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Home My WebLink About0005 ALICIA ROAD , ol PCA 2-6 67 II r. G� I i r y 1 M1 I �� Q �"� I ,� f ��_ ..z .� �y1 1 �� } .r i ` s .�. ' s� �, Z/oa Oo 9,6 r Date: May 17, 2018 To: Building File RE: Illegal Dwelling Unit/Shed conversion Address: 5 Alicia Road, Hyannis Originator: Anonymous Caller to Debi Barrows Complaint: Caller reports shed has been'sheet rocked, bed installed, and lighting. Construction outside shower on shed &portable outhouse,just delivered. Enforcement Process Steps ® 1. Initiate local investigation: Jeffrey Lauzon ® 2. Document/enter into system Yes ® 3. Contact Not available ® 4. Property Owner Jackson Schulte 5. Seek access to subject property no 6. Seek administrative warrant(if necessary) NA 7. Notify state authorities of findings NA ® 8. Document conclusion Open 9. Referred Health Dept. & Building Dept. 10. Stop Work/Cease& Desist Order .NO RB—Residential single family zone 'Called inspector to site 5/17/18 to investigate Pa z S �b q ' G s '� ° -n" � a DC*$-- m-Oa M3>3> _0 I HcD _ ' aa-o 2T+3 m I Ha -<oCO m -<-<m aHH m I 3H aoH S1 mar z M: z rz mmH L�aH H 1 mm...• Z3C H ==a m-om � i ro EA 1 o0 a7�t-i Hm I [Dm 07 3D mm0 m;:o -0 I 3tf)�a TI-�Z om a I wry = o H I ocn �)vz m z a I mach z c om�� 3 I CD r'JH-ia 07 i 07 =03 77 m o mr m :::o o zm m y �n1ZJ a a. CM=o r- -! , rnm— Ull cnc-)o I t :;-,CD CD(=)0 CD o I ; •A i - w o00 o I co 000 0 I I h I �f i � I E I' E I o � - �- � � .. � ® w� ,� �l - !. � . � �- � a TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION 7hon Parcel Application # Date Issued ion Application Fee o Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic - OKH Preservation/ Hyannis 4 0 Project Street Address - e Village Owner /! 2 Address 1P Telephone / 3 7— - R` 7' Z Permit Request � 5 4 se ►��-�, �� c.e G H � ��, rH.e� ��; Square feet: 1 st floor: existing /®ydproposed 2nd floor: existir -�^ proposec�� Total new Zoning District Flood Plain Groundwater Overlay [`Project Valuation f' 00 Construction Type Lot Size Grandfathered: ❑Yes No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family Units) A f Existing St re Historic House: ❑Yes B'No On Old Kin 's Highway: ❑YesZNo Age s 9 9 Basement Type: Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area(sq.ft.) 7-D Basement Unfinished Area(sq.ft) 978, 01 Number of Baths: Full: existing new Half: existing new Number of Bedrooms: -3 existing new Total Room Count (not in uding baths): existing new First Floor Room Count Heat Type and Fuel: G s ❑ Oil ❑ Electric ❑ Other 'Central Air: ❑Yes No Fireplaces: Existing New Existing wood/coal stove: ❑Yes /No Detac hod garage: ❑ existing 0 new size o: ❑exi ting ❑ new size : ❑ existing ❑ new size_ Attac garage: ❑ existing ❑ new size _Shed: existing ❑ new size _ Ot Zoning Board of Appeals�No orization ❑ Appeal # Recorded ❑ Q�3� q 7 9nd Commercial ❑Yes If yes, site plan review# rr'' Current Use Proposed Use uu J O APPLICANT INFORMATION (BUIL-DER OR-HOMEOWNER)— Name ,��5 42&h �� Telephone Number C� `'771'� 8 77 Address Z-�z ��l License # Sg 9 g 7 A(V-. A k ,.s moo, 0 3-f0) Home Improvement Contractor# Worker's Compensation # 7,/G Z --375-P77/I-- 63 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE !�� a` DATE ' _k . i*kid r FOR OFFICIAL USE ONLY 44 APLICATION# rt- DATE ISSUED 1 } ,MAP/PARCEL NO.. 1 -ADDRESS VILLAGE OWNER.' r DATE OF INSPECTION:: ,FOUNDATI0N1 FRAME ',-INSULATIX, FIREPLACE ELECTRICAL: OUGH FINAL PLUMBING: ROUGH NFINAL 4. d +-:GAS: ROUGH ar "FINAL �7i;zFlNALBUILDING `li C f DATE CLOSED OUT. ASSOCIATION PLAN.NO. - e �z V; — — a•.z rnw J 9-7 2c , I m _ x d 04;-e.t o o � § 3 0 7 tirl D 0� Aq ' /V Iry AG 401 IX) N (y)?�z l � � VIA Town of Barnstable0# 5 3 O Expires 6:mnnths fr m' date Regulatory:Services Fee MASS. Thomas F. Geiler,Director se e� . BiiildM'g Division Tom Perry, CBO, Building Commissioner + 200 Main Street,Hyannis,MA.02601 ww :.town-barmtable.ma-us Office: 508-862-403 8 i Fax: 508-790-623 0 EXPRESS PERMIT APPLICATION RESIDENTIAL ONLY of VaUd without Red X-Press Lnprint Map/parcel Numberol Property Address 5 f G/c19 ► /t//t/t:S ❑Residential Value of Work Minimum fee of$35.00 for work under$6000.00 b N � Ow ��ner's'Name&.Address, /�' D" ) �( � • �3 /( Qj Contractor's Name Telephone Number 4 Home Improvement Contractor License#(if applicable) X-PRESS PERMIT Construction Supervisor's License#(if applicable) OWorkman's Compensation Insurance Check one: , El kf�nasole'pr6prietor TOWN OF BARNSTABLE I am the Homeowner ❑.I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit Permit Request(check box) = 0 '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- e #of doors Replacement Wmdows/doors/sliders.U-Value (maximum.35)#of.windows ❑ 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 Improve ent Contractors License.&'Construction Supervisors License is required: SIGNATURE: . QXWPFHM\FORMS1bwlding permit formslEXPRFB1doC l The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le•ibl NaIn �e- Business/Organization/Individual): . U /f.� /' /(`o City/S�-t_ate/Zip:--,. _ 4��s a10 dO(eO/ Phone.#: 5-6,F- 7.7 Are you an employer? Check the appropriate box: Type of project(required):. 1..❑ I am a employer.with 4, ❑ I am a general contractor and I employees (fall and/or.part-time). * have hired the sub-contractors. 6. El New construction . 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g. ❑Demolition workingfor me in an capacity. employees and have workers' Y P tY t ' 9. ElBuilding addition [No wo ers' comp.insurance comp.insurance. fired.] • 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions 3. ' I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees. [No workers' 13.❑ Other comp.insurance required.] . *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy.information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. xContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins". Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure,to secure coverage as required:under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of.a STOP WORK ORDER and a fine . of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and Pe nz&l of perjury that the information provided above is tr a and correct GSi a'_.,.'�e— C. CDate:� m PPhone# ?� _ 0a Official use only. Do not write in this area,to be completed by city or town offciaL City or Town: Permit/License# Issuing Authority(circle one): - 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ' - Information and Instrauctions 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 i acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for,the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority.". Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call.the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is.complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in _(city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call.. The Department's address,telephone-and fax number: .The Commonwealth of Massachusetts D ,partmeut of Industrial.Accidents Office afinvest gations 600 Washington Street Boston, MA 02111 Tel. #617-727-4900 ext 406 or 1-977-MASSAFE Revised 11-22-06 Fax#617-727-7749 www.mass.gov/dia j � t r Town of Barnstable Regulatory Services rUMST,mLE, Thomas F.Geiler,Director y Mnss �A 1639. ,�� Building Division tED MP'I� Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 , www.town.b arnstable.ma,ns Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION �/ ^5 Please Print DATE:-_ JOB-LOCAT-M— g o//(C—//9 kc number street. 7 village "HOMEOWWNER'':— C! l��11J t �f c7 �d(�— 7 /—. cJ O O a name v home phone# work phone# CURRENT MAILrN—G-ADDRE9S--"'.— f3 city/t 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 xeside,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 fours 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 e�quirements and that he/she will comply with said procedures and require ents`� . S�ignature-of Homeowner��` ` ..