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0313 HIGH STREET
a UPC 12543 NOR c���sr•coNS°��� HASTINGS, MN v. ��..•:a+.x ,L„n..�1.. .J, - '.--.-s' .Si.,..'�Gi1i,���.__Z„vrb. .:. N..��,-�.... ..�..:.. - - - _�.-�_ _ - ' .,Fug..,-. ;'13dol3AN3:10 do,IV SENLIER: COMPLETE THIS SECTION I HIS SECTION ON DELIVERY ■ Complete items 1,2,and 3. A rzii 0 0 8 ■ Print your name and address on the reverse X O Agent so that we can return the card to you. ❑Addressee ■ Attach this card to the back of the mailpiece, B. Received= y(Pri Name) C. Date of Delivery or on the front if space permits.• i W ? 1. Article Addressed to: D. Is deiLve Tess diff fro 1? ❑Yes S 2 Zv If YES�en e ivery ad di�y w: p No 3' Service I Signature 0 e 11 Registered Mall riIIIIIII'IIlii 111111111111111111111111111111111 AdultRegistered ❑Adult Signature Delivery ❑ Mail 9590 9402 1933 6123 1646 85 0 Certified Mail® Delivery ❑Certified Mall Restricted Delivery �Retum Receipt for ❑Collect on Delivery Merchandise ❑ act on Delivery Restricted Delivery ❑Signature Confirmation- 1 i —�article-Number(transfer from service/abel)y�� ❑Signature Confirmation Insured Mail 9 i 7 015 7 3 0 0 0 01 4 9 9 3 ;3 2 4 7 ]Insured Mail Restricted Delivery Restricted Delivery over$500) PS Form 3811,July 2015 PSN 7530-02-000-9053 i omestic Return Receipts` USPS TRACKING# First-Class Mail Postage&Fees Paid USPS Permit No.G-10 F-M 5.� 9590 9402 1933 6123 1646 85 United States •Sender: Please print your name,address,and ZIP+4®in this box* Postal Service TOWN OF BARNSTABLE BUILDING DIVISION 200 MAIN ST HYANNIS, MA 02601 i I ` ���:)I)1'j11i)�iilllil,►Iil�))�))ill,j)1��)ii,i)lili�il�Il;fJillii I;, Postal CERTIFIED o RECEIPT Domestic Mail Oniy ru m For delivery information,visit our website at www.usps.comO. Q' Certified Mail Fee Extra Services&Fees(check box,add fee as appropriate) Q� r:l ❑Return Receipt(hardtop» $ C:3 []Return Receipt(electronic) $ Postmark O OCertifled Mail Restricted Delivery $ H � 1-3 ❑Aduk Signature Required $ ❑Adult Signature Restricted Delivery$ Z TPostage � Total Postage and Fees r 026�� u1 $ � Sen To C3S e_ G. �-�---------------------------------------- � 6treet andA-�No.;or� Box o.{v / 7`---------------------------------- City, Certified Mail service provides the following benefits: ■A receipt(this portion of the Certified Mail label). for an electronic return receipt,see a retail ■A unique identifier for your mailplece. associate for assistance.To receive a duplicate ■Electronic verification of delivery or attempted return receipt for no additional fee,present this delivery. USPS®-postmarked Certified Mail receipt to the ■A record of delivery(including the recipients retail associate. Ln signature)that is retained by the Postal Service- Restricted delivery service,which provides rn for a specified period. delivery to the addressee specified by name,or to the addressee's authorized agent ryl Important Reminders: Adult signature service,which requires the -p ■You may purchase Certified Mail service with signee to be at least 21 years of age(not _0 First-Class Mail*,First-Class Package Service°, available at retail). or Priority Mail®service. Adult signature restricted delivery service,which ■Certified Mail service Is notavaliable for requires the signee to be at least 21 years of age International mail. and provides delivery to the addressee specified 3 ■Insurance coverage is not available for purchase by name,or to the addressee's authorize)agent 1 with Certified Mail service.However,the purchase (not available at retail). C3 of Certified Mail service does not change the ■To ensure that your Certified Mail receipt Is insurance coverage automatically included with accepted as legal proof of mailing,it should bear a 1 certain Priority Mail items.'