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Home My WebLink About0005 PIONEER PATH llll ^" c� U/ UPC 12543 No. 53LOR MASTINr4 PAN W\,IA i o•a' --s -jai_- j�,q.i5 1 � 991 7� +m .............. CA C4��.� Lrlspec;r e Matthew Weider 01 President Shoreland 1220 lyannough Road,Rte.132 Hyannis,Massachusetts 02601 Business(508)771-2008 Fax(508)778-2423 Cellular(617)504-0608 mweider@c2leshoreland.com \ www.c21 shoreland.com Each ONIce Is Independentty Owned And Operated I ' i j e K-AT-Hi [EN A. MCMAHON ATTORNEY AT LAW 1401 MANY DUNN ROAD. 3 BARN-SABLE, MA'02630 E TE!"508-685-3786 ` S FAx'508-635-0023 •KAM@KMCMAHONLAW.COM •� , , i •c .rF < Application numb\61-)....... aAR.,qsrAB Date Issued.......m :� I ......................................... MASS. AUG 1 2019 Building Inspectors Initials.... .......................... HARNSABLE Map/Parcel...... ......0�0 .............. TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDWG/WINDOWS/DOORS/TENTS/STOVES/WEATIqERIZATION PROPERTY INFORMATION Address of Project: -�- PI-oleel- 14). NUMBER STREET VILLAGE Owner's Name: t1,-c1,.,e Ile I Phone Number —2 o-7- -,Ih (2-IY4 0 - Email Address: 01 ci 2. e4, cntl Cell Phone Number -2 p 7 q Project cost Check one Residential Commercial— . OWNER'S.AUTHOPEATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR- Owner Signature: If,' A-44 ck\a 00 4'(4-4 Date: TEE OF WORK Siding Windows (no header change) Insulation/Weatherization Doors (no header change)k_I=_ Commercial Doors require an inspector's review Roof(not applying more than 1 layer of shingles) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name -SoA-err\ Afe-i Fr,SIev4 1,Jri-n Glow_S Home Improvement Contractors Registration(if applicable).# 17 3 2-q-5 (attach copy) Construction Supervisor's License#— 0q S-7 G (attach copy) Email of Contractor qq5d J. C b(n Phone number 1101 2- ROLE ALL PROPERTIES THAT HAVE STRUCTURE5,6VER"75YEAMIOLD 61#'I#THE SUBJECT PROPERTY IS/IV A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATIONNUMBER ............................................................ *For Tents ®>t'l��x Date Tent (s)will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X X Y X Additional tent dimensions can be attached on a separate piece of paper. Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached.Provide a site plan with the location(s) of each tent If food is being served at your event please obtain a health Department approval between the hours of 8:00am -9:30 am or 3:30 pm-4:30pm. Commercial events may require fire Department approval *WOOD/COAL/PELLET STOVES x Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State wilding Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date PLICAN Y 9 S SIGNATURE E Signature Date R- l q- 1 7 All permit applications are subject to a building official's approval prior to issuance. Renewal Agreement Document and Payment Terms byAndersen. dba:Renewal By Andersen of Southern New England Chris&Michelle Ryan =.. L.A Legal Name:Southern New England Windows,LLC 5 Pioneer Path RI #36079, MA#173245,CT#0634555, Lead Firm #1237 West Barnstable,MA 02668 10 Reservoir Rd I Smithfield,RI 02917 H:(207)400-4668 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com C:2074004667 Buyer(s)Name: Chris & Michelle Ryan Contract Date: 08/02/19 Buyer(s)Street Address: 5 Pioneer Path, West Barnstable, MA 02668 Primary Telephone Number: (207)400-4668 Secondary Telephone Number: 2074004667 Primary Email: Mebr92@gmail.eom Secondary Email: ejryan93@yahoo.eom Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Cont ractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document, the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this "Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $9,031 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $3,010 Balance Due: $6,021 Estimated Start: Estimated Completion: Amount Financed: $0 8-10 weeks 8-10 weeks Method of Payment: Cash/Check We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 1/3 DEP 1/3 ON START 1/3 ON COMP. TXS PD IN WEST BARNSTABLE MA Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor.Buyer(s)hereby acknowledges that Buyer(s) 1) has read this Agreement, understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 08/06/2019 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name:Southern New England Windows,LLC dba:Renew . A derse f Southern New England Buyer(s) Signature of Sales Person Signature / Signature Eric Woods Chris Ryan Michelle Ryan Print Name of Sales Person Print Name Print Name UPDATED: 08/02/19 Page 2 / 9 . �-�f"l�P� �C�/�if�.�/7iC��lfiG/�C��✓fi.�':�CGfi�i/G�Pi��.� Office of Consumer Affairs and Business Regulation 1000 Washington Street - Suite 710 Boston, Massachusetts 02118 Home Improvement Contractor Registration Type: Supplement card SOUTHERN NEW ENGLAND WINDOWS, LLC• Registration: 173245 10 RESERVOIR ROAD Expiration: 09/18/2020 SMITHFIELD,RI 02917 - scA 1 c, 20M-05n7 Update Address and Return Card. Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only TYPE:Supplement Card before the expiration date. If found return to: Registration . Expiration Office of Consumer Affairs and Business Regulation 1Z3245^_ 09/18/2020 1000 Washington Street-Suite 710 SOUTHERN NEW EtVGLAND WINDOWS,LLC Boston,MA 0211 BRIAN I 10 RESERVOERVOIRR ROAD SMITHFIELD,RI 02917 Undersecretary VL CON without signature f Commonwealth of Massachusetts Division of Professional L icensure Board of Building Regulations and Standards COnstru �6nS' bnprvisor CS-0g 70 _ p i res : 09/08/2020 p��gp -.e �, :.�/f: ,�s d �•.��f it BRIAN ® DENNISON 8 BLACKWELL DRIVE CHARLTON MA-O 1607 1. COMMissioner The Commonwealth of Massachusetts Department of IndustrialAeeidents 1 Congress Stree4 Suite 100 Boston,MA 03114--3017 www mass gov/dia Workers'Compensation insurance Affidavit-Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PER-�11T MN- C AUTHORITY. Aoolicant information Please Print Legibly Name(Business/Organization/Individual): dh e r t*-- LQ lct1) ),A r 1 Address: City/State/Zip: m 1 e �( DL 1 l� S �'t7 � 1 � 7 Phone#:_ �— Ara you an employer'Check the appropriate box: Type of project(required): 1. f am a employer with �� mployees(full and/or part-time).* 7. ❑New construction 2 am a sole proprietor or partnership and have no employees working for me in any capacity.[No workers'comp.insurance required.] 8: ❑Remodeling 3.01 am a homeowner doingall work m selE ]t 9. ❑Demolition Y (No workers'comp.insurance required. 4.❑fain a homeowner and will be hiring contractors to conduct all work on my property. [will 10 D Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.[]Electrical repairs or additions proprietors with no employees. 12.Q Plumbing repairs or additions 5.(3 1 am a general contractor and I:have hired the subcontractors listed on the attached sheet These sub-centracrors have employees and have workers'comp.insurance.t 13.0 Roof re airs 6.o We are a corporation and its officers have exercised their right of exemption per MCL c. 14. Other 0 r 152,¢l(4).and we have no employees.[No workers'comp.insurance required] 11 *Any applicant that checks box ql must also fill out the section below showing their workers'compensation policy' ormetion t Honreownets 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 employee& If the sub-contraetars have employees,they must provide their workers'comp,policy number. I am an employer that is protriding workers'compensation insurance for my employees Below is the policy and job site inforntatfon. Insurance Company Name: 1 t"e AeA5 n�s tbrq 1(- W9, Policy#or Self-ins.Lic.#J C 31,, Y-p?y Expiration Date: L.O Job Site Address: TAD City/State/Zip:W. on Attach a copy of the workers compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by 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.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certAun&rthep ' penalties of pedury that the informadion provided above is ink and orrect. Sigm lure: Date: ,Phone#: Official use only. Do not write in dds area,to be completed by city or town oJWal 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#: �,coRo� CERTIFICATE OF LIABILITY INSURANCE DATE(MWDD/YYYY) `.� 12/28/2018 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 NAME: CoBiz Insurance, Inc.-CO 1401 Lawrence St., Ste. 1200 PHONE t.303-988-0446 q Not:303-988-0804 IL Denver CO 80202 ADDRESS: COMail@cobizinsurance.com INSURE S AFFORDING COVERAGE NAIL# INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER a:Firemens Insurance Company of WA,D.C. 21784 Southern New England Windows,Southern hereLLC INSURER C:Homeland Insurance Company of New York 34452 . dba Renewal by Andersen of Southem New England 10 Reservior Rd INSURERD: Smithfield RI 02917 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER:787175890 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 T INSURANCE ADDL SU R . POLICY EFF LICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILITY CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $1,000,000 CLAIMS-MADE DAMAGE TO RENTEU— a OCCUR PREMISES Ea occurrence $300,000 MED EXP(Any one person) $10.000 PERSONAL&ADV INJURY $11000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 X POLICY JE C LOC PRODUCTS-COMP/OP AGG $2.000,000 OTHER: $ A AUTOMOBILE LIABILITY CPA3158728 1/112019 1/112020 COMBINED SINGLE LIMIT a accident $1.000.000 X ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident)ALTOS AUTOS ) $ NON-OWNED PROPERTY DAMAGE X HIRED AUTOS N AUTOS Par aee dent $ $ A X UMBRELLA LIAR X OCCUR CPA3158728 1/1/2019 1/1/2020 EACH OCCURRENCE $15,000,000 4 DIED CESS LIAR CLAIMS-MADE AGGREGATE $15,000,000 I X I RETENTION$ $ g WORKERS COMPENSATION WCA315872924 1/1/2019 1/1/2020 X STATUTE ER AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORIPARTNER/EXECU ME E.L.EACH ACCIDENT $1,000,000 OFFICERIMEMBER EXCLUDED? ❑N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEd$1.000.000 If es,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $1 000.000 C Pollution UabOiry 7930073340000 1/1/2019 1/1/2020 Each Occurrence $2,000,000 Galms-Made Policy Aggregate $2.000.000 Retroactive Date 06/20/2013 Deductible $25,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is requlred) 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. FOR INFORMATIONAL PURPOSES ONLY AUTHORIZED REPRESENTATIVE /uQ7� `CAI•/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 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 �j MA & Posted Until Final Inspection Has Been Made. Permit i6s¢a`� !!!! 9. Wherea Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit No. B-19-2581 Applicant Name: Dzmitry Labkovich Approvals Date Issued: 08/19/2019 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 02/19/2020 Foundation: Location: 115 COMMERCE ROAD, BARNSTABLE _ _ Map/Lot: 318-017 ,_ Zoning District: RF-1 Sheathing: Owner on Record: KORKUCH,TESS T Contractor Name ,ROOFING AND SIDING OF CAPE Framing: 1 ' COD LLC.� Address: 115 COMMERCE ROAD i 2 BARNSTABLE, MA 02630 - Contractor License: 170787 F '*, Chimney: Description: New Roof and Siding ) ; Est. Project Cost: $7,050.00 t Permit Fee: $35.96 Insulation: i Project Review Req: t Fee Paid: $35.96 Final: Dater 8/19/2019 Plumbing/Gas � Rough Plumbing: Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work,authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted..' All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: 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. - - _- rr Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:{ i 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: 5.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. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Town of Barnstable Building tELAW�� Post This Card So-That it is Visible Fromthe Street-Approved Plans Must be Retained on Job and;this Card Must be Kept; BIA s" Poste&Until'Final Inspection Has Been Made. g s Permit 1 Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made 1 Permit No. B-18-841 Applicant Name: SOUTHERN NEW ENGLAND WINDOWS LLC. Approvals Date Issued: 04/11/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 10/11/2018 Foundation: Location: 5 PIONEER PATH,WEST BARNSTABLE Map/Lot: 128-017-005 Zoning District: RF Sheathing: Owner on Record: RYAN,CHRISTOPHER 1&MICHELLE B Contractor Name.` BRIAN D DENNISON Framing: 1 Address: 5 PIONEER PATH Contractor License: CS`095707 2 WEST BARNSTABLE, MA 02668 Est. Project Cost: $ 12,429.00 Chimney: Description: replace 1 window.30 uvalue &2 doors Permit Fee: $63.39 I Insulation: Project Review Req: Fee Paid:! $63.39 Date: 4/11/2018 Final: Plumbing/Gas Rough Plumbing: ,Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. I ; Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. i -- "- "� Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided onnthis permit. Service: 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: 5.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. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Zs?c Building plans are to be available on site. - All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT f - z c •r Town of Barnstable *Permit#,�-� Expires 6 muntds from issue d Regulatory Services Fee anarterast�, + �� KAM Richard V.Scali,Director ib39• �� a r Building Division � � � ! Tom.Perry,CI30,13uiiding Commissionc q 200 Main Street,Hyannis,M 1 ~� 3 2018 www.town.bamstable.mi �6��®� Office: 508-862-4038 14mV8_V�P&790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ON h Not Valid without Red X-Press Imprint Map/parcel Number ro 1716 V S Property Address kotuww �*`•` Wl Residential Value of Work$_1?_4'IyTigl Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address I cwl-•&ti S Tr_ \_ mLee'er 0"9 Contractor's Name T Telephone Number Home Improvement Contractor License#(if applicable) /T 32/5 Email: Construction Supervisor's License#(if applicable) 076-76 7 I�W orkman'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# WM 816•�7L/ 20 Copy of Insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(hurricane nailed)(stripping old shingles) All construction debris will he taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side //ll Replacement Windows/doors/sliders.U-Value r .V (maximum.32)#of windows #of doors:-,::" ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical& hire 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 requi d. SIGNATURE; • C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2P101 DHR\EXPRESS.doc Revised 040215 Office of Consumer Affairs and Business Reg: lation 10 Farb Plaza - Suite 5170 Boston, Massachusetts 02116 Horne Improvement Contractor Registration Registration: 173245 Type: Supplement Card Expiration: 9/19/2018 SOUTHERN NEW ENGLAND WINDOWS LL BRIAN DENNISON 26 ALBION RD LINCOLN, RI .02865 Update Address and return card.Mark reason for change. Address - Renewal — Employment Lost Card '---Ofrice of Consumer Affairs&Business Regulation Registration valid for individual use only before the expiration date. If found return to: HOME IMPROVEMENT CONTRACTOR Office of Consumer:Affairs and Business Regulation Registration: 172245 Type: 10 Park Plaza-Suite 5170 Expiration: 9i19/2018 Supplement Card Boston.NIA 01-116 SOUTHERN NEW ENGLAND WINDOWS LLC. RENEWAL BY ANDERSON BRIAN DENNISON 26 ALBION RD LINCOLN,RI 02865 (-Undersecretary Not valid without signature ^ .a-lh-iset Lar i of P 5Ca? Of Building Replaiions and' �tasf ra,:s L i en s e: CS-095707 BRIAN D DENNISON 7 LAMBS POND GARGLE CHARLTON MA 01507 �a^ilM;!SSi0ner 09'08/2018 The Common wealth-of Massachusetts Department of Industrial Accidents I Congress Street, Suite 100 Boston,MA 02114-2017 www.mass.gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le 'bl• Name (Business/Organizkion/lndividual): E ow's Address: City/State/Zip: p Phone#i: '�,Dl - 2�g= Q� Are you an employer?Check the appropriate box: Type of project(required): 1,KI am a employer with Zo employees(full and/or part-time).* T.D New construction 2.F�I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.(No workers'comp..insurance required.) 9. ❑Demolition 3.Q I am a homeowner doing all work myself.[No workers'comp.insurance required.) 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 wilt 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.a 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑Roof repairs These sub-contractors have employees and have workers'comp.insurance. /�- 6.� officers We are a corporation and its ocers have exercised their right of exemption per M 14. OOther � GL c. jYN (re 1Q(D 152,61(4),and we have no employees.(No workers'comp.insurance required.) *Any applicant that checks box 81 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 contactors must submit a new affidavit indicating such. +Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: `l r Me I1)S - l f�M Policy#or Self-ins.Lic.#: W e—A 3l s�r 2•L — Z-0 Expiration Date: !' Job Site Address:—s /l .Q��r' /Gam( t'�-- City/State/Zip:We Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation pdnishable by a fine up to 11,500.00 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.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 th ains and penalties of perjury that the information provided abo a is tr a and correct Si afore: Date: cJ L3 1, Phone# ZZ 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#: I dco CERTIFICATE OF LIABILITY INSURANCE DATE 12129//2s/z017n 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). CONTACT PRODUCER NAME: CoBiz Insurance, Inc.