� , wZ *. Approval of Building Official Note: Three-family`dwellings containing 35,000 cubic feet or larger will be required to comply witli 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 forUcensing 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:forrns:homeexempt OpIME T Town of Barnstable ' } Regulatory Services ylag' Thomas F.Geiler,Director a6gq. 10 iOrFn�►.t� Building Division Tom Perry;Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-403 8 Fax: 508-790-623 0 Property Owner Must.. Complete and Sign This Section If Using A Builder as Owner of the subject property, hereby authorize to act on my behalf, in all matters relative to work authorized.by this building permit: (Address of Job) **Pool fences and alarms are the responsibility of the applicant. Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner -Signature of Applicant Print Name Print Name Date Q:FORM&OWNERPERMISSIONPOOLS 62012 Cape Cod Court Reports Page 1 of 1 BARNSTABLE DISTRICT COURT February 7,2012. In court February 6,2012 ARRAIGNMENTS ANTRM,John P,24,194 Knotty Pine Ln,Centerville;kidnapping;assault&battery with a dangerous weapon,not specified;assault&battery;intimidating a witness;threatening to commit a crime;vandalizing property,February 2 in Barnstable. Co-defendant with LONG. Pretrial conference scheduled for February 17. BONFIGLIO;Anthony E;,2Ah„ d,Hyannis;Class B drug possession with intent to distribute,oxycodone; conspiracy to violate drug laws;disorderly conduct-,January 24 in Barnstable. Co-defendant with LITCHMAN and THOMSON. Pretrial conference scheduled for April 9. According to police reports,a Massachusetts state trooper and a Barnstable officer were on undercover patrol with the Barnstable Street Crime Unit.,From an unmarked cruiser parked off Route 28,they watched Bonfigho enter,then exit cars arriving at a Hess station. They followed Bonfigho as he left in a green'Ford Explorer. Police saw the SUV had an expired sticker,then effected a traffic stop. One passenger's lap held a plastic bag holding three pills: one dark blue,marked V/4812,the others light blue and marked M/3o. No one would admit to owning the bag. Police arrested all three men: { http://www.capecodtoday.com/news/Court 2/7/2012 11in�irnr� o� �1C,nst�.��'� Leased Housing Dept: 508.771.7292 Telephone 508.771.7222 w�aNar�nuZ E ABLE FAX: 508.778.9312 TOWN OE BAR ST, •6 9 , Housing Authority 14.6 South Street•Hyannis,MA 02601 2010 NOV -8 Al 11: 32 ZONING VERIFICATION TO: Linda/Robin DIVISION FROM: Kim Gomez, Leased Housing Coordinator PHONE NO#: 508-771.-7292 FAX 508-778-931.2 RE: LEGAL RENTAL UNIT VERIFICATION - DATE: Q ADDRESS: - VILLAGE.: /Y UNIT TYPE _ BEDROOM SIZE_ MAP & PARCEL NO: �qa The owner of the above listed property is entering into a contract with us for rental of the property.Listed above. Please verify by signing below that the unit is legal and meets all.zoning r- rements for a rental in the town of.rB .sta�ble. If it does not, please list the zeason'bel.ow: M 0 U ULA-AIA- ix . you for your. assistance ill this hatter. Si �.aturc Print flame Date: (� VIA FAX: 508-790-6230 Equal.I-fousi.ng Opportunity 7lgey�cy ti TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map C Parcel ZZ ;Application # o 37 Health Division Date Issued Conservation Division Application Fee k Y Planning Dept. h Permit Fee' Date Definitive Plan'Approved by Planning Board r Historic - OKH Preservation /Hyannis Project Street Address Village .44 n r 5 0 wnerJ,� ,� hr'j�. JP 1, Address Telephone Sn c q Permit Request d - Square feet: 1st floor: existing prop rct-fl�r� existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation ?"0 0 Construction Type 7 Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting docut. entation. Dwelling Type: Single Famil Two Family ❑ Multi-Family(# units) — _n Age of Existing Structure .3 Historic House: ❑Yes o On Old King Highway,;, ❑ No Basement Type: Full ❑ Crawl ❑Walkout ❑ Other ' Basement Finished Area (sq.ft.) Basement Unfinished Area (sq. ) O Number of Baths: Full: existing „ new Half: existing new Number of Bedrooms: existing new Total Room Count (not including baths): exi ng new First Floor Room Count Heat Type and Fuel: 4 Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes If No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detach rage: LJ existing ❑ new size_❑ existing ❑ new size _ B . ❑ existing ❑ new size_ Attache rage: ❑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 ( JILDER OR JIOMEOWNER) Name C Telephone Number Address C License# o-, » h 2 S /Mz Home Improvement Contractor# /CSC_g� Worker's Compensation # ti✓c:Z - /S- �!Z 11-03� ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO SIGNATURE DATE / ZL /d FOR OFFICIAL USE ONLY _ r. APPLICATION# DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. 4 r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information y Please Print Legibly Name (Business/Organization/Individual): 0.115 14 4 Address: Is C G City/State/Zip: c.,ra v, i 0 �61 Phone #: G ' Are you an employer?Check the appropriate box: Type of project(required): 1.❑ 1 am a employer with -4. 0 I am a general contractor and I 6 =0 New construction mployees (full and/or part-time).* have hired the sub-contractors.- .. _._ --------- 2.l� 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' q Building"addition • = [No workers comp. insurance comp: insurance.$ 10.0 Electrical repairs or.additions K 5. 0 We are a corporation and its required.] 3.❑ I a homeowner doing all work officers have exercised.their 11,0 Plumbing repairs or additions . myself. [No workers' comp. right of exemption per MGL 12.0 Roof repairs l insurance required.]t c. 152, §1(4),and we have no I Other J employees..[No workers' comp. insurance required.]= *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet shoiving 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 thepolicy and job site information Insurance Company Name: Policy#or Self-ins.Lic.#: 6✓C Z S- 3 I Z t�) 3 Expiration Date: Job Site Address: A-e 1 a �d► 6 - City/State/Zip: / rM'h'? 'f r -�i: �Z�0 Attach a copy of the workers''compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a'STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 1 do hereby certify un a pat9s and penalties of perjury that the information provided above is,true and correct Signature: . —' Date: J 0 • Phone#: �-7 7 1 -. - 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 ,-5. Plumbing Inspector 6.Other 7 Contact Person Phone# ,, Information and rpstructi.ons Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. yee is defined as "...every person'in the servi re, ce of another under any contract of hi Pursuant to this statute, an emplo 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, constriction or repair work on such dwelling house hall not because of such employment-be deemed to be an employer." or on the grounds or building appurtenant thereto s MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall Ivithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." •Additionally,MGL chapter 152, §25C(7) states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation aff davit completely, by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s), address(es)and phone number(s)along with their certificates) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers'.compensation insurance, if an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial . Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The Affidavit should be returned to the city or town that the application for the permit or license.is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'. compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant: Please be sure io fill.in the permit/license number which will be used as a.reference number. In addition, an applicant that most submit multiple permit/license applications in any given year, need only sub (city or mit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in town)."A copy of the affidavit that has been.officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture 0.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this afdavit, The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's'address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-87.7-MASSAFE Fax'# 617-727-7749 Revised 4-24-07 www.mass.gov/dia - Town of Barnstable , Regulatory Services HARNSTABr iE�,` Thomas F. Geiler,Director 0. Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town,b arnstable.ma.us- Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder l as Owner of the subject property- hereby authorize Ist to act on my behalf, ,, in all matters relative to work authorized by this building permit application for (Address of Job) Signature of ate Print Name c w n If Property Owner is applying for permit please complete the ' 'Homeowners License Exemption Form on the reverse side, Q. FORMS:OWNERHRMISSION x Town of Barnstable , a Regulatory Services BA Thomas F.Geiler,Director STABLE MASS 9q, se3q. �0� Building Division prEo �a Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village EOWNER": name home phone# , work phone# CURRENT LING ADDRESS: city/town st e, zip code The current exemption fo "homeowners"was extended to include o r-occu ied dwell' s of six units or less and to allow homeowners to eng a an individual for hire who does not p ssess a license, rov�ided that the owner acts as supervisor. DEFINITION OF HOME WNER Person(s)who owns a parcel of Ian n which he/she resides or i tends to reside,on which here is,or is intended to be, a one or two-family dwelling,attac d or detached structur s accessory to such use and/or farm structures. A person who constructs more than one horn in a two-year pe * d shall not be considered a homeowner. Such "homeowner"shall submit to the Building O ial on a fo acceptable to the Building Official,that he/she shall be responsible for all such work performed under th build' permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibili r compliance with the State Buildin Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that h she understands e Town of Barnstable Buil ing Department minimum inspection procedures and require ents and that he/she 11 comply with said proc lures and requirements. - Signature of/dn owner Approval ofng Official Three-famil dwellings containing 35,000 cubic feet or larger will be re uired o comply with the State Builode Secti n 127.0 Construction Control. HOMEOWNER'S EXEMPTION Tde states at: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this sectition 1 .1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that sm net shall act as supervisor.o eowners who use this exemption are unaware that theyare assuming the responsibilities of a supervisor(see Appendix Q, Rules&Res for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the hoer hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. meowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\bomeexempt.boiC. f q � y � � 4 ' Aa do � pa • � mJ ® I ro rF -. f� e, th s_.._ ;Massachusetts- Department of Public Safett Board of Buildin!- Re.-ulations and Standai-ils Construction Supervisor License 1 License: CS 58987 Restricted to: 00 STEPHEN E BOBOLA 24 ST FRANCIS CIR ,HYANNIS., MA 02601 Expiration: 2/4/2012 " ('ununissiuncr Tr#: 15882 ✓fie -C�arr�nreoouuea� o�✓f/laaaaclzueel� - - . Office of Consumer Affairs&Business Regulation License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registratioti,�'1:58588 Office of Consumer Affairs and Business Regulation Expiratlonw 211't/2012 Tr# 291750 10 Park Plaza-Suite 5170 TYPe v E PartneTsfip Boston,MA 02116 I MASS BUILDING S�GEMS p' STEPHEN BOSO. ?� 24 ST.FARNCIS C RCLE' HYANNIS, MA 02601' r - Undersecretary Not valid without signature tr� r . k,ff rr'pr d J .. s ¢ k`, • q k' _'. _ TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION e 3 Map �qZ7-1 :Parcel Application# Health Division Conservation Division Permit# Tax Collector Date-Issued Treasurer Application Fee Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic-OKH Preservation/Hyannis Iv Project-Street Add essd. Village err�lb� dev�. 1ir�h� i� Add514 rid. �n �`s r.TeIephone___,1S0E ")8 1) 0 (110 - Permit Request Square feet: 1 st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation �0 Construction Type Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure 'Historic House: ❑Yes ❑No On Old Kings Highway: ❑Yes ❑No Basement Type: ❑Full ❑Crawl` ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other C= Central Air: ❑Yes ❑No Fireplaces: Existing New Existing wood/cge:¢stove: 91 es ❑No Detached garage:O existing ❑new size Pool:❑existing ❑new size Barn:❑ ting ❑&w size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: -° Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ CA rn Commercial ❑Yes ❑No If yes, site plan review# Current Use posed Use D BUILDER INFORMATION Nam-- �-- t �� r f Telephone Number 4dre,s---__5 P.i I.I � L LIIiGIIJri T�7 Worker's Compensation# AL-L COO NST- CTION.DEBRIS_RESU M TH18'PROJECT WILL BE TAKEN TO A SIGNATURE DATE FOR OFFICIAL USE ONLY) PERMIT NO. DATE ISSUED MAP/PARCEL NO. 1 ' ADDRESS., VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION FRAME - x INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL , . t GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.- M1 t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111' w0w.mass.gov/dia ' Workers"Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print_JGegibly �Nau1e(Business/OrgaMMtL n/Individual)�n, . i Address: City/Staf,te/Z p.:_ CX Phone t .eyou-an employer?Checkthe appropriatebox; : :Type of project(required). 4. I am a general contractor and I 1;❑ I am a employer with ti. New construction . employees (full and/or part-time).* • have hired the sub-contractors listed on the'attached sheet. 7. ❑Remodeling 2.❑ I am a'sole proprietor or partner- These sub-contrac have tors h ship and have no employees 8. ❑Demolition employees and have workers' iyorking for me in any capacity. $. 9. ❑Building addition [No workers' comp,insurance comp,insurance. C � ❑ 5. We are a corporation and its 10. Electrical repairs or additions� uiied: � . -� _ '] officers have exercised their 11.[]Plumbing repairs or additions ' r 3. I am a ho;eownerdoing ill-work . - --my-s�lf.-,[Norworkeis-comps rightbfexemptionperMGL 12,E]Roof repairs -- •__ t c. 152, §1(4),and we have no insurance.r ] 13.[] Other employees. [No workers' • comp,insurance required] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowoers,who submit this affidavit indicating they are doing all work and then hire outside contractors mugt submit anew affidavit indicating such.. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether ornot those entities have . employees. Kthe 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 jab site information. Insurance Company Name: Policy#or Self-ins.Lic.# Expiration Date: Job Site Address: City/State/Zip• Attach a copy of the workers' compensation policy.declaration page•(showing the policy number and expiration date). Failure•to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine tip to$1,500.00 and/or one-year imprisonment,as well as civilpenalties in the form of a STOP WORK,ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the-Office of Investi a o of the'DlA for insuaance covers eve lion. I do here b c u der the pains. nd a ,'es Of ju at the in provided above,is true and correct; 41 Sil< Phone#: FOther only. Da not write in this area, fo,be completed by,city or town aff�ciaL n: ' .Permit/License# hority(circle one): Health 2,Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector rson: Phone#: Information ana instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for the employees. Pursuant to this statute, an employee is defined as"..,every person in the service of another under any contract of bite, 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." AdditiomaIly,MGL chapter.152,§25C(7).states"Neither the commonwealth nor any of its political subdivisions shall 'enter into any contract for,the performance of public-work until acceptable e'vider ce-afcompliariee:with:t?ie incinaarce- requirements of this chapter have been presented'to the contracting authority." Applicants Please B11 out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-conti•actor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability'Companies'(LLC)or Limited Liability Partnerships(LLP)with no employees other than the . mbmbers*or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage, Also be sure to sign and date the affidavit. The affidavit should be returned to the-city of town that the application for the pemiit.or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law-or if you are required.to obtain a workers' compensation policy,please call the Department at the number listed below, Self-insured companies should enter their self-insurance license number on the appropriate-line. City or Town Officials Please be sure that the affidavit is complete*and printed legibly. The Department has provided a space at the bottom of the-affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all•locatiom in (city-or town)."A copy of the affidavit that has been officially stamped or marked by the city or town maybe provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves-etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank YOU please advance for your cooperation and should you have any questions, please ao not hesitate to give us a call The Depaztment's address,telephone-and fax number:. The Commonwea&of Mamduwtts Departomt dladusWW A.cddmts Qffkl� Of fnvesialgat olks 600 Washington S.tma Boston, 02111 - . W.