. USPS postmark If you would like a postmark on r.1 ■For an additional fee,and with a proper this Certified Mail receipt,please present your -1 endorsement on the mailplece,you may request Certified Mail Item at a Post Office-for F" the following services: postmarking.If you don't need a postmark on this -Return receipt service,which provides a record Certified Mail receipt,detach the barcoded portion.r of delivery(including the recipients signature). of this label,affix it to the mailplece,apply r. You can request a hardcopy return receipt or an appropriate postage,and deposit the mailplece.t-3 electronic version.For a hardcopy return receipt, complete PS Form 3811,Domestic Return Receipt attach PS Form 3811 to your mailplece; IMPORTANT.Save this receipt for your records. Ps Form 3800,April 2015(Reverse)PSN 7530-02-000.9047 I Town of Barnstable Regulatory Services THE 1p� -=a-�L � do Richard V. Scali,Director s , STAB Building Division BARNSTABLE MAS& Paul Roma Sbg9. �� , 1629-2014 Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us January 25, 2017 Dempsey E. Lott Re: 313 High Street Susan S. Lott West Barnstable, MA 02668 313 High Street Map: 111 Parcel: 044 West Barnstable, MA 02668 Dear Dempsey E. and Susan S. Lott, This letter shall serve as notice that this office has observed a violation of the Massachusetts State Building Code 780 CMR. Upon a recent inspection of the above referenced property, work has been observed being done without the benefit of permits or the necessary approvals. The property can be brought into compliance by obtaining the necessary approvals and proper permits. Your immediate attention is necessary to avoid further action by this office which could result in a stop work and related fees or fines. Sincerely, OLD Robert McKechnie Local Inspector 508-862-4033 robert.mckechnie@town.barnstable.ma.us 1 Parcel Detail Page 1 of 4 ' 1 yQp .1639. y0" d`� t t✓" 4 m.2r � Logged In As: Parcel Detail Wednesday,January 25 2017 Parcel Lookup Parcel Info Parcel ID 111-044 ._�._..r Developer Lot I Location 1313 HIGH STR� PH Frontage Sec Road 771 Sec Frontage�� I Village jWeSt Bamstable Fire District W BARNSTABLE Town sewer exists at this address IND .�.......��I Road Index 0702 I Asbuilt Septic Scan: 111044_1 Interactive Map 111044_2 ryr w Owner Info owner ILOTT, DEMPSEY E 8 SI' ow Co - streets 1313 HIGH ST �Street2l city IWEST BARNSTABLE I State jMA zip P6W country Land Info ................_.............................................................._......_......_...................................................._..........................................................................._..........-..........-.-........_............................................................................................................................................................................................................................ Acres 1.84 �use Isingie Fam MDL-01 � zoning RF Nghbd 0107 ... ) Topography Level Road 1paved utilities Septic,Well,Gas ( Location Ir... Construction Info _ Building 1 of 1 swic 1750 �Saoci Gable/Hip well Wood Shingle J Living 2778 ( Roof Wood Shingle AC Central �� Area cover Type Style Cape Cod wall Plastered�� ROBe 3 Bedroom ~� '. Model Residential �� Flo Pine/Soft Wood 1 Rooms 12 Full-0 Half t� Grade Average P177 Type Hot Air Roo me 7 Rooms stories 1 1/2 Storieund- s Fuel Gas F anon Mixed Gross 4652 � Area Permit History Issue Date Purpose Permit# Amount Insp Date Comments 3/1/1988 Addition B31728 $26,000 1/15/1996 12:00:00 AM WB ADUN 10/1/1975 Remodel B18002 $0 1/15/1978 12:00:00 AM WB REM/DO History---------- --- ......__......_.._ http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6399 1/25/2017 1 i Parcel Detail Page 2 of 4 Date Who Purpose 2/24/2015 12:00:00 AM Susan Ricci Cycl Insp Comp 2/23/2015 12:00:00 AM Jeff Rudziak Cycl Insp Comp 8/21/2006 12:00:00 AM Paul Talbot Cyclical Inspection 5/25/2000 12:00:00 AM Donna Dacey Meas/Listed-Interior Access 1/15/1990 12:00:00 AM ML Meas/Listed-Interior Access Sales History Line Sale Date Owner Book/Page Sale Price 1 12/31/1979 LOTT, DEMPSEY E & SUSAN S 3038/218 $71,000 Assessment History _.._.._.................. ............-_...----..._---------...._............................... Save Building Total Parcel # Year Value XF Value OB Value Land Value Value 1 2017 $192,600 $22,700 $26,900 $216,700 $458,900 2 2016 $192,600 $22,700 $26,900 $216,300 $458,500 3 2015 $207,500 $26,100 $22,000 $207,300 $462,900 4 2014 $207,500 $26,100 $22,500 $207,300 $463,400 5 2013 $207,500 $26,100 $22,900 $218,000 $474,500 6 2012 $212,100 $25,900 $21,500 $214,900 $474,400 7 2011 $229,300 $5,900 $20,200 $214,900 $470,300 8 2010 $228,700 $5,900 $20,800 $208,000 $463,400 9 2009 $238,500 $4,000 $14,600 $264,500 $521,600 10 2008 $247,900 $4,000 $14,600 $295,400 $561,900 12 2007 $287,800 $4,000 $12,800 $295,400 $600,000 13 2006 $267,400 $4,000 $13,300 $291,900 $576,600 14 2005 $227,100 $3,700 $13,700 $194,600 $439,100 15 2004 $178,500 $3,700 $13,900 $194,600 $390,700 16 2003 $155,800 $3,700 $14,300 $96,800 $270,600 17 2002 $155,800 $3,700 $14,300 $96,800 $270,600 18 2001 $155,800 $3,900 $14,300 $96,800 $270,800 19 2000 $142,400 $0 $14,000 $65,200 $221,600 20 1999 $142,400 $0 $11,400 $65,200 $219,000 21 1998 $142,400 $0 $11,400 $65,200 $219,000 22 1997 $127,400 $0 $0 $47,400 $184,100 23 1996 $127,400 $0 $0 $47,400 . $184,100 24 1995 $127,400 $0 $0 $47,400 $184,100 25 1994 $112,500 $0 $0 $58,600 $180,800 26 1993 $112,500 $0 $0 $59,700 $181,900 27 1992 $1.18,400 $0 $0 $65,200 $194,600 28 1991 $134,900 $0 $0 $106,600 $258,000 29 1990 $127,400 $0 $0 $106,600 $250,500 30 1989 $106,800 $0 $0 $106,600 $229,900 31 1988 $72,700 $0 $0 $53,300 $134,700 32 1987 $72,700 $0 $0 $53,300 $134,700 http://issgl2/intranet/propdata/ParcelDetail.aspx?ID=6399 1/25/2017 s .,utr.' J..t!E,j•K t�,ft' a y�i ,Yt '� .w '�w� 'J' � '�t"�"!r �:}u.'�,l '�i�weP. h'�"�a Y' .'.�N'�r,�'• +�f�ti'�� ^��`�T 2 `�c p �.t�Y ., x ,a .......... 7�.� Parcel Detail Page 4 of 4 s > vw*, • " v , ram, ' Mll r b, htt ://iss 12/intranet/ ro data/ParcelDetail.as x?ID= 399 p q p p p 6 1/25/2017 ' 1 `ofIKEr Town of Barnstable BARNSPABLE Regulatory Services MASS t639. ,0r Building Division P�fO MAy� 200 Main Street,Hyannis,MA 02601 , Office: 508-862-4038 k Fax: 508-790-6230 Inspection Correction Notice Type of Inspection Lt/ / 7 ou �' / s2� 7- Location-7/3 4s �� Permit Number Owner Builder One notice to remain on job site,one notice on file in Building Department. The following items need correcting: /2 tf f 7�- _ f 1 T 7 - T j w a y *7 u Please call: 508-862-4@3 €erzi-0in c ' Inspected by lam' Date � I N li RIM "4 A . .' sl rtll,����fi tl mSNAd'ti�'aaa m i t e�� 3 ! 3 tl� STr� -r 1 PERMIT PAYMENT RECEIPT TOWN OF BARNSTABLE BUILDING DEPARTMENT 200 MAIN STREET HYANNIS, MA 02601 r,, DATE: 12/24/08 TIME: 10:40 -----------------TOTALS----------------- PERMIT $ PAID 25.00 AMT TENDERED: ' 25.00j CHANGPPLIED: �, M.00 APPLICATION NUMBER: 200801104 PAYMENT METH: - CHECK PAYMENT REF: 25.00. - �' - Town of BarnstablePermit: 7.00g01104 Regulatory ServicesDate: y pip > Thomas F.Geiler,Director Fee: J � Building Division rl enxxsr�►et� Tom Perry, Building Commissioner MAM �6� 200 Main Street, Hyannis,MA 02601 s www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 TOWN OF BARNSTABLE SOLID FUEL STOVE PERMIT Owner: �? I,o i Phone: 5 o A a G`2-- Z(o Install at: ai Village: uj Map/Parcel: iII Q Date: 11 o g Stove A. I e /Used B. Type: Radiant/Circulating Si�v� �`'° �.; r'3 C. Manufacturer: /-� �-rtJ Lab.No. D. Model No.: kbaA-M&AV Chimney A. New Existin (If existing,please note date of last cleaning w B. Flue Size it ©.G- -7Z o.-✓ —� C. Are other appliances attached to Flue. D. Pre-fab Type and Mgligifacturer IV A E. Masonry: ine nlined Hearth A. Materials: (�„r-, c _►L B. Sub Floor Construction: (jo S ca r, d Installer Name: Address: Phone: Location of Installation: H.I.0 Registration# Construction Supervisor# OR check v/ Homeowner Installing,no license required APPLICANTS SIGNATURF, Loi0m APPROVED BY: / p Please make checks payable to the Town o Barnstable *This constitutes an official stove permit after inspection,photographed, and approved by the Building Inspector Q:forms:stove Rev 103107 "�. i �oZVEI° . Town of Barnstable ~� Regulatory Services SARNSTABLE. : Thomas F. Geiler,Director Apr MASS. A.�� Building Division FD MA'I Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4039 Fax: 508-790-6230 ---------------------- HOMEOWNER LICENSE EXEMPTION Please Print DATE: 42 — D JOB LOCATION: -3�J lh X# Sr:_ (N r �IS'�ISpLG� number //-- street village Q �( "HOMEOWNER": 6�'( 4JL 618 36 2_ e-&6 �Z�L'Z`ZJ'r— name home phone# work phone# CURRENT MAILING ADDRESS: 912 A//6./ _—V1— w, city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned."homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable.Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and re ements. SignaturettfHo eowner 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. °F'IKE, Town of Barnstable *Pet=mit#' °�'�' Expires 6 rnorrti,s�ue d w Regulatory Services Fee ♦ r * BARNSTABLE, +` - 9� 163. �0� Thomas F. Geiler, Director. prED MA'S t► ��/ZI�J(, Building Division Tom Perry,CBO, Building Commissioner 200.Main Street,Hyannis,MA 02601 www.lown:barnstable.ma.us - Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number Property Address _3/ Residential Value of Work Minimum fee of$25.00 for work under$6000.00 L Owner's Name& Address e �44,_- i Contractor's Name, t iJ n i n/at/ k_ Telephone Number Home Improvement Contractor License#(if applicable). � ,:%' Construction Supervisor's License#(if applicable) l'✓ !i' �Workman's Compensation Insurance ' Check one: ❑ I am a sole proprietor �a ❑ 1 am the Homeowner mom"® Sow PERMIT I have Worker's Compensation Insurance NOV l 2008 Insurance Company Name TOWN OF BARNSTABLE Workman's Comp. Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) �Re-roof(stripping old shingles) All construction debris will be taken to �— ❑ Re-roof(not stripping. Going over , existing layers of roof) ❑ Re-side, ❑ Replacement Windows/doors/sliders. U-Value (maximum .44) *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 is regdi&dam) ...''Al�''J.' , L��` �'�`'` ;�: r•slt) ; SIGNATURE: t- ''7 Q`.\WPFILES\FORMS\building permit form s\EXPRESS.doC Revised 100608 i The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations' 600 Washington Street Boston, MA 02111 WT www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Address: j"_ f4o �� -•-� City/State/Zip: Phone.#: 3�a Are you an employer? Check the appropriate box: Type of project(required): I am a employer with 4. ❑ I am'a general contractor and 1 6. ❑New construction employees(full and/or part-tim.e).* have hired the sub-contractors .2:0 I am a'sole proprietor or partner-' listed on the attached sheet. 7...❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp.insurance comp. insurance.t required] 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their I LF] Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 1�'Roof repairs insurance required.] t c. 152, §1(4),and we have no employees. [No workers' 13.❑Other comp. insurance required.] "Any applicant.that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pain nd penalties of perjury that the information provided above is true and correct. Si nature J Date: z —O(� Phone k' 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. 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 represeritafives ofa deceased empooyei;of tfie--"— 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 5 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 numbers) along with their certificate(s)of insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out.in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant . that must submit multiple permitflicense 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 iii _(city or town),"..A copy 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 be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone-and fax number: The Commonwealth of Massachusetts Department of Industrial Aocidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-N ASSAFE Fax# 617-727-7749 Revised 11-22-06 www.mass.gtav/dia Pr:r�E CERTIFICATE O ,LIABILITY I ARDObCElI,_-_ ! IdSURAIVCE ✓ 91aGkStOne Ir1SUranCe 8 Fin dATecMIN1DD1YYYy, , Ancial Sarvlces TM'g caRTlmcaTE la IaBueDAS A 10ro7/2008 37�lacvaed 8tre®t Suns 213 ONLY AND CONRQO44 NO RIGHTB�ppZR OEINRORMATION WOrcester,.MA 01609 HOLDER.Trn$CERTTP,CA0E io NOTON TH gCERALTER 794E COVERAGE S ORT APRORDEd BY 7HE POt'ICI6S BELOW.iN@VR&D Linn INSURERS AFFQRE"MC COVERAQ6 T oilEntorpri9es fNBURFRA a;F,I.r,, jNA1C0 -8 Freeboard Lane . INBVRER e: YWMOUth.MA 02678 _ INJURGF C: 1 . COVERA12 1RSUREq 0: IN6iIREr e: THE POUca OF INSURgNCQ LISTED ANY REOUIREN19",TERM OR ELOVY NAVE BQt N ISSUED TO THE 1 PERTAIN,THE INSURANCO AF ORVIpTION OF ANY CONTRACTOR NSUREO NAMED ABOVE FOR THE PQ POLICIES.AOGRE�rgTE LAUIT 9Y THE PauCE!$DESCRISEODH RE�i S Sli JECIT TO gSPtTWE TEp1Ag, UCY IsI;RIOb INDICATED.NOT'NITHSTANOIF7G S SkOWN MAY HAV8 SEEN REDU 0 HICN THIS CERTIPUTI MAY BE 138UED QR MAY RiJ CEO$Y`pA1D CLAIMS, EXCLUSIONS AND CONCI BE 1,9 OF SUCH E OQ INEURAI(C ' GINERAI LJAIWTV POLICY NUM R 'd6u" 1 COWOi RCIAL GENaRAL UADILRY WITS (4AIMLe MADE Q OCCUR i iI EACH"C RRINCE p I III MEO eXP;My eme puffin) / OWL AGGAbGA'e LINfI?APP I pdR80NAI 8A0V INJURY >f LIES o:! 04NQRAL AGGREGATE POLICY PR01ecT lOC AUT040ELLi PRODUE:TS-COMP/Op ACO g UAwll!TY ANY AUTO i I ALL O"EOAUT01! I Ea�(3�IM1IEOISINOLF LIMIT yam_ SCHEOULGD AUT09 I JJ l MIRED AUTOSOILYIN;,URY S I t 1 NON•OWNED AUTOp � i 1 900iLY INJURY 1 (par wfoo tf) S 5 i i r q j miwu�L4tOk P6?oMIRWm]a+ e a t ANYAUio AUTO ONLY,6A,ACCIDENT J i EXCEEIrVMBRELLC LIAYILnY I GT}{IR fkAV ACC $ (� AUTO 0 Y: i OCCUR I� CLAIMS MAD; I AG R EACH EICCURRENCE S A00RE0ATE Ogq6��DU►►�CYISLP I A R�'UAERRY ` S TpN AND S OF;Ig!ZUE-TOR/PA� ECUT1v5 WCC5007447012001' 8J1(2008 EQR 6 �I TO It rro.a..