�'#��8�•,R+q� �`�'� ,� °,r"t�� "1 1 Y'{,t� c.�'+ +Bay l t,_ �� 'q�� 1��C .F i•, �•k' t it �>w �"'^,''��% � 1 �'',oer;mws; '' avtgnaoe q 1S #p} 1 1 OtIt7n00B i • • • •••. • 1 • 7/24/2012 PROPERTY ADDRESS I I ZONING (DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I N81-ID 1RENTIFiCATIOl�-nUjyBj° KEY NO. 0059 CHURCH STREET 05 RF 500 05WB 07/09/95 1091 J. .30AC R153 004.004 _ 35571 ` LANDIOTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS ,, UNIT ADJ'D.UNIT c Lana ByAT;,.o Sin:O�rr,,:nsur„ p ACRES/UNITS VALUE De>�npnpn :R E Y N A,R. G E O R G E J M A P- / CU. FI°dh:,.roAcrua -t-OC./VR.SPEC.CI-ASS ADJ. COND. PRICE PRICE 4 L A N D 1 40,500 - CARDS IN ACCOUNT - L 10 18LDG_SIT 1 X 1 I =10 c 100 34999.99 34999.99 1.00 350L)J 4dL0G(S)-CARD-1 1 90.200 F 01 OF C2 A 11 1RESIDUAL 1 X .581 =100 136 7000.00 9520.00 .58 5501) 40THrR FEATURE 1 2.500 ---17ZVn- IN 1 41 .700 MARKET 118100 BATHS 1 .1 U X C= 100 6000.00 6000.00 1 .00 ( 5JJ ' I 1 'L i9 C(iU tCN ST L! dAP.'dS ITNCOMc FIREPLACE U X � C= 100 I 3100.0 3100.00 1 .00 31J01 d N)L LOT 6 USE A SHED S 12 x 13'1 1984 C= 94 9.75 9.16 216 20JO r- 1-<P- 7306 t-1PPRAISED VALUE 0 SHED S 6 X 8 198 C= 94 11.70 10.99 46 5UU F 'A 1741900 ` D J A U ARCEL SUMMARY T S AND 40500 A T LDGS 131900 IMPS 250C E E ITOTAL 17490C F 4 CNST E N DEED REFERENCE Tyoa DATE R.coraw R I O R YEAR VALUE 9 InSI. D $.Ls P.iec AND 4 0 5 0 C A Brah Pe o M yt, D T S 3»40/108. 12/93 F 1 LDGS 134400 U 4639/253: 1U1 /8 6 169500 OTAL 174900 R 3473/180: 105/82 59500 E PPEAL 1989-52 BUILDING PERMIT S NumtMr Dale Type Amount LAND LAND-ADJ INCOMc SE SP-BEDS FEATURES 3LD-ADJS UNITS 40500 2500 9100 33240 9/3 9 AD 8000 COn$I. TO1:11 B+I NOnn. ODSV. Class Um.s Unos Base Rale AOI Ra.e A I I Age DOpr. Cona. CND Loc. %R.G ROOT C-.New AOI Rep. V.luo Stor Hergnl I Rooms Rms I B.- •Fi.. I P-y-I F.c. O1C+ 000 105 105 65.00 68.25 82 82 12 89 100 89 101333 902U0 1 .5 0 2 1.1 6_0 Do--plY Rate Sq„are Foel RooL Cost MKT.INDEX: 1.00 IMP.BYIDATE: MI- 2/90 SCALE: 1/00.74 ELEMENTS CODE CONSTRUCTION DETAIL S 8AS 100 68.25 750 51188 t CNST „ _ 1707 FSF 90 61 _43 216 13269 i TYL- 04 APE COD 0.0 T FAG 50 34.13 128 4369 8 FAG 8 ESI N Ab-Jf!T 191 5 ESIGh ADJUST 5.0 R B15 42 28_67 750 21503 9TZFIAS SO TNGCU ES -- C FWD 85 8.50 224 1904 b.r3 EA7lAC TYPE 12-5 IL-GARM AIR-----0.6 ! 815 ! -NTi :FINTSR- -91� r!IACL-----------b_._6 T ! ! NTE-R-.-CAY-60T -TZ 1 VE-R.7NOgMAL --D.(J U ! ! NTt`T=<ST)CIA-LTY- TER= R *------1 C0 8-----* ! 0:7 RUCT JT Oa-D-JOTST-------0.0 A c S F ! 22 ! _ C0DR-COVR-- J ARET--K'-HDWR----0.TT L D Toot' A... 352 ..so. 966 ! 30 8ASE 30 0OF--TYPE----- J'T A9tE=A�-P'H-S}f---O.0 E BUILDING DIMENSIONS 12 12 ! C tLTR I CA-L 'J T VFITA G t 1r.0 T 8AS W25 N �-OUT.4-VATITTNFSF W18 N12 E18 S12 ! FSF ! ! i7T '0URED CQNC-----99.4 A .. aAS N22 FAG N08 E16 S08 W16 �. -------------- - --- ---------------------- 1 .. 8AS E25 S30 .. 815 N30 W25 *------18-----* ! ----NtIu}f3URflUZT6 BUAC WFST-BARNSTAB L S30 E25 .. 8 ! LAND TOTAL MARKET ! ! PARCEL 40500 174900 *-------25-------X AREA 16538 VARIANCE +0 +958 STANDARD 25 I _ P ROPE FITV ADDRESS I I ZONING (DISTRICT CODE SP-DISTS.I DATE PRINTED(CSTATE PARCEL IDENTIFICATION NUMBER LASS I PCS I NBHD KEY NO. 0059 CHURCH STREET 05 RF 500 05WB 07/09/95 1U91 01J LANUIOTHER FEATURES DESCRIPTION I ADJUSTMENT FACTORS Ty UNIT ADJ'D.UNIT L untl ryna" --/ See D�u�un.�un LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE Dosedpuu� R E Y N A R, GEORGE J M A P— eD FP Uc'a M1lncre5 - L BATHS 1 _1 U 1 X I C= 100 6000.00 6000.00 1 .00 6000 j CARDS IN ACCOUNT02 OF 02 A COST 174900 N IMARKET 118100 D I �11%,C0ME A I I USE p i IAPPPAISED VALUE J 174,900 A u ARCEL SUMMARY T S AND 40500 A S T LDGS 131900 IMPS 2500 E CTAL 17490C F E CNST E N DEED REFERENCE TY a oDATn ,Gatly RIOR YEAR VALUE A A N D 4 0 5 0 C T S i LDGS 134400 U OTAL 174900 R E I BUILDING PERMIT S I Amount LAND LAND—ADJ INCOME I SE SP—ELDS FEATURES BLD—ADJS UNITS N.- DoleType 6000 Class Cons,. To,al Base Re,e Ad,,Rale Year Bu,lt Age No,m. Ob%v CND LOG %R G Rep,Cost No. AO Rep, Value S,onos Hei b, Rooms Rma Balbs •Fia. Partywall Fx. Units Unls A I Dep,. COetl l 9 USC+ 000 100 100 77.90 77.90 89 89 5 96 100 96 43392 4170J 2.0 2 1 1.1 6.0 D°sc,ip'o Ra,e SQua,a Fee' Rep,.Cos, MKT.INDEX: 1.G0 IMP.BY/DATE. ML 2/90 SCALE: 1/01_48 ELEMENTS CODE CONSTRUCTION DETAIL S BAS 100 77.90 480 3 1 jy jGkOSS AREA 480 GARAGE WITH QTRS ABOVE CNST GP:00 *---------------------30--------------------*T 7YLE - 133ARAGE 8 3TRS 0.0 ------------- ---------------------- ___ R 1 ESLuN ADJ:MT JO Q_Q ! ! XTtR.sdALLJ _1'! OOD SHINGLES 0.0 U i ----------------- EAi/AC TYPE 12 IL—aARM AIR 0_0 C i H- ------------- - - NTE:t.FINIS J4 RY'aALL 0_0 T tJTct.CAYciUT 1[ VEP.%NORAAL 0.0 R ! ! NTER.0 OWL:TY (J� A9E .AS EXTE�. G_G R 16 BASE 16 C�JR STRU C T 61 ____ OOD JO[ST 0_eI A ! ! E COUP COVER �tS ---- - -------b.6 LC - - ----------- ------- -- E T°'a,A,eas BUILDING eas 480 ! OOF TYPE (f5;AM8REL—A_S_PH BUILDING DIMENSIONS ! ! C E C T R]:C A L J 1 U E R A G E ___ 0.0 T BAS W30 N16 E30 S16 .. ! ! 0uNCATIotJ (7G IERS 99— - --------- A ------------- - --- ---------------------- ' --------------- --- ---------------------- L *---------------------30--------------------X LAND TOTAL MARKET PARCEL ' AREA VARIANCE +0 +Q STANDARD 9 (Curd -37 AI RRi Rpr a Town of Barnstable Building Department Complaint/Inquiry Report Date: r _ Rec'd by: Assessor's No.: Complaint Name: 2N�-:�tA Location Address: Say a^(—,AU Q-C\A M/P I-53 O0+ oo4 Originator Naive: r\�d�- ( , `c� Street: Village: State: Zip: Telephone: D/E ComplainXescription: � � � � •� �`�J1 Inquiry 0 Description: For Office Use Only Inspector's Action/Comments Date: ' Ins eaor: P10T, �A -A:k-- �6) 8 9 -S 7- Follow-up Action o 4S S-i , T i � c P Additional Info. Attached 1 .3 J Copy Distribution: White-Department Me 3'ellow-Inspector Pink-Inspector(Retum to Office Manager) • .,. -. ,.. . _..... .� ..y. 3+•r ,�, i�..,. -,�:l��.i. ✓v'i..\.,;«�.-r•a r-JH1•rr-sw•C[,l 'r(1^I��` 'b�.�+-H' ,'S�•r��y�-�1►-��i'{I�.Ir^Y+4=Fa°�1�E�.��r"w`+w:�fi";:.r.3v..•.. . Assessor's office(1 st Floor): Assessor's map and lot number �t Board of Health(3rd floor): Sewage Permit number ~ Z BlHdSTABLE i Engineering Department(3rd floor): i �o rase House number r n_' o 16}0' e� Definitive Plan Approved by Planning Board 19 /� ��rar 6` APPLICATIONS PROCESSED 8:30-9:30 A:M.and 1:00-2:00 P.M.only TOWN OF , BARNSTABLE � + VVI BUILDING INSPECTOR , . APPLICATION FOR PERMIT TO v")•I L. k P,)M-r TYPE OF CONSTRUCTION ' 's��sC� 19 p / TO THE INSPECTOR OF BUILDINGS: 8 The undersigned hereby applies for a permit according to the following information: Location Sg C �, V? :5 T` I_oT-�FS - W - 6 6,2 A(51296'4 P Proposed Use f eAq 2 n/ �• .Zoning District �° Fire District C7,g 4. fip . i" Name of Owner., Cameo s2 P p� Address Ski e u e2 ��. S Name of Builder S'va n Address Name of Architect tq�"1 P Address Number of Rooms Foundation Exterior e- (4 l h/(- Roofing lvS'h h nl f Floors Interior C c T ell c f� Heating 1267 A t►2 1), Plumbing Fireplace A/n Approximate Costu v Area < Diagram of Lot and Building with Dimensions Fee I OCCUPANCY PERMITS REQUIRED FOR,NEW DWELLINGS r 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 REYNAR, GEORGE A=153-0044004 No'Permit For Remodel Portion of Dwelling Family Apartment Location 59 Church Street West Barnstable Owner George Reynar Type of Construction. Frame Plot Lot Permit Granted September 26 , 19 89 Date of Inspection, 19 Date Completed 19 e LMIT C -ffED 11t/t. — C9 o TOWN OF BARNSTABLE Qys't ; ZONING BOARD OF APPEAL-S AR" r J 3' SPECIAL PERMIT , '89 JUL -6 p3 25 DECISION AND,. NOTICE APPLICATION: #1989-52 APPLICANT: GEORGE REYNAR At the regularly scheduled hearing of the Barnstable Zoning Board of Appeals , held. June 22, 1989, notice of .which .was duly published in the Barnstable Patriot, and notice of which was forwarded to all interested parties pursuant to Chapter 40A of the General Laws of' Massachusetts, George Reynar applied for a Special Permit pursuant to the Town of .Barnstable Zoning Bylaw, Section 3- 1 . 1 (3) (D),, Family Apartments. The applicant's property is located at 59 Church Street, .West Barnstab 1 e and i s shown on Assessors-'- p 3 Ma "1-5 , l of 4-4 . The property " is in the Residential F (RF) zoning distri-ct—`� The applicant, George Reynar, `presented the following information: The family apartment will be constructed' in an existing barn and will be occupied year-round by the applicant' s daughter and - her husband. The lower half. of the barn has been, and will continue to be, the applicant' s workshop. FINDINGS OF FACT: Based upon the information submitted, the Zoning Board of Appeals found that the applicant's plan complies with all criteria for the grant of a Special Permit .pursuant to Section 3- 1 . 1 (3) (D) of- the Barnstable Zoning Bylaw. The vote on the findings of fact was as follows: AYES: BOY, JANSSON, LALLY, NIGHTINGALE, WIRTANEN NAYES: NONE 1 DECISION: Based upon the _information .submitted and the. -findings-of fact, at a hearing held on June 22, 1989, by a._motion duly made and . seconded, the Zoning Board of Appeals voted to grant the Special , Permit subject to the terms and conditions of the Barnstabl,e. Zoning Bylaw Section . 3- 1 . 