##617-727-4 eat 406 or I477- ASSAFE Fay##C17-7274749 Revised 11-22.0.6 www.mamgov/dia f ti �°FTHETO�ti 'Town of Barnstable Regulatory Services BABIVSTAEM • Thomas F.Geiler Director 9 MASS $ � . n MAC 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. �Sf ftict.:�Bstimat (� Type o__ f W°Zk: UC trL� /IJUh�S ` A� _ddress-of Work:"`+�j A ` t C_t 0\ PC( . *1G n v i S YE A 0.2ro0 Owner -Name, 1 it i Ytir� Date of A lication:, .15 I y Lai) 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 der.pulling.own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME MROVEMENT WORD DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. Date [Owner's Name Q:forms h omeaffidav r Town of Barnstable yP Regulatory Services sAxrtsrnst e, : Thomas F.Geiler,Director MASS. g q,A 1639• ,0 Building Division lED MAC A, Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEONAINER LICENSE EXEMPTION Please Print DATE:_,SJ 4 Q LOCATION: �l 2 c4 . �_I G[N yl JOB ( S In P WVV number street O village "HOME0NN NER-''"�"_S: A �' �, IZCV, 5(D — I O.9 1,60 5pS 31.0!P S yS home phone# work phone# CURRENT-MAILING:ADDRESS:--"� city/town state zip code The current exemption for"homeowners"was extended to include oymer-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 10.9.1.1) 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 Jh:inimam inspection procedur s and re irements and that he/she will comply with said procedures and e : e ents. i 4 0. Si�gnuture'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 � a7 6 � cj�Hyalt _ � TtHE TOWN OF BARNSTABLEBuilding' n, Application Ref: 200702766 BARNSTABLE, Issue Date: `05/11/07 Permit y MASS �ArFO 339. IN Applicant: PINHEIRO,LIBERINA D Permit Number: B 20071022 Proposed Use: SINGLE FAMILY HOME Expiration Date: 11/08/07 Location 5 ALICIA ROAD Zoning District RB Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 292229 Permit Fee$ 25.00 Contractor PROPERTY OWNER Village HYANNIS App Fee$ 50.00 License Num OWNER Est Construction Cost$ 2,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND RESTORE TO A SINGLE FAMILY HOME BY REMOVING BEAUTY THIS CARD MUST BE KEPT POSTED UNTIL FINAL SALON ON THE 1 ST FLOOR AND THE 3 ILLEGAL BEDROOMS IN Bd SEN1`1 WECTION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: PINHEIRO, LIBERINA D BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 5 ALICIA RD INSPECTION HAS BEEN MADE. HYANNIS,MA 02601 L4 ) Application Entered by: PR- Building Permit Issued By: — ks THIS PERMIT CONVEYS NG RIGHT TO OCCUPY ANYSTREET,"ALLY OR SIDEWALK'.OR.ANY PART THEREOF;.EITHER TEMPORARILYOR PERMANENTLY': ENCROACHEMENTS ON PUBLIC PROPERTY,NOT SPECIFICALLY PERMITTED UNDER THE BUILDINGCODE,MUST BE APPROVED BY TI-IE JURISDICTION. STREET ORALLY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS:MAY BE,OBTAINED FROM;THE,DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE-THE APPLICANT FROM THE CONDITIONS OF,ANY.'APPLICABLE SUBDIVISION RESTRICTIONS MINIMUM OF FOUR CALL INSPECTIONS REQUIRED FOR ALL CONTSTRUCTION WORK: 1.FOUNDATION OR FOOTINGS. 2.ALL FIREPLACES MUST BE INSPECTED AT THE THROAT LEVEL BEFORE FIRST FLUE LINING IS INSTALLED. 3.WIRING&PLUMBING INSPECTIONS TO BE COMPLETED PRIOR TO FRAME INSPECTION. 4.PRIOR TO COVERING STRUCTURAL MEMBERS(READY TO LATH). 5.INSULATION. 6.FINAL INSPECTION BEFORE OCCUPANCY. 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. PERMIT WILL BECOME NULL AND VOID IF CONSTRUCTION WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE PERMIT IS ISSUED AS NOTED ABOVE. PERSONS CONTRACTING WITH UNREGISTERED CONTRACTORS DO.NOT HAVE ACCESS TO GUARANTY FUND(as set forth in MGL c.142A). Ole „a W "low ill ✓r BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 2 2 2 3 1 Heating Inspection Approvals Engineering Dept Fire Dept 2 Board of Health LATEST IN HIS&HERS BLOW STYLE CUTS unisc% MR ''// 1'ina -t OTous.£ of�BEauty SPECIALIZING IN PERMANENT WAVING HAIR COLORING&CUSTOM CONTOUR CUTTING EXPERT WIG HAIR STYLIST IN ATTENDANCE 5 ALICIA ROAD TEL. e HYANNIS,MA 02601 508-778-7160 w www.linashouseofbeauty.com L 02�0`� 4� ))//1 ' 4�. �� '1 J V �� r �\� � ,� � o��' � '� v � .�� 05/25/2007 TOWN OF BARNSTABLE PG 1 10 : 13 PC APPLICATION PROFILE piappent GENERAL APPLICATION ------------------- Application ref 200702766 Department BUILDING DEPARTMENT Location 5 ALICIA ROAD Parcel 292229 Cross streets Add' 1 loc desc LOT 101 Municipality HYANNIS Subdivision Lot 0 Existing use SINGLE FAMILY HOME memo Current Zoning RESIDENCE B DISTRICT Applicant PROPERTY OWNER Proj/Activity RESIDENTIAL ADDITION/ALTERATIO Class of work ALTERATION Description RESTORE TO A SINGLE FAMILY HOME BY REMOVING BEAUTY SALON ON THE 1ST FLOOR AND THE 3 ILLEGAL BEDROOMS IN BASEMEN Proposed use SINGLE FAMILY HOME memo Proposed zoning RESIDENCE B DISTRICT P 9 Non-conforming N Applic received 05/04/07 Estimated cost 2 , 000 Estim start/end Actual start/end Impervious Surf Status ACTIVE Status code desc ACTIVE APPLICATION Multiple submissions N Next action Government owned N memo Ordinance ref Reason for app Parent app ROLES/NAMES Role Name/Address PROPERTY OWNER PINHEIRO, LIBERINA D 5 ALICIA RD HYANNIS, MA 02601 PROPERTY OWNER PROPERTY OWNER Phone : (000) 000-0000 Tradesman Name Lic Type License number Class Expires PROPERTY OWNER OWNER y 05/25/2007 TOWN OF BARNSTABLE PG 2 10 : 13 PC APPLICATION PROFILE piappent Application ref : 200702766 (continued) GENERAL CONTRACTOR PROPERTY OWNER Phone : (000) 000-0000 Tradesman Name Lic Type License number Class Expires PROPERTY OWNER OWNER PREREQUISITES ------------- Prereq Action Dept Needed By Approved By Status CONSERV APPROVAL 6701 05/07/07 FSTE APPR HEALTH APPROVAL 6500 05/07/07 MMOR APPR restoring property to a single family home with 3 bedrooms . removing illegal bedrooms in basement and beauty salon. TAX APPROVAL 6300 05/07/07 JENG APPR 05/07/2007 WORK COMP SUBMISSION 6300 05/07/07 JENG APPR 05/07/2007 PERMITS Type Permit Number Status Issued Fee Unpaid Amt RES APP FE ISSUED 05/04/07 50 . 00 . 00 RES ELEC REVIEW . 00 . 00 RESADD/ALT 20071022 ISSUED 05/11/07 25 . 00 25 . 00 TOTAL: 75 . 00 25 . 00 AUDIT HISTORY -- --- -------- Department Action Source Created by Date Comments BUILDING DEPARTMENT Permit issued APP romap 05/11/07 Permit no 20071022 , Permit type RESADD/ALT, UNPAID BUILDING DEPARTMENT Permit payment collected APP permit 05/07/07 Payment collected on permit RESIDENTIAL ADD/ALT APP FEE B BUILDING DEPARTMENT Prerequisite approved APP permit 05/07/07 WORK COMP on 05/07/07 BUILDING DEPARTMENT Prerequisite approved APP permit 05/07/07 TAX on 05/07/07 BUILDING DEPARTMENT Prerequisite approved APP karled 05/07/07 CONSERV on 05/07/07 BUILDING DEPARTMENT Prerequisite approved APP health 05/07/07 HEALTH on 05/07/07 BUILDING DEPARTMENT Application entered. APP permit 05/04/07 BUILDING DEPARTMENT New plan review started. APP permit 05/04/07 Plan review number 00 was created. ** END OF REPORT - GENERATED BY PERMIT COUNTER USER ** °FTME r° Town of Barnstable °^ Regulatory Services 9s^xMASSs � Thomas R.Geller, Director m o°jDrEnMp�a` Bll11d1l1g Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Building Department Checklist Date: `3- 0 '7 Location: /4 LI c 119 P-b Q Year built: cl -7 '5 1p H-07-0 Zoning district: �- ® P- l�12 S Le ceiling height(T basement; 7'3" house) after 1973 only sleeping'room (70-sq. ft.) smokes 0 egress �1 a carbon monoxide detectors ri 0 # sleeping rooms ' # sleeping rooms allowed septic or town sewer 5 C P T ICL # kitchens ? apartment exit order y s car count and license plate# fire separation if needed mechanicals: make up air proper work clearances other 96956WCN'T - 4 '-Oek&:b bepk5 gfo L7Cb L x r-t- D ev 2 building permit needed (Z E S7v `1-6 5o"TEE F -W Ty electrical permit needed plumbing permit needed I f °FTME Tqy Town of Barnstable Pv ti Regulatory Services * BARNSTABLE� 9 MASS. $ Thomas F. Geiler, Director O°A 039. ♦0 lED MA'S p Building Division Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.b arnstable.maxs Office: 508-862-4038 Fax: 508-790-6230 Building Department Checklist Date: Location: Year built: Zoning district: ceiling height (7' basement; 7'3"house) after 1973 only sleeping room (70-sq. ft.) smokes egress carbon monoxide detectors e # sleeping rooms # sleeping rooms allowed septic or town sewer #kitchens AV ? apartment exit order 144 car count and license plate# fire separation if needed mechanicals: make up air proper work clearances other building permit needed electrical permit needed plumbing permit needed t °FtKWE t° Town of Barnstable Regulatory Services �$" M 'MASS. a Thomas F. Geiler,Director ASS. a r-1639. Building Division Thomas Perry, CBO,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXIT ORDER DATE: IS— 6-7 LOCATION: Under the provisions of 780 CMR, the State Building Code, Section 3400.5.1, you are hereby ordered to immediately discontinue the use of the cellar/basement area for sleeping purposes. LOCAL INSPECTOR SIGNATURE OF RECIPIENT 06 O N w O S.4 Lo�� a Py L�� r T r rc t+ i �' � 'E a'P-" t Fn.. _ t xz � t x AN Av f WF jv VP kT, a `s � k n ft na p q '( ili�ASW p , X `b a ✓ r t y. y,. a _ a c 5 Alicia Road, Hyannis s�S � }„ _ : 5/3/07 WIT- Slow* p sr" ZOO an 0 3° a pN s ' jj 3,1 4�^" �� Om 6 i 3 ��' k 3fr >ij " ' �B7P 1 'k '�c. 5• fiy�, in �`� � •x # '&mot .� Vol ' ll��--,--, Oil _60 � �,3�' �,� ^a. •�. % a ± ,w r a } eiw aaa '"A' may' Y d d sa a ;*� ptr , y -� WIN `p a - MINE s ' AFTSh ZI O , a � ' s x R big 5 ip fix A +Y� "art Ir tK- s .' . ' A.- a�`. l a#` . b .a fi,F. }.f �,r�, £a F 0 Not C ; 01 AIR e, firs Ka IT."' >� Via'It 747 14 � T " 7r r� � In 11 zrjr 5 Alicia Road, Hyannis gA sEme t� ",r 5/3/07 . L oc.ICE��,b ��fZ2� CGS S Da-� /ZP_® i f r x g� ik a E � f4. » 1 5 Alicia Road, Hyannis 5/3/07 MLS Page 1 of 3 Listing Summary Listing#20710952 5 Alicia Rd, Hyannis, MA 02601 * Active (09/28/07) DOM/CDOM:325/325 $115,900 (LP) Beds: 3 Baths: 2 (1 1) (FH) Sq Ft: 1156* Lot Sz: 12196sgft* 'Town: Barn Yr: 1973* Remarks ;Picture Report Listing Violation Hot Price! Buy this bank owned 3 M. bedroom ranch! ' +. r See Map Agent Jack P Creaven (ID: UODQ)Primary:508-737-3728 Secondary:508-428-2300 x28 Other:508-737-3728 Office RE/MAX Classic(ID:CLAS2)Phone:505-428-2300,FAX:508-420-0469 Property Type Single Family Property Subtype(s) Single Family Status Active(09/28/07) Town Barnstable Commission Sub Agent Comm. Buyer Agent Comm. Dual Agent Comm. Dual Var Comm 0% 2.5% 0% No Facilitator Comm 0% Listing Type Excl.Right to Sell Owner Name bank County Barnstable Tax ID 292-229-0-0-BARN Beds 3 Baths (FH) 2(1 1) Approx Square Feet 1156* Sq Ft Source Assessors Records Lot Sq Ft(approx) 12196* Lot Acres(approx) 0.280 Lot Size Source (Assessors Records) Year Built 1973* Publish To Internet Yes Listing Date 09/28/07 Listing Page Commission-Other 0% Showing Instructions Call Listing Office General Page Zoning RB Year Built Desc. Actual Total Rooms 6 Total Levels 1.0 http://ccimis.rapmis.cbm/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAME= 8/18/2008 MLS Page 2 of 3 c:S Basement Baths 0.0 Level 1 Baths 0.0 Level 2 Baths 0.0 Level 3 Baths 0.0 Basement Yes Basement Description Bulkhead Access,Interior Access Foundation Concrete �. Fndation Wing Width 0 Fndation Wing Depth 0 Irregular No Lot Depth 0 Lot Width 0 Topography/Lot Desc. Corner,Level Association No Annual Assoc.Fee $0 Assoc.Fee Year 0 Garage No #of Cars #0 Parking Description Improved Driveway Year Round Yes Separate Living Qtrs No Waterfront No Water View No Convenient To Golf Course,House of Worship,In Town Location,Major Highway,Medical Facility,Shopping Miles to Beach .5-1 Beach Description Ocean Beach Ownership Public Street Description Paved, Public Interior Page. Fireplace Yes Number of Fireplaces #0 ` Master Bedroom OxO Level:First Floor Bedroom#2 OxO Level:First Floor Living/Dining Combo No Living Room OxO Level: First Floor Kitchen/Dining Combo Yes Kitchen OxO Level: First Floor Floors Vinyl,Wall to Wall Carpet Exterior Style Ranch Pool No Dock No Exterior Features Outbuilding Roof Description Asphalt Siding Description Shingle Mechanical Heating/Cooling Natural Gas Water/Sewer/Utility Town Water Hot Water/Water Heat Natural Gas Legal/Tax Annual Tax $1953 Tax Year 2007 Land Assessments $164400 Improvement Asmt $144100 Other Assessments $0 Total Assessments $309100 Annual Betterment $0.00 Unpaid Betterment $0.00 To Be Assessed Unknown http://ccimis.rapmis.com/scripts/mgrqispi.dll?APPNAME=Capecod&PRGNAN E 8/18/2008 MLS Page 3 of 3 Mass Use Code 101-Single Family Title Reference-Book 19978 Title Reference-Page 227 Land Court Cert# 0 Underground Fuel Tnk Unknown Lead Paint Unknown Flood Zone Unknown The listing contract has not yet been validated by MLS Staff. 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©2008 Rapattoni Corporation.All rights reserved. Generated:8/18/08 1:24pm � sir http://ccimis.rapmis.com/scripts/mgrgispi.dll?APPNAME=Capecod&PRGNAME= 8/18/2008 Town of Barnstable Regulatory Services °FT►�rq�� Thomas F.Geiler,Director Building Division swxtvsTAs Tom Perry,Building Commissioner y MASS. 200 Main Street, Hyannis,MA 02601 prfD MA'S� Office: 508-862-4038 Fax: 508-790-6230 Notice of Zoning Ordinances Violation(s) and Order to Cease, Desist and Abate: Liberina D. Pinheiro and all persons having notice of this order. As owner/occupant of the premises/structure located at 5 Alicia Road, Hyannis; Map 292 Parcel 229 ,you are hereby notified that you are in violation of the Town of Barnstable Zoning Ordinances and are ORDERED this date,April 27, 2007, to: 1. CEASE AND DESIST IMMEDIATELY,all functions connected with this violation on or at the above mentioned premises. SUMMARY OF VIOLATION: Violation of Town of Barnstable Zoning Ordinances: Zoning Code Chapter 240-11 Illegal operation of a beauty salon In RB residential zone. 2. COMMENCE immediately, action to abate this violation. SUMMARY OF ACTION TO ABATE: Cease all professional beauty services. And,if aggrieved by this notice and order,to show cause as to why you should not be required to do so,by filing an appeal with the Town Clerk of Barnstable, a Notice of Appeal(specifying the ground thereof) within thirty(30)days of the receipt of this order(in accordance with Chapter 40A Section 15 of the Massachusetts General Laws). If,at the expiration of the time allowed, action to abate this violation has not commenced,further action as the law requires will be taken. By order, W-1 � Robin C. Giangregorio Zoning Enforcement Officer Q/FORMS/viozonel Town o 1,�Barn stable `? 'Y Building-Division 200 Main Street Hyannis, MA 02601 02 1 A $ 00■390,, 0004606238 AUG16 2006 MAILED FROM ZIP CODE 02601 Assist Vaaner 5 Alicia Road ,Hyannis, MA 026011 FORWARD TIME EXFm RTH TO SEND � ASSIS ` 28 )NINE GROVE AVE # 1 i RETURN To sE:NDaR 4 2 I `1 r I f { .�.w •r•w J wriw e \ • kk •.•w e '7 J w. ra` :350 MAIN=STFiEET� X E ,, i t ', TEL:(508 TI52800 A . r?,a?3_ & z: €• - . g.. "ii� f z``dAy . WEST ARMOUTHMA6 (800�1;98 3993. a �� v � (508)778 9628 a tcYService � '�K Mechamcal:Services Pumping&Installation , -_ _ _. Heating&Plumbing : { ,Duct=WolrgVnL+lA - B"' Fire Opt ince EVA� SERVICE INFORMATION, .,w. ......, w ._.:.B..I.LLING__PAy, T # 15322 GNE . -._.�_......... _... VAR " ', °:.. fi,_ ; # .. f .=e. COD ' ;0S8I8`;'"7 O 'VAGI ER ,r* - x VAGNER ASSIS z+: , o_ 5 ALICIA R'D HYANNIS, MA Oc601.. HYANNLS,-....Mp, �+;_C�Q+1 . <_ t CONTACT; VAGNER SITE PHONE:501 8-778-7160 P. 0. # -. VAGNER W 0;; R .K S T E D E. R E 0 U `E E J. T. SEPTIC EVALUATION FOR SALE` pF PROPERTY OPEN DATE: 5/1P.tc�'. �---=------- ---- _�_ — — ----------__—_ _------ -- - -- i NOT RESPONSIBLE FOR DAMAGE TO UNDERGROUND SPRINKLERS OR UTILITIES WHEN DIGGIN! WORK PERFORMED „AND ECU T NEEDED/USED �. Pd"MP- NG/�E�TI'G.�rvSVG: LA�QR � �=;� x� 7, .- _-� ��'� ,"-F�lJt�tF?-INGm8HG.. GALLONS'PUMPED SEAT I C GR'ASE D I,SPOaAL,CHG.o d .....F�' TANK-=S-IZE/T`PE/L.00kTION " r '�{ A'DDL TNK/PIT,_' SIZE/TYPE- LEACHING: FIELD' GALLEY 1�'ITS ` HOSE/LOCATE •: _ DRAIN; CENG: EGIUIP.: D RN :CLEANING:MATL. USED. PRIORTY CHG: 77777777, T CH i -DATE f TRVL ,. ` t ;"3T:At T ` t =END t CHRGD 1 I ME MATERIALS: icy:,, f t 5Y SLS TAX: -. .1 SUBTOTAL: I L:ESS P.YMT..s 1 — -� -- - AMOUNT DUE: r` I (1�ret yt accept` thy : services%��rerfi�r ed as sa sfactb.ry and �n.:,wor in or^der ,. ' Iner^est will :be char^ eda 1 1/ K paad a.lances, : .But er� agree 9 Pit^ month on ,:tn ¢ y CA d rr - "to-`pay .a11 ecti o-n co't's,:-- Ct^e'dit Card - �� ,Type- E77 xp . .- ugm." �",t,. 4}'�� . �^. Py. � {jy, e';:� ti£ ,..� '_-�•' s t i -- -y RO T' 'sPQ�TE.-. _ Page 10 of 11 OFFICIAL INSPECTION FORM-NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFORMATION (continued) Property Address: S Alicia Road Hyannis,MA Owner: Anna NZ Date of Inspection: October 2 2002 Map: Parcel: SKETCH OF SEWAGE DISPOSAL SYSTEM Provide a sketch of the sewage disposal system including ties to at least two permanent reference landmarks or benchmarks. Locate all wells within 100 feet. Locate where public water supply enters the building.._._ 30 � J -0A 10 Barnstable Assessing Search Results Page l of 2 Mk i Home: Departments:Assessors Division: Property Assessment Search Results New Search New Interactive Maas » Owner: 2007 Assessed Values: PINHEIRO, LIBERINA D 5 ALICIA ROAD Appraised Value Assessed Value Map/Parcel/Parcel Extension Building Value: $ 139,800 $ 139,800 292 /229/ Extra Features: $4,900 $4,900 Outbuildings: $0 $0 Mailing Address Land Value: $ 164,400 $ 164,400 PINHEIRO, LIBERINA D Totals $309,100 $309,100 5 ALICIA RD c j ' v! HYANNIS, MA.02601 , (1543 5�N done. Tax Information: Tax information is currently not available for 2007 Construction Details Building Property Sketc arty 3,Ketch & ASI Building value $ 139,800 Interior Floors Carpet Style Ranch Interior Walls Drywall Model Residential Heat Fuel Gas Grade Average Plus Heat Type Hot Air ; ` 4 � . Stories 1 Story AC Type None .� Exterior Walls Wood Shingle Bedrooms 3 Bedrooms r* g Roof Structure Gable/Hip Bathrooms 2 Full ; aA � z* e Roof Cover Asph/F GIs/Cmp living area 1156 ,y b a � f CR' Replacement Cost $162519 Year Built 1973 _. Depreciation 14 Total Rooms 6 Rooms Land http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=29... 4/27/2007 Barnstable Assessing Search Results Page 2 of 2 CODE 1010 Lot Size(Acres) 0.28 AsBuilt Card N/A Appraised Value $ 164,400 View Interactive Maps > Assessed Value $ 164,400i x Sales History: Owner: Sale Date Book/Page: Sale Price: PINHEIRO, LIBERINA D Jun 27 2005 12:OOAM 19978/227 $350,000 DEASSIS,VAGNER Dec 16 2002 12:OOAM 16083/148 $209,900 NG, KIM HOK-KIN &ANNA Y May 15 1990 12:OOAM 7165/016 $95,000 THIBOUTOT, PAULINE E 3095/188 $0 Extra Building Features Code Description Units/SQ ft Appraised Value Assessed Value BRR Bsmt Rec Room 540 $2,300 $2,300 FPL1 Fireplace 1 $2,600 $2,600 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 UST Utility Area(Unfinished) (Finished) 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 TQS Three Quarters Story(Finished) http://www.town.bamstable.ma.us/assessing/assess06/displayparcelO7map.asp?mappar=29... 4/27/2007 WgineeringDept. (3rd floor) Map �T Parcel a eg�it#' ✓5�Z/ 67 House# - ,.� a Date Issued 7 9 d� Board of Health(3rd floor)(8:15 -9:30/F 1:00 4:30) Fee -e, s Conservation Office (4th floor)(8:30- 9:30/1:00- 2:00) Planning Dept.(1st floor/School Admin. Bldg.) Definitive n Appr v d by Planning Board 19 RARNSTARLB, TOWN OFF BARNSTABLE t Building Permit Application ' E Proje t` � ddress ---, c/ Ed , .`'' Village " Ls V Owner A A J u 8 U4 Address\ &J A)LL L L, 4 -Telephone Permit Request First Floor ,�- square feet Second Floor square feet Construction Type Estimated Project Cost $ Q®Q ✓j Zoning District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes ❑No On Old King's Highway ❑Yes ❑No Basement Type: ❑Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No.of Bedrooms: Existing New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas - ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name n Telephone Number Address 7 License# Home Improvement Contractor# Worker's Compensation#Q)(2 NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATU DATE BUILDING PERMIT DENIED A THE FOLLOWING REASON(S) 1 � .\ t FOR OFFICIAL USE ONLY .PERMIT NO. 3 ; DATE ISSUED MAP/PARCEL NO. - ADDRESS VILLAGE- OWNER ' DATE OF INSPECTION: FOUNDATION• FRAME INSULATION FIREPLACE i ELECTRICAL: ROUGH FINAL '.` PLUMBING: ROUGH FINAL ' GAS: ROUGH FINAL ' FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. t' TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map/,9 Parcel Z_ pp Z-9 Application# n Health Division el /1 0,. ►t-f` Conservation Division ' ® , s �� Permit# Tax Collector Date Issued c — Treasurer Application Fee �'' Planning Dept. Permit Fee 6{ O 0 Date Definitive Plan Approved by Planning Board ' Historic-OKH Preservation/Hyannis Project Street Address RL f G/ Zd Village 9V ao✓Jsi�� C / Owner ' L Z < �� Address Telephone a Q k, to Permit Request �J . Square feet: l st floor:existing proposed 2nd floor:existing proposed j Total new Zoning District Flood Plain Groundwater Overlay ' ' ; Project Valuation �� P Construction TYp e / Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting do' umentati6n. _ Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House: ❑Yes - w4o On Old King's Highway: ❑Yes ❑No Basement Type: ❑ Full ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing new Half:existing new Number of Bedrooms: existing new Total Room Count(not including baths):existing new First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air: ❑Yes dNo 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 Vnew size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes ❑No If yes, site plan review# Current Use Proposed Use BUILD/ER INFORMATION Name�� ' i l ✓� ?//,///& ` Telephone Number — 7 / Address � ®s a fR ^� °"F 7 oy' o/�"� License# C. � � � V 1/y/W S Home Improvement Contractor#. Worker's Compensation# ALL CONSTR=�� ! ��TE FR OJECT WILL BE TAKEN TO SIGNATURE 10 FOR OFFICIAL USE ONLY PrARMIT NO. t DATE ISSUED MAP/PARCEL NO. I � ADDRESS _ VILLAGE OWNER - I DATE OF INSPECTION: FOUNDATION FRAME INSULATION ` FIREPLACE ELECTRICAL: ROUGH FINAL , PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO.- f The Commonwealth ofMassachusetts r Department of Industrial Accidents Office of Investigations 0 600 Washington Street Boston, M4 02111 -- � 1v ` .www was&gov1dia . Workers' Coffipensation Insurance LAffidavit., Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 1C,1 I ' City/State/Zip: Phone#: C0 Are you an employer? Check the appropriate box: Type of project(required): 1.0 I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees (full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet t Remodeling ship and have no employees These sub-contractors have Sr. ❑ Demolition workingfor me in any capacity.' workers' comp. insurance. 9 ❑ Building addition o workers' Comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their 3. I am a homeowner doing all work right of exemption per MGL I L[I Plumbing repairs or additions myself.[No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t . employees. [No workers' ! comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy info on t Homeowners wbo submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that cbeck this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name: Policy#or Self-ins.Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failde to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500,.