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0119 ARROWHEAD DRIVE
r/� ��a Y i i� i� I Y� 1 I f IV i 1 1 Town of Barnstable F� Regulatory Services Richard V. Scali,Director Building Division BMWSTABM M'M Paul Roma,Building Commissioner 1639. Fp Mpi& 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Approved: Fee:. Permit#: C�- HOME OCCUPATION REGISTRATION. Date: qN l6 Name: w lv 4� _ Phone#: Address: I�� 40o LJU Village: Name of Business: 1- v/4111 V[,� 02 &O Type of Business: Map/Lot: .l J INTENT: It is the.intent of this section to allow the residents of the Town of Barnstable to operate a home occupation within single family dwellings,subject to the provisions of Section 4-1.4 of the Zoning ordinance,provided that the activity shall not be discernible from outside the dwelling: there shall be no increase in noise or odor;no visual alteration to the premises which would suggest anything other than a residential use;no increase in traffic above normal residential volumes;and no increase in air or groundwater pollution. After registration with the Building Inspector,a customary home occupation shall be permitted as of right subject to the following conditions: • The activity is carried on by the permanent resident of a single family residential dwelling unit,located within that dwelling unit. • -Such use occupies no more than 400 square feet of space.- 0 There are no external alterations to the dwelling which are not customary in residential buildings,and there is no outside evidence of such use: • No traffic will be generated in excess of normal residential volumes. • The use does not involve the production of offensive noise,vibration,smoke,dust or other particular matter,odors,electrical disturbance,heat,glare,humidity or other objectionable-effects. • There is no storage or use of toxic or hazardous materials,or flammable or explosive materials,in excess of normal household quantities. • Any need for parking generated by such use shall be met on the same lot containing the Customary Home Occupation,and not within the required front yard. • There is no exterior storage or display of materials or equipment. - • There are no commercial vehicles related to the Customary Home Occupation,other than one van or one pick-up truck not to exceed one ton capacity,and one trailer not to exceed 20 feet in length and not't_o ' exceed 4 tires,parked on the same lot containing the Customary Home Occupation. , • No sign shall be displayed indicating the Customary Home Occupation. • If the Customary Home Occupation is listed or advertised as a business,the street address shall not be included. • No person shall be employed in the Customary Home Occupation who is not a permanent resident of the dwelling unit. I,the have Dead-and with the above restrictions for my home occupation I am registering. Applicant- Date: ?//A" Homeoc.doc Rev.06/20/16 YOU WISH TO OPEN A BUSINESS? :. For Your Information: Business certificates (cost$40.00 for 4 years). A business certificate ONLY REGISTERS YOUR NAME in town (which you must do by M.G.L.-it does not give you permission to operate.) You must first obtain the necessary signatures on this form at 200 Main St., Hyannis. Take the completed form to the Town Clerk's Office, 1 st FI., 367 Main St., Hyannis, MA 02601. (Town Hall) and get the Business Certificate that is required by law. DATE: Fill in please: APPLICANT'S YOUR NAME/ IS/9��1JW � ::•,,,,,,t;,:�r;,�e:at;zktu-��'�:: �, BUSINESS YOUR HOME ADDRESS: ` TELEPHONE # Home Telephone Number b El N #: E-MA I L: NAME OF CORPORATION: NAME OF NEW BUSINESS PE OF BUSINESS P4M.1l IS THIS A HOME OCCUPATION? NO - ADDRESS OF BUSINESS. : l ti D MAP/PARCEL NUMBER a (Assessing) When starting a new business there are several things you must do in order to be in compliance with the rules and regulations of the Town of Barnstable. This form is intended to assist you in obtaining the information you may need. You MUST GO TO 200 Main St. (corner of Yarmouth ' Rd. & Main Street) to make sure you have the appropriate permits and licenses required to legally operate your business in this town. 1. BUILDING`COIMMISSIONERPKUFFICE This individual has b en ' or of any i e uiremerits that pertain to this`type of business.MUST COMPLY WITH HOME OCCUPATION RULES AND REGULATIONS. F Authorize Signature** COMPLY MAY. GULATESULT IN . FAILURE TO COMMENTS: D _ 2. BOARD OF HEALTH c This individual has been informed of the permit requirements that pertain to this type of business. Authorized Signature** COMMENTS: 3. CONSUMER AFFAIRS (LICENSING AUTHORITY) This individual has been informed of the licensing requirements that pertain to this type of business. Authorized Signature** COMMENTS: . Cape Save Inc. TOWN OF BA NSTABLE, 7-D Huntington Avenue South Yarmouth, MA 02664 °� � Pin -S Pi1 32�., , Tel: 508-398-0398 Fag: 508-398-0399 D7rvis.Cp,,j 11/29/14 Thomas Perry CBO Town of Barnstable Building Division 200 Main St. Hyannis,MA 02601 r RE: Insulation Permits Dear Mr. Perry This affidavit is to certify that all work completed for 119 Arrowhead Dr. (permit#B 20142898) has been inspected by a third party Certified Building Performance Institute(BPI)Inspector. All work performed meets.or exceeds Federal and State Requirements. Sincerely, William McCluskey A TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION �j a T I J "1 6 ®�-P Map Parcel Application # Health Division Date Issued 0- ,Zq /y ?or— Conservation Division Application Fee Planning Dept. Permit Fee �2< Date Definitive Plan Approved by Planning Board Historic - OKH _ Preservation / Hyannis Project Street Address g�crow �►CC4, c Y 8 1 Village Y 4L(1 A 13 WA; Owner Address saM 6 Telephone q 0 3 3 & 1106 Permit Request ��� `R'3 r a+l tl 'k" (_9 C;�l I% I es G -Fe ±6e. Q4r c► At P�a.nP VA P)(joot ld i n5 't-*Oil, Square feet: 1 st floor: existing proposed 2nd floor: existing—proposed Total ne Zoning District Flood Plain Groundwater Overlay -, -. c7) Project Valuation Construction Type ' Q Lot Size Grandfathered: ❑Yes ❑ No If yes, attach s rpporting`flocu ntation. Dwelling Type: Single Family ❑ Two Family ❑ Multi-Family (# units) Age of Existing Structure Historic House: ❑Yes ❑ No On Old KingJ Highway❑Yes ❑ No Basement Type: ❑ Full ❑ Crawl ❑Walkout ❑ Other Basement Finished Area (sq.ft.) Basement Unfinished Area (sq.ft) Number of Baths: Full: existing new Half: existing new Number of Bedrooms: existing _new Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: ❑ Gas ❑ Oil ❑ Electric ❑Other Central Air: ❑Yes ❑ No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑ No Detached garage: ❑ existing ❑ new size_Pool: ❑ existing ❑ new size _ Barn: ❑ existing ❑ new size_ Attached garage: ❑ existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes ; No If yes, site plan review# Current Use Proposed Use APPLICANT INFORMATION c �} (BUILDER OR HOMEOWNER) Name cJart Inc. 1 QVV., ' Telephone Number Address �� . AA n. License #_a—G 50%AA Y&MdW% ►�/ N Home Improvement Contractor# Email Worker's Compensation # VJ W\C^ 3 d 8 %13 ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BETAKEN TO 1 r�(w► 61A'i'I� SIGNATURE DATE FOR OFFICIAL USE ONLY APPLICATION# I DATE ISSUED MAP/PARCEL NO: ADDRESS VILLAGE OWNER ' DATE OF INSPECTION: ;t FOUNDATION Ic FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL t FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. f Building Permit Authorization as owner, hereby give my permission to Cape Save, Inc. 7-D Huntington Avenue - South Yarmouth, MA 02664 Office:508-398-0398 - to take all necessary steps to obtain a building permit to perform work at my property located at 119 Arrowhead Drive Hyannis, MA 02601 Signed Date IJ .. - • The.Commonwealth of im4chusetts -Department of Industrial AccMenfs .' *. . Uffrce of Investigations • s + _ - I 1 Eongress Street,.Suite d Ol1- r ' Y '' Boston,MA D2114--2017 - www.mass«gov/da Workers''Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information - Please Print Legibiy Name(Business/Organization/Iodividual): Cape.Save Inc ' 7D;Huntin ton j' Address: 9 Ave ' z City/State/Zip: South Yarmouth. MA 02664 • `Phone=#: 508-398--0398 Are you an employer?Cheek the appropriate box: Type:of project(rcgqutred}. L�✓ V I am-a employer with �,b 4: 1 am a general contractor ana 1 have<hired the sub-contractors 6 [�New construction ' -. employees(full andlor part-time); 1.- k 2. I am a sole.;proprietor ofpartner: '` listed'on.the attached.sheet.� 7. Q Remodeling Y ship and have no etriployees These sub-contractors have g-° ;Demolition, working forme in any capacity._ employees•and have workers'' , 9 [No v,vorkers comp:insurance comp tnsur-ance* 9 [].Building addition 5-, We:are a corporation and its. It}M Electrical repairs or additions required.] Q officers have exercised their 3:❑ I am-.a homeowner doing al.l work,; ' 11 O Rlumbirig repairs or addtttoh myself..[N6workers'comp: right of exemption per MGL. 12.F!'Roofrepairs. ' c. 15 � 4and whvenoinsurance required]t .Insu- laton- employees.. [No xvorkers' Oter. comp- insurance,required.]. "Any applicant chat checks box I must also fill out ie section below shoo+i7- ih r°.�+orkeis'compensatioirpolicy tntonnatton. t Homeowners.-who suhniilthis at'lidavit inttrcating`fhey are di int all work and then hire�utside;contractors must submit a new ai3id.vit•indicating such. Contractors that check this box must attached an additiona►'siteet sho��`in_the narne of ilie sub-contractors and state whether or no those e'n`trtres Have eanp}oyees. If the sritrcontraetois have employees;they must-provide their workers Lomp:policy nurir6er ` I ant wt employer that is providing workers'.eoot.Iensat nn.insttrance fornty snip/ogees Beloiv' thepgl[ry and joh:She information. Insurance,CoMpany Name: Wesco Insurance Company Policy#or;Sel#`ns..Lic:# WWC3085:633 Expiration Date: 04/09/2015 } y r �r;ve Job Site Address; �� City/State/Zip: rV A Is Attach a;copy of the workers'compensation policy declaration page:(shorving the,poiicy numbs. and expiration date).. Failure to secure coverage as required andery Section 25A of.MGL e. 152 can Iead,to the imposition of cnmmalgpenalties of A fine-up to 1,500'.00 and/pi one-year.imprisonment,as:well as civil penalties in the formofa S.TO,?N 0RK ORDER and a.firie of up to$250.00 a-day against the violator. Be advised that a copy of'this.statement maybe forwarded to the office of - lnvestigatf'ons of the D1A.for insurance coverage wification. I do hereby certi iinder:the dins and:'enalties o er" that the itt orination provided above is true and correeL ' S.Q ature:; _ _ _ _. Date ; , . _._�0 _.. _. _ -. we intls.'ureaoe cipled:6Ofl useoDo not, oi y city=or townocial City or Town::. 'Permivll icen$e# t. F issuing Authority(circIeone): • . r ,, - _ , , � , • . - y l Board of.:Heaith 2;°Bwlduig DepartmenE 3.City/Town Clerk, 4 Electrical hQ pectart 5 Plumbihz.% spectoV A b.Other ' Contact Person , 9 ACVRU® DATE(MMIDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 4/14/2014 THIS CER'TIFICATE..IS ISSUED AS,A:MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIF11 ICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES' NOT CONSTITUTE A CONTRACT BETWEEN THE'ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the;policy(ies)must be endorsed. If SUBRQGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in1leu of such endorsements: COW CT. PRODUCEf. NAME: Colleen Crowley Risk Strategies Company PHONE (781)986-4400 FAC�:C781)963-4420 LAN15 Pacella Park Drive L ADDRCS9- 'Suite 240 INSURERS�:AFFORDINGCOVERAGE .NAICS Randolph M t!'68: INsuRER.a:Selective Ins. of America INSURED, iNsuReR&:Safety.Insurance ComrianV 33618 Cape, Save Inc p INsurzERc Wesco Insurance an 7' D Huntington Ave INSURERDr INSURER E: South Yarmouth MA 62664 INSURER0 COVERAGES CERTIFICATE NUMBER•CL441475243 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF;INSURANCE.LISTED'BELOW HAVE BEEN ISSUED TO THE INSURED NAMED;ABOVE'FOR THE POLICY PERIOD INDICATED r: :NOTWITHSTANDING ANY REQUIREMENT,TERM:OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL,THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH;POLICIES.LIMITS SHOWN'MAY HAVE BEEN REDUCED BY PAID CLAIMS_ INSR _.. POLICYEFF POLICY EXP LTR TYPEOF.INSURANCE POLICYNUMBER :MMIDD MMIOOlYYYYY LIMITS GENERALUABiLfTY EACH OCCURRENCE $_ 1,000,000 X COMMERCIAL GENERAL LIABILITY :PREMISES Eaeccurrence $' 100,000 A CLAIMS-MADE 50 OCCUR S1994480 0/16/2013 0/16/2014 MED EXP(Any we Parson) $ 1G,000 PERSONAL fi ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE,LIMIT APPLI€S;PER: PRODUCTS.:COMPIOPAGG $. 2,006,000 POLICY X PRO X tLOC $ AUTOMOBILE LIABILITY IhJ D tN Ea accident I 1 000 000 ANY AUTO BODILY ROURYOerperson) $ ALL OVVNED X SCHEDULED 6208200 1/6/2013 1/6/261$AUTOS AUTOS: .BO6ILV(NJURY(Per accident).I X X NON-OVMIED PROPERTY DAMAGE $ HIRED.AUTOS AUTOS Per.accidsnt X UMBRELLA LIAR I X _. . .... _. ..... _.. OCCUR. EACH OCCURRENCE $ 1,000,000 EXCESSLIAS fflA cLA1Ms4nADE AGGREGATE $ 1,000,000 DUD RETEN114IV ez 199:44$0 0/16/2,013 0/16/20141 C WORKERS - - Officers I-ncluded EorANDEMPLOYERS'LIABILITY C R RMU- OTRH YIN - ANY PROPP,IETORIPARTNERIENECUTIVE Coverage OFFICERIMEMBER.FXCL:UDED? 091 NIA., E.L EACH ACCIDENT $ 5oIJ 000 (MandatoryInNH). MC3085633 /9/2014 /9/2015., E:C,DISEASE-:EA EMPLOYEE;$� 600,0001 fyes,describe under - DESCRIPTlONOF.OPERATtONS-beiow E.L.DISEASE-POLICY LIMIT $ 500 000 r DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORU 101,Additional Remarks Schedule;if more space is required) Issued as evidence :of insurance. Issued as evidence of insurance. Thi.elsch Engineering, Inc. is listed as additional insured as respects General Liability -as required by written contract., - CERTIFICATE HOLDER CANCELLATION- msong@.cap!alightconpadt,.org. SHoULDANY OF THE ABOVE I DESCRIBED POLICIES BE CANCELLED BEFORE• THE EXPIRATION DATE' THEREOF, NOTICE WILL, BE DELIVERED 1N Cape Light Comp act ACCORDANCE WITH THEPOLICY`PROVISIONS. Attn.