-CO PHOC.NE 303-988-0446 a/c No:303-988-0804 1401 Lawrence St, Ste. 1200 E-MAIL Denver CO 80202 ADDRESS: COMaiI cobizinsurance.com INSURE S AFFORDING COVERAGE NAIC If INSURER A:Acadia Insurance Company 31325 INSURED ESLERCO-01 INSURER B:Flremens Insurance Company of WA,D.C. 21784 Southern New England Windows, LLC. INSURER c:Homeland Insurance Company of New York 34452 dba Renewal by Andersen of Southern New England 10 Reservior Rd INSURER D: Smithfield RI 02917 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:1252851165 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. ADDL SUER POLICY EFF POLICY EXP ILTR TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYY MMIDD/YYYY LIMITS A X COMMERCIAL GENERAL LIABILnY CPA3158728 1112018 1/12019 EACH OCCURRENCE $1.000.000 DAMAGE TO RENTED CLAIMS-MADE FX OCCUR IS Ea occurrence $300.000 MED EXP(Any one person) $10.000 PERSONAL 8 ADV INJURY $1.000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2.000.00D X PRO ❑ LOC PRODUCTS-COMP/OP AGG $2.000.000 POLICY❑JECT $ OTHER: A AUTOMOBILE LIABILITY N CPA3158728 1/12018 1/12019 Eaa accideDISINGLE LIMIT $1 000 000 X ANY AUTO BODILY INJURY(Per person) 5 ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE 5 X HIRED AUTOS X AUTOS Per accident A X UMBRELLA LIAB X OCCUR CPA3158728 1/1/2018 1/12019 EACH OCCURRENCE S 10 000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $10,000.000 DED I X I RETENTIONS n 5 B WORKERS COMPENSATION WCA3158729-20 1/12018 1/12019 X STA ER UTE AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L EACH ACCIDENT $1.000.000 OFFICER/MEMBER EXCLUDED? N I A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$1,000,000 ff yes,describe under E.L DISEASE-POLICY LIMIT S 1.000.000 DESCRIPTION OF OPERATIONS below C Pollution Uability 7930073340000 1112018 1/12019 Each Occurrence S1.000.000 Claims-Mad Policy Aggregate S1.000,000 Retroactive Date 06202013 Deductible 510,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) 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. For Informational Purposes AUTHORIZED REPRESENTATIVE i ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD renewal Agreement Document and Payment Terms byAndersen. dba:Renewal B Andersen of Southern New England Y g Chris Ryan , =.. L Legal Name:Southern New England Windows,LLC 5 Pioneer Path RI#36079,MA#173245,CT#0634555, Lead Firm#1237 West Barnstable,MA 02668 10 Reservoir Rd I Smithfield,RI 02917 H:(207)400.4667 Phone:866-563-2235 1 Fax:401-633-6602 1 sales®renewalsne.com C:2074004668. Buyer(s)Name: Chris Ryan Contract Date: 02/28/18 Buyer(s)Street Address: 5 Pioneer Path, West Barnstable, MA 02668 Primary Telephone Number: (207)400-4667 Secondary Telephone Number: 2074004668 Primary Email: mebr92@gmail.com Secondary Email: Buyer(s)hereby jointly and severally agrees to purchase the products and/or services of Southern New England Windows,LLC d/b/a Renewal By Andersen of Southern New England("Contractor"),in accordance with the terms and conditions described in this Agreement Document and Payment Terms,any documents listed in the Table of Contents,and any other document attached to this Agreement Document,the terms of which are all agreed to by the parties and incorporated herein by reference(collectively,this"Agreement"). Buyer(s)hereby agrees to sign a completion certificate after Contractor has completed all work under this Agreement. Total Job Amount: $12,429 By signing this Agreement,you acknowledge that the Balance Due,and the Amount Financed must be made by personal check,bank check,credit card,or cash. Deposit Received: $0 Balance Due: $12,429 Estimated Start: Estimated Completion: Amount Financed: $12,429 8-10 weeks 8-10 weeks Method of Payment: Financing We schedule installations based on the date of the signed contract and secondarily on the date in which we complete the technical measurements.The installation date that we are providing at this time is only an estimate.We will communicate an official date and time at a later date. Rain and extreme weather are the most common causes for delay. Notes: 50% DEP 50% ON COMPLETION OF JOB,TXS PD IN BARNSTABLE MA Buyer(s)agrees and understands that this Agreement constitutes the entire understandings between the parties and that there are no verbal understandings changing or modifying any of the terms of this Agreement.No alterations to or deviations from this Agreement will be valid without the signed,written consent of both the Buyer(s) and Contractor. Buyer(s)hereby acknowledges that Buyer(s) 1)has read this Agreement,understands the terms of this Agreement,and has received a completed,signed,and dated copy of this Agreement,including the two attached Notices of Cancellation,on the date first written above and 2)was orally informed of Buyer's right to cancel this Agreement. NOTICE TO BUYER: Do not sign this contract if blank.You are entitled to a copy of the contract at the time you sign. YOU,THE BUYER, MAY CANCEL THIS TRANSACTION AT ANY TIME NOT LATER THAN MIDNIGHT OF 03/03/2018 OR THE THIRD BUSINESS DAY AFTER THE DATE OF THIS TRANSACTION, WHICHEVER DATE IS LATER.SEE THE ATTACHED NOTICE OF CANCELLATION FORM FOR AN EXPLANATION OF THIS RIGHT. Legal Name.Southern New England Windows,LLC dbai Rene y-Andersen of Southern New England Buyer(s) Signature of Sales Person Signature Signature Eric Woods Chris Ryan Print Name of Sales Person Print Name Print Name UPDATED: 02/28/18 Page 2 / 10 Town of Barnstable Building Post This Card 5o That it is Visible From the Street-Approved Plans Must be Retained on Job and this Card Must be Kept 1639. Posted Until Final)rispection Has Been Made. Permit ` Where a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. 1 Permit No. B-17-3815 Applicant Name: MARK MACALLISTER Approvals Date Issued: 11/30/2017 Current Use: Structure Permit Type: Building-Alteration INTERIOR Work Only- Expiration Date: 05/30/2018 Foundation: Residential Map/Lot: 128-017-005 Zoning District: RF Sheathing: Location: 5 PIONEER PATH,WEST BARNSTABLE Contractor Name: ,MARK A MACALLISTER Framing: o / z5 � Owner on Record: HAMILTON,ANDORA ROSE Contractor License: CS-079358 2 Address: 5 PIONEER PATH Est. Project Cost: $75,000.00 Chimney: WEST BARNSTABLE, MA 02668 ' Permit Fee: Description: renovates ace over garage and mudroom according to plans I $432.50 Insulation: p attached(bedroom) g g g p Fee Paid:( $432.50 I Date: 11/30/2017 Final: Project Review Req: SMOKE UPGRADE REQUIRED ,�' e Plumbing/Gas Rough Plumbing: wilding Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. Rough Gas: All work authorized by this permit shall conform to the approved application and the approved construction documents for which this permit has been granted. All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. Final Gas: This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open foi'public inspection for the entire duration of the work until the completion of the same. �` Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Service: Minimum of Five Call Inspections Required for All Construction Work:, 'f Rough: 1.Foundation or Footing 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Building plans are to be available on site Final: All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map I a$ Parcel (71`� �0� Application # /—� '" 17— 32� 1 Health Division Date Issued Z1,7 Conservation Division Application Fee Planning Dept. Permit Fee : .% () Date Definitive Plan Approved by Planning Board � G Historic - OKH _ Preservation/ Hyannis Project Street Address Village \rJ esjc" 34c'nS � Owner rf�nr;a�p: Uc�,�,_ Address Telephone " Permit Request VCfw 9,0\)AV W Square feet: 1 st floor: existing 15proposed O 2nd floor: existing 1108 proposed O Total new O Zoning District Flood Plain Groundwater Overlay Project Valuation WO Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family 10 Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes M No On Old King's Highway: ❑Yes QQ No Basement Type: @Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) 00 BasemeVnfinite Are 9( ft) 0 �� Number of Baths: Full: existing 3 new O Hicistir7 new 6 Number of Bedrooms: .3 existing Q new sl. Total Room Count (not including baths): existing new b First FI666ZF�000 m Count Heat Type and Fuel: Dill Gas ❑ Oil ❑ Electric ❑ Other Central Air: %Yes ❑ No Fireplaces: Existing J_New _0 Existing wood/coal stove: ❑Yes No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: Xexisting ❑ 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 �`c �AQC41;size Telephone Number SbS M9 Address (Qq EW2 V,14_r Q,OC,�_ License# 02�0 5S Home Improvement Contractor# Email Qf Worker's Compensation # W C D�o3 5030 ALL CONSTRUCTION DEBRIS RES TING FR M THIS PROJECT WILL BETAKEN TO N RWS wick, MA SIGNATURE DATE Z 01/f 7 r FOR OFFICIAL USE ONLY APPLICATION # - ;` DATE ISSUED �l ` MAP/ PARCEL NO. 1 - • _ _ . ADDRESS VILLAGE OWNER DATE OF INSPECTION: r FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH -. FINAL . r.� FINAL BUILDING j r DATE CLOSED OUT. - y r ASSOCIATION PLAN NO. OFZtiE T -'{ Q� a i BARNSTABLE, � KAM s63q. Town of Barnstable QED MA't 4 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: 508-8624038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section _ If Using A Builder I, ' Chris Ryan ,as Owner of the subject property 3 hereby authorize Mark Macallister of Macallister Building, Inc. to act on my behalf, in all matters relative to work authorized by this building permit application for: 5 Pioneer Path.West Barnstable (Address of Job) ature lowner Date I C�6�cS ,iCY�r✓ Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. C:\Users\Decollik\AppData\Local\Microsoft\Windows\Temporary Internet Files\Content.Outlook\2PIOIDHR\EXPRESS.doc •'" -:wised 040215 The Contntonsvealth of Massachusetts Deparanent of Industrial Accidents Ogwe of Investigations 600 Washingion,Street Boston,MA 02111 wwry ntass.gov/dia Workers' Compensation Insurance Affidavit: Bidders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Bu&iruess/Organizahon/fndivid Q: Macallister Building, Inc. Address: 64 Ebenezer Road City/Sta&Zip: Osterville, MA 02655 Phone#: 508-428-6408 Are you an employer?Check the appropriate box: Type of project(required): 1. X❑ I am a employer with 1 4. ❑ I am a general contractor and I employees(full and/arpsrt-time)_ : have.faired the sub-contractors 6. ❑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.instrance comp-ms�nrp I 9- ❑Building additionrequired] 5. ❑ We are a corporation and its 10.❑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.]Ti c. 152,§1(4) and we have no employees.[No workers' 13_0 Other comp.insurance required.] •Any applium that checks box C umst also fill out the section below showing their workers'compensation policy inf mmfftim 1 Homeowners who submit this affidavit indlizating they are doing all wait and then hire outride contractors must submit a new affidavit indicating such. IConttactors that check this box must attached an additions!sheet showing the name of the sub-cots and state whether or not those entities have employees. If the subcontuutots have employees,they must pmvide their workers'comp.policy number. I am an employer that is proving workers'compensation insurance for my eng doyees Below is the policy and job site injorinaliotb Insurance Company Name: Star Insurance Co. Policy#or Self-ins.Lic_#: WC0632030 Expiration Date: 3/1/2018 Job Site Address: 5 Pioneer Path City/State/Zip: West Bamstable, MA 02668 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required undue 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 itmprisonment,as well as civil penalties in the forma 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 thepains an nabtes of pedtuy that die inforination provided abnue is&w and correct Date: 10/30/2017 Phone#: 508-428-6408 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.Cityfrown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone it: ACORO® DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE F10/31/2017 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 KathySilvia NAME: The Fair Insurance Agency Inc. PHONE (508)775-3131 FAX No):(508)790-1677 619 Main Street AIL ADDRESS:kathy@thefairagency.com Suite 1 INSURER(S)AFFORDING COVERAGE NAIC# Centerville MA 02632 INSURER A:EVanston Insurance co INSURED INSURERB:Commerce Insurance Co. 34754 Macallister Building Inc INSURERC:Star Insurance Company 18023 64 Ebenezer Road INSURER D: INSURER E: Osterville MA 02655 INSURERF: COVERAGES CERTIFICATE NUMBER:17-18 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 ADDL SUBR I POLICY EFF POLICY EXP LTR TYPE OF INSURANCE POLICY NUMBER MM/DD MM/DD LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE Is 500,000 A CLAIMS-MADE �OCCUR PREM SES EaAGE 0Eoccurrence)NTED ($ 50,000 3EM4506 8/11/2017 8/11/2018 MEO EXP(Any one person) Is 10,000 PERSONAL&ADV INJURY $ 500,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE is 1,000,000 X POLICY❑PET LOC PRODUCTS-COMP/OP AGG $ 1,000,000 OTHER: Employee Benefits Is AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT_ (Ea accident)_ I$ _ B 1 ANY AUTO BODILY INJURY(Per person) $ 100,000 ALL OWNED q SCHEDULED TOSAUTOS ZX2082 9/7/2017 9/7/2018 BODILY INJURY(Peracd ,dent) $ 300 000 AUNON-OWNED PROPERTY DAMAGE $ HIRED AUTOSAUTOS Per accident) Uninsured motorist BI split limit $ 100,000 UMBRELLA LIAR HOCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE Is I DEO I I RETENTION$ Is WORKERS COMPENSATION PER I 1OTH- AND EMPLOYERS'LIABILITY YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 100,000 C OFFICER/MEMBER EXCLUDED? ❑ N/A (Mandatory In NH) WC0632030 3/1/2017 3/1/2018 E.L.DISEASE-EA EMPLOYEE$ 100,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 500 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Town of Barnstable THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Main Street ACCORDANCE WITH THE POLICY PROVISIONS. Hyannis, MA 02601 AUTHORIZED REPRESENTATIVE Jackie Stewart/FAIJS2 ©1988-2014 ACORD CORPORATION. All rights reserved. i t Massachusetts Department of Public.Safety . �f Board of Building Regulations and Standards License: CS-079358 Construction Supervisor j MARK A MACALLISTER 64 EBENEZER RD :; ` OSTERVILLE MA 02655 - r� jZCK vim— Expiration: Commissioner 08/12/2018 • �e V,arnnna�e�ae�i�/�o�P/l`ru,;�r�uaeG/a '•ems Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR - TYPE:Individual Registration Expiration 08/02/2019 MARK MACALLISTER:; MARK A.MACALLISTER::.=' 64 EBENEZER ROAD. OSTERVILLE,MA 02655 Undersecretary Registration valid for individual use only before the expiration date. If found return to: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,MA 02116 Not valid without signature . Town of Barnstable Bulldln . . :.. _ Post Tps Card 5o Thai itsis�lLisitile'From the�Street-Approved,,P.,Ians Must be�Retained on Job and this Card`Must;be�Kept��, Posted Until Final Inspection�Has Been IVlade.; � yx' a� ai s Wh w a r rmit ertiae mPe Permit No., y ' $-17 2393 . Applicant Name: MICHAEL WILLIAMS . Approvals Date Issued: `07/28/2017 Current Use: Structure -Permit Type: Building-Restore to Single Family,' Expiration Date: ' 01/28/2018 Foundation: Location:_ .5 PIONEER PATH,WEST BARNSTABLE Map/Lot: 128-017-005 Zoning District: RF Sheathing:- IBM Owner on Record HAMILTON,ANDORA ROSE ' b r0ontractor Name X MICHAEL A WILLIAMS Framing: 11 Address: S PIONEER PATH; Contractor License: CS401155 2 WEST BARNSTABLE,MA"02668 _.._ Est Project Cost: $1,000.00 Chimney: Description: RESTORE TO A SINGLE FAMILY.BY REMOVING THE KITCHEN IN ROOM Rerm�fpFee._ $85.00 � �� - Insulation— OVER GARAGE THIS ROOM TO BE A BONUS ROOM with four foot - Fee Paid; $85.00 rased opening. Final: 4 Date 7/28/2017 Project Review Req: RESTORE TO A SINGLE FAMILY BYREMOVING`TH 'GHEN,�fflN 'ROOM OVER GARAGE THISROOM TO BE A:B®NUS ROOMdh Plumbing/Gas four cased opening. , Rough Plumbing: z Building Officia'Ir Fin 11 al Plumbing: This permit shall be deemed abandoned and invalid unless the work authonzedb this permit is commenced within six months aftec:.issuance. P Y' s Rough Gas: All work authorized by this permit shall conform to the approved application andzthe=approved construction documents-forS�whichthis permit has been,granted. All construction,alterations and changes of use of any building and strructu�ress�hall bye in compliance with the local zonmgby Io_V;a Viand codes. Final Gas:c This permit shall be displayed-in a,location clearly visible from access street orxroad and shall be maintained open for pudiiclnspeetion for the entire duration of the work until the completion of the same. { ? f Electrical The Certificate of Occupancy will not be issued until all applicable signaturessbyKKt�he Building a' -Fire Offiic am,i provided on th permit. Service: Inspections Required for All Construction Work:'Minimum of Five Call Ins Pe 4 1.Foundation or Footing . '' - Rough: 2.Sheathing Inspection 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed - Final: 4.Wiring&Plumbing Inspections to be completed prior to.Frame Inspection S.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough:. 6-Insulation 7.Final,Inspection before.Occupanty Low Voltage Final. Where applicable,separate permits are required for Electrical Plumbing,and,Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction: Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund".(as set forth in MGL c.142A). Fire Department Building plans are to be available.on site Final: APPLICANT-ISSUED RECIPIENT :.All Permit Cards are the property of the TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION f3UI LDING f Map Its Parcel 0S1/a, 'Ep 7. Application # • _ 2n Health Division JUG 28 2017 Date Issued Conservation Division T OwN 0F BANSTg6 Application Fee Planning Dept. LF Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis Project Street AddressIF �DN Village �Aif1� Owner Address 5 P44 w• i Telephone -�+ Permit RequestReg&aAr YO 51OC4G rA46412/ .../ LOG lid 1J4j s kpaAl T'e OF— Square feet: 1 st floor: existing proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation DOiO*'— 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 Q�LNo On Old King's Highway: ❑Yes OiNo 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: J existing 3 new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: X Gas ❑ Oil ❑ Electric ❑ Other Central Air: WYes ❑ 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 [ �. r (BUILDER OR HOMEOWNER) Name c� C� J Telephone Number 7Z0_Z3l- 7Doa Address U&4Ptf�-(,�J License # s"��1�6 DZ770 Home Improvement Contractor# �83 Email 40" Worker's Compensation # ALL CONSTRUCTION DEB IS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE "..cWA DATE 07 /7 E FOR OFFICIAL USE ONLY APPLICATION # DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE , OWNER, . r DATE OF INSPECTION: t FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL r GAS: ROUGH FINAL . : FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. Ile Commumveahh of Massachuseffs Department cr,f luduslrid Accide Ys Office 00MACSfigataons 600 Washington,SYreet Boston,M,4 02111 -- wrvt�mas�gov�ilirt . Wkw1kers' CanspensafsanInsurance AfffiL-avit:Bnitders/Con&actars/Mechicians/Plumbers APPEcant Informatian Please Print .Name Addre— -- cs --=-= - �?�r� Ij7 ---- -- --- - ------ Are you an employer?Checkthe appropriate bo= Type of project(recluir ed): 1.❑ I am a employes with 4_ ❑I am a general contmctar and I 6_ ❑New employees{full andfor part�.me)* have luredilie sub-contractors . 2.El am a sale proprietor orpart aw- listed on the attached sheet` ?- ❑Remodelling strip and have no employees These sub-contractors have 9- ❑Demolition waddng f m me in any capacity. employees and have workers' 9. ❑B.uildmg addition [NO 'pomp ;murance comp-insurance 1 required-] 5. �We are a corporation and its 16-❑Electrical repairs cr additions 3.❑ I ama homeowner doing all work officers have exercised their 1L❑Plumbingrepairs or additions Fysel tight oIDI. €[No woa�kets' - f c_152.§I{ �.oaer Mdwe have no L-❑Roofrepairs =mza=e required-]i 13_El other employees.[No wodmrs' comp—iosuranw required.] 'gap app€cs trot cbedsbos#1 mast also flIIootthe se tioabelowshxrtsiug�eirwozitexs'�pensatioapa&cy i�amafiaaL M meawnem vdw submit des.affidzvg mfficatmg deey axe doing all waak sad dim bzm outside coutcactars amst submit a new affidavit mdirann sach ZCaatrac{a6'd3a 111,11 this bmt mast atierhed as additi mil ShEet Sbndng tb2 rx of axe snb-cmrtcsciom snd state whcthec cff not chose entities hav employees.I€the sub-c=tmcrmhare ffipIcFees�the3'm=srpmvide&ek wad'gyp.policy manber lam arc Below is thepalicy and jobs site irnformalibm Insurance Company Name: 'Policy AlL or Self-iris.Lim k Expinatian Date: Job RteAddressr.7 T/� � CitylStaW2f p: Attach a copy of the workers'compensationpolicy declaration page(showing the-policy number and expiration date). Fail we to serum coverage as requiredunder Section 25A o€MQ.a. 152 can lead to the imposition of criminal penalties of a fine up to SUOD00 and/or otie yearrimprisostmen,as Well as civil penalties n the form of a STOP WORK ORDERand a fihe of up to$250-00 a dap agpicst tiie violator. Be advised that a copy of this statement may be fi n v-drde:d to the Office of Investcg atiom of the DIA for insmmnce coverage vmrificadon. I'do 1MTby C the ' s and per a ry that Ae iaformafiarspnvtirled aloha is true and correct Sitnuature: Date Z$ 7 Phone '71�-23�•-roa7 OBkial use only. Do not unite in tfzb area,tsr be completed by city artoiru affrdat City or Town: Permh tense# Ling Ant1writy(ci cIe one): L strand of Health r.Buffufmg Department 3.Qty/Towa Clerk 4.Electrical luspector S.Phunbing Inspector 6.Otrher Coact Person: Phone 9: Taformation and 11astructions . MassarImsetts e=neaal Laws chsp� M reqmes all cuPIoyess to provide wnQIM&campeosation for their ea Iayees. ParMXM:It`tu this st z,an eapL7=is defined m.every personin the seavi.ce of anothar under Buy contract ofhfi-, express or impHcc%oral or writ." i An em7kyer is domed as Sr anindividual,part aeafii p,assm iatian,corpan dion or other legal entity,or any two or male of the foregoing engaged is a joint etaprise,and inchidnzg the legal Fepreseufatives of a.deceased e¢iplayer,or ffic receiver or tMstee of an individual,PMtaMZhip,association or other Iegal entity,eurployi ag employees. However the owner of a.dwelling house having not mere than three apartments-and who resides therein,or the:occupant of the - dwmM g house of antother who employs persons to do maintrnance,cans(ructi on or repair work.on such dwelling house or en the grounds or bm7d ng appurfen thereto shallnotbecanse of such employmentbe deemedt5o be an eaaployer" MM chapter 152,§25C(6)also states that'every siaia or IDcal ssPn�►g agency shag withhold the iss-nance or ren.ew•al of a license or permit to operate a business or to construct bufidi ags in the commonwealth for any applicanf who has not produced acceptable evidence of compliance with the in mance coverage required_" Additionaljy,MCrL chapter 152,§25C(7)states-Neither the commianwealth nor my ofits poIifical subdfivisims shall enter into any contract for the perms race ofpn Iic work until acceptable evidence of compliance with the insmm3ce._ requiromeaffs of this chapter have been presented to the confiaing ardhouty." App4caats PIease fill out the woil='.compensation affidavit completely,by che&dug the boxes that apply to your situation and,if necessary,supply sob-condractor(s)name(s), addresses)and phone— er(s) along with their certificates)of insurance. LfinitrdLiabilityCompanies(ILC)or Limited Liabi-lityPartaessbips(LIP)witlino employees other than the members or pates,are not rt gcmed to cagy woiicers' compensation igsmaiidx. If an LLC or LLP does have employees,a.policy is regniiod. Be advised that this affda-yif:may be sul m d to the Department of Industrial Acciddmts mr confnmaiion of insurance coverage Also be sure to sign and dafe the affidavit The affidavit should be rstznned to the city or town that the application for the permit or license is being requested,not the Department of Ba asttial Ar - ants_ Shouldyou have any gnestians regardmg the Jaw or ifyou.ate regmned in obtain a wogs' compen caftan policy,please call thd Department at the number listed below. Self-insU ed companies should enter their self fi soiarice license number on the appropdat a Ifi City or Town Officials t Please be sore that the affidavit is complete and prinied IegjIIy. The Department has provided a space at the botfma of tine affidavit for you to full out in.the event the Office of Investigations has in coniact you regaz cling the applicant. Please be sure to fill in the pexmrt/Iicrose mmiber which will be used as a reference number. Im addition,as applicant that must submit mvltipIe pane tili ice applitafions in.any given ycan;need only submit one affidavit i adicaimg cant policy information Cif necessary)and under`clob Site A Adzes"the applicant should wry-all locations in (may or town)-"A copy of the-affidavit that has been.officially stamped or m dmd by the city or town maybe provided to the - applicant as pmof that a valid affidavit is on file for f md�: p or licenses A new affidwitmust be filled out earl year.Where a home owner or ctiizea is obtaining a lidxnse or permit not re7aiDd any business or d�mmeaeial vd�me (i.e. a dog license or permit to bum leaves eta.)said person.is NOT wed to complete this affidavit The Office of Investigations would like to thank you iu advance fur your cooperation and should you have any questions, please do not hesitate to give us a call. The Departmmfs address,telephdme and fax immbrr: 'the �of Ri , De (bent of 7I ed { {AnncG��ie[:dent% Ta 4 617-727-49W ad 406 or 14M-I&A-SSAFE Fax it f 17'27 7M Revised 4-24-t 7 r. Town of Barnstable Regulatory Services. KAM Richnrd V.S=H,DnwWr.. Building Division. Paul Roma,BMUMg Commissioner 200 VAk Street,Hysanis,MA 02601 www.town.barnstable.ma.us Office: 508-9624.038 Fax: 50&790-MO Property Owner Must Complete and Sign This Section If Using A Builder . u m/ h , as Owner of the subject PLOPertY hereby authorize "Butk 4 oto 1A) 409e4 tc act on ray behalf, in aIl 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 Narne Print Name 7 rk�JOL Date QF0R2AS-0WMMPERMISM0N?W S Town of Barnstable Regulatory Services dF Richard V.Scali,Director Building Division t _ Paul Roma,Building Commissioner MAM 200 Main Street, Hyannis,MA 02601 www.town.barnstable:ma.us Office: 508-862-4038 Fax: 50&790-6230 HOMEOWNER LICENSE ElI1VI MON Please Print DATE: JOB LOCATION: mumbrr sttiet village "HOMEOWNER": name home phone# woric phone# .CURRENT MAnJ NG ADDRESS: cityhown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of sic 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. DEFINMON 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 rva=ible 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 Dep minimum inspection procedures-and requirements and that he/she will comply with said procedures and requirements. Signat=of Homcowncr ' 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 EREMPnON 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 aniicensed 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 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. Q.-WPFIL.ESTORIvIM ulding permit fb=\EXPRESS.doc 0620/16 co® CERTIFICATE OF LIABILITY INSURANCE DATE /2017 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(les)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 Ileu of such endorsements. PRODUCER CONTACT Kris KO reski Mark Sylvia Insurance Agency,LLC PHONE 508 957-2125 FAx 508 957-2781 404 Main StreetE-MAIL mark marks Iviainsuranoe.com Centerville,MA 02632 INSURE 9 AFFORDING COVERAGE NAIC 0 INSURER A,Farm Family Casualty Insurance INSURED INSURER B: Michael Williams INSURERC: 692 Walnut Plain Rd Rochester,MA 02770 INSURER D: INSURER E: INSURER : COVERAGES CERTIFICATE NUMBER: 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 DL SUOR POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE POLICY NUMBER M D A COMMERCIA L AL GENERAL LIABILITY 2001X1350 1/9/2017 1/9/2018 EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE �OCCUR DAMAGE TORENTED $ 100.000 w en e MED EXP(Any oneperson) $ 5,000 PERSONAL BADVINJURY $ 1,000,000 GERL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 X POLICY❑PRO- a LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT $ OTHER: AUTOMOBILE LIABILITY (EaCO accci en SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIREDAUTOS AUTOS accident) I UMBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DIED I I RETENTION $ ER WORKERS COMPENSATION P OR AND EMPLOYERS'LIABILITY Y I N ANY PROPRIETORIPARTNERIEXECLITIVE MIA E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? (Mandatory In NH) E.L.DISEASE-EA EMPLOYE $ DESC H yes,RIPdescriTIONbe underOFOPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more apace Is required) Carpentry Insurance coverage is limited to the terms,conditions,exclusions,other limitations and endorsements. Nothing contained in the certificate of Insurance shall be deemed to have altered,waived or extended the coverage provided by the policy provisions. CERTIFICATE HOLDER CANCELLATION (508)694-2019 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL 8E DELIVERED IN Town Of Dennis ACCORDANCE WITH THE POLICY PROVISIONS. Building Department - 685 Route 134 >t,•' South Dennis,MA 02660 AUTHORIZED REPRESENTATIVE �o; ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD r Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement'iContractor Registration Type: Individual .Registration: 168313 MICHAEL WILLIAMS Expiration: 02/19/2019 692 Walnut Plain Rd j d Rochester, MA 02770 =� U • � tip' c � _ 514® Update Address and return card. Mark reason for change. SCA 1 ES 20M•05111 Cl Address D Renewal r1 F , is•Car d �e �pan�nrea�ecuealClz a��lccaaccc�uae� Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration valid for individual use only l TYPE: Individual before the expiration date. If found return to: ^° Office of Consumer Affairs and Business Regulation Registration Expiration 02/19/2019 10 Park Plaza-Suite 5170 1'68313 Boston,MA 02116 MICHAEL WILLIAMSr, ..li MICHAEL WILLIAMS _ 692 Walnut Plain!4Rd__tti�'/� Rochester,MA 02770 :y Undersecretary Not valid without signature A 5 IYIaJAal.I1GJOlW LJupa� Board of Building Regulations and Standards License: CS-101155 T Construction 6upervisor : E yy , MICHAEL A WILLIAMS � ws, 692 WALNUT PLAN RD• ' ROCHESTER MA 027704w)S �i1f Expiration: Commissioner 08/27/2018 r P TOWN OF BARNSTABLE BUILDING-PERMIT APPLICATION i r-� r Map l� Parcel f_ D o � Permit# I I�_ a�� Health Division Q6 -it$o Date Issued _913 D AL Conservation Division Application Feev Tax Collector Permit Fee '*) 19, G r7 Treasurer 0 Planning Dept. SEPTIC SYSTEM DUST BE 1,NSTALLED IN COMPLIANCE Date Definitive Plan Approved by Planning Board VATH TMI S Historic-OKH Preservation/Hyannis ENVIRONMENTAL CODE ANC TOWN REGULAI IONS Project Street Address a PI n P 1 eell- Village Owner y IG2p1S Address Telephone 6-0<rr q-119 X °- X 9 44S Permit Request t'_7 LI 6 Jp !~ pz�? Square feet: 1st floor: existing proposed 2nd floor: existing proposed 76 Total new 2 M Zoning District dy Flood Plain Groundwater Overlay Project Valuatio 0 00 Construction Type WO©c/� loro WR I& Lot Size ©2. Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family, ❑ Multi-Family(#units) Age of Existing Structure /0 .y(?4rS Historic House: ❑Yes No On Old King's Highway: ❑Yes ° No Basement Type: XFull ❑Crawl �❑Walkout ❑Other n Basement Finished Area(sq.ft.) I� Basement Unfinished Area(sq.ft) Number of Baths: Full: existing - new Half:existing t new Number of Bedrooms: existing .� new C7 Total Room Count(not including baths): existing 7 —new-- First Floor RoomFCount r co Czk Heat Type and Fuel: X Gas ❑Oil ❑Electric ❑Other - Central Air: A Yes ❑ No Fireplaces: Existing 0 kIe- New Existing wood/coa stove: 4Yes -1]-XNo Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:Cl e sting 1 new , 'r e rn 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 i BUILDER INFORMATION Name O&1-1 e (,.r/ Telephone Number Address License# Home Improvement Contractor# I Worker's Compensation# ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO DATE SIGNATURE �"' �— G�d FOR OFFICIAL USE ONLY PERMIT NO. DATE ISSUED r MAP/PARCEL NO. 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Q ,v :n .,era:, aw , , + i The Commonwealth of Massachusetts Department of Industrial Accidents Office of/osestigaGoos _ 600 Washington Street -_ Boston,Mass. 02111 .. vv Workers' Com ensation Insurance Affidavit s�� ii io ipo�aoiooi �� // name v�(avlS cSZI rY1 VVIe4g14- Q 'location 1 l oo eir PCt 7-! city phone# b-040— a`�9�✓ I am a homeowner performing all work myself. I am a sole Actor and have no one workin in ca achy %%% %///%%%/%/%%/%%%��/%%%%/%/%/O�//////%/%%%%%%%�%%%%�%////G%%/%/!////�G/%%%%/ I am an em 1 roviding workers' compensation for my employees working on this job.::: :::::.::::::::::::::::::::::Y:Y.::»>«::::::::::::::::::::: ❑ PP..............................::::::::.:::::.:.::::.::.:::::.::.:..........::::.:::.:::::::.:.:......::::::::::::::::.::.::.:. .::.:::::::.::::::::::::::.::::.....:..::::::::..::::.:...........:...:.:::::::::.:: M. :::•Y::.:.;:•Y:.:;;•YY: ' .... < :::`:.... ::::2::i:::'Y•:.a:.;5::;}2::'::; :::;:?;:::'<':::::::::2:::: ::>::::;;::::::::::::::::::•;:;: :::;;:::? :::;:::;;:::::::::::;:;:;:::::::::::;;;:i;:::::; :com an n m :> X. : . ....:. >address :.::......:::::.;...... ............. .::..Y'.::;:.::::..:..:........... <r: xx c k6n ``"all fsuranc ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contractors listed below who have thee followin workers' co ensation polices: ::.::::::::::::::.::.:::::. :::::.YY':::.::::::: ::::::;:.;:Y:.;:<:.Y:;.Y:.::.YY:.;; g rs.......mP....................:: :::::::::.::::::.:...........:.::.:::::::.::.:..........:.::.:::.::::::: .:...:::..::::.:::.:::: :.:::::.:.:...........:..:::::::.::::::::..:...........:.::::: com an n m :;:.:>YY:.;::;;.Y:;.Y;Y: ::: ::::::: :::::::..r::::.. :: ........:. are O Y b n :• £..r...... .. r........... :............: ..................................................:..... ten >�>>< ::::•::::::•::::::::::::YY>YYYYY:••Y:a;•;::::;;.;:•YYY:;.::<•Y:-Yo-:::•::oYY>a:•:;Y::.Y::r:.YYYYYr: .. ..................:__:.:....:............�. .:::::::.-:::::.::.::::::::r•.::w:.Y:aY:oaJ:::::s ?;}:j;:::)iiiiii:^iii:•'i::`i:^:i:1........ .:T r. ;::.}::::{r:;:is r::•:n:;;:._::.};.::::::v..:............:..........:.." .:::::.r::::::v::::::::::::v:::. .................... ..... ..... .::..:::....:r.r:.rn:.:::v...::::::::::..�:::nr::v..::::::.:.r.::::::::::.:::::.,:�'..............:............:......::........................................... ri::rr'ii:r'•:ii�i:' ................:::v.�::•:::.r::v:::::::.:Y:•Y::•::^Yi:•Y::vYiiiiY}::i6Y:iY:4YY}.YY};. :•:::::::v::::::•:::::.�::`��:::::'.'::::::.'::::::::::::::::::.::•..:::::::•::::..:::vr: .. ..... ...... ..:........:..:w.:�::::;w.:................................:...:v:.r:w::::::.r.r:..:i?:J:4Y::•ii:...:...n•: ........rY.3:3.r. ... +'•. r..... ......... ........... .............. ...........................n..........:.::v:....................:::::•::•.i:tit::y.'Y:^:!ir:•:;:::-.�:::w::.r:::::.;v::.;•n+w::::r::.r:..'::::......,r:FYw.C�J.SY.JtiIf•:3Y:^:x::: .nn.......w:.r.�:::::.....r....n...:•::.«:tw:...............••::::v:::::.::::....................::..-:::.t:w::x•.:......;........•-.�•:::.r.: ;:#.;::i:;:;:ii;::;:j;i:}Gjii Div�::::::L{:$::::•::::::i::i:.>.:::::::!:'i;isi::L;Y:::isj:ii:::::?.:L-:-:•::4Y:'i:v.:%:iiiiiiii�:i:i� e an :;;::::;::>::>;:>:;:::<::::::<> ::::::>::>?:.............................. .... ... .. .. `adtEr :>:>:<:::»»>:<:><>':>Y:.Y:.YYY:•;YY;::::;;;•Y:•::.;:.:::::.::.:;:.:•YY;:.;:;•;Y:-;:.:<.::.:::..: ;::.::::;:.Y:.;:•::::....;::.:;::::: .:::.;Y:.Y:::.Y;:.Y•Y::.;:.:.::::.Y:.::::;::.: NX XX ... ............... .............:.::::.:::.::::: .Y::•Y:: :•::.::::.:;::..,•:;:;;•YY:;•YYYYY:.Y;:-;::•;;:;Y::.;YY:.;YYYY:.Y:.Y;:.:�:•Y;:.Y;:�:::::::..;•YY:�:;;•:;,•.:Y:•:•.a.-:.......:.: Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of fine up to S1,S00.00 and/or one year's'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of$100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature Date IN Print name �Q�S �/'Yl Piy GI V Phone# • ofticid use only do not write in this area to be completed by city or town official city or town: permit/license# ❑Bufiding Department ❑Licensing Board ❑checkif immediate response is required ❑Selectmen's Office ❑Health Department contact person: phone#; ❑Other (cued 9/95 PIA) ' T Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the"law", an employee is defined as every person in the service of another under any contract oral or written. of hire, express or implied, � . •� . . � :�`:, ., ;+` { -,rs 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, employnig employees`However'tlie�owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally,neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely,by checking the box that applies to your situation and company names, address and phone numbers along with a certificate of insurance as all affidavits may e supplying mP Y ky submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and 3= 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. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the pennit(license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions. please do not hesitate,to give us a call. l j The Department's address,telephone and number: The Commonwealth Of Massachusetts Department of Industrial Accidents once of IovesUgatfoas 600 Washington Street Boston, Ma. 02111 fax#: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 I _ °FIME 4 Town of Barnstable Regulatory Services BARNSTABM " Thomas F.Geiler,Director 9 MAW g 1 3 `° Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. o /�• , )0 Estimated Cost 00000, —' Type of Work: �-�h/ f Y t'1 Address of Work: 1,5" f 1 oyiep-r yV , West gat'P71 bZ 0?/b6� Owner's Name: cJ41 Date of Application: J 2 0— 03 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 ❑Building not owner-occupied NOwner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. �aylsR�zi��'g� Date Owner's Name Q:f mwhomeaffidav Tia CM%App-d z I 'table J3.2.Ib(eontlaned) With Fossr7 Fuels tl preriptiye psekagd for On,ucd Txo-Fsmily Rrsidentisl Enildtags Sam ' 14SIlYYMU'141 MA}CfMUM Floor Bssern� Stab Hcaing/Cooling Glaring Glaring Ceiling Weli + -y paimeus Equipment EtFeiesey' Area'(IN U-valusa R-valuca R-value A-value R yalu ' R-��l package 3701 to 6500 Resting D_ Days' IO 6 Naraul 12'/1 0.40 3E 13 19 6 Narmal g12'/. 0SZ 30 I9 19 10 6 ES AfVE g 1Z'/. 0.50 3E 13 19 10A Normal 15% 036 3E 13 Z5 N/A B Normal T 19 19 10 U 13VA 0.46 38 N/A 15 AFUE 15'/. 0.44 38 13 ZS NIA ti 11 AFUE V 30 19 19 10 qr 15% 0.52 N/A No=al 19% 0.32 3E S3 15 NIA N/A Nomial L,AkA • 0.42 3E 19 ?S N/A 6 90 AFUE 18/. 0.4Z 3E 13 19 10 6 90.AFUS 30 19 14 10 18% QSO 1. ADDRESS OF PROPERTY: 2. SQUARE FOOTAGE OF ALL EXTERIOR WALLS: use g SQUARE FOOTAGE OF-ALL GLAZING: Wffs 4, o/a GLAZING AREA(93 DIVIDED BY#2): 5, SELECT PACKAGE(Q•-AA-see chart above): �m e OF eu i Icl�'/��/ DETERMINING ENE REQUIREMENTS NOTE: OTHER MORE INVOALSVEU METHODS OF OR THIS INFORMA � ARE AVAILABLE. BUILDING INSPECTOR APPROVAL: YES; N0: I q•forms-M0303 a 780 CMR Appendix J Footnotes to Table J$.2.Ib: lass doors, skylights, and Glazing area is the ratio of the area of the glazing assemblies ('including sliding-g basement windows if located in walls that enclose conditioned space, but excluding opaque doors) to the gross wall area, expressed as a percentage. Up to 1%.of the total glazing area may be excluded from the U-value requirement. For example,3 ft=of decorative glass may be excluded from a building design with 300 ft of glazing area. 2 After January"1, 1999, glazing U-valucs must be tested and documented by the manufacturer in accordance with the National Fenestration Rating Council (NFRC) test procedure, or taken from Table 11.5.3a. U-values are for whole units: center-of-glass U-values cannot be used. The ceiling•R-values do not assume a raised or oversized Truss construction. If the insulation achieves the full insulation.thickness over the exterior walls mwithout R�9 compression, Ceiling R values represent the sst lum of cavity insulation and R-38 insulation may be su insulation plus insulating sheathing (if used). For ventilated ceilings, insulating sheathing must be placed between the conditioned space and the ventilated portion of the roof. 4 wall R-values represent the sum.of the wall cavity insulation plus insulating sheathing (if used). Do not include exterior siding, structural sheathing, and interior drywall.For example, an R 19 requirement could be met EITHER by R-19 cavity insulation OR R-13 cavity insulation plus R-6insulating Ism °onstructioa'Wall requirements Ply to wood-frame or mass(concrete,masonry, log)wall constructions, apply to s The floor requirements apply to floors over unconditioned spaces(such as unconditioned crawlspaces, basements, or garages).Floors over outside air must meet the ceiling requirements. de must The entire opaque portion of any individual basement wall with an average depth less than 5doorseof clow onditioned meet the same R-value requirement otha ovel3asement doorssmust meet door U-value requirement basements must be included with theglazing. dt-scribed in Note b. -The R_value requirements are for unheated slabs.Add an additional R-2 for heated slabs. ' If the building utilizes ele6tric resistance heating use compliance approach 3;4, or 5. If you plan to install more than one piece of heating equipment or more than one pieta of cooling equipment, the equipment with the lowest efficiency rnust meet or exceed the efficiency required by the selected package. 'For Heating Degree Day requirements of the closest city or town see•Table 15.2.1a NOTES: a) Glazing areas and U-values are maximum acceptable levels. Insulation R-values are minimum acceptable leve s. R-value requirements are for insulation only and do not include structural components. b) Opaque doors in the building envelope must have a U-value no greater than 0.35.Door U-values must be tested and documented by the manufacturer in accordance with the NFRC test procedure or taken from the door U-value in Table 11.5.3b.If a door contains glass and an aggregate U-value rating for that door is not available, include the glass area of the door with your windows and use the opaque door U-value to determine compliance of the door. One door may be excluded from this requirement(i.e.,may have a U-value greater than 0.35). c)If a ceiling,wall,floor,basement wall,slab-edge, or crawl space wall component includes two or more areas with different insulation levels,the component complies if the °doorarea-weighted components t come R-if the area-weighted value is averager than or l to U- the R-value requirement for that component. Glazing PY value of all windows or doors is less than or equal to the U-value requirement(0.35 for doors). RE,5IDENTIAI, BUILDING PERMIT FEES APPLICATION FEE New Buildings,Additions $50.00 Alterations/Renovations $25.00 Building Permit Amendment $25.00 I FEE VALUE WORKSHEET NEW LIVING SPACE square feet x$96/sq.foot= x.0031= plus from below(if applicable) ALTERATIONS/RENOVATIONS OF EXISTING SPACES —7o 4 y5 square feet x$64/sq.foot= x.0031= plus from below(if applicable) , ACCESSORY STRUCTURE>120 sq.f� , >120 sf-500 sf $35.00 >500 sf-750 sf 50.00 >750 sf- 1000 sf 75.00 >1000 sf-1500 sf 100.00 . >1500 sf-Same as new building permit: square feet x$96/sq.foot= x.0031= STAND ALONE PERMITS Open Porch x$30.00= (number) Deck x$30.00= (number) Fireplace/Chimney x$25.00= (number) Inground Swimming Pool $60.00 Above Ground Swimming Pool $25.00 Relocation/Moving $150.00 (plus above if applicable) Permit Fee 1�j 3 9. 10-2 proicost Town of Barnstable t)FTHE r� ' Regulatory Services snxtvsT"L& : Thomas F.Geiler,Director MAM 1639. .m Building Division AjEp�,ta Tom Perry,Building Commissioner 200 Main Street,`Hyannis,MA 02601 Office: 508-8624038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: ``7. �o 3 JOB LOCATION:. , i�' � '" an �V ,Ob Vc�/60P number street village • "HOMEOWNER": I �QPZS c1 tom) V7-7aa (1 cl TES name home p �hone# work phone# CURRENT MAILING ADDRESS: i ;J D V Cs 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 ... - minimt,m inspection procedures and requirements and that he/she will comply with said procedures and requ e 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:forms:homeexempt r Town of Barnstable *Permit# D Expires 6 mo orte i 1 date Regulatory Services Fee `�1 -1 • snxxsTasie. • 1 `0$ Richard V.Scali,Director171 Building Division Tom Perry,CBO,Building Commissioner JUN 15 2015 200 Main Street,Hyannis,MA 02601 www.town.bamstable.ma.us TOW IV Iv OF BAR r� �1 � Office: 508-862-4038 hax: 50�8-7.90-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY Not Valid without Red X-Press Imprint Map/parcel Number kloo01 005 Property Address ❑R sidential Value of Work$ q Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �N�� } � "lLXOIJ A s A6cil Contractor's NameDLa.Je� Telephone Number c'--pF� 5p 9. k4bt4 O Home Improvement Contractor License#(if applicable) 112F5[S Email: L�Et_t-y200�'i�tJG t Cc.�u� Construction Supervisor's License#(if applicable) �l 7 ❑Workman's Compensation Insurance Check one: ❑ I am a sole proprietor WIam the Homeowner have Worker's Compensation Insurance Insurance Company Name WUg ' Workman's Comp. Policy# 11 L E C) 120 Copy of Insurance Compliance Certificate must accompany each permit. Permit Req t(check box) / [V Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑.Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. "Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 'Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvem t Contractors License&Construction Supervisors License is required. SIGNATUR9;C N�� L--)— Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 � t .HA MT .'ig�saf�r, r,�n # r -1 ��P,zf�� r� R � ,�ra�.r„� ,� Applicant Ifmnnafim Pi Dame JUzu Area an oppIayer7 Cfiz&ffi� Ijtc bt= I am a e�piaperr vzi$t _ 4-❑ I miia V=MZI=3h=t=aad I e�plrspe�s{€all ane�* 1ave f'e ❑ Z❑ I am a sole grog orparh2er- listed on fhe wed sheet; 7- ❑wing slag znd here no emplayees Them zs have $- ❑ euplap andhavetvnfi=- • �asrlaag fnrmr`in any�g $ Q_ El�mg addt�n INCH'� ,tomrMoce COmP I S_ ❑ We are a curpoustiomaad its M-0 -p-im of additions affi=have�*=Cd$ 3_❑ 2 moo.a homes doiag allwork I1=.❑PlamT�mg apffirs or moons =T-ffI£INo"tvcd='oomg_ zit of==Puciaper hfm Mpaim $naf fi=MM ff rap ire1j•T c- §I(4�ad we base nD camp- rMFirM&I *dap i¢zp��acbea�sbozal�sta}sa SIIoet��eahrTo•�t��ffi�wat�srmpc�-dim. . u�Subn&_J&�:. &y MM =►r--WM MbaE CM3tMr= suhC3rsaeS7-ziHaaarmo a� t-'F,,-3cthig baXma•# d�a-��;fr,,7 s�eeq then�ueaf f s a z ecsmrS� 5s� ez!;lcpers_ Ift'hz mb-c h.-m emmAo eel dLeg Fmuide 9t& 'aamg.pa�tp aambe� ' ;- �tua-rrxe• im¢isgrn•r?iditrgtrat�s'eutt fa{-rs�ets�t�y�ss �dvty is 8iep��mid je6� . InsuEarnr Gampany P,SLT##co:Slf-inr,Zio Tob�ae.fl.dn`r�_ Aitarh z copy a:f fIn wuzkcre mm3:pm a•[irm palrcg deffi=QU IZgC.( $ffi'C P6H3'der xnE cqa-.dioa&s6): Fax)re to 4��cmm ap a&repiLr umler Sactmrz SA of MM c- 152 cza lead to tdre impos:hi=n rcrimi al pcml1im of a free vg to S LUD GD aud/ar onr<yearim as wen ax cirsl penalfia in the fixi�of a S`��7F A�C3R�OPDF�and s fine &.u•to$250JM a day apinst fe viDbdxw_ Be advised t9 a copy of this shdmm maybe ftwn dod to the Grp of T of The DTA thr msm==caverags F cta F Srebr E Er+ $suernraiDu pravids a�ev�is h�ra card'c�sct ac E uw a* Do-twt wri riff 9r area,At bar cavqffzW by cdy or hmn z f ciuL C`y ar Totem m-ensc Ll�oarda€HcaFtlt�. g �t�{Fa�eaGIslz ��Iedricalr �.Pfm�mglfr�r i&Ass:a� �ChnenI Laws •152 regr=all=4Aq=to rmnlde wris'oxaap Dn fbr ih==3PIr7ees'- p.rsamEt-tD 7ft f stzbzb�,an mrp£ayer .is defined as -v�aY P�aa is the sxa�ice of a� mi my Fart gfhrre, � e_qX=or implied, oral 01 An ark tryF�-is deed as�n individual,pare ascian,corpora or her Icaai e�iiy,or any twoor mnre ofthe ihregaing e�gagEd m aJo>nt and of a deed employer;-es the receives or tras=of an indiviciml,parhneahip,assoaLation or ofber legal eadfy,employing cmPlnS'et=- However the owner of a dvnMnglrDuss havrngnntmnre than th=apar m and who r=des$mein,or$e occupant of the hDtzse of another wbD employs peascs to do construction or repair work on such dwetiing house or on ffic;grounds or building agpm t mait f crez shall not b- e-of such mop Dyment be dewed to be-an mnploy er." MCM c mpt Ez 152, §25CCt7 also stairs tbet'every state or local licensing agency slraII wrtblrold the issaanee or renewal of a use or pennit to operate a business or to coustracf bmadmgs in the cnmmoawC-2lth for arty applicant who has not ptodgcced acceptable evidence of coinpliance with ffie insm-mm coverage regmi e-&- Additionally,MCA, chapter 152,§25Cm staffs im at commonwealth nor aay of itspoh cal nL&vrsro= shall e-In info any Caeta.at fnr the peke of pnbrm wcak=trl acceptable evidence of compliance with the;n�ce mclmrmnem_s of tilts chaptm have been p==otDd to fbe contmctmg autbority.� Apprrca nts Please f�71 orsf 1ffie WCa1-as'compensafi0 m affidavit completely,by child g the boxes that apply to your sifnztion and,if nece$sary, supply sub-conbednr(s)name{5).add-�s(es)a�Pl�e mmmbcr(s)along with thra=-LLiners).of ;,,.gym ance_ j�ited I iably Campamts(LLC)or LmmiLiabil>iy Parinerships(LT P)vti$Lno employees other man the member or partners,are notregnbnd to c any wui:l-='compens-ston n sammce If an LLC or LLP does have employees;EL policy is reguired_ Bo advised that fbis affidavit be submitiEd in the.Department o-1 Industrial Accidents for confirmation ofi Wince oovesage` Also be sure to sign and date the affidavit The affidavit should be retrmmed to the city or tuw that thD application fvr the pc mk or license is being raq=tr:d,not tire,Deport n ent of Tnd:cstrra1 Accidents. Should you have any gnesfions reo rd"ura ifie law or you are:regeired to obtain a.v*orl ers' compensation policy,please call the Deparfinenot atthe rmmber lisl d below. Self-insured companies should eater their self-;rem-ance license numbs on fhe.approprizfn line City or Town Officials ` Please be sure the affidavit is caplet m and legibly_ The,Department'has provided a space atthe best n fur you fn fill out in the ev-eat the,Office ofhRmligsiinris has to contact regarding the applicant " of the affidavit Please be s'me to fM.ia the pamit ct=m-rrnbeza which will be used as a refrrmce n=ber. Ia addition,an spplit?n . that must sob=if multiple pen�itlrceose applizations is any given year,need only submit one affidavit indicating mnreat policy info�tion Cifn=:ssary)and under'7ob Site A.ddrzss"fhc applicant should write'all locations in (city or t owa)n A copy of the affidavit that has been officially stamped Dr marTmd.by$e r_47 or gown may be provided to the applicant as proof that a valid affidavit is an file for future peamits or liee;nsm knew affidavit must be filled out each year.Where a home owner or citizra is obtaining a license Or permit not relatad to'any business or commercial vCztrae CL e,a dDg)ic:=se or permit to brmm leaves etc.)said person is NOT mquiEixi to campletn this affidavit The Office of brvesfigafions would lice to thank you in.advance ffr-yoIIr cooperation and sbDuld yDu have any questions, please do not hesi at to give us a call T4.e Departmrofs adds,frlephons end fHxnrmbes: as Atli of IaGhvs TOL.t%61T7274 Qxt4.66 Qz I 477 MAZEAFE F=*6I7-`27 7749� Rovised 4-24-D7 _ � � CERTIFICATE OF LIABILITY INSURANCE DATE 5r2gDD/YYYY) TWLSX"TIFICATE 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 O PRODUCER. ND THE CERTIFICATE OL E R. MPORTANT:If the certificate holder is an ADDITIONAL INSURED,the policy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require and endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER CONTACT NAME: DOWLING&ONEIL INS PHONE FAX 973 IYANNOUGH RD (AIC,No,EIQ): (A/C,No): E-IVIAIL HYANNIS,MA 02601 ADDRESS: 22LGR INSURER(S)AFFORDING COVERAGE NAIC# INSURED INSURER A: ACE AMERICAN INSURANCE COMPANY KELLY ROOFING INC INSURER B: INSURER C: INSURER D: 8 RHINE ROAD INSURER E: YARMOUTHPORT,MA 02675 INSURER F: COVERAGES CERTIFICATE NUMBER: 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 SHOW)MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADD SUB POLICY EFF DATE POLICY EXP DATE LTR TYPE OF INSURANCE L R POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) LIMITS GENERAL LIABILITY CH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY AMAGE TO RENTED $ CLAIMS MADE OCCUR. REMISES(Ea occurrence) ED EXP(Any one person) $ ERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: ENERAL AGGREGATE $ POLICY PROJECT LOC RODUCTS-COMP/OP AGG $ AUTOMOBILE LIABILITY COMBINED SINGLE $ ANY AUTO LIMIT(Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULE AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNEDAUTOS PROPERTY DAMAGE $ (Per accident) UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ A WORKER'S COMPENSATION AND WC ST=OTHER EMPLOYER'S LIABILITY YIN UB-2E901371-15 05/062015 05/062016 X LIMITS ANY PROPER ITORiPARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ 500,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 500,000 D DESCRIPTION OF OPERATIONS!LOCATIONSIVEHICLESIRESTRICTIONSISPECIAL ITEMS THIS REPLACES ANY PRIOR CERTIFICATE ISSUED TO THE CERTIFICATE HOLDER AFFECTING WORKERS COMP COVERAGE. CERTIFICATE HOLDER CANCELLATION TOWN OR BARNSTABLE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED 200 MAIN STREET BEFORE THE EXPIRATION DATE THEREOF,NOTICE WILL B DELI D IN ACCORDANCE WITH THE POLICY PRO AUTHORIZED REPRESENTATIVE HYANNIS,MA 02601 ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD 1988-2010 ACORD CORP r g s reserved. r Massacliusett*-Department of Public Safety —� l3oar4-of Building•Reg-ulations and Standards •;icense: CSSL-099167 • OLIVEO-M KELLY • 8 RffiNE ROAD-2 u s a 1(armouth Port MA 024? Expiration - • Commissioner 09/28/2015 Office of Consumer Affairs and Business Regulation 10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration Registration: 128957 Type: Individual Expiration: 6/14/2017 Tr# 266936 Oliver Kelly Oliver Kelly 8 Rhine Rd Yarmouthport, MA 02675 Update Address and return card.Mark reason for change. sCA1 G 20M-05111 ❑ Address Renewal Employment Lost Card - Office of Consumer Affairs&Business Regulation License or registration valid for individul use only _ -BIOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 128957 Type: Office of Consumer Affairs and Business Regulation - :Expiration:;._6/1.4/2017 Individual 10 Park Plaza-Suite 5170 -"` Boston,MA 02116 Oliver Kelly Oliver Kelly 8 Rhine Rd. Yarmouthport,MA 02675 Undersecretary Not valid without signature KELLY ROOFING INC. MA CSL #99167 PH 508 509 4640 8 RHINE ROAD. MA HIC #128957 YARMOUTHPORT MA 02675 kellyroofing@icloud.com May 14' 2015 Proposal submitted to Andora Hamilton of 5 Pioneer Path West Barnstable MA We propose to supply all materials and labor necessary to remove and replace the existing roof at the address above All debris to be removed to town transfer. 8" White Aluminum drip edge to be installed on all eaves. Ice and water damage protection membrane to be installed on the first three feet of eaves in all valley areas and around all protrusions. Remainder of deck to be covered with #15 Felt Paper. Lifetime limited warranty Architect style shingle to be installed, (Color to be specified) All shingles to be storm nailed. (6) Bathroom vent pipe boots to be replaced with new. Repair/Replace all flashings as necessary. Install Shingle Vent II Ridge vent on all ridges with Hand Nailed Caps. Protect all walls, windows, decks, plants, shrubs, etc. during roof strip. Complete cleanup of area during and after procedure including all nails and cleaning of gutters. Obtaining of Town Permit. At a Total Cost of $9,900 Payment schedule: 50% due at project start, balance upon completion. Respectfully Submitted, Oliver Kelly. Proposal accepted by; /2015` ✓�( GZG� ��'!�/'� Date l� l � y If acceptable please sign and remit one copy to the address above, keeping a copy for your records, this proposal is valid for 45 days from date above, please call to verify thereafter. YOU WISH TO OPEN A BUSINESS? 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. s; ,, Y._. y_ DATE: Z3 7 Fill in please: `aI'MMAflq APPLICANT'S YOURNAME/S:_ P A de sGn rtY BUSINIESS YOUR HOME ADDRESS: $, :e TELEPHONE # Home Telephone Number 7e 3 - e 7 r; . NAME OF CORPORATION: NAME OF NEW BUSINESS Y 1VQ 7r-,C.Tk: TYPE OF BUSINESS %rrwc.C�.�N a IS THIS A HOME OCCUPATION? V YES NO ADDRESS OF BUSINESS M. MAP/PARCEL NUMBER �a�Q` 7 DZ S (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 20D 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 CO ISSIO ER'S OFFICE MUST COMPLY WITH HOME OCCUPATION This individ al ha e i of nd;irefiremen that pertain to this type of businesAULES AND REGULATIONS. FAILURE TO 1, oriz Sin COMPLY MAY RESULT IN FINES. MMENTSC&04./1_) 2. BOARD OF EALTH This individual has been informed of the permit requirements that pertain to this type of business. 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: Town of Barnstable Regulatory Services pZHE TpjY o Richard V. Scali,Director • - Building Division RAMSMAEM MABISL� Paul Roma,Building Commissioner Eo s�� 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us' Office: 508-862-403 8 Fax:. 508-790-6230 Approved: Fee: �5- Permit#: 0-17 HOME OCCUPATION REGISTRATION Date: I Name: ��'� Phone#77 ,? 0—I.-2 7 R Address: PiOlnel<- - /c..'T� Village: [N• tUGoir3Tc,b�i� C Name of Business: f 114 o / rry&o"+y+ 1 Type of Business: I Cur.,G-•w Map/Lot: INTENT: It is the intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling. there shall be no increase in noise or odor;no visual yam` alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal Z residential volumes;and no increase in air or groundwater pollution. N 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 involverhe 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 parking 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,have eau and a e with the above restrictions for my home occupation I am registering. Applicant: ( Date: '-h / Homeoc.doc Rev.06/20/16 PARKING SPACE LEASE AGREEMENT as Lessor, does hereby agree to let to 9-uI , as Lessee, a parking space located at 69-ol f&p1e+&s (�JG Y (Building/Street Address) Y ) -5\-vr, (City), - kod (State) , such parking space being further described Parking Space No. j at the aforementioned location. The following terms and conditions shall apply to this Parking Space Lease Agreement ("Agreement"): Terms and Conditions: 1. Items Left in Vehicle. Lessor shall not be responsible for damage or loss to possessions or items left in Lessee's vehicle. 2. Damage to Vehicle. Lessor shall not be responsible for damage to Lessee's vehicle, whether or not such damage is caused by other vehicle(s) or person(s) in the parking lot and surrounding area. 3. Parking Lot Attendants. Lessor (_j shall U shall not (_) may provide parking lot attendants. In the event that Lessor provides such attendants, any use of such attendant by Lessee to park or drive Lessee's vehicle shall be at Lessee's request, direction and sole risk of any resulting loss and Lessee shall indemnify Lessor for any loss resulting from such use. 4. Payments by Lessee. Lessee agrees to pay $ 00 per (week,(mon or other term) for the lease of the aforementioned parking space. Lessee is to make such leasehold payment=(to Lessor or Lessor's Agent) in person (or by mail) at 69-1 Wj'colc'f°�-% W,--r M,sli!- MA address. Payments shall be made in advance by Lessee on (the first Monday of each week, the first of each month, or other agreed date). 5. Receipts by Lessor. Lessor agrees to provide a receipt to Lessee for each payment received. Such receipt shall show the amount paid and number of the leased parking space. 6. Termination. Either party may terminate this Agreement by providing ( 7 days/30 days/or other time period) written notice to the other party. Any such notice shall be directed to a party at the party's address as listed below in this Agreement. EXECIJTED�ND AGREED by the parties hereto th's a 23 day of.Fib:vx.,,,y, 201`7 . Lessor Lessee MO Lessor's Address Lessee's Address 1VI*S Page 1 of 3 Listing Summary Listing#20702690 5 Pioneer, West Barnstable, MA 02668 Active (03/10/07) DOM/CDOM:25/0 $575,000 (LP) Beds: 3 Baths: 4 (3 1) (FH) Sq Ft: 3000 Lot Sz: 44431 sgft* Town: Barn Yr: 1992" Remarks Picture�� ***Owners looking to downsize to W Barn. M.Mills area-possible home trade?***This home has MANY ' possibilities! Garage space enough , for 5 cars,and a huge bonus room u , above garage. Features include: ` updated kitchen/stainless appliances, re-finished wood floors, new carpet, children's suite with huge playroom, 2 bedrooms and a full bath on the second floor, partially finished P Y Additional Pictures e9a Pictures(13j _Attached Docs _ _ See_Maa Agent u Amy Massey-Weider (ID:U1116)Priniary:508-801-0402 Office Century 21 Shoreland R E(I1):C2ISHR)Phone:508-771-2008,FAX:508-778-2423 Property Type Single Family Property Subtype(s) Single.Family Status Active(03/10/07) Town Barnstable Commission Sub Agent Comm., Buyer Agent Comm. Dual Agent Comm. Dual Var Comm %2.5' %2.5 %2.5 No Facilitator Comm Listing Type. Excl:Right to Sell Owner Name Jason Sanders County. Barnstable Tax ID 128-17-0-5-BARN Beds 3 Baths (FH) 4(3 1) Structure(approx sq ft) 3000 Sq Ft Source Agent Estimated Lot Sq Ft(approx) 44431* Lot Acres(approx) 1.020 Lot Size Source (Assessors Records) Year Built 1992' Rubhsfi`,Tointernet Yes Listing Date,.�03/10/07 All Office Remarks Please tell clients that sellers will negotiate painting allowance for the exterior of the home.Drain and stone will be put in lower driveway.Landscape will be completed to left of 3 car garage.New countertops to be installed.Master bath mirror and desk in basement do not convey.Please call Tina(agent/owner)at 508-221-1265 for showings. Directions To Property' Exit 5 towards Race Lane,bear left at fork onto Osterville-W.Barnstable Road,2nd road on left,#5 on the corner. Listing Page Commission-Other %2.5 Showing Instruct ions _Appointment Req.,Call Listing Office,Yard Sign hap://ccimis:rap`mis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 4/4/2007 Mis Page 2 of 3 General Page Zoning RF Year Built Desc. Actual Total Rooms 8 Total Levels 1.5 Basement Baths 0.0 Level 1 Baths 2.0 Level 2 Baths 2.0 Level 3 Baths 0.0 Basement Yes Basement Description Finished,Full,Garage Access,Interior Access Foundation Concrete,Poured Foundation Width 50 Foundation Depth 26 Fndation Wing Width 0 Fndation Wing Depth 0 Irregular Yes Lot Depth 0 Lot Width 0 Topography/Lot Desc. Cleared,Corner,Level Association No Annual Assoc.Fee 0 Assoc.Fee Year 0 Garage Yes #of Cars 5 Garage Description Attached,Direct Entry,Door Opener,Under Parking Description Paved Driveway,Stone/Gravel Year Round Yes Separate Living Qtrs No Waterfront No Water View No Convenient To Conservation Area,Golf Course,Horse Trail,House of Worship,Major Highway,Marina,School, Shopping Miles to Beach 1 to 2 Beach Description None Beach Ownership None Street Description Dead End Street,Paved Interior Page Fireplace Yes Number of Fireplaces 1 Master Bedroom OxO Level:First Floor Mstr Bdrm Features Closet,Deck,HU Cable TV,Private Master Bath,Sliding Door,Wall to Wall Carpet Bedroom#2 OxO Level:Second Floor Bedroom#2 Features Closet,Private Master Bath,Wall to Wall Carpet Bedroom#3 Features Closet,Wall to Wall Carpet Foyer OxO Level:First Floor Laundry Room OxO Level:First Floor Living/Dining Combo No Living Room Features Bow/Bay Windows,Wood Floor Dining Room OxO Level:First Floor Dining Room Features Deck,French/Patio Door,Gas Fireplace,Wood Floor Kitchen/Dining Combo Yes Kitchen OxO Level:First Floor Kitchen Features Laundry Area,Other,Upgraded Countertops Family Room OxO Level:Second Floor Family Room Features Closet,HU Cable TV,Skylight,Wall to Wall Carpet Other Room 1 OxO Level:Second Floor Other Rm 1 Features Closet,HU Cable TV,Private Master Bath,Walk in Closet,Wall to Wall Carpet Other Room 2 OxO Level:Basement Other Room 2 Type Home Office Other Rm 2 Features Wall to Wall Carpet Appliances Central Vac,Dishwasher,Dryer-Electric,Range-Gas,Refrigerator,Washer http://ccimis.rapmis.com/scripts/mgrgispi.dll?APPNAME=Capecod&PRGNAME= 4/4/2007 mj�S Page 3 of 3 Floors Hardwood,Tile,Vinyl,Wall to Wall Carpet Features HU Cable TV,Dry/HU-E,HU Washer I.-Interior ---— —.�_....._... .—__ .... ..__ _._.... ._..._..._........-....._.....— __..... ---_-.....................__.................:__-.._.-............_...__--.--..........--.. — Exterior Style Cape Pool No Dock No Exterior Features Deck,Exterior Lighting,Prof.Landscaping,Undergroud Sprklr,Yard Roof Description Asphalt Siding Description Clapboard,Shingle -...............--__-. __------ _._..._____ ._._..._......_______.._......___._.._...-......_...._._.__------_...____..........._......_ Mechanical Heating/Cooling 2 Zone Heat,AC Central,Natural Gas,Hot Air . Water/Sewer/Utility Cable,Private Water,Septic,Electricity,Gas Hot Water/Water Heat Natural Gas,Tank Legal/Tax Annual Tax 3416 Tax Year 2006 Land Assessments 0 Improvement Asmt 341000 Other Assessments 0 Total Assessments 341000 Annual Betterment 0.00 Unpaid Betterment 0.00 To Be Assessed Unknown Mass Use Code 101-Single Family Title Reference-Book C#171417 Title Reference-Page 0 Land Court Cert# 0 Underground Fuel Tnk Unknown Lead Paint Unknown Flood Zone Unknown Denotes information autofilled from tax records. Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple Listing Service, Inc.All rights reserved Copyright©2007 Rapattoni Corporation.All rights reserved. http://ccimis.raprnls.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 4/4/2007 1 o r - t I L i •,y �S i _ - I �, '' � � � �,! i � p `�l ^�I I V �1/ II i MILS Page 1 of 4 Picture Gallery — Listing #20702690 � r ]r I �! Dining area overlooking backyard i Y _ Dining/sitting area combo �f Kitchen http://cc iml s.rapml s.com/scripts/mgrgi spi.dll?APPNAME=Capecod&PRGNAME=MLSPic... 4/4/2007 4 � V -elf Living room Living room w i 7 awn %Ml C �1•,L Master bedroom i i MLS Page 3 of 4 I--le >� Master bathroom i r'a � Upstairs family room/playroom Basement Home Office/Den Bonus room above garage a I f http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME=MLSPic... 4/4/2007 MLS Page 4 of 4 Bedroom 2 y Information has not been verified,is not guaranteed,and is subject to change.Copyright 2006 Cape Cod&Islands Multiple Listing Service, Inc.All rights reserved Copyright 02007 Rapattoni Corporation.All rights reserved. http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME=MLSPic... 4/4/2007 eob Ti li��y� 5y5 IMPORTANT MESSAGE FOR A.M. DAT TIME P.M. , OF PHONE/ CELL TELEPHONED PLEASE CALL CAME TO SEE YOU WILL CALLAGAIN WANTS TO SEE YOU RUSH RETURNED YOUR CALL SPECIAL ATTENTION MESSAGE g le,�.� PCs •'.T�� 1 s ku i&fi SIGNED ` 5 Pioneer Path, West Barnstable MA - Trulia Page 1 of 6 Sg4,900nt 59Mc*erwwhaves"aMgfablE:,iMt A?®2669 * S.,E mY Uttin s x�ofession I�ontactv►�I�ite 02668 0 SAVED ♦ Sign In See similar homes For Sale/Re sale 5 Pioneer Path $424,900 Ask a local agent about this property. West Barnstable,MA 02668 $2,169/mo J Mortgage Center ® p�l�y id 2 Deborah Huntley 3 bed,4 full bath,2,677 sgft iMiEl!�ZA1 PRO (508)570-2603 Single-Family Home ® Id 0 Larry Priore LISTING (508)432-6600 AGENT �� ( I * Save I Ib Like x Hide V I Get My Credit Score I Get Prequalified� ® tb 0 Priscilla Stolba Real E... l__ l— PRO (508)591-8700 S Photos(1 of 35) 0 Map — —--Broker:Coldwell Banker Murray R E � Ib 2 Nancy Muccini ® — (508)213-4803 I a I Email 1 py � rt i HI,I found this listing on Trulia and would like A tar, to learn more about 5 Pioneer Path,West ! v 4 Barnstable MA02668.Than kyou. Contact Agent } By sending you agree to Trulia's Terms of Use 8 Privacy Poky. " Lake Michigan Homes For Sal i i i f r 1 ' a -"`"""' r u l ' I Search Homes for Sale Along West Michigan w ' The Andrea Crossman Group zr9$3i:1 �r +3, n __............. _... .-------- 'Needed CDL-A, rivers to run CITR Experian:Credit Report 8 Score$1 's Ir Listing Details for 5 Pioneer Path " '�,. ___ —.— —,__—___�. ___—____.... .�____.--._—_�__.� �--- `..� is '� � .�� T�.��• 180+Days on Trulia 1,503 views 1a=tom_ App1y z Now. � t� Home for sale in West Barnstable,MA 424,900t Provided by:Coldwell Banker Murray R E USD ?,. via Point2 J0 5 Pioneer Path BACK ON THE MARKET!!Location, Broker:Coldwell Banker Murray R E Location,Property is Listed for Sale FOR QUICK SALE, Listing Agent:Larry Priore West Barnstable,Just a few miles down the road to Homes you might like... Alert l Sandy Neck Beach in one direction and golf, i Write a personal note about this listing shopping,schools,medical facilities close by.This home 1529 Race Ln,Barnstable MA shows pride in home ownership throughout.Features -- ——� $349,000 include Master bedroom 1st floor possible.2nd floor I o 3 br z ba ! level has 2-3 more bedrooms..a large separate room over a three car Heated garage/three brand new garage i ril' i 2,400 sq.ft i doors.Has a possible In-law apt.complete with I ny Single-Famlly Home kitchen/bath and separate entrance.An additional lower I -' level garage has a single garage door,room for for 2 , http://www.trulia.com/property/1039493590-5-Pioneer-Path-West-Barnstable-MA-02668 1/27/2014 5 Pioneer Path, West Barnstable MA - Trulia Page 2 of 6 �m�re veh-cles.H e riva a lot ready foryour p I or * save , ,� L'�9cesa e x Hi e x H clT. tact Agent eir'rt '109 t.BrSa �91��n��}A e �t- 9 bWie1QA02668 --,�—)----- been tested for Radon,Titlev in hand,Septic system less 141 White Birch Way,West Barnstabl... than Seven years old.Owner is Motivated!Brokered And Advertised By:Coldwell Banker Murray R E Listing Agent: , i $650,000 3 br 3 ba Larry Priore ft 2,956 sq. Show less' q ` Single-Family^20. Home Listing Info for 5 Pioneer Path Information last updated on 01/26/2014 10:00 PM: * Save ii Like x Hide Price:$424,900 • Status:For Sale MLS/Source ID:21210256 236 Coachman Ln,West Barnstable MA 3 Bedrooms Parking:Attached,Direct Zip:02668 s $479,333 • 4 full Bathrooms Entry,Door Opener,Heated 2,677 sclft i =. 4 br 3 ba • Single-Family Home Contemporary Architecture i 2,264 sq.ft Built In 1992 Single-Family , Home School Info for 5 Pioneer Path * Save I ii Like I Hide • School Districts:Barnstable Public School District,Sandwich Public School District,Dennis Yarmouth Regional Sd„Mashpee Public School District 41 Currycomb Cir,West Barnstable MA • Schools:Bayberry Christian School,Oak Ridge School,New Testament Christian School "', $384,900 3 br 3 ba Public Records for.5 Pioneer Path 2,016 sq.ft Official property,sales,and tax information from county(public)records as of 05/2013: single-Family Home • Single Family Residential 3 Bedrooms 3 Bathrooms 1 Partial Bathroom 2,528 sgft Lot Size:1.00 acres * save ;6 Like x Hide Built In 1992 Stories:2 story A/C 11 Wheeler Rd,Marstons Mills MA • Heating:Forced air unit Exterior Walls:Wood S iding Roof:Asphalt • 8 Rooms 1 Building Style:Cape Cod $625,000 County:Barnstable 3 br 3 ba 1 2,452 sq.ft Single-Family Property Taxes and Assessment for 5 Pioneer Path Home Year Tax Assessment Market * Save ;d Like x Hide 2013 N/A $397,800 i N/A _...-..-_��___.�., __._._... ............... __.. ..,.. ...,__._.. __. 205 Cedar St,West Barnstable MA 2011 $4,053 N/A N/A ~, $494,000 Source:Public Records ^f + 4 br 3 ba 1,876 sq.ft Price Histo for 5 Pioneer �Path Alert Home•Family ._or. _.. _._ ; •' ` Home Date Event Price Source Agents ( ! _. ._,. ... g l * SaLike x Hide 08/22/2008 Sold ►viewdetail $360,000 Public records 484 Cedar St,West Barnstable MA 11/28/2003 Sold ►view detail $205,000 Public records "`r ; $374,900 i 3br2.5ba f ' 1,833 sq.ft Before real estate shopping check your report&score for$1.What will you find? Home•Family Home Rate and Review Like x Hide - - 611 Cedar St,West Barnstable MA You can rate the area around 5 Pioneer Path - 4419,000 4 br 3.5 ba Rate this area: Rate it Overall area rating: - 3,372 sq.ft We need more ratings to calculate an Single-Family Rate these categories: W. Home average. http://www.trulia.com/property/103 9493 590-5-Pioneer-Path-West-Barnstable-MA-02668 1/27/2014 5 Pioneer Path, West Barnstable MA - Trulia Page 3 of 6 5 ctayr -W ; it rated categories: * If �ffceSa e z N��Ike x H duo tact Agent 542��00 5 Pioneer Pat - esC:BamsR aate e MA 02�6� Save L Pet-friendly Rate if We need more ratings to calculate top _._................__......._.._..... Walkability Rate it categories. 82 Deerjump Hill Rd,West Barnstabl... Restaurant&Shopping Rate it Help us out by sharingyour opinion.Do you $685,000 live,or work near here?What Is this area 4br4ba like? Rate and Review W! Home 3,381 sq.ftSingle-Family Like x Hide Local Info ____.___.____ __ 49 Sundelin Way,West Barnstable MA Comparables (Schools I Estimates Crimes Amenities )Transit 3/100fii6k,- $418,500 '! 3br2ba vR 2,058 sq.fti eSingle Family Home o * Save td Like z Hide -p-. ld9 t ^'' View all homes near this property x Trulia Partner Center See the same types of info mortgage !tf $420K \io E386K lenders may see at Experian.com g K o ;'F Ask a question about West F'._ 3 for sale proportle04,744 average price 5425 6�°¢�1t ShomPson- Barnstable,MA 4 sold propeoles,$393,725 average price $360K ep data 02014 Google 9. We Barnstable local info Ask agents or local experts anything � Have A Question About Comparables?Enter It Here. Ask Our Community Get an answer I Sold Homes near 5 Pioneer Path_____ — Address Distance Property Type Sold price Sold date Bed Bath Sqft Discussions in West Barnstable 142 Coachman Ln,West Barnstabl... 035 Single-Family Home $420,000 08/16/13 4 3 2,459 — 248 followers 46 Hane Rd,Marstons Mills MA 0.52 Single-Family Home $425,000 06/27/13 3 2 2,035 Recent Activity 36 Blackbird Rd,Marstons Mills MA 0.64 Single-Family Home $359,900 06/28/13 3 2.5 2,004 28 Trotting Bred Ln,West Barnstab... 0.69 Single-Family Home $370,000 05/07/13 3 2.5 1,824 What is residential construction ------- -- i cost per square foot averaging in 6 Morgan Way,West Barnstable MA 0.81 Single-Family Home $380,000 04/29/13 3 2.5 2,191 12ffla g y g Y the Barnstable area these days. 83 Nelson Ln,Marstons Mills MA 0.81 Single-Family Home $389,000 06/07/13 3 2 1,677 3 answers 311 Church St,West Barnstable MA 0.86 Single-Family Home $400,000 09/30/13 5 3 2,589 I C r Hi-we own a home/property- outright-no mortgage-in West 8 Appaloosa Way,Marstons Mills... 0.87 Single-Family Home $414,000 07/01/13 5 2.5 2,201 Barnstable,MA.Do we look for a 151 Great Hill Dr,West Barnstable... 1.10 Single-Family Home $390,000 04/29/13 3 2.5 1,740 mortgage or construction loan?Not sure where to start?10 answers 37 Heather Ln,Centerville MA 1.17 Single-Family Home $323,000 10/04/13 3 2 1,840 View all homes similar to 5 Pioneer Path,West Barnstable MA n —'--T �+ f What are the cape cod market � F conditions?1 answer THIS HOUSE WAS JUST SOLD HOW Monthly Payment _ 4 ME ITanswers IS FOR SALE AGAIN? 1 - 4 answers Monthly mortgage for 5 Pioneer Path F http://www.trulia.com/property/1039493590-5-Pioneer-Path-West-Barnstable-MA-02668 1/27/2014 5 Pioneer Path, West Barnstable MA - Trulia Page 4 of 6 I do ow?YQY may b ab a&yali fy for a lowe rat I—`� IS 3-M�INTON LANE O r i2 �e th@'rnBR�}15ybTge f'e5[Bamstab[e,MA 02668 ( * Save ) i -L'i a "�MARKdf FOR SURE N ntactAgent 3 answers � Price $424,900 $2,169 r What is the average per sq ft cost Down Payment $ 84,980 (20%) E ; to build a good to high quality /month i_—J home in Orleans,MA(Cape Cod)? Loan Amount $339,920 Answer first 4 Loan Type 30 Year Fixed 4.43% 4 C M Do any local brokers/residents I know how fast the dune erosion is Get your personal rate $1,708 Principal and Interest and about how many feet are lost • $354 Property Taxes per year?5 answers • $106 Homeowner's Insurance View recent questions ►More advice Nearby—Homes Price Comparison -- 110 Pioneer Path,West Barnstable MA 5 Pioneer Path,West Barnstable MA I I Compare homes in the area to 5 Pioneer Path i 80 Pioneer Path,West Barnstable MA !S Sold Price v 55 Pioneer Path,West Barnstable MA This Home ZIP 02668 35 Pioneer Path,West Barnstable MA $424,900 �' West Barnstable$385,000 $385,000 @ ►Show More 10YR SYR 1YR `-_----- — $650K v ---- -- $570K $490K ev $410K - -----— - - -- S330K ...... $250K 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 *Median sales price for all homes in the area. Have A Question About Prices?Enter It Here. Ask Our Community Sales Trends Real Estate Trends in 02668 i Listing price for 5 Pioneer Path $424,900 Average listing price for similar homes $532,574 25%above listing price Average sale price for similar homes $388,107 9%below listing price Average listing price for all homes in 02668 $532,785 20%above listing price Median sale price for all homes in 02668 $385,000 9%below listing price View more Sales Trends for 02668 http://www.trulia.com/property/1039493590-5-Pioneer-Path-West-Barnstable-MA-02668 1/27/2014 5 Pioneer Path, West Barnstable MA - Trulia Page 5 of 6 G0r14ta V Path,West Bamstable,MA 02668 r* Save td Like x Hide J Contact Agent Ask a local agent about this property. li 2 Deborah Huntley e EaNamPRO (508)570-2603 li 0 Larry Priore LISTING Email ® (508)432-6600 AGENT phone O tii 0 Priscilla Stolba Real E... ® PRO (508)591-8700 Hi,I found this listing on Trulia and would like n to learn more about 5 Pioneer Path,West v ® 4 2 NancyMuccini Barnstable,MA 02668.Thank you. (508)213-4803 Contact Agent By senciing,you agree to Trulia's Terms of Use&Privacy Policy. Want to be listed here?Learn More Similar Homes View all is O35 Berkshire TO 484 Cedar St 38 Briar Ln 52 Point Hill Rd 205 Cedar St 82 Deer Jump Hill... O $273,000 $374,900 $899,000 $895,000 $494,000 $685,000 3bd,2ba 3bd,2.5ba 4bd,3ba 3bd,4ba 4bd,3ba 4bd,4ba 1,360 sgft 1,833 sgft 3,406 sgft 2,644 sqft 1,876 sqh 3,381 sgft Single-Family Home Single-Family Home Single-Family Home Single-Family Home Single-Family Home Single-Family Home Communities near 5 Pioneer Path,West Barnstable I MLS#21210256 West Barnstable Real Estate Nearby Cities Homes for5ale Real Estate and Mortgage Guides Compare 5 Pioneer Path With._ West Barnstatle Real Estate Barnstable Homes for Sale West Barnstatle Real Estate Guide Similar homes to 5 PioneerPath West Barnstatle Foreclosures Centerville Homes for Sale West Barnstatle Schools Recently sold West Barnstable homes West Barnstatle Single-Family Homes Marston Mills Horses for Sale Barnstable County Home Prices Heat Map Recently sold 02668 homes 02668 Real Estate East Sandwich Homes for Sale Massachusetts Home Prices Heat Map Compare to 5 Pioneer Path 02668 Single-Family Homes Cummaquid Homes for Sale West Barnstatle Mortgage 02668 Apartments for Rent Hyannis Homes for Sale West Barnstatle Refinance West Barnstatle Apartments for Rent See All Nearby Cities West Barnstatle Home Loan Residential Real Estate San Francisco real estate j New York real estate i Los Angeles real estate Orlando real estate Miami real estate Philadelphia real estate Phoenix real estate fi San Diego real estate San Jose real estate ' Chicago real estate Arizona real estate California real estate Florida real estate Illinois real estate w Massachusetts real estate Newjersey real estate Pennsylvania real estate Texas real estate Other local real esta to California apartments New York apartments Texas apartments . 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Hide I PCo tact nt ay approximately 2.677 syua a eet.��e ro er:v wa bud[rn t Pone r a s Barnstable and in ZIP Code 02668.The list price of$424,900 is 20%lower than the average list price of$532,785 for 02668 real estate and 21%lower than the average list price of 8539,472 for West Barnstable,MA real estate.The price for this property Is 5%higher than the average sales price of$405,500 for 02668 and 5%higher than the average sales price of$405,500 for West Barnstable.The price per square foot for this property is$159,which is 16%lower than the average of$190 for 02668,and 16%lower than the average of$190 for West Barnstable. Copyright®2014 Trulia,Inc.All rights reserved. Fair Housing and Equal Opportunity Have a question?Visit our Help Center to find the answer http://www.trulia.com/property/1039493 590-5-Pioneer-Path-West-Barnstable-MA-02668 1/27/2014 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION. or Map Parcel �0� Application Health Division Date Issued <5 It Conservation Division v" Application Fe Planning Dept. Permit Fee S<•�� Date Definitive Plan Approved by Planning Board Historic- OKH Preservation/ Hyannis Project Street Address �J lJi f� og Q r— 0 o � Village Owner Address Telephone Permit Request C t. Square feet: lest floor: existing j% roposed 2nd floor: existing &OQproposed otal new P Zoning District Flood Plain Groundwater Overlay 0 ( (vL� �Z Project Valuation, Construction Type Cot Size' y ;�7 Grandfathered4 0 Yes ❑ No If yes, attach supporting documentation: Dwelling Type: Single Family, Two Family ❑ Multi-Family(# units) Age of Existing Structure �°��t Historic House: ❑Yes ❑moo On Old K ni g s ighway O Yes 3'No Basement Type: W► Full ❑ Crawl ❑Walkout ❑ Otherco Basement Finished Area (sq.ft.) Basement Unfinished Area(sq.ft). ?: -o Number of Baths: Full: existing new Half: existing _ new er Number of Bedrooms: lz�:, existing _new Total Room Count (not including baths): existing 18� new First Floor Room Co t 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— hone Number SCo? ` ij 5_1 Address License # C1s • � �� ( Home Improvement Contractor# Worker's Compensation # 4 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO L� SIGNATURE DATE l� 1 • FOR OFFICIAL USE ONLY APPLICATION# y •4 DATE ISSUED MAP/PARCEL NO. i ADDRESS VILLAGE ,t =OWNER _DATE OF INSPECTION: 3 FOUNDATION i ; r: FRAME INSULATION � . FIREPLACE ELECTRICAL: ROUGH FINAL = PLUMBING: ROUGH FINAL GAS: ROUGH - FINAL FINAL BUILDING DATE CLOSED-OUT,- u r+ } ASSOCIATION,PLAN NO. Y ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, AAA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors(Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organizahbaffndividual): Address: Ln C. City/State/Zip: l�l��C�' Phone.#: 36�7 —1 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 w construction employers(full and/or part-timr).* have hired the Sub-contractors Z❑ I am a"sole proprietor or partner- listed on the attached sheet 7. Remodeling ship and have no employees 'These sub-contractors have 8. E]Demolition Aoyc*s and have workers'working for me in any capacity. 9. El Building addition [No workers' comp.•insurrancc �ner poe.t S. VTe are a corporation and its 10_❑Electrical repass or additions rtquired] officers have exercised their l l.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work myself[No workers' comp. right 6f exemption per MGL 12.❑Roof repairs c re t . 152, §1(4), and we have no insurance ��] employees. [No workers' 131]Other comp.insurance required_] . *Any applicant that ehecla box#1 must also fill out the section below showing their workeaa'eorupcom ion policy inforaration. t Homeowners who submit this affidavit indicafing tbey arc doing all work and than hire outside contractors must submit anew affidavit indicating ruch. h-=tractors that cbmk this box must attacbcd an additional sbmt sbowing the namena of the sub-caahmzt and state whether err not those entities have employees. 