�l 81 1/2009 _ 11'ECIALPR �f °•I:EACMACC10ENT OTH Of1S U!'ew E.L.DI7GA8f•Gd EltM,p4• >t 100.00D �< t f 00,000 E.L DISMSG•*OLICV LIiAI >f 500,000 i CEIM 1 13 MOlOtR CANCELLATION SHOULD ANV_OF THE 490Vf 0690RJ6®P6LICIlI��CANCCtt180 6EFORf C7Mi11/1TION DATE TNER60f,THE IJSVINOINEURAWW1rL ENDEAVOR TO K.AIL 1$ NOT'"Te TNC MrIFICATENOLOCA NA ---- OArawlGitsN "M TO THE LEFT,SUT FAILLIRe TO 00 30 SQL VAPOSE NO 09LIOAT>ION OR UAEIUTY OF ANY RWp UVOR TNi INEURCR,I)'E AQENTg OR " RE�Ri{iktaTTVeii - AUTNBRttiiD RBPRiEENTATIVE AGOtD 25{200IMal 0 ACORD CORPORATION 108E oF�NET Town of Barnstable . Regulatory Services i`M Sa Thomas F. Geiler, Director CIL 619. ID a � Building Division Tom Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder as Owner of the subject property hereby authorize to act on my behalf, in altmatters relative to work authorized by this building permit application for: (AdcWss of Job) Signature o Owner Date Print Name if Property Owner is applying for permit please complete the Homeowners License Exemption Form on the reverse side. Town of-Barnstable op1He roy� ` ;Regulatory Services H Thomai F. Geiler,Director � • BARNSTABLE, • . .g MAS5. . i63g. `m Building Division PTf0 Tom.Perry,Building Con nissioner 200 Main Street, Hyannis, MA 02601 R-ww.town.barnstabl e.ma.us Office: 508-862-4038 Fax: 5.08-790-6230 HOMMOWNER LICENSE EXEMPTION Please Print DATE:' JOB LOCATION: number. street village "HOMEOWNER name home phone# work phone# CURRENT MAFLING ADDRESS: city/town state zip code 'a The.current.exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and k 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.budding permit. (Section 109,1.1) z The undersigned"homeowner"'.assumes responsibility for compliance with the State Building Code and other applicable codes,--bylaws,rules an®ulations. The undersigned"homeowner certifies that be/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 ere 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 liccnscd Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the bomeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe 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 fomi/certification for use in your community. i 4auoiss�wwo0 f 9L9Z0 VVV'i80dHinovwjb',l N;1.42id08332id 69. 3NNITrCjlnb'0 (; ZBLZ #J1 600Z/Ll� of e�idx 1 1J 3+ L09LL .* SO :a'su'aol � t {f asuaoll JosiniadnS u0i;onj;suo3 ` splepue;S Pug suotjeln.9a g.2 utPf�u$3o - �7an��a�zrv�� ,/ e • •�.��g r���l? i ' � ` i�S'" �Jvoma�arcaecw jl !' •- v or<r "rind*/ -�3 e gis rat before the expiration date, ivi ul use.onl j Board Of Building ff•found return y One g Regulations and to: Ashburton place Rm 1301 Standards ' Boston Ala.02,08 ,.., Jo;e.i;SIulwPt/ '• �:� I 9L9ZO b W '1bOdH1f10W21t/l atfl a2id08 332i3 69 4. Not valid bf'113NN11 G]At/a i y` without signaYur� �- - �'HSl;1:'€ 131N3113NN11 5-1`1W.� 1 `; Z60£9Z #lal NbZ/642dx3 6990ZL �:uoi;e�3siBaa U013VIdIN03lN3kUAONMd 3WOH ! splgpuuiS Sur suoprin2ad guippng 10 p.luog -\ �°'n��'•/y'� �a"'xo°z`ve`o°a'- axJG `O' � � ._.... .. ---._ c 1J .-. .......... -35,000 cf lA-Masoenclosed space v nry only. X-1_2 Family Homes i t Fail ' oreto possess a current edition Massachusetts State Baildin of the is cause for revocati . ' • -. - on of g Code is.license. �. ........... — JI F /f Assessor's mop and lot number ....... ..... ......... .......... J� Sewage Permit number ......................../.......................... ....... TNETD�y� TOWN OF BARNSTABLE Z 13MOSTADLE. i "6 BUILDING INSPECTOR o M °r APPLICATIONFOR PERMIT TO ............................................................................................................................. TYPE Cr CONSTRUCTION fir�'m +...: '/�/ ....................19.7s TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a' per according to the follow ing"information: ' Location .....:� .647/a... /'- ....... S 4r�:/ �' �� .................................................................. Proposed Use � �� ...................................................................: ............................. ............................................ .............................. Al Zoning District .......................Fire District ¢'' L7'Q// 0�t�/� "/'f�..............Address /�� R_ .f�'Cf/1 �-G Name of Owner ............... ............................ ........ .........:...... .............. ........ Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms Foundation ....5......��'� ............................................ .................................................................. Exterior .... e ' eld fn.. ...........................°.1 / 11 Floors .........�.it _..................................................................Interior ....4�1....?°�'..'...�4i?L�„':`?P!��'�/ �c%t, . i Heating P�'............................... .....Plumbing � - Fireplace ..... ....................................................................Approximate Cost ................................................................... Definitive Plan Approved by Planning Board -------------------_-----------19___r___. Area .......................................... � I 1 Diagram of Lot and Building with Dimensions Fee ............................... ........r.... SUBJECT TO APPROVAL OF BOARD OF HEALTH AVe�i 1i79 %few GCs ,� i-a vrr - /7 �i !risja I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .....1 ? .............................� . Sutton, George 7 J�9�� remodel' dw llinNo .... Permit ......................... .........g & add dormer - outbuildings to be demolished ...... ......................................................................... Location (-3\!)High Street 4-A ................................................................ West Barnstable ................................................................ Owner George Sutton ................................................................ Type of Construction ...........frame i. ........ ...................................................................................................... Plot ............................ Lot ................................ Permit Granted October 17 75 ........................................19 Date of Inspection ....................................19 Date Completed ......................................19 PERMIT REFUSED ..... . . .......... ...... ..... 19 ..... ........ ............. ..... .............................. ..................... ............. l.. .�� .. ... .... ...... . .......... ..................... ................ ...................................................... Approved ................ ..... ....................... 19 ............................................................................... ............................................................................... Assessor's map and lof. number ......f� l = /D—�-fi 7 r SEPTtc INSTALLED Iej. r I C �,. POANCE a Permit number '3 .7/.... WITH ARINCLE:II w ATE, Sewag e ...,. AN I -^I . 4 ED TOWN �t"ET TORN OF :BARNS'T"ARL ii i BARNSTABLE, i :1639- ,•� BUILDING INSPECTOR APPLICATIONFOR PERMIT TO .......�.............eo......................St/7-r.......................o......Av....................................................... TYPE OF CONSTRUCTION ..................19. : TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location / /9h...Sr............,............ ..................... . .6......................................................................... Proposed Use �.��/�1� Al Zoning District ....... Fire District a-s/- �`>✓rr�s'7�2'�� Name of Owner G177't�/7..............Address .l.�-1,010t� r�.4 Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ........ ..:....................................................Address .................................................................................... Number of Rooms ...........Foundation ....................................................... .............................................................................. Exterior (i✓LlfT ... �GLGZ�' r5�i/n �S Roofing !'.. 5 i/sr ........................ q................... y... Interior .. p�l16A,- - S,vowe 2C��/'tmC/` Floors i!?e.<................................... , ........................................................................ Heating ............................................................................Plumbing .. s..`..' !��G�� ............................... 40 Fireplace ....115W.....................................................................Approximate Cost .......... ........................................................ Definitive Plan Approved by Planning Board -----------_______----------- Area .......................................... At 1 Diagram of Lot and Building with Dimensions Fee ........ . .. ............................... SUBJECT TO APPROVAL OF BOARD OF HEALTH /gg oaf • � o I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name ...........................G .............. ... Sutton, George 18002 remodel dwelling No ................. Permit for ................................... & add dormer outbuildings to be demolished ............................................................................... High Street kLocation ......................:......................................... West Barnstable ............................................................................... ..........George Sutton Owner ....................................................... frame Type of Construction .......................................... ................................................................................ Plot ............................ Lot ................................ October 17 75 Permit Granted ..........................................19 Date of Inspection .. . . ...z.........................19 ks Date Completed . ....................19 PERMIT REFUSED ...........................6.................................... 19 ............................................................................... ................................................................................. ............................................................................... ............................................................................... Approved ................................................ 19' ............................................................................... ............................................................................... Assessor's offioe (1st floor): / ® semC SYMM MUST Be cat"Eto Assessor's map and lot number ...��/....`D. .7...........INSTALLED IN COMPLIANCE Board of Health (3rd floor): WITH TITLE 5 Sewage Permit number ..... .-.j33..a., J...... . . .......EW ONMENTAL CODE 4'irND : BAHd9TABLL. : �o r,us Engineering Department (3rd floor): � .313 ; �( � TOWN REGULATIONS House number i639 APPLICATIONS PROCESSED 8:30--9:30 A.M. and 1:00-2:00 P.M. only TOWN OF BARNSTABLE � 2 BUILDING U IHG INSPECTOR APPLICATION FOR PERMIT TO .....C..tin. U��.....4 ,d. :c «?12.........../.....2....G.J. ...�J �j/........... TYPEOF CONSTRUCTION .. .................................................../..................................... J ' -,A� ...... .. ..................19........ TO THE INSPECTOR OF BUILDINGS: n The undersigned hereby applies for a permit according to the following information: ' 1 I Location ...��1.uJ.....:H� �.... .,. ..... �2 ... ��11. `CC ,r �. ..................................................................... 1 a ...... .r.1.V..qd�G.....C+.(.�Q_'��.n!3....7'.f�/ , - &.1Q.R1.K1-....�L.f✓R4 Proposed Use � ;}, . ... ............................ Zoning District ..................../.rt...........................................Fire District ... O1Y n-:.51aA�V�..................... o 4 L -: 1 ..... 1n... 4v. `R a ern....... Name of Owner ..�.rca .Se. ..�...�.t�l,SCi�!c�........0..! !.....Address .......... ........... e..... . LiC # 00s8a? ;� \ Name of Builder ...............Address .-?... %TYG�I.S��(1 ? 4a��..�... .....LZfa4l... Nameof Architect ..................................................................Address .................................................................................... Number of Rooms .............�..............................................Foundation ..4�.Oct-rPa....CO)(lGd.t1 le..... ...X.. .....,.., e ` o i g `,R. < Exterior .... ACh.;.Y....... .1�.t.Y�.�-�I.QS......:..........................Roofin �.... .`�...... Gl.�(.'...�.J���.}�. �:S.................. Floorsl/v.� ..............................................Interior ...........s TY..l.!.Y . .................................................. Heating ............................................Plumbing ........................ ................................................... Fireplace A.O.KL.e............................................ .................Approximate Cost . ........, j..v�•......... Definitive Plan Approved by Planning Board ________________________________19-------- . Area Cl!/!.............•............... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH I OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name .. .............. Construction Supervisor's License ...Q ....... LOTT, DEMPSEY & SUSAN No 31728 Permit for ...ADDITION ' Sin le Family g.............. ..................... ..... Location ..:313...H .gh...$ K.Qe. ......... .................. .P.at;... .dX Tl. t by :..................... Owner Dem se l - } Type of Construction Frame Plot ............................ Lot .................. :............ Permit Granted .... ...............19 88 - Date of.�I spection ..........................::........19 Date Completed ............ .. ..19 EC Cr P e� 0 ; • �E Application to gPP�Q{}e•^S NP ENS Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS Application is hereby made, iri 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 j 2 Addition ❑ Alteration Indicate type of building: Q House ❑ Garage ❑ 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 DATE I t — I U"•1�,1'7 ADDRESS OF PROPOSED WORK 3 3 VW7 �+ , �JZS1 BWCOSs"61'A-SSESSORS MAP NO. OWNER I)QmoSeu ASSESSORS LOT NO. HOME ADDRESS 0pt(Ci_Ii3 TEL. NO. 3(cL I FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). Uo, ct�rA �3 o r Y Uc�cCtl� `IYl- �o�- Bch , L i AGENT OR CONTRACTOR TEL. NO. ADDRESS 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). Signed &_4W4!Ue Space below line for Committee use. P10 tractor-Agent Received by H.D.C. /�)� Date ;The !J ZL C 'cate is hereby l _ Daty L Time By 01 Approved }'• IMPORTANT: If Certificate is approved,approval Is subject to the 10 day appeal period provided In the Act. Disapproved. ❑ i 3j�K1'gh�5`.. w.�je?rn �o:'� of - • I ��' � is , i w.c. L.>v c 7trb ...... ...... br- i F VNI --57 A-4-4 - 7P ILI' I T -T-- I - -1 �I t r r -T--T- us - AL N ZF 0 arl)Oc?,b-je, -77 )ST loti At rs- 71V Xl i I I 1 I' ve/r�pse y ;Susan Lott I I � � � _:3l3.Hi9hSf•-W.eicirnsf-ob,/cam -- I -No y /qe7 I J-j- , II, •, 'I I I I , i I i .' •� i f I f , I I I i r l I I pl I I• I I I -'----- East-.E/,e yol,ion I I { I �xi.5iin i �TNF rq d� X Town of Barnstable *Permit# Qt XEx fires tr months jro ue date / /�"►D � Ag Regulatory Services . e � M^�Fo�'�"• Thomas F.Geiler,Director� APR 1 9 Building Division 2006 Tom Perry,CBO, Building CommissioneTow 200 Main Street,Hyannis,MA 02601 OF BARNSTABLE www.town.bamstable-ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number I 0 Property Address 3 l } �T V Q Q 7 W 1 COY" 'f� 5—� 1� 1 4L7 Residential Value of Work �� �' Minimum fee of$'25.00 for work under$6000.00 Owner's Name&Address .:Q Contractor's Name YY�(21`�(�fIQV� Telephone Number 'sC)a Z-(Oa—ale$ iHome Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: ❑ 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 be on file. Permit Request(check box) ❑ Re-roof(stripping old shingles) All construction debris will be taken to ❑Re-roof(not stripping. Going over existing layers of roof) i Re-side ❑ Replacement Windows. U-Value (maximum.44) •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. Home Improvement Contractors License is required. SIGNATURE: �J Q:Fomis:expmtrg Revise071405 r 4 The Con:motnvealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington.Street Boston,MA 02111 UT ti nt iv.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information -y�- Please Print Legibly Name(Business;Organization/Individual): Q Y�.�5—�-1 �O I 1 Address: �j -4-L�-, _ + City/State/Zip: (,l) c6a-) n<Ao� 2 Phone k 5 O g a.b S 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-tune).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. '+ 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me.in any capacih.. workers' comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3. I am a homeowner doing all work right of exemption per MGL 11.❑Phrnibing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t W 14^ employees. [No workers' 13.❑Other S c S comp. insurance required.] •Airy applicant that checks box A 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 their workers'comp.police information. I am an employer that is providing workers'compensation insurance for my employees Belmv is the policy and job site information. Instirance Company Name: Police#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains rod penalties of perjury that the information provided above is true andcorrect. Si re C12�lOC12� Phone#: O�= Official use only. Do not write in this area,to be completed by city or tmtw official Citv or Town: Permit/Idcense# 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#: