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HomeMy WebLinkAbout0156 ARROWHEAD DRIVE 5 15 i i k I i ' - TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Mapes Parcel / .;`Application # R61 Health Division Date Issued rAL . Conservation Division Application Fee Planning:Dept: Permit Fee` Date Definitive Plan Approved by Planning Board f Historic _ OKH Preservation/Hyannis Project Street Address Village �a-/"17A_ 772. ' Owner [. �i�7��G / /�/�� � Address � c'5 8 Telephone F Permit Request e-t 16 tz. 1 m S��1 ( �� � e_ Vim . Sq:uare feet~: 1 st floor,existing proposed O �2nd floor: existing proposed _Total new t Zoning-District, Flood Plain Groundwater Overlay Project duation "an Construction Type Lot Side �` oR/ Grandfathered: 0 Yes ❑ No If yes, attach supporting documentation. Dwellfi' T ea Single!Family Two Family ❑ Multi-Family # units Age of Existing Structure /Y-4 A g Highway: Historic House: ❑Yes No On Old Kin 's Hi hwa ❑Yes 4No Basement Type: Oral ❑ Crawl ❑Walkout ❑Other y� Basement Finished Area(sq.ft.). Basement Unfinished Area (sq.ft) 44 Number of Baths: Full: existing l new Half: existing f new Number of Bedrooms: \3 xist' �ea�i Total Room Count (not including baths): existing new First Floor Room Count Heat Type and Fuel: Gas ❑ Oil ❑ Electric ❑ Other Central Air: ❑Yes A No Fireplaces: Existing New Existing wood/coal stove: ❑Yes Ylo Detached garage: ❑ existing 0 rfew size_Pool: ❑ existing ❑ 4� size _ Barn: ❑ existing ❑1 ew size_ Attached garage: ❑ existing ❑ ne\size _Shed: hexisting ❑ new size��ther: Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ Commercial ❑Yes /tI No If yes, site plan review# Current Use RO'Sf4l�41(��1�° Proposed UseQIC;�ClJ APPLICANT INFORMATION (BUILDER OR HOMEOWNER) Name RarauT Telephone Number Address (t: ' U License# SID SEE, �J�aj_L MC��71_04"L4 Home Improvement Contractor# Worker's Compensation # ALL CONSTRU TION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO wos�e_ SIGNATURE ��`'� DATE Z I FOR OFFICIAL USE ONLY APPLICATION# W DATE ISSUED MAP/PARCEL NO. r ADDRESS VILLAGE OWNER DATE OF INSPECTION: FOUNDATION FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING y � DATE CLOSED OUT ASSOCIATION PLAN NO. ti 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 Legibly Name(Business/Organization/individual):•?CN Address: -PO.130( 480.� G .1 HN A�3TIAN 7DRI\1 City/State/Zip: f PMb MA O Phone#:(� Are you an employer?Check the appropriate box: Type of project(required): 1.[N I am a employer with c?D 4• ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors' 2.El am a sole proprietor or partner- listed on the attached sheet.I` ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions required.] officers have exercised their 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs t insurance required.]t employees..[No workers' 13. other " • u r 4-i dA l comp.insurance required.] "Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. _ a Insurance Company Name:..R LLf P�Z6TCCT/UIV Policy#or Self-ins.Lic.#: 1?0 R1'(o/6 g /'1102 P70 Expiration Date: Job Site Address: 1 (O "w[As ad 'D m lze City/State/Zip: A Qt, b ZG0J 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$I,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and i fine of up to$250.00 a day,against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi under t ains and penalties of perjury that the information provided above is true and correct Signature: Date:- Z Phone# Official use only. Do not write in this area,to be completed by city or town official. City,or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2,Building Department 3.City/Town Clerk 4:Electrical Inspector"5.Plumbing Inspector 6.Other Contact Person: Phone#: ` Restricted to: 00 00- Unrestricted 1G-1 2 Family Homes Failure to possess a current edition of the Massachusetts State Building Code is cause for revocation of this license. Refer to: WWW.Mass.Gov/DPS a ► till (►f tt� Publicufct�. Dcl ` and St;order+l� llass:tchusc - .� Rc"ul:►[i►►n` cense ` B(rtrd of Buil(lin. Liervisor Construction SUP License: CS 56385 Restricted to: 00 Rp,NDALL J FLORENCEs 5 ANDREO E MA 02644 FOR Expiration: 1pJ1912011 9792 ;.imrr ('nuui. i 'J�e -6 Office of Consumer Affai s and Business Regulation 10'Park Plaza - Suite 5170 Boston Massachusetts 02116 -Home Improve ent,-Contractor Registration f Registration: 108642 Type: .Supplement Card BENABBY INC/ DISASTER SPECIALISTS Expiration: 8i20/2012 RANDALL FLORENCE 9 Jan-Sebastian Way r= Sandwich, MA 02563 I 1 07 Update Address and return card.Mark reason for change. Address Renewal ❑ Employment Lost Card )PS-CA1 0 50M-04/04-G101216 ✓�ie �anzynar¢ulea�tfi a�✓Glaaracl�uaetta. 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: ' Office of Consumer Affairs and Business Regulation Registration;A08642 Type: 10 Park Plaza-Suite 5170 Expiraton_Fg/z02012 Supplement Card Boston,MA 02116 BENABBY INC/DISASTER SPECIALIST _r i RANDALL FLORENCEa_;__- _ Box 480 Sandwich,MA 02563'''- =`:='' Undersecretary No wit out signature f i A�® DATE(MMIDDIYYYY} CERTIFICATE OF LIABILITY INSURANCE 12/9/2010 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: if the certificate holder is an ADDITIONAL INSURED,the pollcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsements. PRODUCER D Catherine Murray NAM Oceanside Insurance Group PHONE (508)775-0500 FAX .(500)790-7958 Oceanside Insuranee Agency Inc ,catherine@oceansideinsurance.com PRODUCER 52 West Main Street CUSMMERIDP00006116 Elvannis MA 02601 INSU S AFFORDING COVERAGE NAIC0 INSURED INSURERAArbella Protection Insurance Benabby, INC. INSUR RB.Zurich-American Assigned Risk DBA: Disaster Specialists INSURERCRockhill Insurance Co P. O. Box 480 INSURERD: INSURER E Sandwich MA 02563 w uR COVERAGES CERTIFICATE NUMBER CLI012901739 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR S POLICY EFF POLICY EXP LTR TYPE OF INSURANCE s POLICY NUMBER (KWDDrfYYYI IMWWMLIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 NCOM MERCIAL GENERAL LIABILITY PREMISES Es occurrence $ 100,000 A CLAIMS-MADE ©OCCUR X 8500038944 1/l/2011 /1/2012 MED EXP(Any one person) $ 10,000 PERSONAL d AVV INJURY $ 1,000,000 i GENERAL AGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOP AGG S 2,000,000 _X1 POLICY Eo- El LOC. $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Es accident) S 1,000,000 ANY AUTO BODILY INJURY(Pefpersan} $ A ALL OWNED AUTOS 7018400003 /1/2011 /1/2012 X BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS (Per accident) $ X NON-OWNED AUTOS PIP-Basic - $ 8,000 CMPBI $ 20,000 X UMBRELLA LIAR OCCUR EACH OCCURRENCE $ 1,000,000 EXCESS LIAR X CLAIMS-MADE AGGREGATE $ 1,000,000 DEDUCTIBLE $ A RETENTION $ X 600039945 /1/2011 /1/2012 $ B WORKERS COMPENSATION I WC STATLL JOTH- JORY EMPLOYERS'LW BILITY YIN - LL ANY PROPRIETORIPARTNERIEXECUTIVE 0 E.L EACH ACGOENT $ 500,000 MEMBER MBECLUDED7 NIAOFFCER/En /1/2011 /1/2012(MandatoryINH) 102P700 E.L.DISEASE-EA EMPLOYEE $ 500,000 IF yes descdbe under DES613IPTION OF OPERATIONS below E.L DISEASE-POLICY LIMIT $ 500,000 C Contractor Pollution Xd X I E002420-01 11/22/201011/22/2011 Per OeclEachOca $1,000,000 i DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,B more space Is required) Crawford S Company and Crawford Contractor Connection, a division of Crawford 6 Company, s=ankenmuth, USAA and The Hartford are named as additional insureds for the above listed coverage's and policies, as they apply to ►rork.performed for Crawford Contractor Connection (excluding Workers' Compensation). The policies shall not restrict coverage for completed operations for the insured or the additional insureds. The General CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C Murray CIC/KI; �• y1Zun n oq ACORD 25(2009/09) 01988-2009 ACORD CORPORATION. All rights reserved. INS028(2mew) The ACORD name and logo are registered marks of ACORD , FROM FLANWax PHONE NO.; 6554887 Apr. 07 2011 .11:59PM P1 TO), .[I ofBI')Is(a )r� 1t'egul-.1toz-3' Seri,ices � pc,�s9. �. ' Thonins r.Gdlcr,Director, 9.�: 163 �y B uildino, Divisi6'n ` - - '1'0l»Terry,)_inilrlinS Cultulussioner. ' 900 Maui Streot,1-1yannit;, 1v1.A 02G01 KtivSY.towu.l5urnztnble,rnn.its 508-790-623( r Property 0w11er l TUSt t;oni�iplete axed Si ri 'his .Section er - - - t i;. D k-4 1=1_1, I ?�_ _ as Owur.r of thti silbjcct property y6- hcrebyiutt:h(�rice ��; ` cc� :�t:C�a cuy,be�alf, in 111 4-'."a c (0 work authorized byth s bulling peIYnit Ppplication for, (A('dl-O.SS UI jUb) a ' Sil; I"71'.c (>I Owner V.)a' ' t D: k,N 1'nnt Niirt;c' f , 1f ]'r�i �rLy Owner is applying far perlia.i't please complete the Ilorncowr)ers Lice rise Exeniptiejj roj-ML 0zj tlje t-evelse.si& t. � ,.�\�4�'.i\N•, •%•%.;.i%.'. �\Z�'.�.�•�, r. •%I�•'.G%�'. sJ:\.,Di.►►�. A/r.!GS��\ASr,S \.N•', /. yi.p.ay./�!1GT..�\Z',..�►1. r. 't. ♦. 7�I'.A.I O\.\..•.�C�.•.�/r.•V%_Tt��%G.I.�I.i-�t �.�,''\!_1��`i__r•�%{ �: a\. .7 +►j j�O. me'TI\gw4 WIN. 1/"! .'Q•/E.�,/ . ' , �V y►\. .rr!'�l%' •� �it.•��,• �... 4./.%•.�t .�.,qQ�l.v .N1.•i ...I,//,.Sl 1.Z�>,• i•1.1.1•i :�/•�l \�.�\,.;. �Nl.ri�..,% 1.��.,;t .. rr'S,./, . ..%�;r• i.1.ri 'r./.ri t,1, � .�►,.,. .•�•. 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II lL n .�.. : fir• 1,1/I d11 ... r 11111. `a/ .1 1II ... . ./• 1.I4 ..r. .11w .O Od r 1.1 , ♦•�': p..,1 .Ire 111a1. •.. ../ ....'•.•. ..• ••.., . • s, ,i••��Sr dt: 'R• �T i 1 �i•� •i - 1• - i 1 r• .I • - •• � : %:. .iC'•a s' r, x :8; a$i s a os c r x ar ,s, x-, � , r x , a ,U, �•.�i'.vr i; , , , . , . , , i0, r:1�,v , , , ;f, . . , , ,x , x , , , > i', r L i s, Interactive Occupational Training _ .,�-• Westminster,Colorado I Phone 866-665-5566 1 www.iot-edu.comi In Agreement With 4 ,•gt rt ti=z_ `'° MISERS Occupational Safety Training, Inc. '• -= :�;" `_.• s. Englweood,Colorado I Phone 303-922-0398 1 www.miserscolorado.com �'•' :am Certit-cate o Atten;c�ance and Successful CotnPlet on ,2 E Renovator Initial English r a: •• Per 40 CFR Part 745.225 ` i Randall Florence 5 Andrea Way, Forestdale, MA 02644 : EPA Certificate Number: R-1-19228-10-0896 A�., �•T �h :: a Course Date: 6/19/2010 ' t §�• "Adw � G. •A• ' Examination Date: 6/19/2010 Expiration Date: This training is effective fora 5-year period, until 2015 . = < Training Manager/ Principal Instructor Wednesday,Fune 30,2010 _ - - a _ f• �`•E e u. tv nfi''i'ti:'i�u .. r+4, !SASi�ia..•- ,., �iyi� .i :.. ii1 ••.i i'i�l' r 3 ••• .1•'1.:'i•• •S•II r•I n.., .... i',ii'•{"7�tiS�i .iS'SS1;� .r�'•i.• •••.. I•f Ir•' e.f 11 •r•.• .1 '1!`e• 11 ••�•' !.�.• •.1 i•'' er.e, o .r•,...•••, ...••, o,.l lll�!.a •..,_.. . . L/'1. •.r•...••, ..... Lf tYi.l•LI e,.• •.r.p• r 51 .•' .,r •�.. 111,1lI i. ..•� "�•. .r r,1.•I it .♦♦•.i..- •'iiS'!''iN�y�• .!y..,.. •.•�. 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'\\i�,1. ���R7/,R. •%�: /� I•'►,tl, Y,�•.el. t 1.A%' n z %Z. ► r� • s�• 'r�• �/ . rb�' \C�. .. � •r.�i •CS.^ � • rwi,• .� y�C�•'� r"`,., ��k4.•s4rti\•.aC�3• .. $ ♦9►p�' 6� ��:'194rt•p•►;.►;•,,���1�14♦4r♦•�...���1. o�: �._�� A�4_ VC fig. .,�k•4♦4r_���i '�/ � �4 �� / R ♦ \' / �4.'. \,�4.e a:. � .. __�"- f DEBRIS FORM In accordance with the provisions of IVIGL c.40,s. 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly Licensed solid waste disposal facility as defined by'MGL c. 111,s. 150A. This Debris will be disposed of in: (LOCATION OF FACILITY) Sig ure of.P it lican Date IF DUMPS _ER IS'USED IN EXCESS OF d CUBIC VARDS.A PERMI T aT FR M THE- FIRE DEPARTMENT IS FOR COMMERCIAL,JNDUSTRIAL, INSTITUTIONAL AND MULTI=FAMILY:RESIDENTIAL OVER 20 UNITS DEMO, RENOVATIONS OP,ALTERATIONS OF THE EXISTING BUILDING: CIRCLE ONE r; HAVE YOU SUBMITTED THE AQ06 NOTIFICATION TO THE MA55ACHU5ETFS DEP? YES NO i I i t Ii I '� Town of Barnstable Building Department - 200 Main Street ALE. * Hyannis, MA 02601 9�b 1639. , ' (508) 862-4038 Certificate of Occupancy Application Number: 200901382 CO Number: 20080420 Parcel ID: 270152 CO Issue Date: 09/15109 Location: 156 ARROWHEAD DRIVE Zoning Classification: RESIDENCE B DISTRICT Proposed Use: SINGLE FAMILY HOME Village: HYANNIS Gen Contractor: PROPERTY OWNER Permit Type: RC00 CERTIFICATE OF OCCUPANCY RES Comments: Building Department Signature Date Signed TOWN OF BARNSTABLEBur�dlnT 'O��E g ti Application Ref: 200901382 Pe­ rmitBARNSTABIZ Issue Date: 04/07/09 y MASS.. �A 1639. �� Applicant: DIAS MARIA S rFC Mp►�A Permit Number: B 20090458 Proposed Use: SINGLE FAMILY HOME Expiration Date: 10/05/09 Location 156.ARROWHEAD DRIVE Zoning District RB Permit Type: RESIDENTIAL ADDITION/ALTERATIO Map Parcel 270152. Permit Fee$ 25.00 Contractor PROPERTY OWNER . Village HYANNIS App Fee$ 50.00 License Num Est Construction Cost$ 2,000 Remarks APPROVED PLANS MUST BE RETAINED ON JOB AND RESTORE TO SINGLE FAMILY HOME REMOVE APARTMENT IN BASEl43;CARD MUST BE KEPT POSTED UNTIL FINAL. REPAIR WATER DAMAGE AND REMOVE 1 WALL IN BASMENT BM G 219M.ETION HAS BEEN MADE. WHERE A CERTIFICATE OF OCCUPANCY IS REQUIRED,SUCH Owner on Record: DIAS, MARIA S BUILDING SHALL NOT BE OCCUPIED UNTIL A FINAL Address: 156 ARROWHEAD DR INSPECTION HAS BE N ADE. HYANNIS,MA 02601 Application Entered by: PR Building Permit Issued By THIS PERMIT.CONVEYS NO RIGHT TO OCCUPY ANY:STREET;ALLY 0R SIDEWALK OR ANY PART.THEREOF 3EITHERTEMPORARILY OR PERMANENTLY. EN CROACH EM ENTS ON PUB LIC,P,ROPERTY;NOT SPECIFICALLY'TERMITTED UNDER THE BUILDING CODE,-MUST BE.APP ROVE D.BY,THE JURISDICTION. STREET ORALLY GRADES AS.WELL AS,DEPTH AND:LOCATION OF PUBLIC SEWERS MAY BEOBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS.,n THE ISSUANCI OF'THIS PERMIT DOES NOTRELEASE 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). XIT, _ _.... ,Nww;. BUILDING INSPECTION APPROVALS PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS 1 1 juR�4 for r V; l � 3 G o, �� 1 Heating Inspection Appro als Engineering Dept Fire Dept 2 Board of Health oK � � r ;p TOWN OF BARNSTABLE BUILDING PERMIT APPLICATION Map 27 Parcel." Application # � � Z Health Division `_.0®B — 2!� � C 'Date Issued Conservation Division ;Application Fe Planning Dept. Permit Fee Date Definitive Plan Approved by Planning Board Historic = OKH Preservation/Hyannis Project Street Address J�o ('��vV 6 a �v'Q i Village �+ i i � Owner N�Z Address 'P: 33,/*cv�Rna ,, D6`�(� Telephone 2_0 3 ' Permit Request 1-0 4-o(`k U'KS-C- ' v S' N 2' 1 av . c ,,,l- 01VU : e- - air w0_4,er 1) rew^oVe. wa- fit{ L,_'baq_wewfi a,p W64-11 ")p kAk I I ro 0 vv\ , Rrl,"� 80&e,,4 tv+.A�knq OAA4,o cok T : w--4 KQt !,76 , Square Teek 1 st floor: existing—proposed 2nd floor: existing proposed Total new Zoning District Flood Plain Groundwater Overlay Project Valuation Lo 0(o - Construction Type (wo© Lot Size Grandfathered: ❑Yes ❑ No If yes, attach supporting documentation. Dwelling Type: Single Family .JA, Two Family ❑ Multi-Family(# units) Age of Existing Structure S Historic House: ❑Yes WNo On Old King's Highway: ❑Yes ❑ No Basement Type: §kFull ❑ 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 3 Heat Type and Fuel: 4Gas ❑Oil ❑ Electric ❑ Other Central Air: ❑Yes &No Fireplaces: Existing New Existing wood/coal stove: ❑Yes ANo &/A Detached garage: ❑ existing ❑ new size—Pool: ❑existing ❑ new size _ Barn: ❑ exi ting ❑ new size_ Attached garage: ❑existing ❑ new size _Shed: ❑ existing ❑ new size _ Other: Cal Zoning Board of Appeals Authorization ❑ Appeal # Recorded ❑ -c Commercial ❑ U� o Yes No If yes, site plan review# mo` =. (current Use Proposed Use ry � APPLICANT INFORMATION D (BUILDER OR HOMEOWNER) Name iP t— -� i /V Z- Telephone Number 7-0 Address 1 1 V . D �'33 License# CA h &Dt✓V _ O $`tf l) Home Improvement Contractor# Worker's Compensation # ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO ,1. SIGNATURE DATE .S , t lot FOR OFFICIAL USE ONLY APPLICATION# DATE ISSUED i, MAP/PARCEL NO. ADDRESS VILLAGE OWNER DATE OF INSPECTION: J FOUNDATION F FRAME i INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ROUGH FINAL FINAL BUILDING DATE CLOSED OUT ASSOCIATION PLAN NO. -\ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations• ' 600 Washington Street Boston, MA 02111 �4 �v www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information `� //�� Please Print Legibly Name(Business/Organizatio ndividual) I ��b K t Address:_ e a , fT� -)---3 3 City/State/Zip:,e!�/ r�/ CAna G �q LI ® o$kD Phone.#: 20 3 3 Are you an employer? Check the appropriate box: Type of project(required): 1.❑ I am a employer with . ' 4. ❑ 1 am a general contractor and I . employees(full and/or part-tim.e).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or'partner-' Listed on the-attached sheet. T. Remodeling ship and have no employees These sub-contractors have g..N Demolition working for me in any capacity. employees and have workers' 9 ❑ Building addition [No workers'.comp.-insurance comp. insurance.# required.] - 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions I am 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.❑Roof repairs insurance required.] r 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. . f 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 entiiics have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic.#: Expiration Date: Job Site Address: City/State/Zip: _ Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of crinurial penalties of a fine tip to$1,50D.00 and/or one-year imprisonment, as well as civil penalties in the form.of a STOP WORK ORDER and a fine of up to$250.00 a day.against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi der th pains d penalties of perjury that the information provided above i true and correct Signafore: Date: 3 Phone#: Official use only. Do not write in this area, to be completed by city or town official .City or Town: Perm i Micense# Issuing Authority(circle one): 1.Board of Health '2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursut to this statute,an employee is defined as"...every person in the service of another under any contract of hire, an 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 tbmtee 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 mploys persons to do maintenance, construction or repair work on such dwelling house dwelling house of another who e 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 insurapce requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),.address(es)and.phone numbers)along with their certificate(s)of . insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested.,not the Department of Industrial Accidents. Should you have any questions*regarding the law or if you are required to obtain a workers' compensation policy,please-call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete-and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant _, l— T-...irl,4+n.. an annliranf Please be sure to fill in the permivlicense number which will be mrlu as a LCLC:1G11UU=iu+ai��- . that must submit multiple permittlicense 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 fo any business or commercial venture (i.e.a dog license of permit to btim 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 e6mmoziwe-al.th of Massachusetts Depadment of Indusb il'1 Accidents Office of lavestigations- 600 Vlashingwn Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727=7749 Revised 11-22-06 www.mass.gov/dia THE Town of Barnstable �~ Tp�y y�P o Regulatory Services RA " Thomas F.Geiler,Director NUB& �* t659. Building Division PrE° F Tom Perry,Building Commissioner 200 Mairi-Street,--Hyannis,MA 02601.. www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION nn�Q Please Print DATE: V 1 JOB LOCATION:` S Arro—i "I number nst�reet village "HOMEOWNER": r 1�D�IZ� 2z3 name home phone# work phone# CURRENT MAILING ADDRESS: V g b X J� 3 NPR. Cu,, AC4 C7 Df//9 f yo eityhown 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 siructures 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 Budding 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 -ocedures and requirements and that he/she will comply with said procedures and r en Sign 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 bon=wner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 1 o9.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a parson(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 assuning the responsibilities of a supervisor(see Appendix Q. m Rules&Regulations for Licensing Construction Supervisors,Section 2.15 This lack of awarauss often er p results in sious problems, articularly 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 Marc of his/her responsibilities,many communities require,as part of the permit application, that the homeowner certify that hdshe understands the mspansrbilities 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/certifieatian for use in your community. Q:forrns:homccacmpt I1WE Town of Barnstable ` Regulatory Services . � saRrrsrART�F,� h $ Thomas F. Geiler,Director �Eo 16 Building Division Tom Perry,Building Commissioner 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using ABuilder as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit please complete.the Homeowners License Exemption Form on the reverse side. Q:FORMS:O WNERFERMISSION Pro �Av f tit4 � c+q /i� �ro skin�Tgo(— D I tv P- 3 40 Q Asa ri -�t�/ 1� LA U,u WS 1 r� Si N re-movJ rt � fD y /JR -----..... re-w�o v G.�p� p��� STANDARD FORM Purchase and Sale Agreement AGREEMENT made this ' day of MARCH 2009. 1. PARTIES AND MARIA S.DIAS,of Hyannis,MA MAILING ADDRESSES Hereinafter called the SELLER,agrees to SELL and FREDERICK M.KNIZE of 398 Carter Street,New Canaan,CT 06840-6014 Hereinafter called the BUYER,agrees to BUY,upon the terms hereinafter set forth,the following described premises: 2. DESCRIPTION the land located at 156 Arrowhead Drive,Hyannis,MA 02601 as fully described in a deed duly recorded with the Barnstable Registry of Deeds in Book 21005 Page 329 to which reference is made for a more particular description. 3. BUILDINGS, Included in the sale as a part of said premises are the buildings,structures,and improvements now STRUCTURES, thereon,and the fixtures belonging to the SELLER and used in connection therewith including,if IMPROVEMENTS, any,all wall-to-wall carpeting,drapery rods,automatic garage door openers,Venetian blinds, FIXTURES window shades,screens,screen doors,storm windows and doors,awnings,shutters,furnaces, heaters,heating equipment,stoves,ranges,oil and gas burners and fixtures appurtenant thereto,hot water heaters,plumbing and bathroom fixtures,garbage disposers,electric and other lighting fixtures,mantels,outside television antennas,fences,gates,trees,shrubs,plants,and; All Appliances/fixtures included in"AS IS"condition.. 4. TITLE DEED Said premises are to be conveyed by.a good and sufficient quitclaim deed running to the BUYER, or to the nominee designated by the BUYER by written notice to the SELLER at least seven days before the deed is to be delivered as herein provided,and said deed shall convey a good and clear record and marketable title thereto,free form encumbrances,except (a) Provisions of existing buildings and zoning laws; (b) Existing rights and obligations in party walls which are not the subject of written i agreement; I (c) Such taxeg for the then r_.tirre-.nt vear ac are not tine anti nnvahlP nn the date of tbP rlelivPn,of such deed; (d),Any liens for municipal betterments assessed after date of this agreement; (e) Easements,restrictions and reservations of record,if any,so long as the same do not prohibit or materially interfere with the current use of said premises; 5. PLANS If said deed refers to a plan necessary to be recorded therewith the Seller shall deliver such plan with the deed in form adequate for recording or registration. 6. REGISTERED TITLE In addition to the foregoing,if the title to said premises is registered,said deed shall be in form sufficient to entitle the BUYER to a Certificate of Title of said premises,and the SELLER shall deliver with said deed all instruments,if any,necessary to enable the BUYER to obtain such Certificate of Title. 7. PURCHASE PRICE The agreed purchase price for said premises is One Hundred Thirty Thousand and no/100 ($130,000.00)DOLLARS of which $ 1,000.00 Paid at signing of offer $ 9,000.00 To be paid on signing of Purchase and Sales Agreement —' $ 120,000.00 are to paid at the time of delivery.of the deed in cash,or 1 J Town Of Barnstable P �^ Regulatory Services ILIRNbTA°' Thomas F. Geiler, Director -p MASS. 0h - FtiMr�"� Building Division Tom.Perry, Building Commissioner 200 Main Street, Hyannis,MA 02601' Nwww.towvn.barnstable.ma.us Office: 508-862-4038 Fax:, .508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S)TO: TO: ffp ATTN: C -rAX NO: -7 `Sr FROM DATE: PNGE(S): (INCLUDING COVER SHEET) Town of Barnstable Regulatory Services * * :AMSTABLE; MASS. Thomas F. Geiler,Director �A .i63q �� rft639 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 January 13,2009 Ms. Melissa Morris 525 South St. Unit C2 Hyannis, MA 02601 Re: 156 Arrowhead Dr., Hyannis, MA Dear Ms. Morris, Due to a recent flood at the above referenced address,please be advised that the Certificate of Occupancy for this property has been rescinded. The house will remain uninhabitable until a permit 'has been obtained to rectify all areas of concern. If you have any questions,please do not hesitate to call. Sincerely, Paul Roma Local Inspector OFVE ram, Town of Barnstable Pv � Regulatary-Swervices • saRrrstAst.e, v ,Hass. � Thomas F. Geiler, Director Building Divia oD.,._ Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 December 30, 2008 Ms. Melissa Morris 525 South St. Unit C2 Hyannis MA 02601 Re: 156 Arrowhead Dr.,Hyannis, MA Dear Ms. Morris, At your request, an inspection of the above referenced property was conducted by both this office and the Hyannis Fire Dept. In 2006 an illegal apartment had been removed but at some time after the last inspection, an unpermitted, illegal apartment was put back into the basement. Your suspicion was correct: the sale of this propeq.cannot go ahead until a building permit has been obtained to restore this house to a single-family dwelling. . If you have any questions,please do not hesitate to call. Sincerely, Paul Roma Local Inspeetor F - - Hyannis Fire Department 95 High School Road Extension, Hyannis Massachusetts 02601 Business 508-775-1300 Facsimile 508-778-6448 'j Emergency 911 'Emergency 508-775-2323 v December 30, 2008 To whom it may concern, On this date I met with Ms. Melissa Morris'of the Home Source Realty Group and Town of Barnstable Building Inspector Paul Roma at 156 Arrowhead Drive in Hyannis. We found a non-code compliant living space in the basement of this residence. To the best of my knowledge there where no building permits issued for this construction. A smoke detector and carbon monoxide detector compliance inspection certificate (M.G:L. Chap 148 ss 26F) is mandatory for all transfers of property in Massachusetts. The Hyannis Fire Department will not issue this certificate until the code compliance issues at this property have been properly resolved to the satisfaction of the Town of Barnstable Building Department. Deputy Chief, Dean L. Melanson Hyannis Fire Department Sent via email mmorris homesourcerg.com - Paul.Roma@town.barnstable.ma.us I P. 1 Communication Result Report ( Feb, 17. 2009 3:42PM ) 1) 2) Date/Time : Feb, 17. 2009. 3: 35PM File Page No, Mode Destination Pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 1714 Memory TX 917815850386 P. 4 E-3) 3) P, 1-4 ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang up or line fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Exceeded max. E-mai 1 s i ze E. Town of Barnstable Regulatory Services eur,c' Th—F.Geller,Director �oMo' Building Division Terr{Perry,Building Commlatoiier - 200 Main Sweet,Hyannis,MA 02601 ' www.lown.harnstohle.ma.ut Office:508-862-4038 Fax: 508-790-6230 PLEASE FORWARD THE ATTACTTED PAGE(S)TO: TO: ATTN: -FAXNO: -7�l FROM: PA-JL P-0MA- DATE: -( 7- 01 PAGE(S): (INCLUDING COVER SHEET) P. 1 t � Communication Result Report ( Feb. 18. 