1 (3) (D) . Any violation ,'of such terms and ,conditions shal.1 constitute a basis for revocation of the Special . Permit. The vote was as follows: AYES: BOY, JANSSON, LALLY, NIGHTINGALE,. WI,RTANEN NAYES• NONE i Any person aggrieved by .thls decislon may appeal to the Barnstable Superior Court , as de' scrlbed in Section 17 of Chapter 40A of the General Laws of the Commonwealth of Massachusetts by filing a complaint in said Court as well as notice of action with the Barnstable Town Clerk , within twenty ( 20) days after the filing of this decision In the office of the Town Clerk. i CT r1,51D tj Chairman, Cy Zoning Board of Appeals Town of Barnstable 1 , Clerk of the Town cif' Barnstable, Barnstable County, Massachusetts , hereby certify that twenty (20) days have elapsed since. the Board' of Appeals rendered its decision In the above entitled petition and that no appeal of said .declsion has been filed In the office of the Town Clerk. Signed and sealed this day of 19_ _under the pains of perjury. Town Clerk DISTRIBUTION: Town Clerk Property Owner Applicant Persons Interested Building Commissioner Public Information Board of Appeals wn of Barnstable Health Inspector FIKE l Regulatory Services Office Hours g y 8:30—9:30 os Thomas F.Geiler;Director 3:30—4:30 i anRr,sT"M Public Health Division 9�A 163� a�e� Thomas McKean,Director EED MA'I 200 Main Street,Hyannis,MA 02601 Office: 508-862-4644 Fax: 508-790-6304 AMNESTY PROGRAM APPLICANT - SEPTI.0 QUESTIONNAIRE . Date: October 6,2011 1. General Information: Size of Property: 1.58 acres Address: 59 Church Street west Barnstable,MA Map/Parcel 153/004/004 Name: George J. and Ruth E.Reynar Phone#: 508-360-0796 2a. How many bedrooms exist at your property now?4 2b. Are you planning to add any bedrooms?NO If yes,how many? 0 2c. How many bedrooms total are proposed at this property(including the amnesty unit)?4 2d.Please include a copy of the floor plans for the entire property. Neatly use a straight-edge. Show all existing rooms in the home and the proposed amnesty apartment. Provide width measurements of any open doorways. Please label each room clearly. 3. Is the dwelling connected to public sewer? NO If the dwelling is connected to public sewer,skip_questions#4.through#9 below. 4. Location of dwelling is OUTSIDE a Saltwater Estuary Protection Zone —� 5 . Location of dwelling is INSIDE a Zone of Contribution to public supply wells WP 6. Is the dwelling connected to an ONSITE WELL _ �= 7. Is a disposal works construction permit on file? YES or NO 8. If yes,how many bedrooms were approved according to this permit? Bedrooms. 9. Were any building permits obtained for construction of additional bedrooms? YES or NO 10. Is there an engineered septic system plan on file at the Health Division? YES or NO 11. Has the septic system been inspected by a DEP certified inspector within the last two years? YES or NO ' ---------------------------------------------------------------------------------------------- ----------------- FOR OFFICE USE ONLY ! �� The Public Health Division has no objection to bedrooms at this property. Special Conditions: Signed: Date: I b2y' ZA u. Town of Barnstable Regulatory Services o�IKE Two, Thomas F. Geiler,DifVMTOF BARNSTABLE Building Division a"R AS& Thomas Per CBO BuildingQ p¢mmissionerq 2: 03 lypgq �� bLvO 9NlY G/ r�1t 2 QI 'bpr��+ 200 Main Street, Hyannis, MA 02601 www.town.barnstable.maxs Office: 508-862-4038 DIVISION Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is _gip a �'e fe- V A14�X I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: . Name & relationship to owner: Name & relationship to owner: The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing..I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. _ The apartment has been transferred to e Amnesty Program (Appeal No. p _ Other 1`'te.e Sworn to der the pains and penalties of perjury this day of 2012. O O 6 Signa a Phone Number Print Name q:forms/famaf .d.doc rev 11/08/11 L J Town of Barnstable Regulatory Services Thomas F. Geiler, Director.""' ` Building Division $' Thomas Perry, CBQ5 Build issioner BAMSPABLE in Mus a 200 Main Street, Hyannis, MA 02601 ED� www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable, Family Apartment Affidavit I, being on oath, depose and state as follows: My name is 0— .4—'Nj iT I am the owner/resident of the property located at: ��!? G Mid C - I V The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: � /1 Name & relationship to owner: IJ�jt LM �ke MO YZA1 9 0,40&M- Name & relationship to owner:1.1--1;7 /L y�' Li��l0 ��D U�� Epp The Family Apartment will be the primary year-round residence for th bov�deiikaVek(Id�A family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree to note the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of pe ' _ y this day of 2011. - g10 Agna Phone Number Print Name G-eo&e R e imp ) I E-N R a Town of Barnstable Regulatory Services pFiME tOy� Thomas F.Geiler,Director Building Division anxxsTnat e, ' Tom Perry, Building Commissioner. Mass. $ 1639. .0 200 Main Street,Hyannis,MA 02601 www.towri.