- Margaret song . PO SOX 427/8CH AUTHORIZED REPRESENrATIVE 3195 Main street Barnstable; M, 02630 chael Christian/CLC- �`y ACO.RD 25(2010I05) (0198840t0 ACORD CORPORATION. All rights reserved. INS025(2bido5pi ThoA.CORD name and.logo are m registered arks of AGORD �e o- cu�2rc�ea l� tz, Ci �aJ��Q�41 uvf§ Office of Consumer Affairs and Business Regulation r F„10 Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement C6ntractor Registration Registration: 171380 Type: Corporation Expiration: _ 3/14/2016 Tr# 249649 CAPE SAVE INC. , WILLIAM McCLUSKEY 7-D HUNTINGTON AVENUE SOUTH YARMOUTH, MA 02664 - - -- -- --_ s r 0- Update Address and return card.Mark reason for change. scn i t zorn-os ii E] Address Mj Renewal Employment E] Lost Card Office of Consumer Affairs&Business Regulation License or registration valid for individul use only OME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: egistration: -1,1380 Type: Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 �'Expiration 3714/2016; Corporation ' A_ . -z. Boston,MA 02116 CAPE SAVE INC. y WILLIAM MCCLUSKEY 7-D HUNTINGTON AVENUEQ SOUTH YARMOUTH,MA 02664 Undersecretary Not vali rthout signature Massachusetts -Department of Public Safety' ` Board of Building Regulations and Standards Construction Supervisor Specialty License: CSSL-102776 _ WILLIAM J MC C3,US� _- 37 NAUSET ROAD # West Yarmouth NIA 026 `%�.., lJ i ,•ta Expi:iaton Commissioner 0612812015 a ° Barnstable District Court CapeCodOnline.com Page 1 of 2 Barnstable District Court `a May 20,2010 2:00 AM In court May 13: DISPOSITIONS CHIPMAN, Cody J., 19,65 Woodland Ave., Hyannis;admitted sufficient facts to creating a school disturbance,, June 17 in Barnstable, continued without a finding for 90 days, 30 flours of community service. NARICKAS,.Gary, 57, Route 28, Falmouth; making obscene telephone calls and threatening to,commit a crime, Nov.30 in Yarmouth, dismissed. ARRAIGNMENTS (The following pleaded not guilty.) .� BARNABY, Demer A., 19, 119 Arrowhead Drive, Hyannis`forcible child rape and rape, Feb. 17 in Barnstable. Pretrial hearing June 17.E ' BARNABY, Kemar,2�1, 119 Arrowhead Drive, Hyannis;forcible-child rape, rape, contributingo the delinquency of a minor and providing Icoroollb a-minor;Feb. 17 in,Barnstable. Pretrial hearing June 17. CAMERON, Mario A., 19;_168 Barnstable Road,'Hyannis; rape and statutory child rape, Feb.17 in Barnstable. Pretrial hearing June 17. CAMERON, Ralston N., 18,168 Barnstable Road, Hyannis;two counts of forcible child rape and rape,^Feb. 17 in { Barnstable. Pretrial hearing June 17: . HARHKA, Carene(Careeme), 177 152'Bristol-Ave., Hyannis;two counts of forcible child rape and rape, Feb. 17 in Barnstable. Pretrial hearing June 17. MULLALY, Daniel R.,51, 61`St.Joseph's St,Hyannis;assault and battery, May 12+in Barnstable. Pretrial hearing i June 10. MULLINS, Richard M.,21,46 Oak Neck Road,S:Hyannis; larceny of more than $250, March 8 in'Barnstable. Pretrial' hearing May 20. ROBERTSON,Tyler W., 19,635 Pitcher's Way, Hyannis;forcible child rape and rape,Feb. 17,in Barnstable. Pretrial hearing June 17. � In court Friday: DISPOSITIONS . BLACKBURN, Eric A., 21,80 Woodbury Ave., Hyannis;three counts of assault and battery, intimidating aywitness, and assault and battery with'a dangerous weapon,Jan. 1 and Jan. 7 in Barnstable,dismissed. FLYNN, Brian S.,21,4 Cranberry Knoll Court, Bourne;admitted-sufficient facts to possession of heroin, March 2 in Sandwich; continued without a finding for nine months,$585 costs and $50 fee; possession of Paxil, dismissed; not responsible for two traffic violations. GIBBS, Paul R., 39,45 Asa Meigs Road, Sandwich;guilty of assault and battery,April 18 in Sandwich, 18 months in Barnstable County Correctional Facility with six months to serve(25 days.of pretrial credit)and the balance suspended;two-year probation, $1,170 costs and$50 fee. z http://www.capecodonline.com/apps/pbes.dll/article?AID=/20100520/NEW S/5200334/-1/... 5/20/2.010 TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map Z Parcel Application# Health Division Permit# -roc-Collector Date Issued Treasurer Application Fee 5 Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board ig C� Historic-OKH Preservation/Hyannis Project Street Address !/9 Af..0e -40 A_Ac� Village "✓o Owner :50.5Ua LoPcrS Address Telephone 77L X 3 6 sad/ Permit Request j VA6 C-0 A.a k&6� L Square feet: 1st floor:existing proposed 2nd floor:existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation .- Construction Type Lot Size Grandfathered: ❑Yes ❑No If yes, attach supporting documentation. Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure �.�� Historic House: ❑Yes ❑ No On Old King's Highway: ❑Yes ❑No Basement Type: 20ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full:existing 3 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: CdGas ❑Oil ❑ Electric ❑Other Central Air: ❑Yes kAo Fireplaces: Existing New Existing wood/coal stove: ❑Yes ❑No Detached garage:❑existing ❑new size Pool:❑existing ❑new size Barn:❑existing ❑new size Attached garage:❑existing ❑new size Shed:❑existing ❑new size Other: Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ ----Commerciah'O Yes ONo If yes, site plan review# Current Use Proposed Use 'LlkULDER7INFORMATION Name Y0,50cs 60(QD Telephone Number F Address !0 tat'Ll )fe,�- to /tg�_k. License# t CL - ;/hv SLrr•�— Home Improvement Contractor# = Worker's Compensation# � ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO I `" +� cn SIGNATURE ---DATE----- 4 r FOR OFFICIAL USE ONLY r r j PERMIT NO. DATE ISSUED MAP/PARCEL NO. ADDRESS VILLAGE- OWNER- DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL p FINAL BUILDING ® I�-- ! I 1 DATE CLOSED OUT ASSOCIATION PLAN NO. . r �(\ i/aG vVilailaVia�yGLLaL/a Vf 1►JKJJ'Kl:LZL4JCLW - - a�S1e.` Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia, Workers' Compensation Insurance Affidavit:Binders/ContractorsXlectridans/Pluivabers Applicant Information Please Print Leelbly �IName—ou—on ess/Organization/Individu&D: GT to pbrs Add�ess "�Js�9 AR.,gQ,�,a•D D�n�a• •' City/Stato'Zip: • bydLvvn w o-Zo/• Phone#; �r4-.- ,fw 1-�6/ Are you an employer? Check the-appropriate boa; Type of projecf(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-contractors7.6• New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet t 8; ❑ Demolition ship and have no employees These sub-contractors have SS ❑ emolition worldrig for me in any capacity.. workers' comp.insurance, 9. ❑ Building addition [No workers' comp.insurance • 5• ❑ We are a corporation and its _ officers have exercised thefr 10.❑ Elccicai repairs or additions requn ed] ot of ea on a MGL 11•❑ t''lunioin airs or additiors aayhomeowner-doing all work z empti p g repairs myself.[N� o workers+ comp, c. 152,§1(4),and we have no 12.❑Roof repairs employees.(No workers' 13.❑ Other cam.•innu ce required.] *Any applicant that checks box#1 mast elso fill out the section below showing thaa workers'compe lion policyinfoxmatiow t Homeownen who submit this affidavit indicating they are doing ell work andffien hire outside contractors must submit anew aMdze iadic:tiag=sruch. kcm b actoxa that check This box must att elhad an additional sheet showing the name of the sub-contractors and their workers'camp,policy information. I am an employer that Is providing workers'compensation Insurance for.my employees. Below is the policy and job sit; Information. ; ' Imaanco Company Name ` -Ur Sys.Lie. attc: t Job Site Address: City/5tat It i.. Attach a copy of the workers' compensation p.eliey declaration page(showing the policy number and W.1ratfon date). Fmiure to secure-coverage as required under Section 25A of MGL c. 152 sari lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year im4aismment,as well as civil penalties in the.fa m of.a STOP WORK ORDER and a f'me 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 DLk for insurance coverage verification. 