2009 8: OOAM ) 2) Date/Time : Feb, 18. 2009 1: 53AM File Page No, Mode Destination Pg (s) Result Not Sent ---------------------------------------------------------------------------------------------------- 1723 Memory TX 917815850386 P. 4 E-3) 3) P, 1-4 ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang up or 1 i n e fail E. 2) Busy E. 3) No answer E. 4) No facsimile connection E. 5) Ex c e e d e d m a x. E—mail size Town of Barnstable x Regulatory Services TM atio Thomas F.G6hr,Director arP Building Division corny° Tout Perry,ftfiftg Commissioner 200 Main St—t.Hymmis,MA 02601 ' www.lown.barnsiabfe.me.os - _ Office:508.862-4038 Fax:508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S)TO: TO: ATTN: S C O'f IG E7—C t'F64 al . FAX NO: `��' r 5$ FROM: Pli�� lZ0o h anti DATE: 3-i 7- 0 4 I►�t .j�-t g-oq PAGIZ(S): (INCLUDING COVER SHEET) - " oOHE tas, Town of Barnstable Regulatory Services * saxivsrnaLE, Thomas F. Geiler; Director �A .i63q �0 rF1639 a 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 January.13, 2009 Ms. Melissa Morris 525 South St.Unit C2 Hyannis,MA 02601 Re: 156 Arrowhead Dr., Hyannis, MA Dear Ms. Morris, Due to a recent flood at the above referenced address;please be advised that the Certificate of Occupancy for this property has been rescinded. The house will.remain uninhabitable until a permit has been obtained to rectify all areas of concern. If you have any questions,please do not hesitate to call. Sincerely, .Paul Roma Local Inspector Communication Result Report ( Jan. 13. 2009 4, 10PM ) — 2) . Date/Time : Jan, 11 2009 4: 1OPM File Page No. Mode Des.t i nat ion Pg (s) Result Not Sent 1134 Memory TX 915087781981 P., 2 OK Reason for error E. 1) Hang up or line fail E. 2) Busy E. 3) No answer E.. 4) No facsimile connection E. 5) Exceeded max. E—mail size d.rxer Town of Barnstable ro Regulatory Services Thnmu F.Gciler,llirutnr - - �•` Building Division Tam Perry,9ut[dinx Cnmmis i— - . 200 Moen S&cd,Hyannis,MA 02601 ; - - '- www.town.barnslabiama.ur' - - _ 1 Office: SOS-662-4038 Fax:.50S-790-6230 - PLEASE FORWARD TT-IF ATTACHED PAGE(S)TO: - TO: M EL S SR 1it 0Oe-P-15 FAXNO: 7:7 FROM: P v L R O s f A - -. .DATE: 0 PAGE(S): (INCLUDINGCOVLRSHEET) �OtIKErp�L Town of Barnstable y Regulatory Services ll ftNSTABL�. Thomas;F. Geiler,Director .9 MASS.. _ - �°°r`6a9. Building'din Division fo Ma Tom.Perry, Building Commissioner 200 Main Street, Hyannis, MA 02601 rvw�vaowvn.barristable.ma.;us: Office: 508-862-4038 Pax: 508-790-6230 PLEASE FORWARD THE ATTACHED PAGE(S) T0: TO: ATTN: FAX NO: 7 �. r4 �r FROM: A 111AOE(S): (INCLUDING COVER SHEET) oFt rq,;, Town of Barnstable Re guIatcr ervices B''MASS. Thomas F. Geiler,Director -i639, `g 'Aren nw�" Building DivjSion..... Thomas Perry, CBO Building Commissioner 200 Main Street, Hyannis, MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 .December 30, 2008 Ms. Melissa Morris 525 South St. Unit C2 Hyannis MA 02601 Re: 156 Arrowhead Dr., Hyannis, MA Dear Ms. Morris, At your request, an inspection of the above referenced property was conducted by both this office and the Hyannis Fire Dept. In 2006 an illegal apartment had been removed but at some time after the last inspection,an unpermitted, illegal apartment was put back into the basement. Your suspicion was correct: the sale of this propexty-.Qannot go ahead until a building permit has been obtained to restore this house to a single_fAmily dwelling. If you have any questions, please do not hesitate to call. Sincerely, Paul Roma Local Inspector Hyannis Fire Department 95 High School Road Extension, Hyannis Massachusetts 02601 Business 508-775-1300 s Facsimile 508-778-6448 Emergency 911 Emergency 508-775-2323 December 30, 2008 To whom it may. concern, On this date I met with Ms. Melissa Morris of the Home Source Realty Group and Town of Barnstable Building Inspector Paul Roma at 156 Arrowhead Drive in Hyannis. We found a non-code compliant living space in the basement of this residence. To the best of my knowledge there where no building permits issued for this construction. A smoke detector and carbon monoxide detector compliance inspection certificate (M.G.L. Chap 148 ss 26F) is mandatory for all transfers of property in Massachusetts. The Hyannis Fire Department will not.issue this certificate until the code compliance issues at this property have been properly resolved to the satisfaction of the Town of Barnstable Building Department. Deputy Chief, Dean L. Melanson Hyannis Fire Department Sent via email mmorris@homesourcerg.com Paul.Roma@town.barnstable.ma.us < f 1 �Of RE r Town of Barnstable Regulatory Services MassII1 � Thomas F. Geiler,Director 0o i659, �� ArFOMA�a, Building Division Tom Perry,Building Commissioner 200 Main Street, Hyannis, MA 02601 rWNV W.towWn.bnrnstable.nia.Lis Office: 508-862-4038 Fax: 508-790-6230 PLEASE FOR'"IAR D THE ATTACHED PAGE(S) TO: To: M L-I ATTN: FAX N O FROM: Pt1 L O DATE: PAGE(S): (INCLUDING COVER SHEET) Co.mmun i cat i on' Resul t Repo r:t ( Dec, 30, 2008 4: OOPM ) m 2) Date/Time : Dec, 30, 2008 4: 00PM File Page No, Mode Destination Pg (s) Result Not Sent -------------------------------------------------- ----- -------------------------------------------- 0931 Memory TX 915087781981 P, 2 OK Reason #or error E. 1) Hang up or line fail E. 2) Busy E.-3) No answer E. 4) No facsimile connection E. 5) Ex c e e d e d max. E—m a i l si z e �. Town of Barnstable Regulatory Services Thomns F.'Geiter,Director sc big BuitdingDivision Tom Perry,Building Comnmriioner - - 200 Main Street,Hyannis,MA 02601 - - - www.tow•n.harns[ahlc.maue - - - ' ofrM 506-862-4038 - Fax:S08-790-6290 PLEASE FORWARD THE ATTACHED PAGES)TO: T0: M C u S 5 i9 ATTN: FAXNO: Kok -77 �9S/ MOM: PA-1)L R O 64 DATE: PAGE(5): SHEET)(INC[.UDING COVER - - � - • - Town of Barnstable *Permit# ADS N9 Expires 6 months from issue date Regulatory Services Fee g rY Thomas F.Geiler,Director Building Division C Mp� LE Tom Perry,CBO, Building Commissioner \ RNST AB 200 Main Street,Hyannis,MA 02601 V pF BP 0W www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 EXPRESS PERNHT APPLICATION - RESIDENTIAL ONLY j E Not Valid without Red X-Press Imprint Map/parcel Number a /D ' r 7�C� 0 Property Address ❑Residential Value of Work t O Q . Minimum fee of$25.00 for work under$6000.00 Owner's Name&Address t-o ul h ead J- (Ila n iq Contractor's Name Telephone Number_G a 1, I '7' • Home Improvement Contractor License#(if applicable) Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance" Check one: ❑ I am a sole proprietor [� I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must be on file. Permit Request(check box) 1 5Q Re-roof(stripping old shingles) All construction debris will be taken to , QQAY17 ❑Re-roof(not stripping, Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows. U-Value (maximum,44) 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. Home Improvement Contractors License is required. SIGNATURIE: 30 10-4 V Q:Forms:expmt Revise071405 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/Plumlbers Applicant Information Please Print Legib1Y Name(Business/Organization/Individual): m 0lk 1 C1 1'Ci C Address:A City/State/Zip: S. _ Phone#: S Are you an;employer? Check the•appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑ New construction employees(fall and/or part time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner-►ner- listed on the attached sheet# ❑ Remodeling ship and have no employees These sub-contractors have 8: Demolition working for mein any capacity. workers' comp.insurance. 9. ❑ Building addition [No workers'pomp.insurance 5. ❑ We are a corpgration and its required,] officers have exercised their 10.❑ Electrical repairs or additions 3. 0 I am a homeowner doing all work right of exemption per MGL 11.['j 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' 13.❑ Other comp.insurance required.] *Any applicant that checks box#l must also fill out the section below showing their workers'armpeusation policyinfon=tiow t Homeowners wbo submit this affidavit indicating they are doing all work andthea hire outside coatmetors must submit anew e$idavit indicating such =Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp,policyinfarsrne4on. tam 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.#: Bxpiration 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. 1 do hereby certrfy under the pains and penalties of perjury that the information provided above is true and correct �n Sienature: A QS::ii Date: ',�S i,; Q1QG� Phone#: Official use only. Do not write in this area,to be completed by city or town of iciaz City or Town: Permit/License# Issuing Authority (circle one): 1.Board of wealth 2.Building Department 3.City/Town Clerk a.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: -mni®rmaza®n ajaci instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. �p 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 represeMtatives 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 bean 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 corrimouwealth 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 regufrements of this chapter have been presented to the contracting authority," Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and, if necessary,supply sub-contractor(s)name(s),address(es) and phone n=ber(s) along with their certificate(s) of insurance. Limited Liability Companies.(LLQ 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 compasnes should eater$ielr 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 mast 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 off cially 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. Anew 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 ae 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-a77-MASSAFE Revised 5-26-05 Fax#617-727-7749 W�Ww.M2-ss.0rOv/cla THETO'LLOWING IS/ARE THE BEST , IMAGES FROM POUR QUALITY ORIGINAL (S) : I M 7 ATA .ALE MOM Realtor® W=f of Cape Cod P/1UJLCP6 -sus:508-79 F-ce O)4i CJzt f/1�2 . a2000 Fax:sos-836-4005 6953 �tp��y Q7776 Cell:774-836-6953 5, � �Q.CG� � Email:nile@mariesouzarealtyteam.com si c -gig. FOR CERTIFICATE OF COMPLIANCE 1597 Falmouth Road TORS AND CARBON MONOXIDE ALARMS Centerville,iv1no263z AFTER 148, SECTIONS 26F, 26F�/2 City or Town 'HYANNIS. FIRE DISTRICT Date: Application is herebynade for inspection of smoke detectors and carbon monoxide alarms as required by Massachusetts General Law, Chapter 148, Sections 26F,26F�/z and 527 CMR 31,et seq. ' NOTE:SUBMIT APPLICATION TO LOCAL FIRE DEPARTMENT HEADQUARTERS Location of Property ��"O L4) 4" �/�/(/� CLOSING DATE:�� Owner of Property �dE�� Buyer,.• Number of Dwelling Units / . Signature of Applicant Inspection/Testing completed on: By: Inspector Feb: (M.G.L:Chapter 148-Sec. 10A) $25.00 Fire Chief Harold S. Brunel-le Note:Any certificate issued in accordance with provisions of M.G.L. Chapter 148, Sections 26F, 26F1/2 expires sixty. (60) days after issuance by head of the Fire Department. J ,, .FIRE DEPARTMENT'S COPY � -7 7 y_53.6 -b9S3 APPOIN NY--DATE '&`TIME WITH SPECIFIC 'INFO TEL. CONTACT NUMBER — ----------- ----ON REVERSE SIDE ----------- ------- �G �� 0/Gq� a2' - ups Vd arte cq FP-7(rev.1106) ar t 11 e&& Roalal V&&,, 9/ &16. 0-1775 TIFICATE OF COMPLIANCE M.G.2,11 PTER 148, SECTIONS 26F, 26F'h City or Town HYANNIS FIRE DISTRICT- Date: This Certifies that the property located at has been equipped with approved smoke detectors, and carbon mono ' alarms and was found to be in compliance with Massachusetts General Law, Chapter 148 Sections 26F, 26F'/z and 527 CM t seq. Inspectionlfesting completed on: By: ector Fee Paid: : Head of Fire Department: Chief Harold - B Note:This certificate ezpires.sixty(60) days after date of issue. SELLER'S COPY PERMIT # Y Town of Barnstable °FT"e roy, Regulatory Services Thomas F.Geiler,Director * BARNSTABM �. Building Division 059. ♦0 AlE p Mpr s Tom Perry Building Commissioner 200 Main Street, Hyannis,MA 02601 Office: 508-86274038 Fax: 508-790-6230 COMPLAINT/INQUIRY REPORT Date: G - 'Rec'd by: Complaint Nam Map/Parcel 7 7,5� Location Address: Originator Name: Street: Village: State: Zip: Telephone: Complaint Description: � ✓ r c✓ r r Jl FOR OFFICE USE ONLY Inspector's Action/Comments Date: QJ A !� o ?(,.? Inspector: Additional Info.Attached �� `, Q:forms:complaint s t ' 44 r ~_Vk OF NNLUAM � yE SNvw U a N -t4 t 5 P(-a N Cou;Z)Z�4 S N ►v ►v t TtAE TGVI-J U OP Asse�sor's>_map-and 'lot number 4.7 ~/ t" SEPTIC SYSTct �;�� Se;wage'rPermit number ..... 4...... !?/ ...........57 1NSTF;e.,1sED IN CO��P171AI`�C1e\� r i kkITH 1,�tTICLE .II ST' t f Cr M7NE ., ' C ��, *a.rnryc�+ � t�sT� r° r. TOWN OF BA-RNS FuT �B�; H9HH�9TdDIfE, i ,J t1 f tit ' '� "�9 _; B�UILDIHG INSPECTOR r6 t °, "' APPLICATION FOR PERMIT TO � .....0 � .......... r TYPE OF CONSTRUCTION .. . .. .......................... n .. ...................19.. 0 TO THE INSPECTOR OF"BUILDINGS: The undersigned hereby applies for a permit according to the following information: Location ... 1�'L... ..../,�................ ............ . .,r' ,..... .. . .(....�....... ... ......... o�, Proposed Use J r�� " .............. r... ......................... ✓�1•... ............... .......... Zoning District .......7.1,b..................................................Fire District ................................:. Name of Owner � /�y ............:. . .....Address ......(1..1.....( ...0/et i Nameof Builder ....................................................................Address .........................................................:.......................... Nameof Architect ..................................................................Address ..........................r......�.................................................... Number of Rooms ...............v.............................................Foundation ..,, ...i...... ......................... ...................... Exierior ��. ... Roofing ..:...... ........ ...........:.. ......................................... Floors ....... ........................Interior .................................................................................... Heating ...... L ......:. .....................Plumbing ..................................................:............................... Fireplace ............. :........:..................................Approximate Cost ......(32 D ....4�..��............. ......... Definitive Plan Approved by Planning Board --Z19 Area Diagram of Lot and Building with Dimensions Fee ........ .1........... SUBJECT TO APPROVAL OF BOARD OF HEALTH s Q 30 n ,��ry 11231ti I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. Name . !?:'�l.. .1: ................................... Franco Real Estate Development Co. , Inc. 18101 1 1/2 story, N9.................. Permit,for ... single family dwelling ............................................................................ Arrowhead Drive • Location ................................................................ Hyannis ............................................................................... Development Co. ,Inc. Franco Real Estate Owner ...................................................... ............. k frame Type of Construction .......................................... ............. ....................................................... Pot ............................. Lot ........... 419 ..................... "Permit Granted ..... December 10...................................19 75 1-1 —-' . . .bate of Inspection .... ......I 69Ke�_ Date Completed :.19 PERMIT REFUSED f ................................................................. . 19 ..................................I............................................ ........................................................... .................... ell, ................................................................................ .............................I.................................................. Approved ...................................... I....... 19 01 ............................................................................... ................... ........ ............................................... Assessors ma and lot number �. l� f ( C - /,z- p ......;.. .... Sewage Permit number ............................/. ... .................... + T"Er°�° TOWN OF BAR.NSTABLE 2. i BARNSTABLE, i "6 9 BUILDING ' INSPECTOR CEO�pY a� APPLICATION FOR+PERMIT TO "?//i ✓�!A P !'!� ..................... .......................................................... . TYPE OF CONSTRUCTION ..//.��......................................i� - ''7,( !x �'r ''-r' / l . ........ ...................19......... ` N F BUILDINGS:TO THE INSPECTOR O I S O U GS: " The undersigned hereby applies fora. permit according to the following information: / Location .....�� / I......................" i�//� Il r- ��i3�:I ! .... i................................. Proposed Use .r .f,.... / iZ1 ..... 6//".r .0.0.C+' !,/!'/....{."* /!` -'..c ......................... ..... .,.. Zoning District ........................................................................fFire District .........................:...... Name of Owner+�?��=� 4,4)� f � Adclress . �+r. .�...........:............................... Nameof Builder ............................... l........ ........ .........Address ........................: Name of Architect .....................................................................Address ...........................................:...............:.:....... :.::.:.:..:.:.. `►-� Foundation .. J4- �4�,l7 M Number of Rooms ...................................... ................................................ ExteriorJfal.. ....1/,..(.� /j'✓� ...Roofing ..................................................................................... ,� :. Floors ,...................�!�...... .. Interior Heating ......:��� ..."� _.. /i.e'7 ..Plumbing 610,r /rf�i ....; Fireplace '................................Approximate Cost ........:.:........:..::...............................:.::;:::.:::. Definitive Plan Approved by Planning Board Area '� �� Diagram of Lot and Building with Dimensions Fee ... r� 1. r ' SUBJECT TO APPROVAL OF BOARD OF/HEALTH � -0 I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above` construction. Name ... /L, 1414.4.../.� ............: Franco Real Estate Development Co. , Inc. No ...��P.l.... Permit for ....1...1 .2...story,. . ...........single...family dwelling I .. . ........ ...... . . ..:--*---,--**--.........%-�W Location Nr5WAr-rowhead Drive ................................................................. ......................HY.anniA........ Owner . Franco Re 1 Estate Development Co.,, Inc. ...................... .......................................... Type of Construction ........frame.......................... . ................................................................................ #19 Plot ................... . ................ December '1'0 75 Permit Granted ... ............................?.........19 Date of Inspection ............... .............I.%.......19 Date Completed ...../......... .....................19 PERMIT REFUSED ............................................ ................... 19 ........................................... ............ ................ ............................................ .................................. .. ............................ ............ .. ....... ....................... ................ 1,7 ... ................ Approved ................................... ............ 19 ............................................................................... ............................................................................... Assessor's map and lot number ,. .. . L7ii L V iV� / *THEtO Sewage Permit number ..........A�... - Z BARNSiLBLE, i House number " y ..,,,,,;, 9 MABa Op i63q 9� YFY a\ - TOWN OF BARNSTABLE BUILDING INSPECTOR APPLICATIONFOR PERMIT TO ..................................................................................................................:.......... TYPEOF CONSTRUCTION ........................................................................................:............................................ ..... ......................19 � TO THE INSPECTOR OF BUILDINGS: The undersigned hereby plies for permit ccor ing to the o owing information: Location . .......... ............................................. .....y.......,.......................................... Proposed Use .......'31e ...........:*......... &.......... ........ ................ ZoningDistrict ....................... ....... . ....... ..................Fire District .........................I....... ........... ..........1................... � Gc�/ �S Name of Owner ... .. .G..®.4:.. .... . ...�.���....Address ..............................................�...... .. Nameof Builder ....................................................................Address .................................................................................... l� if Nameof Architect ..................................................................Address ................................ ..... .j�.,............:............................ Number f R / � e o 0o s ................. .../.......... .................................Foundation ...... Exterior Roofing .. 1;�..... .... ... ..... ..... ....... ..... ........... ................................ g. �� Floors ......%�..��.�.�...................................................Interior ... .. ................................................................................................ Heating .................................'.............................................Plumbing ............................ :.................................................... Fireplace ..................................................................................Approximate Cost ...................................................... Definitive Plan Approved by Planning Board ________________________________19________, Area � ..� S . ...... . .......................... �S Diagram of Lot and Building with Dimensions -� Fee ............ ................................ SUBJECT TO APPROVAL OF BOARD OF HEALTH 4 -7 4-;7 I hereby agree to conforl to all the Rules and Regulations ofpthewBarnstable rega ding t bove construction. Name .....A..................................... . i ',DeBECBEVE-12 PADL A. ` ~ . ` � � 20580 ' add to dwaIIiu� � � ' No -----.. Perm� for ---...---.----. . . . . ' � . ^ | ' ' i --^--^---------'--'~--'^'-----' 156 Arrowhead Dr i � Locoikon -------------. � ----Hyann uu'u� ..------.-....:....---------------. Paul A. deBeubevet ' . < . ' �/wo�ar ----............._.......................--_-- �r��a � Type of O�nx�uchon -------------- � . . ----..--------------------.. r ' ' Plot .--------_ Lot ----------.. ` . ` ^ ` . , / Parmh`Gronte6 `—.. .]�i--l9 78 ` r / Date of |n ------------l9 ' �'� Date Como��a6 ��~- - ^ lA � . . ---. -------- .'� � ^ . � ' PERMIT REFUSED � ' ~ ` . ----~_.--_..~.---................ lV ' . \ ---~^^--'---'----^~—^-------'— ^--_—.~.~,,.--,.---~—.—..--.----.. . ` . . . --.~......,.----.~.,.----.......—... ' ^ ' .----.—.--......—..---.._.,...—.--.- Approved ..... ._------------. l9 . ^ -------.----.-,..--._.---...~.—. . ^ ' ^ � . � ----^'---'--^—'—'---'^~'—'----~— - ` s ' Assessor's map and lot number ......................................... of THE Toy h/ Sewage Permit number .. �1...i71 ' �1� s{ 11/li� !�- ro�Q� ♦� Z 33ARN TME. House number " 9�C "639 ATE 0 Uri of, TOWN OF BARNSTABLE BUILDING INSPECTOR 4., APPLICATION FOR PERMIT TO ............................................................................................................................. TYPEOF CONSTRUCTION ............................................................................................�...Q.................................... id................... ........................ TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies applies for a/permit`according to the following information: Proposed Use .......r—':/ / / .......... ........ ......... ! ......... ......... ... — - Zoning District ....... ...............................^.......:.................Fire District .................................../ i rr / ....... r. ........... f Jf ia✓.1� /`7 1 Y lGl�f`f. l /Q.�{���' . g Nameof Owner .,............................................. ...Address .....:................................................................... .. Nameof Builder ....................................................................Address .................................................................................... Nameof Architect ..................................................................Address ................................ .................................................. Oylew Numberof Rooms .................:.............. ................................Foundation ................................�............................................ Exterior ..�....................... ....,2c ..................................Roofing .............. .. ..�`5..................................... C/ Floors -�/�� �, Interior Ej� � .......................................................................... ........:.............:......................................................... Heating ...............................................................Plumbing .............................F.................................................... Fireplace ..................................................................................Approximate Cost ................................'...................................... Definitive Plan Approved by Planning Board -----------_______-----------19 . Area ...............f...... ................ Diagram of Lot and Building with Dimensions Fee J' j I ............................................. SUBJECT TO APPROVAL OF BOARD OF HEALTH xl I I l+ f I hereby agree to conform to all the Rules and Regulations of the Town of Barnstable regarding the above construction. ' Names:. ...................(........................... deBECHEVET, PAUL A. _20580 �, t No ........20580. . Permit for ......add.to..dwelling.. . ..... ........ .... ........... ... ............................................................................... Location 156 Arrowhead Drive ................................................................ Hyannis . ............................................................................... .A Paul A. deBechevet Owner ................................................................... Type of Construction ... frame Plot .................... ..Lot ................................ Permit Granted ...........S,Pwt�z11 Qr..1.5...19 78 Date of Inspection .................. ................19 Date Completed ................... ..................19 PER XREFUSED ................................... 19 ................ ....�..... .�. ............. .......... .... ..?..... ................... . ....................................... ........... Ilk /' Approved ................................................ 19 ............................................................................... ...............................................................................