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Gcb .f. I am the evvr_er/resident of the property located at: J C, W�2 S V�1 - ►��t It v\s wl•�- d (0 6 k The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address- Name Name &relationship to owner: �. '�/ k, (' Name &relationship to owner: inn i 6 (and Yk "-k5 ,-i The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZU-A Pecial 15 mit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1,.a ree= to notify the Building Commissioner immediately in the event of the sale of this' r-operty. -�� O If there is no longer a Family Apartment at this location, please explain: "' The apartment has been dismantled. =r. The apartment has been transferred to the Amnesty Program (Appeal No. N ) :I- Other rn Sworn to under the pains and penalties of perjury.this day of Y1 2010. Signature V Phone Number Print Name Gtti Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services °FINE A Thomas F.Geiler,Director Building Division CI �°1 t' �ijRyiu( z 'L MUNSTaeiE, Tom Perry, Building Commissioner Mass. 1639. �0� 200 Main Street,Hyannis, MA 02601 21H19 11P12 -6 PM 1 ' 2 1 Grp www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is �� ' � `�"` I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: h+ze_�r Name & relationship to owner: lr J lu�oL YG- a.0. - The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately note the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of a �' `^ _-2009. p p p Jm'Y Y �r3 -f (3 Signature Phone Number Print Name � co -J `�. Q/bldg/forms/famaffid Rev:12/08 Town of Barnstable Regulatory Services F� r°kti Thomas F. Geiler,Director y °^ Building Division i r lt�?t131_t � STAB ss Tom Perry, Building Commissioner Ma 1639• `0� 200 Main Street,Hyannis,MA 02601",,inn Ay _5 PH, 12 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name& relationship to owner: IqJ,, 1/1, 011� . Name & relationship to owner: AAW I 4A X The Family ApartmeYtP�t e imary year-round rt's c or a above-i a to family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting-or subleasing of said Family Apartment is permitted. 1 understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. 1 also understand that 1 am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no'longer a Family Apartment at this location,please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No, ) Other Sworn to under the pains and penalties of perjury this day of 2008. 4 Signa ure Phone um er Print Name 1? �Iuq Q/b idg/fo rms/famaffid Rev:1/03 Town of Barnstable Regulatory Services pFTME�qy, Thomas F.Geiler,Director ti Building Division snWsrnBte, Tom Perry, Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is ne-sLh Le .n'tAy)r a I am the owner/resident of the property located at: S G'1 C�Jij6,tt T F�� The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name & relationship to owner: AwnV. �'� -Name &relationship to owner: Kj V dn4 The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that 1 am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. 1 agree "to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the.pains and penalties of perjury this_ day of 2007. Signa a f Phone Number Print Name E� Q/bldg/forms/famaffid 3�g ,Sf��'9 � '��Rev:1/03 r ,s.- Town of Barnstable Regulatory Services -IKE Tp Thomas F.Geiler,Director Building Division „ .`'" '' �� ,AnL BARNSTABLE4 Tom Perry, Building Commissioner 1'006 JUL — a639. ,�� 200 Main Street,Hyannis,MA 02601 PI-1 �4 ArEv �a www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: Map and Parcel Number O � C27 0 y The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: Name &-relationship to owner: VO nLj The Family Apartment wil e the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. - I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA Special Permit and/or the Town of Barnstable Zoning Ordinances Section 240-47.1 Family Apartments. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this_ _day of ; 2006. 6 % Si tore - Phone-Number Print Named-��j l'1�� (,rL `� '�. Y k) k- Q/bldg/forms/famaffid Rev:1/03 Town of Barnstable Regulatory Services pFTME�0�._ Thomas F.Geiler,Director B 10 CIF gY�I�NST�B�� Building Division anMsrnat s Tom Perry, BuildingCommissioner 1';� a�0� 200 Maintreet,Hynnis,MA 02601 2405 APR 19 EO�r www.town.barnstable.ma.us p"`�1�1V1510N Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is Oedra z Pt o Yf kd k&/L. I am the owner/resident of the property located at: 'T_q 0.�14 40' 1' Map and Parcel Number f e7 O U�! The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in 01 Barnstable County: Book /IT�Page. %' 1 ,5 �- The following members of my family will be the sole occupants of the Family`Apartm nt at the aforementioned address: L.J9S -r Name & relationship to owner: l�.�f,� /� /�ij>I° � y�fJ d2 Name & relationship to owner: e AA1,0V�E�e2 The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. 1 understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program (Appeal No. ) Other Sworn to under the pains and penalties of perjury this T day of gn I L 2005. gna e Phone:Number Print Name Oc_gle ��N �;! � l�`�B j� h A Q/b1dg/forms/famaffid2 Rev:1/03 Town of Barnstable 0 )� Regulatory Services OFF T Thomas F.Geiler,Director Building Division BL.6,M BLE, Tom Perry, Building Commission"04 Y K 90 1: (5 v� SS 16 ,0�a 200 Main Street,Hyannis,MA 02601 ISION Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I,being on oath, depose and state as follows: My name is OV-6 �P ti ti I am the owner/resident of the located at: -► q Z y � �� (A) 0-i Q'7 c,�r G� property Map and Parcel Number 00 171 00/ The ZBA granted me a Special Permit/Variance on `� JTj Date Appeal No. The decision of the Zoning Board of 4ppeals has bee recorded with the Registry of Deeds in Barnstable County: Book IO Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name&relationship to owner: C l C.tZ e A 11.CG Name &relationship to owner: 010 4AI-e tO The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, 1 will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this day of 2003: i Signature G�G� �' "� Phone Number So r-,? Print Name Q/bldggfonnVfamaffid Rev:l/03 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE(,sss: AFFIDAVIT I , " ` ,oV being on oath de and state as follows: G, pose 1 . ) I reside at / o' 2 . ) I am th ,10 ear Jof h rop ty locate shown on Barnstable Assessors ' Maps as : Map 3 .) On Appeals, on Appeal No. 19 the Zoning Board of permit to maintain a family -.rar�.,:.�,_� ' granted me a special 4 . ) I understand that the Lfamily �a ��" above address. occupied by .members of my family who are persons may only be me by blood or by marriage. per.,ons related to 5 . ) The following members of my family will be the sole occupants tho family apartmen at the above address: (1) Name• �(:�+/. L Relationship to Owner: ' (2) Name: Relationship to Owner: ' 6. ) The family apartment will be the round residence for the above-identified family cmembers. 7 . ) In the event that the above-listed relative(s) . vacate said apartment, I will immediately notify the Building Commissioner in writing. 8•') I understand that no subletting or subleasing of said family apartment is permitted.* 9. ) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said family apartment. 10. ) I understand that I am required to•.comply with all conditions imposed by the Board of Arr�,_.i _ ppec_s In Appeal No. agree to immediately notify the Building Commissioner in the event of the sale of the above-listed Property. Sworn to under t e p ins and day of 19 penalties of perjury this TOWN OF BARNSTABLE (Sign tur Cf BUILDINGDEPT. (Please Print N me) D ,NOV- f 194 E C E I V E COMMONWEALTH OF MASSACHUSETTS' BARNSTABLE, ss: AFFIDAVIT I be - and state as fol ow- : my on oath, depose 1 . ) I reside at G • 2 . ) I am the ner o' he Ipro ,'erty located at shown on Barnstable ' Maps as Assessors ' `'`' �`' � Map /5-3 Lot 00-1/1 COY , 3 . ) On 19 , the Zoning Board of Appeals,. on Appeal No. / granted me a special Permit to maintain a family apartment at the above address. 4 . ) I understand that the family apartment ' may ,only. be . ` occupied by ,members of my family who are persons related to me by blood or by marriage. 5 . ) The following members Of my family will be the sole occupants of the family apartment at the above address: (1) Name: of Relationship to Owner: (2) Name: Relationship to Owner: 6 . ) The family apartment will be the . primary year- round residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 8. ) I understand that no subletting or subleasing of said family apartment is permitted. 9. ) I understand that I am required to annually file . an:-Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said family apartment . 10 . ) I understand that I am required tO;,comply with all conditions imposed by the Board of Appeals in Appeal No. 10 . ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. Sworn to under Lthe pa ns and penalties of perjury this �, day of / 19 � .�ECEIVEa . � (Si at e) ►r. OV 610992 (Please Print a e ttjgf("n .GIG 'T I . COMMONWEALTH OF MASSACHUSETTS BARNSTABLE,,� ss: AFFIDAVIT being on oath, depose and state as follows: 1'. ) I reside at 2 . ) . I am the owner of the property located at u`—._ c.A.uw,cl c,-'o' shown on Barnstable Assessors '. Maps as : Map / , LotpOS�Qa V )-�,* . 3 . ) On , 19 the Zoning Board of Appeals, on Appeal No. granted me a special permit to maintain a family apartment at the above address. 4 . ) I understand that the family apartment may' only. be occupied by .members of my family who are persons related to me by blood or by marriage . 5 . ) The following members of my family will be the sole occupant; of the family apartment at the above address: (1) Name • Relationship to Owner: (2) Name: Z �. Relationship to Ow er: _ � '�s C-(,;T, -e- - I • 6 . ) The family apartment will be the primary year- round . residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. S . ) I understand that no subletting or subleasing of said family .apartment is permitted. 9. ) I understand that. I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said family apartment . 10 . ) I understand that I am required to;.comply with all conditions imposed by the Board of Appeals in Appeal No. 10 . ) I agree to immediately notify the Building . Commissioner in the event of the sale of the above-listed property. Sworn to er the pains and penalties of perjury this Ve day of c_ 199/. S i ►atu " (Please Print Name) : c)Go p,(5c _ e �,/ �_ D . r 1 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss: AFFIDAVIT I , 6ft196e �E�N � being on oath, depose and state as follows : 1 . ) I reside at SS Ck.v2.lb, S 2 . ) I am the owner of the property located at shown on Barnstable Assessors�s as : Map 4K3 Lotc)o Od t1 /4 3 . ) On , 19 , the Zoning Board of Appeals, on Appeal No. granted me a special permit to maintain a family apartment at the above address . 4 . ) I understand that the family apartment may only be occupied by .members of my family who are persons related to me by blood or by marriage . 5 . ) The following members of my family will be the sole occupant, of the family apart nt at the above address: (1) Name: C go Relationship to Owner: 'r (2) Name: Relationship to Owner: • 6 . ) The family apartment will be the primary year- round - residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. . S. ) I understand that no subletting or subleasing of said family apartment is permitted. 9 . ) I understand that. I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said family apartment . 10 . ) I understand that I am required to:.comply with all conditions imposed by the Board of Appeals' in Appeal No. 10 . ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. Sworn to under the pains and penalties of perjury this 11 day of 6 Ct- 191' . ( igriature) (Please Print Name) : `J•oseph D. DaLuz Telephone: 790-6227 Building Commissioner TOWN OF BARNSTABLLE BUILDING DEPARTMENT TOWN OFFICE BUILDING HYANNIS , MASS . 02601 September 24 , 1990 Mr. George J . Reynar 59 Church Street West Barnstable , MA 02668 Re: Family apartment located at: 59 Church Street , West Barnstable Dear Mr. Reynar: A year ago you filed an affidavit �wit.h this office re the above referenced family apartment . It is required, by Section 3-1 . 1 (3) ( D) ( 1 ) of the Town of Barnstable Zoning By-law, that an affidavit be submitted annually for the duration of such occupancy . Enclosed is an affidavit form for your convenience. Please complete this form and return it to this officre as soon as possible. Peace , Joseph D. DaLuz Building Commissioner- JDD/km enclosure 34 COMMONWEALTH OF MASSACHUSETTS BARNSTABLE, ss: AFFIDAVIT I • being on oath, depose and state as o s : 1 . ) I r 0side 2 . ) I the ow e t property to t shown on Barnstable Assess Maps a Map 15 -z' , Lot -© O O / 3 . ) On � 19 the Zoning Board of Appeals, on Ap eal o. 1 g,q �, "'02 , granted me a special permit to maintain- a family apartment at the above address . 4 . ) I understand that the family apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 5 . ) The following members of my family will be the sole occupantsa t e family a rtment at the e dress: (1) Name: Relations 'p t Owne�: (2) Name: Relationship to Owner: 6 . ) The family apartment will be the primary year- round residence for the above-identified family members . 7 . ) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. 8. ) I understand that no subletting or subleasing of said family apartment is permitted. 9. ) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said family apartment . 10 . ) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 10. ) I agree to immediately notify the Building Commissioner in the event of the sale of the above-listed property. Sworn to undAr t e pains and penalties of perjury this to day of 19 CL0_ 3Ga-,IQ r atu (Please Print Name) : TOWN OF BARNSTABTE"Y94. CLERK ZONING BOARD OF APPEALS SPECIAL PERM�T JUL -6 3 :26 DECISION AND, NOTICE APPLICATION: #1989-52 APPLICANT: GEORGE REYNAR At the regularly scheduled hearing of the. Barnstable Zoning Board of Appeals, held June 22, 1989, notice of which was duly published in the Barnstable Patriot, and notice of which was forwarded to all interested parties pursuant to Chapter40A of the General Laws of Massachusetts, George Reynar applied for a Special Permit pursuant to the Town of Barnstable Zoning Bylaw, Section 3- 1 . 1 (3) .(D) , Family Apartments . The applicant's property is located at 59 Church Street, West Barnstable and is shown on Assessors' Map 153 , lot -t5WW Th,e property . is in the Residential F (RF) zoning district . The applicant, George Reynar, 'presented the following information: The family apartment will be constructed: in an existing barn and will be occupied year-round by the applicant' s daughter and - her husband. The lower hal.f of the barn has been, and will continue to be, the applicant's workshop. j FINDINGS OF FACT: Based upon the information submitted, the Zoning Board of Appeals found that the applicant's plan complies with all criteria for the grant of a Special Permit pursuant to Section 3- 1 . 1 (3) (D) of the Barnstable Zoning Bylaw. The vote on the findings of fact was as follows : AYES: BOY, JANSSON, LALLY, NIGHTINGALE, WIRTANEN NAYES: NONE- i :1 DECISION: Based upon the .information .submitted and the findings of fact, at a hearing held .on June 22, 1989, by a ,moti'on duly made and seconded, the Zoning Board of Appeals- voted .to . grant the Special . Perm.it subject to the terms and conditions of the Barnstabl,e. Zoning Bylaw Seetion . 3- 1 . 1 (3) (D) . Any violation of such terms and conditions"shal,l constitute a basis for revocation of the Special Permit. The vote was as follows: AYES: BOY, JANSSON, LALLY, NIGHTINGALE, WI,RTANEN NAYES: NONE � 1 Any person aggrieved by this decislon may appeal to the Barnstable Superior Court , as described in Section 17 of Chapter 40A of the General laws of the Commonwealth of Massachusetts by filing a complaint in said Court as well as notice of action with the Barnstable' Town Clerk , within twenty ( 20) days after the filing of this decision in the office of the Town Clerk. Chairman, cy Zoning Board of Appeals Town of Barnstable Clerk of the Town of Barnstable, Barnstable County, Massachusetts , hereby certify that twenty (20) days have elapsed since the Board of Appeals rendered its decislon in the above entitled petition and that no appeal of . said decision has been filed in the office of the Town Clerk. Signed and sealed this day of 19_ _under the pains of perjury. i j Town Clerk DISTRIBUTION: Town Clerk Property Owner Applicant Persons interested Building Commissioner Public Information Board of Appeals R 153 004. 004 A P P R AN S A L D A T A KEY 355715 REYNAR, GEORGE J & Fib TH E LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=Rl*-- 92, 600 0, 400 95, 000 ALCOST 196, SOO B—MKT 118, 100 BY 00/ BY /00 C—I NCOME PCA=IOLI PCS=00 SIZE= 1656. JUST—VAL ——COMPARISON TO CONTROL AREA'50AC --MAY NOT BE COMPARABLE— NEIGHBORHOOD SOAC WEST BARNSTABLE PARCEL TONTROL AREA TREND STANDARD 103 1& LAND—TYPE i I 92600:1 LAND—MEAN 40% 1968003 99229 IMPROVED-MEAN _3% 25% -I FRONTOFT A 100 DEPTH/ACRES TABLE 01 160%] LOCATION—ADJ APPLY—VAL—STA ,LNR3LAN[ LFT/IMP3ADJS/SB/FLAT STRATRUCTWRE ARW AIDE A—MEASOREMENTS NOR 3NOTES COM3MARKET INC31NCOME PMR3PERMITS GRRJGRAPHIC I FUNCTION—E 3 STRUCTURI—CARD NO-10003 DATA—C I XMTE?l ?h 'I'"I A 1\1 C R I f-'A R D C 0 0 0 1 K E:Y 3557 1 R1.5'---: 004. 001; p k::- R i1i 00000000 1 VALUE C B Y IV FIERM'j"r- NO M0 Y R- J'YPE YR %(-'IYIF' NEW/E,EIvIO COMMENT .1 c 3 c "I I- 1 .1 C C I 1' 3 1 1 1 1 L 3 1 1 1 1 1 c I L I I C I c I c I c I I L a L I I I I I c I c c I c c E I E, I c ..I c -I I'.' I c C ..I I c I f'. I c I c "I E: I r 3 L E 3 c I E I E :1 E I c I c .1 c 'I c -I I c I I' I c 'I I C 'A j I c 1 C. E "I I I E I r., I I- c c .1 1- L I c c 3 1 :I E -.I I ]l I I L. -j I- J 3 3 c I E F'O.5'D 0()4. C)0 4 hl (D T E C.j\1 I'.J-17] I KEY 35571.• 5 .1 A C:T 10 N—C C-1 D E'E; R=REAFI W=WRI*TE X E X i T—1\1 CI W 1=t r.I=EIELF—I-E 0()(--)O()C)()Ol I I I c c IXMI** -- -------- --------------- Town of Barnstable Regulatory Services °Firms�opti Thomas F.Geiler,Director 0 1F� 0t= BARNSTABLE °+ Building Division • BAxxsTAsi e - Tom Perry, Building Commissioner 2N3 MAY —S AM I 1' 15 MASS. 9 1639. ,0� 200 Main Street,Hyannis,MA 02601 �ptFD MA'S a Office: 508-862-4038 Fax: 508-790-6230 Town of Barnstable Family Apartment Affidavit I, being on oath, depose and state as follows: My name is I am the owner/resident of the property located at: P Y Map and Parcel Number / The ZBA granted me a Special Permit/Variance on Date Appeal No. The decision of the Zoning Board of Appeals has been recorded with the Registry of Deeds in Barnstable County: Book Page The following members of my family will be the sole occupants of the Family Apartment at the aforementioned address: Name &relationship to owner: C 4 !� l C,cZ e {�i�VJ.4 l� �p2 Name &relationship to owner: i, .4'Vd to f V6 -, The Family Apartment will be the primary year-round residence for the above-identified family members. In the event that the listed relatives vacate said apartment, I will immediately notify the Building Commissioner in writing. I understand that no subletting or subleasing of said Family Apartment is permitted. I understand that I am required to file an Affidavit annually with the Building Commissioner listing the names and relationship of occupants in said Family Apartment. I also understand that I am required to comply with all conditions imposed by the ZBA in the Appeal No. identified above. I agree to notify the Building Commissioner immediately in the event of the sale of this property. If there is no longer a Family Apartment at this location, please explain: The apartment has been dismantled. The apartment has been transferred to the Amnesty Program(Appeal No. ) Other Sworn to under the pains and penalties of perjury this J _day of 2003. Signature Gf Phone Number 0—a r-1 Print Name e,G n T=T n Q/bldg/forms/famaffid Rev:1/03 11f . Ar-TIDAVrr BARNSTABLE ,0 I; eo �(,e 2 y/V/9�_ ,being on oath, depose and state as follows: 1.) I reside at 2.) I am the owner of the prope/rty located S rLh(S /� e s� ,UAL& shown on Barnstable Assessors' maps as MAP •L3 PARCEL GO Uo 3.) I Do Do not have a Family Apartment at this location. 