1 do hereby certify under the pains and penalties of perjury that the information provided above u true and correct, taro: � Date•��^'� o/ o� Phone#; Offt"ai usE OF}. Do rV&Mft.1r,Ift tea,to-U C d 4,c#or tam sfjlicad City or Town: Permit/License# Lassu:ng AuthoM (circle one); 1.Board of health 2.Building Department 3.City/-I l own Clerk Q.Electrical Inspector 5•Plumbing Iuspector l 6.Other Coeact Person: Phone#: I oFSNE, Town of Barnstable Regulatory Services w snaxsrnsi,E, MASS. �, Thomas F.Geiler,Director 'oMn+°,� Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 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:-�K�Gllsv� Qe►++odAC„ / 1SoD r- Estimated Cost = _ o ¢� Address Own er's'Name: _ Z506L.'O GO A S Date of Application:-�-®6�n/ �p 6 I hereby certify that: Registration is not required for the following reason(s): ❑Work excluded by law ❑Job Under$1,000 OBuilding not owner-occupied �2Owner.pullin_g rown permit= Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c.142A. SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR Ze_ Date Owner's e Qmpfiles.forms:homeaffi day Town of Barnstable �OFTNE 1p�� NP Regulatory Services sAMSTABLE, ; Thomas F.Geiler,Director 9 MASS. 059• Building Division �A�ED MP't s 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 DA rE" Q__ -d o �,JOB_ LOCATION:j1 IPQOw!Amoo 0 4,(/y r' N1t�+✓v�r number restr-eet "HLOMEOWNER',': ,„': SO lu Grr LO 4Pe-3 Lr- �7 fj46 j7W .name home phone# work phone# CURRENT MAII..IIdG-ADDRESS: -'��`��` �,�,? f{t91�/) �C�'1Jvr a rvo� ty/town state zip code .The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units.or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is, or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirerInts. �Signa _ ,_-of Hom er 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 hues 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:fomis:homeexempt (i3(�o� ------ - - - —___...__ � �� � Yw� o uV�--��— �l C�`�`'� ' --�� vim-��..�-�- r oF1He 1pN, Town of Barnstable ti Regulatory Services vBMWSTABg Y MASS' Thomas F.Geiler,Director � s6gq. A �b tE619�A Building Division Thomas Perry,Building Commissioner 200 Main Street, Hyannis,MA 02601 r www.town.barnstable.ma.us Office: 508-862-4024 Fax: 508-790-6230 t May 8, 2006 Mr. Josue Lopes 119 Arrowhead Drive Hyannis, Ma. 02601 Re: Illegal Apartmentl 19 Arrowhead Drive Hyannis, Ma. 02601 Map 271 Parcel 056 Dear Property Owner: Our records indicate that your house at the above-referenced location is currently being used as a multi-family home,which is contrary to Barnstable Zoning Ordinances. Violation of zoning ordinances is a misdemeanor, conviction for which results in a criminal record. You must contact this office within 14 days to either: • Apply for a building permit to restore the property to a one-family home • Apply to the Amnesty Program • Prove that this is a legal multi-family home. Please contact this office immediately to tell us what direction you wish to take. F Sincerely i a Edson Amnesty Program Zoning Officer Building Department gforms:zoning3 Parcel Detail Page 1 of 2 t�� I . ;t eye ... Logged In As: Parcel Detail Tuesday, h Parcel Lookup Parcellnfo ........ ........ ...... Parcel ID 271 056 Developer!LOTS 71 & 72 Lot Location 119 ARROWHEAD DRIVE Pri Frontage 1150 Sec Road Sec Frontage village HYANNIS N xN� m N� Fire DistrictHYANNIS Sewer Acct. Road Index 0039 Owner Info Owner:LOPES, JOSUE C Co-owner .... Streetl 119 ARROWHEAD DR Street2 . _.. ........... _...... ...... ... city j.HYANNIS State 1 MA Zip 102601 Country US Land Info . .._: _�. � 9 g Acres,0 52 Use Sin le Fam MDL-01 Zoning E RB Nghbd 0107 ....... .. ... .... ......... ...._... .........___ Topography Level Road Paved ............... ......... ......... utilities Public Water,Gas,Septic Location .......... . Construction Info ......... . . . .. ........ .. _.. . ............__....................._...._......... ......................................... _ ........ ........ _ ............................._.......................... Building Year Roof Ext 1980 Gable/Hip Wood Shingle Built Struct I Wall Effect 1281 , Roof'As....h/F GIs/Cm .... AC None Area Cover 1 p. P. Type!. ..._. . . s Style i Ranch Int.Drywall Bed 3 Bedrooms t Wall' Rooms i __........ Int- Bath Model Residential I 1 Fully s y , Floor Rooms# v iij�i' h °t Grade Average Minus Heat}Hot Water Total ,6 Rooms Type= Rooms - _ ........... ..... ... ,_.__ Stones 1 Story Heat Gas Found- PouredConc Fuel __.. _. ... ation http://issql/intranet/propdata/ParcelDetail.aspx?ID=20439 5/9/2006 Parcel Detail Page 2 of 2 Permit History Issue Date Purpose I Permit# I Amount insp Date Comments Visit Histo _......_...._..._ _. Date Who Purpose 2/23/2004 12:00:00 AM Paul Talbot Meas/Est 5/16/2002 12:00:00 AM Paul Talbot Meas/Listed 9/15/1989 12:00:00 AM ML Sales History Line Sale Date Owner Book/Page Sale P 1 10/2/2003 LOPES, JOSUE C 17741/279 2 3/5/2003 CHEVALIER, JOSEPH 16512/102 3 NATIONAL CONSTRUCTION CO IN 1633/220 Assessment History ............ ....... Save# Year Building Value XE Value OB Value Land Value Total Parce 1 2006 $107,200 $13,600 $0 $205,300 2 2005 $101,800 $13,600 $0 $146,600 3 2004 $81,900 $2,600 $0 $146,600 4 2003 $74,700 $2,600 $0 $45,600 5 2002 $74,700 $2,600 $0 $45,600 6 2001 $74,700 $2,600 $0 $45,600 7 2000 $61,400 $2,500 $0 $30,400 8 1999 $61,400 $2,500 $0 $30,400 9 1998 $61,400 $2,500 $0 $30,400 10 1997 $57,500 $0 $0 $30,400 11 1996 $57,500 $0 $0 $30,400 12 1995 $57,500 $0 $0 $30,400 13 1994 $55,900 $0 $0 $34,200 14 1993 $55,900 $0 $0 $34,200 15 1992 $63,500 $0 $0 $38,000 16 1991 $71,400 $0 $0 $53,100 17 1990 $71,400 $0 $0 $53,100 18 1989 $71,400 $0 $0 $53,100 19 1988 $54,400 $0 $0 $25,100 20 1987 $54,400 $0 $0 $25,100 21 1986 $54,400 $0 $0 $25,100 Photos http://issql/intranet/propdata/ParcelDetail.aspx?ID=20439 5/9/2006 �•�, , a a:• a ;++< a. :.'. 'f x•:,^k. 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L„ i rtl t^'I y,�••L:, n I 1 Y >r} i ,; 1 t -t r ..:i 2.. a r i ._ 'r t. .. ,^� `s�yS Ti''{ "�r4 ..'r ., ,..,„,. 1-n..w s. x •-.di' r •:.:1 a *.,::;t+ .,a,.,r..,...: i {..: It .x_- 1 I- ;i -1. °t- I.. _L1. ; �'fi�_.. 1.; 1 1. 1 TOWN OF BARNSTABLE. Permit No. ____---� � : Building Inspector 1 s.urr..c Cash °"pY~ OCCUPANCY PERMIT Bona No building nor structure shall be erected, and no land, building or structure shall be used for a new, different, changed, or enlarged use without a Building Permit therefor first having been obtained from the Building Inspector. No building shall be occupied until a certificate of occupancy has been issued by the Building Inspector." Issued to National Construction COsAddress 27 Ad.�-ns St,y Braintree, MA. r 1.ni r 71 A 77 110 Arrrruqh(:nfi T)r i Vp_ FhTannj e Wiring Inspector � � Inspection date r f _ Plumbing Limector� r Inspection date f .te r. -'� « 4p s tis e< ,,,, -© Gas Inspectors ( ! �. Inspection date � ffEngineering Department Inspection date ' t THIS PERMIT WILL NOT BE VALID, AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS. ..................�.. ............._............, 18.. .................. Building Inspector �� Assessor's map and lot number . .. ......... d� �F � Sewage Permit number ...... . �... ... SEPTIC SYSTEM M INSTALLED IN CO M • House number � ......I �, NAB&LE, J WITH TITLE 5 0 i6 �.. ENVIRONMENTAL CO TOWN OF R'A�R N S T A DUI-ATIONS BUILDINGA' SPECTOR APPLICATION FOR PERMIT TO 4a! tP n. ...YY ,,,,,,,,,,,,,,,, ...................... . j� ® TYPE OF CONSTRUCTION .. .... v. ......,,/,`,1�' . � r+ TO THE INSPECTOR OF BUILDINGS: t The undersigned hereby applies for a permit according to the following information: Location .��' ...!...`.....�.. ��(1 �"................................. ................................... .................. ....... . ..... ...... .... Proposed Use �� � � ............................................................................................................................................................................. ZoningDistrict ..........�..................................................................Fire District .............................�............................................... Name of Owner/.fi'L' 1. ..�/�•j� ...� ' )�/f�Y� ,� rK-..Z Name of Builder10.7.5�%—,..: . ... if '...Address �r ... .... ..... . Nameof Architect ..................................................................Address .................................................................................... Number of Rooms ........ � '. ........................................Foundation Exterior ... .J`f:�...... ..c.... ... ................ �� .a/ 1.11f ..........................Roofing ... �� ff`. ............................ Floors .....�.'/......... .......... .........................................Interior .................................................................................... w Heating �"°�` � .........Plumbing ' /�'f ......... ......... .. Fireplace 4..:....... ... .—............................................................Approximate Cost ...........�d/.�................................ ... ....... Definitive Plan Approved by Planning Board ---------------_---------------19 . Area ......'�.!...T.!... S ` Diagram of Lot and Building with Dimensions Fee �— f ` SUBJECT TO APPROVAL OF BOARD OF HEALTH `'E6NW I hereby agree to conform to all the Rules and Regulations of the To n of Barnstable regarding the above construction. Name , .................. .............. ..................................... �"-�N.ATIONAL CONSTRUCTION CO. 22024 Sinle No.r................ Permit for ..............g...................... Family Dwelling ................................................................ Location 1Q.t.,9..r.&72...119..Ar.rombead brt�' Hyannis ............................................................................... Owner NAti.QTla.1...QQ a St-r.U.Q t.i.Q a...Co... Type of Construction ..Frame........................... ............................................................................... Plot ............................ Lot ................................. Permit Granted .......Ma.rc.jj..,�,.......... March .19 80 .. . ......... Date of Inspection ...... 19 Date Completecl�7/���**—** ........19-1 PERMIT REFUSED VII19. ...... ........................i........... M ,, .................... .......................... c1b 0 ........ 12 M cz fn Z9, .............................. (r IV 0 Appmoved ...... ....... ........................... 19 ............................................................................... 7 ri, Assessor's map and lot number .<- � ,ems .� v CFTHET� Sewage Permit number ........U'v ' / t Z MARISTAXE, i House number ..................................:.. ................................... 9 rasa _z._ p� 039. MPY p TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATION FOR PERMIT TO ::.� ..? /...A .......... "= t` ... e .�' ...................: TYPE OF CONSTRUCTION ... ... a !d. 'r'��.........le .................. ! �� .. /./..........................19........ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a/jpermit according to the following information: Location ,� r / a¢t l 'H� .............................. ... Proposed Use f�. ( Ave- ...........p .. ........ ................................... .......... .... Zoning District ........................................................................Fire District Name of Owner/11�� f'l ! I...7/7j/ ... ��." Address'/ 4� i i�',� A Name of Builderl�!""! �/,,... at"Jr!!r r.,. '....Address ' . ... ....:: Nameof Architect ................................:.................................Address ..................................................................................... yam" �� ' Number of Rooms .........,:I,!0! .........................................Foundationl,.. ; 7Ce°' r .......................................... Exterior ....... ....................................................Roofing. ........................:! ....•... ............................. ' Floors �7 !............... ...........................................Interior .................................................................................... Heating ........... .........:..:..Plumbing ........ :/..... !.......'. . ......................................... r^ Fireplace ....... .............................................:.'............Approximate Cost .......> J� r. ....................... ................... Definitive Plan Approved by Planning Board ________________________________19________. Area .......................................... Diagram of Lot and Building with Dimensions Fee SUBJECT TO APPROVAL OF BOARD OF HEALTH Aqt I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name :.... .:.. ....................................................... A=27r 56 NATIONAL CONSTRUCTION CO. No.t..�...02.... Permitifor ..SincJ:le.................. i Family....j)k7.q.�..1.jn.......R....... ' �............................ Location Lo s 2,e& 72 119 Arrowhead Dr. ..................... ...... .......... ......................Hyannis........./............................ Owner Nationa. ....l Construction Co. .. . ......................................... Type of Construction Fr. me............................. .......................................... ..................................... Plot ............................ Lot ........... .................... Permit Granted ...March...5.r...............19 80 Date of Inspection...................................19 Date Completed ......................................19 PERMIT REFUSED e�.... .......... 19 ........................ ..... ....................... ........................�........................ ......... .......... Approved ................................................ 19 k ............................................................................... ...............................................................................