1f the sub—ontraetors have m-nploy=n,tbry moat providb their workrrs'comp.policy number. I am an employer 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/Statelzip: 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 rrirnmal penalties of a fine tip to$1r500.00 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 st demerit may be forwarded to the Office of Investi tions of the DIA for insurance coverage verification. I do hereby ce r the pain punalfes of perjury that the information provided above is true and correct Si ahuc: Data: Phone# Official use only. Do not write in this area, to be completed by city or town offtciaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6. Other Contact Person: Phone#: Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees: pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or Implied, Oral Or written-" An employer is defined as"an individual.,partnership, association, corporation or other legal entity, or any two or more Of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL ohaptcr 152, §25C(7) states`Neither the commonwealth nor any of its political subdivisions shall enter into any contract fors the performance of public work until acceptable evidence of compliance azth the insurance requircr cnis 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-eontractor(s)name(s), addresses) 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 umbers or partncrs, air not required to carry workers' compensation insurance. If an LLC 6r LLP does have :mployees, a policy is required Be advised that this affidavit may be submitted to the Department of Industrial kmidcats for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should )e returned to the city or town that the application for the pcmat or license is being rcqucstcd, not the Department of ndustrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' :ompensation policy,please call the Department at the nurgber listed below. Self insured companies should enter their ,cam insttranGe license number on the appropriate line. :ity or Towit Officials ,lease be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom ,f the affidavit for you to fill out in the-event the Office of Investigations has to contact you regarding the applicant ,lease be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant rat must submit multiple permit/license applications in any given year,need only submit oup affidavit indicating eunrent olicy information(if necessary) and under"Job Siie Address" the applicant should write"all locations in (city or )wn)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the pplicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit,must be filled out each car.Where a home owner or citizen is obtain a license or permit not related fo any business or commercial venture _e. a dog license or pemuit to brim leaves etc.) said person is NOT required to complete this affidavit he Office of Investigations would hire to than you in advance for your cooperation and should you have any questions, lease do not hesitate to give us a call ie Depaiiment's address, tcicphoac•and fax number. The C6mmonwealth of Massachusetts Dq)ertment of Iadustzial Accidents Office of Lavestipfiuns 6.00 Washington Street Boston, MA 02111 TeI. # 617-727-4900 cxt'4-46 ar 1-V7-MASSAFE :d 11-22-06 Fax# 617-727-774� - www.mass.gov/dia ENERGY CONSERVATION APPLICATION FORM FOR ENERGY EFFICICIENCY FOR ONE-AND TWO-FAMILY DETACHED RESIDENTIAL'CONSTRUCTION (780'CNIR 61.00) Applicant Name: - Site Address: �— print Town: 411W �J, Applicant Phone: rod 360 1/51 Applicant Signature: �� - Date of Application: 91 18 68 NEW CONSTRUCTION: choose ONE of the following two options) 780 CMR TABLE 6107.1 PRESCRIPTIVE ENVELOPE COMPONENT CRITERIA FOR NEW ONE- ,AND TWO-FAMILY BUILDINGS MAXIMUNf MINIMUM Ceiling or Basement Slab -Option 1: Fenestration exposed Wall Floor Perimeter Wall AFUE 14SPF SEER U-factor floors, R-Value R-Value R-Vfllue R-Value R-Value and Depth National Appliwiee Energy R-10, Conservation Act(NAECA)of 35 R=3$ R-19 R-19 It-10 4 ft. 1987 as amended,minimums or reatrr ns applicable Note: This form is not required if you choose either of the two versions of REScheck.as.listed below. ❑ Option 2: �• RES check Version 4.1.2 or later variant software analysis must-be completed (780 CMR.6107.3.2 RES check—Web which can be accessed at http•//www.energ c�odes.gov/reschecld A:D)DITIONS'OIZ.aTERA.TIONS:T'O:EXISTING-BUILDINGS%OVER5:'YtA.RS OLD *Buildings under 5 years old must use opfion#1 or 92 in New Construction section above: . Complete the following formula to determine the % of glazing: (a) Gross Wall & Ceiling Area equals Formula: (100 x b- a) . SF 100 x — _ % of glazing b Q (b) Glazing area equals. SF f lazing is :40%o.use. he-chart b6lo.w. If.,gglazW J" >-:40`-% proceed to "SUNROOM" section 780 CMR TABLE 6101.3 P SCRIPTIVE ENVELOPE COMPONENT CRITERIA ADDITIONS TO EXISTING LOW-RISE RESIDENTLAL BUILDINGS r7t .R-37 Slab Perimeter Ceiling and Wall Floor Basement Wall Exposed floors R-Value R-Value R-value R-Value and De th' R-Value• a R-13 ! R-19 R-10' R-10, 4 feet if insulation achieves the full R-value over the entire ceiling R-30 ceiling insulation may be used in place of R-37 area(i.e. not com ressed over exterior aValls, and including any access openings).- ' SUNROOM—An addition or alteration to an existing buildin�/dwelling unit where the total glazing ar e ea of said addition exceeds 40% of the combined gross wall and ceiling area of the addition, Note:. Owner to fill out Consumer Information Form (found in Appendix 120.P _ r-� I 1 h O 1 Matthew Weider - President 21- - e Sh 1220 lyannough Road,Rte.132 Hyannis,Massachusetts 02601 Business(508)771-2008 Fax(508)778-2423 Cellular(617)504-0608 mweider@c2lshoreland.com www.c2lshoreland.com Each office Is Independently Owned And Operated Q VErp T'oWn of Bairustable Regulatory Services RARNSTy ABLY- � Thomas F. Geiler,Director. Eohu� - Building Division Tom Perry, Building Commissioner 200 Main street, Hyannis, MA 02601 www.town.barnstable_ma.us Office: 508-862403 8 Fax: 508-790-623 0 Property Owner Must Complete and Sign This Section If Using A Builder I, J��-- _ /�//f�✓�i�''1 ^�' , as Owner of the'subject property hereby authorize � Cto act on my behalf, in all matters relative to work authorized by this building permit application for. (Address of Job) J Signature of Owner A&,a7 Date C2/ 3��,a,GPw10 Print Name If Property Owner is applying for permit please complete the Homeowners License Exemption Form on th'e reverse side. A `Town of Barnstable h�ofYHt=ro�y� Regulatory Services BAHNSTABM ThomasF. Geiler,.Director 'E" Building Division p�PTED j,,tp'i A,�� Tom Perry,Building Commissioner . 200 Main Strct;t; Hyannis, MA 02601 www.town.barnstable.ma.us 'flee: 508-862 4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number Streei 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. DEFINrrION OF HOMEOWNER Persons) 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 fvvo-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 wrth'said procedures and requirements. Signatirc of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the ;torte Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that "Any homeowncr performing work for which a building permit is required shall be exempt from the provisions -f this section(Section 1 og.).1-uccnsing of construction Supervisors);provided that if the homeowner engages a Pe sons)for hire to do such +ork,that such Homeowner shall act as supervisor:" Many homeowners who use this excrnption aic unaware that they are assuming the responsrbilitics of a supervisor(sec Appendix Q, .ulcs&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly ,hen the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would With a licensed upervisor. 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, at the homeowner certify that hc/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by Yeral towns. You may rare t amcnd•and adopt such a form/certification for use in your community. JUL-23-2008 15:34 From:SHEPLEY SALES 508 862 6012 To:915085349266 P.3/3 i � - Single 16". BCI8 60s-2.0 SP JOISN01 SC CALL®9.5 Design Report-US 1 span I No cantilevers 10/12 slope Wednesday,July 23,200816;34 guild 91 16"OCS Non-Repetitive►Glued&nailed construction File Name: 80 CA4C Project Job Name: Description:J01 Address: Specifier: Bill Campbell City, State,Zip: ,Me Deslgner: Customer, Echo Custom Carpentary Company,, Shepley Wood Products Code reports. ESR-1:336 Misc: zs-0 .o 80,2.112" 81,2-1t2" LL 667 ibs Lt.667 Ibs DL 167 Ibs DI.167 The Total Horizontal product Length=2&00.00 Load Summary Livo Dead Snow wind Roof LIvo Tao Description Load Trpe Ref, Start End 100% -90% 116% 133%_ 126%__ OCS 1 Standard Load Unf,Area(POLeft 00.00.00 25.OD-00 40 10 16" Load Disclosure Controls Summary values .- %Allowable Duration case Span Location Completeness and accuracy of Input must Pos.Moment 5098 ft•lbs '59.8% 100% 1 1 -Internal be verified by anyone who would rely on End Reaction 819 Ibs 51,9% 100% 1 1 -Right output as evidence of suitability for Total Load Defl. U499(0,594") 48 1% 1 1 particular application,Output here based Live Load Deli. U624(0.475") 78.996 1 1 on budding code-accepted design Max Defl, 0.594" 59.4% 1 1 propertiesand analysis methods Installation of E30ISE engineered wood Span/Depth 18,5 n/a 0 1 products must be in accordance with current Installation Guide and applicable %Allow %Allow building codes.To obtain Installation Guide Bearing Supports _Dim.(L x w) Value Support Member Material or ask questions,please call 80 Wall/Plate 2.1/2"x 2.5116" 833 Ibs rya n/a Unspecified (899)234•0056 before installation. 81 Wall/Plate 2-1/2"x 2-5/16" 833 Ibs n/a n/a Unspecified BC CALCO,80 FRAMER®,AJSTM ALWOISTG,BC RIM BOARD-,8CID, Notes BOISE GLULAM'DA SIMPLE FRAMING SYSTEMS,VERSA-LAM®,VERSA-RIM Design meets Code minimum(U240)Total load deflection Criteria, PLVSO,VERSA-RIMS, Design meets User specified(U480)Live load deflection criteria, VERSA-STRANDS,VERSA-STUD®Ord Design meets arbitrary(1")Maximum load deflection criteria, trademarks of Boise Wood Products, Composite El value based on 23/32"thick sheathing glued and nailed to joist. L.L.C. Page 1 of 1 y� ✓!xe' rOanvinortuiea Board of Building Regulations and Standards., ; t 1-Construction Supervisor,t.icense i Llcens S 75281 si►thdat 3/12/1967 it Ft{ iraj"' 3/1 209 Trik 11056 t ,. Res ri . n: t ` TODD J CANTARA ' .. ,' 10 ECHO Rd.. W YARMOUTH,MA 02673 Commissioner � � _ r '::+tea ,tom —� s �.._ • R ✓�ze �omimaon�uea °�`/�"°°ac�ivaPCla z, Board of Building Regulations and Standards _ HOME IMPROVEMENT CONTRACTOR Registrat `�159211 E c�pirat 10/2010 Tr# 266397 .1 Till=T.p;•=P i nership ECHO CUSTOM RPEN�jT�RY F TODD CANTARA- _ l 10 ECHO RD. I Administrator W.YAR Y MOUTH,MA 02673 '00-35,000 cf enclosed space License or registration valid for individui use oty. lA-Masonry only f before the,-expiration date. If found retnn to: r 1G-1 _2 Family Homes \ - Board of Building Regulations and Standards 1 One; shburton,Place Rm 1301 Failure to possess a current edition of the I _ Boston;.Ma.02108 Massachusetts State Building Code ' \ is cause for revocation of this license. Not valid without signature ty �G��' I ,� �,� � i; 4 f l a° -�; - .� c: �/ , ' _ v _ '� �� Y 1 ��I� i i 1 � . i ` ',1�1 � � ,u 1 � " �. r"�, � � �;� .o �'. � . � � � m V pen "- � o Oft A � AIIX��A ` . TOWN�OF BARN3`�TABLE, MASSACHUSETTS :.J1 BUILD�NT A41! 0 r 'DATE April. 17,, 19 9.2 P.ERMIT N'O. NQ •1'��/./..1rr�Ar z Owner APPLICANT . ADDRESS Listed' BelOW r - (NO.) ,'(STREET)' (COt1TR,S LfCENQEI .� I i RERMIT0 i. ' NUMBER OF { e r Huild Dwell�inQ. I 1 1 sTORY incrle Fa' JL.7 DWELLING UNITS ' is .ITYPf OI IMPROVEMENT) NO. IPROPOSED'USE) Af`(toAtloNi 5 Pioneer Path, W. Barnstable . ZONING °sTR cT p (N0.) (STREET) as ff I BETWEEN AND (CROSS STREET( (CROSS STREET( 7. LOT.. SUBDIVISION LOT BLOCK •SIZE 1 BDING IS TO BE FT. WIDE BY FT. LONG BY FT.:'IN'•HEIGHT AND SHALL CONFORM 1lICONSTAUCTION •', ; 1 TO TYPE �" USE GROUP BASEMENT WALLS OR FOUNDATION. j "- (TYPE) '• REMARKS Sewage #90-118 , Bona.{, I .-AREA•OR VOLUME 2324 scl ft. PERMIT 186.'UU (CUEIC/SQUARE IFFY( ESTIMATED COST $ HU i O'OO.O0- FEE f oER Hans 5zimmetat. :iroDaess. 63.-Mountain Ash Road Marstons M111S. BUILDING DE PT. %c By - y -h�1 �. r - yr ��' y .4,rt1Y 7h� •.� OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. ' MINIMUM 'OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB'ANO THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS 'ARE REQUIRED FOR ALL CONSTRUCTION WORK: CARD KEPT'POSTEO UNTIL FINAL INSPECTION HAS BEEN ELECTRICAL, PLUMBING AND 1. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY, IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR.TO COVERING STRUCTURAL OUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MEMBFINAL INSPECTION TI TO BEFORE FINAL INSPEGTION HAS BEEN MADE. 3. FINAL INSPECTION BEFORE - OCCUPANCY. POST THIS CARD SO IT IS VISIBLE --FROM STREET BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECZION APPROVALS I , . 2 2 3 HEAT G INSFTECTION APPROVALS ENGINEERING DEPARTMENT' f OTHER BOARD OF HEALTH • i a- a�-9a�'S� WORK SHALL NOT PR EO'UNTIL THE INSPEC- PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN Bf; TOR HAS APPROVED E VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE CONSTRUCTIO' PERMIT IS ISSUED AS NOTED ABOVE, ARRANGED FOR BY TELEPHONE OR WRITTEN . NOTIFICATION. i -�,,� ,.�..,.-Y^ . . .w+ n.^. '? . - � �•1nv i'• ..r"�'•tiv�y�'.{M+ .r••< i +' �J..o � °•.w TOWN OF BARNSTABLE BUILDING DEPARTMENT TOWN OFFICE BUILDING HYANNIS, MASS. 02601 1 i MEMO TO: Town Clerk FROM: Building Department DATE: An Occupancy Permit has been issued for the building authorized by BuildingPermit #.......JW77_ _... .. ...................................................................._...._....................__.._................. _ ...._ issued to k' /1 .._�/i/ i1�1 %G � .................................._...._.......... ... . ..._ Please- release the performance bond. 1 T-1 TOWN OF BARNSTABLE 'Permit No. .34977 • ` BUILDING DEPARTMENT I s.,,n I TOWN OFFICE BUILDING Cash ayv HYANNIS.MASS.02601 Bond .....x......... r CERTIFICATE OF USE AND OCCUPANCY Issued to Hans Szimmetat Address Lot #18, 5 Pioneer Path West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. I December 24, 92 19................. ........... `g... ................. Buildinn Inspector � �� I � � � - - =- �- Barnstable Assessing Search Results Page 1 of 2 - Vs 1 Y Sk�Ri�1'ABl.� � pry+, 45 Home: Departments:Assessors Division: Property Assessment Search Results i ,5 PIONEER PATH Owner: SANDERS,JASON&MARTINA Property Sketch Legend Map/Parcel/Parcel Extension 128 /017/005 Mailing Address SANDERS,JASON&MARTINA 80 , C/O FIRST NATL BK OF NASSAU CTY 4 1891 S 14TH ST hilt FERANDINA BEACH, FL.32034 2005 Assessed Values: Appraised Value Assessed Value Building Value: $294,300 $294,300 Extra Features: $ 15,400 $ 15,400 Outbuildings: $0 $0 Land Value: $235,800 $235,800 Interactive Property Map: ap requires Plug in: - Totals:$_545,500 $645,500 1 have visited the maps before Show Me The Map April 2001 photos available Sales History: Owner: Sale Date Book/Page: Sale Price: SZIMMETAT, HANS A 10/15/1995 C138536 $ 125,000 BEYER,WALTRAUT TRS& 4/15/1993. C129936 $ 1 SZIMMETAT,HANS A 7/15/1991 C123978 $7,000 ZISSULIS,WILLIAM G 8/15/1986 C107702 $80,000 SANDERS,JASON&MARTINA. 11/28/2003 C171417 $205,000 Tax Information. Tax information is currently not available for this parcel Land and Building Information Land:-1.- Building Lot Size(Acres) 1.02 Year Built - 1992 http://wwwaown.ba'astable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessin... 11/22/2004 Barnstable Assessing Search Results Page 2 of 2 Appraised Value $235,800 Living Area 2745 Assessed Value $235,800 Replacement Cost$313,045 Depreciation 6 Building Value 294,300 Construction Details Style Cape Cod Interior Floors Hardwood Model Residential Interior Walls Plastered ' Grade Average Plus Heat Fuel Gas Stories 1 1/2 Stories Heat Type Hot Air Exterior Walls Wood ShingleClapboard AC Type Central Roof Structure Gable/Hip Bedrooms 3 Bedrooms Roof Cover Asph/F GIs/Cmp Bathrooms 3 1/2 Bathrms Total Rooms 8 Rooms Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BFA Bsmt Fin-Aver 624 $8,800 $8,800 FPL2 Fireplace 1 $2,800 $2,800 BGAR Bsmt Garage 1 $3,800 $3,800 Property Sketch Legend BAS First Floor, Living Area FST Utility Area (Finished Interior) UAT Attic Area(Unfinished) BMT Basement Area(Unfinished) FTS Third Story Living Area(Finished) UHS Half Story(Unfinished) CAN Canopy FUS Second Story Living Area(Finished) UST Utility Area.(Unfinished) FAT Attic Area(Finished) GAR Garage UTQ Three Quarters Story(Unfinished) FCP Carport GRN Greenhouse UUA Unfinished Utility Attic FEP Enclosed Porch PTO Patio UUS Full Upper 2nd Story(Unfinished) FHS Half Story(Finished) SFB Semi Finished Living Area WDK Wood Deck FOP Open or Screened in Porch TOS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/tob02/Depts/AdministrativeServices/Finance/Assessin... 11/22/2004 TOWN OF BARNSTABLE BUILDING DEPARTMENT HOMEOWNER LICENSE EXEMPTION Please .pririt. JOB LOCATION _ Number Street address "HOMEOWNER" Section. of 0,11 Name2z �. �( Home phone E MAILING PRES NT .' . .. ADDRESS � O e ,•�•1. ity town The current exemptionstate .;., . . dwellin for homeowners -Zip of six units or less and rs was extended to dlVidual for hire who does not include owner-occupied acts as su ervisor. Possess a ners to engage an in- DEFINITION OF license, provided that the owner Person s HOMEOWNER: side ) who owns a parcel of ' On which there is land on which he/she resides attached or detached °r is intended or intends A person who structures accessorto be' a one to six famil to re- consid Constructs more than y to such use and/or farm structures.. Bred a homeowner, one Dome on a form act.e Such homeowner" In a two-year period shall for all such Ptable to the Buildingshall submit to not be work erformed under Official, / the Building Official the buJcial that he/she shall be res ermit. (Section 109.1�1�nsible e undersigned �� Building Code andhomeowner" assumes res.. other applicable Ponsibility for Compliance codes, for with the Stat The undersigned "homeowner" , rules and regulations. Barnstable Building Departmentrtlfies and that he/she minimum that he/ understands will comply with inspection the-Town rqu of s d Procedures procedures and iiOMEOWNER'S SIGNATURE a requirements. APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35, 000 cubic ;! State Building Code Section feet, Co . ntrol. r � r HOME OWNER' S EXEMPTION The code state that: "Any Home Permit is Owner required shall be exem t horn Performing work for which..a,:buildin'' (Section 109. 1 . 1 - Licensing of Cons :provisions of this section Home Owner engages a �i•on Supervisors) 1 .provided that if shall act as supervisor. " for mire to do such work; that, such •Home" Owne. Many Home Owners who use this exeml:>i:.ion are unaware the responsibilities of a supervisor that they are assuming for licensinguer (see Appendix Q, Rules and:,.Regulations Construction Supervisors ,� often results in serious Section 2. 15) . This lack` of. awarene: unlicensed persona. problems, particularly when the Home Owner hires inlicensed In this case our Board cannot proceed against. the as supervisor as it would with Licensed Supervisor. The HOme `'OWner' actir pervisor is it responsi.l�le. To ensure that the Home Owner is fully aware of his/her re certify that require, e usre,uas part of the Permit applicati sPonsibil tie's; ':mar.. last understands tilt res one that 'tho HOMO 'Owner page of this issue is a form c;"� l (,P yibicditbes. o f a 'supervisor: ` On the care to amend and adopt p much a to�,n/c:c rt.i. fication foreusea1ntowns: .:: You may your• community. .. t 1 Assessor's office(1st Floor): Assessor's map and lot number � — z V �b J r:THE?o`` Conservation BASTALLED IN COMPLIANCE Board of Health(3rd floor): WI7M TITLE 5 { qQ �' �g ENVIRONMENTAL CODE AND o�� Sewage Permit,number 8"L � Engineering Department(3rd floor):,', TOWN REGULATIONS o'�o mw House.number .' Definitive Plan Approved by Planning Board" ( 19 APPLICATIONS PROCESSED e:30;9:30 A.M.and 1:00-2:00 .M.o y 7 } TOWN OF ' BARNS�11 BU DING INSPECTOR APPLICATION FOR PERMIT TO // S TYPE OF CONSTRUCTION 19 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to the following information: nn � Location FI POA 64 " 21 Proposed Use w�%wG?� Zoning District V\ F Fire District Name of Owner Address C 3 Ho will rG!// 9� T9,(/ Hl M^ Name of Builder Address Name of Architect Z y UC 2 Q ✓L� Address Number of Rooms Foundation Exterior �'�� C� E- c)y1l(/1 Gl �� - Roofing Floors ✓,1m 't' V t1 b i _e 'f V lil t✓ Interior ✓' �/1��li Heating /��)� e� Plumbing Fireplace Approximate Cost 0 00, Area Diagram of Lot and Buildi 74vth' Dimensions Fee �[a� i OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS f 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 SZIMMETAT, HANS - No 34977 Permit For 12 Story Single Family Dwelling Location 5 Pioneer Path (Lot #18) West Barnstable Owner __Hans Szimmetat r Type of Construction Frame r Plot i Lot r 1 Permit Granted April 17 , 19 92 Date of Inspection Date om ed �' 19 •. tL➢ � ► i rrn J r � Town of Barnstable Regulatory Services yP �� Thomas F.Geiler,Director MAS& ' ' Building Division 9 MASS' 0w . s639. �0 OtFo Mp(a Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 COMPLAINUINQUIRY'REPORT Date: �G�/b3 Rec'd by: �-- Complaint Name: Z yne� �'a _ Map/Parcel Location Address: S /l)new hk�A r M? .,,i-Zo n j 121-, Originator Name: L d.,(Jaz ,Sh&4_1 f Street: )(a 96 dsle,-di)lif - i�kL rn 1 6 le Villa e• ) � r J b k State: �?�,4 —zip:• 621�e- Telephone: �6D� ) a a I - r 3 b y Complaint Description: fQ i li"or /7as ri rl :S 1� �/ /.[iP o✓� Crc� g ur,ccb'-c- /. V i rteL b 7i d fi[1 bL) CO FOR OFFICE USE ONLY Inspector's Action/Comments Date: /�� Inspector: N) VV © CDw e ;e- iwi-s Additional Info.Attached i CUNBMAQUID SURVEY, INC. Box 51 Cummaquid, N.?. 02637 Edward E. Kelley , President' June 15, 1992 Town of Barnstable Board of Health 367 Main Street Hyannis, Ma. 02601 Ref: Lot # 21 Pioneer Path West Barnstable, Ma. The Leach Pit was installed in accordance with the Variance granted by the Board of Health on September .18, 1989. The Pit was installed' in June of 1992• Ep�TH Of I,1 3;'�Y ' .?:•. +'.�;;{=�. !`.��^'�•'• oho sr q�u' .. ,. R.HALL ...i Reg. Re ��flRA W\ •' THETO6o The Town of Barnstable Health Department 119. 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren J. Rutherford, Town' Manager FROM: Thomas A. McKean, Director of Public Health-=}- O./7n.,6�. DATE: October 26, 1992 SUBJECT: Shufelt Letter Dated October 16, 1992 My memorandum dated September 29, 1992 briefly responds to Mr. and Mrs. Shufelt's concern regarding the date of installation of the septic system. Health Inspector Jerome Dunning stated the septic system construction began within the two year time frame, prior to March 21, 1992 . The Certificate of Compliance was not issued until months later, after June 15, 1992 when we received the certification letter from the designing Sanitarian. I believe the confusion here is the difference between the date of construction of the septic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only refers to the date the licensed installer begins construction of the onsite sewage disposal system, not the date of completion of the onsite sewage disposal system construction. Also, the Disposal Works Construction permit #90-118 was issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as follows: 1) The first concern is the possibility of re-designing house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this process. I would like to discuss this issue further with Mr. Joseph DaLuz, the Building Commissioner and Mr. Robert Schernig, the Planning Director. The Health Department and the Building Department work together along with the Conservation Department, Planning Department, and the Historic Department as one Division, entitled the Planning and Permitting Division. This Division meets on a regular basis to discuss permitting issues. I will ask Mr. Schernig, the Planning Director, to place this issue on the agenda of our next Division meeting. 2) The second concern is there is a. finished "area" located above the garage. As the variance letter states, the dwelling cannot contain more than three (3) bedrooms. If the room above the garage is enclosed, heated, and provides sufficient area to be utilized for sleeping purposes, that room shall be counted as a "bedroom" . I again suggest that the Building Department personnel inspect the dwelling and the garage to ensure it conforms with the State and local Building Codes and the submitted plans. 3) The variance requires the owner to pump the septic system every three years. This will be enforced by the Health Department. On or prior to June 15, 1995, the owner is required to certify to' the Board of Health that the system was pumped. If the certification is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 4 ) The concern is that another variance will be granted without Mr. and Mrs. Shufelt's knowledge should the septic system at Lot 21 Pioneer Path become saturated. Please be advised that another variance will not be necessary. According to the letter from the Board of Health dated September 18, 1989, the Board also granted a variance to install the reserve area 125 feet from the abutters well at Lot 7. In conclusion, please be advised anyone can request a hearing before the Board of Health. If Mr. and Mrs. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health,- P.O. Box 534, Hyannis MA 02601. Thank you. THE The Town of Barnstable `p{ �0♦ -J. Health Department rurrr"r. 367 Main Street, Hyannis, MA 02601 Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren Rutherford, Town Manager —t- FROM: Thomas McKean, Director of Public Health c�h O. DATE: September 29, 1992 SUBJECT: SHUFELT COMPLAINT, WEST BARNSTABLE-SEPTIC VARIANCE I am in receipt of the electronic mail correspondence dated September 28, 1992. I believe Mrs. Shufelt is misinformed, the permit was not issued after the variance expired. The disposal works construction permit for Lot 21 Pioneer Path, West Barnstable was issued on 3/21/90, more than four months before the variance expired. The permit was valid for two years and the septic installation began within that two year time frame. A copy of the permit is attached. Also, this variance was granted from a local Board of Health Regulation which prohibits the installation of a leaching facility within 150 feet of a private well. The State Sanitary Code, Title V, also regulates the set-back distance and prohibits the installation of a leaching facility within 100 feet of a private well. The applicant in this case met the State Sanitary Code but not the local Health Regulation; he/she requested a variance to install the leaching facility 133 from his/her neighbor's well. I do not believe a 17 foot variance is significant. The Board has granted variances with only a 102 feet separation distance in the past. I believe the appeal period has lapsed and it is now too late to appeal the Board of Health decision. An appeal could have been filed within thirty (30) days of the Board of Health variance hearing, which was held September 16, 1989. In regards to the groundwater direction flow question, a hydrologist or some similar professional would have install at least three ( 3)' monitoring wells and study the water depths in the monitoring wells on the site for several days in order to figure out which direction the groundwater flows. J� .S t iI i Mr. Dunning stated he spoke with Mrs. Shufelt several .times. He believes she is unhappy about the large garage constructed on this site. The owner apparently collects classic cars and stores them in this large garage. In regards to your question concerning an occupancy permit, the Building Department has control over such permits. However, in the Health Department's view, there would be no basis to deny the occupancy permit due to the fact that the applicant appears to have followed the proper Board of Health and Health Department procedures. However, the occupancy permit could be denied for other issues which may apply, such as building code violations. If the real issue is that Mrs. Shufelt is upset about the size of the garage, I suggest that the Building Department personnel should check to see if the garage conforms with the Building Permit issued and to see if the garage .conforms with the State and local Building Code regulations. I A TH �SEE0 1pl ��L;Ao•0°, R 1270 4' LOT 17 oD g0 i i 1. �4N / AY / , �N 4. UTILITY POLE 14-35 LOT 18 LOT .o r o° of go633 N52o0 FLOOD .ZONE "c-- FO UNDA TION CERTIFICA TIONREs ZONE- "RF"__ TO WN.• W. BARNSTABLE SCALE, 50 PL.R F. 37157-E ELEV N/A I CERTIFY THAT THE ABOVE (, FOUNDATION IS LOCATED ON <, YANKEE SURVEY CONSULTANTS THE GROUND AS SHOWN, AND 143 ROUTE 149 P. 0. BOX 265 IT'S POSITION- DOES —_--- Pam, "" MARSTONS MILLS, MASS. 02648 CONFORM TO THE ZONING LAW , r�EprrH y TEL: 428-0055 SETBACK REQUIREMENTS OF No. 32098 z FAX 420-5553 _ _ BA_RNSTABLE � s�9fc�stEK,�) a��4 —2��—tR�ITHE JOB PA UL A. W _o DA TE.•IZ1LI-92 NUMBER SOLE ND BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT LABORATORY REPORT VOLATILE ORGANIC CHEMICAL ANALYTICAL RESULTS Client : GARY A EL•LIS Collection Date: 03/12/90 Mailing Address: 20 CAPT SIMMONS Date of Analysis : 03/13/90 S YARMOUTH MA 02664 Type of Supply: WELL Well Depth (FT) : Not Given Telephone: 362-9802 Sample Location:LOT 15 PIONEER PATH LAT. . (DDMMSS) : Not Given N BARN LONG. (DDMMSS) : Not Given Collector: GEORGE HEUFELDER Map/Parcel : 28-017-001 Affiliation: BCHED Analytical Method: 502. 1=1 , 502 . 2=2 , 503 . 1=3 , 504=4 , 524 . 1=5 , 524 . 2=6 , 502 . 11 , 1, Contaminants Anal . Result MCL Detection Meth. ug/1 ug/1 Limits (ug/1) ------------------------------- ------------------------------------ Chloroform 7 0 . 5 0 . 5 Only those compounds listed above were detected. Attached is a_ list of chemicals -which the method is capable of detecting. NOTE: Contaminant levels equal to or exceeding the Detection Limits are reported. Contaminant levels below the indicated Detection Limits are reported as -ND- MCL means Maximum Contaminant Level for EPA-regulated compounds . (ug/1 = micrograms per liter = Parts Per Billion) The Environmental Protection Agency has set Maximum Contaminant Levels (MCL) for the following compounds . This sample compares as follows : COMPOUND MCL (in PPB) Benzene 5. 0 * level not exceeded * Carbon Tetrachloride 5 .0 * level not exceeded * 1 , 2-Dichloroethane 5.0 * level not exceeded 1 , 1-Dichloroethene 7 . 0 * level not exceeded 1 , 4-Dichlorobenzene 75 * level not exceeded 1 , 1 , 1-Trichloroethane 200 * level not exceeded Trichloroethene 5. 0 * level not exceeded Vinyl Chloride 2 .0 level not exceeded Comments or additional compounds found: Bernard E. Bartels., .D. L oratory Director 6 �a BARNSTABLE COUNTY HEALTH AND ENVIRONMENTAL DEPARTMENT typ SUPERIOR COURT HOUSE. BARNSTABLE, MASSACHUSETTS 02630 J TABLE 1. Compounds Detectable by EPA Method 502.1* PHONE: 362.2511 . MA 55 EXT. 330 LAB'337 COMPOUND D.L. COMPOUND D.L. CLINIC 340 Benzene . 0.5 1 ,1-Dichloroethane 0.5 Carbont.etrachloride 0.5 1 ,1-Dichloropropene 0.5 1 ,1-Dichloroethylene 0.5 1 ,3-Dichloropropene 0.5 . 1 ,2-Dichloroethane 0.5' 1 ,2-Dichloropropane 0.5 para Dichlorobenzene 0.5 1 ,3-Dichloropropane 0.5 Trichloroethylene 0.5 2,2-Dichloropropane.. 0.5 1 ,1 ,1-Trichloroethane 0.5 Ethylbenzene 0.5 Vinyl Chloride 0.5 Styrene 0.5 Bromobenzene 0.5 1 ,1 .2-Trichloroethane 0.5 Bromodichloromethane 0.5 1 ,1 ,1 ,2-Tetrachlor.oethane . 0.5 . Bromoform 0.5 1 ,1 ,2,2-Tetrachloroethane . 0.5 Bromomethane 0.5 Tetracfiloroethylene 0.5 Chlorobenzene 0.5 1 ,2 ,3-Tri.chloropropane 0.5 Chlorodibromomethane. 0.5 Toluene 0.5 Chloroethane . 0.5 para Xylene 0.5 Chloroform 0.5 ortho Xylene 0.5 Chloromethane 0.5 meta .Xylene 0.5 ortho Chlorotoluene 0.5 Bromochloromethane. 0.5 para Chlorotoluene 0.5 . Dichlorodifluoromethane 0.5 Dibr.omomethane 0.5 Fluorotrichloromethane 0.5 meta Dichlorobenzene 0.5 Hexachlorobutadiene 0.5 . ortho `Dichlorobenzene 0.5 Isopropylbenzene 0.5 trans-1 ,2 Dichloroethylene 0.5 n-Propylbenzene 0.5 cis-1 ,2 Dichloroethylene 0.5 Sec:butylbenzene. 0.5 Dichloromethane 0.5 Tert-butylbenzene 0.5 D.L. is Detection Limit in micrograms per liter or parts per billion (ppb). . This table lists our ..normal limits of detection. If we -report a smaller amount, then our detection .limit was lower for that analysis. *A photoionization .detector is used in series with the electroconductivity. detector, thus allowing for the analysis of most. of the compounds listed in . . . EPA Method 503.1 as well . TABLE- 2. Compounds which have Maximum Contaminant Levels (MCLs) set by the Environmental Protection, Agency. COMPOUND MCL (in ppb) Benzene 5.0 Carbontetrachloride 5.0 1 ,2-Dichloroethane 5.0 .1 ,1-Dichloroethylene 7.0 para Dichlorobenzene. 75 1,1 ,1-Trichloroethane 200 Trichloroethylene 5.0 Vinyl Chloride 2.0 Total Trihalomethanes .100 Chloroform, Bromodichloromethane , Chlorodibromomethane, and Bromoform comprise the total .trihalomethanes. P�0*lHr 0�y TOWN OF BARNSTABLE I D, 1 l OFFICE OF i' DARISTAX : BOARD OF HEALTH NABS. i639. p NAY ir. 367 MAIN STREET HYANNIS, MASS. 02601 September 18, 1989 Edward E. Kelley oil . P. O. Box 51 Cummaquid, Ma 02637 Dear Mr. Kelley: You are granted variances on behalf of your client, William Zissulis to install a leaching facility at Lot 21 .Pioneer Path, West Barnstable, 133 feet from the abuttor's well at Lot 7, with it's reserve 125 feet from the abuttor's well at Lot 7, and to allow the proposed well to be 132 feet from the abuttor's leaching facility at Lot 20, in lieu of the required 150 feet'. The variances are granted with the following conditions: (1) All other Regulations contained in Title 5, of the State Environmental Code and Town of Barnstable Health Regulations must be complied with. (2) The well water must be tested bacteriologically, chemically, and, for volatile organics prior to the issuance of a building permit.' The water must meet all of the standards established by the Safe . Drinking Act . of 1974, revised 1986, and of the Town of Barnstable Board of Health Private Well Regulation effective June 1, 1989. (3) The system must be installed in strict accordance to the submitted plans (not dated). (4) The designing Registered Sanitarian shall supervise the installation of the onsite sewage disposal system and shall certify in writing the system was installed in strict accordance to the submitted plan.' (5) The dwelling cannot contain more than three (3) bedrooms, dens, study rooms, playrooms, enclosed porches, sleeping lofts, finished cellars and similar type rooms are considered bedrooms according to the Department of Environmental Protection. (6) The onsite sewage disposal system shall be pumped at least every three (3) years and certification of the pumping submitted to the. Board by a licensed septage hauler. The variances expire October 1, 1990. Very truly yours, n Ann Jane Eshbaugh }G �- Acting Chairperson BAO.RD OF HEALTH TOWN OF BARNSTABLE r i �TMe'a'�� The Town of Barnstable • MARN&M . • Office of Town Manager i ,19. 1% 367 Main Street,Hyannis,MA 02601 Office: 508-790-6205 Warren J.Rutherford Fax: 508-775-3344 Town Manager TO: Thomas McKean, Director Health Department FROM: Warren J. Rutherford Town Manager/ab �U SUBJECT: Shufelt Complaint DATE: October 23, 1992 In reference to additional information received from the Shufelts (see attached), please attempt to provide a further response to this particular matter at your earliest convenience. e Laura F. Shufelt Eric W. Shufelt 1696 Osterville-?Jest Barnstable Rd. TOWN 09 BAR4STABLE [west Barnstable, MA 02668 T0WM MAs J:r,';''1.! 0f,rICE (508) 420-0579 October 16, 1992 '92 OCT 21 A10 42 Mr. Warren Rutherford Town Manager 367 Main Street Hyannis, MA 02601 Dear Mr. Rutherford: I received your letter and the copy of the correspondence from Mr. McKean today. My reaction is one of anger and disbelief. Contrary to what Mr. McKean wrote, the .septic system was installed June 11 & 12, 1992, two and a half months after the expiration of the disposal works permit he refers to. However, according to the Building Inspector's office, the work was completed using disposal works permit #90-118 which was applied for on 11/28/91, well after the expiration of the variance. I would like to have our concerns taken seriously, not brushed off as "not significant" as Mr. McKean wrote. From my first call to the Health Department, I have been treatea like a bothersome pest. Mr. McKean justifies the decision to grant a variance by comparing it to past decisions, but history has shown that past decisions have not always been right or safe. His statement that the appeals period has expired is amazing. How were we suppose to appeal a decision that was made behind our backs three years before construction began? This is especially true since in 1989 we were assured by the Health Department that we would be notified if a variance was requested. This total disregard for our. rights as taxpaying property owners is the real issue. If, after our many conversations, Mr. Dunning believes my main objection is the size of the garage, I can only say he should enroll in a course to improve listening skills. My complaint from day 1, June 15, 1992, has been the issuance of a variance that may affect the health of my family without our being notified. The copy of the variance, after 3 months of requests, only added to my concerns. First, the issue of the expiration date. r J Page 2 That, to me, states that the owner has until that date to get a building permit. Maybe there is a loophole whereby if the owner applies for a disposal works permit he can extend the variance 2 years, during which time he can sell the lot and the new owner can reapply for a disposal works permit with a different design, and it will all be legal and above board. Somehow, I doubt it. Second, the house size, or rather number of rooms, is restricted by the variance but, uben asked, the Health Department had not even looked at the plans prior to signing off on the building permit. My concern regarding the garage is not its size but rather the fact that the area above it is finished and should be included in the room count. I question whether that has been done. Third, the variance requires the owner to have the septic system pumped out every three years. Given the performance of the Health Department to date on this, I wDuld like some assurance that this will be monitored and enforced. Fourth, and last, as I discussed with you, our septic system is seven years old and must be increased due to the saturation of the leaching area. Fortunately, we have the space to add another. Ha,aever, should this occur on the lot in question, the only place to add another is closer to our well. We are concerned that, if the Health Department doesn't change its policy, another variance will be granted without our knowledge that further endangers our water quality and the health of our children. We are not asking for the house to be torn down, although we do believe it was built after the variance expired and should, at the very least, be subject to a new hearing. We are asking for some simple controls and assurances to make sure our water ;remains safe. Thank you ,�- Al 65/�� Laura F. Shufelt Eric 14. Shuf elt TO: Warren J. Rutherford, Town Manager FROM: Thomas A. McKean, Director of Public Health DATE: October 26, 1992 SUBJECT: Shufelt Letter Dated October 16, 1992 My memorandum dated September 29, 1992 briefly responds to Mr. and Mrs. Shufelt's concern regarding the date of installation of the septic system. Health Inspector Jerome Dunning stated the septic system construction began within the two year time frame, prior to March .21, 1992 . The Certificate of Compliance was not issued until months later, after June 15, 1992 when we received the certification letter from the designing Sanitarian. I believe the confusion here is the difference between the date of construction of the septic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only refers to the date the licensed installer begins construction of the onsite sewage disposal system, not the date of completion of the onsite sewage disposal system construction. Also, the Disposal Works Construction permit #90-118 was issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as follows: 1) The first concern is the possibility of re-designing house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this process. I would like to discuss this issue further with Mr. Joseph DaLuz, the Building Commissioner and Mr. Robert Schernig, the Planning Director. The Health Department and the Building Department work together along with the Conservation Department, Planning Department, and the Historic Department as one Division, entitled the Planning and Permitting Division. This Division meets on a regular basis to discuss permitting issues. I will ask Mr. Schernig, the Planning Director, to place this issue on the agenda of our next Division meeting. 2) The second concern is there is a finished ."area" located above the garage. As the variance letter states, the _ dwelling cannot contain more than three (3) bedrooms. If the room above the garage is enclosed, heated, and provides sufficient area to be utilized for sleeping purposes, that room shall be counted as a "bedroom" . I again suggest that the Building Department personnel inspect the dwelling and the garage to ensure it conforms with the State and local Building Codes and the submitted plans. 3) The variance requires the owner to pump the septic system every three years. This will be enforced by the Health Department. On or prior to June 15, 1995, the owner is required to certify to the Board of Health that the system was pumped. If the certification is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 4 ) The concern is that another variance will be granted without Mr. and Mrs. Shufelt's knowledge should the septic system at Lot 21 Pioneer Path become saturated. Please be advised that another variance will not be necessary. According to the letter from the Board of Health dated September 18, 1989, the Board also granted a variance to install the reserve area 125 feet from the abutters well at Lot 7. In conclusion, please be advised that anyone can request a hearing before the Board of Health. If Mr. and Mrs. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health, P.O. Box 534, Hyannis MA 02601. Thank you. i... The Town of Barnstable ►L Inspection Department 00, i610• `�o� ►l 367 Main Street, Hyannis, MA 02601 508-790-6227 Joseph D. DaLui Building Commissioner October 27, 1992 Mrs. Laura Shufelt 1696 Osterville-West Barnstable Road West Barntable, MA 02668 RE: A=128 017.005 Lot #21 Pioneer Path, West Barnstable Dear Mrs. Shufelt: Please be advised that on October 23, 1992 Inspector Richard. Bearse did inspect the dwelling/garage under construction at the above location. The only variation from the original plans submitted are the "dog house" dormers on the front of the garage. Upon inspection it was noted that the construction does comply with the provisions of the Massachusetts State Building Code and as a single family dwelling/garage does comply with the Town of Barnstable Zoning .Ordinance. If I may be of any further assistance, please contact the office. Peace, Joe 'hD.p DaLuz ilding Commissioner . I JDD/gr cj'• cc: Town Manager it r-7 d Li i`i NS L l lO,cJ > ©iz Lc( �. '� � ry .i The Town-of Barnstable • MRNSTABLE, MASS1639. a Office of Town Manager 'E0 367 Main Street,Hyannis,MA 02601 Office 508-790-6205 Warren J.Rutherford FAX 508-775-3344 Town Manager TO: Joseph DaLuz, Building Commissioner n FROM: Warren J. Rutherford, Town Manager W DATE: October 14, 1992 RE: Lot 21, Pioneer Path, West Barnstable' Garage Size Conformity with Building Code Please advise at your earliest convenience whether the garage at this site conforms to the permit issued and to state .regulations. At my request, please provide response to Mrs. Laura Shufelt, 1696 Osterville-West Barnstable Road, West Barnstable. 311199 ak j � � - ni ♦per h .. u D ' - i p� • j N : : 29 Itl p i< O ` W G EU O ^ e) fin's 7 Q� �� \ \ �� • � •0 � � G ! � i ��. ID i -01 02 xx AN SO J ` , "O d S p �i i � r �•� " I 9 q! _N C J o V � G >> -- J a Q 17 ' a I o6� O ao� 3 � �, O sue• �� a��y � Y 01 o i i ` o 'yOfTHE TO`I The Town of Barnstable PA Health Department "a"T"' 367 Main Street, Hyannis, MA 02601 �0 Nix M. Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren J. Rutherford, Town Manager FROM: Thomas A. McKean, Director of Public Health-7zzzi�G 'M7I , DATE: October 26, 1992 SUBJECT: Shufelt Letter Dated October 16, 1992 My memorandum dated September 29, 1992 briefly responds to Mr. and Mrs. Shufelt's concern regarding the date of installation of the septic system. Health Inspector Jerome Dunning stated the septic system construction began within the two year time frame, prior to March 21, 1992 . The Certificate of Compliance was not issued until months later, after June 15, 1992 when we received the certification letter from the designing Sanitarian. I believe the confusion here is the difference between the date of construction of the septic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only refers to the date the licensed installer begins construction of the onsite sewage disposal system, not the date of completion of the onsite sewage disposal system construction. Also, the Disposal Works Construction permit #90-118 was issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as follows: 1) The first concern is the possibility of re-designing house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this process. I would like to discuss this issue further with Mr. Joseph DaLuz, the Building Commissioner and Mr. Robert Schernig, the Planning Director. The Health Department and the Building Department work together along with the Conservation Department, Planning Department, and the Historic Department as one Division, entitled the Planning and Permitting Division. This Division meets on a regular basis to discuss permitting issues. I will ask Mr. Schernig, the Planning Director, to place this issue on the agenda of our next Division meeting. 2) The second concern is there is a finished "area" located above the garage. As the variance letter states, the dwelling cannot contain more than three (3) bedrooms. If the room above the garage is enclosed, heated, and provides sufficient area to be utilized for sleeping purposes, that room shall be counted as a "bedroom" . I again suggest that the Building Department personnel inspect the dwelling and the garage to ensure it conforms with the State and local Building Codes and the submitted plans. 3) The variance requires the owner to pump the septic system every three years. This will be enforced by the Health Department. On or prior to June 15, 1995, the owner is required to certify to the Board of Health that the system was pumped. If the certification is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 4 ) The concern is that another variance will be granted without Mr. and Mrs. Shufelt's knowledge should the septic system at Lot 21 Pioneer Path become saturated. Please be advised that another variance will not be necessary. According to the letter from the Board of Health dated September 18, 1989, the Board also granted a variance to install the reserve area 125 feet from the abutters well at Lot 7. In conclusion, please be advised anyone can request a hearing before the Board of Health. If Mr. and Mrs. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health,- P.O. Box 534, Hyannis MA 02601. Thank you. The Town of Barnstable BARN8TABM • Office of Town Manager 0 367 Main Street,Hyannis,MA 02601 Office: 508-790-6205 Warren J.Rutherford Fax: 508-775-3344 Town Manager TO: Thomas McKean, Director Health Department FROM: Warren J. Rutherford Town Manager/ab � SUBJECT: Shufelt Complaint DATE: October 23, 1992 In reference to additional information received. from the Shufelts (see attached), please attempt to provide a further response to this particular matter at your earliest convenience. r Laura F. Shufelt Eric 14. Shufelt 1696 Osterville-West Barnstable Rd. TOWN 09 SAR4, STABLE [lest Barnstable, MA 02668 TOWN �'�:N-P, r`''; (}�"�irE (508) 420-0579 October 16, 1992 '92 OCT 21 A10 :42 Mr. Warren Rutherford Town Manager 367 Main Street Hyannis, MA 02601 Dear Mr. Rutherford: I received your letter and the copy of the correspondence from Mr. McKean today. My reaction is one of anger and disbelief. Contrary to what Mr. McKean wrote, the septic system was installed June 11 & 12, 1992, two and a half months after the expiration of the disposal works permit he refers to. However, according to the Building Inspector's office, the work was completed using disposal works permit #90-118 which was applied for an 11/28/91, well after the expiration of the variance. I would like to have our concerns taken seriously, not brushed off as "not significant" as Mr. McKean wrote. From my first call to the Health Department, I have been treated like a bothersome pest. Mr. McKean justifies the decision to grant a variance by comparing it to past decisions, but history has shown that past decisions have not always been right or safe. His statement that the appeals period has expired is amazing. How were we suppose to appeal a decision that was made behind our backs three years before construction began? This is especially true since in 1989 we were assured by the Health Department that we would be notified if a variance was requested. This total disregard for our. rights as taxpaying property owners is the real issue. If, after our many conversations, Mr. Dunning believes my main objection is the size of the garage, I can only say he should enroll in a course to improve listening skills. My complaint from day 1, June 15, 1992, has been the issuance of a variance that may affect the health of my family without our being notified. The copy of the variance, after 3 months of requests, only added to my concerns. First, the issue of the expiration date. i • Page 2 That, to me, states that the owner has until that date to get a building permit. Maybe there is a loophole whereby if the owner applies for a disposal works permit he can extend the variance 2 years, during which time he can sell the lot and the new owner can reapply for a disposal works permit with a different design, and it will all be legal and above board. Somehow, I doubt it. Second, the house size, or rather number of rooms, is restricted by the variance but, when asked, the Health Department had not even looked at the plans prior to signing off on the building permit. My concern regarding the garage is not its size but rather the fact that the area above it is finished and should be included in the room count. I question whether that has been done. Third, the variance requires the owner to have the septic system pumped out every three years. Given the performance of the Health Department to date on this, I would like some assurance that this will be monitored and enforced. Fourth, and last, as I discussed with you, our septic system is seven years old and must be increased due to the saturation of the leaching area. Fortunately, we have the space to add another. Haaever, should this occur on the lot in question, the only place to add another is closer to our well. We are concerned that, if the Health Department doesn't change its policy, another variance will be granted without our knowledge that further endangers our water quality and the health of our children. We are not asking for the house to be torn down, although we do believe it was built after the variance expired and should, 'at the very least, be subject to a new hearing. We are asking for some simple controls and assurances to make sure our water remains safe. Thank you, ,.�Q,lvtU- �• d�U�U Laura F. Shufelt Eric W. Shufelt 19, 0 05 R123017.605 APPRAI SAL DATA KEY 411432 SZIMMETAT, HANS A LAND P,LD/FEATURES BUILDINGS NUMBER 2N1FL=RF 270500 A-COST 27,500 B—M T BY oo/ BY /()0 C-INCOME, ' PCAQ 3 01 PCS=00 SI £= JUST—VAL 27 a5OO LEV=500 CONST—C C' -----COMPARISON TO CONTROL AREA 33B -- --MAY NOT BE COMPARABLE-- NEIGHBORHOOD 83 C NEST BARNSTABL£ PARCEL CONTROL AREA ' . "TREND STANDARD 13 . 10 LAND-TYPE 27500 LAUD--BEAN -a0% 27500 64-557 !MPROVEO-nEAN +0% 25' FRONT-FT 1 100 DEPTH/ACRES TABLE 02 100% LOCATION-ADJ APFLY-VAL-STAT AR LAND LPT%IMP AD3S/SS/FEAT STR STRUCTURE ARR AREA-nEAS•UREMENTS NOR NOTES COO MARKET INC; INCOME FOR PERMITS ORR GRAPHIC FUNCTION- STRUCTURE-CARD NO- 000 DATA- XMT ;, ::!2.�_' 017.0105 F E R M .I T FMT ACTION h LARD 000 KEG` 4114320 PERMIT-NO nO YR TYPE VALUE CK-BY MO YR %CMP NEW/DEMO COMMENT B34977 04 92 ND 80000 00 00 000 XFW WB 1.112 ST TOWN OF BARNSTABLE �pF TH E T° OFFICE OF t BABd9TdBL 'r BOARD OF HEALTH NAB& i639* `00 367 MAIN STREET RFD MAY k. HYANNIS, MASS.02601 October 30, 1992 TO: Joe DaLuz Building Commissioner FROM: Thomas McKeani4, Director of Public Health Thank you for your memo dated October 27, 1992. Please advise if the room above the garage is approved for construction into a recreation room or some other "finished" room. *TO/CC LIST* From: W. RUTHERFORD Date/Time: Tuesday 10/27/92 03:03 PM Subject: SHUFELT-BLDG FOLLOW-UP To: T. MCKEAN *MESSAGE* _________________________ THANKS FOR LAST 10/26 MEMO. I AM SENDING TO SHUFELTS. PLS DISCUSS WITH BLDG T HE NEED TO INSPECT DWELLING AND GARAGE TO ENSURE CONFORMITY AS YOU INDICATE. t TO: Warren J. Rutherford, Town Manager FROM: Thomas A. McKean, Director of Public Health DATE: October 26, 1992 SUBJECT: Shufelt Letter Dated October 16, 1992 My memorandum dated September 29, 1992 briefly responds to Mr. and Mrs. Shufelt's concern regarding the date of installation of the septic system. Health Inspector Jerome Dunning stated the septic system construction began within the two year time frame, prior to March 21, 1992 . The Certificate of Compliance was not issued until months later, after June 15, 1992 when we received the certification letter from the designing Sanitarian. I believe the confusion here is the difference between the date of construction of the septic system versus the date of completion of the septic system. The two year expiration deadline of the Disposal Works Construction permit only refers to the date the licensed installer begins construction of the onsite sewage disposal system, not the date of completion of the onsite sewage disposal system construction. Also, the Disposal Works Construction permit #90-118 was issued on March 21, 1990, not on 11/28/91. The additional four concerns in the above referenced letter are addressed as follows: 1) The first concern is the possibility of re-designing house plans prior to construction. This is presently enforced by the Building Department. The Health Department has been involved in this process. I would like to discuss this issue further with Mr. Joseph DaLuz, the Building Commissioner and Mr. Robert Schernig, the Planning Director. The Health Department and the Building Department work together along with the Conservation Department, Planning Department, and the Historic Department as one Division, entitled the Planning and Permitting Division. This Division meets on a regular basis to discuss permitting issues. I will ask Mr. Schernig, the Planning Director, to place this issue on the agenda of our next Division meeting. 2) The second concern is there is a finished "area" located above the garage. As the variance letter states, the dwelling cannot contain more than three (3) bedrooms. If the room above the garage is enclosed, heated, and provides " sufficient area to be utilized for sleeping purposes, that room shall be counted as a "bedroom" . I again suggest that the Building Department personnel inspect the, dwelling and the garage to ensure it conforms with the State and local Building Codes and the submitted plans. 3) The variance requires the owner to pump the septic system every three years. This will be. enforced by the Health Department. On or prior to June 15, 1995, the owner is required to certify to the Board of Health that the system was pumped. If the certification is not received, the Board of Health may require the Health Department to write an order letter to the owner of the dwelling. 4) The concern is that another variance will be granted without Mr. and Mrs. Shufelt's knowledge should the septic system at Lot 21 Pioneer Path become saturated. Please be advised that another variance will not be necessary. According to the letter from the Board of Health dated September 18, 1989, 'the Board also granted a variance to install the reserve area 125 feet from the abutters well at Lot 7 . In conclusion, please be advised anyone can request a hearing before the Board of Health. If Mr. and Mrs. Shufelt would like to request a hearing, please write a letter briefly explaining the concerns to: Town of Barnstable Board of Health, P.O. Box 534, Hyannis MA 02601. Thank you. i� I TOWN OF BARNSTABL.E 'Permit NoAA3 7?...... � BUILDING DEPARTMENT A"IT j TOWN OFFICE BUILDING Cash „ 7 •Y� 679• HYANNIS.MASS.02601 Bond ..... ......... CERTIFICATE OF USE AND OCCUPANCY Issued to Hans Szimmetat Address Lot #18, 5 Pioneer Path West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID, AND,THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. i December 24, 19 92 ................. ............... ................. Building Inspector i The Town of Barnstable Health Department { "MUK 367 Main Street, Hyannis, MA 02601 ap 039�6)9• ` �a VAX Office 508-790-6265 Thomas A. McKean FAX 508-775-3344 Director of Public Health TO: Warren Rutherford, Town Manager �--�- FROM: Thomas. McKean, Director of Public Health DATE: September 29, 1992 SUBJECT: SHUFELT COMPLAINT, WEST BARNSTABLE-SEPTIC VARIANCE I am in receipt of the electronic mail correspondence dated September 28, 1992. The disposal works construction permit for Lot 21 Pioneer Path, West Barnstable was issued on 3/21/90, more than four months before the variance expired. The permit was valid for two years and the septic installation began within that two year time frame. This variance which was granted was from a local Board of Health Regulation which prohibits the installation of a leaching facility within 150 feet of a private well. The State Sanitary Code, Title V, also regulates the set-back distance and prohibits the installation of a leaching facility within 100 feet of a private well. The applicant in this case met the State Sanitary Code but not the local Health Regulation; he/she requested a variance to install the leaching facility 133 from his/her neighbor's well. I do not believe a 17 foot variance is significant. The Board has granted variances with only a 102 feet separation distance in the past. I believe her recourse for appeal has lapsed. An appeal could have been filed within thirty (30) days of the Board of Health variance hearing, which was held September 16, 1989. In regards to the groundwater direction flow question, a hydrologist or some similar professional would have install at least three (3) monitoring wells and study the water depths in the monitoring wells on the site for several days in order to figure out which direction the groundwater flows. Mr. Dunning stated he has spoken to Mrs. Shufelt several times. He believes she is unhappy about the large garage constructed on this site. The owner collects classic cars and stores them in this large garage. In regards to your question concerning an occupancy permit, the Building Department has control over such permits. However, in my opinion, there would be no basis to deny the occupancy permit due to the fact that the applicant appears to have followed the proper Board of Health and Health Department procedures. If the real issue is that Mrs. Shufelt is upset about the size of the garage, I suggest that the Building Department personnel should check to see if the garage conforms with the Building Permit issued and to see if the garage conforms with the State and local Building Code regulations. i i October 27, 1992 Mrs. Laura Shufelt 1696 Osterville-West Barnstable Road West Barntable, MA 02668 RE: A=128 017.005 Lot #21 Pioneer Path, West Barnstable Dear Mrs. Shufelt: Please be advised that on October 23, 1992 Inspector Richard Bearse did inspect the dwelling/garage under construction at the above location. The only variation from the original plans submitted are the "dog house" dormers on the front of the garage. Upon inspection it was noted that the construction does comply with the provisions of the Massachusetts State Building Code and as .a single family dwelling/garage does comply with the Town of Barnstable Zoning Ordinance. 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