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a facie of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ce 1 u r the pains nd hies o per" ry that the information provided above/is true and correct signafore: A Date: < ® Q Phone#: � S— L 79 ! ` 60 Official use only. Do not write in this area,to be completed by city or town official City or Town: PermitfLicense# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Towu Clerk 4.Electrisai Inspector 5:Plumbing laspe-Itor it 6. Other Contact Persou: Phone#: Information and Instructions , Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employee 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 repreSCntatives of a deceased employer, or the . receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,-§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom. of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future perrnits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, lA 02111 Tel. 617-727-4900 ext 406 or 1-a77-MASSAFE Fax ;; 617-727-7749 Revised 5-26-05 www.mass.aovidia °FtME, Town of Barnstable Regulatory Services �BMAMAMSTABIX Thomas F.Geiler,Director 16 ,19.r A Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-862-4038 Fax: 508-790-6230 Permit no. Date AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the"reconstruction,alterations,renovation,repair,modernization,conversion, improvement,removal,demolition,or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors,with certain exceptions,along with other requirements. Type of Work:. Estimated Cost o' Address of Work a LLn Owner's Name: �I �% �yI �/� Whtn��'� Date of Application: I hereby certify that: Registration is not required for the following reason(s): ElYrork excluded by law Job Under$1,000 ❑Building not owner-occupied ❑Owner 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' i Contr for Name Registratio No. � p 9 e Date wner's ame Q:forms:homeaffidav Town of Barnstable y�P�pF1NE Tp�� Regulatory Services sAxivsiAatE, : Thomas F.Geiler,Director 9 MASS. q,A 039• a,� Building Division • lED MP't ,. Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 - www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: O JOB LOCATION: number i street village "HOMEOWNER": /1 name /home phone# work phone CURRENT MAILING ADDRESS: / � /"I 0 L 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-familydwelling,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 dersigned"homeowner"certi s that he/she derstands the Town of Barnstable Building Department ins ction procedures a uirements n at he/she will comply with said procedures and req SipatureV 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 zk l� � l 1 l� �.�; �'� �.va..va1 na, a,aura t. �r,ttaru UUUt•Cfit! - WiU'uz Wc7cNci C---- Inspeccton -iNti, P�ii oro locaaart, -pMperty. 14 a n iq rs wt; 102 n to o _ I5 101 OhP. SiFOI�! dwe,111 q , appro)(IM 1tel area o� oc�r,�}oation %� nff Gerem 1Q0W�f iooa PMU' .- 7,50LV 1000$G f oodl zonzz Ce ,,lL�A OF PAUL I.CL' y WVt j IfWM# 5 mortgage inswtiott was_pMpared,-f yr w cRoT. v.ER. %Zwg t1110 /U. Boua'►WU dr witc iuortgage, CorpNo 3tJ11 shown. hereon, does h of c faU in a speaca T tx, .j oo c o • with,uxt,e{�ecttve date o f 8-t9-85 and. ate locail'on. o� -dwe ng . does caifonYn.qa if,e local j5onang 6y laws tn.¢ eat' tw oFcolwim4cx m vitt aspect:to horiion-trd dune"tona� scale: V Bach or is exvn pro:,orm mlaht a e»f oreenumt ' Dace: t.Wn, Under MASS. &"11 LJ-aWS C1' '40A-SeC 7L-oT.`r File No- .-v5=AED-- .EASE NOTE: The structures as shown on this plot plan are approximate only. An actual survey is necessary for a precise :termination of the building Incation and encroachment.,, if any exist. either way scross property lines This plan must not he ed for recording purposes or for uac in. preparing deed descriptions and must not he used for variance or building plan irposes. This plan must not be used to locate property lines. verification of building locations, property line dimensions, fences lot configuration can only be accomplished by an accurate instrument survey which may'reflcct,diffcrcnt information than what shown hereon. Please note that this is 'NOT A .BOUNDARY SURVEY' and Is--'FOR MORTGAGE PURPOSES ONLY'. COLONIAL LAND SURVEYING COMPANY, INC. 269 Hanover Street - "Hanover, Mass. 02339 - Phone:.781-826-7186 Fax: 781-8264823 " t } f. a t a ;t t lfigt } r ` 7A / .t 3''�A 'I y�� '�• �1 e• ��. Irk �'". ��,. 1`��,�P #k1 ,f, & A' • w`4R '�' R{„y,�r. , � t t .. �+ �. • ` s � ' �'i� ��A �• �.� „� �`� �� '�,•-. 'J � fl�°��\ AyY��'}a': .t.,#FA.A�;�1� ��" �� J�,✓,�.. PAO TA .��.t. IWE lip— t �➢ ,k :� ��..: �� 'I ai'. x �.=Ar"f,+��r + ��4q, „� � ��n,�� a"•t;'� ._ �fr f f,�l��(`y . T ! ' o .I s� �. *4 ��{y`t Srrt • 'k *��aiA^'� .a ��k m��" ✓fit ;+ }� s.i ;. ry gas'' .�� t�' �s'` o ! � a fA VA fA fit3p 7 1 � M� � � \°i •S . e� 46! g„' ,i i.l t ��I! � �'� •�t�"-•t1�1 v .,"� 7�' s w R ,A4 e t s tad_ �'•.�j - �•x ! •, 3� * 1y ��. E F.iX� ,R�. � �+` ►3�.�`i a`�l��t �y%�.,��? � ir9`y, rs7t�rt�h a k 1 ;11II' ''ttiir•,,t VI�{ s r ' A4 a ' "' � � this lot on an-old New England estate,this new �' � �� -.j '� _ .storage shed is sited to 116, r�' ,,�' .� i pro�ide'a eonyenient spot � � � for garden tools an Fawn A'M equipment. Y x. Y CHAPTER BUILD THE FLOOR Floor joists a Lay the floor out on the slab j j 1 the way it will be nailed together, lining joists up with the marks on 9, the plates. f . . c, `` r ®Using two 3-inch nails for each joint,nail through the plates and into the joists.Ensure that plates and joists -are flush'at top and bottom. ®Measure the completed floor's diagonals.If the measurements f ' are the same,your floor is square.If they aren't,push or pull at the r comers of the floor until the measurements are the same. SHED AND GAZEBO PROJECTS 87 `: CHAPTER ®Lift outside trusses into place so that they } ' siding on the trusses is flush with the wall siding. t ; Install screws at an angle at positions indicated jby arrows. ' ! 2nd Overhang 6" — a on gable ends r __ Y --f 'I s t Center on truss ' + , ®Place oriented-strand roof } decking on the trusses,rough side + ! up,in the order indicated on the o drawing.Nail the decking to the - lit r ; trusses with 2-inch nails at 8-inch intervals,leaving a 6-inchp' ( q 4 overhang at each end of the building,and center the ends of the decking near the dormer over the trusses at each side , 1st f t} - /. afttie dormer. 't. ,i € : B ®Cut decking pieces to • � ��-��^j � - �� fit around the dormer by measuring A and B,transferring v 'w ' 2nd ' i \ Ind the measurements to decking, and using a straightedge or C! chalk line to conned the marks _ \ pit r j for line C.Cut along the marks and nail the decking in place.' E Use the same method to cut' , decking for the dormer roof. i SHED AND GAZEBO PROJECTS 95 ,.�.BU1.4D1-IJG_A GAR.DE.N_SH.ED(_c.o_n-t.i.n_u-ed_) { l� ' TRIM ASSEMBLY Screw from top. °� N 16 IL �6"overhang r ;QX t comer I ' <:. ""�:'"�t"' '_=�..-----.---• cap. � I ®Install soffit trim on the underside of the roof decking on the ®Nail comer caps to the soffit with four 24ch nails. gable ends of the building.Drive wood screws through the decking and into the soffit while holding the soffit tightly against the underside of the decking.Butt soffit board ends tightly against one another.Nail soffit trim on the underside of the trusses with two 2-inch nails per truss.Cut soffit so that joints are centered on the undersides of trusses;butt soffit trim ends tightly. Cut vertically 41 t ftr ®Install gable-end fascia,overlapping the boards at the 11111 � ` peak;nail it in place with 2-inch nails.Using a handsaw,cut -` a line vertically through both boards,then nail the ends in place.Nail front and back fascia to the soffits using 2-inch l nails spaced a foot or so apart. it 46 SHED AND GAZEBO PROJECTS I BUIL+DI.NG_A GAR-DEN—SH.ED cc.onti.n_u_e.d) GABLE ROOF ASSEMBLY t ®Assemble ceiling trusses on a flat } surface.Nail them together as shown " 'a with three 2-inch nails. ,y i :1 J � t { • as ®Place plywood gussets �, .. shown.Use approximately 12 nails to secure each gusset Nail the side gussets first,then the peak gusset then the gusset at the base of the A C". yy `. king post. ®Nail siding in place using four 2-inch'nails in each } piece.Place nails within Y4 inch of the ends of the siding I so that they will be covered by trim when the -- — building is complete.Snug each piece of t ainst the last and use n 4 i siding up ag m \ fl framing square to ensure each piece I of siding is perpendicular to the bottom of the truss. / i{ a 1t iy � f i _ i' a� SHED AND GAZEBO PROJECTS CHAPTER 14 ®Siding for windows and doors will t Place the completed walls around the floor in their proper location.With a helper or two,tip '- overhang the opening slightly.Cut the siding the back wall into place.Have your helpers hold it in place while you tip a sidewall into place. i flush with the openings using a handsaw or Tightly hold or clamp the sidewall flush with the back wall.Secure the two walls together using reci roc p attng saw. . 3-inc h screws placed approximately 8 inches apart.Repeat this procedure with the opposite side ! s,. PP wall,then with the front wall. 41 441 r i �Check the walls for square by measuring diagonals and adjust the J �Screw the walls to the floor.Have a helper the faq�g�pt� ,WJuA UkIAe UMnTent5 are-the same.(Note:the illustrations for wall you're fastening inward,ensuring the wall is tight to the floor but steps 8-10 show horizontal siding nailers between studs.These are taking care not to knock the wall out of square.Fasten the walls to the + required if you're installing vertical siding,but you can leave them out if floor with 3-inch screws placed approximately every 8 inches. you're using lap siding.) 1 i,. I� 1 SHED AND GAZEBO PROJECTS 91 f L. CHAPTER t' ' i� BUILD THE WALLS " ®Assemble all the precut wall parts on the newly completed floor. :` _ Floor::�t�tr,Aj plate Lay out the plates first. 0f Place studs at the marks provided on each plate. r E: Doorheader, `�!~ 1 Nail the studs to the plates using 3-inch nails ` two nails to each joint. Measure the completed stud wall from comer 4 _ - - i to comer.As with the -' - T '" floor,adjust the assembly i — Wall stud until the measurements header �`• t w T are equal. ®Drive a screw through the wall w Top plate assembly into the decking at each comer to ensure I that the wall remains ! square while it is being sided. fir e 1 1 I O I ®Side the walls with the horizontal tongue-and-groove siding provided.(On front and back walls,position siding so that it overhangs the wall by 3%inches Starter Bottom course plate t, on either side so that when the walls are assembled,the siding will cover the gable-end walls.On gable-end walls,install the siding flush with the studs on t either end of the wall.)Use the siding on which the tongue has been cut off for t] ° YV 4 Tongue the first course.Place this course with the square side down,overlapping the i , \has been bottom plate by%inches.Use two 2-inch nails to secure the siding to each stud. Lower lip�� trimmed SHED AND GAZEBO PROJECTS 89 1- ' a � ` . �'�ea 6H ,..- r OME „IMPROVEMENT CONTRACTORS R� ST2 �O1V j oard�o�f B CE.'V'n�R gul ta�ons, an ds ,� . ,. '+ :, i^��Za r.�lecr„ v •`.t*FaW't��rtsre F�'r mod` y»�'�rn. � �'� �> $.. aE30St;Q'1'F e f`!�a'S'SS'8'C�'►USBI.tS', �:,0_�" .`" �'. s J r i� 0 E gMPRflt1IfENTCC�N #2AC�-OR Rb41s . >� �0�3714,�, ;1 N � t�a��on{•0.7�09/�0 �";i�� t ,�. 1 �TYP.b ARTNERSF,IPA •+ r ,r y A F: °' '-'�� "�"� OM� IMPROVEMENT CONTRACTOR ' ,� �,� ; •ram s �� ,��".. � ram' GAZEAULT ON��-ROOF6I I�t;G *: `T ; YPe � RTNERSRIP 4 Pa Cazeault t � - 's � °`�, j'o. t"�r r• Expr anion '�Or109t00 �2 6�ddai�a=lt�Rd v P�$ �.- ;Box 2781' yy ,L'• L q �I Pau ' Cazeau�-t 378.- �� a t)F':F'nRI'MENT OF F'I.JR1,IC AF-F JY 1,36726 ONF •ASHR[.JRl ON'llL(.WE, RM 1.301 L3OSl"OWN i]Fl 021.08-161.8 .ONS1"F2U T : l C ION >JF)F_F2J.0 3Of. L.:rr..rAlSt.. Number,: F-xp.i.rcr CS 026325 10/20/1.999 Rec,tr.icted -ro: s F S yam{ fAUL 1 C A IFf1Ul.'i :;w r _....._.__............ .._.._..__.__...._,..._ ._..._. _ 1585 MAIN S'T .............. 'l OSTERVILI_t_, Lan 02655 �4 { Keep top for receiF�t: and change �M bf adcirc-!ss not.i.fi.cati.on. DEPARTMENT OF PUBLIC SAFETY CONSTRU410i'SUPERVISOR LICENSE 1 .j I Nu bar Expires: F 1585 MRTM'�S1 ); OSTERVIL�E, MA 02655 � • ___ The Commonwealth of Massachusetts Department of industrial Accidents Office 0117 OS99.atloos :. 600 Washington Street s+� Boston Mass. 02111 Workers' Compensation Insurance Affidavit arom �p , name: ,tl A2R N ( location: (x city )a A)A)I! S ohone ❑ I am a homeo er performing all work myself ❑ 1 am a sole proprietor and have no one working in any ca acity ❑ I am an employer providing workers' compensation for my employees working on this job. companvname• DATA- ;;E;<Ha +Pr address: :.:.:..... . dh,. nnILT ---r4I�• phone#: 4 2 8—1 1 7 7 insurance co. CUP= C99N99AX R01icV# / /////%// ❑ I am a sole proprietor, general contractor, or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name: address- hone#: city insurance co nolicv# company name.. -..:,.:.::.. address: dtv- phone#: :..:. :.,:.....:,:,;,., .. , . ;.;.:<.:>:>::::.:�:•::.:::::::::::>:<.:::'. : •of .... Insurance co. Failure to secure coverage as required under Section 25A of.%IGL 152 can lead to the imposition of criminal penalties of a One up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and aline of 5100.00 a day against me. I understand that o copy of this statement may be forwarded to the OIIIce of Investigations of the DIA for coverage verillcation. 1 do hereby certify under the paj#,s and penalties off,erjury that the information provided above is tru,-and ncorrect Print name PAUL CAZEAUL`T' _____Phoned A_1 177 otIIcial use only do not write in this area to be completed by city or town olIIrjal city or town:• permit/license 0 ❑Building Department ❑Licensing Board ❑cheek if Immediate response Is required ❑Selectmen's Office ❑Health Department contact person: phone#• (]Other (antes 9/95 P!A) .V 4� he Town of Barnstable HAM �$ Department of Health Safety and Environmental Services Building Division 367 Main Sian,Hyannis MA 02601 Otlice: 308-?90-62Z7 .. Ralph Ctossca Fax: 509-790-6230 Building Cammissio-. For oMce use only Permit ao. Date AFFIDAVIT SOME ZWROVEMENT'CONTRACTOR LAW SUPPLEMENT TO PERMIT APPIJCA77ON IHGL a 147A requires that the "reconstruction, alterations, renovation, repair, moderni:=tion. conversion. improvement, removal, demoiition, or construction of an addition to any pre-aisting comer 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 amain ceptions.along with other requirements. Ado Type of Est.Cost Address of Work: _ Owner's Name N A Date of Permit Appil=don: / -.� -4 I hereby certify that: Registration is not required for the foilowing reason(s): Work ezduded by taw Job under SI.00D. __Building not mmeroccupied __wner p tag ows permit Notice is hereby Ares that: OWMERS pULIMG TIMM OWN PERMIT OR DEALING_ WITH QNREGLS'TERED COMZiACTORS FOR APPLICABLE H011'IE MWROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGZAM OR GUARANTY FUND UNDER MGL c 142A SI Z UNDER PENALTIES OF PERJURY . x, I hereby afpiy Ora.permit as eat of the owner: Due ntractor Rame Registration No. OR Date Owners Name IIIIIVITIIIifIIIIII -7 '7777 IIII ,77 IIIIIIIitIitIIIIIIIiIItIIIIIIIfIIIIIIifIIIiIIIIIIIIIIIITIIIIIIIitilIIIIitIIIfit A,itIIIIIIilIIII4,IIIIIIIIifIIVIIIIIIIVittIIIIiIilIIIIIifIfIIIIItIIIIIIIVIIIIItIitIIIiIIIIIllIIifIIitIiIItItIIIIIitIC) u IIIM E iIIIIIIIIIIIIIIIIitIIIiIIIVIIIItlIIIIIIf14 4 IIITttIIIIItIifIIIIIIIR 00 m ItItIliIIIIIt_00 4,IIIIIIA 7 IItIIIIIIIIIIiITfIIitIIlIIIIVIIITIIIIIIIIiIIIIfIIIIIIItITeIIIIIitIIIIIIIIifIIIIIIIItItIIIitIIIifIItIIIIlitIIVitIIIIIIIIITIIIitletIillIII41 ititTIIIVIIIIIIIIIIIIIItItIIIIIITVtitIIitItIIIIIIIitititIIIIIIIiIIIIItIIIIIAI;3 IittIfjk,: VIIIIItIIliIfIIIIITIIItIIIIIIIItiIIIIIIIitItIIIIIIIITIITIIIIetIIIIIIIIIiitIIIIIIfitIIIIIItVIIIIIIVIIIiIIiftIIIIIitIIIillII00 M, iIIItIitIiIIIIIIIIIIITtItItIIiIIIIIIITelIIellIlIIilItIItIIillIVIIIor itIItIIiteIIItIVIIIIIIItIIIIIIIIIifIIIIIIitIIllVifIIIIillIIIitIIIIIIIIIIIitittIIttiIIIIIIIititIIIIifIr) IIIIIIIIIIIIIIItIIIIIIllIoo,IIitIIilIitIIIIIItIIIIII4 IIVitVtitr, ItIIIIIIIIIIIiIIIIIIiIIIIIIIIIIIIIIIIIiIIitIIIllIIIIIITIITIIIVitIliIIIIitIIIIIIIITIItIIIIIitIIlIIIIIIIIititIIIIItIIIIIIIIIIIIII�V tIIIIIitIiIIITiIIIIIIIIIIIIIIifIIIfIIItIIIitIIIliIIltIIIIIIIIIIII]1 IIIIIletIit# IilIIIIITItIIIIIIifIiIIVIfIIItIIIIitttIttVIIfIIIIIIIIIIIiIj., IIIIIifitIIIIfIITillIITIIIIIItIIVIitIIIfIIIIlIIIITIII -7777-7- -,T,;ItIIIIIIlIIIIII------------7-77 IitIIIItIItIIIIIiI;', 7 IItIIIIIIIIitIIIIIitITIIIIIIIIIIIItIIIIitIIItIIIIIitVitIIItIIIIliIIIItIillItIIIIIIIitiIIIIitIItIIIIIIIIIIIIIifIITIfiIifIIIIIiifIItifiIIIIIITIIIitIIIIIIitIIIIl't ilIIitIIitIVIIIIIIVIItIIIIIIIIIIIIitITIIIIIIIIIIIIIIiiIIIItIIIIIITIitIifIIIIIIIIIIIitIill IIIIIIItIitTIIIIIIIIIIIIIIII0 c IIIIIIIIIIIIIjkV IIIIttIIItIIIIIitIIIIIfIIII % IIIIIIIIIIIIIititIIIITIIIitIIItitIIIIIIIIIIIIlIIIIIIIIIIIIITITZ IIIIITVIIIiIIVIitIIIIIIIIIIIIITtif ...i i.....IIIIIIIIIIIitIIIIIVjr ITIIIIIitfIIIIIIIIIIIIfIIIIVIIIIIIIIIIIIIitIIIItIIIIIIIIIIIIIIVIillIIfIIIVIIiIVVIIIitIitIitIIIIIIfi i IIIIItIII 'I! 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