8 4.) On , 199 . the Zoning Board of Appeals, on Appeal No. granted me a Special Pennit/Variance to maintain a Family Apartment at the above address. , 5.) I understand that the Family Apartment may only be occapied by mernbers of my family who are persons related to me by blood or.by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the. above address: a) NAME 3141?4 e�P Relationship to owner. TP b) NAME 14 Relationship to owner.P. G/1 vG Te 7.) The Family Apartment will be the primary year round residence for the above-identified family members. 8.) In the event that the above-listed relative(s) vacate said apartment, I will immediately notify the Building Commissioner in writing. t 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that 1 am required to aimuZY fide an°ffidav't`"'-rI the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. Sworn to under the pains and penalties of pet ury this 2� day of V N Signature - Print Name , I COMMONWEALTH OF MASSACHUSETTS BARNSTABLE AFFIDAVIT I, - &eak.;6 e-__ .. - 1A�_,_____—________, being on oath, depose and state as follows: 1.) I reside at_ --- 2.) I am the owner off the property located shown on Barnstable Assessors' maps as MAP PARCEL 3.) I Do___ Do not —_have a Family Apartment at this location. 4.) On —__, 199---, the Zoning Board of Appeals, on Appeal No.__—__ granted me a Special Permit/Variance to maintain a Family Apartment at the above address. 5.) I understand that the Family Apartment may only be occupied by members of my family who are persons related to me by blood or by marriage. 6.The following members of my family will be the sole occupants of the Family Apartment at the above address: a) NAME— i �_4,en eo------- � 1� ------ Relationship to owner:__ _ �� "'� b) NAME_ Ni1k -- ---- — ------- Relationship to owner:___— _ 13UII DlI%' 7.) The Family Apartment'will be the primary year round residence for the bove-identified family members. JD)` FEB 2 5 1998 8.) In the event that the above-listed relatives) vacate said apartment, I wAjL1rJdJLeE n"oti e Building Commissioner in writing. 00 9.) I understand that no subletting or subleasing of said Family Apartment is permitted. 10.) I understand that I am required to annually file an Affidavit with the Building Commissioner listing the names and relationship of my family members occupying said Family Apartment. 11.) I understand that I am required to comply with all conditions imposed by the Board of Appeals in Appeal No. 12.) I agree to immediately notify the building Commissioner in the event of the sale of the above- listed property. Sworn to under the ains and- penalties of perjury thisP'2L—dayofP P P rJ rY Signature -------- ---- --- ---------------- . -------------- Print Nam o� The Town of Barnstable Department of Health Safety and Environmental Services ,,AOMABIX 1 Building Division 059. � 367 Main Street, Hyannis MA 02601 Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commission February 18, 1998 The Reynar Residence 59 Church Street West Barnstable, MA 02668 Re: Family Apartment located at the above address Dear Mr./Ms. Reynar, A letter was sent to you on December 31, 1997 requesting information regarding your Family Apartment. The affidavit has not been received as of this date. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that it be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit and return to this office by March 1, 1998 in order to comply with the conditions of approval. Thank you in advance, Ralph Crossen Building Commissioner oFWE T� The Town of Barnstable Department of Health Safety and Environmental Services Building Division ,0�' 367 Main Street, Hyannis MA 02601 A�FD MA'S A . Office: 508-790-6227 Ralph M. Crossen Fax: 508-790-6230 Building Commissione December 31, 1997 The Reynar Residence 59 Church Street West bamstable, MA 02668 Re: Family Apartment located at the above address Dear Mr./Ms. Reynar, Our records indicate you have not filed an affidavit regarding the above referenced family apartment for quite some time. It is required under Section 3-1.1 (3) (D) (1) of the Town of Barnstable Zoning Ordinance that an affidavit be submitted annually for the duration of such occupancy. Please indicate the status of the family apartment on the enclosed affidavit return to this office by January 30, 1998. Enclosed is an affidavit for your convenience. Thank you in advance, c'� (g Ralph Crossen Building Commissioner QUERY PROPERTY: QUERY END QUERY PROPERTY PENTAMATION----------------------------------------------------------- 12/31/97 PARCEL ID 153 004 004 GEO ID 35571 LOT/BLOCK 8 DBA PROPERTY ADDRESS OWNER REYNAR 59 CHURCH STREET GEORGE J W BARNSTABLE 59 CHURCH ST W BARNSTABLE MA 02668 PHONE DISTRICT WB DEVELOPMENT STATUS C ASSESSOR' S CODE CAPACITY(NOTES) ZONING DIST/ZOC RF SEWER SYSTEM FLOOD PLN/ELEV. WATER SYSTEM OKH? Y ## BEDROOMS ZBA DECISION FAMILY APT LOT SIZE 68824 . 8 OPER/MGR NAME WET LANDS MULT ADDRESS USE 109 PROTECT DIST WP (N) EXT / (P) REVIOUS / NO (T) ES / PER (M) ITS / (V) IOLATIONS / (G) EOBASE / (E) XIT